Biomedical subjects

L W van Laake

Publications and source records attributed to L W van Laake.

3 recordsLinked to original sources

PubMed2006

[Stress echocardiography in 11 patients with symptoms of ischemia and a myocardial bridge: no indication of a causal connection in 10 cases].

OBJECTIVE: To determine whether in patients with a myocardial bridge, systolic compression of the affected coronary branch may cause cardiac ischaemia and is of clinical relevance. DESIGN: Pilot inventory. METHOD: In 11 consecutive patients with an established myocardial bridge who presented with possible ischaemic symptoms angiographic dobutamine stress-echocardiography was used to visualize hypokinesia caused by ischaemia in the area ofmyocardium supplied by the bridged artery. RESULTS: Hypokinesia was observed in the area supplied by the bridged artery in one of the patients (9%). The symptoms in the other patients were not associated with the bridge. CONCLUSION: The clinical relevance of myocardial bridging appeared to be smaller than is generally assumed. In patients with known myocardial bridging and symptoms that could be caused by myocardial ischaemia, it should first be established that the bridge is actually causing the ischaemia before any therapeutic intervention aimed at the bridge is undertaken.

Coronary Vessels↗

PubMed2006

[Progress and clashes in stem cell therapy research].

The concept of stem cell therapy, the repair of damaged or diseased tissue by transplantation of healthy cells, is deceptively simple. This simplicity has led to the hype among desperate patients, their doctors and the media: it would seem that every ailment can be treated with stem cells. At this time, however, the scientific truth is mostly disappointing. The recent claim from Korea of a major breakthrough - the ability to grow stem cells from cloned embryos - turned out to be fraudulent. With the exception ofapplications in haematologic diseases, skin wounds, and bone and cartilage diseases, most of the putative therapeutic applications of stem cell therapy are still under preclinical investigation. These include the treatment of Parkinson's and Alzheimer's disease, paraplegia, cerebral infarction, amyotrophic lateral sclerosis, multiple sclerosis and muscular dystrophy. The treatment of cardiac infarction is currently being investigated in clinical trials.

Clinical Trials as Topic↗

PubMed2005

Systemic dilation diathesis in patients with abdominal aortic aneurysms: a role for matrix metalloproteinase-9?

INTRODUCTION: Accumulating evidence suggests that patients with abdominal aortic aneurysm (AAA) suffer from a systemic dilating condition affecting all arteries. Matrix metalloproteinases (MMPs) and their natural inhibitors, the tissue inhibitors of metalloproteinases (TIMPs), appear to be involved in aneurysm formation, as evidenced by increased aortic tissue MMP activity and plasma MMP levels in patients with AAA. Hypothesizing that an imbalance in plasma MMP/TIMP level might be associated with a systemic dilation diathesis, we studied mechanical vessel wall properties of non-affected arteries of patients with either AAA or aorto-iliac obstructive lesions in association with plasma MMP-9 and TIMP-1 levels. METHODS: Twenty-two patients with AAA and 12 with aorto-iliac occlusive disease (AOD) were included. Diastolic diameter (d) and distension (Deltad) were measured at the level of the common carotid artery (CCA) and suprarenal aorta (SA) using ultrasonography. Distensibility (DC) and compliance (CC) were calculated from d, Deltad and brachial pulse pressure. Plasma MMP-9 and TIMP-1 were determined with specific immunoassays. RESULTS: The average (+/-SD) age was 72.3+/-5.6 and 65.0+/-8.2 years for the AAA and AOD patients, respectively, (P=0.005). CCA diameter was 9.1+/-1.3mm in AAA patients and AOD 7.8+/-1.4mm in AOD patients, P=0.009. This difference persisted after correction for age. Plasma MMP-9 and TIMP-1 did not differ significantly between AAA and AOD patients. In the total 34 patients, the MMP-9/TIMP-1 ratio was correlated inversely with distensibility (r=-0.74, P=0.002) and to compliance (r=-0.58, P=0.024) of the suprarenal aorta. CONCLUSIONS: The CCA diameter was larger in AAA patients compared to AOD patients. MMP-9/TIMP-1 ratio was associated with decreased distensibility and compliance of the suprarenal aorta. These data support the idea that AAA patients exhibit a systemic dilation diathesis, which might be attributable to MMP/TIMP imbalances.

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