High-resolution Ultrasound System Research Articles

PCSK-9-inhibitor therapy improves endothelial function in high-risk patients with cardiovascular disease.

Impaired endothelial function predicts cardiovascular events. The aim of this study was to analyze the effect of evolocumab on endothelial function in patients with cardiovascular disease. This was a prospective, double-blinded, randomized, controlled, single center study including patients with cardiovascular disease and treated with statins. Patients were consecutively randomized (1:1) to either evolocumab treatment or placebo. All patients underwent examination of endothelial function at baseline, and after 1, 4 and 8weeks of treatment by a semi-automatic high-resolution ultrasound system (UNEX EF 18G). Parameters of endothelial function were flow-mediated vasodilation (FMD), low flow-mediated vasoconstriction (L-FMC) and vasoactive range (VAR). Hundred three patients with a mean age of 66.2 ± 7.7years and a mean LDL-cholesterol of 98 ± 19.1mg/dl completed the study. The change in VAR from baseline to week 8 was significantly different with evolocumab compared to placebo (p = 0.045). Moreover, VAR increased after 8weeks of treatment with evolocumab compared to baseline (p = 0.034). No change has been noticed in FMD and L-FMC after 8weeks of treatment with evolocumab. In subgroup analyses, VAR improved in patients with age ≤ 67years, lower systolic blood pressure (≤ 125mmHg) and higher baseline LDL-cholesterol (> 95mg/dl), (p = 0.006, p = 0.049 and p = 0.042, respectively) after 8weeks of evolocumab treatment. No serious adverse event related to study medication occurred during the study. Our data indicate that endothelial function improved with evolocumab treatment in high-risk patients on statin therapy with preexisting cardiovascular disease. Our results contribute to the mechanistic explanation why lower incidence of the cardiovascular composite endpoint has been demonstrated in the FOURIER study.

Ultrasonographic Picture Of The Skin And Subcutaneous Tissue In The Treatment Of Cellulite Using The Compressive Microvibration®

In recent years, the demand for non-invasive methodologies in aesthetic medicine for treating localized adiposity, cellulite, and sagging skin has increased significantly, particularly the demand for massage techniques with mechanical vibrations. The aim of the present study is to evaluate the effectiveness of Compressive Microvibration® in reducing the expression of cellulite and improving skin conditions in women of different ages under ultrasound control during 60 days of observation. A prospective, single-center, nonrandomized study enrolled 27 women with mild to moderate gynoid lipodystrophy, aged 40 to 69 years, who have been subject to twelve sessions of Compressive Microvibration® (Endospheres®). A specialized high-resolution digital ultrasound system, the DUB SkinScanner (tpm GmbH, Germany), has been used to visualize the skin. Also, the sample anthropometric parameters have been measured, the body mass index has been calculated, and photographs have been taken. In the patients included in the study, in all age groups, after complete treatment of Endospheres®, a decrease in BM has been noted, with a reduction of the bitrochanteric and hip circumference. An improvement in the morphological topography of the skin in terms of regularization of skin irregularities, leveling of reliefs, reduction of depressions, and increase in skin elasticity and density has also been recorded. After a cycle of therapy on the anterior surface of the abdomen and the thigh anterior and posterior surfaces, the scannograms revealed a decrease in the thickness of the epidermis at various levels, the resolution of the phenomenon of hyperkeratosis, a compaction of the dermis, and an increase in its homogeneity and echogenicity. The effect obtained was still present during a control examination two months after the conclusion of the treatment. The analysis of the dynamics of ultrasound criteria demonstrated the effectiveness of the Compressive Microvibration® in women with mild to moderate gynoid lipodystrophy to improve their skin conditions and maintain the obtained effect for 2 months of observation without unwanted side complications.

A 48-Channel High-Resolution Ultrasound Beamforming System for Ultrasound Endoscopy Applications

We introduce a highly efficient 48-channel ultrasound beamforming system ideal for ultrasound endoscopy applications. The system includes a transmitter and a receiver that allows for low-area, high-resolution imaging acquisition. The transmitter uses a charge redistribution HV (high-voltage) scheme to generate three-level pulses that actuate the transducer, implemented with the standard CMOS process for optimal cost and power savings. Meanwhile, the receiver features a sub-array structure and a delay generator that reduces the area usage. To achieve high-resolution ultrasound imaging acquisition with low computational power, we developed a Shift Coherence Factor (SCF) algorithm that is hardware-friendly. This approach delivers a lateral resolution of over 20% better than that of the conventional delay and sum (DAS) algorithm, with a contrast ratio of over 30 dB. The system was implemented in a 180 nm standard CMOS process with an area of 24.98 mm2, power consumption of 8.23 mW per channel, achieving a delay resolution of 8.33 ns, and a low-area implementation of 0.52 mm2 per channel. The system offers high-quality imaging acquisition with minimal additional area and power consumption, which has great potential for 3D imaging or catheterized ultrasound systems.

A Quantitative Method for the Evaluation of Deep Vein Thrombosis in a Murine Model Using Three-Dimensional Ultrasound Imaging.

Deep vein thrombosis (DVT) is a life-threatening condition that can lead to its sequelae pulmonary embolism (PE) or post-thrombotic syndrome (PTS). Murine models of DVT are frequently used in early-stage disease research and to assess potential therapies. This creates the need for the reliable and easy quantification of blood clots. In this paper, we present a novel high-frequency 3D ultrasound approach for the quantitative evaluation of the volume of DVT in an in vitro model and an in vivo murine model. The proposed method involves the use of a high-resolution ultrasound acquisition system and semiautomatic segmentation of the clot. The measured 3D volume of blood clots was validated to be correlated with in vitro blood clot weights with an R2 of 0.89. Additionally, the method was confirmed with an R2 of 0.91 in the in vivo mouse model with a cylindrical volume from macroscopic measurement. We anticipate that the proposed method will be useful in pharmacological or therapeutic studies in murine models of DVT.

Achilles tendon thickness and serum asprosin level significantly increases in patients with polycystic ovary syndrome.

In our study, we aimed to investigate the Achilles tendon thickness (ATT) and asprosin levels in patients with polycystic ovary syndrome (PCOS) and to evaluate the relationship of these parameters, which may be related to cardio-metabolic diseases. In our prospective cross-sectional study, 45 female patients with PCOS and 30 female healthy individuals similar in age were included. Serum dehydroepiandrosterone sulfate (DHEAS), total testosterone, anti-Müllerian hormone (AMH) and asprosin levels were measured using appropriate kits and homeostatic model assessment of insulin resistance (HOMA-IR), luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio was calculated. ATT measurements were performed by two radiologists using a high-resolution ultrasound doppler system. Serum DHEAS, total testosterone, AMH and asprosin levels, HOMA-IR value, LF/FSH ratio, and ATT values were higher in patients with PCOS compared to healthy controls. Correlation analysis was performed between ATT and other parameters in patients with PCOS. In univariate analysis, parameters associated with ATT were detected as asprosin, DHEAS and AMH. In the linear regression analysis performed with significant parameters, asprosin and DHEAS levels were found to be associated with ATT. ATT values and serum asprosin levels were found to be significantly increased in patients with PCOS, and there is a very close positive relationship between ATT and serum asprosin levels. For this reason, it was thought that ATT measurement could be a cheap, simple and non-invasive monitoring parameter that can be used in the routine cardiometabolic follow-up of patients with PCOS.

Dynamics of the ultrasonographic picture of the skin and subcutaneous tissue in the physiotherapy treatment of cellulite by compression microvibration: а non-randomized prospective study

BACKGROUND: Various methods are offered to effectively eliminate cellulite and improve skin appearance; however, its treatment remains one of the most difficult tasks in aesthetic medicine. The arsenal of tools that allow an objective assessment of cosmetic and esthetic therapeutic measures is very limited.
 AIM: To evaluate the effectiveness of the compression microvibration method to treat structural and functional skin changes in women with gynoid lipodystrophy of different age groups.
 MATERIALS AND METHODS: A single-center, nonrandomized, prospective study of the effectiveness of the compression microvibration method (Endospheres Therapy) was carried out in 27 women (4069 years old) with mild-to-moderate gynoid lipodystrophy under the control of ultrasonographic skin examination before treatment, after 12 procedures, and after 2 months. After a course of therapy, skin ultrasonography was performed using a specialized high-resolution digital ultrasound system DUB SkinScanner (tpm GmbH, Germany) equipped with a 75 MHz transducer with a resolution of 21 m and a scanning depth of 46 mm. Additionally, anthropometric parameters were measured, and the body mass index was calculated.
 RESULTS: Changes in body mass index (BMI) revealed a trend toward weight loss in most of the participants. The circumference of the hips and waist in participants aged 4049, 5059 and 6069 years decreased by 3.01.1 and 5.31.1, 2.20.9 and 4.11.3 and 2.50.9 and 6.31.5 cm, respectively. It was found that after the course of Endospheres Therapy in patients of the 1st, 2nd and 3rd age groups in the areas of the anterior, inner, posterior surface of the thigh and the anterior surface of the abdomen, the thickness of the dermis decreased by 15.6, 9.5 and 18.1%; 10.9, 10.5 and 19.3%; 6.1, 15.7 and 13.8%, 23.4, 14.7 and 14.5% (p 0.05), respectively; increased echogenicity of the dermis in the areas of the anterior, inner, posterior thigh and anterior abdominal surface by 2, 1.4 and 1.3; 1.2, 1.4 and 1.2; 1.4, 1.4 and 1.5; 1.3, 1.5 and 1.7 times (p 0.05), respectively. The echogenicity of the hypodermis decreased in the studied areas by 30.8, 27.6 and 31.2% (p 0.05); 20.1, 37.3 and 40.4% (p 0.05); 43.2, 57.8 (p 0.05) and 9.3%; 23.6, 15.2 (p 0.05) and 9.3%, respectively. The effect persisted 60 days after the course of therapy.
 CONCLUSION: These results have convincingly demonstrated the effectiveness of Endospheres Therapy in women with mild-to-moderate gynoid lipodystrophy for body shaping and skin improvement in the long term without revealing any side effects.

2 Improving Visualization and Guidance for Breast Brachytherapy: Developing, Commissioning, and Implementing a High-Resolution Robotic 3D Ultrasound System

2 Improving Visualization and Guidance for Breast Brachytherapy: Developing, Commissioning, and Implementing a High-Resolution Robotic 3D Ultrasound System

In-ovo echocardiography for application in cardiovascular research

Preclinical cardiovascular research relies heavily on non-invasive in-vivo echocardiography in mice and rats to assess cardiac function and morphology, since the complex interaction of heart, circulation, and peripheral organs are challenging to mimic ex-vivo. While n-numbers of annually used laboratory animals worldwide approach 200 million, increasing efforts are made by basic scientists aiming to reduce animal numbers in cardiovascular research according to the 3R’s principle. The chicken egg is well-established as a physiological correlate and model for angiogenesis research but has barely been used to assess cardiac (patho-) physiology. Here, we tested whether the established in-ovo system of incubated chicken eggs interfaced with commercially available small animal echocardiography would be a suitable alternative test system in experimental cardiology. To this end, we defined a workflow to assess cardiac function in 8–13-day-old chicken embryos using a commercially available high resolution ultrasound system for small animals (Vevo 3100, Fujifilm Visualsonics Inc.) equipped with a high frequency probe (MX700; centre transmit: 50 MHz). We provide detailed standard operating procedures for sample preparation, image acquisition, data analysis, reference values for left and right ventricular function and dimensions, and inter-observer variabilities. Finally, we challenged incubated chicken eggs with two interventions well-known to affect cardiac physiology—metoprolol treatment and hypoxic exposure—to demonstrate the sensitivity of in-ovo echocardiography. In conclusion, in-ovo echocardiography is a feasible alternative tool for basic cardiovascular research, which can easily be implemented into the small animal research environment using existing infrastructure to replace mice and rat experiments, and thus, reduce use of laboratory animals according to the 3R principle.

Simultaneous Assessment of the Whole Eye Biomechanics Using Ultrasonic Elastography.

Current elastography techniques in the field of ophthalmology usually target one specific tissue, such as the cornea or the sclera. However, the eye is an inter-related organ, and some ocular diseases can alter the biomechanical properties of multiple anatomical structures. Hence, there is a need to develop an imaging tool that can non-invasively, quantitatively, and accurately characterize dynamic changes among these biomechanical properties. A high resolution ultrasound elastography system was developed to achieve this goal. The efficacy and accuracy of the system was first validated on tissue-mimicking phantoms while mechanical testing measurements served as the gold standard. Next, an in vivo elevated intraocular pressure (IOP) model was established in rabbits to further test our system. In particular, elastography measurements were obtained at 5 IOP levels, ranging from 10 mmHg to 30 mmHg in 5 mmHg increments. Spatial-temporal maps of the multiple ocular tissues (cornea, lens, iris, optic nerve head, and peripapillary sclera) were obtained. The spatial-temporal maps were acquired simultaneously for the ocular tissues at the 5 different IOP levels. The statistical analysis of the elastic wave speed was presented for ocular tissues. Finally, the mapping for the elastic wave speed of each ocular component was acquired at each IOP level. Our elastography system can concurrently assess the biomechanical properties of multiple ocular structures and detect changes in biomechanical properties associated with changes in IOP. This system provides a novel tool to measure and quantify the biomechanical properties of the whole eye.

PS-BPC02-1: PCSK-9-INHIBITOR THERAPY IMPROVES ENDOTHELIAL FUNCTION IN HIGH-RISK PATIENTS WITH CARDIOVASCULAR DISEASE

Background: Impaired endothelial function predicts cardiovascular events. The aim of this study was to analyse the effect of evolocumab on endothelial function in patients with cardiovascular disease and on obligatory statin therapy. Methods: This was a prospective, double-blinded, randomized, controlled, single center study (NCT03626831) including patients with cardiovascular disease (diagnosis of coronary artery disease, non-hemorrhagic stroke, transient ischemic attack or symptomatic peripheral artery disease) and treated with statins, similar to the inclusion criteria of the FOURIER study. Patients were consecutively randomized (1:1) to either evolocumab treatment (420 mg was administrated in monthly intervals, twice during the study) or placebo. All patients underwent examination of endothelial function at baseline, and after 1, 4 and 8 weeks of treatment by a semi-automatic high-resolution ultrasound system (UNEX EF 18G; Unex Co., Nagoya, Japan). Endothelial function parameter such as flow-mediated vasodilation (FMD; vasodilator responsiveness), low flow-mediated vasocontriction (L-FMC; vasoconstrictor responsiveness) and vasoactive range (VAR; total vasomotor responsiveness) were measured. Results: 103 patients with a mean age of 66.2 (±7.7) years and a mean LDL-cholesterol of 98.2 (±19.1) mg/dl completed the study. 83.5% of the study population was known to have coronary artery disease. Endothelial function parameter (VAR) increased after 8 weeks of treatment with evolocumab compared to baseline (p = 0.034), whereas there was no significant change at 1 and 4 weeks after treatment. Moreover, an improvement in VAR from baseline at week 8 was found with evolocumab compared to placebo (p = 0.045). In a subgroup analysis, in patients with age < 67 years, lower systolic blood pressure (< 125 mmHg) or higher baseline LDL-cholesterol (> 95 mg/dl), significant evolocumab treatment effect was found in VAR improvement (p = 0.006, p = 0.049 and p = 0.042, respectively) from baseline at week 8. No serious adverse event related to study medication occurred during the study. Conclusion: Our data indicate that endothelial function could be improved with evolocumab treatment in high-risk patients with preexisting cardiovascular disease and on statin therapy. Our results contribute to the mechanistic explanation why lower incidence of the cardiovascular composite endpoint has been demonstrated in the FOURIER study.

PCSK-9-inhibitor therapy improves endothelial function in high-risk patients with cardiovascular disease

Abstract Background Impaired endothelial function predicts cardiovascular events. The aim of this study was to analyse the effect of evolocumab on endothelial function in patients with cardiovascular disease and on obligatory statin therapy. Methods This was a prospective, double-blinded, randomized, controlled, single center study including patients with cardiovascular disease (diagnosis of coronary artery disease, non-hemorrhagic stroke, transient ischemic attack or symptomatic peripheral artery disease) and treated with statins, similar to the inclusion criteria of the FOURIER study. Patients were consecutively randomized (1:1) to either evolocumab treatment (420mg was administrated in monthly intervals, twice during the study) or placebo. All patients underwent examination of endothelial function at baseline, and after 1, 4 and 8 weeks of treatment by a semi-automatic high-resolution ultrasound system (UNEX EF 18G; Unex Co., Nagoya, Japan). Endothelial function parameter such as flow-mediated vasodilation (FMD; vasodilator responsiveness), low flow-mediated vasocontriction (L-FMC; vasoconstrictor responsiveness) and vasoactive range (VAR; total vasomotor responsiveness) were measured. Results 103 patients with a mean age of 66.2 (±7.7) years and a mean LDL-cholesterol of 98.2 (±19.1) mg/dl completed the study. 83.5% of the study population was known to have coronary artery disease. Endothelial function parameter (VAR) increased after 8 weeks of treatment with evolocumab compared to baseline (p=0.034), whereas there was no significant change at 1 and 4 weeks after treatment. Moreover, an improvement in VAR from baseline at week 8 was found with evolocumab compared to placebo (p=0.045). In a subgroup analysis, in patients with age ≤67 years, lower systolic blood pressure (≤125 mmHg) or higher baseline LDL-cholesterol (>95 mg/dl), significant evolocumab treatment effect was found in VAR improvement (p=0.006, p=0.049 and p=0.042, respectively) from baseline at week 8. No serious adverse event related to study medication occurred during the study. Conclusion Our data indicate that endothelial function could be improved with evolocumab treatment in high-risk patients with preexisting cardiovascular disease and on statin therapy. Our results contribute to the mechanistic explanation why lower incidence of the cardiovascular composite endpoint has been demonstrated in the FOURIER study. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): AMGEN GmbH

Effect of the General Inhibitor of Nitric Oxide Synthase (L‐NAME) On Cardiac and Aortic Function and Structure in A Mouse Model of Marfan Syndrome‐Associated Aortic Aneurysm

Marfan Syndrome (MFS) is an autosomal‐dominant connective tissue disorder caused by missense mutations in the gene that encodes for Fibrillin‐1 (FBN1). FBN1 is an extracellular matrix glycoprotein that functions as a scaffolding protein during the formation and maturation of elastic fibers. The mechanism underlying MFS pathogenesis stems from a crosstalk between the Angiotensin‐II pathway and over activation of transforming growth factor‐beta signaling. There are several clinical manifestations seen in MFS, but the most serious and life‐threatening is the aortic aneurysm due to degradation and fragmentation of aortic wall elastin fibers. If left untreated, aortic aneurysm progression may lead to dissection and rupture.Previous studies in the MFS mouse model have shown that the progression of aortic aneurysm is associated with a significant decline in endothelial function and nitric oxide (NO) production in the aortic wall, and that overexpression of endothelial nitric oxide synthase (eNOS) could delay the progression of aortic root aneurysm in MFS mice. A recent study in our lab has also shown that mild aerobic exercise can block aortic aneurysm in MFS mice. It is well established that exercise can improve endothelial function mainly through an increase in eNOS‐mediated NO production. Therefore, we tested the hypothesis that mild aerobic exercise prevents aortic aneurysm progression in the mouse model of MFS mainly through increasing the production of NO within the aortic wall.To test this hypothesis, C57BL/6 WT and MFS mice were subjected to daily treadmill exercise (at 55% of VO2max, starting at 4 weeks of age) in the absence or presence of the general inhibitor of NO production, N(G)‐Nitro‐L‐arginine methyl ester (L‐NAME) at 0.05 g per 100 mL of drinking water. At 6‐months of age, in vivo imaging of the aortic root diameter and pulse wave velocity (PWV) as an index of wall stiffness, was performed using a high‐resolution Vevo2100 ultrasound system. The aortic root diameter at the sinus of Valsalva, and pulse wave velocity were both increased in MFS mice compared to WT, however MFS mice subjected to treadmill exercise had significantly decreased aortic root diameter and pulse wave velocity compared to sedentary MFS mice. In situ analysis of aortic wall integrity was analyzed at 6 months by Van Geison staining. Our results revealed that MFS mice had an increase in elastin fragment count and a decrease in elastin fiber length compared to WT. Interestingly, MFS mice subjected to exercise had fewer elastin fragment count and an increase in elastin fiber length compared to sedentary MFS mice. Interestingly, L‐NAME treatment reversed the protective effects of exercise on aortic root diameter and pulse wave velocity in MFS mice to a level that was not different than MFS sedentary groups. This study provides preliminary evidence that mild aerobic exercise blocks the progression of aortic root dilation in MFS mice through increasing the production of NO within the aortic wall, and further emphasizes the value of increased physical activity in aneurysm population.

Superficial Circumflex Iliac Artery Perforator Flap Elevation Using Preoperative High-Resolution Ultrasonography for Vessel Mapping and Flap Design.

The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has gained acceptance among reconstructive microsurgeons, the minimal donor site morbidity being its greatest advantage. The purpose of this article is to introduce the use of preoperative ultrasonography to facilitate elevation and to avoid postoperative complications of the SCIP flap. Preoperative mapping of the SCIA and the superficial circumflex iliac vein (SCIV) using a high-resolution ultrasound system were performed in patients undergoing reconstruction using a free SCIP flap. The skin paddle was designed placing the SCIA and the SCIV in the middle of the flap. Preoperatively marked SCIA and SCIV were found intraoperatively in all cases. The skin paddle design for sufficient arterial inflow and venous drainage resulted in no postoperative flap complications. The use of a preoperative high-resolution ultrasound system significantly facilitates elevation of the SCIP flap, notably via the following 2 points: 1) pedicle can always be found under the markings made with preoperative ultrasonography, 2) satisfactory perfusion of the flap can be guaranteed via a safe flap design that includes preoperatively marked vessels within the skin paddle.

Endothelial progenitor cells predict vascular damage progression in naive hypertensive patients according to sex.

Low levels of endothelial progenitor cells (EPCs) are associated with cardiovascular (CV) morbidity and mortality. Early indicators of vascular damage represent independent predictors of CV prognosis. The aim of this study was to evaluate the possible association of EPCs and circulating cytokine levels with vascular damage markers in naive hypertensive patients according to sex and to evaluate the role of EPCs in vascular damage progression. We enrolled 60 subjects; circulating EPCs were determined by cytometric analysis, and serum cytokines were determined by chemiluminescence microarray technology. Endothelial function was estimated with the measurement of the reactive hyperemia index (RHI), arterial stiffness (AS) was evaluated with the measurement of carotid-femoral pulse wave velocity (PWV) and carotid intima-media thickness (IMT) was determined by a high-resolution ultrasound B-mode system. Patients were evaluated at baseline and after an average follow-up of 3.0 ± 0.6 years. RHI was correlated with EPCs and inversely related to HOMA, TNF-α, IL-6, hs-CRP, and IL-1β. PWV was positively correlated with HOMA, TNF-α, IL-6, IL-1β, and hs-CRP, and it was inversely related to EPCs. An inverse relationship was observed between c-IMT and EPCs and e-GFR. EPCs were the major predictor of the RHI and PWV. After adjustment for vascular index basal values and the other covariates, EPCs explained 17.0%, 27.7%, and 10.6% of the variability in ΔRHI, ΔPWV, and Δc-IMT at follow-up, respectively. Our study results support the hypothesis of an etiological link between circulating EPCs and morphofunctional vascular parameters in hypertensive subjects. Of interest, circulating EPCs, after adjusting for possible confounding factors, may indicate vascular damage progression.

Use of Preoperative High-Resolution Ultrasound System to Facilitate Elevation of the Superficial Circumflex Iliac Artery Perforator Flap.

During elevation of the superficial circumflex iliac artery (SCIA) perforator (SCIP) flaps, the flap pedicle must often be converted from the superficial branch to the deep branch of the SCIA, complicating and prolonging the procedure. The goal of the present study was to demonstrate the effectiveness of high-resolution ultrasonography to decrease the conversion rate on which no previous report has focused, by making a comparison with a conventional method. Forty-five consecutive cases where free SCIP flap transfer was performed for reconstruction were retrospectively reviewed. To preoperatively mark the course of the superficial branch, handheld Doppler ultrasonography was used in 27 cases (group 1) and a high-resolution ultrasound system in 18 cases (group 2). The conversion rate was significantly greater in group 1 than in group 2 (10/27 [37%] vs. 0/18 [0%], p = 0.003]. The frequency of use of multiple venous anastomoses was significantly higher in group 1 than in group 2 (21/27 [78%] vs. 2/18 [11%], p < 0.001). The operative time was significantly longer in group 1 than in group 2 (p = 0.038). There were no significant differences in postoperative complication rates (1/27 [4%] versus 0/18 [0%], p = 1.0). The use of a preoperative high-resolution ultrasound system significantly decreased the rate from of intraoperative conversion from the superficial branch to the deep branch of the SCIA. It also resulted in significantly fewer venous anastomoses and a shorter operative time, while maintaining a low incidence of postoperative complications.

English

BACKGROUND Evaluation of endothelial function in isolated coronary artery ectasia (ICAE) with flow-mediated dilation (FMD) is limited and use of flow mediated vasodilation as a surrogate marker for the extent of coronary atherosclerosis remains unknown. Thus, the following study was done to evaluate for endothelial dysfunction (ED) in subjects with ICAE by assessing the FMD in the brachial artery. METHODS This was an observational study, conducted at a referral hospital providing tertiary care in India between June 2017 and November 2018. Fifty patients with ICAE and fifty control patients with normal coronary arteries (NCA) on coronary angiogram, done by using a standard Seldinger technique via femoral route, were the subjects of the study. Brachial artery FMD was determined by using a highresolution ultrasound system (Samsung RS80A) using a linear transducer of a frequency of 7.5 Mega Hertz. RESULTS The groups had same baseline characteristics in terms of age, sex etc. (all P values &gt; 0.05). However, values of serum uric acid and low-density lipoproteins were statistically significantly higher in ICAE subjects (P &lt; 0.0001). Whereas, dilatation of brachial artery in response to shear stress was significantly lower in patients with ICAE subjects than in patients with normal coronaries. (8.85 ± 0.49 vs. 12.83 ± 0.45, P &lt; 0.0001). Marki’s classification, type 1, type 2, type 3 and type 4 coronary artery ectasia (CAE) was present in 8 (16 %), 4 (8 %), 13 (26 %), and 25 (50 %), respectively. CONCLUSIONS Atherosclerosis may play a pivotal role in the genesis of ICAE. Hyperlipidaemia may have a specific role in the disease process. Further research is required to evaluate the exact molecular mechanisms involved in CAE. KEYWORDS Coronary Artery Disease, Ectasia, Endothelial Dysfunction, Hyperlipidaemia

Analysis of the effectiveness of chemical peelings in the treatment of acne vulgaris assessed using high-frequency ultrasound-A comparative study.

The use of high-frequency ultrasound for noninvasive assessment of skin during chemical peeling therapies may be a useful tool. To determine whether high-frequency ultrasound is a useful tool to noninvasive assessment of skin and evaluation therapy progress. The 14 women underwent four treatments with chemical peelings at 2-week intervals. Before, after 4weeks and after 9weeks, photographic documentation and scans were recorded using a high-resolution ultrasound system. As a result of applying pyruvic acid peeling, the thickness of the entrance echo on the forehead, cheek, and chin was reduced. After applying the peeling consisting of a mixture of glycolic and salicylic acids, the thickness of the entrance echo of the epidermis decreased on the forehead, cheek, and chin. As a result of applying a 50% pyruvic acid peeling, the density of dermis on the forehead, cheeks, and chin increased. A similar increase in the density of dermis was observed on the forehead, cheeks, and chin after applying a mixture of glycolic and salicylic acid. High-frequency ultrasound is a useful tool for monitoring the progress in the treatment of acne vulgaris using chemical peelings.

Upregulation of miR-335 reduces myocardial injury following myocardial infarction via targeting MAP3K2.

Acute myocardial infarction (AMI) is a serious cardiovascular disease with a high incidence worldwide and the main cause of sudden cardiac death. The aim of this article was to study the protective role of miR-335 in myocardial infarction (MI) and the underlying molecular mechanism. Thirty Sprague Dawley (SD) rats were randomly divided into sham group, MI + NC group and MI + agomiR-335 group. The expression of miR-335 in rat myocardium was detected by quantitative Real Time-Polymerase Chain Reaction (RT-PCR). Western blot was performed to detect the expression of TNF-α, IL-6, IL-1β, Caspase-3, Cleaved Caspase-3 (C-Caspase-3) and MAP3K2 in rat myocardium. On the 7th day of the establishment of the rat MI model, a high-resolution small animal ultrasound system was utilized to detect the cardiac function of the rats, and the heart tissues and blood samples of the rats were collected. The corresponding kits were purchased to detect the contents of LDH, CK-MB, MDA and SOD in rat serum, and HE staining was employed to observe the morphology of rat myocardial tissue. The expression of miR-335 in myocardial infarcted zones and border zones of MI rats decreased significantly. The upregulation of miR-335 remarkably inhibited myocardial inflammation and apoptosis after MI, thus improving the cardiac function of MI rats. Compared with the sham group, the MAP3K2 expression in the MI + NC group was observably increased, while the overexpression of miR-335 could inhibit the expression of this protein. Through the Luciferase reporter gene experiment, we found that miR-335 could directly target MAP3K2. The expression of miR-335 decreased in myocardial tissue after MI, and the overexpression of miR-335 reduced myocardial damage by inhibiting oxidative stress, inflammation, and apoptosis via targeting MAP3K2, thereby improving the cardiac function of MI rats.

Carotid Artery Intimal Medial thickness in Diabetic and Non-Diabetic Subjects in Central Kerala

Background: Increase in intimal medial thickness (IMT) of the carotid arteries is contemplated as a guide to atherosclerotic vascular disease and subclinical organ damage and foretell cardiovascular disease. The study aimed to analyse IMT in non-diabetic and diabetic subjects. Subjects and Methods: There were 105 diabetic and 95 non-diabetic subjects in this study. Common carotid artery (CCA) IMT was calculated using a linear probe of a high-resolution ultrasound medical system. Results: Diabetic subjects (0.95 mm) showed significantly higher mean intimal medial thickness (IMT) when compared non-diabetic subjects (0.85 mm) (p &lt;0.05). Correlation of IMT was seen with age, total cholesterol, triglycerides, HDL &amp; LDL cholesterol and systolic blood pressure (SBP) in diabetic subjects. Total cholesterol, SBP and diastolic blood pressure (DBP) showed a correlation with IMT in the non-diabetic subjects. Age, total cholesterol, SBP, and diabetes were independent risk factors for intimal medial thickness in multivariate linear regression analysis. Conclusion: Higher intimal medial thickness was seen in diabetic subjects when compared to non-diabetic subjects. We conclude that age, total cholesterol, SBP and duration of diabetes showed a significant correlation with IMT. IMT can be considered as a screening tool in diabetic patients for the early detection of atherosclerosis.

The Diagnostic Value of Radial and Carotid Intima Thickness Measured by High-Resolution Ultrasound for Ischemic Stroke

No study has examined intima thickness of the carotid artery and peripheral arteries in subjects with acute ischemic stroke due to large-artery atherosclerosis (LAAS). The aim of this study was to test whether carotid intima thickness (CIT), radial intima thickness (RIT), and dorsalis pedis intima thickness (PIT) are closely associated to atherosclerotic risk factors and whether they possess independent and additive value for differentiating LAAS stroke. One hundred and two patients with LAAS stroke and 104 age- and gender-matched control subjects were enrolled. CIT, RIT, and PIT were measured using a 24-MHz, high-resolution ultrasound system. Multivariate linear regression was performed to determine associations between ultrasonic parameters and risk factors. Binary logistic regression was used to evaluate the diagnostic value of different parameters. Receiver operating characteristic curves were plotted to compare the performance of several diagnostic models. CIT ([36.97±11.27]×10-2 vs [23.68±5.12]×10-2mm, P<.001) and RIT ([15.40±3.62]×10-2 vs [11.06±2.22]×10-2mm, P<.001) were significantly thicker in patients with LAAS stroke than in control subjects. CIT and RIT were associated with traditional risk factors for atherosclerosis, including age, systolic blood pressure, and serum levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, homocysteine, and glucose. CIT had incremental diagnostic value to traditional risk factors for LAAS stroke (area under the curve, 0.945 vs 0.860; P=.006). The addition of CIT and RIT to traditional risk factors had the best diagnostic performance (area under the curve, 0.961). Measurement of CIT, RIT, and PIT is feasible and reliable using newly developed ultrasound techniques. CIT and RIT were associated with traditional risk factors for atherosclerosis and exhibited incremental value to traditional risk factors for differentiating patients with LAAS stroke from control subjects.