Mechanisms of atherosclerotic plaque stabilization for a lipophilic calcium antagonist amlodipine.

Coronary artery disease (CAD) is the result of atherosclerosis, a vascular disorder characterized by abnormalities in vasoconstriction and endothelial function, ultimately leading to partial or complete vessel occlusion. Because the atherosclerotic plaque is marked by changes in calcium regulation, there has been interest in a potential antiatherosclerotic role for calcium antagonists. In support of this hypothesis, a recent clinical study demonstrated in patients with CAD that treatment with the lipophilic dihydropyridine-type calcium antagonist amlodipine resulted in significantly fewer cardiovascular procedures and events.

Peripheral vascular disease intervention in patients with end-stage renal disease: few complications in those treated with peritoneal dialysis.

Background: We assessed the results of peripheral vascular surgery in patients with end-stage renal disease (ESRD) who were being treated with peritoneal dialysis.

Methods: Sixty-seven ESRD patients on peritoneal dialysis who had peripheral vascular surgery were assessed retrospectively for preoperative risk factors, primary and secondary patency rates, and mortalitv. The study group had 48 proximal femoral-popliteal bypasses, 12 distal femoral-popliteal bypasses, and 7 distal femoral-tibial and/or peroneal revascularizations.

Contemporary Approaches to the Management of Neurosurgical Complications of Infective Endocarditis.

Infective endocarditis can often involve the nervous system, resulting in stroke, intracerebral hemorrhage, infectious aneurysm formation, cerebral abscess, and spinal epidural infection. Many of these problems require neurosurgical attention. Modern advances in neuro- surgical critical care, computerization, instrumentation, and radiologic imaging have affected the treatments available to patients with neurosurgical manifestations of infective endocarditis.

Current assessment of thromboembolic disease and pregnancy.

This study was undertaken to assess incidence of deep venous thrombosis and pulmonary emboli in an inner-city pregnant population. Thromboembolic disease is believed to occur in 0.05 to 0.

Modification of a choledochoscope for extraction of difficult biliary stones.

Cholelithiasis is a common problem in the United States, affecting 10 to 15 per cent of the population. Although only one per cent of these patients have intrahepatic gallstones their discovery intraoperatively may present a technical challenge for the surgeon. This paper describes a simple method for dislodging difficult intrahepatic biliary stones: modification of a rigid choledochoscope to permit use of a biliary Fogarty catheter and Segura basket under direct visualization.

Hemicricoidectomy for voice rehabilitation following hemilaryngectomy with ipsilateral arytenoid removal.

The purpose of this article is to describe an approach to reconstruction of the larynx after vertical partial laryngectomy with removal of the ipsilateral arytenoid cartilage. This method addresses the problem of postoperative posterior glottal incompetence (aphonia with or without aspiration). The technique involves resection of the ipsilateral half of the cricoid cartilage, use of an inferiorly based strap muscle flap for vocal fold reconstruction, and placement of a customized stent.

Complications of lower extremity arteriovenous grafts in patients with end-stage renal disease.

Background: More data are needed to assess lower extremity angioaccess sites for hemodialysis.

Methods: We did a retrospective review of 843 consecutive hospital records of upper and lower extremity arteriovenous (AV) fistulas from 1992 to 1996.

Results: Lower extremity grafts accounted for 16% (134/843) of patients in this series.

Nonocclusive mesenteric infarction in hemodialysis patients.

Background: Dialysis patients develop nonocclusive mesenteric ischemia (NOMI) at an increased rate. Previous studies have associated atherosclerosis and hemodialysis-induced hypotension as inciting factors for NOMI development. A retrospective review of 29 of 1,370 longterm hemodialysis patients who developed NOMI from January 1992 to December 1997 was performed.

The selective effects of alcohol on automatic and effortful memory processes.

Automatic and effortful memory processes were evaluated in a 2-session, within-subjects design involving an alcohol challenge and a no-alcohol condition. Free recall of a 90-word list measured effortful processing. Estimation of word frequency from the same list measured automatic processing.

Information-processing characteristics of explicit time estimation by patients with schizophrenia and normal controls.

The information-processing characteristics of time estimation have not been well-documented. This research investigated explicit time estimation to test whether (1) it can occur "automatically" and (2) the cognitive function generally known as "working memory" predicts accuracy of time estimation. Data on two tasks requiring explicit time judgement (time interval estimation and production) are reported for a sample of 43 normal, healthy controls and 19 inpatients with chronic schizophrenia.

Relation of serum anticholinergicity to cognitive status in schizophrenia patients taking clozapine or risperidone.

Background: A potential beneficial outcome of treatment with certain of the atypical neuroleptics is the reduced risk of cognitive impairment, stemming from purported low affinity for cholinergic receptors. In vitro experiments have shown that clozapine is highly anticholinergic and risperidone is minimally so. In vivo tests of the anticholinergic burden imposed by these medications and its potential cognitive consequences are needed.

Cigarette smoking and lung cancer trends. A light at the end of the tunnel?

Objective: To update the epidemic curves for lung cancer in the United States by gender in relation to the temporal trends in adult current cigarette smoking prevalence.

Methods: The design of the study was ecologic, based on population figures. Available data on the prevalence of current cigarette smoking from 1920 to 1990 were plotted in conjunction with age-adjusted lung cancer mortality rates from 1930 to 1992 for each sex.

The in vivo effect of bilirubin on the N-methyl-D-aspartate receptor/ion channel complex in the brains of newborn piglets.

Bilirubin neurotoxicity can be mediated by numerous mechanisms due to its increased permeability in neuronal membranes. The present study tests the hypothesis that a prolonged bilirubin infusion modifies the N-methyl-D-aspartate (NMDA) receptor/ ion channel complex in the cerebral cortex of newborn piglets. Studies were performed in seven control and six bilirubin-exposed piglets, 2-4 d of age.