Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MAINE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Partner-specific sexual behaviors among persons with both main and other partners.

CONTEXT: If men and women engage in different sexual behavior with main partners than with other types of partners, then programs aimed at preventing the spread of sexually transmitted diseases (STDs) may need to address individuals' differential risk with each partner type. METHODS: Relationship characteristics, partner risk behaviors and sexual behaviors are examined among 123 male and 106 female STD clinic patients who had both main and other partners. Individual-level comparisons are made for two types of partner pairs: main vs. other frequent (side) partners and main vs. casual partners. RESULTS: Among men and women with both main and side partners, the proportion who had known only their main partner for at least a year (48% of men and 41% of women) was significantly higher than the proportion who had known only their side partner for that long (2% and 9%, respectively); no other variable differed significantly by partner type. Among those with main and casual partners, both men and women were more likely to use alcohol or drugs before or during sex with main partners only (15%) than with casual partners only (1-3%). Women with main and casual partners were more likely to have oral sex only with main partners than only with casual partners (37% vs. 3%), and were more likely to use condoms only with casual partners than only with main partners (33% vs. 4%). CONCLUSIONS: Providers need to ask individuals about their sexual behaviors with different partner types, and should tailor prevention messages to an individual's risks and reproductive intentions with each partner.

Chi-Square Distribution↗
PubMed2006

[Left main coronary artery angioplasty: report of five cases illustrating the current indications].

OBJECTIVES: The purpose of our study is to illustrate by five original observations the various situations where the stenting of the left main coronary artery can be proposed in alternative to aortocoronary bridging with encouraging results in short- and long-term. MATERIALS AND METHODS: We report a retrospective study relating to five cases with left main disease treated by stenting between 1996 and 2002 at our institution. In two cases the left main stem was unprotected. In two other cases, the left main trunk was protected. And the last case was an emergency stenting for an iatrogenic dissection of the left main coronary artery. RESULTS: The stenting was carried out successfully among the five patients without major in-hospital complication. During the follow-up of 29 months at mean, no death was deplored, and no target lesion revascularization was required on the left main coronary artery (with a left main trunk permeable on three coronarographic controls). CONCLUSIONS: In the light of these results, and basing on the published data, we conclude that stenting for the left main coronary disease may be a safe and effective alternative to coronary artery bypass surgery in particular cases among "selected" patients (refusal or surgical contraindication, protected left main coronary artery, spontaneous or iatrogenic acute occlusion of the left main coronary artery).

Adult↗
PubMed1997

Examination of the compaction properties of a 1:1 acetaminophen:microcrystalline cellulose mixture using precompression and main compression.

The compaction properties of a 1:1 acetaminophen and microcrystalline cellulose (MCC) mixture have been studied using a compaction simulator to make tablets by single compression and by a combination of precompression and main compression. The tensile strengths of the tablets and the energies involved in the compressions were determined. The tensile strengths of the tablets increased with increases in single compression pressure from 80 to 400 MPa and as the total applied pressure increased from 80 MPa up to around 400 MPa when combinations of precompression and main compression pressures were used. The tablet porosity decreased with increase in main compression pressure while the tablet tensile strengths increased. At minimum tablet porosity, further increase in main compression pressure could no longer result in increase in tablet strengths. Tablets compressed with combinations of precompression and main compression were stronger (2.15 +/- 0.02 to 3.99 +/- 0.1 MPa) than those produced with single compression (0.73 +/- 0.01 to 3.09 +/- 0.05 MPa). The total gross energies of compression increased with an increase in pressure of both the precompression and main compression. The elastic energies during main compression increased with an increase in precompression pressure as the tablet exhibited greater elastic deformation and reduced plasticity on second compression. The increase in elastic energies during main compression may also be because elastic energy is recoverable and is independent of precompression. As the precompression pressure increased, the minimum tablet porosity was attained; hence, the plastic energy during main compression became smaller while the elastic energy increased. Thus, a combination of low precompression and main compression pressures of 160/80 MPa or 80/160 MPa are more advantageous in the tableting of the 1:1 acetaminophen:MCC than a high single compression pressure of 320 or 400 MPa.

Acetaminophen↗
PubMed1996

Detection of main renal artery stenosis using phase-contrast cine MR angiography.

OBJECTIVE: The purpose of our study was to assess the ability of phase-contrast cine MR angiography to detect the presence of main renal artery stenosis. SUBJECTS AND METHODS: We prospectively evaluated 75 hypertensive patients form main renal artery stenosis using phase-contrast cine MR angiography. Each main renal artery was evaluated as normal or abnormal. Thirty-seven of the 75 patients underwent conventional arteriography or intraarterial digital subtraction arteriography; these results were compared with the MR angiographic interpretations. Only those patients who had confirmatory arteriography were included in the statistical analysis. RESULTS: Thirty-six main renal arteries interpreted as normal by MR angiography were found to be without a focal stenosis on invasive arteriography. MR angiography suggested 32 main renal artery stenoses; invasive arteriography showed 29 of these as stenoses. Three main renal arteries that were interpreted as having focal stenoses by MR angiography were shown to be not stenotic by invasive arteriography. Three other patients had diffusely narrowed main renal arteries bilaterally without a focal stenosis on MR angiography; bilateral proximal renal artery stenoses were seen at arteriography in two of these patients, and diffusely narrowed main renal arteries were seen in the third patient. Thus, the sensitivity of phase-contrast cine MR angiography for detecting a focal stenosis or abnormal main renal artery was 100% (95% confidence interval, 88-100%) and the specificity was 93% (95% confidence interval, 80-99%). The kappa coefficient was 0.85 with a standard error of 0.08. CONCLUSION: Phase-contrast cine MR angiography had a high degree of accuracy and a high negative predictive value in detecting the presence of main renal artery stenoses and may be a good screening technique for renovascular hypertension.

Adult↗
PubMed2002

[Main grade of Gleason's 7 score of the surgical sample correlated with biologic progression in patients treated for total prostatectomy].

OBJECTIVES: To analyse the influence of the main grade of Gleason score 7 of the operative specimen correlated with the blood PSA level on the laboratory progression-free survival of patients treated by radical prostatectomy. MATERIALS AND METHODS: 331 patients consecutively treated by radical prostatectomy and presenting a Gleason score 7 were analysed. Exclusion criteria were the use of radiotherapy and/or preoperative and/or postoperative endocrine therapy. The main grade (3 or 4), histological stage, and blood PSA level were analysed for their predictive value of laboratory progression-free survival. The mean follow-up was 3.5 years (range: 13.6 to 72.8 months). Laboratory recurrence was defined by a PSA > 0.4 ng/ml. RESULTS: The main grade of Gleason score 7 was 3 in 199 (60%) patients and 4 in 132 (40%) patients with a mean follow-up of 3.6 years. Laboratory progression-free survival rates were 89% and 72% for main grades 3 and 4, respectively (p = 0.03). When the cancer was confined to the prostate, the progression-free survival rates were 96% and 88% for main grades 3 and 4, respectively (p = 0.01). For a PSA < 10 ng/ml, main grade 3 was associated with a better laboratory progression-free survival rate than main grade 4 (p = 0.0007). No difference in terms of laboratory progression was observed in the presence of extraprostatic extension or PSA > 10 ng/ml. CONCLUSION: A high correlation was observed between the main grade of Gleason score 7 and laboratory progression-free survival. Main grade 3 constituted a factor of better prognosis than main grade 4.

Disease Progression↗
PubMed2003

Impact of Maine's Medicaid drug formulary change on non-Medicaid markets: spillover effects of a restrictive drug formulary.

BACKGROUND: Market penetration of HMOs affect physician practice styles for non-HMO patients. OBJECTIVE: To study the impact of a restrictive Medicaid drug formulary on prescribing patterns for other patients, ie, so-called spillover effects. DESIGN: A before-and-after, 3-state comparison study. EVENT: On January 1, 2001, Maine's Medicaid program implemented a restrictive drug formulary for the proton pump inhibitor class, with pantoprazole as the only preferred drug. MAIN OUTCOME MEASURE: The Medicaid and non-Medicaid market shares of pantoprazole in Maine (vs New Hampshire and Vermont and among Maine physicians with different Medicaid share of practice. RESULTS: After 3 months, the market share of pantoprazole in Maine (vs 2 control states) increased 79% among Medicaid prescriptions (vs 1%-2%), 10% among cash prescriptions (vs 3%), and 7% among other third-party payer prescriptions (vs 1%). The market shares increased more among Maine physicians with a higher Medicaid share of practice (high vs middle vs low [market]: 16% vs 8% vs 5% [cash]; 11% vs 5% vs 4% [other third-party payers]). Linear regression results indicate that practicing medicine in Maine leads to a 72% increase in pantoprazole share among Medicaid prescriptions (P < .001). In addition, for each 10% Medicaid share of practice in Maine, the share of pantoprazole increases 1.8% among cash prescriptions (P = .01) and 1.4% among other third-party payer prescriptions (P < .001). CONCLUSIONS: Maine's Medicaid drug formulary generated spillover effects in cash and other third-party payer markets, with somewhat stronger effects in the cash market.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2004

Surgical reconstruction of the left main coronary artery: fresh autologous pericardium or saphenous vein patch.

BACKGROUND: Isolated stenosis of the left main coronary artery is usually treated by coronary bypass surgery. However, this approach restores a less physiologic perfusion of the myocardium that leads to occlusion of the left main coronary artery, and restores only a retrograde perfusion of a rather extensive myocardial area. Coronary ostial plasty has been described as an alternative surgical technique in isolated ostial left main coronary artery stenosis without calcification. We review our experience with 15 patients. METHODS: After placing the patient on cardiopulmonary bypass and aortic cross clamping, the main pulmonary trunk was retracted laterally. The left main coronary artery was approached anteriorly through a curved aortotomy. Reconstruction was performed using fresh pericardial patch or saphenous vein that was tailored as a patch. RESULTS: There were no early mortality or perioperative myocardial infarctions. During mean follow-up of 55 +/- 39 months, no patients had any cardiac events or required repeated coronary intervention. All patients underwent follow-up transesophageal echocardiography, which demonstrated a wide open left main coronary artery (range 3 to 8 mm), normal flow pattern by pulsed-wave Doppler, and no aneurysmal dilatation or calcification of the onlay patch. Coronary angiography and intravascular ultrasound were performed in 2 patients because of nonspecific chest discomfort. In both cases, the left main coronary artery was found to be wide open, and there were no signs of patch calcification. CONCLUSIONS: Surgical reconstruction of the left main coronary artery is safe and effective for the treatment of selected cases of isolated left main stenosis. The use of autologous pericardium appears to be as safe as saphenous vein patch. Neither method was associated with postoperative aneurysmal dilatation or calcification.

Aged↗
PubMed2006

Long-term outcome after surgical left main coronary angioplasty.

BACKGROUND: Direct surgical angioplasty of the left main coronary artery is aimed to restore a more physiologic flow of the left coronary artery compared with conventional coronary artery bypass graft surgery and allows subsequent percutaneous coronary interventions of more distal coronary lesions if necessary. Relatively little data are known about long-term outcome in these patients. METHODS: In 1996 and 1997, in 31 patients in our hospital, surgical angioplasty of the left main coronary artery was attempted. The left main coronary artery was approached in the anterior way. Follow-up was performed during 8 years and concluded by invasive anatomic and functional evaluation of the left main coronary artery. RESULTS: In 4 of these patients, the procedure was converted to conventional coronary artery bypass graft surgery owing to calcification of the left main coronary artery. Of the remaining 27 patients, 3 patients died in the perioperative period and 4 other patients died during follow-up. In 18 of the 20 survivors, coronary angiography was performed after 8 years, and the left main coronary artery was also evaluated by intravascular ultrasound and coronary pressure-based fractional flow reserve measurement. At angiography and intravascular ultrasound, a dilated funnel-shaped left main coronary artery was seen in all of these patients. In 1 patient, a hemodynamically significant left main coronary artery stenosis was present (fractional flow reserve < 0.75), and in this patient coronary artery bypass graft surgery was performed. CONCLUSIONS: Although the total mortality of 23% was somewhat disappointing, the majority of the survivors had an excellent anatomic and physiologic result after direct surgical angioplasty of the left main coronary artery. Therefore, this technique deserves a place in the surgical armamentarium.

Adult↗
PubMed1997

[The family function of patients on home oxygen therapy and their main caregivers].

We examined family APGAR scores in patients on home oxygen therapy (n = 101) and their main caregivers (n = 91), and compared them with those obtained from members of a seniors' club who were not on home oxygen therapy themselves, nor had any family members on home oxygen therapy. Furthermore, the relationship between the main caregivers recognition of the patients' mental state and the patients' CESD score was examined. Family APGAR scores for the main caregivers were significantly lower than those of the patients (p < 0.002), or the seniors' club members (p < 0.004). Since most the main caregivers were women, we compared family APGAR scores of the female main caregivers and the age-matched female members of the seniors' club, revealing that the satisfaction of the female main caregivers with the "adaptation" component of the APGAR score (the component dealing with support given when something troublesome happens), was significantly lower than that of the members of the seniors' club (p < 0.0001). The CESD of the patients whom the main caregivers recognized as depressed was significantly higher. Thus, we concluded that satisfaction of the main caregivers with family function who were family members was low, and that the role of the main caregivers is important in alleviating the depression of patients on home oxygen therapy.

Aged↗
PubMed1981

Tonsillectomy in Maine: regulation versus education as modulators of medical care.

The reduction in the rate of tonsillectomy, using the state of Maine as an example, and the causes thereof are addressed. Are federal and state regulations required to change the behavior of physicians and the public, or is education of greater importance? A study of tonsillectomy in the state of Maine was based on data covering a period of approximately 30 years. The data were based on direct contact with hospitals, in which we achieved the cooperation of virtually all of the hospitals of Maine, encompassing 98% of the hospital beds. These data were placed in context by information provided by the Maine Health Data Service, and by information for the northeastern United States, for the eastern United States, and for the entire United States, from the Department of Health, Education and Welfare. The operation of tonsillectomy and its variants, including adenoidectomy, has declined remarkably in the past 30 years, most drastically in the past eight years. It now occupies only 4.5% of the total operative admissions for the State, where it formerly was 17%. It now has a populational incidence for the State of 3.3 operations per thousand population per year, whereas it formerly was at a level of about 10.0. From this study, as well as from physicians in Maine, to whom an informal questionnaire was sent, it is clear that this reduction has come about largely because of education of physicians and the public. Increased awareness by the public, pediatricians and general practitioners of the limitations of this operation has been significant. In addition, there is a general sense of improved general health of young people in Maine, with fewer chronic respiratory infections. Some negative opinions were expressed, including the possibility that peritonsillar abcesses may be more frequent in the future and that some pediatricians and general practitioners overuse antibiotics. Federal regulations, state regulations, Medicare, Medicaid, Blue Cross or Blue Shield regulations concerning tonsillectomy were not instituted at any point in the State of Maine, during the period under study. There were no alterations in payment, second opinion programs or other restrictions or constraints placed on the operation at any level of official or hospital regulation. Formerly performed in large numbers by general practitioners, family practitioners, and general surgeons, the operation(s) is now predominantly carried out by trained otolaryngologists, largely board certified. Evidence is presented to support the view that concentration of this operation in the hands of fewer, more highly trained surgical specialists has been positively associated with its sharper indications and declining frequency. The conclusion is offered that increased education of physicians, both specialists and general practitioners as well as family doctors, and of the public as a whole, is the most important single factor in producing this significant alteration in the behavior of the health care system in the State of Maine. Effective limitation of the operation to specialists has been an important feature both of this educational process and of the more rational use of the operation(s).

Adenoidectomy↗
PubMed1978

Origin and length of left main coronary artery: its relation to height, weight, sex, age, pattern of coronary distribution, and presence or absence of coronary artery disease.

The distance from the base of the left coronary sinus to the origin of the left main coronary artery was measured in 54 patients. The length of the left main coronary artery and the pattern of arterial dominance were determined in the last 37 patients. These variables were correlated with height, weight, age, sex, and presence or absence of coronary artery disease. Average distance from the basis of the left coronary sinus to the origin of the left main coronary artery was 19.4 +/- 2.7 mm. Average length of the left main coronary artery was 9.7 +/- 4.3 mm. There was a large inherent variability between distance from the base of left coronary sinus to the origin of the left main coronary artery and height of the subjects. Other variables did not show positive correlation. Similar large variability was noticed between of the left main coronary artery and height of the subjects. Thus, from these observations it was not possible to predict the distance from the base of the left coronary sinus to the origin of the left main coronary artery or the length of the left main coronary artery using height or any other variable. The importance of these findings in relation to coronary angiography is discussed.

Adult↗
PubMed2006

Trends in percutaneous versus surgical revascularization of unprotected left main coronary stenosis in the drug-eluting stent era: a report from the American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR).

OBJECTIVES: We sought to determine how practice patterns for unprotected left main stenosis have changed with the advent of drug-eluting stents (DES). BACKGROUND: Percutaneous coronary intervention (PCI) of unprotected left main coronary stenosis has been controversial. METHODS: We analyzed data submitted to the American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR) between January 1, 2002 and December 31, 2004 from 1,276,582 cardiac catheterizations at 417 institutions. Of these, 53,548 (4.2%) had left main stenosis >50% and no prior CABG. After excluding the unrevascularized, the patient sample (N = 32,562) was analyzed for PCI vs. CABG. Data was stratified by year/quarter, bare metal stent vs. DES, elective vs. urgent/emergent situations, LVEF < or > or =40%, and %left main and RCA stenosis. RESULTS: Of unprotected left main revascularizations from 2002 to 2004, PCI increased from 17.0% to 21.9%, while CABG decreased from 83.0% to 78.1% (P < 0.0001). In 2002, bare metal stents were used for all PCIs; in 2004, bare metal stent use was only 25.5%, while DES use was 74.5% (P < 0.0001). Of elective procedures, PCI rose from 19.1% to 27.5% while CABG fell from 80.9% to 72.5% (P < 0.0001). Similar trends, all significant, were seen in every clinical situation. CONCLUSIONS: In the era of DES, the rate of PCI for unprotected left main stenosis has risen, while CABG has declined. These findings are seen across varying clinical situations, including elective procedures. DES have rapidly and largely replaced bare metal stents for PCI of unprotected left mains. However, PCI is still chosen less frequently than CABG for unprotected left main revascularization.

Angioplasty, Balloon, Coronary↗
PubMed2001

A new noninvasive method for evaluation of coronary endothelial function in hypertensive patients based on change in diameter of the left main coronary artery induced by cold pressor test using echocardiography.

BACKGROUND: Coronary endothelial function is frequently studied by measuring the vasodilator response of coronary arteries to acetylcholine or to cold pressor test by invasive quantitative coronary angiography. Because invasive methods have substantial inherent limitations, studies should attempt to evaluate coronary endothelial function noninvasively. HYPOTHESIS: We attempted to evaluate the accuracy of measurement of the percent change in diameter of the left main trunk induced by cold pressor test with two-dimensional (2-D) echocardiography. Furthermore, we applied this method to the evaluation of coronary artery endothelial function in hypertensive patients. METHODS: We measured the left main trunk diameter in 21 subjects (51 +/- 4 years) before and after cold pressor test using quantitative coronary angiography followed immediately by 2-D echocardiography. The accuracy of measurement of the left main trunk diameter and its percent change by echocardiography was evaluated by comparing the values obtained by the two methods. In addition, using echocardiography, we compared left main trunk diameter responses to cold pressor test in 16 hypertensive patients [51 +/- 5 years (mean +/- standard deviation)] and 16 matched healthy subjects (50 +/- 4 years). RESULTS: Although there was only a weak correlation between the absolute values of the left main trunk diameter measured by the two methods (r = 0.61; p = 0.04), a strong correlation was found between the percent change in diameter measured by the two methods (r = 0.93; p = 0.0001). The percent change in diameter of the left main trunk induced by cold pressor test in hypertensive patients (-3.7 +/- 10.6%) was significantly lower than that in control subjects (13.2 +/- 6.8%, p = 0.0001). CONCLUSIONS: Percent change in diameter of the left main trunk induced by cold pressor test can be evaluated accurately using 2-D echocardiography. Our study showed reduced vasodilation or vasoconstriction of the left main trunk after cold pressor test in hypertensive patients compared with healthy subjects, indicating impaired coronary endothelial function in hypertensive patients. The present echocardiographic method is a potentially useful new noninvasive method for evaluating coronary endothelial function.

Adult↗
PubMed1977

Efferent projections of the main and the accessory olfactory bulb in the tree shrew (Tupaia glis).

The projections of the main and the accessory olfactory bulb in the tree shrew (Tupaia glis) have been analyzed with anterograde degeneration and autoradiographic methods for identifying axonal projections, and with the horseradish peroxidase method for identifying the distribution of neurons from which these projections originate. The cytoarchitectonic features of the paleocortical areas which receive projections from the main and the accessory olfactory bulb have also been described. The efferent projections of the accessory olfactory bulb are distributed to the bed nucleus of the accessory olfactory tract, the medial amygdaloid area, the posteromedial cortical amygdaloid area, and to the caudal portion of the bed nucleus of the stria terminalis. In contrast, the efferent projections of the main olfactory bulb are distributed to the anterior olfactory nucleus, the tenia tecta, the olfactory tubercle, the pyriform cortex, the anterior cortical amygdaloid area, the posterolateral cortical amygdaloid area, and to the lateral entorhinal cortex. These observations are consistent with the notion that the olfactory system can be divided into at least two major subsystems: one related to the vomeronasal organ and accessory olfactory bulb, and another related to the main olfactory organ and main olfactory bulb. The paleocortical areas receiving olfactory projections have three basic layers: a superficially positioned plexiform layer (layer I), a pyramidal cell layer (layer II), and a polymorphic cell layer (layer III). The projections of both the main and the accessory olfactory bulb terminate in the outer portion of the plexiform layer (sublamina Ia). Sublamina Ia contains the distal segments of dendrites which originate from a heterogeneous population of neurons located in layer II and, to a lesser extent, layer III. Although the efferent projections of the main and the accessory olfactory bulb are segregated, evidence for a more refined topographical organization within these projections was not obtained. However, the distribution of retrogradely labeled neurons in the main olfactory bulb, following injections of horseradish peroxidase into its various paleocortical targets, indicates that the olfactory projections to these areas may not all originate from the same population of cells.

Amygdala↗
PubMed1992

Organization of the septal organ projection to the main olfactory bulb in adult and newborn rats.

The septal organ, which is regarded as an olfactory subsystem, is a small patch of sensory epithelium located ventral to the main olfactory sheet on the septal wall of the nasal cavity. The only consensus to date regarding some proper area of projection of this subsystem is that the septal organ projects to the medial aspect of the main olfactory bulb. The purpose of our study was to analyze precisely the topographical organization of the bulbar projection of the septal organ in adult rats and in 3- to 15-day-old rats following WGA-HRP placements at the level of the septal epithelium. Results show that the septal organ projects exclusively to the posterior half of the main olfactory bulb and its projection area is mainly restricted to the ventromedial bulbar aspect. When the septal organ was fully injected, the pattern of bulbar projection was characterized by two types of glomerular labeling: 1) presence of single heavily labeled glomeruli identified as "septal" glomeruli, since they were mainly built up by afferents coming from the septal organ and (2) presence of a thin network of labeled septal fibers distributed in glomeruli which were mainly formed by afferents coming from the main olfactory epithelium. Although the pattern of mucosobulbar projection of the septal organ is already established in newborns, a significant increase in the number of "septal" glomeruli occurs during the first 15 postnatal days. Anatomical data indicate that even if the projection of the septal organ does not appear completely segregated in the olfactory bulb, this projection is not either exactly similar to that of the main olfactory epithelium.

Aging↗
PubMed1986

Specific perfusion pattern in stress 201Tl myocardial scintigraphy of left main coronary artery disease.

The usefulness of stress 201Tl myocardial scintigraphy for identifying left main coronary artery disease was evaluated with data from 23 patients with 50% or more narrowing of the left main coronary artery and 56 patients with 75% or more narrowing of the major coronary arteries but without left main coronary artery involvement (no left main coronary artery disease). Quantitative evaluation of stress perfusion scintigrams in all five patients with narrowing of the left main coronary artery of 90% or more showed a characteristic perfusion pattern (left main pattern) of extensive homogeneous defect over the whole anterolateral segment and simultaneous defects in all radii of the high anteroseptal and high posterolateral segments. On the other hand, such a perfusion pattern was noted in only 1 of 18 patients with less than 90% stenosis of the left main coronary artery and in only 1 of 56 patients with no left main coronary artery disease.

Coronary Circulation↗
PubMed2002

[Surgical angioplasty of the left main coronary artery. Evaluation and postoperative follow-up with intravascular ultrasound].

We report the case of a 45 year old man presenting to our emergency ward with acute onset of typical chest pain. The ECG showed ST-segment depression in the postero-lateral leads without elevation of any cardiac enzymes. The coronary angiogram showed a three-vessel disease with a subtotal, short stenosis of the right coronary artery and a severe ostial stenosis of the left main coronary artery. An operative revascularization with a venous graft to the right coronary artery and a angioplasty with an autologous vein patch of the left main coronary artery were performed. No peri- or postoperative complications occurred. Because of the importance of the left main coronary artery, the patient underwent an early post-operative coronary angiogram with intravascular ultrasound (IVUS) to confirm the patency of the patch angioplasty. We discuss the historical development, the indications and the main advantages of the patch angioplasty in comparison to conventional CABG procedures. The main issue of the presentation is the special value of IVUS in the pre- and postoperative assessment of the left main coronary artery. Within the last few years, IVUS has emerged from a pure research tool to the gold standard of coronary imaging. It is playing a more and more important role in the assessment of angiographically unclear lesions, mainly in the left main stem and its bifurcation. In addition, IVUS has a large influence in clinical decision making, e.g., reverral to CABG or PCI. It is also a powerful tool for optimizing the operative setting and provides the best possible postoperative control.

Cardiac Catheterization↗
PubMed1989

Supraoptic nucleus afferents from the main olfactory bulb--I. Anatomical evidence from anterograde and retrograde tracers in rat.

The morphological features of a putative connection between the main olfactory bulb and the supraoptic nucleus of the rat was studied using a combination of anatomical techniques. Immunocytochemistry of neurophysin-containing processes were employed to delineate morphological features of supraoptic dendrites. Main olfactory bulb efferents to the supraoptic nucleus were studied by injection of the anterogradely transported substances, wheatgerm agglutinin conjugated horseradish peroxidase or Phaseolus vulgaris leucoagglutinin, into the main olfactory bulb. To confirm the results of these studies, the distribution of retrogradely labeled cells within the main olfactory bulb was determined after injection of rhodamine-labeled latex microspheres or Fluoro-Gold into the supraoptic nucleus. Neurophysin immunocytochemistry revealed the supraoptic nucleus dendritic plexus which coursed anteroposteriorly beneath supraoptic somata. Additionally, a portion of this plexus also projected ventrolaterally into periamygdaloid areas, a feature of supraoptic architecture which is not generally appreciated. The anterograde tracers labeled main olfactory bulb efferents including a dense plexus of terminals and fibers ventrolateral to the ipsilateral supraoptic nucleus. The pattern of anterogradely labeled fibers and terminals appeared to overlap with the distribution of ventrolaterally projecting neurophysin-containing processes. Since the latter consists of dendritic processes of supraoptic origin, this suggests that the main olfactory bulb projects to the supraoptic nucleus. Injections of rhodamine-labeled latex microspheres or Fluoro-Gold resulted in retrogradely labeled mitral cells throughout the ipsilateral main olfactory bulb. Taken together, these anatomical studies demonstrate a direct projection from the main olfactory bulb to the supraoptic nucleus of the rat. A comparison electrophysiological study confirmed these results.

Animals↗