ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Background—Screening electron-beam computed tomography (EBCT) examinations for the detection and quantification of coronary artery calcification are being performed throughout the country. In addition to information about the heart, great vessels, and coronary arteries, these examinations include portions of the lungs, bony thorax, and upper abdomen. The purpose of this study was to determine the prevalence of significant noncardiac findings in a series of patients undergoing coronary artery calcification screening studies with EBCT scanning.Methods and Results—Between January 1, 2001, and October 1, 2001, 1326 consecutive patients underwent coronary artery calcification screening with EBCT (3-mm-thick slices were obtained at 3-mm intervals). Two board-certified radiologists reviewed the examinations on a workstation using standard mediastinal windows, lung windows, and bone windows. Significant extracardiac abnormalities were noted. Of 1326 patients, 103 (7.8%) had significant extracardiac pathology requiring clinical or imaging follow-up. These included 53 patients with noncalcified lung nodules <1 cm, 12 patients with lung nodules ≥1 cm, 24 patients with infiltrates, 7 patients with indeterminate liver lesions, 2 patients with sclerotic bone lesions, 2 patients with breast abnormalities, 1 patient with polycystic liver disease, 1 patient with esophageal thickening, and 1 patient with ascites.Conclusions—In this study, 7.8% of patients undergoing screening EBCT examinations for coronary artery calcification were found to have important extracardiac pathology requiring additional work-up. Therefore, it is essential that a radiologist review the entire examination.

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Background—Possible intermediate circulating markers linking blood stasis to vein remodeling were explored in patients with varicose veins in the lower limbs.Methods and Results—Blood was sampled at rest (supine position) and after a stasis of 30 minutes both in the varicose vein (limbs hanging down) and in the brachial vein (arm hanging down) as a paired control. Several endothelial and leukocyte markers were measured in plasma with the use of ELISA kits. Angiotensin-converting enzyme activity was determined by use of a specific substrate. Matrix metalloproteinases (MMPs) 9 and 2 were evaluated with the use of gelatin zymography. No markers were significantly modified after 30 minutes of blood stasis in the brachial vein. After 30 minutes of blood stasis in the varicose vein, oxygen partial pressure decreased (P<0.01). Although thrombomodulin, von Willebrand factor, vascular endothelial growth factor, and MMP-2 were not modified in these conditions, the proteins released by proteolysis from the endothelial membrane intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and angiotensin-converting enzyme were increased (P<0.01). After blood stasis in varicose veins, the leukocyte markers lactoferrin, myeloperoxidase, and interleukin-8 were not modified, whereas L-selectin shed from leukocytes increased (P<0.05), and a major increase in pro-MMP-9, which is released from tertiary granules during polymorphonuclear activation, was observed (P=0.0001).Conclusions—The marked increase in plasma pro-MMP-9 activity provides evidence of polymorphonuclear activation and granule release in the varicose vein in response to postural blood stasis. Similarly, detection in the plasma of membrane proteins shed from the endothelium or leukocytes provides evidence of pericellular proteolysis.

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Background—Postcoronary angioplasty vascular brachytherapy (VBT) has emerged as a successful intervention for restenosis prevention in some clinical scenarios. Longer-term follow-up after VBT in de novo nonstented lesions has not been reported.Methods and Results—Thirty patients treated with post–percutaneous transluminal coronary angioplasty (PTCA) VBT with Sr90underwent clinical and angiographic follow-up at 6 and 24 months. Specific vessel segment quantitative coronary angiographic analyses were performed to identify radiation edge effects. Nineteen patients who had not undergone index procedure stenting or target vessel revascularization (TVR) over the 2-year period were analyzed separately. Of the 30 patients, 3 underwent TVR by 6-month follow-up. An additional 4 patients required TVR between 6 and 24 months. In the total cohort of 26 patients undergoing angiographic follow-up at 6 and 24 months, an increase in minimal lumen diameter of the initial target segment was noted at 6 months compared with postprocedure analysis (2.31±0.48 versus 2.04±0.43 mm,P<0.05). At 24 months, this was no longer significant (2.19±0.61 mm). In the proximal segments of the entire cohort and the nonintervened subgroup, the principal late loss occurred over the first 6 months with no additional late loss at 2-year follow-up. The distal segments remained stable over the entire follow-up period.Conclusions—Although some late failures of post-PTCA VBT are seen between 6 and 24 months, most treated vessels remain stable with no late loss or additional luminal increase beyond the 6-month period. This suggests that late aneurysm formation and significant late edge restenosis are unlikely in VBT after PTCA of de novo lesions for up to 2 years.

ISSN:0009-7322    

出版商:OVID    

年代:2002

数据来源: OVID