vitamin-b-12 and Dilatation--Pathologic

This article reports a case of a 59-year-old male who suffered from left brachial plexopathy occurring at night in bed. He had experienced multiple surgical courses of thyroid tumor resection including neck dissection and had presented left secondary jugular phlebectasia Jugular phlebectasia is mainly congenital and sometimes secondarily induced by compression, mechanical ventilation, trauma, thrombosis, etc. Brachial plexopathy is usually caused by neck and arm trauma, additionally caused by iatrogenic nerve and vessel injury. To our knowledge, this is the first report of brachial plexopathy accompanied by ipsilateral jugular phlebectasia. We hypothesized the etiology of this case through multimodal examinations and reviewed the literature about jugular phlebectasia and brachial plexopathy.

Topics: Brachial Plexus Neuropathies; Diagnostic Imaging; Dilatation, Pathologic; Humans; Jugular Veins; Male; Middle Aged; Physical Therapy Modalities; Postoperative Complications; Thyroid Neoplasms; Vitamin B 12

Topics: Adrenergic beta-Antagonists; Calcium Channel Blockers; Coronary Artery Disease; Dilatation, Pathologic; Diltiazem; Female; Folic Acid; Homocysteine; Humans; Male; Metoprolol; Middle Aged; Treatment Outcome; Vitamin B 12

Brachial artery flow-mediated dilation (BAFMD) has been proposed as a measurement of the degree and severity of cardiovascular disease. The purpose of this study was to (1) evaluate the associations between BAFMD and homocysteine, folate, vitamin B(12), vitamin B(6); (2) examine the influence of 5,10-methylenetetrahydrofolate reductase (MTHFR) genotypes on homocysteine levels and BAFMD; and (3) evaluate the effect of homocysteine on the baseline diameter of the vessel vs BAFMD. A total of 174 healthy research subjects were examined for BAFMD, homocysteine, folate, vitamin B(12), vitamin B(6), and MTHFR genotype, nucleotide 677 C-->T. The data indicated a significant inverse correlation between homocysteine and BAFMD (r = -0.1763, P = .02). There was a significant difference in BAFMD between MTHFR genotype groups (P = .01) (T/T vs C/C, P = .042; C/C vs C/T, P = .13; T/T vs C/T, P = .003). Homocysteine was significantly associated with the baseline brachial artery diameter (r = 0.1878, P = .013). The data confirmed a significant inverse correlation between baseline diameter and BAFMD (r = -0.3321, P = .0001). Regression analysis indicated that the MTHFR genotype, homocysteine, and age were significant predictors of BAFMD (P = .0001, r(2) = 0.118). When the baseline brachial diameter was incorporated into the model, the effect of homocysteine on BAFMD disappeared. The present data indicate an association between homocysteine and BAFMD and reduced BAFMD in individuals with the MTHFR nucleotide 677 T/T genotype, despite similar blood values for folate and homocysteine. Finally, the data suggest that the effect of homocysteine on vascular reactivity is in part a consequence of its influence on baseline brachial artery diameter.

Topics: 5,10-Methylenetetrahydrofolate Reductase (FADH2); Aged; Brachial Artery; Cardiovascular Diseases; Dilatation, Pathologic; DNA; Female; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Multivariate Analysis; Point Mutation; Polymerase Chain Reaction; Ultrasonography; Vitamin B 12; Vitamin B 6

Hyperhomocysteinemia is recognized as an independent risk factor for arterial disease including coronary artery disease, cerebrovascular disease and peripheral vascular disease. Previously, an association between increased plasma homocysteine level and peripheral arterial aneurysms has been reported. However, the relationship between coronary artery ectasia (CAE) and plasma homocysteine level has not been investigated. Accordingly, this study was designed to investigate plasma homocysteine level in patients with isolated CAE.. Thirty-two patients with isolated CAE without significant stenosis and 30 control subjects with angiographically normal coronary arteries were included in this study. Fasting plasma homocysteine concentrations were measured by Fluorescence Polarization Immunoassay method using homocysteine kids. Hyperhomocysteinemia is defined as plasma homocysteine levels above the 95th percentile of the control subjects (13.6 mumol/l).. According to the definition of hyperhomocysteinemia, 19 (59%) of patients with isolated CAE had elevated levels of plasma homocysteine compared to 2 (7%) in the control subjects with angiographically normal coronary arteries (p<0.001). In addition, patients with isolated CAE had significantly higher levels of plasma homocysteine compared to control subjects (14.9+/-4.5 micromol/l vs. 8.6+/-1.9 micromol/l respectively, p<0.001). Besides, we detected a significant positive correlation between the number of ectasic segment and plasma homocysteine level (r=0.537, p=0.002).. We have shown for the first time an association between elevated plasma homocysteine level and isolated CAE. Larger prospective studies are needed to confirm the role of hyperhomocysteinemia in CAE and to evaluate the usefulness of homocysteine-lowering therapies.

Topics: Biomarkers; Case-Control Studies; Coronary Angiography; Coronary Artery Disease; Dilatation, Pathologic; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Male; Middle Aged; Prospective Studies; Vitamin B 12