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)

Aneurysms of an aberrant subclavian artery are rare. They are usually secondary to atherosclerosis. Dysphagia is the most common presenting symptom. The diagnosis of the lesions is easily established by CT scan or MRI. Biplane arteriography is necessary in order to clearly analyse the aortic arch and its branches. Surgical resection is usually indicated. We treated a patient who suffered from an aneurysm of an aberrant subclavian artery. The surgical technique is detailed as well as a review of all the surgical cases of the literature.
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PMID:Aberrant right subclavian artery aneurysm--a surgical review. 888 48

Of 2,130 consecutive patients admitted to two hospitals with acute brain infarction, we examined 11 patients (0.52%) with medial medullary infarction. The infarcts documented by MRI were unilateral in 9 patients and bilateral in 2 patients, and located in the anteromedial arterial territory of the upper or middle part of the medulla. Atherosclerosis of the vertebral arteries was the predominant vascular pathology. The vertebral artery was occluded at its terminal portion in 7 patients. Nine patients had hypertension, and 8 of these had additional risk factors. Male gender (10 patients) and smoking habits (7 patients) were more prevalent compared with patients with pontine infarction. One patient had a medial medullary infarction attributed to dissection of the vertebral arteries following blunt head injury. Limb weakness was the major symptom in all patients, and gaze-evoked nystagmus was also frequent (6 patients). Tongue weakness ipsilateral to the infarct, the classic sign of medial medullary syndrome, was evident in only 3 patients. The outcome was usually excellent.
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PMID:Medial medullary infarction: analyses of eleven patients. 890 19

The aim of this study is to evaluate the accuracy of three-step diagnosis in discriminating subtypes of acute ischemic stroke. A total of 120 consecutive patients with first-ever ischemic stroke, admitted to one general hospital, were prospectively studied. In the first step (within 24 hours of clinical onset), the first diagnosis was made according to clinical symptoms and signs, and patients were subdivided into four groups according to the classification of Oxfordshire Community Stroke Project: lacunar infarcts (LACI), total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), and posterior circulation infarcts (POCI). In the second step (24 hours to 72 hours from the onset), neuroimaging diagnosis was performed by CT and/or MRI. Four lesion sites were classified: 1) small subcortical infarction < or = 1.5 cm in diameter in the perforating artery territory (SSI), 2) supratentorial cortical or striatocapsular infarction (CI), 3) low-flow infarction (LFI) which includes centrum semiovale infarct and internal junctional infarct, and 4) posterior circulation infarction other than SSI (PI). In the third step, etiological diagnosis was made by examination including trans-thoracic echocardiography and MRA (3-D, PC). In accordance with the TOAST Study, the presumed stroke mechanism was categorized as either small-vessel occlusion (lacune), cardioembolism (CE), large-artery atherosclerosis (LAA), or others. The majority of patients with TACI, PACI or POCI showed the corresponding lesions on CT or MRI, while only 69% of LACI patients demonstrated SSI. Seventy-five percent of patients with TACI were categorized as CE in the third diagnosis, while the etiology of the patients with PACI was either CE or LAA in equal numbers. Only 60% of LACI patients were classified as lacune and 21% of them as LAA. Patients with LACI but classified as LAA usually had atypical clinical symptoms (e.g. monoparesis) and lesions other than SSI. The positive predictive value (PPV) of lacune in the combination of LACI and SSI was 0.75. Eighty-two percent of patients with CE had atrial fibrillation (af), which was the most frequent cardioembolic source. When patients with TACI or PACI had af, the PPV of CE was 0.93, but when they did not, the PPV of LAA was only 0.68. The etiology of POCI was variable. In conclusion, the agreement of the three-step diagnosis is considerable, but more rigorous clinical examination is needed for some clinical groups (POCI and LACI) and the etiological diagnosis of LAA.
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PMID:[Accuracy of three-step diagnosis in discriminating subtypes of acute ischemic stroke]. 914 68

The aortic dissection is an expanding intramural hematoma in the aortic wall separating its layers. That is the most common catastrophic condition of the aorta. Its incidence in Hungary about 3.0%/000/year may be appreciated. The mortality rate of the untreated cases exceeds the 90 per cent. The dissection begins by an intimal tear or by a medial hemorrhage, seldom. The progressing hematoma results in a false lumen running parallel with the true aortic lumen. On the basis of the location of the primary intimal tear the dissection may be proximal or distal. The inherited or acquired medial weakness and the hypertension are the main etiologic factors. Some pathological findings refer to predisposing role of the atherosclerosis. The ischemia caused by the dissection may damage any organ. The clinical picture is characterized by the polymorphism and the migration of the clinical signs. The suspicion of the disease may be raised on the basis of the anamnesis and the clinical picture. The diagnosis may be confirmed by the rutin chest roentgenograms and by the angiography, CT, MRI and ultrasonic examinations. The transoesophageal echocardiography is the best diagnostic tool. The treatment is medical and/or surgical. Advances in the surgical treatment brought turn in the very poor prognosis.
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PMID:[Aortic dissection]. 916 92

The early stages of atherosclerosis are characterized by the deposition of cholesteryl esters and triglycerides into the arterial wall. In the excised human atherosclerotic plaque these lipids are in a liquid-like state at body temperature and observable via MRI and NMR spectroscopy. To assess the ability of MRI to quantitatively image the lipids of atherosclerotic plaque in vivo, we have investigated eight New Zealand White rabbits fed atherogenic diets (2 weight (wt)% cholesterol, 1 wt% cholesterol + 6 wt% peanut oil, and 1 wt% cholesterol + 6 wt% com oil). Postmortem examination indicated that all rabbits developed atherosclerosis in the aorta. Except for one animal, magnetic resonance angiography showed no noticeable obstruction in the aorta. MRI was carried out in an attempt to image atherosclerotic plaque lipids directly, but no signal was detected in vivo. However, a plaque lipid signal was observed from excised tissue using a small diameter RF coil. 1H NMR spectroscopy of the atherosclerotic plaque from excised aortas indicated that the major fraction of plaque lipids in rabbits is not in a liquid state at physiological temperature and are only marginally MRI-visible compared to human plaque lipid. The differences in the MRI characteristics of rabbit and human plaque are due to differences in the fatty acid profile of the cholesteryl esters, chiefly a decrease of linoleic acid in rabbit lesions.
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PMID:MRI and NMR spectroscopy of the lipids of atherosclerotic plaque in rabbits and humans. 921 75

Heparin-binding epidermal growth factor-like growth factor (HB-EGF), a potent mitogen and migration factor for vascular smooth muscle cells (SMC), promoted neovascularization in vivo in the rabbit cornea. MRI demonstrated quantitatively the angiogenic effect of HB-EGF when introduced subcutaneously into nude mice. HB-EGF is not directly mitogenic to endothelial cells but it induced the migration of bovine endothelial cells and release of endothelial cell mitogenic activity from bovine vascular SMC. This mitogenic activity was specifically blocked by neutralizing anti-vascular endothelial growth factor (VEGF) antibodies. In contrast, EGF or transforming growth factor-alpha (TGF-alpha) had almost no effect on release of endothelial mitogenicity from SMC. In addition, RT-PCR analysis demonstrated that VEGF165 mRNA levels were increased in vascular SMC 4-10-fold by 0.35-2 nM of HB-EGF, respectively. Our data suggest that HB-EGF, as a mediator of intercellular communication, may play a new important role in supporting wound healing, tumor progression and atherosclerosis by stimulating angiogenesis.
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PMID:Intercellular communication between vascular smooth muscle and endothelial cells mediated by heparin-binding epidermal growth factor-like growth factor and vascular endothelial growth factor. 956 10

Acute infarcts of the anterior inferior cerebellar artery (AICA) are unusual. We report 15 cases of AICA infarcts and their correlation with the topography of the lesion by brain MRI. During 2 years we prospectively identified 7 cases of AICA infarcts among 770 acute strokes (0.9% of the acute strokes seen in our department). We studied these cases and also another 8 that we found retrospectively. Most patients (8/15) had a unilateral affectation of both middle cerebellar peduncle (MCP) and inferior lateral pontine area (ILP), in these cases the main symptoms were vertigo, ataxia, peripheral facial palsy and hypoacusia. Two other patients had isolated MCP infarcts and were characterized by peripheral vertigo and ataxia, without hypoacusia or facial palsy. Another 2 patients had isolated ILP territory infarct characterized by vertigo, left peripheral facial palsy without hypoacusia and mild or no ataxia. One patient had a Gasperini syndrome. Finally 3 patients had bilateral AICA infarcts due to basilar thrombosis. The etiology was atherosclerosis in 9 patients, lacunar due to hypertension in 1, cardiac embolism in 1, migraine in 1 and unknown in 3. Among the 15 patients only 2 died, both with AICA plus infarcts. In the remaining patients a follow-up during a mean of 31 months (3 months to 12 years) showed no recurrences.
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PMID:The anterior inferior cerebellar artery infarcts: a clinical-magnetic resonance imaging study. 957 36

Atheromatous aneurysms of the thoracic aorta are much less common than those of the abdominal aorta. Associated atherosclerosis of the coronary, cerebral and peripheral limb arteries is observed in 16, 10 and 11% of cases, respectively. Ultrasonography. CT scanning, and mostly MRI and digitised angiography provide very accurate morphological data. The natural history is dominated by the risk of rupture with a 3 year survival of 50% in aneurysms with a diameter superior to 5 cm. The surgical indication should be considered in cases of aneurysms with diameters over 5 cm after full carotid, coronary, respiratory and renal investigations. Surgery is simple in descending aortic aneurysms but more complicated in aneurysms of the transverse and descending aorta, especially in long lesions. Technical innovations have reduced the incidence of both cerebral complications after surgery of the aortic arch by improved cerebral protection and of medullary complications after surgery of the descending thoracic aorta, especially of thoraco-abdominal aneurysms, by better medullary protection against ischaemia during aortic clamping. The operative results have a mortality of: 3% for aneurysms of the ascending aorta: 10% for aneurysms of the aortic arch: 9% with a 15% risk of paraplegia, for long aneurysms of the descending thoracic aorta.
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PMID:[Atheromatous aneurysms of the thoracic aorta]. 958 60

Recent improvements in intravascular magnetic resonance imaging techniques mandate an accurate method of monitoring the introduction of MR catheter probes into the vessel of interest. For this purpose, a novel imaging protocol and a display method have been designed. First, a roadmap 3D image data set with standard pulse sequences is obtained using an external imaging coil. Subsequently, using very narrow rectangular-FOV fast-spoiled gradient recalled (SPGR), a movie of the percutaneous placement procedure of an MR catheter probe is acquired at a rate of 7.3 frames/second. In this protocol, the probe is used to transmit RF pulses and receive MR signal. A computer program was written for image unwrapping and for displaying the unwrapped movie frames on the roadmap image. In an alternative protocol, the movie frames in two projection angles were acquired in an interleaved fashion. Frames were unwrapped and combined with a 3D roadmap and displayed on a Silicon Graphics workstation equipped with stereovision goggles. Using these methods, percutaneous catheter placement in a phantom and a dog was examined. In conclusion, a new visualization technique for MR catheter placement is proposed. Combining this technique with high resolution intravascular MRI techniques may result in a very useful diagnostic tool for the evaluation of atherosclerosis and other vessel diseases.
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PMID:Catheter-tracking FOV MR fluoroscopy. 984 Aug 31

MRI of subjects with silent intracranial damages may provide more evidence than CT. Our objectives were to determine the prevalence of silent MRI lesions in patients with coronary artery disease. The study included 72 consecutive patients with angiographically proven coronary artery disease and 26 age and sex matched controls with normal coronary angiography. All subjects were evaluated for coronary atherosclerosis (Gensini and coronary angiography scores), the number of silent cerebral lesions detected by MRI, carotid stenosis and the risk factors for stroke. Thirty one of 72 (43.0%) patients had silent brain lesions on MRI while 8 of 26 (30.7%) control subjects showed silent brain infarction. The main finding on T2-weighted MRI was white matter hyperintensities (WMH) which were seen in all patients with silent brain lesions. The mean age of the patients with coronary artery disease and with silent cerebral lesions was significantly higher than that of patients without silent brain lesions. The Gensini score, coronary angiography score and prevalence of carotid stenosis are significantly higher in patients with silent cerebral lesions than that of patients without silent cerebral lesions. There was no significant difference between silent cerebral lesions and the other risk factors for stroke. Silent brain lesions are a common complication in patients with coronary artery disease. In patients with coronary artery disease, carotid artery stenosis and age were important risk factors for the development of silent brain infarction.
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PMID:Silent cerebral lesions on magnetic resonance imaging in subjects with coronary artery disease. 992 92


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