A coronary-pulmonary artery fistula with giant aneurysmal dilatation is an extremely rare clinical constellation.The natural course of this disease and the incidence of complications are unknown.Hence,optimal treatmen...A coronary-pulmonary artery fistula with giant aneurysmal dilatation is an extremely rare clinical constellation.The natural course of this disease and the incidence of complications are unknown.Hence,optimal treatment,particularly in asymptomatic patients,is still a matter of debate.Here we report a case of a 71-year-old asymptomatic woman with a diastolic murmur.Comprehensive cardiovascular assessments including cardiac computed tomography and invasive coronary angiography revealed a coronary-pulmonary artery fi stula with giant aneurysmal dilatation.The patient was managed conservatively and has now been followed up for 5 years without any events.展开更多
A 43-year-old woman with recurrent atypical angina underwent invasive coronary angiography including intracoronary Doppler blood flow assessment and coronary spasm provocation testing.While obstructive epicardial dise...A 43-year-old woman with recurrent atypical angina underwent invasive coronary angiography including intracoronary Doppler blood flow assessment and coronary spasm provocation testing.While obstructive epicardial disease could be ruled-out angiographically,the patient experienced reproduction of her angina symptoms after intracoronary administration of acetylcholine(100μg)during spasm provocation testing.Simultaneously,the ECG showed new-onset ST-segment depression in the absence of epicardial spasm.In addition,coronary fl ow velocity was signifi cantly reduced after acetylcholine compared to the baseline condition.Following intracoronary administration of nitroglycerine(200μg),the patient’s symptoms as well as the ECG changes and coronary flow reduction were reversed.Considering the ongoing challenges in appropriate evaluation of the pathophysiological mechanisms of coronary microvascular dysfunction,simultaneous intracoronary Doppler flow measurement during spasm testing–as shown in this case–may provide objective evidence for microvascular spasm in addition to the standardized diagnostic criteria,especially if they are ambiguous.展开更多
The objective of this study was to investigate expression profiles of genes involved in the immune responses in the head kidney,as well as stress response-related genes in the pituitary in juvenile koi carp after expo...The objective of this study was to investigate expression profiles of genes involved in the immune responses in the head kidney,as well as stress response-related genes in the pituitary in juvenile koi carp after exposure to an acute positive(feed reward)or negative cue(air exposure).Both,the head kidney and the pituitary transcriptome analysis,revealed distinct gene expression patterns in fish subjected to the different treatments.Notably,expression changes of genes with the greatest impact on the fish's stress status were identified,emphasizing their role in stress perception and immune regulation related to stress.This allows the identification of promising candidates for further investigations.Additionally,the application of ElasticNet regression enabled,with high accuracy,the classification of stimulus presence,absence and valence,based on the gene expression patterns,representing a novel and valuable tool for transcript analysis in stressed fish.To our knowledge,the ElasticNet regression was used for the first time in such an application.These findings further confirm the differential perception and response of fish to negative and positive stimuli,offering insights into the complex interplay between stress and immune responses.展开更多
文摘A coronary-pulmonary artery fistula with giant aneurysmal dilatation is an extremely rare clinical constellation.The natural course of this disease and the incidence of complications are unknown.Hence,optimal treatment,particularly in asymptomatic patients,is still a matter of debate.Here we report a case of a 71-year-old asymptomatic woman with a diastolic murmur.Comprehensive cardiovascular assessments including cardiac computed tomography and invasive coronary angiography revealed a coronary-pulmonary artery fi stula with giant aneurysmal dilatation.The patient was managed conservatively and has now been followed up for 5 years without any events.
基金This work was funded by the Robert Bosch Stiftung,Stuttgart,Germany,and the Berthold Leibinger Stiftung,Ditzingen,Germany.
文摘A 43-year-old woman with recurrent atypical angina underwent invasive coronary angiography including intracoronary Doppler blood flow assessment and coronary spasm provocation testing.While obstructive epicardial disease could be ruled-out angiographically,the patient experienced reproduction of her angina symptoms after intracoronary administration of acetylcholine(100μg)during spasm provocation testing.Simultaneously,the ECG showed new-onset ST-segment depression in the absence of epicardial spasm.In addition,coronary fl ow velocity was signifi cantly reduced after acetylcholine compared to the baseline condition.Following intracoronary administration of nitroglycerine(200μg),the patient’s symptoms as well as the ECG changes and coronary flow reduction were reversed.Considering the ongoing challenges in appropriate evaluation of the pathophysiological mechanisms of coronary microvascular dysfunction,simultaneous intracoronary Doppler flow measurement during spasm testing–as shown in this case–may provide objective evidence for microvascular spasm in addition to the standardized diagnostic criteria,especially if they are ambiguous.
基金supported by the Bridge program(project no.40B2-0_180864)through the Swiss National Science Fonds(SNSF)and the Innosuisse.
文摘The objective of this study was to investigate expression profiles of genes involved in the immune responses in the head kidney,as well as stress response-related genes in the pituitary in juvenile koi carp after exposure to an acute positive(feed reward)or negative cue(air exposure).Both,the head kidney and the pituitary transcriptome analysis,revealed distinct gene expression patterns in fish subjected to the different treatments.Notably,expression changes of genes with the greatest impact on the fish's stress status were identified,emphasizing their role in stress perception and immune regulation related to stress.This allows the identification of promising candidates for further investigations.Additionally,the application of ElasticNet regression enabled,with high accuracy,the classification of stimulus presence,absence and valence,based on the gene expression patterns,representing a novel and valuable tool for transcript analysis in stressed fish.To our knowledge,the ElasticNet regression was used for the first time in such an application.These findings further confirm the differential perception and response of fish to negative and positive stimuli,offering insights into the complex interplay between stress and immune responses.
