Successful weaning from mechanical ventilation after coronary angioplasty.

Weaning failure can be caused by myocardial ischaemia during the switch from mechanical to spontaneous ventilation. We report ischaemic left ventricular failure and ischaemic mitral insufficiency during weaning. Angiography showed that the coronary vessels were stenosed.

Correlation between nerve conduction studies and clinical scores in diabetic neuropathy.

Polyneuropathy, a frequent complication of diabetes, can be assessed clinically and electrophysiologically. Neurological examination can be quantified by validated scores, e.g.

Long-term mechanical circulatory support with the wearable Novacor left ventricular assist system.

Objective: As of July 1st 1999, 36 European patients have lived for more than 1 year supported by the Novacor wearable electric left ventricular assist system (LVAS). All were unresponsive to maximum medical therapy, prior to implantation. These patients offer an unique opportunity to evaluate the feasibility of long-term ambulatory mechanical circulatory support as a therapeutic option for patients in profound cardiac failure.

Inflammatory cells as well as epithelial cells in nasal polyps express vascular endothelial growth factor.

In nasal polyps (NPs), locally secreted growth factors are involved in the remodelling of the epithelium and extracellular matrix but little is known concerning vessel remodelling. The in situ expression of vascular endothelial growth factor (VEGF) in NPs and control nasal mucosa (CM) were evaluated and in vitro secretion of VEGF from primary human cultures of nasal epithelial cells (HNECs) was quantified. VEGF expression was evaluated in NP (n=14) and CM (n=6) after immunolabelling.

Biologic material in needles and cartridges after insulin injection with a pen in diabetic patients.

Objective: To evaluate the frequency of non-inert material, including cells, in needles and cartridges after insulin injection with pen-like devices in diabetic patients.

Research Design And Methods: A prospective study was conducted in 120 insulin-treated diabetic patients who used pen-like devices. The patients, 46 women and 74 men, were 20-77 years old; 60% had type 1 diabetes, and 38% were overweight.

Percutaneous aspiration for bacteriological studies in patients with necrotizing pancreatitis.

Background: Percutaneous computed tomography (CT)-guided aspiration of abdominal collections is performed in necrotizing pancreatitis to detect infection of necrosis, which is an adverse prognostic factor and requires surgical drainage. However, in the case of sterile aspirates, the outcome and the optimum management are subject to debate. This study examined the clinical and bacteriological outcome of patients with severe acute pancreatitis with initially sterile necrosis and assessed the efficiency of percutaneous drainage in this setting.

Radiotherapy in the management of epidemic Kaposi's sarcoma: a retrospective study of 643 cases.

Purpose: To report to the literature the largest published series of epidemic Kaposi's sarcoma (EKS), treated with radiation therapy, to summarize and discuss our 10 years experience in the treatment of this malignancy.

Methods And Materials: From June 1986 to December 1996, 643 patients with acquired immunodeficiency syndrome (AIDS)-related epidemic Kaposi's sarcoma were treated with radiation therapy (RT) at the Cancerology Department of Henri Mondor University Hospital. The patients, 640 men and 3 women had an average age of 38.

Is left atrial appendage flow a predictor for outcome of cardioversion of nonvalvular atrial fibrillation? A transthroacic and transesophageal echocardiographic study.

Accurate echocardiographic parameters for predicting the success of cardioversion or maintenance of sinus rhythm are poorly defined. This prospective transthoracic and transesophageal echocardiographic study was conducted to test the hypothesis that the left atrial appendage flow pattern could be a predictive parameter of the success of cardioversion and maintenance of sinus rhythm in patients with nonvalvular atrial fibrillation. Eighty-two consecutive patients with nonvalvular atrial fibrillation of <6 months' duration underwent transesophageal examination after transthoracic echocardiography.

Coronary laser angioplasty.

Balloon angioplasty was introduced among the armament of therapy for coronary heart disease in 1977 by Gruentzig in Zurich. Since the first case was successful, this method of treatment spread out rapidly so that at the present time, more than 400,000 procedures are being performed per year in the U.S.

In vitro study of a radiofrequency guidewire aimed at recanalization of totally occluded peripheral arteries.

A novel radiofrequency ablative system (40 msec-train pulses with twenty 200 msec pulses at the carrier frequency of 750 KHz and 1 Hz repetition rate) aimed at recanalizing totally occluded peripheral arteries was investigated by means of in vitro tissue ablation from human postmortem arterial wall samples. The samples were submitted to irradiation with a guidewire 150 cm long, maximum diameter of ceramic tip 0.033 inch positioned perpendicular to the tissue surface in saline, contrast medium or blood using varying generator power.

Percutaneous angioscopy in patients with restenosis after excimer laser coronary angioplasty.

Coronary angioscopy was performed in two patients with restenosis after excimer laser coronary angioplasty to improve our knowledge of restenosis after excimer laser angioplasty. The characteristics of the angioscopic findings in restenosis after excimer laser angioplasty consisted of smooth white plaques, which were distinctly different from the yellow plaques commonly observed in primary lesions. These findings indicate that restenosis in these patients after excimer laser angioplasty may be associated with smooth muscle cell proliferation and fibrosis.

Angioscopy after laser and balloon coronary angioplasty.

Objectives: Percutaneous intracoronary angioscopy was used to study the morphologic changes occurring in coronary arteries after balloon or laser angioplasty.

Background: Angioscopy is thought to provide details of the coronary vessel lumen and the inner wall.

Methods: Coronary lesions were studied in 44 patients with a 4.

Cost-effectiveness of screening for microalbuminuria using immunochemical dipstick tests or laboratory assays in diabetic patients.

To analyse the cost-effectiveness ratio of screening for microalbuminuria in diabetic patients using either dipstick tests or laboratory assays, 506 diabetic patients were screened for microalbuminuria using both a traditional laboratory assay (strategy I) or a laboratory assay only in the case of a positive dipstick result (strategy II). Dipstick pre-screening was considered positive if at least one of the tests performed by the two different operators showed an albumin excretion rate > 20 micrograms min-1. It was performed using a new dipstick, Micral-Test, designed to distinguish low albumin concentrations.

Assessment of coronary vasomotion by intracoronary ultrasound.

This study was performed to evaluate the accuracy of intravascular ultrasound for the assessment of coronary artery vasomotion and endothelial function in patients with atherosclerosis. Twenty patients with luminal irregularities on the coronary angiogram and a high cholesterol level (287 +/- 19 mg/dl) (group 1) and six patients with angiographically smooth arteries and a minimally elevated cholesterol level (197 +/- 12 mg/dl) (group 2) were studied. A mechanical intravascular ultrasound probe (4.

Smell dysfunction and related factors in diabetic patients.

Objective: To analyze smell function in diabetic patients and healthy control subjects, with reference to individual characteristics and major complications of the disease.

Research Design And Methods: A cross-sectional study of smell recognition in 68 diabetic patients and 30 control subjects without known cause of smell impairment was conducted. Smell was studied using a kit of flavors that patients were asked to recognize, leading to a smell recognition score ranging from 0 (no recognition) to 20 (perfect recognition).

Acute response of the arterial wall to pulsed laser irradiation.

This study was designed to examine the acute response of normal arterial wall to pulsed laser irradiation. Irradiation with an Excimer or a Holmium YAG laser was performed in 15 normal iliac sites of 8 male New Zealand white rabbits. The excimer laser was operated at 308 nm, 25 Hz, 50 mJ/mm2/pulse, and 135 nsec/pulse and the Ho:YAG laser was operated at 2.

Effects of pulsed lasers on agar model simulation of the arterial wall.

Coronary laser angioplasty is limited by a high rate of dissection and the occurrence of abrupt closure and perforation. The aim of this study was to visualize the mechanical effects of pulsed lasers on two chamber in vitro models. These models consisted of 1 or 2 agar layers and calcium carbonate inclusions (1-layer model) or lipid (2-layer model) simulating lipid or calcified tissue.

Percutaneous angioscopic evaluation of luminal changes induced by excimer laser angioplasty.

Angioscopy has been shown to provide more detailed information on lesion morphology before and after interventional procedures than angiography. Therefore to evaluate the effects of laser angioplasty, angioscopy was performed in five patients with peripheral or coronary vascular disease who underwent excimer laser angioplasty. The excimer laser was operated at 308 nm, 135 nsec, 25 Hz, and 40 to 60 mjoules/mm2 and was coupled into multifiber wire-guided catheters of 1.

Aneurysmal formation after successful pulsed laser coronary angioplasty.

We report two cases of coronary artery aneurysmal formation as long term consequences of Ho:YAG and excimer laser coronary angioplasty. This case report suggests that pulsed laser angioplasty may result in severe vessel wall damage that may lead ultimately to aneurysmal formation.

Early detection of diabetic patients at risk of developing degenerative complications using electric gustometry: a five-year follow-up study.

Objectives: Taste impairment has been reported during the course of diabetes. Although a degenerative mechanism has been suspected, the natural history of taste disorders in diabetes remains unknown. The purpose of this study was to describe the five-year evolution of electric gustometry in diabetic patients compared to healthy control subjects and with reference to degenerative complications of the disease.

Influence of non-carbohydrate foods on glucose and insulin responses to carbohydrates of different glycaemic index in type 2 diabetic patients.

In order to study the influence of non-carbohydrate foods on responses to carbohydrates during mixed meals, 30 Type 2 (non-insulin-dependent) diabetic patients followed a standardized diet for 5 consecutive days. On days 2, 3, 4, and 5, four different lunches were eaten in a randomized order. Lunches consisted of rice or glucose (50 g carbohydrate) eaten either alone, or as part of a mixed meal (32 g protein, 20 g fat).

Mechanical circulatory support in the 1990s.

The current experience in bridging patients to weaning (more than 965 implants) and to transplantation (more than 544 implants) has shown the feasibility of mechanical circulatory support in patients with major cardiac dysfunction, who are unresponsive to optimal medical management. The complications are mostly related to the patient's initial condition at the time of implantation. The rehabilitation of the patient is related to both the extent of recovery from organ dysfunction and the type of device.

Enhancement of pulsed-dye laser ablation of arterial tissues with blood medium: effects of laser-induced shock waves.

The influence of blood medium on tissue ablation by a pulsed dye laser and its selectivity for atheroma were investigated. The role of shock waves on tissue ablation was also evaluated. Normal and atherosclerotic human aortas were irradiated by a 480 nm pulsed dye laser activated at 5 Hz.