冠動脈内視鏡法によるPalmaz-Schatzステント植込み後の内膜表面変化 : 経時的観察の検討 [in Japanese] Serial Coronary Angioscopic Observations afrer Palmaz-Schatz Coronary Stent Implantation [in Japanese] ...
Fig. 8. (A) Angioscopic image of the left anterior descending artery in a patient with acute MI demonstrating yellow plaque. (B,C,D) Intravascular ultrasound images as depicted in lesion A demonstrating compensatory enlargement. (B) At the defined proximal reference site the external elastic membrane (EEM) cross-sectional area (CSA) was 11.8 mm2. (C) At the culprit lesion, EEM CSA was 13.5 mm2. (D) At the distal reference site, EEM CSA was 9.6 mm2. The remodeling ratio (RR) was 1.26. (E) Angioscopic image of the left anterior descending artery in a patient with stable angina demonstrating white plaque. (F,G,H) Intravascular ultrasound images at the same lesion as E demonstrating paradoxical shrinkage. (F) At the proximal reference site, EEM CSA was 17.1 mm2. (G) At the culprit lesion EEM CSA was 10.1 mm2. (H) At the distal reference site, EEM CSA was 15.3 mm2. The RR was 0.62 (79).. Fig. 8. (A) Angioscopic image of the left anterior descending artery in a patient with acute MI demonstrating ...
The study by den Heijer and colleagues is of interest to both interventional cardiologists and internists. The availability of low-profile, flexible, and steerable angioscopic systems has allowed the routine percutaneous application of this technology. Interpretable images can now be obtained in most patients having interventional procedures, although the technique still has important limitations. Problems remain with aiming the angioscope, and a clear imaging field cannot always be obtained. The widespread availability of second-generation interventional technologies, including stents, atherectomy catheters, and local drug delivery systems, give the interventionist a choice of therapies. Precise knowledge of coronary morphology may have an important effect on the decision of which technique to use to treat a given lesion. The study by den Heijer and colleagues suggests that, in a few patients, the angioscopic information was useful to the clinician. These results, however, cannot be ...
Angioscopy represents a diagnostic tool with the unique ability of assessing the true color of intravascular structures. Current angioscopic interpretation is entirely subjective, however, and the visual interpretation of color has been shown to be marginal at best. The quantitative colorimetric angioscopic analysis system permits the full characterization of angioscopic color using two parameters (C1 and C2), derived from a custom color coordinate system, that are independent of illuminating light intensity. Measurement variability was found to be low (coefficient of variation = 0.06-0.64%), and relatively stable colorimetric values were obtained even at the extremes of illumination power. Variability between different angioscopic catheters was good (maximum difference for C1, 0.022; for C2, 0.015). Catheter flexion did not significantly distort color transmission. Although the fiber optic illumination bundle was found to impart a slight yellow tint to objects in view (deltaC1 = 0.020, deltaC2 ...
Background: Although sirolimus-eluting stent (SES) has significantly reduced in-stent restenosis by inhibiting neointimal hyperplasia, insufficient neointimal coverage after stenting may result in adverse outcomes. Determinants of neointimal coverage following SES, however, are poorly understood.. Methods: We evaluated 28 SES lesions using both angioscopy and intravascular ultrasound (IVUS). Degree of neointimal coverage was judged by angioscopy at follow-up (11 ± 6 months): complete/incomplete coverage, based on whether the stent struts were embedded by the neointima. Minimal stent area (MSA), external elastic membrane (EEM), lumen cross-sectional area (CSA) and plaque burden (EEM minus lumen/EEM CSA) were measured by IVUS at stent implantation. Both proximal and distal references were used. Stent expansion was assessed by stent expansion index (SEI) as MSA/reference EEM CSA. Under-expansion was defined as SEI , 0.4. Incomplete apposition was defined as the lack of contact between any strut ...
Hyperspectral imaging (HSI) of rabbit atherosclerotic plaque in near-infrared (NIR) range from 1150 to 2400 nm was demonstrated. A method to identify vulnerable plaques that are likely to cause acute coronary events has been required. The object of this study is identifying vulnerable plaques by NIR-HSI for an angioscopic application. In this study, we observed the hyperspectral images of the atherosclerotic plaque in WHHLMI rabbit (atherosclerotic rabbit) artery under simulated angioscopic conditions by NIR-HSI. NIR-HSI system was constructed by a NIR super continuum light and a mercury-cadmium-telluride camera. Spectral absorbance values (log (1/R) data) were obtained in the wavelength range from 1150 to 2400 nm at 10 nm intervals. The hyperspectral images were constructed with spectral angle mapper algorithm. As a result, the detections of atherosclerotic plaque under angioscopic observation conditions were achieved especially in the wavelength around 1200 nm, which corresponds to the second ...
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For diagnostic imaging. Primarily indicated in diagnostic fluorescein angiography or angioscopy of the fundus and of the iris vasculature ...
Identifying cell-enhancement strategies, be it genetic modification (1) or small molecule antagonism (2), is essential to improve the therapeutic efficacy of cell-based therapies. Indeed, transplanted cells in a wide variety of models demonstrate poor engraftment, with high rates of cell attrition. Herein, we highlight important differences in GSK3β signaling as a factor for enhanced EPC senescence in DM resulting in accelerated rates of apoptosis. Moreover, using a proteomics approach, we identified upregulation of cathB as protective for reductions in basal and stress-induced apoptosis. Finally, in a xenotransplant model, we confirm that cathB activity is required for GSKi-induced improvements in EPC mediated arterial repair.. Patients with DM have increased rates of cardiovascular disease and markedly higher rates of in-stent restenosis after revascularization. This, in part, is owing to attenuated EPC function in patients and fewer circulating cells (16). Multiple mechanisms of EPC ...
TY - JOUR. T1 - Evaluation of thrombus removal by transluminal extraction coronary atherectomy by percutaneous coronary angioscopy. AU - Annex, Brian H.. AU - Larkin, Timothy J.. AU - ONeill, William W.. AU - Safian, Robert D.. PY - 1994/9/15. Y1 - 1994/9/15. N2 - Coronary angioscopy was superior to angiography for evaluating the efficacy of thrombus removal after TEC. In patients with acute ischemic syndromes, TEC was effective in removing intraluminal thrombus.. AB - Coronary angioscopy was superior to angiography for evaluating the efficacy of thrombus removal after TEC. In patients with acute ischemic syndromes, TEC was effective in removing intraluminal thrombus.. UR - http://www.scopus.com/inward/record.url?scp=0027971027&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0027971027&partnerID=8YFLogxK. U2 - 10.1016/0002-9149(94)90753-6. DO - 10.1016/0002-9149(94)90753-6. M3 - Article. C2 - 8074047. AN - SCOPUS:0027971027. VL - 74. SP - 606. EP - 609. JO - American ...
Figure 3.. Endoscopic view of renal papilla from stone forming phenotypes with BD plugs, yellow plaque and attached stones to Randalls plaque. Panel A shows extensive regions of yellow plaque in IMCD (arrows) and a single site of Randalls plaque (double arrow) of a brushite patient. Panel B shows modest changes in a papilla from an ileostomy patient including dilated BD (asterisk), yellow plaque (arrowhead) and white plaque (arrow). Patients with small bowel resection (panel C) show attached stones (double arrows) in a region of white (arrows) and yellow (arrowheads) plaque. Patients with hyperparathyroidism (panel D) also have attached stones (within white box and insert) is magnified in the insert at the upper right; the stone is outlined within the insert by a black dotted overlay and the plaque border is indicated with an arrow. Areas of yellow (double arrows), white (single arrowhead) plaque and BD plug (single arrow) are seen on one papillum.. Histopathologic observations: The primary ...
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Drug-eluting stent (DES) achieved significant reduced restenosis, however the safety of efficacy of DES in acute myocardial infarction (AMI) are still controversial. In this study, we compared angioscopic parameters between DES and bare metal stent (BMS) in patients with AMI. Eighty-seven consecutive patients who received DES or BMS for AMI were enrolled. At 6-month after AMI, coronary angiography was performed in all patients. We performed coronay angioscope (CAS) if the patients did not show significant in-stent restenosis (,50% stenosis). Using CAS, we evaluated the maximum and minimum grade of neointimal coverage within one stent using the following CAS score: 0: stent struts were exposed similary to right implantaiton, 1: stent were covered by very thin neointima, 2: struts were embedded but visible and 3: struts were fully embedded and invisible. We adopted minimium grade as the magnitude of neointimal coverage and calculated heterogeneity score as the following formula: (maximum grade) ...
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Intravascular ultrasound is a new method for visualizing the details of vascular pathology, providing high resolution images of plaque and thrombus. This review summarizes the potential applications of ultrasound imaging in the guidance of balloon angioplasty, atherectomy, laser ablation and stenting. Ultrasound differs from angiography and angioscopy in its ability to penetrate below the surface of the vessel lumen, demonstrating specific aspects about the distribution and composition of plaque. Because the different layers of the arterial wall have different acoustic properties, ultrasound catheters are able to define the layers of normal wall in comparison with plaque. Particularly in combination with therapeutic techniques designed to remove or ablate plaque, ultrasound may prove useful in maximizing the amount of plaque treated and minimising trauma to normal vessel wall components. Combined imaging/therapeutic devices are in the pilot phase of development and show promise for enhancing the ...
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Coronary thrombi in patients who die suddenly are more likely to display signs of healing if they are caused by a plaque erosion rather than a rupture, researchers found.
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To allow for the differences in yellow color in each plant extract primarily due to varying amounts of contaminating photosynthetic pigments, it was necessary to blank each extract separately with diluted extract in buffer lacking the GUS substrate, PNPG. Once you have obtained corrected absorbance values by subtracting the absorbance due to yellow color that is not related to PNPG breakdown, you also must normalize the activities further so that you can compare plants. Typically activities are expressed on a per mg fresh weight or protein basis. Because the method used to cut the tissue disks produce tissue pieces of a uniform size we will express our enzyme activities on a per disk basis. Calculate the GUS activity found in each of your extracts as: Activity = nmoles product formed/minute-leaf disk. You may then compare your data with those of your classmates ...
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Late and sudden thrombotic coronary occlusion after percutaneous coronary interventions was first noted as a significant problem 2 to 15 months after brachytherapy (22). In contrast, meta-analyses of initial long-term outcomes after sirolimus-eluting (10,23) or paclitaxel-eluting stent implantation (12) pointed to the overall benefit of DES compared with BMS in selected patient groups and suggested no increased hazard of stent thrombosis compared with BMS use. However, there were case reports (8,16) demonstrating the occurrence of late stent thrombosis after DES implantation associated with a high risk of death or nonfatal MI. Reasons for thrombotic events were described in experimental (24) and autopsy studies (25): DES may delay endothelialization and impair intimal healing, partly in association with hypersensitivity and inflammatory reactions, and thereby extend the time window during which stents are prone to thrombosis (8). This has been confirmed recently by angioscopic findings (26). Two ...
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The extent of luminal narrowing varies with underlying plaque morphology. TCFAs and fibroatheromas have the least luminal narrowing while lesions with acute plaque rupture, haemorrhage, or healed repair sites show the most stenosis. Over 74% of TCFAs have , 75% cross sectional area luminal narrowing (equivalent to , 50% diameter stenosis). Healed and acute plaque ruptures show the greatest luminal narrowing with 46% and 43%, respectively, containing , 75% cross sectional area narrowing. In contrast, only 26% of TCFAs show severe luminal narrowing (fig 3B). In a population where sudden cardiac death is the first manifestation of coronary disease, these morphologic findings strongly suggest that TCFAs are precursors to acute ruptures and healed plaque ruptures are often clinically silent.. TCFAs with ⩽ 50% diameter stenosis may be the ideal candidate lesions one should first attempt to identify and treat as a measure to reduce the incidence of myocardial infarction in high risk patients. If a ...
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Bleach could be the cause of the newer stains because my friend used bleach to get a stain out of her white sweatshirt before and because she did not wash it after using the bleach it had a big yellow stain where she had been rubbing...and for us we found out pretty quickly that it was irreversible i know that s not what u want to hear but we tried just about everything with her sweatshirt and nothing brought it out because its like a bleach stain and how do u get out a bleach stain.I hope my answer will help you a lot ...
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Hi! Im a vet student; Ive just necropsied a pigeon and found a green liver with two white plaques. What could be happening? Is it a sign of toxicity or infection, or is it just normal colour variation? The pigeon was previously diagnosed to have Candidiasis because of white-yellowish masses in the mouth. When I did the swab examination, I found hyphae but couldnt determine yet whether its Candida. Respiratory system got no lesion, unless some compaque-white appearance of the trachea. Digestive system got severe lesion in the crop, where theres some brown crusts. Is it a sole Candida infection or perhaps I should consider differential diagnose like Pox virus or Salmonella? I cant find any colour picture reference that match the lesion of my pigeon.. Could you please recommend me any book or online atlas? Thanks a million!. ...
Purpose: : To evaluate the clinical, histopathologic and genetic features of retinoblastoma (RB) in children over age 5 years. Methods: : Of 90 consecutive patients with RB who presented to the Retina Service at the Massachusetts Eye and Ear Infirmary, 6 patients (6.7%) had initial diagnosis after age 5 years. 4 had active tumors (4.4% of all cases) and 2 had inactive tumors (retinoma). Genetic testing for RB1 mutations was performed on constitutional and tumor DNA in 2 cases. Results: : There were 2 boys and 2 girls, all unilateral with no family history, ranging in age from 6 to 11 years (mean 8 years). 3 (2 girls, 1 boy) with unilateral decrease in vision (1 symptomatic, 2 by vision screen), total retinal detachment (RD) with vascular dilatation and telangiectasia were referred with diagnosis of Coats disease. 2 had RD in contact with the lens and third had tumor spherules in the vitreous. White plaques or tumors with dilated vessels that dive or arise from them were seen. Ultrasound (US) and ...
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The researchers believe that it might ultimately be possible to forestall or even prevent the development of atherosclerosis by injecting these cells into patients, or to induce the patients own stem cells to differentiate into progenitor cells capable of arterial repair.. Our studies indicate that the inability of bone marrow to produce progenitor cells which repair and rejuvenate the lining of the arteries drives the process of atherosclerosis and the formation of plaques in the arteries, said Duke cardiologist Pascal Goldschmidt, M.D., chairman of the Department of Medicine. For a long time weve known that aging is an important risk factor for coronary artery disease, and weve also known that this disease can be triggered by smoking, bad diet, diabetes, high blood pressure and other factors.. But if you compare someone who is over 60 with someone who is 20 with the same risk factors, there is obviously something else going on as well, he continued. The possibility that stem cells may ...
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Vanguard is well known for pioneering index funds, and index investing remains a vital part of Vanguards business strategy. However, the fund family also has a number of actively managed funds that seek to outperform their benchmarks, rather than simply match them.. However, when a fund fails to beat its benchmark and instead tends to see its returns align closely to broad market averages, investors have to ask themselves whether the returns warrant the higher expenses associated with actively managed funds. Vanguards Growth Equity fund is an example of this phenomenon; despite a relatively high (for Vanguard) expense ratio of 0.72%, the fund has fallen in the bottom 20% of its fund category over long periods of time. If youre paying more and not getting better performance, you may be better off sticking with one of Vanguards index funds.. A similar pattern exists with some special classes of funds. For instance, the Fidelity Advisor fund mentioned above looks pretty similar to another fund ...
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