Heparin monitoring in the coronary care unit after percutaneous transluminal coronary angioplasty.

The rate of acute restenosis in patients after percutaneous transluminal coronary angioplasty (PTCA) is related to thrombotic complications triggered by the PTCA. This risk is reduced by anticoagulating the patients with heparin after the procedure. The anticoagulation state of patients receiving heparin therapy is routinely monitored with the activated partial thromboplastin time (APTT) test.

Catecholamine and thyroid hormones in traumatic injury.

During hyperthyroidism, hypothyroidism, and severe stress there is often an inverse relationship between plasma norepinephrine (NE) and thyroid hormones. We evaluated this relationship in patients who were severely burned, patients who had injury to both brain and body, patients with head injury, and patients receiving high dose barbiturates for head injury. Head-injured patients had a low thyroxine (T4), low triiodothyronine (T3), and high reverse T3.

Acetabular augmentation in primary and revision total hip arthroplasty with cementless prostheses.

Twenty-four consecutive cementless hip arthroplasties (13 autografts and 11 allografts) have been done in which large bone grafts were used to augment major acetabular deficiencies and have been followed for a minimum of 24 months with a mean of 34 and a maximum follow-up period of 55 months. The autograft augmentations were uniformly successful. Two fixation failures occurred in the allograft group.

Thioureas react with superoxide radicals to yield a sulfhydryl compound. Explanation for protective effect against paraquat.

Thiourea and superoxide dismutase were effective antidotes to paraquat toxicity in an HL60 cell culture system, whereas other hydroxyl scavengers were ineffective. The efficacy of thioureas was not due to blockage of intracellular paraquat uptake, inhibition of NADPH-P-450 reductase, or reaction with the paraquat radical. Thiourea also competitively inhibited the reduction of cytochrome c by the xanthine/xanthine oxidase superoxide-generating system, and the release of iron from ferritin by superoxide radicals.

Epinephrine synthesis in rat skin by an N-methyltransferase.

Homogenates of rat skin N-methylated norepinephrine to form epinephrine. In the brain and adrenal medulla the enzyme phenylethanolamine-N-methyltransferase synthesizes epinephrine, but the skin epinephrine forming enzyme was an N-methyltransferase distinct from phenylethanolamine-N-methyltransferase. Skin N-methyltransferase was not inhibited by the phenylethanolamine-N-methyltransferase inhibitor SKF 29661.

Postburn suppression of murine lymphocyte and neutrophil functions is not reversed by prostaglandin blockade.

Certain arachidonic acid metabolites, including prostaglandins (PGs) E1 and E2, have been shown to exert marked immunosuppressive effects on T-cell and macrophage functions. Cyclooxygenase blockade with indomethacin or ibuprofen may ameloriate these effects. In the current study we measured lymphocyte proliferation by thymidine incorporation, the presence of T-cell activation antigens with monoclonal antibodies and two-color flow cytometry, and neutrophil (PMN) oxidative burst using a fluorescent marker, in control mice and in burned mice treated with indomethacin for 10 days after injury.

Characterization of a 78-kilodalton outer membrane protein of Haemophilus somnus.

A 78-kilodalton (kDa) outer membrane protein (OMP) of Haemophilus somnus was one of the two antigens most consistently and most intensely immunoreactive in Western immunoblots of whole cells of H. somnus reacted with convalescent-phase serum obtained from cattle with experimental H. somnus pneumonia.

Two live-born infants with trisomy 22.

The autopsy findings and karyotypes of two live-born fetuses with full trisomy 22 are discussed. Confined placental mosaicism was documented in one of the two cases. Confined placental mosaicism may play a role in the intrauterine survival of some trisomy 22 conceptions.

Should safety concerns with available ulcer treatment influence drug selection?

With the identification of the parietal cell receptors for gastric acid secretion coupled with the introduction of cimetidine in 1977, treatment of acid-peptic diseases was transformed from empiric therapy to an approach based on a clearer understanding of human physiology. Today, physicians are confronted with an array of antiulcer agents that differ within their drug class (e.g.

Decreased adrenergic sensitivity in patients with hypothyroidism.

Cardiovascular sensitivity to catecholamines was assessed in 15 patients with hypothyroidism (mean [+/- SEM] thyroxine [T4] index 2.7 +/- 0.5 micrograms/100 ml, thyroid stimulating hormone [TSH] 136.

Severe toxicity from ingestion of a topical minoxidil preparation.

A 36-year-old man ingested several products, including a topical minoxidil solution. Within two hours of the ingestion the patient was difficult to arouse, tachycardic, and hypotensive with a systolic BP of 90 mmHg. Dopamine was required for two days to maintain his BP.

Serial magnetic resonance and carotid duplex examinations in the management of carotid dissection.

We followed 2 patients with extracranial internal carotid dissection and associated occlusion or preocclusive stenosis with serial magnetic resonance and carotid duplex examinations. These studies demonstrated progressive anatomic resolution in both cases.

Pretreatment with phorbol esters abrogates mast cell adenosine responsiveness.

Adenosine potentiates preformed mediator release from mouse bone marrow-derived mast cells stimulated with specific Ag or the calcium ionophore A23187. When these mast cells were cultured for 30 to 120 min with the phorbol ester PMA (10(-8) or 10(-7) M), protein kinase C activity was increased and Ag-stimulated beta-hexosaminidase release was modestly inhibited, whereas A23187-stimulated release was synergistically enhanced. However, in both cases, exogenous adenosine failed to augment beta-hexosaminidase release.

Echocardiographic and clinical predictors for outcome of elective cardioversion of atrial fibrillation.

Previous studies have suggested that success of elective direct-current cardioversion for atrial fibrillation (AF) can be predicted from clinical features and M-mode echocardiographic left atrial diameter. We evaluated clinical variables as well as M-mode and 2-dimensional echocardiographic measurements of atrial size in 85 patients undergoing electrical cardioversion for AF. Of 65 patients who were initially converted to sinus rhythm, 45 (69%) and 38 (58%) remained in sinus rhythm at 1 and 6 months, respectively.

Quantitative dual-energy radiographic absorptiometry of the lumbar spine: in vivo comparison with dual-photon absorptiometry.

Quantitative dual-energy radiographic absorptiometry (DRA) and dual-photon absorptiometry (DPA) were compared to determine the best means of assessing bone density. Both methods were used to evaluate the lumbar spine in 107 women (aged 35-84 years [mean, 64 years]) referred for evaluation of osteoporosis risk. High correlation was documented between measurements derived by the two techniques, with a .

Gallbladder and bile duct stones: percutaneous therapy with primary MTBE dissolution and mechanical methods.

The authors describe percutaneous treatment of gallbladder or bile duct stones in 18 patients who were poor surgical candidates or in whom conventional therapy failed. Dissolution was performed in most cases with methyl tert-butyl ether (MTBE) because of its potent dissolution properties; other solvents used included monooctanoin or chelating solutions. Gallbladder stones were eliminated in 11 of 13 patients (six of seven with dissolution alone, four of four with dissolution and basket extraction, one with basket removal alone).

Structure of a collagen-GAG dermal skin substitute optimized for cultured human epidermal keratinocytes.

Collagen and glycosaminoglycan (GAG) dermal skin substitutes (membranes) were studied as substrates for cultured human epidermal keratinocytes. Structure of dermal substitutes was optimized for pore size to promote ingrowth of fibrovascular tissue from the wound bed and for culture of human keratinocytes of the membrane's surface. Pore size of the freeze-dried material was regulated by control of the temperature of freezing between -50 degrees C and -20 degrees C and by concentration of starting materials between 0.

Ganciclovir prophylaxis for cochlear pathophysiology during experimental guinea pig cytomegalovirus labyrinthitis.

The effectiveness of the antiviral agent ganciclovir (9-[1,3-dihydroxy-2-propoxymethyl]guanine) against guinea pig cytomegalovirus was tested in vitro in guinea pig embryonic fibroblasts and in vivo in an experimental guinea pig cytomegalovirus labyrinthitis model. In vitro, ganciclovir completely prevented guinea pig cytomegalovirus infection of guinea pig embryonic fibroblasts at concentrations above 32.6 micrograms/ml.

Use of fiber-optic pressure transducer for intracranial pressure measurements: a preliminary report.

Invasive monitoring of intracranial pressure (ICP) is becoming the standard of care for management of acute neurologic and neurosurgical patients. As a result of improved fiber-optic technology, a new disposable 4 French fiber-optic transducer-tipped catheter (FTC) has been introduced for facilitating measurement of intracranial pressure. Placement of the FTC can be intraventricular, subarachnoid, subdural, or intraparenchymal.

Late clinical outcome in patients with early ventricular fibrillation after myocardial infarction.

Whether ventricular fibrillation occurring within 48 h after acute myocardial infarction is associated with particular clinical features and poor prognosis, especially in patients with anterior myocardial infarction, is still debated. Therefore, clinical variables and in-hospital and 1 year mortality rates were analyzed in 2,088 patients, aged 18 to 95 years (mean +/- SD 64 +/- 12), admitted to the hospital with acute myocardial infarction between 1979 and mid 1984. One hundred forty-seven patients (7%) had at least one episode of ventricular fibrillation occurring within 48 h of hospital admission.

Simple apparatus to avoid inadvertent needle puncture.

Current heightened awareness and concern about accidental needle puncture prompted design of a device to reduce this risk. Holes are made in the top of a prepurchased film cannister; these allow placement of all sharp objects used for angiographic and interventional radiology procedures. This protective cannister is recommended for routine use on all instrument trays, since it lessens the likelihood of inadvertent puncture.

Quantitative assessment of regional left ventricular function by densitometric analysis of digital-subtraction ventriculograms: correlation with myocardial systolic shortening in dogs.

Conventional wall motion analysis of contrast ventriculograms assesses only that part of the wall that is tangential to the x-ray beam. To assess regional left ventricular function in three dimensions, a new computerized method based on densitometric analysis of digital subtraction left ventriculograms was developed and validated in nine open-chest dogs instrumented with a circumflex coronary artery occluder and sonomicrometers in the anterior and posterior walls. Each dog underwent digital subtraction ventriculography at baseline and at five levels (I to V) of dysfunction of the inferior wall induced by progressive stenoses of the circumflex coronary artery.

Densitometric regional ejection fraction: a new three-dimensional index of regional left ventricular function--comparison with geometric methods.

Densitometric regional ejection fraction obtained by computer analysis of digital subtraction ventriculography was evaluated as a new, quantitative, three-dimensional index of regional left ventricular performance. Eighteen patients with coronary artery disease and seven control subjects had right anterior oblique ventriculography at rest and immediately after rapid atrial pacing using central venous injection of contrast material. Regional left ventricular ejection fraction was determined by densitometry in six segments drawn around the end-diastolic center of gravity, and compared with two conventional indexes of segmental wall motion: area and radial regional ejection fraction.