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unstable plaque

Yidan Zhang, Wei Guo, Xiaodong Tang, Rongli Yang, Taiqiang Yan, Sen Dong, Shidong Wang, Nikolas Zaphiros
BACKGROUND: Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these difficult tumors. QUESTIONS/PURPOSES: (1) Is the use of aortic balloon occlusion associated with reduced blood loss in sacral tumor resections when the lower lumbar spine is also involved? (2) Does the use of the aortic balloon prolong total operating time? (3) What complications are associated with the use of a balloon? METHODS: We retrospectively studied all 56 patients diagnosed with sacral tumors involving the lower lumbar spine (L4, L5) who were treated surgically between 2004 and 2015 at our institute...
March 2018: Clinical Orthopaedics and related Research
Heesun Lee, Yeonyee E Yoon, Wonjae Lee, Hong-Mi Choi, Jun-Bean Park, Hack-Lyoung Kim, Hyo Eun Park, Seung-Pyo Lee, Hyung-Kwan Kim, Su-Yeon Choi, Yong-Jin Kim, Goo-Yeong Cho, Joo-Hee Zo, Dae-Won Sohn
BACKGROUND: While coronary computed tomography angiography (CCTA) provides comprehensive anatomic evaluation of coronary artery disease (CAD) with prognostic implications, clinically, the focus is usually placed on presence or absence of functionally significant CAD. Herein, we aimed to suggest a new risk stratification strategy using CCTA in patients with anatomic CAD but without myocardial ischemia on single-photon emission computed tomography (SPECT). METHODS: Consecutive patients (n=798) with CAD on CCTA who underwent SPECT for evaluation of myocardial ischemia were retrospectively evaluated...
March 7, 2018: Journal of Cardiology
Aleksander Falkowski, Iwona Gorący, Mariusz Kaczmarczyk, Marcin Szemitko, Hubert Bogacki, Julia Kostka
BACKGROUND: To compare the results of computer estimation of atherosclerotic plaque with biochemical data and ascertain any relationship with the occurrence of stroke. METHODS: The study involved 20 atherosclerotic plaques causing 70-99% stenosis of internal carotid arteries (ICA). Ultrasonographic examination (USG) images of plaques were analyzed using a computer program. A histogram was obtained for each plaque and a gray scale median (GSM) was determined for each histogram in order to measure the echogenicity of an examined plaque...
March 6, 2018: International Angiology: a Journal of the International Union of Angiology
Katarzyna Pawlaczyk, Marcin Gabriel, Daria A Strzelecka-Węklar, Zbigniew Krasiński, Michal Stanisic, Zofia Gabriel, Łukasz Dzieciuchowicz, Zygmunt Adamski
Introduction: Peripheral microembolism is one of the most frequent causes of acute limb ischemia. In order to effectively prevent relapses it is essential to localize and eliminate the source of embolism. Aim: To evaluate the role of Duplex Doppler ultrasound examination in identifying the causes of blue toe syndrome (BTS). Material and methods: The group of 165 patients with clinical symptoms of BTS on their upper limbs ( n = 16) and lower limbs ( n = 149) was investigated...
October 2017: Postȩpy Dermatologii i Alergologii
Yoshiro Ito, Wataro Tsuruta, Yasunobu Nakai, Tomoji Takigawa, Aiki Marushima, Tomohiko Masumoto, Yuji Matsumaru, Eiichi Ishikawa, Akira Matsumura
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are not appropriate treatment procedure for internal carotid artery stenosis (ICAS) in some patients. The importance of plaque vulnerability and the treatment risk evaluation has been reported. We analyzed whether treatment selection contributes to the outcome. We retrospectively examined 121 patients who underwent CEA or CAS. Treatment was selected based on plaque vulnerability and the treatment risk evaluation. We selected CAS for patients with stable plaques and CEA for patients with unstable plaques, and considered the other treatment for high-risk patients...
March 3, 2018: Neurologia Medico-chirurgica
Hong Jin, Daniel Y Li, Ekaterina Chernogubova, Changyan Sun, Albert Busch, Suzanne M Eken, Peter Saliba-Gustafsson, Hanna Winter, Greg Winski, Uwe Raaz, Isabel N Schellinger, Nancy Simon, Renate Hegenloh, Ljubica Perisic Matic, Maja Jagodic, Ewa Ehrenborg, Jaroslav Pelisek, Hans-Henning Eckstein, Ulf Hedin, Alexandra Backlund, Lars Maegdefessel
miRNAs are potential regulators of carotid artery stenosis and concordant vulnerable atherosclerotic plaques. Hence, we analyzed miRNA expression in laser captured micro-dissected fibrous caps of either ruptured or stable plaques (n = 10 each), discovering that miR-21 was significantly downregulated in unstable lesions. To functionally evaluate miR-21 in plaque vulnerability, miR-21 and miR-21/apolipoprotein-E double-deficient mice (Apoe-/- miR-21-/- ) were assessed. miR-21-/- mice lacked sufficient smooth muscle cell proliferation in response to carotid ligation injury...
January 31, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
Wen-Jing Liang, Sheng-Nan Zhou, Mei-Rong Shan, Xue-Qin Wang, Miao Zhang, Yuan Chen, Yun Zhang, Shuang-Xi Wang, Tao Guo
Diabetes mellitus is one of risk factors of cardiovascular diseases including atherosclerosis. Whether and how diabetes promotes the formation of unstable atherosclerotic plaque is not fully understood. Here, we show that streptozotocin-induced type 1 diabetes reduced collagen synthesis, leading to the formation of unstable atherosclerotic plaque induced by collar placement around carotid in apolipoprotein E knockout (Apoe-/- ) mice. These detrimental effects of hyperglycemia on plaque stability were reversed by metformin in vivo without altering the levels of blood glucose and lipids...
March 3, 2018: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
Mohammad A Helwani, Amit Amin, Paul Lavigne, Srikar Rao, Shari Oesterreich, Eslam Samaha, Jamie C Brown, Peter Nagele
BACKGROUND: The objective of this investigation was to determine the etiology of perioperative acute coronary syndrome with a particular emphasis on thrombosis versus demand ischemia. METHODS: In this retrospective cohort study, adult patients were identified who underwent coronary angiography for acute coronary syndrome within 30 days of noncardiac surgery at a major tertiary hospital between January 2008 and July 2015. Angiograms were independently reviewed by two interventional cardiologists who were blinded to clinical data and outcomes...
February 26, 2018: Anesthesiology
Paolo Raggi
The lifetime cardiovascular risk of a diabetic patient is approximately 4-5 times higher than that of an age and sex matched individual without diabetes mellitus. Despite the well-publicized cardiovascular risk equivalence of diabetes mellitus, it has become apparent that not all diabetic patients are equally at high-risk and many patients may have a level of risk similar to that of the general population. Cardiovascular imaging has been employed to address the dilemma of a more accurate risk stratification of diabetic patients...
February 15, 2018: Atherosclerosis
Amir Tajbakhsh, Mehdi Rezaee, Petri T Kovanen, Amirhossein Sahebkar
Atherosclerosis is a dynamic and progressive inflammatory process in the intimal layer of large and medium-sized arteries, and it is the major contributor to the atherosclerotic cardiovascular disease (ACVD), the leading cause of death worldwide. In an atherosclerotic plaque, phagocytosis of apoptotic cells occurs through an intricate process designated efferocytosis. Defective efferocytosis has emerged as a causal factor in the etiopathogenesis of atherosclerosis and its progression into overt ACVD. Both specialized phagocytes (macrophages and dendritic cells) and non-specialized cells with phagocytic capabilities (smooth muscle and endothelial cells) are involved in the efferocytotic process...
February 11, 2018: Pharmacology & Therapeutics
Giampaolo Niccoli, Domenico D'Amario, Josip A Borovac, Erminio Santangelo, Giancarla Scalone, Francesco Fracassi, Rocco Vergallo, Vincenzo Vetrugno, Giorgia Copponi, Anna Severino, Giovanna Liuzzo, Asiia Imaeva, Andrea Siracusano, Filippo Crea
BACKGROUND: Perilipin 2 (PLIN2) is a protein that potentially facilitates atherogenesis in native coronary arteries or arteries with an implanted drug-eluting stent (DES). The aim of the study was to determine PLIN2 protein levels in peripheral monocytes of enrolled subjects and compare them between patients with native coronary artery disease (CAD) and those with an in-stent restenosis (ISR) due to neoatherosclerosis occurring >1 year after DES implantation. METHODS: Forty-two patients were prospectively enrolled in the study in 3:1 fashion and underwent coronary catheterization...
February 5, 2018: International Journal of Cardiology
Chrissta X Maracle, Rabia Agca, Boy Helder, John A L Meeuwsen, Hans W M Niessen, Erik A L Biessen, Menno P J de Winther, Saskia C A de Jager, Mike T Nurmohamed, Sander W Tas
BACKGROUND AND AIMS: Neovascularization is associated with atherosclerotic plaque instability and increased chance of myocardial infarction (MI). Patients with chronic inflammatory diseases (CID) have increased risk of atherosclerosis, and evidence demonstrates that NF-κB inducing kinase (NIK)-mediated noncanonical NF-κB signaling in endothelial cells (EC) is linked to inflammation and angiogenesis. Here, we hypothesized NIK may also be activated in EC of atherosclerotic lesion microvessels...
January 29, 2018: Atherosclerosis
Jinseong Lee, Jinsang Kil, Dae-Won Kim, Sung-Don Kang
Objective: Measurement of the degree of stenosis is not enough to decide on the treatment strategy for patients with carotid stenosis. Plaque morphology examination is needed for such a decision-making. Thus, we evaluated the usefulness of plaque magnetic resonance imaging (MRI) to decide on the modality of treatment for patients with carotid atherosclerotic plaques. Materials and Methods: Fifteen patients presenting with carotid stenosis between 2014 and 2016 were included...
December 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Puneet Raman, Lakshmi Madhavpeddi, Rayna J Gonzales
Vascular basal cyclooxygenase-2 (COX-2) expression and activity can be induced by endotoxin, hypoxia, or ischemia. During vascular pathologies such as atherosclerosis, increases in COX-2 activity result in prostanoid production, a contributor to the development and progression of vascular inflammation leading to unstable atherosclerotic plaques and increased risk for thrombotic events. Recent studies demonstrate that select free fatty acids, such as palmitate, can act as pro-inflammatory mediators. However, the effect of palmitate on COX-2 expression and activity, and its impact on the development and progression of vascular inflammation is not well elucidated...
January 31, 2018: American Journal of Physiology. Cell Physiology
Hripsime Nahapetyan, Julien Faccini, Elodie Mucher, Marie-Hélène Grazide, Meyer Elbaz, Wim Martinet, Cécile Vindis
No abstract text is available yet for this article.
August 2017: Atherosclerosis
Aline Lopes Bressan, Daniele Pereira, Paula Mota Medeiros, Sueli Carneiro, Luna Azulay-Abulafia
Psoriasis is a chronic disease, characterized by erythematous scaly lesions, presented in eight different forms: plaques, guttate, pustular, erythrodermic, inverse, nail and scalp psoriasis, and psoriatic arthritis. Its development depends on genetic factors, external stimulus and immune response alteration.1 Proinflammatory cytokines such as TNF-alpha, IL-12 and 23 may also be involved. In the worst cases, systemic complications linked to endothelial alterations may occur. A literature review was conducted for a better understanding of what roles VEGF (vascular endothelial growth factor) and ICAM-1 (intercellular adhesion molecule) have, among other cytokines, in systemic capillary leak syndrome, involved in erythrodermic and pustular psoriasis, the most unstable forms of the disease...
November 2017: Anais Brasileiros de Dermatologia
Yoko Irie, Naoto Katakami, Tomoya Mita, Mitsuyoshi Takahara, Taka-Aki Matsuoka, Masahiko Gosho, Hirotaka Watada, Iichiro Shimomura
INTRODUCTION: Ultrasonic tissue characterization of the carotid wall using gray-scale median (GSM) reflects its composition and low-GSM plaque is considered to be unstable. The present study evaluated the effect of alogliptin, a dipeptidyl peptidase-4 inhibitor, on the longitudinal change in GSM, an index of the tissue characteristics of the carotid wall, in patients with type 2 diabetes (T2DM). METHODS: This is a post hoc subanalysis using data obtained from the SPEAD-A trial, a randomized controlled trial that demonstrated the beneficial effect of alogliptin treatment on the progression of carotid intima-media thickness in patients with T2DM with no past history of apparent cardiovascular disease...
January 12, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Maros Ferencik, Thomas Mayrhofer, Daniel O Bittner, Hamed Emami, Stefan B Puchner, Michael T Lu, Nandini M Meyersohn, Alexander V Ivanov, Elizabeth C Adami, Manesh R Patel, Daniel B Mark, James E Udelson, Kerry L Lee, Pamela S Douglas, Udo Hoffmann
Importance: Coronary computed tomographic angiography (coronary CTA) can characterize coronary artery disease, including high-risk plaque. A noninvasive method of identifying high-risk plaque before major adverse cardiovascular events (MACE) could provide practice-changing optimizations in coronary artery disease care. Objective: To determine whether high-risk plaque detected by coronary CTA was associated with incident MACE independently of significant stenosis (SS) and cardiovascular risk factors...
January 10, 2018: JAMA Cardiology
Yusuke Ishiyama, Kazuo Eguchi, Katsuaki Yokota, Tomokazu Ikemoto, Kazuomi Kario
We herein report the case of a 25-year-old Japanese woman with left-main-trunk acute myocardial infarction (LMT-AMI). She had cardiogenic shock, so emergency percutaneous intervention was performed. Intravascular ultrasound of LMT-AMI showed that the three-layered structure of the intima, tunica media, and adventitia was not clearly visible, and the vessel was concentrically thickened; unstable plaque and calcification were not seen. AMI is rarely seen in young women, but Takayasu's arteritis is one major cause...
January 11, 2018: Internal Medicine
Francesco Burzotta, Roberto Nerla, Jonathan Hill, Lazzaro Paraggio, Antonio Maria Leone, Jonathan Byrne, Italo Porto, Giampaolo Niccoli, Cristina Aurigemma, Carlo Trani, Philip MacCarthy, Filippo Crea
BACKGROUND: The decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but frequency-domain optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique, which allows physiopathologic assessment of coronary plaque. We investigated the possible relation between OCT and FFR in selected ICL patients...
February 15, 2018: International Journal of Cardiology
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