Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI between May 2009 and May 2010 in Ibn Al-Baitar Hospital for cardiac surgery and Al-Nassryia cardiac center were prospectively analyzed . The clinical data were collected using the patients files and angiographic data by review of their films.
Results: There were (80) Patients with CTO ,They included 62 men (77.5%) and 18 women (22.5%) ,Age range 36-76 year with mean age 55±8.75 and male to female ratio was 3:1 .The procedural success rate of PCI was 66 patients (82.5%). All 23patients(100%) with lesionlength less than 15 mm had successful PCI compared to 43 out of 57 patients in whom the lesion was more than 15mm (75.4%) p value < 0.01. The procedure was successful in 54 patients out of 60 with tapered stump(90%) compared to 12 out of 20 patients with abrupt stump(60%) p value <0.005.In CTO lesion with angulations less than 45 degree ,the procedure was successful in 27 patients out of 28 (96.4%)compared to 39 out of 52 patients in whom the angulations was more than 45 degree 52(75%) p value<0.01. The most common cause of procedural un success was inability of guide wire crossing through the totally occluded segments which represented 11(78.5%), Inability to cross the lesion with a balloon in 2 patients(14.2%) and inability to dilate balloon in one patient (7.1%) P<0.001.
Conclusion: Percutaneous coronary intervention of chronic total occlusion is an effective therapeutic procedure with high success rate 82.5%. The length of chronic total occlusion ,degree of angulations and stump morphology are strong predictors of success procedure.
The Love Creek Nature Center, one of the three nature centers located within the boundaries of Berrien County, is owned and operated by the county for public enjoyment and instruction of nature. The 44.5 ha study area, located seven km east of Berrien Springs, and two km southwest of Berrien Center, on Huckleberry Road, in T6S, R17W, sections 16, 17 (Lat. 41° 56' N; Long. 86° 18' W) is made up of deciduous woods and abandoned fields at various stages of succession. It is bounded on the east by the Berrien County Dog Pound and Huckleberry Road, to the north by cultivated Berrien County land and the Berrien General Hospital, to the west by the recently closed Berrien - Oronoko Township Landfill Dump; and to the south b
... Show MoreIn this study, multi-objective optimization of nanofluid aluminum oxide in a mixture of water and ethylene glycol (40:60) is studied. In order to reduce viscosity and increase thermal conductivity of nanofluids, NSGA-II algorithm is used to alter the temperature and volume fraction of nanoparticles. Neural network modeling of experimental data is used to obtain the values of viscosity and thermal conductivity on temperature and volume fraction of nanoparticles. In order to evaluate the optimization objective functions, neural network optimization is connected to NSGA-II algorithm and at any time assessment of the fitness function, the neural network model is called. Finally, Pareto Front and the corresponding optimum points are provided and
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The present study addressed "Performance Appraisal of Human Resource Management and Its Effect on Achieving the Organizational Success", for the topics of performance appraisal of human resource management and the organizational success gained an increasing interest being relatively important and modern topics which had a great effect on the future of organizations.
The study aimed at revealing the pattern of appraising the performance of human resource management for the study sample, and whether it was qualified to lead the ministry towards the organizational success, for this purpose two main hypotheses were formulated: 1) there is a positive significant correlation between both variables: performanc
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Abstract
The goal of current research to describe and diagnose the level of attention of doctors to design and regulatory dimensions, (strategic vision, organizational structure, organizational processes, business systems, personnel), and the performance of hospitals and dimensions, in six hospitals in medicine and selected a sample for research, as well as identify organizational design effect in the performance of hospitals and dimensions (efficiency, the development of human resources, patient satisfaction, achieve financial results, quality of health care).
Research has focused in part theoretical on key variables to look organizational des
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The inelastic longitudinal electron scattering form factors are calculated for the low-lying excited states of 7Li {the first excited state 2121TJ (0.478 MeV) and the second excited state 2127TJ (4.63 MeV)}. The exact value of the center of mass correction in the translation invariant shell model (TISM) has been included and gives good results. A higher 2p-shell configuration enhances the form factors for high q-values and resolves many discrepancies with the experiments. The data are well described when the core polarization (CP) effects are included through effective nucleon charge. The results are compared with other theoretical models.
Keyword: 7Li inelastic electron scattering form factors calculated with exact
The historic cities in the Arab and Islamic world (including the cities of the holy shrines in Iraq) suffer from many and varied problems and most notably it is clear in its origin functional structure. It had been transformed from a basic place to live for a few thousand of the population to the center or part of the main center of large city populations of more than one million. Functional structure of the ancient city have been change with the beginning of the twentieth century and accelerated rate of change in the second half of the last century. The research aims to analyze the problems of the historic centers of holy cities and analyze the methods of dealing with these problems, leading to discrimination method could be the
... Show MoreThe types of development potential in the city vary, from the nature of city, to its society, environment, economy, and history. The city of Baghdad contains many historical development potentials out of using, and most of them towards declining, this will be the research problem, within the aim of trying to clarify how to invest one of the important historical elements in the development of the city, based on the hypothesis that the sustainable development of the city should be stand on the activation of its historical assets. The historical wall of Baghdad is located on the Rusafa side, which is a wall that has not been left except for one gate and the site of another gate from it is f
... Show MoreThe research aims present to highlight the importance of creating construction Organizational appropriate to achieve strategic success and reduce many of the negative effects experienced by organizations has been developing his questionnaire especially so was distributed to a sample of workers in the Asia-cellular as sample included (60) responsive 0 and can embody intellectual dilemma following questions (What are the dimensions of the organizational infrastructure, and what are the justifications for carrying out the reform and development cleared the organizational structure to make it more flexible) to contribute to the achievement of the strategic requirements for success of the organization surveyed.
Find recommended a number o
The study aims to predict Total Dissolved Solids (TDS) as a water quality indicator parameter at spatial and temporal distribution of the Tigris River, Iraq by using Artificial Neural Network (ANN) model. This study was conducted on this river between Mosul and Amarah in Iraq on five positions stretching along the river for the period from 2001to 2011. In the ANNs model calibration, a computer program of multiple linear regressions is used to obtain a set of coefficient for a linear model. The input parameters of the ANNs model were the discharge of the Tigris River, the year, the month and the distance of the sampling stations from upstream of the river. The sensitivity analysis indicated that the distance and discharge
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