Cryoplasty for Arterial Restenosis

ObjectiveA prospective follow-up study of patients with arterial restenosis undergoing cryoplasty.Materials & methodsBetween May 2004 and June 2005, 10 patients with restenosis following ilio-femoral endovascular treatment underwent twelve cryoplasty procedures. All patients had had at least one previous episode of stenosis treated by conventional endovascular methods and had suffered further restenosis. The indications for treatment were grafts at risk (n=5) and symptomatic in-stent restenosis (n=5). Two patients underwent re-cryoplasty. Cryoplasty was performed in accordance with manufacturer's instructions using 6-8mm balloons. All patients had Doppler ultrasound evaluation at 1, 3, 6 and 12 months.ResultsAll procedures had angiographically successful immediate outcome with <30% residual stenosis. Non flow limiting dissection was evident in two cases. In six procedures (50%), restenosis was evident within 6 months post-procedure, whilst in the other six, there was progressive restenosis appearing between 6–12 months. Five cryoplasty procedures have needed endovascular re-intervention due to symptomatic high-grade restenosis and a sixth is awaiting surgery.ConclusionCryoplasty is of no value in patients with restenosis in the iliofemoral segment with half the procedures failing within six months and all of them within the first year. Evidence to support the use of cryoplasty in the peripheral arterial restenotic lesions is lacking

Regulation of the Gene Encoding Transaction Elongation-Factor-3 During Growth and Morphogenesis in Candida Albicans

The level of the TEF3 mRNA, which encodes the fungal-specific translation elongation factor 3 (EF-3), was measured during the yeast-to-hyphal transition in Candida albicans. In contrast to a previous report, TEF3 mRNA levels were shown to change during dilution into fresh medium, increasing only transiently when dimorphism was induced by either (i) an increase in growth temperature (from 25 degrees C to 37 degrees C) combined with the addition of 10% (v/v) bovine calf serum to the medium, or (ii) an increase in growth temperature (from 25 degrees C to 37 degrees C) combined with an increase in the ph of the medium (from pH 4.5 to 6.5). TEF3 mRNA levels also increased in control cultures under conditions where germ tubes were not formed. but they remained elevated in contrast to cultures undergoing morphological changes. TEF3 mRNA levels were not significantly affected by heat-shock, but were tightly regulated during batch growth of the yeast form, reaching maximal levels in exponential phase. Therefore, the changes in TEF3 expression that accompany the dimorphic transition in C. albicans appear to reflect the underlying physiological changes that occur during morphogenesis and are not a response to morphogenesis per se. For this reason TEF3 mRNA measurement cannot be used as a loading control in Northern analyses of dimorphic gene regulation. Comparison of TEF3 mRNA levels with the abundance of the EF-3 polypeptide indicated that the synthesis of this essential translation factor might be subject to post-transcriptional regulation