Assessment of intracoronary morphology in cardiac transplant recipients by angioscopy and intravascular ultrasound.

Percutaneous coronary angioscopy and intravascular ultrasound are sensitive intravascular imaging methods for detecting early changes in coronary morphology in cardiac transplant recipients. To compare the 2 imaging modalities, 29 consecutive cardiac transplant recipients underwent percutaneous coronary angioscopy and intravascular ultrasound during annual coronary angiography. Surface morphology, presence of plaque, and percent area stenosis were determined with each procedure.

Induction immunosuppression with the monoclonal antibody OKT3 after cardiac transplantation.

The routine use of monoclonal induction immunosuppression with OKT3 after orthotopic heart transplantation remains controversial. This study examined the clinical response of prophylactic monoclonal induction immunosuppression versus standard triple-drug immunosuppression in 41 patients who underwent orthotopic heart transplantation from January 1989 to December 1990 at this institution. Of these, eight received monoclonal induction immunosuppression for a period of 10 to 14 days.

Cardiac allograft vasculopathy: current concepts.

The major cause of late death in cardiac transplant recipients is cardiac allograft vasculopathy also referred to as cardiac transplant atherosclerosis which occurs in 15% to 20% of transplant recipients. It differs from traditional atherosclerosis in that it is a concentric and diffuse intimal hyperplastic process, the internal elastic lamina remains intact, and calcification is rare. The distal portion of the coronary vessel is the earliest to occlude, with occlusion occurring rapidly.

Cardiac transplantation: an overview of recipient selection.

Cardiac transplantation is an accepted treatment for end-stage heart disease. Potential recipients are carefully screened in order to best place the short supply of donor organs with the best recipient. The success of heart transplantation in the United States today is directly related to careful donor and recipient selection criteria and improvements in immunosuppression.

Prior arterial injury enhances luciferase expression following in vivo gene transfer.

We determined the time course of gene expression following DNA/Lipofectin transfection of normal or previously injured arterial segments using direct intraluminal infusion following surgical exposure. Constructs possessing the firefly luciferase cDNA regulated by Simian virus 40, Rous sarcoma virus, or alpha-actin promoter were incubated together with Lipofectin for 30 minutes. Arterial segments were assayed for luciferase activity following harvest at 2-21 days.

Cardiac transplantation: clinical aspects of recipient selection.

The improved outcome following cardiac transplantation has produced changes in the traditional criteria for potential candidates. We have analyzed these changes and the clinical aspects involved in the selection process, which are of critical importance to assure an excellent result of cardiac transplantation in patients with advanced heart failure.

Current issues in advanced heart failure.

In the past 50 years, an increased understanding of the pathophysiologic mechanisms associated with the development of heart failure has produced a more precise treatment of this syndrome. The effects of the agents used for the treatment of patients with advanced heart failure have been summarized in this article and demonstrate the importance of vasodilatory drugs on the survival and progression of dilated cardiomyopathy.

Cardiac transplantation. How recipients are selected.

Your patients with heart disease may ask about transplantation. Those who are potential candidates need a physician who knows enough about the selection system to get them into it. For other patients, an explanation of why the procedure is contraindicated in their case can help them refocus on compliance with recommended therapy.

Determinants of multi-site phosphorylation of peptide analogues of ribosomal protein S6 by novel protease-activated protein kinases.

The substrate specificity determinants of a protease-activated protein kinase from rat liver, termined PAK-1, have been investigated using peptide analogues of the ribosomal protein S6 sequence: Ala229-Lys-Arg-Arg-Arg-Leu-Ser-Ser-Leu-Arg-Ala-Ser-Thr-Ser-Lys- Ser244. Low peptide substrate Km's and a preference for Ser236 were attributed to a combination of sequence determinants located in the vicinity of this site. Thus, Km's are increased appreciably with analogues in which the N-terminal cluster of basic residues is reduced or where alanine is substituted for Arg238.

A rapid whole-blood immunoassay system.

A new immunoassay system has been developed which allows the detection of circulating antigens, antibodies or drugs in whole blood without specialized personnel or equipment. This is achieved by the use of bispecific reagents, which comprise specific antibodies or antigens that are coupled to a non-agglutinating antierythrocyte antibody. Within two minutes, these reagents cause specific agglutination of a patient's own red cells in samples that contain the relevant analyte.

Autologous red cell agglutination assay for HIV-1 antibodies: simplified test with whole blood.

An antibody detection procedure based on agglutination of autologous red cells has been developed for samples of whole blood. A nonagglutinating monoclonal antibody to human red blood cells conjugated to a synthetic peptide antigen (in this case residues 579 to 601 of the HIV-1 envelope precursor, Arg-Ile-Leu-Ala-Val-Glu-Arg-Tyr-Leu-Lys-Asp-Gln-Gln-Leu-Leu-Gly-Ile-Trp- Gly-Cys - Ser-Gly-Lys) permitted the detection of antibodies to the human immunodeficiency virus type 1 (HIV-1) in 10 microliters of whole blood within 2 minutes. Agglutination was specifically inhibited by addition of synthetic peptide antigen but not by unrelated peptides.

Educational attainment and cohort size.

"We argue that the postwar baby boom [in the United States] caused substantial fluctuations in both the economic rewards to education and educational attainment over the last 3 decades. If substitutability between young and old workers diminishes with education, the present value of lifetime earnings for a boom cohort is depressed more for highly educated workers, reducing incentives for educational attainment. The opposite is true for pre- and postboom cohorts.

Recognition of envelope and tat protein synthetic peptide analogs by HIV positive sera or plasma.

A series of synthetic peptides corresponding to segments of HIV encoded proteins were selected using criteria described by Welling et al. [(1985) FEBS Lett. 188, 215].

Parathyroid hormone-related protein of malignancy: active synthetic fragments.

Peptides corresponding to the amino-terminal region of the parathyroid hormone-related protein (PTHrP) of humoral hypercalcemia of malignancy were synthesized. A 34-amino acid peptide, PTHrP(1-34), was two to four times more potent than bovine or human PTH(1-34) in bioassays promoting the formation of adenosine 3',5'-monophosphate (cAMP) and plasminogen activator activity in osteogenic sarcoma cells and adenylate cyclase activity in chick kidney membranes. Like parathyroid hormone itself, in which the activity resides in the first 34 residues, PTHrP peptides of less than 30 residues from the amino terminus showed substantially reduced activity.

AIDS: Psychosocial Dimensions.

In order to provide comprehensive care to patients who have AIDS, it is important for the family physician to understand the psychosocial elements of the disease. Homosexual men who have AIDS face particular problems, such as the disclosure of sexual orientation to family and friends. Issues discussed in this article include the reactions of the patient, family and friends to the diagnosis, the stigma of AIDS, the patient's support network, and preparations for disability and death.