6,963 publications from this institution
Molecular biology: principles and applications Analysis of protein synthesis Methods for in situ hybridization Finding disease genes Protein and gene polymorphisms Site directed mutagenesis Tissue specificity Applications of molecular biology to lung disease: bacterial infection Molecular biology and respiratory disease Application to pathology Oncogenes, cancer and growth factors Molecular biology of lung receptors The regulation of collagen and elastin gene expression in normal lung and during pulmonary disease Transepithelial transport of secretory immunoglobulins Heat shock proteins Molecular cellular and genetic studies of atopic disease Interleukins in the pulmonary inflammatory response Gene therapy
DNA-binding proteins enable extracellular signals to influence cellular manufacture of substances implicated in chronic inflammation. Cross-talk between the nuclear messenger pathways subserving such regulation accounts for differences among inflammatory diseases. It also explains much of the efficacy of current therapies and may be the basis for novel, more specific approaches to treatment.
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There are many examples of meta-languages to describe computer network models, experiment designs, data formats, and visualization parameters. It is clear that the field recognizes the importance and benefits of a concise, portable and precise problem description, abstracted from the native represen
No abstract is provided for this article.
This study investigated the differences in clinical outcomes between patients with bifurcation lesions (BL) treated with a biolimus-eluting stent (BES) with a biodegradable polymer, and a sirolimus-eluting stent (SES) with a durable polymer.The clinical outcomes were assessed in the 497 patients (BES 258, SES 239) enrolled in the multicentre, randomised LEADERS trial who underwent treatment of ≥1 BL (total=534 BL). At 12-months follow-up there was no significant difference in the primary endpoint of MACE, a composite of cardiac death, myocardial infarction and clinically indicated target vessel revascularisation (BES 12.8% vs. SES 16.3%, p=0.31). Patients treated with BES had comparable rates of cardiac death (BES 2.7% vs. SES 2.9%, p=1.00), numerically higher rates of myocardial infarction (BES 8.9% vs. SES 5.4%, p=0.17), and significantly lower rates of clinically indicated target vessel revascularisation (4.3% vs. 11.3%, p=0.004) when compared to those treated with SES. The rate of stent thrombosis at 12-months was 4.3% and 3.8% for BES and SES, respectively (p=0.82).In the treatment of BL the use of BES lead to superior efficacy and comparable safety compared to SES.
The presence of thrombus is associated with adverse clinical outcomes. Our aim was to develop a classification of thrombus burden (TB) in patients with ST-segment elevation myocardial infarction (STEMI).We retrospectively analyzed 900 consecutive patients treated with percutaneous coronary intervention for STEMI. Drug-eluting stents were used in 90.1%. TB was graded (G) as G0 = no thrombus, G1 = possible thrombus, G2 = small [greatest dimension ≤ 1/2 vessel diameter (VD)], G3 = moderate (> 1/2 but < 2VD), G4 = large (≥ 2VD), G5 = unable to assess TB due to vessel occlusion. Patients with G5 were reclassified to a thrombus category after flow achievement either with a guidewire or a small (1.5 mm) balloon. The incidence of major adverse cardiac events (MACE) - defined as death, myocardial infarction and infarct-related artery revascularization - was computed using the Kaplan-Meier method.Median duration of follow-up was 18.5 months. G5 patients constituted 57.7% of all patients and reclassification was achieved in 97.9%. TB after reclassification was G0, 8.1%; G1, 19%; G2, 24.5%, G3,16.6%, G4, 30%, G5, 1.9%. The 2-year cumulative MACE-free survival was comparable in G1, G2, G3 (84.5%, 85.9% and 87% respectively, p = 0.83), while G0 (75.8%) and G4 (75%) did significantly worse (p = 0.001). After stratification in two groups of small (G0-3) and large (G4) TB, the latter was found to be an independent predictor for 2-year mortality (HR: 1.66, 95% CI: 1.04-2.68, p = 0.035) and MACE rate (HR: 2.04, 95% CI: 1.44-2.88, p < 0.001).In patients with STEMI, TB can be reliably estimated in occluded infarct-related arteries. Large thrombus (≥ 2 VD) is a significant independent predictor for mortality and MACE.
Luminal renarrowing (restenosis) is the major limitation of percutaneous transluminal coronary angioplasty (PTCA), and the search for a 'magic bullet' to prevent this apparent biological healing response to vessel injury has thus far been unsuccessful. Large clinical trials using serial quantitative coronary angiography have, however, provided some valuable insight into this area. In particular, the restenosis process may be measured as the loss in minimal luminal diameter from post-PTCA to follow-up angiography, and is essentially ubiquitous and normally distributed. The angiographic outcome of clinical trials can thus be appropriately evaluated using a continuous rather than a categorical approach, which also considerably reduces the number of patients required. Fluvastatin, a synthetic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, has been shown experimentally to reduce the neointimal proliferative response after PTCA, independent of its lipid-lowering action. The FLuvastatin Angioplasty REstenosis trial was designed to evaluate whether fluvastatin 40 mg twice daily, commencing at least 2 weeks before planned PTCA, can reduce luminal loss by 30% from successful PTCA to follow-up angiography at 26 +/- 2 weeks in 730 evaluable patients.
Advances in additive manufacturing are increasingly allowing bespoke, carefully designed, metamaterial lattice structures to be constructed for enhanced mechanical performance. For instance, in structural elements that are designed to absorb energy and shield a more valuable structure, the properties combining a high initial stiffness followed by a practically zero underlying stiffness, ensure that a desired energy quantity may be absorbed within a limited displacement and that any stress transfer to the valuable structure is minimized. Presently, a lattice structure is studied that is deliberately designed to switch locally under compression between conventional material behaviour to that exhibiting auxetic (negative Poisson's ratio) behaviour through a sequence of snap-through instabilities within layers of individual lattice cells. The sequence of buckling instabilities can potentially be controlled to maintain the loading level alongside the low structural stiffness while the required energy quantity is absorbed, without necessarily damaging the material in the process. This departs from the usual paradigm where such structures are presently designed to be sacrificial and opens up the intriguing possibility of introducing such structural elements that are repairable and therefore reusable.
The direct traumatic effects of coronary artery bypass surgery may counter-balance the expected improvement of myocardial function in the early postoperative period. In 55 patients, the regional shortening fraction was measured over 12 months using radiopaque epicardial markers pairs implanted during surgery in the newly perfused regions. The time course of cardiothoracic ratio, heart rate and cuff blood pressure was documented. All patients were catheterized before surgery and 1 year afterwards. There is an initial depression in myocardial function lasting up to 3 months after surgery which is not directionally related to changes in loading conditions or chronotropic state, but most likely to recovery of the myocardium from perioperative injury. At 1 year after surgery the overall ventricular function is unchanged. The evaluation of ventricular function after coronary artery bypass grafting should be performed no sooner than 3 months after surgery to avoid this transient period of depressed myocardial performance.
