bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress factors predicting injuries of hospital personnel
Authors: Salminen Simo , Kivimäki Mika , Elovainio Marko , Vahtera Jussi
Published: June 2003

Background

Stress at work has long been recognized as a factor in increasing risk for mental and physical health problems. The extent to which work stressors and stress predicted injuries occur in a large population of Finnish hospital workers was studied.

Methods

A total of 5,111 employees (624 men, 4,487 women) from 10 hospitals participated in this study. Their psychological distress was measured by the General Health Questionnaire, and overload and job control by the Harris scale and the Job Content Questionnaire, respectively. Injuries certified by a physician were followed up for 3 years: injuries in 1997 (n = 213) were used as a measure of baseline and injuries in 1998–1999 (n = 443) were the dependent variables.

Results

Psychological distress was not significantly related to injuries. However, low decision latitude (risk ratio = 1.27 (1.04 to 1.54)), low skill discretion only for men (risk ratio = 2.76 (1.78 to 4.30)), and highly monotonous work (risk ratio = 1.26 (1.02 to 1.55)) were stressors predicting injuries. In addition, workers with numerous problems in interpersonal relationships (risk ratio = 1.43 (1.18 to 1.73)) or many conflicts in collaboration at work (risk ratio = 1.40 (1.15 to 1.71)) were more often involved in injuries.

Conclusions

This study showed that stressors related to autonomy of work and interpersonal relationship at workplace are predictors of injuries in hospital settings. These factors are potentially amenable to organizational interventions. Am. J. Ind. Med. 44:32–36, 2003. © 2003 Wiley‐Liss, Inc.
Exposure assessment for study of olfactory function in workers exposed to styrene in the reinforced‐plastics industry
Authors: Lees Peter S.J. , Stefaniak Aleksandr , Emmett Edward A. , Dalton Pamela
Published: June 2003

Background

This study was undertaken in conjunction with an evaluation of the olfactory function of 52 persons exposed to styrene vapors to provide quantitative styrene exposure histories of each subject for use in the interpretation of the results of olfactory function testing.

Methods

Current and historic exposures were investigated. Historic exposures were reconstructed from employment records and measurements of styrene exposure made in the subject facilities over the last 15 years. Current exposures were estimated for every exposed subject though personal air sampling and through pre‐ and post‐shift measurements of urinary metabolites of styrene.

Results

The study population had been employed in the reinforced‐plastics industry for an average of 12.2 ± 7.4 years. Their mean 8‐hr time weighted average (TWA) respirator‐corrected annual average styrene exposure was 12.6 ± 10.4 ppm; mean cumulative exposure was 156 ± 80 ppm‐years. The current respirator‐corrected 8‐hr TWA average exposure was 15.1 ± 12.0 ppm. The mean post‐shift urinary mandelic and phenylglyoxylic acid (PGA) concentrations were 580 ± 1,300 and 170 ± 360 mg/g creatinine, respectively and were highly correlated with air concentrations of styrene.

Conclusions

This quantitative exposure evaluation has provided a well‐characterized population, with documented exposure histories stable over time and in the range suitable for the purposes of the associated study of olfactory function. Am. J. Ind. Med. 44:12–23, 2003. © 2003 Wiley‐Liss, Inc.
Cancer incidence and mortality in workers employed at a transformer manufacturing plant: Update to a cohort study
Authors: Yassi Annalee , Tate Robert B. , Routledge Michael
Published: June 2003

Background

This study is an extension of a previously published analysis of cancer mortality in a transformer manufacturing plant where there had been extensive use of mineral oil transformer fluid. The objectives of the present study were to update the mortality analysis and include deaths for the past 6 years as well as to do an analysis of cancer incidence of the cohort.

Methods

A cohort of 2,222 males working at a transformer manufacturing plant between 1946 and 1975 was constructed. Using a classical historical cohort study design, cancer incidence and mortality were determined through record linkage with Canadian provincial and national registries. The rates of cancer incidence and mortality experienced by this cohort were compared to that of the Canadian male population.

Results

A statistically significant increased risk of developing and dying of pancreatic cancer was found but not an increase in overall cancer mortality. This was consistent with the previous report from this group. Interestingly, the cohort demonstrated a statistically significant risk of overall cancer incidence and specific increased incidence of gallbladder cancer.

Conclusions

This study contributes further evidence to the growing body of literature indicating the carcinogenic properties of mineral oils used in occupational settings, in particular those used prior to 1970s. Am. J. Ind. Med. 44:58–62, 2003. © 2003 Wiley‐Liss, Inc.
Wheat flour exposure results in recruitment of inflammatory cells in the lungs of healthy individuals
Authors: Gripenbäck Sofia , Lundgren Lennart , Eklund Anders , Lidén Carola , Skare Lizbet , Tornling Göran , Grunewald Johan
Published: June 2003

Background

Flour dust in bakeries is known to cause allergic as well as nonallergic respiratory symptoms. Fungal α‐amylase is a commonly used baking additive that has been shown to have allergenic properties. The aim of this study was to investigate any effects on bronchoalveolar lavage (BAL) cells and peripheral blood lymphocytes (PBL) of healthy individuals exposed to airborne wheat flour dust with or without fungal α‐amylase added.

Methods

Fifteen subjects were exposed during 1 hr in an exposure chamber, ten individuals to wheat flour alone and five with α‐amylase added. BAL was performed 2–6 weeks before and 1 day after the exposure. BAL cells were differentially counted and flowcytometric analysis of the expression of activation, adhesion, and subset markers on alveolar macrophages (AM) and T cells in BAL fluid and peripheral blood were carried out.

Results

Exposure to wheat flour dust increased the total number of cells in BAL fluid from 75.4 (i.q. range 70.4–104.1) to 127.4 (92.1–187.4) cells × 106/L, P < 0.01. There was a significant difference in the change of total BAL cell concentration between the study group exposed to wheat flour only (n = 10; increase with 91.9 × 106/L) and the group exposed to wheat flour with the baking additive fungal α‐amylase (n = 5; decrease with 5.4 × 106/L). The exposure level of respirable dust was lower in the group that received α‐amylase and the increase in BAL cell concentration showed a positive correlation with the concentration of respirable dust in the exposure chamber (r = 0.80, P < 0.001). The phenotypic analysis of AM indicated an influx of monocytic cells.

Conclusions

The results indicate that the concentration of respirable dust, but not α‐amylase, is of importance for the recruitment of inflammatory cells to the peripheral airways in healthy individuals exposed to wheat flour dust. Am. J. Ind. Med. 44:75–82, 2003. © 2003 Wiley‐Liss, Inc.
Effects of occupational exposure to diesel exhaust on porphyrin metabolism in lymphocytes of workers employed at black coal and oil‐shale mines
Authors: Muzyka Vladimir , Bogovski Sergei , Scheepers Paul , Volf Jaroslav , Kusova Jaromira
Published: June 2003

Background

This pilot study was conducted to investigate biochemical effects of exposure to diesel engine exhaust at two mines. For this purpose, heme biosynthesis, and PP association with DNA (PP/DNA) in lymphocytes of miners exposed to diesel exhaust were determined.

Methods

The pilot study was carried out at a black coal mine in Czech Republic, and at an oil‐shale mine in Estonia. The subjects were ten drivers from each mine, who were exposed to diesel exhaust (underground workers). Control groups consisted of ten maintenance workers from each mine (surface workers). The content of 1‐nitropyrene (NP) in respirable dust was measured using GC‐MS. The levels of PP, PP/DNA, heme, and activity of ferrochelatase (FC) were determined by spectrophotometry.

Results

The exposure to diesel exhaust evaluated as the level of NP associated to particulate matter in air. NP level was significantly higher in oil‐shale mine compared with coal mine. The values of PP and PP/DNA in lymphocytes appeared to be significantly increased only in miners in the oil‐shale mine. There was no difference in the levels of PP and PP/DNA and FC activity between surface workers and miners at the coal mine. The level of heme in lymphocytes of coal mine miners was significantly higher than in miners of the oil‐shale mine. The activity of FC was significantly lower in underground workers compared to surface workers at this mine. High level of NP was accompanied by an increase of alterations in cells porphyrin metabolism in lymphocytes of miners.

Conclusions

Alterations of porphyrin and heme metabolism in peripheral lymphocytes may serve as biomarker in assessment of exposure to diesel exhaust effects. Am. J. Ind. Med. 44:70–74, 2003. © 2003 Wiley‐Liss, Inc.
An update of a mortality study of talc miners and millers in Italy
Authors: Coggiola Maurizio , Bosio Davide , Pira Enrico , Piolatto Pier Giorgio , Vecchia Carlo La , Negri Eva , Michelazzi Marco , Bacaloni Alessandro
Published: June 2003

Background

While talc containing asbestiform fibers is considered a human carcinogen, only limited animal and human data are available on non‐asbestiform talc. To provide further evaluation on the issue, we updated the analysis of an Italian cohort of talc miners and millers in Val Chisone; talc found here is free from asbestiform fibers.

Methods

The cohort was comprised of 1,795 men who had worked for at least 1 year in the mine and/or in the factory between 1946 and 1995. Vital status and death certificates were obtained from registration offices in the municipality of death or of birth. Employment, termination of employment, and detailed job history were obtained from personnel records at the plant.

Results

No excess was found for total cancer mortality, nor mortality for lung cancer. No case of mesothelioma was reported. There was a significant excess mortality from non‐neoplastic respiratory diseases (SMR 228.2, 95% CI 190.2–271.5). Mortality excess for non‐neoplastic respiratory diseases was mainly due to silicosis.

Conclusions

This study provides additional support for an association between talc in mining and milling and non‐neoplastic respiratory diseases, while showing no significant excess risk for lung cancer and mesothelioma. The results also provide additional information of interest to evaluate the potential association between silica and lung cancer. Am. J. Ind. Med. 44:63–69, 2003. © 2003 Wiley‐Liss, Inc.
Titelbild: Direct Catalytic Asymmetric Enolexo Aldolizations (Angew. Chem. 24/2003)
Authors: Pidathala Chandrakala , Hoang Linh , Vignola Nicola , List Benjamin
Published: June 2003

Federleicht katalysiert …︁ die auf dem Titelbild gezeigte Aminosäure (S)‐Prolin eine Reihe von asymmetrischen intramolekularen Aldolisierungen, über die B. List et al. auf S. 2891 ff. berichten. Die vorgestellten enolexo‐Aldolisierungen ergänzen die in jüngster Zeit rasch wachsende Gruppe von Prolin‐katalysierten Reaktionen. Kaum zu glauben ist, dass fast die Hälfte der 250 Tonnen an jährlich produziertem Prolin aus Hühnerfedern isoliert wird!
Application and Limitations of X‐ray Crystallographic Data in Structure‐Based Ligand and Drug Design
Authors: Davis Andrew M. , Teague Simon J. , Kleywegt Gerard J.
Published: June 2003

Structure‐based design usually focuses upon the optimization of ligand affinity. However, successful drug design also requires the optimization of many other properties. The primary source of structural information for protein–ligand complexes is X‐ray crystallography. The uncertainties introduced during the derivation of an atomic model from the experimentally observed electron density data are not always appreciated. Uncertainties in the atomic model can have significant consequences when this model is subsequently used as the basis of manual design, docking, scoring, and virtual screening efforts. Docking and scoring algorithms are currently imperfect. A good correlation between observed and calculated binding affinities is usually only observed only when very large ranges of affinity are considered. Errors in the correlation often exceed the range of affinities commonly encountered during lead optimization. Some structure‐based design approaches now involve screening libraries by using technologies based on NMR spectroscopy and X‐ray crystallography to discover small polar templates, which are used for further optimization. Such compounds are defined as leadlike and are also sought by more traditional high‐throughput screening technologies. Structure‐based design and HTS technologies show important complementarity and a degree of convergence.
Cover Picture: Direct Catalytic Asymmetric Enolexo Aldolizations (Angew. Chem. Int. Ed. 24/2003)
Authors: Pidathala Chandrakala , Hoang Linh , Vignola Nicola , List Benjamin
Published: June 2003

A feather in the cap of the aldol reaction. The cover picture shows the amino acid (S)‐proline surrounded by some new catalytic asymmetric intramolecular aldolizations, which are described by B. List et al. on page 2785 ff. Another example of the ever‐increasing number of proline‐catalyzed reactions are enolexo aldolizations. Despite these exciting discoveries, it is often forgotten that almost half of the 250 tonnes of proline produced each year is isolated from chicken feathers!
Synthesis and 5‐HT2A Radioligand Receptor Binding Assays of DOMCl and DOMOM, Two Novel 5‐HT2A Receptor Ligands
Authors: Harms Antje , Ulmer Ernst , Kovar Karl‐Artur
Published: June 2003

A synthesis of two new active substances, DOMCl (1‐(4‐chloromethyl‐2, 5‐dimethoxyphenyl)‐2‐propanamine; 2) and DOMOM (1‐(2, 5‐dimethoxy‐4‐methoxymethylphenyl)‐2‐propanamine; 3), was developed. Unexpectedly, the Blanc reaction permitted successful synthesis of 2, 5‐dimethoxyphenylpropylamine derivatives having a substituted methyl group in position 4 since solvation of the reactant occurs during the reaction. Afterwards, their affinities towards the 5‐HT2A receptor were examined in 5‐HT2A radioligand receptor binding assays. The study of these substances is of considerable interest because they were predicted, by preliminary molecular modeling studies based on mescalin units, to be potential new hallucinogens that should be added to the list of substances prohibited by law. It was assumed that DOMCl would be 82 times more potent as a hallucinogen than mescalin, and DOMOM would be 94 times more potent. The 5‐HT2A radioligand receptor binding studies showed that the affinities of DOMCl and DOMOM for the 5‐HT2A receptor are less than expected but are nevertheless 1.6 and 8.7 times higher, respectively, than that of mescalin. Therefore, scheduling these substances as potential drugs of abuse might be considered.
Synthesis of Novel Isoxazolidine Derivatives and Their Antifungal and Antibacterial Properties
Authors: Kumar Kodagahally R. Ravi , Mallesha Honnaiah , Rangappa Kanchugarakoppal S.
Published: June 2003

The synthesis of some biologically interesting isoxazolidine derivatives has been accomplished by the cycloaddition reaction of C‐(4‐biphenyl)‐N‐(3‐methylphenyl) nitrone and C‐(4‐biphenyl)‐N‐(3‐chlorophenyl) nitrone to monosubstituted alkenes. The compounds were screened for their antibacterial and antifungal activities. Among the tested compounds 3a (ii), 3a (vii), 3a (viii), 3b (iv), 3b (vii), and 3b (viii) showed significant antifungal activity comparable with that of the standard drug Nystatin against Botrydiplodia theobromae.
Synthesis of 2‐(4‐Biphenylyl)quinoline‐4‐carboxylate and Carboxamide Analogs. New Human Neurokinin‐3 (hNK‐3) Receptor Antagonists
Authors: Saudi Manal N. S. , Rostom Sherif A. F. , Fahmy Hesham T. Y. , El Ashmawy Ibrahim M.
Published: June 2003

The 2‐phenylquinoline‐4‐carboxamide 1 (Chart[TH]1) has been found to possess moderate affinity for human neurokinin‐3 (hNK‐3) receptor. In the present work, and in a trial to investigate the effect of the lipophilic moiety at C‐2 of the quinoline ring on the antagonistic activity, an enlargement of the aromatic area at this position was suggested. In this respect, two series of 2‐(4‐biphenylyl)quinoline‐4‐carboxylates and carboxamides have been synthesized with certain modifications at the quinoline‐2 and 4‐position in order to study their effect on the anticipated hNK‐3 receptor antagonistic activity. Fifteen compounds were screened for such activity using guinea‐pig isolated ileum longitudinal muscle preparation and senktide as selective hNK‐3 receptor agonist. Some compounds showed considerable antagonistic effect. Compound 7b, 6‐bromo‐2‐(4‐biphenylyl)quinoline‐4‐carboxylic acid, was the most prominent hNK‐3 receptor antagonist in this study. Unexpectedly, some compounds were agonists.
Antimycobacterial Activity of 1‐Substituted Indolizines
Authors: Gundersen Lise‐Lotte , Negussie Ayele H. , Rise Frode , Østby Ole Benny
Published: June 2003

Indolizine derivatives were tested as antimycobacterials against Mycobacterium tuberculosis H37Rv (ATCC 27294)in BACTEC 12B medium using the Microplate Alamar Blue Assay. The most active compounds examined carry an α‐hydroxybenzyl substituent in the indolizine 1‐position. MICs against Mycobacterium tuberculosis for these compounds were 6.25 μg/mL
Influence of linker unit on performance of palladium(II) coproporphyrin labelling reagent and its bioconjugates
Authors: Soini Aleksi E. , Yashunsky Dmitri V. , Meltola Niko J. , Ponomarev Gelii V.
Published: June 2003

In this paper we describe the preparation of a series of new phosphorescent labelling reagents, based on monosubstituted palladium(II) coproporphyrin‐I and the isothiocyanato reactive group. The labelling reagents differ with respect to the chemical composition of the linker unit that combines the reactive group and the porphyrin chromophore. Altogether, seven different labelling reagents are prepared. The new labelling reagents are conjugated with monoclonal mouse IgG to yield label conjugates with variable degrees of conjugation. The effect is studied of linker unit on: (a) the conjugation reaction kinetics; (b) the biological activity of the resulting IgG conjugates; and (c) the efficiency of phosphorescence emission. The results show that an increase in the length of the linker unit has a positive effect on both the reactivity of the label and the biological activity of the resulting conjugates. In addition, the results indicate that the labels with the most hydrophilic linker units exhibit the highest phosphorescence emission efficiencies. Copyright © 2003 John Wiley & Sons, Ltd.
„Hot Spots”︁ der Nährelementaufnahme?: Steine im Waldboden
Authors: Kohler Martin , Wolsfeld Norbert , Hildebrand Ernst E.
Published: June 2003

Steine in Waldböden sind offensichtlich in weitaus größerem Umfang an geo‐/biochemischen Ionenkreisläufen beteiligt, als man bislang angenommen hat. In feinen Fissuren der Steine findet man Feinmaterial, das relativ hohe Gehalte an pflanzenverfügbaren Nährelementkationen aufweist. Dieses Ernährungspotenzial wird von Pilzhyphen genutzt. Damit ist ein verbreitetes Plausibilitätsdefizit der Bodenchemie beseitigt, wonach gesunde Bestände auf dramatisch nährstoffarmen Böden wachsen können. Wir fanden auch Pilzhyphen, die ohne Verwitterungszonen direkt in den Mineralverband von Steinen eingedrungen waren. Wir können damit die Ergebnisse einer nordeuropäischen Forschergruppe bestätigen, dass es „rock‐eating‐fungi”︁ gibt.
Haie im Mittelmeer: Fakten, Forschung, Probleme
Authors: De Maddalena Alessandro , Reckel Frank
Published: June 2003

Etwa 50 der weltweit fast 500 Haiarten kommen im Mittelmeer vor. Neben Arten, für die das Mittelmeer schon immer zum Verbreitungsgebiet zählte, wie beispielsweise Blau‐ und Fuchshai, wurden in den vergangenen Jahren auch eingewanderte tropische Spezies wie Wal‐ und Tigerhai beobachtet. Kleinere Haiarten sind im Mittelmeer nach wie vor häufig. Dagegen gingen die Bestände der Großhaie stark zurück. Die Ursachen sind möglicherweise eine intensivere Fischerei und eine erhöhte Umweltbelastung. Trotz der großen ökologischen und ökonomischen Bedeutung des Hais im Mittelmeerraum wurden kaum Maßnahmen zu seinem Schutz ergriffen. Da zudem bislang keine langfristigen und länderübergreifenden Studien durchgeführt wurden, ist das Wissen über Biologie, Status und Verbreitung vieler Haiarten noch lückenhaft. Mit der Gründung der Mediterranean Shark Research Group, die bereits erste Projekte initiierte, deutet sich eine Wende zum Positiven an.
Kollektiver Kraftakt zweier Exzentriker: Phloemtransport
Authors: van Bel Aart J. E. , Hess Paul
Published: June 2003

Siebröhren sind modular aufgebaute Transport‐ und Kommunikationskanäle im Phloem der Pflanzen. Sie transportieren nicht nur Photoassimilate, sondern auch eine Vielfalt anderer chemischer Verbindungen, beispielsweise verschiedene Proteine und sogar genetische Information in Form von RNA. Die einzelnen Module der Siebröhren bestehen aus zwei Komponenten: dem kernlosen Siebelement und der gleichsam hyperaktiven Geleitzelle, die den Stoffwechsel des Siebelements metabolisch unterstützt und deren Energieversorgung übernimmt. Sie funktionieren als untrennbare Einheit, dem Siebelement‐Geleitzell‐Komplex. Die hintereinander gereihten Siebelemente bilden das eigentliche Transportrohrsystem, das einen effektiv gesteuerten Ferntransport innerhalb der Pflanze ermöglicht. So sorgt das Phloemleitsystem dafür, dass alle Abschnitte der Pflanze mit Nährstoffen versorgt werden und aufeinander abgestimmt auf Umwelteinflüsse wie Schädlingsbefall und endogene Prozesse wie Fruchtbildung reagieren können.
Nachzucht führt zu kleineren Lachseiern
Authors: Wendler Silke
Published: June 2003

Für bedrohte Tierarten ist oft die letzte Möglichkeit der Arterhaltung die Nachzucht in Gefangenschaft und spätere Rückführung in die freie Wildbahn. Die Auswirkungen eines solchen Nachzuchtprogrammes wurden bei dem beliebten Königslachs (Oncorhynchus tschawytscha) untersucht.
Sehen Verwandte die Welt ähnlich?
Authors: Wolf Fred , Kaschube Matthias , Geisel Theo , Löwel Siegrid
Published: June 2003

Wie genetische Faktoren und Umwelteinflüsse die Struktur des Gehirns und seine kognitiven Leistungen beeinflussen, ist eine zentrale Frage in den Neurowissenschaften. Eine wissenschaftliche Überprüfung des Einflusses genetischer Information auf die Struktur des Gehirns war bisher allerdings beschränkt auf grobe Faktoren, wie das Volumen des Gehirns oder seiner Teile. Nun wurde nachgewiesen, dass sich neuronale Aktivitätsmuster des Gehirns bei nah verwandten Tieren viel stärker ähneln als bei solchen, die nicht miteinander verwandt sind.
Alzheimer: Wege zur Diagnose
Authors: Kriesten Klaus
Published: June 2003

Schätzungen zufolge leiden heutzutage weltweit rund zehn Prozent der über 65‐Jährigen und und etwa 25 Prozent der über 85‐Jährigen an der Alzheimer‐Krankheit [4]. Um Alzheimer‐Patienten von normal alternden Menschen unterscheiden zu können, sucht man nicht nur nach den bekannten extrazellulären Amyloid‐Plaques, sondern auch nach intrazellulären Tau‐Protein‐Ablagerungen.
Klaus Paysan
Authors: von See Claudia
Published: June 2003

Er ist Naturfotograf, Buchautor — und in Afrika sogar ein Edelmann. Der 73‐jährige Stuttgarter Klaus Paysan hat unzählige Tiere und Pflanzen auf der ganzen Welt fotografiert. Tierfotografen gibt er einen ungewöhnlichen Ratschlag: So wenig wie möglich mit dem Objektiv auf ein Tier zielen.
Inadvertent dilation of a saphenous vein graft stenosis by the PercuSurge GuardWire distal protection balloon
Authors: Sharma Naveen , Kalaria Vijay G.
Published: June 2003

Distal embolization protection devices are fast becoming an integral part of percutaneous vein graft interventions. The distal elastomeric balloon of the PercuSurge GuardWire system is supposed to be atraumatic to the vessel wall. We report the inadvertent dilation of a moderate distal stenosis at the site of GuardWire balloon inflation while intervening on a critical proximal saphenous vein graft stenosis. This case illustrates that plaque compression and potential vessel wall trauma might occur during the inflation of the PercuSurge GuardWire distal protection balloon. Cathet Cardiovasc Intervent 2003;59:346–349. © 2003 Wiley‐Liss, Inc.
Resistance to thienopyridines: Clinical detection of coronary stent thrombosis by monitoring of vasodilator‐stimulated phosphoprotein phosphorylation
Authors: Barragan Paul , Bouvier Jean‐Louis , Roquebert Pierre‐Olivier , Macaluso Gilles , Commeau Philippe , Comet Bertrand , Lafont Antoine , Camoin Laurence , Walter Ulrich , Eigenthaler Martin
Published: June 2003

We carried out a prospective evaluation of a new vasodilator‐stimulated phosphoprotein (VASP) phosphorylation assay in order to detect patients with high‐risk coronary subacute stent thrombosis (SAT) despite thienopyridine regimen. Twenty healthy donors (group 1) without any medication were compared to 16 stented patients (group 2) treated by ticlopidin or clopidogrel initiated 2 days before stenting and aspirin (250 mg/day). No difference in platelet reactivity was noted between group 1 and group 2 treated only with aspirin (72.00% ± 4.17% vs. 69.73% ± 5.62%, respectively; P = NS). Significant differences were found between patients of group 2 treated with aspirin alone (69.73% ± 5.62%), after 2.0 days (60.14% ± 9.60%; P < 0.05), and after 4.8 ± 1.3 days (48.37% ± 11.19%; P < 0.05) with thienopyridine‐aspirin. Among 1,684 consecutive stented patients, 16 patients who presented an SAT (group 3) were compared with 30 other stented patients free of SAT (group 4). We found a significant difference between group 3 (63.28% ± 9.56%) and group 4 (39.80% ± 10.9%; P < 0.0001). VASP phosphorylation analysis may be useful for the detection of coronary SAT. Cathet Cardiovasc Intervent 2003;59:295–302. © 2003 Wiley‐Liss, Inc.
Simultaneous treatment of native coarctation of the aorta combined with patent ductus arteriosus using a covered stent
Authors: Sadiq Masood , Malick Nadeem Hayat , Qureshi Shakeel A.
Published: June 2003

A 19‐year‐old girl with coarctation of the aorta and patent ductus arteriosus underwent simultaneous treatment of native coarctation and closure of ductus arteriosus using a covered Cheatham‐Platinum stent. This technique may be used as an alternative to other forms of interventional therapy or surgery for this combination of lesions in adolescents and adults. Cathet Cardiovasc Intervent 2003;59:387–390. © 2003 Wiley‐Liss, Inc.
Angioplasty for chronic total occlusion by using tapered‐tip guidewires
Authors: Saito Shigeru , Tanaka Shinji , Hiroe Yoshitaka , Miyashita Yusuke , Takahashi Saeko , Satake Shutaro , Tanaka Kazushi
Published: June 2003

Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is still technically challenging. The use of tapered‐tip guidewires in these lesions may improve the success rate of PCI. In order to avoid the needless radiation exposure or contrast consumption, we have to determine a guideline for the termination of procedures in these lesions. We retrospectively analyzed the data of 182 patients between April 1997 and December 1999 (phase 1) and 80 patients between January and August 2001 (phase 2) who underwent angioplasty for CTO lesions ≥ 3 months. There were no significant differences in clinical or lesion characteristics except the use of tapered‐tip guidewires. Tapered‐tip guidewires were used in 60% of patients in phase 2 period but no patients in phase 1 period. The overall success rate of PCI was improved from 67% in phase 1 to 81% in phase 2 (P = 0.019). In the phase 2 period, the success rate was higher in tapered‐type occlusion (P = 0.002) and shorter length of occlusion (P = 0.004). Total procedure time was 46 ± 17 min and total volume of contrast dye was 180 ± 63 ml. The success rate was higher in patients treated by transradial coronary intervention (TRI) than transfemoral coronary intervention (89% vs. 64%; P = 0.008). The use of tapered‐tip guidewires can improve the success rate of PCI in CTO lesions. The following guideline for the termination of the procedures is reasonable: time from arterial access to successful penetration of a guidewire through occlusion ≤ 30 min; total procedure time ≤ 90 min; and total dye volume ≤ 300 ml. TRI can achieve a high success rate even in CTO lesions provided that the case selection is adequate. Cathet Cardiovasc Intervent 2003;59:305–311. © 2003 Wiley‐Liss, Inc.
Utility of a 0.014″ pressure‐sensing guidewire to assess renal artery translesional systolic pressure gradients
Authors: Colyer William R. , Cooper Christopher J. , Burket Mark W. , Thomas William J.
Published: June 2003

Renal ischemia due to renal artery stenosis (RAS) is an important cause of secondary hypertension and renal insufficiency. Several methods are available to diagnose RAS; however, the identification of clinically significant lesions remains problematic. We measured the translesional systolic pressure gradient (TSPG) with a 4 Fr catheter and a 0.014″ pressure‐sensing guidewire and compared these data to angiographic findings. The TSPG obtained by pressure‐sensing guidewire correlated more strongly with angiographic minimal lumen diameter (r2 = 0.801) than those obtained by 4 Fr catheter (r2 = 0.360). The relationship of TSPG with percent stenosis was not strong, regardless of the method used (r2 = 0.228 with pressure‐sensing guidewire, 0.358 with 4 Fr catheter). Using a 0.014″ pressure‐sensing guidewire is effective for assessing TSPG and provides a more reliable indication of stenosis significance than use of a 4 Fr catheter. Cathet Cardiovasc Intervent 2003;59:372–377. © 2003 Wiley‐Liss, Inc.
The VB‐1 catheter: An improved catheter for difficult‐to‐engage internal mammary artery grafts
Authors: Warner John J. , Gehrig Thomas R. , Behar Victor S.
Published: June 2003

As patients with prior coronary artery bypass grafting age, internal mammary artery grafts are more frequently encountered in the cardiac catheterization laboratory. Angiography and interventions involving these grafts are often difficult, particularly in patients with tortuous subclavian anatomy and/or proximal internal mammary artery origins. We describe a new catheter shape, the Cordis Behar Internal Mammary, VB‐1, which allows selective intubations of both right and left internal mammary arteries that are not possible with conventional catheters. Cathet Cardiovasc Intervent 2003;59:361–365. © 2003 Wiley‐Liss, Inc.
Retrograde dilatation of a totally occluded ostial left anterior descending artery from saphenous venous graft in the descending aorta following stenting of the aorto‐ostial graft restenosis in a patient with left main coronary artery stenosis
Authors: Cheng Nye‐Jan , Chang Chi‐Jen , Ho Wan‐Jing
Published: June 2003

Treatment of native coronary and saphenous vein graft aorto‐ostial stenoses with balloon angioplasty is associated with lower procedural success rates and more complications compared with percutaneous transluminal coronary angioplasty of nonostial stenoses. A patient with totally occluded ostial left anterior descending artery at ostium following aortocoronary bypass developed ostial stenosis at the saphenous vein graft in the descending aorta. The aorto‐ostial lesion of saphenous vein graft was successfully stented and was followed by retrograde dilatation of the left anterior descending artery, and the totally occluded ostial lesion was reopened. The ischemia was eliminated following the procedure. Cathet Cardiovasc Intervent 2003;59:357–360. © 2003 Wiley‐Liss, Inc.
Percutaneous coronary intervention‐associated nephropathy foreshadows increased risk of late adverse events in patients with normal baseline serum creatinine
Authors: Lindsay Joseph , Apple Sue , Pinnow Ellen E. , Gevorkian Natalie , Gruberg Luis , Satler Lowell F. , Pichard Augusto D. , Kent Kenneth M. , Suddath William , Waksman Ron
Published: June 2003

In patients with chronic renal insufficiency, further decline in renal function (DRF) after percutaneous coronary intervention (PCI) is accompanied not only by adverse in‐hospital events but also by increased risk of mortality and myocardial infarction at 1 year. This analysis was undertaken to determine if patients with normal renal function who develop DRF after PCI have a comparable increase in risk of death and myocardial infarction at 1 year, and whether this risk is independent of in‐hospital complications (death, myocardial infarction, urgent coronary artery bypass grafting). We performed a retrospective analysis of all patients from a single center who underwent successful PCI with no major in‐hospital complications who had pre‐PCI serum creatinine (SCr) ≤ 1.2 mg/dl and no history of renal insufficiency. One‐year follow‐up was obtained by mail or telephone. There were 5,967 consecutive patients who met the inclusion criteria. Of these, 208 (3.5%) developed DRF (an increase in SCr ≥ 50% of baseline). They were more likely to be older, female, non‐Caucasian, diabetic and/or hypertensive. They reported more prior cerebral or peripheral vascular events. They had undergone more complex PCI and were exposed to more radiographic contrast than the 96.5% who did not develop DRF. After adjustment for baseline variables, DRF remained an independent predictor of 1‐year mortality, myocardial infarction, and target vessel revascularization. In patients without prior renal impairment, DRF post‐PCI is rare but is associated with an increased risk of late adverse cardiac events similar to that in chronic renal insufficiency patients. Cathet Cardiovasc Intervent 2003;59:338–343. © 2003 Wiley‐Liss, Inc.
Transcatheter closure of aortopulmonary window using Amplatzer device
Authors: Naik Guruprasad D. , Chandra V. Subash , Shenoy Anand , Isaac B.C. , Shetty G.G. , Padmakumar P. , Jayranganath M.
Published: June 2003

Two cases of transcatheter closure of aortopulmonary window (APW) using an Amplatzer duct occluder in one and a septal occluder device in the second are described. Transcatheter device closure of APW should be considered when anatomy is favorable in terms of location and size of the defect with absence of associated anomalies. Cathet Cardiovasc Intervent 2003;59:402–405. © 2003 Wiley‐Liss, Inc.
Obstinate thrombosis during percutaneous coronary intervention in a case with heparin‐induced thrombocytopenia with thrombosis syndrome successfully treated by argatroban anticoagulant therapy
Authors: Sakai Katsuyuki , Oda Hirotaka , Honsako Akihiro , Takahashi Kazuyoshi , Miida Tutomu , Higuma Norio
Published: June 2003

We describe a case of massive coronary thrombus after the coronary stenting due to heparin‐induced thrombocytopenia with thrombosis syndrome (HITTS). Only argatroban was able to resolve the thrombus. This is the first case in which argatroban successfully treated massive thrombus during percutaneous coronary intervention in a patient with HITTS. Cathet Cardiovasc Intervent 2003;59:351–354. © 2003 Wiley‐Liss, Inc.
Impact of intravascular ultrasound‐guided stenting on long‐term clinical outcome: A meta‐analysis of available studies comparing intravascular ultrasound‐guided and angiographically guided stenting
Authors: Casella Gianni , Klauss Volker , Ottani Filippo , Siebert Uwe , Sangiorgio Pietro , Bracchetti Daniele
Published: June 2003

To date, only a few studies have compared the clinical efficacy of intracoronary ultrasound (IVUS)‐guided to angiographically guided stenting. Furthermore, it is not yet known whether the lower restenosis rate shown with the former strategy would translate into a substantial clinical advantage. Therefore, the aim of the present investigation was to improve the level of evidence of these studies by means of a formal meta‐analysis. Nine studies were considered suitable for analysis. Odds ratios (ORs) were calculated for 6‐month clinical follow‐up. Primary endpoint was a composite of death and nonfatal myocardial infarction (MI), as considered in every single study. Secondary endpoints were major adverse cardiac events (MACEs), according to single study definition, the individual cardiac events, as well as several pre‐ and postprocedure and follow‐up angiographic parameters. Overall, 2,972 patients were included. At 6 months, the OR for death and nonfatal MI was 1.13 (95% CI = 0.79–1.61; P = 0.5) for patients with IVUS‐guided stenting. However, patients with IVUS‐guided stenting had less target vessel revascularizations (OR = 0.62; 95% CI = 0.49–0.78; P = 0.00003) and MACEs (OR = 0.79; 95% CI = 0.64–0.98; P = 0.03) compared to angiographically guided stenting. In addition, subjects treated with IVUS‐guided stenting had significantly less binary restenosis (OR = 0.75; 95% CI = 0.60–0.94; P = 0.01). The present meta‐analysis demonstrates that IVUS‐guided stenting implantation has a neutral effect on long‐term death and nonfatal MI compared to an angiographic optimization. However, IVUS‐guided stenting significantly lowers 6‐month angiographic restenosis and target vessel revascularizations. Whether these benefits could be very helpful when dealing with lesions at high risk for restenosis is still an issue. Cathet Cardiovasc Intervent 2003;59:314–321. © 2003 Wiley‐Liss, Inc.
Staged rehabilitation of ductal origin of the left pulmonary artery in an infant fallot's tetralogy
Authors: Peirone Alejandro , Lee Kyong‐Jin , Yoo Shi‐Joon , Musewe Norman , Smallhorn Jeffrey , Benson Lee
Published: June 2003

Isolation of a branch pulmonary artery from ductal closure is an unusual finding in patients with tetralogy of Fallot. A case report of a newborn is presented where the closing arterial duct was balloon‐dilated and stented to reestablish blood supply to the affected lung as a strategy of improving systemic saturations and promoting the growth of the hiliar branch pulmonary artery. Five months after the initial palliation, complete surgical repair with stent removal was successfully achieved. Cathet Cardiovasc Intervent 2003;59:392–395. © 2003 Wiley‐Liss, Inc.
Acute coronary syndrome secondary to a complex lesion within a stent implanted over 6 years previously
Authors: Baker David M. , Osborn Larry A.
Published: June 2003

We report on an acute coronary syndrome resulting from a complex severe lesion within a stent over 6 years after implantation. This may represent an uncommon long‐term limitation of coronary artery stenting. Cathet Cardiovasc Intervent 2003;59:366–368. © 2003 Wiley‐Liss, Inc.
Large left atrial thrombus formation despite warfarin therapy after device closure of a patent foramen ovale
Authors: Cetta Frank , Arruda M. Janine , Graham Lynn C.
Published: June 2003

Appropriate anticoagulation after transcatheter device placement is controversial. Patients with no history of thromboembolism or neurologic event typically receive antiplatelet therapy for several months while the device endothelializes. For patients with a history of stroke, there are no established guidelines for postdevice anticoagulation. Most patients receive warfarin, antiplatelet therapy, or a combination. Thrombus formation after transcatheter device placement has been reported for most commercially available devices. We describe a patient who developed a left atrial thrombus after closure of a patent foramen ovale with a CardioSEAL device. The patient had a normal hypercoaguable laboratory evaluation prior to device placement. Thrombosis occurred despite warfarin therapy before and after device placement. The patient's international normalized ratio was checked every 2 weeks after device placement and ranged between 2.0 and 2.8. She had no clinical arrhythmia during this time period. The left atrial thrombus was detected on routine follow‐up transthoracic echocardiogram performed 6 months after device deployment. A subsequent transesophageal echocardiogram demonstrated no residual shunt, appropriate positioning of the device, flat against the septum, and a 1 × 2 cm thrombus attached to the superior and posterior left atrial arm near the junction with the native septum. A fluoroscopic image demonstrated no arm fractures. The device and thrombus were subsequently removed at surgery without complication. This case is perplexing in that the patient received appropriate anticoagulation had a negative hypercoaguable work‐up, no residual shunt, and a well‐positioned device. Cathet Cardiovasc Intervent 2003;59:396–398. © 2003 Wiley‐Liss, Inc.
Stent deployment failure: Reasons, implications, and short‐ and long‐term outcomes
Authors: Nikolsky Evgenia , Gruberg Luis , Pechersky Sirush , Kapeliovich Michael , Grenadier Ehud , Amikam Shlomo , Boulos Monther , Suleiman Mahmoud , Markiewicz Walter , Beyar Rafael
Published: June 2003

Stents have revolutionized percutaneous coronary interventions (PCI), impacting on both acute and long‐term results. However, despite improvements in stent design, stent deployment failure is not an unusual event. The aim of the present study was to assess the frequency and causes of stent deployment failure, as well as the outcome of these patients. Between 1997 and 2001, a total of 3,537 patients underwent stent‐assisted PCI and delivery of 5,275 stents was attempted. In the majority of patients (118; 78.1%), stenting was performed as provisional; in the remaining 33 (21.8%) as a bailout procedure. A total of 175 (3.3%) stents in 151 (4.3%) patients failed. Failure to deliver the stent to the lesion site was the main cause in 139 patients (92%) and failure either to expand adequately the stent or premature disengagement of the stent from the balloon in only 12 patients (8%). Peripheral stent embolization occurred in 10 (0.3%) patients. Deployment of a different stent in place of the failed one was attempted in 122 patients and was successful in the majority (108; 88.5%). In‐hospital major adverse cardiac events were observed in six patients (4%): three patients required emergency coronary artery bypass surgery, two had a myocardial infarction (MI), and one patient underwent urgent repeat coronary intervention. At a mean follow‐up of 32.2 ± 17.7 months, 22 major adverse cardiac event occurred in 17 patients (11.2%): 1 cardiac death, 3 patients had an MI, and 18 patients required target vessel revascularization. One‐year event‐free survival for the whole group was 91.2%. Patients with stent embolization did not have any major adverse cardiac or vascular events. Thus, the rate of stent deployment failure in our series was 3.3%, mainly due to failure to deliver the stent to the site. Another stent was successfully deployed in the majority of cases and these patients had favorable short‐ and long‐term outcomes. Cathet Cardiovasc Intervent 2003;59:324–328. © 2003 Wiley‐Liss, Inc.
Improvement of protein‐losing enteropathy by coil embolization of the left azygos vein
Authors: Ishii Akira , Fuse Shigeto , Kubo Noriaki , Hatakeyama Kinya , Takamuro Motoki , Tomita Hideshi , Tsutsumi Hiroyuki
Published: June 2003

We report a 17‐year‐old boy with double‐outlet right ventricle, atrioventricular septal defect, pulmonary stenosis, and persistent left superior vena cava who developed a protein‐losing enteropathy, which was cured by coil embolization of the left azygos vein, thereby interrupting the vein‐to‐vein shunt. Cathet Cardiovasc Intervent 2003;59:399–401. © 2003 Wiley‐Liss, Inc.
Use of a percutaneous vascular suture device for closure of an inadvertent subclavian artery puncture
Authors: Fraizer Michael C. , Chu William W. , Gudjonsson Thorbjorn , Wolff Matthew R.
Published: June 2003

A well‐known complication of central venous catheterization is inadvertent arterial sheath placement. Sheath removal from noncompressible arteries has the potential for severe complications. We report a case of inadvertent subclavian arterial sheath placement during an attempted internal jugular venous catheterization. This was successfully removed using a percutaneous vascular suture device. Cathet Cardiovasc Intervent 2003;59:369–371. © 2003 Wiley‐Liss, Inc.
Endovascular stent implantation in patients with stenotic aortoarteriopathies: Early and medium–term results
Authors: Siwik Ernest S. , Perry Stanton B. , Lock James E.
Published: June 2003

Data regarding stent implantation for stenotic aortoarteriopathy (SAA) are incomplete. We report on nine patients with this rare syndrome who underwent arterial stent implantation. Indications, results, and complications for patients with SAA were reviewed. Nine patients underwent 11 procedures. Twenty‐two stents were implanted in the aorta or brachiocephalic vessels. Five patients had diffuse stenoses, three patients had middle aortic syndrome, and one patient had thoracic and abdominal coarctation. Associated diagnoses included Williams syndrome (2), neurofibromatosis (2), Takayasu's (1), and congenital rubella (1). Median gradient was 60 mm Hg (20–140 mm Hg). Poststent gradient was 15 mm Hg (0–60 mm Hg; P < 0.001). Additional stents were implanted in two patients and five underwent stent redilation. Two patients (22%) were found to have aneurysm formation. Stent implantation effectively provides gradient relief in SAA. Gradient reduction persists or is amenable to redilation. Importantly, however, uncomplicated stent implantation does not preclude aneurysm formation and may be more common than in traditional patient groups. Cathet Cardiovasc Intervent 2003;59:380–386. © 2003 Wiley‐Liss, Inc.
The Genesis stent: A new low‐profile stent for use in infants, children, and adults with congenital heart disease
Authors: Forbes Thomas J. , Rodriguez‐Cruz Edwin , Amin Zahid , Benson Lee N. , Fagan Thomas E. , Hellenbrand William E. , Latson Larry A. , Moore Phillip , Mullins Charles E. , Vincent Julie A.
Published: June 2003

Placement of intravascular stents that can reach adult size in infants and smaller children has been limited by the large profile and poor flexibility of currently available stents. In vitro and in vivo testing of the Genesis stent was performed to evaluate crimpability, predeployment flexibility, and radial strength. Comparisons were made to the Palmaz iliac and IntraStent (IS) LD stents. Nine physicians placed 30 Genesis stents in swine pulmonary and systemic arteries to evaluate stent deliverability/crimpability. Two swine were recovered and underwent a second catheterization 8 weeks later, where the stents (n = 8) were reexpanded to maximal size. Angiographic and intravascular ultrasound (IVUS) assessments were performed. In vitro testing revealed the Genesis stent to have superior crimpability, flexibility, and comparable radial strength to the Palmaz iliac stent, and superior crimpability and radial strength and comparable flexibility to the IS LD series. During in vivo testing, the physicians graded the Genesis stent superior to the Palmaz stent regarding crimpability and deliverability, and superior to the IS LD stent in regard to crimpability, and comparable to or superior in deliverability. In the chronic animals, the Genesis stent was expanded up to maximal diameter 8 weeks following implantation. Angiographic and IVUS revealed no fractures no in‐stent restenosis. The Genesis stent can be easily delivered through smaller sheaths, which will facilitate their use in infants and smaller children with vascular stenosis. Cathet Cardiovasc Intervent 2003;59:406–414. © 2003 Wiley‐Liss, Inc.
Transcatheter interventions across an inferior vena cava filter
Authors: Rhodes John F. , Miller Stephen G. , Lane Geoffrey K. , Latson Larry A.
Published: June 2003

Patients who suffer from an embolic event often undergo placement of an inferior vena caval filter. Few data are available regarding treatment of this patient population with concurrent right‐to‐left shunting across an atrial communication. We report four cases of transcatheter device closure of an atrial communication across an inferior vena cava filter. Cathet Cardiovasc Intervent 2003;59:333–337. © 2003 Wiley‐Liss, Inc.