Blood Flow Status Research Articles

Analysis of Umbilical Artery Hemodynamics in Development of Intrauterine Growth Restriction Using Computational Fluid Dynamics with Doppler Ultrasound.

Intrauterine growth restriction (IUGR), the failure of the fetus to achieve his/her growth potential, is a common and complex problem in pregnancy. Clinically, IUGR is usually monitored using Doppler ultrasound of the umbilical artery (UA). The Doppler waveform is generally divided into three typical patterns in IUGR development, from normal blood flow (Normal), to the loss of end diastolic blood flow (LDBF), and even to the reversal of end diastolic blood flow (RDBF). Unfortunately, Doppler ultrasound hardly provides complete UA hemodynamics in detail, while the present in silico computational fluid dynamics (CFD) can provide this with the necessary ultrasound information. In this paper, CFD is employed to simulate the periodic UA blood flow for three typical states of IUGR, which shows comprehensive information on blood flow velocity, pressure, and wall shear stress (WSS). A new finding is the "hysteresis effect" between the UA blood flow velocity and pressure drop in which the former always changes after the latter by 0.1-0.2 times a cardiac cycle due to the unsteady flow. The degree of hysteresis is a promising indicator characterizing the evolution of IUGR. CFD successfully shows the hemodynamic details in different development situations of IUGR, and undoubtedly, its results would also help clinicians to further understand the relationship between the UA blood flow status and fetal growth restriction.

Cerebral Infarct Growth: Pathophysiology, Pragmatic Assessment, and Clinical Implications.

Cerebral ischemic injury occurs when blood flow drops below a critical level, resulting in an energy failure. The progressive transformation of hypoperfused viable tissue, the ischemic penumbra, into infarction is a mechanism shared by patients with ischemic stroke if timely reperfusion is not achieved. Yet, the pace at which this transformation occurs, known as the infarct growth rate (IGR), exhibits remarkable heterogeneity among patients, brain regions, and over time, reflecting differences in compensatory collateral flow and ischemic tolerance. We review (1) the pathophysiology of infarct growth, (2) the advantages and pitfalls of different approaches of IGR measurement, (3) research gaps for future studies, and (4) the clinical implications of stroke progressor phenotypes. The estimated average IGR in patients with acute large vessel occlusion stroke is 5.4 mL/h although there is wide variability based on ischemic stroke subtype, occlusion location, presence of collaterals, and patient baseline status. The IGR can be calculated using various pragmatic strategies, mostly either quantifying the extension of the infarct at a particular time and dividing this measure by the time that elapsed from symptom onset to imaging assessment or by using collateral blood flow status as a radiological surrogate marker. The IGR defines a spectrum of clinical stroke phenotypes, often dichotomized into fast and slow progressors. An IGR ≥10 mL/h and the perfusion metric hypoperfusion intensity ratio ≥0.5 are commonly used definitions of fast progressors. A nuanced understanding of the IGR and stroke progressor phenotypes could have clinical implications, including informing prognostication, acute decision-making in peripheral-to-comprehensive transfer patients eligible for thrombectomy, and selection for adjuvant neuroprotective agents.

Analyses of gingival papilla blood flow via color doppler flow imaging and micro-flow imaging in patients with advanced periodontitis: a clinical pilot study

BackgroundResearch investigating the potential link between gingival microvascular blood flow and inflammatory status is scarce. This study aims to assess color doppler flow imaging (CDFI) and micro-flow imaging (MFI) as tools for the assessment of gingival papilla blood flow (GPBF) and to examine their diagnostic utility as a noninvasive means of detecting gingival bleeding.MethodsCDFI and MFI were used to assess the GPBF grade (0–4) of 140 anterior gingival papilla sites in advanced periodontitis patients. Correlations between GPBF grades and periodontal characteristics were examined, and diagnostic performance as a means of predicting bleeding on probing (BOP) was examined using receiver operating characteristic curves.ResultsGPBF grades 0 and 1 assessed by the MFI were 14.29% and 15.71% respectively, lower than the 28.57% and 24.29% assessed by the CDFI. In contrast, MFI detected a higher frequency of GPBF grade 2 sites (40.71%) relative to CDFI (22.14%). The CDFI and MFI provided consistent results in 62.14% of the sites, while the MFI demonstrated higher ratings in rest 37.86% of the sites. A significant positive correlation was detected between GPBF grade and the modified gingival index (MGI), bleeding index (BI), BOP, and probing depth (PD). It showed high accuracy for CDFI or MFI to diagnosing BOP with a sensitivity of 80.51% and 96.43% and a specificity of 77.27% and 57.14%, respectively. Area under the receiver operator characteristic curve values when predicting BOP based on the GPBF grade determined using CDFI and MFI approaches 0.887 (95% CI 0.833–0.942) and 0.917 (95% CI 0.862–0.972), respectively, and there were no significant differences between these values (Z = − 1.502, p = 0.133).ConclusionsBoth MFI and CDFI can be employed for the evaluation of GPBF, and MFI is better suited to detecting mild inflammation.Trial registration ChiCTR2200066021 (Date of registration: 22/11/2022).

Resolution of Non-Diabetic Intractable Wounds with Severe Comorbidities Using Autologous Micrografts

The wound healing process is a complex mechanism related to many factors, such as the patient’s comorbidity, blood flow, and nutritional status. This study aimed to retrospectively evaluate patients affected by various disease states and treated with Rigenera® technology, a standardized micrograft preparation system. A total of 8 patients were treated with a suspension of autologous micrografts obtained from mechanical disaggregation of small pieces of skin tissue. The micrografts suspension was applied alone to the wound or in combination with porcine collagen scaffolds directly onto the wound as described in the text. Across all cases, there was marked improvement in wound healing, with a mean healing time of 103 days and a reduction of the diameter of the wounds by 54%. Notably, the use of micrografts resulted in an overall higher quality of life for the patients. This simple and low-cost micrografting procedure that can promote wound healing of different kinds of chronic non-healing wounds and does not require postoperative rest.

The relationship between the state of cerebral blood flow and volemic status in patients with ischemic stroke in the acute period

The objective was to assess the relationship between the state of cerebral blood flow and volemic status in patients with acute ischemic stroke using the laboratory and instrumental parameters.Materials and methods. 51 patients with newly diagnosed ischemic stroke confirmed by MSCT/MRI of the brain were examined within less than 24 hours from the onset of the disease, and 20 practically healthy individuals (control group). To determine cerebral blood flow, the hemodynamic parameters of transcranial Doppler imaging were used: blood flow rates (maximum systolic, diastolic, averaged over time), Gosling’s pulsatility index and Purcelo’s index of peripheral resistance in the anterior, posterior, middle and main cerebral arteries from the affected and intact sides. Volemic status was assessed using laboratory (serum sodium and brain natriuretic peptide NT-pro-BNP) and instrumental parameters (echocardiography – end-diastolic volume of the left ventricle, left ventricular ejection fraction, diameter and degree of collapse on inhalation of the inferior vena cava).Results. Deterioration of the state of cerebral blood flow by speed indicators and an increase in the resistance parameters of the vascular wall was noted in the studied affected and intact arteries against the background of violations of the volemic status by the level of brain natriuretic peptide, end-diastolic volume of the left ventricle, diameter of the inferior vena cava, left ventricular ejection fraction and degree of collapse of the inferior vena cava. There is a correlation of vascular wall resistance parameters with laboratory and instrumental indicators of volemia, since both the development of deficiency and volume overload negatively affect cerebral perfusion.Conclusions. The cerebral blood flow parameters are correlated with the volemic status of patients with ischemic stroke in the acute period.

Effectiveness of different tirofiban administration times in patients with no-reflow myocardial infarction during percutaneous coronary intervention.

To compare the effectiveness of different tirofiban administration time windows in patients with no-reflow myocardial infarction (MI) during percutaneous coronary intervention (PCI). This single centre retrospective observational study included patients with no-reflow MI, undergoing PCI at the Hanyang Hospital affiliated to Wuhan University of Science and Technology from March 2020 to May 2023. All patients were administered tirofiban. Patients who received tirofiban with postinterventional thrombolysis in myocardial infarction (TIMI) flow ≥ 1 were grouped as Group-I, and patients who were directly given tirofiban through the guiding catheter without forward blood flow were grouped as Group-II. TIMI blood flow classification, levels of cardiac troponin T (cTnT) and creatine kinase isoenzyme MB (CK-MB), incidence of complications and major adverse cardiovascular events (MACE) in the two groups before and after the treatment were statistically analyzed. A total of 156 patients were included in this study, including 79 patients in Group-I and 77 patients in Group-II. There was no significant difference in the baseline data between the two groups (P>0.05). After treatment, TIMI blood flow classification of the two groups improved and was significantly better in Group-I compared to Group-II (P<0.05). After treatment, levels of Serum cTnT and CK-MB in the two groups decreased, and were significantly lower in Group-I than in Group-II (P<0.05). There was no significant difference in the incidence of complications between Group-I (3.80%) and Group-II (6.49%) (P>0.05). The incidence of MACE in Group-I (3.80%) was lower than that in Group-II (12.99%) (P<0.05). Compared with the direct application of tirofiban, tirofiban given when TIMI Grade≥ 1 for patients with no-reflow MI during PCI can more effectively regulate the blood flow status of target vessels, reduce myocardial injury, and reduce the risk of MACE.

Benefits of recombinant human brain natriuretic peptide to improve ventricular function and hemodynamics in patients with ST-elevation myocardial infarction.

Abstract. This study aimed to assess the impact of recombinant human brain natriuretic peptide (rh-BNP) on ventricular function and hemodynamics in post-ST-segment elevation myocardial infarction (STEMI). We compared the outcomes of 65 STEMI patients treated with rh-BNP to an equal cohort given tirofiban following percutaneous coronary intervention (PCI). Data collected pre- and post-intervention included biochemical markers, TIMI (Thrombolysis In Myocardial Infarction) grade, hemodynamics, thrombotic score (TS), left ven-tricular ejection fraction (LVEF), high-sensitivity C-reactive protein (CRP) levels, liver and kidney function, and ECG. The TIMI level (p=0.03), the ratio of TIMI myocardial perfusion grade III (p=0.04), and the thrombus score (p&lt;0.001) in the rh-BNP group after the intervention markedly exceeded those in the tirofiban group. After correction, the TIMI frame count (CTFC) (p=0.02), the incidence of slow flow (p=0.02), thrombus score (p&lt;0.001), stent length (p=0.02) as well as times of administration of sodium nitroprusside medication in the rh-BNP group were markedly below those in the tirofiban group (p=0.01). Creatine ki-nase (CK) (p&lt;0.001), CK-MB (p=0.01), and N-terminal pro-b-type natriuretic peptide (NT-proBNP) (p&lt;0.02) in the rh-BNP group were markedly below those the in tirofiban group 24 hours after intervention; and the sum-STR (p&lt;0.03) immediately after intervention markedly exceeded that in the tirofiban group. No significant differences were found in major cardiac adverse events (MACE) between the treatments. At the 30-day follow-up, rh-BNP showed a more effective enhancement of blood flow status, with the safety profiles of both treatments be-ing comparable. The findings suggest that the rh-BNP has significant potential for treating PPCI-related slow flow.

Effect of vascular compression and drug injection time on thrombolytic therapy: Numerical simulation and validation

Venous thromboembolism (VTE) has been occurring frequently in human society. There is an urgent need to study the influence of several factors on thrombolytic therapy, such as the effects of vascular pressure levels (VPL) and the drug injection time (DIT). Considering blood as a non-Newtonian fluid, valve as a hyperelastic material, and thrombus as a porous medium, a new numerical simulation model of biofluid mechanics incorporating fluid–solid coupling phenomena and biochemical substance reactions is established based on the N-S equations and the convection–diffusion reaction equations. Then, a unique in vitro experimental platform is established to verify the correctness of the constructed mathematical model. The results showed that vascular compression resulted in significant differences in blood flow status localized within the vessel. Vascular compression causes the blood boosting index to fluctuate and the valve displacement values are 135% and 158% greater than the lower VPL, respectively. At the same time, vascular compression weakened vortex intensity, accelerated material transport and response, and improved the treatment. Compared with low VPL, the therapeutic efficacy increased by 7% and 15%, respectively. In addition, when the dose of the drug is high, different injection times can increase the therapeutic effect to different degrees, with a maximum difference of 12%. Our in vitro experiments are similar to the results obtained by numerical simulation, which can verify the reliability of numerical simulation. The computational model proposed and the experimental platform designed in this study have the potential to assist in clinical medication prediction in different venous thromboembolism patients.

Exosomes from Hypoxia Preconditioned Muscle-Derived Stem Cells Enhance Cell-Free Corpus Cavernosa Angiogenesis and Reproductive Function Recovery.

Tissue engineering for penile corpora cavernosa defects requires microvascular system reconstruction.GelMA hydrogels show promise for tissue regeneration. However, using stem cells faces challenges such as immune rejection, limited proliferation and differentiation, and biosafety concerns. Therefore, acellular tissue regeneration may avoid these issues. Exosomes are used from muscle-derived stem cells (MDSCs) to modify 3D-printed hydrogel scaffolds for acellular tissue regeneration. Hypoxia-preconditioned MDSC-derived exosomes are obtained to enhance the therapeutic effect. In contrast to normoxic exosomes (N-Exos), hypoxic exosomes (H-Exos) are found to markedly enhance the proliferation, migration, and capillary-like tube formation of human umbilical vein endothelial cells (HUVECs). High-throughput sequencing analysis of miRNAs isolated from both N-Exos and H-Exos revealed a significant upregulation of miR-21-5p in H-Exos following hypoxic preconditioning. Further validation demonstrated that the miR-21-5p/PDCD4 pathway promoted the proliferation of HUVECs. Epigallocatechin gallate (EGCG) is introduced to improve the mechanical properties and biocompatibility of GelMA hydrogels. EGCG-GelMA scaffolds loaded with different types of Exos are transplanted to repair rabbit penile corpora cavernosa defects, observed the blood flow and repair status of the defect site through color Doppler ultrasound and magnetic resonance imaging, and ultimately restored the rabbit penile erection function and successfully bred offspring. Thus, acellular hydrogel scaffolds offer an effective treatment for penile corpora cavernosa defects.

The Efficacy of Ultrasound-Guided Microwave Ablation for Benign Thyroid Nodules and the Correlation Analysis of Its Influencing Factors

Objective: To investigate the efficacy of ultrasound-guided microwave ablation (MWA) for benign thyroid nodules and to analyze the correlation between treatment outcomes and various influencing factors. Methods: 95 patients with pathologically confirmed benign thyroid nodules（ totally 96 nodules) who underwent MWA under ultrasound guidance were enrolled in this retrospective study. Pre-ablation and post-ablation follow-up examinations including two-dimensional ultrasound, color Doppler, and contrast-enhanced ultrasound were conducted at 1, 3, and 6 months. The clinical efficacy was assessed, including the reduction in nodule volume and the success rate of ablation. Factors that might influence treatment outcomes, such as patient age, gender, nodule size, type, and ablation parameters, were analyzed. Statistical correlations were evaluated using Spearman’s correlation coefficient and multiple regression analysis. Results: MWA has demonstrated favorable efficacy in treating benign thyroid nodules, with a low incidence of complications. Most nodules experienced significant volume reduction or even complete disappearance after treatment (P &lt; 0.05). The average volume reduction ratio (VRR) of benign thyroid nodules undergoing MWA at 1 month, 3 months, and 6 months post-operation were 52.98%±22.23%, 68.18%±19.81%, and 82.39%±15.03%, respectively, with a significant reduction rate (VRR &gt; 50%) observed in 95.8% (92/96) of the nodules (VRR &gt; 50%). Cystic nodules exhibited the most substantial volume reduction following ablation. The initial volume of the nodule, blood flow status, nodule composition, and the energy absorption per unit volume were all related to the postoperative VRR (P &lt; 0.05). Factors such as patient age, gender, and ablation duration did not show significant correlation with ablation efficacy (P＞0.05). Conclusion: MWA is a promising minimally invasive treatment for benign thyroid nodules. The treatment efficacy is closely related to the initial volume of the thyroid nodule, the composition of the nodule, the blood flow situation of the nodule, and the ablation energy per unit volume.

The Efficacy of Ultrasound-Guided Microwave Ablation for Benign Thyroid Nodules and the Correlation Analysis of Its Influencing Factors

Objective: To investigate the efficacy of ultrasound-guided microwave ablation (MWA) for benign thyroid nodules and to analyze the correlation between treatment outcomes and various influencing factors. Methods: 95 patients with pathologically confirmed benign thyroid nodules（ totally 96 nodules) who underwent MWA under ultrasound guidance were enrolled in this retrospective study. Pre-ablation and post-ablation follow-up examinations including two-dimensional ultrasound, color Doppler, and contrast-enhanced ultrasound were conducted at 1, 3, and 6 months. The clinical efficacy was assessed, including the reduction in nodule volume and the success rate of ablation. Factors that might influence treatment outcomes, such as patient age, gender, nodule size, type, and ablation parameters, were analyzed. Statistical correlations were evaluated using Spearman’s correlation coefficient and multiple regression analysis. Results: MWA has demonstrated favorable efficacy in treating benign thyroid nodules, with a low incidence of complications. Most nodules experienced significant volume reduction or even complete disappearance after treatment (P &lt; 0.05). The average volume reduction ratio (VRR) of benign thyroid nodules undergoing MWA at 1 month, 3 months, and 6 months post-operation were 52.98%±22.23%, 68.18%±19.81%, and 82.39%±15.03%, respectively, with a significant reduction rate (VRR &gt; 50%) observed in 95.8% (92/96) of the nodules (VRR &gt; 50%). Cystic nodules exhibited the most substantial volume reduction following ablation. The initial volume of the nodule, blood flow status, nodule composition, and the energy absorption per unit volume were all related to the postoperative VRR (P &lt; 0.05). Factors such as patient age, gender, and ablation duration did not show significant correlation with ablation efficacy (P＞0.05). Conclusion: MWA is a promising minimally invasive treatment for benign thyroid nodules. The treatment efficacy is closely related to the initial volume of the thyroid nodule, the composition of the nodule, the blood flow situation of the nodule, and the ablation energy per unit volume.

A Multidisciplinary Approach to End-Stage Limb Salvage in the Highly Comorbid Atraumatic Population: An Observational Study.

Background: The use of free tissue transfer (FTT) is efficacious for chronic, non-healing lower extremity (LE) wounds. The four pillars of managing patient comorbidities, infection control, blood flow status, and biomechanical function are critical in achieving successful limb salvage. The authors present their multidisciplinary institutional experience with a review of 300 FTTs performed for the complex LE limb salvage of chronic LE wounds. Methods: A single-institution, retrospective review of atraumatic LE FTTs performed by a single surgeon from July 2011 to January 2023 was reviewed. Data on patient demographics, comorbidities, preoperative management, intraoperative details, flap outcomes, postoperative complications, and long-term outcomes were collected. Results: A total of 300 patients who underwent LE FTT were included in our retrospective review. Patients were on average 55.9 ± 13.6 years old with a median Charlson Comorbidity Index of 4 (IQR: 3). The majority of patients were male (70.7%). The overall hospital length of stay (LOS) was 27 days (IQR: 16), with a postoperative LOS of 14 days (IQR: 9.5). The most prevalent comorbidities were diabetes (54.7%), followed by peripheral vascular disease (PVD: 35%) and chronic kidney disease (CKD: 15.7%). The average operative LE FTT time was 416 ± 115 min. The majority of flaps were anterolateral thigh (ALT) flaps (52.7%), followed by vastus lateralis (VL) flaps (25.3%). The immediate flap success rate was 96.3%. The postoperative ipsilateral amputation rate was 12.7%. Conclusions: Successful limb salvage is possible in a highly comorbid patient population with a high prevalence of diabetes mellitus, peripheral vascular disease, and end-stage renal disease. In order to optimize patients prior to their LE FTT, extensive laboratory, arterial, and venous preoperative testing and diabetes management are needed preoperatively. Postoperative monitoring and long-term follow-up with a multidisciplinary team are also crucial for long-term limb salvage success.

Evaluation of incision healing status after transverse uterine fundal incision for cesarean delivery and postoperative pregnancy: a ten-year single-center retrospective study

BackgroundTransverse uterine fundal incision (TUFI) is a beneficial procedure for mothers and babies at risk due to placenta previa-accreta, and has been implemented worldwide. However, the risk of uterine rupture during a subsequent pregnancy remains unclear. We therefore evaluated the TUFI wound scar to determine the approval criteria for pregnancy after this surgery.MethodsBetween April 2012 and August 2022, we performed TUFI on 150 women. Among 132 of the 150 women whose uteruses were preserved after TUFI, 84 women wished to conceive again. The wound healing status, scar thickness, and resumption of blood flow were evaluated in these women by magnetic resonance imaging (MRI) and sonohysterogram at 12 months postoperatively. Furthermore, TUFI scars were directly observed during the Cesarean sections in women who subsequently conceived.ResultsTwelve women were lost to follow-up and one conceived before the evaluation, therefore 71 cases were analyzed. MRI scans revealed that the “scar thickness”, the thinnest part of the scar compared with the normal surrounding area, was ≥ 50% in all cases. The TUFI scars were enhanced in dynamic contrast-enhanced MRI except for four women. However, the scar thickness in these four patients was greater than 80%. Twenty-three of the 71 women conceived after TUFI and delivered live babies without notable problems until August 2022. Their MRI scans before pregnancy revealed scar thicknesses of 50–69% in two cases and ≥ 70% in the remaining 21 cases. And resumption of blood flow was confirmed in all patients except two cases whose scar thickness ≥ 90%. No evidence of scar healing failure was detected at subsequent Cesarean sections, but partial thinning was found in two patients whose scar thicknesses were 50–69%. In one woman who conceived seven months after TUFI and before the evaluation, uterine rupture occurred at 26 weeks of gestation.ConclusionsCertain criteria, including an appropriate suture method, delayed conception for at least 12 months, evaluation of the TUFI scar at 12 months postoperatively, and cautious postoperative management, must all be met in order to approve a post-TUFI pregnancy. Possible scar condition criteria for permitting a subsequent pregnancy could include the scar thickness being ≥ 70% of the surrounding area on MRI scans, at least partially resumed blood flow, and no abnormalities on the sonohysterogram.Trial registrationRetrospectively registered.

Realtime assessment of vascular occlusion and reperfusion in animal models of intraoperative imaging- a pilot study.

Intraoperative monitoring of blood flow (BF) remains vital to guiding surgical decisions. Here, we report the use of SurgeON™ Blood Flow Monitor (BFM), a prototype system that attaches to surgical microscopes and implements laser speckle contrast imaging (LSCI) to noninvasively obtain and present vascular BF information in real-time within the microscope's eyepiece. The ability of SurgeON BFM to monitor BF status during reversible vascular occlusion procedures was investigated in two large animal models: occlusion of saphenous veins in six NZW rabbit hindlimbs and clipping of middle cerebral artery (MCA) branches in four Dorset sheep brain hemispheres. SurgeON BFM acquired, presented, and stored LSCI-based blood flow velocity index (BFVi) data and performed indocyanine green video angiography (ICG-VA) for corroboration. Stored BFVi data were analyzed for each phase: pre-occlusion (baseline), with the vessel occluded (occlusion), and after reversal of occlusion (re-perfusion). In saphenous veins, BFVi relative to baseline reduced to 5.2±3.7 % during occlusion and returned to 102.9±14.9 % during re-perfusion. Unlike ICG-VA, SurgeON BFM was able to monitor reduced BFVi and characterize re-perfusion robustly during five serial occlusion procedures conducted 2-5 min apart on the same vessel. Across four sheep MCA vessels, BFVi reduced to 18.6±7.7 % and returned to 120.1±27.8 % of baseline during occlusion and re-perfusion phases, respectively. SurgeON BFM can noninvasively monitor vascular occlusion status and provide intuitive visualization of BF information in real-time to an operating surgeon. This technology may find application in vascular, plastic, and neurovascular surgery.

Effect of PCI on ophthalmic artery hemodynamics in patients with acute coronary syndrome.

We aimed to explore the effects of percutaneous coronary intervention (PCI) on the ophthalmic artery (OA) hemodynamics in patients with acute coronary syndrome (ACS). A total of 73 participants (Group0: healthy controls, Group1: Patients with ACS underwent PCI < 3 months, Group2: Patients with ACS underwent PCI ≥ 3 months) were enrolled. Computed tomographic angiography images were used to construct three-dimensional models of participants' OAs. Numerical simulations based on computational fluid dynamics were used to acquire hemodynamic parameters. The angle between the OA and internal carotid artery in Group2 was significantly larger compared with Group0 and Group1 (P = 0.003 and P = 0.044). Hemodynamic simulation showed a significantly slower OA blood velocity in Group1 than in the control (P < 0.001) and Group2 (P = 0.033). Lower wall shear stress was found in Group1 than that in control (P = 0.040). Patients after PCI had a higher wall pressure than healthy controls (P = 0.012 and P = 0.004). Mass flow ratios were decreased in Group1 and Group2 (P = 0.021 and P = 0.002). The hemodynamic parameters of OA were correlated with several clinical indicators. The OA blood flow velocity of patients with ACS after PCI initially slowed down, which increased the risk of plaque formation, and then showed an increasing trend. There was a correlation between OA hemodynamic parameters and clinical indexes related to cardiac stress. Ischemia-reperfusion injury and changes in blood flow status after PCI may affect OA morphology and hemodynamics, leading to ocular lesions. ChiCTR2100050428.

Quantitative Assessment of Hemodynamics Associated With Embolization Degree in Brain Arteriovenous Malformations.

Grading systems, including the novel brain arteriovenous malformation endovascular grading scale (NBAVMES) and arteriovenous malformation embocure score (AVMES), predict embolization outcomes based on arteriovenous malformation (AVM) morphological features. The influence of hemodynamics on embolization outcomes remains unexplored. In this study, we investigated the relationship between hemodynamics and embolization outcomes. We conducted a retrospective study of 99 consecutive patients who underwent transarterial embolization at our institution between 2012 and 2018. Hemodynamic features of AVMs were derived from pre-embolization digital subtraction angiography sequences using quantitative digital subtraction angiography. Multivariate logistic regression analysis was performed to determine the significant factors associated with embolization outcomes. Complete embolization (CE) was achieved in 17 (17.2%) patients, and near-complete embolization was achieved in 18 (18.2%) patients. A slower transnidal relative velocity (TRV, odds ratio [OR] = 0.71, P = .002) was significantly associated with CE. Moreover, higher stasis index of the drainage vein (OR = 16.53, P = .023), shorter transnidal time (OR = 0.15, P = .013), and slower TRV (OR = 0.9, P = .049) were significantly associated with complete or near-complete embolization (C/nCE). The area under the receiver operating characteristic curve for predicting CE was 0.87 for TRV, 0.72 for NBAVMES scores (ρ = 0.287, P = .004), and 0.76 for AVMES scores. The area under the receiver operating characteristic curve for predicting C/nCE was 0.77 for TRV, 0.61 for NBAVMES scores, and 0.75 for AVMES scores. Significant Spearman correlation was observed between TRV and NBAVMES scores and AVMES scores (ρ = 0.512, P < .001). Preoperative hemodynamic factors have the potential to predict the outcomes of AVM embolization. A higher stasis index of the drainage vein, slower TRV, and shorter transnidal time may indicate a moderate blood flow status or favorable AVM characteristics that can potentially facilitate embolization.

Melatonin Administration Enhances Testicular Volume, Testicular Blood Flow, Semen Parameters and Antioxidant Status during the Non-Breeding Season in Bafra Rams

Our objectives were to investigate the effects of exogenous melatonin on testicular volume (TV), testicular blood flow (TBF), and semen quality in Bafra rams during the non-breeding season. One group of rams (MEL, n = 5) received a 36 mg melatonin implant twice, with 30 days in between, while the other group (CON, n = 5) served as the control. TBF, TV, and semen quality parameters were determined at three-week intervals starting three weeks before until twelve weeks after the first melatonin implant. Testicular blood flow was determined in the supratesticular (STA) and marginal testicular artery (MA) using color Doppler ultrasound. Semen was collected and evaluated, and the total oxidative status (TOS) and total antioxidative status (TAS) was determined using an ELISA. The MEL group had increased (p &lt; 0.05) TV between the sixth and twelfth week after the start of treatment. Overall, the MEL group had lower resistance and pulsatility indexes (p &lt; 0.05) between the third and ninth week, although there was no difference (p &gt; 0.05) between the two groups in most semen quality parameters. However, TAS concentrations increased (p &lt; 0.05) in the MEL group compared with the CON. The results of this study show that exogenous melatonin in the non-breeding season significantly increased both TBF and TV in Bafra rams. Therefore, giving rams implants with 36 mg melatonin twice at least one month prior to the non-breeding season is expected to improve testicular size and function and reproductive capacity.

Prognostic value of CBV index in patients with acute ischemic stroke treated with endovascular thrombectomy in late therapeutic window.

To evaluate the prognostic value of the cerebral blood volume (CBV) index for 90-day functional outcomes in patients with acute ischemic stroke (AIS) treated within a late therapeutic window. We retrospectively reviewed patients who underwent pre-treatment computed tomography perfusion (CTP) and endovascular thrombectomy (EVT) for large-vessel occlusion (LVO) of the anterior circulation within the late therapeutic window between January 2021 and February 2023. Clinical data, the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) based on unenhanced computed tomography (CT), and perfusion parameters, including ischemic core, hypoperfusion volume, mismatch volume between the core and penumbra, and CBV index, were assessed and compared between patients who achieved favorable outcomes (defined as a modified Rankin Scale score of 0-2). Of the 118 patients, 56 (47.5%) had favorable outcomes. In the univariate analysis, age, National Institutes of Health Stroke Scale (NIHSS) score at admission, ASPECTS score, CBV index, and ischemic core volume were significantly associated with functional outcomes (P < 0.05). In multivariate analyses, age (odds ratio [OR], 1.060; 95% confidence interval [CI] 1.013-1.110, P = 0.012), NIHSS score at admission (OR, 1.126; 95% CI 1.031-1.229, P = 0.009), and CBV index (OR, 0.001; 95% CI 0.000-0.240, P = 0.014) were independent predictors of a 90-day favorable outcome. A high CBV index was independently associated with favorable outcomes in patients who underwent mechanical thrombectomy within the late therapeutic window. In addition, a higher CBV index reflects improved blood flow and favorable digital subtraction angiography collateral status.

High salt diet accelerates skin aging in wistar rats: an 8-week investigation of cell cycle inhibitors, SASP markers, and oxidative stress.

Recent studies have shown that the high salt diet (HSD) is linked to increased dermal pro-inflammatory status and reduced extracellular matrix (ECM) expression in inflamed skin of mice. Decreased ECM content is a known aging phenotype of the skin, and alterations in ECM composition and organization significantly contribute to skin aging. This study aimed to determine whether a high salt diet accelerates skin aging and to identify the time point at which this effect becomes apparent. Wistar rats were randomly divided into normal diet and high salt diet groups and fed continuously for 8weeks. Skin samples were collected at weeks 7 and week 8. Skin pathological sections were evaluated and levels of cell cycle inhibitors, senescence-associated secretory phenotype (SASP), oxidative stress and vascular regulatory factors (VRFs) were examined. Correlation analyses were performed to reveal the effect of a high salt diet as an extrinsic factor on skin aging and to analyse the correlation between a high salt diet and intrinsic aging and blood flow status. At week 8, HSD rats exhibited thickened epidermis, thinned dermis, and atrophied hair follicles. The expression of cell cycle inhibitors and oxidative stress levels were significantly elevated in the skin of HSD rats at both week 7 and week 8. At week 7, some SASPs, including TGF-β and PAI-1, were elevated, but others (IL-1, IL-6, IL-8, NO) were not significantly changed. By week 8, inflammatory molecules (IL-1, IL-6, TGF-β), chemokines (IL-8), proteases (PAI-1), and non-protein molecules (NO) were significantly increased. Notably, despite elevated PAI-1 levels suggesting possible blood hypercoagulation, the ET-1/NO ratio was reduced in the HSD group at week 8. The data suggest that a high salt diet causes skin aging by week 8. The effect of a high salt diet on skin aging is related to the level of oxidative stress and the expression of cell cycle inhibitors. Additionally, a potential protective mechanism may be at play, as evidenced by the reduced ET-1/NO ratio, which could help counteract the hypercoagulable state and support nutrient delivery to aging skin.

The influence of radical trachelectomy on endometrial thickness in in vitro fertilization-embryo transfer.

Both morbidity and mortality rates of cervical cancer are increasing, especially in reproductive-aged women. Radical trachelectomy (RT) is an effective fertility-preserving surgery for early-stage cervical cancer. This study aimed to determine the influence of RT on endometrial thickness during in vitro fertilization-embryo transfer (IVF-ET). Forty-four patients had undergone RT, and 23 women undergoing IVF-ET treatment (105 ET cycles) were included. Endometrial thickness during hormone replacement therapy (HRT) was retrospectively evaluated and compared between patients with and without RT. Eleven patients (50 ET cycles) in the RT group and 12 (52 ET cycles) in the control group were investigated. Compared with the control group, higher ET cancellation rates were observed in patients in the RT group (1 of 52 cycles [control group] vs. 8 of 50 cycles [RT group], p < 0.01). Endometrial thinning was not affected by patient age at first IVF-ET treatment, history of artificial abortion, preservation of uterine arteries during RT, or postoperative chemotherapy (p = 0.27, 1, 1, and 1, respectively). Our data revealed that RT influenced endometrial thickness in IVF-ET. This was not affected by the background of the patients or perioperative management in this study. We could not reveal the underlying mechanism, but it is postulated that the transient postoperative uterine blood flow status and postoperative infections may have some effect on the endometrium. To resolve these issues, accumulation of evidences are required. We recommend informing patients about the impact of RT on IVF-ET before starting assisted reproductive technology (ART).