Clinical trends in stent treatment of simple and complex coronary disease

This is a retrospective analysis of a consecutive group of patients from a single medical center who underwent stent implantation. It describes 316 patients who constituted 53% of the angioplasty procedures carried out in a single year. The authors describe the complications and their 1-year follow-up. We aimed to study the short and long-term results of stenting in our centre in relation to multiple clinical and angiographic variables. During 1996, 316 consecutive patients were treated with stent implantation for a total of 381 coronary lesions. The pharmacological protocol methods of stent implantation and patient characteristics were used. Clinical variables were: age 59.1 3 10.7 years, diabetes mellitus 25.3%, hypertension 33.0% and angina pectoris 88.7% (unstable in 44.1%). Previous coronary surgery had been undergone by 9.2%. Multivessel disease was present in 56% of the patients. The indications for stenting were: primary 58.5%, suboptimal results 33.0% and threatened or acute occlusion 8.5%. Angiographic success was 98.9% and clinical success 96.8%. The major in-hospital complications were acute myocardial infarction (2.2%), acute revascularization (0.3%) and major bleeding (0.6%). All occurred within 24 h of revascularization. Repeated angiography was performed in 115 cases (30.2%) at 160.3 3 109.4 days after stent procedure for unstable angina (38.7%), stable angina (26.1%) and other causes (35.2%). The restenosis rate in those catheterized was 38.1%, with an overall clinical restenosis rate of 11.3% during the follow-up period. Restenosis was more prevalent among diabetic patients (17.9 vs 9.15%, P 3 0.02) and patients with prior balloon angioplasty (18.6 vs 9.75%, P 3 0.046). Clinical follow-up was available in 90.8% of the patients for 291 3 112 days. The actuarial survival at the end of the follow-up period was 93.8%. Death/myocardial infarction was associated with unstable angina pectoris (P 3 0.006), hypertension (P 3 0.001), smoking (P 3 0.046) and threatened or acute occlusion (P < 0.001). In the first year of extensive stent use, stenting is associated with high technical and clinical success rates. Long-term results after stent implantation are associated with the occurrence of acute or threatened occlusion, and the in-hospital complications diabetes mellitus and hypertension.     

我国粘虫发生危害新特点及趋势分析

粘虫Mythimna separata是我国玉米、小麦和水稻三大主粮作物上的重大害虫,对我国粮食安全有重大威胁,每年在我国南北往返迁飞危害。近年来,粘虫在我国的发生危害呈现出新的特点,主要体现为:一是受害严重区域发生变化,各世代危害范围扩大;二是主要危害世代发生变化,2代、3代粘虫发生较重;三是主害作物发生变化,玉米成第一大危害作物;四是迁飞规律发生变化,南北往返迁飞格局不变;五是田间种群抗药性明显增强,防治困难程度加重;六是生物学习性发生变异,适应能力增强。针对以上发生危害新特点的形成原因和未来趋势进行了分析与讨论。     

甲基丙烯酸甲酯支架在治疗新生血管性青光眼的临床观察

目的探讨应用甲基丙烯酸甲酯（PMMA）巩膜瓣支架在新生血管性青光眼手术中的疗效。方法选择29例新生血管性青光眼作巩膜瓣下支架植入术.术后随访6～24个月,检查眼压、视力、滤过泡及术后并发症等。结果术后6个月均见功能性滤过泡,眼压控制良好。结论应用PMMA巩膜瓣支架在新生血管性青光眼的手术治疗中安全、有效,降眼压效果显著而持久。     

Social and economic impact of violence in the Americas

Violence is a social and a public health problem that has grown in the Americas in recent decades that has negative effects on social, health, and the economy of countries, communities, families, and individuals. More than 115,000 people are murdered every year, the majority of them are men; other 55,000 commit suicide. In 20 to 60% of households some form of domestic violence against girls, boys, women, and the elderly occurs; juvenile gangs, involved in violent and criminal activities, increases at alarming rate. Other forms of violence are wars and internal or international conflicts, political violence, abductions, lynching, multinational violence by organized crime units involved in narcotic trafficking, sexual trade or smuggling of weapons. The public health approach is based on a methodology of work, as follows: 1. Characterization of the problem in its basic variables of person, place, time, circumstances, and related situations; 2. Identification of causes, associations, or risk factors; 3. Proposal of interventions and their evaluation; 4. Extension of the evaluated interventions. Violence is an intentional act of multicausal origin. Various factors are interconnected showing the relations among them. Those which have been primarily studied or that have shown greater evidence are discussed. A historical look is proposed, that integrates the repression and control, the prevention and the recovery of the social fabric. Violence demands an expenditure of money that represents a significant proportion of the GDP that was estimated in $168 billion dollars for Latin America. Violence can be prevented. Primary prevention projects are driven to avoid the occurrence of a violent act, but if it has already occurred it is necessary to avoid its repetition, through secondary prevention projects. Tertiary prevention is applied in order to avoid major damages; it aims at improving the quality of life of those already traumatized. The programs should be comprehensive and sustained in the medium and long terms. Finally, comments have been made on PAHO and WHO policies, in particular the recently launched World Report on Violence and Health, a working tool for violence prevention.     

The epidemiology and economic impact of llama parasites

Camelids are distributed over vast areas of South America, ranging from south Ecuador to north Chile, with high concentrations in Peru and Bolivia. Guillermo Leguio discusses the effects that parasitic infections have on the health and productivity of these animals.     

New trends in CLL treatment

We review here results obtained from the various treatment modalities that have been used in CLL patients: chemotherapy; radiotherapy; splenectomy; leukapheresis; monoclonal antibodies and other immunomodulating agents. We conclude that it is still unclear whether patients in stage A (good prognosis) should be treated; intermediate forms of the disease (stage B) should, in most cases, be treated, but a better treatment than chlorambucil has not emerged; results from the Cooperative Group on CLL of Société Fran?aise d'Hématologie indicate that significant progress in the therapy of the advanced stage (stage C) has been achieved with the introduction of the CHOP regimen, using low doses of adriamycin; radiotherapy, splenectomy and immunomodulators such as levamizol, interleukins or interferons, and possibly monoclonal antibodies, are now being actively tested; the results are not yet conclusive.     

Sorting nexins--unifying trends and new perspectives

The sorting nexins (SNXs) are a family of PX domain-containing proteins found in yeast and mammalian cells that have been proposed to regulate intracellular trafficking. Mammalian SNXs have been suggested to function variously in pro-degradative sorting, internalization, endosomal recycling, or simply in endosomal sorting. In yeast, the defining function for these proteins is a regulation of cargo retrieval. Here we examine recent data on the SNX family of proteins and attempt to draw out unifying themes between the work performed in yeast and mammalian systems.     

Environmental and economic impact of using new-generation wide-base tires

Purpose

New-generation wide-base tire (NG-WBT) is known for improving fuel economy and at the same time for potentially causing a greater damage to pavement. No study has been conducted to evaluate the net environmental saving of the combined system of pavements and NG-WBT. This study adopted a holistic approach (life cycle assessment [LCA] and life cycle costing [LCC]) to quantitatively evaluate the environmental and economic impact of using NG-WBT.

Methods

The net effect of different levels of market penetration of NG-WBT on energy consumption, global warming potential (GWP), and cost based on the fatigue cracking and rutting performance of two different asphalt concrete (AC) pavement structures was evaluated. The performance of pavements was determined based on pavement design lives; pavement surface characteristics, and pavement critical strain responses obtained from the artificial neural network (ANN) based on finite element (FE) simulations were used to calculate design lives of pavements. Based on the calculated design lives, life cycle inventory (LCI) and cost databases, and rolling resistance (RR) models previously developed by the University of Illinois at Urbana-Champaign (UIUC) were used to calculate the environmental and economic impact of the combined system.

Results and discussion

The fuel economy improvement using NG-WBT is 1.5% per axle. Scenario-based case studies were conducted. Considering 0% NG-WBT market penetration (or 100% standard dual tire assembly [DTA]) as a baseline, scenario 1 assumed the same fatigue and rutting potential between NG-WBT and DTA; therefore, the only difference came from fuel economy improvement of using NG-WBT. In scenario 2, pavement fatigue cracking potential determined the pavement design life; both thick and thin AC overlay sections experienced positive net environmental savings, but mixed net economic savings. In scenario 3, pavement rutting potential determined the pavement design life; the thick AC overlay section experienced positive net environmental savings, but mixed net economic savings. The thin section experienced negative net environmental and economic savings.

Conclusions

The outcomes of scenario-based case studies indicated that NG-WBT can result in significant savings in life cycle energy consumption and cost, and GWP; however, these benefits were sensitive to the method used to determine the pavement performance; especially, a small change in pavement strain can result in significant change in pavement life. In addition, the effect of fuel price/economy improvement, discount rate, and International Roughness Index (IRI) threshold values was studied in the sensitivity analyses.

     

Old experiments and new trends in avian sex differentiation

Summary The influence of steroid hormones on sex differentiation was first demonstrated in birds in 1935. Steroid female hormones injected in vivo into male embryos determined a partial or total feminization of gonads and genital ducts. Male hormones determined only the sex reversal of the ducts. Some substances of the group of androgens, such as dehydroandrosterone, had a paradoxical effect; they feminized males and masculinized females. Similar effects were observed later by several authors in all groups of vertebrates. In placentary mammals, only genital ducts were transformed. Castration of avian embryos also demonstrated the role of embryonic sexual hormones on genital ducts. These results, first obtained in vivo, were confirmed by experiments in vitro. Since then numerous studies have been undertaken on the nature of the hormone responsible for the regression of müllerian ducts in embryos of birds and other groups of vertebrates. Some authors assumed that these substances are proteins; many offered new evidence for the role of steroid sexual hormones during sex differentiation. Thus the problem appeared more complicated than it was thought at first. In recent years, synthesis of steroid sexual hormones have been demonstrated in young embryos during or even before sex differentiation; and enzymes that catalyze the synthesis of these hormones, such as hydroxysteroiddehydrogenase, also have been discovered. Further research has been oriented toward the characterization of steroid hormones by techniques of immunochemistry and labeled isotopes confirming the results obtained by other techniques. Specific proteins are being isolated in the effectors; they work as receptors of steroid hormones. Nuclear receptors of estradiol have been discovered in the embryonic gonads and in the cloacal wall at the time of sexual differentiation. Thus a mechanism can be conceived in which proteins and steroid hormones play mutual roles in the process of sex differentiation. Presented in the formal symposium on Sexual Differentiation in Vitro and in Vivo at the 29th Annual Meeting of the Tissue Culture Association, Denver, Colorado, June 4–8, 1978.