Outcomes of direct stenting in patients with ST-elevated myocardial infarction.

BACKGROUND: We compared direct stenting (DS) with conventional stenting (CS) - i.e., stenting after predilation - during primary percutaneous coronary intervention (P-PCI) in terms of procedural results and long-term mortality in patients with ST-elevated myocardial infarction (STEMI). METHODS: We retrospectively analyzed 2306 patients (mean age 59 years, 22% female) who underwent P­PCI within 12 h of symptom onset. Patients were then followed up prospectively for clinical events. Patients were divided into a DS group (n = 597) and a CS group (n = 1709). The CS group was further divided into a CS-1 group (baseline thrombolysis in myocardial infarction [TIMI] flow grade ≥ 1) and a CS-2 group (baseline TIMI flow grade 0). Main outcome measures were postprocedural myocardial reperfusion and all-cause mortality in long-term follow-up. RESULTS: Patients in the DS group had a higher percentage of final TIMI-3 flow, myocardial blush grade 3 and complete ST-segment resolution, better left ventricular ejection fraction, and a lower incidence of distal embolization compared with CS patients. In-hospital (1.5 vs. 4.6%, respectively, p = 0.001) and long-term all-cause mortality (8.8 vs. 17.0%, respectively, p < 0.001) were significantly lower in the DS group than in the CS group. Kaplan-Meier survival analysis showed similar survival rates in the DS and CS-1 groups (log-rank p = 0.40), but significantly worse survival in the CS-2 group than in the other groups (log-rank p < 0.001). After adjusting for risk factors, DS was not found to be a predictor of long-term mortality. CONCLUSION: DS in P­PCI was associated with better postprocedural angiographic results and long-term survival. However, the DS group had similar in-hospital and long-term mortality to matched patients in the CS group.

The adsorption behavior of cesium on silica gel.

Cesium adsorption on silica gel has been studied as a function of different particle sizes (15, 40 and 63 microm), cation concentrations and temperatures. The adsorption behavior of cesium was evaluated by using the radiotracer method. The temperatures chosen for the study were 25 degrees C, 40 degrees C, and 60 degrees C. Cesium concentrations were ranged between 1 x 10(-6) - 1 x 10(-3)M. The data were fitted to both Freundlich and Dubinin-Radushkevich isoterms. The thermodynamic parameters calculated from the adsorption results were used to explain the mechanism of the adsorption.

Initiation of bone and amnion banking in Turkey.

There is a growing demand in Turkey for human tissue to use in surgery and wound healing. However, our country does not have facilities for local production of tissue grafts and generally depends on imported products. Under a multi-year project initiated in 1997, the International Atomic Energy Agency has provided main equipment for tissue processing and experts on Tissue Banking as well as training on tissue processing methods.In this presentation, information on various stages of the project implementation is given. Details of lay out for the process laboratories and equipment are given. Donor selection and testing criteria, processing procedures for bone and amnion, setting up product design, implementation of quality system and radiation sterilisation are described briefly. Quality procedures included preparation of quality manual, record forms, document control, non-conformance and corrective actions, training records, equipment maintenance and calibration are all in line with GMP/GLP Standards. Clinical applications of tissue grafts and medico-legal position of organ and tissue donation in Turkey are also discussed briefly.