Coronary artery aneurysms: Comprehensive review and a case report of a left main coronary artery aneurysm

Coronary artery aneurysms (CAAs) are rare anatomical disorders of the coronary arteries. Atherosclerosis and Kawasaki disease are the principal causes of CCAs, while other causes including genetic factors, inflammatory arterial diseases, connective tissue disorders, endothelial damage after cocaine use, iatrogenic complications after interventions and infections, are also common among patients with CAAs. Although there is a variety of non-invasive methods including echocardiography, computed tomography, and magnetic resonance imaging, coronary angiography remains the gold standard diagnostic method. There is still no consensus about the most appropriate therapeutic strategy. Medical therapy including antiplatelets, anticoagulants, statins and ACEs are preferred either in patients with atherosclerosis, inflammatory status and stable CAAs, while percutaneous or surgery interventions are usually applied in patients with acute coronary syndrome due to a CAA culprit, obstructive coronary artery disease or large saccular aneurysms at a high risk of rupturing.

Infrared Spectroscopic Study and Mathematical Simulations of Carotid Atherosclerosis

BACKGROUND/AIM

The pathogenesis, treatment and prevention of atherosclerosis continue to be the subject of intensive research and study by the scientific community. Based on Fourier-transform infrared spectra and 3D-Doppler echogram, we attempted to develop a computational simulation model for predicting the association of atherosclerotic risk factors with pathogenic molecular structural changes.

MATERIALS AND METHODS

Atheromatic carotid arteries from 56 patients (60-85 years old) were used as samples. Color 3D-Doppler echogram screening was performed on all patients preoperatively. Each infrared spectrum consisted of 120 co-added spectra at a spectral resolution of 4 cm^-1 Results: The infrared spectral analysis reveals 'marker bands', such as the 1,744 cm^-1 band assigned to aldehyde formation and to the 'fingerprint' digital spectral region of 1,050-1,169 cm^-1, characteristic of the presence of advanced glycation end products (C-O-C). The accumulation of calcium phosphate salts increases the formation rate of stenosis. The critical point of stenosis risk starts at about 45%, while when stenosis is over 60-70%, the risk of ischemic stroke or other major adverse cardiovascular events increases dramatically.

CONCLUSION

Fourier-transform infrared spectroscopy and mathematical simulation models showed that carotid artery stenosis over 45% reduces the blood flow rate, while stenosis over 65% dramatically increases the hemodynamic disturbance, with a parallel increase the rate of ischemic stroke or other major adverse cardiovascular events.

Inappropriate antidiuretic hormone secretion due to squamous cell lung cancer

The syndrome of inappropriate secretion of antidiuretic hormone is a disorder of impaired water excretion caused by the inability to suppress secretion of antidiuretic hormone. It has been commonly associated with small cell carcinoma. The association of this syndrome with squamous cell lung carcinoma has rarely been reported, with only 4 cases over the past two decades in the English literature. We describe the case of a 75-year-old Caucasian male who developed the syndrome after a right pneumonectomy for down-staged squamous cell lung cancer previously treated with neoadjuvant platinum-based chemotherapy and radiotherapy.

An infrared spectroscopic study of aortic valve. A possible mechanism of calcification and the role of magnesium salts

In the present study fourier transform infrared (FT-IR) spectroscopy was used to study the mechanism of pathogenesis of aortic valve calcification. The high intensity bands of vCH3 and vCH2 groups of lipids and phospholipids of membranes, in the spectral region 3000-2800 cm(-1), show the high concentration of lipids and fatty components in aortic valve, resulting from degradation of the main aliphatic chain of the membranes, with a change of their permeability and fluidity. The presence of bands at 3075 and 1744 cm(-1), assigned to olefinic (v=CH) and aldehyde carbonyl groups, respectively, implies that reactive oxygen species are involved in the initiation of peroxidation of the lipids and phospholipids. These latter bands are related to the oxidative stress of the patients. From the shifts of bands to lower frequencies of the characteristic absorption bands of amide I and amide II, it is suggested that the proteins change their secondary structure from α-helix to β-sheets and random coil due to modifications of collagen, associated with the permeability of aortic valve atherosclerosis. From the spectral region 1150-900 cm(-1), where the characteristic stretching vibration bands of the phosphate groups (vPO4(-3)) absorb, the calcified aortic valve was found to contain biological hydroxyapatite (Ca10(PO4)6(OH)2), as well as amorphous hydroxyapatite (Ca5(PO4)xOH) and CaHPO4. These findings are in agreement with scanning electron microscopy energy-dispersive X-ray analysis and X-ray diffraction analyses. SEM micrographs show that the valves are rich in fibrils and that the protein-protein cross-linked chemical bonds seem to be the points of initiation of calcification.