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中国实用护理杂志 2009年第21期25卷 56-57页

作者：丁国红武汉市妇女儿童医疗保健中心

川崎病为小儿时期发热伴出疹性疾病,发病有逐年增多的趋势,感染性超抗原激发机体产生异常的免疫应答反应可能为其发病机制。川崎病的发病以5岁以下婴幼儿为主,男女发病之比为3:1,其继发冠状动脉损害为小儿时期后天性心脏病的最常见原因... 详细信息

川崎病为小儿时期发热伴出疹性疾病,发病有逐年增多的趋势,感染性超抗原激发机体产生异常的免疫应答反应可能为其发病机制。川崎病的发病以5岁以下婴幼儿为主,男女发病之比为3:1,其继发冠状动脉损害为小儿时期后天性心脏病的最常见原因,临床上采用大剂量静脉滴注丙种球蛋白可明显减少冠状动脉病变。我科2001年1月-2006年1月对386例川崎病患儿采用此法进行治疗,效果显著,现报道如下。

关键词：丙种球蛋白类超抗原发热感染冠状动脉疾病冠状血管/病理学输注静脉内黏膜皮肤淋巴结综合征儿童儿童学龄前女(雌)性人类婴儿婴儿新生

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Disruption of the sarcoglycan-sarcospan complex in vascular smooth muscle: A novel mechanism for cardiomyopathy and muscular dystrophy

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CELL 1999年第4期98卷 465-474页

作者： Coral-Vazquez, R Cohn, RD Moore, SA Hill, JA Weiss, RM Davisson, RL Straub, V Barresi, R Bansal, D Hrstka, RF Williamson, R Campbell, KP Univ Iowa Coll Med Howard Hughes Med Inst Dept Physiol & Biophys Iowa City IA 52242 USA Univ Iowa Coll Med Dept Neurol Iowa City IA 52242 USA Univ Iowa Coll Med Dept Pathol Iowa City IA 52242 USA Univ Iowa Coll Med Dept Obstet & Gynecol Iowa City IA 52242 USA Dept Vet Affairs Iowa City IA 52242 USA Univ Iowa Dept Anat & Cell Biol Iowa City IA 52242 USA Univ Iowa Dept Internal Med Iowa City IA 52242 USA

To investigate mechanisms in the pathogenesis of cardiomyopathy associated with mutations of the dystrophin-glycoprotein complex, we analyzed genetically engineered mice deficient for either alpha-sarcoglycan (Sgca) or delta-sarcoglycan (Sgcd). We found that only Sgcd null mice developed cardiomyopathy with focal areas of necrosis as the histological hallmark in cardiac and skeletal muscle. Absence of the sarcoglycan-sarcospan (SG-SSPN) complex in skeletal and cardiac membranes was observed in both animal models. Loss of vascular smooth muscle SG-SSPN complex was only detected in Sgcd null mice and associated with irregularities of the coronary vasculature. Administration of a vascular smooth muscle relaxant prevented onset of myocardial necrosis. Our data indicate that disruption of the SG-SSPN complex in vascular smooth muscle perturbs vascular function, which initiates cardiomyopathy and exacerbates muscular dystrophy.

关键词：心肌病扩张型/遗传学心肌病扩张型/代谢心肌病扩张型/病理学载体蛋白质类/生理学冠状血管/病理学细胞支架蛋白质类/缺乏细胞支架蛋白质类/遗传学细胞支架蛋白质类/生理学大分子物质膜糖蛋白类/缺乏膜糖蛋白类/遗传学膜糖蛋白类/生理学膜蛋白质类/生理学小鼠基因敲除肌平滑血管/代谢肌平滑血管/病理学肌营养不良动物/遗传学肌营养不良动物/代谢肌营养不良动物/病理学心肌/病理学坏死肿瘤蛋白质类肌聚糖类动物小鼠

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Augmentation of vessel squeezing at coronary-myocardial bridge by nitroglycerin: Study by quantitative coronary angiography and intravascular ultrasound

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AMERICAN HEART JOURNAL 1999年第2期138卷 345-350页

作者： Hongo, Y Tada, H Ito, K Yasumura, Y Miyatake, K Yamagishi, M Natl Cardiovasc Ctr Cardiol Div Med Suita Osaka 565 Japan

Background Nitroglycerin is known to augment vessel wall squeezing ai the site with coronary-myocardial bridging (CMB). This study was designed td define the mechanism of nitroglycerin-induced augmentation of CMB in clinical settings. Methods We analyzed nitroglycerin reactivity at the site with CMB in 39 patients. Maximal and minimal diameters of CMB during a cardiac cycle were measured by quantitative angiography before and after intracoronary administration of 250 mu g nitroglycerin. In 15 patients, CMB sites were observed by intravascular ultrasound to determine the intimal thickness and the time-serial change in vessel area. Results Before nitroglycerin, CMB was demonstrated with angiography in 25 patients, and the remaining 14 patients showed CMB after nitroglycerin. The maximal diameter during diastole increased from 1.4 +/- 0.4 mm to 1.9 +/- 0.4 mm after nitroglycerin, whereas the minimal diameter during systole decreased from 1.0 +/- 0.4 mm to 0.7 +/- 0.4 mm (P <.01). Thus nitroglycerin augmented the percent vessel narrowing during systole from 24% +/- 21% to 65% +/- 16% (P <.01). Under these conditions, intravascular ultrasound showed the reduction of the cross-sectional area of the sites with CMB by -38% +/- 16% (P <.01) during systole, and this phenomenon continued to early diastole (-30% +/- 16%). The intimal thickness was 0.32 +/- 0.10 mm, which suggests the absence of atherosclerotic disease at CMB sites. Conclusions These results indicate that nitroglycerin-induced augmentation of the percent narrowing of CMB can be derived from further systolic compression of the vessel lumen as well as diastolic expansion, probably because of the increase in vessel compliance after nitroglycerin. We suggest that the delayed dilation of coronary lumen during the early diastole may contribute to the occurrence of myocardial ischemia.

关键词：缩窄病理性冠状血管造影术冠状血管/病理学冠状血管/超声检查硝酸甘油/药理学超声检查介入性成年人老年人女(雌)性人类男(雄)性中年人

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Implications of small reference vessel diameter in patients undergoing percutaneous coronary revascularization

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第1期34卷 40-48页

作者： Schunkert, H Harrell, L Palacios, IF Massachusetts Gen Hosp Cardiac Catheterizat Lab Cardiac Unit Dept Med Boston MA 02114 USA Univ Regensburg Med Klin & Poliklin Innere Med 2 D-8400 Regensburg Germany

OBJECTIVES The purpose of this study was to determine whether small reference diameter of the culprit coronary artery influences the outcome of an attempted percutaneous revascularization procedure in the current era of interventional cardiology. BACKGROUND Alhough the interventional strategy is largely determined by the size of the culprit coronary artery, earlier quantitative studies have not shown a worse acute outcome for small reference vessel diameter (less than or equal to 2.5 mm). METHODS A total of 2,306 patients undergoing percutaneous coronary revascularization was divided in groups with reference diameters less than or equal to 2.5 mm (n = 813) or >2.5 mm (n = 1,493). Success and in-hospital major adverse cardiac event (death, Q-wave myocardial infarction and emergency coronary artery bypass graft) rates between both groups were compared. RESULTS Patients with lesions in small vessels were older and presented more frequently with female gender, diabetes mellitus, heart failure, peripheral vascular, multivessel coronary disease and American Heart Association/American College of Cardiology (AHA/ACC) lesion type C (p less than or equal to 0.01, each). Further, utilization of interventional devices differed markedly. In contrast to stents (18.5% vs. 41.9%) and directional atherectomy (3.7% vs. 13.5%), conventional balloon angioplasty (73% vs. 50%) and rotational atherectomy (16.1% vs. 8.3%) were used more often in smaller vessels (p less than or equal to 0.0001, each). Success rate was lower in the small vessel group (92% vs. 95%;p = 0.006). Major adverse cardiac events occurred more frequently in small than large vessels (univariate 3.4% vs. 2.0%, p = 0.03;multivariate odds ratio 2.1, p = 0.02), particularly when proximal coronary segments were compared. CONCLUSIONS Lesions in vessels with small reference diameter represent a distinct group with respect re, clinical and morphologic characteristics as well, as device utilization. These lesions have lower cha

关键词：血管成形术气囊冠状动脉共病现象冠状血管造影术冠心病/诊断显像冠心病/流行病学冠心病/治疗冠状血管/病理学 Logistic模型比值比预后前瞻性研究危险因素治疗结果老年人女(雌)性人类男(雄)性中年人

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Local adenovirus-mediated transfer of C-type natriuretic peptide suppresses vascular remodeling in porcine coronary arteries in vivo

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 2000年第4期35卷 1040-1047页

作者： Morishige, K Shimokawa, H Yamawaki, T Miyata, K Eto, Y Kandabashi, T Yogo, K Higo, T Egashira, K Ueno, H Takeshita, A Kyushu Univ Grad Sch Med Sci Dept Cardiovasc Med Higashi Ku Fukuoka 8128582 Japan

OBJECTIVE This study was designed to examine whether or not adenovirus-mediated gene transfer of C-type natriuretic peptide (CNP) can prevent coronary restenotic changes after balloon injury in pigs in vivo. BACKGROUND Gene therapy to prevent restenosis after percutaneous transluminal coronary angioplasty (PTCA) might be useful but requires a method applicable for in vivo gene delivery into the coronary artery as well as the efficient vector encoding a potent antiproliferative substance. We tested whether the adenovirus-mediated gene transfer of CNP by use of an infiltrator angioplasty balloon catheter (IABC) might prevent the coronary restenotic changes after balloon injury. METHODS Balloon angioplasty was performed in the left anterior descending and the left circumflex coronary artery in pigs. Immediately after the balloon injury, adenovirus solution encoding either CNP (AdCACNP) or beta-galactosidase (AdCALacZ) gene was injected with IABC into the balloon-injured coronary segments. Expression of CNP was assessed by immunohistochemical staining and cyclic guanosine 3',5'-monophosphate (cGMP) measurement. Coronary restenotic changes were evaluated by both angiographic and histological examinations. RESULTS CNP was highly expressed in the media and the adventitia of the coronary artery at the AdCACNP-transfected but not at the AdCALacZ-transfected segment. In the AdCALacZ-transfeaed segment, vascular cGMP levels tended to be reduced as compared with the untreated segment, whereas in the AdCACNP-transfected segment, vascular cGMP levels were restored. Angiographic coronary stenosis was significantly less at the AdCACNP-transfected than at the AdCALacZ-transfected segment. Histological examination revealed that this was achieved primarily by the marked inhibition of the geometric remodeling of the coronary artery by the CNP gene transfer. CONCLUSIONS Adenovirus-mediated CNP gene transfer with the IABC system may be a useful gene therapy to prevent restenosis after PT

关键词：腺病毒科/遗传学血管成形术气囊冠状动脉冠状血管造影术冠状动脉循环/遗传学冠心病/遗传学冠心病/病理学冠心病/治疗冠状血管/损伤冠状血管/病理学基因表达调控/生理学基因转移技术利钠肽 C型/遗传学复发猪动物

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Improved quantitative characterization of atherosclerotic plaque composition with immunohistochemistry, confocal fluorescence microscopy, and computer-assisted image analysis

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HISTOCHEMISTRY AND CELL BIOLOGY 2000年第3期113卷 161-173页

作者： Taatjes, DJ Wadsworth, MP Schneider, DJ Sobel, BE Univ Vermont Coll Med Dept Pathol Burlington VT 05405 USA Univ Vermont Coll Med Dept Med Burlington VT 05405 USA Univ Vermont Coll Med Cell Imaging Facil Burlington VT 05405 USA

To quantitatively characterize contributions of major constituents to the composition of a given atherosclerotic plaque, we have developed an approach employing immunohistochemistry. confocal scanning laser microscopy, and computer-assisted image analysis. The method developed permits identification of plaques that are particularly vulnerable to rupture and elucidation of the nature of the composition of a given plaque, as well as the extent of luminal encroachment. Thus, it should be useful in experimental animals and ultimately in patients in delineating compositional changes in response to potentially deleterious genetic and environmentally induced factors and to potentially therapeutic interventions designed to diminish plaque vulnerability.

关键词：动脉硬化/代谢动脉硬化/病理学胶原/代谢冠状血管/代谢冠状血管/病理学荧光染料图像处理计算机辅助/方法免疫组织化学/方法脂类代谢小鼠近交C57BL 小鼠突变型显微镜检查共焦/方法动物小鼠

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HETEROGRAFTS AS AORTOCORONARY BYPASS CONDUITS IN HUMAN BEINGS

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AMERICAN JOURNAL OF CARDIOLOGY 1975年第6期36卷 823-828页

作者： BULKLEY, BH ROBERTS, WC NHLI SECT PATHOLBLDG 10ARM 3E-30BETHESDAMD 20014

Clinical and necropsy observations are described in a man in whom two sheep carotid arterial heterografts were inserted as aortocoronary bypass conduits 30 months before death, and in whom a canine saphenous vein heterograft was inserted several hours before death. All three grafts failed. The lumens of the sheep carotid arterial heterografts had closed by the time of catheterization 6 months after operation; at necropsy both grafts were totally occluded at their coronary and aortic ends and their media and adventitia were infiltrated by granulomatous inflammatory cells. Little information is available regarding the use of heterografts as coronary bypass conduits. Examination of previous reports describing heterografts for vascular reconstruction or bypass in both man and experimental animals and observations in our patient suggest that heterografts are unsatisfactory as aortocoronary bypass conduits.

关键词：颈动脉/病理学颈动脉/移植冠状动脉分流术/方法冠心病/外科学冠状血管/病理学隐静脉/病理学隐静脉/移植绵羊移植异种/方法成年人动物狗人类中年人

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CORRELATION OF ABNORMAL Q-WAVES, CORONARY PATHOLOGY, AND VENTRICULAR CONTRACTILITY

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AMERICAN HEART JOURNAL 1975年第4期90卷 451-457页

作者： GOTTLIEB, RS DUCA, PR KASPARIAN, H SCARIATO, A BREST, AN JEFFERSON MED COLL PHILADELPHIAPA THOMAS JEFFERSON UNIV HOSP 11TH & WALNUT STPHILADELPHIAPA 19107

Four hundred and ninety-two patients with coronary artery disease underwent analysis of their electrocardiograms, coronary arteriograms, and ventriculograms. Significant Q-waves were correlated with critical coronary occlusions (≥ 75 per cent obstruction) and ventricular contractility. It was found that Q-waves correlate equally well with ventriculographic abnormalities and critical coronary occlusions. The Q-wave correlation varied from 77 to 87 per cent, depending on the area of myocardium under consideration, except for true posterior myocardial infarction, which correlated 55 per cent with ventriculographic abnormalities and 55 per cent with critical coronary occlusions. Significant Q-waves in Leads II, III, and a VF are better indicators of ventriculographic abnormality than in Leads III and a VF alone, whereas Q-waves in the latter two leads are more definitive than in Lead III alone. Patients who have critical coronary occlusions and normal electrocardiograms have normal ventriculograms in 71 to 78 per cent of the cases, again depending on the area of the myocardium under consideration. Thus, the normal electrocardiogram correlates better with the ventriculogram than with coronary pathology. The abnormal electrocardiogram correlates equally well with both.

关键词：冠状血管造影术冠心病/病理学冠心病/病理生理学冠心病/放射摄影术冠状血管/病理学心电描记术心室/病理生理学心肌收缩人类

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CORONARY THROMBOSIS - FACTS AND BELIEFS

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AMERICAN HEART JOURNAL 1976年第6期91卷 683-688页

作者： BAROLDI, G UNIV PISA CNR CLIN PHYSIOL LAB I-56100 PISA ITALY UNIV MILAN SCH MED IST ANAT PATOL MILAN ITALY

Selected patients (100) were used as a basis for discussion. The distinction between small and large infarcts was considered with regard to the primary role of the thrombus. Tables were presented depicting correlation of noncorrelation between infarct size, survival time, size of myocardial scar, heart weight, hypertension, anticoagulant therapy and terminal irreversible shock.

关键词：急性病动脉硬化/并发症动脉硬化/病理学冠心病/并发症冠心病/病理学冠状血管/病理学心肌梗死/病因学心肌梗死/病理学血栓形成/并发症血栓形成/病理学人类

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SCANNING ELECTRON-MICROSCOPE STUDY OF HUMAN VEINS AND AORTA-CORONARY ARTERY VEIN GRAFTS

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JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 1976年第5期71卷 673-679页

作者： BARBORIAK, JJ VANHORN, DL PINTAR, K BATAYIAS, GE KORNS, ME VET ADM HOSP SERV RES WOOD WI 53193 USA VET ADM HOSP SERV PATHOL WOOD WI 53193 USA MED COLL WISCONSIN DEPT PHARMACOL MILWAUKEE WI 53233 USA MED COLL WISCONSIN DEPT PHYSIOL MILWAUKEE WI 53233 USA MED COLL WISCONSIN DEPT OPTHAL MOL MILWAUKEE WI 53233 USA MED COLL WISCONSIN PATHOL MILWAUKEE WI 53233 USA ST LUKES HOSP DEPT PATHOL MILWAUKEE WI USA

Scanning EM study of 2 vein grafts which were removed after 50 mo. of implantation as aorta-coronary artery vein grafts showed considerable subendothelial thickening, which consisted of a relatively cell-poor fibrous layer. In 1 of the grafts the endothelial surface was intact;the 2nd graft showed focal loss of endothelial cells. Sections of 2 fresh human veins, studied prior to their insertion as aorta-coronary artery vein grafts, showed that they retained an intact endothelial layer. A 3rd fresh vein showed focal damage with missing endothelial cells and adherent fibrin.

关键词：尸体解剖冠状动脉分流术冠状血管/病理学冠状血管/超微结构显微镜检查电子扫描隐静脉/病理学隐静脉/超微结构人类男(雄)性中年人

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