PTCA at first sight: angioplasty based on video only.

The results of 326 coronary angioplasties (PTCAs) performed during a first diagnostic angiography and based on video images only (PTCA at first sight, Group I) are compared with those of 756 PTCAs done during the same time period in patients with a previous cine-film and therefore a known or predictable coronary anatomy (Group II). Group I patients had more single vessel disease (74% versus 58%, p less than 0.001), single vessel PTCA (93% versus 84%, p<0.

Percutaneous transluminal coronary angioplasty through six French catheters.

We present the results of 221 coronary angioplasty (PTCA) procedures in which a 6 French diagnostic catheter was chosen as a guiding catheter. A total of 218 were done through a femoral and 3 through an axillary approach. Total occlusion PTCA was done in 9 (4%) and multivessel PTCA in 19 procedures (9%).

Intracoronary electrocardiogram during coronary angioplasty.

This prospective study examines the data derived from the intracoronary electrocardiogram (ECG) (derived from the coronary guide wire) compared with that from four standard surface leads (I, II, III, and V2) in documenting myocardial ischemia during coronary angioplasty. Intracoronary and surface ECGs were simultaneously recorded in 300 consecutive patients (mean age 59 +/- 10; range 33 to 80 years; 246 males [82%] during coronary angioplasty in 368 lesions (167 left anterior descending [46%], 85 left circumflex [23%], 107 right coronary arteries [29%], and nine bypass grafts [2%]), before balloon inflation, at 1 minute of inflation, and at the end of the procedure. ST segment changes (greater than 0.

EEG sleep in Cushing's disease and Cushing's syndrome: comparison with patients with major depressive disorder.

Because patients with Cushing' syndrome (CS) and Major depressive disorder (MDD) share features of hypercortisolism and the depressive syndrome, we compared electro-encephalographic (EEG) sleep in patients with pituitary-ACTH-dependent Cushing's syndrome (Cushing's disease, CD), patients with ACTH-independent Cushing's syndrome (AICS), patients with major depressive disorder (MDD), and normal subjects. There were substantial similarities in the abnormal polysomnography profiles of patients with CD, AICS, and MDD. All three patient groups demonstrated poorer sleep continuity, shortened rapid eye movement (REM) latency, and increased first REM period density compared with normal subjects.

A longitudinal evaluation of dexamethasone pharmacokinetics in depressed patients and normal controls.

Ten depressed patients and eight control subjects received 1 mg of dexamethasone intravenously at two different time points. Depressed patients were studied when they were depressed and following an improvement in their depression. In control subjects the first and second studies were performed approximately 1 month apart.

Instantaneous recruitment of reversed coronary collaterals that had been dormant for six years.

We report a case of instantaneous recruitment of reversed coronary collaterals 6 years after their disappearance with recanalization of the recipient vessel. Coronary collaterals can provide flow in both directions and remain immediately recruitable for years in case of occlusion of either vessel involved.

Magnum/Magnarail versus conventional systems for recanalization of chronic total coronary occlusions: a randomized comparison.

The Magnum/Magnarail system consists of "over-the-wire" balloon catheters and a 0.021 inch (0.53 mm) guide wire with a 1 mm olive-shaped tip.

Aortic dissection as complication of percutaneous transluminal coronary angioplasty.

We report two cases of aortic dissection during coronary angioplasty with a disparate evolution that was due to the different location of the entry port of the dissection. Aortic dissection occurring during coronary angioplasty may be self-limiting, but it may also be life-threatening and may call for urgent surgical repair.

Early experience with coronary stenting.

From April 1988 to December 1991, we implanted 75 coronary stents (29 self-expanding and 46 balloon expandable) in 62 patients. All had New York Heart Association class II to IV angina, and 11 (18%) had prior coronary artery bypass grafting (CABG). Thirty nine patients (63%) had 1 vessel disease, and 23 (37%) had multivessel disease.

Coronary and left ventricular pacing as standby in invasive cardiology.

Coronary pacing using as unipolar negative electrode a guidewire placed in a coronary branch was tested in 349 sites of 300 consecutive patients undergoing coronary angioplasty. It was possible for 339 sites (97%). The threshold currents ranged from 1 to 15 (mean +/- standard deviation 3.

Randomized evaluation of 5 French catheters for coronary angiography with or without the CO2 powered Hercules syringe.

To evaluate the CO2 power-assisted hand-held Hercules syringe (Cordis) for diagnostic coronary angiography using 5 French catheters (Judkins number 4 exclusively), 200 consecutive patients (excluding patients with valve disease and prior bypass surgery) were randomized to conventional manual or Hercules injections. The angiography was done through a femoral artery with or without a sheath. Total duration and fluoroscopy time from the end of the ventriculogram to the end of the procedure, quantity of contrast medium required, length of cinefilm, quality of film (good, satisfactory, or bad), streaming, technical ease [scale 1 (easy) to 6 (difficult)], and need for larger catheters were analyzed.

Malignant pheochromocytoma.

We present an interesting case of paroxysmal hypertension in a young male caused by malignant pheochromocytoma. This patient, who had history of paroxysms of abdominal pain with severe hypertension, developed osseous metastasis in the first lumbar vertebra resulting in collapse of the vertebra and it caused paraplegia. The diagnosis of pheochromocytoma was confirmed on histopathology.

Intermolecular protein interactions in solutions of calf lens alpha-crystallin. Results from 1/T1 nuclear magnetic relaxation dispersion profiles.

From analyses of the magnetic field dependence of 1/T1 (NMRD profiles) of water protons in solutions of calf lens alpha-crystallin at several concentrations, we find two regimes of solute behavior in both cortical and nuclear preparations. Below approximately 15% vol/vol protein concentration, the solute molecules appear as compact globular proteins of approximately 1,350 (cortical) and approximately 1,700 (nuclear) kD. At higher concentrations, the effective solute particle size increases, reversibly, as evidenced by the appearance of spectra-like 14N peaks in the NMRD profiles and a change in the field and temperature dependence of 1/T1.

Coronary angioplasty with 7F guiding catheters.

The performance of 7F guiding catheters for percutaneous transluminal coronary angioplasty (PTCA) was investigated in 300 patients. A total of 233 patients had single-vessel PTCA and 67 had multivessel PTCA. Angioplasty was attempted for 371 lesions (141 [38%] in the left anterior descending, 124 [33%] in the right coronary artery, and 95 [26%] in the left circumflex coronary artery or their branches; 10 [3%] in a bypass graft, and one in the left main stem).

An Indian hospital study of viral causes of acute respiratory infection in children.

From Sept. 1986 to Jan. 1989, a hospital-based study was conducted on 736 children, under 5 years of age, with acute respiratory infection.

Coronary angioplasty with second generation Monorail catheters.

The Monorail system (Schneider) consists of a balloon catheter in which the guidewire passes through the balloon itself, exits the catheter proximal to the balloon, and runs alongside its small shaft (3 French) through the length of the guiding catheter. It offers distinct advantages over conventional systems of coronary angioplasty. It facilitates contrast injections and permits rapid balloon exchanges.

Heterogeneity in the beta-endorphin immunoreactivity response to electroconvulsive therapy.

Electroconvulsive therapy is accompanied by an activation of the hypothalamic-pituitary-adrenal axis, resulting in a release of beta-endorphin from the anterior pituitary corticotrophs of humans. As a group, patients in our study demonstrated similar plasma beta-endorphin immunoreactivity response to their initial and final treatments. However, approximately half of the patients demonstrated greater beta-endorphin immunoreactivity release with their first seizure compared with their last seizure, and half of the patients demonstrated the opposite pattern.

A longitudinal evaluation of dexamethasone and cortisol plasma concentrations in the dexamethasone suppression test before and during treatment with antidepressant drugs.

Thirty depressed in- and outpatients received serial dexamethasone suppression tests (DSTs). Plasma dexamethasone and cortisol concentrations were drawn at 1600 on the day following a 1-mg oral dose of dexamethasone. The first DST was performed after patients were drug-free for a period of 1 week; the second, third, and fourth DSTs while patients received antidepressant medication.

Electroconvulsive therapy in delusional and non-delusional depressive disorder.

Major depressive disorder (MDD) patients (n = 66) treated with electroconvulsive therapy were stratified by the presence (n = 30) or absence (n = 36) of delusional symptoms (by Research Diagnostic Criteria) to compare their response to treatment. At discharge from hospital 83% of the MDD with psychosis group and 58% of the MDD without psychosis group were good responders (P = 0.03).