PubMed Health⌕ Search

Biomedical subjects

M Ferraro

Publications and source records attributed to M Ferraro.

At least 37 records · Page 2Linked to original sources

Intracoronary stent implantation in native coronary arteries and saphenous vein grafts: a consecutive experience with six types of stents without prolonged anticoagulation.

OBJECTIVE: To analyze the results of implantation of six different intracoronary stents without the use of prolonged anticoagulation. MATERIAL AND METHODS: Between Mar. 30, 1993, and Jun. 30, 1995, 889 patients with 1,194 coronary or vein graft lesions underwent implantation of one of six types of stents-Palmaz-Schatz, Gianturco-Roubin, Wiktor, Micro, Cordis, or Wallstent. The patients were classified into seven groups on the basis of the type of stent that was implanted, including one group with combined use of two or more types of stents. Among the 851 patients with successful stent delivery and without major complications, 801 received only antiplatelet therapy, and 50 received a standard anticoagulation regimen. One-month clinical followup data were obtained in all patients, and clinical events were investigated. RESULTS: The mean number of stents was 1.8 per lesion and 2.4 per patient. Procedural success was achieved in 93% of the lesions. The clinical success rate at 1 month was 90%. Intravascular ultrasound assessment was performed in 90% of the lesions. The final minimal luminal cross-sectional area of the stent increased from 6.8 to 7.8 mm2 after intravascular ultrasound-guided optimization. Within 1 month, 16 stent thrombosis events (1.9%) occurred. No significant differences were noted in stent thrombosis rates among the various stent cohorts. Multivariate logistic regression analysis revealed that the final stent minimal luminal diameter measured by intravascular ultrasonography was the only variable associated with stent thrombosis. CONCLUSION: This study showed that six different stents could possibly be inserted without subsequent anticoagulation if optimal stent expansion and total lesion coverage were achieved.

Anticoagulants↗

Coronary stenting in 1000 consecutive patients. Long-term clinical and angiographic results.

Coronary stent implantation has become an accepted treatment for selected patients but the long-term outcome after stent implantation has not been investigated in a large unselected population. This study reports clinical and angiographic results after coronary stent implantation in a consecutive group of 1000 patients treated between November 1989 and June 1994. A total of 2012 stents were implanted in 1216 lesions. The anticoagulation regimen after successful stenting was abolished in the last 499 patients, treated with aspirin and ticlopidina. Complex lesions (type B2, type C lesions and chronic total occlusions) were less frequent in the group with anticoagulation (67%, 355/529 lesions) than in the group without anticoagulation (76%, 485/641; p < 0.01). Vessel size was also significantly smaller in the group with no anticoagulation (3.21 +/- 0.50 mm vs 2.89 +/- 0.70 mm; p < 0.001). Procedural success was achieved in 96% of cases. Major complications occurred in 49 pts, including death (1%), emergency bypass surgery (2.7%), and myocardial infarction (2.1%). Subacute stent thrombosis, observed in 2.6% of the patients treated with anticoagulation, decreased to 1% in the last 499 patients receiving only antiplatelet drugs after high pressure stent expansion controlled with intravascular ultrasound (p < 0.05). Angiographic follow-up was obtained at a mean interval of 6.6 +/- 3.0 months in 718 patients (75% of the eligible candidates). The global restenosis rate (greater than 50% diameter stenosis) was 22%, with no statistically significant difference in patients with and without anticoagulation after stenting. Clinical follow-up was available in 890 patients at a mean interval of 14 +/- 17 months. Late cardiac events occurred in 251 patients and included: 159 repeat coronary angioplasties for restenosis (20%), 114 coronary angioplasties for de novo lesions (10%), 33 elective by-pass surgery operations (3.7%) and 42 late deaths (4.7%). At the most recent follow-up there were 719 pts (81%) free of anginal symptoms, including patients having repeat angioplasty for restenosis or disease progression. Coronary stenting has a low incidence of procedural complications and high-pressure ultrasound guided implantation has drastically reduced the risk of subacute thrombosis. Repeat procedures due to restenosis remain the most important limitation of the technique and do not seem to be affected by evolving technique and operator experience.

Angioplasty, Balloon, Coronary↗

A randomized comparison of combined ticlopidine and aspirin therapy versus aspirin therapy alone after successful intravascular ultrasound-guided stent implantation.

BACKGROUND: Previous studies have shown that it is feasible to withhold anticoagulation after a successful intracoronary stent procedure with a low incidence of stent thrombosis. The importance of specific antiplatelet agents when stenting is performed without anticoagulation is unknown. METHODS AND RESULTS: After successful intravascular ultrasound-guided stenting, 226 patients were randomly assigned to receive either aspirin therapy alone (n = 103) or a combination of ticlopidine and short-term aspirin therapy (n = 123). Primary angiographic and clinical end points were stent thrombosis, death, myocardial infarction, the need for postprocedure coronary artery bypass surgery or repeated angioplasty, and significant medication side effects requiring termination of the medication within the first month of a successful procedure. At 1 month, the rate of stent thrombosis was 2.9% in the aspirin only group and 0.8% in the ticlopidine-aspirin group (P = .2). Cumulative major clinical events after successful stenting occurred in 3.9% of the patients in the aspirin group and in 0.8% in the ticlopidine-aspirin group (P = .1). There were no medication side effects in the aspirin group; in the combined ticlopidine-aspirin group, medication side effects occurred in 3 patients (P = .2). CONCLUSIONS: At 1 month, there was no difference in the incidence of stent thrombosis or other clinical end points between the two poststent antiplatelet regimens. However, the relatively small size of the study and the low incidence of thrombosis events may have contributed to the failure to detect differences in angiographic and clinical end points between the two groups.

Aged↗

Implantation of the peripheral Wallstent for diffuse lesions in coronary arteries and vein grafts.

The Wallstent (Schneider, Bulach, Switzerland) is available in different lengths without much compromise in flexibility and radial support compared to some other stents. We treated 24 patients (26 vessels) with diffuse coronary lesions or vein graft lesions with intravascular ultrasound-guided peripheral Wallstent implantation. Average balloon pressure during stent optimization was 16.4 +/- 2.7 atm. The stents could be successfully implanted in 24 vessels. Minimal lumen diameter and percent diameter stenosis after stenting were 3.60 +/- 0.62 mm and -8 +/- 13%, respectively. Average stent length was 63.7 +/- 22.7 mm. There was one procedure-related complication. After stenting, all patients were treated only with antiplatelet agents. During 1-month follow-up, there was one subacute stent thrombosis due to incomplete coverage of a distal dissection. These preliminary results show the feasibility of this novel approach in selected lesions.

Adult↗

Acute recoil of Palmaz-Schatz stent: a rare cause of suboptimal stent implantation--report of two cases with intravascular ultrasound findings.

It is generally believed that the Palmaz-Schatz stent maintains a strong radial force, preventing stent recoil. However, the capacity to prevent recoil is largely governed by the hardness or resistance of the lesion. We report two cases of "acute Palmaz-Schatz stent recoil," documented by intravascular ultrasound, and suggest a novel treatment of this unusual problem.

Angioplasty, Balloon, Coronary↗

Effects of sequential stimuli on Halobacterium salinarium photobehavior.

We analyzed the motor photoresponses of Halobacterium salinarium to different test stimuli applied after a first photophobic response produced by a step-down of red-orange light (prestimulus). We observed that pulses given with a suitable delay after the prestimulus produced unusual responses. Pulses of blue, green, or red-orange light, each eliciting no response when applied alone, produced a secondary photophobic response when applied several seconds after the prestimulus; the same occurred with a negative blue pulse (rapid shut-off and turning on of a blue light). Conversely, no secondary photophobic response was observed when the test stimulus was a step (a step-up for red-orange light, a step-down for blue light) of the same wavelength and intensity. When the delay was varied, different results were obtained with different wavelengths; red-orange pulses were typically effective in producing a secondary photophobic response, even with a delay of 2 s, whereas the response to a blue pulse was suppressed when the test stimulus was applied within 5 s after the prestimulus. The secondary photophobic response to pulses was abolished by reducing the intensity of the prestimulus without affecting the primary photophobic response. These results, some of which were previously reported in the literature as inverse effects, must be produced by a facilitating mechanism depending on the prestimulus itself, the occurrence of reversals being per se ineffective. The fact that red-orange test stimuli are facilitated even at the shortest delay, whereas those of different wavelengths become effective only after several seconds, suggests that the putative mechanism of the facilitating effect is specific for different signaling pathways.

Biophysical Phenomena↗

Results of coronary stenting for restenosis.

OBJECTIVES: This study attempted to analyze immediate and long-term angiographic and clinical results of coronary stent implantation for restenosis in a consecutive group of patients. BACKGROUND: The rate of stent utilization in patients with coronary artery disease has increased exponentially in recent years. There are many unanswered questions about the use of stenting in patients with restenosis, particularly with respect to late clinical and angiographic results. METHODS: A total of 159 stents were implanted in 128 consecutive patients with 139 lesions (mean 1.3 stents/patient). A technique of optimal stent expansion was used in all patients, and intravascular ultrasound guidance with no subsequent anticoagulation was performed in 41 patients. RESULTS: Stent implantation was successful in 126 patients (98%). Four patients (3.1%) had complications (in two after successful stenting): death in one, emergency bypass surgery operation in two and subacute stent thrombosis in one. Stents were implanted with a final balloon size (mean +/- SD) of 3.5 +/- 0.5 mm and a mean maximal pressure of 11 +/- 4 atm (range 8 to 20). Angiographic restenosis occurred in 27 patients (25%). Regression analysis on clinical and angiographic variables for prediction of restenosis showed no statistical significance for any variable. Late events occurred in 23 patients (19%). The actuarial survival rate was 98% at 1 year and at 3 years, and the event-free survival rate including freedom from repeat angioplasty for restenosis was 95% and 76%, respectively. CONCLUSIONS: The late angiographic outcome, restenosis rate and total clinical events are favorable for selected patients undergoing stent implantation for the indication of restenosis.

Aged↗

Viral induction of low frequency interferon-alpha producing cells.

The human peripheral blood mononuclear cells responsible for IFN-alpha production in response to viral stimuli have been most often described as either monocytes (as typified by the response to Sendai virus) or as a light density, HLA-DR+ population which is negative for most cell surface markers characteristic of mature T cells, B cells, monocytes, or natural killer cells (as typified by the response to Herpes simplex virus (HSV)). The frequency of IFN-alpha-producing cells (IPC) responding to Sendai virus is typically 10-fold or more higher than those responding to HSV. In the current study, we have used ELISpot assays to determine the frequency of IPC responding to DNA and RNA viruses including HSV, Sendai, vesicular stomatitis virus, cytomegalovirus, adenovirus, SV40, influenza, measles, mumps, Newcastle disease virus (NDV) and human immunodeficiency virus (HIV). The enveloped viruses but not the nonenveloped viruses (adenovirus and SV40) elicited an IFN-alpha response. The frequency of IPC for each of the other viruses was more similar to the low frequency HSV-responding population than to the higher frequency Sendai virus response. These included several viruses in the same family as Sendai virus, namely the paramyxo viruses measles, mumps, and NDV. IPC were also tested for sensitivity to the lysosomotropic drug chloroquine, which diminishes IFN-alpha produced in response to HSV but not Sendai virus. With the exception of Sendai virus, chloroquine treatment abrogated the majority of IFN-alpha produced and IPC against each of the viruses. We conclude that low frequency, nonmonocytic NIPC account for the majority of IFN-alpha production in response to different viruses.

Cell Line↗

DNA methylation changes during mouse spermatogenesis.

Genomic imprinting in mammals is thought to be mediated by differences in the methylation level of cytosine residues in the genome. These differences in DNA methylation are thought to be generated during the development of the germ line. To characterize the profile of global methylation of the mouse genome during male gametogenesis, we have quantified the relative level of methylation in individual cells during meiosis and spermatogenesis. A decrease in the level of DNA methylation is observed from meiotic cells to elongated spermatids. The erasure of the somatic pattern of methylation during spermatogenesis suggests the existence of a subsequent mechanism generating the parental specific methylation patterns leading to genomic imprinting of specific alleles.

Alleles↗

Stereokinetic effects with sharp and fuzzy illusory contours.

A black, 8-shaped pattern, whose centre of gravity is in the centre of a rotating disc, appears to split into two black discs rotating with phenomenal independent motion, orientation stability, and sliding of one on the other. The type of observed movement, the order of overlapping, and the extent of the stereokinetic depth in relation to the contour type and different dimensions of the pattern were investigated. The experimental data show that a fuzzy contour facilitates the stereokinetic effect. Furthermore, the extent of the stereokinetic depth has been found to be greater in case of fuzzy contour and vertical orientation of the pattern. These results are in contrast with the models in which this effect is considered as a problem of minimisation of distances or velocities. A vector model of the observed movement and an interpretation of the overlapping based on an energy approach are proposed. A tentative explanation of the stereokinetic depth for our patterns is put forward.

Adult↗

Lie transformation groups, integral transforms, and invariant pattern recognition.

This paper considers image representations based on integral transforms which are invariant under certain transformations, while preserving the uniqueness of the encoding. Necessary and sufficient conditions are determined for the existence of such representations and a method to determine the kernels of the related integral transforms is presented. Finally, the possible relevance of such considerations for the understanding of invariant recognition systems in biological vision is also explored.

Humans↗

Modifications of the Poggendorff effect as a function of random dot textures between the verticals.

In the present research, we investigated the modification of the strength of the Poggendorff illusion as a function of different densities of random dot textures filling the space between the verticals. The results of Experiment 1 show that the illusory effect is a nonlinear function of the texture parameter r, the ratio of black pixels to white and black pixels, with a minimum for r = 0.5, approximately, and a maximum for r = 0 and r = 1. The results may be interpreted by an analytical model of perceptual space dynamics, in which the effect depends on the amount of interaction between points of different light intensity. A computer simulation performed by applying the analytical model to different values of r shows a good agreement between the predictions and the experimental data. To test the hypothesis underlying the model, a second experiment was carried out to measure the magnitude of the expansion of the space between the verticals as a function of the parameter r. The results are consistent with the hypothesis of the model. The overall data are discussed in terms of their implications on various theories proposed for the Poggendorff illusion.

Adult↗

[Brachial artery stenosis in a subject with a past traumatic fracture of the elbow].

We report a case of elbow fracture associated with brachial artery stenosis. Several authors reported that elbow fractures are associated with brachial artery injury. In the present case we detected brachial artery stenosis in a patient with a history of elbow fracture. Therefore we suggest that every patient with elbow trauma should undergo an assessment for brachial artery stenosis.

Brachial Artery↗

In human chromosomes telomeric regions are enriched in CpGs relative to R-bands.

Human chromosomes were in situ nick-translated using as nicking agents the endonucleases MspI (CCGG), its methyl-sensitive isoschizomer HpaII, HaeIII (GGCC), SacII (CCGCGG), EcoRI (GAATTC) and DNaseI. We show that in metaphase chromosomes R-bands are enriched, as compared with G-bands, in the dinucleotide CpG but no more than what is expected on the basis of their relative G+C content. The telomeric regions, on the contrary, besides having a chromatin conformation that is particularly relaxed and accessible to endonucleases, also show an enrichment in CpGs.

Autoradiography↗

A neural model of discrete and continuous modes of visual discrimination.

A simple neural model of visual pattern discrimination is presented, based on the assumption that visual discrimination is determined by the differences in activity of a certain set of filters. These filters are the input units of a three-layer network. The units of the second layer have probabilities of activation that depend on the differences in activity of the input units and in turn they determine the probabilities of activation of a layer of output units from which probabilities of correct discrimination can be predicted. This model has been used to simulate discrete and continuous modes of curved-line discrimination and the results show good agreement with experimental data found in the literature.

Computer Simulation↗

The use of a passive motion machine in the postoperative rehabilitation of Dupuytren's disease.

The purpose of this study was to prospectively compare the postoperative use of passive motion (PM) and standard hand therapy after surgical treatment of Dupuytren's disease for extent and rate of recovery of joint motion. Our data indicate that metacarpophalangeal joint contractures improved completely to a mean of 0 degrees, regardless of the postoperative protocol. Contractures at the proximal interphalangeal joint showed incomplete recovery in both study groups, with a mean residual contracture of 28 degrees for PM patients and 38 degrees for control patients. Contractures of the metacarpophalangeal-proximal interphalangeal joints in the same finger showed complete metacarpophalangeal joint recovery to a mean of 0 degrees but incomplete proximal interphalangeal joint recovery with a mean residual contracture of 30 degrees in PM patients and 22 degrees in control patients. We conclude that the use of a PM machine in the rehabilitation of Dupuytren's disease does not offer an advantage in the postoperative management of this condition.

Dupuytren Contracture↗