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1.
Int J Mol Sci ; 25(13)2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-39000253

RESUMO

It has been reported that, in the spontaneously hypertensive rat (SHR) model of hypertension, different components of the G-protein/adenylate cyclase (AC)/Calcium-activated potassium channel of high conductance (BK) channel signaling pathway are altered differently. In the upstream part of the pathway (G-protein/AC), a comparatively low efficacy has been established, whereas downstream BK currents seem to be increased. Thus, the overall performance of this signaling pathway in SHR is elusive. For a better understanding, we focused on one aspect, the direct targeting of the BK channel by the G-protein/AC pathway and tested the hypothesis that the comparatively low AC pathway efficacy in SHR results in a reduced agonist-induced stimulation of BK currents. This hypothesis was investigated using freshly isolated smooth muscle cells from WKY and SHR rat tail artery and the patch-clamp technique. It was observed that: (1) single BK channels have similar current-voltage relationships, voltage-dependence and calcium sensitivity; (2) BK currents in cells with a strong buffering of the BK channel activator calcium have similar current-voltage relationships; (3) the iloprost-induced concentration-dependent increase of the BK current is larger in WKY compared to SHR; (4) the effects of activators of the PKA pathway, the catalytic subunit of PKA and the potent and selective cAMP-analogue Sp-5,6-DCl-cBIMPS on BK currents are similar. Thus, our data suggest that the lower iloprost-induced stimulation of the BK current in freshly isolated rat tail artery smooth muscle cells from SHR compared with WKY is due to the lower efficacy of upstream elements of the G-Protein/AC/BK channel pathway.


Assuntos
Cálcio , Hipertensão , Iloprosta , Canais de Potássio Ativados por Cálcio de Condutância Alta , Músculo Liso Vascular , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY , Vasodilatadores , Animais , Canais de Potássio Ativados por Cálcio de Condutância Alta/metabolismo , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/metabolismo , Músculo Liso Vascular/citologia , Ratos , Cálcio/metabolismo , Iloprosta/farmacologia , Hipertensão/metabolismo , Hipertensão/tratamento farmacológico , Vasodilatadores/farmacologia , Miócitos de Músculo Liso/metabolismo , Miócitos de Músculo Liso/efeitos dos fármacos , Masculino , Artérias/efeitos dos fármacos , Artérias/metabolismo , Cauda/irrigação sanguínea , Transdução de Sinais/efeitos dos fármacos
2.
J Cardiothorac Surg ; 19(1): 432, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38987788

RESUMO

BACKGROUND: Arterial tortuosity syndrome is a rare Autosomal recessive disease that leads to a loss of function of the connective tissues of the body, this happens due to a mutation in the solute carrier family 2 member 10 (SLC2A10) gene. ATS is more likely to occur in Large and medium-sized arteries including the aorta and pulmonary arteries. This syndrome causes the arteries to be elongated and tortuous, This tortuosity disturbs the blood circulation resulting in stenosis and lack of blood flow to organs and this chronic turbulent flow increases the risk of aneurysm development, dissection and ischemic events. CASE PRESENTATION: A 2 years old Arabian female child was diagnosed with ATS affecting the pulmonary arteries as a newborn, underwent a pulmonary arterial surgical reconstruction at the age of 2 years old due to the development of pulmonary artery stenosis with left pulmonary artery having a peak gradient of 73 mmHg with a peak velocity of 4.3 m/s and the right pulmonary artery having a peak gradient of 46 mmHg with a peak velocity of 3.4 m/s causing right ventricular hypertension. After surgical repair the left pulmonary artery has a peak pressure gradient of 20 mmHg, with the right pulmonary artery having a peak pressure gradient of 20 mmHg. CONCLUSION: ATS is a rare genetic condition that affects the great arteries especially the pulmonary arteries causing stenotic and tortuous vessels that may be central branches or distal peripheral branches that leads to severe right ventricular dysfunction and hypertension. We believe that surgical treatment provides the optimum outcomes when compared to transcather approaches especially when the peripheral arteries are involved. Some challenges and hiccups might occur, especially lung reperfusion injury that needs to be diagnosed and treated accordingly.


Assuntos
Artéria Pulmonar , Dermatopatias Genéticas , Malformações Vasculares , Humanos , Artéria Pulmonar/cirurgia , Artéria Pulmonar/anormalidades , Feminino , Malformações Vasculares/cirurgia , Malformações Vasculares/complicações , Pré-Escolar , Dermatopatias Genéticas/cirurgia , Dermatopatias Genéticas/complicações , Dermatopatias Genéticas/genética , Procedimentos Cirúrgicos Vasculares/métodos , Estenose de Artéria Pulmonar/cirurgia , Instabilidade Articular/cirurgia , Instabilidade Articular/genética , Procedimentos de Cirurgia Plástica/métodos , Artérias/anormalidades
3.
Int J Med Sci ; 21(9): 1640-1648, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39006836

RESUMO

Objective: Our study aims to evaluate the value of 256-slice dual-energy computed tomography (DECT) in supporting prostatic artery embolization (PAE) under digital subtraction angiography (DSA) for benign prostatic hyperplasia (BPH). Methods: The study was conducted on 88 patients who underwent PAE to treat BPH from January 2022 to November 2023. Of these, 38 patients who had PAE without DECT were placed in group 1, while the other 50 patients with pre-interventional DECT were assigned to group 2. The results of DECT imaging of the prostate artery (PA) were compared with the results of DSA imaging. Test for statistically significant differences between the variables of the two research groups using the T - student test and Mann-Whitney test algorithms with p < 0.05 corresponding to a 95% confidence interval. The data were analyzed according to medical statistical methods using SPSS 20.0 software. Results: DECT can detect the PA origin in 96.1% of cases, identify atherosclerosis at the root of the artery with a sensitivity of 66.7% and a specificity of 89.5%, and present anastomosis with a sensitivity of 72.7% and a specificity of 72.2%. There is no statistically significant difference in PA diameter on DECT compared to DSA with 95% confidence. Group 2 used DECT for 3D rendering of the PA before PAE had procedure time reduced by 25.8%, fluoroscopy time reduced by 23.2%, dose-area product (DAP) reduced by 25.6%, contrast medium volume reduced by 33.1% compared to group 1 not using DECT, statistically significant with 95% confidence. Conclusion: DECT is a valuable method for planning before PAE to treat BPH. 3D rendering DECT of PA provides anatomical information that minimizes procedure time, fluoroscopy time, dose-area product, and contrast medium volume.


Assuntos
Angiografia Digital , Embolização Terapêutica , Próstata , Hiperplasia Prostática , Humanos , Hiperplasia Prostática/diagnóstico por imagem , Hiperplasia Prostática/terapia , Masculino , Embolização Terapêutica/métodos , Idoso , Próstata/diagnóstico por imagem , Próstata/irrigação sanguínea , Próstata/patologia , Angiografia Digital/métodos , Pessoa de Meia-Idade , Artérias/diagnóstico por imagem , Resultado do Tratamento , Tomografia Computadorizada por Raios X/métodos
4.
Biol Pharm Bull ; 47(7): 1288-1295, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39010214

RESUMO

The active form of discoidin domain receptors (DDRs) is expressed in cell surface and regulated post-translationally by glucose. The DDR2 and DDR1 transfected in HEK293 cells were expressed mainly in their active forms with sizes of 130 and 120 kDa, respectively. DDRs were observed predominantly as 100 kDa proteins in glucose-depleted culture conditions. However, transfection of endothelial growth factor receptor (EGFR) in HEK293 cells resulted in the expression of only one form regardless of glucose concentration. Vascular smooth muscle cells, HT1080s, and MDA-MB-231 cancer cells expressed DDRs in their active forms in high glucose concentrations, which did not occur with EGFR. In diabetic rats, DDRs were expressed at high levels in arterial tissue but EGFR was not highly expressed. Taken together, these results suggest that DDRs expression depends on glucose concentration it may cooperate in the development of atherosclerosis and kidney fibroblasts, promoting nephropathy in diabetic rats.


Assuntos
Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 2 , Glucose , Animais , Humanos , Glucose/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/genética , Masculino , Diabetes Mellitus Experimental/metabolismo , Células HEK293 , Ratos , Artérias/metabolismo , Artérias/patologia , Receptores ErbB/metabolismo , Receptores ErbB/genética , Linhagem Celular Tumoral , Receptor com Domínio Discoidina 2/metabolismo , Receptor com Domínio Discoidina 2/genética , Músculo Liso Vascular/metabolismo , Receptores Proteína Tirosina Quinases/metabolismo , Receptores Proteína Tirosina Quinases/genética , Ratos Wistar
5.
Acta Neurochir (Wien) ; 166(1): 285, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977512

RESUMO

Cervicocerebral artery dissection stands out as a significant contributor to ischemic stroke in young adults. Several studies have shown that arterial tortuosity is associated with dissection. We searched Pubmed and Embase to identify studies on the association between arterial tortuosity and cervicocerebral artery dissection, and to perform a review on the epidemiology of cervicocerebral artery tortuosity and dissection, pathophysiology, measurement of vessels tortuosity, strength of association between tortuosity and dissection, clinical manifestation and management strategies. The prevalence of tortuosity in dissected cervical arteries was reported to be around 22%-65% while it is only around 8%-22% in non-dissected arteries. In tortuous cervical arteries elastin and tunica media degradation, increased wall stiffness, changes in hemodynamics as well as arterial wall inflammation might be associated with dissection. Arterial tortuosity index and vertebrobasilar artery deviation is used to measure the level of vessel tortuosity. Studies have shown an independent association between these two measurements and cervicocerebral artery dissection. Different anatomical variants of tortuosity such as loops, coils and kinks may have a different level of association with cervicocerebral artery dissection. Symptomatic patients with extracranial cervical artery dissection are often treated with anticoagulant or antiplatelet agents, while patients with intracranial arterial dissection were often treated with antiplatelets only due to concerns of developing subarachnoid hemorrhage. Patients with recurrent ischemia, compromised cerebral blood flow or contraindications for antithrombotic agents are usually treated with open surgery or endovascular technique. Those with subarachnoid hemorrhage and intracranial artery dissection are often managed with surgical intervention due to high risk of re-hemorrhage.


Assuntos
Dissecação da Artéria Vertebral , Humanos , Dissecação da Artéria Vertebral/diagnóstico por imagem , Artéria Vertebral/cirurgia , Artéria Vertebral/anormalidades , Artérias/anormalidades , Instabilidade Articular , Dermatopatias Genéticas , Malformações Vasculares
6.
Sci Rep ; 14(1): 13400, 2024 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862596

RESUMO

The intended research aims to explore the convection phenomena of a hybrid nanofluid composed of gold and silver nanoparticles. This research is novel and significant because there is a lack of existing studies on the flow behavior of hybrid nanoparticles with important physical properties of blood base fluids, especially in the case of sidewall ruptured dilated arteries. The implementation of combined nanoparticles rather than unadulterated nanoparticles is one of the most crucial elements in boosting the thermal conduction of fluids. The research methodology encompasses the utilization of advanced bio-fluid dynamics software for simulating the flow of the nanofluid. The physical context elucidates the governing equations of momentum, mass, momentum, and energy in terms of partial differential equations. The results are displayed in both tabular and graphical forms to demonstrate the numerical and graphical solutions. The effect of physical parameters on velocity distribution is illustrated through graphs. Furthermore, the study's findings are unique and original, and these computational discoveries have not been published by any researcher before. The finding implies that utilizing hybrid nanoparticles as drug carriers holds great promise in mitigating the effects of blood flow, potentially enhancing drug delivery, and minimizing its impact on the body.


Assuntos
Hemodinâmica , Nanopartículas Metálicas , Humanos , Nanopartículas Metálicas/química , Ouro/química , Simulação por Computador , Artérias , Prata/química , Nanopartículas/química , Modelos Cardiovasculares , Hidrodinâmica
7.
Orphanet J Rare Dis ; 19(1): 227, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38849913

RESUMO

BACKGROUND: Increased arterial tortuosity has been associated with various cardiovascular complications. However, the extent and role of arterial tortuosity in non-atherosclerotic vascular diseases remain to be fully elucidated. This study aimed to assess arterial tortuosity index (ATI) in patients with non-atherosclerotic vascular diseases and the associated factors. METHODS: This is a retrospective analysis of patients with non-atherosclerotic vascular diseases referred to the Malformation and Rare Vascular Disease Center at the University Hospital in Lausanne (Switzerland). Computed tomography angiography (CTA) images performed between October 2010 and April 2022 were retrieved and the aortic tortuosity index (ATI) was calculated. Patients were classified based on diagnosis into the following groups: arterial dissection & aneurysm, arteritis & autoimmune disease, hereditary connective tissue diseases, and fibromuscular dysplasia (FMD). Univariate and multivariate logistic regression analysis was used to determine potentially relevant predictors of aortic tortuosity. RESULTS: The mean age upon computed tomography angiography (CTA) was 46.8 (standard deviation [SD] 14.6) years and 59.1% of the patients were female. Mean ATI was higher in patients over 60 years old (1.27), in those with arterial aneurysms (mean: 1.11), and in those diagnosed with hypertension (mean: 1.13). When only patients over 60 years old were considered, those diagnosed with connective tissue diseases had the highest ATI. At multivariate regression analysis, increasing age (p < 0.05), presence of arterial aneurysms (p < 0.05), and hypertension (p < 0.05) were independently associated with ATI. CONCLUSIONS: The ATI may be a promising tool in diagnostic evaluation, cardiovascular risk stratification, medical or surgical management, and prognostic assessment in several non-atherosclerotic vascular conditions. Further studies with longitudinal design and larger cohorts are needed to validate the role of ATI in the full spectrum of vascular diseases.


Assuntos
Aneurisma , Angiografia por Tomografia Computadorizada , Hipertensão , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto , Hipertensão/complicações , Aneurisma/patologia , Aneurisma/diagnóstico por imagem , Doenças Vasculares/patologia , Doenças Vasculares/diagnóstico por imagem , Idoso , Artérias/patologia , Artérias/diagnóstico por imagem , Fatores Etários
8.
Int J Mol Sci ; 25(12)2024 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-38928086

RESUMO

Atherosclerosis is an inflammatory reaction that develops at specific regions within the artery wall and at specific sites of the arterial tree over a varying time frame in response to a variety of risk factors. The mechanisms that account for the interaction of systemic factors and atherosclerosis-susceptible regions of the arterial tree to mediate this site-specific development of atherosclerosis are not clear. The dynamics of blood flow has a major influence on where in the arterial tree atherosclerosis develops, priming the site for interactions with atherosclerotic risk factors and inducing cellular and molecular participants in atherogenesis. But how this accounts for lesion development at various locations along the vascular tree across differing time frames still requires additional study. Currently, murine models are favored for the experimental study of atherogenesis and provide the most insight into the mechanisms that may contribute to the development of atherosclerosis. Based largely on these studies, in this review, we discuss the role of hemodynamic shear stress, SR-B1, and other factors that may contribute to the site-specific development of atherosclerosis.


Assuntos
Aterosclerose , Modelos Animais de Doenças , Aterosclerose/metabolismo , Aterosclerose/patologia , Animais , Camundongos , Humanos , Hemodinâmica , Artérias/patologia , Artérias/metabolismo
9.
Int J Mol Sci ; 25(12)2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38928311

RESUMO

Aneurysms pose life-threatening risks due to the dilatation of the arteries and carry a high risk of rupture. Despite continuous research efforts, there are still no satisfactory or clinically effective pharmaceutical treatments for this condition. Accelerated inflammatory processes during aneurysm development lead to increased levels of matrix metalloproteinases (MMPs) and destabilization of the vessel wall through the degradation of the structural components of the extracellular matrix (ECM), mainly collagen and elastin. Tissue inhibitors of metalloproteinases (TIMPs) directly regulate MMP activity and consequently inhibit ECM proteolysis. In this work, the synthesis of TIMP-1 protein was increased by the exogenous delivery of synthetic TIMP-1 encoding mRNA into aortic vessel tissue in an attempt to inhibit MMP-9. In vitro, TIMP-1 mRNA transfection resulted in significantly increased TIMP-1 protein expression in various cells. The functionality of the expressed protein was evaluated in an appropriate ex vivo aortic vessel model. Decreased MMP-9 activity was detected using in situ zymography 24 h and 48 h post microinjection of 5 µg TIMP-1 mRNA into the aortic vessel wall. These results suggest that TIMP-1 mRNA administration is a promising approach for the treatment of aneurysms.


Assuntos
Metaloproteinase 9 da Matriz , RNA Mensageiro , Inibidor Tecidual de Metaloproteinase-1 , Inibidor Tecidual de Metaloproteinase-1/genética , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Animais , Humanos , Ratos , Aneurisma/terapia , Aneurisma/genética , Aorta/metabolismo , Masculino , Artérias/metabolismo , Inibidores de Metaloproteinases de Matriz/farmacologia
10.
Front Endocrinol (Lausanne) ; 15: 1393126, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38911037

RESUMO

Objective: This meta-analysis examines peak systolic velocities (PSVs) in thyroid arteries as potential biomarkers for thyroid disorders, which includes treated and untreated Graves' disease(GD) and destructive thyrotoxicosis(DT). Methods: A search across databases including PubMed, Google Scholar, Embase, and Web of Science identified studies assessing peak systolic flow velocity in the inferior thyroid artery (ITA-PSV) and superior thyroid artery (STA-PSV) diagnostic efficacy in GD and DT.And the search was restricted to publications in the English language.The analysis compared STA-PSV and ITA-PSV across patient groups, evaluating intra-group variances and synthesizing sensitivity and specificity data. Results: The analysis covered 18 studies with 1276 GD, 564 DT patients, and 544 controls. The difference of STA-PSV between GD group, DT group and normal group and the difference of ITA-PSV were analyzed in subgroups, and there was no statistical significance between subgroups when comparing any two groups. Normal subjects displayed intra-group ITA-PSV and STA-PSV differences with established cut-off values of 20.33 cm/s (95% CI, 17.48-23.18) for ITA-PSV and 25.61 cm/s (95% CI, 20.37-30.85) for STA-PSV. However, no significant intra-group differences were observed in the STA-PSV and ITA-PSV cut-off values among groups with GD or DT. The combined cut-off values for these patient groups and normal subjects were 68.63 cm/s (95% CI, 59.12-78.13), 32.08 cm/s (95% CI, 25.90-38.27), and 23.18 cm/s (95% CI, 20.09-26.28), respectively. The diagnostic odds ratio(DOR) for these values was 35.86 (95% CI, 18.21-70.60), and the area under the summary receiver operating characteristic (SROC) curve was 0.91, with a sensitivity estimate of 0.842 (95% CI, 0.772-0.866). Conclusion: PSVs in thyroid arteries are useful diagnostic tools in distinguishing DT from GD. A PSV above 68.63 cm/s significantly improves GD diagnosis with up to 91% efficacy. No notable differences were found between superior and inferior thyroid arteries in these conditions.


Assuntos
Doença de Graves , Glândula Tireoide , Tireotoxicose , Humanos , Doença de Graves/fisiopatologia , Doença de Graves/diagnóstico , Glândula Tireoide/irrigação sanguínea , Glândula Tireoide/fisiopatologia , Glândula Tireoide/diagnóstico por imagem , Velocidade do Fluxo Sanguíneo/fisiologia , Tireotoxicose/diagnóstico , Tireotoxicose/fisiopatologia , Artérias/fisiopatologia , Artérias/diagnóstico por imagem , Diagnóstico Diferencial , Sístole
11.
Anim Reprod Sci ; 267: 107515, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38908170

RESUMO

Several studies have demonstrated the correlation between Doppler velocimetric parameters of testicular artery and semen quality in domestic species, but in felines data are scarce. This study aimed to correlate the Doppler velocimetry of the testicular artery with sperm kinetics and sperm defects, in sedated and non-sedated cats. Forty tomcats were divided into two groups: sedated (SG; n=20) with dexmedetomidine (10 µm/kg) and ketamine (12 mg/kg), and non-sedated (NSG; n=20). The animals were subjected to ultrasound Doppler velocimetry of the distal supratesticular and marginal region of the testicular artery and subsequently orchiectomized. Epididymal tail spermatozoa were recovered and analyzed using a CASA system for motility, and morphology took place. Animals of SG presented a significantly higher velocity in the marginal region of the cat's testicular artery [peak systolic velocity (PSV) 11.51 cm/s; end-diastolic velocity (EDV) 7.72 cm/s] compared to NSG (PSV 7.72 cm/s, P < 0.001; EDV 4.93 cm/s, P < 0.001). Sedated cats presented higher pulsatility and resistivity indexes than non-sedated cats. The supratesticular PSV of NSG was moderately correlated with major (rs = 0621; P < 0.001) and total sperm defects (rs = 0614; P < 0001). Doppler velocimetry was fairly correlated with minor, major, and total sperm defects. In conclusion, Doppler velocimetric evaluation emerges as an important possibility in the reproductive evaluation of tomcats, once the testicular artery hemodynamics were associated with sperm defects. However, it is advisable to carry out this evaluation in non-sedated animals. If sedation is necessary, peripheral vasoconstriction should be considered.


Assuntos
Artérias , Testículo , Ultrassonografia Doppler , Animais , Masculino , Gatos , Testículo/irrigação sanguínea , Testículo/diagnóstico por imagem , Ultrassonografia Doppler/veterinária , Artérias/diagnóstico por imagem , Artérias/fisiologia , Espermatozoides/fisiologia , Análise do Sêmen/veterinária , Velocidade do Fluxo Sanguíneo , Dexmedetomidina/farmacologia , Motilidade dos Espermatozoides , Ketamina/farmacologia , Ketamina/administração & dosagem , Hipnóticos e Sedativos/farmacologia
12.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 41(3): 469-475, 2024 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-38932532

RESUMO

Accurately evaluating the local biomechanics of arterial wall is crucial for diagnosing and treating arterial diseases. Indentation measurement can be used to evaluate the local mechanical properties of the artery. However, the effects of the indenter's geometric structure and the analysis theory on measurement results remain uncertain. In this paper, four kinds of indenters were used to measure the pulmonary aorta, the proximal thoracic aorta and the distal thoracic aorta in pigs, and the arterial elastic modulus was calculated by Sneddon and Sirghi theory to explore the influence of the indenter geometry and analysis theory on the measured elastic modulus. The results showed that the arterial elastic modulus measured by cylindrical indenter was lower than that measured by spherical indenter. In addition, compared with the calculated results of Sirghi theory, the Sneddon theory, which does not take adhesion forces in account, resulted in slightly larger elastic modulus values. In conclusion, this study provides parametric support for effective measurement of arterial local mechanical properties by millimeter indentation technique.


Assuntos
Aorta Torácica , Módulo de Elasticidade , Artéria Pulmonar , Animais , Suínos , Fenômenos Biomecânicos , Aorta Torácica/fisiologia , Aorta Torácica/anatomia & histologia , Artéria Pulmonar/fisiologia , Estresse Mecânico , Artérias/fisiologia
13.
Math Biosci Eng ; 21(4): 5634-5657, 2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38872551

RESUMO

This paper is concerned with the PDE (partial differential equation) and numerical analysis of a modified one-dimensional intravascular stent model. It is proved that the modified model has a unique weak solution by using the Galerkin method combined with a compactness argument. A semi-discrete finite-element method and a fully discrete scheme using the Euler time-stepping have been formulated for the PDE model. Optimal order error estimates in the energy norm are proved for both schemes. Numerical results are presented, along with comparisons between different decoupling strategies and time-stepping schemes. Lastly, extensions of the model and its PDE and numerical analysis results to the two-dimensional case are also briefly discussed.


Assuntos
Artérias , Simulação por Computador , Análise de Elementos Finitos , Modelos Cardiovasculares , Humanos , Stents , Algoritmos , Stents Farmacológicos
14.
Medicine (Baltimore) ; 103(23): e38385, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38847727

RESUMO

Patients with traumatic ischemic mangled extremities first undergo arterial reconstruction using autogenous vein grafts, followed by flap transplantation as a staged treatment for soft tissue reconstruction. This study aimed to report the outcomes of such a staged treatment. Thirteen patients underwent arterial reconstruction between February 2015 and April 2017 due to damage to the major blood vessels by the traumatic mangled extremities. Of them, 6 patients (5 males and 1 female with a mean age of 51 years, age range: 36-60 years) who underwent soft tissue reconstruction due to necrosis were retrospectively analyzed. The average Mangled Extremity Severity Score was 7.2 (range, 6-8). Injuries were found in the lower leg (4 cases), foot (1 case), and wrist and hand (1 case). Arterial reconstruction was performed using autologous venous grafts. The reconstructed arteries included the posterior tibial artery (3 cases), anterior tibial artery (1 case), dorsalis pedis artery (1 case), and radial artery (1 case). The blood circulation status of the reconstructed blood vessels was assessed using computed tomography angiography at an average of 5 weeks (range, 4-6 weeks) after arterial reconstruction. For some necrotic soft tissues, debridement and flap transplantation were performed an average of 7 weeks (range, 6-8 weeks) after arterial reconstruction. Soft tissue reconstruction was performed with an anterolateral thigh free flap in 4 cases, a local flap in 1 case, and a muscle flap in 1 case. In 5 out of 6 cases, blood circulation was maintained in the reconstructed blood vessels, resulting in the salvaging of the extremities. All the patients who underwent flap surgery survived. Notably, there were no special complications during a follow-up visit conducted at an average of 19 months post-reconstruction. To treat an ischemic mangled extremity, the limbs should first be salvaged with arterial reconstruction, followed by subsequent appropriate flap surgery when soft tissue necrosis occurs at the mangled site as a staged treatment.


Assuntos
Isquemia , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/transplante , Procedimentos de Cirurgia Plástica/métodos , Isquemia/cirurgia , Lesões dos Tecidos Moles/cirurgia , Artérias/cirurgia , Desbridamento/métodos , Resultado do Tratamento
15.
J Appl Physiol (1985) ; 137(1): 194-222, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38813611

RESUMO

Cardiovascular diseases (CVDs) are the leading cause of death in the United States. However, disparities in CVD-related morbidity and mortality exist as marginalized racial and ethnic groups are generally at higher risk for CVDs (Black Americans, Indigenous People, South and Southeast Asians, Native Hawaiians, and Pacific Islanders) and/or development of traditional CVD risk factors (groups above plus Hispanics/Latinos) relative to non-Hispanic Whites (NHW). In this comprehensive review, we outline emerging evidence suggesting these groups experience accelerated arterial dysfunction, including vascular endothelial dysfunction and large elastic artery stiffening, a nontraditional CVD risk factor that may predict risk of CVDs in these groups with advancing age. Adverse exposures to social determinants of health (SDOH), specifically lower socioeconomic status (SES), are exacerbated in most of these groups (except South Asians-higher SES) and may be a potential mediator of accelerated arterial aging. SES negatively influences the ability of marginalized racial and ethnic groups to meet aerobic exercise guidelines, the first-line strategy to improve arterial function, due to increased barriers, such as time and financial constraints, lack of motivation, facility access, and health education, to performing conventional aerobic exercise. Thus, identifying alternative interventions to conventional aerobic exercise that 1) overcome these common barriers and 2) target the biological mechanisms of aging to improve arterial function may be an effective, alternative method to aerobic exercise to ameliorate accelerated arterial aging and reduce CVD risk. Importantly, dedicated efforts are needed to assess these strategies in randomized-controlled clinical trials in these marginalized racial and ethnic groups.


Assuntos
Envelhecimento , Doenças Cardiovasculares , Etnicidade , Classe Social , Humanos , Envelhecimento/fisiologia , Envelhecimento/etnologia , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/fisiopatologia , Artérias/fisiopatologia , Grupos Raciais , Fatores de Risco , Determinantes Sociais da Saúde/etnologia
16.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 38(5): 593-597, 2024 May 15.
Artigo em Chinês | MEDLINE | ID: mdl-38752247

RESUMO

Objective: To investigate the accuracy of positioning perforator of medial sural artery with three-dimensional ultrasound technique guided by a wide band linear matrix array volume transducer probe before operation, and the effectiveness of the flap design based on this in repairing the dorsal foot wounds. Methods: Between January 2019 and December 2022, 30 patients with skin and soft tissue defects of the dorsal foot were treated. There were 19 males and 11 females, with an average age of 43.9 years (range, 22-63 years). There were 12 cases of traffic accident injury, 15 cases of heavy crushing injury, and 3 cases of machine injury. The time from injury to hospitalization was 1-8 hours (mean, 3.5 hours). The wounds in size of 5 cm×3 cm to 17 cm×5 cm were thorough debrided and covered with vacuum sealing drainage dressing. Then the wounds were repaired with the medial sural artery perforator flaps after no obvious infection observed. To obtain the complete three-dimensional image, the number and position of the medial sural artery perforator branches and the position of the main blood vessels in the muscle were detected and recorded by wide band linear matrix array volume transducer probe before operation. Suitable perforating branches were selected to design the flap and guide the flap incision on this basis. The size of the perforating flap ranged from 6 cm×4 cm to 18 cm×6 cm. The sensitivity and positive predictive value were calculated by comparing preoperative exploration with intraoperative observation of perforating branches, so as to evaluate the positioning accuracy of three-dimensional ultrasound technique. The donor sites were sutured directly in 25 cases and repaired with free skin grafting in 5 cases. Results: The 60 perforating branches of medial sural artery were found before operation and 58 during operation in 30 patients. Among them, pre- and intra-operative perforations were consistent with 56. The sensitivity was 93.3% and positive predictive value was 96.6%. The intramuscular position and route of the main blood vessels were basically consistent with the pre- and intra-operative observation. All flaps survived and wounds healed by first intention. All incisions at the donor sites healed by first intention, and all skin grafts survived. All patients were follow up 9-24 months (mean, 14.7 months). The appearance, color, and texture of the flaps were good, and no obvious effect on wearing shoes and walking. At last follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind score ranged from 80 to 92, with an average of 87.5. The patient satisfaction was excellent in 29 cases and good in 1 case. Conclusion: The three-dimensional ultrasound technique guided by the wide band linear matrix array volume transducer probe can accurately locate the perforating branch of the medial sural artery, and the three-dimensional imaging is more intuitive, which can be used to guide the design and incision of the medial sural artery perforator flap.


Assuntos
Traumatismos do Pé , Imageamento Tridimensional , Retalho Perfurante , Lesões dos Tecidos Moles , Ultrassonografia , Humanos , Masculino , Adulto , Feminino , Retalho Perfurante/irrigação sanguínea , Pessoa de Meia-Idade , Traumatismos do Pé/cirurgia , Ultrassonografia/métodos , Lesões dos Tecidos Moles/cirurgia , Lesões dos Tecidos Moles/diagnóstico por imagem , Adulto Jovem , Procedimentos de Cirurgia Plástica/métodos , Fíbula/irrigação sanguínea , Artérias , Cicatrização , Transplante de Pele/métodos
17.
J Physiol ; 602(14): 3505-3518, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38743485

RESUMO

NaV1.7 plays a crucial role in inducing and conducting action potentials in pain-transducing sensory nociceptor fibres, suggesting that NaV1.7 blockers could be effective non-opioid analgesics. While SCN9A is expressed in both sensory and autonomic neurons, its functional role in the autonomic system remains less established. Our single neuron rt-PCR analysis revealed that 82% of sympathetic neurons isolated from guinea-pig stellate ganglia expressed NaV1.7 mRNA, with NaV1.3 being the only other tetrodotoxin-sensitive channel expressed in approximately 50% of neurons. We investigated the role of NaV1.7 in conducting action potentials in postganglionic sympathetic nerves and in the sympathetic adrenergic contractions of blood vessels using selective NaV1.7 inhibitors. Two highly selective NaV1.7 blockers, GNE8493 and PF 05089771, significantly inhibited postganglionic compound action potentials by approximately 70% (P < 0.01), with residual activity being blocked by the NaV1.3 inhibitor, ICA 121431. Electrical field stimulation (EFS) induced rapid contractions in guinea-pig isolated aorta, pulmonary arteries, and human isolated pulmonary arteries via stimulation of intrinsic nerves, which were inhibited by prazosin or the NaV1 blocker tetrodotoxin. Our results demonstrated that blocking NaV1.7 with GNE8493, PF 05089771, or ST2262 abolished or strongly inhibited sympathetic adrenergic responses in guinea-pigs and human vascular smooth muscle. These findings support the hypothesis that pharmacologically inhibiting NaV1.7 could potentially reduce sympathetic and parasympathetic function in specific vascular beds and airways. KEY POINTS: 82% of sympathetic neurons isolated from the stellate ganglion predominantly express NaV1.7 mRNA. NaV1.7 blockers inhibit action potential conduction in postganglionic sympathetic nerves. NaV1.7 blockade substantially inhibits sympathetic nerve-mediated adrenergic contractions in human and guinea-pig blood vessels. Pharmacologically blocking NaV1.7 profoundly affects sympathetic and parasympathetic responses in addition to sensory fibres, prompting exploration into the broader physiological consequences of NaV1.7 mutations on autonomic nerve activity.


Assuntos
Canal de Sódio Disparado por Voltagem NAV1.7 , Animais , Cobaias , Canal de Sódio Disparado por Voltagem NAV1.7/genética , Canal de Sódio Disparado por Voltagem NAV1.7/fisiologia , Canal de Sódio Disparado por Voltagem NAV1.7/metabolismo , Humanos , Masculino , Potenciais de Ação/efeitos dos fármacos , Potenciais de Ação/fisiologia , Fibras Simpáticas Pós-Ganglionares/fisiologia , Fibras Simpáticas Pós-Ganglionares/efeitos dos fármacos , Feminino , Artérias/fisiologia , Artérias/efeitos dos fármacos , Artérias/inervação , Bloqueadores dos Canais de Sódio/farmacologia , Gânglio Estrelado/fisiologia , Sistema Nervoso Simpático/fisiologia , Sistema Nervoso Simpático/efeitos dos fármacos
18.
Surg Radiol Anat ; 46(8): 1213-1217, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38717502

RESUMO

PURPOSE: Understanding of rare or unknown anatomical variations of the vasculature of the neck is critical to reduce the risk of complications during surgeries and other invasive procedures in the neck and shoulder regions. METHODS: Bilateral dissection of the neck and muscles of the back of an 87-year-old Caucasian male donor was performed to demonstrate the origin, course and termination of the arteries that arise in the neck. RESULTS: Several anatomical variations were noted on the right side of the neck of the donor body - (i) only inferior thyroid and ascending cervical arteries originated from the thyrocervical trunk (TCT), from the first part of the subclavian artery (SA), whereas the transverse cervical (TCA) and suprascapular (SSA) arteries were entirely absent, (ii) Dorsal scapular artery (DSA) emerged normally from the third part of the SA. However, after supplying the rhomboids and levator scapulae muscles, DSA provided two additional branches to the trapezius muscle and a branch to the supraspinatus muscle. Interestingly, the branches to the trapezius muscle from the DSA were the only sources of blood supply to the muscle. CONCLUSION: We report a unique anatomical variation involving the absence of the TCA and SSA from the TCT. The unilateral absence of these major vessels and the branches of DSA supplying the trapezius and supraspinatus muscles have not been reported previously in the literature in a single case report. This case study may provide useful information for head and neck reconstruction and shoulder repair surgeries.


Assuntos
Variação Anatômica , Cadáver , Humanos , Masculino , Idoso de 80 Anos ou mais , Escápula/irrigação sanguínea , Artéria Subclávia/anormalidades , Artéria Subclávia/anatomia & histologia , Músculos do Dorso/irrigação sanguínea , Músculos do Dorso/diagnóstico por imagem , Pescoço/irrigação sanguínea , Dissecação , Artérias/anormalidades , Artérias/anatomia & histologia , Músculos Superficiais do Dorso/irrigação sanguínea
20.
Am J Otolaryngol ; 45(4): 104343, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38729013

RESUMO

OBJECTIVE: Landmark arteries during endoscopic sinus surgery are currently identified on the basis of anatomy, CT imaging and navigation, and Doppler flowmetry. However, the advantage of intraoperative fluorescence imaging during endoscopic sinus surgery has not been demonstrated. This study aimed to investigate whether Indocyanine Green (ICG) is useful for visualizing landmark arteries during endoscopic sinus and skull base surgery. METHODS: Eight patients who underwent endoscopic sinus and pituitary surgeries and consented to study participation were included. After planned procedures were performed as usual, landmark arteries were examined by ICG endoscope. Recorded video and preoperative CT images were analyzed for identification of five landmark arteries: anterior ethmoidal artery (AEA), posterior ethmoidal artery (PEA), internal carotid artery (ICA), sphenopalatine artery (SPA), and postnasal artery (PNA). Identification of arteries was evaluated three grades: identifiable, locatable, unrecognizable. RESULTS: Eight patients and eleven sides were evaluated. The ICG dose was 2.5 mg/body and a single shot was sufficient for evaluation. 100 % of AEA was identified (9/9 sides), 86 % of PNA (6/7 sides), 56 % of ICA (5/9 sides), and 25 % of PEA and SPA (2/8 sides). CONCLUSION: ICG could visualize landmark arteries, even thin arteries like AEA, during endoscopic sinus and skull base surgeries. Visualization was affected by thickness of bone or soft tissue above arteries, blood clots, sensitivity setting, and angle and distance of near-infrared light irradiation. ICG visualization of landmark arteries may help avoid vascular injuries during endoscopic sinus and skull base surgeries, particularly of AEA, PNA and ICA.


Assuntos
Endoscopia , Verde de Indocianina , Seios Paranasais , Base do Crânio , Humanos , Endoscopia/métodos , Base do Crânio/cirurgia , Base do Crânio/diagnóstico por imagem , Base do Crânio/irrigação sanguínea , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Idoso , Seios Paranasais/cirurgia , Seios Paranasais/diagnóstico por imagem , Seios Paranasais/irrigação sanguínea , Artérias/diagnóstico por imagem , Pontos de Referência Anatômicos , Corantes/administração & dosagem , Tomografia Computadorizada por Raios X/métodos , Fluorescência , Imagem Óptica/métodos
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