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Biomedical subjects

C Werner

Publications and source records attributed to C Werner.

At least 19 recordsLinked to original sources
PubMed2001

[Effect of intraocular lens design on posterior capsule opacification: an in-vitro model].

BACKGROUND: The development of posterior capsule opacification (PCO) is one of the commonest complications of modern cataract surgery. The various designs of intraocular lenses (IOL) seem to exert a barrier effect on the proliferation and migration of lens epithelial cells and the following development of PCO. METHODS: We set up a cell culture model (advanced 3D capsular bag model) and investigated six differently designed IOL made of different materials as to their effect on cell proliferation. Proliferation and migration of the cells were analysed and documented over a period of 28 days. A cell viability test using the LIVE/DEAD kit (Molecular Probes) was carried out at the end of the investigation. RESULTS: In all tests, lens epithelial cells adhered to and migrated onto the capsular bag. During the culture period, lens epithelial cells migrated only to the optical rim of two of the implanted IOL. On the other four, lens epithelial cells migrated further and covered the whole optical area of the IOL. CONCLUSIONS: Certain lens designs seem to have a reducing effect on the development of PCO. Our advanced in vitro capsular bag model is a suitable cell culture model for the investigation of the reducing effect of various IOL on the development of PCO.

Cataract↗
PubMed2001

Intraoperative monitoring in neuroanesthesia: a national comparison between two surveys in Germany in 1991 and 1997. Scientific Neuroanesthesia Research Group of the German Society of Anesthesia and Intensive Care Medicine.

UNLABELLED: Two surveys initiated by the Neuroanesthesia Research Group of the German Society of Anesthesia and Intensive Care Medicine examined the practice of intraoperative monitoring during intracranial procedures in Germany in 1991 and 1997. Questionnaires were mailed to departments that were registered members of the German Society of Anesthesia and Intensive Care Medicine and that provided neuroanesthesia service on a routine basis in 1991. In 1997, the survey was repeated in the 1991 respondents. In 1991, 68 departments and in 1997, 44 departments returned completed questionnaires, indicating a response rate of 87% for 1991 and of 65% for 1997. Compared with 1991, the standards for monitoring, such as surveillance of oxygenation, ventilation, circulation, and body temperature, were universally applied in adult and pediatric patients in 1997. Overall, there was a 20% increase in neuromuscular blockade monitoring and in the use of electroencephalography and evoked potentials in 1997 compared with 1991. Further brain-specific monitoring was rarely provided in 1997. Overall, jugular venous oximetry was used in 20% and transcranial Doppler ultrasonography in 15% of responding hospitals. To detect venous air embolism in sitting patients, 75% of all responding hospitals used precordial Doppler ultrasonography in both years, whereas transesophageal echocardiography was more often used in 1997 (38%) as compared with 1991 (17%). IMPLICATIONS: Standards of anesthetic monitoring were surveyed in neuroanesthesia in Germany in 1991 and 1997. Central nervous system monitoring was not the standard of practice.

Adult↗
PubMed2001

Effects of xenon on cerebral blood flow and cerebral glucose utilization in rats.

BACKGROUND: The effects of xenon inhalation on mean and local cerebral blood flow (CBF) and mean and local cerebral glucose utilization (CGU) were investigated using iodo-[14C]antipyrine and [14C]deoxyglucose autoradiography. METHODS: Rats were randomly assigned to the following groups: conscious controls (n = 12); 30% (n = 12) or 70% xenon (n = 12) for 45 min for the measurement of local CBF and CGU; or 70% xenon for 2 min (n = 6) or 5 min (n = 6) for the measurement of local CBF only. RESULTS: Compared with conscious controls, steady state inhalation of 30 or 70% xenon did not result in changes of either local or mean CBF. However, mean CBF increased by 48 and 37% after 2 and 5 min of 70% xenon short inhalation, which was entirely caused by an increased local CBF in cortical brain regions. Mean CGU determined during steady state 30 or 70% xenon inhalation remained unchanged, although local CGU decreased in 7 (30% xenon) and 18 (70% xenon) of the 40 examined brain regions. The correlation between CBF and CGU in 40 local brain structures was maintained during steady state inhalation of both 30 and 70% xenon inhalation, although at an increased slope at 70% xenon. CONCLUSION: Effects of 70% xenon inhalation on CBF in rats are time-dependent. During steady state xenon inhalation (45 min), mean values of CBF and CGU do not differ from control values, and the relation of regional CBF to CGU is maintained, although reset at a higher level.

Anesthetics, Inhalation↗
PubMed2000

An Improved Method of Determining the zeta-Potential and Surface Conductance.

In the classical "slope-intercept" method of determining the zeta potential and the surface conductance, the relationship between DeltaP and E(s) is measured experimentally at a number of different channel sizes (e.g., the height of a slit channel, h). The parameter (epsilon(r)epsilon(0)DeltaP/µE(s)lambda(b)) is then plotted as a function of 1/h and linear regression is performed. The y-intercept of the regressed line is then related to the zeta-potential and its slope to the surface conductance. However, in this classical method, the electrical double layer effect or the electrokinetic effects on the liquid flow are not considered. Consequently, this technique is valid or accurate only when the following conditions are met: (1) relatively large channels are used; (2) the electrical double layer is sufficiently thin; and (3) the streaming potential is sufficiently small that the electroosmotic body force on the mobile ions in the double layer region can be ignored. In this paper a more general or improved slope-intercept method is developed to account for cases where the above three conditions are not met. Additionally a general least-squares analysis is described which accounts for uncertainty in the measured channel height as well as unequal variance in the streaming potential measurements. In this paper, both the classical and the improved slope-intercept techniques have been applied to streaming potential data measured with slit glass channels, ranging in height from 3 µm to 66 µm, for several aqueous electrolyte solutions. The comparison shows that the classical method will always overestimate both the zeta-potential and the surface conductance. Significant errors will occur when the classical method is applied to systems with small channel heights and low ionic concentrations. Furthermore, it is demonstrated that traditional regression techniques where the uncertainty is confined only to the dependent variable and each measurement is given equal weight may produce physically inconsistent results. Copyright 2000 Academic Press.

Journal Article↗
PubMed2000

Immobilization of PEO-PPO-PEO triblock copolymers on PTFE-like fluorocarbon surfaces.

Poly(ethylene oxide)-poly(propylene oxide)-poly(ethylene oxide) (PEO-PPO-PEO) triblock copolymers were immobilized on thin fluorocarbon films with a structure very similar to poly(tetrafluoroethylene) (PTFE) using a microwave argon plasma. Fourier transform infrared attenuated total reflection and spectroscopic ellipsometry were used to study this process. After investigating the decomposition behavior of PEO-PPO-PEO triblock copolymers, we found that under appropriate plasma conditions, this material can be immobilized on a PTFE-like surface, while its general structure is preserved.

Biocompatible Materials↗
PubMed2000

Antimicrobial activities of secondary metabolites produced by endophytic fungi from Spondias mombin.

We performed a search for bioactive compounds produced by fungal endophytes from Spondias mombin (Anacardiaceae). Culture broth extracts of Guignardia sp., Phomopsis sp. and Pestalotiopsis guepinii were separated by chromatographic methods and tested for biological activities. The crude extracts of these endophytes were tested against fourteen organisms, including actinomycetes, Gram-negative and Gram-positive bacteria, yeast, and filamentous fungi. All fungal extracts inhibited actinomycete growth. Guignardia sp. was also active against Escherichia coli, Staphylococcus aureus, Saccharomyces cerevisiae, Geotrichum sp., and Penicillium canadensis. Culture extracts of P. guepinii were active against S. cerevisae, while strains of Phomopsis sp. showed a pronounced antifungal effect against Cladosporium elatum, Mycotypha sp. and S. cerevisae.

Anti-Bacterial Agents↗
PubMed2000

High-dose S(+)-ketamine improves neurological outcome following incomplete cerebral ischemia in rats.

PURPOSE: To determine the effects of the non-competitive NMDA-receptor antagonist S(+)-ketamine on neurological outcome in a rat model of incomplete cerebral ischemia. METHODS: Thirty rats were anesthetized, intubated and mechanically ventilated with isoflurane, O2 30% and nitrous oxide 70%. Following surgery animals were randomly assigned to one of the following treatment groups: Rats in group 1 (n = 10,OFF control) received fentanyl (bolus: 10 microg x kg(-1) i.v.; infusion 25 microg x kg(-1) x h(-1)) and N2O 70% / O2. Rats in group 2 (n = 10) received O2 30% in air and low-dose S(+)-ketamine (infusion: 0.25 mg x kg(-1) x min(-1)). Rats in group 3 (n = 10) received O2 30% in air and high-dose S(+)-ketamine (infusion: 1.0 mg x kg(-1) min(-1)). Following 30 min equilibration period ischemia was induced by combined unilateral common carotid artery ligation and hemorrhagic hypotension to 35 mm Hg for 30 min. Plasma catecholamines were assayed before and at the end of ischemia. Neurological deficit was evaluated for three postischemic days. RESULTS: Neurological outcome was improved with high-dose S(+)-ketamine when compared to fentanyl / N2O -anesthetized controls (9 vs. 1 stroke related deaths, P<0.05). Increases in plasma catecholamine concentrations were higher in fentanyl / N2O -anesthetized (adrenaline baseline 105.5+/-92.1 pg x ml(-1), during ischemia 948+/-602.8 pg x ml(-1), P<0.05; noradrenaline baseline 407+/-120.2 pg x ml(-1), ischemia 1267+/-422.2 pg x ml(-1), P <0.05) than in high-dose S(+)-ketamine-treated animals (adrenaline baseline 71+/-79.5 pg x ml(-1), ischemia 237 +/-131.9; noradrenaline baseline 317.9+/-310.5 pg x ml(-1), ischemia 310.5+/-85.7 pg x ml(-1)). CONCLUSION: Neurological outcome is improved following incomplete cerebral ischemia with S(+)-ketamine. Decreases in neuronal injury may be related to suppression of sympathetic discharge.

Animals↗
PubMed2000

[The neuroprotective effect of the glutamate antagonist acamprosate following experimental cerebral ischemia. A study with the lipid peroxidase inhibitor u-101033e].

INTRODUCTION: This study investigates the effects of acamprosate, a glutamatergic modulator, and the lipid peroxidation inhibitor U-101033E on neurological outcome following incomplete cerebral ischemia and reperfusion in rats. MATERIAL AND METHODS: Twenty-seven male Sprague-Dawley rats were randomly assigned to one of the following treatment groups: 1 (n = 9, control, no drug treatment), 2 (n = 9, 2 x 200 mg/kg acamprosate i.p.), and 3 (n = 9, 2 x 0.3 mg/kg U-101033E i.v.). Background anesthesia was maintained using a combination of fentanyl and O2/N2O (FiO2 = 0.3). Ischemia was produced by combined unilateral common carotid artery ligation and hemorrhagic hypotension to a mean arterial blood pressure (MAP) of 35 mm Hg for 30 minutes. Functional neurological deficit was evaluated for the following 3 days after cerebral ischemia. RESULTS: At the third postischemic day, five control animals and five animals treated with U-101033E were dead for stroke-related reasons. Surviving animals presented severe neurological deficits. In contrast, acamprosate improved neurological outcome, with stroke-related death occurring in one animal only and a minor neurological deficit in the surviving rats. DISCUSSION: The present study demonstrates that acamprosate, in contrast to U-101033E, significantly reduces neurological deficits following transient hemispheric ischemia. The neuroprotective mechanisms of acamprosate may be related to its antiglutamatergic effect with consecutive reduction of transmembraneous Ca++ flux through NMDA-activated ion channels.

Acamprosate↗
PubMed2000

Bioluminescent most-probable-number monitoring of a genetically engineered bacterium during a long-term contained field release.

Pseudomonas fluorescens HK44 is a lux-based bioluminescent bioreporter capable of emitting light upon exposure to naphthalene, salicylate, and other substituted analogs. The bacterium was inoculated into intermediate-scale field lysimeters and population dynamics were monitored with time. Two methods were used to enumerate cell numbers in soil: a standard selective plating technique with colony hybridization verification and a modified lux-based most-probable-number (lux-MPN) assay based on the detection of bioluminescence. The lux-MPN assay was developed and evaluated as a possible supplement or replacement for the labor-intensive and time-consuming selective plating assay. Comparisons between selective plate counts and lux-MPN population estimates showed similar trends over the 2-year study, except that lux-MPN estimates were consistently less than selective plate counts. Verification of P. fluorescens HK44 genotype through colony hybridization techniques revealed that selective plating was actually overestimating HK44 populations and that lux-MPN values were more closely approximating true HK44 cell densities, except within the first few weeks after inoculation, when lux-MPN estimates underrepresented population densities. Thus, utilizing bioluminescence as a population monitoring tool for lux-based microorganisms was shown to be more effective and precise than standard selective plating techniques, and provided an accurate ecological analysis of P. fluorescens HK44 population dynamics over an extended period.

Colony Count, Microbial↗
PubMed2000

Resistance of L132 lung cell clusters to glyoxal-induced apoptosis.

Glyoxal is a highly reactive glycating agent involved in the formation of advanced glycation end products (AGEs) and known to induce apoptosis. AGE-mediated apoptosis may be an important mechanism of alveolar epithelial remodelling in pulmonary fibrosis. In this study, we investigated the cytotoxic effect of glyoxal on the fetal human epithelial lung cell line L132 under serum-free conditions. This type of culture, which forces the cells to grow as spheroids, also excludes effects of preformed AGEs by the reaction of glyoxal with fetal calf serum proteins. Our results showed that in cells treated with 200 microM glyoxal, the intercellular contacts in spheroids were disrupted, i.e. cells became totally dissociated. Immunocytochemical analysis revealed a dose-dependent accumulation of the AGE product epsilonN-(carboxymethyl)lysine (CML) in cells detached from cell clusters. The loss of cell attachment was associated with decreased expression of beta1-integrins and CD44 as revealed by laser scanning cytometry (LSC). Increasing concentrations of glyoxal induced an increase in the number of apoptotic cells which were identified by the immunoreactivity for active caspase-3. Remaining cell clusters showed resistance to both CML formation and apoptosis. The present findings demonstrate that cells treated with glyoxal undergo possibly anoikis, a specific mode of apoptosis caused by loss of cell adhesion.

Anoikis↗
PubMed2000

Benzoxazinoids-cyclic hydroxamic acids, lactams and their corresponding glucosides in the genus Aphelandra (Acanthaceae).

An improved method of sample preparation and simultaneous HPLC separation was developed that allowed the separation of 2,4-dihydroxy-1,4-benzoxazine-3(4H)-one (DIBOA), 2,4-dihydroxy-7-methoxy-1,4-benzoxazine-3(4H)-one (DIMBOA), 2-hydroxy-1,4-benzoxazine-3(2H)-one (HBOA), 2-hydroxy-7-methoxy-1,4-benzoxazine-3(2H)-one (HMBOA) and their corresponding glucosides as well as the benzoxazolinones BOA and MBOA. The amount and distribution of these compounds was determined in the roots of Aphelandra squarrosa and A. fuscopunctata plants. There is a significant difference in the amount and distribution of this substance class in the two species analyzed. The results are discussed in relation to their function as defence compounds and allelochemicals.

Benzoxazines↗
PubMed2000

A mechanized gait trainer for restoring gait in nonambulatory subjects.

OBJECTIVE: To construct an advanced mechanized gait trainer to enable patients the repetitive practice of a gaitlike movement without overstraining therapists. DEVICE: Prototype gait trainer that simulates the phases of gait (by generating a ratio of 40% to 60% between swing and stance phases), supports the subjects according to their ability (lifts the foot during swing phase), and controls the center of mass in the vertical and horizontal directions. PATIENTS: Two nonambulatory, hemiparetic patients who regained their walking ability after 4 weeks of daily training on the gait trainer, a 55-year-old woman and a 62-year-old man, both of whom had a first-time ischemic stroke. INTERVENTION: Four weeks of training, five times a week, each session 20 minutes long. MAIN OUTCOME MEASURES: Functional ambulation category (FAC, levels 0-5) to assess gait ability and ground level walking velocity. Rivermead motor assessment score (RMAS, 0-13) to assess gross motor function. RESULTS: Patient 1: At the end of treatment, she was able to walk independently on level ground with use of a walking stick. Her walking velocity had improved from .29m/sec to .59m/sec. Her RMAS score increased from 4 to 10, meaning she could walk at least 40 meters outside, pick up objects from floor, and climb stairs independently. Patient 2: At end of 4-week training, he could walk independently on even surfaces (FAC level 4), using an ankle-foot orthosis and a walking stick. His walking velocity improved from .14m/sec to .63m/sec. His RMAS increased from 3 to 10. CONCLUSION: The gait trainer enabled severely affected patients the repetitive practice of a gaitlike movement. Future studies may elucidate its value in gait rehabilitation of nonambulatory subjects.

Equipment Design↗
PubMed2000

Increasing isoflurane concentration may cause paradoxical increases in the EEG bispectral index in surgical patients.

We have studied the effects of increases in isoflurane concentration on the EEG bispectral index (BIS) in 70 patients anaesthetized with isoflurane-nitrous oxide-sufentanil for major abdominal surgery. During surgery, baseline BIS was recorded at 0.8% end-tidal isoflurane with nitrous oxide in oxygen (FIO2 0.35). After this, end-tidal isoflurane was increased to 1.6% for 15 min and decreased subsequently to 0.8% for 20 min to assess recovery. In 20 patients, BIS decreased from a mean value of 40 (SD 9) during baseline to 25 (10) at 1.6% isoflurane. In contrast, BIS did not change in 23 patients and increased in 27 patients from 35 (6) to 46 (8) as isoflurane was increased to 1.6%. In all patients, BIS recovered to baseline values at 0.8% isoflurane. The changes in BIS with increasing isoflurane concentration were not related to drugs or differences in physiological variables, which did not differ between groups. Patients with a decrease in BIS were significantly younger (38 (range 18-68) yr) than those with unchanged (55 (26-70) yr) or increased (60 (40-70) yr) BIS values (P < 0.001). It is possible that the paradoxical increase in BIS is related to continuous pre-burst EEG patterns consisting of high-frequency activity. This suggests that the use of BIS as a guide for isoflurane administration may be misleading in some patients undergoing surgical procedures.

Abdomen↗
PubMed2000

Effects of xenon on cerebral blood flow and autoregulation: an experimental study in pigs.

We have investigated the effects of xenon on regional cerebral blood flow (rCBF) and autoregulation in pigs sedated with propofol 4 mg kg-1 h-1. Balloon-tipped catheters were placed into the descending aorta and inferior vena cava of 15 Göttingen Minipigs for manipulation of arterial pressure and blood sampling. rCBF was measured using the sagittal sinus outflow technique. Xenon was adjusted randomly to end-tidal fractions (FE'Xe) of 0, 0.30, 0.50 and 0.70. After baseline measurements of heart rate (HR), mean arterial pressure (MAP), rCBF, sagittal sinus pressure (SSP) and calculation of regional cerebrovascular resistance (rCVR) at each respective FE'Xe, autoregulation was tested in the MAP range 60-120 mm Hg. Increasing FE'Xe had no effect on HR, MAP, rCBF or SSP. rCVR increased with increases in MAP, regardless of FE'Xe. Autoregulation was not impaired. We conclude that xenon inhalation had no effect on rCBF and autoregulation in our model, which could suggest that xenon is an adequate adjunct for neurosurgical anaesthesia.

Anesthetics, Inhalation↗
PubMed2000

Preanesthetic train-of-four fade predicts the atracurium requirement of myasthenia gravis patients.

BACKGROUND: The most sensitive diagnostic criterion of myasthenia gravis is a decrement in the muscular response to repetitive stimulation. The authors hypothesized that myasthenia gravis patients who show a train-of-four ratio (T4/T1) < 0.9 in the preanesthetic period will have increased sensitivity to nondepolarizing neuromuscular blocking agents compared with myasthenia gravis patients with preanesthetic T4/T1 > or = 0.9. METHODS: After institutional review board approval was obtained, 20 electrophysiologically documented myasthenia gravis patients were studied. Current pyridostigmine therapy was continued until the morning of surgery. Before induction of anesthesia, neuromuscular transmission was recorded from the hypothenar muscles using electromyography with train-of-four stimulation of the ulnar nerve. According to the T4/T1 ratio, patients were assigned to the "normal" group (T4/T1 > or = 0.9) or the "decrement" group (T4/T1 < 0.9). After induction of intravenous anesthesia, the effective dose to achieve a 95% neuromuscular blockade (ED95) for atracurium was assessed with a cumulative bolus technique. Postoperatively, pyridostigmine was titrated to obtain a T4/T1 > 0.75 and to treat residual myasthenic symptoms. RESULTS: In 14 patients, preanesthetic T4/T1 was > or = 0.9 (normal), whereas 6 patients presented with T4/T1 < 0.9 (decrement). Decrement patients had a lower ED95 of 0.07 +/- 0.03 mg/kg atracurium (mean +/- SD) compared with normal patients with an ED95 of 0.24 +/- 0.11 mg/kg atracurium (P = 0.002). All patients were extubated within 30 min after surgery. Postoperative pyridostigmine infusion did not differ significantly between groups. CONCLUSIONS: The requirement for atracurium is significantly reduced in myasthenia gravis patients with a T4/T1 ratio < 0.9 before anesthesia. This study indicates that routine neuromuscular monitoring in myasthenia gravis patients should be extended into the preinduction period to identify patients who require less atracurium.

Adult↗
PubMed2000

Identification of novel serine/threonine protein phosphatases in Trypanosoma cruzi: a potential role in control of cytokinesis and morphology.

We cloned two novel Trypanosoma cruzi proteins by using degenerate oligonucleotide primers prepared against conserved domains in mammalian serine/threonine protein phosphatases 1, 2A, and 2B. The isolated genes encoded proteins of 323 and 330 amino acids, respectively, that were more homologous to the catalytic subunit of human protein phosphatase 1 than to those of human protein phosphatase 2A or 2B. The proteins encoded by these genes have been tentatively designated TcPP1alpha and TcPP1beta. Northern blot analysis revealed the presence of a major 2.3-kb mRNA transcript hybridizing to each gene in both the epimastigote and metacyclic trypomastigote developmental stages. Southern blot analysis suggests that each protein phosphatase 1 gene is present as a single copy in the T. cruzi genome. The complete coding region for TcPP1beta was expressed in Escherichia coli by using a vector, pTACTAC, with the trp-lac hybrid promoter. The recombinant protein from the TcPP1beta construct displayed phosphatase activity toward phosphorylase a, and this activity was preferentially inhibited by calyculin A (50% inhibitory concentration [IC(50)], approximately 2 nM) over okadaic acid (IC(50), approximately 100 nM). Calyculin A, but not okadaic acid, had profound effects on the in vitro replication and morphology of T. cruzi epimastigotes. Low concentrations of calyculin A (1 to 10 nM) caused growth arrest. Electron microscopic studies of the calyculin A-treated epimastigotes revealed that the organisms underwent duplication of organelles, including the flagellum, kinetoplast, and nucleus, but were incapable of completing cell division. At concentrations higher than 10 nM, or upon prolonged incubation at lower concentrations, the epimastigotes lost their characteristic elongated spindle shape and had a more rounded morphology. Okadaic acid at concentrations up to 1 microM did not result in growth arrest or morphological alterations to T. cruzi epimastigotes. Calyculin A, but not okadaic acid, was also a potent inhibitor of the dephosphorylation of (32)P-labeled phosphorylase a by T. cruzi epimastigotes and metacyclic trypomastigote extracts. These inhibitor studies suggest that in T. cruzi, type 1 protein phosphatases are important for the completion of cell division and for the maintenance of cell shape.

Amino Acid Sequence↗
PubMed2000

[A simple model for describing pressure-volume curves in free balloon dilatation with reference the dynamics of inflation hydraulic aspects].

We propose a simple model to describe pressure-time and pressure-volume curves for the free balloon (balloon in air) of balloon catheters, taking into account the dynamics of the inflation device. On the basis of our investigations of the flow rate-dependence of characteristic parameters of the pressure-time curves, the appropriateness of this simple model is demonstrated using a representative example. Basic considerations lead to the following assumptions: (1) the flow within the shaft of the catheter is laminar, and (ii) the volume decrease of the liquid used for inflation due to pressurization can be neglected if the liquid is carefully degassed prior to inflation, and if the total volume of the liquid in the system is less than 2 ml. Taking into account the dynamics of the inflation device used for pumping the liquid into the proximal end of the shaft during inflation, the inflation process can be subdivided into the following three phases: initial phase, filling phase and dilatation phase. For these three phases, the transformation of the time into the volume coordinates is given. On the basis of our model, the following parameters of the balloon catheter can be determined from a measured pressure-time curve: (1) the resistance to flow of the liquid through the shaft of the catheter and the resulting pressure drop across the shaft, (2) the residual volume and residual pressure of the balloon, and (3) the volume compliance of the balloon catheter with and without the inflation device.

Angioplasty, Balloon, Coronary↗