RESUMEN
BACKGROUND: Studies have pointed out a higher mortality after coronary artery bypass surgery (CABG) in patients with stent. OBJECTIVE: To evaluate inflammatory markers in peripheral blood cells and in coronary artery tissue samples obtained during CABG in patients with stent compared to controls. METHODS: The case series consisted of two groups, one with previous stent implantation (n = 41) and one control (n = 26). The expression of the LIGHT, IL-6, ICAM, VCAM, CD40, NFKB, TNF, IFNG genes was analyzed in peripheral blood cells collected preoperatively. The coronary artery was evaluated for: interleukin-6, ICAM, VCAM, CD40, NFKB, TNF-alpha and IFN-gamma by immunohistochemistry. A total of 176 tissue samples were grouped for analysis in: A1- arteries with stent (n = 38); A2- native arteries from patients with stent in another artery (n = 68); and A3- arteries without stent from controls undergoing routinely CABG surgery (n = 70). A significance level of 0.05 was adopted. RESULTS: Patients with stent showed higher TNF (p = 0.03) and lower CD40 gene expression (p = 0.01) in peripheral blood cells than controls without stent. In coronary artery samples, the TNF-alpha protein staining was higher in the group A1, not only in the intima-media layer (5.16 ± 5.05 vs 1.90 ± 2.27; p = 0.02), but also in the adipose tissue (6.69 ± 3.87 vs 2.27 ± 4.00; p < 0.001). Furthermore, group A1 had a higher interleukin-6 protein staining in adipose tissue than group A3 (p = 0.04). CONCLUSION: We observed a persistently higher systemic TNF expression associated with exacerbated TNF-alpha and interleukin-6 local production in patients with stents. This finding may contribute to a worse clinical outcome.
Asunto(s)
Angioplastia Coronaria con Balón/efectos adversos , Arteritis/etiología , Biomarcadores/sangre , Células Sanguíneas/metabolismo , Revascularización Miocárdica/efectos adversos , Stents/efectos adversos , Arteritis/diagnóstico , Estudios de Casos y Controles , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
The authors present the study of four children with arteritis as vascular complication of acute bacterial meningitis. They report pathophysiological mechanisms involved in vascular lesions, and progress in the understanding of these complications.
Asunto(s)
Arteritis/etiología , Meningitis Bacterianas/complicaciones , Enfermedad Aguda , Arteritis/diagnóstico por imagen , Arteritis/fisiopatología , Femenino , Humanos , Lactante , Tomografía Computarizada por Rayos XRESUMEN
Os autores apresentam o estudo de quatro crianças que tiveram arterite como complicaçäo vascular de meningite bacteriana aguda. Apresentaram revisäo dos mecanismos fisiopatológicos envolvidos nas alteraçöes vasculares que têm trazido reais progressos no entendimento dessas complicaçöes
Asunto(s)
Humanos , Femenino , Lactante , Arteritis/etiología , Meningitis Bacterianas/complicaciones , Enfermedad Aguda , Arteritis , Arteritis/fisiopatología , Tomografía Computarizada por Rayos XRESUMEN
Os autores descrevem três casos de pacientes com nódulo subcutâneos em diferentes fases de evoluçäo, com sintomas sistêmicos inespecíficos, PPD positivo e raio-X de tórax normal. O estudo anátomo-patológico dos nódulos antigos mostrou arterite granulomatosa e com raros bacilos álcool-ácido resistentes na parede vascular; os nódulos recentes mostraram peniculite inepecífica com alguns bacilos álcool-ácido resistentes na parede de vasos cutâneos aparentemente normais. Esses achados sugerem que a micobactéria tem um tropismo vascular e pode causar arterite granulomatosa
Asunto(s)
Adulto , Humanos , Masculino , Femenino , Arteritis/etiología , Eritema Nudoso/complicaciones , Arteritis/patología , Diagnóstico Diferencial , Eritema Indurado/complicaciones , Eritema Indurado/patología , Eritema Nudoso/patologíaRESUMEN
Os autores relatam quatro casos de pacientes com diagnóstico clínico presumível de doenças difusas do colágeno, com manifestaçöes neurológicas severas e anunciadores da doença, comentam os casos e revisam a literatura médica. Também alertam para o polimorfismo e a rápida evoluçäo do quadro clínico
Asunto(s)
Adulto , Humanos , Masculino , Femenino , Arteritis/etiología , Enfermedades del Colágeno/complicaciones , Miositis/etiología , Neuritis/etiología , Polimorfismo GenéticoRESUMEN
To examine the possible correlation between mucocutaneous lymph node syndrome and thromboarteritis, we studied the capacity of polymorphonuclear leukocytes from 30 pediatric patients with mucocutaneous lymph node syndrome to generate oxygen intermediates and to release lysosomal enzymes. Cultured endothelial cells from human umbilical cord vein were also incubated with PMNs to assess oxygen intermediate-induced tissue injury. Within five days of MLNS onset, oxygen intermediate production, except for chemiluminescence generation, was markedly increased and the 51Cr release from labeled endothelial cells was significantly elevated. The lysosomal enzyme release was slightly, but significantly, higher. In the presence of superoxide dismutase and catalase, the 51Cr release was reduced to the control level, indicating the specificity of the effect of oxygen intermediate endothelial cell damage. At more than six to seven days after MLNS onset, the PMN functions were normal or decreased and the 51Cr release was reduced. In view of reports that coronary occlusion may appear one week after MLNS onset, we suggest that in the early stage of MLNS, a marked increase in oxygen intermediate generation induced by activated PMNs gives rise to coronary vascular injury, possibly leading to thromboarteritis and aneurysm formation.
Asunto(s)
Arteritis/etiología , Enfermedad Coronaria/etiología , Síndrome Mucocutáneo Linfonodular/fisiopatología , Neutrófilos/fisiología , Oxígeno/biosíntesis , Niño , Preescolar , Radioisótopos de Cromo/metabolismo , Pruebas Inmunológicas de Citotoxicidad , Femenino , Humanos , Lactante , Lisosomas/metabolismo , Masculino , Síndrome Mucocutáneo Linfonodular/inmunología , Agregación PlaquetariaRESUMEN
The case of a 21 years old man with hemiplegia and hyperthermia of sudden onset is reported. The angiographic study showed thrombosis of the distal portion of the internal carotid artery. Laboratorial studies revealed positive rheumatic tests. The authors think that the rheumatic arteritis may be responsible for this ischemic cerebral accident. Differential diagnosis with the embolic accidents caused by the rheumatic disease is discussed.