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Meng-Luen Lee,Ming-Yuh Chang,Tung-Ming Chang,Rei-Cheng Yang,Ming-Che Chang,Albert D. Yang 대한의학회 2018 Journal of Korean medical science Vol.33 No.10
Concurrent involvement of bilateral renal and cerebral arteries, usually incurred as stenosis is rare in childhood-onset Takayasu arteritis (c-TA). We report the case of a 14-year-old girl, with c-TA, presenting with transient ischemic attack after endovascular revascularization for renal artery stenosis and cerebrovascular stroke after surgical revascularization for cerebral artery stenosis associated with childhood-onset moyamoya syndrome. We deem th decrease of blood pressure by endovascular revascularization and improvement of cerebral perfusion by surgical revascularization may have jeopardized the cerebral deep watershed zone to cerebral ischemia followed by cerebral hyperperfusion syndrome and caused transient ischemic attack and cerebrovascular stroke in our patient. Revascularization could be a double-edge sword for c-TA patients presenting with concomitant renal artery stenosis and cerebral artery stenosis, and should be performed with caution. Quantitative analysis of cerebral blood flow by brain magnetic resonance imaging and angiography should be performed within 48 hours after surgical revascularization in c-TA.
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Increased Serum Cathepsin K in Patients with Coronary Artery Disease
Xiang Li,Lan Cui,Yuzi Li,Jiyong Jin,Dehao Jin,Xiangshan Li,Yanna Rei,Haiying Jiang,Guangxian Zhao,Guang Yang,Enbo Zhu,Yongshan Nan,Xianwu Cheng 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.4
Purpose: Cathepsin K is a potent collagenase implicated in human and animal atherosclerosis-based vascular remodeling. This study examined the hypothesis that serum CatK is associated with the prevalence of coronary artery disease (CAD). Materials and Methods: Between January 2011 and December 2012, 256 consecutive subjects were enrolled from among patients who underwent coronary angiography and percutaneous coronary intervention treatment. A total of 129 age-matched subjects served as controls. Results: The subjects’ serum cathepsin K and high sensitive C-reactive protein (hs-CRP) and high-density lipoprotein cholesterolwere measured. The patients with CAD had significantly higher serum cathepsinK levels compared to the controls (130.8±25.5 ng/mL vs. 86.9±25.5 ng/mL, p<0.001), and the patients with acute coronary syndrome had significantly higher serum cathepsin K levels compared to those with stable angina pectoris (137.1± 26.9 ng/mL vs. 102.6±12.9 ng/mL, p<0.001). A linear regression analysis showed that overall, the cathepsin K levels were inversely correlated with the high-density lipoprotein levels (r=-0.29, p<0.01) and positively with hs-CRP levels (r=0.32, p<0.01). Multiple logistic regression analyses shows that cathepsin K levels were independent predictors of CAD (odds ratio, 1.76; 95% confidence interval, 1.12 to 1.56; p<0.01). Conclusion: These data indicated that elevated levels of cathepsin K are closely associated with the presence of CAD and that circulating cathepsin K serves a useful biomarker for CAD.
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