Objective: Transcranial direct current stimulation (tDCS) is one of the methods described in the literature to decrease the perceived loudness and distress caused by tinnitus. However, the main effect is not clear and the number of responders to the treatment is variable. The objective of the present study was to investigate the effect of the placement of the cathode on the outcome measurements. Methods: Patients considered for the trial were chronic non-pulsatile tinnitus patients with complaints for more than 3 months and a Tinnitus Functional Index (TFI) score that exceeded 25. The anode was placed on the right dorsolateral prefrontal cortex (DLPFC). In the first group-"bifrontal"-the cathode was placed on the left DLPFC, while in the second group-"shoulder"-the cathode was placed on the shoulder. Each patient received two sessions of tDCS weekly and eight sessions in total. Evaluations took place on the first visit for an ENT consultation, at the start of therapy, after eight sessions of tDCS and at the follow-up visit, which took place 84 days after the start of the therapy. Subjective outcome measures such as TFI, Visual Analog Scales (VAS) for loudness and percentage of consciousness of tinnitus were administered in every patient. Results: There was no difference in the results for tinnitus loudness and the distress experienced between the placement of the cathode on the left DLPFC or on the shoulder. In addition, no statistically significant overall effect was found between the four test points. However, up to 39.1% of the patients experienced a decrease in loudness, measured by the VAS for loudness. Moreover, 72% of those in the bifrontal group, but only 46.2% of those in the shoulder group reported some improvement in distress. Conclusion: While some improvement was noted, this was not statistically significant. Both electrode placements stimulated the right side of the hippocampus, which could be responsible for the effect found in both groups. Further research should rule out the placebo effect and investigate alternative electrode positions.

Retrotransposon long interspersed nuclear element-1 (LINE-1) occupies a large proportion of the mammalian genome, comprising approximately 100,000 genomic copies in mice. Epigenetic status of the 5' untranslated region (5'-UTR) of LINE-1 is critical for its promoter activity. DNA methylation levels in the 5'-UTR of human active LINE-1 subfamily can be measured by well-established methods, such as a pyrosequencing-based assay. However, because of the considerable sequence and structural diversity in LINE-1 among species, methods for such assays should be adapted for the species of interest. Here we developed pyrosequencing-based assays to examine methylcytosine (mC) and hydroxymethylcytosine (hmC) levels of the three active LINE-1 subfamilies in mice (TfI, A, and GfII). Using these assays, we quantified mC and hmC levels in four brain regions and four nonbrain tissues including tail, heart, testis, and ovary. We observed tissue- and subfamily-specific mC and hmC differences. We also found that mC levels were strongly correlated among different brain regions, but mC levels of the testis showed a poor correlation with those of other tissues. Interestingly, mC levels in the A and GfII subfamilies were highly correlated, possibly reflecting their close evolutionary relationship. Our assays will be useful for exploring the epigenetic regulation of the active LINE-1 subfamilies in mice.

A new β-diketone, 2-(2,2,2-trifluoroethyl)-1-indone (TFI), which contains a trifluorinated alkyl group and a rigid indone group, has been designed and employed for the synthesis of two series of new TFI lanthanide complexes with a general formula [Ln(TFI)(3)L] [Ln = Eu, L = (H(2)O)(2) (1), bpy (2), and phen (3); Ln = Sm, L = (H(2)O)(2) (4), bpy (5), and phen (6); bpy = 2,2'-bipyridine, phen = 1,10-phenanthroline]. X-ray crystallographic analysis reveals that complexes 1-6 are mononuclear, with the central Ln(3+) ion eight-coordinated by six oxygen atoms furnished by three TFI ligands and two O/N atoms from ancillary ligand(s). The room-temperature photoluminescence (PL) spectra of complexes 1-6 show strong characteristic emissions of the corresponding Eu(3+) and Sm(3+) ions, and the substitution of the solvent molecules by bidentate nitrogen ligands essentially enhances the luminescence quantum yields and lifetimes of the complexes.

In the last few years several indices and tools, aimed at identifying frail subjects in various care settings have been developed. However, to date none of them has been incorporated into usual practice in the primary care setting. The purposes of this study are: 1) to evaluate the predictive capacity of the Tilburg Frailty Indicator (TFI), the Gérontopôle Frailty Screening Tool (GFST) and the KoS model together with two biomarker levels (SOX2 and p16INK4a) for adverse events related to frailty; 2) to determine differences in the use of healthcare services according to frailty.

Prospective multicentre cohort study with a 2-year follow-up. The study will be performed in primary care centres of Gipuzkoa and Costa del Sol, both located in Spain. Autonomous, non-institutionalized individuals aged 70 and over that agree to participate in this study will constitute the study population. A total of 900 individuals will be randomly selected from the healthcare administrative data bases of the participating health services. Data will be collected at baseline and at 1 and 2 years. The main independent variables assessed at baseline will be TFI outcomes, GFST and the KoS model, together with the expression of SOX2 and p16INK4a levels. During follow-up, loss of autonomy, the occurrence of death and consumption of healthcare resources will be assessed.

The main focus of this work is the identification and evaluation of several instruments constructed under different rationales to identify frail subjects in primary care settings. The resulting outcomes have potential for direct application to the primary care practice. Early identification of the onset of functional impairment of elderly is an essential, still unresolved aspect in the prevention of dependence in the scope of primary care.

The effect of cactus (Opuntia ficus-indica) added to the diet of lactating (21 days of lactation) sows on voluntary feed intake, and its impact on the productive and reproductive post-weaning performance was evaluated. Data collected of 72 farrowings from 37 hybrid sows were analyzed during 12-month period. The sows were divided into two groups: (i) control group (CG; n = 18 sows), sows fed only with commercial feed, and (ii) experimental group (EG; n = 19 sows), sows fed with commercial feed plus cactus supplement. The variables evaluated were blood glucose (BG), daily feed intake (DFI) and total feed intake (TFI), loss of body weight (LBW), weaning-estrus interval (WEI), and subsequent litter size (SLS). Data analysis was carried out using fixed effects models. A nested effect was found for farrowing number (FN) into of group and an interaction group × season on the analyzed variables (P < 0.001). EG observed lower levels of BG with 47.0 ± 7.9 mg dL-1 pre-prandial and 56.1 ± 5.9 mg dL-1 post-prandial at the 10th day of lactation (P < 0.05). DFI and TFI were higher in the sows of the EG independently of the FN and season (P < 0.05). No differeces were observed on the nested effect of FN into group on the levels of BG (P < 0.05). Autumn showed the higher TFI: 121.4 kg-1 sow-1 (P < 0.05). Sows from CG 3rd farrowing and from EG 4th farrowing observed higher LBW (13.8 and 6.9%, respectively) (P < 0.05). Summer showed a higher LBW with 12.7% for CG and 8.2% for EG (P < 0.05). EG showed a lower WEI (5.5 days) and greater SLS up to 1.8 piglets more depending upon the season (P < 0.05). The lactating sow's diet supplemented with cactus can counterbalance the negative effects of lactational hypophagia due to reduction on levels of BG during lactation and an increase on DFI and, therefore, improves performance of LBW, WEI, and SLS.

BACKGROUND

Studies have shown reduction in major bleeding with trans-radial intervention (TRI) compared with trans-femoral intervention (TFI), and with use of bivalirudin compared with heparin+glycoprotein IIb/IIIa inhibitors (GPI). We compared major bleeding, mortality and the interaction between arterial access site and the anticoagulant used for PCI in Veterans.

METHODS

A retrospective cohort of 1192 consecutive patients who underwent PCI at a VA hospital between 2006 and 2012 was divided into TFI-heparin (n=192), TFI-bivalirudin (n=272), TRI-heparin (n=274) and TRI-bivalirudin (n=454) groups. Primary outcomes were in-hospital major bleeding, in-hospital and 1-year all-cause mortality. Secondary outcomes were in-hospital MI, in-hospital and 1-year MACE and net adverse cardiovascular events (NACE - composite of major bleeding+MACE).

RESULTS

Femoral access was associated with a significantly increased risk of major bleeding compared with radial access (OR 11.87, p<0.001). Correspondingly, radial access was protective against major bleeding compared with femoral access (OR 0.128, p<0.01), but did not lower mortality or MACE by itself. Severe anemia was the only predictor of in-hospital all-cause mortality (OR=27.62, p<0.008). Presence of anemia and age>70 predicted 1-year mortality, whereas major bleeding and anemia predicted 1-year MACE. An interaction was noted between anticoagulant and access site, such that heparin showed significantly greater major bleeding in the femoral group compared with the radial group. Bivalirudin resulted in similar risk of bleeding, regardless of access site. There was a synergistic interaction between radial access and heparin (HR 0.38, p<0.05), but not radial access and bivalirudin, on reduction in 1-year NACE.

CONCLUSIONS

Radial access for PCI is associated with reduction in major bleeding, but does not have an effect on in-patient or 1-year MACE and mortality. Major bleeding is associated with poor short and intermediate term outcomes. In addition, anemia is strongly associated with increased in-patient and 1-year mortality. There is a differential effect of heparin but not bivalirudin on major bleeding, depending on the access site. There is no synergism between radial access and bivalirudin in lowering the composite outcome of MACE and major bleeding at 1year.

Treatment of transplant-ineligible (TNE) newly diagnosed multiple myeloma (NDMM) requires a balance between disease control and maintaining quality of life (QoL). Patients value treatment-free remission periods in this incurable condition, as they are associated with better QoL. We set out to study clinical outcomes of consecutive TNE NDMM patients in routine care treated in Thames Valley Cancer Network between 2009 and 2017. The primary outcome was the evaluation of the treatment-free interval (TFI) after 1st and subsequent lines of therapy in the total cohort and in individual subgroups, according to age (≤75 vs. >75 years), and co-morbidities using Charlson Co-morbidity Index (CCI): mild: 0-2 vs. moderate: 3-4 vs. severe: ≥5). Secondary outcomes include response rates, overall survival (OS) and progression-free survival (PFS) between subgroups: according to age and according to co-morbidities. In a total cohort of 292 patients, median TFI (IQR) was longest after first-line therapy 6.9 months (1.4-16.9), reducing after second line therapy to 1.8 months (.7-6.9), and after third line therapy to 0.6 months (0.2-1.5). Median TFI followed the same trend across the different subgroups, by age (≤75, >75 years) and by CCI (0-2, 3-4, ≥5). Overall response rate (ORR) to first line therapy for total cohort was 67%, with responses categorised as complete response (CR): 21%, very good partial response: 16%, partial response: 30%, stable disease: 18%, and progressive disease: 8%. ORR in individual subgroups by age were (≤75: 70% vs. >75: 63%), and by CCI (0-2: 65% vs. 3-4: 71% vs. ≥5: 77%). Median OS and PFS for the total cohort were (30.2 months, 95% CI: 23.8-36.9), and (9 months, 95% CI: 7.9-9.8), respectively. Patients aged >75 years showed a significant reduction in OS and PFS compared to those ≤75 years of age: OS (49.0 vs. 22.4 months, p<0.0001, HR: 2.08, 95% CI: 1.5-2.8), PFS (9.7 vs. 8.0 months, p<0.01, HR: 1.47, 95% CI: 1.1-1.9). Median OS was significantly reduced with worsening co-morbidities: (CCI 0-2: 52.4 months vs. CCI 3-4: 33.0 months vs. CCI ≥5: 24.0 months, p = 0.01, HR: 1.43, 95% CI: 1.1-1.9). Median PFS was significantly reduced in the severely co-morbid subgroup (CCI 0-2: 9.4 months vs. CCI 3-4: 9.6 months vs. CCI ≥5: 7.1 months, p = 0.025, HR: 1.3, 95% CI: 1.0-1.6). This study demonstrated that first line therapy in the TNE NDMM setting resulted in the longest TFI which was modest at a median of 6.9 months, and decreased significantly following subsequent lines of therapy and across the different subgroups by age and by co-morbidities. Therapy objective should be to maximise the benefit of first line treatment. We envisage that the recent shift towards a continuous therapeutic approach will benefit TNE patients in view of improved survival data demonstrated by a number phase 3 trials. When continuous therapy is not appropriate due to patient choice or toxicities, an efficacious (not limited to thalidomide and bortezomib) but tolerable first line FDT strategy, which can maximise TFI and maintain a good QoL, remains a reasonable alternative approach.

This work presents a new scale to measure conflicting attitudes toward sexual minorities. This scale parallels existing measures of conflicting racial attitudes (anti-Black and pro-Black attitudes; Katz & Hass, 1988). After constructing and validating measures of antigay and progay attitudes, we tested relationships among core American values with racial and sexual minority attitudes. We examined relations among the Protestant Work Ethic (PWE), Traditional Family Ideology (TFI), and egalitarian values with attitudes toward racial outgroups and sexual minorities. The results revealed that both PWE values and egalitarian values predicted anti-Black attitudes. By contrast, endorsement of egalitarian values, but not PWE values, predicted pro-Black attitudes. Results also revealed a similar but distinct pattern among values and heterosexuals' attitudes toward sexual minorities. TFI, but not egalitarian value endorsement, predicted antigay attitudes, whereas both TFI and egalitarian value endorsement predicted progay attitudes. The implications of these findings are discussed.

Bilateral testicular biopsies were performed on 66 children undergoing orchiopexy for unilateral cryptorchidism and the tubular fertility index (TFI) recorded. The results in both the descended and undescended testes at various ages were compared with previously reported control data. There were no significant differences between the germ cell activity of the scrotal testis in cases with unilateral cryptorchidism and that of controls. By contrast, the mean TFI of the undescended testis was significantly less than that of control patients of all ages. In neither group was there evidence of a progressive loss of germ cell activity during childhood. It is concluded that there is little to be gained from very early orchiopexy, performed before the third year of life.

We have operated on 2204 cryptorchid testis between 1972 and 1995. We took pathological specimens, not only in the undescended testis but also in the normally descended contralateral testis in 122 children. Clinical, surgical and anatomopathological records were reviewed. Moreover, we have studied the spermiograms in 10 young men. We found the Tubular Fertility Index (TFI) was abnormal in 37% of the contralateral testis. In 5 cases we didn't find germinal line. The Tubular Diameter was abnormal in 6.5% of the contralateral testicles only. When we compared the anatomopathological records in the contralateral testis depending on the surgical age and the surgical location of the undescended testis, we didn't find significant differences. When we studied the spermiograms in the 10 young men we obtained some cases where the TFI and the spermiogram were discordant. In conclusion, more than 1/3 of the children with unilateral undescended testis have an abnormal TFI in both testis. Moreover, neither the surgical age nor surgical location of the undescended testis have an influence on the contralateral TFI. Finally, according to the spermiogram results we should question TFI as a fertility index.

Multiple series of undescended testes reported in the 1970's shown a significant decrease in spermatogonia content and tubular growth. After that most pediatric surgeons perform elective orchiopexy earlier. Pathologic studies in undescended testes shown significant complications. We studied 82 patients who were surgical treated between 1 to 13 years and we studied the tubular fertility index (TFI), mean of tubular diameter and Sertoli cells index (SCI). We found no correlation between age of patients and lesions. In our point of view the alterations of undescended testes is secondary to primary disease no to remain out of the scrotum. Current evidence suggests that the optimal time for performing orchiopexy is between four to seven years.

OBJECTIVE

The aim of this study was to find out the relationship in the patient with cryptorchidism between the number of spermatogonia at surgical age and spermiogram data at adulthood.

METHODS

Between 1971 and 1996 the authors surgically treated 1,550 children for 2,249 undescended testis. In 21 unilateral and 41 bilateral cryptorchidism patients, both testis were biopsied at surgical procedure during childhood. We currently have spermiogram data for a patient at adulthood.

RESULTS

By using the best Tubular Fertility Index (TFI) figures of both testis, the Sperman correlation index between the two parameters is r = 0.22, statistically nonsignificant. The TFI test sensitivity is 0.68 and the specificity is 0.60. The likehood ratio for a positive test result is 0.84 and the likehood ratio for a negative test result is 0.37.

CONCLUSIONS

Although the authors have only one spermiogram, and there are few cases, they suspect the TFI is not a good index to predict the potential fertility in cryptorchidism patients.

OBJECTIVE

To compare the clinical and morphological features of impalpable and palpable cryptorchid testes, as there is debate about how much effort is appropriate to bring an impalpable undescended testicle into the scrotum.

METHODS

We reviewed retrospectively 189 cases of undescended testicles in 168 patients who were explored surgically by one surgeon between August 1997 and September 2000. Operative findings of palpability, testicular size and location were collected. The mean tubular diameter (MTD), tubular fertility index (TFI) and mean number of germ cells per tubule (MGCT) were calculated using immunohistochemistry for CD-99, a Sertoli-cell marker, to classify germ cells more accurately.

RESULTS

Sixty-three testes (33%) were impalpable; the median age at the time of surgical exploration was 23 months for both groups. The mean (sd) testicular volume for the impalpable and palpable groups were 0.83 (0.38) and 1.22 (0.54) mL, respectively. Using fitted curves of size vs age, impalpable testes were smaller than palpable testes at all ages, with the difference nearly statistically significant (P < 0.06). The MTD, TFI and MGCT decreased with age in both groups, with no statistically significant differences between the groups. A sub-analysis of abdominal and extra-abdominal testes confirmed no significant differences.

CONCLUSIONS

Impalpable testes are smaller at the time of exploration than palpable cryptorchid testes. However, histological factors predict that impalpable testes have a significant chance of future fertility and therefore orchidopexy is appropriate. CD-99 immunohistochemistry makes objective morphological information easier to obtain.

The gene encoding Thermus filiformis (Tfi) DNA ligase was cloned and its nucleotide sequence was determined by the chain-termination method. The primary structure of Tfi DNA ligase was deduced from its nucleotide sequence. The Tfi DNA ligase comprises of 667 amino acid residues and its molecular mass was determined to be 75,936 Da. The deduced amino acid sequence of Tfi DNA ligase showed a 86.5% homology to Tth DNA ligase and 43.5% to E. coli DNA ligase. The Lys-116 of Lys-Val-Asp-Gly motif was proposed to be the active residue of Tfi DNA ligase. In comparison with the amino acid composition of DNA ligase, Tfi DNA ligase showed a significant increase in the proportion of charged residues, Arg and Glu, compared to E. coli DNA ligase. The G + C content in the first, second, and third positions of the codons used were 70.3%, 40.3%, and 90.3%, respectively. Codon usage in Tfi DNA ligase was heavily biased towards the use of G + C in the third position. Under tac promoter control, Tfi DNA ligase was overproduced to greater than 9% of E. coli BL26Blue cellular proteins.

Preservation of enamel during composite veneer restorations of fluorosed teeth could be achieved by conservative preparation with Erbium lasers. This study evaluated the effect of fluorosed enamel preparation with Er,Cr:YSGG vs. conventional diamond bur on the micromorphology and bond strength of a self-etch and an etch-and-rinse adhesives. Er,Cr:YSGG laser or diamond bur preparation was performed on the flattened midbuccal surfaces of 70 extracted human premolars with moderate fluorosis (according to Thylstrup and Fejerskov index, TFI = 4-6). Adper Single Bond (SB) with acid etching for 20 or 40 s and Clearfil SE Bond (SEB) alone or with additional etching was applied in four laser groups. The same adhesive procedures were used in three bur groups except for 40 s of etching along with SB. After restoration, microshear bond strength was measured (MPa). Data were analyzed using ANOVA and Tamhane tests (α = 0.05). Six additional specimens were differently prepared and conditioned for scanning electron microscopy evaluation. The highest and lowest bond strengths were obtained for bur-prepared/SB (39.5) and laser-prepared/SEB (16.9), respectively, with a significant difference (P = 0.001). The different adhesive procedures used associated to two adhesives exhibited insignificantly lower bonding in laser-prepared groups compared to bur-prepared ones (P>> 0.05), with the exception of additional etching/SEB, which bonded significantly higher to bur-prepared (36.4) than to laser-prepared enamel (18.7, P = 0.04). Morphological analyses revealed a delicate etch pattern with exposed enamel prisms on laser-prepared fluorosed enamel after acid etching and less microretentive pattern after self-etching primer. The etch-and-rinse adhesive was preferred in the laser-prepared fluorosed enamel in terms of bonding performance.

OBJECTIVE

To determine the utility of the tear function index (Liverpool modification TFI) in assessing tear turnover rate (TTR), evaluate association of tear clearance rate (TCR) and TFI with measurements of TTR by fluorophotometry, and determine effectivity of these test measures in dry eye (DE) diagnosis.

METHODS

Forty-one subjects with DE and 15 control subjects participated. Tests included symptoms, fluorophotometry (by automated scanning fluorophotometry), and TCR and TFI from a prepared Liverpool modification TFI strip.

RESULTS

Significant differences between subjects with DE and control subjects were found for all tests. Although wetting length values gave highest sensitivity (SS) and specificity (SP) (71% and 73%, respectively), this resulted from a high degree of selection bias because the Schirmer test was one of the inclusion criteria for patients entering the study. Therefore, the best tear production test was found to be TTR (SS 71% and SP 60%). The TTR test is not readily available in clinical settings; therefore, associations between the TTR test and other tests were determined. Significant correlations were found between TTR and wetting length/TCR/TFI, indicating these latter clinical tests useful as surrogates. The strongest correlations, TTR/TCR at 0.69 (P = 0.000) and TTR/TFI at 0.65 (P = 0.000), indicate TCR/TFI with the Liverpool test can be used as an alternative to TTR by fluorophotometry. The diagnostic effectiveness between these tests was compared, with both TCR and TFI found to have equal effectivity of 78% SS and 40% SP (TCR) and 83% SS and 40% SP (TFI).

CONCLUSIONS

TCR measured by the commercially available Liverpool modification TFI strip is an acceptable alternative to TTR by fluorophotometry as a measure of tear production. It is effective as a single test for the discrimination of those with DE from those without the condition.

Human salivary gland adenocarcinoma cells (HSG) express nuclear receptors, all-trans-retinoic acid (at-RA) receptors (RARs), and retinoid X/9-cis-retinoic acid (9-c-RA) receptors (RXRs). In order to investigate whether the endogenous RARs or RXRs of HSG cells can induce transcription activation, the thymidine kinase promoter (TK)-driven luciferase reporter gene containing the retinoic acid response element (RARE), of RARbeta, betaRARE2-TK-Luc, was transfected into HSG cells and ligand-dependent transcription activation was examined. Luciferase activity of cell lysate increased by the treatment with either at-RA or 9-c-RA. Co-transfection of RARalpha and (or) RXRalpha-expression plasmids with the reporter gene enhanced the luciferase activity, suggesting that endogenous RARs and RXRs work as ligand-dependent transfactors in HSG cells. Reverse transcriptase - polymerase chain reaction analysis revealed that HSG cells express chicken ovalbumin upstream promoter - transcription factor I (COUP-TFI). Co-transfection of COUP-TFI-expression plasmid suppressed the at-RA-induced transcription activation of the reporter gene. Similar results were shown using a chromatin-integrated reporter gene system, using a stably transfected beta-RARE2-TK-beta-galactosidase (beta-Gal) reporter gene. The at-RA-dependent increase in the beta-Gal expression was completely inhibited by COUP-TFI. The transfection of antisense oligonucleotide of COUP-TFI squelched the RA-dependent growth inhibition induced by RAR-RXR heterodimers. Conclusively, RARs and RXRs of HSG cells are functional and play roles as transactivators in at-RA-sensitive processes such as the proliferation or differentiation of cells. COUP-TFI very likely regulates these processes by repressing the functions of these transactivators.

Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI).

A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9%) were compared to those of the TFI group (n = 469, 28.1%).

After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4% vs. 0.5%, p = 0.003), target vessel revascularization (6.4% vs. 0.5%, p = 0.003), and major adverse cardiac events (MACE; 11.6% vs. 4.6%, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up.

In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.

OBJECTIVE

It is unknown whether using a single guiding catheter for both nonculprit and culprit vessel angiography and intervention during transradial primary percutaneous coronary intervention (PCI) is feasible.

METHODS

This single-center study enrolled 242 consecutive patients with ST segment elevation myocardial infarction (STEMI) who received primary PCI. Among them, 102 patients received primary PCI via transfemoral approach (TFI), 109 patients received primary PCI via transradial approach using conventional technique (Conventional TRI), and 31 underwent primary TRI using a single guiding catheter (Single Guiding TRI). The catheter used for this purpose was 6 Fr RM® 3.5 guiding catheter.

RESULTS

Using a single guiding catheter, both coronary artery angiograms and intervention were successful in 30 of 31 patients (96.7%). Needle-to-balloon time (from puncture to first balloon) and door-to-balloon (D2B) time were similar between TFI and Conventional TRI groups and significantly lower in the Single Guiding TRI group (13.8 [TFI] and 14.1 [Conventional TRI] vs. 7.6 minutes, P < 0.001; 89.5 [TFI] and 91.0 [Conventional TRI] vs. 68.5 minutes, P = 0.008, respectively), whereas proportion of patients achieving D2B time within 90 minutes increased significantly in the Single Guiding TRI group from 51.0% for TFI and 49.5% for Conventional TRI to 74.2% (P = 0.023).

CONCLUSIONS

Primary transradial PCI using a single guiding catheter is feasible and highly successful and might allow timely restoration of blood flow in infarct-related artery.

OBJECTIVE

To evaluate transradial intervention (TRI) for chronic total occlusion (CTO).

BACKGROUND

Although TRI has been applied to more complex lesions in percutaneous coronary intervention, efficacy and feasibility of TRI versus transfemoral intervention (TFI) for CTO have not yet been determined.

METHODS

We retrospectively analyzed 207 CTO lesions in 195 patients in a single center between January 2008 and December 2011. Patients were divided into four groups according to procedures: TRI (135 lesions in 124 patients); TFI (40 lesions in 39 patients); TRI/TFI (20 lesions in 20 patients); and TFI/TFI (12 lesions in 12 patients). Antegrade approach was used in TRI and TFI, but antegrade plus retrograde approach was used in TRI/TFI and TFI/TFI.

RESULTS

Although there were no differences in patient characteristics, complex CTO lesions such as blunt-type entry and retry lesions were frequently observed in the TFI/TFI group. Average sheath size was 5.7 Fr for TRI and 6.6 Fr for TFI. Fluoroscopy time was significantly longer for the antegrade plus retrograde approach. Procedure success rates were not statistically different: 82.2% in TRI, 72.5% in TFI, 75.0% in TRI/TFI, and 75.0% in TFI/TFI groups. There was no death, myocardial infarction, or stroke at 30 days in any groups. Two femoral cases and no radial cases had access-site complications. Access-site crossover from radial to femoral was conducted in 4 cases.

CONCLUSIONS

More than one-half of CTO lesions can be treated with high success and low complication rates by TRI if the lesions are carefully selected.

Transforming growth factor2 (TGFbeta2) is a prototypic member of a large superfamily of multifunctional cytokines, and its potential mechanisms of the neuroprotective activity in ischemic stroke and subcellular compartmentalization are largely unknown. The present study investigated TGF-beta2 protein expression in hippocampal neuronal cells after transient forebrain ischemia (TFI). TFI was induced in male adult gerbils with bilateral occlusion of both common carotid arteries for 10 minutes. With immunohistochemical methods we observe the expression of TGF-beta2 and morphological alternation in Golgi appratus (GA) in different postischemic periods and sham-operation (6 hours, 1, 3 and 7 days). In addition, the subcellular localization of TGF-beta2 is determined in trans-Golgi network (TGN) by double-labeling confocal immunofluorographs with TGN38.The results showed that TGF-beta2 persistent express in the ischemic animals and it peaks at 3 days, then decreased 7 days postocclusion. No significant alterations to the GA were noted at the point of 6 hours,1 and 3 days following TFI, but there are a few neurons in which the GA lost the normal network-like configuration and its elements decreased in cortical cells from gerbils survived 7 days postocclusion. In addition, TGF-beta2 was colocalized with TGN38 in the TGN after TFI .Taken together, this result suggested that TGF-beta2 protein expression increased in neurons after ischemia, which may represent an endogenous adaptative response of the brain damage and its secretion via GA after ischemia is supposed to be beneficial for GA . Furthermore, fragmentation of GA is not common phenomenon in the ischemia, but intact GA structural of neurons is beneficial for cell survival.