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Kollberg, S. Torbjörnsson, E. (2012). The lived experience in patients with screening-diagnosed abdominal aortic aneurysm (AAA).     ABSTRACT The aim of this study was to describe the patients’ experiences of living with the knowledge of having an abdominal aortic aneurysm (AAA) that was found during screening. Eleven patients from two different screening centers, with initially measured aneurysms of 40-46 mm, were invited to participate in the interview study. Three of the men declined to participate, so in total eight men were interviewed. The interviews were analyzed by qualitative content analysis.  Four categories were identified: the informant’s reasons for taking part in the screening program for abdominal aortic aneurysm, the experience of the screening, the experience of living with their abdominal aortic aneurysm and the thoughts on the present screening program. The result showed that the men joined the screening program (SCP) with very little knowledge of both aneurysms and the purpose of the screening. In connection with the ultrasound the men became upset over the information about them having an AAA. After they had received information about the diagnose from the vascular surgeon , all of the men felt soothed and understood that despite of their aneurysm, they could continue to live their life as they used to do. The men didn’t believe that the AAA affected their lives, though most of them had made changes in their way of living.   The result of this interview study shows that the men experience a lack of information between the ultrasound and the appointment with the physician. It could be of interest to investigate if an aortic nurse with the same function as the breast nurse in the mammography screening could be the solution of this problem.   Keywords: Abdominal Aortic Aneurysm, screening, information / Kollberg, S. Torbjörnsson, E. (2012). The lived experience in patients with screening-diagnosed abdominal aortic aneurysm (AAA).   SAMMANFATTNING Syftet med den här studien var att beskriva patienternas upplevelse av att leva med kunskapen av att ha en förstorad kroppspulsåder som är hittat via screening. Elva patienter från två olika screeningcenter, med en ursprunglig diameter på sin aorta uppmätt till 40 – 46 mm, bjöds in för deltagande i studien. Tre avböjde att delta, så totalt utfördes åtta intervjuer. Intervjuerna analyserades med kvalitativ innehållsanalys. Fyra kategorier identifierades: Informanternas anledning till att delta i screeningprogrammet, upplevelsen av screeningen, upplevelsen av att leva med AAA och patienternas tankar om det nuvarande screeningprogrammet. Resultatet visade att männen deltog i screeningsprogrammet (SCP) med en begränsad kunskap både om vad aneurysm är och vad syftet med screeningen är. I samband med ultraljudsundersökningen blev männen upprörda över beskedet att de har ett förstorat aneurysm, men efter besöket hos en kärlkirurg som gav information om diagnosen blev de lugnade och förstod att det går bra att fortsätta leva som vanligt trots deras diagnos. Männen i studien tyckte inte att diagnosen påverkade de i deras dagliga liv, trots att många av dem hade genomfört förändringar. Resultatet av den här studien visar att männen upplever en brist i informationen mellan ultraljudsundersökningen och besöket hos läkaren. Det skulle vara intressant att se om en aortasjuksköterska, med samma funktion som en bröstsjuksköterska inom mammografiscreeningen har, skulle kunna vara en lösning på problemet.   Nyckelord: Abdominellt aorta aneurysm, screening, information   Abstraktet är justerat efter instruktioner i Journal of Vascular Nursing

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Diss. (sammanfattning) Linköping : Linköpings universitet, 2004. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1963. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Made available in DSpace on 2014-06-11T19:22:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2003Bitstream added on 2014-06-13T19:08:21Z : No. of bitstreams: 1 mello_fmc_me_botfm.pdf: 590394 bytes, checksum: 6bd49179dbdb5496cc2a8f6a9ebad2ed (MD5) / Com o objetivo de avaliar a ocorrência de aneurisma da aorta abdominal infra-renal (AAAIR), estudou-se uma amostra da população masculina do Município de Marília, com idade igual ou acima de 50 anos, no período de 2000 a 2002. Foram avaliados 240 homens por meio da ultrasonografia abdominal (USAb), com média de idade de 65,1 anos (±9,8 anos). A aorta abdominal foi medida no sentido ânteroposterior (AP) e látero-lateral (LL) aproximadamente a 2cm abaixo da artéria mesentérica superior (AMS) e 2cm acima de sua bifurcação. O critério utilizado para considerar aneurisma foi o maior diâmetro encontrado igual ou maior que 3,1cm. Também por questionário, foram avaliados os fatores de risco (tabagismo, sedentarismo, alimentação) e as doenças associadas (HAS, DPOC, IM, DM, AOP ou hiperlipidemia). Nos 240 homens, foram encontrados 11 aneurismas, sendo, portanto, a freqüência de 4,6%. Desses 11 aneurismas, 8 mediam entre 3,1 e 4cm (72,7%) e 3, entre 4,1 e 5cm (27,3%). O maior diâmetro da aorta aneurismática foi de 5 cm (sentido AP a 2cm abaixo da AMS). Foi encontrada uma associação significativa entre aneurisma e AOP e DM, não ocorrendo o mesmo com os demais fatores de risco ou outras doenças associadas. A freqüência de aneurisma encontrada em nossa amostra não foi diferente da referida nos estudos populacionais publicados na literatura, o que mostra a importância da doença em nosso meio, e os indivíduos com AOP e DM têm risco maior de desenvolver a doença. / In order to evaluate the occurrence of Infra-Renal Abdominal Aortic Aneurysm (AAAIR), a sample of the male population in the city of Marília aged 50 years or older was studied from 2000 to 2002. A group of 240 men with mean age of 65,1 years (±9,8 years) was evaluated through abdominal ultra-sonography examination. The abdominal aorta was measured in the anteroposterior (AP) and in the latero-lateral directions (LL) approximately 2cm below the superior mesenteric artery and 2cm above its bifurcation. The largest diameter equal or larger than 3.1cm found was the criterion used for aneurysm. Risk factors such as smoking, eating, and exercise habits and associated diseases (systemic arterial hypertension, chronic obstructive pulmonary disease, myocardial infarction, diabetes mellitus, occlusive peripheral arterial disease, or hyperlipidemia) were also evaluated through questionnaires. Eleven aneurysms were found in the 240 men, which meant a frequency of 4,6%. Out of these 11 aneurysms, 8 measured from 3.1 to 4cm (72,7%) and 3 measured from 4.1 to 5cm (27,3%). The largest diameter of the aneurysmatic aorta was 5cm (AP direction approximately 2cm of the superior mesenteric artery). A significant association between aneurysm and peripheral vascular disease and diabetes mellitus was found. The same did not occur with the other risk factors or other associated diseases. The frequency of aneurysm found in our sample was not different from the frequency mentioned in population studies published in the literature, which shows the importance of the disease in our environment and that patients with peripheral vascular disease and diabetes mellitus have a higher risk to develop the disease.

Abstract Fibrillar type I and III collagens are the major constituents of the extracellular matrix, providing the tissue with tensile strength and influencing cell attachment and migration. The amount of type III collagen and the extent of its processing and cross-link maturation were studied in human atherosclerotic plaques, abdominal aortic aneurysms, colon and ovarian cancer, and finally, colon diverticulosis, using a novel radioimmunoassay for the cross-linked aminoterminal telopeptide of type III collagen. In addition, immunoassays for different structural domains of type I and type III collagens, together with immunohistochemical methods, were applied. In atherosclerotic plaques, the fully cross-linked type III collagen was the major collagen type. Type III collagen was completely processed, since the amount of type III pN-collagen was negligible. The amounts of free type I and III procollagen propeptides in the soluble fraction were small, indicating a low rate of collagen turnover. The proportion of type III collagen was lower in abdominal aortic aneurysms than in atherosclerotic aortic control samples. Furthermore, the amount of type III pN-collagen was significantly increased in aneurysms. Type I and III collagens were also maturely cross-linked in colon diverticulosis, the only difference from normal colon tissue being the increased amount of the aminoterminal propeptide of type III procollagen in the soluble tissue extract, indicating a slightly increased metabolic activity of type III collagen. In malignant ovarian tumors, the cross-linking of type I and III collagens was defective. A similar trend was also seen for type I collagen in colon cancer. Even though procollagen synthesis was increased in these malignancies, the total collagen content and the amounts of cross-linked collagens were decreased. The amount of type III pN-collagen was increased in malignant ovarian tumors, whereas no such tendency was seen in colon cancer. These findings suggest a wide variety of changes in the metabolism of type I and III collagens in diseases. Defective processing and cross-link maturation of these collagen types might result in impaired fibril formation or increased susceptibility of collagens to proteolytic attack - both of them processes with a potential role in the pathogenesis of diseases.

Ho Siu-ying, Salina. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 51-59). / Abstract and appendix in English and Chinese. / List of Tables --- p.v / List of Figures --- p.vi / Introduction --- p.1 / Method --- p.10 / Results --- p.15 / Discussion --- p.42 / References --- p.51 / Appendices --- p.60

Aortic aneurysm is a complex disease manifesting in a localized dilation of the aorta developing over years and carries with it a significant chance of rupture resulting in death. As only surgical methods are currently available for treatment, there is a need to understand the underlying mechanisms of the disease and how they develop and lead to expansion and rupture. Thus, the study of the formation and progression of aneurysm has also focused on quantifying any changes observed in fiber realignment and altered mechanical properties leading to vascular disease. Animal models of aneurismal disease can be useful for studying alterations during disease development (e.g., in the tissue's mechanical response). Recent efforts have been aimed at determining both the biomechanical alterations that occur with aneurysm formation and their potential for rupture. However, previous animal model work is lacking quantitative descriptions of how biomechanical response and vessel remodeling change with time and lead to the diseased state. Thus, there is a need for determining an appropriate animal model for aneurysm and developing an adequate method for quantifying and determining disease progression through alterations in biomechanical response.

Les anévrysmes de l'aorte abdominale sont retrouvés chez 5 à 9 % de la population après l'âge de 65 ans, et la rupture de ces anévrysmes cause chaque année au moins 15000 décès. Bien que la plupart soient petits et asymptomatiques, typiquement leur diamètre s'accroît avec le temps et environ 60% finissent par nécessiter une réparation chirurgicale. A ce jour, aucune thérapeutique ne permet de ralentir ou de stopper la croissance des petits anévrysmes. La paroi anévrysmale est caractérisée par une inflammation chronique et un remodelage du tissu conjonctif associant synthèse et destruction qui conduisent à l'appauvrissement de la paroi en élastine. Tous ces éléments sont présents dans le modèle d'anévrysme à l'élastase chez la souris. Alors que de nombreuses données ont été accumulées sur l'implication des metalloprotéinases dans la dégradation de la matrice extracellulaire, le rôle des serines protéases a reçu beaucoup moins d'intérêt. En utilisant le modèle d'anévrysme à l'élastase chez les souris cathepsine S et cathepsine C knockout, nous avons montré que leur présence était indispensable au développement anévrysmal. Nous avons également montré qu'il était possible de bloquer le modèle au moyen d'un inhibiteur des cathepsines, l'E64. L'ensemble de nos travaux semblent montrer que les cathepsines jouent un rôle prépondérant dans la phase d'initiation de la réaction inflammatoire et que les cathepsines sont une voie de recherche potentielle pour le développement de traitements médicamenteux pouvant ralentir la croissance des AAAs. / Abdominal aortic aneurysms occur in 5-9% of the population over the age of 65, and rupture of these aneurysms cause every year at least 15,000 deaths. Although most AAAs are small and asymptomatic, their diameter typically increases over time and about 60% eventually require surgical repair. To date, no therapy can slow or stop the growth of small aneurysms. The aneurysmal wall is characterized by chronic inflammation and tissue remodeling involving synthesis and destruction that leads to the loss of elastin. All these elements are present in the elastase model of aneurysm in mice. While many data have been accumulated on the involvement of metalloproteinases in the degradation of the extracellular matrix, the role of serine proteases has received much less interest. Using this model in mice cathepsin S and cathepsin C knockout, we have shown that their presence was essential for aneurysmal development. We also showed that it was possible to block the model using E64, an inhibitor of cathepsins. Taken together these data suggest that cathepsins play a role in the initiation of the inflammatory reaction and that cathepsins are a potential way of research for the development of medication which could slow down the AAAs growth. In order to block by pharmacological means the model, we developed the possibility to infuse doxycyline directly on the aneurysm. These studies showed that it was possible to block the model with an infusion of local doxycycline without blood levels of doxycycline. This experimental work opens the way for the development of drug-eluting stent graft, i.e. a stent graft able to infuse an active product which can stabilize the wall of the aneurysm.