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Histologic differences between the ascending and descending aortas in young adults with fibrillin-1 mutations.

Fibrillin-1 突变的年轻人升主动脉和降主动脉之间的组织学差异。

  • 影响因子:1.52
  • DOI:10.1016/j.jtcvs.2019.01.126
  • 作者列表:"Seike Y","Minatoya K","Matsuda H","Ishibashi-Ueda H","Morisaki H","Morisaki T","Kobayashi J
  • 发表时间:2020-04-01
Abstract

OBJECTIVES:This study aimed to review the clinical results of young adult patients with aortic disease associated with mutations in the fibrillin-1 gene (FBN1) and disclose the histologic differences between the ascending and descending aortas. METHODS:Between 2012 and 2015, 94 patients aged less than 50 years underwent surgery for thoracic aortic diseases. Forty-two patients (44.7%) had FBN-1 mutations. Of these, 40 patients (42.5%) with surgical specimens for histologic evaluation were included in the study. With the histologic results including the specimen sampled at their previous operations, cystic medial necrosis was classified into 3 grades according to the degree of the cystic area. RESULTS:Thirty-nine patients (97.5%) had aortic root dilatation (Z ≥2), and 13 patients (32.5%) had ectopia lentis. Thirty-nine patients (97.5%) fulfilled the diagnostic criteria for Marfan syndrome. There were no in-hospital deaths. The majority (27/29: 93.1%) of the specimens of the ascending aorta revealed cystic medial necrosis pattern. With grade III being the most severe condition, these cases were classified into grade I (n = 2), grade II (n = 5), and grade III (n = 20). In contrast, only 6 specimens (6/17: 35.3%) of the descending aorta showed a cystic medial necrosis pattern that was classified into grade I (n = 2) and grade III (n = 4), (P < .00001). CONCLUSIONS:Fewer specimens of the descending aorta revealed cystic medial necrosis compared with those of the ascending aorta. This difference might influence the characteristic aortic disease in Marfan syndrome associated with FBN-1 mutations.

摘要

目的: 本研究旨在回顾与fibrillin-1 基因 (FBN1) 突变相关的年轻成人主动脉疾病患者的临床结果,揭示升主动脉和降主动脉之间的组织学差异。 方法: 在 2012 和 2015 之间,94 例年龄小于 50 岁的患者接受了胸主动脉疾病的手术。42 例患者 (44.7%) 有FBN-1 突变。其中,40 例 (42.5%) 手术标本用于组织学评估的患者被纳入研究。根据包括既往手术标本在内的组织学结果,根据囊性区域的程度将囊性内侧坏死分为 3 级。 结果: 39 例 (97.5%) 有主动脉根部扩张 (Z ≥ 2),13 例 (32.5%) 有异位。39 例 (97.5%) 符合马凡综合征诊断标准。没有住院死亡病例。大多数 (27/29: 93.1%) 的升主动脉标本显示囊性内侧坏死模式。III级是最严重的情况,这些病例分为I级 (n = 2) 、II级 (n = 5) 和III级 (n = 20)。相比之下,只有 6 个标本 (6/17: 35.3%) 的降主动脉显示囊性内侧坏死模式,分类为I级 (n = 2) 和 ⅲ 级 (n = 4),(P <.00001)。 结论: 与升主动脉相比,降主动脉显示囊性内侧坏死的标本较少。这种差异可能影响与FBN-1 突变相关的马凡综合征的特征性主动脉疾病。

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影响因子:2.42
发表时间:2020-02-01
DOI:10.1007/s12011-019-01715-5
作者列表:["Heidar Z","Hamzepour N","Zadeh Modarres S","Mirzamoradi M","Aghadavod E","Pourhanifeh MH","Asemi Z"]

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影响因子:2.42
发表时间:2020-02-01
DOI:10.1007/s12011-019-01720-8
作者列表:["Jamilian M","Foroozanfard F","Kavossian E","Kia M","Aghadavod E","Amirani E","Asemi Z"]

METHODS::The primary aim of our study was to determine the influence of taking chromium plus carnitine on insulin resistance, with a secondary objective of evaluating the influences on lipid profiles and weight loss in overweight subjects with polycystic ovary syndrome (PCOS). In a 12-week randomized, double-blind, placebo-controlled clinical trial, 54 overweight women were randomly assigned to receive either supplements (200 μg/day chromium picolinate plus 1000 mg/day carnitine) or placebo (27/each group). Chromium and carnitine co-supplementation decreased weight (- 3.6 ± 1.8 vs. - 1.0 ± 0.7 kg, P < 0.001), BMI (- 1.3 ± 0.7 vs. - 0.3 ± 0.3 kg/m2, P < 0.001), fasting plasma glucose (FPG) (- 5.1 ± 6.0 vs. - 1.1 ± 4.9 mg/dL, P = 0.01), insulin (- 2.0 ± 1.4 vs. - 0.2 ± 1.2 μIU/mL, P < 0.001), insulin resistance (- 0.5 ± 0.4 vs. - 0.04 ± 0.3, P < 0.001), triglycerides (- 18.0 ± 25.2 vs. + 5.5 ± 14.4 mg/dL, P < 0.001), total (- 17.0 ± 20.3 vs. + 3.6 ± 12.0 mg/dL, P < 0.001), and LDL cholesterol (- 13.3 ± 19.2 vs. + 1.4 ± 13.3 mg/dL, P = 0.002), and elevated insulin sensitivity (+ 0.007 ± 0.005 vs. + 0.002 ± 0.005, P < 0.001). In addition, co-supplementation upregulated peroxisome proliferator-activated receptor gamma (P = 0.02) and low-density lipoprotein receptor expression (P = 0.02). Overall, chromium and carnitine co-supplementation for 12 weeks to overweight women with PCOS had beneficial effects on body weight, glycemic control, lipid profiles except HDL cholesterol levels, and gene expression of PPAR-γ and LDLR. Clinical trial registration number: http://www.irct.ir: IRCT20170513033941N38.

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囊肿方向

囊肿是一种良性疾病,它可以长在人体表面,也可以长在内脏里;囊肿就是长在体内某一脏器、囊状的良性包块,其内容物的性质是液态的。

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