Changes In Vessels Research Articles

Neurogenic Аrthropathy, Сhronic Osteomyelitis, Diabetic Foot: Differential X-Ray and MSCT Diagnostics

X-ray and MSCT-differential diagnostics between neurogenic arthropathy, diabetic osteoneuroarthropathy (DONAP), complicated by osteomyelitis and chronic osteomyelitis, has not been studied enough.The purpose of the study was to study the MSCT semiotics of various variants of neurogenic arthropathy, DONAP complicated by osteomyelitis and chronic post-traumatic osteomyelitis in order to substantiate etiopathogenetic treatment. In 44 patients with neurogenic arthropathy, DONAP, complicated by osteomyelitis and chronic osteomyelitis, the results of polypositional radiography, MSCT were studied before treatment for the purpose of differential diagnosis. Single center retrospective study. MSCT and x-ray revealed differential diagnostics differences between neurogenic arthropathy, DONAP, complicated by osteomyelitis and chronic osteomyelitis. They are manifested by the localization of destructive processes, characteristic changes in the angles of the foot and a violation of the architectonics of the bones, concomitant changes in blood vessels and soft tissues. Neurogenic arthropathy is characterized by disorganization of the joints, bone resorption, giving the impression of surgical amputation, sharpening of the ends of the metatarsal bones, a symptom of «pestle in a mortar», a violation of the structure of spongy bones. DONAP is manifested by pronounced destructive changes in the midfoot, collapse of the tarsal bones with defects, fragmentation, vascular calcifications (Menckeberg), a «pathological» reference line, an increase in the Meary angle, a decrease in the angle of the calcaneus, and a «rocking foot», increased density of the calcaneus. Chronic osteomyelitis is characterized by an isolated lesion of one or more bones; the presence of a fistulous tract, focal disorders of the trabecular pattern, a decrease in the density of adjacent bones, the presence of isolated foci of sclerosis.

Abstract WP138: Intracranial Artery Stenosis In Relation To Blood Pressure Components

Introduction: Vascular aging is characterized by structural and functional changes in blood vessels that lead to reduced perfusion pressure to distal organs and high blood pressure (BP). Cerebrovascular aging is strongly associated with high BP, however, systemic BP is constituted by the steady and pulsatile components. We aimed this study to investigate the association of intracranial artery stenosis in relation to the steady and pulsatile components of the systemic BP - such association remains undocumented. Methods: We used cross-sectional data from 292 participants from the Maracaibo Aging Study who underwent ambulatory BP monitoring, magnetic resonance angiography, and MRI between 2011 to 2016. The stenosis of eleven intracranial arteries was measured using magnetic resonance angiography scans and encompassed the right and left sides of the anterior (ACA), middle (MCA), posterior (PCA) cerebral arteries, and internal carotid arteries (ICA), vertebral arteries, and the basilar artery. The steady BP component included the 24-hour mean arterial pressure (MAP) while the pulsatile component included the 24-hour pulse pressure (PP). We performed multivariable logistic regression models to assess the association between intracranial artery stenosis and BP components. Models were accounted for age, sex, head circumference, years of education, body mass index, total and high-density cholesterol ratio, creatinine, diabetes mellitus, and antihypertensive treatments. Results: Mean age was 57.5±11 years, 75% women. After adjustment for confounders, 24-hour pulse pressure was associated (P≤ 0.020) with the stenosis of ICA (Odds ratios [OR], 2.00 per every 5 mmHg of PP; 95% confidence interval [CI], 1.49-2.69), ACA (OR, 1.50; 95% CI, 1.23-1.84), MCA (OR, 1.46; 95%, CI, 1.21-1.77), PCA (OR, 1.55; 95% CI, 1.26-1.91), basilar artery (OR, 1.28; 95% CI, 1.03-1.59) and vertebral arteries (OR, 1.42; 95% CI, 1.14-1.78). The ORs of ICA, ACA, MCA, PCA, basilar artery, and vertebral arteries in relation to high 24-hour MAP levels (P≤ 0.040) ranged from 1.27 (95% CI, 1.00-1.61) to 1.48 (95% CI, 1.15 - 1.91). Conclusion: Elevated levels in the steady and pulsatile components of the systemic BP are associated with intracranial artery stenosis.

Combining Feature Correspondence With Parametric Chamfer Alignment: Hybrid Two-Stage Registration for Ultra-Widefield Retinal Images.

We propose a novel hybrid framework for registering retinal images in the presence of extreme geometric distortions that are commonly encountered in ultra-widefield (UWF) fluorescein angiography. Our approach consists of two stages: a feature-based global registration and a vessel-based local refinement. For the global registration, we introduce a modified RANSAC (random sample and consensus) that jointly identifies robust matches between feature keypoints in reference and target images and estimates a polynomial geometric transformation consistent with the identified correspondences. Our RANSAC modification particularly improves feature point matching and the registration in peripheral regions that are most severely impacted by the geometric distortions. The second local refinement stage is formulated in our framework as a parametric chamfer alignment for vessel maps obtained using a deep neural network. Because the complete vessel maps contribute to the chamfer alignment, this approach not only improves registration accuracy but also aligns with clinical practice, where vessels are typically a key focus of examinations. We validate the effectiveness of the proposed framework on a new UWF fluorescein angiography (FA) dataset and on the existing narrow-field FIRE (fundus image registration) dataset and demonstrate that it significantly outperforms prior retinal image registration methods in accuracy. The proposed approach enhances the utility of large sets of longitudinal UWF images by enabling: (a) automatic computation of vessel change metrics such as vessel density and caliber, and (b) standardized and co-registered examination that can better highlight changes of clinical interest to physicians.

Is Alzhezimer’s disease a New Type Diabetes? Crosstalk between two serious disorders: review

Introduction and purpose: More and more reports suggest that diabetes plays an important role in the pathogenesis of Alzheimer's disease (AD). Understanding this link may provide a new approach to modulating the onset and progression of sporadic AD cases. The aim of the study is to present the current state of knowledge on the basic mechanisms and factors influencing the development of AD in patients with type 2 diabetes in the context of clinical practice.
 State of knowledge: It is estimated that up to 80% of Alzheimer's patients have glucose intolerance or diabetes. Impaired insulin signaling can lead to abnormal processing and accumulation of beta-amyloid protein, which can result in memory deficits and cognitive decline. Insulin deficiency can also cause over-activity of the GSK3 enzyme, leading to tau hyperphosphorylation and senile plaque accumulation. Diabetes can also cause fibrotic changes in cerebral vessels, disrupting brain metabolism and potentially leading to hippocampus atrophy. The release of cytokines during the metabolic syndrome can also cause oxidative stress and neuroinflammation, which may contribute to neuronal atrophy. It has been reported that healthy diet, physical exercises and prevention of metabolic diseases may reduce the incidence of AD.
 Conclusions: Epidemiological data and pathophysiological studies indicate a significant relationship between these diseases that AD is sometimes called Type 3 diabetes. Early detection of hyperglycemia and its proper management, may be crucial in the context of the clinical prevention of dementia diseases. It is essential to pay attention to the cognitive abilities of patients with metabolic diseases.

Cooking in Iron Age Alalakh: Change and Continuity in Vessels’ Functional Role

The site of Alalakh is located in the modern province of Hatay, southern Turkey. The recent discovery of Iron Age levels at the site offered the perfect opportunity to shed new light on the Iron Age I and the beginning of the Iron Age II (12th-9th century BC). This paper will focus on the analysis of cooking vessels retrieved from the Iron Age levels of the site. Studies on cooking and food preparation activities represent a long-standing lacuna in the archaeology of the Ancient Near East. The analysis of cooking vessels’ typology and function can offer a deep understanding of social habits and cultural behaviours and add new data towards the interpretations of the Iron Age in the site and in the Northern Levant.

Optical Coherence Tomography Angiography in Diabetic Macular Edema Treated with Intravitreal Aflibercept: A 48-Week Observational Study (the DOCTA Study)

Introduction: Central vision loss due to diabetic macular edema (DME) is related to the macular edema itself but also, in some cases, to alterations of the foveal avascular zone (FAZ). The aim of this trial was to study changes in macular vessels in eyes with DME treated with aflibercept using optical coherence tomography angiography (OCTA). Methods: This was a longitudinal, prospective, noncontrolled, single-arm study. The primary objective was the quantitative assessment of macular vessels over time in patients with DME treated with intravitreal aflibercept during a 48-week follow-up using OCTA. Results: Twenty-six DME eyes from 26 patients were included (mean age, 64.6 years; women, 53.8%; prior anti-VEGF treatment, 46.1%). Each eye received a mean (SD) of 7.2 (2.2) injections. The following parameters of the FAZ did not change during the 48-week follow-up: the mean (SD) FAZ area varied from 0.19 (0.19) mm² at baseline (n = 22) to 0.23 (0.20) mm² at week 48 (n = 15), boundary from 1.54 (1.21) to 2.04 (1.20) mm, and circularity from 0.45 (0.33)% to 0.57 (0.20)%. There was no change in perfusion density and vessel density of the macula in the 3-mm circle. As expected, mean central retinal thickness, macular volume, and visual acuity improved during follow-up. Conclusion: No change in macular perfusion was observed in eyes with DME during a 48-week follow-up after intravitreal injections of aflibercept. Randomized controlled trials using OCT angiography in large populations with extended observation periods are needed to assess changes in macular vessels after intravitreal anti-VEGF treatment.

Correlation between concentration, droplet size, turbulent intensity and explosion parameters of gas-liquid two-phase mixture

In this study, concentration and droplet size of aerosol and turbulence distribution in the 20 L vessel over time under pneumatic pressure of 1 MPa–2MPa were observed and correlation between actual concentration, droplet size, turbulent intensity of the ethanol aerosol and pneumatic pressure were analyzed. The effect of concentration, droplet size, and turbulent intensity on aerosol explosion parameters of the ethanol aerosol were examined. The actual concentration of ethanol aerosol in the vessel is much lower than the design concentration. The ratio between the actual concentration and the designed concentration is about 65%–90% at the pneumatic pressure from 1.0 MPa to 2.0 MPa. The concentration of ethanol aerosol in the vessel increases with time from 0 ms to 50 ms, maintains a stead state from 50 ms to 100 ms and decreases gradually after 100 ms. In the initial stage of injecting, the size of aerosol droplets in the vessel changes with time sharply and tends to constant at 50 ms. The turbulence intensity from 10sm to 50 ms is higher and decreases rapidly from 50 ms to 100 ms. The effect of the pneumatic pressure on the maximum rate of explosion pressure rise of ethanol aerosol is much higher than that on the peak explosion pressure. The maximum rate of explosion pressure rise of the ethanol aerosol is lower than that of ethanol vapor/air. The explosion index of ethanol vapor/air is higher than that of ethanol aerosol. Ethanol vapor/air has a higher explosion hazard, compared with ethanol aerosol with the same concentration.

Assessment of Meningeal Lymphatics in the Parasagittal Dural Space: A Prospective Feasibility Study Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging.

Meningeal lymphatic vessels are predominantly located in the parasagittal dural space (PSD); these vessels drain interstitial fluids out of the brain and contribute to the glymphatic system. We aimed to investigate the ability of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing the dynamic changes in the meningeal lymphatic vessels in PSD. Eighteen participants (26-71 years; male:female, 10:8), without neurological or psychiatric diseases, were prospectively enrolled and underwent DCE-MRI. Three regions of interests (ROIs) were placed on the PSD, superior sagittal sinus (SSS), and cortical vein. Early and delayed enhancement patterns and six kinetic curve-derived parameters were obtained and compared between the three ROIs. Moreover, the participants were grouped into the young (< 65 years; n = 9) or older (≥ 65 years; n = 9) groups. Enhancement patterns and kinetic curve-derived parameters in the PSD were compared between the two groups. The PSD showed different enhancement patterns than the SSS and cortical veins (P < 0.001 and P < 0.001, respectively) in the early and delayed phases. The PSD showed slow early enhancement and a delayed wash-out pattern. The six kinetic curve-derived parameters of PSD was significantly different than that of the SSS and cortical vein. The PSD wash-out rate of older participants was significantly lower (median, 0.09; interquartile range [IQR], 0.01-0.15) than that of younger participants (median, 0.32; IQR, 0.07-0.45) (P = 0.040). This study shows that the dynamic changes of meningeal lymphatic vessels in PSD can be assessed with DCE-MRI, and the results are different from those of the venous structures. Our finding that delayed wash-out was more pronounced in the PSD of older participants suggests that aging may disturb the meningeal lymphatic drainage.

Study of the Orbital Vessels by Color Doppler in Known Diabetic Patients for Evaluation of Diabetic Retinopathy

Introduction: Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused bychanges in the blood vessels of retina. If untreated, it may lead to blindness which is usually preventable if retinopathyis diagnosed early and treated promptly. As the prevalence of diabetes is rising, the systemic complications thatinclude retinopathy, nephropathy , neuropathy and involvement of cardiovascular system are also increasing.Diabetic retinopathy is the leading cause of blindness in the world. Prevention of retinopathy needs early diagnosis.(1) In ophthalmology, Color Doppler imaging is a new method that enables us to assess the orbital vasculature. Itallows for simultaneous two dimensional anatomical and Doppler evaluations of retinal artery.Objective and Aim: Aim of the study is to evaluate the ocular blood flow in patients with diabetes mellitus withno ocular symptoms.Materials and Methods: Color Doppler evaluation of 50 diabetic patients (100 eyes) was done with SIEMENSSONOLINE G- 50 machine with High frequency probe (5-7.5 Mega Hertz). Doppler spectral analysis of ophthalmicarteries (OA) and central retinal arteries (CRA) were done. The peak systolic velocity (PSV), end diastolic velocity(EDV), resistive index (RI) and S/D ratio were calculated. PSV, EDV, RI were measured in all patients in both the eyes.Results: The PSV of CRA in diabetics was significantly reduced (p=&lt;0.05). The EDV of CRA in diabetics wasalso significantly reduced (p=&lt;0.05). The RI of CRA is significantly increased (p=&lt;0.05) in diabetics. The 95%confidence interval is observed in PSV, EDV, RI of CRA in diabetics.Conclusion: There was statistical significant difference between the PSV, EDV and RI of CRA in diabetics. Thissignificant difference could be due to the circulatory changes in blood vessels in diabetics. No significant differencewas made in OA in diabetics. This study concludes that retinal hemodynamic changes were present even beforethe clinical manifestations of retinopathy in diabetics.

Cross-Validation Convolution Neural Network-Based Algorithm for Automated Detection of Diabetic Retinopathy

The substantial vision loss due to Diabetic Retinopathy (DR) mainly damages the blood vessels of the retina. These feature changes in the blood vessels fail to exist any manifestation in the eye at its initial stage, if this problem doesn’t exhibit initially, that leads to permanent blindness. So, this type of disorder can be only screened and identified through the processing of fundus images. The different stages in DR are Micro aneurysms (Ma), Hemorrhages (HE), and Exudates, and the stages in lesion show the chance of DR. For the advancement of early detection of DR in the eye we have developed the CNN-based identification approach on the fundus blood lesion image. The CNN-based automated detection of DR proposes the novel Graph cutter-built background and foreground superpixel segmentation technique and the foremost classification of fundus images feature was done through hybrid classifiers as K-Nearest Neighbor (KNN) classifier, Support Vector Machine (SVM) classifier, and Cascaded Rotation Forest (CRF) classifier. Over this classifier, the feature cross-validation made the classification more accurate and the comparison is made with the previous works of parameters such as specificity, sensitivity, and accuracy shows that the hybrid classifier attains excellent performance and achieves an overall accuracy of 98%. Among these Cascaded Rotation Forest (CRF) classifier has more accuracy than others.

Irisin: A Potentially Fresh Insight into the Molecular Mechanisms Underlying Vascular Aging.

Aging is a natural process that affects all living organisms, including humans. Aging is a complex process that involves the gradual deterioration of various biological processes and systems, including the cardiovascular system. Vascular aging refers to age-related changes in blood vessels. These changes can increase the risk of developing cardiovascular diseases, such as hypertension, atherosclerosis, and stroke. Recently, an exercise-induced muscle factor, irisin, was found to directly improve metabolism and regulate the balance of glucolipid metabolism, thereby counteracting obesity and insulin resistance. Based on a growing body of evidence, irisin modulates vascular aging. Adenosine monophosphate-activated protein kinase (AMPK) serves as a pivotal cellular energy sensor and metabolic modulator, acting as a central signaling cascade to coordinate various cellular processes necessary for maintaining vascular homeostasis. The vascular regulatory effects of irisin are closely intertwined with its interaction with the AMPK pathway. In conclusion, understanding the molecular processes used by irisin to regulate changes in vascular diseases caused by aging may inspire the development of techniques that promote healthy vascular aging. This review sought to describe the impact of irisin on the molecular mechanisms of vascular aging, including inflammation, oxidative stress, and epigenetics, from the perspective of endothelial cell function and vascular macroregulation, and summarize the multiple signaling pathways used by irisin to regulate vascular aging.

Could a nonfunctional adrenal incidentaloma be a risk factor for increased carotid intima-media thickness and 10-year cardiovascular mortality based on the SCORE algorithm? A study from a single centre in Poland.

Adrenal incidentaloma (AI) secreting small amounts of glucocorticoids may cause morphological and functional changes in the blood vessels. Early stages of cardiovascular remodeling may be observed among asymptomatic patients with AI. But it is unclear whether the nonfunctional adrenal incidentalomas (NFAI) may also be a risk factor for cardiovascular diseases. The aim of this study was to determine the relationship between NFAI, carotid intima-media thickness (CIMT), and cardiovascular risk (CVR) based on Systematic Coronary Risk Evaluation (SCORE) prediction models for Europe. This study from a single centre in Poland included 48 NFAI patients and 44 individuals in the control group matched for age, sex, and body mass index (BMI). All participants underwent adrenal imaging, biochemical evaluation, measurement of CIMT, and assessment of the 10-year risk of cardiovascular mortality based on the SCORE algorithm. Hormonal evaluation was conducted in AI patients. The NFAI group showed significantly higher sodium (p = 0.02) and glucose levels in the 2-h oral glucose tolerance test (OGTT) (p = 0.04), a higher CIMT (p < 0.01), and a higher CVR calculated according to the SCORE algorithm (p = 0.03). The estimated glomerular filtration rate (eGFR) was higher in the NFAI group (p = 0.015). Hypertension (p < 0.01) and IGT (p = 0.026) were more common in the NFAI group. Statistically significant positive correlations were found between CIMT and age (r = 0.373, p = 0.003), waist circumference (r = 0.316, p = 0.029), diastolic blood pressure (r = 0.338, p = 0.019), and CVR based on the SCORE algorithm (r = 0.43, p = 0.004). There was a statistically significant positive correlation between CIMT and serum cortisol levels after 1 mg dexamethasone suppression test (r = 0.33, p = 0.02). Non-functional adrenal adenomas are associated with increased CIMT and CVR. Early stages of cardiovascular remodelling can be observed in asymptomatic NFAI patients.

Dual-Branch-UNet: A Dual-Branch Convolutional Neural Network for Medical Image Segmentation

In intelligent perception and diagnosis of medical equipment, the visual and morphological changes in retinal vessels are closely related to the severity of cardiovascular diseases (e.g., diabetes and hypertension). Intelligent auxiliary diagnosis of these diseases depends on the accuracy of the retinal vascular segmentation results. To address this challenge, we design a Dual-Branch-UNet framework, which comprises a Dual-Branch encoder structure for feature extraction based on the traditional U-Net model for medical image segmentation. To be more explicit, we utilize a novel parallel encoder made up of various convolutional modules to enhance the encoder portion of the original U-Net. Then, image features are combined at each layer to produce richer semantic data and the model’s capacity is adjusted to various input images. Meanwhile, in the lower sampling section, we give up pooling and conduct the lower sampling by convolution operation to control step size for information fusion. We also employ an attention module in the decoder stage to filter the image noises so as to lessen the response of irrelevant features. Experiments are verified and compared on the DRIVE and ARIA datasets for retinal vessels segmentation. The proposed Dual-Branch-UNet has proved to be superior to other five typical state-of-the-art methods.

Analysis of Cerebral Small Vessel Changes in AD Model Mice.

Amyloid β (Aβ) peptide is deposited in the brains of sporadic Alzheimer's disease (AD) due to impaired vessel-dependent clearance. To understand the mechanisms, we investigated time-dependent cerebrovascular changes in AD model mice. Cerebrovascular and other pathological changes were analyzed in AD model mice (J20 strain) aging from 2 to 9 months by immunostaining. At 2 months, Aβ was only intraneuronal, whereas vessels were positive from 3 months in J20 mice. Compared to wild-type (WT), vessel density was increased at 2 months but decreased at 9 months in J20 mice, claudin-5 levels were decreased, and vascular endothelial growth factor (VEGF) levels were increased in the cortex and hippocampus of J20 mice brain at all time points. Albumin extravasation was evident from 3 months in J20 brains. Collagen 4 was increased at 2 and 3 months. Aquaporin 4 was spread beyond the vessels starting from 3 months in J20, which was restricted around the vessel in wild-type mice. In conclusion, the study showed that an early decrease in claudin-5 was associated with VEGF expression, indicating dysfunction of the blood-brain barrier. Decreased claudin-5 might cause the leakage of blood constituents into the parenchyma that alters astrocyte polarity and its functions.

Features of functional changes in blood vessels during the period of early recovery after static physical exercise

The cardiovascular system is one of the leading functional systems of the body, which ensure and maintain the proper level of physical performance of the body during physical exertion. Bodybuilding is one of the areas of sports activity in which taking into account the individual characteristics of the adaptation of the circulatory system to powerful muscle work of significant intensity is decisive for building an optimal training regimen. Anatomical and physiological remodeling of the heart as a result of regular sports leads to changes in the pumping function of the myocardium, as well as indicators of central and peripheral hemodynamics. Currently, there is a problem of insufficient study of the functional changes of blood vessels in response to a static regime of physical exertion in the early post-workout period. The purpose of the research is to study the characteristics of the reaction of blood vessels during the early recovery period after dosed physical exertion of a static nature. During the study, 34 young men were examined in the following groups: 1 group – persons engaged in bodybuilding; 2 group – young men engaged in fitness; 3 group – untrained persons. Maximum arbitrary static force was determined in all examined persons using a static dynamometer DS-500, static load was modeled by holding on a static dynamometer for 30 seconds an effort corresponding to 50 % of the maximum static force. Functional changes of blood vessels and central hemodynamics were registered by the method of tetrapolar thoracic impedance rheoplethysmography using the computerized diagnostic complex “Cardio+” (Ukraine). Statistical data processing was carried out using the computer program IBM SPSS Statistics (version 26), using non-parametric methods of evaluating the obtained results. It was established that static exercise in young bodybuilders leads to an increase in minute blood volume due to optimal physiological changes in central hemodynamic parameters. In persons engaged in fitness and in untrained young men, the minute volume of blood decreases and circulation conditions deteriorate immediately after exercise, which complicates the processes of rapid recovery after physical exercise in a static mode. A decrease in vascular resistance to blood flow with a simultaneous increase in minute blood volume was revealed immediately after static exercise in young bodybuilders compared to individuals engaged in fitness and untrained individuals. It was established that the circulatory system of young bodybuilders is most optimally adapted to static loads compared to persons engaged in fitness and untrained young men.

The level of hydrogen sulfide and morphological changes in the aorta of rats under the influence of vitamin D under the conditions of modulation of the H2S / cystathionine-γ-lyase system

Annotation. Vitamin D and hydrogen sulfide (H2S) belong to pleitropic regulators, which are involved in the control of many cellular functions and biochemical processes, determine the adaptive potential of the cardiovascular system. The relationship between vitamin D and the H2S system is not fully investigated. The aim of the study was to evaluate the effect of the active form of vitamin D - calcitriol (1,25 (OH)2D3) on the morphological state of the thoracic aorta of rats and the level of it’s saturation with hydrogen sulfide under the conditions of the H2S / cystathionine-γ-lyase system modulation. The experiments were performed on 90 white male laboratory rats in accordance with the principles of bioethics (Strasbourg, 1986). 1,25(OH)2D3 was administered in doses of 0.1 μg/kg and 1 μg/kg for 4 weeks. Propargylglycine (50 mg/kg) and NaHS (1 mg/kg) were used to modulate the state of the H2S/cystathionine-γ-lyase system. The content of H2S was determined in the thoracic aorta and morphological changes were evaluated. Statistical calculations were performed in IBM Statistics SPSS 26, differences were evaluated in the Mann-Whitney test at the significance level of p&lt;0.05. It was established that 1,25 (OH)2D3 in a dose of 1.0 μg/kg leads to the formation of H2S deficiency and a complex of morphological changes in the aorta, which are manifested by damage of epithelial cells and stromal elements, and the formation of calcifications. Modulation of the H2S / cystathionine-γ-lyase system is a factor that modifies the effect of high doses of 1,25 (OH)2D3 on vessels: H2S deficiency increases damage of the vascular wall, while increasing tissue H2S saturation has the opposite effect. 1,25 (OH)2D3 in a dose of 0.1 μg/kg shows the ability to increase the level of endogenous H2S and reduces the development of pathological changes in blood vessels under the conditions of long-term inhibition of the H2S / cystathionine-γ-lyase system.

1427. Correlation of Dermoscopic and Histopathologic Patterns in Leprosy-a Pilot Study

Abstract Background Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. It is diagnosed based on clinical features and confirmed on the histological findings and peripheral slit skin smear staining. Dermoscopy is a handy easily accessible tool to diagnose this granulomatous disease and classify patients based on the immunological and clinical response. Methods A total of 50 patients in different poles of leprosy were evaluated as a single spot observational analysis. The clinical and histological findings were correlated with the characteristic dermoscopy findings. A Lepromatous leprosy showing xerosis and scaling along leg as part of glove and stocking distribution of lesions Dermoscopic pattern in lepromatous leprosy showing partial loss of hair follicles, dry xerotic skin, and white characteristic scaling (Heine Delta® 20 T dermatoscope; 16×; polarizing) Results The dermoscopy findings correlated with the clinical and histological findings. Tuberculoid poles of leprosy classically showed loss of hair and skin pigment along with absence of white dots as sweat glands in dermoscopy. Lack of blood vessel changes ruled out any lepra reaction. Lepromatous pole of leprosy on the other hand showed characteristic xerosis and white scaling on dermoscopy in the background of hypotrichosis and hypopigmentation. leprosy reactions were characterized by blood vessel changes and arborizing blood vessels were characteristic in erythema nodosum leprosum and a diffuse erythema was a clue towards diagnosing type I lepra reaction. Interestingly clofazimine induced pigmentation was picked up characteristically on dermoscopy as a ‘honey comb pattern’. Borderline tuberculoid leprosy with a hypoaesthetic patch on the left side of face with a thickened greater auricular nerve Dermoscopic pattern in borderline tuberculoid leprosy showing white areas with loss of hair follicles. In between yellow globules can be seen which was the hallmark apart from white areas demonstrating hypopigmentation. Absence of blood vessels rules out lepra reaction (Heine Delta® 20 T dermatoscope; 16×; polarizing) Conclusion Dermoscopy is certainly a handy tool in aiding the diagnosis of leprosy, lepra reactions and course of therapy. Characteristic patterns during the course of leprosy would certainly facilitate a quick and definitive diagnosis of patients suffering from leprosy. Also patient drug compliance particularly to Clofazimine can also be picked up objectively on Clofazimine. Multiple erythematous plaques on the back depicting type 1 lepra reaction Dermoscopic features of type I lepra reaction showing characteristic diffuse erythematous background and branching telangiectatic vessels along with sparse hair follicles and scaling (Heine Delta®20 T dermatoscope; 16×; polarizing) Disclosures All Authors: No reported disclosures.

Structural and vascular retinal parameters in early onset type 2 diabetics

AbstractThe number of patients suffering from type 2 diabetes mellitus (T2DM) has been steadily increasing along with another worrying trend: while typically T2DM is diagnosed in individuals over the age of 40 years, more and more patients are diagnosed with the condition when they are much younger. Those diagnosed with T2DM at less than 40 years of age appear to have a particular high “disease burden” compared to those diagnosed older than 40 years.Retinal vessel changes have been well documented to reflect systemic changes: i.e. arteriolar narrowing with increasing blood pressure and venular widening in diabetes. When it comes to patients with multi‐morbidities this can make it difficult to interpret ocular vascular changes in particular when it comes to establishing a causal relationship. This presentation seeks to discuss the findings of a sample of T2DM patients with such a complex disease profile.

Device‐assisted therapies in MGD

AbstractMeibomian gland dysfunction (MGD) is the most frequent cause of evaporative dry eye disease (DED). Until now, the only available treatments were as follows: warm compresses, massage, omega 3, and antibiotics. As a result, multiple devices have appeared in the marketplace designed to use heat and pressure to alleviate MG blockages, as well as to remove residue along the lid margins. The mechanism of action of Lipiflow®, Miboflo®, iLux® and Jett Plasma Lift® is thermal expression. The Lipiflow® consists of a console and a single‐use sterile device that uses sensor‐regulated heat and peristaltic motion to evacuate obstructed meibum. One section of the device goes behind the eyelids, providing the warmth; an outer section gently massages the lids against the inner section. Its effects last usually 12 months. Jett Plasma Lift also remove keratinized material from de lid margin. ILux® system is not available in Europe.​Intense pulsed light (IPL) was originally developed for use in dermatology. Brief, powerful bursts of light at specific wavelengths (in this case, between 500 and 800 nm) cause changes in blood vessels near the surface of the skin, raise skin temperature and eliminate problematic flora on the skin and eyes, all of which may have a beneficial effect on meibomian gland dysfunction. Closing the abnormal vessels decrease inflammation and oxygen supply to meibocytes (they work in anaerobic conditions). Usually four sessions are needed. Expression with forceps and the treatment directly of the lids improve results. There are multiple platforms and not all are the same. BlephEx® produces microblepharoexfoliation. It's typically repeated at four to six‐month intervals. It is useful for anterior blepharitis. Rexon‐Eye® is an electro‐medical device for the treatment of DED. The applied electrical stimulation is based on the principle of quantum molecular resonance. Transferring energy to biological tissues in the form of high frequency oscillating electrical fields biostimulate the lachrymal and the MG. Thus, it is helpful for evaporative and aqueous‐deficient DED.​The use of these devices reset the MG. They should be used on the glands before they atrophy. A combination of these treatments will probably work best for difficult patients. Independent clinical trials and studies comparing these devices and the new coming instruments are needed.

Гистоморфометрическая оценка большеберцового нерва и мелких мышц стопы после внутреннего невролиза и аутогенной пластики большеберцовой порции седалищного нерва крыс

Introduction Transformations of the nerves and muscles of the distal extremities after nerve injuries at the level of the proximal segments are critical for the restoration of functions, but have not been sufficiently studied in experimental biological models. Purpose Histomorphometric evaluation of the tibial nerves and plantar interosseous muscles after internal neurolysis and autogenous plasty of the tibial portion of the sciatic nerve (SN) in rats. Materials and methods The study was performed on 21 male Wistar rats, aged 8-10 months. Series 1 (internal SN neurolysis) – n = 6. Series 2 (autogenous SN neuroplasty) – n = 8. Control – 7 intact rats. The rats were euthanized 6 months after the operation. Light microscopy and histomorphometry of transverse semithin sections of the tibial nerve at the level of the middle third of the lower leg and paraffin sections of the plantar interosseous muscles of the foot were performed. Results In series 1, endoneural vessels had increased diameters and wall thickness in the tibial nerve, but a smaller lumen compared to the norm; the dimensional characteristics of the myelinated fiber population were increased due to myelin decompactization and axonal edema; about 10 % of myelinated fibers were destructively changed. In series 2, the numerical density of the endoneural vessels of the tibial nerve was doubled in comparison with the intact one; the numerical and dimensional composition of the regenerated myelinated fibers indicated active but incomplete regeneration. The vascularization index of the plantar interosseous muscles in series 1 was close to normal, in series 2 it decreased twice, the median of muscle fiber diameters was reduced by 12.41 % (p = 0.000) and 20.96 % (p = 0.000), respectively. Muscle fibers with a diameter of more than 30 μm increased in series 2 compared to series 1. Conclusion Internal neurolysis and interfascicular autoplasty of the sciatic nerve cause multidirectional changes in the endoneural vessels of the tibial nerve, which predetermine the multidirectional nature and severity of denervation and reinnervation changes in the nerves of the lower leg and small muscles of the foot.