Cranial Arteries Research Articles

A common celiacomesenteric trunk is a rare anatomic variant in dogs.

With the increasing use of CT and MRI for diagnostic imaging and planning of interventional procedures, it is important for veterinary radiologists to be familiar with variations in normal vascular anatomy and not mistake them for pathology. The arterial blood supply to the cranial abdominal viscera is provided by the celiac and the cranial mesenteric arteries. A common celiacomesenteric trunk (CMT) has been reported as a rare anatomical variant in dogs. The goals of this retrospective, observational, cross-sectional prevalence study were to determine the prevalence of a CMT in dogs with non-abdominal disease and compare it to the prevalence in dogs with portosystemic shunts (PSS). Magnetic resonance imaging studies of the thoracolumbar and lumbosacral spine in dogs that included the origin of the celiac and cranial mesenteric arteries and dual-phase CT angiography studies of the abdomen in dogs with portosystemic shunts were retrospectively reviewed by a veterinary student and a board-certified veterinary radiologist. The prevalence of a CMT was determined as the proportion of dogs diagnosed with this vascular anomaly in the MRI and CT group, respectively. Fisher's exact test was used to determine any association of a CMT with the concurrent presence of a PSS, sex, and breed size. A CMT was identified in seven of 606 (1.2%) MRI studies and in none of 47 abdominal CT studies. There was no association between the presence of a CMT and PSS (P=1.000), sex (P=.4694), or breed size (P=1.000). A CMT is a rare incidental finding in dogs.

Validation of the Southend giant cell arteritis probability score in a Scottish single-centre fast-track pathway.

ObjectiveThe aim was to provide external validation of the Southend GCA probability score (GCAPS) in patients attending a GCA fast-track pathway (GCA FTP) in NHS Lanarkshire.MethodsConsecutive GCA FTP patients between November 2018 and December 2020 underwent GCAPS assessment as part of routine care. GCA diagnoses were supported by US of the cranial and axillary arteries (USS), with or without temporal artery biopsy (TAB), and confirmed at 6 months. Percentages of patients with GCA according to GCAPS risk group, performance of total GCAPS in distinguishing GCA/non-GCA final diagnoses, and test characteristics using different GCAPS binary cut-offs were assessed. Associations between individual GCAPS components and GCA and the value of USS and TAB in the diagnostic process were also explored.ResultsForty-four of 129 patients were diagnosed with GCA, including 0 of 41 GCAPS low-risk patients (GCAPS <9), 3 of 40 medium-risk patients (GCAPS 9–12) and 41 of 48 high-risk patients (GCAPS >12). Overall performance of GCAPS in distinguishing GCA/non-GCA was excellent [area under the receiver operating characteristic curve, 0.976 (95% CI 0.954, 0.999)]. GCAPS cut-off ≥10 had 100.0% sensitivity and 67.1% specificity for GCA. GCAPS cut-off ≥13 had the highest accuracy (91.5%), with 93.2% sensitivity and 90.6% specificity. Several individual GCAPS components were associated with GCA. Sensitivity of USS increased by ascending GCAPS risk group (nil, 33.3% and 90.2%, respectively). TAB was diagnostically useful in cases where USS was inconclusive.ConclusionThis is the first published study to describe application of GCAPS outside the specialist centre where it was developed. Performance of GCAPS as a risk stratification tool was excellent. GCAPS might have additional value for screening GCA FTP referrals and guiding empirical glucocorticoid treatment.

Diagnostic accuracy of vascular ultrasound in patients with suspected giant cell arteritis (EUREKA): a prospective, multicentre, non-interventional, cohort study.

Temporal artery biopsy is considered the diagnostic gold standard for giant cell arteritis, despite approximately 39% of patients who are negative for the condition by biopsy subsequently being given a clinical diagnosis of giant cell arteritis. We aimed to assess the diagnostic accuracy of ultrasound examination in patients with suspected giant cell arteritis. In this prospective, multicentre, non-interventional, cohort study (evaluation of ultrasound's role in patients suspected of having extracranial and cranial giant cell arteritis; EUREKA), we consecutively recruited patients aged 50 years or older, with clinically suspected giant cell arteritis from three Danish hospitals (South West Jutland Hospital in Esbjerg, Silkeborg Regional Hospital, and Rigshospitalet, Glostrup). Participants had a bilateral ultrasound of the temporal, facial, common carotid, and axillary arteries. Ultrasounds were done by ultrasonographers who were systematically trained in vascular ultrasound using appropriate equipment and settings. Participants then had a temporal artery biopsy within 7 days of initiation of corticosteroid treatment. A blinded ultrasound expert assessed all ultrasound images. Ultrasound vasculitis was defined in cranial arteries as a homogeneous, hypoechoic, intimamedia complex thickness and a positive compression sign and as a homogeneous intimamedia complex of 1 mm in thickness or wider in the axillary arteries and of 1·5 mm thickness or wider in the common carotid artery. Participants were followed up at 6 months. During this 6 month period, clinicians were able to collect data from all clinical examinations to enable a full clinical diagnosis at 6 months. Clinical diagnosis was based on the expert opinion of the treating rheumatologist. The diagnostic criterion standard was diagnosis confirmed after 6 months of follow-up. We used logistic regression analyses to calculate the odds ratio and 95% CI of ultrasound as a predictor for giant cell arteritis. Between April 1, 2014, and July 31, 2017, 118 patients were screened for inclusion, of whom 106 had both ultrasound examinations and an eligible temporal artery biopsy and were included in the intention-to-diagnose population. The mean age was 72·7 years (SD 7·9), 63 (59%) participants were women, and 43 (41%) were men. Temporal artery biopsy was positive in 46 (43%) of 106 patients, and 62 (58%) of 106 patients had a clinically confirmed diagnosis of giant cell arteritis at 6 months (temporal artery biopsy sensitivity 74% [95% CI 62-84], specificity 100% [95% CI 92-100]). Cranial artery ultrasound was positive in all patients who had a positive temporal artery biopsy, and seven (58%) of 12 patients who were positive by ultrasound and negative by temporal artery biopsy were confirmed to have large-vessel giant cell arteritis via other imaging methods. The sensitivity of ultrasound diagnosis of giant cell arteritis was 94% (84-98) and specificity was 84% (70-93). Logistic regression analysis confirmed that ultrasound was the strongest baseline predictor for a clinically confirmed diagnosis of giant cell arteritis at 6 months (crude odds ratio 76·6 [95% CI 21·0-280·0]; adjusted for sex and age 141·0 [27·0-743·0]). Vascular ultrasound might effectively replace temporal artery biopsy as a first-line diagnostic method in patients suspected of having giant cell arteritis when done by systematically trained ultrasonographers using appropriate equipment and settings. The Institute for Regional Research at Hospital of Southwest Jutland, Esbjerg, Denmark.

The neuroanatomy of Zulmasuchus querejazus (Crocodylomorpha, Sebecidae) and its implications for the paleoecology of sebecosuchians.

The endocranial structures of the sebecid crocodylomorph Zulmasuchus querejazus (MHNC 6672) from the Lower Paleocene of Bolivia are described in this article. Using computed tomography scanning, the cranial endocast, associated nerves and arteries, endosseous labyrinths, and cranial pneumatization are reconstructed and compared with those of extant and fossil crocodylomorphs, representative of different ecomorphological adaptations. Z. querejazus exhibits an unusual flexure of the brain, pericerebral spines, semicircular canals with a narrow diameter, as well as enlarged pharyngotympanic sinuses. First, those structures allow to estimate the alert head posture and hearing capabilities of Zulmasuchus. Then, functional comparisons are proposed between this purportedly terrestrial taxon, semi-aquatic, and aquatic forms (extant crocodylians, thalattosuchians, and dyrosaurids). The narrow diameter of the semicircular canals but expanded morphology of the endosseous labyrinths and the enlarged pneumatization of the skull compared to other forms indeed tend to indicate a terrestrial lifestyle for Zulmasuchus. Our results highlight the need to gather new data, especially from altirostral forms in order to further our understanding of the evolution of endocranial structures in crocodylomorphs with different ecomorphological adaptations.

Lars Edvinsson: bench-to-bedside discovery

Lars Edvinsson: bench-to-bedside discovery

The Effect of K ATP Channel Blocker Glibenclamide on CGRP-Induced Headache and Hemodynamic in Healthy Volunteers.

BackgroundCalcitonin gene-related peptide (CGRP) dilates cranial arteries and triggers headache. The CGRP signaling pathway is partly dependent on activation of ATP-sensitive potassium (KATP) channels. Here, we investigated the effect of the KATP channel blocker glibenclamide on CGRP-induced headache and vascular changes in healthy volunteers.MethodsIn a randomized, double-blind, placebo-controlled, cross-over study, 20 healthy volunteers aged 18–27 years were randomly allocated to receive an intravenous infusion of 1.5 μg/min CGRP after oral pretreatment with glibenclamide (glibenclamide-CGRP day) or placebo (placebo-CGRP day). The primary endpoints were the difference in incidence of headache and the difference in area under the curve (AUC) for headache intensity scores (0–14 h) between glibenclamide and placebo. The secondary endpoints were the difference in AUC for middle cerebral artery blood flow velocity (VMCA), superficial temporal artery (STA) and radial artery (RA) diameter, facial flushing, heart rate (HR) and mean arterial blood pressure (MAP) (0–4 h) between glibenclamide and placebo.ResultsWe found no significant difference in the incidence of headache between glibenclamide-CGRP day (14/20, 70%) and placebo-CGRP day (19/20, 95%) (P = 0.06). The AUC for headache intensity, VMCA, STA, RA, facial skin blood flow, HR, and MAP did not differ between glibenclamide-CGRP day compared to placebo-CGRP day (P > 0.05).ConclusionPretreatment with a non-selective KATP channel inhibitor glibenclamide did not attenuate CGRP-induced headache and hemodynamic changes in healthy volunteers. We suggest that CGRP-induced responses could be mediated via activation of specific isoforms of sulfonylurea receptor subunits of KATP channel.

A Four‐Week Urban Diet Impairs Vasodilation but Not Nutritional Physiology in Wild‐caught Mourning Doves (Zenaida macroura)

Birds living in urban areas routinely consume anthropogenic foods, but the physiological consequences of this consumption are poorly understood. To address this question, we investigated the effects of an urban diet (UD) in wild, urban-caught mourning doves in a controlled environment. Since anthropogenic foods often contain a high proportion of refined carbohydrate and fat, we predicted that UD consumption alters body mass as well as plasma and tissue metabolites and impairs vasodilation. To test this prediction, we compared the nutritional physiology and peripheral vasodilation of doves fed an UD (1:1 ratio of bird seeds and French fries; n=7) with those of doves receiving a control diet (CON: bird seed diet; n=6) for four weeks. At the end of the dietary manipulation period, birds were euthanized and we dissected cranial tibial arteries to measure ex vivovasodilation in response to acetylcholine treatment after phenylephrine-induced vasoconstriction. We also collected cardiac blood as well as liver, pectoralis and gastrocnemius muscle samples to measure nutritional metabolite concentrations. The vasodilation of tibial arteries was impaired in UD compared to CON-fed birds (p=0.004), suggesting the potential for UD consumption to cause cardiovascular pathologies. Neither body mass, plasma osmolality, glucose, sodium, insulin, triglyceride, uric acid, liver glycogen and triglycerides, nor muscle glycogen differed between groups. The results suggest that short term consumption of a diet comprised of 50% anthropogenic foods is not associated with major metabolic perturbations in urban mourning doves.

A Four-Week Urban Diet Impairs Vasodilation but Not Nutritional Physiology in Wild-Caught Mourning Doves (Zenaida macroura).

AbstractBirds living in urban areas routinely consume anthropogenic foods, but the physiological consequences of this consumption are poorly understood. To address this question, we investigated the effects of an urban diet (UD) in wild, urban-caught mourning doves in a controlled environment. Since anthropogenic foods often contain a high proportion of refined carbohydrate and fat, we predicted that UD consumption alters body mass as well as plasma and tissue metabolites and that it impairs vasodilation. To test this prediction, we compared body mass, various nutritional physiology parameters, and peripheral vasodilation of doves fed an UD (1∶1 ratio of bird seeds and french fries; [Formula: see text]) with those of doves receiving a control diet (CON, bird seed diet; [Formula: see text]) for 4 wk. At the end of the dietary manipulation period, birds were euthanized, and we dissected cranial tibial arteries to measure ex vivo vasodilation in response to acetylcholine treatment after phenylephrine-induced vasoconstriction. We also collected cardiac blood as well as liver, pectoralis, and gastrocnemius muscle samples to measure nutritional metabolite concentrations. Vasodilation of tibial arteries was impaired in UD- compared to CON-fed birds ([Formula: see text]), suggesting the potential for UD consumption to alter cardiovascular function. Body mass, plasma osmolality, glucose, sodium, insulin, triglyceride, uric acid, liver glycogen and triglycerides, and muscle glycogen did not differ between groups. The results suggest that short-term consumption of a diet composed of 50% anthropogenic foods is not associated with major metabolic perturbations in urban mourning doves.

Ultrasound Can Effectively Replace Temporal Artery Biopsy in the Diagnosis of Giant Cell Arteritis: A Multicentre, Prospective Cohort Study

Background: Temporal artery biopsy (TAB) is considered the diagnostic gold standard for giant cell arteritis (GCA), despite up to 39% of biopsy-negative patients receiving a clinical diagnosis of GCA. This is a prospective, multicentre study assessing the diagnostic utility of ultrasound examination in patients with suspected GCA. Methods: Participants were recruited from three Danish centres among patients with clinically suspected GCA. Temporal (TA), facial (FA), common carotid (CC), and axillary arteries (AA) were examined by ultrasonographers, systematically trained in vascular ultrasound, using appropriate equipment and settings, before TAB. A blinded ultrasound expert evaluated all images. The primary outcome was the proportion of participants with clinically diagnosed GCA confirmed after 6-month follow-up. Ultrasound vasculitis was defined in cranial arteries as increased, hypoechoic intima-media thickness (IMT) and a positive compression sign, in large vessels as homogeneous IMT ≥ 1 mm in the AA and ≥1·5 mm in the CA. Findings: One hundred six patients were included in the intention-to-survey population. TAB was positive in 46 patients (43%), and 64 (60%) patients had a clinically confirmed diagnosis of GCA at 6-month follow-up (TAB sensitivity 74%, 95% CI 62–84%, specificity 100%, 95% CI 92–100%). Cranial artery ultrasound was positive in all TAB-positive patients. The sensitivity and specificity of the ultrasound diagnosis of clinical GCA were 94% (84–98%) and 84% (70–93%). Logistic regression analysis confirmed that ultrasound was the strongest baseline predictor for a clinically confirmed diagnosis of GCA at 6 months (crude: OR 76·6, 21·0–280·0; Adjusted for sex and age OR=141·0, 27·0–743). Interpretation: Vascular ultrasound can effectively replace TAB as a first-line diagnostic modality in patients suspected of having GCA when applied by systematically trained ultrasonographers using appropriate equipment and settings. Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: Written consent was obtained from all participating patients according to the Declaration of Helsinki. The study was approved by The Regional Committees on Health Research Ethics for Southern Denmark (reference number S-2014003) and the Danish Data Protection Agency (reference number 2008-58-0035).

Sources of Arterial Vascularization of the Polar Owl’s Kidneys

The sources of vascularization of the kidneys of five polar owl carcasses were studied by filling the vessels with self-hardening plastic Belokril through the femoral artery. High-grade oil paints were added to the monomer to give the vessels the desired color. After the injection, the carcasses were placed in a high concentration caustic soda solution for three days. The resulting corrosion impression was washed under warm water and dried. It was identified that in the lumbar trunk, the main vessel was the descending aorta, from which extra- and intraorganic arteries departed for vascularizing the kidneys. Extraorganic arteries included external and internal iliac, sciatic and middle sacral arteries. Intraorganic arteries included cranial, middle, and caudal renal arteries. Inside the parenchyma of each lobe of the kidney, intraorganic arteries branched in the main type of caudomedial, dorsomedial and lateromedial directions and were subdivided into segmental, interlobular and perilobular arteries and intralobular capillaries. An asymmetry in the branching of the renal arteries was observed. During histological examination, we noted that the renal arteries were lined with endothelium on the inner side and the intima contained endotheliocytes with oval nuclei. Under the endothelial layer were loose collagen fibers running along the middle shell. There was no loose connective tissue between the inner and middle shells, so the subendothelial layer was very weak and there was no internal elastic membrane. The muscle membrane was well developed, with collagen and elastic fibers located between the muscle fibers. The outer shell was represented by loose connective tissue with the presence of arterial and venous vessels. The collagen fibers had a slightly convoluted course.&#x0D; Keywords: birds, polar owl, arteries, kidneys, parenchyma, capillaries, endotheliocytes, intima

Tacrolimus Induced Severe Cerebral and Coronary Vasospasm after Heart Transplantation

IntroductionTacrolimus has several cardiovascular adverse events. We report case of tacrolimus-induced severe cerebral and coronary vasospasm after heart transplantation.Case ReportA 62-year-old female underwent orthotropic heart transplantation due to dialted cardiomyopathy. Her postoperative course was benign. At 2 months, she complained of severe pulsatile headache. CTA of the brain showed diffuse cerebral artery constriction with multifocal beaded features at nearly all distal cranial arteries and scant SAH in the right parietal area (Figure 1). We diagnosed reversible cerebral vasospasm syndrome (RCVS) induced by tacrolimus and planned to switch tacrolimus to sirolimus using the vasodilator. She inevitably maintained a low level of tacrolimus due to sirolimus induced diarrhea. Using nimodipine, her symptoms disappeared, and follow-up CTA of the brain showed relieved cerebral vasoconstriction and absorption of hemorrhage (Figure 1). At 5 months after surgery, she was admitted from acute rejection. After 2 weeks of treatment, she was stabilized with biopsy improvement. We maintained a triple regimen. She soon complained of chest pain. Telemetry revealed transient ST segment elevation (Figure 2). We assumed that this event was associated with elevated tacrolimus levels; thus, tacrolimus was reduced, and oral diltiazem was administered. Using a vasodilator, a coronary vasospasm provocation test was performed. During the test, severe coronary spasm was noted. Intracoronary and intravascular nitroglycerin was administered aggressively. The study was completed after confirming a normalized coronary artery(Figure 3). Twenty minutes later, she collapsed with squeezing chest pain. On-site CPR and ECMO insertion were performed. Two days later, she died of cardiogenic shock even with ECMO support.SummaryEarly detection of disease and withholding tacrolimus are important strategies. Tacrolimus has several cardiovascular adverse events. We report case of tacrolimus-induced severe cerebral and coronary vasospasm after heart transplantation. A 62-year-old female underwent orthotropic heart transplantation due to dialted cardiomyopathy. Her postoperative course was benign. At 2 months, she complained of severe pulsatile headache. CTA of the brain showed diffuse cerebral artery constriction with multifocal beaded features at nearly all distal cranial arteries and scant SAH in the right parietal area (Figure 1). We diagnosed reversible cerebral vasospasm syndrome (RCVS) induced by tacrolimus and planned to switch tacrolimus to sirolimus using the vasodilator. She inevitably maintained a low level of tacrolimus due to sirolimus induced diarrhea. Using nimodipine, her symptoms disappeared, and follow-up CTA of the brain showed relieved cerebral vasoconstriction and absorption of hemorrhage (Figure 1). At 5 months after surgery, she was admitted from acute rejection. After 2 weeks of treatment, she was stabilized with biopsy improvement. We maintained a triple regimen. She soon complained of chest pain. Telemetry revealed transient ST segment elevation (Figure 2). We assumed that this event was associated with elevated tacrolimus levels; thus, tacrolimus was reduced, and oral diltiazem was administered. Using a vasodilator, a coronary vasospasm provocation test was performed. During the test, severe coronary spasm was noted. Intracoronary and intravascular nitroglycerin was administered aggressively. The study was completed after confirming a normalized coronary artery(Figure 3). Twenty minutes later, she collapsed with squeezing chest pain. On-site CPR and ECMO insertion were performed. Two days later, she died of cardiogenic shock even with ECMO support. Early detection of disease and withholding tacrolimus are important strategies.

Associations among temporal and large artery abnormalities on vascular ultrasound in giant cell arteritis

Objectives: Giant cell arteritis (GCA) can manifest in cranial and/or extracranial arteries. We investigated the distribution of affected arteries on vascular ultrasound (VUS) among patients with new-onset or prior-onset GCA. Method: We retrospectively studied patients with either new-onset or prior-onset GCA and an abnormal VUS, from 2013 to 2017. Trained vascular technologists imaged the bilateral temporal arteries and carotid, axillary, and subclavian arteries. Vascular medicine physicians interpreted the images. Vasculitis-related abnormalities in individual vessels and their distribution (temporal artery, large artery, or both) were evaluated. Phi coefficients (φ) and Fisher’s exact test were used to assess correlations among individual abnormal arteries. Results: Among 66 GCA patients, 28.8% had prior-onset GCA (median duration 17.8 months). Acute arteritis on VUS was observed in the majority of patients with both new-onset (72.3%) and prior-onset GCA (68.4%); the remainder had hyperechoic wall thickening without acute arteritis. Involvement of the temporal arteries only (45.5%) or large arteries only (34.8%) was more common than involvement of both (19.7%); this finding was similar in new-onset and prior-onset GCA. There were moderate positive correlations among temporal artery branches (φ = 0.51–0.58, p < 0.003) and among axillary and subclavian arteries (φ = 0.51–0.77, p < 0.003), and moderate negative correlations between abnormalities in the temporal and large arteries (φ = −0.46 to −0.58, p < 0.003). Conclusion: On VUS, vasculitis-related abnormalities in the temporal arteries only or large arteries only were more common than concurrent temporal and large artery abnormalities in patients with both new-onset GCA and prior-onset GCA.

Effect of occipitoatlantal decompression on cerebral blood flow dynamics as evaluated by Doppler ultrasonography.

Osteopathic manipulative treatment reduces symptoms in patients with headache disorders, but the underlying mechanisms are unclear. To evaluate blood flow in the intracranial and extracranial vasculature before and after occipitoatlantal decompression (OAD) using Doppler ultrasonography. Healthy, first-year osteopathic medical students from A.T. Still University's Kirksville College of Osteopathic Medicine participated in a randomized, single-blinded, two-period, two-treatment crossover study. The participants were randomly assigned to 1 of 2 treatment interventions: OAD or sham touch. After one week, participants returned to have the other intervention performed. Blood flow parameters-peak systolic velocity (PSV) and end-diastolic velocity (EDV)-in the middle cerebral artery (MCA), internal carotid artery (ICA), and vertebral artery (VA) were evaluated before, immediately after, 5minutes after, and 10minutes after treatment. Differences in PSV, EDV, heart rate (HR), and blood pressure (BP) for both interventions were analyzed for the four time points using mixed-effects models. Thirty healthy medical students (11 men, 19 women; mean age, 24years) participated in this study. EDV increased after OAD in the MCA, ICA, and VA (all p<0.001); no change occurred after sham touch (all p>0.05). EDV was greater for all post-treatment timepoints after OAD in the MCA, ICA, and VA than after sham touch (all p<0.001). Although baseline PSV in the MCA measured before treatment was different between treatment interventions (p=0.01), no difference was found between interventions at any post-treatment time point (all p>0.59). Changes in PSV in the ICA and VA and for HR and BP did not depend on treatment intervention (p>0.06). Increases in EDV occurred in major cranial arteries after OAD but not after sham touch, indicating that OAD improves blood flow to the brain. The exact mechanism of this increase is unknown; however, it can be explained by either parasympathetic stimulation through the secretion of vasodilating neurotransmitters or by a decrease in external tissue pressure on ICA and VA, with the resulting flow causing further dilation in the MCA.

The Arterial Vascularization of the Small and Large Intestine in Adult Male Turkeys (Meleagris gallopavo)

The aim of this study was to reveal the blood supply of the intestinal tract in male adult turkey. Five healthy birds were collected from local suppliers at Baaqoba province. All birds were euthanized and their coelomic cavity was dissected. The descending aorta was cannulated and injected with colored latex, and then the course of arteries along the intestinal tract investigated. Small intestine received the blood by celiac artery, cranial and caudal mesenteric artery. Celiac was split into two branches right and left, the right branch of celiac artery supplied the proventriculus, gizzard, duodenum, pancreas, jejunum and distal part of ileum and cecum while left branch supply the stomach. The crania mesenteric artery nourished the terminal parts of duodenum, jejunum ileum and cranial part of the two ceca, on the other hand. Caudal mesenteric artery was the third artery that supplied the intestine which was short branch originated from descending aorta and divided into two groups cranial groups supplied distal part of ileum and base of ceca while the caudal groups supplied the rectum and cloaca and anastomosed with cranial mesenteric artery. Form the above results, it was concluded that the small and large intestine are nourished by the three major arteries namely Celiac, Cranial and Caudal mesenteric arteries and its branches.

Correlation of Prostatic Artery Blood Flow Assessed by Doppler Ultrasonography with Semen Characteristics in Beagle Dogs.

Simple SummaryThis study examined the blood flow parameters of the prostate artery before dog ejaculation assessed by pulsed-wave Doppler ultrasound (PwD) changes. The main objective of this study was to characterize the vascular parameters of the prostatic artery in beagle dogs and to explore the potential use of Doppler ultrasonography as a complementary method in dog stud selection. These findings report differences between blood flow parameters in cranial and caudal locations of the prostatic artery in comparison to subcapsular and parenchymal locations. There was a high positive correlation of peak systolic velocity with total volume and sperm concentration. In conclusion, estimation of the PwD parameters of the cranial prostatic artery may be useful in the breeding evaluation of dogs.Pulsed-wave Doppler ultrasonography (PwD) is a method used to rapidly and noninvasively assess blood flow dynamics of the canine prostate. Modifications in gland vascularization can affect seminal plasma production and consequently sperm quality. The aim of this study was to determine the normal blood flow parameters of the prostate artery in beagle dogs and to analyze the correlations between vascular flow and semen quality characteristics. PwD was performed on five beagle dogs (5–6 years) measuring vascular features in four different locations of the prostatic artery (cranial, subcapsular, parenchymal and caudal); the measured features were peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI). Ejaculates were obtained using digital manipulation and semen quality was evaluated by determining macroscopic (total volume, sperm-rich fraction volume, color and pH) and microscopic (sperm motility, morphology, viability and acrosome integrity) characteristics. The values of PSV, PI and RI in cranial and caudal prostatic arteries were significantly higher than in subcapsular and parenchymal arteries (p < 0.05). Moreover, a positive correlation of PSV value in the cranial region of the prostatic artery with total ejaculate volume (p < 0.01, r = 0.612) and sperm concentration (p < 0.01, r = 0.587) was determined. PI index was negatively correlated with sperm concentration (p < 0.01, r = −0.709). In conclusion, the results suggest that the prostatic artery blood flow parameters can affect macroscopic semen quality characteristics in healthy dogs.

Isquemia de extremidades inferiores secundaria a arteritis de la arteria temporal

Giant cell arteritis is more common in women older than 60 years, is associated with systemic inflammation symptoms and mainly involves the aortic arch and cranial arteries, specially the temporal artery. Symptomatic lower extremity arterial stenosis or occlusion is uncommon and can lead to limb loss. We report a 73-year-old woman presenting with a one-month history of lower extremity intermittent claudication of sudden onset. She also complained of fever, malaise, headache and weight loss. A non-invasive vascular study showed moderate femoral popliteal occlusive disease, with and abnormal ankle-brachial index (0.68 and 0.83 on right and left sides, respectively). An angio-computed tomography showed thickening of the aortic wall and severe stenosis in both superficial femoral arteries. Steroidal treatment was started, and a temporal artery biopsy was performed confirming giant cell arteritis. Six weeks after steroid therapy the patient had a complete remission of symptoms. A serologic exacerbation was subsequently treated with a humanized monoclonal antibody against the interleukin-6 receptor Tocilizumab, obtaining long time remission.

The cut-off values for the intima-media complex thickness assessed by colour Doppler sonography in seven cranial and aortic arch arteries.

Colour Doppler sonography (CDS) is becoming ever more important in the diagnosis of GCA. Data on cut-off values for intima-media complex thickness (IMT) that can be used in clinical practice to distinguish between normal and inflamed arteries are limited. We aimed to derive potential cut-off values for IMT of seven preselected arteries by comparing IMT between GCA patients and a control group. We performed CDS of the preselected temporal, facial, occipital, carotid, vertebral, subclavian and axillary arteries in consecutive newly diagnosed GCA patients between October 2013 and September 2019. A 'halo' with positive compression sign was considered a positive finding. We measured the maximum IMT in the preselected arteries and compared it with the maximum IMT of the control group. We were able to demonstrate a halo sign in at least one of the examined arteries of 244/248 (98.4%) GCA patients. Temporal arteries were the most commonly affected vessels, involved in 192 (77.4%) patients. We found extracranial large vessel involvement in 87 (35.1%) patients. The following cut-off values showed high levels of diagnostic accuracy: ≥0.4 mm for temporal, facial and occipital arteries, ≥0.7 mm for vertebral arteries, and ≥1 mm for carotid, subclavian and axillary arteries. The involvement of a large array of arteries is easily and commonly detected by CDS and provides a high diagnostic yield in patients with suspected GCA. Proposed IMT cut-off values might further improve the diagnostic utility of CDS in these patients.

Vascularização do intestino do bicho-preguiça (Bradypus variegatusSCHINZ, 1825)

Common sloth (Bradypus variegatus) is a mammal that belongs to the superorder Xenarthra, typical from neotropical regions, with geographic distribution from Honduras to northern Argentina. Our study aimed to describe the intestine blood supply of these Bradipodids in order to collaborate with the clinical-surgical for these animals. For that, ten animals, included four females and six males, were sampled from the collection of the Anatomy Division, Department of Animal Morphology and Physiology, Universidade Federal Rural de Pernambuco DMFA/UFRPE. Corpses received formalin, preserved in saline solution and subsequently dissected for description of the cranial (AMCr) and caudal (AMC) mesenteric arteries. Sixty percent of sloths presented AMCr and AMC, cwhile 30% of them had intestines (small and large) irrigation from the common mesenteric artery (AMCo), an arterial trunk from which AMCr and AMC originated. For 10% of the specimens, the entire intestine was vascularized only by AMCr. Along the AMCr branches, there were arched arrangements, with arches size reductionat the level of the small intestine. Therefore, B. variegatus presents anatomical variations regarding the irrigation of the intestine, which can be made from AMCr and AMC, from the AMCo arterial trunk or to a lower frequency exclusively through AMCr branches.

Two-hour infusion of vasoactive intestinal polypeptide induces delayed headache and extracranial vasodilation in healthy volunteers.

In recent years, vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating polypeptides (PACAPs) have gained special interest in headache science. VIP and PACAPs (two isoforms, PACAP27 and PACAP38) are related in structure and function, as are their receptors, but they show differences in vasodilating- and headache-inducing properties. Intravenous infusion of PACAP27 or PACAP38, but not VIP, induces a long-lasting dilation of cranial arteries and delayed headache. The relationship between the long-lasting cranial vasodilation and headache development is not fully clarified. In a double-blinded, placebo-controlled, crossover study in 12 healthy volunteers, diameter changes of cranial arteries, occurrence of headache and the parasympathetic system were examined before, during and after a 2-hour continuous intravenous infusion of VIP and placebo. Primary endpoints were the differences in area under the curve for the superficial temporal artery diameter and headache intensity scores, as well as in headache incidence, between VIP and placebo. The superficial temporal artery diameter was significantly larger on the VIP day compared to placebo (p < 0.001) and the dilation lasted for more than 2 h. The incidence of headache was higher (p = 0.003) on the VIP day compared to the placebo day. The difference in headache intensity scores was more evident in the post-infusion period (120-200 min, p = 0.034) and in the post-hospital phase (4-12 h, p = 0.025). Cranial parasympathetic activity, measured through the production of tears, was higher during VIP compared to placebo (p = 0.033). Continuous intravenous infusion of VIP over 2 h induced a long-lasting cranial vasodilation, activation of the cranial parasympathetic system, and delayed mild headaches in healthy volunteers.Trial Registration: The study is registered at ClinicalTrials.gov (NCT03989817).

Anatomical study of the arterial blood supply of dog pancreas

This research was carried out to study the arterial blood vessels of the pancreas in dogs by using latex injection. The six adult male and female dogs were collected from Sumel town -Duhok governorate, Kurdistan region-Iraq. Our results exhibited that the left lobe of dog pancreas was supplied by pancreatic branches originated from celiac, splenic and gastroduodenal arteries. The right lobe was equipped by pancreatic branches aroused from both cranial and caudal pancreaticoduodenal arteries which were anastomosed within the gland. In addition to supply the right lobe, the cranial pancreaticoduodenal artery was also supplied the body of pancreas. The present study recorded a significant variation in the origin, number and distribution of most aforementioned arteries. Therefore, the anatomists and surgeons should take this into account during dissected of cadavers or performed the surgical operations.