Acute angiographic and clinical results of long balloon percutaneous transluminal coronary angioplasty and adjuvant stenting for long narrowings.

Historically, long coronary artery stenoses undergoing percutaneous transluminal coronary angioplasty (PTCA) are reported to have reduced procedural and clinical success in comparison with shorter lesions. The efficacy of long balloons (30 or 40 mm) in long lesions was evaluated. Eighty-two patients had 84 PTCA procedures with a primary long balloon.

Hypertension following kidney transplantation.

Patients often have hypertension after successful kidney transplantation. In the long term, this hypertension adds to patient mortality and morbidity. The widespread use of cyclosporine appears to have changed the nature of posttransplantation hypertension.

Rationale for immunotherapy in multiple sclerosis.

The presumed but unspecified immune-mediated basis for the pathogenesis of multiple sclerosis (MS) has led to therapeutic attempts to modify the immune system in general and in selective ways in patients with MS. In general, antiviral, anti-inflammatory, immunosuppressant, and immunomodulatory therapies have been considered. More specifically, these treatments have involved the use of glucocorticoids; immunosuppressant drugs and physical agents such as irradiation; modifications of the immune environment with therapeutic plasma exchange and intravenous immunoglobulin; and more recently, alteration of events surrounding antigen presentation and stages of the immune response of cellular proliferation, recruitment, and infiltration of the central nervous system.

Determining the competency of Alzheimer patients to consent to treatment and research.

Loss of competency is an inevitable consequence of Alzheimer disease (AD) and other progressive dementias. Of particular importance to clinicians and researchers studying dementia is determining whether a patient has the capacity to provide informed consent to treatment and medical research. No widely accepted standardized instruments exist for competency assessment, nor has competency assessment training been available to physicians.

Poliovirus capsid proteins derived from P1 precursors with glutamine-valine cleavage sites have defects in assembly and RNA encapsidation.

Assembly of poliovirus virions requires proteolytic cleavage of the P1 capsid precursor polyprotein between two separate glutamine-glycine (QG) amino acid pairs by the viral protease 3CD. In this study, we have investigated the effects on P1 polyprotein processing and subsequent assembly of processed capsid proteins caused by substitution of the glycine residue at the individual QG cleavage sites with valine (QG-->QV). P1 cDNAs encoding the valine substitutions were created by site-directed mutagenesis and were recombined into wild-type vaccinia virus to generate recombinant vaccinia viruses which expressed the mutant P1 precursors.

Role of nitric oxide synthesis in salt-sensitive hypertension in Dahl/Rapp rats.

Nitric oxide is a potent endogenous vasodilator that regulates arterial tone. A family of nitric oxide synthases uses L-arginine and L-homoarginine stereospecifically as substrates for nitric oxide production in vivo. By preventing expression of inducible but not constitutive nitric oxide synthases, glucocorticoids differentiate which enzyme in this family is the predominant source of nitric oxide generation in a given situation.

Role of cytokines and inflammatory mediators in tissue destruction.

Colonization or emergence of microbial pathogens may result in tissue destruction by activation of one or more of five distinct host degradative pathways (matrix metalloproteinase pathway, plasminogen-dependent pathway, phagocytic pathway, PMN-serine proteinase pathway and osteoclastic bone resorption) or by direct cleavage of extracellular matrix constituents by microbial proteinases. Activation of endogenous destructive pathways may be mediated by immune responses resulting in expression of degradative cellular phenotypes among both immigrant and resident cell populations. In addition, expression of degradative phenotypes may be triggered by direct influences on host cells of microbial products (LPS, enzymes, toxins).

Race and prognosis after myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) phase II trial.

Background: To better understand the role of race/ethnicity in survival after acute myocardial infarction, we compared clinical and laboratory data, response to thrombolytic therapy, and clinical outcome in 2885 patients participating in the Thrombolysis in Myocardial Infarction Phase II (TIMI II) Trial among three groups of patients (2564 whites, 174 blacks, and 147 Hispanics).

Methods And Results: Differences were found in baseline characteristics among the three groups including (1) age (mean age for whites, 57.2 years; blacks, 54.

Murine models of autoimmune disease and Sjögren's syndrome.

Murine models of autoimmune disease exhibit heterogenous features that are now being understood in terms of their basic molecular defects. Defects in apoptosis genes or genes that contribute to B-cell activation, T-cell tolerance loss, and development of autoimmune disease, including glomerulonephritis, have been identified. The interaction of primary and secondary predisposing genes leads to a diverse spectrum of autoimmune features that is different in different strains of mice.

Renal involvement in plasma cell dyscrasias.

Monoclonal light chain-related renal diseases represent a unique collection of renal disorders with monoclonal light chain deposition underlying the pathogenesis of these disorders. Yet, despite this common pathogenic mechanism, each renal lesion is unique. In addition, these syndromes are unusual in that, unlike many other renal disorders, they are potentially reversible causes of renal failure.