Causal Relationship between Celiac Stenosis and Pancreaticoduodenal Artery Aneurysm: Interpretation by Simulation Using an Electric Circuit.

Pancreaticoduodenal artery (PDA) aneurysm and celiac artery (CA) stenosis are rare diseases in themselves. Interestingly, however, there are more cases documented in the literature in which these two disease entities occurred together than could be coincidental, and CA stenosis has been suggested as the provocative condition in developing PDA aneurysm. This study is aimed at examining the causal relationship between CA stenosis and PDA aneurysm by simulating the splanchnic circulation with an electric circuit. A patient with multiple PDA aneurysms and collaterals with CA stenosis was treated in our institution using hybrid techniques. The patient's pre- and postoperative status was simulated using an electric circuit, and the two possible scenarios were tested for compatibility: the stenosis-first scenario vs. the aneurysm-first scenario. The simulation was performed in two ways: using Simulink® software (MATLAB® Release 2018b) and actual circuit construction on a breadboard. The stenosis-first scenario showed that as the CA stenosis progresses, the blood flow through PDA increases, favoring the development of an aneurysm and/or collaterals if the artery was already compromised by a weakening condition. On the other hand, the aneurysm-first scenario also showed that if the aneurysm or collaterals developed first, the aneurysm will steal the blood flow through the CA, causing it to collapse if the artery was already compromised by increased wall tension. Contrary to the common belief, this study showed that in patients suffering from concurrent CA stenosis and PDA aneurysm, either condition could develop first and predispose the development of the other. The simulation of splanchnic blood flow with an electric circuit provides a useful tool for analyzing rare vascular diseases that are difficult to provoke in clinical and animal studies.

Trombo flotante de aorta torácica y trombosis venosa esplácnica: a propósito de 2 casos / Floating thoracic aortic thrombus and splanchnic vein thrombosis: A presentation of 2 cases

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Age-related disappearance of the inhibitory effect of vascular endothelium on agonist-induced vasoconstriction in rat mesenteric vascular beds.

We previously reported that endothelium-derived hyperpolarizing factor (EDHF)-mediated response time-dependently suppressed methoxamine-induced vasoconstriction in mesenteric vascular beds isolated from 8-week-old rats. We investigated age-related changes in endothelial regulation of methoxamine-induced vasoconstriction. Mesenteric vascular beds isolated from young (8-week-old) to adult (16-week-old) rats were perfused, and changes in perfusion pressure induced by continuous perfusion of methoxamine or high KCl (60 mM) were measured over 180 min. In young preparations with intact endothelium, methoxamine-induced vasoconstriction time-dependently decreased to 20% of the initial levels, while time-dependent reduction was not observed in adult preparations. High KCl-induced vasoconstriction in young and adult preparations did not show time-dependent reduction. Endothelium removal abolished time-dependent reduction of methoxamine-induced vasoconstriction in young preparations and significantly attenuated vasoconstriction in adult preparations. Indomethacin, seratrodast, or tempol but not catalase significantly reduced methoxamine-induced vasoconstriction in adult preparations with endothelium. A23187 (Ca(2+)-ionophore)-, but not acetylcholine-, induced endothelium-dependent vasodilation in the presence of N(G)-L-nitro arginine methyl ether in adult preparations was significantly smaller than that in young preparations. These findings suggest that the inhibitory effect of mesenteric vascular endothelium on methoxamine-induced vasoconstriction disappears with aging by reducing EDHF and increasing endothelium-derived contracting factors and reactive oxygen species.

Differentiated hemodynamic changes controlled by splanchnic nerve.

The splanchnic (SPL) nerve is a postganglionic sympathetic nerve involved in the tonic regulation of the cardiovascular system. Electrical stimulation of this nerve produces mesenteric vasoconstriction and it has been assumed that vasodilatory responses are dependent on inhibition of the vasoconstrictor tone. Several different central stimuli have been shown to dilate the hindquarter vascular bed and constrict the mesenteric vascular bed. To determine whether vasodilatory and vasoconstrictor effects in different vascular beds are elicited by activation of different sympathetic nerves, we investigated the hemodynamic changes in hindquarter, mesenteric and renal vascular beds evoked by electrical stimulation of the SPL nerve. Stimulation of the intact or sectioned SPL nerve in chloralose-anesthetized, artificially ventilated rats evoked increases in the hindquarter vascular conductance and simultaneously decreased the mesenteric and renal vascular conductance. Intravenous (i.v.) administration of L-NAME prior to stimulation of the proximal end of the sectioned SPL nerve abolished the increase in hindquarter conductance, suggesting the involvement of nitric oxide in this response. In assessing the hemodynamic effects of tonic activity on the SPL nerves, no significant changes were observed after unilateral section of the SPL nerve, but bilateral section of the SPL nerves decreased hindquarter conductance and did not significantly change the mesenteric conductance simultaneously. No consistent response was observed in the renal vascular bed after unilateral and subsequent contralateral section of the SPL nerves. These findings demonstrate that electrical stimulation of the SPL nerve produces mesenteric vasoconstriction and simultaneous hindquarter vasodilatation, which is mediated by nitric oxide. Moreover, the present data suggest that SPL nerves may provide a tonic vasodilatory tone in the hindquarter vascular bed and simultaneously a vasoconstrictor tone in another, undetermined vascular bed.

[Effect of low-intensity He-Ne laser irradiation on rat mesenteric microcirculation]. / Vliianie nizkointensivnogo izlucheniia gelii-neonovogo lazera na mikrotsirkuliatsiiu v bryzheike krys.

Changes in microcirculation during low-intensity He-Ne laser irradiation were studied by measurement of blood vessels and lymphangions' diameter in anesthetized rat mesentery using method of videomicroscopy in vivo. We demonstrated that the red coherent light induced a significant increase in contractility of vessels' smooth muscle cells. The flow decreased in the mesenteric microvessels during H2O2-mediated oxidant stress was restored after He-Ne laser irradiation.

[Role of environmental factors in patients with circulatory disturbance syndrome who developed low-dose radiation-induced peptic ulcer]. / Rol' faktorov vneshnei sredy v formirovanii disreguliatornogo sindroma pri iazvennoi bolezni, voznikshei vsledstvie deistviia ioniziruiushchego izlucheniia.

98 patients actually in the zone of abnormal radiation developed peptic ulcer with its characteristic clinical manifestations as evidenced by a morphological study of the mucus and values for gastric secretion. The findings secured are considered to be a manifestation of parasympaticotonia-related discirculatory syndrome, which fact warrants institution of a corrective therapy.

Systemic diseases affecting the mesenteric circulation.

The mesenteric circulation is acutely sensitive to processes that affect the entire body. Such systemic diseases and syndromes are reviewed with particular emphasis on the mechanisms by which they influence the mesenteric vasculature and blood flow.

A modification of the 133Xe inhalation method for the measurement of liver blood flow in man.

The 133Xe inhalation technique for liver blood flow measurements was modified by using a gamma camera for data acquisition. Desaturation curves were derived from regions of interest (ROIs) over different parts of the liver, the lung and that lung area overlapping the liver, the liver hilus, and the splanchnic area. An additional liver scan with 99mTc-sulfur colloid facilitated the choice of these regions and allowed the estimation of the total liver volume. Thirteen healthy volunteers were examined under baseline conditions. Uncorrected blood flow values derived from the 133Xe-washout curves over the liver (40 +/- 10 ml/min/100 g liver) were lower than those found with other methods. A multicompartment model, based on the input functions calculated from the lung and splanchnic curves, gave values in accordance with those reported in the literature (94 +/- 20 ml/min/100 g or 1,356 +/- 382 ml/min/liver; mean liver volume: 1,475 +/- 227 g). Some methodologic limitations are shared with other invasive or noninvasive techniques.

Reaction of blood pressure and mesenteric blood flow to an infusion of biogenic amines in rats: influence of irradiation and alpha blockers.

The reaction of systemic blood pressure and mesenteric blood flow to an infusion of different biogenic amines was determined in controls and in lethally (8 Gy) X-irradiated rats. The influence of the alpha blocker phenoxybenzamine on these reactions was also investigated. Changes in blood pressure and flow response similar to, but less marked than, those seen earlier after a supralethal (20 Gy) exposure were detected 3 and 7 days after irradiation. These observations as well as the consequences of alpha blockade suggest that the reactivity of alpha receptors in blood vessels is reduced after irradiation, and that the function of the heart is impaired.

Acute post-irradiation canine intestinal blood flow.

Radiation-induced early transient incapacitation (ETI) is accompanied by severe systemic hypotension, during which arterial blood pressure often decreases to less than 50 per cent of normal. One haemodynamic compensatory mechanism is increased peripheral resistance due to vasoconstriction. This vasoconstriction in the small intestine of dogs is disproportionately increased during haemorrhagic or endotoxic shock, and intestinal ischaemia is frequent. In an attempt to elucidate mechanisms underlying radiation-induced ETI and the gastrointestinal radiation syndrome, canine intestinal submucosal blood flow was measured by the hydrogen polarographic technique, both before and after exposure to gamma radiation. Systemic blood pressures, blood gases and haematocrits were determined simultaneously. Data obtained from 12 sham-irradiated dogs and 12 irradiated dogs indicated that 90 Gy, whole-body, gamma radiation produced a 31 per cent decrease in systemic mean blood pressure beginning within 20 min post-irradiation and lasting for at least 90 min. However, the intestinal submucosal blood flow did not decrease as anticipated, but it exhibited an actual post-irradiation increase. This increase in post-irradiation intestinal submucosal blood flow began within 5 min after irradiation and lasted for at least 90 min. Post-irradiation haematocrits were 10.5 per cent higher than those obtained before irradiation and those obtained from sham-irradiated subjects. Histopathological examination of ileal mucosa revealed significant pathologic lesions in some irradiated animals within two hours after exposure.