Coronary Artery Aneurysms: Comprehensive Review and a Case Report of a Left Main Coronary Artery Aneurysm.

Coronary artery aneurysms (CAAs) are rare anatomical disorders of the coronary arteries. Atherosclerosis and Kawasaki disease are the principal causes of CCAs, while other causes including genetic factors, inflammatory arterial diseases, connective tissue disorders, endothelial damage after cocaine use, iatrogenic complications after interventions and infections, are also common among patients with CAAs. Although there is a variety of noninvasive methods including echocardiography, computed tomography, and magnetic resonance imaging, coronary angiography remains the gold standard diagnostic method. There is still no consensus about the most appropriate therapeutic strategy. Medical therapy including antiplatelets, anticoagulants, statins and ACEs are preferred either in patients with atherosclerosis, inflammatory status and stable CAAs, while percutaneous or surgery interventions are usually applied in patients with acute coronary syndrome due to a CAA culprit, obstructive coronary artery disease or large saccular aneurysms at a high risk of rupturing.

Comparison of In-Vivo and Ex-Vivo Ascending Aorta Elastic Properties through Automatic Deep Learning Segmentation of Cine-MRI and Biomechanical Testing.

Ascending aortic aneurysm is a pathology that is important to be supervised and treated. During the years the aorta dilates, it becomes stiff, and its elastic properties decrease. In some cases, the aortic wall can rupture leading to aortic dissection with a high mortality rate. The main reference standard to measure when the patient needs to undertake surgery is the aortic diameter. However, the aortic diameter was shown not to be sufficient to predict aortic dissection, implying other characteristics should be considered. Therefore, the main objective of this work is to assess in-vivo the elastic properties of four different quadrants of the ascending aorta and compare the results with equivalent properties obtained ex-vivo. The database consists of 73 cine-MRI sequences of thoracic aorta acquired in axial orientation at the level of the pulmonary trunk. All the patients have dilated aorta and surgery is required. The exams were acquired just prior to surgery, each consisting of 30 slices on average across the cardiac cycle. Multiple deep learning architectures have been explored with different hyperparameters and settings to automatically segment the contour of the aorta on each image and then automatically calculate the aortic compliance. A semantic segmentation U-Net network outperforms the rest explored networks with a Dice score of 98.09% (±0.96%) and a Hausdorff distance of 4.88 mm (±1.70 mm). Local aortic compliance and local aortic wall strain were calculated from the segmented surfaces for each quadrant and then compared with elastic properties obtained ex-vivo. Good agreement was observed between Young's modulus and in-vivo strain. Our results suggest that the lateral and posterior quadrants are the stiffest. In contrast, the medial and anterior quadrants have the lowest aortic stiffness. The in-vivo stiffness tendency agrees with the values obtained ex-vivo. We can conclude that our automatic segmentation method is robust and compatible with clinical practice (thanks to a graphical user interface), while the in-vivo elastic properties are reliable and compatible with the ex-vivo ones.

Infrared Spectroscopic Study and Mathematical Simulations of Carotid Atherosclerosis.

BACKGROUND/AIM: The pathogenesis, treatment and prevention of atherosclerosis continue to be the subject of intensive research and study by the scientific community. Based on Fourier-transform infrared spectra and 3D-Doppler echogram, we attempted to develop a computational simulation model for predicting the association of atherosclerotic risk factors with pathogenic molecular structural changes. MATERIALS AND METHODS: Atheromatic carotid arteries from 56 patients (60-85 years old) were used as samples. Color 3D-Doppler echogram screening was performed on all patients preoperatively. Each infrared spectrum consisted of 120 co-added spectra at a spectral resolution of 4 cm-1 Results: The infrared spectral analysis reveals 'marker bands', such as the 1,744 cm-1 band assigned to aldehyde formation and to the 'fingerprint' digital spectral region of 1,050-1,169 cm-1, characteristic of the presence of advanced glycation end products (C-O-C). The accumulation of calcium phosphate salts increases the formation rate of stenosis. The critical point of stenosis risk starts at about 45%, while when stenosis is over 60-70%, the risk of ischemic stroke or other major adverse cardiovascular events increases dramatically. CONCLUSION: Fourier-transform infrared spectroscopy and mathematical simulation models showed that carotid artery stenosis over 45% reduces the blood flow rate, while stenosis over 65% dramatically increases the hemodynamic disturbance, with a parallel increase the rate of ischemic stroke or other major adverse cardiovascular events.

Oxidative stress in ageing and disease development studied by FT-IR spectroscopy.

FT-IR spectroscopy was used to investigate the effect of oxidative stress and to approach the mechanism on cancer bone demineralization, aortic valve mineralization and heterotopic ossification on disease development. The FT-IR spectra obtained from paediatric, adult bone and ex vivo irradiated adult healthy bone with a dose of 20Gy were compared with those of healthy bone. The increase of band intensity changes of vasCH2,vsCH2 in the region 3000-2850cm-1 depended on aging, the disease progression and the dose of irradiation. The bands at 3080cm-1 and 1744cm-1, which originate from olefinic terminal bond (v=CH) and ester carbonyl group (vROCO), respectively, indicate the influence of oxidative stress on lipid degradation and peroxidation, respectively. The new bands at about 1690cm-1 and 1516cm-1 denote the presence of ß-sheet conformation of the proteins due to the diseases, confirming the increasing amount of lipophilic environment and fibril formation. Comparison of the FT-IR spectra of calcified aortic valve and hip heterotopic ossification with that of normal bones showed that in the bone-like formation the peroxide anion free radicals play an important role in the disease.

Inappropriate antidiuretic hormone secretion due to squamous cell lung cancer.

The syndrome of inappropriate secretion of antidiuretic hormone is a disorder of impaired water excretion caused by the inability to suppress secretion of antidiuretic hormone. It has been commonly associated with small cell carcinoma. The association of this syndrome with squamous cell lung carcinoma has rarely been reported, with only 4 cases over the past two decades in the English literature. We describe the case of a 75-year-old Caucasian male who developed the syndrome after a right pneumonectomy for down-staged squamous cell lung cancer previously treated with neoadjuvant platinum-based chemotherapy and radiotherapy.

An infrared spectroscopic study of aortic valve. A possible mechanism of calcification and the role of magnesium salts.

In the present study fourier transform infrared (FT-IR) spectroscopy was used to study the mechanism of pathogenesis of aortic valve calcification. The high intensity bands of vCH3 and vCH2 groups of lipids and phospholipids of membranes, in the spectral region 3000-2800 cm(-1), show the high concentration of lipids and fatty components in aortic valve, resulting from degradation of the main aliphatic chain of the membranes, with a change of their permeability and fluidity. The presence of bands at 3075 and 1744 cm(-1), assigned to olefinic (v=CH) and aldehyde carbonyl groups, respectively, implies that reactive oxygen species are involved in the initiation of peroxidation of the lipids and phospholipids. These latter bands are related to the oxidative stress of the patients. From the shifts of bands to lower frequencies of the characteristic absorption bands of amide I and amide II, it is suggested that the proteins change their secondary structure from α-helix to ß-sheets and random coil due to modifications of collagen, associated with the permeability of aortic valve atherosclerosis. From the spectral region 1150-900 cm(-1), where the characteristic stretching vibration bands of the phosphate groups (vPO4(-3)) absorb, the calcified aortic valve was found to contain biological hydroxyapatite (Ca10(PO4)6(OH)2), as well as amorphous hydroxyapatite (Ca5(PO4)xOH) and CaHPO4. These findings are in agreement with scanning electron microscopy energy-dispersive X-ray analysis and X-ray diffraction analyses. SEM micrographs show that the valves are rich in fibrils and that the protein-protein cross-linked chemical bonds seem to be the points of initiation of calcification.