Model Of Microcirculation Research Articles

The suppression of OTUD7B by miR-491-5p enhances the ubiquitination of VEGFA to suppress vascular mimicry in non-small cell lung cancer.

Non-small cell lung cancer (NSCLC) is the main type of lung cancer with high morbidity and mortality. Vascular mimicry (VM), a distinct microcirculation model in tumors that differs from classical angiogenesis, is strongly associated with poor clinical outcomes in cancer patients. miR-491-5p has been reported to prevent NSCLC progression, including proliferation, metastasis, and angiogenesis. However, the effect and mechanism of miR-491-5p on VM have not been studied in NSCLC. The expression of miR-491-5p was detected by quantitative reverse transcription PCR (qPCR) and fluorescence in situ hybridization (FISH). Cell counting kit-8 (CCK-8) and 5-ethynyl-2'-deoxyuridine (EdU) staining assays were used to examine cell growth. Tube formation assay was used to assess VM in NSCLC cells. Immunohistochemistry (IHC) and western blot were performed to detect protein expression. Immunoprecipitation was used to confirm the interaction between OTU deubiquitinase 7B (OTUD7B) and vascular endothelial growth factor A (VEGFA), and the level of ubiquitinated VEGFA. A nude mouse tumorigenesis model was used to evaluate the carcinogenic capacity of NSCLC cells in vivo. Luciferase reporter assay was used to identify the potential target of miR-491-5p. MiR-491-5p was found downregulated in NSCLC tissues, and miR-491-5p deficiency was strongly associated with angiogenesis. miR-491-5p mimics suppressed cell viability, migration, and VM. Conversely, an inhibitor of miR-491-5p had the opposite effect. OTUD7B, a deubiquitinase, was identified as a downstream target of miR-491-5p. A luciferase reporter assay indicated that miR-491-5p directly binds to the 3'UTR of OTUD7B. Moreover, mimics of miR-491-5p caused a significant reduction in the OTUD7B protein in NSCLC cells, and an inhibitor of miR-491-5p stabilized the OTUD7B protein. In addition, overexpression of OTUD7B promoted cell proliferation, migration, and VM, similar to the effects of an inhibitor of miR-491-5p. Further exploration revealed that OTUD7B interacts with VEGFA and that the miR-491-5p-OTUD7B axis modulates the ubiquitination of VEGFA. The rescue experiment indicated that OTUD7B compromised the inhibitory effects of miR-491-5p on the cellular function of NSCLC cells. Overall, our study first proved that miR-491-5p impedes VM by suppressing OUTD7B and promoting the ubiquitination of VEGFA. The miR-491-5p/OTUD7B axis may be a novel target for antiangiogenic therapy in NSCLC.

A multi-domain model for microcirculation in optic nerve: Blood flow and oxygen transport

Microcirculation of blood and transport of oxygen play important roles in the biological function of the optic nerve and its diseases. This work develops a multi-domain model for the optic nerve, that includes important biological structures and various physical mechanisms in blood flow and oxygen delivery. The two vascular networks are treated as five domains in the same geometric region, with various exchanges among them (such as Darcy’s law for fluid flow) and with the tissue domain (such as water leak, diffusion). The numerical results of the coupled model for a uniform case of vasculature distribution show mechanisms and scales consistent with literature and intuition. The effects of various important model parameters (relevant to pathological conditions) are investigated to provide insights into the possible implications. The vasculature distribution (resting volume fractions here) has significant impacts on the blood circulation and could lead to insufficient blood supply in certain local regions and thereby affect the delivery of oxygen. The water leak across the capillary wall will have nontrivial effects after the leak coefficients pass a threshold. The pulsatile arterial pressure leads to expected pulsatile patterns and stable spatial profiles, and the uniform case is almost the averaged version of pulsatile case. The effects of viscosity, the stiffness of blood vessel wall, oxygen demand, etc. have also been analyzed. The framework can be extended to include ionic transport or to study the retina when more biological structural information is available.

The deubiquitinase USP7 and E3 ligase TRIM21 regulate vasculogenic mimicry and malignant progression of RMS by balancing SNAI2 homeostasis

BackgroundRhabdomyosarcoma (RMS) is a rare malignancy and the most common soft tissue sarcoma in children. Vasculogenic mimicry (VM) is a novel tumor microcirculation model different from traditional tumor angiogenesis, which does not rely on endothelial cells to provide sufficient blood supply for tumor growth. In recent years, VM has been confirmed to be closely associated with tumor progression. However, the ability of RMS to form VM has not yet been reported.MethodsImmunohistochemistry, RT-qPCR and western blot were used to test the expression level of SNAI2 and its clinical significance. The biological function in regulating vasculogenic mimicry and malignant progression of SNAI2 was examined both in vitro and in vivo. Mass spectrometry, co-immunohistochemistry, immunofluorescence staining, and ubiquitin assays were performed to explore the regulatory mechanism of SNAI2.ResultsOur study indicated that SNAI2 was abnormally expressed in patients with RMS and RMS cell lines and promoted the proliferation and metastasis of RMS. Through cell tubule formation experiments, nude mice Matrigel plug experiments, and immunohistochemistry (IHC), we confirmed that RMS can form VM and that SNAI2 promotes the formation of VM. Due to SNAI2 is a transcription factor that is not easily drugged, we used Co-IP combined with mass spectrometry to screen for the SNAI2-binding protein USP7 and TRIM21. USP7 depletion inhibited RMS VM formation, proliferation and metastasis by promoting SNAI2 degradation. We further demonstrated that TRIM21 is expressed at low levels in human RMS tissues and inhibits VM in RMS cells. TRIM21 promotes SNAI2 protein degradation through ubiquitination in the RMS. The deubiquitinase USP7 and E3 ligase TRIM21 function in an antagonistic rather than competitive mode and play a key role in controlling the stability of SNAI2 to determine the VM formation and progression of RMS.ConclusionOur findings reveal a previously unknown mechanism by which USP7 and TRIM21 balance the level of SNAI2 ubiquitination, determining RMS vasculogenic mimicry, proliferation, and migration. This new mechanism may provide new targeted therapies to inhibit the development of RMS by restoring TRIM21 expression or inhibiting USP7 expression in RMS patients with high SNAI2 protein levels.

Mechanisms of coronary sinus reducer for treatment of myocardial ischemia: in silico study.

The coronary sinus reducer (CSR) is an emerging medical device for treating patients with refractory angina, often associated with myocardial ischemia. Patients implanted with CSR have shown positive outcomes, but the underlying mechanisms are unclear. This study sought to understand the mechanisms of CSR by investigating its effects on coronary microcirculation hemodynamics that may help explain the therapy's efficacy. We applied a validated computer model of the coronary microcirculation to investigate how CSR affects hemodynamics under different degrees of coronary artery stenosis. With moderate coronary stenosis, an increase in capillary transit time (CTT) [up to 69% with near-complete coronary sinus (CS) occlusion] is the key change associated with CSR. Because capillaries in the microcirculation can still receive oxygenated blood from the upstream artery with moderate stenosis, the increase in CTT allows more time for the exchange of gases and nutrients, aiding tissue oxygenation. With severe coronary stenosis; however, the redistribution of blood draining from the nonischemic region to the ischemic region (up to 96% with near-complete CS occlusion) and the reduction in capillary flow heterogeneity are the key changes associated with CSR. Because blood draining from the nonischemic region is not completely devoid of O2, the redistribution of blood to the capillaries in the ischemic region by CSR is beneficial especially when little or no oxygenated blood reaches these capillaries. This simulation study provides insights into the mechanisms of CSR in improving clinical symptoms. The mechanisms differ with the severity of the upstream stenosis.NEW & NOTEWORTHY Emerging coronary venous retroperfusion treatments, particularly coronary sinus reducer (CSR) for refractory angina linked to myocardial ischemia, show promise; however, their mechanisms of action are not well understood. We find that CSR's effectiveness varies with the severity of coronary stenosis. In moderate stenosis, CSR improves tissue oxygenation by increasing capillary transit time, whereas in severe stenosis, it redistributes blood from nonischemic to ischemic regions and reduces capillary flow heterogeneity.

Real-time model-based cerebral perfusion calculation for ischemic stroke

Background and ObjectivesClinical diagnosis of ischemic stroke commonly relies on examining cerebral perfusion changes by using computed tomography perfusion (CTP) techniques. However, the radiation dose in CTP is quite higher in comparison to computed tomography angiography (CTA), with associated costs and time. MethodsHence, this study established a lumped-parameter model (LPM) of brain tissue microcirculation (BTM) based on CTA, aiming to achieve real-time calculation of cerebral perfusion. After validation of calculated flow results with clinical data, the BTM-LPM model was used to examine the changes in cerebral perfusion following ischemic stroke, in which the effects of nine anatomical structures of the Circle of Willis (CoW) together with various distribution patterns of stenosis in the feeding arteries were considered. ResultsWhen compared the calculated flow results from BTM-LPM with the clinically measured data of literature, the mean squared error (MSE) value for the feeding arteries was 3.9 % and its total value for microcirculatory flow in each region was 0.1 %. Notably, the calculation time was 35.6 s. In the case of the CoW missing the left and right posterior communicating artery, a 60 % stenosis of the basilar artery is likely to cause ischemic damage to some temporal and occipital lobes of the right and left hemispheres. While in the case of the CoW missing the anterior communicating artery and the left posterior communicating artery, ischemic damage to the entire frontal lobe and parts of the temporal and parietal lobes of the left hemisphere was found when 80 % stenosis occurred in the left internal carotid artery. ConclusionsThe BTM-LPM proposed in this study could accurately calculate cerebral perfusion in real time and demonstrated the importance of CoW anatomy in different ischemic injuries to cerebral tissue. The calculated cerebral perfusion would be a reference value for early diagnosis and preoperative planning of different ischemic injuries to cerebral tissue, thereby the BTM-LPM holds great promising for replacing CTP examination.

Extended-volume image-derived models of coronary microcirculation.

Recent advances in tissue clearing and high-throughput imaging have enabled the acquisition of extended-volume microvasculature images at a submicron resolution. The objective of this study was to extract information from this type of images by integrating a sequence of 3D image processing steps on Terabyte scale datasets. We acquired coronary microvasculature images throughout an entire short-axis slice of a 3-month-old Wistar-Kyoto rat heart. This dataset covered 13 × 10 × 0.6 mm at a resolution of 0.933 × 0.933 × 1.866 μm and occupied 700 Gigabytes of disk space. We used chunk-based image segmentation, combined with an efficient graph generation technique, to quantify the microvasculature in the large-scale images. Specifically, we focused on the microvasculature with a vessel diameter up to 15 μm. Morphological data for the complete short-axis ring were extracted within 16 h using this pipeline. From the analyses, we identified that microvessel lengths in the rat coronary microvasculature varied from 6 to 300 μm. However, their distribution was heavily skewed toward shorter lengths, with a mode of 16.5 μm. In contrast, vessel diameters ranged from 3 to 15 μm and had an approximately normal distribution of 6.5 ± 2 μm. The tools and techniques from this study will serve other investigations into the microcirculation, and the wealth of data from this study will enable the analysis of biophysical mechanisms using computer models.

Effect of resin photopolymerization on primary teeth pulpal temperature change.

Purpose: The polymerization of restorative materials has the potential to increase pulpal temperature and may result in damage to the health of pulpal tissue. The aim of this study is to investigate the pulpal temperature change of primary teeth with two LED light-curing units (Valo Cordless®, EliparTM DeepCure-S) and three restorative groups (Filtek™ Bulk Fill Flowable, Filtek™ Z250 Universal Restorative and empty cavity) by using a microcirculation model.
 Material and Methods: Ten sound human maxillary second primary molars were used. Standardized Class V cavity preparations were performed with a dentin thickness of 1 mm and restorative groups were cured with LED light-curing units. The highest temperature point in the pulp chamber was recorded. A repeated measures ANOVA and paired samples t-test were used for analysis of the data (𝑝

Swirling of vesicles: Shapes and dynamics in Poiseuille flow as a model of RBC microcirculation

Soft particles display a rich zoology of dynamics with bifurcation dynamics depending on the interfacial mechanical response. One intriguing issue is the origin of motions along helices, a dynamic only observed with active particles. Numerical simulations of a vesicle, a passive particle in Poiseuille flow, show that this dynamic called swirling is in fact more ubiquitous and emerges spontaneously. Swirling is the ultimate state of the symmetry loss sequence parachute \ensuremath{\rightarrow} croissant \ensuremath{\rightarrow} slipper \ensuremath{\rightarrow} swirling, where the last symmetry lost is the mirror plane of the slipper.

Effect of Ylang-Ylang (Cananga odorata Hook. F. & Thomson) Essential Oil on Acute Inflammatory Response In Vitro and In Vivo.

The aim of this study is to evaluate the phytochemical profile, oral acute toxicity, and the effect of ylang-ylang (Cananga odorata Hook. F. & Thomson) essential oil (YEO) on acute inflammation. YEO was analyzed by gas chromatography/mass spectrometry. For in vitro tests, YEO was assessed using cytotoxicity, neutrophil chemotaxis induced by N-formyl methionyl leucyl phenylalanine (fMLP), and phagocytic activity tests. YEO was orally administered in zymosan-induced peritonitis, carrageenan-induced leukocyte rolling, and adhesion events in the in situ microcirculation model and in carrageenan-induced paw edema models. YEO (2000 mg/kg) was also tested using an acute toxicity test in Swiss mice. YEO showed a predominance of benzyl acetate, linalool, benzyl benzoate, and methyl benzoate. YEO did not present in vitro cytotoxicity. YEO reduced the in vitro neutrophil chemotaxis induced by fMLP and reduced the phagocytic activity. The oral treatment with YEO reduced the leukocyte recruitment and nitric oxide production in the zymosan-induced peritonitis model, reduced rolling and adherent leukocyte number induced by carrageenan in the in situ microcirculation model, and reduced carrageenan-induced edema and mechanical hyperalgesia. YEO did not present signs of toxicity in the acute toxicity test. In conclusion, YEO affected the leukocyte activation, and presented antiedematogenic, anti-hyperalgesic, and anti-inflammatory properties.

Effect of Collateral Flow on Catheter-Based Assessment of Cardiac Microvascular Obstruction

Cardiac microvascular obstruction (MVO) associated with acute myocardial infarction (heart attack) is characterized by partial or complete elimination of perfusion in the myocardial microcirculation. A new catheter-based method (CoFI, Controlled Flow Infusion) has recently been developed to diagnose MVO in the catheterization laboratory during acute therapy of the heart attack. A porcine MVO model demonstrates that CoFI can accurately identify the increased hydraulic resistance of the affected microvascular bed. A benchtop microcirculation model was developed and tuned to reproduce in vivo MVO characteristics. The tuned benchtop model was then used to systematically study the effect of different levels of collateral flow. These experiments showed that measurements obtained in the catheter-based method were adversely affected such that collateral flow may be misinterpreted as MVO. Based on further analysis of the measured data, concepts to mitigate the adverse effects were formulated which allow discrimination between collateral flow and MVO.

Vasculogenic Mimicry-An Overview.

Vasculogenic mimicry (VM), a tumor microcirculation model found in melanoma in the last 20years, is a vascular channel-like structure composed of tumor cells, but without endothelial cells, that stains positive for periodic acid-Schiff (PAS) and negative staining for CD31. VM provides, to the highly aggressive malignant tumor cells, adequate oxygen and nutrient supply for tumor growth and subsequent metastasis process and its presence are related to poor prognosis in patients. VM is independent of endothelial cells, which may partly explain why angiogenesis drug inhibitors have not achieved the expected success for cancer treatment.

Plasma components to protect the endothelial barrier after shock: A role for sphingosine 1-phosphate

BackgroundHemorrhagic shock leads to endothelial glycocalyx shedding, endothelial cellular inflammation, and increased vascular permeability. Early plasma administration improves survival in severely injured patients; this may be due in part to its ability to ameliorate this trauma-induced endotheliopathy. The protective effect of early plasma administration may be due to its sphingosine 1-phosphate content. Principle carriers of plasma sphingosine 1-phosphate include apolipoprotein M and albumin. The relative roles of these carriers on sphingosine 1-phosphate protective effects are unknown and were studied in an in vitro model of microcirculation. MethodsEndothelial cell monolayers were established in microfluidic perfusion devices and exposed to control or biomimetic shock conditions. Sphingosine 1-phosphate, albumin + sphingosine 1-phosphate, or apolipoprotein M + sphingosine 1-phosphate were added later to the perfusate. Biomarkers of endothelial and glycocalyx activation and damage were then determined. ResultsSphingosine 1-phosphate preserved endothelial and glycocalyx barrier function after exposure to conditions of shock in the microcirculation. The protective effect was related to sphingosine 1-phosphate chaperones; the apolipoprotein M loaded with sphingosine 1-phosphate had the most profound effect. ConclusionCarrier-based sphingosine 1-phosphate may be a useful adjunct in early hemorrhagic shock resuscitation.

Bio-Mechanical and Bio-Rheological Aspects of Sickle Red Cells in Microcirculation: A Mathematical Modelling Approach

Sickle cell disease (SCD) is an inherited monogenic disease characterized by distorted red blood cells that causes vaso-occlusion and vasculopathy. Presently, electrophoresis of haemoglobin and genotyping are used as routine tests for diagnosis of the SCD. These techniques require specialized laboratories and are expensive. The low-cost microfluidics-based diagnostic tool holds a great attention for screening of red blood cell (RBC) deformability. In the present study, lubrication theory has been applied in order to develop a biomechanical model of microcirculation with altered rheological properties of sickle blood in the capillary, which is smaller in size compared to the cell diameter, to explain the multifactorial nature and pathogenesis of vaso-occlusion in SCD. The governing equations have been solved analytically for realistic boundary conditions and simulated using MATLAB. We found that the axial velocity of the cell decreases with a decrease in deformability and compliance. The height of the lubricating film predicts deformation of the cell with respect to local pressure in the microcirculation. Leak back and drag force depend non-linearly on the deformed cell radius with varying viscosity of the plasma and Reynolds number. The modelling predictions of this study is in coherence with experimental results. The analyzed parameters provide unique insights with novel possibilities to design a microfluidics-based effective therapeutic intervention for SCD.

A porous circulation model of the human brain for in silico clinical trials in ischaemic stroke: A human brain model for ischaemic stroke

The advancement of ischaemic stroke treatment relies on resource-intensive experiments and clinical trials. In order to improve ischaemic stroke treatments, such as thrombolysis and thrombectomy, we target the development of computational tools for in silico trials which can partially replace these animal and human experiments with fast simulations. This study proposes a model that will serve as part of a predictive unit within an in silico clinical trial estimating patient outcome as a function of treatment. In particular, the present work aims at the development and evaluation of an organ-scale microcirculation model of the human brain for perfusion prediction. The model relies on a three-compartment porous continuum approach. Firstly, a fast and robust method is established to compute the anisotropic permeability tensors representing arterioles and venules. Secondly, vessel encoded arterial spin labelling magnetic resonance imaging and clustering are employed to create an anatomically accurate mapping between the microcirculation and large arteries by identifying superficial perfusion territories. Thirdly, the parameter space of the problem is reduced by analysing the governing equations and experimental data. Fourthly, a parameter optimization is conducted. Finally, simulations are performed with the tuned model to obtain perfusion maps corresponding to an open and an occluded (ischaemic stroke) scenario. The perfusion map in the occluded vessel scenario shows promising qualitative agreement with computed tomography images of a patient with ischaemic stroke caused by large vessel occlusion. The results highlight that in the case of vessel occlusion (i) identifying perfusion territories is essential to capture the location and extent of underperfused regions and (ii) anisotropic permeability tensors are required to give quantitatively realistic estimation of perfusion change. In the future, the model will be thoroughly validated against experiments.

Does the heat generated by fluorescence-aided caries excavation system effect the pulp temperature of primary teeth irreversibly? An in-vitro evaluation of the temperature changes in the pulp chamber.

BackgroundThis study aimed to analyze the effect of the Fluorescence Aided Caries Excavation (FACE) and the remaining dentin thickness on the temperature changes of the pulp chamber. Material and MethodsFreshly extracted deciduous molars and a pulpal microcirculation model were used in the study. The sample size was calculated according to power analyses (power at 90%) based on previous studies. Thus, 40 samples were needed. Standard cavities (3x3 mm) were designed to obtain a 2 mm distance through to the pulp chamber, and in each tooth (n=10), these cavities were modified to obtain 1.5 mm, 1mm, and 0.5 mm final distance through to the pulp. Coronal parts of the teeth were placed on an acrylic plate with three gaps for feeding and extraction needles and the thermocouple. The temperature changes were recorded from the initial time to 15 s and 30 s,1 min, 1.5 min, 2 min, 2.5 min, 3 min intervals. ResultsThe results showed that hence the thickness between cavity floor and pulp chamber was decreased, and application time of FACE was increased, an increase in temperature changes was detected. However, the recorded values were not mean to cause irreversible damages to the pulp chamber. ConclusionsThe recent study showed that Face is an appropriate caries detecting system that does not affect the pulp chamber’s health, and it can be safely used in the primary teeth. Key words:Caries assessment, dental caries, dental pulp, pediatric dentistry.

A porous circulation model of the human brain for in silico clinical trials in ischaemic stroke.

The advancement of ischaemic stroke treatment relies on resource-intensive experiments and clinical trials. In order to improve ischaemic stroke treatments, such as thrombolysis and thrombectomy, we target the development of computational tools for in silico trials which can partially replace these animal and human experiments with fast simulations. This study proposes a model that will serve as part of a predictive unit within an in silico clinical trial estimating patient outcome as a function of treatment. In particular, the present work aims at the development and evaluation of an organ-scale microcirculation model of the human brain for perfusion prediction. The model relies on a three-compartment porous continuum approach. Firstly, a fast and robust method is established to compute the anisotropic permeability tensors representing arterioles and venules. Secondly, vessel encoded arterial spin labelling magnetic resonance imaging and clustering are employed to create an anatomically accurate mapping between the microcirculation and large arteries by identifying superficial perfusion territories. Thirdly, the parameter space of the problem is reduced by analysing the governing equations and experimental data. Fourthly, a parameter optimization is conducted. Finally, simulations are performed with the tuned model to obtain perfusion maps corresponding to an open and an occluded (ischaemic stroke) scenario. The perfusion map in the occluded vessel scenario shows promising qualitative agreement with computed tomography images of a patient with ischaemic stroke caused by large vessel occlusion. The results highlight that in the case of vessel occlusion (i) identifying perfusion territories is essential to capture the location and extent of underperfused regions and (ii) anisotropic permeability tensors are required to give quantitatively realistic estimation of perfusion change. In the future, the model will be thoroughly validated against experiments.

Implications of Integrated Pancreatic Microcirculation: Crosstalk between Endocrine and Exocrine Compartments.

The endocrine and exocrine pancreas have been studied separately by endocrinologists and gastroenterologists as two organ systems. The pancreatic islet, consisting of 1-2% mass of the whole pancreas, has long been believed to be regulated independently from the surrounding exocrine tissues. Particularly, islet blood flow has been consistently illustrated as one-way flow from arteriole(s) to venule(s) with no integration of the capillary network between the endocrine and exocrine pancreas. It is likely linked to the long-standing dogma that the rodent islet has a mantle of non-β-cells and that the islet is completely separated from the exocrine compartment. A new model of islet microcirculation is built on the basis of analyses of in vivo blood flow measurements in mice and an in situ three-dimensional structure of the capillary network in mice and humans. The deduced integrated blood flow throughout the entire pancreas suggests direct interactions between islet endocrine cells and surrounding cells as well as the bidirectional blood flow between the endocrine and exocrine pancreas, not necessarily a unidirectional blood flow as in a so-called insuloacinar portal system. In this perspective, we discuss how this conceptual transformation could potentially affect our current understanding of the biology, physiology, and pathogenesis of the islet and pancreas.

An adaptive fractal model for sublingual microcirculation

The hemodynamic conditions and partial pressure of oxygen in microcirculation generally indicate the status of tissue perfusion, which provides essential information for the assessment and treatment of critical diseases such as sepsis. The human tongue is known to have abundant microcirculation and is an ideal window to observe the microcirculation. At present, the monitoring of sublingual microcirculation is mostly achieved using handheld vital microscopy (HVM). Microcirculation is organized and works as a network. However, HVM can obtain only limited view of few vessels and is not able to acquire information regarding the entire network. In this work, we proposed a method to construct a mathematical network model of sublingual microcirculation to solve the problems. The proposed method is based on fractal analysis to model and simulate the hemodynamic and functional activities of sublingual microcirculation. Specifically, the HVM technology is used to obtain the partial morphological and hemodynamic data of sublingual microcirculation, and fractal analysis is applied thereafter to establish the hemodynamic model of the network based on the data from few vessels. Further, the adaptive regulation mechanism of microcirculation is introduced to enhance the performance of the model. The model was validated by the experimental data and the results are consistent with the characteristics of microcirculation. The work demonstrates the potential of the proposed method in sublingual microcirculation research and for the further assessment of tissue perfusion.

Obesity blunts cephalic-phase microvascular responses to food

Neurally mediated anticipatory responses, also named cephalic-phase responses, and microcirculatory regulation are two important mechanisms to maintain metabolic homeostasis. Altered cephalic-phase responses in obesity and its metabolic consequences have been proposed. There is, however, a lack of studies focusing on in vivo assessment of the microcirculation during this phase in patients with obesity. In this randomized controlled trial, we selected patients with obesity and healthy subjects after clinical and laboratory assessments. Those with obesity were randomized into two groups: experimental (cephalic-phase microvascular response stimulation – CP group, n = 13) and controls (n = 14). Healthy subjects (n = 17) were also included to form a CP control group. Skin microvascular assessment was used as a model of systemic microcirculation. Resting functional capillary density (FCD) and peak FCD during post-occlusive reactive hyperemia (PORH) were measured by dorsal finger videocapillaroscopy and expressed mainly capillary recruitment capacity. Resting red blood cell velocity (RBCV), peak RBCV during PORH (RBCVmax), and time taken to reach RBCVmax (TRBCVmax) were assessed by dynamic nailfold videocapillaroscopy and expressed the microhemodynamics. Patients with obesity (with or without stimulus) failed to show an increase on FCD during PORH post-stimulus (p = 0.221 and p = 0.307, respectively) depicting lack of capillary recruitment. In contrast, healthy subjects presented an increase in this microvascular outcome (p = 0.004). Changes in all variables of microhemodynamics occurred in both CP groups (healthy and those with obesity). During CP, we originally demonstrated an absence of capillary recruitment in subjects with obesity. These findings might contribute to the literature of microvascular impairment and metabolic conditions.

The experience of polyhexanide usage as a part of wet environment in the treatment of limited burns

INTRODUCTION. The results of the treatment of patients with restrictive burns I-II degrees are presented in the article. The OBJECTIVE of the research was to establish the efficiency of the usage of polyhexanide included in wet environment in the treatment of burns I-II degrees. METHODS AND MATERIALS. The research was conducted in 2 groups of patients. In the first group (N=33), local treatment of hand wounds was performed in condition of wet environment created by isotonic solution of sodium chloride, in the second group (N=18) - with usage of polyhexanide as antiseptic and isotonic chloride saline solution. For evaluation of efficiency of the treatment, we studied the terms of the beginning of epithelialization of the wound surface, pain syndrome severity, microcirculation and conducted microbiological research of wound exudate. RESULTS. The appearance of the first signs of wound epithelialization after the beginnings of treatment was observed in 1.5 times in average sooner in the second group than in the first group. Pain syndrome was jugulated by the 3rd day in the first (research) group in 19 % of cases, in the second (control) group - in 46 % (p<0.05). In the second group, perfusion of tissues in the border area reduced, in the same time in the first group, it remained unchanged. The number of swabbing cases with Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae and Enterococcus faecalis increased in the first group by the 3rd day in contrast with the second group, where such cases was not noted or occurred significantly less often. CONCLUSION. The usage of polyhexanide as a part of wet environment promotes the reduction of wound surface swabbing level that allows to speed up the appearance of the first signs of wound epithelialization, reduces the severity of pain syndrome, and modeling of tissue microcirculation in periwound area.