Angiographic morphology was analysed in 32 patients who developed restenosis after initially successful coronary angioplasty. The mean minimal luminal diameter of the dilated coronary segments increased from 0.9 mm to 2.3 mm after dilatation, but decreased to 0.9 mm at restenosis. The reference diameter was unchanged after dilatation and at restenosis. Mean stenosis length before the initial angioplasty was 7.0 mm but at the repeat procedure had increased to 8.7 mm (mean increase 1.7 mm, 95% confidence interval 0.6 to 2.8 mm, p less than 0.01). There were no significant differences in mean trans-stenotic pressure gradient and mean eccentricity ratio between the initial and repeat angioplasty procedures. In individual patients the changes in stenosis morphology were unpredictable, but overall stenoses tended to be longer at restenosis. In some patients stenosis length increased by several millimetres but the success rate of repeat angioplasty was high and the clinical importance of the changes in stenosis morphology are uncertain.

Angioplasty, Balloon, Coronary↗

PubMedDate not supplied

Adaptation to ethanol-induced fluidization of brain lipid bilayers.

We have shown that ethanol is less able to fluidize reconstituted membranes prepared from lipid extracts of tolerant mice synaptosomal membranes than those prepared from controls. The effects of ethanol on membrane fluidity were assessed by fluorescence polarization technique. Acute in vivo administration of ethanol did not alter ethanol-induced fluidization of the bilayers. These results suggest that changes in the lipid composition of membranes can account, at least in part, for tissue adaptation to ethanol-induced membrane fluidization. We also discuss the use of reconstituted membranes as a tool both to analyze the significance of changes in membrane composition for the development of tolerance and to refine our concepts concerning the relation between membrane fluidity and anesthetic activity.

Animals↗

PubMedDate not supplied

Effectiveness and acceptability of a newly designed hip protector: a pilot study.

Hip fracture has a significant economic and personal cost, involving hospital admission and functional impairment for elderly people. To assess the benefit of using a newly designed hip protector (new material and new design) to prevent fracture in a realistic setting, a randomised intervention-control design was used to trial the effectiveness of pads worn by high falls risk residents (n=71) in nursing home for 9 months. 40 residents were in the intervention group and 31 were in the control group. A profile of falls, including time of day, and orientation was obtained to demonstrate the potential effectiveness of the protectors for injury prevention. Acceptance of the hip protector was also surveyed amongst nursing home staff and residents. One hundred and one falls and six fractures occurred in the control group. In contrast, one hundred and ninety one falls and three fractures occurred in the hip protector (pads) group. The three fractures in the protector wearing group occurred when pads were not in place. This was extrapolated as 1 in every 16.8 falls and 1 in every 63.7 falls resulting in fracture in the two groups, respectively. The relative risk of fracture was 0.264 (95% CI=0.073-0.959) when the fracture incidence rate in the intervention group (three fractures per 191 falls) was compared to the control group (six fractures per 101 falls). This is a statistically significant result and implies that this newly designed hip protector is effective in preventing hip fracture. The majority of falls occurred during the day, which was when protectors were worn in this study, but the data on orientation was incomplete, with direction unknown in 74% of falls. Compliance was an issue, which was interpreted as only 50.3% of falls recorded with protectors in place. Dementia was identified as the explanation for this as the pads were often removed by these residents who comprised the majority of participants. Perception of low risk was the primary barrier to residents accepting the intervention. Comfort of protectors was not a significant concern for staff or residents, and only staff described appearance as an issue. In conclusion, the newly designed hip protector is protective against fractures in a realistic setting. Compliance and acceptance of the protectors will ultimately determine the viability of this prophylaxis.

Clinical Trial↗

PubMedDate not supplied

Synthesis and characterization of novel spin-labeled photoaffinity nonnucleoside analogues of ATP as structural and EPR probes for myosin.

Two new spin-labeled photoreactive nonnucleoside ATP analogues, 1-(4-azido-2-nitrophenyl)amino-3-(1-oxyl-2,2,5, 5-tetramethylpyrrolidinyl-3-carbamido)-2-propyl triphosphate (SL-NANTP) and 2-(4-azido-2-nitrophenyl)amino-2,2-(1-oxyl-2,2,6, 6-tetramethyl-4-piperidylidene)di(oxymethylene) ethyl triphosphate (SSL-NANTP), were synthesized and characterized. This study aims to develop a second generation of NANTP-based analogues containing immobile spin labels that can be used to monitor conformational changes in myosin during the contractile cycle of muscle. Previous studies have shown that both a photoaffinity nonnucleoside ATP analogue, 2-[(4-azido-2-nitrophenyl)amino] ethyl triphosphate (NANTP) [Nakamaye et al. (1985) Biochemistry 24, 5226-5235], and a photoaffinity ATP analogue, 3'(2')-O-4-[4-oxo-(4-amino-2,2,6, 6-tetramethyl-piperidino-1-oxyl)-4-benzoyl] benzoyl adenosine 5'-triphosphate (SL-Bz(2)ATP) [Wang et al. (1999) J. Muscle Res. Cell Motil. 20, 743-753], behave like ATP in their interactions with myosin. Remarkably, photolabeled myosin recovers all of its normal enzymatic properties after treatment with actin in the presence of MgATP [Luo et al. (1995) Biochemistry 34, 1978-1987]. For SL-NANTP, the spin label moiety is attached to NANTP via an aminomethyl side chain. In SSL-NANTP, attachment is via a restricted spiro ring. The two new probes interact with myosin subfragment-1 (S1) in a manner analogous to ATP, and after photoincorporation, labeled S1 recovers full activity after treatment with actin and MgATP. The electron paramagnetic resonance (EPR) spectrum resulting from S1 photolabeled with SL-NANTP shows a very high degree of probe mobility. However, the EPR spectrum of S1 photolabeled with SSL-NANTP shows that the probe is highly immobilized with respect to S1, constrained to move within a cone of angle 52 degrees (full-width, half-max). Unlike the parent, NANTP, which photolabels on the 23 kDa tryptic fragment of S1, SSL-NANTP photolabels on the 20 kDa fragment. Its highly immobile nature means that it is potentially a useful reporter group to monitor cross-bridge motion in muscle fibers.

Actins↗

PubMedDate not supplied

How do we prioritize patients on the waiting list for coronary angiography?

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Coronary Angiography↗

PubMedDate not supplied

Intracoronary nitrates may avoid unnecessary angioplasty.

Explore the source record for details and available documents.

Adult↗