bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stent fracture, an incidental finding or a significant marker of clinical in‐stent restenosis?
Authors: Shaikh Fareed , Maddikunta Rajesh , Djelmami‐Hani Mohamed , Solis Joaquin , Allaqaband Suhail , Bajwa Tanvir 
Published: March 2008

AbstractBackground:The predictors and clinical significance for stent fracture (SF) in drug‐eluting stents (DES) remain unknown. We identified procedural factors leading to SF and its clinical consequences in DES.Methods:Percutaneous coronary interventions were performed on 3,920 patients with DES over 12 months. In‐stent restenosis (ISR) of DES was observed in 188 cases with 121 cases (64.4%) receiving a sirolimus‐eluting stent (SES) and 67 (35.6%) a paclitaxol‐eluting stent (PES).Results:SF was identified in 35 (18.6%) of the 188 cases. The 35 cases were then compared with 153 cases of ISR without angiographic evidence of SF. SF was identified in 29 (23.9%) SES compared with 6 (9.0%) in PES (P < 0.05). With univariate analysis, additional factors associated with SF included longer mean stented segment length, male gender, overlapping stents, vessel segment angulation >75°, and more stents (all P < 0.05). With multivariate adjustment, three factors, i.e., stenting on a bend >75° (OR = 13.8, 95%CI 3.7 to 51; P < 0.001), SES (OR = 4.1, 95%CI 1.3 to 13.4; P < 0.018) and overlapping stented segments (OR = 3.9, 95%CI 1.1 to 14.1; P < 0.041) were statistically significant independent predictors of SF while larger stent diameter was protective (OR = 0.14, 95%CI 0.04 to 0.70; P < 0.017).Conclusion:SF proved to be associated with angiographically‐documented clinical ISR. Although the exact mechanism is unknown, factors that appear to play a negative role in SF include vessel tortuosity, use of SES and overlapping stents. Larger stent diameter was protective. Further studies are needed to better define the factors important in the mechanism of SF. © 2008 Wiley‐Liss, Inc.
Survival advantage in Medicare patients receiving drug‐eluting stents compared with bare metal stents: Real or artefactual?
Authors: Wang Fen Wei , Uretsky Barry F. , Freeman Jean L. , Zhang Dong , Giordano Sharon H. , Goodwin James S. 
Published: March 2008

AbstractBackground:Concerns have been raised regarding late mortality, particularly from late stent thrombosis, from drug‐eluting stents (DES). Randomized clinical trials have shown that DES decrease restenosis but do not decrease mortality compared with bare metal stents (BMS). These studies utilized well‐defined clinical and angiographic subsets. In the “real world” drug‐eluting stents are used in a much broader crosssection of patients. We evaluated mortality in the first year after implantation of DES, specifically the sirolimus‐eluting stent (SES), Cypher vs. BMS in “real world” older patients using the Medicare claims database.Methods and Results:Data for the years 2002 (n = 6,890; pre‐DES) and 2003 (n = 7,566; first year of DES use) (May through December of each year) were analyzed. BMS and DES groups had similar baseline characteristics except for small but significant differences with BMS patients being somewhat older, having more males and African Americans, and a higher percentage of peripheral artery disease and heart failure while DES patients had a higher percentage of diabetics and patients with prior revascularization procedures. A significant improvement in mortality using both unadjusted and adjusted analyses was observed for DES (6.0% vs. 11.4%, P < 0.0001; hazard ratio 1.98, 95% CI 1.68–2.34). Controlling for comorbidity, extent of disease, and other chararacteristics by multivariable analysis or by propensity analysis had little impact on these results. On the other hand, there was no change in overall mortality in all stented patients in 2003 compared with all stented patients in 2002.Conclusion:An observed mortality benefit for DES compared with BMS in 2003 was observed, demonstrating the safety of DES, and suggesting the possibility of superiority in outcome in older patients with DES vs. BMS. However, the lack of improved survival from 2002 to 2003 in all stented patients suggests that the mortality advantage with DES finding may be due to unidentified selection biases. Our data suggest that DES in the Medicare population is as safe as, and possibly superior, to BMS for survival over the first year after implantation. © 2008 Wiley‐Liss, Inc.
The impact of interruption of anomalous systemic arterial supply on scimitar syndrome presenting during infancy
Authors: Uthaman Babu , Abushaban Lulu , Al‐Qbandi Mustafa , Rathinasamy Jebaraj 
Published: March 2008

AbstractObjectives:We sought to evaluate the impact of interruption of anomalous systemic arterial supply (ASAS) on clinical course and management outcome of scimitar syndrome (SS) presenting during infancy.Background:No systematic study has been reported so far on this subject, although there are conflicting sporadic reports indicating variable effect.Methods:Out of 23 children diagnosed to have SS during the past 25 years, 16 symptomatic infants had ASAS. After interrupting ASAS (coil embolization ‐14, surgical ligation ‐2), they were prospectively followed up to define their clinical course and management outcome.Results:All 16 infants had sizable ASAS and 9 had variable scimitar vein (SV) stenosis. Fifteen (94%) had pulmonary hypertension and significant left to right shunt. Post intervention, there was variable reduction of shunt in 14 and pulmonary artery pressure in 15 cases. All showed varying clinical improvement. One died of septicemia shortly afterwards. Definitive surgery was deferred for optimal results in seven children for a mean period of 8 months (range 1 month to 3 years). Remaining eight children did not require definitive surgery. One among them had closure of stenosed partial SV by Amplatzer duct occluder (“physiologic correction”). Two children on short term and six children on long term follow‐up (mean 5.2 years; range 3.3–10.3 years) are doing well.Conclusion:Interruption of ASAS helps to avoid or defer definitive surgery for SS during infancy. Therefore, we recommend coil embolization of ASAS as initial palliation, and long term surveillance to assess need for further intervention. © 2008 Wiley‐Liss, Inc.
Assessment of operability of congenital cardiac shunts with increased pulmonary vascular resistance
Authors: Viswanathan Sangeetha , Kumar R. Krishna 
Published: March 2008

AbstractPatients with large left to right shunts as a result of congenital heart disease can develop changes in pulmonary vasculature that are initially reversible. It is critical in these patients to determine whether closure of the defect would reverse some of the changes in the pulmonary vasculature. A comprehensive clinical and noninvasive evaluation often allows classification in the extremes of the spectrum, but for borderline situations, cardiac catheterization is traditionally undertaken. It is important to obtain invasive data meticulously and efficiently recognizing that the numbers only offer a snapshot and may not be representative of the usual physiologic state of the patient. There are, in addition, several caveats that need to be considered while calculating flows and resistances in these patients. Currently a holistic approach that combines clinical, noninvasive, and invasive data may be the only realistic way of making a decision regarding operability in this challenging group of patients with shunt lesions and elevated pulmonary vascular resistance. © 2008 Wiley‐Liss, Inc.
Percutaneous implantation of the first repositionable aortic valve prosthesis in a patient with severe aortic stenosis
Authors: Buellesfeld Lutz , Gerckens Ulrich , Grube Eberhard 
Published: March 2008

AbstractObjectives and Background:Percutaneous aortic valve replacement is a new less‐invasive alternative for high‐risk surgical candidates with aortic stenosis. However, the clinical experience is still limited, and the currently available ‘first‐generation devices’ revealed technical shortcomings, such as lack of repositionability and presence of paravalvular leakages. We report the first‐in‐man experience with the new self‐expanding Lotus™ Valve prosthesis composed of a nitinol frame with implemented bovine pericardial leaflets which is designed to address these issues, being repositionable and covered by a flexible membrane to seal paravalvular gaps. We implanted this prosthesis in a 93‐year old patient presenting with severe symptomatic aortic stenosis (valve area: 0.6 cm2). Surgical valve replacement had been declined due to comorbidities.Methods and Results:We used a retrograde approach for insertion of the 21‐French Lotus catheter loaded with the valve prosthesis via surgical cut‐down to the external iliac artery. Positioning of the valve was guided by transesophageal echo and supra‐aortic angiograms. The prosthesis was successfully inserted and deployed within the calcified native valve. Echocardiography immediately after device deployment showed a significant reduction of the transaortic mean pressure gradient (32 to 9 mmHg; final valve area 1.7 cm2) without evidence of residual aortic regurgitation. The postprocedural clinical status improved from NYHA‐IV to NYHA‐II. These results remained unchanged up to the 3 month follow‐up.Conclusions:Successful percutaneous aortic valve replacement can be performed using the new self‐expanding and repositionable Lotus valve for treatment of high‐risk patients with aortic valve stenosis. Further studies are mandatory to assess device safety and efficacy in larger patient populations. © 2008 Wiley‐Liss, Inc.
Carotid artery dissection: Endovascular treatment. Report of 12 patients
Authors: Fava Mario , Meneses Luis , Loyola Soledad , Tevah Jose , Bertoni Hernan , Huete Isidro , Mellado Patricio 
Published: March 2008

AbstractObjective:The purpose of this article is to report our experience with endovascular treatment of internal carotid artery (ICA) dissection with the use of stents.Background:Carotid Dissection is an important cause of ischemic stroke in young and middle‐aged patients. There are some patients in whom invasive management is recommended.Methods:Twelve patients (eight females, four males), mean age of 50 years (range 35–80 years) with ICA dissection, were treated with the endovascular approach during a 24‐month period. Patients included in this study underwent magnetic resonance (MR) and digital subtraction angiography (DSA) for diagnosis. Over this time period, 162 patients with ICA dissections were seen at our institution. Indications for endovascular treatment were: recurrent ischemic events despite adequate anticoagulant treatment in seven cases, contraindication to anticoagulation in four cases, and one case with significant mismatch between diffusion and perfusion weighted MR. Eleven dissections were spontaneous and one was traumatic. The follow‐up was performed clinically with Doppler ultrasound (US) and MR at 6, 12, and 24 months.Results:Stent deployment was successful in all cases. Acute symptoms were resolved in 66.7% of patients. No patients deteriorated their neurological status. There were no new clinical events, stent stenosis or occlusion on 24 months follow‐up.Conclusion:Our results showed an excellent clinical outcome of the treated patients. This suggests promising results with the use of endovascular treatment in selected patients. © 2008 Wiley‐Liss, Inc.
State of the art: Management of iliac artery aneurysmal disease
Authors: Michael Bacharach J. , Slovut David P. 
Published: March 2008

AbstractAlthough relatively uncommon, isolated iliac artery aneurysms are associated with significant risk of rupture and death. Clinical presentation can be confusing and ultrasound or CT imaging is paramount in establishing the diagnosis and anatomical extent of disease. Important considerations prior to intervention include determination of proximal neck, involvement of the internal iliac artery, and status of the contralateral internal iliac artery. Endovascular repair has evolved as the first choice treatment option for patients with anatomically suitable iliac artery aneurysms. In uncommon circumstances when endovascular treatment may result in significant pelvic ischemia or the primary symptoms are related to extrinsic compression of adjacent structures, surgical repair may be the preferred option. © 2008 Wiley‐Liss, Inc.
Optimal treatment of renal artery in‐stent restenosis: Repeat stent placement versus angioplasty alone
Authors: N'Dandu Zola M. , Badawi Ramy A. , White Christopher J. , Grise Mark A. , Reilly John P. , Jenkins J. Stephen , Collins Tyrone J. , Ramee Stephen R. 
Published: March 2008

AbstractObjective:We investigated whether repeat renal artery stent placement compared with treatment with balloon angioplasty alone results in better patency in patients presenting with renal artery in‐stent restenosis (ISR).Background:Although stent placement for renal artery stenosis has been demonstrated to be superior to balloon angioplasty for “de novo” renal artery lesions, the optimal therapy for ISR remains unclear.Methods:Between January 1997 and August 2006, 34 consecutive patients (41 renal arteries) with ISR were treated at the discretion of the operator with balloon angioplasty or repeat stent placement. Quantitative angiography was performed before and immediately after intervention and at follow‐up. Angiographic follow‐up was obtained for clinical indications in 75% of lesions and routine noninvasive follow‐up imaging was obtained in 95% of lesions.Results:Repeat renal artery stent placement demonstrated improved patency compared with balloon angioplasty alone with a 58% reduction in recurrent ISR (29.4% vs. 71.4%, P = 0.02) and a 30% reduction in follow‐up diameter stenosis (41% vs. 58.2%, P = 0.03). The repeat stent group also had better secondary patency (P = 0.05) and a greater freedom from repeat ISR (P = 0.01) when compared with balloon angioplasty alone. There was a trend favoring repeat stent placement for cumulative freedom from target vessel revascularization (TVR) (P = 0.08).Conclusions:Repeat stent placement appears to result in superior patency compared with balloon angioplasty alone for the treatment of renal ISR. © 2008 Wiley‐Liss, Inc.
Synthesis of Antiproliferative Cephalotaxus Esters and Their Evaluation against Several Human Hematopoietic and Solid Tumor Cell Lines: Uncovering Differential Susceptibilities to Multidrug Resistance
Authors: Eckelbarger Joseph D. , Wilmot Jeremy T. , Epperson Matthew T. , Thakur Chandar S. , Shum David , Antczak Christophe , Tarassishin Leonid , Djaballah Hakim , Gin David Y. 
Published: March 2008

AbstractDeoxyharringtonine (2), homoharringtonine (3), homodeoxyharringtonine (4), and anhydroharringtonine (5) are reported to be among the most potent members of the antileukemia alkaloids isolated from the Cephalotaxus genus. Convergent syntheses of these four natural products are described, each involving novel synthetic methods and strategies. These syntheses enabled evaluation of several advanced natural and non‐natural compounds against an array of human hematopoietic and solid tumor cells. Potent cytotoxicity was observed in several cell lines previously not challenged with these alkaloids. Variations in the structure of the ester chain within this family of alkaloids confer differing activity profiles against vincristine‐resistant HL‐60/RV+, signalling new avenues for molecular design of these natural products to combat multi‐drug resistance.
Bcl‐xL antisense oligonucleotide and cisplatin combination therapy extends survival in SCID mice with established mesothelioma xenografts
Authors: Littlejohn James E. , Cao Xiaobo , Miller Steven D. , Ozvaran Mustafa K. , Jupiter Daniel , Zhang Lidong , Rodarte Charles , Smythe W. Roy 
Published: March 2008

AbstractBcl‐xL functions as a dominant regulator of apoptotic cell death and is implicated in chemotherapeutic resistance of malignant pleural mesothelioma (MPM). Mesothelioma cell lines demonstrate increasing levels of Bcl‐xL as resistant clones are selected invitro. Moreover, upon introduction of antisense oligonucleotides specific to Bcl‐xL mRNA, MPM cells are sensitized to chemotherapeutic agents. Here we describe the therapeutic effects of a novel combination therapy, Bcl‐xL antisense oligonucleotide (ASO 15999) and cisplatin, on mesothelioma cell lines in vitro and invivo; in addition, efficacy of ASO 15999 in decreasing tumor load as well as its effect on survival in an animal model. Finally, we initiated preliminary toxicity studies involved with intraperitoneal (IP) injections of ASO 15999 into mice. This novel combination, with doses of cisplatin four times below established IC50 levels, significantly decreased viability of MPM cell lines after 48 hr. The growth of established mouse flank human tumor xenografts was reduced with intra‐tumor administration of ASO 15999. Local spread and development of IP xenografts was reduced with treatments of ASO alone, and survival of mice afflicted with these xenografts was prolonged after administration of ASO alone and ASO 15999 + cisplatin combination therapy. These findings suggest that ASO 15999 sensitizes MPM cell lines to the toxic effects of cisplatin. ASO 15999 induced reduction of Bcl‐xL is effective in slowing the progression of human mesothelioma cell lines both in vitro and in vivo. More notably, the combination of Bcl‐xL ASO and cisplatin extends survival in an orthotopic tumor xenograft model. © 2008 Wiley‐Liss, Inc.
Biomechanical and immunohistochemical properties of meniscal cartilage after high hydrostatic pressure treatment
Authors: Naal Florian D. , Schauwecker Johannes , Steinhauser Erwin , Milz Stefan , von Knoch Fabian , Mittelmeier Wolfram , Diehl Peter 
Published: March 2008

AbstractMeniscal allograft processing procedures, in particular gamma irradiation, deteriorate the biomechanical and biological properties of the transplanted tissue. High hydrostatic pressure (HHP) treatment, widely used in food technology to inactivate microorganisms while preserving natural compounds, might serve as a gentle alternative to gamma irradiation in the processing of meniscal allografts. We therefore investigated the effects of HHP treatment on the biomechanical and immunohistochemical properties of meniscal cartilage. Specimens of bovine menisci were treated with HHP for 10 min (20°C) at 300 MPa and 600 MPa. Untreated control samples were left at room temperature and ambient pressure. We performed repetitive cycling indentation‐tests to assess the biomechanical properties—in particular the viscoelastic behavior—of HHP treated and untreated meniscal specimens. Immunohistochemical analysis for collagens type I, II, and III and for the proteoglycans versican, aggrecan and for link‐protein was performed by immunolabeling cross‐sections of untreated and at 600 MPa HHP treated specimens. Comparing untreated and HHP treated meniscal specimens there were no significant differences for all tested biomechanical parameters. All cross‐sections of untreated and HHP treated specimens stained positive for the collagens and proteoglycans. We demonstrated that meniscal cartilage can be treated by HHP at levels as high as 600 MPa without affection of the biomechanical and immunochistochemical properties. Therefore, HHP treatment might serve as a gentle alternative to gamma irradiation in the processing of meniscal allografts. Further research is necessary to verificate the present results in vivo. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008
Plasma surface modification of poly(D,L‐lactic acid) as a tool to enhance protein adsorption and the attachment of different cell types
Authors: Alves C. M. , Yang Y. , Marton D. , Carnes D. L. , Ong J. L. , Sylvia V. L. , Dean D. D. , Reis R. L. , Agrawal C. M. 
Published: March 2008

AbstractWe have studied the influence of oxygen radio frequency glow discharge (RfGD) on the surface and bulk properties of poly(D,L‐lactic acid) (PDLLA) and the effect of this surface modification on both protein adsorption and bone cell behavior. PDLLA films were characterized before and after plasma surface modification by water contact angle, surface energy, and adhesion tension of water as well as by scanning electron microscopy (SEM), X‐ray electron spectroscopy (XPS), and Fourier transform infra‐red (FTIR) spectroscopy. RfGD‐films showed an increase in hydrophilicity and surface energy when compared with untreated films. Surface morphological changes were observed by SEM. Chemical analysis indicated significant differences in both atomic percentages and oxygen functional group. Protein adsorption was evaluated by combining solute depletion and spectroscopic techniques. Bovine serum albumin (BSA), fibronectin (FN), vitronectin (VN), and fetal bovine serum (FBS) were used in this study. RfGD‐treated surfaces adsorbed more BSA and FN from single specie solutions than FBS that is a more complex, multi‐specie solution. MG63 osteoblast‐like cells and primary cultures of fetal rat calvarial (FRC) cells were used to assess both the effect of RfGD treatment and protein adsorption on cell attachment and proliferation. In the absence of preadsorbed proteins, cells could not distinguish between treated and untreated surfaces, with the exception of MG63 cells cultured for longer periods of time. In contrast, the adsorption of proteins increased the cells' preference for treated surfaces, thus indicating a crucial role for adsorbed proteins in mediating the response of osteogenic cells to the RfGD‐treated PDLLA surface. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008
Occult hepatitis C virus infection during an outbreak in a hemodialysis unit in Thailand
Authors: Thongsawat Satawat , Maneekarn Niwat , Kuniholm Mark H. , Pantip Chansom , Thungsuputi Amornrat , Lumlertkul Dusit , Bannachak Derek , Nelson Kenrad E. 
Published: March 2008

AbstractControl of hepatitis C virus (HCV) in hemodialysis populations is a major public health priority, but the preferred methods to prevent and rapidly detect HCV outbreaks in these populations remains subject to debate. We enrolled 231 hemodialysis patients at three dialysis centers in Chiang Mai, Thailand. Patients were followed every 6 months for 3 years and tested for the presence of serum HCV antibody and HCV RNA at each visit. We additionally isolated and tested peripheral blood mononuclear cells (PBMCs) for HCV RNA collected at the 30‐month follow‐up visit. Fifty‐one study participants negative for anti‐HCV at the baseline enrollment visit seroconverted over the course of the 3‐year follow‐up period. Of 11 individuals who transiently lost detectable serum HCV viremia, we were able to detect HCV RNA from the PBMCs of two individuals. Our results suggest that occult HCV infection may be common among hemodialysis patients, and serum HCV RNA testing may be supplemented with PBMC testing to maximize diagnostic sensitivity and aid in outbreak containment. Further work on the diagnostic implications of HCV compartmentalization in hemodialysis and other settings is urgently needed. J. Med. Virol. 80:808–815, 2008. © 2008 Wiley‐Liss, Inc.