Influence of the route of infection on development of T-cell receptor beta-chain repertoires of reovirus-specific cytotoxic T lymphocytes.

It is well established that the route of infection affects the nature of the adaptive immune response. However, little is known about the effects of the route of exposure on development of cytotoxic T-lymphocyte (CTL) responses. Alternative antigen-presenting cell populations, tissue-restricted expression of class I major histocompatibility complex-encoded molecules, and unique T-cell receptor (TCR)-bearing cells in mucosal tissues could influence the selection and expansion of responder T cells.

Hyperosmolar solution effects in guinea pig airways. IV. Lipopolysaccharide-induced alterations in airway reactivity and epithelial bioelectric responses to methacholine and hyperosmolarity.

We investigated the in vivo and in vitro effects of lipopolysaccharide (LPS) treatment (4 mg/kg i.p.) on guinea pig airway smooth muscle reactivity and epithelial bioelectric responses to methacholine (MCh) and hyperosmolarity.

AHEC in West Virginia: a case study. Area health education centers.

This case study describes the area health education centers (AHEC) program in West Virginia, spanning 30 years from a first-generation project at Charleston in 1972 (AHEC 1) to a newly funded statewide program (AHEC 2). The outcome is an evolving university-community partnership designed to meet changing work-force and community health needs in the heart of rural Appalachia. West Virginia University's (WVU's) application of the original Carnegie Commission AHEC recommendations (1970) resulted in the Charleston AHEC, now part of the Robert C.

Restenting for subclavian in-stent restenosis with symptomatic recurrent coronary-subclavian steal.

Purpose: To determine whether restenting for recurrent coronary-subclavian syndrome is technically feasible, provides durable results, and is a reasonable alternative to surgery.

Case Report: A 58-year-old woman with a left internal mammary artery (LIMA) bypass to the left anterior descending artery underwent angioplasty and stent placement for left subclavian stenosis and coronary-subclavian steal. Twenty-three months later, she returned with progressive angina and left arm claudication; heart catheterization demonstrated restenosis of the subclavian artery at the stent site with recurrence of the coronary-subclavian steal.

Early postsurgical carotid restenosis: redo surgery versus angioplasty/stenting.

Purpose: To compare the results of balloon angioplasty/stenting (BA/S) versus redo surgery in patients with early carotid restenosis.

Methods: Sixty-one patients (35 women; mean age 69 years, range 46-82) with early restenosis (<24 months from the primary endarterectomy) in 63 carotid arteries were treated during a 5-year period; 41 patients (41 arteries) had redo surgery (group A) and 20 patients (22 arteries) had BA/S (group B). Patients were followed regularly with duplex ultrasound to detect >or=50% recurrent restenosis (RRS) after redo surgery or BA/S.

Endovascular intervention for stenosis following carotid stent-supported angioplasty--a case report.

This report is on a patient with symptomatic late restenosis after carotid stent-supported angioplasty (CSSA). Initially, the patient underwent carotid endarterectomy (CEA) with primary closure in response to an index transient ischemic attack 13 months before CSSA. He returned with angiographic evidence of recurrent carotid artery stenosis.

Carotid plaque ultrasonic heterogeneity and severity of stenosis.

Background And Purpose: Several studies have reported on the correlation of ultrasonic carotid plaque morphology, cerebrovascular symptoms, and intraplaque hemorrhage. This study correlates ultrasonic carotid plaque morphology with the degree of carotid stenosis.

Methods: Carotid arteries (n=2460) were examined by using color duplex ultrasound during a 1-year period.

Quantitative image analysis of drug-induced lung fibrosis using laser scanning confocal microscopy.

Pulmonary fibrosis is a serious lung disorder that in certain cases may be difficult to quantify. It was our objective to evaluate the use of laser scanning confocal microscopy (LSCM) in quantifying fibrosis after exposure to amiodarone (AD) and bleomycin (BLM), two commonly used therapeutic drugs known to cause debilitating lung fibrosis in humans. Male F344 rats were intratracheally dosed with AD (6.

Lysis/balloon angioplasty versus thrombectomy/ open patch angioplasty of failed femoropopliteal polytetrafluoroethylene bypass grafts.

Purpose: Several studies have reported on the outcome of lysis/percutaneous transluminal balloon angioplasty (PTA) of failed or failing femoropopliteal bypass grafts (FPGs) with mixed results. None of these studies have compared the results of lysis/PTA versus thrombectomy/open patch repair for failed above-knee polytetrafluoroethylene (PTFE) FPGs.

Methods: Patients with failed (thrombosed) above-knee FPGs (PTFE, Goretex) during a 10-year period were given the option to choose between thrombectomy/open patch repair for localized anastomotic short stenosis (less-than-or-equal2 cm; group A, 31 patients) and lysis/PTA or thrombectomy/balloon angioplasty when lysis failed or was contraindicated (group B, 26 patients).

Prospective randomized study of carotid endarterectomy with polytetrafluoroethylene versus collagen-impregnated Dacron (Hemashield) patching: perioperative (30-day) results.

Purpose: Several studies have reported that carotid endarterectomy (CEA) with patch angioplasty has results that are superior to primary closure. Polytetrafluoroethylene (PTFE) patching has been shown to have results comparable with autogenous vein patching; however, it requires a prolonged hemostasis time. Therefore, many surgeons are using collagen-impregnated Dacron patching (Hemashield [HP]).

Endovascular repair of abdominal aortic aneurysms: our early experience.

Endovascular repair of abdominal aortic aneurysms (AAA) seems to hold the potential for decreased perioperative mortality and morbidity associated with the standard open repair by eliminating major surgical exposure of the aorta and prolonged aortic cross-clamping. After several years of FDA-approved clinical trials of multiple aortic-stented grafts, the FDA, in September 1999, approved two devices (the ANCURE and the AneuRx) for commercial use in the United States. We implanted the first device in the Tri-State area at the Charleston Area Medical Center (CAMC) on Feb.

Redo carotid endarterectomy versus primary carotid endarterectomy.

Background And Purpose: Several authorities have recently advocated carotid stenting for recurrent carotid stenosis because of the perception that redo surgery has a higher complication rate than primary carotid endarterectomy (CEA). This study compares the early and late results of reoperations versus primary CEA.

Methods: All reoperations for recurrent carotid stenosis performed during a recent 7-year period by a single vascular surgeon were compared with primary CEA.

Comparative study of operative treatment and percutaneous transluminal angioplasty/stenting for recurrent carotid disease.

Purpose: This study is a nonrandomized parallel comparison of the outcome for carotid endarterectomy (CEA) and percutaneous transluminal angioplasty (PTA)/stenting for recurrent carotid artery stenosis (RCS).

Methods And Patients: Between June 1996 and June 2000, 83 carotid procedures (58 reoperations, Group I, and 25 PTA/stentings, Group II) were done for RCS. Patients were followed at regular intervals with duplex ultrasound scanning.

Prospective controlled study of carotid endarterectomy with hemashield patch: is it thrombogenic?

The use of patch angioplasty after carotid endarterectomy (CEA) has been shown to have superior results to CEA with primary closure. Polytetrafluoroethylene (PTFE) patches have been shown to have comparable results to autogenous vein patching; however, PTFE has the disadvantage of prolonged hemostasis time. Therefore, many surgeons are using collagen-impregnated Dacron patches (Hemashield[HP]).

Iliofemoral deep vein thrombosis: conventional therapy versus lysis and percutaneous transluminal angioplasty and stenting.

Objective: To compare conventional treatment (heparin and warfarin) of iliofemoral venous thrombosis with multimodality treatment (lysis and stenting).

Summary Background Data: Several studies have reported on conventional therapy for iliofemoral venous thrombosis with disappointing results. However, more recent studies have reported better results with multimodality treatment.

Evaluation of documentation before and after implementation of a nursing information system in an acute care hospital.

Economic pressures on healthcare systems have intensified the necessity of demonstrating the unique contribution of nursing care to patient outcomes. The use of nursing information systems (NIS) has increased completeness of some nursing documentation elements. This study's purpose was to evaluate differences in documentation completeness of nurse assessments of patient outcomes (NASSESS), achievement of patient outcomes (NGOAL), nursing interventions done (NQUAL), and routine assessments before and after implementation of an NIS in a 100-bed urban university hospital in west Tennessee and before and after retraining in NIS use and care planning.

La Crosse encephalitis in children.

Background: La Crosse encephalitis is a mosquito-borne disease that can be mistaken for herpes simplex encephalitis. It has been reported in 28 states but may be underrecognized.

Methods: We investigated the manifestations and clinical course of La Crosse encephalitis in 127 patients hospitalized from 1987 through 1996.

Pulmonary responses to single versus multiple intratracheal instillations of silica in rats.

The pulmonary toxicity of particles is often studied using a single intratracheal instillation of the material. It was hypothesized that smaller multiple intratracheal administrations of silica would result in differences in pulmonary responses as compared to a single large intratracheal administration. In the first of a series of experiments, the pulmonary responses in male F344 rats to a single intratracheal instillation of crystalline silica (5 mg/100 g body weight) given on d 0 were compared with those resulting from 5 consecutive daily intratracheal administrations of the dust (1 mg/100 g body weight/d) with the initial dose given on d 0.

Selecting patients for combined femorofemoral bypass grafting and iliac balloon angioplasty and stenting for bilateral iliac disease.

Purpose: This study examines the selection of patients for combined femorofemoral bypass (FFB) grafting and iliac balloon angioplasty (IBA) and stenting for bilateral iliac occlusive disease (successively or simultaneously) and the correlation of the length and location of stenoses of the donor iliac artery to the success of FFB grafts.

Methods: Forty-one patients with long iliac occlusion and significant contralateral iliac stenosis were treated with combined FFB grafting and IBA and stenting, which were performed simultaneously or percutaneously within 1 to 2 days before surgery. Stenting was performed for suboptimal IBAs.

Frequency of postoperative carotid duplex surveillance and type of closure: results from a randomized trial.

Background/purpose: In several nonrandomized studies investigators have reported on the value of postoperative carotid duplex surveillance (PCDS) with mixed results; however the type of closure was not analyzed in these studies. In this study we analyze the frequency and timing of postoperative carotid duplex ultrasound scanning according to the type of closure from a randomized carotid endarterectomy (CEA) trial comparing primary closure (PC) versus patching.

Patient Population And Methods: We randomized 399 CEAs into 135 PCs, 134 polytetrafluoroethylene (PTFE) patch closures, and 130 vein patch closures (VPCs) with a mean follow-up of 47 months.

Dexamethasone worsens nitric oxide inhibition-induced hypertension and renal dysfunction.

Chronic nitric oxide (NO) inhibition with Nomega-nitro-L-arginine methyl ester (L-NAME) has previously been reported to produce systemic hypertension, renal vasoconstriction, and renal damage. In this study we investigated whether a compensatory restoration of NO synthesis occurs in chronic L-NAME hypertension and whether chronic treatment with dexamethasone (Dex) (which inhibits inducible NO synthase [iNOS]) can influence the course of the hypertension. We found that in the conscious chronically L-NAME-treated (approximately =10 mg/kg/24 h) hypertensive rats, acute systemic NOS inhibition elicited a further increase in blood pressure (BP), indicating partial restoration of NO production.

Cranial and cervical nerve injuries after repeat carotid endarterectomy.

Background And Purpose: The incidence of cranial and/or cervical nerve injuries after primary carotid endarterectomy (CEA) ranges from 3% to 48%; however, the clinical outcome of these injuries after repeat CEA has not been thoroughly analyzed in the English-language medical literature. This prospective study analyzes the incidence and outcome of cranial nerve injuries after repeat CEA.

Patients And Methods: This study includes 89 consecutive patients who had repeat CEAs.