Non-invasive assessment of saphenous vein graft patency in asymptomatic patients.

The development and progression of atherosclerotic disease in saphenous vein grafts (SVGs) following coronary artery bypass surgery (CABG) are often without symptoms. Four-slice CT is a non-invasive imaging technique reliable for assessing SVG patency. This study utilised CT to assess temporal progression of patency in asymptomatic patients.

Guidelines to practice gap in the use of glycoprotein IIb/IIIa inhibitors: from ISAR-REACT to overreact?

Unlabelled: Adjunctive use of glycoprotein IIb/IIIa inhibitors (GPI) is associated with favorable outcomes following percutaneous coronary intervention (PCI). Guidelines for use of GPI have been published by various national societies including National Institute of Clinical Excellence (NICE), United Kingdom. The latter has not been updated since publication.

A profibrotic effect of plasminogen activator inhibitor type-1 (PAI-1) in the heart.

Increased expression of PAI-1 is profibrotic in several organs. However, its potentially profibrotic effects in the heart subjected to infarction have not been elucidated. Accordingly, we induced coronary occlusion in 10-week-old mice congenic on a C57BL6 background and in mice overexpressing PAI-1 (PTG) in multiple tissues.

A comparison of hepatopathologists' and community pathologists' review of liver biopsy specimens from patients with hepatitis C.

Background & Aims: Assessment of liver histology has an important role in the management of chronic liver disease. It is not clear whether there are interobserver variabilities between hepatopathologists and general community pathologists. We evaluated the effect of type of pathologist and biopsy specimen size on interobserver agreement for hepatic fibrosis.

Analysis of haemodynamic factors involved in carotid atherosclerosis using computational fluid dynamics.

Atherosclerosis presents a massive healthcare burden in both the developing and developed world. There is mounting evidence relating to the involvement of haemodynamic factors in the pathogenesis of this process. This article aims to review the current understandings that have developed in this area, and to present a demonstrative case study obtained using state of the art computational fluid dynamics (CFD) methodology to model and analyse haemodynamic factors within the atheromatous carotid artery bifurcation.

The magnitude and temporal dependence of apoptosis early after myocardial ischemia with or without reperfusion.

In view of the conventional wisdom in the cardiology literature that apoptosis is extensive early after myocardial ischemia, predicated largely from results with the TUNEL assay known to be nonspecific, this study was performed to delineate its extent with multiple assays and at multiple intervals. Coronary occlusion with and without subsequent revascularization was induced in 10-wk-old C57BL6 mice subjected to 1 or 4 h of transient ligation followed by 24 h of reperfusion, or 24 h persistent ligation. Apoptosis was quantified throughout the left ventricle immunohistochemically by assay of TUNEL, single-stranded DNA (ssDNA), and cleaved caspase 3; electron microscopy (EM); and activity assays of caspase 3 and 8.

Percutaneous coronary intervention in anticoagulated patients via radial artery access.

Objectives: To assess safety and feasibility of using radial artery access for percutaneous coronary intervention (PCI) in patients on oral anticoagulation without interrupting therapy.

Background: The radial artery approach for PCI is intuitively attractive for patients receiving chronic oral anticoagulation with vitamin K antagonists (VKAs) but little data exist concerning feasibility or safety of this approach in this population. The main advantage of this strategy would be to avoid bridging therapy with heparin that increases risk of thrombotic and bleeding events.

S-nitrosylation of surfactant protein-D controls inflammatory function.

The pulmonary collectins, surfactant proteins A and D (SP-A and SP-D) have been implicated in the regulation of the innate immune system within the lung. In particular, SP-D appears to have both pro- and anti-inflammatory signaling functions. At present, the molecular mechanisms involved in switching between these functions remain unclear.

In vivo non-invasive serial monitoring of FDG-PET progression and regression in a rabbit model of atherosclerosis.

We investigated the ability of fluorodeoxyglucose positron emission tomography (FDG PET) imaging to serially monitor macrophage content in a rabbit model of atherosclerosis. Atherosclerosis was induced in rabbits (n = 8) by a combination of atherogenic diet and balloon denudation of the aorta. At the end of nine months, the rabbits were randomized to a further six months of the same atherogenic diet (progression group) or normal diet (regression group).

Olfactory perceptual stability and discrimination.

No two roses smell exactly alike, but our brain accurately bundles these variations into a single percept 'rose'. We found that ensembles of rat olfactory bulb neurons decorrelate complex mixtures that vary by as little as a single missing component, whereas olfactory (piriform) cortical neural ensembles perform pattern completion in response to an absent component, essentially filling in the missing information and allowing perceptual stability. This piriform cortical ensemble activity predicts olfactory perception.

Local vessel injury following percutaneous coronary intervention does not promote early mobilisation of endothelial progenitor cells in the absence of myocardial necrosis.

Background/objectives: Endothelial progenitor cells (EPCs) are circulating mononuclear cells that are released from the bone marrow in response to injury and participate in vascular repair. Some previous studies have suggested an early mobilisation of EPCs following percutaneous coronary intervention (PCI) that could modulate the subsequent risk of restenosis or stent thrombosis. However, those studies did not discriminate between vascular injury caused by PCI and any associated myocardial injury.

Radial artery anomaly and its influence on transradial coronary procedural outcome.

Background: The transradial approach for percutaneous coronary procedures has the advantage of reduced access site complications but is associated with specific technical challenges in comparison with the transfemoral approach. Transradial procedure failures can sometimes be due to variation in radial artery anatomy. However, data describing such variations are limited.

The epidemiology of newly diagnosed chronic liver disease in gastroenterology practices in the United States: results from population-based surveillance.

Objectives: Chronic liver disease (CLD) is an important cause of morbidity and mortality, but the epidemiology is not well described. We conducted prospective population-based surveillance to estimate newly diagnosed CLD incidence, characterize etiology distribution, and determine disease stage.

Methods: We identified cases of CLD newly diagnosed during 1999-2001 among adult county residents seen in any gastroenterology practice in New Haven County, Connecticut; Multnomah County, Oregon; and Northern California Kaiser Permanente Medical Care Program (KPMCP, Oakland, California [total population 1.

Procedural performance in gastrointestinal endoscopy: an assessment and self-appraisal tool.

Aims: Assessing endoscopic technical skills competency in a structured manner is a topical issue, in light of several workforce factors that may affect the training of future endoscopists. To date there has been little attempt to comprehensively assess both generic and specific technical skills in lower gastrointestinal endoscopies; the current study aimed to develop and validate a tool that can assess these varied skills.

Methods: Hierarchical task analyses of generic and specific technical skills were constructed on flexible sigmoidoscopy and colonoscopy after expert panel discussions.

Platelet hyperactivity in type 2 diabetes: role of antiplatelet agents.

Type 2 diabetes mellitus increases atherothrombotic risk. Platelets in individuals with diabetes show increased activity at baseline and in response to agonists, ultimately leading to increased aggregation. Increased expression of platelet surface adhesion molecules and receptors, enhanced production of thromboxane and thrombin and disturbances in platelet calcium homeostasis are well documented.

Malignancy: an unrecognized risk factor for coronary stent thrombosis?

Stent thrombosis is a potentially catastrophic complication of coronary artery stenting. There have been particular concerns about the incidence of stent thrombosis following insertion of drug-eluting stents. We report a series of cases in which stent thrombosis occurred in association with malignancy and describe the potential mechanisms behind such an association.

Statin therapy alone and in combination with an acyl-CoA:cholesterol O-acyltransferase inhibitor on experimental atherosclerosis.

The ability to modify the enzymatic processes involved in promoting atherosclerotic plaque disruption and to serially monitor atherosclerotic evolution could provide novel information in the management of patients with atherosclerosis. We studied the effects of a statin (atorvastatin) and its combination with an acyl-CoA:cholesterol O-acyltransferase (ACAT) inhibitor (avasimibe) on atherosclerotic regression and plaque stability as measured by matrix metalloproteinase 1 and 3 (MMP-1 and MMP-3) levels. Watanabe Heritable Hyperlipidemic (WHHL) rabbits treated with atorvastatin alone experienced an attenuated increase in atherosclerotic burden versus controls as determined by MR imaging.

The importance of acuity, stereopsis, and contrast sensitivity for health-related quality of life in elderly women with cataracts.

Purpose: To investigate the relative contribution of visual and other factors to quality of life among elderly women with bilateral cataract.

Methods: Data were analyzed from a trial of first-eye cataract surgery. Visual parameters, general health, and social variables, and disease-specific (VF-14 Index of Visual Function), generic (Euroqol: EQ-5D, London Handicap Scale, Barthel), and intermediate (anxiety, depression, and activity) outcomes were measured at baseline and 6 months later, when approximately half the group had had surgery.

Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments after phacoemulsification.

Purpose: To review the clinical features and outcomes of pars plana vitrectomy (PPV) in patients with retained lens fragments after phacoemulsification and compare the results with those in previous studies.

Setting: Department of Ophthalmology, Queen's Medical Centre, Nottingham, United Kingdom.

Methods: This retrospective chart review comprised 82 consecutive eyes of 82 patients who had vitrectomy for retained lens material after phacoemulsification between January 2000 and June 2006.

Deaths from chronic liver disease and viral hepatitis, Multnomah County, Oregon, 2000.

Goals: Identify deaths related to chronic liver disease (CLD) in 2000 among Multnomah County, Oregon residents and estimate the proportion of these deaths attributable to hepatitis B or hepatitis C.

Background: Although CLD is among the most common causes of mortality in the United States, little information is available regarding the proportion of CLD mortality attributable to viral hepatitis.

Study: We developed a comprehensive list of 117 International Classification of Disease-10 codes potentially related to CLD.

A novel dual staining method for identification of apoptotic cells reveals a modest apoptotic response in infarcted mouse myocardium.

Confocal scanning laser microscopy was used to investigate the myocardium of control C57BL/6 and plasminogen activator inhibitor 1 knockout (PAI-1KO) mice 3 days following persistent ligation of the left descending coronary artery. Paraffin sections taken from infarcted areas of the left ventricle were stained with antibodies recognizing cardiomyocytes, neutrophils, macrophages and apoptotic cells. In both animal groups, a strong neutrophil response was noted in the infarcted myocardium, with a large proportion of these cells also displaying staining for anti-alpha-sarcomeric actin in the PAI-1KO animals.

Spontaneous dislocation of posterior polar cataract.

We report an unusual case of unilateral spontaneous lens dislocation in a 52-year-old woman with a posterior polar cataract. We postulate that the increasing lens size secondary to nuclear sclerosis may have exerted pressure on a thinned posterior capsule, causing the capsule to rupture spontaneously. The unusual weak posterior capsule in posterior polar cataract is a well-recognized risk factor in phacoemulsification surgery.