Comparison of medical treatment with percutaneous closure of patent foramen ovale in patients with cryptogenic stroke.

Objectives: The purpose of this study was to compare the efficacy of medical treatment with percutaneous closure of patent foramen ovale (PFO).

Background: Patients with cryptogenic stroke and PFO are at risk for recurrent cerebrovascular events.

Methods: We compared the risk of recurrence in 308 patients with cryptogenic stroke and PFO, who were treated either medically (158 patients) or underwent percutaneous PFO closure (150 patients) between 1994 and 2000.

Myosin VI is required for structural integrity of the apical surface of sensory hair cells in zebrafish.

Unconventional myosins have been associated with hearing loss in humans, mice, and zebrafish. Mutations in myosin VI cause both recessive and dominant forms of nonsyndromic deafness in humans and deafness in Snell's waltzer mice associated with abnormal fusion of hair cell stereocilia. Although myosin VI has been implicated in diverse cellular processes such as vesicle trafficking and epithelial morphogenesis, the role of this protein in the sensory hair cells remains unclear.

Risk of decompression illness among 230 divers in relation to the presence and size of patent foramen ovale.

Background: The risk of developing decompression illness (DCI) in divers with a patent foramen ovale (PFO) has not been directly determined so far; neither has it been assessed in relation to the PFO's size.

Methods: In 230 scuba divers (age 39+/-8 years), contrast trans-oesophageal echocardiography (TEE) was performed for the detection and size grading (0-3) of PFO. Prior to TEE, the study individuals answered a detailed questionnaire about their health status and about their diving habits and accidents.

Giant anastomotic pseudoaneurysm complicating aortic xenograft replacement.

A 74-year-old woman was referred for investigation of a 2-week history of progressive dyspnea. Her medical history included an aortic valve replacement with a stentless bioprosthesis followed 13 months later by the replacement of the aortic root with a porcine xenograft. Transesophageal echocardiography revealed a giant circular pseudoaneurysm of the aortic xenograft with compression of the prosthetic aortic valve and concomitant severe aortic regurgitation.

Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma.

Background: Mortality rates associated with pancreatic resection for cancer have steadily decreased with time, but improvements in long-term survival are less clear. This prospective study evaluated risk factors for survival after resection for pancreatic adenocarcinoma.

Methods: Data from 366 consecutive patients recorded prospectively between November 1993 and September 2001 were analysed using univariate and multivariate models.

Coronary collateral perfusion in patients with coronary artery disease: effect of metoprolol.

Background: The use of ultrathin Doppler angioplasty guidewires has made it possible to measure collateral flow quantitatively. Pharmacologic interventions have been shown to influence collateral flow and, thus, to affect myocardial ischaemia.

Methods: Twenty-five patients with coronary artery disease undergoing PTCA were included in the present analysis.

Percutaneous closure of patent foramen ovale reduces the frequency of migraine attacks.

Among 215 patients referred for percutaneous closure of patent foramen ovale (PFO) after presumed paradoxical embolism, we assessed the prevalence of migraine. In the year prior to PFO closure, 48 (22%) patients had migraine, twice the expected prevalence of 10 to 12% in the general European population. In patients with migraine with aura, percutaneous PFO closure reduced the frequency of migraine attacks by 54% (1.

Percutaneous closure of patent foramen ovale: impact of device design on safety and efficacy.

Objective: To compare the safety and efficacy of percutaneous closure of patent foramen ovale (PFO) with the Amplatzer PFO occluder (Amplatzer) or the PFO STAR device (STAR) in patients with presumed paradoxical embolism.

Methods: Implantation characteristics, procedural complications, residual shunt, and recurrence of thromboembolic events were recorded prospectively in 100 consecutive patients undergoing percutaneous PFO closure with the STAR (n = 50) or Amplatzer (n = 50) devices between 1998 and 2001. The study was not randomised.

Aortic root replacement with a new stentless aortic valve xenograft conduit: preliminary hemodynamic and clinical results.

Background And Aim Of The Study: Beside aortic valve-sparing surgery, a composite graft, homograft or (more rarely) an autograft are the most common options to replace a diseased or destroyed aortic root in adults. Recently, a new stentless xenograft valved conduit (Shelhigh, No-React) was introduced in Europe. This totally biologic conduit is glutaraldehyde cross-linked, detoxified and heparin-treated with No-React; this process eliminates residual glutaraldehyde and ensures stable tissue cross-linking.

Postsurgical pain outcome of vertical and transverse abdominal incision: design of a randomized controlled equivalence trial [ISRCTN60734227].

Background: There are two ways to open the abdominal cavity in elective general surgery: vertically or transversely. Various clinical studies and a meta-analysis have postulated that the transverse approach is superior to other approaches as regards complications. However, in a recent survey it was shown that 90 % of all abdominal incisions in visceral surgery are still vertical incisions.

Early exercise after coronary stenting is safe.

Objectives: In this study, we sought to assess safety of symptom-limited exercise stress tests the day after coronary stenting.

Background: Isolated cases of coronary stent thrombosis have been linked to early exercise stress testing, thereby questioning the safety of unrestricted physical activity after the coronary procedure.

Methods: At a single center, 1,000 patients were randomized to a symptom-limited stress test the day after coronary stenting or no stress test.

Impact of acute hypoxic pulmonary hypertension on LV diastolic function in healthy mountaineers at high altitude.

In pulmonary hypertension right ventricular pressure overload leads to abnormal left ventricular (LV) diastolic function. Acute high-altitude exposure is associated with hypoxia-induced elevation of pulmonary artery pressure particularly in the setting of high-altitude pulmonary edema. Tissue Doppler imaging (TDI) allows assessment of LV diastolic function by direct measurements of myocardial velocities independently of cardiac preload.

[The Sorin pericardial bioprosthesis--a stentless aortic valve with very good hemodynamic performance].

Background: The Sorin Pericarbon Freedom Stentless aortic valve has the potential to provide superior hemodynamic function and durability. In this study we assessed the hemodynamic performance of this valve and its impact on LV-mass regression after aortic valve replacement.

Methods: 31 consecutive patients who received a Sorin Pericarbon Freedom Stentless aortic valve were analysed.

[Atrial fibrillation and stroke].

Atrial fibrillation (AF) is the most common cardiac arrhythmia. The prevalence of AF is 0.4% in the general population and increases with age up to 6-8% in octogenarians.

Exercise-induced human coronary collateral function: quantitative assessment during acute coronary occlusions.

In 50 patients undergoing percutaneous transluminal coronary angioplasty because of chronic angina pectoris, a collateral flow index (CFI) was determined at the start and the end of two 1-min coronary occlusions, randomly accompanied by a resting state or a 3-min dynamic handgrip exercise (DHE). CFI expressing collateral flow relative to normal antegrade flow was determined by simultaneous coronary occlusive pressure, mean aortic pressure and central venous pressure measurements. When comparing CFI without and with DHE at the start as well as at the end of balloon occlusions, a significant increase was observed with DHE (overall p < 0.

[Stomata--surgical standards].

The placement of an intestinal stoma is still a common procedure despite the recent advantages in intestinal surgery. It is mandatory to apply meticulously sound surgical principles in order to achieve good results. Nevertheless, intestinal stomas are envisioned with a high perioperative morbidity which is mostly caused by surgical inadequacy.

[Carcinomas of the esophago-gastric junction: surgical strategies].

There is increasing incidence of adenocarcinoma of the esophagastric junction (EGJ) especially in young white men (+35% in 30 years). The reasons for this are not yet well known, however one of the main causes is gastro-esophageal-reflux disease (GERD). The differentiation of a EGT carcinoma in three subtypes is important for therapy: adenocarcinoma of the distal esophagus (type I), cardia carcinoma (type II) and subcardial gastric carcinoma (type III).