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1.
Int J Mol Sci ; 22(13)2021 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-34206648

RESUMO

The aim of this study was to investigate the C-terminal cleavage of (pyr)-apelin-13 in human endothelial cells with respect to the role and subcellular location of prolyl carboxypeptidase (PRCP). Human umbilical vein and aortic endothelial cells, pre-treated with prolyl carboxypeptidase-inhibitor compound 8o and/or angiotensin converting enzyme 2 (ACE2)-inhibitor DX600, were incubated with (pyr)-apelin-13 for different time periods. Cleavage products of (pyr)-apelin-13 in the supernatant were identified by mass spectrometry. The subcellular location of PRCP was examined via immunocytochemistry. In addition, PRCP activity was measured in supernatants and cell lysates of LPS-, TNFα-, and IL-1ß-stimulated cells. PRCP cleaved (pyr)-apelin-13 in human umbilical vein and aortic endothelial cells, while ACE2 only contributed to this cleavage in aortic endothelial cells. PRCP was found in endothelial cell lysosomes. Pro-inflammatory stimulation induced the secretion of PRCP in the extracellular environment of endothelial cells, while its intracellular level remained intact. In conclusion, PRCP, observed in endothelial lysosomes, is responsible for the C-terminal cleavage of (pyr)-apelin-13 in human umbilical vein endothelial cells, while in aortic endothelial cells ACE2 also contributes to this cleavage. These results pave the way to further elucidate the relevance of the C-terminal Phe of (pyr)-apelin-13.


Assuntos
Aorta/citologia , Carboxipeptidases/metabolismo , Células Endoteliais/metabolismo , Células Endoteliais da Veia Umbilical Humana/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Enzima de Conversão de Angiotensina 2/metabolismo , Linhagem Celular , Citocinas/metabolismo , Células Endoteliais/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Humanos , Mediadores da Inflamação/metabolismo , Peptídeos/sangue , Proteólise , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
2.
Curr Cardiol Rep ; 23(8): 108, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34213661

RESUMO

PURPOSE OF REVIEW: Preservation or repair of the aortic valve has evolved dynamically in the past 20 years. It leads to a high freedom from valve-related complications if an adequate valve durability can be achieved; it may possibly also improve survival. To date, little structured information is available about which valves can be repaired and which should better be replaced. RECENT FINDINGS: For surgical decision-making, the size of the aortic root is important and the anatomy of the aortic valve must be considered. In the presence of root aneurysm, most tricuspid and bicuspid aortic valves can be preserved. In aortic regurgitation and normal aortic dimensions, the majority of tricuspid and bicuspid aortic valves can be repaired with good long-term durability. In bicuspid aortic valves, the morphologic characteristics must be taken into consideration. Unicuspid and quadricuspid aortic valves can be repaired in selected cases. Generally, cusp calcification is a sign of a poor substrate for repair; the same is true for cusp retraction and cusp destruction due to active endocarditis. They are associated with limited valve durability. Using current concepts, many non-calcified aortic valves can be repaired. Modern imaging, in particular three-dimensional transesophageal echocardiography (TEE), should be able to define repairable aortic valves with a high probability.


Assuntos
Insuficiência da Valva Aórtica , Doença da Válvula Aórtica Bicúspide , Aorta , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/cirurgia , Humanos , Reoperação
3.
Mayo Clin Proc ; 96(7): 1874-1887, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34218860

RESUMO

OBJECTIVE: To elucidate sex differences in valve morphology, disease phenotype, progression, and outcomes among children and young adults with bicuspid aortic valve (BAV). PATIENTS AND METHODS: This is a retrospective cohort study examining all children and young adults (aged ≤22 years) with isolated BAV diagnosed, by excluding patients with concomitant congenital heart defects or genetic syndromes, from January 1, 1990, through December 1, 2016, at Mayo Clinic in Rochester, Minnesota. RESULTS: Of 1010 patients with BAV, 558 had isolated BAV. Distributions of morphology were right-left in 65.8% (n=367), right-noncoronary in 34% (n=190), and left-noncoronary cusp fusion in 0.2% (n=1) of patients; with no sex differences. Male to female ratio was 3:1. At the first echocardiographic evaluation in the study, there were no sex differences in terms of frequency of aortic valve stenosis or regurgitation. However, males had significantly higher grades of aortic valve regurgitation at 17 years of age onward (P<.0001). Males had significantly larger mid-ascending aorta (P=.01) and sinus of Valsalva dimensions (z score; P=.0001) as compared with females, with a novel finding of peak aortic dimensions around 8 years of age. Males also had more than 2-fold higher risk for sinus of Valsalva dilation (z score >2) as compared with females (odds ratio, 2.3; 95% CI, 1.2 to 4.2; P=.01). There were no significant sex differences in the primary cardiac outcomes of interventions on aortic valve and/or aorta, aortic dissection, or death. CONCLUSION: In children and young adults with BAV, males have a higher grade of aortic regurgitation in late adolescence, significantly larger aortic dimensions, different patterns of aortic growth, and more frequent sinus of Valsalva dilation as compared with females. Overall, the rate of primary cardiac events is lower in young patients, with no significant sex differences.


Assuntos
Aorta , Valva Aórtica , Doença da Válvula Aórtica Bicúspide , Ecocardiografia/métodos , Fatores Sexuais , Seio Aórtico , Adolescente , Fatores Etários , Aorta/diagnóstico por imagem , Aorta/crescimento & desenvolvimento , Aorta/patologia , Valva Aórtica/anormalidades , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/diagnóstico , Insuficiência da Valva Aórtica/etiologia , Doença da Válvula Aórtica Bicúspide/diagnóstico , Doença da Válvula Aórtica Bicúspide/fisiopatologia , Variação Biológica da População , Criança , Progressão da Doença , Feminino , Humanos , Masculino , Tamanho do Órgão , Seio Aórtico/diagnóstico por imagem , Seio Aórtico/patologia
4.
Nat Commun ; 12(1): 4419, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34285208

RESUMO

Electroadhesion, i.e., adhesion induced by an electric field, occurs between non-sticky cationic and anionic hydrogels. Here, we demonstrate electroadhesion between cationic gels and animal (bovine) tissues. When gel and tissue are placed under an electric field (DC, 10 V) for 20 s, the pair strongly adhere, and the adhesion persists indefinitely thereafter. Applying the DC field with reversed polarity eliminates the adhesion. Electroadhesion works with the aorta, cornea, lung, and cartilage. We demonstrate the use of electroadhesion to seal cuts or tears in tissues or model anionic gels. Electroadhered gel-patches provide a robust seal over openings in bovine aorta, and a gel sleeve is able to rejoin pieces of a severed gel tube. These studies raise the possibility of using electroadhesion in surgery while obviating the need for sutures. Advantages include the ability to achieve adhesion on-command, and moreover the ability to reverse this adhesion in case of error.


Assuntos
Hidrogéis/administração & dosagem , Procedimentos Cirúrgicos sem Sutura/métodos , Ferimentos e Lesões/cirurgia , Testes de Impedância Acústica , Adesividade , Animais , Aorta/cirurgia , Bovinos , Estudos de Viabilidade , Humanos , Hidrogéis/química , Teste de Materiais , Resistência ao Cisalhamento
5.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209567

RESUMO

Collagen tripeptide (CTP) is defined as a functional food material derived from collagenase digests of type I collagen and contains a high concentration of tripeptides with a Gly-X-Y sequence. CTP has several biological effects, including the acceleration of fracture healing, ameliorating osteoarthritis, and improving dryness and photoaging of the skin. Recently, an antiatherosclerotic effect of CTP has been reported, although its molecular mechanism is yet to be determined. In this study, we examined the effects of CTP on primary cultured human aortic endothelial cells (HAECs) under oxidative stress, because oxidative endothelial dysfunction is a trigger of atherosclerosis. DNA microarray and RT-qPCR analyses showed that CTP treatment recovered the downregulated expression of several genes, including the interleukin-3 receptor subunit alpha (IL3RA), which were suppressed by reactive oxygen species (ROS) treatment in HAECs. Furthermore, IL3RA knockdown significantly decreased the viability of HAECs compared with control cells. RT-qPCR analysis also showed that solute carrier 15 family peptide transporters, which are involved in CTP absorption into cells, were expressed in HAECs at levels more than comparable to those of a CTP-responsive human osteoblastic cell line. These results indicated that CTP exerts a protective effect for HAECs, at least in part, by regulating the recovery of ROS-induced transcriptional repression.


Assuntos
Aorta/citologia , Colágeno Tipo I/farmacologia , Células Endoteliais/efeitos dos fármacos , Substâncias Protetoras/farmacologia , Ativação Transcricional/efeitos dos fármacos , Aterosclerose/prevenção & controle , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Regulação para Baixo/efeitos dos fármacos , Alimento Funcional/análise , Humanos , Subunidade alfa de Receptor de Interleucina-3/efeitos dos fármacos , Osteoblastos , Estresse Oxidativo , Transportador 1 de Peptídeos/metabolismo , Espécies Reativas de Oxigênio/metabolismo
6.
J Med Case Rep ; 15(1): 283, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34074328

RESUMO

BACKGROUND: Acute DeBakey type I and type II aortic dissections are indications for emergent surgical repair; however, there are currently no standard protocols in the management of isolated supra-aortic dissections. Prompt diagnosis and management of an isolated innominate artery dissection are necessary to prevent distal malperfusion and thromboembolic sequelae. CASE PRESENTATION: A 50-year-old Caucasian gentleman presented with chest pain radiating to his jaw and right arm. He had no recent history of trauma. On physical exam, he was neurologically intact and malignantly hypertensive. Computed tomographic angiography of the chest and neck confirmed a spontaneous isolated innominate artery dissection without ascending aorta involvement. Given the lack of evidence for rupture, distal emboli, and/or end-organ malperfusion, the decision was made for initial non-operative management-anti-impulse regimen, antiplatelet therapy, and close follow-up. CONCLUSIONS: Medical management of a spontaneous isolated innominate artery dissection is appropriate for short-term and potentially long-term therapy. This not only spares the patient from a potentially unnecessary surgical operation but also provides the surgeon and the patient the time to plan for a surgical approach if it becomes necessary.


Assuntos
Aneurisma Dissecante , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/cirurgia , Aorta , Tronco Braquiocefálico/diagnóstico por imagem , Tronco Braquiocefálico/cirurgia , Angiografia por Tomografia Computadorizada , Dissecação , Humanos , Masculino , Pessoa de Meia-Idade
7.
Kyobu Geka ; 74(6): 413-417, 2021 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-34059582

RESUMO

Aortic valve-sparing surgery is a delicate procedure that requires specialized skills to control aortic valve regurgitation. Therefore, simulating the surgery before performing it on a patient is good practice for inexperienced surgeons. Herein, we present our experience of a simulation surgery using a three-dimensionally printed aortic root model of a 60-year-old man with severe aortic regurgitation and aortic root enlargement. We fabricated the model using multi-slice computed tomography data. The model revealed the two pitfalls:unbalanced commissure position and lower coaptation height of the right coronary cusp. We completed the simulation surgery from the proximal suture and valve reimplantation to coronary ostial reconstructions during approximately three hours with medical staffs. In the actual operation, the aortic valve regurgitation completely disappeared by accurately reconstructing the commissure in the Valsalva graft and adjusting the height of the right coronary cusp using central plication procedure. We believe that carrying out simulations before the actual surgery improves the surgeon's confidence and the patient's outcomes.


Assuntos
Insuficiência da Valva Aórtica , Procedimentos Cirúrgicos Cardíacos , Aorta/diagnóstico por imagem , Aorta/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Reimplante
8.
Kyobu Geka ; 74(6): 465-468, 2021 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-34059594

RESUMO

We report a case of a 64-year-old man with descending necrotizing mediastinitis. He had undergone ascending aortic replacement for Stanford type A acute dissection five years before, and thoracic endovascular aortic repair from the distal arch to the descending aorta for dilation of residual dissection three years before. The patient was admitted to our hospital complaining persistent fever, rubescent neck and chest. Computed tomography( CT) revealed a deep-seated mass extending between the neck and the right upper mediastinum and another mass around the ascending aorta graft. Computed tomography-guided drainage revealed infection of both masses. Surgical debridement, graft replacement, and omental flap transposition were performed. He recovered uneventfully, and no relapse of infection was observed.


Assuntos
Aneurisma Dissecante , Aneurisma da Aorta Torácica , Mediastinite , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/cirurgia , Aorta , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Humanos , Masculino , Mediastinite/diagnóstico por imagem , Mediastinite/etiologia , Mediastinite/cirurgia , Pessoa de Meia-Idade
9.
Zhonghua Wai Ke Za Zhi ; 59(6): 443-446, 2021 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-34102725

RESUMO

In recent years, the endovascular procedures has considerably evolved in concepts, technologies, materials and devices on cardiovascular surgery, and influenced the development and the future direction of cardiovascular surgery technology. Endovascular aorta repair is well recognized as the optimal therapy for patients presenting with acute or chronic pathology of distal aortic arch, descending aorta and thoraco-abdominal aorta. The use of catheter-based endovascular repair in the ascending aorta pathology including aneurysms, pseudoaneurysms, penetrating aortic ulcers and acute or chronic Stanford type A aortic dissection has been concerned and reported. Comparing to the open surgical procedures for ascending aorta and aortic root disease with high perioperative mortality and morbidity, the catheter-based endovascular repair has minimally invasive, expanding the alternative treatment of ascending aorta disease, especially for patients with high-risk profiles. However, due to the complex anatomy and functional properties, materials and devices, the use of this technique in ascending aorta and aortic root is still questionable. In addition, the long-term and reliable clinical research results is still inadequate, and the safety and effectiveness need further research.


Assuntos
Aneurisma da Aorta Torácica , Doenças da Aorta , Implante de Prótese Vascular , Procedimentos Endovasculares , Aorta/cirurgia , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Cateteres , Humanos , Stents , Resultado do Tratamento
10.
Gen Physiol Biophys ; 40(3): 197-206, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34100376

RESUMO

We examined the effect of endothelium and lipid emulsion on vasodilation induced by minoxidil at a toxic dose and determined the underlying mechanism. The effects of endothelial denudation, NW-nitro-L-arginine methyl ester (L-NAME), methylene blue, 1H-[1,2,4]oxadiazolo[4,3-a] quinoxalin-1-one (ODQ), and glibenclamide, alone or in combination, on minoxidil-induced vasodilation in endothelium-intact rat aorta were examined. Additionally, the effects of lipid emulsion on minoxidil-induced membrane hyperpolarization and minoxidil concentration were examined. The vasodilatory effects of minoxidil at the toxic dose were higher in endothelium-intact aorta than in endothelium-denuded aorta. L-NAME, methylene blue, ODQ, and glibenclamide attenuated minoxidil-induced vasodilation of endothelium-intact rat aorta. Combined treatment with L-NAME and glibenclamide almost eliminated minoxidil-induced vasodilation. However, lipid emulsion pretreatment did not significantly alter minoxidil-induced vasodilation. Lipid emulsion did not significantly alter minoxidil-induced membrane hyperpolarization and minoxidil concentration. Overall, minoxidil-induced vasodilation is mediated by ATP-sensitive potassium channels and pathways involving nitric oxide and guanylate cyclase.


Assuntos
Óxido Nítrico , Vasodilatação , Animais , Aorta , Endotélio Vascular , Minoxidil , NG-Nitroarginina Metil Éster , Óxido Nítrico Sintase Tipo III , Ratos
11.
BMJ Case Rep ; 14(6)2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34083197

RESUMO

Coral reef aorta (CRA) is a rare condition with potentially devastating complications. It is characterised by atherosclerotic calcification and stenosis of the visceral part of the aorta, usually occurring at the juxtarenal or suprarenal locations, and causing refractory hypertension and renal dysfunction. Surgical intervention, which is the recommended definitive treatment, is associated with significant morbidity and mortality. Endovascular stenting has been reported to be an alternative management option. To the best of our knowledge, this is the first case report to describe medical management of a patient with CRA with diuretics and angiotensin receptor blockade without surgical treatment.


Assuntos
Antagonistas de Receptores de Angiotensina/uso terapêutico , Doenças da Aorta , Diuréticos/uso terapêutico , Aorta , Humanos , Receptores de Angiotensina , Stents , Resultado do Tratamento
12.
Artigo em Japonês | MEDLINE | ID: mdl-34148898

RESUMO

PURPOSE: This study aimed to compare the contrast effects of administration via the subclavian vein, the superior vena cava and right ventricular venous tract, and the aorta in three-dimensional computed tomography angiography (3D-CTA) using one-step injection and trapezoidal cross-injection. METHOD: The subjects were 56 patients who underwent aortic 3D-CTA. In the one-step injection method, a 30-second injection of contrast medium was followed by saline injected at the same rate as the 30-ml contrast medium. In the trapezoidal cross-injection method, after injecting the contrast agent for 15 seconds, a variable mixture of the contrast agent and saline was injected for 15 seconds, followed by 20 ml saline injected at the same rate as the initial contrast agent injection. CT values were measured in the subclavian vein, superior vena cava, right ventricle, and aorta. RESULT: A significant difference was found in the subclavian vein and right ventricle, with the trapezoidal cross-injection method showing a lower CT value than the one-step injection method (p<0.01). There were no significant differences in the CT values in the superior vena cava and the aorta. CONCLUSION: The trapezoidal cross-injection method for aortic 3D-CTA produced lower CT values in venous pathways than those via the one-step injection method, but no changes were observed in the aortic CT values. These results suggest that the trapezoidal cross-injection method is useful in aortic 3D-CTA.


Assuntos
Meios de Contraste , Veia Cava Superior , Angiografia , Aorta , Humanos , Tomografia Computadorizada por Raios X , Veia Cava Superior/diagnóstico por imagem
13.
Anticancer Res ; 41(6): 3099-3107, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34083303

RESUMO

BACKGROUND/AIM: To determine the prognostic utility of trastuzumab-based chemotherapy based on human epidermal growth factor receptor 2 (HER2) expression in patients with para-aortic lymph node (PAN) metastasis from gastric cancer. PATIENTS AND METHODS: A total of 41 patients with clinical PAN metastasis from gastric cancer who underwent chemotherapy were retrospectively enrolled. RESULTS: Eighteen (43.9%) patients had HER2-positive tumors and consequently, received trastuzumab-based chemotherapy. A total of 11 patients underwent surgery. HER2 status was significantly correlated with the number of distant metastatic sites, the presence or absence of trastuzumab-based chemotherapy, and the presence or absence of gastrectomy. HER2-positive patients had significantly better prognosis than HER2-negative patients. Multivariate analysis identified age and trastuzumab-based chemotherapy based on HER2 status as an independent prognostic factor. CONCLUSION: Assessing HER2 expression and subsequent trastuzumab-based chemotherapy can be an effective method for determining the prognosis of patients with PAN metastasis from gastric cancer.


Assuntos
Aorta/patologia , Metástase Linfática , Receptor ErbB-2/metabolismo , Neoplasias Gástricas/patologia , Feminino , Humanos , Masculino , Prognóstico , Neoplasias Gástricas/metabolismo
15.
Int J Mol Sci ; 22(9)2021 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-34063297

RESUMO

Our study aimed to examine the effects of hypertension and the chronic administration of the fatty acid amide hydrolase (FAAH) inhibitor URB597 on vascular function and the endocannabinoid system in spontaneously hypertensive rats (SHR). Functional studies were performed on small mesenteric G3 arteries (sMA) and aortas isolated from SHR and normotensive Wistar Kyoto rats (WKY) treated with URB597 (1 mg/kg; twice daily for 14 days). In the aortas and sMA of SHR, endocannabinoid levels and cannabinoid CB1 receptor (CB1R) expression were elevated. The CB1R antagonist AM251 diminished the methanandamide-evoked relaxation only in the sMA of SHR and enhanced the vasoconstriction induced by phenylephrine and the thromboxane analog U46619 in sMA in SHR and WKY. In the sMA of SHR, URB597 elevated anandamide levels, improved the endothelium-dependent vasorelaxation to acetylcholine, and in the presence of AM251 reduced the vasoconstriction to phenylephrine and enhanced the vasodilatation to methanandamide, and tended to reduce hypertrophy. In the aortas, URB597 elevated endocannabinoid levels improved the endothelium-dependent vasorelaxation to acetylcholine and decreased CB1R expression. Our study showed that hypertension and chronic administration of URB597 caused local, resistance artery-specific beneficial alterations in the vascular endocannabinoid system, which may bring further advantages for therapeutic application of pharmacological inhibition of FAAH.


Assuntos
Amidoidrolases/efeitos dos fármacos , Amidoidrolases/metabolismo , Benzamidas/farmacologia , Carbamatos/farmacologia , Endocanabinoides/metabolismo , Hipertensão Essencial/metabolismo , Hipertensão Essencial/terapia , Acetilcolina , Animais , Aorta , Ácidos Araquidônicos , Hipertensão/metabolismo , Masculino , Artérias Mesentéricas/efeitos dos fármacos , Nitroprussiato , Alcamidas Poli-Insaturadas , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY , Receptores de Canabinoides , Vasoconstrição , Vasodilatação/efeitos dos fármacos
16.
BMC Surg ; 21(1): 294, 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34134678

RESUMO

BACKGROUND: Migration of wires and pins within the heart is an uncommon complication. Intracardic migration of Kirschner wire can cause several complications. CASE PRESENTATION: A 55-year-old male patient was admitted to the emergency service with dyspnea, stabbing chest pain. The patient's medical history showed that he had undergone a fixation operation using Kirschner wire and plate for treatment of the right sternoclavicular joint dislocation about 5 months prior. Chest computerized tomography revealed a metallic foreign body locating in the pericardium between the aorta and the right ventricle. There were not any serious complications occurred before operation due to the timely detection of potential risks. Removal of the wire was performed via median sternotomy under general anesthesia without cardiopulmonary bypass. The symptoms of dyspnea and chest pain were relieved after surgery, and the patient recovered without any complications. CONCLUSION: The Kirschner wire should be used judiciously in amphiarthrosis in orthopedic surgery for the risk of breakage and migration. The possibility of intracardiac migration of wire should be considered when chest symptoms presenting after surgery with the Kirschner wire. Migrated wires must be removed immediately to prevent serious complications. Regular follow-up and early removal of fixation wires are recommended to prevent migration of wires.


Assuntos
Migração de Corpo Estranho , Articulação Esternoclavicular , Aorta , Fios Ortopédicos/efeitos adversos , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Fixação Interna de Fraturas , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
17.
Molecules ; 26(10)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064778

RESUMO

Kynurenic acid (KYNA) is derived from tryptophan, formed by the kynurenic pathway. KYNA is being widely studied as a biomarker for neurological and cardiovascular diseases, as it is found in ischemic conditions as a protective agent; however, little is known about its effect after ischemia-reperfusion in the vascular system. We induced ischemia for 30 min followed by 5 min reperfusion (I/R) in the rat aorta for KYNA evaluation using functional assays combined with proteomics. KYNA recovered the exacerbated contraction induced by phenylephrine and relaxation induced by acetylcholine or sodium nitroprussiate in the I/R aorta, with vessel responses returning to values observed without I/R. The functional recovery can be related to the antioxidant activity of KYNA, which may be acting on the endothelium-injury prevention, especially during reperfusion, and to proteins that regulate neurotransmission and cell repair/growth, expressed after the KYNA treatment. These proteins interacted in a network, confirming a protein profile expression for endothelium and neuron repair after I/R. Thus, the KYNA treatment had the ability to recover the functionality of injured ischemic-reperfusion aorta, by tissue repairing and control of neurotransmitter release, which reinforces its role in the post-ischemic condition, and can be useful in the treatment of such disease.


Assuntos
Aorta/patologia , Ácido Cinurênico/uso terapêutico , Traumatismo por Reperfusão Miocárdica/tratamento farmacológico , Traumatismo por Reperfusão Miocárdica/metabolismo , Proteômica , Acetilcolina/farmacologia , Animais , Aorta/efeitos dos fármacos , Aorta/fisiopatologia , Modelos Animais de Doenças , Ácido Cinurênico/farmacologia , Contração Miocárdica/efeitos dos fármacos , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Nitroprussiato/farmacologia , Fenilefrina/farmacologia , Mapas de Interação de Proteínas/efeitos dos fármacos , Ratos Sprague-Dawley , Vasodilatação/efeitos dos fármacos
18.
Angiol Sosud Khir ; 27(2): 41-49, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34166343

RESUMO

The analysis of the gained experience in treatment of patients with pathology of the arch and descending portion of the aorta is suggestive that the 'frozen elephant trunk' technique is an effective and safe method. In this connection, there is an increasing need for universal hybrid devices characterized by ease of use and durability in various aortic pathologies. Discussed in the article is the state of the art of the technology of treatment of patient with aortic arch pathology by means of hybrid grafts, followed by comparative analysis of currently used vascular hybrid prostheses, and although none of the hybrid grafts available worldwide is either universal or ideal, the grafts for the 'frozen elephant trunk' procedure continue to be improved, which will inevitably lead to wide implementation of this technique.


Assuntos
Aneurisma Dissecante , Aneurisma da Aorta Torácica , Implante de Prótese Vascular , Aneurisma Dissecante/cirurgia , Aorta , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Prótese Vascular , Implante de Prótese Vascular/efeitos adversos , Humanos , Stents , Resultado do Tratamento
19.
Am J Case Rep ; 22: e931844, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34149045

RESUMO

BACKGROUND Traumatic rupture of the ascending aorta is a life-threatening injury, with a survival rate of around 15% to 20%. Treatment with open surgical repair is the criterion standard. However, open surgical repair is associated with high mortality and morbidity in patients with multiple traumas. There are no systematic data on traumatic thoracic rupture and aorta rupture in a cohort of patients who had undergone partial or total replacement of the thoracic aorta. We can only speculate about the mechanisms and consequences of such an injury. Therefore, even unorthodox endovascular techniques are a welcome advancement in this field and should be considered, providing they do not compromise patient safety. CASE REPORT A 61-year-old man presented with polytrauma after a fall from height. Since the patient had a history of a Bentall procedure, hypertension, coronary disease, and nicotinism, we quickly excluded open surgery as a treatment option. However, the patient's condition, additional injuries, and anatomical features prompted us to perform coil pseudoaneurysm, reducing his operative trauma and allowing for his faster recovery and early rehabilitation. The patient has remained under careful clinical supervision. The result of the patient's 1-year follow-up was satisfactory. CONCLUSIONS In this case, the endovascular approach was an effective, if temporary, option to open or hybrid surgery. This demonstrates that minimally invasive surgery can be helpful in some patients and can also be helpful as a bridge therapy. A good rapport between the surgeon and the patient is crucial to understanding the advantages and disadvantages of such treatment.


Assuntos
Falso Aneurisma , Implante de Prótese Vascular , Procedimentos Endovasculares , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Aorta/cirurgia , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
20.
J Cardiothorac Surg ; 16(1): 181, 2021 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-34162399

RESUMO

BACKGROUND: During cardiac surgery, micro-air emboli regularly enter the blood stream and can cause cognitive impairment or stroke. It is not clearly understood whether the most threatening air emboli are generated by the heart-lung machine (HLM) or by the blood-air contact when opening the heart. We performed an in vitro study to assess, for the two sources, air emboli distribution in the arterial tree, especially in the brain region, during cardiac surgery with different cannulation sites. METHODS: A model of the arterial tree was 3D printed and included in a hydraulic circuit, divided such that flow going to the brain was separated from the rest of the circuit. Air micro-emboli were injected either in the HLM ("ECC Bubbles") or in the mock left ventricle ("Heart Bubbles") to simulate the two sources. Emboli distribution was measured with an ultrasonic bubble counter. Five repetitions were performed for each combination of injection site and cannulation site, where air bubble counts and volumes were recorded. Air bubbles were separated in three categories based on size. RESULTS: For both injection sites, it was possible to identify statistically significant differences between cannulation sites. For ECC Bubbles, axillary cannulation led to a higher amount of air bubbles in the brain with medium-sized bubbles. For Heart Bubbles, aortic cannulation showed a significantly bigger embolic load in the brain with large bubbles. CONCLUSIONS: These preliminary in vitro findings showed that air embolic load in the brain may be dependent on the cannulation site, which deserves further in vivo exploration.


Assuntos
Aorta , Encefalopatias/etiologia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Cateterismo/efeitos adversos , Embolia Aérea/etiologia , Circulação Sanguínea , Pressão Sanguínea , Cateterismo/métodos , Humanos , Técnicas In Vitro , Injeções/métodos
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