Middle Artery Research Articles

Progression of atherosclerosis in smokers: a longitudinal nation-wide serial angiography study

Abstract Introduction Smoking is a modifiable risk factor for coronary artery disease (CAD). Cross-sectional studies have shown that prevalence of CAD is higher among smokers as is incidence of myocardial infarction. However, few studies have assessed how smoking affects the incidence of coronary artery plaque progression. Purpose To investigate how CAD progress in smokers. Method All coronary artery segments with <50% luminal stenosis in patients having a first-time coronary angiogram between 1989-2017 were identified from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) and followed until a clinically indicated angiography within 15 years was performed or death or end of follow-up occurred. The patients were divided into cohorts based on smoking status and studied with regard to plaque progression defined as the occurrence of ≥50 luminal stenosis on subsequent coronary angiogram. Results A total of 2,272,518 coronary artery segments in 215,364 patients were included of whom 48.1% were never smokers (NS), 33.4% were previous smokers and 18.5% were active smokers (S). The plaque progression incidence rate (IR) was 2.1 (2.04-2.16) per 1000 segment years (SY) for S, 1.77 (1.73-1.81) per 1000 SY for PS, and 1.33 (1.30-1.36) per 1000 SY for NS. The largest increase in plaque progression IR per 1000 SY in relation to smoking status was the middle right coronary artery (RCA) segment (NS: 1.36 (1.27-1.45), PS: (2.23 (2.08-2.39), S: 3.25 (3.01-3.51)). Kaplan-Meier curves depict increased progression in the RCA among smokers (supplementary picture 1). Discussion: In this nationwide longitudinal coronary angiography study, plaque progression occurred more frequently in smokers and in whom the right coronary artery was more commonly affected by coronary atherosclerosis.Plaque progression in RCA vs LAD

Identification of the low wall shear stress area in the middle and distal coronary artery: a dynamic angiography and deep learning analysis

Abstract Background Based on the principle and practice of fluid mechanic, when applying to the coronary circulation, at the location of turbulence (collision of the antegrade against the retrograde flow), stagnant flow was of low velocity and low wall shear stress (WSS). This low WSS triggers the atherosclerotic process. Furthermore, our prior studies showed that turbulent flow inflicted the first damage to the intima in young people, even before the effects of hypertension or hyperlipidemia kick in. Turbulence also promoted faster growth in the plaque by cracking the cap of vulnerable plaque which was translated into acute coronary syndrome. How could we image the flow in low WSS area? How does the stagnant and turbulent flow effect on the wall of coronary artery? In this study, could dynamic angiography and deep learning model aswer the above questions. Method Patients underwent a new dynamic angiography and were sequentially selected if they had one moderate lesion. At first, after the coronary arteries were filled completely with contrast (in black color), the blood (in white color) was seen moving in and recorded at 15 frames per second. All characteristics of the blood flow, its direction, movement, shape of the tip and velocity were identified and tabulated. At the same time, an artificial intelligence program was designed based on Deep Learning Model to analyse the blood flow. First, the segmentation model was built with U-Net and Densenet-121 to recognize the coronary artery, then the Convolutional Neural Network was build to classify the boundary layer, identify the low WSS area and calculate the duration of the arterial phase (AP). Results Thirty-two patients (23 males) with forty-five lesions were enrolled and their data analyzed with Quantitative Coronary Analysis (QCA) and Deep learning (Figure 1). In the group of patients with stagnant flow (low velocity – low WSS), the mean time of contrast hangover (arterial phase) at the internal-boudary layer was 2.61 +/- 0,66 millisecond. In contrast, in the patients with no stagnant flow, the mean time was 1.86 +/- 0.41 millisecond, statistically significant with p =0.02 (Fig 2). Furthermore, the group with stagnant flow has thirty-one lesions in comparison with fourteen the group with no stagnant flow. Conclusion The turbulent and stagnant flow were successfully detected and measured by the new dynamic angiography and Machine Learning program. The prolonged contrast stagnation at the boundary layer identified the area with low velocity and low WSS which was the culprit in triggering the atherosclerotic process. This stagnant flow also delayed the delivery of new blood to the distal myocardium and could cause chest pain. It is important to understand and image the mechanism of CAD in order to further the understanding and management of this condition.Deep learning model suggest the stenosisArterial Phase Time of Coronary Artery

Method of dynamic one-stage Dopplerography of coronary and cerebral blood flow with analysis of efficiency of antler balneotherapy in patients with arterial hypertension

Integration of highly sensitive Doppler methods of assessment of coronary and cerebral blood circulation into process of functional and diagnostic audit of results of recovery treatment of patients with an arterial hypertension allows to estimate positive tendencies at normalization of processes regional perfusion. Use of the designated technologies showed reliable decrease in peak velocity in middle cerebra artery without increase in vascular resistance at the persons which passed a therapeutic course of antler reindeer breeding.Peak velocity in an middle cerebra artery before the designated treatment was within 92–115 cm/ c (Me 105 [96,3–104,5]), after the therapeutic procedures was registered in a big way 78–98 cm / c (Me 90 [82,4–94,3]). The designated phenomenon indicated improvement of regional cerebral oxygenation and natural reduction of volume of brain perfusion. At the same time, Doppler parameters in coronary arteries at the patients who completed the analyzed course of recovery treatment were transformed minimum, without reliable distinctions that presumably.

A case of lymphatic flow evaluation using indocyanine green fluorescence imaging for recurrence of anastomotic site after laparoscopic right hemicolectomy

BackgroundAnastomotic recurrence of colorectal cancer is rare, but reoperation improves prognosis. However, there is no clear evidence regarding the extent of dissection, and there are few reports on the details of surgery. We used intraoperative lymphatic flow imaging with indocyanine green (ICG) fluorescence as a reference to determine the range of additional resection.Case presentationThe patient was a 75-year-old man who underwent laparoscopic right hemicolectomy and extracorporeal functional terminal anastomosis for ascending colon cancer 4 years ago. Histopathological examination revealed a well-differentiated tubular adenocarcinoma, T4aN0M0, pathological stageIIB. During follow-up, anemia was observed, and colonoscopy indicated anastomotic recurrence, so additional laparoscopic resection was performed. Intraoperatively, ICG was injected into the anastomotic site, and the operation proceeded under near-infrared light observation. Lymphatic vessels along the middle colonic artery were visualized down to the root of the vessel. Using this as an indicator, the vessel was ligated from the root. Using the fact that the lymphatic vessels were also depicted in the small intestinal mesentery on the oral side of the anastomosis as an indicator, the small intestine and mesentery were resected about 7 cm from the anastomosis.ConclusionsThe optimal surgical approach for anastomotic recurrence of colorectal cancer has not been defined. Intraoperative ICG fluorescence imaging can provide images of lymphatic flow from the site of recurrence and may be an indicator of lymph node dissection in the case of anastomotic recurrence.

Embolization and bleeding in patients with anticardiolipin antibodies

The patient, a 32-year-old male, was positive for anti-cardiolipin antibody syndrome and had a history of smoking for 15 years. He underwent “inferior vena cava filter implantation + catheter hemolysis” 10 years ago due to deep vein thrombosis of the right lower limb. After surgery, he continued to take farwarin and aspirin orally. Three years ago, due to thrombosis again, intravenous thrombolysis was performed in the lower extremity. After surgery, pharhualin was taken orally continuously. Massive hemoptysis occurred after intense exercise and eating spicy stimulating food 5 months ago. DSA showed abnormal bleeding in the right bronchial artery and right internal thoracic artery, so 300-500 um microsphere was used to embolize the peripheral artery. 350-560 um PVA granules embolized bronchial arteries; Three months ago, due to the recurrence of hemoptysis after oral administration of TCM blood-promoting drugs, angiography showed an increase in the number of responsible arteries, abnormal bleeding of the left bronchial artery and the right upper lobar bronchial artery of the lung segment, the formation of the middle and lower lobar bronchial artery of the right lung segment and the formation of collateral circulation of the right internal thoracic artery. Embolization of the above arteries was performed, and the patient recovered well after surgery and was discharged from hospital.

Hemodynamic changes in late advanced pregnant Zaraibi goats during the peripartum period

The objective of the present study was to demonstrate the blood flow velocities, blood flow rate (BFR; bpm) with the accurate ratio of both systolic and diastolic velocities points (S/D) in addition to Doppler indices (resistive and pulsatility index [RI and PI]) in both fetal [fetal heart (FH), fetal abdominal aorta (Ab. A), and umbilical artery (UM.A)] and maternal [Middle uterine artery (MU.A)] sides during the last month of gestation. Ten Zaraibi (Egyptian Nubian) goats weighing 40-50kg and aged from 5–7 years were examined twice per month till reached the last month of pregnancy. Then all females were examined every 5 days starting from day -35 till day -1 before kidding.The pregnant goats were examined by ultrasonic and Doppler indices were recorded with Doppler scanning (7.5 -12 MHz, with colored and spectral graph to form the perfect wave to assess Doppler measurements). The obtained data were analyzed using analysis of variance. Results indicated that on the fetal side; the maximum point of velocity (MSV; cm/sec) in the FH and BFRwere elevated from day -35 till day -10 with a slight decline at days -5 and -1 at the peripartum period (P < 0.05), while FH.PI and S/D ratio declined till day -1(P < 0.05). In addition, the fetal Ab. A, and UM.A PI, RI, and S/D ratio declined from day -35 till day -1 at the peripartum period with a significant increase in the peak systolic velocity (PSV) and BFR(P < 0.05). However, non-significant changes in the end diastolic velocity (EDV) were detected. On the maternal side, the MU.A PI and S/D declined from day -35 till day -1 with an elevation of both PSV and BFRat the same time points (P < 0.05). In conclusion, the Doppler evaluation of fetal and maternal blood flow vessels is important to give complete information that directly affects the health status of the mother and fetus.

FRI240 Aspirin Induced Adrenal Hemorrhage: Rare Side Effect Of A Common Medication!

Abstract Disclosure: H.A. Qadeer: None. R. Samkutty: None. V. Singh: None. Introduction: Adrenal hemorrhage is a heterogeneous disorder with various clinical presentations. Bilateral adrenal hemorrhage can result in acute adrenal insufficiency that can be fatal. With the increasing use of DOAC, cases of anticoagulation therapy induced adrenal hemorrhage have been reported. We present a rare case of unilateral adrenal hemorrhage in a patient with pre-existing adrenal myelolipoma after using Aspirin. Based on our literature search, previously only two cases of Aspirin Induced adrenal hemorrhage in a stable adrenal mass have been reported. Case Presentation: 55-year-old male with history of stable 6.2 cm right adrenal gland myelolipoma, fatty liver disease and hypertension, recent use of 2 doses 81 mg Aspirin after receiving right shoulder replacement surgery presented to emergency department with acute onset right sided flank pain, constant, radiating to the back and right upper quadrant associated with an episode of vomiting. He was hemodynamically stable. Blood work showed normal electrolytes, liver function and renal function at baseline. Hemoglobin was stable around 10g/dL. CT scan abdomen/pelvis with contrast showed increase in the size of a previously stable adrenal myelolipoma to 12.9 x 15.6 cm with mass effect upon the liver. Acute hemorrhage was suspected with the blood extending beyond the margins of the mass into the right retroperitoneal space, displacing the right kidney. On admission, aspirin was discontinued. With absence of hemodynamic instability, normal electrolytes, and normal AM cortisol level of 11.9 mcg/dL, adrenal insufficiency was ruled out. Hormonal work up for hyperfunctioning adrenal tumor was performed that ruled out pheochromocytoma, Cushing syndrome and Primary Aldosteronism. With symptomatic improvement, absence of progression of adrenal hemorrhage on repeat CT scan of the abdomen/pelvis, patient was discharged home. He received IR guided embolization of the right superior adrenal artery and middle adrenal artery in the outpatient setting. Discussion: Spontaneous adrenal gland hemorrhage is a rare event. Bilateral adrenal hemorrhage is associated with acute adrenal insufficiency that can be fatal. Major risk factors for adrenal hemorrhage include anticoagulant therapy, heparin Induced thrombocytopenia, hypercoagulable state, trauma and sever sepsis. Here we have reported a rare case of adrenal gland hemorrhage with therapeutic dose of aspirin used after orthopedic surgery. Aspirin is a very commonly used medication and high index of suspicion is required to avoid this side effect as Immediate discontinuation of the medication is necessary to prevent progression of the disease. Conclusion: Aspirin use can be associated with progression of stable benign adrenal tumors by causing spontaneous hemorrhage. A high index of clinical suspicion is required for timely recognition of this side effect. Presentation: Friday, June 16, 2023

Effect of Naoluoxintong formula and its split prescriptions on cerebral vascular regeneration in rats with the cerebral ischemia-reperfusion.

To observe regulatory effect of Naoluoxintong formula (, NLXT) and its split prescriptions on vascular regeneration of rats suffering from cerebral ischemia-reperfusion (IR) syndrome of Qi deficiency with blood stasis (QDBS). NLXT is the representative prescription of Yiqi Huoxue Tongluo decoction, and NLXT is divided into Yiqi herbs and Huoxue Tongluo herbs according to their efficacies. One hundred and eight specific-pathogen-free, clean-grade, Sprague-Dawley male rats were selected to prepare the classical rat model with QDBS due to middle artery ischemia-reperfusion using the multi-factor compound simulation approach. The animals were classified into sham operation (S), model (M), Nimodping (NMDP), NLXT, YQ and HXTL groups, each having 18 rats. Cerebral ischemia was reperfused after 2 h, and 24 h later, they were administered traditional Chinese medicine treatment for 14 d twice a day. Angiogenesis changes after NLXT administration to middle cerebral artery occlusion-reperfusion (MCAO/R) rats with QDBS were analyzed using the neurological deficit score and hematoxylin-eosin staining. Cerebral infarct area by 2,3,5-Triphenyltetrazolium chloride was detected, and the ultrastructure of the blood vessel in the ischemic frontoparietal cortex was observed by transmission electron microscopy. Angiopoietin 1 (Ang1), angiopoietin 2 (Ang2), vascular endothelial growth factor A (VEGFA), vascular endothelial growth factor receptor 2 (VEGFR2), platelet endothelial cell adhesion molecule-1 (CD31), angiopoietin receptor 2 (Tie2), and P38 mitogen-activated protein kinase (MAPK) protein levels in the frontal and parietal cortex were quantified by immunofluorescence, reverse transcription-polymerase chain reaction, and Western blotting assays. Relative to the S group, VEGFA and VEGFR2 levels in the frontal and parietal cortex of group M were increased, and Ang1, Ang2, Tie2, CD31, and p38 MAPK levels remarkably increased (P < 0.05); cerebral infarct area was significant and pathological morphology and ultrastructure damage was obvious. Relative to the group M, VEGFA, VEGFR2, CD31, Ang1, Ang2, and Tie2 expression of group NLXT and NMDP remarkably elevated (P < 0.05) and infarct focus, pathological morphology and ultrastructure were significantly improved; VEGFA and VEGFR2 levels in the groups YQ and HXTL increased, and Ang1, Ang2, CD31, and Tie2 levels remarkably increased (P < 0.05); p38 MAPK levels in the three treatment groups decreased (P < 0.05). Relative to the group NLXT, the expression levels of p38 MAPK in group YQ and group HXTL were significantly increased, and the expression levels of other indicators were significantly decreased (P < 0.05). NLXT can promote the angiogenesis of the rat model of MCAO/R with QDBS by activating VEGFA and inhibiting P38 MAPK, and the effect is better than that of split prescription groups.

Basilar artery occlusion location and clinical outcome: data from the ATTENTION multicenter registry

BackgroundAcute basilar artery occlusion is a disabling and life-threatening condition. The purpose of this study was to evaluate the impact of occluded vessel location on the prognostic outcomes of patients...

Successful recanalization of an acute occlusion of the left internal carotid artery and the left cerebral middle artery via the transbrachial approach: A case report

Introduction: This case study presents an elderly patient with an acute ischemic stroke due to occlusion of the left internal carotid artery (ICA) and the left cerebral middle artery (MCA). The study aimed to evaluate the feasibility and effectiveness of a transbrachial approach for mechanical thrombectomy (MT) in patients with tandem occlusions. Patient concerns: The patient presented with stroke symptoms, including severe aphasia, right-sided facial palsy, left gaze deviation and right-sided weakness. The patient had a history of uncontrolled hypertension. Diagnosis: Diagnostic tests, including computed tomography and angiography, confirmed the presence of occlusions in both the left ICA and the left MCA. Interventions: The patient received MT bridging intravenous thrombolysis. When bilateral iliac arteries were found to be occluded, a puncture via the transbrachial approach was attempted. Angiography suggested an acute occlusion of both the left ICA and the left MCA. The C1 segment was inflated with a pre-dilated balloon and the thrombus in the M1 segment was removed successfully. Outcomes: Successful reperfusion was achieved, and the patient had a good outcome at discharge. No access-site complications were encountered. Conclusion: Transbrachial approach for MT, especially in those with tandem occlusions, is feasible and could provide an alternative to the transfemoral approach. This approach may be beneficial for patients with occlusions in multiple sites or with iliac artery occlusions. Further research is needed to evaluate the long-term effectiveness of this approach.

Patent iliolumbar artery increase no risk of type II endoleaks after endovascular abdominal aortic aneurysm: a case-control study.

The aims of the present study were to explore the risk factors for type 2 endoleaks (T2ELs) after endovascular aneurysm repair (EVAR) and the association between T2ELs and the iliolumbar artery. A single-center, retrospective case-control study in West China Hospital was conducted among patients with infrarenal abdominal aortic aneurysm (AAA) who underwent EVAR between June 2010 and June 2019. The associations of patient characteristics, anatomical factors, internal iliac artery embolization, and ILA with the primary outcome were analyzed. The secondary objective was to analyze survival and reintervention between the T2EL group and the non-T2EL group. Kaplan-Meier survival, propensity matching analysis and multivariate logistic regression analysis were used. A total of 603 patients were included. The median follow-up was 51 months (range 5.0-106.0). There was a significant difference in the diameter of the lumbar artery (LA), middle sacral artery (MSA) and inferior mesentery artery (IMA), proportion of thrombus and LA numbers. The univariate analysis showed that T2ELs were more likely to develop more thrombus in aneurysm cavity (OR = 0.294, p = 0.012), larger MSA (OR = 1.284, p = 0.04), LA (OR = 1.520, p = 0.015), IMA (OR = 1.056, p < 0.001) and more LAs (OR = 1.390, p = 0.019). The multivariate analysis showed that the number of LAs (HR: 1.349, 95% CI: 1.140-1.595, p < .001) and the diameter of the IMA (HR: 1.328, 95% CI: 1.078-1.636, p = 0.008) were significantly associated with T2ELs. There were no new findings from the propensity score matching. The reintervention-free survival rates were significantly different between the two groups (p = 0.048). Overall survival and AAA-related death rates were not different between the two group. This was consistent with the PSM analysis. The iliolumbar artery and the different internal iliac artery interventions may not increase the incidence of T2ELs. But the numbers of LAs and IMA diameter were independent risk factors for T2Els. T2ELs was associated with the reintervention but did not affect long-term survival or increase aneurysm-related mortality after EVAR.

Anomalous origin of the left suprarenal, inferior phrenic arteries and left ovarian artery in a human cadaver.

This report addresses three variants identified within a female cadaver. Specifically, these were an anomalous origin of the right suprarenal artery, an abnormal bilateral ovarian vein branch, and a arterial tortuosity of the left ovarian artery. Indeed, the cadaver evinced abnormal origins in the case of the middle suprarenal artery (MSA), right inferior phrenic artery (IPA), and the renal capsule artery (emanating from the right renal artery). The MSA and IPA shared a common trunk with the inferior suprarenal artery. It was additionally observed that the right ovarian vein anastomoses the branches from the right kidney posterior inferior along with those to the renal fat capsule. Abnormal origin was evident in the case of the left ovarian artery, and arterial tortuosity was apparent in the lower region of the vessels. This report addresses both the clinical import of these variations and their likely causes. In the subdiaphragmatic region, surgical success and prognosis may be impacted by such anomalies; accordingly surgeons must be aware of anatomical variants of the ovarian and suprarenal arteries.

Revisited Surgical Anatomy of the Left Colonic Angle for Tailored Carcinologic Colectomy: A Review.

Although several types of surgical procedure have been advocated to date, the optimal resection of the left colonic angle in cancer treatment remains controversial. Located at the border of the transverse and descending colons, the anatomy of the left colonic angle is complex and characterized by numerous anatomic variations. Recent advances in preoperative (three-dimensional CT angiography with colonography) and/or intraoperative (indocyanine green staining) imaging have allowed for a better identification of these variations. We performed a methodological review of studies assessing the anatomical variations of the left colic artery. While the left colonic angle is classically vascularized by branches of the superior and inferior mesenteric arteries, an accessory middle colonic artery has been identified from 6 % to 36% of cases, respectively, leading to their classification of five types. In the absence of a left colic artery, this artery becomes predominant. In parallel to the variations in the venous drainage of the left colonic angle, which has been classified into four types, new lymphatic drainage routes have also been identified via this accessory artery and the inferior mesenteric vein. Collectively, these newly obtained findings plead for preoperative identification in cases of cancer of the left colonic angle and a surgical strategy adapted to these anatomical variations.

A current insight into Human Knee Menisci

Menisci of the knee are semilunar-shaped structures located between the condyles of the femur and tibia, together with articular surfaces of the tibial condyles form the acetabulum of the knee joint. They have multiple functions, affecting the proper joint biomechanics, even though in the past they were perceived as embryonic remnants. Menisci are involved in such vital functions as: load bearing, joint stability, joint congruity, increasing joint contact area, decreasing joint contact stresses, protection of articular cartilage, shock absorption, lubrication, limitation of extreme movement and proprioception.Menisci arise from a condensation of the intermediate layer of mesenchymal tissue. At later stages of development, it is observed a gradual decrease in the cellularity of the structure and increase of the collagen fibers, where collagen type I is a major fibrillar component. The meniscus is composed of an extracellular matrix mainly filled with water (72%) and collagen (22%), with a minority of proteoglycans, glycoproteins, peptides, and local cells - fibrochondrocytes.When it comes to vascularization, two main areas are present in the structure of meniscus: red-red zone - vascular, white-white zone – rather avascular, and in between the red-white zone. Major vascularization is ensured by the popliteal artery branches: medial, lateral and middle geniculate arteries. It was shown that meniscus can be vascularized in each zone, what is linked with the hypovascular zone regenerative potential. The vascularization pattern and nutritional status of a torn meniscus and the morphological pattern of the tear are crucial factors determining the success of a meniscus surgery. The healing potential of a torn meniscus is directly dependent on its blood supply.At present, it is known that proper performance of the knee joint is directly proportional to the amount of meniscus tissue. Their involvement in the multiple important functions leads to modern solutions focused on saving meniscus tissue.

Comprehensive Study of Arrangement of Renal Hilar Structures and Branching Pattern of Segmental Renal Arteries: An Anatomical Study.

Background The knowledge of renal artery(RA) and its segmentation is critical before attempting any surgical procedure of kidney. The RA receives blood supply from various arteries during its descent in the embryonic period. As a result, the segmental RAs show a lot of variability in the site and pattern of origin as well as its point of entry in the kidney. Aim/objective The aim is to study the variable pattern existing in different segmental RAs and the arrangement of structures at the renal hilum. Methods The RA of 205 kidneys (68 paired and 69 unpaired) was studied and the segmental pattern was exclusively observed in cadavers bydissecting 161 kidneys, making resin/silicon casts of 34 kidneys and radiological imaging of 10 kidneys. Results The results obtained were quite significant and provided in detail understanding of the five main segmental arteries and the arrangement of structures at the renal hilum. Great variations were seen in the disposition of structures at the renal hilum. Six different patterns of structures at the renal hilum were obtained. Pattern 1 was the commonest pattern with an incidence of 30.3% followed by pattern 2. The site of origin of segmental arteries and their point of entry into the kidney were recorded and tabulated. The segmental arteries were classified into different types based on the frequency of their occurrence in decreasing order. In each of them, Type 1 is the commonest variant seen based on the origin of the apical artery (A), anterior upper segmental artery (AU), anterior middle segmental artery (AM), lower segmental artery (L), and posterior segmental artery (P). Conclusions The arrangement of hilar structures has been classified into sixpatterns andthe variations existing in each of the segmental branchesof the RA have been categorized as well. The knowledgewill be invaluable for accurate radiographic interpretation of the renal vasculature and effective surgical planning in cases involving kidney transplantation, renal trauma, and partial nephrectomy. Furthermore, it will serve to preventcomplications during surgical procedures.

Administration of Estradiol Benzoate Enhances Ovarian and Uterine Hemodynamics in Postpartum Dairy Buffaloes.

The postpartum (PP) period is a crucial stage for the resumption of reproductive performance and ovarian cyclicity in dairy buffaloes. The present study aimed, for the first time, to assess the effect of the administration of estradiol benzoate (EB) on ovarian and uterine hemodynamics in PP dairy buffaloes. Eight pluriparous acyclic domestic buffaloes were enrolled in the present experiment and received a dose of 10 mg of estradiol benzoate (EB) intramuscularly 4 weeks after parturition. All animals were examined two times before EB administration (days -3, and -1) and on the day of EB administration (day 0), followed by examinations on days 1, 3, 5, 7, and 9 post-EB administration. The middle uterine artery (MUA) and ovarian artery (OA) blood flow patterns were assessed using a color Doppler ultrasound device. The reproductive parameters were (1) the cross-sectional diameters (cm) of the OA and MUA, (2) cranial uterine horn thickness (UHT; cm), and (3) hemodynamic changes within the MUA on both the ipsi- and contra-lateral sides of the previous pregnant horn and within the OA corresponding to the ovarian tissues. The examined blood flow parameters were the pulsatility index (PI), resistance index (RI), peak systolic/end-diastolic ratio (S/D), time-averaged maximum velocity (TAV; cm/s), uterine blood flow rate (BFR; bpm), and uterine blood flow volume (BFV; mL/min). Concomitantly, blood samples were collected from the coccygeal vein, and the sera were stored at -18 °C for use in estradiol (E2-17β) and nitric oxide (NO) assays. The results revealed increases in both OA and MUA cross-sectional diameter (cm) on the ipsi-lateral and contra-lateral (p < 0.05) sides within 24 h until day 9 post-treatment. The values of the RI and PI of blood flow within the OA and MUA on the ipsi-lateral and contra-lateral sides of the previous pregnancy were obviously lower (p < 0.05) at 24 h after the administration of EB, and then, started to gradually elevate, reaching the pre-treatment values on day 9 after EB administration. Both the BFR and BFV in the OA and MUA significantly increased from 24 h to 72 h after EB administration on both the ipsi-lateral and contra-lateral sides (p < 0.05); then, their values started to decrease to reach the pretreatment value on day 9 after EB administration. Both E2 and NO concentrations significantly increased (p < 0.05) from 24 h until day 3 after EB injection and then started to decline after that, reaching the pre-treatment value on day 9. In conclusion, the administration of EB enhances the ovarian and uterine blood flow concomitantly with increased levels of NO in PP dairy buffaloes.

Mapping the branching pattern of the middle cerebral artery in the camel (Camelus dromedarius): a comprehensive anatomical analysis.

The complex branching structure of the middle cerebral artery serves as a crucial component in the blood supply to the cerebral cortex, playing a key role in sustaining brain function and overall neurological health in mammals. A thorough understanding of the branching structure of the middle cerebral artery is required for the advancement of veterinary medicine and neuroscience research. In this study, we provide the first comprehensive anatomical analysis of the branching structure of the middle cerebral artery (MCA) in the dromedary brain. To date, no study has examined the MCA branches in dromedaries. By examining 80 cerebral hemispheres from freshly slaughtered male dromedary camels aged 2-6 years, we aimed to explain the origin, course, and branching patterns of the MCA in the dromedary camel. Advanced casting techniques using colored latex, epoxy paint, and liquid plastic have been used to create precise renderings of the MCA structure. Our findings revealed that the MCA is the principal branch of the rostral cerebral artery and serves as the primary blood supply to the telencephalon in dromedaries. The main trunk of the MCA splits into several cortical branches, each supplying blood to a specific cerebral hemisphere. These branches comprise the rostral and caudal olfactory arteries; orbital artery; superior, middle, and inferior frontal arteries; rostral, middle, and caudal parietal arteries; and dorsal, middle, and ventral temporal arteries. This groundbreaking work considerably advances our understanding of the dromedary cerebrovascular system by providing insightful information on the anatomy and topography of the MCA. Our findings open new avenues for advancements in veterinary medicine and neuroscience research, with potential applications in the diagnosis and treatment of neurological disorders in dromedary camels. Furthermore, understanding the unique branching pattern of the MCA may have implications for comparative neuroanatomy and the evolution of cerebrovascular systems across species.

Middle lobe pulmonary artery branch running ventral to the upper lobe pulmonary vein

Middle lobe pulmonary artery branch running ventral to the upper lobe pulmonary vein

Rare and Combined Hepatic Artery Variants as Seen in Cadaveric and Postmortem Investigations: Anatomical Implications in Surgical Practice

Context: Vascular variations are an unexpected finding during cadaveric dissections, postmortems, and surgical and diagnostic angiographic procedures. Usually, such abnormalities are asymptomatic, but the existence of hepatic vasculature anomalies might cause accidental injuries to the vasculature while performing surgical procedures. Aim: This study aimed to dissect human cadavers and postmortem specimens and to examine the variations of the hepatic artery system. Materials and Method: This study was conducted on 50 specimens, with 22 conducted in the dissection hall cadavers, while 28 were collected from the postmortem among the South Indian population irrespective of age and sex and investigated for variant hepatic arteries. The data were collected between January 2014 and December 2015. Results: The results of this study demonstrated that the common hepatic artery (CHA) originated directly from the aorta in 2%, and it was trifurcated into the right hepatic artery (RHA), left hepatic artery (LHA), and gastroduodenal artery (GDA) in 8%. It continued only as the LHA in 16% and only as RHA in 4%. The RHA arises from CHA in 8%, from the superior mesenteric artery (SMA) in 10%, from GDA in 4%, and from replaced CHA in 2%. The GDA accounted for 4% of the accessory RHA's origin, while the proper hepatic artery (PHA) accounted for 2%. The LHA from the CHA in 8% replaced the origin from the left gastric artery (LGA) in 4% and replaced CHA in 2%. The middle hepatic artery was noticed in 62% of the specimens. Conclusion: Surgeons and radiologists participating in angiographic procedures must have up-to-date knowledge of hepatic artery normal variant abnormalities.

Evaluation of fetal adrenal artery Doppler velocimetry and fetal adrenal gland size in pregnancies after recovery from COVID-19.

Assessment of the fetal adrenal gland (FAG) size and middle adrenal artery (MAA) Doppler parameters in pregnancy recovered from Coronavirus Disease (COVID-19) and comparison of the values with the healthy control group. Thirty-eight pregnant women who had recovered from COVID-19 infection and 76 healthy control group between 33 and 35 weeks of gestation were involved in this case-control study. Fetuses were examined for fetal biometry, fetal well-being, adrenal gland dimensions, and Doppler parameters 4-6 weeks after the diagnosis of COVID 19 infection. FAG dimensions were measured in two planes and MAA blood flow velocity was evaluated with pulsed Doppler. Pregnant women with COVID-19 infection were grouped according to the National Institutes of Health for the severity of the disease, and those with mild and moderate infections were examined in the study. The total adrenal gland (TAG) height, fetal zone (FZ) length and width, and MAA-Peak Systolic Velocity (MAA-PSV) were significantly higher, and the MAA-Pulsatility Index (MAA-PI) was significantly lower in the COVID-19 group (p < 0.05). The lower in MAA-PI and the higher in MAA-PSV, the width of the FZ, and width of the TAG were found to be significant in the moderate group compared to the mild groups (p < 0.05). COVID-19 pregnancies might cause early maturation of the FAG and its vasculature depends on the intrauterine stress due to the hyper-inflammation, so fetuses exposed to maternal COVID-19 suggested to have an increase in blood flow to the adrenal gland and fetal adrenal size.