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Sample records for arteritis

  1. Arter 2014

    DEFF Research Database (Denmark)

    Søgaard, Bjarne; Mikkelsen, Peter; Bladt, Jesper;

    2015-01-01

    I rapporten fremlægges resultaterne af overvågningen af arter i NOVANA i 2014. Overvågningen omfatter primært udvalgte plante- og dyrearter omfattet af Habitatdirektivet. Artsovervågning i NOVANA har til formål at bidrage med konkret viden om ændringer i arternes udbredelse og bestandsstørrelse o...

  2. Arteritis temporalis

    Directory of Open Access Journals (Sweden)

    Øyvind Palm

    2009-10-01

    Full Text Available Giant cell arteritis (GCA is a common systemic vasculitis in elderly Norwegian patients. Scandinavian studies confirm that GCA usually starts rather acute and is diagnosed within less than two months in most cases. Temporal headache, tenderness and reduced pulsation of the temporal artery combined with significantly elevated ESR are typical features of the disease. A declining incidence from North to South across Europe has been found. The estimated annual incidence in Norway is 20.6-29.1 per 100.000 persons aged 50 years or more, which is among the highest worldwide. The high incidence in the Northern countries and the still incomplete understood ethiopathogenesis should encourage Scandinavian research on GCA.

  3. Giant Cell Arteritis

    Science.gov (United States)

    Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

  4. Takayasu arteritis in Colombia.

    Science.gov (United States)

    Cañas, C A; Jimenez, C A; Ramirez, L A; Uribe, O; Tobón, I; Torrenegra, A; Cortina, A; Muñoz, M; Gutierrez, O; Restrepo, J F; Peña, M; Iglesias, A

    1998-10-01

    Takayasu arteritis has been recognized in Colombia just recently, and so far we do not have any report concerning its presentation here. In this first report, some issues related to the presentation of the disease are indicated and compared with those found in the medical literature. No differences were found in age and sex. Most of the cases were diagnosed during an inactive phase of the disease with advanced manifestations due to vascular lesion which suggests the existence of some genetic factor influencing such a presentation, or may be the consequence of a delay in diagnosing the disease during initial and active stages due to not suspecting it. Comparing the vessels which are affected among other races and countries, we can find both differences and similarities. With the purpose of discovering the demographic, clinical, angiographic and laboratorial characteristics of Takayasu arteritis in Colombia, the present study was carried out by studying 35 clinical cases in different medical centers of the country.

  5. Giant Cell Arteritis.

    Science.gov (United States)

    Hoffman, Gary S

    2016-11-01

    This issue provides a clinical overview of giant cell arteritis, focusing on diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  6. Arteritis de Takayasu

    OpenAIRE

    PAZ, Eliana; Calvo, Armando; SILICANI, Armando

    2013-01-01

    Revisamos los casos de Arteritis de Takayasu (AT) diagnosticados en el Hospital Cayetano Heredia entre 1970 y 1988. Reportamos 7 pacientes con diagnóstico angiográfico de AT, todas mujeres, seis de raza mestiza y una blanca. El tiempo de enfermedad promedio al diagnóstico fue de 7 años (rango: 4 meses a 15 años). Los pacientes tuvieron síntomas sistémicos (fiebre, artralgias, cefalea); síntomas y signos de estenosis vascular (claudicación, hipertensión), todos presentaron soplos vasculares y ...

  7. Arteritis de Takayasu

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    Viviana Hernández-de Mezerville

    2007-07-01

    Full Text Available Resumen Se reporta un caso de arteritis de Takayasu en una paciente con disminución de pulsos arteriales en miembro superior derecho e hipertensión arterial de larga data. La AT es una vasculitis crónica de etiología desconocida, principalmente de arterias de gran calibre como la aorta y sus ramas. Es más frecuente en mujeres de edad reproductiva, pero puede presentarse a cualquier edad. Se manifiesta con una clínica variada secundaria a síntomas isquémicos por lesiones estenóticas o formación de trombos. Estas lesiones pueden llevar a hipertensión secundaria, retinopatía, cardiopatía, enfermedad cerebrovascular o muerte prematura. El diagnóstico debe sospecharse ante una mujer joven con disminución o ausencia de pulsos arteriales, desigualdad de la presión arterial o soplos carotídeos, y se confirma con la arteriografía. Dentro de las opciones terapéuticas se encuentran los esteroides, los agentes inmunosupresores y la resolución de las complicaciones de la enfermedad.Abstract We report the case of a woman with Takayasu יs Arteritis (AT who had decreased arterial pulses in the right arm along with arterial hypertension. AT is a chronic vasculitis of unknown etiology involving mainly the aorta and its branches. It is most prevalent in women of reproductive age but it can occur at any age. The clinical presentation is variable and the symptoms are ischemic secondary to stenotic lesions or thrombus formation in the arterial tree. These lesions can lead to secondary hypertension, retinopathy, cerebrovascular disease, cardiopathy and premature death. The diagnosis of AT should be suspected in young women with diminished or absent peripheral pulses, discrepancies in blood pressure, and arterial bruits. It is confirmed with by angiogram. Therapeutic options include glucocorticoids, inmunosupprant agents and treatment of its complications.

  8. Arteritis de Takayasu

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    Viviana Hernández-de Mezerville

    2007-07-01

    Full Text Available Resumen Se reporta un caso de arteritis de Takayasu en una paciente con disminución de pulsos arteriales en miembro superior derecho e hipertensión arterial de larga data. La AT es una vasculitis crónica de etiología desconocida, principalmente de arterias de gran calibre como la aorta y sus ramas. Es más frecuente en mujeres de edad reproductiva, pero puede presentarse a cualquier edad. Se manifiesta con una clínica variada secundaria a síntomas isquémicos por lesiones estenóticas o formación de trombos. Estas lesiones pueden llevar a hipertensión secundaria, retinopatía, cardiopatía, enfermedad cerebrovascular o muerte prematura. El diagnóstico debe sospecharse ante una mujer joven con disminución o ausencia de pulsos arteriales, desigualdad de la presión arterial o soplos carotídeos, y se confirma con la arteriografía. Dentro de las opciones terapéuticas se encuentran los esteroides, los agentes inmunosupresores y la resolución de las complicaciones de la enfermedad.

  9. Takayasu arteritis in children

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    Cochat Pierre

    2008-09-01

    Full Text Available Abstract Takayasu arteritis (TA is a large vessel vasculitis that usually affects young female patients during the second and third decades of life, but has been reported in children as young as 24 months of age. Aim of this report was to describe four children (two girls with TA, as well as summarizing main published studies. The mean age at presentation of our cases was 11 years (range 8–15. Three patients were Caucasians and one Asian. Arterial hypertension was the commonest mode of presentation followed by systemic symptoms. Other related symptoms were due to ischemia and consisted of abdomen, chest, and limb pain. An abdominal bruit was noted in only one patient. Inflammation markers were always abnormal. Angiography was performed in all cases; left subclavian artery and common carotid artery were more frequently involved. Renal artery stenosis was observed in two patients. One boy was diagnosed as having an associated immune deficiency (Wiskott-Aldrich syndrome. Treatment modalities included prednisone (n = 4, methotrexate (n = 3, and mycophenolate mofetil (MMF (n = 1. Surgery was required in two patients. Follow-up ranged from 3 to 10 years since diagnosis. In three cases antihypertensive drugs and methotrexate were stopped, and prednisone was reduced to 7.5 mg/day.

  10. Hepatic Giant Cell Arteritis and Polymyalgia Rheumatica

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    Donald R Duerksen

    1994-01-01

    Full Text Available Polymyalgia rheumatica (PMR is a clinical syndrome of the elderly characterized by malaise, proximal muscle aching and stiffness, low grade fever, elevated erythrocyte sedimentation rare and the frequent association with temporal giant cell arteritis. The authors describe a case of PMR associated with hepatic giant cell arteritis. This lesion has been described in two other clinical reports. The distribution of the arteritis may be patchy; in this report, diagnosis was made with a wedge biopsy performed after an initial nonspecific percutaneous liver biopsy. The authors review the spectrum of liver involvement in PMR and giant cell arteritis. Hepatic abnormalities respond to systemic corticosteroids, and patients with hepatic arteritis have a good prognosis.

  11. Patient with Takayasu arteritis presented as cardiogenic shock.

    Science.gov (United States)

    Tacoy, Gulten; Akyel, Ahmet; Tavil, Yusuf; Cengel, Atiye

    2010-11-01

    Takayasu arteritis is a chronic inflammatory disease involving the aorta, its main branches and affects particularly young women. Symptomatic coronary artery disease and cardiogenic shock are rare signs of Takayasu arteritis. We describe a 47-year-old male patient in whom cardiogenic shock was the initial presentation of Takayasu arteritis with coronary, subclavian, celiac and total abdominal aortic occlusion.

  12. Neurological Manifestations of Takayasu Arteritis

    Institute of Scientific and Technical Information of China (English)

    Li-xin Zhou; Jun Ni; Shan Gao; Bin Peng; Li-ying Cui

    2011-01-01

    Objective To investigate the clinical neurological manifestations of Takayasu arteritis (TA).Methods A retrospective study was conducted with 63 consecutive TA cases admitted to Peking Union Medical College Hospital from January 2009 to May 2010.All the patients fulfilled the diagnostic criteria of TA by the American College of Rheumatology.Among the 63 TA patients,27 with neurological manifestations were included in the present study.All the patients were evaluated using standardized neurological examination,sonography,computed tomography (CT) angiography,and cerebral CT or magnetic resonance imaging.Results Dizziness and visual disturbance were the most common symptoms,which occurred in 20 (74.1%) and 16 (59.3%) patients respectively.Another common symptom was headache,observed in 15 (55.6%) patients.Six (22.2%) patients had suffered from ischemic stroke; 7 (25.9%) patients had epileptic seizures.Two (7.4%) patients were diagnosed as reversible posterior encephalopathy syndrome (RPES) based on typical clinical and imaging manifestations.Conclusions Neurological manifestations are common symptoms in TA patients in the chronic phase,including dizziness,visual disturbance,headache,ischemic stroke,seizures,and some unusual ones such as RPES.We suggested RPES be included into the differential diagnosis of acute neurological changes in TA.

  13. [Rare complication in a patient with giant cell arteritis].

    Science.gov (United States)

    Olivera, S; Gonzalez, S Olivera; Amores, B; Arriaga, B Amores; Torralba, M A; Cabeza, M A Torralba; Pérez Calvo, J I; Calvo, J I Pérez

    2010-01-01

    Giant cell arteritis (temporal arteritis) is a chronic vasculitis that usually affects older people. Although this is a systemic disease, it most often affects the cranial arteries. The most frequent complication of this disorder is visual loss. We report the case of a patient who suffered several rare complications, including tongue necrosis, as a result of being diagnosed with giant cell arteritis following the start of treatment.

  14. [Endovascular intervention in Takayasu Arteritis. Case report].

    Science.gov (United States)

    Di Santo, Marisa; Stelmaszewski, Érica V; Villa, Alejandra

    2016-06-01

    A four year old patient with no medical history was admitted to our hospital's Emergency Department, suffering from edema and hypertension. During physical examination a low pulse was detected in the left arm and a lack of pulses in lower limbs, with a blood pressure difference greater than 10 mm Hg between both arms. An echocardiogram demonstrated severe aortic abdominal coarctation and ventricular dysfunction. Takayasu arteritis was diagnosed and cardiac angiography was performed. Disconnection of left subclavian artery and severe tightness at the abdominal aorta were confirmed. The definitive diagnosis was Takayasu arteritis. Angioplasty with stent was performed in abdominal aorta, with good subsequent results. The pulses improved in the lower limbs, and normal blood pressure values without gradient between all members were registered. The echocardiogram improved ventricular function and the gradient in the coarctation area was significantly reduced.

  15. Clinical aspects of the temporal arteritis

    Directory of Open Access Journals (Sweden)

    Palheta Neto, Francisco Xavier

    2008-12-01

    Full Text Available Introduction: The Horton's disease, or temporal arteritis, is the most common autoimmune systemic vasculitis in adults, especially the old-aged. Objective: To review the literature about the several aspects of the Horton's disease, and confirm the otorhinolaryngologic clinical manifestations. Method: The study searched online databases such as EMedicine, Encyclopedia of Medicine, FindArticles, LILACS, MEDLINE, Merck Manuals On-Line Medical Library and Scielo, and applied to the search the terms: Horton's disease, Temporal Arteritis and Giant Cells Arteritis, for articles published between 1996 and 2008. Literature's Review: The disease's clinical manifestations start after 50 years old, and it's more frequent near 72 years old. The intense headache, temporal tumefaction, mandibular claudication and visual loss are the main signals and symptoms. There may occur dysacusis, necrosis of the tongue and odynophagia. Considerations: Lots of aspects of the Horton's disease do not have their due elucidation and, even being a disease that affects many adults, it doesn't have deep investigations in great quantity. A better understanding of this disease will lead to the increment of cure possibilities and reduction of morbidity in the patients, especially in ophthalmologic and otorhinolaryngologic areas.

  16. Koroner arter ektazisi olan hastalarda plazma viskozitesi

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    Halil Bilgili

    2014-09-01

    Full Text Available Amaç. Koroner arter ektazisi (CAE koroner arterlerdeki lokalize veya yaygın anevrizmatik genişlemeler olarak tanımlanır. Plazma viskozitesi fibrinojen, immünoglobülinler ve lipoproteinler gibi çeşitli makromoleküller tarafından belirlenir. Bu nedenle kardiyovasküler hastalıklarda klasik risk faktörleri, hemostatik bozukluklar ve enflamasyon etkilerini çeşitli açılardan yansıtabilir. Çalışmada koroner arter hastalığında (KAH risk faktörü olarak kabul edilen plazma viskozitesinin, koroner arter ektazili hastalarda bir farklılık gösterip göstermediğini incelemeyi amaçladık. Yöntem. Çalışmaya rutin koroner anjiyografiler sırasında koroner arter ektazisi (24 hasta ve koroner arter hastalığı (24 hasta tespit edilen hastalar alındı. Hastaların yaş, cinsiyet, diyabet varlığı, hipertansiyon, tütün içiciliği gibi kardiyovasküler risk faktörleri ve aldığı tedaviler sorgulandı. Tüm hastaların plazma viskozite düzeyleri ölçüldü ve istatistiksel olarak karşılaştırıldı. Bulgular. Plazma viskozitesi KAH’lı grupta 1,19 ± 0,70 mPa•s, KAE’li grupta 1,18 ± 0,80 mPa•s olarak ölçüldü. Her iki grup arasında istatistiksel olarak anlamlı fark bulunamadı (p>0,05. Sonuç. Plazma viskozitesinin kardiyovasküler risk faktörü olmakla birlikte, KAE hastalığı fizyopatolojisinde, nedensel bir rol oynamadığı söylenebilir. Fibrinojen seviyelerinde gruplar arası değişiklik saptanmaması viskozite değerleri bulgularımızı desteklemektedir.

  17. Vessel involvement in giant cell arteritis : an imaging approach

    NARCIS (Netherlands)

    Holm, Pieter W; Sandovici, Maria; Slart, Riemer H.; Glaudemans, Andor W; Rutgers, Abraham; Brouwer, Elisabeth

    2016-01-01

    Vasculitis is classified based on the size of the involved vessels. The two major forms are small vessel vasculitis (SVV) and large vessel vasculitis (LVV). Main forms of LVV are Takayasu Arteritis (TA), Giant Cell Arteritis (GCA), Isolated Aortitis (IA) and Chronic Periaortitis (PC). This manuscrip

  18. Multidetector CT angiography in Takayasu arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Khandelwal, Niranjan; Kalra, Naveen [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Garg, Mandeep Kumar, E-mail: gargmandeep@hotmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Kang, Mandeep; Lal, Anupam [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Jain, Sanjay [Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Suri, Sudha [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India)

    2011-02-15

    Objective: To analyse the spectrum of Takayasu's arteritis (TA) on multidetector CT angiography (MDCTA). Materials and methods: A retrospective analysis of the MDCTA findings was performed on 15 patients clinically diagnosed as Takayasu's arteritis. The spectrum and incidence of imaging findings on CTA were compared to studies in literature on catheter angiography in Takayasu's arteritis. Laboratory parameters were available in nine patients. The disease was considered active if erythrocyte sedimentation rate (ESR) levels were elevated and 'C' reactive protein (CRP) was positive. An attempt was made to correlate disease activity with the imaging findings. Results: Ascending aorta, arch of aorta and descending thoracic aorta were involved in 14 out of 15 (93%) patients. The wall thickness varied between 1 and 10 mm with maximal involvement in arch and descending thoracic aorta. Major neck vessels were involved in 11 (73%) patients with most pronounced changes seen in the brachiocephalic trunk, left common carotid artery (CCA) and left subclavian artery (SCA). Abdominal aorta and its branches were involved in all the 11 (100%) patients in whom abdominal CTA was performed. Celiac axis and SMA were involved in 10 (91%) and seven (64%) patients, respectively while renal artery stenosis was present in five (45%) patients. In six patients, ESR was elevated and CRP was positive indicating active disease. All patients in whom the laboratory parameters were available showed mural thickening in the aorta and at least one of the neck vessels except for one patient with inactive disease who had aortic mural thickening only. Conclusion: MDCTA provides information about both the vessel wall and lumen in patients with Takayasu's disease.

  19. Lyme carditis mimicking giant cell arteritis

    Directory of Open Access Journals (Sweden)

    Krati Chauhan

    2015-10-01

    Full Text Available Presenting an interesting case of a patient who complained of myalgias, fatigue, headache, jaw claudication and scalp tenderness. Patient’s physical examination was unremarkable. Laboratory findings showed elevated erythrocyte sedimentation rate and C-reactive protein, bilateral temporal artery biopsy results were negative and first degree atrioventricular block was seen on electrocardiogram. Serology for Borrelia burgdorferi was positive; patient was diagnosed with Lyme carditis and treated with doxycycline. Lyme is a tick-borne, multi-system disease and occasionally its presentation may mimic giant cell arteritis. On follow-up there was complete resolution of symptoms and electrocardiogram findings.

  20. Paroxysmal hemicrania as the clinical presentation of giant cell arteritis

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    Jennifer L. Beams

    2011-11-01

    Full Text Available Head pain is the most common complaint in patients with giant cell arteritis but the headache has no distinct diagnostic features. There have been no published reports of giant cell arteritis presenting as a trigeminal autonomic cephalalgia. We describe a patient who developed a new onset headache in her fifties, which fit the diagnostic criteria for paroxysmal hemicrania and was completely responsive to corticosteroids. Removal of the steroid therapy brought a reemergence of her headaches. Giant cell arteritis should be considered in the evaluation of secondary causes of paroxysmal hemicrania; in addition giant cell arteritis needs to be ruled out in patients who are over the age of 50 years with a new onset trigeminal autonomic cephalalgia.

  1. Takayasu arteritis associated with severe renovascular hypertension

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    Mohamed Hassani

    2016-01-01

    Full Text Available Takayasu arteritis (TA is an inflammatory process frequently associated with stenosis and obliteration of the aorta and its primary branches. We report a 16-year-old girl in whom TA manifested mainly with a sudden decrease in visual acuity and severe arterial hypertension in both legs. Bilateral radial pulses were absent. Ultrasound showed renal size asymmetry and raised the possibility of renal artery stenosis. The diagnosis of TA was confirmed by computed tomography angiography, which showed a thickened abdominal aortic wall and narrowing of its lumen. In addition, occlusions of left renal artery and of both left and right subclavian arteries were observed. Hypertension was hardly under control by a combination of three antihypertensive drugs. The outcome was favorable with corticosteroids alone with regression of the clinical signs, disappearance of inflammation, and control of hypertension.

  2. Excess mortality in giant cell arteritis

    DEFF Research Database (Denmark)

    Bisgård, C; Sloth, H; Keiding, Niels

    1991-01-01

    A 13-year departmental sample of 34 patients with definite (biopsy-verified) giant cell arteritis (GCA) was reviewed. The mortality of this material was compared to sex-, age- and time-specific death rates in the Danish population. The standardized mortality ratio (SMR) was 1.8 (95% confidence...... with respect to SMR, sex distribution or age. In the group of patients with department-diagnosed GCA (definite + probable = 180 patients), the 95% confidence interval for the SMR of the women included 1.0. In all other subgroups there was a significant excess mortality. Excess mortality has been found in two...... of seven previous studies on survival in GCA. The prevailing opinion that steroid-treated GCA does not affect the life expectancy of patients is probably not correct....

  3. Cannabis arteritis: ever more important to consider.

    Science.gov (United States)

    Santos, Rui Pedro; Resende, Cristina Isabel Pinho; Vieira, Ana Paula; Brito, Celeste

    2017-03-13

    Cannabis arteritis (CA) is a major and underdiagnosed cause of peripheral arterial disease in young patients. A 34-year-old man, daily smoker of 20 cigarettes and two cannabis cigarettes for 14 years, presented with a necrotic plaque of left hallux for 3 weeks. The Doppler ultrasound and angiography were compatible with severe Buerger's disease. Submitted to a revascularisation procedure and hypocoagulation with rivaroxaban. He had ceased smoking but maintained consumption of cannabis. Owing to the persistence of distal necrosis, amputation of the hallux was performed with good evolution. CA is a subtype of Buerger's disease. It is poorly known but increasingly prevalent and manifests in cannabis users regardless of tobacco use. The drug is considered at least a cofactor of the arteriopathy. The most effective treatment is cessation of consumption. Being cannabis one of the most consumed drugs, its mandatory to ask about its use in all young patients with arteriopathy.

  4. Doppler ultrasound and giant cell arteritis

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    Ana Marina Suelves

    2010-11-01

    Full Text Available Ana Marina Suelves1, Enrique España-Gregori1,2, Jose Tembl3, Stephanie Rohrweck1, Jose Maria Millán4, Manuel Díaz-Llopis1,4,51Service of Ophthalmology, La Fe University Hospital, Valencia, Spain; 2Department of Optics, University of Valencia, Valencia, Spain; 3Service of Neurology, La Fe University Hospital, Valencia, Spain; 4CIBERER, Ciber de Enfermedades Raras, Valencia, Spain; 5Faculty of Medicine, University of Valencia, Valencia, SpainObjective: To evaluate the utility of ultrasound in aiding the diagnosis of giant cell arteritis (GCA, in monitoring the response to corticotherapy, and in detecting early relapses.Methods: A pilot study, prospective, included 10 patients with suspected GCA. All patients underwent ultrasound examination of both temporal arteries before temporal artery biopsy (TAB, 3 weeks after starting treatment, and 3 months after diagnosis. For this study, the histological findings alone were used to define if patients were suffering from GCA. The findings on ultrasound were compared with the results of biopsy. The best place to perform TAB was observed by ultrasound.Results: All patients with positive biopsy were detected with ultrasound. No false positives were observed on ultrasound. The results presented give a sensibility, specificity, and positive predictive value of 100% for the use of ultrasound in the diagnosis of GCA. Two relapses were detected early by ultrasound during the follow-up.Conclusions: This pilot study suggests that eco-doppler may be a useful tool in diagnosis and clinic follow-up in patients with suspected GCA.Keywords: giant cell arteritis, ultrasound, temporal artery biopsy, optic nerve

  5. Giant cell arteritis associated with chronic active Epstein-Barr virus infection

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    A. Giardina

    2013-03-01

    Full Text Available Giant cell arteritis is an inflammatory vasculopathy that preferentially affects medium-sized and large arteries. A viral cause has been suspected but not confirmed in polymyalgia rheumatica and giant-cell arteritis. We report the case of a 81-year-old female who suffered from chronic active Epstein-Barr virus infection and developed giant cell temporal arteritis.

  6. Giant cell temporal arteritis associated with overlying basal cell carcinoma: co-incidence or connection?

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    Salem Alowami

    2012-06-01

    Full Text Available Giant cell arteritis is a granulomatous vasculitis of large and medium sized arteries manifesting as temporal arteritis and/or polymyalgia rheumatica. The histological assessment of temporal artery biopsies is frequently encountered in anatomical pathology and has important diagnostic consequences in patients clinically suspected of having giant cell arteritis. We present an intriguing case of giant cell arteritis associated with a Basal cell carcinoma and discuss the ongoing controversy pertaining to the association of giant cell arteritis/polymyalgia rheumatica with malignancy.

  7. Retinal arterial occlusion in Takayasu′s arteritis

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    Kaushik Sushmita

    2005-01-01

    Full Text Available Takayasu′s arteritis is an auto-immune disorder of the large and medium-sized arteries, commonly involving the heart and its main vessels. It is now recognised that the inflammatory process of the large arteries affects regions of the walls supplied by the vasa vasorum, suggesting that primary small vessel involvement may contribute to the development of the clinico-pathological features of Takayasu aorto-arteritis. Classical ophthalmic features of the disease result from reduced ocular perfusion, which manifests as hypoxic retinal changes such as microaneurysms, arterio-venous anastomosis and non-perfused areas. Branch retinal artery occlusion has not been previously described in this condition. This case illustrates retinal arterial occlusion as the presenting feature of Takayasu′s arteritis.

  8. Severe pulmonary hypertension associated with Takayasu arteritis

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    Arevalo Guerrero, Edwin

    2014-10-01

    Full Text Available We describe the case of a 57 year-old woman with chronic hypertension, dyspnea, general symptoms, malaise, fatigability and exercise intolerance, impaired functional capacity and occasional episodes of pre-syncope. Physical examination disclosed arterial hypertension, with a difference of more than 10 mm Hg between the pressures of the right and the left upper limbs, holosystolic murmur grade III/VI in the aortic valve area, left subclavian murmur, and decreased intensity in the peripheral pulses of the left arm. Noninvasive studies showed severe pulmonary hypertension and right ventricular dysfunction, also confirmed by cardiac catheterization. Chest tomography and pulmonary arterial angiography showed bilateral pulmonary artery stenosis. Cardiac magnetic resonance revealed concentric stenosis (6 mm, affecting the origin of the upper lobe branch and circumferential involvement of the left branch (8 mm and the branch to the lower lobe. Endoluminal irregularities were observed in the aorta and the neck vessels, both in the resonance and the angiography. With these findings diagnoses of Takayasu arteritis and associated severe pulmonary hypertension were established. Treatment was started with prednisolone and methotrexate.

  9. [Visual hallucinations and giant cell arteritis: the Charles Bonnet syndrome].

    Science.gov (United States)

    Bloch, J; Morell-Dubois, S; Koch, E; Launay, D; Maillard-Lefebvre, H; Buchdahl, A-L; Hachulla, E; Rouland, J-F; Hatron, P-Y; Lambert, M

    2011-12-01

    In patients with visual hallucinations, diagnostic strategy is unclearly codified. In patients known to have giant cell arteritis, the main diagnostic assumption is disease relapse. Indeed, this should lead to rapid corticosteroid therapy. However, the Charles Bonnet syndrome, that is a poorly known etiology of visual hallucinations usually observed in elderly people, should be part of the differential diagnosis. We report a 87-year-old woman, with a 2-year history of giant cell arteritis who was admitted with an acute onset of visual hallucinations and who met all the criteria for Charles Bonnet syndrome.

  10. [(18)F]-Sodium fluoride uptake in Takayasu arteritis

    NARCIS (Netherlands)

    Alexanderson-Rosas, E; Monroy-Gonzalez, A G; Juarez-Orozco, Luis Eduardo; Martinez-Aguilar, M M; Estrada, E; Soldevilla, I; Garcia-Pérez, O; Soto-Lopez, M E

    2016-01-01

    BACKGROUND: While (18)F-fluorodeoxyglucose and (18)F-sodium fluoride with positron emission tomography relate with inflammation and calcification, their role in the assessment of patients with Takayasu arteritis has not yet been studied. METHODS: We present 5 patients with suspected active metabolic

  11. Giant cell arteritis: a multicenter observational study in Brazil

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    Alexandre Wagner Silva de Souza

    2013-01-01

    Full Text Available OBJECTIVE: To describe demographic features, disease manifestations and therapy in patients with giant cell arteritis from referral centers in Brazil. METHODS: A retrospective cohort study was performed on 45 giant cell arteritis patients from three university hospitals in Brazil. Diagnoses were based on the American College of Rheumatology classification criteria for giant cell arteritis or temporal artery biopsy findings. RESULTS: Most patients were Caucasian, and females were slightly more predominant. The frequencies of disease manifestations were as follows: temporal headache in 82.2%, neuro-ophthalmologic manifestations in 68.9%, jaw claudication in 48.9%, systemic symptoms in 44.4%, polymyalgia rheumatica in 35.6% and extra-cranial vessel involvement in 17.8% of cases. Aortic aneurysms were observed in 6.6% of patients. A comparison between patients with biopsy-proven giant cell arteritis and those without temporal artery biopsies did not yield significant differences in disease manifestations. All patients were treated with oral prednisone, and intravenous methylprednisolone was administered to nearly half of the patients. Methotrexate was the most commonly used immunosuppressive agent, and low-dose aspirin was prescribed to the majority of patients. Relapses occurred in 28.9% of patients, and aspirin had a protective effect against relapses. Females had higher prevalences of polymyalgia rheumatica, systemic manifestations and jaw claudication, while permanent visual loss was more prevalent in men. CONCLUSIONS: Most of the clinical features of Brazilian giant cell arteritis patients were similar to those found in other studies, except for the high prevalence of neuro-ophthalmic manifestations and permanent blindness in the Brazilian patients. Aspirin had a protective effect on relapses.

  12. Mieloma múltiple y arteritis de células gigantes sin amiloidosis Simultaneous multiple myeloma and giant cell arteritis without systemic amyloidosis

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    Bárbara C. Finn

    2006-12-01

    Full Text Available La amiloidosis sistémica primaria y el mieloma múltiple con amiloidosis primaria se han presentado con características clínicas e histopatológicas que simulan una arteritis de células gigantes. Hasta el momento la asociación se basaba en el rol antigénico del depósito de amiloide sobre las arterias, desencadenando la respuesta inmune que finaliza con una arteritis. Presentamos el primer caso en la literatura de un paciente con mieloma múltiple y arteritis de células gigantes sin amiloidosis sistémica, sugiriendo una relación patogénica entre estas dos entidades. En el caso de nuestro paciente se descartó la presencia de amiloide en la pared arterial, por lo que proponemos que el estímulo para el desarrollo de la arteritis podría ser una excesiva producción de interleuquina 6 fabricada por las células mielomatosas.Primary systemic amyloidosis with clinical and histopathologic features of giant cell arteritis has already been described. The association of multiple myeloma (with primary amyloidosis and giant cell arteritis is also known. We present the first case in the literature of a patient with multiple myeloma and giant cell arteritis without systemic amyloidosis, suggesting a pathogenic relationship between the two diseases.

  13. Etiopatogenia de la arteritis de células gigantes Etiopathogenesis of giant cell arteritis

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    J.M. Casas

    2003-04-01

    Full Text Available La arteritis de células gigantes es una vasculitis que afecta a arterias de diámetro medio y ancho, preferentemente aquellas del arco aórtico con distribución extracraneal, pero también la aorta y otras de sus ramas mayores. Se caracteriza por la presencia de infiltrados inflamatorios mononucleares en la proximidad de la lámina elástica interna constituidos por linfocitos y macrófagos, que en aproximadamente algo más del 50% de los casos contienen células gigantes multinucleadas. La morbilidad asociada a esta enfermedad se relaciona con fenómenos de isquemia distales a la estenosis luminal de las arterias inflamadas y en menor medida con la formación de aneurismas por el debilitamiento de la pared arterial. De etiología desconocida, su patogenia es inmune a través de la migración y localización de células T productoras de γ-INF en la capa adventicia de las arterias inflamadas, suponiéndose que éste es el lugar del estímulo inmune por un antígeno aún no identificado. El reclutamiento y activación de macrófagos por esta citocina constituye uno de los puntos más importantes de su patogenia. La destrucción por éstos del tejido elástico arterial es un fenómeno relevante, así como la producción de otros factores promotores de neoangiogénesis y proliferación de la neoíntima, responsable a través de la obliteración de la luz, de las manifestaciones isquémicas de la enfermedad. El proceso se acompaña de una importante repercusión sistémica caracterizada por una fuerte reacción de fase aguda y síntomas generales de enfermedad poco específicos. Por otra parte, un importante porcentaje de los pacientes presentan un cuadro de polimialgia reumática, entidad en histórica y controvertida relación con esta arteritis. En los últimos años se han producido importantes aportaciones al conocimiento de los mecanismos inmunes implicados en su patogenia.Giant cell arteritis is a vasculitis of large and medium size

  14. Visceral and renal arteries stenosis associated with Takayasu arteritis

    Institute of Scientific and Technical Information of China (English)

    ZHU Ting; FU Wei-guo; CHEN Bin; SHI Zhen-yu; GUO Da-qiao; JIANG Jun-hao; YANG Jue

    2006-01-01

    @@ Takayasu arteritis (TA) is a nonspecific granulomatous inflammatory arteriopathy of unknown cause that results in occlusive obliteration or less commonly aneurysm degeneration of large and medium-sized elastic arteries. Most descriptions of this disease have emphasized the "pulseless"syndrome, however, less attention has been paid to involvement of other segments of the aorta, renal arteries, and in particular the visceral arteries. We reported a case of type Ⅱ TA, in which both the visceral and the bilateral renal arteries were involved.

  15. Takayasu's arteritis and liver transplantation: Association and implications

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    Fahdah Alokaily

    2015-01-01

    Full Text Available We present a 37-year-old lady who had liver transplantation for hepatitis B cirrhosis and was on immune suppressive treatment consisting of mycophenolate mofetil (MMF and tacrolimus. She presented with undue fatigue and recurring pain in both arms. The diagnosis of Takayasu's arteritis was made, supported by angiographic findings of significant stenosis of the left subclavian and both renal arteries. She was managed by adjusting the immune suppressive medications and underwent a successful percutaneous transluminal balloon angioplasty (PTBA.

  16. Optimal management of giant cell arteritis and polymyalgia rheumatica

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    Charlton R

    2012-04-01

    Full Text Available Rodger CharltonCollege of Medicine, Swansea University, Wales, UKAbstract: Giant cell arteritis (GCA and polymyalgia rheumatica (PMR are clinical diagnoses without "gold standard" serological or histological tests, excluding temporal artery biopsy for GCA. Further, other conditions may mimic GCA and PMR. Treatment with 10–20 mg of prednisolone daily is suggested for PMR or 40–60 mg daily for GCA when temporal arteritis is suspected. This ocular involvement of GCA should be treated as a medical emergency to prevent possible blindness and steroids should be commenced immediately. There are no absolute guidelines as to the dose or duration of administration; the therapeutics of treating this condition and the rate of reduction of prednisolone should be adjusted depending on the individual's response and with consideration of the multiple risks of high-dose and long-term glucocorticoids. Optimal management may need to consider the role of low-dose aspirin in reducing complications. Clinicians should also be aware of studies that indicate an increased incidence of large-artery complications with GCA. This clinical area requires further research through future development of radiological imaging to aid the diagnosis and produce a clearer consensus relating to diagnosis and treatment.Keywords: arteritis, visual loss, blindness, erythrocyte sedimentation rate, stiffness, pain, aspirin, disability, glucocorticoids

  17. Imaging diagnosis and interventional radiology in systemic vasculitis with particular emphasis on Takayasu arteritis: Part 2

    Institute of Scientific and Technical Information of China (English)

    Ichiro SAKAMOTO; Kuniaki HAYASHI; Naofumi MATSUNAGA; Kazuto ASHIZAWA; Yohjiro MATSUOKA; Masataka UETANI

    2005-01-01

    In part 1 of this article, clinical features and imaging findings of Takayasu arteritis (also known as aortitis syndrome) were described in detail. In part 2, treatment of Takayasu arteritis will be first described and discussed. This will be followed by description of clinical features and imaging findings of other systemic vasculitis. Comments on interventional radiology for systemic vasculitis will also be made.

  18. Paciente con complicación poco frecuente de arteritis de células gigantes Rare complication in a patient with giant cell arteritis

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    S. Olivera

    2010-12-01

    Full Text Available La arteritis de células gigantes (arteritis de la arteria temporal es una vasculitis crónica que afecta mayoritariamente a personas de edad avanzada. Aunque se trata de una enfermedad sistémica, se afectan sobre todo las arterias craneales. La complicación más frecuente de esta patología es la pérdida visual. Presentamos el caso clínico de una paciente que padeció varias complicaciones, entre ellas una necrosis lingual, a raíz de serle diagnosticada una arteritis de células gigantes tras iniciar el tratamiento de la misma.Giant cell arteritis (temporal arteritis is a chronic vasculitis that usually affects older people. Although this is a systemic disease, it most often affects the cranial arteries. The most frequent complication of this disorder is visual loss. We report the case of a patient who suffered several rare complications, including tongue necrosis, as a result of being diagnosed with giant cell arteritis following the start of treatment.

  19. Giant Cell Arteritis and Polymyalgia Rheumatica: 2016 Update

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    Gideon Nesher

    2016-10-01

    Full Text Available Giant cell arteritis (GCA and polymyalgia rheumatica (PMR are both more common among people of North European decent than among Mediterranean people. Women are 2–3 times more commonly affected. Giant cell arteritis and PMR are extremely rare before age 50 years. Polymyalgia rheumatica may be “isolated” or associated with GCA. There is increased expression of inflammatory cytokines in temporal arteries of PMR patients, without overt histological evidence of arteritis. One-third of “isolated” PMR patients have vascular uptake in positron emission tomography (PET scans, suggesting clinically unrecognized, “hidden” GCA. Typical manifestations of GCA are headache, tenderness over temporal arteries, jaw claudication, PMR, acute vision loss, and low-grade fever. Bilateral aching of the shoulders with morning stiffness is typical for PMR. In both conditions sedimentation rate and C-reactive protein are elevated, and anemia and thrombocytosis may occur. Color duplex ultrasonography of the temporal arteries may aid in GCA diagnosis. Temporal artery biopsy showing vasculitis, often with giant cells, confirms GCA diagnosis. In cases with negative biopsy one must rely on the clinical presentation and laboratory abnormalities. The diagnosis of PMR is made primarily on clinical grounds. Other conditions that may mimic GCA or PMR must be excluded. Glucocorticoids are the treatment of choice for both conditions. Prompt treatment is crucial in GCA, to prevent irreversible complications of acute vision loss and stroke. Addition of low-dose aspirin may further prevent these complications. The average duration of treatment is 2–3 years, but some patients require a prolonged course of treatment, and some may develop disease-related or treatment-related complications. No steroid-sparing agent has been proven to be widely effective thus far, but some promising therapeutic agents are currently being studied.

  20. Giant Cell Arteritis and Polymyalgia Rheumatica: 2016 Update.

    Science.gov (United States)

    Nesher, Gideon; Breuer, Gabriel S

    2016-10-31

    Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are both more common among people of North European decent than among Mediterranean people. Women are 2-3 times more commonly affected. Giant cell arteritis and PMR are extremely rare before age 50 years. Polymyalgia rheumatica may be "isolated" or associated with GCA. There is increased expression of inflammatory cytokines in temporal arteries of PMR patients, without overt histological evidence of arteritis. One-third of "isolated" PMR patients have vascular uptake in positron emission tomography (PET) scans, suggesting clinically unrecognized, "hidden" GCA. Typical manifestations of GCA are headache, tenderness over temporal arteries, jaw claudication, PMR, acute vision loss, and low-grade fever. Bilateral aching of the shoulders with morning stiffness is typical for PMR. In both conditions sedimentation rate and C-reactive protein are elevated, and anemia and thrombocytosis may occur. Color duplex ultrasonography of the temporal arteries may aid in GCA diagnosis. Temporal artery biopsy showing vasculitis, often with giant cells, confirms GCA diagnosis. In cases with negative biopsy one must rely on the clinical presentation and laboratory abnormalities. The diagnosis of PMR is made primarily on clinical grounds. Other conditions that may mimic GCA or PMR must be excluded. Glucocorticoids are the treatment of choice for both conditions. Prompt treatment is crucial in GCA, to prevent irreversible complications of acute vision loss and stroke. Addition of low-dose aspirin may further prevent these complications. The average duration of treatment is 2-3 years, but some patients require a prolonged course of treatment, and some may develop disease-related or treatment-related complications. No steroid-sparing agent has been proven to be widely effective thus far, but some promising therapeutic agents are currently being studied.

  1. Telethermography with thermostimulus in the study of temporal arteritis

    Science.gov (United States)

    Di Carlo, Aldo

    2004-12-01

    Giant-cell arteritis or Horton's arteritis (HA) is an immunomediated disease of large vessels. In particular it affects temporal arteries; its outcome is generally benign, but in some cases brain strokes or blindness are possible. Paraclinical diagnostic tools and, in particular, imaging techniques are very useful for diagnosing and monitoring the evolution. The method of thermostimulus applied to traditional telethermography (Ts-TTG) is particularly useful in the study of HA. While direct thermography (TTG) is limited in the evaluating fluximetric data because of its reduced sensitivity (no more than 0.1 °C), the thermostimulus technique allows us to know exactly the minimal variations in blood flow of these arteries. This method uses a thermogenerator connected with a thermal probe, a latex balloon containing a mixture of alcohol-water. Once this liquid reaches the temperature of the thermal stress (5 °C × 20 s), the probe is applied by contact on the cutaneous area of interest. Thermal insulation enables us to see, immediately after the thermal stimulus, a time-lag in the thermal recovery of these two components, respectively that of the artery (mean time of thermal recovery ⩽20 s) and that of the surrounding healthy skin (mean time of thermal recovery ⩾60 s). Moreover, applying the thermal stimulus successively on the two temporal areas, there will be a temporal difference in their respective thermal recoveries, also in cases of very low thermal differences (<0.01 °C). A group of 10 subjects affected by monolateral temporal arteritis was examined in a retrospective study. The results demonstrate the usefulness of this innovative method that, among other advantages, excludes the possibility of false negatives.

  2. [Giant cell arteritis: guidelines of the University Hospital of Lausanne].

    Science.gov (United States)

    Tsetsou, S; Michel, P; Ribi, C; Hirt, L; Kawasaki, A; Hugli, O; De Leval, L; Bart, P-A; Waeber, G; Meuli, R; Raffoul, W; So, A; Du Pasquier, R

    2015-02-11

    Giant cell arteritis (GCA) is a subacute/chronic vasculitis and represents the most common form of systemic vasculitis in people over the age of 50 years. The absence of clear and specific diagnostic criteria with the highly variable clinical presentation is a diagnostic challenge requesting a multidisciplinary approach. Yet, GCA is an emergency and the treatment must be initiated very rapidly due to the risk of blindness. This article presents a review of GCA as well as the diagnostic and therapeutic institutional guidelines of the University Hospital of Lausanne.

  3. Takayasu’s arteritis - aphasia as an initial presentation

    Institute of Scientific and Technical Information of China (English)

    Davinder Singh Rana; Anuradha Batra; Ish Anand; Samir Patel; Pooja Gupta

    2016-01-01

    Takayasu arteritis (TA) is an uncommon disease of young women, characterized by granulomatous vasculitis of medium and large arteries. Neurological involvement is reported in only a minority of patients and occurrence of neurological syndromes as the ifrst manifestation of disease has been rarely reported. We present clinical, laboratory and imaging ifndings of a 40 years old lady with TA, who initially presented with clinical manifestations of stroke in form of aphasia. The rarity of the disease and especially such a presentation can cause considerable delay in the diagnosis and treatment.

  4. Leflunomide in Takayasu arteritis – A long term observational study

    OpenAIRE

    Souza, Alexandre Wagner Silva de [UNIFESP; Agustinelli,Renan de Almeida; Almeida,Hemerli de Cinque; Oliveira,Patrícia Bermudes; Pinheiro,Frederico Augusto Gurgel; Oliveira,Ana Cecilia Diniz; Sato, Emilia Inoue [UNIFESP

    2016-01-01

    ABSTRACT Objective: To evaluate the extended follow-up data on efficacy and toxicity of leflunomide therapy in Takayasu arteritis (TA) patients previously enrolled in the original open-label study of short-term effects of leflunomide in TA. Methods: An open-label long-term longitudinal study was performed in TA patients who fulfilled the 1990 American College of Rheumatology criteria for TA and had participated in a previous study that evaluated short-term efficacy of leflunomide in TA. Com...

  5. Hypertensive crisis in young woman with Takayasu arteritis.

    Science.gov (United States)

    Ogawa, Osamu; Watanabe, Ritsuo; Shimizu, Hiroshi; Masani, Fumiaki

    2011-01-01

    A young woman who was experiencing repeated convulsions was admitted. The patient's brain magnetic resonance image revealed reversible posterior leukoencephalopathy. Blood pressure fluctuated at times to more than 200 mmHg, and the measurement of the right and left upper arms differed by approximately 70 mmHg. Enhanced computed tomography revealed stenotic lesions of some arteries including the left renal artery. Such findings led to an initial diagnosis of Takayasu arteritis and hypertensive encephalopathy caused by renovascular hypertension. A percutaneous transluminal renal angioplasty was successfully performed. The patient's blood pressure returned to normal value without the use of antihypertensive drugs.

  6. Lethal subarachnoid bleeding under immunosuppressive therapy due to mycotic arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Weigel, S.; Kloska, S.; Freund, M. [Dept. of Clinical Radiology, Univ. Hospital of Muenster, Muenster (Germany); Kehl, H.G. [Dept. of Pediatric Cardiology, Univ. Hospital of Muenster, Muenster (Germany)

    2003-12-01

    A subarachnoid haemorrhage (SAH) occurred 67 days after cardiac transplantation in 10-year-old girl with consecutive immunocompromising therapy. Neither digital subtraction angiography (DSA) nor computed tomographic angiography showed signs of intracranial vascular malformations. One month before the lethal SAH occurred, she had developed arterial hypertension and attacks of severe headache with cerebrospinal fluid (CSF) pleocytosis while CT scans showed an infarct of the left thalamus. Pathologic findings established the rare diagnosis of SAH due to aspergillosis-related mycotic arteritis. Imaging characteristics are presented. (orig.)

  7. [Chances of avoiding amputation in an arteritis patient with gangrene].

    Science.gov (United States)

    Natali, J; Firouz-Abadie, H; Maraval, M; Kieffer, E

    1975-01-01

    During the period 1970-1974, restorative surgery was carried out 324 times in patients with gangrene or severe ischaemia caused by arteritis of the lower limbs. In 67 percent of the cases major excision surgery, such as amputation at the thigh or of the whole leg, was avoided and the support was retained. In 61 cases (19 percent) amputation was necessary either immediately or within a few weeks or months. Death occurred in 47 patients (14 percent) either in the operative period or in the 3 following years.

  8. Imaging diagnosis and interventional radiology in systemic vasculitis with particular emphasis on Takayasu arteritis: Part 1

    Institute of Scientific and Technical Information of China (English)

    Kuniaki HAYASHI; Ichiro SAKAMOTO; Naofumi MATSUNAGA; Kazuto ASHIZAWA; Masataka UETANI

    2005-01-01

    This is a review article describing some new and interesting aspects in the diagnosis and treatment in systemic vasculitis and demonstrating several cases that we have encountered. Particular emphasis will be put on Takayasu arteritis (also known as aortitis syndrome) most commonly observed in Japan and other oriental countries. CT and MRI better demonstrate the vessel wall abnormality of Takayasu arteritis than angiography. Importance of plain chest radiograph should also be kept in mind; it could provide a clue in the diagnosis of Takayasu arteritis in its early stage.

  9. Acknowledged Signatures of Matrix Metalloproteinases in Takayasu’s Arteritis

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    Gang Wu

    2014-01-01

    Full Text Available Takayasu’s arteritis (TA was reported as an eye disease in the year 1905 and later was confirmed as a vasculitis. Since then, the etiology of the disease remains unknown; however, characteristic clinical features suggest multiple causative factors. Recent progress in vascular biology and other disciplines enlightens the pathophysiology of TA and demonstrated induction of various nonspecific inflammatory symptoms and destruction of the arterial wall, which leads to aneurysms and rupture of the affected arteries. Matrix metalloproteinases (MMPs as an enzyme family have well-established roles in several vascular pathologies including intima formation, atherosclerosiss and aneurysms. MMPs have been proposed to be one of the molecules with a potential of having dual role in the course of TA, first as an active participant in pathophysiology and secondly as a diagnostic biomarker for TA disease. The desire to improve our understanding of the importance of MMPs and their endogenous inhibitors (TIMPs in TA disease and for the development of therapeutic agents has inspired basic and clinical scientists for over a decade. In the present paper, we summarized the scientific rationale which highlights the signatures of matrix metalloproteinases and their endogenous inhibitors in pathophysiology as well as their being a potential candidate as biomarker for Takayasu’s arteritis.

  10. Non specific aorto-arteritis. Clinical picture, diagnosis and therapy.

    Science.gov (United States)

    Miani, S; De Monti, M; Keller, G; Bordoni, M G; Bianchi, E; Giordanengo, F

    1999-06-01

    This study is aimed at analyzing clinical features, angiographic findings and evolution of Takayasu's arteritis and the criteria adopted to establish the indication for non-surgical versus operative treatment. Eighteen patients affected by non specific aortarteritis were observed and treated at our Department between 1973 and 1996. All patients met the American College of Rheumatology 1990 criteria of classification of Takayasu's arteritis. Sixteen patients were young females. Two patients were males. Nine patients underwent surgical procedures. One young female underwent a PTA. All eight asymptomatic patients were only medically treated. One patient died some days after an aorto-bicarotid bypass graft due to acute myocardial infarction. Two other patients died two and four years after intervention for renal and cardiac failure respectively. One patient after an aorto bicarotid bypass underwent a left hemiplegia due to thrombosis of the right graft branch. All the other 14 patients either surgically or medically treated are well and are under strict surveillance through rigorous follow-up. The 10 patients who underwent surgical or interventional radiological treatment were certainly the most seriously affected patients and were symptomatic (presented neurological disturbances or a severe hypertensive state). This fact explains, to some extent, the mortality and morbidity rate observed in this group. The seven medically treated patients were completely asymptomatic in spite of a major involvement of various vascular districts.

  11. Case Report: Takayasu's arteritis associated with Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    You-shi LIU; You-hong FANG; Ling-xiang RUAN; You-ming LI; Lin LI; Ling-ling JIANG

    2009-01-01

    Takayasu's arteritis (TA), also known as the "pulseless disease," is a chronic vasculitis of the aorta and aortic branches. TA with Crohn's disease is rare and has not been documented in China before. In this paper we report on a case of Takayasu's arteritis associated with concurrent Crohn's disease. A 17-year-old Chinese male developed upper limb sourness and a sensation of fatigue, and his upper limb pulses were absent. He was diagnosed with TA and underwent an axillary artery bypass with autolo-gous great saphenous vein on the left subclavian artery. After the surgery, he regained the normal blood pressure. This patient also had years of diarrhea and developed an anal canal ulcer, and was diagnosed with inflammatory bowel disease and ulcerative colitis before. Five months after the TA surgery, he was hospitalized for severe stomachache and diarrhea and was finally diagnosed with Crohn's disease. The possible pathophysiological mechanisms responsible for concurrent existence of TA and Crohn's disease may be associated with immune disorders, especially autoimmunity.

  12. Cutaneous necrotizing vasculitis complicating Takayasu's arteritis with a review of cutaneous manifestations.

    Science.gov (United States)

    Mousa, A R; Marafie, A A; Dajani, A I

    1985-06-01

    We report a case of a 32-year-old man with chronic active Takayasu's arteritis complicated by cutaneous necrotizing vasculitis. Symptoms of the early phase of his disease coexisted with complications of the late phase.

  13. Extracranial–intracranial bypass for Takayasu’s arteritis: A case report

    Directory of Open Access Journals (Sweden)

    Richard M. Young, M.D.

    2014-12-01

    Conclusion: STA–MCA bypass to enhance cerebral blood flow in the setting of stroke symptoms due to Takayasu’s arteritis can serve as a bridge before definitive cardiothoracic treatment of the great vessels.

  14. Takayasu's arteritis and primary antiphospholipid syndrome presenting as hypertensive urgency.

    Science.gov (United States)

    Yang, Andrew; Nayeemuddin, Mohammed; Prasad, Bhanu

    2016-01-18

    A 33-year-old Caucasian man was admitted to the hospital with chest pain and hypertensive urgency. Physical examination revealed widespread arterial bruits and marked difference in blood pressure between the upper limbs. Vascular imaging showed widespread narrowing in multiple vascular territories. He met the established American College of Rheumatology criteria for Takayasu's arteritis. His resistant hypertension was considered to be a consequence of bilateral renal artery stenosis and he subsequently underwent sequential stenting of his renal arteries leading to improvement in blood pressure and reduction in the number of antihypertensive medications. Subsequent imaging revealed progression of aortic thrombus in the setting of an elevated erythrocyte sedimentation rate, and persistently elevated antiphospholipid antibodies fulfilling diagnostic criteria for primary antiphospholipid syndrome, requiring initiation of immunosuppression and anticoagulation.

  15. Phylogenetic characterisation of the G(L) sequences of equine arteritis virus isolated from semen of asymptomatic stallions and fatal cases of equine viral arteritis in Denmark

    DEFF Research Database (Denmark)

    Larsen, Lars Erik; Storgaard, Torben; Holm, Elisabeth

    2001-01-01

    The study describes for the first time the phylogenetic relationship between equine arteritis virus (EAV) isolated from asymptomatic virus-shedding stallions and fatal cases of equine viral arteritis (EVA) in an European country. EAV was isolated from three dead foals and an aborted foetus during...... three different outbreaks of EVA. From these fatalities, the complete open reading frame 5, encoding the EAV GL protein, was amplified by reverse transcription-polymerase chain reaction and subjected to nucleotide sequence analysis. Furthermore, DNA sequences were obtained from virus isolated from semen...

  16. Tratamento da arterite de Takayasu Takayasu’s arteritis treatment

    Directory of Open Access Journals (Sweden)

    Alexandre Wagner Silva de Souza

    2006-06-01

    Full Text Available A arterite de Takayasu (AT é uma vasculite granulomatosa crônica que envolve a aorta e seus principais ramos. A monitoração da atividade da doença e o melhor esquema terapêutico ainda têm sido um desafio para todos os que tratam estes pacientes. Corticosteróides e imunossupressores vêm sendo utilizados na prática clínica diária com resultados nem sempre animadores. Apesar de não haver estudos controlados que abordem o tratamento da AT, diferentes estudos observacionais descrevem a resposta de pacientes com AT ao uso de corticosteróides, metotrexato (MTX, azatio-prina e ciclofosfamida. Após a introdução da terapia biológica, novas perspectivas têm surgido para os pacientes com AT refratários aos esquemas terapêuticos tradicionais.Takayasus’s arteritis is a chronic granulomatous vasculitis involving the aorta and its main branches. Monitoring disease activity and the choice for the best therapy has been major challenger faced by all physicians who treat these patients. Corticosteroids and immunosuppressive therapy have been used in daily medical practice, but results have not always been encouraging. Although there are no controlled studies evaluating the treatment of Takayasu’s arteritis, observational studies have described the response to the use of corticosteroids, methotrexate, azathioprine and cyclophosphamide. The emerging of biological therapy has brought new perspective for Takayasu’s patients who are refractory to conventional therapy.

  17. Tos prolongada como manifestación inicial de la arteritis de la temporal Prolonged cough as initial symptom of temporal arteritis

    Directory of Open Access Journals (Sweden)

    María E Galván

    2007-12-01

    Full Text Available La tos prolongada puede ser un desafío diagnóstico y terapéutico. Presentamos el caso de un enfermo de 62 años con tos seca y quebrantamiento del estado general durante cuatro semanas, seguido de un síndrome febril prolongado cuyo diagnóstico final fue arteritis de la temporal, con confirmación por anatomía patológica. El dolor en los pabellones auriculares al adoptar el decúbito lateral fue otro síntoma interesante. La tos prolongada puede ser una manifestación inicial de la arteritis temporal en adultos mayores.Prolonged cough could be a diagnostic and therapeutic dilemma. We present here the case of an elder man who suffered from a dry cough and malaise during four weeks, followed by a fever of unknown origin. After many studies and review of symptoms, a biopsy of the temporal artery confirmed a giant cell arteritis. Cough and malaise could be an early symptom of temporal arteritis in elderly patients. Pain in the outer ear on the lateral decubitus could be another interesting symptom in this disease.

  18. Pseudoarthrosis and ankylosis of the vertebral spine without sacroiliitis associated with Takayasu's arteritis: review of the association

    Energy Technology Data Exchange (ETDEWEB)

    Schuetz, C.T.; Anderson, S.E. [Department of Diagnostic Radiology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland); Aeberli, D.; Oertle, S. [Department of Rheumatology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland)

    2002-09-01

    Pseudoarthrosis and ankylosis of the vertebral spine associated with Takayasu's arteritis is extremely rare. We present a patient with the entity who was HLA-B27 negative and had normal sacroiliac joints. The association between Takayasu's arteritis and ankylosing spondylitis appears real but seemingly rare. (orig.)

  19. Design of the Tocilizumab in Giant Cell Arteritis Trial

    Directory of Open Access Journals (Sweden)

    Sebastian H. Unizony

    2013-01-01

    Full Text Available Overview. The GiACTA trial is a multicenter, randomized, double-blind, and placebo-controlled study designed to test the ability of tocilizumab (TCZ, an interleukin (IL-6 receptor antagonist, to maintain disease remission in patients with giant cell arteritis (GCA. Design. Approximately 100 centers will enroll 250 patients with active disease. The trial consists of a 52-week blinded treatment phase followed by 104 weeks of open-label extension. Patients will be randomized into one of four groups. Group A (TCZ 162 mg weekly plus a 6-month prednisone-taper; group B (TCZ 162 mg every other week plus a 6-month prednisone-taper; group C (placebo plus a 6-month prednisone-taper; and group D (placebo plus a 12-month prednisone taper. We hypothesize that patients assigned to TCZ in addition to a 6-month prednisone course are more likely to achieve the primary efficacy endpoint of sustained remission (SR at 52 weeks compared with those assigned to a 6-month prednisone course alone, thus potentially minimizing the long-term adverse effects of corticosteroids. Conclusion. GiACTA will test the hypothesis that interference with IL-6 signaling exerts a beneficial effect on patients with GCA. The objective of this paper is to describe the design of the trial and address major issues related to its development.

  20. COARCTATION OF AORTA AND TAKAYASU ARTERITIS FOR LSCS: ANAESTHESIA MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Rashmi

    2015-10-01

    Full Text Available Coarctation of aorta is a congenital disorder with 5-10% incidence. It occurs in about 1 in 10,000 births .It may remain asymptomatic till adulthood. During pregnancy, early gestational hypertension is the presenting sign. Difference in blood pressure in upper and lower limb is a characteristic finding of coarctation of aorta. Association of bicuspid aortic valve and ventricular septal defect is seen in 50% patients of coarctation. Major cardiovascular complications are infrequent but continue to be a source of concern for patients with coarctation who become pregnant. Coarctation of aorta commonly located at the junction of the arch of aorta and proximal descending aorta at the level of ductal structure, may be diagnosed for the first time during pregnancy. Dilatation and dissection of the aorta can lead to increased maternal mortality; significant stenosis is a contraindication to pregnancy. However, successful pregnancies have been reported in women with uncorrected coarctation if preconception risk stratification is done. Here is a case of LSCS with coarctation of aorta and Takayasu arteritis done successfully under epidural anaesthesia.

  1. Remission Achieved in Refractory Advanced Takayasu Arteritis Using Rituximab

    Directory of Open Access Journals (Sweden)

    D. Ernst

    2012-01-01

    Full Text Available A 25-year-old patient was referred due to subclavian stenosis, identified on echocardiography. She presented with exertional dizziness and dyspnoea. Questioning revealed bilateral arm claudication. Examination demonstrated an absent right ulnar pulse and asymmetrical brachial blood pressure. Bruits were evident over both common carotid arteries. Doppler ultrasound and MRI angiograms revealed occlusion or stenosis in multiple large arteries. Takayasu arteritis (TA was diagnosed and induction therapy commenced: 1 mg/kg oral prednisolone and 500 mg/m2 intravenous cyclophosphamide (CYC. Attempts to reduce prednisolone below 15 mg/d proved impossible due to recurring disease activity. Adjuvant azathioprine 100 mg/d was subsequently added. Several weeks later, the patient was admitted with a left homonymous hemianopia. The culprit lesion in the right carotid artery was surgically managed and the patient discharged on azathioprine 150 mg/d and prednisolone 30 mg/d. Despite this, deteriorating exertional dyspnoea and angina pectoris were reported. Reimaging confirmed new stenosis in the right pulmonary artery. Surgical treatment proved infeasible. Given evidence of refractory disease activity on maximal standard therapy, we initiated rituximab, based on recently reported B-cell activity in TA.

  2. Giant cell arteritis. Part I. Terminology, classification, clinical manifestations, diagnosis

    Directory of Open Access Journals (Sweden)

    Azamat Makhmudovich Satybaldyev

    2012-01-01

    Full Text Available Giant cell arteritis (GCA is a vasculitis affecting mainly large and medium-sized arteries, which the classification of systemic vasculitides refers to as those mainly involving the large vessels. GCA is typified by the involvement of extracranial aortic branches and intracranial vessels, the aorta and its large vessels are being affected most frequently. The paper considers the terminology, classification, prevalence, major pathogenic mechanisms, and morphology of GCA. A broad spectrum of its clinical subtypes is due to target vessel stenosis caused by intimal hyperplasia. In 40% of cases, GCA is shown to be accompanied by polymyalgia rheumatica that may either precede or manifest simultaneously with GCA, or follow this disease. The menacing complications of GCA may be visual loss or ischemic strokes at various sites depending on the location of the occluded vessel. Along with the gold standard verification of the diagnosis of GCA, namely temporal artery biopsy, the author indicates other (noninvasive methods for detection of vascular lesions: color Doppler ultrasonography of the temporal arteries, fluorescein angiography of the retina, mag-netic resonance angiography, magnetic resonance imaging, and computed tomography to rule out aortic aneurysm. Dynamic 18F positron emission tomography is demonstrated to play a role in the evaluation of therapeutic effectiveness.

  3. Palpable mass of the neck in the course of Takayasu arteritis.

    Science.gov (United States)

    Andrzejewska, Karolina; Starba, Aleksandra; Misterska-Skóra, Maria; Wiland, Piotr; Guziński, Maciej

    2017-01-01

    Takayasu arteritis is a rare, idiopathic inflammatory disease of the aorta and its major branches, usually affecting young women of Asian descent. In the course of the disease stenosis, occlusions as well as dilatations and aneurysms of vessels occur. Because of many possible localizations of pathological changes, the symptoms have a wide range, but the most common are a weak pulse or its absence on the brachial artery and a difference in systolic pressure above 10 mm Hg between the upper extremities. Here we present a case report of a young woman with Takayasu arteritis, who presented a palpable mass in the back of her neck, significantly diminished after treatment with glucocorticoids.

  4. Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu's Arteritis and Antiphospholipid Antibody Syndrome.

    Science.gov (United States)

    Gerede, Demet Menekşe; Yüksel, Bağdagül; Tutar, Eralp; Küçükşahin, Orhan; Uzun, Cağlar; Atasoy, Kayhan Çetin; Düzgün, Nurşen; Bengisun, Uğur

    2013-01-01

    We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu's arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu's arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases.

  5. Takayasu's arteritis with renal artery stenosis diagnosed in a patient with 65 years old.

    Science.gov (United States)

    Valente, Ellen Simionato; de Almeida, Rafael; Sacco, Alexander Gonçalves; Lazzarin, Mauricio Costa; da Silva, André Melchiades; Andreazza, Marcos

    2015-01-01

    Takayasu arteritis is a rare disease of unknown etiology that affects the aorta and its main branches. It is a condition, geographically more common in Southeast Asia, which mainly affects women of reproductive age. The clinical presentation is nonspecific, with signs and symptoms that vary according to the affected arterial segment. The most commonly affected vessel is the subclavian artery, while renal artery stenosis is relatively uncommon. Cardiac involvement and association with other diseases may also be present. We present in this report the case of an elderly patient with late diagnosis of Takayasu's arteritis and various comorbidities or related complications.

  6. Takayasu’s Arteritis with Systemic Lupus Erythematosus: A Rare Association

    Directory of Open Access Journals (Sweden)

    Dhrubajyoti Bandyopadhyay

    2015-01-01

    Full Text Available We report the case of a 24-year-old nondiabetic, nonhypertensive lady with history of fatigue, dyspnoea and limb claudication. She has been diagnosed with Takayasu’s arteritis. Subsequently she developed rash, alopecia, joint pain, and various other laboratory abnormalities which led to a diagnosis of SLE. Takayasu’s arteritis (TA rarely coexists with systemic lupus erythematosus (SLE. The absence of specific SLE markers in patients with TA who subsequently develop SLE suggests that the coexistence of these conditions may be coincidental. The antiphospholipid syndrome in patients with SLE may mimic the occlusive vasculitis of TA.

  7. Takayasu arteritis masquerading as stable angina in a 29-year-old man.

    Science.gov (United States)

    Wang, Lei; Ma, Teng; Zhao, Yun-Tao

    2017-04-01

    Takayasu arteritis is a form of vasculitis that involves the aorta, its major branches, and the pulmonary arteries. Coronary artery involvement is not uncommon, and most frequently includes the ostia and proximal segments. Early diagnosis of Takayasu arteritis is difficult since it is a rare disease and is accompanied by various nonspecific clinical symptoms. However, recent advances in imaging modalities-including magnetic resonance angiography, computed tomography (CT), sonography, and fluoro-deoxyglucose positron emission tomography (FDG-PET)/CT Isobe (2013) [2]-have facilitated earlier and more accurate diagnoses of this condition. Here we report a case in which imaging revealed stenosis in the ostia of the coronary artery.

  8. The activation pattern of macrophages in giant cell (temporal) arteritis and primary angiitis of the central nervous system.

    Science.gov (United States)

    Mihm, Bernhard; Bergmann, Markus; Brück, Wolfgang; Probst-Cousin, Stefan

    2014-06-01

    To determine if the pattern of macrophage activation reflects differences in the pathogenesis and clinical presentation of giant cell arteritis and primary angiitis of the central nervous system, specimens of 10 patients with giant cell arteritis and five with primary angiitis of the central nervous system were immunohistochemically studied and the expression of the macrophage activation markers 27E10, MRP14, MRP8 and 25F9 was determined in the vasculitic infiltrates. Thus, a partly different expression pattern of macrophage activation markers in giant cell arteritis and primary angiitis of the central nervous system was observed. The group comparison revealed that giant cell arteritis cases had significantly higher numbers of acute activated MRP14-positive macrophages, whereas primary angiitis of the central nervous system is characterized by a tendency toward more MRP8-positive intermediate/late activated macrophages. Furthermore, in giant cell arteritis comparably fewer CD8-positive lymphocytes were observed. These observations suggest, that despite their histopathological similarities, giant cell arteritis and primary angiitis of the central nervous system appear to represent either distinct entities within the spectrum of granulomatous vasculitides or different stages of similar disease processes. Their discrete clinical presentation is reflected by different activation patterns of macrophages, which may characterize giant cell arteritis as a more acute process and primary angiitis of the central nervous system as a more advanced inflammatory process.

  9. Leflunomide in Takayasu arteritis – A long term observational study

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    Alexandre Wagner Silva de Souza

    Full Text Available ABSTRACT Objective: To evaluate the extended follow-up data on efficacy and toxicity of leflunomide therapy in Takayasu arteritis (TA patients previously enrolled in the original open-label study of short-term effects of leflunomide in TA. Methods: An open-label long-term longitudinal study was performed in TA patients who fulfilled the 1990 American College of Rheumatology criteria for TA and had participated in a previous study that evaluated short-term efficacy of leflunomide in TA. Complete follow-up information could be retrieved from 12 out of 15 patients enrolled in the original study. Disease activity was evaluated by Kerr's criteria and by the Indian Takayasu Activity Score 2010 (ITAS2010. Results: The mean follow up time was 43.0 ± 7.6 months and 5 (41.6% TA patients remained on leflunomide therapy while 7 (58.3% TA patients had to change to another therapy due to failure to prevent relapses in 6 patients and toxicity in one patient. No significant differences were found between patients who remained on leflunomide therapy and those who changed to another agent regarding age at study entry, time since diagnosis, prednisone daily dose at study entry, baseline ITAS2010, mean or maximum ESR and CRP, and cumulative prednisone dose at study end. Among TA patients who had changed leflunomide to another agent, two had an additional clinical relapse and needed to change therapy. Conclusion: Leflunomide led to sustained remission in approximately half of patients at a mean time of 12 months and was well tolerated by TA patients.

  10. Surgical treatment of brachiocephalic vessel involvement in Takayasu's arteritis

    Institute of Scientific and Technical Information of China (English)

    WU Xin; DUAN Hong-yong; GU Yong-quan; LI Jian-xin; CHEN Bing; WANG Zhong-gao; ZHANG Jian

    2010-01-01

    Background Takayasu's arteritis (TA) is a chronic idiopathic inflammatory disease that affects large and medium size arteries. The brachiocephalic trunk is the most frequently involved site in TA, and multi-vessel lesions are common. Surgical treatment includes vessel reconstruction surgery and percutaneous transluminal angioplasty (PTA). Herein, we report our preliminary experience with surgical treatment of cerebral ischemia caused by cervical arterial lesions due to TA.Methods From January 2000 to December 2007, 38 patients with cerebral ischemia caused by cervical arterial occlusive lesions due to TA were treated surgically. There were three males and 35 females, with an age range of 15-42 years (mean 26.5 years). All patients had operative repairs undertaken. Twenty eight patients received bypass operation and 10 patients received percutaneous transluminal angioplasty. One case with coronary stenosis received coronary artery bypass simultaneously. Patients were followed up for 11 months to eight years.Results There were no peri-operative deaths in cerebrovascular reconstruction patients. Symptoms of cerebral ischemia were improved or cured in 25 of 38 patients. There was a low incidence of cerebral reperfusion syndrome. Two patients died at five and seven years after surgery due to heart failure. Another 8 patients (20%) required further surgery for stenosis (5 patients) or anastomotic aneurysms (3 patients). Percutaneous transluminal angioplasty was performed successfully for treatment of aortic and renal lesions. Repeated angioplasty for revascularization was performed in six PTA cases with restenosis after 5-24 months.Conclusions When cerebral perfusion has potential to be affected by TA, a definitive corrective procedure is advised when the patient is relatively stable. Although the recurrence rate is very high, percutaneous transluminal angioplasty is the first choice procedure. Bypass operation is optimal for brachiocephalic-vessel involvement in TA

  11. Three Presentations of Takayasu’s Arteritis in Hispanic Patients

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    Ramy Magdy Hanna

    2012-01-01

    Full Text Available Takayasu’s arteritis (TA is a medium and large vessel vasculitis, defined as a nonspecific aortitis that usually involves the aorta and its branches Kobayashi and Numano (2002. Its etiology remains unclear, and its complications are diverse and severe, including stenosis of the thoracic and abdominal aorta, aortic valve damage and regurgitation, and stenosis of the branches of the aorta. Carotid stenosis, coronary artery aneurysms, and renal artery stenosis resulting in renovascular hypertension are also reported sequellae of TA Kobayashi and Numano (2002. The disease was first described in Japan, but has also been diagnosed in India and Mexico Johnston (2002. Its incidence in the United States has been quoted as 2.6 patients per 1,000,000 people/year Johnston (2002. In Japan, its incidence is 3.6 patients per 1,000,000 patients/year and prevalence is 7.85 patients per 100,000 per year Morita et al. (1996. The natural history of this disease, which is commonly present in Asian populations, has only recently been studied in Hispanic patients despite the notable incidence and prevalence of TA in Mexican, South American, and Indian populations (Johnston 2002, Gamarra et al. 2010 . We present three cases of Hispanic patients who presented with TA at Olive-View-UCLA Medical Center (OVMC. We review their clinical and radiographic presentations. Finally, we review the literature to compare the clinical features of our three patients with data regarding the presentation of TA in more traditional Asian populations.

  12. Temporal artery biopsy is not required in all cases of suspected giant cell arteritis.

    LENUS (Irish Health Repository)

    Quinn, Edel Marie

    2012-07-01

    Temporal artery biopsy (TAB) is performed during the diagnostic workup for giant cell arteritis (GCA), a vasculitis with the potential to cause irreversible blindness or stroke. However, treatment is often started on clinical grounds, and TAB result frequently does not influence patient management. The aim of this study was to assess the need for TAB in cases of suspected GCA.

  13. Verminous Arteritis Due to Crassicauda sp. in Cuvier's Beaked Whales (Ziphius Cavirostris).

    Science.gov (United States)

    Díaz-Delgado, J; Fernández, A; Xuriach, A; Sierra, E; Bernaldo de Quirós, Y; Mompeo, B; Pérez, L; Andrada, M; Marigo, J; Catão-Dias, J L; Groch, K R; Edwards, J F; Arbelo, M

    2016-11-01

    The vascular system of Cuvier's beaked whales (CBW) (Ziphius cavirostris; family Ziphiidae), an extremely deep, prolonged-diving cetacean, is increasingly receiving anatomic and physiologic study due to possible anthropogenic interactions; however, vascular pathology rarely has been reported in this species. Thirteen CBW stranded in the Canary Islands from June 2008 to June 2014 were autopsied. A careful dissection of the thoracic and abdominal vasculature was performed on these animals. All had moderate to severe and extensive chronic fibrosing arteritis with aneurysms, hemorrhages, and thrombosis primarily involving the mesenteric and gastroepiploic arteries and the thoracic and abdominal aorta. Microscopically, the lesions varied from subacute subintimal hemorrhages and severe neutrophilic, eosinophilic, and histiocytic dissecting arteritis with intralesional nematode larvae to marked, chronic, fibrosing arteritis with thickening and distortion of the vascular wall with calcification and occasional cartilage metaplasia. In addition, adult nematodes in renal arteries and veins, renal parenchyma and/or ureter were identified morphologically as Crassicauda sp. Nucleic acid sequenced from renal nematodes from 2 animals yielded closest nucleotide identity to C. magna The pathogenesis is proposed to involve a host response to larval migration from the intestine to the kidney through the mesenteric arteries, abdominal aorta, and renal arteries. Severe consequences for such lesions are possible and could vary from reduced vascular compliance to chronic renal disease and predisposition to the development of disseminated intravascular coagulation and multiorgan failure. Severe chronic arteritis in CBW is associated with renal parasitism by Crassicauda spp.

  14. Takayasu's arteritis following Crohn's disease in a young woman: Any evidence for a common pathogenesis?

    Institute of Scientific and Technical Information of China (English)

    Melissa AL Farrant; Justin C Mason; Newton ACS Wong; Robert J Longman

    2008-01-01

    Takayasu's arteritis and Crohn's disease are chronic inflammatory diseases of uncertain aetiology. They rarely occur together, with only twenty nine cases of co-existent Takayasu's arteritis and Crohn's disease reported in the literature. In 88% of these cases, Takayasu's arteritis was diagnosed simultaneously or following a diagnosis of Crohn's disease. We present a case of a young Caucasian medical student, incidentally found to have bilateral carotid bruits on auscultation by a colleague. Magnetic resonance angiography revealed stenoses of the common carotid arteries with established collaterals, and a diagnosis of Type 1 Takayasu's arteritis was made. An 18F-fluorodeoxyglucose positron emission tomography scan revealed no active disease. Nine months later, she presented with a short history of abdominal pain, vomiting and abdominal distension. Barium follow-through and computer tomography revealed a terminal ileal stricture and proximal small bowel dilation. An extended right hemicoloectomy was performed and histopathology supported a diagnosis of Crohn's disease. This case report is presented with a particular focus on the temporal relationship between these two disease processes and explores whether their concurrence is more than just co-incidence.

  15. Increased angiotensin II type 1 receptor expression in temporal arteries from patients with giant cell arteritis

    DEFF Research Database (Denmark)

    Dimitrijevic, Ivan; Malmsjö, Malin; Andersson, Christina

    2009-01-01

    PURPOSE: Currently, giant cell arteritis (GCA) is primarily treated with corticosteroids or immunomodulating agents, but there is interest in identifying other noncorticosteroid alternatives. Similarities exist in the injury pathways between GCA and atherosclerosis. Angiotensin II is a vasoactive...... DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article....

  16. Eosinophillic myocarditis and coronary arteritis in a fatal case of asthma

    Directory of Open Access Journals (Sweden)

    Rupani Asha

    2010-10-01

    Full Text Available Mortality is very unusual in the case of asthma. We recently came across a fatal case of asthma which showed a rare combination of unusual complications like eosinophilic myocarditis, coronary arteritis, biventricular cardiac hypertrophy, eosinophilic pneumonitis and pulmonary hypertension.

  17. Takayasu arteritis with coronary aneurysms causing acute myocardial infarction in a young man.

    Science.gov (United States)

    Ouali, Sana; Kacem, Slim; Ben Fradj, Fatma; Gribaa, Rim; Naffeti, Elyes; Remedi, Fahmi; Laaoueni, Chedia; Boughzela, Essia

    2011-01-01

    Takayasu arteritis is an inflammatory condition that involves the large cardiac vessels, predominantly the aorta and its main branches. It typically affects young women (age, ≤40 yr), most often Asians and Latin Americans. Herein, we describe a rare manifestation of Takayasu arteritis in a 19-year-old black Tunisian man who presented with acute inferior myocardial infarction and complete atrioventricular block after occlusion from a giant aneurysm in the right coronary artery. The coronary artery disease was associated with aneurysmal dilations in the carotid, vertebral, and right renal arteries. Medical therapy improved Thrombolysis in Myocardial Infarction flow in the area of the giant aneurysm from grade 1 to grade 3. Upon the diagnosis of Takayasu arteritis, intravenous methylprednisolone and oral prednisone therapy was started. After 10 days of hospitalization, the patient was discharged on a medical regimen. Renovascular hypertension due to renal artery stenosis was suspected, so he underwent successful percutaneous transluminal angioplasty of the inferior segmental artery of the right renal artery. During 12 months of close postprocedural monitoring, he experienced lower blood pressure, no chest pain, and no cardiovascular complications.This association of conditions has not been previously reported. Besides presenting this very rare combination of findings, we discuss the differential diagnosis of Takayasu arteritis in our patient.

  18. Exertional dyspnea as initial manifestation of Takayasu's arteritis – A case report and literature review

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    Bachmann Lucas M

    2001-12-01

    Full Text Available Abstract Background Takayasu's arteritis is a chronic systemic inflammatory disease that usually affects the aorta, its primary branches and occasionally the pulmonary and coronary arteries. Female gender in reproductive age and Asian origin are known factors associated with higher disease prevalence. The clinical manifestations vary considerably and are typically caused by limb or organ ischemia illness and fever. The estimated incidence rate in the western world is 2.6 cases per million persons per year. Occasionally, exertional dyspnea can be the sole primary clinical manifestation of Takayasu's arteritis. Case presentation We report the case of a 57-year-old woman who was referred to our institution with increasing exertional dyspnea caused by pulmonary artery involvement in Takayasu's arteritis. In a review of the literature we discuss demographic data, clinical and radiographic findings and available therapeutic options. Conclusions Dyspnea due to pulmonary artery involvement can be the initial symptom of Takayasu's arteritis. Simple clinical tests, including a complete pulse-status and blood pressure measuring at both arms can lead to the right diagnosis and should always be done beyond the auscultation of the heart and lungs in patients with dyspnea.

  19. Involvement of innate and adaptive immunity in a murine model of coronary arteritis mimicking Kawasaki disease.

    Science.gov (United States)

    Schulte, Danica J; Yilmaz, Atilla; Shimada, Kenichi; Fishbein, Michael C; Lowe, Emily L; Chen, Shuang; Wong, Michelle; Doherty, Terence M; Lehman, Thomas; Crother, Timothy R; Sorrentino, Rosalinda; Arditi, Moshe

    2009-10-15

    Kawasaki disease (KD) is the most common cause of acquired cardiac disease and acute vasculitis in children in the developed world. Injection of a cell wall extract isolated from Lactobacillus casei (LCCWE) into mice causes a focal coronary arteritis that histopathologically mimics the coronary lesions observed in KD patients. In this study we used this model to investigate the participation of T cells, B cells, and dendritic cells (DC) in the development of coronary arteritis. RAG1(-/-), B cell(null), and wild-type (WT) mice were injected with a single dose of LCCWE (500 microg/mouse i.p.). None of the RAG1(-/-) mice developed coronary arteritis, whereas 70% of WT and 100% of B cell(null) mice developed coronary lesions, indicating that T cells were required for lesion formation. When splenocytes isolated from LCCWE-treated mice were restimulated with LCCWE, we observed significant IFN-gamma secretion in WT but not in RAG1(-/-) mice. Immunohistochemical staining showed F4/80(+) macrophages, activated MIDC-8(+) myeloid DCs (mDC), plasmacytoid DCs, and colocalization of CD3(+) T cells with mDCs in coronary artery lesions, suggesting an Ag-driven process. T cells but not B cells are required for LCCWE-induced coronary arteritis. Similar to human lesions, the coronary lesions contain macrophages, activated mDCs, and plaslmacytoid DCs all in close proximity to T cells, further strengthening the relevance of this mouse model to the immunopathology of coronary disease in KD. These studies are consistent with the interpretation that macrophages and DCs may collaborate with T cells in the pathological mechanisms of coronary arteritis.

  20. F-18 FDG PET/CT Findings of a Patient with Takayasu Arteritis Before and After Therapy

    Directory of Open Access Journals (Sweden)

    Sait Sağer

    2012-04-01

    Full Text Available Vasculitis is defined as inflammation and necrosis with leukocytic infiltration of the blood vessel wall. Takayasu arteritis is a chronic inflammatory arteritis that primarily involves the aorta and its main branches. A 64-year-old female patient with a 2-month history of fever of unknown origin was presented to our clinic for F-18 FDG PET/CT imaging. Baseline PET/CT images demonstrated intense F-18 FDG uptake in the aorta, bilateral subclavian and brachiocephalic arteries consistent with Takayasu arteritis. After 2 months of immunosuppressive therapy, she was asymptomatic and follow-up FDG PET/CT scan showed almost complete disappearance of large vessels’ F-18 FDG uptake. FDG PET/CT is a sensitive technique for assessing presence of large-vessel vasculitis such as Takayasu arteritis, extent of large-vessel inflammation and disease activity after therapy. (MIRT 2012;21:32-34

  1. Combined Spinal-Epidural for Vaginal Delivery in a Parturient With Takayasu’s Arteritis

    Directory of Open Access Journals (Sweden)

    Sean Patrick Clifford MD

    2016-12-01

    Full Text Available Takayasu’s arteritis is a rare, progressive panendarteritis involving all layers of the arterial wall. This disease includes variable involvement of the aorta and its major branches. The most common complication with this condition is severe, uncontrolled hypertension, often leading to end organ dysfunction. We describe the management of a 27-year-old woman diagnosed with Takayasu’s arteritis that presented in labor with intense pain and underwent a combined spinal-epidural for anesthetic management. Per literature review, a combined spinal-epidural technique for planned vaginal delivery has not been described for a laboring Takayasu patient. Our technique, utilizing intrathecal opioids and a low-dose local anesthetic-opioid epidural infusion, provided adequate analgesia while maintaining hemodynamic stability throughout labor augmentation and successful vaginal delivery.

  2. Coronary artery involvement in pediatric Takayasu’s arteritis: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Mohan Shaun

    2013-02-01

    Full Text Available Abstract Takayasu’s arteritis (TA is a form of chronic vasculitis that typically occurs in young adult Asian females, but it can also present in younger patients not fitting this classic profile. In these cases, the sequelae are generally similar to those found in adults. The disease predominantly affects the aorta and its primary branches. However, the coronary arteries are also affected in up to 20% of cases, which may precipitate myocardial infarction. Imaging of the coronary arteries therefore becomes critically important in the evaluation of a patient with possible Takayasu’s arteritis. We present a case of a pediatric patient with TA who had no symptoms of angina but who was found to have significant coronary artery involvement on diagnostic imaging. This necessitated tailoring of traditional management.

  3. Serological survey for equine viral arteritis in several municipalities in the Orinoquia region of Colombia

    OpenAIRE

    Agustín Góngora O; María Barrandeguy; Karl Ciuoderis A.

    2015-01-01

    ABSTRACTObjective. The goal of this study was to determine the current status of the Equine Arteritis virus (EAV) in horse populations in the Orinoquia region of Colombia. Materials and methods. A transversal study was conducted by serological survey of equine (n=100) from 11 municipalities of the Colombian Orinoquia region. Serum samples were tested by virus seroneutralization assay according to the guidelines provided by the World Organization for Animal Health. Results. After testing was c...

  4. The association between statin use and polymyalgia rheumatica/arteritis temporalis: Demonstrated by spontaneous reports and self-described case-reports

    NARCIS (Netherlands)

    De Jong, Hilda J.; Saldi, Siti R.; Klungel, Olaf H.; Vandebriel, Rob J.; Souverein, Patrick C.; Meyboom, Ron H.; Passier, Anneke; Van Loveren, Henk; Tervaert, Jan Willem Cohen

    2011-01-01

    Background: Two case reports of polymyalgia rheumatica (PMR) and one case-report of PMR and temporalis arteritis (AT) suggest that the use of statins may have triggered the development of these inflammatory rheumatic diseases. PMR is closely linked to the disease arteritis temporalis which makes it

  5. Takayasu’s arteritis. A concise review and some observations on a putative case reported by Giovanni Battista Morgagni (1761

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    G. Zanchin

    2011-09-01

    Full Text Available The discovery of Takayasu’s arteritis is likely to date back as far as 1830, owing to the first description of the Japanese Rokushu Yamamoto. Thereafter, several authors from certain geographical areas and in various historical periods described such a vascular disorder, by introducing a quantity of definitions. At present, it is defined as an eponymic disease, namely Takayasu’s arteritis, since Makito Takayasu, a Japanese ophtalmologist, reported in 1908 the clinical history of a woman showing some particular retinal anastomotic shunts of arterioles and venules. In the present study the description of an about 40 year-old woman suffering from a pulseless disease, as reported by Giovanni Battista Morgagni in 1761, is summarized. Such a description could be the first case report of Takayasu’s arteritis, according to some previous literature data and our critical analysis.

  6. A case of MCTD overlapped by Takayasu's arteritis, presenting Raynaud's phenomenon as the initial manifestation of both diseases.

    Science.gov (United States)

    Lim, Mie Jin; Kwon, Seong Ryul; Kim, Sang Gu; Park, Won

    2009-04-01

    Raynaud's phenomenon is characteristic three-phase color change of digits that occurs when hands are exposed to cold and subsequently rewarmed. Raynaud's phenomenon has many possible causes, but evaluation tends to focus on a few notorious etiologies, such as, connective tissue diseases. Thus, having reached a diagnosis, detailed physical exam to rule out other possible causes is often not performed. The authors present a case of mixed connective tissue disease (MCTD) and Takayasu's arteritis overlap in a woman, who showed Raynaud's phenomenon as an initial manifestation. She was first diagnosed as having MCTD, but her treatment did not improve the persistent Raynaud's phenomenon. Several years later, follow-up chest CT showed underlying Takayasu's arteritis and a subsequent physical examination revealed that typical abnormalities consistent with Takayasu's arteritis were present. The authors advocate thorough history taking and complete physical examinations on a routine basis to help unearth other underlying causes.

  7. Endothelial Nlrp3 inflammasome activation associated with lysosomal destabilization during coronary arteritis.

    Science.gov (United States)

    Chen, Yang; Li, Xiang; Boini, Krishna M; Pitzer, Ashley L; Gulbins, Erich; Zhang, Yang; Li, Pin-Lan

    2015-02-01

    Inflammasomes play a critical role in the development of vascular diseases. However, the molecular mechanisms activating the inflammasome in endothelial cells and the relevance of this inflammasome activation is far from clear. Here, we investigated the mechanisms by which an Nlrp3 inflammasome is activated to result in endothelial dysfunction during coronary arteritis by Lactobacillus casei (L. casei) cell wall fragments (LCWE) in a mouse model for Kawasaki disease. Endothelial dysfunction associated with increased vascular cell adhesion protein 1 (VCAM-1) expression and endothelial-leukocyte adhesion was observed during coronary arteritis in mice treated with LCWE. Accompanied with these changes, the inflammasome activation was also shown in coronary arterial endothelium, which was characterized by a marked increase in caspase-1 activity and IL-1β production. In cultured endothelial cells, LCWE induced Nlrp3 inflammasome formation, caspase-1 activation and IL-1β production, which were blocked by Nlrp3 gene silencing or lysosome membrane stabilizing agents such as colchicine, dexamethasone, and ceramide. However, a potassium channel blocker glibenclamide or an oxygen free radical scavenger N-acetyl-l-cysteine had no effects on LCWE-induced inflammasome activation. LCWE also increased endothelial cell lysosomal membrane permeability and triggered lysosomal cathepsin B release into cytosol. Silencing cathepsin B blocked LCWE-induced Nlrp3 inflammasome formation and activation in endothelial cells. In vivo, treatment of mice with cathepsin B inhibitor also abolished LCWE-induced inflammasome activation in coronary arterial endothelium. It is concluded that LCWE enhanced lysosomal membrane permeabilization and consequent release of lysosomal cathepsin B, resulting in activation of the endothelial Nlrp3 inflammasome, which may contribute to the development of coronary arteritis.

  8. Bilateral Blindness in a Patient With Temporal Arteritis After Wisdom Tooth Extraction.

    Science.gov (United States)

    Tartaglia, Gianluca Martino; Maiorana, Carlo; Sforza, Chiarella

    2016-03-01

    A 78-year-old woman reported pain in her right hemiface (middle and upper portions) together with nuchal headache, some days after upper right wisdom tooth extraction. She was treated with nonsteroidal anti-inflammatory drugs by her dentist. Three weeks later, a localized headache over her right superficial temporal artery was reported, and progressive bilateral blindness appeared. A biopsy showed a late stage of temporal arteritis. All the symptoms disappeared following corticosteroid treatment, except blindness. The possible complications linking oral bacteria and extraoral infections and diseases should always be attentively considered during the clinical management of fragile patients.

  9. Acute limb ischemia secondary to radiation-induced arteritis: case report

    Directory of Open Access Journals (Sweden)

    Jose Emerson dos Santos Souza

    2013-09-01

    Full Text Available Radiation-induced arteritis is a rare but well-known complication of radiotherapy. This report describes the case of a 34-year-old woman with uterine cervical cancer who was diagnosed with left iliofemoral deep vein thrombosis (DVT 2 years after radiotherapy, and 2 months later, during the treatment of DVT with effective anticoagulation, developed an episode of acute arterial ischemia of the left lower limb secondary to a long subocclusive lesion of the external iliac artery. The patient was treated with angioplasty and stenting of the lesion and recovered uneventfully after the endovascular procedure.

  10. Increased angiotensin II type 1 receptor expression in temporal arteries from patients with giant cell arteritis

    DEFF Research Database (Denmark)

    Dimitrijevic, Ivan; Malmsjö, Malin; Andersson, Christina

    2009-01-01

    PURPOSE: Currently, giant cell arteritis (GCA) is primarily treated with corticosteroids or immunomodulating agents, but there is interest in identifying other noncorticosteroid alternatives. Similarities exist in the injury pathways between GCA and atherosclerosis. Angiotensin II is a vasoactive...... DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article....... with antibodies for the AT(2) receptor was similar in the patients with GCA and in controls. CONCLUSIONS: These results suggest that AT(1) receptors play a role in the development of GCA. Inhibition of the angiotensin system may thus provide a noncorticosteroid alternative for the treatment of GCA. FINANCIAL...

  11. Subclavian artery stenosis caused by non-specific arteritis (Takayasu disease): treatment with Palmaz stent

    Energy Technology Data Exchange (ETDEWEB)

    Maskovic, J.; Jankovic, S.; Lusic, I.; Cambj-Sapunar, L.; Mimica, Z.; Bacic, A

    1999-09-01

    A 32-year old woman was admitted to the hospital with a sudden onset of right-sided hemiplegia and aphasia. Immediate angiographic examination revealed a severe form of type I Takayasu arteritis with occlusion of all supra-aortic vessels, with the exception of the left subclavian artery which was, however, almost completely occluded 1 cm proximal to the origin of the left vertebral artery. Since the latter provided the entire blood supply to the brain tissues, an immediate attempt was undertaken to dilate the left subclavian artery; when this was unrewarding, stenting of the lesion was successfully accomplished with excellent primary and 6-month follow-up results.

  12. Association between rheumatic fever and Takayasu’s arteritis – Case report

    Directory of Open Access Journals (Sweden)

    Natali W.S. Gormezano

    2016-04-01

    Full Text Available ABSTRACT Takayasu’s arteritis (TA and rheumatic fever are diseases that can start with cardiac fea-tures, making the diagnosis difficult. There are reports of association of RF with Takayasu’sarteritis beginning with cardiac involvement in pediatric patients. The aim of this study isto report the possible association of RF and TA in patients with cardiac abnormalities. Wedescribe the case of an adolescent initially diagnosed with RF who progressed with changesthat allowed making the diagnosis of TA. TA and RF are two important causes of valveinvolvement that may have systemic manifestations.

  13. Monocyte chemoattractant protein 1 (MCP-1) in temporal arteritis and polymyalgia rheumatica

    OpenAIRE

    Ellingsen, T.; Elling, P; Olson, A.; Elling, H; Baandrup, U; Matsushima, K.; Deleuran, B; Stengaard-Pederse..., K

    2000-01-01

    OBJECTIVE—To examine the localisation of monocyte chemoattractant protein 1 (MCP-1) in the inflamed vessel wall in temporal arteritis (TA) and to measure MCP-1 in plasma both in patients with TA and patients with polymyalgia rheumatica (PMR).
METHODS—By immunohistochemical techniques MCP-1 was localised to the vessel wall in patients with TA. In TA, PMR, and healthy controls MCP-1 was quantified by enzyme linked immunosorbent assay (ELISA) in plasma.
RESULTS—MCP-1 was localised to the majorit...

  14. Giant Cell Arteritis in a 12-Year-Old Girl Presenting with Nephrotic Syndrome

    Directory of Open Access Journals (Sweden)

    Zeinab A. El-Sayed

    2014-01-01

    Full Text Available Giant cell arteritis (GCA is rare in children. The kidneys are generally spared. We present a case of GCA in a 12-year-old girl with severe headache and tender scalp especially over the right temporal area. The right superficial temporal artery was cord like and nodular and the pulsations were barely felt. Several small tender nodular swellings were felt in the occipital area. She had been previously diagnosed as a case of nephrotic syndrome due to underlying membranoproliferative glomerulonephritis. This report is aimed at drawing attention to this rare form of vasculitis in children aiming at decreasing its morbidities.

  15. Takayasu’s Arteritis and Crohn’s Disease in a Young Hispanic Female

    Directory of Open Access Journals (Sweden)

    Namrata Singh

    2014-01-01

    Full Text Available Takayasu’s arteritis (TA and Crohn’s disease (CD are chronic inflammatory granulomatous disorders of undetermined etiology. TA is a large vessel vasculitis with a predilection for the aorta and its branches in young women of Asian descent; whereas CD has characteristic gastrointestinal manifestations more prevalent in young Caucasians. We describe a case of both diseases in a young Hispanic female, review the literature, and impart new insight on possible genetic linkage and the role of interleukin 12 B (IL-12B as the common autoimmune mechanism and potential therapeutic target in this rare disease combination.

  16. Idiopathic CD4 lymphocytopenia with giant cell arteritis and pulmonary mucormycosis

    Directory of Open Access Journals (Sweden)

    Ryan A. Denu

    2014-10-01

    Full Text Available Idiopathic CD4 lymphocytopenia (ICL is characterized by a low CD4+ lymphocyte count in the absence of HIV or other underlying etiologies. We report a case of a 57-year old man with ICL and giant cell arteritis (GCA who developed pulmonary mucormycosis, which, to our knowledge, is the first report of these occurring in a patient with ICL. Abnormally low total lymphocyte or CD4+ cell counts occurring in patients with autoimmune disorders should alert clinicians to the possibility of ICL. Immunosuppressive treatment should be used with caution in this context.

  17. Arteritis with left carotid artery thrombosis produced by Salmonella enteritides. Study with CT, MR and angiography with digital subtraction. Arteritis con trombosis carotidea izquierda por Salmonella enteritidis. Estudio con TC, RM y angiografia con sustraccion digital

    Energy Technology Data Exchange (ETDEWEB)

    Iribarren Marin, M.A.; Fernandez Cruz, J.; Serrano Gotarredona, P.; Reyes Dominguez, M.J. (Hospital Universitario Virgen del Rocio, Sevilla (Spain))

    1994-01-01

    We present a case of suppurative arteritis of left common carotid artery produced by Salmonella enteritides in a 66-year-old man. We show the findings obtained by CT, MR and selective arteriography of the supra-aortic branches. We review this uncommon disorder. (Author)

  18. Mannose-binding lectin variant alleles and HLA-DR4 alleles are associated with giant cell arteritis

    DEFF Research Database (Denmark)

    Jacobsen, Soren; Baslund, Bo; Madsen, Hans Ole

    2002-01-01

    To determine whether variant alleles of the mannose-binding lectin (MBL) gene causing low serum concentrations of MBL and/or polymorphisms of HLA-DRB1 are associated with increased susceptibility to polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) or particular clinical phenotypes of PMR/GCA....

  19. Stroke as the Sole Manifestation of Takayasu Arteritis in a 15-Year-Old Boy with Latent Tuberculosis

    Directory of Open Access Journals (Sweden)

    Espen Benjaminsen

    2016-01-01

    Full Text Available Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear. Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive. After he suffered a cerebral infarct in the right hemisphere, childhood Takayasu arteritis was diagnosed. The diagnosis was based on diagnostic imaging showing a high-grade stenosis of the origin of the right common carotid artery, an occluded common carotid artery on the left side, a circumferential thickening of the vessel walls in the right and left common carotid artery, and laboratory findings with elevated C-reactive protein. Conclusion. Takayasu arteritis is an uncommon cause of stroke. It should however be kept in mind as a cause of cerebrovascular disease, especially in the young.

  20. Is aorto-arteritis a manifestation of primary antiphospholipid antibody syndrome?

    Science.gov (United States)

    Dhaon, P; Das, S K; Saran, R K; Parihar, A

    2011-12-01

    A 23 year old female presented with dyspnea on exertion and absent pulses in the left upper limb. She had prior history of two first trimester abortions and pre-eclampsia with premature delivery. A Doppler examination had revealed left subclavian and axillary artery thrombosis for which she had been given warfarin six months previously. She was admitted and investigated. Patient had low positive aCL IgG antibody, positive antibeta2gp1 antibody, negative lupus anticoagulant and negative ANA. Patient had cardiomegaly and her echocardiography showed severe aortic regurgitation, moderate mitral regurgitation and moderate pulmonary artery hypertension with poor ejection fraction with normal aortic root. A diagnosis of primary antiphospholipid antibody syndrome with valvular involvement with dilated cardiomyopathy was entertained. A CT angiogram of the aorta revealed narrowing and irregularity of the aorta and its multiple branches suggestive of type III Takayasu's arteritis. Temporal relationship suggests development of aorto-arteritis secondary to APS but simultaneous presence of both these disorders in this patient cannot be ruled out.

  1. The Thromboembolic Risk in Giant Cell Arteritis: A Critical Review of the Literature

    Directory of Open Access Journals (Sweden)

    A. Guida

    2014-01-01

    Full Text Available Giant cell arteritis is a systemic vasculitis characterized by granulomatous inflammation of the aorta and its main vessels. Cardiovascular risk, both for arterial and venous thromboembolism, is increased in these patients, but the role of thromboprophylaxis is still debated. It should be suspected in elderly patients suffering from sudden onset severe headaches, jaw claudication, and visual disease. Early diagnosis is necessary because prognosis depends on the timeliness of treatment: this kind of arteritis can be complicated by vision loss and cerebrovascular strokes. Corticosteroids remain the cornerstone of the pharmacological treatment of GCA. Aspirin seems to be effective in cardiovascular prevention, while the use of anticoagulant therapy is controversial. Association with other rheumatological disease, particularly with polymyalgia rheumatica is well known, while possible association with antiphospholipid syndrome is not established. Large future trials may provide information about the optimal therapy. Other approaches with new drugs, such as TNF-alpha blockades, Il-6 and IL-1 blockade agents, need to be tested in larger trials.

  2. Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma

    Science.gov (United States)

    Rana, Abdul Qayyum; Saeed, Usman; Khan, Osama A.; Qureshi, Abdul Rehman M.; Paul, Dion

    2014-01-01

    Giant cell arteritis (GCA) or Temporal arteritis (TA) is an autoimmune disease and the most common type of vasculitis in the elderly. It causes inflammation of the medium and large arteries in the upper part of the body. GCA is an under-recognized cause of  head aches in the elderly, especially when it presents itself with atypical features, resulting in delayed or incorrect diagnosis. Since GCA is a treatable condition, an accurate diagnosis is crucial to prevent the most serious complication of CGA, permanent vision loss. The diagnosis can be further complicated as GCA may present with features of other painful neurological conditions. The present case is an 81-year-old woman diagnosed with GCA, who initially presented with features similar to tension-type headache. Due to overlapping features of these conditions, the diagnosis of GCA was delayed, resulting in irreversible vision loss. Although previous research highlights diagnostic dilemmas featuring GCA and other disease states, this case is exclusive in describing a unique dilemma where tension-type headache mimics GCA. PMID:25288850

  3. Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Abdul Qayyum Rana

    2014-01-01

    Full Text Available Giant cell arteritis (GCA or Temporal arteritis (TA is an autoimmune disease and the most common type of vasculitis in the elderly. It causes inflammation of the medium and large arteries in the upper part of the body. GCA is an under-recognized cause of  head aches in the elderly, especially when it presents itself with atypical features, resulting in delayed or incorrect diagnosis. Since GCA is a treatable condition, an accurate diagnosis is crucial to prevent the most serious complication of CGA, permanent vision loss. The diagnosis can be further complicated as GCA may present with features of other painful neurological conditions. The present case is an 81-year-old woman diagnosed with GCA, who initially presented with features similar to tension-type headache. Due to overlapping features of these conditions, the diagnosis of GCA was delayed, resulting in irreversible vision loss. Although previous research highlights diagnostic dilemmas featuring GCA and other disease states, this case is exclusive in describing a unique dilemma where tension-type headache mimics GCA.

  4. A Model of Left Ventricular Dysfunction Complicated by CAWS Arteritis in DBA/2 Mice

    Directory of Open Access Journals (Sweden)

    Naoto Hirata

    2012-01-01

    Full Text Available It was reported previously that a Candida albicans water-soluble fraction (CAWS, including a mannoprotein and β-glucan complex, has strong potency in inducing fatal necrotizing arteritis in DBA/2 mice. In this study, histopathological changes and cardiac function were investigated in this system. One mg/day of CAWS was given to DBA/2 mice via peritoneal injection for five days. The CAWS-treated DBA/2 mice were induced aortitis and died at an incidence of 100% within several weeks. Histological findings included stenosis in the left ventricular outflow tract (LVOT and severe inflammatory changes of the aortic valve with fibrinoid necrosis. Cardiomegaly was observed and heart weight increased 1.62 fold (<0.01. Echocardiography revealed a severe reduction in contractility and dilatation of the cavity in the left ventricle (LV: LV fractional shortening (LVFS decreased from 71% to 38% (<0.01, and the LV end-diastolic diameter (LVDd increased from 2.21 mm to 3.26 mm (<0.01. The titer of BNP mRNA increased in the CAWS-treated group. Severe inflammatory changes resulting from CAWS brought about lethal LV dysfunction by aortic valve deformation with LVOT stenosis. This system is proposed as an easy and useful experimental model of heart failure because CAWS arteritis can be induced by CAWS injection alone.

  5. The role of {sup 18}F-FDG PET in characterising disease activity in Takayasu arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John [Department of Nuclear Medicine, Hammersmith Hospital, Du Cane Road, W12 0HS, London (United Kingdom); Mason, Justin C. [Department of Rheumatology, Hammersmith Hospital, London (United Kingdom)

    2004-05-01

    Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 {sup 18}F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. {sup 18}F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that {sup 18}F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

  6. Arteritis de Takayasu de evolución fulminante en una paciente pediátrica

    Directory of Open Access Journals (Sweden)

    Maikel Vargas-Sanabria

    2007-07-01

    Full Text Available Resumen Se presenta el caso de una lactante de 4 meses, conocida sana, con un cuadro de 4 días de evolución, inicialmente inespecífico, que el último día se tornó fulminante, con signos francos de hipoperfusión tisular, que la llevaron a 2 paros cardiorrespiratorios y a la muerte. Al realizarse la autopsia médico legal y el estudio histopatológico se encontró una vasculitis de grandes vasos, correspondiente con enfermedad de Takayasu. La arteritis de Takayasu es por sí misma muy poco frecuente en el hemisferio occidental, esto aunado a que se manifieste en una lactante caucásica con evolución fulminante, constituye una entidad extremadamente rara y por lo tanto de interés para un diagnóstico más expedito.Abstract We present the case of a previously healthy 4 monthsold child, , who suffered a 4 day illness, unspecific at the beginning, but during her last day showed signs of tissue hipoperfusion, had 2 cardicac arrests and died. The forensic autopsy and histological examination demonstrated great vessels vasculitis. This findings are compatible with Takayasu’s arteritis. Takayasu is a very uncommon disease in the occidental hemisphere, and is also unusual in caucasic children and uncommonly has a lethal outcome.

  7. Risk of Diabetes Mellitus among Patients Diagnosed with Giant Cell Arteritis or Granulomatosis with Polyangiitis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Ahlström, Magnus G; Lindhardsen, Jesper;

    2017-01-01

    OBJECTIVE: Patients with organ- or life-threatening vasculitis receive high cumulative glucocorticoid (GC) doses during their disease course. GC have diabetogenic effects, but the risk of diabetes mellitus (DM) related to vasculitis therapy is not well characterized. We assessed the DM risk among...... patients diagnosed with giant cell arteritis (GCA) or granulomatosis with polyangiitis (GPA), i.e., patients with relatively common forms of systemic vasculitis. METHODS: We used Danish healthcare registries to identify 1682 patients diagnosed with GCA and 342 patients diagnosed with GPA from 1997 to 2015...... and to obtain information regarding medication exposures. Each patient with vasculitis was matched with 9 population controls. Date of new-onset DM was defined as date of first claimed prescription for an antidiabetic drug. We used Cox regression analyses to calculate incidence rate ratios (IRR) for DM...

  8. Serological survey for equine viral arteritis in several municipalities in the Orinoquia region of Colombia

    Directory of Open Access Journals (Sweden)

    Agustín Góngora O.

    2014-09-01

    Full Text Available Objective. The goal of this study was to determine the current status of the Equine Arteritis virus (EAV in horse populations in the Orinoquia region of Colombia. Materials and methods. A transversal study was conducted by serological survey of equine (n=100 from 11 municipalities of the Colombian Orinoquia region. Serum samples were tested by virus seroneutralization assay according to the guidelines provided by the World Organization for Animal Health. Results. After testing was carried out no positives samples to EAV were found in the population analyzed. Conclusions. Although the sample size of the population screened in this study does not represent the total equine population size for the region or the country, data obtained has shown the absence of EAV infection in these animals. However, a wider study area including other regions of the country, with a feasible statistical design, would determine if this infection continues to be an exotic disease for Colombia.

  9. ELA-DRA polymorphisms are not associated with Equine Arteritis Virus infection in horses from Argentina.

    Science.gov (United States)

    Kalemkerian, P B; Metz, G E; Peral-Garcia, P; Echeverria, M G; Giovambattista, G; Díaz, S

    2012-12-01

    Polymorphisms at Major Histocompatibility Complex (MHC) genes have been associated with resistance/susceptibility to infectious diseases in domestic animals. The aim of this investigation was to evaluate whether polymorphisms of the DRA gene the Equine Lymphocyte Antigen is associated with susceptibility to Equine Arteritis Virus (EAV) infection in horses in Argentina. The equine DRA gene was screened for polymorphisms using Pyrosequencing® Technology which allowed the detection of three ELA-DRA exon 2 alleles. Neither allele frequencies nor genotypic differentiation exhibited any statistically significant (P-values=0.788 and 0.745) differences between the EAV-infected and no-infected horses. Fisher's exact test and OR calculations did not show any significant association. As a consequence, no association could be established between the serological condition and ELA-DRA.

  10. Arteritis de Takayasu de evolución fulminante en una paciente pediátrica

    Directory of Open Access Journals (Sweden)

    Maikel Vargas-Sanabria

    2007-07-01

    Full Text Available Resumen Se presenta el caso de una lactante de 4 meses, conocida sana, con un cuadro de 4 días de evolución, inicialmente inespecífico, que el último día se tornó fulminante, con signos francos de hipoperfusión tisular, que la llevaron a 2 paros cardiorrespiratorios y a la muerte. Al realizarse la autopsia médico legal y el estudio histopatológico se encontró una vasculitis de grandes vasos, correspondiente con enfermedad de Takayasu. La arteritis de Takayasu es por sí misma muy poco frecuente en el hemisferio occidental, esto aunado a que se manifieste en una lactante caucásica con evolución fulminante, constituye una entidad extremadamente rara y por lo tanto de interés para un diagnóstico más expedito.

  11. Giant Cell Arteritis: An Atypical Presentation Diagnosed with the Use of MRI Imaging

    Directory of Open Access Journals (Sweden)

    Siddesh Shambhu

    2016-01-01

    Full Text Available Giant cell arteritis (GCA is the most common primary systemic vasculitis in western countries in individuals over the age of 50. It is typically characterised by the granulomatous involvement of large and medium sized blood vessels branching of the aorta with particular tendencies for involving the extracranial branches of the carotid artery. Generally the diagnosis is straightforward when characteristic symptoms such as headache, jaw claudication, or other ischemic complications are present. Atypical presentations of GCA without “overt” cranial ischemic manifestations have become increasingly recognised but we report for the first time a case of GCA presenting as mild upper abdominal pain and generalized weakness in the context of hyponatremia as the presenting manifestation of vasculitis that was subsequently diagnosed by MRI scanning. This case adds to the literature and emphasises the importance of MRI in the evaluation of GCA patients without “classic” cranial ischemic symptoms.

  12. Subtotal tongue necrosis in delayed diagnosed giant-cell arteritis: a case report.

    Science.gov (United States)

    Biebl, Matthias Oliver; Hugl, Beate; Posch, Lydia; Tzankov, Alexandar; Weber, Florian; Perkmann, Reinhold; Fraedrich, Gustav

    2004-01-01

    Giant-cell arteritis (GCA) is a chronic systemic vasculitis of large- and medium-sized vessels, mainly affecting elderly patients. Headache, vision impairment, jaw claudication, and scalp tenderness are common symptoms. However, diagnosis can be difficult because GCA can affect almost every vascular pathway and lead to a variety of possible manifestations. We report the case of a belated diagnosed GCA, resulting in nearly complete necrosis of the mobile part of the tongue, visual impairment, and neurologic as well as intestinal ischemic symptoms. Aggressive immunosuppressive treatment resolved the symptoms, but the patient remained severely morbid because of bilateral necrosis of the mobile part of the tongue. In any case of unclear ischemic symptoms in an elderly patient, one must keep GCA in mind as the possible culprit disease.

  13. THE CASE OF THE GIANT-CELL ARTERITIS MANIFESTED AS DORSOLATERAL MEDULLARY INFARCTION

    Directory of Open Access Journals (Sweden)

    V. S. Akimov

    2014-01-01

    Full Text Available The case of a giant-cell arteritis is presented. First clinical signs of the disease were fewer and development of infarction in the basin of the left vertebral artery. Magnetic resonance angiography showed its prolonged diminution. Laboratory results were remarkable for the high rate of erythrocyte sedimentation and the increase of C-reactive protein (CRP concentration. Physical examination revealed acrotism in temporal arteries. Diagnosis was proven by biopsy results which included giant multinucleate cells. Authors discuss problems of diagnosis of the disease, the role of radiological methods (angio-ultrasonography, magnetic resonance and computed tomography aided angiography, positron-emission tomography and the necessity to pay particular attention to the elderly patients with high rate of erythrocyte sedimentation and the increased CRP concentration.

  14. MRI in giant cell (temporal) arteritis; Magnetresonanztomografie der Arteriitis temporalis Horton

    Energy Technology Data Exchange (ETDEWEB)

    Bley, T.A.; Uhl, M.; Frydrychowicz, A.; Langer, M. [Uniklinik Freiburg (Germany). Roentgendiagnostik; Markl, M. [Uniklinik Freiburg (Germany). Roentgendiagnostik - Medizinische Physik

    2007-07-15

    Giant cell (temporal) arteritis is a diagnostic challenge. Blindness is a dreaded complication, especially if high-dose steroid treatment is delayed. With an optimized MR protocol, noninvasive diagnosis of giant cell arteritis is facilitated. Submillimeter in-plane resolution makes it possible to distinguish healthy segments from inflamed segments. The lumen and arterial wall can be depicted in high detail. Post-contrast high-resolution MRI visualizes the superficial cranial arteries bilaterally and simultaneously, allowing assessment of the cranial involvement pattern. In combination with MR angiography of the aortic arch and supra-aortic arteries, the extracranial involvement pattern can be demonstrated in a single comprehensive MR examination assessing the cranial, cervical and thoracic vasculature. Good diagnostic image quality can be achieved at 1.5 Tesla and at 3 Tesla. However, due to higher signal-to-noise ratios, image quality seems to be superior at 3 Tesla. Over the course of successful long-term treatment, MR signs of mural inflammation decrease significantly and eventually vanish entirely. In contrast to color-coded Duplex sonography, which is a comparatively cost-efficient imaging modality, acquisition of high-resolution MRI is almost independent of the investigator's expertise. Compared to positron emission tomography with 18F-fluoro-2-deoxy-D-glucose, which is a very sensitive whole-body screening tool for detecting extracranial involvement of large vessel vasculitis, MRI allows visualization and assessment of both the superficial cranial arteries in high detail and the extracranial large artery involvement in the same investigation. (orig.)

  15. Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu’s Arteritis and Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Demet Menekşe Gerede

    2013-01-01

    Full Text Available We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu’s arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu’s arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases.

  16. 18F-FDG PET/CT for Detection Sarcoma of the Aorta in a Patient with Takayasu Arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Yakahashi, Tomoko; Watanabe, Naoto; Wakasa Minoru; Kajinami, Kouji; Tonami, Hisao [Kazazawa Medical Univ., Ishikawa (Japan)

    2016-06-15

    Sarcoma of the aorta is extremely rare; however, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging is a useful modality for detecting malignant tumors, including various sarcomas. We report on a case of sarcoma of the aorta associated concomitantly with Takayasu arteritis. The 18F-FDG PET/CT detected an abnormal increased up take in an aortic mass of the descending thoracic aorta, thoracic vertebra, and ilium. The standardized uptake value (SUV) of 18F-FDG in the aortic mass was 21.7, suggesting that 18F-FDG PET/CT imaging may be useful for detecting sarcoma of the aorta associated with Takayasu arteritis and bone metatases during treatment.

  17. The equine arteritis virus induces apoptosis via caspase-8 and mitochondria-dependent caspase-9 activation.

    Science.gov (United States)

    St-Louis, Marie-Claude; Archambault, Denis

    2007-10-10

    We have previously showed that equine arteritis virus (EAV), an arterivirus, induces apoptosis in vitro. To determine the caspase activation pathways involved in EAV-induced apoptosis, target cells were treated with peptide inhibitors of apoptosis Z-VAD-FMK (pan-caspase inhibitor), Z-IETD-FMK (caspase-8-specific inhibitor) or Z-LEHD-FMK (caspase-9-specific inhibitor) 4 h prior to infection with the EAV T1329 Canadian isolate. Significant inhibition of apoptosis was obtained with all peptide inhibitors used. Furthermore, apoptosis was inhibited in cells expressing the R1 subunit of herpes simplex virus type 2 ribonucleotide reductase (HSV2-R1) or hsp70, two proteins which are known to inhibit apoptosis associated with caspase-8 activation and cytochrome c release-dependent caspase-9 activation, respectively. Given the activation of Bid and the translocation of cytochrome c within the cytoplasm, the overall results indicate that EAV induces apoptosis initiated by caspase-8 activation and subsequent mitochondria-dependent caspase-9 activation.

  18. Giant cell arteritis mimicking infiltrative leptomeningeal disease of the optic nerves.

    Science.gov (United States)

    Kornberg, Michael D; Ratchford, John N; Subramaniam, Rathan M; Probasco, John C

    2015-04-09

    A 67-year-old man presented with several days of progressive, painless left eye vision loss. He reported mild jaw claudication but denied headache, scalp tenderness or constitutional symptoms. Examination revealed palpable temporal arteries, blurring of the left optic disc, and 20/100 vision in the left eye with mild relative afferent pupillary defect. Inflammatory markers were sent, and methylprednisolone was initiated for presumptive giant cell arteritis (GCA). Erythrocyte sedimentation rate was normal, however, and C reactive protein was only mildly elevated, prompting further investigation. Orbital MRI revealed nodular enhancement of the optic nerve sheaths bilaterally from optic nerve head to chiasm, raising concern for an infiltrative leptomeningeal process such as sarcoidosis or lymphoma. Methylprednisolone was temporarily stopped while a broad work up for inflammatory and neoplastic causes was pursued. Fluorodeoxyglucose-positron emission tomography ultimately revealed hypermetabolism in the temporal, ophthalmic and occipital arteries suggesting GCA, which was confirmed by temporal artery biopsy. Steroids were restarted, and the patient's vision stabilised.

  19. Lower extremity vasculitis in giant cell arteritis: important differential diagnosis in patients with lower limb claudication.

    Science.gov (United States)

    Sigl, Martin; Hsu, Eric; Scheffel, Hans; Haneder, Stefan; Rümenapf, Gerhard; Amendt, Klaus

    2014-09-01

    Most patients with peripheral arterial disease suffer from arteriosclerosis, the prevalence of which increases with age. In some of these patients, however, the ischemic symptoms are not caused by stenotic arteriosclerosis, but by large vessel giant cell arteritis (LV-GCA), a disease also predominantly affecting patients of the older generation. Identifying large vessel vasculitis is a challenge for all physicians caring for patients with peripheral artery disease. The results of invasive treatment such as bypass surgery and angioplasty of inflammatory vascular lesions differ fundamentally from those of patients with atherosclerosis. Duplex ultrasound is a widely available diagnostic method for examining patients with lower limb claudication and pathological ankle-/toe- brachial index or pulse volume recording with or without exercise. Knowledge of characteristic sonographic findings suspicious about large vessel vasculitis is essential for a differential diagnosis of vasculitis versus atherosclerosis. In addition to clinical and laboratory findings, further imaging techniques, e.g. contrast-enhanced computed tomography, magnetic resonance imaging or a combination of positron emission tomography and computed tomography (PET-CT) can provide information on further vessel involvement and inflammatory activity. The present study focuses on diagnostic imaging of LV-GCA in patients presenting with claudication, illustrated by a series of cases.

  20. Takayasu's Arteritis in Pregnancy: A Rare Case Report from a Tertiary Care Infirmary in India

    Science.gov (United States)

    Rajput, Monika; Mohindra, Ritin; Sharma, Manjula; Topden, Sonam R.

    2017-01-01

    Background. Takayasu's arteritis (TA) is a rare, chronic, inflammatory, progressive, idiopathic arteriopathy, afflicting young women of reproductive age group, causing narrowing, occlusion, and aneurysms of systemic and pulmonary arteries, especially the aorta and its branches. During pregnancy, such patients warrant special attention. An interdisciplinary collaboration of obstetricians, cardiologists, and neurologists is necessary to improve maternal and fetal prognosis. Here a case is reported where a patient with diagnosis of TA, complicated by neurological sequelae, successfully fought the vagaries of the condition twice to deliver uneventfully. Case. 25-year-old G2P1L1 presented at 34 weeks of gestation, with chronic hypertension, with TA, with epilepsy, and with late-onset severe IUGR. Following a multidisciplinary approach, she delivered an alive born low birth weight baby (following induction). Her postpartum course remained uneventful. Conclusion. Pregnancy with TA poses a stringent challenge to an obstetrician. Despite advancements in cardiovascular management and advent of new-fangled drugs, the optimal management for pregnant patients with this disease still remains elusive. PMID:28265476

  1. Granulomatous encephalitis, intracranial arteritis, and mycotic aneurysm due to a free-living ameba.

    Science.gov (United States)

    Martínez, A J; Sotelo-Avila, C; Alcalá, H; Willaert, E

    1980-01-01

    Primary amebic meningoencephalitis and granulomatous amebic encephalitis are well recognized clinicopathological entities caused by free-living amebas. Associated arteritis and "mycotic aneurysms" with infiltration of intracranial arteries by lymphocytes, amebic trophozoites and cysts have not been previously reported. A 26-month-old girl had a 3-week history of encephalitis, characterized, initially, by vomiting and low-grade fever. Subsequently, she developed ataxia, generalized weakness, lethargy, and esotropia. The first CSF showed 490 RBC/microliters, 705 WBC/microliters with 90% mononuclears. Her pupils reacted briskly to light. Moderate nuchal rigidity, nystagmus, fixed downward gaze, anisocoria, bilateral 6th nerve palsy, left arm monoparesis and left Babinski were present. CAT scan revealed slight symmetrical dilatation of anterior horns of lateral ventricles and an area of abnormal enhancement above the 3rd ventricle. She died 14 days after admission, 5 weeks after onset of symptoms. The brain showed focal necrotizing encephalopathy, involving thalami, cerebellum, brain stem, and cervical and upper thoracic spinal cord. Numerous free-living amebic trophozoites and cysts were present within a chronic granulomatous encephalitis. There were trombosis of basilar, posterior cerebral, and vertebral arteries with profuse chronic panarteritis, fibrinoid necrosis, and mycotic aneurysms.

  2. Giant cell arteritis. Part III. New trends in its treatment (role of genetically engineered drugs

    Directory of Open Access Journals (Sweden)

    Azamat Makhmudovich Satybaldyev

    2013-01-01

    Full Text Available Giant cell arteritis (GCA is a well-known vasculitis sensitive to glucocorticoid (GC immuno-suppression. However, during long-term treatment there may be many adverse reactions that remain a serious problem so far. Since GCA encompasses a broad spectrum of clinical subtypes, ranging from severe visual loss and neurological deficits to isolated systemic signs, its treatment must be adjusted specially to each case. The literature contains contradicting recommendations for the therapy for GCA. The paper considers different treatment options for GCA, including that with neuro-ophthalmic and neurological complications, as well as the evidence for their possible adjuvant therapies. Although there is no randomized controlled clinical trial in GCA with ocular and neurological complications, the data available in the literature suggest that these patients are recommended to be admitted for high-dose intravenous methylprednisolone, monitoring, and prevention of GC-induced complications. It is expedient to use aspirin in these cases. The evidence supporting the use of methotrexate, as well as genetically engineered agents (GEAs, infliximab, etanercept as steroid-sparing agents is discussed. Cases of using individual GEAs (adalimumab, tocilizumab and rituximab as an alternative to GC monotherapy are described. It is concluded that there is a need for extended clinical trials evaluating the most effective and safe GC-sparing drugs.

  3. Mycobacterium theory regarding pathogenesis of Takayasu’s arteritis: Numerous unsolved dilemmas

    Directory of Open Access Journals (Sweden)

    Chogle AR

    2015-07-01

    Full Text Available Mycobacterium tuberculosis (Mtb has been implicated in the pathogenesis of Takayasu’s arteritis (TA, but there is no direct evidence substantiating the association. Several cases series and laboratory studies provide indirect evidence on the role of Mtb and other related species in the immunopathogenesis of TA. This association could be explained by the molecular mimicry between mycobacterium heat shock protein (mHSP 65 and the human homologue (hHSP60 driving immune response in TA. Two different histopathological studies that have evaluated the presence of mycobacteria in aortic tissue have reported contradictory results. This may be due to regional differences in the prevalence of Mtb, ethnicity, and study methodology. Recent progress in identifying susceptibility genes and study of TNFα-308 gene polymorphism has opened up new avenues for research on mycobacterium theory. Based on the currently available data, three different models have been proposed. Among these, two models favor the mycobacterium theory, while one does not. Transcriptomic and proteomic studies of mycobacteria could help in identifying specific or common traits of mycobacteria that are relevant to the development and reactivation of TA.

  4. Portal hypertension: an uncommon clinical manifestation of Takayasu arteritis in a 9-year-old child

    Science.gov (United States)

    Herrera, Cristina N; Tomala-Haz, Javier E

    2016-01-01

    Takayasu arteritis (TA) is the third most common childhood vasculitis and its clinical manifestations depend on the arteries involved. We report a case of a 9-year-old boy with multiple aneurysms in carotid and iliac arteries, subclavian and coronary arteries, and abdominal aorta. At the age of 7 years, he presented with recurrent fever and hepatosplenomegaly. An angio-computed tomography scan showed aneurysms in the left subclavian artery, abdominal aorta, and both proximal iliac arteries. He was diagnosed with TA and was treated with corticosteroids, aspirin, and enalapril. One year later, he was admitted to Dr Roberto Gilbert Children’s Hospital because of intracranial hemorrhage. Angiography revealed enlargement of aneurysms enlargement and new aneurysms. He also developed portal hypertension. Treatment with intravenous corticosteroids, azathioprine, and monthly intravenous cyclophosphamide was begun. After 6 months of no improvement, infliximab was begun. The aim of this article was to report the concurrence of coronary involvement and portal vein hypertension in pediatric TA because there were scarce reports on this matter. PMID:27895519

  5. Glomerular Disease Associated with Takayasu Arteritis:6 Cases Analysis and Review of the Literature

    Institute of Scientific and Technical Information of China (English)

    Xue-mei Li; Wen-ling Ye; Yu-bing Wen; Hang Li; Li-meng Chen; Dong-yan Liu; Xue-jun Zeng; Xue-wang Li

    2009-01-01

    To evaluate the clinical features, renal histopathology and therapeutic response to glucocorticoid and immunosuppressive agents in patients with glomerular disease associated with Takayasu arteritis (TA).Methods Patients with TA and renal biopsy-confirmed glomerular disease were investigated retrospectively. None of them had renal artery stenosis or occlusive changes.Results Six patients with glomerulopathy, accounting for 3.75% of the 160 TA patients admitted to our hospital at the same period, were analyzed. All of them were females with a mean age of 35.5 ± 10.0 years. Four cases presented with lower extremity edema. Laboratory tests showed that one was nephrotic syndrome, three were nephrotic range proteinuria, and two of them had mild renal dysfunction. The other two patients were asymptomatic microscopic hematuria and proteinuria. Renal pathology revealed mild immunoglobulin A nephropathy in two cases, mild mesangial proliferative glomerulonephritis (GN),membranoproliferative GN, minimal change disease, and fibrillary GN in one case respectively. Five cases received glucocorticoids and cyclophosphamide therapy. Proteinuria and microscopic hematuria disappeared in 2 to 4 weeks after the initiation of therapy in three cases. The patient with membranoproliferative GN also reached complete remission of proteinuria and recovered renal function 6 months after the treatment.Conclusions TA may induce glomerular disease as a part of its histological spectrum. Apart from ischemic glomerular disease, glomerular disease should be suspected when TA patients have microscopic hematuria or proteinuria, that may be therapeutically responsive to glucocorticoids and immunosuppressive agent in relative early phase.

  6. Acute Myocardial Infarction with Left Ventricular Failure as an Initial Presentation of Takayasu’s Arteritis

    Science.gov (United States)

    Sontakke, Tushar R; Mishra, Deepankar; Saxena, Shilpa; Banode, Pankaj

    2016-01-01

    Takayasu’s Arteritis (TA) is an uncommon chronic inflammatory and stenotic disease of medium and large-sized arteries characterized by a strong predilection for the aortic arch and its major branches. We report a rare manifestation of TA in a 16-year-old female with no previous history of heart disease who presented with heart failure. She was found to have hypertension and discrepancies of pulses in upper and lower limbs. She developed ST elevated anterior wall myocardial infarction (MI) during hospitalization. Her aortography revealed narrowing of descending thoracic, upper abdominal and infrarenal aorta with significant stenosis of both renal arteries. She was diagnosed as a case of TA on the basis of her clinical profile and arteriography. Her coronary angiography did not reveal any stenosis or occlusion or aneurysm in coronary arteries or at coronary ostia which is in contrast to patients of TA with MI reported in the literature who had focal or diffuse stenosis or aneurysm in the coronaries. PMID:27437287

  7. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk, E-mail: hongsukpark@gmail.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Do, Young Soo, E-mail: ysdo@skku.edu [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Kim, Duk-Kyung, E-mail: dukkyung.kim@samsung.com [Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, Sung Wook, E-mail: sw.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Shin, Sung Wook, E-mail: sw88.shin@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Cho, Sung Ki, E-mail: sungkismc@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Hyun, Dongho, E-mail: mesentery.hyun@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, In Wook, E-mail: inwook.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of)

    2013-11-01

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.

  8. Incidentally diagnosed Takayasu arteritis on thyroid ultrasonography showing prominent collateral vessels of thyroidal arteries and common carotid artery occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Se Jin; Kim, Eun Kyung [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    We report a case of middle-aged woman incidentally diagnosed with Takayasu arteritis during the ultrasonography of a thyroid gland nodule. Prominent collaterals of the thyroidal arteries and a thin common carotid artery with mural thickening and deficient intraluminal flow signals were initially depicted on the ultrasonography with color Doppler. Subsequent magnetic resonance angiography and computed tomography aortography confirmed the diagnosis with the imaging features of a bilateral long segment common carotid artery occlusion and segmental stenosis of the left subclavian artery in addition to the suggestive physical findings.

  9. Ocular pulse amplitude as a diagnostic adjunct in giant cell arteritis

    Science.gov (United States)

    Knecht, P B; Bachmann, L M; Thiel, M A; Landau, K; Kaufmann, C

    2015-01-01

    Background To develop an algorithm based on the ocular pulse amplitude (OPA) to predict the probability of a positive temporal artery biopsy (TAB) result in the acute phase of suspected giant cell arteritis (GCA). Methods Unilateral TAB was performed and ipsilateral OPA measurements were taken by Dynamic Contour Tonometry. Among the clinical signs and laboratory findings tested in univariate analyses, OPA, Erythrocyte Sedimentation Rate (ESR) and thrombocyte count showed a strong association with a positive TAB result. Algorithm parameters were categorized into three groups (OPA >3.5, 2.5–3.5, and 60 mm/h; thrombocyte count 500'000/μl). Score values (0, 1, and 2) were attributed to each group, resulting in a total score range from 0 to 6. A univariate logistic regression analysis using the GCA diagnosis as the dependent and the total score as the independent variate was fitted and probability estimates were calculated. Results Thirty-one patients with suspected GCA undergoing TAB during an eighteen-month observation period were enrolled. Twenty patients showed histologically proven GCA. Four patients had score values ≤2, fourteen between 3 and 4, and thirteen of ≥5. The corresponding estimated probabilities of GCA were95%. Conclusion The present study confirms previous findings of reduced OPA levels, elevated ESR, and elevated thrombocyte counts in GCA. It indicates that a sum score based on OPA, ESR, and thrombocyte count can be helpful in predicting TAB results, especially at the upper and the lower end of the sum score range. PMID:26088675

  10. A Large-Scale Genetic Analysis Reveals a Strong Contribution of the HLA Class II Region to Giant Cell Arteritis Susceptibility

    NARCIS (Netherlands)

    David Carmona, F.; Mackie, Sarah L.; Martin, Jose-Ezequiel; Taylor, John C.; Vaglio, Augusto; Eyre, Stephen; Bossini-Castillo, Lara; Castaneda, Santos; Cid, Maria C.; Hernandez-Rodriguez, Jose; Prieto-Gonzalez, Sergio; Solans, Roser; Ramentol-Sintas, Marc; Francisca Gonzalez-Escribano, M.; Ortiz-Fernandez, Lourdes; Morado, Inmaculada C.; Narvaez, Javier; Miranda-Filloy, Jose A.; Beretta, Lorenzo; Lunardi, Claudio; Cimmino, Marco A.; Gianfreda, Davide; Santilli, Daniele; Ramirez, Giuseppe A.; Soriano, Alessandra; Muratore, Francesco; Pazzola, Giulia; Addimanda, Olga; Wijmenga, Cisca; Witte, Torsten; Schirmer, Jan H.; Moosig, Frank; Schoenau, Verena; Franke, Andre; Palm, Oyvind; Molberg, Oyvind; Diamantopoulos, Andreas P.; Carette, Simon; Cuthbertson, David; Forbess, Lindsy J.; Hoffman, Gary S.; Khalidi, Nader A.; Koening, Curry L.; Langford, Carol A.; McAlear, Carol A.; Moreland, Larry; Monach, Paul A.; Pagnoux, Christian; Seo, Philip; Spiera, Robert; Sreih, Antoine G.; Warrington, Kenneth J.; Ytterberg, Steven R.; Gregersen, Peter K.; Pease, Colin T.; Gough, Andrew; Green, Michael; Hordon, Lesley; Jarrett, Stephen; Watts, Richard; Levy, Sarah; Patel, Yusuf; Kamath, Sanjeet; Dasgupta, Bhaskar; Worthington, Jane; Koeleman, Bobby P. C.; de Bakker, Paul I. W.; Barrett, Jennifer H.; Salvarani, Carlo; Merkel, Peter A.; Gonzalez-Gay, Miguel A.; Morgan, Ann W.; Martin, Javier

    2015-01-01

    We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip a

  11. In this issue: Nef, a lingering problem; are there better immunoglobulins for human use; and Takayasu arteritis, still a mystery.

    Science.gov (United States)

    Bot, Adrian

    2012-12-01

    The current issue of the International Reviews of Immunology brings the latest in three different areas of basic and clinical immunology. First, there is the lingering question of residual HIV-related pathology in patients on chronic antiretroviral therapy. The specific role of Nef in the macrophage-mediated disease manifested through lymphoma, metabolic disease and neurological disorder, is extensively discussed. A second topic is a clinical immunology one, a critical perspective on the efficacy and safety profile of various preparations of immunoglobulin products currently prescribed for a range of immunodeficiencies. Surprisingly, the authors showed that while the available preparations are equivalent from efficacy standpoint, they differ from the standpoint of toxicity. The third subject is again, in the arena of clinical immunology and deals with a relatively rare yet extremely puzzling disease -Takayasu arteritis -with a pathogenesis that needs elucidation and a dire need for better treatments. The authors provide a state of the art in terms of genetic association, other factors possibly involved in the onset and progression of this unusual inflammatory disease of large arteries, and provide a perspective on current standard of care and potential usefulness of TNF-α blockade as therapy for Takayasu arteritis.

  12. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria

    DEFF Research Database (Denmark)

    Ozen, Seza; Pistorio, Angela; Iusan, Silvia M

    2010-01-01

    To validate the previously proposed classification criteria for Henoch-Schönlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA)....

  13. [Clinical and angiographic manifestations inpatients without previous diagnosis of Takayasu´s arteritis].

    Science.gov (United States)

    Hernández-González, Claudia; López-Flores, Luis Antonio; Sánchez-González, Mariela; Vera-Lastra, Olga Lidia

    2015-01-01

    Introducción: la arteritis de Takayasu (AT) es una vasculitis sistémica que afecta a la aorta y sus ramas principales, se distingue por disminución o ausencia de pulsos. La arteriografía corrobora el diagnóstico de AT. El objetivo de este estudio es analizar las manifestaciones clínicas y hallazgos arteriográficos en pacientes sin diagnóstico previo de AT.Métodos: se estudiaron 10 pacientes enviadas al Departamento de Radiodiagnóstico para la realización de panangiografía por enfermedad cerebrovascular (EVC) en pacientes jóvenes, hipertensión renovascular (HRV) e insuficiencia arterial (IA) de alguna extremidad. Se investigaron manifestaciones clínicas orientadas al diagnóstico de AT y se realizó arteriografía con sustracción digital y ultrasonido Doppler color. A las pacientes se les realizó el diagnóstico de AT y por arteriografía se usó la clasificación de Numano.Resultados: la EVC en paciente joven se encontró en 4 casos, HRV en 3, e IA de las extremidades superiores en 3. Por arteriografía los tipos de AT fueron I: 50 %, V: 40 % y IV 10 %. La afección principal se demostró en los tronco supraaórticos y de estos las carótidas 80 %, subclavia derecha 80 %, subclavia izquierda 70 %, vertebral izquierda 40 %, vertebral derecha 30 %, aorta abdominal 40 %, renal derecha 40 % y renal izquierda 10 %.Conclusión: las manifestaciones clínicas más comunes fueron: EVC, HRV e IA de las extremidades superior. La AT tipo I fue la más frecuente y explica las manifestaciones de EVC, seguida de la tipo V.

  14. Experimental exposure of pregnant mares to the asinine-94 strain of equine arteritis virus

    Directory of Open Access Journals (Sweden)

    J.T. Paweska

    1997-07-01

    Full Text Available Clinical, virological and serological responses were evaluated in 10 pregnant mares after different challenge exposures to the asinine-94 strain of equine arteritis virus (EAV. The outcome of maternal infection on the progeny was also investigated. Mares were inoculated intranasally (n = 4, intramuscularly (n = 2, intravenously (n = 1, or contact-exposed (n = 3. All inoculated mares developed pyrexia, 5 showed mild clinical signs related to EAV infection and 2 remained asymptomatic. Viraemia was detected in all the inoculated animals and shedding of virus from the respiratory tract occurred in 6. Five mares were re-challenged intranasally 7 and 15 weeks after inoculation. Clinical signs of the disease in these mares were limited to mild conjunctivitis. After re-challenge, virus was recovered from buffy coat cultures of 2 mares 2-6 days after re-infection. EAV was not recovered from colostrum and milk samples during the 1st week post partum. All inoculated mares seroconverted to EAV 8-12 days post inoculation and also seroconverted after re-challenge. No clinical signs of EAV infection were observed in the 3 mares kept in close contact during the post-inoculation and re-challenge periods. Serum neutralising antibody to the virus was detected in 1 in-contact mare only, while a detectable concentration of specific IgG was found by ELISA in the colostrum of 1 of the other in-contact mares. Eight of the mares gave birth to clinically normal foals, although 1 was born prematurely. Shortly after birth, 7 foals developed fever and variable clinical signs; 5 foals became septicaemic and 3 of them died 2-5 days after birth, while the remaining 2 were euthanased at 1 month of age. EAV was not recovered from the placenta, from buffy coat fractions of blood collected from foals immediately after birth and 1-3 days later, or from a range of tissues taken from the 3 foals that died and 2 that were euthanased. Virus was not isolated from tissues collected from

  15. Mannose-binding lectin variant alleles and HLA-DR4 alleles are associated with giant cell arteritis

    DEFF Research Database (Denmark)

    Jacobsen, Soren; Baslund, Bo; Madsen, Hans O.

    2002-01-01

    OBJECTIVE: To determine whether variant alleles of the mannose-binding lectin (MBL) gene causing low serum concentrations of MBL and/or polymorphisms of HLA-DRB1 are associated with increased susceptibility to polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) or particular clinical...... phenotypes of PMR/GCA. METHODS: MBL and HLA-DRB1 alleles were determined by polymerase chain reaction in 102 Danish patients with PMR (n = 37) or GCA (n = 65). Two hundred fifty and 193 healthy individuals served as controls for MBL and HLA genotyping, respectively. RESULTS: The prevalence of MBL variant...... alleles in controls, patients with PMR only, and patients with GCA was 37, 32, and 53% (p = 0.01), respectively. HLA-DRB1*04 was found in 47% of patients with PMR only and in 54% of patients with GCA, which differed significantly from the 35% found in controls (p = 0.01). HLA-DR4 alleles were...

  16. A forma arterítica da neuropatia óptica isquêmica anterior: estudo de 25 casos

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Lana-Peixoto

    1994-09-01

    Full Text Available O quadro clínico, laboratorial, campimétrico e angiofluoresceinográfico de 25 pacientes (40 olhos com a forma arterítica da neuropatia óptica isquémica anterior (NOIA-A foi estudada com a finalidade de definir o perfil da doença possibilitando seu diagnóstico diferencial com a forma não arterítica (NOIA-NA e com outras doenças do nervo óptico. A NOIA-A ocorreu em pacientes entre 60 e 88 anos (média 74 anos, predominando no sexo feminino (64%. Em 15 pacientes o envolvimento foi bilateral, ocorrendo simultaneamente ou nas primeiras semanas após o acometimento inicial. Cefaléia e dor ocular foram os pródromos mais frequentes, enquanto todos os pacientes apresentavam, ao momento da perda visual, sintomas e sinais sistêmicos da arterite de células gigantes (ACG. Elevação da proteina C reativa, do fibrinogênio e da velocidade de hemossedimentação foram as alterações laboratoriais mais frequentemente encontradas. A acuidade visual, em geral, foi severamente acometida. As principais anormalidades fundoscópicas foram edema do disco óptico, usualmente pálido, com ou sem hemorrragias, e alterações retinianas. Exame do campo visual demonstrou uma variedade de defeitos, principalmente altitudinais inferiores enquanto a principal característica angiofluoresceinográfica observada foi o atraso setorial ou difuso do enchimento da coróide.

  17. High-resolution black-blood contrast-enhanced T1 weighted images for the diagnosis and follow-up of intracranial arteritis

    Science.gov (United States)

    Saam, T; Habs, M; Pollatos, O; Cyran, C; Pfefferkorn, T; Dichgans, M; Dietrich, O; Glaser, C; Reiser, M F; Nikolauo, K

    2010-01-01

    Primary arteritis of the central nervous system (CNS) comprises a heterogeneous group of CNS disorders, which is characterised by non-atheromatous inflammation and necrosis of the arterial wall. The clinical presentation is highly variable, with stroke being the most common manifestation. Conventional angiography is considered to be the best imaging tool for diagnosing the disease. However, angiographic findings, which usually show lumen irregularities and stenosis, are often unspecific and can occur with a variety of other vascular disorders, such as atherosclerosis and arterial dissection. Therefore, brain biopsies are often needed to confirm the diagnosis. Recent reports have shown that MRI is able to visualise contrast enhancement in subjects with known primary CNS arteritis. PMID:20739338

  18. Association of HLA-DRB1*1602 and DRB1*1001 with Takayasu arteritis in Colombian mestizos as markers of Amerindian ancestry.

    Science.gov (United States)

    Salazar, M; Varela, A; Ramirez, L A; Uribe, O; Vasquez, G; Egea, E; Yunis, E J; Iglesias-Gamarra, A

    2000-08-31

    We performed HLA Class I and Class II typing in 16 patients (15 women, one man) with a confirmed diagnosis of Takayasu arteritis. We did not find any of the previously described associations with HLA-B52, and/or HLA-DRB1*1301 alleles. However, in our patients, HLA-DRB1*1602 and HLA-DRB1*1001 were significantly increased. The association of Takayasu arteritis with Amerindian and Asian HLA-DRB1 alleles (DRB1*1602 and DRB1*1001) in the Colombian mestizo patients reported here, and with HLA-B*3906 previously reported in Mexicans, suggest the possibility that some HLA and disease associations are markers for ethnicity of a population carrying a disease gene which is present in an admixed population with the disease.

  19. Comportamento da musculatura das arteríolas intra-hepáticas na forma hepatesplênica da esquistossomose mansônica

    Directory of Open Access Journals (Sweden)

    Maria do Socorro Almeida Barbosa

    1988-03-01

    Full Text Available A determinação da relação parede-lume das arteríolas intra-hepáticas, na esquistossomose mansônica (forma hepatesplênica, demonstra a existência de uma hipotrofia da camada muscular daqueles vasos. Esse achado sugere redução do fluxo sangüíneo arterial hepático nessa entidade.

  20. Use of an internal standard in a closed one-tube RT-PCR for the detection of equine arteritis virus RNA with fluorescent probes

    OpenAIRE

    Westcott, David; King, Donald; Drew, Trevor; Nowotny, Norbert; Kindermann, Johanna; Hannant, Duncan; Beláke, Sándor; Paton, David

    2003-01-01

    International audience; Routine detection of equine arteritis virus (EAV) can be achieved by virus isolation (VI) in cell culture, or by the amplification of viral genome by molecular methods. To simplify molecular diagnosis, a number of different Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and RT-nested PCR (RT-nPCR) assays were compared, and a one-tube method was developed and optimised utilizing a fluorogenic probe (TaqMan®). An artificial RNA template (Mimic) and associated p...

  1. Koroner arter anevrizmalı hastaların anjiyografik ve klinik özellikleri: 52 hastanın retrospektif incelenmesi ve literatürün gözden geçirilmesi

    OpenAIRE

    Acar, Gürkan; Dede, Özkan; Türker, Yasin; AKÇAY, Selahaddin; Altınbaş, Ahmet

    2009-01-01

    Süleyman Demirel Üniversitesi TIP FAKÜLTESİ DERGİSİ: 2008 Aralık; 15 (4)Koroner arter anevrizmalı hastaların anjiyografik ve klinik özellikleri: 52 hastanın retrospektif incelenmesi ve literatürün gözden geçirilmesiGürkan Acar*, Özkan Dede**, Yasin Türker**, Selahaddin Akçay**, Ahmet Altınbaş**ÖzetAmaç: Koroner arter anevrizması, koroner arter hastalığının nadir rastlanan bir türüdür. Koroner anevrizmalı hastaların klinik özellikleri ve uzun dönem prognozlarına dair literatür bilgisi azdır. B...

  2. Marked Acceleration of Atherosclerosis following Lactobacillus casei induced Coronary Arteritis in a Mouse Model of Kawasaki Disease

    Science.gov (United States)

    Chen, Shuang; Lee, Young Ho; Crother, Timothy R.; Fishbein, Michael; Zhang, Wenxuan; Yilmaz, Atilla; Shimada, Kenichi; Schulte, Danica J; Lehman, Thomas J.A.; Shah, Prediman K.; Arditi, Moshe

    2012-01-01

    Objective To investigate if Lactobacillus casei cell wall extract (LCWE)-induced Kawasaki Disease (KD) accelerates atherosclerosis in hypercholesterolemic mice. Method and Resuslts Apoe−/− or Ldlr−/− mice were injected with LCWE (KD mice) or PBS, fed high fat diet for 8 weeks, and atherosclerotic lesions in aortic sinuses (AS), arch (AC) and whole aorta were assessed. KD mice had larger, more complex aortic lesions with abundant collagen, and both extracellular and intracellular lipid and foam cells, compared to lesions in control mice despite similar cholesterol levels. Both Apoe−/− KD and Ldlr−/− KD mice showed dramatic acceleration in atherosclerosis vs. controls, with increases in en face aortic atherosclerosis and plaque size in both the AS and AC plaques. Accelerated atherosclerosis was associated with increased circulating IL-12p40, IFN-γ, TNF-α, and increased macrophage, DC, and T cell recruitment in lesions. Furthermore, daily injections of the IL-1Ra, which inhibits LCWE induced KD vasculitis, prevented the acceleration of atherosclerosis. Conclusions Our results suggest an important pathophysiologic link between coronary arteritis/vasculitis in the KD mouse model and subsequent atherosclerotic acceleration, supporting the concept that a similar relation may also be present in KD patients. These results also suggest that KD in childhood may predispose to accelerated and early atherosclerosis as adults. PMID:22628430

  3. Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Alberto Lo Gullo

    Full Text Available To investigate the incidence of venous thromboembolism (VTE and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA compared to the general population.A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review.The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (% of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014 but similar rates of stroke, transient ischemic attack (TIA, and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events.In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects.

  4. Takayasu’s Arteritis in Pregnancy: A Rare Case Report from a Tertiary Care Infirmary in India

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    Sheeba Marwah

    2017-01-01

    Full Text Available Background. Takayasu’s arteritis (TA is a rare, chronic, inflammatory, progressive, idiopathic arteriopathy, afflicting young women of reproductive age group, causing narrowing, occlusion, and aneurysms of systemic and pulmonary arteries, especially the aorta and its branches. During pregnancy, such patients warrant special attention. An interdisciplinary collaboration of obstetricians, cardiologists, and neurologists is necessary to improve maternal and fetal prognosis. Here a case is reported where a patient with diagnosis of TA, complicated by neurological sequelae, successfully fought the vagaries of the condition twice to deliver uneventfully. Case. 25-year-old G2P1L1 presented at 34 weeks of gestation, with chronic hypertension, with TA, with epilepsy, and with late-onset severe IUGR. Following a multidisciplinary approach, she delivered an alive born low birth weight baby (following induction. Her postpartum course remained uneventful. Conclusion. Pregnancy with TA poses a stringent challenge to an obstetrician. Despite advancements in cardiovascular management and advent of new-fangled drugs, the optimal management for pregnant patients with this disease still remains elusive.

  5. 马动脉炎病毒分子生物学研究进展%Molecular Biological Progression of Equine Arteritis Virus

    Institute of Scientific and Technical Information of China (English)

    韦祖樟; 袁世山

    2008-01-01

    马动脉炎病毒(Equine Arteritis virus,EAV)与猪繁殖与呼吸综合征病毒(Porcine reproductive and respirtory syndrome virus,PRRSV)、鼠乳酸脱氢酶升高症病毒(Lactate dehydrogenase elevating virus,LDV)、以及猴出血热病毒(Simian hemorrhagic fever virus,SHFV)同属于尼多病毒目(Nidovirale)、动脉炎病毒科(Atteriviridae)、动脉炎病毒属(Arterivirus)。

  6. Equine arteritis virus: a new isolate from the presumable first carrier stallion in Argentina and its genetic relationships among the four reported unique Argentinean strains.

    Science.gov (United States)

    Metz, Germán E; Serena, María S; Ocampos, Giselle Martín; Panei, Carlos J; Fernandez, Verónica L; Echeverría, María G

    2008-01-01

    Equine arteritis virus (EAV) was isolated from a testicle of the presumable first stallion infected with EAV in Argentina. This virus isolate (named LT-LP-ARG) was confirmed by GP5-specific PCR and indirect immunofluorescence assays. The PCR product was sequenced, and the phylogenetic analysis revealed that the LT-LP-ARG strain of EAV forms a monophyletic group, together with other strains previously isolated in our laboratory (LP02 group). However, all Argentinean EAV strains belong to a polyphyletic group. We believe that the virus isolate presented in this report could be the origin of EAV infection in our country.

  7. Comportamento da musculatura das arteríolas intra-hepáticas na forma hepatesplênica da esquistossomose mansônica

    Directory of Open Access Journals (Sweden)

    Maria do Socorro Almeida Barbosa

    1988-03-01

    Full Text Available A determinação da relação parede-lume das arteríolas intra-hepáticas, na esquistossomose mansônica (forma hepatesplênica, demonstra a existência de uma hipotrofia da camada muscular daqueles vasos. Esse achado sugere redução do fluxo sangüíneo arterial hepático nessa entidade.The determination of the wall-to-lumen ratio of hepatic arterioles in hepatosplenic schistosomiasis shows atrophy of the muscular layer of those vessels. This finding suggests a reduction of hepatic arterial flow as reported by others.

  8. Consecuencias clínicas de la persistencia de actividad inflamatoria en la arteritis de células gigantes. Estudio de factores implicados

    OpenAIRE

    García Martínez, Ana

    2010-01-01

    La arteritis de células gigantes (ACG) afecta arterias de mediano y gran calibre. La inflamación de la carótida y sus ramas da lugar a los síntomas craneales típicos de la enfermedad. Las lesiones inflamatorias expresan gran cantidad de mediadores que provocan la muerte celular y la destrucción de fibras elásticas. El remodelado de la pared arterial puede dar lugar a alteraciones estructurales vasculares, como la aparición de estenosis arteriales que producen síntomas isquémicos o el desarrol...

  9. Effects of glucocorticoids and tumor necrosis factor-alpha inhibitors on both clinical and molecular parameters in patients with Takayasu arteritis

    Directory of Open Access Journals (Sweden)

    Raffaele Serra

    2014-01-01

    Full Text Available Objective: To explore the effect of sequential treatment with glucocorticoid and tumor necrosis factor-alpha inhibitors in patients with Takayasu arteritis (TA. Materials and Methods: In five patients with TA, the effects of the sequential treatment with prednisone for 5-7 months and then with adalimumab (ADA + methotrexate (MTX or infliximab + MTX, or with ADA only, for 12 months on both clinical and laboratory findings were evaluated. Results: All treatments improved both symptoms and laboratory parameters without the development of side-effects. Conclusions: It was hypothesized that MMP-9 and neutrophil gelatinase-associated lipocalin could be markers of the response to the treatments.

  10. In vivo assessment of equine arteritis virus vaccine improvement by disabling the deubiquitinase activity of papain-like protease 2.

    Science.gov (United States)

    van Kasteren, Puck B; Knaap, Robert C M; van den Elzen, Paul; Snijder, Eric J; Balasuriya, Udeni B R; van den Born, Erwin; Kikkert, Marjolein

    2015-07-09

    Arteriviruses are a family of positive-stranded RNA viruses that includes the prototypic equine arteritis virus (EAV) and porcine reproductive and respiratory syndrome virus (PRRSV). Although several vaccines against these viruses are commercially available there is room for improvement, especially in the case of PRRSV. The ability of arteriviruses to counteract the immune response is thought to decrease the efficacy of the current modified live virus vaccines. We have recently shown that the deubiquitinase (DUB) activity of EAV papain-like protease 2 (PLP2) is important for the inhibition of innate immune activation during infection. A vaccine virus lacking PLP2 DUB activity may therefore be more immunogenic and provide improved protection against subsequent challenge than its DUB-competent counterpart. To test this hypothesis, twenty Shetland mares were randomly assigned to one of three groups. Two groups were vaccinated, either with DUB-positive (n=9) or DUB-negative (n=9) recombinant EAV. The third group (n=2) was not vaccinated. All horses were subsequently challenged with the virulent KY84 strain of EAV. Both vaccine viruses proved to be replication competent in vivo. In addition, the DUB-negative virus provided a similar degree of protection against clinical disease as its DUB-positive parental counterpart. Owing to the already high level of protection provided by the parental virus, a possible improvement due to inactivation of PLP2 DUB activity could not be detected under these experimental conditions. Taken together, the data obtained in this study warrant further in vivo investigations into the potential of using DUB-mutant viruses for the improvement of arterivirus vaccines.

  11. Coexisting Crohn’s Disease and Takayasu’s Arteritis in Two Patients Treated with Anti-TNF-α Therapies

    Directory of Open Access Journals (Sweden)

    S. Ratuapli

    2010-02-01

    Full Text Available Crohn’s disease (CD and Takayasu’s arteritis (TA are inflammatory granulomatous autoimmune disorders. Simultaneous occurrence of CD and TA in the same individual is rare. We report two cases treated with biologic agents. Case 1: A 16-year-old male presented with abdominal pain, nausea, vomiting. CT angiogram showed thickening of the terminal ileum, wall thickening and narrowing of multiple large and medium arteries including aorta and left common carotid. Colonoscopy with biopsy of the stenotic ileocecal valve confirmed CD. Resected carotid artery pathology was consistent with TA. Treatment was initially begun with prednisone, then methotrexate was started followed by infliximab. Due to side effects, methotrexate was switched to azathioprine. He remained asymptomatic. Case 2: A 38-year-old male with well-characterized Crohn’s ileocolitis for 15 years, who had been treated with prednisone, mesalamine, sulfasalazine, and azathioprine presented with chest, upper back and abdominal pain. CT angiogram showed vasculitis of large and medium arteries, with stenosis of the right renal artery, and wall thickening of the sigmoid colon. He was diagnosed with TA. He underwent treatment with infliximab and adalumimab on different occasions, which were later discontinued due to fever, bacteremia and complications from sepsis. He remained on prednisone and azathioprine. In these two patients with both CD and TA the diagnoses were confirmed by imaging and pathologic findings. Both patients developed vascular complications. Tumor necrosis factor inhibitor therapy was effective in one patient but discontinued in the other due to infection. Further research into the association of CD and TA may provide clues to their etiologies and guide effective interventions.

  12. Leflunomide as a Corticosteroid-Sparing Agent in Giant Cell Arteritis and Polymyalgia Rheumatica: A Case Series

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    Andreas P. Diamantopoulos

    2013-01-01

    Full Text Available Objectives. Giant cell arteritis (GCA and polymyalgia rheumatica (PMR affect individuals older than 50 years of age and corticosteroids are the mainstay of treatment. The aim of our study was to explore the role of leflunomide as a corticosteroid-sparing agent in GCA and PMR patients. Methods. Patients with difficult-to-treat GCA and PMR were retrospectively identified in the period from 2010 to 2013. The doses of corticosteroids and CRP values were noted before, after three months, and at the end of the treatment with leflunomide (for patients continuing treatment, censoring date was January 1, 2013. Results. Twenty-three patients were identified (12 with PMR and 11 with GCA. A reduction of 6 mg/dL (CI 95% –10.9–34.2, P=0.05 in CRP and 3.7 mg (CI 95% 0.5–7.0, P=0.03 in prednisolone dose was observed in the PMR group. In GCA patients, the reduction was 12.4 mg/dL (CI 95% 0.7–25.5, P=0.06 in CRP and 6.6 mg (CI 95% 2.8–10.3, P<0.01 in prednisolone dose. Conclusion. Leflunomide seems to be effective as a corticosteroid-sparing agent in patients with difficult-to-treat GCA and PMR. Randomized controlled trials are warranted in order to confirm the usefulness of leflunomide in the therapy of GCA/PMR.

  13. Estimating the incidence of equine viral arteritis and the sensitivity of its surveillance in the French breeding stock.

    Science.gov (United States)

    Amat, J P; Vergne, T; Tapprest, J; Ferry, B; Hans, A; Hendrikx, P; Dufour, B; Leblond, A

    2016-08-30

    Equine viral arteritis (EVA) may have serious economic impact on the equine industry. For this reason, it is monitored in many countries, especially in breeding stock, to avoid its spread during breeding activities. In France, surveillance is mainly based on serological tests, since mares are not vaccinated, but difficulties in interpreting certain series of results may impair the estimation of the number of outbreaks. In this study, we propose specific rules for identifying seroconversion in order to estimate the number of outbreaks that were detected by the breeding stock surveillance component (BSSC) in France between 2006 and 2013. A consensus among multidisciplinary experts was reached to consider seroconversion as a change in antibody titer from negative to at least 32, or as an eight-fold or greater increase in antibody level. Using these rules, 239 cases and 177 outbreaks were identified. Subsequently, we calculated the BSSC's sensitivity as the ratio of the number of detected outbreaks to the total number of outbreaks that occurred in breeding stock (including unreported outbreaks) estimated using a capture-recapture model. The total number of outbreaks was estimated at 215 (95% credible interval 195-249) and the surveillance sensitivity at 82% (CrI95% 71-91). Our results confirm EVA circulation in French breeding stock, show that neutralizing antibodies can persist up to eight years in naturally infected mares and suggest that certain mares have been reinfected. This study shows that the sensitivity of the BSSC is relatively high and supports its relevance to prevent the disease spreading through mating.

  14. MRI displays involvement of the temporalis muscle and the deep temporal artery in patients with giant cell arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Veldhoen, Simon; Bley, Thorsten A. [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Klink, Thorsten [Inselspital - University Medical Center Bern, Department of Diagnostic, Interventional and Pediatric Radiology, Bern (Switzerland); Geiger, Julia [University Medical Center Freiburg, Department of Diagnostic and Interventional Radiology, Freiburg (Germany); University Children' s Hospital Zuerich, Division of Radiology, Zuerich (Switzerland); Vaith, Peter; Glaser, Cornelia [University Medical Center Freiburg, Department of Rheumatology and Immunology, Freiburg (Germany); Ness, Thomas [University Medical Center Freiburg, Department of Ophthalmology, Freiburg (Germany); Duwendag, Dirk [University Medical Center Kiel, Department of Ophthalmology, Kiel (Germany); Both, Marcus [University Medical Center Kiel, Department of Diagnostic and Interventional Radiology, Kiel (Germany)

    2014-11-15

    To assess deep temporal artery and temporalis muscle involvement in patients with giant cell arteritis (GCA). Ninety-nine patients who received magnetic resonance imaging (MRI) and superficial temporal artery biopsy (TAB) were included in this study. Patients with positive TAB (n = 61) were defined as GCA patients, those with negative TAB (n = 38) as the GCA-negative reference group. Contrast-enhanced T1w-images were acquired utilizing 1.5 T and 3 T MRI. Two radiologists assessed the images. Mural contrast-hyperenhancement and wall thickening of the deep temporal artery and hyperenhancement of the muscle were defined as inflammation. MRI results were correlated with jaw claudication in 70 patients. The two observers found temporalis muscle involvement in 19.7 % (n = 12) and 21.3 % (n = 13) of GCA patients. It occurred bilaterally in 100 %. Specificities were 92/97 % and sensitivities were 20/21 %. Deep temporal artery involvement was found in 34.4 % (n = 21) and 49.2 % (n = 30) and occurred bilaterally in 80/90.5 %. Specificities were 84/95 % and sensitivities were 34/49 %. Both structures were affected simultaneously in 18/21.3 %. Jaw claudication correlated moderately with inflammation of the temporalis muscle (r = 0.31; p < 0.05) and the deep temporal artery (r = 0.38; p = 0.01). MRI visualizes changes in the temporalis muscle and the deep temporal artery in GCA. Moderate correlation of clinical symptoms with MRI results was observed. circle Approximately 20 % of GCA patients presented with temporalis muscle inflammation. (orig.)

  15. Color Doppler imaging features in patients presenting central retinal artery occlusion with and without giant cell arteritis

    Directory of Open Access Journals (Sweden)

    Catalin Jianu Dragos

    2016-01-01

    Full Text Available Introduction. Central retinal artery obstruction (CRAO represents an abrupt diminution of blood flow through the CRA that is severe enough to cause ischemia of the inner retina with permanent unilateral visual loss. We presented the role of color Doppler imaging (CDI of orbital vessels and of extracranial duplex sonography (EDS in the etiological diagnosis of CRAO in two patients with clinical suspicion of unilateral CRAO. Case report. Patients were examined following the protocol which included CDI of orbital vessels and EDS. Both patients had no emboli visible on ophthalmoscopy. The B-scan ultrasound evaluation of the first patient found a small round, moderately reflective echo within the right optic nerve, 1.5 mm behind the optic disc (emboli of cholesterol. CDI of retrobulbar vessels revealed the normal right ophthalmic artery (OA hemodynamic parameters, but the first patient had no arterial flow signal on CDI at the distance of 1.5 mm behind the right optic disc. In contrast, the left eye had the normal aspect on CDI of retrobulbar vessels. The right internal carotid artery EDS identified a severe stenosis at its origin as CRA’s emboli source. The second patient had characteristic CDI findings for giant cell arteritis (GCA with eye involvement: severe diminished blood flow velocities, especially end-diastolic velocities, in both CRAs. Less abnormalities were observed in the posterior ciliary arteries, and in the ophthalmic arteries. The second patient had no systemic symptoms or signs of GCA. Conclusion. In the presented cases, the ultrasound investigation enabled prompt differentiation between central retinal artery occlusion of embolic mechanism and CRAO caused by GCA.

  16. Color duplex ultrasonography of temporal arteries: role in diagnosis and follow-up of suspected cases of temporal arteritis.

    Science.gov (United States)

    Habib, Hisham M; Essa, Ashraf A; Hassan, Ayman A

    2012-02-01

    The objectives of this study are to study the diagnostic value of color duplex ultrasonography (CDU) compared with the clinical results and temporal artery biopsy (TAB) in patients with suspected temporal arteritis (TA) and evaluate the prognostic value of CDU in follow-up of patients of sure diagnosis of TA under treatment in correlation to clinical response. The study included 32 consecutive patients of clinically suspected TA, and 30 age- and gender-matched control subjects. Baseline clinical characteristics and bilateral CDU of temporal arteries were performed to all subjects. CDU aimed to assess presence of a dark halo around the arterial lumen (a halo sign) or presence of stenoses and occlusions of temporal arteries. Unilateral TAB was performed then in all patients but not in control subjects. Subsequent CDU examinations were performed at 2, 4, 8, and 12 weeks after onset of treatment in patients with abnormal CDU. A halo sign at baseline CDU was evident in 13 TA patients (81%) and in 2 non-TA patients (12%) but none in control subjects. The presence of a halo sign in total yielded 81% sensitivity and 88% specificity whereas the presence of bilateral halo sign yielded 37% sensitivity and 100% specificity. Subsequent CDU examinations of TA patients showed disappearance of a halo sign in nine patients at 2 weeks and in four patients at 4 weeks with a mean of disappearance of 21 days after initiation of treatment. CDU is non-invasive, easy, and inexpensive method for diagnosis of TA. It is of higher sensitivity and specificity. It can be used in combination with clinical and laboratory tools for diagnosis of TA. It can effectively predict which patient will need TAB. In patients with bilateral halo sign, TAB is not necessary.

  17. Anesthesia management of caesarean section for pregnant women complicated with Takayasu’s arteritis%合并大动脉炎产妇行剖宫产术的围术期管理

    Institute of Scientific and Technical Information of China (English)

    孙杰; 曾鸿; 王永清; 赵扬玉

    2016-01-01

    SUMMARY Takayasu’s arteritis is a rare,idiopathic,chronic inflammatory disease.Its course is un-predictable,but slow progression is usual,leading to stenosis,occlusion,or aneurismal degeneration of the aorta or its major branches.We present the anesthesia management of pregnancy in four women ad-mitted to Peking University Third Hospital for caesarean section from year 2006 to 2015 complicated with Takayasu’s arteritis and review this disease with special reference to natural history,diagnostic criteria, classification,prognostic factors,and anesthesia considerations.Anesthesiological data were retrospec-tively analyzed for clinical manifestations,anesthesia process,perioperative complications,and pregnan-cy outcome.One patient received only epidural anesthesia,while the other three patients received com-bined spinal and epidural anesthesia (CSEA).Surgeries for all the four patients were successful with sta-ble vital signs.We found comprehensive examinations including whether the disease was in the active phase and the clinical classification of the disease before conception was recommended for patients diag-nosed with Takayasu’s arteritis.CSEA and continuous epidural block could be both used as anesthesio-logical method in patients with Takayasu’s arteritis.During the surgery,to avoid rapid hemodynamic fluctuations and protect the major organs’function is very essential to allow for a satisfactory outcome.

  18. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: Overall methodology and clinical characterisation

    DEFF Research Database (Denmark)

    Ruperto, Nicolino; Ozen, Seza; Pistorio, Angela;

    2010-01-01

    To report methodology and overall clinical, laboratory and radiographic characteristics for Henoch-Schönlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA) classification criteria....

  19. Third cranial nerve palsy (ptosis, diplopia accompanied by orbital swelling: case report of unusual clinical presentation of giant cell arteritis associated with polymyalgia rheumatica

    Directory of Open Access Journals (Sweden)

    Prassede Bravi

    2012-12-01

    Full Text Available IntroductionGiant cell arteritis (GCA is the most common systemic vasculitis in older individuals, characterized by granulomatosus inflammation of the wall of large and medium-sized arteries. The wide spectrum of arterial sites involved leads to ischemia of different organs resulting in a wide range of clinical signs and symptoms. Temporal artery is commonly involved (temporal arteritis. Unusual patterns of presentation, such as extraocular motility disorders and orbital swelling, may be early and transient manifestations of GCA and precede the permanent visual loss due to ischemic optic neuropathy.Case reportWe describe a patient with uncommon manifestations of GCA consisting of transient recurrent diplopia, ptosis, orbital swelling together with more typical clinical features of the disease such as musculoskeletal manifestations (polymyalgia rheumatica and facial pain: all signs and symptoms promptly resolved under corticosteroid therapy without relapse.Conclusions A high level of suspicion of GCA in individuals over the age of 50 years is needed to prevent the development of severe complications. Clinicians should be aware of uncommon manifestations of the disease such as head–neck swelling and ophthalmoplegia: management guidelines have stated that prompt administration of adequate dose of corticosteroids as soon as ocular manifestations of GCA are noted may almost totally prevent blindness.

  20. A survey for antibodies to equine arteritis virus in donkeys, mules and zebra using virus neutralisation (VN) and enzyme linked immunosorbent assay (ELISA).

    Science.gov (United States)

    Paweska, J T; Binns, M M; Woods, P S; Chirnside, E D

    1997-01-01

    A seroepidemiological survey of donkeys in South Africa (n = 4300) indicated a wide distribution and increasing prevalence of antibodies to equine arteritis virus (EAV). Donkey sera inhibited equine arteritis virus infection in virus neutralisation (VN) tests and in ELISA specifically bound to a recombinant antigen derived from the Bucyrus isolate of EAV. These results suggest that donkeys have been exposed to the same serotype of this virus as circulates among horses. A good correlation existed between EAV neutralising antibody titres and ELISA absorbance values (0.8631); the ELISA was sensitive and specific (99.2% and 80.3% respectively) for donkey sera when compared to the VN test and the recombinant ELISA antigen did not cross-react with sera positive for common African equine pathogens. VN+ ELISA+ donkeys were also found in Morocco and Zimbabwe and seropositive mules in both South Africa and Morocco. No seropositive zebra (n = 266) were detected from game reserves or zoos in 9 countries. The results confirm that in addition to horses and donkeys, mules are naturally infected with EAV.

  1. No evidence of parvovirus B19, Chlamydia pneumoniae or human herpes virus infection in temporal artery biopsies in patients with giant cell arteritis

    DEFF Research Database (Denmark)

    Helweg-Larsen, J; Tarp, B; Obel, N;

    2002-01-01

    conditions. DNA was extracted from frozen biopsies and PCR was used to amplify genes from Chlamydia pneumoniae, parvovirus B19 and each of the eight human herpes viruses: herpes simplex viruses HSV-1 and 2, Epstein-Barr virus, cytomegalovirus, varicella zoster virus and human herpes viruses HHV-6, -7 and -8......OBJECTIVES: Recent studies have suggested that infective agents may be involved in the pathogenesis of giant cell arteritis (GCA), in particular Chlamydia pneumoniae and parvovirus B19. We investigated temporal arteries from patients with GCA for these infections as well as human herpes viruses...... using the polymerase chain reaction (PCR). METHODS: Thirty temporal artery biopsies from 30 patients suspected of having GCA within a period of 1 yr were examined. Thirteen patients had classical GCA, two had biopsy-negative GCA, 10 patients had polymyalgia rheumatica and five patients had other...

  2. Polimiosite associada à arterite linfocítica do sistema nervoso central Polymyositis associated with lymphocytic arteritis of the central nervous system

    Directory of Open Access Journals (Sweden)

    Izaias Pereira da Costa

    2010-02-01

    Full Text Available Complicações do Sistema Nervoso Central (SNC raramente são descritas em miopatias inflamatórias idiopáticas. Os autores relatam o caso de uma paciente de 48 anos com diagnóstico de polimiosite com autoanticorpo anti-Jo-1 positivo que, após cinco anos de evolução, apresentou extensa lesão desmielinizante do SNC associada à arterite linfocítica.Central Nervous System (CNS complications in idiopathic inflammatory myopathies are seldom reported. The authors describe the case of a 48-year old female with polymyositis and positive anti-Jo-1 autoantibody who, after five years of evolution, developed extensive CNS demyelinating injury associated with lymphocytic arteritis.

  3. Giant Cell Arteritis

    Science.gov (United States)

    ... Pharyngitis, Adenitis Syndrome (Juvenile) Polymyalgia Rheumatica Psoriatic Arthritis Raynaud's Phenomenon Reactive Arthritis Rheumatoid Arthritis Scleroderma Sjogren's Syndrome Spinal Stenosis Spondyloarthritis Systemic Lupus Erythematosus (Juvenile) Takayasu's ...

  4. 大动脉炎的介入及外科治疗%The surgical and interventional treatment for Takayasu's arteritis

    Institute of Scientific and Technical Information of China (English)

    陈兵; 汪忠镐; 俞恒锡; 张建; 李建新; 谷涌泉; 齐立行; 齐一侠; 黄莹; 董宗俊

    2011-01-01

    Objective To evaluate vascular surgery and interventional technique applied in Takayasu's arteritis. Methods Data of 26 patients of Takayasu's arteritis admitted between January 2006 and December 2009 were retrospectively analyzed. The sex ratio(M/F) was 1: 4. 2, age averaged at (27±15)y. There were 16 cases of type Ⅰ , 7 cases of type Ⅱ and 3 cases of type Ⅲ according to Lupi-Herrera classification. 25 patients received surgery including 16 patients undergoing pecutaneous transluminal angioplasty operations, 9 patients doing traditional bypass surgery, and one patient was treated conservatively. Results 23 case-times of percutaneous transluminal angioplasty (PTA) were performed in 16 patients, including 12 cases of balloon angioplasty and 4 cases of stent angioplasty. Four significantly stenotic and occluded carotid arteries were revascularized successfully in 5 patients. Thrombosis of the carotid artery was found in one patient after balloon angioplasty. There were 4 patients in which repeated PTA treatment up to a total of 11 times were needed to guarantee vessel patency. Open surgery succeeded in 9 patients, and clinical symptoms were relieved in all cases during peri-operative period. 22 patients were followed up for 12 -46 months,one patient died of cerebral hemorrhage 3 months post-operation, one patient was found pseudoaneurysm at anastomotic stoma, and 2 patients suffered from anastomotic restenosis.Conclusions Vascular surgery played important role in the therapy of Takayasu's arteritis. PTA can be used repeatedly. Surgical bypass operation is difficult in technology, and can be used in cases that fail to response to PTA or in patients with severe cerebral ischemia.%目的 探讨介入技术和外科手术在大动脉炎治疗中的应用.方法 2006年1月至2009年12月共收治大动脉炎26例,男女比例为1:4.2,平均年龄(27±15)岁;Lupi-Herre法分型,Ⅰ型16例,Ⅱ型7例,Ⅲ型3例.16例患者实施介入治疗,9例行开放手术,1

  5. Value of multi-detector CT angiography in Takayasu arteritis%多排螺旋CT对多发性大动脉炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    陈海雄; 胡秋根; 李景雷

    2014-01-01

    目的 探讨多排螺旋CT(MDCT)在多发性大动脉炎中的诊断价值。方法 回顾性分析32 例经临床确诊为大动脉炎患者的MDCT 资料及实验室检查,图像后处理方法包括多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积再现(VR),实验室检查主要包括红细胞沉降率(ESR)和C 反应蛋白(CRP)。结果 按照Lupi-Herrea 分类法,Ⅰ型10 例,Ⅱ型9 例,Ⅲ型8 例,Ⅳ型5 例;共累及血管134 支,狭窄- 阻塞型112 支;扩张型8 支;混合型14 支。受累血管管壁最大厚度范围为1.3~8.6 mm(平均3.65±1.58),活动期管壁最大厚度约2.7~8.6 mm(平均5.24±1.59),明显大于非活动期1.3~6.0 mm (平均2.93±0.92)(P<0.05)。增强扫描活动期管壁强化8 例(80.0%),非活动期管壁轻度强化2 例(9.0%),非活动期管壁钙化 7 例(31.8%)。结论 MDCT 能准确判断多发性大动脉炎的分型、分期及病变范围,可作为其首选检查方法。%ObjectiveTo investigate the clinical value of multi-detector computed tomography(MDCT)in the diagnosis of Takayasu's arteritis.Methods MDCT, erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels of 32 patients with Takayasu’s arteritis were analyzed retrospectively. Image processing included multi-planar reformation(MPR), maximum intensity projection (MIP), and volume rendering reconstruction(VR).Results The patients were classified Lupi-Herrea type I(10), type II(9), type III(8) and type IV(5). Of 134 abnormal vessels, 112 were stenotic or occlusive, 8 were dilated and 14 were mixed. The vessel wall thickness was 1.3-8.6 mm(average 3.65±1.58 mm)with significantly(P<0.05)thicker walls in the active phase(2.7-8.6 mm)than that in the resting phase(1.3-6.0 mm). There was heterogeneous contrast enhancement of the vessel walls in the active phase(80.0%), mild enhancement(9.0%)and calcification (31.8%)in the resting

  6. Arterite de Takayasu e doença de Crohn: uma associação incomum Takayasu's arteritis and Crohn's disease: an unusual association

    Directory of Open Access Journals (Sweden)

    Clóvis Konopka

    2009-12-01

    Full Text Available A arterite de Takayasu e a doença de Crohn são doenças inflamatórias com etiologia desconhecida. Raramente ocorrem de modo concomitante em um mesmo indivíduo, havendo menos de 30 casos relatados na literatura. Este trabalho descreve essa associação em uma paciente de 36 anos de idade portadora de doença de Crohn, que apresentou redução dos pulsos no membro superior esquerdo e pressão arterial de 60/40 mmHg. A angiotomografia evidenciou estenose segmentar de artéria subclávia esquerda e espessamento parietal circunferencial da aorta na transição toracoabdominal entre T10 e L1, estabelecendo o diagnóstico de arterite de Takayasu. Ambas as patologias são mediadas imunologicamente e apresentam granulomas e vasculite granulomatosa, o que contribui para reforçar a hipótese de uma origem imunológica comum no seu desenvolvimento. Acreditamos que este seja o primeiro caso relatado na literatura brasileira da presença concomitante destas duas enfermidades.Takayasu's arteritis and Crohn's disease are chronic inflammatory diseases with unknown etiology. They rarely occur together in the same individual, with less than 30 cases reported in the literature. This case report describes this association in a 36-year-old woman with Crohn’s disease and weak pulses in her left arm with blood pressure of 60/40 mmHg. Angiotomography showed segmental stenosis in the left subclavian artery and circumferential thickening of the aortic wall between T10 and L1, establishing the diagnosis of Takayasu's arteritis. Both are organ-specific and immune-mediated diseases and exhibit granulomas and granulomatous vasculitis, which contribute to reinforce the hypothesis of a common immunologic origin. We believe that this is the first case of concomitant presence of these two diseases reported in the Brazilian literature.

  7. Anestesia peridural contínua para cesariana em paciente com arterite de Takayasu: relato de caso Anestesia peridural continua para cesárea en paciente con arteritis de Takayasu: relato de caso Continuous epidural anesthesia for cesarean section in a patient with Takayasu’s arteritis: case report

    Directory of Open Access Journals (Sweden)

    Aloísio Cerqueira Buettel

    2002-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Anestesia peridural contínua com titulação das doses de anestésico local proporciona eficácia e segurança em pacientes que não toleram flutuações da pressão arterial. O objetivo deste relato é apresentar um caso em que foi utilizada com sucesso anestesia peridural contínua para cesariana em paciente com arterite de Takayasu. RELATO DO CASO: Paciente primigesta, 25 anos, 63 kg, portadora de arterite de Takayasu, com 34-35 semanas de gestação, apresentando sofrimento fetal agudo, PA de 155/85 mmHg, FC de 92 bpm, com ausência de pulsos carotídeos, assim como nos membros superiores e do membro inferior direito. Apresentava apenas pulso poplíteo esquerdo palpável. Foi realizado bloqueio peridural contínuo com doses fracionadas de 25 mg de bupivacaína a 0,5% com epinefrina (1:200.000, a intervalos de 5 em 5 minutos até um total de 100 mg, associando-se 2 mg de morfina e 100 µg de fentanil. CONCLUSÕES: A anestesia peridural contínua com doses tituladas de bupivacaína a 0,5% com epinefrina pode ser utilizada em pacientes com Arterite de Takayasu, tomando-se as medidas de precaução com portadoras dessa doença.JUSTIFICATIVA Y OBJETIVOS: Anestesia peridural continua con titulación de las dosis de anestésico local proporciona eficacia y seguridad en pacientes que no toleran flutuaciones de la presión arterial. El objetivo de este relato es presentar un caso en que fue utilizado con suceso anestesia peridural continua para cesárea en paciente con arteritis de Takayasu. RELATO DEL CASO: Paciente primigesta, 25 años, 63 kg, portadora de Arteritis de Takayasu, con 34-35 semanas de gestación, presentando sufrimiento fetal agudo, PA de 155/85 mmHg, FC de 92 bpm, con ausencia de pulsos carotídeos, así como en los miembros superiores y del miembro inferior derecho. Presentaba apenas pulso poplíteo izquierdo palpable. Fue realizado bloqueo peridural continuo con dosis fraccionadas de 25 mg de bupivaca

  8. Koroner arter hastalığının teşhis ve tedavisi amacıyla anjioplasti geçiren hastalarda periodontal hastalıkla ilişkili risk faktörlerinin değerlendirilmesi

    OpenAIRE

    BİLGİN, Mehtap

    2011-01-01

    Araştırmamız, Türk populasyonunda anjiografi ile koroner arter hastalığı tespit edilen hastalarda periodontal durum ve koroner arter hastalığı arasındaki ilişkiyi değerlendirmek amacıyla planlanmıştır.Araştırmamıza İbni Sina Hastanesi Kardiyoloji bölümünde koroner arter hastalığı riski taşıyıp koroner anjiyografiye giren 309 hasta dahil edilmiştir. Tüm hastaların periodontal ve radyolojik değerlendirilmesi yapılmıştır. Klinik değerlendirme amacıyla PI, GI, CD, SK değerler...

  9. Late diagnosis of Takayasu's arteritis with repeated attacks of heart failure and uncontrolled hypertension due to abdominal aortic thrombosis: case report and review of the literature.

    Science.gov (United States)

    Wang, Huan; Lai, Baochun; Wu, Xiaoying; Han, Tao; Chen, Hui

    2015-01-01

    Takayasu's arteritis (TA) is a chronic, idiopathic, inflammatory disease affecting the aorta and its branches. To date, only one case involving abdominal aortic thrombosis due to TA has been reported. After bilateral artificial subclavian-iliac bypass, a case of abdominal aortic thrombosis due to TA received a delayed diagnosis in a 44-year-old Chinese male who experienced recurrent episodes of heart failure and uncontrolled hypertension with claudication of two extremities. Abdominal color Doppler sonography and computed tomography aortography (CTA) showed occlusion of the abdominal aorta and bilateral renal artery stenosis. After vascular bypass and during 1 year follow-up, his cardiac function improved and blood pressure was well controlled, with reduced serum creatinine. Postoperative CTA still showed abdominal aortic thrombosis resulting in arterial occlusion extending from the left renal artery initial segment level to the bilateral common iliac artery and the bifurcation of the renal artery, except for the vascular bypass. Abdominal aortic thrombosis due to TA is very rare and potentially life threatening, probably becoming an atherosclerosis risk factor. Doppler sonography and CTA results are important for diagnosis. Artificial vascular bypass can be used for TA in debilitated patients with diffuse aortic disease.

  10. Development and characterization of an infectious cDNA clone of the modified live virus vaccine strain of equine arteritis virus.

    Science.gov (United States)

    Zhang, Jianqiang; Go, Yun Young; Huang, Chengjin M; Meade, Barry J; Lu, Zhengchun; Snijder, Eric J; Timoney, Peter J; Balasuriya, Udeni B R

    2012-08-01

    A stable full-length cDNA clone of the modified live virus (MLV) vaccine strain of equine arteritis virus (EAV) was developed. RNA transcripts generated from this plasmid (pEAVrMLV) were infectious upon transfection into mammalian cells, and the resultant recombinant virus (rMLV) had 100% nucleotide identity to the parental MLV vaccine strain of EAV. A single silent nucleotide substitution was introduced into the nucleocapsid gene (pEAVrMLVB), enabling the cloned vaccine virus (rMLVB) to be distinguished from parental MLV vaccine as well as other field and laboratory strains of EAV by using an allelic discrimination real-time reverse transcription (RT)-PCR assay. In vitro studies revealed that the cloned vaccine virus rMLVB and the parental MLV vaccine virus had identical growth kinetics and plaque morphologies in equine endothelial cells. In vivo studies confirmed that the cloned vaccine virus was very safe and induced high titers of neutralizing antibodies against EAV in experimentally immunized horses. When challenged with the heterologous EAV KY84 strain, the rMLVB vaccine virus protected immunized horses in regard to reducing the magnitude and duration of viremia and virus shedding but did not suppress the development of signs of EVA, although these were reduced in clinical severity. The vaccine clone pEAVrMLVB could be further manipulated to improve the vaccine efficacy as well as to develop a marker vaccine for serological differentiation of EAV naturally infected from vaccinated animals.

  11. Evaluation of a 32-channel versus a 12-channel head coil for high-resolution post-contrast MRI in giant cell arteritis (GCA) at 3T.

    Science.gov (United States)

    Franke, Philipp; Markl, Michael; Heinzelmann, Sonja; Vaith, Peter; Bürk, Jonas; Langer, Mathias; Geiger, J

    2014-10-01

    The aim of this study was to evaluate the diagnostic value of a 32-channel head coil for the characterization of mural inflammation patterns in the superficial cranial arteries in patients with giant cell arteritis (GCA) compared to a standard 12-channel coil at 3T MRI. 55 patients with suspected GCA underwent high resolution T1-weighted post-contrast MRI at 3T to detect inflammation related vessel wall enhancement using both coils. To account for different time delays between contrast agent injection and sequence acquisition, the patients were divided into two cohorts: 27 patients were examined with the 32-channel coil first and 28 patients with the 12-channel coil first. Images were evaluated by two blinded readers with regard to image quality, artifact level and arteries' inflammation according to a standardized ranking scale; furthermore signal-to-noise ratio (SNR) measurements were performed at three locations. Identification of arteries' inflammation was achieved with both coils with excellent inter-observer agreement (κ=0.89 for 12-channel and κ=0.96 for 32-channel coil). Regarding image grading, the inter-observer variability was moderate for the 12-channel (κ=0.5) and substantial for the 32-channel coil (κ=0.63). Significantly higher SNR and improved image quality (pcoil in either coil order. Image quality for depiction of the superficial cranial arteries was superior for the 32-channel coil. For standardized GCA diagnosis, the 12-channel coil was sufficient.

  12. Analysis of ORFs 2b, 3, 4, and partial ORF5 of sequential isolates of equine arteritis virus shows genetic variation following experimental infection of horses.

    Science.gov (United States)

    Liu, Lihong; Castillo-Olivares, Javier; Davis-Poynter, Nick J; Baule, Claudia; Xia, Hongyan; Belák, Sándor

    2008-06-22

    Samples from horses experimentally infected with the "large plaque variant (LP3A+)" of equine arteritis virus were analysed. These included 182 nasal swabs collected from day 1 to 14 post-infection (p.i.), and 21 virus isolates obtained from white blood cells of animals that showed a prolonged viraemia between days 30 to 72 p.i. In order to determine the genetic stability of the virus and particularly to characterise the genetic variants found during the prolonged viraemia, partial sequences of open reading frame 5 (ORF5) encoding glycoprotein 5 (GP5) were generated. Viruses with amino acid substitutions in GP5 were used for further amplification and sequencing of a fragment encompassing ORFs 2b, 3, and 4. The ORF5 nucleotide sequences of the virus present in 65 out of 66 nasal swabs were identical to that of the inoculated virus, suggesting that the ORF5 gene of LP3A+ was genetically stable during the first 2 weeks p.i. Contrary to this, a number of mutations were found in the ORF5 of virus isolates obtained from day 30 p.i. The mutations mainly clustered in antigenic neutralization site C within variable region 1 of the GP5 ectodomain. Sequence variability was also identified in ORFs 2b, 3 and 4, with ORF 4 having the highest proportion of non-synonymous changes (4/6).

  13. The angiographic features of cerebral ischemia due to Takayasu arteritis%大动脉炎性脑缺血的脑血管造影特征分析

    Institute of Scientific and Technical Information of China (English)

    刁士元

    2010-01-01

    Objective To explore the angiographic features of c cerebral ischemia due to Takayasu arteritis. Methods The clinical data and angiographic findings of twenty patients with Takayasu rteritis were analyzed retrospectively. Two experienced radiologists read all the angiographic images of the patients with a double-blind method, then discussed together, and finally formed an unanimous interpretation. Results According to the Lupi-Herrera classification, 17 of 20 patients were type Ⅰ and the rest 3 were type Ⅲ on angiograms. The affected arteries mainly included subclavian artery (19 patients), carotid artery (17 patients), vertebral artery (12 patients), and brachiocephalic trunk (6 patients). Conclusions Cerebral angiography can accurately and effectively assess the vascular status in patients with cerebral ischemia due to Takayasu arteritis. It is beneficial in the diagnosis of Takayasu arteritis..%目的 探讨大动脉炎性脑缺血的脑血管造影特征.方法 回顾性分析20例大动脉炎性脑缺血患者的病例资料及脑血管造影结果.脑血管造影资料由有经验的介入放射学医师按盲法对比进行分析,然后共同讨论并达成一致意见.结果 20例中,经血管造影按Lupi-Herrera 综合分型法Ⅰ型17例,Ⅲ型3例.主要受累动脉包括锁骨下动脉19例,颈动脉17例,椎动脉12例,头臂干6例.结论脑血管造影可准确、有效的评估大动脉炎性脑缺血患者的血管情况,有利于大动脉炎的诊断.

  14. Evaluation of a 32-channel versus a 12-channel head coil for high-resolution post-contrast MRI in giant cell arteritis (GCA) at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Franke, Philipp, E-mail: philipp.franke@uniklinik-freiburg.de [Institut für Diagnostische Radiologie, Gartenstr. 28, 79098 Freiburg (Germany); Markl, Michael, E-mail: mmarkl@northwestern.edu [Departments of Radiology and Biomedical Engineering, Northwestern University Chicago, 737 North Michigan Avenue, Suite 1600, Chicago, IL 60611 (United States); Heinzelmann, Sonja, E-mail: sonja.heinzelmann@uniklinik-freiburg.de [Department of Ophthalmology, University Hospital Freiburg, Killianstr. 5, 79106 Freiburg (Germany); Vaith, Peter, E-mail: peter.vaith@uniklinik-freiburg.de [Department of Rheumatology and Immunology, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg (Germany); Bürk, Jonas, E-mail: jonas.buerk@uniklinik-freiburg.de [Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg (Germany); Langer, Mathias, E-mail: mathias.langer@uniklinik-freiburg.de [Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg (Germany); Geiger, J., E-mail: julia.geiger@uniklinik-freiburg.de [Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg (Germany); Department of Radiology, University Children‘s Hospital Zurich, Steinwiesstr. 75, 8032 Zurich (Switzerland)

    2014-10-15

    The aim of this study was to evaluate the diagnostic value of a 32-channel head coil for the characterization of mural inflammation patterns in the superficial cranial arteries in patients with giant cell arteritis (GCA) compared to a standard 12-channel coil at 3 T MRI. 55 patients with suspected GCA underwent high resolution T1-weighted post-contrast MRI at 3 T to detect inflammation related vessel wall enhancement using both coils. To account for different time delays between contrast agent injection and sequence acquisition, the patients were divided into two cohorts: 27 patients were examined with the 32-channel coil first and 28 patients with the 12-channel coil first. Images were evaluated by two blinded readers with regard to image quality, artifact level and arteries’ inflammation according to a standardized ranking scale; furthermore signal-to-noise ratio (SNR) measurements were performed at three locations. Identification of arteries’ inflammation was achieved with both coils with excellent inter-observer agreement (κ = 0.89 for 12-channel and κ = 0.96 for 32-channel coil). Regarding image grading, the inter-observer variability was moderate for the 12-channel (κ = 0.5) and substantial for the 32-channel coil (κ = 0.63). Significantly higher SNR and improved image quality (p < 0.01) were obtained with the 32-channel coil in either coil order. Image quality for depiction of the superficial cranial arteries was superior for the 32-channel coil. For standardized GCA diagnosis, the 12-channel coil was sufficient.

  15. Towards an optimal semiquantitative approach in giant cell arteritis: an {sup 18}F-FDG PET/CT case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Besson, Florent L.; Bouvard, Gerard [CHU Caen, Department of Nuclear Medicine, Caen (France); Boysson, Hubert de; Bienvenu, Boris [CHU Caen, Department of Internal Medicine, Caen (France); Parienti, Jean-Jacques [CHU Caen, Department of Biostatistics, Caen (France); Agostini, Denis [CHU Caen, Department of Nuclear Medicine, Caen (France); University of Caen Lower-Normandy, EA 4650, Caen (France)

    2014-01-15

    Giant cell arteritis (GCA) is the most common form of vasculitis in western countries. {sup 18}F-FDG PET has been shown to be a valuable tool for the diagnosis of extracranial GCA, but results of studies are inconsistent due to a lack of standardized {sup 18}F-FDG PET criteria. In this study, we compared different semiquantitative approaches using a controlled design to define the most efficient method. All patients with biopsy-proven GCA who had undergone an {sup 18}F-FDG PET/CT scan in our PET unit were reviewed and matched with a control group based on age and sex. Different semiquantitative arterial (ascending and descending thoracic aorta and aortic arch) to background (liver, lung and venous blood pool) SUV ratios were blindly compared between GCA patients and matched controls. We included 11 patients with biopsy-proven GCA cases and 11 matched controls. There were no differences between the groups with regard to body weight, injected radioactivity, blood glucose level or CRP. The arterial to venous blood pool ratios discriminated the two groups better than other methods when applied to the aortic arch and the descending thoracic aorta (p < 0.015). In particular, the highest aortic to highest blood pool SUV{sub max} ratio, when applied to the aortic arch, provided optimal diagnostic performance (sensitivity 81.8 %, specificity 91 %, AUC 0.87; p < 0.0001) using a cut-off value of 1.53. Among all tested {sup 18}F-FDG PET/CT methods, the aortic to blood pool SUV{sub max} ratio outperformed the liver and lung ratios. We suggest the use of this ratio for the assessment of aortic inflammation in GCA patients. (orig.)

  16. Tratamento de angina mesentérica em pacientes com arterite de Takayasu Treatment of mesenteric angina in patients with Takayasu's arteritis

    Directory of Open Access Journals (Sweden)

    Luana Thayse Barros de Lima

    2011-04-01

    Full Text Available Aarterite de Takayasu (AT é uma doença inflamatória crônica do tecido conectivo, idiopática, que acomete preferencialmente a aorta e seus ramos. A terapêutica utilizada baseia-se sobretudo no uso de corticosteroides e imunossupressores. É relatado o caso de uma paciente, 33 anos, com mal-estar, febre, mialgia, cefaleia intensa, pulsátil, holocraniana, resistente a analgésicos, hipertensão arterial sistêmica de difícil controle, claudicação no membro inferior direito e dor abdominal de forte intensidade, a qual piorava após a alimentação. A angiotomografia revelou aneurisma da aorta ascendente, estenose da artéria ilíaca comum direita, estenose das artérias renais e estenose da artéria mesentérica superior, fato que embasou o diagnóstico de angina mesentérica e a conduta intervencionista através da angioplastia transluminal percutânea múltipla com a colocação de stents.Takayasu's arteritis (TA is an idiopathic chronic inflammatory disease of the connective tissue that affects mainly the aorta and its branches. Treatment is mainly based on corticosteroids and immunosuppressants. We report the case of a 33-year-old female complaining of malaise, fever, myalgia, severe pulsing holocranial headache resistant to analgesics, systemic arterial hypertension hard to control, right lower limb claudication, and severe abdominal pain that worsened after the meals. Angiotomography revealed aneurysm of the ascending aorta, and stenosis of the following vessels: right common iliac artery, renal arteries, and superior mesenteric artery. Those findings supported the diagnosis of mesenteric angina and the interventional approach by use of percutaneous transluminal angioplasty with stent placement.

  17. A Large-Scale Genetic Analysis Reveals a Strong Contribution of the HLA Class II Region to Giant Cell Arteritis Susceptibility

    Science.gov (United States)

    Carmona, F. David; Mackie, Sarah L.; Martín, Jose-Ezequiel; Taylor, John C.; Vaglio, Augusto; Eyre, Stephen; Bossini-Castillo, Lara; Castañeda, Santos; Cid, Maria C.; Hernández-Rodríguez, José; Prieto-González, Sergio; Solans, Roser; Ramentol-Sintas, Marc; González-Escribano, M. Francisca; Ortiz-Fernández, Lourdes; Morado, Inmaculada C.; Narváez, Javier; Miranda-Filloy, José A.; Martínez-Berriochoa, Agustín; Unzurrunzaga, Ainhoa; Hidalgo-Conde, Ana; Madroñero-Vuelta, Ana B.; Fernández-Nebro, Antonio; Ordóñez-Cañizares, M. Carmen; Escalante, Begoña; Marí-Alfonso, Begoña; Sopeña, Bernardo; Magro, César; Raya, Enrique; Grau, Elena; Román, José A.; de Miguel, Eugenio; López-Longo, F. Javier; Martínez, Lina; Gómez-Vaquero, Carmen; Fernández-Gutiérrez, Benjamín; Rodríguez-Rodríguez, Luis; Díaz-López, J. Bernardino; Caminal-Montero, Luis; Martínez-Zapico, Aleida; Monfort, Jordi; Tío, Laura; Sánchez-Martín, Julio; Alegre-Sancho, Juan J.; Sáez-Comet, Luis; Pérez-Conesa, Mercedes; Corbera-Bellalta, Marc; García-Villanueva, M. Jesús; Fernández-Contreras, M. Encarnación; Sanchez-Pernaute, Olga; Blanco, Ricardo; Ortego-Centeno, Norberto; Ríos-Fernández, Raquel; Callejas, José L.; Fanlo-Mateo, Patricia; Martínez-Taboada, Víctor M.; Beretta, Lorenzo; Lunardi, Claudio; Cimmino, Marco A.; Gianfreda, Davide; Santilli, Daniele; Ramirez, Giuseppe A.; Soriano, Alessandra; Muratore, Francesco; Pazzola, Giulia; Addimanda, Olga; Wijmenga, Cisca; Witte, Torsten; Schirmer, Jan H.; Moosig, Frank; Schönau, Verena; Franke, Andre; Palm, Øyvind; Molberg, Øyvind; Diamantopoulos, Andreas P.; Carette, Simon; Cuthbertson, David; Forbess, Lindsy J.; Hoffman, Gary S.; Khalidi, Nader A.; Koening, Curry L.; Langford, Carol A.; McAlear, Carol A.; Moreland, Larry; Monach, Paul A.; Pagnoux, Christian; Seo, Philip; Spiera, Robert; Sreih, Antoine G.; Warrington, Kenneth J.; Ytterberg, Steven R.; Gregersen, Peter K.; Pease, Colin T.; Gough, Andrew; Green, Michael; Hordon, Lesley; Jarrett, Stephen; Watts, Richard; Levy, Sarah; Patel, Yusuf; Kamath, Sanjeet; Dasgupta, Bhaskar; Worthington, Jane; Koeleman, Bobby P.C.; de Bakker, Paul I.W.; Barrett, Jennifer H.; Salvarani, Carlo; Merkel, Peter A.; González-Gay, Miguel A.; Morgan, Ann W.; Martín, Javier

    2015-01-01

    We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip array. We also imputed HLA data with a previously validated imputation method to perform a more comprehensive analysis of this genomic region. The strongest association signals were observed in the HLA region, with rs477515 representing the highest peak (p = 4.05 × 10−40, OR = 1.73). A multivariate model including class II amino acids of HLA-DRβ1 and HLA-DQα1 and one class I amino acid of HLA-B explained most of the HLA association with GCA, consistent with previously reported associations of classical HLA alleles like HLA-DRB1∗04. An omnibus test on polymorphic amino acid positions highlighted DRβ1 13 (p = 4.08 × 10−43) and HLA-DQα1 47 (p = 4.02 × 10−46), 56, and 76 (both p = 1.84 × 10−45) as relevant positions for disease susceptibility. Outside the HLA region, the most significant loci included PTPN22 (rs2476601, p = 1.73 × 10−6, OR = 1.38), LRRC32 (rs10160518, p = 4.39 × 10−6, OR = 1.20), and REL (rs115674477, p = 1.10 × 10−5, OR = 1.63). Our study provides evidence of a strong contribution of HLA class I and II molecules to susceptibility to GCA. In the non-HLA region, we confirmed a key role for the functional PTPN22 rs2476601 variant and proposed other putative risk loci for GCA involved in Th1, Th17, and Treg cell function. PMID:25817017

  18. Arterite de Takayasu na infância e na adolescência: relato de três casos Takayasu's arteritis in children and adolescents: report of three cases

    Directory of Open Access Journals (Sweden)

    Ana Karina Soares Nascif

    2011-10-01

    Full Text Available A arterite de Takayasu (AT é uma vasculite sistêmica que acomete principalmente a aorta e seus ramos. Apesar de ser a terceira vasculite mais frequente na infância, sua ocorrência na faixa etária pediátrica é pouco descrita. Relatamos três casos de AT na faixa etária pediátrica com ênfase nas manifestações clínicas, alterações angiográficas e abordagem terapêutica.Takayasu's arteritis (TA is a systemic vasculitis that affects mainly the aorta and its major branches. Despite being the third most frequent vasculitis in childhood, the occurrence of TA in the pediatric age group is scarce. We report three cases of TA in children, emphasizing signs and symptoms, angiographic alterations and therapeutics.

  19. Conserved arginine residues in the carboxyl terminus of the equine arteritis virus E protein may play a role in heparin binding but may not affect viral infectivity in equine endothelial cells.

    Science.gov (United States)

    Lu, Zhengchun; Sarkar, Sanjay; Zhang, Jianqiang; Balasuriya, Udeni B R

    2016-04-01

    Equine arteritis virus (EAV), the causative agent of equine viral arteritis, has relatively broad cell tropism in vitro. In horses, EAV primarily replicates in macrophages and endothelial cells of small blood vessels. Until now, neither the cellular receptor(s) nor the mechanism(s) of virus attachment and entry have been determined for this virus. In this study, we investigated the effect of heparin on EAV infection in equine endothelial cells (EECs). Heparin, but not other glycosaminoglycans, could reduce EAV infection up to 93 %. Sequence analysis of the EAV E minor envelope protein revealed a conserved amino acid sequence (52 RSLVARCSRGARYR 65) at the carboxy terminus of the E protein, which was predicted to be the heparin-binding domain. The basic arginine (R) amino acid residues were subsequently mutated to glycine by site-directed mutagenesis of ORF2a in an E protein expression vector and an infectious cDNA clone of EAV. Two single mutations in E (R52G and R57G) did not affect the heparin-binding capability, whereas the E double mutation (R52,60G) completely eliminated the interaction between the E protein and heparin. Although the mutant R52,60G EAV did not bind heparin, the mutations did not completely abolish infectivity, indicating that heparin is not the only critical factor for EAV infection. This also suggested that other viral envelope protein(s) might be involved in attachment through heparin or other cell-surface molecules, and this warrants further investigation.

  20. Development and evaluation of a reverse transcription-insulated isothermal polymerase chain reaction (RT-iiPCR) assay for detection of equine arteritis virus in equine semen and tissue samples using the POCKIT™ system.

    Science.gov (United States)

    Carossino, Mariano; Lee, Pei-Yu A; Nam, Bora; Skillman, Ashley; Shuck, Kathleen M; Timoney, Peter J; Tsai, Yun-Long; Ma, Li-Juan; Chang, Hsiao-Fen G; Wang, Hwa-Tang T; Balasuriya, Udeni B R

    2016-08-01

    Equine arteritis virus (EAV) is the causative agent of equine viral arteritis (EVA), a respiratory and reproductive disease of horses. Most importantly, EAV induces abortion in pregnant mares and can establish persistent infection in up to 10-70% of the infected stallions, which will continue to shed the virus in their semen. The objective of this study was to develop and evaluate a reverse transcription insulated isothermal polymerase chain reaction (RT-iiPCR) for the detection of EAV in semen and tissue samples. The newly developed assay had a limit of detection of 10 RNA copies and a 10-fold higher sensitivity than a previously described real-time RT-PCR (RT-qPCR). Evaluation of 125 semen samples revealed a sensitivity and specificity of 98.46% and 100.00%, respectively for the RT-qPCR assay, and 100.00% and 98.33%, respectively for the RT-iiPCR assay. Both assays had the same accuracy (99.2%, k=0.98) compared to virus isolation. Corresponding values derived from testing various tissue samples (n=122) collected from aborted fetuses, foals, and EAV carrier stallions are as follows: relative sensitivity, specificity, and accuracy of 88.14%, 96.83%, and 92.62% (k=0.85), respectively for the RT-qPCR assay, and 98.31%, 92.06%, and 95.08% (k=0.90), respectively for the RT-iiPCR assay. These results indicate that RT-iiPCR is a sensitive, specific, and a robust test enabling detection of EAV in semen and tissue samples with very considerable accuracy. Even though the RT-qPCR assay showed a sensitivity and specificity equal to virus isolation for semen samples, its diagnostic performance was somewhat limited for tissue samples. Thus, this new RT-iiPCR could be considered as an alternative tool in the implementation of EAV control and prevention strategies.

  1. Arterite de Takayasu: tratamento com anti-TNF em uma casuística brasileira Takayasu arteritis: anti-TNF therapy in a Brazilian setting

    Directory of Open Access Journals (Sweden)

    Guilherme Nunes

    2010-06-01

    Full Text Available O objetivo deste estudo é descrever as características clínicas e as respostas às intervenções terapêuticas, incluindo a terapia antifator de necrose tumoral (TNF, em uma série de casos brasileiros de arterite de Takayasu (AT. Foi realizado um estudo observacional, retrospectivo, com base na revisão de prontuários, incluindo todos os pacientes com AT, de acordo com os critérios de classificação do American College of Rheumatology, em acompanhamento no Serviço de Reumatologia do Hospital Universitário da Universidade Federal de Santa Catarina (UFSC, Brasil. Foram incluídos 15 pacientes, sendo 14 (93,3% mulheres, com idade média ao diagnóstico de 29,6 anos. Hipertensão arterial sistêmica (60,0% e ausência de pulsos em membros superiores (53,3% foram os achados clínicos mais comuns ao diagnóstico. As artérias subclávias e carotídeas foram os vasos mais frequentemente acometidos. Doze pacientes (80,0% não obtiveram remissão sustentada em terapia isolada com corticosteroide, tendo sido empregada terapia imunossupressora, sendo metotrexato, azatioprina e ciclofosfamida as drogas utilizadas. Intervenções cirúrgicas foram necessárias em 53,3% dos casos. Três casos (20,0% foram refratários à terapia com corticoides e imunossupressores e foram tratados com agentes anti-TNF, com subsequente remissão da doença. Em conclusão, observou-se que uma parcela importante dos casos de AT é refratária à terapia tradicional e os agentes anti-TNF podem representar uma opção promissora para o controle da doença nesses casos.The aim of this study was to describe clinical features and response to different therapeutic interventions, including anti-tumor necrosis factor (TNF agents, in a case series of Takayasu arteritis (TA from Brazil. A retrospective observational chart-review study was performed including all patients meeting the American College of Rheumatology TA classification criteria followed at the rheumatology

  2. Retrospective analysis of 25 children with Takayasu's arteritis%儿童多发性大动脉炎25例回顾性分析

    Institute of Scientific and Technical Information of China (English)

    李亚男; 李善玉; 刘丽

    2011-01-01

    Objective To explore the clinical feature of children with Takayasn's arteritis (TA), and to analyze the relevant treatment methods and prognosis. Methods Retrospective analysis was performed on the clinical manifestations of 25 children with TA, and the process of treatment and prognosis. Results In this study, the ratio of male to female was 8 : 17, and the average onset age was ( 10.8 ± 3.0) years old. The most common TA type was 1 (56.0%), and the initial symptoms included headache, convulsions, fatigue, protcinuria, etc. All children had high blood pressure and 19 cases had lo (Tubercle bacillus) injection, 22 cases received cortjcosterojcis, and/or eveiophos-pharnide treatment All patient's condition relieved, but 16 patients had recurrence. Three cases received interventional therapy, no stenosis happened again. Conclusions For children, especially adolescent children with headache and high blood pressure as the main clinical manifestation, the diagnosis of TA should be kept in mind, TA in children is often caused by tuberculosis infection, therefore, early diagnosis and treatment of tuberculosis infection can effectively prevent the occurrence of TA. Drug treatment have a higher recurrence rate, interventional therapy can effectively improve ischemic symptoms.%目的 探讨儿童多发性大动脉炎(TA)的临床特征,分析相关治疗方法和转归.方法回顾性分析25例儿童多发性大动脉炎患儿的临床表现、治疗过程及预后.结果 患儿发病年龄为(10.8±3.0)岁,男女比为8:17.TA临床分型中以Ⅲ型最多(56.0%),常以头痛、抽搐、乏力、蛋白尿等为首发症状,25例患儿均有高血压,其中19例有结核感染.22例患儿接受糖皮质激素和(或)环磷酰胺治疗后病情缓解,其中16例出现复发;3例患儿接受血管内介入治疗,效果良好,未再出现狭窄.结论 儿童尤其是青春期以头痛、高血压为主要表现时需注意多发性大动脉炎可能.儿童多发性大动脉

  3. What Is Giant Cell Arteritis?

    Science.gov (United States)

    ... Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American Academy of ...

  4. Takayasu's arteritis: a challenging diagnosis.

    LENUS (Irish Health Repository)

    Fanning, D M

    2009-03-01

    The practices of medicine and surgery are inherently and irrevocably entwined. This case report highlights the need for an integrated, multi-disciplinary approach to care of the modern patient. Our patient fulfils the traditional Ishikawa\\'s criteria and the modified Ishikawa\\'s criteria for the clinical diagnosis of Takayasu\\'s disease. Her case underpins the need for co-ordinated care and careful periodic review of the symptomatology and signs of the multiple clinic attendees.

  5. 儿童发病的大动脉炎15例临床分析%Clinical analysis of 15 childr en with Takayasu arteritis

    Institute of Scientific and Technical Information of China (English)

    夏慧; 周纬

    2015-01-01

    Objective To investigate the clinical features and treatment programs in children with Takayasu arteritis (TA) in order to improve awareness of the disease. Methods A retrospective study of hospi-talized children with TA in our hospital from Jan. 1999 to Dec. 2012 was performed. Results Between the 15 patients with TA, the ratio of male to female was 1∶2. The onset was from 14 months to 15 years old, with average age at (10 ±4) years old. It is according to (the European League against Rheumatism/the Pediatric Rheumatology European Society (EULAR/PRES) criteria for the diagnosis of TA. The most common clinical manifestations are hypertension, which occurred in 13 cases(87%), weak pulse or pulseless in 11 cases (73%), and heart failure in 10 cases (67%). About two-thirds of patients were diagnosed when the onset of heart failure occurred. The most common clinical type was type Ⅱ, which occrred in 9 cases (60%). Antihypertensive drugs, oral steroid and congestive heart failure controlling were the main treatment. Three patients with positive purifiedproteinderivative (PPD) test received anti-TB treatment. Three patients had vascular bypass surgery, one patient had percutaneous transluminal angioplasty. Conclusion TA may be life-threatening and progressive. Many patients are with advanced disease at the time of treatment, so the prognosis is generally poor. Early recognition is necessary to initiate appropriate therapy. The disease should be considered in patients with unexplained arterial hypertension or unexplained inflammatory syndromes without local signs.%目的:研究儿童发病的大动脉炎患者的临床特点和治疗方案,提高对此病的认识,以求早期诊断,改善预后。方法收集我院1999年1月至2012年12月住院的大动脉炎患者的临床资料进行回顾性分析。结果15例患者中,男女比例为1∶2,年龄14个月至15岁,平均(10±4)岁。按照EULAR/欧洲儿童风湿病学协会(PRES)标准诊

  6. Hipertensão arterial pulmonar e acidente vascular encefálico em paciente com Arterite de Takayasu Pulmonary arterial hypertension and cerebrovascular disease in patient with Takayasu Arteritis

    Directory of Open Access Journals (Sweden)

    Carlos Frederico Rodrigues Parchen

    2006-12-01

    Full Text Available Arterite de Takayasu (AT é uma doença rara caracterizada por vasculite dos grandes vasos, principalmente aorta e seus ramos. A inflamação vascular leva a irregularidades na parede do vaso, causando estenoses e aneurismas. O envolvimento da artéria pulmonar (AP é freqüente na AT. Apesar disso, o desenvolvimento de hipertensão arterial pulmonar (HAP é menos comum, alterando o tratamento e o prognóstico dos pacientes. Descrevemos um caso de uma paciente com AT com estenoses múltiplas em artérias pulmonares, HAP e doença cerebrovascular, além de revisão de literatura sobre o assunto.Takayasu arteritis (TA is a rare illness characterized by vasculitis of great vessels, mainly of aorta and its branches. The vascular inflammation leads to irregularities of the vessel wall causing stenosis and aneurysms. The pulmonary artery (PA involvement is frequent in TA. Despite this, the development of pulmonary arterial hypertension is less common, modifying the treatment and the prognosis of the patients. We describe a case of a patient with TA with multiple stenosis in pulmonary arteries, pulmonary arterial hypertension and cerebrovascular disease, as well as review of the literature on the subject.

  7. 大动脉炎肾动脉狭窄或闭塞介入治疗临床效果观察%Clinical effects of interventional therapy for the treatment of Takayasu arteritis renal artery stenosis or occlusion

    Institute of Scientific and Technical Information of China (English)

    赵峰

    2014-01-01

    研究介入治疗在治疗大动脉炎肾动脉狭窄或闭塞的临床效果以及并发症。方法选取2007年3月至2012年3月在河北大学附属医院经实验室检查和血管造影诊断为大动脉炎肾动脉狭窄或闭塞的患者150例,分为介入治疗(A组)和外科手术(B组)两组,比较两组临床效果以及并发症。结果 A组手术时间、术中出血量、出院时间分别为(45.2±2.1)min、(51.4±3.5)mL、(5.70±0.45)d ,显著低于B组,差异有统计学意义(P<0.05)。A组经治疗6个月后,其收缩压、舒张压、肾小球滤过率以及血肌酐分别为(145.6±11.3)mmH g、(75.6±7.2)mm Hg、(127.8±6.7)mL/min、(85.7±9.1)μmol/L ,比治疗前有显著改善,差异有统计学意义(P<0.05);而B组在治疗6个月后,与治疗前差异无统计学意义(P>0.05)。同时A组患者的成功率、再狭窄率以及总并发症发生率分别为93.3%、12.0%、17.3%,明显低于B组,差异有统计学意义( P<0.05)。结论介入治疗大动脉炎肾动脉狭窄或闭塞成功率高,并发症少,临床应用价值高。%Objective To investigate the clinical effects and complications of interventional therapy for the treatment of Takayasu arteritis renal artery stenosis or occlusion .Methods A total of 150 patients with Takayasu ar‐teritis renal artery stenosis or occlusion ,treated in this hospital during Mar .2007 and Mar .2012 ,were enrolled and divided into interventional therapy group (group A) and surgical operation group (group B) .Clinical effects and com‐plication were compared between the two groups .Results In group A ,the time of surgery ,amount of bleeding and duration of hospital stays were respectively (45 .2 ± 2 .1)min ,(51 .4 ± 3 .5)mL and (5 .70 ± 0 .45)d ,which were obvi‐ously lower than group B (P0 .05) .The success rate ,ste‐nosis rate and total incidence

  8. DQA1基因启动子区及编码区与大动脉炎的关联研究%The association of polymorphisms in the HLA-DQ gene with Takayasu arteritis

    Institute of Scientific and Technical Information of China (English)

    吕纳强; 党爱民; 郑德裕; 刘国仗

    2014-01-01

    目的 大动脉炎(Takayasu arteritis)是一种累及主动脉及其主要分支的慢性进行性非特异血管炎性疾病.本研究以人类白细胞抗原(HLA)-DQA1为候选基因分析其编码区基因型和启动子区多态性与中国大动脉炎的关联.方法 采用病例对照研究的方法,入选中国汉族大动脉炎患者100例和健康对照104例,应用聚合酶链反应-序列特异性引物(PCR-SSP)和聚合酶链反应-单链构象多态性分析(PCR-SSCP)方法检测HLA-DQA1基因编码区和启动子区基因型,并分析基因型与疾病的关联.结果 具有类似DQα链蛋白抗原结合槽部位肽结合袋的氨基酸组成结构的DQA1*0301/2/3基因型,在大动脉炎组显著低于对照组(P=0.003).DQA1启动子QAP 1.3在大动脉炎组低于对照组(P=0.036).结论 DQA1*0301/2/3基因型、DQA1启动子QAP 1.3基因型可能是大动脉炎的保护基因型.

  9. Tratamento coadjuvante da arterite de Takayasu através de angioplastia transluminal percutânea com stents: relato de caso e revisão de literatura Coadjuvant treatment of Takayasu Arteritis by percutaneous transluminal angioplasty with stents: case report and literature review

    Directory of Open Access Journals (Sweden)

    Glauber Tercio de Almeida

    2008-04-01

    Full Text Available Os autores fazem uma breve revisão de literatura sobre o uso coad-juvante de stents na arterite de Takayasu e apresentam um relato de caso de uma mulher jovem, 27 anos de idade, com quadro de cefaléia holocraniana acompanhada de náuseas, síncopes e tonturas. Concomitantemente apresentou turvação visual e claudicação de membros superiores. Entre as várias possibilidades, aventou-se a hipótese diagnóstica de arterite de Takayasu, confirmada posteriormente, sendo então realizado tratamento coadjuvante através de angioplastia transluminal percutânea com stents.The authors present a brief literature review about coadjuvant treatment with stents in Takayasu Arteritis and report a case of a 27 year old woman showing a holocranial cephalalgia, associated with nausea, fainting and dizziness. Simultaneously she suffered blurred sight and claudication of the upper limbs. Among the different diagnostic possibilities, the hypothesis of Takayasu Arteritis was first considered and later confirmed. Coadjuvant treatment by a percutaneous transluminal angioplasty with stents was performed.

  10. Toll-like receptors 4 and 9 are responsible for the maintenance of the inflammatory reaction in canine steroid-responsive meningitis-arteritis, a large animal model for neutrophilic meningitis

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    Maiolini Arianna

    2012-09-01

    Full Text Available Abstract Background Steroid-responsive meningitis-arteritis (SRMA is a systemic inflammatory disease affecting young adult dogs and a potential large animal model for neutrophilic meningitis. Similarities between SRMA and infectious central nervous system (CNS diseases in lymphocyte subsets suggest an infectious origin. Toll-like receptors (TLRs are pattern recognition receptors playing an important role in innate immunity. Due to their ability to recognize both self and non-self antigens, we hypothesize that TLRs are among the key factors for the induction of the inflammatory process in SRMA and provide an indirect hint on the etiology of the disease. Methods The expression profile of cell surface TLRs (TLR2, TLR4 and TLR5 and intracellular TLRs (TLR3 and TLR9 of canine leukocytes was analyzed by immunophenotyping and subsequent flow cytometric measurements. Experiments were performed on cerebrospinal fluid (CSF and peripheral blood (PB samples of dogs affected with SRMA during the acute phase (n = 14 as well as during treatment (n = 23 and compared with those of dogs with bacterial meningitis (n = 3, meningoencephalitis of unknown etiology (n = 6, neoplasia of the central nervous system (n = 6 and a group of dogs with miscellaneous neurological diseases (n = 9. Two additional control groups consisted of dogs with pyogenic infections (n = 13 and of healthy dogs (n = 6. Results All examined groups showed a high percentage of TLR2, TLR4 and TLR5 positive PB polymorphonuclear cells (PMNs in comparison to healthy dogs. Very high values of TLR9 positive PB PMNs were detected in acute SRMA. Only a few similarities were found between SRMA patients and dogs with pyogenic infections, both groups were characterized by high expression of TLR4 positive PB monocytes. Glucocorticosteroid therapy reduced TLR2, TLR4 and TLR9 expression in PB monocytes. Conclusions A relatively high expression of TLR4 and TLR9 in acute SRMA

  11. 中国华南、华中、东北和西北地区马动脉炎病毒(EAV)感染马血清流行病学调查%Seroepidemiological Survey of Equine Arteritis Virus (EAV) Infection among the Horses from Southern,Central,Northeastern and Northwestern China

    Institute of Scientific and Technical Information of China (English)

    李红梅; 侯玉杰; 时成龙; 郭巍; 胡兰; 赵立平; 相文华

    2012-01-01

      Equine viral arteritis (EVA),caused by equine arteritis virus (EAV),is a highly contagious respiratory and reproductive viral disease of equids,can have a significant economic effect on both breeding and performance sectors of the horse industry. To understand the serological prevalence of equine arteritis virus (EAV) infection among the horses from Southern, Central,Northeastern and Northwestern China in 2009,an EAV-antigen indirect enzyme-linked immunosorbent assay (ELISA) was utilized to examine 383 horse serum samples collected from the racehorses and draft horses randomly selected from the above four administrative regions in this study. Data showed that a total seropositive rate of EAV antibodies was 26%in Southern China and 0%among the race horses in Central China. And the seropositive rate of EAV antibodies among the draft horses in Northeastern and Northwestern China were 7.55%and 8.26%separately. Therefore,it is important to strengthen EVA surveillance and understand its distribution in the country in order to prevent and control its occurrence and spreading.%  马病毒性动脉炎(EVA)是一种由马动脉炎病毒(EAV)引起马属动物主要通过呼吸系统和生殖系统传播的传染病,是危害养马业及赛马业的重要疾病之一.本试验应用纯化EAV全病毒为抗原建立EAV-IgG间接ELISA方法与西班牙INGEZIM-ARTERITIS试剂盒分别检测华南、华中、东北和西北地区共计383份马血清样品.其结果为:华南地区赛马动脉炎阳性率为26%,华中地区赛马动脉炎阳性率为0,东北地区役用马动脉炎阳性率为8.26%,西北地区役用马动脉炎阳性率为7.55%.鉴于此,有必要加强EVA检测,掌握EVA在我国分布,以有效的预防和控制本病传播.

  12. Role of 3.0 T MR vessel wall imaging for identifying the activity of Takayasu arteritis%3.0 T高分辨率MR血管壁成像对大动脉炎活动性判断的价值

    Institute of Scientific and Technical Information of China (English)

    刘晓晟; 许建荣; 赵辉林; 成芳; 路青; 姚秋英

    2010-01-01

    Objective To analyze and explore the value of 3 T high resolution magnetic resonance vessel wall imaging for identifying the activity of Takayasu arteritis. Methods Twenty-six consecutive patients with Takayasu arteritis underwent 3.0 T high resolution MR vessel wall imaging on supraortic vessels (according to the classification of Lupi-Herrea , type Ⅰ and Ⅲ were included). Sixteen patients were in active phase and 10 in inactive phase based on the Kerr criteria. The MR vessel wall imaging appearances of Takayasu arteritis were compared between the active phase and inactive phase cases. Results Wall thickening was demonstrated in all involved arteries. There were statistically significant differences between active phase and inactive phase cases in MR appearances including multi-ring thickening of vessel wall (75/80 and 18/50), arterial inner wail enhancement (50/80 and 19/50), obscurity of perivascular fat (55/80 and 18/50,X=50.39,7.41,13.40,P<0.01). There was also a statistically significant difference in the thickness of carotid artery wall between the two groups [ (3.8±0.2) mm vs (2.5±0.8) mm]. Conclusion 3 T high resolution MR vessel wall imaging is valuable for identifying the activity of Takayasu arteritis.%目的 探讨3.0 T高分辨率MR血管壁成像对大动脉炎活动性判断的价值.方法 26例确诊为大动脉炎的患者(根据Lupi-Herrea分类,为Ⅰ和Ⅲ型,均累及主动脉弓及其主要大分支)接受了颈部及上胸部MR血管壁成像,其中处于病情活动期16例,非活动期10例.分析并比较了2组患者受累动脉管壁的MRI表现特征.采用X~2检验对2组患者的血管壁形态进行统计学分析.结果 所有受累动脉的血管壁均有不同程度的环形增厚.活动期组患者的管壁厚度较非活动期组患者增厚明显[分别为(3.8±0.2)和(2.5±0.8) mm];比较2组增厚的血管壁形态,管壁呈多环征(分别为75/80和18/50)、内壁明显强化(分别为50/80和19/50)、血管

  13. Atypical visual loss in giant cell arteritis

    DEFF Research Database (Denmark)

    Thystrup, Jan Deichmann; Knudsen, G M; Mogensen, A M

    1994-01-01

    in the terminal stage of his disease due to bilateral occipital cortex infarctions, verified by CT-scan. Autopsy revealed involvement of several intracranial arteries. In case No. 2 there was severe unilateral visual loss and cotton-wool exudates in both eyes. Central vision recovered after corticosteroid therapy......; in our experience this is unusual. In case No. 3 irreversible unilateral visual loss was typical for GCA, but the association with polyneuropathy unique. Neurological remission coincided with systemic corticosteroid therapy....

  14. Parliamentary Democracy in Scandinavia / David Arter

    Index Scriptorium Estoniae

    Arter, David

    2004-01-01

    Põhjamaade poliitika võrdlus Westminster-stiilis majoritaarse süsteemiga, seadusandlike ja täidesaatvate institutsioonide suhted; rahvusparlamentide suhteline suletus avalikkuse ees (eriti komisjonid)

  15. 31例巨细胞动脉炎临床分析并文献复习%Giant cell arteritis clinical characteristics of 31 cases and literature review

    Institute of Scientific and Technical Information of China (English)

    李艳; 朱剑; 金京玉; 黄烽

    2012-01-01

    目的 总结巨细胞动脉炎的临床特点,提高临床医师认识,以达到早期诊断、有效治疗.方法 根据美国风湿病学学会( ACR)分类标准诊断为巨细胞动脉炎(GCA)的解放军总医院的住院患者31例,对其临床特点、实验室检查、预后进行分析总结.并与国外文献报道进行对比分析.结果 本组31例,男17例,女14例,年龄47~92岁,平均67.1岁.急性起病者20例.有头痛者29例、乏力者27例、发热者25例、风湿性多肌痛17例、体质量下降者15例、咀嚼困难12例、视力改变8例.颞动脉形态异常15例,搏动异常者16例.脑部CT可见梗死灶(包括腔隙性脑梗死)21例;颞动脉超声异常22例.初诊红细胞沉降率50~150 mm/h,平均(81±26)mm/h;治疗2周后红细胞沉降率2~43 mm/h,平均(19±12) mm/h.综合国内文献,中国人GCA不同于国外,男性发病比例高于女性,且发热、体质量下降等全身症状较突出.结论 本组患者及国人GCA不同于国外文献报道,男性多发;常见表现也多为发热、头痛、风湿性多肌痛,对激素治疗反应较好.超声检查是明确诊断、评判治疗效果的有效手段.%Objective To investigate the clinical features of giant cell arteritis(GCA). Methods Data of 31 patients with GCA (diagnosed according to American College of Rheumatology classification standard) in Chinese PLA General Hospital from 2008 to 2011 were analyzed. The clinical manifestation, assistant examinations, response to steroid therapy and follow-up data were recorded and compared with results in literatures abroad. Results There were 17 male cases and 14 female cases and mean age was 67.1 years (range 47-92 years) and 20 cases were acute onset. There were 29 cases with headache, 27 cases with weakness, 25 cases with fever, 17 cases with rheumatic polymyalgia, 15 cases with weight loss, 12 cases with dysmasesia, and 15 cases with temporal artery abnormal morphology and pulsation. Brain CT showed

  16. 多发性大动脉炎合并心脏损害患者临床特点及危险因素分析%Manifestations and risk factors of cardiac involvement in patients with Takayasu's arteritis

    Institute of Scientific and Technical Information of China (English)

    万瑾; 潘丽丽; 慈维苹; 廖华; 王天

    2015-01-01

    尖瓣关闭不全(比值比=0.192,95%置信区间:0.040 ~ 0.929,P<0.05)和三尖瓣关闭不全(比值比=0.093,95%置信区间:0.011 ~ 0.761,P<0.05)的独立危险因素.结论 TA出现心脏损害并不少见,临床医师应关注其临床特征,早诊断早治疗,有助于减少TA患者心脏损害的发生.%Objective To explore manifestations and risk factors of cardiac involvement in patients with Takayasu's arteritis (TA).Methods Data of 55 TA patients complicated with cardiac injury among 85 TA patients,including clinical manifestations and results of physical,laboratory,imaging examination,were retrospectively analyzed.The cardiac injury was assessed by echocardiography and coronary CT angiography CT.Relative clinical data of TA patients complicated with cardiac injury were compared withTA patients without cardiac injury.Results In the 55 patients,47 were female and 8 were male.The time of confirmed diagnosis in TA patients with cardiac injury was significantly later [36 (9,168)months vs 12 (6,24) months],compared with that in TA patients without cardiac injury;meanwhile chest pain and blood pressure difference > 10 mmHg between right-to-left sides were more like to occur [27.3% (15/55) vs 6.7% (2/30),69.1% (38/55) vs 46.7% (14/30)] (P < 0.05).The proportions of patients with increased erythrocyte sedimentation rate and C reactive protein were not statistically different between TA patients with or without cardiac injury [63.6% (35/55) vs 56.7% (17/30),58.2% (32/55) vs 53.3% (16/30)] (P > 0.05).In TA patients with cardiac injury,there were 13 of type Ⅰ (23.6%),11 of type Ⅱ (20.0%),28 of type Ⅲ (50.9%),1 of type Ⅰ +Ⅳ (1.8%),2 of type Ⅲ+ Ⅳ (3.6%);30 patients (54.5%) had hypertensive heart disease,including 18 of renal arterial stenosis or occlusion the onset hypersension were of (28 ± 14) years,which was younger than those without renal arterial involvement [(44 ± 14) years] (P < 0.05);6 patients (10.9%) had old of age

  17. Pregnancy in Takayasu arteritis - maternal and fetal outcome

    Directory of Open Access Journals (Sweden)

    Kavitha Garikapati

    2016-08-01

    Results: All the 4 patients with TA had medical complication like hypertension in the form of chronic hypertension and pre eclampsia that needed good monitoring of BP in all 4 limbs. Conclusions: As the typing of disease increased, more medical and obstetric complications were noticed. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2596-2600

  18. Tekrarlayan Aspirasyon Pnomonisinin Nadir Bir Nedeni: Pulmoner Arter Sling

    Directory of Open Access Journals (Sweden)

    Abdullah Özyurt

    2013-08-01

    Full Text Available Pulmonary artery sling is the rarest vascular ring anomaly that left pulmonary artery originates from posterior of right pulmonary artery with an abnormal course and ends in hilus of the left lung. A Six months old girl was brought to our emergency unit for cough, dyspnea, and cyanosis which were started after feeding. She was hospitalized with the diagnosis of aspiration pneumonia and solid food remnants were aspirated from the left main bronchus by bronchoscopy. In her second hospitalization when she was 15 months old, pulmonary artery sling was seen in her thoracic tomography and was corrected by surgery. Hypoplasia and compression of left main bronchus were also noted in her thoracic tomography. She was 22 months old on her last visit and is followed by our outpatient clinic without any problems. Recurrent wheezing episodes, brassy cough, chronic stridor, vomiting, and dysphagia are the main presenting signs and symptoms of pulmonary artery sling. PAS diagnosis is rare for recurrent aspiration pneumonia. Due to abnormal course of the left pulmonary artery it presses over trachea or right pulmonary artery. The presentation of this case was considered for its atypical anatomy and clinical presentation. (Journal of Current Pediatrics 2013;11:81-4

  19. What Are Polymyalgia Rheumatica and Giant Cell Arteritis?

    Science.gov (United States)

    ... de células gigantes? (Esenciales: hojas informativas de fácil lectura) Order a NIAMS publication to be mailed Health ... if you have polymyalgia rheumatica. The doctor usually bases the diagnosis on: Medical history Symptoms Physical exam ...

  20. Mõnus kontsert Bostonis / Rein Pirn ; foto: Marko Mumm (Arter)

    Index Scriptorium Estoniae

    Pirn, Rein

    2004-01-01

    8. veebr. 2004 esinesid Bostoni First and Second Church'is lauljatar Hanna-Liina Võsa ning pianist Hando Nahkur; kõlasid eesti rahvalaulud, eesti ja ameerika heliloojate laulud ning F. Liszti klaverimuusika

  1. Clinical features of Takayasu arteritis patients with pulmonary hypertension due to pulmonary artery involvement%多发性大动脉炎累及肺动脉所致肺动脉高压患者的临床特征

    Institute of Scientific and Technical Information of China (English)

    曾绮娴; 柳志红; 何建国; 倪新海; 程显声; 顾晴; 赵智慧; 罗勤; 熊长明

    2016-01-01

    目的 总结多发性大动脉炎累及肺动脉所致肺动脉高压患者的临床特征.方法 收集阜外医院1988年6月至2014年6月多发性大动脉炎累及肺动脉患者94例,根据主动脉有无受累分为主动脉及肺动脉均受累(APTA组,48例)和单独肺动脉受累(PTA组,46例);分析其临床及血管影像学特征.结果 患者男女比例1:3.3,发病时年龄8~60岁,中位年龄33.5岁.主要临床表现为劳力性气短;体征包括心脏杂音及收缩中期肺野血管杂音.超声心动图检查提示所有患者均有肺动脉高压;病变多累及肺叶、段动脉,其次为亚段血管;双侧多于单侧,右侧多于左侧.APTA组与PTA组的临床症状、体征无显著差异.而入院时APTA组的红细胞沉降率和N末端脑钠肽原均显著高于PTA组[14.0(5.0,28.0)比8.5(3.0,19.3)mm/1 h和(1 936±1 769)比(1 627±1 153)ng/L,均P<0.05].结论 多发性大动脉炎累及肺动脉患者以气短为主诉,就诊时多有肺动脉高压,并伴中重度心功能不全.%Objective To summarize the clinical features of Takayasu arteritis (TA) patients with pulmonary hypertension due to pulmonary artery involvement.Methods Ninety-four TA patients with pulmonary artery involvement treated in Fuwai Hospital from Jun 1988 to Jun 2014 were retrospectively summarized.Patients were divided into two groups according to whether aorta and its main branches affected (APTA,n =48) or not (PTA,n =46).Clinical features and angiographic data were further analyzed.Results Of all the patients,male to female rate was 1:3.3,age ranged from 8 to 60 years with median age of 33.5 years when symptom onset.Main symptoms included dyspnea on exertion.Heart murmur and midsystolic murmur in pulmonic area were commonly found by physical examination.All patients had pulmonary hypertension by echocardiographic examination.Angiographic data showed that multi-lobular and multisegmental pulmonary branches were predominantly affected,followed by sub

  2. YKL-40 in giant cells and macrophages from patients with giant cell arteritis

    DEFF Research Database (Denmark)

    Johansen, J S; Baslund, B; Garbarsch, C

    1999-01-01

    of this study was to evaluate whether macrophages and giant cells of patients with GCA produce YKL-40, and whether serum YKL-40 concentrations are elevated in these patients. METHODS: Serum YKL-40 was determined by radioimmunoassay in 19 patients with GCA and 8 patients with polymyalgia rheumatica (PMR) who......-matched controls (median 118 microg/liter), and the serum level of YKL-40 decreased to normal levels during prednisolone treatment (-38% after 1 month; PPMR had normal serum YKL-40 levels (median 158 microg/liter) and had no changes in the serum YKL-40 levels during prednisolone...

  3. Serum markers associated with disease activity in giant cell arteritis and polymyalgia rheumatica

    NARCIS (Netherlands)

    van der Geest, Kornelis S. M.; Abdulahad, Wayel H.; Rutgers, Abraham; Horst, Gerda; Bijzet, Johan; Arends, Suzanne; Roffel, Mirjam P.; Boots, Annemieke M. H.; Brouwer, Elisabeth

    2015-01-01

    Objective. To compare multiple serum markers for their ability to detect active disease in patients with GCA and in those with PMR. Methods. Twenty-six markers related to immune cells that may be involved in GCA and PMR were determined by ELISA and multiplex assay in the serum of 24 newly diagnosed,

  4. Contribution a la modelisation et simulation numerique de l ecoulement du sang dans l artere

    CERN Document Server

    Alla, H; Bensaid, M H

    2009-01-01

    Numerous are the questionings raised by medicine interventionnelle, concerning the hold in charge of the pathologies of the arterial partition (aneurysm, dissection, coarctation, atherosclerosis).for it we made the modeling and the numeric simulation of the blood flow in the renal artery taken by the Medical imagery. Geometry has been rebuilt from the medical pictures of angiography, angioscanner and IRM. While considering that blood like a fluid Newtonian and stationary flow. The results gotten in terms of the physical parameters as the velocity, the dynamic pressure is shown that the simplest case was enough to collect relevant data for the development of stenos or thrombosis in the arteries.

  5. Ajakiri "Arters" : esteetika ja eetika / Anu Saluäär

    Index Scriptorium Estoniae

    Saluäär, Anu, 1948-

    2008-01-01

    Rootsi Muusikaakadeemia, Kunstiakadeemia ja Rootsi Akadeemia ühisväljaandest "Artes", pikemalt teisest numbrist, mis kajastab Pariisis toimunud kollokviumit "Kirjandus ja filosoofia". - Varem ilmunud: Looming 1989, nr. 11

  6. Self-reported use of medicines among university students in Oslo, Norwayyvind Palm: Arteritis temporalis

    Directory of Open Access Journals (Sweden)

    Elin O. Rosvold

    2009-09-01

    Full Text Available Background: Medicine use can be used as an indicator of state of health in a population. Knowledge about health and medicine use among university students is scarce. Objective: The aim of this study was to analyse medicine use in relation to age and gender in an university student population. Methods: A survey on health and medicine use among students was carried out at the University of Oslo, Norway, in 2003 by means of a postal questionnaire. In all, 45% (789 of 1750 students participated. Students younger than 30 years of age (n=604 were included in the study of medicine use. Results: More female (77% than male (53% students reported use of medicines during the preceding four weeks. Female students had used more over the counter analgesics and more psychotropic drugs than the males. One in five students reported daily or weekly use of allergy medicines. Conclusions: This study showed that female university students below 30 years of age used more medicines than their male counterparts. The gender difference was mainly due to a higher use of analgesics among women. The study was performed during the pollen season in spring, and the high proportion of allergy medicine users indicates that many university students may have symptoms that can influence on their academic performance during spring exams

  7. Vertebral Arter Dissection%椎动脉夹层分离

    Institute of Scientific and Technical Information of China (English)

    李志立; 杨树东; 哈志远

    2008-01-01

    The vertebral artery dissection may be associated with the structural abnormalities of vascular wall or enviromental factors.The symptoms are usually caused by the luminal stenosis or the formation of blood clot,including the pain in posterior neck or mastoid region with local neurological deficits.The diagnostic methods for vertebral artery dissection include digital subtraction angiogaphy,magnetic resonance imaging,CT angiograpby and color Doppler ultrasonography.Anticoagulation is the main treatment option for most patients with vertebral artery dissection.%椎动脉夹层分离可能与血管壁结构异常或环境因素有关.症状通常由夹层分离造成管腔狭窄或血凝块形成所致,包括颈后或乳突区疼痛伴随局部神经功能障碍.椎动脉夹层分离的诊断方法包括数字减影血管造影、MRI、CT血管造影以及彩色多普勒超声等.治疗以抗凝为主.

  8. Painful Horner syndrome due to arteritis of the internal carotid artery

    NARCIS (Netherlands)

    Bollen, AE; Krikke, AP; de Jager, AEJ

    1998-01-01

    A 44-year-old man presented with painful Horner syndrome: severe periorbital pain, ptosis, and miosis of his right eye, with intact facial sweating. Lymphadenitis at the right side of his neck preceded the symptoms. MRI and magnetic resonance angiography showed thickening of the right internal carot

  9. Temporal Artery Calciphylaxis Presenting as Temporal Arteritis in a Case of Rhinoorbitocerebral Mucormycosis.

    Science.gov (United States)

    Chi, Mijung; Kim, H Jane; Basham, Ryan; Yoon, Michael K; Vagefi, Reza; Kersten, Robert C

    2015-01-01

    Mucormycosis is a rare often fatal opportunistic fungal infection. It is typically described in patients with diabetes in ketoacidotic status and is rare in renal transplant recipients. Calciphylaxis is a rare and highly morbid disease of vascular calcification affecting patients with end-stage renal disease (ESRD). The first case of a renal transplant recipient who was inflicted with both rhinoorbitocerebral mucormycosis and calciphylaxis is reported. A 45-year-old man presented with 2-day history of left upper blepharoptosis, periorbital pain, left-sided headache, binocular diplopia, and left V2 numbness. He had undergone renal transplant for ESRD 7 months earlier with resultant immunosuppressive therapy. MRI and nasal biopsy confirmed rhinoorbitocerebral mucormycosis. Immunosuppressive therapy was stopped and antifungal therapy begun. He had orbital exenteration for progressive rhinoorbitocerebral mucormycosis. Two months later, the patient reported new-onset intermittent bitemporal headache and bilateral swollen, tender temporal arteries. Temporal artery biopsy revealed features consistent with calciphylaxis. Clinical presentation, treatment course, and follow up are discussed.

  10. Five Vessel Coronary Arter Bypass Graft Surgery in a Case with Familial Hypercholesterolemia

    Directory of Open Access Journals (Sweden)

    Sureyya Talay

    2014-08-01

    Full Text Available We report a case of a rare and sypmtomatic familyal hypercholesterolemia case with an end-point of coronary artery bypass surgery at the age of 16. Patient was evaluated at the emergency department with chest pain and discomfort. Physical examination were within normal limits. The electrocardiogram showed a normal sinus rhythm for 108/ min. Arterial blood pressure was 90/60 mmHg. Lungs and heart were clear to auscultation. Patient was under treatment with a prior diagnosis of familial hypercholesterolemia (FH for one year by daily 40 mgs rosuvastatine. A coronary artery angiography was performed for chest pain. Multivessel coronary artery disease was diagnosed with a total occlusion of left anterior descending artery. Transthoracic echocardiography presented a left ventricular (LV ejection fraction 50%, LV diameters 44/26 mm, aneurysm formation at interatrial septum and mild dyskinesia of anterior wall. Thus, a five vessel emergent coronary artery graft bypass surgery was performed at this early age. FH is with a severe elevation in total cholesterol (TC and low density lipoprotein cholesterol (LDL in an autosomal dominant characteristic disorder that approximately occurs in 1 per 500 persons by its heterozygous form. FH is most certainly associated with premature coronary artery disease (CAD with catasthrophic early age results. [Cukurova Med J 2014; 39(4.000: 872-875

  11. Educational Needs of Patients With Systemic Vasculitis

    Science.gov (United States)

    2014-07-11

    Behcet's Disease; Churg-Strauss Syndrome; Vasculitis, Central Nervous System; Giant Cell Arteritis; Wegener Granulomatosis; Henoch-Schoenlein Purpura; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu's Arteritis

  12. Egzersiz testi normal olan bir olguda ciddi ana koroner arter darlığının izlenmesi

    OpenAIRE

    Türker, Yasin; Özaydın, Mehmet; Acar, Gürkan; İçli, Atilla

    2011-01-01

    Treadmill egzersiz testine yaygın olarak ulaşılabilir ve testin maliyeti düşüktür. Egzersiz testinin duyarlılığa ve özgüllüğü diğer stres görüntüleme tekniklerinden düşüktür. Bu yazıda tipik göğüs ağrısı yakınması ile başvuran, egzersiz testi normal olan, ana koroner arterde ciddi darlık saptanan olgu sunuldu.

  13. Phage display of the Equine arteritis virus nsp1 ZF domain and examination of its metal interactions

    DEFF Research Database (Denmark)

    Oleksiewicz, Martin B.; Snijder, E.J.; Normann, Preben

    2004-01-01

    of the ZF domain, a binding assay was developed, based on the use of immobilized Ni2+ ions (Ni-NTA). Phages displaying ZF bound significantly better to Ni-NTA than did phages displaying negative-control peptides, which also contained metal-coordinating residues. Also, binding of ZF-displaying phages could...... structure was involved in binding of the ZF to Ni-NTA. These findings provide the first experimental evidence that the putative nsp 1 ZF domain can coordinate divalent metal ions, and that this property is associated with the secondary structure of the domain. The Ni-NTA binding assay developed...... be inhibited by an anti-nsp 1 serum, or by mutation of residues predicted to be important for zinc coordination. Finally, binding was abolished by low concentrations (0.1%) Tween 20, and rescued by including Zn2+, Ni2+ or Cu2+, but not Mg2+, in the binding buffer, suggesting that formation of secondary...

  14. Increased tissue endothelin-1 and endothelin-B receptor expression in temporal arteries from patients with giant cell arteritis

    DEFF Research Database (Denmark)

    Dimitrijevic, Ivan; Andersson, Christina; Rissler, Pehr;

    2010-01-01

    of temporal arteries using archival formalin-fixed, paraffin-embedded tissue. PARTICIPANTS: The study included 10 patients with GCA and 10 control patients with clinically suspected GCA but diagnosed not to have GCA. METHODS: Immunohistochemistry, with anti ET-1, anti-ET(A), and anti-ET(B) antibodies...... states. High doses of corticosteroids currently are used in the treatment of GCA, whereas other treatments are not as reliably effective. The present study was performed to elucidate the role for ET-1, ET(A), and ET(B) receptors in GCA. DESIGN: Experimental, retrospective immunohistochemical study......, was performed on formalin-fixed and paraffin-embedded temporal arteries. MAIN OUTCOME MEASURES: Endothelin-1, ET(A), and ET(B) receptor immunostaining intensities were quantified. RESULTS: Temporal arteries from the patients with GCA showed the typical histologic features, including intimal thickening...

  15. Vasculitis Illness Perception (VIP) Study

    Science.gov (United States)

    2014-07-11

    Wegener Granulomatosis; Microscopic Polyangiitis; Churg-Strauss Syndrome; Polyarteritis Nodosa; Giant Cell Arteritis; Takayasu's Arteritis; Henoch-Schoenlein Purpura; Behcet's Disease; CNS Vasculitis

  16. Reproductive Health in Men and Women With Vasculitis

    Science.gov (United States)

    2014-06-25

    Giant Cell Arteritis; Takayasu's Arteritis; Polyarteritis Nodosa; Wegener's Granulomatosis; Microscopic Polyangiitis; Churg-Strauss Syndrome; Behcet's Disease; Kawasaki Disease; Henoch-schoenlein Purpura; Vasculitis, Central Nervous System; Drug-induced Necrotizing Vasculitis

  17. The genera Conocybe and Pholiotina (Agaricomycotina, Bolbitiaceae) in temperate Asia

    DEFF Research Database (Denmark)

    Hausknecht, Anton; Kalamees, Kuulo; Knudsen, Henning Jørgen;

    2009-01-01

    44 arter af keglehatte (Conocybe og Pholiotina) bliver rapporteret fra Sibirien, Georgien og en række Centralasiatiske republikker baseret på forfatternes egne indsamlinger. Tre af dem beskrives som nye arter, og tre andre er formodede nye arter, men med utilstrækkeligt materiale til en beskrivel...

  18. 钩端螺旋体性脑动脉炎患者的临床护理%Clinical nursing on leptospirosis cerebral arteritis

    Institute of Scientific and Technical Information of China (English)

    陈吟卿

    2001-01-01

    通过对15例散发性钩端螺旋体性脑动脉炎(简称钩体性脑动脉炎)的护理体会,提出了此病一经确诊,严密观察病情,防止赫氏反应,预防颅内压增高,以及偏瘫病例的早期康复训练等是提高抢救成功率的关键。

  19. Follow-up in Polymyalgia Rheumatica and Temporal Arteritis%28例风湿性多肌痛和颞动脉炎随诊分析

    Institute of Scientific and Technical Information of China (English)

    李军; 唐福林; 王晓东; 余建华

    2002-01-01

    目的评价28例风湿性多肌痛(PMR)和颞动脉炎(TA)患者治疗过程,分析影响激素治疗时间和复发的因素.方法回顾性分析1992年至2001年本院诊治的28例PMR和TA患者,其中22例患单纯性PMR,3例PMR合并TA,3例单纯性TA,全部患者均应用糖皮质激素.其中13例加用免疫抑制剂.平均治疗时间25.5±24.0个月.按患者对激素有无抵抗及治疗后有无复发分组,对临床资料分析比较并分析影响PMR和TA治疗及预后的因素.结果激素抵抗组治疗前血沉和外周血白细胞水平较无抵抗组明显升高(P<0.01);复发组激素减量速度较无复发组快 (P<0.05).结论治疗前血沉快和外周血白细胞高者易发生激素抵抗.激素减量过快易复发.对激素治疗抵抗和复发者,或PMR合并TA者应加用免疫抑制剂治疗.

  20. Level of Adherence to Prophylactic Osteoporosis Medication amongst Patients with Polymyalgia Rheumatica and Giant Cell Arteritis: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    A. Emamifar

    2015-01-01

    Full Text Available Objective. To estimate level of adherence to oral calcium and vitamin D supplementation as well as bisphosphonate amongst patients with PMR and GCA treated with glucocorticoids. Method. A total of 138 patients with the diagnosis of PMR and/or GCA registered in our department in December 2013. In this cross-sectional study we interviewed all the patients to measure level of adherence to calcium and vitamin D, as well as bisphosphonates. Results. Out of the 118 included patients, 88.9% of them were adherent to their prescription. Only 2 patients (1.7% did not take calcium and vitamin D at all and 10 patients (8.5% took their medication infrequently, 9 and 1 out of 10 patients took the medication 50–100% of the time and less than 50% of the prescribed dose, respectively. Sixty-one patients received additional treatment with bisphosphonate and 96.6% were adherent to this therapy. The remaining 3.4% of the patients did not take the medication at all. Forgetfulness, adverse side effects, and lack of understanding of treatment benefits were the most significant causes for nonadherence to calcium and vitamin D. Conclusions. Contrary to what we expected this study found that adherence to osteoporosis preventive medication in patients with PMR and GCA was high.

  1. Polimiosite associada à arterite linfocítica do sistema nervoso central Polymyositis associated with lymphocytic arteritis of the central nervous system

    OpenAIRE

    Izaias Pereira da Costa; Elisangela Possebon Pradebon; Julia Villegas Campos; Fabrícia Santos Melo; Flávia Midori Arakaki Ayres Tavares

    2010-01-01

    Complicações do Sistema Nervoso Central (SNC) raramente são descritas em miopatias inflamatórias idiopáticas. Os autores relatam o caso de uma paciente de 48 anos com diagnóstico de polimiosite com autoanticorpo anti-Jo-1 positivo que, após cinco anos de evolução, apresentou extensa lesão desmielinizante do SNC associada à arterite linfocítica.Central Nervous System (CNS) complications in idiopathic inflammatory myopathies are seldom reported. The authors describe the case of a 48-year old fe...

  2. Aorto-arteritis: A Collective Review of Angiography in 415 Cases%大动脉炎及其血管造影综合分析

    Institute of Scientific and Technical Information of China (English)

    宋金松; 刘玉清; 凌坚

    2000-01-01

    目的:总结国人大动脉炎血管造影和某些临床特点,提高其认识水平.材料和方法:回顾分析415例大动脉炎(DSA171例,普通血管造影244例)和某些临床资料.与某些亚洲国家资料对比.结果:大动脉炎病变以狭窄-阻塞型最为常见(84.8%),扩张-动脉瘤型少见(1.9%);大动脉炎最常受累部位为腹主动脉及其分支(56.8%),其中肾动脉病变占29.7%,日本,韩国,印度则分别为34%,76%和92%,主动脉弓和头臂动脉病变占32.8%,日本,韩国,印度则分别为99%,83%和60%;按Lupi-Herrea分型以Ⅱ型多见(38.3%).结论:大动脉炎是亚洲地区常见的血管疾病,但有明显的地域分布和种族差异;本病诊断DSA已取代普通血管造影.

  3. 大动脉炎性脑缺血血管内介入诊疗%Angiographic diagnosis and interventional therapy for cerebral ischemia due to Takayasu arteritis

    Institute of Scientific and Technical Information of China (English)

    刁士元; 段佩琰; 阎浩

    2009-01-01

    目的 探讨大动脉炎性脑缺血的血管造影诊断与介入治疗价值.方法 18例大动脉炎患者行血管造影检查.由有经验的介入放射学医师按盲法对其血管造影及介入治疗资料进行回顾性分析,然后共同讨论并达成一致意见.结果 18例中,经血管造影按Lupi-Herrera综合分型法Ⅰ型16例,Ⅲ型 2例.主要受累动脉包括锁骨下动脉17例,颈动脉15例,椎动脉10例,头臂干5例.8例行经皮腔内血管成形术和支架置入术均获成功.结论 血管造影有利于大动脉炎性脑缺血的临床诊断与指导治疗,血管内介入治疗是一种微创的疗效可靠的治疗手段.

  4. Angiographic diagnosis and interventional therapy for Takayasu arteritis%大动脉炎的血管内介入诊疗

    Institute of Scientific and Technical Information of China (English)

    戚跃勇; 邹利光; 孙清荣; 黄岚; 帅杰; 周政; 肖颖彬

    2004-01-01

    目的探讨大动脉炎的血管造影诊断与介入治疗价值.方法 38例大动脉炎患者行血管造影检查.由2名有经验的介入放射学医师按盲法对其血管造影及介入治疗资料进行回顾性分析,然后共同讨论并达成一致意见.结果 38例中,经血管造影按Lupi-Herrera综合分型法,Ⅰ型11例,Ⅱ型15例,Ⅲ型7例,Ⅳ型5例.主要受累的动脉包括锁骨下动脉20例(52.6%),腹主动脉15例(39.5%),肾动脉,4例(36.8%),胸主动脉10例(26.3%),颈动脉9例(23.7%),髂动脉9例(23.7%),腋动脉7例(18.4%),肠系膜上动脉4例(10.5%),冠状动脉3例(7.9%)和肺动脉3例(7.9%)等.22例行经皮腔内血管成形术和12例行狭窄段支架置入术均获成功.结论血管造影有利于大动脉炎的临床诊断与指导治疗,血管内介入治疗是一种微创的疗效可靠的治疗手段.

  5. Angiographic diagnosis and interventional therapy for Takayasu arteritis%大动脉炎的血管造影诊断与介入治疗

    Institute of Scientific and Technical Information of China (English)

    戚跃勇; 邹利光; 戴书华; 黄岚; 王旭开; 朱结辉

    2004-01-01

    目的:探讨大动脉炎的血管造影诊断与介入治疗价值.方法:大动脉炎38例,男性11例,女性27例,年龄8~54岁,平均(30.5±18)岁,均行血管造影检查.由2名有经验的介入放射学医师按双盲法对其血管造影及介入治疗资料进行回顾性分析,然后共同讨论并达成一致意见.结果:38例中,经血管造影按Lupi-Herrera的综合分型法属Ⅰ型者11例,Ⅱ型15例,Ⅲ型7例,Ⅳ型5例.主要受累的动脉包括锁骨下动脉20例(52.6%),腹主动脉15例(39.5%),肾动脉4例(36.8%),胸主动脉10例(26.3%),颈动脉9例(23.7%),髂动脉9例(23.7%),腋动脉7例(18.4%),肠系膜上动脉4例(10.5%),冠状动脉3例(7.9%),肺动脉3例(7.9%)等.22例行经皮腔内血管成形术和12例行狭窄段支架置入术均获成功.结论:血管造影有利于大动脉炎的临床诊断与指导治疗,血管内介入治疗是一种微创的疗效可靠的治疗手段.

  6. 多发性大动脉炎的多层螺旋CT诊断%Diagnosis of Takayasu's arteritis with multi-slice spiral CT

    Institute of Scientific and Technical Information of China (English)

    平学军; 孟淑萍; 汪芳

    2008-01-01

    目的 分析总结多发性大动脉炎(TA)的多层螺旋CT检查方法及CT 征象,提高TA的CT诊断水平.方法 回顾性分析20例TA的多层螺旋CT检查资料,总结CT 检查方法及CT 表现并结合文献进行分析讨论.结果 按照Lupi-Herrea分类法,包括Ⅰ型5例,Ⅱ型3例,Ⅲ型12例.受累血管48支. CT 表现包括:受累血管管壁增厚48支、管腔狭窄46支、闭塞2支,2例并有血管瘤样扩张.结论 正确选择多层螺旋CT检查方法, 能够为TA的正确诊断提供可靠信息.

  7. [Ischemic stroke and the ways of compensation of cerebral circulation in patients with nonspecific aorto-arteritis with lesions of the brachiocephalic arteries].

    Science.gov (United States)

    Kazanchian, P O; Varava, B N; Todua, F I; Kuntsevich, G I; Zotikov, A E; Iudin, V I; Kon, M V; Volokina, O I; Buklina, S B

    1991-01-01

    In patients suffering from nonspecific aortoarteritis associated with impairment of the common carotid arteries, cerebral blood flow is compensated for at the expense of an increase of the volumetric blood flow in the vertebral arteries. During the first three years since the onset of the first disease symptoms, the blood content in the basin of the internal carotid arteries is reduced. Brain strokes occur most frequently within that period. They mostly develop without any preceding transitory ischemic attacks. The origin of neurological symptomatology depends to a considerable measure on the condition of the anterior and posterior communicating arteries.

  8. From arteritis to mycotic aneurysm: visualization of the progression of mycotic aneurysm development following femoral arterial line insertion in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Beck-Razi, Nira [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Rambam Medical Center, Department of Medical Imaging, Haifa (Israel); Bar-Joseph, Gad [Israel Institute of Technology, Pediatric Critical Care Unit, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Ofer, Amos; Gaitini, Diana [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Hoffman, Aharon [Israel Institute of Technology, Department of Vascular Surgery, Rambam Health Care Center, The Rappaport Faculty of Medicine, Technion, Haifa (Israel)

    2010-12-15

    Although uncommon, mycotic aneurysms in infants can be lethal because of the high risk of rapid expansion and rupture. Most catheter-associated mycotic aneurysms reported in the first year of life develop following umbilical artery catheterizations. We describe the sonographic detection of an early stage mycotic aneurysm in a 4-month-old following femoral artery catheterization complicated by methicillin-resistant Staphylococcus aureus (MRSA) septicemia. We also describe the sonographic and radiographic progression of this mycotic aneurysm before surgery. (orig.)

  9. Isquemia grave de membros inferiores por arterite por HIV Severe ischemia of lower limbs due to arteritis caused by HIV infection

    Directory of Open Access Journals (Sweden)

    Guilherme Benjamin Brandão Pitta

    2011-12-01

    Full Text Available A isquemia aguda de membros pode se manifestar, embora de forma incomum, como consequência à vasculite associada ao vírus da imunodeficiência humana (HIV. O presente caso descreve a evolução de uma paciente soropositiva para o HIV, que apresentou quadro de isquemia distal bilateral, com diminuição da temperatura de terço distal das pernas e pés, dor intensa, cianose fixa de pododátilos e ausência de pulsos distais. Submetida ao tratamento com terapia trombolítica, apresentou sinais de lesões decorrentes da isquemia e lesão tecidual de reperfusão com perda tecidual em regiões distais dos dedos, porém com melhora dos sinais e sintomas dos membros inferiores. Trata-se de um caso raro na literatura em função da associação da vasculite com o HIV e do acometimento dos vasos distais nos membros inferiores. Entretanto, o conhecimento desta associação é de extrema importância devido à repercussão na vida dos pacientes acometidos.The acute limb ischemia may manifest itself, albeit unusual, as a consequence of vasculitis associated with human immunodeficiency virus (HIV. This case report described a patient seropositive for HIV who developed bilateral distal ischemia with temperature decrease of distal legs and feet, severe pain, cyanosis of fixed toes, and absence of distal pulses. She underwent treatment with thrombolytic therapy, showed signs of injury resulting from ischemia and reperfusion tissue injury with tissue loss in the distal regions of the fingers, but with improvement of the signs and symptoms of lower limbs. It is a rare case in literature due to the association of vasculitis with HIV and to the torment of distal vases of the lower limbs. Despite of that, the knowledge of the pathology is extremely important because of the repercussion in the patients' lives.

  10. Diagnostic value of 3D contrast-enhanced magnetic resonance angiography in Takayasu's arteritis - a comparative study with digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Garg, Shobhit K.; Kumar, Sunil [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow, UP (India); Mohan, Suyash [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow, UP (India); University of Pennsylvania Health System, Neuroradiology Division, Department of Radiology, Philadelphia, PA (United States)

    2011-08-15

    To assess the diagnostic value of 3D CEMRA in TA compared with DSA. Twenty-two patients with clinically suspected TA based on 1990 ACR criteria for the classification of TA, were included in this study. There were 16 female and 6 male patients with ages ranging from 11 to 50 years (mean age 25 years). CEMRA and DSA were performed in all patients within 4 weeks of each other, for detection of stenosis, occlusion and aneurysm in the arch vessels, renal arteries and aortic segments. (1) TA was confirmed by CEMRA in all patients. (2) 147 arteries did not reveal any steno-occlusive lesion on CEMRA compared with 158 on DSA. (3) 75 stenoses, (excluding occlusions) were detected on CEMRA compared with DSA, which revealed 65 stenotic lesions, with sensitivity, specificity, PPV, NPV and DA for detection of a significant (>50%) stenotic lesion being 98.33%, 97.25%, 92.18%, 99.43% and 97.52% respectively. (4) Aneurysmal dilatation was detected in 13 arteries on CEMRA compared with 16 on DSA. Diagnostic value of CEMRA is comparable to that of DSA with a very strong and statistically significant correlation between DSA and CEMRA in detection and grading of characteristic steno-occlusive lesions of TA. (orig.)

  11. Rapport fra Riskens soppkurs i Eikesdalen 25.-28.09.2008

    DEFF Research Database (Denmark)

    2009-01-01

    Rapporten indeholder en analyse af over 800 fund af storsvampe fra den klimatisk set meget varme hassel-og elmedominerede Eikesdal i Nordvestnorge. Der blev fundet 447 arter på workshoppen (3 dage) på trods af meget tørre forhold, heraf 40 rødlistede arter, 11 nye arter for Norge og to med 2. gan...

  12. Dyreknogler fra Ronæs Skov-bopladsen, Summary

    DEFF Research Database (Denmark)

    Enghoff, Inge Bødker

    2009-01-01

    Analyser af dyreknogler fra en submarin boplads, Ronæs Skov, ved Gamborg Fjord på Fyn, påviser mindst syv arter af fisk, fire arter af fugle og nitten arter af pattedyr. Fiskeriet har især været domineret af torsk. Fuglefangsten har bestået af skarv, svane, spurvehøg og natugle. Foruden den for p...

  13. Pediatric Vasculitis Initiative

    Science.gov (United States)

    2016-08-19

    Wegeners Granulomatosis (Granulomatosis With Polyangiitis); Microscopic Polyangiitis; Churg Strauss Syndrome (Eosinophilic Granulomatosis With Polyangiitis); Polyarteritis Nodosa; Takayasu Arteritis; Primary CNS Vasculitis; Unclassified Vasculitis

  14. 9 CFR 113.47 - Detection of extraneous viruses by the fluorescent antibody technique.

    Science.gov (United States)

    2010-01-01

    ...: (i) Equine herpesvirus; and (ii) Equine viral arteritis virus. (5) Feline cells shall, in addition, be tested for: (i) Feline infectious peritonitis virus; and (ii) Feline panleukopenia virus....

  15. Arterite de Takayasu diagnosticada durante o puerpério em mulher com doença hipertensiva gestacional: relato de caso = Takayasu Arteritis diagnosed during puerperium in a woman with pregnancy-induced hypertension: case report

    Directory of Open Access Journals (Sweden)

    Hentschke, Marta Ribeiro et al.

    2014-01-01

    Conclusões: O diagnóstico precoce da Arterite de Takayasu é difícil, pois as manifestações iniciais são inespecíficas e os sintomas discretos. Entretanto, um exame físico cuidadoso pode evidenciar sinais que suscitem suspeitas e justifiquem investigação adicional, podendo prevenir um desfecho negativo, especialmente no período gestacional.

  16. 布卡综合征和多发性大动脉炎纤维蛋白原的对照研究%Study on Fibrinogen Related Budd- Chiari Syndrome and Takayasus Arteritis

    Institute of Scientific and Technical Information of China (English)

    韩新巍; 陈呈世; 段广才

    2007-01-01

    目的 通过对布卡综合征(Budd-Chiari Syndrome,BCS)患者和多发性大动脉炎(Takayasus Artritis,TA)患者纤维蛋白原(Fibrinogen,Fib)含量的分析,以了解我国BCS与炎症间的关系.方法 对34例BCS患者和16例TA患者化验Fib含量.结果 BCS患者的Fib含量和TA患者Fib含量的平均值分别为2.72和4.80,t值为-4.517,P值为0.0003,有统计学意义.结论 我国BCS的主要病因可能不是炎症.

  17. Multi-slice CT angiography in the diagnosis of Takayasu's arteritis%多层螺旋CT血管成像在大动脉炎中的应用

    Institute of Scientific and Technical Information of China (English)

    马祥兴; 张伟; 马晓峰; 王青; 于德新; 李笃民; 崔凤玉; 李传福

    2007-01-01

    目的 探讨多层螺旋CT(MSCT)血管成像在诊断大动脉炎中的临床应用价值.方法 对临床拟诊大动脉炎的14例患者进行MSCT血管成像,扫描范围自颈2椎体水平至耻骨联合水平,图像后处理方法包括多平面重组、最大密度投影、容积重组、血管内镜及血管分析,充分显示受累血管的部位、范围及程度.结果 14例患者CT表现为不同程度的动脉管壁增厚,管腔狭窄或闭塞,管腔狭窄具有向心性的特点,部分伴狭窄后扩张.按管腔情况包括狭窄-阻塞型8例,混合型6例.重组图像结合轴面图像观察,可以清晰显示受累大血管及其分支血管的狭窄程度或闭塞情况以及侧支血管形成情况.依据Lupi-Herrea分类法包括Ⅰ型5例,Ⅱ型2例,Ⅲ型6例,Ⅳ型1例,CT结果均与其临床表现相符.结论 MSCT血管成像同时显示大动脉炎的管腔情况和管壁改变,后者对于早期诊断及治疗、改善预后具有重要意义,可以作为此病的首选检查方法.

  18. Value of 64-slice spiral CT angiography in diagnosis of Takayasu's arteritis%64排螺旋CT血管成像在大动脉炎诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    徐崇明; 赵晓军

    2012-01-01

    目的 探讨64排螺旋CT血管成像(CTA)在大动脉炎临床诊断中的应用价值.方法 对临床拟诊大动脉炎的9例患者进行64排螺旋CT血管成像,图像后处理方法包括多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)、曲面重组(CPR)及血管分析,显示受累血管的部位、范围及程度.结果 64排螺旋CT血管成像清楚显示受累动脉不同程度的管壁增厚,管腔狭窄或闭塞,管腔狭窄具有向心性的特点,部分伴狭窄后扩张.后处理图像可以直观显示受累大血管及其分支血管的狭窄程度或闭塞情况以及侧支血管形成情况,依据Lupi-Herrea分类法包括I型5例,Ⅱ型1例,Ⅲ型3例,CT结果均与其临床表现相符.结论 64排CTA可清晰地显示大动脉炎累及主动脉及其分支的管壁变化,三维重建可更直观地显示病变的程度和范围,可以作为此病的首选影像学检查方法.

  19. Clinical application of multi-slice CT angiography in the diagnosis of multiple Takayasu's arteritis%多层螺旋CT血管成像在多发性大动脉炎诊断中的临床价值

    Institute of Scientific and Technical Information of China (English)

    李蓓; 史新平; 陈文华; 邱建国; 邢伟

    2010-01-01

    目的 探讨多层螺旋CT血管成像(MSCTA)在多发性大动脉炎诊断中的临床应用价值.方法 回顾分析18例疑为多发性大动脉炎患者的MSCTA图像,图像后处理方法包括多平面重组、最大密度投影和容积再现技术进行重建.结果 18例按Lupi-Herrea分类法包括Ⅰ型6例,Ⅱ型3例,Ⅲ型9例.管腔情况包括狭窄-阻塞型15例,混合型3例.MSCTA图像可以清楚显示受累血管的异常表现如管壁增厚,管腔狭窄或闭塞,部分伴狭窄后扩张.结论 MSCTA在多发性大动脉炎诊断方面有很高的准确性,可以作为多发性大动脉炎早期诊断的首选影像检查.

  20. Koroner Arter Kalsiyum Skor İndeksi ile Karotis ve Yüzeyel Femoral Arterlerin İntima Media Kalınlıkları Arasındaki İlişkinin Değerlendirilmesi

    OpenAIRE

    VARDI, Eşref Cem; BOZGEYİK, Zülkif; POYRAZ, Ahmed Kürşad; Onur, Mehmet Ruhi

    2012-01-01

    Objective: To investigate the relationship between intima-media thicknesses (IMT) of carotid and superficial femoral arteries and coronary artery calcium index quantified using Agatston score. Materials and Methods: Cardiac multidetector computed tomography (MDCT) angiography of 75 patients were included in the study. Coronary artery calcium scores were measured using a workstation. Calcium scores were calculated according to the Agatston method. Bilateral carotid artery and superficial f...

  1. Dynamic study of lower limb arteries using the ECTRICKS MRI technique; La perspective d'une etude dynamique des arteres des membres inferieures en IRM grace a la sequence ECTRICKS

    Energy Technology Data Exchange (ETDEWEB)

    Nicolas, M.; Laurent, V.; Tissier, S.; Cannard, L.; Leclerc, J.C.; Beot, S.; Regent, D. [Centre Hospitalier Universitaire Nancy-Brabois, Service de Radiologie Adultes, 54 - Vandoeuvre-les-Nancy (France)

    2005-01-15

    Purpose. This article presents a new MR angiography technique, Elliptic Centric Time Resolved Imaging on Contrast KineticS (ECTRICKS), which allows dynamic evaluation of the lower limb arteries opacification when venous return prevents adequate diagnostic evaluation of calf arteries. Patient and methods. Comparative examination of the calf arteries in 59 patients using a standard MRA technique and the ECTRICKS technique. Results. A total of 33 examinations could be compared. Additional arteries could be evaluated in 10% of our patient population using the ECTRICKS technique, and in 20% for our diabetic population. Arterial evaluation was better with the ECTRICKS technique in patients with diabetes and venous insufficiency. Conclusion. ECTRICKS is a good complementary sequence for evaluating the calf arteries in patients with diabetes or early venous return. (author)

  2. 针灸治疗多发性大动脉炎(头臂动脉型)40例临床研究%Clinical Study on 40 Cases of Multiple Aorto-Arteritis (Brachiocephalic Artery Type) Treated with Acupunture

    Institute of Scientific and Technical Information of China (English)

    丁晓蓉; 高其芳; 李平

    2003-01-01

    目的:采用客观、严格的诊断及疗效评定标准开展针灸治疗本病的临床研究,以确定其疗效.方法:选取80例患者(头臂动脉型),随机分为针灸组和药物组各40例,比较两组的疗效.结果:针灸组临床治愈率15%,显效率62.6%,总有效率95%;药物组显效率12.5%,总有效率75%.两组比较有显著性差异(P<0.01).结论:提示针灸治疗多发性大动脉(头臂动脉型)疗效确切,明显优于目前常规药物疗法.

  3. Combined analysis of stress myocardial tomo-scintigraphies and coronaries angio scanners to identify the arteries responsible of ischemia;Analyse combinee des tomoscintigraphies myocardiques de stress et angioscanners coronaires pour identifier les arteres responsables de l'ischemie

    Energy Technology Data Exchange (ETDEWEB)

    Didot, N.; Djaballah, W.; Daragon, N.; Gillet, N.; Meneroux, B.; Netter, F.; Paris-Grandpierre, S.; Karcher, G.; Marie, P.Y. [CHU de Nancy-Brabois, Service de medecine nucleaire, 54 (France); Mandry, D. [CHU de Nancy-Brabois, Service de radiologie, 54 (France)

    2010-05-15

    The purpose of this study is to assess the contribution of an analysis by image fusion of myocardium tomo-scintigraphy and coronary angio scanner in the identification of coronary artery responsible for myocardial ischemia stress. As results, the identification in myocardium tomo-scintigraphy of the ischemic arterial trunk is rarely changed by a combined analysis with coronary angio scanner. Discrepancies between the two examinations are common, even after fusion, but especially for mild ischemia. (N.C.)

  4. Autologous Peripheral Blood Stem Cell Transplantation in Patients With Life Threatening Autoimmune Diseases

    Science.gov (United States)

    2005-06-23

    Purpura, Schoenlein-Henoch; Graft Versus Host Disease; Anemia, Hemolytic, Autoimmune; Rheumatoid Arthritis; Churg-Strauss Syndrome; Hypersensitivity Vasculitis; Wegener's Granulomatosis; Systemic Lupus Erythematosus; Giant Cell Arteritis; Pure Red Cell Aplasia; Juvenile Rheumatoid Arthritis; Polyarteritis Nodosa; Autoimmune Thrombocytopenic Purpura; Takayasu Arteritis

  5. Spontaneous perinephric hemorrhage associated with urolithiasis in pregnancy.

    Science.gov (United States)

    McMann, Leah P; Peterson, Andrew C; Ahuja, Sunil A

    2004-06-07

    Spontaneous perinephric hematoma in the absence of anticoagulation, arteritis, or trauma is uncommon. We report the case of a postpartum patient with nephrolithiasis who initially presented to the obstetric service with a spontaneous perinephric hemorrhage.

  6. Spontaneous Perinephric Hemorrhage Associated with Urolithiasis in Pregnancy

    OpenAIRE

    2004-01-01

    Spontaneous perinephric hematoma in the absence of anticoagulation, arteritis, or trauma is uncommon. We report the case of a postpartum patient with nephrolithiasis who initially presented to the obstetric service with a spontaneous perinephric hemorrhage.

  7. Cerebral Autoregulation in Normal Pregnancy and Preeclampsia

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Panerai, Ronney B.; Haeri, Sina; Griffioen, Annemiek C.; Zeeman, Gerda; Belfort, Michael A.

    2013-01-01

    OBJECTIVE: To test the hypothesis that preeclampsia is associated with impaired dynamic cerebral autoregulation. METHODS: In a prospective cohort analysis, cerebral blood flow velocity of the middle cerebral artery (determined by transcranial Doppler), blood pressure (determined by noninvasive arter

  8. Spontaneous Perinephric Hemorrhage Associated with Urolithiasis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Leah P. McMann

    2004-01-01

    Full Text Available Spontaneous perinephric hematoma in the absence of anticoagulation, arteritis, or trauma is uncommon. We report the case of a postpartum patient with nephrolithiasis who initially presented to the obstetric service with a spontaneous perinephric hemorrhage.

  9. Explicit volume-preserving and symplectic integrators for trigonometric polynomial flows

    CERN Document Server

    Quispel, G R W

    2003-01-01

    We introduce explicit volume-preserving and symplectic integrators for the case of generalized trigonometric polynomial flows. The method is demonstrated using the Arter flow, and computational trials are conducted using a 4-dimensional vector field.

  10. Coronary artery bypass grafting in Takayasu's disease--importance of the proximal anastomosis: a case report

    NARCIS (Netherlands)

    Kuijer, A.; Oosterhout, M.F. van; Kloppenburg, G.T.; Morshuis, W.J.

    2015-01-01

    INTRODUCTION: Treatment of coronary artery involvement in Takayasu's arteritis is challenging. Coronary artery bypass grafting may be required. The use of saphenous vein grafts is recommended because of possible inflammatory involvement of the internal thoracic arteries. However, inserting the proxi

  11. Vandmiljø 2002

    DEFF Research Database (Denmark)

    Andersen, J. M.; Boutrup, S.; Svendsen, L. M.

    rengøringsmidler, og DEHP anvendes som blødgører i plastprodukter. Der registreres stadig en udbredt forekomst af påvirkning af kønsorganerne i de fire undersøgte arter af havsnegle, som skyldes TBT (tributyltin). Først og fremmest i kystnære områder, men i de følsomme arter er der også effekter i åbne farvande...

  12. Infiltrated papules on the trunk and headaches: A case of actinic granuloma and a review of the literature

    Directory of Open Access Journals (Sweden)

    Sonal A. Parikh, BS

    2015-08-01

    Full Text Available Actinic granuloma is a rare granulomatous reaction that is more commonly seen in females and thought to occur as an autoimmune response to actinic damage of elastic tissue. We discuss a case of a patient with actinic granuloma presenting with concomitant temporal arteritis. Our case and review of the literature emphasize the association between actinic granuloma and temporal arteritis, a serious inflammatory condition that could lead to blindness if misdiagnosed.

  13. An unusual differential for a pulseless trauma patient

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2012-01-01

    Full Text Available Hemorrhagic shock is the most common reason to explain the inability to feel pulse in a trauma patient. However, clinicians should always suspect atypical causes for differential pulses in this population and Takayasu′s arteritis (TA is one such example. We report a case of aorto-arteritis in a patient who presented with trauma and was later diagnosed with TA. She had blood pressure discrepancy between upper and lower limbs noted upon her initial trauma evaluation.

  14. Preliminary study of the clinical value of 64- slice spiral CT angiography in the diagnosis of Takayasu arteritis in children%儿童多发性大动脉炎64层螺旋CT 血管成像临床诊断价值初探

    Institute of Scientific and Technical Information of China (English)

    胡迪; 彭芸

    2013-01-01

    目的:探讨多层螺旋CT血管成像(MSCTA)对儿童多发性大动脉炎的诊断价值.方法:回顾性分析本院37例多发性大动脉炎患儿的MSCTA资料,图像后处理方法包括多平面重组(MPR)、最大密度投影(MIP)和容积再现(VR)技术.结果:37例按Lupi-Herrea 分类法,Ⅰ型2例,Ⅱ型18例,Ⅲ型15例,Ⅳ型2例.初诊时MSCTA检查显示所有受累血管共150支,狭窄-阻塞型37支,其中5支管腔闭塞,4支伴有细小侧支循环形成,1支伴局部血栓形成;扩张型11支,部分管壁伴有钙化;其余为混合型.狭窄血管中17支轻度狭窄、102支中度狭窄、15支重度狭窄、5支完全闭塞.不同时期受累血管均有不同程度的管壁增厚(2.0~7.0mm),活动期3.4~7.0mm,非活动期1.1~3.2mm.活动期CT平扫可见受累血管壁有环形低密度水肿状态带,增强扫描血管壁不均匀强化;非活动期局部血管可呈囊样扩张,管壁密度增高,部分可见钙化,增强扫描无强化.治疗后受累较轻血管可以完全恢复正常血管状态.结论:MSCTA在多发性大动脉炎的诊断方面有很高的准确性,可以作为多发性大动脉炎早期诊断的首选影像检查方法.

  15. {sup 99m}Tc-SSS lipiodol: development and study of its biodistribution following injection intra-hepatic artery of healthy pigs; {sup 99m}Tc-SSS lipiodol: mise au point du marquage et biodistribution apres injection au niveau de l'artere hepatique du porc

    Energy Technology Data Exchange (ETDEWEB)

    Garin, E.; Dazord, L.; Moisan, A.; Lecloirec, J.; Herry, J.Y.; Bourguet, P. [Centre Eugene-Marquis, UPRES EA 1794, Service de Medecine Nucleaire, 35 - Rennes (France); Noiret, N.; Lepareur, N.; Roucoux, A. [Ecole Nationale Superieure de Chimie, UMR CNRS 6052, 35 - Rennes (France); Malbert, C. [Institut National de Recherches Agronomiques (INRA/UMR VP), 35 - Saint Gilles (France); Caulet-Maugendre, S.; Turlin, B. [Centre Hospitalier Universitaire Pontchaillou, Service d' Anatomopathologie, 35 - Rennes (France); Tribut, O. [Centre Hospitalier Universitaire Pontchaillou, Service de Pharmacologie Clinique, 35 - Rennes (France)

    2003-12-01

    Aims. Intra-arterial metabolic radiotherapy with {sup 131}I-lipiodol is a therapeutic approach witch can be used for hepatocellular carcinoma, but several drawbacks limit its use. We report here the development of lipiodol labelling with {sup 99m}Tc and its biodistribution after infusion in the hepatic artery in healthy pigs. In fact, labelling lipiodol with {sup 99m}Tc is the first step towards the development of labelling Lipiodol with {sup 188}Re and {sup 99m}Tc lipiodol could be used for dosimetric purpose. Method. The {sup 99m}Tc lipiodol is obtained after dissolving in lipiodol a lipophilic chelating agent labelled with {sup 99m}Tc: the {sup 99m}Tc-(PhCS3)2(PhCS2). The radiochemical purity was assessed immediately after the labelling and 24 hours later. {sup 99m}Tc-lipiodol was injected through the hepatic artery in 7 pigs. Scintigraphic acquisitions were performed 1 and 24 hours after injection. Pigs were killed after 1 or 24 hours for removal of organs and in vitro counting. Results. The labelling of lipiodol with {sup 99m}Tc is achieved with a very high yield, 96 {+-} 0,8%. The radiochemical purity is satisfactory: 92 {+-} 2,6% immediately after labelling and at least 88 {+-} 3,5% at 24 hours. Scintigraphic acquisitions showed a predominant liver uptake and a faint lung uptake without other site of uptake at one hour and the apparition of a faint digestive elimination at 24 hours. Those results are confirmed by ex-vivo counting. Conclusion. This preliminary study point out that labelling lipiodol with {sup 99m}Tc can be performed with a good yield and a good radiochemical purity. It's biodistribution in healthy pigs is satisfactory. Labelling lipiodol with {sup 188}Re is now under development with the same chelating agent. (author)

  16. Will the myocardial tomo-scintigraphies with Tl-201 allow predicting the ventricular remodeling ensuing after the angioplasty of an artery responsible of an infarction?; Les tomoscintigraphies myocardiaques au Tl-201 permettent-elles de predire le modelage ventriculaire survenant apres angioplastie de l`artere responsable d`un infarctus?

    Energy Technology Data Exchange (ETDEWEB)

    Davin, N.; Arsena, T.; Quiri, N.; Hassan, N.; Marie, P.Y.; Olivier, P.; Angioi, M.; Juilliere, Y.; Karcher, G.; Danchin, N.; Bertrand, A. [Service de Medecine Nucleaire, CHU-Nancy (France)

    1997-12-31

    The coronary transluminal angioplasty (CTA) of the artery responsible of an infarction is susceptible of limiting the left ventricular remodeling. However, the influence of the residual myocardial viability on the remodeling was never analyzed. We have included 64 patients which have had in-effort thallium-201 tomo-scintigraphies with at-rest reinjection (MTS) having a CTA in the territory of a recent infarction (26 {+-} 24 days). The ejection fraction (EF) and the telediastolic (TDV) and telesystolic (TSV) volumes of the left ventricle were determined by radiological ventriculography, before the CTA and at {>=} 4 months later (the method of areas and lengths, OAD 30{sup o}). Thirty eight patients had not restenosis (GI) and 26 had one (GII). The evolution of TDV was equivalent in GI and GII ({Delta}TDV (ml): +1 {+-} 18 vs + 10 {+-} 30, NS), while the evolution of TSV and EF were better in GI than in GII ({Delta}TSV (ml): -6 {+-} 19 vs + 8 {+-} 28, p < 0.01; {Delta}EF (%): +5 {+-} 9 vs - 13 {+-} 10, p < 0.02). The predictive parameters independent, of the evolution of EF, were: [1] - the extension of the reversible lacuna in MTS (p < 0.002) and [2] - the absence of restenosis (p < 0.002). The only predictive parameter of the evolution of TDV was the extension of the reversible lacuna in MTS (p < 0.02). After coronary angioplasty in the territory of a recent infarction and the evolution of EF as well as that of TDV (remodeling) depends on the residual myocardial viability

  17. 肝癌肝动脉化疗栓塞术后外周血AFP mRNA变化及意义%THE ALTERATION OF AFP mRNA CONCENTRATION IN PERIPHERAL BLOOD WITH HEPATOCELLULAR CARCINOMA DURING TRANSHEPATIC ARTERAL CHEMOTHERAPY AND EMBOLIZATION

    Institute of Scientific and Technical Information of China (English)

    刘迎娣; 梁敏; 孙晓华; 汪鸿志; 程留芳

    2001-01-01

    To find the rule of alterations in AFP mRNA concentration in peripheral blood in patients with hepatocellular carcinoma(HCC) before and after the treatment with transhepatic arterial chemotherapy and embolization(TAE), 15 cases of the pateints with HCC were included in this survey. The AFP mRNA concentration in peripheral blood of the patients were investigated using compatitive RT-PCR technique before and 1,2,3,4, 5,6,7, 14, 28 days after TAE. The results showed that AFP mRNA concentration on the third day after TAE was the highest. It declined to the level before treatment during one week.It suggested that AFP mRNA concentration changed with a rule, and following the rule, preventive measure to distant metastasis could be instituted in clinical work.%通过对肝癌肝动脉化疗栓塞术(TAE)治疗前后外周血AFP mRNA定量检测,探讨治疗前后外周血AFP mRNA定量变化规律,并分析其临床意义。采用分子生物学反转录竞争PCR技术,定量检测了15例原发性肝细胞癌患者TAE治疗前及术后第1、2、3、4、5、6、7、14、28日外周血AFP mRNA水平。结果显示TAE前后外周血AFP mRNA有不同程度的变化,其中术后第3日呈最高水平,1周后基本恢复至术前水平,与术前比较,术后4周1例升高,8例基本相同,6例下降。提示TAE治疗后第3日外周血AFP mRNA水平最高,临床可给予积极治疗,预防肝外转移的发生。

  18. [{sup 18}F]FDG-PET in large vessel vasculitis; [{sup 18}F]FDG-PET bei Grossgefaess-Vaskulitiden

    Energy Technology Data Exchange (ETDEWEB)

    Hauser, A.S.D.; Walter, M.A. [Universitaetsspital Basel (Switzerland). Inst. fuer Nuklearmedizin

    2007-06-15

    [{sup 18}F]FDG-PET is a non-invasive metabolic imaging modality based on the regional distribution of fluorine-18-fluorodeoxyglucose that is highly effective in assessing the activity and the extent of giant cell arteritis and Takayasu's arteritis. It has shown to identify more affected vascular regions than morphologic imaging with Magnetic Resonance Imaging in both diseases. A visual grading of vascular [{sup 18}F]FDG-uptake helps to discriminate arteritis from atherosclerosis und therefore provides high specificity. High sensitivity is reached by scanning during the active inflammatory phase. [{sup 18}F]FDG-PET has the potential to develop into a valuable tool in the diagnostic work-up of giant cell arteritis and Takayasu's arteritis, respectively, and might become a first-line investigation technique. Therefore consensus regarding the most favorable imaging procedure as well as further clinical evidence is needed. The purpose of this review is to summarize current information on the present clinical data and to assist nuclear medicine practitioners in recommending, performing and interpreting the results of [{sup 18}F]FDG-PET in patients with suspected large vessel vasculitis. (orig.)

  19. Branch facial nerve trauma after superficial temporal artery biopsy: a case report

    Directory of Open Access Journals (Sweden)

    Rison Richard A

    2011-01-01

    Full Text Available Abstract Introduction Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy. Case presentation A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia. Conclusion Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.

  20. Vasculitis assessment with [{sup 18}F]F.D.G. positron emission tomography; Place de la tomographie par emission de positons (TEP) au [{sup 18}F]FDG dans l'exploration des vascularites

    Energy Technology Data Exchange (ETDEWEB)

    Liozon, E. [CHU Dupuytren, Services de Medecine Interne A, 87 - Limoges (France); Monteil, J. [CHU Dupuytren, Services de Medecine Nucleaire, 87 - Limoges (France)

    2008-10-15

    [{sup 18}F]fluorodeoxyglucose ({sup 18}F.D.G.) positron emission tomography (PET) is a noninvasive metabolic imaging modality that is well suited to the assessment of activity and extent of large vessel vasculitis, such as giant cell arteritis and Takayasu arteritis. PET could be more effective than magnetic resonance imaging in detecting the earliest stages of vascular wall inflammation. The visual grading of vascular [{sup 18}F]F.D.G. uptake makes it possible to discriminate arteritis from atherosclerosis, providing therefore high specificity. High sensitivity can be achieved provided scanning is performed during active inflammatory phase, preferably before starting corticosteroid treatment. Large scale prospective studies are needed to determine the exact value of PET imaging in assessing the large vessel vasculitis outcome and response to immunosuppressive treatment.

  1. Granuloma actinico de O'Brien O'Brien actinic granuloma

    Directory of Open Access Journals (Sweden)

    J A Gregoris

    2009-03-01

    Full Text Available Se comunica un caso de granuloma actínico en una paciente de sexo femenino, caucásica, la cual presentaba concomitantemente arteritis de la temporal y polimialgia reumática. Actualmente se considera que debido a la fisiopatogenia de las tres entidades mencionadas, podría tratarse la primera, de un marcador de las dos restantes.We present a female, white, with an actinic granuloma, concomitantly with temporal arteritis and polymyalgia rheumatica. Today it is considered that, due to the phisiopathogenia of the three entities mentioned before, the first one could be used as a reference for the other two.

  2. Storkarsvaskulitis påvist ved PET/CT hos patient med initialt formodet cancer

    DEFF Research Database (Denmark)

    Andersen, Kim Francis; Skøt, Jens; Bülow, Jens

    2012-01-01

    Large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, is traditionally diagnosed and classified according to the American College of Rheumatology criteria, which do not include findings on imaging modalities. We present a case in which non-invasive imaging with 18F......-fluorodeoxyglucose positron emission tomography/computed tomography gave essential information in the diagnostic work-up of large vessel vasculitis in a female presenting with non-specific symptoms. We discuss the role of nuclear medicine imaging in early diagnosis and follow-up of this inflammatory disease, characterized...... by granulomatous panarteritis of the aorta and its major branches....

  3. Faldvildt undersøgelser på DTU Veterinærinstituttet i 2013

    OpenAIRE

    Hansen, Mette Sif; Larsen, Gitte; Holm, Elisabeth; Jensen, Tim Kåre; Al-Sabi, Mohammad Nafi Solaiman; Chriél, Mariann

    2014-01-01

    Overvågning af sundhedstilstanden i den danske vilde fauna er af vital betydning for at kunne spore ændringer i sygdomsforekomster og sammensætning af bakterier, virus og parasitter. I denne forbindelse obduceres der på DTU-Vet faldvildt, som er indsendt af privat personer og offentlige instanser fra hele landet. I 2013 blev der undersøgt 771 landpattedyr, 31 havpattedyr og 184 fugle. Fordelingen af arter favner bredt, og for enkelte arter gælder det at der modtages mange individer. I det eft...

  4. Evaluation and management of "sinus headache" in the otolaryngology practice.

    Science.gov (United States)

    Patel, Zara M; Setzen, Michael; Poetker, David M; DelGaudio, John M

    2014-04-01

    Patients, primary care doctors, neurologists and otolaryngologists often have differing views on what is truly causing headache in the sinonasal region. This review discusses common primary headache diagnoses that can masquerade as "sinus headache" or "rhinogenic headache," such as migraine, trigeminal neuralgia, tension-type headache, temporomandibular joint dysfunction, giant cell arteritis (also known as temporal arteritis) and medication overuse headache, as well as the trigeminal autonomic cephalalgias, including cluster headache, paroxysmal hemicrania, and hemicrania continua. Diagnostic criteria are discussed and evidence outlined that allows physicians to make better clinical diagnoses and point patients toward better treatment options.

  5. Lorentz Spengler's descriptions of chitons (Mollusca: Polyplacophora)

    NARCIS (Netherlands)

    Kaas, P.; Knudsen, J.

    1992-01-01

    The present paper deals with an important Danish paper on the Polyplacophora, published in 1797 by Lorentz Spengler: Udförlig Beskrivelse over det mangeskallede Konkylie-Slaegt, af Linnaeus kaldet Chiton; med endeel nye Arter og Varieteter. -Skrivter af Naturhistorie-Selskabet, 4e Bind, Ie Hefte, VI

  6. Hõivatute edetabelisse jõudis kolm meest Ugalast / Tea Raidsalu

    Index Scriptorium Estoniae

    Raidsalu, Tea

    2009-01-01

    Postimehe nädalalõpulisa "Arter" kõige hõivatumate näitlejate loendis on Ugalast Tanel Ingi, Arvo Raimo ja Arvi Mägi. Andmeid nimekirja koostamiseks andsid teatrite trupijuhid. Ugala näitlejate kaalukamate rollide väljaselgitamist kommenteerib kirjandustoimetaja Helle Leppik

  7. Pediatric isolated bilateral iliac aneurysm.

    Science.gov (United States)

    Chithra, R; Sundar, R Ajai; Velladuraichi, B; Sritharan, N; Amalorpavanathan, J; Vidyasagaran, T

    2013-07-01

    Aneurysms are rare in children. Isolated iliac artery aneurysms are very rare, especially bilateral aneurysms. Pediatric aneurysms are usually secondary to connective tissue disorders, arteritis, or mycotic causes. We present a case of a 3-year-old child with bilateral idiopathic common iliac aneurysms that were successfully repaired with autogenous vein grafts.

  8. Data for forurenende træer i Europa samlet og tilpasset model for luftforurening

    DEFF Research Database (Denmark)

    Voigt, Steen

    2008-01-01

    Træer forurener. Nogle arter mere end andre. De afgiver både pollen og flere kemiske forbindelser, der påvirker menneskers sundhed - ofte efter transport med vinden over store afstande. Nu har forskere fra Danmarks Miljøundersøgelser ved Aarhus Universitet kortlagt forekomst og udbredelse af 39 t...

  9. First record of a chiton from the Palaeocene of Denmark (Polyplacophora: Leptochitonidae) and its phylogenetic affinities

    DEFF Research Database (Denmark)

    Sigwart, Julia D.; Andersen, Søren Bo; Schnetler, K. Ingemann

    2007-01-01

    Den første rapport om en skallus fra Fakse Kalkbrud, i løs koralkalk fra Mellem Danien. Det er samtidig opstillingen af en ny art, Leptochiton faksensis. En cladistisk analyse udføres med flere end 100 recente og fossile arter af ordenen Lepidopleurida. Palæoøkologisk udsiger denne arts forekomst...

  10. The effect of endovascular treatment on isolated iliac artery aneurysm treatment and mortality

    NARCIS (Netherlands)

    Buck, Dominique B.; Bensley, Rodney P.; Darling, Jeremy; Curran, Thomas; McCallum, John C.; Moll, Frans L.; Van Herwaarden, Joost A.; Schermerhorn, Marc L.

    2015-01-01

    Objective Isolated iliac artery aneurysms are rare, but potentially fatal. The effect of recent trends in the use of endovascular iliac aneurysm repair (EVIR) on isolated iliac artery aneurysm-associated mortality is unknown. Methods We identified all patients with a primary diagnosis of iliac arter

  11. Træfacader - udvendige bræddebeklædninger

    DEFF Research Database (Denmark)

    Jensen, Bjørn; Thomassen, Thomas

    Bogen vejleder om træbeklædningers opbygning og beskyttelse mod vejrliget, samt om gældende materialekrav og udvalgte træarter egnethed. Bogen handler om de mest anvendte former for bræddebeklædninger både til træskelethuse og som beklædning på huse af andre materialer....

  12. Økologisk risikovurdering af genmodificeret majs event 5307 i anmeldelse vedr. markedsføring under Forordning 1829/2003/EF

    DEFF Research Database (Denmark)

    Kjellsson, Gøsta; Sørensen, Jesper Givskov; Strandberg, Morten Tune;

    2011-01-01

    DMUs konklusioner vedr. den økologiske risikovurdering af den genmodificerede, insektresistente 5307-majs i Danmark Den genmodificerede majs 5307, adskiller sig fra konventionel majs ved at have indsat gener der gør planterne tolerante over for insektangreb fra larverne af nogle bestemte arter af...... friendly procedure than the conventional use of herbicide-resistance markers....

  13. Økologisk risikovurdering af genmodificeret majs event 5307 i anmeldelse vedr. markedsføring under Forordning 1829/2003/EF

    DEFF Research Database (Denmark)

    Kjellsson, Gøsta; Sørensen, Jesper Givskov; Damgaard, Christian;

    2012-01-01

    DMUs konklusioner vedr. den økologiske risikovurdering af den genmodificerede, insektresistente 5307-majs i Danmark Den genmodificerede majs 5307, adskiller sig fra konventionel majs ved at have indsat gener der gør planterne tolerante over for insektangreb fra larverne af nogle bestemte arter af...... environmentally friendly procedure than the conventional use of herbicide-resistance markers....

  14. Vasculitis Pregnancy Registry

    Science.gov (United States)

    2016-09-08

    Vasculitis; Behcet's Disease; CNS Vasculitis; Cryoglobulinemic Vasculitis; Eosinophilic Granulomatosis With Polyangiitis (EGPA); Churg-Strauss Syndrome (CSS); Granulomatosis With Polyangiitis (GPA); Wegener's Granulomatosis; IgA Vasculitis; Henoch-Schoenlein Purpura (HSP); Microscopic Polyangiitis (MPA); Polyarteritis Nodosa (PAN); Takayasu Arteritis (TAK); Urticarial Vasculitis; Systemic Vasculitis

  15. Hvilke planter er hjemmehørende i Danmark?

    DEFF Research Database (Denmark)

    Erik, Buchwald,; Wind, Peter; Bruun, Hans Henrik;

    2013-01-01

    Der har i de senere år været debat om, hvorvidt konkrete plantearter - fx Ær (Acer pseudoplatanus) og Gyvel (Cytisus scoparius) - er hjemmehørende arter i Danmark eller indførte fremmede (Buchwald 2008, 20110: Friis 2010: Møller 2011; Bruun2011). En medvirkende årsag til diskussionerne er, at der...

  16. Ion Channels in Leukocytes

    Science.gov (United States)

    1991-07-01

    muscle k142), heart muscle (80), bo- are released. In recent years much has been learned vine pulmonar arter endothelial cells (251), and rat about the...channel analysbib of Lt. Potassium permeability in HeLa cancer BioL Chem. 265: 142416-141263, 1990. cells. evidence for a calcium-a’tivated potassium

  17. Regulation of Neurotransmitter Responses in the Central Nervous System.

    Science.gov (United States)

    1987-05-01

    Phinucol. E-rp. flier. 230. ison of the effects of clonidine on ir-r. and postsvniaptic 31-323. adrenoceptors in the rapnit pulmonar \\ arter\\. .\\iinvn...E. (1982) J. Cell. Physiol. 112:42-50. 22. Jaken, S., Tashjian A.H. and Blumberg, P.M. (1981) Cancer Res. 41:2175-2181. 23. Niedel. J.E., Kuhn, LJ

  18. Botanisk genbesøg i Simested sogn 178 år efter Salomon Drejer

    DEFF Research Database (Denmark)

    Bruun, Hans Henrik

    2016-01-01

    Tag med tidsmaskinen tilbage til Himmerland år 1836-37 og bliv klogere på hvordan den lokale flora er forandret. Det er en bestemt slags arter og naturtyper som denne egn - og Danmark som helhed – er blevet fattigere på siden dengang....

  19. Muslinger i miljøovervågning i Grønland

    DEFF Research Database (Denmark)

    Bach, Lis; Strand, Jakob; Zbawicka, Malgorzata;

    I Grønland har vi hidtil formodet, at der kun fandtes en art blåmusling: Mytilus edulis. Et helt nyt genetisk studie med SNPs har nu vist, at der rent faktisk findes to arter: Mytilus edulis og Mytilus trossulus samt hybrider imellem dem. De to arters udbredelse i Grønland er ukendt, og vi ved...... derfor ikke, om vores hidtidige overvågning har været baseret på den ene, den anden eller evt. en kombination af de to arter. Vi ved heller ikke, om der er forskel på de to arters evne til at ophobe kontaminanter inkl. metaller fra det grønlandske miljø, og om der er forskel i de to muslingearters...... tolerance overfor metaller. Studier om optagelse og akkumulering af metaller i blåmuslinger viser dog indikationer på, at der kan være en sådan forskel. I Grønland er der lang tradition for at anvende blåmuslinger som indikatororganismer for miljøbelastning, bl.a. for at kontrollere om der ophobes metaller...

  20. Fever of unknown origin in the elderly is a diagnostic challenge

    DEFF Research Database (Denmark)

    Zajworoniuk-Wlodarczyk, Jolanta; Drozdowska, Joanna; Pedersen, Hanne

    2013-01-01

    Elderly individuals often have different causes of fever of unknown origin compared to young persons. While infections dominate in the young, system diseases like temporal arteritis and polymyalgia rheumatica, malignancy and drug fever are common causes in the elderly. The symptoms may be blunted...

  1. In search of sharp fat contours

    NARCIS (Netherlands)

    Van de Graaf, A.

    2005-01-01

    A heart attack is usually caused by a build-up of fatty deposits in the coronary arteries. In many cases the patient will have noticed early warnings signs such as rapid exhaustion and shortness of breath. A cardiologist can now use an ultrasonic sensor to detect fatty deposits in the coronary arter

  2. Habitats Directive classification of Danish wetlands

    DEFF Research Database (Denmark)

    Nygaard, Bettina; Ejrnæs, Rasmus; Baattrup-Pedersen, Annette

    EUs Habitatdirektiv blev vedtaget i 1992 med det overordnede formål at sikre den biologiske mangfoldighed i Europa. Direktivet forpligter medlemsstaterne til at sikre gunstig bevaringsstatus for de naturtyper og arter, der er opført på direktivets bilagslister. NOVANAs naturtypeprogram har til fo...

  3. Looks like a stroke, acts like a stroke, but it's more than a stroke: a case of cerebral mucormycosis.

    Science.gov (United States)

    Ermak, David; Kanekar, Sangam; Specht, Charles S; Wojnar, Margaret; Lowden, Max

    2014-09-01

    Mucormycosis is a fungus that exhibits angiocentric growth and can cause a thrombotic arteritis. Infection with this organism is uncommon and cerebral involvement is most often secondary to direct invasion through the paranasal sinuses. Here, we present a case of mucormycosis with cerebral involvement without sinus disease, which resulted in ischemic stroke with rapid progression resulting in death.

  4. The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures

    DEFF Research Database (Denmark)

    Lenzen, Mattie J; Scholte op Reimer, Wilma J M; Pedersen, Susanne S.

    2007-01-01

    Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary arter...

  5. Tuberkulose forårsaget af Mycobacterium africanum

    DEFF Research Database (Denmark)

    Bek, Dorte; Kjeldsen, Marianne Kirstine; Hansen, Nikolaj Friis;

    2010-01-01

    Tuberkulose (TB) forårsages af patogene arter fra Mycobacterium tuberculosis komplekset (MTBC) og har en incidens på cirka 7/100.000 i Danmark. På mistanke om TB hos en akut indlagt 40 årig afrikansk mand initieredes anti-TB behandling. Efter 13 timers indlæggelse afgik patienten ved døden. Fra l...

  6. Teeme tutvust / David Vseviov ; Intervjueerinud Urve Elias, Stina Eilsen, Jüri Aarma...[jt.

    Index Scriptorium Estoniae

    Vseviov, David, 1949-

    2009-01-01

    Koostatud varem ajakirjanduses ilmunud intervjuude katkenditest. Katkendid pärinevad järgmistest ajalehtedest ja ajakirjadest : Postimees/Arter (8.09.2007 ; Maaleht (11.12.2008 ; Õpetajate Leht 21. 12. 2001 ; Eesti Päevaleht/Arkaadia (24. 01. 2003) ; Eesti Ekspress (15. 12. 1995) ; Sakala (19. 04. 2006) ; Õhtuleht (29. 11. 2008 ; Annabella (veebruar 2005)

  7. Priming the Tumor Immune Microenvironment Improves Immune Surveillance of Cancer Stem Cells and Prevents Cancer Recurrence

    Science.gov (United States)

    2013-10-01

    Scientist Debbie Liao, Ph.D., Research Associate Ze Lui , B.S., Graduate Student...Arter- ioscler Thromb Vasc Biol 2012; 32: 1675–1686. 34 Diehl S, Rincon M. The two faces of IL-6 on Th1/Th2 differentiation. Mol Immunol 2002; 39: 531

  8. Biopsia de la arteria temporal: revisión de indicaciones y técnica quirúrgica para cirujanos plásticos Temporal artery biopsy: review of indications and surgical technique for plastic surgeons

    Directory of Open Access Journals (Sweden)

    A. Rodríguez Lorenzo

    2007-06-01

    Full Text Available La arteritis de células gigantes (ACG es una vasculitis que presenta complicaciones graves si no es diagnosticada y tratada precozmente con corticoides a altas dosis. La biopsia de la arteria temporal (BAT es la técnica diagnóstica estandarizada utilizada para confirmar la enfermedad. Se trata de una técnica sencilla y con poca morbilidad. No obstante, en la actualidad existe una controversia sobre su indicación en pacientes con sospecha clínica de arteritis sin síntomas craneales debido a la baja tasa de positividad de la biopsia. Presentamos en este trabajo una serie de 28 pacientes en los que se realizaron 30 BAT con el objetivo de revisar las indicaciones y describir la técnica quirúrgica utilizada.Giant cell arteritis is a vasculitis that presents serious complications if it is not diagnosed and treated prematurely with corticosteroids to high dose. The temporal artery biopsy is the gold estandar technique of diagnosis used to confirm the disease. It is a simple technique with little morbidity. Nevertheless, currently there is a controversy on its indication in patients with clinical suspicion of arteritis without craneal symptoms because of the downward rate of positiveness of the biopsy. We present in this work a serie of 28 patients in which 30 biopsies were carried out with the objective to review the indications and to describe the surgical technique utilized.

  9. Kragefuglejagt i Danmark

    DEFF Research Database (Denmark)

    Asferg, T.; Prang, A.

    Mere end hver femte af de jægere, der fik udbytte i jagtsæsonen 1990 /-91, nedlagde én eller flere kragefugle. Kragefugle omfatter i denne forbindelse fem arter: Krage (Corvus corone), husskade (Pica pica), skovskade (Garrulus glandarius), råge (C. frugilegus) og allike (C. monedula). Med 91...

  10. Takayasus arteritt

    Directory of Open Access Journals (Sweden)

    Øyvind Palm

    2009-10-01

    Full Text Available Takayasu arteritis (TA is a systemic vasculitis, most often affecting young, fertile women. In pre-pulseless phase with systemic inflammation, examination with ultrasound, MRA and 18FDG-PET can detect arteritis of the large arteries even before stenosis occurs. Among Caucasians the aorta arch and its branches are most often affected, whereas in Indian cohorts abdominal arteries are most often inflamed. The estimated incidence in Norway of 2.7/million inhabitants corresponds to that of North-Americans, but is based on very few cases. Outcome of pregnancy in TA depends on the distribution and amount of the vasculitis, secondary complications and access of medical follow-up. More focus on TA may result in earlier diagnosis and more multi-center studies should be initiated.

  11. Man kan inte tänka isär naturen och samhället

    DEFF Research Database (Denmark)

    Tsing, Anna; Lien, Marianne

    2015-01-01

    Livet på jorden är en kompromiss mellan arter och miljö. Samspelet är grundläggande för att skapa en värld där människor och andra varelser kan överleva, skriver Marianne Lien och Anna Tsing i DN:s och KTH:s artikelserie om miljö och humaniora.......Livet på jorden är en kompromiss mellan arter och miljö. Samspelet är grundläggande för att skapa en värld där människor och andra varelser kan överleva, skriver Marianne Lien och Anna Tsing i DN:s och KTH:s artikelserie om miljö och humaniora....

  12. Imaging of large vessel vasculitis with {sup 18}FDG PET: illusion or reality? A critical review of the literature data

    Energy Technology Data Exchange (ETDEWEB)

    Belhocine, Tarik; Vandevivere, Johan [Department of Nuclear Medicine, A.Z. Middelheim Hospital, 2020, Antwerp (Belgium); Blockmans, Daniel [Department of Internal Medicine, Gasthuisberg University Hospital, Leuven (Belgium); Hustinx, Roland [Department of Nuclear Medicine, University Hospital of Liege, Liege (Belgium); Mortelmans, Luc [Department of Nuclear Medicine, Gasthuisberg University Hospital, Leuven (Belgium)

    2003-09-01

    Fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}FDG PET) plays a major role in the management of oncology patients. Owing to the singular properties of the glucose tracer, many patients suffering from non-malignant diseases such as inflammatory or infectious diseases may also derive clinical benefit from the appropriate use of metabolic imaging. Large vessel vasculitides such as giant cell arteritis and Takayasu arteritis are other examples that may potentially extend the field of {sup 18}FDG PET indications. The purpose of the present article is to assess the feasibility of metabolic imaging in vasculitis on the basis of the current literature data. In particular, the clinical context and the {sup 18}FDG imaging patterns seen in patients with large vessel vasculitis are analysed in order to identify potential indications for metabolic imaging. (orig.)

  13. Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus.

    Directory of Open Access Journals (Sweden)

    Hassan Borji

    2014-09-01

    Full Text Available Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

  14. Regulering af jagt på vandfugle i kystzonen: Forsøg med dato-regulering på Nyord

    DEFF Research Database (Denmark)

    Bregnballe, T.; Hounisen, J. P.; Bøgebjerg, E.

    Et 4-årigt forsøg udført på Nyord Sydeng ved Møn har vist at jagt med 1-3 ugers interval ikke påvirkede antallet af gæs, ænder og vadefugle negativt, bort set fra at enkelte arter (især jagtbare arter) optrådte i lavere antal dagen efter en jagt. Fuglenes adfærdsmæssige reaktion på udøvelse af ja...... samt effekten på fuglenes antal var mindst i et år hvor engene blev oversvømmet tidligt på efteråret. Det konkluderes at dato-regulering af jagt på strandenge kan være et velegnet værktøj hvis der skal findes et alternativ til total jagtfredning...

  15. Fire ud af fem særligt beskyttede naturtyper har det dårligt

    DEFF Research Database (Denmark)

    Pedersen, Jens Christian

    2008-01-01

    Hele 78 % af de naturtyper som er omfattet af Habitatdirektivets fortegnelse over natur vi skal passe særligt på, og som vi har viden nok til at vurdere, har en tilstand som biologerne vurderer som "ugunstig". Det samme gælder for 59 % af de arter af dyr og planter som står på direktivets liste. ...

  16. Klimaændringer vender op og ned på naturen

    DEFF Research Database (Denmark)

    Pedersen, Jens Christian

    2009-01-01

    Undersøgelser forskellige steder på Jorden viser at den globale opvarmning fører til længere vækstsæsoner. Samtidig peger studier af planter og dyr på at mange arter gennemfører deres livscyklus hurtigere når klimaet bliver varmere. Disse modsatrettede tendenser betyder at det bliver mere sandsyn...

  17. Diagnosis performance of the positron computed tomography with {sup 18}F-F.D.G. in the Horton disease: meta-analysis; Performances diagnostiques de la tomographie par emission de positons au 18F-FDG dans la maladie de Horton: meta-analyse

    Energy Technology Data Exchange (ETDEWEB)

    Besson, F.; Costo, S.; Agostini, D. [CHU de Caen, Departement de medecine nucleaire, 14 (France); Dunet, V.; Prior, J. [CHU Vaudois, departement de medecine nucleaire, Lausanne (Switzerland); Hamon, M. [CHU de Caen, Departement de cardiologie, 14 (France); Parienti, J.J. [CHU de Caen, Departement de biostatiques, 14 (France)

    2010-07-01

    The PET with {sup 18}F-F.D.G. is a sensitive and specific technique to detect Horton disease. It could be used to invalidate the diagnosis among patients suffering of this disease, especially these ones presenting a negative or non contributive temporal artery biopsy or an atypical symptomatology. Furthermore, it should allow to better evaluate the extension of arteritis injuries. (N.C.)

  18. [Ankylosing spondylarthritis associated with Takayasu disease: a new case].

    Science.gov (United States)

    Taharboucht, S; Lanasri, N; Laroche, J-P

    2010-07-01

    Ankylosing spondylarthritis and Takayasu aorto-arteritis are two inflammatory diseases with a not yet elucidated pathogenic mechanism. Their association is quite exceptional with only a few cases (14) being published in the literature. We report a new case in a 26-year-old woman whose Takayasu disease led to stenosis of the subclavian artery and the thoracic aorta 9 years after diagnosis of ankylosing spondylarthritis with sacro-iliac involvement. This association is probably not fortuitous.

  19. Activated myeloid dendritic cells accumulate and co-localize with CD3+ T cells in coronary artery lesions in patients with Kawasaki disease.

    Science.gov (United States)

    Yilmaz, Atilla; Rowley, Anne; Schulte, Danica J; Doherty, Terence M; Schröder, Nicolas W J; Fishbein, Michael C; Kalelkar, Mitra; Cicha, Iwona; Schubert, Katja; Daniel, Werner G; Garlichs, Christoph D; Arditi, Moshe

    2007-08-01

    Emerging evidence implicating the participation of dendritic cells (DCs) and T cells in various vascular inflammatory diseases such as giant cell arteritis, Takayasu's arteritis, and atherosclerosis led us to hypothesize that they might also participate in the pathogenesis of coronary arteritis in Kawasaki disease (KD). Coronary artery specimens from 4 patients with KD and 6 control patients were obtained. Immunohistochemical and computer-assisted histomorphometric analyses were performed to detect all myeloid DCs (S-100(+), fascin(+)), all plasmacytoid DCs (CD123(+)) as well as specific DC subsets (mature myeloid DCs [CD83(+)], myeloid [BDCA-1(+)] and plasmacytoid DC precursors [BDCA-2(+)]), T cells (CD3(+)), and all antigen-presenting cells (HLA-DR(+)). Co-localization of DCs with T cells was assessed using double immunostaining. Significantly more myeloid DCs at a precursor, immature or mature stage were found in coronary lesions of KD patients than in controls. Myeloid DC precursors were distributed equally in the intima and adventitia. Mature myeloid DCs were particularly abundant in the adventitia. There was a significant correlation between mature DCs and HLA-DR expression. Double immunostaining demonstrated frequent contacts between myeloid DCs and T cells in the outer media and adventitia. Plasmacytoid DC precursors were rarely found in the adventitia. In conclusion, coronary artery lesions of KD patients contain increased numbers of mature myeloid DCs with high HLA-DR expression and frequent T cell contacts detected immunohistochemically. This suggests that mature arterial myeloid DCs might be activating T cells in situ and may be a significant factor in the pathogenesis of coronary arteritis in KD.

  20. 8.4.Electrolytes,water,acid-base imbalance

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920951 The effects of high dietary potas-sium on blood pressure,glomeruli and arter-ioles of kidney and spleen in two-kidney oneclip hypertensive rats.ZHANG Jianzhong (张中),ZHANG Hongyan (张宏彦).Dept Pathol,Ningxia Med Coll.Yin Chin Cir J 1991; 6 (5):380-382.in two-kidney,one clip (2K,1C) hypertensiveWistar rats,we studied the effects of high dietary

  1. Isolated periostitis as a manifestation of systemic vasculitis in a child: imaging features.

    Science.gov (United States)

    Cheon, Jung-Eun; Kim, In-One; Kim, Woo Sun; Yeon, Kyung Mo

    2010-12-01

    We report a case of isolated periostitis associated with Takayasu arteritis in a 10-year-old boy presenting with calf pain. Radiographs revealed a localized, thick periosteal reaction with irregular margin in the proximal left fibula. MRI revealed irregular thickening with enhancement of the periosteum in the proximal fibula and heterogeneous enhancement along vascular bundles in the calf. Isolated periostitis is a rare skeletal manifestation of systemic vasculitis that could be misdiagnosed as neoplastic or traumatic periosteal reaction.

  2. Dynamic CT of tuberculous meningeal reactions

    Energy Technology Data Exchange (ETDEWEB)

    Jinkins, J.R.

    1987-07-01

    The technique of intravenous dynamic cranial computed tomography has been applied to the patient population at this location in Saudi Arabia with meningeal tuberculosis. The various manifestations and sequelae including meningitis, arteritis, infarct, and true meningeal tuberculomata all have characteristic if not specific appearances. The dynamic study enhances an otherwise static examination and reveals a great deal about the pathophysiology of tuberculosis involving the cerebral meningeal surfaces.

  3. Antisense Treatments for Biothreat Agents

    Science.gov (United States)

    2006-08-01

    89,90] Equine arteritis virus PMO In vitro, cell culture [91] Flaviviruses (ie, dengue and West Nile viruses) PMO In vitro, cell culture [65-68,69...Bavari S: Induction of humoral and CD8 + T cell responses are required for protection against lethal Ebola virus infection. J Immunol (2005) 175(2...Dreher TW, Iversen PL, Stein DA: Inhibition of dengue virus serotypes 1 to 4 in vero cell cultures with morpholino oligomers. J Virol (2005) 79(8

  4. Isolated periostitis as a manifestation of systemic vasculitis in a child: imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung-Eun; Kim, In-One; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National University College of Medicine and the Institute of Radiation Medicine, Department of Radiology, 101 Daehang-ro Jongro-gu, Seoul (Korea, Republic of)

    2010-12-15

    We report a case of isolated periostitis associated with Takayasu arteritis in a 10-year-old boy presenting with calf pain. Radiographs revealed a localized, thick periosteal reaction with irregular margin in the proximal left fibula. MRI revealed irregular thickening with enhancement of the periosteum in the proximal fibula and heterogeneous enhancement along vascular bundles in the calf. Isolated periostitis is a rare skeletal manifestation of systemic vasculitis that could be misdiagnosed as neoplastic or traumatic periosteal reaction. (orig.)

  5. Parametric Simulation of Tactical Single Channel Frequency Modulated Communications.

    Science.gov (United States)

    1980-09-01

    Payne, Director U. S. Army TRADOC Systems Analysis Activity hite Sands Missile Range, New Mexico 88002 21. Hea4 arters, Department of the Army Offile of...S HS (C PT Steve Shupack) 8120 WoodMont Avenue Bethesda, Haryland 20014 146 23. Commander U. S. Army Concepts Analysis Agency ATTN: MOCA -WG (LTC Earl...26. Director USATRASANA ATTN: Mr. Ray Heath White Sands Missile Range, New Mexico 88002 27. Commander MICOM ATTN: DRSAII-YC (Mai..Hagewoodf Redstone

  6. Uracil and beta-alanine degradation in Saccharomyces Kluyveri - discovery of a novel catabolic pathway

    DEFF Research Database (Denmark)

    Andersen, Gorm

    2006-01-01

    ’en i gær og de genetiske forudsætninger for uracil og beta-alanine (BAL) katabolisme i S. kluyveri undersøgt. Evnen til at bruge uracil, dihydrouracil (DHU), beta-ureidopropionate (BUP) og BAL som nitrogenkilde blev studeret i 38 gær arter. Disse var udvalgt, så de dækkede “Saccharomyces komplekset...

  7. Comparison of Predictive Value of Cardiometabolic Indices for Subclinical Atherosclerosis in Chinese Adults

    OpenAIRE

    Ying Xu; Fang-fang Zeng; Li-ping He; Wen-hua Ling; Wei-qing Chen; Yu-ming Chen

    2014-01-01

    Objectives Metabolic disturbances are well-known risk factors for atherosclerosis, but it remains unclear which cardiometabolic components are the predominant determinants. This study aimed to compare and identify the key determinants of carotid atherosclerosis in asymptomatic middle-aged and elderly Chinese. Methods A community-based cross-sectional study including 3,162 apparently healthy residents aged 37–75 years was performed from July 2008 to June 2010 in Guangzhou, China. Carotid arter...

  8. New species in Old World Boehmeria (Urticaceae)

    DEFF Research Database (Denmark)

    Wilmot-Dear, Christine Melanie; Friis, Ib; Thomas, Zarah

    2010-01-01

    Fire nye arter af slægten Boehmeria (Urticaceae) er nybeskrevet og navngivet: Boehmeria listeri Friis & Wilmot-Dear og B. manipurensis Friis & Wilmot-Dear, begge fra dem østlige del af Himalaya, B. leptostachya Friis & Wilmot-Dear fra Yunan i Kina, Thailan of den nordlige del af Sumatra, og B. su....... subintegra Friis & Wilmot-Dear fra Papua Ny Guinea....

  9. [Acute benign cerebral angiopathy. 6 cases].

    Science.gov (United States)

    Rousseaux, P; Scherpereel, B; Bernard, M H; Guyot, J F

    1983-10-08

    The 6 cases reported here constitute, with 5 previously published cases, a special nosological entity tentatively called "acute benign cerebral angiopathy" by the authors. These 11 cases have in common certain radiological and clinical features. Arteriography shows segmental, multifocal and assymetrical stenoses involving the cerebral arteries between Willis' circle and the terminal arterioles and looking like "strings of sausages". The lesions disappear within one month and present the radiological characteristics of arteritis of medium caliber vessels. The clinical symptoms are suggestive of meningeal haemorrhage or acute cerebromeningeal oedema, with acute repetitive attacks of severe headache and agitation with obnubilation; epileptic seizures and transient neurological deficit may occur. True meningeal haemorrhage confirmed by lumbar puncture is seen in nearly one half of the cases; it seems to be due to alterations in the blood-brain barrier induced by the angiopathy. Intracerebral haematoma may develop, but the disease is usually benign and regresses spontaneously in a few days. None of the usual causes of cerebral arteritis (intra-cranial infection, collagen disease, allergic or toxic angitis) has been found. Pseudo-arteritis (notably spasm of ruptured arterial aneurysms) has been excluded. No aetiological factor common to the 11 cases reported has been elicited, although 6 of the patients had recently given birth and our 6 patients had benign virus infection before or during the clinical manifestations of the disease. In the authors' opinion, the most rewarding line of research would be the role of short acute attacks of arterial hypertension.

  10. Phytophthora rotråte i juletrefelt

    DEFF Research Database (Denmark)

    Talgø, Venche; Thomsen, Iben Margrete

    2015-01-01

    Phytophthora rotråte forårsaket av ulike arter av Phytophthora er et stort problem i juletreproduksjonen iUSA. I Norge er det også rapportert om flere tilfeller av skade på grunn av Phytophthora både i juletrær og klippegrønt, men så langt ikke i Danmark. I begge landene er flere arter av...... Phytophthora funnet på treaktige vekster i grøntanlegg. Vi har også sett en urovekkende spredning av Phytophthora til løvtrær i bynære skoger, vassdrag og naturområder det siste tiåret, spesielt i Norge. Både i Norge og Danmark har vi undersøkt vann i eller like ved juletreplantinger og funnet flere...... Phytophthora-arter, så dette er en skadegjører juletredyrkere må være på vakt overfor...

  11. Actualización en polimialgia reumática Polymyalgia rheumatica revisited

    Directory of Open Access Journals (Sweden)

    Pablo Przygoda

    2002-08-01

    Full Text Available La polimialgia reumática (PMR es una enfermedad inflamatoria que afecta generalmente a personas mayores de 50 años y se caracteriza por dolor y entumecimiento doloroso de los músculos proximales junto con la elevación de la velocidad de sedimentación globular en la 1º hora. Si bien cada vez se diagnostica más frecuentemente, la PMR sigue siendo un diagnóstico de exclusión y los criterios diagnósticos propuestos no son universalmente aceptados. Si bien es reconocida la asociación de PMR con arteritis de células gigantes (ACG, la biopsia sistemática de la arteria temporal no está indicada en los pacientes con PMR que no presentan síntomas de ACG. El diagnóstico precoz y el tratamiento con esteroides en dosis bajas provocan una mejoría muy importante en los síntomas y la capacidad funcional de los pacientes con PMR. El tratamiento suele durar entre 12 y 24 meses y un alto porcentaje de los pacientes logra la suspensión definitiva del mismo.Polymyalgia rheumatica is an inflammatory disorder that usually affects persons over the age of 50 causing proximal muscle pain and stiffness, and an elevated erythrocyte sedimentation rate. Although increasingly recognized in this age group, it remains a diagnosis of exclusion and although several diagnostic criteria have been proposed, none has been clearly accepted. While polymyalgia rheumatica is associated with giant cell arteritis, obtaining a temporal artery biopsy is not recommended in patients with polymyalgia rheumatica without symptoms of giant cell arteritis. Early diagnosis and low dose corticosteroid therapy improve patients' clinical features and functional status. Treatment usually lasts between 12 and 24 months and the majority of patients manage to discontinue treatment completely.

  12. Elaphostrongylus spp. from Scandinavian cervidae - a scanning electron microscope study (SEM

    Directory of Open Access Journals (Sweden)

    Margareta Stéen

    1990-08-01

    Full Text Available Nematodes of the genus Elaphostrongylus collected from moose (Alces alces L., reindeer (Rangifer tarandus tarandus L., and red deer (Cervus elaphus L., respectively, were studied by means of scanning electron microscopy. Morphological differences in the ribs of the genital bursa were demonstrated. The Elaphostrongylus species from reindeer and red deer differed from each other in four ribs of the genital bursa. These results agree with the morphological characters of E. cervi and E. rangiferi described by Cameron (1931 and Mitskevitch (1960. The genital bursa of Elaphostrongylus sp. from moose, in accordance with the description of E. alces by Steen et al. (1989 showed characteristics differing from those found in Elaphostrongylus spp. from reindeer and red deer respectively. These results support the hypothesis that there are three separate species of Elaphostrongylus present in Scandinavian Cervidae. Svep-elektroniska studier på Elaphostrongylus spp. hos skandinaviska hjortdjur.Abstract in Swedish / Sammandrag: Rundmaskar inom slaktet Elaphostrongylus funna hos alg (Alces alces L., ren (Rangifer tarandus tarandus L. och kronhjort(Cervus elaphus L. studerades med hjalp av svepelelektronmikroskop. De hanliga bursorna med sin a stodjeribbor uppvisade variationer i utseende, langd och placering mellan dessa rundmaskar. De arter av Elaphostrongylus funna hos ren och kronhjort skilde sig åt avseende fyra stodjeribbor på de hanliga bursorna. Dessa resultat stammer val overens med de karaktarer som tidigare ar beskrivna av Cameron(1931 och av Mitskevich (1960. Den hanliga bursan hos arten Elaphostrongylus funnen hos alg, vilken tidigare ar beskriven av Steen et al. (1989, visade upp ett utseende som skilde sig från bursorna hos de Elaphostrongylus-arter funna hos ren och kronhjort. Dessa resultat stoder hypotesen om tre skilda arter av Elaphostrongylus hos skandinaviska hjortdjur.

  13. Resistin Enhances Inflammatory Cytokine Production in Coronary Artery Tissues by Activating the NF-κB Signaling

    Directory of Open Access Journals (Sweden)

    Fang Gao

    2016-01-01

    Full Text Available Purpose. Kawasaki disease (KD is a systemic vasculitis and is a leading cause of coronary artery lesions (CALs in childhood. Our previous study has shown higher levels of serum Resistin in KD patients with coronary aneurysm. This study aimed at examining the association of Resistin with inflammatory cytokine expression in mouse model of coronary arteritis and determining the potential mechanisms. Methods. C57BL/6 mice were injected with Lactobacillus cell wall extract (LCWE to induce coronary arteritis. The relative levels of Resistin, TNF-α, IL-1β, and MMP-9 expression and inflammatory infiltrates in the coronary arteries were determined longitudinally by quantitative RT-PCR, ELISA, and histology. The effect of TLR4 and NF-κB activation on Resistin-induced TNF-α and IL-1β expression in human coronary artery endothelium cells (HCAECs was examined by quantitative RT-PCR. Results. Higher levels of Resistin, TNF-α, IL-1β, and MMP-9 expression were associated with the degrees of inflammatory infiltrates in the coronary artery walls of the LCWE-injected mice. Resistin enhanced TNF-α and IL-1β expression in HCAECs at 18 or 24 hours after stimulation. Pretreatment with anti-TLR4 attenuated Resistin-enhanced IL-1β, but not TNF-α, expression and pretreatment with parthenolide or QNZ demolished Resistin-enhanced TNF-α expression in HACECs. Pretreatment with parthenolide, but not QNZ, blocked Resistin-enhanced IL-1β expression in HCAECs. Conclusion. Resistin may enhance inflammation by cross-talking with TLR4/NF-κB signaling during the development of coronary arteritis in mice.

  14. Refractory PMR with aortitis: life-saving treatment with anti-IL6 monoclonal antibody (tocilizumab) and surgical reconstruction of the ascending aorta.

    Science.gov (United States)

    Ashraf, Fahd Adeeb Mohamed; Anjum, Shakeel; Hussaini, Abid; Fraser, Alexander

    2013-06-18

    Aortitis is uncommon but well described in patients with polymyalgia rheumatica (PMR). While glucocorticoid remains the mainstay therapy for large-vessel vasculitis, there have been cases where tocilizumab therapy led to clinical and serological improvement in patients with relapsing or refractory disease. We report a case of life-threatening PMR with aortitis in the absence of manifestations related to giant cell arteritis, which, having failed to respond to corticosteroid therapy, was successfully treated with tocilizumab and emergency reconstruction of the ascending aorta. This case adds to the literature supporting the potential value of interleukin-6 inhibition in rare rheumatological conditions such as inflammatory aortitis.

  15. Treating Principles and Methods of Traditional Chinese Medicine in Treatment of Peripheral Vascular Diseases

    Institute of Scientific and Technical Information of China (English)

    张雅洁; 陈知行; 刘玉洁; 张雅琳

    2001-01-01

    @@Peripheral vascular disease embraces a variety of conditions such as thromboangiitis obliterans, Raynaud's disease, thrombophlebitis, aorto-arteritis, obliterate atherosclerosis, varix or phlebothrombosis of the lower limb. Although the affected blood vessel may be arterial or venous one and caused either by inflammation or degenerate changes, they share common symptoms and signs, such as blood stasis, ischemia, thrombosis, ecchymosis, swelling, constriction or obliteration of blood vessels due to circulatory impairment. Since they share common characteristics, the treating principles and methods will be discussed as follows.

  16. Gorillas´ (Gorilla gorilla) use of experimenter-given manual and facial cues in an object-choice task

    DEFF Research Database (Denmark)

    Byrnit, Jill

    2009-01-01

    -valgs opgaver. Størstedelen af objekt-valgs-forsøg er imidlertid blevet foretaget med chimpanser og meget få forsøg har undersøgt andre menneskeabe-arter, hvilket gør det svært at generalisere om menneskeaber. Det eneste objekt-valgs-forsøg med gorillaer har interessant nok indikeret, at de kan klare opgave. I...... nærværende undersøgelse brugte gorillaer ikke konsekvent manuelle og visuelle tegn til at løse opgaven....

  17. Pulmonary vasculitis.

    Science.gov (United States)

    Lally, Lindsay; Spiera, Robert F

    2015-05-01

    Pulmonary vasculitis encompasses inflammation in the pulmonary vasculature with involved vessels varying in caliber from large elastic arteries to capillaries. Small pulmonary capillaries are the vessels most commonly involved in vasculitis affecting the lung. The antineutrophil cytoplasmic antibody-associated vasculitides, which include granulomatosis with polyangiitis (formerly Wegener granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome), are the small vessel vasculitides in which pulmonary vasculitis is most frequently observed and are the major focus of this review. Vasculitic involvement of the large pulmonary vessels as may occur in Behçet syndrome and Takayasu arteritis is also discussed.

  18. Pneumatic compression for embolic protection during upper extremity endovascular intervention.

    Science.gov (United States)

    Cassar, Andrew; Barsness, Gregory W; Wysokinski, Waldemar E; Gifford, Shaun M; Bower, Thomas C; Edwards, William D; Gulati, Rajiv

    2014-01-01

    Embolic protection devices are occasionally employed during endovascular interventions to prevent complications caused by embolic debris. However, these devices have imperfect efficacy, confer risk of endovascular trauma, and are expensive. We report a patient with giant cell arteritis and symptomatic axillary artery stenosis, with a perceived elevated risk of distal embolization during endovascular intervention. We describe a straightforward embolic protection technique of brachial pressure cuff inflation during endovascular intervention and aspiration of displaced thrombotic material from the static column of blood. This novel, effective, and cost-free technique could also be employed in other vascular beds during endovascular intervention.

  19. En lytterkomposition over mødet med musik i DR

    Directory of Open Access Journals (Sweden)

    Ansa Lønstrup

    1991-08-01

    Full Text Available Musikken i radioen handler også om lyttere. Hvor den foregående artikel af Lars Ole Bonde havde sit udgangspunkt i musikproduktionen og dens vilkår i DR, beskæftiger Ansa Lønstrup sig med musikken, når den forlader højt- taleren. Artiklen handler ikke om musiklytning i arter og kvantiteter, men om de oplevelsesformer og -muligheder, som musikken i radioen tilbyder for den ikke-gennemsnitlige lytter.

  20. TECHNICAL PROBLEMS ON RIGHT LUNG TRANSPLANTATION

    OpenAIRE

    田, 大力; "青木, 稔; 山崎, 文郎; 和田, 洋巳; 人見, 滋樹; 乾, 健二

    1989-01-01

    This report describes the technique of the allo-transplantation of the right lung of an adult mongrel dog. Compare to the transplantation of the left lung, we found several pitfalls in the right lung transplantation. 1) The intraatrial groove of the recipient must be divided carefully just at the middle of the right and the left atrium in order to make a generous cuff for the left atrial anastomosis. 2) It is preferable to divide azygos vein to perfom easy anastomosis of right pulmonary arter...

  1. Fatal hemorrhage following trans--sphenoidal resection of a pituitary adenoma: a case report and review of the literature.

    Science.gov (United States)

    Kepron, C; Cusimano, M; Pollanen, M S

    2010-12-01

    A 58-year-old woman with acromegaly developed massive epistaxis 7 days following trans-sphenoidal resection of a growth hormone-secreting pituitary adenoma. At autopsy, it was determined that the source of the hemorrhage was a rupture of the intracavernous segment of the internal carotid artery secondary to a bacterial arteritis. We describe the gross dissection and histologic examination undertaken in this unusual case, discuss the possible etiology of the infection and review the potential complications of this surgical approach with a view to improving forensic examination of these patients.

  2. AFRRI Reports Third Quarter, July - September 1991

    Science.gov (United States)

    1991-10-01

    learned ,ine pulmonar arter endothelial cells (251), and rat about the physiology of phagocytic cells, including the basophilic leukemia cells (154). role...m. nge r get r~atiun I n t ht. prtuni I-onU titteci I r I IL-uu.J. channel anasl. of thle potasmom permeailikt3 in lIeLa cancer Thi. (lien, 265... pulmonar . macrophages. 2V7. SEGEL. G. M. AND M. A. LICIITMAN. Potassium transport in Xiernry 21. 6321-6.26. 19F2. hoinam bliood .mphtoe 71 Lreauieaa tilt ph

  3. AN INTERESTING CASE OF VALVULAR HEART DISEASE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Anusuya

    2016-06-01

    Full Text Available A 24-year-old male presented with symptoms of acute onset altered sensorium and seizures. He was diagnosed with hypertensive encephalopathy and retinopathy. He was a candidate of double valve replacement surgery, which he underwent 3 years back. Further workup with renal artery Doppler revealed unilateral renal artery stenosis with extensive collateral circulation. Patient underwent a complete CT aortogram, which revealed large vessel vasculitis. We report this case as it is a rare initial presentation of Takayasu arteritis in a male to involve double valves of the heart

  4. Vasculitis cerebral cisticercosa y neuropatía óptica isquémica en una paciente con amaurosis unilateral y recuperación ad integrum

    OpenAIRE

    Enríquez Coronel,Guillermo; Santos Marcial,Edgar; Cabrera Aldana,Eibar Ernesto

    2004-01-01

    La cisticercosis es una parasitósis bien conocida que puede causar una gran cantidad de síndromes. La neuropatía isquémica-óptica es una enfermedad de adultos cuyas causas principales son hipertensión arterial y la diabetes y la arteritis de células gigantes. Presentamos el caso de una estudiante de medicina de 22 años que presentó súbitamente pérdida de la visión en el ojo derecho y después completa ceguera. Los estudios demostraron múltiples cisticercos en el hemisferio derecho. Fue tratada...

  5. Experimental West Nile virus infection in Eastern Screech Owls (Megascops asio)

    Science.gov (United States)

    Nemeth, N.M.; Hahn, D.C.; Gould, D.H.; Bowen, R.A.

    2006-01-01

    Eastern Screech Owls (EASOs) were experimentally infected with the pathogenic New York 1999 strain of West Nile virus (WNV) by subcutaneous injection or per os. Two of nine subcutaneously inoculated birds died or were euthanatized on 8 or 9 days postinfection (DPI) after myocardial and skeletal muscle necrosis and mild encephalitis and nephritis, whereas some of the clinically healthy birds that were sacrificed on 14 DPI had myocardial arteritis and renal phlebitis. WNV is a significant pathogen of EASOs, causing pathologic lesions with varying clinical outcomes.

  6. Ischaemic necrosis of the tongue as a rare complication of cardiogenic shock.

    Science.gov (United States)

    Hulstaert, E; Roggeman, E; Beeckman, A-S; Moerman, M; Vanderstraeten, E; Rasquin, K; Monsaert, E; Baert, D; Dewint, P; Burvenich, P; Van Steenkiste, C

    2015-12-01

    Ischaemic necrosis of the tongue is an unusual clinical finding. In most cases it is associated with vasculitis, particularly giant cell arteritis (GCA). Other causes include profound cardiogenic shock. We report a case of tongue necrosis in an 81-year-old Caucasian woman. The patient was admitted to the intensive care unit (ICU) for cardiogenic shock. Swelling of the tongue was reported before intubation and evolved into tongue ischaemia and necrosis of the tip of the tongue. After surgical debridement the patient recovered. To our knowledge, this is the second report of a patient surviving tongue necrosis resulting from cardiogenic shock.

  7. Ocular Lyme borreliosis as a rare presentation of unilateral vision loss.

    Science.gov (United States)

    Patterson-Fortin, Jeffrey; Kohli, Anita; Suarez, Maria J; Miller, P Elliott

    2016-04-25

    Ocular Lyme borreliosis is a rare manifestation of Lyme disease. We describe a case of an 80-year-old woman who presented with a 1-month history of unilateral painless central vision loss. Based on a temporal artery biopsy, she was initially diagnosed with giant cell arteritis and treated with a 3-day course of high-dose intravenous steroids. A more detailed history uncovered multiple previous treatments for Lyme disease and residence in an endemic Lyme area. The patient was subsequently diagnosed with ocular Lyme borreliosis and treated with intravenous antibiotics. After 5 weeks of treatment, unilateral vision loss did not progress and optic disc oedema resolved.

  8. Necrotizing vasculitis in acute postinfectious glomerulonephritis

    OpenAIRE

    Riyuso,Márcia C; CARVALHO Maria Fernanda C.; Trindade,Amélia A. T; Luciana B. Mendonça; Saggioro, Fabiano P.; Viero, Rosa Marlene

    2004-01-01

    Os autores relatam dois casos de glomerulonefrite difusa aguda pós-infecciosa com evolução clinicomorfológica incomum. As biópsias renais mostraram alterações características de glomerulonefrite difusa aguda associada à extensa necrose fibrinóide e infiltrado inflamatório leucocitário na parede de arteríolas e artérias interlobulares. Foram também observadas crescentes. Ambos os pacientes cursaram com insuficiência renal aguda severa, sendo que um dos pacientes recuperou a função renal e outr...

  9. Vasculite necrosante na glomerulonefrite difusa aguda pós-infecciosa

    OpenAIRE

    Riyuso Márcia C; Carvalho Maria Fernanda C; Trindade Amélia A. T; Mendonça Luciana B.; Saggioro Fabiano P; Viero Rosa M

    2004-01-01

    Os autores relatam dois casos de glomerulonefrite difusa aguda pós-infecciosa com evolução clinicomorfológica incomum. As biópsias renais mostraram alterações características de glomerulonefrite difusa aguda associada à extensa necrose fibrinóide e infiltrado inflamatório leucocitário na parede de arteríolas e artérias interlobulares. Foram também observadas crescentes. Ambos os pacientes cursaram com insuficiência renal aguda severa, sendo que um dos pacientes recuperou a função renal e outr...

  10. Clinical features in patients with simultaneous cerebral arterial and venous lesions (with literature survey

    Directory of Open Access Journals (Sweden)

    Lee Peng Chew

    2014-01-01

    Full Text Available Nowadays, only few cases of simultaneous cerebral arterial and venous thrombosis were reported. However, there might be high probability of coexisted cerebral arterial and venous changes. It is worthy to study the reasons and frequency of these coexisted vascular changes contributing to the development of clinical pictures. We analyzed 12 cases of simultaneous cerebral and/or neck vascular changes based on vascular images and ultrasonography which were divided into 4 groups: coexistence of simultaneous arterial and venous thrombosis; venous thrombosis with arterial hypoplasia; arterial thrombosis, arteritis or dissections with venous sinus hypoplasia; coexistence of arterial and venous hypoplasia.

  11. Giant coronary artery aneurysms in a 58-year-old

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhi

    2014-01-01

    Full Text Available All giant Kawasaki aneurysms may not regress fully; some may eventually calcify, undergo thrombosis, and get detected in asymptomatic adults at later age. Tomisaku Kawasaki initially described this illness as mucocutaneous lymph node syndrome in childhood in 1967 and coronary arteritis was recognized later. We present a 58-year-old male, possibly one of the oldest surviving patients with giant coronary aneurysms who presented with large secundum atrial septal defect (ASD with heart failure. This indicates that the disease was perhaps prevalent outside Japan even before the first Kawasaki′s description.

  12. United States Air Force Personnel and Exposure to Herbicide Orange

    Science.gov (United States)

    1988-02-01

    other than hepatitis, Jaundice , or cirrhosis veri- fied by medical record while two of 773 comparisons had the same (p-0.004). Throughout the hepatic...suggest th•j TCDD toxicity may b? associated with radical-induced lipid peroxidation. Kociba and colleaguesŖ saw an Wcreased incidence of arteritis in...Wiley and Sons, NY, 1980. 43. Albro PW, Corbett JT, Harris M, et al: Effects of 2,3,7,8-Tetrachloro- dibenzo-p-Dioxin on Lipid Profiles in Tissue of

  13. Doença renal ateroembólica: uma causa de insuficiência renal aguda pouco explorada

    OpenAIRE

    Dummer, Claus Dieter; Veronese,Francisco J. V.; Piana,Marjana

    2010-01-01

    O ateroembolismo é uma doença multisistêmica que afeta vários órgãos, entre os quais o rim, através da liberação de êmbolos de colesterol de uma placa aterosclerótica erosada, ocasionando obstrução vascular em diversos tecidos. A doença renal ateroembólica (DRAE), histologicamente representada por cristais de colesterol nas arteríolas do rim acompanhados de um infiltrado inflamatório perivascular, é causa de insuficiência renal aguda muitas vezes grave e prolongada, que ocorre semanas ou mesm...

  14. The solitary sellar plasmacytoma: a diagnostic challenge

    DEFF Research Database (Denmark)

    Soejbjerg, Anne; Dyve, Suzan; Baerentzen, Steen

    2016-01-01

    UNLABELLED: Solitary sellar plasmacytomas are exceedingly rare and difficult to distinguish from other pituitary tumors. We report a case of a 62-year-old woman presenting with blurred vision of the right eye and tenderness of the right temporal region, which was interpreted as temporal arteritis...... frequent symptoms stem from compression of the cranial nerves in the cavernous sinus (III, IV, V), whereas the anterior pituitary function is mostly intact. LEARNING POINTS: A solitary plasmacytoma is a rare cause of a sellar mass lesion.The radiological and clinical features are nonspecific, but cranial...

  15. Kartlegging og overvåking av eremitt Osmoderma eremita i Norge 2013

    OpenAIRE

    Endrestøl, Anders; Hanssen, Oddvar; Flåten, Magne*

    2014-01-01

    Eremitten Osmoderma eremita er en stor, brunsvart bille i familien skarabider. Den lever i gamle, hule løvtrær og er vurdert som truet i store deler av Europa. I Norge ble den antatt å være utdødd inntil den ble gjenfunnet i Tønsberg i 2008. Den er listet i kategori kritisk truet (CR) i Norsk rødliste for arter 2010, og er en prioritert art (fredet) i Norge. I tillegg er den på vedlegg til EUs habitatdirektiv og vurdert som nær truet (NT) på global rødliste. Handlingsplanen for er...

  16. Kartlegging og overvåking av eremitt Osmoderma eremita i Norge 2014

    OpenAIRE

    Endrestøl, Anders; Staverløkk, Arnstein; Flåten, Magne*

    2015-01-01

    Eremitten Osmoderma eremita er en stor, brunsvart bille i familien skarabider. Den lever i gamle, hule løvtrær og er vurdert som truet i store deler av Europa. I Norge ble den antatt å være utdødd inntil den ble gjenfunnet i Tønsberg i 2008. Den er listet i kategori kritisk truet (CR) i Norsk rødliste for arter 2010, og er en prioritert art (fredet) i Norge. I tillegg er den på vedlegg til EUs habitatdirektiv og vurdert som nær truet (NT) på global rødliste. Handlingsplanen for er...

  17. Kartlegging og overvåking av eremitt Osmoderma eremita i Norge 2012

    OpenAIRE

    Endrestøl, Anders; Flåten, Magne*; Hanssen, Oddvar

    2013-01-01

    Eremitten Osmoderma eremita er en stor, brunsvart bille i familien skarabider. Den lever i gamle, hule løvtrær og er vurdert som truet i store deler av Europa. I Norge ble den antatt å være utdødd inntil den ble gjenfunnet i Tønsberg i 2008. Den er listet i kategori kritisk truet (CR) i Norsk rødliste for arter 2010, og er en prioritert art (fredet) i Norge. I tillegg er den vurdert som nær truet (NT) på global rødliste. Handlingsplanen for eremitt ble publisert av Direktoratet fo...

  18. Overvågning af fugle, sæler og planter 1999-2000, med resultater fra feltstationerne

    DEFF Research Database (Denmark)

    af spættet sæl i den vestlige del af Østersøen, Kattegat og Limfjorden blev overvåget ved hjælp af optællinger fra fly i 2000. Formålet er at etablere en tidsserie med indekstal der kan bruges til at vurdere forandringer i bestandene af spættet sæl. Tællingerne foretages hvert andet år. Den årlige......Med det formål at følge svingninger i fugles og planters forekomst foretages der årligt overvågning på Miljø- og Energiministeriets feltstationer. Denne rapport præsenterer registreringer fra 1999 samt resultater af et forskningsprojekt fra en af feltstationerne. Desuden præsenteres resultater fra....... Der blev imidlertid konstateret tilbagegang hos almindelig ryle*, brushane* og dobbeltbekkasin. Alle tre arter har vist tilbagegange på omkring 50% gennem de sidste 10 år. Vejlerne er en vigtig lokalitet for disse arter herhjemme med hen ved halvdelen af landets yng-le-par. Hættemåge havde en god...

  19. Effectiveness of fenbendazole against later 4th-stage Strongylus vulgaris in ponies.

    Science.gov (United States)

    Slocombe, J O; McCraw, B M; Pennock, P W; Baird, J D

    1983-12-01

    Twelve pony foals (reared worm-free) were inoculated with Strongylus vulgaris. Approximately 8 weeks later, 4 of the foals were given fenbendazole (10% suspension) at a dosage rate of 10 mg/kg of body weight daily for 5 days and 4 foals were given the suspension at a dosage rate of 50 mg/kg daily for 3 days; the remaining foals were given a placebo. All treatments were administered by stomach tube. Fenbendazole was 99.6 and 97.9% effective in the 2 treatment groups, respectively, in eliminating later 4th-stage S vulgaris larvae located near the origin of major intestinal arteries. On microscopic examination of the ileocolic artery from fenbendazole-treated foals, a few larval remnants were found beneath the tunica intima in small organized mural thrombi overgrown with endothelium. It would appear that larvae are rapidly destroyed after administration of fenbendazole. A pony foal reared on pasture and with arteriographic evidence of arteritis of the cranial mesenteric and ileocolic arteries was treated with fenbendazole (10% suspension) by stomach tube at a dosage rate of 50 mg/kg of body weight daily for 3 days. By arteriographic examination made 4 weeks later, there was evidence of regression of the lesion, and at necropsy done a week later, there was no arteritis or larvae in the lumen of those arteries.

  20. Current status of outcome measure development in vasculitis.

    Science.gov (United States)

    Merkel, Peter A; Aydin, Sibel Z; Boers, Maarten; Cornell, Christina; Direskeneli, Haner; Gebhart, Don; Hatemi, Gulen; Luqmani, Raashid; Matteson, Eric L; Milman, Nataliya; Robson, Joanna; Seo, Philip; Tomasson, Gunnar

    2014-03-01

    The conduct of randomized controlled trials for vasculitis, especially for the antineutrophil cytoplasmic antibody-associated vasculitides [AAV, granulomatosis with polyangiitis (Wegener's) and microscopic polyangiitis], has been greatly advanced by the development, use, and acceptance of validated outcome measures. Trials have subsequently provided the opportunity to validate and refine reliable, valid outcome measures for these multisystemic and relapsing rare diseases. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group was formed in 2004 to foster development of validated and widely accepted outcomes in vasculitis using data-driven analyses, a dedication to building consensus, and adherence to, and guidance by, the principles of the OMERACT approach. This work led to the endorsement by OMERACT of the core set of domains and associated outcome measures for AAV. Next steps for the study of existing outcome tools in AAV include better definition of response criteria through development of more data-driven weighting of the elements of activity and damage assessment. The Working Group is now also embarking on a series of linked projects to develop validated patient-reported outcomes for use in clinical research in vasculitis. Additionally, the Working Group is studying how current methods of disease assessment and plans for new outcomes can be informed by the conceptual framework of the International Classification of Function of the World Health Organization. The success of the Group's work in AAV has also led to a formal process for developing outcomes for the large vessel vasculitides (Takayasu arteritis and giant cell arteritis) and Behçet disease.

  1. Chest Pain: The Need to Consider Less Frequent Diagnosis

    Science.gov (United States)

    Morais, Anabela; Carvalho, Sofia; Cunha, Joana; Lima, Ana R.; Moreira, J. Ilídio; Faria, Trigo

    2016-01-01

    Chest pain is one of the most frequent patient's complaints. The commonest underlying causes are well known, but, sometimes, in some clinical scenarios, it is necessary to consider other diagnoses. We report a case of a 68-year-old Caucasian male, chronically hypertensive, who complained of recurrent episodes of chest pain and fever with elevated acute phase reactants. The first investigation was negative for some of the most likely diagnosis and he quickly improved with anti-inflammatory drugs. Over a few months, his symptoms continued to recur periodically, his hypertension was aggravated, and he developed headaches and lower limbs claudication. After a temporal artery biopsy that was negative for vasculitis, he underwent a positron emission tomography suggestive of Takayasu Arteritis. Takayasu Arteritis is a rare chronic granulomatous vasculitis of the aorta and its first-order branches affecting mostly females up to 50 years old. Chest pain is experienced by >40% of the patients and results from the inflammation of the aorta, pulmonary artery, or coronaries. PMID:27034853

  2. [Ocular ischemic syndrome--a case report].

    Science.gov (United States)

    Zemba, M; Avram, Corina Ioana; Ochinciuc, Uliana; Stamate, Alina Cristina; Camburu, Raluca Lăcrămioara

    2013-01-01

    Ocular ischemic syndrome, also known as hypoperfusion/ hypotensive retinopathy or as ischemic oculopathy is a rare ocular disease determined by chronic arterial hypoperfusion through central retinal artery, posterior and anterior ciliary arteries. It is bilateral in 20% of the cases. Most often it appears due to severe occlusion of the carotid arteries (ICA, MCA>ECA), described in 1963 by Kearns and Hollenhorst. Occasionally it can be determined by the obstruction of ophtalmic artery or some arterities (Takayasu, giant cell arteritis). The risk factors are: age between 50-80 years, males (M:F = 2:1), arterial hypertension, diabetes, coronary diseases (5% of the cases develop ocular ischemic syndrome), vascular stroke, hemodialysis. The case we present is of an 63 years old man known with primary arterial hypertension, hypercholesterolemia, diabetes type 2 non insulin dependent and diagnosticated with ischemic cerebral stroke and bilateral obstruction of internal carotid arteries in march 2010, who is presenting for visual impairment in both eyes. The imaging investigations show important carotid occlusion and at the ophthalmologic evaluation there are ocular hypertension and rubeosis iridis at the right eye, optic atrophy at both eyes (complete in the right eye and partial in the left eye), with superior altitudinal visual field defect in left eye. The following diagnosis was established: Chronic ocular ischemic syndrome in both eyes with Neovascular glaucoma at the right eye, Anterior ischemic optic neuropathy at the left eye and laser panphotocoagulation at the right eye was started.

  3. Chest Pain: The Need to Consider Less Frequent Diagnosis

    Directory of Open Access Journals (Sweden)

    Pedro Magalhães

    2016-01-01

    Full Text Available Chest pain is one of the most frequent patient’s complaints. The commonest underlying causes are well known, but, sometimes, in some clinical scenarios, it is necessary to consider other diagnoses. We report a case of a 68-year-old Caucasian male, chronically hypertensive, who complained of recurrent episodes of chest pain and fever with elevated acute phase reactants. The first investigation was negative for some of the most likely diagnosis and he quickly improved with anti-inflammatory drugs. Over a few months, his symptoms continued to recur periodically, his hypertension was aggravated, and he developed headaches and lower limbs claudication. After a temporal artery biopsy that was negative for vasculitis, he underwent a positron emission tomography suggestive of Takayasu Arteritis. Takayasu Arteritis is a rare chronic granulomatous vasculitis of the aorta and its first-order branches affecting mostly females up to 50 years old. Chest pain is experienced by >40% of the patients and results from the inflammation of the aorta, pulmonary artery, or coronaries.

  4. Nodular glomerulosclerosis in a non-diabetic hypertensive smoker with dyslipidemia Glomeruloesclerosis nodular en un tabaquista hipertenso no-diabético con dislipidemia

    Directory of Open Access Journals (Sweden)

    A.F. Predosa

    2011-08-01

    Full Text Available Nodular glomerulosclerosis may be idiopathic or develop associated with diabetes mellitus, membranoprolipherative glomerulonephritis, light or heavy chain deposits, amyloidosis, fibrillary or immunotactoide disease, and Takayasu's arteritis. Histological features of idiopathic nodular glomerulosclerosis are similar to the Kimmelstiel-Wilson changes. Recent evidence points to the role of hyperglycemia, hyperlipidemia, hypertension and smoking in the mechanisms of this uncommon condition. The case study of a 65-year-old male presenting recent arterial hypertension and nodular non-diabetic glomerulosclerosis is described, and the possible role of heavy smoking in the pathogenesis of this condition is emphasized.La glomeruloesclerosis nodular puede ser idiopática o desarrollarse asociada con diabetes mellitus, glomerulonefritis membranoproliferativa, depósitos de cadenas leves o pesadas, amiloidosis, enfermedad fibrilar o inmmunotactoide, y arteritis de Takayasu. Los aspectos histológicos de la glomeruloesclerosis nodular idiopática son similares a las alteraciones de Kimmelstiel-Wilson. Recientes evidencias indican el papel de la hiperglicemia, la hiperlipidemia, la hipertensión y el tabaquismo en los mecanismos de esta entidad rara. Se presenta el estudio del caso de un hombre con 65 años que presentó hipertensión arterial reciente y glomeruloesclerosis nodular no diabética, y se da énfasis al posible papel de excesivo tabaquismo en la patogénesis de esta condición.

  5. A scoping review of the use of non-biologic disease modifying anti-rheumatic drugs in the management of large vessel vasculitis.

    Science.gov (United States)

    Misra, Durga Prasanna; Sharma, Aman; Kadhiravan, Tamilarasu; Negi, Vir Singh

    2017-02-01

    Takayasu's arteritis (TA) and Giant cell arteritis (GCA) comprise the large vessel vasculitides (LVV). Patients with LVV are treated with disease-modifying anti-rheumatic drugs (DMARDs), both conventional (cDMARDs) and biologic (bDMARDs). We undertook a scoping review to assess the effectiveness of cDMARDs in TA and GCA. We could identify 11 studies in TA and 18 studies in GCA. There were only 3 randomized controlled trials on methotrexate, one on hydroxychloroquine and two on cyclosporine in GCA, the others being case series (including all studies on TA). Most of these studies had small patient numbers (median 15 in TA and 27 in GCA). Outcome measures reported in different studies were heterogenous. Overall, methotrexate, leflunomide, azathioprine, mycophenolate mofetil and cyclophosphamide were effective in TA (low quality of evidence). Methotrexate (high quality of evidence), hydroxychloroquine and cyclosporine (moderate quality of evidence) appeared to be ineffective in GCA. Azathioprine (moderate quality of evidence), leflunomide, mycophenolate mofetil, cyclophosphamide and dapsone (low quality of evidence) were effective in GCA. There exists a paucity of high quality evidence to guide use of cDMARDs in TA and GCA. There is an unmet need to conduct large multi-centric randomized placebo-controlled trials to accurately assess the utility on cDMARDs in LVV.

  6. Antiviral activity of a Bacillus sp. P34 peptide against pathogenic viruses of domestic animals

    Science.gov (United States)

    Silva, Débora Scopel e; de Castro, Clarissa Caetano; Silva, Fábio da Silva e; Sant’anna, Voltaire; Vargas, Gilberto D’Avila; de Lima, Marcelo; Fischer, Geferson; Brandelli, Adriano; da Motta, Amanda de Souza; Hübner, Silvia de Oliveira

    2014-01-01

    P34 is an antimicrobial peptide produced by a Bacillus sp. strain isolated from the intestinal contents of a fish in the Brazilian Amazon basin with reported antibacterial activity. The aim of this work was to evaluate the peptide P34 for its in vitro antiviral properties against canine adenovirus type 2 (CAV-2), canine coronavirus (CCoV), canine distemper virus (CDV), canine parvovirus type 2 (CPV-2), equine arteritis virus (EAV), equine influenza virus (EIV), feline calicivirus (FCV) and feline herpesvirus type 1 (FHV-1). The results showed that the peptide P34 exhibited antiviral activity against EAV and FHV-1. The peptide P34 inhibited the replication of EAV by 99.9% and FHV-1 by 94.4%. Virucidal activity was detected only against EAV. When P34 and EAV were incubated for 6 h at 37 °C the viral titer reduced from 104.5 TCID50 to 102.75 TCID50, showing a percent of inhibition of 98.6%. In conclusion, our results demonstrated that P34 inhibited EAV and FHV-1 replication in infected cell cultures and it showed virucidal activity against EAV. Since there is documented resistance to the current drugs used against herpesviruses and there is no treatment for equine viral arteritis, it is advisable to search for new antiviral compounds to overcome these infections. PMID:25477947

  7. Antiviral activity of a Bacillus sp: P34 peptide against pathogenic viruses of domestic animals

    Directory of Open Access Journals (Sweden)

    Débora Scopel e Silva

    2014-09-01

    Full Text Available P34 is an antimicrobial peptide produced by a Bacillus sp. strain isolated from the intestinal contents of a fish in the Brazilian Amazon basin with reported antibacterial activity. The aim of this work was to evaluate the peptide P34 for its in vitro antiviral properties against canine adenovirus type 2 (CAV-2, canine coronavirus (CCoV, canine distemper virus (CDV, canine parvovirus type 2 (CPV-2, equine arteritis virus (EAV, equine influenza virus (EIV, feline calicivirus (FCV and feline herpesvirus type 1 (FHV-1. The results showed that the peptide P34 exhibited antiviral activity against EAV and FHV-1. The peptide P34 inhibited the replication of EAV by 99.9% and FHV-1 by 94.4%. Virucidal activity was detected only against EAV. When P34 and EAV were incubated for 6 h at 37 °C the viral titer reduced from 10(4.5 TCID50 to 10(2.75 TCID50, showing a percent of inhibition of 98.6%. In conclusion, our results demonstrated that P34 inhibited EAV and FHV-1 replication in infected cell cultures and it showed virucidal activity against EAV. Since there is documented resistance to the current drugs used against herpesviruses and there is no treatment for equine viral arteritis, it is advisable to search for new antiviral compounds to overcome these infections.

  8. Research into the transmission of natural gas by gas pipeline

    Energy Technology Data Exchange (ETDEWEB)

    Gadonneix, P.

    1998-12-31

    This paper is the press release of the talk given at the `Gaz de France scientific meeting with the press` by P. Gadonneix, chairman of Gaz de France company, on October 7, 1998. The aim of this talk concerns the new French and European supply link for bringing natural gas from the Norwegian North Sea fields. This new supply link is the first direct link between Norway and France and the NorFra gas pipeline which brings natural gas from the North Sea to France is the longest offshore pipeline in the world. The `Artere des Hauts de France` pipeline (the largest diameter gas pipeline ever laid in France) is devoted to the transfer of natural gas from Dunkerque to the Gournay-sur-Aronde underground storage site. This paper describes successively: the French European gas supply hub, the NorFra project, the Artere des Hauts de France pipeline, the network performance research, the safety and quality guaranties, the reduction of overland natural gas transmission costs (improvement of pipe-laying techniques and optimization of line route and welding operations), the specific techniques used for road and river crossing (micro-tunnel digging, river-crossing ditches) and for anchoring (buoyancy compensation). Finally, the environmental impact of the laying operations is briefly described. (J.S.)

  9. Jagt- og forstyrrelsesfrie kerneområder for vandfugle: Status 1999

    DEFF Research Database (Denmark)

    Clausen, P.; Bøgebjerg, E.; Jørgensen, H. E.;

    reservater i Danmark uden for Vadehavet der tilgodeser trækkende vandfugle, er med disse nye reservater forøget fra ca. 430 km2 i 1992 til 835 km2 ved jagtsæsonens start 1. september 1999. Oprettelserne sker som led i en udbygning af det eksisterende netværk af reservater, således at reservater for rastende...... skal forvente at fuglene reagerer på de nye reservater umiddelbart efter oprettelsen. Der er en vis forsinkelse før fuglene for alvor tager reservaterne i brug. Denne rapport præsenterer resultater fra DMU's overvågning af vandfugle i årene 1994-1999. Der gives en vurdering af i hvilket omfang fire...... forventninger til reservatnetværket er under indfrielse. De fire forventninger er: o at der vil ske en betragtelig forøgelse af antallet af svømmeænder og gæs; o at antallet vil stige mest markant for de jagtbare arter, især for forstyrrelsesfølsomme arter; o at fuglenes opholdstider vil blive væsentligt...

  10. The value of [{sup 18}F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease

    Energy Technology Data Exchange (ETDEWEB)

    Walter, Martin A.; Mueller-Brand, Jan; Nitzsche, Egbert U. [University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Melzer, Ralph A.; Tyndall, Alan [University Hospital Basel, Division of Rheumatology (Switzerland); Schindler, Christian [University Hospital Basel, Institute of Social and Preventive Medicine (Switzerland)

    2005-06-01

    This study was performed to investigate the value of{sup 18}F-fluorodeoxyglucose positron emission tomography ([{sup 18}F]FDG-PET) in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Twenty-six consecutive patients (21 females, 5 males; median age - years, range 17-86 years) with giant cell arteritis or Takayasu's arteritis were examined with [{sup 18}F]FDG-PET. Follow-up scans were performed in four patients. Twenty-six age- and gender-matched controls (21 females, 5 males; median age 71 years, range 17-86 years) were included. The severity of large-vessel [{sup 18}F]FDG uptake was visually graded using a four-point scale. C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured and correlated with [{sup 18}F]FDG-PET results by logistic regression. [{sup 18}F]FDG-PET revealed pathological findings in 18 of 26 patients. Three scans were categorised as grade I, 12 as grade II and 3 as grade III arteritis. Visual grade was significantly correlated with both CRP and ESR levels (p=0.002 and 0.007 respectively; grade I: CRP 4.0 mg/l, ESR 6 mm/h; grade II: CRP 37 mg/l, ESR 46 mm/h; grade III: CRP 172 mg/l, ESR 90 mm/h). Overall sensitivity was 60% (95% CI 40.6-77.3%), specificity 99.8% (95% CI 89.1-100%), positive predictive value 99.7% (95% CI 77-100%), negative predictive value 67.9% (95% CI 49.8-80.9%) and accuracy 78.6% (95% CI 65.6-88.4%). In patients presenting with a CRP <12 mg/l or an ESR <12 mm/h, logistic regression revealed a sensitivity of less than 50%. In patients with high CRP/ESR levels, sensitivity was 95.5%/80.7%. [{sup 18}F]FDG-PET is highly effective in assessing the activity and the extent of large-vessel vasculitis. Visual grading was validated as representing the severity of inflammation. Its use is simple and provides high specificity, while high sensitivity is achieved by scanning in the state of active inflammation. (orig.)

  11. Clinical Feature And Pathogeny Analysis Of Brain Hemorrhage In Young Adult Group

    Institute of Scientific and Technical Information of China (English)

    Wang Jianming; Zeng Xiaoyun

    2000-01-01

    Objection: The trend of brain hemorrhage cases of young adults have increased recently. In this article, We studied brain hemorrhage clinical feature and pathogenic causes of 72 young adults, Whose ages are all beneath 45Y. We found That the major pathogen reasons of young adult brain hemorrhage are blood system diseases、 arteriovenous malformation of cerebral blood vessel、 hypertension arteriosclerosis、 arteritis and rheumatic heart disease et. We also found that the trend can be related to hard work、 tense life、 drinking too much alcohol and eating high lipid food, and cercbral vascular disease family history. So in order to reduce the incidence of young adult brain hemorrhage, Young adults should not drink and smoke heavily, should not eat too much high lipid food. Young adults who have hypertension and brain vessel disease family history should be regularly measured blood pressure and blood lipid. If they had hypertension, should be treated regularly.

  12. Contribution of the SPECT-CT in the diagnosis of systemic osteonecrosis: about one case;Apport de la TEMP-TDM dans le diagnostic des osteonecroses systemiques: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Thelu-Vanysacker, M.; Blanc, D.; Huglo, D.; Steinling, M. [CHRU de Lille, Service de medecine nucleaire, hopital Huriez, 59 - Lille (France); Sivova, N.; Launay, D. [CHRU de Lille, service de medecine interne, hopital Huriez, 59 - Lille (France)

    2010-05-15

    Systemic osteonecrosis remains currently a very bad bone disease due to its poor functional prognosis. The multiple locations are frequent, but undervalued. We report a case illustrating the contribution of morpho SPECT (SPECT-CT) in screening for this complication. This case illustrates the potential of hybrid imaging to differentiate in a D.P.D. {sup 99m}Tc ({sup 99m}Tc 2,3-di-carboxy propane-1,1-diphosphonate) a bone and joint damage associated with peri-arteritis of systemic osteonecrosis. In addition, through its whole body study, bone scan allows an exhaustive site of necrosis knowing that the description of the extent and topography of the site of osteonecrosis is an important prognostic factor. (N.C.)

  13. Contribution of the tomography by positrons emission with fluorodeoxyglucose labelled with fluorine 18 in the case of a Takayasu disease; Apport de la tomographie par emission de positons au fluorodeoxyglucose marque au fluor 18 dans un cas de maladie de Takayasu

    Energy Technology Data Exchange (ETDEWEB)

    Cristofol, H.; Esquerre, J.P.; Payoux, P. [Service de medecine nucleaire, CHU Purpan, Toulouse, (France); Delavigne, K. [service de medecine interne, CHU Purpan, Toulouse, (France)

    2009-05-15

    The objective of the clinical case is to evaluate the interest of the PET with {sup 18}F.D.G. to confirm the active character and the disease extent in a suspicion of Takayasu disease. Conclusions: the PET with {sup 18}F.D.G. is a non invasive and low irradiating mean of metabolic imaging to evaluate the activity and the extent of arteritis of big and middle caliber vessels as the Takayasu disease and in an early way. To do again a PET some months after a cortico-therapy would allow to have an idea of the prognosis in function of the still active or not character. (N.C.)

  14. Anterior Uveitis as an Initial Manifestation of Polymyalgia Rheumatica

    Directory of Open Access Journals (Sweden)

    Hiromasa Tsuda

    2011-01-01

    Full Text Available A 74-year-old woman without contributory medical history presented with acute iridocyclitis in the right eye. Although the iridocyclitis disappeared within two weeks under topical steroid, she complained of acute progressing bilateral shoulder pain and morning stiffness of upper extremities. She was diagnosed as having polymyalgia rheumatica (PMR, and iridocyclitis was considered as its related manifestation. PMR and giant cell arteritis (GCA are closely related conditions and frequently occur together. GCA with uveitis has been rarely noted. However, ocular symptoms in PMR have not been previously mentioned. This is a first reported case of PMR presented with uveitis, without a complication of GCA. This anterior uveitis might be caused by ischemia of the posterior ciliary arteries and their branches.

  15. [Goodpasture's disease or syndrome? Apropos of a case].

    Science.gov (United States)

    Berti, F; Carnabuci, A; Onetti, A; Polchi, S; Sorrentino, R

    1997-01-01

    Goodpasture's disease is characterized by lung haemorrhage, associated with glomerulus basement membrane antibody glomerulonephritis, and circulating basement membrane antibody. Other diseases (Wegener, LES, arteritis) may have the same kidney and lung involvement. The Authors present a clinical case of rapidly progressive renal failure where renal biopsy showed an extensive extracapillary proliferative glomerulonephritis with linear deposits of antibody in the basement membrane, similar to Goodpasture's disease, with following lung involvement, but without hemoptysis and in absence of circulating antiglomerular basement membrane antibody. The Authors think it could be a case of Goodpasture's disease, even if it did not show the above-mentioned symptoms, whether out of the characteristic clinical course or the exclusion of all the other diseases. The Authors believe that the absence of circulating basement membrane antibody could be due to their sediment in the target organs and suggest a revision of the standards required for the Goodpasture's disease diagnosis.

  16. Visual disturbance with systemic symptoms: old lessons revisited.

    Science.gov (United States)

    Hume, Megan E; Fernandes, Peter M; MacLean, Kirsty; McRorie, Euan; Davenport, Richard

    2016-10-25

    We describe a retired physician who presented with visual disturbance and systemic symptoms. The presence of general malaise, headache and scalp tenderness, with raised inflammatory markers, suggested that giant cell arteritis (GCA) was the likely diagnosis. Rapid response to initial steroid therapy and histological evidence of inflammation in the temporal artery supported this diagnosis. The character of these visual symptoms was, however, atypical for GCA. The patient, who had heart valve disease, subsequently deteriorated and developed further symptoms warranting investigation of bacterial endocarditis. Retinal emboli are a recognised complication of endocarditis, which could account for these visual symptoms. Moreover, interpretation of the temporal artery biopsy is limited in the context of existing steroid therapy. Our patient was consequently diagnosed with bacterial endocarditis. This case reminds us to consider the wider differential diagnoses for headache, visual disturbance and systemic symptoms, where echocardiogram and blood cultures may be crucial to reach the diagnosis.

  17. Enteropathic Spondyloarthritis: From Diagnosis to Treatment

    Directory of Open Access Journals (Sweden)

    Rosario Peluso

    2013-01-01

    Full Text Available Enteropathic arthritis (EA is a spondyloarthritis (SpA which occurs in patients with inflammatory bowel diseases (IBDs and other gastrointestinal diseases. Diagnosis is generally established on the medical history and physical examination. It was, generally, made according to the European Spondyloarthropathy Study Group (ESSG criteria. Rheumatic manifestations are the most frequent extraintestinal findings of IBD with a prevalence between 17% and 39%, and IBD is associated, less frequently, with other rheumatic disease such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis, and fibromyalgia. Although the pathogenesis of EA has not been plainly clarified, the most popular theory supposes that joint inflammation occurs in genetically predisposed subjects with bacterial gut infections, provided an important evidence for a possible relationship between inflammation of the gut mucosa and arthritis. The management of patients with EA requires an active cooperation between the gastroenterologist and rheumatologist.

  18. Varicella Zoster Virus in the Nervous System [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Don Gilden

    2015-11-01

    Full Text Available Varicella zoster virus (VZV is a ubiquitous, exclusively human alphaherpesvirus. Primary infection usually results in varicella (chickenpox, after which VZV becomes latent in ganglionic neurons along the entire neuraxis. As VZV-specific cell-mediated immunity declines in elderly and immunocompromised individuals, VZV reactivates and causes herpes zoster (shingles, frequently complicated by postherpetic neuralgia. VZV reactivation also produces multiple serious neurological and ocular diseases, such as cranial nerve palsies, meningoencephalitis, myelopathy, and VZV vasculopathy, including giant cell arteritis, with or without associated rash. Herein, we review the clinical, laboratory, imaging, and pathological features of neurological complications of VZV reactivation as well as diagnostic tests to verify VZV infection of the nervous system. Updates on the physical state of VZV DNA and viral gene expression in latently infected ganglia, neuronal, and primate models to study varicella pathogenesis and immunity are presented along with innovations in the immunization of elderly individuals to prevent VZV reactivation.

  19. An Infant with Benign Isolated Abducens Palsy After Vaccination

    Directory of Open Access Journals (Sweden)

    Celebi Kocaoglu

    2014-02-01

    Full Text Available Benign isolated abducens palsy is a self-improving clinical entity characterized by esotropia and diplopia led by the deficiency of abduction, and accompanied by no other neurological findings. The entity may occur after experiencing minor fever episodes, viral infection. The pathophysiological mechanism of cellular injury remains unclear. Hypotheses involve damage arising from autoimmune mediation or direct viral invasion causing demyelination, localized arteritis or genetic predisposition, which could increase susceptibility to such nerve palsies. Diagnosed with benign isolated abducens palsy, a 19-month-old girl infant admitted to our outpatient clinic with an acute onset of esotropia in the right eye developing two weeks after the vaccination of diphtheria, acellular pertussis, tetanus, inactivated polio and Haemophilus influenzae type b (DTPa-IP-Hib was presented in this report.

  20. Angiographic findings in 2 children with cerebral paragonimiasis with hemorrhage.

    Science.gov (United States)

    Chen, Zhi; Chen, Jingyu; Miao, Hongpin; Li, Fei; Feng, Hua; Zhu, Gang

    2013-05-01

    Hemorrhagic events associated with cerebral paragonimiasis are not rare, especially in children and adolescents; however, angiographic evidence of cerebrovascular involvement has not been reported. The authors describe angiographic abnormalities of the cerebral arteries seen in 2 children in whom cerebral paragonimiasis was associated with hemorrhagic stroke. The patients presented with acute intracerebral and subarachnoid hemorrhage. Angiography revealed a beaded appearance and long segmental narrowing of arteries, consistent with arteritis. In both patients, involved vessels were seen in the area of the hemorrhage. The vascular changes and the hemorrhage, together with new lesions that developed close to the hemorrhage and improved after praziquantel treatment, were attributed to paragonimiasis. Further study of the frequency and mechanism of hemorrhagic cerebrovascular complications associated with cerebral paragonimiasis is needed.

  1. Vasculite necrosante na glomerulonefrite difusa aguda pós-infecciosa

    Directory of Open Access Journals (Sweden)

    Riyuso Márcia C

    2004-01-01

    Full Text Available Os autores relatam dois casos de glomerulonefrite difusa aguda pós-infecciosa com evolução clinicomorfológica incomum. As biópsias renais mostraram alterações características de glomerulonefrite difusa aguda associada à extensa necrose fibrinóide e infiltrado inflamatório leucocitário na parede de arteríolas e artérias interlobulares. Foram também observadas crescentes. Ambos os pacientes cursaram com insuficiência renal aguda severa, sendo que um dos pacientes recuperou a função renal e outro evoluiu para insuficiência renal crônica e óbito.

  2. The Effects of Combined Hepatectomy and Immunochemotherapy on Postoperative Recurrence of Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    ZHOUWeiping; WUMengchao; 等

    2002-01-01

    Ojbective To Study the effects of combined hepatectomy and immunochemotherapy on postoperative recurrence of primary liver cancer.Methods 121 caes were divided into four groups:operation only(OP group);combined operation and chemotherapy(OC group);combined operation and immunotherapy(OI group);combined operation and immunochemotherapy(OIC group).Chemotherapy was performed through hepatic arter or port vein,and the immunotherapy was used with LAK cell IL-2 and IFN-γ。Results Three-yeau recurrence rate in the four groups was 76.7%,55.6%,45.2% and 36.4%,respectively.The recurrence rate of OI group and OIC group was significantly lower than that of OP group.Conclusion Combined operation and immunochemotherapy in useful in preventing postoperative recurrence of primary liver cancer.

  3. Cerebral tubercular thrombophlebitis presenting as venous infarct: Magnetic resonance imaging and pathologic correlation

    Directory of Open Access Journals (Sweden)

    Sandhya Mangalore

    2014-01-01

    Full Text Available Central nervous system involvement by tuberculosis to produce basal meningitis, hydrocephalus, arteritis and infarcts is well-known, the brunt of the pathology being borne by the arterial vasculature to produce neurological sequelae. However, tuberculous thrombophlebitis causing venous infarction is exceedingly rare. We present imaging and pathological features of two autopsy proven cases of tuberculous thrombophlebitis with venous infarcts involving superficial venous system in one and deep venous system in the other. This is the first study presenting radiopathologic correlation of this rare complication. Tuberculous thrombophlebitis should be suspected if basal exudates and multiple white matter T2 hyperintensities are seen on neuroimaging and the imaging protocol should include both magnetic resonance arteriogram and venogram.

  4. [Novel immunopathological approaches to pulmonary arterial hypertension].

    Science.gov (United States)

    Perros, Frédéric; Montani, David; Dorfmüller, Peter; Huertas, Alice; Chaumais, Marie-Camille; Cohen-Kaminsky, Sylvia; Humbert, Marc

    2011-04-01

    Inflammation is important for the initiation and the maintenance of vascular remodeling in the most commun animal models of pulmonary hypertension (PH), and its therapeutical targeting blocks PH development in these models. In human, pulmonary vascular lesions of PH are also the source of an intense chemokine production, linked to inflammatory cell recruitment. However, arteritis is uncommon in PH patients. Of note, current PH treatments have immunomodulatory properties. In addition, some studies have shown a correlation between levels of circulating inflammatory mediators and patients' survival. The study of autoimmunity in the pathophysiology of pulmonary arterial hypertension is becoming an area of intense investigation. New immunopathological approaches to PH should allow the development of innovative treatments for this very severe condition.

  5. Prosthetic valve endocarditis 1976-1987. Antibiotics, anticoagulation, and stroke.

    Science.gov (United States)

    Davenport, J; Hart, R G

    1990-07-01

    We retrospectively reviewed the clinical characteristics and outcomes of 61 patients with 62 episodes of prosthetic valve endocarditis, paying particular attention to neurologic complications (stroke). Atypical features of the group included a benign outcome of early postoperative infection (18% mortality) and a high stroke morbidity and mortality rate with Staphylococcus epidermidis infections. Eleven patients (18%) suffered an embolic stroke, most less than or equal to 3 days after diagnosis and before the initiation of antimicrobial therapy; the rate of embolic stroke recurrence was low (9%). The risk of embolic stroke was lower with bioprosthetic than with mechanical valves. No protective effect of anticoagulation therapy with warfarin was observed. Six patients (8%) suffered brain hemorrhage due to septic arteritis, brain infarction, or undetermined causes; no specific risk of hemorrhagic stroke was evident with anticoagulation therapy. Antibiotic treatment appears to be more important than anticoagulation to prevent neurologic complications in patients with prosthetic valve endocarditis.

  6. Repeated Hemothorax Following Ipsilateral Left Internal Jugular and Left Subclavian Venous Catheterization(Olgu Bildirimi)

    OpenAIRE

    ÜLGER,, F.; SARIHASAN, B.; ŞENEL, A.

    2009-01-01

    Aynı Taraf Sol İnternal Jugular ve Subklavian Venöz Kateterizasyondan Sonra Tekrarlayan Hemotoraks Kritik hastada en sık kullanılan invaziv girişimlerden birisi de santral kateterizasyon işlemidir. Kateterizasyon sıklıkla internal juguler ve subklavian vene uygulanır. Bu venler hemo-dinamik monitorizasyona izin verdiği gibi ilaç ve sıvı tedavileri, kan transfüzyonu ve total pa-renteral beslenmeye için de olanak sağlar. Komplikasyonlar internal juguler vende %1-4 sıklıkla arter delinmesi ve...

  7. Spectrum of Histomorphologic Findings in Liver in Patients with SLE: A Review

    Directory of Open Access Journals (Sweden)

    Shrruti Grover

    2014-01-01

    Full Text Available Collagen vascular diseases (CVDs like systemic lupus erythematosus (SLE, rheumatoid arthritis, Sjogren syndrome (SS, and scleroderma are immunologically mediated disorders that typically have multisystem involvement. Although clinically significant liver involvement is rare, liver enzyme abnormalities are common in these patients. The reported prevalence of hepatic involvement in SLE, histopathologic findings, and its significance is very variable in the existing literature. It is important to be familiar with the causes of hepatic involvement in SLE along with histomorphological features which aid in distinguishing hepatitis of SLE from other hepatic causes as they would alter the patient management and disease course. Histopathology of liver in SLE shows a wide morphological spectrum commonly due to a coexisting pathology. Drug induced hepatitis, viral etiology, and autoimmune overlap should be excluded before attributing the changes to SLE itself. Common histopathologic findings in SLE include fatty liver, portal inflammation, and vascular changes like hemangioma, congestion, nodular regenerative hyperplasia, arteritis, and abnormal vessels in portal tracts.

  8. [Intermittent thrombolytic treatment. Results during severe, chronic arterial diseases].

    Science.gov (United States)

    Fiessinger, J N; Aiach, M; Lagneau, P; Cormier, J M; Housset, E

    1975-04-20

    38 patients with severe chronic arteritis of the lower limbs were treated with streptokinase intermittently. All had been refused for surgical operation. One patient died, 4 others had early interruption of treatment. Eleven of the 38 patients had efficient thrombolysis confirmed by arteriography. The facts confirm the possibility of thrombolysis during chronic arterial disease. The fact that the aggravation was recent was favourable factor in prognosis. The eleven patients improved, had severe aggravation of symptomes for less than 2 months. Thus thrombolytic treatment has a place of choice in the treatment of severe arterial disease where surgery is impossible, or dangerous, owing to the uncertain state of the vascular bed below the lesion. Efficacious, it permits reconstructive surgery in cases where it had been at first refused. The use of intermittent treatment, apart from advantages of confort and cost, seems to increase the efficacy of treatment.

  9. Role of autoimmunity and autoinflammation in the pathogenesis of idiopathic recurrent pericarditis.

    Science.gov (United States)

    Cantarini, Luca; Imazio, Massimo; Brizi, Maria Giuseppina; Lucherini, Orso Maria; Brucato, Antonio; Cimaz, Rolando; Galeazzi, Mauro

    2013-02-01

    Idiopathic recurrent pericarditis is the most common and troublesome complication of acute pericarditis affecting about one third of such patients. The pericardium may be involved in different systemic autoimmune diseases (i.e., systemic lupus erythematosus, rheumatoid arthritis, progressive systemic sclerosis, mixed connective tissue disease, Sjogren's Syndrome, polyarteritis, giant cell arteritis, other systemic vasculitides) either in a symptomatic form (usually during the active phase of the disease) or as asymptomatic pericardial effusion. Moreover, idiopathic recurrent pericarditis mimicks hereditary periodic fever syndromes (HPFSs). HPFSs are a group of disorders characterized by primary dysfunction of the innate immune system mostly caused by mutations of genes involved in the regulation or activation of the inflammatory response, without any apparent involvement of antigen-specific T cells or significant production of autoantibodies. These disorders usually manifest in the pediatric population, with onset ranging from the first hours to the first decade of life, however a limited number of patients experience disease onset during adulthood.

  10. Left ventricular non-compaction revealed by aortic regurgitation due to Kawasaki disease in a boy with LDB3 mutation.

    Science.gov (United States)

    Hachiya, Akira; Motoki, Noriko; Akazawa, Yohei; Matsuzaki, Satoshi; Hirono, Keiichi; Hata, Yukiko; Nishida, Naoki; Ichida, Fukiko; Koike, Kenichi

    2016-08-01

    Kawasaki disease (KD) is an acute febrile illness of childhood characterized by systemic vasculitis, especially coronary arteritis. Aortic valve regurgitation (AVR) is a relatively common complication. There have been no reports to date of heart failure and left ventricular non-compaction (LVNC) after acute KD, although the precise etiology of this condition remains unclear. A 6-month-old boy with KD was admitted to hospital. Despite high-dose i.v. gammaglobulin for dilation of the coronary artery, moderate AVR appeared, and thereafter he developed heart failure. A rough, dense LV myocardium indicated LVNC. On genetic testing a heterogenous 163G > A substitution changing a valine to isoleucine in LIM domain binding protein 3 (LDB3) was identified. Additional cardiac stress, such as that caused by AVR and/or KD might have triggered cardiac failure in the form of LVNC due to LDB3 mutation.

  11. Atrophic coarctation of the abdominal aorta.

    Science.gov (United States)

    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F

    1980-01-01

    Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453

  12. The stealthy nature of PRRSV infection: The dangers posed by that ever-changing mystery swine disease%PRRSV感染的神秘本质

    Institute of Scientific and Technical Information of China (English)

    Raymond R.; R.Rowland; 刘朝明; 马洁莹

    2008-01-01

    猪繁殖与呼吸综合征病毒(PRRSV)是动脉炎病毒属(Arterivirus)的一员,其他成员还包括小鼠乳酸脱氢酶-升高症病毒(Lactate Dehydrogenase—elevating Virus,LDV)、马动脉炎病毒(Equine Arteritis Virus,EAV)和猕猴出血热病毒(Simian Hemorrhagic Fever Virus,SHFV)。在哺乳动物病毒性发病机理中,动脉炎病毒属表现出与其它病毒完全不同的机理。

  13. Comparison of transcatheter laser and direct-current shock ablation of endocardium near tricuspid anulus

    Science.gov (United States)

    Zhang, Yu-Zhen; Wang, Shi-Wen; Li, Junheng

    1993-03-01

    Forty to eighty percent of the patients with accessory pathways (APs) manifest themselves by tachyarrhythmias. Many of these patients needed either life-long medical therapy or surgery. In order to avoid the discomfort and expenses in surgical procedures, closed chest percutaneous catheter ablation of APs became a potentially desirable therapeutic approach. Many investigations indicated that ablation of right APs by transcatheter direct current (dc) shock could cause life-threatening arrhythmias, right coronary arterical (RCA) spasm, etc. With the development of transcatheter laser technique, it has been used in drug-incurable arrhythmias. The results show that laser ablation is much safer than surgery and electric shock therapy. The purpose of this study is to explore the effectiveness, advantages, and complications with transcatheter Nd:YAG laser and dc shock in the ablation of right atrioventricular accessory pathways in the atrium near the tricuspid annulus (TA) in 20 dogs.

  14. Large Vessel Vasculitis Occurring in Rheumatoid Arthritis Patient under Anti-TNF Therapy

    Directory of Open Access Journals (Sweden)

    Valentina Cestelli

    2014-01-01

    Full Text Available Vasculitis is a heterogeneous group of disorders characterized by the presence of necrotic inflammatory phenomena and destruction of blood vessels. Vasculitis is classified as primary (idiopathic or secondary to infections, connective tissue diseases and drugs but can also be considered as a paraneoplastic phenomenon. Evidence shows that the increasing use of biological agents results in a growing number of reports of autoimmune diseases induced by these therapies. An inflammatory articular chronic disease such as rheumatoid arthritis may be complicated by extra-articular manifestations, such as cutaneous or systemic vasculitis. Herewith, we describe the case of a great vessels arteritis in a patient affected by rheumatoid arthritis in therapy with an anti-TNF agent (etanercept.

  15. Primary angiitis of the central nervous system with diffuse cerebral mass effect and giant cells.

    LENUS (Irish Health Repository)

    Kinsella, J A

    2012-02-01

    Primary angiitis of the central nervous system (PACNS), also called primary CNS vasculitis, is an idiopathic inflammatory condition affecting only intracranial and spinal cord vessels, particularly medium-sized and smaller arteries and arterioles. Angiography and histopathology typically do not reveal evidence of systemic vasculitis.(1,2) Histopathology usually reveals granulomatous inflammation affecting arterioles and small arteries of the parenchyma and\\/or leptomeninges, similar to that seen in Takayasu\\'s or giant cell arteritis.(1-3) We report a patient with biopsy-proven PACNS with giant cells and cerebral mass effect on MRI. Magnetic resonance angiography and cerebral angiography appeared normal and there was no evidence of extracranial vasculitis.

  16. Aortitis in patients with psoriatic arthropathy: report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Gleb Slobodin

    2014-11-01

    Full Text Available Aortitis, which is well described in patients with other spondyloarthritides, has been rarely cited in relation to psoriatic arthropathy (PsA. Two patients with known PsA, who developed aortitis, are reported herein. The PubMed database was searched using the following keywords: aortitis, Takaysu arteritis, PsA, ankylosing spondylitis, reactive arthritis, inflammatory bowel disease. The relevant articles were critically reviewed and pertinent data organized. Analysis of 5 cases of aortitis in patients with PsA, including the 2 cases reported herein, revealed no specific pattern of PsA joint involvement in the patients who developed aortitis. All aortic segments can be involved and complications, such as insufficiency of the aortic valve and stenosis of the major aortic branches, have been described. The genetic association involving the IL12B locus may be involved in the clinical association of aortitis and spondyloarthritis.

  17. [Femoral angioplasty. Long-term results].

    Science.gov (United States)

    Foucart, H; Carlier, C; Baudrillard, J C; Joffre, F; Cécile, J P

    1990-01-01

    A study on the long-term efficacy of femoral-popliteal angioplasty was carried out on 185 angioplasty cases over a 5 year follow-up period. A classification of data according to the type of lesion treated, revealed that results were favorable in case of stenosis (87%), short obstruction (70%) and long obstruction (35%). A special study of the outcome of treatments for stage IV arteritis was carried out. After comparing results with those obtained by other teams, the authors list the complications encountered, hematomas, and thromboses, and show their current tendency for regression. Lastly, the authors stress the advantages of angioscopy, which permits to identify the nature of the treated lesions and to predict possible complications, which are usually underrated by angiography.

  18. [Immune system and rheumatic diseases in the elderly].

    Science.gov (United States)

    Schirmer, Michael

    2016-06-01

    Impairments of the immune system play an important role in all immun-mediated rheumatic diseases. Recently, the following news were reported: · Early aging of the immune system with thymus insufficiency has now been reported for both patients with rheumatoid arthritis and axial spondyloarthritis, without prethymic lack of progenitors at least in rheumatoid arthritis.. · For giant cell arteritis, the most frequent vasculitis in the elderly, an increased expression of IL-17A in temporal artery biopsies coincides with good prognosis and reponse to glucocorticoids.. · Concerning immunosenescence in systemic lupus erythematosus, BAFF appears to have an important role for relapses after B-cell depletion.. For the future it can be anticipated that the use of unified classification criteria for rheumatic diseases (as with the new 2012 EULAR / ACR classification criteria for polymyalgia rheumatica) will ensure better comparability of immunological studies also in the elderly.

  19. Management of Pregnancy with Ankylosing Spondylitis

    Institute of Scientific and Technical Information of China (English)

    Qian Zhou; Xu-ming Bian; Jun-tao Liu

    2012-01-01

    To discuss the interaction between pregnancy and ankylosing spondylitis,and the management of pregnancy with ankylosing spondylitis.Methods Twelve cases of pregnancy with ankylosing spondylitis in Peking Union Medical College Hospital from September 2004 to July 2011 were analyzed retrospectively,focusing on the arteritis condition,pregnancy complications,and outcomes.Results All the 12 patients had full-term pregnancy.Five cases gave birth naturally,and 7 cases received cesarean section for maternity factors.No adverse pregnancy outcomes were encountered.Waist pain appeared in 2 cases in the second trimester,for both of which medication failed.One of the 2 cases had natural childbirth,while the other maintained pregnancy smoothly to cesarean section.Conclusions Pregnancy monitoring can help obtain favorable pregnancy outcomes.Attention should be paid to postpartum change of the illness.

  20. [Structure and function of fungal cell wall].

    Science.gov (United States)

    Ohno, Naohito

    2008-12-01

    Cell wall glycans of fungi/yeasts are reviewed. Fungi/yeasts produce various kinds of polysaccharides. As part of the cell wall they are interlinked with other components forming a huge network. The insolubility and complex with multiple components makes the research very tough. Studies on beta-glucan have been performed from various views, such as chemistry, conformation, solubility, tissue distribution and metabolism, biological activity, clinical application, receptor, biosynthesis, and antibody. Studies on mannan focus on immunotoxicity, such as anaphylactoid reaction and coronary arteritis induction. alpha-glucan, chitin, and capsular polysaccharide were also mentioned in relation to structure and genes. Compared with human and animal polysaccharides, fungi/yeasts polysaccharides have very characteristic properties.

  1. Diagnosis and Treatment Progress of Systemic Vasculitis%系统性血管炎的诊治进展

    Institute of Scientific and Technical Information of China (English)

    方琳; 方富安

    2011-01-01

    Vasculitis is a medical problem which is long plagued medical doctors. Systemic vasculitis is a disease, which takes vascular wall inflammation and fibrinoid necrosis as pathological features and has variety clinical manifestations. The disease can be divided into primary and secondary, common primary vasculitis with giant cell arteritis, Takayasu's arteritis, polyarteritis nodosa, Kawasaki disease, Churg-Strauss vasculitis, Wegener swell, microscopic polyangiitis. In recent years, In recent years, the primary systemic vasculitis diagnosis standard and treatment has made a lot of progress. The article reviewed the latest development of diagnosis and the treatment of the disease, which have certain clinical reference value.%系统性血管炎是以血管壁炎症和纤维素样坏死为病理特征,具有多种,临床表现的一组疾病。可分为原发性和继发性。常见原发性血管炎有巨细胞动脉炎、大动脉炎、结节性多动脉炎、川崎病、变应性肉芽肿性血管炎、韦格纳肿、显微镜下多血管炎等。近几年,有关原发性系统性血管炎的诊断标准和治疗方面已取得不少的进展,本文综述了诊断与治疗该病的最新进展,有一定临床参考价值。

  2. Epigenetics and Vasculitis: a Comprehensive Review.

    Science.gov (United States)

    Renauer, Paul; Coit, Patrick; Sawalha, Amr H

    2016-06-01

    Vasculitides represent a group of relatively rare systemic inflammatory diseases of the blood vessels. Despite recent progress in understanding the genetic basis and the underlying pathogenic mechanisms in vasculitis, the etiology and pathogenesis of vasculitis remain incompletely understood. Epigenetic dysregulation plays an important role in immune-mediated diseases, and the contribution of epigenetic aberrancies in vasculitis is increasingly being recognized. Histone modifications in the PR3 and MPO gene loci might be mechanistically involved in the pathogenesis of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Similarly, other studies revealed important epigenetic contribution to other vasculitides, including Kawasaki disease and IgA vasculitis. More recently, genome-wide epigenomic studies have been performed in several vasculitides. A recent genome-wide DNA methylation study uncovered an important role for epigenetic remodeling of cytoskeleton-related genes in the pathogenesis of Behçet's disease and suggested that reversal of some of these DNA methylation changes associates with disease remission. Genome-wide DNA methylation profiling characterized the inflammatory response in temporal artery tissue from patients with giant cell arteritis and showed increased activation of calcineurin/nuclear factor of activated T cells (NFAT) signaling, prompting the suggestion that a specific calcineurin/NFAT inhibitor that is well tolerated and with the added beneficial anti-platelet activity, such as dipyridamole, might be of therapeutic potential in giant cell arteritis. While epigenetic studies in systemic vasculitis are still in their infancy, currently available data clearly indicate that investigating the epigenetic mechanisms underlying these diseases will help to better understand the pathogenesis of vasculitis and provide novel targets for the development of disease biomarkers and new therapies.

  3. The role of biological agents in the management of large vessel vasculitis (LVV: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Mohammed Osman

    Full Text Available BACKGROUND: Giant cell arteritis (GCA and Takayasu's arteritis (TAA are large vessel vasculitides (LVV for which corticosteroids (CS are the mainstay for treatment. In patients with LVV unable to tolerate CS, biological agents have been used with variable effectiveness. OBJECTIVE: To systematically review the effectiveness and safety of biological agents in patients with LVV. METHODS: We searched 5 electronic databases (inception to October 2012 and conference abstracts with no language restrictions. Two reviewers independently selected studies, extracted data and assessed methodological quality. Our protocol was registered in PROSPERO. RESULTS: We included 25 studies (3 RCTs and 22 case series with ≥2 cases. 95 GCA and 98 TAA patients received biological agents. The RCTs using anti-TNF agents (infliximab, etanercept and adalimumab did not suggest a benefit in GCA. GCA patients receiving tocilizumab, in case series, achieved remission (19 patients and reduction of corticosteroid dose (mean difference, -16.55 mg/day (95% CI: -26.24, -6.86. In case series, 75 patients with refractory TAA treated with infliximab discontinued CS 32% of the time. Remission was variably defined and the studies were clinically heterogeneous which precluded further analysis. CONCLUSION: This systematic review demonstrated a weak evidence base on which to assess the effectiveness of biological treatment in LVV. Evidence from RCTs suggests that anti-TNF agents are not effective for remission or reduction of CS use. Tocilizumab and infliximab may be effective in the management of LVV and refractory TAA, respectively, although the evidence comes from case series. Future analytical studies are needed to confirm these findings.

  4. Vasculites dos médios e grandes vasos Medium and large vessel vasculitis

    Directory of Open Access Journals (Sweden)

    Hebert Roberto Clivati Brandt

    2009-02-01

    Full Text Available As vasculites são constituídas por um grande grupo de síndromes caracterizadas por inflamação e necrose da parede dos vasos sangüíneos, resultando em estreitamento ou oclusão do lúmen. A distribuição dos vasos envolvidos varia consideravelmente e serve de base para a classificação das síndromes vasculíticas: grandes vasos (arterite de Takayasu, arterite temporal; pequenos e médios vasos (poliarterite nodosa, síndrome de Churg-Strauss, granulomatose de Wegener, vasculites nas doenças reumáticas; e pequenos vasos (vasculite de hipersensibilidade, púrpura de Henoch-Schonlein, poliangeíte microscópica, crioglobulinemia. Este artigo revisa as vasculites dos médios e grandes vasos e opções terapêuticas atuais; além de oferecer orientação sobre abordagem diagnóstica e tratamento dos pacientes com suspeita de vasculite cutânea.Vasculitis comprises a broad group of syndromes characterized by inflammation and necrosis on the walls of blood vessels, resulting in narrowing or occlusion of the lumen. The distribution of involved blood vessel varies considerably and serves as the basis for one classification of vasculitic syndromes: large vessels (Takayasu arteritis, giant cell arteritis; medium and small muscular arteries (polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, vasculitis in rheumatic diseases; and small vessels ("hypersensitivity" vasculitis, Henoch-Schonlein purpura, microscopic polyangiitis, cryoglobulinemia. This article reviews medium and large vessel vasculitis and current treatment options; it also presents a comprehensive approach to diagnosing and treating patients with suspected cutaneous vasculitis.

  5. Análise da remodelação vascular na isquemia pulmonar experimental, nas fases aguda e crônica Analysis of acute and chronic vascular remodeling in an experimental model of pulmonary ischemia

    Directory of Open Access Journals (Sweden)

    Wanderley M. Bernardo

    2005-02-01

    Full Text Available INTRODUÇÃO: Alterações estruturais da circulação pulmonar traduzem processo de remodelação vascular e têm relação provável com variações locais de fluxo e isquemia. OBJETIVO: Definir as alterações histológicas na circulação pulmonar após obstrução experimental da artéria pulmonar. Correlacioná-las com os padrões de redistribuição sangüínea e remodelação vascular. MÉTODO: Foram submetidos à toracotomia esquerda 48 ratos Wistar, alocados aleatoriamente em dois grupos, com ligadura da artéria pulmonar e controle, e sacrificados com 1, 7, 30 e 60 dias. Nos pulmões retirados avaliou-se presença de sinais de injúria no parênquima e mensurou-se diâmetro externo e espessura da parede das arteríolas de bronquíolos terminais, respiratórios e alveolares. Diâmetro interno e porcentagem de espessura da parede foram calculados. RESULTADOS: Só ocorreu infarto, necrose e hemorragia no pulmão isquêmico. No não isquêmico houve aumento mantido dos diâmetros externo e interno das arteríolas, com redução inicial da espessura no 1º dia e valores semelhantes aos do grupo controle no 60º dia. No pulmão isquêmico houve redução transitória nos diâmetros externo e interno das arteríolas de bronquíolos terminais e respiratórios, com aumento, inicial e transitório, na sua espessura. As arteríolas alveolares apresentaram aumento do diâmetro externo e espessura da parede, com redução do diâmetro interno, mantida e progressiva. CONCLUSÃO: Este modelo reproduz arteriopatia distal em pacientes com tromboembolismo pulmonar crônico. A resposta vascular no pulmão não isquêmico é compatível com padrão de remodelação de hiperfluxo; a no pulmão isquêmico com hipofluxo e isquemia. Nas arteríolas de bronquíolos terminais e respiratórios a resposta foi transitória. Nas alveolares foi progressiva e mantida, pela provável ocorrência tardia de hiperfluxo local.BACKGROUND: Structural alterations to the

  6. 肺血管炎的研究进展%Advance in the pulmonary vasculitis in children

    Institute of Scientific and Technical Information of China (English)

    刘秀云

    2014-01-01

    儿童血管炎分为大血管炎、中血管炎和小血管炎.肺血管炎可影响任何血管,包括大小不同的血管,影响肺微脉系统的血管炎称为肺毛细血管炎.肺血管炎常见的为肉芽肿性多血管炎、显微镜下多血管炎和变应性肉芽肿血管炎,少见的肺血管炎包括过敏性紫癜,多发性大动脉炎,巨细胞动脉炎,冷球蛋白血症,结节性多动脉炎,白塞病.肺部血管炎的表现包括肺泡出血、咯血、贫血、肺部渗出影,也可以表现为咳嗽、发热、体质量减轻等非特异表现.诊断主要依据临床症状、体征和抗中性粒细胞胞质抗体阳性或肺活检诊断.大血管炎可采用彩色多普勒和血管磁共振检查协助诊断.治疗主要应用糖皮质激素,部分可加用免疫抑制剂.%Vasculitis is divided into large,medium-sized,small vasculitis based on the size of the affect vessel.Pulmonary vasculitis may affect any vessel of the lung.It was pulmonary capillaritis if capillary vessels were involved.The common pulmonary vasculitis were granulomatosis polyangiitis,microscopic polyangiitis,allergic granulomatosis angitis,the less common pulmonary vasculitis were Schonlein-Henoch purpura,Takayasu'arteritis,Giant-cell arteritis,cryglobulinemia,polyarteritis nodosa,and Bechet'disease.The clinical features of the pulmonary vasculitis were alveolar hemorrhage,hemoptysis,anemia and pulmonary infiltration,other clinical manifestation were cough,fever,weight loss.The diagnosis of the pulmonary vasculitis was based on the clinical symptoms,signs and positive anti-neutrophil cytoplasmic antibodies or lung biopsy.Large vasculitis was diagnosised by the magnetic resonance imaging and colour Doppler ultrasonography.The glucocorticoid and immunosuppressant was used in the treatment of the vasculitis.

  7. Inflammatory aortic arch syndrome: contrast-enhanced, three-dimensional MR - angiography in stenotic lesions; Entzuendliches Aortenbogensyndrom: Stenosediagnostik mittels kontrastmittelverstaerkter 3D-MR-Angiographie im Vergleich mit der DSA

    Energy Technology Data Exchange (ETDEWEB)

    Both, M.; Mueller-Huelsbeck, S.; Biederer, J.; Heller, M.; Reuter, M. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer Diagnostische Radiologie; Reinhold-Keller, E.; Gross, W.L. [Rheumaklinik Bad Bramstedt GmbH (Germany)

    2004-01-01

    Purpose: To determine the value of contrast-enhanced, three-dimensional MR angiography for the evaluation of stenotic and occlusive vascular lesions in inflammatory aortic arch syndrome. Materials and Methods: 14 patients with inflammatory aortic arch syndrome (giant cell arteritis: n = 8, Takayasu arteritis: n = 4, ankylosing spondylitis: n = 1 sarcoidosis: n = 1) underwent MR angiography of the aortic arch and the supra-aortic vessels (n = 15,2 patients were examined twice) and of the abdominal aorta (n = 2). MRA was performed using a 3D-FLASH sequence (TR/TE 4.6/1.8 ms, flip angle 30 ) on a 1.5T system. MRA imaging was compared with the findings of DSA, which served as gold standard. Results: In a total of 467 examined vascular territories, DSA revealed 50 stenoses and 35 occlusions. All lesions were detected by MRA. In 23 segments, the degree of stenosis was overestimated by MRA. Sensitivity and specificity of MRA were 100% and 94,3%, positive and negative predictive values were 73.6 and 100%, and the accuracy was 95,1%. Conclusions: Despite a tendency to overestimate stenoses, contrast-enhanced three-dimensional MR angiography is a valid, non-invasive technique in the assessment of inflammatory aortic arch syndrome. (orig.) [German] Ziel: Bestimmung der Aussagekraft der kontrastmittelverstaerkten 3D-Magnetresonanzangiographie bei der Bewertung stenosierender und okkludierender Gefaessveraenderungen im Rahmen des entzuendlichen Aortenbogensyndroms. Material und Methoden: Bei 14 Patienten mit entzuendlichem Aortenbogensyndrom (Arteriitis temporalis: n = 8, Takayasu-Arteriitis: n = 4, Morbus Bechterew: n = 1, Sarkoidose: n = 1) erfolgte eine MRA des Aortenbogens und der supraaortalen Aeste (n = 15, darunter zwei Doppeluntersuchungen) sowie der Aorta abdominalis (n = 2). Zur Anwendung kam eine kontrastmittelverstaerkte 3D-FLASH-Sequenz (TR/TE 0,4/1,8 ms, Flipwinkel 30 ) an einem 1,5 Tesla-System. Die Befunde der MRA wurden mit der DSA als Referenzmethode

  8. Cardiovascular disease due to accelerated atherosclerosis in systemic vasculitides.

    Science.gov (United States)

    Cohen Tervaert, Jan Willem

    2013-02-01

    Patients with different forms of systemic vasculitis experience long-term morbidity and mortality caused by cardiovascular disease due to premature atherosclerosis. Epidemiologic reports of patients with GCA suggest that long-term mortality in this disease is not increased compared with the general population of the same age. The risk of a stroke, however, in particular in the vertebrobasilar territory, is increased. In addition, the occurrence of aortic aneurysmal disease and aortic dissection is also clearly increased in GCA. Mortality due to ischaemic heart disease, however, is not increased. In Takayasu arteritis accelerated atherosclerosis has been clearly documented both clinically and in autopsy reports. Atherosclerotic plaques in the carotid artery may be present in the carotid arteries especially in patients with a documented history of arteritis involving the carotid artery. It is controversial whether Kawasaki disease is associated with accelerated atherosclerosis. Young adults with a history of Kawasaki disease may have abnormal brachial artery reactivity, increased carotid IMT values and increased arterial stiffness. At autopsy examinations of KD patients, however, no significant atherosclerotic lesions are detected and carotid IMT measurements were found to be clearly different from those in young adults with familiar hypercholesterolaemia, suggesting that the remodeling process in KD is different from atherosclerosis. In ANCA-associated vasculitis (AAV), an increased mortality as a consequence of cardiovascular disease is well-documented. In these patients the relative risk for coronary heart disease is two- to fourfold that in control subjects. In addition, a similar relative risk has been found for stroke. Diabetes, hypertension, dyslipidemia, abdominal obesity (metabolic syndrome), impaired renal function, persistent proteinuria and increased production of C-reactive protein are common risk factors for premature atherosclerosis in patients with

  9. Granulomatosis sarcoidea necrosante con compromiso sistémico Necrotizing sarcoid granulomatosis with systemic involvement

    Directory of Open Access Journals (Sweden)

    María Elena Ceballos

    2006-09-01

    Full Text Available Mujer mapuche de 70 años quien en el curso de 1 año presentó baja de peso, ojo rojo bilateral y úlcera corneal que evolucionó hacia la perforación con herniación uveal y pérdida de la visión. Posteriormente se agregaron lesiones nodulares, violáceas, sensibles, algunas ulceradas en las zonas distales de ambas extremidades inferiores. La TAC de tórax demostró múltiples nódulos pulmonares. Tras un estudio exhaustivo se descartaron la tuberculosis y otras infecciones. Tanto la biopsia de las lesiones cutáneas como la biopsia pulmonar obtenida mediante toracotomía confirmaron la presencia de granulomas necrotizantes no caseificantes y arteritis granulomatosa. Se trató con esteroides y ciclofosfamida con mejoría de su condición general y regresión de las lesiones cutáneas y pulmonares en menos de 1 mes. Se realizó un trasplante de cornea. A los seis meses de seguimiento continúa en tratamiento, no ha presentado recaídas y tiene recuperación parcial de la visiónA 70-year-old mapuche female presented with a 1 year history of weight loss, bilateral red painful eyes and corneal ulcer that evolved into perforation and uveal herniation with complete visual loss. Reddish and painful nodules appeared on the distal aspect of both lower extremities, that ulcerated after months. A thoracic CT scan showed multiple pulmonary nodules. Infectious diseases were ruled out. An open lung biopsy and a skin biopsy were performed and both showed non-caseating necrotizing granulomas and granulomatous arteritis. Steroids and cyclophosphamide were started with complete regression of skin and pulmonary lesions within a month. Corneal transplantation was done. After 6 months follow-up, the patient is on low-dose of steroids, free of disease with partial vision recovery

  10. The Chernobyl accident: Can lichens be used to characterize a radiocesium contaminated range?

    Directory of Open Access Journals (Sweden)

    Eldar Gaare

    1987-06-01

    sammenligne artsnivåene og for å studere innsamlings-prosedyrer. Vi fant at det fra sted til sted var en svært stor variasjon, til og med innen samme art. På grunn av dette var vi ikke i stand til å vise statistisk sikre forskjeller mellom artene. Men vi fant at arter fra mer eller mindre snøfrie rabbetopper, Cornicularia divergens, Alectoria ochroleuca, Cetraria nivalis og Cladina mitis viste mindre variasjon og derfor må anbefales som de beste arter for overvåkning og sammenligning av områder.

  11. Radiology of the primary systemic vasculitides; Radiologie der primaeren systemischen Vaskulitiden

    Energy Technology Data Exchange (ETDEWEB)

    Reuter, M.; Biederer, J.; Both, M.; Heller, M.L. [Universitaetsklinikum Kiel (Germany). Klinik fuer Diagnostische Radiologie; Schnabel, A. [Universitaetsklinik Luebeck (Germany). Poliklinik fuer Rheumatologie; Medizinische Krankenhausabteilung Rheumaklinik Bad Bramstedt GmbH (Germany); Sana Rheumazentrum Baden-Wuerttemberg (Germany). Klinik fuer Internistische Rheumatologie und Klinische Immunologie; Reinhold-Keller, E.; Gross,W. [Universitaetsklinik Luebeck (Germany). Poliklinik fuer Rheumatologie; Medizinische Krankenhausabteilung Rheumaklinik Bad Bramstedt GmbH (Germany)

    2003-09-01

    Determination of disease extension and disease activity are in the foreground of diagnostic imaging in vasculitides. There are several radiologic modalities available each having specific indications. Magnetic resonance imaging (MRI) readily depicts granulomas and mucosal inflammations in the paranasal sinuses, nasal cavity and orbits. Computed tomography detects osseous lesions of the skull. Due to its superb sensitivity MRI is an established screening modality for CNS vasculitides, although there are limitations with regard to specificity. In spite of its limited accuracy in most institutions angiography is still required for radiological confirmation of CNS vasculitis. Perfusion and diffusion MR-imaging may combine the advantages of ''conventional'' MRI and angiography. By now the method is not fully validated for vasculitides, however. Vascular disease in Takayasu's arteritis and in giant cell arteritis involving predominantly large and medium sized vessels is readily diagnosed by non invasive magnetic resonance angiography. Percutaneous transluminal angioplasty has proven to be an effective and save therapeutic modality for the cure of vascular stenoses and occlusions. Plain film radiography in two planes is the established modality for pulmonary imaging. In pulmonary vasculitides a more thorough analysis of lung disease is provided by high resolution computed tomography. Diagnostic imaging does substantially assist in the interdisciplinary management of patients suffering from vasculitides. (orig.) [German] Die Bestimmung der Krankheitsausdehnung und die Festlegung der Krankheitsaktivitaet stehen im Vordergrund der bildgebenden Diagnostik von Vaskulitiden. Fuer die eigentliche Diagnosefindung ist die Radiologie von untergeordneter Bedeutung. Die verschiedenen radiologischen Methoden weisen jeweils spezifische Indikationen auf. Die Magnetresonanztomographie (MRT) hat sich als hilfreich fuer die Diagnostik von Granulomen und

  12. Early diagnosis and follow-up of aortitis with [{sup 18}F]FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Meller, J.; Siefker, U.; Sahlmann, C.O.; Lehmann, K.; Conrad, M. [Department of Nuclear Medicine, Georg August University, Robert Koch-Strasse 40, 37075, Goettingen (Germany); Strutz, F.; Scheel, A. [Department of Nephrology and Rheumatology, Georg August University, Goettingen (Germany); Vosshenrich, R. [Department of Radiology, Georg August University, Goettingen (Germany)

    2003-05-01

    The aim of this prospective study was to compare fluorine-18 fluorodeoxyglucose ([{sup 18}F]FDG) positron emission tomography (PET) with magnetic resonance imaging (MRI) in patients with early aortitis, at the time of initial diagnosis and during immunosuppressive therapy. The study population consisted of 15 patients (nine females and six males; median age 62 years, range 26-76 years) who presented with fever of unknown origin or an elevated erythrocyte sedimentation rate or elevated C-reactive protein and who showed pathological aortic [{sup 18}F]FDG uptake. Fourteen of these patients had features of early giant cell arteritis (GCA), while one had features of early Takayasu arteritis. During follow-up, seven PET scans were performed in six patients with GCA 4-30 months (median 19 months) after starting immunosuppressive medication. The results of [{sup 18}F]FDG imaging were compared with the results of MRI at initial evaluation and during follow-up and with the clinical findings. At baseline, abnormal [{sup 18}F]FDG uptake was present in 59/104 (56%) of the vascular regions studied in 15 patients. Seven follow-up PET studies were performed in six patients. Of 30 regions with initial pathological uptake in these patients, 24 (80%) showed normalisation of uptake during follow-up. Normalisation of [{sup 18}F]FDG uptake correlated with clinical improvement and with normalisation of the laboratory findings. All except one of the patients with positive aortic [{sup 18}F]FDG uptake were investigated with MRI and MRA. Thirteen of these 14 patients showed inflammation in at least one vascular region. Of 76 vascular regions studied, 41 (53%) showed vasculitis on MRI. Of 76 vascular regions studied with both PET and MRI, 47 were concordantly positive or negative on both modalities, 11 were positive on MRI only and 18 were positive on PET only. MRI was performed during follow-up in six patients: of 17 regions with inflammatory changes, 15 regions remained unchanged and two

  13. 小儿肾血管性高血压的外科治疗(包括6例自体肾移植术)%Surgical Treatment of Renovascular Hypertension in Children: Including 6 Cases of Renal Autotransplantation

    Institute of Scientific and Technical Information of China (English)

    李衷初; 余亚雄

    1982-01-01

    @@ 近十余年来,对肾血管性高血压的外科治疗有较大的进展,国内外文献报导亦渐见增多,但有关小儿病例的报告尚少.我院自1976~1981年间共收治9例,均作了腹主动脉、肾动脉造影术,诊断明确.本文重点介绍与讨论自体肾移植术的疗效与评价.%From 1976 to 1981,9 cases of renovas,cular hypertension in children were treated surgically.The etiology of renal artery steno sis in this series consisted of congenital abhor real renal artery(2 cases),fibromuscular dyspla sin(1 case)and Takayasu's arteritis(6 cases).The diagnosis was made by the aorto-reno gram in each case and was proved by the intervention and the pathological examination.Except those 3 cases,the others were treated by nephrectomy,of which one case died from unknown cause one year after operation,6 cases had undergone the renal autotransplan tation.The authors reviewed 13 pediatric cases(including this series)reported in Chinese literature(<12 years old),who were treated by renal autotransplantation with cure rate 84.6%(normotension on no medication).The authors indicated that the results of the renal autotrancplantation were much better than that of the revascularization techni ques with the following advantages:(1)the success rate was higher;(2)it provided excellent exposure for the vascular anastomosis in the iliac fossa;(3)the blood pressure in internal itiac artery was generally higher than that of the renal artery so that the blood pressure in transplanted kidney could be elevated after operation,and(4)it seemed more profitable in cases with renal artery stenosis by Takayasu's arteritis,because of no apparent stenosis:in the internal iliac arteries,which was observed from the arteriograms in the papers reported by others and us.

  14. Impact of chronic kidney disease on use of evidence-based therapy in stable coronary artery disease: a prospective analysis of 22,272 patients.

    Directory of Open Access Journals (Sweden)

    Paul R Kalra

    Full Text Available To assess the frequency of chronic kidney disease (CKD, define the associated demographics, and evaluate its association with use of evidence-based drug therapy in a contemporary global study of patients with stable coronary artery disease.22,272 patients from the ProspeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease (CLARIFY were included. Baseline estimated glomerular filtration rate (eGFR was calculated (CKD-Epidemiology Collaboration formula and patients categorised according to CKD stage: >89, 60-89, 45-59 and <45 mL/min/1.73 m2.Mean (SD age was 63.9±10.4 years, 77.3% were male, 61.8% had a history of myocardial infarction, 71.9% hypertension, 30.4% diabetes and 75.4% dyslipidaemia. Chronic kidney disease (eGFR<60 mL/min/1.73 m2 was seen in 22.1% of the cohort (6.9% with eGFR<45 mL/min/1.73 m2; lower eGFR was associated with increasing age, female sex, cardiovascular risk factors, overt vascular disease, other comorbidities and higher systolic but lower diastolic blood pressure. High use of secondary prevention was seen across all CKD stages (overall 93.4% lipid-lowering drugs, 95.3% antiplatelets, 75.9% beta-blockers. The proportion of patients taking statins was lower in patients with CKD. Antiplatelet use was significantly lower in patients with CKD whereas oral anticoagulant use was higher. Angiotensin-converting enzyme inhibitor use was lower (52.0% overall and inversely related to declining eGFR, whereas angiotensin-receptor blockers were more frequently prescribed in patients with reduced eGFR.Chronic kidney disease is common in patients with stable coronary artery disease and is associated with comorbidities. Whilst use of individual evidence-based medications for secondary prevention was high across all CKD categories, there remains an opportunity to improve the proportion who take all three classes of preventive therapies. Angiotensin-converting enzyme inhibitors were used less frequently

  15. Direct determination of single nucleotide polymorphism haplotype of NFKBIL1 promoter polymorphism by DNA conformation analysis and its application to association study of chronic inflammatory diseases.

    Science.gov (United States)

    Shibata, Hiroki; Yasunami, Michio; Obuchi, Nobuhisa; Takahashi, Megumi; Kobayashi, Yasushi; Numano, Fujio; Kimura, Akinori

    2006-01-01

    We previously revealed that one of the human leukocyte antigen-linked susceptibility genes for Takayasu's arteritis (TA) was mapped between TNFA and MICB loci and that -63T allele of NFKBIL1, which is between TNFA and MICB loci, was associated with rheumatoid arthritis (RA) in the Japanese population. We have developed a novel typing method based on reference strand-mediated conformation analysis for the upstream sequence of the NFKBIL1 gene, where -422 (T)8/(T)9, -325 C/G, -263 A/G, and -63 T/A polymorphisms were found. Upon the analysis of the patients with TA (n = 84), those with RA (n = 120), and healthy control subjects (n = 217), five common haplotypes named IKBLp*01 through IKBLp*05 were found in the Japanese population. The frequency of IKBLp*03 was significantly increased in the patient with TA (57.1% vs 35.0%, giving an odds ratio of 2.47). In addition, the frequency of IKBLp*01, but not that of other -63T-bearing alleles, was increased in the patients with RA (73.3% vs 58.1%, giving an odds ratio of 1.99), suggesting that the susceptibility to RA was conferred not by -63T alone but by combination of single nucleotide polymorphisms in the NFKBIL1 promoter. A higher promoter activity associated with IKBLp*03 and a lower activity associated with IKBLp*01 may contribute to the susceptibility to TA and RA, respectively.

  16. [Tonic pupil caused by ischemia].

    Science.gov (United States)

    Wilhelm, H

    1989-01-01

    Tonic pupil is usually an idiopathic condition. In some cases, the cause of the ciliary ganglion lesion leading to tonic pupils is obvious. Rarely ischemia causes a lesion of the ciliary ganglion or the short ciliary nerves due to the good blood supply of the ciliary ganglion. Only two cases of tonic pupils in the course of giant cell arteritis are mentioned in the literature, but tonic pupils are probably much more common with this disease. Five cases are demonstrated here. All had associated ischemic optic neuropathy, and stagnation of the blood flow in the supratrochlear artery could be demonstrated in two cases by Doppler sonography. Tonic pupils may also occur when an oclusion of the internal carotid artery resolves, probably because of transient stasis of the orbital blood flow. In another case, tonic pupils were associated with choroidal ischemia (proved by video fluorescent angiography) of unknown origin. The diagnosis of tonic pupils was made by pharmacological testing for cholinergic hypersensitivity with 0.1% pilocarpine.

  17. Goplers relative trofiske niveau bestemt ved δ15N

    DEFF Research Database (Denmark)

    Christensen, Jens Tang; Sode, Sidsel; Krawack, Marie-Louise

    , hvor den indbyrdes afstand mellem to arter er bestemt på samme tid og i samme vandmasse. I laboratorieforsøg har Aurelia vist lave værdier for trofisk berigelse (forskel på fødens og Aurelias 15N) på 0,74 ‰ for Artemia, 0,99 ‰ for Brachionus og 0,58 ‰ for skrubbelarver. Dette bør undersøges i flere...... forsøg, men giver dog et sammenligningsgrundlag for prøver taget i havet. I seks hav-prøvetagninger lå Cyanea capillata 0,21-2,28 ‰ over Aurelia i 15N, mens Aurelia i en syvende prøvetagning lå 0,86 ‰ over Cyanea (forskel dog ikke signifikant). I tre prøvetagninger lå Mnemiopsis leidyi 0,01-1,61 ‰ over...... Aurelia i 15N mens Mnemiopsis lå 0,29 ‰ over Cyanea capillata i én sammenligning, mens den lå 1,72 ‰ over Cyanea lamarcki i en anden prøvetagning. I tre prøvetagninger lå Pleurobrachia pileus 1,74-4,18 ‰ over Aurelia i 15N og 1,06-2,51 ‰ over Cyanea capillata. Generelt synes ribbegoplerne at ligge på et...

  18. Parameters and criteria for repair and strengthening of buildings in the old town core of Dubrovnik based on seismic risk analysis

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    M. Vladimir

    1995-06-01

    Full Text Available Definition of the seismicity conditions, the design seismic parameters and the seismic risk level are important and inevitable phases ol the complex process of repair and strengthening of existing structures in certain towns located in seismically active areas. These should be studied in all necessary details in order to provide corresponding bases and define the necessary preventive measures against expected strong earthquakes. Such an approach becomes even nlore necessary arter the experience regarding the last catastrophic earthquakes that occurred in Former Yugoslavia (Skopje. Banja Luka, Montenegro coast and Kopaonik and inflicted heavy losses of human lives and material properties. The old town core of Dubrovnik is known for the large concentration of buildings of enorrnous cultural-historic importance. Considering the high seismic activity of this area. all these buildings are very likely to experience heavy damage and failure. Tlie history of the town records many catastrophic earthquakes that inflicted heavy material losses and loss of human lives. Here, we can rnention the great Dubrovnik earthquake of 1667 and the last Montenegro earthquake of April 15, 1979 with an epicenter in the Ulcinj-Bar area. The consequences of the latter are well known. The purpose of this paper is to present some results and experience gained from the investigations performed for the area of Dubro~nikil lustrated by several examples of buildings existing in the old town core of Dubrovnik.

  19. Granulomatous pneumonia caused by Pythium insidiosum in a central American jaguar, Panthera onca.

    Science.gov (United States)

    Camus, Alvin C; Grooters, Amy M; Aquilar, Roberto E

    2004-11-01

    A 7-month-old, male jaguar presented with dyspnea and leukocytosis unresponsive to antibiotic therapy. Radiographs revealed unilateral pulmonary consolidation. An exploratory thoracotomy was performed, and the left lung, which contained a large multilobular mass with extensive fibrosis and numerous caseonecrotic foci, was removed. Microscopically, eosinophilic granulomatous inflammation surrounded broad (4.4-8.3 microm) rarely septate hyphae. A diagnosis of Pythium insidiosum infection was confirmed by immunohistochemistry, immunoblot serology, culture, and polymerase chain reaction. Dyspnea recurred despite treatment, and the animal succumbed 3 weeks after surgery. Necropsy findings indicated that death resulted from occlusion of the right main stem bronchus by a fungal granuloma. The oomycete P. insidiosum typically causes granulomatous disease of the skin or gastrointestinal tract in animals and arteritis, keratitis, or cellulitis in humans. Infection is uncommon in felines, and pulmonary involvement is rare. This report details the first case of P. insidiosum infection in an exotic felid and provides the first description of primary pulmonary pythiosis in any species.

  20. Antropocæne monstre og vidundere. Kartofler, samarbejdsformer og globale forbindelser i et dansk ruinlandskab

    Directory of Open Access Journals (Sweden)

    Frida Hastrup

    2016-07-01

    Full Text Available Med afsæt i forarbejdningen af kartofler til avanceret kartoffelstivelse i et område af Jylland, der tidligere lagde grund til udvinding af brunkul, udforsker vi i denne artikel former for liv på en stærkt industrialiseret jord. Gennem en kulturanalyse i jordhøjde i et særligt menneskeskabt landskab viser vi, at jyske kartofler har alt muligt at gøre med vingummi, brunkulsudvinding, hjorte, asiatiske nudler, parmesanost og frembringelsen af nye forbindelser i verden. Ved at rette blikket mod sådanne forbindelser i et landskab gennemgribende formet af ressourceudvinding, diskuterer vi muligheder for forskellige arters sameksistens og retter blikket mod både monstrøse og vidunderlige effekter af industriel virksomhed. Begrebet antropocæn bruger vi til at undersøge det menneskeskabte brunkulslandskab som en mangetydig økologi sammensat af både planlagte og løbske elementer.

  1. Hyperthyroidism and ischemic stroke%甲状腺功能亢进症和缺血性脑卒中

    Institute of Scientific and Technical Information of China (English)

    王燕燕

    2010-01-01

    The occurrence of atrial fibrillation in hyperthyroidism and subclinical hyperthyroidism increases over the time. Hypercoagulability state,usually accompanying with these two diseases above,can also result in the formation of cardioembolic stroke. Additionally, hyperthyroidism is related with ischemic cerebro-vascular disease,for instance acute cerebral venous thrombosis,giant cell temporal arteritis. Moyamoya disease, but sound evidence is lacking. Here reviews the relationship between hyperthyroidism and cerebrovas-cular disease, in order to investigate the pathogenesis and clinical characteristics and provide the evidence for corrent therapy.%甲状腺功能亢进症(甲亢)和亚临床甲亢时房颤的发生率增加,其伴有的高凝状态也可引起心源性脑卒中的发生.此外,甲亢时可伴有急性脑静脉血栓形成、巨细胞性颞动脉炎和烟雾病等缺血性脑血管病,但缺乏相关证据.现对甲亢与脑血管疾病之间的关系作一综述,旨在探讨其共同的发病机制及临床特点,并为两者合并存在时的正确治疗提供参考.

  2. Lung vasculitis and alveolar hemorrhage: pathology.

    Science.gov (United States)

    Fishbein, Gregory A; Fishbein, Michael C

    2011-06-01

    Pulmonary vasculitides are a diverse group of limited and systemic disorders associated with inflammation of pulmonary vessels and parenchyma. These diseases often have distinctive clinical, serological, and histopathological features-extrapulmonary sites of involvement, circulating autoantibodies, predispositions for small or large vessels, and others. Some have characteristic inflammatory lesions; others are characterized by the absence of such lesions. Frequently pathological findings overlap, rendering classification, and diagnosis a challenge. The anti-neutrophil cytoplasmic antibody (ANCA)-associated small-vessel diseases constitute the major pulmonary vasculitides. These include Wegener granulomatosis (WG), Churg Strauss syndrome (CSS), and microscopic polyangiitis (MPA). Less frequently, diseases such as polyarteritis nodosa, Takayasu arteritis, Behçet syndrome, and connective tissue diseases may involve pulmonary vessels, but these entities are better associated with extrapulmonary disease. Diffuse alveolar hemorrhage (DAH) is a severe manifestation of pulmonary vasculitis. DAH is most commonly seen in small-vessel vasculitides, specifically MPA and WG. Other syndromes associated with DAH include Goodpasture syndrome, Henoch-Schönlein purpura, and systemic lupus erythematosus. Less commonly, DAH may be secondary to infection or drugs/toxins. Furthermore, in the absence of discernable systemic disease, DAH may be idiopathic-referred to as isolated pulmonary capillaritis (IPC) or idiopathic pulmonary hemosiderosis (IPH), depending on the presence of capillaritis.

  3. A candidate gene approach identifies an IL33 genetic variant as a novel genetic risk factor for GCA.

    Directory of Open Access Journals (Sweden)

    Ana Márquez

    Full Text Available Increased expression of IL-33 and its receptor ST2, encoded by the IL1RL1 gene, has been detected in the inflamed arteries of giant cell arteritis (GCA patients. The aim of the present study was to investigate for the first time the potential influence of the IL33 and IL1RL1 loci on GCA predisposition.A total of 1,363 biopsy-proven GCA patients and 3,908 healthy controls from four European cohorts (Spain, Italy, Germany and Norway were combined in a meta-analysis. Six genetic variants: rs3939286, rs7025417 and rs7044343, within the IL33 gene, and rs2058660, rs2310173 and rs13015714, within the IL1RL1 gene, previously associated with immune-related diseases, were genotyped using predesigned TaqMan assays.A consistent association between the rs7025417 polymorphism and GCA was evident in the overall meta-analysis, under both allele (P(MH = 0.041, OR = 0.88, CI 95% 0.78-0.99 and recessive (P(MH = 3.40E-03, OR = 0.53, CI 95% 0.35-0.80 models. No statistically significant differences between allele or genotype frequencies for the other IL33 and IL1RL1 genetic variants were detected in this pooled analysis.Our results clearly evidenced the implication of the IL33 rs7025417 polymorphism in the genetic network underlying GCA.

  4. Lipids and stable isotopes in marine food webs in West Greenland

    DEFF Research Database (Denmark)

    Møller, Per

    Lipider er essentielle for alle livsformer og er den vigtigste molekyle i energitransporten i de arktiske fødekæder. Inden for det marine miljø har lipidsammensætningen tilpassets, for at maksimere produktiviteten og assimilationseffektiviteten hos primær producenter og konsumenter, med en følgelig...... positiv effekt på biodiversitet og produktivitet. Udover betydning på produktiviteten i disse farvande har befolkninger i Arktis også haft gavn af den favorable lipid sammensætning, da det er påvist at den haver en gavnlig effekt på folkesundheden. Med henblik på anvendelse af lipider og stabile isotoper...... som informationskilde til det det trofiske sammenhæng i det vestgrønlandske marine økosystem (62°N – 72°N) og ernæringskvaliteten af den traditionelle arktiske kost, er der blevet analyseret lipider og stabile isotoper fra 42 arter af særlig betydning, samt kosten fra et udsnit af en lokal befolkning...

  5. Advances in epidemiology, etiology and pathogenesis of Kawasaki disease%川崎病流行病学、病因和发病机制的新进展

    Institute of Scientific and Technical Information of China (English)

    杨波; 朱义杰(综述); 罗军; 张召艳(审校)

    2014-01-01

    川崎病(KD)是一种以急性全身血管炎为主要病理变化的疾病,好发于6个月至4岁的婴幼儿。KD主要累及冠状动脉,导致动脉瘤和血栓形成,引起严重的并发症甚至猝死。目前KD的病因和发病机制尚不完全清楚。文章就KD的流行病学、病因、发病机制及易感因素等新进展作一综述。%Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects young children between 6 months and 4 years old. Coronary arteritis is an important clinical feature of KD because it is associated with aneurysms and thromboembolic events that can lead to severe complications, even sudden death. To date, the etiology and pathogenesis of Kawasaki disease has not been understood completely. In this paper, we will review the recent advances in epidemiology, etiology, pathogenesis and genetic susceptibility of Kawasa-ki disease.

  6. Autoimmune diseases in pregnancy: maternal and fetal outcomes

    Directory of Open Access Journals (Sweden)

    Pavithra M. Vengetesh

    2015-02-01

    Full Text Available Background: The aim of this study was to assess the impact of autoimmune connective tissue disorders on the outcomes of pregnancy and the influence of treatment on pregnancy. Methods: Thirty-seven antenatal patients with autoimmune connective tissue diseases, comprising of Systemic Lupus Erythematosus (SLE, primary antiphospholipid antibody syndrome (APS, Mixed Connective Tissue Diseases (MCTD, ankylosing spondylitis and Takayasu arteritis were analysed. Results: Multigravidas constituted 89.4% and were associated with bad obstetric history. Before diagnosis and treatment, serious maternal complications of eclampsia and thromboembolism were observed in patients with SLE and APS. The live birth rates were 9% and 2.4% respectively in patients with SLE and APS. With appropriate treatment- aspirin, heparin and immunosuppressant, the live birth rates were raised to 70% in SLE and 100% in APS patients. Investigation for autoimmune disease in recurrent pregnancy loss is important. A rare association between MCTD and congenital anomaly - Rhizomelic chondrodysplasia punctata was observed. Preeclampsia, gestational diabetes, fetal growth restriction and preterm labour were the common complications noted. Conclusions: Active disease at onset of pregnancy, presence of Anti-ds DNA antibodies and secondary APS were strong predictors of poor pregnancy outcomes among patients with SLE. Vigilant monitoring during pregnancy is required for favourable outcomes. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 9-14

  7. Behçet's disease

    Directory of Open Access Journals (Sweden)

    Saadoun David

    2012-04-01

    Full Text Available Abstract Definition of the disease Behçet disease (BD is a chronic, relapsing, multisystemic disorder characterized by mucocutaneous, ocular, vascular and central nervous system manifestations. Epidemiology BD seems to cluster along the ancient Silk Road, which extends from eastern Asia to the Mediterranean basin. European cases are often described, not exclusively in the migrant population. Clinical description The clinical spectrum includes oral and genital ulcerations, uveitis, vascular, neurological, articular, renal and gastrointestinal manifestations. Etiology The etiopathogenesis of the disease remains unknown, although genetic predisposition, environmental factors and immunological abnormalities have been implicated. Diagnostic methods Diagnosis is only based on clinical criteria. Differrential diagnosis It depends on the clinical presentation of BD, but sarcoidosis, multiple sclerosis, Crohn’s disease, Takayasu’s arteritis, polychondritis or antiphospholipid syndrome need to be considered. Management Treatment is symptomatic using steroids and immunomodulatory therapy. It is efficient depending on the rapidity of initiation, the compliance, and the duration of therapy. Prognosis The prognosis is severe due to the ocular, neurological and arterial involvement.

  8. Natural and experimental West Nile virus infection in five raptor species.

    Science.gov (United States)

    Nemeth, Nicole; Gould, Daniel; Bowen, Richard; Komar, Nicholas

    2006-01-01

    We studied the effects of natural and/or experimental infections of West Nile virus (WNV) in five raptor species from July 2002 to March 2004, including American kestrels (Falco sparverius), golden eagles (Aquila chrysaetos), red-tailed hawks (Buteo jamaicensis), barn owls (Tyto alba), and great horned owls (Bubo virginianus). Birds were infected per mosquito bite, per os, or percutaneously by needle. Many experimentally infected birds developed mosquito-infectious levels of viremia (>10(5) WNV plaque forming units per ml serum) within 5 days postinoculation (DPI), and/ or shed virus per os or per cloaca. Infection of organs 15-27 days postinoculation was infrequently detected by virus isolation from spleen, kidney, skin, heart, brain, and eye in convalescent birds. Histopathologic findings varied among species and by method of infection. The most common histopathologic lesions were subacute myocarditis and encephalitis. Several birds had a more acute, severe disease condition represented by arteritis and associated with tissue degeneration and necrosis. This study demonstrates that raptor species vary in their response to WNV infection and that several modes of exposure (e.g., oral) may result in infection. Wildlife managers should recognize that, although many WNV infections are sublethal to raptors, subacute lesions could potentially reduce viability of populations. We recommend that raptor handlers consider raptors as a potential source of WNV contamination due to oral and cloacal shedding.

  9. Fertility and pregnancy in vasculitis.

    Science.gov (United States)

    Pagnoux, Christian; Mahendira, Dharini; Laskin, Carl A

    2013-02-01

    Despite the rarity of vasculitides, fertility and pregnancy outcome in the setting of vasculitis have become a major topic of interest within the past decade. The potential impact of vasculitis therapies, particularly cyclophosphamide, has been examined to some extent, but data are limited on the possible impact of the disease itself on fertility. Ideally, pregnancy should be planned when the vasculitis is in remission. The outcome for mothers and newborns is usually good when vasculitis is known before the pregnancy and is in remission, but every pregnant woman must be monitored by a specialised health-care team consisting of obstetricians specialised in high-risk births and internists/rheumatologists with expertise in managing these rare conditions. Most maternal complications during pregnancy are indeed due to vasculitis damage: hypertension in Takayasu arteritis (TAK) or granulomatosis with polyangiitis (GPA)/microscopic polyangiitis (MPA) with renal insufficiency, asthma or cardiac damage in eosinophilic granulomatosis with polyangiitis (EGPA) and subglottic and/or bronchial stenosis(es) in GPA. Pregnancy loss can occur in about 10% of cases in GPA, up to 20% in EGPA, 20-30% in Behçet's disease and up to 25% in TAK, and several studies found high rates of preterm births, at least with some vasculitides. Vasculitis manifestations in newborns from mothers with known vasculitis are very rare and usually transient.

  10. Childhood vasculitis hospitalizations in Spain, 1997-2011.

    Science.gov (United States)

    Villaverde-Hueso, A; Alonso, V; Morales-Piga, A; Hens-Pérez, M; Abaitua, I; Posada-de-la-Paz, M

    2014-05-01

    The aim of this study is to describe the childhood vasculitis hospital burden in Spain (1997-2011), considering type of disease, hospitalization rates and time trends. Data were obtained from the National Discharges Basic Minimum Data Set (National Patient Data Base). Inpatient events of children younger than 15 years of age were analyzed. Principal diagnosis of vasculitis were selected according Ninth Revision of the International Classification of Diseases: Takayasu arteritis, Polyarteritis nodosa, Kawasaki disease, Wegener`s granulomatosis, Churg-Strauss syndrome, and Henoch-Schönlein purpura. A total of 14518 children hospitalizations related to vasculitis were identified in Spain from 1997 to 2011. The average hospitalization rate for children was 13.33±1.71 per 100,000. Henoch-Schönlein purpura and Kawasaki disease were the most common type of vasculitis, hospitalization rates were 11.00 and 3.97 per 100,000 children, respectively. Other vasculitis hospitalizations are much rare in childhood. Average length of stay was 6.04 days and estimated cost per inpatient hospital care was 2,847€. Hospital case fatality rate was 0.05% for overall vasculitis. In conclusion, epidemiological data of childhood vasculitis are useful both to health decision-making and to identify research priorities.

  11. [Safety and efficacy of biologics directed against TNF-alpha and CD20 in the therapy of vasculitis and systemic lupus erythematosus].

    Science.gov (United States)

    Walker, Ulrich A; Hasler, Paul

    2008-05-01

    While the inhibition of TNF-alpha has been shown to improve vasculitis in vitro and in animal models, the clinical evidence for the efficacy of TNF-alpha blockade in most forms of vasculitis is mainly based on case reports and case series. Randomised controlled studies have so far not shown superiority of anti-TNF-alpha agents for Wegener's granulomatosis and giant cell arteritis. Moreover, in the context of Wegener's granulomatosis, a higher frequency and severity of infections are to be expected. In refractory cases of Behçet's disease therapy of uveitis and other organ manifestations is promising. Rituximab has achieved good effects in case reports of vasculitis. Results from controlled trials are not available. Observational studies indicate that in refractory systemic lupus erythematosus, and possibly also in several instances of small vessel vasculitis, rituximab can achieve good responses. The increased frequency of severe infections under TNF-alpha blockade requires a stringent benefit and risk assessment in addition to a multidisciplinary analysis of follow-up parameters. A detailed information of the patient regarding symptoms and signs of a possible infection are a prerequisite. Due to the complexity of the field and the danger of morbidity and mortality as a consequence of vasculitis or systemic lupus erythematosus on the one hand, and of the therapy on the other, biologics should only be used to treat these disorders in institutions fully equipped and staffed for this purpose.

  12. Systemic and non-systemic vasculitis affecting the peripheral nerves.

    Science.gov (United States)

    Finsterer, J

    2009-06-01

    Vasculitis affecting the peripheral nerves predominantly manifests as subacute, progressive, asymmetric sensorimotor polyneuropathy or mononeuritis multiplex, and more rarely as painful mononeuropathy, pure sensory neuropathy, neuropathy of the cranial nerves, plexopathy, or as autonomic neuropathy. Vasculitic neuropathy may occur isolated or non-isolated (systemic) together with involvement of other organs. Systemic vasculitis with involvement of the peripheral nerves is further subdivided into primary (Takayasu syndrome, giant cell arteritis, classical panarteritis nodosa, thrombangitis obliterans, Kawasaki disease, Churg-Strauss syndrome, Wegener granulomatosis, cryoglobulinemic vasculitis, Behcet disease, microscopic polyangitis, Schoenlein Henoch purpura) or secondary systemic vasculitis (autoimmune connective tissue diseases, vasculitis from infection, sarcoidosis, malignancy, drugs, radiation, or diabetes). In addition to routine laboratory investigations and nerve conduction studies, nerve biopsy is essential for diagnosing the condition and to delineate it from differentials, although its sensitivity is only approximately 60%. Therapy of non-viral vasculitic neuropathy is based on corticosteroids and cyclophosphamide alone or in combination. Additional options include azathioprine, methotrexate, mycophenolate mofetil, or rituximab. In single cases immunoglobulins, immunoadsorbtion, or plasma exchange have been successfully applied. In case of virus-associated vasculitis interferon-alpha plus lamivudine or ribaverin may be beneficial.

  13. Comparison between Adventitial and Intimal Inflammation of Ruptured and Nonruptured Atherosclerotic Plaques in Human Coronary Arteries

    Directory of Open Access Journals (Sweden)

    Higuchi Maria L.

    2002-01-01

    Full Text Available OBJECTIVE: To verify the possible role of adventitial inflammation in atherosclerotic plaque vulnerability and coronary artery remodelling. METHODS: We compared the mean numbers of lymphocytes in the adventitia and in the plaque of ruptured thrombosed and stable equi-stenotic coronary segments of 34 patients who died due to acute myocardial infarction. We also analysed adventitial microvessels, adventitial fibrosis and the external elastic membrane. RESULTS: In the adventitia, the numbers of lymphocytes and microvessels/mm² were 69.5±88.3 and 60.9± 32.1 in culprit lesions and 16.4 ± 21.1 and 44.3±16.1 in stable lesions (p<0.05; within the plaques, the mean number of lymphocytes was 24±40.8 in culprit lesions and 10.9±13.2 in stable ones (p=0.17. The mean percent area of adventitial fibrosis/cross-sectional area of the vessel was significantly lower in unstable plaques (p<0.001. The confocal images showed holes in the external elastic membrane. CONCLUSION: Unstable plaques exhibit chronic pan-arteritis, accompanied by enlargement, medial thinning, and less fibrosis than in stable lesions, which is compatible with vessel aneurysm. Adventitial inflammation may contribute significantly to atheroma instability.

  14. Oral necrotizing microvasculitis in a patient affected by Kawasaki disease.

    Science.gov (United States)

    Scardina, Giuseppe Alessandro; Fucà, Gerlandina; Carini, Francesco; Valenza, Vincenzo; Spicola, Michele; Procaccianti, Paolo; Messina, Pietro; Maresi, Emiliano

    2007-12-01

    Kawasaki disease (KD) was first described in 1967 by Kawasaki, who defined it as "mucocutaneous lymph node syndrome". KD is an acute systemic vasculitis, which mainly involves medium calibre arteries; its origin is unknown, and it is observed in children under the age of 5, especially in their third year. The principal presentations of KD include fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Within KD, oral mucositis - represented by diffuse mucous membrane erythema, lip and tongue reddening and lingual papillae hypertrophy with subsequent development of strawberry tongue - can occur both in the acute stage of the disease (0-9 days), and in the convalescence stage (>25 days) as a consequence of the pharmacological treatment. KD vascular lesions are defined as systemic vasculitis instead of systemic arteritis. This study analyzed the anatomical-pathological substrata of oral mucositis in a baby affected by Kawasaki disease and suddenly deceased for cardiac tamponade caused by coronary aneurysm rupture (sudden cardiac death of a mechanical type).

  15. A STUDY OF ARTERIAL SUPPLY OF VERMIFORM APPENDIX IN HUMANS

    Directory of Open Access Journals (Sweden)

    Hosmani

    2012-11-01

    Full Text Available ABSTRACT: The surgical procedures like appendicectomy, demands a precise knowledge of vascular anatomy of ileocolic region. The aim of th is study is to study the arterial supply of the appendix, findings of which may reveal more anatomica l facts about the arteries of appendix and their variations. Total 52 specimens of caecum a nd appendix with their arteries intact were collected, cleaned and dissected. The ileocolic art ery and its branches to the appendix were traced carefully and observations were recorded. Th e ileocolic artery arises independently from superior mesenteric artery in 96.88% of cases and en ds by dividing into superior and inferior division in 93.76% of cases. The appendicular artery arises from inferior division in 46.88%, ileal branch 28.13%, ileocolic artery 18.75% and fr om arterial arcade in 6.25% of cases. 21.87% of cases showed additional appendicular artery. KEYWORDS: Caecum, appendix, ileocolic artery, appendicular arter y.

  16. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide

    Science.gov (United States)

    Watanabe, Kae; Rajderkar, Dhanashree A.; Modica, Renee F.

    2016-01-01

    Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors' knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition. PMID:27018080

  17. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide

    Directory of Open Access Journals (Sweden)

    Kae Watanabe

    2016-01-01

    Full Text Available Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors’ knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition.

  18. Study of tuberculous meningitis by CT

    Energy Technology Data Exchange (ETDEWEB)

    Rovira, M.; Romero, F.; Torrent, O.; Ibarra, B.

    1980-04-01

    Computed tomography is a very valuable method by which the pathogenic evolution of tuberculous meningitis may be followed, thereby facilitating its differential diagnosis and controlling the efficiency of therapy. The initial miliary tuberculosis in the brain, very often unaccompanied by neurological symptoms, may offer very evident CT images. CT may also demonstrate the fibrogelatinous exudate which fills the basal cisterns and surrounds the arterial vessels which cross this region. Because of this, secondary arteritis is frequent and may be indirectly detected by CT in the form of foci of ischemic infarcts. Tuberculomas may be multiple, and are found equally in the cerebral and the cerebellar parenchyma. These tuberculomas present different images on CT, depending on the evolution of the disease at that moment. Hydrocephalus is a common complication of TM and is caused by a lack of reabsorption of the cerebrospinal fluid, or by an obstructive lesion in the ventricular drainage pathways due to a tuberculoma. This complication is usually easily identified by CT, which, moreover, permits the control of its evolution.

  19. Development of an antigen-capture ELISA for the detection of equine influenza virus nucleoprotein.

    Science.gov (United States)

    Ji, Yuanyuan; Guo, Wei; Zhao, Liping; Li, Hongmei; Lu, Gang; Wang, Zheng; Wang, Guibin; Liu, Cuiyun; Xiang, Wenhua

    2011-07-01

    An antigen-capture enzyme-linked immunosorbent assay (AC-ELISA) was developed for the detection of the equine influenza virus (EIV), employing monoclonal and polyclonal antibodies against the A/equine/Xingjiang/2007 (H3N8) nucleoprotein (NP). Immunoglobulin G antibodies were purified and used as capture or detector antibodies. The specificity of the optimized AC-ELISA was evaluated using EIV, equine herpesvirus 1 (EHV-1), equine herpesvirus 4 (EHV-4), equine arteritis virus (EAV) and Japanese encephalitis virus (JEV), resulting in only EIV specimens yielding a strong signal. A minimal concentration of 50 ng/ml EIV protein was detected in Nonidet P40-treated virus preparations. Virus from the nasal swabs of equines infected experimentally were detected from days 3 to 7 post-infection using this AC-ELISA, with results confirmed by virus isolation and multi reverse transcription polymerase chain reaction. Both H3N8 and H7N7 EIV subtypes were AC-ELISA positive, indicating that this assay is suitable for the detection of all EIV subtypes.

  20. Thoracic vasculitis presenting as surgical problems.

    LENUS (Irish Health Repository)

    Jansen, Michael

    2010-01-01

    We present four patients with vasculitis manifesting with unusual clinical or pathological features, generating surgical problems. Two cases presented with pulmonary hypertension, with investigations and radiological evidence prompting clinical suspicion of pulmonary thrombo-embolic disease. First case, with an antecedant history of Wegener\\'s granulomatosis (WG), demonstrated following "embolectomy", WG involving the large pulmonary elastic arteries. The second case of inoperable "pulmonary thrombo-embolic disease" was subsequently found at limited post mortem to have giant cell arteritis, which affected widespread small peripheral pulmonary arterial vessels. The other two cases were of aortitis occurring in the background of immune-mediated disease, which had been treated with aggressive immunosuppression regimens. The first of these was a case of Cogan\\'s syndrome complicated by descending aortitis, a rarely reported phenomenon, with co-existent acute endocarditis of the aortic valve leaflets. Most cases of endocarditis in this context occur secondary to and in continuity with ascending aortitis. That this case, and a case of ascending aortitis occurring in the context of relapsing polychondritis occurred in the face of aggressive immunosuppression with an apparent clinical response, underscores the need to not accept a clinical picture at face value. This has implications for clinical management, particularly in the follow-up of surgical prosthetic devices such as grafts which may be used in these cases. All four cases emphasise the continued importance of histology and the post-mortem examination in elucidating previously undetected or unsuspected disease.

  1. Disseminate Fungal Infection after Acute Pancreatitis in a Simultaneous Pancreas-Kidney Recipient

    Directory of Open Access Journals (Sweden)

    Anna Rossetto

    2010-01-01

    Full Text Available Fungal infections after kidney transplantation are a major cause of morbidity and mortality, and Candida infection of the pancreas is considered an infrequent but important agent in necrotizing pancreatitis. We report the case of a 43-year-old Caucasian patient who underwent simultaneous pancreas-kidney transplantation because of diabetes type I, and chronic renal failure with peritoneal dialysis. The postoperative course was complicated by acute pancreatitis due to the thrombosis of the splenic artery of the graft, the subsequent acute rupture of the external iliac artery caused by fungal arteritis (Candida glabrata, and peritonitis a few days later caused by sigmoid perforation with detection of Candida glabrata infection of the resected intestinal tract. The present case remarks that awareness and prevention of fungal infection are major issues in the transplant field. Important information can be added by systematic culture of conservation perfusates but, probably, the best way for early recognition of a critical level of infectious risk remains the routine application of the colonization index screening. In cases of positive results, preemptive antifungal therapy could be warranted.

  2. Bilateral acute retinal necrosis after herpetic meningitis

    Directory of Open Access Journals (Sweden)

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  3. Art and rheumatology: the artist and the rheumatologist's perspective.

    Science.gov (United States)

    Hinojosa-Azaola, Andrea; Alcocer-Varela, Jorge

    2014-10-01

    The reflection of medicine in the universal arts has motivated several rheumatologists to discover features of rheumatic diseases depicted by the artist's eyes long before they were defined as specific pathologic entities. The result has been the identification of several pieces of art dating from the Middle Ages, the Renaissance, the Baroque and Post-Impressionist periods that depict clear features of several rheumatic diseases such as RA, OA, camptodactyly and temporal arteritis, among others. On the other hand, great artists such as Pierre-Auguste Renoir, Antoni Gaudí, Raoul Dufy, Paul Klee, Frida Kahlo and Niki de Saint Phalle are good examples of how rheumatic diseases such as RA, scleroderma and chronic pain can influence the artist's perspective, the technique used and the content of their work. Art can serve as a powerful resource to understand the natural course of diseases. By learning through the artist's eyes the way illnesses behave and evolve in time, rheumatologists can trace the history of several conditions.

  4. Radiology of ischemic strokes in children

    Energy Technology Data Exchange (ETDEWEB)

    Raybaud, C.A.; Jiddane, M.; Livet, M.O.; Pinsard, N.

    1985-11-01

    Arterial ischemic strokes are a relatively frequent diagnostic occurrence in pediatric neuroradiology. They occur mostly in three main etiologic contexts: 1) congenital heart disease; 2) neonatal distress; 3) infections, focal or general inducing vasculitis, but many cases are considered as idiopathic. The positive diagnosis is made by CT; in neonates, however, ultrasound appears as a promising tool. The CT features are basically similar at that age and in adults, although the site of the infarct may result from pathologies more particular to children (e.g. basal ganglia infarction due to arteritis of the carotid syphon and its branches). Infarcts may be multiple and also more frequently hemorrhagic at that age, the homorrhagic phenomena affecting only the gray matter except in young infants in which the subcortical white matter may be affected also. Anatomical sequels include focal atrophy and asymmetry of the brain. Data regarding the etiology can be gathered from angiography which may show the degree of impairment of the arterial bed, its extent, the collateral blood supply and the morphological type of arterial lesion responsible for the cerebral damage. The most particular picture at that age is that of the often diffuse vasculitis, with its various expressions (segmental narrowing of the lumen, dissecting aneurysm, string-of-beads appearance). (orig.).

  5. Acute aortic dissection: be aware of misdiagnosis

    Directory of Open Access Journals (Sweden)

    Asteri Theodora

    2009-02-01

    Full Text Available Abstract Background Acute aortic dissection (AAD is a life-threatening condition requiring immediate assessment and therapy. A patient suffering from AAD often presents with an insignificant or irrelevant medical history, giving rise to possible misdiagnosis. The aim of this retrospective study is to address the problem of misdiagnosing AD and the different imaging studies used. Methods From January 2000 to December 2004, 49 patients (41 men and 8 women, aged from 18–75 years old presented to the Emergency Department of our hospital for different reasons and finally diagnosed with AAD. Fifteen of those patients suffered from arterial hypertension, one from giant cell arteritis and another patient from Marfan's syndrome. The diagnosis of AAD was made by chest X-ray, contrast enhanced computed tomography (CT, transthoracic echocardiography (TTE and coronary angiography. Results Initial misdiagnosis occurred in fifteen patients (31% later found to be suffering from AAD. The misdiagnosis was myocardial infarction in 12 patients and cerebral infarction in another three patients. Conclusion Aortic dissection may present with a variety of clinical manifestations, like syncope, chest pain, anuria, pulse deficits, abdominal pain, back pain, or acute congestive heart failure. Nearly a third of the patients found to be suffering from AD, were initially otherwise diagnosed. Key in the management of acute aortic dissection is to maintain a high level of suspicion for this diagnosis.

  6. Multiple Changes of Gene Expression and Function Reveal Genomic and Phenotypic Complexity in SLE-like Disease.

    Directory of Open Access Journals (Sweden)

    Maria Wilbe

    2015-06-01

    Full Text Available The complexity of clinical manifestations commonly observed in autoimmune disorders poses a major challenge to genetic studies of such diseases. Systemic lupus erythematosus (SLE affects humans as well as other mammals, and is characterized by the presence of antinuclear antibodies (ANA in patients' sera and multiple disparate clinical features. Here we present evidence that particular sub-phenotypes of canine SLE-related disease, based on homogenous (ANA(H and speckled ANA (ANA(S staining pattern, and also steroid-responsive meningitis-arteritis (SRMA are associated with different but overlapping sets of genes. In addition to association to certain MHC alleles and haplotypes, we identified 11 genes (WFDC3, HOMER2, VRK1, PTPN3, WHAMM, BANK1, AP3B2, DAPP1, LAMTOR3, DDIT4L and PPP3CA located on five chromosomes that contain multiple risk haplotypes correlated with gene expression and disease sub-phenotypes in an intricate manner. Intriguingly, the association of BANK1 with both human and canine SLE appears to lead to similar changes in gene expression levels in both species. Our results suggest that molecular definition may help unravel the mechanisms of different clinical features common between and specific to various autoimmune disease phenotypes in dogs and humans.

  7. Role of FDG-PET and PET/CT in the diagnosis and management of vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Zerizer, Imene; Tan, Kathryn; Khan, Sameer; Barwick, Tara [Department of Nuclear Medicine, Imperial College Healthcare, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Marzola, Maria Cristina [Department of Nuclear Medicine, PET/CT Centre, Radiology and Medical Physics, ' Santa Maria della Misericordia' Hospital, Rovigo (Italy); Rubello, Domenico [Department of Nuclear Medicine, PET/CT Centre, Radiology and Medical Physics, ' Santa Maria della Misericordia' Hospital, Rovigo (Italy)], E-mail: domenico.rubello@libero.it; Al-Nahhas, Adil [Department of Nuclear Medicine, Imperial College Healthcare, Hammersmith Hospital, Du Cane Road, London (United Kingdom)

    2010-03-15

    Purpose: to investigate the role of FDG-PET and PET/CT in the evaluation of vasculitis. Materials and methods: a systematic revision of the papers published in PubMed/Medline until December 2009 was done. Results: FDG-PET and PET/CT have been proven to be valuable in the diagnosis of large-vessel vasculitis, especially giant cells arteritis with sensitivity values ranging 77% to 92%, and specificity values ranging 89% to 100%. In particular, FDG-PET/CT has demonstrated the potential to non-invasively diagnose the onset of the vasculitis earlier than traditional anatomical imaging techniques, thus enabling prompt treatment. False positive results mainly occur in the differential diagnosis between vasculitis and atherosclerotic vessels in elderly patients. Another area where FDG-PET/CT is gaining wider acceptance is in monitoring response to therapy; it can reliably detect the earliest changes of disease improvement post-therapy, and persistent activity is an indicator of non-responders to therapy. A few data have been reported about medium/small vessel vasculitis. Discussion: FDG-PET and PET/CT have proven utility: (a) in the initial diagnosis of patients suspected of having vasculitis particularly in those who present with non-specific symptoms; (b) in the identification of areas of increased FDG uptake in which a biopsy should be done for obtaining a diagnosis; (c) in evaluating the extent of the disease; (d) in assessing response to treatment.

  8. Turisterne, naturen og nationalparken

    DEFF Research Database (Denmark)

    Kvistgaard, Peter; Smed, Karina Madsen; Møn, Team

    benyttes mest. Møns turister vælger i høj grad Møn på grund af naturen og bruger den meget. Der er stort behov for at udvikle nye oplevelsesmuligheder i den mønske natur, for at gøre dem tilgængeli-ge og informere om dem. Samtidig indebærer den store turisme selvfølgelig - selv om mange turi-ster har et...... stort kendskab til Møns natur og er ”kvalitetsbrugere” - også en risiko for nedslidning af de følsomme naturområder og arter. Formålet med undersøgelsen er derfor: · At registrere turisternes nuværende brug af de mønske naturområder – hvilke aktiviteter, hvilke lokaliteter, hvor ofte etc., heru....... indkredse evt. naturbelastninger ved turismens brug af naturen; · At indkredse turisternes oplevelse af og meninger om den mønske natur, deres behov for / øn-sker til fremtidig brug af de mønske naturområder (nye naturattraktioner, nye oplevelsesmulig-heder, nye aktiviteter) heru. vurdere risiko...

  9. A well-balanced finite volume scheme for 1D hemodynamic simulations

    CERN Document Server

    Delestre, Olivier

    2011-01-01

    We are interested in simulating blood flow in arteries with variable elasticity with a one dimensional model. We present a well-balanced finite volume scheme based on the recent developments in shallow water equations context. We thus get a mass conservative scheme which also preserves equilibria of Q=0. This numerical method is tested on analytical tests. Nous nous int\\'eressons \\`a la simulation d'\\'ecoulements sanguins dans des art\\`eres dont les parois sont \\`a \\'elasticit\\'e variable. Ceci est mod\\'elis\\'e \\`a l'aide d'un mod\\`ele unidimensionnel. Nous pr\\'esentons un sch\\'ema "volume fini \\'equilibr\\'e" bas\\'e sur les d\\'eveloppements r\\'ecents effectu\\'es pour la r\\'esolution du syst\\`eme de Saint-Venant. Ainsi, nous obtenons un sch\\'ema qui pr\\'eserve le volume de fluide ainsi que les \\'equilibres au repos: Q=0. Le sch\\'ema introduit est test\\'e sur des solutions analytiques.

  10. Evaluation of a microsphere-based immunofluorescence assay for the determination of Immunoglobulin A concentrations in cerebrospinal fluid of dogs.

    Science.gov (United States)

    Roerig, A; Carlson, R; Tipold, A

    2013-02-01

    The simultaneous increase of immunoglobulin A (IgA) in serum and cerebrospinal fluid (CSF) is a characteristic finding in dogs suffering from canine steroid-responsive meningitis-arteritis (SRMA). The study aimed at developing and evaluating a microsphere-based immunofluorescence assay (MIA) for the measurement of IgA, trying to fulfill the need of a quicker method using only small volumes of CSF. Microsphere beads were coated with goat-anti-dog IgA antibodies and bound IgA was detected by a mouse-anti-dog IgA antibody in combination with a PE-labeled goat-anti-mouse IgG. CSF from 44 dogs were tested for IgA and compared with an in-house utilized ELISA. Using clinical relevant reference ranges, the new method showed a good agreement (84.17%) with the ELISA. A method comparison revealed a moderate agreement only. These findings indicate that the MIA will not replace the ELISA, but it opens the possibility for further research with microsphere-based assays.

  11. PSEUDOANEURYSM OF INTERNAL ILIAC ARTERY

    Directory of Open Access Journals (Sweden)

    Seema Khanna

    2014-04-01

    Full Text Available An unusual cause of vaginal beeding after total abdominal hysterectomy is being reported. Histopathology revealed adenomyosis uteri and bilateral ovarian cyst. On examination there was a single lump in the hypogastrium and left iliac fossa. Auscultation revealed a faint continuous hum. On digital rectal examination, a bulge was felt, while per vaginum examination revealed mucosal congestion and bulging of mucosa. Ultrasound revealed a mass posterior to the urinary bladder. Duplex study demonstrated the yin-yang sign suggestive of a pseudo-aneurysm .CT Angiography was confirmatory and demonstrated a pseudoaneurysm arising from the left internal iliac artery. Patient underwent surgery.Postoperative period was uneventful . The commonest cause of IIA aneurysm is atherosclerosis. Other causes are arteritis ,collagen vascular disease, infection, trauma. An important subgroup is young females, who have undergone difficult delivery, forceps delivery or caesarian section or abdominal hysterectomy IIA aneurysms are usually discovered incidentally on pelvic imaging for any other indication. Surgery is the mainstay of treatment but endovascular procedures are gaining ground . [Natl J Med Res 2014; 4(2.000: 181-182

  12. Postmortem examination of the kidney in allogeneic hematopoietic stem cell transplantation recipients: possible involvement of graft-versus-host disease.

    Science.gov (United States)

    Kusumi, Eiji; Kami, Masahiro; Hara, Shigeo; Hoshino, Junichi; Yamaguchi, Yutaka; Murashige, Naoko; Kishi, Yukiko; Shibagaki, Yugo; Shibata, Taro; Matsumura, Tomoko; Yuji, Koichiro; Masuoka, Kazuhiro; Wake, Atsushi; Miyakoshi, Shigesaburo; Taniguchi, Shuichi

    2008-03-01

    To investigate the association between graft-versus-host disease (GVHD) and renal injury after allogeneic stem cell transplantation (allo-SCT), we compared autopsy findings of 26 consecutive allo-SCT recipients with two control groups: patients with hematologic malignancies who received cytotoxic chemotherapy alone (Control 1, n = 21) and those with non-hematologic diseases (Control 2, n = 12). We evaluated the following renal pathology; renal tubulitis, allograft glomerulitis, intimal arteritis, allograft nephropathy, and peritubular capillaritis. These changes were found in 11 allo-SCT recipients and 10 patients in Control 1, but none in Control 2. While overall frequency of renal impairments was similar between allo-SCT recipients and Control 1 (3/26 vs. 1/21), allo-SCT recipients were more likely to have renal tubulitis and peritubular capillaritis compared to Control 1 (5/26 vs. 1/21), but less likely to present with glomerulitis (1/26 vs. 6/21). Grade III-IV acute or extensive-type chronic GVHD were seen in all of the three patients with renal tubulitis and four of the five patients with peritubular capillaritis. Allo-SCT recipients with severe GVHD tended to have tubulitis and peritubular capillaritis. These findings have implications of some renal impairment attributable to GVHD.

  13. Periodontal hastalıklar ile erken yaşlarda görülen ateroskleroza bağlı koroner hastalıklar arasındaki ilişkinin değerlendirilmesi

    OpenAIRE

    KARAGÖZ, Şükran

    2011-01-01

    Bu çalışmada erken yaşta (?50 yaş) koroner arter hastalığı (KAH) tanısı almış olan kişilerle aterosklerotik kardiyovasküler hastalığı olmayanlar arasında bazı periodontal parametreler ve bazı kan tahlili parametreleri bakımından kıyaslama yaparak, periodontal hastalık gibi enflamatuvar bir durumun erken yaşlarda ortaya çıkışı ile erken yaşlarda KAH gelişimi arasındaki olası ilişkinin değerlendirilmesi amaçlanmıştır.Çalışmamızda KAH tanısı almış, yaşları 31-50 arasında (or...

  14. Granulomatous interstitial nephritis secondary to chronic lymphocytic leukemia/small lymphocytic lymphoma.

    Science.gov (United States)

    Nasr, Samih H; Shanafelt, Tait D; Hanson, Curtis A; Fidler, Mary E; Cornell, Lynn D; Sethi, Sanjeev; Chaffee, Kari G; Morris, Joseph; Leung, Nelson

    2015-06-01

    Granulomatous interstitial nephritis (GIN) is an uncommon pathologic lesion encountered in 0.5% to 5.9% of renal biopsies. Drugs, sarcoidosis, and infections are responsible for most cases of GIN. Malignancy is not an established cause of GIN. Here, we report a series of 5 patients with GIN secondary to chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Patients were mostly elderly white males with an established history of CLL/SLL who presented with severe renal impairment (median peak serum creatinine, 7.3 mg/dL), leukocyturia, and mild proteinuria. One had nephromegaly. In 2 patients, the development and relapse of renal insufficiency closely paralleled the level of lymphocytosis. Kidney biopsy in all patients showed GIN concomitant with CLL/SLL leukemic interstitial infiltration. Granulomas were nonnecrotizing and epithelioid and were associated with giant cells. One biopsy showed granulomatous arteritis. One patient had a granulomatous reaction in lymph nodes and skin. Steroids with/without CLL/SLL-directed chemotherapy led to partial improvement of kidney function in all patients except 1 who had advanced cortical scarring on biopsy. In conclusion, we report an association between CLL/SLL and GIN. Patients typically present with severe renal failure due to both GIN and leukemic interstitial infiltration, which tends to respond to steroids with/without CLL/SLL-directed chemotherapy. The pathogenesis of GIN in this clinical setting is unknown but may represent a local hypersensitivity reaction to the CLL/SLL tumor cells.

  15. Aortopathy in pregnancy.

    Science.gov (United States)

    Smok, Dorothy A

    2014-08-01

    Up to half of all aortic dissections and ruptures in women younger than 40 years are associated with pregnancy. In pregnancy, women with aortic disease such as arteritis and aortitis are at significant risk of aneurysmal formation and dissection with potential for catastrophic outcomes. Pregnancy places predisposed women at an increased risk of dissection due to physiological and hormonal changes that occur, particularly those with connective tissue disorders, genetic syndromes, congenital heart disease, and other heritable and acquired conditions involving the aorta. Thus, preconception counseling and preparation are advised to determine which patients may cautiously pursue pregnancy, to optimize medical management prior to conception (antihypertensive medications and anticoagulants in the setting of mechanical valves), to identify women in whom aortic root repair should occur prior to pregnancy, and lastly, those in whom pregnancy is contraindicated. Additionally, discussion of the heritable nature of many aortic conditions and associated syndromes is indicated. Preconception and genetic counseling, management by a multidisciplinary team, along with close echocardiographic surveillance and medical management, are recommended if precursors of dissection are identified.

  16. History of primary vasculitis in Latin America.

    Science.gov (United States)

    Iglesias Gammara, Antonio; Coral, Paola; Quintana, Gerardo; Toro, Carlos E; Flores, Luis Felipe; Matteson, Eric L; Restrepo, José Félix

    2010-03-01

    A literature review utilizing Fepafem, Bireme, LiLacs, Scielo Colombia, Scielo Internacional, former MedLine, Pubmed, and BVS Colombia as well as manual searches in the libraries of major Latin American universities was performed to study vasculitis in Latin America. Since 1945, a total of 752 articles have been published by Latin American authors. However, only a minority are devoted to primary vasculitides, and even fewer have been published in indexed journals. Approximately 126 are in OLD, Medline, Pubmed, Bireme, and Scielo. Most publications are from Mexico, followed by Brazil and Colombia. Systematic studies of the epidemiology of primary idiopathic vasculitis are available for a few countries, i.e. Brazil, Mexico, Colombia, Chile, and Peru. Takayasu arteritis and ANCA-associated vasculitis are the best studied forms of vasculitis in Latin America. Interest and expertise in vasculitis is growing in Latin America, as reflected in the increased number of published articles from this region of the world in the last decade. Racial and environmental factors are possibly responsible for the differential expression of various types of primary vasculitis observed in Latin America. With time, the unique features, epidemiology, and better treatment strategies for idiopathic vasculitides in Latin America will emerge.

  17. [Central nervous system vasculitis and of the peripheral nerves in the elderly].

    Science.gov (United States)

    Boddaert, Jacques; Verny, Marc

    2002-11-01

    Vasculitis of the nervous system are rare in the elderly. When present, they may constitute an urgent diagnosis and a therapeutic emergency. Clinical expression is rich and without specificity. Atypical signs (unusual course of dementia, systemic signs) or atypical laboratory results (inflammatory syndrome) may suggest the diagnosis of vasculitis. However, as multiple comorbidity is the rule in elderly subjects, searching for intercurrent factors (e.g. atrial fibrilation due to infectious disease causing embolic stroke) may be more contributive than searching for proof of a rare disease (vasculitis) with invasive procedures in this population. Giant cell (temporal) arteritis is the only vasculitis specifically related with age; the vital prognosis of vision may be compromised. Corticosterid therapy must be instituted without delay. Periartritis nodosa begins in 30% of cases after 60 years of age. The clinical features are the same as in younger subjects. Other vasculidis are rare in the elderly. In absence of specific studies in this population, therapeutic protocols are the same as in younger subjects but may have to be adjusted.

  18. Update on the evaluation of transient vision loss.

    Science.gov (United States)

    Pula, John H; Kwan, Katherine; Yuen, Carlen A; Kattah, Jorge C

    2016-01-01

    Transient vision loss may indicate underlying vascular disease, including carotid occlusion and thromboembolism, or it may have a more benign etiology, such as migraine or vasospasm. This review focuses on the differential diagnosis and workup of patients presenting with transient vision loss, focusing on several key areas: the relationship to thromboembolic vascular disease, hypercoagulable testing, retinal migraine, and bilateral vision loss. The objective is to provide the ophthalmologist with information on how to best manage these patients. Thromboembolic etiologies for transient vision loss are sometimes managed with medications, but when carotid surgery is indicated, earlier intervention may prevent future stroke. This need for early treatment places the ophthalmologist in the important role of expediting the management process. Hospital admission is recommended in patients presenting with transient symptoms within 72 hours who meet certain high-risk criteria. When the cause is giant cell arteritis, ocular ischemic syndrome, or a cardioembolic source, early management of the underlying condition is equally important. For nonthromboembolic causes of transient vision loss such as retinal migraine or retinal vasospasm, the ophthalmologist can provide reassurance as well as potentially give medications to decrease the frequency of vision loss episodes.

  19. [Interventional angioscopy].

    Science.gov (United States)

    Foucart, H; Baudrillard, J C; Carlier, C; Cécile, J P

    1993-01-01

    Since 1987, routine angioscopic examination has been performed in 191 patients undergoing angioplasty, with interventions (196) after a 2 year surveillance period (55). Angioscopy allowed follow up "de visu" of the performance of angioplasty, details of its mechanism to be precise and under dilatation to be carried out. For femoral artery occlusions it allowed treatment "à la carte": conventional dilatation of vegetating atheroma, specific treatment of established thrombi (5) and abstention from therapy of atheroma covered by endothelium (3). It also enabled fresh thrombi complicating a stenosis or at the origin of a thrombus to be detected. The extraction technique employed (15) is described. It facilitated catheterization by directing the probe, enabled avoidance of bypassing of stenosis and flaps and of dissection or false introduction into collaterals (10). Directed biopsy could be carried out in inflammatory arteritis (7). Vegetating atheromatous lesions could be opened and extracted, facilitating subsequent dilatation and allowing an approach to removal of iliac artery obstructions without major risks of complications (13). Finally, after an ineffective dilatation or the presence of a dissection, it assisted making the decision to introduce a stent (9), the tolerance and outcome of these stents are described. Or the 196 patients considered suitable for angioplasty, our therapeutic conduct was modified by angioscopy in 58 cases (29%). Not simply a new diagnostic tool, it plays a role in interventional vascular techniques.

  20. [Cerebrovascular disease and neurocysticercosis].

    Science.gov (United States)

    Rocha, M S; Brucki, S M; Ferraz, A C; Piccolo, A C

    2001-09-01

    We report three cases of stroke secondary to neurocysticercosis. The first one is a 36 years old man with bilateral middle cerebral artery occlusions who had presented acute right hemiparesia and aphasia. MRI demonstrated several enhancing subarachnoid cysts surrounding the occluded vessels, a right parietal racemose cyst and a left temporal large infarction area. Angiographic study showed total occlusion of left middle cerebral artery and a subtotal occlusion of right middle cerebral artery. The second one is a 42 years old man with vasculitis of small cortical vessels who presented with headache, seizures and focal neurological deficit. CT scan demonstrated several calcifications and a left temporal infarction area. Cerebral angiographic study was normal. The third case was a woman, 53 years old, with a past history of six stroke events and an actual behavior disturbance and seizures. MRI demonstrated several cortical and subcortical infarction areas and cisternal cysts. Angiographic study showed diffuse arteritis of basilar and carotid arterial system. In all three cases CSF study showed linfomonocitic pleocytosis and positive ELISA for cysticercosis.

  1. CT and MR findings in HIV-negative neurosyphilis

    Energy Technology Data Exchange (ETDEWEB)

    Peng Fuhua [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: pfh93@21cn.com; Hu Xueqiang [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: huxueqiangqm@yahoo.com.cn; Zhong Xiufeng [State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center of Sun Yat-Sen University, 54 Xianlie Road, Guangzhou, 510060 Guangdong Province (China)], E-mail: xiufengzhong@yahoo.com.cn; Wei Qiu [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: qw9406@tom.com; Jiang Ying [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: jiangying722@163.com; Bao Jian [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: baoj92@tom.com; Wu Aimin [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: wuaim@126.com; Pei Zhong [Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University, 89 Zhongshaner Road, Guangzhou, 510080 Guangdong Province (China)], E-mail: peizhong@yahoo.com

    2008-04-15

    Background and purpose: The purpose of this study was to describe and evaluate neuroimaging findings of patients with neurosyphilis. Methods: The neuroimaging studies of 14 patients with documented neurosyphilis were reviewed. Diagnosis was established in 14 patients with cerebrospinal fluid for a Treponema Pallidum Particle Agglutination (TPPA) test. All patients had reactive TPPA and Unheated Serum Regain test (USR) in their sera. Imaging studies included plain, contrast-enhanced CT of the brain, plain and gadolinium-enhanced MR, and MR angiography. Results: In the 14 HIV-negative patients with neurosyphilis, CT and MR showed the presence of cerebral infarction in six cases, arteritis in four cases, nonspecific white matter lesion in three cases, acute syphilitic meningitis in one case and normal neuroimaging finding in one case. In addition, 4 in 14 patients had general paresis, and MRI showed high signal intensity on T2 -weighted images involving frontotemporal lobes, hippocampus and periventricular area. Treatment with penicillin significantly diminished the size of these high signal intensity on T2-weighted images with general paresis. Conclusion: These results suggest that MR and CT images have some characteristic manifestations in patients of neurosyphilis. Because early diagnosis and treatment of neurosyphilis are crucial to avoid persistent brain damage, the neuroimaging findings are valuable adjunct to clinical diagnosis and to provide useful information to follow-up after therapy.

  2. The solitary sellar plasmacytoma: a diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Anne Soejbjerg

    2016-06-01

    Full Text Available Solitary sellar plasmacytomas are exceedingly rare and difficult to distinguish from other pituitary tumors. We report a case of a 62-year-old woman presenting with blurred vision of the right eye and tenderness of the right temporal region, which was interpreted as temporal arteritis. MRI revealed a pituitary mass lesion (20mm×14mm×17mm without compression of the optic chiasm and her pituitary function was normal. Pituitary surgery was undertaken due to growth of the lesion, and histopathological examination showed a highly cellular neoplasm composed of mature monoclonal plasma cells. Subsequent examinations revealed no evidence of extrasellar myeloma. The patient received pituitary irradiation and has remained well and free of symptoms apart from iatrogenic central diabetes insipidus. Until now, only eight cases of solitary sellar plasmacytoma have been reported. Most frequent symptoms stem from compression of the cranial nerves in the cavernous sinus (III, IV, V, whereas the anterior pituitary function is mostly intact.

  3. Determinants of Vessel Targeting in Vasculitis

    Directory of Open Access Journals (Sweden)

    Gary S. Hoffman

    2004-01-01

    Full Text Available Studies of autoimmune diseases have not yet elucidated why certain organs or vessels become the objects of injury while others are spared. This paper will explore the hypothesis that important differences exist in regions of the aorta that determine vulnerability to diseases, such as atherosclerosis, aortitis, giant cell arteritis and Takayasu's disease. The reader is invited to reassess; (1 whether the aorta is indeed a single homogeneous structure, and (2 whether the initial stage of aortitis (and indeed other diseases considered “autoimmune” may be primarily due to acquired alterations of substrate, that influence unique immune profiles, which by themselves may not be pathogenic. Disease susceptibility and patterns are influenced by many factors that are inborn and acquired. Examples include genetic background, gender, ethnicity, aging, prior and concomitant illnesses, habits, diet, toxin and environmental exposures. Studies of vascular diseases must assess how such variables may affect regional differences in endothelial cells, subendothelial matrix, vascular smooth muscle and the response of each to a variety of stimuli.

  4. Pediatric renovascular hypertension in Thailand: CT angiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Visrutaratna, Pannee; Srisuwan, Tanop; Sirivanichai, Chusak [Chiang Mai University, Department of Radiology, Faculty of Medicine, Chiang Mai (Thailand)

    2009-12-15

    Renovascular disease is an uncommon but important cause of hypertension in children. When unrecognized and untreated, renovascular hypertension in children can have serious complications. To review the causes of renovascular hypertension and computed tomography angiographic (CTA) findings in children and adolescents. Twenty-eight CTAs from January 2004 to March 2008 of 23 children and adolescents with hypertension were reviewed for the causes and CTA findings. Nine of the 23 children (39%) had abnormal renal arteries with or without abnormal abdominal aortas. Four of these children had Takayasu arteritis, one had moyamoya disease, and one had median arcuate ligament syndrome. One with chronic pyelonephritis had severe stenosis of the proximal right renal artery. The other two children had renal artery stenosis with a nonspecific cause. One child with a normal abdominal aorta and renal arteries had a right suprarenal mass. On pathological examination a ganglioneuroma was found. CTA can help in diagnosis of renovascular hypertension in children and adolescents. Although CTA is not a screening modality, it is appropriate in some situations. (orig.)

  5. A SUCCESSFULLY TREATED CASE OF MOYA MOYA DISEASE

    Directory of Open Access Journals (Sweden)

    Yashodhara

    2015-01-01

    Full Text Available Moyamoya disease is a rare cerebrovascular disease characterized by progressive occlusive cerebral arteritis affecting the distal internal carotid arteries near the circle of Willis. A collateral circulation develops around the blocked vessels which appear as a "pu ff of smoke". Incidence is variable depending on the geographical location. The clinical features of Moyamoya disease are recurrent transient ischemic attacks (TIAs, strokes, sensorimotor paralysis, convulsions and/or migraine - like headaches. Magnetic resonance imaging (MRI and MR Angiogram (MRA should be performed for the diagnosis and follow - up of Moyamoya disease. Neurosurgical proceures like Encephalo myo synangiosis (EMS, multiple burr holes and some direct procedures are useful to reestablish new circulation after a few weeks. The long term outlook for patients with treated Moyamoya seems to be good. Once major stroke or bleeding take place, even with treatment, the patient may be left with permanent loss of function . So it is very important to treat this condition promptly. Herewith, we are reporting a 15 month old child with history of right focal adversive seizures, 3 - 4 events a month followed by post ictal drowsiness. Imaging studies revealed a vascular insult with infarct in the left fronto parietal lobes as well as multiple infarcts in other regions of the brain. MR Angio Brain revealed Moya moya disease. Child was successfully managed by prompt referral to Neurosurgical C entre where he underwent EMS and he is under their follow up.

  6. 贵州省部分马病血清学调查%Serological Investigation of some Equine Diseases in Guzhou

    Institute of Scientific and Technical Information of China (English)

    冉隆仲; 洪尼宁

    2014-01-01

    [目的]调查贵州省马群马流感病毒、马疱疹病毒1/4型或马动脉炎病毒感染情况。[方法]用酶联免疫吸附试验(ELISA)对采自贵州省9个市(州)及第九届民运会参赛马匹的363份血清进行了A型流感病毒、马疱疹病毒1/4型、马动脉炎病毒和非洲马瘟病毒抗体检测。[结果]结果显示这四种病原的血清抗体群阳性率分别为79.49%(31/39)、7.69%(3/39)、43.59%(17/39)和0%(0/39),贵州本地役用马和赛马差异不显著(P>0.05);血清抗体个体阳性率分别57.85%(210/363)、1.38%(5/363)、11.29%(41/363)和0%(0/363),其中贵州本地役用马阳性率分别为38.16%(87/228)、4.39%(1/228)、8.33%(19/228)和0%(0/228),赛马阳性率分别为91.11%(123/135)、2.96%(4/135)、16.30%(22/135)和0%(0/135)。相比之下,A型流感病毒及马动脉炎病毒抗体阳性率存在差异(P<0.01或0.01<P<0.05),马疱疹病毒1/4型病毒抗体阳性率差异不显著(P>0.05)。[结论]调查表明贵州省部分马群存在不同程度的马流感病毒、马疱疹病毒1/4型或马动脉炎病毒感染。%Serological Investigation of Infections with Equine Infl uenza Virus,Equine Herpesvirus Type 1/4,Equine Arteritis Virus and African Horse Sickness Virus in Guizhou Province. 363 equine serum samples taken from 31 working and 8 racing horse herds in Guizhou Province were examined for antibodies against equine infl uenza virus(EIV), equine herpesvirus type 1/4(EHV-1/4),equine arteritis virus(EAV) and African horse sickness virus(AHSV) by enzyme-linked immunosorbert assay(ELISA).The results showed that the positive rates of the four pathogens in the sampled horses were 57.85%(210/363),1.38%(5/363),11.29%(41/363)and 0%(0/363)and the positive rates in herds were 79.49%(31/39),7.69 %(3/39),43.59%(17/39)and 0%(0/39)respectively.The local working horses were different from racing horses in the positive

  7. 慢性肝病患者CT血流灌注与肝纤维化血清指标相关性探讨%Evaluation of CT perfusion to liver fibrosis and cirrhosis and the correlation with serum indicator

    Institute of Scientific and Technical Information of China (English)

    张晓莹; 姜诗路; 许晓岚; 徐凤娣; 郑海宁

    2011-01-01

    目的:探讨肝脏纤维化及早期肝硬化患者CT血流灌注参数与肝纤维化血清指标的相关性.方法:使用GE64层螺旋CT灌注技术计算40例经病理证实不同分期肝纤维化患者及10例正常对照人群肝血流量(blood flow,BF)、肝血容积(blood volume,BV)、肝动脉血流(hepatic arteral fraction,HAF)、平均通过时间(mean transit time,MTT)、表面通透性(permeability surface,PS)等血流动力学参数,同时检测肝纤维化血清学指标:血清Ⅲ型胶原(typeⅢ,procollagen peptide)、透明质酸(hyaluronic,HA)、层粘蛋白(laminin,LN)、Ⅳ型胶原(collagen,CIV),并与病理结果对照.结果:自肝炎到早期肝硬化阶段,S0,S2,S4期的HAF呈升高趋势,BV和BF都升高,MTT缩短,PS降低,在不同时期BV、BF、HAF和MTT的差异有统计学意义.血清学指标HA、LN、胶原Ⅳ、胶原Ⅲ及CT灌注指标BV、BF、MTT、PS、HAF之间,除HA与MTT、PS与LN,MTT与Ⅳ型胶原呈负相关,其余各指标间均呈正相关.结论:肝脏血流动力学微循环变化反映了肝纤维化及早期肝硬化的病理过程.%Objective: To evaluate the correlation of hepatic perfusion with multi-slice spiral CT and several serum markers in the diagnosis of liver fibrosis and cirrhosis. Methods: CT perfusion parameters of blood flow (BF). blood volume ( BV) . hepatic arteral fraction ( HAF) . mean transit time ( MTT) , permeability surface ( PS) along with the serum fibrosis markers: procollagen peptide (typeⅢ), hyaluronic( HA) , laminin (LN) , Ⅳ collagen were achieved and compared in different groups proved by pathology. Results : CT pcrfusion parameters had significant differences in control and different fibrosis groups. BV. BF and HAF were increasing while MTT shorten and PS decrease with fibrosic degree. HA was inverse correlation with MTT and PS with LN, MTT with collagen Ⅳ. other perfusion paramerers were direct correlation with serum indicators. Conclusion: CT perfusion parameters can

  8. Prehospital thrombolysis in acute myocardia infarction:a meta-analysis%急性心肌梗死院前溶栓治疗的Meta分析

    Institute of Scientific and Technical Information of China (English)

    姚蓝; 谢小铭

    2010-01-01

    目的 本研究应用Meta分析方法对多个急性心肌梗死院前溶栓治疗的临床研究进行综合分析和评价,以期找到科学的证据指导临床治疗.方法 检索1989年1月至2009年4月在国内外公开发布的关于急性心肌梗死院前溶栓治疗的文献,以冠状动脉再通率、并发症发生率、短期(<30d)死亡率作为效应指标,应用RevMan4.2.8软件进行Meta分析.结果 Meta分析结果显示,院前溶栓组冠脉再通率优于院内溶栓组[OR 2.67,P<0.01],短期(<30 d)死亡率低于院内溶栓组[OR 0.71,P<0.01],两者在并发症发生率上差异无统计学意义[OR 0.84,P=0.94].与PCI组相比,院前溶栓组并发症发生率高于PCI组[OR 2.91,P=0.005],短期(<30 d)死亡率两者差异无统计学意义[OR 1.11,P=0.56],但其存在发表偏倚,敏感性相对差,院前溶栓疗效与预后均优于院内溶栓,而并发症发生率无明显增加,是一种安全有效的治疗方法,具有显著的临床意义.结论 与PCI相比,院前溶栓疗效及预后与PCI相当,但并发症发生率较高,但因存在发表偏倚,敏感性相对差,仍需要更多高质量的研究来进一步证实.%Objective A meta-analysis of clinical trials of prehospital thrombolysis versus in-hospital thrombolysis or PCI for acute myocardia infarction (AMI). Method We collected the literature on prehospital thrombolysis for AMI published at home and abroad from January 1989 to April 2009. Recanalization rate of infarct-related arter, complication incidence and mortality ( < 30 d) were regarded as result indicators. Software RevMan 4.2.8 was used to process meta-analysis. Results There were only 27 literatures selected. Prehospital thrombolysis was associated with higher recanalization rate of infarct-related arter[OR 2.67,95%CI(1.86 ~ 3.85);P <0.01] and lower mortality ( < 30 d ) [OR 0.71,95%CI(0.64 ~ 0.78); P < 0.01] than in-hospital thrombolysis. There was no significant difference in

  9. Serosurveillance of infectious agents in equines of the Central Valley of Costa Rica.

    Science.gov (United States)

    Jiménez, D; Romero-Zuñiga, J J; Dolz, G

    2014-01-01

    Blood samples from 181 equines from the Central Valley of Costa Rica were collected in the year 2012 to determine the presence of antibodies against selected infectious agents in horses and to determine the risk factors associated with these agents. The presence of antibodies against Equine Infectious Anemia Virus (EIAV), Equine Herpes Virus 1 and 4 (EHV-1 and EHV-4), West Nile Virus (WNV), Influenza A Virus (IAV), Equine Viral Arteritis Virus (EVAV), Babesia caballi, Theileria equi, Neospora caninum and Chlamydia abortus was determined using commercial assays, and risk factors associated with seropositivity to the different infectious agents was established. The most seroprevalent agent detected was EHV-4 (96.7%), followed by WNV (44.2%), and IAV (41.8%). Horses >3 years, used for work or sports, and with access to pastures, had significantly increased probability to be seropositive to WNV, whereas horses used for breeding and recreational purposes, being stabled, and without access to pastures, had significantly greater probability to be seropositive to IAV. Seroprevalence to B. caballi (19.9%) was lower than to T. equi (38.1%). For B. caballi, access to pastures was determined as a risk factor, whereas being older than 3 years was established as a risk factor for T. equi. Low seroprevalences were determined for EHV-1 (5.0%), EVAV (5.0%), C. abortus (4.8%), and N. caninum (4.4%). Mares having history of abortion were more likely to be seropositive to EHV-1, whereas horses >3 years, used for work and sports, and mares having multiple parturitions, were more likely to be seropositive to N. caninum. None of the horses were seropositive to EIAV. Earlier, only diseases caused by EIAV, WNV and piroplasmosis were reported in Costa Rica. The present study however, determined the presence of carriers for EHV-1, EHV-4, and EIAV.

  10. Estimating the incidence of connective tissue diseases and vasculitides in a defined population in Northern Savo area in 2010.

    Science.gov (United States)

    Elfving, P; Marjoniemi, O; Niinisalo, H; Kononoff, A; Arstila, L; Savolainen, E; Rutanen, J; Kaipiainen-Seppänen, O

    2016-07-01

    Objective of the study was to evaluate the annual incidence and distribution of autoimmune connective tissue diseases and vasculitides during 2010. All units practicing rheumatology in the Northern Savo area, Finland, participated in the study by collecting data on newly diagnosed adult patients with autoimmune connective tissue disease or vasculitis over 1-year period. Seventy-two cases with autoimmune connective tissue disease were identified. The annual incidence rates were as follows: systemic lupus erythematosus 3.4/100,000 (95 % CI 1.4-7.0), idiopathic inflammatory myopathies 1.9 (0.5-5.0), systemic sclerosis 4.4 (2.0-8.3), mixed connective tissue disease 1.0 (0.1-3.5), Sjögren's syndrome 10.7 (6.7-16.1) and undifferentiated connective tissue disease 13.6 (9.0-19.6). The annual incidence rates among vasculitis category were as follows: antineutrophil cytoplasmic antibody-associated vasculitis 1.5/100,000 (95 % CI 0.3-4.3), central nervous system vasculitis 0.5 (0-2.7) and Henoch-Schönlein purpura 1.5 (0.3-4.3). The annual incidence of giant cell arteritis in the age group of 50 years or older was 7.5/100,000 (95 % CI 3.2-14.8). The longest delay from symptom onset to diagnosis occurred in systemic sclerosis. The incidences of autoimmune connective tissue diseases and vasculitides were comparable with those in published literature. The present study showed female predominance in all connective tissue diseases, excluding idiopathic inflammatory muscle diseases and mean age at onset of disease around 50 years of age. Despite improved diagnostic tools, diagnostic delay is long especially among patients with systemic sclerosis.

  11. Morphology of the walls of the cavernous sinus of Cebus apella (tufted capuchin monkey Morfologia das paredes do seio cavernoso em Cebus apella (macaco-prego

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    ROBSON JOSÉ DE SOUSA DOMINGUES

    1999-09-01

    Full Text Available The morphology of the dura mater and its relationship with the structures of the cavernous sinus were analyzed in five tufted capuchin monkeys (Cebus apella using histological sections, showing that the walls of the cavernous sinus of this species are similar to those of other primates, including man. Except for the medial wall of the cavernous sinus, the remaining walls consist of two distinct dura mater layers. The deep layer of the lateral wall of the cavernous sinus is contiguous to the sheath of the oculomotor, trochlear and ophthalmic nerves. Arterioles, venules, venous spaces, neuronal bodies and nervous fiber bundles are found on this lateral wall.A morfologia da dura-máter e sua relação com as estruturas do seio cavernoso, analisadas em cinco macacos-prego (Cebus apella através de cortes histológicos, mostrou que as paredes do seio cavernoso nessa espécie são semelhantes a de outros primatas, inclusive o homem. Com exceção da parede medial do seio cavernoso as demais paredes são formadas de duas camadas distintas de dura-máter. A camada profunda da parede lateral do seio cavernoso está em continuidade com a bainha dos nervos oculomotor, troclear e oftálmico. Nesta parede lateral são encontradas arteríolas, vênulas, espaços venosos, corpos de neurônios e feixes de fibras nervosas.

  12. 甲状腺疾病与脑血管病%Thyroid Diseases and Cerebrovascular Diseases

    Institute of Scientific and Technical Information of China (English)

    孙亚鸣; 刘春风

    2008-01-01

    There are significant correlations between cerebral embolism and thyrotoxic atrial fibrillation in patients with hyperthyroidism. The incidence of thyrotoxic atrial fibrillation increases significantly in patients with subclinical hyperthyroidism with serum thyroid-stimula-ting hormone levels < 0. 1 mU/L. Hyperthyroidism may result in cerebral venous thrombosis,moyamoya disease and giant cell arteritis; while hypothyroidism is closely associated with the risk factors of arteriosclerosis, especially hypertension, hyperlipidemia, and hyperhomocysteine-mia. However, this association remains uncertain in subclinical hyperthyroidism.%在甲状腺功能亢进患者中,脑栓塞与甲状腺毒性心房颤动存在显著的相关性;在血清促甲状腺激素水平<0.1 mU/L的亚临床甲状腺功能亢进患者中,毒性心房颤动的发生率亦显著增高.甲状腺功能亢进可能导致脑静脉血栓形成、烟雾病和巨细胞动脉炎;而甲状腺功能减退则与动脉粥样硬化的危险因素,尤其是高血压、高脂血症和高同型半胱氨酸血症有密切关系.但在亚临床甲状腺功能亢进患者中,这种联系尚不明确.

  13. Clinical picture of polymialgia rheumatica in Habarovsk region’s residents

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    T. Y. Kocherova,

    2007-01-01

    Full Text Available Objective. To study clinical picture and significance of diagnostic criteria of polymyalgia rheumatica (PMR in pts of Habarovsk region.Material and methods. 76 pts (63 female, 13 male fulfilled modified PMR diagnostic criteria (h. Bird 1997, 2001 were included. Mean age of the patients at the diagnosis was 66,2±1,0 years. Frequency and intensity of myalgia and joint syndrome, laboratory changes, and efficacy of corticosteroid (CS low doses were evaluated.Results. Annually 4-9 new cases of PRM were revealed in Habarovsk region. Mean duration of the disease before the diagnosis was 7,5±1,0 months. 69 pts (86,3% had typical disease onset with cervical, shoulder, pelvic muscles involvement. In 11 pts (13,7% joint syndrome was the presenting feature and in 3 pts the disease onset resembled McCarty disease. Knee and wrist joints were involved most frequently (43,8% and 25,0% respectively. Giant cell arteritis (Horton disease developed in 5,3% of cases. ESR exceeded 30 mm/hour in 68 pts (89,5%. In 8 pts (10,5% ESR remained in normal limits. CS test in 3 pts (3,9% provided positive result after the first several hours, in 6 pts (7,9% – during the first day, in 59 pts (77,7% – after 3 days and in 8 pts (10,5% – to the end of the week.Conclusion. PMR course in the Far East residents did not differ from classical picture. CS low doses administration is an important test for PMR diagnosis.

  14. Clinical characteristics and prognostic factors for relapse in patients with polymyalgia rheumatica (PMR).

    Science.gov (United States)

    Lee, Jung Hwa; Choi, Sang Tae; Kim, Jin Su; Yoon, Bo Young; Kwok, Seung-Ki; Kim, Hyun-Sook; Kim, Yun Sung; Song, Jung-Soo; Lee, Sang-Heon; Kim, Hae-Rim

    2013-06-01

    Polymyalgia rheumatica (PMR) is a common inflammatory disease of the elderly in western countries, but the prevalence is apparently different between races and countries. Until now, an epidemiologic study of PMR is limited in Korea. We retrospectively evaluated the clinical data of 78 patients with PMR who were treated in 5 tertiary hospitals, and analyzed initial laboratory data, symptoms, therapeutic responses, and prognostic factors for relapse 1 year after treatments. Sixty percent of patients had pain in both shoulder and hip girdles with 10.6 weeks of duration, 75.9 ± 32.7 mm/h of erythrocyte sedimentation rate (ESR), and 6.2 ± 6.4 mg/dl of C-reactive protein. The rate of relapse and remission at 1 year was 38.4 and 2.5 %, respectively. The rate of overall relapse was 46.1 %, and the relapse occurred mostly in a year, especially between 6 and 12 months after diagnosis. There were more female in relapse group (88.9 %, p = 0.037), and cumulative steroid dose of 1 year was significantly higher in relapse group (5.5 ± 2.7 vs. 4.4 ± 2.5 g, p = 0.018). Independent risk factors for relapse were initial CRP ≥ 2.5 mg/dl (OR 6.296, p = 0.047) and the use of hydroxychloroquine (OR 6.798, p = 0.035). Initial dosage or tapering speed of steroid did not influence on prognosis. In Korean patients with PMR, baseline clinical characteristics and relapse rate were similar to previous studies, but our patients accompanied no giant cell arteritis and showed lower remission rate as well as delayed therapeutic response and later occurrence of relapse. More aggressive management would be needed according to the clinical status of patients.

  15. Central nervous system involvement in pediatric rheumatic diseases: current concepts in treatment.

    Science.gov (United States)

    Duzova, Ali; Bakkaloglu, Aysin

    2008-01-01

    Central nervous system (CNS) manifestations are not rare in pediatric rheumatic diseases. They may be a relatively common feature of the disease, as in systemic lupus erythematosus (SLE) and Behçet's disease. Direct CNS involvement of a systemic rheumatic disease, primary CNS vasculitis, indirect involvement secondary to hypertension, hypoxia and metabolic changes, and drug associated adverse events may all result in CNS involvement. We have reviewed the CNS manifestations of SLE, Behçet's disease, Henoch-Schönlein purpura, polyarteritis nodosa, juvenile idiopathic arthritis, juvenile ankylosing spondylitis, familial Mediterranean fever, scleroderma, sarcoidosis, Wegener's granulomatosis, Takayasu's arteritis, CINCA syndrome, Kawasaki disease, and primary CNS vasculitis; and adverse CNS effects of anti-rheumatic drugs in pediatric patients. The manifestations are diverse; ranging from headache, seizures, chorea, changes in personality, depression, memory and concentration problems, cognitive impairment, cerebrovascular accidents to coma, and death. The value of cerebrospinal fluid (CSF) examination (pleocytosis, high level of protein), auto-antibodies in serum and CSF, electroencephalography, neuroimaging with computerized tomography, magnetic resonance imaging, SPECT, PET, and angiography depends on the disease. Brain biopsy is gold standard for the diagnosis of CNS vasculitis, however it may be inconclusive in 25% of cases. A thorough knowledge of the rheumatic diseases and therapy-related adverse events is mandatory for the management of a patient with rheumatic disease and CNS involvement. Severe CNS involvement is associated with poor prognosis, and high mortality rate. High dose steroid and cyclophosphamide (oral or intravenous) are first choice drugs in the treatment; plasmapheresis, IVIG, thalidomide, and intratechal treatment may be valuable in treatment-resistant, and serious cases.

  16. Breast Gangrene

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    Husasin Irfan

    2011-08-01

    Full Text Available Abstract Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

  17. Management and Prevention of Herpes Zoster Ocular Disease.

    Science.gov (United States)

    Cohen, Elisabeth J

    2015-10-01

    Herpes zoster (HZ) is caused by reactivation of latent varicella zoster virus (VZV) in people who have had chicken pox, usually resulting in a painful, unilateral, dermatomal, vesicular rash. Herpes zoster ophthalmicus occurs when the first division of cranial nerve V is involved. HZ is common, with approximately 1 million new cases per year in the United States, and occurs in 1 in 3 persons. Although the rate of HZ increases with age, over half of all cases occur under the age of 60 years. Complications of herpes zoster ophthalmicus include eye disease, postherpetic neuralgia (PHN), and strokes. VZV has also been found in temporal arteritis biopsies. There is growing evidence that HZ is followed by chronic active VZV infection contributing to these complications. In view of this, and the efficacy of suppressive antiviral treatment in reducing recurrent herpes simplex keratitis, a randomized controlled trial of suppressive valacyclovir to reduce new or worsening anterior segment disease and/or PHN is needed. The zoster vaccine (ZV) is safe and effective in reducing the burden of illness, severity of PHN, and incidence of HZ. It is Centers for Disease Control and Prevention recommended for persons aged 60 years and above without impaired cellular immunity, and Food and Drug Administration approved for those aged 50 and older. It is most effective in preventing HZ in recipients in their 50s. Because of underusage of the ZV, it has not impacted the epidemiology of the disease. Barriers to its use include cost, variable reimbursement, frozen storage, and lack of a strong recommendation by doctors.

  18. Priority-setting tools for rheumatology disease referrals: a review of the literature.

    Science.gov (United States)

    De Coster, Carolyn; Fitzgerald, Avril; Cepoiu, Monica

    2008-11-01

    As part of a larger body of work to develop a rheumatology priority referral score, a literature review was conducted. The objective of the literature review was to identify preexisting priority-setting, triage, and referral tools/scales developed to guide referrals from primary care to specialist care/consultation usually provided by a rheumatologist. Using a combination of database, citation, Internet, and hand-searching, 20 papers were identified that related to referral prioritization in three areas: rheumatoid arthritis (RA; 5), musculoskeletal (MSK) diseases other than RA (3), and MSK diseases in general (12). No single set of priority-setting criteria was identified for rheumatologic disorders across the spectrum of patients who may be referred from primary care providers (PCPs) to rheumatologists. There appears to be more congruence on conditions at either end of the urgency spectrum with conditions such as suspected cranial arteritis or systemic vasculitis deemed to be emergency referrals and fibromyalgia and other soft-tissue syndromes deemed to be more routine referrals. Between these two extremes, there is a divergence of opinion about urgency and few papers on the issue. The exception to this is referral for early RA for which several criteria have been established. Despite the inherent complexities in developing a tool to prioritize patients referred by PCPs to rheumatologists, there are compelling reasons to proceed. With the aging of the population, the number of patients being referred to rheumatologists is expected to increase. With pharmaceutical advances, there are demonstrable benefits in early referral for some conditions. These trends have led to increased pressure on scarce rheumatological human resources. A tool to prioritize referrals is a critical component of improving access and the referral process.

  19. Histopathologic Overlap between Fibrosing Mediastinitis and IgG4-Related Disease

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    Tobias Peikert

    2012-01-01

    Full Text Available Fibrosing mediastinitis (FM and IgG4-related disease (IgG4-RD are two fibroinflammatory disorders with potentially overlapping clinical and radiological features. In this paper, we looked for histopathologic features of IgG4-RD and enumerated infiltrating IgG4-positive plasma cells within mediastinal tissue biopsies from FM patients. We identified 15 consecutive FM surgical mediastinal tissue biopsies between 1985 and 2006. All patients satisfied the clinical and radiological diagnostic criteria for FM. All patients had either serological or radiological evidence of prior histoplasmosis or granulomatous disease, respectively. Formalin-fixed paraffin-embedded tissue sections of all patients were stained for H&E, IgG, and IgG4. Three samples met the predefined diagnostic criteria for IgG4-RD. In addition, characteristic histopathologic changes of IgG4-RD in the absence of diagnostic numbers of tissue infiltrating IgG4-positive plasma cells were seen in a number of additional cases (storiform cell-rich fibrosis in 11 cases, lymphoplasmacytic infiltrate in 7 cases, and obliterative phlebitis/arteritis in 2 cases. We conclude that up to one-third of histoplasmosis or granulomatous-disease-associated FM cases demonstrate histopathological features of IgG4-RD spectrum. Whether these changes occur as the host immune response against Histoplasma or represent a manifestation of IgG4-RD remains to be determined. Studies to prospectively identify these cases and evaluate their therapeutic responses to glucocorticoids and/or other immunosuppressive agents such as rituximab are warranted.

  20. Deubiquitinase function of arterivirus papain-like protease 2 suppresses the innate immune response in infected host cells.

    Science.gov (United States)

    van Kasteren, Puck B; Bailey-Elkin, Ben A; James, Terrence W; Ninaber, Dennis K; Beugeling, Corrine; Khajehpour, Mazdak; Snijder, Eric J; Mark, Brian L; Kikkert, Marjolein

    2013-02-26

    Protein ubiquitination regulates important innate immune responses. The discovery of viruses encoding deubiquitinating enzymes (DUBs) suggests they remove ubiquitin to evade ubiquitin-dependent antiviral responses; however, this has never been conclusively demonstrated in virus-infected cells. Arteriviruses are economically important positive-stranded RNA viruses that encode an ovarian tumor (OTU) domain DUB known as papain-like protease 2 (PLP2). This enzyme is essential for arterivirus replication by cleaving a site within the viral replicase polyproteins and also removes ubiquitin from cellular proteins. To dissect this dual specificity, which relies on a single catalytic site, we determined the crystal structure of equine arteritis virus PLP2 in complex with ubiquitin (1.45 Å). PLP2 binds ubiquitin using a zinc finger that is uniquely integrated into an exceptionally compact OTU-domain fold that represents a new subclass of zinc-dependent OTU DUBs. Notably, the ubiquitin-binding surface is distant from the catalytic site, which allowed us to mutate this surface to significantly reduce DUB activity without affecting polyprotein cleavage. Viruses harboring such mutations exhibited WT replication kinetics, confirming that PLP2-mediated polyprotein cleavage was intact, but the loss of DUB activity strikingly enhanced innate immune signaling. Compared with WT virus infection, IFN-β mRNA levels in equine cells infected with PLP2 mutants were increased by nearly an order of magnitude. Our findings not only establish PLP2 DUB activity as a critical factor in arteriviral innate immune evasion, but the selective inactivation of DUB activity also opens unique possibilities for developing improved live attenuated vaccines against arteriviruses and other viruses encoding similar dual-specificity proteases.

  1. NUMERICAL SIMULATION AND EXPERIMENTS OF THE VECTOR-FLOW CLEANROOM%矢流洁净室的数学模拟和实验研究

    Institute of Scientific and Technical Information of China (English)

    涂光备; 陈文浩; 王莱

    2000-01-01

    Based on K-ε two equation turbulence model,the air distribution and contamination field under different conditions was numerically simulated in a vector-flow cleanroom.Special mesh system was introduced to deal with the qu arter-circle-shaped inlets.Model experiments were also made.By analysis of num erical as well as experimental results,we made some predictions about flow chara cteristics,contaminant control effect and ventilation performance of this energy -saving cleanroom.It has been proved that the vector-flow can meet class 100 o f Fed. St.with 1/3 to 1/2 conv entional air change per hour,and re-duce layer height and simplify air clean system.%气流流型主要受送回风口的位置、尺寸、房间几何形状及室内设备的影响.基于k-ε两个方程的紊流模型对矢流洁净室在不同情况下的气流分布和浓度场进行了三维数学模拟与优化,并进行了模型试验.根据理论分析和实验结果,得出了气流及污染控制特性、节能效果等方面结论 ,证明了送风量仅相当于1/3~1/2 常规换气次数的条件下即可达到美国联邦标准100级的洁净度,同时可降低层高,简化系统 .这些结论将有助于促进这种新流型在中国的应用.

  2. Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Kannan, Anusha; Srinivasan, Sivasubramanian [Khoo Teck Puat Hospital, Singapore (Singapore)

    2012-09-15

    We read with great interest, the case report on ischemic optic neuropathy (1). We would like to add a few points concerning the blood supply of the optic nerve and the correlation with the development of post-operative ischemic neuropathy. Actually, the perioperative or post-operative vision loss (postoperative ischemic neuropathy) is most likely due to ischemic optic neuropathy. Ischemic optic neuropathy (2) is classified as an anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). This classification is based on the fact that blood supply (2) to the anterior segment of the optic nerve (part of the optic nerve in the scleral canal and the optic disc) is supplied by short posterior ciliary vessels or anastamotic ring branches around the optic nerve. The posterior part of the optic canal is relatively less perfused, and is supplied by ophthalmic artery and central fibres are perfused by a central retinal artery. So, in the post-operative period, the posterior part of the optic nerve is more vulnerable for ischemia, especially, after major surgeries (3), one of the theories being hypotension or anaemia (2) and resultant decreased perfusion. The onset of PION is slower than the anterior ischemic optic neuropathy. AION on the other hand, is usually spontaneous (idiopathic) or due to arteritis, and is usually sudden in its onset. The reported case is most likely a case of PION. The role of imaging, especially the diffusion weighted magnetic resonance imaging, is very important because the ophthalmoscopic findings in early stages of PION is normal, and it may delay the diagnosis. On the other hand, edema of the disc is usually seen in the early stages of AION.

  3. Diagnostic approach and current treatment options in childhood vasculitis.

    Science.gov (United States)

    Barut, Kenan; Şahin, Sezgin; Adroviç, Amra; Kasapçopur, Özgür

    2015-12-01

    All inflammatory changes in the vessel wall are defined as vasculitis. Pediatric vasculitis may present with different clinical findings. Although Henoch-Schönlein purpura which is the most common pediatric vasculitis generally recovers spontaneously, it should be monitorized closely because of the risk of renal failure. Although Kawasaki disease is easy to diagnose with its classical findings, the diagnosis may be delayed in case of incomplete Kawasaki disease. Kawasaki disease should be considered especially in infants in case of prolonged fever even if the criteria are not fully met and intravenous immunoglobulin treatment should be administered without delay in order to prevent development of coronary artery aneurism. Reaction at the site of administration of Bacillus Calmette-Guerin (BCG) vaccine may be observed as commonly as cervical lymphadenopathy in Kawasaki disease and may be used as a valuable finding in suspicious cases. Although anti-neutrophil cytoplasmic antibody-associated vasculitides are rare in children, renal involvement is more common and progression is more severe compared to adults. Hence, efficient and aggressive treatment is required. Takayasu's arteritis is observed commonly in young adult women and rarely in adolescent girls. Therefore, a careful physical examination and blood pressure measurement should be performed in addition to a detailed history in daily practice. In children with unexplained neurological findings, cerebral vasculitis should be considered in the absence of other systemic vasculitides and necessary radiological investigations should be performed in this regard. This review will provide an insight into the understanding of pediatric vasculitis, current diagnostic approaches and prognosis by the aid of new studies.

  4. IL-1 signaling is critically required in stromal cells in Kawasaki Disease Vasculitis Mouse Model. Role of both IL-1α and IL-1β

    Science.gov (United States)

    Lee, Youngho; Wakita, Daiko; Dagvadorj, Jargalsaikhan; Shimada, Kenichi; Chen, Shuang; Huang, Ganghua; Lehman, Thomas J.A.; Fishbein, Michael C.; Hoffman, Hal M.; Crother, Timothy R.; Arditi, Moshe

    2015-01-01

    Objective Kawasaki disease (KD) is the most common cause of acute vasculitis and acquired cardiac disease among US children. We have previously shown that both TLR2/MyD88 and IL-1β signaling are required for the Lactobacillus casei cell wall extract (LCWE)-induced KD vasculitis mouse model. The objectives of this study were to investigate the cellular origins of IL-1 production, the role of CD11c+ Dendritic Cells (DCs) and macrophages and the relative contribution of hematopoietic and stromal cells for IL-1 responsive cells, as well the MyD88 signaling in LCWE-induced KD mouse model of vasculitis. Approach and Results Using mouse knockout models as well as antibody depletion, we found that both IL-1α and IL-1β were required for LCWE-induced KD. Both DCs and macrophages were necessary and we found that MyD88 signaling was required in both hematopoietic and stromal cells. However, IL-1 response and signaling was critically required in non-endothelial stromal cells, but not hematopoietic cells. Conclusions Our results suggest that IL-1α and IL-1β as well as CD11c+ DCs and macrophages are essential for the development of KD vasculitis and coronary arteritis in this mouse model. Bone marrow chimera experiments suggest that MyD88 signaling is important in both hematopoietic and stromal cells, while IL-1 signaling and response is required only in stromal cells, but not in endothelial cells. Determining the role IL-1α and IL-1β and of specific cell types in the KD vasculitis mouse model may have important implications for the design of more targeted therapies and understanding of the molecular mechanisms of KD immunopathologies. PMID:26515418

  5. IL-1β is Crucial for Induction of Coronary Artery Inflammation in a Mouse Model of Kawasaki Disease

    Science.gov (United States)

    Lee, Young Ho; Schulte, Danica J.; Shimada, Kenichi; Chen, Shuang; Crother, Timothy R.; Chiba, Norika; Fishbein, Michael C.; Lehman, Thomas J.A.; Arditi, Moshe

    2012-01-01

    Background Kawasaki disease (KD) is the most common cause of acute vasculitis and acquired cardiac disease in US children. Untreated, children may develop coronary artery aneurysms, myocardial infarction and sudden death as a result of the illness. Up to a third of KD patients fail to respond to intravenous gammaglobulin (IVIG), the standard therapy, and alternative treatments are being investigated. Genetic studies have indicated a possible role for IL-1β in KD. We therefore explored the role of IL-1β in a murine model of KD. Methods and Results Using an established mouse model of KD that involves injection of Lactobacillus casei cell wall extract (LCWE), we investigated the role of IL- 1β and caspase-1 (activated by the inflammasome and required for IL-1β maturation) in coronary arteritis, and evaluated the efficacy of IL-1 receptor antagonist (IL-1Ra) as a potential treatment. LCWE-induced IL-1β maturation and secretion was dependent on the NLRP3 inflammasome in macrophages. Both caspase1-deficient and IL-1R-deficient mice were protected from LCWE-induced coronary lesions. Injection of recombinant IL-1β to caspase-1-deficient mice restored the ability of LCWE to cause coronary lesions in response to LCWE. Furthermore, daily injections of the IL-1Ra prevented LCWE-mediated coronary lesions, up to three days after LCWE injection. Conclusions Our results strongly suggest that caspase-1 and IL-1β play critical roles in the development of coronary lesions in this KD mouse model, blocked by IL-1Ra. Therefore, anti-IL-1β treatment strategies may constitute an effective, more targeted treatment of KD to prevent coronary lesions. PMID:22361326

  6. Chronic graft-versus-host disease in the rat radiation chimera: I. clinical features, hematology, histology, and immunopathology in long-term chimeras

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    Beschorner, W.E.; Tutschka, P.J.; Santos, G.W.

    1982-04-01

    The clinical features, pathology, and immunopathology of chronic graft-versus-host disease (GVHD) developing in the long-term rat radiation chimera are described. At 6 to 12 months post-transplant, the previously stable ACI/LEW chimeras developed patchy to diffuse severe hair loss and thickened skin folds, and had microscopic features resembling scleroderma, Sjogren's syndrome, and chronic hepatitis. Skin histology showed dermal inflammation and acanthosis with atrophy of the appendages, with progression to dermal sclerosis. The liver revealed chronic hepatitis with bile duct injury and proliferation and periportal piecemeal necrosis. The tongue had considerable submucosal inflammation, muscular necrosis, and atrophy and arteritis. The serous salivary glands, lacrimal glands, and bronchi had lymphocytic inflammation and injury to duct, acinar, and mucosal columnar epithelium. The thymus had lymphocyte depletion of the medulla with prominent epithelium. The spleen and lymph nodes had poorly developed germinal centers but increased numbers of plasma cells. IgM was observed along the basement membrane and around the basal cells of the skin and tongue and along the basement membrane of the bile ducts. IgM was present also in the arteries of the tongue. Immunoglobulins eluted from the skin, cross-reacted with the bile duct epithelium and usually with both ACI and Lewis skin. Increased titers of speckled antinuclear antibodies were present in the serum of rats with chronic (GVHD). Chronic GVHD in the long-term rat radiation chimera is very similar to human chronic GVHD and is a potentially excellent model for autoimmune disorders including scleroderma, Sjorgren's syndrome, and chronic hepatitis.

  7. Pulmonary Involvement in Rheumatic Diseases: HRCT Findings

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    Serhat Avcu

    2011-05-01

    Full Text Available Aim: Systemic rheumatic disease (SRD may affect all the components of the pulmonary system. This study was designed to investigate the frequency and pattern of pulmonary involvement of systemic collagen tissue diseases. Material and Methods: A total of 128 patients -44 with rheumatoid arthritis (RA, 8 with giant cell arteritis, 14 with systemic lupus erythematosus (SLE, 8 with juvenile chronic arthritis, 24 with ankylosing spondylitis (AS, 6 with scleroderma, 12 with Behcet’s disease, 4 with mixed connective tissue disease (MCTD, 4 with polymyositis and 4 with dermatomyositis- who had presented to the Department of Physical Medicine and Rehabilitation/Rheumatology between January 2007 and December 2008 were included in the study. All the ptients were informed about the study in detail and all gave written consent before enrollment. HRCT was performed in all patients. Results: Pulmonary involvement was detected in 21 patients with RA (48%, in 8 patients withcSLE (57%, in 16 patients with AS (67%, in 4 patients with scleroderma (67%, and in 4 patients with MCTD (50%. No pulmonary involvement was observed in patients with Behçet’s disease, polymyositis and dermatomyositis. Conclusions: Our results suggest that patients with SRD may present with pulmonary involvement in varying degrees. Pulmonary symptoms may be underdiagnosed due to limited capacity of exercise secondary to musculoskeletal involvement. Therefore, a routine pulmonary X-ray should be performed in the process of the diagnosis and prior to treatment, even in the lack of complaints suggesting pulmonary involvement. Further investigations including HRCT should be performed if needed. 

  8. Update on the evaluation of transient vision loss

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    Pula JH

    2016-02-01

    Full Text Available John H Pula,1 Katherine Kwan,2 Carlen A Yuen,3 Jorge C Kattah4 1Department of Neurology, 2Department of ophthalmology, NorthShore University HealthSystem, Evanston IL, USA; 3University of Illinois College of Medicine at Peoria, 4Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, USA Abstract: Transient vision loss may indicate underlying vascular disease, including carotid occlusion and thromboembolism, or it may have a more benign etiology, such as migraine or vasospasm. This review focuses on the differential diagnosis and workup of patients presenting with transient vision loss, focusing on several key areas: the relationship to thromboembolic vascular disease, hypercoagulable testing, retinal migraine, and bilateral vision loss. The objective is to provide the ophthalmologist with information on how to best manage these patients. Thromboembolic etiologies for transient vision loss are sometimes managed with medications, but when carotid surgery is indicated, earlier intervention may prevent future stroke. This need for early treatment places the ophthalmologist in the important role of expediting the management process. Hospital admission is recommended in patients presenting with transient symptoms within 72 hours who meet certain high-risk criteria. When the cause is giant cell arteritis, ocular ischemic syndrome, or a cardioembolic source, early management of the underlying condition is equally important. For nonthromboembolic causes of transient vision loss such as retinal migraine or retinal vasospasm, the ophthalmologist can provide reassurance as well as potentially give medications to decrease the frequency of vision loss episodes. Keywords: transient vision loss, TVL, amaurosis fugax, retinal migraine, ocular migraine, retinal vasospasm

  9. Fever of unknown origin caused by adult juvenile rheumatoid arthritis: the diagnostic significance of double quotidian fevers and elevated serum ferritin levels.

    Science.gov (United States)

    Cunha, Burke A

    2004-01-01

    Fever of unknown origin (FUO) in adults is a commonly encountered clinical problem. Treatable causes of FUO in the adult should be the primary focus of the diagnostic workup. Neoplasms have replaced infectious diseases as being the most common cause of FUO in adults, and collagen vascular diseases are now relatively rare. The most important collagen vascular diseases presenting as an FUO include Takayasu's arteritis, Kikuchi's disease, polymyalgia rheumatica, and adult juvenile rheumatoid arthritis (JRA) (adult Still's disease). There are no specific diagnostic tests for these disorders, which commonly present as prolonged fevers that are not easily diagnosed (i.e., FUO). Adult JRA is a rare but important cause of FUO in adults. Typically, patients with adult Still's disease present with liver/spleen involvement, posi-articular arthritis, ocular involvement, and evanescent salmon-colored truncal rash. An important diagnostic finding in adult JRA is the presence of a double quotidian fever, which occurs in few other disorders. Only visceral leishmaniasis and adult JRA are causes of FUO in adults associated with double quotidian fevers. Highly elevated serum ferritin levels are the most important nonspecific diagnostic finding associated with adult JRA. We present a case of FUO caused by adult JRA presenting with diffuse polyarticular migrating arthritis, evanescent rash, and splenomegaly. The diagnosis of adult JRA was suggested by these findings in association with a double quotidian fever and a highly elevated serum ferritin level. Clinicians should appreciate the diagnostic significance of fever patterns and the diagnostic significance of elevated serum ferritin levels in patients with FUO.

  10. Salmonelosis no tifoidea y su transmisión a través de alimentos de origen aviar.

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    Catalina Uribe

    2009-11-01

    Full Text Available La infección de origen alimentario por Salmonella spp., es una de las causas más importantes de gastroenteritis en seres humanos. Los principales reservorios de estos microorganismos son animales portadores asintomáticos y las fuentes de infección más frecuente son los alimentos o los productos derivados de estos. El aumento de la incidencia de Salmonella spp., es de gran impacto tanto en salud pública como en salud animal y se ha relacionado con un incremento de la diseminación de los microorganismos a través de las cadenas productivas animales (bovinos, cerdos, pollos asaderos y en especial gallinas ponedoras. En la presente revisión se busca realizar una compilación sistemática de información referida a la gastroenteritis y otras manifestaciones causadas por serovariedades no tíficas de Salmonella spp., con énfasis en la importancia de los alimentos de origen aviar en su transmisión. Las canales de aves frecuentemente pueden estar infectadas con el microorganismo; los huevos se pueden contaminar por transmisión vertical (transovárica, durante la postura o durante la manipulación o el almacenamiento. La infección en el hombre se adquiere por consumo de pollo, huevo crudo o parcialmente cocido, o alimentos preparados con éstos. El cuadro clínico de la salmonelosis no tífica (gastroenteritis o enterocolitis puede incluir diarrea, cefalalgia, dolor abdominal, náusea, vómito, fiebre y deshidratación especialmente en niños y ancianos. Las serovariedades no tíficas de Salmonella spp., pueden causar septicemia, estado portador o infecciones como meningitis, artritis, osteomielitis, colangitis, neumonía, arteritis, endocarditis o infecciones del aparato urinario.

  11. Salmonelosis no tifoidea y su transmisión a través de alimentos de origen aviar

    Directory of Open Access Journals (Sweden)

    Martha Cecilia Suárez

    2006-06-01

    Full Text Available La infección de origen alimentario por Salmonella spp., es una de las causas más importantes de gastroenteritis en seres humanos. Los principales reservorios de estos microorganismos son animales portadores asintomáticos y las fuentes de infección más frecuente son los alimentos o los productos derivados de estos. El aumento de la incidencia de Salmonella spp., es de gran impacto tanto en salud pública como en salud animal y se ha relacionado con un incremento de la diseminación de los microorganismos a través de las cadenas productivas animales (bovinos, cerdos, pollos asaderos y en especial gallinas ponedoras. En la presente revisión se busca realizar una compilación sistemática de información referida a la gastroenteritis y otras manifestaciones causadas por serovariedades no tíficas de Salmonella spp., con énfasis en la importancia de los alimentos de origen aviar en su transmisión. Las canales de aves frecuentemente pueden estar infectadas con el microorganismo; los huevos se pueden contaminar por transmisión vertical (transovárica, durante la postura o durante la manipulación o el almacenamiento. La infección en el hombre se adquiere por consumo de pollo, huevo crudo o parcialmente cocido, o alimentos preparados con éstos. El cuadro clínico de la salmonelosis no tífica (gastroenteritis o enterocolitis puede incluir diarrea, cefalalgia, dolor abdominal, náusea, vómito, fiebre y deshidratación especialmente en niños y ancianos. Las serovariedades no tíficas de Salmonella spp., pueden causar septicemia, estado portador o infecciones como meningitis, artritis, osteomielitis, colangitis, neumonía, arteritis, endocarditis o infecciones del aparato urinario.

  12. Protective Effect of the Persian Gulf brittle star Ophiocoma Erinaceus extract on carbon tetrachloride (CCl4 induced liver damage in adult male Wistar rats

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    Aida Soheili

    2015-12-01

    Full Text Available Background and Aim:  Brittle star possess  bioactive compounds which confer the wound healing capacity and regenerative potency of damaged  arms and organisms to this creature. The aim of the current study was to assess the   protective  effect  of  the  star extract on liver damages induced by carbon tetrachloride in adult male Wistar rats. Materials and Methods: In this experimental study, 32 adult male rats were randomly divided into 4 equal groups: control, Sham exposed, experimental 1 (treated with %25 extract and experimental 2 (treated with %50 extract of star Ophiocoma Erinaceus. The control group received no treatment. The sham exposed groups received carbon tetrachloride .(50% in olive oil .0.5 ml/kg for 7 days. The experimental groups firstly received carbon tetrachloride, then received %25, %50 brittle star extract as intragastric for 7 days. Finally, the animals were sacrificed, and their bodies and livers were weighed. Then, the livers sections were prepared and were examined by means of light microscope. Finally, the obtained  quantitative data was analyzed using SPSS (V; 20, Mini Tab software, ANOVA, and Tukey. at the significant level of P<0.001. Results: Carbon tetrachloride significantly decreased the rats’ body weight, but it increased their livers weight (P<0.001. Histopathological evaluations showed .extensive liver damage. On the other hand, treatment with brittle star extract .ncreased liver weight, reduced. body weight and significantly altered other induced changes by carbon tetrachloride on liver structure such as hepatocytes number, Kupffer cells, and arteritis, which indicated  the improvement of damaged liver tissue (P<0.001. Conclusion: It was found that brittle star extract can exert protective effects on  liver damages induced by carbon tetrachloride on male Wistar rat.

  13. A Candidate Gene Approach Identifies an IL33 Genetic Variant as a Novel Genetic Risk Factor for GCA

    Science.gov (United States)

    Márquez, Ana; Solans, Roser; Hernández-Rodríguez, José; Cid, Maria C.; Castañeda, Santos; Ramentol, Marc; Rodriguez-Rodriguez, Luis; Narváez, Javier; Blanco, Ricardo; Ortego-Centeno, Norberto; Palm, Øyvind; Diamantopoulos, Andreas P.; Braun, Niko; Moosig, Frank; Witte, Torsten; Beretta, Lorenzo; Lunardi, Claudio; Cimmino, Marco A.; Vaglio, Augusto; Salvarani, Carlo; González-Gay, Miguel A.; Martín, Javier

    2014-01-01

    Introduction Increased expression of IL-33 and its receptor ST2, encoded by the IL1RL1 gene, has been detected in the inflamed arteries of giant cell arteritis (GCA) patients. The aim of the present study was to investigate for the first time the potential influence of the IL33 and IL1RL1 loci on GCA predisposition. Methods A total of 1,363 biopsy-proven GCA patients and 3,908 healthy controls from four European cohorts (Spain, Italy, Germany and Norway) were combined in a meta-analysis. Six genetic variants: rs3939286, rs7025417 and rs7044343, within the IL33 gene, and rs2058660, rs2310173 and rs13015714, within the IL1RL1 gene, previously associated with immune-related diseases, were genotyped using predesigned TaqMan assays. Results A consistent association between the rs7025417 polymorphism and GCA was evident in the overall meta-analysis, under both allele (PMH = 0.041, OR = 0.88, CI 95% 0.78–0.99) and recessive (PMH = 3.40E-03, OR = 0.53, CI 95% 0.35–0.80) models. No statistically significant differences between allele or genotype frequencies for the other IL33 and IL1RL1 genetic variants were detected in this pooled analysis. Conclusions Our results clearly evidenced the implication of the IL33 rs7025417 polymorphism in the genetic network underlying GCA. PMID:25409453

  14. Head and neck pain review: traditional and new perspectives.

    Science.gov (United States)

    Friedman, M H; Nelson, A J

    1996-10-01

    A variety of conditions are frequently associated with the occurrence of head and neck pain. The purposes of this review are: to describe the characteristics of several musculoskeletal, neurological, and systemic conditions frequently cited as possible causes of head and neck pain and to suggest a new technique for treating head and neck pain. The characteristics of musculoskeletal conditions, such as muscle spasm, tendinitis, trigger points, and joint inflammation, and their relationship to head and neck pain are considered. The features and clinical implications of neurologic conditions, such as atypical facial pain, trigeminal and glossopharyngeal neuralgia, reflex sympathetic dystrophy, and neurogenic inflammation, are also described. The distinguishing characteristics of headaches, including cluster, tension, chronic daily, rebound, posttraumatic, and postlumbar puncture, are detailed. This review also addresses the contributions of systemic disorders, such as osteoarthritis, rheumatoid arthritis and the variants, and rheumatoid-related conditions, like dermatomyositis, temporal arteritis, Lyme's disease, and fibromyalgia, to head and neck pain. The results of a recent pilot study of the effectiveness of intraoral circulating ice water for resolving symptoms related to head and neck pain secondary to neurogenic inflammation are presented in this work. Ice water circulating through hollow metal tubes was placed intraorally for 15 minutes in the posterior maxillary area on 12 individuals with cervical pain and muscle spasm. In nine of these individuals, reduced cervical pain perception, upper trapezius electromyography signal reduction, and increased cervical range of motion was produced. Six out of 12 individuals had accompanying headache, which was reduced or eliminated in four cases. These findings suggest a strong trigemino-cervical relationship to neck pain and headache.

  15. Spotlight on sirukumab for the treatment of rheumatoid arthritis: the evidence to date.

    Science.gov (United States)

    Lazzerini, Pietro Enea; Capecchi, Pier Leopoldo; Guidelli, Giacomo Maria; Selvi, Enrico; Acampa, Maurizio; Laghi-Pasini, Franco

    2016-01-01

    Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease primarily affecting synovial joints and is characterized by persistent high-grade systemic inflammation. Proinflammatory cytokines, particularly interleukin-6 (IL-6), are of crucial importance in the pathogenesis of the disease, driving both joint inflammation and extra-articular comorbidities. Tocilizumab, a humanized IL-6 receptor-inhibiting monoclonal antibody, has been the first, and, to date, the only, IL-6 inhibitor approved for the treatment of RA. Many studies have demonstrated the potency and effectiveness of tocilizumab in controlling disease activity and radiological progression of RA. These successful results have encouraged the development of novel IL-6 inhibitors, among which a promising agent is sirukumab (SRK), a human anti-IL-6 monoclonal antibody currently under evaluation in Phase II/III studies in patients with RA, systemic lupus erythematosus, giant-cell arteritis, and major depressive disorder. The evidence to date indicates SRK as an effective and well-tolerated new therapeutic tool for patients with active RA, with some preliminary data suggesting a specific beneficial impact on relevant systemic complications associated with the disease, such as depression and cardiovascular disease. Conversely, although pathophysiological considerations make plausible the hypothesis that IL-6 blockade with SRK may also be beneficial in the treatment of many diseases other than RA (either autoimmune or not), available clinical data in patients with systemic lupus erythematosus do not seem to support this view, also giving rise to potentially relevant concerns about drug safety. If large Phase III clinical trials currently in progress in patients with RA confirm the efficacy and tolerability of SRK, then in the long term, this drug could, in the near future, occupy a place in the treatment of the disease, potentially also opening the doors to a more extended use of SRK in a wide range of

  16. Effect of CAWS, a mannoprotein-beta-glucan complex of Candida albicans, on leukocyte, endothelial cell, and platelet functions in vitro.

    Science.gov (United States)

    Kurihara, Kiyoshi; Shingo, Yuko; Miura, Noriko N; Horie, Shuichi; Usui, Yukio; Adachi, Yoshiyuki; Yadomae, Toshiro; Ohno, Naohito

    2003-02-01

    Candida albicans is a medically important fungus which induces a disseminated candidasis and candidemia in immunocompromised hosts, and releases a polysaccharide fraction into the blood. We recently found that C. albicans released a water-soluble polysaccharide fraction (CAWS) into synthetic medium and demonstrated that CAWS was mainly composed of a complex of mannan and beta-glucan. In the murine system, CAWS showed a lethality resembling anaphylactic shock when administered i.v., and induced coronary arteritis similar to Kawasaki Disease (KD) when given i.p. In the present study, we examined the biological activity of CAWS in the cell culture and found the following: i) CAWS slightly induced production of IFN-gamma and IL-6 by splenocytes at lower dose (ca. 10 micro g/ml), but at a higher dose strongly inhibited the proliferation of splenocytes induced by a B cell mitogen, lipopolysaccharide (LPS) and a T cell mitogen, concanavalin A. ii) The viability of these splenocytes monitored by propidium iodide staining was significantly reduced. iii) The addition of CAWS to a culture of monophage RAW264.7 cells significantly reduced cellular growth rate dose dependently. iv) The LPS-mediated synthesis of cytokines by RAW264.7 cells was significantly inhibited by CAWS. v) CAWS induced an aggregation of platelets in human platelet-rich plasma, and vi) CAWS inhibited the production of thrombomodulin by human umbilical endothelial cells and acted synergistically with TNF-alpha. Thus, CAWS strongly inhibited the cellular functions of leukocytes in vitro, partly through direct cytotoxicity. The enhanced production in injured cells of the vascular endothelium would be related to the local inflammatory response in the coronary artery.

  17. 提高低功耗电流源阵列中电流匹配精度的研究%Study on Improvement of Current Matching for Low-Power Current Source Array

    Institute of Scientific and Technical Information of China (English)

    汤英; 袁方; 伍冬; 沈延钊; 许军

    2011-01-01

    The accuracy of current matching for current-mode D/A converter in low-power current source array was studied By using analog calibration technology and high-precision RGC current mirror, effects of different process parameters, temperature and electrical properties in the array on the accuracy of current matching was reduced. Simulation was made with Hspice based on Chartered 0. 35 fim process. Results showed that, in the current range from 10 nA to 1 ftA,the system had a matching accuracy greater than 96. 5% and a static power consumption less than 213 /nW, effectively improving the accuracy of current matching.%针对低功耗阵列中电流型D/A转换器的电流匹配精度进行研究.通过模拟校准技术和高精度RGC电流镜的使用,减小了阵列中工艺参数、温度、电学特性等因素的差异对电流匹配精度的影响.在Chartered 0.35μm工艺下,利用Hspice进行仿真.结果表明,在10 nA到1μA电流范围内,系统匹配精度大于96.5%,静态功耗低于213 μW,有效提高了电流的匹配精度.

  18. Arterivirus Nsp1 modulates the accumulation of minus-strand templates to control the relative abundance of viral mRNAs.

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    Danny D Nedialkova

    2010-02-01

    Full Text Available The gene expression of plus-strand RNA viruses with a polycistronic genome depends on translation and replication of the genomic mRNA, as well as synthesis of subgenomic (sg mRNAs. Arteriviruses and coronaviruses, distantly related members of the nidovirus order, employ a unique mechanism of discontinuous minus-strand RNA synthesis to generate subgenome-length templates for the synthesis of a nested set of sg mRNAs. Non-structural protein 1 (nsp1 of the arterivirus equine arteritis virus (EAV, a multifunctional regulator of viral RNA synthesis and virion biogenesis, was previously implicated in controlling the balance between genome replication and sg mRNA synthesis. Here, we employed reverse and forward genetics to gain insight into the multiple regulatory roles of nsp1. Our analysis revealed that the relative abundance of viral mRNAs is tightly controlled by an intricate network of interactions involving all nsp1 subdomains. Distinct nsp1 mutations affected the quantitative balance among viral mRNA species, and our data implicate nsp1 in controlling the accumulation of full-length and subgenome-length minus-strand templates for viral mRNA synthesis. The moderate differential changes in viral mRNA abundance of nsp1 mutants resulted in similarly altered viral protein levels, but progeny virus yields were greatly reduced. Pseudorevertant analysis provided compelling genetic evidence that balanced EAV mRNA accumulation is critical for efficient virus production. This first report on protein-mediated, mRNA-specific control of nidovirus RNA synthesis reveals the existence of an integral control mechanism to fine-tune replication, sg mRNA synthesis, and virus production, and establishes a major role for nsp1 in coordinating the arterivirus replicative cycle.

  19. Radiological findings of dissecting aneurysm -a correlative study of CT with angiography-

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    Bae, Tae Yeong; Park, Jae Hyung; Kim, Seung Hyup; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1987-06-15

    This study comprised 16 patients with aortic dissecting aneurysm who were admitted to Seoul National University Hospital from May 1984 to January 1987. CT findings in 16 cases of aortic dissecting aneurysm were correlated with angiographic findings retrospectively. The results were analysed. 1. Number of male was 11 and that of female was 5. Male patients in fifties were most common and 4 in number. 13 patients had hypertension or history of hypertension among 14 patients. There were one case of Marfan's syndrome, preeclampsia and Takayasu's arteritis respectively. 2. There were 5 cases of DeBakey type I, 1 case of type II and 9 cases of types III dissecting aneurysm. Type III was most common. 3. CT confirmed as superior vena cava which was not identified whether it was superior vena cava or unopacified false lumen by angiography in one case. Regarding distal extent, authors defined A whose extent was proximal to diaphragm and B beyond it for convenience sake. There was one false negative case in CT among 16 cases which was diagnosed as dissecting aneurysm type IIIB by angiography and confirmed as type III surgically. One case was diagnosed as type IB by CT and as type IIIB by angiography and confirmed as type I surgically. Extent was more accurate in CT than angiography. One case was diagnosed as type II by CT but misdiagnosed as right atrial tumor by angiography. 4. Diagnostic sensitivities of CT and angiography in this study were 94% (15/16) respectively. CT was more advantageous in hemothorax, hemopericardium, hemomediastinum, unopacified false lumen, aortic wall calcification and getting information about mediastinum. In angiography aortic regurgitation and tear site and involvement of abdominal vessels could be observed.

  20. Malignant catarrhal fever in a bison (Bison bison) feedlot, 1993-2000.

    Science.gov (United States)

    O'Toole, D; Li, H; Sourk, C; Montgomery, D L; Crawford, T B

    2002-05-01

    A fatal enteric syndrome was identified in American bison (Bison bison) at a large feedlot in the American Midwest in early 1998. An estimated 150 bison died of the syndrome between January 1998 and December 1999. The syndrome was identified as malignant catarrhal fever (MCF), primarily the alimentary form. Clinical onset was acute, and most affected bison died within 1-3 days; none recovered. Consistent lesions were hemorrhagic cystitis, ulcerative enterotyphlocolitis, and arteritis-phlebitis. Vasculitis was milder and more localized than that in cattle with MCF, and in contrast to the situation in cattle, lymphadenomegaly was minimal. Virtually all affected bison examined were positive for ovine herpesvirus 2 (OvHV-2) by polymerase chain reaction (PCR) assay. A retrospective study of archived tissues established that MCF occurred in the yard as early as 1993. A prospective study was undertaken to establish the importance of MCF relative to other fatal diseases at the feedlot. The fate of a group of 300 healthy male bison in a consignment of 1,101 animals was followed for up to 7 months to slaughter. At entry, 23% (71/300) of bison were seropositive for MCF viruses, and 11% (8/71) of these seropositive bison were PCR positive for OvHV-2. Forty seronegative bison were selected at random from the group, and all were PCR negative for OvHV-2. There was no change in seroprevalence in the group during the investigation. The minimum infection rate for MCF virus was 36.3% (93/256). Twenty-two (7.3%) of the 300 bison in the feedlot died. Of these, 15 had MCF, 4 had acute or chronic pneumonia, and 3 were unexamined. Losses in the entire consignment were higher (98/1,101; 8.8% death loss); 76% of deaths were attributable to MCF. The study failed to reveal a relationship between subclinical infection and development of clinical disease.

  1. Molecular epidemiology and pathology of spirorchiid infection in green sea turtles (Chelonia mydas).

    Science.gov (United States)

    Chapman, Phoebe A; Owen, Helen; Flint, Mark; Soares Magalhães, Ricardo J; Traub, Rebecca J; Cribb, Thomas H; Kyaw-Tanner, Myat T; Mills, Paul C

    2017-04-01

    Spirorchiid blood fluke infections affect endangered turtle populations globally, and are reported as a common cause of mortality in Queensland green sea turtles. Both the flukes and their ova are pathogenic and can contribute to the stranding or death of their host. Of particular interest are ova-associated brain lesions, which have been associated with host neurological deficits. Accurate estimations of disease frequency and the relative effect of infection relating to different spirorchiid species are made difficult by challenges in morphological identification of adults of some genera, and a lack of species-level identifying features for ova. A new specifically designed molecular assay was used to detect and identify cryptic spirorchiids and their ova in Queensland green sea turtle tissues collected from 2011 to 2014 in order to investigate epidemiology, tissue tropisms and pathology. Eight spirorchiid genotypes were detected in 14 distinct tissues, including multiple tissues for each. We found no evidence of a characteristic pathway of the eggs to the exterior; instead the results suggest that a high proportion of eggs become lost in dead-end tissues. The most common lesions observed were granulomas affecting most organs with varying severity, followed by arteritis and thrombi in the great vessels. The number of spirorchiid types detected increased with the presence and severity of granulomatous lesions. However, compared with other organs the brain showed relatively low levels of spirorchiid diversity. An inverse relationship between host age and spirorchiid diversity was evident for the liver and kidneys, but no such relationship was evident for other organs. Molecular data in this study, the first of its kind, provides the first species-level examination of spirorchiid ova and associated pathology, and paves the way for the future development of targeted ante-mortem diagnosis of spirorchiidiasis.

  2. Zn(2+ inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture.

    Directory of Open Access Journals (Sweden)

    Aartjan J W te Velthuis

    Full Text Available Increasing the intracellular Zn(2+ concentration with zinc-ionophores like pyrithione (PT can efficiently impair the replication of a variety of RNA viruses, including poliovirus and influenza virus. For some viruses this effect has been attributed to interference with viral polyprotein processing. In this study we demonstrate that the combination of Zn(2+ and PT at low concentrations (2 µM Zn(2+ and 2 µM PT inhibits the replication of SARS-coronavirus (SARS-CoV and equine arteritis virus (EAV in cell culture. The RNA synthesis of these two distantly related nidoviruses is catalyzed by an RNA-dependent RNA polymerase (RdRp, which is the core enzyme of their multiprotein replication and transcription complex (RTC. Using an activity assay for RTCs isolated from cells infected with SARS-CoV or EAV--thus eliminating the need for PT to transport Zn(2+ across the plasma membrane--we show that Zn(2+ efficiently inhibits the RNA-synthesizing activity of the RTCs of both viruses. Enzymatic studies using recombinant RdRps (SARS-CoV nsp12 and EAV nsp9 purified from E. coli subsequently revealed that Zn(2+ directly inhibited the in vitro activity of both nidovirus polymerases. More specifically, Zn(2+ was found to block the initiation step of EAV RNA synthesis, whereas in the case of the SARS-CoV RdRp elongation was inhibited and template binding reduced. By chelating Zn(2+ with MgEDTA, the inhibitory effect of the divalent cation could be reversed, which provides a novel experimental tool for in vitro studies of the molecular details of nidovirus replication and transcription.

  3. Heterogeneity of Human Research Ethics Committees and Research Governance Offices across Australia: An observational study

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    Elisabeth De Smit

    2016-02-01

    Full Text Available Background Conducting ethically grounded research is a fundamental facet of all investigations. Nevertheless, the administrative burdens of current ethics review are substantial, and calls have been made for a reduction in research waste. Aims To describe the heterogeneity in administration and documentation required by Human Research Ethics Committees (HRECs and Research Governance Offices (RGOs across Australia. Methods In establishing a nationwide study to investigate the molecular aetiology of Giant Cell Arteritis (GCA, for which archived pathological specimens from around Australia are being recruited, we identified variation across separate HREC and RGO requirements. Submission paperwork and correspondence from each collaborating site and its representative office for research were reviewed. This data was interrogated to evaluate differences in current guidelines. Results Twenty-five pathology departments across seven Australian States collaborated in this study. All states, except Victoria, employed a single ethics review model. There was discrepancy amongst HRECs as to which application process applied to our study: seven requested completion of a “National Ethics Application Form” and three a “Low Negligible Risk” form. Noticeable differences in guidelines included whether electronic submission was sufficient. There was variability in the total number of documents submitted (range five to 22 and panel review turnaround time (range nine to 136 days. Conclusion We demonstrate the challenges and illustrate the heavy workload involved in receiving widespread ethics and governance approval across Australia. We highlight the need to simplify, homogenise, and nationalise human ethics for non-clinical trial studies. Reducing unnecessary administration will enable investigators to achieve research aims more efficiently

  4. Ogräs, åkertistlar och taggiga växter

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    Lars Klintwall

    2012-06-01

    Full Text Available Psykiatriska diagnoser är kontroversiella. Vissa, ofta psykiatriker, menar att psykiska tillstånd går att dela upp i distinkta klasser medan andra, ofta psykologer, menar att all sådan uppdelning gör våld på verkligheten. Dessutom har psykiatrin anklagats för att vara moraliserande: vem kan avgöra vad som är sjukt och friskt? Är autism en sjukdom? Utifrån en pragmatisk begreppsanalys är uppdelningen mellan sjukt och friskt nödvändigtvis godtycklig. Precis som när en trädgårdsmästare avgör vad som är ogräs så beror det på situationen och ens syften. Och precis som växterarter ibland är distinkta arter så kan vissa psykiatriska diagnoser vara distinkta klasser, och andra inte. Kanske är autism en avgränsad diagnos, kanske inte. Men ibland är inte artsuppdelning det mest användbara för en trädgårdsmästare, precis som det inte behöver vara det för psykiatrin. Istället kan man formulera nya kategoriseringar helt baserade på pragmatiska hänsyn. Ibland räcker det med taggiga växter och socialt indifferenta barn.

  5. Imaging of systemic vasculitis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Soliman, Magdy [The Hospital for Sick Children, Department of Medical Imaging, Toronto, ON (Canada); Cairo University, Department of Medical Imaging, Cairo (Egypt); Laxer, Ronald; Yeung, Rae [The Hospital for Sick Children, Department of Rheumatology, Toronto, ON (Canada); Manson, David; Doria, Andrea S. [The Hospital for Sick Children, Department of Medical Imaging, Toronto, ON (Canada)

    2015-08-15

    The term ''systemic vasculitis'' encompasses a diverse set of diseases linked by the presence of blood-vessel inflammation that are often associated with critical complications. These diseases are uncommon in childhood and are frequently subjected to a delayed diagnosis. Although the diagnosis and treatment may be similar for adult and childhood systemic vasculitides, the prevalence and classification vary according to the age group under investigation. For example, Kawasaki disease affects children while it is rarely encountered in adults. In 2006, the European League Against Rheumatism (EULAR) and the Pediatric Rheumatology European Society (PReS) proposed a classification system for childhood vasculitis adopting the system devised in the Chapel Hill Consensus Conference in 1993, which categorizes vasculitides according to the predominant size of the involved blood vessels into small, medium and large vessel diseases. Currently, medical imaging has a pivotal role in the diagnosis of vasculitis given recent developments in the imaging of blood vessels. For example, early diagnosis of coronary artery aneurysms, a serious complication of Kawasaki disease, is now possible by magnetic resonance imaging (MRI) of the heart and multidetector computed tomography (MDCT); positron emission tomography/CT (PET/CT) helps to assess active vascular inflammation in Takayasu arteritis. Our review offers a unique approach using the integration of the proposed classification criteria for common systemic childhood vasculitides with their most frequent imaging findings, along with differential diagnoses and an algorithm for diagnosis based on common findings. It should help radiologists and clinicians reach an early diagnosis, therefore facilitating the ultimate goal of proper management of affected children. (orig.)

  6. Doença renal ateroembólica: uma causa de insuficiência renal aguda pouco explorada Atheroembolic renal disease: a cause of acute renal failure not much explored

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    Claus Dieter Dummer

    2010-01-01

    Full Text Available O ateroembolismo é uma doença multisistêmica que afeta vários órgãos, entre os quais o rim, através da liberação de êmbolos de colesterol de uma placa aterosclerótica erosada, ocasionando obstrução vascular em diversos tecidos. A doença renal ateroembólica (DRAE, histologicamente representada por cristais de colesterol nas arteríolas do rim acompanhados de um infiltrado inflamatório perivascular, é causa de insuficiência renal aguda muitas vezes grave e prolongada, que ocorre semanas ou mesmo meses após o episódio embólico. A DRAE apresesenta prognóstico ruim com elevada mortalidade. Apresentamos neste relato o caso de um paciente com DRAE que se manifestou clinicamente dois meses após a realização de um cateterismo cardíaco seguido de uma angioplastia coronária. A prevalência, manifestações clínicas, histologia renal, tratamento e o prognóstico da DRAE são discutidos.Atheroembolism is a multisytemic disease which affects many organs, including the kidneys, by the release of cholesterol emboli to tissues from an erosed atherosclerotic plaque, causing vascular obstruction in many tissues. The atheroembolic renal disease (AERD is histologically represented by cholesterol crystals in renal arterioles with an inflammatory infiltrate around the vessels, and causes acute renal failure that may be severe and prolonged, weeks or even months after the embolic episode. The AERD carries a bad prognosis, with a high mortality. We herein report a case of a patient presenting AERD which was manifested two months after he was submitted to a cardiac catheterism and coronary angioplasty. The prevalence, clinical findings, renal histology, treatment and prognosis of AERD are discussed.

  7. Molecular epidemiology and pathology of spirorchiid infection in green sea turtles (Chelonia mydas

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    Phoebe A. Chapman

    2017-04-01

    Full Text Available Spirorchiid blood fluke infections affect endangered turtle populations globally, and are reported as a common cause of mortality in Queensland green sea turtles. Both the flukes and their ova are pathogenic and can contribute to the stranding or death of their host. Of particular interest are ova-associated brain lesions, which have been associated with host neurological deficits. Accurate estimations of disease frequency and the relative effect of infection relating to different spirorchiid species are made difficult by challenges in morphological identification of adults of some genera, and a lack of species-level identifying features for ova. A new specifically designed molecular assay was used to detect and identify cryptic spirorchiids and their ova in Queensland green sea turtle tissues collected from 2011 to 2014 in order to investigate epidemiology, tissue tropisms and pathology. Eight spirorchiid genotypes were detected in 14 distinct tissues, including multiple tissues for each. We found no evidence of a characteristic pathway of the eggs to the exterior; instead the results suggest that a high proportion of eggs become lost in dead-end tissues. The most common lesions observed were granulomas affecting most organs with varying severity, followed by arteritis and thrombi in the great vessels. The number of spirorchiid types detected increased with the presence and severity of granulomatous lesions. However, compared with other organs the brain showed relatively low levels of spirorchiid diversity. An inverse relationship between host age and spirorchiid diversity was evident for the liver and kidneys, but no such relationship was evident for other organs. Molecular data in this study, the first of its kind, provides the first species-level examination of spirorchiid ova and associated pathology, and paves the way for the future development of targeted ante-mortem diagnosis of spirorchiidiasis.

  8. The electroneurophysiological findings in rheumatoid arthritis patients.

    Science.gov (United States)

    Sivri, A; Güler-Uysal, F

    1999-01-01

    In rheumatoid arthritis (RA), vasculitis is a serious complication usually found in patients with long-standing erosive nodular seropositive disease. One clinical hallmark of this systemic arteritis is the appearance of neurological findings. However, it is often difficult to diagnose these slight or early neuropathies and the study of the peripheral neuromuscular system is often made difficult by symptoms resulting from pain in the joints and limitations of movement. It is nevertheless often possible by means of electroneuromyography to show objectively the existence and distribution of even subclinical neuropathies. In order to evaluate the neurophysiological functions of RA patients by means of the peripheral nerve conduction and somatosensorial evoked potential studies, 33 RA patients and 20 healthy controls were included in this study. Two (6%) patients were found to have carpal tunnel syndrome, while 6 (18%) patients had mononeuritis multiplex. Delayed N12, N13, N1 and P1 latencies were detected in 6 (18%) of 33 RA patients suggesting central nervous system involvement with intact peripheral nervous system. Our results confirm earlier observations that symptoms of neuropathy are fairly common in cases of RA without there being any clear correlation with any clinical variable. By means of electroneurophysiological studies, it is to evaluate the integrity of the peripheral nerve, the spine and the central pathways. Besides enabling to detect early subclinical involvement of the peripheral nervous system in RA, SEPs should also be used for the evaluation of subclinical myelopathy due to atlantoaxial subluxation or vasculitis. The inclusion of an electroneurophysiologic examination of the RA patients is recommended in routine diagnostic procedure.

  9. Association of Wolbachia with heartworm disease in cats and dogs.

    Science.gov (United States)

    Dingman, Patricia; Levy, Julie K; Kramer, Laura H; Johnson, Calvin M; Lappin, Michael R; Greiner, Ellis C; Courtney, Charles H; Tucker, Sylvia J; Morchon, Rodrigo

    2010-05-28

    Although the presence of adult Dirofilaria immitis in the pulmonary arteries and its associated arteritis and thromboembolic disease can explain some of the manifestations of canine and feline heartworm disease, the cause of other findings remains unclear. Cats with D. immitis antibodies but lacking adult parasites in the pulmonary arteries frequently develop histological lesions of the airways, resulting in a condition termed Heartworm-Associated Respiratory Disease. All D. immitis parasites harbor Wolbachia pipientis bacteria and D. immitis-infected animals can have circulating Wolbachia antibodies and pro-inflammatory Wolbachia antigens (WSP) deposited in tissues. Little is known about the role that Wolbachia plays in lung disease of animals naturally infected with D. immitis. The purpose of this study was to determine the contribution of Wolbachia to the pathogenesis of natural heartworm disease in cats and dogs. We hypothesized that animals having sufficient Wolbachia burden to be detected in lung tissue by immunohistochemistry and/or polymerase chain reaction (PCR) would have more severe pulmonary disease than those with bacteria below the limits of detection. We further hypothesized that animals that were immunoreactive to pro-inflammatory WSP would have more severe pulmonary lesions than those that were seronegative for WSP antibodies. Blood and lung tissue samples were collected from cats and dogs representing three different D. immitis infection statuses: heartworm-free, heartworm-exposed, heartworm-infected. There was a positive but weak correlation between the magnitude of D. immitis antibody titers and WSP titers in cats (r=0.57, pheartworm disease creates a dilemma for veterinarians treating animals in D. immitis-endemic areas. Although the indiscriminant use of antibiotics should be avoided, many clinicians prescribe doxycycline based on the favorable responses observed in human filarial diseases and promising results from the first published studies

  10. Evaluation of C-reactive protein as a clinical biomarker in naturally heartworm-infected dogs: a field study.

    Science.gov (United States)

    Venco, Luigi; Bertazzolo, Walter; Giordano, Guglielmo; Paltrinieri, Saverio

    2014-11-15

    Canine heartworm disease caused by Dirofilaria immitis is considered a pulmonary disease, which leads to pulmonary hypertension, and in the late stage, may induce right cardiac insufficiency. Adult worms are localized in the pulmonary arteries, which undergo endothelial damage (proliferative endoarteritis), the severity of which depends on the duration of infection and the worm burden. C-reactive protein (CRP) is a major canine acute-phase protein that rapidly increases in a wide range of inflammatory conditions and rapidly decreases when inflammation resolves. CRP is therefore considered a sensitive but nonspecific marker of inflammation. Pulmonary arterial damage in canine heartworm may induce an increase in CRP concentrations similar to what occurs in humans with endoarteritis. The aim of the present study was to investigate whether CRP may be a diagnostic and/or prognostic marker in canine heartworm, whether it may be used for staging and monitoring canine heartworm, and whether its concentration depends on worm burden or on pulmonary arterial damage. Serum CRP concentrations were determined in 57 dogs with heartworm disease, 47 of which were grouped according to parasite burden (low: n=11; high: n=10) or on severity of pulmonary hypertension (mild: n=16; severe: n=10). An additional 23 heartworm-free cardiopathic dogs were grouped on the absence of pulmonary hypertension (n=8), presence of dilated cardiomyopathy (DCM) (n=6), or presence of cardiomyopathy and pulmonary hypertension (n=3) due to previous heartworm disease that had been treated (n=6). Twenty control dogs also were sampled for CRP concentrations. Results show that CRP was significantly increased (p29.8 mg/L). In conclusion, CRP can be used as a marker of endothelial arteritis and pulmonary hypertension in dogs with heartworm.

  11. Oclusão da artéria central da retina em paciente com poliangeíte microscópica

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    Cláudia Gallicchio Domingues

    2015-12-01

    Full Text Available RESUMO A poliangeíte microscópica é uma vasculite necrotizante sistêmica que acomete arteríolas, capilares e vênulas, mas também pode atingir pequenas e médias artérias. É considerada uma doença rara, idiopática e autoimune. Diversas anormalidades oculares e sistêmicas estão associadas às oclusões arteriais retinianas. Dentre as doenças vasculares do colágeno, a literatura cita como possíveis causas de obstrução das artérias retinianas o lúpus eritematoso sistêmico, a poliarterite nodosa, a arterite de células gigantes, a granulomatose de Wegener e a granulomatose linfóide de Liebow. Até o presente momento, não se encontrou na literatura relatos da associação de casos de oclusão arterial retinana associados à PAM. Os autores relatam o caso de um paciente com poliangeíte microscópica que apresentou comprometimento renal importante e oclusão da artéria central da retina unilateral. Atenta-se para a inclusão de pesquisa da PAM, através do p-ANCA, na avaliação de possível origem sistêmica em pacientes acometidos por oclusão arterial retiniana.

  12. 贵州矮马和西南马3种病毒性疫病的血清学分析%Serological Analysis of Three Viral Epidemic Diseases in Guizhou Pony and Southwest Horse

    Institute of Scientific and Technical Information of China (English)

    薛艳; 邓显佑; 王嘉福; 冉雪琴; 田松军; 魏小红

    2016-01-01

    为探明2012-2013年贵州省紫云县马匹大量死亡的病因,为其科学防治提供参考,采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)方法对当地养殖的贵州矮马、西南马进行马传染性贫血病毒(Equine Infectious Anemia virus,EIAV)、马动脉炎病毒(Equine arteritis virus,EAV)和马疱疹病毒Ⅰ型(Equine herpesvirus type-1,EHV-1)3种病毒的抗体水平检测,并与伊犁马进行比较.结果表明:3个马群中均未检测到EIAV抗体,EHV-1抗体阳性率达98.15%~100%;与伊犁马相比,贵州矮马和西南马EAV抗体的阳性率较高,分别为48.15%和19.35%,并与2个马群的血液理化指标存在一定相关性.紫云县贵州矮马和西南马存在较高比例的EAV感染,马驹和虚弱马匹感染EAV后死亡率较高,因此推测EAV可能是导致马匹死亡的原因之一.

  13. Antiviral activity of carbohydrate-binding agents against Nidovirales in cell culture.

    Science.gov (United States)

    van der Meer, F J U M; de Haan, C A M; Schuurman, N M P; Haijema, B J; Peumans, W J; Van Damme, E J M; Delputte, P L; Balzarini, J; Egberink, H F

    2007-10-01

    Coronaviruses are important human and animal pathogens, the relevance of which increased due to the emergence of new human coronaviruses like SARS-CoV, HKU1 and NL63. Together with toroviruses, arteriviruses, and roniviruses the coronaviruses belong to the order Nidovirales. So far antivirals are hardly available to combat infections with viruses of this order. Therefore, various antiviral strategies to counter nidoviral infections are under evaluation. Lectins, which bind to N-linked oligosaccharide elements of enveloped viruses, can be considered as a conceptionally new class of virus inhibitors. These agents were recently evaluated for their antiviral activity towards a variety of enveloped viruses and were shown in most cases to inhibit virus infection at low concentrations. However, limited knowledge is available for their efficacy towards nidoviruses. In this article the application of the plant lectins Hippeastrum hybrid agglutinin (HHA), Galanthus nivalis agglutinin (GNA), Cymbidium sp. agglutinin (CA) and Urtica dioica agglutinin (UDA) as well as non-plant derived pradimicin-A (PRM-A) and cyanovirin-N (CV-N) as potential antiviral agents was evaluated. Three antiviral tests were compared based on different evaluation principles: cell viability (MTT-based colorimetric assay), number of infected cells (immunoperoxidase assay) and amount of viral protein expression (luciferase-based assay). The presence of carbohydrate-binding agents strongly inhibited coronaviruses (transmissible gastroenteritis virus, infectious bronchitis virus, feline coronaviruses serotypes I and II, mouse hepatitis virus), arteriviruses (equine arteritis virus and porcine respiratory and reproductive syndrome virus) and torovirus (equine Berne virus). Remarkably, serotype II feline coronaviruses and arteriviruses were not inhibited by PRM-A, in contrast to the other viruses tested.

  14. Oscular system changes and functional state of endothelium in systemic vasculitides

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    N P Shilkina

    2007-01-01

    Full Text Available Objective. To assess by noninvasive methods degree, character and relationship of structural and functional endothelium state disturbances in different regions of vascular bed in systemic vasculitides. Material and methods. 65 pts with systemic vasculitides were examined: 20 with hemorrhagic vasculitis (HV, 20 — with thromboangitis obliterans (TO, 10 — with polyarteritis nodosa (PN, 15 — with Takayasu arteritis (ТА. 30 conditionally healthy persons were included in the control group. Carotid angioscanning with intima-media complex thickness (IMT measurement and functional tests on brachial artery under sonographic control using SONOS-1500 apparatus with assessment of endothelium-dependent and endothelium- independent vasodilatation were performed. Intracutaneous blood flow was examined by laser Doppler flowmetry with functional tests using LAKK-01 apparatus. Results. Examination of common carotid arteries showed significant increase of IMP in pts with PN and ТА. Pts with HV and TO did not differ from control. Endothelium-dependent vasodilatation was decreased in all groups of pts. The most prominent changes were revealed in ТА and TO. Response to nitroglycerine was normal only in pts with TO. In other groups it was decreased. Endothelium sensitivity to reactive hyperemia was decreased. Hyperemic type of microcirculation prevailed in groups with systemic vasculitides but in HV group microcirculation was mainly normal. Capillary blood flow reserve was significantly lower in PN and TO. Correlation relationship was revealed between main IMP, brachial artery reactivity measures and skin microcirculation. Conclusion. Structural and functional endothelium state disturbances of different regions of vascular bed revealed in systemic vasculitides are interconnected what proves their participation in endothelium damage in these diseases.

  15. Serosurveillance of infectious agents in equines of the Central Valley of Costa Rica

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    D. Jiménez

    2014-11-01

    Full Text Available Blood samples from 181 equines from the Central Valley of Costa Rica were collected in the year 2012 to determine the presence of antibodies against selected infectious agents in horses and to determine the risk factors associated with these agents. The presence of antibodies against Equine Infectious Anemia Virus (EIAV, Equine Herpes Virus 1 and 4 (EHV-1 and EHV-4, West Nile Virus (WNV, Influenza A Virus (IAV, Equine Viral Arteritis Virus (EVAV, Babesia caballi, Theileria equi, Neospora caninum and Chlamydia abortus was determined using commercial assays, and risk factors associated with seropositivity to the different infectious agents was established. The most seroprevalent agent detected was EHV-4 (96.7%, followed by WNV (44.2%, and IAV (41.8%. Horses >3 years, used for work or sports, and with access to pastures, had significantly increased probability to be seropositive to WNV, whereas horses used for breeding and recreational purposes, being stabled, and without access to pastures, had significantly greater probability to be seropositive to IAV. Seroprevalence to B. caballi (19.9% was lower than to T. equi (38.1%. For B. caballi, access to pastures was determined as a risk factor, whereas being older than 3 years was established as a risk factor for T. equi. Low seroprevalences were determined for EHV-1 (5.0%, EVAV (5.0%, C. abortus (4.8%, and N. caninum (4.4%. Mares having history of abortion were more likely to be seropositive to EHV-1, whereas horses >3 years, used for work and sports, and mares having multiple parturitions, were more likely to be seropositive to N. caninum. None of the horses were seropositive to EIAV. Earlier, only diseases caused by EIAV, WNV and piroplasmosis were reported in Costa Rica. The present study however, determined the presence of carriers for EHV-1, EHV-4, and EIAV.

  16. Effects of reindeer density on vascular plant diversity on North Scandinavian mountains

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    Johan Olofsson

    2005-04-01

    studerade hur renbete påverkar kärlväxtflorans artrikedom och diversitet på dolomitpåverkade lågalpina lokaler i de artrikaste delarna av norra Fennoskandien. Vi inventerade 8 lokaler med olika rentätheter. Två lokaler ligger inom Malla Nationalpark, där renar har varit förbjudna sedan 1981 och starkt begränsade sedan 1950-talet. De sex andra lokalerna ligger i andra artrika områden med samma dolomitdominerade berggrund, men är betade av renar. Rentätheterna vid de studerade lokalerna varierar från helt obefintligt till bland de högsta rentätheter man kan finna i Fennoskandien. Inventeringen utfördes genom att systematiskt undersöka fyra 2 m x 10 m stora ytor i varje lokal i en habitattyp som är speciellt rik i ovanliga kärlväxter (fjällsippehed-lågörtsäng komplex. Varje yta delades upp i 20 småytor (1 m x 1 m, och en total artlista upprättades för var och en av dessa småytor. Den första axeln i DCA (detrended correspondence analyses analysen korrelerade med rentätheten. Det visar att renar påverkar sammansättningen av växtsamhället. Ingen av de vanliga måtten på biodiversitet (artrikedom eller Shannon-Wiener diversitetsindex var korrelerade med rentätheten. Trots detta, var tätheterna av Ca-gynnade växter och arter rödlistade i Finland positivt korrelerade med rentätheten. Trots att renarna inte påverkade totala artrikedommen, kan de vara betydelsefulla för regionala biodiversiteten eftersom de gynnar ovanliga och hotade arter. De vanliga måtten på biodiversitet har begränsat värde för bevarandebiologiska frågeställningar, eftersom de är lika känsliga för ovanliga och vanliga arter.

  17. Scattering and Absorbing Characteristics of Rabbit Arteries and Veins in Kubelka-Munk Model at He-Cd Laser in Vitro%Kubelka-Munk 模型下的兔血管对He-Cd激光的散射与吸收特性

    Institute of Scientific and Technical Information of China (English)

    魏华江; 李晓原; 刘小星; 魏冬季; 谭润初

    2001-01-01

    测量了兔动脉和静脉对He-Cd激光的反射和透射传输特性。实验采用两积分球系统及波长为441.6nm的He-Cd激光器,并根据测量数据及采用Kubelka-Munk模型分析和计算了兔动脉和静脉组织对该波长激光的吸收系统、散射系数及总的光强I(x)及前向散射通量i(x)和后向散射通量j(x)随厚度的变化情况。结果表明,兔动脉和静脉的漫反射率和透射率有明显差别,而且,动脉对激光的吸收系数明显较静脉的要小,而动脉对激光的散射系数却明显较静脉的要大,在动脉和静脉组织中总的光强I(x)及前向散射通量i(x)和后向散射通量j(x)随厚度的变化情况也有明显的区别。%The diffuse reflectance and transmittance of rabbit arter ies andveins were studied.441.6nm wavelength of He-Cd laser was used in the ex p eriment. The measurements were performed with two standard integrating sphere sy stems.The absorption coefficient,scattering coefficient and the changes of total optical intensities I(x),forward scattering flux i(x),backward scattering flux j(x) as a function of thickness of rabbit arteries and veins were evaluated and analyzed from the experimented data by Kubelka-Munk model.The results of measur e ment showed significant difference of diffuse reflectance and transmittance betw een arteries and veins at 441.6nm wavelength of He-Cd laser. Furthermore ,the a bsorption coefficient of arteries were obviously lesser than that of Veins at He -Cd laser wavelength.And the scattering coefficient of arteries were obviously bi gger than that of veins at He-Cd laser wavelength.The changes of total optical i ntensities I(x),forward scattering flux i(x), backward scattering flux j(x) as a function of thickness of rabbit arteries and veins were also significant differ ence.

  18. The role of international transport of equine semen on disease transmission.

    Science.gov (United States)

    Metcalf, E S

    2001-12-03

    Despite the numerous benefits of having the capability to transport semen internationally, there are serious potential ramifications if that semen is contaminated with a communicable disease. Bacteria: Many commensal bacteria colonize the exterior of the stallion penis and are not regarded as pathogenic. They may be cultured from an ejaculate. Alterations of the normal bacterial flora on the exterior genitalia may cause the growth of opportunistic bacteria such as Klebsiella pneumonia, Pseudomonas aeruginosa, Streptococcus zooepidemicus, which, if inseminated, may cause infertility in susceptible mares. Contagious equine metritis (CEM), a highly transmissible, true venereal disease of horses, is caused by the gram-negative coccobacillis, Taylorella equigenitalis. Even with the use of rigorous testing protocols, the current techniques used may not ensure accuracy of results. Viruses: Equine coital exanthema (equine herpes virus type 3; EHV-3) is a highly contagious virus that causes painful lesions on the stallion's penis and mare's vulva. Although it is primarily transmitted through coitus, infected fomites have also been implicated in its spread. Therefore, it is possible that the virus can potentially be transmitted to the ejaculate through penile contact with an artificial vagina or sleeve. Equine arteritis virus appears to be becoming more prevalent in recent years. The most common method of transmission is through respiratory disease, but the organism can also be shed in the semen of asymptomatic stallions. Equine infectious anemia virus has also been found to be present in the semen of an infected stallion, although no evidence exists at this time that there is venereal transmission of this disease. Protozoa: Dourine, caused by Trympanosoma equiperidum, is a venereal disease found only in Africa, South and Central America and the Middle East. Serological testing using complement fixation is recommended for diagnosis. Piroplasmosis, a disease caused by Babesia

  19. 马流感病毒双抗体夹心ELISA检测方法的建立%Development of Double Antibody Sandwich ELISA for Detection of Equine Influenza Virus

    Institute of Scientific and Technical Information of China (English)

    姬媛媛; 郭巍; 王晓钧; 王征; 卢刚; 赵立平; 李红梅; 相文华

    2011-01-01

    To develop a rapid and effective method for Equine influenza virus (EIV) detection,polyclonal antibodies against EIV A/equine/Xinjiang/07 strain and monoclonal antibody against NP of EIV were generated respectively. Then a double antibody sandwich ELISA (DAS-ELISA)was developed. The specificity of the optimized DAS-ELISA was evaluated using EIV, Equine arteritis virus, Equine herpes virus-1, Equine herpes virus-4 and Japanese encephalitis virus, resulting in only EIV specimens yielding a strong signal. Compared with hemagglutination test, its sensitivity was as two point five to ten times as the later. And it had cross-reactivity with H7N7 subtype. Meanwhile it is suitable for detection of virus from the nasal swabs of experimentally infected equines. The results revealed that the ELISA possessed good specificity and higher sensitivity, indicating a suitable method for rapid detection of EIV.%为建立一种快速、有效的检测马流感病毒(Equine influenza virus,EIV)的方法,以EIV中国分离株A/马/新疆/07(H3N8)制备的多克隆抗体为捕获抗体,原核表达的核蛋白(NP)制备的单克隆抗体为检测抗体,在国内首次建立了检测EIV的双抗体夹心ELISA方法.用该检测方法分别检测EIV、马动脉炎病毒、马疱疹病毒1型、马疱疹病毒4型和马乙型脑炎病毒阳性样品.结果表明,该ELISA方法具有良好的特异性;与常规检测EIV的血凝试验相比,其敏感性是后者的2.5~10倍;同时与H7N7亚型EIV有交叉反应.攻毒试验结果表明该方法可有效检测鼻腔分泌物中的EIV.该方法的建立为EIV的检测及早期防控提供了有效工具.

  20. [Risk factors for long-term result of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm].

    Science.gov (United States)

    Ye, W; Di, X; Liu, Q; Li, Y J; Zheng, Y H; Zeng, R; Song, X J; Liu, Z L; Liu, C W

    2016-12-06

    Objective: To summarize results of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm(AIPA), and to analysis clinical predictors of long term major adverse clinical events(MACE). Methods: Retrospectively collected endovascular treatment for AIPA cases in Peking Union Medical College Hospital within 2000 to 2015. Twenty-nine cases with AIPA treated by endovascular therapy were enrolled in this study. Twenty five cases were male, range from 23 to 67 years old, mean age was (39.3±11.4) years old.Demographic characters, locations of aneurysms, type to auto-immune disease, immuno medical therapy, operation strategy and long term follow-up data were reported. Statistical analysis was made to verify clinical predictors of long-term MACE. Results: Among the 29 cases, 22 cases with bechet's disease, 4 cases with Takayasu's arteritis, 2 cases with systemic lupus erythematosus, 1 cases with polyarteritis nodosa. Eight cases had ruptured or pending ruptured pesudo-aneurysms, the rest 21 cases had dull pain or no overt symptome. Twenty-four cases had infra-renal artery aneurysms, two were para-and supra-renal artery, two were supra-celiac artery, and the rest one had multiple aneurysms involved thoracic and abdominal aorta.All the cases received regular immune medical therapy except the three emergency cases. All the operations were under general anaesthesia. Nineteen cases underwent classical Endovascular aortic aneurysm repair (EVAR), 5 cases underwent fenestration EVAR, the rest 5 cases underwent hybrid procedure. All the 29 operations were successful, without conversion to open surgery. Major peri-operation complication included 3 incision infection, 3 pulmonary infection. No death occurred. All the cases received regular follow-up from 1 to 120 months. There were five recurrence of pseudo-aneurysm, 1 case suffered from iliac limb occlusion. 5 cases received re-intervention procedure. No occlusion of revascularizal visceral artery was