Blood Flow In Circulation Research Articles

P0131 Characterisation of a human multi-organ-on-chip model to unravel gut-blood-brain communication

Abstract Background Persistent fatigue is a frequently reported symptom among patients with Inflammatory Bowel Disease (IBD), significantly diminishing quality of life. Due to the lack of understanding how IBD-associated fatigue originates, currently available treatments do not efficiently tackle this symptom. Developing targeted therapies requires tools to unravel the mechanisms behind central nervous system dysfunction in response to chronic intestinal inflammation. We are therefore establishing and characterising a human multi-organ-on-chip model to recapitulate key physiological elements of gut-brain communication via the systemic circulation. Methods In our model, a gut-blood barrier, comprised of Caco-2 (enterocytes) and HT29-MTX cells (goblet cells), is connected to a blood-cerebrospinal fluid (CSF) barrier, composed of HIBCPP and iHCPEnC cells (choroid plexus epithelial and endothelial cells respectively), and to a brain compartment (SH-SY5Y, neurons) via recirculation of cell culture medium. Gut inflammation was mimicked by the addition of the pro-inflammatory cytokines TNFα and IFNγ to the intestinal epithelial cells. Barrier integrity was measured by transepithelial/endothelial resistance (TEER) and by paracellular permeability assays with 4 kDa FITC-dextran. In addition, we performed a bead-based immunoassay to measure secreted IL-8 levels and RT-qPCR to analyse differential gene expression. Results The gut-blood barrier under low perfusion (3,6*10-4 mPa) exhibited increased expression of differentiation marker genes compared to static culture, such as LYZ, SOX9 and CYP3A4, indicating an improvement of cell differentiation. Moreover, low perfusion induced the formation of 3D villi-like structures, mucus production and the reduction of barrier strength towards more physiological relevant levels (TEER: 81,6±44,8 Ω.cm2; Papp: 1.10-5±4.10-6 cm/s). The gut-blood barrier was responsive to the addition of TNFα and IFNγ and high IL-8 levels could be measured in the circulatory blood flow. The barrier properties of the blood-CSF barrier under low perfusion (endothelial: 2,52 mPa, epithelial: 4,6*10-4 mPa) were not significantly different from a static setup, but less variance was observed in TEER. Neurons differentiated with BDNF and retinoic acid in our model displayed long projections and expressed mature neuronal marker genes (SYP, SNAP25, TUBB3). Conclusion We have successfully established and characterised each organ compartment of the gut-blood-brain model. Moreover, we have proven that low perfusion improves the physiological relevance of our model, especially of the gut-blood barrier. We are now exploring phenotypical and transcriptional alterations across the blood-CSF barrier and the brain compartment when gut inflammation is triggered.

Cerebral blood flow following successful living kidney transplantation: the VINTAGE study.

Chronic kidney disease (CKD) is a significant risk factor for cerebrovascular disease. However, there is limited research on how successful living donor kidney transplantation (LDKT) affects cerebral blood flow (CBF). This study aims to comprehensively investigate how LDKT influences CBF across various brain levels and regions. Data from 53 recipients between 2016 and 2020 were obtained from the VINTAGE study conducted at our hospital. CBF was measured by level and region using single-photon emission computed tomography (SPECT), according to the Talairach brain atlas. The primary endpoint was the mean difference in CBF before and 1-year post-LDKT. Subgroup analysis using traditional risk factors assessed the heterogeneity of the effect on CBF in the frontal lobe region. LDKT improved blood flow in the anterior cerebral artery and middle cerebral artery but had less impact on the posterior cerebral artery. The most consistent improvements were observed in the frontal lobe region {left frontal lobe: -0.12 [95% confidence interval (CI) -0.18 to -0.05], P<.001; right frontal lobe: -0.13 [95% CI -0.21 to -0.05], P=.001}. Subgroup analysis showed a consistent effect of LDKT on frontal lobe CBF improvement, with no qualitative interaction observed. LDKT contributes to the normalization of CBF, with improvement in anterior circulation and frontal lobe blood flow. To clarify the clinical significance of KT's CBF-improving effect, future studies should investigate the relationship between specific cognitive impairments (e.g. short-term memory, visuospatial ability, executive function) and CBF in each perfusion region.

Relationship between flap microcirculation and hard tissue changes following alveolar ridge augmentation: a prospective case series.

To assess blood flow alterations after horizontal Guided Bone Regeneration (GBR) and to evaluate correlations between blood flow and hard tissue changes. Twelve mandibular surgical sites were involved in the current case series. GBR was carried out using a split-thickness flap design. Blood circulation was assessed with Laser Speckle Contrast Imaging at baseline as well as 1, 4, 6, 11, 13, 20, 27, and 34 days after the surgery, subsequently on a monthly basis until 6 months. Hard tissue alterations were measured horizontally and vertically using linear measurements. The first measurement point was 2 mm distal to the distal surface of the last tooth; additional measurement points were placed every 3 mm up to the 15th mm. Volumetric hard tissue loss and gain were also assessed. Baseline blood circulation was statistically significantly higher on the buccal side. On the first postoperative day, all regions presented a statistically significant decrease in blood flow circulation. The buccal-inner region presented significant ischemia on day 6. Mean volumetric hard tissue gain and loss were 712.62 ± 317.08 mm3 and 222.431 ± 103.19 mm3, respectively. Mean baseline alveolar ridge width was 4.82 ± 1.02 mm, 6 months ridge width averaged 7.21 ± 0.99 mm. Vertical resorption measured 1.24 ± 0.5 mm. Correlations between blood flow changes and hard tissue alterations were only found on Day 34 and Day 60. Laser Speckle Contrast Imaging is an efficient method to measure flap microcirculation. No correlation was found between flap microcirculation changes hard tissue and alterations.

Investigation of Sutterby fluid flow through elliptic multi-stenosed artery: analytical solutions of blood flow problem

PurposeThe presence and progression of stenosis disturb the normal circulation of blood through an artery and cause serious consequences. The proposed investigation is aimed to assess non-Newtonian characteristics of blood in an elliptical artery having stenosis. The blood is taken as Sutterby fluid flowing via a multi-stenosed elliptical cross-section artery.Design/methodology/approachThe analytical solution of a mathematical model representing the considered problem is extracted in a non-dimensional form by utilizing the perturbation technique under the mild stenosis assumptions.FindingsThe graphical nature of these results is examined and discussed comprehensively for different physical parameters. The height and shape of stenosis are noted to have prominent effects on flow velocity. The wall shear stress and flow velocity attained high values in the stenotic portion of the artery. The non-uniform stenosis is observed to create higher resistance to the flow than the uniform stenosis. Further, a high disorder is noticed in the constricted region of the artery by streamlines analysis.Research limitations/implicationsThe manuscript completely comprehends the blood’s non-Newtonian flow in the arteries of elliptical shape having multiple stenoses. The present study is about the properties of non-Newtonian blood flow through an elliptical artery with many stenoses. The Sutterby fluid model is used to describe the blood’s non-Newtonian nature. By utilizing presumptions of mild stenosis, the mathematical model’s non-linearity is decreased, and the perturbation method is applied to generate the resulting equations.Practical implicationsThe presence of stenosis can significantly impact the circulation of blood flow. When an artery becomes narrowed, it can create a constriction or obstruction in the flow path of blood, which can lead to several important fluid dynamics phenomena, i.e. increased velocity, shear stress, pressure drop, etc. The presence of stenosis can cause various damages and complications in the affected blood arteries and surrounding tissues, resulting in heart attacks or diseases like atherosclerosis.Originality/valueThe work presented in the manuscript was not published earlier in any form.

Acute Severe Chest Pain with ST-Segment Elevation in Inferior Leads During Pharmacological Cardioversion of Paroxysmal Supraventricular Tachycardia: A Case Report

Paroxysmal supraventricular tachycardia (PSVT) is a frequently encountered arrhythmia in emergency departments, significantly affecting cardiac function and hemodynamics. The sudden onset of severe chest pain with accompanying ST-segment elevation on the electrocardiogram (ECG) during pharmacological cardioversion is rare but requires immediate intervention with coronary vasodilators, anticoagulants, and antiplatelet agents. Continuous ECG monitoring and assessment of cardiac biomarkers are essential. In facilities with appropriate resources, urgent coronary angiography is recommended to evaluate coronary anatomy, blood flow, and collateral circulation. Due to the rarity of this presentation, we report this case as a reference for clinical diagnosis and management.

Vasospasm in Pediatric Subarachnoid Hemorrhage.

Cerebral vasospasm (CV) is a common severe complication of subarachnoid hemorrhage (SAH), a severe type of intracranial bleeding that is uncommon in children. The purpose of this article is to review the current literature regarding this potentially devastating complication. CV may be asymptomatic and is less common in children compared to adults. Several molecular phenomena, including inflammatory ones, contribute to its pathophysiology. Better collateral circulation and higher cerebral blood flow are protective factors in children. When clinically apparent, CV may manifest as a change in the child's neurologic status or vital signs. CV can be diagnosed using brain vessel imaging, such as computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, transcranial Doppler ultrasonography, and computed tomography perfusion. A reduction of < 50% in the artery's caliber confirms the diagnosis. Besides general supportive measures and causative treatment of SAH, CV management options include the administration of calcium channel blockers and neurointerventional approaches, such as intra-arterial vasodilators and balloon angioplasty. Long-term outcomes in children are usually favorable.

Association between Bilateral Vertebral Artery Blood Flow Changes and Posterior Circulation Infarction in Patients with Severe Intracranial Stenosis

Plain Language SummaryThis study investigates the relationship between vertebral artery (VA) blood flow and posterior circulation infarctions (PCI), which are strokes in the back of the brain. VAs play a crucial role in supplying blood to this area. Using color duplex ultrasonography, we measured blood flow in 234 patients with severe VA narrowing (≥70%). These patients were divided into two groups: those who had experienced PCI and those who had not. We analyzed the correlation between blood flow in the VAs and various brain imaging data to understand the occurrence of PCI under different conditions. The findings showed that lower blood flow through the VAs was significantly associated with a higher risk of PCI, particularly in cases involving large artery atherosclerosis (a type of artery disease). However, this association was not observed in cases of branch artery occlusive disease. A detailed analysis revealed that for every 10 mL/min increase in blood flow, the risk of PCI decreased by 11%. This relationship also varied according to the patients’ blood glucose levels: patients with lower blood glucose levels showed a stronger link between increased blood flow and reduced PCI risk compared to those with moderate or high blood glucose levels. In conclusion, measuring the blood flow in the VAs can help identify patients at high risk of strokes in the back part of the brain. However, it is important to consider this measurement in combination with blood glucose levels to improve the identification of high-risk patients.

Comparison of Immediate Intensive Care Outcomes of Patent Ductus Arteriosus Stenting Versus Modified Blalock-Taussig-Thomas Shunt in Infants With Ductal-Dependent Pulmonary Circulation.

Patent Ductus Arteriosus (PDA) stenting is an alternative to Modified Blalock-Taussig-Thomas Shunt (BT) to increase pulmonary blood flow in ductal-dependent pulmonary circulation. The objective of this study is to compare the immediate Intensive Care Unit (ICU) outcomes of PDA stent versus BT shunt in infants with ductal-dependent pulmonary circulation. This is a single center, retrospective study in infants less than 6months with ductal-dependent pulmonary circulation palliated with either PDA stenting or BT shunt from January 2015 till December 2023. Data were reviewed from pediatric ICU database. Demographics details, ICU parameters, mortality and morbidity were compared. The propensity score with inverse probability weighting was used to control the effect of covariates. A total of 302 patients with PDA stenting and 100 patients with BT shunt were included. Majority of the patients had intervention at first month of life. 126 (41.7%) patient underwent PDA stenting while 36 (36%) had BTS. The PDA stenting group has shorter ICU stay, 3 (2.0,6.0) days versus 8 (4.8,13.0) days (p < 0.001), shorter length of hospital stay, 9 (6.8,15.0) days versus 16 (11.0,22.0) days (p < 0.001), shorter ventilation days, 2 (1.0,4.0) days versus 3 (2.0,7.0) days (p < 0.001) and lower mortality, 7 (2.3%) versus 16 (16.0%) (p < 0.001). At 3months follow-up, the survival was higher in the PDA stenting group (p < 0.001). Conclusion: PDA stenting in infants with ductal-dependent pulmonary blood flow has a more favorable intensive care outcomes with shorter ICU and hospital stay. PDA stenting has a better survival outcome.

Influence of the Presence of Different Signatures on the Heat Transfer Profile of Laminar Flow Inside a Microchannel

Abstract The process of transferring heat and mass involves a high-pressure decline. Hence microchannels are utilized in extremely efficient heat and mass transfer processes, such as in the systems of the lungs and kidneys. Due to their high surface-to-volume ratio and compact volume, microchannels have demonstrated superior thermal performance. In this work, micro-fins of different topologies and arrangements were used inside microchannels for modulating heat transfer from the surface of the fins, in the presence of flowing media. The influx of media was simulated in sinusoidal form, reproducing simplified form of physiological circulatory blood flow. The study was conducted in numerical domain, while heat transfer and mass transfer equations were solved using pardiso solver. Temperature modulation at the fin surfaces was conducted to examine the transient profile of heat transfer, as function of both variable fluid velocity as well as variable feeding heat sources. In case of different input boundary conditions, the effect of heat distributions on fluid flow with respect to spatial distribution of micro-fins within a microchannel was evaluated. Results revealed the difference in heat transfer profiles in microchannels in presence of different sets of fin configurations. It was found that rectangular fins have the highest heat transfer in fluid at all its spatial configurations; while semi-ellipsoidal-shaped fins had shown the least heat transfer profile at same surface area. At the same time, it was also observed that the rate of heat dissipation was faster and limited in semi-ellipsoidal-shaped fins configuration; while the heat transfer rate was found symmetrical and low in presence of rectangular fins. Hence, this article emphasizes the modulation of temperature and velocity variations within the working fluid by emphasizing the thermo-fluid coupling effects in microchannels.

Pathophysiological Approach of Myocardial Infarction: A Review

Coronary artery disease (CAD) is the primary cause of myocardial infarction (MI), which is defined by a decreased or stopped blood supply to a portion of the heart myocardium, resulting in cardiac cell death. Because CAD robs the heart of oxygen supply, it frequently presents as silently or with symptoms like radiating chest pain to the shoulder, arm, neck, or jaw. Elevated cardiac troponins and ECG alterations are involved in the diagnosis. MI is caused by prolonged blockage of a major coronary artery; collateral circulation, hemodynamics, and residual blood flow all affect the size of the infarct. Atherosclerosis, thrombosis, and plaque erosion are the primary causes of ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI). Male pattern baldness, advancing age, a family history of the condition, high cholesterol, smoking, hypertension, diabetes, obesity, and stress are risk factors for MI. Aortic dissection, drug misuse, and anomalies in the heart are further causes. Anaerobic respiration and lactate buildup are the results of tissue oxygen deprivation, which starts both reversible and irreversible phases of Myocardial infarction. Oxidative stress and endothelial dysfunction, in conjunction with inflammation and susceptible plaques, worsen the development of MI. Significant MI risks are highlighted by epidemiological research on smoking, obesity, diabetes, hypertension, and socioeconomic variables. Other factors include family history and genetic predisposition. Given that MI continues to be a major cause of morbidity and death worldwide, an understanding of its pathophysiology and risk factors is essential for both prevention and intervention. To lessen the effects of this terrible illness, effective strategies require prompt intervention and thorough risk factor control.

LITERATURE REVIEW: PENGARUH PIJAT BAYI TERHADAP PERUBAHAN KADAR BILIRUBIN DIRECT DAN BILIRUBIN INDIRECT PADA BAYI DENGAN TERAPI SINAR

Infant massage is one of the tactile stimulation and has become a hereditary tradition and has been studied in research in the fields of neonatal science, neurology, psychology, and several other health sciences. The incidence of hyperbilirubinemia in general is a physiological problem that occurs in almost 80% of newborns with prematurity and up to 60% of aterm newborns and occurs in the first week of life. This study aims to determine the implementation of massage therapy in neonates to reduce bilirubin levels. The research method used literature review by searching articles obtained through databases including Science Direct, Elsevier and Google Scholar. The results showed five articles involving neonates in five countries with a randomized control trial (RCT) design, stating that infant massage therapy is the most influential in reducing the degree of neonatal jaundice in the group given massage therapy because it can stimulate defecation. In addition, the provision of physiological massage therapy can improve the circulation of blood flow, lymph and tissue fluids thereby increasing bilirubin output.

Diagnosis and treatment of neonatal machete syndrome

Aim: To provide suggestions for clinical diagnosis, treatment and eugenics through the retrospective analysis of a case of neonatal machete syndrome.Methods: The clinical data of a newborn with machete syndrome admitted to the pediatrics department of Baogang Hospital of Inner Mongolia were analyzed, and suggestions of eugenics were provided based on the literatures.Results: The child, male, natural conception, G2P2, gestational age 38+4 weeks, was born by cesarean section (at am 09:24 on November 13th, 2021). He was hospitalized in our department for 9 days and given NCPAP positive pressure ventilation to give oxygen and anti-infection symptomatic treatment. The dyspnea of the child was not significantly alleviated, and the heart murmurs became increasingly obvious. The child was transferred to the neonatology Department of the Seventh Medical Center of the PLA General Hospital for further treatment on 9 days after birth. After admission, piperacillin and tazobactam were treated with anti-infection, high-frequency oscillation mode of invasive ventilator, limited fluid volume and other symptomatic treatments. Fiberbronchoscopy showed atelectasis of right lung and tracheomalacia of left lung. Echocardiography showed partial anomalous pulmonary venous drainage, atrial septal defect (secondary foramina), inferior vena cava dilatation, pulmonary hypertension, initial coronary artery dilatation, and patent ductus arteriosus. CT 3D imaging of pulmonary veins showed: Congenital heart disease: partial anomalous pulmonary venous drainage (subcardial), consideration of "machete syndrome," atrial septal defect, consideration of pulmonary hypertension, right pulmonary artery stenosis, right lower lung receiving abdominal aorta blood supply, right lung tissue dysplasia, and widening of inferior vena cava pulmonary veins. Therefore, the comprehensive diagnosis was "machete syndrome." Considering the high surgical risk of the child, conservative symptomatic treatment was recommended, and the family requested discharge after 22 days of treatment. The patient died at home at 3 months follow-up after discharge.Conclusions: Machete syndrome is a rare congenital property of abnormal partial or complete pulmonary venous drainage from the right or left lung to the inferior vena cava. With an incidence of approximately 2 in 100,000 live births, the syndrome is commonly associated with right lung dysplasia, pulmonary sequestration, persistent left superior vena cava, and right tilt of the heart. In this case, the child had these syndromes after birth, since the primary hospital did not recognize the disease, the child was clearly diagnosed in the higher hospital. Children with machete syndrome can be treated with surgery in the early neonatal period, but the indication of surgical treatment is still controversial, and the need for surgery is evaluated according to the severity of the patient's symptoms and pulmonary circulation blood flow.

Modeling of blood flow in cerebral arterial circulation and its dynamic impact on electrical conductivity in a realistic multi-compartment head model

Background and ObjectiveThis study aims to assess the dynamic impact of non-Newtonian cerebral arterial circulation on electrical conductivity within a realistic multi-compartment head model. Evaluating this research question is crucial and challenging due to its relevance to electrophysiological modalities like transcranial electrical stimulation (tES), electro-/magnetoencephalography (EEG/MEG), and electrical impedance tomography (EIT). In these modalities, accurate forward modeling depends on the electrical conductivity, which is affected by complex tortuous vessel networks, limited data acquisition in Magnetic Resonance Imaging (MRI), and non-linear blood flow phenomena, including shear rate and viscosity in non-Newtonian fluid. MethodsTo obtain an approximation for the blood concentration, we first use Navier–Stokes equations (NSEs) to solve for the pressure and velocity of the blood in the major vessels. Then Fick's law is used to solve for the blood concentration in the tissues. Finally, Archie's law is used to estimate the electrical conductivity distribution based on the blood concentration. ResultsThe results, obtained with an open 7 Tesla MRI dataset, suggest that a dynamic model of cerebral blood flow (CBF) for both arterial and microcirculation can be established; we find blood pressure and electrical conductivity distributions given a numerically simulated pulse sequence and approximate the blood concentration and electrical conductivity inside the brain based on those. ConclusionsOur model provides an approximation of the dynamical blood flow and the corresponding electrical conductivity distribution in the different parts of the brain. The advantage of our approach is that it is applicable with limited a priori information about the blood flow and with an arbitrary head model distinguishing the arteries.

Digital subtraction angiography findings of stroke in young adult population: a multi-center record-based study

BackgroundStroke is one of the main causes of disability, in which nearly 2/3 of survivors experience disability and interferes with the patient’s daily functional activities. Hypertension, dyslipidemia, obesity, and smoking habits are the main causes of stroke in young adults. Vascular abnormalities are also risk factor for stroke in young adults. Advanced imaging examinations such as cerebral digital subtraction angiography (DSA) can provide a clear picture of the vasculature of the blood vessels of the human brain and provide a real-time picture of the hemodynamic status, blood flow and collateral circulation of the cerebral vessels.ResultsThere were approximately 999 patients who had DSA cerebral examination during the study period. The total young adult population was 147 [92 males (62.4%) and 55 females (37.6%)]. There were 82 patients with ischemic stroke (60.7%). The main etiology of ischemic stroke in this study was intracranial atherosclerotic disease (ICAD) [44 (53.65%)]. The young adult population had 53 hemorrhagic stroke patients (39.3%). The main cause of hemorrhagic stroke is hypertensive vasculopathy (41.5%), followed by a ruptured cerebral arteriovenous malformation (CAVM) (37.7%). There were 12 patients with cerebral sinus venous thrombosis (CSVT). Headache is the main complaint of patients with venous stroke, followed by seizures and hemiparesis. The transverse sinus is the most common site for occlusion (66.7%).ConclusionThis study describes the characteristics and prevalence of stroke in young adults based on the results of cerebral DSA examination. Stroke in young adults is not uncommon. Several traditional risk factors in old age are now found in young people. Lifestyle modification is needed to reduce the prevalence of stroke in young adults.

State-of-the-art methods of qualitative and quantitative assessment of eye microcirculation

Circulatory disorders in eye vessels play an important role in the development of ophthalmic pathologies, in particular socially significant diseases such as glaucoma, age-related macular degeneration, diabetic retinopathy, and retinal vascular occlusion. Eye hemodynamics features are an important diagnostic criterion for both ocular and systemic diseases. A comprehensive assessment of blood flow in various structures of the eyeball offers additional information on the pathogenesis of the diseases and helps develop new approaches to monitoring the effectiveness of treatment and vascular pathology prognostication. Thanks to the improved technologies, we have today a variety of invasive and non-invasive techniques for examining ocular hemoperfusion, including those intended for retrobulbar blood flow and intraocular blood circulation evaluation. The review article is focused on the state-of-the-art techniques: fluorescein angiography, ultrasound examination involving blood flow assessment by colour Doppler mapping and Dopplerography, optical coherence tomography in the angiographic mode and laser speckle flowgraphy. The role of these techniques in the diagnosis of vascular pathology and their advantages and disadvantages when used in ophthalmological practice is considered.

Parametric analysis of transcatheter aortic valve replacement in transcatheter aortic valve replacement: evaluation of coronary flow obstruction.

Transcatheter aortic valve replacement (TAVR) is increasingly being considered for use in younger patients having longer life expectancy than those who were initially treated. The TAVR-in-TAVR procedure represents an appealing strategy to treat failed transcatheter heart valves (THV) likely occurring in young patients. However, the permanent displacement of first THV can potentially compromise the coronary access and ultimately inhibit the blood flow circulation. The objective of this study was to use finite-element analysis (FEA) to quantify coronary flow in a patient who underwent TAVR-in-TAVR. A parametric investigation was carried out to determine the impact of both the implantation depth and device size on coronary flow for several deployment configurations. The FEAs consisted of first delivering the SAPIEN 3 Ultra THV and then positioning the Evolut PRO device. Findings indicates that high implantation depth and device undersize of the second THV could significantly reduce coronary flow to 20% of its estimated level before TAVR. Additionally, a positive correlation was observed between coronary flow and the valve-to-coronary distance (R = 0.86 and p = 0.032 for the left coronary artery, and R = 0.93 and p = 0.014 for the right coronary artery). This study demonstrated that computational modeling can provide valuable insights to improve the pre-procedural planning of TAVR-in-TAVR.

Emerging Woman Leader in Technical Computing Tackles Cardiovascular Disease using HPC

SIGHPC is delighted to announce that Dr. Amanda Randles (Duke U.) is the winner of its 2023 Emerging Woman Leader in Technical Computing Award. She is recognized for her innovative work in developing new approaches to circulatory blood flow simulation at all scales of computing, as well as her dedicated mentorship and community service.

Intrahepatic Venous Collateral Circulation and Reverse Blood Flow After Main Hepatic Vein Obstruction: A Case Report with Literature Review

Intrahepatic Venous Collateral Circulation and Reverse Blood Flow After Main Hepatic Vein Obstruction: A Case Report with Literature Review

Physiotherapy Management in Cases of Spasticity Hemiparese Sinistra ec Ischemic Cerebrovascular Accident a Case Report

A cerebrovascular accident or often referred to as a stroke is a clinical condition that occurs when the circulation of blood flow to the brain is disrupted due to a blockage of blood vessels or due to bleeding. The problem in this case is related to the low LGS value as measured using a goniometer, reduced muscle strength using the MMT value, related to the balance value as measured using the berg balance scale, there is pain as measured using the NRS value and the presence of spasticity as measured by using the Asworth scale, as well as decreased functional ability with the Barthel index and incorrect gait patterns. The physiotherapy intervention given in this study is by giving Infrared, Core stability exercise, Exercise therapy, and Gait Retraining Exercises. This research method uses a case report. The result is an increase in the value of LGS, MMT, berg balance scale, and there is a reduction in the value of pain, spasticity and improvement in gait patterns. But there is no change in the value of functional ability. Keywords : Stroke, Ischemic, Spasticity, Hemipares, Physiotherapy Intervention.

Specific dilation pattern in placental circulation and the NO/sGC role in preeclampsia placental vessels.

Endothelial functions in controlling blood flow in placental circulation are still unclear. The present study compares vascular dilations between placental circulation and other vessels, as well as between normal and preeclampsia placental vessels. Placental, umbilical, and other vessels (cerebral and mesenteric arteries) were collected from humans, sheep, and rats. Vasodilation was tested by JZ101 and DMT. Q-PCR, Western blot, and Elisa were used for molecular experiments. Endothelium-dependent/derived vasodilators, including acetylcholine, bradykinin, prostacyclin, and histamine, mediated no or minimal dilation in placental circulation, which was different from that in other vessels in sheep and rats. There were lower mRNA expressions of muscarinic receptors, histamine receptors, bradykinin receptor 2, endothelial nitric oxide synthesis (eNOS), and less nitric oxide (NO) in human umbilical vessels when compared with placental vessels. Exogenous NO donors (sodium nitroprusside, SNP) and soluble guanylate cyclase (sGC) activators (Bay41-2272) decreased the baseline of vessel tone in placental circulation in humans, sheep, and rats, but not in other arteries. The sGC inhibitor ODQ suppressed the reduced baseline caused by the SNP. The decreased baseline by SNP or Bay41-2272 was higher in placental vessels than in umbilical vessels, suggesting that the role of NO/sGC is more important in the placenta. NO concentrations in preeclampsia placental vessels were lower than those in control, while no significant change was found in umbilical plasma between the two groups. eNOS expression was similar between normal and preeclampsia placental vessels, but phosphorylated eNOS levels were significantly lower in preeclampsia. Following serotonin, SNP or Bay41-2272-mediated dilations were weaker in preeclampsia placental vessels. The decreased amplitude of SNP- or Bay41-2272 at baseline was smaller in preeclampsia. The decreased amplitudes of ODQ + SNP were comparable between the two groups. Despite higher beta sGC expression, sGC activity in the preeclampsia placenta was lower. This study demonstrated that receptor-mediated endothelium-dependent dilation in placental circulation was significantly weaker than other vessels in various species. The results, showed firstly, that exogenous NO played a role in regulating the baseline tone of placental circulation via sGC. Lower NO production and decreased NO/sGC could be one of the reasons for preeclampsia. The findings contribute to understanding specific features of placental circulation and provide information about preeclampsia in placental vessels.