Circulatory Injury Research Articles

Pathophysiological changes and injury markers for acute lung injury from blunt impact in infant rabbits.

Traffic accidents, particularly blunt impacts, cause serious injuries in children. We aimed to assess inflammatory and injury responses in infant rabbits subjected to acute lung injury resulting from blunt impact, with the goal of identifying potential circulatory injury markers. Forty 4-week-old infant rabbits were subjected to a right chest impact using a Hopkinson bar with 2,600 g. Computed tomography was employed to assess injury severity. Pathological changes were observed using hematoxylin and eosin staining in the control, 0, 24, and 72 h groups, post-injury. Immunohistochemistry was used to examine surfactant protein A (SP-A) changes in right lung tissues and upper main bronchi. Serum levels of interleukin-6 (IL-6), IL-8, and SP-A were measured using ELISA within 24 h post-injury in the control, 0 h, and 24 h groups. Following blunt injury, significant increases were observed in blood white blood cell count (F = 101.556, P < 0.01) and neutrophil percentage (F = 104.228, P < 0.01), which gradually decreased after 24 and 72 h. The lung wet/dry weight ratio indicated significant edema (F = 79.677, P < 0.01), corroborated by hematoxylin and eosin staining showing edema, exudation, and marked granulocyte infiltration in the control, 0 h, 24 h and 72 h groups. SP-A levels decreased rapidly at 0 h, and recovered between 24 and 72 h in the right lung tissues (F = 6.7, P < 0.05), left lung (F = 15.825, P < 0.05) and upper main bronchi (F = 59.552, P < 0.01). The ELISA results showed increasing trends for the control and 0 h groups, while decreasing trends were observed in 24 h group for IL-6 (F = 58.328, P < 0.01) and IL-8 (F = 41.802, P < 0.01). Conversely, SP-A exhibited a decreasing trend in the control and 0 h groups but increased in the serum of 24 h group (F = 52.629, P < 0.01). In cases of direct chest trauma in infant rabbits, particularly mild injuries without rib fractures. SP-A levels correlated with pathological changes across all groups and may serve as biomarkers for pediatric blunt lung impact.

Morphological placental findings in women infected with SARS-CoV-2 according to trimester of pregnancy and severity of disease

IntroductionPlacental morphology findings in SARS-CoV-2 infection are considered nonspecific, although the role of trimester and severity of infection are underreported. Therefore, we aimed to investigate abnormal placental morphology, according to these two criteria. MethodsThis is an ancillary analysis of a prospective cohort study of pregnant women with suspected SARS-CoV-2 infection, managed in one maternity, from March 2020 to October 2021. Charting of clinical/obstetric history, trimester and severity of COVID-19 infection, and maternal/perinatal outcomes were done. Placental morphological findings were classified into maternal and fetal circulatory injury and acute/chronic inflammation. We further compared findings with women with suspected disease which tested negative for COVID-19. Diseases’ trimester of infection and clinical severity guided the analysis of confirmed COVID-19 cases. ResultsNinety-one placental discs from 85 women were eligible as a COVID-19 group, and 42 discs from 41 women in negative COVID-19 group. SARS-CoV-2 infection occurred in 68.2% during third trimester, and 6.6% during first; 16.5% were asymptomatic, 61.5% non-severe and 22.0% severe symptomatic (two maternal deaths). Preterm birth occurred in 33.0% (one fetal death). Global maternal vascular malperfusion (MVM) were significant in COVID-19 group whether compared with negative COVID-19 tests group; however, fetal vascular malperfusion lesions and low-grade chronic villitis were not. Three placentas had COVID-19 placentitis. Decidual arteriopathy was associated with infection in first/mid trimester, and chorangiosis in asymptomatic infections. DiscussionPlacental abnormalities after an infection by COVID-19 were more frequent after first/mid-trimester infections. Extensive placental lesions are rare, although they may be more common upon underlying medical conditions.

Iatrogenic Portal Venous Circulatory Injuries in the IR Suite.

Advanced portal venous interventions including transjugular intrahepatic portosystemic shunts, variceal sclerotherapy, and portal venous recanalization are more widely performed, as more aggressive approaches to manage portal hypertension increase patient candidacy for liver transplantation and other therapies. Initial percutaneous portal access may be achieved through transjugular, transsplenic, and transhepatic accesses. Although rare, a potentially life-threatening complication from these approaches is hemorrhage from venous perforation.[1] [2] Patients with portal hypertension often have tortuous vascular anatomy, weakened vessel walls, and high portal venous pressures, predisposing them to potentially devastating outcomes if this complication is encountered. As such, interventional radiologists must take extra precaution to avoid venous injuries during advanced portal venous interventions.[3] [4] Herein we present two patients who experienced rapid, dramatic decompensation from intraperitoneal hemorrhage after initial access was achieved. These cases provide an overview of the clinical course and management strategies for this rare complication in the hopes of improving patient outcomes.

Administration of ascorbic acid in the treatment of septic shock

Introduction: Septic shock is a common condition encountered in the intensive care unit. Sepsis is the leading cause of death with mortality ranging from 35-50%. Several factors are involved in the increasing incidence of sepsis including age, immunosuppression and antibiotic resistance. Gram+ or Gram- infections are considered leading causes of sepsis. Septic shock prognosis is significantly affected by early treatment. The hospitalization of the patient in the intensive care unit is particularly important as it is essential to support vital functions due to the complications of the shock.Aim: To investigate the action of ascorbic acid in the treatment of septic shock and the benefits of its administration. Method-Material: Randomized trials were searched in CENTRAL, EMBASE and PubMed databases. The total number of studies included was 6. The Cochrane Risk of Bias Tool Review Manager Revman 5.3 was used to control the studies. Τhe criteria for the inclusion of patients were: age more specifically over 18 years old, patients accepted to intensive care unit with septic shock, patients with septic shock who received ascorbic acid randomized studies and cohort studies and articles in English with a time limit from 2008 to the first semester of 2020.Results: The results of the studies showed that patients with septicemia and septic shock have shown beneficial effects of ascorbic acid alone or in combination with corticosteroids and thiamine in the prevention of progressive organ dysfunction and in the reduction in mortality and severity of severe sepsis. Also, there was a reduced inflammatory response observed in septic shock and attenuated levels of circulatory injury biomarker.Conclusions: Ascorbic acid has beneficial properties in septic shock and various studies have highlighted the importance of the combination of ascorbic acid and other vitamins and trace elements.

Review of the Problems of Diagnosis of Endopelvic Haemorrhage, Its Intensity, Volume, and Duration, and Treatment Methods of Circulatory Injuries and Surgical Hemostasis after Pelvic Fractures.

Objective. The development of pelvic surgeries is now making new evolutionary jump for us to witness; this would be unimaginable without significant achievements in anesthesiology and new technologies of blood replacement. Methods. This overview presents analysis of 41 domestic and 20 foreign references sources that are devoted to the problematics of treating patients with fluid injuries of pelvis accompanied by retroperitoneal haemorrhage. Results. The following considers details on determination of endopelvic haemorrhage nature, its intensity, volume, and duration, as well as the treatment methods for circulatory injuries and surgical haemostasis. Conclusions. Energy of mechanical influence of traumatizing agent determines the damage levels (system disintegration) for pelvic ring, the bone core, and soft tissue mass. Diagnosis tactics and treatment of patients with disintegrating pelvic damage in the end are determined with volumes and intensity of haemorrhage as well as the character of related damage.

MP89-13 DIAGNOSTICS OF PENILE MICROCIRCULATION DISORDERS IN PATIENTS WITH VASCULOGENIC ERECTILE DYSFUNCTION

You have accessJournal of UrologySexual Function/Dysfunction: Basic Research & Pathophysiology II1 Apr 2016MP89-13 DIAGNOSTICS OF PENILE MICROCIRCULATION DISORDERS IN PATIENTS WITH VASCULOGENIC ERECTILE DYSFUNCTION Dmitry Kurbatov, Roman Aliev, and Ruslan Aliev Dmitry KurbatovDmitry Kurbatov More articles by this author , Roman AlievRoman Aliev More articles by this author , and Ruslan AlievRuslan Aliev More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2474AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Duplex Doppler ultrasonography (DDU) is the conventional test for penile haemodynamic evaluation for erectile dysfunction (ED) screening. We used since 2007 a new method for vasculogenic ED diagnosis - Laser Doppler Microcirculation Floumetry (LDMF). METHODS Ninty six patients were examined – 69 men (mean age 56±5,2) suffered arteriovenous form of ED and 27 healthy men (mean age 28±4,6) as control group. Patients with diabetes mellitus, severe arterial hypertension were excluded. Initially all men undergone DDU with pharmacological test, then tested by LDMF with laser analyzer LAKK-02 («LAZMA», Russia) and helium-neon laser of LGN-207 B-type with 0,63 microns wave length. RESULTS Slow rhythms with frequency of 1-10 oscillations per minute prevailed in the control group. These rhythms were accompanied with the maximum intravascular resistance and active microcirculations mechanism. We considered these blood flow parameters as a physiological norm of the peripheral microcirculation and it correlated with the dynamics fluctuations of the blood flow. The patients with ED had intravascular circulatory injuries. It characterized by abrupt decrease of the blood flow and statistically significant fluctuations of the erythrocytes velocity, decreasing of the myogenic tone and increasing of the neurogenic tone in the precapillary net. The microcirculation’s effectiveness index was also decreased. There were the decreasing of the blood perfusion intensity in cavernous tissue, blood volume reduction in the arterioles, and the congestion in venules with increasing of the erythrocytes amount. These data indicated that the patients with vasculogenic ED had the spastic form of microcirculation injure - decreasing of blood inflow due to cavernous tissue vessels spasm. In these cases the microcirculation index and sphygmic fluctuations amplitude decreased, but the slow oscillations amplitude and vasomotory activity increased. CONCLUSIONS LDMF is a new method of vasculogenic ED diagnosis. In comparison with DDU this method allows to check the microcirculation mechanism and evaluate blood flow disturbances directly in the cavernous tissue. It helps to study the pathogenic changes caused by vasculogenic ED and thus improves the quality of diagnosis. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1141 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Dmitry Kurbatov More articles by this author Roman Aliev More articles by this author Ruslan Aliev More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Long-term allergen exposure induces adipose tissue inflammation and circulatory system injury

The purpose of this study was to study whether allergen exposure can induce inflammation and lower the anti-inflammation levels in serum and in adipose tissues, and further develop cardiovascular injury. Our data showed that heart rate was significantly higher in the OVA-challenged mice compared to control mice. Moreover, there were higher expressions of pro-inflammation genes in the OVA-challenged mice in adipose tissues, and the expressions of anti-inflammation genes were lower. The levels of inflammation mediators were associated in serum and adipose tissues. The level of circulatory injury lactate dehydrogenase was significantly associated with the levels of E-selectin, resistin and adiponectin in the serum. The hematoxylin and eosin and immunohistochemistry stains indicated the OVA-challenged mice had higher levels of inflammation. In summary, the current study demonstrated allergen exposure can cause cardiovascular injury, and inflammatory mediators in adipose tissues play an important role in the pathogenesis of cardiovascular injury.

Cerebrovascular ischemic protection by pre- and post-conditioning

Stroke and cardiac arrest involve injury to all the brain's resident cells and their respective progenitors, including neurons, all glial subtypes, vascular smooth muscle, vascular endothelium, and pericytes, resulting either in the death of the individual or in a lesion that likely manifests as long-term impairments across a number of cognitive and functional domains. Thousands of studies in experimental animals and results from a few clinical trials in humans have demonstrated that the mechanisms responsible for ischemic brain injury can be blocked or slowed by survival-enhancing epigenetic responses induced by conditioning the brain with a stress stimulus paradigm before or even after ictus. The resultant reduction in lesion size and functional deficits are often termed endogenous neuroprotection, but this in fact involves cytoprotective responses on the part of all the aforementioned resident brain cells and the circulating immune cells as well. The present review will summarize findings demonstrating conditioning-induced protection of the cerebral vasculature, that in turn manifests as reductions in vascularly targeted inflammatory responses; less endothelial injury and improvements in structural integrity of the circulation across all levels of organization; enhanced perfusion with less thrombosis; reductions in vascular dysregulation and reactivity impairments; and, over the longer term, more robust angiogenesis and vascular remodeling. Advancing the mechanistic basis for these innately vasculoprotective phenotypes may provide therapeutic targets for limiting cerebral circulatory injury and dysfunction following stroke and cardiac arrest.

Structural changes in mature rat thymus under the systematic exposure to +Gx acceleration and Glutarginum

Objective: Experimental work was designed primary to study morphological and functional changes in the mature rat\'s thymus under systematic exposure to +Gx acceleration. Secondary task is to determine a possible corrective potential of Glutarginum (L-arginine and L-glutamic acid). Methods: Mature male Wistar rats were exposed to systematic +Gx acceleration (9G, 10 min daily, 10 times). Morphology of the thymus was investigated by light and transmission electron microscopy. Results: Analysis of changes in the thymus of the mature rats under systematic exposure to +Gx acceleration showed marked structural transformation, which is characterized by a process of accidental involution and microcirculatory disturbances caused by the systematic action of gravitational forces. Such changes were potentiated by the age-related involution. Proliferation and expanding of the connective tissue structures, replacement of the parenchyma by the adipose tissue, degeneration of the epithelial component are characteristics of mature rat\'s thymus. At the same time, histoarchitecture of the thymus was characterized by typical stress-induced changes. Concomitant usage of Glutarginum promotes less pronounced circulatory injuries and involutive changes than in the experiments without Glutarginum treatment. Conclusion: Systematic action of +Gx acceleration causes significant alteration of normal structural organisation of the thymus of the matured rats. Using L-arginine + L-glutamate increases the adaptive capacity of the thymus.

A Variant Form of Nasogastric Tube Syndrome

Nasogastric tube syndrome named by Sofferman et al in 1981 is a laryngeal complication presenting with life-threatening vocal cord abductor paralysis derived from peroforation of the NG tube-induced esophageal ulcer. As compared with the previously reported cases of this syndrome, our 4 autopsied patients were so peculiar in the following two points that vocal cord abductor paralysis developed repeatedly and no esophageal ulcer was present in spite of the presence of the laryngeal abductor muscle injury. We hypothesized that the etiology of such a variant form was circulatory injury of the laryngeal abductor muscle which was caused by the compression of the postcricoid blood vessels perfusing this muscle. Nasogastric tube syndrome, which is treatable by decannulation, cannot be ruled out even if no esophageal ulcer is detected by fiberoptic laryngoscopy.

Polymicrogyria in monozygous twins and an elder sibling

Monozygous twin births have been associated with brain lesions such as hydranencephaly, multicystic encephalomalacia, and porencephaly. Prenatal circulatory injury has been considered to be the cause. Polymicrogyria is rare but has been reported in autopsied cases. The sibship in this case report, comprising monozygotic male twins and their elder sister from the same non‐consanguineous parents, all had global developmental delay. Brain MRI showed polymicrogyria. We suggest that, apart from circulatory compromise, genetic etiology must be implicated as the cause of polymicrogyria.

New ultrastructural evidence for a protein transport system in endothelial cells of gerbil brains.

Pathways for transfer of horseradish peroxidase (HRP) across the cerebral microvasculature were studied in Mongolian gerbils after inducing either unilateral carotid-artery ligation or intracarotid air embolism. Electron microscopy on samples from both ipsilateral and contralateral brain hemispheres showed the reaction product (HRP) in the endothelial cytoplasm of capillaries and arteriols in all animals; in the basal lamina, HRP was seen only after long (3--4 h) ischemic periods. HRP was seen within both spherical and tubular structures, with the latter appearing in obliquely or longitudinally sectioned blood vessels. These endothelial channel-like structures are part of a tubulovesicular network which seemingly exists in the normal endothelium of the gerbil brain. The tubules serve as pathways for proteins into the brain; protein transfer becomes enhanced following circulatory injuries such as ischemia.