Gender Differences on the Effect of Non-HDL-C on Blood Pressure, Blood Flow Velocities and Arterial Wall Thickness; An Observational Analysis in Madurai Population

Background:Non-high density lipoprotein cholesterol has been shown to be a predictor of initial coronary heart disease events and arthrogenic. Women from Madurai have been shown to develop dyslipedemias from an early agerequiring surgical intervention when compared to women from other regions of India. This observational study was undertaken to find if the women had a higher risk for CHD when compared to men from the same region. Methods: 50 subjects (n=50) were inducted into this study with 26 (52%) of them were males and 24 (48%) of them were females.Patients with significant past history of major illness were excluded, including dyslipidemias, Diabetes mellitus, hypertension, myeloproliferative disorders, cardiac diseases and alcohol addiction. Blood lipid profile, Pulsed Doppler profile of right brachial artery blood flow velocities, Brachial arterial wall thickness, Blood pressure were measured.Results: In males there was significant correlation between Non HDL–C peak Systolic velocity (PSV), wall thickness (WT) and systolic Blood pressure (SBP) (P< 0.01) and End diastolic velocity (EDV) (p<0.05). Females in addition correlated significantly with diastolic blood pressure (DBP) (p<0.05) and without correlation with EDV. Total cholesterol (TC) in males were significantly correlated to PSV, EDV, WT and SBP (p<0.01). In females TC was significantly correlated to PSV, WT and SBP (P<0.01) and with DBP and Age (P<0.05). Conclusion: Our results show that females in Madurai develop higher risk for CHD from an early age than men because, Non-HDL-C was correlated significantly with SBP and DBP, SPV and WT, where as in men there was no correlation with DBP, and TC was additionally correlated significantly with DBP and Age in females and not in males. Early intervention with life style changes, Dietary modifications and exercise program may mitigate these risk factors for CHD.

The diagnostic value of MSCT on diagnosis and prognosis evaluation of abdominal aortic aneurysm / 实用放射学杂志

Objective To evaluate the diagnostic value of MSCT in abdominal aortic aneurysm(AAA).Methods 26 patients suspected AAA and admitted to our hospital were studied and checked by MSCT prospectively.The accuracy and features of MSCT were analyzed. Results 26 patients were diagnosed as AAA by MSCT,in which 17 cases were true AAA,and 9 were false AAA.MSCT for true AAA patients showed fusiform dilatation of abdominal aorta bulging to the left,and showed visible thrombus and calcification in aneurysm wall of residual tumor around the cavity when aneurysm ruptured.MSCT of false AAA showed aortic eccentric enlargement lump,which could be outside the boundaries of vascular calcification.25 cases of AAA were surgically confirmed,and the coincidence rate of MSCT and pathology was as high as 96.1% (25/26).Arterial wall calcification was found in all patients,in which 17 cases had mural thrombus.Conclusion MSCT is a safe,effective and non-invasive diagnostic technology for early detection and treatment of AAA, which may help determine patient’s condition and guide the treatment.

The Contribution of Resident Vascular Stem Cells to Arterial Pathology

Intimal accumulation of smooth muscle cells contributes to the development and progression of atherosclerotic lesions and restenosis following endovascular procedures. Arterial smooth muscle cells display heterogeneous phenotypes in both physiological and pathological conditions. In response to injury, dedifferentiated or synthetic smooth muscle cells proliferate and migrate from the tunica media into the intima. As a consequence, smooth muscle cells in vascular lesions show a prevalent dedifferentiated phenotype compared to the contractile appearance of normal media smooth muscle cells. The discovery of abundant stem antigen-expressing cells in vascular lesions also rarely detected in the tunica media of normal adult vessels stimulated a great scientific debate concerning the possibility that proliferating vascular wall-resident stem cells accumulate into the neointima and contribute to the progression of lesions. Although several experimental studies support this hypothesis, others researchers suggest a positive effect of stem cells on plaque stabilization. So, the real contribute of vascular wall-resident stem cells to pathological vascular remodelling needs further investigation. This review will examine the evidence and the contribution of vascular wall-resident stem cells to arterial pathobiology, in order to address future investigations as potential therapeutic target to prevent the progression of vascular diseases.

Atherosclerosis Vaccine Using Bacteria Salmonella typhimurium on Rat Models.

Aims: To prove the effect of S. typhimurium vaccine on inhibiting foam cell formation and arterial wall thickness, and also to decrease body weight and abdominal visceral fat. Study Design: This experimental research was conducted using rat models. Place and Duration of Study: Faculty of Medicine, Brawijaya University, Indonesia, between February – May 2011. Methodology: The vaccine was 108 CFU of heat-killed S. typhimurium/100μl vaccine per rat. The adjuvant was CFA-IFA 100μl per rat. Twenty Wistar rats were divided into fivegroups: a negative control group (have normal diet), and four treatment groups which were given with atherogenic diet. The four treatment groups were positive control group (atherogenic diet only), vaccine + adjuvant group (added with the vaccine + adjuvants), vaccine group (added with vaccine only), and adjuvant group (added with adjuvant only). The vaccines were injected intraperitoneally, five times in two-week intervals. Results: There was no significantly difference in the average diet intake every day among the groups (P=0.17). The administration of ‘vaccine + adjuvants’, ‘vaccine only’ and ‘adjuvants only’ could decrease foam cell formation and arterial wall thickness compared to the positive control group (P= .00). The ‘vaccine alone’ treatment returned the foam cell numbers to be a normal value just like negative control (P=.15), but ‘vaccine + adjuvants ‘and ‘adjuvant alone’ did not (P=.01). There was a strong and significantly correlation between the foam cell formation with arterial wall thickness (R=0.842, P=.00). In addition, administration of ‘vaccine only’ decreased the rats’ body weight and abdominal visceral fat accumulation significantly compared to the positive control (P=.04 and P=.00 respectively). Conclusion: The heat-killed Salmonella typhimurium vaccine without CFA-IFA adjuvant decreases foam cells expression and aortic wall thickness, body weight, and abdominal visceral fat accumulation in rat-induced atherogenic diet. In suggestion, heat-killed S. typhimurium is a potential antigen to be developed as an atherosclerosis vaccine in the future.

The application of Chaperon guiding catheter system in endovascular treatment of intracranial aneurysms / 介入放射学杂志

Objective To discuss the application of Chaperon guiding catheter system in endovascular treatment of intracranial aneurysms. Methods A total of 20 patients with intracranial aneurysms were enrolled in this study. The patients hadⅡorⅢtype of aortic arch (n=11) or sclerotic plague at the orifice of internal carotid or vertebral artery (n = 9). Endovascular embolization of the intracranial aneurysm was carried out in all patients. By using Cordis guiding catheter system the catheter was placed into the target artery. Chaperon guiding catheter system was used during the procedure in order to determine whether the Chaperon guiding catheter could be smoothly placed into the target artery or not. Results When the Chaperon guiding catheter system was employed in the endovascular procedure, the difficulties of catheterization caused by the distortion of the aorta or by the plagues on the walls of arteries could be basically overcome. The Guiding catheter could be smoothly placed into the target arteries. Conclusion The Chaperon guiding catheter system can be successfully used in the endovascular treatment for the intracranial aneurysms, especially when the patient has tortuous aorta or there is sclerotic plague on the artery wall. (J Intervent Radiol, 2014, 23:281-283).

MODELACIÓN POR ELEMENTOS FINITOS EN UN MODELO DE ANEURISMA

En un modelo con características geométricas y un comportamiento mecánico de la pared arterial generalizado para aneurismas periféricos, se realiza una modelación por elementos finitos (MEF) del efecto de la presión arterial y del espesor de la pared arterial en el saco de un aneurisma. Se analizan los esfuerzos de Von Misses, los esfuerzos tensores transversales y el desplazamiento en el saco del aneurisma. Se encuentra que el lugar más propenso a la ruptura para esta geometría de aneurismas es la región circundante a la arteria eferente y opuesta al flujo aferente. Se propone un proceso para realizar MEF en cualquier geometría de aneurisma y condiciones de presión, para analizar el riesgo y el lugar más probable de la ruptura.

Considering a model with generalized geometry and mechanical properties of the arterial wall for the peripheral vasculature aneurisms, a finite element modeling (FEM) is developed for analyzing the effects of arterial blood pressure and the arterial wall thickness in the aneurismal sac. The von Misses stresses, the transversal tensor stresses and the displacement in the aneurismal sac wall are analyzed. The possible site of rupture for this aneurism geometry is found surrounding the efferent artery and opposed to the flow inlet. A method for applying FEM to any aneurism geometry and blood pressure conditions is proposed for analyzing the risk of rupture and possible rupture site.

An Experimental Study for the Effect of Interrupted(Intermittently-Repeated) versus Continuous Temporary Clipping on the Change of Arterial Wall of Rat / 대한뇌혈관학회지

The benefits of the use of temporary clipping for intracerebral aneurysm surgery were proved through many experimental and clinical studies. There are two techniques of temporary clipping which are interrupted and continuous clipping. In the study of cerebral perfusion, interrupted clipping reduced ischemic damage to the brain. However, the comparison of histological changes in the arterial wall between them is not reported yet. Temporary clipping on the iliac artery of 80 rats was performed using Yasargil temporary mini clip. The specimens were divided into two groups; Group I (intermittently repeated clipping for 5 minutes was done 3 times on the same site with resting interval for 5 minutes: total clipping time was 15 minutes) and Group II (continuous clipping for 15 minutes). Under the light microscope, the histological findings were examined in the specimens, which were obtained at each time-interval after clipping (0 hr, 3 hrs, 6 hrs, 12 hrs, 3 days, and 3 months). The histological changes of the arterial wall of rat by two techniques for temporary clipping were observed. Although there is no significant difference between two temporary clippings, there is a trend of milder and more delayed arterial change in intermittently-repeated temporary clipping.

Chronological Relationships between the Irreversible Vasoconstriction by the Vasodilator and the Electron Microscopic Changes of the Arterial Wall in the Rabbit Chronic Vasospasm Model

One of the characteristics of the cerebral vasospasm is its irreversibility with the vasodilators. Under the hypothesis that the irreversibility with vasodilators might be caused by the structural change in the arterial wall, authors examined the chronological relationships between the irreversibility and the electron microscopic findings of the arterial wall in the rabbit chronic vasospasm model. The development of the vasospasm and the irreversibility of the vasospasm with the intra-arterial papaverine were defined angiographically. After the second angiography done in ont to 30 days after subarachnoid hemorrhage(SAH), eighteen rabbits were sacrificed, and the basilar artery was examined with electron microscope. Arterial narrowing was the severest one day after SAH(54.1% of the pre-SAH diameter), and was maintained up to 30 days after SAH. The irreversibility of the arterial constriction with the papaverine developed 5 days after SAH, which had a tendency to recover 6 to 9 days after SAH. However the irreversibility was noted again 16 days after SAH. Electron microscopy revealed the endothelial wrinkling, disorganization of muscle fiber, myonecrosis, thickening of smooth muscle fibers, and increase of connective tissue in the tunica media. These structural changes were severest one day after SAH, and gradually diminished up to 30 days after SAH. These data show that there are no chronological relationships between the irreversibility and the structural change per se. However the fact that the irreversibility developed during the reparative phase of the arterial wall injury by SAH suggests that the chronic vasospasm is not a primary event but a secondary phenomenon following an injury to the cerebral arterial wall.

Reconstitution of Arterial Wall Using Cell Culture Technique / 昆明医科大学学报

Using cell culture technique, in vitro an artificial arterial wall has been constructed by adding cultured endothelial cells derived from the human umbilical vein to the smooth muscle cells isolated from the human umbilical artery. On the condition of vit C and the endothelial cell growth factor in the medium, both the endothelial cells and smooth muscle cells grew very well and formed living arterial walls with the ability of generation and metabolism. A confluent monolayer of flat endothelial cells and multilayer of smooth muscle cells were observed under the light and electron microscope. Among these cells were plenty of collagenous fiber, elastic fiber and glycoproteins produced by the smooth muscle cells. This blood vessel wall model can be used for studying the physiological and pathological process of arteries.