• Title/Summary/Keyword: Intimal Hyperplasia

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Flow Changes by Stent Insertion in Fusiform Aneurysm Models (스텐트 삽입에 의한 방추형 동맥류 내부 유동의 변화)

  • 이계한;서남현
    • Journal of Biomedical Engineering Research
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    • v.22 no.6
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    • pp.535-542
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    • 2001
  • Endovascular embolization technique using a steno is currently used to treat the wide neck aneurysm. Since intraaneurysmal flow characteristics affect thrombus formation and embolisation process. flow visualization technique incorporating photochromic dye was used to elucidate hemodynamic changes by stenting Inside the fusiform aneurysm models. Qualitative observation of flow field and measurement of wall shear rates were Performed at five aneurysm wall locations under pulsatile flow. Intraaneurysmal flow motion was reduced and sluggish vortical motion was maintained during late deceleration phase by stenting. Also wall shear rates were reduced and OSI's were increased in the stented model. These flow characteristics Provide hemodynamic environment favorable for thrombus formation and intimal hyperplasia. The results of this study show hemodynamic changes by stenting Promote thrombus formation and aneurysm embolisation.

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Cl--Channel Is Essential for LDL-induced Cell Proliferation via the Activation of Erk1/2 and PI3K/Akt and the Upregulation of Egr-1 in Human Aortic Smooth Muscle Cells

  • Heo, Kyung-Sun;Ryoo, Sung-Woo;Kim, Lila;Nam, Miyoung;Baek, Seung-Tae;Lee, Hyemi;Lee, Ah-Reum;Park, Song-Kyu;Park, Youngwoo;Myung, Chang-Seon;Kim, Dong-Uk;Hoe, Kwang-Lae
    • Molecules and Cells
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    • v.26 no.5
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    • pp.468-473
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    • 2008
  • Low-density lipoprotein (LDL) induces cell proliferation in human aortic smooth muscle cells (hAoSMCs), which may be involved in atherogenesis and intimal hyperplasia. Recent studies have demonstrated that $Cl^-$ channels are related to vessel cell proliferation induced by a variety of stimuli. In this study, we investigated a potential role of $Cl^-$ channels in the signaling pathway of LDL effects on hAoSMC proliferation with a focus on the activation of Erk1/2-PI3K/Akt and the subsequent upregulation of Egr-1. $Cl^-$ channel blockers, DIDS, but neither NPPB nor Furosemide, completely abolished the LDL-induced DNA synthesis and cell proliferation. Moreover, DIDS, but not NPPB, significantly decreased LDL-stimulated $Cl^-$ concentration, as judged by flow cytometry analysis using MQAE as a $Cl^-$-detection dye. DIDS pretreatment completely abolished the activation of Erk1/2 and PI3K/Akt in a dose-dependent manner that is the hallmark of LDL activation, as judged by Western blot and proliferation assays. Moreover, pretreatment with DIDS ($Cl^-$ channel blockers) but not LY294002 (PI3K inhibitors) completely abolished the LDL-induced upregulation of Egr-1 to the same extent as PD98059 (MEK inhibitors to inhibit Erk), as judged by Western blot and luciferase reporter assays. This is the first report, to our knowledge, that DIDS-sensitive $Cl^-$-channels play a key role in the LDL-induced cell proliferation of hAoSMCs via the activation of Erk1/2 and PI3K/Akt and the upregulation of Egr-1.

Complications Following Transradial Cerebral Angiography : An Ultrasound Follow-Up Study

  • Yoon, Wonki;Kwon, Woo-Keun;Choudhri, Omar;Ahn, Jaegeun;Huh, Hanyong;Ji, Choel;Do, Huy M.;Mantha, Aditya;Jeun, Sin-Soo
    • Journal of Korean Neurosurgical Society
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    • v.61 no.1
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    • pp.51-59
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    • 2018
  • Objective : The feasibility and usefulness of transradial catheterization for coronary and neuro-intervention are well known. However, the anatomical change in the catheterized radial artery (RA) is not well understood. Herein, we present the results of ultrasonographic observation of the RA after routine transradial cerebral angiography (TRCA). Methods : Patients who underwent routine TRCA with pre- and post-procedure Doppler ultrasonography (DUS) of the catheterized RA were enrolled. We then recorded and retrospectively reviewed the diameter and any complicated features of the RA observed on DUS, and the factors associated with the diameter and complications were analyzed. Results : A total of 223 TRCAs across 181 patients were enrolled in the current study. The mean RA diameter was 2.48 mm and was positively correlated with male gender (p<0.001) and hypertension (p<0.002). The median change in diameter after TRCA was less than 0.1 mm (range, -1.3 to 1.2 mm) and 90% of changes were between -0.8 and +0.7 mm. Across 228 procedures, there were 12 cases (5.3%) of intimal hyperplasia and 22 cases (9.6%) of asymptomatic local vascular complications found on DUS. Patients with abnormal findings on the first procedure had a smaller pre-procedural RA diameter than that of patients without findings (2.26 vs. 2.53 mm, p=0.0028). There was no significant difference in the incidence of abnormal findings for the first versus subsequent procedures (p=0.68). Conclusion : DUS identified the pre- and post-procedural diameter and local complications of RA. Routine TRCA seems to be acceptable with regard to identifying local complications and changes in RA diameter.

Histomorphological Comparison of the Coronary Artery and Available Graft Conduits (관상동맥 및 이식편으로 사용 가능한 혈관들의 조직형태학적 비교)

  • Kim, Yong-Ho;Lee, Seok-Ki;Yu, Jeong-Hwan;Kim, Si-Wook;Kang, Shin-Kwang;Lim, Seung-Pyung;Yu, Jae-Hyeon;Lee, Young
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.563-567
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    • 2008
  • Background: The histomorphological properties of the left anterior desecending artery (LAD), the left internal thoracic arteries (LITA), the radial arteries (RA) and the intercostal arteries (ICA) were studied for their use as a conduit for coronary artery bypass grafting (CABG), and we compared them with each other. Material and Method: All the vessels were harvested from nineteen cadavers (17 males and 2 females). The mid-portion of the LAD, the mid-portion of the LITA, the distal RA and the mid-portion of the 5th ICA were obtained. All of them were stained with hematoxylin-eosin and with Van Gieson's elastin stain. The morphological characteristics were examined and the thicknesses of the intima and media (I/M ratio: the intima to media ratio) were compared using one-way ANOVA tests. Result: The mean age of the cadavers was $61.5{\pm}9.6$ years. The LITA and ICA were elastic arteries, and the LAD and RA were muscular arteries. The I/M ratio showed statistically significant differences: $0.07{\pm}0.03$ in the LITA, $0.16{\pm}0.11$ in the ICA, $0.45{\pm}0.29$ in the RA and $0.93{\pm}0.52$ in the LAD, respectively. Conclusion: This study showed that the degrees of intimal hyperplasia of the CA and the various conduits for CABG were different significantly. The ICA was found to have relatively favorable characteristics as a coronary by pass conduit, but its suitability for clinical use is a challenging issue.

Snuffbox Arteriovenous Fistula Formation for Hemodialysis (Snuffbox에 시행한 혈액투석을 위한 동정맥루조성술)

  • 서필원;류재욱;박정옥;장성욱;김미순;박성식;김삼현
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.154-159
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    • 2004
  • The arteriovenous fistula (AVF), which maintains satisfactory blood flow, is necessary to the patients of end-stage renal disease for the long term hemodialysis. We performed the snuffbox fistula as the first operation for hemodialysis vascular access. This study was performed to investigate the patency rates, complications, risk factors for occlusion of the AVF, and the types of reoperations. Material and Method: We performed 146 snuffbox fistulas from Jun. 1994 to Dec. 2001 The records of the patients except six patients who were lost from follow up were analyzed retrospectively, Mean age and male:female ratio were 52$\pm$15 years (range, 17∼79 years) and 80 : 60 respectively. Diabetes mellitus and hypertension were combined in 47 patients and 101 respectively. Preoperative levels of creatinine and potassium were 9.09$\pm$3.68 mg/dL (range, 2.55∼20.09 mg/dL) and 4.7$\pm$0.9 mmol/L (range, 2.3∼8.1 mmol/L). One hundred thirteen cases of the snuffbox fistulas were done at left side hand and the others at right hand. Result: Mean follow up period of the patients was 41.8$\pm$31.0 months (range, 0.2∼108,8 months). During the follow up period, 35 occlusions of AVF occurred and these AVFs were patent for 9.8$\pm$10.1 months (range, 0.1∼40.4 months). The patency rates of f month, and 1, 2, 3, 5 years were known as 92.8, 80.2, 73.8, 71.3, 69.6% respectively. Right sided snuffbox fistulas (p-value=0.045) and old age (p-value=0.048) were revealed as significant risk factors for occlusion of AVF. The postoperative complications consisted of occlusions of AVF caused by intimal hyperplasia of vein in 24, thrombosis in nine, stenosis of anastomosis site in three, and venous hypertensions in two. After the first operation 37 patients underwent 86 reoperations. Conclusion: The snuffbox fistulas showed acceptable patency rates and low complication rates. The snuffbox fistulas as the first operation for AVF formation can be a good option for the patients with end-stage renal disease.