Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Smooth muscle is an important component of the vessel wall. Smooth muscle cell undergoes phenotypic modulation during development of vascular lesions, such as atherosclerosis and restenosis following percutaneous transluminal coronary angioplasty (PTCA). In order to understand the mechanism of vascular remodeling, it is important to identify the smooth muscle cell in the vascular lesion and identify its phenotype by using molecular markers specific to the smooth muscle cell. Three types of myosin heavy chain (MHC) isoforms (SM1, SM2 and SMemb) expressed in smooth muscles are suitable for this purpose. In this study we first demonstrated that the expression of smooth muscle specific MHCs, such as SM1 and SM2, is reduced in human coronary arteries after the fifth decade. On the other hand, rapidly proliferating smooth muscles in the restenotic lesion express abundant SMemb but less amount of SM2. These observations indicate that deranged vascular smooth muscle differentiation is involved the development of vascular lesion. We furthermore demonstrated that smooth muscle-specific MHC is released into serum from the arterial wall following vascular damage as in dissecting aneurysm. Circulating smooth muscle MHC level was elevated 5-10 times above normal at 24 hours after aortic dissection as determined using a sensitive ELISA. We conclude from these results that smooth muscle MHC isoforms are important molecular markers for vascular pathology as well as for biochemical diagnosis of vascular injuries.
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PMID:[Smooth muscle myosin heavy chain expression in the arterial wall; a new viewpoint for vascular pathology]. 773 13

The patient was a 26-year-old man with Cushing's disease who underwent transsphenoidal microscopic surgery for a pituitary microadenoma. His postoperative course was uneventful, but he died suddenly five years after the operation. At autopsy, a ruptured dissecting aneurysm with marked atherosclerosis was observed in the aorta. In the pituitary, a small focus of adrenocorticotropic hormone (ACTH) producing adenoma, possibly residual adenoma, was detected and Crooke's degeneration was observed in the non-tumorous pituitary gland. But immunohistochemical patterns of pituitary hormones in the non-tumorous pituitary gland were normal and the adrenal cortex was unremarkable. In the hypothalamus, corticotropin-releasing hormone immunoreactivity was not detected and arginine vasopressin was sporadically positive. Considering these findings, this patient may have developed subclinical hypercortisolism due to the residual adenoma at the time of autopsy, despite clinical remission. Cushing's syndrome is considered to be a risk factor dissecting aneurysm, and in this case the metabolic changes in Cushing's disease may have influenced the development of the dissecting aneurysm. Periodic cardiovascular re-evaluations should therefore be performed when there is clinical remission of Cushing's syndrome.
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PMID:A case of ruptured dissecting aneurysm 5 years after pituitary microsurgical treatment of Cushing's disease: autopsy findings in the hypothalamic-pituitary-adrenal axis. 795 28

Atherosclerosis causes various types of flow disturbances within the affected arteries. Recent advances in the Doppler imaging technique have made possible evaluation of the temporal and spatial flow characteristics in the different portions of the arterial system, such as aorta, coronary, carotid and peripheral arteries. In the diagnosis of dissecting aneurysm of the aorta, transesophageal Doppler color flow imaging is quite useful to detect the site of entry, which is essential information for surgery. Intracoronary flow velocity can be accurately measured by intravascular Doppler technique. The recent introduction of a Doppler-tipped angioplasty guide wire makes it possible to measure the phasic flow deep within a coronary artery. The flow velocity measurement using a duplex system enables us to quantify the stenotic severity in carotid and peripheral arteries, and the Doppler color flow imaging, which has become available recently, also facilitates the demonstration and grading of atheromatous lesions in these arteries.
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PMID:[Doppler ultrasound in the diagnosis of atherosclerosis]. 841 70

Arterial dissection is usually associated with pathological states such as malignant hypertension, severe atherosclerosis, severe trauma, Marfan syndrome, or Ehlers-Danlos syndrome. However, we report three cases in which renal artery dissection occurred in otherwise healthy, normotensive men. In two cases, the onset of symptoms of renal artery dissection was coincident with an unusual degree of physical activity. In the third case, the symptoms occurred while the patient was sitting but during a stressful business meeting. In each case, the patient experienced severe unilateral flank pain. Urolithiasis was suspected, but intravenous pyelography showed only ipsilateral impaired renal cortical perfusion, and the urinalyses showed no hematuria. The diagnosis of renal artery dissection was established by arteriography in two cases and by nephrectomy in one case. The latter case showed fibromuscular dysplasia by arteriography performed after the nephrectomy. The other two cases showed no evidence of fibromuscular dysplasia. We conclude that spontaneous renal artery dissection can occur in otherwise healthy individuals. Our experience and the reports of others indicate that this condition occurs mainly in men, conservative (nonsurgical) management is generally indicated, and the long-term prognosis is generally excellent. In some patients, an unusual degree of physical exertion might be the cause of renal artery dissection.
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PMID:Renal artery dissection causing renal infarction in otherwise healthy men. 939 33

Arterial dissection, intimal tears, and intraluminal thrombosis are common sequelae of catheter-based interventional procedures for coronary artery disease. These may not be recognized reliably by contrast angiography. Intravascular ultrasound imaging is an innovative method that allows visualization of the cross-sectional anatomy with high-resolution real-time images. This article presents the recent experience in arterial imaging with this method. Studies documenting the ability of intravascular ultrasound to demonstrate arterial atherosclerosis and to unmask some problems related to atherosclerotic disease and its treatment by catheter-based maneuvers are presented. Problems of arterial dissection, intimal flaps, and intravascular thrombosis are described with in vitro and in vivo documentation of the capability of intravascular ultrasound to visualize these abnormalities. The clinical implications of real-time imaging of intimal flaps and intraluminal clots, and the possible value of this imaging modality in the performance of catheter-based therapeutic procedures for coronary and peripheral arterial disorders are discussed.
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PMID:Intravascular ultrasound assessment of arterial dissection, intimal flaps, and intraarterial thrombi. 1014 88

An autopsy case of extracranial internal carotid artery (ICA) dissecting aneurysm due to atherosclerosis was reported. A 74-year-old man was admitted to our hospital with the chief complaints of hoarseness and a pulsatile mass below the left mandibular angle. Neurological examination showed no obvious deficits except left recurrent laryngeal nerve palsy. Angiography revealed narrowing of the original segment of left ICA with dissection and aneurysmal dilation at the level of C3 vertebra. Seven days after admission, the patient had a sudden onset of consciousness disturbance. The second angiography showed no obvious changes compared with the first findings except slight narrowing in the distal portion above the aneurysmal dilation. The possible mechanism was thought to be recanalization following transient occlusion of the left ICA caused by extension of dissection or intracranial embolism due to a thrombus within the aneurysm. He was managed conservatively, but unfortunately he died of pneumonia. Macroscopic autopsy showed that the aneurysm was fusiform. Histologically, it demonstrated dissection of the hematoma between the media and adventitia layer. Hemorrhage in the atheromatous plaque with disruption of the elastic lamina were observed along with severe degenerative changes of the intima, media and, in part, adventitia layer due to atherosclerosis. In addition, a dissecting aneurysm of the right iliac artery and severe arteriosclerosis were observed in the systemic arteries. On the basis of these findings, the dissecting aneurysm presumably developed after disruption of a weak portion of the atherosclerotic wall, where intraplaque hemorrhage occurred earlier. We suggest that atherosclerosis be regarded as one of the pathogenic factors capable of causing dissecting aneurysm of the extracranial ICA in elderly patients.
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PMID:[Autopsied case of an extracranial internal carotid artery dissecting aneurysm]. 1100 95

Most aneurysms of the isthmus aortae, particularly those following thoracic trauma, are most likely to be diagnosed as acute dissecting or post-traumatic pseudoaneurysms. Furthermore, penetrating atherosclerotic ulcers in patients with atherosclerosis, congenital aneurysms such as ductus diverticulum and Kommerell's diverticulum, luetic aneurysms, and saccular aneurysms associated with Marfan's syndrome have to be included in the list of differential diagnoses. In view of the severe effect of any open thoracic surgical intervention, exact preoperative diagnosis is crucial. We report the case of a 73-year-old male patient who was accidentally diagnosed with an aneurysm of the atherosclerotic isthmus aortae. The aneurysm extended from the aorta to the dorsal site. The sacciform aneurysm (4.5 cm) was resected electively. Based upon localisation and pathomorphological findings, a penetrating ulcer was diagnosed. We also present a review of the current literature and give a survey of the differential diagnoses of aneurysms of the aortic isthmus: penetrating atherosclerotic ulcus, acute (traumatic) dissecting aneurysm, post-traumatic pseudoaneurysm, ductus diverticulum, Kommerell's diverticulum, syphilitic aneurysm, and sacciform aneurysm due to Marfan's syndrome.
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PMID:[Differential diagnosis of saccular aneurysms of the isthmus aortae: example of a penetrating atherosclerotic ulcer. Case-report and review of the literature]. 1525 52

Aging seems to be related to various vascular diseases, such as dissecting aneurysm and atherosclerosis. The nature of the relationship between aging and these vascular diseases has not been completely clarified. The goal of this study was to investigate, using morphological and morphometrical methods, the age related modifications of the arterial wall in rabbits of three different ages, evaluating separately two different vascular districts and the various aortic segments. Our results confirm that the most relevant age-related structural aortic changes were the increase of thickness, length, volume and diameter of the vessels, together with the development of an intimal thickening. The latter was diffuse in the aorta and focal in coronary vessels and it appears earlier in the aorta than in the coronaries, being absent in the coronaries of young rabbits. In addition, morphological and ultrastructural studies revealed the presence in aged rabbits of some marked intimal storage of a ground substance into intimal thickening of proximal aortic segments. Morphometric studies demonstrated an age-related decrease of aortic cellularity of tunica media and a parallel increase of the content of collagen and glycosaminoglycans, whereas elastin did not vary. The different relationships between cells and interstitial tissue occurring with aging are most probably a phenomenon of adaptation to the changing forces acting on the arterial wall and they might constitute the structural background of the increased arterial susceptibility to various noxae. Finally, the intimal storage of the ground substance, probably related to a functional disturbance of endothelium and or smooth muscle cells, may play an initiating role in atherogenesis.
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PMID:Age-related modifications of aorta and coronaries in the rabbit: a morphological and morphometrical assessment. 1537 30

Aneurysms of the superior mesenteric artery branches are rarely reported, even among them colic artery aneurysms are seldom. We report a case of 78-year-old male with ruptured dissecting aneurysm of middle colic artery. The patient complained abdominal pain and nausea during hospital stay for renal stone. The patient suddenly developed severe abdominal pain, leading to shock. He underwent emergency surgery under a preoperative diagnosis of intraperitoneal hemorrhage. At exploratory laparotomy, a large hematoma involving the mesentery root of the transverse colon was associated with a ruptured aneurysm measuring 15 x 10 mm in size, which was located to the mid-portion of middle colic artery. Right-hemicolectomy was carried out because of ischemic changes in the ascending colon. Histological examination demonstrated a ruptured dissecting aneurysm of the middle colic artery approximately 5 cm in length, associated with destruction of the tunica interna and media. The aneurysm was thought to result from idiopathic segmental arterial mediolysis, because no definitive evidence of atherosclerosis or arteritis was observed.
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PMID:A case report: spontaneous rupture of dissecting aneurysm of the middle colic artery. 1571 85

We report a case of 58-year-old woman with a ruptured dissecting aneurysm of the middle colic artery (MCA). Her initial manifestation was sudden and severe right-sided abdominal pain, followed by hemorrhagic shock and acute anemia. Abdominal CT showed a right retroperitoneal hemorrhage. Emergency catheter angiography and therapeutic coil embolization of the middle colic artery were performed and micro aneurysms were enhanced in the jejunal branch. Immunological tests showed nothing abnormal. Follow-up angiography after 3 months showed that the micro aneurysms had disappeared. The patient was diagnosed as having segmental arterial mediolysis (SAM), because no definitive evidence of atherosclerosis and polyarteritis nodosa were observed. SAM is a rare disease of unknown etiology. The arterial lesions developing in elderly patients are characterized by segmental lysis of the abdominal splanchnic arteries resulting in aneurysms, and acute bleeding in a skip pattern. Multiple aneurysms and abdominal pain due to the rupture of these lesions in SAM resemble the clinical findings in polyarteritis nodosa. Differential diagnosis of the two diseases is important because steroid therapy is not beneficial for SAM.
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PMID:[A case report of segmental arterial mediolysis]. 1760 60


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