Changes In Vessels Research Articles

Histological changes of the adrenal glands vessels after experimental thermal trauma and under the conditions of lyophilized xenoskin use

Burns, as a stress factor, cause circulatory and microcirculation disorders in the organs. In the scientific literature, the issues of structural reorganization of the vascular bed of the adrenal glands in thermal trauma and under conditions of correction by lyophilized xenoskin are insufficiently covered and therefore require further study. The aim of our study was to study the microscopic changes of the vessels of the adrenal glands in the dynamics after experimental thermal trauma and under conditions of correction. The experiment was performed on adult white male rats. Grade III burn (18-20 % of the skin surface) was applied under thiopental-sodium anesthesia with copper plates heated in water to a temperature of 97-1000C, on the epilated surface of the skin of the back for 10 seconds. One day after the thermal injury, an early necrectomy was performed and the wound was covered with a substrate of lyophilized xenoskin. Animal decapitation and microscopic changes were studied at days 7, 14, and 21 of injury modeling. The manufacture of histopreparations was carried out according to conventional methods. Histological examinations after experimental thermal trauma and correction of xenoskin substrate on the 7th day showed that already in this period of the experiment there were less pronounced destructive changes in the structure of the vessels of the adrenal glands. Some blood vessels were unevenly filled and dilated. The hemocapillaries of the microcirculatory tract are blood-filled, the vessel wall is destructively altered, and perivascular edema is present. On the 14th day of the experiment, moderately blood vessels were observed. The wall of large vessels is slightly swollen, partially thickened, hemocapillaries are moderately blood-filled, with dilated lumens and continuous endothelial lining. Under the conditions of application of the substrate of lyophilized xenoskin on the 21st day of the experiment, the structural organization of the vascular bed of the adrenal glands was significantly better compared to the previous terms of the study. Most vessels had evenly dilated lumens and moderate blood supply, and wall edema was insignificant. The walls of microvessels are preserved, well structured, endotheliocytes without severe damage, without signs of infiltration and edema. Thus, the results of microscopic examination showed that early necrectomy, and subsequent closure of the wound with a substrate of lyophilized xenoskin, creates optimal conditions for regenerative processes in both burns and vascular bed of the adrenal glands. On the 7th day after the burn and under conditions of correction, the study of the vascular bed of the adrenal glands showed a moderate degree of destructive changes in the vascular bed of the adrenal glands and the initial signs of their regeneration. In the late terms (14-21 days) of the experiment the relative normalization of cellular parenchymal components of the organ was established against the background of restoration of the structural organization of the microcirculatory tract.

Microscopic changes of the pancreas vessels in the dynamics after experimental thermal injury

The problem of burns is relevant in the world and in Ukraine. Thermal injury is not limited to local tissue changes, but causes significant morphofunctional disorders in the organs and systems of the affected organism, the result of this factor is a violation of blood supply to organs, including the pancreas. The aim of this work was to establish the histological condition of the vessels of the pancreas after experimental thermal injury. The experiments were performed on 40 adult white rats. Burns were applied under thiopental-sodium anesthesia with copper plates at a temperature of 96-97℃ on the epilated surface of the skin of the back of animals for 15 seconds (the lesion area was 18-20 % of the body surface). Decapitation of animals was performed on 1, 7, 14 and 21 days of the experiment. Pieces of the pancreas were taken for histological examination and processed according to generally accepted methods. Histological sections 5-6 μm thick were stained with hematoxylin-eosin, impregnated with silver by the Gordon-Sweets method, as well as staining by the tricolor method of MSB (ORB). Histological specimens were examined and documented using an SEO SCAN light microscope and a Vision CCD Camera. In the early stages of the experiment revealed a violation of the blood supply to the body. The lumens of most arteries were found to be dilated, and the wall thickness increased due to hypertrophy of the smooth muscle cells of the media. Leukocyte infiltration was determined in the perivascular spaces. The lumens of the small and middle veins were dilated and filled with blood, with parietal thrombi in some of them. Capillaries are characterized by a moderate expansion of their lumens, stasis. There was swelling of the paravasal spaces. Significant destructive-degenerative, inflammatory and sclerotic changes were observed in the later stages of the experiment. The walls of the vessels were moderately swollen. Smooth myocytes of the arterial media were hypertrophied, the cytoplasm was vacuolated, and contained pyknotically altered nuclei. Adventitia of vessels, especially veins, was swollen and fibrous. Occasionally there were violations of the wall of the components of the microcirculatory tract, which was accompanied by hemorrhage. There are single thrombosed vessels, spasmed arterioles, hemocapillaries with dilated lumens. The greatest changes, especially on the 21st day, were the adventitial membrane with the growth of collagen and reticular fibers. The blood supply to the vessels was moderate. Vessels of small diameter and hemomicrocirculatory tract were also significantly altered, their wall is deformed, thin, homogeneous. The lumens are dilated, with the formation of blood clots. Thus, in the early stages of the experiment there are adaptive-compensatory processes and initial destructive changes in the walls of the vessels of the organ, manifested by stasis, thrombosis, edema, deformation, infiltration of the wall and perivascular space. In the late period, significant destructive-degenerative changes in the structure of the walls of the vessels of the pancreas, accompanied by hemorrhage, inflammation, sclerosis of the wall and edema of the adventitia. These changes lead to a deterioration of blood supply and, consequently, a decrease in the functional activity of the body.

Clinical study of diabetic peripheral neuropathy screening by retinal vascular geometric parameters

To investigate the relationship between geometrical changes of retinal vessels and diabetic peripheral neuropathy (DPN), and to determine the effectiveness of retinal vascular geometry analysis and vibration perception threshold (VPT) for DPN assessment. Type 2 diabetes patients (n = 242) were categorized by stage of DPN. VPT and fundus photography was performed to obtain retinal vascular geometry parameters. The risk factors for DPN and the correlation between DPN stages were analyzed. The efficiency of the retinal vascular geometric parameters obtained with VPT as a diagnostic tool for DPN was examined. Stages of DPN showed a linear correlation with VPT (r = 0.818), central retinal vein equivalent (CRVE) (r = 0.716), and fractal dimension arterioles (DFa) (r = − 0.769). VPT, CRVE, DFa, and fractal dimension veins (DFv) showed high sensitivity (80%, 55%, 82%, and 67%, respectively) and specificity (92%, 93%, 82%, and 80%, respectively) for DPN diagnosis. Good agreement was observed between combined use of geometric parameters (CRVE, DFa and DFv) and VPT (Kappa value 0.430). The detection rate of DPN with combined use of geometric parameters of retinal vessels (64.88%) was significantly higher than that with use of VPT (47.52%). Retinal vascular geometry changes demonstrated significant correlation with DPN severity. VPT, CRVE, DFa, and DFv may provide insights for understanding DPN.

Surgical treatment for brachiocephalic artery aneurysm with Takayasu arteritis using isolated cerebral perfusion: a case study

BackgroundTakayasu arteritis (TA) is a chronic inflammatory disease that induces stenosis, occlusion, or aneurysmal degeneration of the aorta and its major branches. Though rarely reported, proximal aneurysmal lesions from the aortic root to the arch are more common in Asian populations than in Western populations. In the surgical treatment of TA, anastomotic aneurysm can be problematic. Furthermore, atherosclerotic complications should be considered in surgical treatment for elderly TA patients.Case presentationHere, we report a case of brachiocephalic artery (BCA) aneurysm with TA for which surgical treatment was successful. Though it was solely a lesion of the brachiocephalic artery, after considering the patient’s clinical background and the features of TA, we chose a partial arch replacement. Further, for avoidance of anastomotic aneurysm, both distal and proximal anastomosis were reinforced with Teflon felt strips. Preoperative computed tomography detected severe atherosclerotic changes in the arch vessels. The patient underwent partial arch replacement using isolated cerebral perfusion (ICP) for brain protection and recovered without any neurological deficits.ConclusionsIn avoidance with anastomotic aneurysm, reinforcement of the anastomosis was introduced. ICP was effective for brain protection in case with severe atherosclerotic changes.

Experimental research in rats on the reactivity of new corneal blood vessels to adrenaline.

Aim: The purpose of this experimental study was to evaluate the existence of adrenergic receptors in ketamine-induced corneal blood vessels in rat pups. Methods: The study of corneal neovascularization motricity was performed on 45-day-old Wistar rats in which, starting from the 15th day of life, corneal blood vessels were obtained by injecting intraperitoneal ketamine at a dose of 150 mg/ kg body weight, a total of 5 successive doses. The examination of the neovascularization was done with the help of a Nikon stereomicroscope connected to a video camera and a computer, the total magnification being 400X. The reactivity of the new corneal blood vessels to the administration in conjunctival instillations of a 1.5 mmol/L adrenaline solution was tested. The parameters followed were represented by variations in the caliber of corneal blood vessels. The data were analyzed using Microsoft Office Excel.Results: Administration of distilled water did not produce statistically significant changes in corneal blood vessels, while adrenaline produced a statistically significant constriction of vascular diameter (p=0.01 at T9, p=0.004 at T10, p=0.019 at time T11 of examinations).Conclusions: The results showed that adrenaline produces vasoconstriction in the new corneal blood vessels, which allows us to assume that they contain α-adrenergic receptors. However, we cannot say that corneal pathological vessels do not contain β2-type adrenergic receptors, because the effect of adrenaline may be an algebraic sum between vasoconstriction produced by stimulating α-adrenergic receptors and vasodilation produced by stimulating β2-adrenergic receptors, but in which the vasodilating effect may be masked by the vasoconstrictor effect given by a higher density of α-adrenergic receptors.Abbreviations: A= adrenaline, DNM = non-measurable diameter, NA= noradrenaline, Std.Er.= Standard error

Bulbar Conjunctival Microvascular Alterations in Thyroid-Associated Ophthalmopathy Patients with Different Activities

ABSTRACT Purpose: To evaluate the morphologic and hemodynamic changes of bulbar conjunctival vessels in thyroid-associated ophthalmopathy (TAO) patients and the correlations with the activity. Methods: Patients diagnosed as TAO with different clinical activity scores (CAS) and healthy participants were recruited. All subjects underwent a complete ophthalmic examination and functional slit-lamp biomicroscope. Vascular variables including the vessel density, vessel complexity, average diameter, blood flow velocity and blood flow rate in microvascular networks were measured. The correlations among microvascular parameters, CAS and exophthalmos were analyzed. Areas under the receiver operating characteristic curves (AUROCs) were applied to evaluate the diagnostic accuracy of microvascular alterations for active TAO. Results: A total of 46 eyes were enrolled in our study. The vessel complexity and blood flow velocity increased in the active TAO group significantly compared with the inactive group and healthy controls (P < .05). Meanwhile, the vessel complexity and blood flow rate were positively correlated with CAS (r = 0.641 and r = 0.526). Bulbar conjunctival microvascular parameters performed a good ability in distinguishing the active stage of TAO (AUROC = 0.793). Conclusions: Increasing bulbar conjunctival vessel complexity and blood flow were evident in TAO with severe inflammation. The measurements of bulbar conjunctival microvasculature could be a reference to evaluate activity in TAO.

Chorioretinal Alterations Induced by Preeclampsia.

Hypertension during pregnancy, which is essentially a microvascular disease that destroys the end-organ microcirculation, should not be underestimated, as it could lead to organ failure in the kidneys, lungs, and brain. Preassessment of the microcirculatory state through systematic observation of the fundus has been proven to be noninvasive and feasible. Although hypertension in preeclampsia patients will resolve after childbirth, the sticking point is determining the best termination moment. Early diagnosis and treatment can prevent long-term ocular complications and cardiovascular risks for pregnant women in the future. In order to adjust the treatment strategy through more sensitive and precise fundus changes, we comprehensively summarized the common structural changes in the fundus in preeclampsia patients, including changes in the blood vessels, choroid, and retina, as well as the application of quantitative observation for chorioretinal alterations in recent years.

Quantitative analysis of vascular changes during photoimmunotherapy using speckle variance optical coherence tomography (SV-OCT).

Near-infrared (NIR) photoimmunotherapy (NIR-PIT) is an emerging cancer therapy based on a monoclonal antibody and phthalocyanine dye conjugate. Direct tumor necrosis and immunogenic cell death occur during NIR irradiation. However, the alteration of tumor blood vessels and blood volume inside the blood vessels induced by the NIR-PIT process is still unknown. In our study, a speckle variance (SV) algorithm combined with optical coherence tomography (OCT) technology was applied to monitor the change of blood vessels and the alterations of the blood volume inside the blood vessels during and after NIR-PIT treatment. Vascular density and the measurable diameter of the lumen in the blood vessel (the diameter of the region filled with blood) were extracted for quantitively uncovering the alterations of blood vessels and blood volume induced by NIR-PIT treatment. The results indicate that both the density and the diameter of the lumen in the blood vessels decrease during the NIR-PIT process, while histological results indicated the blood vessels were dilated. The increase of permeability of blood vessels could lead to the increase of the blood pool volume within the tumor (shown in histology) and results in the decrease of free-moving red blood cells inside the blood vessels (shown in SV-OCT).

Prevalence of retinal changes in patients with systemic sclerosis: the association between retinal vascular changes and nailfold capillaroscopic findings.

BackgroundSystemic sclerosis (SSc) is a connective tissue disease affecting the skin and multiple organs. Most of the evidence on ocular involvement comes from small studies. We evaluated the retinal vascular changes in patients with SSc and its associations with types, disease duration, skin score, and nailfold capillaroscopy changes.Material and methodsWe evaluated the demographic, clinical and nailfold capillaroscopy data of 52 patients referring to the clinic of scleroderma with SSc according to the 2013 ACR/EULAR SSc criteria. In addition, full ophthalmic examination in 52 patients and fundus photography in 40 patients were done in the ophthalmology clinic.ResultsThere were 52 (49 women and 3 men, 17 diffuse and 35 limited) patients with SSc with mean disease duration of 8 ±5 years and mean age of 40 ±9 years. Retinal changes in the ophthalmologic examination were seen in 30.7% as increased vascular tortuosity. None of the patients had cotton wool spot, hemorrhage or hard exudate. Forty patients underwent fundus photography and 22.5% of them had vascular tortuosity. Only the presence of hemorrhage in the nailfolds was correlated with retinal tortuosity, and the other characteristics of nailfold capillaroscopy did not have any association with retinal changes.ConclusionsRetinal vascular changes were seen in about one third of our patients. There was no correlation between nailfold capillaroscopy, disease duration, type and skin score of SSc patients and retinal vascular changes. These findings suggest that the mechanisms or the quality of changes in the retinal vessels and nailfold vasculature may be different.

Optical coherence tomography angiography and cardiovascular diseases. An overview of the current knowledge

HintergrundKardiovaskuläre Erkrankungen (KVE) sind die Haupttodesursache weltweit. Die Beobachtbarkeit von Veränderungen der retinalen Gefäße im Zusammenhang mit KVE mittels Fundoskopie ist schon seit Langem bekannt. Ein neuartiges Verfahren zur nichtinvasiven und detaillierten Darstellung und Quantifizierung der retinalen und papillären Gefäße stellt die optische Kohärenztomographie-Angiographie (OCT-A) dar. Durch die OCT‑A ist es möglich, Gefäßveränderungen einfach und gut reproduzierbar zu visualisieren, weswegen ihr Einsatz nicht nur auf augenärztliche Fragestellungen beschränkt ist. In den vergangenen Jahren sind einige experimentelle und klinische Studien zur Darstellbarkeit und Quantifizierung von Gefäßveränderungen durch die OCT‑A bei Erkrankungen des kardiovaskulären Spektrums publiziert worden. In der vorliegenden Übersicht werden die wichtigsten Erkenntnisse aus diesen Studien zusammengefasst.MethodenGrundlage dieser Arbeit bilden eine umfassende selektive Literaturrecherche und die Darstellung eigener Daten.ErgebnisseMittlerweile liegen zu vielen Erkrankungen des kardiovaskulären Spektrums OCT-A-Studien vor, die verdeutlichen, dass systemische Gefäßerkrankungen mit Veränderungen der retinalen Mikrozirkulation verbunden sind. Mit der OCT‑A können diese Veränderungen visualisiert und reproduzierbar quantifiziert werden. Oftmals ist es möglich, subklinische Veränderungen aufzuzeigen, bevor die zugrunde liegende Erkrankung anderweitig messbare Veränderungen oder für den Patienten merkbare Symptome verursacht.SchlussfolgerungDie OCT‑A ist eine vielversprechende Bildgebungsmethode auf dem Gebiet der KVE in Wissenschaft und klinischer Anwendung. Sie kann zur Diagnostik und Quantifizierung retinaler Gefäßveränderungen eingesetzt werden. Weitere Studien werden zeigen, ob die OCT‑A bei der Einschätzung des individuellen kardiovaskulären Risikoprofils helfen kann.

Sequential Exposure to Antenatal Microbial Triggers Attenuates Alveolar Growth and Pulmonary Vascular Development and Impacts Pulmonary Epithelial Stem/Progenitor Cells.

Perinatal inflammatory stress is strongly associated with adverse pulmonary outcomes after preterm birth. Antenatal infections are an essential perinatal stress factor and contribute to preterm delivery, induction of lung inflammation and injury, pre-disposing preterm infants to bronchopulmonary dysplasia. Considering the polymicrobial nature of antenatal infection, which was reported to result in diverse effects and outcomes in preterm lungs, the aim was to examine the consequences of sequential inflammatory stimuli on endogenous epithelial stem/progenitor cells and vascular maturation, which are crucial drivers of lung development. Therefore, a translational ovine model of antenatal infection/inflammation with consecutive exposures to chronic and acute stimuli was used. Ovine fetuses were exposed intra-amniotically to Ureaplasma parvum 42 days (chronic stimulus) and/or to lipopolysaccharide 2 or 7 days (acute stimulus) prior to preterm delivery at 125 days of gestation. Pulmonary inflammation, endogenous epithelial stem cell populations, vascular modulators and morphology were investigated in preterm lungs. Pre-exposure to UP attenuated neutrophil infiltration in 7d LPS-exposed lungs and prevented reduction of SOX-9 expression and increased SP-B expression, which could indicate protective responses induced by re-exposure. Sequential exposures did not markedly impact stem/progenitors of the proximal airways (P63+ basal cells) compared to single exposure to LPS. In contrast, the alveolar size was increased solely in the UP+7d LPS group. In line, the most pronounced reduction of AEC2 and proliferating cells (Ki67+) was detected in these sequentially UP + 7d LPS-exposed lambs. A similar sensitization effect of UP pre-exposure was reflected by the vessel density and expression of vascular markers VEGFR-2 and Ang-1 that were significantly reduced after UP exposure prior to 2d LPS, when compared to UP and LPS exposure alone. Strikingly, while morphological changes of alveoli and vessels were seen after sequential microbial exposure, improved lung function was observed in UP, 7d LPS, and UP+7d LPS-exposed lambs. In conclusion, although sequential exposures did not markedly further impact epithelial stem/progenitor cell populations, re-exposure to an inflammatory stimulus resulted in disturbed alveolarization and abnormal pulmonary vascular development. Whether these negative effects on lung development can be rescued by the potentially protective responses observed, should be examined at later time points.

A Stress Syndrome Prototype Reflects Type 3 Diabetes and Ischemic Stroke Risk: The SABPA Study.

Simple SummaryThe relationship between diabetes, dementia and neuronal injury defines type 3 diabetes (T3D). Similar retinal vessel changes were observed in Alzheimer’s and chronic stressed individuals. The aim was to assess associations of chronic stress with T3D and retina pathology. An established validated chronic stress and stroke risk score (hereafter Stress) stratified participants into Stressed (high stress) and non-Stressed (low stress) groups. Early dementia signs (insulin sensitivity, cognitive dysfunction, neuronal injury) were evident in Stressed compared to non-Stressed individuals. Stress was associated with poor retinal oxygen perfusion, potentiating glaucoma risk. Stress was further related to four dementia risk markers (cognitive dysfunction; telomere shortening, neuronal injury and waist circumference), which comprised a novel Stress syndrome prototype. This prototype showed high risk for T3D as well as retinal vein widening and perfusion deficits, indicating stroke risk. Findings should increase awareness on the detrimental role of chronic stress in the human brain.Type 3 diabetes (T3D) accurately reflects that dementia, e.g., Alzheimer’s disease, represents insulin resistance and neurodegeneration in the brain. Similar retinal microvascular changes were observed in Alzheimer’s and chronic stressed individuals. Hence, we aimed to show that chronic stress relates to T3D dementia signs and retinopathy, ultimately comprising a Stress syndrome prototype reflecting risk for T3D and stroke. A chronic stress and stroke risk phenotype (Stressed) score, independent of age, race or gender, was applied to stratify participants (N = 264; aged 44 ± 9 years) into high stress risk (Stressed, N = 159) and low stress risk (non-Stressed, N = 105) groups. We determined insulin resistance using the homeostatic model assessment (HOMA-IR), which is interchangeable with T3D, and dementia risk markers (cognitive executive functioning (cognitiveexe-func); telomere length; waist circumference (WC), neuronal glia injury; neuron-specific enolase/NSE, S100B). Retinopathy was determined in the mydriatic eye. The Stressed group had greater incidence of HOMA-IR in the upper quartile (≥5), larger WC, poorer cognitiveexe-func control, shorter telomeres, consistently raised neuronal glia injury, fewer retinal arteries, narrower arteries, wider veins and a larger optic cup/disc ratio (C/D) compared to the non-Stressed group. Furthermore, of the stroke risk markers, arterial narrowing was related to glaucoma risk with a greater C/D, whilst retinal vein widening was related to HOMA-IR, poor cognitiveexe-func control and neuronal glia injury (Adjusted R2 0.30; p ≤ 0.05). These associations were not evident in the non-Stressed group. Logistic regression associations between the Stressed phenotype and four dementia risk markers (cognitiveexe-func, telomere length, NSE and WC) comprised a Stress syndrome prototype (area under the curve 0.80; sensitivity/specificity 85%/58%; p ≤ 0.001). The Stress syndrome prototype reflected risk for HOMA-IR (odds ratio (OR) 7.72) and retinal glia ischemia (OR 1.27) and vein widening (OR 1.03). The Stressed phenotype was associated with neuronal glia injury and retinal ischemia, potentiating glaucoma risk. The detrimental effect of chronic stress exemplified a Stress syndrome prototype reflecting risk for type 3 diabetes, neurodegeneration and ischemic stroke.

Characterisation of early ultrastructural changes in the cerebral white matter of CADASIL small vessel disease using high-pressure freezing/freeze-substitution.

The objective of this study was to elucidate the early white matter changes in CADASIL small vessel disease. We used high-pressure freezing and freeze substitution (HPF/FS) in combination with high-resolution electron microscopy (EM), immunohistochemistry and confocal microscopy of brain specimens from control and CADASIL (TgNotch3R169C ) mice aged 4-15months to study white matter lesions in the corpus callosum. We first optimised the HPF/FS protocol in which samples were chemically prefixed, frozen in a sample carrier filled with 20% polyvinylpyrrolidone and freeze-substituted in a cocktail of tannic acid, osmium tetroxide and uranyl acetate dissolved in acetone. EM analysis showed that CADASIL mice exhibit significant splitting of myelin layers and enlargement of the inner tongue of small calibre axons from the age of 6months, then vesiculation of the inner tongue and myelin sheath thinning at 15months of age. Immunohistochemistry revealed an increased number of oligodendrocyte precursor cells, although only in older mice, but no reduction in the number of mature oligodendrocytes at any age. The number of Iba1 positive microglial cells was increased in older but not in younger CADASIL mice, but the number of activated microglial cells (Iba1 and CD68 positive) was unchanged at any age. We conclude that early WM lesions in CADASIL affect first and foremost the myelin sheath and the inner tongue, suggestive of a primary myelin injury. We propose that those defects are consistent with a hypoxic/ischaemic mechanism.

Manoeuvring prediction of a container ship in shallow water using numerical planar motion mechanism

ABSTRACT Manoeuvring behaviour of a vessel changes drastically when it enters from deep water region to a shallow water region. Flow characteristics, around the hull changes and the vessel, respond poorly to the use of control surfaces. Aim of this paper is to study the manoeuvring behavioural changes in a container ship for different water depth conditions. Computational fluid dynamic (CFD) methods are used for simulating static and dynamic captive model tests. Variation in hydrodynamic reaction forces and moments caused by the reduction in water depth and the subsequent effect in hydrodynamic derivatives appearing in the equation of motion are explained in detail. Standard turning circle and zigzag manoeuvring tests are simulated using the CFD generated hydrodynamic derivatives to assess the manoeuvring characteristics of the vessel.

Quantitative Evaluation of Retinal Vessel Density in Central Serous Chorioretinopathy after Half-dose Photodynamic Therapy

ABSTRACT Purpose To determine vessel changes in retinochoroid with optical coherence tomographic angiography (OCT angiography) and spectral-domain OCT (SD-OCT) of patients with central serous chorioretinopathy (CSC) after half-dose photodynamic therapy (hd-PDT). Methods A prospective observational study of 62 eyes of 58 patients undergoing hd-PDT was followed for 3 months. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed at baseline; best-corrected visual acuity (BCVA), fundus photography, OCT angiography and SD-OCT were performed at baseline, 1-month, and 3-month follow-up visits. Results The mean vessel density of inner retina (VDIR) layer was 50.72 ± 3.17 at baseline, then decreased to 48.97 ± 4.34 at 1-month follow-up (p < .001), and partially recovered to 49.00 ± 4.28 at 3-month follow-up (p < .001); the mean area of foveal avascular zone (FAZ) was 0.303 ± 0.107 mm2 at baseline, and then increased to 0.339 ± 0.121 mm2 and 0.342 ± 0.125 mm2 at 1-month and 3-month follow-up after hd-PDT (p < .001, p < .001). The mean diameters of choroidal big vessels (DCV) were 309.66 ± 72.24 microns at baseline, then decreased to 300.13 ± 69.38 microns at 1-month and 293.39 ± 69.92 microns at 3-month after treatment (p < .001, p < .001). Conclusions Currently common applied hd-PDT for patients with CSC has significantly impact on both retinal and choroidal vessels. The retinal capillary flow decreased, therefore optimizing PDT parameters for treating CSC may still be necessary in the future.

Major Aortic Reconstruction with the Replacement of Supra-Aortic Branches: Successful Surgical Treatment of Takayasu Arteritis Initially Presented as Congestive Heart Failure.

Takayasu arteritis (TA) is a rare, large vessel vasculitis that affects aorta, its major branches, and occasionally pulmonary arteries. Patients with TA can present with constitutional features and/or various symptoms and signs caused by morphological changes in the blood vessels affected by the inflammatory process. Corticosteroids (CS) and immunosuppressives (IS) are the first line treatment for active TA. Open surgery remains a treatment of choice for TA patients with moderate-to-severe aortic regurgitation (AR) and ascending aortic aneurysm (AAA). We present a 26-year-old female diagnosed with an advanced stage of TA, initially presented as congestive heart failure. Due to a progressive course of the disease (AR 3+, AAA 5.5 cm), surgery of the Aortic valve and root (Bentall procedure), with total arch reconstruction and replacement of supra-aortic branches was performed. The patient has had an uneventful recovery during the postoperative course with no complications at one year follow-up. Normal left ventricle (LV) diameter, LV ejection fraction 67%, and a trace of AR were seen on the last echocardiography.

Will Repeated Low-Energy 1064-nm Q-Switched Nd:YAG Laser Treatment Sessions Affect Facial Skin Sensitivity? Results of a 12-Month, Prospective, Randomized Split-Face Study.

To compare changes in skin sensitivity before and after treatment with a 1064-nm Q-switched Nd:YAG laser in healthy individuals, and to provide a reference for clinicians to use this laser reasonably. Nineteen healthy female volunteers underwent 10 random unilateral 1064-nm Q-switched Nd:YAG laser treatments. The skin transepidermal water loss rate (TEWL), skin glossiness, epidermal and dermal thickness and density, current perception threshold (CPT) value, facial blood perfusion were determined before and after treatment at different time points. Moreover, the changes in skin barrier function, blood vessels, and sensory nerve reaction in the treated and untreated sides of the face were recorded before and after treatment. Seventeen volunteers completed the 12-month follow-up study after 1064-nm Q-switched Nd:YAG laser treatment. At D3, M3, and M6, skin TEWL was decreased on the treated side of the face. Skin glossiness was significantly improved in the early post-treatment period (D1-D7) and M3, M6, and M12 compared with the untreated side of the face. There was no significant change in dermal and epidermal thickness or density at all time points before and after treatment. There were no significant differences in sensory nerve CPT values and local blood flow volume or velocity between the treated side of the face and the untreated side before and after treatment. Multiple low-energy 1064-nm Q-switched Nd:YAG laser treatments will not affect the barrier function of facial skin, skin nerve sensitivity, or local microcirculation of healthy skin over the long term. Therefore, 1064-nm Q-switched Nd:YAG laser treatment is safe, and does not alter skin sensitivity. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

Spatial Management Measures Alter Vessel Behavior in the Aleutian Archipelago

The Aleutian Archipelago and surrounding waters have enormous ecological, cultural, and commercial significance. As one of the shortest routes between North American and Asian ports, the North Pacific Great Circle Route, which crosses through the Aleutian Archipelago, is traveled by thousands of large cargo ships and tanker vessels every year. To reduce maritime risks and enhance navigational safety, the International Maritime Organization built upon earlier offshore routing efforts by designating five Areas To Be Avoided (ATBAs) in the Aleutian Islands in 2016. The ATBAs are designed to keep large vessels at least 50 nautical miles (93 km) from shore unless calling at a local port or transiting an authorized pass between islands. However, very few studies have examined the effectiveness of ATBAs as a mechanism for changing vessel behavior and thereby reducing the ecological impacts of maritime commerce. In this study, we use 4 years of satellite-based vessel tracking data to assess the effectiveness of the Aleutian ATBAs since their implementation in 2016. We determined whether vessels transiting the North Pacific Great Circle Route changed behavior after ATBA implementation, both in terms of overall route selection and in terms of compliance with each ATBA boundary. We found a total of 2,252 unique tankers and cargo vessels &amp;gt;400 gross tons transited the study region, completing a total of 8,794 voyages. To quantify routing changes of individual vessels, we analyzed the 767 vessels that transited the study region both before and after implementation. The percentage of voyages transiting through the boundaries of what would become ATBAs decreased from 76.3% in 2014–2015 (prior to ATBA designation) to 11.8% in 2016–2017 (after implementation). All five Aleutian ATBAs had significant increases in compliance, with the West ATBA showing the most dramatic increase, from 32.1% to 95.0%. We discuss the framework for ATBA enforcement and highlight the value of local institutional capacity for real-time monitoring. Overall, our results indicate that ATBAs represent a viable strategy for risk mitigation in sensitive ecological areas and that through monitoring, spatial protections influence vessel route decisions on multiple spatial scales.

Altered Vascular Extracellular Matrix in the Pathogenesis of Atherosclerosis

Cardiovascular disease continues to grow as a massive global health burden, with coronary artery disease being one of its most lethal varieties. The pathogenesis of atherosclerosis induces changes in the blood vessel and its extracellular matrix (ECM) in each vascular layer. The alteration of the ECM homeostasis has significant modulatory effects on the inflammatory response, the proliferation and migration of vascular smooth muscle cells, neointimal formation, and vascular fibrosis seen in atherosclerosis. In this literature review, the role of the ECM, the multitude of components, and alterations to these components in the pathogenesis of atherosclerosis are discussed with a focus on versatile cellular phenotypes in the structure of blood vessel. An understanding of the various effects of ECM alterations opens up a plethora of therapeutic options that would mitigate the substantial health toll of atherosclerosis on the global population.

Epistaxis and arterial hypertension: a pathogenic link

Was to study changes in the nasal mucosa vessels in hypertensive patients suffering from recurrent epistaxis. 78 hypertensive patients aged between 50 and 70, admitted due to epistaxis were studied. Diabetic, coagulopathic patients and those taking anticoagulants were excluded from the research. All the patients were divided into 2 groups: group 1 (46 people) with a single epistaxis, group 2 (32 people) with a recurrent epistaxis. At the admission time all the patients showed elevated arterial pressure, yet the differences between the patients of group 1 and group 2 were not significant. 14 patients of group 2 did not reveal any source of hemorrhage due to a severely deviated septum. These patients underwent septoplasty followed by mucoperichondrium biopsy. Histological study of samples showed multiple erosions within the epithelial layer, as well as necrotic patches spreading to the deeper mucous coat layers. The microvasculature showed dystrophic changes in the endothelium, its focal desquamation with basal membrane exposure and thrombocytes and erythrocytes adhesion at such places, erythrocyte aggregation, plasma separation, erythrocyte and fibrinous thrombi formation. Ultrastructural investigation revealed dystrophic changes in the capillary endothelium of the nasal mucosa combined with rheological disorders expressed as erythrocytes sludge. Thus, the cause of epistaxis is not high arterial pressure, but those changes in the nasal mucosa vessels promoted by long arterial hypertension.