Biomedical subjects

L Conte

Publications and source records attributed to L Conte.

At least 19 recordsLinked to original sources

PubMed2006

Optimisation of multislice computed tomography protocols in angio-CT examinations.

PURPOSE: The aim of this paper is to explain a general procedure for the optimisation of multislice computed tomography (MSCT) protocols. MATERIALS AND METHODS: Four angio-CT protocols with a GE LightSpeed Plus 4-slice CT scanner were considered. Effective doses were computed for a sample of patients. First the dose was optimised for arterial-phase scans on a standard patient and adapted to the weight of individual patients with a scaling factor. RESULTS: The mean effective dose for an angio-CT examination ranged from 18.8 mSv to 28.8 mSv, depending on the protocol adopted. Following the optimisation procedure, we drew up a table indicating tube current values for each patient weight. Calculation of the effective dose before and after the optimisation procedure revealed a dose reduction of about 40%. CONCLUSIONS: Angio-CT examinations deliver high doses, but these doses can be reduced without affecting image quality.

Adult↗

PubMed2004

Radiochromic film measurement of anisotropy function for high-dose-rate Ir-192 brachytherapy source.

The dose distribution produced by the high-dose-rate (HDR) 192Ir source is inherently anisotropic due to self-absorption by the high-density source core, oblique filtration by the source capsule and the asymmetric geometry of the source capsule. To account for the dose distribution anisotropy of brachytherapy sources, AAPM Task Group No 43 has included a two-dimensional anisotropy function, F(r, theta), in the recommended dose calculation formalism. Gafchromic HS radiochromic film (RCF) was used to measure anisotropy function for microSelectron HDR 192Ir source (classic/old design). Measurements were carried out in a water phantom using specially fabricated PMMA cylinders at radial distances 1, 2, 3, 4 and 5 cm. The data so generated are comparable to both experimental and Monte Carlo calculated values for this source reported earlier by other authors. The RCF method described in this paper is comparatively high resolution, simple to use and is a general method, which can be applied for other brachytherapy sources as well.

Algorithms↗

PubMed2004

Relative hopane content confirming the mineral origin of hydrocarbons contaminating foods and human milk.

Hopanes, triterpenoid hydrocarbons formed under geological conditions, were analysed to confirm the mineral origin of the unresolved complex mixtures of hydrocarbons observed in the gas chromatography with flame ionization detection chromatograms of human milk and certain foodstuffs. The 'relative hopane content' (RHC) is introduced, i.e. it is the area ratio of the sum of the hopanes and the paraffins in the same segment of the chromatogram. The RHC in various mineral oil products (motor oils, hydraulic oils, lubricating oils, Vaseline) was 3.4%, with a relative standard deviation of 19%. The RHC determined in samples of vegetable oils, mussels and clams as well as of human milk containing an unresolved complex mixture of hydrocarbons was in the same range, confirming that these samples were contaminated by mineral oil material.

Animals↗

PubMed2002

Patient effective dose from endovascular brachytherapy with 192Ir sources.

The growing use of endovascular brachytherapy has been accompanied by the publication of a large number of studies in several fields, but few studies on patient dose have been found in the literature. Moreover, these studies were carried out on the basis of Monte Carlo simulation. The aim of the present study was to estimate the effective dose to the patient undergoing endovascular brachytherapy treatment with 112Ir sources, by means of experimental measurements. Two standard treatments were taken into account: an endovascular brachytherapy of the coronary artery corresponding to the activity x time product of 184 GBq.min and an endovascular brachytherapy of the renal artery (898 GBq.min). Experimental assessment was accomplished by thermoluminescence dosemeters positioned in more than 300 measurement points in a properly adapted Rqndo phantom. A method has been developed to estimate the mean organ doses for all tissues and organs concerned in order to calculate the effective dose associated with intravascular brachytherapy. The normalised organ doses resulting from cronary treatment were 2.4 x 10(-2) mSv.GBq(-1).min(-1) for lung, 0.9 x 10(-2) mSv.GBSq(-1).min(-1) for oesophagus and 0.48 x 10(-2) mS.GBq(-1).min(-1) for bone marrow. During brachytherapy of the renal artery, the corresponding normalised doses were 4.2 x 10(-2) mS.GBq(-1).min(-1) for colon, 7.8 x 10(-2) mSv.GBq(-1).min(-1) for stomach and 1.7 x 10(-2) mSv.GBq(-1).min(-1) for liver. Coronary treatment iJnvlled an efl'fective dose of (0.046 mSv.GBq(-1).min(-1), whereas the treatment of the renal artery resulted in an effective dose of 0.15 mSv.GBq(-1).min(-1); there were many similarities with data from former studies. Based on these results it can be concluded that the dose level of patients exposed during brachytherapy treatment is low.

Arteries↗

PubMed2002

A new method to assess the fluidodynamic behaviour of an angiographic contrast agent.

PURPOSE: To propose a new method for the assessment of the fluidodynamic behaviour of angiographic contrast agents. The method enables measurement of the spatial distribution and time dependence of the contrast agent along a pseudo-vessel on images obtained with an X-ray image intensifier. MATERIAL AND METHODS: A particular phantom was devised consisting of a plexiglas box with an insert into which a latex tube with a 0.4 cm in diameter was placed in order to simulate the tortuous flow of a blood vessel. The box, which is filled with water to simulate the thickness of a normal patient, is connected to an injection and pumping system which serve to keep the contrast agent flowing in the pseudo-vessel tube. The pseudo-vessel tube was filled with plain water in one case and with saline solution in another case to assess their different dilution capabilities. The phantom and the flow of contrast agent were imaged with a conventional X-ray image intensifier system and the images were stored in digital format during 35 second acquisitions at a speed of 4 frames per second; for any frame it is possible to measure the mathematical contrast in any position in the image. Further, a diagram showing the time dependence of the spatial distribution of the mathematical contrast is proposed. The X axis shows the spatial distribution of the mathematical contrast, whereas the Y axis shows its temporal variation with a gray level proportional to the mathematical contrast value. By building an horizontal profile of this diagram one can obtain the spatial distribution at a fixed time, while by building a vertical profile one can obtain the temporal variation at a fixed point. Several different contrast agents were so tested. RESULTS: The proposed method allows different fluido-dynamic behaviour patterns of contrast agents and flowing media to be shown. Owing to the different chemical characteristics of water and saline solution these media have different dilution capabilities (higher for water) and this is well demonstrated by the diagram profiles obtained for each. The system has also allowed the detection of a particular behaviour of some contrast agents, whose spatial distribution was non uniform even in the last frames, thus showing a tendency to maintain their bolus-nature over time. An interesting feature which can be noticed in all the temporal profiles is the presence of a "pre-bolus", i.e. the contrast is higher at the very beginning of the flow, then decreases and after some time starts to increase again. Though the initial contrast value obviously depends on the iodine concentration employed, the method shows the contrast variation as a function of time is different for different contrast agents. CONCLUSIONS: The method and the equipment proposed provide a good description of the fluidodynamic behaviour of different contrast agents, but do not constitute a reference method for testing haemodynamic behaviour which, "in vivo", is obviously affected by several other chemical and metabolic factors. However, the method allows evaluation of the contrast agents from a physical and fluidodynamic point of view, showing that the iodine content is not the only feature affecting their behaviour. The method can be used in quality control to test the constancy of the physical behaviour of different contrast agents.

Angiography↗

PubMed2000

Biochemical responses in a Candida famata strain adapted to high copper concentrations.

A strain of Candida famata adapted to high copper concentration (1.26 mM) and a number of biochemical parameters have been tested, in order to get information on the mechanisms of metal toxicity and detoxification as well as on the metabolic responses to the treatment. The cytoplasmic levels of superoxide dismutase, peroxidase and glutathione were found significantly increased with respect to control cells, in contrast to catalase which is not affected. The activities of enolase and of triosephosphate isomerase are found to decrease as a consequence of the exposure to copper. Statistically significant differences in the content of some aminoacids are found between copper-treated and control cells.

Adaptation, Physiological↗

PubMed2000

[Feasibility of the use of elastographic techniques with ultrasound in the diferentiation of different tissues].

PURPOSE: To investigate the feasibility of distinguishing different tissues by detecting their different elastic properties when mechanically stimulated with an ultrasound wide beam. MATERIAL AND METHODS: A tissue-mimicking material phantom was placed in a water filled box. Two devices (Teuco Hydrosonic) emitting two US beams (3.2 MHz) were placed on two opposite walls of the box. The US beams had a circular diameter of about 10 cm; their intensity could be set by varying the power voltage applied to the device from 0 to 12 V. The US beams caused a mechanical stimulation of both the phantom and the water surrounding it. An ATL HDI 5000 scanner was used in order to acquire tissue Color Doppler images using the fundamental frequency (Tissue Doppler Imaging, TDI), and the second harmonic (Harmonic Tissue Doppler Imaging, HTDI). The images allowed to visualize, using a color scale, the vibrational status of both the phantom and the water surrounding it. Both fundamental and second harmonic images were taken using different power values supplied to the stimulation device, with the voltage ranging from 0 to 12 V. In order to quantify the vibrational status of the water and of the tissue-mimicking phantom two Regions Of Interest (ROI) were taken on the images. A parameter describing the "color amount" in each ROI and defined by an appropriate mathematical function was proposed. RESULTS: Differences between the values of the "color amount" parameter in the phantom and in water were statistically significant both at the fundamental frequency and at second harmonic imaging, and for each positive value of the voltage of the power supplied to the device for the stimulation. Also the differences between the parameter "color amount" at the fundamental frequency and second harmonic imaging were statistically significant; the differences were found for both water and phantom and for any positive voltage. The correlation between the intensity of the stimulation (voltage) and the "color amount" parameter is statistically significant with the second harmonic technique in the phantom, nearly significant with the second harmonic technique in water and not significant in the other cases. CONCLUSIONS: It is possible to try to characterize a tissue by analyzing its elastic properties when an ultrasound wide beam mechanically stimulates it. The most promising technique consists in acquiring images using Harmonic Tissue Doppler Imaging, (HTDI) and measuring the vibrational status by using the "color amount" parameter proposed.

Elasticity↗

PubMed1999

Assessment of polycyclic aromatic hydrocarbon content of smoked fish by means of a fast HPLC/HPLC method.

Polycyclic aromatic hydrocarbon (PAH) concentrations in smoked food can reach levels hazardous for the human health, especially when the smoking procedure is carried out under uncontrolled conditions. In this work a simple and rapid method for the determination of PAHs in smoked fish samples is described. PAHs were extracted from the insoluble samples (together with fat substances) by homogenization with acidified chloroform. The fat extract was then submitted to a first LC sample preparation step (performed on a large silica column) to isolate PAHs from triglycerides. After reconcentration, the PAH fraction was finally injected into the reverse-phase analytical column. The proposed method, which presents good characteristics of recoveries and repeatability, was also used to analyze PAH content of some smoked trout samples packed under vacuum.

Animals↗

PubMed1999

Evaluation of commercial and purified Pluronic F-68 in a human blood neutrophil bioassay.

The effects have been studied of commercial grade Pluronic F-68 or its purified fractions, prepared by passage through silica gel resin (SGR) or by supercritical fluid fractionation (SFF), on human polymorphonuclear leucocyte (PMNL) chemiluminescence in vitro. The mean (+/- s.d., n = 3) total chemiluminescence following stimulation of neutrophils with phorbol 12-myristate 13-acetate in saline controls, was 190 +/- 3 mV x min. Commercial Pluronic inhibited chemiluminescence by a maximum of 26% (P < 0.05), whilst, in contrast, Pluronic F-68 fractions prepared by SGR or SFF stimulated chemiluminescence by up to 53% over control (P < 0.05). The total chemiluminescence with Pluronic F-68 prepared by SFF followed by SGR was not significantly different to that produced by saline (0.9% w/v NaCl). These results reinforce previous suggestions that trace impurities in commercial preparations of the Pluronic F-68 are responsible for reported adverse biological effects.

Humans↗

PubMed1999

[Heart catheterization via the femoral artery with a 4 French and mobilization at 2 hours].

The use of small catheters for cardiac catheterization, as well as for other diagnostic and interventional procedures, can reduce iatrogenic trauma on cardiac and vascular structures. Early patient mobilization may thus reduce both patient discomfort and the length and cost of stays. The performance of 4 French catheters was evaluated in a pilot cohort of consecutive in patients who underwent coronary arteriography with the use of the femoral Judkins technique and who had no restriction to full ambulation. Patients were helped to resume full ambulation two hours after the procedure, and the femoral access site was inspected 24 hours later upon discharge. Coronary arteriography with 4 French catheters was performed in 45 patients (10 women) aged 62 +/- 10 years. In one patient with anomalous origin of the right coronary artery, selective catheterization of the coronary ostium required a catheter style available only in 5 French. In all cases, selective opacification with 4 French catheters was adequate for diagnosis. Forty-three patients were mobilized 115 +/- 10 minutes after the end of manual compression. Hematoma, bleeding or limb perfusion disturbances were absent in all cases upon inspection 22 +/- 4 hours later. This pilot experience indicates that coronary arteriography with femoral 4 French Judkins catheters is technically feasible and that patient ambulation 2 hours later is safe. This data requires confirmation in a larger patient cohort and can lead to new standards for both patient comfort and the use of hospital resources in coronary arteriography.

Adult↗

PubMed1999

[Study of ultrasonographic image textures with second-order statistical methods].

BACKGROUND: We report the sonographic image texture of the neonatal heart in different stages of development by calculating numerical parameters extracted from the gray scale cooccurrence matrix. To show pixel values differences and enhance texture structure, images were equalized, and then the gray level range was reduced to 16 to allow for sufficiently high occupancy frequency of the cooccurrence matrix. MATERIALS AND METHODS: We measured B-mode US images, all acquired with the same unit, using the same setup (gain, frequency, constant TGC). For each case measurements were made on 3 diastolic images by selecting a 32 x 64 pixel on the interventricular septum ROI. This procedure was applied to 3 different examinations made at birth, at 3 days, and after a month of life. For each 8 bit image we obtained a coocurrence matrix by sampling adjacent pixels at 0 degree, from which we calculated entropy; then the images were equalized and converted to 4 bit format; on these processed images we calculated 4 gray scale coocurrence matrix samplings adjacent pixels at angles of 0 degree, 45 degrees, 90 degrees, and 180 degrees. Parameters obtained from different angles cooccurrence matrix were averaged to get a numerical parameter independent of sampling angles. RESULTS: The one-way analysis of variance and Student's "t"-test were performed on the parameters obtained from 3 different examinations and the differences among different developmental stages are 95% significant. No significance was obtained comparing images at birth with those at 3 days. CONCLUSIONS: Differences are so little significant that they may be due to different factors affecting image texture and the variability introduced by manual ROI positioning; therefore no definitive conclusions can be drawn as to considering this kind of analysis capable of discriminating different stages of myocardial development. To apply this analysis to routine US examinations, different correction factors for range, azimuth, and focal dependence of texture must be considered.

Mathematics↗

PubMed1998

New azole antifungals. 2. Synthesis and antifungal activity of heterocyclecarboxamide derivatives of 3-amino-2-aryl-1-azolyl-2-butanol.

A series of 92 azole antifungals containing an amido alcohol unit was synthesized. The nature and substitution of the amide portion was systematically modified in search of improved antifungal activity, especially against filamentous fungi. The compounds were tested in vitro against a variety of clinically important pathogens and in vivo (po) in a murine candidosis model. Thiazole and thiophene carboxamides carrying both a substituted phenyl ring and a small alkyl group were best suited for activity against filamentous fungi. In a subset of these compounds, the amide portion was conformationally locked by means of a pyrimidone ring and it was proven that only an orthogonal orientation of the phenyl ring yields bioactive products. A tendency to display long plasma elimination half-lives was observed in both series. Two compounds, 74 and 107, representative of the open and cyclic amides, respectively, were chosen for further studies, based on their excellent activity in in vivo murine models of candidosis and aspergillosis. This work describes the SARs found within this series. The next paper displays the results obtained in a related series of compounds, the quinazolinones.

Animals↗

PubMed1998

New azole antifungals. 3. Synthesis and antifungal activity of 3-substituted-4(3H)-quinazolinones.

A series of azole antifungal agents featuring a quinazolinone nucleus have been subjected to studies of structure-activity relationships. In general, these compounds displayed higher in vitro activities against filamentous fungi and shorter half-lives than the structures described in our preceding paper. The most potent products in vitro carried a halogen (or an isostere) at the 7-position of the quinazolinone ring. Using a murine model of systemic candidosis, oral activity was found to be dependent on hydrophobicity, which, in turn, modulated the compound's half-life. The 7-Cl derivative, (1R,2R)-7-chloro-3-[2-(2, 4-difluorophenyl)-2-hydroxy-1-methyl-3-(1H-1,2, 4-triazol-1-yl)propyl]quinazolin-4(3H)-one (20, UR-9825), was selected for further testing due to its high in vitro activity, low toxicity, good pharmacokinetic profile, and ease of obtention. Compound 20 is the (1R,2R) isomer of four possible stereoisomers. The other three isomers were also prepared and tested. The enantiomer (1S,2S) and the (1R,2S) epimer were inactive, whereas the (1S,2R) epimer retained some activity. In vitro 20 was superior to fluconazole, itraconazole, SCH-42427, and TAK-187 and roughly similar to voriconazole and ER-30346. In vivo, 20 was only moderately active in a mouse model of systemic candidosis when administration was limited to the first day. This was attributed to its short half-life in that species (t1/2 = 1 h po). Protection levels comparable to or higher than those of fluconazole, however, were observed in systemic candidosis models in rat and rabbit, where the half-life of the compound was found to be 6 and 9 h, respectively. Finally, 20 showed excellent protection levels in an immunocompromised rat model of disseminated aspergillosis. The compound showed low toxicity signs when administered to rats at 250 mg/kg qd or at 100 mg/kg bid during 28 days.

Animals↗

PubMed1998

Detection of plum pox virus in apricot seeds.

Twelve different apricot selection trees from a germplasm collection naturally infected with plum pox virus (PPV) were chosen to investigate the role of seeds in the epidemiology of this dangerous pathogen. All the considered plants showed typical symptoms on leaves and fruits and were positive in enzyme-linked immunosorbent assay (ELISA). The virus was characterized by immunocapture reverse transcription-polymerase chain reaction (IC-RT-PCR) followed by restriction fragment length polymorphism (RFLP) analysis with RsaI enzyme as a PPV-D isolate. The presence of PPV was checked on fully ripe seeds and seedlings. One half of the seed stock was analysed immediately by ELISA and IC-RT-PCR tests: the cotyledons containing also the embryo were separated from the teguments. The other half of the seed stock was germinated and maintained in an insect-proof screenhouse over a 2-year period. PPV was detected by ELISA only in the seed coat while by IC-RT-PCR also in cotyledons. Seedlings from infected seeds did not show any typical symptoms and were PPV-negative in serological and molecular assays. So far, the presence of PPV in seeds seems to play no role in its epidemiology.

Blotting, Western↗

PubMed1997

Influence of formulation on the in vitro transdermal penetration of flutrimazole.

Flutrimazole (1-[(2-fluorophenyl)(4-fluorophenyl)phenylmethyl]-1 H-imidazole, CAS 119006-77-8, UR-4056) is a new wide spectrum local imidazolic antifungal agent that has already been formulated as a dermal cream (FDC). A comparative study was carried out of the release of flutrimazole from two emulsions in which the drug has been incorporated differently: one dissolved in the oily phase (E24) and the other dispersed in the aqueous formulation phase (E25). Based on the E25 formulation, two more dermal creams were prepared, E27 with benzyl alcohol and E28 with diazolidinyl urea as preservative agents. A comparative study of transdermal penetration including E27, E28, FDC (reference 1% flutrimazole dermal cream) and 1% flutrimazole hydroalcoholic solution was also performed. An amount of the sample dosage form containing 10 mg of flutrimazole was applied to a Franz type cell. The penetration membrane used was cellulose acetate in the release studies and human skin provided by a plastic surgery clinic in the transdermal penetration study. The amount released after 7 h was 36.3 +/- 4.9 micrograms when flutrimazole was dissolved (E24) and 35.9 +/- 5.3 micrograms when flutrimazole was dispersed (E25). Although the differences were not significant, the cream with dispersed flutrimazole was selected for further penetration studies due to its better stability observed in previous studies. The amounts of drug penetrated after 44 h were 31.3, 41.5, 38.3 and 186.5 micrograms for E27, E28, FDC dermal creams and topical hydroalcoholic solution, respectively. The solution showed a statistically significant difference (p < 0.05) from the other formulations, however, no differences were observed between the dermal cream formulations. No differences were neither obtained between the different dermal creams when the amount of drug retained in the skin was compared. This allows to assert that the excipients used do not have different influences on transdermal penetration. In all cases, the mean quantity penetrated in relation to the dose applied was at most 0.5%. These results allow to infer that flutrimazole shows scarce transdermal penetration. Further, the amount of flutrimazole retained per gram of skin is more than 100 times the MIC per gram obtained in previous in vitro studies. It may be assumed that the topical application of the new formulations assayed would allow to obtain a good therapeutic response.

Administration, Cutaneous↗

PubMed1996

Ambulation three hours after elective cardiac catheterisation through the femoral artery.

OBJECTIVE: To test whether very early resumption of ambulation after femoral cardiac catheterisation is feasible and safe in patients with stable symptoms. DESIGN: Prospective study in a selected group of men and women undergoing elective cardiac catheterisation, with next day physical inspection. SETTING: Inpatient study. SUBJECTS: Two hundred consecutive ambulant patients submitted to diagnostic cardiac catheterisation through the femoral arterial route using 5F catheters: a femoral right heart study was done at the same time in 40 patients (20%). RESULTS: No patient had major complications during the study. Early ambulation was not allowed in two patients (1%) because of haematoma formation immediately after sheath removal, and in seven (3%) because of poor haemostasis or haematoma on inspection at 3 h. Early ambulation was interrupted in two patients (1%) because of transient arterial hypotension on standing in one, and the patient's preference in the other. Of 189 patients who resumed full ambulation at 3 h, one (0.5%) had a groin haematoma on discharge the next morning. Overall, haematoma 12 h after cardiac catheterisation was present in seven of the 200 patients initially included in the study (3.5%). None of the 191 patients with attempted early mobilisation had signs or symptoms of vascular complications one month or later after discharge. CONCLUSION: Supervised resumption of ambulation 3 h after uncomplicated cardiac studies with 5F femoral arterial catheters is safe and feasible in most ambulant patients undergoing elective cardiac catheterisation.

Adolescent↗

PubMed1995

[A method of image enhancement in the use of hydrosoluble uro-angiographic contrast media].

The radiographic contrast, when using hydrosoluble uro-angiographic contrast media, depends on several factors. A phantom and a new method are proposed to assess and optimize the contrast. The phantom allows to simulate three pseudovessels with diameter of 2 mm, 5 mm, and 10 mm, placed in a water-equivalent layer of 20/cm thickness. The phantom is exposed to a photon beam produced by a conventional X ray tube, and the images are obtained using conventional screen film system. The aim of the study is to assess the radiographic contrast between the vessel and the background when modifying the optical density of the radiograph (by different settings of the mAs switching), the X-ray tube high voltage and the diameter of the vessels; the contrast was studied with four different contrast media (Uromiro 24%, Conray 36%, Iopamiro 300 and Iomeron 400) and three X-ray tube high voltages (60 kV, 80 kV, 100 kV). The curve fitting the contrast as a function of the optical density of the background (in each condition of high voltage, diameter of the vessel and contrast media used) is a parabola. A quite narrow distribution of abscissas of the maxima of the parabolas was found, ranging from the minimum optical density 1.21 in the case of 100 kV high voltage and 2 mm diameter to the maximum optical density 1.58 in the case 60 kV and 10 mm. The mean value (1.40) is proposed as the optical density of the background optimizing the contrast according to the screen-film system used. In conclusion, the authors suggest to optimize the use of contrast media, trying to obtain radiographs with an optical density approaching the optimal value in any clinical situation. Therefore tables of the settings of the X-ray tube and generator are required; the tables must take into account the main parameters influencing the settings, such as the source-film distance, the water-equivalent thickness of the patient and the film-screen system used.

Angiography↗

PubMed1995

[The use of activated clotting time (ACT) to optimize heparinization during coronary angioplasty. The nursing personnel of the Hemodynamics Laboratory].

BACKGROUND: Suboptimal anticoagulation during coronary angioplasty is reported to be a major risk factor for occlusive complications. AIM: To define an appropriate timing for activated clotting time (ACT) tests in order to optimize anticoagulation with heparin during coronary angioplasty. METHODS: In 50 consecutive procedures of elective angioplasty ACT was measured at baseline, at 30, 60 and 120 min after heparin 10,000 U iv. In a subgroup of 25 patients (SG1) no additional heparin was given until the ACT test at 60 min. In a second subgroup of 25 patients (SG2) heparin 5,000 U was administered 30-45 min after the initial bolus if the ACT at 30 min was < 300 sec. ACT values were analyzed, and the correlation with the biological variables of patients was tested. RESULTS: In 20 patients out of 50 (40%) ACT values at 30 min were < 275 min. Heparin response was correlated with the body surface area but nor with age, neither with baseline ACT. Values at 60 min showed an adequate anticoagulation in only 6 patients (24%) in SG1 vs 21 (84%) in SG2. There were not complications. CONCLUSIONS: ACT testing 30 min after heparin 10,000 U during coronary angioplasty identifies most patients requiring early supplemental heparin. This yields an adequate anticoagulation at 60 min in most patients.

Adult↗