Middle Artery Research Articles

Maresin1 inhibits the NF-κB/caspase-3/GSDME signaling pathway to alleviate hepatic ischemia-reperfusion injury

Objective: To investigate the role of Maresin1 (MaR1) in hepatic ischemia-reperfusion injury (HIRI). Methods: The HIRI model was established and randomly divided into a sham operation group (Sham group), an ischemia-reperfusion group (IR group), and a MaR1 ischemia-reperfusion group (MaR1+IR group). MaR1 80ng was intravenously injected into each mouse's tail veins 0.5h before anesthesia. The left and middle hepatic lobe arteries and portal veins were opened and clamped. The blood supply was restored after 1h of ischemia. After 6h of reperfusion, the mice were sacrificed to collect blood and liver tissue samples. The Sham's group abdominal wall was only opened and closed. RAW267.4 macrophages were administered with MaR1 50ng/ml 0.5h before hypoxia, followed by hypoxia for 8h and reoxygenation for 2h, and were divided into the control group, the hypoxia-reoxygenation group (HR group), the MaR1 hypoxia-reoxygenation group (MaR1 + HR group), the Z-DEVD-FMK hypoxia-reoxygenation group (HR+Z group), the MaR1 + Z-DEVD-FMK hypoxia-reoxygenation group (MaR1 + HR + Z group), and the Con group without any treatment. Cells and the supernatant above them were collected. One-way analysis of variance was used for inter-group comparisons, and the LSD-t test was used for pairwise comparisons. Results: Compared with the Sham group, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), interleukin (IL)-1β, and IL-18 in the IR group were significantly higher (P < 0.05), with remarkable pathological changes, while the level in the MaR1 + IR group was lower than before (P < 0.05), and the pathological changes were alleviated. Compared with the Con group, the HR group had higher levels of IL-1β and IL-18 (P < 0.05), while the MaR1 + HR group had lower levels of IL-1β and IL-18 (P < 0.05). Western blot showed that the expressions of caspase-3, GSDME, and GSDME-N were significantly higher in the HR group and IR group than in the other groups; however, the expression was lower following MaR1 pretreatment. The Z-DEVD-FMK exploration mechanism was inhibited by the expression of caspase-3 in HIRI when using MaR1. Compared with the HR group, the IL-1β and IL-18 levels and the expressions of caspase-3, GSDME, and GSDME-N in the HR + Z group were decreased (P < 0.05), while the expression of nuclear factor κB was increased, but following MaR1 pretreatment, nuclear factor κB was decreased. There was no significant difference in the results between the MaR1 + H/R group and the MaR1 + H/R + Z group (P > 0.05). Conclusion: MaR1 alleviates HIRI by inhibiting NF-κB activation and caspase-3/GSDME-mediated inflammatory responses.

Sjúkratilfelli Skyndileg aftanskinublæðing

A 50-year old male presented to our emergency department with sudden abdominal pain. Upon arrival he was diaphoretic, pale and tachycardic. A CT showed retroperitoneal hemorrhage with suspected tumor at the left adrenal gland. He was quickly stabilized with intravenous fluids and blood transfusion. Rebleed occurs roughly a week after discharge and a new CT showed a visceral pseudoaneurysm from the left middle adrenal artery. The pseudoaneurysm was embolized and the patient discharged in good condition. Follow-up MRI depicted reabsorption of the hematoma and no adrenal tumor. Thus, the etiology of the previous retroperitonal hemorrhage is considered spontaneous.

Morphological study of the arterial supply to the menisci in pigs with special reference to creating meniscus injury model.

Some reports have used pigs to establish models of meniscus injury. However, accurate information on the origin, course, and access of the arteries supplying the menisci remains unclear. This information is important to avoid damaging vital arteries when creating the meniscus injury model. In this study, fetal and adult pigs were employed to investigate the arterial supply of the menisci in pigs using gross anatomical and histological methods. Macro-anatomically, the anterior horn, body, and posterior horn of the medial meniscus were found to be supplied by the medial superior genicular artery, medial inferior genicular artery, and posterior middle genicular artery. The anterior and posterior horns of the lateral meniscus were supplied by the cranial tibial recurrent artery and the middle genicular artery, respectively. Anastomosis was observed in some cases, but appeared to be infrequent and too thin to expect the anastomotic branches to provide adequate blood flow. The histological examination showed that the arteries entered the meniscus along the tie-fiber. The access process of the artery was the same irrespective of whether it was in fetal or mature pigs, the medial or lateral meniscus, or the anterior horn or body or posterior horn. The medial inferior genicular artery ran along the medial meniscus in the circumferential direction. Therefore, the clinical longitudinal incision should take into account the characteristics of the vessel course in order to protect the blood vessels from damage. Based on the results of this study, the protocol for creating a pig meniscus injury model should be reconsidered.

Clinical characteristics and risk factors of coronary artery lesions in chinese pediatric Takayasu arteritis patients: a retrospective study

BackgroudTo summarize the clinical characteristics and identify the risk factors for pediatric Takayasu arteritis (TAK) with coronary artery lesions (CALs).MethodsClinical data of pediatric TAK patients in our center were retrospectively assessed. Independent risk factors for CALs were identified using multivariate logistic regression analysis. Survival analysis was used to compare differences in survival rates between the groups.ResultsAmong the 66 pediatric TAK cases, the incidence of accompanying CALs was 39.4%. In the CAL group, 19 (73.1%) cases started within 36 months. None of the patients had symptoms of angina or ischemia on electrocardiogram (ECG), the CALs were detected using coronary ultrasound. The CALs most commonly were the left main and right coronary arteries. The lesions were mostly small or middle coronary artery aneurysms; some children may have giant coronary aneurysmal dilations, thrombosis and heart failure. The age of onset and symptom onset to diagnosis in TAK patients with CAL were lower than those in TAK patients without CAL(P < 0.005). TAK patients with CAL had significantly higher CRP,WBC, PLT,TNF-α and IL-2R levels (P < 0.05), lower HGB (P = 0.01), lower rate of renal artery stenosis (RAS) (P = 0.009). In multivariate logistic regression, the risk factors for pediatric TAK combined with CAL included the age of TAK onset (OR = 0.9835, 95% CI: 0.9710–0.9946, P = 0.006) and RAS (OR = 0.1901, 95% CI: 0.0386–0.7503, P = 0.03). In addition, there was no significant difference in survival rates between the two groups after regular treatment.ConclusionThis study showed that the occurrence of CAL in pediatric TAK patients has a relatively more rapid clinical course, and a stronger inflammatory state at the time of diagnosis. The earlier the age of TAK onset and without RAS are more likely to cause CAL.

Effects of monitoring exercise rehabilitation with target intensity on the patient with twice PCI: A case report.

As the core of cardiac rehabilitation (CR), early exercise rehabilitation is beneficial for patients with coronary heart disease (CHD), and center-based CR with target intensity is superior to home-based CR. However, there was no research to observe the effects of exercise rehabilitation on cardiopulmonary exercise capacity, oxygen uptake efficiency slope, endothelial function evaluated as flow-mediated vasodilation (FMD), and blood plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) in CHD patients undergone percutaneous coronary intervention (PCI) for 3 months. A 57-year-old woman had been identified with triple vessel disease and undergone twice PCI for complete revascularization, however, there was no improvement in Lp-PLA2, FMD, and related indicators of cardiopulmonary exercise testing. Coronary angiography showed an 85% stenosis in the middle left anterior descending artery, an 85% stenosis in the proximity of a thick first-diagonal branch, a long 75 to 85% stenosis in the middle left circumflex artery, and a 90 to 95% stenosis in the proximal. The case was diagnosed as CHD. The patient obtained optimal medical therapy comprising therapeutic lifestyle changes, and began monitoring exercise rehabilitation with target intensity 3 months after the second PCI in the CR center. There were changes in cardiopulmonary exercise capacity, oxygen uptake efficiency slope, FMD, and Lp-PLA2 in the patient with 3 apparent stenotic coronary arteries who was done PCI twice, without or with postoperative exercise rehabilitation, respectively. We proved that monitoring exercise rehabilitation training with target intensity could improve the prognosis of chronic coronary syndrome patients, and it was never too late to do regular exercise rehabilitation.

Variations in the origin of the right gastric artery: a systematic review and meta-analysis.

The right gastric artery (RGA) supplies the lesser curvature of the stomach. The prevalence of variations in RGA origins can be of interests to students, surgeons, and radiologists who wish to increase their understanding of this vessel. The aim of this study was to perform a systematic review and meta-analysis on the origin of the RGA. The PRISMA 2020 checklist was followed. Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. There were no constraints based on language or publication status. Database search, data extraction and risk of bias assessment were performed independently by two authors. A random-effects meta-analysis of the prevalence of different RGA origins was conducted. A total of 9084 records were screened in the initial search. Fifteen studies were included, assessing 1971 right gastric arteries. The RGA arose most frequently from the Proper Hepatic Artery (PHA), with a pooled prevalence of 53.6% (95% CI 44.5-60.8%), followed by the Left Hepatic Artery (LHA) with a pooled prevalence of 25.9% (95% CI 18.6-32.8%), and the Gastroduodenal Artery (GDA) with a pooled prevalence of 8.89% (95% CI 4.62-13.9%). Less common origins were the Common Hepatic Artery (CHA) (6.86%, 95% CI 3.15-11.5%), the Right Hepatic Artery (RHA) (3.43%, 95% CI 0.93-7.04%), and Middle Hepatic Artery (MHA) (1.31%, 95% CI 0-3.44%). This meta-analysis provides an accurate estimate of the prevalence of different RGA origins. Anatomical knowledge combined with pre-operative planning and imaging can prevent iatrogenic injury during surgery.

Bilateral absence of the deep brachial artery.

The aim of the following study was to present and comprehensively describe a case of a bilateral absence of the deep brachial artery (DBA). Furthermore, its embryology and clinical significance will also be discussed. During routine dissection, a 71-year-old male cadaver with a bilateral abnormality in the DBA and its branches was found. The first branch of the brachial artery (BA) was found to be the radial collateral artery, which passed behind the radial nerve. Furthermore, the middle collateral artery originated distal to the radial collateral artery and gave off first a singular, minor muscular branch and then the superior ulnar collateral artery. Later, the preceding nutrient arteries of the humerus and the deltoid branch consecutively branched off from the middle collateral artery. Subsequently, the middle ulnar collateral artery, the inferior ulnar collateral artery, the deltoid artery, the radial artery, and the ulnar artery branched off from the BA, as adapted in the current knowledge regarding the anatomy of the upper extremity. Furthermore, detailed measurements of the distances between the mentioned arteries were carried out. In the present study, a bilateral absence of the DBA was demonstrated. Meta-analysis focusing on the anatomy of this artery has shown how variable its characteristics are. However, our case report is the first in the literature to present this extremely rare variation. Having adequate knowledge regarding the anatomy of the arteries of the proximal arm is of immense importance when performing orthopaedic and reconstructive surgeries in this area.

388 Percutaneous Transluminal Angioplasty and/or Stenting for the Treatment of Basilar Artery Stenosis: A Systematic Review and Meta-Analysis

INTRODUCTION: Basilar artery stenosis (BAS) carries high morbidity and mortality, with variable outcomes reported after endovascular treatments. METHODS: PubMed, EMBASE, Web-of-Science, Scopus, and Cochrane were searched upon the PRISMA guidelines to include studies describing PTAS for BAS. Pooled rates of intervention-related complications and outcomes were analyzed with random-effect model meta-analyses. RESULTS: We included 25 studies comprising 1016 patients. Patients were mostly male (79.5%), with hypertension (81.1%) and/or dyslipidemia (56.4%), and presenting with transient ischemic attack (54.4%) or stroke (45.6%). BAS frequently involved the middle basilar artery (51.4%), and were mostly classified as Mori-B (57.4%). PTAS for BAS was indicated in patients with severe (≥50%-70%) symptomatic BAS refractory to dual antiplatelet therapy. Patients underwent angioplasty (95.5%) and/or stenting (92.2%), preferably using Wingspan or Apollo stents. Median baseline BAS was 81% (range, 53%-99%), while median post-intervention BAS was 13% (0%-75%). Actuarial rates of successful intervention and “good” final outcome were 100% (95% CI: 100%-100%) and 89% (95% CI: 85%-93%). Intervention-related recurrent ischemic stroke occurred in 85 patients (8.3%) with actuarial rates of 5% (95% CI: 4%-7%), and was differentiated into perforator (5.4%), in-stent (2.6%), and embolic (0.4%). Actuarial rates of intervention-related dissection, restenosis, and death were 0% (95% CI: 0%-0%), 1% (95%CI: 0%-1%), and 0% (95% CI: 0%-2%). CONCLUSIONS: Elective PTAS is safe and effective in selected patients with medically-refractory, severe, symptomatic, and non-acute BAS. Different stent types and angioplasty-assisted procedures should be considered based on specific clinico-radiological characteristics of the lesions.

Altered trafficking of miRNAs at mitochondria modulates mitochondrial functions and cell death in brain ischemia.

Stroke is one of the major causes of death and disabilities worldwide. The rapid induction of cell death by necrosis and apoptosis is observed at the ischemic core, while long lasting apoptosis and brain inflammation continue in the penumbra. The emerging evidence suggests a critical role of mitochondria in acute and chronic inflammation and cell death. Mitochondrial dysfunction may result in the release of mitokines and/or mitochondrial DNA into the cytoplasm and activate multiple cytosolic pathways which in turn triggers inflammation. The role of miRNA, specifically mitochondria-associated miRNAs (mitomiRs) in the regulation of mitochondrial functions is emerging. In the current study, we hypothesized that ischemia-induced mitomiRs may modulate the mitochondrial functions and such alterations under stress conditions may lead to mitochondrial dysfunction and cell death. We have demonstrated the specific pattern of miRNAs associated with mitochondria that is altered under ischemic condition induced by transient middle artery occlusion (tMCAo) in rats. The putative targets of altered miRNAs include several mitochondrial proteins which signifies their involvement in maintaining mitochondrial homeostasis. The alterations of selected miRNA in mitochondria was further detected in a cellular models when hypoxia is induced using a chemical agent CoCl2 in three cell lines. Two candidate mitomiRs, hsa-miR-149-3p and hsa-miR-204-5p were further analyzed for their functional role during in vitro hypoxia by transfecting mitomiR mimics into cells and determining critical mitochondrial functions and cell viability. The results here emphasize the role of certain mitomiRs as an important modulator of mitochondrial function under the ischemic condition.

Prevalence of Michel’s Type 1 hepatic arterial anatomy on CT angiography in Nepalese population

Multidetector Computed Tomography (MDCT), with an accuracy of 95-100%, is the modality of choice for preoperative assessment of hepatic artery anatomy in this era of modern hepatic surgeries. Celiac trunk is the first anterior branch of the abdominal aorta and trifurcates into left gastric, splenic, and common hepatic artery which branches into gastroduodenal and proper hepatic artery which then divides into right, middle and left hepatic arteries. Superior mesenteric artery (SMA) originates from abdominal aorta one centimeter below the celiac trunk. This “classic” anatomy pattern is seen only in approximately 61.3% of patients. This study aims at establishing prevalence of hepatic artery anatomical variations on MDCT in Nepalese population since such study has not been published in context of Nepal yet. Cross-sectional descriptive study was performed on MDCT images of all patients undergoing CT abdomen and pelvis with angiography between November 2018 and October 2022 (four years) at Nepal Medical College and Teaching Hospital. The Type of variation was categorized according to Michel’s classification. The values were further grouped under male and female categories. Data obtained was compiled and analyzed using SPSS 16. Out of 504 patients, 258 were males (51.2%) and 246 were females (48.8%). Youngest was nine years and the eldest was 93 years old with mean age of 48.1 years. The commonest variation was Michel’s Type 1, seen in 371 (73.6%) followed by Type 2 in 61 patients (12.1%) and Type 3 in 46 (9.1%). Type 4 was seen in 11 patients (2.2%) and Type 5 variant in nine patients (1.8%). Only one patient each had Type 6 and 7 (0.2 % each). Two had Type 9 (0.4%). We did not find Type 8 and 10. Statistically significant difference between male and female was found only in Type 2 with females having higher prevalence. Two patients showed celiac trunk and SMA arising from single celiomesenteric trunk of abdominal aorta, accounting for 0.4% of total cases which was tabled under unclassified category. MDCT is excellent modality to depict normal and variant hepatic arterial anatomy. Michel’s Type 1 is the commonest hepatic arterial anatomy variant and should be considered as normal “classic” pattern.

Cerebrovascular reactivity after functional activation of the Brain using Photic Stimulation in Migraine and Tension Type Headache: a transcranial doppler Ultrasonography Study

BackgroundPrevious studies in headache patients measured the cerebrovascular reactivity (CVR) in response to photic stimulation but they have yielded contradictory results. The purpose of study was to measure CVR of both migraine and chronic tension headache (TTH) patients in response to photic stimulation.MethodsThe study included 37 migraineurs and 24 chronic TTH patients compared with 50 age- and sex-matched healthy volunteers. Peak systolic, end diastolic, mean flow velocities and CVR (PSV, EDV, MFV, and CVR) were measured using TCD ultrasonography of the middle, anterior, posterior cerebral and vertebral arteries (MCA, ACA, PCA, and VA) before and after 100 s of 14 Hz photic stimulation.ResultsA three-way repeated measures ANOVA interaction with main factors of Vessels (MCA, ACA, PCA, VA), Time (pre-post photic) and Groups (migraine, TTH, and control group) revealed significant 3-way interactions for measures of PSV (P = 0.012) and MFV (P = 0.043). In the migraine patients there was significantly higher PSV, EDV, and MFV in the MCA, ACA, and PCA after photic stimulation compared with baseline. The CVR of the MCA was also significantly higher in migraineurs than controls. In the TTH group, there was significantly higher PSV, EDV, and MFV (P = 0.003, 0.012, 0.002 respectively) in the VA after photic stimulation than at baseline. The CVR was significantly higher in the VA of TTH patients than controls.ConclusionCompared with controls after photic stimulation, the higher CVR of the MCA in migraineurs and of the VA in TTH patients could be used as diagnostic tool to differentiate between the two types of headaches.

Morphology of the brain base arteries of the giant anteater (Myrmecophaga tridactyla)

This study aimed to describe the brain base arteries of the Myrmecophaga tridactyla using ten cadavers of adults from this species, including five male and five female specimens. The arterial vascular bed was perfused via the thoracic aorta with a dyed natural latex solution, and the animals were fixed and preserved with a 10% formaldehyde buffered solution. The encephala were removed, and their vessels dissected. Basilar artery formation occurred by anastomosis of the thick ventral spinal artery with vertebral arteries. The basilar artery formed two arterial islands and gave bulbar and pontine branches, and cranial, middle, and caudal cerebellar arteries and ended by forking into its terminal branches, the caudal communicating arteries. The blood supply of the encephalon derived solely from the vertebrobasilar system, and the arterial circle of the brain was closed caudally and rostrally. The absence of participation of internal carotid arteries in encephalon irrigation, the island formations by the basilar artery, and the fusiform shape of the arterial circle of the brain are peculiar characteristics of the vascular anatomy of the brain base of M. tridactyla.

Percutaneous transluminal angioplasty and/or stenting for the treatment of basilar artery stenosis: a systematic review and meta-analysis.

Basilar artery stenosis (BAS) carries high morbidity and mortality, with variable outcomes after endovascular treatments. We systematically reviewed the literature on percutaneous transluminal angioplasty and/or stenting (PTAS) for BAS. PubMed, EMBASE, Web-of-Science, Scopus, and Cochrane were searched upon the PRISMA guidelines to include prospective/retrospective cohort studies describing PTAS for BAS. Pooled rates of intervention-related complications and outcomes were analyzed with random-effect model meta-analyses. We included 25 retrospective cohort studies comprising 1016 patients. All patients were symptomatic, presenting with transient ischemic attack or ischemic stroke. BAS frequently involved the middle basilar artery (51.4%), mostly classified as Mori-B (57.4%). PTAS for BAS was indicated in severe (≥ 50-70%), symptomatic BAS refractory to dual antiplatelet therapy. Patients underwent angioplasty (95.5%) and/or stenting (92.2%), preferably using Wingspan or Apollo stents. Median baseline BAS was 81% (range, 53-99%), while median post-intervention BAS was 13% (0-75%). Actuarial rates of successful intervention and "good" final outcome were 100% (95% CI: 100-100%) and 89% (95% CI: 85-93%). Intervention-related recurrent ischemic stroke occurred in 85 patients (8.3%) with actuarial rates of 5% (95% CI: 4-7%), differentiated into perforator (5.4%), in-stent (2.6%), and embolic (0.4%). Actuarial rates of intervention-related dissection, restenosis, and death were 0% (95% CI: 0-0%), 1% (95% CI: 0-1%), and 0% (95% CI: 0-2%). Elective PTAS appears to be safe and effective in selected patients with medically refractory, severe, symptomatic, and non-acute BAS. Different stent types and angioplasty-assisted procedures should be considered based on specific clinico-radiological characteristics of the lesions. Future randomized controlled trials are required to corroborate these findings.

Pulmonary Vascular Remodeling in Pulmonary Hypertension.

Pulmonary vascular remodeling is the critical structural alteration and pathological feature in pulmonary hypertension (PH) and involves changes in the intima, media and adventitia. Pulmonary vascular remodeling consists of the proliferation and phenotypic transformation of pulmonary artery endothelial cells (PAECs) and pulmonary artery smooth muscle cells (PASMCs) of the middle membranous pulmonary artery, as well as complex interactions involving external layer pulmonary artery fibroblasts (PAFs) and extracellular matrix (ECM). Inflammatory mechanisms, apoptosis and other factors in the vascular wall are influenced by different mechanisms that likely act in concert to drive disease progression. This article reviews these pathological changes and highlights some pathogenetic mechanisms involved in the remodeling process.

Strengthening the Description of Superior Mesenteric Artery Occlusions in Acute Mesenteric Ischaemia: Proposition for an Anatomical Classification

The aim of this study was to propose computed tomography angiography (CTA) based anatomical segmentation of the superior mesenteric artery (SMA), in order to standardise the reporting of occlusive lesions in acute mesenteric ischaemia (AMI). A retrospective CTA evaluation of patients with occlusive AMI admitted between 2016 and 2021. After the screening of 468 patients, 95 were included. The SMA was segmented into proximal (S1, ostium to the inferior pancreaticoduodenal artery), middle (S2, from the inferior pancreaticoduodenal to the ileocolic artery), and distal (S3, downstream the ileocolic artery) sections. The jejunal arteries were labelled J1 to J6, and the middle, right, and ileocolic arteries C1, C2, and C3. Two radiologists independently applied the proposed segmentation to a cohort of patients with occlusive AMI to describe occlusive lesions. Intra- and inter-rater agreement was assessed with kappa statistics. Occlusions involved one segment in 50 (53%) patients (S1, n= 27 [28%]; S2, n= 12 [13%]; S3, n= 11 [12%]); two segments in 37 (39%) patients (S2/S3, n= 31 [33%]; S1/S2, n= 3 [3%]; S1/S3, n= 3 [3%]); and all three segments in eight patients (S1/S2/S3, 8%). The median number of jejunal arteries was four (interquartile range 3, 4.5). C1 and C2 were present in 93 (98%) and 23 patients (24%), respectively. Almost perfect intra-rater agreement was obtained for S1 (91% agreement, κ= 0.82, 95% confidence interval [CI] 0.72 - 0.92); substantial agreement was obtained for S2 (90% agreement, κ= 0.80, 95% CI 0.68 - 0.92) and S3 (86% agreement, κ= 0.72, 95% CI 0.58 - 0.86). Almost perfect inter-rater agreement (with the second junior reading) was obtained for S1 (97% agreement, κ= 0.95, 95% CI 0.89 - 1.0), S2 (91% agreement, κ= 0.82, 95% CI 0.72 - 0.92), and S3 (agreement 96%, κ= 0.91, 95% CI 0.83 - 0.99). A standardised CTA based anatomical segmental description of SMA occlusive lesions in AMI is proposed; it provided substantial to almost perfect intra- and inter-rater agreement for most anatomical segments.

Median artery of the corpus callosum in the context of AComA aneurysm rupture: The relevance of a perianeurysmal anatomy

It is important to understand the patient's vascular anatomy before treating cerebral aneurysms. The middle artery of the corpus callosum is one of the least common variations of the AComA complex. We describe the case of a 59-year-old woman who suffered a subarachnoid hemorrhage due to an AComA complex aneurysm that had ruptured. Fluorescein injection during the aneurysm clipping procedure revealed a partial obstruction of the middle artery, requiring repositioning of the clip. The vascular variations that our patients may exhibit at the time of aneurysm clipping must be kept in mind and understood.

Comparison of peripheral and cerebral vascular function between premenopausal, early and late postmenopausal females.

What is the central question of this study? We sought to investigate whether peripheral and cerebrovascular function are impaired in early and late postmenopausal females compared with premenopausal females, while also accounting for nitric oxide and estradiol levels. What is the main finding and its importance? We observed no differences in peripheral vascular and cerebrovascular function between healthy and physically active premenopausal females and early and late postmenopausal females. Our findings contradict previous cross-sectional observations of vascular and cerebrovascular dysfunction across menopause. Longitudinal studies assessing vascular and cerebrovascular outcomes across the menopausal transition are warranted. The risk of cardiovascular and cerebrovascular disease increases in ageing females, coinciding with the onset of menopause. Differences in peripheral and cerebrovascular function across menopausal stages, however, are poorly characterized. The aim of this study was to compare peripheral and cerebrovascular function between healthy premenopausal (PRE), early (1-6 years after final menstrual period; E-POST) and late (>6 years after final menstrual period; L-POST) postmenopausal females. We also explored the association between reproductive hormones, NO bioavailability and cerebrovascular function. In 39 females (40-65 years of age), we measured arterial stiffness, brachial artery flow-mediated dilatation, and cerebrovascular reactivity (CVR) to hypercapnia in the middle (MCAv) and internal (ICA) carotid arteries. Follicle-stimulating hormone, estradiol, progesterone and plasma nitrate and nitrite concentrations were also measured. Years since final menstrual period (PRE, 0±0 years; E-POST, 3±1 years; L-POST, 11±4 years; P<0.001) and estradiol levels (PRE, 145.5±65.6 pgml-1 ; E-POSTm 30.2±81.2 pgml-1 ; L-POST, 7.7±11.3 pgml-1 ; P<0.001) were different between groups. All groups exceeded the guidelines for recommended physical activity. There were no group differences in blood pressure (P=0.382), arterial stiffness (P=0.129), flow-mediated dilatation (P=0.696) or MCAv CVR (P=0.442). The ICA CVR blood flow response was lower in PRE compared with L-POST (26.5±19.2vs. 47.8±12.6%; P=0.010), but after adjusting for age these differences were no longer present. Flow-mediated dilatation (r=0.313, P=0.105) and ICA CVR (r=-0.154, P=0.495) were not associated with the estradiol concentration. There were no associations between the estradiol concentration and NO bioavailability. These results suggest that in healthy, physically active early and late postmenopausal females, vascular and cerebrovascular function is generally well preserved.

CLINICAL AND ECHOGRAPHIC PARAMETERS OF PREGNANT COWS WITH DIFFERENT GESTATION PATTERNS

The article presents the material of study on clinical and echographic parameters of pregnant cows with various gestation pattern. The syndrome of fetal developmental retardation is recorded on average in 33.3% of pregnant animals, including complicated by gestosis – in 22.6%. In the cows with fetal developmental retardation syndrome at 135-150 days of gestation, a decrease in the intensity of blood supply to the developing embryo was observed, manifested by a decrease in the size of the placenta by 33.8-46.7% and the diameter of the middle uterine arteries – by 14.7-24.5%. Fetal developmental retardation syndrome complicated by gestosis at 7 months of gestation is clinically characterized by hypertension, edema in 85.8% of animals and the presence of protein (1.0 mg/ml or higher) in the urine.

Особливості мозкового кровотоку у пацієнтів з різними видами головного болю

Introduction. Currently, the most common types of neurological diseases presenting with headache are migraine (M), tension-type headache (TTH) and cervicogenic headache (CH). At the current level, the use of such a highly informative method as duplex scanning in the diagnosis of various types of headache is relevant. A large number of works are devoted to the study of cerebral hemodynamic disorders in patients with migraine with and without aura, in the period between attacks and during an attack. In patients with M, a change in the tone of the vessels of the arterial bed, an increase in interictal hypotension, a decrease in cerebral blood flow reserves, and the phenomenon of venous dysemia were determined. Paradoxical vascular reaction and disruption of autoregulation were noted in patients with TTH. Hemodynamic characteristics of TTH were signs of increased tone in extracranial arteries and decreased tone in intracranial vessels; decrease in cerebral blood flow reserves; signs of venous dyscirculation. In patients with CH the most pronounced changes in hemodynamics in the form of a decrease in speed and an increase in blood flow kinematic indices are observed in VA and BA. Also, in patients with CH, there is a correlation between the severity of vertebral dysfunction and cerebral dysgemia In the available works, hemodynamic patterns characteristic of certain types of headache were not determined. Nor was a comparison of hemodynamic characteristics in patients with M, TTH and CH. In connection with the above, the question of the role of vascular factors is relevant for the study of pathogenetic mechanisms of the development of various types of headache. The aim of the work was to study the features of blood circulation in extra- and intracerebral vessels in patients with migraine, tension type headache and cervicogenic headache. Materials and methods. 458 young patients (16-44 years old, men – 203, women – 255) with various types of headache were studied; including migraine – 124 patients, tension type headache – 186 patients, cervicogenic headache – 146 patients. The indicators of peak systolic blood flow velocity (Vs), time-averaged maximum blood flow velocity (TAMX), pulsatility (PI) and resistance (RI) indices in general (CCA), external (ECA), internal carotid (ICA), vertebral (VA) in segments V2 and V4, anterior (ACA), middle (MCA), posterior (PMA) cerebral, and basilar (BA) arteries were studied The results. In all clinical groups, there was a decrease in speed indicators and an increase in the values of the resistance index in VA. Changes in hemodynamics in the V2 segments are possibly due to extravasal compression and hypoplasia of the VA. In patients with M, the flow rate along the MCA was significantly increased. Patients with TTH showed excessive perfusion of BA. Pulsation index in MCA was increased in TTH and in M. PI values in patients with TTH were moderately increased in PMA and BA. In patients with M and TTH an increase in the PI index was observed in the MCA, the PI index was increased in the PMA in patients with CH and decreased in the groups with M and TTH. This index was increased in VA and BA in all clinical groups. In the group of patients with M, the peak-like variant of the spectrum in MCA prevailed. A characteristic feature of the group of patients with CH was the dominance of the peak-like spectrum in VA. Conclusions. Hemodynamic indicators in the extracranial segments of VA were reduced in all clinical groups, which is probably caused in most cases by vertebral impact and structural changes. Patterns of excessive perfusion in MCA were characteristic for patients with M and TTH, in PMA – for patients with M, in VA – for patients with CH, in BA – for patients with M and CH. In the group of patients with CH, the leading hemodynamic pattern was the presence of vasospastic reactions in the vertebral vessels. Pulsation indices increased in patients with TTH in MCA, as well as in patients with CH in PMA and BA. The predominance of the peak-like spectrum of the Doppler curve was noted in MCA in patients with M and in VA in patients with CH.

Sigma-1 receptor-regulated efferocytosis by infiltrating circulating macrophages/microglial cells protects against neuronal impairments and promotes functional recovery in cerebral ischemic stroke.

Background: Efferocytosis of apoptotic neurons by macrophages is essential for the resolution of inflammation and for neuronal protection from secondary damage. It is known that alteration of the Sigma-1 receptor (Sig-1R) is involved in the pathological development of some neurological diseases, including ischemic stroke. The present study aimed to investigate whether and how Sig-1R regulates the phagocytic activity of macrophages/microglia and its significance in neuroprotection and neurological function in stroke. Methods: The roles of Sig-1R in the efferocytosis activity of microglia/macrophages using bone marrow-derived macrophages (BMDMs) or using Sig-1R knockout mice subjected to transient middle artery occlusion (tMCAO)-induced stroke were investigated. The molecular mechanism of Sig-1R in the regulation of efferocytosis was also explored. Adoptive transfer of Sig-1R intact macrophages to recipient Sig-1R knockout mice with tMCAO was developed to observe its effect on apoptotic neuron clearance and stroke outcomes. Results: Depletion of Sig-1R greatly impaired the phagocytic activity of macrophages/microglia, accordingly with worsened brain damage and neurological defects in Sig-1R knockout mice subjected to tMCAO. Adoptive transfer of Sig-1R intact bone marrow-derived macrophages (BMDMs) to Sig-1R knockout mice restored the clearance activity of dead/dying neurons, reduced infarct area and neuroinflammation, and improved long-term functional recovery after cerebral ischemia. Mechanistically, Sig-1R-mediated efferocytosis was dependent on Rac1 activation in macrophages, and a few key sites of Rac1 in its binding pocket responsible for the interaction with Sig-1R were identified. Conclusion: Our data provide the first evidence of the pivotal role of Sig-1R in macrophage/microglia-mediated efferocytosis and elucidate a novel mechanism for the neuroprotection of Sig-1R in ischemic stroke.