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Sample records for calcified carotid atheroma

  1. Distribution of alkaline phosphatase, osteopontin, RANK ligand and osteoprotegerin in calcified human carotid atheroma.

    PubMed

    Higgins, Catherine L; Isbilir, Salim; Basto, Pamela; Chen, Iou Yih; Vaduganathan, Muthiah; Vaduganathan, Periyanan; Reardon, Michael J; Lawrie, Gerald; Peterson, Leif; Morrisett, Joel D

    2015-10-01

    Ectopic vascular calcification is a significant component of atherosclerotic disease. Osteopontin (OPN), Osteoprotegerin (OPG), Receptor Activator of NFκB Ligand (RANKL), and alkaline phosphatase (ALP) are each thought to play central roles in the calcification or demineralization of atherosclerotic lesions. Abnormalities in the balance of these proteins may lead to perturbations in bone remodeling and arterial calcification. The purpose of this study was to measure the distribution of these proteins in human carotid lesions and to elucidate possible mechanism(s) whereby they control the deposition or depletion of arterial calcification. Thirty-three patients who had undergone carotid endarterectomy (CEA) within the previous 18 months and 11 control patients were enrolled. CEA specimens were analyzed by EBCT for calcification content in terms of Agatston (AGAT) and Volume scores. CEA specimens were then cut into 5 mm segments which were homogenized and extracted. Extracts were analyzed for tissue levels of calcium, phosphorus, ALP, OPN, RANKL, and OPG. Fasting blood samples were analyzed for the same components. In CEA tissue segments, the calcification levels (CHA AGAT) were inversely associated with the levels of OPG (r = -0.432/-0.579, p < 0.05) and positively associated with the levels of RANKL (r = 0.332/0.415, p < 0.05). In turn, the tissue levels of OPG were associated with homologous serum levels of OPG (r = 0.820/0.389, p < 0.001), and the tissue levels of RANKL were associated with the serum levels of homologous RANKL (r = 0.739/0.666, p < 0.0001). This study suggests that serum levels of OPG and RANKL may be useful biomarkers for estimating the degree of calcification in carotid atherosclerotic lesions. PMID:26307009

  2. Panoramic Radiography in the Diagnosis of Carotid Artery Atheromas and the Associated Risk Factors

    PubMed Central

    Guimarães Henriques, João César; Kreich, Eliane Maria; Helena Baldani, Márcia; Luciano, Mariely; Cezar de Melo Castilho, Julio; Cesar de Moraes, Luiz

    2011-01-01

    Atherosclerosis is a serious chronic disease, responsible for thousands of deaths worldwide and is characterized by thickening and loss of elasticity of the arterial walls, associated with the presence of atheromatous plaques. Various risk factors act directly on predisposition to the disease, among which the following are pointed out: diabetes mellitus, arterial hypertension and inadequate diet and eating habits. More recent researches have elucidated new risk factors acting in the development of this disease, such as, for example: periodontitis, chronic renal disease and menopause. The panoramic radiograph, commonly used in dental practice, makes it possible to see calcified atherosclerotic plaques that are eventually deposited in the carotid arteries. The aim of this review article was to emphasize the dentist’s important role in the detection of carotid artery atheromas in panoramic radiographs and the immediate referral of patients affected by these calcifications to doctors. In addition, the study intended to guide the dentist, especially the dental radiologist, with regard to differential diagnosis, which should be made taking into consideration particularly the triticeal cartilage when it is calcified. PMID:21760860

  3. Quest for the Vulnerable Atheroma: Carotid Stenosis and Diametric Strain--A Feasibility Study.

    PubMed

    Xu, Canxing; Yuan, Chun; Stutzman, Edward; Canton, Gador; Comess, Keith A; Beach, Kirk W

    2016-03-01

    The Bernoulli effect may result in eruption of a vulnerable carotid atheroma, causing a stroke. We measured electrocardiography (ECG)-registered QRS intra-stenotic blood velocity and atheroma strain dynamics in carotid artery walls using ultrasonic tissue Doppler methods, providing displacement and time resolutions of 0.1 μm and 3.7 ms. Of 22 arteries, 1 had a peak systolic velocity (PSV) >280 cm/s, 4 had PSVs between 165 and 280 cm/s and 17 had PSVs <165 cm/s. Eight arteries with PSVs <65 cm/s and 4 of 9 with PSVs between 65 and 165 cm/s had normal systolic diametric expansion (0% and 7%) and corresponding systolic wall thinning. The remaining 10 arteries had abnormal systolic strain dynamics, 2 with diametric reduction (>-0.05 mm), 2 with extreme wall expansion (>0.1 mm), 2 with extreme wall thinning (>-0.1 mm) and 4 with combinations. Decreases in systolic diameter and/or extreme systolic arterial wall thickening may indicate imminent atheroma rupture. PMID:26705891

  4. Serum Osteoprotegerin Is Associated With Calcified Carotid Plaque

    PubMed Central

    Kwon, Ami; Choi, Yun-Seok; Choi, Yong-Won; Chung, Woo-Baek; Park, Chul-Soo; Chung, Wook-Sung; Lee, Man-Young; Youn, Ho-Joong

    2016-01-01

    Abstract Osteoprotegerin (OPG) is a kind of tumor necrosis factor, which is related to bone metabolism and vascular calcification. The increase of Osteoprotegerin concentration in serum is related to cardiovascular diseases in humans. The purpose of this study was to figure out the relevance between osteoprotegerin in serum and carotid calcification. Serum OPG concentrations were compared in 145 patients who underwent carotid sonography (average age: 68 ± 9 years old, male: female = 81:64). A calcified plaque (CP) (37 people [27%]), a noncalcified plaque (NCP) (54 people [37%]), and a nonplaque (NP) (54 people [37%]) were classified for this study. No significant differences among 3 groups were demonstrated in the distribution of age, diabetes, high blood pressure, and hyperlipidemia. Serum osteoprotegerin concentrations were significantly increased in CP group rather than NCP group or NP group; (median [interquartile range], 4016 [1410] vs 3210 [1802] pg/mL, P < 0.05 and 4016 [1410] vs 3204 [1754] pg/mL, P < 0.05). Serum osteoprotegerin concentrations did not indicate a significant difference between NCP Group or NP Group. This study had proved that patient group accompanied with carotid calcification in carotid artery disease had an increased serum OPG concentration, so it could consider that OPG plays an important function on calcification related to arteriosclerosis. PMID:27082605

  5. Identification of novel genes and pathways in carotid atheroma using integrated bioinformatic methods

    PubMed Central

    Nai, Wenqing; Threapleton, Diane; Lu, Jingbo; Zhang, Kewei; Wu, Hongyuan; Fu, You; Wang, Yuanyuan; Ou, Zejin; Shan, Lanlan; Ding, Yan; Yu, Yanlin; Dai, Meng

    2016-01-01

    Atherosclerosis is the primary cause of cardiovascular events and its molecular mechanism urgently needs to be clarified. In our study, atheromatous plaques (ATH) and macroscopically intact tissue (MIT) sampled from 32 patients were compared and an integrated series of bioinformatic microarray analyses were used to identify altered genes and pathways. Our work showed 816 genes were differentially expressed between ATH and MIT, including 443 that were up-regulated and 373 that were down-regulated in ATH tissues. GO functional-enrichment analysis for differentially expressed genes (DEGs) indicated that genes related to the “immune response” and “muscle contraction” were altered in ATHs. KEGG pathway-enrichment analysis showed that up-regulated DEGs were significantly enriched in the “FcεRI-mediated signaling pathway”, while down-regulated genes were significantly enriched in the “transforming growth factor-β signaling pathway”. Protein-protein interaction network and module analysis demonstrated that VAV1, SYK, LYN and PTPN6 may play critical roles in the network. Additionally, similar observations were seen in a validation study where SYK, LYN and PTPN6 were markedly elevated in ATH. All in all, identification of these genes and pathways not only provides new insights into the pathogenesis of atherosclerosis, but may also aid in the development of prognostic and therapeutic biomarkers for advanced atheroma. PMID:26742467

  6. Serum Osteoprotegerin Is Associated With Calcified Carotid Plaque: A Strobe-Compliant Observational Study.

    PubMed

    Kwon, Ami; Choi, Yun-Seok; Choi, Yong-Won; Chung, Woo-Baek; Park, Chul-Soo; Chung, Wook-Sung; Lee, Man-Young; Youn, Ho-Joong

    2016-04-01

    Osteoprotegerin (OPG) is a kind of tumor necrosis factor, which is related to bone metabolism and vascular calcification. The increase of Osteoprotegerin concentration in serum is related to cardiovascular diseases in humans. The purpose of this study was to figure out the relevance between osteoprotegerin in serum and carotid calcification. Serum OPG concentrations were compared in 145 patients who underwent carotid sonography (average age: 68 ± 9 years old, male: female = 81:64). A calcified plaque (CP) (37 people [27%]), a noncalcified plaque (NCP) (54 people [37%]), and a nonplaque (NP) (54 people [37%]) were classified for this study. No significant differences among 3 groups were demonstrated in the distribution of age, diabetes, high blood pressure, and hyperlipidemia. Serum osteoprotegerin concentrations were significantly increased in CP group rather than NCP group or NP group; (median [interquartile range], 4016 [1410] vs 3210 [1802] pg/mL, P < 0.05 and 4016 [1410] vs 3204 [1754] pg/mL, P < 0.05). Serum osteoprotegerin concentrations did not indicate a significant difference between NCP Group or NP Group. This study had proved that patient group accompanied with carotid calcification in carotid artery disease had an increased serum OPG concentration, so it could consider that OPG plays an important function on calcification related to arteriosclerosis. PMID:27082605

  7. Relationship of Elongated Styloid Process in Digital Panoramic Radiography with Carotid Intima Thickness and Carotid Atheroma in Doppler Ultrasonography in Osteoporotic Females

    PubMed Central

    Hamedani, Shahram; Dabbaghmanesh, Mohammad Hossein; Zare, Zahra; Hasani, Mahvash; Torabi Ardakani, Mahshid; Hasani, Mahsa; Shahidi, Shoaleh

    2015-01-01

    Statement of the Problem Cardiovascular disease and osteoporosis are major health dilemmas. Osteoporotic patients frequently display vascular calcification that consequently increases the cardiovascular morbidity and mortality. Purpose This study aimed to investigate the relation of osteoporosis, vascular calcification (atheroma, intima-media thickness (IMT)) and elongated styloid process (ESP) in a sample of osteoporotic and normal female individuals. Materials and Method This study recruited 78 women who were assessed for bone mass density (BMD). Sample included individuals with normal BMD (n=13, 17 %), osteopenia (n=36, 46 %), and osteoporosis (n=29, 37%). The presence of atheroma and IMT was examined using color Doppler ultrasonography (CD-US). In addition, digital panoramic radiographs (PRs) were obtained to assess ESP. Results In this study, 55 subjects (70%) with low BMD exhibited at least one side ESP. Femoral BMD decreased significantly in subjects with ESP (p= 0.03). Bilateral ESP was correlated with the presence of atheroma (p= 0.029). The CIMT was greater in patients with ESP, although the relation was not significant. Conclusion The obtained data suggest referring the aged individuals with ESP for BMD assessment and individuals with low bone mass and ESP for more cardiovascular risk assessment. PMID:26046104

  8. Common Carotid Intima Media Thickness and Ankle-Brachial Pressure Index Correlate with Local but Not Global Atheroma Burden: A Cross Sectional Study Using Whole Body Magnetic Resonance Angiography

    PubMed Central

    Weir-McCall, Jonathan R.; Khan, Faisel; Lambert, Matthew A.; Adamson, Carly L.; Gardner, Michael; Gandy, Stephen J.; Ramkumar, Prasad Guntur; Belch, Jill J. F.; Struthers, Allan D.; Rauchhaus, Petra; Morris, Andrew D.; Houston, J. Graeme

    2014-01-01

    Background Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). Methods 50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR). The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50–70%, 3 = 70–99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated. Results The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045), however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01) with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β −0.39, p = 0.012), which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45), while the correlation between ABPI and atheroma burden persisted (β −0.45 p = 0.005). Conclusion ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral

  9. Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs

    PubMed Central

    Soroushian, Sheila; Ganguly, Rumpa

    2013-01-01

    Purpose This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. Materials and Methods One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively. Results There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, "With CCAP" and "Without CCAP", there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking. Conclusion This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health. PMID:24380062

  10. Micro-FTIR imaging spectroscopy of calcified atheromatous carotid plaques. Part IV

    NASA Astrophysics Data System (ADS)

    Alò, Francesco; Conti, Carla; Ferraris, Paolo; Giorgini, Elisabetta; Rubini, Corrado; Sabbatini, Simona; Tosi, Giorgio

    2009-03-01

    Micro-imaging infrared spectroscopy has been performed on atheromatous plaques in order to localize and characterize substances responsible for the cytotoxic effects that prevent macrophages clearance of lipidic and calcified materials. In plaques with different graded atherosclerotic lesions, infrared determinations allowed to visualize gruel and ceroid toxic components and variously calcified zones. Compare correlations let to visualize the progression of the lesion on going from the lumen to the outer media of the plaque.

  11. Detection of common carotid artery calcifications on panoramic radiographs: prevalence and reliability

    PubMed Central

    Alves, Nilton; Deana, Naira F; Garay, Ivonne

    2014-01-01

    The aim of this study was to determine the prevalence of common carotid artery calcifications (CCAC) detected by panoramic radiographs (PR) in the population and main risk factors with review of the literature. Furthermore, the reliability of PR was verified to detect these calcifications. CCAC detected on PR was powerful markers for future cardiovascular or cerebrovascular events. We found that the prevalence of CCAC identified by PR may range from 0.43% to 9.4%, depending on the age and lifestyle of the population studied. In individuals with systemic diseases the prevalence was higher than in the general population, reaching up to 38.8%. The radiopaque masses compatible with CCAC identified by PR were more common in women and occurred unilaterally or both sides, without preference for one or the other. According to the literature reviewed PR had low sensitivity and acceptable accuracy for detecting CCAC. We conclude that calcified atheroma in the common carotid artery can be demonstrated in PR, and this is an important tool for early detection of CCAC. However, it is always necessary to refer the patient to a cardiology service to confirm the findings, determine the real extent of the disease and establish its corresponding treatment. PMID:25232373

  12. Can Orthopantomography be used as a tool for screening of carotid atheromatous pathology and thus be used to help reduce the prevalence of ischemic stroke within the population?

    PubMed Central

    Chimenos-Küstner, Eduardo

    2012-01-01

    Objective: To assess the possibility of Dentists being able to screen patients with higher risk of vascular diseases. Material: Kodak 8000C Orthopantomographer, eco-Doppler Logiq-500 General Electric at the Lisbon Hospital Particular. Methods: Assessment of orthopantomographies made to 142 patients aged 50 or more, as well as the existing risk factors. Conduction of carotid eco-Doppler to patients who appear to have calcified plaques of the atheroma. Results: Strong dependence between dichotomised age and having the pathology (p = 0.02).Smokers are twice more likely to present plaques (OR= 2). Being hypertensive increases in about 1.4 the likelihood of having a stroke (OR= 1.4). Of the 27 individuals who presented calcifications in the Orthopantomography, they were all submitted to an eco-Doppler and 21 had the pathology confirmed. 27 individuals, who did not show any plaques in the Orthopantomography, were randomly selected to be the control group. They were submitted to an eco-Doppler. And 23 confirmed the non-existence of plaques. Conclusions: Orthopantomography used for assessing the oral cavity reveals more information which should be the object of the Dentist’s attention. Key words:Orthopantomography, atheroma, stroke. PMID:24558519

  13. Association of Neutrophil/Lymphocyte Ratio with Plaque Morphology in Patients with Asymptomatic Intermediate Carotid Artery Stenosis

    PubMed Central

    Köklü, Erkan; Arslan, Şakir; Çağırcı, Göksel; Göksu, Eylem Özaydın; Koç, Pınar; Çay, Serkan; Kızılırmak, Filiz

    2016-01-01

    Background and Objectives Non-calcified carotid plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism, and consequently, stroke. The purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to neutrophil/lymphocyte ratio (NLR). Subjects and Methods A total number of 139 asymptomatic patients with 50-70% stenosis of the carotid artery were included in this study. Carotid Doppler ultrasound imaging and computed tomography angiography were performed to divide the carotid artery plaques into two groups as calcified and non-calcified. Patients included in the calcified (n=73) and non-calcified (n=66) plaque groups were compared with respect to total neutrophil count, lymphocyte count and NLR. Results Total lymphocyte count was statistically significantly lower in the non-calcified plaque group compared to the calcified plaque group (total lymphocyte count in non-calcified/calcified plaque groups [103/mm3]: 2.1/2.3, respectively) (p=0.002). NLR was statistically significantly higher in the non-calcified plaque group compared to the calcified plaque group (NLR in non-calcified/calcified plaque groups: 2.6/2.1, respectively) (p<0.001). The cut-off value for NLR was found to be >2.54. Multivariate regression analysis showed that NLR was independently associated with non-calcified carotid artery plaques (odds ratio 5.686, 95% CI 2.498-12.944, p<0.001). Conclusions NLR is increased in the presence of non-calcified carotid artery plaques that cause asymptomatic intermediate stenosis. Increased NLR can be used as a marker to assess the risk of rupture of non-calcified carotid artery plaques. PMID:27721862

  14. Prevalence of suggestive images of carotid artery calcifications on panoramic radiographs and its relationship with predisposing factors.

    PubMed

    Brito, Ana Caroline Ramos de; Nascimento, Helena Aguiar Ribeiro; Argento, Rafaela; Beline, Thamara; Ambrosano, Glaucia Maria Bovi; Freitas, Deborah Queiroz

    2016-06-01

    Panoramic radiographs (PR) can display radiopaque images suggestive of calcified atheroma in the carotid artery in asymptomatic patients. The aim of this study was to evaluate the prevalence of these images on PR and their linkage with hypertension, obesity, age, gender and smoking habits. PR of 505 patients were evaluated. They were older than 30 years old and their PR had been taken for different clinical reasons. Their body mass index was calculated; their waist circumference was also taken into consideration. Information about smoking habits and hypertension was obtained. The observers analyzed the presence of radiopaque mass in the region of the cervical vertebrae C3-C4 through the PR, confirmed by an antero-posterior (AP) radiograph. The results showed a 7.92% prevalence of suggestive images of calcifications on PR and on AP radiograph. The adjusted Odds Ratio showed association with age and smoking habits. The calcification process is almost nine times higher for the elderly when compared to the young. As far as smokers are concerned, this process is twice worse when compared to no smokers. In conclusion, 7.92% of the group studied presented suggestive images of carotid atherosclerosis on PR, which is directly associated with the age and smoking habits.

  15. Prevalence of suggestive images of carotid artery calcifications on panoramic radiographs and its relationship with predisposing factors.

    PubMed

    Brito, Ana Caroline Ramos de; Nascimento, Helena Aguiar Ribeiro; Argento, Rafaela; Beline, Thamara; Ambrosano, Glaucia Maria Bovi; Freitas, Deborah Queiroz

    2016-06-01

    Panoramic radiographs (PR) can display radiopaque images suggestive of calcified atheroma in the carotid artery in asymptomatic patients. The aim of this study was to evaluate the prevalence of these images on PR and their linkage with hypertension, obesity, age, gender and smoking habits. PR of 505 patients were evaluated. They were older than 30 years old and their PR had been taken for different clinical reasons. Their body mass index was calculated; their waist circumference was also taken into consideration. Information about smoking habits and hypertension was obtained. The observers analyzed the presence of radiopaque mass in the region of the cervical vertebrae C3-C4 through the PR, confirmed by an antero-posterior (AP) radiograph. The results showed a 7.92% prevalence of suggestive images of calcifications on PR and on AP radiograph. The adjusted Odds Ratio showed association with age and smoking habits. The calcification process is almost nine times higher for the elderly when compared to the young. As far as smokers are concerned, this process is twice worse when compared to no smokers. In conclusion, 7.92% of the group studied presented suggestive images of carotid atherosclerosis on PR, which is directly associated with the age and smoking habits. PMID:27383353

  16. Why marine phytoplankton calcify.

    PubMed

    Monteiro, Fanny M; Bach, Lennart T; Brownlee, Colin; Bown, Paul; Rickaby, Rosalind E M; Poulton, Alex J; Tyrrell, Toby; Beaufort, Luc; Dutkiewicz, Stephanie; Gibbs, Samantha; Gutowska, Magdalena A; Lee, Renee; Riebesell, Ulf; Young, Jeremy; Ridgwell, Andy

    2016-07-01

    Calcifying marine phytoplankton-coccolithophores- are some of the most successful yet enigmatic organisms in the ocean and are at risk from global change. To better understand how they will be affected, we need to know "why" coccolithophores calcify. We review coccolithophorid evolutionary history and cell biology as well as insights from recent experiments to provide a critical assessment of the costs and benefits of calcification. We conclude that calcification has high energy demands and that coccolithophores might have calcified initially to reduce grazing pressure but that additional benefits such as protection from photodamage and viral/bacterial attack further explain their high diversity and broad spectrum ecology. The cost-benefit aspect of these traits is illustrated by novel ecosystem modeling, although conclusive observations remain limited. In the future ocean, the trade-off between changing ecological and physiological costs of calcification and their benefits will ultimately decide how this important group is affected by ocean acidification and global warming.

  17. Why marine phytoplankton calcify.

    PubMed

    Monteiro, Fanny M; Bach, Lennart T; Brownlee, Colin; Bown, Paul; Rickaby, Rosalind E M; Poulton, Alex J; Tyrrell, Toby; Beaufort, Luc; Dutkiewicz, Stephanie; Gibbs, Samantha; Gutowska, Magdalena A; Lee, Renee; Riebesell, Ulf; Young, Jeremy; Ridgwell, Andy

    2016-07-01

    Calcifying marine phytoplankton-coccolithophores- are some of the most successful yet enigmatic organisms in the ocean and are at risk from global change. To better understand how they will be affected, we need to know "why" coccolithophores calcify. We review coccolithophorid evolutionary history and cell biology as well as insights from recent experiments to provide a critical assessment of the costs and benefits of calcification. We conclude that calcification has high energy demands and that coccolithophores might have calcified initially to reduce grazing pressure but that additional benefits such as protection from photodamage and viral/bacterial attack further explain their high diversity and broad spectrum ecology. The cost-benefit aspect of these traits is illustrated by novel ecosystem modeling, although conclusive observations remain limited. In the future ocean, the trade-off between changing ecological and physiological costs of calcification and their benefits will ultimately decide how this important group is affected by ocean acidification and global warming. PMID:27453937

  18. Gastric calcifying fibrous tumour

    PubMed Central

    Attila, Tan; Chen, Dean; Gardiner, Geoffrey W; Ptak, Theadore W; Marcon, Norman E

    2006-01-01

    Intramucosal gastric tumours are most commonly found to be gastrointestinal stromal tumours or leiomyomas (smooth muscle tumours); however, a variety of other uncommon mesenchymal tumours can occur in the stomach wall. A rare benign calcifying fibrous tumour is reported and the endoscopic appearance, ultrasound findings and morphology are documented. A review of the literature found only two similar cases. PMID:16858502

  19. Carotid Endarterectomy

    MedlinePlus

    ... the carotid arteries. This limits or blocks the flow of oxygen-rich blood to your brain, which can lead to a stroke. Carotid Arteries Figure A shows ... normal carotid artery that has normal blood flow. Figure C show the inside of a carotid ...

  20. Why marine phytoplankton calcify

    PubMed Central

    Monteiro, Fanny M.; Bach, Lennart T.; Brownlee, Colin; Bown, Paul; Rickaby, Rosalind E. M.; Poulton, Alex J.; Tyrrell, Toby; Beaufort, Luc; Dutkiewicz, Stephanie; Gibbs, Samantha; Gutowska, Magdalena A.; Lee, Renee; Riebesell, Ulf; Young, Jeremy; Ridgwell, Andy

    2016-01-01

    Calcifying marine phytoplankton—coccolithophores— are some of the most successful yet enigmatic organisms in the ocean and are at risk from global change. To better understand how they will be affected, we need to know “why” coccolithophores calcify. We review coccolithophorid evolutionary history and cell biology as well as insights from recent experiments to provide a critical assessment of the costs and benefits of calcification. We conclude that calcification has high energy demands and that coccolithophores might have calcified initially to reduce grazing pressure but that additional benefits such as protection from photodamage and viral/bacterial attack further explain their high diversity and broad spectrum ecology. The cost-benefit aspect of these traits is illustrated by novel ecosystem modeling, although conclusive observations remain limited. In the future ocean, the trade-off between changing ecological and physiological costs of calcification and their benefits will ultimately decide how this important group is affected by ocean acidification and global warming. PMID:27453937

  1. Carotid artery surgery

    MedlinePlus

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  2. Odonto calcifying cyst

    PubMed Central

    Aswath, Nalini; Mastan, Kader; Manikandan, Tirupathi; Samuel, Gigi

    2013-01-01

    The calcifying odontogenic cyst (COC) is reported to be associated with odontoma in 24% of cases. Separation of the cases of calcifying odontogenic cyst associated with odontoma (COCaO) may lead to a better understanding of the pathogenesis of this lesion. The literature revealed 52 cases of COCaO. The male to female ratio was 1:1.9, with a mean age of 16 years. Most common location was the maxilla (61.5%). The radiographic appearance of most cases (80.5%) was a well-defined, mixed radiolucent-radiopaque lesion. Histologically, the lesions consisted of a single large cyst with tooth-like structures as an integral part, giving the impression of a single lesion. In addition to the unique histologic features, differences in gender and distribution were found between the cases of COCaO and those of simple COC. COCaO may be regarded as a separate entity and classified as a benign, mixed odontogenic tumor. The term odontocalcifying odontogenic cyst is suggested. PMID:23853467

  3. Calcified retroperitoneal fibroma.

    PubMed

    Illuminati, G; Bertagni, A; Montesano, G; Soda, G; Baiocchini, A; Melis, M; Vietri, F

    1997-01-01

    A case of 31-year-old male with a retroperitoneal tumor is described. Abdominal ultrasound revealed a left para-aortic calcific mass, adjacent to the left lobe of the liver and to the upper pole of the left kidney. A CT-scan of the abdomen showed the mass to originate from the left adrenal gland. At operation, a large, retroperitoneal mass, adherent to the left kidney and the spleen, but not infiltrating, was excised. Histologically the tumor was diagnosed as a calcified osteo-producing fibroma. Benign retroperitoneal tumors represent about 25% of all retroperitoneal neoplasm. This reported case represents a retroperitoneal tumor of slow growth and benign clinical course whose characteristic consists of the heavy calcifications which are normally absent in a fibroma type mass.

  4. Fiber Optic Laser Delivery For Endarterectomy Of Experimental Atheromas

    NASA Astrophysics Data System (ADS)

    Eugene, John; Pollock, Marc E.; McColgan, Stephen J.; Hammer-Wilson, Marie; Berns, Michael W.

    1986-08-01

    Fiber optic delivery of argon ion laser energy and Nd-YAG laser energy were compared by the performance of open laser endarterectomy in the rabbit arteriosclerosis model. In Group I, 6 open laser endarterectomies were performed with an argon ion laser (488 nm and 514.5 nm) with the laser beam directed through a 400 pm quartz fiber optic. In Group II, 6 open laser endarterectomies were performed with a Nd-YAG laser (1.06 pm) with the laser beam directed through a 600 pm quartz fiber optic. Gross and light microscopic examination revealed smooth endarterectomy surfaces with tapered end points in Group I. In Group II, the endarterectomy surfaces were uneven and perforation occurred at 5/6 end points. Although energy could be precisely delivered with each laser by fiber optics, satisfactory results could only be achieved with the argon ion laser because argon ion energy was well absorbed by atheromas. Successful intravascular laser use requires a strong interaction between wavelength and atheroma as well as a precise delivery system.

  5. Carotid Ultrasound

    MedlinePlus

    ... plaque narrows the carotid arteries and reduces the flow of oxygen-rich blood to the brain. If the plaque ruptures, a blood clot can form on its surface. A clot can mostly or completely block blood flow through a carotid artery, which can cause a ...

  6. Calcifying Fibrous Tumor

    PubMed Central

    Chorti, Angeliki; Papavramidis, Theodossis S.; Michalopoulos, Antonios

    2016-01-01

    Abstract Calcifying fibrous tumor (CFT) is a benign lesion characterized by its specific histological findings and is found as solitary or multiple lesions in several locations of the human body. The aim of the present systematic review is to give a detailed account of all reported cases of CFT in the literature and to analyze the available data, to completely characterize the entity from epidemiological, medical, and surgical aspects. A bibliographic research was performed from 1988 until 2015. A database with the patients’ characteristics was made, including sex, age, location of the tumor, symptoms, symptoms duration, size of the tumor, diagnostic methods, treatment, metastasis, and follow-up. A total of 104 articles were identified, reporting 157 cases of CFT. Mean age of patients was 33.58 years and the ratio between men and women was 1:1.27. The most common locations of CFT were stomach (18%), small intestine (8.7%), pleura (9.9%), mesentery (5%), and peritoneum (6.8%). Mean diameter of the tumor was estimated 4.6 cm. The correlations proceeded showed that as age increases, size decreases (P = 0.001) and that the tumor is larger in females (P = 0.027). Kruskal-Wallis test showed that the larger tumors appear in the neck and adrenal gland (P = 0.001). The percentage of asymptomatic patients was 30.57%. Computed tomography and biopsy were the most common tests for the diagnosis of CFT. Open surgical procedure was performed in the majority of cases. The median hospitalization was 6.06 days and the mean follow-up period was 29.97 months. Recurrences were mentioned in 10 of 96 patients with available data. No deaths owing to CFT were mentioned in the literature. CFT should be included in the differential diagnosis of enlarging mass revealed by clinical or imaging examination either incidentally or after specific acute or chronic symptomatology. PMID:27196478

  7. An abundant dysfunctional apolipoprotein A1 in human atheroma

    PubMed Central

    Huang, Ying; DiDonato, Joseph A.; Levison, Bruce S.; Schmitt, Dave; Li, Lin; Wu, Yuping; Buffa, Jennifer; Kim, Timothy; Gerstenecker, Gary; Gu, Xiaodong; Kadiyala, Chandra; Wang, Zeneng; Culley, Miranda K.; Hazen, Jennie E.; DiDonato, Anthony J.; Fu, Xiaoming; Berisha, Stela; Peng, Daoquan; Nguyen, Truc; Liang, Shaohong; Chuang, Chia-Chi; Cho, Leslie; Plow, Edward F.; Fox, Paul L.; Gogonea, Valentin; Tang, W.H. Wilson; Parks, John S.; Fisher, Edward A.; Smith, Jonathan D.; Hazen, Stanley L.

    2014-01-01

    Recent studies indicate high density lipoproteins (HDL) and their major structural protein, apolipoprotein A1 (apoA1), recovered from human atheroma, are dysfunctional and extensively oxidized by myeloperoxidase (MPO), while in vitro oxidation of apoA1/HDL by MPO impairs its cholesterol acceptor function. We developed a high affinity monoclonal antibody (mAb) that specifically recognizes apoA1/HDL modified by the MPO/H2O2/Cl-system using phage display affinity maturation. An oxindolyl alanine (2-OH-Trp) moiety at tryptophan 72 of apoA1 is the immunogenic epitope. Mutagenesis studies confirm a critical role for apoA1 Trp72 in MPO-mediated inhibition of ABCA1-dependent cholesterol acceptor activity of apoA1 in vitro and in vivo. ApoA1 containing a 2-OH-Trp72 group (oxTrp72-apoA1) is in low abundance within the circulation, but accounts for 20% of the apoA1 in atherosclerotic plaque. OxTrp72-apoA1 recovered from human atheroma or plasma was lipid-poor, virtually devoid of cholesterol acceptor activity, and demonstrated both potent pro-inflammatory activities on endothelial cells and impaired HDL biogenesis activity in vivo. Elevated oxTrp72-apoA1 levels in subjects presenting to a cardiology clinic (n=627) were associated with increased cardiovascular disease risk. Circulating oxTrp72-apoA1 levels may serve as a way to monitor a pro-atherogenic process in the artery wall. PMID:24464187

  8. Orthopantomography contribution to prevent isquemic stroke

    PubMed Central

    Chimenos-Küstner, Eduardo; López-López, osé

    2014-01-01

    Objectives: The ortopantomography (OPG) can be a valuable way for an early detection of calcified atheroma plaques, thus contributing for a preliminary stroke risk evaluation. The study looks for the existence of calcified atheroma plates through the use of OPG, comparing the results with the stenosis percentage found through eco-doppler. It has been analyzed the correlation of the number of years as a smoker, arterial hypertension and body mass index, against the risk of having calcified atheroma plaques. Study Design: Observational, transversal and prospective study with 84 patients from the Dental Center of Hospital Particular de Lisboa. First the patients answered to an inquiry and them they were submitted to an OPG and an eco-doppler. Results and Conclusions: It is possible to detect calcified atheroma plaques in the carotid artery through an OPG and patients who have them have got a fifteen fold greater risk of suffering from carotid stenosis. In this study, it has been confirmed the increase in carotid stenosis for long term smokers (OR = 1,033, n=18, 42,9%). The study results show that hypertension patients have a probability 5,426 greater than normal of developing atheroma plaques (with sig=0,049). Amid analyzed patients, the correlation between obesity and the existence of carotid atheroma plaques was significant, although negative (sig=0,047). OPG can help find patients with higher risk of isquemic stroke. Key words:Orthopantomography, Stroke, Carotid disease, Calcified atheroma. PMID:24790711

  9. Deep Crater in Heavily Calcified Aortic Valve Leaflet: A "Smoking Gun" for Embolic Stroke.

    PubMed

    Xu, Sarah Chaoying; Canter, Lisa; Zeeshan, Ahmad; Elefteriades, John A

    2015-10-01

    The association of severe calcific aortic stenosis with clinically significant stroke has not been well established. This case vividly describes the relationship with clinical and pathological (gross and microscopic) findings in a 62-year-old man with a severely calcified bicuspid aortic valve. Eleven months prior to aortic valve surgery, the patient had stigmata of cerebral embolic events in the absence of any other embolic source. During the aortic valve replacement surgery for aortic stenosis, he was found to have a large atheroma on the aortic valve cusp with a crater containing friable debris in its center. These findings support the potential for embolic stroke in patients with severe calcific aortic stenosis. We recommend that the aortic valve be considered as an embolic source in patients with an otherwise cryptogenic cerebrovascular accident. PMID:27175368

  10. Deep Crater in Heavily Calcified Aortic Valve Leaflet: A "Smoking Gun" for Embolic Stroke.

    PubMed

    Xu, Sarah Chaoying; Canter, Lisa; Zeeshan, Ahmad; Elefteriades, John A

    2015-10-01

    The association of severe calcific aortic stenosis with clinically significant stroke has not been well established. This case vividly describes the relationship with clinical and pathological (gross and microscopic) findings in a 62-year-old man with a severely calcified bicuspid aortic valve. Eleven months prior to aortic valve surgery, the patient had stigmata of cerebral embolic events in the absence of any other embolic source. During the aortic valve replacement surgery for aortic stenosis, he was found to have a large atheroma on the aortic valve cusp with a crater containing friable debris in its center. These findings support the potential for embolic stroke in patients with severe calcific aortic stenosis. We recommend that the aortic valve be considered as an embolic source in patients with an otherwise cryptogenic cerebrovascular accident.

  11. Aberrant right subclavian artery and calcified aneurysm of kommerell's diverticulum: an alternative approach

    PubMed Central

    Alvarez, Jose Rubio J; Quiroga, Sierra JL; Nazar, Adrio B; Comendador, Martinez JM; Carro, Garcia J

    2008-01-01

    We report a 72 year-old man with dysphagia and dizziness. Aortography and Computed tomographic scans revealed the aberrant right subclavian artery arising from a calcified aneurysm of the Kommerell's diverticulum and bilateral carotid artery disease with atherosclerotic narrowing. Surgical relief was accomplished by excluding the aneurysm from circulation through the aortic arch and a 10 mm graft was interposed between the aberrant artery and the ascending aorta. PMID:18613969

  12. A pigmented calcifying odontogenic cyst.

    PubMed

    Soames, J V

    1982-04-01

    A case of the pigmented variant of the calcifying odontogenic cyst occurring in a 15-year-old West Indian girl is reported. Melanin pigment was widely distributed and appeared in greatest amount in cells exhibiting the appearance of stellate reticulum. Ultrastructural examination demonstrated large numbers of melanosomes in these cells but relatively few in epithelial ghost cells. The latter contained thick bundles of tonofilaments. Melanocytes were identified and two forms were distinguished, depending on their content of premelanosomes and fully melanized melanosomes.

  13. Uptake of Plasmin-PN-1 Complexes in Early Human Atheroma.

    PubMed

    Boukais, Kamel; Bayles, Richard; Borges, Luciano de Figueiredo; Louedec, Liliane; Boulaftali, Yacine; Ho-Tin-Noé, Benoit; Arocas, Véronique; Bouton, Marie-Christine; Michel, Jean-Baptiste

    2016-01-01

    Zymogens are delivered to the arterial wall by radial transmural convection. Plasminogen can be activated within the arterial wall to produce plasmin, which is involved in evolution of the atherosclerotic plaque. Vascular smooth muscle cells (vSMCs) protect the vessels from proteolytic injury due to atherosclerosis development by highly expressing endocytic LDL receptor-related protein-1 (LRP-1), and by producing anti-proteases, such as Protease Nexin-1 (PN-1). PN-1 is able to form covalent complexes with plasmin. We hypothesized that plasmin-PN-1 complexes could be internalized via LRP-1 by vSMCs during the early stages of human atheroma. LRP-1 is also responsible for the capture of aggregated LDL in human atheroma. Plasmin activity and immunohistochemical analyses of early human atheroma showed that the plasminergic system is activated within the arterial wall, where intimal foam cells, including vSMCs and platelets, are the major sites of PN-1 accumulation. Both PN-1 and LRP-1 are overexpressed in early atheroma at both messenger and protein levels. Cell biology studies demonstrated an increased expression of PN-1 and tissue plasminogen activator by vSMCs in response to LDL. Plasmin-PN-1 complexes are internalized via LRP-1 in vSMCs, whereas plasmin alone is not. Tissue PN-1 interacts with plasmin in early human atheroma via two complementary mechanisms: plasmin inhibition and tissue uptake of plasmin-PN-1 complexes via LRP-1 in vSMCs. Despite this potential protective effect, plasminogen activation by vSMCs remains abnormally elevated in the intima in early stages of human atheroma.

  14. Uptake of Plasmin-PN-1 Complexes in Early Human Atheroma

    PubMed Central

    Boukais, Kamel; Bayles, Richard; Borges, Luciano de Figueiredo; Louedec, Liliane; Boulaftali, Yacine; Ho-Tin-Noé, Benoit; Arocas, Véronique; Bouton, Marie-Christine; Michel, Jean-Baptiste

    2016-01-01

    Zymogens are delivered to the arterial wall by radial transmural convection. Plasminogen can be activated within the arterial wall to produce plasmin, which is involved in evolution of the atherosclerotic plaque. Vascular smooth muscle cells (vSMCs) protect the vessels from proteolytic injury due to atherosclerosis development by highly expressing endocytic LDL receptor-related protein-1 (LRP-1), and by producing anti-proteases, such as Protease Nexin-1 (PN-1). PN-1 is able to form covalent complexes with plasmin. We hypothesized that plasmin-PN-1 complexes could be internalized via LRP-1 by vSMCs during the early stages of human atheroma. LRP-1 is also responsible for the capture of aggregated LDL in human atheroma. Plasmin activity and immunohistochemical analyses of early human atheroma showed that the plasminergic system is activated within the arterial wall, where intimal foam cells, including vSMCs and platelets, are the major sites of PN-1 accumulation. Both PN-1 and LRP-1 are overexpressed in early atheroma at both messenger and protein levels. Cell biology studies demonstrated an increased expression of PN-1 and tissue plasminogen activator by vSMCs in response to LDL. Plasmin-PN-1 complexes are internalized via LRP-1 in vSMCs, whereas plasmin alone is not. Tissue PN-1 interacts with plasmin in early human atheroma via two complementary mechanisms: plasmin inhibition and tissue uptake of plasmin-PN-1 complexes via LRP-1 in vSMCs. Despite this potential protective effect, plasminogen activation by vSMCs remains abnormally elevated in the intima in early stages of human atheroma. PMID:27445860

  15. Uptake of Plasmin-PN-1 Complexes in Early Human Atheroma.

    PubMed

    Boukais, Kamel; Bayles, Richard; Borges, Luciano de Figueiredo; Louedec, Liliane; Boulaftali, Yacine; Ho-Tin-Noé, Benoit; Arocas, Véronique; Bouton, Marie-Christine; Michel, Jean-Baptiste

    2016-01-01

    Zymogens are delivered to the arterial wall by radial transmural convection. Plasminogen can be activated within the arterial wall to produce plasmin, which is involved in evolution of the atherosclerotic plaque. Vascular smooth muscle cells (vSMCs) protect the vessels from proteolytic injury due to atherosclerosis development by highly expressing endocytic LDL receptor-related protein-1 (LRP-1), and by producing anti-proteases, such as Protease Nexin-1 (PN-1). PN-1 is able to form covalent complexes with plasmin. We hypothesized that plasmin-PN-1 complexes could be internalized via LRP-1 by vSMCs during the early stages of human atheroma. LRP-1 is also responsible for the capture of aggregated LDL in human atheroma. Plasmin activity and immunohistochemical analyses of early human atheroma showed that the plasminergic system is activated within the arterial wall, where intimal foam cells, including vSMCs and platelets, are the major sites of PN-1 accumulation. Both PN-1 and LRP-1 are overexpressed in early atheroma at both messenger and protein levels. Cell biology studies demonstrated an increased expression of PN-1 and tissue plasminogen activator by vSMCs in response to LDL. Plasmin-PN-1 complexes are internalized via LRP-1 in vSMCs, whereas plasmin alone is not. Tissue PN-1 interacts with plasmin in early human atheroma via two complementary mechanisms: plasmin inhibition and tissue uptake of plasmin-PN-1 complexes via LRP-1 in vSMCs. Despite this potential protective effect, plasminogen activation by vSMCs remains abnormally elevated in the intima in early stages of human atheroma. PMID:27445860

  16. Association between calcifying nanoparticles and placental calcification

    PubMed Central

    Guo, Yanan; Zhang, Dechun; Lu, He; Luo, Shuang; Shen, Xuecheng

    2012-01-01

    Background The purpose of this study was to examine the possible contribution of calcifying nanoparticles to the pathogenesis of placental calcification. Methods Calcified placental tissues and distal tissue samples were collected from 36 confirmed placental calcification cases. In addition, 20 normal placental tissue samples were obtained as a control group. All the tissue samples were cultured using special nanobacterial culture methods. The cultured calcifying nanoparticles were examined by transmission electron microscopy (TEM), and their growth was monitored by optical density (OD) at a wavelength of 650 nm. 16S rRNA gene expression of the cultured calcifying nanoparticles was also isolated and sequenced. Results Novel calcifying nanoparticles wrapped with electron-dense shells between 50 nm to 500 nm in diameter were observed in the extracellular matrix of calcified placental tissues. They were detected in placental villi and hydroxyapatite crystals, and contained “nucleic acid-like materials”. After isolation and four weeks of culture, 28 of 36 calcified placental tissue samples showed white granular precipitates attached to the bottom of the culture tubes. OD650 measurements indicated that the precipitates from the calcified placental tissues were able to grow in culture, whereas no such precipitates from the control tissues were observed. The 16S rRNA genes were isolated from the cultured calcifying nanoparticles and calcified placental tissues, and their gene sequencing results implied that calcifying nanoparticles were novel nanobacteria (GenBank JF823648). Conclusion Our results suggest that these novel calcifying nanoparticles may play a role in placental calcification. PMID:22615531

  17. Carotid Stent Fracture from Stylocarotid Syndrome

    PubMed Central

    Hooker, Jeffrey D; Joyner, David A; Farley, Edward P; Khan, Majid

    2016-01-01

    Eagle syndrome is a rare condition resulting from elongation of the temporal styloid process or calcification of its associated stylohyoid ligaments. Although usually presenting with pain or odynophagia, Eagle syndrome has been reported to cause a multitude of neurologic symptoms or vascular complications, some of which can be life-threatening. We present a case in which an endovascularly placed internal carotid artery stent in close proximity to a calcified stylohyoid ligament resulted in stent fracture with subsequent stent and vessel occlusion. We review and discuss the presentation, diagnosis, etiology, complications and treatment options of the syndrome. PMID:27761179

  18. Effect of rosiglitazone on progression of atherosclerosis: insights using 3D carotid cardiovascular magnetic resonance

    PubMed Central

    Varghese, Anitha; Yee, Michael S; Chan, Cheuk F; Crowe, Lindsey A; Keenan, Niall G; Johnston, Desmond G; Pennell, Dudley J

    2009-01-01

    Background There is recent evidence suggesting that rosiglitazone increases death from cardiovascular causes. We investigated the direct effect of this drug on atheroma using 3D carotid cardiovascular magnetic resonance. Results A randomized, placebo-controlled, double-blind study was performed to evaluate the effect of rosiglitazone treatment on carotid atherosclerosis in subjects with type 2 diabetes and coexisting vascular disease or hypertension. The primary endpoint of the study was the change from baseline to 52 weeks of carotid arterial wall volume, reflecting plaque burden, as measured by carotid cardiovascular magnetic resonance. Rosiglitazone or placebo was allocated to 28 and 29 patients respectively. Patients were managed to have equivalent glycemic control over the study period, but in fact the rosiglitazone group lowered their HbA1c by 0.88% relative to placebo (P < 0.001). Most patients received a statin or fibrate as lipid control medication (rosiglitazone 78%, controls 83%). Data are presented as mean ± SD. At baseline, the carotid arterial wall volume in the placebo group was 1146 ± 550 mm3 and in the rosiglitazone group was 1354 ± 532 mm3. After 52 weeks, the respective volumes were 1134 ± 523 mm3 and 1348 ± 531 mm3. These changes (-12.1 mm3 and -5.7 mm3 in the placebo and rosiglitazone groups, respectively) were not statistically significant between groups (P = 0.57). Conclusion Treatment with rosiglitazone over 1 year had no effect on progression of carotid atheroma in patients with type 2 diabetes mellitus compared to placebo. PMID:19635160

  19. Magnetic resonance of calcified tissues

    PubMed Central

    Wehrli, Felix W.

    2016-01-01

    MRI of the human body is largely made possible by the favorable relaxation properties of protons of water and triacyl glycerides prevalent in soft tissues. Hard tissues – key among them bone – are generally less amenable to measurement with in vivo MR imaging techniques, not so much as a result of the lower proton density but rather due to the extremely short life-times of the proton signal in water bound to solid-like entities, typically collagen, or being trapped in micro-pores. Either mechanism can enhance T2 relaxation by up to three orders of magnitude relative to their soft-tissue counterparts. Detection of these protons requires solid-state techniques that have emerged in recent years and that promise to add a new dimension to the study of hard tissues. Alternative approaches to probe calcified tissues exploit their characteristic magnetic properties. Bone, teeth and extra-osseous calcium-containing biomaterials are unique in that they are more diamagnetic than all other tissues and thus yield information indirectly by virtue of the induced magnetic fields present in their vicinity. Progress has also been made in methods allowing very high-resolution structural imaging of trabecular and cortical bone relying on detection of the surrounding soft-tissues. This brief review, much of it drawn from work conducted in the author’s laboratory, seeks to highlight opportunities with focus on early-stage developments for image-based assessment of structure, function, physiology and mechanics of calcified tissues in humans via liquid and solid-state approaches, including proton, deuteron and phosphorus NMR and MRI. PMID:23414678

  20. Magnetic resonance of calcified tissues

    NASA Astrophysics Data System (ADS)

    Wehrli, Felix W.

    2013-04-01

    MRI of the human body is largely made possible by the favorable relaxation properties of protons of water and triacyl glycerides prevalent in soft tissues. Hard tissues - key among them bone - are generally less amenable to measurement with in vivo MR imaging techniques, not so much as a result of the lower proton density but rather due to the extremely short life-times of the proton signal in water bound to solid-like entities, typically collagen, or being trapped in micro-pores. Either mechanism can enhance T2 relaxation by up to three orders of magnitude relative to their soft-tissue counterparts. Detection of these protons requires solid-state techniques that have emerged in recent years and that promise to add a new dimension to the study of hard tissues. Alternative approaches to probe calcified tissues exploit their characteristic magnetic properties. Bone, teeth and extra-osseous calcium-containing biomaterials are unique in that they are more diamagnetic than all other tissues and thus yield information indirectly by virtue of the induced magnetic fields present in their vicinity. Progress has also been made in methods allowing very high-resolution structural imaging of trabecular and cortical bone relying on detection of the surrounding soft-tissues. This brief review, much of it drawn from work conducted in the author's laboratory, seeks to highlight opportunities with focus on early-stage developments for image-based assessment of structure, function, physiology and mechanics of calcified tissues in humans via liquid and solid-state approaches, including proton, deuteron and phosphorus NMR and MRI.

  1. Calcifying nanoparticles associated encrusted urinary bladder cystitis

    PubMed Central

    Jelic, Tomislav M; Roque, Rod; Yasar, Uzay; Tomchin, Shayna B; Serrato, Jose M; Deem, Samuel G; Tierney, James P; Chang, Ho-Huang

    2008-01-01

    Encrusted cystitis is a subtype of chronic cystitis characterized by multiple calcifications in the form of plaques located in the interstitium of the urinary bladder mucosa and frequently associated with mucosal ulcers. It is a very rare disease of controversial etiology. Our transmission electron microscopy of the calcified plaques of encrusted cystitis has revealed that the smallest formed particles (elementary units) of these calcifications are electron-dense shells surrounding an electron lucent core, diagnostic of calcifying nanoparticles (previously called nanobacteria). We pioneer the notion that calcifying nanoparticles are the causative agents of encrusted urinary bladder cystitis. PMID:18990947

  2. Calcifying nanoparticles associated encrusted urinary bladder cystitis.

    PubMed

    Jelic, Tomislav M; Roque, Rod; Yasar, Uzay; Tomchin, Shayna B; Serrato, Jose M; Deem, Samuel G; Tierney, James P; Chang, Ho-Huang

    2008-01-01

    Encrusted cystitis is a subtype of chronic cystitis characterized by multiple calcifications in the form of plaques located in the interstitium of the urinary bladder mucosa and frequently associated with mucosal ulcers. It is a very rare disease of controversial etiology. Our transmission electron microscopy of the calcified plaques of encrusted cystitis has revealed that the smallest formed particles (elementary units) of these calcifications are electron-dense shells surrounding an electron lucent core, diagnostic of calcifying nanoparticles (previously called nanobacteria). We pioneer the notion that calcifying nanoparticles are the causative agents of encrusted urinary bladder cystitis. PMID:18990947

  3. Carotid Artery Disease

    MedlinePlus

    ... brain with blood. If you have carotid artery disease, the arteries become narrow, usually because of atherosclerosis. ... one of the causes of stroke. Carotid artery disease often does not cause symptoms, but there are ...

  4. Study on calcifying treatments of hydroxyapatite (HAp) using calcifying promotion solution

    NASA Astrophysics Data System (ADS)

    Wakaki, Moriaki; Yazaki, Syungo; Sunada, Yoshikazu

    2009-02-01

    Apatite is expected to be a useful material for artificial bones in surgery and artificial dental roots in dentistry. In particular, studies have recently been conducted into the reconstruction of teeth using Hydroxyapatite (HAp), and several supplements such as gum have become popular for keeping teeth in good condition. However, the decalcifying and calcifying processes are still not well understood. The aim of this research is to study the decalcifying and calcifying mechanisms of HAp. Specifically, the calcifying treatments were carried out on sintered pellets of HAp without pores using Phosphate Acid Maltodextrin (PMD) and Xylitol calcifying promotion agents. A natural calcifying liquid which simulates the situation within a human mouth was used as a reference. SEM, EDX, X-ray, IR and Raman measurements were used for the characterization of structures, morphologies, formed elements and physical properties. It was confirmed that a precursor material OCP was grown on the HAp pellet by the calcification treatment using each promotion agent.

  5. Detection of disease at the carotid bifurcation using ultrasound including an imaging system1

    PubMed Central

    Lewis, R R; Beasley, M G; Gosling, R G

    1980-01-01

    A two-stage approach is described for the detection of occlusive arterial disease at the carotid bifurcation using continuous wave Doppler-shift ultrasound with spectral analysis of backscattered signals from erythrocytes. The first stage involves analysis of Doppler-shift signals from the supraorbital and common carotid arteries. Abnormal signals from these arteries are frequently caused by the presence of atheroma at the carotid bifurcation and are used to indicate the necessity for imaging the bifurcation. This latter technique produces a physiological image of the arteries, as it depends on detecting erythrocyte velocities beneath a transducer which is guided over the surface of the neck. The investigation has advantages over arteriography in that it is noninvasive, has no attendant risk and may be repeated as often as required. In order to evaluate the accuracy of these methods the results have been compared with x-ray findings in patients undergoing carotid arteriography. In 20 comparisons there were no false positives and one false negative in which the arteriogram showed a small lesion. These results indicate that the two noninvasive methods may be used in sequence to demonstrate operable disease around the carotid junction. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6. PMID:7230199

  6. Improving visualization of intracranial arteries at the skull base for CT angiography with calcified plaques

    NASA Astrophysics Data System (ADS)

    Huang, Adam; Lee, Chung-Wei; Yang, Chung-Yi; Liu, Hon-Man

    2010-03-01

    Bony structures at the skull base were the main obstacle to detection and estimation of arterial stenoses and aneurysms for CT angiography in the brain. Direct subtraction and the matched mask bone elimination (MMBE) have become two standard methods for removing bony structures. However, clinicians regularly find that calcified plaques at or near the carotid canal cannot be removed satisfactorily by existing methods. The blood-plaque boundary tends to be blurred by subtraction operation while plaque size is constantly overestimated by the bone mask dilation operation in the MMBE approach. In this study, we propose using the level of enhancement to adjust the MMBE bone mask more intelligently on the artery- and tissue-bone/plaque boundaries. The original MMBE method is only applied to the tissue-bone boundary voxels; while the artery-bone/blood-plaque boundary voxels, identified by a higher enhancement level, are processed by direct subtraction instead. A dataset of 6 patients (3 scanned with a regular dose and 3 scanned with a reduced dose) with calcified plaques at or near the skull base is used to examine our new method. Preliminary results indicate that the visualization of intracranial arteries with calcified plaques at the skull base can be improved effectively and efficiently.

  7. Transverse Colon Diverticulitis with Calcified Fecalith

    PubMed Central

    Solak, Aynur; Solak, Ilhami; Genç, Berhan; Sahin, Neslin; Yalaz, Seyhan

    2013-01-01

    Left colonic diverticula are common in Western populations, whereas right colonic diverticulosis primarily occurs in Oriental populations. Diverticulitis of the transverse colon is very rare, with very few cases reported in the literature. Herein, we report a case of transverse colon diverticulitis caused by a calcified stone in a 69-year-old female. This was a solitary diverticulum. The signs and symptoms of the disease are similar to acute pancreatitis. To the best of our knowledge, this is the first report describing the MRI findings of a patient with trans-verse colon diverticulitis caused by a calcified stone. PMID:25610254

  8. Nitric oxide pre-treatment enhances atheroma component highlighting in vivo with ICAM-1 targeted echogenic liposomes

    PubMed Central

    Kee, Patrick H.; Kim, Hyunggun; Huang, Shaoling; Laing, Susan T.; Moody, Melanie R.; Vela, Deborah; Klegerman, Melvin E.; McPherson, David D.

    2014-01-01

    We present an ultrasound technique to detect the inflammatory changes in developing atheroma. We used contrast enhanced ultrasound imaging (CEUS) with 1) ICAM-1 targeted microbubbles, a molecule of adhesion involved in the inflammatory processes into the lesions of atheroma in New Zealand White rabbits, 2) a pre-treatment with NO-loaded microbubbles and US activation at the site of the endothelium in order to enhance the permeability of the arterial wall and the penetration of the ICAM-1 targeted microbubbles. Following this procedure, the acoustic enhancement is increased by 1.2 fold. NO-ELIP pretreatment with ultrasound activation can potentially facilitate the subsequent penetration of targeted ELIP into the arterial wall, thus allowing improved detection of inflammatory changes in developing atheroma. PMID:24613216

  9. Nitric oxide pretreatment enhances atheroma component highlighting in vivo with intercellular adhesion molecule-1-targeted echogenic liposomes.

    PubMed

    Kee, Patrick H; Kim, Hyunggun; Huang, Shaoling; Laing, Susan T; Moody, Melanie R; Vela, Deborah; Klegerman, Melvin E; McPherson, David D

    2014-06-01

    We present an ultrasound technique for the detection of inflammatory changes in developing atheromas. We used contrast-enhanced ultrasound imaging with (i) microbubbles targeted to intercellular adhesion molecule-1 (ICAM-1), a molecule of adhesion involved in inflammatory processes in lesions of atheromas in New Zealand White rabbits, and (ii) pretreatment with nitric oxide-loaded microbubbles and ultrasound activation at the site of the endothelium to enhance the permeability of the arterial wall and the penetration of ICAM-1-targeted microbubbles. This procedure increases acoustic enhancement 1.2-fold. Pretreatment with nitric oxide-loaded echogenic liposomes and ultrasound activation can potentially facilitate the subsequent penetration of targeted echogenic liposomes into the arterial wall, thus allowing improved detection of inflammatory changes in developing atheromas.

  10. Carotid labyrinth of amphibians.

    PubMed

    Kusakabe, Tatsumi

    2002-11-01

    The amphibian carotid labyrinth is a characteristic maze-like vascular expansion at the bifurcation of the common carotid artery into the internal and external carotid arteries. The carotid labyrinths of anurans are spherical and those of urodeles are oblong. In the intervascular stroma of both anuran and urodelan carotid labyrinths, the glomus cells (type I cells, chief cells) are distributed singly or in clusters between connective tissue cells and smooth muscle cells. In fluorescence histochemistry, the glomus cells emit intense fluorescence for biogenic monoamines. In fine structure, the glomus cells are characterized by a number of dense-cored vesicles in their cytoplasm. The glomus cells have long, thin cytoplasmic processes, some of which are closely associated with smooth muscle cells, endothelial cells, and pericytes. Afferent, efferent, and reciprocal synapses are found on the glomus cells. The morphogenesis of the carotid labyrinth starts in the larvae at the point where the carotid arch descends to the internal gills. Through the early stages of larval development, the slightly expanded region of the external carotid artery becomes closely connected with the carotid arch. By the end of the foot stage, the expanded region becomes globular, and at the final stage of metamorphosis the carotid labyrinth is close to its adult form. In fine structure, the glomus cells appear as early as the initial stage of larval development. At the middle stages of development, the number of dense-cored vesicles increases remarkably. Distinct afferent synapses are found in juveniles, although efferent synapses can be seen during metamorphosis. The carotid labyrinth is innervated by nerve fibers containing several kinds of regulatory neuropeptides. Double-immunolabeling in combination with a multiple dye filter system demonstrates the coexistence of two different neuropeptides. The amphibian carotid labyrinth has been electrophysiologically confirmed to have arterial chemo

  11. Mathematical modelling of atheroma plaque formation and development in coronary arteries

    PubMed Central

    Cilla, Myriam; Peña, Estefanía; Martínez, Miguel A.

    2014-01-01

    Atherosclerosis is a vascular disease caused by inflammation of the arterial wall, which results in the accumulation of low-density lipoprotein (LDL) cholesterol, monocytes, macrophages and fat-laden foam cells at the place of the inflammation. This process is commonly referred to as plaque formation. The evolution of the atherosclerosis disease, and in particular the influence of wall shear stress on the growth of atherosclerotic plaques, is still a poorly understood phenomenon. This work presents a mathematical model to reproduce atheroma plaque growth in coronary arteries. This model uses the Navier–Stokes equations and Darcy's law for fluid dynamics, convection–diffusion–reaction equations for modelling the mass balance in the lumen and intima, and the Kedem–Katchalsky equations for the interfacial coupling at membranes, i.e. endothelium. The volume flux and the solute flux across the interface between the fluid and the porous domains are governed by a three-pore model. The main species and substances which play a role in early atherosclerosis development have been considered in the model, i.e. LDL, oxidized LDL, monocytes, macrophages, foam cells, smooth muscle cells, cytokines and collagen. Furthermore, experimental data taken from the literature have been used in order to physiologically determine model parameters. The mathematical model has been implemented in a representative axisymmetric geometrical coronary artery model. The results show that the mathematical model is able to qualitatively capture the atheroma plaque development observed in the intima layer. PMID:24196695

  12. Human-derived nanoparticles and vascular response to injury in rabbit carotid arteries: proof of principle.

    PubMed

    Schwartz, Maria A K; Lieske, John C; Kumar, Vivek; Farell-Baril, Gerard; Miller, Virginia M

    2008-01-01

    Self-calcifying, self-replicating nanoparticles have been isolated from calcified human tissues. However, it is unclear if these nanoparticles participate in disease processes. Therefore, this study was designed to preliminarily test the hypothesis that human-derived nanoparticles are causal to arterial disease processes. One carotid artery of 3 kg male rabbits was denuded of endothelium; the contralateral artery remained unoperated as a control. Each rabbit was injected intravenously with either saline, calcified, or decalcified nanoparticles cultured from calcified human arteries or kidney stones. After 35 days, both injured and control arteries were removed for histological examination. Injured arteries from rabbits injected with saline showed minimal, eccentric intimal hyperplasia. Injured arteries from rabbits injected with calcified kidney stone- and arterial-derived nanoparticles occluded, sometimes with canalization. The calcified kidney stone-derived nanoparticles caused calcifications within the occlusion. Responses to injury in rabbits injected with decalcified kidney stone-derived nanoparticles were similar to those observed in saline-injected animals. However, decalcified arterial-derived nanoparticles produced intimal hyperplasia that varied from moderate to occlusion with canalization and calcification. This study offers the first evidence that there may be a causal relationship between human-derived nanoparticles and response to injury including calcification in arteries with damaged endothelium. PMID:18686783

  13. Durability of carotid endarterectomy.

    PubMed

    Baker, W H; Hayes, A C; Mahler, D; Littooy, F N

    1983-07-01

    Carotid endarterectomy is the preferred treatment for patients with transient ischemic attacks and carotid stenosis. Although clinically these patients do well, the long-term fate of the operated carotid artery has not been well documented. To address this question, repeated noninvasive testing has been employed to follow our carotid endarterectomy patients since 1976. Supraorbital Doppler examination, oculoplethysmography-Kartchner, carotid phonoangiography and, later in this series, spectral analysis of the carotid Doppler velocities were performed after 193 endarterectomies. One hundred fifty-eight patients were initially tested within 3 months of operation, and 35 were initially tested 3 or more months after operation. Twenty-four arteries, four of which were symptomatic, had an initial abnormal test and are excluded from this study of carotid artery durability. Of the 169 patients with normal carotid tests, 36 had no further evaluation. Among the 133 patients who returned for serial testing from 1 to 60 months (mean 20 months), 115 carotid arteries continued to test normal at late follow-up but 18 subsequently developed test abnormalities. Ten had more than 75% stenosis, eight had 50% to 75% stenosis. Eight of these patients had contrast studies: three had normal findings; the five that had abnormal findings underwent reoperation. Interestingly, only two patients presented with symptoms appropriate to the abnormal test. The findings suggest that carotid endarterectomy is a reasonably durable operation. Recurrent stenosis was presumed or proven in 10% of 133 serially tested carotid arteries. This threat of restenosis makes long-term follow-up of these patients mandatory.

  14. Calcifying odontogenic cyst with atypical features.

    PubMed

    Balaji, S M; Rooban, Thavarajah

    2012-01-01

    The calcifying odontogenic cyst (COC) was first delineated in 1962. It is a rare developmental odontogenic cyst with notable presence of histopathological features which include a cystic lining demonstrating characteristic "Ghost" epithelial cells with a propensity to calcify. In addition, the COC may be associated with other recognized odontogenic tumors. This gives rise to a spectrum of variants of COC according to clinical, histopathological, and radiological characteristics. Very few reports have actually captured the actual transformation while most reported cases are documents of co-existing lesions. This article presents one such entity, where the asymptomatic presentation misled the diagnosis and on histopathological examination revealed the COC with areas suggestive of adenomatoid odontogenic tumor.

  15. Comparative LIBS Analysis Of Calcified Tissues

    NASA Astrophysics Data System (ADS)

    Abdel-Salam, Z. A.; Harith, M. A.

    2008-09-01

    Signal enhancement, limits of detection, and relevance to environmental concentration for element in calcified tissues using LIBS with single and double laser pulses will be presented. These measurements were performed on three calcified tissues representing different matrices, namely enamel of human teeth, shells and eggshells. This method depends on the role of the laser induced shock wave on the ionization rate of the ablated target material atoms. The effect of the laser single and double pulse on the ionic to atomic ratio of calcium and magnesium spectral emission lines, CaII/CaI and MgII/MgI, will be presented and compared with the previous results and its relevance to the target material hardness. The results show that in case of single pulse the intensity ratios in calcium are higher than the double pulse while there is no appreciable difference between both in case of magnesium.

  16. Comparative LIBS Analysis Of Calcified Tissues

    SciTech Connect

    Abdel-Salam, Z. A.; Harith, M. A.

    2008-09-23

    Signal enhancement, limits of detection, and relevance to environmental concentration for element in calcified tissues using LIBS with single and double laser pulses will be presented. These measurements were performed on three calcified tissues representing different matrices, namely enamel of human teeth, shells and eggshells. This method depends on the role of the laser induced shock wave on the ionization rate of the ablated target material atoms. The effect of the laser single and double pulse on the ionic to atomic ratio of calcium and magnesium spectral emission lines, CaII/CaI and MgII/MgI, will be presented and compared with the previous results and its relevance to the target material hardness. The results show that in case of single pulse the intensity ratios in calcium are higher than the double pulse while there is no appreciable difference between both in case of magnesium.

  17. Micro-CT of Carotid Arteries: A Tool for Experimental Studies

    SciTech Connect

    Mohr, Andreas; Wenke, Ruediger; Roemer, Frank W.; Lynch, John A.; Gatzka, Christian; Priebe, Markus; Guermazi, Ali; Grigorian, Mikayel; Heller, Martin; Mueller-Huelsbeck, Stefan

    2004-11-15

    Micro-computed tomography (micro-CT) is a high-resolution, nondestructive tool for two- and three-dimensional imaging and quantification. The ability of this technique to assess atherosclerosis of the carotid artery was evaluated in three human cadaver samples based on the original axial acquisitions, multiplanar reconstructions and volume rendering techniques. Quantitative analysis included the calculation of: (1) the original lumen perimeter, original lumen area, plaque area, residual lumen area, calcified area and gross sectional area reduction of the vascular lumen from two-dimensional slices; (2) the total tissue volume, soft tissue volume and calcified tissue volume from the three-dimensional data set. This preliminary study demonstrates the potential of micro-CT as a supplementary method for the two- and three-dimensional ex vivo evaluation of carotid atherosclerosis.

  18. Association between Randall's Plaque and Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

    Citfcioglu, Neva; Vejdani, Kaveh; Lee, Olivia; Mathew, Grace; Aho, Katja M.; Kajander, Olavi; McKay, David S.; Jones, Jeffrey A.; Feiveson, Alan H.; Stoller, Marshall L.

    2007-01-01

    Randall initially described calcified subepithelial papillary plaques, which he hypothesized as nidi for kidney stone formation. The discovery of calcifying nanoparticles (CNP) in many calcifying processes of human tissues has raised another hypothesis about their possible involvement in urinary stone formation. This research is the first attempt to investigate the potential association of these two hypotheses. We collected renal papilla and blood samples from 17 human patients who had undergone laparoscopic nephrectomy due to neoplasia. Immunohistochemical staining (IHS) was applied on the tissue samples using monoclonal antibody 8D10 (mAb) against CNP. Homogenized papillary tissues and serum samples were cultured for CNP. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analysis were performed on fixed papillary samples. Randall's plaques were visible on gross inspection in 11 out of 17 collected samples. IHS was positive for CNP antigen in 8 of these 11 visually positive samples, but in only 1 of the remaining 6 samples. SEM revealed spherical apatite formations in 14 samples, all of which had calcium and phosphate peaks detected by EDS analysis. From this study, there was some evidence of a link between the presence of Randall's plaques and the detection of CNP, also referred to as nanobacteria. Although causality was not demonstrated, these results suggest that further studies with negative control samples should be made to explore the etiology of Randall's plaque formation, thus leading to a better understanding of the pathogenesis of stone formation.

  19. Different manifestations of calcifying cystic odontogenic tumor.

    PubMed

    Utumi, Estevam Rubens; Pedron, Irineu Gregnanin; da Silva, Leopoldo Penteado Nucci; Machado, Gustavo Grothe; Rocha, André Caroli

    2012-01-01

    The calcifying cystic odontogenic tumor normally presents as a painless, slow-growing mass, involving both maxilla and mandible, primarily the anterior segment (incisor/canine area). It generally affects young adults in the third to fourth decades, with no gender predilection. Computerized tomography images revealed important characteristics that were not detected by panoramic radiography, such as fenestration, calcification and tooth-like structures. The typical microscopic feature of this lesion is the presence of variable amounts of aberrant epithelial cells, without nuclei, which are named "ghost cells". In addition, dysplastic dentine can be found and occasionally the cyst can be associated with an area of dental hard tissue formation resembling an odontoma. The treatment for calcifying cystic odontogenic tumor involves simple enucleation and curettage. The purpose of this article is to present two different manifestation of calcifying cystic odontogenic tumor in which computerized tomography, associated to clinical features, served as an important tool for diagnosis, adequate surgical planning and follow-up of patients.

  20. Imaging and analysis of microcalcifications and lipid/necrotic core calcification in fibrous cap atheroma.

    PubMed

    Maldonado, Natalia; Kelly-Arnold, Adreanne; Laudier, Damien; Weinbaum, Sheldon; Cardoso, Luis

    2015-06-01

    The presence of microcalcifications (µCalcs) >5 µm within the cap of human fibroatheroma has been shown to produce a 200-700% increase in peak circumferential stress, which can transform a stable plaque into a vulnerable one, whereas µCalcs < 5 µm do not appear to increase risk. We quantitatively examine the possibility to distinguish caps with µCalcs > 5 µm based on the gross morphological features of fibroatheromas, and the correlation between the size and distribution of µCalcs in the cap and the calcification in the lipid/necrotic core beneath it. Atherosclerotic lesions (N = 72) were imaged using HR-μCT at 2.1-μm resolution for detailed analysis of atheroma morphology and composition, and validated using non-decalcified histology. At 2.1-μm resolution one observes four different patterns of calcification within the lipid/necrotic core, and is able to elucidate the 3D spatial progression of the calcification process using these four patterns. Of the gross morphological features identified, only minimum cap thickness positively correlated with the existence of µCalcs > 5 µm in the cap. We also show that µCalcs in the cap accumulate in the vicinity of the lipid/necrotic core boundary with few on the lumen side of the cap. HR-μCT enables three-dimensional assessment of soft tissue composition, lipid content, calcification patterns within lipid/necrotic cores and analysis of the axial progression of calcification within individual atheroma. The distribution of µCalcs within the cap is highly non-uniform and decreases sharply as one proceeds from the lipid pool/necrotic core boundary to the lumen. PMID:25837377

  1. Nitric Oxide Improves Molecular Imaging of Inflammatory Atheroma using Targeted Echogenic Immunoliposomes

    PubMed Central

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

    2013-01-01

    Objective: This study aimed to demonstrate whether pretreatment with nitric oxide (NO) loaded into echogenic immunoliposomes (ELIP) plus ultrasound, applied before injection of molecularly targeted ELIP can promote penetration of the targeted contrast agent and improve visualization of atheroma components. Methods: ELIP were prepared using the pressurization-freeze method. Atherosclerosis was induced in Yucatan miniswine by balloon denudation and a hyperlipidemic diet. The animals were randomized to receive anti-intercellular adhesion molecule-1 (ICAM-1) ELIP or immunoglobulin (IgG)-ELIP, and were subdivided to receive pretreatment with standard ELIP plus ultrasound, NO-loaded ELIP, or NO-loaded ELIP plus ultrasound. Intravascular ultrasound (IVUS) data were collected before and after treatment. Results: Pretreatment with standard ELIP plus ultrasound or NO-loaded ELIP without ultrasound resulted in 9.2 ± 0.7% and 9.2 ± 0.8% increase in mean gray scale values, respectively, compared to baseline (p<0.001 vs. control). Pretreatment with NO-loaded ELIP plus ultrasound activation resulted in a further increase in highlighting with a change in mean gray scale value to 14.7 ± 1.0% compared to baseline (p<0.001 vs. control). These differences were best appreciated when acoustic backscatter data values (RF signal) were used [22.7 ± 2.0% and 22.4 ± 2.2% increase in RF signals for pretreatment with standard ELIP plus ultrasound and NO-loaded ELIP without ultrasound respectively (p<0.001 vs. control), and 40.0 ± 2.9% increase in RF signal for pretreatment with NO-loaded ELIP plus ultrasound (p<0.001 vs. control)]. Conclusion: NO-loaded ELIP plus ultrasound activation can facilitate anti-ICAM-1 conjugated ELIP delivery to inflammatory components in the arterial wall. This NO pretreatment strategy has potential to improve targeted molecular imaging of atheroma for eventual true tailored and personalized management of cardiovascular diseases. PMID:24267236

  2. On the effect of calcification volume and configuration on the mechanical behaviour of carotid plaque tissue.

    PubMed

    Barrett, H E; Cunnane, E M; Kavanagh, E G; Walsh, M T

    2016-03-01

    Vascular calcification is a complex molecular process that exhibits a number of relatively characteristic morphology patterns in atherosclerotic plaques. Treatment of arterial stenosis by endovascular intervention, involving forceful circumferential expansion of the plaque, can be unpredictable in calcified lesions. The aim of this study was to determine the mechanical stretching mechanisms and define the mechanical limits for circumferentially expanding carotid plaque lesions under the influence of distinct calcification patterns. Mechanical and structural characterisation was performed on 17 human carotid plaques acquired from patients undergoing endarterectomy procedures. The mechanical properties were determined using uniaxial extension tests that stretch the lesions to complete failure along their circumferential axis. Calcification morphology of mechanically ruptured plaque lesions was characterised using high resolution micro computed tomography imaging. Scanning electron microscopy was used to examine the mechanically induced failure sites and to identify the interface boundary conditions between calcified and non-calcified tissue. The mechanical tests produced four distinct trends in mechanical behaviour which corresponded to the calcification patterns that structurally defined each mechanical group. Each calcification pattern produced unique mechanical restraining effects on the plaque tissue stretching properties evidenced by the variation in degree of stretch to failure. Resistance to failure appears to rely on interactions between calcification and non-calcified tissue. Scanning electron microscopy examination revealed structural gradations at interface boundary conditions to facilitate the transfer of stress. This study emphasises the mechanical influence of distinct calcification configurations on plaque expansion properties and highlights the importance of pre-operative lesion characterisation to optimise treatment outcomes.

  3. Plaque components affect wall stress in stented human carotid artery: A numerical study

    NASA Astrophysics Data System (ADS)

    Fan, Zhen-Min; Liu, Xiao; Du, Cheng-Fei; Sun, An-Qiang; Zhang, Nan; Fan, Zhan-Ming; Fan, Yu-Bo; Deng, Xiao-Yan

    2016-09-01

    Carotid artery stenting presents challenges of in-stent restenosis and late thrombosis, which are caused primarily by alterations in the mechanical environment of the artery after stent implantation. The present study constructed patient-specific carotid arterial bifurcation models with lipid pools and calcified components based on magnetic resonance imaging. We numerically analyzed the effects of multicomponent plaques on the distributions of von Mises stresses (VMSs) in the patient-specific models after stenting. The results showed that when a stent was deployed, the large soft lipid pool in atherosclerotic plaques cushioned the host artery and reduced the stress within the arterial wall; however, this resulted in a sharp increase of VMS in the fibrous cap. When compared with the lipid pool, the presence of the calcified components led to slightly increased stresses on the luminal surface. However, when a calcification was located close to the luminal surface of the host artery and the stenosis, the local VMS was elevated. Overall, compared with calcified components, large lipid pools severely damaged the host artery after stenting. Furthermore, damage due to the calcified component may depend on location.

  4. Carotid stenting and endarterectomy.

    PubMed

    Yip, Hon-Kan; Sung, Pei-Hsun; Wu, Chiung-Jen; Yu, Cheuk-Man

    2016-07-01

    Stroke, either ischemic or hemorrhagic, remains the second commonest cause of death worldwide in the last decade. Etiologies for ischemic stroke (IS) vary widely. Atherothrombotic occlusion is an essential cause to which carotid artery stenosis (CAS) is a major contributor. Administration of anti-platelet agent to patients with CAS has been shown to reduce incidence of long-term IS. In additional, in patients with symptomatic CAS, clinical trials have demonstrated that carotid endarterectomy (CEA) is superior to medical therapy for prevention of future CAS-related IS. However, CEA is not suitable for CAS post-radiotherapy or those located at higher level of the internal carotid artery; and major complications of this procedure including cranial nerve injuries have stimulated the interest of using percutaneous transfemoral carotid stenting as an alternative approach. Although transfemoral arterial approach of carotid stenting is not inferior to CEA in improving clinical outcomes, it has been reported to be associated with vascular complication and has its limitations in patients with athero-occlusive disease of abdominal aorta or bilateral iliac arteries, level II or III aortic arch, or bovine type carotid arterial anatomy. Therefore, transradial/transbrachial arterial approach has emerged as a novel method for carotid stenting. This article provides a critical review on interventional approaches for the treatment of CAS.

  5. Supraspinatus Intramuscular Calcified Hematoma or Necrosis Associated with Tendon Tear

    PubMed Central

    Lädermann, Alexandre; Genevay, Muriel; Abrassart, Sophie; Schwitzguébel, Adrien Jean-Pierre

    2015-01-01

    Introduction. Rotator cuff intramuscular calcification is a rare condition usually caused by heterotopic ossification and myositis ossificans. Case Presentation. We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear. Histological examination corresponded to a calcified hematoma or necrosis. Patient was surgically managed with open excision of the calcified hematoma and rotator cuff arthroscopic repair. At 6 months, supraspinatus muscle was healed, and functional outcome was good. Discussion and Conclusion. We hypothesized that supraspinatus intramuscular calcified hematoma was responsible for mechanical stress on the tendon. This association has never been described. PMID:26380138

  6. Calcifying species sensitivity distributions for ocean acidification.

    PubMed

    Azevedo, Ligia B; De Schryver, An M; Hendriks, A Jan; Huijbregts, Mark A J

    2015-02-01

    Increasing CO2 atmospheric levels lead to increasing ocean acidification, thereby enhancing calcium carbonate dissolution of calcifying species. We gathered peer-reviewed experimental data on the effects of acidified seawater on calcifying species growth, reproduction, and survival. The data were used to derive species-specific median effective concentrations, i.e., pH50, and pH10, via logistic regression. Subsequently, we developed species sensitivity distributions (SSDs) to assess the potentially affected fraction (PAF) of species exposed to pH declines. Effects on species growth were observed at higher pH than those on species reproduction (mean pH10 was 7.73 vs 7.63 and mean pH50 was 7.28 vs 7.11 for the two life processes, respectively) and the variability in the sensitivity of species increased with increasing number of species available for the PAF (pH10 standard deviation was 0.20, 0.21, and 0.33 for survival, reproduction, and growth, respectively). The SSDs were then applied to two climate change scenarios to estimate the increase in PAF (ΔPAF) by future ocean acidification. In a high CO2 emission scenario, ΔPAF was 3 to 10% (for pH50) and 21 to 32% (for pH10). In a low emission scenario, ΔPAF was 1 to 4% (for pH50) and 7 to 12% (for pH10). Our SSDs developed for the effect of decreasing ocean pH on calcifying marine species assemblages can also be used for comparison with other environmental stressors.

  7. Angioplasty and stent placement - carotid artery

    MedlinePlus

    Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery; Carotid artery stenosis - angioplasty; ... Carotid angioplasty and stenting (CAS) is done using a small surgical cut. Your surgeon will make a surgical cut ...

  8. [Evaluation of carotid stenosis by using carotid ultrasonography].

    PubMed

    Seike, Nahoko; Ito, Michiko; Yasaka, Masahiro

    2010-12-01

    Carotid stenosis is observed in several diseases such as atherosclerosis, moyamoya disease, and aortitis. Carotid stenosis can be assessed using computed tomography (CT), magnetic resonance angiography (MRA), ultrasonography, or cerebral angiography. Carotid ultrasonography is superior to other modalities because it is a noninvasive, repeatable, and easy method that does not involve much cost. The intima-media complex thickness (IMT) can be easily measured using carotid ultrasonography. The incidence of cerebral and cardiovascular events increases with increase in the thickness of the IMT. The percentage of stenosis was expressed using the NASCET, ECST, or area methods. The NASCET criterion of 70% stenosis for performing carotid endarterectomy for symptomatic carotid stenosis corresponded to 85% ECST stenosis, 90% area stenosis, and 200 cm/sec of peak systolic velocity. Carotid ultrasonography provides information on not only carotid stenosis but also unstable plaques such as ulcer, hypoechoic plaque, thin fibrous cap, and mobile plaque. In patients with moyamoya disease, carotid ultrasonography often reveals that the diameter of the internal carotid artery (ICA) is greatly reduced at the proximal portion above the bulbus (resembling a champagne bottle neck) and is less than 50% that of the common carotid artery (champagne bottle neck sign); the diameter of the ICA is smaller than that of the external carotid artery (diameter reversal sign). In patients with aortitis, IMT thickness is frequently observed at the common carotid artery (Macaroni sign) but not at the ICA. PMID:21139180

  9. Computational solution of the velocity and wall shear stress distribution inside a left carotid artery under pulsatile flow conditions

    NASA Astrophysics Data System (ADS)

    Arslan, Nurullah; Turmuş, Hakan

    2014-08-01

    Stroke is still one of the leading causes for death after heart diseases and cancer in all over the world. Strokes happen because an artery that carries blood uphill from the heart to the head is clogged. Most of the time, as with heart attacks, the problem is atherosclerosis, hardening of the arteries, calcified buildup of fatty deposits on the vessel wall. In this study, the fluid dynamic simulations were done in a left carotid bifurcation under the pulsatile flow conditions computationally. Pulsatile flow waveform is given in the paper. In vivo geometry and boundary conditions were obtained from a patient who has stenosis located at external carotid artery (ECA) and internal carotid artery (ICA) of his common carotid artery (CCA). The location of critical flow fields such as low wall shear stress (WSS), stagnation regions and separation regions were detected near the highly stenosed region and at branching region.

  10. Natriuretic Peptide Receptor-C is Up-Regulated in the Intima of Advanced Carotid Artery Atherosclerosis

    PubMed Central

    Zayed, Mohamed A; Harring, Scott D; Abendschein, Dana R; Vemuri, Chandu; Lu, Dongsi; Detering, Lisa; Liu, Yongjian; Woodard, Pamela K

    2016-01-01

    Objective Natriuretic peptide receptor-C (NPR-C/NPR-3) is a cell surface protein involved in vascular remodelling that is up-regulated in atherosclerosis. NPR-C expression has not been well characterized in human carotid artery occlusive lesions. We hypothesized that NPR-C expression correlates with intimal features of vulnerable atherosclerotic carotid artery plaque. Methods To test this hypothesis, we evaluated NPR-C expression by immunohistochemistry (IHC) in carotid endarterectomy (CEA) specimens isolated from 18 patients. The grade, location, and co-localization of NPR-C in CEA specimens were evaluated using two tissue analysis techniques. Results Relative to minimally diseased CEA specimens, we observed avid NPR-C tissue staining in the intima of maximally diseased CEA specimens (65%; p=0.06). Specifically, maximally diseased CEA specimens demonstrated increased NPR-C expression in the superficial intima (61%, p=0.17), and deep intima (138% increase; p=0.05). In the superficial intima, NPR-C expression significantly co-localized with vascular smooth muscle cells (VSMCs) and macrophages. The intensity of NPR-C expression was also higher in the superficial intima plaque shoulder and cap regions, and significantly correlated with atheroma and fibroatheroma vulnerable plaque regions (β=1.04, 95% CI=0.46, 1.64). Conclusion These findings demonstrate significant NPR-C expression in the intima of advanced carotid artery plaques. Furthermore, NPR-C expression was higher in vulnerable carotid plaque intimal regions, and correlate with features of advanced disease. Our findings suggest that NPR-C may serve as a potential biomarker for carotid plaque vulnerability and progression, in patients with advanced carotid artery occlusive disease. PMID:27547837

  11. Calcified right atrial thrombus in HIV infected patient

    PubMed Central

    Mwita, Julius Chacha; Goepamang, Monkgogi; Mkubwa, Jack Joseph; Gunness, Teeluck Kumar; Reebye, Deshmukh; Motumise, Kelebogile

    2013-01-01

    Calcified right atrial thrombi are rare cardiac masses that may be complicated by pulmonary embolism. Although they can be discovered by a transthoracic echocardiography, they may need histological examination to differentiate them from other cardiac masses. We report a case of a 44-year-old woman who presented with a calcified right atrial thrombus and progressive dyspnoea. PMID:23819008

  12. Pulmonary hyalinizing granuloma presenting as multiple cavitary calcified nodules.

    PubMed

    Patel, Y; Ishikawa, S; MacDonnell, K F

    1991-12-01

    We describe a patient with PHG who presented with multiple cavitary calcified nodules. Laboratory evaluations revealed that she had serum immune abnormalities, and a histoplasmin skin test yielded positive results. Her Histoplasma infection may have produced a hyperimmune reaction that resulted in PHG and the calcified nodules. PMID:1720371

  13. Multi-analyte profiling in human carotid atherosclerosis uncovers pro-inflammatory macrophage programming in plaques.

    PubMed

    Shalhoub, Joseph; Viiri, Leena E; Cross, Amanda J; Gregan, Scott M; Allin, David M; Astola, Nagore; Franklin, Ian J; Davies, Alun H; Monaco, Claudia

    2016-05-01

    Molecular characterisation of vulnerable atherosclerosis is necessary for targeting functional imaging and plaque-stabilising therapeutics. Inflammation has been linked to atherogenesis and the development of high-risk plaques. We set to quantify cytokine, chemokine and matrix metalloproteinase (MMP) protein production in cells derived from carotid plaques to map the inflammatory milieu responsible for instability. Carotid endarterectomies from carefully characterised symptomatic (n=35) and asymptomatic (n=32) patients were enzymatically dissociated producing mixed cell type atheroma cell suspensions which were cultured for 24 hours. Supernatants were interrogated for 45 analytes using the Luminex 100 platform. Twenty-nine of the 45 analytes were reproducibly detectable in the majority of donors. The in vitro production of a specific network of mediators was found to be significantly higher in symptomatic than asymptomatic plaques, including: tumour necrosis factor α, interleukin (IL) 1β, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF), CCL5, CCL20, CXCL9, matrix metalloproteinase (MMP)-3 and MMP-9. Ingenuity pathway analysis of differentially expressed analytes between symptomatic and asymptomatic patients identified a number of key biological pathways (p< 10(-25)). In conclusion, the carotid artery plaque culprit of ischaemic neurological symptoms is characterised by an inflammatory milieu favouring inflammatory cell recruitment and pro-inflammatory macrophage polarisation. PMID:26763091

  14. Multi-analyte profiling in human carotid atherosclerosis uncovers pro-inflammatory macrophage programming in plaques.

    PubMed

    Shalhoub, Joseph; Viiri, Leena E; Cross, Amanda J; Gregan, Scott M; Allin, David M; Astola, Nagore; Franklin, Ian J; Davies, Alun H; Monaco, Claudia

    2016-05-01

    Molecular characterisation of vulnerable atherosclerosis is necessary for targeting functional imaging and plaque-stabilising therapeutics. Inflammation has been linked to atherogenesis and the development of high-risk plaques. We set to quantify cytokine, chemokine and matrix metalloproteinase (MMP) protein production in cells derived from carotid plaques to map the inflammatory milieu responsible for instability. Carotid endarterectomies from carefully characterised symptomatic (n=35) and asymptomatic (n=32) patients were enzymatically dissociated producing mixed cell type atheroma cell suspensions which were cultured for 24 hours. Supernatants were interrogated for 45 analytes using the Luminex 100 platform. Twenty-nine of the 45 analytes were reproducibly detectable in the majority of donors. The in vitro production of a specific network of mediators was found to be significantly higher in symptomatic than asymptomatic plaques, including: tumour necrosis factor α, interleukin (IL) 1β, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF), CCL5, CCL20, CXCL9, matrix metalloproteinase (MMP)-3 and MMP-9. Ingenuity pathway analysis of differentially expressed analytes between symptomatic and asymptomatic patients identified a number of key biological pathways (p< 10(-25)). In conclusion, the carotid artery plaque culprit of ischaemic neurological symptoms is characterised by an inflammatory milieu favouring inflammatory cell recruitment and pro-inflammatory macrophage polarisation.

  15. Screening for Carotid Artery Stenosis

    MedlinePlus

    ... Task Force learned about the potential benefits and harms of screening for carotid artery stenosis: Health professionals ... blood flow through the arteries. Potential Benefits and Harms of Carotid Artery Stenosis Screening and Treatment The ...

  16. Impact of medical therapy on atheroma volume measured by different cardiovascular imaging modalities.

    PubMed

    Sinno, Mohamad C N; Al-Mallah, Mouaz

    2010-01-01

    Atherosclerosis is a systemic disease that affects most vascular beds. The gold standard of atherosclerosis imaging has been invasive intravascular ultrasound (IVUS). Newer noninvasive imaging modalities like B-mode ultrasound, cardiac computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) have been used to assess these vascular territories with high accuracy and reproducibility. These imaging modalities have lately been used for the assessment of the atherosclerotic plaque and the response of its volume to several medical therapies used in the treatment of patients with cardiovascular disease. To study the impact of these medications on atheroma volume progression or regression, imaging modalities have been used on a serial basis providing a unique opportunity to monitor the effect these antiatherosclerotic strategies exert on plaque burden. As a result, studies incorporating serial IVUS imaging, quantitative coronary angiography (QCA), B-mode ultrasound, electron beam computed tomography (EBCT), and dynamic contrast-enhanced magnetic resonance imaging have all been used to evaluate the impact of therapeutic strategies that modify cholesterol and blood pressure on the progression/regression of atherosclerotic plaque. In this review, we intend to summarize the impact of different therapies aimed at halting the progression or even result in regression of atherosclerotic cardiovascular disease evaluated by different imaging modalities. PMID:20672024

  17. Exploring the nature of atheroma and cardiovascular inflammation in vivo using positron emission tomography (PET)

    PubMed Central

    2015-01-01

    Positron emission tomography (PET) has become widely established in oncology. Subsequently, a whole new “toolbox” of tracers have become available to look at different aspects of cancer cell function and dysfunction, including cell protein production, DNA synthesis, hypoxia and angiogenesis. In the past 5 years, these tools have been used increasingly to look at the other great killer of the developed world: cardiovascular disease. For example, inflammation of the unstable plaque can be imaged with 18-fludeoxyglucose (18F-FDG), and this uptake can be quantified to show the effect that statins have in reducing inflammation and explains how these drugs can reduce the risk of stroke. 18F-FDG has also become established in diagnosing and monitoring large-vessel vasculitis and has now entered routine practice. Other agents such as gallium-68 (68Ga) octreotide have been shown to identify vascular inflammation possibly more specifically than 18F-FDG. Hypoxia within the plaque can be imaged with 18F-fluoromisonidazole and resulting angiogenesis with 18F-RGD peptides. Active calcification such as that found in unstable atheromatous plaques can be imaged with 18F-NaF. PET imaging enables us to understand the mechanisms by which cardiovascular disease, including atheroma, leads to morbidity and death and thus increases the chance of finding new and effective treatments. PMID:26110339

  18. Impact of Medical Therapy on Atheroma Volume Measured by Different Cardiovascular Imaging Modalities

    PubMed Central

    Sinno, Mohamad C. N.; Al-Mallah, Mouaz

    2010-01-01

    Atherosclerosis is a systemic disease that affects most vascular beds. The gold standard of atherosclerosis imaging has been invasive intravascular ultrasound (IVUS). Newer noninvasive imaging modalities like B-mode ultrasound, cardiac computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) have been used to assess these vascular territories with high accuracy and reproducibility. These imaging modalities have lately been used for the assessment of the atherosclerotic plaque and the response of its volume to several medical therapies used in the treatment of patients with cardiovascular disease. To study the impact of these medications on atheroma volume progression or regression, imaging modalities have been used on a serial basis providing a unique opportunity to monitor the effect these antiatherosclerotic strategies exert on plaque burden. As a result, studies incorporating serial IVUS imaging, quantitative coronary angiography (QCA), B-mode ultrasound, electron beam computed tomography (EBCT), and dynamic contrast-enhanced magnetic resonance imaging have all been used to evaluate the impact of therapeutic strategies that modify cholesterol and blood pressure on the progression/regression of atherosclerotic plaque. In this review, we intend to summarize the impact of different therapies aimed at halting the progression or even result in regression of atherosclerotic cardiovascular disease evaluated by different imaging modalities. PMID:20672024

  19. Association between Randall's Plaque and Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

    Ciftcioglu, Neva; Vejdani, Kaveh; Lee, Olivia; Mathew, Grace; Aho, Katja M.; Kajander, Olavi; McKay, David S.; Jones, Jeff A.; Hayat, Matthew; Stoller, Marshall L.

    2007-01-01

    Randall's plaques, first described by Alexander Randall in the 1930s, are small subepithelial calcifications in the renal papillae (RP) that also extend deeply into the renal medulla. Despite the strong correlation between the presence of these plaques and the formation of renal stones, the precise origin and pathogenesis of Randall s plaque formation remain elusive. The discovery of calcifying nanoparticles (CNP) and their detection in many calcifying processes of human tissues has raised hypotheses about their possible involvement in renal stone formation. We collected RP and blood samples from 17 human patients who had undergone laparoscopic nephrectomy due to neoplasia. Homogenized RP tissues and serum samples were cultured for CNP. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analysis were performed on fixed RP samples. Immunohistochemical staining (IHS) was applied on the tissue samples using CNP-specific monoclonal antibody (mAb). Randall s plaques were visible on gross inspection in 11 out of 17 collected samples. Cultures of all serum samples and 13 tissue homogenates had CNP growth within 4 weeks. SEM revealed spherical apatite formations in 14 samples, with calcium and phosphate peaks detected by EDS analysis. IHS was positive in 9 out of 17 samples. A strong link was found between the presence of Randall s plaques and the detection of CNP, also referred to as nanobacteria. These results suggest new insights into the etiology of Randall's plaque formation, and will help us understand the pathogenesis of stone formation. Further studies on this topic may lead us to new approaches on early diagnosis and novel medical therapies of kidney stone formation.

  20. Formation and diagenesis of modern marine calcified cyanobacteria.

    PubMed

    Planavsky, N; Reid, R P; Lyons, T W; Myshrall, K L; Visscher, P T

    2009-12-01

    Calcified cyanobacterial microfossils are common in carbonate environments through most of the Phanerozoic, but are absent from the marine rock record over the past 65 Myr. There has been long-standing debate on the factors controlling the formation and temporal distribution of these fossils, fostered by the lack of a suitable modern analog. We describe calcified cyanobacteria filaments in a modern marine reef setting at Highborne Cay, Bahamas. Our observations and stable isotope data suggest that initial calcification occurs in living cyanobacteria and is photosynthetically induced. A single variety of cyanobacteria, Dichothrix sp., produces calcified filaments. Adjacent cyanobacterial mats form well-laminated stromatolites, rather than calcified filaments, indicating there can be a strong taxonomic control over the mechanism of microbial calcification. Petrographic analyses indicate that the calcified filaments are degraded during early diagenesis and are not present in well-lithified microbialites. The early diagenetic destruction of calcified filaments at Highborne Cay indicates that the absence of calcified cyanobacteria from periods of the Phanerozoic is likely to be caused by low preservation potential as well as inhibited formation.

  1. Irregularly calcified eggs and eggshells of Caiman latirostris (Alligatoridae: Crocodylia)

    NASA Astrophysics Data System (ADS)

    Fernández, Mariela Soledad; Simoncini, Melina Soledad; Dyke, Gareth

    2013-05-01

    We describe irregularly calcified egg and eggshell morphologies for the first time in nests of the broad-snouted caiman, Caiman latirostris. Research is based on detailed descriptions of 270 eggs from a total sample of 46,800 collected between 2005 and 2011 in Santa Fe Province, Argentina, and encompasses animals from both natural habitats and held in captivity. We discuss possible reasons for the occurrence of eggs with different mineralisation patterns in our extensive C. latirostris field sample and its conservation significance; the chemistry of egg laying in amniotes is sensitive to environmental contamination which, in turn, has biological implications. Based on our egg sample, we identify two caiman eggshell abnormalities: (1) regularly calcified eggs with either calcitic nodules or superficial wrinkles at one egg end and (2) irregularly calcified eggs with structural gaps that weaken the shell. Some recently laid clutches we examined included eggs with most of the shell broken and detached from the flexible membrane. Most type 1 regularly calcified eggs lost their initial calcified nodules during incubation, suggesting that these deposits do not affect embryo survival rates. In contrast, irregularly calcified caiman eggs have a mean hatching success rate of 8.9 % (range 0-38 %) across our sample compared to a mean normal success of 75 %. Most irregularly calcified caiman eggs probably die because of infections caused by fungi and bacteria in the organic nest material, although another possible explanation that merits further investigation could be an increase in permeability, leading to embryo dehydration.

  2. Carotid Artery Disease

    MedlinePlus

    ... and efficacy continues to be studied in several medical centers. This procedure involves the placement of a small flexible tube (catheter) into an artery from the groin. The catheter is then directed to the neck to reach the carotid artery blockage. A balloon pushes open the artery wall and a stent ( ...

  3. Carotid Artery Screening

    MedlinePlus

    ... or radiologist then places the transducer on the skin in various locations, sweeping over the area of interest or angling the sound beam from a different location to better see an area of concern. Doppler sonography and Carotid IMT US are performed using the ...

  4. Increased apolipoprotein E and c-fms gene expression without elevated interleukin 1 or 6 mRNA levels indicates selective activation of macrophage functions in advanced human atheroma.

    PubMed Central

    Salomon, R N; Underwood, R; Doyle, M V; Wang, A; Libby, P

    1992-01-01

    Cells found within atherosclerotic lesions can produce in culture protein mediators that may participate in atherogenesis. To test whether human atheromata actually contain transcripts for certain of these genes, we compared levels of mRNAs in carotid or coronary atheromata and in nonatherosclerotic human vessels by polymerase chain reaction (PCR) amplification of cDNAs reverse-transcribed from RNA. We measured PCR products (generated during exponential amplification) by incorporation of 32P-labeled primers. Levels of interleukin 1 alpha, 1 beta, or 6 mRNAs in plaques and controls did not differ. Compared to uninvolved vessels, plaques did contain higher levels of mRNA encoding platelet-derived growth factor A chain (42 +/- 24 vs. 12 +/- 10 fmol of product; mean +/- SD; n = 8 and 8, respectively; P = 0.007) and B chain (41 +/- 36 vs. 4 +/- 3 fmol of product, n = 14 and 6, respectively; P = 0.024). Atherosclerotic lesions consistently had much higher levels of apolipoprotein E (apoE) mRNA than did control vessels (131 +/- 71 vs. 5 +/- 3 fmol of product; n = 12 and 10, respectively; P less than 0.001). Direct RNA blot analyses confirmed elevated levels of apoE mRNA in plaque extracts. To test whether mononuclear phagocytes might be a source of the apoE mRNA, we studied a selective marker for cells of the monocytic lineage, the c-fms protooncogene, which encodes the receptor for macrophage colony-stimulating factor. Plaques also contained elevated levels of c-fms mRNA (30 +/- 17 vs. 5 +/- 3 fmol of product; n = 10 and 7, respectively; P = 0.002). Immunohistochemical colocalization demonstrated apoE protein in association with macrophages in plaques, whereas nonatherosclerotic vessels showed no immunoreactive apoE. ApoE produced locally in atheroma might modulate the functions of lesional T cells or promote "reverse cholesterol transport" by associating with high density lipoprotein particles, thus targeting them for peripheral uptake. Macrophages within the advanced

  5. Association between Aortic Atheroma and Cerebral Small Vessel Disease in Patients with Ischemic Stroke

    PubMed Central

    Song, Tae-Jin; Kim, Young Dae; Yoo, Joonsang; Kim, Jinkwon; Chang, Hyuk-Jae; Hong, Geu Ru; Shim, Chi Young; Song, Dongbeom; Heo, Ji Hoe; Nam, Hyo Suk

    2016-01-01

    Background and Purpose Cerebral small vessel disease (SVDs) are related with large artery atherosclerosis. However, the association between aortic atheroma (AA) and cerebral small vessel disease has rarely been reported. This study evaluated the relationship between presence and burden of AAs and those of SVDs in patients with acute ischemic stroke. Methods We included 737 consecutive patients who underwent transesophageal echocardiography (TEE) and brain magnetic resonance imaging (MRI) for evaluation of acute stroke. AA subtypes were classified as complex aortic plaque (CAP) and simple aortic plaque (SAP). Presence and burden of SVDs including cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), perivascular spaces (PVSs), asymptomatic lacunar infarctions (ALIs), and total SVD score, were investigated. Results AA was found by TEE in 360 (48.8%) patients including 11.6% with CAP and 37.2% with SAP. One or more types of SVDs was found in 269 (36.4%) patients. In multivariable analysis, presence of CMBs (odds ratio [OR] 4.68), high-grade WMHs (OR 3.13), high-grade PVSs (OR 3.35), and ALIs (OR 4.24) were frequent in patients with AA than those without AA. Each 1-point increase in total SVD score increased the odds of presence of CAP (OR 1.94, 95% confidence interval (CI) 1.44-1.85) and SAP (OR 1.54, 95% CI 1.35-1.75). Conclusions In this study, patients with AA frequently had cerebral SVDs. Larger burden of AA was associated with advanced cerebral SVDs. Our findings give an additional information for positive relationship with systemic atherosclerosis and coexisting cerebral SVDs in acute ischemic stroke patients. PMID:27488980

  6. Impact of baseline lipoprotein and C-reactive protein levels on coronary atheroma regression following high-intensity statin therapy.

    PubMed

    Puri, Rishi; Nissen, Steven E; Shao, Mingyuan; Uno, Kiyoko; Kataoka, Yu; Kapadia, Samir R; Tuzcu, E Murat; Nicholls, Stephen J

    2014-11-15

    Guidelines now recommend high-intensity statin therapy in all patients with proven atherosclerotic disease. Yet the impact of baseline lipoprotein and C-reactive protein (CRP) levels on measures of disease regression to this therapy are unknown. The aim of this study was to test the hypothesis that high-intensity statin therapy causes equivalent degrees of coronary atheroma regression irrespective of baseline lipoprotein and CRP levels. In 8 prospective randomized trials using serial coronary intravascular ultrasound, 1,881 patients who maintained or switched to 18- to 24 months of high-intensity statin therapy (rosuvastatin 40 mg or atorvastatin 80 mg) were stratified according to baseline lipoprotein and CRP levels. Changes in coronary percentage atheroma volume (PAV) and total atheroma volume (TAV) were evaluated. High-intensity statin therapy produced significant reductions from baseline in low-density lipoprotein cholesterol by 38.4%, non-high-density lipoprotein (HDL) cholesterol by 33.6%, triglycerides by 13.1%, and CRP by 33.3%, while increasing HDL cholesterol by 11.7% (p <0.001 for all). This was associated with regression of PAV by 0.7% and of TAV by 8.2 mm(3) (p <0.001 for both). No significant differences of changes in PAV and TAV were observed across baseline quintiles of low-density lipoprotein cholesterol, HDL cholesterol, non-HDL cholesterol, triglycerides, or CRP. Moreover, across all measured lipoproteins and CRP, most patients demonstrated plaque regression (defined as any change from baseline in PAV or TAV <0). In conclusion, high-intensity statin therapy attenuated the natural progression of coronary atherosclerosis in all strata of patients with coronary artery disease irrespective of baseline lipoprotein or CRP levels. These findings provide support for the latest United States guideline recommendations for the broad use of high-intensity statin therapy in all patients with atherosclerosis, regardless of baseline lipid status.

  7. Usefulness of Coronary Atheroma Burden to Predict Cardiovascular Events in Patients Presenting With Acute Coronary Syndromes (from the PROSPECT Study).

    PubMed

    Shan, Peiren; Mintz, Gary S; McPherson, John A; De Bruyne, Bernard; Farhat, Naim Z; Marso, Steven P; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

    2015-12-01

    We investigated the relation between overall atheroma burden and clinical events in the Providing Regional Observations to Study Predictors of Events in the Coronary Tree (PROSPECT) study. In PROSPECT, 660 patients (3,229 nonculprit lesions with a plaque burden ≥ 40% and complete intravascular ultrasound data) were divided into tertiles according to baseline percent atheroma volume (PAV: total plaque/vessel volume). Patients were followed for 3.4 years (median); major adverse cardiac events (MACE: death from cardiac causes, cardiac arrest, myocardial infarction, or rehospitalization because of unstable or progressive angina) were adjudicated to either culprit or nonculprit lesions. Compared with patients in low or intermediate PAV tertiles, patients in the high PAV tertile had the greatest prevalence of plaque rupture and radiofrequency thin-cap fibroatheroma (VH-TCFA) and the highest percentage of necrotic core volume; they were also more likely to have high-risk lesion characteristics: ≥ 1 lesion with minimal luminal area ≤ 4 mm(2), plaque burden >70%, and/or VH-TCFA. Three-year cumulative nonculprit lesion-related MACE was greater in the intermediate and high tertiles than in the low tertile (6.3% vs 14.7% vs 15.1%, low vs intermediate vs high tertiles, p = 0.009). On Cox multivariable analysis, insulin-dependent diabetes (hazard ratio [HR] 3.98, p = 0.002), PAV (HR 1.06, p = 0.03), and the presence of ≥1 VH-TCFA (HR 1.80, p = 0.02) were independent predictors of nonculprit MACE. In conclusion, increasing baseline overall atheroma burden was associated with more advanced, complex, and vulnerable intravascular ultrasound lesion morphology and independently predicted nonculprit lesion-related MACE in patients with acute coronary syndromes after successful culprit lesion intervention.

  8. Food supply confers calcifiers resistance to ocean acidification.

    PubMed

    Ramajo, Laura; Pérez-León, Elia; Hendriks, Iris E; Marbà, Núria; Krause-Jensen, Dorte; Sejr, Mikael K; Blicher, Martin E; Lagos, Nelson A; Olsen, Ylva S; Duarte, Carlos M

    2016-01-01

    Invasion of ocean surface waters by anthropogenic CO2 emitted to the atmosphere is expected to reduce surface seawater pH to 7.8 by the end of this century compromising marine calcifiers. A broad range of biological and mineralogical mechanisms allow marine calcifiers to cope with ocean acidification, however these mechanisms are energetically demanding which affect other biological processes (trade-offs) with important implications for the resilience of the organisms against stressful conditions. Hence, food availability may play a critical role in determining the resistance of calcifiers to OA. Here we show, based on a meta-analysis of existing experimental results assessing the role of food supply in the response of organisms to OA, that food supply consistently confers calcifiers resistance to ocean acidification. PMID:26778520

  9. Food supply confers calcifiers resistance to ocean acidification

    PubMed Central

    Ramajo, Laura; Pérez-León, Elia; Hendriks, Iris E.; Marbà, Núria; Krause-Jensen, Dorte; Sejr, Mikael K.; Blicher, Martin E.; Lagos, Nelson A.; Olsen, Ylva S.; Duarte, Carlos M.

    2016-01-01

    Invasion of ocean surface waters by anthropogenic CO2 emitted to the atmosphere is expected to reduce surface seawater pH to 7.8 by the end of this century compromising marine calcifiers. A broad range of biological and mineralogical mechanisms allow marine calcifiers to cope with ocean acidification, however these mechanisms are energetically demanding which affect other biological processes (trade-offs) with important implications for the resilience of the organisms against stressful conditions. Hence, food availability may play a critical role in determining the resistance of calcifiers to OA. Here we show, based on a meta-analysis of existing experimental results assessing the role of food supply in the response of organisms to OA, that food supply consistently confers calcifiers resistance to ocean acidification. PMID:26778520

  10. Food supply confers calcifiers resistance to ocean acidification.

    PubMed

    Ramajo, Laura; Pérez-León, Elia; Hendriks, Iris E; Marbà, Núria; Krause-Jensen, Dorte; Sejr, Mikael K; Blicher, Martin E; Lagos, Nelson A; Olsen, Ylva S; Duarte, Carlos M

    2016-01-18

    Invasion of ocean surface waters by anthropogenic CO2 emitted to the atmosphere is expected to reduce surface seawater pH to 7.8 by the end of this century compromising marine calcifiers. A broad range of biological and mineralogical mechanisms allow marine calcifiers to cope with ocean acidification, however these mechanisms are energetically demanding which affect other biological processes (trade-offs) with important implications for the resilience of the organisms against stressful conditions. Hence, food availability may play a critical role in determining the resistance of calcifiers to OA. Here we show, based on a meta-analysis of existing experimental results assessing the role of food supply in the response of organisms to OA, that food supply consistently confers calcifiers resistance to ocean acidification.

  11. Multiple calcifying hyperplastic dental follicles: A case report

    PubMed Central

    Aydin, Ulkem; Baykul, Timucin; Yildirim, Benay; Yildirim, Derya; Karaduman, Ayse

    2013-01-01

    This report describes a 31-year-old female patient with six impacted teeth. The crowns of the impacted teeth were surrounded with cyst-like lesions with a mixed internal structure and well-defined cortical borders. Microscopic examination of the specimen obtained from the follicle of the left mandibular third molar tooth revealed loose to moderately dense collagenous connective tissue with abundant calcified material and sparse epithelial islands. A diagnosis of multiple calcifying hyperplastic dental follicles was made. PMID:24380071

  12. Management of Carotid Artery Trauma

    PubMed Central

    Lee, Thomas S.; Ducic, Yadranko; Gordin, Eli; Stroman, David

    2014-01-01

    With increased awareness and liberal screening of trauma patients with identified risk factors, recent case series demonstrate improved early diagnosis of carotid artery trauma before they become problematio. There remains a need for unified screening criteria for both intracranial and extracranial carotid trauma. In the absence of contraindications, antithrombotic agents should be considered in blunt carotid artery injuries, as there is a significant risk of progression of vessel injury with observation alone. Despite CTA being used as a common screening modality, it appears to lack sufficient sensitivity. DSA remains to be the gold standard in screening. Endovascular techniques are becoming more widely accepted as the primary surgical modality in the treatment of blunt extracranial carotid injuries and penetrating/blunt intracranial carotid lessions. Nonetheless, open surgical approaches are still needed for the treatment of penetrating extracranial carotid injuries and in patients with unfavorable lesions for endovascular intervention. PMID:25136406

  13. Carotid body paraganglioma.

    PubMed

    Manzoor, Tahir; Ahmed, Bashir; Najam, Atif; Ayub, Zeeshan

    2009-08-01

    Carotid body tumours are benign neoplasms. This case report describes two patients with this rare tumour with diagnostic workup and treatment options. The first case was a 36-year-old gentleman who presented with 6 months history of painless swelling on the left side of neck. The second patient was 60-years-old man who presented with slowly growing swelling on the right side of neck for the last 20 years. Both patients had transmitted pulsations over the swelling. On suspicion of a vascular lesion, a contrast enhanced CT scan and Doppler's ultrasound of neck was advised which suggested the diagnosis of a carotid body tumour. Magnetic Resonance Angiography (MRA) confirmed the diagnosis. Excision in collaboration with vascular surgeon was planned for the first case. The second case was subjected to radiation therapy due to the large size of tumour and the patient's age.

  14. Carotid Artery Stenting versus Endarterectomy

    PubMed Central

    Gahremanpour, Amir; Perin, Emerson C.; Silva, Guilherme

    2012-01-01

    For about 2 decades, investigators have been comparing carotid endarterectomy with carotid artery stenting in regard to their effectiveness and safety in treating carotid artery stenosis. We conducted a systematic review to summarize and appraise the available evidence provided by randomized trials, meta-analyses, and registries comparing the clinical outcomes of the 2 procedures. We searched the MEDLINE, SciVerse Scopus, and Cochrane databases and the bibliographies of pertinent textbooks and articles to identify these studies. The results of clinical trials and, consequently, the meta-analyses of those trials produced conflicting results regarding the comparative effectiveness and safety of carotid endarterectomy and carotid stenting. These conflicting results arose because of differences in patient population, trial design, outcome measures, and variability among centers in the endovascular devices used and in operator skills. Careful appraisal of the trials and meta-analyses, particularly the most recent and largest National Institutes of Healthsponsored trial (the Carotid Revascularization Endarterectomy vs Stenting Trial [CREST]), showed that carotid stenting and endarterectomy were associated with similar rates of death and disabling stroke. Within the 30-day periprocedural period, carotid stenting was associated with higher risks of stroke, especially for patients aged >70 years, whereas carotid endarterectomy was associated with a higher risk of myocardial infarction. The slightly higher cost of stenting compared with endarterectomy was within an acceptable range by cost-effectiveness standards. We conclude that carotid artery stenting is an equivalent alternative to carotid endarterectomy when patient age and anatomy, surgical risk, and operator experience are considered in the choice of treatment approach. PMID:22949763

  15. Increasing the Spatial Resolution of 3T Carotid MRI Has No Beneficial Effect for Plaque Component Measurement Reproducibility

    PubMed Central

    van Wijk, Diederik F.; Strang, Aart C.; Duivenvoorden, Raphael; Enklaar, Dirk-Jan F.; Zwinderman, Aeilko H.; van der Geest, Rob J.; Kastelein, John J. P.; de Groot, Eric; Stroes, Erik S. G.; Nederveen, Aart J.

    2015-01-01

    Purpose Different in-plane resolutions have been used for carotid 3T MRI. We compared the reproducibility, as well as the within- and between reader variability of high and routinely used spatial resolution in scans of patients with atherosclerotic carotid artery disease. Since no consensus exists about the optimal segmentation method, we analysed all imaging data using two different segmentation methods. Materials and Methods In 31 patient with carotid atherosclerosis a high (0.25 × 0.25 mm2; HR) and routinely used (0.50 × 0.50 mm2; LR) spatial resolution carotid MRI scan were performed within one month. A fully blinded closed and a simultaneously open segmentation were used to quantify the lipid rich necrotic core (LRNC), calcified and loose matrix (LM) plaque area and the fibrous cap (FC) thickness. Results No significant differences were observed between scan-rescan reproducibility for HR versus LR measurements, nor did we find any significant difference between the within-reader and between-reader reproducibility. The same applies for differences between the open and closed reads. All intraclass correlation coefficients between scans and rescans for the LRNC, calcified and LM plaque area, as well as the FC thickness measurements with the open segmentation method were excellent (all above 0.75). Conclusions Increasing the spatial resolution at the expense of the contrast-to-noise ratio does not improve carotid plaque component scan-rescan reproducibility in patients with atherosclerotic carotid disease, nor does using a different segmentation method. PMID:26161783

  16. Carotid barochemoreceptor pathological findings regarding carotid plaque status and aging

    PubMed Central

    Milei, José; Lavezzi, Anna M; Bruni, Barbara; Grana, Daniel R; Azzato, Francisco; Matturri, Luigi

    2009-01-01

    BACKGROUND: Carotid barochemoreceptor pathological lesions have been studied in animals, but few human necropsies have been performed. Therefore, data rely on case patients following surgery, radiotherapy and carotid endarterectomy. Almost no data are available regarding whether the effect of aging prevails over pathological conditions, despite the classic description that glomic fibrosis increases with age. OBJECTIVE: To morphometrically characterize the alterations of the carotid barochemoreceptors and their supplying arteries. METHODS: Patients (n=23) who had suffered and died from stroke, with and without complicated internal carotid atheromatosis, were divided by age (group 1: older than 80 years; group 2: 65 to 80 years; and group 3: younger than 65 years). Carotid segments were obtained at autopsy. The specimens were stained for light microscopy and immunohistochemistry. RESULTS: Carotid glomus presented from moderate-to-severe atrophy and fibrosis. A focal decrease in vascularization (CD34-positive) of the glomus (greater than 50%) was observed in areas of atrophy and fibrosis. Damaged nerve endings (S100 protein-positive) were observed at the media of the carotid sinus. Morphometric data showed no differences between groups for glomus area, number of type 1 and 2 cells, and the wall to lumen arteriole ratio. No statistical differences were demonstrated in the pathological findings of the carotid glomus when comparing complicated with noncomplicated plaques or age groups. CONCLUSION: Severe carotid chemoreceptor damage exists in patients who have died from stroke and suffered from carotid atheromatosis. These findings were independent from aging and plaque type. However, damage was correlated with a marked narrowing of the supplying arterioles as a consequence of hemodynamic and/or metabolic alterations (dyslipidemia, diabetes). PMID:19148350

  17. Carotid chemoreceptor development in mice.

    PubMed

    Shirahata, Machiko; Kostuk, Eric W; Pichard, Luis E

    2013-01-01

    Mice are the most suitable species for understanding genetic aspects of postnatal developments of the carotid body due to the availability of many inbred strains and knockout mice. Our study has shown that the carotid body grows differentially in different mouse strains, indicating the involvement of genes. However, the small size hampers investigating functional development of the carotid body. Hypoxic and/or hyperoxic ventilatory responses have been investigated in newborn mice, but these responses are indirect assessment of the carotid body function. Therefore, we need to develop techniques of measuring carotid chemoreceptor neural activity from young mice. Many studies have taken advantage of the knockout mice to understand chemoreceptor function of the carotid body, but they are not always suitable for addressing postnatal development of the carotid body due to lethality during perinatal periods. Various inbred strains with well-designed experiments will provide useful information regarding genetic mechanisms of the postnatal carotid chemoreceptor development. Also, targeted gene deletion is a critical approach.

  18. Regional calcium distribution and ultrasound images of the vessel wall in human carotid arteries

    NASA Astrophysics Data System (ADS)

    Szikszai, Z.; Kertész, Zs.; Uzonyi, I.; Szíki, G. Á.; Magyar, M. T.; Molnár, S.; Ida, Y.; Csiba, L.

    2005-04-01

    Arterial calcification can take place at two sites in the vessel wall: the intima and the media. Intimal calcification occurs exclusively within atherosclerotic plaques, while medial calcification may develop independently. Extensive calcified plaques in the carotid arteries can be easily detected by B-mode ultrasonic imaging. The calcium content might correlate with the ultrasound reflectance of the vessel wall, and could be a surrogate marker for arteriosclerosis. In this study, segments of human carotid arteries collected at autopsy were examined by ultrasonography in vitro and calcium distributional maps of sections from the same segments were determined by particle induced X-ray emission. Our aim was to make a first step towards investigating the relationship between the calcium distributional maps and the respective ultrasound images.

  19. Carotid revascularization: risks and benefits

    PubMed Central

    O’Brien, Marlene; Chandra, Ankur

    2014-01-01

    Despite a decline during the recent decades in stroke-related death, the incidence of stroke has remained unchanged or slightly increased, and extracranial carotid artery stenosis is implicated in 20%–30% of all strokes. Medical therapy and risk factor modification are first-line therapies for all patients with carotid occlusive disease. Evidence for the treatment of patients with symptomatic carotid stenosis greater than 70% with either carotid artery stenting (CAS) or carotid endarterectomy (CEA) is compelling, and several trials have demonstrated a benefit to carotid revascularization in the symptomatic patient population. Asymptomatic carotid stenosis is more controversial, with the largest trials only demonstrating a 1% per year risk stroke reduction with CEA. Although there are sufficient data to advocate for aggressive medical therapy as the primary mode of treatment for asymptomatic carotid stenosis, there are also data to suggest that certain patient populations will benefit from a stroke risk reduction with carotid revascularization. In the United States, consensus and practice guidelines dictate that CEA is reasonable in patients with high-grade asymptomatic stenosis, a reasonable life expectancy, and perioperative risk of less than 3%. Regarding CAS versus CEA, the best-available evidence demonstrates no difference between the two procedures in early perioperative stroke, myocardial infarction, or death, and no difference in 4-year ipsilateral stroke risk. However, because of the higher perioperative risks of stroke in patients undergoing CAS, particularly in symptomatic, female, or elderly patients, it is difficult to recommend CAS over CEA except in populations with prohibitive cardiac risk, previous carotid surgery, or prior neck radiation. Current treatment paradigms are based on identifying the magnitude of perioperative risk in patient subsets and on using predictive factors to stratify patients with high-risk asymptomatic stenosis. PMID

  20. Carotid Atherosclerotic Disease Predicts Cardiovascular Events in Hemodialysis Patients: A Prospective Study

    PubMed Central

    Nicolau, Carlos; Pons, Mercedes; Cruzado, Josep M

    2015-01-01

    Background To evaluate the predictive value of carotid atherosclerotic disease (CAD) and intima-media thickness (IMT) on incident cardiovascular disease and mortality in hemodialysis patients. Methods Multicenter, observational, prospective study including 110 patients, followed-up to 6 years. Carotid doppler ultrasonographic findings were classified in 4 degrees of severity: 1) IMT <0.9 mm, 2) IMT >0.9 mm, 3) carotid plaque with stenosis <50% and 4) plaque with stenosis >50%. The associations between IMT and CAD and cardiovascular events, total and cardiovascular mortality were assessed. Results 83% of the patients had atherosclerotic plaques (CAD degrees 3-4). During follow-up, 29.1% of patients experienced cardiovascular events, and 28.2% died, 38.7% of cardiovascular origin. The presence of plaques was associated with cardiovascular events (p = 0.03) while calcified plaques were associated with both cardiovascular events (p = 0.01), cardiovascular mortality (p = 0.03) and non-significantly with overall mortality (p = 0.08) in the survival analysis. Carotid IMT was not associated with outcomes. Cardiovascular events correlated with CAD severity (HR 2.27, 95% CI 1.13-4.54), age (HR 1.04, 1.01-1.06), previous cardiovascular disease (HR 1.75, 1.05-4.42), dyslipidemia (HR 2.25, 1.11-4.53), lipoprotein (a) (HR 1.01, 1.00-1.02), troponin I (HR 3.89, 1.07-14.18), fibrinogen levels (HR 1.38, 0.98-1.94) and antiplatelet therapy (HR 2.14, 1.04-4.4). In an age-adjusted multivariate model, cardiovascular events were independently associated with previous coronary artery disease (HR 3.29, 1.52-7.15) and lipoprotein (a) (HR 1.01, 1.00-1.02). Conclusions The presence of carotid plaques and, especially, calcified plaques, are predictors of new cardiovascular events and cardiovascular mortality in hemodialysis patients, while IMT was not. The prognostic value of calcified plaques should be confirmed in future studies. PMID:26029907

  1. Ameloblastomatous Calcifying Cystic Odontogenic Tumour: A Rare Variant

    PubMed Central

    Devaraju, Rama Raju; Duggi, Lakshmi Srujana; Sanjeevareddygari, Shylaja; Potturi, Abhinand

    2015-01-01

    Calcifying Cystic Odontogenic Tumor (CCOT) was previously described by Gorlin et al., in 1962 as Calcifying odontogenic cyst. CCOT is a rare lesion which accounts for 2% of all odontogenic pathological changes in the jaws. One of the variants, Ameloblastomatous proliferating type of CCOT is even more rare and very few cases have been reported in the light of literature review. This case report is an effort to bring forth a case of ameloblastomatous proliferating type of CCOT in a 65 year male, who presented with a painful swelling in the right jaw crossing midline causing facial asymmetry and confirmed by histopathological evaluation. PMID:25954714

  2. Mesenteric calcified cystic lymphangioma in an adult patient.

    PubMed

    Albayrak, Yavuz; Albayrak, Fatih; Arslan, Serdar; Calik, Ilknur

    2011-06-01

    Abdominal cystic lymphangiomas are rare congenital benign malformations of the lymphatic system. To the best of our knowledge, only 6 mesenteric calcified cystic lymphangiomas have ever been reported. We herein describe a woman who presented to our hospital with stomachache that had been continuous for approximately 8 months. An abdominal computed tomography showed a cystic lesion. In the exploration, the cyst was totally excised. Based on the histomorphological data, a case of "calcified cystic lymphangioma" was diagnosed. Although mesenteric lymphangiomas are rare, especially in adults, they should be considered as a possible cause of abdominal pain. Treatment is surgical with resection of the mass, sometimes including resection of adjacent bowel.

  3. Carotid chemoreceptor "resetting" revisited.

    PubMed

    Carroll, John L; Kim, Insook

    2013-01-01

    Carotid body (CB) chemoreceptors transduce low arterial O(2) tension into increased action potential activity on the carotid sinus nerves, which contributes to resting ventilatory drive, increased ventilatory drive in response to hypoxia, arousal responses to hypoxia during sleep, upper airway muscle activity, blood pressure control and sympathetic tone. Their sensitivity to O(2) is low in the newborn and increases during the days or weeks after birth to reach adult levels. This postnatal functional maturation of the CB O(2) response has been termed "resetting" and it occurs in every mammalian species studied to date. The O(2) environment appears to play a key role; the fetus develops in a low O(2) environment throughout gestation and initiation of CB "resetting" after birth is modulated by the large increase in arterial oxygen tension occurring at birth. Although numerous studies have reported age-related changes in various components of the O(2) transduction cascade, how the O(2) environment shapes normal CB prenatal development and postnatal "resetting" remains unknown. Viewing CB "resetting" as environment-driven (developmental) phenotypic plasticity raises important mechanistic questions that have received little attention. This review examines what is known (and not known) about mechanisms of CB functional maturation, with a focus on the role of the O(2) environment.

  4. Carotid Disease Management: Surgery, Stenting, or Medication.

    PubMed

    Khandelwal, Priyank; Chaturvedi, Seemant

    2015-09-01

    Internal carotid artery stenosis accounts for about 7-10 % of ischemic strokes. Conventional risk factors such as aging, hypertension, diabetes mellitus, and smoking increase the risk for carotid atherosclerosis. All patients with carotid stenosis should receive aggressive medical therapy. Carotid revascularization with either endarterectomy or stenting can benefit select patients with severe stenosis. New clinical trials will examine the contemporary role of carotid revascularization relative to optimal medical therapy.

  5. Calcified scleral choristoma in organoid nevus syndrome simulating retinoblastoma.

    PubMed

    Shields, Charlotte Nelle; Shields, Carol L; Lin, Chris J; Menacker, Sheryl J; Shields, Jerry A

    2014-01-14

    A child referred for management of retinoblastoma who alternatively had a calcified scleral choristoma as part of previously undiagnosed organoid nevus syndrome is described. A 31-month-old male infant with scalp alopecia was referred for retinoblastoma management after a calcified mass in his left eye was found. Ophthalmic examination revealed the mass was of choroidal or scleral origin, underlying the retina. The amelanotic circumpapillary mass extended superonasally in a geographic configuration and measured 14×12 mm. There was no subretinal fluid, hemorrhage, feeder vessels, or tumor seeding. Ocular ultrasonography confirmed a homogeneous calcified intraocular mass 3.1 mm in thickness. Enhanced depth imaging optical coherence tomography revealed that the lesion was located within the sclera compressing the overlying choroidal tissue. Further evaluation disclosed cutaneous aplasia cutis congenita with nevus sebaceous of Jadassohn. Magnetic resonance imaging disclosed an arachnoid cyst of the brain. Later, optical coherence tomography revealed the mass to be in the deep choroid or within the sclera. This constellation of ocular, cutaneous, and neurological features were suggestive of organoid nevus syndrome. At the 2-year follow-up, the findings were stable. The calcified choristoma of organoid nevus syndrome, located within the sclera in this case, has distinctive clinical features that differentiate this benign tumor from retinoblastoma.

  6. CALCIFYING TENDINOPATHY: A LOCAL OR A SYSTEMIC CONDITION?

    PubMed Central

    Ejnisman, Benno; Andreoli, Carlos Vicente; Monteiro, Gustavo Cará; Pocchini, Alberto de Castro; Cohen, Carina; Tortato, Simone; Franklin, Marcelo Marques Khede; Machado, Arthur Beber; Cohen, Moisés

    2015-01-01

    Objective: To evaluate the relationship between cases of calcifying tendinopathy of the shoulder and symptomatic metabolic diseases such as kidney stones, gallstones and gout. Methods: Calcifying tendinopathy of the shoulder was diagnosed in 63 patients between May 2007 and September 2011. All the patients were treated by the same orthopedic surgeon and were interviewed to gather the following data: age at diagnosis, sex, affected side, dominant side, body mass index (BMI), smoking status and previous histories of kidney stones, gallstones or gout. For statistical analysis, a control group of 63 patients with similar demographic characteristics was used. Results: Among the 63 patients with calcifying tendinopathy of the shoulder, 35 (56%) were male. The right side was affected in 38 patients (60%) and the average age was 48.2 years. Thirty-one patients (49%) had histories involving some of the metabolic diseases investigated: 20 patients (32%) reported kidney stones, six (9.5%) gallstones, four (6.3%) gout and one (2%) concurrent diagnoses of kidney stones and gout. In the control group, eleven patients (17%) had histories involving some of the metabolic diseases investigated: six patients (9.5%) reported kidney stones, four (6.3%) gallstones and one (1.6 %) gout. Conclusions: The high frequency of nephrolithiasis in patients with calcifying tendinopathy of the shoulder in our study suggests that there are common mechanisms in the pathophysiology of these disorders. Better understanding of these diseases may enable improvement of diagnostics and treatments. PMID:27047854

  7. [About a case of calcifying fibrous tumor of the pleura].

    PubMed

    Rocas, Delphine; Thivolet-Béjui, Françoise; Tronc, François; Chalabreysse, Lara

    2015-12-01

    Calcifying fibrous tumor is a rare soft tissue benign tumor (OMS 2002). Some pleural localisations are described, which affect slightly older individuals than the other soft tissue forms. The calcifying fibrous tumor is included in the 2004 World Health Organization classification of pleural tumors. A pleural tumor located in the right inferior pulmonary lobe is diagnosed in a 59-year-old man. This pleural tumor is macroscopically well-circumscribed. Histologically, the rare spindle tumoral cells are located between bundles of a collagenous tissue, sometimes hyalinized, with psammomatous or dystrophic calcifications. The tumoral cells have a fibrohistiocytic origin. They stain positively for antibodies against vimentin, factor XIIIa, CD68, CD163, CD34. Antibodies against smooth muscle actin, desmin, PS100, ALK1 and EBV are negative. Main differencial diagnoses are other benign pleural tumors (solitary fibrous tumor, inflammatory myofibroblastique tumor), some malignant tumors (desmoplastic malignant pleural mesothelioma) and pleural pseudotumors (calcified pleural plaques, chronic fibrous pleuritis, amylose, hyalinizing granuloma). Our case is the 15th pleural calcifying fibrous tumor being reported. PMID:26608111

  8. [Calcified cerebral embolism as a cause of ischemic stroke].

    PubMed

    Smeeing, Diederik P J; Kappelle, L J Jaap; Hendrikse, Jeroen

    2015-01-01

    A 60-year-old woman with a history of hypertension presented with acute onset of left-sided weakness and drowsiness. Non-contrast CT at baseline and follow-up showed a focal high density lesion in the right middle cerebral artery, consistent with a calcified embolus. CT angiography confirmed its location.

  9. Severely calcified leiomyoma of broad ligament in a postmenopausal woman: Report of a rare case

    PubMed Central

    Pal, Subrata; Mondal, Sajeeb; Mondal, Palash Kr; Raychaudhuri, Gargi; Pradhan, Rajashree; Banerjee, Suparna

    2016-01-01

    Calcified broad ligament leiomyoma is a rare benign lesion in postmenopausal age group. It causes diagnostic confusion with solid calcified adnexal mass and large bladder calculi at the pelvic region. Clinical and radiological diagnoses were confirmed by histopathology of the hysterectomy specimen. We hereby present a case of heavily calcified broad ligament fibroid in a postmenopausal woman. PMID:27721644

  10. Vascular risk factors, large-artery atheroma, and brain white matter hyperintensities

    PubMed Central

    Allerhand, Michael; Doubal, Fergus N.; Valdes Hernandez, Maria; Morris, Zoe; Gow, Alan J.; Bastin, Mark; Starr, John M.; Dennis, Martin S.; Deary, Ian J.

    2014-01-01

    Objective: To determine the magnitude of potentially causal relationships among vascular risk factors (VRFs), large-artery atheromatous disease (LAD), and cerebral white matter hyperintensities (WMH) in 2 prospective cohorts. Methods: We assessed VRFs (history and measured variables), LAD (in carotid, coronary, and leg arteries), and WMH (on structural MRI, visual scores and volume) in: (a) community-dwelling older subjects of the Lothian Birth Cohort 1936, and (b) patients with recent nondisabling stroke. We analyzed correlations, developed structural equation models, and performed mediation analysis to test interrelationships among VRFs, LAD, and WMH. Results: In subjects of the Lothian Birth Cohort 1936 (n = 881, mean age 72.5 years [SD ±0.7 years], 49% with hypertension, 33% with moderate/severe WMH), VRFs explained 70% of the LAD variance but only 1.4% to 2% of WMH variance, of which hypertension explained the most. In stroke patients (n = 257, mean age 74 years [SD ±11.6 years], 61% hypertensive, 43% moderate/severe WMH), VRFs explained only 0.1% of WMH variance. There was no direct association between LAD and WMH in either sample. The results were the same for all WMH measures used. Conclusions: The small effect of VRFs and LAD on WMH suggests that WMH have a large “nonvascular,” nonatheromatous etiology. VRF modification, although important, may be limited in preventing WMH and their stroke and dementia consequences. Investigation of, and interventions against, other suspected small-vessel disease mechanisms should be addressed. PMID:24623838

  11. Advancement in stationary phase for peptide separation helps in protein identification: application to atheroma plaque proteomics using nano-chip liquid chromatography and mass spectrometry.

    PubMed

    Delporte, Cédric; Noyon, Caroline; Raynal, Pierre; Dufour, Damien; Nève, Jean; Abts, Frederic; Haex, Martin; Zouaoui Boudjeltia, Karim; Van Antwerpen, Pierre

    2015-03-13

    In the last decades, proteomics has largely progressed. Mass spectrometry and liquid chromatography (LC) are generally used in proteomics. These techniques enable proper separation of peptides and good identification and/or quantification of them. Later, nano-scaled liquid chromatography, improvements of mass spectrometry resolution and sensitivity brought huge advancements. Enhancements in chemistry of chromatographic columns also brought interesting results. In the present work, the potency of identification of proteins by different nano-chip columns was studied and compared with classical LC column. The present study was applied to cardiovascular field where proteomics has shown to be highly helpful in research of new biomarkers. Protein extracts from atheroma plaques were used and proteomics data were compared. Results show that fewer spectra were acquired by the mass spectrometer when nano-chip columns were used instead of the classical ones. However, approximately 40% more unique peptides were identified by the recently optimized chip named Polaris-HR-chip-3C18 column, and 20% more proteins were identified. This fact leads to the identification of more low-abundance proteins. Many of them are involved in atheroma plaque development such as apolipoproteins, ceruloplasmin, etc. In conclusion, present data shows that recent developments of nanoLC column chemistry and dimensions enabled the improved detection and identification of low-abundance proteins in atheroma plaques. Several of them are of major interest in the field of cardiovascular disease. PMID:25680550

  12. Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure

    PubMed Central

    Arvin, Armita; Darvish, Alireza; Aflaki, Sareh

    2014-01-01

    Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible. PMID:24716000

  13. Treatment of necrotic calcified tooth using intentional replantation procedure.

    PubMed

    Moradi Majd, Nima; Arvin, Armita; Darvish, Alireza; Aflaki, Sareh; Homayouni, Hamed

    2014-01-01

    Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.

  14. Subepidermal calcified nodule in a 7-month-old boy.

    PubMed

    Xu, Yaohui; Petronic-Rosic, Vesna; Stein, Sarah L

    2007-01-01

    A 7-month-old healthy white boy presented for evaluation of a papule on his right ear. His mother reported a small cut-like lesion at this site shortly after birth that had gradually grown over time. The patient was born full term via repeat cesarean section. On physical examination, located on the right superior helix, there was a 5-6 mm, pink, firm papule with a rough scaly surface and peripheral erythema (Figure 1). The lesion was shave excised and sent for histologic analysis. Microscopic examination revealed a defect of the epidermis with underlying fibrin deposits (Figure 2). Subjacent to the ulcer, there was chondroid tissue, granulation tissue with prominent vascularity, and an extensive amount of amorphous calcified material throughout the dermis extending to the base of the specimen (Figure 3). The clinical and pathologic findings were consistent with a subepidermal calcified nodule (SCN), an uncommon idiopathic calcinosis. The lesion was surgically removed with good results.

  15. How Is Carotid Artery Disease Treated?

    MedlinePlus

    ... Links Related Topics Atherosclerosis Carotid Endarterectomy Carotid Ultrasound Stents Stroke Send a link to NHLBI to someone ... outward against the wall of the artery. A stent (a small mesh tube) is then put in ...

  16. Sympathoinhibition and hypotension in carotid sinus hypersensitivity

    NASA Technical Reports Server (NTRS)

    Smith, M. L.; Ellenbogen, K. A.; Eckberg, D. L.

    1992-01-01

    Carotid sinus reflex hypersensitivity is a known cause of syncope in humans. The condition is characterized by cardioinhibition and vasodepression, each to varying degrees. The extent and importance of sympathoinhibition has not been determined in patients with carotid sinus hypersensitivity. This study reports on the extent of sympathoinhibition measured directly directly during carotid massage with and without atrioventricular sequential pacing, in a patient with symptomatic carotid sinus reflex hypersensitivity. Carotid massage elicited asystole, hypotension and complete inhibition of muscle sympathetic nerve activity. Carotid massage during atrioventricular pacing produced similar sympathoinhibition, but with minimal hypotension. Therefore, sympathoinhibition did not contribute importantly to the hypotension during carotid massage in the supine position in this patient. Further investigations are required to elucidate the relation of sympathoinhibition to hypotension in patients with carotid sinus hypersensitivity in the upright position.

  17. Calcified-tissue investigations using synchrotron x-ray microscopy

    SciTech Connect

    Jones, K.W.; Spanne, P.; Schidlovsky, G.; Dejun, X. ); Bockman, R.S. . Medical Coll.); Rabinowitz, M.B. ); Hammond, P.B.; Bornschein, R.L. ); Hoeltzel, D.A. )

    1990-10-01

    Synchrotron x-ray microscopy (SXRM) in both emission and absorption modes has been used to examine elemental distributions in specimens of rat tibia, human deciduous teeth, and an orthopedic implant phantom. The work was performed with a spatial resolution of 8 {mu}m for the emission work and 25 {mu}m for the absorption work. The results illustrate the usefulness of SXRM for measurements of different types of calcified tissue. 3 figs.

  18. CALCIFIED ECTODERMAL COLLAGENS OF SHARK TOOTH ENAMEL AND TELEOST SCALE.

    PubMed

    MOSS, M L; JONES, S J; PIEZ, K A

    1964-08-28

    Amino acid analysis of protein from the enamel of shark teeth and from teleost scales shows the presence of collagens which can be classified chemically as ectodermal. This finding, together with results from a histological examination of the development of these tissues, constitutes strong evidence that both proteins are derived from the ectoderm, like the enamel of higher vertebrates. Since both are calcified, calcification cannot be a specific property of collagens of mesodermal origin alone.

  19. Multimodality Imaging of Carotid Stenosis

    PubMed Central

    Adla, Theodor; Adlova, Radka

    2015-01-01

    Four diagnostic modalities are used to image the following internal carotid artery: digital subtraction angiography (DSA), duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). The aim of this article is to describe the potentials of these techniques and to discuss their advantages and disadvantages. Invasive DSA is still considered the gold standard and is an indivisible part of the carotid stenting procedure. DUS is an inexpensive but operator-dependent tool with limited visibility of the carotid artery course. Conversely, CTA and MRA allow assessment of the carotid artery from the aortic arch to intracranial parts. The disadvantages of CTA are radiation and iodine contrast medium administration. MRA is without radiation but contrast-enhanced MRA is more accurate than noncontrast MRA. The choice of methods depends on the clinical indications and the availability of methods in individual centers. However, the general approach to patient with suspected carotid artery stenosis is to first perform DUS and then other noninvasive methods such as CTA, MRA, or transcranial Doppler US. PMID:26417185

  20. [Cerebral paragonimiasis with peculiar calcified foci: a case report].

    PubMed

    Kinoshita, K; Koga, T

    1986-04-01

    In Japan more than 400 cases of intracranial invasion of Paragonimus westermani have been reported. In recent years, however, because of the decrease of incidence of parasitic disease, erroneous diagnosis is apt to be made. Peculiar but characteristic calcified cystic lesions in chronic stage of cerebral paragonimiasis were described as "soap bubble appearance" in x-rays by Oh in 1968. We report such a case with calcified lesions of soap bubble appearance in plain x-ray films in the right parieto-occipital region. The patient was a 30-year-old man who had generalized convulsive seizures since childhood. CT scan revealed these lesions to have high density in the margin and relatively low density in the center. Recently some cases of cerebral involvement by Paragonimus miyazakii were reported in Japan. The immunoserological tests are most useful for the diagnosis of paragonimiasis. Bithionol administration is the treatment of choice in acute stage. Calcified lesions with positive serological tests in two years after the onset of cerebral signs should be removed surgically, if possible.

  1. ARTHROSCOPIC TREATMENT OF CALCIFYING TENDINITIS OF THE ROTATOR CUFF

    PubMed Central

    Neto, Arnaldo Amado Ferreira; Trevizani, Cassio Silva; Benegas, Eduardo; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emílio Conforto; Bitar, Alexandre Carneiro; Neto, Francisco José dos Santos

    2015-01-01

    To evaluate the clinical and radiographic results from arthroscopic surgical treatment of the rotator cuff in patients with calcifying tendinitis. Method: A retrospective study was conducted on twenty patients who underwent arthroscopic treatment for calcifying tendinitis of the shoulder between March 1999 and November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57%) were female and six (43%) were male. The right side was affected in 10 cases (71%) and the left in four cases (29%). Nine cases (64%) had calcification in the supraspinatus tendon, two (14%) in the infraspinatus tendon, and three (21%) in both tendons. Results: In all cases, resection of the calcium deposits was performed by means of a needle (Jelco® No. 14) in combination with curettage (mini-curette). Two shoulders (14%) underwent subacromial decompression, and one (7%) underwent excision of the distal clavicle. A tendon-tendon suture was performed in three shoulders (21%). None of the patients underwent tendon-bone reinsertion. The mean score obtained on the UCLA scale was 33 points (26-35), thus indicating that a majority of patients had good results. In the final radiographic evaluation, none of the patients showed signs of calcification. Conclusion: Arthroscopic treatment of calcifying tendinitis of the shoulder safely allows excision of the calcification, leading to good results in relation to shoulder pain and function. PMID:27022591

  2. Gastric calcifying fibrous tumor removed by endoscopic submucosal dissection

    PubMed Central

    Ogasawara, Naotaka; Izawa, Shinya; Mizuno, Mari; Tanabe, Atsushi; Ozeki, Tomonori; Noda, Hisatsugu; Takahashi, Emiko; Sasaki, Makoto; Yokoi, Toyoharu; Kasugai, Kunio

    2013-01-01

    The World Health Organization describes calcifying fibrous tumors (CFTs) as rare, benign lesions characterized by hypocellular, densely hyalinized collagenization with lymphoplasmacytic infiltration. These tumors rarely involve the gastrointestinal (GI) tract. A routine endoscopic upper gastrointestinal screen detected a 10-mm submucosal tumor (SMT) in the lesser curvature of the lower corpus of the stomach of an apparently healthy, 37-year-old woman with no history of Helicobacter pylori infection. Endoscopic ultrasonography (EUS) localized the internally isoechoic, homogeneous SMT mainly within the submucosa. Malignancy was ruled out using endoscopic submucosal dissection (ESD). A pathological examination confirmed complete resection of the SMT, and defined a hypocellular, spindle-cell tumor with a densely hyalinized, collagenous matrix, scattered lymphoplasmacytic aggregates as well as a few psammomatous, dystrophic calcified foci. The mass was immunohistochemically positive for vimentin and negative for CD117 (c-kit protein), CD34, desmin, smooth muscle actin (SMA) and S100. Therefore, the histological findings were characteristic of a CFT. To date, CFT resection by ESD has not been described. This is the first case report of a gastric calcifying fibrous tumor being completely resected by ESD after endoscopic ultrasonography. PMID:24044047

  3. Carotid bruits as predictor for carotid stenoses detected by ultrasonography: an observational study

    PubMed Central

    Johansson, Elias P; Wester, Per

    2008-01-01

    Background Carotid surgery in asymptomatic subjects with carotid stenosis is effective to prevent ischemic stroke. There is, however, uncertainty how to find such persons at risk, because mass screening with carotid artery ultrasonography (US) is not cost-effective. Signs of carotid bruits corresponding to the carotid arteries may serve as a tool to select subjects for further investigation. This study is thus aimed at determining the usefulness of carotid bruits in the screening of carotid stenoses. Methods 1555 consecutive carotid ultrasonography investigations from 1486 cases done between January 2004 and March 2006 at Norrlands University Hospital, Sweden, were examined. 356 subjects, medium age 69 (27–88) years, had a significant (≥ 50%) US-verified carotid stenosis uni- or bilaterally, 291 had been examined for signs of carotid bruits. The likelihood ratios for carotid bruits to predict US-verified carotid stenoses were calculated and expressed as likelihood percentages. Results Thirty-one out of 100 persons (31%) with carotid bruit as an indication to perform carotid US had a significant (≥ 50%) carotid stenosis. 281 of the 356 (79%) cases with significant carotid stenoses were found among patients with cerebrovascular disease (CVD). 145 of 226 (64%) CVD patients with a significant carotid stenosis had a carotid bruit. In patients with 50–99% carotid stenoses carotid bruits had an accuracy of 75% (436/582), a sensitivity of 71% (236/334), a specificity of 81% (200/248), a positive likelihood ratio at 3.65 and a negative likelihood at 0.36. Patients with 70–99% stenoses had the highest sensitivity at 77% (183/238). In patients with 100% carotid stenoses, carotid bruits had a sensitivity of 26% (15/57) and a specificity of 49% (256/525). Conclusion Although carotid bruits are not accurate to confirm or to exclude significant carotid stenoses, these signs are appropriate for directed screening for further investigation with carotid US if the patient

  4. Effects of insulin sensitizers on plaque vulnerability associated with elevated lipid content in atheroma in ApoE-knockout mice.

    PubMed

    Cefalu, W T; Wang, Z Q; Schneider, D J; Absher, P M; Baldor, L C; Taatjes, D J; Sobel, B E

    2004-03-01

    Acute coronary syndromes are generally precipitated by rupture of lipid-laden, relatively acellular, vulnerable atherosclerotic plaques with thin fibrous caps. We investigated whether a high-fat diet alters insulin sensitivity and whether insulin sensitizers (troglitazone and rosiglitazone) alter the composition of otherwise lipidladen atherosclerotic plaques in mice deficient in apolipoprotein E (ApoE). ApoE-knockout mice were fed a high-fat (n=30) or standard chow (n=10) diet for two weeks. Thereafter, those fed the high-fat diet were treated with troglitazone (n=10), rosiglitazone (n=10) or no drug (n=10) for 16 weeks beginning at 8 weeks of age. Carbohydrate metabolism was assessed with intraperitoneal glucose tolerance tests and insulin tolerance tests. Plaque composition was characterised with confocal laser scanning microscopy. The high-fat diet induced insulin resistance in the absence of weight gain. Compared with control animals on the high-fat diet, animals given troglitazone (400 mg/kg/day) or rosiglitazone (4 mg/kg/day) had significantly less area under the curve (AUC) for insulin ( p<0.05) and glucose disposal ( p<0.05). Despite significant increases in insulin sensitivity with drug treatment, no change in HDL-cholesterol and triglyceride levels, nor reduction in atheroma size or lipid content was noted. Thus, improvement in insulin resistance induced by a high-fat diet in this animal model of vasculopathy did not alter plaque composition.

  5. Effect of Ocean acidification on growth, calcification and reproduction of calcifying and non-calcifying epibionts of brown algae

    NASA Astrophysics Data System (ADS)

    Saderne, V.; Wahl, M.

    2012-04-01

    Anthropogenic emissions of CO2 are leading to an acidification of the oceans of 0.4 pH units in the course of this century according to the more severe model scenarios. The excess of CO2 could notably affect the benthic communities of calcifiers and macrophytes in different aspects (photosynthesis, respiration and calcification). Seaweeds are one of the key species of nearshore benthic ecosystems of the Baltic Sea. They are the substratum of several fouling epibionts like bryozoans and tubeworms. Most of those species are bearing calcified structures and could therefore be potentially impacted by the seawater pCO2. On the other hand, the biological activity of the host may substantially modulate the pH and pCO2 conditions in the boundary layer where the epibionts live. The aim of the present study was to test the sensitivity of seaweed macrofouling communities to higher pCO2 concentration. Fragments of macroalgae Fucus serratus bearing the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium gelatinosum (Bryozoa) were maintained for 30 days under three pCO2: natural 460 ± 59 µatm and enriched 1193 ± 166 µatm and 3150 ± 446 µatm. Our study showed a significant reduction of growth rates and reproduction of Spirorbis individuals at the highest pCO2. Tubeworms Juveniles exhibited enhanced calcification of 40 % when in the light compare to dark, presumably due to effect of photosynthetic and respiratory activities of the host alga. Electra colonies showed significantly improved growth rates at 1193 µatm. The overall net dissolution of the communities was significantly higher at 3150 µatm. No effect on Alcyonidium colonies growth rates was observed. Those results suggest a remarkable resistance of the algal macro-epibiontic communities to the most elevated pCO2 predicted for 2100 for open ocean (~1000 µatm) conditions. Concerns remains with regards to higher pCO2 possibly found in the future Baltic Sea.

  6. [Radiological study of the internal carotid artery].

    PubMed

    Meder, J F; Brugières, P; Leguen, O

    1993-12-01

    Three radiologic methods are used to investigate the internal carotid artery. The main indication of CT scan is the assessment of brain ischaemic complications of carotid disease. Magnetic resonance imaging allows in addition to detect dissecting hematomas and carotid flow abnormalities. Cerebral angiography, which owes much to the advent of digital techniques, remains the standard examination of internal carotid artery. Complications of angiography although rare and usually benign explain the recent development of less invasive explorations such as dynamic CT scan and magnetic resonance angiography. This latter method is still under evaluation for diagnosis of carotid stenosis and small size aneurysms.

  7. Calcifying cystic odontogenic tumor associated with ameloblastic fibro-odontoma of the anterior mandible.

    PubMed

    Lee, Jun; Song, Young-Gook; Moon, Seong-Yong; Choi, Boyoung; Kim, Bong Chul; Yoon, Jung-Hoon

    2014-05-01

    Calcifying cystic odontogenic tumor, which was formerly named calcifying odontogenic cyst, is a benign odontogenic tumor containing clusters of ghost cells within ameloblastic epithelium. Calcifying cystic odontogenic tumors have been associated with other odontogenic tumors, a finding that is a rare event in other types of odontogenic cysts or tumors. This report describes a case of hybrid odontogenic tumor composed of calcifying cystic odontogenic tumor and ameloblastic fibroma-odontoma of the anterior mandible that occurred in a 4-year-old Korean girl.

  8. Reappraisal of velocity criteria for carotid bulb/internal carotid artery stenosis utilizing high-resolution B-mode ultrasound validated with computed tomography angiography

    PubMed Central

    Shaalan, Wael E.; Wahlgren, Carl M.; Desai, Tina; Piano, Giancarlo; Skelly, Christopher; Bassiouny, Hisham S.

    2012-01-01

    Objective Reliability of the most commonly used duplex ultrasound (DUS) velocity thresholds for internal carotid artery (ICA) stenosis has been questioned since these thresholds were developed using less precise methods to grade stenosis severity based on angiography. In this study, maximum percent diameter carotid bulb ICA stenosis (European Carotid Surgery Trial [ECST] method) was objectively measured using high resolution B-mode DUS validated with computed tomography angiography (CTA) and used to determine optimum velocity thresholds for ≥50% and ≥80% bulb internal carotid artery stenosis (ICA). Methods B-mode DUS and CTA images of 74 bulb ICA stenoses were compared to validate accuracy of the DUS measurements. In 337 mild, moderate, and severe bulb ICA stenoses (n = 232 patients), the minimal residual lumen and the maximum outer bulb/proximal ICA diameter were determined on longitudinal and transverse images. This in contrast to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method using normal distal ICA lumen diameter as the denominator. Severe calcified carotid segments and patients with contralateral occlusion were excluded. In each study, the highest peak systolic (PSV) and end-diastolic (EDV) velocities as well as ICA/common carotid artery (CCA) ratio were recorded. Using receiver operating characteristic (ROC) analysis, the optimum threshold for each hemodynamic parameter was determined to predict ≥50% (n = 281) and ≥80% (n = 62) bulb ICA stenosis. Results Patients mean age was 74 ± 8 years; 49% females. Clinical risk factors for atherosclerosis included coronary artery disease (40%), diabetes mellitus (32%), hypertension (70%), smoking (34%), and hypercholesterolemia (49%). Thirty-three percent of carotid lesions (n = 110) presented with ischemic cerebrovascular symptoms and 67% (n = 227) were asymptomatic. There was an excellent agreement between B-mode DUS and CTA (r = 0.9, P = .002). The inter/intraobserver agreement

  9. [CALCIFYING NANOPARTICLES IN PATHOMORPHOGENESIS OF STRUCTURAL LESIONS OF HEART VALVES].

    PubMed

    Gulyaev, N I; Korovin, A E; Kusay, A S; Nevorotin, A I

    2015-01-01

    Over the last 10 years, calcifying nanoparticles (CNP) have attracted attention as structures detected. together with many other nanostructures in biopsies from patients operated for the correction of aortic valve malformations. The results of the present work performed with the use of high-resolution transmission and scanning electron microscopes agree on the whole with the data of other authors. Some new findings include CNP adhesion to collagen fibers and specifically-shaped, shallow invaginations or craters at their surface. The possible pathophysiological mechanisms that promote involvement of CNP in the development of the disease are considered. PMID:26669035

  10. Calcified amorphous tumor of the left atrial appendage.

    PubMed

    Watanabe, Yusuke; Naganuma, Toru; Nakao, Tatsuya; Nakamura, Sunao

    2016-01-01

    A 57-year-old female with end-stage renal dysfunction was admitted to our hospital. The echocardiogram revealed a 9mm×22mm hyperechoic mass in the left atrial appendage (LAA). The mass was extremely mobile. Considering the high risk of embolic events, we decided on a surgical resection. Microscopic examination of the mass revealed a nodular focus of calcification and fibrosis with focal chronic inflammation of the atrial endocardium. The endocardium was uniformly thickened with no evidence of neoplastic proliferation. The mass was diagnosed with a calcified amorphous tumor (CAT). This is first report of CAT of the LAA. PMID:26964029

  11. Multifocal peritoneal calcifying fibrous tumour: incidental finding at cholecystectomy

    PubMed Central

    Gatt, Noel; Falzon, Sharon; Ratynska, Marzena

    2011-01-01

    Calcifying fibrous tumour (CFT) is a benign tumour of elusive aetiology and a potential for local recurrence. Despite its peculiar histological characteristics it can still be confused with interrelated differential diagnosis like inflammatory myofibroblastic tumour (IMT) or solitary fibrous tumours. The clinical differential diagnosis is however much wider. To date seven cases of multiple peritoneal CFTs are on record. The authors present a case discovered incidentally during laparoscopic cholecystectomy, with no previous history and no radiological diagnosis achieved despite having undergone magnetic resonance cholangiopancreatography (MRCP) and normal routine perioperative investigation. The patient is disease-free 12 months after diagnosis. The case report is followed by a detailed literature review. PMID:22689663

  12. Coronary atheroma composition and its association with segmental endothelial dysfunction in non-ST segment elevation myocardial infarction: novel insights with radiofrequency (iMAP) intravascular ultrasonography.

    PubMed

    Puri, Rishi; Nicholls, Stephen J; Brennan, Danielle M; Andrews, Jordan; Liew, Gary Y; Carbone, Angelo; Copus, Barbara; Nelson, Adam J; Kapadia, Samir R; Tuzcu, E Murat; Beltrame, John F; Worthley, Stephen G; Worthley, Matthew I

    2015-02-01

    Little is known of the relationship between coronary atheroma composition and corresponding endothelial dysfunction. We tested the hypothesis that segmental epicardial vasoreactivity relates to atheroma composition in patients with non-ST segment elevation myocardial infarction (NSTEMI) in vivo. In 23 NSTEMI patients referred for coronary angiography, a non-culprit vessel underwent intracoronary salbutamol (0.30 μg/min) provocation during automated IVUS pullback. A 40 MHz rotational IVUS catheter delivered radiofrequency signals at constant 67 μm intervals via a custom-built IVUS console (iMAP, iLAB, Boston Scientific). Macrovascular response [change in segmental lumen volume (SLV) at baseline and following salbutamol], percent atheroma volume (PAV) and tissue composition was evaluated in 187 contiguous non-overlapping 5 mm coronary segments. Compared with segments that dilated, constrictive segments showed similar SLV, but greater vessel volumes and PAV at baseline. The extent of necrotic and lipidic plaque was significantly greater in constrictive segments, whereas fibrotic plaque content was significantly greater in segments that dilated. Calcific plaque content did not relate to endothelium-dependent vasoreactivity. The change in SLV correlated inversely with the amount of lipidic and necrotic plaque (both r = -0.23, p = 0.002), and directly with fibrotic plaque content (r = 0.23, p = 0.002). In a multivariable model, the extent of both lipidic and necrotic plaque independently associated with segmental vasoconstriction (β = 1.2, p = 0.023; β = 0.66, p = 0.027). Following NSTEMI, both lipidic and necrotic plaque content each associate with segmental endothelial dysfunction. The link between plaque composition and vessel reactivity provides a mechanistic basis of the pathogenesis associated with vulnerable plaque in humans in vivo. PMID:25296909

  13. Effect of Ocean acidification on growth, calcification and recruitment of calcifying and non-calcifying epibionts of brown algae

    NASA Astrophysics Data System (ADS)

    Saderne, V.; Wahl, M.

    2012-03-01

    Anthropogenic emissions of CO2 are leading to an acidification of the oceans by 0.4 pH units in the course of this century according to the more severe model scenarios. The excess of CO2 could notably affect the benthic communities of calcifiers and macrophytes in different aspects (photosynthesis, respiration and calcification). Seaweeds are key species of nearshore benthic ecosystems of the Baltic Sea. They frequently are the substratum of fouling epibionts like bryozoans and tubeworms. Most of those species secrete calcified structures and could therefore be impacted by the seawater pCO2. On the other hand, the biological activity of the host may substantially modulate the pH and pCO2 conditions in the thallus boundary layer where the epibionts live. The aim of the present study was to test the sensitivity of seaweed macrofouling communities to higher pCO2 concentrations. Fragments of the macroalga Fucus serratus bearing the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium gelatinosum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460 ± 59 μatm and enriched 1193 ± 166 μatm and 3150 ± 446 μatm. Our study showed a significant reduction of growth rates and recruitment of Spirorbis individuals only at the highest pCO2. At a finer temporal resolution, the tubeworm recruits exhibited enhanced calcification of 40% during irradiation hours compared to dark hours, presumably due to the effect of photosynthetic and respiratory activities of the host alga on the carbonate system. Electra colonies showed significantly increased growth rates at 1193 μatm. No effect on Alcyonidium colonies growth rates was observed. Those results suggest a remarkable resistance of the algal macro-epibiontic communities to the most elevated pCO2 foreseen in year 2100 for open ocean (~1000 μatm) conditions possibly due to the modulation of environmental conditions by the biological activities of the host

  14. Do blood-borne calcifying nanoparticles self-propagate?

    PubMed Central

    Mathew, Grace; McKay, David S; Çiftçioglu, Neva

    2008-01-01

    The nanotechnology industry is currently in the process of producing new nanoparticles. The biological activity of nanoparticles including adverse as well as beneficial effects tends to increase as their size decreases. The smaller the particles are, the greater their bioactivity and toxicity. Thus, one can easily conjecture the impact of a nanoparticle if it could also self-replicate. This in vitro study reveals the self-propagating ability of unique calcifying nanoparticles (CNP) that can be as small as 50 nm in size and found in blood, blood products, and calcified soft tissues. Although specific detection techniques, morphological characteristics and biomineralizing properties of CNP are well established, their genomic information and self-propagating capability have always been challenged. The objective of this study is to document the propagation of CNP under physiological conditions, using inverted light microscopy (LM) and the Biostation IM time-lapse imaging system. Their detailed morphological structure was examined using scanning (SEM) and transmission (TEM) electron microscopy. This present study, in conjunction with previous findings of metabolic activity, antibiotic sensitivity, antibody specificity, morphological aspects and infectivity, validates CNP as self-replicators. Therefore these sterile-filterable, blood-borne nanoparticles should be of concern to the nanomedicine industry. PMID:18686786

  15. The calcified lung nodule: What does it mean?

    PubMed Central

    Khan, Ali Nawaz; Al-Jahdali, Hamdan H.; Allen, Carolyn M.; Irion, Klaus L.; Al Ghanem, Sarah; Koteyar, Shyam Sunder

    2010-01-01

    The aim of this review is to present a pictorial essay emphasizing the various patterns of calcification in pulmonary nodules (PN) to aid diagnosis and to discuss the differential diagnosis and the pathogenesis where it is known. The imaging evaluation of PN is based on clinical history, size, distribution and the gross appearance of the nodule as well as feasibility of obtaining a tissue diagnosis. Imaging is instrumental in the management of PN and one should strive not only to identify small malignant tumors with high survival rates but to spare patients with benign PN from undergoing unnecessary surgery. The review emphasizes how to achieve these goals. One of the most reliable imaging features of a benign lesion is a benign pattern of calcification and periodic follow-up with computed tomography showing no growth for 2 years. Calcification in PN is generally considered as a pointer toward a possible benign disease. However, as we show here, calcification in PN as a criterion to determine benign nature is fallacious and can be misleading. The differential considerations of a calcified lesion include calcified granuloma, hamartoma, carcinoid, osteosarcoma, chondrosarcoma and lung metastases or a primary bronchogenic carcinoma among others. We describe and illustrate different patterns of calcification as seen in PN on imaging. PMID:20582171

  16. Surgical Management of Calcified Hydatid Cysts of the Liver

    PubMed Central

    Tzardinoglou, E.; Kosmidis, Ch.; Katsohis, K.; Aletras, O.

    1999-01-01

    Hydatid disease of the liver is still a major cause of morbidity in Greece. Beside the common complications of rupture and suppuration, calcification of the hepatic cysts represent a not well studied, less frequent and sometimes difficult surgical problem. In the present study 75 cases with calcified symptomatic liver echinococcosis were operated on in the 1st Propedeutic Surgical Clinic between 1964 to 1996. Twenty-eight patients were male and 47 female with ages from 23 to 78 years. The diagnosis was based mainly on the clinical picture and radiological studies. In 5 cases the operative method was cystopericystectomy. We performed evacuation of the cystic cavity and partial pericystectomy and primary closure of the residual cavity in 6 cases, omentoplasty or filling of the residual cavity with a piece of muscle of the diaphragm in 4 cases and external drainage by closed tube, in 60 cases. In 12 of those with drainage, after a period of time, a second operation with easy, removal of most of the calcareous wall plaques was performed. The mortality rate was 2%. Our results could be considered satisfactory. In the calcified parasitic cysts of the liver the proposed technique is cystopericystectomy. An alternative procedure is pericystectomy and drainage with a “planned” reoperation with a bloodless, due to intervening inflammation, chiseling of the calcification. PMID:10468117

  17. Do blood-borne calcifying nanoparticles self-propagate?

    PubMed

    Mathew, Grace; Mckay, David S; Ciftçioglu, Neva

    2008-01-01

    The nanotechnology industry is currently in the process of producing new nanoparticles. The biological activity of nanoparticles including adverse as well as beneficial effects tends to increase as their size decreases. The smaller the particles are, the greater their bioactivity and toxicity. Thus, one can easily conjecture the impact ofa nanoparticle if it could also self-replicate. This in vitro study reveals the self-propagating ability of unique calcifying nanoparticles (CNP) that can be as small as 50 nm in size and found in blood, blood products, and calcified soft tissues. Although specific detection techniques, morphological characteristics and biomineralizing properties of CNP are well established, their genomic information and self-propagating capability have always been challenged. The objective of this study is to document the propagation of CNP under physiological conditions, using inverted light microscopy (LM) and the Biostation IM time-lapse imaging system. Their detailed morphological structure was examined using scanning (SEM) and transmission (TEM) electron microscopy. This present study, in conjunction with previous findings of metabolic activity, antibiotic sensitivity, antibody specificity, morphological aspects and infectivity, validates CNP as self-replicators. Therefore these sterile-filterable, blood-borne nanoparticles should be of concern to the nanomedicine industry. PMID:18686786

  18. Spontaneous internal carotid artery dissection.

    PubMed

    Khimenko, L P; Esham, H R; Ahmed, W

    2000-10-01

    Once considered uncommon, spontaneous dissection of the carotid artery is an increasingly recognized cause of stroke, headache, cranial nerve palsy, or ophthalmologic events, especially in young adults. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced physicians of all specialties. We report a case of spontaneous internal carotid artery dissection in a 38-year-old woman with a cortical stroke and visual disturbances as initial symptoms. The diagnosis was confirmed by magnetic resonance imaging/angiography and by angiography. Prompt anticoagulation was instituted, and the patient had complete resolution of symptoms. Cervicocephalic arterial dissection should be included in the differential diagnosis of the causes of cerebrovascular events.

  19. Carotid artery stenting: current and emerging options

    PubMed Central

    Morr, Simon; Lin, Ning; Siddiqui, Adnan H

    2014-01-01

    Carotid artery stenting technologies are rapidly evolving. Options for endovascular surgeons and interventionists who treat occlusive carotid disease continue to expand. We here present an update and overview of carotid stenting devices. Evidence supporting carotid stenting includes randomized controlled trials that compare endovascular stenting to open surgical endarterectomy. Carotid technologies addressed include the carotid stents themselves as well as adjunct neuroprotective devices. Aspects of stent technology include bare-metal versus covered stents, stent tapering, and free-cell area. Drug-eluting and cutting balloon indications are described. Embolization protection options and new direct carotid access strategies are reviewed. Adjunct technologies, such as intravascular ultrasound imaging and risk stratification algorithms, are discussed. Bare-metal and covered stents provide unique advantages and disadvantages. Stent tapering may allow for a more fitted contour to the caliber decrement between the common carotid and internal carotid arteries but also introduces new technical challenges. Studies regarding free-cell area are conflicting with respect to benefits and associated risk; clinical relevance of associated adverse effects associated with either type is unclear. Embolization protection strategies include distal filter protection and flow reversal. Though flow reversal was initially met with some skepticism, it has gained wider acceptance and may provide the advantage of not crossing the carotid lesion before protection is established. New direct carotid access techniques address difficult anatomy and incorporate sophisticated flow-reversal embolization protection techniques. Carotid stenting is a new and exciting field with rapidly advancing technologies. Embolization protection, low-risk deployment, and lesion assessment and stratification are active areas of research. Ample room remains for further innovations and developments. PMID:25349483

  20. Carotid endarterectomy: current consensus and controversies.

    PubMed

    Meerwaldt, Robbert; Hermus, Linda; Reijnen, Michel M P J; Zeebregts, Clark J

    2010-10-01

    Stroke is the third most common cause of mortality, and carotid artery stenosis causes 8% to 29% of all ischemic strokes. Best medical treatment forms the basis of carotid stenosis treatment, and carotid endarterectomy (CEA) has an additional beneficial effect in high-grade stenosis. Carotid angioplasty and stenting (CAS) has challenged CEA as a primary carotid intervention. At present, CEA remains the gold standard, but in the future, CAS techniques will evolve and might become beneficial for subgroups of patients with carotid stenosis. This chapter briefly describes the history of carotid interventions and current consensus and controversies in CEA. In the last two years, several meta-analyses were published on a variety of aspects of best medical treatment, CEA, and CAS. It is still a matter of debate as to whether asymptomatic patients with carotid stenosis should undergo a carotid intervention. Especially because medical treatment has dramatically evolved since the early carotid trials. On the other hand, it is clear that carotid interventions in symptomatic patients with a high-grade stenosis should be performed as early as possible after the initial neurological event in order to achieve optimal stroke risk reduction. In CEA, the use of patching is advocated above primary closure, while the role of selective patching is still unclear. No differences in stroke and mortality rates are observed for routine versus selective shunting, for conventional versus eversion CEA, or for local versus general anesthesia. It is anticipated that in the future, there will be several interesting developments in carotid interventions such as plaque morphology analysis, acute interventions during stroke in progress, and further evolvement of CAS techniques. PMID:21082576

  1. Carotid endarterectomy: current consensus and controversies.

    PubMed

    Meerwaldt, Robbert; Hermus, Linda; Reijnen, Michel M P J; Zeebregts, Clark J

    2010-10-01

    Stroke is the third most common cause of mortality, and carotid artery stenosis causes 8% to 29% of all ischemic strokes. Best medical treatment forms the basis of carotid stenosis treatment, and carotid endarterectomy (CEA) has an additional beneficial effect in high-grade stenosis. Carotid angioplasty and stenting (CAS) has challenged CEA as a primary carotid intervention. At present, CEA remains the gold standard, but in the future, CAS techniques will evolve and might become beneficial for subgroups of patients with carotid stenosis. This chapter briefly describes the history of carotid interventions and current consensus and controversies in CEA. In the last two years, several meta-analyses were published on a variety of aspects of best medical treatment, CEA, and CAS. It is still a matter of debate as to whether asymptomatic patients with carotid stenosis should undergo a carotid intervention. Especially because medical treatment has dramatically evolved since the early carotid trials. On the other hand, it is clear that carotid interventions in symptomatic patients with a high-grade stenosis should be performed as early as possible after the initial neurological event in order to achieve optimal stroke risk reduction. In CEA, the use of patching is advocated above primary closure, while the role of selective patching is still unclear. No differences in stroke and mortality rates are observed for routine versus selective shunting, for conventional versus eversion CEA, or for local versus general anesthesia. It is anticipated that in the future, there will be several interesting developments in carotid interventions such as plaque morphology analysis, acute interventions during stroke in progress, and further evolvement of CAS techniques.

  2. Carotid Stump Syndrome: Pathophysiology and Endovascular Treatment Options

    SciTech Connect

    Lakshminarayan, Raghuram; Scott, Paul M.; Robinson, Graham J.; Ettles, Duncan F.

    2011-02-15

    Carotid stump syndrome is one of the recognised causes of recurrent ipsilateral cerebrovascular events after occlusion of the internal carotid artery. It is believed that microemboli arising from the stump of the occluded internal carotid artery or the ipsilateral external carotid artery can pass into the middle cerebral artery circulation as a result of patent external carotid-internal carotid anastomotic channels. Different pathophysiologic causes of this syndrome and endovascular options for treatment are discussed.

  3. Quantification of carotid vessel atherosclerosis

    NASA Astrophysics Data System (ADS)

    Chiu, Bernard; Egger, Micaela; Spence, J. D.; Parraga, Grace; Fenster, Aaron

    2006-03-01

    Atherosclerosis is characterized by the development of plaques in the arterial wall, which ultimately leads to heart attacks and stroke. 3D ultrasound (US) has been used to screen patients' carotid arteries. Plaque measurements obtained from these images may aid in the management and monitoring of patients, and in evaluating the effect of new treatment options. Different types of measures for ultrasound phenotypes of atherosclerosis have been proposed. Here, we report on the development and application of a method used to analyze changes in carotid plaque morphology from 3D US images obtained at two different time points. We evaluated our technique using manual segmentations of the wall and lumen of the carotid artery from images acquired in two US scanning sessions. To incorporate the effect of intraobserver variability in our evaluation, manual segmentation was performed five times each for the arterial wall and lumen. From this set of five segmentations, the mean wall and lumen surfaces were reconstructed, with the standard deviation at each point mapped onto the surfaces. A correspondence map between the mean wall and lumen surfaces was then established, and the thickness of the atherosclerotic plaque at each point in the vessel was estimated to be the distance between each correspondence pairs. The two-sample Student's t-test was used to judge whether the difference between the thickness values at each pair corresponding points of the arteries in the two 3D US images was statistically significant.

  4. Smooth muscle cells in human atherosclerosis: proteomic profiling reveals differences in expression of Annexin A1 and mitochondrial proteins in carotid disease.

    PubMed

    Viiri, Leena E; Full, Louise E; Navin, Tina J; Begum, Shajna; Didangelos, Athanasios; Astola, Nagore; Berge, Rolf K; Seppälä, Ilkka; Shalhoub, Joseph; Franklin, Ian J; Perretti, Mauro; Lehtimäki, Terho; Davies, Alun H; Wait, Robin; Monaco, Claudia

    2013-01-01

    Smooth muscle cells (SMC) contribute to the development and stability of atherosclerotic lesions. The molecular mechanisms that mediate their properties are incompletely defined. We employed proteomics and in vitro functional assays to identify the unique characteristics of intimal SMC isolated from human carotid endarterectomy specimens and medial SMC from thoracic aortas and carotids. We verified our findings in the Tampere Vascular Study. Human atheroma-derived SMC exhibit decreased expression of mitochondrial proteins ATP Synthase subunit-beta and Aldehyde dehydrogenase 2, and decreased mitochondrial activity when compared to control SMC. Moreover, a comparison between plaque-derived SMC isolated from patients with or without recent acute cerebrovascular symptoms uncovered an increase in Annexin A1, an endogenous anti-inflammatory protein, in the asymptomatic group. The deletion of Annexin A1 or the blockade of its signaling in SMC resulted in increased cytokine production at baseline and after stimulation with the pro-inflammatory cytokine Tumor Necrosis Factor α. In summary, our proteomics and biochemical analysis revealed mitochondrial damage in human plaque-derived SMC as well as a role of Annexin A1 in reducing the production of pro-inflammatory mediators in SMC.

  5. Risk Factors and Complications Associated with Difficult Retrieval of Embolic Protection Devices in Carotid Artery Stenting

    SciTech Connect

    Lian Xuegan; Liu Wenhua; Li Min; Lin Min; Zhu Shuanggen; Sun Wen; Yin Qin; Xu Gelin; Zhang Renliang; Liu Xinfeng

    2012-02-15

    Purpose: This study was designed to investigate the risk factors and complications of difficult retrieval (DR) of embolic protection devices (EPDs) in carotid artery stenting (CAS). Methods: A total of 195 consecutive patients who underwent CAS between December 2007 and March 2010 in a general hospital were enrolled and divided into two groups: with DR and without DR. The risk factors of DR were analyzed with univariate and multivariate analyses. The complications of DR were recorded and analyzed. Results: A total of 30 (15.4%) patients with DR of EPDs were observed, of whom EPDs were successfully retrieved in 29, and in 1 was it taken out by surgical treatment. The retrieval time was significantly longer in patients with DR (490.5 {+-} 143.9 s) than in patients without DR (157.2 {+-} 15.7 s, p = 0.000). Vasospasm was observed more frequently in patients with DR than in patients without DR (55.2% vs. 14.5%, p = 0.000). Intracranial compilations were more frequent in patients with DR than in those without DR (17.2% vs. 0.6%, p = 0.000). Calcified plaques, degree of residual stenosis, types of the stents, and tortuosity index (TI > 80 Degree-Sign) were all associated with DR. A logistic regression analysis indicated that calcified plaques (odds ratio (OR) = 6.5; p = 0.000) and TI > 80 Degree-Sign (OR = 18.8; p = 0.000) were independent predictors of DR. Conclusions: Calcified plaques and TI > 80 Degree-Sign may be related to DR in patients with CAS. DR may lengthen the retrieving time and increase the complications of the procedure.

  6. Coral symbiotic algae calcify ex hospite in partnership with bacteria

    PubMed Central

    Frommlet, Jörg C.; Sousa, Maria L.; Alves, Artur; Vieira, Sandra I.; Suggett, David J.; Serôdio, João

    2015-01-01

    Dinoflagellates of the genus Symbiodinium are commonly recognized as invertebrate endosymbionts that are of central importance for the functioning of coral reef ecosystems. However, the endosymbiotic phase within Symbiodinium life history is inherently tied to a more cryptic free-living (ex hospite) phase that remains largely unexplored. Here we show that free-living Symbiodinium spp. in culture commonly form calcifying bacterial–algal communities that produce aragonitic spherulites and encase the dinoflagellates as endolithic cells. This process is driven by Symbiodinium photosynthesis but occurs only in partnership with bacteria. Our findings not only place dinoflagellates on the map of microbial–algal organomineralization processes but also point toward an endolithic phase in the Symbiodinium life history, a phenomenon that may provide new perspectives on the biology and ecology of Symbiodinium spp. and the evolutionary history of the coral–dinoflagellate symbiosis. PMID:25918367

  7. Characterization of calcified deposits on contraceptive intrauterine devices.

    PubMed

    Patai, K; Berényi, M; Sipos, M; Noszál, B

    1998-11-01

    The formation of calcified deposits on > 200 contraceptive intrauterine devices (IUD) was quantitated as a function of time in healthy women, pregnant women, and women with a pathologic lesion. The incrustment formation was significantly enhanced when inflammation occurred, but change could not be observed in cases of pregnancy. The incrustments were analyzed by x-ray diffraction, infrared spectroscopy, x-ray microprobe, and ultramicrochemical stone analysis techniques. Major components and their average w/w percent quantities in the incrustments are as follows: calcium carbonate 75%, apatite 5%, and organic matrix 20%. Earlier hypotheses on the chemical processes of deposit formation are discussed, and a new, ionic mechanism of calcification on IUD surfaces is suggested.

  8. Intraosseous calcifying epithelial odontogenic (Pindborg) tumor: A rare entity

    PubMed Central

    More, Chandramani B; Vijayvargiya, Ritika

    2015-01-01

    Calcifying epithelial odontogenic tumor (CEOT) is a locally aggressive, rare benign odontogenic neoplasm that accounts for <1% of all odontogenic tumors. It was first described by a Dutch pathologist Jens Jorgen Pindborg in 1955. It is most often located in the posterior mandible. The tumor usually appears between the second and sixth decade of life and has no gender predilection. It is slow-growing neoplasm with a recurrence rate of 10–15% and with rare malignant transformation. Early diagnosis is essential to avoid oro-maxillofacial deformation and destruction. CEOT is rarely reported in India. We, herewith present a rare case of CEOT with unusual features associated with an impacted right third molar in the posterior mandible of 35 years male, with an emphasis on clinical, radiographic, histopathology and immunohistochemical features. PMID:26604515

  9. Calcifying odontogenic cyst with ameloblastic fibroma: report of three cases.

    PubMed

    Lin, Cheng-Chung; Chen, Chung-Ho; Lin, Li-Min; Chen, Yuk-Kwan; Wright, John M; Kessler, Harvey P; Cheng, Yi-Shing Lisa; Ellis, Edward

    2004-10-01

    Although it is a rare event, odontogenic tumors such as ameloblastoma, ameloblastic fibroma (AF), ameloblastic fibro-odontoma, and odontoma have been reported associated with calcifying odontogenic cyst (COC). There are only four cases of COC with AF cited in the English literature. However, three of these four cases were either included in a review of a series of cases or reported as an abstract, and limited clinical and histological information was provided. We present three additional cases of COC with AF and discuss the management for this combined lesion. Because COC is known for its histologic diversity and variable clinical behavior, and the clinical significance of an association of COC with AF is still unknown, we think it is valuable to report COC with AF with detailed clinical and pathological documentation.

  10. Coral symbiotic algae calcify ex hospite in partnership with bacteria.

    PubMed

    Frommlet, Jörg C; Sousa, Maria L; Alves, Artur; Vieira, Sandra I; Suggett, David J; Serôdio, João

    2015-05-12

    Dinoflagellates of the genus Symbiodinium are commonly recognized as invertebrate endosymbionts that are of central importance for the functioning of coral reef ecosystems. However, the endosymbiotic phase within Symbiodinium life history is inherently tied to a more cryptic free-living (ex hospite) phase that remains largely unexplored. Here we show that free-living Symbiodinium spp. in culture commonly form calcifying bacterial-algal communities that produce aragonitic spherulites and encase the dinoflagellates as endolithic cells. This process is driven by Symbiodinium photosynthesis but occurs only in partnership with bacteria. Our findings not only place dinoflagellates on the map of microbial-algal organomineralization processes but also point toward an endolithic phase in the Symbiodinium life history, a phenomenon that may provide new perspectives on the biology and ecology of Symbiodinium spp. and the evolutionary history of the coral-dinoflagellate symbiosis. PMID:25918367

  11. Effect of calcifying bacteria on permeation properties of concrete structures.

    PubMed

    Achal, V; Mukherjee, A; Reddy, M S

    2011-09-01

    Microbially enhanced calcite precipitation on concrete or mortar has become an important area of research regarding construction materials. This study examined the effect of calcite precipitation induced by Sporosarcina pasteurii (Bp M-3) on parameters affecting the durability of concrete or mortar. An inexpensive industrial waste, corn steep liquor (CSL), from starch industry was used as nutrient source for the growth of bacteria and calcite production, and the results obtained with CSL were compared with those of the standard commercial medium. Bacterial deposition of a layer of calcite on the surface of the specimens resulted in substantial decrease of water uptake, permeability, and chloride penetration compared with control specimens without bacteria. The results obtained with CSL medium were comparable to those obtained with standard medium, indicating the economization of the biocalcification process. The results suggest that calcifying bacteria play an important role in enhancing the durability of concrete structures. PMID:21104104

  12. Enrichment of calcifying extracellular vesicles using density-based ultracentrifugation protocol

    PubMed Central

    Hutcheson, Joshua D.; Goettsch, Claudia; Pham, Tan; Iwashita, Masaya; Aikawa, Masanori; Singh, Sasha A.; Aikawa, Elena

    2014-01-01

    Calcifying extracellular vesicles (EVs) released from cells within atherosclerotic plaques have received increased attention for their role in mediating vascular calcification, a major predictor of cardiovascular morbidity and mortality. However, little is known about the difference between this pathologic vesicle population and other EVs that contribute to physiological cellular processes. One major challenge that hinders research into these differences is the inability to selectively isolate calcifying EVs from other vesicle populations. In this study, we hypothesized that the formation of mineral within calcifying EVs would increase the density of the vesicles such that they would pellet at a faster rate during ultracentrifugation. We show that after 10 min of ultracentrifugation at 100,000×g, calcifying EVs are depleted from the conditioned media of calcifying coronary artery smooth muscle cells and are enriched in the pelleted portion. We utilized mass spectrometry to establish functional proteomic differences between the calcifying EVs enriched in the 10 min ultracentrifugation compared to other vesicle populations preferentially pelleted by longer ultracentrifugation times. The procedures established in this study will allow us to enrich the vesicle population of interest and perform advanced proteomic analyses to find subtle differences between calcifying EVs and other vesicle populations that may be translated into therapeutic targets for vascular calcification. Finally, we will show that the differences in ultracentrifugation times required to pellet the vesicle populations can also be used to estimate physical differences between the vesicles. PMID:25491249

  13. Calcifying nanoparticles (nanobacteria): an additional potential factor for urolithiasis in space flight crews.

    PubMed

    Jones, Jeffrey A; Ciftcioglu, Neva; Schmid, Josef F; Barr, Yael R; Griffith, Donald

    2009-01-01

    Spaceflight-induced microgravity appears to be a risk factor for the development of urinary calculi, resulting in urolithiasis during and after spaceflight. Calcifying nanoparticles, or nanobacteria, multiply more rapidly in simulated microgravity and create external shells of calcium phosphate. The question arises whether calcifying nanoparticles are nidi for calculi and contribute to the development of clinically significant urolithiasis in those who are predisposed to the development of urinary calculi because of intrinsic or extrinsic factors. This case report describes a calculus recovered after flight from an astronaut that, on morphologic and immunochemical analysis (including specific monoclonal antibody staining), demonstrated characteristics of calcifying nanoparticles. PMID:18718644

  14. 21 CFR 882.5175 - Carotid artery clamp.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Carotid artery clamp. 882.5175 Section 882.5175...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5175 Carotid artery clamp. (a) Identification. A carotid artery clamp is a device that is surgically placed around a patient's carotid...

  15. 21 CFR 882.5175 - Carotid artery clamp.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Carotid artery clamp. 882.5175 Section 882.5175...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5175 Carotid artery clamp. (a) Identification. A carotid artery clamp is a device that is surgically placed around a patient's carotid...

  16. 21 CFR 882.5175 - Carotid artery clamp.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Carotid artery clamp. 882.5175 Section 882.5175...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5175 Carotid artery clamp. (a) Identification. A carotid artery clamp is a device that is surgically placed around a patient's carotid...

  17. 21 CFR 882.5175 - Carotid artery clamp.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Carotid artery clamp. 882.5175 Section 882.5175...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5175 Carotid artery clamp. (a) Identification. A carotid artery clamp is a device that is surgically placed around a patient's carotid...

  18. 21 CFR 882.5175 - Carotid artery clamp.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Carotid artery clamp. 882.5175 Section 882.5175...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5175 Carotid artery clamp. (a) Identification. A carotid artery clamp is a device that is surgically placed around a patient's carotid...

  19. Distal protection for treatment of complete cervical internal carotid occlusion.

    PubMed

    Hungerford, John P; Chaudry, Imran; Turner, Raymond; Turk, Aquilla S

    2012-01-01

    Distal protection devices (DPD) have been advocated for carotid artery stenting to reduce the risk of distal embolization. These devices were designed for deployment in the straight cervical segment of the internal carotid artery. We present a case of total cervical carotid occlusion recanalized with the aid of a distal protection device deployed 'distally' in the intracranial internal carotid artery.

  20. Future Management of Carotid Stenosis: Role of Urgent Carotid Interventions in the Acutely Symptomatic Carotid Patient and Best Medical Therapy for Asymptomatic Carotid Disease

    PubMed Central

    Bazan, Hernan A.; Smith, Taylor A.; Donovan, Melissa J.; Sternbergh, W. Charles

    2014-01-01

    Background Stroke is the fourth leading cause of death in the United States, leading to devastating disability. Most strokes are ischemic, and nearly one-third of these are caused by carotid disease. The primary mechanism of carotid-related stroke is an atheroembolic event from an unstable atherosclerotic plaque rupture. In the 1990s, randomized trials demonstrated the benefit of carotid endarterectomy (CEA) in reducing the risk of stroke in both symptomatic and asymptomatic carotid disease. Methods We review best medical therapy (BMT) for asymptomatic carotid disease and recent randomized trials comparing CEA and carotid angioplasty stenting (CAS), and we discuss the role of urgent carotid interventions in patients with acute neurologic symptoms. Results In 2010, 2 large trials demonstrated the efficacy of CAS in select patients, although CAS was associated with an increased procedural stroke risk compared to CEA. An age effect was observed; patients >75 years do worse with CAS compared to CEA. As BMT has evolved in the past decade, a future trial (CREST-2) will address whether BMT is equal to intervention (CEA or CAS) in asymptomatic carotid disease. In a subgroup of patients with asymptomatic carotid disease, CEA plus BMT will likely remain the mainstay therapy for carotid disease compared to BMT alone. CEA and CAS will continue to play complementary roles in the future, as CAS will be done in select patients in whom CEA cannot be undertaken because of high-risk anatomical or medical conditions. Finally, a role for urgent carotid interventions in a select group of patients who present with acute neurologic symptoms is developing as a way to prevent recurrent stroke after an initial carotid plaque rupture event. Conclusion CAS has an increasingly higher risk of stroke with advancing age. Patients treated with CAS have a 1.76-fold increased risk of stroke (95% CI, 1.35-2.31) with each 10-year increase in age. No such age effect is seen in patients treated with CEA

  1. Management of Bilateral Carotid Occlusive Disease

    PubMed Central

    Jadhav, Ashutosh P.; Ducruet, Andrew F.; Jankowitz, Brian T.; Jovin, Tudor G.

    2016-01-01

    Background Symptomatic bilateral internal carotid occlusive disease is a rare but potentially devastating entity. Medical therapy alone is associated with high rates of mortality and recurrent stroke. The optimal management of this disease remains poorly understood. Methods A retrospective review of a prospectively maintained database was conducted for patients who presented with an acute stroke in the setting of bilateral carotid occlusive disease between May and October 2013. Results We identified 3 patients. The admission National Institutes of Health Stroke Scale score ranged from 4 to 7. All patients had small- to moderate-sized infarcts in the anterior circulation on presentation. Angiography confirmed bilateral internal carotid occlusions with collateral filling via the posterior communicating artery and retrograde filling via external carotid artery supply to the ophthalmic artery. All patients were initially managed with permissive hypertension and anticoagulation followed by carotid angioplasty and stenting. At 1-year follow-up, all patients demonstrated a modified Rankin scale score of 0-1. Conclusions Carotid stenting may be a safe and effective therapy for patients presenting with symptomatic bilateral carotid occlusions. PMID:27051405

  2. Signal processing at mammalian carotid body chemoreceptors.

    PubMed

    Nurse, Colin A; Piskuric, Nikol A

    2013-01-01

    Mammalian carotid bodies are richly vascularized chemosensory organs that sense blood levels of O(2), CO(2)/H(+), and glucose and maintain homeostatic regulation of these levels via the reflex control of ventilation. Carotid bodies consist of innervated clusters of type I (or glomus) cells in intimate association with glial-like type II cells. Carotid bodies make afferent connections with fibers from sensory neurons in the petrosal ganglia and receive efferent inhibitory innervation from parasympathetic neurons located in the carotid sinus and glossopharyngeal nerves. There are synapses between type I (chemosensory) cells and petrosal afferent terminals, as well as between neighboring type I cells. There is a broad array of neurotransmitters and neuromodulators and their ionotropic and metabotropic receptors in the carotid body. This allows for complex processing of sensory stimuli (e.g., hypoxia and acid hypercapnia) involving both autocrine and paracrine signaling pathways. This review summarizes and evaluates current knowledge of these pathways and presents an integrated working model on information processing in carotid bodies. Included in this model is a novel hypothesis for a potential role of type II cells as an amplifier for the release of a key excitatory carotid body neurotransmitter, ATP, via P2Y purinoceptors and pannexin-1 channels.

  3. Prediction of Prolonged Hemodynamic Instability During Carotid Angioplasty and Stenting

    PubMed Central

    Rhim, Jong Kook; Park, Jeong Jin; Choi, Hyuk Jai; Cho, Young Dae; Sheen, Seung Hun; Jang, Kyung-Sool

    2016-01-01

    Purpose The aim of this study was to assess the risk factors of prolonged hemodynamic instability (HDI) after carotid angioplasty and stenting (CAS). Herein, a simplified predictive scoring system for prolonged HDI is proposed. Materials and Methods Sixty-six patients who had CAS from 2011 to 2016 at a single institution were evaluated. Prolonged HDI was defined as systolic blood pressure >160 mm Hg or <90 mm Hg or heart rate <50 beats/min, lasting over 30 minutes despite medical treatments. For the study, clinical data and radiologic data, including plaque morphology and stenosis were analyzed. Results Prolonged HDI was observed in 21 patients (31.8%). Multivariable analysis revealed that calcification (OR, 6.726; p=0.006), eccentric stenosis (OR, 3.645; p=0.047) and extensive plaque distribution (OR, 7.169; p=0.006) were related to prolonged HDI. According to these results, a simplified scoring scale was proposed based on the summation of points: 2 points for calcified plaque, 2 points for extensive plaque distribution, and 1 point for eccentric stenosis. The percentages of prolonged HDI according to the total score were as follows: score 0, 8.7%; score 1, 20.0%; score 2, 38.5%; score 3, 72.7%; score 4, 66.7%; score 5, 100%. From the analysis, the total score in patients with prolonged HDI was significantly higher than those without prolonged HDI (p<0.001). Conclusion Prolonged HDI can be associated with calcification of plaque, eccentric stenosis and extensive plaque distribution, and a simplified scoring system enables prediction of prolonged HDI according to our cohort. PMID:27621949

  4. Prediction of Prolonged Hemodynamic Instability During Carotid Angioplasty and Stenting

    PubMed Central

    Rhim, Jong Kook; Park, Jeong Jin; Choi, Hyuk Jai; Cho, Young Dae; Sheen, Seung Hun; Jang, Kyung-Sool

    2016-01-01

    Purpose The aim of this study was to assess the risk factors of prolonged hemodynamic instability (HDI) after carotid angioplasty and stenting (CAS). Herein, a simplified predictive scoring system for prolonged HDI is proposed. Materials and Methods Sixty-six patients who had CAS from 2011 to 2016 at a single institution were evaluated. Prolonged HDI was defined as systolic blood pressure >160 mm Hg or <90 mm Hg or heart rate <50 beats/min, lasting over 30 minutes despite medical treatments. For the study, clinical data and radiologic data, including plaque morphology and stenosis were analyzed. Results Prolonged HDI was observed in 21 patients (31.8%). Multivariable analysis revealed that calcification (OR, 6.726; p=0.006), eccentric stenosis (OR, 3.645; p=0.047) and extensive plaque distribution (OR, 7.169; p=0.006) were related to prolonged HDI. According to these results, a simplified scoring scale was proposed based on the summation of points: 2 points for calcified plaque, 2 points for extensive plaque distribution, and 1 point for eccentric stenosis. The percentages of prolonged HDI according to the total score were as follows: score 0, 8.7%; score 1, 20.0%; score 2, 38.5%; score 3, 72.7%; score 4, 66.7%; score 5, 100%. From the analysis, the total score in patients with prolonged HDI was significantly higher than those without prolonged HDI (p<0.001). Conclusion Prolonged HDI can be associated with calcification of plaque, eccentric stenosis and extensive plaque distribution, and a simplified scoring system enables prediction of prolonged HDI according to our cohort.

  5. [A Case of Carotid Free-Floating Thrombus Treated by Carotid Ultrasonography-Guided Endovascular Approach].

    PubMed

    Otawa, Masato; Kinkori, Takeshi; Watanabe, Kenichi; Ando, Ryo; Tambara, Masao; Arima, Toru

    2016-06-01

    We experienced a case of carotid free-floating thrombus treated by carotid ultrasonography-guided endovascular approach. A 63-year-old man was brought to our hospital with the chief complaint of sudden onset left hemiplegia. MRI revealed acute infarction of the right MCA territory due to the right M1 occlusion. Carotid ultrasonography showed a pedunculated, polypoid mobile plaque floating with the cardiac beat. We attempted ultrasonography-guided endovascular treatment. Under proximal balloon protection, the floating plaque was successfully aspirated into the Penumbra aspiration catheter. Carotid stent was also placed to stabilize the residual pedicle of the plaque. Aspirated plaque was identified as fresh thrombus by pathological examination. Carotid ultrasonography-guided endovascular approach was effective for getting the picture of real-time dynamics of the carotid FFT. PMID:27270147

  6. Hemodynamic changes and baroreflex sensitivity associated with carotid endarterectomy and carotid artery stenting.

    PubMed

    Cao, Qinqin; Zhang, Jun; Xu, Gelin

    2015-01-01

    Atherosclerotic carotid lesion is a major cause of stroke which accounts for up to 20% of ischemic stroke. Aggressive treatment of carotid stenosis may prevent stroke. Currently, carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the first-line treatments for severe carotid stenosis. CEA is superior to medical therapy in preventing stroke and cardiovascular death. CAS has emerged as an alternative to CEA in recent years due to its less invasive nature. However, both CEA and CAS may be associated with adverse hemodynamic changes as well as a variation of carotid baroreflex sensitivity. There is no consensus on which of these two methods is more advantageous concerning the procedure-related hemodynamic changes. This article reviews the hemodynamic changes and baroreflex sensitivity after CEA and CAS. PMID:25999987

  7. Calcifying cystic odontogenic tumor in a 5-year-old boy: a case report.

    PubMed

    Desai, Rajiv S; Sabnis, Rajesh; Bhuta, Bansari A; Yadav, Archana

    2015-03-01

    The calcifying cystic odontogenic tumor (CCOT), formerly known as calcifying odontogenic cyst, is a rare developmental neoplasm/cyst of odontogenic epithelial origin with considerable histopathologic diversity and variable clinical behaviour. The occurrence of CCOT in the first decade of life is very uncommon. We report an interestingly rare variant of CCOT with ameloblastomatous proliferation affecting the mandibular left posterior region associated with an impacted permanent tooth in a 5-year-old boy.

  8. The role of calcifying nanoparticles in biology and medicine

    PubMed Central

    Kutikhin, Anton G; Brusina, Elena B; Yuzhalin, Arseniy E

    2012-01-01

    Calcifying nanoparticles (CNPs) (nanobacteria, nanobacteria-like particles, nanobes) were discovered over 25 years ago; nevertheless, their nature is still obscure. To date, nobody has been successful in credibly determining whether they are the smallest self-replicating life form on Earth, or whether they represent mineralo-protein complexes without any relation to living organisms. Proponents of both theories have a number of arguments in favor of the validity of their hypotheses. However, after epistemological analysis carried out in this review, all arguments used by proponents of the theory about the physicochemical model of CNP formation may be refuted on the basis of the performed investigations, and therefore published data suggest a biological nature of CNPs. The only obstacle to establish CNPs as living organisms is the absence of a fairly accurately sequenced genome at the present time. Moreover, it is clear that CNPs play an important role in etiopathogenesis of many diseases, and this association is independent from their nature. Consequently, emergence of CNPs in an organism is a pathological, not a physiological, process. The classification and new directions of further investigations devoted to the role of CNPs in biology and medicine are proposed. PMID:22287843

  9. Lasers in the management of calcified urinary tract stents

    NASA Astrophysics Data System (ADS)

    Nseyo, Unyime O.; Tunuguntla, Hari S. G. R.; Crone, Michael

    2003-06-01

    Indwelling double J ureteral stents are used for internal urinary diversion for ureteral obstruction and post-surgical drainage of the upper urinary tract. Stent calcification is a serious complication especially in those with forgotten stents. In a retrospective review of 16 patients (10 male and 6 female) we found holmium laser to be highly effective in the management of calcified stents. Encrustations/calcifications were noted on the distal end of the sent in 6 patiens (37.5%), middle and distal portions in 2 patients (12.5%), along the entire length of the stent in 3 patients (18.75%), lower portion of the stent in 4 patients (25%) and at the upper and lower ends of the stent in one patient (6.25%). Cystolitholapaxy, retrograde ureteroscopy (URS) with holmium: YAG (yttrium-aluminum-garnet) laser intracorporeal lithotripsy, percutaneous nephrostolithotomy (PNL) and antegrade URS with holmium: YAG laser intracorporeal lithotripsy were effectively performed without intraoperative complications. Lithotripsy became necessary before stent removal in 11 patients (68.75%). Holmium laser lithotripsy was useful in managing 7 patients (43.75%), and shockwave lithotripsy (SWL) in 6 patients (37.5%). In two patients (12.5%) both holmium and SWL were used before the stent can be removed.

  10. Bioconvection in Cultures of the Calcifying Unicellular Alga Pleurochrysis Carterae

    NASA Technical Reports Server (NTRS)

    Montufar-Solis, Dina; Duke, P. Jackie; Marsh, Mary E.

    2003-01-01

    The unicellular, marine, calcifying alga P leurochiysis carterae--a model to study cell morphogenesis, cell polarity, calcification, gravitaxis, reproduction and development-- has extremely flexible culture requirements. Support studies for a flight experiment addressing cell motility suggested that cell density (cells/ml) affects cell movement in P. carterae cultures through the gradual establishment of bioconvection as the culture grows. To assess the effect of cell density on direction of the movement, without the effects of aging of the culture, swimming behavior was analyzed in aliquots from a series of dilutions obtained from a stock culture. Results showed that at low concentrations cells swim randomly. As the concentration increases, upswimming patterns overtake random swimming. Gradually, up and down movement patterns prevail, representative of bioconvection. This oriented swimming of P. carterae occurs in a wide range of concentrations, adding to the list of flexible requirements, in this case, cell concentration, to be used for spaceflight studies addressing cell motility and bioconvection in a unicellular model of biologically directed mineralization.

  11. The role of calcifying nanoparticles in biology and medicine.

    PubMed

    Kutikhin, Anton G; Brusina, Elena B; Yuzhalin, Arseniy E

    2012-01-01

    Calcifying nanoparticles (CNPs) (nanobacteria, nanobacteria-like particles, nanobes) were discovered over 25 years ago; nevertheless, their nature is still obscure. To date, nobody has been successful in credibly determining whether they are the smallest self-replicating life form on Earth, or whether they represent mineralo-protein complexes without any relation to living organisms. Proponents of both theories have a number of arguments in favor of the validity of their hypotheses. However, after epistemological analysis carried out in this review, all arguments used by proponents of the theory about the physicochemical model of CNP formation may be refuted on the basis of the performed investigations, and therefore published data suggest a biological nature of CNPs. The only obstacle to establish CNPs as living organisms is the absence of a fairly accurately sequenced genome at the present time. Moreover, it is clear that CNPs play an important role in etiopathogenesis of many diseases, and this association is independent from their nature. Consequently, emergence of CNPs in an organism is a pathological, not a physiological, process. The classification and new directions of further investigations devoted to the role of CNPs in biology and medicine are proposed. PMID:22287843

  12. Association between dental pulp stones and calcifying nanoparticles.

    PubMed

    Zeng, Jinfeng; Yang, Fang; Zhang, Wei; Gong, Qimei; Du, Yu; Ling, Junqi

    2011-01-01

    The etiology of dental pulp stones, one type of extraskeletal calcification disease, remains elusive to date. Calcifying nanoparticles (CNPs), formerly referred to as nanobacteria, were reported to be one etiological factor in a number of extraskeletal calcification diseases. We hypothesized that CNPs are involved in the calcification of the dental pulp tissue, and therefore investigated the link between CNPs and dental pulp stones. Sixty-five freshly collected dental pulp stones, each from a different patient, were analyzed. Thirteen of the pulp stones were examined for the existence of CNPs in situ by immunohistochemical staining (IHS), indirect immunofluorescence staining (IIFS), and transmission electron microscope (TEM). The remaining 52 pulp stones were used for isolation and cultivation of CNPs; the cultured CNPs were identified and confirmed via their shape and growth characteristics. Among the dental pulp stones examined in situ, 84.6% of the tissue samples staines positive for CNPs antigen by IHS; the corresponding rate by IIFS was 92.3 %. In 88.2% of the cultured samples, CNPs were isolated and cultivated successfully. The CNPs were visible under TEM as 200-400 nm diameter spherical particles surrounded by a compact crust. CNPs could be detected and isolated from a high percentage of dental pulp stones, suggesting that CNPs might play an important role in the calcification of dental pulp. PMID:21289988

  13. Post-polymerization of urease-induced calcified, polymer hydrogels.

    PubMed

    Rauner, Nicolas; Buenger, Lea; Schuller, Stefanie; Tiller, Joerg C

    2015-01-01

    Urease-induced calcification is an innovative method to artificially produce highly filled CaCO3-based composite materials by intrinsic mineralization of hydrogels. The mechanical properties of these hybrid materials based on poly(2-hydroxyethylacrylate) cross-linked by triethylene glycol dimethacrylate are poor. Increasing the degree of calcification to up to 94 wt% improves the Young's moduli (YM) of the materials from some 40 MPa to more than 300 MPa. The introduction of calcium carbonate affine groups to the hydrogel matrix by copolymerizing acrylic acid and [2-(methacryloyloxy) ethyl]trimethylammonium chloride, respectively, does not increase the stiffness of the composites. A Young's modulus of more than 1 GPa is achieved by post-polymerization (PP) of the calcified hydrogels, which proves that the size of the contact area between the matrix and calcium carbonate crystals is the most crucial parameter for controlling the stiffness of hybrid materials. Switching from low Tg to high Tg hydrogel matrices (based on poly(N,N-dimethyl acrylamide)) results in a YM of up to 3.5 GPa after PP. PMID:25284027

  14. Can a closed carotid artery be reopened?

    PubMed

    Issawi, Ahmad; Klopfenstein, Jeffrey

    2015-10-01

    Carotid occlusion is a disease that presents a difficult decision for the treating provider. Traditionally, many providers would opt for expectant management with risk factor reduction and supportive therapy. There is a growing body of literature however pointing to possible improved outcomes of more aggressive treatments, including reopening of the occluded carotid. In this review, we discuss the difficulties involved in diagnosing a patient presenting with symptomatic carotid occlusion, the natural history of the disease, and the emerging treatment options and paradigms of different institutions based on recent literature. PMID:26277365

  15. CBCT-Aided Microscopic and Ultrasonic Treatment for Upper or Middle Thirds Calcified Root Canals

    PubMed Central

    Yang, Ying-Ming; Guo, Bin; Guo, Li-Yang; Yang, Yan; Hong, Xiao; Pan, Hong-Ying

    2016-01-01

    Root canal calcification is considered a great challenge during root canal treatment. Although the application of ultrasonic instruments and dental operating microscope (DOM) has advantages, dealing with calcified root canals still suffers a great risk of failure because of limited information about the location, length, and direction of obliteration on periapical radiographs. In this work, a cone-beam computed tomography- (CBCT-) aided method aimed at solving complicated calcified root canals in which conventional approaches could not work was proposed. Thirteen teeth with sixteen calcified canals (12 calcified in the upper third, 4 calcified in the middle third), which cannot be negotiated with conventional methods, were treated with the aid of CBCT. The location of calcification and depth of instrumentation and operating direction were calculated and assessed in three dimensions with ultrasonic instruments under DOM. In all thirteen teeth, canals with upper and middle thirds calcification were treated successfully. Finally, a guideline was proposed to help achieve consistent apical patency in calcified canals. PMID:27525269

  16. Evaluation of Carotid Plaque Using Ultrasound Imaging

    PubMed Central

    2016-01-01

    Traditional risk factors for predicting of cardiovascular disease are not always effective predictors for development of cardiovascular events. This review summarizes several newly developed noninvasive imaging techniques for evaluating carotid plaques and their role in cardiovascular disease risk. PMID:27358696

  17. Complications of cerebral angiography for patients with mild carotid territory ischaemia being considered for carotid endarterectomy.

    PubMed Central

    Hankey, G J; Warlow, C P; Molyneux, A J

    1990-01-01

    It is essential to image the carotid bifurcation adequately in patients with symptomatic carotid territory ischaemia if they are being considered for carotid endarterectomy. Optimal resolution is achieved by selective intraarterial contrast angiography which is an invasive procedure carrying some risk. The overall risk-benefit of carotid endarterectomy is currently being investigated in several large randomised trials in Europe and North America. Because cerebral angiography is a prerequisite for carotid endarterectomy, the risks of cerebral angiography will need to be added to those of surgery when considering whether carotid endarterectomy is effective in the management of these patients. This study evaluated prospectively 382 patients with symptomatically mild carotid ischaemia who had cerebral angiography to visualise a potentially resectable lesion at the carotid bifurcation. Complications followed 14 cerebral angiograms in 13 patients (3.4%); two complications were local (0.5%), two systemic (0.5%) and 10 were neurological (2.6%). The neurological complications were transient (TIA 1, generalised seizure 1) in two patients (0.5%), reversible (stroke) in three (0.8%) and permanent (stroke) in five patients (1.3%). There were no deaths. The significant risk factors for post angiographic stroke were (1) stroke before angiography compared with transient ischaemic attacks of the eye or brain and (2) the presence of greater than or equal to 50% diameter stenosis of the symptomatic internal carotid artery; unfortunately it may be the latter patients who are most at risk of stroke as part of the natural history of their disease and therefore most in need of prophylactic carotid endarterectomy (which requires cerebral angiography). The absolute risk of post-angiographic stroke of patients for cerebral angiography using clinical evaluation and Duplex carotid ultrasound screening. PMID:2118171

  18. Microscopic Observation of Self-Propagation of Calcifying Nanoparticles (Nanobacteria)

    NASA Technical Reports Server (NTRS)

    Mathew, Grace; McKay, David S.; Ciftcioglu, Neva

    2007-01-01

    Biologists typically define living organisms as carbon and water-based cellular forms with :self-replication" as the fundamental trait of the life process. However, this standard dictionary definition of life does not help scientists to categorize self-replicators like viruses, prions, proteons and artificial life. CNP also named nanobacteria were discovered in early 1990s as about 100 nanometer-sized bacteria-like particles with unique apatite mineral-shells around them, and found to be associated with pathological-calcification related diseases. Although CNP have been isolated and cultured from mammalian blood and diseased calcified tissues, and their biomineralizing properties well established, their biological nature and self-replicating capability have always been severely challenged. The terms "self-replication", "self-assembly" or "self-propagation" have been widely used for all systems including nanomachines, crystals, computer viruses and memes. In a simple taxonomy, all biological and non-biological "self replicators", have been classified into "living" or "nonliving" based on the properties of the systems and the amount of support they require to self-replicate. To enhance our understanding about self-replicating nature of CNP, we have investigated their growth in specific culture conditions using conventional inverted light microscope and BioStation IM, Nikon s latest time-lapse imaging system. Their morphological structure was examined using scanning (SEM) and transmission (TEM) electron microscopy. This present study, in conjunction with previous findings of metabolic activity, antibiotic sensitivity, antibody specificity, morphological aspects and infectivity, all concomitantly validate CNP as living self-replicators.

  19. Persistent Seroconversion after Accidental Eye Exposure to Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

    Ciftcioglu, Neva; Aho, Katja M.; McKay, David S.; Kajander, E. Olavi

    2007-01-01

    Biosafety of nanomaterials has attracted much attention recently. We report here a case where accidental human eye exposure to biogenic nanosized calcium phosphate in the form of calcifying nanoparticles (CNP) raised a strong IgG immune response against proteins carried by CNP. The antibody titer has persisted over ten years at the high level. The IgG was detected by ELISA using CNPs propagated in media containing bovine and human serum as antigen. The exposure incident occurred to a woman scientist (WS) at a research laboratory in Finland at 1993. CNP, also termed "nanobacteria", is a unique self-replicating agent that has not been fully characterized and no data on biohazards were available at that time. Before the accident, her serum samples were negative for both CNP antigen and anti-CNP antibody using specific ELISA tests (Nanobac Oy, Kuopio, Finland). The accident occurred while WS was harvesting CNP cultures. Due to a high pressure in pipetting, CNP pellet splashed into her right eye. Both eyes were immediately washed with water and saline. The following days there was irritation and redness in the right eye. These symptoms disappeared within two weeks without any treatment. Three months after the accident, blood and urine samples of WS were tested for CNP cultures (2), CNP-specific ELISA tests, and blood cell counts. Blood cell counts were normal, CNP antigen and culture tests were negative. A high IgG anti-CNP antibody titer was detected (see Figure). The antibodies of this person have been used thereafter as positive control and standard in ELISA manufacturing (Nano-Sero IgG ELISA, Nanobac Oy, Kuopio, Finland).

  20. Ocean acidification and calcifying reef organisms: a mesocosm investigation

    NASA Astrophysics Data System (ADS)

    Jokiel, P. L.; Rodgers, K. S.; Kuffner, I. B.; Andersson, A. J.; Cox, E. F.; MacKenzie, F. T.

    2008-09-01

    A long-term (10 months) controlled experiment was conducted to test the impact of increased partial pressure of carbon dioxide ( pCO2) on common calcifying coral reef organisms. The experiment was conducted in replicate continuous flow coral reef mesocosms flushed with unfiltered sea water from Kaneohe Bay, Oahu, Hawaii. Mesocosms were located in full sunlight and experienced diurnal and seasonal fluctuations in temperature and sea water chemistry characteristic of the adjacent reef flat. Treatment mesocosms were manipulated to simulate an increase in pCO2 to levels expected in this century [midday pCO2 levels exceeding control mesocosms by 365 ± 130 μatm (mean ± sd)]. Acidification had a profound impact on the development and growth of crustose coralline algae (CCA) populations. During the experiment, CCA developed 25% cover in the control mesocosms and only 4% in the acidified mesocosms, representing an 86% relative reduction. Free-living associations of CCA known as rhodoliths living in the control mesocosms grew at a rate of 0.6 g buoyant weight year-1 while those in the acidified experimental treatment decreased in weight at a rate of 0.9 g buoyant weight year-1, representing a 250% difference. CCA play an important role in the growth and stabilization of carbonate reefs, so future changes of this magnitude could greatly impact coral reefs throughout the world. Coral calcification decreased between 15% and 20% under acidified conditions. Linear extension decreased by 14% under acidified conditions in one experiment. Larvae of the coral Pocillopora damicornis were able to recruit under the acidified conditions. In addition, there was no significant difference in production of gametes by the coral Montipora capitata after 6 months of exposure to the treatments.

  1. Ocean acidification and calcifying reef organisms: A mesocosm investigation

    USGS Publications Warehouse

    Jokiel, P.L.; Rodgers, K.S.; Kuffner, I.B.; Andersson, A.J.; Cox, E.F.; MacKenzie, F.T.

    2008-01-01

    A long-term (10 months) controlled experiment was conducted to test the impact of increased partial pressure of carbon dioxide (pCO2) on common calcifying coral reef organisms. The experiment was conducted in replicate continuous flow coral reef mesocosms flushed with unfiltered sea water from Kaneohe Bay, Oahu, Hawaii. Mesocosms were located in full sunlight and experienced diurnal and seasonal fluctuations in temperature and sea water chemistry characteristic of the adjacent reef flat. Treatment mesocosms were manipulated to simulate an increase in pCO2 to levels expected in this century [midday pCO2 levels exceeding control mesocosms by 365 ?? 130 ??atm (mean ?? sd)]. Acidification had a profound impact on the development and growth of crustose coralline algae (CCA) populations. During the experiment, CCA developed 25% cover in the control mesocosms and only 4% in the acidified mesocosms, representing an 86% relative reduction. Free-living associations of CCA known as rhodoliths living in the control mesocosms grew at a rate of 0.6 g buoyant weight year-1 while those in the acidified experimental treatment decreased in weight at a rate of 0.9 g buoyant weight year-1, representing a 250% difference. CCA play an important role in the growth and stabilization of carbonate reefs, so future changes of this magnitude could greatly impact coral reefs throughout the world. Coral calcification decreased between 15% and 20% under acidified conditions. Linear extension decreased by 14% under acidified conditions in one experiment. Larvae of the coral Pocillopora damicornis were able to recruit under the acidified conditions. In addition, there was no significant difference in production of gametes by the coral Montipora capitata after 6 months of exposure to the treatments. ?? 2008 Springer-Verlag.

  2. Internal carotid artery rupture caused by carotid shunt insertion

    PubMed Central

    Illuminati, Giulio; Caliò, Francesco G.; Pizzardi, Giulia; Vietri, Francesco

    2015-01-01

    Introduction Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. Presentation of case A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arterial rupture at the distal tip of the shunt was detected and was repaired via a small saphenous vein patch. Eversion CEA and subsequent CABG completed the procedure whose postoperative course was uneventful. Discussion Shunting during combined CEA-CABG may be advisable to assure cerebral protection from possible hypoperfusion due to potential hemodynamic instability of patients with severe coronary artery disease. Awareness and prompt management of possible shunt-related complications, including the newly reported one, may contribute to limiting their harmful effect. Conclusion Arterial wall rupture is a possible, previously not reported, shunt-related complication to be aware of when performing CEA. PMID:26255001

  3. Carotid endarterectomy and prevention of cerebral ischemia in symptomatic carotid stenosis

    SciTech Connect

    Mayberg, M.R.; Eskridge, J.; Winn, H.R.; Eskridge, J. ); Wilson, S.E. ); Yatsu, F. ); Weiss, D.G. ); Messina, L. ); Hershey, L.A. ); Colling, C. ); Deykin, D. )

    1991-12-18

    The objective of this study was to determine whether carotid endarterectomy provides protection against subsequent cerebral ischemia in men with ischemic symptoms in the distribution of significant ipsilateral internal carotid artery stenosis. The study group was comprised of men who presented within 120 days of onset of symptoms that were consistent with transient ischemic attacks, transient monocular blindness, or recent small completed strokes between July 1988 and February 1991. Among 5,000 patients screened, 189 individuals were randomized with angiographic internal carotid artery stenosis greater than 50% ipsilateral to the presenting symptoms. Forty-eight eligible patients who refused entry were followed up outside of the trial. For a selected cohort of men with symptoms of cerebral or retinal ischemia in the distribution of a high-grade internal carotid artery stenosis, carotid endarterectomy can effectively reduce the risk of subsequent ipsilateral cerebral ischemia. The risk of cerebral ischemia in this subgroup of patients is considerably higher than previously estimated.

  4. Oculoplethysmography and carotid phonoangiography for the noninvasive detection of extracranial carotid occlusive disease.

    PubMed

    McRae, L P; Cadwallader, J A; Kartchner, M M

    1979-01-01

    Clinical applications of imaging techniques and noninvasive physiological vascular evaluations provide useful assistance in the detection and management of stroke-prone patients by minimizing unnecessary carotid arteriography and surgery. Two such evaluation techniques are oculoplethysmography (OPG) and carotid phonoangiography (CPA). Developed, used, and proved highly reliable at the Tucson (Arizona) Medical Center, the techniques have been documented in 12,000 tests on approximately 8500 patients. OPG simultaneously records the bilateral ocular pulses concomitantly with external carotid pulses. Delays in timing of these pulses reflect reduction of flow in the internal and/or external carotid arteries, respectively. CPA consists of electronic stethoscopic auscultation, direct visualization, and photographic recording of carotid bruits or blood flow sounds.

  5. Obesity and carotid artery remodeling

    PubMed Central

    Kozakova, M; Palombo, C; Morizzo, C; Højlund, K; Hatunic, M; Balkau, B; Nilsson, P M; Ferrannini, E

    2015-01-01

    Background/Objective: The present study tested the hypothesis that obesity-related changes in carotid intima-media thickness (IMT) might represent not only preclinical atherosclerosis but an adaptive remodeling meant to preserve circumferential wall stress (CWS) in altered hemodynamic conditions characterized by body size-dependent increase in stroke volume (SV) and blood pressure (BP). Subjects/Methods: Common carotid artery (CCA) luminal diameter (LD), IMT and CWS were measured in three different populations in order to study: (A) cross-sectional associations between SV, BP, anthropometric parameters and CCA LD (266 healthy subjects with wide range of body weight (24–159 kg)); (B) longitudinal associations between CCA LD and 3-year IMT progression rate (ΔIMT; 571 healthy non-obese subjects without increased cardiovascular (CV) risk); (C) the impact of obesity on CCA geometry and CWS (88 obese subjects without CV complications and 88 non-obese subjects matched for gender and age). Results: CCA LD was independently associated with SV that was determined by body size. In the longitudinal study, baseline LD was an independent determinant of ΔIMT, and ΔIMT of subjects in the highest LD quartile was significantly higher (28±3 μm) as compared with those in the lower quartiles (8±3, 16±4 and 16±3 μm, P=0.001, P<0.05 and P=0.01, respectively). In addition, CCA CWS decreased during the observational period in the highest LD quartile (from 54.2±8.6 to 51.6±7.4 kPa, P<0.0001). As compared with gender- and age-matched lean individuals, obese subjects had highly increased CCA LD and BP (P<0.0001 for both), but only slightly higher CWS (P=0.05) due to a significant increase in IMT (P=0.005 after adjustment for confounders). Conclusions: Our findings suggest that in obese subjects, the CCA wall thickens to compensate the luminal enlargement caused by body size-induced increase in SV, and therefore, to normalize the wall stress. CCA diameter in obesity could

  6. Calcified microbes in Neoproterozoic carbonates: implications for our understanding of the Proterozoic/Cambrian transition

    NASA Technical Reports Server (NTRS)

    Knoll, A. H.; Fairchild, I. J.; Swett, K.

    1993-01-01

    Tidal flat and lagoonal dolostones of the Neoproterozoic Draken Formation, Spitsbergen, exhibit excellent preservation of carbonate fabrics, including heavily calcified microfossils. The crust-forming cyanobacterium Polybessurus is preserved locally by carbonate precipitated on and within sheaths in mildly evaporitic upper intertidal to supratidal environments. In contrast, calcified filaments in columnar stromatolites reflect subtidal precipitation. Filament molds in dolomicrites independently document extremely early lithification. The presence of heavily calcified cyanobacteria in Draken and other Proterozoic carbonates constrains potential explanations for the widespread appearance of calcified microorganisms near the Proterozoic-Cambrian boundary. We propose that the rarity of Proterozoic examples principally reflects the abundance and wide distribution of carbonate crystals precipitated on the sea floor or in the water column. Cyanobacterial sheaths would have competed effectively as sites for carbonate nucleation and growth only where calcitic and/or aragonitic nuclei were absent. In this view, the Proterozoic-Cambrian expansion of calcified microfossils primarily reflects the emergence of skeletons as principal agents of carbonate deposition.

  7. Use of Circular Foldable Nitinol Blades for Resecting Calcified Aortic Heart Valves

    NASA Astrophysics Data System (ADS)

    Hauck, Florian; Wendt, Daniel; Stühle, Sebastian; Kawa, Emilia; Wendt, Hermann; Müller, Wiebke; Thielmann, Matthias; Kipfmüller, Brigitte; Vogel, Bernd; Jakob, Heinz

    2009-08-01

    The use of percutaneous aortic valve implantation is limited, as the native calcified valve is left in situ. A new device has been developed for resecting calcified aortic valves, using collapsible nickel-titanium blades: laser-cut T-structures of Nitinol sheet-material (Ni51Ti49 at.%) have been grinded on a high-speed milling cutter to produce cutting edges which have been given the shape of half-circles afterwards. These have been connected to each other and to struts by using rivets which also serve as articulating axes for the cutting ring. The blades are folded around these axes and retreated into a tube to be inserted in the heart through the calcified valve leaflets. Once released, the cutting edges regain their ring-shape. By combining rotation of the ring with a translating movement against a second ring of slightly greater diameter on the instrument, a punching process is created which cuts the calcified valve leaflets and leaves a circular annulus, where a prosthesis can be fixed. In vitro cutting of artificially calcified valves ( n = 6) resulted in a resection time of t = 22 ± 6.29 s with a maximum turning moment of M = 2.4 ± 1.27 Nm, proving the function and the feasibility of the concept.

  8. Comparative study of calcified changes in aortic valvular diseases.

    PubMed

    Togashi, Mayuko; Tamura, Koichi; Masuda, Yukinari; Fukuda, Yuh

    2008-06-01

    Calcification of the aortic valve leads to stenosis or regurgitation or both. To clarify the mechanism of heart valve calcification, comparative studies using histological and ultrastructural examinations were performed of calcified aortic valves. These valves were obtained at valve replacement surgery from 11 patients with rheumatic aortic valvular disease (RAVD), 10 patients with degenerative aortic valve disease (DAVD), and 10 patients with congenitally bicuspid aortic valves (CBAV). For electron microscopic study, 5 cases were selected from each group. In RAVD, histological examination revealed calcification in a degenerated amorphous area at the center of fibrous thickened regions and in laminar fibrous thickened areas near the valve surface. In DAVD, calcification was observed mainly in the fibrosa near the valve ring. In CBAV, basic pathological changes were similar to those in DAVD; however, additional severe calcification of the raphe was observed, if the raphe was present. Ultrastructural examinations showed deposition of electron-dense materials in two patterns in all three groups; one pattern was observed in the interfibrillar spaces of collagen fibrils, and the other pattern was widespread macular deposition unrelated to the preexisting structure. In RAVD, microfibril-like fibrillar structures were found in the areas of deposition of electron-dense materials. These findings suggest that newly formed connective tissue degraded and became necrotic because of nutritional deprivation, especially in the thickened central area, causing calcium deposition. In DAVD and CBAV, numerous lipid vacuoles were found in the electron-dense deposition areas similar to lipid deposition in aortic atherosclerosis. Localized calcium deposition in the fibrosa suggests that the stress of valvular motion and pressure load induces sclerotic changes with the degeneration of collagen fibers, providing a core for calcification. In CBAV, the raphe was the main location of

  9. Who Is at Risk for Carotid Artery Disease?

    MedlinePlus

    ... Prevention Living With Clinical Trials Links Related Topics Atherosclerosis Carotid Endarterectomy Carotid Ultrasound Stents Stroke Send a ... who don’t have diabetes. Family history of atherosclerosis . People who have a family history of atherosclerosis ...

  10. Implications of Total to High-Density Lipoprotein Cholesterol Ratio Discordance With Alternative Lipid Parameters for Coronary Atheroma Progression and Cardiovascular Events.

    PubMed

    Elshazly, Mohamed B; Nicholls, Stephen J; Nissen, Steven E; St John, Julie; Martin, Seth S; Jones, Steven R; Quispe, Renato; Stegman, Brian; Kapadia, Samir R; Tuzcu, E Murat; Puri, Rishi

    2016-09-01

    The total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio may quantify atherogenic lipoproteins beyond low-density lipoprotein cholesterol (LDL-C), non-HDL-C and apolipoprotein B (apoB). We analyzed pooled data from 9 trials involving 4,957 patients with coronary artery disease undergoing serial intravascular ultrasonography to assess changes in percent atheroma volume (ΔPAV) and 2-year major adverse cardiovascular event (MACE) rates when TC/HDL-C levels were discordant with LDL-C, non-HDL-C, and apoB. Discordance was investigated when lipid levels were stratified by atheroma progression and MACE rates when discordant with LDL-C, non-HDL-C, and apoB within subjects. Thus, using the ratio, in addition to individual lipid parameters, may identify patients who may benefit from more intensive lipid modification. PMID:27392507

  11. Pulmonary epithelioid hemangioendothelioma accompanied by bilateral multiple calcified nodules in lung

    PubMed Central

    2011-01-01

    Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor. It can present either as one solitary nodule or bilateral multiple nodules, usually without calcification. We describe here an unusual case of PEH in a 42-year-old female with a 6.0 cm dominant mass along with bilateral multiple calcified small nodules measuring 0.2-1.0 cm in diameter with a 25-year plus followup history. Overall histologic findings of the solitary tumor accorded with conventional PEH. While multiple calcified small nodules were composed predominantly of intra-alveolar homogeneously eosinophilic matrix, and only a few bland small cells were embedded in it. This lesion has never been reported in the literature. After comprehensive analysis of morphology, radiography, histochemistry, immunohistochemistry and differential diagnoses, PEH presenting multiple calcified small nodules was confirmed. PMID:21418612

  12. MIGRAINE, CAROTID STIFFNESS AND GENETIC POLYMORPHISM.

    PubMed

    Kes, Vanja Basić; Jurasić, Miljenka-Jelena; Zavoreo, Iris; Corić, Lejla; Rotim, Kresimir

    2015-12-01

    Recently migraine has been associated with increased arterial stiffness, procoagulant state, increased incidence of cerebral white matter lesions (WML) and stroke. Our aim was to compare the characteristics of migraineurs to headache free controls regarding their functional carotid ultrasound parameters. Sixty patients (45 women) with migraine (mean age 40.42 ± 10.61 years) were compared with 45 controls (30 women) with no prior history of repeating headache (mean age 38.94 ± 5.46 years) using E-tracking software on Alpha 10 ultrasound platform. Student's t-test was used on statistical analysis with alpha < 0.05. All tested carotid vascular parameters were worse in patients with migraine including increased intima-media thickness, greater carotid diameter and carotid diameter change, as well as several arterial stiffness indices. Additionally, patients with migraine had greater incidence of homozygous mutations for procoagulant genes (MTHFR (C677T), PAI-1 and ACE I/D) than expected. Computed tomography and magnetic resonance imaging of the brain showed WML in 11 patients, four of them migraine with aura patients. Since we established increased carotid stiffness and higher frequency of procoagulant gene mutations in migraineurs, we propose prospective ultrasound monitoring in such patients, especially those with detected WML, in order to timely commence more active and specific preventive stroke management strategies.

  13. Carotid artery disease following external cervical irradiation.

    PubMed Central

    Elerding, S C; Fernandez, R N; Grotta, J C; Lindberg, R D; Causay, L C; McMurtrey, M J

    1981-01-01

    A retrospective study of 910 patients surviving at least five years after cervical irradiation for Hodgkin's disease, non-Hodgkin's lymphoma, or primary head an neck neoplasms showed the incidence of stroke following cervical irradiation was 63 of 910 patients (6.3%) during a mean period of observation of nine years. This represents a trend toward an increased risk for this population observed over the same period of time (p = 0.39). A prospective study of 118 similar patients currently living five years after cervical radiotherapy was performed to determine the incidence of carotid artery disease occurring as a consequence of neck irradiation. Abnormal carotid phonangiograms (CPA) were found in 25% of the patients and abnormal oculoplethysmographs (OPG) were found in 17%. These studies represent significant carotid lesions that are not expected in such a population. It is concluded that the carotid stenoses demonstrated are most likely a consequence of prior irradiation. Patients that are five-year survivors of cervical irradiation should have noninvasive vascular laboratory studies performed as part of their routine follow-up examinations in order to detect these carotid lesions while they are occult. PMID:7294930

  14. Carotid body tumors: a 40-year study.

    PubMed

    Farr, H W

    1980-01-01

    A total of 44 carotid body tumors were observed for over 40 years at Memorial Sloan-Kettering Cancer Center in New York. The true nature of th paraganglioma can remain obscure in those patients without prior tissue biopsy or sophisticated diagnostic studies. Eighteen patients came to surgery without a primary working diagnosis of the conditions, 43 percent of the seris. Significant advances in the preoperative workup of a cervical mass attached to the carotid sheath are now recommended: ultrasonography, radioisotope perfusion scanning, and selective carotid arteriography. Catecholamine determination should be considered for any paraganglioma exhibiting vasomotor instability or hypertension. Prior to 1945 the carotid bifurcation was sacrificed eight times with a 50 percent mortality occurring in relatively youthful subjects. In the 35 years since then, a more sophisticated surgical technique preserving the carotid circulation has resulted in over 30 resections with but one fatality. Multicentricity, both in the sporadic and the familial form, is characteristic of this rare tumor, also called "APUDoma." (APUD is an acronym derived from three of the most important characteristics of these cells: a high amine content, amine precursor uptake, and decarboxylation. Its malignant potential is beyond debate.

  15. Carotid intraplaque neovascularization quantification software (CINQS).

    PubMed

    Akkus, Zeynettin; van Burken, Gerard; van den Oord, Stijn C H; Schinkel, Arend F L; de Jong, Nico; van der Steen, Antonius F W; Bosch, Johan G

    2015-01-01

    Intraplaque neovascularization (IPN) is an important biomarker of atherosclerotic plaque vulnerability. As IPN can be detected by contrast enhanced ultrasound (CEUS), imaging-biomarkers derived from CEUS may allow early prediction of plaque vulnerability. To select the best quantitative imaging-biomarkers for prediction of plaque vulnerability, a systematic analysis of IPN with existing and new analysis algorithms is necessary. Currently available commercial contrast quantification tools are not applicable for quantitative analysis of carotid IPN due to substantial motion of the carotid artery, artifacts, and intermittent perfusion of plaques. We therefore developed a specialized software package called Carotid intraplaque neovascularization quantification software (CINQS). It was designed for effective and systematic comparison of sets of quantitative imaging biomarkers. CINQS includes several analysis algorithms for carotid IPN quantification and overcomes the limitations of current contrast quantification tools and existing carotid IPN quantification approaches. CINQS has a modular design which allows integrating new analysis tools. Wizard-like analysis tools and its graphical-user-interface facilitate its usage. In this paper, we describe the concept, analysis tools, and performance of CINQS and present analysis results of 45 plaques of 23 patients. The results in 45 plaques showed excellent agreement with visual IPN scores for two quantitative imaging-biomarkers (The area under the receiver operating characteristic curve was 0.92 and 0.93). PMID:25561454

  16. Benthic marine calcifiers coexist with CaCO3-undersaturated seawater worldwide

    NASA Astrophysics Data System (ADS)

    Lebrato, M.; Andersson, A. J.; Ries, J. B.; Aronson, R. B.; Lamare, M. D.; Koeve, W.; Oschlies, A.; Iglesias-Rodriguez, M. D.; Thatje, S.; Amsler, M.; Vos, S. C.; Jones, D. O. B.; Ruhl, H. A.; Gates, A. R.; McClintock, J. B.

    2016-07-01

    Ocean acidification and decreasing seawater saturation state with respect to calcium carbonate (CaCO3) minerals have raised concerns about the consequences to marine organisms that build CaCO3 structures. A large proportion of benthic marine calcifiers incorporate Mg2+ into their skeletons (Mg-calcite), which, in general, reduces mineral stability. The relative vulnerability of some marine calcifiers to ocean acidification appears linked to the relative solubility of their shell or skeletal mineralogy, although some organisms have sophisticated mechanisms for constructing and maintaining their CaCO3 structures causing deviation from this dependence. Nevertheless, few studies consider seawater saturation state with respect to the actual Mg-calcite mineralogy (ΩMg-x) of a species when evaluating the effect of ocean acidification on that species. Here, a global dataset of skeletal mole % MgCO3 of benthic calcifiers and in situ environmental conditions spanning a depth range of 0 m (subtidal/neritic) to 5600 m (abyssal) was assembled to calculate in situ ΩMg-x. This analysis shows that 24% of the studied benthic calcifiers currently experience seawater mineral undersaturation (ΩMg-x < 1). As a result of ongoing anthropogenic ocean acidification over the next 200 to 3000 years, the predicted decrease in seawater mineral saturation will expose approximately 57% of all studied benthic calcifying species to seawater undersaturation. These observations reveal a surprisingly high proportion of benthic marine calcifiers exposed to seawater that is undersaturated with respect to their skeletal mineralogy, underscoring the importance of using species-specific seawater mineral saturation states when investigating the impact of CO2-induced ocean acidification on benthic marine calcification.

  17. A multi-modal multiphoton investigation of microstructure in the deep zone and calcified cartilage

    PubMed Central

    Mansfield, Jessica C; Peter Winlove, C

    2012-01-01

    Multi-modal multiphoton microscopy was used to investigate tissue microstructure in the zone of calcified cartilage, focussing on the collagen fibre organisation at the tidemark and cement line. Thick, unstained and unfixed sagittal sections were prepared from the equine metacarpophalangeal joint. Second harmonic generation (SHG) provided contrast for collagen, two-photon fluorescence (TPF) for endogenous fluorophores, and coherent anti-Stokes Raman scattering (CARS) allowed the cells to be visualised. The structure of radial and calcified cartilage was found to vary with location across the joint, with the palma regions showing a more ordered parallel arrangement of collagen fibres than the cortical ridge and dorsal regions. These patterns may be associated with regional variations in joint loading. In addition, the cell lacunae had a greater diameter in the dorsal region than in the palmar region. At the cement line some collagen fibres were observed crossing between the calcified cartilage and the subchondral bone. At the tidemark the fibres were parallel and continuous between the radial and calcified cartilage. Beneath early superficial lesions the structure of the tidemark and calcified cartilage was disrupted with discontinuities and gaps in the fibrillar organisation. Cartilage microstructure varies in the deep zones between regions of different loading. The variations in collagen structure observed may be significant to the local mechanical properties of the cartilage and therefore may be important to its mechanical interactions with the subchondral bone. The calcified cartilage is altered even below early superficial lesions and therefore is important in the understanding of the aetiology of osteoarthritis. PMID:22332832

  18. Complications of cerebral angiography in patients with symptomatic carotid territory ischaemia screened by carotid ultrasound.

    PubMed Central

    Davies, K N; Humphrey, P R

    1993-01-01

    After nearly 40 years, carotid endarterectomy has been shown to be of benefit to patients with symptomatic carotid territory ischaemia and greater than 70% stenosis of the relevant internal carotid artery. Cerebral angiography is performed before surgery and is not without risk. These risks must be added to those of surgery before recommending the procedure to patients. The study evaluated the local, systemic and neurological complications following digital subtraction angiography with selective catheterisation of the carotid arteries in 200 patients presenting to a cerebrovascular clinic for assessment of cerebral ischaemia. All patients had carotid ultrasound screening before angiography to screen out those with normal arteries or mild disease (less than 30% stenosis of symptomatic internal carotid artery). Complications occurred in 28 patients. There were six (3%) local, two (1%) systemic and 20 (10%) neurological complications. Seventeen neurological complications occurred within 24 hours and there were three late complications (24-72 hours). Neurological complications occurred more frequently when angiography was performed by a trainee rather than a consultant neuroradiologist (p < 0.01). The neurological complications were transient (resolved within 24 hours) in 10/200 (5%), reversible (resolved within seven days) in two (1%) and permanent in 8/200 (4%). Two patients died after a stroke and two other patients suffered a disabling stroke. At 24 hours post angiography the permanent (persisting beyond seven days) neurological complication rate was 2.5%. The incidence of total neurological complications and post angiographic strokes was higher in patients with greater than 90% stenosis of the symptomatic internal carotid artery (p < 0.001). The increased use of non-invasive Doppler duplex screening will reduced the absolute number of patients put at risk of angiography, yet the rate of post angiographic complications is likely to increase as patients with severe

  19. Safety Outcomes Using a Proximal Protection Device in Carotid Stenting of Long Carotid Stenoses

    PubMed Central

    Atchaneeyasakul, Kunakorn; Khandelwal, Priyank; Ambekar, Sudheer; Ramdas, Kevin; Guada, Luis; Yavagal, Dileep

    2016-01-01

    Background Embolic protection devices can prevent atherosclerotic emboli during carotid stenting. Newer proximal protection devices reverse flow in the internal carotid artery (ICA), leading to reduction in perioperative microemboli. The risk of stroke is high for carotid stenting of ICA lesions with a length >10 mm and/or angiographic string sign. Objective We aimed to evaluate the safety outcomes of proximal embolic protection device usage in this high-risk group. Methods This is a retrospective analysis of patients who underwent carotid stenting procedures with proximal embolic protection devices at a tertiary care center. High-risk features for adverse events with carotid stenting were identified. Peri- and postprocedural outcomes were recorded. We further compared outcomes in patients with a carotid stenosis length >10 mm to those with shorter stenosis. Results From January 2011 to December 2014, we included 27 patients; 96.3% were symptomatic and 3.7% were asymptomatic. There was a stent placement technical success rate of 100%. No major stroke or coronary events were recorded. One minor stroke event developed in one patient. A carotid lesion length >10 mm and/or angiographic string sign was noted in 21/27 patients, with an average lesion length of 14.4 mm. One patient (4.8%) in this group developed a minor stroke event. Neither a coronary nor a major stroke event was recorded in this group. There was no significant difference in the complication rate between the long lesion and the control group. Conclusion In our patient cohort, it was found that a proximal embolic protection device is safe for patients with carotid stenosis, including those with a carotid lesion length >10 mm and/or angiographic string sign.

  20. Cigarette smoking and carotid plaque echodensity in the Northern Manhattan Study

    PubMed Central

    Yang, Dixon; Iyer, Sunil; Gardener, Hannah; Della-Morte, David; Crisby, Milita; Dong, Chuanhui; Cheung, Ken; Mora-McLaughlin, Consuelo; Wright, Clinton B.; Elkind, Mitchell S.; Sacco, Ralph L.; Rundek, Tatjana

    2015-01-01

    Background We sought to determine the association between cigarette smoking and carotid plaque ultrasound morphology in a multi-ethnic cohort. Methods We analyzed 1,743 stroke-free participants (mean age, 65.5±8.9 years; 60% women; 18% white, 63% Hispanic, 19% black; 14% current and 38% former smokers, 48% never smoked) from the Northern Manhattan Study using an ultrasound index of plaque echodensity, the Gray-Scale Median (GSM). Echolucent plaque (low GSM) represents soft plaque and echodense (high GSM) more calcified plaque. The mean GSM weighted by plaque area for each plaque was calculated for those with multiple plaques. Quintiles of GSM were compared to no plaque. Multinomial logistic regression models were used to assess associations of cigarette smoking with GSM, adjusting for demographics and vascular risk factors. Results Among subjects with carotid plaque (58%), the mean GSM scores for quintiles 1 to 5 were 48, 72, 90, 105, and 128, respectively. Current smokers had over a 2-fold increased risk of having GSM in quintile 1 (Odds Ratio [OR]=2.17; 95% Confidence Interval [CI], 1.34–3.52), quintile 2 (OR=2.33; CI, 1.42–3.83), quintile 4 (OR=2.05; CI, 1.19–3.51), and quintile 5 (OR=2.13; CI, 1.27–3.56) but not in quintile 3 (OR=1.18; CI, 0.67–2.10) as compared to never smokers in fully adjusted models. Former smokers had increased risk in quintile 2 (OR=1.46; CI, 1.00–2.12), quintile 3 (OR=1.56; CI, 1.09–2.24), quintile 4 (OR=1.66; CI, 1.13–2.42), and quintile 5 (OR=1.73; CI, 1.19–2.51), but not in quintile 1 (OR=1.05; CI, 0.72–1.55). Conclusions A non-linear, Vshaped like relationship between current cigarette smoking and plaque echodensity was observed. Former smokers were at highest risk for plaques in high GSM quintiles. Thus, current smokers were more likely to have either soft or calcified plaques and former smokers were at greater risk of only echodense plaques when compared against never smokers. Further research is needed to

  1. Differential responses of calcifying and non-calcifying epibionts of a brown macroalga to present-day and future upwelling pCO2.

    PubMed

    Saderne, Vincent; Wahl, Martin

    2013-01-01

    Seaweeds are key species of the Baltic Sea benthic ecosystems. They are the substratum of numerous fouling epibionts like bryozoans and tubeworms. Several of these epibionts bear calcified structures and could be impacted by the high pCO2 events of the late summer upwellings in the Baltic nearshores. Those events are expected to increase in strength and duration with global change and ocean acidification. If calcifying epibionts are impacted by transient acidification as driven by upwelling events, their increasing prevalence could cause a shift of the fouling communities toward fleshy species. The aim of the present study was to test the sensitivity of selected seaweed macrofoulers to transient elevation of pCO2 in their natural microenvironment, i.e. the boundary layer covering the thallus surface of brown seaweeds. Fragments of the macroalga Fucus serratus bearing an epibiotic community composed of the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium hirsutum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460 ± 59 µatm, present-day upwelling1193 ± 166 µatm and future upwelling 3150 ± 446 µatm. Only the highest pCO2 caused a significant reduction of growth rates and settlement of S. spirorbis individuals. Additionally, S. spirorbis settled juveniles exhibited enhanced calcification of 40% during daylight hours compared to dark hours, possibly reflecting a day-night alternation of an acidification-modulating effect by algal photosynthesis as opposed to an acidification-enhancing effect of algal respiration. E. pilosa colonies showed significantly increased growth rates at intermediate pCO2 (1193 µatm) but no response to higher pCO2. No effect of acidification on A. hirsutum colonies growth rates was observed. The results suggest a remarkable resistance of the algal macro-epibionts to levels of acidification occurring at present day upwellings in the Baltic. Only extreme

  2. Photoacoustic imaging of carotid artery atherosclerosis

    NASA Astrophysics Data System (ADS)

    Kruizinga, Pieter; van der Steen, Antonius F. W.; de Jong, Nico; Springeling, Geert; Robertus, Jan Lukas; van der Lugt, Aad; van Soest, Gijs

    2014-11-01

    We introduce a method for photoacoustic imaging of the carotid artery, tailored toward detection of lipid-rich atherosclerotic lesions. A common human carotid artery was obtained at autopsy, embedded in a neck mimicking phantom and imaged with a multimodality imaging system using interstitial illumination. Light was delivered through a 1.25-mm-diameter optical probe that can be placed in the pharynx, allowing the carotid artery to be illuminated from within the body. Ultrasound imaging and photoacoustic signal detection is achieved by an external 8-MHz linear array coupled to an ultrasound imaging system. Spectroscopic analysis of photoacoustic images obtained in the wavelength range from 1130 to 1250 nm revealed plaque-specific lipid accumulation in the collagen structure of the artery wall. These spectroscopic findings were confirmed by histology.

  3. Current status of carotid ultrasound in atherosclerosis

    PubMed Central

    2016-01-01

    Cardiovascular disease (CVD) primarily caused by atherosclerosis is a major cause of death and disability in developed countries. Sonographic carotid intima-media thickness (CIMT) is widely studied as a surrogate marker for detecting subclinical atherosclerosis for risk prediction and disease progress to guide medical intervention. However, there is no standardized CIMT measurement methodology in clinical studies resulting in inconsistent findings, thereby undermining the clinical value of CIMT. Increasing evidences show that CIMT alone has weak predictive value for CVD while CIMT including plaque presence consistently improves the predictive power. Quantification of plaque burden further enhances the predictive power beyond plaque presence. Sonographic carotid plaque characteristics have been found to be predictive of cerebral ischaemic events. With advances in ultrasound technology, enhanced assessment of carotid plaques is feasible to detect high-risk/vulnerable plaques, and provide risk assessment for ischemic stroke beyond measurement of luminal stenosis. PMID:27429912

  4. Calcifying Aponeurotic Fibroma with Osseous Involvement of the Finger: a Case Report with Radiologic and US Findings

    PubMed Central

    Ahn, Jae Hong; Kang, Gilhyun; Lee, Jong Hyeog; Park, Man Soo; Ryu, Dae Sik; Jung, Seung Moon

    2008-01-01

    Calcifying aponeurotic fibroma is a rare soft tissue tumor that occurs in the distal extremities of children and adolescents. We report ultrasound and X-ray findings of a calcifying aponeurotic fibroma in the finger of a 36-year-old woman, associated with distal phalangeal bone involvement. PMID:18253083

  5. ULTRASTRUCTURE OF THE CAROTID BODY

    PubMed Central

    Biscoe, T. J.; Stehbens, W. E.

    1966-01-01

    An electron microscope investigation was made of the carotid body in the cat and the rabbit. In thin-walled blood vessels the endothelium was fenestrated. Larger vessels were surrounded by a layer of smooth muscle fibers. Among the numerous blood vessels lay groups of cells of two types covered by basement membranes. Aggregates of Type I cells were invested by Type II cells, though occasionally cytoplasmic extensions were covered by basement membrane only. Type I cells contained many electron-opaque cored vesicles (350 to 1900 A in diameter) resembling those in endocrine secretory cells. Type II cells covered nerve endings terminating on Type I cells and enclosed nerve fibers in much the same manner as Schwann cells. The nerve endings contained numerous microvesicles (∼500 A in diameter), mitochondria, glycogen granules, and a few electron-opaque cored vesicles. Junctions between nerve endings and Type I cells were associated with regions of increased density in both intercellular spaces and the adjoining cytoplasm. Cilia of the 9 + 0 fibril pattern were observed in Type I and Type II cells and pericytes. Nonmyelinated nerve fibers, often containing microvesicles, mitochondria, and a few electron-opaque cored vesicles (650 to 1000 A in diameter) were present in Schwann cells, many of which were situated close to blood vessels Ganglion cells near the periphery of the gland, fibrocytes, and segments of unidentified cells were also seen. It was concluded that, according to present concepts of the structure of nerve endings, those endings related to Type I cells could be efferent or afferent. PMID:5971007

  6. Diagonal ear lobe crease and atherosclerosis: A review of the medical literature and dental implications

    PubMed Central

    López-López, José; Velasco-Ortega, Eugenio

    2012-01-01

    In Spain a significant number of individuals die from atherosclerotic disease of the coronary and carotid arteries without having classic risk factors and prodromal symptoms. The diagonal ear lobe crease (DELC) has been characterized in the medical literature as a surrogate marker which can identify high risk patients having occult atherosclerosis. This topic however has not been examined in either the medical or dental literature emanating from Spain. The majority of clinical, angiography and postmortem reports support the premise that DELC is a valuable extravascular physical sign able to distinguish some patients at risk of succumbing to atherosclerosis of the coronary arteries. A minority of studies have however failed to support this hypothesis. More recently reports using B mode ultrasound have also linked DELC to atherosclerosis of the carotid artery and another report has related DELC to the presence of calcified carotid artery atheromas on panoramic radiographs. DELC is readily visible during head and neck cancer screening examinations. In conjunction with the patient’s medical history, vital signs, and panoramic radiograph, the DELC may assist in atherosclerotic risk assessment. Key words: Diagonal ear lobe crease, atherosclerosis disease, calcified carotid artery, atheromas, panoramic radiographs. PMID:21743392

  7. Current management of asymptomatic carotid stenosis.

    PubMed

    Castilla-Guerra, L; Fernández-Moreno, M C; Serrano-Rodríguez, L

    2015-05-01

    Asymptomatic carotid stenosis (ACS) is a common problem in daily clinical practice, and its management is still the subject of controversy. In contrast to symptomatic carotid disease, the main studies on surgical treatment of patients with ACS have shown only a modest benefit in the primary prevention of stroke. In addition, current medical treatment has drastically decreased the risk of stroke in patients with ACS. Selecting patients amenable to endovascular treatment and determining how and when to conduct the ultrasound follow-up of these patients are issues that still need resolving. This article analyzes two new studies underway that provide evidence for better management of ACS in daily clinical practice.

  8. Coronary atherosclerosis burden is not advanced in patients with β-thalassemia despite premature extracardiac atherosclerosis: a coronary artery calcium score and carotid intima-media thickness study

    PubMed Central

    Hahalis, George; Zacharioglou, Evangelia; Xanthopoulou, Ioanna; Koniari, Ioanna; Kalogeropoulou, Chistina; Tsota, Irene; Rigopoulou, Aspasia; Diamantopoulos, Athanasios; Gkizas, Vasilios; Davlouros, Periklis; Akinosoglou, Karolina; Leopoulou, Marianna; Gogos, Charalampos; Alexopoulos, Dimitrios

    2016-01-01

    Background Thalassemic patients demonstrate an increased rate of extracardiac vascular complications and increased carotid wall intima-media thickness (cIMT), but very low prevalence of coronary artery disease (CAD). We investigated the atheroma burden by assessing the coronary artery calcium (CAC) and cIMT in these patients. Methods We examined 37 patients with β-thalassemia and 150 healthy control volunteers with multi-detector computer tomography (CT) and ultrasonography to determine CAC score and cIMT, respectively. Results Propensity score matching (C-statistic: 0.88; 95% CI: 0.83–0.93) resulted in 27 pairs of patients; severe CAC was observed in 2 (7.4%) and 0 of β-thalassemia patients and healthy volunteers respectively (P = 0.5). Median calcium score was 0 (0–0) in β-thalassemia patients and 0 (0–4) in healthy volunteers (P = 0.8). Median intima-media thickness was higher in β-thalassemia patients compared to control group [0.45 (0.06–0.65) vs. 0.062 (0.054–0.086); P = 0.04]. Conclusions Patients with β–thalassemia in comparison with healthy control subjects exhibit similar CAC score and increased cIMT. Our findings indicate a disparate rate of progression of atherosclerosis between coronary and extracardiac arteries in these patients lending support to the epidemiological evidence. PMID:27168742

  9. Carotid Body Tumor as a Cause of Stroke.

    PubMed

    Budincevic, Hrvoje; Piršic, Ana; Bohm, Tihana; Trajbar, Tomislav; Ivkošic, Ante; Pavlovic, Tomislav; Bielen, Ivan; Soldo-Butkovic, Silva

    2016-01-01

    We herein report a case of a 78-year-old woman who was admitted to our hospital due to a stroke with left-sided hemiparesis. Ultrasound of the carotid arteries showed a carotid body tumor on the bifurcation of the right common carotid artery, which was subsequently confirmed by a further neuroradiological investigation. Magnetic resonance imaging of the head confirmed an acute ischemic lesion located in the right periventricular region. The carotid body tumor (CBT) was surgically removed and confirmed on histopathology. Our case reveals the role of carotid ultrasound in the diagnosis of a CBT, which may be a potential cause of stroke. PMID:26831027

  10. Occipital infarction with hemianopsia from carotid occlusive disease.

    PubMed

    Pessin, M S; Kwan, E S; Scott, R M; Hedges, T R

    1989-03-01

    Extracranial internal carotid artery occlusive disease usually produces stroke in the middle cerebral artery territory or the border zone between the middle and anterior cerebral arteries. It is unusual for occipital infarction in the posterior cerebral artery territory to be caused by internal carotid artery disease despite the fact that the posterior cerebral artery may arise directly from the internal carotid artery as an anatomic variation. We describe a patient with a fetal posterior cerebral artery originating from the internal carotid artery, and the initial manifestation of his extracranial internal carotid artery occlusive disease was hemianopsia from occipital infarction.

  11. Tasting arterial blood: what do the carotid chemoreceptors sense?

    PubMed Central

    Prabhakhar, Nanduri R.; Joyner, Michael J.

    2015-01-01

    The carotid bodies are sensory organs that detect the chemical composition of the arterial blood. The carotid body sensory activity increases in response to arterial hypoxemia and the ensuing chemoreflex regulates vital homeostatic functions. Recent studies suggest that the carotid bodies might also sense arterial blood glucose and circulating insulin levels. This review focuses on how the carotid bodies sense O2, glucose, and insulin and some potential implications of these sensory functions on physiological regulation and in pathophysiological conditions. Emerging evidence suggests that carbon monoxide (CO)-regulated hydrogen sulfide (H2S), stemming from hypoxia, depolarizes type I cells by inhibiting certain K+ channels, facilitates voltage-gated Ca2+ influx leading to sensory excitation of the carotid body. Elevated CO and decreased H2S renders the carotid bodies insensitive to hypoxia resulting in attenuated ventilatory adaptations to high altitude hypoxia, whereas reduced CO and high H2S result in hypersensitivity of the carotid bodies to hypoxia and hypertension. Acute hypoglycemia augments the carotid body responses to hypoxia but that a prolonged lack of glucose in the carotid bodies can lead to a failure to sense hypoxia. Emerging evidence also indicates that carotid bodies might sense insulin directly independent of its effect on glucose, linking the carotid bodies to the pathophysiological consequences of the metabolic syndrome. How glucose and insulin interact with the CO-H2S signaling is an area of ongoing study. PMID:25642193

  12. Tasting arterial blood: what do the carotid chemoreceptors sense?

    PubMed

    Prabhakhar, Nanduri R; Joyner, Michael J

    2014-01-01

    The carotid bodies are sensory organs that detect the chemical composition of the arterial blood. The carotid body sensory activity increases in response to arterial hypoxemia and the ensuing chemoreflex regulates vital homeostatic functions. Recent studies suggest that the carotid bodies might also sense arterial blood glucose and circulating insulin levels. This review focuses on how the carotid bodies sense O2, glucose, and insulin and some potential implications of these sensory functions on physiological regulation and in pathophysiological conditions. Emerging evidence suggests that carbon monoxide (CO)-regulated hydrogen sulfide (H2S), stemming from hypoxia, depolarizes type I cells by inhibiting certain K(+) channels, facilitates voltage-gated Ca(2+) influx leading to sensory excitation of the carotid body. Elevated CO and decreased H2S renders the carotid bodies insensitive to hypoxia resulting in attenuated ventilatory adaptations to high altitude hypoxia, whereas reduced CO and high H2S result in hypersensitivity of the carotid bodies to hypoxia and hypertension. Acute hypoglycemia augments the carotid body responses to hypoxia but that a prolonged lack of glucose in the carotid bodies can lead to a failure to sense hypoxia. Emerging evidence also indicates that carotid bodies might sense insulin directly independent of its effect on glucose, linking the carotid bodies to the pathophysiological consequences of the metabolic syndrome. How glucose and insulin interact with the CO-H2S signaling is an area of ongoing study. PMID:25642193

  13. Evidence-based surgical treatment of carotid stenosis. Literature review.

    PubMed

    Andaluz, N; Zuccarello, M

    2004-03-01

    Carotid stenosis is an important cause of transient ischemic attacks and stroke. The cause of carotid stenosis is most often atherosclerosis, which accounts for 10% to 20% of brain infarction cases. Despite the introduction of tissue-plasminogen activator and other promising experimental therapies for select patients with acute ischemic stroke prevention remains the best approach to reduce its impact. Stroke-prone patients can be identified and targeted for specific interventions. At this juncture, treatment of carotid stenosis is a well-established therapeutic target and a pillar of stroke prevention. Two main strategies exist for the treatment of carotid stenosis. The 1st is stabilization or halting the progression of the carotid plaque formation with medications and modifications of risk factors (e.g., hypertension, diabetes, smoking, obesity, high cholesterol). The 2nd approach is the elimination or reduction of carotid stenosis by carotid endarterectomy or angioplasty and stenting. Carotid endarterectomy is the mainstay of therapy for symptomatic, severe carotid stenosis. Although its role for asymptomatic patients appears more limited, it is distinct for severe stenosis. Carotid angioplasty and stenting are techniques in maturation with the attractiveness of being less invasive that face the challenge of at least replicating the results of surgery. In this article, we will discuss the surgical management of symptomatic and asymptomatic carotid stenosis based on the evidence provided by the literature. PMID:15257259

  14. Perilesional brain edema and seizure activity in patients with calcified neurocysticercosis

    PubMed Central

    Nash, Theodore E.; Pretell, E. Javier; Lescano, Andres. G.; Bustos, Javier A.; Gilman, Robert H.; Gonzalez, Armando E.; Garcia, Héctor H.

    2013-01-01

    Background Cysticercosis due to Taenia solium is a leading cause of adult acquired seizures and epilepsy that frequently occurs in patients with only calcified larval cysts. Transient episodes of perilesional brain edema occur around calcified foci but its importance, association with seizures, incidence, and pathophysiology are unknown. Methods One hundred and ten persons with only calcified lesions and a history of seizures or severe headaches were followed prospectively in a cohort design to assess the incidence of seizure relapses. In a nested case-control sub study, perilesional edema was assessed by MRI at the time a seizure occurred in the symptomatic patient and in a matched asymptomatic control, amongst the 110 followed. Results Median follow up was 32.33 months (SD 19.99). Twenty-nine people had an incident seizure with an estimated 5 year seizure incidence of 36%. Twenty-four patients of the 29 with seizure relapse had an MRI evaluation within five days of the event. Perilesional edema was found in 12 (50.0%) compared to 2 of 23 asymptomatic matched controls (8.7%). Conclusions Perilesional edema occurs frequently and is associated with episodic seizure activity in calcified neurocysticercosis. Our findings are likely representative of symptomatic patients in endemic regions and suggest a unique and possibly preventable cause of seizures in this population. PMID:18986841

  15. Effectiveness of the hugging balloon technique in coronary angioplasty for a heavy, encircling, calcified coronary lesion.

    PubMed

    Ahn, Min Soo; Yoon, Junghan; Lee, Jun Won; Lee, Kyoung Hoon; Kim, Jang Young; Yoo, Byung Su; Lee, Seung Hwan; Choe, Kyung Hoon

    2009-11-01

    We report our experience in coronary angioplasty and intravascular ultrasonography (IVUS) on a heavy, encircling, calcified lesion that was not dilated with the use of a cutting balloon and a non-compliant balloon. The angioplasty was successfully performed with a simple and inexpensive hugging balloon technique. PMID:19997547

  16. Long-Term Trends in Calcifying Plankton and pH in the North Sea

    PubMed Central

    Beare, Doug; McQuatters-Gollop, Abigail; van der Hammen, Tessa; Machiels, Marcel; Teoh, Shwu Jiau; Hall-Spencer, Jason M.

    2013-01-01

    Relationships between six calcifying plankton groups and pH are explored in a highly biologically productive and data-rich area of the central North Sea using time-series datasets. The long-term trends show that abundances of foraminiferans, coccolithophores, and echinoderm larvae have risen over the last few decades while the abundances of bivalves and pteropods have declined. Despite good coverage of pH data for the study area there is uncertainty over the quality of this historical dataset; pH appears to have been declining since the mid 1990s but there was no statistical connection between the abundance of the calcifying plankton and the pH trends. If there are any effects of pH on calcifying plankton in the North Sea they appear to be masked by the combined effects of other climatic (e.g. temperature), chemical (nutrient concentrations) and biotic (predation) drivers. Certain calcified plankton have proliferated in the central North Sea, and are tolerant of changes in pH that have occurred since the 1950s but bivalve larvae and pteropods have declined. An improved monitoring programme is required as ocean acidification may be occurring at a rate that will exceed the environmental niches of numerous planktonic taxa, testing their capacities for acclimation and genetic adaptation. PMID:23658686

  17. Calcified neurocysticercosis associates with hippocampal atrophy: a population-based study.

    PubMed

    Del Brutto, Oscar H; Salgado, Perla; Lama, Julio; Del Brutto, Victor J; Campos, Xavier; Zambrano, Mauricio; García, Héctor H

    2015-01-01

    Calcified neurocysticercosis has been associated with hippocampal atrophy in patients with refractory epilepsy, but the relevance of this association in the population at large is unknown. We assessed calcified cysticerci and its association with hippocampal atrophy in elderly persons living in Atahualpa, an Ecuadorian village endemic for neurocysticercosis. All Atahualpa residents ≥ 60 years of age were invited to undergo computed tomography/magnetic resonance imaging for neurocysticercosis detection. Twenty-eight (11%) out of 248 enrolled persons had calcified cysticerci (case-patients) and were matched 1:1 by age, sex, and years of education to individuals without neurocysticercosis on computed tomography/magnetic resonance imaging (controls). Four case-patients and none of the controls had epilepsy (P = 0.134). Cognitive performance was similar across both groups. The Scheltens' medial temporal atrophy scale was used for hippocampal rating in case-patients and matched controls without neurocysticercosis. Mean score in the Scheltens' scale was higher in case-patients than in controls (P < 0.001). Atrophic hippocampi were noticed in 19 case-patients and five controls (P = 0.003). Atrophy was bilateral in 11 case-patients and unilateral in eight. All case-patients with unilateral hippocampal atrophy had at least one ipsilateral calcification. This study shows an association between calcified cysticerci and hippocampal atrophy and raises the possibility of an inflammation-mediated hippocampal damage as the responsible mechanism for these findings.

  18. Effects of seawater pCO2 changes on the calcifying fluid of scleractinian corals

    NASA Astrophysics Data System (ADS)

    Hohn, S.; Merico, A.

    2012-03-01

    Rising atmospheric CO2 concentrations due to anthropogenic emissions induce changes in the ocean carbonate chemistry and a drop in ocean pH. This acidification process is expected to harm calcifying organisms like coccolithophores, molluscs, echinoderms, and corals. A severe decline in coral abundance is, for example, expected by the end of this century with associated disastrous effects on reef ecosystems. Despite the growing importance of the topic, little progress has been made with respect to modelling the impact of acidification on coral calcification. Here we present a model for a coral polyp that simulates the carbonate system in four different compartments: the seawater, the polyp tissue, the coelenteron, and the calicoblastic layer. Precipitation of calcium carbonate takes place in the metabolically controlled calicoblastic layer beneath the polyp tissue. The model is adjusted to a state of activity as observed by direct microsensor measurements in the calcifying fluid. Simulated CO2 perturbation experiments reveal decreasing calcification rates under elevated pCO2 despite strong metabolic control of the calcifying fluid. Diffusion of CO2 through the tissue into the calicoblastic layer increases with increasing seawater pCO2 leading to decreased aragonite saturation in the calcifying fluid of the coral polyp. Our modelling study provides important insights into the complexity of the calcification process at the organism level and helps to quantify the effect of ocean acidification on corals.

  19. Best evidence for medical therapy for carotid artery stenosis.

    PubMed

    Constantinou, Jason; Jayia, Parveen; Hamilton, George

    2013-10-01

    Carotid atheromatous disease is an important cause of stroke and represents a key target in stroke prevention. Randomized trials have shown the efficacy of carotid endarterectomy in secondary stroke prevention. Carotid stenting presents a less invasive alternative to surgical intervention. Advances in medical management, if compliance can be ensured, are leading to improvement in outcomes when implemented as sole therapy in the treatment of atherosclerotic carotid stenosis. This includes lifestyle modification, blood pressure control, and antiplatelet and statin therapy. Over the last 20 years, the annual rate of ipsilateral stroke associated with asymptomatic carotid stenosis has decreased from 2% to 4% to less than 1%. This is largely due to improvements in medical therapy. However, despite numerous trials and years of clinical research, the optimal management of symptomatic and asymptomatic carotid disease remains controversial. This article presents and summarizes the evidence supporting best medical treatment for carotid artery stenosis.

  20. Comparative studies of inorganic carbon utilization in Emiliania huxleyi and some non-calcifying marine microalgae

    NASA Astrophysics Data System (ADS)

    Liang-Feng, Dong; Merrett, M. J.; Chao-Yuan, Wu

    1999-09-01

    Inorganic carbon utilization in the non-calcifying marine microalgae, Nannochloropsis oculata, Phaeodactylum tricornutum and Porphyridium purpureum was compared with high- and low-calcifying strains of Emiliania huxleyi grown in artificial seawater medium aerated with either air (0.03% V/V CO2) or CO2-free air. For high-calcifying strain of E. oculata and P. tricornutem, similar growth patterns were observed in air-and CO2-free air-grown cultures. P. purpureum showed a less final cell density in CO2-free air than in air-grown culture. However, low-calcifying strain of E. huxleyi was able to grow only in air-grown culture, but not in CO2-free air-grown culture. Measurements of alkalinity, pH, concentration of dissolved inorganic carbon (DIC) and free CO2 showed different patterns of DIC utilization. With N. oculata, P. tricornutum and P. purpureum the pattern of DIC utilization was characterized by an increase of pH and a decrease of DIC but a constant alkalinity in the cultures aerated with air or CO2-free air, suggesting that bicarbonate utilization was concomitant with an efflux of OH-. Both alkalinity and pH were maintained rather constant in air-grown culture of low-calcifying strain of E. huxleyi, suggesting that diffusive entry of CO2 could meet the requirement of DIC for its photosynthesis and growth. High-calcifying strain of E. huxleyi, however, showed a pattern of decrease of alkalinity and DIC but an almost constant pH, indicating that bicarbonate was the major form of inorganic carbon utilised by this organism and bicarbonate uptake is unlikely to be accompanied by an efflux of OH-. The final pH values reached by N. oculata, P. tricornutum and P. purpureum in a closed system were 10.75, 10.60 and 9.85 respectively, showing that bicarbonate utilisation is concomitant with an efflux of OH-. While the final pH of 8.4 in high-calcifying E. huxleyi suggests that bicarbonate utilization was not accompanied by an efflux of OH-.

  1. Carotid Artery Intima-Media Thickness, Carotid Plaque and Coronary Heart Disease and Stroke in Chinese

    PubMed Central

    Chien, Kuo-Liong; Su, Ta-Chen; Jeng, Jiann-Shing; Hsu, Hsiu-Ching; Chang, Wei-Tien; Chen, Ming-Fong; Lee, Yuan-Teh; Hu, Frank B.

    2008-01-01

    Background Our aim was to prospectively investigate the association between carotid artery intima-media thickness (IMT) as well as carotid plaque and incidence of coronary heart disease (CHD) and stroke in Chinese, among whom data are limited. Methods and Findings We conducted a community-based cohort study composed of 2190 participants free of cardiovascular disease at baseline in one community. During a median 10.5-year follow up, we documented 68 new cases of coronary heart disease and 94 cases of stroke. The multivariate relative risks (RRs) associated with a change of 1 standard deviation of maximal common carotid IMT were 1.38 (95% confidence interval [CI], 1.12–1.70) for CHD and 1.47 (95% CI, 1.28–1.69) for stroke. The corresponding RRs with internal carotid IMT were 1.47 (95% CI, 1.21–1.79) for CHD and 1.52 (95% CI, 1.31–1.76) for stroke. Carotid plaque measured by the degree of diameter stenosis was also significantly associated with increased risk of CHD (p for trend<0.0001) and stroke (p for trend<0.0001). However, these associations were largely attenuated when adjusting for IMT measurements. Conclusions This prospective study indicates a significant association between carotid IMT and incidence of CHD and stroke in Chinese adults. These measurements may be useful for cardiovascular risk assessment and stratification in Chinese. PMID:18927612

  2. Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography.

    PubMed

    Omoto, Shusaku; Hasegawa, Yuki; Sakai, Kenichiro; Matsuno, Hiromasa; Arai, Ayumi; Terasawa, Yuka; Mitsumura, Hidetaka; Iguchi, Yasuyuki

    2016-10-01

    Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy. PMID:27567297

  3. Association of Circulating Matrix Metalloproteinases with Carotid Artery Characteristics: The ARIC Carotid MRI Study

    PubMed Central

    Gaubatz, John W.; Ballantyne, Christie M.; Wasserman, Bruce A.; He, Max; Chambless, Lloyd E.; Boerwinkle, Eric; Hoogeveen, Ron C.

    2010-01-01

    Objective To examine the relationship of plasma levels of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase-1 (TIMP-1) with carotid artery characteristics measured by magnetic resonance imaging (MRI) in a cross-sectional investigation among Atherosclerosis Risk in Communities (ARIC) Carotid MRI Study participants. Methods and Results A stratified random sample was recruited based on intima-media thickness (IMT) from a previous ultrasound examination. A high-resolution gadolinium-enhanced MRI exam of the carotid artery was performed in 2004–2005 on 1,901 ARIC cohort participants. Multiple carotid wall characteristics including wall thickness, lumen area, calcium area, lipid core and fibrous cap measures were evaluated for associations with plasma MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9 and TIMP-1. Plasma MMP-1, MMP-3, and MMP-7 were significantly higher among participants in the high IMT group compared to those in the low IMT group. Normalized wall index was independently associated with MMP-3, MMP-7, and TIMP-1. MMP-7 was positively associated with carotid calcification. Mean fibrous cap thickness was significantly higher in individuals with elevated TIMP-1 levels. In addition, TIMP-1 was positively associated with measures of lipid core. Conclusions Circulating levels of specific MMPs and TIMP-1 were associated with carotid wall remodeling and structural changes related to plaque burden in the elderly. PMID:20167662

  4. Assessment of Carotid Atherosclerosis in Type 2 Diabetes Mellitus Patients with Microalbuminuria by High-Frequency Ultrasonography

    PubMed Central

    Zhang, Yu-Hong; Gao, Yuan; Mao, Xin; Shang, Jing; Su, Ben-Li

    2013-01-01

    The aim of this study is to evaluate carotid atherosclerosis in patients of type 2 diabetes mellitus with microalbuminuria (MA) by high-frequency ultrasonography. Two hundred and fifty patients of type 2 diabetes mellitus were divided into two groups according to urinary albumin excretion rate (UAER): normoalbuminuria group (130 cases) and microalbuminuria group (120 cases). The intimal-medial thickness (IMT) and the atherosclerotic plaques of carotid artery were observed in both groups by high-frequency ultrasound. Fasting blood glucose (FBG), hemoglobin A1c, and lipid profiles were measured. The values of IMT of microalbuminuria group were significantly higher than those of normoalbuminuria group (P < 0.05). In univariate analysis, IMT was positively and significantly associated with age (r = 0.265, P < 0.05), waist circumference (r = 0.263, P < 0.05), body mass index (r = 0.285, P < 0.05), systolic blood pressure (r = 0.276, P < 0.05), UAER (r = 0.359, P < 0.05), HbA1c (r = 0.462, P < 0.05) and, duration of diabetes (r = 0.370, P < 0.05). In multivariate linear regression analysis, UAER and HbA1c were independent predictors of IMT (P < 0.05 for all). In the two groups, the rate of soft plaques was higher than that of dense plaques and calcified plaques. In conclusion, there is a significant association between microalbuminuria and IMT which is regarded as the early sign of carotid atherosclerosis in type 2 diabetic patients. PMID:23573090

  5. Carotid Doppler evaluation in cerebrovascular disease.

    PubMed Central

    D'Alton, J. G.; Norris, J. W.

    1983-01-01

    The Doppler technique has proven to be a useful noninvasive technique for evaluating the patency of the carotid artery in patients at risk of stroke. The data obtained from 246 carotid Doppler examinations were compared with the angiographic findings in the same patients. The sensitivity, specificity and accuracy were high when the degree of stenosis was greater than 50%, but occlusions were less reliably detected, with 8 (33%) of the 24 being misdiagnosed as high-grade stenoses. Carotid Doppler evaluation guides and accelerates decisions regarding further investigations, such as cerebral angiography. It helps one decide whether a neck bruit is of arterial origin and aids assessment following cerebrovascular surgery. It is not a substitute for cerebral angiography because it poorly visualizes both the posterior and the intracranial circulations and cannot accurately detect low-grade (less than 50%) stenoses or ulcerated arterial plaques. Detection of stenosis in a carotid artery in an otherwise uncertain case is an indication for cerebral angiography, so the Doppler technique will probably increase the number of angiograms performed. However, this technique is also useful in follow-up, being without hazard, and should, therefore, reduce the likelihood of unnecessary angiographic examinations. Images FIG. 2 FIG. 3A FIG. 3B FIG. 5 PMID:6640454

  6. Topographic congruence of calcified parenchymal neurocysticercosis and other structural brain lesions with epileptiform activity

    PubMed Central

    Saito, Erin K; Nagpal, Meera; Leon, Amanda; Mehta, Bijal; McMurtray, Aaron Matthew

    2016-01-01

    Introduction: Calcified parenchymal neurocysticercosis (NCC) lesions are commonly detected in many individuals with refractory epilepsy. However, the relationship between these lesions and epilepsy is not fully determined. We sought to determine if calcified parenchymal NCC demonstrated topographic congruence with epileptiform activity in refractory epilepsy patients. Additional patients with other structural brain lesions were included for comparison. Subjects and Methods: Retrospective cross-sectional analysis of all patients treated at a community-based neurology clinic for refractory epilepsy during a 3-month period and with structural brain lesions detected by neuroimaging studies. Results: A total of 105 patients were included in the study, including 63 with calcified parenchymal NCC lesions and 42 with other structural brain lesions. No significant relationship was detected between hemispheric localization of calcified parenchymal NCC lesions and epileptiform activity. For those with other structural brain lesions, the hemispheric localization was significantly related to the side of epileptiform activity (Chi-square = 11.13, P = 0.025). In addition, logistic regression models showed that those with right-sided non-NCC lesions were more likely to have right-sided epileptiform activity (odds ratio = 4.36, 95% confidence interval [CI] =1.16–16.31, P = 0.029), and those with left-sided non-NCC lesions were more likely to have left-sided epileptiform activity (odds ratio = 7.60, 95% CI = 1.89–30.49, P = 0.004). Conclusion: The lack of correlation between the side of calcified parenchymal NCC lesions and the side of the epileptiform activity suggests that these lesions may be incidental findings in many patients. PMID:26998434

  7. Automated carotid artery intima layer regional segmentation

    NASA Astrophysics Data System (ADS)

    Meiburger, Kristen M.; Molinari, Filippo; Rajendra Acharya, U.; Saba, Luca; Rodrigues, Paulo; Liboni, William; Nicolaides, Andrew; Suri, Jasjit S.

    2011-07-01

    Evaluation of the carotid artery wall is essential for the assessment of a patient's cardiovascular risk or for the diagnosis of cardiovascular pathologies. This paper presents a new, completely user-independent algorithm called carotid artery intima layer regional segmentation (CAILRS, a class of AtheroEdge™ systems), which automatically segments the intima layer of the far wall of the carotid ultrasound artery based on mean shift classification applied to the far wall. Further, the system extracts the lumen-intima and media-adventitia borders in the far wall of the carotid artery. Our new system is characterized and validated by comparing CAILRS borders with the manual tracings carried out by experts. The new technique is also benchmarked with a semi-automatic technique based on a first-order absolute moment edge operator (FOAM) and compared to our previous edge-based automated methods such as CALEX (Molinari et al 2010 J. Ultrasound Med. 29 399-418, 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CULEX (Delsanto et al 2007 IEEE Trans. Instrum. Meas. 56 1265-74, Molinari et al 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CALSFOAM (Molinari et al Int. Angiol. (at press)), and CAUDLES-EF (Molinari et al J. Digit. Imaging (at press)). Our multi-institutional database consisted of 300 longitudinal B-mode carotid images. In comparison to semi-automated FOAM, CAILRS showed the IMT bias of -0.035 ± 0.186 mm while FOAM showed -0.016 ± 0.258 mm. Our IMT was slightly underestimated with respect to the ground truth IMT, but showed uniform behavior over the entire database. CAILRS outperformed all the four previous automated methods. The system's figure of merit was 95.6%, which was lower than that of the semi-automated method (98%), but higher than that of the other automated techniques.

  8. Anatomical Considerations on Surgical Anatomy of the Carotid Bifurcation

    PubMed Central

    Michalinos, Adamantios; Chatzimarkos, Markos; Arkadopoulos, Nikolaos; Safioleas, Michail

    2016-01-01

    Surgical anatomy of carotid bifurcation is of unique importance for numerous medical specialties. Despite extensive research, many aspects such as precise height of carotid bifurcation, micrometric values of carotid arteries and their branches as their diameter, length, and degree of tortuosity, and variations of proximal external carotid artery branches are undetermined. Furthermore carotid bifurcation is involved in many pathologic processes, atheromatous disease being the commonest. Carotid atheromatous disease is a major predisposing factor for disabling and possibly fatal strokes with geometry of carotid bifurcation playing an important role in its natural history. Consequently detailed knowledge of various anatomic parameters is of paramount importance not only for understanding of the disease but also for design of surgical treatment, especially selection between carotid endarterectomy and carotid stenting. Carotid bifurcation paragangliomas constitute unique tumors with diagnostic accuracy, treatment design, and success of operative intervention dependent on precise knowledge of anatomy. Considering those, it becomes clear that selection and application of proper surgical therapy should consider anatomical details. Further research might ameliorate available treatment options or even lead to innovative ones. PMID:27047690

  9. Carotid baroreflex responsiveness in heat-stressed humans

    NASA Technical Reports Server (NTRS)

    Crandall, C. G.

    2000-01-01

    The effects of whole body heating on human baroreflex function are relatively unknown. The purpose of this project was to identify whether whole body heating reduces the maximal slope of the carotid baroreflex. In 12 subjects, carotid-vasomotor and carotid-cardiac baroreflex responsiveness were assessed in normothermia and during whole body heating. Whole body heating increased sublingual temperature (from 36.4 +/- 0.1 to 37.4 +/- 0.1 degrees C, P < 0.01) and increased heart rate (from 59 +/- 3 to 83 +/- 3 beats/min, P < 0. 01), whereas mean arterial blood pressure (MAP) was slightly decreased (from 88 +/- 2 to 83 +/- 2 mmHg, P < 0.01). Carotid-vasomotor and carotid-cardiac responsiveness were assessed by identifying the maximal gain of MAP and heart rate to R wave-triggered changes in carotid sinus transmural pressure. Whole body heating significantly decreased the responsiveness of the carotid-vasomotor baroreflex (from -0.20 +/- 0.02 to -0.13 +/- 0.02 mmHg/mmHg, P < 0.01) without altering the responsiveness of the carotid-cardiac baroreflex (from -0.40 +/- 0.05 to -0.36 +/- 0.02 beats x min(-1) x mmHg(-1), P = 0.21). Carotid-vasomotor and carotid-cardiac baroreflex curves were shifted downward and upward, respectively, to accommodate the decrease in blood pressure and increase in heart rate that accompanied the heat stress. Moreover, the operating point of the carotid-cardiac baroreflex was shifted closer to threshold (P = 0.02) by the heat stress. Reduced carotid-vasomotor baroreflex responsiveness, coupled with a reduction in the functional reserve for the carotid baroreflex to increase heart rate during a hypotensive challenge, may contribute to increased susceptibility to orthostatic intolerance during a heat stress.

  10. Recanalization of a Heavily Calcified Chronic Total Occlusion in a Femoropopliteal Artery Using a Wingman Crossing Catheter

    PubMed Central

    Inoue, Naoto; Tanaka, Akiko

    2016-01-01

    We present a 77-year-old female with heavily calcified chronic total occlusions (CTO) in a superficial femoral artery treated by endovascular therapy using a Wingman crossing catheter, which is an over-the-wire catheter with a metallic blade, controlled manually. The blade could probe and track the calcified cap of CTO, wherein any hydrophilic guidewires or looped wires could not penetrate. Moreover, the Wingman could proceed through the occlusion and introduce a guidewire into distal intramedial lumen as a support catheter. Finally, wire crossing was achieved using a bi-directional approach. The Wingman can be a simple solution for crossing calcified peripheral CTO. PMID:27375810

  11. Differential Responses of Calcifying and Non-Calcifying Epibionts of a Brown Macroalga to Present-Day and Future Upwelling pCO2

    PubMed Central

    Saderne, Vincent; Wahl, Martin

    2013-01-01

    Seaweeds are key species of the Baltic Sea benthic ecosystems. They are the substratum of numerous fouling epibionts like bryozoans and tubeworms. Several of these epibionts bear calcified structures and could be impacted by the high pCO2 events of the late summer upwellings in the Baltic nearshores. Those events are expected to increase in strength and duration with global change and ocean acidification. If calcifying epibionts are impacted by transient acidification as driven by upwelling events, their increasing prevalence could cause a shift of the fouling communities toward fleshy species. The aim of the present study was to test the sensitivity of selected seaweed macrofoulers to transient elevation of pCO2 in their natural microenvironment, i.e. the boundary layer covering the thallus surface of brown seaweeds. Fragments of the macroalga Fucus serratus bearing an epibiotic community composed of the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium hirsutum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460±59 µatm, present-day upwelling1193±166 µatm and future upwelling 3150±446 µatm. Only the highest pCO2 caused a significant reduction of growth rates and settlement of S. spirorbis individuals. Additionally, S. spirorbis settled juveniles exhibited enhanced calcification of 40% during daylight hours compared to dark hours, possibly reflecting a day-night alternation of an acidification-modulating effect by algal photosynthesis as opposed to an acidification-enhancing effect of algal respiration. E. pilosa colonies showed significantly increased growth rates at intermediate pCO2 (1193 µatm) but no response to higher pCO2. No effect of acidification on A. hirsutum colonies growth rates was observed. The results suggest a remarkable resistance of the algal macro-epibionts to levels of acidification occurring at present day upwellings in the Baltic. Only extreme future

  12. Differential responses of calcifying and non-calcifying epibionts of a brown macroalga to present-day and future upwelling pCO2.

    PubMed

    Saderne, Vincent; Wahl, Martin

    2013-01-01

    Seaweeds are key species of the Baltic Sea benthic ecosystems. They are the substratum of numerous fouling epibionts like bryozoans and tubeworms. Several of these epibionts bear calcified structures and could be impacted by the high pCO2 events of the late summer upwellings in the Baltic nearshores. Those events are expected to increase in strength and duration with global change and ocean acidification. If calcifying epibionts are impacted by transient acidification as driven by upwelling events, their increasing prevalence could cause a shift of the fouling communities toward fleshy species. The aim of the present study was to test the sensitivity of selected seaweed macrofoulers to transient elevation of pCO2 in their natural microenvironment, i.e. the boundary layer covering the thallus surface of brown seaweeds. Fragments of the macroalga Fucus serratus bearing an epibiotic community composed of the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium hirsutum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460 ± 59 µatm, present-day upwelling1193 ± 166 µatm and future upwelling 3150 ± 446 µatm. Only the highest pCO2 caused a significant reduction of growth rates and settlement of S. spirorbis individuals. Additionally, S. spirorbis settled juveniles exhibited enhanced calcification of 40% during daylight hours compared to dark hours, possibly reflecting a day-night alternation of an acidification-modulating effect by algal photosynthesis as opposed to an acidification-enhancing effect of algal respiration. E. pilosa colonies showed significantly increased growth rates at intermediate pCO2 (1193 µatm) but no response to higher pCO2. No effect of acidification on A. hirsutum colonies growth rates was observed. The results suggest a remarkable resistance of the algal macro-epibionts to levels of acidification occurring at present day upwellings in the Baltic. Only extreme

  13. Estimation of Stiffness Parameter on the Common Carotid Artery

    NASA Astrophysics Data System (ADS)

    Koya, Yoshiharu; Mizoshiri, Isao; Matsui, Kiyoaki; Nakamura, Takashi

    The arteriosclerosis is on the increase with an aging or change of our living environment. For that reason, diagnosis of the common carotid artery using echocardiogram is doing to take precautions carebropathy. Up to the present, several methods to measure stiffness parameter of the carotid artery have been proposed. However, they have analyzed at the only one point of common carotid artery. In this paper, we propose the method of analysis extended over a wide area of common carotid artery. In order to measure stiffness parameter of common carotid artery from echocardiogram, it is required to detect two border curves which are boundaries between vessel wall and blood. The method is composed of two steps. The first step is the detection of border curves, and the second step is the calculation of stiffness parameter using diameter of common carotid artery. Experimental results show the validity of the proposed method.

  14. The Development of Carotid Stent Material

    PubMed Central

    He, Dongsheng; Liu, Wenhua; Zhang, Tao

    2015-01-01

    Endovascular angioplasty with stenting is a promising option for treating carotid artery stenosis. There exist a rapidly increasing number of different stent types with different materials. The bare-metal stent is the most commonly used stent with acceptable results, but it leaves us with the problems of thrombosis and restenosis. The drug-eluting stent is a breakthrough as it has the ability to reduce the restenosis rate, but the problem of late thrombosis still has to be addressed. The biodegradable stent disappears after having served its function. However, restenosis and degradation rates remain to be studied. In this article, we review every stent material with its characteristics, clinical results and complications and point out the standards of an ideal carotid stent. PMID:26019710

  15. Endovascular Treatment of Extracranial Internal Carotid Aneurysms Using Endografts

    SciTech Connect

    Baldi, Sebastian Rostagno, Roman D.; Zander, Tobias; Llorens, Rafael; Schonholz, Claudio; Maynar, Manuel

    2008-03-15

    Aneurysms of the extracranial internal carotid artery (EICA) are infrequent. They are difficult to treat with conventional surgery because of their distal extension into the skull base. We report three cases of EICA aneurysms in two symptomatic patients successfully treated with polytetrafluoroethylene self-expanding endografts using an endovascular approach. The aneurysms were located distal to the carotid bifurcation and extended to the subpetrous portion of the internal carotid artery.

  16. Comparative Review of the Treatment Methodologies of Carotid Stenosis

    PubMed Central

    Bae, Coney; Szuchmacher, Mauricio; Chang, John B.

    2015-01-01

    The treatment of carotid stenosis entails three methodologies, namely, medical management, carotid angioplasty and stenting (CAS), as well as carotid endarterectomy (CEA). The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) have shown that symptomatic carotid stenosis greater than 70% is best treated with CEA. In asymptomatic patients with carotid stenosis greater than 60%, CEA was more beneficial than treatment with aspirin alone according to the Asymptomatic Carotid Atherosclerosis (ACAS) and Asymptomatic Carotid Stenosis Trial (ACST) trials. When CAS is compared with CEA, the CREST resulted in similar rates of ipsilateral stroke and death rates regardless of symptoms. However, CAS not only increased adverse effects in women, it also amplified stroke rates and death in elderly patients compared with CEA. CAS can maximize its utility in treating focal restenosis after CEA and patients with overwhelming cardiac risk or prior neck irradiation. When performing CEA, using a patch was equated to a more durable result than primary closure, whereas eversion technique is a new methodology deserving a spotlight. Comparing the three major treatment strategies of carotid stenosis has intrinsic drawbacks, as most trials are outdated and they vary in their premises, definitions, and study designs. With the newly codified best medical management including antiplatelet therapies with aspirin and clopidogrel, statin, antihypertensive agents, strict diabetes control, smoking cessation, and life style change, the current trials may demonstrate that asymptomatic carotid stenosis is best treated with best medical therapy. The ongoing trials will illuminate and reshape the treatment paradigm for symptomatic and asymptomatic carotid stenosis. PMID:26417191

  17. Carotid artery access for transcatheter aortic valve replacement.

    PubMed

    Guyton, Robert A; Block, Peter C; Thourani, Vinod H; Lerakis, Stamatios; Babaliaros, Vasilis

    2013-10-01

    We report three patients who had successful transcatheter aortic valve replacement (TAVR) via carotid artery access. None were candidates for thoracotomy (including minimal access incisions) and had no other vascular access sites that would accommodate the transcatheter valve sheath. Antegrade carotid perfusion and retrograde insertion of the delivery sheath maintained cerebral blood flow without sequelae. Carotid access for TAVR is an option for unusual patients without other access.

  18. Are Carotid Stent Fractures Clinically Significant?

    SciTech Connect

    Garcia-Toca, Manuel; Rodriguez, Heron E.; Naughton, Peter A.; Keeling, Aiofee; Phade, Sachin V.; Morasch, Mark D.; Kibbe, Melina R.; Eskandari, Mark K.

    2012-04-15

    Purpose: Late stent fatigue is a known complication after carotid artery stenting (CAS) for cervical carotid occlusive disease. The purpose of this study was to determine the prevalence and clinical significance of carotid stent fractures. Materials and Methods: A single-center retrospective review of 253 carotid bifurcation lesions treated with CAS and mechanical embolic protection from April 2001 to December 2009 was performed. Stent integrity was analyzed by two independent observers using multiplanar cervical plain radiographs with fractures classified into the following types: type I = single strut fracture; type II = multiple strut fractures; type III = transverse fracture; and type IV = transverse fracture with dislocation. Mean follow-up was 32 months. Results: Follow-up imaging was completed on 106 self-expanding nitinol stents (26 closed-cell and 80 open-cell stents). Eight fractures (7.5%) were detected (type I n = 1, type II n = 6, and type III n = 1). Seven fractures were found in open-cell stents (Precise n = 3, ViVEXX n = 2, and Acculink n = 2), and 1 fracture was found in a closed-cell stent (Xact n = 1) (p = 0.67). Only a previous history of external beam neck irradiation was associated with fractures (p = 0.048). No associated clinical sequelae were observed among the patients with fractures, and only 1 patient had an associated significant restenosis ({>=}80%) requiring reintervention. Conclusions: Late stent fatigue after CAS is an uncommon event and rarely clinically relevant. Although cell design does not appear to influence the occurrence of fractures, lesion characteristics may be associated risk factors.

  19. Aterofisiol® in carotid plaque evolution

    PubMed Central

    Amato, Bruno; Compagna, Rita; Amato, Maurizio; Gallelli, Luca; de Franciscis, Stefano; Serra, Raffaele

    2015-01-01

    Background In patients with carotid stenosis, the risk of plaque rupture is related to the composition of the atherosclerotic plaque rather than to its magnitude. In this regard, we evaluated the effects of a supplement, Aterofisiol,® containing omega-3 (EPA [eicosapen acid] DHA [docosahexaenoic acid]), vitamin K2, vitamin B6, vitamin B12, oligomeric proanthocyanidins (OPC) and resveratrol on the composition of atherosclerotic plaque and on neurological symptoms in patients with carotid stenosis undergoing carotid endarterectomy. Methods The study was randomized, prospective, and double-blinded. Eligible patients were of both sexes, with carotid stenosis >70% who underwent endarterectomy. Enrolled patients were randomly allocated to receive either one tablet of acetylsalicylic acid 100 mg (Cardioaspirin®) + one tablet of Aterofisiol every 24 hours or one tablet of Cardioaspirin + one tablet of placebo every 24 hours. Each treatment was started 30 days before the surgery and was stopped 5 days before the surgery. The plaques were removed “en bloc” using standard surgical technique. Results During the study period, 214 patients (135 men and 79 women) were enrolled for intent-to-treat and randomized in two groups: Group A: 107 patients (68 men and 39 women) were treated with Cardioaspirin + Aterofisiol. Group B: 107 patients (67 men and 40 women) were treated with Cardioaspirin + placebo. At the end of the study, 202 patients participated fully (103 patients in Group A and 99 patients in Group B), making up the protocol evaluation population (94.4%). The mean lipid content of removed plaques was significantly lower (P<0.05) in Group A. We recorded a significantly lower incidence of neurological symptoms in Group A in comparison with Group B (P<0.05). Conclusion In the study, Aterofisiol showed to be effective in reducing the amounts of cholesterol and lipids in the plaques and in reducing adverse neurological events in the study group with respect to controls

  20. Integrally calcified solitary fibrous tumor in the retroperitoneum: a case report and review of the literature.

    PubMed

    Maki, Takehiro; Fujino, Syotaro; Misu, Kenjiro; Kaneko, Hiroyuki; Inomata, Hitoshi; Omi, Makoto; Tateno, Masatoshi; Nihei, Kazuyoshi

    2016-12-01

    Solitary fibrous tumor (SFT) is a rare stromal neoplasm and usually occurs in the thoracic cavity. We here report a case of retroperitoneal SFT with prominent calcification. A 64-year-old man presented with an incidentally detected retroperitoneal mass in the right upper abdomen. Imaging tests indicated an integrally calcified mass. The lesion was observed for 2 years and laparoscopically resected according to the patient's wish. Microscopically, the mass was mostly occupied by calcification and proliferous spindle cells were scattered with positive CD34 expression. We diagnosed morphologically benign SFT and the patient remained disease-free 1 year after the excision. There has been no report of such integrally calcified SFT. Retroperitoneal SFT is difficult to make a preoperative diagnosis, and careful follow-up after the excision is recommended because morphological malignancy does not always correspond to clinical malignancy. PMID:26943690

  1. Integrally calcified solitary fibrous tumor in the retroperitoneum: a case report and review of the literature.

    PubMed

    Maki, Takehiro; Fujino, Syotaro; Misu, Kenjiro; Kaneko, Hiroyuki; Inomata, Hitoshi; Omi, Makoto; Tateno, Masatoshi; Nihei, Kazuyoshi

    2016-12-01

    Solitary fibrous tumor (SFT) is a rare stromal neoplasm and usually occurs in the thoracic cavity. We here report a case of retroperitoneal SFT with prominent calcification. A 64-year-old man presented with an incidentally detected retroperitoneal mass in the right upper abdomen. Imaging tests indicated an integrally calcified mass. The lesion was observed for 2 years and laparoscopically resected according to the patient's wish. Microscopically, the mass was mostly occupied by calcification and proliferous spindle cells were scattered with positive CD34 expression. We diagnosed morphologically benign SFT and the patient remained disease-free 1 year after the excision. There has been no report of such integrally calcified SFT. Retroperitoneal SFT is difficult to make a preoperative diagnosis, and careful follow-up after the excision is recommended because morphological malignancy does not always correspond to clinical malignancy.

  2. Bilateral Calcifying Cystic Odontogenic Tumour of Mandible: A Rare Case Report and Review of Literature

    PubMed Central

    Khandelwal, Pragun; Mhapuskar, Amit

    2015-01-01

    Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination. PMID:26673837

  3. Calcifying cystic odontogenic tumor associated with an odontome – a diverse lesion encountered

    PubMed Central

    Radheshyam, Chourasia; Alokenath, Bandyopadhyay; Kumar, Harish; Abikshyeet, Panda

    2015-01-01

    The human jaw is an exclusive habitat for odontogenic lesions. Ghost cells associated odontogenic lesions are a diverse group with a variety of presentations in the jaws. Calcifying cystic odontogenic tumor is a benign cystic neoplasm of odontogenic origin which demonstrates ghost cells in the epithelial component. This tumor sometimes mimics the features of a cyst clinically and radiographically, but histopathologically as well as behavior-wise shows the features of a tumor. Many classification systems have been proposed and revised from time to time. Presently a dualistic concept is highlighted to classify this group of lesions. The present case highlights a case of calcifying cystic odontogenic tumor associated with a complex composite odontome, which appeared like a cyst clinically and radiographically. PMID:26345145

  4. Bilateral Calcifying Cystic Odontogenic Tumour of Mandible: A Rare Case Report and Review of Literature.

    PubMed

    Khandelwal, Pragun; Aditya, Amita; Mhapuskar, Amit

    2015-11-01

    Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination.

  5. A role for diatom-like silicon transporters in calcifying coccolithophores

    PubMed Central

    Durak, Grażyna M.; Taylor, Alison R.; Walker, Charlotte E.; Probert, Ian; de Vargas, Colomban; Audic, Stephane; Schroeder, Declan; Brownlee, Colin; Wheeler, Glen L.

    2016-01-01

    Biomineralization by marine phytoplankton, such as the silicifying diatoms and calcifying coccolithophores, plays an important role in carbon and nutrient cycling in the oceans. Silicification and calcification are distinct cellular processes with no known common mechanisms. It is thought that coccolithophores are able to outcompete diatoms in Si-depleted waters, which can contribute to the formation of coccolithophore blooms. Here we show that an expanded family of diatom-like silicon transporters (SITs) are present in both silicifying and calcifying haptophyte phytoplankton, including some globally important coccolithophores. Si is required for calcification in these coccolithophores, indicating that Si uptake contributes to the very different forms of biomineralization in diatoms and coccolithophores. Significantly, SITs and the requirement for Si are absent from highly abundant bloom-forming coccolithophores, such as Emiliania huxleyi. These very different requirements for Si in coccolithophores are likely to have major influence on their competitive interactions with diatoms and other siliceous phytoplankton. PMID:26842659

  6. A role for diatom-like silicon transporters in calcifying coccolithophores.

    PubMed

    Durak, Grażyna M; Taylor, Alison R; Walker, Charlotte E; Probert, Ian; de Vargas, Colomban; Audic, Stephane; Schroeder, Declan; Brownlee, Colin; Wheeler, Glen L

    2016-02-04

    Biomineralization by marine phytoplankton, such as the silicifying diatoms and calcifying coccolithophores, plays an important role in carbon and nutrient cycling in the oceans. Silicification and calcification are distinct cellular processes with no known common mechanisms. It is thought that coccolithophores are able to outcompete diatoms in Si-depleted waters, which can contribute to the formation of coccolithophore blooms. Here we show that an expanded family of diatom-like silicon transporters (SITs) are present in both silicifying and calcifying haptophyte phytoplankton, including some globally important coccolithophores. Si is required for calcification in these coccolithophores, indicating that Si uptake contributes to the very different forms of biomineralization in diatoms and coccolithophores. Significantly, SITs and the requirement for Si are absent from highly abundant bloom-forming coccolithophores, such as Emiliania huxleyi. These very different requirements for Si in coccolithophores are likely to have major influence on their competitive interactions with diatoms and other siliceous phytoplankton.

  7. An Additional Potential Factor for Kidney Stone Formation during Space Flights: Calcifying Nanoparticles (Nanobacteria): A Case Report

    NASA Technical Reports Server (NTRS)

    Jones, Jeffrey A.; Ciftcioglu, Neva; Schmid, Joseph; Griffith, Donald

    2007-01-01

    Spaceflight-induced microgravity appears to be a risk factor for the development of urinary calculi due to skeletal calcium liberation and other undefined factors, resulting in stone disease in crewmembers during and after spaceflight. Calcifying nanoparticles, or nanobacteria, reproduce at a more rapid rate in simulated microgravity conditions and create external shells of calcium phosphate in the form of apatite. The questions arises whether calcifying nanoparticles are niduses for calculi and contribute to the development of clinical stone disease in humans, who possess environmental factors predisposing to the development of urinary calculi and potentially impaired immunological defenses during spaceflight. A case of a urinary calculus passed from an astronaut post-flight with morphological characteristics of calcifying nanoparticles and staining positive for a calcifying nanoparticle unique antigen, is presented.

  8. The prognosis of carotid siphon stenosis.

    PubMed

    Wechsler, L R; Kistler, J P; Davis, K R; Kaminski, M J

    1986-01-01

    We retrospectively reviewed the clinical course and angiograms of 15 patients with carotid siphon stenosis of 50% or greater. Fourteen had less than 50% stenosis at the origin of the ipsilateral internal carotid artery, and one had a greater degree of stenosis but underwent endarterectomy after an initial angiogram. Angiograms were examined for evidence of hemodynamic abnormalities in addition to residual lumen diameter. Seven patients initially had TIAs, 5 had strokes, and 3 were asymptomatic. In an average followup of 51 months (range 4-123 months) subsequent cerebral ischemic events occurred in 6 (40%), but only 1 had a stroke with a persisting neurological deficit that could be directly attributed to the siphon stenosis. Stenoses were hemodynamically significant by angiography in 5 of 7 TIA patients, and only 1 of 5 stroke patients. The incidence of subsequent ischemic events in this study was similar to 2 previous studies of siphon stenosis, however in this study most of the events ipsilateral to the siphon stenosis were TIAs or minor strokes. The association of hemodynamic angiographic abnormalities and initial TIAs but not strokes suggests that the mechanism producing ischemic symptoms may differ in patients with TIA and stroke who have carotid siphon stenosis.

  9. The anterior loop of the carotid siphon.

    PubMed

    Alencastro, L C

    1991-01-01

    The extracavernous-presubarachnoid segment of the carotid artery (EPCA), medial to the clinoid process, was studied in 48 sphenoid bones. Ten specimens were submitted to microdissection; the remainders were cut in 1 mm thick slices after electrolytic decalcification. The studies showed that the EPCA has a mean length of 3.09 mm (0.5 to 6.5 mm). It has a shorter length than the whole medioclinoid (paraclinoid) segment of the artery because the subarachnoid space may enter between the artery and the clinoid process, as well as the venous space of the cavernous sinus. Venous channels of extremely small diameter were found between the EPCA and the clinoid process in 30.3% of the cases and between the EPCA and the sphenoid body in 48.6%. The distal limit of the intracavernous cartoid artery is the projection of the caudal surface of the clinoid process, which is coincident with the vertex of the anterior loop of the carotid siphon in 91.7% of the cases. The origin of the ophthalmic artery was verified to be from the EPCA in 9.7%, at the transition to the subarachnoid space in 6.5%, and intracavernous in 3.2%. Immediately proximal to the EPCA, the anterior horizontal segment of the carotid artery may be reached without entering the venous space of the cavernous sinus through the superior wall in 27.8% and through the lateral wall in 66.6%.

  10. Carotid artery rupture and cervicofacial actinomycosis.

    PubMed

    Kummer, Anne; Lhermitte, Benoît; Ödman, Micaela; Grabherr, Silke; Mangin, Patrice; Palmiere, Cristian

    2012-11-01

    Cervicofacial actinomycosis is an uncommon, progressive infection caused by bacilli of the Actinomyces genus. Actinomyces are common commensal saprophytes in the oral cavity which may have medical importance as facultative pathogens. Subsequent to local injuries to the oral mucosa, they may penetrate the deep tissues and be responsible for suppurative or granulomatous infections. We herein report a case of a 65-year-old man who underwent surgery followed by chemotherapy and radiotherapy for a tonsillar carcinoma. An ulcerous lesion in the base of the tongue developed and spread to the carotid artery wall. The man died of a massive hemorrhage due to left carotid artery rupture. Postmortem computed tomography angiography performed prior to autopsy allowed the precise localization of the source of bleeding to be detected. Postmortem biochemical investigations confirmed the presence of inflammation associated with local bacterial infection. Histological investigations revealed the rupture of the left carotid artery surrounded by numerous colonies of Actinomyces. Acute and chronic inflammation with tissue necrosis as well as post-actinic, fibrotic changes were also found in the tissues surrounding the ruptured artery wall. PMID:22819527

  11. Stationary and high-frequency pulsed electron paramagnetic resonance of a calcified atherosclerotic plaque

    NASA Astrophysics Data System (ADS)

    Abdul'Yanov, V. A.; Galiullina, L. F.; Galyavich, A. S.; Izotov, V. G.; Mamin, G. V.; Orlinskii, S. B.; Rodionov, A. A.; Salakhov, M. Kh.; Silkin, N. I.; Sitdikova, L. M.; Khairullin, R. N.; Chelyshev, Yu. A.

    2008-09-01

    New possibilities of applying high-frequency electron paramagnetic resonance in medicine are demonstrated on an example of the investigation of a calcified atherosclerotic plaque. After the irradiation of the atherosclerotic plaque by x rays, a new type of paramagnetic centers—organomineral radicals—is detected. The spectral and relaxation characteristics of these radicals depend on the calcification degree of the atherosclerotic plaque and can be used for diagnostics.

  12. Calcifying odontogenic cyst in infancy: report of case associated with compound odontoma.

    PubMed

    Oliveira, J A; da Silva, C J; Costa, I M; Loyola, A M

    1995-01-01

    A case of calcifying odontogenic cyst associated with compound odontoma in an unerupted primary tooth in a three-year-old patient is reported. Some considerations regarding the age of the patient, differential diagnosis and treatment are discussed. Although the cyst can occur at any age, the majority of cases appear before the fourth decade of life. This malady represents less than 2 percent of all odontogenic tumors and cysts.

  13. Clear cell variant of calcifying epithelial odontogenic tumor of maxilla: Report of a rare case.

    PubMed

    Badrashetty, Dinesh; Rangaswamy, Shruthi; Belgode, Niranjan

    2013-09-01

    The calcifying epithelial odontogenic tumor (CEOT) is a rare benign tumor of the jaws. Pindborg's tumor having clear cells is extremely rare. Twelve central lesions have been reported of which only three cases have occurred in maxilla. Clear cell variant is a distinct entity, has more aggressive biological behavior and higher chances of recurrence. Hence it is important that presence of clear cells be included in histopathological diagnosis. Here we present a rare case of clear cell CEOT having aggressive behavior.

  14. Clear cell variant of calcifying epithelial odontogenic tumor of maxilla: Report of a rare case

    PubMed Central

    Badrashetty, Dinesh; Rangaswamy, Shruthi; Belgode, Niranjan

    2013-01-01

    The calcifying epithelial odontogenic tumor (CEOT) is a rare benign tumor of the jaws. Pindborg's tumor having clear cells is extremely rare. Twelve central lesions have been reported of which only three cases have occurred in maxilla. Clear cell variant is a distinct entity, has more aggressive biological behavior and higher chances of recurrence. Hence it is important that presence of clear cells be included in histopathological diagnosis. Here we present a rare case of clear cell CEOT having aggressive behavior. PMID:24574681

  15. Management of Giant Calcified Thoracic Disks and Description of the Trench Vertebrectomy Technique

    PubMed Central

    Al-Mahfoudh, Rafid; Mitchell, Paul S.; Wilby, Martin; Crooks, Daniel; Barrett, Chris; Pillay, Robin; Pigott, Tim

    2015-01-01

    Study Design  Case series and review of the literature. Objective  To review the management of giant calcified disks in our large cohort and compare with the existing literature. We discuss our surgical technique. Methods  Twenty-nine cases of herniated thoracic disk between 2000 and 2013 were reviewed. Eighteen patients were identified as having giant calcified thoracic disks, defined as diffusely calcified disks occupying at least 40% of the spinal canal. Demographic data was collected in addition to presentation, imaging findings, operative details, and outcomes using the modified Japanese Orthopaedic Association (mJOA) scale. Results  Giant calcified thoracic disks (GCTDs) are unique clinical entities that require special neurosurgical consideration owing to significant (≥40%) involvement of the spinal canal and compression of the spinal cord, often leading to myelopathy. The median age at diagnosis was 51.2 years (range 37 to 70) with the mean duration of presenting symptoms being 9.9 months (range 2 weeks to 3 years). Seventeen (94.4%) patients presented with at least one sign of myelopathy (hyperreflexia, hypertonia, bladder or bowel dysfunction) with the remaining 1 (5.6%) patient presenting with symptoms in keeping with radiculopathy. Thoracotomy was performed on 17 (94.4%) patients, and 1 (5.6%) patient had a costotransverse approach. Mean follow-up was 19.8 months (range 7 months to 2 years). mJOA score improved in 15 (83.3%) patients. mJOA scores in the other patients remained stable. Conclusions  GCTDs are difficult neurosurgical challenges owing to their size, degree of spinal cord compression, and consistency. We recommend a trench vertebrectomy via a thoracotomy in their surgical management. This procedure safely allows the identification of normal dura on either side of the compressed segment prior to performing a diskectomy. Excellent fusion rates were achieved with insertion of rib head autograft in the trench. PMID:27556000

  16. Noninvasive evaluation and management of the "asymptomatic" carotid bruit.

    PubMed

    Kartchner, M M; McRae, L P

    1977-12-01

    Cervical bruits in patients who are asymptomatic or who have nonhemispheric neurological symptoms present a universal challenge. Of 4,000 patients evaluated noninvasively for carotid occlusive disease, 1,287 presented with "asymptomatic" bruits (697 had nonhemispheric neurological symptoms and 590 were clinically asymptomatic). Carotid phonoangiography (CPA), the visual analysis of carotid bruits, identifies bruits indicative of significant stenosis, documents progression, and differentiates bruits of carotid bifurcation and sub-bifurcation origin. Sub-bifurication bruits were diagnosed in 619, insignificant bifurcation bruits in 426, and significant carotid bruits in 242 patients by CPA. Oculoplethysmography (OPG) evaluates the hemodynamic significance of carotid bruits by comparative timing of simultaneously recorded ocular and ear lobe pulses. OPG detected 273 asymptomatic bruit patients with significant internal carotid flow reduction and indicated 5% of the bifurcation bruits were of external carotid origin. An accuracy of 89% in determining greater than 40% stenosis by OPG/CPA in 295 patients having arteriography increases to 97% when both OPG and CPA are positive. Six-month to 70-month clinical follow-up of the 1,287 patients documented 154 carotid endarterectomies and 38 strokes. Analysis of the strokes favors arteriography and operation only for those patients with appropriately positive or progressive OPG/CPA or with focal transient ischemic attacks (TIAs).

  17. [An integrated segmentation method for 3D ultrasound carotid artery].

    PubMed

    Yang, Xin; Wu, Huihui; Liu, Yang; Xu, Hongwei; Liang, Huageng; Cai, Wenjuan; Fang, Mengjie; Wang, Yujie

    2013-07-01

    An integrated segmentation method for 3D ultrasound carotid artery was proposed. 3D ultrasound image was sliced into transverse, coronal and sagittal 2D images on the carotid bifurcation point. Then, the three images were processed respectively, and the carotid artery contours and thickness were obtained finally. This paper tries to overcome the disadvantages of current computer aided diagnosis method, such as high computational complexity, easily introduced subjective errors et al. The proposed method could get the carotid artery overall information rapidly, accurately and completely. It could be transplanted into clinical usage for atherosclerosis diagnosis and prevention. PMID:24195385

  18. Percutaneous Injection of Lidocaine Within the Carotid Body Area in Carotid Artery Stenting: An 'Old-New' Technique

    SciTech Connect

    Mourikis, Dimitrios; Chatoupis, Konstantinos; Katsenis, Konstantinos; Vlahos, Lampros; Chatziioannou, Achilles

    2008-07-15

    Severe bradycardia is a common untoward effect during balloon angioplasty when performing carotid artery stenting. Therefore atropine injection even before dilatation and the presence of an anesthesiologist are advocated in all patients. In the surgical literature, injection of a local anesthetic agent into the carotid sinus before carotid endarterectomy was performed in an attempt to ameliorate perioperative hemodynamic instability. This study was undertaken to test the hypothesis that percutaneous infiltration of the carotid sinus with local anesthetic immediately before balloon dilatation reduces bradycardia and ameliorates the need for atropine injection or the presence of an anesthesiologist. Infiltration of the carotid sinus with 5 ml of 1% lidocaine, 3 min before dilatation, was performed in 30 consecutive patients. No one exhibited any significant rhythm change that required atropine injection. The anesthesiologist did not face any hemodynamic instability during the carotid artery stenting procedure.

  19. Can calcified pulmonary metastases detected by (18)F-FDG PET/CT suggest the primary tumor?

    PubMed

    Hong, Chae Moon; Ahn, Byeong Cheol

    2016-01-01

    Many calcified nodules are encountered on the (18)F-FDG PET/CT scan and even though most of them are benign, the possibility of calcified pulmonary metastases (CPM) should be considered. The CT portion can often differentiate benign diseases due to their morphology. Measuring SUVmax is very important. Understanding the mechanism of calcification in malignant metastatic pulmonary lesions may be useful to suggest their origin. PMID:27035906

  20. Grossly calcified choroid plexus concealing foramen of Monro meningiomas as an unusual cause of obstructive hydrocephalus

    PubMed Central

    Kawaguchi, Tomohiro; Fujimura, Miki; Tominaga, Teiji

    2016-01-01

    Various intraventricular tumors can present with calcifications; however, the choroid plexus can also have physiological calcifications. This is the first case report of meningiomas located at the bilateral foramen of Monro (FOM), concealed by a grossly calcified choroid plexus, presenting with obstructive hydrocephalus. A 60-year-old woman with disturbed consciousness was admitted by ambulance. Head computed tomography revealed significantly high-density lesions that smoothly extended from the choroid plexus of the lateral ventricles to the third ventricle. They occupied both sides of the FOM, resulting in obstructive hydrocephalus. The diagnostic endoscopic biopsy was performed using a flexible neuroendoscopic system, and an egg shell-like grossly calcified choroid plexus was found to smoothly extend toward the FOM. Resection was not selected because the calcified lesions had tightly adhered to the veins and fornix; therefore, the patient underwent ventriculo-peritoneal shunting. The lesions were histologically identified as psammomatous meningiomas with low proliferation potential (the Ki-67 labeling index was lower than 1%). She was discharged 10 days after surgery without neurological deficits. As calcifications can have tumoral and nontumoral origins, we considered neuroendoscopic exploration to be essential in order to achieve an accurate diagnosis and select optimal management. PMID:26889294

  1. Pacific-wide contrast highlights resistance of reef calcifiers to ocean acidification

    PubMed Central

    Comeau, S.; Carpenter, R. C.; Nojiri, Y; Putnam, H. M.; Sakai, K.; Edmunds, P. J.

    2014-01-01

    Ocean acidification (OA) and its associated decline in calcium carbonate saturation states is one of the major threats that tropical coral reefs face this century. Previous studies of the effect of OA on coral reef calcifiers have described a wide variety of outcomes for studies using comparable partial pressure of CO2 (pCO2) ranges, suggesting that key questions remain unresolved. One unresolved hypothesis posits that heterogeneity in the response of reef calcifiers to high pCO2 is a result of regional-scale variation in the responses to OA. To test this hypothesis, we incubated two coral taxa (Pocillopora damicornis and massive Porites) and two calcified algae (Porolithon onkodes and Halimeda macroloba) under 400, 700 and 1000 μatm pCO2 levels in experiments in Moorea (French Polynesia), Hawaii (USA) and Okinawa (Japan), where environmental conditions differ. Both corals and H. macroloba were insensitive to OA at all three locations, while the effects of OA on P. onkodes were location-specific. In Moorea and Hawaii, calcification of P. onkodes was depressed by high pCO2, but for specimens in Okinawa, there was no effect of OA. Using a study of large geographical scale, we show that resistance to OA of some reef species is a constitutive character expressed across the Pacific. PMID:25056628

  2. Characterising the microbiome of Corallina officinalis, a dominant calcified intertidal red alga.

    PubMed

    Brodie, Juliet; Williamson, Christopher; Barker, Gary L; Walker, Rachel H; Briscoe, Andrew; Yallop, Marian

    2016-08-01

    The living prokaryotic microbiome of the calcified geniculate (articulated) red alga, Corallina officinalis from the intertidal seashore is characterised for the first time based on the V6 hypervariable region of 16S rRNA. Results revealed an extraordinary diversity of bacteria associated with the microbiome. Thirty-five prokaryotic phyla were recovered, of which Proteobacteria, Cyanobacteria, Bacteroidetes, Actinobacteria, Planctomycetes, Acidobacteria, Verrucomicrobia, Firmicutes and Chloroflexi made up the core microbiome. Unclassified sequences made up 25% of sequences, suggesting insufficient sampling of the world's oceans/macroalgae. The greatest diversity in the microbiome was on the upper shore, followed by the lower shore then the middle shore, although the microbiome community composition did not vary between shore levels. The C. officinalis core microbiome was broadly similar in composition to those reported in the literature for crustose coralline algae (CCAs) and free-living rhodoliths. Differences in relative abundance of the phyla between the different types of calcified macroalgal species may relate to the intertidal versus subtidal habit of the taxa and functionality of the microbiome components. The results indicate that much work is needed to identify prokaryotic taxa, and to determine the nature of the relationship of the bacteria with the calcified host spatially, temporally and functionally. PMID:27222222

  3. Edema surrounding calcified intracranial cysticerci: clinical manifestations, natural history, and treatment

    PubMed Central

    Nash, Theodore

    2012-01-01

    Calcified granulomas are the most common radiological finding in neurocysticercosis (10–20% of endemic populations). A small proportion serves as foci of seizure activity, which results in large numbers of persons with epilepsy. Calcified granulomas are not all the same. Some demonstrate blood–brain barrier dysfunction (magnetic resonance imaging enhancement) most likely due to the presence of inflammation, visualizable scolices, and/or gliosis. About half the patients with a recent history of seizures, positive serology, and only calcified lesions develop perilesional edema at the time of a seizure recurrence. The natural history, treatment, and pathophysiology of this phenomenon are not well studied. Episodes are usually associated with seizures or other neurological manifestations, resolve by 4–6 weeks, sometimes occur repeatedly, and usually involve a subset of the same calcifications. Treatment is supportive. Histopathological examination of one calcification associated with multiple perilesional edema episodes revealed significant inflammation and supports the concept that perilesional edema is inflammatory in nature. This most likely is due to host responses to released or newly recognized parasite antigen and/or upregulation of the host immune response. Immunosuppressive and anti-inflammatory agents may be useful in prevention and/or treatment of this phenomenon. PMID:23265551

  4. Pacific-wide contrast highlights resistance of reef calcifiers to ocean acidification.

    PubMed

    Comeau, S; Carpenter, R C; Nojiri, Y; Putnam, H M; Sakai, K; Edmunds, P J

    2014-09-01

    Ocean acidification (OA) and its associated decline in calcium carbonate saturation states is one of the major threats that tropical coral reefs face this century. Previous studies of the effect of OA on coral reef calcifiers have described a wide variety of outcomes for studies using comparable partial pressure of CO2 (pCO2) ranges, suggesting that key questions remain unresolved. One unresolved hypothesis posits that heterogeneity in the response of reef calcifiers to high pCO2 is a result of regional-scale variation in the responses to OA. To test this hypothesis, we incubated two coral taxa (Pocillopora damicornis and massive Porites) and two calcified algae (Porolithon onkodes and Halimeda macroloba) under 400, 700 and 1000 μatm pCO2 levels in experiments in Moorea (French Polynesia), Hawaii (USA) and Okinawa (Japan), where environmental conditions differ. Both corals and H. macroloba were insensitive to OA at all three locations, while the effects of OA on P. onkodes were location-specific. In Moorea and Hawaii, calcification of P. onkodes was depressed by high pCO2, but for specimens in Okinawa, there was no effect of OA. Using a study of large geographical scale, we show that resistance to OA of some reef species is a constitutive character expressed across the Pacific.

  5. Proteomic analysis of the organic matrix of the abalone Haliotis asinina calcified shell

    PubMed Central

    2010-01-01

    Background The formation of the molluscan shell is regulated to a large extent by a matrix of extracellular macromolecules that are secreted by the shell forming tissue, the mantle. This so called "calcifying matrix" is a complex mixture of proteins and glycoproteins that is assembled and occluded within the mineral phase during the calcification process. While the importance of the calcifying matrix to shell formation has long been appreciated, most of its protein components remain uncharacterised. Results Recent expressed sequence tag (EST) investigations of the mantle tissue from the tropical abalone (Haliotis asinina) provide an opportunity to further characterise the proteins in the shell by a proteomic approach. In this study, we have identified a total of 14 proteins from distinct calcified layers of the shell. Only two of these proteins have been previously characterised from abalone shells. Among the novel proteins are several glutamine- and methionine-rich motifs and hydrophobic glycine-, alanine- and acidic aspartate-rich domains. In addition, two of the new proteins contained Kunitz-like and WAP (whey acidic protein) protease inhibitor domains. Conclusion This is one of the first comprehensive proteomic study of a molluscan shell, and should provide a platform for further characterization of matrix protein functions and interactions. PMID:21050442

  6. Proteomic evaluation of biological nanoparticles isolated from human kidney stones and calcified arteries.

    PubMed

    Shiekh, Farooq A; Charlesworth, Jon E; Kim, Sung-Hoon; Hunter, Larry W; Jayachandran, Muthuvel; Miller, Virginia M; Lieske, John C

    2010-10-01

    Calcifying biological nanoparticles (NPs) develop under cell culture conditions from homogenates of diverse tissue samples displaying extraosseous mineralization, including kidney stones and calcified aneurysms. Probes to definitively identify NPs in biological systems are lacking. Therefore, the aim of this study was to begin to establish a proteomic biosignature of NPs in order to facilitate more definitive investigation of their contribution to disease. Biological NPs derived from human kidney stones and calcified aneurysms were completely decalcified by overnight treatment with ethylenediaminetetraacetic acid or brief incubation in HCl, as evidenced by lack of a calcium shell and of Alizarin Red S staining, by transmission electron microscopy and confocal microscopy, respectively. Decalcified NPs contained numerous proteins, including some from bovine serum and others of prokaryotic origin. Most prominent of the latter group was EF-Tu, which appeared to be identical to EF-Tu from Staphylococcus epidermidis. A monoclonal antibody against human EF-Tu recognized a protein in Western blots of total NP lysate, as well as in intact NPs by immunofluorescence and immunogold EM. Approximately 8% of NPs were quantitatively recognized by the antibody using flow cytometry. Therefore, we have defined methods to reproducibly decalcify biological NPs, and identified key components of their proteome. These elements, including EF-Tu, can be used as biomarkers to further define the processes that mediate propagation of biological NPs and their contribution to disease. PMID:20466084

  7. Characterising the microbiome of Corallina officinalis, a dominant calcified intertidal red alga.

    PubMed

    Brodie, Juliet; Williamson, Christopher; Barker, Gary L; Walker, Rachel H; Briscoe, Andrew; Yallop, Marian

    2016-08-01

    The living prokaryotic microbiome of the calcified geniculate (articulated) red alga, Corallina officinalis from the intertidal seashore is characterised for the first time based on the V6 hypervariable region of 16S rRNA. Results revealed an extraordinary diversity of bacteria associated with the microbiome. Thirty-five prokaryotic phyla were recovered, of which Proteobacteria, Cyanobacteria, Bacteroidetes, Actinobacteria, Planctomycetes, Acidobacteria, Verrucomicrobia, Firmicutes and Chloroflexi made up the core microbiome. Unclassified sequences made up 25% of sequences, suggesting insufficient sampling of the world's oceans/macroalgae. The greatest diversity in the microbiome was on the upper shore, followed by the lower shore then the middle shore, although the microbiome community composition did not vary between shore levels. The C. officinalis core microbiome was broadly similar in composition to those reported in the literature for crustose coralline algae (CCAs) and free-living rhodoliths. Differences in relative abundance of the phyla between the different types of calcified macroalgal species may relate to the intertidal versus subtidal habit of the taxa and functionality of the microbiome components. The results indicate that much work is needed to identify prokaryotic taxa, and to determine the nature of the relationship of the bacteria with the calcified host spatially, temporally and functionally.

  8. Feature-based characterization of motion-contaminated calcified plaques in cardiac multidetector CT

    SciTech Connect

    King, Martin; Giger, Maryellen L.; Suzuki, Kenji; Pan, Xiaochuan

    2007-12-15

    In coronary calcium scoring, motion artifacts affecting calcified plaques are commonly characterized using descriptive terms, which incorporate an element of subjectivity in their interpretations. Quantitative indices may improve the objective characterization of these motion artifacts. In this paper, an automated method for generating 12 quantitative indices, i.e., features that characterize the motion artifacts affecting calcified plaques, is presented. This method consists of using the rapid phase-correlated region-of-interest (ROI) tracking algorithm for reconstructing ROI images of calcified plaques automatically from the projection data obtained during a cardiac scan, and applying methods for extracting features from these images. The 12 features include two dynamic, six morphological, and four intensity-based features. The two dynamic features are three-dimensional (3D) velocity and 3D acceleration. The six morphological features include edge-based volume, threshold-based volume, sphericity, irregularity, average margin gradient, and variance of margin gradient. The four intensity-based features are maximum intensity, mean intensity, minimum intensity, and standard deviation of intensity. The 12 features were extracted from 54 reconstructed sets of simulated four-dimensional images from the dynamic NCAT phantom involving six calcified plaques under nine heart rate/multi-sector gating combinations. In order to determine how well the 12 features correlated with a plaque motion index, which was derived from the trajectory of the plaque, partial correlation coefficients adjusted for heart rate, number of gated sectors, and mean feature values of the six plaques were calculated for all 12 features. Features exhibiting stronger correlations (|r| set-membership sign [0.60,1.00]) with the motion index were 3D velocity, maximum intensity, and standard deviation of intensity. Features demonstrating stronger correlations (|r| set-membership sign [0.60,1.00]) with other

  9. Carotid artery stenting versus endarterectomy: a systematic review.

    PubMed

    Gahremanpour, Amir; Perin, Emerson C; Silva, Guilherme

    2012-01-01

    For about 2 decades, investigators have been comparing carotid endarterectomy with carotid artery stenting in regard to their effectiveness and safety in treating carotid artery stenosis. We conducted a systematic review to summarize and appraise the available evidence provided by randomized trials, meta-analyses, and registries comparing the clinical outcomes of the 2 procedures. We searched the MEDLINE, SciVerse Scopus, and Cochrane databases and the bibliographies of pertinent textbooks and articles to identify these studies. The results of clinical trials and, consequently, the meta-analyses of those trials produced conflicting results regarding the comparative effectiveness and safety of carotid endarterectomy and carotid stenting. These conflicting results arose because of differences in patient population, trial design, outcome measures, and variability among centers in the endovascular devices used and in operator skills. Careful appraisal of the trials and meta-analyses, particularly the most recent and largest National Institutes of Health-sponsored trial (the Carotid Revascularization Endarterectomy vs Stenting Trial [CREST]), showed that carotid stenting and endarterectomy were associated with similar rates of death and disabling stroke. Within the 30-day periprocedural period, carotid stenting was associated with higher risks of stroke, especially for patients aged >70 years, whereas carotid endarterectomy was associated with a higher risk of myocardial infarction. The slightly higher cost of stenting compared with endarterectomy was within an acceptable range by cost-effectiveness standards. We conclude that carotid artery stenting is an equivalent alternative to carotid endarterectomy when patient age and anatomy, surgical risk, and operator experience are considered in the choice of treatment approach. PMID:22949763

  10. Computerized assessment of motion-contaminated calcified plaques in cardiac multidetector CT

    SciTech Connect

    King, Martin; Giger, Maryellen L.; Suzuki, Kenji; Bardo, Dianna M. E.; Greenberg, Brent; Lan Li; Pan Xiaochuan

    2007-12-15

    An automated method for evaluating the image quality of calcified plaques with respect to motion artifacts in noncontrast-enhanced cardiac computed tomography (CT) images is introduced. This method involves using linear regression (LR) and artificial neural network (ANN) regression models for predicting two patient-specific, region-of-interest-specific, reconstruction-specific and temporal phase-specific image quality indices. The first is a plaque motion index, which is derived from the actual trajectory of the calcified plaque and is represented on a continuous scale. The second is an assessability index, which reflects the degree to which a calcified plaque is affected by motion artifacts, and is represented on an ordinal five-point scale. Two sets of assessability indices were provided independently by two radiologists experienced in evaluating cardiac CT images. Inputs for the regression models were selected from 12 features characterizing the dynamic, morphological, and intensity-based properties of the calcified plaques. Whereas LR-velocity (LR-V) used only a single feature (three-dimensional velocity), the LR-multiple (LR-M) and ANN regression models used the same subset of these 12 features selected through stepwise regression. The regression models were parameterized and evaluated using a database of simulated calcified plaque images from the dynamic NCAT phantom involving nine heart rate/multi-sector gating combinations and 40 cardiac phases covering two cardiac cycles. Six calcified plaques were used for the plaque motion indices and three calcified plaques were used for both sets of assessability indices. In one configuration, images from the second cardiac cycle were used for feature selection and regression model parameterization, whereas images from the first cardiac cycle were used for testing. With this configuration, repeated measures concordance correlation coefficients (CCCs) and associated 95% confidence intervals for the LR-V, LR-M, and ANN

  11. Numerical simulation of blood flow and plaque progression in carotid-carotid bypass patient specific case.

    PubMed

    Filipovic, Nenad; Saveljic, Igor; Nikolic, Dalibor; Milosevic, Zarko; Kovacevic, Pavle; Velicki, Lazar

    2015-01-01

    This study describes computer simulation of blood flow and plaque progression pattern in a patient who underwent surgical treatment for infected carotid prosthetic tube graft using carotid-carotid cross-over bypass. The 3D blood flow is governed by the Navier-Stokes equations, together with the continuity equation. Mass transfer within the blood lumen and through the arterial wall is coupled with the blood flow and is modelled by the convection-diffusion equation. Low-density lipoprotein (LDL) transport in lumen of the vessel is described by Kedem-Katchalsky equations. The inflammatory process is solved using three additional reaction-diffusion partial differential equations. Calculation based on a computer simulation showed that flow distribution in the left carotid artery (CA) was around 40-50% of the total flow in the right common CA. Also, the left CA had higher pressure gradient after surgical intervention. Plaque progression simulation predicted development of the atherosclerotic plaque in the position of the right common CA and the left internal CA. A novel way of atherosclerotic plaque progression modelling using computer simulation shows a potential clinical benefit with significant impact on the treatment strategy optimization. PMID:26291584

  12. Carotid and vertebrobasilar transient ischemic attacks: clinical and angiographic correlation.

    PubMed

    Ueda, K; Toole, J F; McHenry, L C

    1979-08-01

    Carotid and vertebrobasilar transient ischemic attacks (TIAs) were clinically and angiographically correlated in 85 patients who had four-vessel angiography within 2 weeks after a TIA. The patients were divided into carotid and vertebrobasilar groups by clinical criteria. In the correlations of symptoms with arteriography, lesions of the contralateral internal carotid artery were observed in 54 percent of the patients. Of 39 patients with vertebrobasilar symptoms, 34 percent also had one carotid lesion and six patients had combinations of symptoms of both carotid and vertebrobasilar disease. In correlation with carotid bruits of the 85 patients, bruits were heard over one carotid artery in 42 percent. Subclavian bruits were heard in 47 percent of the patients with vertebrobasilar symptomatology. TIAs owing to arteriosclerosis of the cervical arteries occurred in 85 percent of the patients, but there was no significant difference in the incidence of atherosclerosis-induced TIA in the carotid and vertebrobasilar systems. For accurate population surveys of the prevalence of TIAs, and for clinical decisions, proper categorization of patients is necessary.

  13. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Carotid sinus nerve stimulator. 870.3850 Section 870.3850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3850 Carotid...

  14. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Carotid sinus nerve stimulator. 870.3850 Section 870.3850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3850 Carotid...

  15. Stroke. Geometry is destiny for carotid atherosclerotic plaques.

    PubMed

    Fisher, Mark

    2011-01-01

    The geometry of carotid arteries, both normal and narrowed, produces flow characteristics that predict the location of atherosclerosis and the site of plaque rupture. A recent study has shown that the upstream carotid plaque undergoes profound biochemical and apoptotic changes that are closely linked to the development of stroke symptoms.

  16. Internal carotid artery dissection associated with scuba diving.

    PubMed

    Nelson, E E

    1995-01-01

    A 52-year-old man presented to the emergency department with dysphasia and a headache after scuba diving. He was treated initially for decompression sickness. Subsequent workup revealed bilateral internal carotid artery dissection. The risk factors, presenting symptoms, diagnosis, and treatment of internal carotid artery dissection are reviewed. The importance of considering unusual causes of neurologic deficits after scuba diving is emphasized.

  17. Traumatic internal carotid artery dissections caused by blunt softball injuries.

    PubMed

    Schievink, W I; Atkinson, J L; Bartleson, J D; Whisnant, J P

    1998-03-01

    This report describes recently treated patients with carotid artery dissection caused by blunt softball injuries, as well as the results of a study of carotid artery trauma in a community. Data obtained through the medical records linkage system used for epidemiologic studies in Olmsted County, MN were used to identify all cases of traumatic internal carotid artery dissection diagnosed from 1987 through 1994. Four patients with traumatic internal carotid artery dissections were identified during the 8-year period under study. In two patients (50%) the carotid dissection was a result of the direct impact of a softball. A 39-year-old-man, who developed transient cerebral ischemic symptoms, and a 35-year-old woman, who developed a painful Horner's syndrome, were struck by a softball on the anterolateral aspect of the neck. Both patients had a low carotid bifurcation. These data suggest that internal carotid artery dissections may be underrecognized sequelae of direct softball injuries to the anterolateral neck. A low carotid bifurcation may be a risk factor for such injuries.

  18. [Ophthalmological complications associated with clinically significant carotid stenosis].

    PubMed

    Rozegnał-Madej, Agnieszka; Bielecka, Emilia; Swiech-Zubilewicz, Anna; Zarnowski, Tomasz; Karakuła, Wacław; Zubilewicz, Tomasz

    2012-01-01

    The aim of the study was to show ocular manifestations in carotid artery occlusive disease, with pathogenesis, diagnostic and therapeutic abilities of this changes. Carotid arteries are the main route by which the blood is supplied to the cerebrum and eyes. Clinical significant carotid artery stenosis is mainly caused by atherosclerosis. Most frequent neurological symptoms are transient ischemic attacks (TIA) and temporary visual loss (amaurosos fugax) are most common ocular symptoms. Other ocular pathologies in fundus examination are retinal embolies, retinal vein occlusion, anterior ischemic optic neuropathy, ocular ischemic syndrome or glaucoma. Most dangerous complications are stroke, blindness, or even patients death. Besides clinical examination the diagnosis is usually confirmed by carotid artery color Doppler ultrasound, magnetic resonance angiography and retinal fluorescein angiography. It is important to refer a patient with suspected or confirmed significant carotid artery stenosis for appropriate evaluation and treatment to a endovascular surgeon. PMID:22783748

  19. Everted cervical vein for carotid patch angioplasty.

    PubMed

    Yu, A; Dardik, H; Wolodiger, F; Raccuia, J; Kapadia, I; Sussman, B; Kahn, M; Pecoraro, J P; Ibrahim, I M

    1990-11-01

    Because of the theoretic benefits of autologous vein we undertook an investigation to evaluate cervical veins (facial, external jugular) as patch material after carotid endarterectomy. A device that stimulated both circumferential fixation by sutures and radial tension exerted on in vivo patches was constructed to measure burst strength of tissue. Mean bursting pressure for groin saphenous vein (n = 10) was 94.5 +/- 15.1 pounds per square inch (psi), 75.5 +/- 8.9 psi for ankle saphenous vein (n = 10), 83.3 +/- 14.5 psi for everted (double layer) cervical vein (n = 5) and 10 +/- 3.3 psi for single layer cervical vein (n = 5). No significant differences between saphenous vein at any level and everted (double layer) cervical vein, but all were significantly different from single layer cervical vein (p less than 0.05). From June 1987 through November 1989, 19 patients underwent 21 carotid endarterectomies complemented with adjunctive everted cervical vein patch angioplasty. Indications for surgery were asymptomatic stenosis (53%), transient ischemic attack (29%), and cerebrovascular accident with recovery (18%). All patients were studied after surgery with duplex scanning. Asymptomatic recurrent stenosis was observed in one patient. Transient hypoglossal nerve dysfunction occurred in one other patient. One postoperative death occurred as a result of massive aspiration. These results indicate that everted cervical vein is comparable to the saphenous vein in resistance to bursting and can yield similar results as patch material after carotid endarterectomy. Accordingly, saphenous vein can be spared and lower extremity incisions avoided.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Congenital Absence of the Internal Carotid Artery

    SciTech Connect

    Florio, Francesco; Balzano, Silverio; Nardella, Michele; Strizzi, Vincenzo; Cammisa, Mario; Bozzini, Vincenzo; Catapano, Giuseppe; D'Angelo, Vincenzo

    1999-01-15

    We report three cases of congenital absence of an internal carotid artery (ICA), diagnosed incidentally by digital subtraction angiography. The analysis of the cases is based on the classification of segmental ICA agenesis proposed by Lasjaunias and Berenstein. Usually the patients with this rare vascular anomaly are asymptomatic; some may have symptoms related to cerebrovascular insufficiency, compression by enlarged intracranial collateral vessels, or complications associated with cerebral aneurysms. Diagnosis of congenital absence of ICA is made by skull base computed tomography (CT) scan, CT and magnetic resonance angiography, and conventional or digital subtraction angiography.

  1. Concomitant Carotid and Coronary Artery Reconstruction

    PubMed Central

    Craver, Joseph M.; Murphy, Douglas A.; Jones, Ellis L.; Curling, Patrick E.; Bone, David K.; Smith, Robert B.; Perdue, Garland D.; Hatcher, Charles R.; Kandrach, Michael

    1982-01-01

    Data are presented on 68 patients who underwent concomitant carotid endarterectomy (CE) and coronary artery bypass surgery (CAB) at Emory University Hospital from January 1974 to February 1981. This group is then compared with a randomly selected, matched population without known carotid disease who underwent CAB alone. Asymptomatic bruit was the reason for investigation in 40 patients (59%); another 23 patients (34%) experienced transient cerebral ischemic attacks (TIAs); and five patients (7%) had TIA and prior stroke. Carotid stenoses (>75% luminal narrowing) were demonstrated as follows: isolated left, 24 patients; isolated right, 27 patients; and bilateral lesions, 16 patients. One patient had innominate artery stenosis. Associated total occlusion of one or both vertebral arteries was demonstrated in six patients. Ninety-seven per cent of patients had disabling angina pectoris prior to operation; the angina was unstable in 57%, 15% had congestive heart failure, and 54% had had at least one prior myocardial infarction (MI). Single-vessel coronary disease was present in 12.5% of patients, double in 37.5%, triple in 41.1%, and left main stenosis in 9%; 43% of patients had abnormal ventricular contractility. CE was performed on 67 patients (36 left and 31 right); aortocarotid bypass was performed on one. The CE procedures were performed immediately prior to the sternotomy for CAB under the same anesthesia. CAB consisted of single bypass in eight patients (11.8%); double in 16 patients (23.5%); triple in 22 patients (32.4%); and quadruple or more in 22 patients (32.4%) (mean = 2.9 grafts per patient). There was no hospital mortality. Perioperative MI occurred in 2.0% and stroke with residual deficit in 1.3%. Cumulative survival is 98.5% at two years. Sixty-three patients (92%) reported improvement or elimination of anginal symptoms after operation. Rehospitalization for stroke was necessary in 3.7% patients. Postoperative activity levels are; self-care only, 3

  2. Clinical Carotid Measurements: Present and Future State

    PubMed Central

    Strandness, D.E.

    1982-01-01

    The most satisfactory methods of evaluating the carotid artery have included Doppler imaging and ultrasonic duplex scanning. It is now recognized that these techniques are most accurate when used in combination with spectral analysis to more objectively determine the flow patterns present across this important bifurcation. In the centers where there is the most experience in their use, the sensitivity of the methods approach 90% and are most accurate for detecting high-grade stenoses (greater than 50% diameter reduction). The most promising future applications include the use of computerized pattern recognition techniques to quantitatively separate patients with varying degrees of disease. PMID:15226956

  3. Recommendations for Carotid Stenting in Korea

    PubMed Central

    Chang, Hyuk Won; Suh, Sang-il; Jeong, Hae Woong; Suh, Dae Chul

    2015-01-01

    Carotid artery angioplasty with stenting (CAS) is being performed in many hospitals in Korea. Most of the guidelines which are being used are similar, but the practical aspects such as techniques are different between hospitals. For example, usage of various protective devices, the oral antiplatelet regimen prior to procedure and placing of temporary pacemaker to prevent bradycardia are different between hospitals. In this article, we summarize and propose the guidelines for CAS which is currently being accepted in Korea. These guidelines may be helpful in providing protocol to neurointerventionalist who perform CAS and to standardize the process including reporting of CAS in the future comparative trials in Korea. PMID:25763292

  4. Management of Extracranial Carotid Artery Disease

    PubMed Central

    Ooi, Yinn Cher

    2015-01-01

    Stroke is the third leading cause of death in developed nations. Up to 88% of strokes are ischemic in nature. Extracranial carotid artery atherosclerotic disease is the third leading cause of ischemic stroke in the general population and the second most common non-traumatic cause among adults <45 years of age. The aim of this paper is to provide comprehensive, evidence-based recommendations for the management of extracranial atherosclerotic disease, including imaging for screening and diagnosis, medical management and interventional management. PMID:25439328

  5. Association between the Gensini Score and Carotid Artery Stenosis

    PubMed Central

    Fidan, Serdar; Tabakçı, Mehmet Mustafa; Toprak, Cuneyt; Alizade, Elnur; Acar, Emrah; Bayam, Emrah; Tellice, Muhammet; Naser, Abdurrahman; Kargın, Ramazan

    2016-01-01

    Background and Objectives The aim of this study was to evaluate the association between the extent of coronary artery disease assessed by the Gensini score and/or the SYNTAX score and the significant carotid stenosis in patients undergoing coronary artery bypass grafting (CABG). Subjects and Methods A total of 225 patients who had carotid doppler ultrasonography prior to CABG were included retrospectively. Significant coronary artery disease was assumed as a lumen diameter stenosis of ≥50% in any of the major epicardial coronary arteries. The severity of carotid stenosis was determined by B-mode and duplex ultrasonography. Clinically significant carotid stenosis was defined as peak systolic velocity greater than 125 cm/s. Results The mean value of SYNTAX score and Gensini score was highest in patients allocated to significant carotid stenosis (22.98±7.32, p<0.001 and 77.40±32.35, p<0.001, respectively). The other risk factors for significant carotid stenosis were found to be male gender (p=0.029), carotid bruit (p<0.001), diabetes (p=0.021), left main disease (p=0.002), 3-vessel disease (p=0.008), chronic total coronary occlusion (p=0.001), and coronary artery calcification (p=0.001) in univariate analysis. However, only the Gensini score (odds ratio[OR]=1.030, p=0.004), carotid bruit (OR=0.068, p<0.001), and male gender (OR=0.190, p=0.003) were the independent predictors. The Gensini score cut off value predicting significant carotid stenosis was 50.5 with 77% sensitivity (p<0.001). Conclusion The Gensini score may be used to identify patients at high risk for significant carotid stenosis prior to CABG. PMID:27721854

  6. Successful Endovascular Treatment of a Left Common Carotid Artery Aneurysm Following Failed Surgery of a Right Common Carotid Artery Aneurysm

    SciTech Connect

    Cil, Barbaros E. Ucar, Ibrahim; Ozsoy, Fatma; Arat, Anil; Yorgancioglu, Cem; Boeke, Erkmen

    2005-04-15

    Aneurysm of the common carotid artery is a rare and serious disease requiring prompt treatment in order to avoid neurologic complications. A 39-year-old man presented with voice impairment and a pulsatile mass at the right side of his neck and was found by color Doppler examination to have bilateral common carotid artery aneurysms of unknown origin. The right-sided large aneurysm was treated with placement of an 8 mm interposition Gore-Tex graft between the right common and internal carotid arteries. The surgical graft thrombosed 7 days after the surgery but the left-sided aneurysm was successfully treated by a Jostent peripheral stent-graft. Color Doppler examination showed a patent stent and no filling of the aneurysm on his first and sixth-month follow-up. Bilateral common carotid artery aneurysm is an exceptionally unusual condition and endovascular treatment of carotid artery aneurysms with covered stents may become an effective treatment alternative for these lesions.

  7. Effects of Ocean Acidification and Temperature Increases on the Photosynthesis of Tropical Reef Calcified Macroalgae.

    PubMed

    Scherner, Fernando; Pereira, Cristiano Macedo; Duarte, Gustavo; Horta, Paulo Antunes; E Castro, Clovis Barreira; Barufi, José Bonomi; Pereira, Sonia Maria Barreto

    2016-01-01

    Climate change is a global phenomenon that is considered an important threat to marine ecosystems. Ocean acidification and increased seawater temperatures are among the consequences of this phenomenon. The comprehension of the effects of these alterations on marine organisms, in particular on calcified macroalgae, is still modest despite its great importance. There are evidences that macroalgae inhabiting highly variable environments are relatively resilient to such changes. Thus, the aim of this study was to evaluate experimentally the effects of CO2-driven ocean acidification and temperature rises on the photosynthesis of calcified macroalgae inhabiting the intertidal region, a highly variable environment. The experiments were performed in a reef mesocosm in a tropical region on the Brazilian coast, using three species of frondose calcifying macroalgae (Halimeda cuneata, Padina gymnospora, and Tricleocarpa cylindrica) and crustose coralline algae. The acidification experiment consisted of three treatments with pH levels below those occurring in the region (-0.3, -0.6, -0.9). For the temperature experiment, three temperature levels above those occurring naturally in the region (+1, +2, +4°C) were determined. The results of the acidification experiment indicate an increase on the optimum quantum yield by T. cylindrica and a decline of this parameter by coralline algae, although both only occurred at the extreme acidification treatment (-0.9). The energy dissipation mechanisms of these algae were also altered at this extreme condition. Significant effects of the temperature experiment were limited to an enhancement of the photosynthetic performance by H. cuneata although only at a modest temperature increase (+1°C). In general, the results indicate a possible photosynthetic adaptation and/or acclimation of the studied macroalgae to the expected future ocean acidification and temperature rises, as separate factors. Such relative resilience may be a result of the

  8. Effect of chronic uremia on the transcriptional profile of the calcified aorta analyzed by RNA sequencing

    PubMed Central

    Rukov, Jakob L.; Gravesen, Eva; Mace, Maria L.; Hofman-Bang, Jacob; Vinther, Jeppe; Andersen, Claus B.; Lewin, Ewa

    2016-01-01

    The development of vascular calcification (VC) in chronic uremia (CU) is a tightly regulated process controlled by factors promoting and inhibiting mineralization. Next-generation high-throughput RNA sequencing (RNA-seq) is a powerful and sensitive tool for quantitative gene expression profiling and the detection of differentially expressed genes. In the present study, we, for the first time, used RNA-seq to examine rat aorta transcriptomes from CU rats compared with control rats. Severe VC was induced in CU rats, which lead to extensive changes in the transcriptional profile. Among the 10,153 genes with an expression level of >1 reads/kilobase transcript/million mapped reads, 2,663 genes were differentially expressed with 47% upregulated genes and 53% downregulated genes in uremic rats. Significantly deregulated genes were enriched for ontologies related to the extracellular matrix, response to wounding, organic substance, and ossification. The individually affected genes were of relevance to osteogenic transformation, tissue calcification, and Wnt modulation. Downregulation of the Klotho gene in uremia is believed to be involved in the development of VC, but it is debated whether the effect is caused by circulating Klotho only or if Klotho is produced locally in the vasculature. We found that Klotho was neither expressed in the normal aorta nor calcified aorta by RNA-seq. In conclusion, we demonstrated extensive changes in the transcriptional profile of the uremic calcified aorta, which were consistent with a shift in phenotype from vascular tissue toward an osteochondrocytic transcriptome profile. Moreover, neither the normal vasculature nor calcified vasculature in CU expresses Klotho. PMID:26739890

  9. Effects of Ocean Acidification and Temperature Increases on the Photosynthesis of Tropical Reef Calcified Macroalgae

    PubMed Central

    Pereira, Cristiano Macedo; Duarte, Gustavo; Horta, Paulo Antunes; e Castro, Clovis Barreira; Barufi, José Bonomi; Pereira, Sonia Maria Barreto

    2016-01-01

    Climate change is a global phenomenon that is considered an important threat to marine ecosystems. Ocean acidification and increased seawater temperatures are among the consequences of this phenomenon. The comprehension of the effects of these alterations on marine organisms, in particular on calcified macroalgae, is still modest despite its great importance. There are evidences that macroalgae inhabiting highly variable environments are relatively resilient to such changes. Thus, the aim of this study was to evaluate experimentally the effects of CO2-driven ocean acidification and temperature rises on the photosynthesis of calcified macroalgae inhabiting the intertidal region, a highly variable environment. The experiments were performed in a reef mesocosm in a tropical region on the Brazilian coast, using three species of frondose calcifying macroalgae (Halimeda cuneata, Padina gymnospora, and Tricleocarpa cylindrica) and crustose coralline algae. The acidification experiment consisted of three treatments with pH levels below those occurring in the region (-0.3, -0.6, -0.9). For the temperature experiment, three temperature levels above those occurring naturally in the region (+1, +2, +4°C) were determined. The results of the acidification experiment indicate an increase on the optimum quantum yield by T. cylindrica and a decline of this parameter by coralline algae, although both only occurred at the extreme acidification treatment (-0.9). The energy dissipation mechanisms of these algae were also altered at this extreme condition. Significant effects of the temperature experiment were limited to an enhancement of the photosynthetic performance by H. cuneata although only at a modest temperature increase (+1°C). In general, the results indicate a possible photosynthetic adaptation and/or acclimation of the studied macroalgae to the expected future ocean acidification and temperature rises, as separate factors. Such relative resilience may be a result of the

  10. Effects of Ocean Acidification and Temperature Increases on the Photosynthesis of Tropical Reef Calcified Macroalgae.

    PubMed

    Scherner, Fernando; Pereira, Cristiano Macedo; Duarte, Gustavo; Horta, Paulo Antunes; E Castro, Clovis Barreira; Barufi, José Bonomi; Pereira, Sonia Maria Barreto

    2016-01-01

    Climate change is a global phenomenon that is considered an important threat to marine ecosystems. Ocean acidification and increased seawater temperatures are among the consequences of this phenomenon. The comprehension of the effects of these alterations on marine organisms, in particular on calcified macroalgae, is still modest despite its great importance. There are evidences that macroalgae inhabiting highly variable environments are relatively resilient to such changes. Thus, the aim of this study was to evaluate experimentally the effects of CO2-driven ocean acidification and temperature rises on the photosynthesis of calcified macroalgae inhabiting the intertidal region, a highly variable environment. The experiments were performed in a reef mesocosm in a tropical region on the Brazilian coast, using three species of frondose calcifying macroalgae (Halimeda cuneata, Padina gymnospora, and Tricleocarpa cylindrica) and crustose coralline algae. The acidification experiment consisted of three treatments with pH levels below those occurring in the region (-0.3, -0.6, -0.9). For the temperature experiment, three temperature levels above those occurring naturally in the region (+1, +2, +4°C) were determined. The results of the acidification experiment indicate an increase on the optimum quantum yield by T. cylindrica and a decline of this parameter by coralline algae, although both only occurred at the extreme acidification treatment (-0.9). The energy dissipation mechanisms of these algae were also altered at this extreme condition. Significant effects of the temperature experiment were limited to an enhancement of the photosynthetic performance by H. cuneata although only at a modest temperature increase (+1°C). In general, the results indicate a possible photosynthetic adaptation and/or acclimation of the studied macroalgae to the expected future ocean acidification and temperature rises, as separate factors. Such relative resilience may be a result of the

  11. Effect of chronic uremia on the transcriptional profile of the calcified aorta analyzed by RNA sequencing.

    PubMed

    Rukov, Jakob L; Gravesen, Eva; Mace, Maria L; Hofman-Bang, Jacob; Vinther, Jeppe; Andersen, Claus B; Lewin, Ewa; Olgaard, Klaus

    2016-03-15

    The development of vascular calcification (VC) in chronic uremia (CU) is a tightly regulated process controlled by factors promoting and inhibiting mineralization. Next-generation high-throughput RNA sequencing (RNA-seq) is a powerful and sensitive tool for quantitative gene expression profiling and the detection of differentially expressed genes. In the present study, we, for the first time, used RNA-seq to examine rat aorta transcriptomes from CU rats compared with control rats. Severe VC was induced in CU rats, which lead to extensive changes in the transcriptional profile. Among the 10,153 genes with an expression level of >1 reads/kilobase transcript/million mapped reads, 2,663 genes were differentially expressed with 47% upregulated genes and 53% downregulated genes in uremic rats. Significantly deregulated genes were enriched for ontologies related to the extracellular matrix, response to wounding, organic substance, and ossification. The individually affected genes were of relevance to osteogenic transformation, tissue calcification, and Wnt modulation. Downregulation of the Klotho gene in uremia is believed to be involved in the development of VC, but it is debated whether the effect is caused by circulating Klotho only or if Klotho is produced locally in the vasculature. We found that Klotho was neither expressed in the normal aorta nor calcified aorta by RNA-seq. In conclusion, we demonstrated extensive changes in the transcriptional profile of the uremic calcified aorta, which were consistent with a shift in phenotype from vascular tissue toward an osteochondrocytic transcriptome profile. Moreover, neither the normal vasculature nor calcified vasculature in CU expresses Klotho.

  12. Calcified central venous catheter fibrin sheath: case report and review of the literature.

    PubMed

    Keehn, Aryeh; Rabinowitz, Dan; Williams, Steve K; Taragin, Benjamin H

    2015-01-01

    We present a 6-year-old girl with acute lymphoblastic leukemia who demonstrated on chest X-ray a radiopacity in the superior vena cava after removal of an implanted venous access device. This radiopacity was initially thought to be a retained catheter fragment. On review of previous imaging, we were able to document the temporal development of a calcified catheter cast as distinct from the catheter. This case represents a rare consequence of central venous catheterization in children. Knowledge of this finding as a possible complication may help avoid performance of unnecessary follow-up imaging or invasive procedures.

  13. Peripheral Calcifying Epithelial Odontogenic Tumour Mimicking a Gingival Inflammation: A Diagnostic Dilemma

    PubMed Central

    de Carvalho, Danielle Lima Corrêa; do Canto, Alan Motta; Eduardo, Fernanda de Paula; Bezinelli, Letícia Mello

    2016-01-01

    The calcifying epithelial odontogenic tumour (CEOT) is an extremely rare benign neoplasia, accounting for approximately 1% of all odontogenic tumours. CEOT can have two clinical manifestations: central or intraosseous (94% of the cases) and peripheral or extraosseous (6% of the cases). Although the latter is less common, the peripheral variant has been described as an insidious lesion, since it is usually asymptomatic and may be erroneously mistaken with gingival hyperplasia, hamartomas, or even metastasis of malignant neoplasia. We report a case of a young male patient presenting with a peripheral CEOT in the mandibular posterior region, mimicking a located gingival inflammation. PMID:27807486

  14. Metastatic Osteosarcoma to the Breast Presenting as a Densely Calcified Mass on Mammography

    PubMed Central

    Kim, Jonghyeon; Woo, Ha Young; Kim, Eun-Kyung; Kim, Min Jung; Moon, Hee Jung

    2016-01-01

    Osteosarcoma most commonly metastasizes to the lung or the skeleton, and metastatic osteosarcoma to the breast is very rare, with only a few cases reported. Due to its rarity, little has been reported about its imaging features. In this report, we represent a 58-year-old woman with metastatic osteosarcoma to the right breast from a tibial osteosarcoma. The imaging features of the metastatic osteosarcoma to the breast by using dedicated breast imaging modalities are described. Although rare, metastatic osteosarcoma to the breast should be considered when dense calcified masses with suspicious features are seen on breast imaging in patients with a history of osteosarcoma. PMID:27064762

  15. Glaucoma Management in Carotid Cavernous Fistula

    PubMed Central

    Calafiore, Silvia; Perdicchi, Andrea; Scuderi, Gianluca; Contestabile, Maria Teresa; Abdolrahimzadeh, Solmaz; Recupero, Santi Maria

    2016-01-01

    Carotid cavernous fistulas (CCF) are vascular communications between the carotid artery and the cavernous sinus. Ophthalmologists are called to diagnose and manage the condition in cases that present with ocular features. A 73-year-old female was referred to our glaucoma center clinic. Eight years before, she had started receiving medication for glaucoma and had undergone laser iridotomy, but a satisfactory management of intraocular pressure (IOP) had not been achieved. The patient was complaining of intermittent diplopia, bilateral proptosis, and conjunctival chemosis over the past 6 months. Best-corrected visual acuity in the right (OD) and left eye (OS) was 9/10 and 10/10, respectively. Visual field testing showed slight paracentral field defects mostly in OS. IOP was 20 mm Hg in OD and 34 mm Hg in OS. We referred the patient to neuroradiology, and MRI angiography revealed a CCF with angiographic classification of Cognard grade 2. Closure of the CCF by transarterial embolization was performed in the neuroradiology department. One week following the procedure, the clinical signs of diplopia, proptosis, and conjunctival chemosis had greatly improved, and IOP was reduced to 12 mm Hg OD and 19 mm Hg in OS. Glaucoma treatment was maintained with topical brimatoprost, brinzolamide, and timolol. Owing to the risk of vision loss associated with vascular stasis, retinal ischemia, and high IOP, ophthalmologists must be aware of the clinical features of CCF and should request appropriate imaging studies such as MRI angiography in order to confirm the diagnosis and plan multidisciplinary treatment. PMID:27462258

  16. Stenting of Extracranial Carotid Artery Stenosis

    PubMed Central

    Koshimae, N.; Morimoto, T.; Nagata, K.

    2003-01-01

    Summary The purpose of this study is to evaluate our cases of cervical internal carotid artery stenosis for safty stenting. We investigate the preoperative internal carotid artery stenosis using by integrated backscatter (IBS) method of ultra sonography, comparing with the thirty five surgical specimens as to their nature, histological structure, thickness of fibrous cap. We choose the protection method according to plaque structure, and placed Easy-Wall stent or Smart stent after prePTA. We added post PTA according to the extent of expansion and IVUS findings. Calibrated IBS = IBS value (ROI) /intinal IBS value of ‘bleeding’, ‘lipiď, ‘thrombus’, fiber, ‘hyalinization’ were -27.5, -22.5, -15.2, -11.1, +2.1. That of the thin fibrous cap were -10.9*, that of thic fibrous cap were -2.4 (*p < 0.001). There was a good coleration between the extent of expansion and expected histological findings. All conplications were two cases of small cerebral infarction and a case of bleeding from the complicated lung cancer. The protection at prePTA lead to no complications in case of acute cerebral infarctions. It is very important to check the histological specimen carefully for safty stenting. PMID:20591243

  17. Glaucoma Management in Carotid Cavernous Fistula.

    PubMed

    Calafiore, Silvia; Perdicchi, Andrea; Scuderi, Gianluca; Contestabile, Maria Teresa; Abdolrahimzadeh, Solmaz; Recupero, Santi Maria

    2016-01-01

    Carotid cavernous fistulas (CCF) are vascular communications between the carotid artery and the cavernous sinus. Ophthalmologists are called to diagnose and manage the condition in cases that present with ocular features. A 73-year-old female was referred to our glaucoma center clinic. Eight years before, she had started receiving medication for glaucoma and had undergone laser iridotomy, but a satisfactory management of intraocular pressure (IOP) had not been achieved. The patient was complaining of intermittent diplopia, bilateral proptosis, and conjunctival chemosis over the past 6 months. Best-corrected visual acuity in the right (OD) and left eye (OS) was 9/10 and 10/10, respectively. Visual field testing showed slight paracentral field defects mostly in OS. IOP was 20 mm Hg in OD and 34 mm Hg in OS. We referred the patient to neuroradiology, and MRI angiography revealed a CCF with angiographic classification of Cognard grade 2. Closure of the CCF by transarterial embolization was performed in the neuroradiology department. One week following the procedure, the clinical signs of diplopia, proptosis, and conjunctival chemosis had greatly improved, and IOP was reduced to 12 mm Hg OD and 19 mm Hg in OS. Glaucoma treatment was maintained with topical brimatoprost, brinzolamide, and timolol. Owing to the risk of vision loss associated with vascular stasis, retinal ischemia, and high IOP, ophthalmologists must be aware of the clinical features of CCF and should request appropriate imaging studies such as MRI angiography in order to confirm the diagnosis and plan multidisciplinary treatment. PMID:27462258

  18. Hypothermia during Carotid Endarterectomy: A Safety Study

    PubMed Central

    Candela, Serena; Dito, Raffaele; Casolla, Barbara; Silvestri, Emanuele; Sette, Giuliano; Filippi, Federico; Taurino, Maurizio; Brancadoro, Domitilla; Orzi, Francesco

    2016-01-01

    Background CEA is associated with peri-operative risk of brain ischemia, due both to emboli production caused by manipulation of the plaque and to potentially noxious reduction of cerebral blood flow by carotid clamping. Mild hypothermia (34–35°C) is probably the most effective approach to protect brain from ischemic insult. It is therefore a substantial hypothesis that hypothermia lowers the risk of ischemic brain damage potentially associated with CEA. Purpose of the study is to test whether systemic endovascular cooling to a target of 34.5–35°C, initiated before and maintained during CEA, is feasible and safe. Methods The study was carried out in 7 consecutive patients referred to the Vascular Surgery Unit and judged eligible for CEA. Cooling was initiated 60–90 min before CEA, by endovascular approach (Zoll system). The target temperature was maintained during CEA, followed by passive, controlled rewarming (0.4°C/h). The whole procedure was carried out under anesthesia. Results All the patients enrolled had no adverse events. Two patients exhibited a transient bradycardia (heart rate 30 beats/min). There were no significant differences in the clinical status, laboratory and physiological data measured before and after CEA. Conclusions Systemic cooling to 34.5–35.0°C, initiated before and maintained during carotid clamping, is feasible and safe. Trial Registration ClinicalTrials.gov NCT02629653 PMID:27058874

  19. Noninvasive Assessment of Carotid Artery Disease

    PubMed Central

    Bandyk, Dennis F.; Thiele, Brain L.

    1983-01-01

    Noninvasive methods of detecting carotid disease were developed to avoid the morbidity and occasional mortality associated with cerebral angiography. The tests developed are of the following two types: direct, which uses imaging or the detection of flow disturbances to identify disease at the bifurcation, and indirect, which infers the presence of bifurcation disease by detecting changes at a remote site. The initial goal of only detecting disease has now been broadened, with this technology being used to address important clinical and epidemiologic questions such as the natural history of carotid bifurcation disease. The recognition of these important contributions has been compounded, however, by the large number of tests that are available, producing the problem of deciding which test or tests should be used for a particular patient. The use of multiple tests avoids the deficiencies of single tests but compounds medical costs. For a cost-effective single form of testing for all circumstances, duplex scanning methods offer the greatest possibility of detecting all degrees of disease. Images PMID:6649597

  20. Medical treatment in carotid artery intervention.

    PubMed

    Kolkert, J L; Meerwaldt, R; Lefrandt, J D; Geelkerken, R H; Zeebregts, C J

    2011-12-01

    Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical therapy has evolved tremendously. Next to aspirin, antiplatelet regimens acting on a different level in the modulation of platelet aggregation have made their entry. Moreover, statin therapy has been introduced. These changes among others in secondary stroke prevention, along with better understanding in life-style adjustments and perioperative medical management, have led to a decrease in stroke recurrence. Secondary prevention is therefore now the most important pillar of medical therapy. It consists of antiplatelet therapy, statins and blood pressure lowering agents in all patients. Small adjustments are recommended for those patients referred for invasive treatment. Moreover, long-term medical treatment is imperative. In this article, we summarize current evidence in literature regarding medical management in patients with previous stroke or TIA. PMID:22051989

  1. Radiation therapy of carotid body tumors

    SciTech Connect

    Valdagni, R.; Amichetti, M. )

    1990-02-01

    Chemodectomas of carotid artery bifurcation are generally managed with surgery, irradiation being reserved for inoperable, bulky, and recurrent tumors. Probably due to this pretreatment selection of patients, chemodectomas are anedoctally considered radioresistant tumors, although this concept is not supported by the recent literature. From 1968 to 1987, 13 carotid body tumors in seven patients were treated with irradiation as sole treatment (10 lesions) or as postoperative modality (three lesions). Familial occurrence and bilateral presentation were observed in 3 of 7 and in 6 of 7 patients, respectively. Total dose of irradiation was of 46-60 Gy (median 50 Gy, mean 52.25 Gy) with dose per fraction of 1.8-2.5 Gy. Local control (subjective or objective) was obtained in all the patients. Clinical results following World Health Organization (WHO) criteria were: 3 of 13 complete response, 7 of 13 partial response and 3 of 13 no change. Follow-up range is 1-19 years. Acute side effects were minimal and mid- or long-term toxicity was absent.32 references.

  2. Medical treatment in carotid artery intervention.

    PubMed

    Kolkert, J L; Meerwaldt, R; Lefrandt, J D; Geelkerken, R H; Zeebregts, C J

    2011-12-01

    Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical therapy has evolved tremendously. Next to aspirin, antiplatelet regimens acting on a different level in the modulation of platelet aggregation have made their entry. Moreover, statin therapy has been introduced. These changes among others in secondary stroke prevention, along with better understanding in life-style adjustments and perioperative medical management, have led to a decrease in stroke recurrence. Secondary prevention is therefore now the most important pillar of medical therapy. It consists of antiplatelet therapy, statins and blood pressure lowering agents in all patients. Small adjustments are recommended for those patients referred for invasive treatment. Moreover, long-term medical treatment is imperative. In this article, we summarize current evidence in literature regarding medical management in patients with previous stroke or TIA.

  3. Should patients with asymptomatic significant carotid stenosis undergo simultaneous carotid and cardiac surgery?

    PubMed Central

    Ogutu, Peter; Werner, Raphael; Oertel, Frank; Beyer, Michael

    2014-01-01

    A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether patients with severe asymptomatic carotid and coronary artery diseases should undergo simultaneous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG). A total of 624 papers were found using the reported search, of which 20 represent the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study results of these papers are tabulated. Previous cohort studies showed mixed results, while advocating for the necessity of a randomized controlled trial (RCT). A recent RCT showed that patients undergoing prophylactic or simultaneous CEA + CABG had lower rates of stroke (0%) compared with delayed CEA 1–3 months after CABG (7.7%), without significant perioperative mortality difference. This study included patients with unilateral severe (>70%) asymptomatic carotid stenosis requiring CABG. An earlier partly randomized trial also showed better outcomes for patients undergoing simultaneous procedures (P = 0.045). Interestingly, systematic reviews previously failed to show compelling evidence supporting prophylactic CEA. This could be partly due to the fact that these reviews collectively analyse different cohort qualities. Neurological studies have, however, shown reduced cognitive and phonetic quality and function in patients with unilateral and bilateral asymptomatic carotid artery stenosis. Twenty-one RCTs comparing lone carotid artery stenting (CAS) and CEA informed the American Heart Association guidelines, which declared CAS comparable with CEA for symptomatic and asymptomatic carotid stenosis (CS). However, the risk of death/stroke for CAS alone is double that for CEA alone in the acute phase following onset of symptoms, while CEA alone is associated with a doubled risk of myocardial infarction. There is

  4. [Simultaneous carotid and vertebral revascularization in the aged].

    PubMed

    Illuminati, G; Caliò, F G; Bertagni, A; Piermattei, A; Vietri, F; Martinelli, V

    1997-09-01

    Five patients of a mean age of 76, have been submitted to combined vertebral and carotid artery revascularization for a severe vertebro-basilar insufficiency. Vertebral artery revascularization consisted of a transposition to the common carotid artery in one case and of a carotid-distal vertebral artery saphenous bypass graft. The associated carotid artery revascularization consisted of a carotid endarterectomy with patch in 4 cases and without patch in one case. There were no postoperative mortality and no postoperative stroke. Postoperative morbidity included a transitory revascularization syndrome, a myocardial ischemia and a Horner's syndrome. Complete relief of vertebrobasilar symptoms was obtained in 4 patients whereas in one patient only a mild positional vertigo persisted. All vascular reconstructions have been assessed with postoperative arteriography and duplex-scan every six months. At 11 months mean follow-up, all revascularizations are patent. Combined carotid and vertebral artery surgery is effective in well selected cases, and it does not enhance the risk of the two operations performed separately. It also eliminate the possibility of failure of isolated carotid revascularization for vertebrobasilar symptoms.

  5. Carotid Stenting vs Endarterectomy: New Results in Perspective

    PubMed Central

    Perkins, William J.; Lanzino, Guiseppe; Brott, Thomas G.

    2010-01-01

    Carotid artery stenosis is a major risk factor for stroke, and treatments for this condition to decrease the risk of stroke include medical therapy, carotid endarterectomy (CEA), and, more recently, carotid angioplasty and stenting (CAS). Randomized controlled trials comparing the efficacy of CEA vs medical therapy showed a clear benefit for CEA in patients with symptomatic carotid artery stenosis of greater than 70% and a lesser benefit in patients with 50% to 69% stenosis. Treatments have evolved in the ensuing 20 years, and a new method, CAS, has emerged as a possible alternative to CEA. In early results, CAS proved feasible but did not compare favorably with CEA. Later and larger-scale studies comparing CAS to CEA failed to reach conclusions regarding a clear neurologic outcome advantage of one method over the other. This subject was of sufficient interest that 2 larger-scale randomized controlled trials comparing CAS and CEA, the Carotid Revascularization Endarterectomy vs Stenting Trial and the International Carotid Stenting Study, were undertaken to further explore this issue. This brief review places the new data arising from these studies in the context of prior efforts to address the problem of carotid artery stenosis and explores further opportunities for improvement and patient recommendations in light of these new findings. PMID:21123637

  6. Life expectancy and late stroke following carotid endarterectomy.

    PubMed Central

    Bernstein, E F; Humber, P B; Collins, G M; Dilley, R B; Devin, J B; Stuart, S H

    1983-01-01

    A review of the UCSD experience with 456 consecutive carotid endarterectomy procedures confirms the acceptably low operative mortality and morbidity associated with this operation. Immediate complications were not different when routine or selective shunting was performed, but the patients with a low internal carotid artery back pressure had higher operative complication rates. The coexistence of atherosclerosis in other parts of the body severe-enough to warrant surgery for them was not associated with either higher early or late carotid surgery complication rates. Following both coronary bypass and carotid procedures, the late mortality was decreased, and the late incidence of stroke was particularly low in comparison to the remainder of the patient group. Late follow-up emphasized the high continuing attrition rate from all causes in these patients. Late strokes continued to occur, particularly in patients with prior strokes and severe preoperative bilateral carotid disease. The late course of patients with posterior circulation transient ischemic attacks treated by carotid endarterectomy was quite similar to that of patients treated for anterior circulation transient ischemia attacks (TIAs). Newer postoperative screening procedures may decrease the incidence of late postoperative stroke by identifying recurrent carotid stenosis while it is still in the asymptomatic stage. PMID:6602597

  7. [A Novel, Less Invasive Protection Method for Carotid Artery Stenting].

    PubMed

    Ohshima, Tomotaka; Goto, Shunsaku; Yamamoto, Taiki; Imai, Tasuku; Nishizawa, Toshihisa; Shimato, Shinji; Kato, Kyozo

    2016-07-01

    Purpose: We present a novel, less invasive protection method for carotid artery stenting. Case presentation: A 67-year-old man presented with symptomatic severe left carotid artery stenosis. A transfemoral approach was dangerous because of an abdominal aortic aneurysm. A 6Fr Axcelguide Simmonds catheter was inserted into the right brachial artery, and advanced into the left common carotid artery. Next, a 6Fr Optimo 100-cm catheter was coaxially navigated into the left common carotid artery. A PercuSurge GuardWire 300-cm was coaxially navigated into the left external carotid artery. Under flow reversal with the 2 balloons, another PercuSurge GuardWire 300-cm was navigated into the distal left internal carotid artery through the lesion. After both PercuSurge GuardWire balloons were inflated, the 6Fr Optimo was deflated and retrieved using a catheter exchange technique. Then, under distal double-balloon protection, routine stenting was performed. Conclusions: This technique is safer and less invasive than previous methods, especially in cases with difficult femoral access and vulnerable carotid plaque. PMID:27384116

  8. Peripheral Chemoreceptors: Function and Plasticity of the Carotid Body

    PubMed Central

    Kumar, Prem; Prabhakar, Nanduri R.

    2014-01-01

    The discovery of the sensory nature of the carotid body dates back to the beginning of the 20th century. Following these seminal discoveries, research into carotid body mechanisms moved forward progressively through the 20th century, with many descriptions of the ultrastructure of the organ and stimulus-response measurements at the level of the whole organ. The later part of 20th century witnessed the first descriptions of the cellular responses and electrophysiology of isolated and cultured type I and type II cells, and there now exist a number of testable hypotheses of chemotransduction. The goal of this article is to provide a comprehensive review of current concepts on sensory transduction and transmission of the hypoxic stimulus at the carotid body with an emphasis on integrating cellular mechanisms with the whole organ responses and highlighting the gaps or discrepancies in our knowledge. It is increasingly evident that in addition to hypoxia, the carotid body responds to a wide variety of blood-borne stimuli, including reduced glucose and immune-related cytokines and we therefore also consider the evidence for a polymodal function of the carotid body and its implications. It is clear that the sensory function of the carotid body exhibits considerable plasticity in response to the chronic perturbations in environmental O2 that is associated with many physiological and pathological conditions. The mechanisms and consequences of carotid body plasticity in health and disease are discussed in the final sections of this article. PMID:23728973

  9. An absent ophthalmic artery or carotid siphon signal on transcranial Doppler confirms the presence of severe ipsilateral internal carotid artery disease.

    PubMed

    Wilterdink, J L; Feldmann, E; Bragoni, M; Brooks, J M; Benavides, J G

    1994-10-01

    Transcranial Doppler ultrasound provides a useful adjunct to extracranial ultrasound in the diagnosis of carotid bifurcation disease. Previous studies have shown that collateral flow patterns and diminished flow velocities in the ipsilateral middle cerebral artery correlate with hemodynamically significant carotid disease. In a series of 7,054 carotid duplex and transcranial Doppler examinations, 12.5% (95% confidence interval [CI]: 8.7, 16.4) of 287 ophthalmic arteries ipsilateral to an apparent carotid occlusion had no detectable flow signal, compared with 0.5% (95% CI: 0.3, 0.7) of 6,767 ophthalmic arteries ipsilateral to a non-occluded carotid artery (p < 0.001). Carotid siphon signals were not detectable in 24.4% (95% CI: 19.4, 29.4) of arteries ipsilateral to the carotid occlusion, versus 1.0% (95% CI: 0.8, 1.3) ipsilateral to nonoccluded carotid arteries (p < 0.001). A significant number of absent ophthalmic artery and carotid siphon signals (5.7 and 8.7%, respectively) were also found in patients with 80 to 99% extracranial carotid stenosis. A subset of 216 studies with angiographic correlation confirmed the high association of these transcranial Doppler findings with severe stenosis or occlusion of the internal carotid artery. Primary ophthalmological disease or siphon occlusion did not explain these findings. An absent ophthalmic artery or carotid siphon signal on transcranial Doppler examination is believed to represent a failure to detect slow flow distal to severe carotid bifurcation lesions. As a sign of ipsilateral carotid occlusion, the sensitivities of absent ophthalmic artery and carotid siphon signals are quite low (12.5 and 24.4%, respectively). The high specificities of 99.5 and 99.0%, however, make these findings useful in confirming the diagnosis of presumptive carotid occlusion by carotid duplex ultrasound.

  10. Heavy Snoring as a Cause of Carotid Artery Atherosclerosis

    PubMed Central

    Lee, Sharon A.; Amis, Terence C.; Byth, Karen; Larcos, George; Kairaitis, Kristina; Robinson, Tracey D.; Wheatley, John R.

    2008-01-01

    Study Objectives: Previous studies have suggested that snoring and obstructive sleep apnea hypopnea syndrome may be important risk factors for the development of carotid atherosclerosis and stroke. However, it is not clear if snoring per se is independently related to the risk of developing carotid atherosclerotic plaque. Design: Observational cohort study. Setting: Volunteer sample examined in a sleep laboratory. Participants: One hundred ten volunteers (snorers and nonsnorers with only mild, nonhypoxic obstructive sleep apnea hypopnea syndrome) underwent polysomnography with quantification of snoring, bilateral carotid and femoral artery ultrasound with quantification of atherosclerosis, and cardiovascular risk factor assessment. Subjects were categorized into 3 snoring groups: mild (0%–25% night snoring), moderate (> 25%–50% night snoring), and heavy (> 50% night snoring). Interventions: N/A. Measurements and Results: The prevalence of carotid atherosclerosis was 20% with mild snoring, 32% with moderate snoring, and 64% with heavy snoring (P < 0.04, Χ2). Logistic regression analysis was used to determine the independent effect of snoring on the prevalence of carotid and femoral atherosclerosis. After adjustment for age, sex, smoking history, and hypertension, heavy snoring was significantly associated with carotid atherosclerosis (odds ratio 10.5; 95% confidence interval 2.1–51.8; P = 0.004) but not with femoral atherosclerosis. Conclusions: Heavy snoring significantly increases the risk of carotid atherosclerosis, and the increase is independent of other risk factors, including measures of nocturnal hypoxia and obstructive sleep apnea severity. Considering the high prevalence of snoring in the community, these findings have substantial public health implications for the management of carotid atherosclerosis and the prevention of stroke. Citation: Lee SA; Amis TC; Byth K; Larcos G; Kairaitis K; RobinsonTD; Wheatley JR. Heavy snoring as a cause of carotid

  11. Hydrocortisone supresses inflammatory activity of metalloproteinase - 8 in carotid plaque

    PubMed Central

    Gabriel, Sthefano Atique; Antonangelo, Leila; Capelozzi, Vera Luiza; Beteli, Camila Baumann; de Camargo Júnior, Otacílio; de Aquino, José Luis Braga; Caffaro, Roberto Augusto

    2015-01-01

    Objective Matrix metalloproteinases are inflammatory biomarkers involved in carotid plaque instability. Our objective was to analyze the inflammatory activity of plasma and carotid plaque MMP-8 and MMP-9 after intravenous administration of hydrocortisone. Methods The study included 22 patients with stenosis ≥ 70% in the carotid artery (11 symptomatic and 11 asymptomatic) who underwent carotid endarterectomy. The patients were divided into two groups: Control Group - hydrocortisone was not administered, and Group 1 - 500 mg intravenous hydrocortisone was administered during anesthetic induction. Plasma levels of MMP-8 and MMP-9 were measured preoperatively (24 hours before carotid endarterectomy) and at 1 hour, 6 hours and 24 hours after carotid endarterectomy. In carotid plaque, tissue levels of MMP-8 and MMP-9 were measured. Results Group 1 showed increased serum levels of MMP- 8 (994.28 pg/ml and 408.54 pg/ml, respectively; P=0.045) and MMP-9 (106,656.34 and 42,807.69 respectively; P=0.014) at 1 hour after carotid endarterectomy compared to the control group. Symptomatic patients in Group 1 exhibited lower tissue concentration of MMP-8 in comparison to the control group (143.89 pg/ml and 1317.36 respectively; P=0.003). There was a correlation between preoperative MMP-9 levels and tissue concentrations of MMP-8 (P=0.042) and MMP-9 (P=0.019) between symptomatic patients in the control group. Conclusion Hydrocortisone reduces the concentration of MMP- 8 in carotid plaque, especially in symptomatic patients. There was an association between systemic and tissue inflammation. PMID:26313719

  12. Experimental determination of circumferential properties of fresh carotid artery plaques.

    PubMed

    Lawlor, Michael G; O'Donnell, Michael R; O'Connell, Barry M; Walsh, Michael T

    2011-06-01

    Carotid endarterectomy (CEA) is currently accepted as the gold standard for interventional revascularisation of diseased arteries belonging to the carotid bifurcation. Despite the proven efficacy of CEA, great interest has been generated in carotid angioplasty and stenting (CAS) as an alternative to open surgical therapy. CAS is less invasive compared with CEA, and has the potential to successfully treat lesions close to the aortic arch or distal internal carotid artery (ICA). Following promising results from two recent trials (CREST; Carotid revascularisation endarterectomy versus stenting trial, and ICSS; International carotid stenting study) it is envisaged that there will be a greater uptake in carotid stenting, especially amongst the group who do not qualify for open surgical repair, thus creating pressure to develop computational models that describe a multitude of plaque models in the carotid arteries and their reaction to the deployment of such interventional devices. Pertinent analyses will require fresh human atherosclerotic plaque material characteristics for different disease types. This study analysed atherosclerotic plaque characteristics from 18 patients tested on site, post-surgical revascularisation through endarterectomy, with 4 tissue samples being excluded from tensile testing based on large width-length ratios. According to their mechanical behaviour, atherosclerotic plaques were separated into 3 grades of stiffness. Individual and group material coefficients were then generated analytically using the Yeoh strain energy function. The ultimate tensile strength (UTS) of each sample was also recorded, showing large variation across the 14 atherosclerotic samples tested. Experimental Green strains at rupture varied from 0.299 to 0.588 and the Cauchy stress observed in the experiments was between 0.131 and 0.779 MPa. It is expected that this data may be used in future design optimisation of next generation interventional medical devices for the

  13. Intracranial subdural osteoma: a rare benign tumor that can be differentiated from other calcified intracranial lesions utilizing MR imaging.

    PubMed

    Barajas, Ramon F; Perry, Arie; Sughrue, Michael; Aghi, Manish; Cha, Soonmee

    2012-10-01

    We report the magnetic resonance (MR) imaging characteristics of subdural osteoma and other benign calcified intracranial lesions to highlight imaging features that differentiate between these disease entities. A 63-year-old woman presented with progressively altered mental status. Non-contrast CT demonstrated a densely calcified right middle cranial fossa extra-axial mass. MR imaging of the lesion demonstrated T1 and T2 hypointensity without evidence of contrast enhancement, parenchymal abnormality, or connection to adjacent venous structures. Diffusion weighted imaging demonstrated markedly decreased signal intensity and artificially reduced diffusion on apparent diffusion coefficient map. Histologically, the tumor was predominantly composed of lamellar bone and small fragments of residual dura consistent with subdural osteoma. This case demonstrates that radiological examination can provide additional insight into the origin of intracranial osteomas (extradural versus subdural versus sinonasal) and help distinguish from other diagnostic considerations including benign meningeal ossification and calcified meningioma prior to surgical resection.

  14. The effect of hypodynamia on mineral and protein metabolism in calcified tissues of the maxillodental system (experimental radioisotope study)

    NASA Technical Reports Server (NTRS)

    Prokhonchukov, A. A.; Kovalenko, Y. A.; Kolesnik, A. G.; Kondratyev, Y. I.; Ilyushko, N. A.

    1980-01-01

    Mineral and protein metabolism was studied in experiments on 60 white rats, using P-32 and Ca-45 uptake in the mineral fractions, 2C-14-glycine in the protein fractions, and P-32 in both fractions of calcified tissues as indices over a 100 day period of experimental hypodynamia. Combined alterations in mineral and protein metabolism occurred in the calcified tissues of the experimental animals. The most pronounced changes were found in P-32 and 2C-14-glycine metabolism. In the incisors and femoral bones, these alterations occurred in two phases: P-32 and 2C-14-glycine uptake first increased, then decreased. Changes in Ca-45 metabolism were less pronounced, particularly in the initial period of the experiment. A marked reduction in P-32, Ca-45, and 2C-14-glycine uptake was found in various fractions of the calcified tissues on the 100th day of experimental hypodynamia.

  15. External Carotid-Internal Jugular Fistula as a Late Complication After Carotid Endarterectomy: A Rare Case

    SciTech Connect

    Bakar, Bulent; Cekirge, Saruhan; Tekkok, Ismail Hakki

    2011-02-15

    A 66-year-old man presented with mild amnesia, progressive fatigue, ataxia, visual hallucinations, and debility. His past medical history included right-sided carotid endarterectomy performed elsewhere 6 years previously. Cranial magnetic resonance imaging showed left parieto-occipital arteriovenous malformation-like tortous vessels, venous congestion, and ischemic areas. Cerebral angiography showed right-sided compound external carotid artery-internal jugular vein (IJV) fistula, and distal occlusion of the right IJV. Transvenous embolization via contralateral IJV was performed, and the fistula, together with fistulous portion of the distal IJV, was sealed using coils. Two years later, patient is well with normal neurologic examination findings. The presence of an arteriovenous communication after vascular surgery is a serious complication with potential long-term effects and therefore should be diagnosed and treated as promptly as possible.

  16. Pathophysiology and management of reperfusion injury and hyperperfusion syndrome after carotid endarterectomy and carotid artery stenting.

    PubMed

    Farooq, Muhammad U; Goshgarian, Christopher; Min, Jiangyong; Gorelick, Philip B

    2016-01-01

    Cerebral hyperperfusion is a relatively rare syndrome with significant and potentially preventable clinical consequences. The pathophysiology of cerebral hyperperfusion syndrome (CHS) may involve dysregulation of the cerebral vascular system and hypertension, in the setting of increase in cerebral blood flow. The early recognition of CHS is important to prevent complications such as intracerebral hemorrhage. This review will focus on CHS following carotid endarterectomy and carotid artery stenting. We will discuss the typical clinical features of CHS, risk factors, pathophysiology, diagnostic modalities for detection, identification of patients at risk, and prevention and treatment. Although currently there are no specific guidelines for the management of CHS, identification of patients at risk for CHS and aggressive treatment of hypertension are recommended. PMID:27602202

  17. [Non-invasive explorations of the carotid arteries (author's transl)].

    PubMed

    Persson, A V; Dyer, V E

    1981-01-01

    For the non-invasive evaluation of patients suspected of having extracranial carotid artery disease, the non-invasive vascular laboratory at the Lahey Clinic, Boston, Massachusetts uses three tests. Carotid phonoangiography (C.P.A.) by itself is 60% accurate, the Kartchner-McRae Oculoplethysmograph (O.P.G.) by itself 80% accurate, and the Echoflow doppler arterial imager, by itself 90% accurate. These examinations are used for surveillance of high-risk patients and to determine the need for carotid arteriography. In a series of 94 patients, the combination of these non-invasive methods yielded one false negative and 2 false positive studies, for an overall accuracy of 95%.

  18. Glomus tissue in the vicinity of the human carotid sinus.

    PubMed Central

    Garfia, A

    1980-01-01

    Three of 60 cadavers have shown, in the adventitia or in the adipose tissue from the human carotid sinus region, small islands of tissue richly and typically vascularized and with nerve endings contacting cells like the tissue of the principal carotid body. In two of the cases such 'miniglomera' were single but in the third there were several all on the same side. A modified en bloc silver nitrate reduction stain was used to demonstrate the microvascular arrangements and the nerve endings by light microscopy of serial tangential sections of the carotid bifurcation. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 PMID:7364653

  19. Clinical implications of calcifying nanoparticles in dental diseases: a critical review

    PubMed Central

    Alenazy, Mohammed S; Mosadomi, Hezekiah A

    2014-01-01

    Background Unknown cell-culture contaminants were described by Kajander and Ciftçioğlu in 1998. These contaminants were called nanobacteria initially and later calcifying nanoparticles (CNPs). Their exact nature is unclear and controversial. CNPs have unique and unusual characteristics, which preclude placing them into any established evolutionary branch of life. Aim The aim of this systematic review was to assess published data concerning CNPs since 1998 in general and in relation to dental diseases in particular. Materials and methods The National Library of Medicine (PubMed) and Society of Photographic Instrumentation Engineers (SPIE) electronic and manual searches were conducted. Nanobacteria and calcifying nanoparticles were used as keywords. The search yielded 135 full-length papers. Further screening of the titles and abstracts that followed the review criteria resulted in 43 papers that met the study aim. Conclusion The review showed that the existence of nanobacteria is still controversial. Some investigators have described a possible involvement of CNPs in pulpal and salivary gland calcifications, as well as the possible therapeutic use of CNPs in the treatment of cracked and/or eroded teeth. PMID:24376354

  20. Distribution of calcified concretions and calcium ions in the pig pineal gland.

    PubMed

    Lewczuk, B; Przybylska, B; Wyrzykowski, Z

    1994-01-01

    Serial sections of pig pineal glands were stained with von Kossa's and Alizarin red S methods to determine the occurrence and localization of calcified concretions. In the pineal glands of pigs aged eight months, concretions were not found. A small number of concretions was observed in all investigated pineal glands of three years old pigs. The concretions were distributed in the connective tissue of the pineal capsule and septa. The potassium pyroantimonate method was used for ultracytochemical localization of calcium ions. In pinealocytes, precipitates were observed in nuclei, mitochondria, Golgi apparatus, endoplasmic reticulum and cytoplasmic matrix. Single precipitates were found on the outer membranes of dense bodies, multivesicular bodies and lysosomes. There were no differences in the amount or the localization of precipitates between dark and light pinealocytes and between pinealocytes of animals aged both eight months and three years. The results suggest that: (1) the calcified concretions in the pig pineal gland are formed by the leptomeningeal tissue without participation of the pinealocytes, (2) cytoplasmic dense bodies, specific components of the pig pineal gland, are only slightly involved in calcium turnover in the pinealocytes. PMID:7758619

  1. Slow-flow habitats as refugia for coastal calcifiers from ocean acidification.

    PubMed

    Hurd, Catriona L

    2015-08-01

    The pH of the oceans' surface water is dropping, termed ocean acidification (OA), and the 0.4 unit reduction in pH by 2100 is projected to negatively impact benthic coastal organisms that produce calcium carbonate "skeletons." Research has focussed on identifying species that are susceptible to OA, but there is an urgent need to discover refuge habitats that will afford protection to vulnerable species. The susceptibility of calcium carbonate skeletons to dissolution by OA depends on the pH at their surface, and this is controlled by the interaction between seawater velocity and organismal metabolism. This perspective considers how seawater velocity modifies the responses of calcifying organisms (seaweed, shellfish, and tropical corals) to OA through its action on controlling diffusion boundary layer thickness and thereby the pH and calcium carbonate saturation state (Ω) at the organisms' surface. Evidence is presented to support the idea that slow-flow habitats, such as wave-sheltered bays or the within canopies of seaweed/seagrass beds, might provide inexpensive refugia from OA for vulnerable coastal calcifiers. PMID:26986784

  2. Calcifying odontogenic cyst associated with complex odontoma: case report and review of the literature.

    PubMed

    Gallana-Alvarez, Silvia; Mayorga-Jimenez, Francisco; Torres-Gómez, Francisco Javier; Avellá-Vecino, Francisco Javier; Salazar-Fernandez, Clara

    2005-01-01

    We report a calcifying odontogenic cyst associated with odontoma (COCaO) and an included permanent canine in the superior maxilla, in a 19 year-old-man. The calcifying odontogenic cyst (COC) was first described as a distinct entity by Gorlin et al in 1962. The lesion is a mixed odontogenic benign tumor, and although most of the cases present cystic characteristics, a few are of the solid type (15%), and its rare malignant transformation is well documented. The COC may occur in association with other odontogenic tumors, the most common is the odontoma, occurring in about 24% of the cases. For this association the term Odontocalcifying odontogenic cyst has been suggested. Radiographically is a well defined mixed lesion and histologically consists of a large cyst. In the central area of the cyst enamel and dentin deposits can be found, irregularly distributed in areas and in other parts it takes on a well defined organoid aspect. A thorough review of literature takes place and the pathogenesis is discussed.

  3. Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting.

    PubMed

    Georgiadis, George S; Georgakarakos, Efstratios I; Schoretsanitis, Nikolaos; Argyriou, Christos C; Antoniou, George A; Lazarides, Miltos K

    2015-01-01

    Endovascular therapy for iliac artery chronic total occlusions is nowadays associated with low rates of procedure-related complications and improved clinical outcomes, and it is predominantly used as first-line therapy prior to aortobifemoral bypass grafting. Herein, we describe the case of a patient presenting with an ischemic left foot digit ulcer and suffering complex aortoiliac lesions, who received common iliac arteries kissing stents, illustrating at final antegrade and retrograde angiograms the early recognition of a blood flow obstructing valve-like calcified intimal flap protruding through the stent struts, which was obstructing antegrade but not retrograde unilateral iliac arterial axis blood flow. The problem was resolved by reconstructing the aortic bifurcation at a more proximal level. Completion angiogram verified normal patency of aorta and iliac vessels. Additionally, a severe left femoral bifurcation stenosis was also corrected by endarterectomy-arterioplasty with a bovine patch. Postintervention ankle brachial pressure indices were significantly improved. At the 6-month and 2-year follow-up, normal peripheral pulses were still reported without intermittent claudication suggesting the durability of the procedure. Through stent-protruding calcified intimal flap, is a very rare, but existing source of antegrade blood flow obstruction after common iliac arteries kissing stents. PMID:26783493

  4. Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting

    PubMed Central

    Georgiadis, George S.; Georgakarakos, Efstratios I.; Schoretsanitis, Nikolaos; Argyriou, Christos C.; Antoniou, George A.; Lazarides, Miltos K.

    2015-01-01

    Endovascular therapy for iliac artery chronic total occlusions is nowadays associated with low rates of procedure-related complications and improved clinical outcomes, and it is predominantly used as first-line therapy prior to aortobifemoral bypass grafting. Herein, we describe the case of a patient presenting with an ischemic left foot digit ulcer and suffering complex aortoiliac lesions, who received common iliac arteries kissing stents, illustrating at final antegrade and retrograde angiograms the early recognition of a blood flow obstructing valve-like calcified intimal flap protruding through the stent struts, which was obstructing antegrade but not retrograde unilateral iliac arterial axis blood flow. The problem was resolved by reconstructing the aortic bifurcation at a more proximal level. Completion angiogram verified normal patency of aorta and iliac vessels. Additionally, a severe left femoral bifurcation stenosis was also corrected by endarterectomy-arterioplasty with a bovine patch. Postintervention ankle brachial pressure indices were significantly improved. At the 6-month and 2-year follow-up, normal peripheral pulses were still reported without intermittent claudication suggesting the durability of the procedure. Through stent-protruding calcified intimal flap, is a very rare, but existing source of antegrade blood flow obstruction after common iliac arteries kissing stents. PMID:26783493

  5. [Calcified deep vein thrombosis in a patient with recurrent deep vein thrombosis and sarcoidosis].

    PubMed

    Krmek, Dubravka Zupanić; Brajković, Ivana; Bekić, Dinko; Krnić, Antun; Jurković, Petar; Pavlović, Tomislav

    2013-12-01

    In this article, we present a rare case of calcified deep vein thrombosis in a 42-year-old female patient with frequent relapses of pulmonary sarcoidosis since 1995, for which she was on maintenance therapy with corticosteroids and with consequential secondary diabetes. Recent femoral vein thrombosis was diagnosed with color Doppler in 2012. At the same time, calcified occlusive thrombus in vena cava inferior from the level of renal vein to the confluence of hepatic veins was diagnosed on abdominal multi-slice computed tomography (MSCT). Digital subtraction venography (DSV) revealed a well-developed collateral circulation through the paravertebral veins, azygos and hemiazygos vein. There were no risk factors for thrombosis other than sarcoidosis and diabetes. Deep vein thrombosis is rarely described with sarcoidosis, but according to literature reports, it usually appears as a recurrence and simultaneously at multiple locations. According to the current knowledge, we cannot say for sure whether it is a disease with an increased risk of deep vein thrombosis or there is a combination of multiple risk factors present simultaneously.

  6. Pituitary Stone or Calcified Pituitary Tumor? Three Cases and Literature Review

    PubMed Central

    Chentli, Farida; Safer-Tabi, Amel

    2015-01-01

    Introduction: Pituitary stone or pituitary calculus is a scientific enigma characterized by a large calcification in the pituitary sella. It can be discovered incidentally or in a patient with endocrine and/or neurological problems. Its mechanism is not understood. In this article, we described three patients harboring a large pituitary calcification. Case Presentation: The first case was observed in a 27-year-old woman who consulted for secondary amenorrhea. The second case concerned a woman who consulted for infertility, and the third one was observed in an 11-year and nine-month-old girl who was sent to our department for short stature. Clinical examination was normal in both adults. The pediatric case had dwarfism with lack of pubertal development. Hormonal assessment showed hyperprolactinemia in both women and thyrotroph and somatotroph deficits in the child. Radiologic exploration discovered pituitary calcifications measuring 10, 11, and 45 mm without any cystic or solid mass. Conclusions: Radiological findings pleaded for a pituitary stone, but calcified adenomas in women, and calcified craniopharyngioma in the pediatric case could not be excluded, as our three patients were not operated on. PMID:26401144

  7. Calcified foci at the junction between adrenal cortex and medulla of rhesus monkeys.

    PubMed

    Kast, A; Peil, H; Weisse, I

    1994-01-01

    The occurrence of calcified foci at the junction of adrenal medulla and cortex in monkeys obtained from toxicity studies during a 10-year period is reported. The survey included reinvestigated adrenal samples from 274 male and 270 female rhesus monkeys and 52 male and 52 female cynomolgus monkeys. The incidence of calcified foci was 46% in male and 45% in female rhesus monkeys, and 6% in male cynomolgus monkeys, while their females did not show the lesion. In male rhesus monkeys, the mean number of foci was 4 for both glands, in females, 2 for the right and 4 for the left one. Initial stages indicated that the lesions develop possibly from focal apoptosis of medulla cells followed by a dystrophic mineralization. No correlation was observed concerning dose groups, test article, study length, testing facility, origin of monkeys, their sex, age, diet or final body weight. The foci of mineralization were dystrophic, species-specific in the rhesus monkey and possibly related to stress. The location of the foci at the cortico-medullary junction, precisely the location of the remnants of the fetal zone, may indicate their origin from this zone.

  8. Rapid Mass Movement of Chloroplasts during Segment Formation of the Calcifying Siphonalean Green Alga, Halimeda macroloba

    PubMed Central

    Larkum, Anthony W. D.; Salih, Anya; Kühl, Michael

    2011-01-01

    Background The calcifying siphonalean green alga, Halimeda macroloba is abundant on coral reefs and is important in the production of calcium carbonate sediments. The process by which new green segments are formed over-night is revealed here for the first time. Methodology/Principal Findings Growth of new segments was visualised by epifluorescence and confocal microscopy and by pulse amplitude modulation (PAM) fluorimetry. Apical colourless proto-segments were initiated on day 1, and formed a loose network of non-calcified, non-septate filaments, containing no chloroplasts. Rapid greening was initiated at dusk by i) the mass movement of chloroplasts into these filaments from the parent segment and ii) the growth of new filaments containing chloroplasts. Greening was usually complete in 3–5 h and certainly before dawn on day 2 when the first signs of calcification were apparent. Mass chloroplast movement took place at a rate of ∼0.65 µm/s. Photosynthetic yield and rate remained low for a period of 1 to several hours, indicating that the chloroplasts were made de novo. Use of the inhibitors colchicine and cytochalasin d indicated that the movement process is dependent on both microtubules and microfilaments. Significance This unusual process involves the mass movement of chloroplasts at a high rate into new segments during the night and rapid calcification on the following day and may be an adaptation to minimise the impact of herbivorous activity. PMID:21750703

  9. Quantitative laser-induced breakdown spectroscopy analysis of calcified tissue samples

    NASA Astrophysics Data System (ADS)

    Samek, O.; Beddows, D. C. S.; Telle, H. H.; Kaiser, J.; Liška, M.; Cáceres, J. O.; Gonzáles Ureña, A.

    2001-06-01

    We report on the application of laser-induced breakdown spectroscopy (LIBS) to the analysis of important minerals and the accumulation of potentially toxic elements in calcified tissue, to trace e.g. the influence of environmental exposure, and other medical or biological factors. This theme was exemplified for quantitative detection and mapping of Al, Pb and Sr in representative samples, including teeth (first teeth of infants, second teeth of children and teeth of adults) and bones (tibia and femur). In addition to identifying and quantifying major and trace elements in the tissues, one- and two-dimensional profiles and maps were generated. Such maps (a) provide time/concentration relations, (b) allow to follow mineralisation of the hydroxyapatite matrix and the migration of the elements within it and (c) enable to identify disease states, such as caries in teeth. In order to obtain quantitative calibration, reference samples in the form of pressed pellets with calcified tissue-equivalent material (majority compound of pellets is CaCO 3) were used whose physical properties closely resembled hydroxyapatite. Compounds of Al, Sr and Pb were added to the pellets, containing atomic concentrations in the range 100-10 000 ppm relative to the Ca content of the matrix. Analytical results based on this calibration against artificial samples for the trace elements under investigation agree with literature values, and with our atomic absorption spectroscopy (AAS) cross-validation measurements.

  10. Implications of carotid sinus hypersensitivity following preoperative embolization of a carotid body tumor. An indication for prophylactic intraoperative cardiac pacing.

    PubMed

    Bauer, Ashley M; Smith, Russell B; Thorell, William E

    2014-05-01

    IMPORTANCE Carotid body tumors are rare neoplasms of neural crest origin that are both highly vascularized and locally invasive. Treatment options for these tumors often include surgery with preoperative embolization, which can pose major cardiovascular risk to patients. As demonstrated by this case report, hemodynamic instability following preoperative embolization of a carotid body tumor may indicate severe carotid sinus hypersensitivity and the need for temporary cardiac pacing. OBSERVATIONS This case report describes a man in his early 30s who presented for staged surgical resection of bilateral carotid body tumors with preoperative embolization. After embolization of the second tumor, the patient displayed transient episodes of bradycardia and hypotension, which resolved with medical management. Surgery commenced, and with minimal manipulation intraoperatively, the patient became asystolic and required resuscitation. Following a negative cardiac workup, a temporary pacemaker was implanted, and surgical resection of the tumor was successfully completed. CONCLUSIONS AND RELEVANCE Carotid sinus hypersensitivity is a rare but serious risk of preoperative embolization of carotid body tumors. Postembolization bradycardia or hypotension should be assessed as potential harbingers of carotid sinus hypersensitivity, and the need for temporary intraoperative cardiac pacing should be strongly considered. PMID:24651937

  11. Comparison of Intensive Versus Moderate Lipid-Lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-Rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging.

    PubMed

    Hou, Jingbo; Xing, Lei; Jia, Haibo; Vergallo, Rocco; Soeda, Tsunerari; Minami, Yoshiyasu; Hu, Sining; Yang, Shuang; Zhang, Shaosong; Lee, Hang; Yu, Bo; Jang, Ik-Kyung

    2016-03-01

    Despite marked clinical benefit, reduction in atheroma volume with statin therapy is minimal. Changes in plaque composition may explain this discrepancy. We aimed in the present study to assess the effect of statin therapy on coronary plaque composition and plaque volume using serial multimodality imaging. From an open-label, single-blinded study, patients with angiographically mild-to-moderate lesion were randomized to receive atorvastatin 60 (AT 60) mg or atorvastatin 20 (AT 20) mg for 12 months. Optical coherence tomography was used to assess fibrous cap thickness (FCT) and intravascular ultrasound to assess atheroma burden at 3 time points: baseline, at 6 months, and at 12 months. Thirty-six lipid-rich plaques in 27 patients with AT 60 mg and 30 lipid-rich plaques in 19 patients with AT 20 mg were enrolled in this study. Low-density lipoprotein cholesterol level was significantly decreased at 6 months without further reduction at 12 months. AT 60 mg induced greater reduction in low-density lipoprotein cholesterol compared with AT 20 mg. Optical coherence tomography revealed continuous increase in FCT from baseline to 6 months and to 12 months in both groups. AT 60 mg induced greater increase in FCT compared with AT 20 mg at both follow-up points. The prevalence of thin-cap fibroatheroma and the presence of macrophage at 6 months were significantly lower in AT 60 mg compared with AT 20 mg. Plaque burden did not change significantly in both groups. In conclusion, both intensive and moderate statin therapy stabilizes coronary plaques, with a greater benefit in the intensive statin group. However, no significant changes in plaque volume were observed over time regardless of the intensity of statin therapy. PMID:26778524

  12. Carotid siphon geometry and variants of the circle of Willis in the origin of carotid aneurysms.

    PubMed

    Silva Neto, Ângelo Raimundo; Câmara, Ródio Luis Brandão; Valença, Marcelo Moraes

    2012-12-01

    This study evaluated anatomical variants in the carotid siphon and of the circle of Willis in patients with aneurysms. We performed a retrospective analysis of cerebral angiographies. The Control Group was composed of patients without aneurysms. Posterior communicating artery (PcomA) aneurysms were more common in women (p<0.05), and the anterior communicating artery (AcomA) aneurysms in men (p<0.1). The incidence of fetal-type PcomA was higher in cases with co-occurring PcomA aneurysm (24 versus 8%, p<0.05). Patients with AcomA aneurysm had higher incidence of A1 hypoplasia (p<0.0001, OR=32.13, 95%CI 12.95-79.71) and lower frequency of fetal-type PcomA compared to their control counterparts (p=0.0125). The angle of carotid siphon was narrower in patients with PcomA aneurysm (27.3±19.1 versus 34.8±22.6, p=0.028). In conclusion, a narrower carotid siphon or the presence of fetal-type PcomA or A1 hypoplasia may cause hemodynamic stress, thereby promoting the formation of aneurysms in susceptible individuals.

  13. Comparison of Neurocognitive Outcomes after Carotid Endarterectomy and Carotid Artery Stenting.

    PubMed

    Kim, Jerry J; Schwartz, Samuel; Wen, Johnny; deVirgilio, Christian; Lobue, Abeline; Walot, Irwin; Koopmann, Matthew; Donayre, Carlos; White, Rodney A

    2015-10-01

    Cognitive and emotional outcomes after carotid endarterectomy (CEA) and carotid artery stenting with embolic protection device (CAS + EPD) are not clear. Patients were entered prospectively into a United States Food and Drug Administration-approved single-center physician-sponsored investigational device exemption between 2004 and 2010 and received either CEA or CAS + EPD. Patients underwent cognitive testing preprocedure and at 6, 12, and 60 months postprocedure. Cognitive domains assessed included attention, memory, executive, motor function, visual spatial functioning, language, and processing speed. Beck Depression and anxiety scales were also compared. There were a total of 38 patients that met conventional indications for carotid surgery (symptomatic with ≥50% stenosis or asymptomatic with ≥70% stenosis)-12 patients underwent CEA, whereas 26 patients underwent CAS + EPD. Both CEA and CAS + EPD patients showed postprocedure improvement in memory and executive function. No differences were seen at follow-up in regards to emotional dysfunction (depression and anxiety), attention, visual spatial functioning, language, motor function, and processing speed. Only two patients underwent neuropsychiatric testing at 60 months-these CAS + EPD patients showed sustained improvement in memory, visual spatial, and executive functions. In conclusion, cognitive and emotional outcomes were similar between CEA and CAS + EPD patients. PMID:26463299

  14. Calcified algae and bryozoans from the Ordovician - Silurian successions of the Spiti Himalaya, India

    NASA Astrophysics Data System (ADS)

    Pandey, Shivani; Parcha, Suraj Kumar

    2015-04-01

    The Tethys Himalaya contains an extensive record of sediments ranging from Precambrian to Cretaceous. These successions are well exposed in Pin, Parahio, Kunzum La and in the Takche sections. The present work is focused on the Ordovician and Silurian succession in the Pin Valley. The Ordovician succession consists of purple coloured quartzite, shale, siltstone, grits, dolarenites etc. Whereas, the Silurian succession comprises of thick sequence of slate, dolomite, calcarenites, olive green shale, limestone and pink dolomite. Both the successions contain a rich assemblage of the microfossils along with other body fossils. These successions show a wide variety of marine calcareous algae, along with corals and bryozoans. The calcified algae and bryozoans reported from the Ordovician - Silurian succession are mostly in carbonate beds. The various genera of bryozoan identified are as Calloporella, Cyphotrypa, Dekayai, Eridotrypa, Insignia, Trematopora, etc. along with them are various forms of calcified algae which were found in association in the same thin sections. The prominent genera of calcified algae are as: Dasyporella, Moniliporella, and Vermiporella. The algal assemblages mainly consist of the order Dasycladales, which predominants in the entire successions. Three genera of Dasycladacean algae were identified, among them genus Moniliporella was reported first time from the Pin section. The presence of bryozoans and calcified green algae in these successions indicates shallow marine to near shore environmental conditions followed by different stages of regression and transgression during this time span. Based on the faunal elements, middle to late Ordovician age can be assigned to Thango Formation and late Ordovician to late Silurian to the Takche Formation.The bryozoan communities identified indicates a correlation with that of southern China, Russia, Siberia, Kazakhstan and Mongolia. The genera Insignia and Tremaptopora which are reported from the Spiti Basin

  15. The relationship between preoperative serum cortisol level and the stability of plaque in carotid artery stenosis patients undergoing carotid endarterectomy

    PubMed Central

    Qin, Feng; Sun, Yudong; Hu, Wenping; Wei, Xiaolong; Li, Zhenjiang

    2016-01-01

    Background Stability of plaque has been implicated as risk factor for stroke. Serum cortisol regulates lipoprotein metabolism and immune response, contributing to plaque stability in atherosclerosis. However, the relationship between serum cortisol and stability of carotid plaque has not been well characterized. We conducted a serology analysis to identify the relationship between serum cortisol and carotid plaque stability. Methods Between May 2013 to October 2015, 73 patients with carotid stenosis patients undergoing carotid endarterectomy (CEA) were enrolled in our study. Serum cortisol was analyzed at 8:00 AM in the morning before surgery via liquid chromatography tandem mass spectrometry. According to the classification made by the American Heart Association, hematoxylin-and-eosin staining was performed to divide these patients into either a stable or unstable group, according to the morphology of fibrous cap, lipid core and intima layer. A curve fitting method was used to identify the relationship between preoperative serum cortisol and stability of carotid plaque. Univariate and multivariate logistic regression analysis were used to identify carotid plaque stability-associated serum cortisol. Results Curve fitting’s result represents a U-shape characteristic. A total of 314.92 and 395.23 nmol/L were considered as the cut point for preoperative serum cortisol when trisected the patients. When adjusted for degree of stenosis, hyperlipemia, smoking and low-density lipoprotein (LDL), univariate and multivariate logistic regression analysis’ results demonstrated that preoperative serum cortisol can significantly affect carotid plaque stability. The odds ratio values in multivariate logistic regression analysis for C reactive protein (CRP), white blood cell (WBC), interleukin-6 (IL-6) and preoperative serum cortisol level were 7.67 and 20.86 respectively. Conclusions Preoperative serum cortisol was associated with stability of carotid plaque in patients

  16. Carotid and vertebral artery dissection syndromes

    PubMed Central

    Thanvi, B; Munshi, S; Dawson, S; Robinson, T

    2005-01-01

    Cervicocerebral arterial dissections (CAD) are an important cause of strokes in younger patients accounting for nearly 20% of strokes in patients under the age of 45 years. Extracranial internal carotid artery dissections comprise 70%–80% and extracranial vertebral dissections account for about 15% of all CAD. Aetiopathogenesis of CAD is incompletely understood, though trauma, respiratory infections, and underlying arteriopathy are considered important. A typical picture of local pain, headache, and ipsilateral Horner's syndrome followed after several hours by cerebral or retinal ischaemia is rare. Doppler ultrasound, MRI/MRA, and CT angiography are useful non-invasive diagnostic tests. The treatment of extracranial CAD is mainly medical using anticoagulants or antiplatelet agents although controlled studies to show their effectiveness are lacking. The prognosis of extracranial CAD is generally much better than that of the intracranial CAD. Recurrences are rare in CAD. PMID:15937204

  17. Rat Carotid Artery Balloon Injury Model

    PubMed Central

    Tulis, David Anthony

    2010-01-01

    i. Summary Numerous and diverse experimental animal models have been used over the years to examine reactions to various forms of blood vessel disease and/or injury across species and in multiple vascular beds in a cumulative effort to relate these findings to the human condition. In this context, the rat carotid artery balloon injury model is highly characterized and commonly used for investigating gross morphological, cellular, biochemical, and molecular components of the response to experimentally-induced arterial injury. The mechanical damage caused by the balloon catheter completely removes the intimal endothelial lining and creates a distending mural injury in the operated vessel. This elicits a reproducible remodeling response characterized by vascular smooth muscle cell (SMC) mitogenesis and migration (via phenotypic switching), SMC apoptosis, partial vascular endothelial cell regeneration, enhanced matrix synthesis, and establishment of an invasive neointima in time-dependent fashion. This multi-factorial process allows for investigation of these many important pathophysiological processes and can serve as a valuable “proof-of-concept” tool to verify and substantiate in vitro results; however, inherent anatomical and adaptive constraints of this in vivo model ration comparison to the diseased human system (see Note 1). In this chapter, brief overview of the materials needed and the methodologies commonly employed for successful routine performance of this important experimental animal model will be provided. Individual sub-sections will cover animal care and handling, pre- and post-operative procedures, and the surgery proper. Protocols for histopathology and morphometry and procedures for data management and interpretation pertinent to the rat carotid artery balloon injury model will be discussed in Chapter __ of this series. Notes will conclude with important caveats, limitations, and considerations for practical use of this technique. PMID:18287662

  18. Assessment of Carotid Artery Stenosis and the Use of Statins

    PubMed Central

    Whayne, Thomas F.

    2015-01-01

    General thinking has previously centered on managing carotid artery stenosis (CAS) by carotid endarterectomy and subsequently, stenting for higher risk patients. However for CAS and other forms of vascular disease, especially when asymptomatic, there is new emphasis on defining underlying mechanisms. Knowledge of these mechanisms can lead to medical treatments that result in possible atherosclerotic plaque stabilization, and even plaque regression, including in the patient with CAS. For now, the key medication class for a medical approach are the statins. Their use is supported by good cardiovascular clinical trial evidence including some directed carotid artery studies, especially with a demonstrated decrease in carotid intima-media thickness. Procedural controversy still exists but the current era in medicine offers significant support for medical management of asymptomatic CAS while techniques to recognize the vulnerable plaque evolve. If CAS converts to a symptomatic status, early referral for endarterectomy or stenting is indicated. PMID:26417184

  19. Branch retinal artery occlusion following carotid stenting: A case report

    PubMed Central

    Sun, Ran; Peng, Xiao-Yan; You, Qi-Sheng; Jiao, Li-Qun; Liu, Da-Chuan

    2016-01-01

    A 70 year old male was diagnosed with carotid stenosis and underwent carotid artery stenting (CAS). Severe postoperative complications arose subsequent to the procedure, including decreased visual acuity and symptoms of a visual field defect, and the patient was eventually diagnosed with retinal artery embolism. CAS reduces carotid plaque; however, the subsequent shedding of carotid plaque may cause retinal artery embolism, resulting in the serious loss of visual function in patients. This complication is of paramount importance and requires great consideration from the neurologist and the patients undergoing CAS. Ophthalmic evaluation is paramount following CAS due to the possibility of embolic occlusion of the retinal artery. It is imperative that patients be informed of the risk of permanent vision loss as a result of CAS.

  20. Data on TREM-1 activation destabilizing carotid plaques.

    PubMed

    Rao, Velidi H; Rai, Vikrant; Stoupa, Samantha; Subramanian, Saravanan; Agrawal, Devendra K

    2016-09-01

    The data described herein are related to the article entitled "Tumor necrosis factor-α regulates triggering receptor expressed on myeloid cells-1-dependent matrix metalloproteinases in the carotid plaques of symptomatic patients with carotid stenosis" (Rao et al., 2016) [1]. Additional data are provided on the dose-response effect of TNF-α, TREM-1 antibody and recombinant rTREM-1/Fc fusion chimera (TREM-1/FC) on the expression of MMP-1 and MMP-9 in vascular smooth muscle cells (VSMCs) isolated from human carotid endarterectomy tissues. Data are also presented on the distribution of CD86+ M1- and CD206+ M2-macrophages and their co-localization with TREM-1 in symptomatic carotid plaques as visualized by dual immunofluorescence. The interpretation of this data and further extensive insights can be found in Rao et al. (2016) [1]. PMID:27331093

  1. Carotid body tumor imitator: An interesting case of Castleman's disease

    PubMed Central

    Shakir, Hakeem J.; Diletti, Sara M.; Hart, Alexandra M.; Meyers, Joshua E.; Dumont, Travis M.; Siddiqui, Adnan H.

    2015-01-01

    Background: There are very few reports in the literature of Castleman's disease affecting the carotid artery and a single previous report of a case of Castleman's disease of the neck originally mistaken as a carotid body tumor. Case Description: We describe a rare case of Castleman's disease, manifesting with classic radiographic hallmarks of a carotid body tumor. The postoperative pathologic examination identified the resected mass as Castleman's lymphadenopathy. The management of this particular case is discussed, and the findings are highlighted. Conclusions: We present a unique case of a tumor initially and incorrectly diagnosed as a carotid body tumor. However, after comprehensive treatment with endovascular and surgical modalities and subsequent pathologic examination, the diagnosis of this rare entity was made. PMID:26677415

  2. Common carotid artery dissection caused by radiotherapy: A case report

    PubMed Central

    Wang, Jiayan; Yue, Dandan; Chen, Xin; Wei, Zhenyu; Lu, Wenmei; Wu, Danhong

    2016-01-01

    In the present study, a case of acute cerebral infarction with radiation-induced carotid artery dissection is reported. Carotid artery dissection is generally asymptomatic at the early stages. Due to the non-specific clinical manifestations of carotid artery dissection, a detailed inquiry of the past history of a patient has a critical role in making a diagnosis of radiation-induced common carotid artery dissection. Onset of acute ischemic stroke is the predominant manifestation, and for patients with a history of head-and-neck radiotherapy, dissection should be considered. The condition may progress rapidly, and result in a poor prognosis. Therefore, a correct early diagnosis and initiation of appropriate therapy may lead to rapid recovery, and influence the overall prognosis.

  3. Ultrasonic imaging and oculoplethysmography in diagnosis of carotid occlusive disease.

    PubMed

    Wasserman, D H; Hobson, R W; Lynch, T G; Berry, S M; Jamil, Z

    1983-10-01

    Pulsed Doppler ultrasonic imaging (UI) of the cervical carotid artery provides flow-dependent anatomic detail of the carotid bifurcation, while oculoplethysmography (Kartchner) (OPG-K) and ocular pneumoplethysmography (Gee) (OPG-G) reflect changes in flow and pressure resulting from hemodynamically significant lesions. We examined 66 patients prospectively with UI, OPG-K, and OPG-G to compare the relative accuracy of these techniques with contrast arteriography. Both UI and OPG-G were significantly more accurate than OPG-K. While the accuracies of UI and OPG-G were not significantly different, their combined use resulted in a significant increase in sensitivity compared with that of Doppler imaging alone. In addition, UI correctly identified 22 (85%) of 26 occlusions of the internal carotid artery. The use of UI and OPG-G together provided accurate anatomic and hemodynamic information useful in the evaluation of carotid occlusive disease.

  4. Common carotid artery dissection caused by radiotherapy: A case report

    PubMed Central

    Wang, Jiayan; Yue, Dandan; Chen, Xin; Wei, Zhenyu; Lu, Wenmei; Wu, Danhong

    2016-01-01

    In the present study, a case of acute cerebral infarction with radiation-induced carotid artery dissection is reported. Carotid artery dissection is generally asymptomatic at the early stages. Due to the non-specific clinical manifestations of carotid artery dissection, a detailed inquiry of the past history of a patient has a critical role in making a diagnosis of radiation-induced common carotid artery dissection. Onset of acute ischemic stroke is the predominant manifestation, and for patients with a history of head-and-neck radiotherapy, dissection should be considered. The condition may progress rapidly, and result in a poor prognosis. Therefore, a correct early diagnosis and initiation of appropriate therapy may lead to rapid recovery, and influence the overall prognosis. PMID:27699045

  5. Aneurysm of the internal carotid artery after minor trauma.

    PubMed

    Laissaoui, Younès; Noureddine El Alami, Mohamed

    2014-01-01

    We report a rare case of posttraumatic aneurysm of the internal carotid artery. The aneurysm was surgically removed, followed by a simple postoperative course. Such lesions should be highly suspected in cases of penetration into the retroangulomandibular neck region.

  6. Carotid and Aortic Stiffness in Patients with Heterozygous Familial Hypercholesterolemia

    PubMed Central

    Meshkov, Alexey N.; Rozhkova, Tatyana A.; Kalinina, Maria V.; Deev, Alexander D.; Rogoza, Anatoliy N.; Balakhonova, Tatyana V.; Boytsov, Sergey A.

    2016-01-01

    Background The role of plasma cholesterol in impairing arterial function and elasticity remains unclear. We evaluated arterial stiffness, measured locally in the common carotid artery by high-resolution echo-tracking, and aortic stiffness, using carotid-femoral pulse wave velocity (PWV) (the “gold-standard” measurement of arterial stiffness), in treatment-naive patients with heterozygous familial hypercholesterolemia (FH). Methods The study included 66 patients with FH (10–66 years old) and 57 first-degree relatives without FH (11–61 years old). Carotid-femoral PWV was determined by SphygmoCor (AtCor, Australia). The parameters of carotid stiffness β-index, Peterson elastic modulus and local PWV were assessed with regard to the common carotid artery at a distance of 1cm from the bifurcation (AlokaProsound Alpha7, Japan). Results FH patients showed significantly higher β-index (6.3(4.8–8.2) vs. 5.2(4.2–6.4), p = 0.005), Ep (78(53–111) kPa vs. 62(48–79) kPa, p = 0.006), local PWV (5.4(4.5–6.4) m/c vs. 4.7(4.2–5.4) m/c, p = 0.005), but comparable values of carotid-femoral PWV (6.76(7.0–7.92) m/c vs. 6.48(6.16–7.12) m/c, p = 0.138). Carotid arteries and the aorta stiffened with age in patients with FH, but after 30 years, carotid arteries stiffened more significantly than the aorta. Conclusions Our study demonstrated that treatment-naive patients with FH had stiffer carotid arteries than their relatives, but showed no difference in aortic stiffness. We also found out that the rate of reduction of elasticity of the aorta and carotid arteries in FH patients varies: it is observed earlier in carotid arteries than in the aorta. PMID:27434535

  7. Cavernous Carotid Artery Pseudoaneurysm Following a Radical Cavernous Sinus Resection

    PubMed Central

    Katzir, Miki; Gil, Ziv; Cohen, José Enrique; Sviri, Gill Efraim

    2016-01-01

    Iatrogenic cavernous carotid pseudoaneurysms are a special group among other intracranial aneurysms. They can occur during the dissection phase of the surgery if the tumor encases a vessel. Complications of their rupture as hemorrhage or stroke are life threatening. Early recognition and treatment is mandatory to avoid catastrophic sequelae. We present the successful diagnosis and endovascular treatment of a postoperative cavernous carotid pseudoaneurysm following radical cavernous sinus resection. PMID:27330923

  8. Cavernous Carotid Artery Pseudoaneurysm Following a Radical Cavernous Sinus Resection.

    PubMed

    Katzir, Miki; Gil, Ziv; Cohen, José Enrique; Sviri, Gill Efraim

    2016-06-01

    Iatrogenic cavernous carotid pseudoaneurysms are a special group among other intracranial aneurysms. They can occur during the dissection phase of the surgery if the tumor encases a vessel. Complications of their rupture as hemorrhage or stroke are life threatening. Early recognition and treatment is mandatory to avoid catastrophic sequelae. We present the successful diagnosis and endovascular treatment of a postoperative cavernous carotid pseudoaneurysm following radical cavernous sinus resection. PMID:27330923

  9. ESVS guidelines. Invasive treatment for carotid stenosis: indications, techniques.

    PubMed

    Liapis, C D; Bell, P R F; Mikhailidis, D; Sivenius, J; Nicolaides, A; Fernandes e Fernandes, J; Biasi, G; Norgren, L

    2009-04-01

    The European Society for Vascular Surgery brought together a group of experts in the field of carotid artery disease to produce updated guidelines for the invasive treatment of carotid disease. The recommendations were rated according to the level of evidence. Carotid endarterectomy (CEA) is recommended in symptomatic patients with >50% stenosis if the perioperative stroke/death rate is <6% [A], preferably within 2 weeks of the patient's last symptoms [A]. CEA is also recommended in asymptomatic men <75 years old with 70-99% stenosis if the perioperative stroke/death risk is <3% [A]. The benefit from CEA in asymptomatic women is significantly less than in men [A]. CEA should therefore be considered only in younger, fit women [A]. Carotid patch angioplasty is preferable to primary closure [A]. Aspirin at a dose of 75-325 mg daily and statins should be given before, during and following CEA. [A] Carotid artery stenting (CAS) should be performed only in high-risk for CEA patients, in high-volume centres with documented low peri-operative stroke and death rates or inside a randomized controlled trial [C]. CAS should be performed under dual antiplatelet treatment with aspirin and clopidogrel [A]. Carotid protection devices are probably of benefit [C].

  10. Imaging of the Fibrous Cap in Atherosclerotic Carotid Plaque

    SciTech Connect

    Saba, Luca; Potters, Fons; Lugt, Aad van der; Mallarini, Giorgio

    2010-08-15

    In the last two decades, a substantial number of articles have been published to provide diagnostic solutions for patients with carotid atherosclerotic disease. These articles have resulted in a shift of opinion regarding the identification of stroke risk in patients with carotid atherosclerotic disease. In the recent past, the degree of carotid artery stenosis was the sole determinant for performing carotid intervention (carotid endarterectomy or carotid stenting) in these patients. We now know that the degree of stenosis is only one marker for future cerebrovascular events. If one wants to determine the risk of these events more accurately, other parameters must be taken into account; among these parameters are plaque composition, presence and state of the fibrous cap (FC), intraplaque haemorrhage, plaque ulceration, and plaque location. In particular, the FC is an important structure for the stability of the plaque, and its rupture is highly associated with a recent history of transient ischaemic attack or stroke. The subject of this review is imaging of the FC.

  11. Intravascular Ultrasound for Intracranial and Extracranial Carotid Artery Stent Placement

    PubMed Central

    Hussain, Ahmad S

    2016-01-01

    Intravascular ultrasound (IVUS) can provide valuable information regarding endoluminal morphology. We present the first description of IVUS-guided intracranial and extracranial carotid artery stent placement for arterial dissection. A 41-year-old female with a sudden-onset headache and blurred vision underwent a computed tomography (CT) angiogram imaging that revealed bilateral carotid artery dissections (BCAD) and a left vertebral artery dissection (VAD). Endovascular treatment (EVT) of a long segment right carotid artery dissection (CAD) was performed employing two Carotid WALLSTENT™ Monorails™ (8 x 36 mm, 10 x 31 mm) (Boston Scientific, Marlborough, MA). With the help of the IVUS, the distal stent was placed up to the petrous carotid artery, followed by the placement of the second stent in the immediate proximal location with some overlap that extended down to the carotid artery bulb. Intraoperative angiography and post-stenting IVUS revealed excellent stent placement with good resolution of the dissection and good luminal patency with pseudolumen obliteration. Stent use for intracranial circulation dissections will continue to be a favorable option given the decreased morbidity of endovascular therapy in this location. As endovascular surgeons become more facile with the use of IVUS, using it as a guide for stent placement and post-stenting confirmation will help them to ensure proper positioning and improved patency rates. PMID:27672529

  12. Intravascular Ultrasound for Intracranial and Extracranial Carotid Artery Stent Placement

    PubMed Central

    Hussain, Ahmad S

    2016-01-01

    Intravascular ultrasound (IVUS) can provide valuable information regarding endoluminal morphology. We present the first description of IVUS-guided intracranial and extracranial carotid artery stent placement for arterial dissection. A 41-year-old female with a sudden-onset headache and blurred vision underwent a computed tomography (CT) angiogram imaging that revealed bilateral carotid artery dissections (BCAD) and a left vertebral artery dissection (VAD). Endovascular treatment (EVT) of a long segment right carotid artery dissection (CAD) was performed employing two Carotid WALLSTENT™ Monorails™ (8 x 36 mm, 10 x 31 mm) (Boston Scientific, Marlborough, MA). With the help of the IVUS, the distal stent was placed up to the petrous carotid artery, followed by the placement of the second stent in the immediate proximal location with some overlap that extended down to the carotid artery bulb. Intraoperative angiography and post-stenting IVUS revealed excellent stent placement with good resolution of the dissection and good luminal patency with pseudolumen obliteration. Stent use for intracranial circulation dissections will continue to be a favorable option given the decreased morbidity of endovascular therapy in this location. As endovascular surgeons become more facile with the use of IVUS, using it as a guide for stent placement and post-stenting confirmation will help them to ensure proper positioning and improved patency rates.

  13. Intravascular Ultrasound for Intracranial and Extracranial Carotid Artery Stent Placement.

    PubMed

    Hussain, Ahmad S; Hussain, Namath S

    2016-01-01

    Intravascular ultrasound (IVUS) can provide valuable information regarding endoluminal morphology. We present the first description of IVUS-guided intracranial and extracranial carotid artery stent placement for arterial dissection. A 41-year-old female with a sudden-onset headache and blurred vision underwent a computed tomography (CT) angiogram imaging that revealed bilateral carotid artery dissections (BCAD) and a left vertebral artery dissection (VAD). Endovascular treatment (EVT) of a long segment right carotid artery dissection (CAD) was performed employing two Carotid WALLSTENT™ Monorails™ (8 x 36 mm, 10 x 31 mm) (Boston Scientific, Marlborough, MA). With the help of the IVUS, the distal stent was placed up to the petrous carotid artery, followed by the placement of the second stent in the immediate proximal location with some overlap that extended down to the carotid artery bulb. Intraoperative angiography and post-stenting IVUS revealed excellent stent placement with good resolution of the dissection and good luminal patency with pseudolumen obliteration. Stent use for intracranial circulation dissections will continue to be a favorable option given the decreased morbidity of endovascular therapy in this location. As endovascular surgeons become more facile with the use of IVUS, using it as a guide for stent placement and post-stenting confirmation will help them to ensure proper positioning and improved patency rates. PMID:27672529

  14. Endovascular Treatment of Iatrogenic and Traumatic Carotid Artery Dissection

    SciTech Connect

    Schulte, Stefan; Donas, Konstantinos P. Pitoulias, Georgios A.; Horsch, Svante

    2008-09-15

    This paper reports on the early and midterm results of endovascular treatment of acute carotid artery dissections, its specific problems, and its limitations. We encountered seven patients with symptomatic extracranial carotid artery dissection, three cases of which occurred after carotid endarterectomy, two after carotid angioplasty and stenting, and two after trauma. Balloon-expandable and self-expanding stents were placed using a transfemoral approach. Success in restoring the carotid lumen was achieved in all patients. No procedure-related complications occurred. All patients experienced significant clinical improvement while in the hospital and achieved complete long-term recovery. At follow-up (mean, 22.4 months), good luminal patency of the stented segments was observed. In conclusion, in this small series, primary stent-supported angioplasty seems to be a safe and effective strategy in the treatment of selected patients having acute traumatic extracranial carotid artery dissection, with excellent early and midterm results. Larger series and longer-term follow-up are required before definitive recommendations can be made.

  15. Transcriptome and proteome analysis of Pinctada margaritifera calcifying mantle and shell: focus on biomineralization

    PubMed Central

    2010-01-01

    Background The shell of the pearl-producing bivalve Pinctada margaritifera is composed of an organic cell-free matrix that plays a key role in the dynamic process of biologically-controlled biomineralization. In order to increase genomic resources and identify shell matrix proteins implicated in biomineralization in P. margaritifera, high-throughput Expressed Sequence Tag (EST) pyrosequencing was undertaken on the calcifying mantle, combined with a proteomic analysis of the shell. Results We report the functional analysis of 276 738 sequences, leading to the constitution of an unprecedented catalog of 82 P. margaritifera biomineralization-related mantle protein sequences. Components of the current "chitin-silk fibroin gel-acidic macromolecule" model of biomineralization processes were found, in particular a homolog of a biomineralization protein (Pif-177) recently discovered in P. fucata. Among these sequences, we could show the localization of two other biomineralization protein transcripts, pmarg-aspein and pmarg-pearlin, in two distinct areas of the outer mantle epithelium, suggesting their implication in calcite and aragonite formation. Finally, by combining the EST approach with a proteomic mass spectrometry analysis of proteins isolated from the P. margaritifera shell organic matrix, we demonstrated the presence of 30 sequences containing almost all of the shell proteins that have been previously described from shell matrix protein analyses of the Pinctada genus. The integration of these two methods allowed the global composition of biomineralizing tissue and calcified structures to be examined in tandem for the first time. Conclusions This EST study made on the calcifying tissue of P. margaritifera is the first description of pyrosequencing on a pearl-producing bivalve species. Our results provide direct evidence that our EST data set covers most of the diversity of the matrix protein of P. margaritifera shell, but also that the mantle transcripts encode

  16. Association of SERPINA9 gene variants with carotid artery atherosclerosis: the Atherosclerosis Risk in Communities (ARIC) Carotid MRI Study

    PubMed Central

    Tang, Weihong; Morrison, Alanna; Wasserman, Bruce A; Folsom, Aaron R; Sun, Wei; Campbell, Stephen; Kao, W H Linda; Boerwinkle, Eric

    2013-01-01

    The SNP rs11628722 in the SERPINA9 gene was previously associated with incident ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) study. Centerin, the protein encoded by SERPINA9, is involved in maturation and maintenance of naïve B cells, which play a role in atherogenesis. We investigated whether 21 tag SNPs in the SERPINA9 gene are associated with features of carotid artery atherosclerotic plaque measured by magnetic resonance imaging (MRI). Carotid MRI data were obtained from 1,282 European Americans and 341 African Americans of the ARIC Carotid MRI study, which recruited participants from ARIC by a stratified sampling plan that over-sampled participants with carotid intima-media thickening. Five MRI measures, focused on carotid wall volume, wall thickness, and lipid core, were analyzed. Genetic associations between the MRI measurements and each of the 21 SNPs were analyzed in linear regression models with adjustment for sample weights and traditional risk factors. Rs11628722 was tested a priori. In African Americans, rs11628722 was significantly associated with carotid wall volume (p < 0.05). Among the other 20 SNPs, adjusted for multiple testing, rs4905204, which encodes an Ala to Val amino acid change, was significantly associated with maximum wall thickness (p < 0.000625) and suggestively associated with total wall volume (p < 0.0026) in European Americans. In conclusion, SNPs in the SERPINA9 gene showed race-specific associations with characteristics of carotid atherosclerotic plaques. Replications in other populations are needed to validate findings of this study and to establish the SERPINA9 gene as a candidate in the etiology of carotid atherosclerosis. PMID:24319541

  17. Calcifying fibrous pseudotumor of pleura. A report of three cases of a newly described entity involving the pleura.

    PubMed

    Pinkard, N B; Wilson, R W; Lawless, N; Dodd, L G; McAdams, H P; Koss, M N; Travis, W D

    1996-02-01

    A newly recognized distinctive fibrous soft tissue lesion called "calcifying fibrous pseudotumor" (CFPT) was recently described in the soft tissues of the extremities, trunk, scrotum, groin, neck, or axilla. To date, CFPT has not been described in the pleura. The authors reviewed the clinical, radiologic, and pathologic features of three cases. A 23-year old woman and 34-year old man who presented with chest pain, and a 28-year old woman without chest symptoms were found to have a pleural mass on chest radiographs. Computed tomography (CT) scans of each patient revealed pleural-based nodular masses with central areas of increased attenuation due to calcifications. Each lesions consisted of circumscribed, but unencapsulated masses of hyalinized collagenous fibrotic tissue interspersed with lymphoplasmacytic infiltrates and calcifications, many of which had psammomatous features. The lesions were limited to the pleura and did not involve the underlying lung parenchyma. Electron microscopy in one case showed fibroblasts scattered in dense collagenous tissue. Calcifying fibrous pseudotumor is distinct from other pleural lesions such as fibrous tumor of pleura, calcified granulomas, calcified pleural plaques, and chronic fibrous pleuritis as well as intrapulmonary lesions such as hyalinizing granuloma, inflammatory pseudotumor, and amyloid. As in the soft tissues, local excision appears adequate therapy for CFPT of the pleura. If these lesions behave in a similar fashion to CFPT of soft tissues, one might expect a low frequency of local recurrence. PMID:8607443

  18. First evidence of chitin in calcified coralline algae: new insights into the calcification process of Clathromorphum compactum

    PubMed Central

    Rahman, M. Azizur; Halfar, Jochen

    2014-01-01

    Interest in calcifying coralline algae has been increasing over the past years due to the discovery of extensive coralline algal dominated ecosystems in Arctic and Subarctic latitudes, their projected sensitivity to ocean acidification and their utility as palaeoenvironmental proxies. Thus, it is crucial to obtain a detailed understanding of their calcification process. We here extracted calcified skeletal organic matrix components including soluble and insoluble fractions from the widely-distributed Subarctic and Arctic coralline alga Clathromorphum compactum. The lyophilized skeletal organic matrix fractions showed comparatively high concentrations of soluble and insoluble organic matrices comprising 0.9% and 4.5% of skeletal weight, respectively. This is significantly higher than in other skeletal marine calcifiers. Attenuated Total Reflection-Fourier Transform Infrared Spectroscopy (ATR-FTIR) and X-Ray Diffraction (XRD) results indicate that chitin is present in the skeletal organic matrices of C. compactum. This polymer exhibits similar hierarchical structural organizations with collagen present in the matrix and serves as a template for nucleation and controls the location and orientation of mineral phases. Chitin contributes to significantly increasing skeletal strength, making C. compactum highly adapted for living in a shallow high-latitude benthic environment. Furthermore, chitin containing polysaccharides can increase resistance of calcifiers to negative effects of ocean acidification. PMID:25145331

  19. MDCT of right aortic arch with aberrant left subclavian artery associated with kommerell diverticulum and calcified ligamentum arteriosum.

    PubMed

    Kanza, Rene Epunza; Berube, Michel; Michaud, Pierre

    2013-04-28

    We present a case of the right aortic arch with kommerell diverticulum (KD) and aberrant left subclavian artery in a symptomatic 50-year-old patient with a calcification in the presumed attachment site of the ligamentum arteriosum (LA) to the KD. In another 30-year-old male patient, the entire course of a calcified LA was demonstrated using multidetector row computed tomography.

  20. First evidence of chitin in calcified coralline algae: new insights into the calcification process of Clathromorphum compactum

    NASA Astrophysics Data System (ADS)

    Rahman, M. Azizur; Halfar, Jochen

    2014-08-01

    Interest in calcifying coralline algae has been increasing over the past years due to the discovery of extensive coralline algal dominated ecosystems in Arctic and Subarctic latitudes, their projected sensitivity to ocean acidification and their utility as palaeoenvironmental proxies. Thus, it is crucial to obtain a detailed understanding of their calcification process. We here extracted calcified skeletal organic matrix components including soluble and insoluble fractions from the widely-distributed Subarctic and Arctic coralline alga Clathromorphum compactum. The lyophilized skeletal organic matrix fractions showed comparatively high concentrations of soluble and insoluble organic matrices comprising 0.9% and 4.5% of skeletal weight, respectively. This is significantly higher than in other skeletal marine calcifiers. Attenuated Total Reflection-Fourier Transform Infrared Spectroscopy (ATR-FTIR) and X-Ray Diffraction (XRD) results indicate that chitin is present in the skeletal organic matrices of C. compactum. This polymer exhibits similar hierarchical structural organizations with collagen present in the matrix and serves as a template for nucleation and controls the location and orientation of mineral phases. Chitin contributes to significantly increasing skeletal strength, making C. compactum highly adapted for living in a shallow high-latitude benthic environment. Furthermore, chitin containing polysaccharides can increase resistance of calcifiers to negative effects of ocean acidification.

  1. Contrast-enhanced ultrasound imaging of the vasa vasorum of carotid artery plaque

    PubMed Central

    Song, Ze-Zhou; Zhang, Yan-Ming

    2015-01-01

    The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasound contrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound (CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS. PMID:26120382

  2. Carotid occlusive disease as a risk factor in major cardiovascular surgery.

    PubMed

    Kartchner, M M; McRae, L P

    1982-08-01

    Carotid occlusive disease in patients undergoing major cardiovascular surgery raises the question of the perioperative risk factor of stroke. We evaluated 234 cardiovascular patients preoperatively by oculoplethysmography (OPG) to detect hemodynamically severe carotid occlusive disease. The perioperative stroke risk without flow-reducing carotid occlusive disease was 1%, in contrast to a 17% incidence of stroke when OPG studies indicated internal carotid artery stenosis of more than 60%. Oculoplethysmography is a reliable indicator of hemodynamically severe carotid occlusive disease with an associated high risk of stroke that warrants prophylactic carotid endarterectomy before major cardiovascular surgery.

  3. Carotid Artery Stenting: Review of Technique and Update of Recent Literature

    PubMed Central

    Ahn, Sun Ho; Prince, Ethan A.; Dubel, Gregory J.

    2013-01-01

    Stroke is the fourth leading cause of death and the number one cause of long-term disability in the United States. Carotid stenosis is an important cause of ischemic strokes, accounting for 20 to 25%. Previous studies have established carotid endarterectomy as standard of care of symptomatic patients with > 50% stenosis and asymptomatic patients with > 60% stenosis; recently, carotid artery stenting has emerged as an alternative treatment for carotid stenosis. Several studies have been published comparing carotid artery stenting with endarterectomy with mixed results. In this article, the authors discuss carotid artery stenting technique, the results from the most recent trials, and future directions. PMID:24436551

  4. Toll-like Receptor-4 Polymorphisms and Serum Matrix Metalloproteinase-9 in Newly Diagnosed Patients With Calcified Neurocysticercosis and Seizures.

    PubMed

    Lachuriya, Gaurav; Garg, Ravindra Kumar; Jain, Amita; Malhotra, Hardeep Singh; Singh, Arvind Kumar; Jain, Bhawna; Kumar, Neeraj; Verma, Rajesh; Sharma, Praveen Kumar

    2016-04-01

    We evaluated seizure profile, Toll-like receptor (TLR)-4 polymorphisms, and serum matrix metalloproteinases (MMPs) in patients with calcified neurocysticercosis.One-hundred nine patients with calcified neurocysticercosis with newly diagnosed seizures and 109 control subjects were enrolled. TLR-4 Asp299Gly and Thr399Ile polymorphisms and serum MMP-9 levels were evaluated. The patients were followed for 1 year.Asp/Gly (P = 0.012) and Thr/Ile (P = 0.002), Gly (Asp/Gly plus Gly/Gly) (P = 0.008) and Ile (Thr/Ile plus Ile/Ile) (P = 0.003) genotypes were significantly associated with calcified neurocysticercosis compared with controls. Gly/Gly and Ile/Ile genotypes were not significantly associated (P = 0.529 for Gly/Gly, P = 0.798 for Ile/Ile) with either group. The levels of MMP-9 were higher in calcified neurocysticercosis (P =  < 0.001). The levels of MMP-9 were higher in patients with multiple calcified neurocysticercosis compared with single calcified neurocysticercosis (P =  < 0.001).Headache (P = 0.031), status epilepticus (P = 0.029), Todd paralysis (P = 0.039), lesion size >10 mm (P = 0.001), and perilesional edema (P =  < 0.001) were significantly associated with seizure recurrence. Heterozygous form Asp/Gly (P =  < 0.001) and heterozygous form Thr/Ile (P =  < 0.001) were significantly associated with seizure recurrence. The Gly (Asp/Gly plus Gly/Gly) (P =  < 0.001) and Ile (Thr/Ile plus Ile/Ile) (P =  < 0.001) genotypes were also significantly associated with seizure recurrence. Higher serum MMP-9 levels were significantly associated with seizure recurrence (P =  < 0.001).The TLR-4 gene abnormalities may trigger inflammation around calcified neurocysticercosis leading to an increase in perilesional edema and provocation of seizures.

  5. Toll-like Receptor-4 Polymorphisms and Serum Matrix Metalloproteinase-9 in Newly Diagnosed Patients With Calcified Neurocysticercosis and Seizures

    PubMed Central

    Lachuriya, Gaurav; Garg, Ravindra Kumar; Jain, Amita; Malhotra, Hardeep Singh; Singh, Arvind Kumar; Jain, Bhawna; Kumar, Neeraj; Verma, Rajesh; Sharma, Praveen Kumar

    2016-01-01

    Abstract We evaluated seizure profile, Toll-like receptor (TLR)-4 polymorphisms, and serum matrix metalloproteinases (MMPs) in patients with calcified neurocysticercosis. One-hundred nine patients with calcified neurocysticercosis with newly diagnosed seizures and 109 control subjects were enrolled. TLR-4 Asp299Gly and Thr399Ile polymorphisms and serum MMP-9 levels were evaluated. The patients were followed for 1 year. Asp/Gly (P = 0.012) and Thr/Ile (P = 0.002), Gly (Asp/Gly plus Gly/Gly) (P = 0.008) and Ile (Thr/Ile plus Ile/Ile) (P = 0.003) genotypes were significantly associated with calcified neurocysticercosis compared with controls. Gly/Gly and Ile/Ile genotypes were not significantly associated (P = 0.529 for Gly/Gly, P = 0.798 for Ile/Ile) with either group. The levels of MMP-9 were higher in calcified neurocysticercosis (P =  < 0.001). The levels of MMP-9 were higher in patients with multiple calcified neurocysticercosis compared with single calcified neurocysticercosis (P =  < 0.001). Headache (P = 0.031), status epilepticus (P = 0.029), Todd paralysis (P = 0.039), lesion size >10 mm (P = 0.001), and perilesional edema (P =  < 0.001) were significantly associated with seizure recurrence. Heterozygous form Asp/Gly (P =  < 0.001) and heterozygous form Thr/Ile (P =  < 0.001) were significantly associated with seizure recurrence. The Gly (Asp/Gly plus Gly/Gly) (P =  < 0.001) and Ile (Thr/Ile plus Ile/Ile) (P =  < 0.001) genotypes were also significantly associated with seizure recurrence. Higher serum MMP-9 levels were significantly associated with seizure recurrence (P =  < 0.001). The TLR-4 gene abnormalities may trigger inflammation around calcified neurocysticercosis leading to an increase in perilesional edema and provocation of seizures. PMID:27124018

  6. Toll-like Receptor-4 Polymorphisms and Serum Matrix Metalloproteinase-9 in Newly Diagnosed Patients With Calcified Neurocysticercosis and Seizures.

    PubMed

    Lachuriya, Gaurav; Garg, Ravindra Kumar; Jain, Amita; Malhotra, Hardeep Singh; Singh, Arvind Kumar; Jain, Bhawna; Kumar, Neeraj; Verma, Rajesh; Sharma, Praveen Kumar

    2016-04-01

    We evaluated seizure profile, Toll-like receptor (TLR)-4 polymorphisms, and serum matrix metalloproteinases (MMPs) in patients with calcified neurocysticercosis.One-hundred nine patients with calcified neurocysticercosis with newly diagnosed seizures and 109 control subjects were enrolled. TLR-4 Asp299Gly and Thr399Ile polymorphisms and serum MMP-9 levels were evaluated. The patients were followed for 1 year.Asp/Gly (P = 0.012) and Thr/Ile (P = 0.002), Gly (Asp/Gly plus Gly/Gly) (P = 0.008) and Ile (Thr/Ile plus Ile/Ile) (P = 0.003) genotypes were significantly associated with calcified neurocysticercosis compared with controls. Gly/Gly and Ile/Ile genotypes were not significantly associated (P = 0.529 for Gly/Gly, P = 0.798 for Ile/Ile) with either group. The levels of MMP-9 were higher in calcified neurocysticercosis (P =  < 0.001). The levels of MMP-9 were higher in patients with multiple calcified neurocysticercosis compared with single calcified neurocysticercosis (P =  < 0.001).Headache (P = 0.031), status epilepticus (P = 0.029), Todd paralysis (P = 0.039), lesion size >10 mm (P = 0.001), and perilesional edema (P =  < 0.001) were significantly associated with seizure recurrence. Heterozygous form Asp/Gly (P =  < 0.001) and heterozygous form Thr/Ile (P =  < 0.001) were significantly associated with seizure recurrence. The Gly (Asp/Gly plus Gly/Gly) (P =  < 0.001) and Ile (Thr/Ile plus Ile/Ile) (P =  < 0.001) genotypes were also significantly associated with seizure recurrence. Higher serum MMP-9 levels were significantly associated with seizure recurrence (P =  < 0.001).The TLR-4 gene abnormalities may trigger inflammation around calcified neurocysticercosis leading to an increase in perilesional edema and provocation of seizures. PMID:27124018

  7. Interferon-α and the calcifying microangiopathy in Aicardi–Goutières syndrome

    PubMed Central

    Klok, Melanie D; Bakels, Hannah S; Postma, Nienke L; van Spaendonk, Rosalina M L; van der Knaap, Marjo S; Bugiani, Marianna

    2015-01-01

    Aicardi–Goutières syndrome is a leukoencephalopathy with calcifications and increased cerebrospinal fluid interferon-α. The relation between interferon-α and brain pathology is poorly understood. We report a patient with mutations in the disease-associated gene SAMHD1. Neuropathology showed an extensive microangiopathy with calcifications consistently associate with blood vessels. In an in vitro model of the microangiopathy, interferon-α enhanced vascular smooth muscle cell-derived calcifications. The noninfarcted white matter harbored apoptotic oligodendrocytes and increased numbers of oligodendrocyte progenitors. These findings better define the white matter pathology and provide evidence that interferon-α plays a direct pathogenetic role in the calcifying angiopathy typical of this disease. PMID:26273690

  8. Primary localized amyloidosis presenting as diffuse amorphous calcified mass in both orbits: case report.

    PubMed

    Gonçalves, Allan Christian Pieroni; Moritz, Rodrigo Bernal da Costa; Monteiro, Mário Luiz Ribeiro

    2011-01-01

    Primary localized amyloidosis is rare in the orbit. We report the case of a 63-year-old woman that presented with bilateral proptosis and ophthalmoplegia. A computed tomography scan revealed an infiltrative amorphous and markedly calcified mass in both orbits while a magnetic resonance scan showed a heterogeneous hypointense signal on T2-weighted images. A biopsy was performed through an anterior orbitotomy. Microscopy revealed extracellular amorphous and eosinophilic hyaline material which stained pink with Congo red and displayed green birefringence on polarized microscopy, leading to a diagnosis of amyloidosis. The results of the systemic workup were completely normal. A two-year follow-up period without any treatment disclosed no worsening of the condition. While calcification of nonvascular orbital lesions has often been regarded as suggestive of malignant disease, our case is a reminder that it can also be a characteristic presenting sign of orbital amyloidosis.

  9. Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder.

    PubMed

    Loew, M; Daecke, W; Kusnierczak, D; Rahmanzadeh, M; Ewerbeck, V

    1999-09-01

    We report a prospective study of the effects of extracorporeal shock-wave therapy in 195 patients with chronic calcifying tendinitis. In part A 80 patients with chronic symptoms were randomly assigned to a control and three subgroups which had different treatment by low-energy and high-energy shock waves. In part B 115 patients had either one or two high-energy sessions. We recorded subjective, functional and radiological findings at six months after treatment. The results showed energy-dependent success, with relief of pain ranging from 5% in our control group up to 58% after two high-energy sessions. The Constant scores and the radiological disintegration of calcification were also dose-dependent. Shockwave therapy should be considered for chronic pain due to calcific tendinitis which is resistant to conservative treatment.

  10. Coral calcifying fluid pH dictates response to ocean acidification.

    PubMed

    Holcomb, M; Venn, A A; Tambutté, E; Tambutté, S; Allemand, D; Trotter, J; McCulloch, M

    2014-01-01

    Ocean acidification driven by rising levels of CO2 impairs calcification, threatening coral reef growth. Predicting how corals respond to CO2 requires a better understanding of how calcification is controlled. Here we show how spatial variations in the pH of the internal calcifying fluid (pHcf) in coral (Stylophora pistillata) colonies correlates with differential sensitivity of calcification to acidification. Coral apexes had the highest pHcf and experienced the smallest changes in pHcf in response to acidification. Lateral growth was associated with lower pHcf and greater changes with acidification. Calcification showed a pattern similar to pHcf, with lateral growth being more strongly affected by acidification than apical. Regulation of pHcf is therefore spatially variable within a coral and critical to determining the sensitivity of calcification to ocean acidification. PMID:24903088

  11. Calcified epibionts as palaeoecological tools: examples from the Recent and Pleistocene reefs of Barbados

    NASA Astrophysics Data System (ADS)

    Martindale, W.

    1992-09-01

    Calcified epibionts (crustose coralline algae, bryozoans, foraminiferans and serpulid worms) which colinize primary framebuilders of Recent Barbados reefs exhibit a well-defined zonation of species and morphological growth forms in response to environmental factors such as water turbulence and light. Exposed environments are characterized by thick crusts of coralline algae whereas cryptic environments are dominated by thin crusts of algae, bryozoans, foraminiferans and serpulid worms. A model, based on this zonation, was used to decipher the environments of growth and early burial of Pleistocene reefs. Lagoonal corals possess an assemblage of encrusters which document prolonged growth in a uniform environment. Reef crest corals support a mixed succession of shallow water encrusters which record a gradual decrease in light as substrates are smothered by accumulating debris. Sequences such as these represent growth under stable conditions. The model can also be used to interpret sequences formed by catastrophic events and fluctuations in sea level.

  12. Discovery of the mineral brucite (magnesium hydroxide) in the tropical calcifying alga Polystrata dura (Peyssonneliales, Rhodophyta).

    PubMed

    Nash, Merinda C; Russell, Bayden D; Dixon, Kyatt R; Liu, Minglu; Xu, Huifang

    2015-06-01

    Red algae of the family Peyssonneliaceae typically form thin crusts impregnated with aragonite. Here, we report the first discovery of brucite in a thick red algal crust (~1 cm) formed by the peyssonnelioid species Polystrata dura from Papua New Guinea. Cells of P. dura were found to be infilled by the magnesium-rich mineral brucite [Mg(OH)2 ]; minor amounts of magnesite and calcite were also detected. We propose that cell infill may be associated with the development of thick (> ~5 mm) calcified red algal crusts, integral components of tropical biotic reefs. If brucite infill within the P. dura crust enhances resistance to dissolution similarly to crustose coralline algae that infill with dolomite, then these crusts would be more resilient to future ocean acidification than crusts without infill. PMID:26986657

  13. Anterior Herniation of Partially Calcified and Degenerated Cervical Disc Causing Dysphagia.

    PubMed

    Ozdol, Cagatay; Turk, Cezmi Cagri; Yildirim, Ali Erdem; Dalgic, Ali

    2015-08-01

    We report a rare case of anterior cervical disc herniation associated with dysphagia. A 32-year-old man presented with complaints of dysphagia and concomitant pain in the right arm resistant to conservative therapy. On physical examination with respect to the muscle strength, the right shoulder abduction and flexion of the forearm were 3/5. Lateral X-ray revealed calcified osteophytes at the anterior C4-5 level. Magnetic resonance imaging showed soft disc herniation involving the right C6 root at the C5-6 level and anterior herniation of the C4-5 cervical disc. Anterior discectomies for C4-5 and C5-6 levels stabilized and ameliorated the dysphagia and pain. Cervical disc herniation usually presents with radicular findings. However, dysphagia may be an uncommon presentation. Anterior cervical disc herniation should be considered in a patient presenting with dysphagia. PMID:26240723

  14. Calcifying odontogenic cyst with luminal and mural component (Type 1c)

    PubMed Central

    Sharma, Bhushan; Koshy, George; Kapoor, Shekhar

    2016-01-01

    Calcifying odontogenic cyst (COC) was first described and classified by Gorlin et al. It is defined as a cystic lesion in which the epithelial lining shows a well defined basal layer of columnar cells, an overlying layer that often resemble stellate reticulum and masses of ghost cells that may be in the epithelial cystic lining or in the fibrous capsule. The lesion generally occurs in the region anterior to maxillary and mandibular molars and either intraosseous or extraosseus. This entity might present as a cystic or solid lesion. Praetorius et al. classified COC into 2 main entities namely a cyst (Type 1) and a neoplasm (Type 2). The present case report exhibit a cystic lesion with both luminal and mural component. PMID:27433053

  15. Cone Beam Computed Tomography Findings in Calcifying Cystic Odontogenic Tumor Associated with Odontome: A Case Report

    PubMed Central

    Phulambrikar, Tushar; Vilas Kant, Sanchita; Kode, Manasi; Magar, Shaliputra

    2015-01-01

    The calcifying cystic odontogenic tumor (CCOT) is a rare cystic odontogenic neoplasm frequently found in association with odontome. This report documents a case of CCOT associated with an odontome arising in the anterior maxilla in a 28-year-old man. Conventional radiographs showed internal calcification within the lesion but were unable to visualize its relation with the adjacent structures and its accurate extent. In this case cone beam computed tomography (CBCT) could accurately reveal the extent and the internal structure of the lesion which aided the presumptive diagnosis of the lesion as CCOT. This advanced imaging technique proved to be extremely useful in the radiographic assessment and management of this neoplasm of the maxilla. PMID:26636128

  16. Calcifying odontogenic cyst associated with compound odontoma: a study on undemineralized material.

    PubMed

    Piattelli, A; Scarano, A; Piattelli, M

    1995-01-01

    In a minority of cases of calcifying odontogenic cyst (COC) it is possible to observe the formation of dental hard tissues in the cyst wall. The use of undemineralized sections has allowed an evaluation of the mineralized tissues normally lost with the use of demineralizing agents. All the dental hard tissues presented a high degree of morpho- and histodifferentiation. The histochemical staining for calcium salts (von Kossa) showed the presence of areas of low mineralization in the portion of the lesion, where the tissue maturation was not complete. In conclusion the appearance of the dental hard tissues in this case of compound odontoma arising in the cyst wall of a COC is similar to that already described in compound odontoma not associated with COC.

  17. Calcifying epithelial odontogenic tumor (Pindborg tumor) without calcification: A rare entity

    PubMed Central

    Kaushal, Seema; Mathur, Sandeep R; Vijay, Maneesh; Rustagi, Ankur

    2012-01-01

    The calcifying epithelial odontogenic tumor is a rare benign odontogenic tumor that was first described by Pindborg in 1955. It accounts for less than 1% of all odontogenic neoplasms. The tumor is characterized histologically by the presence of polygonal epithelial cells, calcification, and eosinophilic deposits resembling amyloid. Noncalcifying Pindborg tumor is very rare and only three cases have been documented in the English language literature so far. We present an additional case of noncalcifying Pindborg tumor and review the previously reported cases. Because noncalcifying Pindborg tumor is believed to be an aggressive variant, a definitive resection of the tumor with tumor-free surgical margins and long-term follow-up is recommended. PMID:22434947

  18. Calcifying epithelial odontogenic tumor (Pindborg tumor) without calcification: A rare entity.

    PubMed

    Kaushal, Seema; Mathur, Sandeep R; Vijay, Maneesh; Rustagi, Ankur

    2012-01-01

    The calcifying epithelial odontogenic tumor is a rare benign odontogenic tumor that was first described by Pindborg in 1955. It accounts for less than 1% of all odontogenic neoplasms. The tumor is characterized histologically by the presence of polygonal epithelial cells, calcification, and eosinophilic deposits resembling amyloid. Noncalcifying Pindborg tumor is very rare and only three cases have been documented in the English language literature so far. We present an additional case of noncalcifying Pindborg tumor and review the previously reported cases. Because noncalcifying Pindborg tumor is believed to be an aggressive variant, a definitive resection of the tumor with tumor-free surgical margins and long-term follow-up is recommended.

  19. Coral calcifying fluid pH dictates response to ocean acidification.

    PubMed

    Holcomb, M; Venn, A A; Tambutté, E; Tambutté, S; Allemand, D; Trotter, J; McCulloch, M

    2014-06-06

    Ocean acidification driven by rising levels of CO2 impairs calcification, threatening coral reef growth. Predicting how corals respond to CO2 requires a better understanding of how calcification is controlled. Here we show how spatial variations in the pH of the internal calcifying fluid (pHcf) in coral (Stylophora pistillata) colonies correlates with differential sensitivity of calcification to acidification. Coral apexes had the highest pHcf and experienced the smallest changes in pHcf in response to acidification. Lateral growth was associated with lower pHcf and greater changes with acidification. Calcification showed a pattern similar to pHcf, with lateral growth being more strongly affected by acidification than apical. Regulation of pHcf is therefore spatially variable within a coral and critical to determining the sensitivity of calcification to ocean acidification.

  20. Pathological calcification and replicating calcifying-nanoparticles: general approach and correlation.

    PubMed

    Ciftçioğlu, Neva; McKay, David S

    2010-05-01

    Calcification, a phenomenon often regarded by pathologists little more than evidence of cell death, is becoming recognized to be important in the dynamics of a variety of diseases from which millions of beings suffer in all ages. In calcification, all that is needed for crystal formation to start is nidi (nuclei) and an environment of available dissolved components at or near saturation concentrations, along with the absence of inhibitors for crystal formation. Calcifying nanoparticles (CNP) are the first calcium phosphate mineral containing particles isolated from human blood and were detected in numerous pathologic calcification related diseases. Controversy and critical role of CNP as nidi and triggering factor in human pathologic calcification are discussed. PMID:20094006

  1. Calcifying odontogenic cyst with luminal and mural component (Type 1c).

    PubMed

    Sharma, Bhushan; Koshy, George; Kapoor, Shekhar

    2016-01-01

    Calcifying odontogenic cyst (COC) was first described and classified by Gorlin et al. It is defined as a cystic lesion in which the epithelial lining shows a well defined basal layer of columnar cells, an overlying layer that often resemble stellate reticulum and masses of ghost cells that may be in the epithelial cystic lining or in the fibrous capsule. The lesion generally occurs in the region anterior to maxillary and mandibular molars and either intraosseous or extraosseus. This entity might present as a cystic or solid lesion. Praetorius et al. classified COC into 2 main entities namely a cyst (Type 1) and a neoplasm (Type 2). The present case report exhibit a cystic lesion with both luminal and mural component.

  2. Clear cell variant of calcifying epithelial odontogenic tumor: case report and review of the literature.

    PubMed

    Hicks, M J; Flaitz, C M; Wong, M E; McDaniel, R K; Cagle, P T

    1994-01-01

    The calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm which was first described by Pindborg in 1955 and accounts for less than 1% of all odontogenic lesions. Recently, a clear cell variant of CEOT has been identified with only eight well-documented cases in the literature. We present an additional case of clear cell CEOT of the mandible and review the salient clinical, radiologic, and histopathologic features of this entity and CEOTs in general. The differential diagnosis of clear cell tumors in the mandible includes: clear cell odontogenic tumor, clear cell ameloblastoma (odontogenic carcinoma), metastatic clear cell adenocarcinoma, primary intraosseous mucoepidermoid carcinoma, acinic cell carcinoma, epithelial-myoepithelial carcinoma, clear cell salivary gland tumors, and clear cell variant of squamous cell carcinoma. Because of the belief that clear cell odontogenic tumors are locally aggressive neoplasms, definitive resection of the entire mass with tumor-free surgical margins and long-term follow-up are recommended.

  3. [Is Malherbe calcifying epithelioma in the ENT area of a rare tumor?].

    PubMed

    Ganz, H

    1986-07-01

    The calcifying epithelioma (pilomatrixoma) is a benign tumour of the skin originating from hair sheath cells. The head, especially the cheek and preauricular region with the parotid gland, is a very common site (about 50%). The tumour arises predominantly in younger people, with a 2:1 female to male ratio. It is not so rare as suggested by the few ENT publications. The histologic picture shows two characteristic epithelial cells, the basophilic and ghost cell. Calcification is present in most cases. The prognosis after removal of the tumour is good. Two personal cases are reported, multiple pilomatrixomas on the cheek of an 12 year old girl, and a tumour on the auricle, an unusual site.

  4. Automated calculation of bifurcation carotid angle for analyzing the risk of carotis plaques by using carotid CT angiographic images

    NASA Astrophysics Data System (ADS)

    Demir, N.; Demir, S.

    2015-05-01

    The aim of this study is calculation of bifurcation carotid angle by detection of vessel boundaries to assist the medical doctors if this angle is a risk factor about formation of carotid plaques.Carotid ct angiography images are clustered automatically by ISODATA unsupervised classification algorithm. Since the spectral digital numbers (DN) of vessel pixels are bigger than the other part of the images, the cluster which has the biggest median value of DN among all other classes gives the vessel class. The cluster image in raster format is converted into the vector format which allows working on the vessel geometry. The converted vector vessel cluster dataset has been simplified using Douglas-Peucker algorithm to eliminate the zigzag effects of pixel data which are remained on the vector form dataset. Then the cluster polygon is converted to lines and the vertices which will be used for the calculation of bifurcation carotid angle. For sorting the vertex points to calculate the angle on each vertex, alpha-shapes algorithm is applied along the boundary. Then all the angles on each vertex point along the boundary of vessels are calculated. It is also visually clear that the angle which has the minimum value among all the calculated angles, gives the bifurcation carotid angle for one projected plane. The final carotid angle has calculated and 18 sample datasets are used to test the method.

  5. The Prognostic Significance of Asymptomatic Carotid Bruits in the Elderly

    PubMed Central

    Shorr, Ronald I; Johnson, Karen C; Wan, Jim Y; Sutton-Tyrrell, Kim; Pahor, Marco; Bailey, James E; Applegate, William B

    1998-01-01

    OBJECTIVE To determine the association between asymptomatic carotid bruits and the development of subsequent stroke in older adults with isolated systolic hypertension. DESIGN Retrospective cohort study. SETTING The Systolic Hypertension in the Elderly Program (SHEP), a 5-year randomized trial testing the efficacy of treating systolic hypertension in noninstitutionalized persons aged 60 years or older. From the original 4,736 SHEP participants, we identified a cohort of 4,442 persons who had no prior history of stroke, transient ischemic attack, or myocardial infarction at randomization. MEASUREMENTS AND MAIN RESULTS The end point for this ancillary study was the development of a stroke. The average follow-up was 4.2 years. Carotid bruits were found in 284 (6.4%) of the participants at baseline. Strokes developed in 21 (7.4%) of those with carotid bruits and in 210 (5.0%) of those without carotid bruits. The unadjusted risk of stroke among persons with carotid bruits was 1.53 (95% confidence interval [CI] 0.98, 2.40). Adjusting for age, gender, race, blood pressure, smoking, lipid levels, self-reported aspirin use, and treatment group assignment, the relative risk of stroke among persons with asymptomatic carotid bruits was 1.29 (95% CI 0.80, 2.06). Among SHEP enrollees aged 60 to 69 years, there was a trend (p=.08) toward increased risk (relative risk [RR] 2.05; 95% CI 0.92, 4.68) of subsequent stroke in persons with, compared to those without, carotid bruits. However, among enrollees aged 70 years or over, there was no relation between carotid bruit and subsequent stroke (RR 0.98; 95% CI 0.55, 1.76). In no other subgroup of SHEP enrollees did the presence of carotid bruit independently predict stroke. CONCLUSIONS Although we cannot rule out a small increased risk of stroke associated with bruits in asymptomatic SHEP enrollees aged 60 to 69 years, the utility of carotid bruits as a marker for increased risk of stroke among asymptomatic elderly with isolated

  6. Increased temperature mitigates the effects of ocean acidification in calcified green algae ( Halimeda spp.)

    NASA Astrophysics Data System (ADS)

    Campbell, Justin E.; Fisch, Jay; Langdon, Chris; Paul, Valerie J.

    2016-03-01

    The singular and interactive effects of ocean acidification and temperature on the physiology of calcified green algae ( Halimeda incrassata, H. opuntia, and H. simulans) were investigated in a fully factorial, 4-week mesocosm experiment. Individual aquaria replicated treatment combinations of two pH levels (7.6 and 8.0) and two temperatures (28 and 31 °C). Rates of photosynthesis, respiration, and calcification were measured for all species both prior to and after treatment exposure. Pre-treatment measurements revealed that H. incrassata displayed higher biomass-normalized rates of photosynthesis and calcification (by 55 and 81 %, respectively) relative to H. simulans and H. opuntia. Furthermore, prior to treatment exposure, photosynthesis was positively correlated to calcification, suggesting that the latter process may be controlled by photosynthetic activity in this group. After treatment exposure, net photosynthesis was unaltered by pH, yet significantly increased with elevated temperature by 58, 38, and 37 % for H. incrassata, H. simulans, and H. opuntia, respectively. Both pH and temperature influenced calcification, but in opposing directions. On average, calcification declined by 41 % in response to pH reduction, but increased by 49 % in response to elevated temperature. Within each pH treatment, elevated temperature increased calcification by 23 % (at pH 8.0) and 74 % (at pH 7.6). Interactions between pH, temperature, and/or species were not observed. This work demonstrates that, in contrast to prior studies, increased temperature may serve to enhance the metabolic performance (photosynthesis and calcification) of some marine calcifiers, despite elevated carbon dioxide concentrations. Thus, in certain cases, ocean warming may mitigate the negative effects of acidification.

  7. Shockwave application in calcifying tendinitis of the shoulder--prediction of outcome by imaging.

    PubMed

    Maier, M; Stäbler, A; Lienemann, A; Köhler, S; Feitenhansl, A; Dürr, H R; Pfahler, M; Refior, H J

    2000-01-01

    This prospective study examined 62 patients (65 shoulders) with chronic courses of calcifying tendinitis of the shoulder before and after low-energy extracorporeal shockwave application (ESWA) in order to identify variables associated with the outcome of this treatment. Before ESWA, radiographs and contrast-enhanced magnetic resonance imaging (MRI) of the affected shoulders were obtained in order to document the size and morphology of the calcifications and the contrast media reactions in areas of interest (deposit, synovia, bursae), respectively. In addition, a clinical evaluation was performed. After ESWA (mean follow-up 18.2 months), clinical evaluations of all 65 shoulders revealed an increase in the Constant score from 44% to 78% (p < 0.0001). While size (p = 0.61) and morphology (p = 0.7) of the deposits before ESWA were not associated with the clinical outcome, negative contrast reactions around the deposits (p) = 0.0001), synovia (p = 0.0049) and bursae (p < 0.01) were associated with improved clinical outcomes. After the total study group was divided into two groups, one with Constant scores > or = 75% (n = 43) and the other with scores < 75% (n = 22), the positive predictive value (ppv), specificity (sp) and sensitivity (se) were determined for the negative reaction around the deposit (ppv: 0.94; sp: 0.95; se: 0.38), synovia (ppv: 0.84; sp: 0.82; se: 0.49) and bursae (ppv: 0.86; sp: 0.86; se: 0.44). In 5 cases (7.7%), surgery of the affected shoulder during the follow-up period was performed. No major side-effects were seen in the study group. In conclusion, our results suggest that in patients with chronic calcifying tendinitis, the absence of contrast enhancement, especially around the deposit, is a strong predictive parameter of a positive clinical outcome of ESWA.

  8. Surgical Treatment for Central Calcified Thoracic Disk Herniation: A Novel L-Shaped Osteotome.

    PubMed

    Zhuang, Qing-shan; Lun, Deng-xing; Xu, Zhao-wan; Dai, Wei-hua; Liu, Da-yong

    2015-09-01

    Few reports are available on the posterior transfacet approach for the treatment of central calcified thoracic disk herniation (TDH). The objective of this study was to assess outcomes and complications in a consecutive series of patients with TDH who underwent posterior transfacet decompression and diskectomy with segmental instrumentation and fusion. The data for 27 patients (16 males and 11 females) were retrospectively reviewed and analyzed, including clinical presentation, blood loss, operative time, pre- and postoperative complications, visual analog scale, Japanese Orthopedic Association (JOA) score, and Frankel grade. All patients underwent trans-facet decompression and segmental instrumentation with interbody fusion. Mean patient age at surgery was 55.2 years (range, 21-81 years). Average follow-up was 30±19 months (range, 12-50 months). All patients were successfully treated with posterior decompression and segmental instrumentation with interbody fusion. Average operative time was 124±58 minutes (range, 87-180 minutes). Mean blood loss was 439±225 mL (range, 300-1500 mL). Average pre- and postoperative JOA scores were 4.12±0.87 and 8.01±0.97 points, respectively. Overall JOA scores showed a significant postoperative improvement. Overall recovery rates were excellent in 12 patients, good in 6, fair in 5, and unchanged in 1. No patient was classified as worse. The results suggest that the posterior approach using a special L-shaped osteotome is feasible. No major complications occurred while achieving adequate decompression for central calcified TDH. PMID:26375537

  9. Proposed clinical internal carotid artery classification system

    PubMed Central

    Abdulrauf, Saleem I; Ashour, Ahmed M; Marvin, Eric; Coppens, Jeroen; Kang, Brian; Hsieh, Tze Yu Yeh; Nery, Breno; Penanes, Juan R; Alsahlawi, Aysha K; Moore, Shawn; Al-Shaar, Hussam Abou; Kemp, Joanna; Chawla, Kanika; Sujijantarat, Nanthiya; Najeeb, Alaa; Parkar, Nadeem; Shetty, Vilaas; Vafaie, Tina; Antisdel, Jastin; Mikulec, Tony A; Edgell, Randall; Lebovitz, Jonathan; Pierson, Matt; Pires de Aguiar, Paulo Henrique; Buchanan, Paula; Di Cosola, Angela; Stevens, George

    2016-01-01

    Introduction: Numerical classification systems for the internal carotid artery (ICA) are available, but modifications have added confusion to the numerical systems. Furthermore, previous classifications may not be applicable uniformly to microsurgical and endoscopic procedures. The purpose of this study was to develop a clinically useful classification system. Materials and Methods: We performed cadaver dissections of the ICA in 5 heads (10 sides) and evaluated 648 internal carotid arteries with computed tomography angiography. We identified specific anatomic landmarks to define the beginning and end of each ICA segment. Results: The ICA was classified into eight segments based on the cadaver and imaging findings: (1) Cervical segment; (2) cochlear segment (ascending segment of the ICA in the temporal bone) (relation of the start of this segment to the base of the styloid process: Above, 425 sides [80%]; below, 2 sides [0.4%]; at same level, 107 sides [20%]; P < 0.0001) (relation of cochlea to ICA: Posterior, 501 sides [85%]; posteromedial, 84 sides [14%]; P < 0.0001); (3) petrous segment (horizontal segment of ICA in the temporal bone) starting at the crossing of the eustachian tube superolateral to the ICA turn in all 10 samples; (4) Gasserian-Clival segment (ascending segment of ICA in the cavernous sinus) starting at the petrolingual ligament (PLL) (relation to vidian canal on imaging: At same level, 360 sides [63%]; below, 154 sides [27%]; above, 53 sides [9%]; P < 0.0001); in this segment, the ICA projected medially toward the clivus in 275 sides (52%) or parallel to the clivus with no deviation in 256 sides (48%; P < 0.0001); (5) sellar segment (medial loop of ICA in the cavernous sinus) starting at the takeoff of the meningeal hypophyseal trunk (ICA was medial into the sella in 271 cases [46%], lateral without touching the sella in 127 cases [23%], and abutting the sella in 182 cases [31%]; P < 0.0001); (6) sphenoid segment (lateral loop of ICA within the

  10. Proposed clinical internal carotid artery classification system

    PubMed Central

    Abdulrauf, Saleem I; Ashour, Ahmed M; Marvin, Eric; Coppens, Jeroen; Kang, Brian; Hsieh, Tze Yu Yeh; Nery, Breno; Penanes, Juan R; Alsahlawi, Aysha K; Moore, Shawn; Al-Shaar, Hussam Abou; Kemp, Joanna; Chawla, Kanika; Sujijantarat, Nanthiya; Najeeb, Alaa; Parkar, Nadeem; Shetty, Vilaas; Vafaie, Tina; Antisdel, Jastin; Mikulec, Tony A; Edgell, Randall; Lebovitz, Jonathan; Pierson, Matt; Pires de Aguiar, Paulo Henrique; Buchanan, Paula; Di Cosola, Angela; Stevens, George

    2016-01-01

    Introduction: Numerical classification systems for the internal carotid artery (ICA) are available, but modifications have added confusion to the numerical systems. Furthermore, previous classifications may not be applicable uniformly to microsurgical and endoscopic procedures. The purpose of this study was to develop a clinically useful classification system. Materials and Methods: We performed cadaver dissections of the ICA in 5 heads (10 sides) and evaluated 648 internal carotid arteries with computed tomography angiography. We identified specific anatomic landmarks to define the beginning and end of each ICA segment. Results: The ICA was classified into eight segments based on the cadaver and imaging findings: (1) Cervical segment; (2) cochlear segment (ascending segment of the ICA in the temporal bone) (relation of the start of this segment to the base of the styloid process: Above, 425 sides [80%]; below, 2 sides [0.4%]; at same level, 107 sides [20%]; P < 0.0001) (relation of cochlea to ICA: Posterior, 501 sides [85%]; posteromedial, 84 sides [14%]; P < 0.0001); (3) petrous segment (horizontal segment of ICA in the temporal bone) starting at the crossing of the eustachian tube superolateral to the ICA turn in all 10 samples; (4) Gasserian-Clival segment (ascending segment of ICA in the cavernous sinus) starting at the petrolingual ligament (PLL) (relation to vidian canal on imaging: At same level, 360 sides [63%]; below, 154 sides [27%]; above, 53 sides [9%]; P < 0.0001); in this segment, the ICA projected medially toward the clivus in 275 sides (52%) or parallel to the clivus with no deviation in 256 sides (48%; P < 0.0001); (5) sellar segment (medial loop of ICA in the cavernous sinus) starting at the takeoff of the meningeal hypophyseal trunk (ICA was medial into the sella in 271 cases [46%], lateral without touching the sella in 127 cases [23%], and abutting the sella in 182 cases [31%]; P < 0.0001); (6) sphenoid segment (lateral loop of ICA within the

  11. Solitary fibrous tumor surrounding the carotid sheath.

    PubMed

    Gómez-Oliveira, Guillermo; Alvarez-Flores, Modesto; Arribas-García, Ignacio; Martínez-Gimeno, Carlos

    2010-03-01

    Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms that are mostly found arising from the pleura. Although SFTs recently have been reported in other regions, they are rare in the head and neck and have often been misdiagnosed due to their rarity. SFTs are benign in most cases. Clinically, SFTs usually manifest as well-circumscribed, slow-growing, smooth and painless masses. Symptoms are often minimal, although they may include sore throat, difficulty in swallowing, change of voice or trismus. CT-Scan and MRI are the most sensitive imaging procedures used. The treatment of choice is complete surgical excision of the lesion. Because recurrences have been noted up to 30 years after surgery, long-term follow up is mandatory. In this article, we present a case of a Solitary Fibrous Tumor arising in the parapharyngeal space in a 20-year-old man, involving the carotid sheath, treated by surgical excision with no recurrence after 1 year. The clinical presentation, surgical management and pathological findings are described.

  12. Venous Drainage Patterns in Carotid Cavernous Fistulas

    PubMed Central

    Aralasmak, Ayse; Karaali, Kamil; Senol, Utku; Ozdemir, Huseyin; Alkan, Alpay

    2014-01-01

    Purpose. The carotid-cavernous fistula (CCF) is an abnormal arteriovenous communication and its drainage pathways may affect the clinic presentation and change treatment approach. We evaluated drainage patterns of CCFs by digital subtraction angiography (DSA) and categorized drainage pathways according to their types and etiology. Materials and Methods. Venous drainage patterns of 13 CCFs from 10 subjects were studied and categorized as anterior, posterior, superior, inferior, and contralateral on DSA. Drainage patterns were correlated to types and etiology of CCFs. Diagnosis of CCFs was first made by noninvasive imaging techniques. Results. On DSA, traumatic CCFs were usually high flow, direct type while spontaneous CCFs were usually slow flow, indirect type. Bilaterality and mixed types were observed among the indirect spontaneous CCFs. In all CCFs, anterior and inferior drainages were the most common. Contrary to the literature, posterior and superior drainages were noted only in high flow and long standing direct fistulas. Contralateral drainage was not observed in all, supporting plausible compartmentalization of cavernous sinuses. Conclusion. Types, etiology, and duration of the CCFs may affect their drainage patterns. DSA is valuable for categorization of CCFs and verification of drainage patterns. Drainage pathways may affect the clinic presentation and also change treatment approach. PMID:24967298

  13. Contemporary carotid imaging: from degree of stenosis to plaque vulnerability.

    PubMed

    Brinjikji, Waleed; Huston, John; Rabinstein, Alejandro A; Kim, Gyeong-Moon; Lerman, Amir; Lanzino, Giuseppe

    2016-01-01

    Carotid artery stenosis is a well-established risk factor of ischemic stroke, contributing to up to 10%-20% of strokes or transient ischemic attacks. Many clinical trials over the last 20 years have used measurements of carotid artery stenosis as a means to risk stratify patients. However, with improvements in vascular imaging techniques such as CT angiography and MR angiography, ultrasonography, and PET/CT, it is now possible to risk stratify patients, not just on the degree of carotid artery stenosis but also on how vulnerable the plaque is to rupture, resulting in ischemic stroke. These imaging techniques are ushering in an emerging paradigm shift that allows for risk stratifications based on the presence of imaging features such as intraplaque hemorrhage (IPH), plaque ulceration, plaque neovascularity, fibrous cap thickness, and presence of a lipid-rich necrotic core (LRNC). It is important for the neurosurgeon to be aware of these new imaging techniques that allow for improved patient risk stratification and outcomes. For example, a patient with a low-grade stenosis but an ulcerated plaque may benefit more from a revascularization procedure than a patient with a stable 70% asymptomatic stenosis with a thick fibrous cap. This review summarizes the current state-of-the-art advances in carotid plaque imaging. Currently, MRI is the gold standard in carotid plaque imaging, with its high resolution and high sensitivity for identifying IPH, ulceration, LRNC, and inflammation. However, MRI is limited due to time constraints. CT also allows for high-resolution imaging and can accurately detect ulceration and calcification, but cannot reliably differentiate LRNC from IPH. PET/CT is an effective technique to identify active inflammation within the plaque, but it does not allow for assessment of anatomy, ulceration, IPH, or LRNC. Ultrasonography, with the aid of contrast enhancement, is a cost-effective technique to assess plaque morphology and characteristics, but it is

  14. Outcome of Carotid Artery Stenting for Radiation-Induced Stenosis

    SciTech Connect

    Dorresteijn, Lucille; Vogels, Oscar; Leeuw, Frank-Erik de; Vos, Jan-Albert; Christiaans, Marleen H.; Ackerstaff, Rob; Kappelle, Arnoud C.

    2010-08-01

    Purpose: Patients who have been irradiated at the neck have an increased risk of symptomatic stenosis of the carotid artery during follow-up. Carotid angioplasty and stenting (CAS) can be a preferable alternative treatment to carotid endarterectomy, which is associated with increased operative risks in these patients. Methods and Materials: We performed a prospective cohort study of 24 previously irradiated patients who underwent CAS for symptomatic carotid stenosis. We assessed periprocedural and nonprocedural events including transient ischemic attack (TIA), nondisabling stroke, disabling stoke, and death. Patency rates were evaluated on duplex ultrasound scans. Restenosis was defined as a stenosis of >50% at the stent location. Results: Periprocedural TIA rate was 8%, and periprocedural stroke (nondisabling) occurred in 4% of patients. After a mean follow-up of 3.3 years (range, 0.3-11.0 years), only one ipsilateral incident event (TIA) had occurred (4%). In 12% of patients, a contralateral incident event was present: one TIA (4%) and two strokes (12%, two disabling strokes). Restenosis was apparent in 17%, 33%, and 42% at 3, 12, and 24 months, respectively, although none of the patients with restenosed vessels became symptomatic. The length of the irradiation to CAS interval proved the only significant risk factor for restenosis. Conclusions: The results of CAS for radiation-induced carotid stenosis are favorable in terms of recurrence of cerebrovascular events at the CAS site.

  15. Indium-111-labeled platelet scintigraphy in carotid atherosclerosis

    SciTech Connect

    Minar, E.; Ehringer, H.; Dudczak, R.; Schoefl, R.J.; Jung, M.; Koppensteiner, R.; Ahmadi, R.; Kretschmer, G.

    1989-01-01

    We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index.

  16. Pulp Stone, Haemodialysis, End-stage Renal Disease, Carotid Atherosclerosis

    PubMed Central

    Patil, Santosh; Sinha, Nidhi

    2013-01-01

    Objectives: The aim of this study was to determine the relationship between the presence of pulp calcification and carotid artery calcification on the dental panoramic radiographs in End Stage Renal Disease (ESRD) patients who were on haemodialysis. Methods: A total of 112 End Stage Renal Disease (ESRD) patients on who were haemodialysis participated in this study. The periapical and the panoramic radiographs for all the patients were evaluated for the presence or absence of the narrowing of the dental pulps and for pulp stones in the pulp chambers and the pulp canals. The panoramic radiographs were also evaluated to determine the carotid calcification. Results: Carotid calcifications were detected in none of the patients. 84 (74.99%) patients had dental pulp narrowing, and 38 (33.92%) patients had pulp stones. There was no statistical correlation between pulp narrowing and Carotid Artery Calcification (CAC) in the haemodialysis patient group. There was also no statistical correlation between pulp stones and CAC in the haemodialysis patients. Conclusion: However, the incidental finding of CAC on a panoramic radiograph can provide life-saving information for the vascular disease patients, but in the present study, no significant relationship was found between the presence of the pulpal calcification and CAC in the ESRD patients who were on haemodialysis. Therefore, the presence of pulp calcification does not seem to serve as a diagnostic marker for carotid atherosclerosis. PMID:23905147

  17. The distribution of cholinesterases in the cat carotid body.

    PubMed

    Biscoe, T J; Silver, A

    1966-03-01

    1. The distribution of acetyl- and butyrylcholinesterase in the carotid body of the cat has been examined histochemically. Studies were made on normal carotid bodies and on carotid bodies from cats in which certain nerves had been cut some time previously. The nerves sectioned were the sinus nerve, the post-ganglionic sympathetic branch of the superior cervical ganglion or the preganglionic cervical sympathetic trunk.2. It was confirmed that more butyrylcholinesterase than acetylcholinesterase is present. Both enzymes are found in three sites: (i) as strands, (ii) as plexuses, (iii) inside a few cells.3. The distribution is unaffected by cutting the sinus nerve or preganglionic cervical sympathetic nerves. Disorganization and depletion of the cholinesterases in the strands and plexuses occurs when the post-ganglionic branch of the superior cervical ganglion is cut. The cholinesterase in cells is unaffected.4. In carotid bodies in which vessels were filled with red blood cells or in which the vascular bed was injected with carmine-gelatine, it was seen that strands and plexuses are associated with blood vessels, and with blood vessels and cells respectively.5. It is suggested that a cholinergic pathway controlling carotid body blood vessels runs in the post-ganglionic cervical sympathetic.

  18. Delayed presentation of a carotid pseudoaneurysm following penetrating neck trauma

    PubMed Central

    Alfawaz, Abdullah; Li, Xiaoyi; Kénel-Pierre, Stefan; Yang, Jane; Rey, Jorge; Robinson, Handel

    2016-01-01

    Objective: Penetrating carotid trauma in a hemodynamically stable patient invariably presents with a pseudoaneurysm on initial imaging. Although extremely rare, delayed pseudoaneurysm formation has been reported. The purpose of this paper is to define this rare entity and propose a diagnostic and treatment plan. Methods: We present a case of delayed presentation of carotid pseudoaneurysm following penetrating neck trauma. A systematic review of the literature was performed. Results: A 21-year-old male presents to the trauma center after sustaining a gunshot wound to the left upper back resulting in a zone 2 hematoma and pneumothorax. Bullet fragment artifact interfered with computed tomography. Carotid angiogram was normal. The patient was discharged after 3 days. He returned to the Emergency Department 3 months later with a painful pulsatile hematoma. Computed tomography angiogram revealed a 6-cm pseudoaneurysm arising from the proximal left internal carotid artery (ICA). A left common carotid artery (CCA) to ICA bypass with reversed great saphenous vein was performed. The patient’s post-operative course was uneventful, neurologic deficits improved, and he was discharged. Conclusion: Delayed presentation of traumatic pseudoaneurysms has been reported, although usually these cases are iatrogenic access complications in extremities. While endovascular therapies are first line for zone 1 and 3 vascular injuries, management of zone 2 injuries is still controversial. This patient was treated with a bypass due to the need to evacuate the hematoma that was exerting a mass effect in the neck. PMID:27489718

  19. Anatomical and functional characteristics of carotid sinus stimulation in humans

    NASA Technical Reports Server (NTRS)

    Querry, R. G.; Smith, S. A.; Stromstad, M.; Ide, K.; Secher, N. H.; Raven, P. B.

    2001-01-01

    Transmission characteristics of pneumatic pressure to the carotid sinus were evaluated in 19 subjects at rest and during exercise. Either a percutaneous fluid-filled (n = 12) or balloon-tipped catheter (n = 7) was placed at the carotid bifurcation to record internal transmission of external neck pressure/neck suction (NP/NS). Sustained, 5-s pulses, and rapid ramping pulse protocols (+40 to -80 Torr) were recorded. Transmission of pressure stimuli was less with the fluid-filled catheter compared with that of the balloon-tipped catheter (65% vs. 82% negative pressure, 83% vs. 89% positive pressure; P < 0.05). Anatomical location of the carotid sinus averaged 3.2 cm (left) and 3.6 cm (right) from the gonion of the mandible with a range of 0-7.5 cm. Transmission was not altered by exercise or Valsalva maneuver, but did vary depending on the position of the carotid sinus locus beneath the sealed chamber. These data indicate that transmission of external NP/NS was higher than previously recorded in humans, and anatomical variation of carotid sinus location and equipment design can affect transmission results.

  20. An Experimental and Computational Study of Blunt Carotid Artery Injury

    PubMed Central

    Gayzik, F. Scott; Bostrom, Ola; Örtenwall, Per; Duma, Stefan M.; Stitzel, Joel D.

    2006-01-01

    A carotid artery dissection begins as a tear or defect of the intimal lining of the artery, and can lead to luminal occlusion and ultimately cerebral ischemia. Our aim is to conduct an organ level validation of a finite element model of the carotid artery using an experiment designed to elicit internal layer failure within fluid-filled carotid artery samples. A 2.4-kg beveled guillotine is dropped from three heights (0.3, 0.5 and 0.7 m) onto fluid-filled porcine carotid arteries and resulting damage is recorded. These events are modeled using finite element analysis. Stress, strain and strain rate are correlated to experimental outcome. Internal layer damage is reported in half of the experiments, with damage occurring with 100% frequency at a drop height of 0.7 m. Simulations of this experiment result in maximum principal stress and strain values of 1.43 MPa and 46.2% respectively. The strain level predicted by the model for this impact scenario approaches the strain to intimal failure level for porcine arteries found in the literature. The results of this study represent an important step in validating this finite element carotid artery model at the organ level. PMID:16968627

  1. [Endovascular treatment for cervical carotid artery aneurysm: a case report].

    PubMed

    Hattori, Yasuhiko; Sugiu, Kenji; Hishikawa, Tomohito; Tokunaga, Koji; Takahashi, Kazuya; Date, Isao

    2013-06-01

    We report here a case of cervical carotid artery aneurysm. This 37-year-old male suffered from acute neck swelling when he was taking lunch after physical work. Ultrasonography demonstrated a cervical pseudoaneurysm and a jet flow, which was blowing into the dome from the carotid artery. Angiogram revealed an aneurysm with a diameter of 3 cm at the bifurcation of the common carotid artery. Coil embolization using double-catheter technique was performed and complete occlusion of the aneurysm was obtained without any complications. The patient returned to his normal life. Cervical carotid artery aneurysms are rare and they induce pain by swelling in the neck, hoarseness, swallowing disturbance, hemorrhage, and cerebral ischemia due to embolism. In case of a cervical carotid artery aneurysm, safe and effective treatments are required and endovascular treatment should be considered. Although stent-assisted coil embolization or covered-stent placement were reported as an effective treatment for cervical aneurysms, coil embolization without using a stent was performed in this particular patient who is a young, blue-collar worker because the avoidance of long-term anti-platelet therapy was desirable. Preoperative evaluation is important to select adequate treatment. PMID:23732763

  2. Carotid Artery Stenting Trials: Conduct, Results, Critique, and Current Recommendations

    SciTech Connect

    Macdonald, Sumaira

    2012-02-15

    The carotid stenting trialists have demonstrated persistence and determination in comparing an evolving technique, carotid artery stenting (CAS), against a mature and exacting standard for carotid revascularisation, carotid endarterectomy (CEA). This review focuses on their endeavours. A total of 12 1-on-1 randomised trials comparing CAS and CEA have been reported; 6 of these can be considered major, and 5 of these reflect (in part) current CAS standards of practice and form the basis of this review. At least 18 meta-analyses seeking to compare CAS and CEA exist. These are limited by the quality and heterogeneity of the data informing them (e.g., five trials were stopped prematurely such that they collectively failed to reach recruitment target by >4000 patients). The Carotid Stenting Trialists' Collaboration Publication represents a prespecified meta-analysis of European trials that were sufficiently similar to allow valid conclusions to be drawn; these trials and conclusions will be explored. When the rate of myocardial infarction (MI) is rigorously assessed, CAS and CEA are equivalent for the composite end point of stroke/death and MI, with more minor strokes for CAS and more MIs for CEA. These outcomes have a discrepant impact on quality of life and subsequent mortality. The all-stroke death outcomes for patients <70 years old are equivalent, with more minor strokes occurring in the elderly during CAS than CEA. There are significantly more severe haematomas and cranial nerve injuries after CEA. The influence of experience on outcome cannot be underestimated.

  3. Clinical use of noninvasive evaluation of the carotid artery.

    PubMed

    Persson, A V; O'Leary, D H; Kovacs, A; Dyer, V E

    1980-06-01

    The noninvasive evaluation of carotid artery disease should include a battery of tests that includes one direct and one indirect assessment of the extracranial carotid arteries. The resulting data should be correlated with the clinical findings and the patient's general status so the risks and benefits of carotid endarterectomy may be determined. These studies are usually outpatient procedures and allow one to determine in the office which patients would benefit from carotid surgery and who should be followed serially. Carotid arteriography is reserved for those patients who will be subjected to surgery. In our hands, the combination of CPA, Kartchner-McRae OPG, and Echoflow fulfill these requirements. In a small number of patients the history, physical examination, and noninvasive studies are inconclusive. For most patients, we are able to make decisions as to the best therapy in the office and can discuss risks and benefits with patients and their families with an accuracy of approximately 95 per cent before hospitalization and arteriography are considered.

  4. Gasotransmitter regulation of ion channels: a key step in O2 sensing by the carotid body.

    PubMed

    Prabhakar, Nanduri R; Peers, Chris

    2014-01-01

    Carotid bodies detect hypoxia in arterial blood, translating this stimulus into physiological responses via the CNS. It is long established that ion channels are critical to this process. More recent evidence indicates that gasotransmitters exert powerful influences on O2 sensing by the carotid body. Here, we review current understanding of hypoxia-dependent production of gasotransmitters, how they regulate ion channels in the carotid body, and how this impacts carotid body function.

  5. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial

    PubMed Central

    2010-01-01

    Summary Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Findings The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4·0%) events of disabling stroke or death in the stenting group compared with 27 (3·2%) events in the endarterectomy group (hazard ratio [HR] 1·28, 95% CI 0·77–2·11). The incidence of stroke, death, or procedural myocardial infarction was 8·5% in the stenting group compared with 5·2% in the endarterectomy group (72 vs 44 events

  6. Left or Right Carotid Endarterectomy in Patients with Atherosclerotic Disease: Ipsilateral Effects on Cognition?

    ERIC Educational Resources Information Center

    Brand, N.; Bossema, E. R.; van Ommen, M.; Moll, F. L.; Ackerstaff, R. G. A.

    2004-01-01

    We evaluated hemispheric functions ipsilateral to the side of carotid endarterectomy (CEA) in patients with a severe stenosis in the left or right carotid artery. Assessments took place 1 day before and 3 months after CEA. Only right-handed males were included. Nineteen patients underwent surgery of the left carotid artery and 17 of the right.…

  7. Hemodynamic Effects of Long-term Morphological Changes in the Human Carotid Sinus

    PubMed Central

    Seong, Jaehoon; Jeong, Woowon; Smith, Nataliya; Towner, Rheal A.

    2015-01-01

    Previous investigations of morphology for human carotid artery bifurcation from infancy to young adulthood found substantial growth of the internal carotid artery with advancing age, and the development of the carotid sinus at the root of the internal carotid artery during teen age years. Although the reasons for the appearance of the carotid sinus are not clearly understood yet, it has been hypothesized that the dilation of the carotid sinus serves to support pressure sensing, and slows the blood flow to reduce pulsatility to protect the brain. In order to understand this interesting evolvement at the carotid bifurcation in the aspects of fluid mechanics, we performed in vitro phase-contrast MR flow experiments using compliant silicone replicas of age-dependent carotid artery bifurcations. The silicone models in childhood, adolescence, and adulthood were fabricated using a rapid prototyping technique, and incorporated with a bench-top flow mock circulation loop using a computer-controlled piston pump. The results of the in vitro flow study showed highly complex flow characteristics at the bifurcation in all age-dependent models. However, the highest magnitude of kinetic energy was found at the internal carotid artery in the child model. The high kinetic energy in the internal carotid artery during childhood might be one of the local hemodynamic forces that initiate morphological long-term development of the carotid sinus in the human carotid bifurcation. PMID:25702250

  8. Carotid Endothelial VCAM-1 Is an Early Marker of Carotid Atherosclerosis and Predicts Coronary Artery Disease in Swine

    PubMed Central

    Masseau, I.; Bowles, D. K.

    2015-01-01

    Objective The aim was to determine if endothelial VCAM-1 (eVCAM-1) expression in the common carotid artery (CCA) would correlate with predictive markers of atherosclerotic disease, would precede reduction of markers of endothelial cell function and would predict coronary artery disease (CAD). Methods and results Carotid arterial segments (bifurcation, proximal and distal CCA) were harvested from 14 and 24 month-old male castrated familial hypercholesterolemic (FH) swine, a model of spontaneous atherosclerosis. Quantification of local expression of eVCAM-1, intimal macrophage accumulation, oxidative stress, intima-media (I/M) ratio, intima-media thickness (IMT), endothelial nitric oxide synthase (eNOS) and phosphorylated eNOS (p-eNOS) in selected regions of the carotids revealed a relationship between local inflammation and atheroscle-rotic plaque progression. Importantly, inflammation was not uniform throughout the CCA. Endo-thelial VCAM-1 expression was the greatest at the bifurcation and increased with age. Finally, eV-CAM-1 best estimated the severity of CAD compared to blood levels of glucose, hypercholestero-lemia, carotid IMT, and p-eNOS. Conclusion Our data suggested that eVCAM-1 was closely associated with atherosclerotic plaque progression and preceded impairment of EDD. Thus, this study supported the use of carotid VCAM-1 targeting agents to estimate the severity of CAD. PMID:26702331

  9. Border Detection of Common Carotid Artery Using Hough Transform

    NASA Astrophysics Data System (ADS)

    Koya, Yoshiharu; Nagahara, Yoshihiro

    The arteriosclerosis is on the increase with an aging or change of our living environment. For that reason, diagnosis of the common carotid artery using echocardiogram is doing to take precautions carebropathy. The arteriosclerosis of the common carotid artery is diagnosed using Intima-Media Thickness (IMT) which is obtained from echocardiogram. In order to measure IMT from echocardiogram, it is required to detect a border which is a boundary between vessel tissue layers. The method of border detection requires reproducibility and high accuracy. The conventional methods to detect the border curve depend on differential value of brightness on the common carotid artery. Therefore, we can't extract a good candidate point by influence of a noise. In this paper, we propose the high-accuracy detection method by Hough Transform. About high-accuracy, it realized by attaching importance to high reliable candidate point of border.

  10. Carotid body tumors: advantages of contrast ultrasound investigation.

    PubMed

    Giannoni, Maria F; Irace, Luigi; Vicenzini, Edoardo; Massa, Rita; Gossetti, Bruno; Benedetti-Valentini, Fabrizio

    2009-10-01

    Carotid body tumors are rare neoplasms that have to be considered in the evaluation of all lateral neck mass. Early surgical removal has been recommended to avoid possible cranial nerve injury, the most common perioperative complication. Computed tomography (CT) and magnetic resonance imaging (MRA) angiographies are the preferred pre-operative diagnostic imaging investigations, as well as the 111 In-pentetreotide scintigraphic scan, whereas the standard ultrasound investigations have poor sensitivity in characterizing of the blood flows of the parenchimal structure of the carotid body tumors. We describe a case of a patient with a carotid body tumor assessed with contrast ultrasonography that clearly improved the quality of the standard color Duplex. This technique may represent a non-invasive method, easy to use and to repeat, and able to achieve high diagnostic accuracy.

  11. Trace Elements in Calcifying Marine Invertebrates Indicate Diverse Sensitivities to the Seawater Carbonate System

    NASA Astrophysics Data System (ADS)

    Doss, W. C.

    2015-12-01

    Surface ocean absorption of anthropogenic CO2 emissions resulting in ocean acidification may interfere with the ability of calcifying marine organisms to biomineralize, since the drop in pH is accompanied by reductions in CaCO3 saturation state. However, recent experiments show that net calcification rates of cultured benthic invertebrate taxa exhibit diverse responses to pCO2-induced changes in saturation state (Ries et al., 2009). Advancement of geochemical tools as biomineralization indicators will enable us to better understand these results and therefore help predict the impacts of ongoing and future decrease in seawater pH on marine organisms. Here we build upon previous work on these specimens by measuring the elemental composition of biogenic calcite and aragonite precipitated in four pCO2 treatments (400; 600; 900; and 2850 ppm). Element ratios (including Sr/Ca, Mg/Ca, Li/Ca, B/Ca, U/Ca, Ba/Ca, Cd/Ca, and Zn/Ca) were analyzed in 18 macro-invertebrate species representing seven phyla (crustacea, cnidaria, echinoidea, rhodophyta, chlorophyta, gastropoda, bivalvia, annelida), then compared to growth rate data and experimental seawater carbonate system parameters: [CO32-], [HCO3-], pH, saturation state, and DIC. Correlations between calcite or aragonite composition and seawater carbonate chemistry are highly taxa-specific, but do not resemble trends observed in growth rate for all species. Apparent carbonate system sensitivities vary widely by element, ranging from strongly correlated to no significant response. Interpretation of these results is guided by mounting evidence for the capacity of individual species to modulate pH and/or saturation state at the site of calcification in response to ambient seawater chemistry. Such biomineralization pathways and strategies in turn likely influence elemental fractionation during CaCO3 precipitation. Ries, J.B., A.L. Cohen, A.L., and D.C. McCorkle (2009), Marine calcifiers exhibit mixed responses to CO2-induced ocean

  12. Formation mechanism of calcified roots in terrestrial sediments: insights from a multitechnique and multiscale characterization strategy

    NASA Astrophysics Data System (ADS)

    El Khatib, Rime; Huguet, Arnaud; Bernard, Sylvain; Gocke, Martina; Wiesenberg, Guido; Derenne, Sylvie

    2015-04-01

    calcified roots and the surrounding sediment, as also confirmed by 13C NMR analyses. Fresh and calcified roots present similar 13C NMR spectra, showing the good preservation of the root-derived organic matter in carbonated rhizoliths. Altogether, the results allow us to propose a general scenario for the mechanism of plant root encrustation by secondary carbonates in terrestrial sediments.

  13. Carotid Baroreflex Function During Prolonged Exercise

    NASA Technical Reports Server (NTRS)

    Raven, P. B.

    1999-01-01

    Astronauts are often required to work (exercise) at moderate to high intensities for extended periods while performing extra-vehicular activities (EVA). Although the physiologic responses associated with prolonged exercise have been documented, the mechanisms involved in blood pressure regulation under these conditions have not yet been fully elucidated. An understanding of this issue is pertinent to the ability of humans to perform work in microgravity and complies with the emphasis of NASA's Space Physiology and Countermeasures Program. Prolonged exercise at a constant workload is know to result in a progressive decrease in mean arterial pressure (MAP) concomitant with a decrease in stroke volume and a compensatory increase in heart rate. The continuous decrease in MAP during the exercise, which is related to the thermoregulatory redistribution of circulating blood volume to the cutaneous circulation, raises the question as to whether there is a loss of baroreflex regulation of arterial blood pressure. We propose that with prolongation of the exercise to 60 minutes, progressive increases on central command reflect a progressive upward resetting of the carotid baroreflex (CBR) such that the operating point of the CBR is shifted to a pressure below the threshold of the reflex rendering it ineffectual in correcting the downward drift in MAP. In order to test this hypothesis, experiments have been designed to uncouple the global hemodynamic response to prolonged exercise from the central command mediated response via: (1) continuous maintenance of cardiac filling volume by intravenous infusion of a dextran solution; and (2) whole body surface cooling to counteract thermoregulatory cutaneous vasodialation. As the type of work (exercise) performed by astronauts is inherently arm and upper body dependent, we will also examine the physiologic responses to prolonged leg cycling and arm ergometry exercise in the supine positions with and without level lower body negative

  14. Chronic Interactions Between Carotid Baroreceptors and Chemoreceptors in Obesity Hypertension.

    PubMed

    Lohmeier, Thomas E; Iliescu, Radu; Tudorancea, Ionut; Cazan, Radu; Cates, Adam W; Georgakopoulos, Dimitrios; Irwin, Eric D

    2016-07-01

    Carotid bodies play a critical role in protecting against hypoxemia, and their activation increases sympathetic activity, arterial pressure, and ventilation, responses opposed by acute stimulation of the baroreflex. Although chemoreceptor hypersensitivity is associated with sympathetically mediated hypertension, the mechanisms involved and their significance in the pathogenesis of hypertension remain unclear. We investigated the chronic interactions of these reflexes in dogs with sympathetically mediated, obesity-induced hypertension based on the hypothesis that hypoxemia and tonic activation of carotid chemoreceptors may be associated with obesity. After 5 weeks on a high-fat diet, the animals experienced a 35% to 40% weight gain and increases in arterial pressure from 106±3 to 123±3 mm Hg and respiratory rate from 8±1 to 12±1 breaths/min along with hypoxemia (arterial partial pressure of oxygen=81±3 mm Hg) but eucapnia. During 7 days of carotid baroreflex activation by electric stimulation of the carotid sinus, tachypnea was attenuated, and hypertension was abolished before these variables returned to prestimulation values during a recovery period. After subsequent denervation of the carotid sinus region, respiratory rate decreased transiently in association with further sustained reductions in arterial partial pressure of oxygen (to 65±2 mm Hg) and substantial hypercapnia. Moreover, the severity of hypertension was attenuated from 125±2 to 116±3 mm Hg (45%-50% reduction). These findings suggest that hypoxemia may account for sustained stimulation of peripheral chemoreceptors in obesity and that this activation leads to compensatory increases in ventilation and central sympathetic outflow that contributes to neurogenically mediated hypertension. Furthermore, the excitatory effects of chemoreceptor hyperactivity are abolished by chronic activation of the carotid baroreflex. PMID:27160198

  15. Automated landmarking and geometric characterization of the carotid siphon.

    PubMed

    Bogunović, Hrvoje; Pozo, José María; Cárdenes, Rubén; Villa-Uriol, María Cruz; Blanc, Raphaël; Piotin, Michel; Frangi, Alejandro F

    2012-05-01

    The geometry of the carotid siphon has a large variability between subjects, which has prompted its study as a potential geometric risk factor for the onset of vascular pathologies on and off the internal carotid artery (ICA). In this work, we present a methodology for an objective and extensive geometric characterization of carotid siphon parameterized by a set of anatomical landmarks. We introduce a complete and automated characterization pipeline. Starting from the segmentation of vasculature from angiographic image and its centerline extraction, we first identify ICA by characterizing vessel tree bifurcations and training a support vector machine classifier to detect ICA terminal bifurcation. On ICA centerline curve, we detect anatomical landmarks of carotid siphon by modeling it as a sequence of four bends and selecting their centers and interfaces between them. Bends are detected from the trajectory of the curvature vector expressed in the parallel transport frame of the curve. Finally, using the detected landmarks, we characterize the geometry in two complementary ways. First, with a set of local and global geometric features, known to affect hemodynamics. Second, using large deformation diffeomorphic metric curve mapping (LDDMCM) to quantify pairwise shape similarity. We processed 96 images acquired with 3D rotational angiography. ICA identification had a cross-validation success rate of 99%. Automated landmarking was validated by computing limits of agreement with the reference taken to be the locations of the manually placed landmarks averaged across multiple observers. For all but one landmark, either the bias was not statistically significant or the variability was within 50% of the inter-observer one. The subsequently computed values of geometric features and LDDMCM were commensurate to the ones obtained with manual landmarking. The characterization based on pair-wise LDDMCM proved better in classifying the carotid siphon shape classes than the one

  16. The Relationship between Carotid Intima-Media Thickness and Carotid Plaque in the Northern Manhattan Study

    PubMed Central

    Rundek, Tatjana; Gardener, Hannah; Della-Morte, David; Dong, Chuanhui; Cabral, Digna; Tiozzo, Eduardo; Roberts, Eugene; Crisby, Milita; Chueng, Kuen; Demmer, Ryan; Elkind, Mitchell S. V.; Sacco, Ralph L.; Desvarieux, Moise

    2015-01-01

    Objective Carotid intima–media thickness (cIMT) and carotid plaque (CP) are proposed biomarkers of subclinical atherosclerosis associated with stroke risk. Whether cIMT and CP are distinct phenotypes or single traits at different stages of atherosclerotic development is unclear. We explored the relationship between these markers in the population-based Northern Manhattan Study. Methods We used high-resolution ultrasound and validated imaging protocols to study the cross-sectional (N=1,788 stroke-free participants) and prospective relationship (N=768 with follow-up scan; mean years between examinations=3.5) between CP and cIMT measured in plaque-free areas. Results The mean age was 66±9 (40% male, 19% black, 17% white, 61% Hispanic). The mean baseline cIMT was 0.92±0.09mm, 0.94±0.09mm among the 58% with prevalent plaque, 0.90±0.08mm among the 42% without prevalent plaque (p<0.0001). Each 0.1mm increase in baseline cIMT was associated with a 1.72-fold increased odds of plaque presence (95%CI=1.50-1.97), increased plaque thickness (effect on the median=0.46mm, p<0.0001), and increased plaque area (effect on the median=3.45mm2, p<0.0001), adjusting for demographics and vascular risk factors. Elevated baseline cIMT was associated with an increased risk of new plaque in any location at follow-up, but after adjusting for demographics and vascular risk factors this association was no longer present. No association was observed in carotid segment-specific analyses. Conclusion Increased cIMT was associated with baseline prevalent plaque but did not predict incident plaque independent of other vascular risk factors. This finding suggests that increased cIMT is not an independent predictor of plaque development although these atherosclerotic phenotypes often coexist and share some common vascular determinants. PMID:26071659

  17. [Correlation of some biochemical and coagulological parameters in carotid atherosclerosis].

    PubMed

    Akhvlediani, M V; Vorob'eva, E O; Emukhvari, M G; Sharashidze, N A; Kupreishvili, S B

    2009-11-01

    It has been established positive correlation of the degree of stenosis and intima-media thickness of carotid arteries with the following biochemical parameters: total cholesterol, LDL cholesterol, Apo-B, Lp(a), triglycerides, hs-C-reactive protein(CRP), interleukines (IL-1beta and IL-6), fibrinogen, D-dimers. Negative correlation was stated with respect to HDL cholesterol, Apo-A-1, protein C. Relation between the parameters of the blood lipid spectre, proteins and mediators of inflammation as well as those of hemostasis enables us to approach pathophysiological mechanisms of carotid atherosclerosis, define the processes of inflammation and atherosclerosis.

  18. Tissue Characterization on Common Carotid Artery using AR Model

    NASA Astrophysics Data System (ADS)

    Koya, Yoshiharu; Mizoshiri, Isao

    This study uses one image with a echocardiography and detects arteriosclerosis on the common carotid artery by tissue characterization. The conventional methods are measurement of thickness on the vessel wall or stiffness on the common carotid artery. However, they need frames of several beats and great calculation times. But, we detect the arteriosclerosis with only one image. Our method estimate the grade of arteriosclerosis by AR model parameters fitted to the texture on the lumen-intima wall. Experimental results show the validity of the proposed method.

  19. Injury of the peripheral cranial nerves during carotid endarterectomy.

    PubMed

    Theodotou, B; Mahaley, M S

    1985-01-01

    The incidence of local nerve injury among 192 consecutive carotid endarterectomies in 162 patients between 1977-1983 was determined from review of the medical records. Two facial nerve, 5 hypoglossal nerve, and 2 vagus nerve injuries were discovered for a total incidence of 4.7%. Only the 2 facial nerve injuries failed to improve over 2 years. Followup ranged from 1 to 60 months in this group of patients. Careful attention to details of tissue dissection at surgery should lower the incidence of nerve injury during carotid endarterectomy. PMID:4049454

  20. Heuber Maneuver in Evaluation of Direct Carotid-Cavernous Fistula

    PubMed Central

    Rajagopal, Rengarajan; Mehta, Neeraj; Saran, Sonal; Khera, Pushpinder S.

    2016-01-01

    Summary Carotid-cavernous fistulas are abnormal communications between the carotid system and the cavernous sinus. Elevated venous pressure produces congestion in the orbit with resultant transudation of fluid and increased intraocular pressure, thereby leading to secondary glaucoma which may result in visual loss. Immediate treatment is hence, warranted in these cases. The planning of endovascular management is dependent on many parameters, the most important of which are the size and location of the fistula. Since these are high-flow fistulas, assessment requires certain manoeuvers. Heuber manoeuver is one of the manoeuvers used to demonstrate the size of the fistula. PMID:27781074

  1. Aggressive Calcifying Epithelial Odontogenic Tumor of the Maxillary Sinus with Extraosseous Oral Mucosal Involvement: A Case Report

    PubMed Central

    Rani, Vidya; Masthan, Mahaboob Kadar; Aravindha, Babu; Leena, Sankari

    2016-01-01

    Calcifying epithelial odontogenic tumors are benign odontogenic neoplasms whose occurrence in the maxillary sinus is rare. Maxillary tumors tend to be locally aggressive and may rapidly involve the surrounding vital structures. We report a case of a large calcifying epithelial odontogenic tumor of the maxilla, involving the maxillary sinus in a 48-year-old woman. The tumor was largely intraosseous. In the canine and first premolar regions, the loss of bone could be palpated but the oral mucosa appeared normal. Histologically, the tumor tissue could be seen in the connective tissue below the oral epithelium. The most significant finding was the presence of an intraosseous tumor with an extraosseous involvement in a single tumor, indicating aggressive behavior and warranting aggressive treatment. In this article, we discuss the rare presentation of the tumor and its radiological appearance and histological features. We also highlight the importance of a detailed histopathological examination of the excised specimen. PMID:26989286

  2. A cohort study of duplex Doppler examinations of the carotid artery in primary open angle glaucoma

    PubMed Central

    Marmion, Vincent J; Aldoori, Munther I; Woodcock, John P

    2014-01-01

    Objectives To explore the possibility of pathological change in the common carotid artery at the bifurcation and in the internal carotid artery beyond the bifurcation which could contribute to a reduced diastolic pressure as observed in primary open angle glaucoma. Design Duplex ultrasonic examinations of carotid bifurcations were conducted on 80 patients. Carotid artery defects were allocated into three types: no demonstrable flow defects, internal carotid artery abnormalities and disease in the carotid bulb. Setting Bristol Royal Infirmary Vascular Laboratory. Participants Eighty patients (mean age 69.6 years) providing a total of 160 sides to the analysis. Main outcome measures An estimated central retinal artery pressure, intraocular pressure and field loss were recorded for each side measured. Results Doppler investigations revealed significant levels of pathological change in the internal carotid distinct from changes at the carotid bulb. The disease revealed in the internal carotid artery was significantly associated with intraocular pressure (p = 0.032), with an effect small to medium in magnitude. The Q2 measure, derived from mean arterial pressure and intraocular pressure, was also substantively associated with disease in the internal carotid artery. Both intraocular pressure and the Q2 measure effectively discriminated between groups, with field loss providing rather less discriminating capability. There was a strong trend towards a higher intraocular pressures and a greater visual field loss with internal carotid artery disease. Conclusions Pathological changes in the extra cranial carotid artery in primary open angle glaucoma exceed those in the arteries classified as normal. The presence of disease specifically in the internal carotid artery emphasised the need for a mechanism for the evaluation of the internal carotid apart from the carotid bulb. A basis for clarifying the presence of an ischaemic zone is proposed. PMID:25289141

  3. MDCT of right aortic arch with aberrant left subclavian artery associated with kommerell diverticulum and calcified ligamentum arteriosum

    PubMed Central

    Kanza, Rene Epunza; Berube, Michel; Michaud, Pierre

    2013-01-01

    We present a case of the right aortic arch with kommerell diverticulum (KD) and aberrant left subclavian artery in a symptomatic 50-year-old patient with a calcification in the presumed attachment site of the ligamentum arteriosum (LA) to the KD. In another 30-year-old male patient, the entire course of a calcified LA was demonstrated using multidetector row computed tomography. PMID:23671755

  4. Cerebral hemodynamics after contralateral carotid endarterectomy in patients with symptomatic and asymptomatic carotid occlusion: a 10-year follow-up.

    PubMed

    Baracchini, Claudio; Meneghetti, Giorgio; Manara, Renzo; Ermani, Mario; Ballotta, Enzo

    2006-07-01

    We sought to investigate whether carotid endarterectomy (CEA) can achieve long-term cerebral hemodynamic improvement and reduce recurrence of cerebral ischemic events in symptomatic and asymptomatic patients with severe (>70%) carotid artery stenosis contralateral to carotid occlusion (CO). Thirty-nine patients with severe carotid lesion contralateral to CO were studied before (1 day) and after CEA (at 7 days, 1, 3 and 6 months, and then yearly thereafter). Collateral flow and cerebral vasomotor reactivity (VMR) were assessed by transcranial Doppler sonography (TCD). A total of 32 unoperated patients with severe carotid lesion contralateral to CO, who were comparable with respect to age and sex, served as a control group. The average period of TCD follow-up was 10 years and was obtained in all patients; during this period, major clinical events (stroke, acute myocardial infarction and death) were also recorded. The proportion of patients with collateral flow via the anterior communicating artery increased significantly from 61.5% before to 89.7% after CEA (P = 0.01). Cerebral VMR ipsilateral to CO improved in 85.7% of patients (30 of 35) within 30 days of CEA, and in all patients within 90 days. No significant spontaneous VMR recovery was recorded in the control group. After the initial recovery, no significant change in VMR was observed in the surgical group or the control group during the follow-up. In conclusion, in patients with severe carotid stenosis, CEA contralateral to symptomatic and asymptomatic CO determines a durable cerebral hemodynamic improvement not only on the side of the CEA but also on the contralateral side, with no difference between symptomatic and asymptomatic patients.

  5. Eco-physiological adaptation shapes the response of calcifying algae to nutrient limitation

    NASA Astrophysics Data System (ADS)

    Šupraha, Luka; Gerecht, Andrea C.; Probert, Ian; Henderiks, Jorijntje

    2015-11-01

    The steady increase in global ocean temperature will most likely lead to nutrient limitation in the photic zone. This will impact the physiology of marine algae, including the globally important calcifying coccolithophores. Understanding their adaptive patterns is essential for modelling carbon production in a low-nutrient ocean. We investigated the physiology of Helicosphaera carteri, a representative of the abundant but under-investigated flagellated functional group of coccolithophores. Two strains isolated from contrasting nutrient regimes (South Atlantic and Mediterranean Sea) were grown in phosphorus-replete and phosphorus-limited batch cultures. While growing exponentially in a phosphorus-replete medium, the Mediterranean strain exhibited on average 24% lower growth rate, 36% larger coccosphere volume and 21% lower particulate inorganic carbon (PIC) production than the Atlantic strain. Under phosphorus limitation, the same strain was capable of reaching a 2.6 times higher cell density than the Atlantic strain due to lower phosphorus requirements. These results suggest that local physiological adaptation can define the performance of this species under nutrient limitation.

  6. Eco-physiological adaptation shapes the response of calcifying algae to nutrient limitation

    PubMed Central

    Šupraha, Luka; Gerecht, Andrea C.; Probert, Ian; Henderiks, Jorijntje

    2015-01-01

    The steady increase in global ocean temperature will most likely lead to nutrient limitation in the photic zone. This will impact the physiology of marine algae, including the globally important calcifying coccolithophores. Understanding their adaptive patterns is essential for modelling carbon production in a low-nutrient ocean. We investigated the physiology of Helicosphaera carteri, a representative of the abundant but under-investigated flagellated functional group of coccolithophores. Two strains isolated from contrasting nutrient regimes (South Atlantic and Mediterranean Sea) were grown in phosphorus-replete and phosphorus-limited batch cultures. While growing exponentially in a phosphorus-replete medium, the Mediterranean strain exhibited on average 24% lower growth rate, 36% larger coccosphere volume and 21% lower particulate inorganic carbon (PIC) production than the Atlantic strain. Under phosphorus limitation, the same strain was capable of reaching a 2.6 times higher cell density than the Atlantic strain due to lower phosphorus requirements. These results suggest that local physiological adaptation can define the performance of this species under nutrient limitation. PMID:26560531

  7. Calcium carbonate mineralization: involvement of extracellular polymeric materials isolated from calcifying bacteria.

    PubMed

    Ercole, Claudia; Bozzelli, Paola; Altieri, Fabio; Cacchio, Paola; Del Gallo, Maddalena

    2012-08-01

    This study highlights the role of specific outer bacterial structures, such as the glycocalix, in calcium carbonate crystallization in vitro. We describe the formation of calcite crystals by extracellular polymeric materials, such as exopolysaccharides (EPS) and capsular polysaccharides (CPS) isolated from Bacillus firmus and Nocardia calcarea. Organic matrices were isolated from calcifying bacteria grown on synthetic medium--in the presence or absence of calcium ions--and their effect on calcite precipitation was assessed. Scanning electron microscopy observations and energy dispersive X-ray spectrometry analysis showed that CPS and EPS fractions were involved in calcium carbonate precipitation, not only serving as nucleation sites but also through a direct role in crystal formation. The utilization of different synthetic media, with and without addition of calcium ions, influenced the biofilm production and protein profile of extracellular polymeric materials. Proteins of CPS fractions with a molecular mass between 25 and 70 kDa were overexpressed when calcium ions were present in the medium. This higher level of protein synthesis could be related to the active process of bioprecipitation.

  8. Intentional replantation of a mandibular molar with calcified canal: a case report.

    PubMed

    Tang, P M; Chan, C P; Chen, C C; Tsai, A I

    1996-12-01

    Intentional replantation is an accepted endodontic technique for treating teeth in which both conventional and/or surgical endodontic treatments are not recommended. A rare case using intentional replantation technique on one mandibular molar has been successfully treated. This procedure was used owing to inaccessible calcified canal and pain intolerance of the patient. A thirty month post-operative evaluation revealed an asymptomatic, functional tooth with no radiographic signs of pathosis. The favorable results obtained in this case might be attributed to certain factors, such as occlusal adjustment prior to replantation, maintaining asepsis during replantation, no-damaging pressure during extraction, use of noneugenol periodontal packing, preservation of the vitality of the periodontal ligament, a minimal extraoral period, non-rigid splinting, apicoectomy and retrograde amalgam filling were done for hermetic apical seal. Intentional replantation may be limited to those cases when conventional endodontic therapy is not possible, but may be a treatment alternative to maintain the dentition and save an otherwise hopeless tooth.

  9. The Mineral Phase of Calcified Cartilage: Its Molecular Structure and Interface with the Organic Matrix

    PubMed Central

    Duer, Melinda J.; Friščić, Tomislav; Murray, Rachel C.; Reid, David G.; Wise, Erica R.

    2009-01-01

    Abstract We have studied the atomic level structure of mineralized articular cartilage with heteronuclear solid-state NMR, our aims being to identify the inorganic species present at the surfaces of the mineral crystals which may interact with the surrounding organic matrix and to determine which components of the organic matrix are most closely involved with the mineral crystals. One-dimensional 1H and 31P and two-dimensional 1H-31P heteronuclear correlation NMR experiments show that the mineral component is very similar to that in bone with regard to its surface structure. 13C{31P} rotational echo double resonance experiments identify the organic molecules at the mineral surface as glycosaminoglycans, which concurs with our recent finding in bone. There is also evidence of γ-carboxyglutamic acid residues interacting with the mineral. However, other matrix components appear more distant from the mineral compared with bone. This may be due to a larger hydration layer on the mineral crystal surfaces in calcified cartilage. PMID:19383480

  10. Biological Niches within Human Calcified Aortic Valves: Towards Understanding of the Pathological Biomineralization Process

    PubMed Central

    Cottignoli, Valentina; Relucenti, Michela; Agrosì, Giovanna; Cavarretta, Elena; Familiari, Giuseppe; Salvador, Loris; Maras, Adriana

    2015-01-01

    Despite recent advances, mineralization site, its microarchitecture, and composition in calcific heart valve remain poorly understood. A multiscale investigation, using scanning electron microscopy (SEM), transmission electron microscopy (TEM), and energy dispersive X-ray spectrometry (EDS), from micrometre up to nanometre, was conducted on human severely calcified aortic and mitral valves, to provide new insights into calcification process. Our aim was to evaluate the spatial relationship existing between bioapatite crystals, their local growing microenvironment, and the presence of a hierarchical architecture. Here we detected the presence of bioapatite crystals in two different mineralization sites that suggest the action of two different growth processes: a pathological crystallization process that occurs in biological niches and is ascribed to a purely physicochemical process and a matrix-mediated mineralized process in which the extracellular matrix acts as the template for a site-directed nanocrystals nucleation. Different shapes of bioapatite crystallization were observed at micrometer scale in each microenvironment but at the nanoscale level crystals appear to be made up by the same subunits. PMID:26509159

  11. Calcium carbonate mineralization: involvement of extracellular polymeric materials isolated from calcifying bacteria.

    PubMed

    Ercole, Claudia; Bozzelli, Paola; Altieri, Fabio; Cacchio, Paola; Del Gallo, Maddalena

    2012-08-01

    This study highlights the role of specific outer bacterial structures, such as the glycocalix, in calcium carbonate crystallization in vitro. We describe the formation of calcite crystals by extracellular polymeric materials, such as exopolysaccharides (EPS) and capsular polysaccharides (CPS) isolated from Bacillus firmus and Nocardia calcarea. Organic matrices were isolated from calcifying bacteria grown on synthetic medium--in the presence or absence of calcium ions--and their effect on calcite precipitation was assessed. Scanning electron microscopy observations and energy dispersive X-ray spectrometry analysis showed that CPS and EPS fractions were involved in calcium carbonate precipitation, not only serving as nucleation sites but also through a direct role in crystal formation. The utilization of different synthetic media, with and without addition of calcium ions, influenced the biofilm production and protein profile of extracellular polymeric materials. Proteins of CPS fractions with a molecular mass between 25 and 70 kDa were overexpressed when calcium ions were present in the medium. This higher level of protein synthesis could be related to the active process of bioprecipitation. PMID:22697480

  12. Probable calcified metaphytes in the latest Proterozoic Nama Group, Namibia: origin, diagenesis, and implications

    NASA Technical Reports Server (NTRS)

    Grant, S. W.; Knoll, A. H.; Germs, G. J.

    1991-01-01

    Samples from the Huns Limestone Member, Urusis Formation, Nama Group, at two adjacent localities in southern Namibia contain thin foliose to arched, sheet-like carbonate crusts that are 100-500 micrometers thick and up to 5 cm in lateral dimension. Morphologic, petrographic, and geochemical evidence supports the interpretation of these delicate crusts as biogenic, most likely the remains of calcified encrusting metaphytes. The original sediments of the fossiliferous samples contained aragonitic encrusting algae, botryoidal aragonite cements, and an aragonite mud groundmass. Spherulites within the precursor mud could represent bacterially induced mineral growths or the concretions of marine rivularian cyanobacteria. Original textures were severely disrupted during the diagenetic transition of aragonite to low-magnesian calcite, but some primary structures remain discernible as ghosts in the neomorphic mosaic. Gross morphology, original aragonite mineralogy, and hypobasal calcification indicate that the crusts are similar to late Paleozoic phylloid algae and extant peyssonnelid red algae. Structures interpreted as possible conceptacles also suggest possible affinities with the Corallinaceae. Two species of Cloudina, interpreted as the remains of a shelly metazoan, are also known from limestones in the Nama Group. It is possible, therefore, that skeletalization in metaphytes and animals arose nearly simultaneously near the end of the Proterozoic Eon.

  13. Application of a nuclear microprobe to the study of calcified tissues

    NASA Astrophysics Data System (ADS)

    Coote, Graeme E.; Vickridge, Ian C.

    1988-03-01

    The mineral fraction of calcified tissue is largely calcium hydroxyapatite (bones and teeth) or calcium carbonate (shells and fish otoliths). Apatite has such a strong affinity for fluoride ions that the F/Ca ratio can vary markedly with position in a bone or tooth, depending on the amount of fluoride present at the time of calcification or partial recrystallization. New biological information can be obtained by introducing extra fluoride into the diet of an animal and using a microprobe later to scan sections of bones or teeth. In suitable burial sites extra fluoride is introduced after death, and the new distribution may have applications in forensic science and archaeology. Fish otoliths are also of interest since a new carbonate layer is formed each day and the distribution of trace elements may record some aspects of the fish's life history. Results from the following studies are presented: fluorine distributions in the teeth of sheep which ingested extra fluoride for known periods; distributions of calcium and fluorine in femurs of rats which drank water high in fluoride for periods from 2 to 15 weeks; calcium and fluorine distributions in artificially-prepared lesions in tooth enamel; diffusion profiles in archaeological human teeth and animal bones; patterns in the strontium/calcium ratio in sectioned otoliths of several species of fish.

  14. "Unusual brain stone": heavily calcified primary neoplasm with some features suggestive of angiocentric glioma.

    PubMed

    Sajjad, Jahangir; Kaliaperumal, Chandrasekaran; Bermingham, Niamh; Marks, Charles; Keohane, Catherine

    2015-11-01

    This 40-year-old man presented with a 5-month history of progressive right-sided headache associated with visual blurring. He also had a history of epilepsy but had been seizure free with medication for the past 10 years. An initial CT scan of his brain performed 16 years previously had revealed a small area of calcification in the right parietal region. In the current presentation, he had a left-sided homonymous hemianopia but no other neurological deficits. A CT scan of his brain showed a much larger calcified, partly cystic lesion in the right parietal region. Because he was symptomatic, the lesion was excised and the cyst was drained. Histological examination of the excised tissue showed an unusual primary tumor that was difficult to classify but had some features of angiocentric glioma. The heavy calcification, mixed-density cell population, and regions with features of angiocentric glioma were most unusual. The patient remained asymptomatic 5 years after surgery, and follow-up scans did not show recurrence.

  15. Backscattered electron imaging: the role in calcified tissue and implant analysis.

    PubMed

    Bloebaum, R D; Bachus, K N; Boyce, T M

    1990-07-01

    The working distance and tilt studies helped to clarify the influences of specimen variability when the BSE mode is used in calcified tissue research. This work has shown that the BSEPs of cortical bone may be accurately maintained within 2 percent error over a 10 degree range of tilt, or 300 microns working distance variation. If future bone and implant investigators wish to conduct accurate, quantitative mineral microanalysis in bone, then standard grinding and polishing techniques should be adequate if calibration procedures are developed. The BSEP characteristics of the pure metals make them suitable to be used for calibrating the BSE signal. BSE analysis, with correlated biomechanical studies, will lead us to a better understanding of the relationships between structure, function, and mineral content in bone. On-line BSEP analysis techniques will expand our understanding of the mineralization events in bone which are associated with aging, weightlessness, pharmaceutical therapies, and the presence of biomaterials. The future of the BSE imaging technology and the contributions to be made in understanding the histometry, biomechanics and mineral content of bone as well as bone's response to implant materials has just begun to unfold.

  16. Backscattered electron imaging: The role in calcified tissue and implant analysis

    SciTech Connect

    Bloebaum, R.D.; Bachus, K.N.; Boyce, T.M. , Salt Lake City, UT )

    1990-07-01

    The working distance and tilt studies helped to clarify the influences of specimen variability when the BSE mode is used in calcified tissue research. This work has shown that the BSEPs of cortical bone may be accurately maintained within 2 percent error over a 10 degree range of tilt, or 300 microns working distance variation. If future bone and implant investigators wish to conduct accurate, quantitative mineral microanalysis in bone, then standard grinding and polishing techniques should be adequate if calibration procedures are developed. The BSEP characteristics of the pure metals make them suitable to be used for calibrating the BSE signal. BSE analysis, with correlated biomechanical studies, will lead us to a better understanding of the relationships between structure, function, and mineral content in bone. On-line BSEP analysis techniques will expand our understanding of the mineralization events in bone which are associated with aging, weightlessness, pharmaceutical therapies, and the presence of biomaterials. The future of the BSE imaging technology and the contributions to be made in understanding the histometry, biomechanics and mineral content of bone as well as bone's response to implant materials has just begun to unfold. 74 references.

  17. Calcifying odontogenic cyst associated with odontoma: a possible separate entity (odontocalcifying odontogenic cyst).

    PubMed

    Hirshberg, A; Kaplan, I; Buchner, A

    1994-06-01

    The calcifying odontogenic cyst (COC) has been reported to be associated with odontoma in about 24% of cases. Separation of the cases of COC associated with odontoma (COCaO) may lead to a better understanding of the pathogenesis of this lesion. A screen of the literature revealed 52 cases of COCaO. The male to female ratio was 1:1.9, with a mean age of 16 years. The most common location was the maxilla (61.5%). The radiographic appearance of most cases (80.5%) was of a well-defined, mixed radiolucent-radiopaque lesion. Histologically, the lesions usually consisted of a single large cyst (which is similar to simple COC) with tooth-like structures that appear to be an integral part of the lesion, giving the impression of a single lesion. In addition to the unique histologic features, differences in gender and in distribution were found between the cases of COCaO and those of simple COC. COCaO may be regarded as a separate entity and classified as a benign, mixed odontogenic tumor. The term odontocalcifying odontogenic cyst is suggested.

  18. Calcifying coral abundance near low-pH springs: implications for future ocean acidification

    NASA Astrophysics Data System (ADS)

    Crook, E. D.; Potts, D.; Rebolledo-Vieyra, M.; Hernandez, L.; Paytan, A.

    2012-03-01

    Rising atmospheric CO2 and its equilibration with surface ocean seawater is lowering both the pH and carbonate saturation state (Ω) of the oceans. Numerous calcifying organisms, including reef-building corals, may be severely impacted by declining aragonite and calcite saturation, but the fate of coral reef ecosystems in response to ocean acidification remains largely unexplored. Naturally low saturation (Ω ~ 0.5) low pH (6.70-7.30) groundwater has been discharging for millennia at localized submarine springs (called "ojos") at Puerto Morelos, México near the Mesoamerican Reef. This ecosystem provides insights into potential long term responses of coral ecosystems to low saturation conditions. In-situ chemical and biological data indicate that both coral species richness and coral colony size decline with increasing proximity to low-saturation, low-pH waters at the ojo centers. Only three scleractinian coral species ( Porites astreoides, Porites divaricata, and Siderastrea radians) occur in undersaturated waters at all ojos examined. Because these three species are rarely major contributors to Caribbean reef framework, these data may indicate that today's more complex frame-building species may be replaced by smaller, possibly patchy, colonies of only a few species along the Mesoamerican Barrier Reef. The growth of these scleractinian coral species at undersaturated conditions illustrates that the response to ocean acidification is likely to vary across species and environments; thus, our data emphasize the need to better understand the mechanisms of calcification to more accurately predict future impacts of ocean acidification.

  19. Systemic lupus erythematosus with multiple calcified fibrous nodules of the spleen.

    PubMed

    Kitamura, H; Kitamura, H; Ito, T; Kanisawa, M; Kato, K

    1985-01-01

    An autopsy case of systemic lupus erythematosus (SLE) in a 39-year-old woman with peculiar multiple splenic nodules is reported. Multiple calcific nodular shadows were incidentally found in the left hypochondrial region on chest and abdominal X-ray films taken at admission. The patient died of chronic heart failure due to massive pericardial effusion as one of the manifestations of SLE with 2 and a half years' clinical course. Lupus nephritis and terminal miliary tuberculosis were the other conspicuous autopsy findings. The splenic nodules were almost evenly distributed on each cut-surface of the spleen at the density of about 5/cm2. Each nodule was spherical in shape and 1 to 3 mm in diameter. Most of the nodules were calcified in variable degrees. Semi-serial sectionings and reconstruction procedure of the nodules disclosed that they were formed around the central or penicillary arteries and had a close relation to so called "onion-skin lesion" of the spleen in SLE. The true nature, pathogenesis, and relation of the nodules to SLE are discussed. PMID:4003091

  20. Alendronate increases skeletal mass of growing rats during unloading by inhibiting resorption of calcified cartilage

    NASA Technical Reports Server (NTRS)

    Bikle, D. D.; Morey-Holton, E. R.; Doty, S. B.; Currier, P. A.; Tanner, S. J.; Halloran, B. P.

    1994-01-01

    Loss of bone mass during periods of skeletal unloading remains an important clinical problem. To determine the extent to which resorption contributes to the relative loss of bone during skeletal unloading of the growing rat and to explore potential means of preventing such bone loss, 0.1 mg P/kg alendronate was administered to rats before unloading of the hindquarters. Skeletal unloading markedly reduced the normal increase in tibial mass and calcium content during the 9 day period of observation, primarily by decreasing bone formation, although bone resorption was also modestly stimulated. Alendronate not only prevented the relative loss of skeletal mass during unloading but led to a dramatic increase in calcified tissue in the proximal tibia compared with the vehicle-treated unloaded or normally loaded controls. Bone formation, however, assessed both by tetracycline labeling and by [3H]proline and 45Ca incorporation, was suppressed by alendronate treatment and further decreased by skeletal unloading. Total osteoclast number increased in alendronate-treated animals, but values were similar to those in controls when corrected for the increased bone area. However, the osteoclasts had poorly developed brush borders and appeared not to engage the bone surface when examined at the ultrastructural level. We conclude that alendronate prevents the relative loss of mineralized tissue in growing rats subjected to skeletal unloading, but it does so primarily by inhibiting the resorption of the primary and secondary spongiosa, leading to altered bone modeling in the metaphysis.

  1. Secretory pancreatic stone protein messenger RNA. Nucleotide sequence and expression in chronic calcifying pancreatitis.

    PubMed Central

    Giorgi, D; Bernard, J P; Rouquier, S; Iovanna, J; Sarles, H; Dagorn, J C

    1989-01-01

    The pancreatic stone protein and its secretory form (PSP-S) are inhibitors of CaCO3 crystal growth, possibly involved in the stabilization of pancreatic juice. We have established the structure of PSP-S mRNA and monitored its expression in chronic calcifying pancreatitis (CCP). A cDNA encoding pre-PSP-S has been cloned from a human pancreatic cDNA library. Its nucleotide sequence revealed that it comprised all but the 5' end of PSP-S mRNA, which was obtained by sequencing the first exon of the PSP-S gene. The complete mRNA sequence is 775 nucleotides long, including 5'- and 3'- noncoding regions of 80 and 197 nucleotides, respectively, attached to a poly(A) tail of approximately 125 nucleotides. It encodes a preprotein of 166 amino acids, including a prepeptide of 22 amino acids. No overall sequence homology was found between PSP-S and other pancreatic proteins. Some homology with several serine proteases was observed in the COOH-terminal region, however. The mRNA levels of PSP-S, trypsinogen, chymotrypsinogen, and colipase in CCP and control pancreas were compared. PSP-S mRNA was three times lower in CCP than in control, whereas the others were not altered. It was concluded that PSP-S gene expression is specifically reduced in CCP patients. Images PMID:2525567

  2. Eco-physiological adaptation shapes the response of calcifying algae to nutrient limitation.

    PubMed

    Šupraha, Luka; Gerecht, Andrea C; Probert, Ian; Henderiks, Jorijntje

    2015-11-12

    The steady increase in global ocean temperature will most likely lead to nutrient limitation in the photic zone. This will impact the physiology of marine algae, including the globally important calcifying coccolithophores. Understanding their adaptive patterns is essential for modelling carbon production in a low-nutrient ocean. We investigated the physiology of Helicosphaera carteri, a representative of the abundant but under-investigated flagellated functional group of coccolithophores. Two strains isolated from contrasting nutrient regimes (South Atlantic and Mediterranean Sea) were grown in phosphorus-replete and phosphorus-limited batch cultures. While growing exponentially in a phosphorus-replete medium, the Mediterranean strain exhibited on average 24% lower growth rate, 36% larger coccosphere volume and 21% lower particulate inorganic carbon (PIC) production than the Atlantic strain. Under phosphorus limitation, the same strain was capable of reaching a 2.6 times higher cell density than the Atlantic strain due to lower phosphorus requirements. These results suggest that local physiological adaptation can define the performance of this species under nutrient limitation.

  3. Evaluation of the interaction between calcifying nanoparticles and human dental pulp cells: a preliminary investigation.

    PubMed

    Yang, Fang; Zeng, Jinfeng; Zhang, Wei; Sun, Xi; Ling, Junqi

    2011-01-01

    Calcifying nanoparticles (CNPs, previously called nanobacteria) are self-propagating, cultivable macromolecular complexes. Their extraordinary characteristic is that they can aggregate carbonate apatite on their envelope from soluble calcium and phosphorus at physiologic concentrations and display cytotoxic effects on murine and human fibroblast cell lines. The question arises whether CNPs contribute to the degeneration of pulp tissue and thus result in clinically significant human dental pulp stones as nidies. This study evaluates CNPs' effects upon human dental pulp cells (HDPCs, the host cells in pulp tissue). We observed the ultrastructural variation of HDPCs attacked by CNPs. The spatial relationship of HDPCs and CNPs after coculture was also identified by immunofluorescence staining. Furthermore, it was verified by MTT viability assay that CNPs isolated from dental pulp stones exerted cytotoxic effect on HDPCs. Therefore, it could be concluded that the existence of CNPs might interfere with the normal physiologic function of the cells, and that might lead to dental pulp calcification. Elucidation of the cytotoxic characteristics of CNPs may offer a new perspective for understanding the etiology of human dental pulp stones. PMID:21289977

  4. "Unusual brain stone": heavily calcified primary neoplasm with some features suggestive of angiocentric glioma.

    PubMed

    Sajjad, Jahangir; Kaliaperumal, Chandrasekaran; Bermingham, Niamh; Marks, Charles; Keohane, Catherine

    2015-11-01

    This 40-year-old man presented with a 5-month history of progressive right-sided headache associated with visual blurring. He also had a history of epilepsy but had been seizure free with medication for the past 10 years. An initial CT scan of his brain performed 16 years previously had revealed a small area of calcification in the right parietal region. In the current presentation, he had a left-sided homonymous hemianopia but no other neurological deficits. A CT scan of his brain showed a much larger calcified, partly cystic lesion in the right parietal region. Because he was symptomatic, the lesion was excised and the cyst was drained. Histological examination of the excised tissue showed an unusual primary tumor that was difficult to classify but had some features of angiocentric glioma. The heavy calcification, mixed-density cell population, and regions with features of angiocentric glioma were most unusual. The patient remained asymptomatic 5 years after surgery, and follow-up scans did not show recurrence. PMID:26024003

  5. An interesting finding in the uterine cervix: Schistosoma hematobium calcified eggs

    PubMed Central

    Scopin, Ana Carolina; Apfel, Vanessa; Prigenzi, Karla Calaça Kabbach; Tso, Fernanda Kesselring; Focchi, Gustavo Rubino de Azevedo; Speck, Neila; Ribalta, Julisa

    2015-01-01

    Schistosoma hematobium infection is an endemic parasitic disease in Africa, which is frequently associated with urinary schistosomiasis. The parasite infection causes epithelial changes and disruption, facilitating the infection by the human papilloma virus and human immunodeficiency virus (HIV). The authors report the case of a 44-year-old African HIV-positive woman who presented an abnormal routine Pap smear. Colposcopy examination revealed dense acetowhite micropapillary epithelium covering the ectocervix, iodine-negative, an erosion area in endocervical canal, and atypical vessels. Histologic examination of the surgical specimens showed numerous calcified schistosome eggs (probably S. hematobium) and a high-grade cervical intraepithelial neoplasia. The relation between S. hematobium infection and bladder cancer is well known; however, this relationship with cervical cancer remains controversial. The symptoms of schistosomiasis of the female genital tract are rather non-specific, and are often misdiagnosed with other pelvic diseases. The familiarity of health professionals with schistosomiasis of the female genital tract is less than expected, even in endemic regions. Therefore, great awareness of this differential diagnosis in routine gynecological practice is of paramount importance. PMID:26484333

  6. An interesting finding in the uterine cervix: Schistosoma hematobium calcified eggs.

    PubMed

    Toller, Alexia; Scopin, Ana Carolina; Apfel, Vanessa; Prigenzi, Karla Calaça Kabbach; Tso, Fernanda Kesselring; Focchi, Gustavo Rubino de Azevedo; Speck, Neila; Ribalta, Julisa

    2015-01-01

    Schistosoma hematobium infection is an endemic parasitic disease in Africa, which is frequently associated with urinary schistosomiasis. The parasite infection causes epithelial changes and disruption, facilitating the infection by the human papilloma virus and human immunodeficiency virus (HIV). The authors report the case of a 44-year-old African HIV-positive woman who presented an abnormal routine Pap smear. Colposcopy examination revealed dense acetowhite micropapillary epithelium covering the ectocervix, iodine-negative, an erosion area in endocervical canal, and atypical vessels. Histologic examination of the surgical specimens showed numerous calcified schistosome eggs (probably S. hematobium) and a high-grade cervical intraepithelial neoplasia. The relation between S. hematobium infection and bladder cancer is well known; however, this relationship with cervical cancer remains controversial. The symptoms of schistosomiasis of the female genital tract are rather non-specific, and are often misdiagnosed with other pelvic diseases. The familiarity of health professionals with schistosomiasis of the female genital tract is less than expected, even in endemic regions. Therefore, great awareness of this differential diagnosis in routine gynecological practice is of paramount importance.

  7. Mineralization-related modifications in the calcifying tendons of turkey (Meleagris gallopavo).

    PubMed

    Raspanti, Mario; Reguzzoni, Marcella; Protasoni, Marina; Congiu, Terenzio

    2015-04-01

    The tendons of some birds undergo a physiological process of gradual mineralization, usually limited to the central portion of the tendon and resulting in an increase of the elastic modulus and the ultimate strength. The present study was carried out by light microscopy and scanning electron microscopy and was focused on the structural and ultrastructural modifications occurring in this tissue during biomineralization. In comparison with most other tendons, turkey tendons appeared to be more finely subdivided into thinner fascicles and to contain a greater amount of cell-rich endotenon tissue. The most obvious finding, however, was the complete disappearance of the crimps in the calcified portions of the tendon, while they were present with the usual morphology in the non-mineralized portion. The electron microscopy revealed in the mineralized tendon traces of pre-existing crimps, locked in the straightened-out position by the infiltrating mineral phase. This latter was composed of two different types of fine particles, respectively, growing inside and around the collagen fibrils and appearing as tightly packed platelets or as larger, flat platelets regularly arranged in phase with the D-period of collagen. The perifibrillar mineral could play a critical role in the mechanical coupling of adjoining fascicles and in the transmission of tensile loads along the tendon itself.

  8. Increasing Costs Due to Ocean Acidification Drives Phytoplankton to Be More Heavily Calcified: Optimal Growth Strategy of Coccolithophores

    PubMed Central

    Irie, Takahiro; Bessho, Kazuhiro; Findlay, Helen S.; Calosi, Piero

    2010-01-01

    Ocean acidification is potentially one of the greatest threats to marine ecosystems and global carbon cycling. Amongst calcifying organisms, coccolithophores have received special attention because their calcite precipitation plays a significant role in alkalinity flux to the deep ocean (i.e., inorganic carbon pump). Currently, empirical effort is devoted to evaluating the plastic responses to acidification, but evolutionary considerations are missing from this approach. We thus constructed an optimality model to evaluate the evolutionary response of coccolithophorid life history, assuming that their exoskeleton (coccolith) serves to reduce the instantaneous mortality rates. Our model predicted that natural selection favors constructing more heavily calcified exoskeleton in response to increased acidification-driven costs. This counter-intuitive response occurs because the fitness benefit of choosing a better-defended, slower growth strategy in more acidic conditions, outweighs that of accelerating the cell cycle, as this occurs by producing less calcified exoskeleton. Contrary to the widely held belief, the evolutionarily optimized population can precipitate larger amounts of CaCO3 during the bloom in more acidified seawater, depending on parameter values. These findings suggest that ocean acidification may enhance the calcification rates of marine organisms as an adaptive response, possibly accompanied by higher carbon fixation ability. Our theory also provides a compelling explanation for the multispecific fossil time-series record from ∼200 years ago to present, in which mean coccolith size has increased along with rising atmospheric CO2 concentration. PMID:20976167

  9. Diurnal fluctuations in seawater pH influence the response of a calcifying macroalga to ocean acidification.

    PubMed

    Cornwall, Christopher E; Hepburn, Christopher D; McGraw, Christina M; Currie, Kim I; Pilditch, Conrad A; Hunter, Keith A; Boyd, Philip W; Hurd, Catriona L

    2013-12-01

    Coastal ecosystems that are characterized by kelp forests encounter daily pH fluctuations, driven by photosynthesis and respiration, which are larger than pH changes owing to ocean acidification (OA) projected for surface ocean waters by 2100. We investigated whether mimicry of biologically mediated diurnal shifts in pH-based for the first time on pH time-series measurements within a kelp forest-would offset or amplify the negative effects of OA on calcifiers. In a 40-day laboratory experiment, the calcifying coralline macroalga, Arthrocardia corymbosa, was exposed to two mean pH treatments (8.05 or 7.65). For each mean, two experimental pH manipulations were applied. In one treatment, pH was held constant. In the second treatment, pH was manipulated around the mean (as a step-function), 0.4 pH units higher during daylight and 0.4 units lower during darkness to approximate diurnal fluctuations in a kelp forest. In all cases, growth rates were lower at a reduced mean pH, and fluctuations in pH acted additively to further reduce growth. Photosynthesis, recruitment and elemental composition did not change with pH, but δ(13)C increased at lower mean pH. Including environmental heterogeneity in experimental design will assist with a more accurate assessment of the responses of calcifiers to OA.

  10. Calcifying tendinitis of the shoulder: arthroscopic needling versus complete calcium removal and rotator cuff repair. A prospective comparative study

    PubMed Central

    CASTAGNA, ALESSANDRO; DE GIORGI, SILVANA; GAROFALO, RAFFAELE; CONTI, MARCO; TAFURI, SILVIO; MORETTI, BIAGIO

    2015-01-01

    Purpose the aim of the present study was to verify the differences in the clinical outcomes of two arthroscopic techniques used to treat calcifying tendinitis of the shoulder: needling versus complete removal of the calcium deposit and tendon repair. Methods from September 2010 to September 2012, 40 patients with calcifying tendinitis of the rotator cuff were arthroscopically treated by the same surgeon using one of the two following techniques: needling (Group 1) and complete removal of the calcium deposit and tendon repair with suture anchors (Group 2). Both groups followed the same rehabilitation program. The two groups were compared at 6 and 12 months of follow-up for the presence of residual calcifications and for the following clinical outcomes: Constant score, American Shoulder and Elbow Surgeons Evaluation Form (ASES) shoulder score, University of California Los Angeles (UCLA) shoulder rating scale, Simple Shoulder Test (SST) and Visual Analogue Scale (VAS). Results all the clinical scores (Constant, ASES, UCLA, SST and VAS scores) improved significantly between baseline and postoperative follow-up, both at 6 and at 12 months. No differences at final follow-up were found between the two groups. Conclusions both the techniques were effective in solving the symptoms of calcifying tendinitis of the shoulder. Clinical scores improved in both groups. Residual calcifications were found in only a few cases and were always less than 10 mm. Level of evidence Level II, prospective comparative study. PMID:26904521

  11. Effects of incomplete stent apposition on the changes in hemodynamics inside a curved and calcified coronary artery

    NASA Astrophysics Data System (ADS)

    Poon, Eric; Ooi, Andrew; Barlis, Peter; Hayat, Umair; Moore, Stephen

    2014-11-01

    Percutaneous coronary intervention (PCI) is the modern gold standard for treatment of coronary artery disease. Stenting (a common PCI procedure) of simple lesion inside a relatively straight segment of coronary artery has proven to be highly successful. However, incomplete stent apposition (ISA) where there is a lack of contact between the stent struts and lumen wall is not uncommon in curved and calcified coronary arteries. Computational fluid dynamics simulations are carried out to study the changes in hemodynamics as a result of ISA inside a curved and calcified coronary artery. For a 3 mm coronary artery, we simulate a resting condition at 80 mL/min and a range of hyperemic conditions with coronary flow reserve in between 1 and 2. The heartbeat is fixed at 75 BPM. Five different curvatures of the coronary artery are considered. Negative effects on hemodynamic variables, such as low wall shear stress (<0.5 Pa); high wall shear stress gradient (>5,000 Pa/m) and oscillation shear index (0 <= OSI <= 0.5), are employed to identify locations with high possibilities of adverse clinical events. This study will lead to better understandings of ISA in curved and calcified coronary arteries and help improve future coronary stent deployment. Supported by the Australian Research Council (LP120100233) and Victorian Life Sciences Computation Initiative (VR0210).

  12. CO₂ and inorganic nutrient enrichment affect the performance of a calcifying green alga and its noncalcifying epiphyte.

    PubMed

    Hofmann, Laurie C; Bischof, Kai; Baggini, Cecilia; Johnson, Andrew; Koop-Jakobsen, Ketil; Teichberg, Mirta

    2015-04-01

    Ocean acidification studies in the past decade have greatly improved our knowledge of how calcifying organisms respond to increased surface ocean CO2 levels. It has become evident that, for many organisms, nutrient availability is an important factor that influences their physiological responses and competitive interactions with other species. Therefore, we tested how simulated ocean acidification and eutrophication (nitrate and phosphate enrichment) interact to affect the physiology and ecology of a calcifying chlorophyte macroalga (Halimeda opuntia (L.) J.V. Lamouroux) and its common noncalcifying epiphyte (Dictyota sp.) in a 4-week fully crossed multifactorial experiment. Inorganic nutrient enrichment (+NP) had a strong influence on all responses measured with the exception of net calcification. Elevated CO2 alone significantly decreased electron transport rates of the photosynthetic apparatus and resulted in phosphorus limitation in both species, but had no effect on oxygen production or respiration. The combination of CO2 and +NP significantly increased electron transport rates in both species. While +NP alone stimulated H. opuntia growth rates, Dictyota growth was significantly stimulated by nutrient enrichment only at elevated CO2, which led to the highest biomass ratios of Dictyota to Halimeda. Our results suggest that inorganic nutrient enrichment alone stimulates several aspects of H. opuntia physiology, but nutrient enrichment at a CO2 concentration predicted for the end of the century benefits Dictyota sp. and hinders its calcifying basibiont H. opuntia. PMID:25648647

  13. Diurnal fluctuations in seawater pH influence the response of a calcifying macroalga to ocean acidification.

    PubMed

    Cornwall, Christopher E; Hepburn, Christopher D; McGraw, Christina M; Currie, Kim I; Pilditch, Conrad A; Hunter, Keith A; Boyd, Philip W; Hurd, Catriona L

    2013-12-01

    Coastal ecosystems that are characterized by kelp forests encounter daily pH fluctuations, driven by photosynthesis and respiration, which are larger than pH changes owing to ocean acidification (OA) projected for surface ocean waters by 2100. We investigated whether mimicry of biologically mediated diurnal shifts in pH-based for the first time on pH time-series measurements within a kelp forest-would offset or amplify the negative effects of OA on calcifiers. In a 40-day laboratory experiment, the calcifying coralline macroalga, Arthrocardia corymbosa, was exposed to two mean pH treatments (8.05 or 7.65). For each mean, two experimental pH manipulations were applied. In one treatment, pH was held constant. In the second treatment, pH was manipulated around the mean (as a step-function), 0.4 pH units higher during daylight and 0.4 units lower during darkness to approximate diurnal fluctuations in a kelp forest. In all cases, growth rates were lower at a reduced mean pH, and fluctuations in pH acted additively to further reduce growth. Photosynthesis, recruitment and elemental composition did not change with pH, but δ(13)C increased at lower mean pH. Including environmental heterogeneity in experimental design will assist with a more accurate assessment of the responses of calcifiers to OA. PMID:24107535

  14. Diurnal fluctuations in seawater pH influence the response of a calcifying macroalga to ocean acidification

    PubMed Central

    Cornwall, Christopher E.; Hepburn, Christopher D.; McGraw, Christina M.; Currie, Kim I.; Pilditch, Conrad A.; Hunter, Keith A.; Boyd, Philip W.; Hurd, Catriona L.

    2013-01-01

    Coastal ecosystems that are characterized by kelp forests encounter daily pH fluctuations, driven by photosynthesis and respiration, which are larger than pH changes owing to ocean acidification (OA) projected for surface ocean waters by 2100. We investigated whether mimicry of biologically mediated diurnal shifts in pH—based for the first time on pH time-series measurements within a kelp forest—would offset or amplify the negative effects of OA on calcifiers. In a 40-day laboratory experiment, the calcifying coralline macroalga, Arthrocardia corymbosa, was exposed to two mean pH treatments (8.05 or 7.65). For each mean, two experimental pH manipulations were applied. In one treatment, pH was held constant. In the second treatment, pH was manipulated around the mean (as a step-function), 0.4 pH units higher during daylight and 0.4 units lower during darkness to approximate diurnal fluctuations in a kelp forest. In all cases, growth rates were lower at a reduced mean pH, and fluctuations in pH acted additively to further reduce growth. Photosynthesis, recruitment and elemental composition did not change with pH, but δ13C increased at lower mean pH. Including environmental heterogeneity in experimental design will assist with a more accurate assessment of the responses of calcifiers to OA. PMID:24107535

  15. Treatment of a ballistic wound of the common carotid artery revealed by a spontaneous carotid-jugular fistula.

    PubMed

    Mlynski, Amélie; Mocellin, Nicolas; Imperato, Marc; Molimard, Benoît; Bordier, Emmanuel; Menguy, Paul; Baranger, Bernard

    2011-02-01

    The case reported is of a 30-year-old patient with a left internal carotid-jugular fistula secondary to the explosion of an improvised explosive device during the Afghan war. Carotid resection with arterial bypass using a venous allograft and internal jugular ligation were performed by left cervicotomy associated with sternotomy at a specialized center. The management of cervical arteriovenous fistulas that occur as a result of penetrating trauma faced during the war must be considered and it should be noted that, on battlefields, treatment is not always performed in specialized units. PMID:21183314

  16. Wavelet-based neural network analysis of internal carotid arterial Doppler signals.

    PubMed

    Ubeyli, Elif Derya; Güler, Inan

    2006-06-01

    In this study, internal carotid arterial Doppler signals recorded from 130 subjects, where 45 of them suffered from internal carotid artery stenosis, 44 of them suffered from internal carotid artery occlusion and the rest of them were healthy subjects, were classified using wavelet-based neural network. Wavelet-based neural network model, employing the multilayer perceptron, was used for analysis of the internal carotid arterial Doppler signals. Multi-layer perceptron neural network (MLPNN) trained with the Levenberg-Marquardt algorithm was used to detect stenosis and occlusion in internal carotid arteries. In order to determine the MLPNN inputs, spectral analysis of the internal carotid arterial Doppler signals was performed using wavelet transform (WT). The MLPNN was trained, cross validated, and tested with training, cross validation, and testing sets, respectively. All these data sets were obtained from internal carotid arteries of healthy subjects, subjects suffering from internal carotid artery stenosis and occlusion. The correct classification rate was 96% for healthy subjects, 96.15% for subjects having internal carotid artery stenosis and 96.30% for subjects having internal carotid artery occlusion. The classification results showed that the MLPNN trained with the Levenberg-Marquardt algorithm was effective to detect internal carotid artery stenosis and occlusion. PMID:16848135

  17. Reflections by contrarians on the post-CREST evaluation of carotid stenting for stroke prevention.

    PubMed

    Barnett, Henry J M; Pelz, David M; Lownie, Stephen P

    2010-12-01

    Carotid angioplasty and stenting has become a popular alternative to carotid endarterectomy for the treatment of carotid stenosis in stroke. Evidence from early randomized controlled trials comparing these interventions revealed mixed results. The largest such trial, the Carotid Revascularization Endarterectomy vs. Stenting Trial recently showed equivalence of the procedures in a mixed cohort of both symptomatic and asymptomatic patients. These results have been heralded in North America as definitively demonstrating the safety and efficacy of carotid angioplasty and stenting, making it an attractive alternative to carotid endarterectomy. It is therefore probable that many more asymptomatic patients will be subjected to Carotid angioplasty and stenting, perceived by many to be less invasive than carotid endarterectomy. The authors argue that the design of Carotid Revascularization Endarterectomy vs. Stenting Trial was flawed by the mixture of two dissimilar patient groups, thus violating the principle of ceteris paribus, essential for the validity of a randomized controlled trials. The evidence for any invasive treatment of asymptomatic carotid disease is weak, with recent data favouring purely medical management. The authors believe that carotid angioplasty and stenting in asymptomatic patients should cease until better evidence is available. PMID:21050401

  18. Cranial nerve palsies in spontaneous carotid artery dissection.

    PubMed Central

    Sturzenegger, M; Huber, P

    1993-01-01

    Two patients had isolated unilateral cranial nerve palsies due to spontaneous internal carotid artery (ICA) dissection without ischaemic cerebral involvement. One had acute glossopharyngeal and vagal, the other isolated hypoglossal nerve palsy. Reviewing all reported cases of angiographically confirmed ICA dissection in the literature, 36 additional cases with unequivocal ipsilateral cranial nerve palsies were analysed. While an isolated palsy of the IXth and Xth has not been reported previously, palsies of the XIIth nerve or the IXth to XIIth nerves were most frequently found. In these patients, lower cranial nerve palsies are probably the result of compression by an enlarging ICA due to mural haematoma. Symptoms and signs indicative of carotid dissection were concurrently present only in some reported cases. This raises the question of unrecognised carotid dissection as a cause of isolated cranial nerve palsies. When the dissection occurs in the subadventitial layer without relevant narrowing of the arterial lumen and when an aneurysm is thrombosed, angiography does not reliably yield the diagnosis. Therefore, carotid dissection might have been underestimated as a cause of isolated lower cranial nerve palsies before the advent of MRI. MRI demonstrates directly the extension of the wall haematoma in the axial and longitudinal planes. Some arteriopathies such as fibromuscular dysplasia and tortuosity make a vessel predisposed to dissection. Images PMID:8229030

  19. A Parallel Lattice Boltzmann Model of a Carotid Artery

    NASA Astrophysics Data System (ADS)

    Boyd, J.; Ryan, S. J.; Buick, J. M.

    2008-11-01

    A parallel implementation of the lattice Boltzmann model is considered for a three dimensional model of the carotid artery. The computational method and its parallel implementation are described. The performance of the parallel implementation on a Beowulf cluster is presented, as are preliminary hemodynamic results.

  20. Acute Carotid Artery Stent Thrombosis Due to Dual Antiplatelet Resistance

    SciTech Connect

    Köklü, Erkan Arslan, Şakir; Yüksel, İsa Öner; Bayar, Nermin; Koç, Pınar

    2015-08-15

    Carotid artery stenting (CAS) is a revascularization modality that is an alternative to carotid endarterectomy. The efficacy of CAS in primary and secondary prevention from ischemic stroke has been demonstrated in various trials. Acute thrombosis of CAS is a rare complication that can lead to dramatic and catastrophic consequences. We discuss a case of acute CAS thrombosis in a patient who had previously undergone successful CAS. CAS was performed in a 73-year-old man who had had dysarthria lasting 2 weeks with 95 % stenosis in his left internal carotid artery. An acute cerebrovascular event resulting in right-sided hemiplegia developed 24 h after the procedure. Computed tomographic carotid angiography revealed complete occlusion of the stent with thrombus. The cause of stent thrombosis was thought to be antiaggregant resistance to both acetylsalicylic acid and clopidogrel. The most important cause of acute CAS thrombosis is inadequate or ineffective antiaggregant therapy. Evaluating patients who are candidates for CAS for acetylsalicylic acid and clopidogrel resistance may preclude this complication.

  1. [Revascularization of the carotid and vertebral arteries in the elderly].

    PubMed

    Illuminati, G; Bezzi, M; D'Urso, A; Giacobbi, D; Ceccanei, G; Vietri, F

    2004-01-01

    From January 1994 to July 2004, 323 patients underwent 348 revascularization of carotid bifurcation for atherosclerotic stenoses. Eighty eight patients (group A) were 75 year-old or older, whereas 235 (group B) were younger than 75 years. Postoperative mortality/neurologic morbidity rate was 1% in group A, and 1.4% in group B. At 5 years, patency and freedom from symptoms/stroke were, respectively, 91% and 92% in group A, and 89% and 91% in group B. None of these differences was statistically significant. In the same time period, 26 internal carotid arteries were revascularized in 24 patients, 75 or more aged, for a symptomatic kinking. Postoperative mortality/morbidity rate was absent, whereas, at 5 years, patency and freedom from symptoms/stroke were, respectively, 88% and 92%. Twelve vertebral arteries were revascularized in 12 patients, 75 or more aged, for invalidating symptoms of vertebrobasilar insufficiency. Postoperative mortality/neurologic morbidity rate was absent. In one case postoperative recurrence of symptoms occurred, despite a patent revascularization. Patency and freedom from symptoms/stroke were 84% and 75%, at 5 years. Revascularization of carotid and vertebral arteries in the elderly can be accomplished with good results, superposable to those of standard revascularization of carotid bifurcation in a younger patients' population.

  2. Aortic Baroreceptors Display Higher Mechanosensitivity than Carotid Baroreceptors

    PubMed Central

    Lau, Eva On-Chai; Lo, Chun-Yin; Yao, Yifei; Mak, Arthur Fuk-Tat; Jiang, Liwen; Huang, Yu; Yao, Xiaoqiang

    2016-01-01

    Arterial baroreceptors are mechanical sensors that detect blood pressure changes. It has long been suggested that the two arterial baroreceptors, aortic and carotid baroreceptors, have different pressure sensitivities. However, there is no consensus as to which of the arterial baroreceptors are more sensitive to changes in blood pressure. In the present study, we employed independent methods to compare the pressure sensitivity of the two arterial baroreceptors. Firstly, pressure-activated action potential firing was measured by whole-cell current clamp with a high-speed pressure clamp system in primary cultured baroreceptor neurons. The results show that aortic depressor neurons possessed a higher percentage of mechano-sensitive neurons. Furthermore, aortic baroreceptor neurons show a lower pressure threshold than that of carotid baroreceptor neurons. Secondly, uniaxial stretching of baroreceptor neurons, that mimics the forces exerted on blood vessels, elicited a larger increase in intracellular Ca2+ rise in aortic baroreceptor neurons than in carotid baroreceptor neurons. Thirdly, the pressure-induced action potential firing in the aortic depressor nerve recorded in vivo was also higher. The present study therefore provides for a basic physiological understanding on the pressure sensitivity of the two baroreceptor neurons and suggests that aortic baroreceptors have a higher pressure sensitivity than carotid baroreceptors. PMID:27630578

  3. Aortic Baroreceptors Display Higher Mechanosensitivity than Carotid Baroreceptors.

    PubMed

    Lau, Eva On-Chai; Lo, Chun-Yin; Yao, Yifei; Mak, Arthur Fuk-Tat; Jiang, Liwen; Huang, Yu; Yao, Xiaoqiang

    2016-01-01

    Arterial baroreceptors are mechanical sensors that detect blood pressure changes. It has long been suggested that the two arterial baroreceptors, aortic and carotid baroreceptors, have different pressure sensitivities. However, there is no consensus as to which of the arterial baroreceptors are more sensitive to changes in blood pressure. In the present study, we employed independent methods to compare the pressure sensitivity of the two arterial baroreceptors. Firstly, pressure-activated action potential firing was measured by whole-cell current clamp with a high-speed pressure clamp system in primary cultured baroreceptor neurons. The results show that aortic depressor neurons possessed a higher percentage of mechano-sensitive neurons. Furthermore, aortic baroreceptor neurons show a lower pressure threshold than that of carotid baroreceptor neurons. Secondly, uniaxial stretching of baroreceptor neurons, that mimics the forces exerted on blood vessels, elicited a larger increase in intracellular Ca(2+) rise in aortic baroreceptor neurons than in carotid baroreceptor neurons. Thirdly, the pressure-induced action potential firing in the aortic depressor nerve recorded in vivo was also higher. The present study therefore provides for a basic physiological understanding on the pressure sensitivity of the two baroreceptor neurons and suggests that aortic baroreceptors have a higher pressure sensitivity than carotid baroreceptors. PMID:27630578

  4. Factor analytic reduction of the carotid-cardiac baroreflex parameters

    NASA Technical Reports Server (NTRS)

    Ludwig, David A.

    1989-01-01

    An accepted method for measuring the responsiveness of the carotid-cardiac baroreflex to arterial pressure changes is to artificially stimulate the baroreceptors in the neck. This is accomplished by using a pressurized neck cuff which constricts and distends the carotid artery and subsequently stimulates the baroreceptors. Nine physiological responses to this type of stimulation are quantified and used as indicators of the baroreflex. Thirty male humans between the ages 27 and 46 underwent the carotid-cardiac baroreflex test. The data for the nine response parameters were analyzed by principle component factor analysis. The results of this analysis indicated that 93 percent of the total variance across all nine parameters could be explained in four dimensions. Examination of the factor loadings following an orthogonal rotation of the principle components indicated four well defined dimensions. The first two dimensions reflected location points for R-R interval and carotid distending pressure respectively. The third dimension was composed of measures reflecting the gain of the reflex. The fourth dimension was the ratio of the resting R-R interval to R-R interval during simulated hypertension. The data suggests that the analysis of all nine baroreflex parameters is redundant.

  5. Unusual presentation of traumatic extracranial internal carotid artery aneurysm.

    PubMed

    Bradbury, P G; Lambert, C D

    1978-07-01

    A young man presented with apparent transient ischemic attacks following a motorcycle accident in which he sustained minor injuries only. Computerized axial tomography demonstrated a small right frontal infarct, and angiography revealed an aneurysm of the right internal carotid artery in its extracranial course. This was thought to be traumatic in origin.

  6. Differential modulation by extracellular ATP of carotid chemosensory responses.

    PubMed

    Spergel, D; Lahiri, S

    1993-06-01

    The possibility that the carotid body has ATP surface receptors that mediate O2 chemoreception was tested. To distinguish between the event(s) initiating chemoreception and those at the neurotransmitter level, we also tested the chemosensory response to nicotine before and after ATP administration. Carotid bodies from cats anesthetized with pentobarbital sodium were perfused and superfused in vitro with modified Tyrode solution (PCO2 < 1 Torr, pH 7.4, 36 degrees C) equilibrated at PO2 > 400 or approximately 150 Torr while chemosensory discharge was recorded extracellularly. ATP and adenosine 5'-[gamma-thio]triphosphate stimulated discharge with similar dose dependence, whereas adenosine had little effect. ATP infusion for > or = 2 min evoked an initial stimulation of discharge followed by a decline to baseline (desensitization). Desensitization did not affect the response to hypoxia (perfusate flow interruption) but inhibited the response to nicotine (4-nmol pulse). Therefore, 1) the carotid body has surface ATP receptors that may mediate the chemosensory response to nicotine but not to hypoxia and 2) nicotinic receptors are not required for carotid body O2 chemoreception. PMID:8366007

  7. Aortic Baroreceptors Display Higher Mechanosensitivity than Carotid Baroreceptors

    PubMed Central

    Lau, Eva On-Chai; Lo, Chun-Yin; Yao, Yifei; Mak, Arthur Fuk-Tat; Jiang, Liwen; Huang, Yu; Yao, Xiaoqiang

    2016-01-01

    Arterial baroreceptors are mechanical sensors that detect blood pressure changes. It has long been suggested that the two arterial baroreceptors, aortic and carotid baroreceptors, have different pressure sensitivities. However, there is no consensus as to which of the arterial baroreceptors are more sensitive to changes in blood pressure. In the present study, we employed independent methods to compare the pressure sensitivity of the two arterial baroreceptors. Firstly, pressure-activated action potential firing was measured by whole-cell current clamp with a high-speed pressure clamp system in primary cultured baroreceptor neurons. The results show that aortic depressor neurons possessed a higher percentage of mechano-sensitive neurons. Furthermore, aortic baroreceptor neurons show a lower pressure threshold than that of carotid baroreceptor neurons. Secondly, uniaxial stretching of baroreceptor neurons, that mimics the forces exerted on blood vessels, elicited a larger increase in intracellular Ca2+ rise in aortic baroreceptor neurons than in carotid baroreceptor neurons. Thirdly, the pressure-induced action potential firing in the aortic depressor nerve recorded in vivo was also higher. The present study therefore provides for a basic physiological understanding on the pressure sensitivity of the two baroreceptor neurons and suggests that aortic baroreceptors have a higher pressure sensitivity than carotid baroreceptors.

  8. Outcome After Surgical Treatment of Paraclinoid Carotid Aneurysms.

    PubMed

    Pasqualin, Alberto; Meneghelli, Pietro; Cozzi, Francesco; Chioffi, Franco

    2016-01-01

    Surgery on paraclinoid carotid aneurysms is technically demanding and entails considerable risks, especially to visual function. The aim of this study was to evaluate the clinical and visual outcome after surgery in 66 patients with paraclinoid carotid aneurysms (30 ruptured and 36 unruptured) treated between 1990 and 2014. Thirty-six aneurysms were of standard size, and 30 were large (16-20 mm) or giant (>20 mm); the Barami classification was used in every case. During surgery, multiple clips were needed in 25 % of patients with standard, and in 80 % of patients with large-giant aneurysms; temporary carotid occlusion was performed on 11 % of patients with standard and 63 % with large-giant aneurysms. Postoperatively, a cerebrospinal fluid fistula was repaired surgically in two patients. At the 3-month follow-up, the modified Rankin Score (mRS) was favorable (0-2) in 63 % of patients with ruptured and in 97 % with unruptured aneurysms; four patients presenting with large hematomas died. Postoperative visual impairment (worsening or newly developing deficit) was noted in 25 % of cases with standard and 14 % of cases with large-giant ruptured aneurysms, and, respectively, in 10 % with standard and 31 % with large-giant unruptured aneurysms. It has been concluded that surgery remains a reasonable choice in the management of patients with paraclinoid carotid aneurysms. PMID:27637626

  9. [Revascularization of the carotid and vertebral arteries in the elderly].

    PubMed

    Illuminati, G; Bezzi, M; D'Urso, A; Giacobbi, D; Ceccanei, G; Vietri, F

    2004-01-01

    From January 1994 to July 2004, 323 patients underwent 348 revascularization of carotid bifurcation for atherosclerotic stenoses. Eighty eight patients (group A) were 75 year-old or older, whereas 235 (group B) were younger than 75 years. Postoperative mortality/neurologic morbidity rate was 1% in group A, and 1.4% in group B. At 5 years, patency and freedom from symptoms/stroke were, respectively, 91% and 92% in group A, and 89% and 91% in group B. None of these differences was statistically significant. In the same time period, 26 internal carotid arteries were revascularized in 24 patients, 75 or more aged, for a symptomatic kinking. Postoperative mortality/morbidity rate was absent, whereas, at 5 years, patency and freedom from symptoms/stroke were, respectively, 88% and 92%. Twelve vertebral arteries were revascularized in 12 patients, 75 or more aged, for invalidating symptoms of vertebrobasilar insufficiency. Postoperative mortality/neurologic morbidity rate was absent. In one case postoperative recurrence of symptoms occurred, despite a patent revascularization. Patency and freedom from symptoms/stroke were 84% and 75%, at 5 years. Revascularization of carotid and vertebral arteries in the elderly can be accomplished with good results, superposable to those of standard revascularization of carotid bifurcation in a younger patients' population. PMID:15803810

  10. Design of the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST)

    PubMed Central

    Sheffet, Alice J.; Roubin, Gary; Howard, George; Howard, Virginia; Moore, Wesley; Meschia, James F.; Hobson, Robert W.; Brott, Thomas G.

    2009-01-01

    Rationale Carotid endarterectomy (CEA) and medical therapy were shown superior to medical therapy alone for symptomatic (≥50%) and asymptomatic (≥60%) stenosis. Carotid angioplasty stenting (CAS) offers a less invasive alternative. Establishing safety, efficacy, and durability of CAS requires rigorous comparison with CEA in symptomatic and asymptomatic patients. Aims The objective is to compare the efficacy of CAS versus CEA in patients with symptomatic (≥50%) or asymptomatic (≥60%) extracranial carotid stenosis. Design The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) is a prospective, randomized, parallel, two-arm, multi-center trial with blinded endpoint adjudication. Primary endpoints are analyzed using standard time-to-event statistical modeling with adjustment for major baseline covariates. Primary analysis is on an intent-to-treat basis. Study Outcomes The primary outcome is the occurrence of any stroke, myocardial infarction, or death during a 30-day peri-procedural period, and ipsilateral stroke during follow-up of up to four years. Secondary outcomes include restenosis and health-related quality of life. PMID:20088993

  11. Improvement in Cerebral and Ocular Hemodynamics Early after Carotid Endarterectomy in Patients of Severe Carotid Artery Stenosis with or without Contralateral Carotid Occlusion.

    PubMed

    Wang, Jian; Wang, Weici; Jin, Bi; Zhang, Yanrong; Xu, Ping; Xiang, Feixiang; Zheng, Yi; Chen, Juan; Sheng, Shi; Ouyang, Chenxi; Li, Yiqing

    2016-01-01

    Purpose. To investigate the alternation in cerebral and ocular blood flow velocity (BFV) in patients of carotid stenosis (CS) with or without contralateral carotid occlusion (CO) early after carotid endarterectomy (CEA). Patients and Methods. Nineteen patients underwent CEA for ≥50% CS. Fourteen patients had the unilateral CS, and five patients had the ipsilateral CS and the contralateral CO. Transcranial Doppler (TCD) and Color Doppler Imaging (CDI) were performed before and early after CEA. Results. In patients with unilateral CS, significant improvements in BFV were observed in anterior cerebral artery (ACA) and middle cerebral artery (MCA) on the ipsilateral side after CEA. In patients of ipsilateral CS and contralateral CO, significant improvements in BFV were observed in the ACA and MCA not only on the ipsilateral side but also on the contralateral side postoperatively. The ipsilateral ophthalmic artery (OA) retrograde flows in two patients were recovered to anterograde direction following CEA. The BFV in short posterior ciliary artery (SPCA) of the ipsilateral side significantly increased postoperatively irrespective of the presence of contralateral CO. Conclusions. CEA improved cerebral anterior circulation hemodynamics especially in patients of unilateral CS and contralateral CO, normalized the OA reverse flow, and increased the blood perfusion of SPCA. PMID:27642593

  12. Improvement in Cerebral and Ocular Hemodynamics Early after Carotid Endarterectomy in Patients of Severe Carotid Artery Stenosis with or without Contralateral Carotid Occlusion

    PubMed Central

    Wang, Jian; Wang, Weici; Jin, Bi; Zhang, Yanrong; Xu, Ping; Xiang, Feixiang; Zheng, Yi; Chen, Juan

    2016-01-01

    Purpose. To investigate the alternation in cerebral and ocular blood flow velocity (BFV) in patients of carotid stenosis (CS) with or without contralateral carotid occlusion (CO) early after carotid endarterectomy (CEA). Patients and Methods. Nineteen patients underwent CEA for ≥50% CS. Fourteen patients had the unilateral CS, and five patients had the ipsilateral CS and the contralateral CO. Transcranial Doppler (TCD) and Color Doppler Imaging (CDI) were performed before and early after CEA. Results. In patients with unilateral CS, significant improvements in BFV were observed in anterior cerebral artery (ACA) and middle cerebral artery (MCA) on the ipsilateral side after CEA. In patients of ipsilateral CS and contralateral CO, significant improvements in BFV were observed in the ACA and MCA not only on the ipsilateral side but also on the contralateral side postoperatively. The ipsilateral ophthalmic artery (OA) retrograde flows in two patients were recovered to anterograde direction following CEA. The BFV in short posterior ciliary artery (SPCA) of the ipsilateral side significantly increased postoperatively irrespective of the presence of contralateral CO. Conclusions. CEA improved cerebral anterior circulation hemodynamics especially in patients of unilateral CS and contralateral CO, normalized the OA reverse flow, and increased the blood perfusion of SPCA.

  13. Improvement in Cerebral and Ocular Hemodynamics Early after Carotid Endarterectomy in Patients of Severe Carotid Artery Stenosis with or without Contralateral Carotid Occlusion

    PubMed Central

    Wang, Jian; Wang, Weici; Jin, Bi; Zhang, Yanrong; Xu, Ping; Xiang, Feixiang; Zheng, Yi; Chen, Juan

    2016-01-01

    Purpose. To investigate the alternation in cerebral and ocular blood flow velocity (BFV) in patients of carotid stenosis (CS) with or without contralateral carotid occlusion (CO) early after carotid endarterectomy (CEA). Patients and Methods. Nineteen patients underwent CEA for ≥50% CS. Fourteen patients had the unilateral CS, and five patients had the ipsilateral CS and the contralateral CO. Transcranial Doppler (TCD) and Color Doppler Imaging (CDI) were performed before and early after CEA. Results. In patients with unilateral CS, significant improvements in BFV were observed in anterior cerebral artery (ACA) and middle cerebral artery (MCA) on the ipsilateral side after CEA. In patients of ipsilateral CS and contralateral CO, significant improvements in BFV were observed in the ACA and MCA not only on the ipsilateral side but also on the contralateral side postoperatively. The ipsilateral ophthalmic artery (OA) retrograde flows in two patients were recovered to anterograde direction following CEA. The BFV in short posterior ciliary artery (SPCA) of the ipsilateral side significantly increased postoperatively irrespective of the presence of contralateral CO. Conclusions. CEA improved cerebral anterior circulation hemodynamics especially in patients of unilateral CS and contralateral CO, normalized the OA reverse flow, and increased the blood perfusion of SPCA. PMID:27642593

  14. Genetic Polymorphisms Influence Cognition in Patients Undergoing Carotid Interventions.

    PubMed

    Hitchner, Elizabeth; Morrison, Doug; Liao, Phoebe; Rosen, Allyson; Zhou, Wei

    2016-09-01

    While carotid interventions help decrease the risk of stroke, nearly 40% of patients experience cognitive deterioration. Genetic polymorphism in apolipoprotein E (ApoE) and brain-derived neurotrophic factor (BDNF) have been implicated in cognitive impairment; however, it is unclear whether they may influence cognitive changes in patients undergoing carotid intervention. In this study, we seek to assess the role of genetic polymorphisms in carotid intervention-related cognitive change. Polymorphisms related to cognitive function were chosen for this preliminary analysis. Over 2 years, patients undergoing carotid interventions were prospectively recruited. Patients underwent neuropsychological testing 2 weeks prior to and at 1 month following their procedure. Saliva samples were collected for genetic analysis. Logistic regressions were used to identify associations between polymorphisms and cognitive measures. A total of 91 patients were included; all were male with an average age of 70 years. The majority of patients exhibited hypertension (95%) and a history of smoking (81%). Presence of ApoE 4 allele was associated with depression (p= 0.047). After correcting for age and genetic polymorphisms in BDNF and serotonin transporter (5-HTT), ApoE 4 allele was associated with depression (p= 0.044) and showed a trend with baseline cognitive impairment (p= 0.10). Age ≥ 70 years was associated with baseline cognitive impairment after adjusting for the three genetic polymorphisms (p= 0.03). Patients with ApoE 4 and BDNF A polymorphisms performed less well on the visual and verbal memory measures, respectively. Polymorphisms in ApoE and BDNF may provide insight on cognition in patients undergoing carotid interventions; however, the mechanism of this relationship remains unclear. PMID:27574384

  15. Cerebral hemodynamic changes and electroencephalography during carotid endarterectomy

    SciTech Connect

    Algotsson, L.; Messeter, K.; Rehncrona, S.; Skeidsvoll, H.; Ryding, E. )

    1990-05-01

    Some patients undergoing endarterectomy for occlusive carotid artery disease run a risk of brain ischemia during cross-clamping of the artery. The present study of 15 patients was undertaken to evaluate changes in cerebral blood flow (CBF), as measured with an intravenous (IV) tracer (133Xenon) technique, and to relate CBF changes to changes in the electroencephalogram (EEG). CBF was measured before and after induction of anesthesia, during cross-clamping of the carotid artery, after release of the clamps, and at 24 hours after the operation. All the patients were anesthetized with methohexitone, fentanyl, and nitrous oxide and oxygen. EEG was continuously recorded during the operation. Carotid artery shunts were not used. In 8 patients, cross-clamping of the carotid artery did not influence the EEG. In this group of patients, induction of anesthesia caused a 38% decrease in CBF, which presumably reflects the normal reaction to the anesthetic agent given. There were no further changes in CBF during cross-clamping. In 7 patients, the EEG showed signs of deterioration during the intraoperative vascular occlusion. In these patients, anesthesia did not cause any CBF change, whereas cross-clamping the artery induced a 33% decrease in CBF. In individual patients, the severity of EEG changes correlated with the decrease in CBF. The absence of a change in CBF by anesthesia and a decrease due to cross-clamping of the carotid artery may be explained by the presence of a more advanced cerebrovascular disease and an insufficiency to maintain CBF during cross-clamping.

  16. Vascular balloon injury and intraluminal administration in rat carotid artery.

    PubMed

    Zhang, Wei; Trebak, Mohamed

    2014-01-01

    The carotid artery balloon injury model in rats has been well established for over two decades. It remains an important method to study the molecular and cellular mechanisms involved in vascular smooth muscle dedifferentiation, neointima formation and vascular remodeling. Male Sprague-Dawley rats are the most frequently employed animals for this model. Female rats are not preferred as female hormones are protective against vascular diseases and thus introduce a variation into this procedure. The left carotid is typically injured with the right carotid serving as a negative control. Left carotid injury is caused by the inflated balloon that denudes the endothelium and distends the vessel wall. Following injury, potential therapeutic strategies such as the use of pharmacological compounds and either gene or shRNA transfer can be evaluated. Typically for gene or shRNA transfer, the injured section of the vessel lumen is locally transduced for 30 min with viral particles encoding either a protein or shRNA for delivery and expression in the injured vessel wall. Neointimal thickening representing proliferative vascular smooth muscle cells usually peaks at 2 weeks after injury. Vessels are mostly harvested at this time point for cellular and molecular analysis of cell signaling pathways as well as gene and protein expression. Vessels can also be harvested at earlier time points to determine the onset of expression and/or activation of a specific protein or pathway, depending on the experimental aims intended. Vessels can be characterized and evaluated using histological staining, immunohistochemistry, protein/mRNA assays, and activity assays. The intact right carotid artery from the same animal is an ideal internal control. Injury-induced changes in molecular and cellular parameters can be evaluated by comparing the injured artery to the internal right control artery. Likewise, therapeutic modalities can be evaluated by comparing the injured and treated artery to the

  17. Optical detection of structural changes in human carotid atherosclerotic plaque

    NASA Astrophysics Data System (ADS)

    Korol, R. M.; Canham, P. B.; Finlay, H. M.; Hammond, R. R.; Quantz, M.; Ferguson, G. G.; Liu, L. Y.; Lucas, A. R.

    2005-08-01

    Background: Arterial bifurcations are commonly the sites of developing atherosclerotic plaque that lead to arterial occlusions and plaque rupture (myocardial infarctions and strokes). Laser induced fluorescence (LIF) spectroscopy provides an effective nondestructive method supplying spectral information on extracellular matrix (ECM) protein composition, specifically collagen and elastin. Purpose: To investigate regional differences in the ECM proteins -- collagen I, III and elastin in unstable plaque by analyzing data from laser-induced fluorescence spectroscopy of human carotid endarterectomy specimens. Methods: Gels of ECM protein extracts (elastin, collagen types I & III) were measured as reference spectra and internal thoracic artery segments (extra tissue from bypass surgery) were used as tissue controls. Arterial segments and the endarterectomy specimens (n=21) were cut into 5mm cross-sectional rings. Ten fluorescence spectra per sampling area were then recorded at 5 sites per ring with argon laser excitation (357nm) with a penetration depth of 200 μm. Spectra were normalized to maximum intensity and analyzed using multiple regression analysis. Tissue rings were fixed in formalin (within 3 hours of surgery), sectioned and stained with H&E or Movat's Pentachrome for histological analysis. Spectroscopy data were correlated with immunohistology (staining for elastin, collagen types I, III and IV). Results: Quantitative fluorescence for the thoracic arteries revealed a dominant elastin component on the luminal side -- confirmed with immunohistology and known artery structure. Carotid endarterectomy specimens by comparison had a significant decrease in elastin signature and increased collagen type I and III. Arterial spectra were markedly different between the thoracic and carotid specimens. There was also a significant elevation (p<0.05) of collagen type I distal to the bifurcation compared to proximal tissue in the carotid specimens. Conclusion: Fluorescence

  18. Comparative analysis of the biaxial mechanical behavior of carotid wall tissue and biological and synthetic materials used for carotid patch angioplasty.

    PubMed

    Kamenskiy, Alexey V; Pipinos, Iraklis I; MacTaggart, Jason N; Kazmi, Syed A Jaffar; Dzenis, Yuris A

    2011-11-01

    Patch angioplasty is the most common technique used for the performance of carotid endarterectomy. A large number of patching materials are available for use while new materials are being continuously developed. Surprisingly little is known about the mechanical properties of these materials and how these properties compare with those of the carotid artery wall. Mismatch of the mechanical properties can produce mechanical and hemodynamic effects that may compromise the long-term patency of the endarterectomized arterial segment. The aim of this paper was to systematically evaluate and compare the biaxial mechanical behavior of the most commonly used patching materials. We compared PTFE (n  =  1), Dacron (n  =  2), bovine pericardium (n  =  10), autogenous greater saphenous vein (n  =  10), and autogenous external jugular vein (n  =  9) with the wall of the common carotid artery (n  =  18). All patching materials were found to be significantly stiffer than the carotid wall in both the longitudinal and circumferential directions. Synthetic patches demonstrated the most mismatch in stiffness values and vein patches the least mismatch in stiffness values compared to those of the native carotid artery. All biological materials, including the carotid artery, demonstrated substantial nonlinearity, anisotropy, and variability; however, the behavior of biological and biologically-derived patches was both qualitatively and quantitatively different from the behavior of the carotid wall. The majority of carotid arteries tested were stiffer in the circumferential direction, while the opposite anisotropy was observed for all types of vein patches and bovine pericardium. The rates of increase in the nonlinear stiffness over the physiological stress range were also different for the carotid and patching materials. Several carotid wall samples exhibited reverse anisotropy compared to the average behavior of the carotid tissue. A similar characteristic was

  19. Low global sensitivity of metabolic rate to temperature in calcified marine invertebrates.

    PubMed

    Watson, Sue-Ann; Morley, Simon A; Bates, Amanda E; Clark, Melody S; Day, Robert W; Lamare, Miles; Martin, Stephanie M; Southgate, Paul C; Tan, Koh Siang; Tyler, Paul A; Peck, Lloyd S

    2014-01-01

    Metabolic rate is a key component of energy budgets that scales with body size and varies with large-scale environmental geographical patterns. Here we conduct an analysis of standard metabolic rates (SMR) of marine ectotherms across a 70° latitudinal gradient in both hemispheres that spanned collection temperatures of 0-30 °C. To account for latitudinal differences in the size and skeletal composition between species, SMR was mass normalized to that of a standard-sized (223 mg) ash-free dry mass individual. SMR was measured for 17 species of calcified invertebrates (bivalves, gastropods, urchins and brachiopods), using a single consistent methodology, including 11 species whose SMR was described for the first time. SMR of 15 out of 17 species had a mass-scaling exponent between 2/3 and 1, with no greater support for a 3/4 rather than a 2/3 scaling exponent. After accounting for taxonomy and variability in parameter estimates among species using variance-weighted linear mixed effects modelling, temperature sensitivity of SMR had an activation energy (Ea) of 0.16 for both Northern and Southern Hemisphere species which was lower than predicted under the metabolic theory of ecology (Ea 0.2-1.2 eV). Northern Hemisphere species, however, had a higher SMR at each habitat temperature, but a lower mass-scaling exponent relative to SMR. Evolutionary trade-offs that may be driving differences in metabolic rate (such as metabolic cold adaptation of Northern Hemisphere species) will have important impacts on species abilities to respond to changing environments.

  20. The mineralogical responses of marine calcifiers to CO2-induced ocean acidification

    NASA Astrophysics Data System (ADS)

    Ries, J. B.; Cohen, A. L.; McCorkle, D. C.

    2008-12-01

    We have conducted 6-month laboratory experiments to investigate the effect of pCO2-induced reductions in seawater CaCO3 saturation state on biocalcification by 18 aragonitic and calcitic (low-high Mg) taxa representing eight of the major marine calcifying groups: Chlorophyta; Rhodophyta; Crustacea; Bivalvia; Gastropoda; Annelida; Cnidaria; and Echinodermata. The CaCO3 saturation states of the experimental seawaters, constrained by intercalibrated determinations of pH, alkalinity, and DIC, were attained with bubbled air-CO2 mixtures of 400 (ambient), 600, 900, and 2850 ppm pCO2, yielding Ωarag of 2.5 (ambient), 2.0, 1.5, 0.7, respectively. We previously showed that while rates of net calcification obtained from buoyant weighing declined with increasing pCO2 for nearly half of the species investigated, a nearly equal number exhibited constant or, in some cases, increased calcification under moderately (600 ppm) or extremely (900 or 2850 ppm) elevated pCO2. The organisms' investigated in this study secrete various forms of CaCO3, which differ in crystallographic structure and therefore solubility: aragonite and high-Mg are generally more soluble than low-Mg calcite. We have employed powder x-ray diffraction, Raman spectroscopy, inductively-coupled-plasma mass-spectrometry, and scanning electron microscopy to quantify changes in the organisms' skeletal mineralogy (aragonite:calcite ratio) and Mg-content (MgCO3:CaCO3 ratio) that occurred in response to the prescribed reductions in seawater CaCO3 saturation state. We will compare calcification and mineralogical response patterns amongst the organisms to elucidate the role of mineral lability in driving species-specific responses to CO2-induced ocean acidification.

  1. Extracellular matrix protein in calcified endoskeleton: a potential additive for crystal growth and design

    NASA Astrophysics Data System (ADS)

    Azizur Rahman, M.; Fujimura, Hiroyuki; Shinjo, Ryuichi; Oomori, Tamotsu

    2011-06-01

    In this study, we demonstrate a key function of extracellular matrix proteins (ECMPs) on seed crystals, which are isolated from calcified endoskeletons of soft coral and contain only CaCO 3 without any living cells. This is the first report that an ECMP protein extracted from a marine organism could potentially influence in modifying the surface of a substrate for designing materials via crystallization. We previously studied with the ECMPs from a different type of soft coral ( Sinularia polydactyla) without introducing any seed crystals in the process , which showed different results. Thus, crystallization on the seed in the presence of ECMPs of present species is an important first step toward linking function to individual proteins from soft coral. For understanding this interesting phenomenon, in vitro crystallization was initiated in a supersaturated solution on seed particles of calcite (1 0 4) with and without ECMPs. No change in the crystal growth shape occurred without ECMPs present during the crystallization process. However, with ECMPs, the morphology and phase of the crystals in the crystallization process changed dramatically. Upon completion of crystallization with ECMPs, an attractive crystal morphology was found. Scanning electron microscopy (SEM) was utilized to observe the crystal morphologies on the seeds surface. The mineral phases of crystals nucleated by ECMPs on the seeds surface were examined by Raman spectroscopy. Although 50 mM Mg 2+ is influential in making aragonite in the crystallization process, the ECMPs significantly made calcite crystals even when 50 mM Mg 2+ was present in the process. Crystallization with the ECMP additive seems to be a technically attractive strategy to generate assembled micro crystals that could be used in crystals growth and design in the Pharmaceutical and biotechnology industries.

  2. Multiscale mechanics of hierarchical structure/property relationships in calcified tissues and tissue/material interfaces

    PubMed Central

    Katz, J. Lawrence; Misra, Anil; Spencer, Paulette; Wang, Yong; Bumrerraj, Sauwanan; Nomura, Tsutomu; Eppell, Steven J.; Tabib-Azar, Massood

    2007-01-01

    This paper presents a review plus new data that describes the role hierarchical nanostructural properties play in developing an understanding of the effect of scale on the material properties (chemical, elastic and electrical) of calcified tissues as well as the interfaces that form between such tissues and biomaterials. Both nanostructural and microstructural properties will be considered starting with the size and shape of the apatitic mineralites in both young and mature bovine bone. Microstructural properties for human dentin and cortical and trabecular bone will be considered. These separate sets of data will be combined mathematically to advance the effects of scale on the modeling of these tissues and the tissue/biomaterial interfaces as hierarchical material/structural composites. Interfacial structure and properties to be considered in greatest detail will be that of the dentin/adhesive (d/a) interface, which presents a clear example of examining all three material properties, (chemical, elastic and electrical). In this case, finite element modeling (FEA) was based on the actual measured values of the structure and elastic properties of the materials comprising the d/a interface; this combination provides insight into factors and mechanisms that contribute to premature failure of dental composite fillings. At present, there are more elastic property data obtained by microstructural measurements, especially high frequency ultrasonic wave propagation (UWP) and scanning acoustic microscopy (SAM) techniques. However, atomic force microscopy (AFM) and nanoindentation (NI) of cortical and trabecular bone and the dentin–enamel junction (DEJ) among others have become available allowing correlation of the nanostructural level measurements with those made on the microstructural level. PMID:18270549

  3. Osteoclasts but not osteoblasts are affected by a calcified surface treated with zoledronic acid in vitro

    SciTech Connect

    Schindeler, Aaron . E-mail: AaronS@chw.edu.au; Little, David G.

    2005-12-16

    Bisphosphonates are potent inhibitors of osteoclast-mediated bone resorption. Recent interest has centered on the effects of bisphosphonates on osteoblasts. Chronic dosing of osteoblasts with solubilized bisphosphonates has been reported to enhance osteogenesis and mineralization in vitro. However, this methodology poorly reflects the in vivo situation, where free bisphosphonate becomes rapidly bound to mineralized bone surfaces. To establish a more clinically relevant cell culture model, we cultured bone cells on calcium phosphate coated quartz discs pre-treated with the potent nitrogen-containing bisphosphonate, zoledronic acid (ZA). Binding studies utilizing [{sup 14}C]-labeled ZA confirmed that the bisphosphonate bound in a concentration-dependent manner over the 1-50 {mu}M dose range. When grown on ZA-treated discs, the viability of bone-marrow derived osteoclasts was greatly reduced, while the viability and mineralization of the osteoblastic MC3T3-E1 cell line were largely unaffected. This suggests that only bone resorbing cells are affected by bound bisphosphonate. However, this system does not account for transient exposure to unbound bisphosphonate in the hours following a clinical dosing. To model this event, we transiently treated osteoblasts with ZA in the absence of a calcified surface. Osteoblasts proved highly resistant to all transitory treatment regimes, even when utilizing ZA concentrations that prevented mineralization and/or induced cell death when dosed chronically. This study represents a pharmacologically more relevant approach to modeling bisphosphonate treatment on cultured bone cells and implies that bisphosphonate therapies may not directly affect osteoblasts at bone surfaces.

  4. Low global sensitivity of metabolic rate to temperature in calcified marine invertebrates.

    PubMed

    Watson, Sue-Ann; Morley, Simon A; Bates, Amanda E; Clark, Melody S; Day, Robert W; Lamare, Miles; Martin, Stephanie M; Southgate, Paul C; Tan, Koh Siang; Tyler, Paul A; Peck, Lloyd S

    2014-01-01

    Metabolic rate is a key component of energy budgets that scales with body size and varies with large-scale environmental geographical patterns. Here we conduct an analysis of standard metabolic rates (SMR) of marine ectotherms across a 70° latitudinal gradient in both hemispheres that spanned collection temperatures of 0-30 °C. To account for latitudinal differences in the size and skeletal composition between species, SMR was mass normalized to that of a standard-sized (223 mg) ash-free dry mass individual. SMR was measured for 17 species of calcified invertebrates (bivalves, gastropods, urchins and brachiopods), using a single consistent methodology, including 11 species whose SMR was described for the first time. SMR of 15 out of 17 species had a mass-scaling exponent between 2/3 and 1, with no greater support for a 3/4 rather than a 2/3 scaling exponent. After accounting for taxonomy and variability in parameter estimates among species using variance-weighted linear mixed effects modelling, temperature sensitivity of SMR had an activation energy (Ea) of 0.16 for both Northern and Southern Hemisphere species which was lower than predicted under the metabolic theory of ecology (Ea 0.2-1.2 eV). Northern Hemisphere species, however, had a higher SMR at each habitat temperature, but a lower mass-scaling exponent relative to SMR. Evolutionary trade-offs that may be driving differences in metabolic rate (such as metabolic cold adaptation of Northern Hemisphere species) will have important impacts on species abilities to respond to changing environments. PMID:24036933

  5. Calcifying nanoparticles promote mineralization in vascular smooth muscle cells: implications for atherosclerosis

    PubMed Central

    Hunter, Larry W; Charlesworth, Jon E; Yu, Sam; Lieske, John C; Miller, Virginia M

    2014-01-01

    Background Nano-sized complexes of calcium phosphate mineral and proteins (calcifying nanoparticles [CNPs]) serve as mineral chaperones. Thus, CNPs may be both a result and cause of soft tissue calcification processes. This study determined if CNPs could augment calcification of arterial vascular smooth muscle cells in vitro. Methods CNPs 210 nm in diameter were propagated in vitro from human serum. Porcine aortic smooth muscle cells were cultured for up to 28 days in medium in the absence (control) or presence of 2 mM phosphate ([P] positive calcification control) or after a single 3-day exposure to CNPs. Transmission electron-microscopy was used to characterize CNPs and to examine their cellular uptake. Calcium deposits were visualized by light microscopy and von Kossa staining and were quantified by colorimetry. Cell viability was quantified by confocal microscopy of live-/dead-stained cells and apoptosis was examined concurrently by fluorescent labeling of exposed phosphatidylserine. Results CNPs, as well as smaller calcium crystals, were observed by transmission electron-microscopy on day 3 in CNP-treated but not P-treated cells. By day 28, calcium deposits were visible in similar amounts within multicellular nodules of both CNP- and P-treated cells. Apoptosis increased with cell density under all treatments. CNP treatment augmented the density of apoptotic bodies and cellular debris in association with mineralized multicellular nodules. Conclusion Exogenous CNPs are taken up by aortic smooth muscle cells in vitro and potentiate accumulation of smooth-muscle-derived apoptotic bodies at sites of mineralization. Thus, CNPs may accelerate vascular calcification. PMID:24920905

  6. The association of central retinal artery occlusion and extracranial carotid artery disease.

    PubMed Central

    Douglas, D J; Schuler, J J; Buchbinder, D; Dillon, B C; Flanigan, D P

    1988-01-01

    To determine the incidence of associated carotid artery disease and the effect of carotid endarterectomy on subsequent neurologic sequelae, a retrospective study of 66 patients with central retinal artery occlusion (CRAO) was undertaken. Ipsilateral extracranial carotid artery disease was present in 23 of 33 patients (70%) who had carotid arteriography. Sixteen patients had carotid endarterectomy following their CRAO (Group I) and 50 did not (Group II). Seven of the 40 patients available for follow-up in Group II had a subsequent stroke (mean follow-up: 54 months). Of the seven Group II patients shown to have associated carotid disease (Group IIs), three (43%) had a subsequent stroke during follow-up (mean: 28.3 months) compared to zero in Group I (p = 0.033; mean follow-up: 18.7 months). Because of the strong association between CRAO and ipsilateral carotid artery disease and because of the significantly higher incidence of subsequent ipsilateral stroke in CRAO patients with carotid disease who did not undergo endarterectomy, thorough evaluation of the carotid arteries followed by carotid endarterectomy, if indicated, is warranted in CRAO patients who have no other obvious etiology for the occlusion. PMID:3389947

  7. The Human Carotid Body Gene Expression and Function in Signaling of Hypoxia and Inflammation.

    PubMed

    Kåhlin, Jessica; Mkrtchian, Souren; Ebberyd, Anette; Eriksson, Lars I; Fagerlund, Malin Jonsson

    2015-01-01

    Although animal carotid body oxygen sensing and signaling has been extensively investigated, the human carotid body remains essentially uncharacterized. Therefore, we aimed to study the human carotid body in terms of morphology, global and specific expression of sensing and signaling genes as well as inflammatory genes. The human carotid body response to brief or prolonged hypoxia was studied in carotid body slices from adult surgical patients and ACh, ATP and cytokine release was analyzed. We demonstrate that the human carotid body expresses key oxygen sensing and signaling genes in similarity with animal carotid bodies with a few diverging data. The human carotid body moreover shows enrichment of genes in the inflammatory response and releases pro and anti-inflammatory cytokines in response to prolonged hypoxia. In response to acute hypoxia the human carotid body releases ACh and ATP and we thus translate previous findings in animal models to human tissue. We conclude that by releasing pro- and anti-inflammatory cytokines during hypoxia the human carotid body displays a structural and functional capacity to participate in sensing and mediating systemic inflammation.

  8. Collaborative retrospective multicentre series of giant intracavernous carotid aneurysms.

    PubMed

    Penchet, G; Mourier, K

    2015-12-01

    Giant intracavernous carotid aneurysms (GICCA) occur with very unusual clinical symptoms often resulting from a compressive mechanism that may possibly resolve although seldom from a rupture or haemorrhage. In fact, due to their clinical presentation their treatment is different from that of the intracranial subarachnoid aneurysms. The aim of this study was to analyze the clinical symptoms, therapeutic decisions, and the clinical state at 6 months follow up in a retrospective consecutive multicentre series of 27 GICCA between 2004 and 2008. All the patients in the series were female, mean age 65 years (21 to 82 years). A pseudo tumoural cavernous sinus syndrome revealed the disease in 25 patients (92.6%), an atypical headache in one patient, and in another patient an intraoperative haemorrhage led to the diagnosis. In most of the cases the aneurysms were sacciform in shape (89%), with a size between 25 and 30 millimeters (66.6%) and contained a blood clot due to intrasacular thrombosis (57.5%). An occlusion test of the internal carotid artery was performed during the diagnostic angiography in 24 cases (88.8%) and good tolerance of occlusion was observed in 16 of them. An endovascular procedure was performed in 21 patients (77.7%): selective coiling of the aneurysm facilitated by stenting or by remodeling techniques in 2 cases, whereas internal carotid artery occlusion was performed on the 19 other cases. Among these latter patients, 2 of them (10.5%) presented with a poor tolerance during the pre-therapeutic carotid occlusion test, necessitating a surgical intra-extra cranial by-pass prior to the carotid endovascular occlusion. In 1 other case of these 19, the internal carotid endovascular occlusion was carried-out in emergency because the aneurysm was revealed by a major haemorrhage during the surgical transsphenoidal approach of a hypophyseal tumour. No treatment was decided in the remaining 6 cases of the series (22.2%). At 6 months follow-up, 18 of the 21

  9. Evaluation of a New Balloon Catheter for Difficult Calcified Lesions in Infrainguinal Arterial Disease: Outcome of a Multicenter Registry

    SciTech Connect

    Spaargaren, G. J.; Lee, M. J.; Reekers, J. A.; Overhagen, H. van; Schultze Kool, L. J.; Hoogeveen, Y. L.

    2009-01-15

    The purpose of this study was to assess the technical performance and immediate procedure outcome of a new balloon catheter in the treatment of calcified lesions in infrainguinal arterial disease. Seventy-five patients with infrainguinal arterial disease were prospectively entered into the registry. The catheter (ReeKross Clearstream, Ireland) is a 5- to 6-Fr balloon catheter with a rigid shaft intended for enhanced pushability. Only technical procedural outcome was recorded. Treated calcified lesions (range: 5-30 cm), assessed angiographically, were located in the superficial femoral, popliteal, and crural arteries. In 67 patients the lesion was an occlusion. Guidewire passage occurred subintimally in 68 patients. In 24 patients a standard balloon catheter was chosen as first treatment catheter: 5 failed to cross the lesion, 8 balloons ruptured, and in 11 patients there was an inadequate dilatation result. In only one of the five patients did subsequent use of the ReeKross catheter also fail in lesion crossing. The ReeKross was successful as secondary catheter in the other 23 cases. In 50 patients the ReeKross was used as primary catheter. In total the ReeKross crossed the lesions in 74 patients. After passage and dilatation with this catheter in 73 patients (1 failed true-lumen reentry), 19 had >30% residual lesions, of which 11 were not treated and 8 were successfully stented. No ReeKross balloons ruptured. We conclude that in the treatment of difficult calcified lesions in arterial stenotic or occlusive disease, the choice of a high-pushability angioplasty catheter, with more calcification-resistant balloon characteristics, like the ReeKross, warrants consideration.

  10. Calcifying invertebrates succeed in a naturally CO2-rich coastal habitat but are threatened by high levels of future acidification

    NASA Astrophysics Data System (ADS)

    Thomsen, J.; Gutowska, M. A.; Saphörster, J.; Heinemann, A.; Trübenbach, K.; Fietzke, J.; Hiebenthal, C.; Eisenhauer, A.; Körtzinger, A.; Wahl, M.; Melzner, F.

    2010-11-01

    CO2 emissions are leading to an acidification of the oceans. Predicting marine community vulnerability towards acidification is difficult, as adaptation processes cannot be accounted for in most experimental studies. Naturally CO2 enriched sites thus can serve as valuable proxies for future changes in community structure. Here we describe a natural analogue site in the Western Baltic Sea. Seawater pCO2 in Kiel Fjord is elevated for large parts of the year due to upwelling of CO2 rich waters. Peak pCO2 values of >230 Pa (>2300 μatm) and pHNBS values of <7.5 are encountered during summer and autumn, average pCO2 values are ~70 Pa (~700 μatm). In contrast to previously described naturally CO2 enriched sites that have suggested a progressive displacement of calcifying auto- and heterotrophic species, the macrobenthic community in Kiel Fjord is dominated by calcifying invertebrates. We show that blue mussels from Kiel Fjord can maintain control rates of somatic and shell growth at a pCO2 of 142 Pa (1400 μatm, pHNBS = 7.7). Juvenile mussel recruitment peaks during the summer months, when high water pCO2 values of ~100 Pa (~1000 μatm) prevail. Our findings indicate that calcifying keystone species may be able to cope with surface ocean pHNBS values projected for the end of this century when food supply is sufficient. However, owing to non-linear synergistic effects of future acidification and upwelling of corrosive water, peak seawater pCO2 in Kiel Fjord and many other productive estuarine habitats could increase to values >400 Pa (>4000 μatm). These changes will most likely affect calcification and recruitment, and increase external shell dissolution.

  11. Calcifying invertebrates succeed in a naturally CO2 enriched coastal habitat but are threatened by high levels of future acidification

    NASA Astrophysics Data System (ADS)

    Thomsen, J.; Gutowska, M. A.; Saphörster, J.; Heinemann, A.; Trübenbach, K.; Fietzke, J.; Hiebenthal, C.; Eisenhauer, A.; Körtzinger, A.; Wahl, M.; Melzner, F.

    2010-07-01

    CO2 emissions are leading to an acidification of the oceans. Predicting marine community vulnerability towards acidification is difficult, as adaptation processes cannot be accounted for in most experimental studies. Naturally CO2 enriched sites thus can serve as valuable proxies for future changes in community structure. Here we describe a natural analogue site in the Western Baltic Sea. Seawater pCO2 in Kiel Fjord is elevated for large parts of the year due to upwelling of CO2 rich waters. Peak pCO2 values of >230 Pa (>2300 μatm) and pH values of <7.5 are encountered during summer and autumn, average pCO2 values are ~70 Pa (~700 μatm). In contrast to previously described naturally CO2 enriched sites that have suggested a progressive displacement of calcifying auto- and heterotrophic species, the macrobenthic community in Kiel Fjord is dominated by calcifying invertebrates. We show that blue mussels from Kiel Fjord can maintain control rates of somatic and shell growth at a pCO2 of 142 Pa (1400 μatm, pH=7.7). Juvenile mussel recruitment peaks during the summer months, when high water pCO2 values of ~100 Pa (~1000 μatm) prevail. Our findings indicate that calcifying keystone species may be able to cope with surface ocean pH values projected for the end of this century. However, owing to non-linear synergistic effects of future acidification and upwelling of corrosive water, peak seawater pCO2 in Kiel Fjord and many other productive estuarine habitats could increase to values >400 Pa (>4000 μatm). These changes will most likely affect calcification and recruitment, and increase external shell dissolution.

  12. In situ quasi-static and dynamic nanoindentation tests on calcified nodules formed by osteoblasts: Implication of glucocorticoids responsible for osteoblast calcification.

    PubMed

    Miyamoto, Sho; Miyamoto, Yoichi; Shibata, Yo; Yoshimura, Kentaro; Izumida, Eri; Suzuki, Hiroaki; Miyazaki, Takashi; Maki, Koutaro; Kamijo, Ryutaro

    2015-01-01

    The functional requirements of regenerated calcified tissues are that they enable the tissues to bear a variety of imposed stress and consequent contact-induced strain without substantial fracture. Here we demonstrate the effects of glucocorticoid hormones such as dexamethasone and hydrocortisone on the nanomechanical properties of calcified nodules formed by mouse osteoblastic MC3T3-E1 cells in differentiation-inducing medium containing ascorbic acid and β-glycerophosphate. Neither cell proliferation nor calcium deposition, evaluated using alizarin red and von Kossa staining, was affected by dexamethasone. On the other hand, calcified nodules formed in the presence of dexamethasone were significantly harder and stiffer than those formed in their absence. In particular, a series of nanoindentation tests revealed that the calcified nodules formed in the presence of dexamethasone showed enhanced stiffness against dynamic strain as compared to a quasi-static load. Furthermore, Raman spectroscopy revealed that dexamethasone and hydrocortisone increased the apatite/matrix ratio and lowered that of carbonate in the nodules. Our results suggest that glucocorticoids are required for in vitro formation by osteoblasts of more mature calcified nodules containing apatite/phosphate.

  13. Bovine Aortic Arch and Bilateral Retroesophageal Course of Common Carotid Arteries in a Symptomatic Patient

    PubMed Central

    Bissacco, Daniele; Domanin, Maurizio; Schinco, Giuseppina; Gabrielli, Livio

    2016-01-01

    Anatomical variations of carotid arteries may be related to their development (agenesis, aplasia, hypoplasia) or course (coiling, kinking, tortuosity). Partial or total aberrancies in carotid vessel anatomy rarely occur. We describe the case of a 95-year-old woman presented with sudden onset of confusion and disorientation together with upper limb clonus. Computed tomography (CT)-scan revealed a left frontal brain injury with a not conclusive carotid doppler ultrasound. CT angiography reported a bovine aortic arch with bilateral retroesophageal course of both common carotid arteries and left severe (>70%) internal carotid artery stenosis. The knowledge of anatomical variations of the course of carotid arteries is relevant for possible surgical or endovascular repair or in case of otolaryngology or intubation procedures. PMID:27699162

  14. Time-Resolved 4-Dimensional Computed-Tomography Angiography Can Correctly Identify Carotid Pseudo-Occlusion.

    PubMed

    Ng, Felix C; Datta, Mineesh; Choi, Philip M C

    2016-04-01

    Correct identification of symptomatic high-grade internal carotid artery stenosis from low-grade or total chronic occlusion is critical for patient selection for urgent carotid endarterectomy. Carotid pseudo-occlusion is a flow-related artifact on noninvasive imaging that can lead to an incorrect diagnosis of total internal carotid artery occlusion, thereby denying an eligible patient for appropriate surgical treatment. We present an 82-year-old man with a symptomatic critical internal carotid artery, which was detected on time-resolved 4-dimensional computed-tomography angiography, whereas single-phase computed-tomography angiography, magnetic resonance angiography, and Doppler ultrasonography suggested apparent occlusion. To our understanding, the use of 4-dimensional computed-tomography angiography to identify carotid pseudo-occlusion has not been previously reported.

  15. Bovine Aortic Arch and Bilateral Retroesophageal Course of Common Carotid Arteries in a Symptomatic Patient

    PubMed Central

    Bissacco, Daniele; Domanin, Maurizio; Schinco, Giuseppina; Gabrielli, Livio

    2016-01-01

    Anatomical variations of carotid arteries may be related to their development (agenesis, aplasia, hypoplasia) or course (coiling, kinking, tortuosity). Partial or total aberrancies in carotid vessel anatomy rarely occur. We describe the case of a 95-year-old woman presented with sudden onset of confusion and disorientation together with upper limb clonus. Computed tomography (CT)-scan revealed a left frontal brain injury with a not conclusive carotid doppler ultrasound. CT angiography reported a bovine aortic arch with bilateral retroesophageal course of both common carotid arteries and left severe (>70%) internal carotid artery stenosis. The knowledge of anatomical variations of the course of carotid arteries is relevant for possible surgical or endovascular repair or in case of otolaryngology or intubation procedures.

  16. Correlation of carotid artery disease severity and vasomotor response of cerebral blood vessels.

    PubMed

    Krdžić, Ivana; Čovičković-Šternić, Nadežda; Katsiki, Niki; Isenović, Esma R; Radak, Đorđe

    2015-05-01

    We assessed reactivity of cerebral vessels on hypercapnia in patients with carotid occlusive disease. The effects of vascular risk factors on carotid atherosclerosis and vasomotor reactivity (VMR) of cerebral arterioles were also examined. Patients (n = 50) with carotid stenosis (≥30% in 1 or both sides) were included; 30 patients acted as controls. Hypertension, hyperlipidemia, diabetes, cardiac diseases, inflammation, and smoking were recorded. Vasomotor reactivity was assessed with the apnea test by transcranial Doppler ultrasonography and estimated by flow velocity changes in the middle cerebral artery before and after hypercapnia induction. Vasomotor reactivity was defined by the breath holding index, and values under 0.69 were considered critical for VMR impairment. Vasomotor reactivity reduction was significant (P = .004) in patients with severe carotid stenosis (>70%) and with symptomatic carotid disease (P < .05). The risk factors did not significantly influence VMR reduction. Severe carotid stenosis impairs VMR and may increase the risk of stroke, especially in symptomatic patients.

  17. A Preliminary Analysis of Calcifying Particles in the Serum and Prostates of Patients with Prostatic Inflammation

    NASA Technical Reports Server (NTRS)

    Jones, Jeffrey A.; Carlson, Grant; Kajander, E. Olavi; Warmflash, David; Taylor, Karen; Ayala, Gustavo; Shoskes, Daniel; Everett, Meg; Feedback, Dan; Ciftcioglu, Neva

    2006-01-01

    Chronic diseases of the prostate such as benign prostatic hyperplasia (BPH) & chronic pelvic pain syndrome (CPPS) have associated findings of chronic inflammation, despite a lack of causal relationship. Numerous attempts to define an infectious agent responsible for the clinical findings have been inconsistent. The possibility of an infectious agent, that has not been uncovered with routine culturing methods, forms the basis for this study. Serum from 940 healthy Finnish men were compared with serum from 40 Crohn's, 40 path dx prostatitis, & 40 with path dx carcinoma, using an enzyme-linked immunosorbant assay (ELISA), to detect antigens specific to Nanobacteria(NB) utilizing monoclonal antibodies (Ab) 5/3 and 8D10. This ELISA has not been validated for detecting NB-associated with clinical prostatic disease, yet cross-reactivity with other bacterial species is low. Immunohistochemistry was performed on de-paraffinized prostatic tissue slides, de-calcified with EDTA and stained with the DAKO Catalyzed Signal Amplification kit, employing 8D10 as the primary (target/antigen-detecting) Ab. The mean (plus or minus SD) & median concentrations of NB antigen (U/50 L) were 379.59 (plus or minus 219.28) & 640.00 for patients with prostatitis (BPH) vs 3.31 (plus or minus 3.55) & 2.94 for prostate adenocarcinoma, 1.88 (plus or minus 2.94) & 0.80 for Crohn's disease, & 7.43 (plus or minus 25.57) & 0.00 for patients with no clinical prostatic disease. Unpaired t-tests revealed statistically significant differences between the prostatitis (BPH) sera & each of the other groups with p less than 0.005, but no differences between the other groups themselves. Preliminary studies with immunohistochemistry & 3-D confocal microscopy reveal 16/24 tissue sections + for NB Ag in BPH vs. only 2/22 tissue sections with prostate cancer. The preliminary findings of this serum screening study suggest that NB antigen may be commonly found in the serum of patients with the pathological diagnosis

  18. Direct Traumatic Carotid Cavernous Fistula: Angiographic Classification and Treatment Strategies

    PubMed Central

    Chi, Cuong Tran; Nguyen, Dang; Duc, Vo Tan; Chau, Huynh Hong; Son, Vo Tan

    2014-01-01

    Summary We report our experience in treatment of traumatic direct carotid cavernous fistula (CCF) via endovascular intervention. We hereof recommend an additional classification system for type A CCF and suggest respective treatment strategies. Only type A CCF patients (Barrow's classification) would be recruited for the study. Based on the angiographic characteristics of the CCF, we classified type A CCF into three subtypes including small size, medium size and large size fistula depending on whether there was presence of the anterior carotid artery (ACA) and/or middle carotid artery (MCA). Angiograms with opacification of both ACA and MCA were categorized as small size fistula. Angiograms with opacification of either ACA or MCA were categorized as medium size fistula and those without opacification of neither ACA nor MCA were classified as large size fiatula. After the confirm angiogram, endovascular embolization would be performed impromptu using detachable balloon, coils or both. All cases were followed up for complication and effect after the embolization. A total of 172 direct traumatic CCF patients were enrolled. The small size fistula was accountant for 12.8% (22 cases), medium size 35.5% (61 cases) and large size fistula accountant for 51.7% (89 cases). The successful rate of fistula occlusion under endovascular embolization was 94% with preservation of the carotid artery in 70%. For the treatment of each subtype, a total of 21/22 cases of the small size fistulas were successfully treated using coils alone. The other single case of small fistula was defaulted. Most of the medium and large size fistulas were cured using detachable balloons. When the fistula sealing could not be obtained using detachable balloon, coils were added to affirm the embolization of the cavernous sinus via venous access. There were about 2.9% of patient experienced direct carotid artery puncture and 0.6% puncture after carotid artery cut-down exposure. About 30% of cases

  19. CrossFit-related cervical internal carotid artery dissection.

    PubMed

    Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

    2015-08-01

    CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients. PMID:25917634

  20. Is siphon disease important in predicting outcome of carotid endarterectomy?

    PubMed

    Roederer, G O; Langlois, Y E; Chan, A R; Chikos, P M; Thiele, B L; Strandness, D E

    1983-10-01

    The prevalence of atherosclerosis at the carotid bifurcation and in the siphon was reviewed in 141 patients who underwent 149 endarterectomies. The relationship between the presence and severity of siphon lesions and focal neurologic symptoms, both before and after operation, was also examined. Siphon disease was found in 84% of the 282 sides. Most lesions (42%) were in the 20% to 49% diameter-reduction category. Only 9% were stenoses greater than 50%, and 10% were occlusions. The majority (65%) were smooth. No relationship was found between the severity of disease at the carotid bifurcation and in the siphon. No pattern of siphon disease could be related to the occurrence of symptoms. Furthermore, no relation was found between the severity of siphon disease and recurrent symptoms after endarterectomy.