Vascular Reactions Research Articles

P3393Comparison of intermediate-term vascular response to new-generation biodegradable polymer and durable polymer-based drug-eluting stents: optical coherence tomographic study

Abstract Background Over the last decade, drug-eluting stents (DES) have undergone substantial modifications with thinner struts and more biocompatible durable polymer (DP) or biodegradable polymer (BP). In DP-based DES, after drug elusion has been completed, DP remnants may trigger of local inflammatory vascular reactions and promote delayed healing, leading to accelerated neoatherosclerosis (NA). Thus, BPs have been developed to reduce the above-mentioned risks. Recently, poor strut coverage and in-stent NA are increasingly recognized the cause of late stent failure, but it is unclear whether BPs can reduce the incidence of NA and the poor stent coverage as compared to DPs. Objectives The purpose of this study was to compare the incidence of NA and the stent coverage using optical coherence tomography (OCT) between the DPs and the BPs. Methods Between July 2016 and April 2018, 127 consecutive patients with new-generation DES who underwent 8-month follow up OCT imaging were enrolled. Patients were divided into the two groups: DP group who had the new-generation durable polymer everolimus-eluting and zotarolimus-eluting stents and BP group who had the new-generation biodegradable polymer sirolimus-eluting and everolimus-eluting stents. We compared patient characteristics including hypertension, dyslipidemia and diabetes mellitus and 8-month follow up OCT findings including NA, uncovered struts and malapposed struts between the two groups. Results The DP group comprised 64 patients (50.4%. The incidence of NA, uncovered struts and malapposed struts were similar between the two groups (DPs vs BPs, 1.56% vs 7.94%, P=0.11; 7.80% vs 5.88%, P=0.16 and 2.76% vs 2.01%, P=0.43, respectively) (table). The other parameters were also similar between the two groups. Table 1 DP group (n=64) BP group (n=63) P value Hypertension 44 (68.8%) 50 (79.4%) 0.2251 Dyslipidemia 39 (60.9%) 37 (58.7%) 0.8573 Diabetes mellitus 25 (39.1%) 30 (47.6%) 0.3731 8 month OCT follow up findings Neoatherosclerosis 1 (1.6%) 5 (7.9%) 0.1147 Uncovered struts 7.8% (2.8–20.4) 5.9% (0.7–16.7) 0.1616 Malapposed struts 0.2% (0–2.8) 0% (0–2.8) 0.4392 Conclusions The new-generation DP based-DES may have similar effects on vascular response compared to the new-generation BP-based DES during 8-month follow-up period.

Maladaptive neuropathological syndrome of blood vessel aging

This article discusses the relationship between maladaptation and blood vessel aging. The work shows that upright posture created an additional load on the circulatory system, and the lifestyle of a modern human is an additional risk factor of cardiovascular diseases. It has been suggested that a disorder of the nervous regulation of vascular tone is the main etiopathogenetic mechanism of morphofunctional changes in blood vessels and their aging. We discussed the statute that vascular reactions in humans is based on the formation of a maladaptive circuit in the cerebral cortex, consisting of a matrix of motor, sensory and associative cortical neurons involved in the maladaptive process. This hypothesis is based on the fact that any irritations entering the cerebral cortex from the periphery (thermal, pain, and others) cause cortical-vascular reflex reactions that change their tonic activity. Based on this principle, a model of vascular aging is further constructed, which is based on the maladaptive damage to all layers of the vascular wall (intima, media and adventitia). The opinion is expressed about the need for early diagnosis and prevention of vascular disorders to maintain human health. In conclusion, it is concluded that if the age of a person is really determined by the age of his blood vessels, then in order to achieve active longevity it is necessary to normalize the relationship in the adaptation-maladaptation-environment. Detailed study of hypertrophy and calcification of blood vessels is needed, since aging always reveals vascular wall thickening and stiffness increase.

Морфологічна характеристика легенів тварин з експериментальним перитонітом

Мета. Вивчити та оцінити морфологічні зміни в легенях тварин з експериментальним гострим поширеним перитонітом.
 Матеріали і методи. У цьому дослідженні використано 32 білих щури. Гострий перитоніт моделювали шляхом введення 0,5 мл 10% розчину захопленої фекальної суспензії в черевну порожнину досліджуваних тварин. Строки спостереження: 1-ша, 3-тя, 7-ма доби від початку моделювання перитоніту. Для гістологічного дослідження брали тканину легенів. Отримані шматочки органа фіксували в 10% розчині нейтрального формаліну, а потім фарбували гематоксиліном і еозином.
 Результати. Упродовж усього спостереження посилювалася ексудативно-запальна реакція судин, виникали дистелектаз, ділянки спадання та емфізематозного розширення альвеол, а також розширення та повнокров’я судин. Стінка бронхів потовщувалась переважно за рахунок клітинних інфільтратів, просвіти бронхіол були вільними від ексудату та клітинних елементів.
 Висновки. Під час гістологічного дослідження тканини легенів тварин із змодельованим гострим поширеним перитонітом у порівнянні з інтактними щурами на 1-шу добу експерименту було виявлено ділянки спадання та емфізематозного розширення альвеол. На 3-тю добу більшість судин мала широкі повнокровні просвіти, відбувався еритродіапедез як у периваскулярні простори, так і в просвіт окремих альвеол. На 7-му добу спостерігали значне розширення вен та кровонаповнення артерій.

Early and Mid-Term Vascular Responses to Optical Coherence Tomography–Guided Everolimus-Eluting Stent Implantation in Stable Coronary Artery Disease

BackgroundAnalysis of pooled clinical data has shown the safety of 3 months of dual antiplatelet therapy with everolimus-eluting cobalt–chromium stents (Co-Cr EESs). This study evaluated early and mid-term vascular responses to Co-Cr EESs in patients with stable coronary artery disease. MethodsThe Multicenter Comparison of Early and Late Vascular Responses to Everolimus-Eluting Cobalt-Chromium Stent and Platelet Aggregation Studies in Patients With Stable Angina Managed as Elective Case (MECHANISM-Elective) study (NCT02014818) is a multicenter optical coherence tomography (OCT) registry. Enrolled patients were evaluated by OCT immediately after everolimus-eluting stent implantation were prospectively allocated to 1 month (n = 50) or 3 months (n = 50) OCT follow-up and then received a 12-month OCT evaluation. The incidences of intrastent thrombus (IS-Th) and irregular protrusion (IRP) were also assessed. ResultsThe percentage of uncovered struts was 6.4% ± 10.3% at 1 month (P < 0.001 vs. postprocedure) and 0.5% ± 0.9% at 12 months (P < 0.001 vs. 1 month). The corresponding values in the 3-month cohort were 2.0% ± 2.5% (P < 0.001 vs. postprocedure) and 0.5% ± 1.5% (P < 0.001 vs. 3 months). The incidence of IS-Th was 32.7% at 1 month, 5.4% at 3 months, and 2.0% at 12 months. IRP was observed in 21.8% of patients post-EES but had totally resolved at 1, 3, and 12 months. ConclusionEarly and mid-term vascular reactions after Co-Cr EES implantation in stable patients with coronary artery disease in the MECHANISM-Elective included dynamic resolution of IS-Th and IRP and rapid decrease in uncovered struts. Thus, EES may allow shortening of dual antiplatelet therapy duration less than 3 months in this patient subset.

Adaptation disorders caused by nephrectomy

Currently, nephrectomy is performed for various diseases, and the number of this type of surgery does not have a clear tendency to decrease. Operational stress is accompanied by a triggering mechanism for a wide range of disorders, among which psycho-emotional and vegetative (vascular) reactions are important clinical markers. The study of the systemic adaptive reactivity of the body after nephrectomy will provide an integrated approach to the study of the problem of the postoperative period and the rehabilitation of the patient in clinical practice.&#x0D; Objective: to identify the effect of nephrectomy on the overall adaptive response of animals when white rats are exposed to damaging physical loads (acute hyperthermia) and chemical (acute alcohol poisoning, nephrotoxic agents) of nature, normobaric hypoxia, limiting muscular loads and immobilization stress.&#x0D; The results of the experiment showed that laboratory animals with a single kidney become more sensitive (1.5 times) to nephrotoxic agents. Analysis of the effect of nephrectomy on the overall adaptive response of animals under the influence of various damaging factors to reduce the body’s resistance to hypoxia by 20% (p &gt; 0.05); to limit muscular loads – by 25% (p &gt; 0.05); hyperthermia – by 25% (p &lt; 0.05); chemical agents – by one third (p &lt; 0.05); to immobilization stress – by 28% (p &lt; 0.05).&#x0D; Conclusion. The study demonstrated a significant negative impact of nephrectomy on the overall adaptive capacity of the body and allowed to clarify the functional characteristics of the general adaptation disorders in connection with this operation.

Effect of multimodal analgesia using periprostatic nerve block anesthesia combined with flurbiprofen in transperineal template-guided prostate biopsy

Objective: To evaluate the effect of multimodal analgesia using periprostatic nerve block anesthesia (PNB) combined with flurbiprofen in patients undergoing transperineal template-guided prostate biopsy (TTPB). Methods: Totally 166 patients (aged (68.2±9.1) years, range: 47 to 81 years) who received TTPB from October 2017 to June 2018 at Department of Urology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University were enrolled prospectively. All the patients were randomly divided into 2 groups. The observation group (n=79) was given flurbiprofen axetil 1 mg/kg intravenously for half an hour before operation and lidocaine was used for PNB before the biopsy. The control group (n=87) was given normal saline combined with PNB. A visual analog scale (VAS) and visual numeric scale (VNS) were used to assess the patients' pain and quantify their satisfaction at two time points: VAS-1 and VNS-1: during biopsy procedure, VAS-2 and VNS-2: 30 min after the procedure. The date were compared by t test, χ(2) test, Fisher exact test and two-way repeated measures anova analysis between the 2 groups. Results: The age, total prostate volume, serum prostate-specific antigen and the number of cores were comparable among the 2 groups (P>0.05). The VAS-1 scores of the control group and the observation group were 2.8±1.7, 1.9±1.2, respectively, and the VNS-1 were 3.1±0.7, 3.4±0.3, respectively. The VAS-1 were significantly lower in observation group than in control group (F=3.904, P=0.000). Conversely, the VNS-1 were higher in observation group (F=3.526, P=0.000). At 30-minute postoperative, the VAS-2 and VNS-2 were 0.7±0.4 and 3.7±0.2 in the control group, respectively. The VAS-2 and VNS-2 were 0.6±0.5 and 3.8±0.1 in the observation group, respectively. There were no significant differences in the pain scores or the satisfaction scores between the 2 groups (F=1.429, 2.825; P=0.136, 0.083). The incidence of overall complications was 26.4% (23/87) in the control group and 25.3% (20/79) in the observation group, with no statistical difference between the 2 groups (χ(2)=0.027, P=0.869). And the complications had no statistically significant difference among the 2 groups including hematuria, urinary retention, infection, hematospermia, vascular and neurological reactions, nausea, vomiting, dizziness, headache, and respiratory depression (P>0.05). Conclusion: The multimodal analgesia induced by PNB and flurbiprofen could effectively relieve the pain for patients who received TTPB.

Comparative Study of Attenuation of effects of Intubation on Blood Pressure Using IV Xylocard and IV Beta Blocker (Esmolol)

Background: The occurrence of cardio vascular reactions to laryngoscopy and tracheal intubation has attracted the attention of anaesthesiologists and methods to avoid these potentially harmful responses even though transitory have been sought, particularly in critically ill patients, hypertensive patients. Tracheal intubation under light general anaesthesia is consistently accompanied by a pressor response, tachycardia and in some instances by cardiac arrhythmias. This pressor response, which was recognised early as 1951 is due to sympathetic reflex provoked by stimulation of the epipharynx and laryngopharynx. Subjects and Methods: Seventy five (75) patients belonging to ASA grade 1 &amp; 2 scheduled for general surgical, orthopaedic surgical, ENT, gynocological surgical producers were studied. Results: The age of the patients varied from 10 to 60 years. The MAP in group A decreased after induction. There was a highly significant raise to 109+/-11 mm Hg during laryngoscopy and intubation. This decreased to 105+/-9mm Hg after five minutes which is not significant. Conclusion: These responses are transitory, variable and are much more marked in a hypertensive patient than in the normotensive patient. Once the laryngoscopy and endotracheal intubation is completed, the increase in pulse and blood pressure subside, but the dysrhythmia persists for more than 2-3 minutes.

Inflammation induced by different plasmid types of russian &lt;i&gt;Yersinia pseudotuberculosis&lt;/i&gt; strains

In the 2000s, a scientific interest to the Far Eastern scarlet-like fever (FESLF) mainly recorded In Russia and Japanwas remarkably increased. Such clinical and epidemic manifestation of human pseudotuberculosis is related to a certain bacterial clonal lineage characterized by a specific plasmid profile (pVM82, pYV48), sequence type (2ST) as well as the yadA gene allele (1st allele). In our study we examined features of inflammatory changes characterizing plasmidassociated pathogenicity of the FESLF pathogen. In addition, organ histopathology in experimental animals infected intraperitoneally with Y. pseudotuberculosis strains of the four plasmid types 48+:82+; 48+:82-; 48-:82+; 48-:82-; and 48-:82- was investigated. It was found that the mortality rate in animals infected with Y. pseudotuberculosis H-5015 strain (82+:48+) bearing two plasmids with a molecular weight of 82 and 48 MDa was 40%. A picture of diffuse pneumonia with moderate inflammatory infiltration in pulmonary tissue and changes in lymphoid organs characterizing immunodeficiency we observed as early as 3 days postinfection (p.i.). On the contrary, animals infected with Y. pseudotuberculosis H-5015 strain (82+:48) bearing a single plasmid 82 MDa pVM, mortality rate was 30%. A vascular reaction in the lungs and liver as well as deteriorated vascular destructive changes were revealed starting from day 3 and on day 57 days p.i., respectively, which was paralleled with perivascular infiltration mainly by mononuclear cells and focal pneumonia as well as a reaction of bronchialassociated lymphoid tissue and minimal organ destructive changes. On day 7 p.i., signs of granulomatous inflammation in the liver in a form of small mononuclear cell clusters and perivascular compact infiltrates were found. At all time points, lymphoid organ hyperplasia was noted. In case the infection caused by H-5013 strain (48+), the mortality rate was 80%. Inflammatory changes with dominant mononuclear cells were detected as early as 1 day p.i. associated with a picture of large focal bronchopneumonia, more pronounced in the non-survivor animals, also demonstrating signs of severe immunosuppression in the lymphoid organs. Starting from day 3 p.i., lymphoid hypoplasia in the spleen and lymph nodes was detected in all infected animals paralleled with pathogen-associated tissue damage in various organs. Animals infected with the plasmid-free H-5013 strain 48-) resulted in 25% mortality rate. Moreover, starting from day 3 p.i., a slight mononuclear inflammatory infiltration in the lungs and liver, a moderate giant cell reaction in the splenic pulp, and loose perinodal inflammatory infiltration in the lymph nodes were observed. Thus, while modeling infection caused by different plasmid types of Y. pseudotuberculosis, the data on differences in histopathology of changes in diverse organs regarding dynamics and generalization of the inflammatory response, as well as the severity of pathogen-associated damage in the lymphoid tissue were obtained. In case Y. pseudotuberculosis strains contained pVM82 plasmid with or without virulence plasmid pYV vs. single pYV-positive strains, an area of the inflammatory response as well as severity of immunosuppression manifested by splenic and lymph node delymphatization were decreased. It allowed to suggest that pVM82 plasmid found In Russia-originating Y. pseudotuberculosis strains might be implicated in limiting intensity of inflammatory response, bacterial dissemination and severity of lymphoid organ damage.

PROSPECTIVE ANALYSIS OF LIPID SPECTRUM PARAMETERS AND VASCULAR INFLAMMATORY MARKERS AS A VARIANT OF A PERSONIFIED APPROACH TO PROGNOSIS OF UNDESIRABLE CORONARY EVENTS IN PATIENTS WITH CORONARY HEART DISEASE AFTER ANGIOPLASTY

The relevance of the study is due to the fact that the ambiguous role of biochemical mediators in the development of angioplasty complications with stenting and the lack of consensus on the timing of laboratory indicators determine to specify the approaches to the study of biochemical parameters that indicate the nature of the course of coronary heart disease (CHD) and the development of possible undesirable complications after percutaneous coronary intervention. This article aims to analyze the parameters of lipid spectrum and markers of vascular inflammatory reaction in patients with CHD, in groups with stable angina and unstable angina episode after angioplasty with stenting, to trace the dynamics of biochemical parameters and to reveal the predictors of undesirable coronary events. Patients with CHD with significant coronary artery stenosis (CKS, n=95) revealed after coronary angiography (CAG) at the point of maximum increase in the markers of the inflammatory response (3 months after angioplasty) are divided into 2 groups – patients with stable angina pectoris (AP, n=77) until the end of the study and patients with a developed post-revascularization episode of unstable angina (UA, n=18) after angioplasty with stenting. It was established that patients with UA at the initial stage have a significantly higher risk of developing coronary blood flow instability in the post-revascularization period due to initially elevated levels of homocysteine and rf-CRP. The results obtained are very important for the implementation of an optimal program for monitoring patients with coronary artery disease, improving measures to increase adherence to therapy at the outpatient stage of treatment.

Comparisons of early vascular reactions in biodegradable and durable polymer-based drug-eluting stents in the porcine coronary artery

Current drug-eluting stents have abluminal polymer coating; however, thrombus formation in these compared with that in uniformly coated stents remains controversial. We evaluated thrombus formation and early endothelialization after using abluminal biodegradable polymer-coated sirolimus- (BP-SES), and everolimus-eluting stents (BP-EES) versus a durable polymer-coated everolimus-eluting stent (DP-EES) in an in vivo setting. BP-SES, BP-EES, and DP-EES (n = 6 each) were implanted in coronary arteries of 12 mini-pigs that were then sacrificed after 7 and 10 days. Stents were stained with hematoxylin and eosin, and a combined Verhoeff and Masson trichrome stain. Areas of fibrin deposition were digitally detected and measured with off-line morphometric software. Stents were investigated for re-endothelialization by transmission electron microscopy. At 7 days, histological analysis revealed the lowest area of fibrin deposition in BP-SES (BP-SES vs. BP-EES vs. DP-EES; 0.10 ± 0.06 mm2 vs. 0.15 ± 0.07 mm2 vs. 0.19 ± 0.06 mm2, p = 0.0004). At 10 days, the area of fibrin deposition was significantly greater in DP-EES (0.13 ± 0.04 mm2 vs. 0.14 ± 0.05 mm2 vs. 0.19 ± 0.08 mm2, p = 0.007). Endothelial cells in BP-SES demonstrated a significantly greater number of tight junctions than those in DP-EES according to by transmission electron microscopy for both days (p<0.05). Various parameters, including an inflammatory reaction and neointimal formation, were comparable among the groups at 7 and 10 days. An abluminal biodegradable polymer-coated SES showed the least fibrin deposition and greatest endothelial cell recovery at an early stage following implantation in the coronary arteries of mini-pigs.

Биомаркеры эффекта: валовые и гистопатологические показатели атерины каспийской (Atherina boyeri) казахстанского сектора Каспийского моря

Feature of ichthyofauna North-eastern part of the Caspian Sea is the presence of it includes not only the valuable commercial fish species, but also of low value species who participate in the formation of the food chain. Fish, as the top trophic unit of the aquatic ecosystem, are considered indicators of pollution, therefore pathological studies allow us to estimate and predict effects of finding toxic substances in water. This article presents the results of the morphometric and histological study Caspian Aterina (Atherina boyeri), inhabiting the North-Eastern part of the Caspian Sea. As a result of the study, were found that the biomarkers-effect are pathological changes gill tissue and liver. So, in the gills are observed destructive lamella changes, phenomena of hyperplasia of the primary and secondary gill epithelium and degeneration of cartilage elements. The liver changes manifested in the form of parenchymal hepatocytes dystrophy and vascular reaction. The observed pathological changes gills and liver may affect the survival Atherina boyeri and these organs can serve as biomarkers of effect. Histological study of muscle and gonad it did not reveal any changes pamorphological and observed processes are reversible. In these studies, substantiates use of Caspian Aterina (Atherina boyeri) as a test type of monitoring the water of the Caspian Sea basin and including to predict the number of and quality of harvested species. Key words: Caspian atherina, A. boyeri caspia (Eichwald, 1838), Caspian Sea, histological changes, gills, liver.

Evaluation of a new means of pulpal diagnosis through a prospective study of 133 cases

Introduction: The most accurate method for evaluation of pulpal status is histological examination. Unfortunately, it is clinically inapplicable. The goal of our work is to focus on in situ observation, which is proven to be a historically reliable and clinically applicable means. Materials and Methods: This is a 22-month prospective cross-sectional epidemiological study of 133 cases. For each case, the initial pulpal diagnosis is confronted with the in situ observation. The initial pulpal diagnosis is either retained or corrected according to the in situ observation. Results: The Chi-squared test gave a value of P Conclusion: Histologically, when the pulp is irritated, a vascular reaction is observed. This reaction will influence the color and the flow of pulp blood. This blood changes can be detected with the naked eye which led us to propose a classification of the different in situ observations to refine the initial pulp diagnosis.

Astrocytic cytochrome P450 4A/20-hydroxyeicosatetraenoic acid contributes to angiogenesis in the experimental ischemic stroke

20-Hydroxyeicosatetraenoic acid (20-HETE), a cytochrome P450 4A (CYP4A) metabolite of arachidonic acid, is one of the primary eicosanoids in most of microcirculatory beds. Studies have indicated that 20-HETE has important functions in the modulation of vascular tone, ion transport, inflammation reaction, and cellular proliferation. Both we and others have demonstrated that 20-HETE plays an important role in acute phase of ischemic stroke. However, little is known about the effect of 20-HETE on recovery phase of stroke. Crosstalk between the cells within the neurovascular unit is increasingly suspected of playing critical roles in stroke recovery. We found that CYP4A is upregulated in astrocytes exposed to oxygen-glucose deprivation (OGD), which increases the production of 20-HETE that promotes endothelial cell proliferation, tube formation and migration. siRNA suppression of CYP4A or 20-HETE inhibitor prevents this effect. In a mouse model of transient focal cerebral ischemia, inhibition of CYP4A reduces peri-infact angiogenesis and worsens neurological deficits 14 days after stroke. We further showed that ischemia injury increases VEGF and HIF-1α expression in cell cultures and ischemic brains, which is negated by a 20-HETE inhibitor-HET0016. Lastly, we showed that JNK signaling pathway is a component of 20-HETE regulated ischemic angiogenesis after stroke. Taken together, we demonstrated a positive influence of 20-HETE in angiogenesis in later stage of stroke. These molecular and in vivo findings also support a previously undescribed mechanism of crosstalk between reactive astrocytes and endothelial cells wherein 20-HETE promotes neurovascular remodeling and functional recovery after ischemic stroke.

Fully bioresorbable vascular scaffolds: lessons learned and future directions

Fully bioresorbable scaffolds (BRS) were designed to overcome the limitations of metallic drug-eluting stents, which permanently cage the vessel wall, thereby preventing normal coronary vasomotion, preclude bypass grafting and can provoke long-term foreign-body responses. Although multiple scaffolds have been or are in development, the Absorb Bioresorbable Vascular Scaffold (BVS; Abbott Vascular) was the first FDA-approved device and was widely expected to fulfil the dream of interventional cardiologists of a transient scaffold that would disappear 'when the job was done' and would not hamper further treatment options. Although early, small studies and even large, randomized trials showed beneficial outcomes up to 1 year of follow-up, longer-term results have been disappointing, with increased rates of device thrombosis and target-lesion revascularization. The Absorb BVS device was withdrawn from the market because of low demand. In this Review, we summarize the preclinical and clinical data available for BRS to understand how the vascular biological reactions to these devices differ from biological reactions to metallic drug-eluting stents and how these responses translate into clinical outcomes. We also discuss next-generation BRS and outline modifications that are needed to improve the long-term outcomes with these devices so that they eventually become a viable option for patients with symptomatic obstructive coronary artery disease.

Preclinical alternative model for analysis of porous scaffold biocompatibility in bone tissue engineering.

Using scaffolds with appropriate porosity represents a potential approach for repair of critical-size bone defects. Vascularization is essential for bone formation and healing. This study investigates methods for monitoring angiogenesis within porous biopolymer scaffolds on the basis of polyhydroxybutyrate (PHB)/chitosan. We use the chick and quail chorioallantoic membrane (CAM) assay as an in vivo model focused on the formation of new blood vessels inside the implant structure. Chemical properties of the surface in biopolymer scaffold matrix were characterized as well as the tissue reaction of the CAM. Implantation of a piece of polymer scaffold results in vascular reaction, documented visually and by ultrasound biomicroscopy. Histological analysis shows myofibroblast reaction (smooth muscle actin-positive cells) without excessive collagen deposition. Cell invasion is observed inside the implant, and QH1 marker, detecting hemangioblasts and endothelial cells of quail origin, confirms the presence of vascular network. The CAM assay is a rapid and easy way to test biocompatibility and vasculogenic potential of new candidate scaffolds for bone tissue bioengineering with respect to the 3R´ s.

Acute reaction of arterial blood vessels after experimental subarachnoid hemorrhage – An in vivo microscopic study

Subarachnoid hemorrhage (SAH) results in a rapid decrease of cerebral perfusion. While cerebral perfusion pressure (CPP) may quickly recover, a sustained decrease of cerebral blood flow (CBF) has been observed. Acute vasospasm has been concluded from this mismatch. This study was conducted to visualize and investigate immediate vascular reactions during and after experimental SAH. Male Sprague-Dawley rats were subjected to SAH by the endovascular filament model (n = 7) or served as controls (n = 4). Videomicroscopy was performed via a cranial window. Regions of interest were defined in areas covered by videomicroscopy and arterial diameters measured at defined time-points from 15 min before until 3 h after SAH. Local CBF was monitored over the opposite hemisphere by laser-Doppler flowmetry.Local CBF showed a typical decrease immediately after vessel perforation followed by an incomplete recovery in the 3 h thereafter. Videomicroscopy demonstrated a sharp decrease of the arterial diameter in the first minutes after SAH. In some animals, SAH was followed by a complete disappearance of arterial vessel filling. In the following minutes, arterial filling reappeared or improved, respectively. All animals subjected to SAH showed significant vasospasm in subarachnoid arteries.This is the first study to visualize acute vascular reactions during and immediately after SAH. Although the cranial window technique only covers a part of the cerebral vasculature, it covers cerebral vessels rather distant from the site of endovascular perforation. Therefore, it is likely that acute vasospasm observed in the monitored areas reflects a global vascular reaction.

PO422 On Some Genetic Determinants of Heart Vascular Reactions In Simulated Diving Human

PO422 On Some Genetic Determinants of Heart Vascular Reactions In Simulated Diving Human

Prevention and management of acute reactions to intravenous iron in surgical patients.

Absolute or functional iron deficiency is the most prevalent cause of anaemia in surgical patients, and its correction is a fundamental strategy within "Patient Blood Management" programmes. Offering perioperative oral iron for treating iron deficiency anaemia is still recommended, but intravenous iron has been demonstrated to be superior in most cases. However, the long-standing prejudice against intravenous iron administration, which is thought to induce anaphylaxis, hypotension and shock, still persists. With currently available intravenous iron formulations, minor infusion reactions are not common. These self-limited reactions are due to labile iron and not hypersensitivity. Aggressively treating infusion reactions with H1-antihistamines or vasopressors should be avoided. Self-limited hypotension during intravenous iron infusion could be considered to be due to hypersensitivity or vascular reaction to labile iron. Acute hypersensitivity reactions to current intravenous iron formulation are believed to be caused by complement activation-related pseudo-allergy. However, though exceedingly rare (<1:250,000 administrations), they should not be ignored, and intravenous iron should be administered only at facilities where staff is trained to evaluate and manage these reactions. As preventive measures, prior to the infusion, staff should inform all patients about infusion reactions and identify those patients with increased risk of hypersensitivity or contraindications for intravenous iron. Infusion should be started at a low rate for a few minutes. In the event of a reaction, the very first intervention should be the immediate cessation of the infusion, followed by evaluation of severity and treatment. An algorithm to scale the intensity of treatment to the clinical picture and/or response to therapy is presented.

Efficacy of combined atorvastatin calcium, &lt;i&gt;Salviae miltiorrhizae&lt;/i&gt; and ligustrazine hydrochloride injection in cerebral infarction patients

Purpose: To study the effect of a combination of atorvastatin calcium with Salviae miltiorrhizae and ligustrazine hydrochloride injection on serum levels of ferritin (SF), C-reactive protein (CRP) and hypoxia-inducible factor 1α(HIF-1α) in cerebral infarction patients. Methods: A total of 60 cerebral infarction patients (confirmed by CT or MRI scan) were randomly assigned to control group and observation group (30 patients/group). Both groups received routine treatments. All patients took atorvastatin calcium, but those in the observation group were treated with Salviae miltiorrhizae and ligustrazine hydrochloride injection, in addition to atorvastatin hydrochloride for 14 days, with 7 days as treatment course. The levels of SF, CRP and HIF-1α were determined before and after treatment, to assess clinical efficacy and safety. Results: In both groups, SF, CRP and HIF-1α levels were lower after treatment than before treatment (p < 0.05). NIHSS score and platelet activation indices were also significantly reduced, relative to control (p < 0.05). Conclusion: The combination of atorvastatin calcium with Salviae miltiorrhizae and ligustrazine hydrochloride injection can control vascular inflammatory reactions by decreasing the levels of SF, CRP and HIF-1α. Thus, it may be beneficial in the clinical management of cerebral infarction. Keyword: Cerebral infarction, Atorvastatin calcium, Salviae miltiorrhizae , Ligustrazine hydrochloride injection

Peculiarities of the systemic hemodynamics reaction and peripheral blood flow to reactive hyperhemia in young women with arterial hypotension

The aim of the study was to study a vascular reaction to a test with reactive hyperemia in young women with idiopathic arterial hypotension. 72 women with hypotension (SBP 98 mmHg or less) and 37 women with SBP 120-129 mmHg were examined. A comparative analysis of the response of systemic and peripheral hemodynamics to a test with reactive hyperemia by Celermajer D. In hypotension, occlusion was characterized by an increase in SBP, a change in the diameter and velocity of peripheral arterial and venous blood flow. Thus, the pathological reaction of systemic and peripheral hemodynamics in reactive hyperemia in women with hypotension is a sign of remodeling of the cardiovascular system.