Vessel Area Research Articles

Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography

BackgroundTo evaluate whether the specific choroidal neovascularization (CNV) characteristics measured using optical coherence tomography angiography (OCTA) can predict the 6-month prognosis of neovascular age-related macular degeneration (nAMD) after anti-vascular endothelial growth factor (anti-VEGF) therapy.MethodsPatients with type 1, type 2, or mixed-type neovascularization (NV) were prospectively included. Participants underwent an initial loading phase of three consecutive monthly intravitreal injections of Conbercept (0.5 mg) and were switched to a pro re nata (PRN) treatment strategy. OCTA images were evaluated for eyes that underwent follow-up assessments for more than 6 months. CNV lesions were manually segmented, and the CNV area, vessel area, greatest vascular caliber (GVC), and greatest linear dimension (GLD) were compared between responders and non-responders. Two masked graders independently measured the above-mentioned parameters using OCTA, and consistency was assessed using the intraclass correlation coefficient (ICC) values. Multiple logistic regression analysis was performed to evaluate the effect of a 3-month change in the CNV area, GLD, and GVC on the 6-month response to anti-VEGF agents.ResultsAmong the 60 eyes of 60 patients with nAMD, 39 were responders and 21 were non-responders. The proportion of CNV types was significantly different between responders and non-responders (P = 0.009). Patients with type 2 or mixed NV seemed more likely to respond to the treatment (28.2% vs. 0.0%, and 30.8% vs. 23.8%, respectively). The change in GVC showed a significant difference between responders (− 4.98 ± 17.17 μm) and non-responders (11.01 ± 14.10 μm) after three monthly intravitreal anti-VEGF injections. Multiple logistic regression analysis showed that only the change in GVC remained significant after controlling for baseline GVC, injection number, and CNV type (adjusted OR = 1.083; P = 0.008).ConclusionsType 2 and mixed-type NV were significantly associated with a better response to anti-VEGF therapy. Changes in GVC after 3 months of treatment were significantly associated with a response to anti-VEGF therapy at 6 months.

Effects of Provenance, Growing Site, and Growth on Quercus robur Wood Anatomy and Density in a 12-Year-Old Provenance Trial.

Vessels are responsible for an efficient and safe water transport in angiosperm xylem. Whereas large vessels efficiently conduct the bulk of water, small vessels might be important under drought stress or after winter when large vessels are embolized. Wood anatomy can adjust to the environment by plastic adaptation, but is also modified by genetic selection, which can be driven by climate or other factors. To distinguish between plastic and genetic components on wood anatomy, we used a Quercus robur trial where trees from ten Central European provenances were planted in three locations in Austria along a rainfall gradient. Because wood anatomy also adjusts to tree size and in ring-porous species, the vessel size depends on the amount of latewood and thereby ring width, we included tree size and ring width in the analysis. We found that the trees’ provenance had a significant effect on average vessel area (VA), theoretical specific hydraulic conductivity (Ks), and the vessel fraction (VF), but correlations with annual rainfall of provenances were at best weak. The trial site had a strong effect on growth (ring width, RW), which increased from the driest to the wettest site and wood density (WD), which increased from wet to dry sites. Significant site x provenance interactions were seen only for WD. Surprisingly, the drier site had higher VA, higher VF, and higher Ks. This, however, is mainly a result of greater RW and thus a greater proportion of latewood in the wetter forest. The average size of vessels > 70 μm diameter increased with rainfall. We argue that Ks, which is measured per cross-sectional area, is not an ideal parameter to compare the capacity of ring-porous trees to supply leaves with water. Small vessels (<70 μm) on average contributed only 1.4% to Ks, and we found no evidence that their number or size was adaptive to aridity. RW and tree size had strong effect on all vessel parameters, likely via the greater proportion of latewood in wide rings. This should be accounted for when searching for wood anatomical adaptations to the environment.

Karakteristik Working Area di Atas Kapal Mini Purse Seine di Pelabuhan Perikanan Pantai Larangan Kabupaten Tegal

Mini purse seiner are the dominant vessels were operating in Tegal Regency and the number of these vessels have been increasing. These vessels at Larangan fishing port consist of 44 vessels of &lt;10 GT and 37 vessels of ≥10 GT. Working activities on vessels &lt;10 GT requiring 10 crew members, while vessels of ≥10 GT needs 15-20 crew members. Work accidents above the deck of the vessels have a high accident rate and are closely related to the value of theworking area. This research was intended with the aim of identifying activities and working area needs on the vessel by identifying the area of the used working area and formulating the adequacy of the work area for fishing activities. The sampling technique using a accidental sampling method with total sample is two to vessels &lt;10 GT and three to vessels ≥10 GT . The data processing using mathematical calculations. Data analysis used descriptive analysis metode. The results of this study showed that the value of working area of vessels when setting conditions still far from sufficient area value. This conditions occurred because all crew gather in the same area when setting steps was conducted. The area mentioned which is on the left side of the ship when lowering the fishing gear, this will certainly increase the risk of work accidents.

Decreased Vessel Density in Retinal Capillary Plexus and Thinner Ganglion Cell Complex Associated With Cognitive Impairment.

BackgroundTo determine the association of the retinal capillary plexus (RCP) and ganglion cell complex (GCC) with cognitive impairment using optical coherence tomography angiography (OCTA).MethodsA cross-sectional, community-based study utilizing data from the participants enrolled between August 2019 and January 2020 in the Jidong Eye Cohort Study. We assessed the vessel density in RCP and GCC thickness using OCTA, and cognitive testing using the Montreal Cognitive Assessment (MoCA). Cognitive impairment in this study was defined as MoCA score < 24. We used multivariable analysis to evaluate the association of RCP and GCC with cognitive impairment after adjusting for confounders.ResultsThis study analyzed 1555 participants. The mean age of participants was 52.3 (8.4) years, and 861 (55.4%) were women. Cognitive impairment was observed in 268 (17.2%) participants. The adjusted odds ratio (OR) with 95% confidence interval (95% CI) for parafovea vessel density in the deep RCP with cognitive impairment was 1.20 (1.03–1.39). For vessel area and length density surrounding foveal avascular zone with cognitive impairment, the ORs with 95% CIs were 1.23 (1.07–1.41) and 1.30 (1.13–1.49), respectively. For thickness in the superior GCC with cognitive impairment, the OR with 95% CI was 1.16 (1.01–1.32).ConclusionLower vessel density in the RCP and thinner GCC were associated with cognitive impairment. Our results suggest that alterations in the RCP and GCC could provide further evidence when assessing the cognitive function and may even be potentially useful biomarkers in the detection of cognitive impairment.

Root and xylem anatomy varies with root length, root order, soil depth and environment in intermediate wheatgrass (Kernza®) and alfalfa.

Deep roots (i.e. &gt;1 m depth) are important for crops to access water when the topsoil is dry. Root anatomy and hydraulic conductance play important roles in the uptake of soil water, particularly water located deep in the soil. We investigated whether root and xylem anatomy vary as a function of root type, order and length, or with soil depth in roots of two deep-rooted perennial crops: intermediate wheatgrass [Thinopyrum intermedium (Kernza®)] and alfalfa (Medicago sativa). We linked the expression of these anatomical traits to the plants' capacity to take up water from deep soil layers. Using laser ablation tomography, we compared the roots of the two crops for cortical area, number and size of metaxylem vessels, and their estimated root axial hydraulic conductance (ERAHCe). The deepest roots investigated were located at soil depths of 2.25 and at 3.5 m in the field and in rhizoboxes, respectively. Anatomical differences were characterized along 1-m-long individual roots, among root types and orders, as well as between environmental conditions. For both crops, a decrease in the number and diameter, or both, of metaxylem vessels along individual root segments and with soil depth in the field resulted in a decrease in ERAHCe. Alfalfa, with a greater number of metaxylem vessels per root throughout the soil profile and, on average, a 4-fold greater ERAHCe, took up more water from the deep soil layers than intermediate wheatgrass. Root anatomical traits were significantly different across root types, classes and growth conditions. Root anatomical traits are important tools for the selection of crops with enhanced exploitation of deep soil water. The development and breeding of perennial crops for improved subsoil exploitation will be aided by greater understanding of root phenotypes linked to deep root growth and activity.

Clinical application of expanded internal mammary artery perforator flap combined with vascular supercharge in reconstruction of faciocervical scar

Objective: To summarize the clinical experience of expanded internal mammary artery perforator (IMAP) flap combined with vascular supercharge in reconstruction of faciocervical scar. Methods: The retrospective observational study was conducted. From September 2012 to May 2021, 23 patients with postburn or posttraumatic faciocervical scars who met the inclusion criteria were admitted to Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, including 18 males and 5 females, aged from 11 to 58 years, all of whom were reconstructed with expanded IMAP flaps. At the first stage, one or two skin and soft tissue expander (s) with appropriate rated capacity were implanted in the anterior chest area according to the location and size of the scars. The IMAP, thoracic branch of supraclavicular artery, and lateral thoracic artery were preserved during the operation. The skin and soft tissue expanders were inflated with normal saline after the operation. The flaps were transferred during the second stage. The dominant IMAP was determined preoperatively using color Doppler ultrasound (CDU) blood flow detector. The faciocervical scars were removed, forming wounds with areas of 9 cm×7 cm-28 cm×12 cm, and the perforators of superficial temporal artery and vein or facial artery and vein were preserved during the operation. The flaps were designed according to the area and size of the wounds after scar resection with the dominant IMAP as the pedicle. Single-pedicle IMAP flaps were used to repair small and medium-sized wounds. For larger defects, the blood perfusion areas of vessels in the anterior chest were evaluated by indocyanine green angiography (ICGA). In situations where the IMAP was insufficient to nourish the entire flap, double-pedicle flaps were designed by using the thoracic branch of supraclavicular artery or lateral thoracic artery for supercharging. Pedicled or free flap transfer was selected according to the distance between the donor areas and recipient areas. After transplantation of flaps, ICGA was conducted again to evaluate blood perfusion of the flaps. The donor sites of flaps were all closed by suturing directly. Statistics were recorded, including the number, rated capacity, normal saline injection volume, and expansion period of skin and soft tissue expanders, the location of the dominant IMAP, the total number of the flaps used, the number of flaps with different types of vascular pedicles, the flap area, the flap survival after the second stage surgery, the occurrence of common complications in the donor and recipient areas, and the condition of follow-up. Results: Totally 25 skin and soft tissue expanders were used in this group of patients, with rated capacity of 200-500 mL, normal saline injection volume of 855-2 055 mL, and expansion period of 4-16 months. The dominant IMAP was detected in the second intercostal space (20 sides) or the third intercostal space (5 sides) before surgery. A total of 25 expanded flaps were excised, including 2 pedicled IMAP flaps, 11 free IMAP flaps, 4 pedicled thoracic branch of supraclavicular artery+free IMAP flaps, and 8 free IMAP+lateral thoracic artery flaps, with flap areas of 10 cm×8 cm-30 cm×14 cm. After the second stage surgery, tip necrosis of flaps in three patients occurred, which healed after routine dressing changes; one patient developed arterial embolism and local torsion on the vascular pedicle at the anastomosis of IMAP and facial artery, and the blood supply recovered after thrombectomy and vascular re-anastomosis. Fourteen patients underwent flap thinning surgery in 1 month to 6 months after the second stage surgery. The follow-up for 4 months to 9 years showed that all patients had improved appearances of flaps and functions of face and neck and linear scar in the donor sites of flaps, and one female patient had obvious nipple displacement and bilateral breast asymmetry. Conclusions: The expanded IMAP flap is matched in color and texture with that of the face and neck, and its incision causes little damage to the chest donor sites. When combined with vascular supercharge, a double-pedicle flap can be designed flexibly to further enhance the blood supply and expand the flap incision area, which is a good choice for reconstruction of large faciocervical scar.

Human vs. machine vs. core lab for the assessment of coronary atherosclerosis with lumen and vessel contour segmentation with intravascular ultrasound.

A machine learning (ML) algorithm for automatic segmentation of intravascular ultrasound was previously validated. It has the potential to improve efficiency, accuracy and precision of coronary vessel segmentation compared to manual segmentation by interventional cardiology experts. The aim of this study is to compare the performance of human readers to the machine and against the readings from a Core Laboratory. This is a post-hoc, cross-sectional analysis of the IBIS-4 study. Forty frames were randomly selected and analyzed by 10 readers of varying expertise two separate times, 1week apart. Their measurements of lumen, vessel, plaque areas, and plaque burden were performed in an offline software. Among humans, the intra-observer variability was not statistically significant. For the total 80 frames, inter-observer variability between human readers, the ML algorithm and Core Laboratory for lumen area, vessel area, plaque area and plaque burden were not statistically different. For lumen area, however, relative differences between the human readers and the Core Lab ranged from 0.26 to 12.61%. For vessel area, they ranged from 1.25 to 9.54%. Efficiency between the ML algorithm and the readers differed notably. Humans spent 47min on average to complete the analyses, while the ML algorithm took on average less than 1min. The overall lumen, vessel and plaque means analyzed by humans and the proposed ML algorithm are similar to those of the Core Lab. Machines, however, are more time efficient. It is warranted to consider use of the ML algorithm in clinical practice.

Dynamic Changes on Video-capillaroscopy and Potential Microsurgical Application: Temperature and Skin Surface Readings.

Summary:Video-capillaroscopy is being explored as a potential tool for microsurgical flap monitoring. A detailed examination of the effect of temperature on capillary changes using video-capillaroscopy is yet to be investigated. We analyzed the video-capillaroscopy findings on different skin areas often used for flap harvest at normal body temperatures and at lower temperatures. Skin capillaries at the lateral thigh, anterior forearm, mid-axillary line, abdomen, and fingertips were observed using video-capillaroscopy in 20 healthy Japanese individuals. Further, ImageJ software was used to measure the blood vessel area and blood flow velocity, and comparisons were drawn between normal body temperature and lower body temperature states. All measures of blood vessel area and average blood flow velocity for the different anatomical regions were significantly different before and after cooling (P < 0.001). The mean reduction rate of the vessel area was significantly different among anatomic regions (P < 0.001). Post-hoc analysis revealed a significant difference in the vessel area reduction rate between anatomic areas (P < 0.05); except when comparing the thigh versus finger, the forearm versus abdomen, and the mid-axillary line versus abdomen. The mean blood flow velocity was significantly different among anatomic regions (P < 0.001). Post-hoc analysis revealed a significant difference between the thigh and forearm (P = 0.009), the forearm and fingertip (P = 0.001), and the abdomen and fingertip (P = 0.004). Decreasing the skin temperature resulted in a significant vasoconstriction and reduction in capillary flow velocity. It is imperative to keep the monitored area warm during video-capillaroscopy assessment to avoid false diagnosis of vascular occlusion.

Folate-targeted co-delivery polymersomes for efficient photo-chemo-antiangiogenic therapy against breast cancer and in vivo evaluation via OCTA/NIRF dual-modal imaging

Intelligent nanoplatform that combines multimodal imaging and therapeutic effects holds great promise for precise and efficient cancer therapy. Herein, folate-targeted polymersomes with stimuli-responsiveness were fabricated and evaluated by near-infrared fluorescence (NIRF) and optical coherence tomography angiography (OCTA) dual-imaging for photo-chemo-antiangiogenic therapy against cancer. The folate-targeted polymersomes (FA-MIT-SIPS) not only integrated ammonium bicarbonate (ABC) and mitoxantrone (MIT) into their hydrophilic cavity but also encapsulated indocyanine green (ICG) and sorafenib (SOR) within their hydrophobic layer. NIRF imaging demonstrated that FA-MIT-SIPS effectively accumulated and retained in the tumors. Upon 808 nm laser irradiation, the ICG produced hyperthermia and reactive oxygen species (ROS) for efficient photothermal and photodynamic therapy. In addition, the decomposition of ABC in responsive to acidic tumor environment and ICG-induced hyperthermia accelerated drug release. The released MIT accumulated in nucleus to inhibit DNA synthesis, while the released SOR destructed tumor vascularization. Notably, OCTA imaging was applied to observe the tumor blood flow upon the combination therapy, demonstrating that FA-MIT-SIPS obviously decreased the vessels area density. Moreover, the synergistic photo-chemo-antiangiogenic therapy of FA-MIT-SIPS achieved excellent antitumor effect with 40% of the 4T1 tumor-bearing mice being completely cured without recurrence. The multifunctional polymersomes provide a promising dual-modal imaging-evaluated synergistic strategy for tumor therapy.

Pharmacologic conversion of cancer-associated fibroblasts from a protumor phenotype to an antitumor phenotype improves the sensitivity of pancreatic cancer to chemotherapeutics.

Previous therapeutic attempts to deplete cancer-associated fibroblasts (CAFs) or inhibit their proliferation in pancreatic ductal adenocarcinoma (PDAC) were not successful in mice or patients. Thus, CAFs may be tumor suppressive or heterogeneous, with distinct cancer-restraining and -promoting CAFs (rCAFs and pCAFs, respectively). Here, we showed that induced expression of the glycosylphosphatidylinositol-anchored protein Meflin, a rCAF-specific marker, in CAFs by genetic and pharmacological approaches improved the chemosensitivity of mouse PDAC. A chemical library screen identified Am80, a synthetic, nonnatural retinoid, as a reagent that effectively induced Meflin expression in CAFs. Am80 administration improved the sensitivity of PDAC to chemotherapeutics, accompanied by increases in tumor vessel area and intratumoral drug delivery. Mechanistically, Meflin was involved in the suppression of tissue stiffening by interacting with lysyl oxidase to inhibit its collagen crosslinking activity. These data suggested that modulation of CAF heterogeneity may represent a strategy for PDAC treatment.

Research on detection method of bleeding point in two-dimensional DSA image based on parametric color imaging

Digital Subtraction Angiography (DSA) has become an essential method in diagnosing and detecting vascular bleeding points. According to the frame number sequence, doctors subjectively analyze gray-black DSA data to diagnose vascular bleeding points. This study carried out parametric color imaging processing on the original two-dimensional DSA image sequence to assist doctors in judging blood vessel bleeding more accurately and quickly on angiography results and obtain quantitative standards. Five parameter values are calculated by enhancing the two-dimensional DSA image, segmenting the blood vessel area of the two-dimensional DSA image, and fitting the time-concentration curve. The parameters include AUC, time to peak, development time, transit time, and flow rate of contrast agent. The parameter value determines the gray value of the image pixel point and generates a color image with corresponding parameters through image pseudo-color processing. The color imaging results of each parameter of 33 groups of simulated hemorrhage data in-vitro and DSA data of 42 cases of vascular bleeding points determine the selection of parameters to assist in diagnosing vascular bleeding points, and the experimental results finally select the development time parameter color imaging result map to assist doctors in diagnosing blood vessel bleeding points.

1-Year Fixed-Regimen Bevacizumab Treatment in DME-Vascular Network Image Analysis in Optical Coherence Tomography Angiography Study.

Purpose: To evaluate the effectiveness of intravitreal bevacizumab treatment in patients with diabetic macular edema (DME) by assessing retinal changes using AngioTool software (version 0.6a(02.18.14), National Cancer Institute, Bethesda, Maryland). Methods: A total of 27 eyes in patients with treatment-naïve DME were included in this prospective study. OCT-A images with a scan area of 6 × 6 mm were obtained. The DME patients with a central macular thickness (CMT) of ≥300 µm received nine bevacizumab injections within 12 months. The demographic, systemic, and ocular parameters, including the best-corrected visual acuity (BCVA) and CMT, were assessed. Explant area, vessels area, vessels percentage area, total number of junctions, total vessels length, average vessels length, the total number of endpoints, and mean lacunarity in the superficial capillary plexus (SCP) were calculated by using AngioTool software. Results: Twenty-nine eyes of DME patients were subjected to the final analysis. Bevacizumab treatment reduced CMT from 401.84 ± 84.54 µm to 328.93 ± 87.17 µm and improved BCVA from 65.18 ± 8.21 at baseline to 72.63 ± 7.43 letters among participants of the study. The anti-VEGF therapy showed no statistically significant changes in parameters calculated by AngioTool software in the study group of patients. Conclusion: The fixed-regimen intravitreal bevacizumab therapy was effective in treating DME. AngioTool software is an additional tool that could be used to assess vascular networks. However, the use of OCTA is unlikely to alter DME treatment regimens significantly or to find significant predictors. Perhaps using wide-angle devices or software will give a complete picture of the disease and prove to be more helpful.

Quantitative changes in iris vasculature and blood flow in patients with different refractive errors.

To evaluate the association between microvascular changes in the iris and refractive errors. A cross-sectional case study. Seventy eyes from 70 patients with refractive errors were enrolled. Iris microvasculature was analyzed using optical coherence tomography angiography (OCTA). We divided the iris images into three regions and calculated the vessel area density (VAD) and vessel skeleton density (VSD) of the inner one-third, inner two-thirds, and the entirety of the iris. The VADs and VSDs of the different regions were significantly different. The VAD and VSD of the inner one-third of the iris were higher than those of the other regions. The iris blood vessels were denser near the pupil margin, and blood vessels from the iris root to the pupil edge were radially distributed. The VAD and VSD of patients with mild hyperopia and emmetropia were higher than those of patients with moderate and high myopia. As the spherical equivalent increased, the VAD and VSD of the iris increased. Neither age nor sex contributed to significant differences in VAD and VSD. Quantitative changes in iris microvasculature may indicate the development of myopia.

Intrasession Repeatability and Intersession Reproducibility of Macular Vessel Parameters on Optical Coherence Tomography Angiography in Glaucomatous and Non-Glaucomatous Eyes

Purpose Using optical coherence tomography angiography (OCTA), this study compared intrasession repeatability versus intersession reproducibility of macular vessel parameters in glaucoma and non-glaucoma subjects. Methods 6 × 6 mm2 macular OCTA scans (Cirrus HD-OCT 5000) were acquired from glaucomatous and non-glaucomatous subjects as part of an observational, longitudinal study. Vessel area density (VAD) and vessel skeleton density (VSD) were calculated using research-based quantification software while perfusion density (PDZ) and vessel density (VDZ) were calculated using commercially developed software (Cirrus 11.0, Carl Zeiss Meditec). Intrasession repeatability and intersession reproducibility were determined using within-eye standard deviation (SW), within-eye coefficient of repeatability (CRW), within-eye coefficient of variation (CVW), and intraclass correlation coefficients (ICC). Results The intrasession repeatability and intersession reproducibility for macular OCTA parameters were similar to one another for both non-glaucomatous and glaucomatous eyes. Intrasession CVW from the non-glaucoma group (n = 73) was 1.097% for VAD, 1.007% for VSD, 2.980% for PDZ, and 2.714% for VDZ. Intersession CVW from the non-glaucoma group (n = 55) was 1.389% for VAD, 1.279% for VSD, 2.935% for PDZ, and 2.695% for VDZ. Intrasession CVW from the glaucoma group (n = 59) was 1.189% for VAD, 0.970% for VSD, 3.827% for PDZ, and 3.542% for VDZ. Intersession CVW from the glaucoma group (n = 45) was 1.412% for VAD, 1.132% for VSD, 3.915% for PDZ, and 3.654% for VDZ. Non-glaucomatous intrasession ICC ranged from 0.711 to 0.824, non-glaucomatous intersession ICC ranged from 0.649 to 0.762, glaucomatous intrasession ICC ranged from 0.710 to 0.853, and glaucomatous intersession ICC ranged from 0.661 to 0.827. Conclusions Macular OCTA scans can be a useful tool in monitoring the longitudinal progression of glaucoma due to their high repeatability and reproducibility.

Prognostic Significance of Small Pulmonary Vessel Alteration Measured by Chest Computed Tomography in Connective Tissue Diseases With Pulmonary Arterial Hypertension.

Pulmonary arterial hypertension (PAH) is characterized by structural alterations of pulmonary vessels. Few studies have explored the clinical significance of quantitative assessment of pulmonary small vessels by chest computed tomography (CT). Our aim was to assess whether the prognosis of connective tissue diseases (CTD)-PAH patients could be assessed through pulmonary small vessels measured by chest CT. In all, 42 CTD-PAH patients diagnosed based on right heart catheterization were retrospectively investigated. All patients underwent a chest CT within 1 month before and after right heart catheterization examination. Main pulmonary artery (MPA) and the cross-sectional area of small pulmonary vessels <5 mm2 as a percentage of total lung area (%CSA <5) were measured. The primary endpoint was a composite clinical worsening endpoint. After a median follow-up time of 30.5 (interquartile range, 8.5 to 45.25) months, endpoint events occurred in 16 (38.1%) patients after 19.5 (interquartile range, 10.0 to 45.5) months. Cox univariate proportional hazard analysis showed that pulmonary vascular resistance, MPA diameter, and %CSA <5 were associated with the end point. A combination of MPA diameter and %CSA < 5 was the independent risk factor for the prognosis (hazard ratio, 2.180 [95% confidence interval, 1.405-3.383], P=0.001). Kaplan-Meier analysis showed that CTD-PAH patients satisfying %CSA < 5 of <0.382 and MPA >36.75 mm had the highest risk of experiencing the endpoint. Among the pulmonary vascular indicators measured by chest CT, in addition to MPA, %CSA < 5 may be a potential independent risk factor for poor long-term prognosis in Chinese CTD-PAH patients.

Investigation of Circular, Elliptical and Obround Shaped Vessels by Finite Element Method(FEM) Analysis under Internal Pressure Loading

The forms of pressure vessels applicable withinside the aerospace enterprise are starting from essential load-carrying imperative tank systems to small auxiliary tanks and pressurized cabins. Elliptical and obround stress vessels are used in which there may be a space-constrained. In the present work nonlinear(geometric and material within tensile strength) finite element evaluation is performed for the determination of its stress state in open-ended pressure vessels of various shapes(round, elliptical, and obround). A parametric examine has been completed and outcomes offered for different inside areas of vessel shapes and thickness of the cross-sections. As the inside area of the shape of pressure vessel increases, the effective stress increases for a particular thickness. The deformed shape elliptical/obround under internal pressure might no longer be uniformly enlarged because of non-uniform bending. Deformation and effective stress in the elliptical/obround shapes are found higher than circular shape for a particular thickness and inside area of vessel.

Effects of Exercise Training on PPARβ/δ Expression in Skeletal Muscle of Rats with Spontaneous Hypertension.

ABSTRACTPurposeThis study aimed to identify the relationship and mechanism between skeletal muscle peroxisome proliferator–activated receptor β/δ (PPARβ/δ) and spontaneous hypertension.MethodsRats were divided into four groups (n = 10): spontaneous hypertensive rats exercise group (SHR-E), spontaneous hypertensive rats sedentary group (SHR-S), Wistar-Kyoto control rats exercise group (WKY-E), and Wistar-Kyoto control rats sedentary group (WKY-S). Although the sedentary groups were placed on the treadmill without moving during the training sessions, the exercise groups were forced to run on a treadmill for 8 wk, 1 h·d−1, 5 d·wk−1. After training, the density and area of gastrocnemius microvessels were observed. PPARβ/δ, vascular endothelial growth factor A (VEGFA), superoxide dismutase 2 (SOD-2), and nitric oxide synthase in gastrocnemius were measured by real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot.ResultsExcept the sixth week of age, the systolic blood pressure of SHR-S was significantly higher than that of WKY-S at all time periods. Exercise significantly reduced systolic blood pressure in SHR rats. Compared with the SHR-S group, the WKY-S group had significantly higher PPARβ/δ protein level and density of skeletal muscle microvessels. Eight weeks of exercise increased the PPARβ/δ, SOD-2, VEGFA, and microvessel density and area in the skeletal muscle of SHR.ConclusionsExercise training promoted PPARβ/δ mRNA and protein-level expression of PPARβ/δ, SOD-2 and VEGFA in skeletal muscle, thus increasing the density and area of skeletal muscle blood vessels. These regulations contribute to the reduction of peripheral vascular resistance. This may be a potential mechanism of exercise to reduce blood pressure.

Better Therapy for Pancreatic Cancer through More Radical Surgery?

Despite advances in the treatment of pancreatic cancer, the survival of affected patients remains limited. A more radical surgical therapy could help to improve the prognosis, in particular by reducing the local recurrence rate, which is around 45% in patients with resected pancreatic cancer. In addition, patients with oligometastatic pancreatic cancer could also benefit from a more radical indication for surgery.Based on an analysis of the literature, important principles of pancreatic cancer surgery were examined.Even if even more radical surgical approaches such as an "extended" lymphadenectomy or a standard complete pancreatectomy do not bring any survival advantage, complete resection of the tumour (R0), a thorough locoregional lymphadenectomy and an adequate radical dissection in the area of the peripancreatic vessels including periarterial nerve plexuses should be the standard of pancreatic carcinoma resections. Whenever necessary to achieve an R0 resection, resections of the pancreas have to be extended, as well as additional venous vascular resections and multivisceral resections had to be performed. Simultaneous arterial vascular resections as part of pancreatic resections as well as surgical resections in oligometastatic patients should, however, be reserved for selected patients. These aspects of the surgical technique in pancreatic carcinoma mentioned above must not be neglected from the point of view of an "existing limited prognosis". On the contrary, they form the absolutely necessary basis in order to achieve good survival results in combination with system therapy. However, it may always be necessary to adapt these standards according to the age, comorbidities and wishes of the patient.

Antiangiogenic Activity of Sweet Almond (Prunus dulcis) Oil Alone and in Combination with Aspirin in both in vivo and in vitro Assays.

Objective:Angiogenesis is new blood vessels formations that are necessary for certain physiological and pathologic conditions. Almond oil represents adjuvant therapies for numerous health benefits; It has ability for prevent the formation angiogenesis in tumour, due to its high concentration of unsaturated fatty acids, polyphenols, flavonoids and other ingredients content. Aspirin is non-steroidal ant-inflammatory drug; significantly reduce the angiogenesis of cancer. The aim of the study is to investigate the role of Prunus dulcis oil alone and in combination with aspirin, as an anti-angiogenic. Method:A sequential concentrations ex-vivo rat aorta ring assay, investigate the anti-angiogenic activity of Prunus dulcisoil in vivo. After three days of incubation, small holes were created on the fine pinpoint. Acute toxicity study was evaluated after administration of Prunus dulcis oil via intraperitoneal route. Results:the obtained results displayed that the serial concentration dose-response has a significant inhibition effect of blood vessels growth when compared to the negative control (DMSO 1%), the dose depended percentage of inhibition, sweet almond oil in combination with aspirin synergism effect to inhibition growth blood vessels as anti-angiogenic activity. The zone of inhibition was been measured as the mean of inhibition area of blood vessel on eggs in millimetre (mm) ± standard deviation. Conclusion: Almond oil dose has inhibition effect on cancer and can be used as (anti-angiogenesis), the activity of almond oil with Aspirin synergism can significantly reduce blood vessel’s growth in rate aorta ring and CAM assay.

Clinical feasibility of using effective atomic number maps derived from non-contrast spectral computed tomography to identify non-calcified atherosclerotic plaques: a preliminary study.

To assess the clinical feasibility of using effective atomic number (Zeff) maps derived from non-contrast-enhanced computed tomography (NCECT) scans obtained by dual-layer spectral computed tomography (DLCT) to identify non-calcified atherosclerotic plaques. A total of 37 patients with 86 non-calcified atherosclerotic plaques confirmed by contrast-enhanced CT (CECT) were enrolled in this retrospective study. Both spectral-based-images (SBI) and conventional images (CI) were reconstructed from NCECT and CECT scans. The presence of plaques on NCECT Zeff maps and CIs were independently assessed by 2 radiologists. In CECT scans, plaques and regions of interest (ROIs) in vessel lumens were assessed with CT attenuation and Zeff values, and the proportion of plaques was determined as Area (plaque)/Area (vessel). The CT and Zeff values for plaques and blood were recorded from both CECT and NCECT scans. Contrast-to-noise ratios (CNRs) of the plaques were calculated and compared using CT attenuation and Zeff values. Finally, interobserver agreement was evaluated. A total of 47 of the 86 (54.7%) plaques were identified on Zeff map images derived from the NCECT scans while only 7 (8.1%) plaques were identified on the CI. There was no significant difference between the mean vessel ROI area measured on CIs and that measured on Zeff map images (502.19 vs. 498.14 mm2; P=0.28), while the mean plaque ROI area was larger (81.45 vs. 75.46 mm2). The observer consensus of vessel and plaque ROI area measurements using both methods was excellent, with interclass correlation coefficients (ICCs) of 0.99 and 0.94, respectively. For the 7 plaques detected both by NCECT CI and Zeff mapping, the CT attenuation and Zeff blood values were both larger than the plaque values [42.00 vs. 25.67 Hounsfield unit (HU); 7.33 vs. 7.19 HU; both P<0.05]; the plaque ROI area measurement on the NCE Zeff map was smaller than that on the CE CI (48.73 vs. 77.76 mm2), but was much larger than that on the NCE CI (18.39 mm2). For all 47 plaques detected by NCE Zeff mapping, the CT attenuation and Zeff values of blood and plaques on the NCECT images showed no significant differences (42.53 vs. 35.14 HU; P=0.18; 7.32 vs. 7.31, P=0.71); however, the CNR of Zeff was significantly higher than the CT attenuation value (1.69 vs. 1.12; P<0.05) derived from the NCECT scans. Inter-reviewer agreement was good (ICC =0.78). Zeff map images derived from NCECT SBI with DLCT provide a potentially feasible approach for identifying non-calcified atherosclerotic plaques, which might be clinically useful for the screening of asymptomatic at-risk patients.