This case report we presented is that the anomalous left main coronary artery (LMCA) originates from the proximal segment of right coronary artery. In order to confirm the origin and course of the anomalous LMCA, a multi-slice computed tomography (MSCT) of the heart was performed on a 64-slice machine (Philips 64 Slice, Philips, USA) after 6 months of coronary angiography operation. The results showed that the anomalous LMCA originates from the proximal segment of right coronary artery, lies posteriorly to the aorta before taking acute sharply to go between the aorta and left atrium. It was classified as R-II P subtype according to Lipton’s classification. It is a rare case in the clinical practice.
Aged ; Coronary Vessel Anomalies ; diagnosis ; Coronary Vessels ; pathology ; Humans ; Male

Advanced atherosclerosis is often associated with dystrophic calcification and remodeling of extracellular matrix of vascular wall. Recently many studies have documented a general relationship between calcification and severity of coronary disease, and discussed the feasibility of electron beam computed tomography for detecting and quantifying the coronary artery calcification in the patients. The present study investigated the expression and the localization of osteopontin, one of noncollagenous bone matrix protein, within the calcified coronary arteries. Autopsy-derived coronary artery specimens were scanned and reconstructed to visualize the pattern of coronary calcification using a novel microscopic computed tomography technique. The localization of the osteopontin were evaluated by immunohistochemial stain with LF7. The present study showed that the pattern of coronary calcification is variable and the expression of osteopontin is localized mainly to calcified lesion. The smooth muscle cells in addition to macrophage expressed osteopontin protein in human coronary atherosclerotic plaques. Soluble osteopontin released near to the sites of vascular calcification may represent an adaptive mechanism aimed at regulating the process of vascular calcification.
Aged ; Calcinosis/metabolism ; Coronary Arteriosclerosis/pathology* ; Coronary Arteriosclerosis/metabolism* ; Coronary Vessels/pathology* ; Coronary Vessels/metabolism ; Coronary Vessels/chemistry* ; Female ; Human ; Immunohistochemistry ; Male ; Middle Age ; Sialoglycoproteins/biosynthesis ; Sialoglycoproteins/analysis*

Background: Kawasaki is an acute fever disease with systematic vein infection and often seen in children.Objectives:This study aims to determine features and risk factors of coronary artery lesion (CAL) in Kawasaki disease in children. Subjects and method:A descriptive, prospective study was conducted on 83 patients diagnosed with Kawasaki disease whom treated at National Hospital for Pediatric from January 2005 to March 2007. They were divided into 2 groups: with and without CAL. All data from clinical characteristics, laboratory and echocardiography were analyzed to evaluate the differences between 2 groups. Univariate and multivariate analysis were used. Results: Among 83 patients diagnosed with Kawasaki disease, 27 patients (32.5%) was found with CAL. 24 patients (88.9%) had both right and left coronary artery abnormalities. The CAL in left anterior descending (LAD) and in left circumflex coronary artery (LCX) was 55.6% and 25.9% respectively. Risk level II: 7 patients (25.9%). Risk level III: 14 patients (51.9%) and risk level IV: 6 patients (22.2%). 14 patients (51.9%) with CAL were resolved at 6th month of the illness. Independent risk factors of CAL in acute stage included age under 12 months (OR = 3.97, p<0.05). IVIG treatment was within the first 10 day of the illness (OR=0.25, p<0.05). Non - responsiveness to \u03b3globulin therapy (OR=7.69, p<0.01). CRP before starting initial treatment above 90mg/1 (OR = 12.81, p<0.05). Platelets before starting \u03b3 globulin therapy ~ 557 000/ mm3 with OR=4.73 and p<0.05. Conclusion:Early detection and treatment were necessary in order to decrease CAL in patients with Kawasaki disease.
Mucocutaneous Lymph Node Syndrome/ diagnosis ; pathology ; Coronary Vessels/ pathology ; Child

Aged ; Coronary Artery Disease ; diagnosis ; Coronary Vessel Anomalies ; diagnosis ; Coronary Vessels ; pathology ; Humans ; Male

In the preoperative evaluation before coronary artery bypass surgery, review of the coronary arteriogram is the most important step. Expected "normal" lumen diameter at a given coronary anatomic location is a basis for quantative estimation of coronary disease severity that could be more useful than the traditional "percent stenosis". The distribution and number of major coronary artery branches are determinants of number of bypass grafts needed. We reviewed the coronary artery anatomy in 174 adult patients who revealed no coronary pathology in angiographic studies done from September 1994 to June 1996. Quantative analysis was done in all cases by a single person using a Computerized System (Arripro 35(r)). The results were follows; 1) The mean diametre of left main coronary artery was 4.45 mm (range 2.74~6.72). The pattern of branching was bifurcation in 67.24%, trifurcation in 28.74% and quadrifurcation in 4.02% of the patients. 2) The mean diametre of left anterior descending artery was 3.17 mm (range 2.10~5.85), 2.79 (range 1.55~5.59) and 2.17 mm (range 1.37~3.81) in the proximal, mid, and the distal portions, respectively. The number of diagonal branches of left anterior artery was from one to four (mode=2). 3) The mean diametre of proximal and distal left circumflex artery were 3.17mm (range 1.74~4.89) and 2.19 mm (range 1.21~4.46). The number of obtuse marginal branches of left circumflex artery is from one to six (mode 2). 4) The mean diametre of proximal and distal right coronary artery, the posterior descending artery and the largest posterolateral branch were mean 3.51 mm (range 2.07~5.67), 2.09 mm (range 1.42~3.60), 2.09 mm (range 1.02~3.60) and 2.30 mm (range 1.39~4.39). 5) The right coronary artery dominant was 163 cases (93.68%) of the total 174 cases. 6) The large significant acute marginal artery was visualized in more than half of the people.
Adult ; Arteries ; Computer Systems ; Coronary Artery Bypass ; Coronary Disease ; Coronary Vessels ; Humans ; Pathology* ; Single Person ; Transplants

Bronchopulmonary Sequestration ; diagnosis ; Coronary Vessels ; pathology ; Humans ; Male ; Middle Aged

Animals ; Arteritis ; complications ; immunology ; Coronary Artery Disease ; etiology ; pathology ; Coronary Vessels ; pathology ; Models, Animal ; Rabbits

Vulnerable plaques is the hot spot in the researching field of cardiovascular diseases. In this paper, literature about establishment of experimental vulnerable plaques model animals published recent years were briefly reviewed and introduced concretely the conception, significance of researching, histopathologic characteristics of various types model, model assessment and current status of research.
Animals ; Coronary Artery Disease ; pathology ; Coronary Vessels ; pathology ; Disease Models, Animal ; Mice ; Mice, Inbred C57BL

OBJECTIVETo investigate the feasibility and safety in treatment of coronary bifurcation lesions with 6F-guiding catheter by transradial approach.

METHODSClinical data of 1258 patients who were treated with 6F-guiding catheter by transradial approach from Oct. 2003 to Feb. 2007 were reviewed. The most common approach in the treatment of bifurcations was one-stent technique on the main branch; if the side branch was large enough and the lesion was involved in the ostium and proximal part of side branch, two-stent technique was used.

RESULTOf 295 bifurcation lesions, 204 were originally planed to be treated by one stent; but finally 2 side branches were provisional stented due to dissection in this group. Ninety-one cases were planed to use double-stent technique: 73 with crushing stent (46 step crushing, 24 modified balloon crushing, 3 reverse crushing), 5 with T-stent, 3 with Cullote-stent, 5 with modified V-stent, 5 with step kissing stent. There was no acute myocardial infarction or death occurred but 1 case was complicated with cardiac tamponade secondary from coronary perforation.

CONCLUSIONThe treatment of coronary bifurcation lesions with 6F-guiding catheter by transradial approach is a feasible and safe procedure.

Angioplasty, Balloon, Coronary ; methods ; Coronary Angiography ; Coronary Artery Disease ; therapy ; Coronary Vessels ; pathology ; Female ; Humans ; Male ; Radial Artery ; Stents

BACKGROUNDIn the case of hypertension, lesions in the microvessels of the target organs precede and deteriorate further after arteriosclerosis in the small arteries. Thus coronary microvascular lesion (CML) was considered the crucial factor contributing to damage to the target organs. The purpose of this study is to observe the characteristics and differences of CML in autopsies of elderly patients with essential hypertension (EHT), coronary heart disease (CHD), or EHT with CHD, given the same degree of left ventricular wall thickness (LVWT).

METHODSA retrospective study was performed on 246 cases of patients over 60 years old with EHT, CHD, or EHT with CHD, and on 26 cases without cardiovascular disease as controls, out of a total of 3195 consecutive autopsied cases. The arterioles (with diameter 10 - 60 microm) and the capillaries in the cardiac muscle layer were examined by haematoxylin and eosin staining, elastic van Gieson staining, and CD31 immunohistochemistry. To quantify CML severity, measurements were taken of arteriole density (AD), the ratio of wall-to-lumen area of arteriole (RWL), and capillary density (CD), using light microscopy and computer image analysis. Based on LVWT, the cases were divided into four degrees, from I to IV. The EHT, CHD, and EHT with CHD groups all rated LVWT I-IV, and the control group rated LVWT I. SAS software was used for statistical analysis.

RESULTSWith the aggravation of LVWT, both AD and RWL increased while CD decreased significantly in the EHT group (P < 0.05 - 0.0001); there were similar but more severe changes in the EHT with CHD group (P < 0.001 - 0.0001); and AD increased (P < 0.001) while RWL and CD did not change significantly in the CHD group.

CONCLUSIONComparing EHT with CHD patients, there are similar patterns of change to AD, but different patterns of change to RWL and CD. CML is much more severe in EHT patients with CHD. We conclude that CML is one of the main causes of decreased coronary flow reserve and myocardial damage in both EHT patients and EHT patients with CHD.

Aged ; Autopsy ; Coronary Disease ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Hypertension ; pathology ; Male ; Microcirculation ; pathology ; Middle Aged ; Retrospective Studies