Blood Flow Volume Research Articles

Соотношение ультразвуковых и электрокардиографических параметров внутрисердечной гемодинамики при физической нагрузке у человека

The purpose of this article was to study the mechanism of reduction in stroke volume after intense physical activity (the Astrand effect). Materials and methods. The research involved 23 apparently healthy male students of Syktyvkar State University named after Pitirim Sorokin (age: 19 ± 1 years, body weight: 75 ± 13 kg, height: 177 ± 7 cm, body mass index: 24 ± 4 kg/m2). The physical load consisted of the Stange test (voluntary inspiratory breath-holding) and the Martinet test (squats to failure) performed simultaneously. The parameters of intracardiac haemodynamics were assessed using electrocardiography and ultrasonography. Results. We established that at rest, about 80 cm3 of blood passes through the mitral valve and the aortic valve in a cardiac cycle lasting on average about 0.30 s. Under physical load, the total blood flow volume through the mitral valve is reduced by 8 %, while through the aortic valve, by 15 %. The decrease in stroke volume under physical load, accompanied by an increase in heart rate, is due to a reduction in the TP segment of the electrocardiogram (diastole). The free blood flow (during diastole) from the left atrium through the mitral valve stops and the forced flow (during systole) starts, coinciding in time with the PQ interval (left atrial systole) on the electrocardiogram. Changes in the subjects’ parameters associated with the flow dynamics through the mitral valve and further through the aortic valve, as well as the processes in the TP segment (diastole) indicate that it is the shortened diastole during exercise that serves as the main link in the mechanism of all subsequent rearrangements of intracardiac haemodynamics. This study contributes to the understanding of the mechanism of the Astrand effect. Moreover, it demonstrated the dependence of the diastolic function of the ventricles on the volume of free blood flow (during diastole) through the mitral valve during the contraction of the TP segment according to the electrocardiographic data.

Clinical utility of combined assessments of 4D volumetric perfusion CT, diffusion-weighted MRI and 18F-FDG PET-CT for the prediction of outcomes of head and neck squamous cell carcinoma treated with chemoradiotherapy

BackgroundMultiparametric imaging has been seen as a route to improved prediction of chemoradiotherapy treatment outcomes. Four-dimensional volumetric perfusion CT (4D PCT) is useful for whole-organ perfusion measurement, as it reflects the heterogeneity of the tumor and its perfusion parameters. However, there has been no study using multiparametric imaging including 4D PCT for the prognostic prediction of chemoradiotherapy. The purpose of this study was to determine whether combining assessments of 4D PCT with diffusion-weighted MRI (DWI) and 18F-fluorodeoxyglucose PET-CT could enhance prognostic accuracy in head and neck squamous cell carcinoma (HNSCC) patients treated with chemoradiotherapy.MethodsWe examined 53 patients with HNSCC who underwent 4D PCT, DWI and PET-CT before chemoradiotherapy. The imaging and clinical parameters were assessed the relations to locoregional control (LRC) and progression-free survival (PFS) by logistic regression analyses. A receiver operating characteristic (ROC) analysis was performed to assess the accuracy of the significant parameters identified by the multivariate analysis for the prediction of LRC and PFS. We additionally assessed using the scoring system whether these independent parameters could have a complementary role for the prognostic prediction.ResultsThe median follow-up was 30 months. In multivariate analysis, blood flow (BF; p = 0.02) and blood volume (BV; p = 0.04) were significant prognostic factors for LRC, and BF (p = 0.03) and skewness of the ADC histogram (p = 0.02) were significant prognostic factors for PFS. A significant positive correlation was found between BF and BV (ρ = 0.6, p < 0.001) and between BF and skewness (ρ = 0.46, p < 0.01). The ROC analysis showed that prognostic accuracy for LRC of BF, BV, and combination of BF and BV were 77.8%, 70%, and 92.9%, and that for PFS of BF, skewness, and combination of BF and skewness were 55.6%, 63.2%, and 77.5%, respectively. The scoring system demonstrated that the combination of higher BF and higher BV was significantly associated with better LRC (p = 0.04), and the combination of lower BF and lower skewness was significantly associated with worse PFS (p = 0.004).ConclusionA combination of parameters derived from 4DPCT and ADC histograms may enhance prognostic accuracy in HNSCC patients treated with chemoradiotherapy.

A physiologically based pharmacokinetic model for [68Ga]Ga-(HA-)DOTATATE to predict whole-body distribution and tumor sink effects in GEP-NET patients

BackgroundLittle is known about parameters that have a relevant impact on (dis)similarities in biodistribution between various 68Ga-labeled somatostatin analogues. Additionally, the effect of tumor burden on organ uptake remains unclear. Therefore, the aim of this study was to describe and compare organ and tumor distribution of [68Ga]Ga-DOTATATE and [68Ga]Ga-HA-DOTATATE using a physiologically based pharmacokinetic (PBPK) model and to identify factors that might cause biodistribution and tumor uptake differences between both peptides. In addition, the effect of tumor burden on peptide biodistribution in gastroenteropancreatic (GEP) neuroendocrine tumor (NET) patients was assessed.MethodsA PBPK model was developed for [68Ga]Ga-(HA-)DOTATATE in GEP-NET patients. Three tumor compartments were added, representing primary tumor, liver metastases and other metastases. Furthermore, reactions describing receptor binding, internalization and recycling, renal clearance and intracellular degradation were added to the model. Scan data from GEP-NET patients were used for evaluation of model predictions. Simulations with increasing tumor volumes were performed to assess the tumor sink effect.ResultsData of 39 and 59 patients receiving [68Ga]Ga-DOTATATE and [68Ga]Ga-HA-DOTATATE, respectively, were included. Evaluations showed that the model adequately described image-based patient data and that different receptor affinities caused organ uptake dissimilarities between both peptides. Sensitivity analysis indicated that tumor blood flow and blood volume impacted tumor distribution most. Tumor sink predictions showed a decrease in spleen uptake with increasing tumor volume, which seemed clinically relevant for patients with total tumor volumes higher than ~ 550 mL.ConclusionThe developed PBPK model adequately predicted tumor and organ uptake for this GEP-NET population. Relevant organ uptake differences between [68Ga]Ga-DOTATATE and [68Ga]Ga-HA-DOTATATE were caused by different affinity profiles, while tumor uptake was mainly affected by tumor blood flow and blood volume. Furthermore, tumor sink predictions showed that for the majority of patients a tumor sink effect is not expected to be clinically relevant.

Sinomenine promotes flap survival by upregulating eNOS and eNOS-mediated autophagy via PI3K/AKT pathway

Large skin defects and surgical tissue reconstructions are frequently covered utilizing random flaps. The flap has the advantage of being designed according to the size and shape of a surgical wound. However, the necrosis of the distal part of the flap restricts the clinical application of flaps. Sinomenine (SIN) is the major active component of sinomenium acutum. SIN has been demonstrated to inhibit oxidative stress and stimulate autophagy in a cell, animal, and clinical studies. The protective and proliferative effects of sinomenium on HUVECs were evaluated by scratched test, CCK-8, and EDU assays. For the flap survival, we established a mouse random pattern flap model and observed the effects of SIN injected intraperitoneally. The survival area and blood flow intensity of the flap in sinomenium group were significantly increased compared to the control group. Our results demonstrate that SIN promotes flap survival. Sinomenium enhances eNOS expression in the flap and reduces the level of oxidative stress, promotes autophagy flux increase, reduces apoptosis, and promotes angiogenesis. Having a therapeutic benefit of SIN, Autophagy inhibitor 3-MA shows its critical role by reversing the beneficial effects of SIN, and the nitric oxide synthase inhibitor l-NAME both stimulated HUVECs that explore the relationship between autophagy flux and nitric oxide synthase. Furthermore, the mechanism in our study reveals the changes in the signal pathway of PI3K/AKT, the protective effect of SIN during antioxidant activity, the activation of eNOS through PI3K/AKT signaling pathway affects autophagy through the eNOS system, and promote the random flap survival.

Umbilical vein blood flow: State‐of‐the‐art

Placental blood supply to the fetus can be measured by evaluating the umbilical vein blood flow. Despite its potential application in healthcare, the umbilical vein blood flow volume is still used only in research setting. One of the reasons is a concern regarding its reproducibility, partly due to technology issues. Nowadays, technology improvements make this evaluation accurate and reproducible. The aim of this review is to refresh basic elements of the physiology of umbilical vein blood flow and its analysis. Its evaluation in normal and abnormal fetal growth is also discussed.

Rapid-onset dystonia-parkinsonism is associated with reduced cerebral blood flow without gray matter changes.

Previous research showed discrete neuropathological changes associated with rapid-onset dystonia-parkinsonism (RDP) in brains from patients with an ATP1A3 variant, specifically in areas that mediate motor function. The purpose of this study was to determine if magnetic resonance imaging methodologies could identify differences between RDP patients and variant-negative controls in areas of the brain that mediate motor function in order to provide biomarkers for future treatment or prevention trials. Magnetic resonance imaging voxel-based morphometry and arterial spin labeling were used to measure gray matter volume and cerebral blood flow, respectively, in cortical motor areas, basal ganglia, thalamus, and cerebellum, in RDP patients with ATP1A3 variants (n = 19; mean age = 37 ± 14 years; 47% female) and variant-negative healthy controls (n = 11; mean age = 34 ± 19 years; 36% female). We report age and sex-adjusted between group differences, with decreased cerebral blood flow among patients with ATP1A3 variants compared to variant-negative controls in the thalamus (p = 0.005, Bonferroni alpha level < 0.007 adjusted for regions). There were no statistically significant between-group differences for measures of gray matter volume. There is reduced cerebral blood flow within brain regions in patients with ATP1A3 variants within the thalamus. Additionally, the lack of corresponding gray matter volume differences may suggest an underlying functional etiology rather than structural abnormality.

Cerebrovascular impedance estimation with near-infrared and diffuse correlation spectroscopy.

Cerebrovascular impedance (CVI) is related to cerebral autoregulation (CA), which is the mechanism of the brain to maintain near-constant cerebral blood flow (CBF) despite changes in cerebral perfusion pressure (CPP). Changes in blood vessel impedance enable the stabilization of blood flow. Due to the interplay between CVI and CA, assessment of CVI may enable quantification of CA and may serve as a biomarker for cerebral health. We developed a method to quantify CVI based on a combination of diffuse correlation spectroscopy (DCS) and continuous wave (CW) near-infrared spectroscopy (NIRS). Data on healthy human volunteers were used to validate the method. A combined high-speed DCS-NIRS system was developed, allowing for simultaneous, noninvasive blood flow, and volume measurements in the same tissue compartment. Blood volume was used as a surrogate measurement for blood pressure and CVI was calculated as the spectral ratio of blood volume and blood flow changes. This technique was validated on six healthy human volunteers undergoing postural changes to elicit CVI changes. Averaged across the six subjects, a decrease in CVI was found for a head of bed (HOB) tilting of . These impedance changes were reversed when returning to the horizontal (0deg) HOB baseline. We developed a combined DCS-NIRS system, which measures CBF and volume changes, which we demonstrate can be used to measure CVI. Using CVI as a metric of CA may be beneficial for assessing cerebral health, especially in patients where CPP is altered.

Collateral circulation predicts 3-month functional outcomes of subacute ischemic stroke patients: A study combining arterial spin labeling and MR angiography

ObjectiveCollateral circulation could help preserve the blood supply and protect penumbra in ischemic stroke (IS), critical for late-window therapeutic decisions and clinical outcomes. In this study, we aimed to investigate the prognostic value of two collateral indexes measured by arterial spin labeling (ASL) and MR angiography (MRA) in subacute IS patients. Materials and MethodsFifty-five subacute IS patients with large artery atherosclerosis were retrospectively collected. Arterial transit artifact (ATA) on ASL and good circulation (GC) on MRA were ranked as markers of leptomeningeal collaterals and fast collaterals, respectively. Volume and relative cerebral blood flow (rCBF) of infarct and hypoperfusion area were calculated. Stroke severity was determined by baseline- and discharge- National Institute of Hospital Stroke Scale (NIHSS). Functional independence (FI) was defined as 3-month modified Ranking Scale ≤2. Univariate analyses and multivariable logistic regression analyses were conducted to identify the independent predictors of FI. ResultsThirty-eight patients (69.1 %) presented ATA and 29 (52.7 %) patients presented GC. Univariate analyses showed that baseline-NIHSS, discharge-NIHSS, rCBF of infarct, presence of ATA and GC were associated with FI (P < 0.05). After multivariable adjustment, ATA (adjusted Odds Ratio [OR]: 13.785, 95 % CI: 2.608–72.870, P = 0.002) and GC (adjusted OR: 8.317, 95 % CI: 1.629–42.454, P = 0.011) remained independent predictors of FI. Besides, patients with both ATA and GC had the highest frequencies of FI while patients with neither of them showed the lowest (94.7 % vs 14.3 %, P < 0.001), indicating a positive synergistic effect between ATA and GC. ConclusionThe combination of ASL and MRA simultaneously reflects leptomeningeal collaterals and fast collaterals, providing a useful method to predict functional outcomes of subacute IS patients.

Reader Response: Prevalence and Significance of Impaired Microvascular Tissue Reperfusion Despite Macrovascular Angiographic Reperfusion (No-Reflow).

Ng et al.1 recently reported a 25% prevalence of hypoperfusion—a >15% reduction of cerebral blood flow (CBF) or cerebral blood volume (CBV) from the mirror region on CT perfusion imaging—within the 24-hour infarct window, despite complete anterior circulation recanalization (TICI 2c/3), which negatively affected functional outcome. These findings contrast with our earlier finding of 6% (2/33) hypoperfused infarcts, where the 24-hour arterial spin labeling (ASL)-CBF images were analyzed according to the Alberta Stroke Program Early CT Score (ASPECTS) template.2 We have reanalyzed our data set considering the entire middle cerebral arterial (MCA) territory, irrespective of ASPECTS. After excluding areas with confluent hemorrhagic transformation or parenchymal hematoma on the 24-hour MRI, consensus by 2 raters (kappa = 0.752) identified only 2 additional patients exhibiting patchy mild-to-moderate hypoperfusion with volumes too small to be reliably measured on ASL images, for a total prevalence of 4 of 33 patients (12%). After excluding patients with missing mRS (n = 2) or associated infarcts outside the MCA territory (n = 5), univariate analysis showed no significant association of “no-reflow” presence with a 3-month mRS of 0–1 or 0–2. A multivariate analysis was precluded by low occurrence of no-reflow. Taken together with this article and another recent report,3 the prevalence of no-reflow after recanalized MCA stroke appears to stand ∼15–20%, depending on the perfusion modality used, and often involves small areas. The true impact on clinical outcome remains unclear.3

Fibroblast Growth Factor 9 Inhibited Apoptosis in Random Flap via the ERK1/2-Nrf2 Pathway to Improve Tissue Survival.

The application of random pattern skin flaps is limited in plastic surgery reconstruction due to necrosis. Fibroblast growth factor 9 (FGF9) was reported to exert a protective effect against myocardial damage and cerebral ischemia injury, but the impact of FGF9 in random flap survival is still unclear. In this study, we used a mouse model of random flaps to verify that FGF9 can directly increase flap survival area and blood flow intensity by promoting angiogenesis. In total, 84 male C57BL/6 mice weighing between 22 and 25 g were randomly divided into three groups (n = 28 each group). After skin flap operation, one group served as a control, a treatment group received FGF9, and a treatment group received FGF9+U0126. All flap samples were incised on postoperative day 7. Our results showed that flap survival was significantly increased in the FGF9 group compared with that in the control group. This protective function was restrained by U0126. The results of histopathology, laser Doppler, and fluorescent staining all showed significant increases in capillary count, collagen deposition, and angiogenesis. FGF9 also significantly increased the expression of antioxidant stress proteins SOD1, eNOS, HO-1, vascular marker proteins CD31, VE cadherin, and pericyte marker protein PDGFRβ. Western blot showed that the phosphorylation degree of ERK1/2 increased after FGF9 treatment, and the expression of Nrf2, a downstream factor, was u-regulated. Western blot and immunofluorescence results of apoptosis-related proteins cleaved caspase-3, BAX, and Bcl2 showed that FGF9 inhibited apoptosis. ERK inhibitor U01926 reduced the beneficial effects of FGF9 on skin flap survival, including promoting angiogenesis, and showing antiapoptosis and antioxidative stress activities. Exogenous FGF9 stimulates angiogenesis of random flap and survival of tissue. the impact of FGF9 is closely linked to the prevention of oxidative stress mediated by ERK1/2-Nrf2. In the function of FGF9 in promoting effective angiogenesis, there may be a close interaction in the FGF9-FGFR-PDGFR-ERK-VE cadherin pathway. In particular, PDGFR and VE cadherin may interact.

Effect of evolocumab on the progression of intraplaque neovascularization of the carotid based on contrast-enhanced ultrasonography (EPIC study): A prospective single-arm, open-label study.

Background and Purpose: The aim of this study was to explore the effect of half a year of evolocumab plus moderate-intensity statin treatment on carotid intraplaque neovascularization (IPN) and blood lipid levels. Methods: A total of 31 patients with 33 carotid plaques who received evolocumab plus statin treatment were included. Blood lipid levels, B-mode ultrasound and contrast-enhanced ultrasonography (CEUS) at baseline and after half a year of evolocumab plus statin therapy were collected. The area under the curve (AUC) reflected the total amount of acoustic developer entering the plaque or lumen within the 180s measurement period. The enhanced intensity reflected the peak blood flow intensity during the monitoring period, and the contrast agent area reflected the area of vessels in the plaques. Results: Except for high-density lipoprotein cholesterol (HDL-c), all other lipid indices decreased. Compared with baseline, low-density lipoprotein cholesterol (LDL-c) decreased by approximately 57% (p < 0.001); total cholesterol (TC) decreased by approximately 34% (p < 0.001); small dense low-density lipoprotein (sd-LDL) decreased by approximately 52% (p < 0.001); and HDL-c increased by approximately 20% (p < 0.001). B-mode ultrasonography showed that the length and thickness of the plaque and the hypoechoic area ratio were reduced (p < 0.05). The plaque area, calcified area ratio, and lumen cross-sectional area changed little (p > 0.05). CEUS revealed that the area under the curve of plaque/lumen [AUC (P/L)] decreased from 0.27 ± 0.13 to 0.19 ± 0.11 (p < 0.001). The enhanced intensity ratio of plaque/lumen [intensity ratio (P/L)] decreased from 0.37 ± 0.16 to 0.31 ± 0.14 (p = 0.009). The contrast agent area in plaque/area of plaque decreased from 19.20 ± 13.23 to 12.66 ± 9.59 (p = 0.003). The neovascularization score decreased from 2.64 ± 0.54 to 2.06 ± 0.86 (p < 0.001). Subgroup analysis based on statin duration (<6months and ≥6months) showed that there was no significant difference in the AUC (P/L) or intensity ratio (P/L) at baseline or after half a year of evolocumab treatment. Conclusion: This study found that evolocumab combined with moderate-intensity statins significantly improved the blood lipid profile and reduced carotid IPN. Clinical Trial Registration: https://www.clinicaltrials.gov; identifier: NCT04423406.

Estimating the optimal value of diameter of the inlet to the impeller of a centrifugal blood pump

The article is devoted to the optimization of the design of the inlet zone of a centrifugal blood pump. One of the disadvantages of such pumps is the generation of turbulence in the flow of the pumped fluid, which contributes to high blood hemolysis. The reason for turbulence lies in a combination of geometric and kinematic factors, in particular, a 90 degree turn of the flow in the inlet part of the impeller channels and a high circumferential speed of rotation of its channels. The hydrodynamic consequence of this is an increase in the hydraulic resistance of the pump flow path and separation of the boundary layer from the streamlined surface. As a result, the non-uniformity of the flow velocity field increases and separation flow zones appear, stimulating vortex formation and turbulence of the blood flow. The article provides the derivation of an equation for calculating the optimal diameter of the impeller D1, which does not have a bushing in the inlet. This design is typical for centrifugal blood pumps. As a criterion for the optimal value of D1, the minimum level of hydraulic resistance in the inlet zone of the pump was considered. Based on the derived formula, a graph of D1 values was constructed in the range of parameters: blood volume flow 3…6 liters per minute, speed 4000-10000 rpm. With an increase in blood flow and a decrease in the number of revolutions of the impeller, the diameter of the inlet to the impeller must be increased from 6.4 mm to 13.8 mm.

Phthalide derivative CD21 regulates the platelet- neutrophil extracellular trap-thrombin axis and protects against ischemic brain injury in rodents.

Prothrombotic and proinflammatory properties of neutrophil extracellular traps (NETs) contribute to brain damage after ischemic stroke. CD21 is a novel phthalide neuroprotectant against cerebral ischemia in rodents. This study investigated effects of CD21 on the platelet-NET-thrombin axis and ischemic brain injury and the underlying mechanism. CD21 exerteddose-dependent neuroprotectionin rats that were subjected to2h middle cerebral artery occlusion,dose-dependentlyinhibited adenosine diphosphate-mediatedplatelet aggregationin rats, and dose-dependentlyexertedanti-thrombotic activityin rodents that received a collagen-epinephrine combination, ferric chloride, or an arteriovenous shunt. Equimolar CD21 doses exerted stronger efficacy than 3-N-butylphthalide (NBP, natural phthalide for the treatment of ischemic stroke). CD21 dose-dependently improved regional cerebral blood flow, neurobehavioral deficits, and infarct volume in mice that were subjected to photothrombotic stroke (PTS). CD21 (13.79mg/kg, i.v.) significantly decreased NET components (plasma dsDNA concentrations; mRNA levels of elastase, myeloperoxidase, and neutrophil gelatinase-associated lipocalin and protein level of citrullinated histone H3 in ischemic brain tissues), mRNA and protein levels of peptidyl-arginine deiminase 4 (PDA4, NET formation enzyme), and mRNA levels of NET-related inflammatory mediators (interleukin-1β, interleukin-17A, matrix metalloproteinase 8, and matrix metalloproteinase 9) in ischemic brain tissues, despite no effect on mRNA levels of deoxyribonuclease I (NET elimination enzyme). Pretreatment with compound C (inhibitor of adenosine monophosphate-activated protein kinase [AMPK]) significantly reversed the inhibitory effects of CD21 on NETs, PDA4, and inflammatory mediators in PTS mice. These results suggest that CD21 might regulate the platelet-NET-thrombin axis and protect against ischemic brain injury partly through the induction of AMPK activation.

Aging and Sex Differences in Brain Volume and Cerebral Blood Flow.

How do regional brain volume ratios and cerebral blood flow (CBF, mL/min) change with aging, and are there sex differences? This study aimed to comprehensively evaluate the relationships between regional brain volume ratios and CBF in healthy brains. The study participants were healthy volunteers who underwent three-dimensional T1-weighted MRI, time-of-flight MR angiography, and four-dimensional (4D) flow MRI between 2020 and 2022. The brain was automatically segmented into 21 brain subregions from 3D T1-weighted MRI, and CBF in 16 major intracranial arteries were measured by 4D flow MRI. The relationships between segmented brain volume ratios and CBFs around the circle of Willis were comprehensively investigated in each decade and sex. This study included 129 healthy volunteers (mean age ± SD, 48.2 ± 16.8; range, 22-92 years; 43 males and 86 females). The association was strongest between the cortical gray matter volume ratio and total outflow of the intracranial major arteries distal to the circle of Willis (Pearson's correlation coefficient, r: 0.425). In addition, the mean flow of the total inflow and outflow around the circle of Willis were significantly greater in women than men, and significant left-right differences were observed in CBFs even on the peripheral side of the circle of Willis. Moreover, the correlation was strongest between the left cortical gray matter volume ratio and the combined flows of the left anterior and posterior cerebral arteries distal to the circle of Willis (r: 0.486). There was a trend toward greater total intracranial CBF, especially among women in their 40s and younger, who had a larger cortical gray matter volume. This finding may be one of the reasons for the approximately twofold higher incidence of cerebral aneurysms and subarachnoid hemorrhage, and a threefold higher incidence of migraine headaches.

Biomarkers Predictive of Distant Disease-free Survival Derived from Diffusion-weighted Imaging of Breast Cancer.

To investigate whether intravoxel incoherent motion (IVIM) and/or non-Gaussian diffusion parameters are associated with distant disease-free survival (DDFS) in patients with invasive breast cancer. From May 2013 to March 2015, 101 patients (mean age 60.0, range 28-88) with invasive breast cancer were evaluated prospectively. IVIM parameters (flowing blood volume fraction [fIVIM] and pseudodiffusion coefficient [D*]) and non-Gaussian diffusion parameters (theoretical apparent diffusion coefficient [ADC] at a b value of 0 s/mm2 [ADC0] and kurtosis [K]) were estimated using a diffusion-weighted imaging series of 16 b values up to 2500 s/mm2. Shifted ADC values (sADC200-1500) and standard ADC values (ADC0-800) were also calculated. The Kaplan-Meier method was used to generate survival analyses for DDFS, which were compared using the log-rank test. Univariable Cox proportional hazards models were used to assess any associations between each parameter and distant metastasis-free survival. The median observation period was 80 months (range, 35-92 months). Among the 101 patients, 12 (11.9%) developed distant metastasis, with a median time to metastasis of 79 months (range, 10-92 months). Kaplan-Meier analysis showed that DDFS was significantly shorter in patients with K > 0.98 than in those with K ≤ 0.98 (P = 0.04). Cox regression analysis showed a marginal statistical association between K and distant metastasis-free survival (P = 0.05). Non-Gaussian diffusion may be associated with prognosis in invasive breast cancer. A higher K may be a marker to help identify patients at an elevated risk of distant metastasis, which could guide subsequent treatment.

Effects of Online Live Pilates Training during the COVID-19 Pandemic on Body Composition, Cardiovascular Function, and Physical Fitness in Sedentary Middle-aged Obese Women

PURPOSE This study aimed to investigate how a 10-week online live Pilates training held during the COVID-19 pandemic affected body composition, cardiovascular function, and physical fitness in sedentary middle-aged obese women. METHODS Thirty obese women, aged 30 to 49 years (BMI : 25kg/m&lt;sup&gt;2&lt;/sup&gt; or more; waist circumference: 85cm or more) who were leading a sedentary lifestyle for more than 8 hours a day were assigned to one of two groups—that is, the Pilates training group (TR) and the control group (CON). Four participants were dropped from the study during the intervention period. Participants in the TR group (&lt;i&gt;n&lt;/i&gt;=13) performed online live mat Pilates exercises (3 sessions per week; 60 minutes per session for 10 weeks, whereas participants in the CON group (&lt;i&gt;n&lt;/i&gt;=13) were asked to maintain their normal lifestyles during the same intervention period. Independent variables related to body composition, cardiovascular function, venous function in the lower body, physical fitness, and 1-RM (repetition maximum) were measured at pre-test and post-test, and data were compared between the two groups and between the two tests. RESULTS 1) Regarding body composition, body weight, body mass index, fat mass, and waist circumference decreased significantly in the TR group. 2) Regarding cardiovascular function, stroke volume and cardiac output increased significantly in the TR group, and total peripheral resistance decreased significantly in the TR group. 3) Regarding venous function in the lower body, blood flow velocity and blood flow volume of the parenchyma area increased significantly in the TR group. 4) Regarding physical fitness, cardiorespiratory endurance, muscular endurance, flexibility, and balance improved significantly in the TR group. 5) 1RM of biceps curl, lat pull-down, leg curl, and leg extension increased significantly in the TR group. CONCLUSIONS It was concluded that the 10-week online live Pilates training had positive effects on the body composition, cardiovascular function, venous function in the lower body, and physical fitness of middle-aged obese women leading sedentary lifestyles.

Correlation of Ultrasound Umbilical Venous Blood Flow in Normal Pregnancy with Gestational Age and Foetal Weight

Background: Umbilical venous (UV) blood flow is a direct and physiological measurement of vascular placental function.&#x0D; Objectives: To correlate UV blood flow with gestational age (GA) and foetal weight (FW) in a cohort of normal pregnant Nigerian women.&#x0D; Materials and Methods: 2,247 women with normal singleton pregnancy between 20 – 40 weeks were included in this study, which was conducted between May 2020 – October 2022, in Bayelsa State, South-South Nigeria. The women had ultrasound assessment of UV blood flow and foetal biometric parameters and weight. Data was analysed using SPSS version 25, associations between categorical variables and between categorical and continuous variables were assessed using chi square and t-test, respectively, with p-value &lt;0.05 considered statistically significant. Correlation analysis was done, and presented in tables and charts.&#x0D; Results: There was a strong linear correlation between UV blood flow volume and GA (correlation coefficient, ɼ= 0.95; p=0.001), FW (ɼ=0.81; p=0.001), foetal biparietal diameter (BPD) (ɼ=0.88; P=0.001) and abdominal circumference (AC) (ɼ=0.75; P=0.001). Conversely, UV blood flow volume/FW showed a strong inverse relationship with FW (ɼ=- 0.73; p = 0.001), and a weak inverse relationship with GA (ɼ=- 0.36; p = 0.001).&#x0D; Conclusion: UV blood flow increases with advancing gestation and FW. The increase in UV blood flow in later gestation is however surpassed by the increase in FW, resulting in a reduction in UV blood flow volume per unit FW in the third trimester. The linear increase in UV blood flow volume with foetal BPD and AC suggests that these three parameters could be used in combination to estimate both GA and FW.

Using cardiovascular parameters for determination of person’s gender identity

BACKGROUND: Emotional stress is a significant risk factor for the development of cardiovascular diseases. Prenosological diagnostics of these conditions becomes important. The peculiarities of adaptive reactions are largely determined by individual psychological characteristics of an individual, including gender identity.&#x0D; AIM: Determination of correlation of functional parameters of the cardiovascular system for objectification of psychological criteria for classification of gender identity.&#x0D; MATERIALS AND METHODS: Hemodynamics and heart rate variability were studied in people with different gender identities. A total of 200 volunteers of both sexes were examined in a state of mental and physical rest. 14 parameters of cardiovascular activity were selected to construct discriminant functions: stroke volume of blood flow, cardiac output, cardiac index, stroke index, heart rate, standard deviation of RR intervals, square root of the mean squared difference of successive RR, percentage of RR intervals with a sinus rhythm of the heart, which differ by more than 50 ms, index of vegetative equilibrium, vegetative rhythm index, indicator of the adequacy of regulatory processes, stress index of regulatory systems, indicator of the activity of regulatory systems. The obtained indicators and initial coefficients reflecting the contribution of each parameter to the discrimination of groups were used to calculate discriminant functions.&#x0D; RESULTS: It was found that the graphs reflecting the results of discriminant analysis showed a high degree of accuracy in classifying men (97.6%) and women (96.5%) by gender identity based on objective characteristics of cardiovascular activity. The objectivity of psychological testing with a high probability of predicting the type of gender identity based on the analysis of rheography and rhythmocardiography data is shown.&#x0D; CONCLUSIONS: The use of objective characteristics of cardiovascular activity obtained during rheography and rhythmocardiography made it possible to predict the type of a persons gender identity with high probability.

Comparative Analysis of Methods of Laser Doppler Flowmetry and Doppler Ultrasound Measurement of Blood Flow during the Procedure of Intermittent Pneumatic Compression

The results of the analysis of microcirculation of the blood flow of the toe and ultrasound Doppler measurement of blood flow in the femoral artery during the intermittent pneumatic compression procedure are presented. A professional device “Doctor Life Mark 400” (South Korea) was used for the pressotherapy procedure. Microcirculation was measured using a portable laser Doppler flowmeter “LAZMA PF” (Russia). Ultrasonic Dopplerograms were obtained using the device “Edan U50” (China) with a linear sensor model L15-7b with a frequency in pulsed Doppler mode (PW) 7.2 MHz. The study involved a group of 11 subjects without identified vascular disorders, the age of the group was from 23 to 42 years. The method of calculating the average speed and volume of blood flow over the period of the cardiac cycle was used for ultrasound Dopplerograms. Arterial resistance was evaluated, which was compared with the dynamics of perfusion in the limb. In the studies, approximately half of the test subjects had an increase in perfusion of the microcirculatory bed and a decrease in resistance of arterial vessels. At the same time, with an increase in the perfusion of the microcirculatory bed, a decrease in the resistance of arterial vessels was observed.

Doppler indices of uterine arteries and mRNA transcripts of hormone receptors in cervix vis-à-vis dilatation therapy in buffaloes affected with incomplete cervical dilatation associated with uterine torsion

The present study aimed to investigate the Doppler indices and mRNA transcripts of hormone receptors in relation to the response of dilatation therapy in incomplete cervical dilatation (ICD) associated with uterine torsion in buffaloes. Out of 36 successfully detorted uterine torsion cases, eight buffaloes revealed a fully dilated cervix, while the remaining 28 had ICD, and subjected to dilatation therapy (500 μg cloprostenol + 2 mg estradiol benzoate + 80 mg valethamate bromide + 50 IU oxytocin + 250 mL calcium borogluconate). The responses of dilatation therapy were assessed in 26 buffaloes as one died, and one could not follow up. Doppler indices of middle uterine arteries on trans-rectal ultrasound were evaluated pre- and 30–60 min post-detorsion. Cervical tissue biopsies were collected from 16 buffaloes to study mRNA transcripts of hormone receptors. The duration, degree, location of uterine torsion, fetal viability, consistency of the cervix, relaxation of pelvic ligaments, udder engorgement, and gestation length were also recorded to evaluate the response of dilatation therapy. The 73.08% (19/26) buffaloes responded to the therapy with a duration ranging from 2 to 56 hrs (18.41 ± 4.11). The significantly increased blood flow volume (BFV) and time-average peak velocity (TAP) while the significantly reduced resistive index (RI) and pulsatility index (PI) in an ipsilateral middle uterine artery (MUA) at post-detorsion were observed in dilation therapy responded than the not-responded group. The mRNA transcripts of estradiol receptors-α (ESR1), prostaglandin receptors (PTGFR), and oxytocin receptors (OXTR) were upregulated by 7.47, 6.63, and 8.72-fold in the ICD group, respectively. The Doppler indices along with duration of illness, location of uterine torsion, consistency of the cervix, and udder engorgement can be used to predict the response of dilatation therapy in ICD associated with uterine torsion. The upregulated mRNA expression of ESR1, PTGFR and OXTR is mandatory for success of dilatation therapy.