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Iatrogenic aortic dissection during right transradial intervention in a patient with aberrant right subclavian artery:A case report

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World Journal of Clinical Cases 2022年第27期10卷 9897-9903页

作者： Kyungeun Ha Albert Youngwoo Jang Yong Hoon Shin Joonpyo Lee Jeongduk Seo Seok In Lee Woong Chol Kang Soon Yong Suh division of cardiology Department of Internal MedicineYonsei University College of Medicine50 Yonsei-roSeodaemun-guSeoulSouth Korea division of cardiology Department of Internal MedicineGil Medical CenterGachon University College of MedicineIncheonSouth Korea Department of Thoracic and Cardiovascular Surgery Gil Medical CenterGachon University College of MedicineIncheonIncheonSouth Korea

BACKGROUND Aberrant right subclavian artery(ARSA)is the most common congenital anomaly of the aortic *** patients having such anomalies receive transradial intervention(TRI),aortic dissection(AD)may ***,we discuss a case of iatrogenic type B AD occurring during right TRI in an ARSA patient,that was later salvaged by percutaneous *** SUMMARY A 73-year-old man presented to our hospital with intermittent chest *** computed tomography(CT)angiography revealed significant stenosis in the left anterior descending *** coronary angiography was performed via the right radial artery without ***,we were unable to advance the guiding catheter past the ostium of the right subclavian artery to the aortic arch for percutaneous coronary intervention,while the guidewire tended to go down the descending *** patient suddenly complained of chest and back *** CT aortography revealed type B AD propagating to the left renal artery(RA)with preserved renal ***,after 2 d,the patient suddenly complained of right lower limb pain where the femoral pulse was suddenly ***-up CT indicated further progression of dissection to the right external iliac artery(EIA)and left RA with limited *** performed percutaneous angioplasty of the right EIA and left RA without ***-up CT aortography at 8 mo showed optimal *** A caution is required during right TRI in ARSA to avoid *** angioplasty can be a treatment option.

关键词： Aberrant subclavian artery Coronary angiography Aortic dissection Aortography Percutaneous transluminal angioplasty Case report

Forkhead box protein P1, a key player in neuronal development?

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Neural Regeneration Research 2018年第5期13卷 801-802页

作者： Luca Braccioli Cora H.Nijboer Paul J.Coffer Laboratory of Neuroimmunology and Developmental Origins of Disease (NIDOD) University Medical Center Utrecht University Regenerative Medicine center University Medical Center Utrecht Utrecht University center for Molecular Medicine and division of Pediatrics University Medical Center Utrecht Utrecht University

Forkhead box protein P1（FOXP1）is a transcription factor belonging to the forkhead box（FOX）proteins,a family of transcriptional regulators sharing a highly conserved forkhead DNA-binding domain（Bacon and Rappold,2012）.Previous reports have proposed a role for FOXP1 in functionally regulating the central nervous system（CNS）,while mutations in FOXP1 have been implicated in cognitive abnormalities（Bacon and Rappold, 2012）.

关键词： a key player in neuronal development Forkhead box protein P1

Iatrogenic atrial septal defects after transseptal puncture for percutaneous left atrial appendage occlusion and their hemodynamic effects

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Journal of Geriatric cardiology 2022年第9期19卷 675-684页

作者： Ioannis Drosos Roberta De Rosa Philipp C.Seppelt Sebastian Cremer Silvia Mas-Peiro Katrin Hemmann Jana Oppermann Recha Blessing Mariuca Vasa-Nicotera Andreas M.Zeiher Zisis Dimitriadis division of cardiology Department of Medicine IIIUniversity Hospital FrankfurtGoethe University Frankfurt am MainFrankfurtGermany German center for Cardiovascular Research(DZHK) BerlinGermany Cardiopulmonary Institute(CPI) FrankfurtGermany center of cardiology University Medical Center MainzMainzGermany Di-vision of cardiology.and Intensive Care Department of Internal MedicineSt.Ansgar HospitalHöxterGermany

Background Percutaneous left atrial appendage occlusion(LAAO)requires puncture of the interatrial *** immediate hemodynamic effects of iatrogenic atrial septal defects(iASD)after LAAO have not been examined so *** aimed at evaluat-ing these effects through invasive measurements of pressure and oxygen ***,we assessed the incidence of per-sistent iASD at three *** Forty-eight patients scheduled for percutaneous LAAO were prospectively included in the *** and oxygen saturation were measured(1)in the right atrium(RA)before transseptal puncture,(2)in the left atrium(LA)through the transseptal sheath after transseptal puncture,(3)in the LA after removal of introducer sheath,and(4)in the RA after removal of introducer *** echocardiography was performed at three months to detect *** Pressure in the RA increased significantly after removing the introducer sheath(P=0.034),whereas no difference was found in oxygen saturation in the RA(P=0.623).Pressure measurement in the LA showed no significant difference after re-moving the introducer sheath(P=0.718).Oxygen saturation in the LA also showed no significant difference(P=0.129).Follow-up transesophageal echocardiogram at 3 months revealed a persistent iASD in 4 patients(8.5%).CONCLUSIONS Our study suggests that iASD after percutaneous LAAO does not result in significant shunts directly after the procedure,although a significant increase of mean right atrial pressure can be *** iASDs after percutaneous LAAO seem to be relatively rare at three months.

关键词： atrial septal puncture

Microbiome as mediator: Do systemic infections start in the gut?

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World Journal of Gastroenterology 2015年第37期21卷 10487-10492页

作者： Melissa Latorre Suneeta Krishnareddy Daniel E Freedberg division of Digestive and Liver Diseases Columbia University Medical Center

The intestinal microbiome is emerging as a crucial mediator between external insults and systemic infections. New research suggests that our intestinal microorganisms contribute to critical illness and the development of non-gastrointestinal infectious *** pathways include a loss of fecal intestinal bacterial diversity and a disproportionate increase in toxogenic bacterial species. Therapeutic interventions targeting the microbiome- primarily probiotics- have yielded limited results to date. However, knowledge in this area is rapidly expanding and microbiome-based therapy such as short-chain fatty acids may eventually become a standard strategy for preventing systemic infections in the context of critical illness.

关键词： Clostridium difficile Gut Microbiome Critical illn

Emerging approaches and technologies in transplantation:the potential game changers

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Cellular & Molecular Immunology 2019年第4期16卷 334-342页

作者： Anil Dangi Shuangjin Yu Xunrong Luo division of Nephrology Department of MedicineDuke University Medical CenterDurhamNCUSA Duke Transplant center Duke University Medical CenterDurhamNCUSA

Newly emerging technologies are rapidly changing conventional approaches to organ *** the modern era,the key challenges to transplantation include(1)how to best individualize and possibly eliminate the need for life-long immunosuppression and(2)how to expand the donor pool suitable for human *** article aims to provide readers with an updated review of three new technologies that address these ***,single-cell RNA sequencing technology is rapidly evolving and has recently been employed in settings related to *** new sequencing data indicate an unprecedented cellular heterogeneity within organ transplants,as well as exciting new molecular signatures involved in alloimmune ***,sophisticated nanotechnology platforms provide a means of therapeutically delivering immune modulating reagents to promote transplant *** nanoparticles with regulatory molecules and donor antigens are capable of targeting host immune responses with tremendous precision,which,in some cases,results in donor-specific ***,CRISPR/Cas9 gene editing technology has the potential to precisely remove immunogenic molecules while inserting desirable regulatory *** technology is particularly useful in generating genetically modified pigs for xenotransplantation to solve the issue of the shortage of human ***,these new technologies are positioning the transplant community for major breakthroughs that will significantly advance transplant medicine.

关键词： Transplantation Single cell sequencing Crisper Cas9 Nanotechnology

Cardiac biomarkers in children with congenital heart disease

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World Journal of Pediatrics 2015年第4期11卷 309-315页

作者： Masaya Sugimoto Seiko Kuwata Clara Kurishima Jeong Hye Kim Yoich Iwamoto Hideaki Senzaki Department of Pediatrics Asahikawa Medical UniversityAsahikawaJapan Department of Pediatric cardiology Saitama Medical CenterSaitama Medical UniversityKawagoeJapan

Background:Most congenital heart diseases(CHDs)have specific hemodynamics,including volume and pressure overload,as well as cyanosis and pulmonary hypertension,associated with anatomical *** hemodynamic abnormalities can cause activation of neurohormones,inflammatory cytokines,fibroblasts,and vascular endothelial cells,which in turn contribute to the development of pathologic conditions such as cardiac hypertrophy,fi brosis,and cardiac cell damages and *** biomarker levels facilitates the prediction of these pathological changes,and provides information about the stress placed on the myocardial cells,the severity of the damage,the responses of neurohumoral factors,and the remodeling of the *** to the ample information on cardiac biomarkers in adult heart diseases,data from children with CHD are still *** sources:We reviewed cardiac biomarkers-specifi cally focusing on troponin as a biomarker of myocardial damage,amino-terminal procollagen type III peptide(PIIIP)as a biomarker of myocardialfi brosis and stromal remodeling,and B-type natriuretic peptide(BNP)/N-terminal proBNP as biomarkers of cardiac load and heart failure,by introducing relevant publications,including our own,on pediatric CHD patients as well as ***:Levels of highly sensitive troponin I are elevated in patients with atrial septal defects(ASDs)and ventricular septal defects(VSDs).PIIIP levels are also elevated in patients with ASD,VSD,pulmonary stenosis,and Tetralogy of *** of BNP and N-terminal proBNP levels shows good correlation with heart failure score in ***:In the treatment of children with CHD requiring delicate care,it is vital to know the specifi c degree of myocardial damage and severity of heart *** biomarkers are useful tools for ascertaining the condition of CHDs with ease and are likely to be useful in determining the appropriate care of pediatric cardiology.patients.

关键词： biomarker B-type natriuretic peptide congenital heart disease procollagen type III peptide troponin

Ambulatory blood-pressure monitoring, antihypertensive therapy and the risk of fall injuries in elderly hypertensive patients

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Journal of Geriatric cardiology 2018年第4期15卷 284-289页

作者： Michael Jonas Rasisa Kazarski Gil Chemin Department of cardiology Kaplan Medical Center Hebrew University School of Medicine Rehovot Israel Department of Nephrology and Hypertension Kaplan Medical Center Hebrew University School of Medicine Rehovot Israel

Background Fall injuries are common among the elderly. The aim of this study was to investigate whether blood-pressure patterns, as measured by 24-h ambulatory blood pressure monitoring （ABPM）, or intensification of antihypertensive therapy following the 24-h ABPM, may be associated with fall injuries in hypertensive elderly patients. Methods In a retrospective study, community-based elderly patients （age ≥ 70 years） who were referred to 24-h ABPM were evaluated for fall injuries within one-year post-ABPM. We compared the clinical characteristics, 24-h ABPM patterns and the intensification of hypertensive therapy following 24-h ABPM, between patients with and without a fall injury. Results Overall 1032 hypertensive elderly patients were evaluated. Fifty-five （5.3%） had a fall injury episode in the year following ABPM. Patients with a fall injury were significantly older, and with higher rates of previous falls. Lower 24-h diastolic blood-pressure （67.3 ± 7.6 vs. 70.7 ± 8.8 mmHg; P 〈 0.005） and increased pulse-pressure （74.7 ± 14.3 vs. 68.3 ± 13.7 mmHg; P 〈 0.005）, were found in the patients with a fall injury, compared to those without a fall injury. After adjustment for age, gender, diabetes mellitus and previous falls, lower diastolic blood-pressure and increased pulse-pressure were independent predictors of fall injury. Intensification of antihypertensive treatment following the 24-h ABPM was not associated with an increased rate of fall injury. Conclusions Low diastolic blood-pressure and increased pulse-pressure in 24-h ABPM were associated with an increased risk of fall injury in elderly hypertensive patients. Intensification of antihypertensive treatment following 24-h ABPM was not associated with an increased risk of fall injury.

关键词： Ambulatory blood pressure monitoring Hypertension Falls

From biomarker discovery to combined therapies:Advancing hepatocellular carcinoma treatment strategies

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World Journal of Gastrointestinal Oncology 2024年第11期16卷 4518-4521页

作者： Mo-Wei Kong Yang Yu Ying Wan Yu Gao Chun-Xiang Zhang Department of cardiology Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina School of Basic medical Sciences Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina Department of Endocrinology The Affiliated Hospital of Chengde Medical CollegeChengde 067000Hebei ProvinceChina Department of Pharmacology and rush university Cardiovascular Research center Rush University Medical CenterLuzhou 646000Sichuan ProvinceChina

This editorial reviews advances in hepatocellular carcinoma(HCC)treatment,focusing on a triple therapy approach and biomarker *** et al discuss the synergistic potential of transarterial chemoembolization combined with tyrosine kinase inhibitors and PD-1 ***,Li et al identify protein tyrosine phosphatase non-receptor II(PTPN2)as a biomarker for poor prognosis and immune evasion in *** studies highlight the importance of combined therapies and biomarkers in improving HCC treatment efficacy and patient outcomes,with PTPN2 emerging as a potential therapeutic *** article supplements the aforementioned studies with more recent research advancements,focusing on the molecular mechanisms and clinical applications of biomarkers.

关键词： Hepatocellular carcinoma Triple therapy Transarterial chemoembolization Protein tyrosine phosphatase non-receptor II

Long-term outcomes after fractional flow reserve-guided percutaneous coronary intervention in patients with severe coronary stenosis

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Journal of Geriatric cardiology 2019年第4期16卷 329-337页

作者： Ying-Hua ZHANG Jing LI Andreas J. Flammer Yoshiki Matsuo Moo-Sik Lee Ryan J. Lennon Malcolm R. Bell David R. Holmes John F. Bresnahan Charanjit S. Rihal Lilach O. Lerman Amir Lerman division of cardiology Xuanwu Hospital Capital Medical UniversityBeijingChina division of Cardiovascular Diseases Mayo ClinicRochesterUSA Cardiovascular center CardiologyUniversity Hospital ZurichSwitzerland Department of Preventive Medicine College of Medicine Konyang UniversityDaejeonSouth Korea Biomedical Statistics Mayo ClinicRochesterUSA division of Nephrology and Hypertension Mayo ClinicRochesterUSA

Objective To explore the safety and efficacy of FFR-guided percutaneous coronary intervention (PCI) in vessels with severe diameter stenosis. Methods & Results Of 1090 patients undergoing fractional flow reserve (FFR) assessment from 2002 to 2009,we identified 167 patients in whom FFR was measured in at least one 70%–89% stenotic lesion. These patients were subdivided into an FFR-defer group (n = 49) if PCI was deferred (FFR > 0.80),and an FFR-perform group (n = 118) if PCI was performed (FFR ≤ 0.80). Comparatively,an additional 1176 patients undergoing PCI in at least one lesion with 70%–89% stenosis but without measurement of FFR served as a control (angiography- guided) group. Clinical outcomes were compared during a median follow-up of 49.0 months. The 5-year Kaplan-Meier estimated revascularization rates were 16% in the FFR-defer group and 33% in the FFR-perform group (P = 0.046). The incidence of major adverse cardiac events were comparable in these two groups (HR = 0.82,95% CI: 0.37–1.82,P = 0.63). The number of stents placed was significantly lower in the FFR-guided group (0.9 ± 0.8 vs. 1.4 ± 0.8,P < 0.001). Conclusions Functional revascularization for lesions with visually severe stenosis is clinically safe and associated with fewer stents use. This study suggests that extending the use of FFR to more severe coronary lesions may be reasonable.

关键词： Fractional flow reserve Outcome Percutaneous coronary intervention Severe stenosis Stent