A study on the grinding accuracy of a copy milling machine for dental use

In order to assess the relationship between the profiling pressure of a copy milling machine for dental use and the accuracy of the dimensions of the objects produced, a Celay System was used to profile a metal-cylinder model, and its dimensions were compared with the workpieces. The results showed that, when a cylindrical model with a diameter of 6 mm was subjected to freehand profiling, the mean processing error of the object produced was -0.026 mm, and the profiling pressure was 4.6 gf to 131.7 gf (mean: 76.6 gf). However, the fluctuations in profiling pressure decreased by 1/5 during profiling operations when accessories that fixed the profiling pressure and the profiling loci were used. Moreover, while the processing error when the model was profiled at a profiling pressure of 76 gf or less was a mere 0.005 mm, at 110 gf it rose to 0.022 mm. Based on the above, the processing error that occurred as a result of profiling pressure appeared to affect processing accuracy. On the basis of these findings, profiling as light weight must be performed with as possible in order to obtain accurate products using the copy milling machine for dental use, and the results suggested the necessity of attaching control devices to the copy milling machine to make accurate restorations.

Novel smooth muscle cell lines from transgenic mice harboring temperature-sensitive SV40 large T-antigen gene. Temperature-dependent expression of smooth muscle myosin heavy chain-1 and calponin genes

We have established novel vascular smooth muscle cell lines (SVS30 and SVS24 cells) which retain the expression of specific markers for smooth muscle cells, such as alpha-actin, smooth muscle myosin heavy chain-1, and calponin, from transgenic mice harboring the temperature-sensitive SV40 large T-antigen gene. SVS cell lines showed temperature-dependent growth and the expression of SV40 large T-antigen. Interestingly, protein and mRNA levels of smooth muscle myosin heavy chain-1 and calponin seen in culture at the non-permissive temperature (39 degrees C) were higher than those at the permissive temperature (33 degrees C). These results suggest that SV40 large T-antigen affects the expression of smooth muscle-specific markers in SVS cell lines, and that some of the characters in SVS cell lines can be controlled by culture temperature. SVS cell lines should be quite valuable tools with which to study the regulation of phenotypic modulation of smooth muscle cells, and to identify smooth muscle specific transcription factors which involve the expression of smooth muscle myosin heavy chain-1 and calponin genes.

The distribution and dynamic density of oligodendroglial cytoplasmic inclusions (GCIs) in multiple system atrophy: a correlation between the density of GCIs and the degree of involvement of striatonigral and olivopontocerebellar systems

The distribution and dynamic density of oligodendroglial cytoplasmic inclusions (GCIs) were studied based on 30 cases of multiple system atrophy (MSA), including striatonigral degeneration (SND), olivopontocerebellar atrophy (OPCA) and Shy-Drager syndrome. GCIs were widely spread throughout the central nervous system, including the striatonigral and olivopontocerebellar systems. Inclusion-bearing cells appeared to be oligodendrocytes which usually had larger and lighter nuclei than those of normal-looking oligodendrocytes. The distribution of GCIs was similar in all cases, irrespective of the degrees of OPCA and SND, but the frequency of GCIs varied from case to case. We classified all the cases into two categories based on the degree of neuropathological changes of SND (mild and severe) and, independently, into three groups based on that of OPCA (minimal, moderate and severe), i.e., a total of six groups. An association between the frequency of GCIs and the severity of the lesions was obtained. For example, many GCIs were seen the cerebellar white matter in the cases in which OPCA was not histologically confirmed. More GCIs were seen in the cases with moderate OPCA. In the cases with severe OPCA, GCIs were rarer and smaller, in proportion to the devastation of fibers; no GCIs were seen in the cases with more severe OPCA. The incidence of GCIs showed a positive correlation to the severity of OPCA but not that of SND in the corticopontine tracts, of both OPCA and SND in the pyramidal tracts, and of SND but not of OPCA in the pencil fibers of the putamen. It is suggested that GCIs may represent either a change synchronous with neuronal degeneration or a phenomenon preceding neuronal changes, especially in the cerebellar white matter. Thus, they may represent the early changes in MSA and may be a useful neuropathological hallmark for diagnosis of MSA, even in cases with minimal OPCA and SND.

[Influence of sleep apnea on nocturnal blood pressure]

In the present study, we subjected 65 patients to overnight monitoring and continuous nocturnal blood pressure measurement in order to assess the influence of sleep apnea on the circulatory system. Thirty-one patients were compared before and after surgery. The severity of sleep apnea was classified by Apnea Hypopnea Index (AHI), the duration of exposure to low-level oxygen (calculated as the desaturation time: DT), and increment of blood pressure. Before surgery, a significant correlation was noted between the DT and blood pressure changes. Therefore, this index was considered useful for assessing the influence of sleep apnea on nocturnal blood pressure. After surgery, improvement of AHI was greater than 50% in 19/31 patients (61.3%), and this result was almost the same as described in the literature. The improvements in DT and BP change were greater than 50% in 21/31 (67.7%) and 14/31 (45.2%), respectively. With regard to severity before surgery, AHI was > or = 50 and DT was > or = 40% in 10 and 18 patients, respectively. Nineteen patients had BP changes > or = 40 mmHg. After surgery, 1,5, and 2, patients, respectively, still showed these values. Thus, a beneficial effect of surgery was demonstrated.

Expression of alpha and beta genes of human chorionic gonadotropin in lung cancer

To confirm the ectopic production of human chorionic gonadotropin (hCG) in lung cancer, we attempted to detect the presence of mRNA transcripts of the alpha and beta genes for hCG in lung cancer tissues obtained from surgical operations. Although we were able to show the presence of hCG beta mRNA transcripts in lung cancer tissue by Northern blot, the sensitivity of the assay was too low for a precise analysis of hCG beta mRNA transcripts in most lung cancers. Using reverse transcription PCR (RT-PCR) and Southern blot analysis, however, various amounts of mRNA transcripts of hCG beta genes 3, 5, 7 and 8 were demonstrated in 9 of the 14 lung cancer tissues examined, while no mRNA transcripts were detectable in 12 normal lung tissues from the same patients. Our results are consistent with a clear difference in serum and urinary hCG beta levels observed between normal subjects and lung cancer patients. The expression of the hCG alpha gene, however, was detected in normal lung tissues more frequently than in lung cancer tissues using RT-PCR Southern blot. Our results strongly suggest the production of hCG beta as being part of the phenotype of malignantly transformed lung cells and further strengthen its superior specificity over intact hCG or hCG alpha as a tumor marker for lung cancers.

Dihydro-1,4-benzothiazine-6,7-dione, the ultimate toxic metabolite of 4-S-cysteaminylphenol and 4-S-cysteaminylcatechol

4-S-Cysteaminylphenol (4-S-CAP) and the corresponding catechol 4-S-cysteaminylcatechol (4-S-CAC) have been evaluated for melanocytotoxicity. It was shown recently that tyrosinase oxidation of these substrates produces a violet pigment, dihydro-1,4-benzothiazine-6,7-dione (BQ). In this study we examined whether BQ is the ultimate toxic metabolite produced in melanoma cells from 4-S-CAP/4-S-CAC. Biochemical experiments showed that (1) BQ was formed by autoxidation of 4-S-CAC as well as by tyrosinase oxidation of 4-S-CAP/4-S-CAC, (2) BQ reacted rapidly with thiols such as reduced glutathione (GSH), and (3) BQ inhibited the activity of alcohol dehydrogenase, an SH enzyme. In vitro experiments showed that (1) the cytotoxicity of 4-S-CAC was mostly prevented by catalase and superoxide dismutase, (2) BQ was highly cytotoxic to B16 melanoma cells (IC50 being 3.9 microM as compared with 507 microM for 4-S-CAP), (3) BQ was metabolized rapidly to a GSH adduct in melanoma cells, and (4) the same GSH adduct was also formed upon incubation of melanoma cells with 4-S-CAP, the reaction being tyrosinase dependent. In vivo experiments showed that intratumoral administration of BQ (0.5 micromol) inhibited the subcutaneous growth of B16 melanoma nearly as effectively as 4-S-CAP/4-S-CAC (20 micromol). These results indicate that BQ is the ultimate toxic metabolite produced by tyrosinase oxidation of 4-S-CAP/4-S-CAC. BQ deprives melanoma cells of GSH and may inactivate SH enzymes essential for DNA synthesis and cell proliferation by covalent binding through their cysteine residues, thereby exerting melanocytotoxicity. Cytotoxicity of 4-S-CAC depends mostly on autoxidation producing BQ and active oxygens.

[Studies on ocular positions at close distance with a new system of measuring ocular positions]

The purpose of our study was to develop a new system of measuring ocular positions and to assess its clinical applicability. This system is derived from that of the Hess coordimeter and is used at a distance of 40 cm. Our system enables us to distinguish tropia from phoria by testing the ocular positions both with and without a fusional target which can be seen by both eyes. All devices are installed in one structure and it can be used in a lighted room. The system was checked in 10 normal subjects by plotting the data of the charts onto a graph and deriving a static eye position curve. There was no significant vertical deviation, and there was an exodeviation of 5.32 +/- 3.78 (mean +/- standard deviation) degrees without a fusional target, but no significant deviation occurred when the fusional target was lighted. In 37 of the 38 patients with ocular motor disturbance, the results with this system corresponded well with those obtained by the Hess coordimeter or prism cover test. One particular case with extraocular myositis involving more than two extraocular muscles showed an atypical complicated pattern. We believe that our system is simple and easy for clinical evaluation of ocular movement abnormality in ophthalmic diagnosis.

Differential expression of tenascin-C and tenascin-X in human astrocytomas

Tenascins (TNs) are a family of extracellular matrix glycoproteins. The first member of this family to be recognized, tenascin-C (TN-C), is known to be expressed in various tumors including human astrocytomas. Tenascin-X (TN-X) is the latest member of the TN family to be reported, and its expression in tumor tissues has not yet been examined. In this study, we found expression of TN-X in glioma cell lines and human astrocytomas by immunoblot analysis using anti-mouse TN-X antibodies. We also examined the expression of TN-C and TN-X immunohistochemically in a series of 32 human astrocytomas and tissue from 5 normal brains. Expression of TN-X was up-regulated to a higher degree in low-grade astrocytomas than in high-grade astrocytomas. TN-X was mainly localized in the perivascular stroma around tumor vessels, and weakly expressed in the intercellular spaces among tumor cells. In contrast, TN-C was more strongly expressed in the intercellular spaces and in tumor vessels in high-grade astrocytomas (anaplastic astrocytomas and glioblastomas) than in low-grade astrocytomas. In the tissues expressing both TNs, the distribution of TN-X was often reciprocal to that of TN-C. These findings indicate that the expression of TN-C and TN-X in astrocytomas is different, and that these glycoproteins could be involved in neovascularization in different manners.

Osteosynthesis without instrumentation for vertebral pseudarthrosis in the osteoporotic spine

We have performed simple bone grafting in four elderly patients with pain due to unstable pseudarthroses in the osteoporotic spine after compression fracture. At operation, we observed abnormal movement of the affected vertebral body which was covered with a hypertrophic membrane; this seemed to inhibit the blood supply to the lesion. The thick membrane and avascular granulation in the false joint were excised and bone grafting carried out. Symptoms were dramatically improved immediately after operation and bony union was confirmed in the three surviving patients.

OSTEOSYNTHESIS WITHOUT INSTRUMENTATION FOR VERTEBRAL PSEUDARTHROSIS IN THE OSTEOPOROTIC SPINE

We have performed simple bone grafting in four elderly patients with pain due to unstable pseudarthroses in the osteoporotic spine after compression fracture.

At operation, we observed abnormal movement of the affected vertebral body which was covered with a hypertrophic membrane; this seemed to inhibit the blood supply to the lesion. The thick membrane and avascular granulation in the false joint were excised and bone grafting carried out. Symptoms were dramatically improved immediately after operation and bony union was confirmed in the three surviving patients.

An experimental study of a combination method using a pedicle screw and laminar hook for the osteoporotic spine

STUDY DESIGN

Using human cadaver spines, the authors compared the effect of using a combination of pedicle screw and laminar hook on the same vertebra with that of using a pedicle screw alone in reference to bone mineral density of the vertebra under nondestructive cyclic loading.

OBJECTIVES

To quantify stiffness obtained by pedicle screw alone and by the combination method and to clarify a relationship between stiffness obtained by each instrumentation method and bone mineral density of the vertebra.

SUMMARY OF BACKGROUND DATA

The use of pedicle screws apparently improves the union rate of spinal fusion. Instrumentation failures sometimes occur, however, such as loosening or loss of correction of the spine, especially in patients with osteoporosis. Some augmentation method in instrumentation is necessary to overcome bone fragility in the osteoporotic spine.

METHODS

Thirteen cadaver lumbar vertebrae were used for this study. Bone mineral density was measured by dual-energy X-ray absorptiometer. After separating each vertebrae, the pedicle screw was screwed into a vertebra. Five cycles of cephalocaudal loading were performed to the shank of the screw with a cross-head speed of 3 mm/min under a maximum load control of 29.4 N using an Instron type testing machine, and the stiffness obtained with the pedicle screw (Kj) was calculated from the load-deformation curve. Then, a laminar hook was set and connected to the screw via a rod. Mechanical testing was performed in the same way, and the stiffness obtained with the combination method (Kf) was determined. Kj and Kf were compared using the paired t test. The relationship between Kj, Kf, or the stiffness improvement ratio ([Kf-Kj]/Kj) by the combination method and bone mineral density was analyzed by linear regression analysis.

RESULTS

Stiffness obtained by the combination method was significantly greater than that obtained by pedicle screw alone (89.8 +/- 35.0 N/mm by the combination method, 60.2 +/- 19.6 N/mm by pedicle screwing alone; P < 0.0001). Stiffness, whether obtained by pedicle screw alone or by the combination method, was positively correlated with bone mineral density (with pedicle screw alone, R2 = 0.614, P < 0.0001; with the combination method, R2 = 0.645, P < 0.0001). However, there was no significant correlation between stiffness improvement ratio and bone mineral density.

CONCLUSION

Instrumentation stiffness obtained by the combination method was significantly greater than that obtained by the use of pedicle screw alone. There was no significant correlation between the improvement ratio by the combination method and bone mineral density. These results suggest that the combination method is valuable irrespective of the presence of spinal osteoporosis.

Crystal structure of a maltotetraose-forming exo-amylase from Pseudomonas stutzeri

The three-dimensional structure of an exo-type alpha-amylase from Pseudomonas stutzeri which degrades starch from its non-reducing end to produce maltotetraose has been determined by X-ray structure analysis. The catalytic domain of this enzyme (G4-2), whose structure was determined, is a product of spontaneous limited proteolysis in culture broth. It has 429 amino acid residues and a molecular mass of 47,200, and crystallizes in ammonium sulfate solution at pH 7.5. The structure was elucidated by the multiple isomorphous replacement method and refined at 2.0 A resolution, resulting in a final R-factor of 0.178 for significant reflections with a root-mean-square deviation from ideality in bond distances of 0.013 A. The polypeptide chain of this molecule folds into three domains; the first with a (beta/alpha)8 barrel structure, the second with an excursed part from the first one, and the third with five-stranded antiparallel beta-sheets. The active cleft is formed on the C-terminal side of the beta-sheets in the (beta/alpha)8 barrel as in the known endo-type alpha-amylases. A histidine side-chain nitrogen ND1 is coordinated to one of the bound calcium ion. The recognition site of the non-reducing end of the amylose that determines exo-wise degradation is presumed to be at one end of this cleft where there is a disordered loop consisting of the 66th to 72nd residues, and a loop carrying an aspartic acid (Asp160). These structural features may be responsible for the binding of the non-reducing end of the substrate amylose.

A 15-year follow-up study of patients with non-insulin-dependent diabetes mellitus (NIDDM) in Osaka, Japan. Factors predictive of the prognosis of diabetic patients

Risk factors related to the prognosis of diabetic patients were studied in a follow-up study of 1939 patients with non-insulin-dependent diabetes mellitus (NIDDM) for a mean observation period of 15 years at our institute. Age at entry into the study was the most powerful risk factor related to the survival of diabetic patients in this study. Moreover, the risk of death, computed in relation to baseline factors, was significantly increased in male patients; in patients with fasting plasma glucose (FPG) levels greater than 140 mg/dl, with hypertension, with diabetic retinopathy or with proteinuria; and in patients treated with an oral hypoglycemic agent of insulin at baseline, even after correction for age. The baseline factors were compared between the groups of patients who were alive and who had died at the end of the follow-up study. Greater age at onset of NIDDM and at entry into the study, higher FPG level, higher systolic and diastolic blood pressure, as well as an increase in the proportion of male patients and in patients with ischemic ECG changes, with diabetic retinopathy, with proteinuria, and with treatment with an oral hypoglycemic agent of insulin, were observed in the group of deceased patients. Furthermore, multiple logistic analysis indicated a significant relationship of age at entry, FPG, hypertension, retinopathy, proteinuria and therapeutic regimen to prognosis. We also found that the baseline factors predictive of prognosis were very different in each age group.

Mutational analysis of BRCA1 gene in ovarian and breast-ovarian cancer families in Japan

We analyzed the alteration of BRCA1 in DNA obtained from 83 individuals of 13 Japanese site-specific ovarian cancer families and 6 breast-ovarian cancer families. Six germline mutations were detected in 7 families, which consisted of 4 breast-ovarian cancer and 3 site-specific ovarian cancer families, by single-strand conformation polymorphism analysis, followed by direct sequence determination. The mutations included three frameshifts, two nonsense mutations, and one missense mutation causing loss of a zinc-binding motif. The frequency of loss of heterozygosity at the microsatellite markers on the BRCA1 gene was 57% (8 of 14 cases) in site-specific ovarian cancer families, and 100% (6 of 6 cases) in breast-ovarian cancer families. All tumors of the patients carrying a mutation of BRCA1 showed deletion of wild-type alleles, implicating BRCA1 as a tumor suppressor gene. These results suggest that germline mutations of the BRCA1 gene play an important role in the carcinogenesis of breast and/or ovarian cancer in a majority of breast-ovarian cancer families and in some site-specific ovarian cancer families.

Molecular cloning and expression of murine smooth muscle myosin heavy chains

The nucleotide and deduced amino acid sequences of two isoforms of mouse smooth-muscle myosin heavy chain (SM1 and SM2) were determined. SM1 (6175 bp) and SM2 (6214 bp) cDNA contained a single open reading frame that encodes 1972 and 1938 amino acids (227,056 Da and 223,294 Da), respectively. Smooth muscle myosin heavy chain mRNA was expressed highly in smooth muscle tissue (small intestine) and weakly in heart and lung. Each of SM1 and SM2 cDNA was transfected and expressed in CHO cells. The expressed myosin heavy chains were detected with an antibody raised against smooth muscle myosin heavy chains and showed the same mobility as the native smooth muscle myosin heavy chains in SDS-PAGE.

Effects of neuroprotective dose of fructose-1,6-bisphosphate on hypoxia-induced expression of c-fos and hsp70 mRNA in neonatal rat cerebrocortical slices

In situ hybridization (ISH) measurements of c-fos and hsp70 expression were made in brain slice studies of hypoxia, with or without fructose-1,6-bisphosphate (FBP) pretreatment. Each experiment used eighty 350 microns thick cerebrocortical slices, obtained from twenty 7-day old rats. Thirty minute periods of hypoxia were followed by 8 h of hyperoxic perfusion. Slices were removed at eight predetermined times, and processed for ISH and immunohistochemistry. In three of six hypoxia experiments, slices were pretreated for 60 min with 2 mM FBP, a condition known to maintain ATP level in brain slices during hypoxia. In three other hypoxia experiments slices received no pretreatment. In two control experiments slices were perfused for 11.5 h without hypoxia. In control experiments, hsp70 mRNA was barely detectable in slices at all times, although moderate c-fos mRNA expression occurred at 1 h after decapitation. Hypoxia produced a modest but statistically significant increase in c-fos mRNA and hsp70 mRNA induction 4 h following reoxygenation. At all times after hypoxia, FBP pretreatment reduced expression of c-fos and hsp70 mRNA. The absence of hsp70 mRNA in control slices suggests that intracellular protein denaturation was minimal in this preparation. In slices made hypoxic, the decrease in c-fos and hsp70 mRNA caused by FBP pretreatment suggests ameliorated progression towards injury. Immunohistochemistry showed no HSP70 protein at any time following hypoxia, with or without FBP pretreatment, presumably due to delayed HSP70 protein synthesis, or to a block in translation, as observed in vivo in other studies.

[HGV is rare but possible causative agent of non-A non-B fulminant hepatitis]

We analyzed HBV, HCV and HGV using PCR amplification in the 19 fulminant patients with unknown etiology. Three patients(15.8%) had HCV alone and 1(5.2%) was coinfected with HCV and HGV. In all cases, the possibility of contamination of these viral agent through blood transfusion was excluded. HBV was undetectable in the present study. Comparative analysis revealed that in the cases with HCV alone, all patients showed slow progression. On the other hand, the coinfected case rapidly developed into the end stage of hepatic failure. These results demonstrated that the prevalence of HGV in the fulminant hepatitis was rare in Japan. However, there is a possibility that HGV may modify the clinical course of HCV-induced fulminant hepatitis.

[Lymphocytic interstitial pneumonia associated with Sjögren's syndrome and mediastinal lymphadenopathy: diagnosis by open-lung biopsy]

A 56-year-old woman was admitted to the hospital because of dry coughing and shortness of breath on exertion. In addition, dry eyes and cornea guttata suggested Sjögren's syndrome. Chest radiography revealed linear, reticular shadows throughout the lung fields, and enlargement of hilar and mediastinal lymph nodes. A specimen was obtained by transbronchial lung biopsy but the findings were not condusive; open-lung biopsy was done. The histopathological findings suggested lymphocytic meterstitial pneumonia. Results of genetic analysis and of immuno-histochemical examination conformed that the proliferating lymphocytes were polyclonal. Corticosteroids and immunosuppressive drugs have been used to treat lymphocytic interstitial pneumonia, and they were effective in this case.

Morphologic evaluation and surgical simulation of ossification of the posterior longitudinal ligament using helical computed tomography with three-dimensional and multiplanar reconstruction

STUDY DESIGN

Using helical computed tomography with three-dimensional and multiplanar reconstruction, ossification of the posterior longitudinal ligament in the cervical and thoracic region was observed. Preoperative simulation also was performed, and the availability of these methods was evaluated.

OBJECTIVE

To use preoperative evaluation and simulation with helical computed tomography to enhance the accuracy of excision of ossification of the posterior longitudinal ligament lesion.

SUMMARY OF BACKGROUND DATA

Ossification of the posterior longitudinal ligament lesion is sometimes so complicated that preoperative morphologic evaluation and excision of the lesion are difficult when using only conventional imaging techniques.

METHODS

Seven cases of cervical and two cases of thoracic ossification of the posterior longitudinal ligament were scanned using helical computed tomography at 2-mm or 5-mm slice thickness. Three-dimensional and multiplanar reconstruction were performed at 0.7-mm or 2-mm intervals in the bone window. Surgical simulation of the anterior approach for cervical lesion and posterior approaches for thoracic lesion was performed.

RESULTS

Preoperative direct observation of the ossification of the posterior longitudinal ligament lesion was possible, and the complicated structures could be understood more easily than with other conventional methods. When surgical simulation was performed in the workstation, the ossification of the posterior longitudinal ligament lesion was removed sufficiently on arbitrarily reconstructed view in the spinal canal. When the viewpoint then was changed to the approaching side, the location and dimension of the removed area were determined. In all cases, surgical approach and excision of the ossification of the posterior longitudinal ligament lesion were performed more easily and more precisely than in the surgery with no three-dimensional images.

CONCLUSION

Helical computed tomography with three-dimensional, multiplanar reconstruction would be a valuable tool for evaluation and surgical simulation of ossification of the posterior longitudinal ligament lesion by enhancing the accuracy of the surgical procedure.

GA strategy for variable selection in QSAR studies: GA-based PLS analysis of calcium channel antagonists

The GAPLS (GA based PLS) program has been developed for variable selection in QSAR studies. The modified GA was employed to obtain a PLS model with high internal predictivity using a small number of variables. In order to show the performance of GAPLS for variable selection, the program was applied to the inhibitor activity of calcium channel antagonists. As a result, variables largely contributing to the inhibitory activity could be selected, and the structural requirements for the inhibitory activity could be estimated in an effective manner.

Clinical application of transluminal endovascular graft placement for aortic aneurysms

BACKGROUND

In recent years, transluminal endovascular graft placement techniques have been developed for the treatment of aortic aneurysms. We report our initial clinical experience with endovascular graft placement using a graft developed in our laboratory.

METHODS

The procedure was performed in 20 patients with a diagnosed aortic aneurysm. The graft is constructed from a Dacron cylinder, and the surface of the graft is supported with multiple rings of extraflexible wire. After the compactly folded graft is delivered through the sheath to the predetermined target point, the graft is deployed and then pressed against the vessel by balloon inflation. Straight graft insertion was attempted in 10 patients, bifurcated graft insertion in 8, and branched graft insertion in 2.

RESULTS

Graft placement was successful in 19 of the patients and unsuccessful in 1. There were no cases of graft migration, aneurysm rupture, or graft destruction during a mean follow-up period of 9 months.

CONCLUSIONS

Initial clinical results demonstrated the efficacy and safety of endovascular graft placement using this graft.