Clinical Hemorheology and Microcirculation - Volume 69, issue 3

Authors: Wiewiora, Maciej | Krzak, Albert | Twardzik, Maciej | Piecuch, Jerzy

Article Type: Research Article

Abstract: Adipose tissue is actively involved in angiogenesis through secretion of biologically active substances. This topic has been the subject of many recent publications concerning the pathophysiology and treatment of obesity. We discuss the relationship between obesity, angiogenesis and blood rheology.

Keywords: Angiogenesis, obesity

DOI: 10.3233/CH-170348

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 339-342, 2018

Authors: Guo, Le-Hang | Wang, Dan | Qian, Yi-Yi | Zheng, Xiao | Zhao, Chong-Ke | Li, Xiao-Long | Bo, Xiao-Wan | Yue, Wen-Wen | Zhang, Qi | Shi, Jun | Xu, Hui-Xiong

Article Type: Research Article

Abstract: OBJECTIVE: With the fast development of artificial intelligence techniques, we proposed a novel two-stage multi-view learning framework for the contrast-enhanced ultrasound (CEUS) based computer-aided diagnosis for liver tumors, which adopted only three typical CEUS images selected from the arterial phase, portal venous phase and late phase. MATERIALS AND METHODS: In the first stage, the deep canonical correlation analysis (DCCA) was performed on three image pairs between the arterial and portal venous phases, arterial and delayed phases, and portal venous and delayed phases respectively, which then generated total six-view features. While in the second stage, these multi-view features were …then fed to a multiple kernel learning (MKL) based classifier to further promote the diagnosis result. Two MKL classification algorithms were evaluated in this MKL-based classification framework. We evaluated proposed DCCA-MKL framework on 93 lesions (47 malignant cancers vs. 46 benign tumors). RESULTS: The proposed DCCA-MKL framework achieved the mean classification accuracy, sensitivity, specificity, Youden index, false positive rate, and false negative rate of 90.41 ± 5.80%, 93.56 ± 5.90%, 86.89 ± 9.38%, 79.44 ± 11.83%, 13.11 ± 9.38% and 6.44 ± 5.90%, respectively, by soft margin MKL classifier. CONCLUSION: The experimental results indicate that the proposed DCCA-MKL framework achieves best performance for discriminating benign liver tumors from malignant liver cancers. Moreover, it is also proved that the three-phase CEUS image based CAD is feasible for liver tumors with the proposed DCCA-MKL framework. Show more

Keywords: Contrast-enhanced ultrasound, artificial intelligence, liver tumor, deep canonical correlation analysis, multiple kernel learning

DOI: 10.3233/CH-170275

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 343-354, 2018

Authors: Zhang, Ying | Xu, Hui-Xiong | Zhao, Chong-Ke | Li, Xiao-Long | Bo, Xiao-Wan | He, Ya-Ping | Liu, Bo-Ji | Wang, Dan | Ren, Wei-Wei

Article Type: Research Article

Abstract: OBJECTIVE: To assess the performance of conventional high frequency ultrasound (US) and US elastography in diagnosis of complex cystic and solid breast lesions. METHODS: Ninety three lesions in 93 patients underwent conventional US and US elastography, including strain elastography, acoustic radiation force impulse (ARFI) imaging, and point shear wave speed (SWS) measurement. RESULTS: Pathological examination revealed 31 (33.3%) of the 93 lesions were malignant and the remaining 62 (66.7%) were benign. Multivariate analysis showed that elder patient (OR: 25.301), internal vascularity (OR: 4.518), and not circumscribed margin (OR: 3.813) were independent predictors for malignancy, while predominately …cystic lesions (OR: 0.178) was a predictor for benign lesions (all p  < 0.05). Invalid SWS measurement was occurred in 19 of 31 (61.3%) malignant lesions and 16 of 62 (25.8%) benign lesions, respectively (p  < 0.05). The mean SWS value for malignant lesions was significantly lower than that for benign ones, being 1.60±0.63 m/s (range, 0.68–2.70 m/s) versus 2.33±0.77 m/s (range, 0.67–3.97 m/s) (p  < 0.05). Areas under the ROC curve (Azs) for Breast Imaging Reporting and Data System (BI-RADS) assessment, strain elasticity score, ARFI imaging and valid point SWS measurement were 0.844, 0.734, 0.763 and 0.778,respectively. CONCLUSIONS: US BI-RADS category, strain elastography score, ARFI imaging patterns and point SWS measurement are useful for malignancy prediction of complex cystic and solid breast lesions. The result that SWS for malignant lesions is lower than benign one should be carefully interpreted since invalid SWS measurement is excluded for analysis. The true stiffness of malignant cystic and solid lesions should be further evaluated with a new generation of two-dimensional SWS imaging. Show more

Keywords: Complex cystic and solid lesion, breast, ultrasound, elastography, Breast Imaging Reporting and Data System, acoustic radiation force impulse

DOI: 10.3233/CH-170252

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 355-370, 2018

Authors: Hsiu, Hsin | Chen, Chao-Tsung | Hung, Shuo-Hui | Chen, Guan-Zhang | Huang, Yu-Ling

Article Type: Research Article

Abstract: BACKGROUND: There is an urgent need to improve the early diagnosis of breast cancer. OBJECTIVE: The present study applied spectral and beat-to-beat analyses to laser-Doppler (LDF) data sequences measured on the skin surface on the back of the right hands, with the aim of comparing the different peripheral microcirculatory-blood-flow (MBF) perfusion condition between breast-cancer and control subjects. METHODS: ECG and LDF signals were obtained simultaneously and noninvasively from 23 breast-cancer patients and 23 age-matched control subjects. Time-domain beat-to-beat indexes and their variability parameters were calculated. Spectral indexes were calculated using the Morlet wavelet transform. …RESULTS: The beat-to-beat LDF pulse width and its variability were significantly smaller in cancer patients than in the controls. The energy contributions of endothelial-, neural-, and myogenic-related frequency bands were also significantly smaller in cancer patients. CONCLUSIONS: The present study has revealed significant differences in the beat-to-beat and spectral indexes of skin-surface-acquired LDF signals between control subjects and breast-cancer patients. This illustrates that LDF indexes may be useful for monitoring the changes in the MBF perfusion condition induced by breast cancer. Since the breast-cancer patients were at TNM stages 0– 2, the present findings may aid the development of indexes for detecting breast cancer. Show more

Keywords: Breast cancer, laser Doppler, beat-to-beat, spectral analysis, noninvasive

DOI: 10.3233/CH-170295

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 371-381, 2018

Authors: Kovacs, David | Totsimon, Kinga | Biro, Katalin | Kenyeres, Peter | Juricskay, Istvan | Kesmarky, Gabor | Toth, Kalman | Toth, Andras

Article Type: Research Article

Abstract: BACKGROUND: Viscosity measurement is challenging due to the internal properties of blood and the artifacts deriving from the various viscometer systems. OBJECTIVE: We aimed to determine the pitfalls of a cone-plate viscometer (Brookfield DV-III Ultra LV) before starting measurements and compare it to our capillary type model (Hemorex Hevimet 40). Effects of sample storage and thermal calibration were assessed as well. METHODS AND RESULTS: Intra-observer variability was studied by 10 replicate measurements of 7 blood samples, mean coefficients of variation were less than 5%. Instruments were compared by measuring 26 blood samples, an average difference of …7% in WBV and 10% in PV was observed. 9 blood samples were stored at 4°C, 22°C and 37°C up to 48 hours to study the effect of storage on viscosity values. WBV at 50 and 100 s-1 became significantly lower after 3 hours at 37°C (p  < 0.05). WBV at higher shear rates and PV remained constant at all temperatures. To evaluate the possibility of measuring one sample at different temperatures, 8 blood samples were measured at 40°C with the device calibrated both at 20°C and 40°C; no significant difference was observed. CONCLUSIONS: Thorough validation studies are required before starting experimental and routine viscosity measurements. Show more

Keywords: Capillary, rotational, cone-plate, storage, reproducibility, temperature

DOI: 10.3233/CH-170301

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 383-392, 2018

Authors: Brettner, Florian | Darling, Joshua | Baeuml, Edith-Cathrin | Mannell, Hanna | Frank, Hans-Georg | Amini, Martina | Hulde, Nikolai | Kammerer, Tobias | Becker, Bernhard F. | Rehm, Markus | Conzen, Peter | Chappell, Daniel

Article Type: Research Article

Abstract: BACKGROUND: The endothelial glycocalyx plays a decisive role in maintaining vascular homeostasis. Previous animal models have mainly focused on in-vitro experiments or the isolated beating guinea pig heart. To further evaluate underlying mechanisms of up- and down regulation, knock-out animals seem to be a promising option. OBJECTIVE: Aim of the present study was to evaluate if an isolated mouse-heart model is suitable for glycocalyx research. METHODS: Isolated beating mouse hearts (C57/Bl6J) underwent warm, no-flow ischemia and successive reperfusion. Coronary effluent was analyzed by ELISA and Western blot for the glycocalyx core protein: syndecan-1. Hearts were prepared …for either immunofluorescence or electron microscopy and lysed for Western blot analysis. RESULTS: An endothelial glycocalyx covering the total capillary circumference and syndecan-1 were detected by electron and immunofluorescence microscopy. Ischemia/reperfusion seriously deteriorated both findings. Confoundingly, syndecan-1 was not detectable either in the coronary effluent or in the lysates of blood-free hearts by ELISA or Western blot technique. CONCLUSIONS: Blood vessels of mouse hearts contain an endothelial glycocalyx comparable to that of other animals also with respect to its core protein syndecan-1. But, for studies including quantification of intravascular soluble glycocalyx constituents, the amount of syndecan-1 in mouse hearts seems to be too low. Show more

Keywords: Endothelial glycocalyx, isolated beating mouse heart, syndecan-1, electron microscopy, immunofluorescence

DOI: 10.3233/CH-170327

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 393-403, 2018

Authors: Petrovics, Laura | Nagy, Tibor | Hardi, Peter | Bognar, Laura | Pavlovics, Gabor | Tizedes, Gyorgy | Takacs, Ildiko | Jancso, Gabor

Article Type: Research Article

Abstract: BACKGROUND: Ischemia-reperfusion injury may lead to insufficient microcirculation and results in partial flap loss during the free flap surgeries. OBJECTIVE: This study aimed to investigate the effect of trimetazidine (TMZ) on oxidative stress, inflammation and histopathological changes, using the epigastric skin flap model in rats. METHODS: 40 male Wistar rats were used, that were divided into four groups. Control group, non-treated ischemic (I/R)-group and two trimetazidine treated groups (preischemically, postischemically) were established. To create ischemia in the skin flap, the superficial epigastric vessels were clamped for six hours, followed by twenty-four hours of reperfusion. Blood samples …and biopsies from skin flaps were collected at the end of the reperfusion period. The inflammatory response, the degree of oxidative stress (by measuring the plasma level of malondialdehyde (MDA), reduced glutathione (GSH); sulfhydryl (–SH) groups) and histopathological changes were evaluated. RESULTS: Inflammatory response, and oxidative stress were significantly attenuated in the trimetazidine treated groups, compared to the non-treated ischemic group. Histopathological findings were also correlated with the biochemical results. CONCLUSION: In our study trimetazidine could reduce the ischaemia-reperfusion injury, even after an unexpected ischemic period, so it is a promising drug during free tissue transfer, replantation or during revascularization procedures in the future. Show more

Keywords: Ischaemia-reperfusion injury, free flaps, reconstruction, trimetazidine, inflammation, oxidative stress

DOI: 10.3233/CH-170335

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 405-415, 2018

Authors: Ouédraogo, Valentin | Connes, Philippe | Tripette, Julien | Tiendrébéogo, Arnaud Jean Florent | Sow, Abdou Khadir | Diaw, Mor | Seck, Moussa | Diop, Mountaga | Hallab, Magid | Belue, Rhonda | Samb, Abdoulaye | Ba, Abdoulaye | Lefthériotis, Georges

Article Type: Research Article

Abstract: BACKGROUND: Sickle cell trait (SCT) is a benign condition of sickle cell disease. Nevertheless, previous reports showed that SCT carriers have increased blood viscosity and decreased vascular reactivity compared to non-SCT carrier. The benefit of regular exercise on vascular function has been well documented in the general population but no study focused on the SCT population. PURPOSE: The aim of our study was to compare arterial stiffness and blood viscosity between trained and untrained SCT carriers, as well as a group of untrained non-SCT. METHODS: Arterial stiffness (finger-toe pulse wave velocity) and blood viscosity were evaluated …in untrained non-SCT carriers (n  = 10), untrained SCT carriers (n  = 23) and trained SCT carriers (n  = 17) who reported at least 10 hours of physical exercise per week. RESULTS: Untrained SCT carriers had higher pulse wave velocity (p  = 0.032) and blood viscosity (p  < 0.001) than their trained counterparts. In addition, untrained SCT carriers had higher blood viscosity (p  < 0.001) than the untrained non-SCT group. A positive association was noted between blood viscosity and pulse wave velocity in the whole study population. CONCLUSION: Our study suggests that regular exercise may be beneficial for the vascular function of SCT carriers. Show more

Keywords: Sickle cell trait, exercise training, pulse wave velocity, blood viscosity

DOI: 10.3233/CH-170310

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 417-424, 2018

Authors: Ren, Wei-Wei | Li, Xiao-Long | Wang, Dan | Liu, Bo-Ji | Zhao, Chong-Ke | Xu, Hui-Xiong

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate a special kind of ultrasound (US) shear wave elastography for differential diagnosis of breast lesions, using a new qualitative analysis (i.e. the elasticity score in the travel time map) compared with conventional quantitative analysis. METHODS: From June 2014 to July 2015, 266 pathologically proven breast lesions were enrolled in this study. The maximum, mean, median, minimum, and standard deviation of shear wave speed (SWS) values (m/s) were assessed. The elasticity score, a new qualitative feature, was evaluated in the travel time map. The area under the receiver operating characteristic (AUROC) curves were plotted to evaluate …the diagnostic performance of both qualitative and quantitative analyses for differentiation of breast lesions. RESULTS: Among all quantitative parameters, SWS-max showed the highest AUROC (0.805; 95% CI: 0.752, 0.851) compared with SWS-mean (0.786; 95% CI:0.732, 0.834; P  = 0.094), SWS-median (0.775; 95% CI:0.720, 0.824; P  = 0.046), SWS-min (0.675; 95% CI:0.615, 0.731; P  = 0.000), and SWS-SD (0.768; 95% CI:0.712, 0.817; P  = 0.074). The AUROC of qualitative analysis in this study obtained the best diagnostic performance (0.871; 95% CI: 0.825, 0.909, compared with the best parameter of SWS-max in quantitative analysis, P  = 0.011). CONCLUSIONS: The new qualitative analysis of shear wave travel time showed the superior diagnostic performance in the differentiation of breast lesions in comparison with conventional quantitative analysis. Show more

Keywords: Breast lesions, shear wave elastography, shear wave speed, qualitative analysis, diagnostic performance quantitative analysis

DOI: 10.3233/CH-170334

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 425-436, 2018

Authors: Krüger-Genge, Anne | Schulz, Christian | Kratz, Karl | Lendlein, Andreas | Jung, Friedrich

Article Type: Research Article

Abstract: The endothelialization of synthetic surfaces applied as cardiovascular implant materials is an important issue to ensure the anti-thrombotic quality of a biomaterial. However, the rapid and constant development of a functionally-confluent endothelial cell monolayer is challenging. In order to investigate the compatibility of potential implant materials with endothelial cells several in vitro studies are performed. Here, glass and tissue culture plates (TCP) are often used as reference materials for in vitro pre-testing. However, a direct comparison of both substrates is lacking. Therefore, a comparison of study results is difficult, since results are often related to various reference …materials. In this study, the endothelialization of glass and TCP was investigated in terms of adherence, morphology, integrity, viability and function using human umbilical vein endothelial cells (HUVEC). On both substrates an almost functionally confluent HUVEC monolayer was developed after nine days of cell seeding with clearly visible cell rims, decreased stress fiber formation and a pronounced marginal filament band. The viability of HUVEC was comparable for both substrates nine days after cell seeding with only a few dead cells. According to that, the cell membrane integrity as well as the metabolic activity showed no differences between TCP and glass. However, a significant difference was observed for the secretion of IL-6 and IL-8. The concentration of both cytokines, which are associated with migratory activity, was increased in the supernatant of HUVEC seeded on TCP. This result matches well with the slightly increased number of adherent HUVEC on TCP. In conclusion, these findings indicate that both reference materials are almost comparable and can be used equivalently as control materials in in vitro endothelialization studies. Show more

Keywords: Negative control, endothelial cells, glass, TCP, reference

DOI: 10.3233/CH-189904

Citation: Clinical Hemorheology and Microcirculation, vol. 69, no. 3, pp. 437-445, 2018