Publications

Sirolimus-eluting stents (SESs) have been shown to decrease restenosis compared with bare metal stents (BMSs). Currently, there are limited data on the long-term efficacy of these devices in a real-world patient population. Furthermore, the potential of a late restenotic phenomenon has not yet been excluded. From April to October 2002, 508 consecutive patients with de novo lesions exclusively treated with SESs were enrolled and compared with 450 patients treated with BMSs in the preceding 6 months (control group). Patients in the SES group more frequently had multivessel disease and type C lesions, received more stents, and had more bifurcation stenting. After 3 years, the cumulative incidence of major adverse cardiac events (comprising death, myocardial infarction, and target vessel revascularization) was significantly lower in the SES group compared with the pre-SES group (18.9% vs 24.7%, hazards ratio 0.73, 95% confidence interval 0.56 to 0.96, p = 0.026). The 3-year risk of target lesion revascularization was 7.5% in the SES group versus 12.6% in the pre-SES group (hazards ratio 0.57, 95% confidence interval 0.38 to 0.87, p = 0.01). In conclusion, the unrestricted use of SESs is safe and superior to the use of BMSs. The beneficial effects, reported after 1 and 2 years in reducing major adverse cardiac events, persisted with no evidence of a clinical late restenotic “catch-up” phenomenon.

Background Studies on the inflammatory process in the large airways of patients with mild/moderate COPD have shown a prevalent T lymphocyte and macrophage infiltration of the bronchial mucosa. However, bronchial inflammation in more severe disease has not been extensively studied. Objective The aim of the present study was to characterize the lymphocyte infiltration in the bronchial mucosa of subjects with severe, compared to mild, COPD, and to examine the relationship between airflow limitation and T lymphocyte numbers in the bronchial mucosa. Methods We examined bronchial biopsies obtained from nine smokers with severe airflow limitation, nine smokers with mild/moderate airflow limitation and 14 smokers with normal lung function. Immunohistochemical methods on cryostat sections were used to assess the number of CD3 + , CD4 + , CD8 + cells and the number of CD3 + cells coexpressing the chemokine receptor CCR5 (CCR5 + CD3 + ) in the subepithelium. Results Subjects with severe COPD had lower numbers of CD3 + , CD8 + and CCR5 + CD3 + cells than mild/moderate COPD ( P < 0.012, P < 0.02 and P < 0.02, respectively) and control smokers ( P < 0.015, P < 0.005 and P < 0.015, respectively). In subjects with airflow limitation the number of CD3 + and CD8 + cells was inversely correlated with the degree of airway obstruction ( r = 0.59, P < 0.015 and r = 0.52, P < 0.032, respectively). Conclusions Bronchial inflammation in severe COPD is characterized by lower numbers of CD3 + and CD8 + cells and decreased numbers of CD3 + cells coexpressing the chemokine receptor CCR5. T lymphocyte infiltration is inversely correlated with the degree of airflow limitation.

In some species serotonin (5-HT) has been shown to act as a central modulator of the cough reflex. To investigate whether serotonergic mechanisms influence the control of the human cough reflex, we have induced cough responses before and during infusions of 5-HT; its precursor 5-hydroxytryptophan (5-HTP), which, in contrast to 5-HT, crosses the blood-brain barrier; and saline control. At the start of each study day, eight normal male volunteers were challenged with a single inhalation of a solution lacking chloride ions (0.15 M sodium bicarbonate) and a single breath of capsaicin during a sham infusion. After 3 h they received repeat cough challenges during experimental infusions of 5-HT, 5-HTP, or saline control, which were given randomly and single blind. Heart rate, respiratory rate, and blood pressure were measured before, during, and after each infusion. Both 5-HT and 5-HTP reduced cough responses to the chloride-deficient solution (P = 0.035 and P = 0.017, respectively) with respect to saline control, whereas neither infusion reduced responses to capsaicin. 5-HT caused a transient increase in heart rate that was not observed with a similar dose of 5-HTP or saline (P < 0.01). Respiratory rate and blood pressure were not affected by experimental infusions but rose during cough challenge. We conclude that 5-HT exerts an inhibitory influence over the human cough reflex at peripheral and possibly central sites.

No abstract is provided for this article.

Background Optical coherence tomography (OCT) is a light-based imaging modality that can be used in biological systems to study tissues in vivo with near-histologic, ultrahigh resolution. The rationale for intravascular application of OCT is its potential for in vivo visualisation of the coronary artery microstructure. Methods and results The principle is analogous to pulse-echo ultrasound imaging; however, light is used rather than sound to create the image. Low-coherent near-infrared light is emitted by a superluminescent diode and reflected by the microstructures within biological tissues. The echo time delay of reflected light waves is converted into a two-dimensional spatial image. The intensity of the reflected light waves is translated into an intensity map. Experimental studies confirmed the ability of intravascular OCT for plaque characterisation and accurate assessment of vascular structures that are close to the luminal surface. Preliminary clinical experience proved in vivo feasibility of intravascular OCT. A variety of atherosclerotic plaque structures including thin cap fibroatheromas can be visualized in vivo. Conclusions Intravascular OCT allows for accurate assessment of vessel structures close to the luminal side. Clinical application is feasible. To date, however, the clinical relevance of OCT findings in coronary arteries is unclear and further validation of OCT imaging is mandatory.

No abstract is provided for this article.

The introduction of metallic drug-eluting stents has reduced the risk of restenosis and widened the indications of percutaneous coronary intervention in coronary artery disease. However, the presence of a permanent metallic endoprosthesis to restore the patency of a stenotic artery has pitfalls, such as vascular inflammation, stent thrombosis and hindrance of the restoration of the physiologic function of the stented segment. Bioresorbable scaffolds were introduced to potentially overcome these limitations as they provide temporary scaffolding and then disappear, liberating the treated vessel from its cage. Currently, several bioresorbable scaffolds are available that are undergoing evaluation either in clinical trials or in preclinical settings. The aim of this review is to present the new developments in bioresorbable scaffold technology, describe its clinical application and discuss the potential future prospects of this innovative therapy.

Abstract Exposure of guinea-pig eosinophils to leukotriene B4 (LTB4; 1 μM) resulted in a rapid generation of H2O2 (index of NADPH oxidase activation), stimulated [3H]arachidonic acid (AA) release (index of phospholipase A2 activity), and promoted CD18-dependent homotypic aggregation. Under similar conditions, LTB4 (1 μM) induced a rapid activation of extracellular-regulated kinases-1 and 2 (ERK-1/2) but not c-jun N-terminal kinases 46 and 54 (JNK-46/54) or p38 mitogen-activated protein kinase (p38 MAP kinase). To examine the role of ERK-1/2 in the mechanism of eosinophil activation, a selective inhibitor of MAP kinase kinase-1/2 (MEK-1/2), PD098059, was employed. However, PD 098059 at concentrations that attenuated ERK-1/2 activation had no significant affect on eosinophil activation. In contrast, a role for tyrosine kinases in LTB4-induced eosinophil activation was suggested by studies with the tyrosine kinase inhibitors, herbimycin A and lavendustin A. However, the results of those experiments implied divergent pathways for the control of eosinophil responses because the inhibitors were more effective at attenuating H2O2 generation than [3H]AA release, and had little effect on homotypic aggregation. J. Leukoc. Biol. 64: 555–562; 1998.

The high kaolinite content of metakaolin makes it valuable to other industries, thereby affecting its availability and affordability for the production of limestone calcined clay cement (LC3). This work presents a study on the potential utilization of low-grade clay in place of pure metakaolin in the preparation of LC3 for mortar formulations. CEM I was partially substituted with calcined clay and limestone by 20, 30, 40, and 50 wt.%. The weight ratio of calcined clay and limestone was maintained at 2:1 for all mixes and the water-to-binder ratio was 0.48. X-ray diffraction (XRD), thermogravimetric analysis (TGA), and isothermal conduction calorimetry were used to study the hydration process and products after 28 days. Mechanical and durability assessments of the LC3 mortar specimens were conducted. LC3 specimens (marked LC20%, LC30%, LC40%, and LC50%) trailed the control sample by 1.2%, 4%, 9.8%, and 18%, respectively, at 28 days and 1.6%, 2.3%, 3.6%, and 5.5%, respectively, at 91 days. The optimum replacement of OPC clinker, calcined clay, and limestone was 20% (LC20%).

No abstract is provided for this article.