Objective: To examine the expression and localisation of adrenomedullln in hum an coronary atherosclerotic lesions from patients with unstable angina(UAP) and stable angina(SAP), and to study the relation between adre...Objective: To examine the expression and localisation of adrenomedullln in hum an coronary atherosclerotic lesions from patients with unstable angina(UAP) and stable angina(SAP), and to study the relation between adrenomedullin expression and plaque instability. Design: A retrospective observational study. Patients: D irectional coronary atherectomy samples were obtained from 15 patients with UAP and 12 with SAP. Methods: The localisation of adrenomedullin was examined by imm unohistochemistry, and adrenomedullin mRNA expression was measured by quantitati ve polymerase chain reaction. Results: Adrenomedullin immunoreactivity was prefe rentially localised in macrophages, intimai smooth muscle cells, and proliferate d microvessels. The mean number of adrenomedullin positive cells in five high po wer fields(x 400) per specimen was higher in patients with UAP than in those wit h SAP (mean (SEM), 110(13) v 76 (7); p< 0.05); and the ratio of adrenomedullin p ositive to total cells was higher in patients with UAP (43.0 (2.2)%v 34.2 (2.0) %; p< 0.01). More adrenomedullin mRNA was expressed in the plaque of patients w ith UAP than in those with SAP (60.4 (16.9)%v 9.7 (3.3)%; p< 0.01). Conclusion s: The findings suggest that adrenomedullin is involved in the development of at herosclerosis and plaque instability in human coronary arteries, in an autocrine or paracrine manner.展开更多
Background and Purpose -The progression of occlusive lesions in the major intracranial arteries was believed to be very rare in adult patients with moyamoya disease. The present study aims to clarify the incidence and...Background and Purpose -The progression of occlusive lesions in the major intracranial arteries was believed to be very rare in adult patients with moyamoya disease. The present study aims to clarify the incidence and clinical features of disease progression in adult moyamoya disease. Methods -For the past 15 years , 120 adult Japanese patients were diagnosed with moyamoya disease. Of these, 63 patients were enrolled in this historical prospective cohort study on a total o f 86 nonoperated hemispheres. All were followed up with a mean period of 73.6 mo nths. MRI and magnetic resonance angiography were repeated every 6 to 12 months, and cerebral angiography was performed when disease progression was suspected o n MRI and magnetic resonance angiography. Results -Disease progression occurred in 15 of 86 nonoperated hemispheres (17.4%per hemisphere) or in 15 of 63 patie nts (23.8%per patient) during the follow-up period. Occlusive arterial lesions progressed in both anterior and posterior circulations, in both symptomatic and asymptomatic patients, and in both bilateral and unilateral types. Eight of 15 patients developed ischemic or hemorrhagic events in relation to disease progres sion. Multivariate analysis revealed that the odds ratio conferred by a male pat ient was 0.20 (95%CI, 0.04 to 0.97). Conclusions -The incidence of disease pro gression in adult moyamoya disease is much higher than recognized before, and fe male patients may be at higher risk for it than male patients. Careful follow-u p would be essential to prevent additional stroke occurrence in medically treated adult patients with moyamoya disease, even if they are asymptomatic or are diagnosed as having unilateral moyamoya disease.展开更多
文摘Objective: To examine the expression and localisation of adrenomedullln in hum an coronary atherosclerotic lesions from patients with unstable angina(UAP) and stable angina(SAP), and to study the relation between adrenomedullin expression and plaque instability. Design: A retrospective observational study. Patients: D irectional coronary atherectomy samples were obtained from 15 patients with UAP and 12 with SAP. Methods: The localisation of adrenomedullin was examined by imm unohistochemistry, and adrenomedullin mRNA expression was measured by quantitati ve polymerase chain reaction. Results: Adrenomedullin immunoreactivity was prefe rentially localised in macrophages, intimai smooth muscle cells, and proliferate d microvessels. The mean number of adrenomedullin positive cells in five high po wer fields(x 400) per specimen was higher in patients with UAP than in those wit h SAP (mean (SEM), 110(13) v 76 (7); p< 0.05); and the ratio of adrenomedullin p ositive to total cells was higher in patients with UAP (43.0 (2.2)%v 34.2 (2.0) %; p< 0.01). More adrenomedullin mRNA was expressed in the plaque of patients w ith UAP than in those with SAP (60.4 (16.9)%v 9.7 (3.3)%; p< 0.01). Conclusion s: The findings suggest that adrenomedullin is involved in the development of at herosclerosis and plaque instability in human coronary arteries, in an autocrine or paracrine manner.
文摘Background and Purpose -The progression of occlusive lesions in the major intracranial arteries was believed to be very rare in adult patients with moyamoya disease. The present study aims to clarify the incidence and clinical features of disease progression in adult moyamoya disease. Methods -For the past 15 years , 120 adult Japanese patients were diagnosed with moyamoya disease. Of these, 63 patients were enrolled in this historical prospective cohort study on a total o f 86 nonoperated hemispheres. All were followed up with a mean period of 73.6 mo nths. MRI and magnetic resonance angiography were repeated every 6 to 12 months, and cerebral angiography was performed when disease progression was suspected o n MRI and magnetic resonance angiography. Results -Disease progression occurred in 15 of 86 nonoperated hemispheres (17.4%per hemisphere) or in 15 of 63 patie nts (23.8%per patient) during the follow-up period. Occlusive arterial lesions progressed in both anterior and posterior circulations, in both symptomatic and asymptomatic patients, and in both bilateral and unilateral types. Eight of 15 patients developed ischemic or hemorrhagic events in relation to disease progres sion. Multivariate analysis revealed that the odds ratio conferred by a male pat ient was 0.20 (95%CI, 0.04 to 0.97). Conclusions -The incidence of disease pro gression in adult moyamoya disease is much higher than recognized before, and fe male patients may be at higher risk for it than male patients. Careful follow-u p would be essential to prevent additional stroke occurrence in medically treated adult patients with moyamoya disease, even if they are asymptomatic or are diagnosed as having unilateral moyamoya disease.
