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Coronary stenting of nonaorto ostial coronary lesions is challenging because of plaque shift into the main vessel, triggering the use of additional stents.
Previous studies of gingival plaque showed that as gingivitis develops, the microbial constituents of subgingival plaque shift from a population dominated by Gram-positive streptococci to one with elevated levels of Gram-negative anaerobes such as Actinobacillus, Capnocytophaga, Campylobacter, Eikenella, Fusobactrium and Prevotella [ 2, 12, 13].
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To improve the treatment of nonaorto ostial coronary lesions with a novel interventional technique, we tested the hypothesis that inflating a balloon in the main vessel before stenting the side branch (stent pull-back technique) will limit plaque shifting and reduce the use of additional stents.
Digital plaques shift between description of opossums and survivors, pointing to ways the comparison is both useful and problematic.
Lesions are difficult to locate, Lowering of resting pH, Increased volume of dental plaque, Rapid shift in bacterial flora [6] [8].
Increased caries risk during the treatment is due to several factors: Lesions are difficult to locate, Lowering of resting pH, Increased volume of dental plaque, Rapid shift in bacterial flora [6] [8].
In the same study, SMC and collagen content were increased, reflecting a shift in plaque composition towards a stable phenotype.
Accordingly, we hypothesized that the loss of TIMP-2 in mice might result in heightened monocyte/macrophage MMP-14 activity, facilitating macrophage accumulation within atherosclerotic lesions and thereby provoking the detrimental shift in plaque composition.
Moreover, young mouse model harboring a mutation favoring generation of Aβ 1-42 over Aβ 1-40 had a low Aβ 40/42 ratio, was shifted to plaque deposition [ 45].
The dramatic shift in brachiocephalic plaque composition towards vulnerability caused by deletion of TIMP-2 accords with a previous study, which intimated that overexpression of exogenous TIMP-2 favourably affects plaque phenotype, possibly through modulation of macrophage behaviour.
More recently, the research focus has shifted away from plaque formation to earlier events in disease progression such as the deregulation of genes whose impact on disease is still largely unknown [9].
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