Effect of a saline flush technique for head and neck imaging in dual-energy CT: improvement of image quality and perivenous artefact reduction using virtual monochromatic imaging.

AIM: To evaluate the effect of the saline flush (SF) technique on the depiction of lesions and the reduction of perivenous artefacts in the head and neck region using dual-energy computed tomography (CT) with virtual monochromatic imaging (VMI). MATERIALS AND METHODS: Fifty patients with head and neck cancer were divided into two groups: group A, without a SF and group B, with a 30-ml SF. All images were acquired using fast kilovolt-switching CT (Revolution HD, GE Healthcare, Milwaukee, WI, USA). Contrast-to-noise ratios (CNRs) of the lesions were calculated at VMI energy levels ranging from 40 to 80 keV. Subjective analysis of overall image quality, delineation of lesions, and perivenous artefacts was conducted by two reviewers at both VMI energy level 40 keV and the optimal energy level (which showed optimal CNR by objective analysis). RESULTS: Optimal energy level was 63 keV for group A and 61 keV for group B. At VMI energy levels ranging from 40 to 80 keV, the CNR was higher for group B. The highest subjective overall image quality was shown for group B at the optimal energy level (subjective image quality mean value, 3.40). Subjective delineation of lesions was comparable. The perivenous artefact score was significantly higher for group B (2.44 versus 2.74 [p<0.05] at 40 keV, 3.20 versus 3.46 [p<0.05] at the optimal energy level). CONCLUSION: The SF technique results in an improvement of lesion CNR and a reduction of perivenous artefacts in VMI using duel-energy CT, especially at 40 keV.

Telaprevir impairs renal function and increases blood ribavirin concentration during telaprevir/pegylated interferon/ribavirin therapy for chronic hepatitis C.

We aimed to examine the relationship between renal dysfunction and anaemia that may develop during combination therapy involving pegylated interferon, ribavirin and telaprevir (PEG-IFN/RBV/TVR) for the treatment of chronic hepatitis C. Sixty-eight patients with genotype 1b high viral loads were treated with PEG-IFN/RBV/TVR. Peg-IFN and RBV doses were administered according to body weight. TVR was prescribed at 2250 mg/day for 44 patients and at 1500 mg/day for 24 patients who had low haemoglobin level (<12 g/dL). When anaemia had developed, the RBV dose was decreased. The serum TVR concentration at day 8 was measured, and the serum RBV concentration was measured serially. The estimated glomerular filtration rate (eGFR) was estimated to assess renal function. At week 1, serum TVR concentration was not correlated with a decrease in eGFR; however, the TVR dose, on a weight basis (mg/kg), and eGFR were correlated (r = 0.2691; P = 0.0265). Moreover, there was a negative correlation between eGFR and RBV serum concentration (r = −0.3694; P = 0.0025), and the serum RBV concentration and decrease in the haemoglobin were significantly correlated from week 1 to week 8. In triple therapy, the TVR dose per weight is correlated with a decline in renal function. Thus, the serum concentration of RBV increases, with a concomitant decrease in haemoglobin. It is important to adjust the doses of TVR and RBV to avoid excessive serum RBV levels and the development of severe anaemia, to achieve a good clinical effect.

Phase control of a z-current-driven plasma column.

A dynamic mitigation is presented for sausage and kink instability growths of a z-current-driven magnetized plasma column. In this Rapid Communication we found that a wobbling motion of the z-current electron axis induces a phase-controlled perturbation, so that the growths of the sausage and kink instabilities are successfully and remarkably mitigated. In general, plasma instabilities emerge from perturbations, and the perturbation phase is normally unknown. However, if the perturbation phase is known or actively imposed by, for example, a designed driver wobbling behavior, the instability growth would be controlled and mitigated by a superimposition of the perturbations imposed. The results in this Rapid Communication demonstrate that the wobbling z-current electron beam would provide an improvement in the plasma column stability and uniformity.

96Zr beam production for isobar experiment in relativistic heavy ion collider.

To investigate the chiral magnetic effect, 96Zr and 96Ru beams were accelerated at the relativistic heavy ion collider (RHIC) during Run-18 at Brookhaven National Laboratory. The 96Zr beam was provided from the electron beam ion source (EBIS) injector, which consists of a laser ion source, an EBIS high charge state ion breeder, a 300 keV/u radio frequency quadrupole, and a 2 MeV/u interdigital H type drift tube linear accelerator (IH-DTL). The natural abundance of 96Zr is only 2.8% with about 50% of 90Zr. To obtain a sufficient beam current, Zr material enriched to about 60% of 96Zr was used. The only available form of the enriched material was zirconium oxide (ZrO2) powder, which was not well suited for a laser ion source target. We studied and established a sintering technique of the ZrO2 powder to make a solid sample which could be installed into the laser ion source. The singly charged Zr was produced in a laser ablation plasma, extracted, and delivered to the EBIS to be ionized further to 96Zr16+. We optimized the laser irradiation condition, the EBIS confinement time, and transport through the RF linacs to maximize the performance of the injector. The total number of shots provided from the laser ion source for injection into the EBIS was 489 910. The EBIS facility provided a 192 MeV stable beam of 96Zr16+ ions to the booster ring of alternating gradient synchrotron (AGS) for further acceleration and stripping in the AGS/RHIC complex, allowing for successful data acquisition at the Solenoidal Tracker at the RHIC.

Non-uniformity smoothing of direct-driven fuel target implosion by phase control in heavy ion inertial fusion.

We have proposed a dynamic smoothing method based on a phase control to smooth plasma non-uniformities in perturbed plasma systems. In this paper, the dynamic smoothing method is applied to a spherical direct-driven fuel target implosion in heavy ion inertial confinement fusion. We found that the wobbling motion of each heavy ion beam (HIB) axis induces a phase-controlled HIBs energy deposition, and consequently the phase-controlled implosion acceleration is realized, so that the HIBs irradiation non-uniformity is successfully smoothed. HIB accelerators provide a well-established performance to oscillate a HIB axis at a high frequency. In inertial confinement fusion, a fuel implosion uniformity is essentially significant for achieving the DT fuel compression and for releasing the fusion energy, and the non-uniformity of the implosion acceleration should be less than a few %. The results in this paper demonstrate that the wobbling HIBs would provide an improvement in the fuel target implosion uniformity.

Stimulation of Fe(2+)-induced lipid peroxidation in phosphatidylcholine liposomes by aluminium ions at physiological pH.

The effects of aluminium ions on Fe(2+)-induced lipid peroxidation in egg yolk phosphatidylcholine liposomes were examined under various conditions. The degree of Fe(2+)-induced lipid peroxidation of the liposomes was dependent on pH of the reaction mixture: pH 5.0 > pH 7.4. However, Fe2+ did not induce lipid peroxidation in the liposomes at pH 9.0. The addition of AlCl3 to the liposomal suspension resulted in a marked stimulation of Fe(2+)-induced liposomal peroxidation at pH 7.4, depending on the concentration of AlCl3. On the other hand, Fe3+, Cu2+, Pb2+, Cd2+ and Cr6+ did not induce lipid peroxidation in the liposomes at pH 7.4 regardless of the presence and absence of AlCl3. Fe3+ enhanced Fe(2+)-induced liposomal peroxidation at pH 7.4 but is unrelated to the stimulatory effect of AlCl3. In the absence of AlCl3, Fe(2+)-induced liposomal peroxidation was observed after a lag phase of about 15 min. The lag phase of the reaction was shortened by the addition of AlCl3 in a dose-dependent fashion. The shortening of the lag phase was also observed by the decrease of Fe2+ concentration or by the co-presence of Fe3+ in the reaction mixture. In addition, it was found that AlCl3 stimulates Fe2+ disappearance and Fe3+ formation. The addition of AlCl3 to the liposomal suspension at pH 7.4 resulted in a marked increase of the turbidity of the suspension. On the other hand, the turbidity of the liposomal suspension at pH 5.0 did not change by the addition of AlCl3.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of aluminum ion on Fe(2+)-induced lipid peroxidation in phospholipid liposomes under acidic conditions.

The effects of Al3+ on Fe(2+)-induced lipid peroxidation in phospholipid liposomes consisting of phosphatidylcholine (PC) and phosphatidylserine (PS) were examined under acidic conditions. The stimulatory effect of Al3+ on Fe(2+)-induced lipid peroxidation in the liposomes showed a biphasic response against pH variation, and the maximum stimulation was observed around pH 6.0. In addition, it was found that the stimulatory effect of Al3+ on the lipid peroxidation was dependent on the proportion of PS in the liposomes. On the other hand, the lipid peroxidation in PC liposomes was not stimulated by the addition of Al3+. From these findings, it is suggested that the Al3+ effect on Fe(2+)-induced lipid peroxidation under acidic conditions is largely dependent on the phospholipid composition. Trivalent cations such as Tb3+ and Ga3+ also stimulated Fe(2+)-induced lipid peroxidation in PC/PS liposomes under acidic conditions, but divalent cations (Zn2+ and Mn2+) showed no stimulatory effect. The extents of Fe2+ disappearance and Fe3+ formation during the reaction were enhanced by the addition of Al3+ or Ga2+, but Tb3+ had no effect on Fe2+ disappearance. The results with 1,6-diphenyl-1,3,5-hexatriene (DPH) showed that the fluorescence anisotropy of DPH-labeled PC/PS liposomes under acidic conditions was increased by the addition of Al3+. Furthermore, there is a relation between the extents of the fluorescence anisotropy of the complex and TBARS production. In contrast, the fluorescence anisotropy of DPH molecules embedded in PC liposomes was not changed by the addition of Al3+. Based on these results, a possible mechanism of the stimulatory effect of Al3+ on Fe(2+)-induced lipid peroxidation under acidic conditions is discussed.

Flow patterns and preferred sites of intimal thickening in end-to-end anastomosed vessels.

BACKGROUND: Fluid mechanical factors are suspected to be involved in the pathogenesis and localization of intimal hyperplasia in anastomosed vessels. However, no direct correlation has been established between the flow and the exact sites of intimal hyperplasia. Hence we have studied the relationship between the flow and preferred sites of wall thickening in 90-degree- and 45-degree-cut and end-to-end anastomosed vessels. METHODS: Twenty-five 90-degree and twenty-five 45-degree end-to-end anastomoses were performed on the femoral arteries of 17 adult mongrel dogs. The vessels were harvested at 3 months after operation, fixed at 100 mm Hg, dehydrated with ethanol, and rendered transparent by immersing them in methyl salicylate. Exact locations and sizes of intimal thickening and characteristics of the flow prevailing at sites of anastomoses were studied in detail by means of flow visualization and cinemicrographic techniques. RESULTS: It was found that a perfect correlation exists between the preferred sites of intimal thickening and the regions of slow recirculation flows with low wall shear stresses. In both 90-degree and 45-degree anastomosed vessels, intimal thickening developed only in those vessels in which formation of slow recirculation flows was observed. It was also found that although a pronounced and localized intimal thickening developed in 45-degree anastomosed vessels, the degree of circumferential constriction caused by both surgical procedures and development of intimal thickening was much milder in 45-degree than 90-degree anastomosed vessels. CONCLUSIONS: The results suggest that key hemodynamic factors involved in the localization of intimal thickening in end-to-end anastomosed vessels are low velocity of flowing blood and the resultant low shear stresses acting on the vessel wall.

Flow through a venous valve and its implication for thrombus formation.

To elucidate the possible connection between the flow patterns in the pockets of venous valves and thrombus formation, detailed studies of the behavior of model particles and red cells flowing through a venous valve have been carried out using isolated transparent dog saphenous veins containing two-leaflet valves, and cinemicrographic techniques. It was found that large paired vortices, located symmetrically on both sides of the bisector plane of the valve leaflets, were present in each valve pocket under physiological flow conditions. Particles continually entered the valve pockets from the mainstream, spending long periods of time describing a series of spiral orbits of decreasing diameter, while moving away from the bisector plane, and eventually left the vortex, rejoining the mainstream. With concentrated suspensions of red cells, it was found that another smaller counter-rotating secondary vortex, driven by the large primary vortex existed deep in each valve pocket. The concentration of red cells in this secondary vortex remained appreciably lower than that in the mainstream. In such regions, fluid circulated with extremely low velocities, thus creating a very low shear field which allowed red cells to form aggregates. The results suggest that in some pathological states, the valve-pocket vortices could act as automatic traps and generators of thrombi in a fashion similar to that previously demonstrated in an annular vortex formed downstream from a sudden tubular expansion.

p38 MAPK and Ca2+ contribute to hydrogen peroxide-induced increase of permeability in vascular endothelial cells but ERK does not.

To examine the involvement of p38 mitogen-activated protein kinase (p38 MAPK) and extracellular signal-regulated kinase (ERK) in the oxidative stress-induced increase of permeability in endothelial cells, the effects of a p38 MAPK inhibitor (SB203580) and ERK inhibitor (PD90859) on the H2O2-induced increase of permeability in bovine pulmonary artery endothelial cells (BPAEC) were investigated using a two-compartment system partitioned by a semi-permeable filter. H2O2 at 1 mM caused an increase of the permeation rate of fluorescein isothiocyanate (FITC)-labeled dextran 40 through BPAEC monolayers. SB203580 inhibited the H2O2-induced increase of permeability but PD98059 did not, though activation (phosphorylation) of both p38 MAPK and ERK was observed in H2O2-treated cells in Western blot analysis. An H2O2-induced increase of the intracellular Ca2+ concentration ([Ca2+]i) was also observed and an intracellular Ca2+ chelator (BAPTA-AM) significantly inhibited the H2O2-induced increase of permeability. However, it showed no inhibitory effects on the H2O2-induced phosphorylation of p38 MAPK and ERK. The H2O2-induced increase of [Ca2+]i was not influenced by SB203580 and PD98059. These results indicate that the activation of p38 MAPK and the increase of [Ca2+]i are essential for the H2O2-induced increase of endothelial permeability and that ERK is not.

Flow patterns at the major T-junctions of the dog descending aorta.

Using a novel technique developed in our own laboratory, an isolated transparent arterial segment containing the whole descending aorta and its four major branches was prepared from a dog. The flow patterns at each aortic T-junction were studied in detail under the conditions of steady flow by means of flow visualization and cinemicrographic techniques. It was found that a standing recirculation zone consisting of a pair of thin-layered spiral secondary flows located symmetrically about the common median plane of the aorta and side branches was formed at each T-junction over a wide range of flow conditions including the time-averaged estimated mean values of physiological flow rates and flow rate ratios. The results support the recent in vivo findings by other investigators that flow reversal occurs at some junctions of the dog abdominal aorta during each cardiac cycle. The flow patterns at the aortic T-junctions were very much similar to those previously observed in various glass model T-junctions. However, due to the particular anatomical structure of the vessel wall at each branching site (the curvature of the wall was very sharp at the flow divider, but gently rounded at the bend opposite to it) no recirculation zone was formed in the side branches. At a given flow rate ratio, the measured critical Reynolds numbers for the formation of spiral secondary flows and fully developed disturbed flows were much higher in aortic T-junctions than those in glass model T-junctions having equivalent branching angles and diameter ratios. These results indicate that, in the circulation, conditions at arterial T-junctions appear to be optimal for minimizing the formation of disturbed flows.

Computational study on the evolution of an intraventricular vortical flow during early diastole for the interpretation of color M-mode Doppler echocardiograms.

A computational fluid dynamics study of intraventricular flow during early diastole was carried out using a 3D model of the human left ventricle (LV). It was found that a vortical flow formed under the aortic orifice and then grew in size and extended laterally along the ventricular wall towards the posterior side. With further expansion of the LV, it developed into an annular vortex asymmetrically enlarged on the side of the aortic orifice, narrowing the passage of blood inflow and thus causing a shift of the high-velocity portion of inflow towards the apex. This appeared as an elongation of the aliasing area when the velocity of the inflow was expressed as a spatiotemporal map in the same manner as a color M-mode Doppler (CMD) echocardiogram. Based on these findings, it was concluded that the shape of the aliasing area in a CMD echocardiogram shows the change in the velocity of blood inflow affected by the development of an annular vortex formed in the LV.

Microscopic structure of disturbed flows in the arterial and venous systems, and its implication in the localization of vascular diseases.

A novel technique to prepare isolated transparent natural blood vessels was developed and used to investigate the connection between blood flow and the localization of vascular diseases in man. Transparent segments of arteries and veins were prepared from dogs and humans postmortem, and the flow patterns in various regions of the circulation were studied in detail by means of flow visualization and cinemicrographic techniques. It was found that under normal physiological conditions, complex spiral secondary flows and recirculation zones form in various regions of the arterial and venous systems such as the aortic arch, aortic T-junctions, carotid artery bifurcations, the major branching sites of the intracranial cerebral arteries and venous valve pockets. Incipient saccular aneurysms were found at the flow divider of the anterior communicating-anterior cerebral artery junction where the flow directly impinged on the vessel wall. In human cerebral arteries, atherosclerotic thickenings of the vessel wall were found to be localized on the outer wall (hip) of one or both daughter vessels at bifurcations and T-junctions, and at the inner wall of arterial bends, at the very places where secondary and recirculation flows were dominant and wall shear stress was low. The results clearly indicate that there is a strong correlation between the sites of flow disturbance and the preferred sites for the genesis and development of vascular diseases clinically found in man.

Theoretical study of the effect of local flow disturbances on the concentration of low-density lipoproteins at the luminal surface of end-to-end anastomosed vessels.

To elucidate the mechanisms of localisation of intimal hyperplasia in anastomosed arteries, the effects of flow disturbances on the transport of low-density lipoproteins (LDLs) from the flowing blood to the wall of end-to-end anastomosed arteries, with and without a moderate stenosis, were studied theoretically by means of a computer simulation under the condition of steady flow. In an artery with moderate stenosis at the anastomotic junction and intimal thickening distal to it, we found that, owing to the water-permeable nature of the arterial wall, the surface concentration of LDL was elevated up to 20% higher than that of the bulk flow distal to the stenosis, where a recirculation zone was formed and wall shear stresses were low. In contrast to this, no significant elevation of surface concentration of LDLs occurred in another anastomosed vessel in which no stenosis was formed and no intimal thickening was observed. These results suggest that flow-dependent concentration polarisation of LDLs plays a causative role in the localisation of anastomotic intimal hyperplasia in the human arterial system by locally elevating the surface concentration of LDLs, thus augmenting their uptake by endothelial cells.

Effect of flow disturbances remaining at the beginning of diastole on intraventricular diastolic flow and colour M-mode Doppler echocardiograms.

A computational model of the fluid dynamics of intraventricular flow was used to investigate the importance of the effects of flow disturbances existing within the left ventricle (LV) at the onset of diastole on a diastolic flow field. The simulation started with a quiescent flow state; it continued for a number of cardiac cycles to obtain a cyclically repeatable flow. After the flow became periodic, the initial diastolic flow was not quiescent: flow disturbances, remnants of a systolic flow, were present within the LV. Nevertheless, they faded away during an acceleration phase of diastole and almost ceased by the end of this phase. Consequently, a flow field during a deceleration phase of diastole, characterised by the formation of a vortex ring, was hardly affected by the initial flow disturbances. The propagation velocity of a colour M-mode Doppler echocardiogram obtained by scanning velocity along the LV long axis was 0.58 m s(-1) in the case where diastolic flow was initially quiescent and 0.56 m s(-1) in the case where flow disturbances existed at the beginning of diastole. These results indicated that the colour M-mode Doppler echocardiographic technique captures flow dynamics produced purely by ventricular expansion, with little influence from initial diastolic flow disturbances.

Visualization of flow-dependent concentration polarization of macromolecules at the surface of a cultured endothelial cell monolayer by means of fluorescence microscopy.

To substantiate the occurrence of flow-dependent concentration or depletion of atherogenic lipoproteins, which has been theoretically predicted to take place at a blood/endothelium boundary, we have studied the effects of perfusion pressure and wall shear rate on the accumulation and uptake of microspheres by cultured vascular endothelial cells in a monolayer. The study was carried out by flowing a cell culture medium containing fetal calf serum and fluorescent microspheres through a parallel-plate flow chamber having a cultured bovine aortic endothelial cell (BAEC) monolayer on one wall of the chamber. The microspheres had a nominal diameter of 19 nm, approximately the same as that of low-density lipoproteins, and thus served as models and tracers of plasma proteins and lipoproteins. Experiments were carried out in steady flow in the physiological range of wall shear rate and water filtration velocity at the monolayer, while monitoring the intensity of fluorescence of the spheres accumulated at and taken up by the endothelial cells. It was found that in a perfusate containing only fluorescent microspheres, due to increased phagocytic activity of the endothelial cells, the intensity of fluorescence which reflected the number of the microspheres taken up by the endothelial cells, increased almost linearly with time and independently of wall shear rate. However, with perfusates containing fetal calf serum, this abnormal phenomenon did not occur, and the intensity of fluorescence increased with increasing perfusion pressure and decreasing wall shear rate. It was also found that the number of fluorescent microspheres accumulated at and taken up by the BAEC monolayer was shear-dependent only at low wall shear rates, and increased sharply when the flow rate was reduced to zero. These results provided solid experimental evidence that flow-dependent concentration or depletion of macromolecules occurs at the luminal surface of the endothelium at physiological wall shear rates and water filtration velocities, and strongly supports the hypothesis that flow-dependent concentration polarization of lipoproteins plays an important role in the localization of atherosclerosis and intimal hyperplasia in man by facilitating the uptake of atherogenic lipoproteins by endothelial cells.

Flow visualization in isolated transparent natural blood vessels.

A novel technique to prepare isolated transparent natural blood vessels was developed and used to study the detailed flow patterns in some regions of the circulation. It was found that paired spiral secondary flows and recirculation zones form downstream of venous valves, at the arterial T-junctions in the dog abdominal aorta, and in the human carotid sinus over a wide range of geometrical and flow conditions, including the time-averaged mean values of the physiological flow rates.

Theoretical study on flow-dependent concentration polarization of low density lipoproteins at the luminal surface of a straight artery.

It is suspected that physical and fluid mechanical factors play important roles in the localization of atherosclerotic lesions and intimal hyperplasia in man by affecting the transport of cholesterol in flowing blood to arterial walls. Hence, we have studied theoretically the effects of various physical and fluid mechanical factors such as wall shear rate, diffusivity of low density lipoproteins (LDL), and filtration velocity of water at the vessel wall on surface concentration of LDL at an arterial wall by means of a computer simulation of convective and diffusive transport of LDL in flowing blood to the wall of a straight artery under conditions of a steady flow. It was found that under normal physiologic conditions prevailing in the human arterial system, due to the presence of a filtration flow of water at the vessel wall, flow-dependent concentration polarization (accumulation or depletion) of LDL occurs at a blood/endothelium boundary. The surface concentration of LDL at an arterial wall takes higher values than that in the bulk flow in that vessel, and it is affected by three major factors, that is, wall shear rate, gamma w, filtration velocity of water at the vessel wall, Vw, and the distance from the entrance of the artery, L. It increases with increasing Vw and L, and decreasing gamma w hence the flow rate. Thus, under certain circumstances, the surface concentration of LDL could rise locally to a value which is several times higher than that in the bulk flow, or drop locally to a value even lower than a critical concentration for the maintenance of normal functions and survival of cells forming the vessel wall. These results suggest the possibility that all the vascular phenomena such as the localization of atherosclerotic lesions and intimal hyperplasia, formation of cerebral aneurysms, and adaptive changes of lumen diameter and wall structure of arteries and veins to certain changes in hemodynamic conditions in the circulation are governed by this flow-dependent concentration polarization of LDL which carry cholesterol.

Flow-dependent concentration polarization of plasma proteins at the luminal surface of a semipermeable membrane.

The effect of steady shear flow on concentration polarization of plasma proteins and lipoproteins at the luminal surface of a semipermeable vessel wall was studied experimentally using suspensions of these molecules in a cell culture medium and a semipermeable membrane dialysis tube which served as a model of an implanted vascular graft or an artery. The study was carried out by flowing a cell culture medium containing fetal calf serum or bovine plasma lipoproteins or bovine albumin through a 7.5 mm diameter, 60 mm-long dialysis tube in steady flow under a physiologic mean arterial perfusion pressure of 100 mmHg, and measuring the filtration velocity of water (cell culture medium) at the vessel wall which varied as a consequence of the change in concentration of plasma protein particles at the luminal surface of the semipermeable membrane dialysis tube. It was found that for perfusates containing plasma proteins and/or lipoproteins, filtration velocity of water was the lowest in the absence of flow, and it increased or decreased as the flow rate (hence wall shear rate) increased or decreased from a certain non-zero value, indicating that surface concentration of protein particles varied reversibly as a direct function of flow rate. It was also found that at particle concentrations equivalent to those found in a culture medium containing serum at 5% by volume, plasma lipoproteins which were much smaller in number and lower in concentration but larger in size than albumin, had a much larger effect on the filtration velocity of water than albumin. These findings were very much the same as those previously obtained with a cultured endothelial cell monolayer, strongly suggesting that the flow-dependent variation in filtration velocity of water at a vessel wall results from a physical phenomenon, that is, flow-dependent concentration polarization of low density lipoproteins at the luminal surface of the endothelial cell monolayer.

Role of blood cell-wall interactions in thrombogenesis and atherogenesis: a microrheological study.

The relationship between blood flow and the localization of thrombosis and atherosclerosis in vivo was investigated using the approach and techniques of microrheology. The flow patterns and wall-adhesion of platelets were studied in the captive annular vortex formed at a sudden tubular expansion at various hematocrits in steady and pulsatile flow. The adhesion density exhibited a peak within the vortex and just downstream of the reattachment point, which is also a stagnation point. The peaks flattened out with increasing Reynolds number in steady flow and also in pulsatile flow. Platelet adhesion increased markedly with increasing hematocrit. The localization of adhesion peaks was explained by curvature of the streamlines carrying platelets to the wall on either side of the reattachment point. The relevance of these results to the circulation is that stagnation points are found in regions of disturbed flow at various sites in the arterial and venous circulations. This was shown in experiments using a technique whereby flow was visualized in isolated transparent natural blood vessels prepared from dogs and humans postmortem. In dog saphenous vein bileaflet valves, there was a large primary spiral vortex as well as a smaller secondary vortex, the latter acting as a trap and generator of thrombi. Recirculation zones also existed in the dog aorta at T-junctions of the celiac, cranial mesenteric and renal arteries. Finally, in the human carotid bifurcation, a large standing recirculation zone consisting of spiral secondary flows formed in the carotid sinus at physiological flow conditions.(ABSTRACT TRUNCATED AT 250 WORDS)