Recent intervention trials during myocardial infarction demonstrated no benefit from emergency angioplasty after thrombolytic therapy when compared with either delayed percutaneous transluminal ...coronary angioplasty (PTCA) or a conservative strategy. However, it is possible that subgroups of patients may benefit from early intervention with angioplasty. We performed a prospective randomized trial in patients with a patent infarct-related artery after thrombolytic therapy to determine whether initial flow grade is related to infarct-zone function and whether patients with ineffective reperfusion (greater than 90% stenosis or Thrombolysis in Myocardial Infarction TIMI flow less than or equal to 2) might benefit from immediate PTCA. Thrombolytic therapy was administered to 170 patients at a mean of 2.1 +/- 0.5 hours after onset of myocardial infarction. A patent infarct-related artery that was suitable for angioplasty was present in 89 patients who comprised the study group; after randomization, 47 of 50 patients with a patent infarct-related artery had successful emergency PTCA 3.8 +/- 1.5 hours after onset of symptoms, and 39 were scheduled for delayed (18 to 48-hour) PTCA. Reocclusion occurred before the scheduled (delayed) procedure in eight patients (20.5%), and was symptomatic in six. Infarct-region function (by the centerline method) measured initially, before discharge, and at 4 months was similar in both groups; improvement was significant (p less than 0.001) at discharge when compared with initial values with no further change at 4 months. However, patients with ineffective reperfusion had greater hypokinesia initially (p less than 0.05) compared with those with effective reperfusion (less than or equal to 90% stenosis plus TIMI flow 3). Moreover, independent of the timing of PTCA, improvement was greater before discharge in patients with ineffective reperfusion (p less than 0.05) with a trend also evident at 4 months. Importantly, 42 of 51 patients (82%) with a residual lumen less than 0.4 mm after thrombolysis had some improvement in function at discharge; this compared with a previous study in which patients with a similar degree of stenosis (without PTCA) had no improvement. Moreover, reocclusion occurred before scheduled (delayed) PTCA in 37% of patients with greater than 90% stenosis compared with only 5% in those with less than or equal to 90% stenosis (p = 0.02). Thus flow grade is an important determinant of myocardial function in patients with a patent artery after thrombolytic therapy and is predictive both of improvement in wall motion after PTCA and early reocclusion.
NFAT1 (NFATp), a cytosolic component of the nuclear factor of activated T cells (NFAT), is encoded by a single gene which was mapped to mouse chromosome 2 in the vicinity of the
wasted (wst) locus. ...Although
wasted mice display a severe immune disorder, they express normal levels of NFAT1 protein. The NFAT1 protein in
wasted mice is properly regulated and possesses comparable DNA binding activity as that in their littermate controls. Therefore, the
wasted phenotype is not due to a defect in the expression or early regulation of the NFAT1 protein
We describe the morphologic features of 25 cytology specimens (13 fine-needle aspirates and 12 exfoliative specimens) obtained from nine patients with malignant melanoma of soft parts (MMSP). ...Analysis of the fine-needle aspirates and exfoliative specimens revealed primarily a dispersed cell population with occasional cell clustering. Tumor cells were round to polygonal with moderately abundant cytoplasm and had round nuclei with prominent nucleoli. In two cases, an initial definitive diagnosis of MMSP was rendered on material obtained by fine-needle aspiration with the aid of immunocytochemical and ultrastructural studies.
The development trends of ultrasonic devices dictate that frequencies increase, electrode element counts increase, and element pitch dimensions shrink. The high density of the small pitch electrode ...elements combined with the challenging geometry of the device design, and considerations of acoustic impedance and signal interference, mean that new assembly and packaging techniques are required to be developed to form the interconnection between the high frequency ultrasound (HFUS) arrays and external circuitry. Novel assembly methods using photolithography of new epoxy composite alumina/SU-8 and high density flexible circuits, precision dicing of lead zirconate titanate (PZT) material, flexible circuits and SU-8 resin, powder blasting for vias structuring, and conductive and adhesive films bonding are considered as a mass-scale production approach.
The challenges for the realization of a miniaturized high frequency ultrasonic transducer linear array lie in the interconnections on the fine pitch piezoceramic elements. Within the footprint the ...size of a needle, only peripheral interconnections can be allowed on the transducer array such that the acoustic operations on both faces of the vibrating piezoelectric elements are not obstructed. The very low maximum processing temperature allowed also poses difficulty for conventional bonding techniques. This article presents 3-dimensional packaging using spirally rolled flexible circuits, room-temperature anisotropic conductive bonding and stencil printing for the setup of a wafer-level production process flow.
Genome-wide association studies (GWAS) have identified >300 loci associated with measures of adiposity including body mass index (BMI) and waist-to-hip ratio (adjusted for BMI, WHRadjBMI), but few ...have been identified through screening of the African ancestry genomes. We performed large scale meta-analyses and replications in up to 52,895 individuals for BMI and up to 23,095 individuals for WHRadjBMI from the African Ancestry Anthropometry Genetics Consortium (AAAGC) using 1000 Genomes phase 1 imputed GWAS to improve coverage of both common and low frequency variants in the low linkage disequilibrium African ancestry genomes. In the sex-combined analyses, we identified one novel locus (TCF7L2/HABP2) for WHRadjBMI and eight previously established loci at P < 5x10(-8) : seven for BMI, and one for WHRadjBMI in African ancestry individuals. An additional novel locus (SPRYD7/DLEU2) was identified for WHRadjBMI when combined with European GWAS. In the sex-stratified analyses, we identified three novel loci for BMI (INTS10/LPL and MLC1 in men, IRX4/IRX2 in women) and four for WHRadjBMI (SSX2IP, CASC8, PDE3B and ZDHHC1/HSD11B2 in women) in individuals of African ancestry or both African and European ancestry. For four of the novel variants, the minor allele frequency was low (<5%). In the trans-ethnic fine mapping of 47 BMI loci and 27 WHRadjBMI loci that were locus-wide significant (P < 0.05 adjusted for effective number of variants per locus) from the African ancestry sex-combined and sex-stratified analyses, 26 BMI loci and 17 WHRadjBMI loci contained <= 20 variants in the credible sets that jointly account for 99% posterior probability of driving the associations. The lead variants in 13 of these loci had a high probability of being causal. As compared to our previous HapMap imputed GWAS for BMI and WHRadjBMI including up to 71,412 and 27,350 African ancestry individuals, respectively, our results suggest that 1000 Genomes imputation showed modest improvement in identifying GWAS loci including low frequency variants. Trans-ethnic meta-analyses further improved fine mapping of putative causal variants in loci shared between the African and European ancestry populations.
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