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Objective: This study was designed to investigate the relation between plasma von Willebrand factor (VWF) or endothelin-1 (ET-1) and post-carotid artery stenting (CAS) restenosis. Materials and Methods: Plasma levels of VWF and ET-1 were measured in 61 patients (36 males, mean age 64.4 ± 6.8 years) before and after CAS. The mean follow-up time was 13.8 ± 1.7 months (range, 6-63). In-stent restenosis was defined as a >10% narrowing of the vascular lumen with or without ischemic symptoms following CAS. Results: In-stent restenosis was identified in 14 (23%) patients, including 3 with >50% restenosis. In the restenosis group, mean VWF and ET-1 levels at 2 weeks. 1 and 6 months after CAS were higher than the baseline levels (p < 0.05 or p < 0.01). Mean levels of VWF and ET-1 in the restenosis group were higher than in the non-restenosis group within 6 months after CAS (p < 0.05 or p < 0.01). Conclusion: Persistent elevation in plasma VWF and ET-1 within the first 6 months of CAS was found in patients with in-stent restenosis. [ABSTRACT FROM AUTHOR]

Objectives: This study was designed to investigate the value of 3-D optical coherence tomography (3-D OCT) combined with fundus photochromy in the diagnosis of acute central serous chorioretinopathy (CSCR). Subjects and Methods: 3-D OCT and fundus photochromy were performed on 30 patients (36 eyes) with acute CSCR. Fluorescein angiography (FA) was also performed to confirm the diagnosis and to obtain the fluorescein leakage sites. Results: 22 eyes presented neurosensory retinal detachment determined by 3-D OCT (28 leakage spots), 1 eye showed retinal pigment epithelium (RPE) detachment (2 leakage spots), and 13 eyes showed both neurosensory and RPE detachment (17 leakage spots). 3-D OCT showed significant changes in the RPE in 36 of 47 leakage spots (76.6%). Fundus photochromy showed white-gray changes in 22 of the 47 leakage spots (59.6%). 47 leakage spots were identified by FA in 36 eyes. The combination of 3-D OCT and fundus photochromy identified 42 of the 47 leakage spots (89.4%) spotted by FA. Conclusion: A combination of 3-D OCT and fundus photochromy offered a high identification rate of the leakage spots. The combination of the two noninvasive techniques may be used as an alternative diagnostic or evaluation tool for acute CSCR. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: To investigate the safety and efficacy of percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) combined with percutaneous transhepatic biliary drainage (PTCD) in treating malignant biliary obstruction. Subjects and Methods: Nine patients (6 males and 3 females, average age 71.3 ± 5.5 years) with complete obstruction of the biliary tract were treated with PEG/PEJ after PTCD. The PEG/PEJ and PTCD tubes were linked outside of the abdominal wall to direct the externally drained bile back to the jejunum through the PEG/PEJ intestinal tube. Clinical symptoms and liver function were assessed following the treatment. Results: The operations were successfully completed in the 9 patients within 40 min (average 35 ± 2.9 min). Clinical symptoms such as jaundice, abdominal distension, stomachache and diarrhea appeared but improved within 7 days of the operation. Serum levels of bilirubin, aspartate aminotransferase and alanine aminotransferase were reduced (p < 0.01) 4 weeks following the treatment. There were no procedural complications. Conclusions: Combined PEG/PEJ and PTCD appeared to be safe and effective in the management of malignant biliary obstruction. Further, larger-scale studies will be needed to verify findings of this report. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: This study was designed to investigate the relationship between plasma cortisol levels and stress ulcer following acute severe head injury. Patients and Methods: The plasma cortisol levels were prospectively measured by radioimmunoassay in 68 patients following acute head injury. The diagnosis of stress ulcer was based on clinical evidence and was confirmed by endoscopic examination. Results: Patients with stress ulcer and gastrointestinal bleeding (n = 30, 44.1%) were older than those without stress ulcer(38.2 ± 7.9 vs. 28.3 ± 9.7 years, p < 0.01). The combined rate of poor recovery and death in the stress ulcer patients (70.0%) was significantly higher than in the nonulcer patients (42.1%, p = 0.02). On each of the first 3 days following the head injury, the average plasma cortisol levels in the stress ulcer patients were higher than in the nonulcer patients (p < 0.01). Univariate analysis showed a positive relationship between plasma cortisol on admission and stress ulcer (r = 0.329, p = 0.01). Logistic regression analysis revealed that plasma cortisol levels on admission (OR = 2.326, 95% CI = 1.982–2.466) and age (OR = 1.064, 95% CI = 0.861–1.219) were independent predictors of stress ulcer. Conclusions: The data showed that acute severe head injury was associated with a significant increase in plasma cortisol. Plasma levels of cortisol and age were independent predictors of stress ulcer following acute head injury. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: To investigate the value of radiographic esophageal imaging in facilitating transseptal catheterization in patients undergoing percutaneous balloon mitral valvuloplasty. Subjects and Methods: A total of 468 patients were randomized into either the study group (n = 234), in which radiographic esophageal imaging by the oral administration of a contrast media took place, or the control group (n = 234), in which the Ross technique was used.Of the 468 patients, 203 were males and 265 were females. The average ages of the study and control groups were 53 ± 16 and 51 ± 17 years, respectively. The patients had severe left atrial enlargement, as measured using 2-dimensional echocardiography. Results: In the study group, the left atrial impression on the esophagus was clearly seen, and was used to identify the puncture site on the right atrial side for the passage of the transseptal catheter. In the control group, the left atrial silhouette was not clearly shown by fluoroscopy in 112 patients (47.5%). The success rate of transseptal catheterization in the study group was higher than in the control group (99.6 vs. 45.7%, p = 0.0001). There were no complications in the study group, but pericardial tamponade occurred in 1 patient in the control group. Conclusion: Radiographic esophageal imaging facilitates the identification of an optimal atrial transseptal puncture site, and improves the success rate of transseptal catheterization in patients undergoing percutaneous balloon mitral valvuloplasty. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aims: To investigate the effects of testosterone treatment on cytokines, ventricular remodeling in rats with heart failure. Materials and methods: Sprague-Dawley male rats with heart failure were divided into testosterone (n = 22) and placebo (n = 22) group. Pseudo surgery was performed on a third group of 15 male rats as control. Results: Compared with the placebo group, the testosterone group had a greater LVEF (P <0.05), a higher serum IL-10 level (P <0.05) and a lower serum TNF-α level (P<0.05). The expression of TNF-α mRNA, MMP-9 mRNA and the myocardial hydroxyproline contents in the testosterone group were also lower than in the placebo group (P<0.05). The mortality rate in the testosterone and placebo group was 31.8% and 68.2%, respectively (P <0.05). Conclusion: Serum testosterone levels were decreased significantly in male rats with heart failure. Testosterone treatment diminishes the imbalance between interleukin-10 and TNF-α, suppresses ventricular remodeling and improves cardiac function. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]