6,963 publications from this institution
In a 61‐year‐old patient with unstable angina an attempt was made to dilate a severe stenosis in a tortuous obtuse marginal branch. The initial attempt with conventional equipment was not successful; although the wire could be advanced distal to the stenosis, a 2.0 balloon did not cross the stenosis. A second attempt with a balloon on a wire device resulted in fracture of this catheter, with the distal 2.8‐cm‐long fragment looped in the left coronary artery. Immediate bypass surgery was performed and the broken fragment was easily removed from the left coronary ostium. The patient made an uneventful recovery.
Immunology of allergic disease inflammatory mechanisms in asthma asthma and the environment asthma therapy in the future mechanisms and treatment of cough acute and chronic lung infection molecular mechanisms and clinical management of cystic fibrosis AIDS syndrome mechanisms of pulmonary fibrosis cell biology of fibrosing lung disease home ventilation respiratory muscles in health and disease.
The Continuous Strength Method (CSM) is a deformation-based approach to the design of structures that enables a continuous, rational and accurate allowance for material nonlinearity (i.e. the spread of plasticity and strain hardening). Central to the method is the application of strain limits, determined on the basis of the local slenderness of full cross-sections, to define the resistance of a structural member or system. The method can be applied to structures formed using different materials (e.g. steel, stainless steel or aluminium) and manufacturing processes (e.g. hot-rolled or cold-formed) through the assignment of suitable stress–strain relationships, and can be used for steel–concrete composite design and in fire scenarios. In composite construction, the CSM enables a more rigorous assessment to be made of the development of strength in the structural system taking due account of compatibility between the constituent materials. The design method enables enhancements in structural efficiency and, unlike traditional approaches, allows the assessment of both strength and ductility (which is particularly relevant for high strength steel) demands at the ultimate limit state. For hand calculations, a set of straightforward CSM design equations have been developed. Recognising the increasing importance and use of advanced analysis (i.e. GMNIA), recent research, summarised herein, has focussed on integration of the CSM strain limits into a framework of design by second order inelastic analysis, where the benefits of the method become even more substantial. This paper provides a review of the background and recent developments to the CSM, including incorporation into design standards. Current and ongoing research to expand the scope of the CSM is summarised and recommendations for future work are also set out.
Exhaled nitric oxide (NO) is elevated in untreated patients with asthma but not in patients treated with inhaled glucocorticoids. This may reflect an inhibitory effect of glucocorticoids on the induction of the enzyme NO synthase in the respiratory tract. We have now studied the effect of an inhaled glucocorticoid (budesonide 800 micrograms twice daily via a dry powder delivery system for 3 wk) on exhaled NO in 11 patients with mild asthma in a double-blind crossover randomized-order placebo-controlled study. Exhaled NO was reduced from a baseline value of 203 +/- 29 parts per billion (ppb) to 120 +/- 26 ppb after 3 wk of treatment (p < 0.01), whereas there was no change after a matched placebo (169 +/- 20 at baseline compared with 184 +/- 16 ppb after 3 wk). A significant and progressive fall in exhaled NO was found from 1 to 3 wk. There was no significant change in FEV1 after inhaled steroids (although mean FEV1 was 92% predicted normal at baseline), although there was a reduction in airway responsiveness to methacholine (approximately 2.5 doubling dilutions). These results add further support to the view that the elevated levels of exhaled NO in asthma may derive from induction of an inducible isoform of NO synthase and indicate that exhaled NO may be a useful way of monitoring the anti-inflammatory effects of glucocorticoids and other anti-inflammatory treatments in asthma.
I am delighted to introduce the latest addition to the Expert Review journals. While your heart may sink at the thought of yet another journal, this is a journal with a difference. We are bombarded...
