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Sample records for multiple giant coronary

  1. Multiple giant aneurysms and stenoses of the coronary and systemic arteries in an infant with kawasaki disease at the early stage of convalescent period.

    PubMed

    Ekici, Filiz; Varan, Birgül; Kocabaş, Abdullah; Erdoğan, İlkay; Eminoğlu, Sancar; Aktaş, Doğukan

    2014-05-01

    Myocardial infarction and systemic arterial aneurysms are rarely seen during the course of the Kawasaki disease (KD). Herein, we report the case of a 4-month-old Turkish infant who was diagnosed with KD on the 17th day of the illness. On admission, echocardiogram showed multiple coronary arterial aneurysms (CAAs) and massive pericardial effusion. He was given intravenous immunoglobulin, aspirin and anticoagulant drugs. However, the aneurysms progressed to "super giant" CAAs, multiple huge coronary arterial thromboses developed recurrently and caused myocardial ischemia. Furthermore, the conventional angiography revealed multiple giant aneurysms and stenoses in the subclavian, celiac, and iliac arteries, besides CAAs. PMID:24528198

  2. Surgical Resection of a Giant Coronary Aneurysm.

    PubMed

    Mehall, John R; Verlare, Jordan L

    2015-06-01

    Coronary aneurysms are quite uncommon, and those qualifying as giant aneurysms are even more so. Currently, no standardized treatment protocol exists. We report the case of a 46-year-old man presenting with clinical signs and symptoms of acute myocardial infarction who was found to have a giant coronary aneurysm. The patient was initially evaluated with a computed tomography angiogram, which revealed a 9-cm aneurysm of the left circumflex coronary artery. Surgical resection of the aneurysm, ligation of the proximal circumflex artery, and bypass using the left internal mammary artery to vascularize the proximal circumflex artery was performed. PMID:26046882

  3. Bilateral Giant Coronary Artery Aneurysms Complicated by Acute Coronary Syndrome and Cardiogenic Shock.

    PubMed

    Chiu, Peter; Lynch, Donald; Jahanayar, Jama; Rogers, Ian S; Tremmel, Jennifer; Boyd, Jack

    2016-04-01

    Giant coronary aneurysms are rare. We present a 25-year-old woman with a known history of non-Kawasaki/nonatherosclerotic bilateral coronary aneurysms. She was transferred to our facility with acute coronary syndrome complicated by cardiogenic shock. Angiography demonstrated giant bilateral coronary aneurysms and complete occlusion of the left anterior descending (LAD) artery. Emergent coronary artery bypass grafting was performed. Coronary artery bypass grafting is the preferred approach for addressing giant coronary aneurysms. Intervention on the aneurysm varies in the literature. Aggressive revascularization is recommended in the non-Kawasaki/nonatherosclerotic aneurysm patient, and ligation should be performed in patients with thromboembolic phenomena. PMID:27000621

  4. Coronary Artery Fistula with Giant Aneurysm and Coronary Stenosis Treated by Transcatheter Embolization and Stent

    PubMed Central

    Piao, Zhe Hao; Jeong, Hae Chang; Park, Keun Ho; Sim, Doo Sun; Hong, Young Joon; Kim, Ju Han; Ahn, Youngkeun

    2015-01-01

    Coronary artery fistula (CAF) with giant aneurysm and accompanied by coronary artery stenosis is a very rare disease. Herein, we report a case of a 76-year-old woman having a complex coronary-to-pulmonary artery fistula associated with a giant aneurysm and accompanied by coronary artery stenosis. The patient was successfully treated using transcatheter coil embolization and coronary stent implantation. Eight years later, we performed a follow-up coronary angiogram, which revealed the CAF and the aneurysm were completely occluded and previous stent patency. PMID:26023314

  5. Giant atrial septal aneurysm originating from the right coronary artery.

    PubMed

    Osada, Hiroaki; Kanemitsu, Naoki; Meshii, Katsuaki; Ohnaka, Motoaki

    2016-08-01

    Giant coronary artery aneurysm is a rare clinical entity and its involvement in the interatrial space is extremely rare. We here report the rare surgical case of a 67-year old man with giant right coronary artery aneurysm located in the atrial septum with fistula formation to the right atrium, complicated with congestive heart failure, rapid atrial fibrillation and left atrial appendage thrombus. The patient eventually recovered fully without sequelae. PMID:27118290

  6. Giant left main coronary artery to right atrium fistula

    PubMed Central

    Gualis, Javier; Castaño, Mario; Gómez-Plana, Jesús; Mencía, Pilar; Martín, Carlos; Martínez, Jose M; Alonso, David; De Miguel, Antonio; De Diego, Alejandro

    2010-01-01

    Aneurysmal arterial origin of coronary fistulae is an extremely rare combination. We report a case of a giant left main coronary artery to right atrium fistula in a 48-year-old male. We describe the clinical course and management options.

  7. Giant aneurysm of the left main coronary artery with fistulous communication to the right atrium.

    PubMed

    Zhu, Zhicheng; Wang, Yong; Xu, Rihao; Li, Dan; Wang, Tiance; Li, Bo; Zhang, Shudong; Liu, Kexiang

    2015-01-01

    The giant coronary artery aneurysm combined with coronary artery fistula is extremely uncommon. In our case, there was a giant aneurysm of the left main coronary artery with fistulous communication to the right atrium, combined with moderate aortic valve regurgitation, which was initially found by transthoracic echocardiogram and subsequently confirmed by the 256-slice multidetector computer tomography (MDCT) coronary angiography. After consultation, the patient received surgical treatment, including the closure of the drainage and origin sites of the aneurysm and the aortic valve replacement. The patient recovered uneventfully. PMID:26362771

  8. Giant Right Coronary Artery Aneurysm Associated with a Fistula Draining into the Superior Vena Cava

    PubMed Central

    Dolapoglu, Ahmet

    2016-01-01

    Giant coronary artery aneurysm associated with a coronary–cameral fistula is an uncommon condition. Such aneurysms are usually associated with other cardiac diseases, such as coronary atherosclerosis, and therefore might augment myocardial ischemia in adults. The main indications for surgical intervention are severe coexisting coronary artery disease, evidence of embolization, and aneurysmal enlargement or rupture. We describe a large right coronary artery aneurysm and a coronary–cameral fistula that drained into the superior vena cava. The surgical repair was successful. PMID:27547153

  9. Explosive Percolation with Multiple Giant Components

    NASA Astrophysics Data System (ADS)

    Chen, Wei; D'Souza, Raissa M.

    2011-03-01

    We generalize the random graph evolution process of Bohman, Frieze, and Wormald [T. Bohman, A. Frieze, and N. C. Wormald, Random Struct. AlgorithmsRSALFD1042-983210.1002/rsa.20038, 25, 432 (2004)]. Potential edges, sampled uniformly at random from the complete graph, are considered one at a time and either added to the graph or rejected provided that the fraction of accepted edges is never smaller than a decreasing function asymptotically approaching the value α=1/2. We show that multiple giant components appear simultaneously in a strongly discontinuous percolation transition and remain distinct. Furthermore, tuning the value of α determines the number of such components with smaller α leading to an increasingly delayed and more explosive transition. The location of the critical point and strongly discontinuous nature are not affected if only edges which span components are sampled.

  10. Interposition vein graft for giant coronary aneurysm repair

    NASA Technical Reports Server (NTRS)

    Firstenberg, M. S.; Azoury, F.; Lytle, B. W.; Thomas, J. D.

    2000-01-01

    Coronary aneurysms in adults are rare. Surgical treatment is often concomitant to treating obstructing coronary lesions. However, the ideal treatment strategy is poorly defined. We present a case of successful treatment of a large coronary artery aneurysm with a reverse saphenous interposition vein graft. This modality offers important benefits over other current surgical and percutaneous techniques and should be considered as an option for patients requiring treatment for coronary aneurysms.

  11. Coronary Artery Bypass Surgery - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Are Here: Home → Multiple Languages → All Health Topics → Coronary Artery Bypass Surgery URL of this page: https://www.nlm. ... V W XYZ List of All Topics All Coronary Artery Bypass Surgery - Multiple Languages To use the sharing features ...

  12. Position dependent right ventricular dysfunction caused by a giant right coronary artery aneurysm.

    PubMed

    Mora, Bruno; Urbanek, Bernhard; Loewe, Christian; Grimm, Michael; Dworschak, Martin

    2011-01-01

    We describe an instructive case of a 79-year-old patient with a giant coronary aneurysm and a second smaller aneurysm with an uncommon symptomatology. Giant coronary artery aneurysms (>2 cm diameter) are rare pathologic entities with a prevalence of 0.02%. They either can be congenital malformations or are atherosclerotic in origin. Although spontaneous rupture of giant coronary artery aneurysms has been reported, they generally remain silent or induce myocardial ischemia. Our patient, however, showed no signs of myocardial malperfusion but transient position-dependent pre-syncope. The cardiologic work-up and the intraoperative considerations regarding patient management are described. During surgery, manipulation of the giant coronary artery aneurysm caused impairment of right ventricular function and regional wall hypokinesia, as assessed by transesophageal echocardiography. Venous cannulation of the right atrium was thus abandoned and extracorporeal circulation was established via the femoral vein. Subsequent dissection and surgical repair were uneventful and further recovery of the elderly patient was uncomplicated. This case underlines that once the diagnosis is established, proper perioperative management enables successful surgical treatment even of patients of advanced age. PMID:21253776

  13. Giant left anterior descending coronary artery aneurysm in an adult male patient with ST elevation myocardial infarction

    PubMed Central

    Sadeghi, Mohsen Mirmohammad; Jouzdani, Saeid Rezaei

    2016-01-01

    Coronary artery aneurysm is a rare clinical entity encountered incidentally 0.3–5% among patients who undergo coronary angiography. Even giant coronary artery aneurysm is much rarer with an incidence of 0.02% among all atherosclerotic cases. Due to rare occurrence and lack of controlled trials, clinical presentation, prognosis and management of giant coronary artery aneurysm are under controversies in the literature. We report a 43-year-old male patient admitted to our hospital with a typical chest pain associated with ST elevation changes in anterior chest leads and elevated cardiac enzymes. Coronary angiography of the patient revealed a large (1.5 cm × 3 cm) aneurysm of proximal left anterior descending coronary artery. We performed a successful surgical excision and coronary bypass surgery. The patient had an uncomplicated course. PMID:27021297

  14. Multiple coronary arterial loops as a cause of myocardial ischemia

    NASA Technical Reports Server (NTRS)

    Bashour, Tali T.; Mansour, Nagi N.; Lee, Damon

    1993-01-01

    A case of long-standing angina with ischemia documented by exercise testing and thallium scintigraphy in a patient who had multiple proximal loops in all three major coronary arteries in the absence of luminal stenosis, is reported.

  15. Giant right coronary artery aneurysm with unusual physiology: role of intraoperative transesophageal echocardiography.

    PubMed

    Orozco, David M; Abello, Mauricio; Osorio, Javier; Melgarejo, Ivan

    2012-01-01

    A 65-year-old woman presented with a history of dyspnea and atypical chest pain. She was diagnosed with a non-ST-segment elevation myocardial infarction due to a giant right coronary artery aneurysm. After a failed percutaneous embolization, she was scheduled for right coronary artery aneurysm resection, posterior descending artery revascularization and mitral valve repair. During the induction of anesthesia and institution of mechanical ventilation, the patient suffered cardiovascular collapse. The transesophageal echocardiographic examination revealed tamponade physiology owing to compression of the cardiac chambers by the unruptured aneurysm, which resolved with the sternotomy. The surgery was carried out uneventfully. PMID:22772520

  16. A Giant Left Atrial Myxoma Neovascularized from the Right Coronary Artery

    PubMed Central

    Gerede, Demet Menekse; Akbulut, Irem Muge; Ersoz, Sadık; Kilıckap, Mustafa

    2015-01-01

    Myxomas are benign and the most common tumors of the cardiac muscle (Reynen, 1995). They are predominantly located in the left atrium. Clinical manifestations may vary according to the localization and the size of the myxoma. On the other hand, imaging of a myxoma by contrast dye during coronary angiography is a rare sign, which displays the vascular supply of the tumor. Here, we report the case of a 51-year-old man presenting with presyncope and palpitations due to a giant left atrial myxoma having its vascular supply from the right coronary artery (RCA). PMID:25960891

  17. A giant left atrial myxoma neovascularized from the right coronary artery.

    PubMed

    Gerede, Demet Menekse; Akbulut, Irem Muge; Ersoz, Sadık; Kilıckap, Mustafa

    2015-01-01

    Myxomas are benign and the most common tumors of the cardiac muscle (Reynen, 1995). They are predominantly located in the left atrium. Clinical manifestations may vary according to the localization and the size of the myxoma. On the other hand, imaging of a myxoma by contrast dye during coronary angiography is a rare sign, which displays the vascular supply of the tumor. Here, we report the case of a 51-year-old man presenting with presyncope and palpitations due to a giant left atrial myxoma having its vascular supply from the right coronary artery (RCA). PMID:25960891

  18. Recurrent Giant Cell Tumor of Skull Combined with Multiple Aneurysms

    PubMed Central

    Kim, Dae Hwan

    2016-01-01

    Giant cell tumors are benign but locally invasive and frequently recur. Giant cell tumors of the skull are extremely rare. A patient underwent a surgery to remove a tumor, but the tumor recurred. Additionally, the patient developed multiple aneurysms. The patient underwent total tumor resection and trapping for the aneurysms, followed by radiotherapy. We report this rare case and suggest some possibilities for treating tumor growth combined with aneurysm development. PMID:27195256

  19. A giant pseudoaneurysm of the left anterior descending coronary artery related to Behçet disease.

    PubMed

    Calafiore, Antonio M; Al Helali, Sumaya; Iaco', Angela L; Sheickh, Azmat A; Kheirallah, Hatim; Di Mauro, Michele

    2015-03-01

    We report the case of a young patient with a recent diagnosis of Behçet disease, in whom the left anterior descending coronary artery was found fully open into a giant pseudoaneurysm, with occlusion of the distal segment. Surgical treatment included opening of the pseudoaneurysm with clot and fibrous tissue removal, proximal left anterior descending coronary artery closure, and distal left anterior descending coronary artery grafting. In patients with Behçet disease, it is advisable to perform computed tomography coronary angiography to rule out the presence of coronary artery disease and the occurrence of a rare but potentially life-threatening complication. PMID:25742859

  20. Kawasaki Disease With Giant Coronary Aneurysms Requiring a Ventricular Assist Device to Separate From Extracorporeal Membrane Oxygenation: Coronary Issues Can Be a Pediatric Problem Too!

    PubMed

    Adler, Adam C; Kodavatiganti, Ramesh

    2016-08-15

    Kawasaki disease, although common in children, may rarely affect the coronary arteries, leading to aneurysm formation and potential for coronary thrombus formation. Extremely rarely, coronary aneurysms from Kawasaki disease can thrombose, resulting in ischemic myocardium. We present a case of a 31-month-old patient requiring a left ventricular assist device after thrombosis of giant coronary aneurysms led to ischemic cardiomyopathy. At the termination of the surgical procedure, we encountered 2 periods of ventricular assist device dropout requiring intervention. With the increase in the number of pediatric patients with assist devices, we review the basic care for a patient requiring emergent surgery. PMID:27310902

  1. Giant coronary artery aneurysms in juvenile polyarteritis nodosa: a case report

    PubMed Central

    2012-01-01

    Juvenile polyarteritis nodosa (PAN) is a rare, necrotizing vasculitis, primarily affecting small to medium-sized muscular arteries. Cardiac involvement amongst patients with PAN is uncommon and reports of coronary artery aneurysms in juvenile PAN are exceedingly rare. We describe a 16 year old girl who presented with fever, arthritis and two giant coronary artery aneurysms, initially diagnosed as atypical Kawasaki disease and treated with IVIG and methylprednisolone. Her persistent fevers, arthritis, myalgias were refractory to treatment, and onset of a vasculitic rash suggested an alternative diagnosis. Based on angiographic abnormalities, polymyalgia, hypertension and skin involvement, this patient met criteria for juvenile PAN. She was treated with six months of intravenous cyclophosphamide and high dose corticosteroids for presumed PAN related coronary vasculitis. Maintenance therapy was continued with azathioprine and the patient currently remains without evidence of active vasculitis. She remains on anticoagulation for persistence of the aneurysms. This case illustrates a rare and unusual presentation of giant coronary artery aneurysms in the setting of juvenile PAN. PMID:22222048

  2. Acute Interstitial Nephritis Following Multiple Asian Giant Hornet Stings

    PubMed Central

    Li, Xiang-Dong; Liu, Zheng; Zhai, Ying; Zhao, Ming; Shen, Hai-Yan; Li, Yi; Zhang, Bo; Liu, Tao

    2015-01-01

    Patient: Male, 42 Final Diagnosis: Acute interstitial nephritis Symptoms: Difficulty breathing • headache • numbness • oliguria Medication: Methylprednisolone Clinical Procedure: Plasma exchange Specialty: Nephrology Objective: Rare disease Background: The Asian giant hornet is the largest wasp species in the world. Its stings can cause acute interstitial nephritis and acute renal failure. From July to October, 2013, Asian giant hornet attacks have killed 42 people and injured 1675 people with their powerful venomous stings in Hanzhong, Ankang, and Shangluo, three cities in the southern part of Shaanxi Province, China. Case Report: We report here a case of a 42-year-old man with acute interstitial nephritis following multiple Asian giant hornet stings. On admission, the patient had difficulty breathing, headache, and numbness in both limbs (arm and leg). He was treated in the Emergency Department and Department of Nephrology with plasma exchange and dialysis within 24 hours after being stung. A kidney biopsy revealed acute interstitial nephritis with interstitial infiltrations of eosinophils and lymphocytes. After intensive treatment, his liver function recovered within 10 days. Along with oral methylprednisolone, his renal function recovered 1 month later. Conclusions: This case shows that acute interstitial nephritis happens several days after being stung. Since the number of deaths in southern Shaanxi province is much higher than other places, our report draws the attention of fellow clinicians to the acute interstitial nephritis following multiple Asian giant hornet stings. PMID:26076055

  3. Treatment of a giant coronary artery aneurysm: intravascular ultrasound and optical coherence tomography findings.

    PubMed

    Dutary, Jaime; Zakhem, Brian; DE Lucas, Camino Bañuelos; Paulo, Manuel; Gonzalo, Nieves; Alfonso, Fernando

    2012-02-01

    A giant coronary aneurysm (GCA) partially thrombosed was demonstrated in a 77-year-old patient evaluated for an inferior myocardial infarction. Primary angioplasty (balloon only) with suboptimal result was initially obtained. After triple antiplatelet and anticoagulation therapy (4 days), a new angiography was performed and a fusiform GCA was clearly delineated. A second percutaneous intervention was performed using a "scaffolding technique" with conventional stent and subsequent implantation of 2 polytetrafluoroethylene-covered stents to successfully exclude the aneurysm. This case demonstrates a novel technique to treat long GCA.  PMID:21599751

  4. Multiple Coronary Artery Microfistulas in a Girl with Kleefstra Syndrome

    PubMed Central

    Vargiami, Euthymia; Ververi, Athina; Al-Mutawa, Hamda; Gioula, Georgia; Gerou, Spyridon; Rouvalis, Fotios; Kambouris, Marios; Zafeiriou, Dimitrios I.

    2016-01-01

    Kleefstra syndrome is characterized by hypotonia, developmental delay, dysmorphic features, congenital heart defects, and so forth. It is caused by 9q34.3 microdeletions or EHMT1 mutations. Herein a 20-month-old girl with Kleefstra syndrome, due to a de novo subterminal deletion, is described. She exhibits a rare and complex cardiopathy, encompassing multiple coronary artery microfistulas, VSD/ASD, and PFO. PMID:27239352

  5. Multiple giant cell lesions in a patient with Noonan syndrome with multiple lentigines.

    PubMed

    van den Berg, Henk; Schreuder, Willem Hans; Jongmans, Marjolijn; van Bommel-Slee, Danielle; Witsenburg, Bart; de Lange, Jan

    2016-08-01

    A patient with Noonan syndrome with multiple lentigines (NSML) and multiple giant cell lesions (MGCL) in mandibles and maxillae is described. A mutation p.Thr468Met in the PTPN11-gene was found. This is the second reported NSML patient with MGCL. Our case adds to the assumption that, despite a different molecular pathogenesis and effect on the RAS/MEK pathway, NSML shares the development of MGCL, with other RASopathies. PMID:27238887

  6. Coronary CT angiography (cCTA): automated registration of coronary arterial trees from multiple phases

    NASA Astrophysics Data System (ADS)

    Hadjiiski, Lubomir; Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Agarwal, Prachi; Kuriakose, Jean; Kazerooni, Ella; Wei, Jun; Patel, Smita

    2014-08-01

    Coronary computed tomography angiography (cCTA) is a commonly used imaging modality for the evaluation of coronary artery disease. cCTA is generally reconstructed in multiple cardiac phases because different coronary arteries may be better visualized in some phases than in others due to the periodic cardiac motion. We are developing an automated registration method for coronary arterial trees from multiple-phase cCTA that has potential application in building a ‘best-quality’ tree to facilitate image analysis and detection of stenotic plaques. Given the segmented left or right coronary arterial (LCA or RCA) trees from the multiple phases as input, the adjacent phase pairs, where displacements are relatively small, are registered by a specifically designed method based on a cubic B-spline with fast localized optimization (CBSO). For the phase pairs with large displacements, a global registration using an affine transform with quadratic terms and nonlinear simplex optimization (AQSO) is followed by a local registration using CBSO to refine the AQSO registered volumes. 26 LCA and 26 RCA trees with six cCTA phases from 26 patients were used for registration evaluation. The average distances for the tree pairs between the adjacent phases with small displacements before and after CBSO registration were 0.96  ±  0.79 and 0.76  ±  0.61 mm respectively for LCA, and 0.93  ±  0.97 and 0.64  ±  0.43 mm, respectively for RCA. The average distance differences before and after registration were statistically significant (p < 0.001) for both LCA and RCA trees. The average distances for the distant phases with large displacements before registration, after AQSO registration, and finally after the CBSO registration were 2.85  ±  1.46, 1.62  ±  0.76, and 0.97  ±  0.43 mm, respectively for LCA, and 4.03  ±  2.36, 2.18  ±  1.11, and 0.97  ±  0.44 mm, respectively for RCA. The average distance differences between every two

  7. Coronary CT angiography (cCTA): automated registration of coronary arterial trees from multiple phases.

    PubMed

    Hadjiiski, Lubomir; Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Agarwal, Prachi; Kuriakose, Jean; Kazerooni, Ella; Wei, Jun; Patel, Smita

    2014-08-21

    Coronary computed tomography angiography (cCTA) is a commonly used imaging modality for the evaluation of coronary artery disease. cCTA is generally reconstructed in multiple cardiac phases because different coronary arteries may be better visualized in some phases than in others due to the periodic cardiac motion. We are developing an automated registration method for coronary arterial trees from multiple-phase cCTA that has potential application in building a 'best-quality' tree to facilitate image analysis and detection of stenotic plaques. Given the segmented left or right coronary arterial (LCA or RCA) trees from the multiple phases as input, the adjacent phase pairs, where displacements are relatively small, are registered by a specifically designed method based on a cubic B-spline with fast localized optimization (CBSO). For the phase pairs with large displacements, a global registration using an affine transform with quadratic terms and nonlinear simplex optimization (AQSO) is followed by a local registration using CBSO to refine the AQSO registered volumes. 26 LCA and 26 RCA trees with six cCTA phases from 26 patients were used for registration evaluation. The average distances for the tree pairs between the adjacent phases with small displacements before and after CBSO registration were 0.96  ±  0.79 and 0.76  ±  0.61 mm respectively for LCA, and 0.93  ±  0.97 and 0.64  ±  0.43 mm, respectively for RCA. The average distance differences before and after registration were statistically significant (p < 0.001) for both LCA and RCA trees. The average distances for the distant phases with large displacements before registration, after AQSO registration, and finally after the CBSO registration were 2.85  ±  1.46, 1.62  ±  0.76, and 0.97  ±  0.43 mm, respectively for LCA, and 4.03  ±  2.36, 2.18  ±  1.11, and 0.97  ±  0.44 mm, respectively for RCA. The average distance differences

  8. Multiple Air Embolism During Coronary Angiography: How Do We Deal With It?

    PubMed Central

    Suastika, Luh Oliva Saraswati; Oktaviono, Yudi Her

    2016-01-01

    Coronary air embolism remains a serious complication of cardiac catheterization despite careful prevention. The complications of coronary air embolism range from clinically insignificant events to acute coronary syndrome, cardiogenic shock, and death. We report here a case of multiple air emboli in both left coronary arteries, complicated by cardiogenic shock and ventricular fibrillation in a 49-year-old male patient undergoing elective percutaneous coronary intervention. The patient recovered after supportive measures, including oxygen, intravenous dopamine infusion, and cardiac compression, and repeated forceful injection of heparinized saline successfully resolved the air emboli. He then eventually underwent successful percutaneous coronary intervention in the left anterior descending artery without any residual stenosis. PMID:27226738

  9. Multiple Outflows in the Giant Eruption of a Massive Star

    NASA Astrophysics Data System (ADS)

    Humphreys, Roberta M.; Martin, John C.; Gordon, Michael S.; Jones, Terry J.

    2016-08-01

    The supernova impostor PSN J09132750+7627410 in NGC 2748 reached a maximum luminosity of ≈‑14 mag. It was quickly realized that it was not a true supernova, but another example of a nonterminal giant eruption. PSN J09132750+7627410 is distinguished by multiple P Cygni absorption minima in the Balmer emission lines that correspond to outflow velocities of ‑400, ‑1100, and ‑1600 km s‑1. Multiple outflows have been observed in only a few other objects. In this paper we describe the evolution of the spectrum and the P Cygni profiles for 3 months past maximum, the post-maximum formation of a cool, dense wind, and the identification of a possible progenitor. One of the possible progenitors is an infrared source. Its pre-eruption spectral energy distribution suggests a bolometric luminosity of ‑8.3 mag and a dust temperature of 780 K. If it is the progenitor, it is above the AGB limit, unlike the intermediate-luminosity red transients. The three P Cygni profiles could be due to ejecta from the current eruption, the wind of the progenitor, or previous mass-loss events. We suggest that they were all formed as part of the same high-mass-loss event and are due to material ejected at different velocities or energies. We also suggest that multiple outflows during giant eruptions may be more common than reported. Based on observations obtained with the Large Binocular Telescope (LBT), an international collaboration among institutions in the United States, Italy, and Germany. LBT Corporation partners are the University of Arizona on behalf of the Arizona university system; Istituto Nazionale di Astrofisica, Italy; LBT Beteiligungsgesellschaft, Germany, representing the Max-Planck Society, the Astrophysical Institute Potsdam, and Heidelberg University; The Ohio State University and The Research Corporation, on behalf of the University of Notre Dame, University of Minnesota, and University of Virginia.

  10. Multiple Chronic Conditions in Older Adults with Acute Coronary Syndromes.

    PubMed

    Alfredsson, Joakim; Alexander, Karen P

    2016-05-01

    Older adults presenting with acute coronary syndromes (ACSs) often have multiple chronic conditions (MCCs). In addition to traditional cardiovascular (CV) risk factors (ie, hypertension, hyperlipidemia, and diabetes), common CV comorbidities include heart failure, stroke, and atrial fibrillation, whereas prevalent non-CV comorbidities include chronic kidney disease, anemia, depression, and chronic obstructive pulmonary disease. The presence of MCCs affects the presentation (eg, increased frequency of type 2 myocardial infarctions [MIs]), clinical course, and prognosis of ACS in older adults. In general, higher comorbidity burden increases mortality following MI, reduces utilization of ACS treatments, and increases the importance of developing individualized treatment plans. PMID:27113147

  11. Multiple coronary-cameral fistulas to the left ventricle arising from both coronary arteries

    PubMed Central

    Pathak, Ranjan; Giri, Smith; Hwang, Inyong; Alsafwah, Shadwan

    2016-01-01

    Coronary-cameral fistula (CCF) is an anomalous connection between a coronary artery and a cardiac chamber or major vessel, seen in about 0.8% of the cases undergoing coronary angiography. Most patients are asymptomatic and diagnosis is made incidentally during coronary angiography. We present an image case of CCF which was found incidentally during pre-liver transplantation work up. PMID:27406447

  12. Multiple Small Coronary Artery Fistulas Emptying into the Left Ventricle: A Rare but Challenging Problem

    PubMed Central

    Kahaly, Omar

    2016-01-01

    A coronary artery fistula (CAF) is an abnormal communication between a coronary artery and a cardiac chamber or a great vessel. CAFs are rare based on coronary arteriography and when found they most often empty into the right ventricle and atrium and less often into the high pressure, low compliance left ventricle (LV). A patient who presented with atypical chest pain and was found to have multiple small CAFs originating from the ramus intermedius coronary artery and emptying into the LV is presented. This case highlights the challenges in providing an appropriate therapy for multiple small CAFs emptying into the LV. PMID:27525009

  13. Giant cystic cerebral cavernous malformation with multiple calcification - case report.

    PubMed

    Kim, Il-Chun; Kwon, Ki-Young; Rhee, Jong-Joo; Lee, Jong-Won; Hur, Jin-Woo; Lee, Hyun-Koo

    2013-09-01

    Cerebral cavernous malformation with giant cysts is rare and literature descriptions of its clinical features are few. In this case study, the authors describe the clinical symptoms, radiological findings, and pathological diagnosis of cerebral cavernous malformations with giant cysts, reviewing the relevant literature to clearly differentiate this from other disease entities. The authors present a case of a 19-year-old male with a giant cystic cavernous malformation, who was referred to the division of neurosurgery due to right sided motor weakness (grade II/II). Imaging revealed a large homogenous cystic mass, 7.2×4.6×6 cm in size, in the left fronto-parietal lobe and basal ganglia. The mass had an intra-cystic lesion, abutting the basal portion of the mass. The initial diagnosis considered this mass a glioma or infection. A left frontal craniotomy was performed, followed by a transcortical approach to resect the mass. Total removal was accomplished without post-operative complications. An open biopsy and a histopathological exam diagnosed the mass as a giant cystic cavernous malformation. Imaging appearances of giant cavernous malformations may vary. The clinical features, radiological features, and management of giant cavernous malformations are described based on pertinent literature review. PMID:24167810

  14. A 5-year-old boy with only fever and giant coronary aneurysms: the enigma of Kawasaki disease?

    PubMed

    Vignesh, Pandiarajan; Bhattad, Sagar; Singhal, Manphool; Singh, Surjit

    2016-08-01

    Epidemiological case definition of Kawasaki disease (KD) by the American Heart Association requires the presence of fever and four of the following: eye signs, oral mucosal changes, skin rashes, limb edema, and unilateral cervical lymphadenopathy. Incomplete KD is a well-known entity where there is lack of some of mucocutaneous features, and this occurs more often in infants. We report a 5-year-old boy with KD and giant coronary aneurysms, who presented only with fever and there is complete lack of skin and mucosal manifestations at presentation. PMID:27154559

  15. Long-term outcome of transcatheter polytetrafluoroethylene-covered stent implantation in a giant coronary aneurysm of a child with Kawasaki disease.

    PubMed

    Waki, Kenji; Arakaki, Yoshio; Mitsudo, Kazuaki

    2013-03-01

    We report the long-term outcome of a child with Kawasaki disease (KD), who had a giant aneurysm with stenotic lesions in the right coronary artery, resulting in the transcatheter implantation of a polytetrafluoroethylene (PTFE)-covered stent at the age of 8. Quantitative coronary angiography analysis later showed the increase of the diameter stenosis at both stent edges for the first 10 months after implantation; however, the stenosis did not develop thereafter. Coronary perfusion was still well maintained at follow-up coronary angiography 5.5 years after implantation (diameter stenosis was 36.5% at proximal and 37.4% at distal edge, respectively). Although further follow-up is necessary, the long-term outcome of a PTFE-covered stent implantation for a KD patient is satisfactory in this instance. Implantation of a covered stent in a giant aneurysm is considered a promising treatment option. PMID:22605684

  16. Multiple and Contemporary Coronary Thrombosis inspite of Low Platelet Function Response

    PubMed Central

    Calcagno, Simone; Lucisano, Luigi; Pennacchi, Mauro; Sardella, Gennaro

    2014-01-01

    We are reporting a clinical case of a 78-year-old male who had oppressive chest pain at rest, which regressed with the intake of sublingual nitrates. Coronary angiography showed a chronic total occlusion (CTO) of the left anterior descending (LAD) artery, a normal circumflex, a hypoplasic right coronary artery and a Cardiac Magnetic Resonance showing vital tissue in anterior wall. During the procedure of CTO-PCI on LAD, patient developed multiple and contemporary coronary thrombosis in spite of low platelet reactivity, which was assessed by using Multiplate. A manual thrombectomy was performed with a good final result only after drug eluting stents (DES) implantation. PMID:25302230

  17. Multiple coronary aneurysms in a young adult with acquired immunodeficiency syndrome

    PubMed Central

    Heizer, Justin; Petersen, Timothy C.; Flemmer, Mark C.

    2016-01-01

    HIV infection can cause multiple deleterious effects on the cardiovascular system. Emerging evidence has supported a direct association between HIV infection and accelerated atherosclerosis. The mechanism for atherosclerosis in HIV-positive patients is multifactorial, an interplay between conventional risk factors, HIV itself and highly active antiretroviral therapy. The case described is a 29-year-old man with HIV, non-adherent to antiretroviral therapy and with few cardiovascular risk factors, who presented with chest pain and non-ST elevation myocardial infarction. Cardiac catheterization revealed multiple coronary artery aneurysms in the left main coronary artery and the right coronary artery. Aneurysmal formation may develop from vasculitis, HIV itself, accelerated atherosclerosis, congenital formation or medications (e.g. protease inhibitors). The researchers provide a review of coronary artery disease, aneurysmal formation and vasculitic processes in the context of HIV. As this clinical entity becomes more apparent, alternative therapeutic options may need to be explored. PMID:27168940

  18. Giant coronary aneurysm caused by Kawasaki disease: consistency between catheter angiography and electrocardiogram gated dual-source computed tomography angiography.

    PubMed

    Hwang, Eun-Ha; Ju, Jung-Ki; Cho, Min-Jung; Lee, Ji-Won; Lee, Hyoung-Doo

    2015-12-01

    We present the case of a 5-year-old child with coronary complications due to Kawasaki disease; this patient unintentionally underwent both dual-source computed tomography (DSCT) coronary angiography and invasive coronary angiographic examination in 2 months. This case highlights the strong consistency of the results between DSCT coronary angiography and invasive coronary angiography. Compared to conventional invasive coronary angiography, DSCT coronary angiography offered additional advantages such as minimal invasiveness and less radiation exposure. PMID:26770226

  19. Coronary Artery Disease - Multiple Languages: MedlinePlus

    MedlinePlus

    ... 繁體中文) French (français) Japanese (日本語) Korean (한국어) Portuguese (português) Russian (Русский) Somali (af Soomaali) Spanish (español) Tagalog ( ... 한국어 (Korean) Bilingual PDF Health Information Translations Portuguese (português) Coronary Artery Disease (CAD) Doença Arterial Coronariana (DAC) - ...

  20. Coronary Artery Disease - Multiple Languages: MedlinePlus

    MedlinePlus

    ... sharing features on this page, please enable JavaScript. Arabic (العربية) Bosnian (Bosanski) Chinese - Simplified (简体中文) Chinese - Traditional ( ... español) Tagalog (Tagalog) Ukrainian (Українська) Vietnamese (Tiếng Việt) Arabic (العربية) Coronary Artery Disease (CAD) (Arabic) (CAD) تصلب ...

  1. 3D coronary MR angiography in multiple breath-holds using a respiratory feedback monitor.

    PubMed

    Wang, Y; Grimm, R C; Rossman, P J; Debbins, J P; Riederer, S J; Ehman, R L

    1995-07-01

    To reduce respiratory blur and ghosts in 3D coronary imaging, a data acquisition scheme using consistent multiple breath-holds was implemented. A navigator echo was acquired and processed in real time to dynamically measure diaphragm position. This information was provided as a visual prompt to the patient to maintain consistency in breath-hold levels such that the variation range of diastolic heart position was less than 2 mm. Preliminary results indicate that this multiple breath-hold acquisition scheme, compared with acquisition under respiration, can significantly reduce blur and ghost artifacts in 3D coronary imaging. PMID:7674888

  2. Acute myocardial infarction with multiple coronary thromboses in a young addict of amphetamines and benzodiazepines.

    PubMed

    Al Shehri, Mohammed A; Youssef, Ali A

    2016-07-01

    A 35-year-old man of average build and a smoker, with a background of a psychiatric disorder, was brought by his neighbor to the emergency department after an hour of severe chest pain. Upon arrival at the hospital he had cardiac arrest, was resuscitated, and moved to the catheterization laboratory with inferior, posterior, and lateral myocardial infarction. Coronary angiography showed an unusual thrombosis in multiple coronary branches. Toxicology report showed high levels of amphetamines and benzodiazepines in the patient's original blood sample. The patient was kept under ventilation for 18 days, with difficult recovery due to severe withdrawal manifestations, ventilation acquired pneumonia, and rhabdomyolysis inducing acute renal failure. The patient regained near normal left ventricular function after baseline severe regional and global dysfunction. We postulate a relationship between the use of amphetamines, potentiated by benzodiazepines, and occurrence of acute thrombosis of multiple major coronary arteries. PMID:27358538

  3. Coronary Artery Bypass Surgery - Multiple Languages: MedlinePlus

    MedlinePlus

    ... 繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) Somali (af Soomaali) Spanish (español) ... 冠動脈バイパス手術 - 日本語 (Japanese) Bilingual PDF Health Information Translations Korean (한국어) Coronary Artery Bypass Surgery 관상동맥 우회 수술 - ...

  4. Multiple giant intra abdominal lipomas: A rare presentation

    PubMed Central

    Kshirsagar, Ashok Y.; Nangare, Nitin R.; Gupta, Vaibhav; Vekariya, Mayank A.; Patankar, Ritvij; Mahna, Abhishek; Wader, J.V.

    2014-01-01

    INTRODUCTION Solitary or multiple lipomas, composed of mature fat, represents by far the most common benign mesenchymal neoplasm occurring throughout the whole body, but they rarely originate in the intestinal mesentery. PRESENTATION OF CASE A 60-year-old male presented with left sided abdominal distension and pain since 4 months, ultrasonography and computerized tomography abdomen was suggestive of multiple well-defined fat density lesions in the lower abdomen and pelvis. USG guided fine needle aspiration cytology was conclusive of a spindle cell lesion. Exploratory laparotomy was performed and multiple major fat tissue swellings were excised. Histopathology confirmed it to be spindle cell type of lipoma. DISCUSSION Because of the silent nature the exact prevalence of lipomas is unknown. It can arise in any location in which fat is normally present, reported intra abdominal lipomas have been very rare. Clinical manifestations depend on the size and location of the growth. In most patients, symptoms are few or absent. USG and CT scan abdomen are used for the diagnosis. Complete surgical excision being the only treatment. CONCLUSION Intra abdominal lipoma is a very rare entity, and many cases might be ignored due to their silent nature. They might or might not present with any symptoms. Complete surgical excision being the only treatment, with a very good prognosis. PMID:24862028

  5. Endothelial dysfunction and progressive coronary atherosclerosis: sequential invasive studies in a patient with multiple cardiac risk factors.

    PubMed

    Chander, R; Kuhner, P A; Laws Houghton, J

    2001-08-01

    This manuscript describes sequential angiographic, endothelial and vasoreactivity characteristics of the coronary arterial circulation in a middle-aged patient with multiple cardiac risk factors who developed hemodynamically significant coronary atherosclerosis over a 6-year period. A 56-year-old woman demonstrated marked angiographic progression of coronary atherosclerosis over time beginning with minor luminal irregularities in the setting of severe endothelial dysfunction. The association of endothelial dysfunction, ineffective cardiac risk factor management and progressive atherosclerosis is discussed. PMID:11481511

  6. Multiple metastases from histologically benign intraarticular diffuse-type tenosynovial giant cell tumor: a case report.

    PubMed

    Asano, Naofumi; Yoshida, Akihiko; Kobayashi, Eisuke; Yamaguchi, Takehiko; Kawai, Akira

    2014-11-01

    Diffuse-type tenosynovial giant cell tumor (D-TGCT) is a relatively rare mesenchymal tumor. It is a locally aggressive but virtually nonmetastasizing neoplasm and thus regarded as benign. Only a few D-TGCTs with benign histology have been reported to metastasize. We report an extremely rare case of benign D-TGCT in which multiple metastases developed 9 years after surgery for the primary tumor. The present case suggests that conventional D-TGCT has the potential to form distant metastases, albeit exceptionally rarely, and that this probable implantation phenomenon can be managed conservatively. PMID:25130396

  7. HUBBLE SPACE TELESCOPE REVEALS MULTIPLE SUB-GIANT BRANCH IN EIGHT GLOBULAR CLUSTERS

    SciTech Connect

    Piotto, G.; Nascimbeni, V.; Milone, A. P.; Aparicio, A.; Anderson, J.; Bellini, A.; Bedin, L. R.; Cassisi, S.; Marino, A. F. E-mail: luigi.bedin@oapd.inaf.it E-mail: aparicio@iac.es E-mail: bellini@stsci.edu E-mail: amarino@MPA-Garching.MPG.DE

    2012-11-20

    In the last few years many globular clusters (GCs) have revealed complex color-magnitude diagrams, with the presence of multiple main sequences (MSs), broad or multiple sub-giant branches (SGBs) and MS turnoffs, and broad or split red giant branches (RGBs). After a careful correction for differential reddening, high-accuracy photometry with the Hubble Space Telescope (HST) presented in this paper reveals a broadened or even split SGB in five additional Milky Way GCs: NGC 362, NGC 5286, NGC 6656, NGC 6715, and NGC 7089. In addition, we confirm (with new and archival HST data) the presence of a split SGB in 47 Tuc, NGC 1851, and NGC 6388. The fraction of faint SGB stars with respect to the entire SGB population varies from one cluster to another and ranges from {approx}0.03 for NGC 362 to {approx}0.50 for NGC 6715. The average magnitude difference between the bright SGB and the faint SGB is almost the same at different wavelengths. This peculiarity is consistent with the presence of two groups of stars with either an age difference of about 1-2 Gyr or a significant difference in their overall C+N+O content.

  8. Central Giant Cell Granuloma of the Mandible Requiring Multiple Treatment Modalities: A Case Report.

    PubMed

    Jerkins, David; Malotky, Maximilian; Miremadi, Reza; Dole, Mukund

    2016-08-01

    Central giant cell granuloma (CGCG) is a relatively rare non-neoplastic, intraosseous lesion that exhibits a wide spectrum of clinical behavior, and its management can be particularly challenging even for experienced clinicians. The etiopathogenesis of this disease process remains unclear, although factors such as trauma, inflammatory foci, and a genetic predisposition have been implicated. Although multiple treatment modalities have been used with varying degrees of success, there is no accepted algorithm for therapeutic intervention and little is known about the reasons for success or failure of a given treatment. This article reviews the epidemiology, presentation, classification, and currently used therapies for CGCG while describing the clinical course and successful therapeutic outcome of a young female patient with an aggressive CGCG of the mandible. PMID:27000410

  9. Multiple associated variants increase the heritability explained for plasma lipids and coronary artery disease

    PubMed Central

    Tada, Hayato; Won, Hong-Hee; Melander, Olle; Yang, Jian; Peloso, Gina M; Kathiresan, Sekar

    2015-01-01

    Background Plasma lipid levels as well as coronary artery disease (CAD) have been shown to be highly heritable with estimates ranging from 40%–60%. However, top variants detected by large-scale genome-wide association studies (GWAS) explain only a fraction of the total variance in plasma lipid phenotypes and CAD. Methods and Results We performed a conditional and joint association analysis using summary-level statistics from two large GWAS meta-analyses: (1) the Global Lipids Genetics Consortium (GLGC) study, and (2) the Coronary ARtery DIsease Genome-wide Replication and Meta-analysis (CARDIoGRAM) study. There were 100,184 individuals from 46 GLGC studies for plasma lipids, and 22,233 cases and 64,762 controls from 14 studies for CAD. We detected a number of loci where multiple independent SNPs were associated with lipid traits within a locus (12 out of 33 loci for high-density lipoprotein cholesterol [HDL-C], 10 of 35 loci for low-density lipoprotein cholesterol [LDL-C], 13 of 44 loci for total cholesterol [TC], and 8 of 28 loci for triglycerides [TG]), reaching genome-wide significance (P<5×10−8), nearly doubling the heritability explained by GWAS (3.6% to 7.6% for HDL-C, 5.0% to 8.8% for LDL-C, 5.5% to 8.8% for TC, and 5.7% to 8.5% for TG). Multiple SNPs were also associated with CAD (3 of 15 loci, 9.6% to 11.4% of increased heritability). Conclusion These results demonstrate that a portion of the missing heritability for lipid traits and CAD can be explained by multiple variants at each locus. PMID:25170055

  10. RED GIANTS IN ECLIPSING BINARY AND MULTIPLE-STAR SYSTEMS: MODELING AND ASTEROSEISMIC ANALYSIS OF 70 CANDIDATES FROM KEPLER DATA

    SciTech Connect

    Gaulme, P.; McKeever, J.; Rawls, M. L.; Jackiewicz, J.; Mosser, B.; Guzik, J. A.

    2013-04-10

    Red giant stars are proving to be an incredible source of information for testing models of stellar evolution, as asteroseismology has opened up a window into their interiors. Such insights are a direct result of the unprecedented data from space missions CoRoT and Kepler as well as recent theoretical advances. Eclipsing binaries are also fundamental astrophysical objects, and when coupled with asteroseismology, binaries provide two independent methods to obtain masses and radii and exciting opportunities to develop highly constrained stellar models. The possibility of discovering pulsating red giants in eclipsing binary systems is therefore an important goal that could potentially offer very robust characterization of these systems. Until recently, only one case has been discovered with Kepler. We cross-correlate the detected red giant and eclipsing-binary catalogs from Kepler data to find possible candidate systems. Light-curve modeling and mean properties measured from asteroseismology are combined to yield specific measurements of periods, masses, radii, temperatures, eclipse timing variations, core rotation rates, and red giant evolutionary state. After using three different techniques to eliminate false positives, out of the 70 systems common to the red giant and eclipsing-binary catalogs we find 13 strong candidates (12 previously unknown) to be eclipsing binaries, one to be a non-eclipsing binary with tidally induced oscillations, and 10 more to be hierarchical triple systems, all of which include a pulsating red giant. The systems span a range of orbital eccentricities, periods, and spectral types F, G, K, and M for the companion of the red giant. One case even suggests an eclipsing binary composed of two red giant stars and another of a red giant with a {delta}-Scuti star. The discovery of multiple pulsating red giants in eclipsing binaries provides an exciting test bed for precise astrophysical modeling, and follow-up spectroscopic observations of many

  11. Simultaneous thrombosis of multiple coronary arteries in a patient with rheumatoid arthritis.

    PubMed

    Kalayci, Arzu; Arslan, Erol; Bakar, Salih Murat; Guneri, Mahmut; Dizman, Rafet; Kivanc, Eylem; Karabay, Can Yucel

    2016-01-01

    We present a case of simultaneous coronary thrombosis of the left main, the left anterior descending artery and the right coronary artery in a patient, recently diagnosed with rheumatoid arthritis. PMID:27489603

  12. Simultaneous thrombosis of multiple coronary arteries in a patient with rheumatoid arthritis

    PubMed Central

    Kalayci, Arzu; Arslan, Erol; Bakar, Salih Murat; Guneri, Mahmut; Dizman, Rafet; Kivanc, Eylem; Karabay, Can Yucel

    2016-01-01

    We present a case of simultaneous coronary thrombosis of the left main, the left anterior descending artery and the right coronary artery in a patient, recently diagnosed with rheumatoid arthritis. PMID:27489603

  13. Model observers for complex discrimination tasks: assessments of multiple coronary stent placements

    NASA Astrophysics Data System (ADS)

    Zhang, Sheng; Abbey, Craig K.; Teymoorian, Arian; Da, Xiaolin; Whiting, James S.; Eckstein, Miguel P.

    2010-02-01

    As an important clinical task, evaluating the placement of multiple coronary stents requires fine judgments of distance between stents. However, making these judgments is limited by low system resolution, noise, low contrast of the deployed stent, and stent motion during the cardiac cycle. We use task performance as a figure of merit for optimizing image display parameters. In previous work, we described our simulation procedure in detail, and also reported results of human observers for a visual task involving discrimination of 4 gap sizes under various frame rates and number of frames. Here, we report the results of three spatial model observers (i.e. NPW, NPWE, and PWMF) and two temporal sensitivity functions (i.e. transient and sustained) for the same task. Under signal known exactly conditions, we find that model observers can be used to predict human observers in terms of discrimination accuracy by adding internal noise.

  14. Systematic review of randomised controlled trials of multiple risk factor interventions for preventing coronary heart disease.

    PubMed Central

    Ebrahim, S.; Smith, G. D.

    1997-01-01

    OBJECTIVE: To assess the effectiveness of multiple risk factor intervention in reducing cardiovascular risk factors, total mortality, and mortality from coronary heart disease among adults. DESIGN: Systematic review and meta-analysis of randomised controlled trials in workforces and in primary care in which subjects were randomly allocated to more than one of six interventions (stopping smoking, exercise, dietary advice, weight control, antihypertensive drugs, and cholesterol lowering drugs) and followed up for at least six months. SUBJECTS: Adults aged 17-73 years, 903000 person years of observation were included in nine trials with clinical event outcomes and 303000 person years in five trials with risk factor outcomes alone. MAIN OUTCOME MEASURES: Changes in systolic and diastolic blood pressure, smoking rates, blood cholesterol concentrations, total mortality, and mortality from coronary heart disease. RESULTS: Net decreases in systolic and diastolic blood pressure, smoking prevalence, and blood cholesterol were 4.2 mm Hg (SE 0.19 mm Hg), 2.7 mm Hg (0.09 mm Hg), 4.2% (0.3%), and 0.14 mmol/l (0.01 mmol/l) respectively. In the nine trials with clinical event end points the pooled odds ratios for total and coronary heart disease mortality were 0.97 (95% confidence interval 0.92 to 1.02) and 0.96 (0.88 to 1.04) respectively. Statistical heterogeneity between the studies with respect to changes in mortality and risk factors was due to trials focusing on hypertensive participants and those using considerable amounts of drug treatment, with only these trials showing significant reductions in mortality. CONCLUSIONS: The pooled effects of multiple risk factor intervention on mortality were insignificant and a small, but potentially important, benefit of treatment (about a 10% reduction in mortality) may have been missed. Changes in risk factors were modest, were related to the amount of pharmacological treatment used, and in some cases may have been overestimated

  15. Acute coronary syndrome: a rare case of multiple endocrine neoplasia syndromes with pheochromocytoma and medullary thyroid carcinoma.

    PubMed

    Maloberti, Alessadro; Meani, Paolo; Pirola, Roberto; Varrenti, Marisa; Boniardi, Marco; De Biase, Anna Maria; Vallerio, Paola; Bonacina, Edgardo; Mancia, Giuseppe; Loli, Paola; Giannattasio, Cristina

    2015-09-01

    Pheochromocytoma is a tumor arising from neuroectodermal chromaffin tissues in the adrenal gland or extra-adrenal paraganglia (paragangliomas). The prevalence of the tumor is 0.1%-0.6% in the hypertensive population, of which 10%-20% are malignant. Pheochromocytoma produces, stores, and secretes catecholamines, as well as leads to hypertensive crisis, arrhythmia, angina, and acute myocardial infarction without coronary artery diseases. We report a case of acute coronary syndrome (ACS) with a final diagnosis of multiple endocrine neoplasia with pheochromocytoma and medullary thyroid carcinoma (MTC). PMID:26487970

  16. Acute coronary syndrome: a rare case of multiple endocrine neoplasia syndromes with pheochromocytoma and medullary thyroid carcinoma

    PubMed Central

    Maloberti, Alessadro; Meani, Paolo; Pirola, Roberto; Varrenti, Marisa; Boniardi, Marco; De Biase, Anna Maria; Vallerio, Paola; Bonacina, Edgardo; Mancia, Giuseppe; Loli, Paola; Giannattasio, Cristina

    2015-01-01

    Pheochromocytoma is a tumor arising from neuroectodermal chromaffin tissues in the adrenal gland or extra-adrenal paraganglia (paragangliomas). The prevalence of the tumor is 0.1%-0.6% in the hypertensive population, of which 10%-20% are malignant. Pheochromocytoma produces, stores, and secretes catecholamines, as well as leads to hypertensive crisis, arrhythmia, angina, and acute myocardial infarction without coronary artery diseases. We report a case of acute coronary syndrome (ACS) with a final diagnosis of multiple endocrine neoplasia with pheochromocytoma and medullary thyroid carcinoma (MTC). PMID:26487970

  17. SOS1 and PTPN11 mutations in five cases of Noonan syndrome with multiple giant cell lesions

    PubMed Central

    Beneteau, Claire; Cavé, Hélène; Moncla, Anne; Dorison, Nathalie; Munnich, Arnold; Verloes, Alain; Leheup, Bruno

    2009-01-01

    We report five cases of multiple giant cell lesions in patients with typical Noonan syndrome. Such association has frequently been referred to as Noonan-like/multiple giant cell (NL/MGCL) syndrome before the molecular definition of Noonan syndrome. Two patients show mutations in PTPN11 (p.Tyr62Asp and p.Asn308Asp) and three in SOS1 (p.Arg552Ser and p.Arg552Thr). The latter are the first SOS1 mutations reported outside PTPN11 in NL/MGCL syndrome. MGCL lesions were observed in jaws (‘cherubism') and joints (‘pigmented villonodular synovitis'). We show through those patients that both types of MGCL are not PTPN11-specific, but rather represent a low penetrant (or perhaps overlooked) complication of the dysregulated RAS/MAPK signaling pathway. We recommend discarding NL/MGCL syndrome from the nosology, as this presentation is neither gene-nor allele-specific of Noonan syndrome; these patients should be described as Noonan syndrome with MGCL (of the mandible, the long bone…). The term cherubism should be used only when multiple giant cell lesions occur without any other clinical and molecular evidence of Noonan syndrome, with or without mutations of the SH3BP2 gene. PMID:19352411

  18. Multiple giant diverticula of the jejunum causing intestinal obstruction: report of a case and review of the literature

    PubMed Central

    2011-01-01

    Multiple diverticulosis of jejunum represents an uncommon pathology of the small bowel. The disease is usually asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain or discomfort. Related complications such as diverticulitis, perforation, bleeding or intestinal obstruction appear in 10-30% of the patients increasing morbidity and mortality rates. We herein report a case of a 55 year-old man presented at the emergency department with acute abdominal pain, vomiting and fever. Preoperative radiological examination followed by laparotomy revealed multiple giant jejunal diverticula causing intestinal obstruction. We also review the literature for this uncommon disease. PMID:21385440

  19. Co-existence of a giant splenic hemangioma and multiple hepatic hemangiomas and the potential association with the use of oral contraceptives: a case report

    PubMed Central

    Chatzoulis, George; Kaltsas, Andreas; Daliakopoulos, Stauros; Sallam, Osama; Maria, Kaltsa; Chatzoulis, Kostas; Pachiadakis, Ioannis

    2008-01-01

    Introduction Hepatic and splenic hemangiomas are common benign tumors that mainly affect female patients. Giant splenic hemangiomas are extremely rare, especially when correlated with multiple hepatic hemangiomas. Pathogenetic mechanisms between hemangiomas and oral contraceptives, as well as therapeutic approaches, are analyzed in this case report, in particular for the management of synchronous splenic and hepatic hemangiomas. Case presentation We report here a 42-year-old woman with a giant splenic hemangioma, multiple hepatic hemangiomas and a history of oral estrogen intake for many years. At first it was difficult to determine the organ from which the giant hemangioma originated. Angiography proved extremely helpful in tracing its origin in the spleen. Hematomas in the giant hemangioma posed a significant threat of rupture and catastrophic hemorrhage. We left the small hepatic hemangiomas in place, and removed the spleen along with the giant splenic hemangioma. Conclusion Diagnostic pitfalls in the determination of the origin of this giant hemangioma, attribution of its origin to the spleen angiographically, the unusual co-existence of the giant splenic hemangioma with multiple hepatic ones, and the potential threat of rupture of the giant hemangioma are some of the highlights of this case report. Estrogen administration represents a pathogenic factor that has been associated with hemangiomas in solid organs of the abdominal cavity. The therapeutic dilemma between resection and embolization of giant hemangiomas is another point of discussion in this case report. Splenectomy for the giant splenic hemangioma eliminates the risk of rupture and malignant degeneration, whereas observation for the small hepatic ones (<4 cm) was the preferable therapeutic strategy in our patient. PMID:18462497

  20. Nightmare: Simultaneous Subacute Stent Thrombosis of Different New-Generation Drug-Eluting Stents in Multiple Coronary Arteries

    PubMed Central

    Hsu, Po-Chao; Chiu, Chen-An; Su, Ho-Ming; Lin, Tsung-Hsien; Chu, Chih-Sheng

    2015-01-01

    Simultaneous stent thrombosis (ST) of first-generation drug-eluting stents (DES) has been rarely reported and could lead to high morbidity and mortality. However, to date there was no literature discussing simultaneous ST of different new-generation DESs in multiple coronary arteries. Herein, we report a 60-year-old male suffering from acute myocardial infarction complicated with cardiogenic shock. He had percutaneous coronary intervention (PCI) performed approximately 7 days prior to admission at a local teaching hospital, with different DES devices implanted over the left anterior descending and the left circumflex artery. Emergency coronary angiography revealed simultaneous subacute ST over both vessels. After PCI, there was a gradual improvement in both cardiogenic shock and acute pulmonary edema. High dose clopidogrel (150 mg) was used initially, which was later shifted to ticagrelor. Genetic testing of CYP2C19*2 G681A polymorphism revealed heterozygous genotype and platelet function testing showed substantial inhibition after a medication change. This rare case should remind physicians that new-generation DES thrombosis in multiple vessels is still a possible complication of PCI, and checking genetic and/or platelet function testing might be indicated in these high risk patients. The use of a new antiplatelet drug was also strongly suggested to avoid possible clopidogrel resistance. PMID:27122868

  1. Giant cavernous hemangioma of the liver and multiple primary malignant tumors in a patient with suspected familial inhibition of natural killer cell activity--a case report.

    PubMed

    Tomiyama, T; Uchida, K; Yoshida, K; Muto, T; Saito, H; Nemoto, K; Inoue, Z; Morita, T; Miyakoshi, H; Tamura, K

    1989-03-01

    A woman was operated on for a nonepithelial malignant tumor of the left leg and subsequently, for an epithelial carcinoma of the right breast and a borderline malignant tumor of the right ovary. She also developed a giant cavernous hemangioma that caused disseminated intravascular coagulation syndrome, which necessitated a left trisegmentectomy of the liver. Her family history suggested a hereditary predisposition to diverse malignant neoplasms, and also to giant cavernous hemangioma of the liver. Immunological evaluation disclosed selective inhibition of natural killer cell activity. Hormonal and hereditary factors are discussed in relation to the development of multiple primary tumors and giant cavernous hemangioma of the liver. PMID:2724721

  2. Right ventricular ejection fraction during exercise in normal subjects and in coronary artery disease patients: assessment by multiple-gated equilibrium scintigraphy

    SciTech Connect

    Maddahi, J.; Berman, D.S.; Matsuoka, D.T.; Waxman, A.D.; Forrester, J.S.; Swan, H.J.C.

    1980-07-01

    The response of right ventricular ejection fraction (RVEF) during exercise and its relationship to the location and extent of coronary artery disease are not fully understood. We have recently developed and validated a new method for scintigraphic evaluation of RVEF using rapid multiple-gated equilibrium scintigraphy and multiple right ventricular regions of interest. The technique has been applied during upright bicycle exercise in 10 normal subjects and 20 patients with coronary artery disease. Resting RVEF was not significantly different between the groups (0.49 +- 0.04 vs 0.47 +- 0.09, respectively, mean +- SD). In all 10 normal subjects RVEF rose (0.49 +- 0.04 to 0.66 +- 0.08, p < 0.01) at peak exercise. At peak exercise in coronary artery disease patients, the group RVEF remained unchanged (0.47 +- 0.09 to 0.50 +- 0.11, p = NS), but the individual responses varied. In the coronary artery disease patients, the relationship between RVEF response to exercise and exercise left ventricular function, septal motion and right coronary artery stenosis were studied. Significant statistical association was found only between exercise RVEF and right coronary artery stenosis. RVEF rose during exercise in seven of seven patients without right coronary artery stenosis (0.42 +- 0.06 to 0.58 +- 0.08, p = 0.001) and was unchanged or fell in 12 of 13 patients with right coronary artery stenosis (0.50 +- 0.09 to 0.45 +- 0.10, p = NS). We conclude that (1) in normal subjects RVEF increases during upright exercise and (2) although RVEF at rest is not necessarily affected by coronary artery disease, failure of RVEF to increase during exercise, in the absence of chronic obstructive pulmonary disease or valvular heart disease, may be related to the presence of significant right coronary artery stenosis.

  3. Multiple risk factor interventions for primary prevention of coronary heart disease

    PubMed Central

    Ebrahim, Shah; Beswick, Andrew; Burke, Margaret; Smith, George Davey

    2014-01-01

    Background Primary prevention programmes in many countries attempt to reduce mortality and morbidity due to coronary heart disease (CHD) through risk factor modification. It is widely believed that multiple risk factor intervention using counselling and educational methods is efficacious and cost-effective and should be expanded. Recent trials examining risk factor changes have cast considerable doubt on the effectiveness of these multiple risk factor interventions. Objectives To assess the effects of multiple risk factor intervention for reducing cardiovascular risk factors, total mortality, and mortality from CHD among adults without clinical evidence of established cardiovascular disease. Search strategy MEDLINE was searched for the original review to 1995. This was updated by searching the Cochrane Central Register of Controlled Trials on The Cochrane Library Issue 3 2001, MEDLINE(2000 to September 2001) and EMBASE (1998 to September 2001). Selection criteria Intervention studies using counselling or education to modify more than one cardiovascular risk factor in adults from general populations, occupational groups, or high risk groups. Trials of less than 6 months duration were excluded. Data collection and analysis Data were extracted by two reviewers independently. Investigators were contacted to obtain missing information. Main results A total of 39 trials were found of which ten reported clinical event data. In the ten trials with clinical event end-points, the pooled odds ratios for total and CHD mortality were 0.96 (95% confidence intervals (CI) 0.92 to 1.01) and 0.96 (95% CI 0.89 to 1.04) respectively. Net changes in systolic and diastolic blood pressure, and blood cholesterol were (weighted mean differences) −3.6 mmHg (95% CI −3.9 to −3.3 mmHg), −2.8 mmHg (95% CI −2.9 to −2.6 mmHg) and −0.07 mMol/l (95% CI −0.8 to −0.06 mMol/l) respectively. Odds of reduction in smoking prevalence was 20% (95% CI 8% to 31%). Statistical heterogeneity

  4. Osteoclastome-like giant cell thyroid carcinoma controlled by intensive radiation and adriamycin, in a patient with meningioma and multiple myeloma treated by radiation and cytoxan

    SciTech Connect

    Vizel-Schwartz, M.

    1981-01-01

    The eighth cases of osteoclastome-like giant cell carcinoma of the thyroid, and the first one to be treated with adriamycin in addition to surgery and radiation, is reported. This rare variant of anaplastic thyroid carcinoma appeared in a patient operated on for meningioma and treated for multiple myeloma with cranial radiation and chronic administration of cytoxan.

  5. Lesion-specific coronary artery calcium quantification for predicting cardiac event with multiple instance support vector machines.

    PubMed

    Liu, Qingshan; Qian, Zhen; Marvasty, Idean; Rinehart, Sarah; Voros, Szilard; Metaxas, Dimitris N

    2010-01-01

    Conventional whole-heart CAC quantification has been demonstrated to be insufficient in predicting coronary events, especially in accurately predicting near-term coronary events in high-risk adults. In this paper, we propose a lesion-specific CAC quantification framework to improve CAC's near-term predictive value in intermediate to high-risk populations with a novel multiple instance support vector machines (MISVM) approach. Our method works on data sets acquired with clinical imaging protocols on conventional CT scanners without modifying the CT hardware or updating the imaging protocol. The calcific lesions are quantified by geometric information, density, and some clinical measurements. A MISVM model is built to predict cardiac events, and moreover, to give a better insight of the characterization of vulnerable or culprit lesions in CAC. Experimental results on 31 patients showed significant improvement of the predictive value with the ROC analysis, the net reclassification improvement evaluation, and the leave-one-out validation against the conventional methods. PMID:20879266

  6. Logistic regression analysis of multiple noninvasive tests for the prediction of the presence and extent of coronary artery disease in men

    SciTech Connect

    Hung, J.; Chaitman, B.R.; Lam, J.; Lesperance, J.; Dupras, G.; Fines, P.; Cherkaoui, O.; Robert, P.; Bourassa, M.G.

    1985-08-01

    The incremental diagnostic yield of clinical data, exercise ECG, stress thallium scintigraphy, and cardiac fluoroscopy to predict coronary and multivessel disease was assessed in 171 symptomatic men by means of multiple logistic regression analyses. When clinical variables alone were analyzed, chest pain type and age were predictive of coronary disease, whereas chest pain type, age, a family history of premature coronary disease before age 55 years, and abnormal ST-T wave changes on the rest ECG were predictive of multivessel disease. The percentage of patients correctly classified by cardiac fluoroscopy (presence or absence of coronary artery calcification), exercise ECG, and thallium scintigraphy was 9%, 25%, and 50%, respectively, greater than for clinical variables, when the presence or absence of coronary disease was the outcome, and 13%, 25%, and 29%, respectively, when multivessel disease was studied; 5% of patients were misclassified. When the 37 clinical and noninvasive test variables were analyzed jointly, the most significant variable predictive of coronary disease was an abnormal thallium scan and for multivessel disease, the amount of exercise performed. The data from this study provide a quantitative model and confirm previous reports that optimal diagnostic efficacy is obtained when noninvasive tests are ordered sequentially. In symptomatic men, cardiac fluoroscopy is a relatively ineffective test when compared to exercise ECG and thallium scintigraphy.

  7. Comparison of multiple exercise radionuclide methods for detection of coronary artery disease

    SciTech Connect

    Ryan, J.; Gordon, J.; Shaffer, P.; Gibson, R.; Watson, D.; Magorien, R.; Baumert, J.; Kolibash, A.; Bashore, T.

    1985-05-01

    Five planar exercise Thallium (Tl) scintigraphy methods and four exercise radionuclide angiographic criteria were compared for the diagnosis of significant (greater than or equal to50%) angiographic coronary artery disease (CAD). The patient population consisted of 95 randomly selected patients referred for coronary angiography (CATH) for the evaluation of chest pain without other known cardiac pathology. Both Tl and RNA studies were performed on the same day within 48 hours of CATH. Medications were continued. Tl images were evaluated by visual interpretation of analog (A), 20% background subtracted (20), and interpolative background subtracted (INT) images. Quantitative analysis of horizontal profiles (Watson's method) and circumferential profiles (Garcia's method) were also performed. RNA results were classified as abnormal Ejection Fraction response (< 4% rise) (EF), abnormal wall motion (WM), either (E), and both (B). The authors conclude that while significant differences were found among the sensitivities and specificities, the overall accuracy of the methods were not different except for B. Tl and RNA remain useful despite intercurrent drug therapy.

  8. Prognostic Role of Multiple Cardiac Biomarkers in Newly Diagnosed Acute Coronary Syndrome Patients.

    PubMed

    Rahman, M M; Alam, M M; Jahan, N A; Shila, J S; Arslam, M I

    2016-04-01

    Acute coronary syndrome includes unstable angina and myocardial infarction with or without ST-segment elevation, is life-threatening disorders that remain a source of high morbidity and mortality despite advances in treatment. The aim of the study was to evaluate the prognostic role of serum cTnI, CK-MB, hsCRP, MPO and BNP in newly diagnosed acute coronary syndrome patients. This cohort study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University in cooperation with the Department of Cardiology, BSMMU and NICVD during the period of March 2013 to February 2014. A total 100 newly diagnosed acute coronary syndrome patients were purposively enrolled in this study within 24 hours of attacked, among them 30 were NSTEMI, 65 were STEMI and 5 were unstable angina. Serum cTnI, CK-MB, hsCRP, MPO and BNP concentrations were measured at enrollment and grouping of the study subjects were done on the basis of their empirical cut off values into two groups. In cTnI: Group I (n=20) having cTnI <4ng/ml and Group II (n=80) having cTnI ≥4ng/ml. In CK-MB: Group I (n=18) having CK-MB <10ng/ml and Group II (n= 82) having CK-MB ≥10ng/ml. In hsCRP: Group I (n=36) having hsCRP <5mg/L and Group II (n=64) having hsCRP ≥5mg/L. In MPO: Group I (n=30) having MPO <285.5pmol/L and Group II (n=70) having MPO ≥285.5pmol/L. In BNP: Group I (n=26) having BNP <135pg/ml and Group II (n=74) having BNP ≥135pg/ml. All the study subjects were treated and managed identically by standard management protocol and were followed up periodically up to three months from the onset of events during hospital stay and after discharge. Clinical outcomes of the study subjects such as good recovery, morbidity (recurrent ACS, heart failure, arrhythmia and revascularization) and mortality were evaluated with respect to their base line cTnI, CK-MB, hsCRP, MPO and BNP concentrations. Increased levels of base line cardiac biomarkers in Group II patients showed significantly

  9. Vulvar amyloidosis mimicking giant condylomata acuminata in a patient with multiple myeloma.

    PubMed

    Konig, A; Wennemuth, G; Soyer, H P; Hoffmann, R; Happle, R; Krause, W

    1999-01-01

    We report a case of unusual cutaneous amyloidosis involving the vulva in a patient with multiple myeloma. Genital examination revealed a dense agglomeration of verrucous papules and pedunculated condyloma-like tumors. The correct diagnosis was established by immunohistochemical examinations that visualized large amounts of lambda light chains, whereas no reaction was detected for kappa light chains or human papilloma virus. In this way, the differential diagnosis of condylomata acuminata could be ruled out. Condyloma-like lesions have been described in patients suffering from multiple myeloma, but the present case is unusual because of the extensive involvement. Vulvar amyloidosis should be added to the list of possible presentations of myeloma-associated systemic amyloidoses. PMID:9920983

  10. [Perioperative Multiple Pulmonary Embolism in a Patient with Giant Right Atrial Myxoma: Report of a Case].

    PubMed

    Nakashima, Koki; Hanayama, Naoji; Kitamura, Tadashi; Sakaki, Kenjiro; Nie, Masaki; Miyaji, Kagami

    2016-02-01

    It is reported that 20% of cardiac myxomas are located in the right atrium. An 81-year-old man presented with dyspnea, general fatigue and leg edema lasting for a year. Echocardiography revealed an 80 mm tumor occupying the right atrium and the right ventricle. At surgery, the tumor attached to the atrial septum was removed with the surrounding septal wall. As the tricuspid annulus was dilated, tricuspid annuloplasty with an artificial ring was also carried out. After coming off cardiopulmonary bypass, the patient developed pulmonary hypertension with the pulmonary arterial pressure being 80% of the systemic pressure, which subsided gradually day by day. Histopathological diagnosis was cardiac myxoma. Postoperative lung perfusion scintigraphy revealed postoperative multiple defects. It was considered that multiple tumor embolisms in the distal pulmonary artery caused postoperative pulmonary hypertension. Careful follow-up for remote recurrence would be essential. PMID:27075159

  11. The Coincidence of 3 Different Rare Coronary Artery Anomalies in an Adult Patient With Untreated Kawasaki Disease: Case Report.

    PubMed

    Jiang, Xin; Liao, Shusheng; Xiong, Bin; Zheng, Lei; Zhu, Huijia; Zhu, Xuelian; Ni, Xianda; Zheng, Xiangwu; Chen, Bin

    2016-03-01

    The coincidence of 3 different rare coronary artery anomalies is extremely rare, and has not been reported so far.We report multiple imaging findings of a giant coronary artery aneurysm, which has a fistulous connection to the right ventricle associated with anomalous origin of the anterior descending coronary artery from the right coronary artery in a 67-year-old woman who suffered with a 20-year history of progressively chest distress on exertion and a history of untreated Kawasaki disease in her childhood.The patient received surgical treatment. The aneurysm was resected and openings at both ends being oversewn. And the fistula was also closed directly. She recovered and discharged uneventfully.The coincidence of 3 different rare coronary artery anomalies in adult patient with untreated Kawasaki disease is a rare and complicated condition, in which surgical treatment is recommended. PMID:27015213

  12. Multiple Giant Splenic Artery Aneurysms Causing Sinistral (Left-Sided) Portal Hypertension

    PubMed Central

    Beksac, Kemal; Karakoc, Derya

    2016-01-01

    Background. Splenic artery aneurysm is the most common type of visceral aneurysms. They are usually asymptomatic and have a potential for rupture and therefore life-threatening hemorrhage. It is rare for them to cause sinistral portal hypertension. Case Report. A 23-year-old female patient presented to our clinic with gastric varices, splenomegaly, pancytopenia, and normal liver functions. She was thus diagnosed with left-sided portal hypertension. Radiologic evaluation showed splenomegaly, splenic vein obstruction, and multiple aneurysms along the splenic artery ranging from 2.5 cm to 7 cm. Splenic artery aneurysm was thought to be the cause of portal hypertension and hypersplenism. We decided splenectomy is the best course of treatment. Pancytopenia could not be corrected preoperatively despite the transfusion treatment. Surgical exploration revealed multiple aneurysms deeply embedded in pancreas. Thrombocyte and erythrocyte transfusion was performed after splenic artery ligation to correct pancytopenia before further intervention. Splenic artery, spleen, and distal pancreas were resected en bloc. Patient's blood parameters became normal within first postoperative day. Patient had an uneventful postoperative course and was discharged without incident. Conclusion. Splenic artery aneurysms are rare but potentially life-threatening incidents. Therefore, it is important to know the unusual presentations and prepare accordingly. PMID:27110411

  13. The predictive value of multiple electrode platelet aggregometry for postoperative bleeding complications in patients undergoing coronary artery bypass graft surgery

    PubMed Central

    Woźniak, Karolina; Hryniewiecki, Tomasz; Kruk, Mariusz; Różański, Jacek; Kuśmierczyk, Mariusz

    2016-01-01

    Introduction Postoperative bleeding is one of the most serious complications of cardiac surgery and requires transfusion of blood or blood products. Acetylsalicylic acid (ASA) and clopidogrel (CLO) are the two most commonly used antiplatelet agents; when used in combination (i.e., as dual antiplatelet therapy [DAPT]), they exert a synergistic effect. Dual antiplatelet therapy, however, significantly increases the risk of postoperative bleeding. The effect of antiplatelet therapy can be monitored by platelet aggregation testing. One of the most commonly methods used for assessing platelet reactivity is multiple electrode aggregometry (MEA) which can be performed with the use of Multiplate analyzer. Although the method has long been used in interventional cardiology to assess the effect of antiplatelet therapy, it is not available at cardiac surgery departments as a standard diagnostic procedure. The aim of the study was to establish the frequency of bleeding complications following coronary artery bypass graft (CABG) surgery in patients on single antiplatelet therapy (SAPT) and patients on DAPT and to determine the usefulness of routine measurement of platelet responsiveness before CABG surgery in patients receiving antiplatelet therapy. Material and methods A consecutive cohort of 200 patients referred for elective surgical treatment of stable coronary artery disease was enrolled (100 consecutive patients on SAPT [ASA 75 mg/day] and 100 consecutive patients on DAPT [ASA 75 mg/day + CLO 75 mg/day]). All subjects continued their antiplatelet therapy until the day before surgery. For each subject, platelet aggregation testing in the form of an ASPI test and an ADP test was performed on the Multiplate analyzer. Each subject underwent coronary artery bypass grafting surgery. For the primary and secondary endpoints in our study we adopted the definition provided in ‘Standardised Bleeding Definitions for Cardiovascular Clinical Trials: A Consensus Report from the

  14. Coronary Heart Disease Risk between Active and Inactive Women with Multiple Sclerosis.

    ERIC Educational Resources Information Center

    Slawta, Jennifer N.; McCubbin, Jeffrey A.; Wilcox, Anthony R.; Fox, Susan D.; Nalle, Darek J.; Anderson, Gail

    2002-01-01

    Investigated whether abdominal fat accumulation and levels of triglyceride, high-density lipoprotein cholesterol, and glucose differed between 123 active and inactive women with multiple sclerosis (MS). Results indicated that low-to-moderate leisure time physical activity significantly related to less abdominal fat accumulation, lower triglyceride…

  15. Multiple Giant Cell Tumors of Tendon Sheath Found within a Single Digit of a 9-Year-Old

    PubMed Central

    Fitzhugh, Valerie A.; Gibson, Peter D.; Didesch, Jacob; Ahmed, Irfan

    2016-01-01

    Giant cell tumor of tendon sheath is one of the most common soft tissue tumors of the hand. These tumors typically occur in the third or fourth decade of life and present as solitary nodules on a single digit. Currently, the greatest reported number of lesions found within a single digit is five. Although uncommon, giant cell tumor of tendon sheath does occur in the pediatric population. Herein we present a report of a rare case of GCTTS in a child in which seven lesions were identified within a single digit—the greatest number of lesions within a single digit reported to date. PMID:27595029

  16. Chemical abundances in the multiple sub-giant branch of 47 Tucanae: insights on its faint sub-giant branch component

    NASA Astrophysics Data System (ADS)

    Marino, A. F.; Milone, A. P.; Casagrande, L.; Collet, R.; Dotter, A.; Johnson, C. I.; Lind, K.; Bedin, L. R.; Jerjen, H.; Aparicio, A.; Sbordone, L.

    2016-06-01

    The globular cluster 47 Tuc exhibits a complex sub-giant branch (SGB) with a faint-SGB comprising only about the 10 per cent of the cluster mass and a bright-SGB hosting at least two distinct populations. We present a spectroscopic analysis of 62 SGB stars including 21 faint-SGB stars. We thus provide the first chemical analysis of the intriguing faint-SGB population and compare its abundances with those of the dominant populations. We have inferred abundances of Fe, representative light elements C, N, Na, and Al, α elements Mg and Si for individual stars. Oxygen has been obtained by co-adding spectra of stars on different sequences. In addition, we have analysed 12 stars along the two main RGBs of 47 Tuc. Our principal results are (i) star-to-star variations in C/N/Na among RGB and bright-SGB stars; (ii) substantial N and Na enhancements for the minor population corresponding to the faint-SGB; (iii) no high enrichment in C+N+O for faint-SGB stars. Specifically, the C+N+O of the faint-SGB is a factor of 1.1 higher than the bright-SGB, which, considering random (±1.3) plus systematic errors (±0.3), means that their C+N+O is consistent within observational uncertainties. However, a small C+N+O enrichment for the faint-SGB, similar to what predicted on theoretical ground, cannot be excluded. The N and Na enrichment of the faint-SGB qualitatively agrees with this population possibly being He-enhanced, as suggested by theory. The iron abundance of the bright and faint-SGB is the same to a level of ˜0.10 dex, and no other significant difference for the analysed elements has been detected.

  17. EMBRYONIC CORONARY VASCULOGENESIS AND ANGIOGENESIS ARE REGULATED BY INTERACTIONS BETWEEN MULTIPLE FGFS AND VEGF AND ARE INFLUENCED BY MESENCHYMAL STEM CELLS

    PubMed Central

    Tomanek, Robert J.; Christensen, Lance P.; Simons, Michael; Murakami, Masahiro; Zheng, Wei; Schatteman, Gina C.

    2010-01-01

    In embryonic hearts explanted on collagen gels, epicardial cells delaminate and form vascular tubes, thus providing a model for coronary tubulogenesis. Using this model, we show that FGFs 1, 2, 4, 8, 9 and 18 contribute to tubulogenesis and that the availability of multiple FGFs provides the optimal tubulogenic response. Moreover, the FGF effects are VEGF dependent, while VEGF-induced tubulogenesis requires FGF signaling. The number of endothelial cells (ECs) is increased by all of the FGFs, while EC migration is significantly enhanced only by FGF-2 and FGF-18. Finally, addition of embryonic mesenchymal stem cells (EMSC) to the explants markedly enhances EC numbers and a 23-fold increase in SDF-1α, which is FGF dependent. Both explants and EMSCs produce SDF-1α. In conclusion, coronary tubulogenesis of embryonic epicardium: 1) is responsive to many FGF family members, 2) requires both FGF and VEGFA signaling, and 3) is responsive to EMSCs. PMID:20981833

  18. Relationship of the estrogen surge and multiple mates to cub paternity in the giant panda (Ailuropoda melanoleuca): implications for optimal timing of copulation or artificial insemination.

    PubMed

    Huang, Yan; Zhang, Hemin; Li, Desheng; Zhang, Guiquan; Wei, Rongping; Huang, Zhi; Zhou, Yingmin; Zhou, Qiang; Liu, Yang; Wildt, David E; Hull, Vanessa

    2012-11-01

    The effectiveness of ex situ breeding programs for endangered species can be limited by challenges in mimicking mating competitions that naturally occur among multiple mates in the wild. The objective of this study was to evaluate the impact of timed natural matings and/or artificial inseminations in the context of the urinary estrogen surge on cub production in the giant panda (Ailuropoda melanoleuca). We used a large cohort of giant pandas, including 12 females and 17 males. DNA paternity exclusion was used to pinpoint accurately the interval during the estrogen surge that coincided with the ideal sperm deposition time to produce offspring. Of the 31 cubs (in 19 pregnancies), 22 (71.0%; 15 pregnancies) were produced from matings occurring on the day of or the day after the maximal urinary estrogen peak. Sixteen of the 19 pregnancies (84.2%) produced at least one offspring sired by the first male mating with the dam. There was a preponderance of twins (12 of 19; 63.2%), and dual paternities were discovered in 3 of 12 twin sets (25%). These findings indicate a strong relationship between the excreted estrogen surge and sperm deposition to achieve pregnancy in the giant panda. To ensure the production of the most genetically diverse young, it is imperative that the most appropriate male mate first and on the day of or the day after the highest detected estrogen value. There is no advantage to increasing the number of copulations or mating partners within 1 day of the estrogen peak on the incidence of twinning, although this practice may increase the prevalence of dual paternity in cases of multiple births. PMID:22976278

  19. Coronary Angioplasty

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Percutaneous Coronary Intervention? Español Percutaneous (per-ku-TA-ne-us) coronary intervention (PCI), commonly known as coronary angioplasty (AN-jee- ...

  20. Successful endovascular reconstruction of a recurrent giant middle cerebral artery aneurysm with multiple telescoping flow diverters in a pediatric patient.

    PubMed

    Ikeda, Daniel S; Marlin, Evan S; Shaw, Andrew; Powers, Ciarán J

    2015-01-01

    Intracranial aneurysms of the pediatric population are rare, but giant fusiform aneurysms (GFAs) of the middle cerebral artery (MCA) are common within this cohort of patients. These aneurysms are difficult to treat and often require advanced microsurgical skills, as they are usually not amenable to direct clipping. Here, we report the successful treatment of a recurrent GFA of the MCA with three telescoping Pipeline Embolization Devices 6 months after attempted clip reconstruction in a pediatric patient. PMID:25790956

  1. [Coronary endarterectomy].

    PubMed

    Murtra, M; González, I; Igual, A

    1998-01-01

    The technique of coronary endarterectomy, in coronary artery surgery, has been controversial and alternatively indicated or contraindicated by different authors. In this paper coronary endarterectomy is reviewed, including its definition, history and development of different techniques. Early and late results of the main papers in the literature are commented on as well as our results. The surgical technique of endarterectomy in the different coronary artery territories is described with the primary indications and contraindications. Coronary endarterectomy is a valid and well established technique that can provide possibilities of revascularization in patients with extended and diffused coronary artery obstructions, which are unable to be treated with conventional coronary artery bypass grafts. Operative mortality and morbidity are slightly higher, but long-term results, as far as survival and functional class are concerned, are similar to standard coronary artery surgical procedures. PMID:9717404

  2. Noninvasive imaging in coronary artery disease.

    PubMed

    Heo, Ran; Nakazato, Ryo; Kalra, Dan; Min, James K

    2014-09-01

    Noninvasive cardiac imaging is widely used to evaluate the presence of coronary artery disease. Recently, with improvements in imaging technology, noninvasive imaging has also been used for evaluation of the presence, severity, and prognosis of coronary artery disease. Coronary CT angiography and MRI of coronary arteries provide an anatomical assessment of coronary stenosis, whereas the hemodynamic significance of a coronary artery stenosis can be assessed by stress myocardial perfusion imaging, such as SPECT/PET and stress MRI. For appropriate use of multiple imaging modalities, the strengths and limitations of each modality are discussed in this review. PMID:25234083

  3. Noninvasive Imaging in Coronary Artery Disease

    PubMed Central

    Heo, Ran; Nakazato, Ryo; Kalra, Dan; Min, James K.

    2014-01-01

    Noninvasive cardiac imaging is widely used to evaluate the presence of coronary artery disease. Recently, with improvements in imaging technology, noninvasive imaging has also been used for evaluation of the presence, severity, and prognosis of coronary artery disease. Coronary CT angiography and MRI of coronary arteries provide an anatomical assessment of coronary stenosis, whereas the hemodynamic significance of a coronary artery stenosis can be assessed by stress myocardial perfusion imaging, such as SPECT/PET and stress MRI. For appropriate use of multiple imaging modalities, the strengths and limitations of each modality are discussed in this review. PMID:25234083

  4. Successful management of a giant spinal arteriovenous malformation with multiple communications between primitive arterial and venous structures by embolization: report of a case.

    PubMed

    Kuga, T; Esato, K; Zempo, N; Fujioka, K; Harada, M; Furutani, A; Akiyama, N; Toyota, S; Fujita, Y

    1996-01-01

    A 47-year-old woman was admitted to our hospital with a giant spinal arteriovenous malformation (AVM) causing heart failure and thoracic myelopathy. Angiography revealed that the spinal AVM had multiple feeding vessels branching from the 5th through 12th intercostal arteries. The drainage vein flowed to the azygos vein and superior vena cava. The AVM destroyed the 7th thoracic vertebra. The cardiac output was 16.7l/min and the shunt ratio was 64% before treatment. Embolization with cyanoacrylate was performed because the operation was considered to be associated with a significant risk of paraplegia and organ ischemia. The cardiac output decreased to 11.6l/min and the shunt ratio was reduced to 32%. After embolization the patient demonstrated no symptoms of either heart failure or sensory deficits. During embolization, provocative tests using sodium amytal and lidocaine with magnetic stimulation were also performed. The above findings suggest that provocative tests and magnetic stimulation are useful to predict paraplegia, which could result from embolization while, in addition, embolization is considered to be a useful treatment for multiple shunt and nidus in this region. PMID:8883257

  5. Coronary artery fistulas

    PubMed Central

    Said, S.A.M.; Thiadens, A.A.H.J.; Fieren, M.J.C.H.; Meijboom, E.J.; van der Werf, T.; Bennink, G.B.W.E.

    2002-01-01

    The aetiology of congenital coronary artery fistulas remains a challenging issue. Coronary arteries with an anatomically normal origin may, for obscure reasons, terminate abnormally and communicate with different single or multiple cardiac chambers or great vessels. When this occurs, the angiographic morphological appearance may vary greatly from discrete channels to plexiform network of vessels. Coronary arteriovenous fistulas (CAVFs) have neither specific signs nor pathognomonic symptoms; the spectrum of clinical features varies considerably. The clinical presentation of symptomatic cases can include angina pectoris, myocardial infarction, fatigue, dyspnoea, CHF, SBE, ventricular and supraventricular tachyarrhythmias or even sudden cardiac death. CAVFs may, however, be a coincidental finding during diagnostic coronary angiography (CAG). CAG is considered the gold standard for diagnosing and delineating the morphological anatomy and pathway of CAVFs. There are various tailored therapeutic modalities for the wide spectrum of clinical manifestations of CAVFs, including conservative pharmacological strategy, percutaneous transluminal embolisation and surgical ligation. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:25696067

  6. Coalescent-based hypothesis testing supports multiple Pleistocene refugia in the Pacific Northwest for the Pacific giant salamander (Dicamptodon tenebrosus).

    PubMed

    Steele, Craig A; Storfer, Andrew

    2006-08-01

    Phylogeographic patterns of many taxa are explained by Pleistocene glaciation. The temperate rainforests within the Pacific Northwest of North America provide an excellent example of this phenomenon, and competing phylogenetic hypotheses exist regarding the number of Pleistocene refugia influencing genetic variation of endemic organisms. One such endemic is the Pacific giant salamander, Dicamptodon tenebrosus. In this study, we estimate this species' phylogeny and use a coalescent modeling approach to test five hypotheses concerning the number, location and divergence times of purported Pleistocene refugia. Single refugium hypotheses include: a northern refugium in the Columbia River Valley and a southern refugium in the Klamath-Siskiyou Mountains. Dual refugia hypotheses include these same refugia but separated at varying times: last glacial maximum (20,000 years ago), mid-Pleistocene (800,000 years ago) and early Pleistocene (1.7 million years ago). Phylogenetic analyses and inferences from nested clade analysis reveal distinct northern and southern lineages expanding from the Columbia River Valley and the Klamath-Siskiyou Mountains, respectively. Results of coalescent simulations reject both single refugium hypotheses and the hypothesis of dual refugia with a separation date in the late Pleistocene but not hypotheses predicting dual refugia with separation in early or mid-Pleistocene. Estimates of time since divergence between northern and southern lineages also indicate separation since early to mid-Pleistocene. Tests for expanding populations using mismatch distributions and 'g' distributions reveal demographic growth in the northern and southern lineages. The combination of these results provides strong evidence that this species was restricted into, and subsequently expanded from, at least two Pleistocene refugia in the Pacific Northwest. PMID:16842421

  7. Giant perigenital seborrheic keratosis.

    PubMed

    Bandyopadhyay, Debabrata; Saha, Abanti; Mishra, Vivek

    2015-01-01

    Seborrheic keratosis (SK) is a very common benign epidermal proliferation that is prevalent in all races. Most commonly occurring on the trunk, face, scalp, and the extremities, they can occur anywhere on the body except the palms and soles. The most common appearance is that of a very superficial verrucous plaque which appears to be stuck on the surface. Giant lesions are very rare, and their location on the genital area is rarer still. We report here a case of multiple giant SK lesions in a 59-year-old man. PMID:25657917

  8. Giant perigenital seborrheic keratosis

    PubMed Central

    Bandyopadhyay, Debabrata; Saha, Abanti; Mishra, Vivek

    2015-01-01

    Seborrheic keratosis (SK) is a very common benign epidermal proliferation that is prevalent in all races. Most commonly occurring on the trunk, face, scalp, and the extremities, they can occur anywhere on the body except the palms and soles. The most common appearance is that of a very superficial verrucous plaque which appears to be stuck on the surface. Giant lesions are very rare, and their location on the genital area is rarer still. We report here a case of multiple giant SK lesions in a 59-year-old man. PMID:25657917

  9. Characterization of TCF21 Downstream Target Regions Identifies a Transcriptional Network Linking Multiple Independent Coronary Artery Disease Loci

    PubMed Central

    Miller, Clint; Pjanic, Milos; Castano, Victor G.; Kim, Juyong B.; Salfati, Elias L.; Kundaje, Anshul B.; Bejerano, Gill; Assimes, Themistocles; Yang, Xia; Quertermous, Thomas

    2015-01-01

    To functionally link coronary artery disease (CAD) causal genes identified by genome wide association studies (GWAS), and to investigate the cellular and molecular mechanisms of atherosclerosis, we have used chromatin immunoprecipitation sequencing (ChIP-Seq) with the CAD associated transcription factor TCF21 in human coronary artery smooth muscle cells (HCASMC). Analysis of identified TCF21 target genes for enrichment of molecular and cellular annotation terms identified processes relevant to CAD pathophysiology, including “growth factor binding,” “matrix interaction,” and “smooth muscle contraction.” We characterized the canonical binding sequence for TCF21 as CAGCTG, identified AP-1 binding sites in TCF21 peaks, and by conducting ChIP-Seq for JUN and JUND in HCASMC confirmed that there is significant overlap between TCF21 and AP-1 binding loci in this cell type. Expression quantitative trait variation mapped to target genes of TCF21 was significantly enriched among variants with low P-values in the GWAS analyses, suggesting a possible functional interaction between TCF21 binding and causal variants in other CAD disease loci. Separate enrichment analyses found over-representation of TCF21 target genes among CAD associated genes, and linkage disequilibrium between TCF21 peak variation and that found in GWAS loci, consistent with the hypothesis that TCF21 may affect disease risk through interaction with other disease associated loci. Interestingly, enrichment for TCF21 target genes was also found among other genome wide association phenotypes, including height and inflammatory bowel disease, suggesting a functional profile important for basic cellular processes in non-vascular tissues. Thus, data and analyses presented here suggest that study of GWAS transcription factors may be a highly useful approach to identifying disease gene interactions and thus pathways that may be relevant to complex disease etiology. PMID:26020271

  10. The Differentiation of Giant Right Atrial Myxoma from Metastatic Cancer with the Use of Multiple Imaging Modalities.

    PubMed

    Nakabayashi, Keisuke; Murata, Satoru; Kato, Hiroko; Oka, Toshiaki

    2016-01-01

    Whether a cardiac tumor is primary or metastatic strongly influences the therapeutic strategy. We herein present a case of a cardiac tumor that occupied most of the right atrium which required immediate treatment in a patient with breast cancer. Multiple imaging modalities, especially computed tomography and cardiac magnetic resonance imaging, provided a precise preoperative diagnosis. We performed cardiac surgery prior to breast cancer surgery because the cardiac tumor was thought to be a myxoma rather than a metastatic cancer. PMID:27086806

  11. Origin of the giant Allard Lake ilmenite ore deposit (Canada) by fractional crystallization, multiple magma pulses and mixing

    NASA Astrophysics Data System (ADS)

    Charlier, Bernard; Namur, Olivier; Malpas, Simon; de Marneffe, Cédric; Duchesne, Jean-Clair; Vander Auwera, Jacqueline; Bolle, Olivier

    2010-06-01

    The late-Proterozoic Allard Lake ilmenite deposit is located in the Havre-Saint-Pierre anorthosite complex, part of the allochtonous polycyclic belt of the Grenville Province. Presently the world's largest Fe-Ti oxide deposit, it had a pre-mining amount in excess of 200 Mt at grades over 60 wt.% hemo-ilmenite. The main ore body is a funnel-shaped intrusion, measuring 1.03 × 1.10 km and 100-300 m-thick. Two smaller bodies are separated by faults and anorthosite. The ore is an ilmenite-rich norite (or ilmenitite) made up of hemo-ilmenite (Hem 22.6-29.4, 66.2 wt.% on average), andesine plagioclase (An 45-50), aluminous spinel and locally orthopyroxene. Whole-rock chemical compositions are controlled by the proportions of ilmenite and plagioclase ± orthopyroxene which supports the cumulate origin of the deposit. Ore-forming processes are further constrained by normal and reverse fractionation trends of Cr concentration in cumulus ilmenite that reveal multiple magma emplacements and alternating periods of fractional crystallization and magma mixing. Mixing of magmas produced hybrids located in the stability field of ilmenite resulted in periodic crystallization of ilmenite alone. The unsystematic differentiation trends in the Allard Lake deposit, arising from a succession of magma pulses, hybridisation, and the fractionation of hemo-ilmenite alone or together with plagioclase suggest that the deposit formed within a magma conduit. This dynamic emplacement mechanism associated with continuous gravity driven accumulation of Fe-Ti oxides and possibly plagioclase buoyancy in a fractionating ferrobasalt explains the huge concentration of hemo-ilmenite. The occurrence of sapphirine associated with aluminous spinel and high-alumina orthopyroxene (7.6-9.1 wt.% Al 2O 3) lacking exsolved plagioclase supports the involvement of a metamorphic overprint during the synchronous Ottawan orogeny, which is also responsible for strong textural equilibration and external granule of

  12. Tracking Advanced Planetary Systems (TAPAS) with HARPS-N . I. A multiple planetary system around the red giant star TYC 1422-614-1

    NASA Astrophysics Data System (ADS)

    Niedzielski, A.; Villaver, E.; Wolszczan, A.; Adamów, M.; Kowalik, K.; Maciejewski, G.; Nowak, G.; García-Hernández, D. A.; Deka, B.; Adamczyk, M.

    2015-01-01

    Context. Stars that have evolved off the main sequence are crucial for expanding the frontiers of knowledge on exoplanets toward higher stellar masses and for constraining star-planet interaction mechanisms. These stars have an intrinsic activity, however, which complicates the interpretation of precise radial velocity (RV) measurements, and therefore they are often avoided in planet searches. Over the past ten years, we have monitored about 1000 evolved stars for RV variations in search for low-mass companions under the Penn State - Toruń Centre for Astronomy Planet Search program with the Hobby-Eberly Telescope. Selected prospective candidates that required higher RV precision measurements have been followed with HARPS-N at the 3.6 m Telescopio Nazionale Galileo. Aims: We aim to detect planetary systems around evolved stars, to be able to build sound statistics on the frequency and intrinsic nature of these systems, and to deliver in-depth studies of selected planetary systems with evidence of star-planet interaction processes. Methods: We obtained 69 epochs of precise RV measurements for TYC 1422-614-1 collected over 3651 days with the Hobby-Eberly Telescope, and 17 epochs of ultra-precise HARPS-N data collected over 408 days. We complemented these RV data with photometric time-series from the All Sky Automatic Survey archive. Results: We report the discovery of a multiple planetary system around the evolved K2 giant star TYC 1422-614-1. The system orbiting the 1.15 M⊙ star is composed of a planet with mass msini = 2.5 MJ in a 0.69 AU orbit, and a planet or brown dwarf with msini = 10 MJ in an orbit of 1.37 AU. The multiple planetary system orbiting TYC 1422-614-1 is the first finding of the TAPAS project, a HARPS-N monitoring of evolved planetary systems identified with the Hobby-Eberly Telescope. Based on observations obtained with the Hobby-Eberly Telescope, which is a joint project of the University of Texas at Austin, the Pennsylvania State University

  13. Infective endocarditis related to a coronary artery fistula with an unusual localization and ectatic coronary arteries.

    PubMed

    Gerede, Demet Menekse; Acibuca, Aynur; Uzun, Caglar; Goksuluk, Huseyin; Ongun, Aydan; Kilickap, Mustafa; Erol, Cetin

    2015-04-01

    Coronary artery fistulas (CAF) are a rare cardiac anomaly that can be either congenital or acquired. CAFs have clinical significance because of complications such as dyspnea on exertion, congestive heart failure, and cardiac tamponade. The literature also contains case reports of CAF presenting as bacterial endocarditis. We describe a 31-year-old man who presented with native valve infective endocarditis related to an unusual form of a CAF between the circumflex coronary artery and left ventricle. He also had giant coronary arteries, which were imaged with computed tomography angiography and transesophageal echocardiography. The diameter of the circumflex coronary artery and left main coronary artery was measured as 19 mm. Surgical intervention for heart valves was performed because of vegetations resistant to continued antibiotic treatment. At the same time, the CAF was treated with surgery. PMID:25362867

  14. Coronary angiography

    MedlinePlus

    Coronary angiography is often done along with cardiac catheterization . This is a procedure which measures pressures in ... Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe ...

  15. Coronary Arteries

    MedlinePlus

    ... side of the heart is smaller because it pumps blood only to the lungs. The left coronary artery, ... heart is larger and more muscular because it pumps blood to the rest of the body. Updated August ...

  16. Coronary heart disease

    MedlinePlus

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... Coronary heart disease is the leading cause of death in the United States for men and women. Coronary heart ...

  17. Coronary Calcium Scan

    MedlinePlus

    ... the NHLBI on Twitter. What Is a Coronary Calcium Scan? A coronary calcium scan is a test ... you have calcifications in your coronary arteries. Coronary Calcium Scan Figure A shows the position of the ...

  18. Coronary Artery Bypass Grafting

    MedlinePlus

    ... Rehabilitation Coronary Heart Disease Heart Attack Heart Surgery Percutaneous Coronary Intervention Send a link to NHLBI to someone by ... include lifestyle changes, medicines, and a procedure called percutaneous coronary intervention (PCI), also known as coronary angioplasty. PCI is ...

  19. A giant vesical calculus.

    PubMed

    Rahman, M; Uddin, A; Das, G C; Akanda, N I

    2007-07-01

    Massive or giant vesical calculus is a rare entity in the recent urological practice. Males are affected more than the females. Vesical calculi are usually secondary to bladder outlet obstruction. These patients present with recurrent urinary tract infection, haematuria or with retention of urine. We report a young male patient who presented with defaecatory problems along with other urinary symptoms. The patient having an average built, non diabetic but hypertensive. The stone could be palpated by physical examination. His urea levels were within normal limits but urine examination shows infection. USG reveals bilateral hydronephrosis with multiple stones in both kidneys along with a giant vesical calculus. After controlling urinary infection and hypertention he underwent an open cystolithotomy. During operation digital rectal help was needed to remove the stone as it was adherent with bladder mucosa. Post operative period was uneventful. His urinary output was quite normal and had no defaecatory problems. Patient left the hospital 10 days after operation. PMID:17917633

  20. Giant Axonal Neuropathy

    MedlinePlus

    ... Diversity Find People About NINDS NINDS Giant Axonal Neuropathy Information Page Table of Contents (click to jump ... done? Clinical Trials Organizations What is Giant Axonal Neuropathy? Giant axonal neuropathy (GAN) is a rare inherited ...

  1. Total temporary occlusion of blood flow for several hours to treat a giant deep arteriovenous malformation: A series of multiple operations to save a young life

    PubMed Central

    Kozyrev, Danil A.; Jahromi, Behnam Rezai; Hernesniemi, Juha

    2016-01-01

    Background: The treatment of giant deep arteriovenous malformations (AVMs) remains challenging. Case Description: We report a case of giant deep AVM diagnosed in a 9-year-old girl, for whom the AVM rupture occurred 9 years later. At the age of 9, the girl developed mild left hemiparesis. Magnetic resonance imaging revealed a giant deep AVM. The patient underwent one course of stereotactic radiotherapy followed by serial imaging. At the age of 18, we admitted her to our department with left hemiparesis and a loss of consciousness. Computed tomography showed intracerebral hemorrhage related to AVM. The treatment process proved challenging, with recurrent intracerebral hemorrhages. During the second operation, we used total temporary occlusion for almost 4 hours. Eventually, after 4 rounds of embolizations, 4 microsurgical operations, and a month-and-a-half after admission, AVM was successfully occluded. Five years after this treatment, the patient regained the ability to walk without assistance, although a moderate disability with visual changes remained (Modified Rankin Scale score 3). Conclusion: This case illustrates that the cumulative risk of rupture of a high-grade AVM in young patients is evident, while treatment may prove successful with satisfactory results. PMID:27625889

  2. Structure of giant muscle proteins

    PubMed Central

    Meyer, Logan C.; Wright, Nathan T.

    2013-01-01

    Giant muscle proteins (e.g., titin, nebulin, and obscurin) play a seminal role in muscle elasticity, stretch response, and sarcomeric organization. Each giant protein consists of multiple tandem structural domains, usually arranged in a modular fashion spanning 500 kDa to 4 MDa. Although many of the domains are similar in structure, subtle differences create a unique function of each domain. Recent high and low resolution structural and dynamic studies now suggest more nuanced overall protein structures than previously realized. These findings show that atomic structure, interactions between tandem domains, and intrasarcomeric environment all influence the shape, motion, and therefore function of giant proteins. In this article we will review the current understanding of titin, obscurin, and nebulin structure, from the atomic level through the molecular level. PMID:24376425

  3. Coronary artery disease

    MedlinePlus Videos and Cool Tools

    The coronary arteries supply blood to the heart muscle itself. Damage to or blockage of a coronary artery can result in injury to the heart. Normally, blood flows through a coronary artery unimpeded. However, a ...

  4. Giant Magnons Meet Giant Gravitons

    SciTech Connect

    Hofman, Diego M.

    2008-07-28

    We study the worldsheet reflection matrix of a string attached to a D-brane in AdS{sub 5}xS{sup 5}. The D-brane corresponds to a maximal giant graviton that wraps an S{sup 3} inside S{sup 5}. In the gauge theory, the open string is described by a spin chain with boundaries. We focus on open strings with a large SO(6) charge and define an asymptotic boundary reflection matrix. Using the symmetries of the problem, we review the computation of the boundary reflection matrix, up to a phase. We also discuss weak and strong coupling computations where we obtain the overall phase factor and test our exact results.

  5. Coronary Sinus Lead Extraction.

    PubMed

    Cronin, Edmond M; Wilkoff, Bruce L

    2015-12-01

    Expanded indications for cardiac resynchronization therapy and the increasing incidence of cardiac implantable electronic device infection have led to an increased need for coronary sinus (CS) lead extraction. The CS presents unique anatomical obstacles to successful lead extraction. Training and facility requirements for CS lead extraction should mirror those for other leads. Here we review the indications, technique, and results of CS lead extraction. Published success rates and complications are similar to those reported for other leads, although multiple techniques may be required. Re-implantation options may be limited, which should be incorporated into pre-procedural decision making. PMID:26596810

  6. Giant papillary conjunctivitis.

    PubMed Central

    Donshik, P C

    1994-01-01

    Giant papillary conjunctivitis is a syndrome found frequently as a complication of contact lenses. Many variables can affect the onset and severity of the presenting signs and symptoms. Rigid gas permeable contact lenses appear to result in less severe signs and symptoms, with a longer time before the development of giant papillary conjunctivitis. Nonionic, low-water-content soft contact lenses tend to produce less severe signs and symptoms than ionic, low-water-content soft contact lenses. Enzymatic treatment appears to lessen the severity of signs and symptoms. The association of an allergy appears to play a role in the onset of the severity of the signs and symptoms but does not appear to affect the final ability of the individual to wear contact lenses. Using multiple treatment options, such as changing the polymer to a glyceryl methyl methacrylate or a rigid lens, or utilizing a soft lens on a frequent-replacement basis, can result in a success rate of over 90%. In individuals who still have a return of symptoms, the use of topical mast cell stabilizers or a nonsteroidal anti-inflammatory drug as an adjunctive therapy offers the added possibility of keeping these patients in contact lenses. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 11 A FIGURE 11 B FIGURE 11 C FIGURE 11 D PMID:7886881

  7. Successful surgical treatment with mitral valve replacement and coronary embolectomy in a patient with active infective endocarditis complicated by multiple septic embolisms involving cerebral arteries and the right coronary artery.

    PubMed

    Yamasaki, Manabu; Watanabe, Sunao; Abe, Kohei; Uenishi, Michiko; Kawazoe, Kohei

    2010-09-01

    The proper management of a patient with active infective endocarditis (IE) remains to be determined, especially when his or her condition is complicated with intracranial mycotic aneurysm. Here we present a 46-year-old company employee hospitalized with a subarachnoid hemorrhage caused by a ruptured mycotic aneurysm. Cardiac echography showed a verruca on the posterior mitral cusp and leaflet destruction, resulting in severe valvular regurgitation (determined pathogen was α-streptococcus). High-dose antibiotic infusion and restriction of physical activity to prevent heart failure were combined with emergency craniotomy drainage and coiling of the necks of two cerebral mycotic aneurysms. After 2 months of conservative therapy for IE, he suddenly collapsed with hypotension and bradycardia because of embolic occlusion of the proximal right coronary artery (RCA). An emergent operation was carried out to remove the emboli in the RCA and to replace the mitral valve with a mechanical prosthesis. The postoperative course was uneventful. Although disturbances of spatial recognition and manual dexterity remained, he was able to walk and talk. After postoperative sufficient-duration antibiotic therapy, which lasted 20 days, he was transferred to a rehabilitation center. PMID:20859727

  8. Giant Cell Arteritis

    MedlinePlus

    Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

  9. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2012-10-01

    The 2009 impact on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution {enabling the 2009 impact debris field detection} and rapid frame rates {enabling the 2010 impact flash detections and lightcurve measurements}.We propose a Target of Opportunity program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere.HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing {not achievable from the ground} is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  10. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2014-10-01

    The 2009 impact and recent superbolides on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution (enabling the 2009 impact debris field detection) and rapid frame rates (enabling the 2010/2012 impact flash detections and lightcurve measurements).We propose a ToO program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere (10^20 J).HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing (not achievable from the ground) is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  11. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2013-10-01

    The 2009 impact and recent superbolides on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution {enabling the 2009 impact debris field detection} and rapid frame rates {enabling the 2010/2012 impact flash detections and lightcurve measurements}.We propose a ToO program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere {10^20 J}.HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing {not achievable from the ground} is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  12. Non-invasive assessment of coronary flow and coronary flow reserve by transthoracic Doppler echocardiography: a magic tool for the real world.

    PubMed

    Meimoun, Patrick; Tribouilloy, Christophe

    2008-07-01

    Transthoracic Doppler echocardiography, introduced in the echo-lab in recent last years, to measure coronary flow and coronary flow reserve, is a very attractive tool, totally non-invasive, and easily available at bedside. This review summarizes the actual possibilities of this tool, its multiple potential clinical applications and diagnostic insights, and its arising prognosis value, in coronary artery disease as in various settings affecting the coronary microcirculation. PMID:18296409

  13. Usefulness of intraoperative coronary angioplasty in aorto-coronary bypass surgery.

    PubMed

    Ban, T; Sakata, R; Soneda, J; Matsuda, M; Nishimura, K; Hirata, K; Mochizuki, T

    1985-10-01

    Seven patients underwent aorto-coronary bypass grafting combined with intraoperative transluminal coronary angioplasty (OTCA), because of multiple obliteration of the coronary arteries with poor distal run-off. The patients were all males with a mean age of 52.6 years. For OTCA, a SIMPSON-ROBERT vascular dilator system was used. Eight stenoses in seven patients, four in the left anterior descending artery (LAD) and three in the right coronary artery (RCA) were dilated by means of OTCA. In five patients the results were satisfactory but in two patients the procedures resulted in failure. Dilatation failed because of severe calcification of LAD in one case and, in the other, distal RCA was completely obstructed by a compressed atherosclerotic plaque at the bifurcation after the procedure. From these limited experiences we believe that OTCA might be a method of selection to treat the patients with coronary sclerosis with poor distal run-off. PMID:2935652

  14. Two cases of giant pyogenic granuloma of scalp

    PubMed Central

    Chandra, B. Satish; Rao, P. Narasimha

    2013-01-01

    Pyogenic granuloma is a benign vascular tumor of unknown etiology, though multiple factors play a role in its onset, e.g., trauma, chronic irritation, drugs etc., It is commonly seen in children and adolescents. Giant pyogenic granuloma is its atypical variant. We are presenting two cases of giant pyogenic granuloma, one, in a 28-year-old adult, presenting as a giant fluffy swelling of scalp and the other in a 11-year-old child, presenting as a giant ulcerated globular swelling of the scalp. PMID:24350008

  15. Counseling the Coronary Patient

    ERIC Educational Resources Information Center

    Semmler, Caryl; Semmler, Maynard

    1974-01-01

    The article discusses counseling sessions designed to a) help the coronary patient adjust to cardiovascular disease, b) diminish patient anxieties and fears, and c) educate the patient and family members on controlling risk factors to deter another coronary attack. (JS)

  16. Coronary artery fistula

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007315.htm Coronary artery fistula To use the sharing features on this page, please enable JavaScript. Coronary artery fistula is an abnormal connection between one of ...

  17. Coronary artery disease

    MedlinePlus Videos and Cool Tools

    ... heart muscle itself. Damage to or blockage of a coronary artery can result in injury to the heart. Normally, blood flows through a coronary artery unimpeded. However, a process called atherosclerosis ...

  18. Coronary artery stents.

    PubMed Central

    Stewart, A. J.; Coltart, D. J.

    1996-01-01

    The use of coronary stents to treat the acute complications of percutaneous transluminal coronary angioplasty and to reduce the restenosis rate following this procedure is reviewed. Images Figure 1 Figure 2 Figure 3 PMID:8761499

  19. What Is Coronary Angiography?

    MedlinePlus

    ... OG-rah-fee) is a test that uses dye and special x rays to show the insides ... the coronary arteries. Overview During coronary angiography, special dye is released into the bloodstream. The dye makes ...

  20. The Shared Crosstalk of Multiple Pathways Involved in the Inflammation between Rheumatoid Arthritis and Coronary Artery Disease Based on a Digital Gene Expression Profile

    PubMed Central

    Zhang, Zhiguo; Jiang, Miao; He, Dan; Bian, Yanqin; Zhang, Ge; Bian, Zhaoxiang; Lu, Aiping

    2014-01-01

    Rheumatoid arthritis (RA) and coronary artery disease (CAD) are both complex inflammatory diseases, and an increased prevalence of CAD and a high rate of mortality have been observed in RA patients. But the molecular mechanism of inflammation that is shared between the two disorders is unclear. High-throughput techniques, such as transcriptome analysis, are becoming important tools for genetic biomarker discovery in highly complex biological samples, which is critical for the diagnosis, prognosis, and treatment of disease. In the present study, we reported one type of transcriptome analysis method: digital gene expression profiling of peripheral blood mononuclear cells of 10 RA patients, 10 CAD patients and 10 healthy people. In all, 213 and 152 differently expressed genes (DEGs) were identified in RA patients compared with normal controls (RA vs. normal) and CAD patients compared with normal controls (CAD vs. normal), respectively, with 73 shared DEGs between them. Using this technique in combination with Ingenuity Pathways Analysis software, the effects on inflammation of four shared canonical pathways, three shared activated predicted upstream regulators and three shared molecular interaction networks were identified and explored. These shared molecular mechanisms may provide the genetic basis and potential targets for optimizing the application of current drugs to more effectively treat these diseases simultaneously and for preventing one when the other is diagnosed. PMID:25514790

  1. Complete improvement in a patient with multiple irreversible defects of the left ventricle on 99m technetium-sestamibi SPECT after percutaneous coronary intervention.

    PubMed

    Javadi, H; Porpiranfar, M A; Semnani, S; Jallalat, S; Yavari, P; Mogharrabi, M; Hooman, A; Amini, A; Barekat, M; Iranpour, D; Assadi, M; Asli, I N

    2012-10-01

    99mTc-sestamibi has been investigated as a potential viability marker; initial studies have shown good concordance between 201Tl and 99mTc-sestamibi activities in both viable and nonviable myocardium. However, assessment of myocardial viability by 99mTc-sestamibi remains controversial for tissue recovery after revascularization. Here, we present a patient with several regions of severely diminished and irreversible (defect persisting in both early and delay images of each set scanning) defects on initial scan which were dissolved completely on the follow up scan after an intervention. In a 75 year-old Asian woman with acute myocardial infarction who received thrombolytic therapy and subjected to percutaneous coronary angiography (PCI) on day 28 after acute myocardial infarction(MI), resting 99mTc-sestamibi SPECT was applied on day 4 (initial scan) and 138 (follow up scan) after acute MI at 30 and 180 min after injection of tracer (740 MBq); Two-dimensional echocardiography was carried out at the same time. On the initial image set, there was irreversible defects in the apex, anteroapical, inferoapical, anteroseptal, septal and also anterior walls, while the follow up image was normal in all regions.The angiography intervention showed just significant stenosis on left anterior descending (LAD) vessel (95%). This may highlight the failure of 99mTc-sestamibi as a marker of myocardial viability and also mandate further validating of the procedure with follow up scan or other modalities for myocardial viability investigation. PMID:23090825

  2. Embolic protection devices in percutaneous coronary intervention.

    PubMed

    Meneguz Moreno, Rafael A; Costa, José R; Costa, Ricardo A; Abizaid, Alexandre

    2016-06-01

    Clinical benefit of percutaneous coronary intervention (PCI) depends on both angiographic success at lesion site as well as the restoration of adequate macro and microvascular perfusion. The pathophysiology of embolization from coronary lesions during PCI is multifactorial, being more frequently observed in patients with acute coronary syndrome and in those with lesions at saphenous vein graft (SVG). In this population, despite successful epicardial intervention, distal tissue perfusion may still be absent in up to a quarter of all PCI. Multiple devices and pharmacologic regimens have been developed and refined in an attempt to protect the microvascular circulation during PCI. Among them, embolic protection devices have raised as an attractive adjunctive toll due to their ability to retain debris and potentially prevent distal embolization, reducing major adverse cardiac events. Currently, their use has been validated for the treatment of SVG lesions but failed to show effectiveness in the percutaneous approach of acute coronary syndrome patients, including those with ST elevation myocardial infarction. PMID:27007782

  3. Timing of Staged Percutaneous Coronary Intervention for a Non-Culprit Lesion in Patients With Anterior Wall ST Segment Elevation Myocardial Infarction With Multiple Vessel Disease.

    PubMed

    Lee, Wei-Chieh; Wu, Bo-Jui; Fang, Chih-Yuan; Chen, Chien-Jen; Yang, Cheng-Hsu; Yip, Hon-Kan; Hang, Chi-Ling; Wu, Chiung-Jen; Fang, Hsiu-Yu

    2016-07-27

    The optimal timing of a staged percutaneous coronary intervention (PCI) for non-culprit lesions in patients with STsegment elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) remains controversial. We focused on patients with anterior wall STEMI with MVD and determined the clinical effects for timing of staged PCI.From November 2005 to December 2014, 258 patients were diagnosed with anterior wall STEMI with MVD in our hospital. Among them, 37 patients received staged PCI within 3 weeks, 50 patients received staged PCI during 3 weeks to one year, and 167 patients received only primary PCI for culprit lesions. Clinical outcomes such as admission for angina or heart failure, target vessel revascularization, myocardial infarction, stroke, cardiovascular mortality, and allcause mortality were compared among the 3 groups.Acute kidney injury (AKI) after PCI occurred in 18.9% of the 3-week group, 0% of the one-year group, and 7.6% of the control group (P = 0.005). Of the one-year and 3-year clinical outcomes, the one-year group had better results, such as fewer major adverse cardiac cerebral events (P = 0.028, P = 0.023), and lower recurrent MI (P = 0.065; P = 0.018), cardiovascular mortality (P = 0.043; P = 0.020), and all-cause mortality (P = 0.047; P = 0.005).In patients with anterior wall STEMI with MVD, staged PCI for a non-culprit lesion over 3 weeks to one year had a better clinical outcome. Staged PCI for a non-culprit lesion within 3 weeks may be related to the occurrence of AKI, may lead to worse clinical outcomes, and did not decrease the occurrence of angina or post-MI heart failure. PMID:27357434

  4. Multiple effects of ryanodine on intracellular free Ca2+ in smooth muscle cells from bovine and porcine coronary artery: modulation of sarcoplasmic reticulum function.

    PubMed Central

    Wagner-Mann, C.; Hu, Q.; Sturek, M.

    1992-01-01

    1. The effects of ryanodine and caffeine on intracellular free Ca2+ concentration ([Ca2+]i) were studied by use of fura-2 microfluorometry in single smooth muscle cells freshly dispersed from bovine and porcine coronary artery. 2. Bovine and porcine cells demonstrated similar sensitivities to 10 min of exposure to ryanodine in physiological salt solution (PSS), as determined by comparable dose-dependent decreases in the subsequent [Ca2+]i transient induced by 5 mM caffeine. 3. Ryanodine (10 microM) caused a significant increase in [Ca2+]i to a plateau level 27 +/- 3% and 38 +/- 4% above baseline [Ca2+]i (baseline [Ca2+]i = [Ca2+]i at 0 min) in porcine and bovine cells, respectively, when bathed in PSS. In bovine cells the time required to reach 1/2 the plateau level was only 3 min versus 6 min for porcine cells. 4. The ryanodine-induced plateau increase in [Ca2+]i was 35 +/- 5% above baseline for bovine cells bathed in 0 Ca PSS (PSS including 10 microM EGTA with no added Ca2+), but only 7 +/- 3% above baseline in porcine cells during 10 min exposure to 10 microM ryanodine. In bovine cells [Ca2+]i showed proportional increases when extracellular Ca2+ was increased from the normal 2 mM Ca2+ PSS to 5 and 10 mM. 5. Cells pretreated with caffeine in 0 Ca PSS, which depleted the caffeine-sensitive sarcoplasmic reticulum Ca2+ store, showed no increase in [Ca2+]i when challenged with 10 microM ryanodine. The ryanodine-associated increase in [Ca2+]i, which was sustained in 0 Ca PSS during the 10 min ryanodine exposure in cells not pretreated with caffeine, suggests that ryanodine releases Ca2+ from the sarcoplasmic reticulum, but also inhibits Ca2+ efflux.(ABSTRACT TRUNCATED AT 250 WORDS) Images Figure 1 PMID:1504718

  5. Peripheral giant cell granuloma.

    PubMed

    Adlakha, V K; Chandna, P; Rehani, U; Rana, V; Malik, P

    2010-01-01

    Peripheral giant cell granuloma is a benign reactive lesion of gingiva. It manifests as a firm, soft, bright nodule or as a sessile or pedunculate mass. This article reports the management of peripheral giant cell granuloma in a 12-year-old boy by surgical excision. PMID:21273719

  6. Combination of a Giant Dissected Ascending Aortic Aneurysm with Multiple Fistulae into the Cardiac Chambers Caused by Prosthetic Aortic Valve Endocarditis

    PubMed Central

    Sabzi, Feridoun; Faraji, Reza

    2016-01-01

    The combination of a dissected ascending aortic aneurysm (AA) with multiple fistulae to the periaortic root structures is a life-threatening complication that occurs rarely after infective endocarditis of the prosthetic aortic valve. Many risk factors are potentially associated with this complication, including aortic diameter, connective tissue disease of the aortic wall, hypertension and infection. We report a rare case of dissected ascending AA with fistulae to the left atrium and pulmonary artery and a paravalvular leak in a 47-year-old woman with a history of an aortic valve replacement. The patient had presented to the Imam Ali Hospital, Kermanshah, Iran, in January 2015 with clinical features of heart failure. After initially being treated for congestive heart failure, she underwent open-heart surgery via a classic Bentall procedure and double fistula closure. She was discharged 23 days after the operation in good condition. A six-month follow-up showed normal functioning of the composite conduit prosthetic valve and no fistulae recurrence. PMID:26909200

  7. Cardiac surgical procedures for the coronary sequelae of Kawasaki disease

    PubMed Central

    Yuan, Shi-Min

    2012-01-01

    Objectives The aim of this article is to make an evaluation on the clinical features of patients with Kawasaki disease who require a cardiac surgical procedure including coronary artery bypass grafting, coronary arterial aneurysmorrhaphy or heart transplantation. Methods English literature of Kawasaki disease for cardiac surgery (1990–2011) was retrieved in the Pubmed database. The clinical features of the patient setting from the representative articles were collected and analyzed. Results Patients with Kawasaki disease were very young, with some requiring a cardiac surgical procedure at a very early age. The interval between the onset and the surgical operation was 9.5±9.4 years. The prevalence of myocardial infarction and re-infarction was high. Giant aneurysm, critical stenosis with calcification and thrombus formation of the coronary arteries often warrant coronary artery bypass, heart transplantation or coronary arterial aneurysm plication. The left internal mammary artery to the left anterior descending coronary artery was the most commonly used graft in coronary artery bypass. Graft patency rate was 82.4% at 21.4±32.3 (range 0.1–252) month follow-up. The early and late mortalities of this patient setting were 0.6 and 3.0%, respectively. Conclusions Patients with Kawasaki disease may develop coronary artery lesions prone to aneurysmal formation with calcification and thrombus and may require coronary artery bypass at a very early age. With the left internal mammary artery as the first choice of bypass graft, the long-term patency and patient survival was satisfactory. PMID:23226165

  8. Unstable giant gravitons

    SciTech Connect

    Mello Koch, Robert de; Ives, Norman; Smolic, Jelena; Smolic, Milena

    2006-03-15

    We find giant graviton solutions in Frolov's three parameter generalization of the Lunin-Maldacena background. The background we study has {gamma}-tilde{sub 1}=0 and {gamma}-tilde{sub 2}={gamma}-tilde{sub 3}={gamma}-tilde. This class of backgrounds provides a nonsupersymmetric example of the gauge theory/gravity correspondence that can be tested quantitatively, as recently shown by Frolov, Roiban, and Tseytlin. The giant graviton solutions we find have a greater energy than the point gravitons, making them unstable states. Despite this, we find striking quantitative agreement between the gauge theory and gravity descriptions of open strings attached to the giant.

  9. What Causes Coronary Microvascular Disease?

    MedlinePlus

    ... Living With Clinical Trials Links Related Topics Angina Atherosclerosis Coronary Heart Disease Coronary Heart Disease Risk Factors ... Microvascular Disease? The same risk factors that cause atherosclerosis may cause coronary microvascular disease. Atherosclerosis is a ...

  10. How Is Coronary Angioplasty Done?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Percutaneous Coronary Intervention Done? Before you have percutaneous coronary intervention (PCI), ... wall, relieving the blockage and improving blood flow. Percutaneous Coronary Intervention Figure A shows the location of the heart ...

  11. Who Needs Coronary Artery Bypass Grafting?

    MedlinePlus

    ... Rehabilitation Coronary Heart Disease Heart Attack Heart Surgery Percutaneous Coronary Intervention Send a link to NHLBI to someone by ... coronary arteries that can't be treated with percutaneous coronary intervention (PCI), also known as coronary angioplasty. Your doctor ...

  12. Regional Myocardial Perfusion Rates in Patients with Coronary Artery Disease

    PubMed Central

    Cannon, Paul J.; Dell, Ralph B.; Dwyer, Edward M.

    1972-01-01

    Regional myocardial perfusion rates were estimated from the myocardial washout of 133Xenon in 24 patients with heart disease whose coronary arteriograms were abnormal and 17 similar subjects whose coronary arteriograms were judged to be normal. Disappearance rates of 133Xe from multiple areas of the heart were monitored externally with a multiple-crystal scintillation camera after the isotope had been injected into a coronary artery and local myocardial perfusion rates were calculated by the Kety formula. The mean myocardial perfusion rates in the left ventricle exceeded those in the right ventricle or atrial regions in subjects without demonstrable coronary artery disease. In this group there was a significant lack of homogeneity of local perfusion rates in left ventricular myocardium; the mean coefficient of variation of left ventricular local perfusion rates was 15.8%. In the patients with radiographically demonstrable coronary artery disease, a variety of myocardial perfusion patterns were observed. Local capillary blood flow rates were depressed throughout the myocardium of patients with diffuse coronary disease but were subnormal only in discrete myocardial regions of others with localized occlusive disease. Local myocardial perfusion rates were similar to those found in the group with normal coronary arteriograms in patients with slight degrees of coronary disease and in those areas of myocardium distal to marked coronary constrictions or occlusions which were well supplied by collateral vessels. In subjects with right coronary disease, the mean right ventricular perfusion rates were significantly subnormal; in seven subjects of this group perfusion of the inferior left ventricle by a dominant right coronary artery was absent or depressed. The average mean left ventricular perfusion rate of 12 subjects with significant disease of two or more branches of the left coronary artery was significantly lower than that of the group with normal left coronary

  13. Assessment of coronary thrombolysis

    SciTech Connect

    Geltman, E.M.; Abendschein, D.R.; Devries, S.R.

    1987-02-01

    The efficacy of coronary thrombolysis may be assessed by several invasive and noninvasive means, including coronary angiography, contrast and radionuclide angiography, thallium 201 or /sup 99m/Tc-pyrophosphate scintigraphy, positron emission tomography, cardiac ultrasonography, electrocardiography, and analysis of plasma creatine kinase activity. Each technique has its own strengths and limitations, but when used in concert these methods may provide insight into the physiology of coronary reperfusion and the efficacy of reperfusion in individual patients and populations. 104 references.

  14. Giant Subclavian Artery Aneurysm.

    PubMed

    Counts, Sarah; Zeeshan, Ahmad; Elefteriades, John

    2016-06-01

    We report the case of a 37-year-old construction executive presenting with chest pain, shortness of breath, and dizziness on exertion secondary to a giant left subclavian artery aneurysm and aortic valvular disease. PMID:27231430

  15. Giant distal humeral geode.

    PubMed

    Maher, M M; Kennedy, J; Hynes, D; Murray, J G; O'Connell, D

    2000-03-01

    We describe the imaging features of a giant geode of the distal humerus in a patient with rheumatoid arthritis, which presented initially as a pathological fracture. The value of magnetic resonance imaging in establishing this diagnosis is emphasized. PMID:10794554

  16. The Giant Cell.

    ERIC Educational Resources Information Center

    Stockdale, Dennis

    1998-01-01

    Provides directions for the construction of giant plastic cells, including details for building and installing the organelles. Also contains instructions for preparing the ribosomes, nucleolus, nucleus, and mitochondria. (DDR)

  17. The Next Giant Step

    NASA Video Gallery

    Artist Robert McCall painted "The Next Giant Step" in 1979 to commemorate the heroism and courage of spaceflight pioneers. Located in the lobby of Johnson's building 2, the mural depicts America's ...

  18. Percutaneous transluminal coronary angioplasty (PTCA)

    MedlinePlus Videos and Cool Tools

    Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. The procedure ...

  19. Evaluation of Coronary Artery Status by Coronary Angiography after First Survival of Acute Myocardial Infarction

    PubMed Central

    Jain, Siddhant; Sarkar, Piyabi; Modi, Nitin; Tilkar, Mahendra

    2015-01-01

    Introduction Acute Myocardial Infarction (AMI) is a life threatening medical emergency which needs urgent medical attention. It is one of the major cause of mortality and morbidity throughout the world. Aim The aim of the present study was to assess the coronary artery status by Coronary Angiography (CAG) after first survival of the Acute Myocardial Infarction (AMI) and to correlate the CAG findings with Coronary Artery Disease (CAD) Risk Factor (RF) and effect of early thrombolysis. Materials and Methods CAG was done on 870 patients consecutively from June 2013 to May 2015. Age, Gender, Body Mass Index (BMI), CAD risk factors (RF) such as Type 2 diabetes mellitus (T2 DM), hypertension, dyslipidaemia, smoking status and history of thrombolyctic status were recorded. The correlation between the CAD risk factors (RF) and the CAG findings were statistically analyzed. Results Coronary heart disease risk factors analysis revealed ≥ three RF in 23.88%, two RF in 29.88% and one RFin 45.86% of patients. CAG showed Single Vessel Disease (SVD) in 236 (27.1%) patients, double vessel disease (DVD) in 220(25.2%) patients, Triple Vessel Disease (TVD) in 252 (28.9%) patients. Multiple coronary artery involvement were found in the high risk group patients, which was found statistically significant (p-value<0.0001). A total of 348/870 (40%) patients were thrombolysed amongst them 80 (22.9%) revealed minimal and/or normal coronary artery which was found statistically significant (p-value<0.0001). Conclusion Higher the coronary risk factors, more the chance of the multiple coronary arteries involvement. All AMI patients should be thrombolysed as early as possible to get the benefit of recanalization of the culprit vessel. PMID:26816930

  20. Chirp-driven giant phase space vortices

    NASA Astrophysics Data System (ADS)

    Trivedi, Pallavi; Ganesh, Rajaraman

    2016-06-01

    In a collisionless, unbounded, one-dimensional plasma, modelled using periodic boundary conditions, formation of steady state phase space coherent structures or phase space vortices (PSV) is investigated. Using a high resolution one-dimensional Vlasov-Poisson solver based on piecewise-parabolic advection scheme, the formation of giant PSV is addressed numerically. For an infinitesimal external drive amplitude and wavenumber k, we demonstrate the existence of a window of chirped external drive frequency that leads to the formation of giant PSV. The linear, small amplitude, external drive, when chirped, is shown to couple effectively to the plasma and increase both streaming of "untrapped" and "trapped" particle fraction. The steady state attained after the external drive is turned off and is shown to lead to a giant PSV with multiple extrema and phase velocities, with excess density fraction, defined as the deviation from the Maxwellian background, Δ n / n 0 ≃ 20 % - 25 % . It is shown that the process depends on the chirp time duration Δt. The excess density fraction Δn/n0, which contains both trapped and untrapped particle contribution, is also seen to scale with Δt, only inhibited by the gradient of the distribution in velocity space. Both single step drive and multistep chirp processes are shown to lead to steady state giant PSV, with multiple extrema due to embedded holes and clumps, long after the external drive is turned off.

  1. Recurrent myocardial infarction with patent coronary arteries.

    PubMed Central

    Haywood, L. J.; Khan, A. H.; Bornheimer, J.; Finck, E.; Tatter, D.

    1997-01-01

    Two separate episodes of severe chest pain occurred several years apart in a 25-year-old male patient with typical clinical findings of acute myocardial infarction with each episode. Cardiac catheterization following the second infarction confirmed the presence of myocardial dysfunction with apical akinesis and dyskinesis. Both coronary arteries were radiologically patent; however, there was evidence of probable recanalization of the right coronary artery. Several months later, the patient developed flank pain, hematuria, progressive renal failure, and cardiac decompensation, and died with intractable arrhythmias. At autopsy, a large apical mitral thrombosis was found and was the presumptive source of multiple systemic emboli. Images Figure 3 Figure 4 PMID:9195802

  2. [Coronary artery dissection following blunt chest trauma].

    PubMed

    Seven, Ekim; Henningsen, Kristoffer; Abildgaard, Ulrik

    2015-03-16

    A previously healthy 38-year-old man was admitted to hospital with chest pain. The day before the patient had been to a karate session and had received multiple punches and kicks to the chest region. An ECG showed Q-waves in V1 and V2 and flattening of the T-waves in V1-V6. Levels of cardiac enzyme markers were elevated. The patient subsequently underwent coronary angiography with supplemental optical coherence tomography that revealed a bifurcate dissection involving the proximal parts of left ramus interventricularis anterior and circumflex coronary artery. Two drug-eluting stents were implanted with good angiographic result. PMID:25786846

  3. Coronary Microvascular Disease (MVD)

    MedlinePlus

    ... narrows the heart's large arteries and reduces the flow of oxygen-rich blood to your heart muscle. The buildup of plaque also makes it more likely that blood clots will form in your arteries. Blood clots can mostly or completely block blood flow through a coronary artery. In coronary MVD, however, ...

  4. Giant congenital melanocytic nevus in a bulgarian newborn.

    PubMed

    Chokoeva, A A; Fioranelli, M; Roccia, M G; Lotti, T; Wollina, U; Tchernev, G

    2016-01-01

    Giant congenital melanocytic nevus (GCMN) is a rare disorder affecting 1 in 200,000–500,000 live births. Central nervous system defects such as spina bifida, meningocele, Dandy Walker malformation may accompany it and thus cause significant morbidity. Despite the related risk for malignant transformation, GCMNs may be associated with neurocutaneous melanosis, a rare syndrome in which a giant CMN or multiple smaller CMNs are accompanied by melanocytic deposition in the brain and the spinal cord. We present a case of a 5-day-old newborn with giant congenital melanocytic nevus on his back, as we discuss the diagnostic and treatment approach. PMID:27373137

  5. Pathophysiology of Coronary Collaterals#

    PubMed Central

    Stoller, Michael; Seiler, Christian

    2014-01-01

    While the existence of structural adaptation of coronary anastomoses is undisputed, the potential of coronary collaterals to be capable of functional adaptation has been questioned. For many years, collateral vessels were thought to be rigid tubes allowing only limited blood flow governed by the pressure gradient across them. This concept was consistent with the notion that although collaterals could provide adequate blood flow to maintain resting levels, they would be unable to increase blood flow sufficiently in situations of increased myocardial oxygen demand. However, more recent studies have demonstrated the capability of the collateral circulation to deliver sufficient blood flow even during exertion or pharmacologic stress. Moreover, it has been shown that increases in collateral flow could be attributed directly to collateral vasomotion. This review summarizes the pathophysiology of the coronary collateral circulation, ie the functional adapation of coronary collaterals to acute alterations in the coronary circulation. PMID:23701025

  6. Coronary Atherosclerosis: Pathophysiologic Basis for Diagnosis and Management.

    PubMed

    Boudoulas, Konstantinos Dean; Triposciadis, Filippos; Geleris, Paraschos; Boudoulas, Harisios

    2016-01-01

    Coronary atherosclerosis is a long lasting and continuously evolving disease with multiple clinical manifestations ranging from asymptomatic to stable angina, acute coronary syndrome (ACS), heart failure (HF) and sudden cardiac death (SCD). Genetic and environmental factors contribute to the development and progression of coronary atherosclerosis. In this review, current knowledge related to the diagnosis and management of coronary atherosclerosis based on pathophysiologic mechanisms will be discussed. In addition to providing state-of-the-art concepts related to coronary atherosclerosis, special consideration will be given on how to apply data from epidemiologic studies and randomized clinical trials to the individual patient. The greatest challenge for the clinician in the twenty-first century is not in absorbing the fast accumulating new knowledge, but rather in applying this knowledge to the individual patient. PMID:27091673

  7. [Pregnancy and coronary artery dissection].

    PubMed

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Acute myocardial infarction during pregnancy is associated with high maternal and fetal mortality. Coronary atherosclerosis is the most common cause due to an increase in the age of the patients and the association with cardiovascular risk factors such as smoking, hypertension, diabetes mellitus, preeclampsia, and the existence of family history of coronary disease. However, thrombosis, coronary dissection or coronary vasospasms are other causes that may justify it. We report the case of a 33 weeks pregnant first-time mother, without cardiovascular risk factors, who presented an acute coronary event in the context of atherosclerotic disease and coronary dissection after percutaneous coronary intervention. PMID:25795261

  8. Ectopic Origin of Coronary Arteries Diagnozed by Coronary Angiography

    PubMed Central

    Krasniqi, Xhevdet; Gorani, Daut; Sejdiu, Basri; Citaku, Hajdin

    2016-01-01

    Introduction: Anomalous origin of coronary arteries from opposite sinus of Valsalva is rare finding. The incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. The ectopic origin of left coronary artery or right coronary artery from opposite sinus depending on pathways and considering atherosclerotic changes are manifested with different clinical significance. Case report: We report two cases, the first case the coronary angiography showed the left coronary artery arising from the right coronary sinus, presenting with proximally and distally stenosed left anterior descending artery (LAD), associated with medial and distal stenosed right coronary artery (RCA). The second case the coronary angiography revealed the right coronary artery arising from the left coronary sinus, associated with tortuous medial and distal segments of left anterior descending artery (LAD), without atherosclerotic changes. The first case successfully underwent treatment procedures based on guidelines for revascularization. Conclusion: The coronary angiography of patients with coronary ischemia determines atherosclerotic disease with possibility of the presence of coronary artery anomalies that in cases with ectopic origin from opposite sinus continues to exist as a challenge during treatment in interventional cardiology. PMID:27482140

  9. An Innocent Giant

    PubMed Central

    Solanki, Lakhan Singh; Dhingra, Mandeep; Raghubanshi, Gunjan; Thami, Gurvinder Pal

    2014-01-01

    A cutaneous horn (cornu cutaneum) is a protrusion from the skin composed of a cornified material. It may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous dermatoses. In a 24-year-old female, a giant cutaneous horn arising from a seborrheic keratosis located on the leg is presented. This case has been reported to emphasize that a giant cutaneous horn may also occur in young patients, even in photoprotected areas, and are not always associated with malignancy. PMID:25484426

  10. [The single coronary artery].

    PubMed

    Godart, F; Berzin, B; Rihani, R; Pecheux, M; Dutoit, A

    1992-04-01

    Single coronary artery is a fairly rare entity which may nevertheless be found in 0.4 per cent of coronary arteriograms. The authors report 3 cases seen in 2 departments of cardiology. In each patient, despite the existence of definite cardiovascular risk factors, this distribution was a factor worsening coronary ischemia, leading to complete thrombosis in one case. Although most often a chance discovery, a review of the literature justifies the attribution to this anomaly of the onset of angina, infarction or even sudden death. PMID:1642437

  11. Improved image guidance of coronary stent deployment

    NASA Astrophysics Data System (ADS)

    Close, Robert A.; Abbey, Craig K.; Whiting, James S.

    2000-04-01

    Accurate placement and expansion of coronary stents is hindered by the fact that most stents are only slightly radiopaque, and hence difficult to see in a typical coronary x-rays. We propose a new technique for improved image guidance of multiple coronary stents deployment using layer decomposition of cine x-ray images of stented coronary arteries. Layer decomposition models the cone-beam x-ray projections through the chest as a set of superposed layers moving with translation, rotation, and scaling. Radiopaque markers affixed to the guidewire or delivery balloon provide a trackable feature so that the correct vessel motion can be measured for layer decomposition. In addition to the time- averaged layer image, we also derive a background-subtracted image sequence which removes moving background structures. Layer decomposition of contrast-free vessels can be used to guide placement of multiple stents and to assess uniformity of stent expansion. Layer decomposition of contrast-filled vessels can be used to measure residual stenosis to determine the adequacy of stent expansion. We demonstrate that layer decomposition of a clinical cine x-ray image sequence greatly improves the visibility of a previously deployed stent. We show that layer decomposition of contrast-filled vessels removes background structures and reduces noise.

  12. Pictorial review of coronary anomalies in Tetralogy of Fallot.

    PubMed

    Kapur, Sangita; Aeron, Gunjan; Vojta, Christopher N

    2015-01-01

    Tetralogy of Fallot (TOF) classically consists of four characteristic features-right ventricular outflow obstruction, right ventricular hypertrophy, ventricular septal defect and an overriding aorta. In addition there are multiple other associated cardiac anomalies, including coronary artery anomalies. In this review, the role of CT angiography and the spectrum of coronary anomalies will be discussed along with importance of such anomalies in the context of surgery. PMID:26283594

  13. Novel treatment of coronary artery fistulae concealing severe coronary artery lesion: using thrombus aspiration catheter as a delivery guide.

    PubMed

    Korkmaz, Levent; Acar, Zeydin; Dursun, Ihsan; Akyüz, Ali Rıza; Korkmaz, Ayca Ata

    2014-03-01

    In this case report, we present the occlusion of multiple coronary artery fistulae originating from proximal left anterior descending (LAD) and right sinus valsavla and empting to the pulmonary artery at the same place. We occluded LAD fistulae by using thrombus aspiration catheter as a delivery guide. To the best of our knowlege, this is the first case of occlusion of coronary fistulae with the help of thrombus aspiration catheter. Our experience may suggest that thrombus aspiration catheters can be used in treating coronary artery fistulae with difficult anotomy. PMID:24748888

  14. Novel treatment of coronary artery fistulae concealing severe coronary artery lesion: using thrombus aspiration catheter as a delivery guide

    PubMed Central

    Korkmaz, Levent; Acar, Zeydin; Dursun, İhsan; Akyüz, Ali Rıza; Korkmaz, Ayca Ata

    2014-01-01

    In this case report, we present the occlusion of multiple coronary artery fistulae originating from proximal left anterior descending (LAD) and right sinus valsavla and empting to the pulmonary artery at the same place. We occluded LAD fistulae by using thrombus aspiration catheter as a delivery guide. To the best of our knowlege, this is the first case of occlusion of coronary fistulae with the help of thrombus aspiration catheter. Our experience may suggest that thrombus aspiration catheters can be used in treating coronary artery fistulae with difficult anotomy. PMID:24748888

  15. Electroluminescence of Giant Stretchability.

    PubMed

    Yang, Can Hui; Chen, Baohong; Zhou, Jinxiong; Chen, Yong Mei; Suo, Zhigang

    2016-06-01

    A new type of electroluminescent device achieves giant stretchability by integrating electronic and ionic components. The device uses phosphor powders as electroluminescent materials, and hydrogels as stretchable and transparent ionic conductors. Subject to cyclic voltage, the phosphor powders luminesce, but the ionic conductors do not electrolyze. The device produces constant luminance when stretched up to an area strain of 1500%. PMID:26610277

  16. A giant ureteric calculus

    PubMed Central

    Rathod, Rajiv; Bansal, Prashant; Gutta, Srinivas

    2013-01-01

    Ureteric stones are usually small and symptomatic. We present a case of a 35-year old female who presented with minimally symptomatic right distal ureteric calculus with proximal hydroureteronephrosis. Laparoscopic right ureterolithotomy was performed and a giant ureteric calculus measuring 11 cm Χ 1.5 cm, weighing 40 g was retrieved. PMID:24082453

  17. Giant urethral calculus

    PubMed Central

    Kotkar, Kunal; Thakkar, Ravi; Songra, MC

    2011-01-01

    Primary urethral calculus is rarely seen and is usually encountered in men with urethral stricture or diverticulum. We present a case of giant urethral calculus secondary to a urethral stricture in a man. The patient was treated with calculus extraction with end to end urethroplasty. PMID:24950400

  18. Juvenile giant fibroadenoma

    PubMed Central

    Yagnik, Vipul D.

    2011-01-01

    Fibroadenomas are benign solid tumor associated with aberration of normal lobular development. Juvenile giant fibroadenoma is usually single and >5 cm in size /or >500 gms in weight. Important differential diagnoses are: phyllodes tumor and juvenile gigantomastia. Simple excision is the treatment of choice. PMID:24765310

  19. A giant ureteric calculus.

    PubMed

    Rathod, Rajiv; Bansal, Prashant; Gutta, Srinivas

    2013-07-01

    Ureteric stones are usually small and symptomatic. We present a case of a 35-year old female who presented with minimally symptomatic right distal ureteric calculus with proximal hydroureteronephrosis. Laparoscopic right ureterolithotomy was performed and a giant ureteric calculus measuring 11 cm Χ 1.5 cm, weighing 40 g was retrieved. PMID:24082453

  20. Coronary artery spasm

    MedlinePlus

    ... blocker or a long-acting nitrate long-term. Beta-blockers are another type of medicine that is used with other coronary artery problems. However, beta-blockers may make this problem worse. They should be ...

  1. Coronary Artery Disease

    MedlinePlus

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women. CAD happens when the arteries that supply blood to ...

  2. Coronary Artery Bypass Surgery

    MedlinePlus

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  3. Coronary Artery Disease

    MedlinePlus

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death ... both men and women. CAD happens when the arteries that supply blood to heart muscle become hardened ...

  4. Directional coronary atherectomy (DCA)

    MedlinePlus Videos and Cool Tools

    ... caused by blockages. The procedure begins with the doctor injecting some local anesthesia into the groin area ... ostium of one of the coronary arteries, the doctor injects dye and takes an x-ray. If ...

  5. Coronary Artery Disease

    MedlinePlus

    ... ve started to help the medicine work. Other Organizations American Heart Association Questions to Ask Your Doctor Am I at risk for coronary artery disease (CAD)? What lifestyle changes should I make to decrease my risk of ...

  6. [Acute coronary syndromes: epidemiology].

    PubMed

    Ozkan, Alev Arat

    2013-04-01

    Coronary heart disease is the main cause of death in the world as well as in Turkey. It's not only a health issue but also a social problem with a high economic burden and negative impact on quality of life. The majority of deaths are attributable to acute coronary syndromes (ACS) and their complications.This review summarizes some important facts regarding ACS epidemiology in the world and in Turkey. PMID:27323430

  7. Venous waterfalls in coronary circulation.

    PubMed

    Gosselin, R E; Kaplow, S M

    1991-03-21

    Several studies of flow through collapsible tubing deformed by external pressures have led to a concept known as the "vascular waterfall". One hallmark of this state is a positive zero-flow pressure intercept (Pe) in flow-pressure curves. This intercept is commonly observed in the coronary circulation, but in blood-perfused beating hearts a vascular waterfall is not the only putative cause. To restrict the possibilities, we have measured flow-pressure curves in excised non-beating rabbit hearts in which the coronary arteries were perfused in a non-pulsatile way with a newtonian fluid (Ringers solution) containing potent vasodilator drugs. Under these circumstances, vascular waterfalls are believed to be the only tenable explanation for Pe. In physical terms the waterfall is a region where the vessel is in a state of partial collapse with a stabilized intraluminal fluid pressure (Pw). It is argued that the most probable site of this collapse was the intramural veins just before they reached the epicardial surface. In accord with the waterfall hypothesis, Pe increased as the heart became more edematous, but flow-pressure curves also became flatter, implying multiple waterfalls with differing Pws, leading to complete collapse of some of the venous channels. The principal compressive force is believed to have been the interstitial fluid pressure as registered through a needle (Pn) implanted in the left ventricular wall, but a small additional force (Ps) was probably due to swelling of interstitial gels. A method is presented for estimating Ps and Pw. Unlike rubber tubing, blood vessels are both collapsible and porous. Apparently because of increased capillary filtration, Pn was found to increase linearly with the perfusion pressure. Thus, Pw was not the same at all points on the flow-pressure curve. This finding has interesting implications with respect to the concept of coronary resistance. PMID:2062096

  8. Massive right coronary air embolism in the right coronary artery during left coronary angiography: A case report

    PubMed Central

    PARK, CHANG-BUM; HWANG, HUI-JEONG; CHO, JIN-MAN; JO, BYUNG-HYUN; KIM, CHONG-JIN

    2013-01-01

    Coronary air embolism is one of the inadvertent complications of coronary angiography. We report a case of unexpected massive right coronary air embolism during left coronary angiography with a JL4 diagnostic catheter. This report demonstrates that air embolism may occur in the contralateral coronary artery and therefore complete air aspiration must be ensured during coronary angiography. PMID:23596473

  9. Syphilitic aortitis causing bilateral coronary ostial stenosis.

    PubMed

    Hosoba, Soh; Suzuki, Tomoaki; Koizumi, Yusuke; Asai, Tohru

    2011-02-01

    Coronary ostial stenosis in otherwise normal coronary vessels is a rare complication of syphilitic aortitis. A 47-year-old man with no coronary risk factors developed severe isolated ostial stenosis in the left main coronary artery and right coronary artery. He underwent coronary artery bypass grafting using the bilateral internal thoracic arteries and gastroepiploic artery and recovered uneventfully. PMID:21345777

  10. Giant Congenital Melanocytic Nevi and Neurocutaneous Melanosis

    PubMed Central

    Araújo, Catarina; Pardal, Francisco; Brito, Celeste

    2015-01-01

    Introduction. The major medical concern with giant congenital melanocytic nevi CMN is high risk of developing cutaneous melanoma, leptomeningeal melanoma, and neurocutaneous melanocytosis. Case Report. A 30-year-old woman with a giant congenital melanocytic nevus covering nearly the entire right thoracodorsal region and multiple disseminated melanocytic nevi presented with neurological symptoms. Cerebral magnetic resonance imaging revealed a large expansive lesion in the left frontal region. Postsurgically pathological diagnosis revealed characteristics of melanoma. Immunohistochemical examination showed S100(+), HMB45(+), MelanA(+), and MiTF(+). She received radiotherapy with temozolomide followed by two more chemotherapy cycles with temozolomide. She followed a rapidly progressive course, reflecting widespread leptomeningeal infiltration, and she died of multiorgan failure seven months after diagnosis of cerebral melanoma. Discussion. This patient was diagnosed as having a neurocutaneous melanosis with malignant widespread leptomeningeal infiltration. Diffuse spinal involvement is unusual and is described in only another patient. PMID:25722729

  11. Predictors of successful percutaneous coronary intervention in chronic total coronary occlusions

    PubMed Central

    Gür, Mustafa; Acele, Armağan; Şeker, Taner; Quisi, Alaa; Kıvrak, Ali; Yıldırım, Arafat; Uçar, Hakan; Akyol, Selahattin; Çaylı, Murat

    2016-01-01

    Introduction Percutaneous coronary intervention (PCI) of chronic total coronary occlusions (CTOs) is one of the most challenging procedures of interventional cardiology and is associated with increased risk of significant complications. However, debate continues in regard to which factors adversely influence the success rate of PCI and whether the benefits of revascularization of CTO outweigh the risks and challenges. Aim To analyze the relationship between lesion characteristics and overall success rates as well as in-hospital outcomes after PCI for CTO. Material and methods We retrospectively examined the procedural outcomes of 173 consecutive native coronary artery CTO PCIs performed from February 2012 to March 2013 (78% men; mean age: 60.3 ±12.1 years). Results The CTO target vessel was the right coronary artery (53.8%), circumflex (10.4%) and left anterior descending artery (35.8%), respectively. The retrograde approach was used in 13.9% of all procedures. Successful revascularization was achieved in 83.2% of patients. Major complications occurred in 13.3% of patients. In multivariate analysis, bridge collaterals, severe calcification and tortuosity as well as tandem occlusions were independent predictors of procedural failure, whereas existence of micro-channels was the only predictor of procedural success. Conclusions Revascularization of coronary CTOs may be performed with high success and low major complication rates. Bridge collaterals, severe calcification and tortuosity, tandem/multiple occlusions and micro-channels were independent predictors of successful CTO revascularization. PMID:26966445

  12. Lateral rectus palsy following coronary angiography and percutaneous coronary intervention

    PubMed Central

    Nicholson, Luke; Jones, Ruth; Hughes, David S

    2014-01-01

    We present a rare case of unilateral lateral rectus palsy following an elective coronary angiography and percutaneous coronary intervention in a 78-year-oldwoman. Ophthalmoplegia following coronary angiography is extremely rare and this is the first case of a unilateral lateral rectus palsy following the procedure. PMID:24536054

  13. [Coronary veins and coronary sinus tributary veins in Africans].

    PubMed

    Yangni-Angate, H; Kokoua, A; Kouassi, R; Kassanyou, S; Gnagne, Y; Guessan, G N; Cowppli-Bony, P; Memel, J B

    1995-01-01

    This anatomical study carried out on 40 African adults hearts studied branches of the coronary sinus. By using of injection of the coronary arteries and corrosion of the myocardium, the study identified certain peculiarities of the small coronary vein and the posterior descending interventricular vein in Africans. PMID:8519704

  14. Measurement and modeling of coronary blood flow.

    PubMed

    Sinclair, Matthew D; Lee, Jack; Cookson, Andrew N; Rivolo, Simone; Hyde, Eoin R; Smith, Nicolas P

    2015-01-01

    Ischemic heart disease that comprises both coronary artery disease and microvascular disease is the single greatest cause of death globally. In this context, enhancing our understanding of the interaction of coronary structure and function is not only fundamental for advancing basic physiology but also crucial for identifying new targets for treating these diseases. A central challenge for understanding coronary blood flow is that coronary structure and function exhibit different behaviors across a range of spatial and temporal scales. While experimental studies have sought to understand this feature by isolating specific mechanisms, in tandem, computational modeling is increasingly also providing a unique framework to integrate mechanistic behaviors across different scales. In addition, clinical methods for assessing coronary disease severity are continuously being informed and updated by findings in basic physiology. Coupling these technologies, computational modeling of the coronary circulation is emerging as a bridge between the experimental and clinical domains, providing a framework to integrate imaging and measurements from multiple sources with mathematical descriptions of governing physical laws. State-of-the-art computational modeling is being used to combine mechanistic models with data to provide new insight into coronary physiology, optimization of medical technologies, and new applications to guide clinical practice. PMID:26123867

  15. Functional Testing Underlying Coronary Revascularisation

    ClinicalTrials.gov

    2014-08-08

    Multivessel Coronary Artery Disease; Vessel Disease; Stable Angina; Unstable Angina or Stabilized Non-ST Elevated Myocardial Infarction; Patients With ST-elevated Myocardial Infarction; Revascularization of Culprit Coronary Artery

  16. Coronary artery balloon angioplasty - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100160.htm Coronary artery balloon angioplasty - series To use the sharing features ... out of 9 Normal anatomy Overview The coronary arteries supply blood to the heart muscle. The right ...

  17. Giant cell arteritis

    PubMed Central

    Calvo-Romero, J

    2003-01-01

    Giant cell arteritis (GCA), temporal arteritis or Horton's arteritis, is a systemic vasculitis which involves large and medium sized vessels, especially the extracranial branches of the carotid arteries, in persons usually older than 50 years. Permanent visual loss, ischaemic strokes, and thoracic and abdominal aortic aneurysms are feared complications of GCA. The treatment consists of high dose steroids. Mortality, with a correct treatment, in patients with GCA seems to be similar that of controls. PMID:13679546

  18. Giant dedifferentiated retroperitoneal liposarcoma.

    PubMed

    Dominguez, Elias; Lopez de Cenarruzabeitia, Iñigo; Martinez, Manuel; Rueda, J C; Lede, A; Barreiro, Erica; Diz, Susana

    2008-01-01

    Liposarcoma tumors only represent 0.1% of all cancers, but they are the more common of retroperitoneal sarcomas. It has a great tendency for local recurrence, mainly the dedifferentiated variety, but its complete resection can provide a 5-year survival of 70%. In this report, we present a case of a giant dedifferentiated retroperitoneal liposarcoma that did not affect any neighboring organ and that was successfully treated by means of complete surgical resection. PMID:19731863

  19. Ice Giant Exploration

    NASA Astrophysics Data System (ADS)

    Rymer, A. M.; Arridge, C. S.; Masters, A.; Turtle, E. P.; Simon, A. A.; Hofstadter, M. D.; Turrini, D.; Politi, R.

    2015-12-01

    The Ice Giants in our solar system, Uranus and Neptune, are fundamentally different from their Gas Giant siblings Jupiter and Saturn, from the different proportions of rock and ice to the configuration of their planetary magnetic fields. Kepler space telescope discoveries of exo-planets indicate that planets of this type are among the most ubiquitous universally and therefore a future mission to explore the nature of the Ice Giants in our own solar system will provide insights into the nature of extra-solar system objects in general. Uranus has the smallest self- luminosity of all the planets, potentially related to catastrophic events early in the planet's history, which also may explain Uranus' large obliquity. Uranus' atmosphere is subject to extreme seasonal forcing making it unique in the Solar System. Neptune is also unique in a number of ways, notably its large moon Triton which is likely a captured Kuiper Belt Object and one of only two moons in the solar system with a robustly collisional atmosphere. Similar to Uranus, the angle between the solar wind and the magnetic dipole axis is subject to large-amplitude variations on both diurnal and seasonal timescales, but peculiarly it has one of the quietest magnetospheres of the solar system, at least according to Voyager 2, the only spacecraft to encounter Neptune to date. A comprehensive mission, as advocated in the Decadal Survey, would provide enormous science return but is also challenging and expensive. In this presentation we will discuss mission scenarios and suggest how collaboration between disciplines and internationally can help us to pursue a mission that includes Ice Giant exploration.

  20. Giant thymic carcinoid.

    PubMed

    John, L C; Hornick, P; Lang, S; Wallis, J; Edmondson, S J

    1991-05-01

    Thymic carcinoid is a rare tumour. It may present with ectopic endocrine secretion or with symptoms of compression as a result of its size. A case is reported which presented with symptoms of compression where the size of the tumour was uniquely large such as to warrant the term giant thymic carcinoid. The typical histological features are described, together with its possible origin and its likely prognosis. PMID:1852667

  1. Giant rodlike reversed micelles

    SciTech Connect

    Yu, Z.J.; Neuman, R.D. )

    1994-05-04

    Herein we report that sodium bis(2-ethylhexyl)phosphate, which is similar in structure to the classical surfactant sodium bis(2-ethylhexyl)sulfosuccinate (AOT), forms very large rodlike reversed micelles and that their size can be even much larger if water is removed from the apolar solution. We further suggest that long-range electrostatic interactions are the primary driving force for the formation of giant reversed micelles. 19 refs., 3 figs.

  2. Red giants seismology

    NASA Astrophysics Data System (ADS)

    Mosser, B.; Samadi, R.; Belkacem, K.

    2013-11-01

    The space-borne missions CoRoT and Kepler are indiscreet. With their asteroseismic programs, they tell us what is hidden deep inside the stars. Waves excited just below the stellar surface travel throughout the stellar interior and unveil many secrets: how old is the star, how big, how massive, how fast (or slow) its core is dancing. This paper intends to paparazze the red giants according to the seismic pictures we have from their interiors.

  3. Giant radio pulses

    NASA Astrophysics Data System (ADS)

    Kondratiev, Vladislav

    Rotation-powered radio pulsars exhibit a remarkably diverse spectrum of variability with characteristic time scales from days and even years (intermittent pulsars) to minutes-seconds (nulling) and (sub-)microseconds. The latter time scales are associated with the phenomenon of giant pulses (GPs) and micropulses. The story of GPs started in 1968, when Staelin and Reifenstein discovered the Crab pulsar through its spectacularly bright radio pulses. To date, only seven pulsars out of more than 2200 are known to show GP emission, namely the pulsars B0531+21, B1937+21, B0540-69, B1821-24, B1957+20, J0218+4232, and B1820-30A. Giant pulses are characterized by large energies (more than ten times of the energy of the average pulse), short durations, power-law energy distribution, specific rotational phase of occurrence, high degree of polarization, and accompanying high-energy radiation. Large energies of GPs and coincidence of their phase of occurrence with peaks of high-energy profiles hint at the same mechanism of radio GP and high-energy emission. The correlation of Crab pulsar GPs with optical, X-ray and gamma-ray photons was studied for the past 20 years, with only radio/optical link confirmed so far. In my talk I will present the summary of the observational evidence of radio GPs and give an overview of theoretical advances on giant-pulse emission mechanism.

  4. Computer quantitation of coronary angiograms

    NASA Technical Reports Server (NTRS)

    Ledbetter, D. C.; Selzer, R. H.; Gordon, R. M.; Blankenhorn, D. H.; Sanmarco, M. E.

    1978-01-01

    A computer technique is being developed at the Jet Propulsion Laboratory to automate the measurement of coronary stenosis. A Vanguard 35mm film transport is optically coupled to a Spatial Data System vidicon/digitizer which in turn is controlled by a DEC PDP 11/55 computer. Programs have been developed to track the edges of the arterial shadow, to locate normal and atherosclerotic vessel sections and to measure percent stenosis. Multiple frame analysis techniques are being investigated that involve on the one hand, averaging stenosis measurements from adjacent frames, and on the other hand, averaging adjacent frame images directly and then measuring stenosis from the averaged image. For the latter case, geometric transformations are used to force registration of vessel images whose spatial orientation changes.

  5. Gas Giant Planet Formation in the Photoevaporating Disk. I. Gap Formation

    NASA Astrophysics Data System (ADS)

    Xiao, Lin; Jin, Liping; Liu, Chengzhi; Fan, Cunbo

    2016-08-01

    Planet formation and photoevaporation have both been considered as gap opening mechanisms in protoplanetary disks. We have studied giant planet formation in a photoevaporating disk with long-term evolution. Our calculations suggest that the core accretion rate of a protoplanet declines and the trigger of the runaway gas accretion for a giant planet is delayed under the action of photoevaporation. We find that the final mass of a giant planet characterized by the “gap-limiting” case is not influenced by photoevaporation but the final mass of a giant planet characterized by the “diffusion-limiting” case is greatly influenced by photoevaporation. Considering the formation process of giant planets, we suggest that the locations of the gaps opened by giant planets are within 30–40 au and the gap width in the “gap-limiting” case is wider than that in the “diffusion-limiting” case. We also find that gaps in photoevaporating disks are wider than those in non-photoevaporating disks. Our calculations suggest that the origins of multiple gaps in a disk can be diverse depending on their formation locations. In the formation region of giant planets, gaps are opened by giant planets. The outer gap beyond the giant planet formation region may be opened under the action of photoevaporation. A gap may also be opened at 1–3 au under the actions of photoevaporating dissipation and gas accretion of the outer giant planets.

  6. Plasmacytic Aortitis with Occlusion of the Right Coronary Artery.

    PubMed

    Zambetti, Benjamin R; Garrett, Edward

    2016-01-01

    BACKGROUND Inflammation of the aortic wall, known as aortitis, is a rare clinical entity which is frequently asymptomatic, or identified when the patient presents with an aortic aneurysm or dissection. It is most often caused by infection or autoimmune vasculitides such as giant cell or Takayasu's arteritis. CASE REPORT The case presented is that of a 55-year-old man with symptomatic occlusion of the right coronary artery caused by a plasmacytic aortitis suggestive of IgG4 disease, which was successfully treated with coronary artery bypass grafting and an ascending aortic graft. CONCLUSIONS A review of the current literature emphasizes how poorly the etiology and natural history of plasmacytic aortitis is understood. PMID:27471062

  7. Plasmacytic Aortitis with Occlusion of the Right Coronary Artery

    PubMed Central

    Zambetti, Benjamin R.; Garrett, Edward

    2016-01-01

    Patient: Male, 55 Final Diagnosis: Plasmacytic aortitis Symptoms: Dizziness • nausea Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Inflammation of the aortic wall, known as aortitis, is a rare clinical entity which is frequently asymptomatic, or identified when the patient presents with an aortic aneurysm or dissection. It is most often caused by infection or autoimmune vasculitides such as giant cell or Takayasu’s arteritis. Case Report: The case presented is that of a 55-year-old man with symptomatic occlusion of the right coronary artery caused by a plasmacytic aortitis suggestive of IgG4 disease, which was successfully treated with coronary artery bypass grafting and an ascending aortic graft. Conclusions: A review of the current literature emphasizes how poorly the etiology and natural history of plasmacytic aortitis is understood. PMID:27471062

  8. Unusual Giant Prostatic Urethral Calculus

    PubMed Central

    Bello, A.; Maitama, H. Y.; Mbibu, N. H.; Kalayi, G. D.; Ahmed, A.

    2010-01-01

    Giant vesico-prostatic urethral calculus is uncommon. Urethral stones rarely form primarily in the urethra, and they are usually associated with urethral strictures, posterior urethral valve or diverticula. We report a case of a 32-year-old man with giant vesico-prostatic (collar-stud) urethral stone presenting with sepsis and bladder outlet obstruction. The clinical presentation, management, and outcome of the giant prostatic urethral calculus are reviewed. PMID:22091328

  9. Recurrent giant chalazia in hyperimmunoglobulin E (Job's) syndrome.

    PubMed

    Patteri, Pierpaolo; Serru, Alain; Chessa, Maria Letizia; Loi, Michele; Pinna, Antonio

    2009-10-01

    Hyperimmunoglobulinemia E (Job's) syndrome is a rare autosomal dominant disorder appearing early in life with recurrent skin and pulmonary infections, characterized by markedly increased serum immunoglobulin E (IgE) levels. We describe a 50-year-old man with a 4-year history of recurrent, multiple giant chalazia in all eyelids. Medications and surgical intervention had produced only transient improvement. The patient had also had pulmonary and scalp infection. Laboratory tests disclosed elevated serum IgE (>1,000 IU/ml) and eosinophilia. As a result, based on the patient's history and clinical and laboratory findings, a diagnosis of Job's syndrome was made. Even though rarely, recurrent multiple giant chalazia may occur as an ophthalmic feature of Job's syndrome. Hyperimmunoglobulinemia E syndrome should be suspected in any case of recurrent giant chalazia, regardless of the patient's age. Measurement of serum IgE and eosinophils, along with internal evaluation, is essential to establish a proper diagnosis. PMID:18528638

  10. Coronary Intramural Hematoma Presenting as Acute Coronary Syndrome.

    PubMed

    Shimada, Takenobu; Kadota, Kazushige; Kubo, Shunsuke; Habara, Seiji; Mitsudo, Kazuaki

    2016-01-01

    We herein report a case of intramural hematoma without ongoing myocardial ischemia that healed spontaneously with conservative treatment. A 37-year-old woman was admitted due to chest pain. Acute coronary syndrome was diagnosed by electrocardiography and echocardiography. Coronary angiography showed 90% stenosis in the distal portion of the left anterior descending coronary artery, where intravascular ultrasound showed a hematoma, but optical coherence tomography could not detect the entry point. Therefore, we identified the intramural hematoma as the etiology. Because the coronary flow was maintained and chest pain disappeared, we chose conservative treatment. Fifteen days after admission, coronary computed tomography showed an improvement in the intramural hematoma. PMID:27477409

  11. [Acute myocardial infarction after blunt polytrauma -- successful coronary intervention].

    PubMed

    Mauser, M; Schwenk, M; Schmelzeisen, H; Fleischmann, D; Fösel, T

    2003-02-01

    Acute myocardial infarction following blunt chest trauma is a well reported but rare finding. Especially in severely injured patients the optimal therapy of the myocardial infarction is not well established, since anticoagulants, platelet aggregation inhibitors or thrombolytics are frequently contraindicated under these conditions. We report a case of a 41-year-old man, who presented with an acute myocardial infarction in combination with a severe polytrauma (multiple rib fractures, hematothorax, pelvic bone fractures, multiple injuries of intestinal organs) after a motorcycle accident with a blunt chest and abdominal trauma. After surgical treatment of the injuries of the bones and the intestinal organs a coronary angiography was immediately performed. The left anterior descending and the circumflex coronary artery were occluded in the mid-portion of the vessels. Coronary recanalization by PTCA and the implantation of coronary stents were successful in both vessels. Despite of a non-optimal blood flow after recanalization and stenting in one vessel (LAD TIMI II flow after recanalization), and a non-optimal accompanying medical therapy, during and after intervention (intravenous heparin starting 8 hours after the coronary intervention and platelet inhibitors starting 4 days after the intervention) the coronary angiogram after 2 months documented both vessels patent without a reocclusion or a restenosis. The case report documents, that in traumatic myocardial infarctions the treating of both, the attending injuries and the myocardial ischemia, is feasible. Early coronary angiography and coronary interventions, with or without stent-implantation, are indicated, even in cases in which an adequate accompanying medical therapy with heparin and platelet inhibitors is contraindicated. PMID:12557122

  12. MRI of the Coronary vasculature: Imaging the Lumen, Wall and Beyond

    PubMed Central

    Lin, Kai; Carr, James C.

    2015-01-01

    The characteristics of coronary artery disease (CAD) are gradual thickening of the coronary walls and narrowing of the vascular lumen due to the built-up of atherosclerosis plaques. Those morphological changes can be noninvasively detected by coronary MRI/MRA. In addition, functional changes, such as coronary wall distensibility and flow changes may also be evaluated with MRI. However, the application of current MRI/MRA techniques is limited in clinical practice due to several adverse technical and physiological factors, such as cardiac motion and respiratory motion. Many technical innovations have been adopted to address those problems from multiple aspects. PMID:25726999

  13. Relationship between Chemerin Levels and Cardiometabolic Parameters and Degree of Coronary Stenosis in Korean Patients with Coronary Artery Disease

    PubMed Central

    Hah, Yu-Jin; Kim, Nam-Keong; Kim, Mi-Kyung; Kim, Hye-Soon; Hur, Seung-Ho; Yoon, Hyuck-Jun; Kim, Yoon-Nyun

    2011-01-01

    Background Chemerin is a novel adipokine that is associated with inflammation and adipogenesis. However, it remains unclear whether chemerin is involved in patients with cardiovascular disease. We investigated whether the serum chemerin levels of Korean patients with coronary artery disease correlated with specific cardiometabolic parameters. Methods In total, 131 patients, all of whom had coronary artery stenosis exceeding 50%, participated in this study. Their serum chemerin levels and cardiometabolic parameters were measured. The serum chemerin levels of two groups of patients were compared; those with one stenotic vessel (n=68) and those with multiple stenotic vessels, including left main coronary artery disease (n=63). Results Serum chemerin levels correlated positively with the degree of coronary artery stenosis and fasting glucose, triglyceride, total cholesterol, low density lipoprotein cholesterol, and high sensitive C-reactive protein levels. The group with multiple stenotic vessels, including left main disease, had higher chemerin levels than the group with one stenotic vessel (t=-2.129, P=0.035). Multiple binary logistic regression showed chemerin was not an independent risk factor of multiple vessel disease (odds ratio, 1.018; confidence interval, 0.997 to 1.040; P=0.091). Conclusion Serum chemerin levels have a significant correlation with several cardiometabolic risk factors and the degree of coronary artery stenosis in Korean patients with coronary artery disease. However, multiple binary logistic regression showed chemerin was not an independent risk factor of multiple vessel disease. Additional investigations are necessary to fully elucidate the role of chemerin in cardiovascular disease. PMID:21785745

  14. Chromospheric Activity in Red Giants of M67

    NASA Astrophysics Data System (ADS)

    Dupree, A. K.; Whitney, B. A.; Pasquini, L.

    1994-12-01

    Red giants in the old open cluster M67 present a well-studied, homogeneous group of 1.27Msun stars with which to determine the evolution of chromospheric activity and mass loss. Echelle spectra of the Ca II H and K line region (lambda 3950) have been obtained with the 4-m telescope at KPNO, the MMT of the F. L. Whipple Observatory (K only), and the 3.6-m ESO telescope at La Silla, Chile. Spectra of 16 red giant stars down to V ~ 11 were obtained; five of the sample are identified as clump giants. The flux of the emission reversal in the Ca II K core has been calibrated using normalization based on the narrow-band absolute spectrophotometry of Gunn &\\ Stryker (1983, ApJS, 52, 121). A new spectral synthesis of the Calcium line region for radiative models of the M67 giants based on Kurucz atmospheres provides the correction necessary to extract the chromospheric component of the flux. The Ca K emission reversals display asymmetries indicative of outward motions for giants more luminous than M_V ~ +0.5. The chromospheric emission flux in Ca II K decreases with increasing stellar luminosity. Clump giants, which are thought to be in a core-helium burning stage, show Ca II emission comparable to the stars on the red giant branch. Evidence for chromospheric variability is found from multiple observations of several objects. Implications of these results upon the evolution of chromospheres and presence of mass loss in giants will be discussed.

  15. Giant Cardiac Cavernous Hemangioma.

    PubMed

    Unger, Eric; Costic, Joseph; Laub, Glenn

    2015-07-01

    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  16. Giant Coulomb blockade magnetoresistance

    SciTech Connect

    Zhang, Xiaoguang; Wen, Z. C.; Wei, H. X.; Han, Prof. X. F.

    2010-01-01

    We show that the Coulomb blockade voltage can be made to depend strongly on the electron spin in a thin magnetic granular layer inserted in the middle of an insulating layer of a tunnel junction. This strong spin dependence is predicted from the spin-dependent inter-granular conductance through any of the following effects within the granular layer, giant magnetoresistance (GMR), tunneling magnetoresistance (TMR), colossal magnetoresistance (CMR), or GMR through a polymer spacer. The resulting Coulomb blockade magnetoresistance (CBMR) ratio can exceed the magnetoresistance ratio of the granular layer itself by orders of magnitude. Unlike other magenetoresistance effects, the CBMR effect does not require magnetic electrodes.

  17. [Hypertrophy and coronary reserve].

    PubMed

    Motz, W; Scheler, S

    2008-12-01

    Left ventricular hypertrophy represents the structural mechanism of adaptation of the left ventricle as the answer of a chronic pressure overload in arterial hypertension. Initially an increment in left ventricular wall thickness occurs. In this stadium of "concentric hypertrophy" LV systolic wall stress, LV ejection fraction and myocardial oxygen consumption per weight unit myocardium remain unchanged. In the further time course of disease LV dilatation will be present. In this phase of "excentric hypertrophy" LV systolic wall stress and myocardial oxygen consumption per weight unit myocardium rise and LV ejection fraction decreases. Patients with arterial hypertension frequently complain of angina pectoris. Angina pectoris and the positive exercise tolerance test or the positive myocardial scintigraphy are the consequence of the impaired coronary flow reserve. The coronary flow reserve is diminished due to structural and functional changes of the coronary circulation. ACE-inhibitors and AT1-receptor blockers cause a significant improvement of coronary flow reserve and regression of both left ventricular hypertrophy and myocardial fibrosis. PMID:19085802

  18. Elective Percutaneous Coronary Intervention

    PubMed Central

    Madani, Mohsen; Alizadeh, Keivan; Ghazaee, Sepideh Parchami; Zavarehee, Abbas; Abdi, Seifollah; Shakerian, Farshad; Salehi, Negar; Firouzi, Ata

    2013-01-01

    Regardless of the diabetic status of patients with coronary artery disease, hyperglycemia and hypoglycemia are adversely associated with cardiovascular events. The relationship between glucose levels and increased mortality risk in acute myocardial infarction has been shown through various glucose metrics; however, there is a dearth of multivariate analysis of the relationship between elective coronary angioplasty and preprocedural blood glucose levels. We evaluated the relationship between preprocedural blood glucose levels and myocardial injury in 1,012 consecutive patients who underwent elective percutaneous coronary angioplasty. The patients were classified into 4 glycemic groups on the basis of blood glucose levels measured immediately before the procedure: hypoglycemic, euglycemic, mildly hyperglycemic, and hyperglycemic. Samples for troponin I and creatine kinase–MB fraction were collected before each procedure and at 8, 16, and 24 hours after each procedure. Bivariate analysis revealed that postprocedural troponin I levels were significantly higher in the hyperglycemic group (P=0.027). Although postprocedural levels of creatine kinase–MB fraction rose insignificantly in the hypoglycemic patients, our results showed that these patients were more likely to have postprocedural levels 2 to 5 times the upper limit of normal (P=0.013). We tentatively conclude that abnormally low preprocedural plasma glucose levels—together with a recent history of smoking—are associated with an increased incidence of periprocedural myocardial injury in patients undergoing elective percutaneous coronary intervention. PMID:24082370

  19. Coronary artery stenosis.

    PubMed

    Weir, Ian

    2006-05-01

    The near exponential rise in percutaneous coronary intervention(PCI) in the treatment of patients with coronary artery disease and the consequent decline in referral of patients for coronary artery bypass grafting (CABG) has lead to a crisis in cardiac surgery. Is CABG, one of the most successful and widely applied surgical procedures, about to follow surgery for peptic ulcer disease into obsolescence? The question has serious implications for service provision and training as well as for informed patient consent. Keith Dawkins puts the case for PCI and gives a very clear and concise account of its inexorable rise to pre-eminence. David Taggart has taken on the Goliath of interventional cardiology and its associated industry by persuasively marshalling the data from the evidence base which strongly favours surgery in triple vessel and left main coronary disease. He points to the lack of long-term results and also to the weaknesses of many of the comparative studies so far published. His arguments have been positively received on both sides of the Atlantic but it is by no means certain that they will bring about the multidisciplinary approach to providing patients with treatment options which he and others advocate. It also remains to be seen whether the evidence base when it is eventually acquired will vindicate the present increasing dominance of PCI over CABG. PMID:16719994

  20. Coronary Heart Disease

    MedlinePlus

    ... by Mail Close www.diabetes.org > Living With Diabetes > Treatment and Care > Women Share: Print Page Text Size: A A ... heart-and-circulation, In this section Living With Diabetes Treatment and Care Women Coronary Heart Disease Sexual Health Women and ...

  1. An update on coronary bypass graft intervention

    PubMed Central

    Dash, Debabrata

    2014-01-01

    Coronary artery bypass grafting (CABG) remains one of the most common surgical procedures. In spite of great advancements like arterial grafts and off-pump bypass procedure, recurrent ischaemia may ensue with the lesions of the graft. Early postoperative ischaemia (<30 days) is due to graft occlusion or stenosis, and percutaneous coronary intervention (PCI) is frequently feasible. Late postoperative ischaemia (>3 years) is most often due to a saphenous vein graft (SVG) lesion. Multiple diseased grafts, reduced left ventricular function, and available arterial conduits favour repeat CABG, whereas, a patent left internal mammary artery to left anterior descending favours PCI. Embolic protection reduces atheroembolic myocardial infarction during PCI of SVG and should be routinely used in treatment of SVG lesions. A variety of vasodilators may reduce the risk of or mitigate the consequences of no-reflow. Drug-eluting stents reduce restenosis in SVG grafts, and have become the default strategy for many interventionalists. PMID:27326165

  2. Coronary Artery Imaging with Transthoracic Doppler Echocardiography.

    PubMed

    Takeuchi, Masaaki; Nakazono, Akemi

    2016-07-01

    Coronary artery imaging with transthoracic Doppler echocardiography is a simple and useful technique to diagnose significant coronary artery stenosis. The visualization of mosaic flow in the proximal left coronary artery provides a direct indication of the presence of significant stenosis at the corresponding site during routine echocardiography. Coronary flow velocity reserve (CFVR) has a high diagnostic accuracy and feasibility in detecting the presence of functionally significant coronary stenosis in the left anterior descending coronary artery (LAD) and in the right coronary artery. The measurement of CFVR in the LAD also provides prognostic information in patients with intermediate coronary stenosis. This review summarizes the utility of transthoracic coronary artery imaging. PMID:27216843

  3. Magma Reservoirs Feeding Giant Radiating Dike Swarms: Insights from Venus

    NASA Technical Reports Server (NTRS)

    Grosfils, E. B.; Ernst, R. E.

    2003-01-01

    Evidence of lateral dike propagation from shallow magma reservoirs is quite common on the terrestrial planets, and examination of the giant radiating dike swarm population on Venus continues to provide new insight into the way these complex magmatic systems form and evolve. For example, it is becoming clear that many swarms are an amalgamation of multiple discrete phases of dike intrusion. This is not surprising in and of itself, as on Earth there is clear evidence that formation of both magma reservoirs and individual giant radiating dikes often involves periodic magma injection. Similarly, giant radiating swarms on Earth can contain temporally discrete subswarms defined on the basis of geometry, crosscutting relationships, and geochemical or paleomagnetic signatures. The Venus data are important, however, because erosion, sedimentation, plate tectonic disruption, etc. on Earth have destroyed most giant radiating dike swarm's source regions, and thus we remain uncertain about the geometry and temporal evolution of the magma sources from which the dikes are fed. Are the reservoirs which feed the dikes large or small, and what are the implications for how the dikes themselves form? Does each subswarm originate from a single, periodically reactivated reservoir, or do subswarms emerge from multiple discrete geographic foci? If the latter, are these discrete foci located at the margins of a single large magma body, or do multiple smaller reservoirs define the character of the magmatic center as a whole? Similarly, does the locus of magmatic activity change with time, or are all the foci active simultaneously? Careful study of giant radiating dike swarms on Venus is yielding the data necessary to address these questions and constrain future modeling efforts. Here, using giant radiating dike swarms from the Nemesis Tessera (V14) and Carson (V43) quadrangles as examples, we illustrate some of the dike swarm focal region diversity observed on Venus and briefly explore some

  4. Giant solitary trichoepithelioma.

    PubMed

    Teli, Bhavuray; Thrishuli, P B; Santhosh, R; Amar, D N; Rajpurohit, Shravan

    2015-01-01

    Adnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals. PMID:25839021

  5. Giant solitary trichoepithelioma

    PubMed Central

    Teli, Bhavuray; Thrishuli, P. B.; Santhosh, R.; Amar, D. N.; Rajpurohit, Shravan

    2015-01-01

    Adnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals. PMID:25839021

  6. Rheology of giant micelles

    NASA Astrophysics Data System (ADS)

    Cates, M. E.; Fielding, S. M.

    2006-12-01

    Giant micelles are elongated, polymer-like objects created by the self-assembly of amphiphilic molecules (such as detergents) in solution. Giant micelles are typically flexible, and can become highly entangled even at modest concentrations. The resulting viscoelastic solutions show fascinating flow behaviour (rheology) which we address theoretically in this article at two levels. First, we summarize advances in understanding linear viscoelastic spectra and steady-state nonlinear flows, based on microscopic constitutive models that combine the physics of polymer entanglement with the reversible kinetics of self-assembly. Such models were first introduced two decades ago, and since then have been shown to explain robustly several distinctive features of the rheology in the strongly entangled regime, including extreme shear thinning. We then turn to more complex rheological phenomena, particularly involving spatial heterogeneity, spontaneous oscillation, instability and chaos. Recent understanding of these complex flows is based largely on grossly simplified models which capture in outline just a few pertinent microscopic features, such as coupling between stresses and other order parameters such as concentration. The role of ‘structural memory’ (the dependence of structural parameters such as the micellar length distribution on the flow history) in explaining these highly nonlinear phenomena is addressed. Structural memory also plays an intriguing role in the little-understood shear thickening regime, which occurs in a concentration regime close to but below the onset of strong entanglement, and which is marked by a shear-induced transformation from an inviscid to a gelatinous state.

  7. Syncope caused by coronary artery spasm without chest pain leading to ventricular fibrillation

    PubMed Central

    Kawasaki, Yusuke; Kato, Takao; Minamino, Eri; Inoko, Moriaki

    2013-01-01

    We present a case of syncope caused by coronary artery spasm without chest pain leading to ventricular fibrillation despite of vasodilator therapy with a calcium channel blocker (CCB). A 68-year-old man presented with two episodes of syncope without chest pain. Ergonovine provocation test induced a diffuse spasm in the right coronary artery (RCA) and subsequently, ventricular fibrillation. Under the therapy with multiple vasodilators including two CCBs, a second ergonovine provocation induced a spasm of the proximal RCA resulting in complete obstruction. Owing to drug-resistant coronary spasm complicated by ventricular fibrillation, an implantable cardioverter defibrillator (ICD) was implanted. This case report highlights the occurrence of syncope caused by coronary artery spasm without chest pain that was refractory to single CCB therapy and needed ICD implantation. Therapy with multiple vasodilators, including two or more CCBs, along with ICD implantation may be required to treat such refractory coronary artery spasms leading to lethal arrhythmia. PMID:23749837

  8. Results of coronary surgery after failed elective coronary angioplasty in patients with prior coronary surgery.

    PubMed

    Weintraub, W S; Cohen, C L; Curling, P E; Jones, E L; Craver, J M; Guyton, R; King, S B; Douglas, J S

    1990-11-01

    The results of coronary artery bypass surgery after failed elective coronary angioplasty in patients who have undergone prior coronary surgery are unknown. Coronary angioplasty may be performed to relieve angina after surgery either to the native coronary vessels or to grafts. Failure of attempted coronary angioplasty may mandate repeat coronary surgery, often in the setting of acute ischemia. From 1980 to 1989, 1,263 patients with prior coronary bypass surgery underwent angioplasty; of these patients, 46 (3.6%) underwent reoperation for failed angioplasty during the same hospital stay. Of the 46 patients who underwent reoperation, 33 had and 13 did not have acute ischemia. In the group with ischemia, 3 patients (9.1%) died and 14 (42.4%) died or had a Q wave myocardial infarction in the hospital compared with no deaths (p = NS) and no deaths or Q wave myocardial infarction (p = 0.005) in the group without ischemia. At 3 years, the actuarial survival rate was 88 +/- 6% in the group with ischemia, whereas there were no deaths in the group without ischemia (p = NS), and freedom from death or myocardial infarction was 51 +/- 10% in the group with ischemia, versus no events in the group without ischemia (p = 0.006). In most patients with prior coronary bypass surgery, coronary angioplasty was performed without the need for repeat coronary bypass surgery. Should coronary angioplasty fail, reoperation in patients without acute ischemia can be performed with overall patient survival comparable to that of elective reoperative coronary bypass without coronary angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2229784

  9. Allometry indicates giant eyes of giant squid are not exceptional

    PubMed Central

    2013-01-01

    Background The eyes of giant and colossal squid are among the largest eyes in the history of life. It was recently proposed that sperm whale predation is the main driver of eye size evolution in giant squid, on the basis of an optical model that suggested optimal performance in detecting large luminous visual targets such as whales in the deep sea. However, it is poorly understood how the eye size of giant and colossal squid compares to that of other aquatic organisms when scaling effects are considered. Results We performed a large-scale comparative study that included 87 squid species and 237 species of acanthomorph fish. While squid have larger eyes than most acanthomorphs, a comparison of relative eye size among squid suggests that giant and colossal squid do not have unusually large eyes. After revising constants used in a previous model we found that large eyes perform equally well in detecting point targets and large luminous targets in the deep sea. Conclusions The eyes of giant and colossal squid do not appear exceptionally large when allometric effects are considered. It is probable that the giant eyes of giant squid result from a phylogenetically conserved developmental pattern manifested in very large animals. Whatever the cause of large eyes, they appear to have several advantages for vision in the reduced light of the deep mesopelagic zone. PMID:23418818

  10. Giant magnetostrictive composites

    NASA Astrophysics Data System (ADS)

    Duenas, Terrisa Ann

    The limitation of magnetostrictive composites has been in their low magnetostrictive response when compared to their monolithic counterparts. In this dissertation research is presented describing the methods and analysis used to create a giant magnetostrictive composite (GMC) producing giant strains at low fields, exhibiting magnetization ``jumping'' and the ΔE effect. This composite combines the giant magnetostrictive material, Terfenol-D (Tb0.3Dy0.7Fe2) in particle form, with a nonmetallic binder and is capable of producing strains (at room temperature) exceeding 1000 ppm at a nominal field of 1.5 kOe mechanically unloaded and 1200 ppm at 8 MPa preload (2.5 kOe). Several studies leading to the high response of this composite are presented. A connectivity study shows that a [1-3] connected composite produces 50% more strain than a [0-3] composite. A resin study indicates that the lower the viscosity of the resin, the greater the magnetostrictive response; this is attributed to the removal of voids during degassing. A void study correlates the increase in voids to the decrease in strain response. A model is used to correlate analysis with experimental results within 10% accuracy and shows that an optimal volume fraction exists based on the properties of the binder. Using a Polyscience Spurr low- viscosity (60 cps) binder this volume fraction is nominally 20%; this optimum is attributed to the balance of epoxy contracting on the particle (built-in preload) and the actuation delivered by the magnetostrictive material. In addition to the connectivity, resin, void, and volume-fraction study, particle size and gradation studies are presented. Widely dispersed (<106, <212, <300 μm), narrowly dispersed (<45, (90-106), (275-300) μm), and an optimized bimodal (18.7% of (45-90) μm with 81.3% of (250-300) μm) particle distributions are studied. Results show that the larger the particle size, the higher the magnetostrictive response; this is attributed to the reduction of

  11. Outcomes of patients with spontaneous coronary artery dissection

    PubMed Central

    McGrath-Cadell, Lucy; McKenzie, Pamela; Emmanuel, Sam; Muller, David W M; Graham, Robert M; Holloway, Cameron J

    2016-01-01

    Background Spontaneous coronary artery dissection (SCAD) is an uncommon but serious condition presenting as an acute coronary syndrome (ACS) or cardiac arrest. The pathophysiology and outcomes are poorly understood. We investigated the characteristics and outcomes of patients presenting with SCAD. Methods In a retrospective study of a large cohort of patients with SCAD, data were collected regarding clinical presentation, patient characteristics, vascular screening, coronary artery involvement and clinical outcomes. Results 40 patients with SCAD (95% women, mean age 45±10 years) were included. At least 1 traditional cardiovascular risk factor was present in 40% of patients. Migraine was reported in 43% of patients. Events preceding SCAD included parturition (8%), physical stress (13%), emotional stress (10%) and vasoconstrictor substance-use (8%). 65% of patients had a non-ST elevation ACS (NSTEACS) at presentation, 30% had an ST elevation myocardial infarction (STEMI) and 13% had a cardiac arrest. The left anterior descending artery was most frequently involved (68% of patients), and 13% had involvement of multiple coronary territories. Fibromuscular dysplasia (FMD) was identified in 7 (37%) of 19 patients screened. 68% of patients were managed medically, 30% had percutaneous coronary intervention and 5% had coronary artery bypass grafting. Over a median 16-month follow-up period, 8% of patients had at least 1 recurrent SCAD event. There were no deaths. Conclusions Patients with SCAD in this study often had multiple coronary territories involved (13%) and extracardiac vascular abnormalities, suggesting a systemic vascular process, which may explain the high incidence of migraine. All patients with SCAD should be screened for FMD and followed closely due to the possibility of recurrence. PMID:27621835

  12. MedlinePlus: Coronary Artery Bypass Surgery

    MedlinePlus

    ... and Blood Institute Start Here Coronary Artery Bypass (Texas Heart Institute) Also in Spanish Coronary Artery Bypass ... and Blood Institute) Specifics Limited-Access Heart Surgery (Texas Heart Institute) Also in Spanish Types of Coronary ...

  13. Giant magnetofossils and hyperthermal events

    NASA Astrophysics Data System (ADS)

    Chang, Liao; Roberts, Andrew P.; Williams, Wyn; Fitz Gerald, John D.; Larrasoaña, Juan C.; Jovane, Luigi; Muxworthy, Adrian R.

    2012-10-01

    Magnetotactic bacteria biomineralize magnetic minerals with precisely controlled size, morphology, and stoichiometry. These cosmopolitan bacteria are widely observed in aquatic environments. If preserved after burial, the inorganic remains of magnetotactic bacteria act as magnetofossils that record ancient geomagnetic field variations. They also have potential to provide paleoenvironmental information. In contrast to conventional magnetofossils, giant magnetofossils (most likely produced by eukaryotic organisms) have only been reported once before from Paleocene-Eocene Thermal Maximum (PETM; 55.8 Ma) sediments on the New Jersey coastal plain. Here, using transmission electron microscopic observations, we present evidence for abundant giant magnetofossils, including previously reported elongated prisms and spindles, and new giant bullet-shaped magnetite crystals, in the Southern Ocean near Antarctica, not only during the PETM, but also shortly before and after the PETM. Moreover, we have discovered giant bullet-shaped magnetite crystals from the equatorial Indian Ocean during the Mid-Eocene Climatic Optimum (˜40 Ma). Our results indicate a more widespread geographic, environmental, and temporal distribution of giant magnetofossils in the geological record with a link to "hyperthermal" events. Enhanced global weathering during hyperthermals, and expanded suboxic diagenetic environments, probably provided more bioavailable iron that enabled biomineralization of giant magnetofossils. Our micromagnetic modelling indicates the presence of magnetic multi-domain (i.e., not ideal for navigation) and single domain (i.e., ideal for navigation) structures in the giant magnetite particles depending on their size, morphology and spatial arrangement. Different giant magnetite crystal morphologies appear to have had different biological functions, including magnetotaxis and other non-navigational purposes. Our observations suggest that hyperthermals provided ideal conditions for

  14. Two giant stellar complexes

    NASA Astrophysics Data System (ADS)

    Efremov, Yu. N.; Efremov, E. Yu.

    Common star complexes are huge (0.3-1 kpc in diameter) groups of relatively young stars, associations and clusters. The complexes usually form regular chains along spiral arms of grand design galaxies, being evidently formed and supported by magneto- gravitational instability developing along an arm. Special attention is given to a few large complexes which have signatures of gravitational boundness, such as round shape and high central density. Concentrations of stars and clusters in such a complex in M51 galaxy were found in this paper; we concluded it is possible to suggest that the complex is gravitationally bound. It is also stressed that some properties of the giant complex in NGC 6946 (such as its semicircular and sharp Western edge) are still enigmatic.

  15. [Giant adrenal myelolipoma].

    PubMed

    El Mejjad, Amine; Fekak, Hamid; Dakir, Mohamed; Sarf, Ismail; Manni, Ahmed; Meziane, Fethi

    2004-02-01

    Adrenal myelolipoma is a rare, benign, non-secreting tumour composed of adipose and haematopoietic tissue. The authors report a rare case of giant adrenal myelolipoma in a 53-year-old patient presenting with low back pain and a palpable flank mass on examination. CT scan suggested the diagnosis and surgical resection was indicated in view of the size and symptomatic nature of this mass. Histological examination confirmed the diagnosis. The outcome was favourable without recurrence after a follow-up of one year. The diagnosis of adrenal myelolipoma is based on radiology. Conservative management is generally sufficient for small asymptomatic tumours, but resection is required for large (> 5 cm) and/or symptomatic tumours. PMID:15098761

  16. Giant facial lymphangioma.

    PubMed

    Sanger, Claire; Wong, Lindsey; Wood, Jeyhan; David, Lisa R; Argenta, Louis C

    2011-07-01

    Lymphatic malformation (LM) is a benign cystic entity resulting from aberrant lymphatic drainage. Often evident at birth, most LMs have declared themselves by 2 years of age. They can be concerning when they occur near vital structures such as the airway or orbit. The natural history varies considerable from spontaneous gradual regression to long-term growth and debilitation. Depending on the location, structures involved, and clinical course of the LM, therapeutic options include observation, intralesional sclerosis, laser therapy, and surgical excision. The literature provides guidelines for treatment options that must be carefully applied to the facial region. We present a newborn infant who presented to our institution with giant facial lymphangioma who underwent a combination of sclerosis, laser ablation, and surgery with reconstruction. PMID:21772195

  17. Balloon catheter coronary angioplasty

    SciTech Connect

    Angelini, P.

    1987-01-01

    The author has produced a reference and teaching book on balloon angioplasty. Because it borders in surgery and is performed on an awake patient without circulatory assistance, it is a complex and demanding procedure that requires thorough knowledge before it is attempted. The text is divided into seven sections. The first section describes coronary anatomy and pathophysiology, defines the objectives and mechanisms of the procedure and lists four possible physiologic results. The next section describes equipment in the catheterization laboratory, catheters, guidewires and required personnel. The following section is on the procedure itself and includes a discussion of examination, testing, technique and follow-up. The fourth section details possible complications that can occur during the procedure, such as coronary spasms, occlusion, thrombosis, perforations and ruptures, and also discusses cardiac surgery after failed angioplasty. The fifth section details complex or unusual cases that can occur. The sixth and seventh sections discuss radiation, alternative procedures and the future of angioplasty.

  18. Spontaneous Coronary Artery Dissection.

    PubMed

    Tweet, Marysia S; Gulati, Rajiv; Hayes, Sharonne N

    2016-07-01

    Spontaneous coronary artery dissection is an important etiology of nonatherosclerotic acute coronary syndrome, myocardial infarction, and sudden death. Innovations in the catheterization laboratory including optical coherence tomography and intravascular ultrasound have enhanced the ability to visualize intimal disruption and intramural hematoma associated with SCAD. Formerly considered "rare," these technological advances and heightened awareness suggest that SCAD is more prevalent than prior estimates. SCAD is associated with female sex, young age, extreme emotional stress, or extreme exertion, pregnancy, and fibromuscular dysplasia. The clinical characteristics and management strategies of SCAD patients are different than for atherosclerotic heart disease and deserve specific consideration. This review will highlight recent discoveries about SCAD as well as describe current efforts to elucidate remaining gaps in knowledge. PMID:27216840

  19. Left Main Coronary Artery Aneurysm

    PubMed Central

    Doustkami, Hossein; Maleki, Nasrollah; Tavosi, Zahra

    2016-01-01

    Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic. PMID:27403190

  20. Coronary microcirculation: Physiology and mechanics

    NASA Astrophysics Data System (ADS)

    Matsumoto, Takeshi; Kajiya, Fumihiko

    2005-07-01

    The heart is unique among other organs in that coronary arterial flow is exclusively diastolic and venous outflow is systolic. That is, arterial blood flows into intramyocardial coronary vessels during diastole and the stored blood is squeezed out mostly to epicardial veins and partly to the proximal arteries during the subsequent systole. Furthermore, coronary vessels function as highly organized flow regulators to match local blood flows with myocardial energy demands to support the viability of the heart. In this review, we first summarize the intramyocardial microvascular dynamics along with the description of a hierarchical system of coronary microvessels. Then, the spatial heterogeneity of blood supply to myocardium is demonstrated.

  1. TBS Predict Coronary Artery Calcification in Adults

    PubMed Central

    Chuang, Tzyy-Ling; Hsiao, Fu-Tsung; Li, Yi-Da

    2016-01-01

    Purpose. This study analyzes the association between the bony microarchitecture score (trabecular bone score, TBS) and coronary artery calcification (CAC) in adults undergoing health exams. Materials and Methods. We retrospectively collected subjects (N = 81) who underwent coronary computed tomography and bone mineral density studies simultaneously. CAC was categorized to three levels (Group 0, G0, no CAC, score = 0, N = 45; Group 1, G1, moderate CAC, score = 1–100, N = 17; Group 2, G2, high CAC, score ≧ 101, N = 19). Multinomial logistic regression was used to study the association between TBS and CAC levels. Results. CAC is present in 44.4% of the population. Mean TBS ± SD was 1.399 ± 0.090. Per 1 SD increase in TBS, the unadjusted odds ratio (2.393) of moderate CAC compared with no CAC was significantly increased (95% CI, 1.219–4.696, p = 0.011). However, there has been no association of TBS with high CAC (OR: 1.026, 95% CI: 0.586–1.797, p = 0.928). These relationships also existed when individually adjusted for age, sex, and multiple other covariates. Conclusions. Higher TBS was related to moderate CAC, but not high CAC; a possible explanation may be that bone microarchitecture remodeling becomes more active when early coronary artery calcification occurs. However, further researches are needed to clarify this pathophysiology. PMID:27042671

  2. Pharma giants swap research programs.

    PubMed

    2014-07-01

    Pharmaceutical giants Novartis and GlaxoSmithKline (GSK) agreed in late April to swap some assets, with Novartis handing off its vaccine business to GSK and getting most of the British company's cancer portfolio in return. PMID:25002632

  3. Atmospheres of Extrasolar Giant Planets

    NASA Technical Reports Server (NTRS)

    Marley, Mark

    2006-01-01

    The next decade will almost certainly see the direct imaging of extrasolar giant planets around nearby stars. Unlike purely radial velocity detections, direct imaging will open the door to characterizing the atmosphere and interiors of extrasola planets and ultimately provide clues on their formation and evolution through time. This process has already begun for the transiting planets, placing new constraints on their atmospheric structure, composition, and evolution. Indeed the key to understanding giant planet detectability, interpreting spectra, and constraining effective temperature and hence evolution-is the atmosphere. I will review the universe of extrasolar giant planet models, focusing on what we have already learned from modeling and what we will likely be able to learn from the first generation of direct detection data. In addition to these theoretical considerations, I will review the observations and interpretation of the - transiting hot Jupiters. These objects provide a test of our ability to model exotic atmospheres and challenge our current understanding of giant planet evolution.

  4. Landscape of the lost giants

    NASA Astrophysics Data System (ADS)

    2013-09-01

    The Pleistocene megafauna extinction erased a group of remarkable animals. Whether humans had a prominent role in the extinction remains controversial, but it is emerging that the disappearance of the giants has markedly affected the environment.

  5. Digital coronary roadmapping as an aid for performing coronary angioplasty.

    PubMed

    Tobis, J; Johnston, W D; Montelli, S; Henderson, E; Roeck, W; Bauer, B; Nalcioglu, O; Henry, W

    1985-08-01

    In an attempt to improve visualization of the position of the guidewire and dilatation balloon during coronary angioplasty, a method was developed called digital coronary roadmapping. With this method a digitally acquired coronary angiogram is interlaced with the live fluoroscopic image of the guidewire and balloon catheter. The digital coronary angiogram is superimposed at the same magnification and radiologic projection as the live fluoroscopic image onto the video monitor above the catheterization table. The digital roadmap image thus provides immediate feedback to the angiographer to assist in directing the guidewire into the appropriate coronary artery branch and to help in placement of the balloon so that it straddles the site of stenosis. PMID:3161319

  6. Anaplastic giant cell thyroid carcinoma.

    PubMed

    Wallin, G; Lundell, G; Tennvall, J

    2004-01-01

    Anaplastic (giant cell) thyroid carcinoma (ATC), is one of the most aggressive malignancies in humans with a median survival time after diagnosis of 3-6 months. Death from ATC was earlier seen because of local growth and suffocation. ATC is uncommon, accounting for less than 5 % of all thyroid carcinomas. The diagnosis can be established by means of multiple fine needle aspiration biopsies, which are neither harmful nor troublesome for the patient. The cytological diagnosis of this high-grade malignant tumour is usually not difficult for a well trained cytologist. The intention to treat patients with ATC is cure, although only few of them survive. The majority of the patients are older than 60 years and treatment must be influenced by their high age. We have by using a combined modality regimen succeeded in achieving local control in most patients. Every effort should be made to control the primary tumour and thereby improve the quality of remaining life and it is important for patients, relatives and the personnel to know that cure is not impossible. Different treatment combinations have been used since 30 years including radiotherapy, cytostatic drugs and surgery, when feasible. In our latest combined regimen, 22 patients were treated with hyper fractionated radiotherapy 1.6Gy x 2 to a total target dose of 46 Gy given preoperatively, 20 mg doxorubicin was administered intravenously once weekly and surgery was carried out 2-3 weeks after the radiotherapy. 17 of these 22 patients were operated upon and none of these 17 patients got a local recurrence. In the future we are awaiting the development of new therapeutic approaches to this aggressive type of carcinoma. Inhibitors of angiogenesis might be useful. Combretastatin has displayed cytotoxicity against ATC cell lines and has had a positive effect on ATC in a patient. Sodium iodide symporter (NIS) genetherapy is also being currently considered for dedifferentiated thyroid carcinomas with the ultimate aim of

  7. Kuiper Prize: Giant Planet Atmospheres

    NASA Astrophysics Data System (ADS)

    Ingersoll, Andrew P.

    2007-10-01

    The study of giant planet atmospheres is near and dear to me, for several reasons. First, the giant planets are photogenic; the colored clouds are great tracers, and one can make fantastic movies of the atmosphere in motion. Second, the giant planets challenge us with storms that last for hundreds of years and winds that blow faster the farther you go from the sun. Third, they remind us of Earth with their hurricanes, auroras, and lightning, but they also are the link to the 200 giant planets that have been discovered around other stars. This talk will cover the past, present, and future (one hopes) of giant planet research. I will review the surprises of the Voyager and Galileo eras, and will discuss what we are learning now from the Cassini orbiter. I will review the prospects for answering the outstanding questions like: Where's the water? What is providing the colors of the clouds? How deep do the features extend? Where do the winds get their energy? What is the role of the magnetic field? Finally, I will briefly discuss how extrasolar giant planets compare with objects in our own solar system.

  8. [Uncommon indications for coronary angioplasty].

    PubMed

    Vojácek, J; Krupicka, P; Aschermann, M; Holm, F; Humhal, J

    1993-07-01

    During the period between March 16, 1989 and October 7, 1992 at the Second Medical Clinic of the First Medical Faculty, Charles University Prague a total of 173 coronary angioplasties were performed. With expanding experience and greater availability of controllable super thin conductors and balloon catheters with a small profile, gradually the indication criteria of coronary angioplasty were extended. In 93.1% of patients simple balloon dilatation of a significant stenosis of the coronary arteries was performed and in 6.9% before dilatation in addition an attempt of recanalization of a chronic occlusion of the coronary artery was made. In 74% of the patients one coronary stenosis was dilated, in 16.7% several stenoses, in 1.2% of the patients a covered stenosis of the trunk of the left coronary was dilated and in the same number an aortocoronary bypass was performed. Even in the group of patients where only one coronary stenosis was dilated the type B coronary affection according to the classification ACC/AHA predominated and the same applied to the entire group of patients. PMID:8372458

  9. The Coronary Patient in Industry

    NASA Technical Reports Server (NTRS)

    Schuster, B.

    1971-01-01

    The coronary patient, as he pertains to industry particularly NASA, is discussed. Concepts of precoronary care, acute attacks which may develop while on the job, and the return of the cardiac patient to work are covered. Major emphasis was on the prevention of sudden death due to coronary disease.

  10. Myocardial Revascularization for Patients With Diabetes: Coronary Artery Bypass Grafting or Percutaneous Coronary Intervention?

    PubMed

    Castelvecchio, Serenella; Menicanti, Lorenzo; Garatti, Andrea; Tramarin, Roberto; Volpe, Marianna; Parolari, Alessandro

    2016-09-01

    Patients affected by diabetes usually have extensive coronary artery disease. Coronary revascularization has a prominent role in the treatment of coronary artery disease in the expanding diabetic population. However, diabetic patients undergoing coronary artery bypass grafting or percutaneous coronary intervention experience worse outcomes than nondiabetic patients. Several studies comparing coronary artery bypass grafting vs percutaneous coronary intervention in subgroups of diabetic patients demonstrated a survival advantage and fewer repeat revascularization procedures with an initial surgical strategy. This review summarizes the current state of evidence comparing the effectiveness and safety of coronary artery bypass grafting and percutaneous coronary intervention in diabetic patients. PMID:27217297

  11. Giant retinal tears.

    PubMed

    Shunmugam, Manoharan; Ang, Ghee Soon; Lois, Noemi

    2014-01-01

    A giant retinal tear (GRT) is a full-thickness neurosensory retinal break that extends circumferentially around the retina for three or more clock hours in the presence of a posteriorly detached vitreous. Its incidence in large population-based studies has been estimated as 1.5% of rhegmatogenous retinal detachments, with a significant male preponderance, and bilaterality in 12.8%. Most GRTs are idiopathic, with trauma, hereditary vitreoretinopathies and high myopia each being causative in decreasing frequency. The vast majority of GRTs are currently managed with a pars plana vitrectomy; the use of adjunctive circumferential scleral buckling is debated, but no studies have shown a clear anatomical or visual advantage with its use. Similarly, silicone oil tamponade does not influence long-term outcomes when compared with gas. Primary and final retinal reattachment rates are achieved in 88% and 95% of patients, respectively. Even when the retina remains attached, however, visual recovery may be limited. Furthermore, fellow eyes of patients with a GRT are at higher risk of developing retinal tears and retinal detachment. Prophylactic treatment under these circumstances may be considered but there is no firm evidence of its efficacy at the present time. PMID:24138895

  12. Recurrent renal giant leiomyosarcoma

    PubMed Central

    Öziş, Salih Erpulat; Gülpınar, Kamil; Şahlı, Zafer; Konak, Baha Burak; Keskin, Mete; Özdemir, Süleyman; Ataoğlu, Ömür

    2016-01-01

    Primary renal leiomyosarcomas are rare, aggressive tumors. They constitute 1–2% of adult malignant renal tumors. Although leiomyosarcomas are the most common histological type (50–60%) of renal sarcomas, information on renal leiomyosarcoma is limited. Local or systemic recurrences are common. The radiological appearance of renal leiomyosarcomas is not specific, therefore renal leiomyosarcoma cannot be distinguished from renal cell carcinoma by imaging methods in all patients. A 74-year-old female patient presented to our clinic complaining of a palpable mass on the right side of her abdomen in November 2012. The abdominal magnetic resonance imaging revealed a mass, 25 × 24 × 23 cm in size. Her past medical history revealed that she has undergone right radical nephrectomy in 2007, due to a 11 × 12 × 13 cm renal mass that was then reported as renal cell carcinoma on abdominal magnetic resonance imaging, but the pathological diagnosis was low-grade renal leiomyosarcoma. The most recent follow-up of the patient was in 2011, with no signs of local recurrence or distant metastases within this four-year period. The patient underwent laparotomy on November 2012, and a 35 cm retroperitoneal mass was excised. The pathological examination of the mass was reported as high-grade leiomyosarcoma. The formation of this giant retroperitoneal mass in 1 year can be explained by the transformation of the lesion’s pathology from low-grade to a high-grade tumor.

  13. A unique advantage for giant eyes in giant squid.

    PubMed

    Nilsson, Dan-Eric; Warrant, Eric J; Johnsen, Sönke; Hanlon, Roger; Shashar, Nadav

    2012-04-24

    Giant and colossal deep-sea squid (Architeuthis and Mesonychoteuthis) have the largest eyes in the animal kingdom [1, 2], but there is no explanation for why they would need eyes that are nearly three times the diameter of those of any other extant animal. Here we develop a theory for visual detection in pelagic habitats, which predicts that such giant eyes are unlikely to evolve for detecting mates or prey at long distance but are instead uniquely suited for detecting very large predators, such as sperm whales. We also provide photographic documentation of an eyeball of about 27 cm with a 9 cm pupil in a giant squid, and we predict that, below 600 m depth, it would allow detection of sperm whales at distances exceeding 120 m. With this long range of vision, giant squid get an early warning of approaching sperm whales. Because the sonar range of sperm whales exceeds 120 m [3-5], we hypothesize that a well-prepared and powerful evasive response to hunting sperm whales may have driven the evolution of huge dimensions in both eyes and bodies of giant and colossal squid. Our theory also provides insights into the vision of Mesozoic ichthyosaurs with unusually large eyes. PMID:22425154

  14. Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases

    PubMed Central

    Pujades-Rodriguez, Mar; Duyx, Bram; Thomas, Sara L; Stogiannis, Dimitris; Smeeth, Liam; Hemingway, Harry

    2016-01-01

    Objectives Evidence of the association of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) with the full range of cardiovascular diseases (CVDs) is limited. We examined their relationship with the first clinical presentation of the 12 most common CVDs in an unselected population-based cohort of men and women. Methods We analysed CArdiovascular disease research using LInked Bespoke studies and Electronic health Records (CALIBER) data, which links primary care and hospital and mortality data in England, from 1997 to 2010. We assembled a cohort of men and women initially free from CVD at baseline and included all patients with PMR and/or GCA (PMR/GCA) diagnosis, matched by age, sex and general practice with up to 10 individuals without PMR/GCA. Random effects Poisson regression analysis was used to study the association between PMR/GCA and the initial presentation of 12 types of CVDs. Results The analysis included 9776 patients with PMR only, 1164 with GCA only, 627 with PMR and GCA and 105 504 without either condition. During a median of 3.14 years of follow-up 2787 (24.1%) individuals with PMR/GCA and 21 559 (20.4%) without PMR/GCA developed CVDs. Patients with PMR/GCA had lower rates of unheralded coronary death (3.18 vs 3.61/1000 person-years; adjusted incidence ratio 0.79, 95% CI 0.66 to 0.95), transient ischaemic attack (5.11 vs 5.61/1000 person-years; 0.67, 95% CI 0.54 to 0.84) and coronary and death composite (24.17 vs 25.80/1000 person-years; 0.90, 95% CI 0.82 to 0.98). No associations were observed for other CVDs or cerebrovascular diseases, and in patients with only PMR or GCA. No evidence of interaction by age or sex was found. Estimates decreased with longer PMR/GCA duration and findings were robust to multiple sensitivity analyses. Conclusions In this large contemporary population-based cohort the presence of PMR and/or GCA was not associated with an increased risk of CVDs or cerebrovascular diseases regardless of PMR/GCA duration. PMID

  15. Cardiovascular syphilis with coronary stenosis and aneurysm.

    PubMed

    Tewari, Satyendra; Moorthy, Nagaraja

    2014-01-01

    Cardiovascular manifestations of tertiary syphilis include aortitis, aortic root dilation, aneurysm formation, aortic regurgitation, and coronary ostial stenosis. Coronary ostial lesions have been detected in as many as 26% of patients with syphilitic aortitis. However nonostial coronary stenosis and coronary aneurysms in same patient is rarely described in cardiovascular syphilis. PMID:25634420

  16. Hydroxychloroquine, a promising choice for coronary artery disease?

    PubMed

    Sun, Lizhe; Liu, Mengping; Li, Ruifeng; Zhao, Qiang; Liu, Junhui; Yang, Yanjie; Zhang, Lisha; Bai, Xiaofang; Wei, Yuanyuan; Ma, Qiangqiang; Zhou, Juan; Yuan, Zuyi; Wu, Yue

    2016-08-01

    Coronary artery disease is a common disease that seriously threaten the health of more than 150 million people per year. Atherosclerosis is considered to be the main cause of coronary artery disease which begins with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including: smoking, high blood pressure, hypercholesterolemia, sedentary lifestyle, diabetes and insulin resistance. Once a coronary artery disease has developed, all patients need to be treated with long term standard treatment, including heart-healthy lifestyle changes, medicines, and medical procedures or surgery. Hydroxychloroquine, an original antimalarial drug, prevents inflammation caused by lupus erythematosus and rheumatoid arthritis. It is relatively safe and well-tolerated during the treatment. Since atherosclerosis and rheumatoid arthritis have resemble mechanism and increasing clinical researches confirm that hydroxychloroquine has an important role in both anti-rheumatoid arthritis and cardiovascular protection (such as anti-platelet, anti-thrombotic, lipid-regulating, anti-hypertension, hypoglycemia, and so on), we hypothesize that hydroxychloroquine might be a promising choice to coronary artery disease patients for its multiple benefits. PMID:27372847

  17. Coronary Thrombosis without Dissection following Blunt Trauma

    PubMed Central

    Sibel, Michael; Thomas, Peter; Burt, Francis; Cipolla, James; Puleo, Peter; Baker, Keith

    2016-01-01

    Blunt trauma to the chest resulting in coronary thrombosis and ST elevation myocardial infarction (STEMI) is a rare but well-described occurrence in adults. Angiography in such cases has generally disclosed complete epicardial coronary occlusion with thrombus, indistinguishable from the findings commonly found in spontaneous plaque rupture due to atherosclerotic disease. In all previously reported cases in which coronary interrogation with intravascular ultrasound (IVUS) was performed in association with acute revascularization, coronary artery dissection was implicated as the etiology of coronary thrombosis. We present the first case report of blunt trauma-associated coronary thrombosis without underlying atherosclerosis or coronary dissection, as documented by IVUS imaging. PMID:27006836

  18. Socioeconomic Status Correlates with the Prevalence of Advanced Coronary Artery Disease in the United States

    PubMed Central

    Bashinskaya, Bronislava; Nahed, Brian V.; Walcott, Brian P.; Coumans, Jean-Valery C. E.; Onuma, Oyere K.

    2012-01-01

    Background Increasingly studies have identified socioeconomic factors adversely affecting healthcare outcomes for a multitude of diseases. To date, however, there has not been a study correlating socioeconomic details from nationwide databases on the prevalence of advanced coronary artery disease. We seek to identify whether socioeconomic factors contribute to advanced coronary artery disease prevalence in the United States. Methods and Findings State specific prevalence data was queried form the United States Nationwide Inpatient Sample for 2009. Patients undergoing percutaneous coronary angioplasty and coronary artery bypass graft were identified as principal procedures. Non-cardiac related procedures, lung lobectomy and hip replacement (partial and total) were identified and used as control groups. Information regarding prevalence was then merged with data from the Behavioral Risk Factor Surveillance System, the largest, on-going telephone health survey system tracking health conditions and risk behaviors in the United States. Pearson's correlation coefficient was calculated for individual socioeconomic variables including employment status, level of education, and household income. Household income and education level were inversely correlated with the prevalence of percutaneous coronary angioplasty (−0.717; −0.787) and coronary artery bypass graft surgery (−0.541; −0.618). This phenomenon was not seen in the non-cardiac procedure control groups. In multiple linear regression analysis, socioeconomic factors were significant predictors of coronary artery bypass graft and percutaneous transluminal coronary angioplasty (p<0.001 and p = 0.005, respectively). Conclusions Socioeconomic status is related to the prevalence of advanced coronary artery disease as measured by the prevalence of percutaneous coronary angioplasty and coronary artery bypass graft surgery. PMID:23050011

  19. Cannabinoids and atherosclerotic coronary heart disease.

    PubMed

    Singla, Sandeep; Sachdeva, Rajesh; Mehta, Jawahar L

    2012-06-01

    Marijuana is the most abused recreational drug in the United States. Cannabinoids, the active ingredients of marijuana, affect multiple organ systems in the human body. The pharmacologic effects of marijuana, based on stimulation of cannabinoid receptors CB1 and CB2, which are widely distributed in the cardiovascular system, have been well described. Activation of these receptors modulates the function of various cellular elements of the vessel wall, and may contribute to the pathogenesis of atherosclerosis. Clinically, there are reports linking marijuana smoking to the precipitation of angina and acute coronary syndromes. Recently, large published clinical trials with CB1 antagonist rimonabant did not show any significant benefit of this agent in preventing progression of atherosclerosis. In light of these findings and emerging data on multiple pathways linking cannabinoids to atherosclerosis, we discuss the literature on the role of cannabinoids in the pathophysiology of atherosclerosis. We also propose a marijuana paradox, which implies that inhalation of marijuana may be linked to precipitation of acute coronary syndromes, but modulation of the endocannabinoid system by a noninhalation route may have a salutary effect on the development of atherosclerosis. PMID:22278660

  20. Acute coronary syndrome

    PubMed Central

    Jawaid, Saad; Chaudary, Adeel

    2014-01-01

    The paramedics brought a 60-year-old man to the emergency department after a sudden onset of shortness of breath with a subsequent drop in the Glasgow Coma Scale (GCS). On arrival the patient looked peri-arrest. His O2 saturations were 84% on 15 L of oxygen. He had gasping breathing with a completely silent chest and the GCS was 6/15 (E=1, V=1, M=4). The blood gas revealed type-2 respiratory failure. The chest X-ray was unremarkable and ECG was not indicative for cardiac catheterisation lab activation. Bedside shock scan was done which showed global hypokinesia of the left ventricle. In spite of unconvincing ECG and chest X-ray, an acute cardiac event was diagnosed in view of an abnormal bedside echo. The patient was transferred to the cardiac catheterisation lab for urgent percutaneous coronary intervention which revealed critical stenosis of the left main stem coronary artery, which was successfully stented. The patient had a good recovery from the life-threatening event. PMID:24913081

  1. Formation of giant planets

    NASA Astrophysics Data System (ADS)

    Magni, G.; Coradini, A.

    2003-04-01

    In this presentation we address the problem of the formation of giant planets and their regular satellites. We study in particular the problem of formation of the Jupiter System comparing the results of the model with the present characteristics of the system, in order to identify what are those better represented by our approach. In fact here, using a 3-D hydro-dynamical code, we study the modalities of gas accretion onto a solid core, believed to be the seed from which Jupiter started. To do that we have modelled three main regions: the central planet, a turbulent accretion disk surrounding it and an extended region from which the gas is collected. In the extended region we treat the gas as a frictionless fluid. Our main goal is to identify what are the characteristics of the planet during its growth and the physical parameters affecting its growth at the expenses of the nebular gas present in the feeding zone. Moreover we want to understand what are the thermodynamical parameters characterizing the gas captured by the planet and swirling around it. Finally, we check if a disk can be formed in prograde rotation around the planet and if this disk can survive the final phases of the planet formation. Due to the interaction between the accreting planet and the disk it has been necessary to develop a complete model of the Jupiter’s structure. In fact the radiation emitted by the growing planet heats up the surrounding gas. In turn the planet’s thermodynamic structure depend on the mass accretion rate onto it. When the accretion is rapid, shock waves in the gas are formed close to the planet. This region cannot be safely treated by a numerical code; for this reason we have developed a semi-analytically model of a a turbulent accretion disk to be considered as transition between the planet and the surrounding disk.

  2. Rotation of Giant Stars

    NASA Astrophysics Data System (ADS)

    Kissin, Yevgeni; Thompson, Christopher

    2015-07-01

    The internal rotation of post-main sequence stars is investigated, in response to the convective pumping of angular momentum toward the stellar core, combined with a tight magnetic coupling between core and envelope. The spin evolution is calculated using model stars of initial mass 1, 1.5, and 5 {M}⊙ , taking into account mass loss on the giant branches. We also include the deposition of orbital angular momentum from a sub-stellar companion, as influenced by tidal drag along with the excitation of orbital eccentricity by a fluctuating gravitational quadrupole moment. A range of angular velocity profiles {{Ω }}(r) is considered in the envelope, extending from solid rotation to constant specific angular momentum. We focus on the backreaction of the Coriolis force, and the threshold for dynamo action in the inner envelope. Quantitative agreement with measurements of core rotation in subgiants and post-He core flash stars by Kepler is obtained with a two-layer angular velocity profile: uniform specific angular momentum where the Coriolis parameter {Co}\\equiv {{Ω }}{τ }{con}≲ 1 (here {τ }{con} is the convective time), and {{Ω }}(r)\\propto {r}-1 where {Co}≳ 1. The inner profile is interpreted in terms of a balance between the Coriolis force and angular pressure gradients driven by radially extended convective plumes. Inward angular momentum pumping reduces the surface rotation of subgiants, and the need for a rejuvenated magnetic wind torque. The co-evolution of internal magnetic fields and rotation is considered in Kissin & Thompson, along with the breaking of the rotational coupling between core and envelope due to heavy mass loss.

  3. Complimentary use of epicardial echo imaging and Doppler in quantification of coronary artery stenoses

    NASA Astrophysics Data System (ADS)

    Richards, Kent L.; Cannon, Scott R.

    1990-08-01

    As more advanced therapeutic procedures are performed on coronary arteries during open chest surgery more advanced diagnostic procedures will be required to define the location and severity of coronary artery disease. This manuscript describes our preliminary experiences in identifying human coronary artery stenoses using epicardial two-dimensional color flow Doppler. Once the lesions were identified we used standard echo Doppler and imaging techniques to define their severity. The accuracy of stenotic cross sectional area calculated using the continuity equation and pressure gradient calculated using the Bernoulli equation were defined using a pulsatile flow model of the coronary circulation. Suggestions about further hardware development required to allow easy clinical application of this technique are described. 1 - CLINICAL NEED FOR INTRA-OPERATIVE EVAUJATION OFCORONARY ARTERIES The severity of coronary artery disease in adults who require coronary bypass surgery has changed significantly in the last ten years. More effective medications used to control angina pectoris and the wide use of percutaneous y artery angioplasty have delayed the timing of surgery until atherosclerotic involvement is more extensive. In addition patients who have had initial coronary bypass operations are now reaching ages at which atherosclerotic involvement of their bypass grafts and native vessels has progressed and reoperation is required. To meet the challenge of coronary arteries with multiple lesions or diffuse disease intraoperative angioplasty devices are being developed. Whether bypass surgery for advanced lesions or reoperation of

  4. Right sided single coronary artery origin: surgical interventions without clinical consequences.

    PubMed

    Hamid, Tahir; Rose, Samman; Horner, Simon

    2011-11-01

    Congenital coronary anomalies are uncommon and are usually diagnosed incidentally during coronary angiogram or autopsy. Isolated coronary artery anomalies and the anomalous origin of left main stem (LMS) from the proximal portion of the right coronary artery or from the right sinus of valsalva are extremely rare. A 68 years old woman with atypical chest pains was referred for risk assessment for the general anaesthesia. A stress exercise treadmill test and myocardial perfusion scan revealed evidence of mild myocardial ischemia. Her coronary angiography revealed her left coronary artery to have a single origin with the right coronary artery. There were no flowlimiting lesions. A CT aortography confirmed a retro-aortic course of the left coronary artery. She successfully underwent multiple surgical procedures under general anaesthesia including total abdominal hysterectomy, Burch colposuspension (twice) for stress incontinence, intravesical botox injection for urge incontinence and haemorrhoidectomy for recurrent rectal mucosal prolapse. Various anaesthetic agents including halothane, thiopentone, suxamethonium, pancuronium, enflurane, fentanyl, propofol and isoflurane were used without any adverse clinical consequences. She remained well on 48 months follow-up. PMID:22078352

  5. CMB lensing and giant rings

    NASA Astrophysics Data System (ADS)

    Rathaus, Ben; Itzhaki, Nissan

    2012-05-01

    We study the CMB lensing signature of a pre-inationary particle (PIP), assuming it is responsible for the giant rings anomaly that was found recently in the WMAP data. Simulating Planck-like data we find that generically the CMB lensing signal to noise ratio associated with such a PIP is quite small and it would be difficult to cross correlate the temperature giant rings with the CMB lensing signal. However, if the pre-inationary particle is also responsible for the bulk flow measured from the local large scale structure, which happens to point roughly at the same direction as the giant rings, then the CMB lensing signal to noise ratio is fairly significant.

  6. Giant lobelias exemplify convergent evolution

    PubMed Central

    2010-01-01

    Giant lobeliads on tropical mountains in East Africa and Hawaii have highly unusual, giant-rosette growth forms that appear to be convergent on each other and on those of several independently evolved groups of Asteraceae and other families. A recent phylogenetic analysis by Antonelli, based on sequencing the widest selection of lobeliads to date, raises doubts about this paradigmatic example of convergent evolution. Here I address the kinds of evidence needed to test for convergent evolution and argue that the analysis by Antonelli fails on four points. Antonelli's analysis makes several important contributions to our understanding of lobeliad evolution and geographic spread, but his claim regarding convergence appears to be invalid. Giant lobeliads in Hawaii and Africa represent paradigmatic examples of convergent evolution. PMID:20074322

  7. Giant myoma and erythrocytosis syndrome.

    PubMed

    Ozsaran, A A; Itil, I M; Terek, C; Kazandi, M; Dikmen, Y

    1999-08-01

    The objective of this study is to discuss the myomatous erythrocytosis syndrome in a patient with a giant subserous uterine myoma. She presented with plethora and an abdominal mass. After venesection of 4 units of blood, the preoperative haematocrit value of 53.3% and haemoglobin value of 17.5 g/dL had decreased to 48.6% and 16.8 g/dL levels, respectively. After the operative extraction of the giant subserous myoma with attached uterus weighing 14.2 kg, the haematocrit and the haemoglobin values had regressed to 40.3% and 14.3 g/dL levels, respectively. The findings indicated that the giant subserous myoma was the cause of the myomatous erythrocytosis syndrome in this patient. PMID:10554963

  8. Coronary heart disease and pregnancy.

    PubMed

    Karamermer, Yusuf; Roos-Hesselink, Jolien W

    2007-09-01

    The prevalence of coronary artery disease in female patients is increasing due to changing lifestyle patterns including cigarette smoking, diabetes and stress. Since women are delaying childbearing until older age, acute coronary syndrome will more frequently occur during pregnancy. Although rare, acute coronary syndrome during pregnancy often has devastating consequences. It is associated with increased maternal and neonatal mortality and morbidity compared with the nonpregnant situation. Furthermore, it constitutes an important problem for the patient and the treating physician, because the selection of diagnostic and therapeutic approaches is greatly influenced not only by maternal, but also by fetal safety. PMID:19804311

  9. Rule-based automatic segmentation for 3-D coronary arteriography

    NASA Astrophysics Data System (ADS)

    Sarwal, Alok; Truitt, Paul; Ozguner, Fusun; Zhang, Qian; Parker, Dennis L.

    1992-03-01

    Coronary arteriography is a technique used for evaluating the state of coronary arteries and assessing the need for bypass surgery and angioplasty. The present clinical application of this technology is based on the use of a contrast medium for manual radiographic visualization. This method is inaccurate due to varying interpretation of the visual results. Coronary arteriography based quantitations are impractical in a clinical setting without the use of automatic techniques applied to the 3-D reconstruction of the arterial tree. Such a system will provide an easily reproducible method for following the temporal changes in coronary morphology. The labeling of the arteries and establishing of the correspondence between multiple views is necessary for all subsequent processing required for 3-D reconstruction. This work represents a rule based expert system utilized for automatic labeling and segmentation of the arterial branches across multiple views. X-ray data of two and three views of human subjects and a pig arterial cast have been used for this research.

  10. Magnetocardiography with sensors based on giant magnetoresistance

    NASA Astrophysics Data System (ADS)

    Pannetier-Lecoeur, M.; Parkkonen, L.; Sergeeva-Chollet, N.; Polovy, H.; Fermon, C.; Fowley, C.

    2011-04-01

    Biomagnetic signals, mostly due to the electrical activity in the body, are very weak and they can only be detected by the most sensitive magnetometers, such as Superconducting Quantum Interference Devices (SQUIDs). We report here biomagnetic recordings with hybrid sensors based on Giant MagnetoResistance (GMR). We recorded magnetic signatures of the electric activity of the human heart (magnetocardiography) in healthy volunteers. The P-wave and QRS complex, known from the corresponding electric recordings, are clearly visible in the recordings after an averaging time of about 1 min. Multiple recordings at different locations over the chest yielded a dipolar magnetic field map and allowed localizing the underlying current sources. The sensitivity of the GMR-based sensors is now approaching that of SQUIDs and paves way for spin electronics devices for functional imaging of the body.