Clinical Hemorheology and Microcirculation - Volume 85, issue 3

Authors: Liu, Fang | Gao, Bo | Wang, Yu

Article Type: Research Article

Abstract: BACKGROUND: Atherosclerosis (AS) is a common inflammatory cardiovascular disease, and circular RNAs (circRNAs) are associated with the pathogenesis of AS. CircRNA Interleukin (IL)-1 receptor-associated kinase 1 (circIRAK1, hsa_circ_0091822) was upregulated in AS. The aims of this study were to ascertain the function and mechanism of circIRAK1 in AS. METHODS: Human Umbilical Vein Endothelial Cells (HUVECs) were treated with oxidized low-density lipoprotein (ox-LDL). RNA expression was detected by reverse transcription-quantitative polymerase chain reaction assay. Cell viability was examined using Cell Counting Kit-8 assay. Tube formation ability was measured by tube formation assay. Cell apoptosis was assessed using flow cytometry. …Western blot was used for protein detection. Inflammatory reaction was evaluated via Enzyme-linked immunosorbent assay. Oxidative injury was analyzed by commercial kits. Target binding was determined through dual-luciferase reporter assay, RNA immunoprecipitation assay and pull-down assay. RESULTS: The expression of circIRAK1 was upregulated in AS serums and ox-LDL-treated HUVECs. Silencing circIRAK1 enhanced cell viability and angiogenesis while suppressed cell apoptosis, inflammatory response and oxidative stress in ox-LDL-stimulated HUVECs. CircIRAK1 served as a molecular sponge for miR-330-5p. CircIRAK1 regulated ox-LDL-mediated cell injury by absorbing miR-330-5p. In addition, miR-330-5p prevented endothelial cell dysfunction caused by ox-LDL via targeting tripartite motif containing 14 (TRIM14). TRIM14 expression was upregulated by circIRAK1 through sponging miR-330-5p. CONCLUSION: These results suggested that circIRAK1 upregulated TRIM14 by interacting with miR-330-5p, consequently contributing to ox-LDL-induced endothelial cell injury in AS. Show more

Keywords: circIRAK1, atherosclerosis, miR-330-5p, TRIM14

DOI: 10.3233/CH-221551

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 195-209, 2023

Authors: Chen, Kailing | Fan, Peili | Luo, Rongkui | Han, Hong | Mao, Feng | Wang, Kun | Dong, Yi | Wang, Wen-Ping

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the contrast enhanced ultrasound (CEUS) and contrast enhanced magnetic resonance imaging (CEMRI) features of intrahepatic splenosis (IHS). METHODS & MATERIALS: Five patients (three males and two females, median age, 44 years; range,32–73 years) with seven IHSs were retrieved from the database of our hospital from March 2012 to October 2021. All IHSs were confirmed histologically by surgery. The CEUS and CEMRI characteristics of individual lesion were fully analyzed. RESULTS: All IHS patients were asymptomatic and four out of five patients had history of splenectomy. On CEUS, all IHSs were hyperenhancement in arterial phase. …71.4% (5/7) of IHSs manifested overall filling within few seconds, the other two lesions showed centripetal filling. Subcapsular vascular hyperenhancement and feeding artery was seen in 28.6% (2/7) and 42.9% (3/7) of IHSs, respectively. During portal venous phase, IHSs presented hyperenhancement (2/7) or isoenhancement (5/7). Moreover, rim-like hypoenhanced area was uniquely observed surrounding 85.7% (6/7) of IHSs. In late phase, seven IHSs remained continuous hyper- or isoenhancement. On CEMRI, five IHSs showed mosaic hyperintense in early arterial phase, the other two lesions showed homogeneous hyperintense. In portal venous phase, all IHSs revealed continuous hyper- (71.4%, 5/7) or iso-intense (28.6%, 2/7). During late phase, one IHS (14.3%, 1/7) became hypointense, the other lesions remained hyper- or isointense. CONCLUSION: Diagnosis of IHS can be based on typical CEUS and CEMRI features in patients with history of splenectomy. Show more

Keywords: Intrahepatic splenosis, contrast enhanced ultrasound, magnetic resonance imaging

DOI: 10.3233/CH-221582

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 211-221, 2023

Authors: Wang, Kun | Zhu, Yuli | Bao, Jingwen | Zhu, Zheng | Dong, Yi | Han, Hong | Wang, Wenping

Article Type: Research Article

Abstract: OBJECTIVE: The aim in this study was to determine the efficacy of shear wave dispersion (SWD) technique for the prediction of post hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma after hepatectomy and develop an SWD based risk prediction model. METHODS & MATERIALS: We prospectively enrolled 205 consecutive patients who were scheduled to undergo hepatectomy for hepatocellular carcinoma (HCC), pre-operative SWD examination, laboratory data and some other clinicopathological tests were collected. The risk factors of PHLF were identified according to univariate and multivariate analysis, a predictive model was established based on logistic regression analyses. RESULTS: …SWD examination was successfully performed in 205 patients. PHLF occurred in 51 patients (24.9%), including 37/11/3 patients with Grade A/B/C, respectively. There was a high correlation between SWD value of liver and liver fibrosis stage (r  = 0.873, p  < 0.05). Patients with PHLF has a higher median SWD value of liver than patients without PHLF [17.4 vs 14.7 (m/s)/kHz, p  < 0.05 ]. The SWD value of liver, total bilirubin (TB), international normalized ratio of prothrombin time (INR) and splenomegaly were significantly related to PHLF based on the multivariate analysis. A new prediction model (PM) for PHLF was established (PM = –12.918 + 0.183× SWD + 6.668× INR +0.100×TB+1.240×splenomegaly). The optimal cutoff value of SWD for predicting PHLF was 16.7 (m/s)/kHz. The area under the curve (AUC) of the PM for PHLF was 0.833, which was higher than that of SWD, INR, Forns, FIB4, APRI (p  < 0.005, respectively). CONCLUSION: SWD is a promising and reliable method for PHLF prediction in patients with HCC who were undergoing hepatectomy. Compared with SWD, Forns, APRI and FIB-4, PM demonstrate better efficacy for preoperative PHLF prediction. Show more

Keywords: Keywords Hepatocellular carcinoma, shear wave dispersion, post hepatectomy liver failure

DOI: 10.3233/CH-221662

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 223-234, 2023

Authors: Miao, Huanhuan | Zhong, Jingwen | Xing, Xuesha | Sun, Jiawei | Wu, Jiaqi | Wu, Chengwei | Yuan, Yan | Zhou, Xianli | Wang, Hongbo

Article Type: Research Article

Abstract: OBJECTIVE: The purpose of this study was to explore the risk factors of cervical lymph node metastasis(LNM) in papillary thyroid carcinoma(PTC) coexistent with Hashimoto’s thyroiditis(HT). METHODS: The clinical data of patients who underwent thyroid operation between November 2016 and January 2020 in our hospital were analyzed retrospectively. The association between sonographic features and the risk factors of cervical LNM in PTC coexistent with HT was analyzed and a nomogram based on the risk factors was built. RESULTS: Age, US features as calcification, blood flow type, distance between thyroid nodule and fibrous capsule were risk factors of …cervical LNM(P  < 0.05).Size, SWVmax and SWVmean of thyroid nodule, SWVratio between thyroid nodule and thyroid gland were higher in PTCs with LNM than those without LNM(P  < 0.05). The ROC curve showed that the cutoff value of SWVratio for predicting LNM was 1.29 (Sensitivity = 0.806, Specificity = 0.775, AUC = 0.823, P  < 0.001). Based on the risk factors above, a relevant nomogram prediction model was established. The model verification showed that the C-index of the modeling set was 0.814, indicating that the nomogram model had good predicted accuracy. CONCLUSION: Based on the risk factors above, a relevant nomogram prediction model was established. The model verification showed that the C-index of the modeling set was 0.814, indicating that the nomogram model had good predicted accuracy. The nomogram based on the risk factors above had good prediction ability, which could optimize thyroidectomy and cervical lymph node dissection and improving prognosis. Show more

Keywords: Hashimoto’s thyroiditis, papillary thyroid carcinoma, lymph node metastasis, ultrasound, nomogram

DOI: 10.3233/CH-221673

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 235-247, 2023

Authors: Wang, Tianqi | Xu, Mingda | Xu, Changyu | Wu, Yuqing | Dong, Xiaoqiu

Article Type: Research Article

Abstract: OBJECTIVE: To compare the diagnostic value of microvascular flow imaging (MVFI) with that of contrast-enhanced ultrasound (CEUS) for the analysis of blood flow in benign and malignant cervical lymph nodes. MATERIAL AND METHODS: As a prospective study, 95 cervical enlarged lymph nodes (43 benign and 52 malignant) were observed in 95 patients using conventional ultrasonography (including gray and Color Doppler Flow Imaging), CEUS, and MVFI. Two researchers evaluated vascular parameters of MVFI (vascular distribution, internal vascular features, vascular index) and CEUS (enhancement mode, enhancement type) and compared the diagnostic effects of MVFI and CEUS.All results were compared with …pathological findings. RESULTS: There were significant differences in the vascular distribution and internal vascular features of benign and malignant lymph nodes on MVFI (P  < 0.05). The vascular distribution of benign lymph nodes was mainly of the central and avascular types, the internal blood vessels were mostly normal, the vascular distribution of malignant lymph nodes was mainly mixed, the internal vessels were mainly tortuous and displaced. The optimal cut-off value of the benign and malignant lymph node vascular index (VI) was 15.55%, and the area under the receiver operating characteristic curve (AUC) of the VI was 0.876. There were also significant differences in the enhancement mode and types of benign and malignant lymph nodes in CEUS (P  < 0.05). The benign lymph nodes showed centrifugal perfusion, and the enhancement types were mostly type I and type II. Most malignant lymph nodes showed centripetal or mixed perfusion, and the enhancement types were usually type III and type IV. The accuracy, sensitivity, and specificity of CEUS in the diagnosis of lymph node lesions were 84.2%, 84.6% and 83.7%, respectively, and the AUC was 0.845. The accuracy, sensitivity, and specificity of MVFI in the diagnosis of lymph node lesions were 85.3%, 84.6%, and 86.0%, respectively, and the AUC was 0.886. CONCLUSION: Both CEUS and MVFI are valuable in differentiating benign and malignant lesions of lymph nodes and have a similar diagnostic performance; however, MVFI is less invasive and simpler than CEUS. Therefore it is preferred for auxiliary examination of enlarged lymph nodes that are difficult to diagnose by conventional ultrasound. Show more

Keywords: Conventional ultrasound, contrast-enhanced ultrasound, microvascular flow imaging, lymph nodes

DOI: 10.3233/CH-231860

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 249-259, 2023

Authors: Liu, Naxiang | Chen, Yijie | Wang, Yaoqin | Huang, Weiqin | Zhan, Lili | Du, Zhongshi | Zhong, Zhaoming | Wu, Zhougui | Shen, Youhong | Deng, Xiaohong | Ni, Shixiong | Tang, Lina

Article Type: Research Article

Abstract: OBJECTIVES: To present a method combining ultrasound (US) and contrast-enhanced ultrasound (CEUS) features for differential diagnosis of cervical tuberculous lymphadenitis (CTL) and primary lymphoma. METHODS: A total of 155 patients with CTL (n  = 49) and lymphoma (n  = 106) who underwent US and CEUS were retrospectively included. The features extracted from US and CEUS and the significant clinical data were created three models using the least absolute shrinkage and selection operator and logistic regression analysis. The diagnostic performance of the models was assessed using the area under the curve (AUC). RESULTS: The combined model outperformed US model …and CEUS model in distinguish CTL from lymphoma achieved favorable performances in training set and validation set with AUCs of 0.958 and 0.946 as well as high accuracies (91.7% and 87.2%), sensitivities (95.9% and 84.4%) and specificities (82.4% and 93.3%). Delong’s test showed that among the three models, combined model was significantly different from the other two models in training set (p  = 0.011 and 0.029, respectively) and validation set (p  = 0.018 and 0.001, respectively). CONCLUSIONS: A combination of US and CEUS achieved good diagnostic performance in differentiating lymphoma and CTL, which might aid in clinical decision-making. Show more

Keywords: Contrast-enhanced ultrasound, cervical tuberculous lymphadenitis, lymphoma, lymph nodes, LASSO.

DOI: 10.3233/CH-231876

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 261-275, 2023

Authors: Brebant, V. | Lemonnier, L. | Georgieva, M. | Anker, A. | Heine, N. | Seitz, S. | Frank, K. | Prantl, L. | Eigenberger, A.

Article Type: Research Article

Abstract: BACKGROUND: Reconstructive surgery is established as a standard treatment option after mastectomy due to cancer. It is crucial to patients to achieve a natural and symmetric looking breast through reconstruction. Anthropometric measurements are used to assess the objective symmetry of the breast, which are prone to errors and difficult to reproduce. OBJECTIVE: The aim of this work is to validate breast volumetry using three-dimensional surface imaging. METHODS: We compared preoperatively analog and digitally evaluated volume of the breast with our gold standard, direct water displacement measurement of the mastectomy specimen. We examined 34 breast specimens in …total. RESULTS: Each measurement method (Breast Sculptor, VAM, Breast-V) for breast volume/mass determination demonstrates acceptable agreement ranges when compared with resected volumes and masses. The strongest volumetry instrument is Breast Sculptor (digital), the weakest is Breast-V (analog). CONCLUSIONS: 3D surface imaging is a quick, effective, and convenient method to evaluate breast shape and volume. The accuracy, reproducibility, and reliability of 3D surface imaging were comparable with MRI in our study. This takes us a step closer to the long-term goal of establishing robust instruments to plan breast reconstructive surgery, achieve better surgical results, and contribute to quality assurance in breast surgery. Show more

Keywords: Breast reconstruction, breast cancer, 3D imaging, breast surgery, volumetry, anthropometry

DOI: 10.3233/CH-229101

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 277-287, 2023

Authors: Jung, F. | Lamby, P. | Prantl, L. | Wiggermann, P. | Jung, E.M. | Krüger-Genge, A. | Franke, R.P.

Article Type: Research Article

Abstract:  Iodinated contrast media (ICM) are widely used for diagnostic and interventional procedures in radiology and cardiology. Ideally, they should not interact with blood cells or vascular wall cells to avoid deteriorations of the blood circulation. However, it is well known that ICM can affect erythrocytes as well as endothelial cells which consequently might perturb especially the microcirculation. In former studies the influence of two ICM (iodixanol versus iopromide) on the vascular system, the development of blood stasis, on changes in renal resistive index (RRI) and vascular diameters, and on the post-mortem distribution of iodine as marker for ICM in the …explanted kidneys was examined. The modus of ICM application into the supra-renal aorta followed the regime in interventional cardiology, so that 10 bolus injections were administered at steady intervals (iopromide 4,32 ml / iodixanol 5 ml) accompanied by infusion of 500 ml isotonic NaCl-solution. In the present study, the post-mortem X-ray analysis revealed that there were no differences in iodine content in the regions of the mid-cortex and the medullo-pelvic transition zone of the kidneys after application of both ICM. Remarkable differences, however, were found in the region of the capsule-near cortex, where the application of iopromide led to a significantly lower iodine content in the microcirculation. This is in good agreement with former studies, in which a maldistribution in this area, presumably due to a decrease in arteriolar inflow as a result of stasis/occlusion was shown. Show more

Keywords: Iodinated contrast media, iodixanol, iopromide, kidney

DOI: 10.3233/CH-229102

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 289-295, 2023

Authors: Kaiser, Ulrich | Dropco, Ivor | Reuthner, Kathrin | Ertl, Michael | Schlitt, Hans Jürgen | Herr, Wolfgang | Stroszczynski, Christian | Jung, Ernst Michael

Article Type: Research Article

Abstract: OBJECTIVE: The study aim was to investigate the use of a novel device, the Vscan Air™, for rapidly and effectively performing ultrasound in student teaching during the COVID-19 pandemic. MATERIAL AND METHODS: As part of the ultrasound practical course with integrated hands-on activity required by the regular medical curriculum, 100 medical students were instructed in the use of the Vscan Air™, including duplex mode. They then evaluated the quality of the ultrasound images obtained by the Vscan Air™ from previously selected organs. RESULTS: 100 students were interviewed (female n  = 68, male n  = 32; age >18 years …n  = 100). The rated image quality never fell below a mean of 3 for the examined organs and portal vein flow (liver 4,58; spleen 3,99; kidneys 4,29; aorta 4,16; Douglas/rectovesical space 4,14; portal vein 4,43; pancreas 3,53; Focused Assessment with Sonography for Trauma 4,38). Scores below 3 were found sporadically in ultrasounds of the spleen (n  = 4), kidneys (n  = 3), Douglas/rectovesical space (n  = 2), and pancreas (n  = 15). The liver was rated the lowest for 59 ratings. The portal vein was evaluated in 68 cases. The hepatic artery and hepatic veins could be also visualized in all 68 examinations. The aorta was evaluated in 62 cases. CONCLUSION: The Vscan Air™ technology offered adequate image quality and provided a new, fast and patient-oriented technique to support continuous ultrasound examinations and education of students, especially during a pandemic. Particularly noteworthy is the uncomplicated compliance with the required high level of hygiene. Show more

Keywords: VScan Air, mobile ultrasound, ultrasound, student teaching

DOI: 10.3233/CH-229104

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 297-305, 2023

Authors: Anker, Alexandra M. | Lenhard, Jasmin | Klein, Silvan M. | Felthaus, Oliver | Prantl, Lukas | Ruewe, Marc

Article Type: Research Article

Abstract: BACKGROUND: Recent studies have demonstrated that local application of corticosteroids reduces wound exudation following abdominoplasty and other reconstructive surgical procedures. On the other hand, corticosteroids might provoke wound healing disturbances due to their immunosuppressive effects. OBJECTIVE: The main objective of this study was to gain further information about the impact of the corticosteroid triamcinolone on cell migration in abdominoplasty patients. METHODS: An in-vitro scratch assay wound healing model was applied to observe cell migration of fibroblasts cultured with nutrient medium containing human seroma aspirate±triamcinolone. RESULTS: There were no significant differences regarding cell migration …when fibroblasts were incubated with triamcinolone + seroma containing culture medium compared to seroma containing culture medium without triamcinolone. CONCLUSIONS: The performed in-vitro study suggests that triamcinolone does not decelerate fibroblast cell migration which is considered as a surrogate of wound healing. Show more

Keywords: Cell migration, fibroblasts, corticosteroids, triamcinolone, scratch assay

DOI: 10.3233/CH-229106

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 307-314, 2023