Clinical Hemorheology and Microcirculation - Volume Preprint, issue Preprint
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Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research.
The endeavour of the Editors-in-Chief and publishers of
Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of
Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process.
Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.
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Clinical Hemorheology and Microcirculation: medical practitioners in all fields including hematology, cardiology, geriatrics, angiology, surgery, obstetrics and gynecology, ophthalmology, otology, and neurology. Pharmacologists, clinical laboratories, blood transfusion centres, manufacturing firms producing diagnostic instruments, and the pharmaceutical industry will also benefit.
Important new topics will increasingly claim more pages of
Clinical Hemorheology and Microcirculation: the role of hemorheological and microcirculatory disturbances for epidemiology and prognosis, in particular regarding cardiovascular disorders, as well as its significance in the field of geriatrics. Authors and readers are invited to contact the editors for specific information or to make suggestions.
Abstract: BACKGROUND: Measurement of skin oxygen is of great interest in diverse fields of medicine. Different pathologies, e.g. infection, ischemia cancer or chronic wounds show a characteristic oxygen distribution and skin oxygen tension. Additionally diverse operative procedures require a reliable postoperative monitoring in order to ensure success of the therapy. OBJECTIVE: Aim of this study was to assess transepidermal oxygen flux for postoperative wound monitoring after operative treatment of fractures close to the hip. METHODS: 22 patients underwent transepidermal oxygen flux measurement at the first postoperative day. Transepidermal oxygen flux measurement was performed using ratiometric luminescence…imaging. Examination was conducted in close proximity to the operation wound. The corresponding area at the contralateral side served as reference. RESULTS: Oxygen flux in the operation area was higher (0.084±0.021) than the contralateral side (0.071±0.029). CONCLUSIONS: Transepidermal oxygen flux imaging by ratiometric luminescence imaging seems to be a reliable tool to assess postoperative wound healing. However further investigations in greater populations and under pathologic conditions have to be performed to prove these first results.
Abstract: BACKGROUND AND PURPOSE: Iodinated contrast media (Xenetix® , Ultravist® , Omnipaque® , Visipaque® and Iomeron® ) used for computed tomography (CT) may decrease fibrinolysis by recombinant tissue plasminogen activator (rt-PA). We hypothesized that receiving iodinated contrast media before rt-PA may impair thrombolysis as measured by a new model system. METHODS: Whole blood from Wistar Kyoto rats (n = 10) was obtained and allowed to form blood clots. Thrombolysis was performed by placing individually the prepared clots into 15 mL tubes and adding 5 mL saline buffer, 100μg rt-PA and a different contrast media; adjusting the quantity of iodine to…either 30 mg or 60 mg. The thrombolytic efficacy was quantified by measuring the optical density (OD415 ) of the supernatant at different time points, namely at 0, 30, 60, and 90 min. RESULTS: There was a significant decrease in clot lysis efficiency observed in presence of iodine containing contrast media comparing to positive control group. Moreover, when the quantity of iodine was increased from 30 mg to 60 mg; the dissolution rate downturned with additional ∼50%. CONCLUSION: In conclusion, our study suggests that high dose of iodine potentially could negatively affect the efficiency of the thrombolytic therapy performed by rt-PA.
Abstract: OBJECTIVE: The aim of this study was to analyze the effects of dance therapy on selected hematological and rheological indicators in older women. METHODS: The study included 30 women (aged 71.8±7.4), and the control group comprised of 10 women of corresponding age. Women from the experimental group were subjected to a five-month dance therapy program (three 45-minute sessions per week); women from the control group were not involved in any regular physical activity. Blood samples from all the women were examined for hematological, rheological, and biochemical parameters prior to the study and five months thereafter. RESULTS:…The dance therapy program was reflected by a significant improvement of erythrocyte count and hematocrit. Furthermore, the dance therapy resulted in a significant increase in the plasma viscosity, while no significant changes in glucose and fibrinogen levels were noted. CONCLUSIONS: Dance therapy modulates selected hematological parameters of older women; it leads to increase in erythrocyte count and hematocrit level. Dance therapy is reflected by higher plasma viscosity. Concentrations of fibrinogen and glucose are not affected by the dance therapy in older women, suggesting maintenance of homeostasis. Those findings advocate implementation of dance therapy programs in older women.
Abstract: BACKGROUND: Erythrocytes undergo irreversible morphological and biochemical changes during storage. Reduced levels of deformability have been reported for stored erythrocytes. Erythrocyte deformability is essential for healthy microcirculation. OBJECTIVE: The aim of this study is to evaluate shear stress (SS) induced improvements of erythrocyte deformability in stored blood. METHODS: Deformability changes were evaluated by applying physiological levels of SS (5 and 10 Pa) in metabolically depleted blood for 48 hours and stored blood for 35 days with citrate phosphate dextrose adenine-1 (CPDA-1). Laser diffractometry was used to measure erythrocyte deformability before and after application of SS.…RESULTS: Erythrocyte deformability, as a response to continuous SS, was significantly improved in metabolically depleted blood, whereas it was significantly impaired in the blood stored for 35 days with CPDA-1 (p ≤0.05). The SS-induced improvements of deformability were deteriorated due to storage and relatively impaired according to the storage time. However, deformability of stored blood after exposure to mechanical stress tends to increase at low levels of shear while decreasing at high SS levels. CONCLUSION: Impairment of erythrocyte deformability after storage may contribute to impairments in the recipient’s microcirculation after blood transfusion. The period of the storage should be considered to prevent microcirculatory problems and insufficient oxygen delivery to the tissues.
Abstract: PURPOSE: To investigate the correlation between quantitative parameters on contrast-enhanced ultrasound (CEUS) and pathological prognostic factors in patients with breast invasive ductal carcinomas (IDCs). MATERIALS AND METHODS: 102 patients with pathologically proven IDCs were retrospectively enrolled and all were preoperatively evaluated by CEUS. Quantitative analysis was conducted using the SonoLiver® software. On the parametric imaging, the data of rise time (RT), time to peak (TTP), mean transit time (mTT) and maximum intensity (IMAX) were recorded. Pathological prognostic factors, including histological grade, tumor diameter, lymph node status, estrogen receptor (ER), progesterone receptor (PR), C-erb-B2 and Ki-67 expression…were evaluated. Correlation of enhancement parameters with pathological prognostic factors was analyzed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance and operator consistency was evaluated. RESULTS: The RTs and TTPs for lower grade IDCs (grade I or II) and higher histological grade IDCs (grade III) were 9.3 s±3.9 vs. 11.4 s±5.4 (p = 0.016), 11.6 s±6.1 vs. 14.7 s±7.7 (p = 0.028), respectively. The RTs for positive-C-erbB-2 expression and negative-C-erbB-2 expression IDCs were 10.1 s±4.5 vs. 11.9 s±6.0 (p = 0.047). The IMAX showed statistical difference between IDCs with negative-ER and those with positive-ER (p = 0.003), as well as IDCs with negative-PR and those with positive-PR (p = 0.019). The ROC analysis showed that, for the differentiation ER expression, the cut-off point for IMAX was 648.8% with an Az value of 0.718 (95% CI: 0.599–0.836), and the sensitivity and specificity were 63.6% and 70.2% respectively. The intra-operator consistency of the RT, TTP, mTT and IMAX were excellent with an overall ICC of 0.893, 0.858, 0.984 and 0.800, respectively (all p < 0.001). CONCLUSIONS: Quantitative analysis of CEUS may be a useful and objective method in predicting pathological prognostic factors in breast IDCs.
Abstract: BACKGROUD: Contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE) are used for diagnostic purposes. OBJECTIVE: Investigate the diagnostic value of CEUS and SWE for breast lesions of sub-centimeter diameter. METHODS: Sixty-two patients (mean age: 49.3±12.1 years) with 66 lesions (mean diameter, 8.1±1.5 mm) were analyzed. Conventional ultrasound (US), CEUS and SWE were undertaken. Pathologic specimens were obtained through biopsy or surgery. Lesions were measured in kilopascals. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were analyzed. RESULTS: For conventional US, the sensitivity was 92.31%, specificity 28.30%, PPV 24.00%, NPV 93.75%, and…accuracy 40.90%, whereas those for SWE were 61.54%, 98.11%, 88.89%, 91.23%, and 90.91% (p = 0.000) and CEUS were 92.31%, 60.38%, 36.37%, 96.97%, and 66.67% (p = 0.001), respectively. For SWE + CEUS, the sensitivity was 61.54%, specificity 100.00%, PPV 100.00%, NPV 91.38%, and accuracy 92.42% (p = 0.000). There was a significant difference between US and CEUS (p = 0.004), but not for SWE or SWE + CEUS (p = 0.568; p = 0.205). For SWE + CEUS, there was a significant difference with SWE alone and CEUS alone (p = 0.000; p = 0.008). Between SWE and CEUS, the difference was significant (p = 0.031). CONCLUSIONS: SWE and CEUS could help to differentiate between malignant and benign breast lesions <1 cm in diameter.
Abstract: OBJECTIVE: To evaluate the diagnostic performance of shear wave speed (SWS) within the lesion, fat-to-lesion speed ratio (FLR), and gland-to-lesion speed ratio (GLR) for differentiation between benign and malignant breast lesions using a novel SWS imaging technique. METHODS: From April 2016 to June 2016, 182 breast lesions were prospectively included in the study. For each lesion, SWS-lesion, FLR, and GLR were calculated. Pathological results were used as the reference standard. Receiver operating characteristic curves (ROC) were plotted to assess the diagnostic performance. RESULTS: Of the 182 lesions, 142 (78.0%) were benign and 40 (22.0%) were…malignant. Significant differences were found between benign and malignant lesions in SWS-lesion, FLR and GLR (2.12±0.64 m/s vs 3.87±1.45 m/s, 1.63±0.61 vs 2.60±1.04, and 1.33±0.39 vs 2.08±0.78, respectively. All P < 0.001). The optimal cut-off values of SWS-lesion, FLR, GLR were 2.88 m/s, 2.31 and 1.51, respectively. The diagnostic performance of SWS-lesion in terms of AUC was the highest (i.e. AUC = 0.845), in comparison with FLR and GLR alone or their combination. The associated sensitivity, specificity, and accuracy for SWS-lesion were 75.0%, 89.4%, and 86.3%, respectively. CONCLUSION: SWS-lesion is a valuable and sufficient method for differentiation between benign and malignant breast lesions.
Abstract: BACKGROUND: The influence of the recombinant form of human relaxin-2 (serelaxin) on pulmonary hemodynamics under physiologic conditions have not been the subject of studies in an animal model up until now. METHODS: We therefore utilised the large animal model sheep, convenient in its similar cardiovascular physiology, to investigate said influence. All animals underwent right heart catheterization, a safe and reliable invasive procedure for the assessment of pulmonary hemodynamics, and then received either 30μ g/kg serelaxin (n = 11) or saline (n = 13). Systolic, diastolic and mean values of both pulmonary artery pressure (respectively, PAPs, PAPd, PAPm) and pulmonary…capillary wedge pressure (respectively, PCWs, PCWd, PCWm) blood gases, heart rate (HR) and both peripheral and pulmonary arterial oxygen saturation were obtained. Cardiac output (CO), pulmonary vascular resistance (PVR), pulmonary arterial compliance (PAcompl) and systemic vascular resistance (SVR) were calculated. RESULTS: The key findings of the current study are that 20 min after serelaxin injection a rapid decrease of the PAPm, PCWPm, SVR and an increase of the PAcompl was observed (P < 0.001). CONCLUSION: These findings suggest that serelaxin might be suitable to improve pulmonary hemodynamics in clinically relevant scenarios, like acute heart failure or pulmonary hypertension.
Abstract: BACKGROUND: Cryotherapy is a physiotherapy method used to treat back pain in older persons. OBJECTIVE: This study aims to evaluate the changes in the rheological parameters of blood in older women with spondyloarthrosis, who underwent whole-body cryotherapy. METHODS: The experimental group comprised 69 older women with lumbar spondyloarthrosis, aged between 65 and 70 years. Due to the methodology of the procedure, the experimental group was randomly divided into three groups. Each group underwent two weeks of different types of physiotherapy: only whole-body cryotherapy (22 women); only kinesitherapy (23 women); and both cryotherapy and kinesitherapy (24…women). The control group comprised 25 women who did not undergo any form of therapy. The evaluation of the rheological properties of the blood encompassed measurements of the plasma viscosity, the erythrocyte elongation and aggregation indices, and the level of fibrinogen. RESULTS: The conducted rheological tests revealed a significant decrease in the erythrocyte elasticity and aggregation indices only in the group of women who had undergone both whole-body cryotherapy and kinesitherapy. CONCLUSIONS: Applying whole-body cryotherapy to older women with spondyloarthrosis decreases the elasticity of erythrocytes and, despite favourable changes in the aggregation parameters, problems with perfusion may still appear. For this reason, the benefit of using whole-body cryotherapy in these persons is debatable.
Abstract: BACKGROUND: A physiological oxygen transport through a circulatory and microcirculatory system is essential for execution of cellular functions. Several pathological conditions e.g. infections, ischemia, cancer, diabetes, hypertension or chronic wounds show a change of oxygen distribution and oxygen tension in cellular microenvironment. Additionally complex operative procedures in order to reconstruct tissue defects require a reliable monitoring of microcirculation. OBJECTIVE: Target of this study was to evaluate skin oxygenation during an ischemia-reperfusion experiment using transepidermal oxygen flux imaging. METHODS: Twelve patients at the Department of Plastic and Reconstructive surgery of the University hospital of Regensburg underwent…to elective hand operations. During the operation a tourniquet is standardly set on the upper arm to create ischemia in order to facilitate the operative procedure. Measurements were performed at the different time intervals: in rest, under ischemia and after reperfusion. RESULTS: The transepidermal oxygen flux increased during the ischemic condition compared to normal condition and decreased to a lower value during reperfusion (rest: 0.043±0.007, ischemia: 0.063±0.014, reperfusion: 0.030±0.028). CONCULSION: Transepidermal oxygen flux imaging by ratiometric luminescence imaging seems to be a reliable tool to assess skin oxygenation. However dynamic changes seem to be more informative than absolute thresholds. Further investigations are necessary to prove these promising results.