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1

Who might benefit from early aspirin after coronary artery surgery?  

PubMed

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether early administration of aspirin might optimize vein graft patency. More than 250 papers were found using the reported search, of which 4 new papers in addition to the previous 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Early postoperative aspirin administered within 6 h following coronary artery bypass grafting (CABG) has been shown to be optimal for prevention of vein graft occlusion. Early aspirin has significant benefit in reducing vein graft occlusion, mortality, myocardial infarction, stroke, renal failure and bowel infarction. The efficacy of early postoperative aspirin on vein graft patency diminishes the later it is administered. It has optimal benefit at 6 h, some benefit at 24 h and no benefit after 48 h post CABG. ACC/AHA, EACTS and ACCP have issued guidelines recommending administration of early aspirin or an alternative (clopidogrel, ticlopidine and indobufen) at 6 h or soon after bleeding has settled as the standard of care for optimization of vein graft patency. The ACCP guideline has also suggested that optimal prevention of cardiovascular complication should have higher value than prevention of postoperative bleeding. Several randomized, controlled studies, including a meta-analysis, have shown that early administration of aspirin following CABG is not associated with increased blood loss or transfusion requirement. Postoperative bleeding has been identified as a significant reason for non administration of early aspirin in a prospective study. It is essential to define/quantify the postoperative blood loss that precludes administration of early aspirin. This will enhance prompt administration in some cases and guide judgement, especially in patients with high-risk factors for vein graft thrombosis. Administration at 6 h is the optimal time to give aspirin as long as bleeding has settled. PMID:24871533

Gukop, Philemon; Gutman, Nadav; Bilkhu, Rajdeep; Karapanagiotidis, Georgios T

2014-09-01

2

Contrast-enhanced detection of arterial bleeding  

NASA Astrophysics Data System (ADS)

The purpose of this study was to determine the feasibility and usefulness of contrast agent to detect internal bleeding. In a model of acute femoral artery injury, bleeding sites were produced percutaneously in 9 rabbits, using an 18 G needle guided by Doppler and B-mode ultrasound. Imaging was performed pre- and post-injury and after i.v. injection of contrast agent (Optison) using B-mode, Color Doppler (CD), and Pulse Inversion. Gross and histological examination (light microscopy) of the injured blood vessel and the surrounding tissue were performed. Experiments with similar procedure were achieved in a pulsatile phantom with carotid arteries as targeted blood vessels in vitro. Bleeding sites could not be located in non-contrast B-mode sonography. After administration of contrast agent, injuries could be detected by the increased echogenicity of the extravasated blood flow. The resulted hematoma appeared as inhomogeneous hyper-echo region. Color mosaic patterns were observed in the surrounding tissue with CD. Cluster of cavities were found within hematoma upon microscopy, which may be due to aggregated microbubbles. Bleeding sites were recognized in all contrast studies by CD; compared with only 11% in non-contrast control. Contrast-enhanced sonography is a promising tool in detection and evaluation of internal bleeding.

Luo, Wenbo; Zderic, Vesna; Starr, Frank; Paun, Marla; Vaezy, Shahram

2005-04-01

3

Enhanced external counterpulsation improves peripheral resistance artery blood flow in patients with coronary artery disease.  

PubMed

Enhanced external counterpulsation (EECP) increases coronary artery perfusion and improves endothelium-dependent vasodilation in peripheral muscular conduit arteries. It is unknown whether vasodilatory capacity is improved in the peripheral resistance vasculature. Here we provide novel evidence from the first randomized, sham-controlled study that EECP increases peak limb blood flow and improves endothelium-dependent vasodilation in both calf and forearm resistance arteries in patients with coronary artery disease. PMID:24552391

Avery, Joseph C; Beck, Darren T; Casey, Darren P; Sardina, Paloma D; Braith, Randy W

2014-03-01

4

[Total arterial myocardial revascularization--strategy, early and midterm results].  

PubMed

Total arterial myocardial revascularization (TAMR) represents a new alternative procedure to the classical aorto-coronary bypass operation with venous graft material. The early and midterm results with the use of the left and right internal thoracic artery (LITA and RITA) and radial artery (RA) for coronary artery bypass grafting are analyzed to assess the suitability of these conduits for myocardial revascularization. From June 1997 to June 2001, 234 patients suffering from a coronary artery disease underwent TAMR at our institution. The bypass material consisted of 234 LITAs, 160 RITAs and 84 RAs. The most frequently used conduit combination was a T-graft (n=213) consisting of a free arterial graft (RITA or RA) centrally implanted into LIMA "in situ" using an end-to-site grafting technique. The mean left ventricular ejection fraction was 0.59+/-0.4. In 150 patients (64.1%), the operation was performed on an urgent basis and in 24 cases (10.2%) it was a reoperation. A mean of 3.3+/-0.9 coronary anastomoses per patient was performed. The mean aortic cross-clamping time was 71+/-20 minutes. In 194 cases (83%), the postoperative course was uneventful. The early mortality was 0.8% (n=2). Complications included myocardial infarction in 4 patients (1.7%), sternal infection in 2 (0.8%), renal insufficiency in 2 (0.8%), prolonged respiratory ventilation in 28 (11.9%) and reoperation for bleeding in 6 (2.5%). At a mean follow-up of 25+/-1.3 months 197 patients (96.6%) were asymptomatic. Late mortality was 3.3% (n=7). TAMR is a safe and reliable procedure with very good early and midterm results. The results reported in this study support the widened use of this coronary artery grafting strategy. PMID:12658469

Vicol, C; Raab, S; Beyer, M

2003-03-01

5

Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease  

PubMed Central

Background Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE), it is still used as an adjunct to coronary artery bypass grafting (CABG). This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed. Methods Patient demographic information, operative details and outcome data of 104 patients with diffuse calcified coronary artery disease were retrospectively analyzed with respect to functional capacity (NYHA), angina pectoris (CCS) and mortality. Actuarial survival was reported using a Kaplan-Meyer analysis. Results Between August 2001 and March 2005, 104 patients underwent coronary artery bypass grafting (CABG) with adjunctive coronary endarterectomy (CE) in the Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen. Four patients were lost during follow-up. Data were gained from 88 male and 12 female patients; mean age was 65.5 ± 9 years. A total of 396 vessels were bypassed (4 ± 0.9 vessels per patient). In 98% left internal thoracic artery (LITA) was used as arterial bypass graft and a total of 114 vessels were endarterectomized. CE was performed on right coronary artery (RCA) (n = 55), on left anterior descending artery (LAD) (n = 52) and circumflex artery (RCX) (n = 7). Ninety-five patients suffered from 3-vessel-disease, 3 from 2-vessel- and 2 from 1-vessel-disease. Closed technique was used in 18%, open technique in 79% and in 3% a combination of both. The most frequent endarterectomized localization was right coronary artery (RCA = 55%). Despite the severity of endstage atherosclerosis, hospital mortality was only 5% (n = 5). During follow-up (24.5 ± 13.4 months), which is 96% complete (4 patients were lost caused by unknown address) 8 patients died (cardiac failure: 3; stroke: 1; cancer: 1; unknown reasons: 3). NYHA-classification significantly improved after CABG with CE from 2.2 ± 0.9 preoperative to 1.7 ± 0.9 postoperative. CCS also changed from 2.4 ± 1.0 to 1.5 ± 0.8 Conclusion Early results of coronary endarterectomy are acceptable with respect to mortality, NYHA & CCS. This technique offers a valuable surgical option for patients with endstage coronary artery disease in whom complete revascularization otherwise can not be obtained. Careful patient selection will be necessary to assure the long-term benefit of this procedure. PMID:19772645

Schmitto, Jan D; Kolat, Philipp; Ortmann, Philipp; Popov, Aron F; Coskun, Kasim O; Friedrich, Martin; Sossalla, Samuel; Toischer, Karl; Mokashi, Suyog A; Tirilomis, Theodor; Baryalei, Mersa M; Schoendube, Friedrich A

2009-01-01

6

In Vivo Volumetric Intravascular Ultrasound Visualization of Early/Inflammatory Arterial Atheroma Using Targeted Echogenic Immunoliposomes  

PubMed Central

Objectives This study aimed to demonstrate three-dimensional (3D) visualization of early/inflammatory arterial atheroma using intravascular ultrasound (IVUS) and targeted echogenic immunoliposomes (ELIP). IVUS can be used as a molecular imaging modality with the use of targeted contrast agents for atheroma detection. Three-dimensional reconstruction of 2-dimensional IVUS images may provide improved atheroma visualization. Materials and Methods Atheroma were induced in arteries of Yucatan miniswine (n = 5) by endothelial cell denudation followed by a 4-week high cholesterol diet. The contralateral arteries were left intact and served as controls. Anti-intercellular adhesion molecule-1 (ICAM-1) and generic gammaglobulin (IgG) conjugated ELIP were prepared. Arteries were imaged using IVUS before and after ELIP injection. Images were digitized, manually traced, segmented, and placed in tomographic sequence for 3D visualization. Atheroma brightness enhancement was compared and reported as mean gray scale values. Plaque volume was quantified both from IVUS and histologic images. Results Anti-ICAM-1 ELIP highlighting of the atheroma in all arterial segments was different compared with baseline (P < 0.05). There was no difference in the mean gray scale values with IgG-ELIP. Arterial 3D IVUS images allowed visualization of the entire plaque distribution. The highlighted plaque/atheroma volume with anti-ICAM-1 ELIP was greater than baseline (P < 0.01). Conclusion This study demonstrates specific highlighting of early/inflammatory atheroma in vivo using anti-ICAM-1 ELIP. Three-dimensional IVUS reconstruction provides good visualization of plaque distribution in the arterial wall. This novel methodology may help to detect and diagnose pathophysiologic development of all stages of atheroma formation in vivo and quantitate plaque volume for serial and long-term atherosclerotic treatment studies. PMID:20733507

Kim, Hyunggun; Moody, Melanie R.; Laing, Susan T.; Kee, Patrick H.; Huang, Shao-Ling; Klegerman, Melvin E.; McPherson, David D.

2011-01-01

7

Management of early postoperative coronary artery bypass graft failure  

PubMed Central

Perioperative graft failure following coronary artery bypass grafting (CABG) may result in acute myocardial ischaemia. Whether acute percutaneous coronary intervention, emergency reoperation or conservative intensive care treatment should be used is currently unknown. Between 2003 and 2009, 39 of the 5598 patients who underwent isolated CABG surgery underwent early postoperative coronary angiography for suspected myocardial ischaemia. Following angiography, two groups were identified: patients who underwent immediately reintervention (group 1); and those treated conservatively (group 2). Primary study endpoints were mortality and postoperative myocardial infarct size. Postoperative coronary angiography revealed early perioperative bypass graft failure in 32 of 39 patients. Acute percutaneous coronary intervention was performed in 15 patients, redo-CABG in 4 patients and conservative treatment in 13 patients. The number of failing bypass grafts were significantly higher in group 1 compared with group 2 (P = 0.0251). A trend toward lower post-procedural peak cardiac troponin T and creatinine phosphokinase serum levels in group 1 was observed (163.0 vs. 206.0 and 4.35 vs. 5.53, respectively) (P = 0.0662 and 0.1648). Early reintervention may limit the extent of myocardial cellular damage compared with conservative medical strategy in patients with myocardial ischaemia due to early graft failure. PMID:22223760

Laflamme, Maxime; DeMey, Nathalie; Bouchard, Denis; Carrier, Michel; Demers, Philippe; Pellerin, Michel; Couture, Pierre; Perrault, Louis P.

2012-01-01

8

Liposomal nanoparticles encapsulating iloprost exhibit enhanced vasodilation in pulmonary arteries  

PubMed Central

Prostacyclin analogues are standard therapeutic options for vasoconstrictive diseases, including pulmonary hypertension and Raynaud’s phenomenon. Although effective, these treatment strategies are expensive and have several side effects. To improve drug efficiency, we tested liposomal nanoparticles as carrier systems. In this study, we synthesized liposomal nanoparticles tailored for the prostacyclin analogue iloprost and evaluated their pharmacologic efficacy on mouse intrapulmonary arteries, using a wire myograph. The use of cationic lipids, stearylamine, or 1,2-di-(9Z-octadecenoyl)-3-trimethylammonium-propane (DOTAP) in liposomes promoted iloprost encapsulation to at least 50%. The addition of cholesterol modestly reduced iloprost encapsulation. The liposomal nanoparticle formulations were tested for toxicity and pharmacologic efficacy in vivo and ex vivo, respectively. The liposomes did not affect the viability of human pulmonary artery smooth muscle cells. Compared with an equivalent concentration of free iloprost, four out of the six polymer-coated liposomal formulations exhibited significantly enhanced vasodilation of mouse pulmonary arteries. Iloprost that was encapsulated in liposomes containing the polymer polyethylene glycol exhibited concentration-dependent relaxation of arteries. Strikingly, half the concentration of iloprost in liposomes elicited similar pharmacologic efficacy as nonencapsulated iloprost. Cationic liposomes can encapsulate iloprost with high efficacy and can serve as potential iloprost carriers to improve its therapeutic efficacy. PMID:25045260

Jain, Pritesh P; Leber, Regina; Nagaraj, Chandran; Leitinger, Gerd; Lehofer, Bernhard; Olschewski, Horst; Olschewski, Andrea; Prassl, Ruth; Marsh, Leigh M

2014-01-01

9

Effect of enhanced external counterpulsation depends on arterial compliance.  

PubMed

Enhanced external counterpulsation (EECP) is a non-invasive therapy offered to patients with refractory angina pectoris. Previous studies have demonstrated that its clinical effect depends on the diastolic/systolic augmentation ratio (D/S ratio). We hypothesized that the D/S ratio is associated with arterial stiffness measured as pulse wave velocity (PWV) and brachial pulse pressure (PP). Twenty patients with known refractory angina (17 men, 3 women; mean age 64 years) were included and underwent one hour of EECP treatment (Vasomedical Inc., Westbury, NY, USA). Three sets of cuffs were applied around the lower extremities. Gated by electrocardiography (ECG), air was inflated in diastole at a pressure of 260 mmHg and deflated at the start of systole. The D/S ratio was monitored with finger plethysmography. Carotid-femoral pulse wave velocity (PWV) was measured with mechanotransducers (Complior SP, Artech Medical, France). PWV and brachial BP were measured at baseline before EECP. The mean (SD) BP was 140 (23.5)/77 (9.9) mmHg, PP 62.8 (18.3) mmHg and PWV 10.8 (4.4) m/s. EECP treatment increased the D/S ratio during a one-hour session compared with baseline (1.30 (0.11) vs. 0.56 (0.04) P < 0.001), and the D/S ratio at 45 min. was significantly correlated with PWV (r = 0.49, P < 0.05) and PP (r = 0.58, P < 0.05). We demonstrated that the diastolic augmentation (D/S ratio) during EECP treatment depends on arterial stiffness. The results suggest that arterial compliance has a crucial influence on the effect of EECP and that large-artery stiffness may reduce the effect of EECP. PMID:23457909

Eftekhari, Ashkan; May, Ole

2013-02-01

10

Effects of Enhanced External Counterpulsation on Carotid Circulation in Patients with Coronary Artery Disease  

Microsoft Academic Search

Background: Enhanced external counterpulsation (EECP) is a noninvasive method previously shown to improve measures of myocardial ischemia in patients with coronary artery disease. However, the concomitant effects of EECP on large and small arterial properties have been poorly examined. In a randomized controlled study, we investigated whether arterial stiffness and resistance of the carotid circulation are altered by EECP. Methods:

Jaime Levenson; Alain Simon; Jean L. Megnien; Gilles Chironi; Jerome Gariepy; Marie G. Pernollet; Damian Craiem; Marie C. Iliou

2007-01-01

11

Arterial Reactivity Is Enhanced in Genetic Males Taking High Dose Estrogens  

Microsoft Academic Search

Objectives. We sought to assess whether high dose estrogen treatment is associated with enhanced arterial reactivity in genetic males.Background. Although estrogens have been shown to enhance arterial reactivity in women, and are thereby thought to confer cardiovascular benefit, the vascular effects of long-term estrogen therapy in genetic males is unknown.Methods. We studied the arterial physiology of 30 genetic males—15 male

Jane A McCrohon; William A. W Walters; Jacqui T. C Robinson; Robyn J McCredie; Leo Turner; Mark R Adams; David J Handelsman; David S Celermajer

1997-01-01

12

Gadolinium-Enhanced MR Imaging in the Evaluation of Uterine Fibroids Treated with Uterine Artery Embolization  

Microsoft Academic Search

OBJECTIVE . The purpose of this study was to determine whether tumor volume reduc- tion can be predicted by the infarction rate of uterine fibroids as seen on gadolinium-enhanced MR images obtained immediately after uterine artery embolization. MATERIALS AND METHODS . In our study, 36 women with symptomatic uterine fi- broids successfully underwent uterine artery embolization. Unenhanced and enhanced MR

Tetsuya Katsumori; Kazuhiro Nakajima; Mitsukuni Tokuhiro

13

Analysis of Turbulent flow in early stages of atherosclerosis of coronary artery  

NASA Astrophysics Data System (ADS)

During the early stages of atherosclerotic heart disease, fatty material accumulates in the coronary artery resulting in development of streaks of plaque and creating high levels of turbulence, and with significantly modified flow parameters. Diagnostic measures performed during this early stage may not show any evidence of coronary artery disease, because the lumen of the coronary artery has not decreased in caliber. These streaks do not obstruct the flow of blood but alter the flow characteristics, even at this preclinical stage. This talk presents the preliminary results for the analysis of turbulent flow characteristics for a range of atherosclerotic plaque configurations in the left main coronary artery. For this purpose a CAD/medical imaging based direct-simulation (DNS) tool has been developed. The Navier-stokes equations are solved in the vertical vorticity-velocity formulation. The plaque is introduced using immersed body technique. The geometric acquisition of the artery geometry and plaque morphology is obtained using CAD based commercial software.

Bhaganagar, Kiran

2005-11-01

14

Reappraisal of early CT signs to predict the arterial occlusion site in acute embolic stroke  

PubMed Central

Patients: 105 consecutive patients with acute embolic stroke affecting the anterior circulation. Methods: Four early signs were evaluated on cranial CT within six hours of stroke onset: loss of the insular ribbon (LIR); attenuation of the lentiform nucleus (ALN); hemispherical sulcus effacement (HSE); and the hyperdense middle cerebral artery sign (HMCAS). The arterial occlusion site was definitively identified on cerebral angiography within two hours of the CT examination. Results: LIR was present in 55% of patients with internal carotid artery occlusion. ALN was present in 65% of patients with occlusion of the sphenoidal portion (M1) of the middle cerebral artery. HSE was present in 47% of patients with middle cerebral artery branch occlusion. LIR was related independently to internal carotid artery occlusion (odds ratio (OR) 2.8 (95% confidence interval, 1.2 to 6.8)), ALN to M1 occlusion (OR 2.9 (1.2 to 7.4)), and isolated HSE without ALN or LIR to branch occlusion (OR 12.8 (3.2 to 51.5)). The combined presence of the three signs was indicative of internal carotid artery occlusion (p < 0.05), and the presence of ALN and LIR without HSE was indicative of M1 occlusion (p < 0.05) by univariate analysis. HMCAS bore no relation to either arterial occlusion site. Conclusions: LIR, ALS, HSE, and combinations of these were useful predictors of the arterial occlusion site. PMID:12700311

Koga, M; Saku, Y; Toyoda, K; Takaba, H; Ibayashi, S; Iida, M

2003-01-01

15

External iliac artery dissection causing early renal transplant dysfunction.  

PubMed

External iliac artery dissection after kidney transplantation is a rare, catastrophic but potentially reversible complication. Treatment which may save both the transplant and the patient requires clinical suspicion, timely imaging, and prompt intervention. This case report describes successful diagnosis of this complication and surgical intervention which saved the kidney and safeguarded blood supply to the patient's leg. PMID:24695666

Lee, Gwyn; Barlow, Adam; Doughman, Tahir; Nicholson, Michael L

2014-01-01

16

Early neurological complications of coronary artery bypass surgery  

Microsoft Academic Search

A prospective study of 312 patients undergoing elective coronary artery bypass surgery was undertaken to determine the incidence, severity, and functional impact of postoperative neurological complications. Detailed evaluation of the patients showed that neurological complications after surgery were common, occurring in 191 of the 312 patients (61%). Although such a high proportion of the total developed detectable changes, serious neurological

P J Shaw; D Bates; N E Cartlidge; D Heaviside; D G Julian; D A Shaw

1985-01-01

17

Pulmonary Arterial Hypertension: Use of Delayed Contrast-Enhanced Cardiovascular Magnetic Resonance in Risk Assessment  

PubMed Central

Background Pulmonary arterial hypertension is a severe and progressive disease. Its early diagnosis is the greatest clinical challenge. Objective To evaluate the presence and extension of the delayed myocardial contrast-enhanced cardiovascular magnetic resonance, as well as to verify if the percentage of the myocardial fibrosis mass is a severity predictor. Methods Cross-sectional study with 30 patients with pulmonary arterial hypertension of groups I and IV, subjected to clinical, functional and hemodynamic evaluation, and to cardiac magnetic resonance. Results The mean age of patients was 52 years old, with female predominance (77%). Among the patients, 53% had right ventricular failure at diagnosis, and 90% were in functional class II/III. The mean of the 6-minute walk test was 395m. In hemodynamic study with right catheterism, the mean average pulmonary arterial pressure was 53.3mmHg, of the cardiac index of 2.1L/ min.m2, and median right atrial pressure was 13.5 mmHg. Delayed myocardial contrast enhanced cardiovascular magnetic resonance was found in 28 patients. The mean fibrosis mass was 9.9 g and the median percentage of fibrosis mass was 6.17%. The presence of functional class IV, right ventricular failure at diagnosis, 6-minute walk test < 300 meters and right atrial pressure ? 15 mmHg, with cardiac index < 2.0 L/ min.m2, there was a relevant association with the increased percentage of myocardial fibrosis. Conclusion The percentage of the myocardial fibrosis mass indicates a non-invasive marker with promising perspectives in identifying patients with high risk factors for pulmonary hypertension. PMID:23979779

Bessa, Luiz Gustavo Pignataro; Junqueira, Flavia Pegado; Bandeira, Marcelo Luiz da Silva; Garcia, Marcelo Iorio; Xavier, Sergio Salles; Lavall, Guilherme; Torres, Diego; Waetge, Daniel

2013-01-01

18

Robotic computer-assisted telemanipulation enhances coronary artery bypass  

Microsoft Academic Search

Objectives: Totally endoscopic coronary artery bypass grafting depends greatly on perfecting the anastomosis. We tested a new computer-assisted telemanipulation robot (Intuitive Surgical Inc, Mountain View, Calif) in performing endoscopic coronary bypass. Methods: On-bench anastomoses of the porcine arterial graft to the left anterior descending coronary artery were performed with both direct visualization and conventional surgical instruments (group I), endoscopic 3-dimensional

Hani Shennib; Amr Bastawisy; Joan McLoughlin; Frederic Moll

1999-01-01

19

Arterial distensibility is reduced in overweight pre- and early pubescent children  

Microsoft Academic Search

The objective of this study was to examine the differences in arterial distensibility between overweight\\/obese and normal\\u000a weight pre- and early pubescent boys and girls. Arterial distensibility was measured in 65 children (43 normal weight and\\u000a 22 overweight\\/obese) between the ages of 9 and 12 years. Weight classification was based on age and sex-specific body mass\\u000a index (BMI) cut-offs and pubertal

Alayna M. Banach; Jose Peralta-Huertas; Kristina Livingstone; Nicholas Petrella; Panagiota Klentrou; Brent Faught; Terrance Wade; Deborah O’Leary

2010-01-01

20

Signal and image processing for early detection of coronary artery diseases: A review  

NASA Astrophysics Data System (ADS)

Today biomedical signals and image based detection are a basic step to diagnose heart diseases, in particular, coronary artery diseases. The goal of this work is to provide non-invasive early detection of Coronary Artery Diseases relying on analyzing images and ECG signals as a combined approach to extract features, further classify and quantify the severity of DCAD by using B-splines method. In an aim of creating a prototype of screening biomedical imaging for coronary arteries to help cardiologists to decide the kind of treatment needed to reduce or control the risk of heart attack.

Mobssite, Youness; Samir, B. Belhaouari; Mohamad Hani, Ahmed Fadzil B.

2012-09-01

21

Combined magnetic resonance coronary artery imaging, myocardial perfusion and late gadolinium enhancement in patients with suspected coronary artery disease  

Microsoft Academic Search

BACKGROUND: Cardiovascular Magnetic Resonance (CMR) imaging offers methods for the detection of ischemia and myocardial infarction as well as visualization of the coronary arteries (MRCA). However, a direct comparison of adenosine perfusion (PERF), late gadolinium enhancement (LGE) and MRCA or the results of their combination has not been performed. Aim of the study was to evaluate the feasibility\\/diagnostic performance of

Christoph Klein; Rolf Gebker; Thomas Kokocinski; Stephan Dreysse; Bernhard Schnackenburg; Eckart Fleck; Eike Nagel

2008-01-01

22

Diagnostic value of contrast enhanced ultrasound for splenic artery complications following acute pancreatitis  

PubMed Central

AIM: To assess the value of contrast-enhanced ultrasound (CEUS) in diagnosing splenic artery complications (SACs) after acute pancreatitis (AP). METHODS: One hundred and eighteen patients with AP were enrolled in the study. All patients were examined by CEUS and contrast-enhanced computed tomography (CECT). CECT was accepted as a gold standard for the diagnosis of SACs in AP. The diagnostic accuracy of splenic CEUS and pancreatic CEUS was compared with that of CECT. Splenic infarction was the diagnostic criterion for splenic artery embolism and local dysperfusion of the splenic parenchyma was the diagnostic criterion for splenic arterial stenosis. The incidence of splenic sub-capsular hemorrhage, splenic artery aneurysms, and splenic rupture was all lower than that of SACs. RESULTS: Nine patients were diagnosed as having SACs after AP by CECT among the 118 patients. The patients with SACs were diagnosed with severe acute pancreatitis (SAP). Among them, 6 lesions were diagnosed as splenic artery embolism, 5 as splenic artery aneurysms, and 1 as splenic arterial stenosis. No lesion was diagnosed by pancreatic CEUS and 5 lesions were diagnosed by splenic CEUS. By splenic CEUS, 4 cases were diagnosed as splenic artery embolism and 1 as splenic arterial stenosis. The accuracy of splenic CEUS in diagnosis of SACs in SAP was 41.7% (5/12), which was higher than that of pancreatic CEUS (0%). CONCLUSION: Splenic CEUS is a supplementary method for pancreatic CEUS in AP patients, which can decrease missed diagnosis of SACs. PMID:24574783

Cai, Di-Ming; Parajuly, Shyam Sundar; Ling, Wen-Wu; Li, Yong-Zhong; Luo, Yan

2014-01-01

23

Blood pool agent contrast-enhanced MRA: level-set-based artery-vein separation  

NASA Astrophysics Data System (ADS)

Blood pool agents (BPAs) for contrast-enhanced magnetic resonance angiography (CE-MRA) allow prolonged imaging times for higher contrast and resolution by imaging during the steady-state when the contrast agent is distributed through the complete vascular system. However, simultaneous venous and arterial enhancement hampers interpretation. It is shown that arterial and venous segmentation in this equilibrium phase can be achieved if the central arterial axis (CAA) and central venous axis (CVA) are known. Since the CAA can not straightforwardly be obtained from the steady-state data, images acquired during the first-pass of the contrast agent can be utilized to determine the CAA with minimal user initialization. Utilizing the CAA to provide a rough arterial segmentation, the CVA can subsequently be determined from the steady-state dataset. The final segmentations of the arteries and veins are achieved by simultaneously evolving two level-sets in the steady-state dataset starting from the CAA and CVA.

van Bemmel, Cornelis M.; Spreeuwers, Luuk J.; Verdonck, Bert; Viergever, Max A.; Niessen, Wiro J.

2002-05-01

24

Surface Roughness Detection of Arteries via Texture Analysis of Ultrasound Images for Early Diagnosis of Atherosclerosis  

PubMed Central

There is a strong research interest in identifying the surface roughness of the carotid arterial inner wall via texture analysis for early diagnosis of atherosclerosis. The purpose of this study is to assess the efficacy of texture analysis methods for identifying arterial roughness in the early stage of atherosclerosis. Ultrasound images of common carotid arteries of 15 normal mice fed a normal diet and 28 apoE?/? mice fed a high-fat diet were recorded by a high-frequency ultrasound system (Vevo 2100, frequency: 40 MHz). Six different texture feature sets were extracted based on the following methods: first-order statistics, fractal dimension texture analysis, spatial gray level dependence matrix, gray level difference statistics, the neighborhood gray tone difference matrix, and the statistical feature matrix. Statistical analysis indicates that 11 of 19 texture features can be used to distinguish between normal and abnormal groups (p<0.05). When the 11 optimal features were used as inputs to a support vector machine classifier, we achieved over 89% accuracy, 87% sensitivity and 93% specificity. The accuracy, sensitivity and specificity for the k-nearest neighbor classifier were 73%, 75% and 70%, respectively. The results show that it is feasible to identify arterial surface roughness based on texture features extracted from ultrasound images of the carotid arterial wall. This method is shown to be useful for early detection and diagnosis of atherosclerosis. PMID:24146940

Niu, Lili; Qian, Ming; Yang, Wei; Meng, Long; Xiao, Yang; Wong, Kelvin K. L.; Abbott, Derek; Liu, Xin; Zheng, Hairong

2013-01-01

25

Intrathecal morphine for coronary artery bypass graft procedure and early extubation revisited  

Microsoft Academic Search

Objective: To determine the dose of intrathecal (IT) morphine (along with the intraoperative baseline anesthetic) that provides significant analgesia yet does not delay extubation in the immediate postoperative period in patients undergoing cardiac surgery and early extubation.Design: Prospective, randomized, double-blinded, placebocontrolled clinical study.Setting: Single university hospital.Participants: Forty patients undergoing elective coronary artery bypass graft procedure and early extubation.Interventions: Twenty patients

Mark A. Chaney; Mihail P. Nikolov; Bradford P. Blakeman; Mamdouh Bakhos

1999-01-01

26

Effect of Early and Delayed Recanalization on Infarct Pattern in Proximal Middle Cerebral Artery Occlusion  

Microsoft Academic Search

Background: To investigate the effect of early (<6 h) versus delayed (>6 h) recanalization on infarct pattern in acute middle cerebral artery (MCA) occlusion. Methods: 35 patients with acute MCA occlusion (M1 segment; symptom onset <6 h) were analyzed. Stroke MRI was performed immediately after admission (day 0), and on days 1 and 7. In addition, vessel status was assessed

Marek Humpich; Oliver C. Singer; Richard du Mesnil de Rochemont; Christian Foerch; Heiner Lanfermann; Tobias Neumann-Haefelin

2006-01-01

27

Measurement of superior mesenteric artery flow by means of doppler ultrasound in early dumping syndrome  

Microsoft Academic Search

Objective: Dumping occurs in about 10% of patients after gastric surgery. It has been suggested that early dumping is associated with an abnormal increase in postprandial splanchnic flow, but data from controlled studies are lacking. Therefore we have studied basal and postprandial superior mesenteric artery (SMA) blood flow in patients with dumping and in two control groups. Methods: Three groups

J Vecht; J. A van Oostayen; C. B. H. W Lamers; A. A. M Masclee

1998-01-01

28

Is Carotid Artery Intima-Media Thickening a Reliable Marker of Early Atherosclerosis?  

Microsoft Academic Search

Background It is widely believed that carotid artery intimamedia thickening represents an early marker for the development of atheroma. However, carotid intima-media thickening might also be expected to occur in response to an increased tensile stress and decreased wall shear stress which may accompany physical exercise.Design, methods, and results In order to test this hypothesis 24 athletes (professional footballers) were

Jamil Mayet; Alice V. Stanton; Neil Chapman; Rodney A Foale; Alun D. Hughes; Simon A MG Thom

2002-01-01

29

Is carotid artery intima-media thickening a reliable marker of early atherosclerosis?  

Microsoft Academic Search

It is widely believed that carotid artery intima-media thickening represents an early marker for the development of atheroma. It has been shown to be related to the all of the commonly accepted risk factors for cardiovascular disease, including left ventricular hypertrophy. However, carotid intima-media thickening might also be expected to occur in response to an increased tensile wall stress; if

J. Mayet; P. Patel; M. Starmans-Kool; N. Chapman; A. D. Hughes; SAMc G. Thom; A. V. Stanton

2000-01-01

30

128-Slice dual source coronary CTA: defining optimal arterial enhancement levels.  

PubMed

This study aims to correlate coronary artery enhancement levels with quality of vessel visualization and calcified plaque visualization using a 128-slice dual-source CT (DSCT) scanner. Coronary CT angiography exams from 52 patients, mean age of 55 years (range, 22-90) and mean weight of 184 lbs (range, 120-320 lbs), were reviewed retrospectively. Contrast infusion rates ranged from 4.5 to 7 mL/s (mean, 5.8 mL/s). Postcontrast density of the largest calcified plaque and postcontrast density of the left main (LM) and right coronary arteries (RCA) were recorded. Enhancement quality was graded as 1=suboptimal, 2=adequate for diagnosis, and 3=excellent. Pre- and postcontrast acquisitions were compared for calcified plaque conspicuity. The largest calcified plaque density was a mean of 862 HU (range, 376 to 1,384 HU) on the postcontrast scan. The mean LM and RCA coronary artery enhancement levels for studies of excellent enhancement quality (N=43) were 468 and 457 HU, respectively, higher than mean enhancement levels of 320 and 322 HU for adequate enhancement quality (N=8) (p<0.0001 and 0.009). One study was graded as a nondiagnostic enhancement quality. Twenty-five subjects had calcified plaque, 3/8 with adequate and 22/43 with excellent enhancement quality. At least one calcified plaque measuring <2 mm was isodense to contrast enhancement on axial images in 5/25; all five were in the highest enhancement quality group. High coronary artery enhancement quality using 128-DSCT is associated with mean proximal coronary artery enhancement levels over 400 HU. High levels of enhancement may obscure small, calcified plaques. PMID:24700078

Malayeri, Ashkan A; Zimmerman, Stefan L; Lake, Spencer T; Fishman, Elliot K; Johnson, Pamela T

2014-10-01

31

Exercise training enhances multiple mechanisms of relaxation in coronary arteries from ischemic hearts  

PubMed Central

Exercise training of coronary artery disease patients is of considerable interest, since it has been shown to improve vascular function and, thereby, enhance blood flow into compromised myocardial regions. However, the mechanisms underlying exercise-induced improvements in vascular function have not been fully elucidated. We tested the hypothesis that exercise training increases the contribution of multiple mediators to endothelium-dependent relaxation of coronary arteries in the underlying setting of chronic coronary artery occlusion. To induce gradual occlusion, an ameroid constrictor was placed around the proximal left circumflex coronary artery in Yucatan miniature swine. At 8 wk postoperatively, pigs were randomly assigned to sedentary or exercise (treadmill, 5 days/wk) regimens for 14 wk. Exercise training significantly enhanced the contribution of nitric oxide, prostanoids, and large-conductance Ca2+-dependent K+ (BKCa) channels to endothelium-dependent, bradykinin-mediated relaxation in nonoccluded and collateral-dependent arteries. Combined nitric oxide synthase, prostanoid, and BKCa channel inhibition ablated the enhanced relaxation associated with exercise training. Exercise training significantly increased nitric oxide levels in response to bradykinin in endothelial cells isolated from nonoccluded and collateral-dependent arteries. Bradykinin treatment significantly increased PGI2 levels in all artery treatment groups and tended to be further enhanced after nitric oxide synthase inhibition in exercise-trained pigs. No differences were found in whole cell BKCa channel currents, BKCa channel protein levels, or arterial cyclic nucleotide levels. Although redundant, upregulation of parallel vasodilator pathways appears to contribute to enhanced endothelium-dependent relaxation, potentially providing a more refined control of blood flow after exercise training. PMID:23997097

Deer, Rachel R.

2013-01-01

32

Enhancement and segmentation for NMR images of blood flow in arteries  

NASA Astrophysics Data System (ADS)

STRACT The widespread prevalence of atherosclerotic vascular disease has given rise to the need for a simple noninvasive imaging examination of the cardiovascular performance of patients. The potential of using Magnetic Resonance (MR) Imaging to quantify flow in vivo has for reaching possibilities for the future of preventive medicine. In this paper we address the problem of using MR velocity imaging to analyse the flow boundaries in human arteries which are of great importance to the early diagnosis ef occlusive diseases. A flow related enhancement process is introduced in this paper. It is designed to suppress the residuals and the noisy background of the MR velocity images caused by misregistration tissue movement and uneven magnetic field and provide great improvement in signal to noise ratio. From the enhanced image the main flow areas can be delineated by a thresholding process which defines the kernel of the flow. The boundaries of the kernel region are then dynamically guided by a defined flow boundary localization process to their final positions. The results of the application of this coarse to fine process show its robustness and effectiveness for the determination of the blood blow boundaries form very low quality MR velocity images.

Yang, Guang-Zhong; Burger, Peter

1990-09-01

33

Early and mid-term results of minimally invasive coronary artery bypass grafting  

PubMed Central

Introduction Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. This technique coupled with use of off pump technique of surgical revascularization makes it truly less invasive. This method is highly effective even in high-risk patients. Results of this procedure are comparable to standard off pump technique and are better than percutaneous coronary intervention utilizing drug-eluting stent. We present an early and mid-term result of the use of this technique. Method We enrolled 33 patients for analysis operated between 2008 and 2012. Operation was performed utilizing off-pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Median follow up of 2.5 years (6 months–4 years) is available. Results Median age was 58.5 years (41–77) and all were male. Single vessel disease was present in 7, double vessel in 14 and triple vessel disease in 12 patients. All the patients had normal left ventricular size and function. There was no operative and 30-day mortality. Conversion to median sternotomy to complete the operation was done in 6.6% (2 out of 33 patients). One patient had acute myocardial infarction and there were no deaths during follow up. Conclusion MICABG is a safe and effective method of revascularization in low risk candidates for coronary artery bypass grafting. PMID:24814114

Pande, Shantanu; Agarwal, Surendra K.; Gupta, Devendra; Mohanty, Satayapriya; Kapoor, Aditya; Tewari, Satyendra; Bansal, Anubhav; Ambesh, Sushil P.

2014-01-01

34

Arterial dysfunction in early autosomal dominant polycystic kidney disease independent of fibroblast growth factor 23.  

PubMed

Introduction. Recent studies report reduced vascular compliance and elevated levels of fibroblast growth factor 23 (FGF23) in patients with autosomal dominant polycystic kidney disease (ADPKD) and preserved kidney function. In the present study, we investigated the relationship between vascular compliance and FGF23 in patients in early phases of ADPKD. Materials and Methods. We studied 54 ADPKD patients with preserved kidney function and 24 healthy individuals. All participants underwent noninvasive pulse wave analysis in order to determine large arterial elasticity index (LAEI) and small arterial elasticity index (SAEI) using a modi?ed Windkessel model. Levels of FGF23 in addition to several cardiovascular risk factors were evaluated. Linear regression analyses were performed to determine independent correlates of LAEI, SAEI, and FGF23. Results. In the ADPKD group, 33 patients were hypertensive and the remaining patients were normotensive. Serum FGF23 levels of both ADPKD groups were significantly higher than that in the controls. Both hypertensive and normotensive ADPKD patients had lower LAEI and SAEI levels compared to the controls. There was no significant correlation between vascular compliance parameters and FGF23 levels. Having ADPKD was independently associated with increased FGF23 levels and decreased SAEI. Conclusions. Fibroblast growth factor 23 was found substantially elevated and arterial compliance was found significantly decreased in early ADPKD patients regardless of hypertension. However, there was no significant correlation between FGF23 levels and arterial function parameters. Additional studies are required to determine possible mechanisms of these disturbances and cardiovascular effects of FGF23 in ADPKD patients. PMID:25362218

Yildiz, Abdulmecit; Gul, Cuma; Ersoy, Alparslan; Asiltas, Burak; Ermurat, Selime; Dogan, Selda; Karaagac, Kemal; Sag, Saim; Oruc, Aysegul; Aktas, Nimet; Ocakoglu, Gokhan; Dogan, Ibrahim; Gullulu, Sumeyye; Gullulu, Mustafa

2014-11-01

35

Coadministered Amlodipine and Atorvastatin Produces Early Improvements in Arterial Wall Compliance in Hypertensive Patients With Dyslipidemia  

Microsoft Academic Search

BackgroundCombining statins with antihypertensive therapy has been demonstrated to provide an early reduction in cardiovascular events. This nested substudy of the AVALON trial assessed the effects of coadministered amlodipine and atorvastatin vs. either therapy alone or placebo on arterial compliance, to evaluate the vascular benefits of coadministered therapy.MethodsDuring an initial 8-week, double-blind phase, patients with concomitant hypertension and dyslipidemia were

Jay N. Cohn; Daniel J. Wilson; Joel Neutel; Mark Houston; Myron H. Weinberger; Richard Grimm; David H. G. Smith; William Sun

2009-01-01

36

Acute Treatment with Candesartan Reduces Early Injury After Permanent Middle Cerebral Artery Occlusion  

Microsoft Academic Search

We have shown that reduction of blood pressure (BP) immediately after the onset of reperfusion reduced neurovascular damage\\u000a and improved functional outcome after experimental cerebral ischemia and candesartan is particularly effective in improving\\u000a long-term functional outcome. In this study, we sought to determine if early BP lowering with candesartan, in the presence\\u000a of an occluded cerebral artery, will reduce injury

Weihua Guan; Anna Kozak; Azza B. El-Remessy; Maribeth H. Johnson; Bindu A. Pillai; Susan C. Fagan

2011-01-01

37

Measurement of superior mesenteric artery flow by means of doppler ultrasound in early dumping syndrome  

Microsoft Academic Search

Objective:Dumping occurs in about 10% of patients after gastric surgery. It has been suggested that early dumping is associated with an abnormal increase in postprandial splanchnic flow, but data from controlled studies are lacking. Therefore we have studied basal and postprandial superior mesenteric artery (SMA) blood flow in patients with dumping and in two control groups.Methods:Three groups were studied, one

J. Vecht; J A van Oostayen; C. B. H. W. Lamers; A. A. M. Masclee

1998-01-01

38

Music listening enhances cognitive recovery and mood after middle cerebral artery stroke  

E-print Network

included a wide range of cognitive tests as well as mood and quality of life questionnaires, one weekMusic listening enhances cognitive recovery and mood after middle cerebral artery stroke Teppo Sa whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke

39

Enhanced External Counterpulsation Reduces Lung\\/Heart Ratio at Stress in Patients with Coronary Artery Disease  

Microsoft Academic Search

Enhanced external counterpulsation (EECP) is a recently approved treatment modality for patients with angina and heart failure. However, the efficacy of EECP on left ventricular (LV) function has not been well established.The study was aimed to determine whether EECP leads to an improvement in objective parameters of LV function. Patients with coronary artery disease (n = 10) who showed evidence

Chii-Ming Lee; Yen-Wen Wu; Hsiang-Yiang Jui; Ming-Fong Chen; Yuan-Teh Lee; Ozlem Soran

2006-01-01

40

Enhanced vasoconstrictor responses in renal and femoral arteries of the golden hamster during hibernation  

PubMed Central

The present study assessed local regulation of vascular tone of euthermic (control), cold control and hibernating golden hamsters. Sympathetic neurotransmission in the renal artery, the long term effects of hibernation on perivascular nerve activity, and the responsiveness of femoral artery to a number of neurotransmitters and hormones with both constrictor and dilator actions during hibernation are described.The contractile responses of the renal arterial rings to transmural nerve stimulation (80 V, 0.1 ms, 4–64 Hz, for 1 s) were negligible in controls, significantly increased at higher frequencies of stimulation in cold controls and markedly enhanced in the hibernating group at all frequencies tested. The contractile responses to exogenous noradrenaline (NA; 0.1–100 ?m) were significantly increased in the renal arteries of hibernating hamsters compared with controls, but not compared with cold controls. Responses to exogenous ATP (1–3000 ?m) and KCl (120 mm) were similar among all experimental groups.The maximal contractile responses of femoral arterial rings to the sympathetic co-transmitter ATP and 5-hydroxytryptamine were increased by approximately 124 % and 99 %, respectively, in hibernating compared with cold control preparations without a change in the concentration of agonist that produces half-maximal response. However, the responses to NA were not altered during hibernation.Vasoconstriction of femoral arterial rings in response to arginine vasopressin was significantly enhanced in both cold controls and hibernating groups, while vasoconstriction in response to endothelin-1 and KCl was unaltered.The dilator responses of femoral arterial rings to acetylcholine, sodium nitroprusside and adenosine were not different among the groups.It is suggested that the marked augmentation of sympathetic neurotransmission, selective supersensitivity of the vascular smooth muscle to sympathetic contractile agents and unaltered vasodilatory mechanisms may provide a means for maintenance of vascular tone and peripheral resistance during hibernation. PMID:9769433

Karoon, Parastoo; Knight, Gillian; Burnstock, Geoffrey

1998-01-01

41

Lower extremity arterial disease in young adults. A systematic approach to early diagnosis.  

PubMed Central

General and vascular surgeons are consulted occasionally to evaluate young adults with ischemia of the lower extremity. Between 1975 and 1985, 51 adults under 40 years of age who had arterial occlusive disease of the lower limb were managed. Although premature atherosclerosis was the most common problem (50%), claudication or limb-threatening ischemia also resulted from other sources (thromboembolism, popliteal artery entrapment, Buerger's disease, collagen vascular disease, and Takayasu's arteritis). Identifying the exact cause was sometimes difficult. The authors were impressed with the number of young adults who had delay in diagnosis and treatment (30 patients, 59%) before referral for a surgical opinion. In this paper, the attempt has been made to uncover the reasons for delayed diagnosis and to suggest a systematic approach that should lead to early recognition of lower extremity ischemia in this age group. Images FIG. 2. PMID:4051611

Hallett, J W; Greenwood, L H; Robison, J G

1985-01-01

42

Primary Stroke Unit Treatment Followed by Very Early Carotid Endarterectomy for Carotid Artery Stenosis after Acute Stroke  

Microsoft Academic Search

Background: Although it is recognized that carotid endarterectomy (CEA) is the treatment of choice in symptomatic internal carotid artery (ICA) stenosis, in the past, very early CEA has been shown to carry substantial risks. We assessed an interdisciplinary concept of very early CEA in patients with high-grade (>70%) symptomatic ICA stenosis at a single center. Patients and Methods: The course

M. Aleksic; M. A. Rueger; F. G. Lehnhardt; J. Sobesky; V. Matoussevitch; M. Neveling; W. D. Heiss; J. Brunkwall; A. H. Jacobs

2006-01-01

43

A novel vascular homing peptide strategy to selectively enhance pulmonary drug efficacy in pulmonary arterial hypertension.  

PubMed

A major limitation in the pharmacological treatment of pulmonary arterial hypertension (PAH) is the lack of pulmonary vascular selectivity. Recent studies have identified a tissue-penetrating homing peptide, CARSKNKDC (CAR), which specifically homes to hypertensive pulmonary arteries but not to normal pulmonary vessels or other tissues. Some tissue-penetrating vascular homing peptides have a unique ability to facilitate transport of co-administered drugs into the targeted cells/tissues without requiring physical conjugation of the drug to the peptide (bystander effect). We tested the hypothesis that co-administered CAR would selectively enhance the pulmonary vascular effects of i.v. vasodilators in Sugen5416/hypoxia/normoxia-exposed PAH rats. Systemically administered CAR was predominantly detected in cells of remodeled pulmonary arteries. Intravenously co-administered CAR enhanced pulmonary, but not systemic, effects of the vasodilators, fasudil and imatinib, in PAH rats. CAR increased lung tissue imatinib concentration in isolated PAH lungs without increasing pulmonary vascular permeability. Sublingual CAR was also effective in selectively enhancing the pulmonary vasodilation by imatinib and sildenafil. Our results suggest a new paradigm in the treatment of PAH, using an i.v./sublingual tissue-penetrating homing peptide to selectively augment pulmonary vascular effects of nonselective drugs without the potentially problematic conjugation process. CAR may be particularly useful as an add-on therapy to selectively enhance the pulmonary vascular efficacy of any ongoing drug treatment in patients with PAH. PMID:24401613

Toba, Michie; Alzoubi, Abdallah; O'Neill, Kealan; Abe, Kohtaro; Urakami, Takeo; Komatsu, Masanobu; Alvarez, Diego; Järvinen, Tero A H; Mann, David; Ruoslahti, Erkki; McMurtry, Ivan F; Oka, Masahiko

2014-02-01

44

Peripheral resistance artery blood flow in subjects with abnormal glucose tolerance is improved following enhanced external counterpulsation therapy.  

PubMed

Enhanced external counterpulsation (EECP) improves resistance artery function in coronary artery disease patients. However, whether EECP elicits similar effects in persons with abnormal glucose tolerance (AGT) is unknown. Here we provide novel evidence that EECP significantly improves resistance arterial function in the forearm of persons with AGT, whereas the calf only approached significance (P ? 0.10). These improvements were coincident with greater glycemic control, providing further insight into the potential mechanisms of EECP-mediated alterations in glycemia. PMID:24766247

Martin, Jeffrey S; Beck, Darren T; Braith, Randy W

2014-05-01

45

Arterial Blood Pressure Management during Carotid Endarterectomy and Early Cognitive Dysfunction  

PubMed Central

Background A common practice during cross-clamp of carotid endarterectomy (CEA) is to manage mean arterial pressure (MAP) above baseline to optimize collateral cerebral blood flow and reduce risk of ischemic stroke. Objective To determine whether MAP management ?20% above baseline during cross-clamp is associated with lower risk of early cognitive dysfunction, a subtler form of neurologic injury than stroke. Methods One hundred eighty-three patients undergoing CEA were enrolled in this ad hoc study. All patients had radial arterial catheters placed prior to induction of general anesthesia. MAP was managed at the discretion of the anesthesiologist. All patients were evaluated with a battery of neuropsychometric tests pre-operatively and 24hrs post-operatively. Results Overall, 28.4% of CEA patients exhibited early cognitive dysfunction (eCD). Significantly fewer patients with MAP ?20% above baseline during cross-clamp exhibited eCD than those managed <20% above (11.6% vs. 38.6%, P<0.001). In a multivariate logistic regression model, MAP ?20% above baseline during the cross-clamp period was associated with significantly lower risk of eCD (OR: 0.18 [0.07–0.40], P<0.001), while diabetes mellitus (OR: 2.73 [1.14–6.61], P=0.03) and each additional year of education (OR: 1.19 [1.06–1.34], P=0.003) were associated with significantly higher risk of eCD. Conclusion The observations of this study suggest MAP management ?20% above baseline during cross-clamp of the carotid artery may be associated with lower risk of eCD after CEA. More prospective work is necessary to determine whether MAP ?20% above baseline during cross-clamp can improve the safety of this commonly performed procedure. PMID:24335822

Heyer, Eric J.; Mergeche, Joanna L.; Anastasian, Zirka H.; Kim, Minjae; Mallon, Kaitlin A.; Connolly, E. Sander

2014-01-01

46

Effects of early plasmin digests of fibrinogen on isometric tension development in isolated rings of rat pulmonary artery  

Microsoft Academic Search

The purpose of the study was to determine the effects of early plasmin-mediated digests of rat fibrinogen on the vascular tone of rat pulmonary artery in order to compare with reported vasoactive effects of high levels of isolated human peptides in various rat vascular beds. Isometric tension was monitored in isolated rings of rat pulmonary artery precontracted with phenylephrine (4×10?8mol).

Paul A. Boutcher; Patrick J. Gaffney; Sanjeev Raut; Ronan G. O'Regan; Paul McLoughlin

1996-01-01

47

Comparative evaluation of cerebral aneurysms with selective arterially enhanced CT and DSA  

Microsoft Academic Search

.   The purpose of our study was to compare selective arterially enhanced spiral computed tomographs (ACT) with digital subtraction\\u000a angiographies (DSA) in the presurgical assessment of cerebral aneurysms. A total of 24 aneurysms in 18 patients were explored\\u000a in a prospective study by ACT and DSA, using an interactive combined CT-angiography suite. Dimensions of the aneurysm, its\\u000a relation to the

P. Vanderschelden; P. Flandroy; R. F. Dondelinger; D. Martin; J. Lenelle

1998-01-01

48

Efficient sampling of early signal arrival for estimation of perfusion and transit time in whole-brain arterial spin labeling.  

PubMed

Arterial spin labeling can be used to measure both cerebral perfusion and arterial transit time. However, accurate estimation of these parameters requires adequate temporal sampling of the arterial spin labeling difference signal. In whole-brain multislice acquisitions, two factors reduce the accuracy of the parameter estimates: saturation of labeled blood in transit and inadequate sampling of early difference signal in superior slices. Label saturation arises when slices are acquired inferior-to-superior such that slice selection in proximal slices spoils the label for a distal slice. Inadequate sampling arises when the time spent acquiring inferior slices is too long to allow early sampling of the difference signal in superior slices. A novel approach to multislice imaging is proposed to address these two issues. In round-robin arterial spin labeling, slices are acquired in a different order after every pair of control-label acquisitions. Round-robin arterial spin labeling enables the acquisitions of all slices across the same range of postlabel delays in a descending superior-to-inferior order. This eliminates the temporal sampling problem and greatly reduces label saturation. Arterial transit time estimates obtained for the whole brain with round-robin arterial spin labeling show better agreement with a single-slice acquisition than do conventional multislice acquisitions. PMID:22189961

Lee, Wayne; Janik, Rafal; Scouten, Amy; Stefanovic, Bojana; Sled, John G

2012-07-01

49

Restraint stress enhances arterial thrombosis in vivo--role of the sympathetic nervous system.  

PubMed

Stress is known to correlate with the incidence of acute myocardial infarction. However, the molecular mechanisms underlying this correlation are not known. This study was designed to assess the effect of experimental stress on arterial thrombus formation, the key event in acute myocardial infarction. Mice exposed to 20?h of restraint stress displayed an increased arterial prothrombotic potential as assessed by photochemical injury-induced time to thrombotic occlusion. This increase was prevented by chemical sympathectomy performed through 6-hydroxydopamine (6-OHDA). Blood-born tissue factor (TF) activity was enhanced by stress and this increase could be prevented by 6-OHDA treatment. Vessel wall TF, platelet count, platelet aggregation, coagulation times (PT, aPTT), fibrinolytic system (t-PA and PAI-1) and tail bleeding time remained unaltered. Telemetric analysis revealed only minor hemodynamic changes throughout the stress protocol. Plasma catecholamines remained unaffected after restraint stress. Tumor necrosis factor alpha (TNF-?) plasma levels were unchanged and inhibition of TNF-? had no effect on stress-enhanced thrombosis. These results indicate that restraint stress enhances arterial thrombosis via the sympathetic nervous system. Blood-borne TF contributes, at least in part, to the observed effect whereas vessel wall TF, platelets, circulating coagulation factors, fibrinolysis and inflammation do not appear to play a role. These findings shed new light on the understanding of stress-induced cardiovascular events. PMID:24215418

Stämpfli, Simon F; Camici, Giovanni G; Keller, Stephan; Rozenberg, Izabela; Arras, Margarete; Schuler, Beat; Gassmann, Max; Garcia, Irene; Lüscher, Thomas F; Tanner, Felix C

2014-01-01

50

Enhancer RNA Facilitates NELF Release from Immediate Early Genes.  

PubMed

Enhancer RNAs (eRNAs) are a class of long noncoding RNAs (lncRNA) expressed from active enhancers, whose function and action mechanism are yet to be firmly established. Here we show that eRNAs facilitate the transition of paused RNA polymerase II (RNAPII) into productive elongation by acting as a decoy for the negative elongation factor (NELF) complex upon induction of immediate early genes (IEGs) in neurons. eRNAs are synthesized prior to the culmination of target gene transcription and interact with the NELF complex. Knockdown of eRNAs expressed at neuronal enhancers impairs transient release of NELF from the specific target promoters during transcriptional activation, coinciding with a decrease in target mRNA induction. The enhancer-promoter interaction was unaffected by eRNA knockdown. Instead, chromatin looping might enable eRNAs to act locally at a specific promoter. Our findings highlight the spatiotemporally regulated action mechanism of eRNAs during early transcriptional elongation. PMID:25263592

Schaukowitch, Katie; Joo, Jae-Yeol; Liu, Xihui; Watts, Jonathan K; Martinez, Carlos; Kim, Tae-Kyung

2014-10-01

51

Risk factors and therapeutic results of early local recurrence after transcatheter arterial chemoembolization  

PubMed Central

AIM: To identify factors affecting early local recurrence after transcatheter arterial chemoembolization (TACE) and investigate treatments and outcomes for local recurrence. METHODS: Early local recurrence and no early local recurrence groups drawn from 134 patients who were initially diagnosed with hepatocellular carcinoma (HCC) and showed a complete response (CR) to TACE treatment between January 1, 2006, and January 31, 2012, were analyzed by univariate and multivariate analyses. Additionally, the subsequent treatment for patients with recurrence was analyzed, and in cases in which TACE had been performed, the cumulative recurrence rates were calculated using the Kaplan-Meier method and compared with those of the primary lesion. RESULTS: The 1-, 2-, and 3-year survival rates were 92.3%, 60.2%, and 39.8%, respectively, in the early local recurrence group, which were significantly lower than those in both the late local and no local recurrence groups (P < 0.001). On multivariate analyses, non-compact lipiodol uptake, large tumor size, and an alpha-fetoprotein > 20 ng/mL after achieving a CR were significant predictors. When TACE was performed for early and late locally recurrent lesions, a CR was observed in 15 patients (41.7%) and 11 patients (78.6%), and the cumulative recurrence rates at 6, 12, and 24 mo were 17.9%, 43.3%, and 71.2%, respectively, which did not differ significantly from those after the first CR of 20.5%, 44.0%, and 58.6%, respectively (P = 0.639). CONCLUSION: Closer monitoring and active treatments must be provided to patients with risk factors for early local recurrence of HCC. PMID:24944494

Rou, Woo Sun; Lee, Byung Seok; Moon, Hee Seok; Lee, Eaum Seok; Kim, Seok Hyun; Lee, Heon Young

2014-01-01

52

Stenosis enhances role of platelets in growth of regional thrombus and intimal wall thickening in rat carotid arteries.  

PubMed

The authors present the results of a study in which stenosis was induced, resulting in either thrombus or intimal wall thickening, in rat carotid arteries. At > or = 75% stenosis in mildly denuded arteries, an acute and occlusive thrombus formation was induced, but the thrombus was significantly reduced in thrombocytopenia. Thrombus formation near the site of stenosis decreased with decreasing degree of stenosis, whereas the percent formation in the distal region (percent total thrombus) increased. Numerous mural platelet microthrombi were noted at the distal region of the stenosed arteries. After chronic 50% stenosis of the carotid artery for 2 weeks, significant intimal thickening was observed, without any occlusive thrombus formation. The combination with mild denudation was critical in eliciting the effect of stenosis. The magnitude of intimal growth in the stenosed artery was marked by day 6 and plateaued thereafter, whereas it was slight in nonstenosed arteries. The 5-bromodeoxyuridine index of the cells of the medial layer at day 3 was significantly increased by the stenosis, and the effect was reversed in thrombocytopenia. Complete reendothelialization of the intimal surface was observed by 7 to 10 days after surgery in the stenosed arteries. These findings suggest that the introduction of stenosis in these arteries enhances the interaction of platelets with the damaged arterial walls under abnormal fluid shear and that this enhancement leads to acute and occlusive thrombus formation associated with more marked stenosis as well as to sustained increase of intimal wall thickness in less marked stenosis. PMID:7614718

Igawa, T; Nagamura, Y; Ozeki, Y; Itoh, H; Unemi, F

1995-08-01

53

Early recovery of left ventricle following coronary artery bypass grafting and mitral valve repair in a case of anomalous origin of left coronary artery from pulmonary artery  

Microsoft Academic Search

Anomalous origin of Left Coronary Artery from Pulmonary Artery (ALCAPA) is a rare congenital malformation, which can result\\u000a in myocardial infarction, congestive heart failure and sudden death if left untreated. Reports of myocardial revascularization\\u000a and Mitral Valve (MV) repair following ALCAPA repair in infants are uncommon. We report a critically ill infant with ALCAPA\\u000a needing myocardial revascularization and MV repair

Raj Gopal Menon; Salim Maskari; John Valliattu; Taha Al Delamie

2009-01-01

54

The Feasibility of Contrast-Enhanced Ultrasound During Uterine Artery Embolization: A Pilot Study  

Microsoft Academic Search

Purpose  To evaluate the feasibility of using contrast-enhanced ultrasound (CEUS) during uterine artery embolization (UAE) in order\\u000a to define the correct end-point of embolization with complete devascularization of all fibroids.\\u000a \\u000a \\u000a \\u000a Methods  In this prospective study of 10 consecutive women undergoing UAE, CEUS was performed in the angiographic suite during embolization.\\u000a When the angiographic end-point, defined as the “pruned-tree” appearance of the uterine

Eric J. Dorenberg; Jarl Å. Jakobsen; Knut Brabrand; Geir Hafsahl; Hans-Jørgen Smith

2007-01-01

55

Early Development of Arterial Spin Labeling to Measure Regional Brain Blood Flow by MRI  

PubMed Central

Two major avenues of work converged in the late 1980’s and early 1990’s to give rise to brain perfusion MRI. The development of anatomical brain MRI quickly had as a major goal the generation of angiograms using tricks to label flowing blood in macroscopic vessels. These ideas were aimed at getting information about microcirculatory flow as well. Over the same time course the development of in vivo magnetic resonance spectroscopy had as its primary goal the assessment of tissue function and in particular, tissue energetics. For this the measurement of the delivery of water to tissue was critical for assessing tissue oxygenation and viability. The measurement of the washin/washout of “freely” diffusible tracers by spectroscopic based techniques pointed the way for quantitative approaches to measure regional blood flow by MRI. These two avenues came together in the development of arterial spin labeling (ASL) MRI techniques to measure regional cerebral blood flow. The early use of ASL to measure brain activation to help verify BOLD fMRI led to a rapid development of ASL based perfusion MRI. Today development and applications of regional brain blood flow measurements with ASL continues to be a major area of activity. PMID:22245338

Koretsky, Alan P.

2014-01-01

56

Effect of defibrinogenation on the early patency rate of experimental small calibre arterial grafts.  

PubMed

The effect of defibrinogenation with Arvin was studied in a new animal model of early thrombosis of a 3 mm diameter polytetrafluoroethylene (PTFE) graft with a poor run-off. Fifteen control animals were compared with fourteen animals treated with subcutaneous Arvin 20 units kg-1 body weight day-1, starting 2 days before surgery and continuing for 2 days postoperatively. The peroperative fibrinogen level in the controls was 2.8 +/- 0.9 gl-1 compared with 0.4 +/- 0.3 gl-1 in the treated group. There was no significant difference in the peroperative or postoperative platelet count or haematocrit value between the two groups. Plasma viscosity and whole blood viscosity (at a low shear rate of 0.7s-1) were significantly less during and after surgery in the defibrinogenated group. The degree of defibrinogenation in these animals produced no problems with haemostasis during surgery or in the postoperative period. The cumulative patency rates of the controls at 24 h, 48 h, and 4 days were 43 per cent, 28 per cent and 28 per cent compared with 86 per cent (P less than 0.05), 73 per cent (P less than 0.05) and 73 per cent (P less than 0.05) respectively in the defibrinogenated group. In this model of a narrow PTFE graft with a poor run-off, defibrinogenation was a safe and effective method of improving early patency of small calibre arterial grafts. PMID:3607412

Mahir, M S; Hynd, J W; Flute, P T; Dormandy, J A

1987-06-01

57

A genomewide scan for early-onset coronary artery disease in 438 families: the GENECARD Study.  

PubMed

A family history of coronary artery disease (CAD), especially when the disease occurs at a young age, is a potent risk factor for CAD. DNA collection in families in which two or more siblings are affected at an early age allows identification of genetic factors for CAD by linkage analysis. We performed a genomewide scan in 1,168 individuals from 438 families, including 493 affected sibling pairs with documented onset of CAD before 51 years of age in men and before 56 years of age in women. We prospectively defined three phenotypic subsets of families: (1) acute coronary syndrome in two or more siblings; (2) absence of type 2 diabetes in all affected siblings; and (3) atherogenic dyslipidemia in any one sibling. Genotypes were analyzed for 395 microsatellite markers. Regions were defined as providing evidence for linkage if they provided parametric two-point LOD scores >1.5, together with nonparametric multipoint LOD scores >1.0. Regions on chromosomes 3q13 (multipoint LOD = 3.3; empirical P value <.001) and 5q31 (multipoint LOD = 1.4; empirical P value <.081) met these criteria in the entire data set, and regions on chromosomes 1q25, 3q13, 7p14, and 19p13 met these criteria in one or more of the subsets. Two regions, 3q13 and 1q25, met the criteria for genomewide significance. We have identified a region on chromosome 3q13 that is linked to early-onset CAD, as well as additional regions of interest that will require further analysis. These data provide initial areas of the human genome where further investigation may reveal susceptibility genes for early-onset CAD. PMID:15272420

Hauser, Elizabeth R; Crossman, David C; Granger, Christopher B; Haines, Jonathan L; Jones, Christopher J H; Mooser, Vincent; McAdam, Brendan; Winkelmann, Bernhard R; Wiseman, Alan H; Muhlestein, J Brent; Bartel, Alan G; Dennis, Charles A; Dowdy, Elaine; Estabrooks, Susan; Eggleston, Karen; Francis, Sheila; Roche, Kath; Clevenger, Paula W; Huang, Liling; Pedersen, Bonnie; Shah, Svati; Schmidt, Silke; Haynes, Carol; West, Sandra; Asper, Donny; Booze, Michael; Sharma, Sanjay; Sundseth, Scott; Middleton, Lefkos; Roses, Allen D; Hauser, Michael A; Vance, Jeffery M; Pericak-Vance, Margaret A; Kraus, William E

2004-09-01

58

Do Carotid Artery Diameters Manifest Early Evidence of Atherosclerosis in Women with Rheumatoid Arthritis?  

PubMed Central

Abstract Objective Given the high incidence of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA), we examined the associations between RA diagnosis and characteristics and evidence of carotid atherosclerosis. We take a unique approach by evaluating lumen and interadventitial diameters in addition to intima-media thickness and plaque. Methods Ninety-three women with RA were matched with 93 healthy women by age, race, and menopause status. In cross-sectional analyses, we compared common carotid artery measures between groups and examined their relationships with measures of RA severity and activity. Results Mean age was 53.3 years, and median RA duration was 14 years. Lumen diameter in patients was significantly greater than in healthy women (5.50 vs. 5.19?mm, p?artery diameters compared with healthy women. This may reflect premature vascular aging and may be an early indicator of increased cardiovascular risk. PMID:19105681

Kao, Amy H.; Cunningham, Amy; Wildman, Rachel P.; Kuller, Lewis H.; Sutton-Tyrrell, Kim; Wasko, Mary Chester M.

2009-01-01

59

The association between early arterial oxygenation in the ICU and mortality following cardiac surgery.  

PubMed

Many studies have been conducted to investigate the relationship between hyperoxia and mortality in cohorts of intensive care unit (ICU) patients with varied and often contradictory results. The impact of early hyperoxia post ischaemia remains uncertain in various ICU cohorts. We aimed to investigate the association between arterial oxygenation (PaO2) in the first 24 hours in ICU and mortality in patients following cardiac surgery, using a retrospective cohort study of data from the Australian and New Zealand Intensive Care Society adult patient database. Participants were adults admitted to the ICU following cardiac surgery in Australia and New Zealand between 2003 and 2012. Patients were divided according to worst PaO2 level or alveolar-arterial O2 gradient in the 24 hours from admission. We defined 'hyperoxia' as PaO2 ?300 mmHg, 'hypoxia/poor O2 transfer' as either PaO2 <60 mmHg or ratio of PaO2 to fraction of inspired oxygen <300 and 'normoxia' as between hypoxia and hyperoxia. The primary outcome was mortality at hospital discharge. Secondary outcomes were ICU mortality and ICU and hospital length-of-stay. Of the 83,060 patients, 12,188 (14.7%) had hyperoxia, 54,420 (65.5%) had hypoxia/poor O2 transfer and 16,452 (19.8%) had normoxia. There was no association between hyperoxia and in-hospital or ICU mortality compared to normoxia. There was a small increased hospital and ICU length-of-stay for hyperoxic compared to normoxic patients. We concluded that there was no association between mortality and hyperoxia in the first 24 hours in ICU after cardiac surgery. PMID:25342405

Sutton, A D J; Bailey, M; Bellomo, R; Eastwood, G M; Pilcher, D V

2014-11-01

60

Overexpression of Decorin by Rat Arterial Smooth Muscle Cells Enhances Contraction of Type I Collagen In Vitro  

Microsoft Academic Search

Objective—Overexpression of decorin reduces neointimal thickening in balloon-injured carotid arteries of rats by decreasing the volume of neointimal extracellular matrix (ECM). We examined the hypothesis that decorin regulates ECM volume by stimulating cell-mediated contraction of collagen-rich ECMs. Methods and Results—Rat arterial smooth muscle cells (ASMCs) transduced with bovine decorin cDNA by retroviral transfection (LDSN) exhibited enhanced contraction of collagen gels

Hannu Jarvelainen; Robert B. Vernon; Michel D. Gooden; Aleksandar Francki; Stephanie Lara; Pamela Y. Johnson; Michael G. Kinsella; E. Helene Sage; Thomas N. Wight

2010-01-01

61

Delayed Contrast-Enhanced MRI of the Coronary Artery Wall in Takayasu Arteritis  

PubMed Central

Background Takayasu arteritis (TA) is a rare form of chronic inflammatory granulomatous arteritis of the aorta and its major branches. Late gadolinium enhancement (LGE) with magnetic resonance imaging (MRI) has demonstrated its value for the detection of vessel wall alterations in TA. The aim of this study was to assess LGE of the coronary artery wall in patients with TA compared to patients with stable CAD. Methods We enrolled 9 patients (8 female, average age 46±13 years) with proven TA. In the CAD group 9 patients participated (8 male, average age 65±10 years). Studies were performed on a commercial 3T whole-body MR imaging system (Achieva; Philips, Best, The Netherlands) using a 3D inversion prepared navigator gated spoiled gradient-echo sequence, which was repeated 34–45 minutes after low-dose gadolinium administration. Results No coronary vessel wall enhancement was observed prior to contrast in either group. Post contrast, coronary LGE on IR scans was detected in 28 of 50 segments (56%) seen on T2-Prep scans in TA and in 25 of 57 segments (44%) in CAD patients. LGE quantitative assessment of coronary artery vessel wall CNR post contrast revealed no significant differences between the two groups (CNR in TA: 6.0±2.4 and 7.3±2.5 in CAD; p?=?0.474). Conclusion Our findings suggest that LGE of the coronary artery wall seems to be common in patients with TA and similarly pronounced as in CAD patients. The observed coronary LGE seems to be rather unspecific, and differentiation between coronary vessel wall fibrosis and inflammation still remains unclear. PMID:23236382

Schneeweis, Christopher; Schnackenburg, Bernhard; Stuber, Matthias; Berger, Alexander; Schneider, Udo; Yu, Jing; Gebker, Rolf; Weiss, Robert G.; Fleck, Eckart; Kelle, Sebastian

2012-01-01

62

New phenotypic aspects of the decidual spiral artery wall during early post-implantation mouse pregnancy  

SciTech Connect

Highlights: Black-Right-Pointing-Pointer Spiral artery (SA) wall remodeling (SAR) is ill-defined and clinically important. Black-Right-Pointing-Pointer SA muscular phenotype prior to and during SAR in mice is underexplored. Black-Right-Pointing-Pointer SA muscular wall consists of contractile and non-contractile components. Black-Right-Pointing-Pointer SA wall non-contractile component may be synthetic smooth muscle. Black-Right-Pointing-Pointer Timing and extent of SA wall contractile component loss is revealed. -- Abstract: During pregnancy the walls of decidual spiral arteries (SAs) undergo clinically important structural modifications crucial for embryo survival/growth and maternal health. However, the mechanisms of SA remodeling (SAR) are poorly understood. Although an important prerequisite to this understanding is knowledge about the phenotype of SA muscular wall prior to and during the beginning of mouse SAR, this remains largely unexplored and was the main aim of this work. Using histological and immunohistochemical techniques, this study shows for the first time that during early mouse gestation, from embryonic day 7.5 (E7.5) to E10.5, the decidual SA muscular coat is not a homogeneous structure, but consists of two concentric layers. The first is a largely one cell-thick sub-endothelial layer of contractile mural cells (positive for {alpha}-smooth muscle actin, calponin and SM22{alpha}) with pericyte characteristics (NG2 positive). The second layer is thicker, and evidence is presented that it may be of the synthetic/proliferative smooth muscle phenotype, based on absence ({alpha}-smooth muscle actin and calponin) or weak (SM22{alpha}) expression of contractile mural cell markers, and presence of synthetic smooth muscle characteristics (expression of non-muscle Myosin heavy chain-IIA and of the cell proliferation marker PCNA). Importantly, immunohistochemistry and morphometrics showed that the contractile mural cell layer although prominent at E7.5-E8.5, becomes drastically reduced by E10.5 and is undetectable by E12.5. In conclusion, this study reveals novel aspects of the decidual SA muscular coat phenotype prior to and during early SAR that may have important implications for understanding the mechanisms of SAR.

Elia, Artemis; Charalambous, Fotini [Department of Biological Sciences, University of Cyprus, University Campus, P.O. Box 20537, 1678 Nicosia (Cyprus)] [Department of Biological Sciences, University of Cyprus, University Campus, P.O. Box 20537, 1678 Nicosia (Cyprus); Georgiades, Pantelis, E-mail: pgeor@ucy.ac.cy [Department of Biological Sciences, University of Cyprus, University Campus, P.O. Box 20537, 1678 Nicosia (Cyprus)] [Department of Biological Sciences, University of Cyprus, University Campus, P.O. Box 20537, 1678 Nicosia (Cyprus)

2011-12-09

63

Systematic Comparison of the Early Outcome of Angioplasty and Endarterectomy for Symptomatic Carotid Artery Disease  

Microsoft Academic Search

Background and Purpose—Endoluminal treatment is being increasingly used for carotid artery disease. The aim of this study was to compare the stroke and death risk within 30 days of endovascular treatment or endarterectomy for symptomatic carotid artery disease. Methods—A systematic comparison of the 30-day outcome of angioplasty with or without stenting and endarterectomy for symptomatic carotid artery disease reported in

Jonathan Golledge; Adam Mitchell; Roger M. Greenhalgh; Alun H. Davies

64

Comparison of early and 1-year follow-up results of conventional hemorrhoidectomy and hemorrhoid artery ligation: a randomized study  

Microsoft Academic Search

Background and aimsDoppler-guided hemorrhoid artery ligation is a new approach for treating hemorrhoids. Early and 1-year follow-up results of the procedure are presented and compared with those of closed scissors hemorrhoidectomy in a prospective randomized study.Patients and methodsSixty consecutively recruited patients were randomized into two groups: group A ( n=30) was treated with standardized closed scissors hemorrhoidectomy and group B

Attila Bursics; Krisztina Morvay; Péter Kupcsulik; Lajos Flautner

2004-01-01

65

Vasculoprotective properties of enhanced external counterpulsation for coronary artery disease: beyond the hemodynamics.  

PubMed

A growing pool of evidence has shown that enhanced external counterpulsation (EECP) is a non-invasive, safe, low-cost, and highly beneficial therapy for patients with coronary artery disease. However, the exact mechanisms of benefit exerted by EECP therapy remain only partially understood. The favorable hemodynamic effects of EECP were previously considered as the primary mechanism of action. Nevertheless, recent advances have shed light on the shear stress-increasing effects of EECP which are vasculoprotective and anti-atherosclerotic. EECP-induced endothelial shear stress increase may lead to improvement in endothelial function and morphology, attenuation of oxidative stress and inflammation, and promotion of angiogenesis and vasculogenesis. This review summarizes evidence of the potential mechanisms contributing to the immediate and long-term benefits of EECP, from the perspective of its shear stress-increasing effects. PMID:22560950

Yang, Da-ya; Wu, Gui-fu

2013-06-01

66

119 Enhancer of Zeste Homolog 2: A Pivotal Role in Pulmonary Artery Smooth Muscle Cell Proliferation  

PubMed Central

Background Pulmonary arterial hypertension (PAH) is a progressive and a devastating disease characterized by excessive proliferation of pulmonary artery smooth muscle cells (PASMCs). The pathogenesis of PAH is not fully understood and treatment options are limited. Studies suggest that PAH and cancers share apoptosis resistant state featuring excessive cell proliferation. Proliferation of cancer cells is mediated by increased expression of Enhancer of Zeste Homolog 2 (EZH2), a mammalian histone methyltransferase that contributes to the epigenetic silencing of target genes. However, the role of EZH2 in PAH has not been studied. In this study, we hypothesized that EZH2 could play a role in PASMCs proliferation. Methods In the present study the effects of EZH2 overexpression on human PASMCs proliferation were tested. PASMCs were transfected with wild type EZH2 cDNA or GFP using the Lonza 4D nucleofector system. After transfection, cells were incubated for 48 hours at 37°C. PASMCs proliferation and cell cycle analysis were performed by flow cytometry; PASMCs apoptosis was determined using annexin V staining, and cell migration was tested by the wound healing assay. Expression levels of EZH2 were confirmed by real time PCR. Results The overexpression of EZH2 in PASMCs enhances proliferation, migration, and decreases the rate of apoptosis when compared to GFP transfected cells. There was a 3.5-fold increase in proliferation and a 1.5-fold increase in the percentage of cells in the G2/M phase in the EZH2 transfected cells while there was a significant decrease in the rate of apoptosis in the PASMCs. Conclusions These findings suggest that EZH2 plays a role in the migration and proliferation of PASMCs .It also suggest that EZH2 could play a role in PAH development and serve as a potential target for new therapies for PAH.

Aljubran, Salman; Cox, Ruan; Parthasarathy, Prasanna Tamarapu; Lockey, Richard F.; Kolliputi, Narasaiah

2012-01-01

67

Coronary artery calcium quantification from contrast enhanced CT using gemstone spectral imaging and material decomposition.  

PubMed

To explore the feasibility of coronary artery calcium (CAC) measurement from low-dose contrast enhanced coronary CT angiography (CCTA) as this may obviate the need for an unenhanced CT scan. 52 patients underwent unenhanced cardiac CT and prospectively ECG triggered contrast enhanced CCTA (Discovery HD 750, GE Healthcare, Milwaukee, WI, USA). The latter was acquired in single-source dual-energy mode [gemstone spectral imaging (GSI)]. Virtual unenhanced images were generated from GSI CCTA by monochromatic image reconstruction of 70 keV allowing selective iodine material suppression. CAC scores from virtual unenhanced CT were compared to standard unenhanced CT including a linear regression model. After iodine subtraction from the contrast enhanced CCTA the attenuation in the ascending aorta decreased significantly from 359 ± 61 to 54 ± 8 HU (P < 0.001), the latter comparing well to the value of 64 ± 55 HU found in the standard unenhanced CT (P = ns) confirming successful iodine subtraction. After introducing linear regression formula the mean values for Agatston, Volume and Mass scores of virtual unenhanced CT were 187 ± 321, 72 ± 114 mm(3), and 27 ± 46 mg/cm(3), comparing well to the values from standard unenhanced CT (187 ± 309, 72 ± 110 mm(3), and 27 ± 45 mg/cm(3)) yielding an excellent correlation (r = 0.96, r = 0.96, r = 0.92; P < 0.001). Mean estimated radiation dose revealed 0.83 ± 0.02 mSv from the unenhanced CT and 1.70 ± 0.53 mSv from the contrast enhanced CCTA. Single-source dual-energy scanning with GSI allows CAC quantification from low dose contrast enhanced CCTA by virtual iodine contrast subtraction. PMID:24993390

Fuchs, Tobias A; Stehli, Julia; Dougoud, Svetlana; Sah, Bert-Ram; Bull, Sacha; Clerc, Olivier F; Possner, Mathias; Buechel, Ronny R; Gaemperli, Oliver; Kaufmann, Philipp A

2014-10-01

68

Effects of enhanced external counterpulsation on arterial stiffness and myocardial oxygen demand in patients with chronic angina pectoris.  

PubMed

Enhanced external counterpulsation (EECP) is a noninvasive technique for treatment of symptomatic coronary artery disease in patients not amenable to revascularization procedures. However, the mechanisms underlying the benefits of EECP remain unknown. We hypothesized that decreases in arterial stiffness and aortic wave reflection are a therapeutic target for EECP. Patients with coronary artery disease and chronic angina pectoris were randomized (2:1 ratio) to 35 1-hour sessions of EECP (n = 28) or sham EECP (n = 14). Central and peripheral arterial pulse-wave velocity and aortic wave reflection (augmentation index) were measured using applanation tonometry before, and after 17 and 35 1-hour treatment sessions. Wasted left ventricular pressure energy and aortic systolic tension-time index, markers of left-ventricular myocardial oxygen demand, were derived from the synthesized aortic pressure wave. Exercise duration, anginal threshold, and peak oxygen consumption were measured using a graded treadmill test. Central arterial stiffness and augmentation index were decreased after 17 and 35 sessions in the treatment group. Measurements of peripheral arterial stiffness were decreased after 35 sessions in the treatment group. Changes in aortic pressure wave reflection resulted in decreased measurements of myocardial oxygen demand and wasted left ventricular energy. No changes in central or peripheral arterial stiffness were observed in the sham group. Furthermore, measurements of exercise capacity were improved in the EECP group but unchanged in the sham group. In conclusion, EECP therapy decreases central and peripheral arterial stiffness, which may explain improvements in myocardial oxygen demand in patients with chronic angina pectoris after treatment. PMID:21420062

Casey, Darren P; Beck, Darren T; Nichols, Wilmer W; Conti, C Richard; Choi, Calvin Y; Khuddus, Matheen A; Braith, Randy W

2011-05-15

69

Influence of diabetes mellitus on early and late outcome after coronary artery bypass grafting  

Microsoft Academic Search

Background. Diabetes mellitus is an established independent risk factor for significant morbidity and mortality after coronary artery bypass grafting.Methods. The impact of diabetes on short- and long-term follow-up after coronary artery bypass grafting was studied by comparing the outcomes between 9,920 patients without diabetes mellitus and 2,278 patients with diabetes from 1978 to 1993.Results. Compared with nondiabetic patients, the group

Vinod H Thourani; William S Weintraub; Bernardo Stein; Suzanne S. P Gebhart; Joseph M Craver; Ellis L Jones; Robert A Guyton

1999-01-01

70

Early experience with cryopreserved arterial allografts in below-knee revascularization for limb salvage  

Microsoft Academic Search

Background: Below-knee revascularization for limb salvage in the absence of a suitable autogenous saphenous vein is a frequent challenge associated with a high amputation rate. The aim of this prospective study was to evaluate the usefulness of cryopreserved arterial allografts in such cases.Methods: Arterial allografts were harvested from multiple organ donors and cryopreserved at ?80°C. From March 1993 to December

Yves Castier; Guy Lesèche; Tonino Palombi; Marie-Dominique Petit; Olivier Cerceau

1999-01-01

71

The efficacy and safety of enhanced external counterpulsation in patients with peripheral arterial disease.  

PubMed

Peripheral arterial disease (PAD) is common in patients with severe coronary artery disease (CAD) and is considered a relative contraindication to external enhanced counterpulsation (EECP), but there are no data that define the efficacy and safety of EECP in patients with PAD. The International EECP Patient Registry (IEPR) was used to compare initial post-therapy and 2-year follow-up clinical outcomes and adverse event rates in patients with and without PAD. From January 2002 to October 2004, 2126 patients were enrolled in the IEPR, of whom 493 (23%) had a history of PAD. Immediately following EECP, the reduction in angina (> or = 1 Canadian Cardiovascular Society class) was similar in patients with and without PAD (76.6% vs 79.0%, p = 0.27) as was improvement in the Duke Activity Score Index (DASI) score (+4.7% vs +6.1%, p < 0.001). Both angina reduction and DASI score improvement were sustained at 2 years. PAD patients discontinued EECP more frequently (12.0% vs 8.5%, p < 0.05), but lower extremity ulceration did not occur more frequently in patients with PAD (3.7% vs 2.7%, p = 0.26). Rates of death (17.1% vs 8.6%, p < 0.001) and myocardial infarction (9.5% vs 5.0%, p < 0.001) were, as expected, higher in patients with PAD compared to patients without PAD at 2 years. In conclusion, while PAD patients constitute a high-risk cohort with known higher adverse event rates, EECP led to similar short- and long-term improvements in angina and quality of life for individuals with PAD compared to those without PAD. PMID:19841026

Thakkar, Bhavik V; Hirsch, Alan T; Satran, Daniel; Bart, Bradley A; Barsness, Gregory; McCullough, Peter A; Kennard, Elizabeth D; Kelsey, Sheryl F; Henry, Timothy D

2010-02-01

72

Arterial Ageing  

PubMed Central

Arterial ageing is characterized by age associated degeneration and sclerosis of the media layer of the large arteries. However, besides ageing, clinical conditions, which enhance oxidative stress and inflammation act to accelerate the degree of arterial ageing. In this review, we summarized the pathophysiology and contributing factors that accelerate arterial ageing. Among them, we focused on hypertension, the renin-angiotensin-aldosterone system and vascular inflammation which are modifiable causes of the arterial ageing process. Also, novel treatment targets derived from the disease models such as the Hutchinson Gilford Progeria Syndrome were reviewed. PMID:23508642

Lee, Seung-Jun

2013-01-01

73

NEW RESEARCH Early Life Stress and Trauma and Enhanced  

E-print Network

response to negative emotional faces in children with and without a history of depression. Method and other stress-related disorders. However, this pattern varied based on emotion type and history of psychopathology. J. Am. Acad. Child Adolesc. Psychiatry, 2014;53(7):800�813. Key Words: early life stress, early

74

Cutting-Balloon Angioplasty in Transplant Renal Artery Stenosis as First-Line Treatment in the Early Postoperative Period  

SciTech Connect

Percutaneous transluminal angioplasty has been successfully used for the treatment of transplant renal artery stenosis (RAS). Cutting-balloon angioplasty (CBA) is being used as a second option in pressure-resistant stenosis. It is thought that CBA is less traumatic and therefore restenosis occurs less frequently than in conventional angioplasty. This case report describes the unusual use of a cutting balloon in transplant RAS as a first option in the early postoperative period. Long-term follow-up data are also presented.

Ucar, Adem, E-mail: ucaradem@yahoo.com [Istanbul University, Interventional Radiology Department, Istanbul Faculty of Medicine (Turkey); Yahyayev, Aghakishi, E-mail: aghakishi@yahoo.com [Istanbul University, Radiology Department, Istanbul Faculty of Medicine (Turkey); Bakkaloglu, Huseyin, E-mail: drhuseyin@yahoo.com [Istanbul University, Transplantlogy Department, General Surgery, Istanbul Faculty of Medicine (Turkey); Agayev, Ayaz, E-mail: ayazagayev@gmail.com [Istanbul University, Radiology Department, Istanbul Faculty of Medicine (Turkey); Aydin, Ali Emin, E-mail: alieminaydin@hotmail.com [Istanbul University, Transplantlogy Department, General Surgery, Istanbul Faculty of Medicine (Turkey); Rozanes, Izzet, E-mail: rozanes@superonline.com [Istanbul University, Interventional Radiology Department, Istanbul Faculty of Medicine (Turkey)

2011-02-15

75

Early Introduction of Everolimus Immunosuppressive Regimen in Liver Transplantation with Extra-Anatomic Aortoiliac-Hepatic Arterial Graft Anastomosis  

PubMed Central

Liver transplantation is the treatment of choice for patients with acute and chronic end-stage liver disease, when no other medical treatment is possible. Despite high rates of 1- to 5-year survival, long-term adverse effects of immunosuppressant agents remain of major concern. Current research and clinical efforts are made to develop immunosuppressant agents that minimize adverse effects along with a low rate of graft rejection. Tailoring immunosuppressive therapy to individual patients by the use of proliferation signal inhibitors seems to be the best way to minimize toxicity and increase efficacy. Recently everolimus has been introduced in clinical practice; among its adverse effects an increased incidence of arterial graft thrombosis in renal transplants, vascular anastomosis leakage, impaired wound healing, and thrombotic microangiopathy have been reported. We present the case of a 54-year-old patient submitted to liver transplantation for end-stage liver disease treated by an extra-anatomic aortoiliac-hepatic arterial graft anastomosis and early postoperative introduction of everolimus for acute renal failure. Postoperative period was characterized by two abdominal collections and reactivation of cytomegalovirus infection that were treated by percutaneous drainage and antiviral therapy, respectively; the patient is well after 8-month followup with patency of the arterial conduit and no leakage. PMID:25309771

Felli, Emanuele; Vennarecci, Giovanni; Colasanti, Marco; Santoro, Roberto; de Werra, Edoardo; Scotti, Andrea; Burocchi, Mirco; Levi Sandri, Giovanni B.; Campanelli, Alessandra; Lepiane, Pasquale; Ettorre, Giuseppe M.

2014-01-01

76

Screening, Early Detection, and Diagnosis of Pulmonary Arterial Hypertension* ACCP Evidence-Based Clinical Practice Guidelines  

Microsoft Academic Search

Pulmonary arterial hypertension (PAH) occurs as an idiopathic process or as a component of a variety of disease processes, including chronic thromboembolic disease, connective tissue diseases, congenital heart disease, and exposure to exogenous factors including appetite suppres- sants or infectious agents such as HIV. This article reviews evidence for screening in susceptible patient groups and the approach to diagnosing PAH

Michael McGoon; David Gutterman; Virginia Steen; Robin Barst; Douglas C. McCrory; Terry A. Fortin; James E. Loyd

77

Early extubation does not increase complication rates after coronary artery bypass graft surgery with cardiopulmonary bypass  

Microsoft Academic Search

Background: With the evolution of anesthesia and surgical procedures, fast track extubation has gained an increased interest, mainly based on the possibility of reducing health costs seemingly without compromising patient care. Aim: To compare two groups of patients submitted to a non-fast track extubation and a fast track extubation protocol after coronary artery bypass graft surgery with cardiopulmonary bypass, regarding

J. Reis; J. C. MotaSUPbSU; P. Ponce; A. Costa-Pereira; M. Guerreiro

2002-01-01

78

Enhanced external counterpulsation (EECP) does not alter arterial stiffness in patients with angina  

Microsoft Academic Search

EECP is an effective, non-invasive treatment for angina pectoris. Leg pressure cuffs are inflated in diastole which acutely, augments diastolic pressure and reduces afterload. However, the mechanism of the sustained clinical benefit seen is not known. We hypothesized that EECP may lead to an improvement in arterial stiffness. We measured arterial stiffness parameters in 22 men and 1 woman with

Frances Dockery; Christopher J. Bulpitt; Jens P. Bagger; Chakravarthi Rajkumar

2003-01-01

79

Prognostic value of electroencephalography and evoked potentials in the early course of malignant middle cerebral artery infarction.  

PubMed

Space-occupying brain edema may lead to a malignant course in patients with large middle cerebral artery infarction. Decompressive hemicraniectomy has to be initiated early to prevent further tissue damage. In this retrospective study, we analyzed electroencephalography (EEG) and evoked potentials (EPs), obtained within 24 h after onset of stroke, in 22 patients suffering from a large middle cerebral artery infarction. Our findings indicate a prognostic value of EEG and brainstem auditory EP (BAEP): the absence of delta activity and the presence of theta and fast beta frequencies within EEG-focus predicted a non-malignant course. In contrast, diffuse generalized slowing and slow delta activity in the ischemic hemisphere pointed to a malignant course. Likewise, pathological BAEP were correlated with a malignant course. The coexistence of background slowing and pathological BAEP showed the highest level of significance. In conclusion, our findings implicate an additional early application of electrophysiological methods in stroke patients. EEG and EP deliver useful information to select those patients who develop malignant edema. PMID:22538759

Burghaus, Lothar; Liu, Wei-Chi; Dohmen, Christian; Haupt, Walter F; Fink, Gereon R; Eggers, Carsten

2013-05-01

80

Acipimox-enhanced ¹?F-fluorodeoxyglucose positron emission tomography for characterizing and predicting early remodeling in the rat infarct model.  

PubMed

The rat myocardial infarction (MI) model is widely used to study left ventricular (LV) remodeling. In this study, acipimox-enhanced (18)F-Fluorodeoxyglucose (FDG) gated-positron emission tomography (PET) was assessed for characterizing and predicting early remodeling in the rat infarct model. Nineteen Wistar rats had surgical occlusion of the left anterior descending coronary artery and 7 were sham-operated. PET was scheduled 48 h and 2 weeks later for quantifying MI area and LV function. Segments with <50% of FDG uptake had histological evidence of MI (74 ± 9% decrease in parietal thickness, fibrosis development). At 48 h, MI area was large (>35% of LV) in 6 rats, moderate (15-35% of LV) in 8 rats, limited (<15% of LV) in 5 rats and absent in the 7 sham rats. LV remodeling, assessed through the 2 weeks increase in end-diastolic volume, increased between rats with limited, moderate and large MI (+72 ± 25, +109 ± 56, +190 ± 69 ?l, respectively, P = 0.007). This 3-groups classification allowed predicting 44% of the 2 weeks increase in end-diastolic volume, and additional 34% were predicted by heart rate at 48 h. The acipimox-enhanced FDG gated-PET technique provides efficient characterization and prediction of early remodeling in the rat infarct model. PMID:22116590

Bousquenaud, Mélanie; Maskali, Fatiha; Poussier, Sylvain; Marie, Pierre-Yves; Boutley, Henri; Karcher, Gilles; Wagner, Daniel R; Devaux, Yvan

2012-08-01

81

Enhancing international collaboration among early-career researchers  

PubMed Central

Objective The European Association of Communication in Healthcare (EACH) Early Career Researchers Network (ECRN) aims are to (1) promote international collaboration among young investigators and (2) provide a support network for future innovative communication research projects. In October 2009, Miami, USA at a workshop facilitated by the ECRN at the International Conference on Communication in Healthcare (ICCH) hosted by the American Academy of Communication in Healthcare we explored common facilitators and challenges faced by early career researchers in health communication research. Methods Attendees introduced themselves, their research area(s) of interest, and listed one facilitator and one barrier for their career development. EACH ECRN members then led a discussion of facilitators and challenges encountered in communication research projects and career development. We discussed potential collaboration opportunities, future goals, and activities. Results Having supportive collegial relationships, institutional support, job security, and funding are critical facilitators for early career investigators. Key challenges include difficulty with time management and prioritizing, limited resources, and contacts. Conclusion International collaboration among early career researchers is a feasible and effective means to address important challenges, by increasing opportunities for professional support and networking, problem-solving, discussion of data, and ultimately publishing. Practice Implications Future AACH-EACH Early Career Researcher Networks should continue to build collaborations by developing shared research projects, papers, and other scholarly products. PMID:20663630

Carroll, Jennifer K; Albada, Akke; Farahani, Mansoureh; Lithner, Maria; Neumann, Melanie; Sandhu, Harbinder; Shepherd, Heather L

2010-01-01

82

Effects of Enhanced External Counterpulsation on Arterial Stiffness and Myocardial Oxygen Demand in Patients with Chronic Angina Pectoris  

PubMed Central

Enhanced external counterpulsation (EECP) is a non-invasive modality for treatment of symptomatic coronary disease (CAD) in patients not amenable to revascularization procedures. However, the mechanism(s) underlying the benefits of EECP remain unknown. We hypothesized that reductions in arterial stiffness and aortic wave reflection are a therapeutic target for EECP. CAD patients with chronic angina pectoris were randomized (2:1 ratio) to either 35 1-hr sessions of EECP (n=28) or Sham-EECP (n=14). Central and peripheral arterial pulse wave velocity (PWV) and aortic wave reflection (augmentation index; AIx) were measured using applanation tonometry before, and after 17 and 35 1-hr treatment sessions. Wasted left ventricular pressure energy and aortic systolic tension time index, markers of left-ventricular myocardial oxygen demand were derived from the synthesized aortic pressure wave. Exercise duration, anginal threshold, and peak oxygen consumption were measured using a graded treadmill test. Central arterial stiffness and AIx were reduced following 17- and 35-sessions in the treatment group. Measures of peripheral arterial stiffness were reduced following 35 sessions in the treatment group. Changes in aortic pressure wave reflection resulted in decreased measures of myocardial oxygen demand and wasted left ventricular energy. No changes in either central or peripheral arterial stiffness were observed in the Sham group. Furthermore, measures of exercise capacity were improved in the EECP group, but unchanged in the Sham group. In conclusion, EECP therapy reduces central and peripheral arterial stiffness, which may explain improvements in myocardial oxygen demand in patients with chronic angina pectoris following treatment. PMID:21420062

Casey, Darren P.; Beck, Darren T.; Nichols, Wilmer W.; Conti, C. Richard; Choi, Calvin Y.; Khuddus, Matheen A.; Braith, Randy W.

2011-01-01

83

Early diagnosis and treatment of a posttraumatic pseudoaneurysm/dissection of the innominate artery.  

PubMed

A 25-year-old male developed a traumatic intimo-medial dissection and saccular pseudoaneurysm at the origin of the innominate artery following a motorcycle accident. On physical examination there was no perceivable trauma to the chest. In addition, there were no clinical symptoms that suggested this serious injury. The patient was managed with successful stent-graft placement on an elective basis. PMID:24495347

Azarcon, Fernando; Ghaleb, Melhelm

2014-04-01

84

LOW CONCENTRATIONS OF SPHINGOSYLPHOSPHORYLCHOLINE ENHANCE PULMONARY ARTERY VASOREACTIVITY: ROLE OF PKC? AND Ca2+ ENTRY  

PubMed Central

Sphingosylphosphorylcholine (SPC) is a powerful vasoconstrictor, but in vitro its EC50 is ?100-fold more than plasma concentrations. We examined whether sub-contractile concentrations of SPC (?1 ?mol/l) modulated vasoreactivity of rat intrapulmonary arteries (IPA), using myography and measurement of intracellular [Ca2+] ([Ca2+]i). SPC (1 ?mol/l) had no effect on force or [Ca2+]i on its own, but dramatically potentiated constrictions induced by ?25 mmol/l [K+], such that at 40 min force and [Ca2+]i (Fura PE3 340/380 ratio) were increased by 429 ± 96% and 134 ± 26% respectively. The potentiation was stereospecific, apparent at concentrations >100 nmol/l SPC, and independent of the endothelium, 2-APB-sensitive Ca2+ entry, and Rho kinase. It was abolished by the PLC inhibitor U73122, the broad spectrum PKC inhibitor Ro 31-8220 and the PKC? inhibitor rottlerin, but not by Gö6976, which is ineffective against PKC?. The potentiation could be attributed to enhancement of Ca2+ entry. SPC also potentiated the responses to PGF2? and U436619, which activate a 2-APB sensitive non-selective cation channel (NSCC) in IPA. In this case potentiation was partially inhibited by diltiazem, but abolished by 2-APB, Ro31-8220 and rottlerin. 1 ?mol/l SPC caused translocation of PKC? to the perinuclear region and cytoskeleton of cultured IPA smooth muscle cells. We present the novel finding that low, sub-contractile concentrations of SPC potentiate Ca2+ entry in IPA through both voltage-dependent and independent pathways, via a receptor-dependent mechanism involving PKC?. This has implications for the physiological role of SPC, especially in cardiovascular disease where SPC is reported to be elevated. PMID:18158336

Snetkov, Vladimir A.; Thomas, Gavin D.; Teague, Bonnie; Leach, Richard M.; Shaifta, Yasin; Knock, Greg A.; Aaronson, Philip I.; Ward, Jeremy P.T.

2007-01-01

85

Dynamic contrast-enhanced magnetic resonance imaging in patients with pulmonary arterial hypertension  

PubMed Central

Abstract Dynamic contrast–enhanced (DCE) time-resolved magnetic resonance (MR) imaging is a technique whereby the passage of an intravenous contrast bolus can be tracked through the pulmonary vascular system. The aim of this study was to investigate the prognostic significance of DCE-MR pulmonary blood transit times in patients with pulmonary arterial hypertension (PAH). Seventy-nine patients diagnosed with PAH underwent pulmonary DCE imaging at 1.5 T using a time-resolved three-dimensional spoiled gradient echo sequence. The prognostic significance of two DCE parameters, full width at half maximum (FWHM) of the first-pass clearance curve and pulmonary transit time (PTT), along with demographic and invasive catheter measurements, was evaluated by univariate and bivariate Cox proportional hazards regression and Kaplan-Meier analysis. DCE-MR transit times were most closely correlated with cardiac index (CI) and pulmonary vascular resistance index (PVRI) and were both found to be accurate for detecting reduced CI (FWHM area under the curve [AUC] at receiver operating characteristic analysis = 0.91 and PTT AUC = 0.92, respectively) and for detecting elevated PVRI (FWHM AUC = 0.88 and PTT AUC = 0.84, respectively). During the follow-up period, 25 patients died. Patients with longer measurements of FWHM (P = 0.0014) and PTT (P = 0.004) were associated with poor outcome at Kaplan-Meier analysis, and both parameters were strong predictors of adverse outcome from Cox proportional hazards analysis (P = 0.013 and 0.010, respectively). At bivariate analysis, DCE measurements predicted mortality independent of age, gender, and World Health Organization functional class; however, invasive hemodynamic indexes CI, PVRI, and DCE measurements were not independent of one another. In conclusion, DCE-MR transit times predict mortality in patients with PAH and are closely associated with clinical gold standards CI and PVRI. PMID:25006422

Condliffe, Robin; Marshall, Helen; Elliot, Charlie; Kiely, David G.; Wild, Jim M.

2014-01-01

86

Coronary artery angiography and myocardial viability imaging: a 3.0-T contrast-enhanced magnetic resonance coronary artery angiography with Gd-BOPTA.  

PubMed

With improving MR sequence, phase-array coil and image quality, cardiac magnetic resonance imaging is becoming a promising method for a comprehensive non-invasive evaluation of coronary artery and myocardial viability. The study aimed to evaluate contrast-enhanced whole-heart coronary MR angiography (CE WH-CMRA) at 3.0-Tesla for the diagnosis of significant stenosis (?50%) and detection of myocardial infarction (MI) in patients with suspected coronary artery disease (CAD). CE WH-CMRA was performed in consecutive 70 patients with suspected CAD by using a 3.0-T MR system. A respiratory-gated, electrocardiography-triggered, inversion-recovery, segmented fast low angle shot sequence (TI = 200 ms) was used. Data acquisition began 60 s after the slow injection of Gd-BOPTA (0.2 mmol/kg body weight, at an injection rate 0.3 ml/s). At last, breath-hold 2D-PSIR-SSFP sequence was performed. Diagnostic accuracy of CE WH-CMRA in detecting significant stenosis (?50%) was evaluated using invasive coronary angiography as the referenced standard. The MI region appearing as high signal intensity visualized on CEWH-CMRA and 2D-PSIR-SSFP images were compared and analyzed. CE WH-CMRA correctly identified 42 of 44 patients with significant CAD. The overall sensitivity, specificity, negative predictive value, positive predictive value and accuracy for diagnosing significant CAD was 83.6, 95.8, 96.0, 82.8 and 93.4% respectively. The MI region detected by WH-CMRA and 2D-PSIR-SSFP were consistent in 10 patients and these segments manifested with transmural or subendocardial enhancement patterns. Only one MI patient was judged inconsistent between WH-CMRA and 2D-PSIR-SSFP, who was confirmed by clinical and electrocardiogram results. The enhancement pattern in this patient was spotted and focal in 2D-PSIR-SSFP, but was dismissed by WH-CMRA. It is feasible to obtain information about coronary artery stenosis and myocardial viability in a single CE WH-CMRA with administration of Gd-BOPTA. PMID:24068575

Yun, Hong; Jin, Hang; Yang, Shan; Huang, Dong; Chen, Zhang-wei; Zeng, Meng-su

2014-01-01

87

Non-Contrast-Enhanced MR Angiography at 3 Tesla in Patients with Advanced Peripheral Arterial Occlusive Disease  

PubMed Central

Purpose The aim of this study was to assess the diagnostic performance of ECG-gated non-contrast-enhanced quiescent interval single-shot (QISS) magnetic resonance angiography at a magnetic field strength of 3 Tesla in patients with advanced peripheral arterial occlusive disease (PAOD). Method and Materials A total of 21 consecutive patients with advanced PAOD (Fontaine stage IIb and higher) referred for peripheral magnetic resonance angiography (MRA) were included. Imaging was performed on a 3 T whole body MR. Image quality and stenosis diameter were evaluated in comparison to contrast-enhanced continuous table and TWIST MRA (CE-MRA) as standard of reference. QISS images were acquired with a thickness of 1.5 mm each (high-resolution QISS, HR-QISS). Two blinded readers rated the image quality and the degree of stenosis for both HR-QISS and CE-MRA in 26 predefined arterial vessel segments on 5-point Likert scales. Results With CE-MRA as the reference standard, HR-QISS showed high sensitivity (94.1%), specificity (97.8%), positive (95.1%), and negative predictive value (97.2%) for the detection of significant (?50%) stenosis. Interreader agreement for stenosis assessment of both HR-QISS and CE-MRA was excellent (?-values of 0.951 and 0.962, respectively). As compared to CR-MRA, image quality of HR-QISS was significantly lower for the distal aorta, the femoral and iliac arteries (each with p<0.01), while no significant difference was found in the popliteal (p?=?0.09) and lower leg arteries (p?=?0.78). Conclusion Non-enhanced ECG-gated HR-QISS performs very well in subjects with severe PAOD and is a good alternative for patients with a high risk of nephrogenic systemic fibrosis. PMID:24608937

Nikolaou, Konstantin; Sommer, Wieland H.; Schmitt, Peter; Kazmierczak, Philipp M.; Reiser, Maximilian F.; Theisen, Daniel

2014-01-01

88

Early and Midterm Outcome of Redo Coronary Artery Bypass Grafting: On-Pump versus Off-Pump Bypass  

PubMed Central

Background Redo coronary artery bypass grafting (CABG) is still associated with increased morbidity and mortality as compared to the first-time operation. Further, the application of the off-pump technique to redo CABG is limited due to technical difficulties. The aim of this retrospective study was to analyze early and midterm results after redo CABG and compare the outcome of redo on-pump and off-pump CABG. Methods From June 1996 to October 2011, elective redo CABG was performed in 32 patients. Mean age was 64.8 years (on pump 64.3 years vs. off pump 65.5 years; p=0.658), and 21 patients were male. Among these patients, 14 (43.8%) underwent on-pump CABG, and 18 (56.2%) underwent off-pump CABG. Results Internal thoracic artery was used in 22 patients (68.8%), and total arterial revascularization was achieved in 17 patients (53.1%). The average number of distal anastomoses was 2.13, and the rate of incomplete revascularization was 43.8%. The rate of total arterial revascularization was higher in the off-pump group (14.3% vs. 83.3%, p<0.001), and the use of saphenous vein graft was more in the on-pump group (78.6% vs. 16.7%, p<0.001). Overall hospital mortality was 3.1% (n=1) and was comparable in both groups (on pump 7.1% vs. off pump 0%; p=0.249). Postoperative complications occurred in 9 patients (64.2%), and the rate of complications was high in the on-pump group without statistical significance (64.2% vs. 33.3%, p=0.082). The mean follow-up duration was 5.4 years, and overall survival at 10 years was 86.0%±10.5%. There was no significant difference in the 10-year survival rate between the two groups (79.6% vs. 100%, p=0.225). Conclusion Redo CABG can be safely performed with acceptable mortality. Redo off-pump coronary artery bypass is feasible with low mortality and morbidity, comparable target vessel bypass grafting, and long-term survival. The off-pump technique might be considered a safe option for redo CABG in high-risk patients.

Shin, Yu Rim; Lee, Sak; Joo, Hyun Chel; Youn, Young-Nam; Kim, Jong Gun; Yoo, Kyung-Jong

2014-01-01

89

Increased angiotensin II contraction of the uterine artery at early gestation in a transgenic model of hypertensive pregnancy is reduced by inhibition of endocannabinoid hydrolysis.  

PubMed

Increased vascular sensitivity to angiotensin II (Ang II) is a marker of a hypertensive human pregnancy. Recent evidence of interactions between the renin-angiotensin system and the endocannabinoid system suggests that anandamide and 2-arachidonoylglycerol may modulate Ang II contraction. We hypothesized that these interactions may contribute to the enhanced vascular responses in hypertensive pregnancy. We studied Ang II contraction in isolated uterine artery (UA) at early gestation in a rat model that mimics many features of preeclampsia, the transgenic human angiotensinogen×human renin (TgA), and control Sprague-Dawley rats. We determined the role of the cannabinoid receptor 1 by blockade with SR171416A, and the contribution of anandamide and 2-arachidonoylglycerol degradation to Ang II contraction by inhibiting their hydrolyzing enzyme fatty acid amide hydrolase (with URB597) or monoacylglycerol lipase (with JZL184), respectively. TgA UA showed increased maximal contraction and sensitivity to Ang II that was inhibited by indomethacin. Fatty acid amide hydrolase blockade decreased Ang IIMAX in Sprague-Dawley UA, and decreased both Ang IIMAX and sensitivity in TgA UA. Monoacylglycerol lipase blockade had no effect on Sprague-Dawley UA and decreased Ang IIMAX and sensitivity in TgA UA. Blockade of the cannabinoid receptor 1 in TgA UA had no effect. Immunolocalization of fatty acid amide hydrolase and monoacylglycerol lipase showed a similar pattern between groups; fatty acid amide hydrolase predominantly localized in endothelium and monoacylglycerol lipase in smooth muscle cells. We demonstrated an increased Ang II contraction in TgA UA before initiation of the hypertensive phenotype. Anandamide and 2-arachidonoylglycerol reduced Ang II contraction in a cannabinoid receptor 1-independent manner. These renin-angiotensin system-endocannabinoid system interactions may contribute to the enhanced vascular reactivity in early stages of hypertensive pregnancy. PMID:24935942

Pulgar, Victor M; Yamaleyeva, Liliya M; Varagic, Jasmina; McGee, Carolynne M; Bader, Michael; Dechend, Ralf; Howlett, Allyn C; Brosnihan, K Bridget

2014-09-01

90

Enhanced External Counterpulsation Improves Peripheral Artery Flow Mediated Dilation in Patients With Chronic Angina: A Randomized Sham-Controlled Study  

PubMed Central

Background Mechanisms responsible for anti-ischemic benefits of enhanced external counterpulsation (EECP) remain unknown. This was the first randomized, sham controlled study to investigate the extra-cardiac effects of EECP on peripheral artery flow mediated dilation. Methods and Results Forty-two symptomatic patients with coronary artery disease (CAD) were randomized (2:1 ratio) to either 35 1-hr sessions of EECP (n=28) or Sham-EECP (n=14). Flow-mediated dilation of the brachial and femoral arteries was performed using ultrasound. Plasma levels of nitrate and nitrite (NOx), 6-keto prostaglandin F1? (PGF1?), endothelin-1 (ET-1), asymmetric dimethylarginine (ADMA), tumor necrosis factor–? (TNF-?), monocyte chemoattractant protein–1 (MCP-1), vascular cell adhesion molecule (sVCAM), C-reactive protein (hsCRP), and 8-Isoprostane (8-iso-PGF2?) were measured. EECP increased brachial (+51% vs. +2%) and femoral (+30% vs. +3%) artery flow mediated dilation, the nitric oxide turnover/production marker NOx (+36% vs. +2%) and PGF1? (+71% vs. +1%), while decreasing ET-1 (-25% vs. +5%) and the nitric oxide synthase inhibitor ADMA (-28% vs. +0.2%) in treatment vs. sham, respectively (all p<0.05). EECP decreased the pro-inflammatory cytokines TNF-? (-16% vs. +12%), MCP-1 (-13% vs. +0.2%), sVCAM-1 (-6% vs. +1%), hsCRP (-32% vs. +5%), and the lipid peroxidation marker 8-iso-PGF2? (-21% vs. +1.3%) in treatment vs. sham, respectively (all p<0.05). EECP reduced angina classification (-62% vs 0%; p<0.001) in treatment vs. sham, respectively. Conclusions Our findings provide novel mechanistic evidence that EECP has a beneficial effect on peripheral artery flow mediated dilation and endothelial-derived vasoactive agents in patients with symptomatic CAD. PMID:20921442

Braith, Randy W.; Conti, C. Richard; Nichols, Wilmer W.; Choi, Calvin Y.; Khuddus, Matheen A.; Beck, Darren T.; Casey, Darren P.

2010-01-01

91

Early biochemical disorders in the hindlimb muscles following femoral artery stenosis in dogs: protein and electrolyte metabolism.  

PubMed

Investigations regarding the metabolism of proteins and electrolytes in the hindlimb skeletal muscles were carried out in dogs with a moderate unilateral stenosis of femoral artery (reduction of almost 65% of its lumen) early after surgery. The results of these investigations were compared with those obtained by investigating the correspondent skeletal muscles of the opposite hindlimb. This comparison has revealed the following findings: (1) ischemia in a moderate form early elicites a remarkable K+ accumulation (not a K+ loss!) in the skeletal muscle without any change in the concentrations of other cations; (2) in this instance, an activation of muscle proteases and peptidases occurs meading to an important production of histamine, which is detectable in appreciable amounts in the ischemic muscle and, especially, in its effluent blood. On the basis of the findings reported in this study, as well as on the basis of our previous findings on the same experimental model, an approach to correlate and explain the early muscular metabolic disturbances induced by a moderate ischemia is discussed. In addition, it is to be pointed out that the presence of histamine in increased amounts in the effluent blood of a skeletal muscle mass could be a reliable laboratory parameter revealing an incipient muscle ischemia. PMID:899100

Pausescu, E; Proinov, F; Chirvasie, R; Fagarasanu, D; Duducgian, M L

1977-08-01

92

Endermatic, epidermatic, enepidermatic-the early history of penetration enhancers.  

PubMed

Already at the end of the 18th century, attempts were made to administer drugs transdermally. Several techniques were applied, including rubbing drug substances into the intact or wounded skin. Penetration enhancers were investigated as well, including human and animal body fluids, in particular gastric juice and saliva. In the 19th century, lipophilic solubilizers like chloroform and ether were tried. Although the experiments were mostly done against a pre-rational background some may be worth to be judged under scientific premises. PMID:21704689

Helmstädter, Axel

2011-09-15

93

Biomarkers for early detection of risk in female patients with coronary artery disease: pilot study.  

PubMed

In women with coronary artery disease (CAD), clinical presentation is different enough from men which leads to missed or delayed diagnosis. Biomarkers can be used for assessment of CAD patients. In case control study, we analyzed blood samples of 30 controls, 30 cases of Unstable Angina (UA) and 30 cases of Myocardial Infarction (MI) for Pro-inflammatory markers (hs-CRP, IL-6, ICAM-1) and Pregnancy Associated Plasma Protein-A (PAPP-A). Based on discriminant analysis, hs-CRP is the potential marker to discriminate cases of UA from controls while PAPP-A is the reliable marker which can discriminate the cases of MI from UA and controls. PMID:24482944

Mahto, Sunita; Sharma, S B; Dwivedi, S; Puri, D; Tripathi, R L

2013-05-01

94

Racial differences in early-onset renal disease among young adults: the coronary artery risk development in young adults (CARDIA) study  

Microsoft Academic Search

Although 11 million people in the United States have chronic renal insufficiency, little is known about ethnic\\/racial disparities for early-onset renal impairment. This study sought to determine whether there is an independent association between race\\/ethnicity and early-onset renal impairment and to identify other risk factors that might account for observed disparities. All Coronary Artery Risk Development in Young Adults subjects

Catherine O. Stehman-Breen; Daniel Gillen; Michael Steffes; David R. Jacobs; Cora E. Lewis; Catarina I. Kiefe; David Siscovick

2003-01-01

95

Enhancing Fathers' Educational Experiences During the Early Postnatal Period  

PubMed Central

Since the 1970s, men have been encouraged to actively participate in the childbirth process, resulting in a shared experience for couples. Nevertheless, after the baby is born, many fathers find themselves displaced, unsure of how to embrace the transition to parenthood. The shift in cultural practice and evolving needs of families calls for the recognition of fathers as well as mothers in the provision of midwifery services. Innovative strategies must be considered to enhance postnatal education that is father-inclusive and responsive to the needs of families in the 21st century. This article introduces one strategy created from an action research study conducted to develop, implement, and evaluate strategies to improve postnatal education for parents. PMID:19436437

McKellar, Lois; Pincombe, Jan; Henderson, Ann

2008-01-01

96

Power spectrum analysis of heart rate and blood flow velocity variability measured in the umbilical and uterine arteries in early pregnancy: a comparative study  

Microsoft Academic Search

Objective To compare power spectral derived variability parameters from the fetal side of the placental circulation with those from the maternal side of the placental circulation, during early pregnancy. Methods Doppler velocity waveforms were obtained from both the umbilical and the uterine arteries in a study group of 40 pregnant women between 10 and 14 (n = 25) and 15

P. C. Struijk; N. T. C. Ursem; J. Mathews; E. B. Clark; B. B. Keller; J. W. Wladimiroff

2001-01-01

97

Evaluation of cerebrovascular reserve using xenon-enhanced CT scanning in patients with symptomatic middle cerebral artery stenosis.  

PubMed

Cerebrovascular reserve (CVR) is an important prognostic factor in patients with major cerebral arterial steno-occlusive disease. However, few studies have examined CVR in symptomatic intracranial stenosis without ipsilateral extracranial internal carotid artery stenosis. This study sought to evaluate CVR in patients with symptomatic middle cerebral artery (MCA) stenosis using xenon-enhanced computed tomography (Xe/CT) with acetazolamide (ACZ) challenge. Twelve patients with symptomatic MCA stenosis were recruited. All patients were examined by Xe/CT to quantitatively measure resting cerebral blood flow (CBF) and received ACZ challenge to evaluate CVR. For resting CBF, no significant differences were found between the sides in four regions of interest. After the ACZ challenge test, the CVR was significantly different between hemispheres (ipsilateral versus contralateral CVR: 12.9 ± 24.3% versus 28.0 ± 16.8%, respectively; p=0.005) and in the MCA territory (ipsilateral versus contralateral CVR: 8.7 ± 24.7% versus 29.3 ± 24%, respectively; p=0.003). However, no significant differences in CVR were detected between cortical comparisons and white matter comparisons from the two sides. Thus, ACZ-challenge Xe/CT is useful for the measurement of CBF and CVR in these patients. Impaired CVR is an important characteristic of patients with symptomatic MCA stenosis. PMID:24238634

Cao, Wenjie; Cheng, Xin; Li, Haoxiong; Wang, Liang; Zhang, Xiaolong; Dong, Qiang

2014-02-01

98

Hydrophilic Polymers Enhance Early Functional Outcomes after Nerve Autografting  

PubMed Central

Background Approximately 12% of operations for traumatic neuropathy are for patients with segmental nerve loss and less than 50% of these injuries obtain meaningful functional recovery. Polyethylene glycol (PEG) therapy has been shown to improve functional outcomes after nerve severance and we hypothesized this therapy could also benefit nerve autografting. Methods A segmental rat sciatic nerve injury model was used, whereby a 0.5 cm defect was repaired with an autograft using microsurgery. Experimental animals were treated with solutions containing methylene blue (MB) and PEG; control animals did not receive PEG. Compound Actions Potentials (CAPs) were recorded before nerve transection, after solution therapy, and at 72 hours postoperatively. The animals underwent behavioral testing at 24 and 72 hours postoperatively. After sacrifice, nerves were fixed, sectioned, and immunostained to allow for quantitative morphometric analysis. Results The introduction of hydrophilic polymers greatly improved morphological and functional recovery of rat sciatic axons at 1–3 days following nerve autografting. PEG therapy restored CAPs in all animals and CAPs were still present 72 hours postoperatively. No CAPS were detectable in control animals. Footfall asymmetry scores and sciatic functional index scores were significantly improved for PEG therapy group at all time points (p <0.05 and p<0.001; p <0.001 and p <0.01). Sensory and motor axon counts were increased distally in nerves treated with PEG compared to control (p = 0.0189 and p = 0.0032). Conclusions PEG therapy improves early physiologic function, behavioral outcomes, and distal axonal density after nerve autografting. PMID:22521220

Sexton, Kevin W.; Pollins, Alonda C.; Cardwell, Nancy L.; Del Corral, Gabriel A.; Bittner, George D.; Shack, R. Bruce; Nanney, Lillian B.; Thayer, Wesley P.

2014-01-01

99

Intense adrenal enhancement in patients with acute pancreatitis and early organ failure.  

PubMed

Intense adrenal enhancement has previously been reported in patients with hypovolemic and septic shock. The purpose of this study was to assess whether this computed tomography (CT) finding is also observed in patients presenting with severe acute pancreatitis and early organ failure. A retrospective analysis of a prospectively collected database was performed. Out of 38 consecutive patients with predicted severe acute pancreatitis, 3 patients showed intense bilateral adrenal enhancement on early CT. All patients had early multiple organ failure and subsequently died. In two cases, pathologic correlation was obtained. Intense adrenal enhancement may be a new prognostic indicator in patients with acute pancreatitis, particularly when organ failure is present at the time of CT examination. Further studies are necessary to confirm this observation. PMID:17594117

Bollen, T L; van Santvoort, H C; Besselink, M G H; van Ramshorst, B; van Es, H W; Gooszen, H G

2007-10-01

100

Homologous region 1 of Plutella xylostella granulovirus functions as an enhancer for early gene expression.  

PubMed

Homologous regions (hrs) contained in genomes of baculoviruses have been shown to function as origins of viral DNA replication in alphabaculoviruses and betabaculoviruses, and as enhancers for early gene expression in alphabaculoviruses. The hr sequences of betabaculoviruses differ substantially from the ones of alphabaculoviruses. The enhancing property of betabaculovirus hrs has not been reported. In this study, transient assays were performed to investigate the effects of Plutella xylostella granulovirus (PlxyGV) hr1 on early gene expression of the virus. It was shown that hr1 stimulated reporter gene expression from the promoters of four early genes--ie1, dnapol, lef1, and lef9--independent of additional viral gene expression. The PlxyGV ie1 was shown to repress reporter gene expression from all four early gene promoters in a Trichoplusia ni cell line, both in the presence and absence of hr. PMID:24658824

Hu, Yuan; Zhang, Hong-Jie; Li, Lu-Lin

2014-09-01

101

Early computed tomography features in extensive middle cerebral artery territory infarct: prediction of survival  

PubMed Central

Background: To assess the predictive value of prognosis of different computed tomography (CT) features and National Institutes of Health Stroke Scale score (NIHSS) in acute extensive middle cerebral artery (MCA) infarct. Methods: Fifty five patients with acute extensive MCA infarct had the CT performed within 24 hours of the onset of symptoms. A total of 11 CT features were analysed. The age distribution, presence of risk factors, presence of individual CT feature, the total CT score, and the NIHSS were correlated with the 30 day mortality. Results: Single explanatory variable analysis showed NIHSS, presence of midline shift, midline shift of more than 1 cm, extent of infarct, presence of hydrocephalus, effacement of subarachnoid space/cella media, attenuation of corticomedullary differentiation, and total CT score were associated with the 30 day mortality. Both extent of infarct >67% and attenuation of corticomedullary differentiation gave a sensitivity and specificity of 93% and 95%, respectively, for the prediction of survival. Logistic regression analysis showed that the extent of infarct and NIHSS were the only independent predictors. Conclusions: CT features and admission NIHSS are important parameters for prediction of survival in extensive MCA infarct. PMID:15716525

Lam, W; Leung, T; Chu, W; Yeung, D; Wong, L; Poon, W

2005-01-01

102

Early Postnatal EEG Features of Perinatal Arterial Ischaemic Stroke with Seizures  

PubMed Central

Background Stroke is the second most common cause of seizures in term neonates and is associated with abnormal long-term neurodevelopmental outcome in some cases. Objective To aid diagnosis earlier in the postnatal period, our aim was to describe the characteristic EEG patterns in term neonates with perinatal arterial ischaemic stroke (PAIS) seizures. Design Retrospective observational study. Patients Neonates >37 weeks born between 2003 and 2011 in two hospitals. Method Continuous multichannel video-EEG was used to analyze the background patterns and characteristics of seizures. Each EEG was assessed for continuity, symmetry, characteristic features and sleep cycling; morphology of electrographic seizures was also examined. Each seizure was categorized as electrographic-only or electroclinical; the percentage of seizure events for each seizure type was also summarized. Results Nine neonates with PAIS seizures and EEG monitoring were identified. While EEG continuity was present in all cases, the background pattern showed suppression over the infarcted side; this was quite marked (>50% amplitude reduction) when the lesion was large. Characteristic unilateral bursts of theta activity with sharp or spike waves intermixed were seen in all cases. Sleep cycling was generally present but was more disturbed over the infarcted side. Seizures demonstrated a characteristic pattern; focal sharp waves/spike-polyspikes were seen at frequency of 1–2 Hz and phase reversal over the central region was common. Electrographic-only seizure events were more frequent compared to electroclinical seizure events (78 vs 22%). Conclusions Focal electrographic and electroclinical seizures with ipsilateral suppression of the background activity and focal sharp waves are strong indicators of PAIS. Approximately 80% of seizure events were the result of clinically unsuspected seizures in neonates with PAIS. Prolonged and continuous multichannel video-EEG monitoring is advocated for adequate seizure surveillance. PMID:25051161

Low, Evonne; Mathieson, Sean R.; Stevenson, Nathan J.; Livingstone, Vicki; Ryan, C. Anthony; Bogue, Conor O.; Rennie, Janet M.; Boylan, Geraldine B.

2014-01-01

103

Peptide-coated liposomal fasudil enhances site specific vasodilation in pulmonary arterial hypertension.  

PubMed

This study sought to develop a liposomal delivery system of fasudil-an investigational drug for the treatment of pulmonary arterial hypertension (PAH)-that will preferentially accumulate in the PAH lungs. Liposomal fasudil was prepared by film-hydration method, and the drug was encapsulated by active loading. The liposome surface was coated with a targeting moiety, CARSKNKDC, a cyclic peptide; the liposomes were characterized for size, polydispersity index, zeta potential, and storage and nebulization stability. The in vitro drug release profiles and uptake by TGF-? activated pulmonary arterial smooth muscle cells (PASMC) and alveolar macrophages were evaluated. The pharmacokinetics were monitored in male Sprague-Dawley rats, and the pulmonary hemodynamics were studied in acute and chronic PAH rats. The size, polydispersity index (PDI), and zeta potential of the liposomes were 206-216 nm, 0.058-0.084, and -20-42.7 mV, respectively. The formulations showed minimal changes in structural integrity when nebulized with a commercial microsprayer. The optimized formulation was stable for >4 weeks when stored at 4 °C. Fasudil was released in a continuous fashion over 120 h with a cumulative release of 76%. Peptide-linked liposomes were taken up at a higher degree by TGF-? activated PASMCs; but alveolar macrophages could not engulf peptide-coated liposomes. The formulations did not injure the lungs; the half-life of liposomal fasudil was 34-fold higher than that of plain fasudil after intravenous administration. Peptide-linked liposomal fasudil, as opposed to plain liposomes, reduced the mean pulmonary arterial pressure by 35-40%, without influencing the mean systemic arterial pressure. This study establishes that CAR-conjugated inhalable liposomal fasudil offers favorable pharmacokinetics and produces pulmonary vasculature specific dilatation. PMID:25333706

Nahar, Kamrun; Absar, Shahriar; Gupta, Nilesh; Kotamraju, Venkata Ramana; McMurtry, Ivan F; Oka, Masahiko; Komatsu, Masanobu; Nozik-Grayck, Eva; Ahsan, Fakhrul

2014-12-01

104

Enhancing early child care quality and learning for toddlers at risk: the responsive early childhood program.  

PubMed

Despite reports of positive effects of high-quality child care, few experimental studies have examined the process of improving low-quality center-based care for toddler-age children. In this article, we report intervention effects on child care teachers' behaviors and children's social, emotional, behavioral, early literacy, language, and math outcomes as well as the teacher-child relationship. The intervention targeted the use of a set of responsive teacher practices, derived from attachment and sociocultural theories, and a comprehensive curriculum. Sixty-five childcare classrooms serving low-income 2- and 3-year-old children were randomized into 3 conditions: business-as-usual control, Responsive Early Childhood Curriculum (RECC), and RECC plus explicit social-emotional classroom activities (RECC+). Classroom observations showed greater gains for RECC and RECC+ teachers' responsive practices including helping children manage their behavior, establishing a predictable schedule, and use of cognitively stimulating activities (e.g., shared book reading) compared with controls; however, teacher behaviors did not differ for focal areas such as sensitivity and positive discipline supports. Child assessments demonstrated that children in the interventions outperformed controls in areas of social and emotional development, although children's performance in control and intervention groups was similar for cognitive skills (language, literacy, and math). Results support the positive impact of responsive teachers and environments providing appropriate support for toddlers' social and emotional development. Possible explanations for the absence of systematic differences in children's cognitive skills are considered, including implications for practice and future research targeting low-income toddlers. PMID:23772822

Landry, Susan H; Zucker, Tricia A; Taylor, Heather B; Swank, Paul R; Williams, Jeffrey M; Assel, Michael; Crawford, April; Huang, Weihua; Clancy-Menchetti, Jeanine; Lonigan, Christopher J; Phillips, Beth M; Eisenberg, Nancy; Spinrad, Tracy L; de Villiers, Jill; de Villiers, Peter; Barnes, Marcia; Starkey, Prentice; Klein, Alice

2014-02-01

105

Early biochemical disorders in hindlimb muscles following femoral artery stenosis in dogs: oxidative metabolism.  

PubMed

An approach to explain the early metabolic disturbances induced by a moderate ischaemia on the basis of comparative biochemical investigations concerning the oxidative metabolism in the skeletal muscles, is the object of the present paper. These investigations have revealed the following findings: (i) during a slight ischaemia the skeletal muscle maintains its ability to oxidize in vitro lactate and exhibits an increased activity in oxidizing pyruvate, succinate and L-glutamate, and (ii) the stores of adenosine and ATP are depleted and an important accumulation of inorganic phosphate, accompanied by a remarkable activation of phosphatases, occurs in the ischaemic muscle, while no significant changes in the ATPase and creatine phosphokinase activities and in the amount of AMP, ADP and creatine phosphate are detectable in this muscle. PMID:138590

P?u?escu, E; Proinov, F; Chirvasie, R; F?g?r??anu, D; D?buleanu, L; Duducgian, M L

1976-01-01

106

Enhancing Early Child-Parent Relationships: Implications of Adult Attachment Research.  

ERIC Educational Resources Information Center

After reviewing attachment research, this article argues enhancing early child-parent relationships involves two principle tasks: helping parents identify children's needs and parents' responses to these needs; and helping parents gain insight into how their "states of mind with respect to attachment" influence their parenting behaviors and their…

Berlin, Lisa J.; Cassidy, Jude

2001-01-01

107

Music and Speech Listening Enhance the Recovery of Early Sensory Processing after Stroke  

E-print Network

improvement of verbal memory and focused attention induced by music listening. These findings demonstrateMusic and Speech Listening Enhance the Recovery of Early Sensory Processing after Stroke Teppo of these skills after neural damage. Here, we studied the long-term effects of daily music and speech listening

108

Early life antibiotic-driven changes in microbiota enhance susceptibility to allergic asthma  

E-print Network

Early life antibiotic-driven changes in microbiota enhance susceptibility to allergic asthma City, Quebec, Canada Allergic asthma rates have increased steadily in developed countries, arguing for an environmental aetiology. To assess the influence of gut microbiota on experimental murine allergic asthma, we

Strynadka, Natalie

109

Maternal History and Uterine Artery Doppler in the Assessment of Risk for Development of Early- and Late-Onset Preeclampsia and Intrauterine Growth Restriction  

PubMed Central

Objective. To examine the value of one-step uterine artery Doppler at 20 weeks of gestation in the prediction pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR). Methods. A prospective multicentre study that included all women with singleton pregnancies at 19–22 weeks of gestation (w). The mean pulsatility index (mPI) of both uterine arteries was calculated. Receiver-operating characteristics curves (ROC) were drawn to compare uterine artery Doppler and maternal risk factors for the prediction of early-onset PE and/or IUGR (before 32 w) and late-onset PE and/or IUGR. Results. 6,586 women were included in the study. Complete outcome data was recorded for 6,035 of these women (91.6%). PE developed in 75 (1.2%) and IUGR in 69 (1.1%) cases. Uterine Doppler mPI was 0.99 and the 90th centile was 1.40. For 10% false-positive rate, uterine Doppler mPI identified 70.6% of pregnancies that subsequently developed early-onset PE and 73.3% of pregnancies that developed early-onset IUGR. The test had a lower detection rate for the late-onset forms of the disease (23.5% for PE and 30% for IUGR). Maternal history has a low sensitivity in the detection of early-onset cases, although it is better at detecting late-onset PE. Conclusion. Uterine artery Doppler and maternal risk factors seem to select two different populations - early and late-onset PE which might suggest a different pathogenesis. PMID:19936122

Llurba, Elisa; Carreras, Elena; Gratacos, Eduard; Juan, Miquel; Astor, Judith; Vives, Angels; Hermosilla, Eduard; Calero, Ines; Millan, Pilar; Garcia-Valdecasas, Barbara; Cabero, Lluis

2009-01-01

110

Prediction and assessment of responses to renal artery revascularization with dynamic contrast-enhanced magnetic resonance imaging: a pilot study.  

PubMed

The aim of this study was to assess the potential of dynamic contrast-enhanced (DCE) MRI to predict and evaluate functional outcomes after renal artery revascularization for renal artery stenosis (RAS). The single-kidney glomerular filtration rate (SK-GFR) was measured in 15 patients with atherosclerotic RAS with DCE-MRI and radioisotopes at baseline and 4 mo after revascularization. DCE-MRI also produced measurements of blood flow, blood volume, extraction fraction, tubular transit time, and functional volume. Stented kidneys (n = 22) were divided into three response groups on the basis of the changes in radioisotope SK-GFR: improved (n = 5), stable (n = 13), and deteriorated (n = 4). A good agreement was found between SK-GFR values from DCE-MRI and radioisotopes (correlation coefficient: 0.91). Before intervention, kidneys that improved had lower extraction fraction, higher blood volume, longer tubular transit time, and lower SK-GFR. After intervention, improved kidneys had increased functional volume, and deteriorated kidneys had reduced functional volume and extraction fraction. Revascularization improved blood flow and blood volume in all groups. This pilot study led to the hypothesis that well-vascularized kidneys with reduced extraction fractions are most likely to benefit from revascularization. More generally, DCE-MRI has the potential to replace radioisotope measurement of SK-GFR and may improve patient management by providing additional information on tissue perfusion. PMID:23804449

Lim, Su Wei; Chrysochou, Constantina; Buckley, David L; Kalra, Philip A; Sourbron, Steven P

2013-09-01

111

Albumin therapy enhances collateral perfusion after laser-induced middle cerebral artery branch occlusion: a laser speckle contrast flow study.  

PubMed

Laser speckle contrast (LSC) was used to compare the extent of cortical ischemia in two inbred mouse strains that differed in their degree of collateral circulation, after laser occlusion of the distal middle cerebral artery, and after treatment with 25% albumin (ALB) or saline (control). Sequential LSC images acquired over ?90 minutes were coaligned, converted to relative flow, and normalized to baseline. After 3-day survival, infarction was quantified by triphenyl tetrazolium chloride or magnetic resonance imaging. In the sparsely collateralized BALB/c strain, mean flow fell to 13% to 14% and 33% to 34% of baseline in central (core) and peripheral (penumbral) regions of interest, and ALB treatment at 30 minutes enhanced perfusion in both regions by ?2-fold relative to saline, restoring flow to the benign-oligemic range centrally, and to the hyperemic range peripherally. The ALB-induced increment in parenchymal perfusion was disproportionate to the subtle flow increase in the occluded artery itself, suggesting that ALB improved collateral circulation. Cortical infarction in BALB/c mice was reduced 45% by ALB treatment. In contrast to BALB/c mice, the better-collateralized CD-1 strain developed milder ischemia, had smaller infarcts, and showed no differential benefit of ALB. We conclude that where native collateralization is insufficient (BALB/c strain), ALB treatment exerts a significant therapeutic effect after ischemia by augmenting collateral perfusion. PMID:22781334

Defazio, Richard A; Zhao, Weizhao; Deng, Xiaolu; Obenaus, Andre; Ginsberg, Myron D

2012-11-01

112

Treatment of acute cerebral artery occlusion using the penumbra system: our early experience.  

PubMed

Intravenous recombinant tissue-type plasminogen activator (rt-PA) therapy is highly recommended to patients who are diagnosed with ischemic stroke within 4.5 hours after the onset while mechanical clot retrieval can be attempted in patients who are not indicated for or cannot effectively receive intravenous rt-PA therapy. In this article, we report early treatment outcomes and discuss the usefulness of mechanical clot retrieval using the Penumbra system (Penumbra Inc., Alameda, California, USA), especially in terms of technical cautions during the procedure and adaptability to elderly and high National Institutes of Health Stroke Scale (NIHSS) patients. We included 7 patients with thromboembolic occlusion. Pretreatment NIHSS score ranged from 11 to 36 (mean: 24.9). All patients achieved good recanalization [thrombolysis in cerebral infarction (TICI) grade 2a or greater] without complications. The NIHSS score at 30 days after the treatment ranged between 0 and 28 (mean: 12.4), and improved more than 10 points in 4 of the 7 patients (57.1%). To obtain good recanalization without complications, selection of suitable reperfusion catheter and careful manipulation of separator prefiguring the occluded distal vessels are essential. The improved NIHSS score at 30 days after the treatment may have led to favorable results, such as an increased participation in available rehabilitation programs and the alleviation of the burden of care. Our findings suggest that the Penumbra system might be effective for treatment in elderly patients or patients with high NIHSS score wherein rt-PA therapy is inadvisable or ineffective in ischemic stroke secondary to large vessel occlusion. Recanalization can improve their quality of life on condition that the procedure is performed successfully without serious complications. PMID:24759097

Shindo, Atsushi; Kawanishi, Masahiko; Kawakita, Kenya; Okauchi, Masanobu; Kawai, Nobuyuki; Hayashi, Naoki; Osaka, Naohiro; Tamiya, Takashi

2014-06-17

113

Lp(a) lipoprotein, IgG, IgA and IgM antibodies to Chlamydia pneumoniae and HLA class II genotype in early coronary artery disease  

Microsoft Academic Search

The associations previously found between lipoprotein(a) (Lp(a)) levels and atherosclerotic disorders, diabetes, rheumatoid arthritis and renal diseases suggest that Lp(a) may be involved in autoimmune reactions. The relation found between Lp(a) levels and the HLA class II genotype in males with early coronary artery disease (CAD) further support that assumption. It was suggested that an autoimmune process, perhaps triggered by

Gösta H. Dahlén; Jens Boman; Lisbeth Slunga Birgander; Bertil Lindblom

1995-01-01

114

Optic nerve MRI enhancement in posterior ischaemic optic neuropathy due to internal carotid artery dissection  

Microsoft Academic Search

Posterior ischaemic neuropathy (PION) is characterized by infarction in the retrobulbar optic nerve. A 73-year-old man suddenly experienced blurred vision in his left eye and intermittent weakness in his right hand. He had visual defects of superior lateral quarter and inferior medial quarter areas in the left eye. Gadolinium-enhanced magnetic resonance imaging (MRI) revealed segmental enhancement in the left optic

Kiyokazu Kawabe; Teturo Nagaoka; Hiroaki Iguchi; Ken Ikeda; Yasuo Iwasaki

2010-01-01

115

Enhanced external counterpulsation improves exercise tolerance, reduces exercise-induced myocardial ischemia and improves left ventricular diastolic filling in patients with coronary artery disease  

Microsoft Academic Search

OBJECTIVESWe examined whether enhanced external counterpulsation (EECP) improves myocardial ischemia, exercise tolerance and cardiac function in patients with coronary artery disease (CAD).BACKGROUNDEnhanced external counterpulsation reduces angina and improves exercise tolerance in patients with CAD. Some objective improvements of ischemia by EECP have been reported, but they should be confirmed further. Detailed hemodynamic effects of EECP have been less well documented.METHODSEnhanced

Hisashi Urano; Hisao Ikeda; Takafumi Ueno; Takahiro Matsumoto; Toyoaki Murohara; Tsutomu Imaizumi

2001-01-01

116

Delirium in early-stage alzheimer's disease: enhancing cognitive reserve as a possible preventive measure.  

PubMed

Delirium is a disorder of acute onset with fluctuating symptoms and is character ized by inattention, disorganized thinking and altered levels of consciousness. The risk for delirium is greatest in individual with dementia, and the incidence of both is increasing worldwide because of the aging of our population. Although s clinical trials have tested interventions f delirium prevention in individuals without dementia, little is known about the m anisms for the prevention of delirium i early-stage Alzheimer's disease (AD). Th purpose of this article is to explore ways o preventing delirium and slowing the ra of cognitive decline in early-stage AD enhancing cognitive reserve. An agenda for future research on interventions to prevent delirium in individuals with early-stage AD is also presented. PMID:19326827

Fick, Donna M; Kolanowski, Ann; Beattie, Elizabeth; McCrow, Judith

2009-03-01

117

Music listening enhances cognitive recovery and mood after middle cerebral artery stroke  

Microsoft Academic Search

We know from animal studies that a stimulating and enriched environment can enhance recovery after stroke, but little is known about the effects of an enriched sound environment on recovery from neural damage in humans. In humans, music listening activates a wide-spread bilateral network of brain regions related to atten- tion, semantic processing, memory, motor functions, and emotional processing. Music

T. Sarkamo; M. Tervaniemi; S. Laitinen; A. Forsblom; S. Soinila; M. Mikkonen; T. Autti; H. M. Silvennoinen; J. Erkkila; M. Laine; I. Peretz; M. Hietanen

2008-01-01

118

Computational simulations of hemodynamic changes within thoracic, coronary, and cerebral arteries following early wall remodeling in response to distal aortic coarctation  

PubMed Central

Mounting evidence suggests that the pulsatile character of blood pressure and flow within large arteries plays a particularly important role as a mechano-biological stimulus for wall growth and remodeling. Nevertheless, understanding better the highly coupled interactions between evolving wall geometry, structure, and properties and the hemodynamics will require significantly more experimental data. Computational fluid–solid-growth models promise to aid in the design and interpretation of such experiments and to identify candidate mechanobiological mechanisms for the observed arterial adaptations. Motivated by recent aortic coarctation models in animals, we used a computational fluid–solid interaction model to study possible local and systemic effects on the hemodynamics within the thoracic aorta and coronary, carotid, and cerebral arteries due to a distal aortic coarctation and subsequent spatial variations in wall adaptation. In particular, we studied an initial stage of acute cardiac compensation (i.e., maintenance of cardiac output) followed by early arterial wall remodeling (i.e., spatially varying wall thickening and stiffening). Results suggested, for example, that while coarctation increased both the mean and pulse pressure in the proximal vessels, the locations nearest to the coarctation experienced the greatest changes in pulse pressure. In addition, after introducing a spatially varying wall adaptation, pressure, left ventricular work, and wave speed all increased. Finally, vessel wall strain similarly experienced spatial variations consistent with the degree of vascular wall adaptation. PMID:22415052

Coogan, Jessica S.; Humphrey, Jay D.; Figueroa, C. Alberto

2012-01-01

119

Geometry and dimensions of the pulmonary artery bifurcation in children and adolescents: assessment in vivo by contrast-enhanced MR-angiography  

Microsoft Academic Search

We sought to establish normal values for the diameters of the main (MPA), right (RPA), and left (LPA) pulmonary arteries and\\u000a for the angles describing the geometry of the pulmonary artery bifurcation in children by using contrast-enhanced magnetic\\u000a resonance angiography (CE-MRA). CE-MRA was performed in 69 children without cardiovascular disease. The median age was 10 ± 4.9 years\\u000a (range 2–20), weight 37.4 ± 18.5 kg (10–82),

Zita Knobel; Christian J. Kellenberger; Thomas Kaiser; Manuela Albisetti; Eva Bergsträsser; Emanuela R. Valsangiacomo Buechel

2011-01-01

120

Diffusion-weighted imaging in uterine artery embolisation: do findings correlate with contrast enhancement and volume reduction?  

PubMed Central

Objectives The objective of this study was to determine the role of diffusion-weighted imaging (DWI) in uterine artery embolisation (UAE), and to assess the apparent diffusion coefficient (ADC) of the dominant fibroid and its relationship to contrast enhancement and fibroid volume reduction. Methods We carried out a retrospective study of 15 patients who underwent UAE. Calculations were performed at baseline and 6 months post-embolisation. Fibroid ADC (expressed in 10?3 mm2 s?1) was calculated using b=0 and b=1000 DWI values. Fibroid enhancement was compared with background myometrium by measuring signal-difference-to-noise ratio (SDNR). Fibroid volume was calculated using a prolate ellipse formula. Results There was a significant reduction (p<0.001) in fibroid ADC at 6 months (0.48; standard deviation, SD=0.26) as compared with baseline (1.01; SD=0.39). No significant change (p=0.07) was identified in 6-month myometrial ADC (1.09; SD=0.28) as compared with baseline (1.24; SD=0.20). Moderately strong and significant positive correlation was identified between baseline ADC and 6-month percentage volume reduction of the fibroid (correlation=0.66, p=0.007). No correlation was identified between SDNR and ADC at baseline or 6 months (r=0.01, p=0.97 and r=?0.13, p=0.64, respectively) or SDNR and percentage volume reduction at 6 months (correlation r=0.18, p=0.51). Conclusion Baseline ADC of dominant fibroids shows a moderately strong correlation with subsequent volume reduction at 6 months following UAE. No correlation was identified between ADC values and contrast enhancement on the baseline or 6-month scans. Further prospective evaluation is needed before DWI can be utilised in clinical practice. Advances in knowledge DWI imaging may provide additional information about UAE and possibly help to predict uterine volume reduction. PMID:22898156

Ananthakrishnan, G; Macnaught, G; Hinksman, L; Gilmour, H; Forbes, K P; Moss, J G

2012-01-01

121

Cerebrospinal Fluid Enhancement on Fluid Attenuated Inversion Recovery Images After Carotid Artery Stenting with Neuroprotective Balloon Occlusions: Hemodynamic Instability and Blood-Brain Barrier Disruption  

SciTech Connect

Purpose: A rare complication of carotid artery stenting (CAS), prolonged reversible neurological symptoms with delayed cerebrospinal fluid (CSF) space enhancement on fluid attenuated inversion recovery (FLAIR) images, is associated with blood-brain barrier (BBB) disruption. We prospectively identified patients who showed CSF space enhancement on FLAIR images. Methods: Nineteen patients-5 acute-phase and 14 scheduled-underwent 21 CAS procedures. Balloon catheters were navigated across stenoses, angioplasty was performed using a neuroprotective balloon, and stents were placed with after dilation under distal balloon protection. CSF space hyperintensity or obscuration on FLAIR after versus before CAS indicated CSF space enhancement. Correlations with clinical factors were examined. Results: CSF space was enhanced on FLAIR in 12 (57.1%) cases. Postprocedural CSF space enhancement was significantly related to age, stenosis rate, acute-stage procedure, and total occlusion time. All acute-stage CAS patients showed delayed enhancement. Only age was associated with delayed CSF space enhancement in scheduled CAS patients. Conclusions: Ischemic intolerance for severe carotid artery stenosis and temporary neuroprotective balloon occlusion, causing reperfusion injury, seem to be the main factors that underlie BBB disruption with delayed CSF space enhancement shortly after CAS, rather than sudden poststenting hemodynamic change. Our results suggest that factors related to hemodynamic instability or ischemic intolerance seem to be associated with post-CAS BBB vulnerability. Patients at risk for hemodynamic instability or with ischemic intolerance, which decrease BBB integrity, require careful management to prevent intracranial hemorrhagic and other post-CAS complications.

Ogami, Ryo, E-mail: ogami.r@mazda.co.jp; Nakahara, Toshinori [Mazda Hospital, Department of Neurosurgery (Japan); Hamasaki, Osamu [Shimane Prefectural Central Hospital, Department of Neurosurgery (Japan); Araki, Hayato [Mazda Hospital, Department of Neurosurgery (Japan); Kurisu, Kaoru [Hiroshima University Graduate School of Biomedical Sciences, Department of Neurosurgery (Japan)

2011-10-15

122

Hybrid Coronary Revascularization Using Limited Incisional Full Sternotomy Coronary Artery Bypass Surgery in Multivessel Disease: Early Results  

PubMed Central

Background There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, 18.3±10.3 months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease. PMID:24782958

Kang, Joonkyu; Lee, Seok In; Moon, Mi Hyung; Kim, Hwan Wook; Jo, Gyun Hyun

2014-01-01

123

Pax7 is regulated by cMyb during early neural crest development through a novel enhancer  

PubMed Central

The neural crest (NC) is a migratory population of cells unique to vertebrates that generates many diverse derivatives. NC cells arise during gastrulation at the neural plate border (NPB), which is later elevated as the neural folds (NFs) form and fuse in the dorsal region of the closed neural tube, from where NC cells emigrate. In chick embryos, Pax7 is an early marker, and necessary component of NC development. Unlike other early NPB markers, which are co-expressed in lateral ectoderm, medial neural plate or posterior-lateral mesoderm, Pax7 early expression seems more restricted to the NPB. However, the molecular mechanisms controlling early Pax7 expression remain poorly understood. Here, we identify a novel enhancer of Pax7 in avian embryos that replicates the expression of Pax7 associated with early NC development. Expression from this enhancer is found in early NPB, NFs and early emigrating NC, but unlike Pax7, which is also expressed in mesodermal derivatives, this enhancer is not active in somites. Further analysis demonstrates that cMyb is able to interact with this enhancer and modulates reporter and endogenous early Pax7 expression; thus, cMyb is identified as a novel regulator of Pax7 in early NC development. PMID:23942518

Vadasz, Stephanie; Marquez, Jonathan; Tulloch, Maria; Shylo, Natalia A.; Garcia-Castro, Martin I.

2013-01-01

124

Pax7 is regulated by cMyb during early neural crest development through a novel enhancer.  

PubMed

The neural crest (NC) is a migratory population of cells unique to vertebrates that generates many diverse derivatives. NC cells arise during gastrulation at the neural plate border (NPB), which is later elevated as the neural folds (NFs) form and fuse in the dorsal region of the closed neural tube, from where NC cells emigrate. In chick embryos, Pax7 is an early marker, and necessary component of NC development. Unlike other early NPB markers, which are co-expressed in lateral ectoderm, medial neural plate or posterior-lateral mesoderm, Pax7 early expression seems more restricted to the NPB. However, the molecular mechanisms controlling early Pax7 expression remain poorly understood. Here, we identify a novel enhancer of Pax7 in avian embryos that replicates the expression of Pax7 associated with early NC development. Expression from this enhancer is found in early NPB, NFs and early emigrating NC, but unlike Pax7, which is also expressed in mesodermal derivatives, this enhancer is not active in somites. Further analysis demonstrates that cMyb is able to interact with this enhancer and modulates reporter and endogenous early Pax7 expression; thus, cMyb is identified as a novel regulator of Pax7 in early NC development. PMID:23942518

Vadasz, Stephanie; Marquez, Jonathan; Tulloch, Maria; Shylo, Natalia A; García-Castro, Martín I

2013-09-01

125

Routine Use of Three-Dimensional Contrast-Enhanced Moving-Table MR Angiography in Patients with Peripheral Arterial Occlusive Disease: Comparison with Selective Digital Subtraction Angiography  

SciTech Connect

Purpose. To compare the diagnostic accuracy of contrast-enhanced (CE) three-dimensional (3D) moving-table magnetic resonance (MR) angiography with that of selective digital subtraction angiography (DSA) for routine clinical investigation in patients with peripheral arterial occlusive disease. Methods. Thirty-eight patients underwent CE 3D moving-table MR angiography of the pelvic and peripheral arteries. A commercially available large-field-of-view adapter and a dedicated peripheral vascular phased-array coil were used. MR angiograms were evaluated for grade of arterial stenosis, diagnostic quality, and presence of artifacts. MR imaging results for each patient were compared with those of selective DSA. Results. Two hundred and twenty-six arterial segments in 38 patients were evaluated by both selective DSA and MR angiography. No complications related to MR angiography were observed. There was agreement in stenosis classification in 204 (90.3%) segments; MR angiography overgraded 16 (7%) segments and undergraded 6 (2.7%) segments. Compared with selective DSA, MR angiography provided high sensitivity and specificity and excellent interobserver agreement for detection of severe stenosis (97% and 95%, {kappa} = 0.9 {+-} 0.03) and moderate stenosis (96.5% and 94.3%, {kappa} = 0.9 {+-} 0.03). Conclusion. Compared with selective DSA, moving-table MR angiography proved to be an accurate, noninvasive method for evaluation of peripheral arterial occlusive disease and may thus serve as an alternative to DSA in clinical routine.

Deutschmann, Hannes A.; Schoellnast, Helmut; Portugaller, Horst R. [University Hospital Graz, Medical University Graz, Department of Radiology (Austria); Preidler, Klaus W. [Diagnostikum Graz Sued-West (Austria); Reittner, Pia [University Hospital Graz, Medical University Graz, Department of Radiology (Austria); Tillich, Manfred [Diagnostikum Graz Sued-West (Austria); Pilger, Ernst [University Hospital Graz, Medical University Graz, Department of Angiology (Austria); Szolar, Dieter H. M. [Diagnostikum Graz Sued-West (Austria)], E-mail: dieter.szolar@diagnostikum-graz.at

2006-10-15

126

Exercise Training Reverses Unparallel Downregulation of MaxiK Channel ?- and ?1-Subunit to Enhance Vascular Function in Aging Mesenteric Arteries.  

PubMed

This study was designed to determine the effects of aerobic exercise training on aging-associated selective changes of the function and expression of the large-conductance Ca(2+)-activated K(+) (MaxiK) channels in mesenteric arteries. Male Wistar rats aged 19-21 months were randomly assigned to sedentary (O-SED) and exercise-trained groups (O-EX). Two-month-old rats were used as Young control. Addition of iberiotoxin (10(-8) M) increased the norepinephrine-induced arterial contraction in all three groups, with the greatest enhancement being in Young and the least in O-SED. Patch clamp study revealed the characteristics of aging on MaxiK channel function in mesenteric arteries, mainly including (a) decrease of iberiotoxin-sensitive whole-cell K(+) current, (b) decrease of open probability and Ca(2+)/voltage sensitivity of single MaxiK channel, and (c) reduction of tamoxifen-induced MaxiK activation. After exercise training, all of these changes were markedly inhibited. Western blotting revealed that the protein expression of MaxiK was significantly reduced with aging and the suppression of ?1-subunit was larger than that of ?-subunit, although exercise training diminished this alteration. Taken together, aerobic exercise training reverses the aging-related unparallel downregulation of MaxiK ?- and ?1-subunit expression on mesenteric arteries, which partly underlies the beneficial effect of exercise on restoring aging-associated reduction in mesenteric artery vasodilatory properties. PMID:24347614

Shi, Lijun; Liu, Bailin; Zhang, Yanyan; Xue, Zhimin; Liu, Yujia; Chen, Yu

2014-12-01

127

Persistently high venous-to-arterial carbon dioxide differences during early resuscitation are associated with poor outcomes in septic shock  

PubMed Central

Introduction Venous-to-arterial carbon dioxide difference (Pv-aCO2) may reflect the adequacy of blood flow during shock states. We sought to test whether the development of Pv-aCO2 during the very early phases of resuscitation is related to multi-organ dysfunction and outcomes in a population of septic shock patients resuscitated targeting the usual oxygen-derived and hemodynamic parameters. Methods We conducted a prospective observational study in a 60-bed mixed ICU in a University affiliated Hospital. 85 patients with a new septic shock episode were included. A Pv-aCO2 value ? 6 mmHg was considered to be high. Patients were classified in four predefined groups according to the Pv-aCO2 evolution during the first 6 hours of resuscitation: (1) persistently high Pv-aCO2 (high at T0 and T6); (2) increasing Pv-aCO2 (normal at T0, high at T6); (3) decreasing Pv-aCO2 (high at T0, normal at T6); and (4) persistently normal Pv-aCO2 (normal at T0 and T6). Multiorgan dysfunction at day-3 was compared for predefined groups and a Kaplan Meier curve was constructed to show the survival probabilities at day-28 using a log-rank test to evaluate differences between groups. A Spearman-Rho was used to test the agreement between cardiac output and Pv-aCO2. Finally, we calculated the mortality risk ratios at day-28 among patients attaining normal oxygen parameters but with a concomitantly increased Pv-aCO2. Results Patients with persistently high and increasing Pv-aCO2 at T6 had significant higher SOFA scores at day-3 (p < 0.001) and higher mortality rates at day-28 (log rank test: 19.21, p < 0.001) compared with patients who evolved with normal Pv-aCO2 at T6. Interestingly, a poor agreement between cardiac output and Pv-aCO2 was observed (r2 = 0.025, p < 0.01) at different points of resuscitation. Patients who reached a central venous saturation (ScvO)2 ? 70% or mixed venous oxygen saturation (SvO2) ? 65% but with concomitantly high Pv-aCO2 at different developmental points (i.e., T0, T6 and T12) had a significant mortality risk ratio at day-28. Conclusion The persistence of high Pv-aCO2 during the early resuscitation of septic shock was associated with more severe multi-organ dysfunction and worse outcomes at day-28. Although mechanisms conducting to increase Pv-aCO2 during septic shock are insufficiently understood, Pv-aCO2 could identify a high risk of death in apparently resuscitated patients. PMID:24330804

2013-01-01

128

Detection of Coronary Artery Stenoses by Contrast-Enhanced, Retrospectively Electrocardiographically-Gated, Multislice Spiral Computed Tomography  

Microsoft Academic Search

Background—Multislice spiral computed tomography (MSCT) with retrospectively ECG-gated image reconstruction permits coronary artery visualization. We investigated the method's ability to identify high-grade coronary artery stenoses and occlusions. Methods and Results—A total of 64 consecutive patients were studied by MSCT (4 31 mm cross-sections, 500-ms rotation, table feed 1.5 mm\\/rotation, intravenous contrast agent, retrospectively ECG-gated image reconstruction). All coronary arteries and

Stephan Achenbach; Tom Giesler; Dieter Ropers; Stefan Ulzheimer; Hans Derlien; Christoph Schulte; Evelyn Wenkel; Werner Moshage; Werner Bautz; Werner G. Daniel; Willi A. Kalender; Ulrich Baum

129

Voltage-dependent anion channel-2 interaction with nitric oxide synthase enhances pulmonary artery endothelial cell nitric oxide production.  

PubMed

Increased pulmonary artery endothelial cell (PAEC) endothelium-dependent nitric oxide synthase (eNOS) activity mediates perinatal pulmonary vasodilation. Compromised eNOS activity is central to the pathogenesis of persistent pulmonary hypertension of the newborn (PPHN). Voltage-derived anion channel (VDAC)-1 was recently demonstrated to bind eNOS in the systemic circulation. We hypothesized that VDAC isoforms modulate eNOS activity in the pulmonary circulation, and that decreased VDAC expression contributes to PPHN. In PAECs derived from an ovine model of PPHN: (1) there is eNOS activity, but not expression; and (2) VDAC1 and -2 proteins are decreased. Immunocytochemistry, coimmunoprecipitation, and in situ proximity ligation assays in human PAECs (hPAECs) demonstrate binding between eNOS and both VDAC1 and -2, which increased upon stimulation with NO agonists. The ability of agonists to increase the eNOS/VDAC interaction was significantly blunted in hypertensive, compared with normotensive, ovine PAECs. Depletion of VDAC2, but not VDAC1, blocked the agonist-induced increase in eNOS activity in hPAECs. Overexpression of VDAC2 in hypertensive PAECs increased eNOS activity. Binding of VDAC2 enhances eNOS activity in the pulmonary circulation, and diminished VDAC2 constrains eNOS in PAECs derived from fetal lambs with chronic intrauterine pulmonary hypertension. We speculate that decreases in VDAC2 may contribute to the limited eNOS activity that characterizes pulmonary hypertension. PMID:22842492

Alvira, Cristina M; Umesh, Anita; Husted, Cristiana; Ying, Lihua; Hou, Yanli; Lyu, Shu-Chen; Nowak, Jeffrey; Cornfield, David N

2012-11-01

130

Voltage-Dependent Anion Channel-2 Interaction with Nitric Oxide Synthase Enhances Pulmonary Artery Endothelial Cell Nitric Oxide Production  

PubMed Central

Increased pulmonary artery endothelial cell (PAEC) endothelium-dependent nitric oxide synthase (eNOS) activity mediates perinatal pulmonary vasodilation. Compromised eNOS activity is central to the pathogenesis of persistent pulmonary hypertension of the newborn (PPHN). Voltage-derived anion channel (VDAC)-1 was recently demonstrated to bind eNOS in the systemic circulation. We hypothesized that VDAC isoforms modulate eNOS activity in the pulmonary circulation, and that decreased VDAC expression contributes to PPHN. In PAECs derived from an ovine model of PPHN: (1) there is eNOS activity, but not expression; and (2) VDAC1 and -2 proteins are decreased. Immunocytochemistry, coimmunoprecipitation, and in situ proximity ligation assays in human PAECs (hPAECs) demonstrate binding between eNOS and both VDAC1 and -2, which increased upon stimulation with NO agonists. The ability of agonists to increase the eNOS/VDAC interaction was significantly blunted in hypertensive, compared with normotensive, ovine PAECs. Depletion of VDAC2, but not VDAC1, blocked the agonist-induced increase in eNOS activity in hPAECs. Overexpression of VDAC2 in hypertensive PAECs increased eNOS activity. Binding of VDAC2 enhances eNOS activity in the pulmonary circulation, and diminished VDAC2 constrains eNOS in PAECs derived from fetal lambs with chronic intrauterine pulmonary hypertension. We speculate that decreases in VDAC2 may contribute to the limited eNOS activity that characterizes pulmonary hypertension. PMID:22842492

Alvira, Cristina M.; Umesh, Anita; Husted, Cristiana; Ying, Lihua; Hou, Yanli; Lyu, Shu-Chen; Nowak, Jeffrey

2012-01-01

131

The Value of Arterial Spin-Labeled Perfusion Imaging in Acute Ischemic Stroke - Comparison with Dynamic Susceptibility Contrast Enhanced MRI  

PubMed Central

Background and Purpose To evaluate the potential clinical value of arterial spin labeled (ASL) perfusion MRI in acute ischemic stroke (AIS) through comparison with dynamic susceptibility contrast (DSC) enhanced perfusion MRI. Methods Pseudo-continuous ASL with 3D background suppressed GRASE (Gradient and Spin Echo) readout was applied with DSC perfusion MRI on 26 AIS patients. ASL CBF and multi-parametric DSC perfusion maps were rated for image quality and lesion severity/conspicuity. Mean ASL CBF and DSC perfusion values were obtained in main vascular territories. Kendall’s coefficient of concordance was calculated to evaluate the reliability of ratings. Spearman correlation coefficients were calculated to compare ratings and quantitative perfusion values between ASL and DSC perfusion maps. Results ASL CBF and DSC perfusion maps provided largely consistent results in delineating hypoperfused brain regions in AIS. Hyperemic lesions, which also appeared frequently in the AIS cases studied, were more conspicuous on ASL CBF than on DSC CBF, Mean Transit Time (MTT) and Time to the maximum of the tissue residual function (Tmax) maps. Conclusions As a rapid, noninvasive and quantitative technique, ASL has clinical utility in detecting blood flow abnormalities in AIS patients. PMID:22328551

Wang, Danny JJ; Alger, Jeffry R; Qiao, Joe X; Hao, Qing; Hou, Samuel; Fiaz, Rana; Gunther, Matthias; Pope, Whitney B; Saver, Jeffrey L; Salamon, Noriko; Liebeskind, David S

2012-01-01

132

Haploinsufficiency of insulin gene enhancer protein 1 (ISL1) is associated with d-transposition of the great arteries  

PubMed Central

Congenital heart defects are the most common malformation, and are the foremost causes of mortality in the first year of life. Among congenital heart defects, conotruncal defects represent about 20% and are severe malformations with significant morbidity. Insulin gene enhancer protein 1 (ISL1) has been considered a candidate gene for conotruncal heart defects based on its embryonic expression pattern and heart defects induced in Isl1 knockout mice. Nevertheless no mutation of ISL1 has been reported from any human subject with a heart defect. From a population base of 974,579 births during 1999–2004, we used multiplex ligation-dependent probe amplification to screen for microdeletions/duplications of ISL1 among 389 infants with tetralogy of Fallot or d-transposition of the great arteries (d-TGA). We also sequenced all exons of ISL1. We identified a novel 20-kb microdeletion encompassing the entire coding region of ISL1, but not including either flanking gene, from an infant with d-TGA. We confirmed that the deletion was caused by nonhomologous end joining mechanism. Sequencing of exons of ISL1 did not reveal any subject with a novel nonsynonymous mutation. This is the first report of an ISL1 mutation of a child with a congenital heart defect. PMID:25077177

Osoegawa, Kazutoyo; Schultz, Kathleen; Yun, Kenneth; Mohammed, Nebil; Shaw, Gary M; Lammer, Edward J

2014-01-01

133

Emotional enhancement of perceptual priming is preserved in aging and early-stage Alzheimer's disease.  

PubMed

Perceptual priming for emotionally-negative and neutral scenes was tested in early-stage Alzheimer's disease (AD) patients and healthy younger, middle-aged and older adults. In the study phase, participants rated the scenes for their arousal properties. In the test phase, studied and novel scenes were initially presented subliminally, and the exposure duration was gradually increased until a valence categorization was made. The difference in exposure duration required to categorize novel versus studied items was the dependent measure of priming. Aversive content increased the magnitude of priming, an effect that was preserved in healthy aging and AD. Results from an immediate recognition memory test showed that the priming effects could not be attributable to enhanced explicit memory for the aversive scenes. These findings implicate a dissociation between the modulatory effect of emotion across implicit and explicit forms of memory in aging and early-stage AD. PMID:16154458

LaBar, Kevin S; Torpey, Dana C; Cook, Craig A; Johnson, Stephanie R; Warren, Lauren H; Burke, James R; Welsh-Bohmer, Kathleen A

2005-01-01

134

Cholinergic enhancement reduces spatial spread of visual responses in human early visual cortex  

PubMed Central

Summary Animal studies have shown that acetylcholine decreases excitatory receptive field size and spread of excitation in early visual cortex. These effects are thought to be due to facilitation of thalamocortical synaptic transmission and/or suppression of intracortical connections. We have used functional magnetic resonance imaging (fMRI) to measure the spatial spread of responses to visual stimulation in human early visual cortex. The cholinesterase inhibitor donepezil was administered to normal healthy human subjects to increase synaptic levels of acetylcholine in the brain. Cholinergic enhancement with donepezil decreased the spatial spread of excitatory fMRI responses in visual cortex, consistent with a role of acetylcholine in reducing excitatory receptive field size of cortical neurons. Donepezil also reduced response amplitude in visual cortex, but the cholinergic effects on spatial spread were not a direct result of reduced amplitude. These findings demonstrate that acetylcholine regulates spatial integration in human visual cortex. PMID:19081383

Silver, Michael A.; Shenhav, Amitai; D'Esposito, Mark

2009-01-01

135

Enhancement of dynein-mediated autophagosome trafficking and autophagy maturation by ROS in mouse coronary arterial myocytes.  

PubMed

Dynein-mediated autophagosome (AP) trafficking was recently demonstrated to contribute to the formation of autophagolysosomes (APLs) and autophagic flux process in coronary arterial myocytes (CAMs). However, it remains unknown how the function of dynein as a motor protein for AP trafficking is regulated under physiological and pathological conditions. The present study tested whether the dynein-mediated autophagy maturation is regulated by a redox signalling associated with lysosomal Ca(2+) release machinery. In primary cultures of CAMs, reactive oxygen species (ROS) including H2 O2 and O2 (-.) (generated by xanthine/xanthine oxidase) significantly increased dynein ATPase activity and AP movement, which were accompanied by increased lysosomal fusion with AP and APL formation. Inhibition of dynein activity by (erythro-9-(2-hydroxy-3-nonyl)adenine) (EHNA) or disruption of the dynein complex by dynamitin (DCTN2) overexpression blocked ROS-induced dynein activation, AP movement and APL formation, and resulted in an accumulation of AP along with a failed breakdown of AP. Antagonism of nicotinic acid adenine dinucleotide phosphate (NAADP)-mediated Ca(2+) signalling with NED-19 and PPADS abolished ROS-enhanced lysosomal Ca(2+) release and dynein activation in CAMs. In parallel, all these changes were also enhanced by overexpression of NADPH oxidase-1 (Nox1) gene in CAMs. Incubation with high glucose led to a marked O2 (-.) production compared with normoglycaemic CAMs, while Nox1 inhibitor ML117 abrogated this effect. Moreover, ML117 and NED-19 and PPADS significantly suppressed dynein activity and APL formation caused by high glucose. Taken together, these data suggest that ROS function as important players to regulate dynein-dependent AP trafficking leading to efficient autophagic maturation in CAMs. PMID:24912985

Xu, Ming; Li, Xiao-Xue; Chen, Yang; Pitzer, Ashley L; Zhang, Yang; Li, Pin-Lan

2014-11-01

136

Addendum to `numerical modeling of an enhanced very early time electromagnetic (VETEM) prototype system'  

USGS Publications Warehouse

Two numerical models to simulate an enhanced very early time electromagnetic (VETEM) prototype system that is used for buried-object detection and environmental problems are presented. In the first model, the transmitting and receiving loop antennas accurately analyzed using the method of moments (MoM), and then conjugate gradient (CG) methods with the fast Fourier transform (FFT) are utilized to investigate the scattering from buried conducting plates. In the second model, two magnetic dipoles are used to replace the transmitter and receiver. Both the theory and formulation are correct and the simulation results for the primary magnetic field and the reflected magnetic field are accurate.

Cui, T. J.; Chew, W. C.; Aydiner, A. A.; Wright, D. L.; Smith, D. V.; Abraham, J. D.

2000-01-01

137

Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results from a 2-Year Randomized Trial  

ERIC Educational Resources Information Center

Objective: To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and…

Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

2011-01-01

138

Enhanced musical rhythmic perception in Turkish early and late learners of German  

PubMed Central

As language rhythm relies partly on general acoustic properties, such as intensity and duration, mastering two languages with distinct rhythmic properties (i.e., stress position) may enhance musical rhythm perception. We investigated whether competence in a second language (L2) with different rhythmic properties than a L1 affects musical rhythm aptitude. Turkish early (TELG) and late learners (TLLG) of German were compared to German late L2 learners of English (GLE) regarding their musical rhythmic aptitude. While Turkish and German present distinct linguistic rhythm and metric properties, German and English are rather similar in this regard. To account for inter-individual differences, we measured participants' short-term and working memory (WM) capacity, melodic aptitude, and time they spent listening to music. Both groups of Turkish L2 learners of German perceived rhythmic variations significantly better than German L2 learners of English. No differences were found between early and late learners' performance. Our findings suggest that mastering two languages with different rhythmic properties enhances musical rhythm perception, providing further evidence of shared cognitive resources between language and music. PMID:24065946

Roncaglia-Denissen, M. Paula; Schmidt-Kassow, Maren; Heine, Angela; Vuust, Peter; Kotz, Sonja A.

2013-01-01

139

Early and transient sodium-hydrogen exchanger isoform 1 inhibition attenuates subsequent cardiac hypertrophy and heart failure following coronary artery ligation.  

PubMed

Na(+)/H(+) exchanger 1 (NHE-1) inhibition attenuates the hypertrophic response and heart failure in various experimental models. As the hypertrophic program is rapidly initiated following insult, we investigated whether early and transient administration of a NHE-1 inhibitor will exert salutary effects on cardiomyocyte hypertrophy or heart failure using both in vitro and in vivo approaches. Neonatal cardiomyocytes were treated with the novel, potent, and highly specific NHE-1 inhibitor BIX (N-[4-(1-acetyl-piperidin-4-yl)-3-trifluoromethyl-benzoyl]-guanidine; 100 nM) for 1 hour in the presence of 10 µM phenylephrine, after which the cells were maintained for a further 23 hours in the absence of NHE-1 inhibition. One-hour treatment with the NHE-1 inhibitor prevented phenylephrine-induced hypertrophy, which was associated with prevention of activation of calcineurin, a key component of the hypertrophic process. Experiments were then performed in rats subjected to coronary artery ligation, in which the NHE-1 inhibitor was administered immediately after infarction for a 1-week period followed by a further 5 weeks of sustained coronary artery occlusion in the absence of drug treatment. This approach significantly attenuated left ventricular hypertrophy and improved both left ventricular systolic and diastolic dysfunction, which was also associated with inhibition of calcineurin activation. Our findings indicate that early and transient administration of an NHE-1 inhibitor bestows subsequent inhibition of cardiomyocyte hypertrophy in culture as well as cardiac hypertrophy and heart failure in vivo, suggesting a critical early NHE-1-dependent initiation of the hypertrophic program. The study also suggests a preconditioning-like phenomenon in preventing hypertrophy and heart failure by early and transient NHE-1 inhibition. PMID:25216745

Kili?, Ana; Huang, Cathy X; Rajapurohitam, Venkatesh; Madwed, Jeffrey B; Karmazyn, Morris

2014-12-01

140

High Postoperative Serum Cortisol Level Is Associated with Increased Risk of Cognitive Dysfunction Early after Coronary Artery Bypass Graft Surgery: A Prospective Cohort Study  

PubMed Central

Context Stress response induced by surgery is proposed to play an important role in the pathogenesis of postoperative cognitive dysfunction. Objective To investigate the association between postoperative serum cortisol level and occurrence of cognitive dysfunction early after coronary artery bypass graft surgery. Design Prospective cohort study. Setting Two teaching hospitals. Patients One hundred and sixth-six adult patients who were referred to elective coronary artery bypass graft surgery from March 2008 to December 2009. Intervention None. Main Outcome Measures Neuropsychological tests were completed one day before and seven days after surgery. Cognitive dysfunction was defined using the same definition as used in the ISPOCD1-study. Blood samples were obtained in the first postoperative morning for measurement of serum cortisol concentration. Multivariate Logistic regression analyses were performed to assess the relationship between serum cortisol level and occurrence of postoperative cognitive dysfunction. Results Cognitive dysfunction occurred in 39.8% (66 of 166) of patients seven days after surgery. Multivariate Logistic regression analysis showed that high serum cortisol level was significantly associated with the occurrence of postoperative cognitive dysfunction (odds ratio [OR] 2.603, 95% confidence interval [CI] 1.371-4.944, P = 0.003). Other independent predictors of early postoperative cognitive dysfunction included high preoperative New York Heart Association functional class (OR 0.402, 95% CI 0.207-0.782, P = 0.007), poor preoperative Grooved Pegboard test score of nondominant hand (OR 1.022, 95% CI 1.003-1.040, P = 0.020), use of penehyclidine as premedication (OR 2.565, 95% CI 1.109-5.933, P = 0.028), and occurrence of complications within seven days after surgery (OR 2.677, 95% CI 1.201-5.963, P = 0.016). Conclusions High serum cortisol level in the first postoperative morning was associated with increased risk of cognitive dysfunction seven days after coronary artery bypass graft surgery. PMID:24143249

Mu, Dong-Liang; Li, Li-Huan; Wang, Dong-Xin; Li, Nan; Shan, Guo-Jin; Li, Jun; Yu, Qin-Jun; Shi, Chun-Xia

2013-01-01

141

Anterior spinal artery syndrome  

Microsoft Academic Search

Three patients with symptoms due to the anterior spinal artery syndrome were treated by direct perfusion of dexamethasone sodium phosphate and urokinase into the artery of Adamkiewicz. Their symptoms were paraparesis with dissociated sensory loss and sphincter dysfunction, and there was no evidence of the possible cause. In the early phase of the disease, three consecutive injections were carried out

H. Baba; K. Tomita; T. Kawagishi; S. Imura

1993-01-01

142

Photochemical consequences of enhanced CO2 levels in earth's early atmosphere  

NASA Technical Reports Server (NTRS)

Greatly enhanced atmospheric CO2 concentrations are the most likely mechanism for offsetting the effects of reduced solar luminosity early in the earth's history. CO2 levels of 80 to 600 times the present value could have maintained a mean surface temperature of 0 C to 15 C, given a 25 percent decrease in solar output. Such high CO2 levels are at least qualitatively consistent with the present understanding of the carbonate-silicate geochemical cycle. The presence of large amounts of CO2 has important implications for the composition of the earth's prebiotic atmosphere. The hydrogen budget of a high-CO2 primitive atmosphere would have been strongly influenced by rainout of H2O2 and H2CO. The reaction of H2O2 with dissolved ferrous iron in the early oceans could have been a major sink for atmospheric oxygen. The requirement that this loss of oxygen be balanced by a corresponding loss of hydrogen (by escape to space and rainout of H2CO) implies that the atmospheric H2 mixing ratio was greater than 2 x 10 to the -5th and the ground level O2 mixing ratio was below 10 to the -12th, even if other surface sources of H2 were small. These results are only weakly dependent on changes in solar UV flux, rainout rates, and vertical mixing rates in the primitive atmosphere.

Kasting, J. F.

1985-01-01

143

Obstructive apneas induce early activation of mesenchymal stem cells and enhancement of endothelial wound healing  

PubMed Central

Background The aim was to test the hypothesis that the blood serum of rats subjected to recurrent airway obstructions mimicking obstructive sleep apnea (OSA) induces early activation of bone marrow-derived mesenchymal stem cells (MSC) and enhancement of endothelial wound healing. Methods We studied 30 control rats and 30 rats subjected to recurrent obstructive apneas (60 per hour, lasting 15 s each, for 5 h). The migration induced in MSC by apneic serum was measured by transwell assays. MSC-endothelial adhesion induced by apneic serum was assessed by incubating fluorescent-labelled MSC on monolayers of cultured endothelial cells from rat aorta. A wound healing assay was used to investigate the effect of apneic serum on endothelial repair. Results Apneic serum showed significant increase in chemotaxis in MSC when compared with control serum: the normalized chemotaxis indices were 2.20 ± 0.58 (m ± SE) and 1.00 ± 0.26, respectively (p < 0.05). MSC adhesion to endothelial cells was greater (1.75 ± 0.14 -fold; p < 0.01) in apneic serum than in control serum. When compared with control serum, apneic serum significantly increased endothelial wound healing (2.01 ± 0.24 -fold; p < 0.05). Conclusions The early increases induced by recurrent obstructive apneas in MSC migration, adhesion and endothelial repair suggest that these mechanisms play a role in the physiological response to the challenges associated to OSA. PMID:20604943

2010-01-01

144

Time-Efficient Myocardial Contrast Partition Coefficient Measurement from Early Enhancement with Magnetic Resonance Imaging  

PubMed Central

Objective Our purpose was to validate an early enhancement time point for accurately measuring the myocardial contrast partition coefficient (lambda) using dynamic-equilibrium magnetic resonance imaging. Materials and Methods The pre- and post-contrast longitudinal relaxation rates (reciprocal of T1) of the interventricular septum (R1m) and blood pool (R1b) were obtained from fifteen healthy volunteers and three diabetic patients with hypertension using two optimized T1 mapping sequences (modified Look-Locker inversion recovery) on a 3-Tesla magnetic resonance scanner. Reference lambda values were calculated as the slope of the regression line of R1m versus R1b at dynamic equilibrium (multi-point regression method). The simplified pre-/post-enhancement two-acquisition method (two-point method) was used to calculate lambda by relating the change in R1m and R1b using different protocols according to the acquisition stage of the post-enhancement data point. The agreement with the referential method was tested by calculating Pearson's correlation coefficient and the intra-class correlation coefficient. Results The lambda values measured by the two-point method increased (from 0.479±0.041 to 0.534±0.043) over time from 6 to 45 minutes after contrast and exhibited good correlation with the reference at each time point (r?0.875, p<0.05). The intra-class correlation coefficient on absolute agreement with the reference lambda was 0.946, 0.929 and 0.922 at the 6th, 7th and 8th minutes and dropped from 0.878 to 0.403 from the 9th minute on. Conclusions The time-efficient two-point method at 6–8 minutes after the Gd-DTPA bolus injection exhibited good agreement with the multi-point regression method and can be applied for accurate lambda measurement in normal myocardium. PMID:24667489

Zhang, Shi-Jun; Wang, Yi-Xiang; Yuan, Jing; Jin, Jiyang; Wang, Yuan-Cheng; Chang, Di; Weng, Dehe; Greiser, Andreas; Ju, Shenghong

2014-01-01

145

Early reperfusion injury is associated to MMP2 and IL-1? elevation in cortical neurons of rats subjected to middle cerebral artery occlusion.  

PubMed

The pathophysiological processes implicated in ischemic brain damage are strongly affected by an inflammatory reaction characterized by activation of immune cells and release of soluble mediators, including cytokines and chemokines. The pro-inflammatory cytokine interleukin (IL)-1? has been implicated in ischemic brain injury, however, to date, the mechanisms involved in the maturation of this cytokine in the ischemic brain have not been completely elucidated. We have previously suggested that matrix metalloproteinases (MMPs) may be implicated in cytokine production under pathological conditions. Here, we demonstrate that significant elevation of IL-1? occurs in the cortex as early as 1h after the beginning of reperfusion in rats subjected to 2-h middle cerebral artery occlusion (MCAo). At this early stage, we observe increased expression of IL-1? in pericallosal astroglial cells and in cortical neurons and this latter signal colocalizes with elevated gelatinolytic activity. By gel zymography, we demonstrate that the increased gelatinolytic signal at 1-h reperfusion is mainly ascribed to MMP2. Thus, MMP2 seems to contribute to early brain elevation of IL-? after transient ischemia and this mechanism may promote damage since pharmacological inhibition of gelatinases by the selective MMP2/MMP9 inhibitor V provides neuroprotection in rats subjected to transient MCAo. PMID:25108165

Amantea, D; Certo, M; Russo, R; Bagetta, G; Corasaniti, M T; Tassorelli, C

2014-09-26

146

Early Contribution of Arterial Wave Reflection to Left Ventricular Relaxation Abnormalities in a Community-dwelling Population of Normotensive and Untreated Hypertensive Men and Women  

PubMed Central

We examined the contribution of arterial wave reflection to early abnormalities in left ventricular relaxation, whether this association was modified by gender or hypertension, and the role of reflected wave timing and amplitude. We studied a cohort of normotensive and untreated essential hypertensive Taiwanese participants (675 men, 601 women, mean age 52 years). Doppler flow and applanation tonometry were performed to assess carotid-femoral pulse wave velocity (PWV) and augmentation index (AI). Diastolic parameters including transmitral E/A, E-deceleration time, and left atrial diameter were measured by echocardiography. In multivariate models predicting E/A, women were more likely to have lower E/A than men (? ?0.08, p<.001). AI was significantly associated with lower E/A in both men (? ?0.09, p=0.005) and women (? ?0.12, p<.001) independent of PWV. Inclusion of AI in the overall model reduced the gender difference in E/A by 61% and rendered it non-significant. There was a significant interaction between AI and hypertension (p=0.02). The inverse association between AI and E/A was significant only in normotensive men and women, and only for the amplitude but not timing of the reflected wave. In conclusion, the contribution of wave reflection to left ventricular diastolic dysfunction was independent of arterial stiffness, more pronounced in normotensive individuals, and explained a significant portion of the gender difference in diastolic function. PMID:24048294

Canepa, Marco; AlGhatrif, Majd; Strait, James B.; Cheng, Hao-Min; Chuang, Shao-Yuan; Chen, Chen-Huan; Brunelli, Claudio; Ferrucci, Luigi; Lakatta, Edward G.

2013-01-01

147

Early Inducible Nitric Oxide Synthase 2 (NOS 2) Activity Enhances Ischaemic Skin Flap Survival  

Microsoft Academic Search

A functional skin-flap model of angiogenesis in the mouse was utilized to investigate ischaemic flap survival\\/angiogenesis whilst under pharmacological or genetic inhibition of nitric oxide synthase (NOS). In this model, the epigastric artery was cauterized. Following a five-day angiogenic period an abdominal skin-flap supplied by the pre-existing epigastric artery was raised and resutured. After a further six days the outcome

Sunao Furuta; Peter Vadiveloo; Rosalind Romeo-Meeuw; Wayne Morrison; Alastair Stewart; Geraldine Mitchell

2004-01-01

148

Iron Oxide Particle-Enhanced MRI Suggests Variability of Brain Inflammation at Early Stages After Ischemic Stroke  

Microsoft Academic Search

Background and Purpose—Inflammation contributes to brain damage caused by ischemic stroke. Ultrasmall superparamagnetic iron oxide (USPIO)-enhanced MRI allows noninvasive monitoring of macrophage recruitment into ischemic brain lesions. In this study, we determined the extent of USPIO enhancement during early stages of ischemic stroke. Methods—Twelve consecutive patients with typical clinical signs of stroke underwent multimodal stroke imaging at 1.5-T within 24

Andreas Saleh; Michael Schroeter; Adrian Ringelstein; Hans-Peter Hartung; Mario Siebler; Ulrich Modder; Sebastian Jander

2010-01-01

149

Complementary tumor vascularity imaging in a single PET-CT routine using FDG early dynamic blood flow and contrast-enhanced CT texture analysis  

NASA Astrophysics Data System (ADS)

A feasibility study of improved PET-CT tumor imaging approach is presented. A single PET-CT routine includes three different techniques: 18F-FDG early dynamic blood flow intended for perfusion assessment; standard late 18F-FDG uptake; and high-resolution contrast-enhanced CT enabling tissue texture analysis. Both PET protocols utilize the same single standard radiotracer dose administration. Quantitative volumetric arterial perfusion maps are derived from the reconstructed dynamic PET images corresponding to successive acquisition time intervals of 3 seconds only. For achieving high accuracy, the analysis algorithm differentiates the first-pass arterial flow from other interfering dynamic effects, and a noise reduction scheme based on adaptive total-variation minimization aims to provide appreciable quantitative map in physical conditions of high noise and low spatial resolution. The CT texture analysis comprises a practical and robust method for generating volumetric tissue irregularity maps. A local map value is represented by the entropy function which is derived from a weighted co-occurrence matrix histogram of the corresponding image voxel three-dimensional vicinity. Unique entropy scaling scheme and parameter optimization process, as well as appropriate scaling for varying image noise levels and contrast agent concentrations, improve the results toward quantitative absolute measure with respect to diverse scanning conditions and key analysis parameters. Representative imaging results are demonstrated on several clinical cases involving different organs and cancer types. In these cases, significant tumor characterization relative to the normal surrounding tissues is seen on the quantitative maps of all three imaging techniques. This proof of concept can lead the way to a new practical diagnostic imaging application.

Carmi, Raz; Yefremov, Nikolay; Bernstine, Hanna; Groshar, David

2014-03-01

150

Predicting the extent and location of coronary artery disease during the early postinfarction period by quantitative thallium-201 scintigraphy  

SciTech Connect

The ability of quantitative thallium-201 scintigraphy to predict the extent and location of coronary artery disease before hospital discharge after acute myocardial infarction was evaluated in 52 patients. All patients underwent coronary angiography and serial thallium-201 imaging either at rest or after submaximal exercise stress. Two or three vessel disease was designated if abnormal thallium-201 uptake or washout patterns, or both, were seen in two or three vascular segments, respectively. Of 156 vessels analyzed in the 52 patients, 91 stenoses of 70 percent or greater were found by angiography. Seventy-four of these were predicted by scintigraphy. The specificity of scintigraphy for identifying vessel stenoses was 92 percent. Sensitivity for detecting and localizing stenoses supplying an infarct zone was 96 percent compared with 62 percent for stenoses supplying myocardium remote from the acute infarct. Perfusion abnormalities were more frequently seen in the distribution of vessels with severe stenoses than in those with moderate stenoses. Scintigraphy detected a greater proportion of left anterior descending and right coronary arterial stenoses than circumflex stenoses. In the 42 patients who underwent submaximal exercise testing, multivariate analysis of 23 clinical and laboratory variables identified multiple thallium-201 defects as the best predictor of multivessel disease. The predictive accuracy of exercise-induced S-T segment depression was only 45 percent compared with 88 percent for thallium-201 scintigraphy. Thallium-201 imaging at rest is reliable in assessing the extent of coronary disease in hospitalized patients who cannot undergo exercise testing because of unstable angina, uncompensated heart failure, poorly controlled arrhythmias or physical limitations.

Gibson, R.S.; Taylor, G.J.; Watson, D.D.; Stebbins, P.T.; Martin, R.P.; Crampton, R.S.; Beller, G.A.

1981-05-01

151

Enhanced catecholamine transporter binding in the locus coeruleus of patients with early Parkinson disease  

PubMed Central

Background Studies in animals suggest that the noradrenergic system arising from the locus coeruleus (LC) and dopaminergic pathways mutually influence each other. Little is known however, about the functional state of the LC in patients with Parkinson disease (PD). Methods We retrospectively reviewed clinical and imaging data of 94 subjects with PD at an early clinical stage (Hoehn and Yahr stage 1-2) who underwent single photon computed tomography imaging with FP-CIT ([123I] N-?-fluoropropyl-2?-carbomethoxy-3?-(4-iodophenyl) tropane). FP-CIT binding values from the patients were compared with 15 healthy subjects: using both a voxel-based whole brain analysis and a volume of interest analysis of a priori defined brain regions. Results Average FP-CIT binding in the putamen and caudate nucleus was significantly reduced in PD subjects (43% and 57% on average, respectively; p < 0.001). In contrast, subjects with PD showed an increased binding in the LC (166% on average; p < 0.001) in both analyses. LC-binding correlated negatively with striatal FP-CIT binding values (caudate: contralateral, ? = -0.28, p < 0.01 and ipsilateral ? = -0.26, p < 0.01; putamen: contralateral, ? = -0.29, p < 0.01 and ipsilateral ? = -0.29, p < 0.01). Conclusions These findings are consistent with an up-regulation of noradrenaline reuptake in the LC area of patients with early stage PD, compatible with enhanced noradrenaline release, and a compensating activity for degeneration of dopaminergic nigrostriatal projections. PMID:21777421

2011-01-01

152

Contrast-Enhanced Sonography Depicts Spontaneous Ovarian Cancer at Early Stages in a Preclinical Animal Model  

PubMed Central

Objective Our goal was to examine the feasibility of using laying hens, a preclinical model of human spontaneous ovarian cancer, in determining the kinetics of an ultrasound contrast agent indicative of ovarian tumor-associated neoangiogenesis in early-stage ovarian cancer. Methods Three-year-old White Leghorn laying hens with decreased ovarian function were scanned before and after intravenous injection of a human serum albumin–perflutren contrast agent at a dose of 5 µL/kg body weight. Gray scale morphologic characteristics, Doppler indices, the arrival time, peak intensity, and wash-out of the contrast agent were recorded and archived on still images and video clips. Hens were euthanized thereafter; sonographic predictions were compared at gross examination; and ovarian tissues were collected. Archived clips were analyzed to determine contrast parameters and Doppler intensities of vessels. A time-intensity curve per hen was drawn, and the area under the curve was derived. Tumor types and the density of ovarian microvessels were determined by histologic examination and immunohistochemistry and compared to sonographic predictions. Results The contrast agent significantly (P < .05) enhanced the visualization of microvessels, which was confirmed by immunohistochemistry. Contrast parameters, including the time of wash-out and area under the curve, were significantly different (P < .05) between ovaries of normal hens and hens with ovarian cancer and correctly detected cancer at earlier stages than the time of peak intensity. Conclusions The laying hen may be a useful animal model for determining ovarian tumor-associated vascular kinetics diagnostic of early-stage ovarian cancer using a contrast agent. This model may also be useful for testing the efficacy of different contrast agents in a preclinical setting. PMID:21357555

Barua, Animesh; Bitterman, Pincas; Bahr, Janice M.; Basu, Sanjib; Sheiner, Eyal; Bradaric, Michael J.; Hales, Dale B.; Luborsky, Judith L.; Abramowicz, Jacques S.

2011-01-01

153

Acute psychological and physical stress transiently enhances brachial artery flow-mediated dilation stimulated by exercise-induced increases in shear stress.  

PubMed

Exercise elevates conduit artery shear stress and stimulates flow-mediated dilation (FMD). However, little is known regarding the impact of acute psychological and physical stress on this response. The purpose of this study was to examine the impact of the Trier Social Stress Test (TSST (speech and arithmetic tasks)) and a cold pressor test (CPT) with and without social evaluation (SE) on exercise-induced brachial artery FMD (EX-FMD). A total of 59 healthy male subjects were randomly assigned to 1 of 3 conditions: TSST, CPT, or CPT with SE. During 6 min of handgrip exercise, brachial artery EX-FMD was assessed before and 15 and 35 min poststress with echo and Doppler ultrasound. Shear stress was estimated as shear rate, calculated as brachial artery mean blood velocity/brachial artery diameter. Results are means ± SD. All conditions elicited significant physiological stress responses. Salivary cortisol increased from 4.6 ± 2.4 nmol/L to 10.0 ± 5.0 nmol/L (p < 0.001; condition effect: p = 0.292). Mean arterial pressure increased from 98.6 ± 12.1 mm Hg to 131.9 ± 18.7 mm Hg (p < 0.001; condition effect: p = 0.664). Exercise shear rate did not differ between conditions (p = 0.592), although it was modestly lower poststress (prestress: 72.3 ± 4.5 s(-1); 15 min poststress: 70.8 ± 5.4 s(-1); 35 min poststress: 70.6 ± 6.1 s(-1); trial effect: p = 0.011). EX-FMD increased from prestress to 15 min poststress in all conditions (prestress: 6.2% ± 2.8%; 15 min poststress: 7.9% ± 3.2%; 35 min poststress: 6.6% ± 2.9%; trial effect: p < 0.001; condition effect: p = 0.611). In conclusion, all conditions elicited similar stress responses that transiently enhanced EX-FMD. This response may help to support muscle perfusion during stress. PMID:24921439

Szijgyarto, Ingrid C; Poitras, Veronica J; Gurd, Brendon J; Pyke, Kyra E

2014-08-01

154

Value of single-dose contrast-enhanced magnetic resonance angiography versus intraarterial digital subtraction angiography in therapy indications in abdominal and iliac arteries.  

PubMed

The objective of the study was to prove the value of single-dose contrast-enhanced magnetic resonance angiography [three-dimensional (3D) ceMRA] in abdominal and iliac arteries versus the reference standard intra-arterial digital subtraction angiography (i.a.DSA) when indicating a therapy. Patients suspected of having abdominal or iliac artery stenosis were included in this study. A positive vote of the local Ethics Committe was given. After written informed consent was obtained, 37 patients were enrolled, of which 34 were available for image evaluation. Both 3D ceMRA and i.a. DSA were performed for each patient. The dosage for 3D ceMRA was 0.1 mmol/kg body weight in a 1.5-T scanner with a phased-array coil. The parameters of the 3D-FLASH sequence were as follows: TR/TE 4.6/1.8 ms, effective thickness 3.5 mm, matrix 512 x 200, flip angle 30 degrees , field of view 420 mm, TA 23 s, coronal scan orientation. Totally, 476 vessel segments were evaluated for stenosis degree by two radiologists in a consensus fashion in a blinded read. For each patient, a therapy was proposed, if clinically indicated. Sensitivity, specificity, positive and negative predictive values, and accuracy for stenoses > or = 50% were 68%, 92%, 44%, 97%, and 90%, respectively. In 13/34 patients, a discrepancy was found concerning therapy decisions based on MRA findings versus therapy decisions based on the reference standard DSA. The results showed that the used MRA imaging technique of abdominal and iliac arteries is not competitive to i.a. DSA, with a high rate of misinterpretation of the MRAs resulting in incorrect therapies. PMID:17278036

Schaefer, Philipp J; Schaefer, Fritz K W; Mueller-Huelsbeck, Stefan; Both, Markus; Heller, Martin; Jahnke, Thomas

2007-01-01

155

Multi-delay multi-parametric arterial spin-labeled perfusion MRI in acute ischemic stroke - Comparison with dynamic susceptibility contrast enhanced perfusion imaging.  

PubMed

The purpose of the present study was to present a multi-delay multi-parametric pseudo-continuous arterial spin labeling (pCASL) protocol with background suppressed 3D GRASE (gradient and spin echo) readout for perfusion imaging in acute ischemic stroke. PCASL data at 4 post-labeling delay times (PLD = 1.5, 2, 2.5, 3 s) were acquired within 4.5 min in 24 patients (mean age 79.7 ± 11.4 years; 11 men) with acute middle cerebral artery (MCA) stroke who also underwent dynamic susceptibility contrast (DSC) enhanced perfusion imaging. Arterial transit times (ATT) were estimated through the calculation of weighted delays across the 4 PLDs, which were included in the calculation of cerebral blood flow (CBF) and arterial cerebral blood volume (CBV). Mean perfusion parameters derived using pCASL and DSC were measured within MCA territories and infarct regions identified on diffusion weighted MRI. The results showed highly significant correlations between pCASL and DSC CBF measurements (r > = 0.70, p < = 0.0001) and moderately significant correlations between pCASL and DSC CBV measurements (r > = 0.45, p < = 0.027) in both MCA territories and infarct regions. ASL ATT showed correlations with DSC time to the maximum of tissue residual function (Tmax)(r = 0.66, p = 0.0005) and mean transit time (MTT)(r = 0.59, p = 0.0023) in leptomeningeal MCA territories. The present study demonstrated the feasibility for noninvasive multi-parametric perfusion imaging using ASL for acute stroke imaging. PMID:24159561

Wang, Danny J J; Alger, Jeffry R; Qiao, Joe X; Gunther, Matthias; Pope, Whitney B; Saver, Jeffrey L; Salamon, Noriko; Liebeskind, David S

2013-01-01

156

Enhanced normalisation of CD4/CD8 ratio with early antiretroviral therapy in primary HIV infection  

PubMed Central

Introduction Despite normalization of total CD4 counts, ongoing immune dysfunction is noted amongst those on antiretroviral therapy (ART). Low CD4/CD8 ratio is associated with a high risk of AIDS and non-AIDS events and may act as a marker of immune senescence [1]. This ratio is improved by ART although normalization is uncommon (~7%) [2]. The probability of normalization of CD4 count is improved with immediate ART initiation in primary HIV infection (PHI) [3]. We examined whether CD4/CD8 ratio similarly normalized in immediate vs. deferred ART at PHI. Material and Methods Using data from the SPARTAC trial and the UK Register of HIV Seroconverters, we examined the effect of ART with time (continuous) from HIV seroconversion (SC) on CD4/CD8 ratio (?1) adjusted for sex, risk group, ethnicity, enrolment from an African site and both CD4 count and age at ART initiation. We also examined that effect by dichotomizing HIV duration at ART initiation (ART started within six months of SC: early ART; ART initiated>six months after SC: deferred). We also considered time to CD4 count normalization (?900 cells/mm3). Results In total, 353 initiated ART with median (IQR) 97.9 (60.5, 384.5) days from estimated seroconversion; 253/353 early ART, 100 deferred ART. At one year after starting ART, 114/253 (45%) early ART had normalized CD4/8 ratio, compared with 11/99 (11%) in the deferred group, whilst 83/253 (33%) of early ART had normalized CD4 counts, compared with 3/99 (3%) in the deferred group. Individuals initiating within six months of PHI were significantly more likely to reach normal ratio than those initiating later (HR, 95% CI 2.96, 1.75 – 5.01, p<0.001). The longer after SC ART was initiated, the reduced likelihood of achieving normalization of CD4/CD8 ratio (HR 0.98, 95% CI 0.96 – 0.99 for each 30-day increase). CD4 count at ART initiation was also associated with normalization, as expected (HR 1.002, 95% CI 1.001 – 1.002, p<0.001). There was an association between normal CD4/CD8 ratio and being virally suppressed (<400 copies HIV RNA/ml) p<0.001. CD4 count normalization was also significantly more likely for those initiating early (HR 5.00, 95% CI 1.52 – 16.41, p=0.008). Conclusions The likelihood of achieving normalization of CD4/CD8 ratios was increased if ART was initiated within six months of PHI. Higher CD4/CD8 ratio may reflect a more “normal” immune phenotype conferring enhanced prognosis and predict post-treatment control. PMID:25393989

Thornhill, John; Inshaw, Jamie; Oomeer, Soonita; Kaleebu, Pontiano; Cooper, David; Ramjee, Gita; Schechter, Mauro; Tambussi, Giuseppe; Fox, Julie; Maria Miro, Jose; Weber, Jonathan; Babiker, Abdel; Porter, Kholoud; Fidler, Sarah

2014-01-01

157

Demonstration as a rate enhancer to changes in coordination during early skill acquisition.  

PubMed

We compared the nature and rate of change in intra-limb coordination in participants who observed a video model (model) with those who practised based on verbal guidance only (control). Sixteen male novices threw a ball towards a target with maximal velocity using a back-handed, reverse baseball pitch. Participants in the model group immediately changed their intra-limb relative motion to more closely resemble the model's relative motion pattern. This new coordination pattern, and concomitant changes in ball speed, was maintained throughout acquisition, without further change. In contrast, the control group showed no change in coordination or ball speed across acquisition. Our findings suggest that demonstrations act as a rate enhancer, conveying an immediate movement solution that is adopted early in acquisition. A model may constrain the learner to perceive and imitate the model's relative motion pattern as suggested by Scully and Newell (1985). The stability of this new movement pattern questions accounts of learning, which suggest that prescriptive, directed learning may result in the "soft assembly" of an inaccurate and temporary movement solution. PMID:17365545

Horn, Robert R; Williams, A Mark; Hayes, Spencer J; Hodges, Nicola J; Scott, Mark A

2007-03-01

158

Detection of buried targets using a new enhanced very early time electromagnetic (VETEM) prototype system  

USGS Publications Warehouse

In this paper, numerical simulations of a new enhanced very early time electromagnetic (VETEM) prototype system are presented, where a horizontal transmitting loop and two horizontal receiving loops are used to detect buried targets, in which three loops share the same axis and the transmitter is located at the center of receivers. In the new VETEM system, the difference of signals from two receivers is taken to eliminate strong direct-signals from the transmitter and background clutter and furthermore to obtain a better SNR for buried targets. Because strong coupling exists between the transmitter and receivers, accurate analysis of the three-loop antenna system is required, for which a loop-tree basis function method has been utilized to overcome the low-frequency breakdown problem. In the analysis of scattering problem from buried targets, a conjugate gradient (CG) method with fast Fourier transform (FFT) is applied to solve the electric field integral equation. However, the convergence of such CG-FFT algorithm is extremely slow at very low frequencies. In order to increase the convergence rate, a frequency-hopping approach has been used. Finally, the primary, coupling, reflected, and scattered magnetic fields are evaluated at receiving loops to calculate the output electric current. Numerous simulation results are given to interpret the new VETEM system. Comparing with other single-transmitter-receiver systems, the new VETEM has better SNR and ability to reduce the clutter.

Cui, T. J.; Chew, W. C.; Aydiner, A. A.; Wright, D. L.; Smith, D. V.

2001-01-01

159

A Case Study of the Use of Internet Photobook Technology to Enhance Early Childhood "Scientist" Identity  

NASA Astrophysics Data System (ADS)

There are many influences on a child's identity. Photobook technology purposefully prepared around science explorations presents a modern opportunity to repeatedly trigger memories that reinforce the "me, as scientist" viewpoint. Semi-structured interviews at 6 and 8 years of age were conducted with a child who was the subject of a photobook of everyday science activities to gain insights into his thinking about the nature of science and how he interprets his younger self participating. Interview data were recorded, transcribed and analyzed using dimensions from the previously established parameters for the nature of science. The child's statements about his participation in the photos were matched to these dimensions to consider how he sees himself "doing science" through his early years. Preliminary findings suggest that the child recognizes elements of science and regards himself as an active participant. In both interviews, the child reinforces these views by the opportunity to revisit the experiences in the photobook. Affective components may motivate further science involvement as well: the child enjoyed the time and attention that the photos and discussion provided; the child took pride in being the subject of a book. This case study suggests that there is a fertile field of research to investigate how, for whom, and in what ways internet photobook technology may enhance a child's developing identity as capable science explorer.

Katz, Phyllis

2011-10-01

160

Is social isolation/alienation confounded with, and non-independent of, emotional distress in its association with early onset of coronary artery disease?  

PubMed

Both emotional distress (ED) and social isolation/alienation (SI/A) have been found to prospectively predict adverse cardiac events, but few studies have tested the confounding/redundancy of these measures as correlates/predictors of outcomes. In this study, 163 patients with documented coronary artery disease (CAD) were interviewed for multiple indices of SI/A and administered the Symptom Checklist 90 - Revised (SCL90R). A spouse or friend provided an independent rating of ED using the spouse/friend version of the Ketterer Stress Symptom Frequency Checklist (KSSFC). The measures of ED and SI/A covaried. All three scales from the KSSFC (depression, anxiety, and "AIAI" - aggravation, irritation, anger, and impatience), and three scales from the SCL90R (anxiety, depression, and psychoticism), were associated with early Age at Initial Diagnosis (AAID) of CAD. Neither three scales derived from the SCL90R (shyness, feeling abused, and feeling lonely) nor the interview indices of SI/A (married, living alone, having a confidant, self description as a lone wolf, and self-description as lonely) were associated with early AAID. Thus, it is concluded that the present results indicate that ED and SI/A are confounded and that, even when tested head-to-head in a multivariate analysis, only ED is associated with AAID. PMID:21328150

Ketterer, Mark; Rose, Benjamin; Knysz, Walter; Farha, Amjad; Deveshwar, Sangita; Schairer, John; Keteyian, Steven J

2011-03-01

161

Relation between mean arterial pressure and renal function in the early phase of shock: a prospective, explorative cohort study  

PubMed Central

Introduction Because of disturbed renal autoregulation, patients experiencing hypotension-induced renal insult might need higher levels of mean arterial pressure (MAP) than the 65 mmHg recommended level in order to avoid the progression of acute kidney insufficiency (AKI). Methods In 217 patients with sustained hypotension, enrolled and followed prospectively, we compared the evolution of the mean arterial pressure (MAP) during the first 24 hours between patients who will show AKI 72 hours after inclusion (AKIh72) and patients who will not. AKIh72 was defined as the need of renal replacement therapy or "Injury" or "Failure" classes of the 5-stage RIFLE classification (Risk, Injury, Failure, Loss of kidney function, End-stage renal disease) for acute kidney insufficiency using the creatinine and urine output criteria. This comparison was performed in four different subgroups of patients according to the presence or not of AKI at the sixth hour after inclusion (AKIh6 as defined as a serum creatinine level above 1.5 times baseline value within the first six hours) and the presence or not of septic shock at inclusion.The ability of MAP averaged over H6 to H24 to predict AKIh72 was assessed by the area under the receiver operating characteristic curve (AUC) and compared between groups. Results The MAP averaged over H6 to H24 or over H12 to H24 was significantly lower in patients who showed AKIh72 than in those who did not, only in septic shock patients with AKIh6, whereas no link was found between MAP and AKIh72 in the three others subgroups of patients. In patients with septic shock plus AKIh6, MAP averaged over H6 to H24 or over H12 to H24 had an AUC of 0.83 (0.72 to 0.92) or 0.84 (0.72 to 0.92), respectively, to predict AKIh72 . In these patients, the best level of MAP to prevent AKIh72 was between 72 and 82 mmHg. Conclusions MAP about 72 to 82 mmHg could be necessary to avoid acute kidney insufficiency in patients with septic shock and initial renal function impairment. PMID:21645384

2011-01-01

162

Exercise training enhances insulin-stimulated nerve arterial vasodilation in rats with insulin-treated experimental diabetes.  

PubMed

Insulin stimulates nerve arterial vasodilation through a nitric oxide (NO) synthase (NOS) mechanism. Experimental diabetes reduces vasa nervorum NO reactivity. Studies investigating hyperglycemia and nerve arterial vasodilation typically omit insulin treatment and use sedentary rats resulting in severe hyperglycemia. We tested the hypotheses that 1) insulin-treated experimental diabetes and inactivity (DS rats) will attenuate insulin-mediated nerve arterial vasodilation, and 2) deficits in vasodilation in DS rats will be overcome by concurrent exercise training (DX rats; 75-85% VO2 max, 1 h/day, 5 days/wk, for 10 wk). The baseline index of vascular conductance values (VCi = nerve blood flow velocity/mean arterial blood pressure) were similar (P ? 0.68), but peak VCi and the area under the curve (AUCi) for the VCi during a euglycemic hyperinsulinemic clamp (EHC; 10 mU·kg(-1)·min(-1)) were lower in DS rats versus control sedentary (CS) rats and DX rats (P ? 0.01). Motor nerve conduction velocity (MNCV) was lower in DS rats versus CS rats and DX rats (P ? 0.01). When compared with DS rats, DX rats expressed greater nerve endothelial NOS (eNOS) protein content (P = 0.04). In a separate analysis, we examined the impact of diabetes in exercise-trained rats alone. When compared with exercise-trained control rats (CX), DX rats had a lower AUCi during the EHC, lower MNCV values, and lower sciatic nerve eNOS protein content (P ? 0.03). Therefore, vasa nervorum and motor nerve function are impaired in DS rats. Such deficits in rats with diabetes can be overcome by concurrent exercise training. However, in exercise-trained rats (CX and DX groups), moderate hyperglycemia lowers vasa nervorum and nerve function. PMID:24740656

Olver, T Dylan; McDonald, Matthew W; Grisé, Kenneth N; Dey, Adwitia; Allen, Matti D; Medeiros, Philip J; Lacefield, James C; Jackson, Dwayne N; Rice, Charles L; Melling, C W James; Noble, Earl G; Shoemaker, J Kevin

2014-06-15

163

Early outcome and intermediate follow-up of vascular stents in the femoral and popliteal arteries without long-term anticoagulation  

Microsoft Academic Search

Purpose: The role of arterial stenting in the treatment of femoral and popliteal arterial disease is controversial and has been hampered by recommendations for patients to be given anticoagulants (oral warfarin) for several months or more. This study was undertaken to evaluate the immediate and midterm outcomes of vascular stents implanted percutaneously in the femoral and popliteal arteries, without long-term

Geoffrey H. White; Stephen C. C. Liew; Richard C. Waugh; Michael S. Stephen; John P. Harris; Jenifer Kidd; Toos Sachinwalla; Weiyun Yu; James May

1995-01-01

164

Basic polyamino acids rich in arginine, lysine, or ornithine cause both enhancement of and refractoriness to formation of endothelium-derived nitric oxide in pulmonary artery and vein.  

PubMed

The objective of this study was to elucidate the mechanism by which polyamino acids containing L-arginine, L-lysine or L-ornithine cause endothelium-dependent relaxation of bovine intrapulmonary artery and vein. Basic but not acidic or neutral polypeptides ranging in average molecular weights from 17 to 225 kDa elicited time- and concentration-dependent relaxation and cyclic GMP accumulation in precontracted rings of artery and vein by endothelium-dependent mechanisms. Vascular responses were markedly inhibited by oxyhemoglobin, methylene blue, or potassium. The basic polyamino acids stimulated the formation and/or release of an endothelium-derived relaxing factor (EDRF) identified as nitric oxide (NO) in perfused segments of both artery and vein as assessed by bioassay. The polyamino acids and A23187 released a similar endothelium-derived NO (EDNO) from artery and vein, as assessed by the similar half-life (3-5 seconds), antagonism by superoxide anion or oxyhemoglobin, enhancement by superoxide dismutase, and lack of influence by indomethacin. The basic polyamino acids elicited potent relaxant responses with EC50 values ranging from 3 x 10(-9) to 2 x 10(-7) M, and a direct correlation was obtained between molecular weight and relaxation potency irrespective of the basic amino acid incorporated. Prolonged contact of arterial or venous rings with basic polyamino acids resulted in the rapid development of marked refractoriness to relaxation and cyclic GMP formation on addition of polyamino acid. Moreover, refractoriness developed to the vascular responses of other endothelium-dependent vasodilators but not to glyceryl trinitrate or isoproterenol. The mechanism of refractory responses was attributed to interference with EDNO formation and release as assessed by bioassay and chemical assay. The hypothesis is forwarded that the basic polyamino acids serve as partial substrates for the enzyme system that catalyzes the conversion of L-arginine to NO. Prolonged contact between substrate and enzyme results in enzyme desensitization and the development of refractoriness or a form of tolerance to vasodilators whose action is mediated by EDNO. PMID:2492213

Ignarro, L J; Gold, M E; Buga, G M; Byrns, R E; Wood, K S; Chaudhuri, G; Frank, G

1989-02-01

165

Determination of time-course change rate for arterial xenon using the time course of tissue xenon concentration in xenon-enhanced computed tomography  

SciTech Connect

In calculating tissue blood flow (TBF) according to the Fick principle, time-course information on arterial tracer concentration is indispensable and has a considerable influence on the accuracy of calculated TBF. In TBF measurement by xenon-enhanced computed tomography (Xe-CT), nonradioactive xenon gas is administered by inhalation as a tracer, and end-tidal xenon is used as a substitute for arterial xenon. There has been the assumption that the time-course change rate for end-tidal xenon concentration (Ke) and that for arterial xenon concentration (Ka) are substantially equal. Respiratory gas sampling is noninvasive to the patient and Ke can be easily measured by exponential curve fitting to end-tidal xenon concentrations. However, it is pointed out that there would be a large difference between Ke and Ka in many cases. The purpose of this work was to develop a method of determining the Ka value using the time course of tissue xenon concentration in Xe-CT. The authors incorporated Ka into the Kety autoradiographic equation as a parameter to be solved, and developed a method of least-squares to obtain the solution for Ka from the time-course changes in xenon concentration in the tissue. The authors applied this method of least-squares to the data from Xe-CT abdominal studies performed on 17 patients; the solution for Ka was found pixel by pixel in the spleen, and its Ka map was created for each patient. On the one hand, the authors obtained the average value of the Ka map of the spleen as the calculated Ka (Ka{sub calc}) for each patient. On the other hand, the authors measured Ka (Ka{sub meas}) using the time-course changes in CT enhancement in the abdominal aorta for each patient. There was a good correlation between Ka{sub calc} and Ka{sub meas} (r=0.966, P<0.0001), and these two Ka values were close to each other (Ka{sub calc}=0.935xKa{sub meas}+0.089). This demonstrates that Ka{sub calc} would be close to the true Ka value. Accuracy of TBF by Xe-CT can be improved with use of the average value of the Ka map of an organ like the spleen that has a single blood supply (only arterial inflow)

Sase, Shigeru; Takahashi, Hideaki; Ikeda, Hiroki; Kobayashi, Minoru; Matsumoto, Nobuyuki; Suzuki, Michihiro [Anzai Medical Co., Ltd., 3-9-15 Nishi-Shinagawa, Shinagawa-ku, Tokyo 141-0033 (Japan); Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, St. Marianna University, 2-16-1 Miyamae-ku, Sugao, Kawasaki 216-5811 (Japan)

2008-06-15

166

Arterial Catheterization  

MedlinePLUS

Patient Information Series AMERICAN THORACIC SOCIETY Why Do I Need Arterial Catheterization? Common reasons an arterial catheterization is done include: ? Low blood pressure (hypotension or shock)— Low ...

167

Assessment of the early stage of cardiac remodeling of spontaneously hypertensive heart failure rats using the quantitative 3-dimensional analysis provided by acipimox-enhanced FDG-PET.  

PubMed

Spontaneously hypertensive heart failure rats (SHHF) appear to constitute an original model for analyzing the evolution of the metabolic syndrome towards heart failure. This study aimed to characterize early cardiac dysfunction and remodeling in SHHF rats: (1) as compared with spontaneously hypertensive rats (SHR) and with a control group of Kyoto rats (WKY), and (2) by using the 3-dimensional quantitative analysis provided by acipimox-enhanced positron emission tomography (PET) with (18)F-fluorodesoxyglucose (FDG). Left ventricular (LV) ejection fraction (EF) and volume were quantified by automatic software on the FDG-PET images recorded in SHR (n = 20), SHHF (n = 18) and WKY-rats (n = 19) at ages 3 or 10 months old. Arterial blood pressure was determined by cardiac catheterization and cardiac fibrosis was quantified after sacrifice. Blood pressure was similarly elevated in SHR and SHHF rats (respective systolic blood pressures at 10-months: 199 ± 39 vs. 205 ± 2 mmHg), but SHHF rats had higher body mass than SHR rats (at 10-months, 630 ± 36 vs. 413 ± 27 g, p < 0.05) and higher blood levels of cholesterol and of triglycerides. At 3 months, cardiac parameters did not show significant differences between groups but at 10-months, SHHF and SHR rats exhibited an enhancement in myocardial mass and fibrosis associated with a clear decline in LV-EF (SHHF: 46 ± 6 %; SHR: 47 ± 5 %) as compared with WKY (56 ± 6 %, p < 0.01 for both comparisons). Cardiac remodeling of SHHF rats was clearly observable by FDG-PET from the age of 10-months, but in a similar way to that observed for SHR rats, suggesting a predominant role of hypertension. PMID:24384858

Maskali, Fatiha; Poussier, Sylvain; Louis, Huguette; Boutley, Henri; Lhuillier, Mickael; Thornton, Simon N; Karcher, Gilles; Lacolley, Patrick; Marie, Pierre Y

2014-02-01

168

Contrast enhanced MRI characterization of the perfusion territories fed by individual coronary arteries in ex-vivo porcine heart  

NASA Astrophysics Data System (ADS)

Sudden cardiac death is often caused by ventricular arrhythmias. These arrhythmias are believed to originate from the border zones where tissue was damaged by an ischemic event involving the coronary arteries. The specific mechanisms relating the geometry of these territories to the electrical behavior remains poorly understood. A major problem is the lack of detailed information describing the morphology of the affected perfusion bed. We present the first perfusion MR images of excised whole heart preparations where the irregular boundaries of perfusion territories are described. The filling pattern and final volume of the RCA perfusion territory are clearly visualized.

Szeverenyi, Nikolaus M.; Searles, Bruce; Pertsov, Arkady

2008-03-01

169

No Child Misunderstood: Enhancing Early Childhood Teachers’ Multicultural Responsiveness to the Social Competence of Diverse Children  

Microsoft Academic Search

As a result of rapid demographic changes in our society, more children from diverse racial\\/cultural backgrounds join our early\\u000a childhood classrooms. The majority of early childhood teachers, on the other hand, are middle-class and of European-decent.\\u000a This paper provides early childhood teachers with both theoretical and practical understandings about multicultural responsiveness,\\u000a in order to understand and promote social competence of

Heejeong Sophia Han; M. Shelley Thomas

2010-01-01

170

Innominate artery involvement in type iv Ehlers-Danlos syndrome  

Microsoft Academic Search

We report two cases of innominate artery involvement in patients with Ehlers-Danlos syndrome. In the first patient, spontaneous dissection of the innominate artery was treated successfully. In the other, the patient died of spontaneous rupture of the innominate artery in the early postoperative course after operation for aneurysm of the celiac artery. Arterial complications occurring in Ehlers-Danlos syndrome are rare

Alain Valverde; Jean-François Tricot; Bruno de Crepy; Hayssam Bakdach; Koskrow Djabbari

1991-01-01

171

Predictors and outcomes of early coronary angiography in patients with prior coronary artery bypass surgery presenting with non-ST elevation myocardial infarction  

PubMed Central

Introduction The best strategy in patients with prior coronary artery bypass graft surgery (CABG) who present with non-ST elevation myocardial infarction (NSTEMI) remains less well defined. We compare the characteristics, therapeutic interventions and outcomes of patients with prior CABG presenting with NSTEMI. Methods All patients who presented to our hospital during 2007–2012 with available electronic records were analysed retrospectively. Outcomes were compared between patients who underwent coronary angiography or percutaneous coronary intervention (PCI) versus those who were treated medically. Results A total of 117 patients were analysed. Of that, 79 patients were managed medically while 38 underwent early angiography, of which only 11 (9.5%) received PCI. Patients treated medically (did not undergo angiography) were older (74±10 vs70±8; p=0.05). ECG changes were the only independent predictor for early angiography (OR 0.4, 95% CI 0.15 to 0.99; p=0.05) while recurrent chest pain (OR 0.2, 95% CI 0.05 to 0.97; p=0.05) predicted PCI on multivariate analysis. The PCI group had higher Global Registry of Acute Cardiac Events (GRACE) score (176±29 vs 150±31; p=0.01). No significant difference was found in readmission rates, morbidity (unstable angina pectoris, NSTEMI, ST elevation myocardial infarction (STEMI), or combination) or mortality at 12?months between the groups who underwent angiography, PCI, or treated medically on univariate and multivariate analysis. Conclusions The opportunity to intervene in prior CABG patients presenting with NSTEMI is often low. Initial medical management may be a reasonable option in carefully selected patients particularly in the absence of ongoing symptoms, ECG changes or very high GRACE scores. Further studies are required to evaluate the safety of non-invasive strategies in managing this population. PMID:25332800

Asrar ul Haq, Muhammad; Rudd, Nima; Mian, Mueed; Castles, Anastasia; Mogilevski, Tamara; Mutha, Vivek; Van Gaal, William J

2014-01-01

172

Diagnostic impact and prognostic relevance of early contrast-enhanced transcranial color-coded duplex sonography in acute stroke  

Microsoft Academic Search

Background and Purpose—We sought to evaluate the diagnostic value of echo-enhanced transcranial color-coded duplex sonography (TCCD) and the clinical relevance of vascular pathology assessed by sonography for early clinical outcome in acute ischemic stroke. Methods—We present 23 consecutive patients with an anterior circulation stroke in whom clinical examination, CT, and ultrasonography were performed within 5 hours after the onset of

R. Kross; M. Goertler; Matthias Baeumer; Stefan Jost; Reinhard Grote; Sepp Weber; Claus-Werner Wallesch

1998-01-01

173

Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results From a Two-Year Randomized Trial  

PubMed Central

Objective To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method Early course schizophrenia outpatients (N = 58) were randomly assigned to Cognitive Enhancement Therapy (CET) or an Enriched Supportive Therapy (EST) control and treated for two years. Comprehensive data on cognition and employment were collected annually. Results Individuals treated with CET were significantly more likely to be competitively employed, had greater earnings from employment, and were more satisfied with their employment status by the end of treatment compared to EST recipients. Mediator analyses revealed that improvements in both social and non-social cognition mediated the CET effects on employment. Conclusion CET can help facilitate employment in early schizophrenia, by addressing the cognitive impairments that limit functioning in the disorder. Inclusion of cognitive rehabilitation in social work practice can support more optimal functional recovery from schizophrenia. PMID:23885163

Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

2013-01-01

174

Project SEEL: Part II. Using Technology to Enhance Early Literacy Instruction in Spanish  

ERIC Educational Resources Information Center

Custom-made digital media are rich, varied, and motivational early literacy materials. An important component of Project SEEL (Systematic and Engaging Early Literacy Instruction) was the use of tailormade digital books and activities in the reading curriculum. Project SEEL team members created computerized materials in Spanish to relate to…

Culatta, Richard; Culatta, Barbara; Frost, Meghan; Buzzell, Krista

2004-01-01

175

Enhancing Early Childhood Teacher Growth and Development through Professional Development School Partnerships  

ERIC Educational Resources Information Center

The field of early childhood education has traditionally struggled to be viewed as a profession. Recent public attention on the importance of the early years in creating a foundation for later learning success has led to a focus on improving education for young children. One aspect of educational reform and renewal--Professional Development…

Clark, Patricia; Huber, Linda

2005-01-01

176

Teaching Curriculum with Technology: Enhancing Children's Technological Competence During Early Childhood  

Microsoft Academic Search

Emerging technologies hold promise for improv- three assertions are posed that emerged from a withining student achievement and teacher quality. Evidence case analysis of these examples. In the concluding secthat diverse uses of technology in early childhood cur- tion, we inform the reader of the contributions of this ricula show measurable differences in student achieve- study to early childhood education

Belinda Gimbert; Dean Cristol

2004-01-01

177

Improving Early Adaptation Following Long Duration Spaceflight by Enhancing Vestibular Information  

NASA Technical Reports Server (NTRS)

Crewmember adapted to the microgravity state may need to egress the vehicle within a few minutes for safety and operational reasons after g-transitions. The transition from one sensorimotor state to another consists of two main mechanisms: strategic and plastic-adaptive and have been demonstrated in astronauts returning after long duration space flight. Strategic modifications represent "early adaptation" -immediate and transitory changes in control that are employed to deal with short-term changes in the environment. If these modifications are prolonged then plastic-adaptive changes are evoked that modify central nervous system function, automating new behavioral responses. More importantly, this longer term adaptive recovery mechanism was significantly associated with their strategic ability to recover on the first day after return to Earth G. We are developing a method based on stochastic resonance (SR) to enhance information transfer by improving the brain's ability to detect vestibular signals especially when combined with balance training exercises for rapid improvement in functional skill, for standing and mobility. The countermeasure to improve post-flight balance and locomotor disturbances is a stimulus delivery system that is wearable/portable providing low imperceptible levels of white noise based binaural bipolar electrical stimulation of the vestibular system (stochastic vestibular stimulation, SVS). The techniques for improving signal detection using SVS may thus provide additional information to improve such strategic abilities and thus help in significantly reducing the number of days required to recover functional performance to preflight levels after long duration space flight. We have conducted a series of studies to document the efficacy of SVS stimulation on balance/locomotion tasks on unstable surfaces and motion tracking tasks during intra-vestibular system conflicts. In an initial study, we showed that SVS improved overall balance performance while standing on an unstable surface indicating that SVS may be sufficient to provide a comprehensive countermeasure approach for improving postural stability. In a second study, we showed that SVS improved locomotor performance on a treadmill mounted on an oscillating platform indicating that SVS may also be used to maximize locomotor performance during walking in unstable environments. In a third study, SVS was evaluated during an otolith-canal conflict scenario in a variable radius centrifuge at low frequency of oscillation (0.1 Hz) on both eye movements and perceptual responses (using a joystick) to track imposed oscillations. The variable radius centrifuge provides a selective tilting sensation that is detectable only by the otolith organs providing conflicting information from the canal organs of the vestibular system (intra-vestibular conflict). Results show that SVS significantly reduced the timing difference between both the eye movement responses as well as the perceptual tracking responses with respect to the imposed tilt sensations. These results indicate that SVS can improve performance in sensory conflict scenarios like that experienced during space flight. Such a SR countermeasure will act synergistically along with the pre-and in-flight adaptability training protocols providing an integrated, multi-disciplinary countermeasure capable of fulfilling multiple requirements making it a comprehensive and cost effective countermeasure approach to enhance sensorimotor capabilities following long-duration space flight.

Mulavara, Ajitkumar; Kofman, Igor; DeDios, Yiri E.; Galvan, Raquel; Miller, Chris; Peters, Brian; Cohen, Helen; Jeevarajan, Jerome; Reschke, Millard; Wood, Scott; Bloomberg, Jacob

2014-01-01

178

Assessing the end-organ in peripheral arterial occlusive disease--from contrast--enhanced ultrasound to blood-oxygen-level-dependent MR imaging  

PubMed Central

Peripheral arterial occlusive disease (PAOD) is a result of atherosclerotic disease which is currently the leading cause of morbidity and mortality in the western world. Patients with PAOD may present with intermittent claudication or symptoms related to critical limb ischemia. PAOD is associated with increased mortality rates. Stenoses and occlusions are usually detected by macrovascular imaging, including ultrasound and cross-sectional methods. From a pathophysiological view these stenoses and occlusions are affecting the microperfusion in the functional end-organs, such as the skin and skeletal muscle. In the clinical arena new imaging technologies enable the evaluation of the microvasculature. Two technologies currently under investigation for this purpose on the end-organ level in PAOD patients are contrast-enhanced ultrasound (CEUS) and blood-oxygen-level-dependent (BOLD) MR imaging (MRI). The following article is providing an overview about these evolving techniques with a specific focus on skeletal muscle microvasculature imaging in PAOD patients. PMID:24834413

Partovi, Sasan; Jacobi, Bjoern; Fergus, Nathan; Schulte, Anja-Carina; Robbin, Mark R.; Bilecen, Deniz; Staub, Daniel

2014-01-01

179

Enhanced relationship between the tropical Atlantic SST and the summertime western North Pacific subtropical high after the early 1980s  

NASA Astrophysics Data System (ADS)

western North Pacific subtropical high (WNPSH) in boreal summer shows a remarkable enhancement after the early 1980s. Whereas the sea surface temperature (SST) in the North Indian Ocean (NIO) and the equatorial eastern Pacific had been noted to have remarkable local or remote effects on enhancing the WNPSH, the influence of the Atlantic SST, so far, is hardly explored. This article reports a new finding: enhanced relationship between the tropical Atlantic (TA)-SST and the WNPSH after the early 1980s. Regression study suggests that the warm TA-SST produced a zonally overturning circulation anomaly, with descending over the equatorial central Pacific and ascending over the tropical Atlantic/eastern Pacific. The anomalous descending over the equatorial central Pacific likely induced low-level anticyclonic anomaly to the west and therefore enhanced the WNPSH. One implication of this new finding is for predictability. The well-known "spring predictability barrier" (i.e., the influence of El Niño-Southern Oscillation (ENSO) falls dramatically during boreal spring) does not apply to the TA-SST/WNPSH relationship. The TA-SST shows consistently high correlation starting from boreal spring when the ENSO influence continues declining. The TA-SST extends the predictability of the WNPSH in boreal summer approximately one season earlier to boreal spring.

Hong, Chi-Cherng; Chang, Tao-Chi; Hsu, Huang-Hsiung

2014-04-01

180

The effects of the pretreatment of intravenous high dose methylprednisolone on Na + -K + \\/Mg +2 ATPase and lipid peroxidation and early ultrastructural findings following middle cerebral artery occlusion in the rat  

Microsoft Academic Search

Summary The sodium-potassium activated and magnesium dependent adenosine-5'-triphosphatase (Na+-K+\\/Mg+2 ATPase EC.3.6.1.3.) activity and lipid peroxidation and early ultrastructural findings were determined in rat brain at the acute stage of ischaemia produced by permanent unilateral occlusion of the middle cerebral artery (MCA). The effects of the pretreatment with intravenous high-dose methylprednisolone (MP) on these biochemical indices and ultrastructural findings were also

F. Ildan; S. Polat; A. I. Göcer; A. Öner; T. Isbir; U. Ö. Mete; M. Kaya; A. Karadayi

1996-01-01

181

Combinatorial Binding in Human and Mouse Embryonic Stem Cells Identifies Conserved Enhancers Active in Early Embryonic Development  

PubMed Central

Transcription factors are proteins that regulate gene expression by binding to cis-regulatory sequences such as promoters and enhancers. In embryonic stem (ES) cells, binding of the transcription factors OCT4, SOX2 and NANOG is essential to maintain the capacity of the cells to differentiate into any cell type of the developing embryo. It is known that transcription factors interact to regulate gene expression. In this study we show that combinatorial binding is strongly associated with co-localization of the transcriptional co-activator Mediator, H3K27ac and increased expression of nearby genes in embryonic stem cells. We observe that the same loci bound by Oct4, Nanog and Sox2 in ES cells frequently drive expression in early embryonic development. Comparison of mouse and human ES cells shows that less than 5% of individual binding events for OCT4, SOX2 and NANOG are shared between species. In contrast, about 15% of combinatorial binding events and even between 53% and 63% of combinatorial binding events at enhancers active in early development are conserved. Our analysis suggests that the combination of OCT4, SOX2 and NANOG binding is critical for transcription in ES cells and likely plays an important role for embryogenesis by binding at conserved early developmental enhancers. Our data suggests that the fast evolutionary rewiring of regulatory networks mainly affects individual binding events, whereas “gene regulatory hotspots” which are bound by multiple factors and active in multiple tissues throughout early development are under stronger evolutionary constraints. PMID:22215994

Goke, Jonathan; Jung, Marc; Behrens, Sarah; Chavez, Lukas; O'Keeffe, Sean; Timmermann, Bernd; Lehrach, Hans; Adjaye, James; Vingron, Martin

2011-01-01

182

Decreased flow-mediated dilatation with increased arterial stiffness and thickness as early signs of atherosclerosis in polymyositis and dermatomyositis patients.  

PubMed

Several autoimmune rheumatic diseases have been associated with accelerated atherosclerosis or other different types of vasculopathy depending on the underlying disease, leading to increased cardio- and cerebrovascular disease risk. Polymyositis (PM) and dermatomyositis (DM), members of idiopathic inflammatory myopathies (IIMs), a group of systemic autoimmune diseases are also associated with elevated risk of cardiovascular diseases (CVD). Up until now, no specific data is known on the mechanisms, risk factors, or possible vasculopathy leading to increased CVD risk. The aims of the present study were to assess the flow-mediated dilatation of the brachial artery by a TensioClinic arteriograph and to measure the thickness of carotid artery intima-media, the augmentation index, and the pulse wave velocity using high-resolution ultrasonography in a cohort of PM and DM patients. We also investigated the correlation of these parameters with the traditional risk factors of atherosclerosis and overall cardiovascular status within PM and DM patients. Twenty-seven patients (21 females, six males) with IIMs were enrolled in this study, and 38 healthy individuals matched for sex and age served as controls. We found a decreased flow-mediated dilatation in the brachial artery (6.36 vs. 8.39 %) with increased arterial stiffness and carotid artery thickness in our patients compared to healthy controls. We found significantly decreased flow-mediated dilatation of the brachial artery (5.57 vs. 8.39 %) in DM patients. We also detected a correlation between these parameters and the traditional cardiovascular risk factors, as well as hypertriglyceridemy, hypertension, and peripheral arterial disease. In DM, overall, more vascular abnormalities were found than in PM. Our findings suggest that flow-mediated dilatation of the brachial artery, arterial stiffness, and carotid artery thickness measurements could be beneficial for predicting the CVD risk in myositis patients. Further investigations need to find the potential differences and role of inflammation and immune mechanisms in atherosclerotic processes in DM and PM. PMID:24615538

Vincze, Melinda; Dér, H; Kerekes, Gy; Szodoray, P; Zeher, M; Dankó, K; Soltész, P

2014-11-01

183

Contrast-Enhanced 2D Cine Phase MR Angiography for Measurement of Basilar Artery Blood Flow in Posterior Circulation Ischemia  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Dizziness is a symptom that develops with internal ear disturbances and with dysfunctions of the brain stem and cerebellum, in particular with blood flow disturbances of the brain stem and cerebellum (posterior circulation ischemia (PCI)). Patients with PCI often present with various neurologic signs and symptoms. To examine the usefulness of contrast-enhanced 2D cine phase MR angiography

Takeshi Kato; Toshikatsu Indo; Eiji Yoshida; Yasushi Iwasaki; Mie Sone; Gen Sobue

184

Three-Dimensional Model-Based Stenosis Quantification of the Carotid Arteries from Contrast-Enhanced MR Angiography  

E-print Network

-Enhanced MR Angiography Alejandro F. Frangi, Wiro J. Niessen, Paul J. Nederkoorn, Otto E.H. Elgersma, Max A analysis of three-dimensional magnetic resonance angiography (MRA) is presented. The model consists Projection (MIP) CE MRA, and Digital Subtraction Angiography (DSA) as stan- dard of reference. 1

Frangi, Alejandro

185

Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning  

SciTech Connect

Exercise electrocardiography and thallium scanning were performed a mean of 24 days after uncomplicated acute myocardial infarction in 103 patients, aged 36 to 60 years, who also underwent coronary angiography. The purpose of the study was to determine the ability of the noninvasive tests to predict multivessel coronary artery disease (CAD) and prognosis. Patients were followed up to document medical complications (incidence 12%: 3 deaths, 1 resuscitated cardiac arrest, 4 recurrent infarctions, 4 admissions with unstable angina) and combined events (medical events or bypass surgery, incidence 23%). The sensitivity, specificity and predictive accuracy for predicting multivessel CAD were 64%, 77% and 64% for a positive exercise electrocardiographic (ECG) response, 64%, 88% and 80% for a remote thallium defect, and 42%, 96% and 88% for a combination of the 2 tests. With 2 tests yielding negative findings the probability of multivessel CAD was 13%. No variable (positive exercise ECG response, remote thallium defect and presence of multivessel CAD) predicted medical events, although there were nonsignificant trends to more events in patients with any of those findings. The relative risk of combined events was 2.5 (p less than 0.05) for a positive exercise ECG response; 1.8 (NS) for a remote thallium defect; 2.6 (p less than 0.05) for multivessel CAD; and 3.1 (p less than 0.025) for both positive ECG response and remote defect. A combination of exercise electrocardiography and thallium scanning early after acute myocardial infarction helps to identify subsets of patients with high and low probabilities of multivessel CAD and combined medical or surgical events.

Abraham, R.D.; Freedman, S.B.; Dunn, R.F.; Newman, H.; Roubin, G.S.; Harris, P.J.; Kelly, D.T.

1986-09-01

186

Glycosylated hemoglobin A1c as a marker predicting the severity of coronary artery disease and early outcome in patients with stable angina  

PubMed Central

Background Glycosylated hemoglobin A1C (HbA1c) has been widely recognized as a marker for predicting the severity of diabetes mellitus (DM) and several cardiovascular diseases. However, whether HbA1c could predict the severity and clinical outcomes in patients with stable coronary artery disease (CAD) remains largely unknown. We determine relationship of HbA1c with severity and outcome in patients with stable CAD. Methods We enrolled 1433 patients with stable angina who underwent coronary angiography and were followed up for an average 12 months. The patients were classified into three groups by tertiles of baseline HbA1c level (low group <5.7%, n?=?483; intermediate group 5.7 - 6.3%, n?=?512; high group >6.3%, n?=?438). The relationships between the plasma HbA1c and severity of CAD and early clinical outcomes were evaluated. Results High HbA1c was associated with three-vessel disease. Area under the receivers operating characteristic curve (AUC?=?0.67, 95% CI: 0.63-0.71, P?

2014-01-01

187

Prematurely Elevating Estradiol in Early Baboon Pregnancy Suppresses Uterine Artery Remodeling and Expression of Extravillous Placental Vascular Endothelial Growth Factor and ?1?1 and ?5?1 Integrins  

PubMed Central

We previously showed that advancing the increase in estradiol levels from the second to the first third of baboon pregnancy suppressed placental extravillous trophoblast (EVT) invasion and remodeling of the uterine spiral arteries. Cell culture studies show that vascular endothelial cell growth factor (VEGF) plays a central role in regulating EVT migration and remodeling of the uterine spiral arteries by increasing the expression/action of certain integrins that control extracellular matrix remodeling. To test the hypothesis that the estradiol-induced reduction in vessel remodeling in baboons is associated with an alteration in VEGF and integrin expression, extravillous placental VEGF and integrin expression was determined on d 60 of gestation (term is 184 d) in baboons in which uterine artery transformation was suppressed by maternal estradiol administration on d 25–59. EVT uterine spiral artery invasion was 5-fold lower (P < 0.01), and VEGF protein expression, quantified by in situ proximity ligation assay, was 50% lower (P < 0.05) in the placenta anchoring villi of estradiol-treated than in untreated baboons. ?1?1 and ?5?1 mRNA levels in cells isolated by laser capture microdissection from the anchoring villi and cytotrophoblastic shell of estradiol-treated baboons were over 2-fold (P < 0.01) and 40% (P < 0.05) lower, respectively, than in untreated animals. In contrast, placental extravillous ?v?3 mRNA expression was unaltered by estradiol treatment. In summary, extravillous placental expression of VEGF and ?1?1 and ?5?1 integrins was decreased in a cell- and integrin-specific manner in baboons in which EVT invasion and remodeling of the uterine spiral arteries were suppressed by prematurely elevating estradiol levels in early pregnancy. We propose that estrogen normally controls the extent to which the uterine arteries are transformed by placental EVT in primate pregnancy by regulating expression of VEGF and particular integrin extracellular remodeling molecules that mediate this process. PMID:22495671

Bonagura, Thomas W.; Babischkin, Jeffery S.; Aberdeen, Graham W.; Pepe, Gerald J.

2012-01-01

188

Three arginine to cysteine substitutions in the pro-alpha (I)-collagen chain cause Ehlers-Danlos syndrome with a propensity to arterial rupture in early adulthood.  

PubMed

Mutations in the COL1A1 and COL1A2 genes, encoding the proalpha1 and 2 chains of type I collagen, cause osteogenesis imperfecta (OI) or Ehlers-Danlos syndrome (EDS) arthrochalasis type. Although the majority of missense mutations in the collagen type I triple helix affect glycine residues in the Gly-Xaa-Yaa repeat, few nonglycine substitutions have been reported. Two arginine-to-cysteine substitutions in the alpha1(I)-collagen chain are associated with classic EDS [R134C (p.R312C)] or autosomal dominant Caffey disease with mild EDS features [R836C (p.R1014C)]. Here we show alpha1(I) R-to-C substitutions in three unrelated patients who developed iliac or femoral dissection in early adulthood. In addition, manifestations of classic EDS in Patient 1 [c.1053C>T; R134C (p.R312C); X-position] or osteopenia in Patients 2 [c.1839C>T; R396C (p.R574C); Y-position] and 3 [c.3396C>T; R915C (p.R1093C); Y-position] are seen. Dermal fibroblasts from the patients produced disulfide-bonded alpha1(I)-dimers in approximately 20% of type I collagen, which were efficiently secreted into the medium in case of the R396C and R915C substitution. Theoretical stability calculations of the collagen type I heterotrimer and thermal denaturation curves of monomeric mutant alpha1(I)-collagen chains showed minor destabilization of the collagen helix. However, dimers were shown to be highly unstable. The R134C and R396C caused delayed procollagen processing by N-proteinase. Ultrastructural findings showed collagen fibrils with variable diameter and irregular interfibrillar spaces, suggesting disturbed collagen fibrillogenesis. Our findings demonstrate that R-to-C substitutions in the alpha1(I) chain may result in a phenotype with propensity to arterial rupture in early adulthood. This broadens the phenotypic range of nonglycine substitutions in collagen type I and has important implications for genetic counseling and follow-up of patients carrying this type of mutation. PMID:17211858

Malfait, Fransiska; Symoens, Sofie; De Backer, Julie; Hermanns-Lê, Trinh; Sakalihasan, Natzi; Lapière, Charles M; Coucke, Paul; De Paepe, Anne

2007-04-01

189

Enhancing peer cultures of academic effort and achievement in early adolescence: promotive effects of the SEALS intervention.  

PubMed

Peer cultures of effort and achievement influence early adolescents' academic adjustment. A randomized controlled trials design was used to test the extent to which aspects of peer cultures of effort and achievement were enhanced following teachers' participation in the Supporting Early Adolescents' Learning and Social Success (SEALS) intervention. Observational and survey data from teachers (N = 188) and survey data from 6th-graders (N = 2,453) in 36 rural schools across the United States were analyzed. Results indicated that in SEALS versus matched control schools, social prominence was more favorably associated with effort and school valuing, and peer group injunctive norms were more supportive of effort and achievement. Findings indicate that aspects of peer cultures respond to the school context and provide evidence of the efficacy of the SEALS model. PMID:23647418

Hamm, Jill V; Farmer, Thomas W; Lambert, Kerrylin; Gravelle, Maggie

2014-01-01

190

Early interleukin-10 treatment improves survival and enhances immune function only in males after hemorrhage and subsequent sepsis.  

PubMed

Recent studies have demonstrated gender differences in the immune response following hemorrhagic shock with an enhanced immune function and lower mortality following subsequent sepsis in females. Early interleukin-10 (IL-10) treatment has been shown to have beneficial effects on the depressed immune function in males, but not in females following shock. However, it remains unclear if the observed gender-related effect of IL-10 treatment results in an advantage following subsequent polymicrobial sepsis. To study this, male and female CBA/J mice (age 2-3 months) were subjected to hemorrhage (35 +/- 5 mmHg for 90 min and fluid resuscitation). At resuscitation, each received either 10 microg of recombinant murine IL-10 or placebo i.p.. At 48 h after resuscitation, either peritoneal macrophages (pMphi) and plasma were harvested, or polymicrobial sepsis was induced by cecal ligation and puncture (CLP). Following CLP, either survival over 10 days was measured, or pMphi and plasma were harvested 4 h after CLP to assess TNF-alpha, IL-6, IL-10, and prostaglandin E2 (PGE2) release of pMphi and plasma levels of IL-10, free testosteron, and 17-beta estradiol. Early IL-10 treatment restored depressed proinflammatory immune response in males (TNF-alpha and PGE2), which was associated with an enhanced survival (P < 0.05) following subsequent sepsis as compared with placebo-treated mice (8/20 and 1/20, respectively). In contrast, the immune response and survival in females receiving IL-10 was not significantly changed, although females treated with IL-10 had a trend towards higher mortality (7/15 and 2/15, respectively; P = 0.08). Thus, early IL-10 anti-inflammatory treatment following hemorrhage has potential beneficial effects only in males associated with enhanced survival following subsequent sepsis. PMID:12095129

Kahlke, Volker; Dohm, Christoph; Mees, Torge; Brötzmann, Kerstin; Schreiber, Stefan; Schröder, Jörg

2002-07-01

191

Benefit and Safety of Enhanced External Counterpulsation in Treating Coronary Artery Disease Patients with a History of Congestive Heart Failure  

Microsoft Academic Search

Enhanced external counterpulsation (EECP) is used to noninvasively treat refractory angina patients, including those with a history of heart failure. The International EECP Patient Registry was used to examine the benefit and safety of EECP treatment, including a 6-month follow-up, in 1,957 patients, 548 with a history of heart failure. The heart failure cohort was older, with more females, a

William E. Lawson; Elizabeth D. Kennard; Richard Holubkov; Sheryl F. Kelsey; John E. Strobeck; Ozlem Soran; Arthur M. Feldman

2001-01-01

192

A Pathway to Enhancing Professionalism: Building a Bridge between TAFE and University Early Childhood Qualifications  

ERIC Educational Resources Information Center

It has been argued that a key strategy to improve developmental and educational outcomes for young children is to increase the number of childcare staff with early childhood university degrees (Saracho & Spodek, 2007). In order to upgrade the qualifications of staff, a number of Australian universities provide pathways that enable graduates of…

Whitington, Victoria; Ebbeck, Marjory; Diamond, Alexandra; Yim, Hoi Yin Bonnie

2009-01-01

193

Enhancing Early Numeracy by Promoting the Abstract Thought Involved in the Oddity Principle, Seriation, and Conservation  

ERIC Educational Resources Information Center

Although many students who enter kindergarten are cognitively ready to meet the demands of the kindergarten mathematics curriculum, some students arrive without the early abstract reasoning abilities necessary to benefit from the instruction provided. Those who do not possess key cognitive abilities, including understandings of conservation,…

Kidd, Julie K.; Pasnak, Robert; Gadzichowski, Marinka; Ferral-Like, Melissa; Gallington, Debbie

2008-01-01

194

Brief Report: Can Metrics of Reporting Bias Enhance Early Autism Screening Measures?  

ERIC Educational Resources Information Center

The goal of the current study was to develop and pilot the utility of two simple internal response bias metrics, over-reporting and under-reporting, in terms of additive clinical value within common screening practices for early detection of autism spectrum disorder risk. Participants were caregivers and children under 36 months of age (n = 145)…

Taylor, Cora M.; Vehorn, Alison; Noble, Hylan; Weitlauf, Amy S.; Warren, Zachary E.

2014-01-01

195

Clinical Features of Proven Basilar Artery Occlusion  

Microsoft Academic Search

Our study describes the early symptoms and signs of 85 patients with either basilar artery occlusion or bilateral distal vertebral artery occlusion documented by selective angiography. The most common prodromal symptoms were vertigo, nausea, and headache, which occurred during the 2 weeks before the stroke. Angiographic findings of 49 patients were classified into proximal, middle, and distal basilar artery occlusions.

Andreas Ferbert; Hartmut Bruckmann; Renate Drummen

2010-01-01

196

Peripheral Artery Disease and Diabetes  

MedlinePLUS

... hypertension) High LDL ("bad") cholesterol Family history of cardiovascular disease, stroke or PAD Previous history of coronary artery disease ( ... reduce the chances of a heart attack or stroke while enhancing quality of life. This content was last reviewed on ... Disease & Diabetes Peripheral Artery Disease & Diabetes Kidney Disease & Diabetes ...

197

A Report on the Technological Enhancements Project Evaluation: Deepening Early Learning Experiences through Technology  

ERIC Educational Resources Information Center

As part of the "Ready to Learn" Initiative, Education Development Center, Inc. (EDC), was charged with addressing the evaluation of Technological Enhancements for the outreach efforts of three producers: Out of the Blue's Super WHY! Technology Add-On; Sesame Workshop's The Electric Company School's Initiative Curriculum; and WordWorld's eBook…

Hupert, Naomi; Cervantes, Francisco; DeGroof, Emily

2010-01-01

198

Folic Acid Enhances Early Functional Recovery in a Piglet Model of Pediatric Head Injury  

Microsoft Academic Search

For stroke and spinal cord injury, folic acid supplementation has been shown to enhance neurodevelopment and to provide neuroprotection. We hypothesized that folic acid would reduce brain injury and improve neurological outcome in a neonatal piglet model of traumatic brain injury (TBI), using 4 experimental groups of 3- to 5-day-old female piglets. Two groups were intubated, anesthetized and had moderate

Maryam Y. Naim; Stuart Friess; Colin Smith; Jill Ralston; Karen Ryall; Mark A. Helfaer; Susan S. Margulies

2010-01-01

199

Musical Training during Early Childhood Enhances the Neural Encoding of Speech in Noise  

ERIC Educational Resources Information Center

For children, learning often occurs in the presence of background noise. As such, there is growing desire to improve a child's access to a target signal in noise. Given adult musicians' perceptual and neural speech-in-noise enhancements, we asked whether similar effects are present in musically-trained children. We assessed the perception and…

Strait, Dana L.; Parbery-Clark, Alexandra; Hittner, Emily; Kraus, Nina

2012-01-01

200

Enhanced Progression of Early Carotid Atherosclerosis Is Related to Chlamydia pneumoniae (Taiwan Acute Respiratory) Seropositivity  

Microsoft Academic Search

Background— Chlamydia pneumoniae(Cp) infection has been associated with atherosclerosis and has been proposed as a possible additional cardiovascular risk factor. However, the relationship between Cp seropositivity and the progression of early carotid atherosclerosis is not unequivocally clarified. Methods and Results—We evaluated the association between serological detection of Cp IgG and\\/or IgA antibodies and the progression of the intima-media thickness (IMT)

Dirk Sander; Kerstin Winbeck; Jürgen Klingelhöfer; Thorleif Etgen; Bastian Conrad

201

Anomalous left coronary artery arising from the pulmonary artery.  

PubMed

A 24-year-old female presented to her general practitioner with shortness of breath. She was referred for an echocardiogram, which demonstrated features suggestive of a right coronary artery fistula, and referred to our institute. We performed a contrast-enhanced, prospectively triggered cardiac CT angiogram, which demonstrated the primary and secondary features of anomalous left coronary artery arising from the pulmonary artery (ALCAPA), also known as the Bland-White-Garland syndrome, a rare congenital abnormality of the origin of the left main coronary artery. PMID:23044529

Durand, M; Nguyen, E T; Crean, A M

2012-09-01

202

Musical training during early childhood enhances the neural encoding of speech in noise  

PubMed Central

For children, learning often occurs in the presence of background noise. As such, there is growing desire to improve a child’s access to a target signal in noise. Given adult musicians’ perceptual and neural speech-in-noise enhancements, we asked whether similar effects are present in musically-trained children. We assessed the perception and subcortical processing of speech in noise and related cognitive abilities in musician and nonmusician children that were matched for a variety of overarching factors. Outcomes reveal that musicians’ advantages for processing speech in noise are present during pivotal developmental years. Supported by correlations between auditory working memory and attention and auditory brainstem response properties, we propose that musicians’ perceptual and neural enhancements are driven in a top-down manner by strengthened cognitive abilities with training. Our results may be considered by professionals involved in the remediation of language-based learning deficits, which are often characterized by poor speech perception in noise. PMID:23102977

Strait, Dana L.; Parbery-Clark, Alexandra; Hittner, Emily; Kraus, Nina

2012-01-01

203

High Calcium Bioglass Enhances Differentiation and Survival of Endothelial Progenitor Cells, Inducing Early Vascularization in Critical Size Bone Defects  

PubMed Central

Early vascularization is a prerequisite for successful bone healing and endothelial progenitor cells (EPC), seeded on appropriate biomaterials, can improve vascularization. The type of biomaterial influences EPC function with bioglass evoking a vascularizing response. In this study the influence of a composite biomaterial based on polylactic acid (PLA) and either 20 or 40% bioglass, BG20 and BG40, respectively, on the differentiation and survival of EPCs in vitro was investigated. Subsequently, the effect of the composite material on early vascularization in a rat calvarial critical size defect model with or without EPCs was evaluated. Human EPCs were cultured with ?-TCP, PLA, BG20 or BG40, and seeding efficacy, cell viability, cell morphology and apoptosis were analysed in vitro. BG40 released the most calcium, and improved endothelial differentiation and vitality best. This effect was mimicked by adding an equivalent amount of calcium to the medium and was diminished in the presence of the calcium chelator, EGTA. To analyze the effect of BG40 and EPCs in vivo, a 6-mm diameter critical size calvarial defect was created in rats (n?=?12). Controls (n?=?6) received BG40 and the treatment group (n?=?6) received BG40 seeded with 5×105 rat EPCs. Vascularization after 1 week was significantly improved when EPCs were seeded onto BG40, compared to implanting BG40 alone. This indicates that Ca2+ release improves EPC differentiation and is useful for enhanced early vascularization in critical size bone defects. PMID:24244419

Nguyen Ngoc, Christina; Meier, Simon; Nau, Christoph; Schaible, Alexander; Marzi, Ingo; Henrich, Dirk

2013-01-01

204

Enhancing the passing moments: An educational criticism of family visits to an early childhood science exhibition  

NASA Astrophysics Data System (ADS)

This educational criticism describes and interprets the nature of family visits to an early childhood science exhibition, Working Wonders, at The Science Centre in Calgary, Alberta. The specific exhibits are described and features that contributed to exhibit popularity are examined. Examples of visitors' interactions with each exhibit are given. The visit experiences of four families are described in detail and analyzed. Typical family visitors' reactions, expectations, and experiences are summarized. Because one of the mutual expectations of the granting agency, The Science Centre, and the adult visitors was that a visit to the exhibition would be educational, the family visits are examined for instances of learning and analyzed to determine the factors that influenced the learning. Constructivism forms the basis for understanding the process of learning during family visits. The analysis is supported by reference to research from the fields of museum studies, education, and environmental design. The analysis of the educational significance and potential of family visits to an early childhood exhibition leads to the conclusion that specific features may facilitate learning in such an environment. Those features are represented in a set of guidelines for the development and evaluation of early childhood exhibitions. The guidelines suggest attention must be given to the ambience of the space, the general layout of the space, the exhibits, the copy and graphics, additional programs and information, the subtle influences of the building and the staff, and the learning processes of young children, adults, and intergenerational groups. The guidelines suggest specific issues to consider to develop a space that is stimulating and memorable, responsive to the needs of the two distinct visitor groups (young children and adults), and conducive to learning.

Munroe, Elizabeth Ann

205

Effect of enhanced external counterpulsation on inflammatory cytokines and adhesion molecules in patients with angina pectoris and angiographic coronary artery disease.  

PubMed

Cardiovascular disease is associated with chronic low-level inflammation, as evidenced by elevated circulating proinflammatory cytokines. Experimental evidence suggests that inflammation can be suppressed under conditions of high shear stress. This study was conducted to examine the effects of enhanced external counterpulsation (EECP), a noninvasive therapy that increases endothelial shear stress, on circulating levels of inflammatory biomarkers and adhesion molecules in patients with angina pectoris. Twenty-one patients were randomly assigned to either 35 1-hour treatments at cuff pressures of 300 mm Hg (EECP; n=12) or 75 mm Hg (sham; n=9). Plasma tumor necrosis factor-alpha, monocyte chemoattractant protein-1, and soluble vascular cell adhesion molecule-1 were measured before and after 35 1-hour sessions of treatment or sham. Patients in the EECP group demonstrated reductions in tumor necrosis factor-alpha (6.9+/-2.7 vs 4.9+/-2.5 pg/ml, p<0.01; -29%) and monocyte chemoattractant protein-1 (254.9+/-55.9 vs 190.4+/-47.6 pg/ml, p<0.01; -19%) after treatment, whereas there was no change in the sham group. Changes in soluble vascular cell adhesion molecule-1 were not observed in either group. In conclusion, 35 sessions of EECP decreased circulating levels of proinflammatory biomarkers in patients with symptomatic coronary artery disease. PMID:18237588

Casey, Darren P; Conti, C Richard; Nichols, Wilmer W; Choi, Calvin Y; Khuddus, Matheen A; Braith, Randy W

2008-02-01

206

Surface enhanced Raman spectroscopic (SERS) study of saliva in the early detection of oral cancer  

NASA Astrophysics Data System (ADS)

Worldwide, oral cancer is the sixth most common cancer for both sexes. In Singapore, the 5-year survival rate of oral cancer is about 50%. The high mortality rate has been attributed to the difficulties in detecting the disease in an early treatable stage. Currently, the standard screening procedures for oral cancer are histopathology examination of biopsied tissues and exfoliative cytological assessment. These techniques, unfortunately, are low in sensitivity. In this study, we exploit the high amplification factor of SERS to investigate on the possibility of utilising molecular vibrational information from saliva samples to detect oral cancer early. All raw saliva samples were centrifuged at 13,000 krpm for 5 minutes to remove unwanted particles prior to SERS measurements. The purified saliva samples were then applied directly on gold particle films, followed by excitation with a 633 nm HeNe laser. SERS spectrum can be obtained in less than 2 minutes for each sample. We have studied the saliva spectra acquired from 5 normal individuals and 5 patients with oral cancer. In addition, we also observe new peaks at 1097 cm-1 and 1627 cm-1 in some of the abnormal samples. These peaks are not present in the spectra acquired from the normal samples. Preliminary measurements will be presented. This study may lead to the development of a sensitive and portable diagnostics system for oral cancer.

Kho, Kiang W.; Malini, Olivo; Shen, Ze Xiang; Soo, Khee Chee

2005-03-01

207

Early-season effects of solar UV-B enhancement on plant canopy structure, simulated photosynthesis and competition  

SciTech Connect

Mixed-species stands of wheat (Triticum aestivum) and wild oat (Avena fatua) were exposed to enhanced solar UV-B radiation simulating a 20% reduction in column ozone to assess the timing and seasonal development of the UV-B-induced alterations in competitive balance between these species. Results from two years of field studies revealed that UV-B enhancement did not significantly affect the magnitude or timing of seeding emergence of the combined-species LAI of 4-week old mixtures (near 2 for both years). The UV-B did, however, significantly increase (5-9%) the relative proportion of the mixture LAI contributed by wheat which then resulted in a 6-8% increase in its calculated relative light interception and canopy carbon gain. These findings, and others indicate that the effects of enhanced UV-B on competitive balance are realized very early during canopy development and suggest that UV-B-induced alterations in seedling growth may have peristent and significant consequences for light competition later in the growing season.

Barnes, P.W.; Flint, S.D.; Caldwell, M.M. (Southwest Texas State Univ., San Marcos, TX (United States))

1994-06-01

208

Arterial thoracic outlet syndrome.  

PubMed

Arterial thoracic outlet syndrome is a rare cause of shoulder pain due to compression of the subclavian or axillary artery within the thoracic outlet. It is the least common form of thoracic outlet syndrome but is potentially dangerous as it can result in significant morbidity. An athlete initially may present with exertional pain, early fatigability, a dull ache, or discomfort in the affected arm. History and physical examination are paramount in diagnosis, and imaging confirms the anatomy. Surgical repair or resection alleviates the compression of the affected structure and allows for a safe return to participation. Familiarity with this condition aids in the prompt diagnosis and treatment of this disorder. PMID:24614419

Daniels, Brian; Michaud, Leslie; Sease, Franklin; Cassas, Kyle J; Gray, Bruce H

2014-01-01

209

Cationic surface charge enhances early regional deposition of liposomes after intracarotid injection.  

PubMed

Rapid first pass uptake of drugs is necessary to increase tissue deposition after intraarterial (IA) injection. Here we tested whether brain tissue deposition of a nanoparticulate liposomal carrier could be enhanced by coordinated manipulation of liposome surface charge and physiological parameters, such as IA injection during transient cerebral hypoperfusion (TCH). Different degrees of blood-brain barrier disruption were induced by focused ultrasound in three sets of Sprague-Dawley rats. Brain tissue retention was then compared for anionic, cationic, and charge-neutral liposomes after IA injection combined with TCH. The liposomes contained a non-exchangeable carbocyanine membrane optical label that could be quantified using diffuse reflectance spectroscopy (DRS) or visualized by multispectral imaging. Real-time concentration-time curves in brain were obtained after each liposomal injection. Having observed greater tissue retention of cationic liposomes compared to other liposomes in all three groups, we tested uptake of cationic liposomes in C6 tumor bearing rats. DRS and multispectral imaging of postmortem sections revealed increased liposomal uptake by the C6 brain tumor as compared to non-tumor contralateral hemisphere. We conclude that regional deposition of liposomes can be enhanced without BBB disruption using IA injection of cationic liposomal formulations in healthy and C6 tumor bearing rats. PMID:25195130

Joshi, Shailendra; Singh-Moon, Rajinder; Wang, Mei; Chaudhuri, Durba B; Ellis, Jason A; Bruce, Jeffrey N; Bigio, Irving J; Straubinger, Robert M

2014-12-01

210

Excess Optical Enhancement Observed with ARCONS for Early Crab Giant Pulses  

NASA Astrophysics Data System (ADS)

We observe an extraordinary link in the Crab pulsar between the enhancement of an optical pulse and the timing of the corresponding giant radio pulse. At optical through infrared wavelengths, our observations use the high time resolution of ARray Camera for Optical to Near-IR Spectrophotometry, a unique superconducting energy-resolving photon-counting array at the Palomar 200 inch telescope. At radio wavelengths, we observe with the Robert C. Byrd Green Bank Telescope and the Green Bank Ultimate Pulsar Processing Instrument backend. We see an 11.3% ± 2.5% increase in peak optical flux for pulses that have an accompanying giant radio pulse arriving near the peak of the optical main pulse, in contrast to a 3.2% ± 0.5% increase when an accompanying giant radio pulse arrives soon after the optical peak. We also observe that the peak of the optical main pulse is 2.8% ± 0.8% enhanced when there is a giant radio pulse accompanying the optical interpulse. We observe no statistically significant spectral differences between optical pulses accompanied by and not accompanied by giant radio pulses. Our results extend previous observations of optical-radio correlation to the time and spectral domains. Our refined temporal correlation suggests that optical and radio emission are indeed causally linked, and the lack of spectral differences suggests that the same mechanism is responsible for all optical emission.

Strader, M. J.; Johnson, M. D.; Mazin, B. A.; Spiro Jaeger, G. V.; Gwinn, C. R.; Meeker, S. R.; Szypryt, P.; van Eyken, J. C.; Marsden, D.; O'Brien, K.; Walter, A. B.; Ulbricht, G.; Stoughton, C.; Bumble, B.

2013-12-01

211

Novel Polypyrrole-Coated Polylactide Scaffolds Enhance Adipose Stem Cell Proliferation and Early Osteogenic Differentiation  

PubMed Central

An electrically conductive polypyrrole (PPy) doped with a bioactive agent is an emerging functional biomaterial for tissue engineering. We therefore used chondroitin sulfate (CS)-doped PPy coating to modify initially electrically insulating polylactide resulting in novel osteogenic scaffolds. In situ chemical oxidative polymerization was used to obtain electrically conductive PPy coating on poly-96L/4D-lactide (PLA) nonwoven scaffolds. The coated scaffolds were characterized and their electrical conductivity was evaluated in hydrolysis. The ability of the coated and conductive scaffolds to enhance proliferation and osteogenic differentiation of human adipose stem cells (hASCs) under electrical stimulation (ES) in three-dimensional (3D) geometry was compared to the noncoated PLA scaffolds. Electrical conductivity of PPy-coated PLA scaffolds (PLA-PPy) was evident at the beginning of hydrolysis, but decreased during the first week of incubation due to de-doping. PLA-PPy scaffolds enhanced hASC proliferation significantly compared to the plain PLA scaffolds at 7 and 14 days. Furthermore, the alkaline phosphatase (ALP) activity of the hASCs was generally higher in PLA-PPy seeded scaffolds, but due to patient variation, no statistical significance could be determined. ES did not have a significant effect on hASCs. This study highlights the potential of novel PPy-coated PLA scaffolds in bone tissue engineering. PMID:23126228

Pelto, Jani; Bjorninen, Miina; Palli, Aliisa; Talvitie, Elina; Hyttinen, Jari; Mannerstrom, Bettina; Suuronen Seppanen, Riitta; Kellomaki, Minna; Miettinen, Susanna; Haimi, Suvi

2013-01-01

212

Enhancing the case manager's role through early identification of at-risk members.  

PubMed

This article describes a methodology to improve early identification and stratification of at-risk patients with comorbidities that could result in catastrophic illness. Data from the HMO line of business identified diabetic members. Total frequency and total cost for 19 comorbid diseases were calculated on data from the diabetic members who were classified as having high severity and comorbidity rankings. Members were further segmented into quadrants based on frequency and cost for referral to case management and/or educational programs. A total of 1312 HMO diabetic members were classified as high severity. Quadrant 4 diabetic members consumed greater than $10,000 in health care expenses and had 6 or more collapsed DECs. Similar types of comorbid diseases were found in both quadrants 2 and 4. Quadrant 2 diabetic members were identified as "in danger" members with the potential to incur total costs greater than $10,000. PMID:10644293

Dammann, M; Patel, S

1999-01-01

213

Nitrate-enhanced gated technetium 99m sestamibi SPECT for evaluating regional wall motion at baseline and during low-dose dobutamine infusion in patients with chronic coronary artery disease and left ventricular dysfunction: Comparison with two-dimensional echocardiography  

Microsoft Academic Search

Background  The value of gated single photon emission computed tomography (SPECT) in the assessment of wall motion (WM) in patients with\\u000a severe perfusion defects and in the evaluation of low-dose dobutamine (LDD)-induced changes is not yet established. In patients\\u000a with chronic coronary artery disease who have left ventricular (LV) dysfunction, the results of nitrate-enhanced technetium\\u000a 99m sestamibi (sestamibi) gated SPECT for

Mario Leoncini; Gabriella Marcucci; Roberto Sciagrà; Fabio Frascarelli; Anna Maria Traini; Dante Mondanelli; Massimo Magni; Luciano Bini; Francesco Bellandi; Alberto Mennuti; Roberto Piero Dabizzi

2000-01-01

214

Association of Physical Activity in Childhood and Early Adulthood With Carotid Artery Elasticity 21 Years Later: The Cardiovascular Risk in Young Finns Study  

PubMed Central

Background Decreased arterial elasticity is a risk factor for several cardiovascular outcomes. Longitudinal data on the effect of physical activity in youth on adult arterial elasticity are limited. The aim of this study was to determine the long?term effects of physical activity in children and young adults on carotid artery elasticity after 21 years of follow?up. Methods and Results Participants were 1417 children (aged 9 to 15 years) and 999 young adults (aged 18 to 24 years) from the prospective Cardiovascular Risk in Young Finns Study. Participants had questionnaire measures of leisure?time physical activity available from 1986 and ultrasound?derived indices of carotid artery elasticity measured in 2007. Carotid artery elasticity indices were distensibility (%/10 mm Hg), Young's elastic modulus (kPa), and stiffness index (unitless). Physical activity at age 18 to 24 years was directly associated with distensibility (?=0.068, P=0.014) and inversely with Young's elastic modulus (?=?0.057, P=0.0037) and indirectly with stiffness index (?=?0.050, P=0.0028) 21 years later in males and females. The associations remained after adjustment for age, sex, body mass index, smoking, systolic blood pressure, serum lipids and insulin, and 21?year change in physical activity. At age 9 to 15 years, the favorable association, remaining after adjustment, was found in males (distensibility [?=0.097, P=0.010], Young's elastic modulus [?=?0.060, P=0.028], and stiffness index [?=?0.062, P=0.007]) but not in females (P=0.70, P=0.85, and P=0.91, respectively). Conclusions Leisure?time physical activity in boys and young adults is associated with carotid artery elasticity later in life, suggesting that higher levels of physical activity in youth may benefit future cardiovascular health. PMID:24755150

Palve, Kristiina S.; Pahkala, Katja; Magnussen, Costan G.; Koivistoinen, Teemu; Juonala, Markus; Kahonen, Mika; Lehtimaki, Terho; Ronnemaa, Tapani; Viikari, Jorma S. A.; Raitakari, Olli T.

2014-01-01

215

Doppler-Guided Hemorrhoidal Artery Ligation for the Treatment of Symptomatic Hemorrhoids: Early and Three-Year Follow-up Results in 100 Consecutive Patients  

Microsoft Academic Search

Purpose  Doppler-guided ligation of the hemorrhoidal arteries was described as an alternative to hemorrhoidectomy. The authors report\\u000a their experience with this procedure.\\u000a \\u000a \\u000a \\u000a Methods  From 2002 to 2004, 100 consecutive patients underwent hemorrhoidal artery ligation procedure for symptomatic hemorrhoids and\\u000a were reviewed at one month and at three years.\\u000a \\u000a \\u000a \\u000a Results  There were 54 females. Seventy-eight patients had Grade III hemorrhoids. Eighteen patients had previously

Jean-Luc Faucheron; Yves Gangner

2008-01-01

216

Oral acetate supplementation after prolonged moderate intensity exercise enhances early muscle glycogen resynthesis in horses.  

PubMed

Oral acetate supplementation enhances glycogen synthesis in some mammals. However, while acetate is a significant energy source for skeletal muscle at rest in horses, its effects on glycogen resynthesis are unknown. We hypothesized that administration of an oral sodium acetate-acetic acid solution with a typical grain and hay meal after glycogen-depleting exercise would result in a rapid appearance of acetate in blood with rapid uptake by skeletal muscle. It was further hypothesized that acetate taken up by muscle would be converted to acetyl CoA (and acetylcarnitine), which would be metabolized to CO2 and water via the tricarboxylic acid cycle, generating ATP within the mitochondria and thereby allowing glucose taken up by muscle to be preferentially incorporated into glycogen. Gluteus medius biopsies and jugular venous blood were sampled from nine exercise-conditioned horses on two separate occasions, at rest and for 24 h following a competition exercise test (CET) designed to simulate the speed and endurance test of a 3 day event. After the CETs, horses were allowed water ad libitum and either 8 l of a hypertonic sodium acetate-acetic acid solution via nasogastric gavage followed by a typical hay-grain meal (acetate treatment) or a hay-grain meal alone (control treatment). The CET significantly decreased muscle glycogen concentration by 21 and 17% in the acetate and control treatments, respectively. Acetate supplementation resulted in a rapid and sustained increase in plasma [acetate]. Skeletal muscle [acetyl CoA] and [acetylcarnitine] were increased at 4 h of recovery in the acetate treatment, suggesting substantial tissue extraction of the supplemented acetate. Acetate supplementation also resulted in an enhanced rate of muscle glycogen resynthesis during the initial 4 h of the recovery period compared with the control treatment; however, by 24 h of recovery there was no difference in glycogen replenishment between trials. It is concluded that oral acetate could be an alternative energy source in the horse. PMID:19429643

Waller, Amanda P; Geor, Raymond J; Spriet, Lawrence L; Heigenhauser, George J F; Lindinger, Michael I

2009-08-01

217

Early life adversity reduces stress reactivity and enhances impulsive behavior: Implications for health behaviors  

PubMed Central

Altered reactivity to stress, either in the direction of exaggerated reactivity or diminished reactivity, may signal a dysregulation of systems intended to maintain homeostasis and a state of good health. Evidence has accumulated that diminished reactivity to psychosocial stress may signal poor health outcomes. One source of diminished cortisol and autonomic reactivity is the experience of adverse rearing during childhood and adolescence. The Oklahoma Family Health Patterns Project has examined a cohort of 426 healthy young adults with and without a family history of alcoholism. Regardless of family history, persons who had experienced high degrees of adversity prior to age 16 had a constellation of changes including reduced cortisol and heart rate reactivity, diminished cognitive capacity, and unstable regulation of affect, leading to behavioral impulsivity and antisocial tendencies. We present a model whereby this constellation of physiological, cognitive, and affective tendencies is consistent with altered central dopaminergic activity leading to changes in brain function that may foster impulsive and risky behaviors. These in turn may promote greater use of alcohol other drugs along with adopting poor health behaviors. This model provides a pathway from early life adversity to low stress reactivity that forms a basis for risky behaviors and poor health outcomes. PMID:23085387

Lovallo, William R.

2012-01-01

218

Controls on early retention and late enhancement of microporosity in reefal gas reservoirs, offshore north Sumatra basin  

SciTech Connect

Chalky lime-matrix texture is pervasive in 300 m of coralgal and skeletal carbonates in the NSB-A (North Sumatra basin-A) gas field (lower-middle Miocene), offshore northern Sumatra. Much of the reservoir quality can be attributed to matrix with abundant intercrystalline, vuggy, and channel-form micropores. Matrix is composed of calcite microrhombs which are interpreted to have developed during stabilization of the precursor mud. On the same shelf, the smaller NSB-H oil field is composed of more than 45-m thick buildup of similar lithofacies which lack abundant microporosity. In both fields, early diagenesis included dissolution of aragonitic skeletal material, matrix neomorphism, and precipitation of nonluminescent calcite followed by zoned, luminescent calcite cements. Stable isotopes from matrix reflect a more open or water-dominated matrix diagenesis at NSB-H field. More active flushing of oversaturated, organically charged meteoric waters was responsible for thorough matrix cementation and microporosity occlusion at NSB-H field. Calcite cements show progressive enrichment of iron and manganese and depletion of magnesium and strontium during growth. The matrix at NSB-H field contains iron-rich dolomite. At A field, remnant matrix microporosity and intraparticle microporosity in calcitic skeletal material were greatly enhanced after all phases of cementation. Some pore-rimming cements are partially dissolved. At NSB-H field, late-phase dissolution is limited to the vicinity of open fractures where matrix-calcite and dolomite crystals are leached. Reservoir brines have a limey marine origin but are depleted in Ca and Mg relative to seawater, and carbon dioxide accounts for 31% of reservoir gas. If present brines are carbonate undersaturated, they may be substantially enhanced microporosity at NSB-A field. Late-stage dissolution is insignificant at NSB-H field due to the lack of early formed matrix microporosity.

Moshier, S.O.

1989-03-01

219

The scavenger receptor CD36 downmodulates the early inflammatory response while enhancing bacterial phagocytosis during pneumococcal pneumonia.  

PubMed

CD36 is a scavenger receptor that exhibits pleiotropic functions, including adhesion to thrombospondin, inhibition of angiogenesis, transport of long-chain fatty acids, and clearance of apoptotic cells. In addition, it has been implicated in the host immune response because it acts as a coreceptor for TLR2 and plays a role in Staphylococcus aureus infection. However, its role in other Gram-positive bacterial infections is unclear. In this study, using mice deficient in CD36, we sought to examine the role of CD36 in pneumococcal pneumonia, a major cause of morbidity and mortality worldwide. We show that CD36 is expressed on both alveolar macrophages and respiratory epithelial cells. Early in infection, CD36(-/-) mice have an exaggerated inflammatory response compared with wild-type littermate controls. In vitro studies using CD36(-/-) primary cells confirm the enhanced early inflammation in response to S. pneumoniae and its lipoteichoic acid, demonstrate that S. pneumoniae binds to cells via its phosphocholine residues, and suggest a role for CD36 in reducing inflammation induced by the phosphocholine residues of pneumococcal lipoteichoic acid. Later in infection, although CD36(-/-) mice exhibit impaired bacterial clearance, owing to a decreased capacity of CD36(-/-) macrophages to phagocytose S. pneumoniae, minor effects on mortality occur, in comparison with those in wild-type littermate control mice. These data show that CD36 contributes to the pulmonary host response during S. pneumoniae infection by virtue of its ability to act as a phagocytic receptor and as a modulator of the early innate immune response. PMID:23610144

Sharif, Omar; Matt, Ulrich; Saluzzo, Simona; Lakovits, Karin; Haslinger, Isabella; Furtner, Tanja; Doninger, Bianca; Knapp, Sylvia

2013-06-01

220

Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning  

Microsoft Academic Search

Exercise electrocardiography and thallium scanning were performed a mean of 24 days after uncomplicated acute myocardial infarction in 103 patients, aged 36 to 60 years, who also underwent coronary angiography. The purpose of the study was to determine the ability of the noninvasive tests to predict multivessel coronary artery disease (CAD) and prognosis. Patients were followed up to document medical

R. D. Abraham; S. B. Freedman; R. F. Dunn; H. Newman; G. S. Roubin; P. J. Harris; D. T. Kelly

1986-01-01

221

Early Detection of Cerebral Arterial Occlusion on Magnetic Resonance Angiography: Predictive Value of the Baseline NIHSS Score and Impact on Neurological Outcome  

Microsoft Academic Search

The presence of a thrombus on initial arteriography is directly related to the baseline NIHSS score. Magnetic resonance angiography (MRA) offers a noninvasive and rapid assessment of large cerebral vessel patency. We aimed at evaluating (1) the baseline NIHSS score as a tool for predicting the likelihood of an occluded artery on MRA and (2) the course of stroke within

L. Derex; N. Nighoghossian; M. Hermier; P. Adeleine; J. C. Froment; P. Trouillas

2002-01-01

222

Human cytomegalovirus immediate early protein 2 enhances myocardin-mediated survival of rat aortic smooth muscle cells.  

PubMed

Human cytomegalovirus (HCMV) may increase the incidence of restenosis and predispose to atherosclerosis. The lesions of restenosis and atherosclerosis often contain smooth muscle cells (SMCs) with high rates of proliferation and apoptosis. One of the immediate early (IE) gene products of HCMV-IE2 affects transcriptional activities of some cellular factors in SMCs, including myocardin. In this study, we studied the effects of IE2 and myocardin on PI3K pathway inducer wortmannin induced apoptosis in rat aortic SMCs. We show that the transcriptional activity of myocardin on Mcl-1 promoter is enhanced by co-expression of HCMV IE2 in rat aortic SMCs; and the expressions of mRNA and protein of antiapoptotic genes-Mcl-1 and Bcl-2 are upregulated by IE2 alone and co-transfection of myocardin and IE2, but decreased by myocardin-specific shRNA in rat aortic SMCs. We further demonstrate that co-expression of myocardin and HCMV IE2 declines apoptotic cell numbers and caspase-3 activities induced by serum starvation plus wortmannin in rat aortic SMCs. The results suggest that HCMV IE2 enhances myocardin-mediated survival of rat aortic SMCs under serum deprivation and PI3-kinase inhibition, partly via activation of Mcl-1's antiapoptosis effect. Our study connects HCMV IE2 to myocardin-induced transcriptional program for rat aortic SMCs survival and proliferation, involving in HCMV related restenosis and atherosclerosis. PMID:25157858

Liao, Xing-Hua; Dong, Xiumei; Wu, Chenyu; Wang, Tao; Liu, Fenyong; Zhou, Jun; Zhang, Tong-Cun

2014-11-01

223

RNA-Seq defines novel genes, RNA processing patterns and enhancer maps for the early stages of nephrogenesis: Hox supergenes  

PubMed Central

During kidney development the cap mesenchyme progenitor cells both self renew and differentiate into nephrons. The balance between renewal and differentiation determines the final nephron count, which is of considerable medical importance. An important goal is to create a precise genetic definition of the early differentiation of cap mesenchyme progenitors. We used RNA-Seq to transcriptional profile the cap mesenchyme progenitors and their first epithelial derivative, the renal vesicles. The results provide a global view of the changing gene expression program during this key period, defining expression levels for all transcription factors, growth factors, and receptors. The RNA-Seq was performed using two different biochemistries, with one examining only polyadenylated RNA and the other total RNA. This allowed the analysis of noncanonical transcripts, which for many genes were more abundant than standard exonic RNAs. Since a large fraction of enhancers are now known to be transcribed the results also provide global maps of potential enhancers. Further, the RNA-Seq data defined hundreds of novel splice patterns and large numbers of new genes. Particularly striking was the extensive sense/antisense transcription and changing RNA processing complexities of the Hox clusters. PMID:22664176

Brunskill, Eric W; Potter, S. Steven

2012-01-01

224

Otx2 and Oct4 Drive Early Enhancer Activation during Embryonic Stem Cell Transition from Naive Pluripotency  

PubMed Central

Summary Embryonic stem cells (ESCs) are unique in that they have the capacity to differentiate into all of the cell types in the body. We know a lot about the complex transcriptional control circuits that maintain the naive pluripotent state under self-renewing conditions but comparatively less about how cells exit from this state in response to differentiation stimuli. Here, we examined the role of Otx2 in this process in mouse ESCs and demonstrate that it plays a leading role in remodeling the gene regulatory networks as cells exit from ground state pluripotency. Otx2 drives enhancer activation through affecting chromatin marks and the activity of associated genes. Mechanistically, Oct4 is required for Otx2 expression, and reciprocally, Otx2 is required for efficient Oct4 recruitment to many enhancer regions. Therefore, the Oct4-Otx2 regulatory axis actively establishes a new regulatory chromatin landscape during the early events that accompany exit from ground state pluripotency. PMID:24931607

Yang, Shen-Hsi; Kalkan, Tuzer; Morissroe, Claire; Marks, Hendrik; Stunnenberg, Hendrik; Smith, Austin; Sharrocks, Andrew D.

2014-01-01

225

Prognostic value of blood flow estimated by arterial spin labeling and dynamic susceptibility contrast-enhanced MR imaging in high-grade gliomas.  

PubMed

Several studies evaluated the predictive value of dynamic susceptibility contrast enhanced (DSC) imaging and arterial spin labeling (ASL) with regard to histological grade. Yet still less is known about their significance in terms of patients prognosis. Our purpose was to evaluate the agreement between them and the prognostic value of ASL- and DSC-CBF measurements for time-to-recurrence (TTR). Sixty nine cases of WHO Grade 3-4 gliomas underwent both DSC- and ASL-MRI. Normalized ASL and DSC-based cerebral blood flow (CBF) maps as well as DSC-derived cerebral blood volume maps (CBV) were analyzed. Wilcoxon test and Bland-Altman plot analysis were applied in order to compare DSC-rCBF and ASL-rCBF. Spearman's rank correlation coefficients were determined for all perfusion parameters. Receiver operating characteristic (ROC) curve and survival curve analyses were performed. The median values of ASL-rCBF, DSC-rCBF, and DSC-rCBV were 5.3, 6.9, and 8.0, respectively. There was neither significant correlation nor difference between ASL-rCBF and DSC-rCBF. Slight proportional bias was demonstrated in the Bland-Altman plot analysis of ASL-rCBF and DSC-rCBF values. Unlikely to DSC-rCBV, DSC- and ASL-based rCBF parameters demonstrated moderate sensitivity and specifitity for tumor recurrence but no statistical significance regarding their prognostic values for TTR in the Kaplan-Meier analysis. There were neither correlation nor interchangeability between the DSC-rCBF and ASL-rCBF estimations, which demonstrated comparable, though not significant prognostic value for the prediction of TTR. rCBV measurements seem to provide the best sensitivity and specificity to predict tumor recurrence and survival time in these patients. PMID:25154323

Rau, Mandy Kim; Braun, Christian; Skardelly, Marco; Schittenhelm, Jens; Paulsen, Frank; Bender, Benjamin; Ernemann, Ulrike; Bisdas, Sotirios

2014-12-01

226

Dynamic contrast-enhanced MRI-based early detection of acute renal transplant rejection.  

PubMed

A novel framework for the classification of acute rejection versus nonrejection status of renal transplants from 2-D dynamic contrast-enhanced magnetic resonance imaging is proposed. The framework consists of four steps. First, kidney objects are segmented from adjacent structures with a level set deformable boundary guided by a stochastic speed function that accounts for a fourth-order Markov-Gibbs random field model of the kidney/background shape and appearance. Second, a Laplace-based nonrigid registration approach is used to account for local deformations caused by physiological effects. Namely, the target kidney object is deformed over closed, equispaced contours (iso-contours) to closely match the reference object. Next, the cortex is segmented as it is the functional kidney unit that is most affected by rejection. To characterize rejection, perfusion is estimated from contrast agent kinetics using empirical indexes, namely, the transient phase indexes (peak signal intensity, time-to-peak, and initial up-slope), and a steady-phase index defined as the average signal change during the slowly varying tissue phase of agent transit. We used a kn-nearest neighbor classifier to distinguish between acute rejection and nonrejection. Performance of our method was evaluated using the receiver operating characteristics (ROC). Experimental results in 50 subjects, using a combinatoric kn-classifier, correctly classified 92% of training subjects, 100% of the test subjects, and yielded an area under the ROC curve that approached the ideal value. Our proposed framework thus holds promise as a reliable noninvasive diagnostic tool. PMID:23797240

Khalifa, Fahmi; Beache, Garth M; El-Ghar, Mohamed Abou; El-Diasty, Tarek; Gimel'farb, Georgy; Kong, Maiying; El-Baz, Ayman

2013-10-01

227

Is social isolation\\/alienation confounded with, and non-independent of, emotional distress in its association with early onset of coronary artery disease?  

Microsoft Academic Search

Both emotional distress (ED) and social isolation\\/alienation (SI\\/A) have been found to prospectively predict adverse cardiac events, but few studies have tested the confounding\\/redundancy of these measures as correlates\\/predictors of outcomes. In this study, 163 patients with documented coronary artery disease (CAD) were interviewed for multiple indices of SI\\/A and administered the Symptom Checklist 90 – Revised (SCL90R). A spouse

Mark Ketterer; Benjamin Rose; Walter Knysz; Amjad Farha; Sangita Deveshwar; John Schairer; Steven J. Keteyian

2011-01-01

228

Enhance  

NSDL National Science Digital Library

It doesn't take a Photoshop expert to create attractive graphics for the Web. To prove this, the folks at MicroFrontier have released three graphic creation/editing packages for the Macintosh, each aimed at a different user level. All three applications support Photoshop 3.0 compatible plug-ins and basic features such as scanner support, image and resolution scaling, and basic image enhancement. Enhance, aimed at the graphics professionals, adds even more features, including multiple layers, opacity control, sixteen levels of undo, convolution filter effects, and CYMK support. A save-disabled demo version of each application is available at the MicroFrontier Website. The price for Enhance is $100 .

1998-01-01

229

Hepatic Arterial Phase on Gadoxetic Acid-Enhanced Liver MR Imaging: A Randomized Comparison of 0.5 mL/s and 1 mL/s Injection Rates  

PubMed Central

Objective To compare gadoxetic acid injection rates of 0.5 mL/s and 1 mL/s for hepatic arterial-phase magnetic resonance (MR) imaging. Materials and Methods In this prospective study, 101 consecutive patients with suspected focal liver lesions were included and randomly divided into two groups. Each group underwent dynamic liver MR imaging using a 3.0-T scanner after an intravenous injection of gadoxetic acid at rates of either 0.5 mL/s (n = 50) or 1 mL/s (n = 51). Arterial phase images were analyzed after blinding the injection rates. The signal-to-noise ratios (SNRs) of the liver, aorta, portal vein, hepatic vein, spleen, and pancreas were measured. The contrast-to-noise ratios (CNRs) of the hepatocellular carcinomas (HCC) were calculated. Finally, two experienced radiologists were independently asked to identify, if any, HCCs in the liver on the images and score the image quality in terms of the presence of artifacts and the proper enhancement of the liver, aorta, portal vein, hepatic vein, hepatic artery, spleen, pancreas, and kidney. Results The SNRs were not significantly different between the groups (p = 0.233-0.965). The CNRs of the HCCs were not significantly different (p = 0.597). The sensitivity for HCC detection and the image quality scores were not significantly different between the two injection rates (p = 0.082-1.000). Conclusion Image quality and sensitivity for hepatic HCCs of arterial-phase gadoxetic acid-enhanced MR were not significantly improved by reducing the contrast injection rate to 0.5 mL/s compared with 1 mL/s. PMID:25246821

Kim, Sung Mo; Heo, Suk Hee; Kim, Jin Woong; Lim, Hyo Soon; Shin, Sang Soo; Kang, Heoung Keun

2014-01-01

230

Arterial embolism  

MedlinePLUS

... side of the heart and passes through a hole into the left side. The clot can then ... the affected artery Shedding (sloughing) of skin Skin erosion ( ulcer ) Tissue death (necrosis; skin is dark and ...

231

The enhanced value of combining conventional and 'omics' analyses in early assessment of drug-induced hepatobiliary injury  

SciTech Connect

The InnoMed PredTox consortium was formed to evaluate whether conventional preclinical safety assessment can be significantly enhanced by incorporation of molecular profiling ('omics') technologies. In short-term toxicological studies in rats, transcriptomics, proteomics and metabolomics data were collected and analyzed in relation to routine clinical chemistry and histopathology. Four of the sixteen hepato- and/or nephrotoxicants given to rats for 1, 3, or 14 days at two dose levels induced similar histopathological effects. These were characterized by bile duct necrosis and hyperplasia and/or increased bilirubin and cholestasis, in addition to hepatocyte necrosis and regeneration, hepatocyte hypertrophy, and hepatic inflammation. Combined analysis of liver transcriptomics data from these studies revealed common gene expression changes which allowed the development of a potential sequence of events on a mechanistic level in accordance with classical endpoint observations. This included genes implicated in early stress responses, regenerative processes, inflammation with inflammatory cell immigration, fibrotic processes, and cholestasis encompassing deregulation of certain membrane transporters. Furthermore, a preliminary classification analysis using transcriptomics data suggested that prediction of cholestasis may be possible based on gene expression changes seen at earlier time-points. Targeted bile acid analysis, based on LC-MS metabonomics data demonstrating increased levels of conjugated or unconjugated bile acids in response to individual compounds, did not provide earlier detection of toxicity as compared to conventional parameters, but may allow distinction of different types of hepatobiliary toxicity. Overall, liver transcriptomics data delivered mechanistic and molecular details in addition to the classical endpoint observations which were further enhanced by targeted bile acid analysis using LC/MS metabonomics.

Ellinger-Ziegelbauer, Heidrun, E-mail: heidrun.ellinger-ziegelbauer@bayerhealthcare.com [Bayer Schering Pharma AG, Wuppertal (Germany); Adler, Melanie [University of Wuerzburg, Wuerzburg (Germany); Amberg, Alexander [Sanofi aventis R and D, Disposition, Safety and Animal Research, Frankfurt (Germany); Brandenburg, Arnd [Genedata AG, Basel (Switzerland); Callanan, John J. [UCD School of Biomolecular and Biomedical Science and School of Agriculture, Food Science and Veterinary Medicine, UCD Conway Institute, University College Dublin, Dublin (Ireland); Connor, Susan [MetaPro (United Kingdom); Fountoulakis, Michael [Hoffmann-La Roche AG, Basel (Switzerland); Gmuender, Hans [Genedata AG, Basel (Switzerland); Gruhler, Albrecht [Novo Nordisk A/S, Maaloev (Denmark); Hewitt, Philip [Merck KGaA Darmstadt (Germany); Hodson, Mark [MetaPro (United Kingdom); Matheis, Katja A. [Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach (Germany); McCarthy, Diane [Bio-Rad, Laboratories, Hercules, CA (United States); Raschke, Marian; Riefke, Bjoern [Bayer Schering Pharma AG, Berlin (Germany); Schmitt, Christina S. [Merck KGaA Darmstadt (Germany); Sieber, Max [University of Wuerzburg, Wuerzburg (Germany); Sposny, Alexandra [Merck KGaA Darmstadt (Germany); Suter, Laura [Hoffmann-La Roche AG, Basel (Switzerland); Sweatman, Brian [MetaPro (United Kingdom)

2011-04-15

232

Enhanced contractility in pregnancy is associated with augmented TRPC3, L-type, and T-type voltage-dependent calcium channel function in rat uterine radial artery.  

PubMed

In pregnancy, ?-adrenoceptor-mediated vasoconstriction is augmented in uterine radial arteries and is accompanied by underlying changes in smooth muscle (SM) Ca(2+) activity. This study aims to determine the Ca(2+) entry channels associated with altered vasoconstriction in pregnancy, with the hypothesis that augmented vasoconstriction involves transient receptor potential canonical type-3 (TRPC3) and L- and T-type voltage-dependent Ca(2+) channels. Immunohistochemistry showed TRPC3, L-type Cav1.2 (as the ?1C subunit), T-type Cav3.1 (?1G), and Cav3.2 (?1H) localization to the uterine radial artery SM. Fluorescence intensity of TRPC3, Cav1.2, and Cav3.2 was increased, and Cav3.1 decreased in radial artery SM from pregnant rats. Western blot analysis confirmed increased TRPC3 protein expression in the radial artery from pregnant rats. Pressure myography incorporating pharmacological intervention to examine the role of these channels in uterine radial arteries showed an attenuation of phenylephrine (PE)-induced constriction with Pyr3 {1-[4-[(2,3,3-trichloro-1-oxo-2-propen-1-yl)amino]phenyl]-5-(trifluoromethyl)-1H-pyrazole-4-carboxylic acid}-mediated TRPC3 inhibition or with nifedipine-mediated L-type channel block alone in vessels from pregnant rats; both effects of which were diminished in radial arteries from nonpregnant rats. Combined TRPC3 and L-type inhibition attenuated PE-induced constriction in radial arteries, and the residual vasoconstriction was reduced and abolished with T-type channel block with NNC 55-0396 in arteries from nonpregnant and pregnant rats, respectively. With SM Ca(2+) stores depleted and in the presence of PE, nifedipine, and NNC 55-0396, blockade of TRPC3 reversed PE-induced constriction. These data suggest that TRPC3 channels act synergistically with L- and T-type channels to modulate radial artery vasoconstriction, with the mechanism being augmented in pregnancy. PMID:23948776

Senadheera, Sevvandi; Bertrand, Paul P; Grayson, T Hilton; Leader, Leo; Tare, Marianne; Murphy, Timothy V; Sandow, Shaun L

2013-10-15

233

Arterial input function of an optical tracer for dynamic contrast enhanced imaging can be determined from pulse oximetry oxygen saturation measurements.  

PubMed

In many cases, kinetic modeling requires that the arterial input function (AIF)--the time-dependent arterial concentration of a tracer--be characterized. A straightforward method to measure the AIF of red and near-infrared optical dyes (e.g., indocyanine green) using a pulse oximeter is presented. The method is motivated by the ubiquity of pulse oximeters used in both preclinical and clinical applications, as well as the gap in currently available technologies to measure AIFs in small animals. The method is based on quantifying the interference that is observed in the derived arterial oxygen saturation (SaO?) following a bolus injection of a light-absorbing dye. In other words, the change in SaO? can be converted into dye concentration knowing the chromophore-specific extinction coefficients, the true arterial oxygen saturation, and total hemoglobin concentration. A simple error analysis was performed to highlight potential limitations of the approach, and a validation of the method was conducted in rabbits by comparing the pulse oximetry method with the AIF acquired using a pulse dye densitometer. Considering that determining the AIF is required for performing quantitative tracer kinetics, this method provides a flexible tool for measuring the arterial dye concentration that could be used in a variety of applications. PMID:23190567

Elliott, Jonathan T; Wright, Eric A; Tichauer, Kenneth M; Diop, Mamadou; Morrison, Laura B; Pogue, Brian W; Lee, Ting-Yim; St Lawrence, Keith

2012-12-21

234

Arterial input function of an optical tracer for dynamic contrast enhanced imaging can be determined from pulse oximetry oxygen saturation measurements  

NASA Astrophysics Data System (ADS)

In many cases, kinetic modeling requires that the arterial input function (AIF)—the time-dependent arterial concentration of a tracer—be characterized. A straightforward method to measure the AIF of red and near-infrared optical dyes (e.g., indocyanine green) using a pulse oximeter is presented. The method is motivated by the ubiquity of pulse oximeters used in both preclinical and clinical applications, as well as the gap in currently available technologies to measure AIFs in small animals. The method is based on quantifying the interference that is observed in the derived arterial oxygen saturation (SaO2) following a bolus injection of a light-absorbing dye. In other words, the change in SaO2 can be converted into dye concentration knowing the chromophore-specific extinction coefficients, the true arterial oxygen saturation, and total hemoglobin concentration. A simple error analysis was performed to highlight potential limitations of the approach, and a validation of the method was conducted in rabbits by comparing the pulse oximetry method with the AIF acquired using a pulse dye densitometer. Considering that determining the AIF is required for performing quantitative tracer kinetics, this method provides a flexible tool for measuring the arterial dye concentration that could be used in a variety of applications.

Elliott, Jonathan T.; Wright, Eric A.; Tichauer, Kenneth M.; Diop, Mamadou; Morrison, Laura B.; Pogue, Brian W.; Lee, Ting-Yim; St. Lawrence, Keith

2012-12-01

235

Development of fluorescent reporter tagged RIB gene cassettes for replicative transformation, early expression, and enhanced riboflavin production in Eremothecium ashbyi.  

PubMed

Eremothecium ashbyi is a riboflavin overproducing filamentous fungus in which the metabolic pathways have not been genetically characterized. Two genes of the riboflavin biosynthetic (RIB) pathway, RIB1 and RIB3, which encode GTP-cyclohydrolase II (GCH II) and 3,4-dihydroxy-2-butanone 4-phosphate (DHBP) synthase respectively, were selected for the present study. The two RIB genes under their native promoters were obtained from Ashbya gossypii genomic library. Yeast enhanced green fluorescent protein (yEGFP) and mCherry genes were tagged to the C-terminal ends of RIB1 and RIB3 genes to analyse the functionality of the RIB transgenes in E. ashbyi. Shuttle vectors with the reporter tagged RIB genes contained the Escherichia coli kan(R) gene and Saccharomyces cerevisiae ARS element. On transformation with these plasmids, the ARS element was found to be functional in E. ashbyi. The E. ashbyi transcription factors could recognize the Ashbya RIB gene promoters and express the reporter tagged RIB genes as cytoplasmic proteins, in early cell development. Replicative transformants carrying RIB1-mCherry plasmids showed 2.95 times more GCH II activity and 2.44 times more riboflavin production when compared to untransformed. This is the first report of genetic transformation of E. ashbyi and is of significance as the first step towards genetic engineering of this genus. PMID:23063183

Sengupta, Sudeshna; Kaufmann, Andreas; Chandra, T S

2012-10-01

236

Rapidly in situ forming platelet-rich plasma gel enhances angiogenic responses and augments early wound healing after open abdomen.  

PubMed

Objective. The purposes of our present study were to evaluate the potential of platelet-rich plasma gel to enhance granulation tissue formation after open abdomen and to examine whether the effect was attributable to stimulating rapid neovascularization. Methods. Twenty-four rats underwent colon ascendens stent peritonitis surgery to induce sepsis, followed by intraperitoneal injection of nitrogen to create intra-abdominal hypertension. Four hours later, laparotomies were performed. The rats were randomized into three groups (n = 8 for each group): control, platelet-poor plasma (PPP), and platelet-rich plasma (PRP) groups. One week after the treatment, granulation tissue formation and angiogenesis were evaluated by histological and laser Doppler analysis. Results. The resultant platelet count in platelet-rich plasma was higher than that of PPP. The concentrations of platelet-derived growth factor BB, transforming growth factor ? -1, and vascular endothelial growth factor in PRP were significantly higher when compared with that of PPP. Myofibroblast count, granulation tissue thickness, vessel numbers, and blood perfusion were increased in PRP group, followed by PPP group, with control being the least. Conclusion. Rapidly in situ forming platelet-rich plasma gel promoted remarkable neovascularization and early wound healing after open abdomen and may lead to novel and effective treatments for open abdominal wounds. PMID:24382956

Zhou, Bo; Ren, Jianan; Ding, Chao; Wu, Yin; Hu, Dong; Gu, Guosheng; Li, Jieshou

2013-01-01

237

Rapidly In Situ Forming Platelet-Rich Plasma Gel Enhances Angiogenic Responses and Augments Early Wound Healing after Open Abdomen  

PubMed Central

Objective. The purposes of our present study were to evaluate the potential of platelet-rich plasma gel to enhance granulation tissue formation after open abdomen and to examine whether the effect was attributable to stimulating rapid neovascularization. Methods. Twenty-four rats underwent colon ascendens stent peritonitis surgery to induce sepsis, followed by intraperitoneal injection of nitrogen to create intra-abdominal hypertension. Four hours later, laparotomies were performed. The rats were randomized into three groups (n = 8 for each group): control, platelet-poor plasma (PPP), and platelet-rich plasma (PRP) groups. One week after the treatment, granulation tissue formation and angiogenesis were evaluated by histological and laser Doppler analysis. Results. The resultant platelet count in platelet-rich plasma was higher than that of PPP. The concentrations of platelet-derived growth factor BB, transforming growth factor ?-1, and vascular endothelial growth factor in PRP were significantly higher when compared with that of PPP. Myofibroblast count, granulation tissue thickness, vessel numbers, and blood perfusion were increased in PRP group, followed by PPP group, with control being the least. Conclusion. Rapidly in situ forming platelet-rich plasma gel promoted remarkable neovascularization and early wound healing after open abdomen and may lead to novel and effective treatments for open abdominal wounds. PMID:24382956

Wu, Yin; Hu, Dong; Gu, Guosheng; Li, Jieshou

2013-01-01

238

Valproic acid enhances early development of bovine somatic cell nuclear transfer embryos by alleviating endoplasmic reticulum stress.  

PubMed

Despite the positive roles of histone deacetylase inhibitors in somatic cell nuclear transfer (SCNT), few studies have evaluated valproic acid (VPA) and its associated developmental events. Thus, the present study was conducted to elucidate the effect of VPA on the early development of bovine SCNT embryos and the underlying mechanisms of action. The histone acetylation level of SCNT embryos was successfully restored by VPA, with optimal results obtained by treatment with 3mM VPA for 24h. Importantly, the increases in blastocyst formation rate and inner cell mass and trophectoderm cell numbers were not different between the VPA and trichostatin A treatment groups, whereas cell survival was notably improved by VPA, indicating the improvement of developmental competence of SCNT embryos by VPA. Interestingly, VPA markedly reduced the transcript levels of endoplasmic reticulum (ER) stress markers, including sXBP-1 and CHOP. In contrast, the levels of GRP78/BiP, an ER stress-alleviating transcript, were significantly increased by VPA. Furthermore, VPA greatly reduced cell apoptosis in SCNT blastocysts, which was further evidenced by the increased levels of the anti-apoptotic transcript Bcl-xL and decreased level of the pro-apoptotic transcript Bax. Collectively, these results suggest that VPA enhances the developmental competence of bovine SCNT embryos by alleviating ER stress and its associated developmental damage. PMID:23506644

Song, Bong-Seok; Yoon, Seung-Bin; Sim, Bo-Woong; Kim, Young-Hyun; Cha, Jae-Jin; Choi, Seon-A; Jeong, Kang-Jin; Kim, Ji-Su; Huh, Jae-Won; Lee, Sang-Rae; Kim, Sang-Hyun; Kim, Sun-Uk; Chang, Kyu-Tae

2014-03-01

239

Medicago truncatula plants overexpressing the early nodulin gene enod40 exhibit accelerated mycorrhizal colonization and enhanced formation of arbuscules  

PubMed Central

The mutualistic symbiosis between flowering plants and arbuscular mycorrhizal fungi is extremely abundant in terrestrial ecosystems. In this symbiosis, obligately biotrophic fungi colonize the root of the host plants, which can benefit from these fungi by enhanced access to mineral nutrients in the soil, especially phosphorus. One of the main goals of research on this symbiosis is to find plant genes that control fungal development in the host plant. In this work, we show that mycorrhizal colonization is regulated by enod40, an early nodulin gene known to be involved in the nodule symbiosis of legumes with nitrogen-fixing bacteria. Medicago truncatula plants overexpressing enod40 exhibited stimulated mycorrhizal colonization in comparison with control plants. Overexpression of enod40 promoted fungal growth in the root cortex and increased the frequency of arbuscule formation. Transgenic lines with suppressed levels of enod40 transcripts, likely via a cosuppression phenomenon induced by the transgene, exhibited reduced mycorrhizal colonization. Hence, enod40 might be a plant regulatory gene involved in the control of the mycorrhizal symbiosis. PMID:11752473

Staehelin, Christian; Charon, Celine; Boller, Thomas; Crespi, Martin; Kondorosi, Adam

2001-01-01

240

Enhancement of voltage-gated K+ channels and depression of voltage-gated Ca2+ channels are involved in quercetin-induced vasorelaxation in rat coronary artery.  

PubMed

Quercetin is one of the most common flavonoids in the human daily diet. Its affects the coronary artery, especially L-type voltage-gated Ca2+ channels and voltage-gated K+ channels in the arterial smooth muscle cells, which are poorly understood. The present experiments were designed to study the myogenic effect of quercetin and its possible underlying mechanisms in the rat coronary artery. A wire myograph was used to observe the myogenic effects. Arterial smooth muscle cells were freshly isolated from the rat coronary artery and the intracellular free Ca2+ concentration was measured with molecular probe fluo-4-AM. The effects of quercetin on L-type voltage-gated Ca2+ channels and voltage-gated K+ channels were studied using a whole-cell patch clamp. Quercetin (3-30?µM) produced a depression and relaxation on the contraction induced by KCl or the thromboxane A2 analog 9,11-Dideoxy-9?,11?-methanoepoxy prostaglandin F 2? . The vasorelaxation was attenuated by 4-aminopyridine, a specific voltage-gated K+ channel inhibitor, but was not affected by the NG-nitro-L-arginine methylester ester (a nitric oxide synthesis inhibitor), glibenclamide (a ATP-activated K+ channel inhibitor), iberiotoxin (a Ca2+-activated K+ channel inhibitor), BaCl2 (an inward rectifier K+ channel inhibitor), or by endothelium denudation. At the same concentrations, quercetin reduced the KCl-induced elevation of the intracellular free Ca2+ concentration, inhibited the inward Ca2+ currents through L-type voltage-gated Ca2+ channels, and increased the outward K+ currents through voltage-gated K+ channels in the rat coronary artery smooth muscle cells. Collectively, our results demonstrate that quercetin possesses vasospasmolytic effects in RCA and suggest that depression of the Ca2+ influx through L-type voltage-gated Ca2+ channels and augmentation of voltage-gated K+ channel activity in the myocytes may underlie coronary relaxation. PMID:24710898

Hou, Xiaomin; Liu, Yu; Niu, Longgang; Cui, Lijuan; Zhang, Mingsheng

2014-04-01

241

Surgical Treatment of Coronary Artery Anomalies  

PubMed Central

The surgical treatment of coronary artery anomalies continues to evolve. The most common coronary artery anomalies requiring surgical intervention include coronary artery fistulae, anomalous pulmonary origins of the coronary arteries, and anomalous aortic origins of the coronary arteries. The choice of surgical intervention for each type of coronary anomaly depends on several anatomic, physiologic, and patient-dependent variables. As surgical techniques have progressed, outcomes have continued to improve; however, controversy still exists about many aspects of the proper management of patients who have these coronary artery anomalies. We reviewed the surgical treatment of 178 patients who underwent surgery for the above-mentioned types of coronary artery anomalies at the Texas Heart Institute from December 1963 through June 2001. On the basis of this experience, we discuss historical aspects of the early treatment of these anomalies and describe their present-day management. (Tex Heart Inst J 2002;29:299–307) PMID:12484614

Reul, Ross M.; Cooley, Denton A.; Hallman, Grady L.; Reul, George J.

2002-01-01

242

Expression of ? 2 -macroglobulin, neutrophil elastase, and interleukin-1? differs in early-stage and late-stage atherosclerotic lesions in the arteries of the circle of Willis  

Microsoft Academic Search

Different types of atherosclerotic (AS) lesions can be distinguished histologically and represent different stages of AS plaque development. Late-stage lesions more frequently develop complications such as plaque rupture and thrombosis with vessel occlusion than early AS lesions. To clarify whether protective, destructive, and inflammatory proteins are differentially expressed in early-stage and late-stage AS plaques we examined the proteinase inhibitor ?2-macroglobulin

Sergey Larionov; Oliver Dedeck; Gerd Birkenmeier; Dietmar Rudolf Thal

2007-01-01

243

Human bone marrow mesenchymal stem/stromal cells produce efficient localization in the brain and enhanced angiogenesis after intra-arterial delivery in rats with cerebral ischemia, but this is not translated to behavioral recovery.  

PubMed

Intravascular cell therapy is a promising approach for the treatment of stroke. However, high accumulation of cells to lungs and other filtering organs is a major concern after intravenous (i.v.) cell transplantation. This can be circumvented by intra-arterial (i.a.) cell infusion, which improves homing of cells to the injured brain. We studied the effect of i.a. delivery of human bone marrow-derived mesenchymal cells (BMMSCs) on behavioral and histological outcome in rats after middle cerebral artery occlusion (MCAO). Sixty male Wistar rats were subjected to transient MCAO (60 min) or sham-operation. BMMSCs (1×10(6)) were infused into the external carotid artery on postoperative day 2 or 7. Histology performed after a 42-day follow-up did not detect any human cells (MAB1281) in the ischemic brain. Endothelial cell staining with RECA-1 revealed a significant increase in the number of blood vessels in the perilesional cortex in MCAO rats treated with cells on postoperative day 7. Behavioral recovery as assessed in three tests, sticky label, cylinder and Montoya's staircase, was not improved by human BMMSCs during the follow-up. In conclusion, human BMMSCs did not improve functional recovery in MCAO rats despite effective initial homing to the ischemic hemisphere and enhanced angiogenesis, when strict behavioral tests not affected by repeated testing and compensation were utilized. PMID:24177208

Mitkari, Bhimashankar; Nitzsche, Franziska; Kerkelä, Erja; Kuptsova, Kristina; Huttunen, Joanna; Nystedt, Johanna; Korhonen, Matti; Jolkkonen, Jukka

2014-02-01

244

Large vessel vasculitis in elderly patients: early diagnosis and steroid-response evaluation with FDG-PET/CT and contrast-enhanced CT.  

PubMed

Large vessel vasculitis (LVV) is an often-reported cause of inflammation of unknown origin (IUO) in elderly people. The objective of this study was to describe the usefulness of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and contrast-enhanced CT in early diagnosis and treatment follow-up of patients with LVV presenting as elderly onset IUO. We retrospectively compared contrast-enhanced CT findings and FDG-PET/CT findings of the patients diagnosed with LVV and 11 controls; all subjects were 50 years of age or older. We evaluated maximum standardised uptake value (SUVmax) and PET score of the aortic wall for quantitative comparison of FDG-PET/CT findings. We measured the aortic wall thickness (W) and its ratio against the radius (W/R) for quantitative comparison of aortic wall thickening by contrast-enhanced CT. After steroid treatment, we compared these values with those pre-treatment. Of 124 patients who were hospitalised due to advanced age and IUO, 88 underwent FDG-PET/CT and contrast-enhanced CT. Abnormal findings were observed on images from 78 patients. The findings were indicative of LVV in 13 patients (10.5 %), of whom more than half had only non-specific symptoms. Patients with LVV had significantly higher aortic wall SUVmax (3.85 vs. 1.95), PET scores by FDG-PET/CT, and aortic wall thicknesses by contrast-enhanced CT (3.8 vs. 2.6 mm) than controls. Significant improvement in aortic wall thickening was evidenced by reduced PET scores and by contrast-enhanced CT findings in patients who were followed up after treatment. LVV is an important cause of IUO with non-specific symptoms in elderly patients. Imaging examination comprising contrast-enhanced CT and FDG-PET/CT is useful for early diagnosis and early treatment evaluation of LVV, allowing for amelioration of reversible aortic wall thickening. PMID:24643395

Muto, Go; Yamashita, Hiroyuki; Takahashi, Yuko; Miyata, Yoko; Morooka, Miyako; Minamimoto, Ryogo; Kubota, Kazuo; Kaneko, Hiroshi; Kano, Toshikazu; Mimori, Akio

2014-11-01

245

Detection of neuroendocrine tumours in the small intestines using contrast-enhanced multiphase Ga-68 DOTATOC PET/CT: the potential role of arterial hyperperfusion  

PubMed Central

Background Interpretation of small intestinal neuroendocrine tumours (NETs) by Ga-68 DOTATOC PET/CT can be difficult. The potential benefit of arterial hyperperfusion for the detection of NETs was evaluated. Methods Between 2006 and 2009, 320 consecutive Ga-68 DOTATOC PET/CT examinations, performed for NETs, revealed 40 lesions suggesting intestinal NETs in 25 patients. Two groups of lesions were distinguished: epigastric lesions evaluable in the arterial and venous CT scan (Group 1) and hypogastrial lesions evaluable in the venous CT scan only (Group 2). Lesions were jointly rated by two radiologists and a nuclear medicine physician. Maximum standard uptake values (SUVmax) of lesions and background were assessed. The reference standard was histology (available for 28 lesions) or follow-up (for a mean of 22.9 months). Results PET detected all suspicious lesions but was false positive in 3 lesions. In Group 1 the arterial scan performed significantly better than the venous scan (p = 0.008). Diagnostic performance was better in Group 1 than in Group 2 (p < 0.001). SUVmax of true positive lesions were significantly higher than background SUVmax (p < 0.001) and SUVmax of false positive lesions (p = 0.005). Conclusions The arterial phase of multiphase Ga-68 DOTATOC PET/CT might improve the localization of intestinal NETs and, thereby, improve the overall diagnostic accuracy of this modality in the assessment of intestinal NETs by adding information about lesion perfusion not available when only venous CT is performed. PMID:24991201

Schreiter, Nils F.; Maurer, Martin; Pape, Ulrich-Frank; Hamm, Bernd; Brenner, Winfried; Froeling, Vera

2014-01-01

246

Is Computerized Tomography Angiographic Surveillance Valuable for Prevention of Tracheoinnominate Artery Fistula, a Life-Threatening Complication after Tracheostomy?  

PubMed Central

Objective The aim of this study was to evaluate the utility of volume-rendered helical computerized tomography (CT) angiography focusing tracheostomy tube and innominate artery for prevention of tracheoinnominate artery fistula. Methods The authors retrospectively analyzed 22 patients with tracheostomy who had checked CT angiography. To evaluate the relationship between tracheostomy tube and innominate artery, we divided into three categories. First, proximal tube position based on cervical vertebra, named "tracheostomy tube departure level (TTDL)". Second, distal tube position and course of innominate artery, named "tracheostomy tube-innominate artery configuration (TTIC)". Third, the gap between the tube and innominate artery, named "tracheostomy tube to innominate artery gap (TTIG)". The TTDL/TTIC and TTIG are based on 3-dimensional (3D) reconstruction around tracheostomy and enhanced axial slices of upper chest, respectively. Results First, mean TTDL was 6.8±0.6. Five cases (23%) were lower than C7 vertebra. Second, TTIC were remote to innominate artery (2 cases; 9.1%), matched with it (14 cases; 63.6%) or crossed it (6 cases; 27.3%). Only 9% of cases were definitely free from innominate artery injury. Third, average TTIG was 4.3±4.6 mm. Surprisingly, in 6 cases (27.3%), innominate artery, trachea wall and tracheostomy tube were tightly attached all together, thus have much higher probability of erosion. Conclusion If low TTDL, match or crossing type TTIC with reverse-L shaped innominate artery, small trachea and thin TTIG are accompanied all together, we may seriously consider early plugging and tube removal. PMID:21519499

Kim, Il Sup; Yang, Seung Ho; Hong, Jae Taek; Son, Byung Chul; Lee, Sang Won

2011-01-01

247

Arterial grafts: clinical classification and pharmacological management  

PubMed Central

In comparison with standard saphenous vein grafts, use of the internal mammary artery (IMA) as a coronary artery bypass graft has achieved superior long-term results. This is related to the differences in the biological characteristics between the venous and arterial grafts. However, even arterial grafts are not uniform in their biological characteristics. The variation in the perioperative behavior of the grafts and in their long-term patency may be related to different characteristics. These factors should be taken into account in the use of arterial grafts, some of which are subjected to more active pharmacological intervention during and after the operation to obtain satisfactory results. To better understand the biological behavior of the grafts, their common features and their differences, a clinical classification may be useful for a practicing surgeon. Based on experimental studies of their vasoreactivity combined with anatomical, physiological and embryological considerations, we have proposed a functional classification for arterial grafts that may be useful clinically. Our classification suggests that there are three types of arterial grafts: Type I—somatic arteries; Type II—splanchnic arteries; and Type III—limb arteries. Type I arteries have enhanced endothelial function and release more nitric oxide and other relaxing factors. Type II arteries, such as the gastro-epiploic artery, and Type III arteries, such as the radial artery (RA), have higher pharmacological reactivity to vasoconstrictors. This classification explains why the IMA has the best long-term patency. Because Type II and III arteries are prone to spasms due to higher contractility, they require more active pharmacological interventions. Furthermore, the harvesting technique of the conduits, including the saphenous vein and IMA, are described and discussed in this article. Prevention of spasms using two cocktails of medications (verapamil + nitroglycerin and nicardipine + nitroglycerin) during harvesting of the conduits is described. These solutions have been demonstrated to be clinically effective. PMID:23977630

2013-01-01

248

Preradiotherapy Calcium Scores of the Coronary Arteries in a Cohort of Women With Early-Stage Breast Cancer: A Comparison With a Cohort of Healthy Women  

SciTech Connect

Purpose: Breast cancer radiotherapy has been associated with an increased risk of cardiac toxicity. However, no data are available on the probability of developing coronary artery disease (CAD) in breast cancer patients when compared with healthy women. Therefore, baseline coronary artery calcium (CAC) scores, as an accepted tool to predict CAD, were determined and compared with the CAC scores of a healthy, asymptomatic cohort, the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Methods and Materials: Eighty consecutive patients with ductal carcinoma in situ or infiltrative breast cancer referred for radiotherapy after breast-conserving surgery were included in our study. Their cardiovascular risk profile was registered, and a 64 multislice CT scan was performed. The CAC scores of an unselected (Caucasian only) Radiotherapy Centre West (RCWEST) cohort, as well as of those of a selected (comorbidity and race adjusted) RCWEST cohort, were determined. The scores of both cohorts were compared with those of the female (Caucasian only) MESA cohort. Results: For the unselected RCWEST cohort (n = 62) we found significant (p < .01) higher scores for women in the 55-64 age category compared with those of the MESA cohort. In the selected cohort (n = 55) the CAC scores of the women in the age category 55-64 were significantly (p = .02) higher compared with the MESA cohort. No significant differences were noted in the other age categories. Conclusion: Both cohorts revealed that CAC scores in the 55-64 age category were significantly higher than the CAC scores in the asymptomatic (female) MESA population. These data suggest that breast cancer patients bear a higher risk of developing coronary heart disease before the start of radiotherapy. Therefore, measures to decrease cardiac dose further in breast cancer radiotherapy are even more important.

Mast, Mirjam E., E-mail: m.mast@mchaaglanden.nl [Radiotherapy Centre West, The Hague (Netherlands); Heijenbrok, Mark W. [Department of Radiology, Medical Center Haaglanden, The Hague (Netherlands); Petoukhova, Anna L. [Radiotherapy Centre West, The Hague (Netherlands); Scholten, Astrid N. [Department of Clinical Oncology, Leiden University Medical Centre, Leiden (Netherlands); Schreur, Joop H.M. [Department of Cardiology, Medical Center Haaglanden, The Hague (Netherlands); Struikmans, Henk [Radiotherapy Centre West, The Hague (Netherlands); Department of Clinical Oncology, Leiden University Medical Centre, Leiden (Netherlands)

2012-07-01

249

Feeding Artery of Laryngeal and Hypopharyngeal Cancers: Role of the Superior Thyroid Artery in Superselective Intraarterial Chemotherapy  

SciTech Connect

The purpose of this study was to elucidate the role of the superior thyroid artery in intra-arterial infusion chemotherapy for laryngeal and hypopharyngeal cancers. Thirty-nine patients with laryngeal cancer and 29 patients with hypopharyngeal cancer underwent intra-arterial infusion chemotherapy. We performed a retrospective analysis of the feeding arteries confirmed by computed tomography during selective arteriography and compared the results with the extent of the tumors. In 14 of 39 laryngeal and 15 of 29 hypopharyngeal cancers, the tumor did not cross the midline (group 1). In the remaining 25 and 14 cancers, respectively, the tumor crossed the midline or located in the center (group 2). For 13 of 14 laryngeal and 7 of 15 hypopharyngeal cancers in group 1 and for 6 of 25 laryngeal cancers in group 2, the entire tumor was contrast enhanced by the ipsilateral superior thyroid and/or superior laryngeal artery. For 12 of 25 laryngeal and 1 of 14 hypopharyngeal cancers in group 2, the entire tumor was contrast enhanced by the bilateral superior thyroid artery. For the other patients, infusion via the other arterial branches such as the inferior thyroid and the lingual arteries were needed to achieve contrast enhancement of the entire tumor. Superselective intra-arterial chemotherapy for laryngeal cancer from the superior thyroid artery is appropriate, whereas that for hypopharyngeal cancer is less sufficient. To accomplish contrast enhancement of the entire tumor, additional intra-arterial infusion from other arteries such as the inferior thyroid artery is often necessary.

Terayama, Noboru, E-mail: tera@rad.m.kanazawa-u.ac.jp; Sanada, Junichiro; Matsui, Osamu; Kobayashi, Satoshi; Kawashima, Hiroko; Yamashiro, Masashi; Takanaka, Tsuyoshi; Kumano, Tomoyasu; Yoshizaki, Tomokazu [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan); Furukawa, Mitsuru [Kanazawa University Graduate School of Medical Science, Department of Otorhinolaryngology (Japan)

2006-08-15

250

Penile arteries and erection.  

PubMed

Alterations in the flow of blood to and from the penis are thought to be the most frequent causes of male erectile dysfunction and, therefore, the present review focuses on the penile vasculature. In the flaccid state, tonic noradrenaline release from the sympathetic nerves contracts penile arterial and corporal smooth muscle through activation of postjunctional alpha(1)-adrenoceptors, both by increasing intracellular calcium and by enhancing the sensitivity of the contractile apparatus for calcium. In addition, noradrenaline inhibits vasodilatatory neurotransmitter release by prejunctional alpha(2)-adrenoceptors. The exact role of the sympathetic neurotransmitters, neuropeptide Y and adenosine 5'-triphosphate, in erection is largely unknown. Penile vasodilatation during erection is mediated by nitric oxide (NO) through activation of guanylyl cyclase in the smooth muscle layer, followed by increases in cyclic guanosine monophosphate lowering of intracellular calcium and desensitisation of the contractile apparatus for calcium. Acetylcholine, vasoactive intestinal peptide as well as peptides in sensory nerves probably also play a role in penile vasodilation. Increased flow through the penile arteries stimulates the endothelium leading to release of NO, prostanoids and a non-NO non-prostanoid factor, and as such enhances the vasodilatation, while the role of endothelium-derived contractile factors in penile vasoconstriction is not clear. Erectile dysfunction shares arterial risk factors with ischaemic heart disease, and diabetes, age, and hypercholesterolaemia are associated with impairment of both neurogenic and endothelium-dependent vasodilator mechanisms in corpus cavernosum. Only few studies have investigated the impact of these risk factors on the penile vasculature, although recent evidence suggests that arterial insufficiency precedes changes in corpus cavernosum leading to erectile dysfunction. PMID:12187119

Simonsen, Ulf; García-Sacristán, Albino; Prieto, Dolores

2002-01-01

251

Coronary arteries  

Microsoft Academic Search

.   Coronary angiography (CA) is presently considered the gold standard for the assessment of the coronary arteries. However,\\u000a the presence of ionizing radiation, its invasiveness and the small associated risk of morbidity prompted long ago the development\\u000a of more patient-friendly imaging modalities. A promising technique, magnetic resonance imaging (MRI), has been regarded as\\u000a the major modality in the coming decade.

P. A. Wielopolski; R. J. M. van Geuns; P. J. de Feyter; M. Oudkerk

2000-01-01

252

Vertebrobasilar Artery Insufficiency and Electroencephalogram  

Microsoft Academic Search

This is a renewed diagnostic approach to vertebrobasilar artery insufficiency (VBI) — a condition which stood in the focus of this author's interest several decades ago. The time for a revisitation has come.The EEG findings consist mainly of generally reduced voltage output and enhanced photic driving response. There is also some theta activity over anterior temporal and midtemporal region, but

E. Niedermeyer

2008-01-01

253

ANOMALOUS ORIGIN OF LEFT MAIN CORONARY ARTERY FROM PULMONARY ARTERY (ALCAPA)  

Microsoft Academic Search

Anomalous origin of left main coronary artery from pulmonary artery (ALCAPA) is a very rare congenital anomaly, reported in less than 0.5% of all the congenital heart diseases. Left untreated, majority of the patients die in infancy of myocardial ischemia. We report a case with this anomaly, presented in early infancy with progressive dyspnoea, feeding difficulty and cardiomagaly on X-ray.

Maad Ullah

254

Use of mental health telemetry to enhance identification and predictive value of early changes during augmentation treatment of major depression.  

PubMed

Standard clinical trial methodology in depression does not allow for careful examination of early changes in symptom intensity. The purpose of this study was to use daily "Mental Health Telemetry" (MHT) to prospectively record change in depressive and anxiety symptoms for depressed patients receiving augmentation treatment, and determine the extent and predictive capacity of early changes. We report results of a 6-week, open-label study of the addition of quetiapine XR (range, 50-300 mg) for adult patients (n = 26) with major depressive disorder who were nonresponsive to antidepressant treatment. In addition to regular study visits, all participants completed daily, wirelessly transmitted self-report ratings of symptoms on a Smartphone. Daily and 3-day moving average mean scores were calculated, and associations between early symptom change and eventual response to treatment were determined. Improvement in depressive and anxiety symptoms was identified as early as day 1 of treatment. Of the total decline in depression severity over 6 weeks, 9% was present at day 1, 28% at day 2, 39% at days 3 and 4, 65% at day 7, and 80% at day 10. Self-report rating of early improvement (?20%) in depressive symptoms at day 7 significantly predicted responder status at week 6 (P = 0.03). Clinician-rated depressive and anxiety symptoms only became significantly associated with responder status at day 14. In conclusion, very early changes in depressive symptoms were identified using MHT, early changes accounted for most of total change, and MHT-recorded improvement as early as day 7 significantly predicted response to treatment at study end point. PMID:24100787

Schaffer, Ayal; Kreindler, David; Reis, Catherine; Levitt, Anthony J

2013-12-01

255

Surface-enhanced Raman spectral biomarkers correlate with Ankle Brachial Index and characterize leg muscle biochemical composition of patients with peripheral arterial disease.  

PubMed

Peripheral arterial disease (PAD) is characterized by atherosclerotic blockages of the arteries supplying the lower extremities, which cause a progressive accumulation of ischemic injury to the skeletal muscles of the lower limbs. This injury includes altered metabolic processes, damaged organelles, and compromised bioenergetics in the affected muscles. The objective of this study was to explore the association of Raman spectral signatures of muscle biochemistry with the severity of atherosclerosis in the legs as determined by the Ankle Brachial Index (ABI) and clinical presentation. We collected muscle biopsies from the gastrocnemius (calf muscle) of five patients with clinically diagnosed claudication, five patients with clinically diagnosed critical limb ischemia (CLI), and five control patients who did not have PAD. A partial least squares regression (PLSR) model was able to predict patient ABI with a correlation coefficient of 0.99 during training and a correlation coefficient of 0.85 using a full cross-validation. When using the first three PLS factor scores in combination with linear discriminant analysis, the discriminant model was able to correctly classify the control, claudicating, and CLI patients with 100% accuracy, using a full cross-validation procedure. Raman spectroscopy is capable of detecting and measuring unique biochemical signatures of skeletal muscle. These signatures can discriminate control muscles from PAD muscles and correlate with the ABI and clinical presentation of the PAD patient. Raman spectroscopy provides novel spectral biomarkers that may complement existing methods for diagnosis and monitoring treatment of PAD patients. PMID:25247767

Cluff, Kim; Kelly, Abby M; Koutakis, Panagiotis; He, Xiang N; Huang, Xi; Lu, Yong Feng; Pipinos, Iraklis I; Casale, George P; Subbiah, Jeyamkondan

2014-09-01

256

Neighborhood contexts experienced by young Mexican-American women: enhancing our understanding of risk for early childbearing.  

PubMed

Young Mexican-American women are disproportionately affected by teen pregnancy and early childbearing. While many of the studies that have investigated this population's high risk for early childbearing have focused predominantly on micro-level factors, a growing body of research has demonstrated the importance of neighborhood-level factors in shaping risk for this outcome. In order to elucidate the role of neighborhood context with regards to early childbearing among adolescent Mexican-American women, it is important to understand what these young women consider to be their neighborhood context and how they experience these contexts. This study utilized a mixed-methods design incorporating participatory photography, photo-elicitation, and focus groups in order to gain a more nuanced understanding of how neighborhood context is conceptualized and experienced by Mexican-American young women, and how these experiences may influence risk for early childbearing. Major findings include: (1) participants view the blocks on which they live as their neighborhood, but their exposure to neighborhood context extends beyond these blocks and includes the transient spaces they move through daily; and (2) within their neighborhood contexts, participants are influenced by experiences of discrimination and the presence of gangs and violence. These findings point to the importance of neighborhood-level factors in the lives of adolescent Mexican-American women, and may be used to inform future studies looking at the role of neighborhood context in shaping risk for early childbearing among this population. PMID:22143409

Richardson, Dawn M; Nuru-Jeter, Amani M

2012-02-01

257

Arrival time parametric imaging of the hemodynamic balance changes between the hepatic artery and the portal vein during deep inspiration, using Sonazoid-enhanced ultrasonography: A case of Budd-Chiari syndrome  

PubMed Central

This case report concerns a 40-year-old male who had previously been treated for an esophageal varix rupture, at the age of 30 years. The medical examination at that time revealed occlusion of the inferior vena cava in the proximity of the liver, leading to the diagnosis of the patient with Budd-Chiari syndrome. The progress of the patient was therefore monitored in an outpatient clinic. The patient had no history of drinking or smoking, but had suffered an epileptic seizure in 2004. The patient's family history revealed nothing of note. In February 2012, color Doppler ultrasonography (US) revealed a change in the blood flow in the right portal vein branch, from hepatopetal to hepatofugal, during deep inspiration. Arrival time parametric imaging (At-PI), using Sonazoid-enhanced US, was subsequently performed to examine the deep respiration-induced changes observed in the hepatic parenchymal perfusion. US images captured during deep inspiration demonstrated hepatic parenchymal perfusion predominantly in red, indicating that the major blood supply was the hepatic artery. During deep expiration, the portal venous blood flow remained hepatopetal, and hepatic parenchymal perfusion was displayed predominantly in yellow, indicating that the portal vein was the major source of the blood flow. The original diagnostic imaging results were reproduced one month subsequently by an identical procedure. At-PI enabled an investigation into the changes that were induced in the hepatic parenchymal perfusion by a compensatory mechanism involving the hepatic artery. These changes occurred in response to a reduction in the portal venous blood flow, as is observed in the arterialization of hepatic blood flow that is correlated with the progression of chronic hepatitis C. It has been established that the peribiliary capillary plexus is important in the regulation of hepatic arterial blood flow. However, this case demonstrated that the peribiliary capillary plexus also regulates acute changes in portal venous blood flow, in addition to the chronic reduction in blood flow that is observed in patients with chronic hepatitis C. PMID:23935711

WAKUI, NORITAKA; TAKAYAMA, RYUJI; MATSUKIYO, YASUSHI; KAMIYAMA, NAOHISA; KOBAYASHI, KOJIRO; MUKOZU, TAKANORI; NAKANO, SHIGERU; IKEHARA, TAKASHI; NAGAI, HIDENARI; IGARASHI, YOSHINORI; SUMINO, YASUKIYO

2013-01-01

258

Peripheral immune challenge with viral mimic during early postnatal period robustly enhances anxiety-like behavior in young adult rats.  

PubMed

Inflammatory factors associated with immune challenge during early brain development are now firmly implicated in the etiologies of schizophrenia, autism and mood disorders later in life. In rodent models, maternal injections of inflammagens have been used to induce behavioral, anatomical and biochemical changes in offspring that are congruent with those found in human diseases. Here, we studied whether inflammatory challenge during the early postnatal period can also elicit behavioral alterations in adults. At postnatal day 14, rats were intraperitoneally injected with a viral mimic, polyinosinic:polycytidylic acid (PIC). Two months later, these rats displayed remarkably robust and consistent anxiety-like behaviors as evaluated by the open field/defensive-withdrawal test. These results demonstrate that the window of vulnerability to inflammatory challenge in rodents extends into the postnatal period and offers a means to study the early sequelae of events surrounding immune challenge to the developing brain. PMID:21643765

Konat, Gregory W; Lally, Brent E; Toth, Anastasia A; Salm, Adrienne K

2011-09-01

259

Nanomolar ouabain increases NCX1 expression and enhances Ca2+ signaling in human arterial myocytes: a mechanism that links salt to increased vascular resistance?  

PubMed Central

The mechanisms by which NaCl raises blood pressure (BP) in hypertension are unresolved, but much evidence indicates that endogenous ouabain is involved. In rodents, arterial smooth muscle cell (ASMC) Na+ pumps with an ?2-catalytic subunit (ouabain EC50 ?1.0 nM) are crucial for some hypertension models, even though ?80% of ASMC Na+ pumps have an ?1-subunit (ouabain EC50 ? 5 ?M). Human ?1-Na+ pumps, however, have high ouabain affinity (EC50 ? 10–20 nM). We used immunoblotting, immunocytochemistry, and Ca2+ imaging (fura-2) to examine the expression, distribution, and function of Na+ pump ?-subunit isoforms in human arteries and primary cultured human ASMCs (hASMCs). hASMCs express ?1- and ?2-Na+ pumps. Further, ?2-, but not ?1-, pumps are confined to plasma membrane microdomains adjacent to sarcoplasmic reticulum (SR), where they colocalize with Na/Ca exchanger-1 (NCX1) and C-type transient receptor potential-6 (receptor-operated channels, ROCs). Prolonged inhibition (72 h) with 100 nM ouabain (blocks nearly all ?1- and ?2-pumps) was toxic to most cultured hASMCs. Treatment with 10 nM ouabain (72 h), however, increased NCX1 and sarco(endo)plasmic reticulum Ca2+-ATPase expression and augmented ATP (10 ?M)-induced SR Ca2+ release in 0 Ca2+, ouabain-free media, and Ca2+ influx after external Ca2+ restoration. The latter was likely mediated primarily by ROCs and store-operated Ca2+ channels. These hASMC protein expression and Ca2+ signaling changes are comparable with previous observations on myocytes isolated from arteries of many rat hypertension models. We conclude that the same structurally and functionally coupled mechanisms (?2-Na+ pumps, NCX1, ROCs, and the SR) regulate Ca2+ homeostasis and signaling in hASMCs and rodent ASMCs. These ouabain/endogenous ouabain-modulated mechanisms underlie the whole body autoregulation associated with increased vascular resistance and elevation of BP in human, salt-sensitive hypertension. PMID:22842068

Linde, Cristina I.; Antos, Laura K.; Golovina, Vera A.

2012-01-01

260

Early Change in Ferumoxytol-Enhanced Magnetic Resonance Imaging Signal Suggests Unstable Human Cerebral Aneurysm. A Pilot Study  

PubMed Central

Background and Purpose The clinical significance of early (i.e. within the first 24 hours) uptake of ferumoxytol by macrophages in the wall of human cerebral aneurysms is not clear. The purpose of this study was to determine whether early uptake of ferumoxytol suggests unstable cerebral aneurysm. Methods Thirty unruptured aneurysms in 22 patients were imaged with MRI 24 hours after infusion of ferumoxytol. Eighteen aneurysms were also imaged 72 hours after infusion of ferumoxytol. Aneurysm dome tissue was collected from four patients with early MRI signal changes, five patients with late signal changes, and five other patients with ruptured aneurysms. The tissue was immunostained for expression of cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), microsomal-prostaglandin-E2 synthase-1 (mPGES-1) and macrophages. Results In 23% (7/30) of aneurysms, there was pronounced early uptake of ferumoxytol. Four aneurysms were clipped. The remaining three aneurysms were managed conservatively; all three ruptured within six months. In 53% (16/30) of aneurysms, there was pronounced uptake of ferumoxytol at 72 hours. Eight aneurysms were surgically clipped and eight were managed conservatively; none ruptured or increased in size after six months. Expression of COX-2, mPGES-1, and macrophages was similar in unruptured aneurysms with early uptake of ferumoxytol and ruptured aneurysms. Expression of these inflammatory molecules was significantly higher in aneurysms with early uptake of ferumoxytol versus aneurysms with late uptake. Conclusions Uptake of ferumoxytol in aneurysm walls within the first 24 hours strongly suggests aneurysm instability and probability of rupture within six months, and may warrant urgent intervention. PMID:23138441

Hasan, David; Chalouhi, Nohra; Jabbour, Pascal; Dumont, Aaron S.; Kung, David K.; Magnotta, Vincent A.; Young, William L; Hashimoto, Tomoki; Winn, H. Richard; Heistad, Donald

2012-01-01

261

Endovascular Treatment of a Coronary Artery Bypass Graft to Pulmonary Artery Fistula with Coil Embolization  

SciTech Connect

Fistula formation between a coronary artery bypass graft (CABG)and the pulmonary arterial circulation represents a rare cause of recurrent angina in patients following bypass grafting. Therapy has traditionally involved surgical ligation by open thoracotomy. We describe a case of left internal mammary artery-left upper lobe pulmonary artery fistula presenting as early recurrent angina following CABG. The fistula was embolized using platinum coils, resulting in symptomatic relief and improvement in myocardial perfusion on cardiac perfusion scintigraphy. Coil embolization should be considered a therapeutic option in patients with coronary-pulmonary steal syndrome.

Nielson, Jeffery L., E-mail: nielson@uhrad.com; Kang, Preet S. [University Hospitals of Cleveland and Veterans Administration Medical Center-Cleveland, Case Western Reserve University, Departments of Radiology (United States)

2006-04-15

262

Cotransplantation of stroma results in enhancement of engraftment and early expression of donor hematopoietic stem cells in utero  

Microsoft Academic Search

Although promising, clinical and experimental efforts at in utero hematopoietic stem cell (HSC) transplantation currently are limited by minimal donor cell engraftment and lack of early donor cell expression after transplantation. We reasoned that cotransplantation of stromal elements (ST) might condition the fetal microenvironment for the engraftment of donor HSC and facilitate precocious bone marrow (BM) hematopoiesis. In this study

Graça Almeida-Porada; Alan W. Flake; Hudson A. Glimp; Esmail D. Zanjani

1999-01-01

263

Vygotskian Perspectives on Using Dramatic Play to Enhance Children's Development and Balance Creativity with Structure in the Early Childhood Classroom  

ERIC Educational Resources Information Center

What kind of environmental and administrative factors support the balance between child-centred and teacher-directed practices in the early childhood classroom? What specific aspects of children's development are nurtured by this pedagogy? These and other pedagogical issues are addressed in this article as it describes how a particular curriculum…

Gupta, Amita

2009-01-01

264

Using Information from an Early Intervention Program to Enhance Literacy Goals on the Individualized Education Program (IEP)  

ERIC Educational Resources Information Center

The Individuals with Disabilities Education Act requires that an Individualized Education Program (IEP) be developed for each child that receives special education services. To develop the most effective IEP, information is gathered from everyone who has worked with the child. In many schools the child receives early intervention services prior to…

O'Connor, Evelyn A.; Yasik, Anastasia E.

2007-01-01

265

Cross-modal enhancement of the MMN to speech-sounds indicates early and automatic integration of letters and speech-sounds.  

PubMed

Recently brain imaging evidence indicated that letter/speech-sound integration, necessary for establishing fluent reading, takes place in auditory association areas and that the integration is influenced by stimulus onset asynchrony (SOA) between the letter and the speech-sound. In the present study, we used a specific ERP measure known for its automatic character, the mismatch negativity (MMN), to investigate the time course and automaticity of letter/speech-sound integration. We studied the effect of visual letters and SOA on the MMN elicited by a deviant speech-sound. We found a clear enhancement of the MMN by simultaneously presenting a letter, but without changing the auditory stimulation. This enhancement diminishes linearly with increasing SOA. These results suggest that letters and speech-sounds are processed as compound stimuli early and automatically in the auditory association cortex of fluent readers and that this processing is strongly dependent on timing. PMID:18023979

Froyen, Dries; Van Atteveldt, Nienke; Bonte, Milene; Blomert, Leo

2008-01-01

266

Enhanced detection of early-stage oral cancer in vivo by optical coherence tomography using multimodal delivery of gold nanoparticles  

NASA Astrophysics Data System (ADS)

Contrast in optical coherence tomography (OCT) images can be enhanced by utilizing surface plasmon resonant gold nanoparticles. To improve the poor in vivo transport of gold nanoparticles through biological barriers, an efficient delivery strategy is needed. In this study, the improved penetration and distribution of gold nanoparticles were achieved by microneedle and ultrasound, respectively, and it was demonstrated that this multimodal delivery of antibody-conjugated PEGylated gold nanoparticles enhanced the contrast in in vivo OCT images of oral dysplasia in a hamster model.

Kim, Chang Soo; Wilder-Smith, Petra; Ahn, Yeh-Chan; Liaw, Lih-Huei L.; Chen, Zhongping; Kwon, Young Jik

2009-05-01

267

The Role of CT Angiography of Coronaries in Early Diagnosis of Coronary Artery Plaques in Albanian People with No History of Cardiovascular Disease in Correlation with Traditional Risk Factors  

PubMed Central

Objective: To evaluate the role of CT angiography of coronaries (CTAC) in the diagnosis of subclinical atherosclerosis by detection of coronary artery plaques (CAP) in a group of consecutive albanian individuals with no history of coronary artery disease (CAD) or acute coronary syndrome and to investigate the relation between the prevalence of CAP, traditional risk factors and the expected 10-year risk of fatal cardiovascular event (CVE) based on our own experience. Method and Technique: This is a prospective study including 456 patients with no history of CAD who underwent CTAC in our hospital from September 2009 to March 2013. Risk estimation of fatal CVE was assessed using Systematic Coronary Risk Evaluation (SCORE) and then CT scan was performed with a 64 detector CT, including Ca Score and angiography of coronaries with iv contrast. Results: From 456 patients 61.4% were low risk and 32.9% were at intermediate risk according to SCORE. The prevalence of CAP diagnosed by CTAC was calculated as 55.7 % overall. Though the presence and severity of CAP increased significantly with the increase of SCORE, it was found to be 44.1% in the low risk patients and 80% in the intermediate risk group, with a presence of 17% and 25% of stenotic plaques (>50%) respectively. Significant correlation was found between all traditional risk factors and CAP. Conclusion: Although a direct relation between the prevalence of CAP, risk factors and the related 10-year risk of fatal CVE was found, there was a significant prevalence of CAP in low –intermediate risk group with a considerable presence of stenotic lesions. Also 8.3% of patients with no risk factors and 18% of the patients with Ca score 0 had CAP in CT angiography, one resulting with severe stenosis. Our results suggest once more that CT angiography is a reliable, very accurate noninvasive technique for the diagnosis of early CAD, especially in the low-intermediate risk patients compared to the traditional evaluation schemes and Ca score, thus should be considered in this group as a diagnostic guide for optimal therapy planning. PMID:25126008

Allajbeu, Iris; Hajro, Edjon; Temali, Indrit; Cekrezi, Bledi; Preza, Krenar

2014-01-01

268

Early or late IL-10 blockade enhances Th1 and th17 effector responses and promotes fungal clearance in mice with cryptococcal lung infection.  

PubMed

The potent immunoregulatory properties of IL-10 can counteract protective immune responses and, thereby, promote persistent infections, as evidenced by studies of cryptococcal lung infection in IL-10-deficient mice. To further investigate how IL-10 impairs fungal clearance, the current study used an established murine model of C57BL/6J mice infected with Cryptococcus neoformans strain 52D. Our results demonstrate that fungal persistence is associated with an early and sustained expression of IL-10 by lung leukocytes. To examine whether IL-10-mediated immune modulation occurs during the early or late phase of infection, assessments of fungal burden and immunophenotyping were performed on mice treated with anti-IL-10R-blocking Ab at 3, 6, and 9 d postinfection (dpi) (early phase) or at 15, 18, and 21 dpi (late phase). We found that both early and late IL-10 blockade significantly improved fungal clearance within the lung compared with isotype control treatment when assessed 35 dpi. Immunophenotyping identified that IL-10 blockade enhanced several critical effector mechanisms, including increased accumulation of CD4(+) T cells and B cells, but not CD8(+) T cells; specific increases in the total numbers of Th1 and Th17 cells; and increased accumulation and activation of CD11b(+) dendritic cells and exudate macrophages. Importantly, IL-10 blockade effectively abrogated dissemination of C. neoformans to the brain. Collectively, this study identifies early and late cellular and molecular mechanisms through which IL-10 impairs fungal clearance and highlights the therapeutic potential of IL-10 blockade in the treatment of fungal lung infections. PMID:25225664

Murdock, Benjamin J; Teitz-Tennenbaum, Seagal; Chen, Gwo-Hsiao; Dils, Anthony J; Malachowski, Antoni N; Curtis, Jeffrey L; Olszewski, Michal A; Osterholzer, John J

2014-10-15

269

Dynamic contrast-enhanced MRI in mouse tumors at 11.7?T: comparison of three contrast agents with different molecular weights to assess the early effects of combretastatin A4.  

PubMed

Dynamic contrast-enhanced (DCE)-MRI is useful to assess the early effects of drugs acting on tumor vasculature, namely anti-angiogenic and vascular disrupting agents. Ultra-high-field MRI allows higher-resolution scanning for DCE-MRI while maintaining an adequate signal-to-noise ratio. However, increases in susceptibility effects, combined with decreases in longitudinal relaxivity of gadolinium-based contrast agents (GdCAs), make DCE-MRI more challenging at high field. The aim of this work was to explore the feasibility of using DCE-MRI at 11.7?T to assess the tumor hemodynamics of mice. Three GdCAs possessing different molecular weights (gadoterate: 560?Da, 0.29?mmol Gd/kg; p846: 3.5?kDa, 0.10?mmol Gd/kg; and p792: 6.47?kDa, 0.15?mmol Gd/kg) were compared to see the influence of the molecular weight in the highlight of the biologic effects induced by combretastatin A4 (CA4). Mice bearing transplantable liver tumor (TLT) hepatocarcinoma were divided into two groups (n?=?5-6 per group and per GdCA): a treated group receiving 100?mg/kg CA4, and a control group receiving vehicle. The mice were imaged at 11.7?T with a T1 -weighted FLASH sequence 2?h after the treatment. Individual arterial input functions (AIFs) were computed using phase imaging. These AIFs were used in the Extended Tofts Model to determine K(trans) and vp values. A separate immunohistochemistry study was performed to assess the vascular perfusion and the vascular density. Phase imaging was used successfully to measure the AIF for the three GdCAs. In control groups, an inverse relationship between the molecular weight of the GdCA and K(trans) and vp values was observed. K(trans) was significantly decreased in the treated group compared with the control group for each GdCA. DCE-MRI at 11.7?T is feasible to assess tumor hemodynamics in mice. With K(trans) , the three GdCAs were able to track the early vascular effects induced by CA4 treatment. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25323069

Fruytier, A-C; Magat, J; Neveu, M-A; Karroum, O; Bouzin, C; Feron, O; Jordan, B; Cron, G O; Gallez, B

2014-11-01

270

Musical training during early childhood enhances the neural encoding of speech Dana L. Strait a,b  

E-print Network

to improve a child's access to a target signal in noise. Given adult musicians' perceptual and neural speech structure (Bangert & Schlaug, 2006; Hutchinson, Lee, Gaab, & Schlaug, 2003; Schlaug, 2001), function (Besson & Kraus, 2011b). Enhance- ments in musicians have been observed in a structure as evol

271

Ocean Warming Enhances Malformations, Premature Hatching, Metabolic Suppression and Oxidative Stress in the Early Life Stages of a Keystone Squid  

PubMed Central

Background The knowledge about the capacity of organisms’ early life stages to adapt to elevated temperatures is very limited but crucial to understand how marine biota will respond to global warming. Here we provide a comprehensive and integrated view of biological responses to future warming during the early ontogeny of a keystone invertebrate, the squid Loligo vulgaris. Methodology/Principal Findings Recently-spawned egg masses were collected and reared until hatching at present day and projected near future (+2°C) temperatures, to investigate the ability of early stages to undergo thermal acclimation, namely phenotypic altering of morphological, behavioural, biochemical and physiological features. Our findings showed that under the projected near-future warming, the abiotic conditions inside the eggs promoted metabolic suppression, which was followed by premature hatching. Concomitantly, the less developed newborns showed greater incidence of malformations. After hatching, the metabolic burst associated with the transition from an encapsulated embryo to a planktonic stage increased linearly with temperature. However, the greater exposure to environmental stress by the hatchlings seemed to be compensated by physiological mechanisms that reduce the negative effects on fitness. Heat shock proteins (HSP70/HSC70) and antioxidant enzymes activities constituted an integrated stress response to ocean warming in hatchlings (but not in embryos). Conclusions/Significance The stressful abiotic conditions inside eggs are expected to be aggravated under the projected near-future ocean warming, with deleterious effects on embryo survival and growth. Greater feeding challenges and the lower thermal tolerance limits of the hatchlings are strictly connected to high metabolic demands associated with the planktonic life strategy. Yet, we found some evidence that, in the future, the early stages might support higher energy demands by adjusting some cellular functional properties to increase their thermal tolerance windows. PMID:22701620

Rosa, Rui; Pimentel, Marta S.; Boavida-Portugal, Joana; Teixeira, Tatiana; Trubenbach, Katja; Diniz, Mario

2012-01-01

272

A rare cause of upper gastrointestinal haemorrhage: Ruptured cystic artery pseudoaneurysm with concurrent cholecystojejunal fistula???  

PubMed Central

INTRODUCTION Cystic artery pseudoaneurysms and cholecystoenteric fistulae represent two rare complications of gallstone disease. PRESENTATION OF CASE An 86 year old male presented to the emergency department with obstructive jaundice, RUQ pain and subsequent upper gastrointestinal bleeding. Upper GI endoscopy revealed bleeding from the medial wall of the second part of the duodenum and a contrast-enhanced computed tomography scan revealed a cystic artery pseudoaneurysm, concurrent cholecystojejunal fistula and gallstone ileus. This patient was successfully managed surgically with open subtotal cholecystectomy, pseudoaneurysm resection and fistula repair. DISCUSSION To date there are very few cases describing haemobilia resulting from a bleeding cystic artery pseudoaneurysm. This report is the first to describe upper gastrointestinal bleeding as a consequence of two synchronous rare pathologies: a ruptured cystic artery pseudoaneurysm causing haemobilia and bleeding through a concurrent cholecystojejunal fistula. CONCLUSION Through this case, we stress the importance of accurate and early diagnosis through ultra- sonography, endoscopy, and contrast-enhanced CT imaging and emphasise that haemobilia should be included in the differential diagnosis of anyone presenting with upper gastrointestinal bleeding. We have demonstrated the success of surgical management alone in the treatment of such a case, but accept that consideration of combined therapeutic approach with angiography be given in the first instance, when available and clinically indicated. PMID:24394852

Glaysher, Michael A.; Cruttenden-Wood, David; Szentpali, Karoly

2013-01-01

273

Enhanced External Counterpulsation in Patients with Coronary Artery Disease-Associated Erectile Dysfunction. Part II: Impact of Disease Duration and Treatment Courses  

Microsoft Academic Search

Introduction. Enhanced external counterpulsation (EECP) is a noninvasive outpatient treatment used for patients with intractable angina refractory to aggressive surgical and medical treatment. Recent results have demonstrated a positive impact of EECP on patients with ischemic heart disease (IHD)-associated erectile dysfunction (ED). Aim. To assess the effect of IHD duration and number of EECP courses on efficacy and satisfaction rate

Ahmed I. El-Sakka; Ayman M. Morsy; Bassam I. Fagih

2007-01-01

274

Coronary artery bypass graft degenerative disease  

Microsoft Academic Search

Opinion statement  The choice of conduit is the most important factor influencing long-term patency of coronary artery bypass grafts (CABGs);\\u000a arterial grafts are far superior to saphenous vein bypass grafts (SVGs) in this regard. Aspirin therapy should be started\\u000a early in the perioperative period and continued indefinitely. Warfarin (Coumadin; Dupont, Wilmington, DE) and other platelet\\u000a inhibitors offer no added value to

Fredarick L. Gobel; Michael R. Mooney; Kevin J. Graham

2001-01-01

275

Mitochondrial reactive oxygen species enhance AMP-activated protein kinase activation in the endothelium of patients with coronary artery disease and diabetes.  

PubMed

The aim of the present study was to determine whether the endothelial dysfunction associated with CAD (coronary artery disease) and T2D (Type 2 diabetes mellitus) is concomitant with elevated mtROS (mitochondrial reactive oxygen species) production in the endothelium and establish if this, in turn, regulates the activity of endothelial AMPK (AMP-activated protein kinase). We investigated endothelial function, mtROS production and AMPK activation in saphenous veins from patients with advanced CAD. Endothelium-dependent vasodilation was impaired in patients with CAD and T2D relative to those with CAD alone. Levels of mitochondrial H(2)O(2) and activity of AMPK were significantly elevated in primary HSVECs (human saphenous vein endothelial cells) from patients with CAD and T2D compared with those from patients with CAD alone. Incubation with the mitochondria-targeted antioxidant, MitoQ(10) significantly reduced AMPK activity in HSVECs from patients with CAD and T2D but not in cells from patients with CAD alone. Elevated mtROS production in the endothelium of patients with CAD and T2D increases AMPK activation, supporting a role for the kinase in defence against oxidative stress. Further investigation is required to determine whether pharmacological activators of AMPK will prove beneficial in the attenuation of endothelial dysfunction in patients with CAD and T2D. PMID:23057846

Mackenzie, Ruth M; Salt, Ian P; Miller, William H; Logan, Angela; Ibrahim, Hagar A; Degasperi, Andrea; Dymott, Jane A; Hamilton, Carlene A; Murphy, Michael P; Delles, Christian; Dominiczak, Anna F

2013-03-01

276

Dephosphorylation of CCAAT/enhancer-binding protein ? by protein phosphatase 2A containing B56? is required at the early time of adipogenesis.  

PubMed

It is known that protein phosphatase 2A (PP2A) expression is increased in high-fat diet (HFD)-induced obese mice, but the role of PP2A in adipogenesis as well as obesity remains to be addressed. In this study, the role of PP2A in adipogenesis was explored. Preadipocytes were treated with okadaic acid (OA) during adipogenesis and the degree of adipogenesis was determined. The OA treatment blocked adipogenesis at the early time of adipogenesis, but not at the late time. In the early time of adipogenesis, CCAAT/enhancer-binding protein ? (C/EBP?) activation is preceded by the expression of key adipogenic transcription factors including PPAR? and C/EBP?, which function at the late time of adipogenesis, and then C/EBP? is degraded. However, the inhibition of PP2A by OA treatment sustained phosphorylation of C/EBP? and delayed its degradation. In turn, PPAR? and C/EBP? activation was altered. Among the various regulatory B56 subunits consisting of PP2A holoenzyme, B56? was directly bound to C/EBP? and was responsible for the dephosphorylation of C/EBP? by PP2A. Taken together, these findings suggest that the phosphorylation of C/EBP? after hormonal induction has to be inactivated by PP2A containing B56? at the early time of adipogenesis to allow the completion of adipogenesis. PMID:25152162

Park, Miyoung; Choi, Yeon A; Lee, Hee Gu; Kim, Keun Il; Lim, Jong-Seok; Lee, Myeong-Sok; Oh, Ki-Sook; Yang, Young

2014-11-01

277

Extensive complement-dependent enhancement of HIV1 by autologous non-neutralising antibodies at early stages of infection  

Microsoft Academic Search

Background  Non-neutralising antibodies to the envelope glycoprotein are elicited during acute HIV-1 infection and are abundant throughout\\u000a the course of disease progression. Although these antibodies appear to have negligible effects on HIV-1 infection when assayed\\u000a in standard neutralisation assays, they have the potential to exert either inhibitory or enhancing effects through interactions\\u000a with complement and\\/or Fc receptors. Here we report that

Suzanne Willey; Marlén MI Aasa-Chapman; Stephen O’Farrell; Pierre Pellegrino; Ian Williams; Robin A Weiss; Stuart JD Neil

2011-01-01

278

White Spot Syndrome Virus Annexes a Shrimp STAT To Enhance Expression of the Immediate-Early Gene ie1  

Microsoft Academic Search

Received 30 August 2006\\/Accepted 12 October 2006 Although the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway is part of the antiviral response in arthropods such as Drosophila, here we show that white spot syndrome virus (WSSV) uses a shrimp STAT as a transcription factor to enhance viral gene expression in host cells. In a series of deletion

Wang-Jing Liu; Yun-Shiang Chang; Andrew H.-J. Wang; Guang-Hsiung Kou; Chu-Fang Lo

2007-01-01

279

Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness  

PubMed Central

Arterial stiffness has been identified as an independent predictor of prognostic outcomes for patients with cardiovascular disease. Although measurement of pulse wave velocity has been a widely accepted noninvasive approach to the assessment of arterial stiffness, its accuracy is hampered by changes in blood pressure. Taking the exponential relation between intravascular pressure and arterial diameter into consideration, a stiffness parameter can be obtained by plotting the natural logarithm of systolic–diastolic pressure ratio against the arterial wall extensibility. Cardio-ankle vascular index (CAVI), which is calculated based on the stiffness parameter thus obtained, is theoretically independent of changes in blood pressure. With this distinct advantage, CAVI has been widely applied clinically to assess arterial stiffness in subjects with known cardiovascular diseases including those with diagnosed atherosclerosis, coronary heart disease, and stroke as well as those at risk, including those with hypertension, diabetes, the elderly, and the obese. Because of its enhanced sensitivity, not only has the index been used to discern subtle changes in the disease process, it has also been utilized in studying normal individuals to assess their potential risks of developing cardiovascular diseases. The primary aims of assessing arterial stiffness using CAVI are not only to aid in early detection of arteriosclerosis to allow timely treatment and change in lifestyle, but also to quantitatively evaluate the progression of disease and the effectiveness of treatment. Despite its merit of being unaffected by blood pressure, discretion in data interpretation is suggested because an elevated CAVI represents not just vascular stiffness caused by pathological changes in the arterial wall, but can also be attributed to an increased vascular tone brought about by smooth muscle contraction. Moreover, certain patient populations, such as those with an ankle-brachial index < 0.9, may give falsely low CAVI and are suggested to be excluded from study. PMID:23667317

Sun, Cheuk-Kwan

2013-01-01

280

In Vivo Replication of Recombinant Murine Cytomegalovirus Driven by the Paralogous Major Immediate-Early Promoter-Enhancer of Human Cytomegalovirus  

PubMed Central

Transcription of the major immediate-early (MIE) genes of cytomegaloviruses (CMV) is driven by a strong promoter-enhancer (MIEPE) complex. Transactivator proteins encoded by these MIE genes are essential for productive infection. Accordingly, the MIEPE is a crucial control point, and its regulation by activators and repressors is pertinent to virus replication. Since the MIEPE contains multiple regulatory elements, it was reasonable to assume that specific sequence motifs are irreplaceable for specifying the cell-type tropism and replication pattern. Recent work on murine CMV infectivity (A. Angulo, M. Messerle, U. H. Koszinowski, and P. Ghazal, J. Virol. 72:8502–8509, 1998) has documented the proposed enhancing function of the enhancer in that its resection or its replacement by a nonregulatory stuffer sequence resulted in a significant reduction of infectivity, even though replication competence was maintained by a basal activity of the spared authentic MIE promoter. Notably, full capacity for productive in vitro infection of fibroblasts was restored in recombinant viruses by the human CMV enhancer. Using two-color in situ hybridization with MIEPE-specific polynucleotide probes, we demonstrated that a murine CMV recombinant in which the complete murine CMV MIEPE is replaced by the paralogous human CMV core promoter and enhancer (recombinant virus mCMVhMIEPE) retained the potential to replicate in vivo in all tissues relevant to CMV disease. Notably, mCMVhMIEPE was also found to replicate in the liver, a site at which transgenic hCMV MIEPE is silenced. We conclude that productive in vivo infection with murine CMV does not strictly depend on a MIEPE type-specific regulation. PMID:10233967

Grzimek, Natascha K. A.; Podlech, Jurgen; Steffens, Hans-Peter; Holtappels, Rafaela; Schmalz, Susanne; Reddehase, Matthias J.

1999-01-01

281

An alternative estimation of the RF-enhanced plasma temperature during SPEAR artificial heating experiments: Early results  

NASA Astrophysics Data System (ADS)

RF heating of the F region plasma at high latitudes has long been known to produce electron temperature increases that can vary from tens to hundreds of percent above the background, unperturbed level. In contrast, artificial ionospheric modification experiments conducted using the Space Plasma Exploration by Active Radar (SPEAR) heating facility on Svalbard have often failed to produce obvious enhancements in the electron temperatures when measured using the European Incoherent Scatter Svalbard radar (ESR), colocated with the heater. Contamination of the ESR ion line spectra by the zero-frequency purely growing mode (PGM) feature is known to persist at varying amplitudes throughout SPEAR heating, and such spectral features can lead to significant temperature underestimations when the incoherent scatter spectra are analyzed using conventional methods. In this study, we present the first results of applying a recently developed technique to correct the PGM-contaminated spectra to SPEAR-enhanced ESR spectra and derive an alternative estimate of the SPEAR-heated electron temperature. We discuss how the effectiveness of the spectrum corrections can be affected by the data variance, estimated over the integration period. The subsequent electron temperatures, inferred from corrected spectra, range from a few tens to a few hundred Kelvin above the average background temperature. These temperatures are found to be in reasonable agreement with the theoretical “enhanced” temperature, calculated for the peak of the stationary temperature perturbation profile, when realistic absorption effects are accounted for.

Vickers, H.; Baddeley, L.

2011-11-01

282

Cadmium alters the reproductive endocrine disruption and enhancement of growth in the early and adult stages of Oreochromis mossambicus.  

PubMed

Heavy metal cadmium (Cd) traces are able to promote growth (growth promoter) and induce early maturation in Oreochromis mossambicus fries of both sexes, whereas, in the adults, they degenerate the gonads and their function. The gathered data on length-weight relation, gonado-somatic index, hepato-somatic index, egg numbers and reproductive hormones such as gonadotropins (GtH-I and GtH-II) and gonadial hormones such as progesterone, testosterone and estradiol levels all prove Cd as an endocrine disruptor. PMID:22903387

Amutha, C; Subramanian, P

2013-04-01

283

Early exposure to haptic feedback enhances performance in surgical simulator training: a prospective randomized crossover study in surgical residents  

Microsoft Academic Search

Background  In the literature of skill acquisition and transfer of skills, it often is assumed that the rate of skill acquisition depends\\u000a on what has been learned in a similar context (i.e., surgical simulators providing haptic feedback). This study aimed to analyze\\u000a whether the addition of haptic feedback early in the training phase for image-guided surgical simulation improves performance.\\u000a \\u000a \\u000a \\u000a Methods  A randomized

P. Ström; L. Hedman; L. Särnå; A. Kjellin; T. Wredmark; L. Felländer-Tsai

2006-01-01

284

Kidney biomarkers in MCPA-induced acute kidney injury in rats: reduced clearance enhances early biomarker performance.  

PubMed

For improved early detection and assessment of severe acute kidney damage following accidental or intentional ingestion of the herbicide MCPA, we compared a panel of 14 novel kidney injury biomarkers with plasma creatinine. Male Wistar rats received four different oral doses of MCPA and plasma and urine biomarker levels were measured at 8, 24 and 48 h after MCPA exposure. Diagnostic performances using absolute levels, urine levels normalized to urine creatinine or urinary excretion rate were determined by ROC analysis. Plasma creatinine remained the best early biomarker for predicting histological changes at 48 h. The performance of plasma cystatin C in mirroring kidney function was similar to that of plasma creatinine. While urine concentrations were generally less predictive, normalization by urine creatinine greatly improved the performance of several biomarkers. This may be due to an apparent amplification of the biomarker signal on normalizing to creatinine, in the presence of a declining glomerular filtration rate prior to reaching steady state. Normalized 8 h osteopontin and albumin concentrations outperformed other normalized biomarkers in predicting histological changes at later times. Normalized urinary kidney injury molecule-1 at 48 h also correlated well with the degree of kidney damage. PMID:24480514

Wunnapuk, Klintean; Liu, Xin; Gobe, Glenda C; Endre, Zoltan H; Peake, Philip W; Grice, Jeffrey E; Roberts, Michael S; Buckley, Nicholas A

2014-03-21

285

Early drotrecogin alpha (activated) administration in severe sepsis is associated with lower mortality: a retrospective analysis of the Canadian ENHANCE cohort  

PubMed Central

Introduction Early multimodal treatment of severe sepsis, including the use of drotrecogin alfa (activated) (DrotAA) when indicated, is considered essential for optimum outcome. However, predicting which infected patients will progress to severe sepsis and the need for aggressive intervention continues to be problematic. We therefore wished to explore whether there were any potential early markers that might predict improved survival in response to early use of DrotAA in patients with severe sepsis. In particular, in the dynamic setting of severe sepsis, we postulated that changes in markers reflecting evolving rather than baseline clinical status might guide therapy. Methods Data on a cohort of 305 Canadian patients from the open label ENHANCE trial of DrotAA in severe sepsis was retrospectively analyzed to search for potential clinical predictors of outcome in severe sepsis. Patients received a 96-hour infusion of DrotAA and were followed for 28 days. The association between time to treatment and mortality within subgroups defined by dynamic changes in various potential markers was explored. Results Mortality at 28 days was 22.6% and the variables of age, time to treatment, and early changes in serum creatinine and platelet count were identified by logistic regression as independent predictors of mortality. Across all age ranges, 28-day mortality was lower when DrotAA was administered within 24 hours of first sepsis-induced organ dysfunction compared to administration after 24 hours for both subgroups of patients defined by changes in platelet count and creatinine within the first day. Conclusions These findings suggest that when indicated, treatment with DrotAA should be initiated as soon as possible, regardless of age. Trial Registration Previous trial registration number: NCT00568893 PMID:19457240

Hodder, Richard V; Hall, Richard; Russell, James A; Fisher, Harold N; Lee, Bobbie

2009-01-01

286

Trial participants' experiences of early enhanced speech and language therapy after stroke compared with employed visitor support: a qualitative study nested within a randomized controlled trial  

PubMed Central

Objectives: To explore trial participants’ experiences of the process and outcomes of early, enhanced speech and language therapy after stroke with support from an employed visitor. Design: Qualitative study nested within a randomized controlled trial. Participants: Twney-two people who, after stroke, had a diagnosis of aphasia (12), dysarthria (5) or both (5) and who participated in the ACT NoW study. Setting: Eight English NHS usual care settings. Method: Individual interviews. Thematic content analysis assisted by a bespoke data transformation protocol for incorporating non-verbal and semantically ambiguous data. Results: Participants highly regarded regular and sustained contact with someone outside of immediate family/friends who engaged them in deliberate activities/communication in the early months after stroke. Participants identified differences in the process of intervention between speech and language therapists and employed visitors. But no major discriminations were made between the impact or value of this contact according to whether provided by a speech and language therapist or employed visitor. Participant-defined criteria for effectiveness of contact included: impact on mood and confidence, self-recognition of progress and the meeting of individual needs. Conclusions: As in the randomized controlled trial, participants reported no evidence of added benefit of early communication therapy beyond that from attention control. The findings do not imply that regular contact with any non-professional can have beneficial effects for someone with aphasia or dysarthria in the early weeks following a stroke. The study points to specific conditions that would have to be met for contact to have a positive effect. PMID:22837542

Gomersall, Timothy; Bowen, Audrey

2013-01-01

287

The history of arterial revascularization: from Kolesov to Tector and beyond  

PubMed Central

Coronary artery bypass grafting (CABG) is the one of the most effective revascularization strategies for patients with obstructive coronary artery disease. Total arterial revascularization using one or both internal thoracic and radial arteries has been shown to improve early outcomes and reduce long-term cardiovascular morbidity. Although CABG has evolved from an experimental procedure in the early 1900’s to become one of the most commonly performed surgical procedures, there is still significant variation in grafting strategies amongst surgeons. We review the history and development of CABG with a particular emphasis on the early pioneers and the evolution of arterial grafting. PMID:23977617

Galvin, Sean D.

2013-01-01

288

Helical Carbon Nanotubes Enhance the Early Immune Response and Inhibit Macrophage-Mediated Phagocytosis of Pseudomonas aeruginosa  

PubMed Central

Aerosolized or aspirated manufactured carbon nanotubes have been shown to be cytotoxic, cause pulmonary lesions, and demonstrate immunomodulatory properties. CD-1 mice were used to assess pulmonary toxicity of helical carbon nanotubes (HCNTs) and alterations of the immune response to subsequent infection by Pseudomonas aeruginosa in mice. HCNTs provoked a mild inflammatory response following either a single exposure or 2X/week for three weeks (multiple exposures) but were not significantly toxic. Administering HCNTs 2X/week for three weeks resulted in pulmonary lesions including granulomas and goblet cell hyperplasia. Mice exposed to HCNTs and subsequently infected by P. aeruginosa demonstrated an enhanced inflammatory response to P. aeruginosa and phagocytosis by alveolar macrophages was inhibited. However, clearance of P. aeruginosa was not affected. HCNT exposed mice depleted of neutrophils were more effective in clearing P. aeruginosa compared to neutrophil-depleted control mice, accompanied by an influx of macrophages. Depletion of systemic macrophages resulted in slightly inhibited bacterial clearance by HCNT treated mice. Our data indicate that pulmonary exposure to HCNTs results in lesions similar to those caused by other nanotubes and pre-exposure to HCNTs inhibit alveolar macrophage phagocytosis of P. aeruginosa. However, clearance was not affected as exposure to HCNTs primed the immune system for an enhanced inflammatory response to pulmonary infection consisting of an influx of neutrophils and macrophages. PMID:24324555

Walling, Brent E.; Kuang, Zhizhou; Hao, Yonghua; Estrada, David; Wood, Joshua D.; Lian, Feifei; Miller, Lou Ann; Shah, Amish B.; Jeffries, Jayme L.; Haasch, Richard T.; Lyding, Joseph W.; Pop, Eric; Lau, Gee W.

2013-01-01

289

Gibberellic acid (GA3) enhance seed water uptake, germination and early seedling growth in sugar beet under salt stress.  

PubMed

The study was carried out to assess whether water uptake could be improved in sugar beet seeds and salt tolerance at the germination and early seedling stage by soaking the seeds for 10 h in distilled water (control), 100, 150 and 200 mg L(-1) GA3. Electrical Conductivity (EC) values of the NaCl solution were 0.0 (control), 4.7, 9.4 and 14.1 dS n(-1) NaCl. Priming increased the final germination percentage and the germination rate (1/t 50, where t 50 is the time to 50% of germination) under saline condition. Water uptake of primed seeds also increased significantly with increasing concentration of GA3 as compared to control. Priming also alleviated the adverse effect of salt stress on sugar beet in terms of roots and shoots lengths and fresh weights of plants, roots and shoots. PMID:19069553

Jamil, Muhammad; Rha, Eui Shik

2007-02-15

290

Embryos of Robertsonian Translocation Carriers Exhibit a Mitotic Interchromosomal Effect That Enhances Genetic Instability during Early Development  

PubMed Central

Balanced chromosomal rearrangements represent one of the most common forms of genetic abnormality affecting approximately 1 in every 500 (0.2%) individuals. Difficulties processing the abnormal chromosomes during meiosis lead to an elevated risk of chromosomally abnormal gametes, resulting in high rates of miscarriage and/or children with congenital abnormalities. It has also been suggested that the presence of chromosome rearrangements may also cause an increase in aneuploidy affecting structurally normal chromosomes, due to disruption of chromosome alignment on the spindle or disturbance of other factors related to meiotic chromosome segregation. The existence of such a phenomenon (an inter-chromosomal effect—ICE) remains controversial, with different studies presenting contradictory data. The current investigation aimed to demonstrate conclusively whether an ICE truly exists. For this purpose a comprehensive chromosome screening technique, optimized for analysis of minute amounts of tissue, was applied to a unique collection of samples consisting of 283 oocytes and early embryos derived from 44 patients carrying chromosome rearrangements. A further 5,078 oocytes and embryos, derived from chromosomally normal individuals of identical age, provided a robust control group for comparative analysis. A highly significant (P?=?0.0002) increase in the rate of malsegregation affecting structurally normal chromosomes was observed in association with Robertsonian translocations. Surprisingly, the ICE was clearly detected in early embryos from female carriers, but not in oocytes, indicating the possibility of mitotic rather than the previously suggested meiotic origin. These findings have implications for our understanding of genetic stability during preimplantation development and are of clinical relevance for patients carrying a Robertsonian translocation. The results are also pertinent to other situations when cellular mechanisms for maintaining genetic fidelity are relaxed and chromosome rearrangements are present (e.g. in tumors displaying chromosomal instability). PMID:23133396

Alfarawati, Samer; Fragouli, Elpida; Colls, Pere; Wells, Dagan

2012-01-01

291

Targeted Deletion of FGL2 Leads to Increased Early Viral Replication and Enhanced Adaptive Immunity in a Murine Model of Acute Viral Hepatitis Caused by LCMV WE  

PubMed Central

Mounting effective innate and adaptive immune responses are critical for viral clearance and the generation of long lasting immunity. It is known that production of inhibitory factors may result in the inability of the host to clear viruses, resulting in chronic viral persistence. Fibrinogen-like protein 2 (FGL2) has been identified as a novel effector molecule of CD4+CD25+ Foxp3+ regulatory T (Treg) cells that inhibits immune activity by binding to FC?RIIB expressed primarily on antigen presenting cells (APC). In this study, we show that infection of mice with Lymphocytic Choriomeningitis Virus WE (LCMV WE) leads to increased plasma levels of FGL2, which were detected as early as 2 days post-infection (pi) and persisted until day 50 pi. Mice deficient in FGL2 (fgl2?/?) had increased viral titers of LCMV WE in the liver early p.i but cleared the virus by day 12 similar to wild type mice. Dendritic cells (DC) isolated from the spleens of LCMV WE infected fgl2?/? had increased expression of the DC maturation markers CD80 and MHC Class II compared to wild type (fgl2+/+). Frequencies of CD8+ and CD4+ T cells producing IFN? in response to ex vivo peptide re-stimulation isolated from the spleen and lymph nodes were also increased in LCMV WE infected fgl2 ?/? mice. Increased frequencies of CD8+ T cells specific for LCMV tetramers GP33 and NP396 were detected within the liver of fgl2?/? mice. Plasma from fgl2?/? mice contained higher titers of total and neutralizing anti-LCMV antibody. Enhanced anti-viral immunity in fgl2?/? mice was associated with increased levels of serum alanine transaminase (ALT), hepatic necrosis and inflammation following LCMV WE infection. These data demonstrate that targeting FGL2 leads to early increased viral replication but enhanced anti-viral adaptive T & B cell responses. Targeting FGL2 may enhance the efficacy of current anti-viral therapies for hepatotropic viruses. PMID:24146739

Khattar, Ramzi; Luft, Olga; Yavorska, Nataliya; Shalev, Itay; Phillips, M. James; Adeyi, Oyedele; Gao, Darrin; Bartczak, Agata; Urbanellis, Peter; Shyu, Wendy; Zhang, Jianhua; Manuel, Justin; Levy, Gary A.; Selzner, Nazia

2013-01-01

292

Vascular endothelial growth factor acts through novel, pregnancy-enhanced receptor signalling pathways to stimulate endothelial nitric oxide synthase activity in uterine artery endothelial cells.  

PubMed

During pregnancy, VEGF (vascular endothelial growth factor) regulates in part endothelial angiogenesis and vasodilation. In the present study we examine the relative roles of VEGFRs (VEGF receptors) and associated signalling pathways mediating the effects of VEGF(165) on eNOS (endothelial nitric oxide synthase) activation. Despite equal expression levels of VEGFR-1 and VEGFR-2 in UAECs (uterine artery endothelial cells) from NP (non-pregnant) and P (pregnant) sheep, VEGF(165) activates eNOS at a greater level in P- compared with NP-UAEC, independently of Akt activation. The selective VEGFR-1 agonist PlGF (placental growth factor)-1 elicits only a modest activation of eNOS in P-UAECs compared with VEGF(165), whereas the VEGFR-2 kinase inhibitor blocks VEGF(165)-stimulated eNOS activation, suggesting VEGF(165) predominantly activates eNOS via VEGFR-2. Although VEGF(165) also activates ERK (extracellular-signal-regulated kinase)-1/2, this is not necessary for eNOS activation since U0126 blocks ERK-1/2 phosphorylation, but not eNOS activation, and the VEGFR-2 kinase inhibitor inhibits eNOS activation, but not ERK-1/2 phosphorylation. Furthermore, the inability of PlGF to activate ERK-1/2 and the ability of the VEGFR-2 selective agonist VEGF-E to activate ERK-1/2 and eNOS suggests again that both eNOS and ERK-1/2 activation occur predominantly via VEGFR-2. The lack of VEGF(165)-stimulated Akt phosphorylation is consistent with a lack of robust phosphorylation of Ser(1179)-eNOS. Although VEGF(165)-stimulated eNOS phosphorylation is observed at Ser(617) and Ser(635), pregnancy does not significantly alter this response. Our finding that VEGF(165) activation of eNOS is completely inhibited by wortmannin but not LY294002 implies a downstream kinase, possibly a wortmannin-selective PI3K (phosphoinositide 3-kinase), is acting between the VEGFR-2 and eNOS independently of Akt. PMID:18816248

Grummer, Mary A; Sullivan, Jeremy A; Magness, Ronald R; Bird, Ian M

2009-01-15

293

Uveal Melanoma Metastatic to the Liver: The Role of Quantitative Volumetric Contrast-Enhanced MR Imaging in the Assessment of Early Tumor Response after Transarterial Chemoembolization1  

PubMed Central

PURPOSE To determine whether volumetric changes of enhancement as seen on contrast-enhanced magnetic resonance (MR) imaging can help assess early tumor response and predict survival in patients with metastatic uveal melanoma after one session of transarterial chemoembolization (TACE). MATERIALS AND METHODS Fifteen patients with 59 lesions who underwent MR imaging before and 3 to 4 weeks after the first TACE were retrospectively included. MR analysis evaluated signal intensities, World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), European Association for the Study of the Liver (EASL), modified RECIST (mRECIST), tumor volume [volumetric RECIST (vRECIST)], and volumetric tumor enhancement [quantitative EASL (qEASL)]. qEASL was expressed in cubic centimeters [qEASL (cm3)] and as a percentage of the tumor volume [qEASL (%)]. Paired t test with its exact permutation distribution was used to compare measurements before and after TACE. The Kaplan-Meier method with the log-rank test was used to calculate overall survival for responders and non-responders. RESULTS In target lesions, mean qEASL (%) decreased from 63.9% to 42.6% (P = .016). No significant changes were observed using the other response criteria. In non-target lesions, mean WHO, RECIST, EASL, mRECIST, vRECIST, and qEASL (cm3) were significantly increased compared to baseline. qEASL (%) remained stable (P = .214). Median overall survival was 5.6 months. qEASL (cm3) was the only parameter that could predict survival based on target lesions (3.6 vs 40.5 months, P < .001) or overall (target and non-target lesions) response (4.4 vs 40.9 months, P = .001). CONCLUSION Volumetric tumor enhancement may be used as a surrogate biomarker for survival prediction in patients with uveal melanoma after the first TACE. PMID:24953419

Duran, Rafael; Chapiro, Julius; Frangakis, Constantine; Lin, MingDe; Schlachter, Todd R.; Schernthaner, Rudiger E.; Wang, Zhijun; Savic, Lynn J.; Tacher, Vania; Kamel, Ihab R.; Geschwind, Jean-Francois

2014-01-01

294

Early bedside care during preclinical medical education: can technology-enhanced patient simulation advance the Flexnerian ideal?  

PubMed

Flexner wanted medical students to study at the patient bedside-a remarkable innovation in his time-so that they could apply science to clinical care under the watchful eye of senior physicians. Ever since his report, medical schools have reserved the latter years of their curricula for such an "advanced" apprenticeship, providing clinical clerkship experiences only after an initial period of instruction in basic medical sciences. Although Flexner codified the segregation of preclinical and clinical instruction, he was committed to ensuring that both domains were integrated into a modern medical education. The aspiration to fully integrate preclinical and clinical instruction continues to drive medical education reform even to this day. In this article, the authors revisit the original justification for sequential preclinical-clinical instruction and argue that modern, technology-enhanced patient simulation platforms are uniquely powerful for fostering simultaneous integration of preclinical-clinical content in a way that Flexner would have applauded. To date, medical educators tend to focus on using technology-enhanced medical simulation in clinical and postgraduate medical education; few have devoted significant attention to using immersive clinical simulation among preclinical students. The authors present an argument for the use of dynamic robot-mannequins in teaching basic medical science, and describe their experience with simulator-based preclinical instruction at Harvard Medical School. They discuss common misconceptions and barriers to the approach, describe their curricular responses to the technique, and articulate a unifying theory of cognitive and emotional learning that broadens the view of what is possible, feasible, and desirable with simulator-based medical education. PMID:20107370

Gordon, James A; Hayden, Emily M; Ahmed, Rami A; Pawlowski, John B; Khoury, Kimberly N; Oriol, Nancy E

2010-02-01

295

Harvey with a modern twist: how and why conducting arteries amplify the pressure wave originating from the heart.  

PubMed

Current views on cardiovascular physiology differ little from that published by William Harvey in 1628: the heart delivers all energy for blood circulation, forcing its contents into the aorta, via arteries, arterioles and capillaries into the venous system that collects the blood and returns it to the right side of the heart. Similarly, blood from the right side passes through pulmonary arteries and arterioles to pulmonary veins before returning to the left side of the heart. However, from aorta to capillaries there is a great increase in overall cross-sectional area. The arterial system can be seen as a funnel, the heart pumping blood into its narrow end. Theoretically, this implies that pulsatile energy delivered by the heart dilutes significantly along its way through the arterial tree. Also, unfavorable tissue conditions, such as elevated pressure, impede proper perfusion when blood can pass just as easy through adjacent capillary systems. Finally, blood will experience more resistance to flow for capillary systems more distant to the heart due to its longer trajectory. This implies that capillary systems closer to the heart are more easily perfused than more distant ones. In reality, the pulse from the heart has been shown to increase and accelerate towards periphery. This, together with transcranial Doppler observations on the variation in wave morphology in intracranial arteries, for instance during CO2-reactivity testing and during cardiac arrhythmia, has led to the theory of arterial acceleration: at stroke onset, the arterial pressure wave resulting from myocardial contraction is enhanced by a short-lasting and well-synchronised contraction within the smooth muscle layers of conducting arteries. This results in a temporary 'stiffening' of the arterial tree by which cardiac pressure during early systole is amplified and distributed into all the body's capillary systems. This theory would overcome all theoretical and observational concerns sketched above. Such arterial acceleration limited to the first 100-150 ms of every heart beat would augment, accelerate and distribute the pulse generated by heart contraction over the full length and branching of the arterial tree, thereby enforcing a widespread tissue perfusion. It is obvious that the theory of arterial acceleration is a major shift of paradigm forcing us to reconsider many aspects of cardiovascular physiology. Moreover, it improves our understanding how blood expelled by the heart through the small lumen of the aortic notch has sufficient energy to reach every nook and cranny of our body. PMID:24613738

Schaafsma, A

2014-05-01

296

Community Engagement to Enhance Child Survival and Early Development in Low- and Middle-Income Countries: An Evidence Review  

PubMed Central

As part of a broader evidence summit, USAID and UNICEF convened a literature review of effective means to empower communities to achieve behavioral and social changes to accelerate reductions in under-5 mortality and optimize early child development. The authors conducted a systematic review of the effectiveness of community mobilization and participation that led to behavioral change and one or more of the following: child health, survival, and development. The level and nature of community engagement was categorized using two internationally recognized models and only studies where the methods of community participation could be categorized as collaborative or shared leadership were eligible for analysis. The authors identified 34 documents from 18 countries that met the eligibility criteria. Studies with shared leadership typically used a comprehensive community action cycle, whereas studies characterized as collaborative showed clear emphasis on collective action but did not undergo an initial process of community dialogue. The review concluded that programs working collaboratively or achieving shared leadership with a community can lead to behavior change and cost-effective sustained transformation to improve critical health behaviors and reduce poor health outcomes in low- and middle-income countries. Overall, community engagement is an understudied component of improving child outcomes. PMID:25207448

Farnsworth, S. Katherine; Böse, Kirsten; Fajobi, Olaoluwa; Souza, Patricia Portela; Peniston, Anne; Davidson, Leslie L.; Griffiths, Marcia; Hodgins, Stephen

2014-01-01

297

Community engagement to enhance child survival and early development in low- and middle-income countries: an evidence review.  

PubMed

As part of a broader evidence summit, USAID and UNICEF convened a literature review of effective means to empower communities to achieve behavioral and social changes to accelerate reductions in under-5 mortality and optimize early child development. The authors conducted a systematic review of the effectiveness of community mobilization and participation that led to behavioral change and one or more of the following: child health, survival, and development. The level and nature of community engagement was categorized using two internationally recognized models and only studies where the methods of community participation could be categorized as collaborative or shared leadership were eligible for analysis. The authors identified 34 documents from 18 countries that met the eligibility criteria. Studies with shared leadership typically used a comprehensive community action cycle, whereas studies characterized as collaborative showed clear emphasis on collective action but did not undergo an initial process of community dialogue. The review concluded that programs working collaboratively or achieving shared leadership with a community can lead to behavior change and cost-effective sustained transformation to improve critical health behaviors and reduce poor health outcomes in low- and middle-income countries. Overall, community engagement is an understudied component of improving child outcomes. PMID:25207448

Farnsworth, S Katherine; Böse, Kirsten; Fajobi, Olaoluwa; Souza, Patricia Portela; Peniston, Anne; Davidson, Leslie L; Griffiths, Marcia; Hodgins, Stephen

2014-01-01

298

A point-of-care testing system with Love-wave sensor and immunogold staining enhancement for early detection of lung cancer.  

PubMed

It has been reported that detection of exhaled breath condensate (EBC) is available for studies of pulmonary diseases, especially lung disease. In order to detect lung cancer (LC) at early stage, a point-of-care testing system suitable for measurement of tumor markers in EBC is developed. The assay, based on gold nanoparticle sandwich immunoassay and subsequent gold staining, was performed on a Love-wave sensor packaged inside a chip cartridge. Benefit from high sensitivity of Love-wave sensor, oriented immobilization of coating antibodies and immunogold staining enhancement, the present immunosensor could provide a sensitive, specific and rapid measurement. Carcinoembryonic antigen (CEA), neuron specific enolase (NSE) and squamous cell carcinoma antigen (SCC) in EBC collected from 17 patients with LC and 13 healthy volunteers were detected by this system. Results were compared with commercial chemiluminescence immunoassay and showed high correlation between two methods. Additionally, it revealed significantly statistical differences existing between two groups of subjects. These results indicate that the present system is suitable for detection of tumor markers in EBC and could be used as assistant tools for early detection of LC. PMID:25158626

Zou, Yingchang; Zhang, Xi; An, Chao; Ran, Chunxue; Ying, Kejing; Wang, Ping

2014-12-01

299

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnosis with CT Angiography  

PubMed Central

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. It is associated with early infant mortality and sudden death in adults. Traditionally, ALCAPA has been diagnosed by angiography or autopsy; however, the development of cardiac computed tomography (CT) and magnetic resonance imaging (MRI) has allowed noninvasive evaluation of the coronary anatomy by direct visualization of the origin of the left coronary artery (LCA) from the pulmonary artery. We report a case of 10-year-old girl who has been on follow up for dilated cardiomyopathy for 4 years. The definitive diagnosis of ALCAPA is reached by multislice computed tomography (MSCT). The MSCT scan showed an anomalous origin of LCA from the pulmonary trunk, with a tortuous and dilated right coronary artery and right-to-left collateralization. Consequently, the patient was successfully treated with surgery. PMID:23607073

Oncel, Guray; Oncel, Dilek

2013-01-01

300

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnosis with CT Angiography.  

PubMed

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. It is associated with early infant mortality and sudden death in adults. Traditionally, ALCAPA has been diagnosed by angiography or autopsy; however, the development of cardiac computed tomography (CT) and magnetic resonance imaging (MRI) has allowed noninvasive evaluation of the coronary anatomy by direct visualization of the origin of the left coronary artery (LCA) from the pulmonary artery. We report a case of 10-year-old girl who has been on follow up for dilated cardiomyopathy for 4 years. The definitive diagnosis of ALCAPA is reached by multislice computed tomography (MSCT). The MSCT scan showed an anomalous origin of LCA from the pulmonary trunk, with a tortuous and dilated right coronary artery and right-to-left collateralization. Consequently, the patient was successfully treated with surgery. PMID:23607073

Oncel, Guray; Oncel, Dilek

2013-01-01

301

The Contribution of Arterial Calcification to Peripheral Arterial Disease in Pseudoxanthoma Elasticum  

PubMed Central

Background and aims The contribution of arterial calcification (AC) in peripheral arterial disease (PAD) and arterial wall compressibility is a matter of debate. Pseudoxanthoma elasticum (PXE), an inherited metabolic disease due to ABCC6 gene mutations, combines elastic fiber fragmentation and calcification in various soft tissues including the arterial wall. Since AC is associated with PAD, a frequent complication of PXE, we sought to determine the role of AC in PAD and arterial wall compressibility in this group of patients. Methods and Results Arterial compressibility and patency were determined by ankle-brachial pressure index (ABI) in a cohort of 71 PXE patients (mean age 48±SD 14 yrs, 45 women) and compared to 30 controls without PAD. Lower limb arterial calcification (LLAC) was determined by non-contrast enhanced helicoidal CT-scan. A calcification score (Ca-score) was computed for the femoral, popliteal and sub-popliteal artery segments of both legs. Forty patients with PXE had an ABI<0.90 and none had an ABI>1.40. LLAC increased with age, significantly more in PXE subjects than controls. A negative association was found between LLAC and ABI (r?=??0.363, p?=?0.002). The LLAC was independently associated with PXE and age, and ABI was not linked to cardiovascular risk factors. Conclusions The presence of AC was associated with PAD and PXE without affecting arterial compressibility. PAD in PXE patients is probably due to proximal obstructive lesions developing independently from cardiovascular risk factors. PMID:24800819

Leftheriotis, Georges; Kauffenstein, Gilles; Hamel, Jean Francois; Abraham, Pierre; Le Saux, Olivier; Willoteaux, Serge; Henrion, Daniel; Martin, Ludovic

2014-01-01

302

Intra-arterial injection of dissolved flunitrazepam tablets.  

PubMed

Intra-arterial application of dissolved tablets is associated with a high risk of tissue necrosis. An early active vasodilatating and recanalising treatment is necessary. We present the case of 21-year-old female who applied three dissolved Flunitrazepam tablets into the ulnar artery and was successfully treated with prostaglandin E1 and recombinant tissue plasminogen activator. PMID:15061050

Pratikto, T H; Strubel, G; Biro, F; Kröger, K

2004-02-01

303

Evidence-Based Pharmacologic Management of Pulmonary Arterial Hypertension  

Microsoft Academic Search

Background: Pulmonary arterial hypertension (PAH) is a debilitating chronic disorder of the pulmonary vasculature characterized by elevated mean pulmonary arterial pressure, right-sided heart failure, and early mortality.Objectives: This paper reviews the available information on PAH, including its pathophysiology, classification of its severity, current treatment options, drug interactions, pharmacokinetics, and cost considerations. The results of clinical trials of the available treatments

Neal Benedict; Amy Seybert; Michael A. Mathier

2007-01-01

304

The caveats in the diagnosis of anomalous origin of left coronary artery from pulmonary artery (ALCAPA)  

PubMed Central

Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) is an infrequent, well described, but important anomaly of the coronary origin. Early diagnosis and prompt surgical treatment of the disease can be life saving. However, there are several potential sources of error in the seemingly simple stereotype diagnostic pattern. We report a case of ALCAPA and allude to some of the caveats in the diagnosis of this entity. PMID:22368564

Varghese, MJ; Kothari, SS

2010-01-01

305

Effect of Enhanced External Counterpulsation (EECP) on Inflammatory Cytokines and Adhesion Molecules in Patients with Angina Pectoris and Angiographic Coronary Artery Disease  

PubMed Central

Cardiovascular disease is associated with chronic low-level inflammation, as evidenced by elevated circulating proinflammatory cytokines. Experimental evidence suggests that inflammation can be suppressed under conditions of high shear stress. We examined the effects of enhanced external counterpulsation (EECP), a non-invasive therapy that increases endothelial shear stress, on circulating levels of inflammatory biomarkers and adhesion molecules in patients with angina pectoris. Twenty-one patients were randomly assigned to either 35 1-hour treatments at cuff pressures of 300 mmHg (EECP; n= 12) or at 75 mmHg (SHAM; n=9). Plasma tumor necrosis factor alpha (TNF-?), monocyte chemoattractant protein-1 (MCP-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured before and after 35 1-hour sessions of treatment or SHAM. Patients in the EECP group demonstrated reductions in TNF-? (6.9 ± 2.7 vs. 4.9 ± 2.5 pg/ml, P < 0.01; -29%) and MCP-1 (254.9 ± 55.9 vs. 190.4 ± 47.6 pg/ml, P < 0.01; -19%) following treatment, whereas, there was no change in the SHAM group. Changes in sVCAM-1 were not observed in either group. In conclusion, 35 sessions of EECP decreases circulating levels of proinflammatory biomarkers in patients with symptomatic CAD. PMID:18237588

Casey, Darren P.; Conti, C. Richard; Nichols, Wilmer W.; Choi, Calvin Y.; Khuddus, Matheen A.; Braith, Randy W.

2008-01-01

306

Comparative efficacy of a yeast product and bacitracin methylene disalicylate in enhancing early growth and intestinal maturation in broiler chicks from breeder hens of different ages.  

PubMed

The intestine of the newly hatched chick is immature at hatch. Yeast contains nucleotides and ?-glucans that enhance intestinal development and chick growth. Accordingly, a 14-d experiment was conducted to evaluate the efficacy of a novel yeast product and bacitracin methylene disalicylate in enhancing early growth and intestinal maturation in chicks obtained from young (26-27 wk old) and old (58 to 59 wk old) breeder hens. Chicks (384) were randomly assigned to 8 dietary treatments. Treatment 1 (YH) consisted of chicks, from young hens, fed corn-soybean meal (SBM) diet alone. Treatment 2 (YHB) consisted of chicks, from young hens, fed corn-SBM basal into which BMD was added at 0.055 g/kg. Treatment 3 (YHE) consisted of chicks, from young hens, fed corn-SBM basal into which yeast extract (YE) was added at 0.075% level. Treatment 4 (YHED) consisted of chicks, from young hens, fed corn-SBM basal into which YE was added at 0.15% level. Treatments 5 (OH), 6 (OHB), 7 (OHE), and 8 (OHED) consisted of chicks from old hens fed diets similar to those given to YH in treatments 1, 2, 3, and 4, respectively. Growth performance (body weight gain and feed conversion ratio) was evaluated on d 7 and 14. Intestinal tissue samples were also analyzed for alkaline phosphatase (ALP) activity as an indicator of intestinal maturation on d 4 and 13 of experiment. Results showed that by d 14 of experiment, only BMD treatments (YHB and OHB) improved body weight gain (P < 0.05). However, the body weight gains of chicks in the yeast-supplemented treatments (YHE, YHED, OHE, and OHED) were statistically similar (P > 0.05) to those of the BMD treatments. Ileal ALP activity was consistently enhanced by BMD and yeast product supplemented at 0.075% of the diet. It was concluded that antibiotic BMD and our novel yeast product supplemented at 0.075% of the diet improved early chick growth and maturation of the ileal segment of the small intestine. PMID:21489956

Fasina, Y O; Thanissery, R R

2011-05-01

307

Differentiating anomalous left main coronary artery originating from the pulmonary artery in infants from myocarditis and dilated cardiomyopathy by electrocardiogram  

Microsoft Academic Search

Anomalous left main coronary artery (ALMCA) originating from the pulmonary artery is an important cause of morbidity from heart failure and mortality in infants. Discriminating ALMCA from myocarditis or other forms of dilated cardiomyopathy (DC) in infants is critical for proper early management of this treatable disease. This study was performed to characterize electrocardiographic (ECG).patterns in infants with ALMCA, and

Christopher L. Johnsrude; James C. Perry; Frank Cecchin; E. O'Brian Smith; Kennard Fraley; Richard A. Friedman; Jeffrey A. Towbin

1995-01-01

308

Carotid Artery Disease  

MedlinePLUS

... a carotid artery narrowed by plaque. By plaque breaking off from the carotid arteries and blocking a ... disease: High levels of low-density lipoprotein cholesterol (bad cholesterol) and triglycerides in the blood. High blood ...

309

Branched-chain amino acids increase arterial blood ammonia in spite of enhanced intrinsic muscle ammonia metabolism in patients with cirrhosis and healthy subjects.  

PubMed

Branched-chain amino acids (BCAA) are used in attempts to reduce blood ammonia in patients with cirrhosis and intermittent hepatic encephalopathy based on the hypothesis that BCAA stimulate muscle ammonia detoxification. We studied the effects of an oral dose of BCAA on the skeletal muscle metabolism of ammonia and amino acids in 14 patients with cirrhosis and in 7 healthy subjects by combining [(13)N]ammonia positron emission tomography (PET) of the thigh muscle with measurements of blood flow and arteriovenous (A-V) concentrations of ammonia and amino acids. PET was used to measure the metabolism of blood-supplied ammonia and the A-V measurements were used to measure the total ammonia metabolism across the thigh muscle. After intake of BCAA, blood ammonia increased more than 30% in both groups of subjects (both P < 0.05). Muscle clearance of blood-supplied ammonia (PET) was unaffected (P = 0.75), but the metabolic removal rate (PET) increased significantly because of increased blood ammonia in both groups (all P < 0.05). The total ammonia clearance across the leg muscle (A-V) increased by more than 50% in both groups, and the flux (A-V) of ammonia increased by more than 45% (all P < 0.05). BCAA intake led to a massive glutamine release from the muscle (cirrhotic patients, P < 0.05; healthy subjects, P = 0.12). In conclusion, BCAA enhanced the intrinsic muscle metabolism of ammonia but not the metabolism of blood-supplied ammonia in both the patients with cirrhosis and in the healthy subjects. PMID:21636533

Dam, Gitte; Keiding, Susanne; Munk, Ole Lajord; Ott, Peter; Buhl, Mads; Vilstrup, Hendrik; Bak, Lasse Kristoffer; Waagepetersen, Helle Sønderby; Schousboe, Arne; Møller, Niels; Sørensen, Michael

2011-08-01

310

Repair of anomalous origin of the left coronary artery from the pulmonary artery in infants  

PubMed Central

OBJECTIVES Anatomical repair seems an ideal method for the surgical treatment of the anomalous left coronary artery arising from the pulmonary artery (ALCAPA) in infancy. The medium-term outcome has been investigated for infants with ALCAPA following the restoration of a dual-coronary arterial circulation. METHODS Between April 1995 and July 2012, 23 infants with a median age of 4 months underwent surgical repair of ALCAPA in our department. Direct implantation of the anomalous coronary artery into the ascending aorta was feasible in 16 patients. A trap door flap method was used in 5 cases and a tubular extension technique in 2. No infant underwent mitral valve repair at the time of ALCAPA surgery. Left ventricular function and the degree of mitral valve regurgitation were assessed during a 10-year follow-up. RESULTS Four patients died in the early postoperative period, without independent predictors associated with this mortality. During follow-up, improvement in myocardial function occurred in all patients both early and late. There was only one improvement in severe mitral valve regurgitation. Subsequently, 2 children needed mitral valve replacement. There were no early or late reoperations of the reimplanted coronary arteries. CONCLUSIONS Aortic reimplantation is an effective surgical treatment for ALCAPA in infants burdened with a low risk of reoperation due to coronary artery stenosis. There was good potential for myocardial recovery within the first year after surgery. Restoration of the anatomical coronary circulation did not improve mitral valve function in infants with severe preoperative mitral incompetence. PMID:23442939

Kazmierczak, Piotr A.; Ostrowska, Katarzyna; Dryzek, Pawel; Moll, Jadwiga A.; Moll, Jacek J.

2013-01-01

311

Carotid Artery Disease  

MedlinePLUS

... the NHLBI on Twitter. What Is Carotid Artery Disease? Carotid (ka-ROT-id) artery disease is a disease in which a waxy substance ... the United States. Other conditions, such as certain heart problems and ... or treat carotid artery disease and may reduce the risk of stroke. If ...

312

Imaging the vertebral artery  

Microsoft Academic Search

Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based

Keng Yeow Tay; Jean Marie U-King-Im; Rikin A. Trivedi; Nicholas J. Higgins; Justin J. Cross; John R. Davies; Peter L. Weissberg; Nagui M. Antoun; Jonathan H. Gillard

2005-01-01

313

Association Between the Corrected QT Interval and Carotid Artery Intima-Media Thickness in Obese Children  

PubMed Central

Objective: Sudden death has been reported in asymptomatic obese adults and the mechanism is unclear. In recent years, obesity has shown a dramatic increase in children and this enhances the risk factors for the development of cardiovascular disease. The aim of this study was to investigate whether there is repolarization abnormality and any potential risk factor such as increase in intima-media thickness (IMT) of carotid artery for corrected QT (QTc) prolongation among obese children. Methods: A total of 60 obese children, 30 of which had features of metabolic syndrome (MS), and 23 age-matched controls were included in the study. QTc interval was calculated at rest. The IMT of both common carotid arteries (CCA) was measured. The relationship between QTc, IMT of right and left CCA and insulin sensitivity indices were evaluated in the study group. Results: The QTc interval of the children with simple exogenous obesity (SEO) were longer than in the controls (p=0.024). The IMT of both carotid arteries of the obese girls and boys with and without MS were higher than the controls (p=<0.001). The QTc was significantly affected by the parameters pertaining to the right carotid artery IMT, to chronologic age and HDL-C. Conclusion: Since obesity may cause subclinical atherosclerotic disease regardless of sex, obese children must be followed closely for early cardiovascular problems. Conflict of interest:None declared. PMID:21274332

Ozgen, Tolga; Gungor, Olcay; Ayd?n, Murat; Baysal, Kemal

2010-01-01

314

Platelets, Arterial Thrombosis and Cerebral Ischemia  

Microsoft Academic Search

Atherosclerosis is a systemic disease that starts early in life, asymptomatically progressing though adulthood, until clinically manifested. In the last few years, experimental, clinical and pathological investigation has led us to a better knowledge of the pathophysiology of atherothrombotic disease. Atherothrombosis is the result of atherosclerosis progression, and its potentially life-threatening clinical consequences include coronary artery disease, cerebrovascular disease and

Lina Badimon; Gemma Vilahur

2007-01-01

315

"Keyhole" coronary artery bypass surgery.  

PubMed Central

OBJECTIVE: The objective of this study was to identify the utility of "keyhole" thoracotomy approaches to single vessel coronary artery bypass surgery. SUMMARY BACKGROUND DATA: Although minimally invasive surgery is efficacious in a wide variety of surgical disciplines, it has been slow to emerge in cardiac surgery. Among 49 selected patients, the authors have used a left anterior keyhole thoracotomy (6 cm in length) combined with complete dissection of the eternal mammary artery (IMA) pedicle under thoracoscopic guidance or directly through the keyhole incision to accomplish IMA coronary artery bypass grafting (CABG) to the left anterior descending (LAD) coronary artery circulation or to the right coronary artery (RCA). METHODS: Keyhole CABG was accomplished in 46 of 49 patients in which this approach was attempted. All patients had significant (> 70%) obstruction of a dominant coronary artery that had failed or that was inappropriate for endovascular catheter treatment (percutaneous transluminal coronary angioplasty or stenting). Forty-four of the 49 patients had proximal LAD and 5 had proximal RCA stenoses. The mean age of the patients (35 men and 14 women) was 61 years, and their median New York Heart Association anginal class was III. The mean left ventricular ejection fraction was 42%. Femoral cardiopulmonary bypass support was used in 9 (19%) of 46 patients successfully managed with the keyhole procedure. Short-acting beta-blockade was used in the majority of patients (38 of 46) to reduce heart rate and the vigor of cardiac contraction. RESULTS: As 49 patients have survived operation, which averaged 248 minutes in duration. Median, postoperative endotracheal intubation time for keyhole patients was 6 hours with 25 of 46 patients being extubated before leaving the operating room. The median hospital stay was 4.3 days. Conversion to sternotomy was required in three patients to accomplish bypass because of inadequate internal mammary conduits or acute cardiovascular decompensation during an attempted off-bypass keyhole procedure Postoperative complications were limited to respiratory difficulty in three patients and the development of a deep wound infection in one patient. Nine (19%) of 46 patients received postoperative transfusion. There have been no intraoperative or postoperative infarctions, and angina has been controlled in all but one patient who subsequently had an IMA-RCA anastomotic stenosis managed successfully with percutaneous transluminal coronary angioplasty. CONCLUSIONS: These early results with keyhole CABG are encouraging. As experience broadens, keyhole CABG may become a reasonable alternative to repeated endovascular interventions or sternotomy approaches to recalcitrant single-vessel coronary arterial disease involving the proximal LAD or RCA. PMID:8857850

Landreneau, R J; Mack, M J; Magovern, J A; Acuff, T A; Benckart, D H; Sakert, T A; Fetterman, L S; Griffith, B P

1996-01-01

316

Fully automated segmentation of carotid and vertebral arteries from CTA  

E-print Network

Fully automated segmentation of carotid and vertebral arteries from CTA Release 0.01 Olivier (common, internal, external carotid and vertebral arteries) from a contrast enhanced computed tomography for the vessels in the neck region, since the internal carotid goes through the base of the skull, the vertebral

Boyer, Edmond

317

Renal artery aneurysms.  

PubMed

A renal artery aneurysm is defined as a dilated segment of renal artery that exceeds twice the diameter of a normal renal artery. Although rare, the diagnosis and incidence of this entity have been steadily increasing due to the routine use of cross-sectional imaging. In certain cases, renal artery aneurysms may be clinically important and potentially lethal. However, knowledge of their occurrence, their natural history, and their prognosis with or without treatment is still limited. This article aims to review the recent literature concerning renal artery aneurysms, with special consideration given to physiopathology, indications for treatment, different technical options, post-procedure complications and treatment outcomes. PMID:24363127

González, J; Esteban, M; Andrés, G; Linares, E; Martínez-Salamanca, J I

2014-01-01

318

Jet pump assisted artery  

NASA Technical Reports Server (NTRS)

A procedure for priming an arterial heat pump is reported; the procedure also has a means for maintaining the pump in a primed state. This concept utilizes a capillary driven jet pump to create the necessary suction to fill the artery. Basically, the jet pump consists of a venturi or nozzle-diffuser type constriction in the vapor passage. The throat of this venturi is connected to the artery. Thus vapor, gas, liquid, or a combination of the above is pumped continuously out of the artery. As a result, the artery is always filled with liquid and an adequate supply of working fluid is provided to the evaporator of the heat pipe.

1975-01-01

319

Epidermal growth factor-expressing Lactococcus lactis enhances growth performance of early-weaned pigs fed diets devoid of blood plasma.  

PubMed

The effect of supplementing Lactococcus lactis (L. lactis) that was engineered to express epidermal growth factor (EGF-LL) to early-weaned pigs fed diets with typical levels of blood plasma (5%) or diets without blood plasma [blood plasma was substituted with soybean (Glycine max) meal and fish meal, based on amino acid supply] was examined. A total of 108 weaned piglets (19-26 d of age; mean initial BW 6.58 kg; 9 pigs per pen) were fed ad libitum according to a 2-phase feeding program without growth promoters. Three pens were assigned to each of 4 treatments: i) blood plasma-containing diet with blank bacterial growth medium (BP-Con), ii) blood plasma-containing diet with fermented EGF-LL (BP-EGF), iii) blood plasma-free diet with blank bacterial growth medium (BPF-Con), and iv) blood plasma-free diet with fermented EGF-LL (BPF-EGF). The amount of epidermal growth factor (EGF) was determined in the fermentation product and pigs were allotted 60 ?g EGF/kg BW/d for 3 wk postweaning. There were no differences in overall growth performance between BP-Con and BP-EGF pigs and no differences in overall growth performance between LoCon and BPF-EGF pigs. Pigs fed BPF-EGF showed increased daily BW gain (410 vs. 260 g/d; P < 0.01) and gain:feed (0.67 vs. 0.58; P < 0.05) compared to BPF-Con pigs in wk 3 postweaning; this was comparable to values for the BP-Con group (400 g/d and 0.64). These results indicate that supplementation with EGF-LL can be effective in enhancing the performance of early-weaned piglets fed a low complexity diet and reduces the need for feeding high-quality animal proteins and antibiotics. PMID:23365266

Bedford, A; Li, Z; Li, M; Ji, S; Liu, W; Huai, Y; de Lange, C F M; Li, J

2012-12-01

320

Assessment of the Early Effects of 5,6-Dimethylxanthenone-4-Acetic Acid Using Macromolecular Contrast Media-Enhanced Magnetic Resonance Imaging: Ectopic Versus Orthotopic Tumors  

SciTech Connect

Purpose: To investigate the early effects of a vascular disrupting agent (VDA) in ectopic and orthotopic tumors by using macromolecular contrast media (MMCM)-enhanced magnetic resonance imaging (MMCM-MRI). Methods and Materials: The MMCM-MRI of ectopic and orthotopic MCA205 murine fibrosarcomas was performed using the intravascular contrast agent albumin-(gadopentetate dimeglumine){sub 35}. Change in longitudinal relaxation rate ({delta}R1) was measured 24 hours after treatment with 5,6-dimethylxanthenone-4-acetic acid (DMXAA; 30 mg/kg) and used to compute tumor vascular volume and permeability. Correlative histologic and immunohistochemical evaluation was carried out, along with measurement of tumor necrosis factor {alpha} and vascular endothelial growth factor levels in whole tumor extracts using the enzyme-linked immunosorbent assay. Results: Orthotopic tumors showed higher vascular volume (p < 0.05) than ectopic tumors before treatment. Twenty-four hours after DMXAA treatment, a significant (p < 0.0001), but differential, decrease in {delta}R1 (70% in ectopic and 50% in orthotopic tumors) was observed compared with baseline estimates. Consistent with this observation, greater levels of tumor necrosis factor {alpha}, an important mediator of the antivascular activity of DMXAA, were measured in ectopic tumors 3 hours posttreatment compared with orthotopic tumors (p < 0.05). Immunohistochemical (CD31) and histologic (hematoxylin and eosin) sections of ectopic and orthotopic tumors showed highly tumor-selective vascular damage after treatment with the presence of viable surrounding normal tissue. Conclusions: The MMCM-MRI provided early quantitative estimates of change in tumor perfusion after VDA treatment that showed good correlation with cytokine induction. Differences in the response of ectopic and orthotopic tumors highlight the influence of the host microenvironment in modulating the activity of VDAs.

Seshadri, Mukund [Preclinical Imaging Resource, Roswell Park Cancer Institute, Buffalo, NY (United States); Department of Cancer Biology, Roswell Park Cancer Institute, Buffalo, NY (United States)], E-mail: mukund.seshadri@roswellpark.org; Bellnier, David A. [Department of Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, NY (United States); Cheney, Richard T. [Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY (United States)

2008-11-15

321

Delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) Shows No Change in Cartilage Structural Composition after Viscosupplementation in Patients with Early-Stage Knee Osteoarthritis  

PubMed Central

Introduction Viscosupplementation with hyaluronic acid (HA) of osteoarthritic (OA) knee joints has a well-established positive effect on clinical symptoms. This effect, however, is only temporary and the working mechanism of HA injections is not clear. It was suggested that HA might have disease modifying properties because of its beneficial effect on cartilage sulphated glycosaminoglycan (sGAG) content. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is a highly reproducible, non-invasive surrogate measure for sGAG content and hence composition of cartilage. The aim of this study was to assess whether improvement in cartilage structural composition is detected using dGEMRIC 14 weeks after 3 weekly injections with HA in patients with early-stage knee OA. Methods In 20 early-stage knee OA patients (KLG I-II), 3D dGEMRIC at 3T was acquired before and 14 weeks after 3 weekly injections with HA. To evaluate patient symptoms, the knee injury and osteoarthritis outcome score (KOOS) and a numeric rating scale (NRS) for pain were recorded. To evaluate cartilage composition, six cartilage regions in the knee were analyzed on dGEMRIC. Outcomes of dGEMRIC, KOOS and NRS before and after HA were compared using paired t-testing. Since we performed multiple t-tests, we applied a Bonferroni-Holm correction to determine statistical significance for these analyses. Results All KOOS subscales (‘pain’, ‘symptoms’, ‘daily activities’, ‘sports’ and ’quality of life’) and the NRS pain improved significantly 14 weeks after Viscosupplementation with HA. Outcomes of dGEMRIC did not change significantly after HA compared to baseline in any of the cartilage regions analyzed in the knee. Conclusions Our results confirm previous findings reported in the literature, showing persisting improvement in symptomatic outcome measures in early-stage knee OA patients 14 weeks after Viscosupplementation. Outcomes of dGEMRIC, however, did not change after Viscosupplementation, indicating no change in cartilage structural composition as an explanation for the improvement of clinical symptoms. PMID:24223194

van Tiel, Jasper; Reijman, Max; Bos, Pieter K.; Hermans, Job; van Buul, Gerben M.; Bron, Esther E.; Klein, Stefan; Verhaar, Jan A. N.; Krestin, Gabriel P.; Bierma-Zeinstra, Sita M. A.; Weinans, Harrie; Kotek, Gyula; Oei, Edwin H. G.

2013-01-01

322

Glucose regulation and coronary artery disease : Studies on prevalence, recognition and prognostic implications.  

E-print Network

??Coronary artery disease and diabetes mellitus type 2 represent chronic diseases of substantial and growing prevalence. Their coincidence is common, markedly enhancing mortality and morbidity.… (more)

Bartnik, Malgorzata Zofia

2005-01-01

323

Based on surface-enhanced Raman spectroscopy analysis of serum albumin in different stages of liver disease for early screening primary liver cancer  

NASA Astrophysics Data System (ADS)

Despite the introduction of high-technology methods of detection and diagnosis, screening of primary liver cancer (PLC) remains imperfect. To diagnosis PLC earlier, Surface-enhanced Raman spectroscopy (SERS) coupled with cellulose-acetate membrane electrophoresis were introduced to separate human serum albumin and SERS spectra. Three groups (15 normal persons' samples, 17 hepatitis/cirrhosis samples, 15 cases of PLC) of serum albumin were tested. Silver colloid was used to obtain SERS spectra of human serum albumin. Principal component analysis (PCA) and linear discriminant analysis (LDA) were also employed for statistical analysis. The mean Raman spectra of three groups and the difference spectra of any two suggested that the albumin has changed in liver patients. Compared to normal groups, some Raman peaks have shifted or even disappeared in hepatitis/cirrhosis and PLCs groups. The sensitivity and specificity between PLCs and normal groups is 80% and 93.3%. Among hepatitis/cirrhosis and normal groups, the sensitivity is 88.2% and specificity is also 93.3%. Besides, the sensitivity and specificity between PLCs and hepatitis/cirrhosis groups is 86.7% and 76.5%. All the above data and results indicated that early screening of PLC is potential by SERS in different stages of liver disease before cancer occurs.

Liao, Fadian; Ruan, Qiuyong; Lin, Juqiang; Lin, Jinyong; Zeng, Yongyi; Li, Ling; Huang, Zufang; Liu, Nenrong; Chen, Rong

2014-09-01

324

Infusing Early Childhood Mental Health into Early Intervention Services  

ERIC Educational Resources Information Center

This article describes the process of enhancing early childhood mental health awareness and skills in non-mental health staff. The author describes a pilot training model, conducted the U.S. Army's Early Intervention Services, that involved: (a) increasing early childhood mental health knowledge through reflective readings, (b) enhancing

Grabert, John C.

2009-01-01

325

Anomalous origin of right coronary artery from pulmonary artery  

PubMed Central

Anomalous origin of coronary artery from the pulmonary artery is a rare anomaly that most frequently involves the left coronary artery and very rarely the right coronary artery. These lesions can be missed on echocardiography unless carefully looked for. We describe a case of isolated anomalous origin of right coronary artery from pulmonary artery diagnosed on echocardiography and confirmed by computed tomography (CT) angiography. PMID:22529614

Gupta, Rajat; Marwah, Ashutosh; Shrivastva, Savitri

2012-01-01

326

Spontaneous Rupture of the Omental Artery Treated by Transcatheter Arterial Embolization  

PubMed Central

Intra-abdominal hemorrhage caused by omental artery rupture is a rare condition. There are few reports on the treatment of omental artery rupture with only transcatheter arterial embolization (TAE). A 27-year-old man presented to our emergency room with upper abdominal pain that suddenly occurred during sleep. Abdominal computed tomography (CT) revealed fluid collection in the peritoneal cavity and a left subphrenic hematoma with extravasation. Celiac angiography revealed extravasation from the omental artery, which arose from the proximal left gastroepiploic artery. A microcatheter was advanced into the left gastroepiploic artery and around the culprit artery bifurcation, which was embolized by inserting coils. The postoperative course was uneventful without worsening of anemia or abdominal symptoms. The patient was discharged after the absence of extravasation was confirmed by contrast-enhanced CT. Although surgical therapy has often been performed for omental bleeding, TAE, which is less invasive and has the advantage of simultaneous diagnosis and treatment, should be attempted as the first-choice therapy. PMID:23316406

Matsuoka, Yujiro; Yasutake, Tsuyoshi; Abe, Hiroyuki; Sugiyama, Kazuhiro; Oyama, Kazuyuki

2012-01-01

327

Loss of oscillatory arterial compliance is detectable in young patients by radial artery pulse contour analysis  

Microsoft Academic Search

Background: Arterial compliance (AC) is an index of the capacity of vessels to accommodate changes in blood pressure (BP). It has been postulated that the loss of AC may precede clinical manifestations of hypertension, and that AC may have prognostic value in early identification of patients (pts) at risk. A noninvasive method has been developed to determine large (capacitive) and

A. Zimmermann; M. D. VanAuker; A. Zakari

2000-01-01

328

Idiopathic arterial calcification in infancy  

Microsoft Academic Search

An infant with idiopathic arterial calcification is presented. The disease was diagnosed during the life of the patient as an aortogram demonstrated a stenosis of the left coronary artery and complete occlusion of the right coronary artery.

J. M. Retbi; A. Casasoprana; J. C. Gabilan; M. Dehan; J. Rosenstein-Retbi

1978-01-01

329

Neurofibromatosis Type 1: Transcatheter Arterial Embolization for Ruptured Occipital Arterial Aneurysms  

SciTech Connect

Two cases of ruptured aneurysms in the posterior cervical regions associated with type-1 neurofibromatosis treated by transcatheter embolization are reported. Patients presented with acute onset of swelling and pain in the affected areas. Emergently performed contrast-enhanced CT demonstrated aneurysms and large hematomas widespread in the posterior cervical regions. Angiography revealed aneurysms and extravasations of the occipital artery. Patients were successfully treated by percutaneous transcatheter arterial microcoil embolization. Transcatheter arterial embolization therapy was found to be an effective method for treating aneurysmal rupture in the posterior cervical regions occurring in association with type-1 neurofibromatosis. A literature review revealed that rupture of an occipital arterial aneurysm, in the setting of neurofibromatosis type 1, has not been reported previously.

Kanematsu, Masayuki; Kato, Hiroki; Kondo, Hiroshi; Goshima, Satoshi; Tsuge, Yusuke; Kojima, Toshiaki; Watanabe, Haruo [Gifu University Hospital, Department of Radiology (Japan)

2011-02-15

330

Pregnancy-induced remodelling and enhanced endothelium-derived hyperpolarization-type vasodilator activity in rat uterine radial artery: transient receptor potential vanilloid type 4 channels, caveolae and myoendothelial gap junctions.  

PubMed

In pregnancy, the vasculature of the uterus undergoes rapid remodelling to increase blood flow and maintain perfusion to the fetus. The present study determines the distribution and density of caveolae, transient receptor potential vanilloid type 4 channels (TRPV4) and myoendothelial gap junctions, and the relative contribution of related endothelium-dependent vasodilator components in uterine radial arteries of control virgin non-pregnant and 20-day late-pregnant rats. The hypothesis examined is that specific components of endothelium-dependent vasodilator mechanisms are altered in pregnancy-related uterine radial artery remodelling. Conventional and serial section electron microscopy were used to determine the morphological characteristics of uterine radial arteries from control and pregnant rats. TRPV4 distribution and expression was examined using conventional confocal immunohistochemistry, and the contribution of endothelial TRPV4, nitric oxide (NO) and endothelium-derived hyperpolarization (EDH)-type activity determined using pressure myography with pharmacological intervention. Data show outward hypertrophic remodelling occurs in uterine radial arteries in pregnancy. Further, caveolae density in radial artery endothelium and smooth muscle from pregnant rats was significantly increased by ~94% and ~31%, respectively, compared with control, whereas caveolae density did not differ in endothelium compared with smooth muscle from control. Caveolae density was significantly higher by ~59% on the abluminal compared with the luminal surface of the endothelium in uterine radial artery of pregnant rats but did not differ at those surfaces in control. TRPV4 was present in endothelium and smooth muscle, but not associated with internal elastic lamina hole sites in radial arteries. TRPV4 fluorescence intensity was significantly increased in the endothelium and smooth muscle of radial artery of pregnant compared with control rats by ~2.6- and 5.5-fold, respectively. The TRPV4 signal was significantly higher in the endothelium compared with the smooth muscle in radial artery of both control and pregnant rats, by ~5.7- and 2.7-fold, respectively. Myoendothelial gap junction density was significantly decreased by ~37% in radial artery from pregnant compared with control rats. Pressure myography with pharmacological intervention showed that NO contributes ~80% and ~30%, and the EDH-type component ~20% and ~70% of the total endothelium-dependent vasodilator response in radial arteries of control and pregnant rats, respectively. TRPV4 plays a functional role in radial arteries, with a greater contribution in those from pregnant rats. The correlative association of increased TRPV4 and caveolae density and role of EDH-type activity in uterine radial artery of pregnant rats is suggestive of their causal relationship. The decreased myoendothelial gap junction density and lack of TRPV4 density at such sites is consistent with their having an integral, albeit complex, interactive role in uterine vascular signalling and remodelling in pregnancy. PMID:24128141

Senadheera, Sevvandi; Bertrand, Paul P; Grayson, T Hilton; Leader, Leo; Murphy, Timothy V; Sandow, Shaun L

2013-12-01

331

Mechanisms of post-intervention arterial remodelling  

PubMed Central

It has been appreciated over the past two decades that arterial remodelling, in addition to intimal hyperplasia, contributes significantly to the degree of restenosis that develops following revascularization procedures. Remodelling appears to be an adventitia-based process that is contributed to by multiple factors including cytokines and growth factors that regulate extracellular matrix or phenotypic transformation of vascular cells including myofibroblasts. In this review, we summarize the currently available information from animal models as well as clinical investigations regarding arterial remodelling. The factors that contribute to this process are presented with an emphasis on potential therapeutic methods to enhance favourable remodelling and prevent restenosis. PMID:22918976

Goel, Shakti A.; Guo, Lian-Wang; Liu, Bo; Kent, K. C.

2012-01-01

332

Total arterial revascularisation as a primary strategy for coronary artery bypass grafting  

PubMed Central

Background: Bilateral internal thoracic arteries confer improved survival benefit after coronary artery bypass grafting (CABG). Despite increasing evidence, the use of arterial conduits has not been accepted as a primary practice in most of the centres in the UK for various reasons. A series of patients has been analysed to assess the feasibility of total arterial revascularisation as a primary strategy in patients requiring first time CABG. Methods: Altogether 245 patients undergoing first time CABG by one surgeon, from June 1999 to October 2000, were studied. Group 1 consisted of 165 patients undergoing total arterial revascularisation (using bilateral internal thoracic and radial arteries) and group 2 consisted of 80 patients undergoing conventional CABG (using one internal thoracic artery and supplemental veins). Thirty day mortality and early morbidity with particular reference to resternotomy for bleeding, cerebrovascular accidents, renal failure, and sternal dehiscence were the main outcome measures. Results: Patients in group 1 were younger (mean (SD) 60 (10) v 65 (9) years; p<0.001), had lower Parsonnet scores (mean (SD) 5 (5) v 11 (7); p<0.001), and better left ventricular function. Both groups received a similar number of grafts. The percentage of patients undergoing total arterial revascularisation rose from 44% in the first three months to over 75% in the three latter three month periods. Overall 30 day mortality was 1.3%, one patient (0.6%) in group 1 and two patients (2.5%) in group 2. There was a similar incidence of postoperative complications and length of median postoperative stay in both groups. Conclusion: Total arterial revascularisation can be adopted as a primary strategy in most patients undergoing CABG with no increase in mortality or morbidity. PMID:12566552

Naik, M; Abu-Omar, Y; Alvi, A; Wright, N; Henderson, A; Channon, K; Forfar, J; Taggart, D

2003-01-01

333

Arterial Pressure Analog.  

ERIC Educational Resources Information Center

Describes a simple hydraulic analog which allows students to explore some physical aspects of the cardiovascular system and provides them with a means to visualize and conceptualize these basic principles. Simulates the behavior of arterial pressure in response to changes in heart rate, stroke volume, arterial compliance, and peripheral…

Heusner, A. A.; Tracy, M. L.

1980-01-01

334

Biology of Arterial Atheroma  

Microsoft Academic Search

Endothelial dysfunction and changes in arterial wall morphology including thickening of the tunica intima, excess synthesis of collagenous matrix (fibroblastic intimal thickening) and permanent or dynamic deposition of lipids (fatty streaks) already occur in childhood or adolescence. Definite atherosclerotic plaques in the carotid arteries usually do not manifest themselves before menopause in women or age 40 in men. Obviously, cumulative

Johann Willeit; Stefan Kiechl

2000-01-01

335

Long-Segment Arterial  

Microsoft Academic Search

In cases of occlusion of the superficial femoral artery exceeding a length of 10 cm, accompanied by involvement of the popliteal artery and poor runoff, percutaneous transluminal angioplasty is unfavorable. However, when such advanced occlusive disease is present in patients for whom vascular surgery is not feasible, this technique can be of value by averting or at least postponing amputation.

Chien-Tai Lu; Christopher K. Zarins; Chien-Fang Yang; Vikrom Sottiurai

336

Uterine artery embolization  

Microsoft Academic Search

Objective: Evaluation of the studies for the use of uterine artery embolization in various conditions in both obstetrics and gynecology. Design: Literature review. Results: Uterine artery embolization was successful in controlling postpartum hemorrhage in 94.9% of the cases. It was effective in controlling the bleeding in 96% of cases with uterine arteriovenous malformations and in 100% of the cases with

Shawky Z. A Badawy; Amr Etman; Manvinder Singh; Kenneth Murphy; Thomas Mayelli; Melissa Philadelphia

2001-01-01

337

Coronary artery disease (image)  

MedlinePLUS

... through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the ... blood to the heart can slow or stop, causing chest pain (stable ...

338

Ruptured ulnar artery pseudoaneurysm  

Microsoft Academic Search

Ulnar artery aneurysms and pseudoaneurysms are rare lesions that usually occur distal to the wrist and cause symptoms as a result of embolization and not rupture. An elderly woman presented with acute rupture of an ulnar artery pseudoaneurysm proximal to the wrist, which caused severe neurologic compromise as a result of bleeding into Guyon's canal and the carpal tunnel. The

Luke S. Erdoes; William C. Brown

1995-01-01

339

Coronary artery stent (image)  

MedlinePLUS

... with a balloon catheter and expands when the balloon is inflated. The stent is then left there to help keep the artery open. ... with a balloon catheter and expands when the balloon is inflated. The stent is then left there to help keep the artery open.

340

Arterial thoracic outlet syndrome  

Microsoft Academic Search

Thoracic outlet syndrome (TOS) is a well described upper extremity disorder comprising neurovascular complications caused by thoracic outlet compression. By far neurogenic thoracic outlet syndrome is the most common manifesta- tion of this disorder. Arterial complications of thoracic outlet compression are much rarer, accounting for less than 5% of all operations performed for TOS. Major arterial degenerative and thromboembolic complications

Gerald M. Patton

341

Coronary Artery Bypass Grafting  

MedlinePLUS

... plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause ... coronary artery. This creates a new path for oxygen-rich blood to flow to the heart muscle. Surgeons can bypass multiple ...

342

Measurements of the Longitudinal Movement and the Minute Roughness of the Arterial Wall - New Approaches in Arterial Characterisation  

Microsoft Academic Search

Cardiovascular diseases constitute the major cause of morbidity and mortality in the Western World. To increase our knowledge of cardiovascular diseases, it is important to find methods, preferably non-invasive ones, to study very early manifestations of vascular disease. Changes in the mechanical properties of the arteries can be an early manifestation of vascular disease (2). Moreover, changes in the mechanical

Magnus Cinthio; Åsa Rydén Ahlgren; Hideyuki Hasegawa; Tomas Jansson; Hans W Persson; Kjell Lindström; Hiroshi Kanai

343

Reversibility of atherosclerosis--evolving perspectives from two arterial imaging clinical trials: the cholesterol lowering atherosclerosis regression study and the monitored atherosclerosis regression study.  

PubMed

The Cholesterol Lowering Atherosclerosis Study (CLAS) and the Monitored Atherosclerosis Regression Study (MARS) are serial arterial imaging clinical trials that have explored the reversibility of atherosclerosis with lipid-lowering therapy in native coronary, carotid, and femoral arterial beds, as well as in coronary artery bypass grafts. Results demonstrate that progression of atherosclerosis can be reduced in all these vascular beds. Evolving data indicate that coronary lesions > or = 50% diameter stenosis (%S) at baseline respond more readily to lipid-lowering therapy than lesions <50%S. In addition, lipoproteins may have a differential effect on coronary lesion progression according to lesion size, with triglyceride-rich lipoproteins playing an important role in the progression of lesions <50%S. Limited data indicate that progression of atherosclerosis in women may be more responsive to lipid-lowering therapy than in men, and that estrogen replacement may enhance the anti-atherosclerosis effects of lipid lowering. Longitudinal measurements of carotid artery far wall intima-media thickness (IMT) with B-mode ultrasonography in CLAS and MARS indicate that carotid atherosclerosis at a stage before lesions intrude into the vessel lumen can be reduced by lipid-lowering therapy. Together, CLAS and MARS data indicate that the spectrum from very early lesions confined to the arterial wall to established lesions late in the atherosclerotic process can be reversed with lipid-lowering therapy. PMID:8907211

Hodis, H N

1995-01-01

344

Improvement in Central Arterial Pressure Waveform during Hemodialysis Is Related to a Reduction in Asymmetric Dimethylarginine (ADMA) Levels  

Microsoft Academic Search

Background: Cardiovascular mortality is high in hemodialysis (HD) patients. Early arterial pressure wave reflections, reflecting arterial stiffness and the endogenous nitric oxide synthesis inhibitor asymmetric dimethylarginine (ADMA) levels predict mortality in HD patients. Therefore, we aimed to study changes in ADMA levels and central arterial pressure waveform during HD. Methods: Thirty-two chronic HD patients were studied before and after a

Inga Soveri; Lars Lind; Björn Wikström; Mihkel Zilmer; Kersti Zilmer; Bengt Fellström

2007-01-01

345

Dynamic Contrast Enhanced MRI Detects Early Response to Adoptive NK Cellular Immunotherapy Targeting the NG2 Proteoglycan in a Rat Model of Glioblastoma  

PubMed Central

There are currently no established radiological parameters that predict response to immunotherapy. We hypothesised that multiparametric, longitudinal magnetic resonance imaging (MRI) of physiological parameters and pharmacokinetic models might detect early biological responses to immunotherapy for glioblastoma targeting NG2/CSPG4 with mAb9.2.27 combined with natural killer (NK) cells. Contrast enhanced conventional T1-weighted MRI at 7±1 and 17±2 days post-treatment failed to detect differences in tumour size between the treatment groups, whereas, follow-up scans at 3 months demonstrated diminished signal intensity and tumour volume in the surviving NK+mAb9.2.27 treated animals. Notably, interstitial volume fraction (ve), was significantly increased in the NK+mAb9.2.27 combination therapy group compared mAb9.2.27 and NK cell monotherapy groups (p?=?0.002 and p?=?0.017 respectively) in cohort 1 animals treated with 1 million NK cells. ve was reproducibly increased in the combination NK+mAb9.2.27 compared to NK cell monotherapy in cohort 2 treated with increased dose of 2 million NK cells (p<0.0001), indicating greater cell death induced by NK+mAb9.2.27 treatment. The interstitial volume fraction in the NK monotherapy group was significantly reduced compared to mAb9.2.27 monotherapy (p<0.0001) and untreated controls (p?=?0.014) in the cohort 2 animals. NK cells in monotherapy were unable to kill the U87MG cells that highly expressed class I human leucocyte antigens, and diminished stress ligands for activating receptors. A significant association between apparent diffusion coefficient (ADC) of water and ve in combination NK+mAb9.2.27 and NK monotherapy treated tumours was evident, where increased ADC corresponded to reduced ve in both cases. Collectively, these data support histological measures at end-stage demonstrating diminished tumour cell proliferation and pronounced apoptosis in the NK+mAb9.2.27 treated tumours compared to the other groups. In conclusion, ve was the most reliable radiological parameter for detecting response to intralesional NK cellular therapy. PMID:25268630

Thuen, Marte; Gras Navarro, Andrea; Huuse, Else Marie; Thorsen, Frits; Poli, Aurelie; Zimmer, Jacques; Haraldseth, Olav; Lie, Stein Atle; Enger, Per ?yvind; Chekenya, Martha

2014-01-01

346

Fenestrated vertebral artery.  

PubMed

Fenestrations of the vertebral arteries (VAs) are usually identified angiographically. A left fenestrated vertebral artery (fVA) is reported here, identified in an adult specimen by microdissection. The distal segment of this VA was fenestrated and it consisted of two arms, the caudal one being larger than the cranial one. The caudal end of the rostral arm and the left posterior inferior cerebellar artery (PICA) were inserted at the same point. The anterior spinal artery was leaving the caudal arm of the fVA. On that side the anterior inferior cerebellar artery (AICA) was rudimentary, its cerebellar hemispheric territory being supplied by the PICA. The rostral arm of the fVA and the AICA were united by an anastomosis coursing on the ventral side of the olive. The AICA-to-fVA anastomosis, as well as the PICA, were supplying perforator arteries of the retro-olivary sulcus. Anatomical details of various arterial morphologies are important during specific surgical and interventional procedures. PMID:23842727

Rusu, Mugurel Constantin; Pop, Elena

2013-09-01

347

[A case of pulmonary tumor thrombotic microangiopathy induced by early gastric cancer].  

PubMed

A 56-year-old man with chief complaints of dry cough and dyspnea was admitted. He had severe hypoxemia, and his chest radiographs showed enhancement of pulmonary artery opacities with multiple defects on pulmonary blood flow scintigraphy. Enhanced computed tomography (CT) revealed swelling of the mediastinum and hilar lymph nodes, but no apparent thrombi in the pulmonary arteries was seen. A biopsy specimen of a left neck lymph node showed poorly differentiated adenocarcinoma, including signet-ring cell carcinoma components, but the origin was unclear. Despite receiving chemotherapy, his respiratory condition worsened, and he died 3 days after admission. Routine autopsy failed to clarify the tumor origin, but a detailed dissection of specimens confirmed early gastric cancer. Additionally, pathology of the pulmonary arteries was compatible with pulmonary tumor thrombotic microangiopathy (PTTM). PTTM is a rare condition characterized by the presence of diffuse thrombotic microthrombi and fibrocellular intimal proliferation in the pulmonary vasculature. Accompanied with early gastric cancer, this is an extremely rare but important case of PTTM. PMID:21400909

Yasui, Hideki; Akamatsu, Taisuke; Nakamura, Yutarou; Inui, Naoki; Suda, Takafumi; Chida, Kingo; Meguro, Shiori; Baba, Satoshi

2011-02-01

348

Arterial cannulation can hasten the onset of symmetrical peripheral gangrene  

PubMed Central

Symmetrical peripheral gangrene (SPG) is a devastating complication seen in critical care settings due to several contributory factors like low perfusion, high dose of vasopressors, disseminated intravascular coagulation, etc. Arterial cannulation is commonly done in critical patients for monitoring. We report a case of patient who developed early features of SPG which recovered in one hand, although it progressed in the hand which had the arterial cannula.

Srinivasan, Nataraj M.; Chaudhuri, Souvik

2011-01-01

349

Vertebrobasilar Artery Occlusion  

PubMed Central

The presentation of vertebrobasilar artery occlusion varies with the cause of occlusion and location of ischemia. This often results in delay in diagnosis. Areas of the brain supplied by the posterior circulation are difficult to visualize and usually require angiography or magnetic resonance imaging. Intravenous thrombolysis and local-intra arterial thrombolysis are the most common treatment approaches used. Recanalization of the occluded vessel significantly improves morbidity and mortality. Here we present a review of the literature and a case of a patient with altered mental status caused by vertebrobasilar artery occlusion. PMID:21691534

Schoen, Jessica C.; Boysen, Megan M.; Warren, Chase R.; Chakravarthy, Bharath; Lotfipour, Shahram

2011-01-01

350

The effect of occult diabetic status and oral glucose intake on brachial artery vasoactivity in patients with peripheral vascular disease 1 Presented at the Annual Meeting of the Military Vascular Society and the Chesapeake Vascular Society, December 5, 1997, Bethesda, MD, USA. 1  

Microsoft Academic Search

Brachial artery vasoactivity is a well known non-invasive method of assessing arterial endothelial function in vivo. Brachial artery vasoactivity has been found to be impaired in overt diabetes and in patients with coronary artery disease. Impaired brachial artery vasoactivity is felt to be an early indicator of atherosclerosis. The authors identified a group of patients with lower extremity peripheral vascular

R Avena; K. M Curry; A. N Sidawy; J. F Simpkins; R. F Neville; M. E Mitchell; M Bukowski

1998-01-01

351

Pulmonary Artery Sarcoma Masquerading as Chronic Pulmonary Thromboembolism  

PubMed Central

We describe the case of a 60-year-old woman who presented with pulmonary artery sarcoma, a very rare tumor of the cardiovascular system. Her tumor was initially misdiagnosed as chronic pulmonary thromboembolism, and she underwent pulmonary endarterectomy. Early diagnosis of primary pulmonary artery sarcoma is crucial. That alternative should always be considered before settling on a diagnosis of pulmonary embolism. Suspicion should be aroused by the failure of anticoagulant treatment to alleviate pulmonary perfusion abnormalities and systemic symptoms. Surgical resection of the tumor—preferably by pulmonary endarterectomy, followed by reconstruction as needed—is currently the most promising treatment for pulmonary artery sarcoma. PMID:25425987

Coskun, Ugur; Calpar, Ilknur; Yildizeli, Bedrettin; Yanartas, Mehmet; Filinte, Deniz; Kucukoglu, Mehmet Serdar

2014-01-01

352

Arterial disease ulcers, part 1: clinical diagnosis and investigation.  

PubMed

Arterial disease (peripheral vascular disease) is the result of narrowing of the blood vessel lumen. The classic clinical signs need to be recognized early before progression to arterial predominant disease and limb ischemia. Arterial ulcers or tissue breakdown can result from trauma, infection, or other etiologies with diabetes, smoking, increasing age, and hypertension the most important risk factors. Diagnostic testing starts with a palpable pulse with special investigation including handheld Doppler for ankle brachial pressure index ratios, segmental duplex leg Doppler waveforms, and more specialized procedures, including transcutaneous oxygen saturation. PMID:25133344

Weir, Gregory Ralph; Smart, Hiske; van Marle, Jacobus; Cronje, Frans Johannes

2014-09-01

353

Pseudoaneurysm of the Uterine Artery Requiring Bilateral Uterine Artery Embolization  

Microsoft Academic Search

OBJECTIVE: To report a case of uterine artery pseudoaneurysm which initially failed unilateral uterine artery embolization that subsequently responded to bilateral embolization.DESIGN: A case report.SETTING: University hospital.PATIENT(S): 32-year-old G2 P1 female.INTERVENTION(S): Left uterine artery embolization followed by right uterine artery embolization 1 day later.MAIN OUTCOME MEASURE(S): Vaginal bleeding, hemoglobin.RESULTS: Unilateral uterine artery embolization failed to control vaginal bleeding. Repeat embolization

Brian C Cooper; Michelle Hocking-Brown; Joel I Sorosky; Wendy F Hansen

2004-01-01

354

Anomalous left coronary artery from pulmonary artery (ALCAPA) in infants: a 5-year review in a defined birth cohort  

Microsoft Academic Search

Anomalous left coronary artery from pulmonary artery (ALCAPA) is a rare congenital cardiac malformation. It presents predominantly\\u000a in infancy with features of myocardial ischaemia or cardiac failure and may be mistaken for common paediatric conditions such\\u000a as colic, reflux or bronchiolitis. With early surgical correction the prognosis is good, but awareness of this condition is\\u000a essential for prompt diagnosis and

Helen Brotherton; Roy K. Philip

2008-01-01

355

Acute arterial occlusion - kidney  

MedlinePLUS

... way to reduce your risk is to stop smoking. People at risk for developing blood clots may need to take anti-clotting medicines. Taking steps to control diseases related to atherosclerosis (hardening of the arteries) may reduce your risk.

356

Coronary artery spasm  

MedlinePLUS

... as amphetamines and cocaine Cocaine use and cigarette smoking can cause severe spasms of the arteries, and can cause ... without any other heart risk factors (such as smoking, diabetes, high blood pressure, and high cholesterol).

357

Uterine artery embolization - discharge  

MedlinePLUS

Uterine fibroid embolization - discharge; UFE - discharge; UAE - discharge ... You had uterine artery embolization (UAE). UAE is a procedure to treat fibroids using radiology instead of surgery. During the procedure, the blood supply of the fibroids ...

358

Peripheral artery disease - legs  

MedlinePLUS

... and hardening of the arteries . This causes decreased blood flow, which can injure nerves and other tissues. ... stiffer and cannot widen (dilate) to allow greater blood flow when needed. As a result, the muscles of ...

359

Peripheral Artery Disease  

MedlinePLUS

... of restricted blood flow through an artery. Catheter angiography (www.radiologyinfo.org/en/info.cfm?pg=angiocath) : ... section for more information about x-rays . CT angiography (CTA) (www.radiologyinfo.org/en/info.cfm?pg= ...

360

Activation of the adenovirus and BK virus late promoters: effects of the BK virus enhancer and trans-acting viral early proteins.  

PubMed Central

We have examined the activation of the adenovirus major late promoter (MLP) by the cis-acting enhancer element of the human polyomavirus BK and by the trans-acting simian virus 40 (SV40) T antigen and adenovirus E1A proteins. By using chloramphenicol acetyltransferase expression vectors, we found that the MLP (pLP-CAT) was trans-activated in human and monkey kidney cells expressing the SV40 T antigen. In addition, the MLP could be cis-activated by the BK virus enhancer in both human and monkey kidney cells; approximately 20 times more chloramphenicol acetyltransferase was produced from expression vectors containing a hybrid promoter (BL), in which the BK enhancer was upstream of the MLP, than from expression vectors containing the MLP alone. This same level of enhancement of the MLP by the BK enhancer was observed in cells expressing the T antigen of SV40. However, in the 293 cell line, greater enhancement of MLP activity (70-fold) was observed with the BK enhancer sequence. In contrast, MLP activity in the 293 cell line was unchanged by the SV40 enhancer. In cotransfection experiments, MLP activity, augmented by the BK enhancer, could be further stimulated with a plasmid coding for the E1A gene products. By creating deletion mutants, we determined that the high-level activation of the hybrid BL transcriptional unit by the E1A proteins requires both MLP sequences and an intact BK virus enhancer. On the other hand, activation of the BL transcriptional unit by the T antigen did not require an intact enhancer sequence. Our results suggest that the SV40 T antigen and E1A proteins trans-activate the BL promoter by different mechanisms. We also demonstrate in cotransfection experiments that the BK late promoter is activated 45-fold by the SV40 T antigen. Images PMID:3025602

Grinnell, B W; Berg, D T; Walls, J

1986-01-01

361

Bilateral pulmonary artery aneurysms  

Microsoft Academic Search

Pulmonary artery aneurysms are rare. The estimated incidence is 1 in 14,000 in autopsies. Bilateral main pulmonary artery aneurysms have not been previously reported in the literature.A 36-year-old woman who has been diagnosed as having an ostium secundum defect with severe pulmonary hypertension was found dead. Autopsy revealed an emaciated body. The heart was enlarged. Right atrium and ventricle were

Sarathchandra Kodikara; Murugapillei Sivasubramanium

2009-01-01

362

Rotational vertebral artery syndrome  

Microsoft Academic Search

Whether the rotational vertebral artery syndrome (RVAS), consisting of attacks of vertigo, nystagmus and tinnitus elicited\\u000a by head-rotation induced compression of the dominant vertebral artery (VA), reflects ischemic dysfunction of uni- or bilateral\\u000a peripheral or central vestibular structures, is still debated. We report on a patient with bilateral high-grade carotid stenoses,\\u000a in whom rightward headrotation led to RVAS symptoms including

Sarah Marti; Stefan Hegemann; Hans-Christian von Büdingen; Ralf W. Baumgartner; Dominik Straumann

2008-01-01

363

Strategies for Enhancing Adolescents' Health through Music Media. A Commentary on "Popular Music in Early Adolescence" by Peter G. Christensen and Donald F. Roberts.  

ERIC Educational Resources Information Center

The primary purpose of this paper is to describe strategies for enhancing the health behavior of adolescents and their families through increasing the healthfulness of the media environment, particularly radio or the music industry. A second goal is to briefly describe research that would enhance understanding of the healthfulness of the media…

Flora, June A.

364

Long-Term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD)  

Microsoft Academic Search

BackgroundEarly onset of mood symptoms in bipolar disorder has been associated with poor outcome in many studies; however, the factors that might contribute to poor outcome have not been adequately investigated.

Roy H. Perlis; Sachiko Miyahara; Lauren B. Marangell; Stephen R. Wisniewski; Michael Ostacher; Melissa P. DelBello; Charles L. Bowden; Gary S. Sachs; Andrew A. Nierenberg

2004-01-01

365

Identification of a New Intronic BMPR2-Mutation and Early Diagnosis of Heritable Pulmonary Arterial Hypertension in a Large Family with Mean Clinical Follow-Up of 12 Years  

PubMed Central

Background Mutations in the bone morphogenetic protein receptor 2 (BMPR2) gene can lead to hereditary pulmonary arterial hypertension (HPAH) and are detected in more than 80% of cases with familial aggregation of the disease. Factors determining disease penetrance are largely unknown. Methods A mean clinical follow-up of 12 years was accomplished in 46 family members including echocardiography, stress-Dopplerechocardiography and genetic analysis of TGF-? pathway genes. Right heart catheterization and RNA-analysis was performed in members with pathological findings. Results Manifest HPAH was diagnosed in 8 members, 4 were already deceased, two died during the follow-up, two are still alive. Normal pulmonary artery systolic pressure at rest but hypertensive response to exercise has been identified in 19 family members. Analysis of BMPR2 transcripts revealed aberrant splicing due to an insertion of an intronic Alu element adjacent to exon 6. All HPAH patients and 12 further asymptomatic family members carried this insertion. During follow-up two family members carrying hypertensive response and the Alu insertion developed manifest HPAH. Conclusion This is the first report of an intronic BMPR2 mutation due to an Alu element insertion causing HPAH in a large family which has been confirmed on RNA-level. Only those members that carried both hypertensive response and the mutation developed manifest HPAH during follow-up. Our findings highlight the importance of including further methods such as RNA analysis into the molecular genetic diagnostic of PAH patients. They suggest that at least in some families hypertensive response may be an additional risk factor for disease manifestation and penetrance. PMID:24621962

Pfarr, Nicole; Szamalek-Hoegel, Justyna; Lichtblau, Mona; Nagel, Christian; Egenlauf, Benjamin; Ehlken, Nicola; Grunig, Ekkehard

2014-01-01

366

Enhanced Early Head Start with Employment Services: 42-Month Impacts from the Kansas and Missouri Sites of the Enhanced Services for the Hard-to-Employ Demonstration and Evaluation Project. OPRE Report 2012-05  

ERIC Educational Resources Information Center

MDRC is conducting the Enhanced Services for the Hard-to-Employ Demonstration and Evaluation Project under a contract with the Administration for Children and Families (ACF) in the U.S. Department of Health and Human Services (HHS). As part of the multisite Enhanced Services for the Hard-to-Employ Demonstration and Evaluation Project, MDRC,…

Hsueh, JoAnn; Farrell, Mary E.

2012-01-01

367

Current status of arterial grafts for coronary artery bypass grafting  

PubMed Central

For over a decade there has been accumulating evidence that the use of more than a single arterial graft during coronary artery bypass grafting can improve clinical outcomes. However the vast majority of patients in most developed countries still only receive a single arterial conduit even in the presence of multivessel coronary artery disease. This review summarizes the current evidence for the use of a second internal mammary artery and/or radial artery graft. While in comparison to vein grafts the superior patency of internal mammary artery grafts is well established, there now exists strong and consistent evidence of the superior patency of radial arteries over the longer term. Likewise, there is a rapidly growing body of evidence that the superior patency of both these arteries in comparison to vein grafts translates into improved clinical outcomes. PMID:23977618

2013-01-01

368

Adenosine enhances the relaxing influence of retinal tissue  

Microsoft Academic Search

Retinal tissue from different species continuously releases an as yet unidentified retinal relaxing factor (RRF) lowering tone of isolated arteries. The potential influence of adenosine on this relaxing influence was investigated using isometric tension recording of different isolated arteries. The presence of bovine retinal tissue or rat retinal tissue enhanced the vasorelaxing effect of adenosine on isolated bovine retinal artery.

Nele Maenhaut; Koen Boussery; Christophe Delaey; Johan Van de Voorde

2009-01-01

369

Acute and prolonged treatment with low-molecular-weight heparin therapy in patients with unstable coronary artery disease.  

PubMed

Unstable angina and non-ST-segment elevation myocardial infarction (MI) are known as unstable coronary artery disease (UCAD). They are syndromes that share a common pathobiology and represent a frequently encountered and potentially life-threatening medical condition. Acute-phase treatment with aspirin is associated with a significant reduction in death and non-fatal MI in patients with UCAD. This benefit is enhanced by the addition of unfractionated heparin (UFH) to the treatment strategy; however, UFH requires careful monitoring and titration. In contrast, low-molecular-weight heparins (LMWHs), produced by chemical or enzymatic depolymerization of UFH, yield a predictable and consistent pharmacokinetic profile and anticoagulant response making them an attractive alternative treatment to UFH in patients with UCAD. In several studies, acute-phase treatment with LMWH has been shown to be at least as effective and safe as UFH. The optimal duration of treatment with LMWH is an important question that has been influenced by the observation that reactivation of coagulation occurs following the early and abrupt discontinuation of heparin treatment. In early trials, such as FRISC (Fragmin during instability in coronary artery disease) and FRIC (Fragmin in unstable coronary artery disease), the results of extended treatment were inconclusive; however, the trial populations included patients of relatively low risk and used a once-daily dosing regimen. In the TIMI 11B (Thrombolysis in myocardial infarction) extended treatment beyond the few days of acute treatment with enoxaparin did not add to the beneficial LMWH effect, but in this study 40% of the high-risk patients did not continue on extended treatment. The findings derived from the FRISC II trial, which used a twice-daily dose of dalteparin sodium, suggest a benefit for up to 45 days with extended treatment in high-risk UCAD patients. Although an early invasive treatment strategy is particularly beneficial, patients in whom early revascularization is not possible should be considered for extended treatment with dalteparin sodium awaiting percutaneous coronary intervention. PMID:11209983

Husted, S; Kher, A

2000-12-01

370

Preoperative visualization of the marginal tentorial artery as an unusual collateral pathway in a patient with symptomatic bilateral vertebral artery occlusion undergoing arterial bypass surgery: A 7.0-T magnetic resonance imaging study  

PubMed Central

Background: Extracranial–intracranial arterial bypass surgery is rarely performed for recurrent or progressing stroke due to vertebrobasilar artery steno-occlusive disease. Non-enhanced 7.0-T magnetic resonance (MR) imaging reveals cerebral arteries more clearly than 3.0-T or less MR imaging. Case Description: A 45-year-old man developed recurrent transient ischemic attacks due to hemodynamic ischemia caused by occlusion of bilateral vertebral arteries despite antiplatelet therapy. MR angiography with a 7.0-T imager demonstrated that each marginal tentorial artery ran along the tentorial edge and anastomosed with each posterior cerebral artery (PCA) as collateral circulation. Superficial temporal artery (STA)–superior cerebellar artery (SCA) or PCA bypass surgery was planned through a subtemporal approach. During surgery, the SCA was not visible when the tentorial edge was elevated. The tentorium was not cut, and the STA was anastomosed with the P2 segment of the PCA. Ischemic symptoms completely resolved after surgery. Conclusions: Preoperative 7.0-T MR imaging visualized the marginal tentorial artery as an unusual collateral pathway in a patient with symptomatic bilateral vertebral artery occlusion undergoing arterial bypass surgery.

Sato, Yuiko; Ogasawara, Kuniaki; Yoshida, Kenji; Sasaki, Makoto

2014-01-01

371

Successful Treatment of a Dilated Circumflex Artery and Coronary Sinus Fistula  

PubMed Central

Coronary arteriovenous fistula is a rare entity and is mostly diagnosed and corrected in early childhood. We report the case of a 59-year-old female patient who was presented with chest pain during exertion for 3 months because of an aneurysmatic circumflex artery and coronary sinus fistula. We successfully ligated the circumflex artery close to the main stem and to the coronary sinus. The first marginal branch was revascularized by the left internal thoracic artery. The postoperative course was uneventful.

Bernhardt, Alexander Martin; Gulbins, Helmut; Reichenspurner, Hermann

2013-01-01

372

Functional comparison between the human inferior epigastric artery and internal mammary artery  

Microsoft Academic Search

Although the inferior epigastric artery has been used as an alternative arterial graft for coronary artery bypass grafting, little is known about the contractile and relaxation characteristics of this artery. This study was designed to compare the pharmacologic reactivity of the two arterial conduits—the inferior epigastric artery and the internal mammary artery. Forty-one inferior epigastric artery ring segments from eight

Guo-Wei He; Tea E. Acuff; William H. Ryan; Cheng-Qin Yang; Michael J. Mack

1995-01-01

373

Non-invasive imaging for subclinical coronary atherosclerosis in patients with peripheral artery disease.  

PubMed

Patients with peripheral artery disease are at high risk of coronary artery disease. An increasing number of studies show that a large proportion of patients with peripheral artery disease have significant coronary atherosclerosis, even in the absence of symptoms. Although the reported prevalence of subclinical coronary artery disease varies widely in patients with peripheral artery disease, it could include more than half of patients. No consensus exists to date on either the rationale for screening patients with peripheral artery disease for coronary atherosclerosis or the optimal algorithm and method for screening. An increasing number of imaging modalities are emerging that allow improved in vivo non-invasive characterization of atherosclerotic plaques. These novel imaging methods may lead to early detection of high-risk vulnerable plaques, enabling clinicians to improve risk stratification of patients with peripheral artery disease, and thus paving the way for individualized therapy. PMID:24691587

Ripa, Rasmus Sejersten; Kjaer, Andreas; Hesse, Birger

2014-06-01

374

Intra-arterial digital subtraction angiogrpahy: comparison with conventional hepatic arteriography  

SciTech Connect

To evaluate the efficacy of arterial digital subtraction angiography (DSA), 28 patients with a variety of hepatic lesions underwent intra-arterial DSA immediately following conventional celiac or hepatic arteriography. Thirty-one studies were obtained and the results of DSA were compared with the conventional arteriograms. DSA showed good visualization of the arteries in the early arterial phase of the examination. The late arterial phase was better evaluated on conventional arteriograms due to the decreased spatial resolution of DSA. Arterial DSA was most useful in the evaluation of the parenchyma of the liver; the use of remasking techniques allowed improved visualization of hepatic lesions, particularly in the left lobe of the liver. It is concluded that arterial DSA is useful in hepatic imaging and may supplant conventional hepatic arteriography as the technology improves.

Flannigan, B.D.; Gomes, A.S.; Stambuk, E.C.; Lois, J.F.; Pais, S.O.

1983-07-01

375

Early screening for preeclampsia.  

PubMed

Preeclampsia, which affects about 3 to 5% of pregnant women, is the most frequent medical complication in pregnancy and the most important cause of maternal and perinatal morbidity and mortality. During the past three decades, numerous clinical, biophysical, and biochemical screening tests have been proposed for the early detection of preeclampsia. Literature shows large discrepancies in the sensitivity and predictive value of several of these tests. No single screening test used for preeclampsia prediction has gained widespread acceptance into clinical practice. Instead, its value seems to be in increasing the predictive value of panels of tests, which include other clinical measurements. The aim of this review was to examine the combination of maternal risk factors, mean arterial blood pressure, and uterine artery Doppler, together with biomarkers in the preeclampsia prediction. PMID:22267116

Costa, Fabrício da Silva; Murthi, Padma; Keogh, Rosemary; Woodrow, Nicole

2011-11-01

376

Repair of anomalous origin of right coronary artery from the pulmonary artery.  

PubMed

Anomalous origin of the right coronary artery from the pulmonary artery is a rare cardiac malformation. Between July 2002 and July 2005, we operated on 4 patients with this defect. There were 2 males and 2 females, aged from 18 months to 42 years. Three patients underwent direct re-implantation of the right coronary artery into the aorta, and one had an intrapulmonary tunnel repair (intrapulmonary artery baffle with an autologous pericardial patch for tunneling to the anomalous right coronary ostium). Cardiopulmonary bypass was used in 2 patients, and an off-pump technique in the other 2. One patient had an atrial septal defect that was closed with an Amplatzer septal occluder through the right atrium under transesophageal echocardiography, without cardiopulmonary bypass. All patients survived and recovered uneventfully. Follow-up ranged from 3 to 39 months (mean, 17 months). All patients were doing well and free from symptoms, with normal exercise tolerance. Surgical correction of anomalous right coronary artery shows good early and midterm results. PMID:17911071

Guo, Hong-Wei; Xu, Jian-Ping; Song, Yun-Hu; Sun, Han-Song; Shen, Xiang-Dong; Hu, Sheng-Shou

2007-10-01

377

Visceral artery aneurysms.  

PubMed

Visceral artery aneurysms (VAA) frequently present as life-threatening emergencies. The purpose of this study was to review our experience with VAA treatment. Between 1988 and April 2002, 31 VAA were treated in 28 patients (14 males, 14 females) with average age of 55 +/- 15 years. The most common locations were the splenic artery (16) and the hepatic artery (7). Three patients underwent emergency surgery, 22 patients had elective open surgery, and 7 patients underwent endovascular treatment. In the surgical group the perioperative mortality rate was 3.6%. The perioperative morbidity rate was 7.1% (one case of respiratory distress manifested in the immediate postoperative period and one urgent case of bilious fistula). In the endovascular group none of the patients died; the perioperative morbidity rate was of 14.3% (one case of hepatic artery thrombosis after failure of gastroduodenal artery aneurysm embolization). Failure of the procedure was 42.9% (3 cases of aneurysm recanalization). In conclusion, we believe that an aggressive surgical approach is justified, even in the case of asymptomatic VAA, because of the low morbidity and mortality rates. Endovascular treatment should be reserved for selected cases. PMID:15714366

Chiesa, R; Astore, D; Guzzo, G; Frigerio, S; Tshomba, Y; Castellano, R; de Moura, M R Liberato; Melissano, G

2005-01-01

378

Coronary arterial fistulas  

PubMed Central

Abstract A coronary arterial fistula is a connection between one or more of the coronary arteries and a cardiac chamber or great vessel. This is a rare defect and usually occurs in isolation. Its exact incidence is unknown. The majority of these fistulas are congenital in origin although they may occasionally be detected after cardiac surgery. They do not usually cause symptoms or complications in the first two decades, especially when small. After this age, the frequency of both symptoms and complications increases. Complications include 'steal' from the adjacent myocardium, thrombosis and embolism, cardiac failure, atrial fibrillation, rupture, endocarditis/endarteritis and arrhythmias. Thrombosis within the fistula is rare but may cause acute myocardial infarction, paroxysmal atrial fibrillation and ventricular arrhythmias. Spontaneous rupture of the aneurysmal fistula causing haemopericardium has also been reported. The main differential diagnosis is patent arterial duct, although other congenital arteriovenous shunts need to be excluded. Whilst two-dimensional echocardiography helps to differentiate between the different shunts, coronary angiography is the main diagnostic tool for the delineation of the anatomy. Surgery was the traditional method of treatment but nowadays catheter closure is recommended using a variety of closure devices, such as coils, or other devices. With the catheter technique, the results are excellent with infrequent complications. Disease name and synonyms Coronary arterial fistulas Coronary arterial fistulas or malformations PMID:17184545

Qureshi, Shakeel A

2006-01-01

379

Cerebral arterial fenestrations.  

PubMed

Arterial fenestrations are an anatomic variant with indeterminate significance. Given the controversy surrounding fenestrations we sought their prevalence within our practice along with their association with other cerebrovascular anomalies. We retrospectively reviewed 10,927 patients undergoing digital subtraction angiography between 1992 and 2011. Dictated reports were searched for the terms "fenestration" or "fenestrated" with images reviewed for relevance, yielding 228 unique cases. A Medline database search from February 1964 to January 2013 generated 304 citations, 127 cases of which were selected for analysis. Cerebral arterial fenestrations were identified in 228 patients (2.1%). At least one aneurysm was noted in 60.5% of patients, with an aneurysm arising from the fenestration in 19.6% of patients. Aneurysmal subarachnoid hemorrhage or non-aneurysmal subarachnoid hemorrhage were present in 60.1% and 15.8%, respectively. For the subset of patients with an aneurysm arising directly from a fenestration relative to those patients with an aneurysm not immediately associated with a fenestration, the prevalence of aneurysmal subarachnoid hemorrhage was 66.7% vs. 58.6% (p = 0.58). Fenestrations were more often within the posterior circulation (73.2%) than the anterior circulation (24.6%), though there was no difference in the prevalence of aneurysms within these groups (61.1% vs. 60.7%, p = 1.0). Cerebral arterial fenestrations are an anatomic variant more often manifesting at the anterior communicating arterial complex and basilar artery and with no definite pathological relationship with aneurysms. PMID:24976087

Cooke, Daniel L; Stout, Charles E; Kim, Warren T; Kansagra, Akash P; Yu, John Paul; Gu, Amy; Jewell, Nicholas P; Hetts, Steven W; Higashida, Randall T; Dowd, Christopher F; Halbach, Van V

2014-01-01

380

Traumatic Distal Ulnar Artery Thrombosis  

PubMed Central

This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome) but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases.

Karaarslan, Ahmet A.; Karakasl?, Ahmet; Mayda, Aslan; Karc?, Tolga; Aycan, Hakan; Kobak, Senol

2014-01-01

381

Descending septal artery: an important artery for collateral coronary circulation.  

PubMed

We present a case report of a 40-year-old male who underwent elective cardiac catheterization secondary to complaints of intermittent chest pain and inducible ischemia in the anterior wall. Diagnostic catheterization revealed severe coronary artery disease including an occluded mid left anterior descending (LAD) artery. There was a rarely described descending septal artery (Bonapace's branch) originating from a separate ostium in the right aortic sinus. This artery was a very important source of collateralization to the LAD. This artery has been reported once in vivo, while it has been described more frequently in postmortem studies. The descending septal artery is postulated to have an important role in the perfusion of the conduction system and in collateral circulation in patients with coronary artery disease. A literature review confirms the functional importance of this artery. PMID:23388235

Sanghvi, Kintur; de Leon Mansson, Sarah; Patel, Tejas

2013-02-01

382

Safety of Chemotherapeutic Infusion or Chemoembolization for Hepatocellular Carcinoma Supplied Exclusively by the Cystic Artery  

SciTech Connect

Purpose: This study was designed to evaluate the safety of chemotherapeutic infusion or chemoembolization by way of the cystic artery in patients with hepatocellular carcinoma (HCC) supplied exclusively by the cystic artery. Methods: Between Jan 2002 and Dec 2011, we performed chemotherapeutic infusion or chemoembolization using iodized oil for the treatment of 27 patients with HCC supplied exclusively by the cystic artery. Computed tomography (CT) scans, digital subtraction angiograms, and medical records were retrospectively reviewed by consensus. Results: The cystic artery originated from the main right hepatic artery in 24 (89 %) patients, from the right anterior hepatic artery in 2 (7 %) patients, and from the left hepatic artery in 1 (4 %) patient. Selective catheterization of the cystic artery was achieved in all patients. Superselection of tumor-feeding vessels from the cystic artery was achieved in 7 patients (26 %). Chemotherapeutic infusion was performed in 18 patients (67 %), and chemoembolization was performed in 9 patients (33 %). There were no major complications and only 2 minor complications, including vasovagal syncope and nausea with vomiting. Individual tumor response supplied exclusively by the cystic artery at the follow-up enhanced CT scan were complete response (n = 16), partial response (n = 3), and stable disease (n = 8). Conclusion: HCC supplied exclusively by the cystic artery can be safely treated without severe complications by chemotherapeutic infusion or chemoembolization using iodized oil through the cystic artery.

Kang, Beomsik, E-mail: kangbs98@gmail.com; Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Chung, Jin Wook, E-mail: chungjw@snu.ac.kr; Hur, Saebeom, E-mail: hurz21@gmail.com; Joo, Seung-Moon, E-mail: huchi79@gmail.com; Jae, Hwan Jun, E-mail: jhj@radiol.snu.ac.kr; Park, Jae Hyung, E-mail: parkjh4803@gmail.com [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of)

2013-10-15

383

Optimizing Dialysis Modality Choices Around The World: A Review of Literature Concerning The Role of Enhanced Early Pre-ESRD Education in Choice of Renal Replacement Therapy Modality  

Microsoft Academic Search

A s a parent and active caregiver of a renal patient, this author has heard many accounts of how patients made their renal replacement therapy (RRT) choice - or had it made for them. The author's daughter received an early diagnosis of chronic kidney disease (CKD), allowing for close, consistent manage- ment and delay of end stage renal dis- ease

Sharon M. Key

384

FINAL REPORT. ENHANCEMENTS TO AND CHARACTERIZATION OF THE VERY EARLY TIME ELECTROMAGNETIC (VETEM) PROTOTYPE INSTRUMENT AND APPLICATIONS TO SHALLOW SUBSURFACE IMAGING AT SITES IN THE DOE COMPLEX  

EPA Science Inventory

The central aim of the Very Early Time Electromagnetic (VETEM) EMSP project was to improve the state-of-the-art of electromagnetic imaging of the shallow (0 to about 5 m)subsurface through electrically conductive soils. In addition, we aimed to demonstrate the utility of the new ...

385

Early Renal Histological Changes in Alloxan-Induced Diabetic Rats  

PubMed Central

Diabetes mellitus is a progressive disease. Most investigators have focused on glomerular changes in diabetic kidney and non-glomerular alterations have been less attended. The present study has been conducted to find early non-glomerular histological changes in diabetic renal tissue. Twenty male Wistar rats weighting 200-250 g were used for the diabetic group. Diabetes mellitus was induced by single injection of Alloxan. After 8 weeks, paraffin embedded blocks of kidneys were prepared for evaluating the histological changes due to diabetes. Histological study showed the deposit of eosinophilic materials in the intermediate substantial of medulla and thickening of renal arterial wall in the kidney of 70% of diabetic rats. The average weight of kidneys increased when compared to non diabetic animals. Furthermore, the amount of blood flow in arteries of all diabetic kidneys has been enhanced. The present study demonstrates some early renal histological changes in diabetes mellitus which were earlier compared to those reported previously. Diabetic nephropathy is a progressive disease and renal care design can help better prognosis achievement. PMID:24551816

Pourghasem, Mohsen; Nasiri, Ebrahim; Shafi, Hamid

2014-01-01

386

Embolic microspheres within ovarian arterial vasculature after uterine artery embolization  

Microsoft Academic Search

BACKGROUND:Adverse events after uterine artery embolization, including hysterectomy and premature ovarian failure, are concerning for women who desire future fertility.CASE:A 39-year-old woman underwent emergency hysterectomy after uterine artery embolization embolic microspheres found within the ovarian arterial vasculature.CONCLUSION:Uterine artery embolization for the treatment of uterine fibroids has been associated with loss of ovarian function in up to 14% of patients. This

John F Payne; Stanley J Robboy; A. F Haney

2002-01-01

387

[Magnetic resonance angiography of the renal arteries].  

PubMed

Initially, the clinical use of magnetic resonance angiography (MRA) in the abdomen has been restricted because of motion and flow related artifacts. The advent of high performance gradient systems made possible the development of 3D gadolinium-enhanced MRA techniques and expanded the clinical applications of MRA into the abdominal area, particularly for the investigation of renal arteries. This technique is safe, because the administered contrast agent (gadolinium) is free of clinically detectable nephrotoxicity and has a low incidence of allergic reactions. Moreover, contrast MRA also eliminates the risks of ionizing radiation which allows repeating the examination without the accumulation of radiation exposure. The main disadvantages of the technique are its low availability and the fact that the use of contrast agents for this procedure is still not reimbursed by the social security. Many