Clinical Hemorheology and Microcirculation - Volume Pre-press, issue Pre-press

Authors: George, Ashna | Deepika, Chenna | Mohan, Ganesh | Riya, | Rajendran, Vinu | Shastry, Shamee | Blarakrishnan, Jayaraj Mymbilli | Rao, Shwethapriya

Article Type: Research Article

Abstract: BACKGROUND: The assessment of ADAMTS13 factor activity and inhibitor levels was conducted in severe COVID-19 patients as an observational study. RESULTS: A total of 14 patients were included and the average ADAMTS13 activity level at the time of admission was 28.54±30.74% (range 1.83–86.67%) which was reduced compared to controls (88.09±14.77). Nine patients had reduced ADAMTS13 factor activity (<40%) and 77.7% among them had severe deficiency (<10% activity). ADAMTS13 inhibitor was positive (>15 IU/mL) only in two patients and an overall mean value was 8.15±5.8. Elevated D-Dimer and length of hospital stay had significant correlation with ADAMTS13 activity (–0.247 …and 0.306 respectively). No features of thrombotic microangiopathy were observed and hence no plasma exchange was performed. CONCLUSION: Reduced ADAMTS13 factor activity without inhibitor development may give a clue to the disease progress in COVID19. Show more

Keywords: ADAMTS13, Inhibitors, COVID-19, Coagulopathy, SARS CoV2

DOI: 10.3233/CH-221514

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-6, 2022

Authors: Wang, Kun | Dong, Yi | Han, Hong | Cao, Jiaying | Bao, Jingwen | Wang, Wen-Ping

Article Type: Research Article

Abstract: OBJECTIVE: This study aimed to evaluate the diagnostic performance of two-dimensional shear wave elastography (2D-SWE) with a propagation map in evaluating the degree of hepatic fibrosis in patients with liver tumors before resection. METHODS AND MATERIALS: From January 2020 to April 2021, 128 patients with liver tumors were prospectively enrolled, including 20 benign liver tumors and 108 malignant liver tumors. 2D-SWE with a propagation map technology was used to measure the stiffness of liver parenchyma 2 cm away from the tumor. The median value of five measurements was used in this study. The stage of hepatic fibrosis was …graded in accordance with Scheuer standard. Spearman correlation was used to analyze the correlation between liver fibrosis stage and the liver stiffness. Univariate and multivariate linear regression analyses were used to determine significant affecting factors for liver stiffness value. The diagnostic performance of 2D-SWE with a propagation map in predicting fibrosis stage was evaluated by receiver operating characteristic curve analysis. RESULTS: The median liver stiffness value in patients with benign liver tumors was lower than that in patients with malignant liver tumors (6.0 kPa vs. 9.4 kPa, p  <  0.05). The median liver stiffness values in patients with primary liver cancer were higher than that in patients with benign liver tumors and other types of malignant liver tumors (9.6 kPa vs. 6.0 kPa, p  <  0.05). The liver stiffness measured by 2D-SWE was highly correlated with the fibrosis stage confirmed by postoperative pathology (r  = 0.834, p  <  0.05). For the liver stiffness value, PLT,TB,ALB and fibrosis stage are significantly associated with liver stiffness. The median liver stiffness values in stages S0–S4 of fibrosis were 6.0, 7.2, 8.0, 9.4, and 12.6 kPa, respectively. The areas under the ROC curve of S ≥1, S ≥2, S ≥3, and S  = 4 as predicted by SWE were 0.932, 0.945, 0.945, and 0.916, respectively. According to the Youden index, the optimal critical values for predicting fibrosis S ≥1, S ≥2, S ≥3, and S  = 4 were 6.8 (sensitivity of 89.69% and specificity of 93.55%), 7.5 (sensitivity of 87.50 % and specificity of 95.00 %), 8.3 (sensitivity of 87.14 % and specificity of 87.93 %) and 9.8 (sensitivity of 79.55 % and specificity of 86.90 %) kPa. CONCLUSION: 2D-SWE with a propagation map could noninvasively and accurately predict the staging of liver fibrosis in patients with liver tumors before resection. Show more

Keywords: Shear wave elastography, liver fibrosis, ultrasound, propagation map

DOI: 10.3233/CH-221511

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2022

Authors: Zhang, Pu | Wang, Weiping | Li, Meilan

Article Type: Research Article

Abstract: BACKGROUND: Dysfunction of endothelial cells in the arterial vasculature is an essential contributor to the pathogenesis of atherosclerosis. Circular RNAs (circRNAs) exert important regulatory functions in endothelial cell dysfunction. Here, we explored the precise role and mechanism of circ_0050486 in regulating endothelial cell injury induced by oxidized low-density lipoprotein (ox-LDL). METHODS: Circ_0050486, microRNA (miR)-182-5p and myeloid differentiation primary response gene 88 (MyD88) were quantified by quantitative real-time PCR or western blot. Cell viability, proliferation and apoptosis were examined by MTS, 5-Ethynyl-2’-Deoxyuridine (EdU), and flow cytometry assays, respectively. Direct relationship between miR-182-5p and circ_0050486 or MYD88 was verified by …dual-luciferase reporter and RNA immunoprecipitation (RIP) assays. RESULTS: Circ_0050486 was upregulated in atherosclerosis serum and ox-LDL-treated human aortic endothelial cells (HAECs). Silencing of circ_0050486 suppressed HAEC injury induced by ox-LDL. Mechanistically, circ_0050486 targeted miR-182-5p, and the effects of circ_0050486 silencing were partially due to the upregulation of miR-182-5p. MYD88 was a direct target of miR-182-5p, and miR-182-5p-mediated inhibition of MYD88 attenuated ox-LDL-evoked HAEC injury. Circ_0050486 bound to miR-182-5p to regulate MYD88 expression. Additionally, the NF-κB signaling pathway was involved in the regulation of circ_0050486/miR-182-5p/MYD88 axis in ox-LDL-treated HAECs. CONCLUSION: Our study identifies the functional role of circ_0050486 in ox-LDL-induced endogenous cell injury and establishes a mechanism of circ_0050486 function by affecting MYD88 through competitively binding to shared miR-182-5p. Show more

Keywords: Atherosclerosis, endogenous cells, circ_0050486, miR-182-5p, MYD88

DOI: 10.3233/CH-211259

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-18, 2022

Authors: Shi, Xian-Quan | Dong, Yunyun | Tan, Xiaoqu | Yang, Peipei | Wang, Chunmei | Feng, Wei | Lin, Yuxuan | Qian, Linxue

Article Type: Research Article

Abstract: OBJECTIVE: This study was performed to investigate the accuracy of conventional ultrasound (US), contrast-enhanced US (CEUS), and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing the size of breast cancer. METHODS: In total, 49 breast cancer lesions of 48 patients were included in this study. The inclusion criteria were the performance of total mastectomy or breast-conserving surgery for treatment of breast cancer in our hospital from January 2017 to December 2020 with complete pathological results, as well as the performance of conventional US, CEUS, and DCE-MRI examinations with complete results. The exclusion criteria were non-mass breast cancer shown …on conventional US or DCE-MRI, including that found on CEUS with no boundary with surrounding tissues and no confirmed tumor scope; a tumor too large to be completely displayed in the US section, thus affecting the measurement results; the presence of two nodules in the same breast that were too close to each other to be distinguished by any of the three imaging methods; and treatment with preoperative chemotherapy. Preoperative conventional US, CEUS, and DCE-MRI examinations were performed. The postoperative pathological results were taken as the gold standard. The lesion size was represented by its maximum diameter. The accuracy, overestimation, and underestimation rates of conventional US, CEUS, and DCE-MRI were compared. RESULTS: The maximum lesion diameter on US, CEUS, DCE-MRI and pathology were 1.62±0.63 cm (range, 0.6–3.5 cm), 2.05±0.75 cm (range, 1.0–4.0 cm), 1.99±0.74 cm (range, 0.7–4.2 cm) and 1.92±0.83 cm (range, 0.5–4.0 cm), respectively. The lesion size on US was significantly smaller than that of postoperative pathological tissue (P  <  0.05). However, there was no significant difference between the CEUS or DCE-MRI results and the pathological results. The underestimation rate of conventional US (55.1%, 27/49) was significantly higher than that of CEUS (20.4%, 10/49) and DCE-MRI (24.5%, 12/49) (P  <  0.001 and P  = 0.002, respectively). There was no significant difference in the accuracy of CEUS (36.7%, 18/49) and DCE-MRI (34.7%, 17/49) compared with conventional US (26.5%, 13/49); however, the accuracy of both groups tended to be higher than that of conventional US. The overestimation rate of CEUS (42.9%, 21/49) and DCE-MRI (40.8%, 20/49) was significantly higher than that of conventional US (18.4%, 9/49) (P  = 0.001 and P  = 0.015, respectively). CONCLUSIONS: CEUS and DCE-MRI show similar performance when evaluating the size of breast cancer. However, CEUS is more convenient, has a shorter operation time, and has fewer restrictions on its use. Notably, conventional US is more prone to underestimate the size of lesions, whereas CEUS and DCE-MRI are more prone to overestimate the size. Show more

Keywords: Ultrasound, contrast-enhanced ultrasound, dynamic contrast-enhanced magnetic resonance imaging, breast, breast cancer

DOI: 10.3233/CH-221456

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2022

Authors: Jung, Ernst-Michael | Jung, Friedrich | Verloh, Niklas | Haimerl, Michael | Lürken, Lukas | Jage, Simon | Stroszczynski, Christian | Scharf, Gregor

Article Type: Research Article

Abstract: BACKGROUND: Ultrasound follow-up of transjugular intrahepatic portosystemic shunt (TIPS) is challenging due to the bent course of the stent-graft. OBJECTIVE: Aim of this retrospective study was to assess to which extent the combination of HR flow with Glazing Flow improves hemodynamic assessment in the ultrasound follow-up of TIPS. METHODS: Comparative studies with CCDS and High Resolution (HR)-Flow with Glazing Flow were evaluated regarding image quality and artifacts on a 5-point scale (0 = cannot be assessed up to 5 = maximum image quality without artifacts). In all cases, an experienced examiner performed the examinations with a 1–6 MHz probe (Resona 7, …Mindray). RESULTS: 61 ultrasound examinations in 48 patients were performed; the mean patient age was 54±14.2 years. The use of HR-Flow with Glazing Flow resulted in an improved flow display in 55/61 cases (90.2% ). Both methods correlated well (r  = 0.71), but HR flow with Glazing flow values were in general higher than CCDS values. The reading resulted in an average value of 2.52±0.54 for CCDS and 3.52±0.57 for HR flow with Glazing flow (p  = 0.013). CONCLUSION: The combination of HR-Flow and Glazing Flow results in improved flow representation and reduction of artifacts in the ultrasound follow-up of TIPS. Show more

Keywords: Transjugular intrahepatic shunt (TIPS), color coded doppler sonography (CCDS), HR-flow, glazing flow, postinterventional control

DOI: 10.3233/CH-221427

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-8, 2022

Authors: Watson, O. | Pillai, S. | Howard, M. | Cezar-Zaldua, J. | Whitley, J. | Burgess, B. | Lawrence, M. | Hawkins, K. | Morris, K. | Evans, P.A.

Article Type: Research Article

Abstract: BACKGROUND: A significant degree of mortality and morbidity in Covid-19 is due to thromboembolic disease. Coagulopathy has been well described in critically unwell patients on ICU. There is less clear evidence regarding these changes at the time of presentation to the Emergency Department and the progression of disease over time. OBJECTIVE: We sought to investigate whether coagulation markers can predict severity and how they change over the disease course. METHODS: Patients presenting to a single University Teaching Hospital were recruited and followed up if PCR was positive. Alongside routine blood testing, Rotational Thromboelastometry (ROTEM) was performed. …Outcome data was recorded for all patients, and ROTEM values were compared across outcome groups. RESULTS: Extem and Intem Maximum Lysis were significantly reduced in those who died or required an ICU admission, indicating a reduced ability to break down clot mass in the most critically unwell patients. CONCLUSION: Comparisons between groups demonstrated that one distinguishing feature between those who require ICU admission or die of Covid-19 compared with those who survive a hospital stay to discharge was the extent to which fibrinolysis could occur. Mortality and morbidity in Covid-19 infection appears in part driven by an inability to break down clot mass. Show more

Keywords: Covid-19, Coagulopathy, ROTEM, Visco-elastic testing

DOI: 10.3233/CH-221491

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Li, Jia-Xin | Li, Xiao-Long | Zhu, Jing-E | Zhang, Hui-Li | Yu, Song-Yuan | Xu, Hui-Xiong

Article Type: Research Article

Abstract: INTRODUCTION: Abdominal wall endometriosis (AWE) is a relatively uncommon condition associated with diagnostic and therapeutic difficulties among all the extra pelvic endometriosis. The main therapies include surgery and oral contraceptive administration. Percutaneous cryoablation and high intensity focused ultrasound (HIFU) are also proven to be valid alternatives. Microwave ablation (MWA) as one of the thermal ablation methods has not been applied in the treatment of AWE yet. Herein the feasibility of ultrasound (US) –guided MWA for AWE was explored and treatment response evaluation was carried out using contrast-enhanced imaging. METHODS: Three consecutive patients who underwent US-guided MWA for AWE …with typical symptoms were included in the retrospective study. US, magnetic resonance imaging (MRI), laboratory tests, and US-guided core-needle biopsy were conducted for pre-treatment assessment and ruling out malignancy. The interventional procedure was carried out under local anesthesia with the microwave system and the output power was 60w. Post-treatment contrast-enhanced ultrasound (CEUS) was performed to evaluate the instant treatment response. The follow-up intervals were 1 month, 6 months, and 12 months after treatment. The clinical symptoms and condition of AWE lesions were recorded in each follow-up. RESULTS: The MWA procedure was completed in all the patients with no blood perfusion inside each lesion by instant CEUS after treatment. The mean ablation time was 687 seconds (s) for a single patient (ranged from 660s to 742s). Clinical symptoms were relieved evidently at the end of the follow-up. The pain according to the visual analogue scale (VAS) decreased from 4–6 before treatment to 0–2 after treatment. Mild to moderate complications included slightly abdominal pain and fat liquefaction occurred. In terms of technical outcomes, the volume of all six lesions reduced in different degrees at the end of follow-up (ranged: 16.6% to 100% ). CONCLUSION: US-guided MWA may be a feasible and promising approach for symptomatic AWE. Show more

DOI: 10.3233/CH-211287

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2022

Authors: Wang, Yisheng | Pei, Wen | Lu, Ping

Article Type: Research Article

Abstract: BACKGROUND: Circular RNA (circRNA) is considered to be an important regulator of human diseases, including atherosclerosis (AS). However, the role of circ_ARHGAP32 in AS formation needs further confirmation. OBJECTIVE: To explore the role of circ_ARHGAP32 in AS formation. METHODS: Oxidized low density lipoprotein (ox-LDL) was used to treat vascular smooth muscle cells (VSMCs) to mimic AS cell models in vitro . The expression of circ_ARHGAP32, microRNA (miR)-665, and fibroblast growth factor 2 (FGF2) was analyzed by quantitative real-time PCR. VSMCs function was measured by EdU assay, cell counting kit 8 assay and transwell assay. Protein expression …was determined using western blot analysis. Dual-luciferase reporter assay and RNA pull-down assay were performed to verify RNA interaction. RESULTS: Circ_ARHGAP32 was highly expressed in AS patients and ox-LDL-induced VSMCs. Knockdown of circ_ARHGAP32 repressed ox-LDL-induced proliferation and migration in VSMCs. Circ_ARHGAP32 sponged miR-665 to positively regulate FGF2. MiR-665 inhibitor reversed the regulation of sh-circ_ARHGAP32 on ox-LDL-induced VSMCs proliferation and migration. MiR-665 also had a suppressive effect on the proliferation and migration of ox-LDL-induced VSMCs, and this effect could be reversed by FGF2 overexpression. CONCLUSIONS: Circ_ARHGAP32 might be a potential target for AS treatment, which promoted ox-LDL-induced VSMCs proliferation and migration by regulating miR-665/FGF2 network. Show more

Keywords: Atherosclerosis, circ_ARHGAP32, miR-665, FGF2

DOI: 10.3233/CH-221469

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2022

Authors: Zhu, Jing-E. | Li, Jia-Xin | Zhang, Hui-Li | Li, Xiao-Long | Sun, Li-Ping | Yu, Song-Yuan | Xu, Hui-Xiong

Article Type: Research Article

Abstract: Biliary cystadenocarcinoma (BCAC) is an extremely rare intrahepatic cystic tumor. Patients usually present with nonspecific symptoms such as abdominal pain, abdominal distention, and abdominal mass. This tumor occurs most commonly in the left hemiliver and is thought to mainly develop from a benign biliary cystadenoma (BCA). At present, the disease is mainly diagnosed by ultrasound, CT, MR, and other imaging methods, and the main treatment is radical surgical resection. We reported a 75-year-old female with an unresectable huge BCAC (i.e., 161×145×122 mm in three orthogonal directions) and poor general condition (40 in Karnofsky Performance Status, KPS) who received sequential thermal ablation …(i.e., cryoablation and microwave ablation) in combination with sclerotherapy using lauromacrogol. The diagnosis of intrahepatic BCAC was confirmed pathologically. Preablation grayscale US showed the BCAC with a clear boundary, regular shape, and cystic-solid mixed echogenicity, which appeared as a huge multilocular cystic lesions with thick internal sepatations. Preablation contrast-enhanced ultrasound (CEUS) showed honeycomb-like hyper-enhancement of the thick internal sepatations and cystic wall in the arterial and portal phase, and sustained enhancement of the thick internal sepatations and cystic wall in the late phase. 6-month postablation CEUS showed non-enhancement in most parts of the lesion in the arterial phase and 6-month postablation MRI showed the volume reduction ratio (VRR) was about 70% . The abdominal pain and abdominal distension were relieved remarkably, and her quality of life was greatly improved (70 in KPS). In conclusion, sequential thermal ablation in combination with sclerotherapy provides a successful translative therapy for this unresectable huge BCAC with a poor general condition, which makes subsequent curative surgery or ablation possible. Show more

Keywords: Biliary cystadenocarcinoma, microwave ablation, cryoablation, sclerotherapy

DOI: 10.3233/CH-221466

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2022

Authors: Lerchbaumer, Markus Herbert | Fischer, Thomas | Uluk, Deniz | Friedersdorff, Frank | Hamm, Bernd | Spiesecke, Paul

Article Type: Research Article

Abstract: BACKGROUND: B-Mode and Doppler ultrasound are standard diagnostic techniques for early postoperative monitoring and long-term follow-up of kidney transplants. In certain cases, contrast-enhanced ultrasound (CEUS) is used to clarify unclear Doppler findings. OBJECTIVE: To investigate the diagnostic performance of CEUS in the workup of renal allograft pathologies. METHODS: A systematic search for CEUS examinations of renal transplants conducted in our department between 2008 and 2020 was performed using the following inclusion criteria: i) patient age ≥18 years and ii) confirmation of diagnosis by biopsy and histopathology, imaging follow-up by CEUS, contrast-enhanced computed tomography (ceCT), contrast-enhanced magnetic …resonance imaging (ceMRI), or angiography, or intraoperative findings. Exclusion criteria were: i) CEUS performed in the setting of a study and ii) CEUS for other indications than dedicated renal transplant examination. Statistical analysis was performed separately for subgroups with different indications (focal vs non-focal). RESULTS: Overall, 78 patients were included in the statistical analysis, which revealed high sensitivity (92.2%, 95% -confidence interval [CI] 81.5–96.9%) and high specificity (88.9%, 95% -CI 71.9–96.1%) of CEUS. CONCLUSIONS: The high diagnostic performance demonstrated here and the superficial location of kidney allografts advocate the additional use of CEUS in the follow-up of renal transplant recipients. Show more

Keywords: Renal ultrasound, contrast-enhanced ultrasound, CEUS, sensitivity, specificity, renal transplant

DOI: 10.3233/CH-211357

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Li, Jia-Xin | Li, Xiao-Long | Yu, Song-Yuan | Xu, Hui-Xiong

Article Type: Research Article

Abstract: The liver is one of the most frequent metastatic sites of breast cancer with a relatively poor prognosis. Systemic chemotherapy is an effective treatment but the efficacy is different between the subtypes of breast cancer. Percutaneous thermal ablation is considered to be a minimally invasive and effective local treatment for breast cancer liver metastases (BCLM). This case report described a patient with BCLM who adopted a strategy of systemic chemotherapy and repeated ultrasound (US) -guided percutaneous thermal ablation procedures. The survival time already reached 8 years till now with the metastases well-controlled and acceptable life quality was achieved.

DOI: 10.3233/CH-221413

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Wang, Yafei | Jia, Rufu | Chen, Xiao | Li, Guangjun | Li, Zhaoyang

Article Type: Research Article

Abstract: Venous thromboembolism (VTE) is a common coagulative dysfunctional complication of cancer patients. The present study aimed to determine the association and diagnostic values of serum homocysteine (Hcy) and folic acid levels with VTE in cancer patients. We enrolled 700 cancer patients and 100 healthy subjects in our study. All cancer patients, with or without VTE, underwent measurement of serum Hcy and folic acid levels and coagulative markers including D-Dimer, factor VIII, fibrinogen and tissue plasminogen activator. The diagnostic values of Hcy and folic acid were assessed by receiver operative characteristic (ROC) analysis. Correlations between Hcy and folic acid and coagulative …factors were determined. Among the 700 patients with malignant tumors recruited in our study, a total of 89 patients had VTE combined within three months, and 611 patients did not have VTE. Cancer patients with VTE had significantly higher levels of Hcy and significantly lower levels of folic acid in serum. Both Hcy and folic acid in serum demonstrated high sensitivity and specificity in diagnosing VTE in cancer patients and showed strong correlations to coagulative markers. Hcy and folic acid, which have strong correlations to coagulative markers, are potential novel serum markers for stratifying VTE risk in cancer patients. Show more

Keywords: Venous thromboembolism, cancer, homocysteine, folic acid, coagulation

DOI: 10.3233/CH-221479

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Lopes, Karynne Grutter | Farinatti, Paulo | Bottino, Daniel | Souza, Maria das Graças de | Maranhão, Priscila | Bouskela, Eliete | Lourenço, Roberto | Oliveira, Ricardo de

Article Type: Research Article

Abstract: BACKGROUND: Changes in muscle mass, strength, vascular function, oxidative stress, and inflammatory biomarkers were compared in older adults after resistance training (RT) performed with low-intensity without blood flow restriction (RT-CON); low-intensity with BFR (RT-BFR); and high-intensity without BFR (RT-HI). METHODS: Thirty-two untrained individuals (72±7 y) performed a 12-week RT after being randomized into three groups: RT-CON –30% of 1 repetition maximum (RM); RT-BFR –30% of 1RM and mild BFR (50% of arterial occlusion pressure); RT-HI –70% of 1 RM. RESULTS: Improvements in handgrip strength were similar in RT-BFR (17%) and RT-HI (16%) vs. RT-CON (–0.1% ), …but increases in muscle mass (6% vs. 2% and –1%) and IGF-1 (2% vs. –0.1% and –1.5%) were greater (p  <  0.05) in RT-BFR vs. RT-HI and RT-CON. Changes in vascular function, morphology, inflammation, and oxidative stress were similar between groups, except for time to reach maximum red blood cell velocity which showed a greater reduction (p  <  0.05) in RT-BFR (–55%) vs. RT-HI (–11%) and RT-CON (–4% ). CONCLUSION: RT with low intensity and mild BFR improved muscle strength and mass in older individuals while preserving vascular function. This modality should be considered an adjuvant strategy to improve muscle function in older individuals with poor tolerance to high loads. Show more

Keywords: Aging, resistance training, oxidative stress, endothelial function

DOI: 10.3233/CH-221395

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2022

Authors: Yu, Ji-Feng | Zhang, Shen | Yin, Hao-Hao | Zhou, Bang-Guo | Pu, Yin-Ying | Fang, Yan | Du, Dou | Zhang, Yan | Xu, Hui-Xiong

Article Type: Research Article

Abstract: BACKGROUND: Two-dimensional (2D) - shear wave elastography (SWE) has made promising advances in the diagnostic of breast lesions. However, few studies have assessed whether the diagnostic effectiveness of different platforms employing 2D-SWE is equal or different. OBJECTIVE: To compare the diagnostic effectiveness of 2D-SWE techniques from two different systems in differentiating malignant breast lesions from benign ones. METHODS: A total of 84 breast lesions were retrospectively analyzed by experienced radiologists using 2D-SWE on two ultrasound systems, i.e. system-1 (LOGIQ E9 system, GE Healthcare, Wauwatosa, WI, USA), and system-2 (Aixplorer US system, SuperSonic Imagine, Aix-en-Provence, France). …Qualitative and quantitative parameters including color sign, the maximum elasticity modulus values (E-max), the mean elasticity modulus values (E-mean) and standard deviation (E-sd) of elasticity modulus values in two 2D-SWE systems were analyzed. The diagnostic performance between system-1 and system-2 were evaluated in terms of the areas under the receiver operating characteristic curves (AUROCs). RESULTS: Among the 84 lesions in this study, 66 (78.6%) were benign and 18 (21.4%) were malignant. E-max in system-1 showed the best diagnostic performance with a cut-off value of 174.5 kPa with the associated sensitivity and specificity of 100.0% and 80.3% respectively. Meanwhile, E-sd in system-2 displayed the best diagnostic performance with a cut-off value of 12.7 kPa, with the associated sensitivity and specificity of 94.4% and 80.3% respectively. The diagnostic performance of the two 2D-SWE systems was not statistically different according to ROC analysis of E-max, E-mean, and E-sd. CONCLUSION: For identifying breast lesions, system-1 and system-2 appear to be similar in diagnostic performance. However, different cut-off values for different parameters might be selected to obtain the best diagnostic performance for the two 2D-SWE systems. Show more

Keywords: Shear wave elastography, breast, ultrasound

DOI: 10.3233/CH-221471

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Yu, Mei-qin | Zhang, Li-li | Jiang, Li-ping | Zhou, Ai-yun

Article Type: Research Article

Abstract: BACKGROUND: Breast cancer is the most common malignant tumor in women. Early diagnosis of benign and malignant breast tumors is of great significance. OBJECTIVE: To retrospectively analyze the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of Breast Imaging-Reporting and Data System (BI-RADS) 4a breast lesions less than 2 cm in diameter. METHODS: CEUS was performed for 143 breast masses less than 2 cm in diameter that were diagnosed as BI-RADS 4a by ultrasound and reclassified. Considering pathological diagnosis as the gold standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of reclassified lesions …after CEUS for the diagnosis of benign and malignant masses were analyzed. RESULTS: BI-RADS 4a breast masses with a diameter less than 2 cm (n  = 143) were confirmed by pathology; 103 and 40 were classified as benign and malignant, respectively. The sensitivity, specificity, PPV, and NPV of CEUS for the diagnosis were 90%, 86%, 72%, and 95%, respectively. The area under the receiver operating characteristic (ROC) curve of CEUS for the diagnosis of benign and malignant tumors after CEUS was 0.904. CONCLUSION: CEUS can help to improve the diagnostic accuracy of BI-RADS 4a masses with a diameter less than 2 cm. Show more

Keywords: Contrast-enhanced ultrasound, BI-RADS-US 4a, breast, ultrasound

DOI: 10.3233/CH-221460

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2022

Authors: Caimi, Gregorio | Urso, C. | Brucculeri, S. | Amato, C. | Presti, R. Lo | Carlisi, M.

Article Type: Research Article

Abstract: In a cohort of subjects with asymptomatic carotid atherosclerosis (ACA), we have evaluated the neutrophil and lymphocyte count and their ratio (NLR), the gelatinases (MMP-2 and MMP-9) and their tissue (TIMP-1 and TIMP-2). At baseline, no difference was observed between ACA subjects and subject control group regarding neutrophil and lymphocyte count while was evident in ACA subjects a significant increase in MMP-2, MMP-9 and TIMP-2 associated to a significant decrease in TIMP-1. Dividing the ACA according to the number of cardiovascular risk factors (CRFs) we have observed an increase in lymphocyte count in the subgroup with 3–5 CRFs. Evaluating the …leukocyte subtypes according to all the surrogate markers of insulin resistance has been noted, in the subgroups that exceed the medians of these markers, a significant increase in neutrophil and lymphocyte count without any variation of the NLR. Effecting the same evaluation for the MMP/TIMP pattern we observed, instead, that the same subgroups tend to show a decrease in MMP-2 and an increase in MMP-9. No difference instead for TIMP-1 and TIMP-2. The abnormality of the MMP/TIMP pattern, bearing in mind the cardiometabolic clustering present in this cohort of ACA subjects, would induce to use drugs able not only to cure the cardiometabolic risk factors but also to influence the MMP/TIMP profile. Show more

Keywords: Asymptomatic carotid atherosclerosis, neutrophils, lymphocytes, gelatinases, TIMP-1, TIMP-2, cardiovascular risk factors, insulin resistance

DOI: 10.3233/CH-221380

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-15, 2022

Authors: Namba, Haruchi | Hamada, Hironobu | Kimura, Tatsushi | Sekikawa, Kiyokazu | Kamikawa, Norimichi | Ishio-Ueoka, Hatsumi | Kajiwara, Teruki | Sato, Yoshinobu M. | Aizawa, Fumiya | Yoshida, Takamasa

Article Type: Research Article

Abstract: BACKGROUND: Exercise-induced impairment of blood fluidity is considered to be associated with thrombosis development. However, the effects of L-arginine on blood fluidity after exercise remain unclear. OBJECTIVE: We investigated the mechanisms of impaired blood fluidity after high-intensity exercise, and examined whether L-arginine improves exercise-induced blood fluidity impairment in vitro . METHODS: Ten healthy male participants performed 15 minutes of ergometer exercise at 70% of their peak oxygen uptake levels. Blood samples were obtained before and after exercise. L-arginine and NG-monomethyl-L-arginine acetate (L-NMMA)— a nitric oxide (NO) synthase inhibitor— were added to the post-exercise blood samples. Using …Kikuchi’s microchannel method, we measured the blood passage time, percentage of obstructed microchannels, and the number of adherent white blood cells (WBCs) on the microchannel terrace. RESULTS: Exercise increased the hematocrit levels. The blood passage times, percentage of obstructed microchannels, and the number of adherent WBCs on the microchannel terrace increased after exercise; however, they decreased in a dose-dependent manner after the addition of L-arginine. L-NMMA inhibited the L-arginine-induced decrease in blood passage time. CONCLUSIONS: High-intensity exercise impairs blood fluidity by inducing hemoconcentration along with increasing platelet aggregation and WBC adhesion. The L-arginine–NO pathway improves blood fluidity impairment after high-intensity exercise in vitro . Show more

Keywords: Blood fluidity, exercise, L-arginine, nitric oxide

DOI: 10.3233/CH-211201

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2022

Authors: Antonova, Nadia | Velcheva, Irena | Paskova, Vasilka

Article Type: Research Article

Abstract: BACKGROUND: In the blood vessels the impaired hemorheological parameters in patients with type 2 diabetes mellitus (T2DM) could lead to elevated flow resistance, increased forces at the endothelial wall and to microvascular disturbances. OBJECTIVE: The aim of the study is to investigate the hemorheological variables and the changes of the skin blood flow responses to cold stress in T2DM patients. METHODS: The basic hemorheological parameters: hematocrit (Ht), fibrinogen (Fib), whole blood viscosity (WBV) and plasma viscosity (PV) were examined in 20 patients with T2DM and a control group of 10 healthy age and sex matched controls. …The mechanisms of vascular tone regulation were investigated using the wavelet analysis of the skin temperature oscillations (WAST). The degrees of the microvascular tone changes were determined during a cold test in the endothelial (0.02–0.0095 Hz), neurogenic (0.05– 0.02 Hz) and myogenic (0.05– 0.14 Hz) frequency ranges. RESULTS: Significant increase of Fib and WBV in the patients in comparison to controls was found. The mean values of the amplitudes of the skin temperature (ST) pulsations decreased significantly during the cold stress only in the endothelial frequency range for the diabetic patients. CONCLUSIONS: The results of our study reveal parallel impairment of the blood rheological parameters and the cutaneous microcirculation in T2DM patients. Show more

Keywords: Hemorheology, diabetes mellitus type 2 (T2DM), whole blood viscosity, red blood cell (RBC) deformability, RBC aggregation, peripheral microcirculation, skin temperature oscillations, cold test

DOI: 10.3233/CH-221393

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-17, 2022

Authors: Wang, Yueru | Chen, Xiaoyan | Lu, Zhikai | Lai, Chunlin

Article Type: Research Article

Abstract: BACKGROUND: Compelling evidence demonstrated that circular RNAs (circRNAs) were involved in the progression of atherosclerosis (AS). However, the role of circ_0093887 in the progression of AS is unclear. The purpose of this study was to explore the role and mechanism of circ_0093887 in oxidized-low density lipoprotein (ox-LDL)-induced human aortic endothelial cells (HAECs). METHODS: HAECs were stimulated by ox-LDL to simulate AS-like injury in vitro . Circ_0093887, microRNA-758-3p (miR-758-3p), and BMP And Activin Membrane-Bound Inhibitor (BAMBI) levels were detected by quantitative real-time polymerase chain reaction (qRT-PCR). PCNA, Bax, Bcl-2, and BAMBI protein levels were detected by western …blot. Cell viability and apoptosis were examined by Cell Counting Kit-8 (CCK-8) assay and flow cytometry. Tube formation assay was used to assess tube formation. The levels of inflammatory factors TNF-α and IL-1β were detected by corresponding ELISA kits. The relationship between miR-758-3p and circ_0093887 or BAMBI was tested via dual-luciferase reporter analysis and RNA immunoprecipitation. Oxidative stress related indexes (ROS and MDA) were detected by corresponding kits. RESULTS: The expression levels of circ_0093887 and BAMBI were prominently downregulated in ox-LDL-induced HAECs compared with control, whereas the expression of miR-758-3p was upregulated. Overexpression of circ_0093887 promoted HAECs viability and tube formation, and restrained cell apoptosis in ox-LDL-induced HAECs compared with untreated HAECs. Mechanistically, circ_0093887 regulated the expression of BAMBI through miR-758-3p. Further experiments showed that upregulation of miR-758-3p reversed changes in cell function induced by circ_0093887. In addition, reduced BAMBI salvaged miR-758-3p knockdown mediated effects on cell function. CONCLUSION: Circ_0093887 demonstrated its diagnostic and therapeutic value in AS by promoting the role of the miR-758-3p/BAMBI axis in the ox-LDL-induced endothelial injury of HAECs. Show more

Keywords: Atherosclerosis, circ_0093887, ox-LDL, miR-758-3p, BAMBI

DOI: 10.3233/CH-221445

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-15, 2022

Authors: Sun, Hongshuang | Ren, Yunyun

Article Type: Research Article

Abstract: AIM: The aim of this study was to investigate the role of cerebroplacental ratio (CPR) in the final prenatal care for neonatal respiratory diseases and to analyze the risk of relevant factors associated with neonatal respiratory disorders. METHODS: A prospective cohort study of 795 singleton pregnancies was conducted. The pulsatility indices (PI) of the umbilical artery (UA) and the middle cerebral artery (MCA) were measured, and the MCA to UA ratio (CPR) was determined. The severity of the case is determined by whether or not the newborn has respiratory problems. Compare the CPR correlation between the two groups …and examine the illness prediction factors through a binary logistic regression method. RESULTS: Of the 801 participants, 114 had neonatal respiratory disorders. The mean values of CPR between neonatal respiratory diseases group and control group were 1.78±0.6, 1.97±0.9, respectively (P  <  0.001). Maternal age, abortion history, cesarean section history, placental thickness, placental maturity, and amniotic fluid index (AFI) were determined to have no significant link between the two groups after comparison analysis (P >   0.05). It could be found that compared with the control group, CPR MoM indicators of neonatal respiratory distress syndrome, neonatal pneumonia and wet lung disease all show significant decreases. In binary logistic regression analysis, among the variables included in the model, CPR (OR:2.90, P  = 0.015), fetal heart monitoring (OR:5.26, P  <  0.001), delivery mode (OR:2.86, P  <  0.001) and gestational age of delivery (OR:0.92, P  <  0.001) were statistically significant in both groups. CONCLUSION: The findings of this study showed that infant respiratory problems were substantially related to CPR value. The correlation indicates that CPR was a powerful reference marker for respiratory disorders. Show more

Keywords: Cerebroplacental doppler ratio, fetal brain sparing, fetal lung maturation, neonatal respiratory disorders

DOI: 10.3233/CH-211333

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Han, Ling | Guo, Meiliang | Wang, Bing | Meng, Qinqin | Zhu, Jie | Huang, Qiong | Zhang, Zhenghua | Fang, Xu | Yang, Ke | Wu, Siyuan | Zheng, Zhizhong | Yawalkar, Nikhil | Deng, Hui | Yan, Kexiang

Article Type: Research Article

Abstract: BACKGROUND: Psoriasis is associated with an increased risk for cardiovascular disease (CVD). Methotrexate (MTX) is often used as a first-line system therapy and there is a need to determine its effect on whole blood viscosity (WBV) and plasma viscosity (PV) in psoriasis. METHODS A prospective, single-center, interventional study with a total of 111 psoriatic patients who received MTX therapy from October 22, 2018, to December 28, 2019, and 111 age- and sex-matched healthy controls. Changes in WBV, PV, blood counts, liver and renal function were evaluated. RESULTS Psoriatic patients had significantly higher levels of WBV and …relative viscosity (RV) at low shear rate (LSR), erythrocyte aggregation index (EAI), and PV than sex and age-matched healthy controls. PV was positively correlated with erythrocyte sedimentation rate (ESR), ESR was positively correlated with high sensitive C-reactive protein (hCRP). But only hCRP was positively associated with psoriasis area severity index (PASI) score. MTX significantly decreased the levels of PV, ESR, hCRP, and blood pressure (BP) in male patients, and the level of WBV in female patients. CONCLUSION: Sex-specific downregulation of MTX on WBV, PV, hCRP, and BP, indicating that the effect of MTX on the risk of cardiovascular disease was related with sex. Show more

Keywords: Methotrexate, psoriasis, whole blood viscosity, plasma viscosity, erythrocyte aggregation index

DOI: 10.3233/CH-211343

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Cucuruz, B. | Kopp, R. | Hampe-Hecht, H. | Andercou, O. | Schierling, W. | Pfister, K. | Koller, M. | Noppeney, T.

Article Type: Research Article

Abstract: BACKGROUND: Neuromodulation is a therapeutic option to improve limb salvage in end-stage peripheral arterial disease (PAD), but there is no consensus on indication for spinal cord stimulation (SCS) in PAD patients. OBJECTIVE: The aim of this study was to present end-stage PAD patient outcomes treated with SCS. METHODS: This study is a retrospective analysis based on a local prospective registry. Neuromodulation was performed there was: [1 ] no revascularisation option, [2) no septicaemia, [3) Rutherford stage 4–6. The primary endpoint of the study was limb salvage. Secondary endpoints were improvement in pain symptoms (assessed using a …visual anlog scale/VAS) and improvement in walking distance. RESULTS: Limb salvage was reached in 30/34 patients (88%). Patients reported a significant reduction in pain on the 10-point VAS scale from baseline (median = 7.5, IQR = 7–8) to follow-up at 2 years (median = 0, IQR 0–2.75), p  <  0.001. Walking distance also improved from preoperative (median = 50 m, IQR = 20–50 m) to follow-up at 2 years (median = 150 m, IQR 50–272 m), p  <  0.001. RESULTS: SCS implantation in patients with end-stage PAD can enable limb salvage in a high percentage of cases and increase mobility due to pain reduction. The role of microcirculation in these improvements needs to be investigated in further studies. Show more

Keywords: Neuromodulation, spinal cord stimulation, end-stage peripheral artery disease, chronic critical limb ischemia

DOI: 10.3233/CH-221436

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Shaik, Aleesha | Chen, Qinzhong | Mar, Phyu | Kim, HyoungSup | Mejia, Priscilla | Pacheco, Hannah | Goonewardena, Sascha N. | Cho, Daniel J. | Rosenson, Robert S.

Article Type: Research Article

Abstract: BACKGROUND: Elevated estimated blood viscosity (EBV), derived from hematocrit and globulins, is associated with thrombotic complications, organ failure, and higher mortality in COVID-19 patients. Although informative, EBV does not account for cellular interactions or fibrinogen. OBJECTIVE: Investigate whether patients with acute and recent COVID-19 have altered WBV profiles. METHODS: Cross-sectional study of 58 patients: 15 in the intensive care unit with acute COVID-19, 32 convalescent (9 <  8weeks [W] from acute infection, 23 >  8 W), and 11 controls without COVID-19. WBV was measured at high (300 s–1 ) and low (5 s–1 ) shear rates (HSR, LSR) using a scanning …capillary viscometer. RESULTS Acute and convalescent patients <  8 W had mean WBV at LSR (16.0 centipoise [cP] and 15.1 cP) and HSR (5.1 cP and 4.7 cP). Mean WBV of convalescent >  8 W and control patients were 12.3 cP and 13.0 cP at LSR, and 4.1 cP and 4.2 cP at HSR. Acute and <  8 W patients had significantly higher WBV at both HSR and LSR compared to patients >  8 W (all p≤0.01). No significant differences in WBV were observed between acute and <  8 W patients, or between patients >  8 W and controls. CONCLUSIONS: Hyperviscosity provides a possible explanation for thrombotic risk in acute and convalescent (<  8 W) patients. These findings have important implications for thromboprophylaxis. Show more

Keywords: Anticoagulation, blood viscosity, COVID-19, convalescent, thrombosis

DOI: 10.3233/CH-221429

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-7, 2022

Authors: Park, Il Rae | Choi, Jimi | Ha, Eun Young | Chung, Seung Min | Moon, Jun Sung | Shin, Sehyun | Kim, Sin Gon | Won, Kyu Chang

Article Type: Research Article

Abstract: BACKGROUND: The glomerular filtration rate (GFR) and albumin-to-creatinine ratio (ACR) have been widely used to identify and manage diabetic kidney disease (DKD). However, classifications based on these two indices do not always concur in terms of DKD diagnosis; for example, cases of high ACR with normal GFR or normal ACR with low GFR may occur. A recent study suggested that critical shear stress (CSS), a hemorheological parameter to represent aggregating force of red blood cells (RBCs), is a potential screening index for DKD. In the present study, we investigated the diagnostic potential of CSS for DKD according to the KDIGO …2012 Guideline. METHODS: A total of 378 patients with type 2 diabetes who visited Yeungnam University Hospital between 2014 and 2017 were included. CSS was measured using a transient microfluidic hemorheometer, Rheoscan-D300® (Rheomeditech, Seoul, Republic of Korea) with whole blood. Patients who were DKD negative (green zone) were compared with patients who were DKD positive (red zone) as Model 1 and patients at risk for (orange zone) and red zones as Model 2, respectively. RESULTS: After exclusion criteria such as macrovascular complications, alcoholism, and eGFR <  30 mL/min/1.73 m2 were applied, the sensitivity and specificity were 100% and 77.8% for Model 1 and 75.0% and 72.0% for Model 2, respectively. The diagnostic accuracy measures of the CSS for Model 1 were found to be highly accurate or have the potential to alter clinical decisions. Similarly, the diagnostic accuracy measures of CSS for Model 2 were found to provide useful information, despite them expanding to the orange and red zones. CONCLUSION: DKD was successfully identified using a novel integrated hemorheological index of CSS that satisfied both ACR and GFR criteria. Therefore, CSS may be useful for the additive diagnosis of DKD with GFR and uACR. Show more

Keywords: Diabetic kidney disease, screening, critical shear stress, RBC, biomarker

DOI: 10.3233/CH-211326

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2022

Authors: Jung, Ernst Michael | Moran, Valentina Ocaña | Engel, Martin | Krüger-Genge, Anne | Stroszczynski, Christian | Jung, Friedrich

Article Type: Research Article

Abstract: AIM: To examine to what extent the high frame rate contrast-enhanced ultrasound (HiFR) diagnostic enables the conclusive diagnosis of liver changes with suspected malignancy. MATERIAL/METHODS: Ultrasound examinations were performed by an experienced examiner using a multifrequency probe (SC6-1) on a high-end ultrasound system (Resona 7, Mindray) to clarify liver changes that were unclear on the B-scan. A bolus of 1–2.4 ml of the Sulphur hexafluoride ultrasound microbubbles contrast agent SonoVue™ (Bracco SpA, Italy) was administered with DICOM storage of CEUS examinations from the early arterial phase (5–15 s) to the late phase (5–6 min). Based on the image files stored …in the PACS, an independent reading was performed regarding image quality and finding-related diagnostic significance (0 not informative/non-diagnostic to 5 excellent image quality/confident diagnosis possible). References were clinical follow-up, if possible, comparison to promptly performed computed tomography or magnetic resonance imaging, in some cases also to histopathology. RESULTS: We examined 100 patients (42 women, 58 men, from 18 years to 90 years, mean 63±13 years) with different entities of focal and diffuse liver parenchymal changes, which could be detected in all cases with sufficient image quality with CEUS and with high image quality with HiFR-CEUS. Proportionally septate cysts were found in n  = 19 cases, scars after hemihepatectomy with local reduced fat in n  = 5 cases, scars after microwave ablation in n  = 19 cases, hemangiomas in n  = 9 cases, focal nodular hyperplasia in n  = 8 cases, colorectal metastases in n  = 15 cases, hepatocellular carcinoma (HCC) in n  = 11 cases, Osler disease in n  = 8 cases. The size of lesions ranged from 5 mm to 200 mm with a mean value of 33.1±27.8 mm. Conclusive diagnoses could be made by the experienced investigator in 97/100 cases with CEUS, confirmed by reference imaging, in parts by histopathology or follow-up. The image quality for HiFR CEUS was rated with a score of 3 to 5; 62 cases were assessed with an average of good (4 points), 27 cases with very good (5 points), and in 11 cases (3 points) still satisfactory despite aggravated acoustic conditions. The specificity of HIFR-CEUS was 97%, the sensitivity 97%, the positive predictive value 94%, the negative predictive value 99% and the accuracy 97% . CONCLUSION: HIFR-CEUS has demonstrated has demonstrated an improved image quality resulting in a high diagnostic accuracy. In the hands of an experienced investigator, HiFR-CEUS allows the assessment of focal and diffuse unclear liver parenchymal changes on B-scan and dynamic assessment of microcirculation in solid and vascular changes. Show more

Keywords: Contrast-enhanced ultrasound sonography –CEUS –high frame rate contrast-enhanced (HiFR) –liver cancer

DOI: 10.3233/CH-221449

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-16, 2022

Authors: Chebotareva, Natalia | Berns, Angelina | McDonnell, Valerie | Sovetnikov, Egor | Berns, Svetlana | Guliaev, Sergey | Solonkina, Alena

Article Type: Research Article

Abstract: Nephrotic syndrome (NS) is associated with a high risk for venous and arterial thrombosis due to hypercoagulability. Integral tests designed to assess hemostasis can become an alternative for measuring hypercoagulability in patients with NS. STUDY OBJECTIVE: To assess hemostatic disorders in CGN patients complicated by NS using the thrombodynamics test. MATERIALS AND METHODS: The study included 60 adult patients with chronic glomerulonephritis (CGN), mean age 37 years, 31 (52%) women, and 29 (48%) men. Among all patients, 53 % of patients had NS, 47 % had no sign of NS. Hemostasis was assessed using the thrombodynamics test. …The results were compared with biochemical parameters, which are usually associated with NS and renal dysfunction. RESULTS: According to the thrombodynamics test, CGN patients with NS demonstrated a tendency to hypercoagulability: increased rates of V (rate of clot growth), increased D (clot density), and increased CS (clot size) after 30 minutes. A positive correlation of these parameters with the serum albumin, creatinine levels, and glomerular filtration rate (GFR) indicates the influence of severe NS and renal dysfunction on the hemostasis activation in CGN patients with NS. CONCLUSION: According to the thrombodynamics test, CGN patients with NS demonstrate increased rates of clot formation, increased clot size after 30 minutes, and increased clot density due to secondary hemostasis activation. These changes positively correlate with the severity of hypoalbuminemia, hypercholesterolemia, and renal dysfunction in NS patients. Show more

Keywords: Blood coagulation, nephrotic syndrome, thrombodynamics, hypercoagulation

DOI: 10.3233/CH-221391

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-8, 2022

Authors: Wang, Haiyan | Wang, Yuchun | Liang, Xiuying | Zhang, Chunyan | Guo, Binfang

Article Type: Research Article

Abstract: Scoring neonatal acute physiology is significant for improving the survival rate of neonates in neonatal intensive care units (NICU). Red blood cell distribution width to platelet ratio (RPR) has been used to evaluate physiology of multiple diseases. However, the value of RPR as a predictor for morbidity and mortality in NICU remains unclear. The score for neonatal acute physiology and perinatal extension II (SNAPE-II) was used to evaluate the physiology and separate neonates into Mild (n  = 45), Moderate (n  = 45) and Severe (n  = 45) groups. White blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) in cord blood were …examine. Spearman’s correlation and receiver operating characteristic analysis were performed to demonstrated the correlations of these indicators. There was a positive correlation between the SNAPE-II scores and RPR in neonates in NICU. The WBC, PCT and CRP levels increased with the upregulation of SNAPE-II scores in neonates in NICU and there were positive correlations between RPR and WBC, PCT and CRP, respectively. RPR could be used as a supplementary predictor for the evaluation of neonatal morbidity and mortality in NICU beside SNAPE-II. Show more

Keywords: Red cell distribution width-to-platelet ratio (RPR), Neonatal intensive care unit (NICU), White blood cell count (WBC), C-reactive protein (CRP)

DOI: 10.3233/CH-221388

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2022

Authors: Wenzel, C. | Brix, E. | Heidekrueger, P. | Lonic, D. | Lamby, P. | Klein, S.M. | Anker, A. | Taeger, C. | Prantl, L. | Kehrer, A.

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: In complex hand traumas nerves and vessels are often destructed without the possibility for primary repair. For bridging defects of nerves, veins and arteries grafts are necessary. Commonly nerve and vein grafts from adjacent donor sites as the wrist, forearm or cubital region are harvested. METHODS: This study is a retrospective cohort study. Between 2017 and 2019, 10 patients with complex hand injuries were treated. There were 8 males and 2 females, with an average age of 39 years (range 8–63 years). In all cases grafts were used of the dorsum of the foot for …reconstructing of the severed digital nerves and arteries. All donor sites could be closed primarily. RESULTS: In 100% of cases nerves and veins of the dorsum of the foot showed a good size match as well as adequate length for a sufficient repair. The overall Hand Injury Severity Score (HISS) was determined with a median of 86 (range 57 to 286). In the area of the donor site no relevant complications were seen. CONCLUSIONS: In complex hand injuries the dorsum of the foot is a favorable donor site for nerve and vein graft harvest. Show more

DOI: 10.3233/CH-211135

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Wang, Jianing | Li, Jia | Yin, Xiaoping | Zhou, Huan | Zheng, Yating | Huaijun Liu, MM

Article Type: Research Article

Abstract: OBJECTIVE: This study aims to investigate the application value of three-dimensional arterial spin labeling (ASL) perfusion imaging in detecting cerebral hemodynamics of neonates with hypoxic-ischemic encephalopathy (HIE). METHODS: Sixty normal full-term neonates and 60 HIE neonates were enrolled in this study and were respectively divided into three groups: the 1–3 days group, the 4–7 days group, and the 8–15 days group. The brains of these neonates were scanned with the 3D ASL sequence, and cerebral blood flow (CBF) images were obtained. The CBF values of the bilateral symmetrical brain regions and brain stem were measured on CBF images, …and the values were averaged. The cerebral blood flow of HIE neonates in the 1–3 days group, the 4–7 days group, and the 8–15 days group was compared with normal neonates at matched ages, and the characteristics of cerebral hemodynamics in HIE neonates at different ages were summarized. RESULTS: The CBF values of the basal ganglia, thalamus, and brainstem in the 1–3 days HIE group were higher than normal neonates at matched ages, and the CBF value of the frontal lobe was lower than the normal group, and the differences were statistically significant (P  <  0.05). The CBF values of the basal ganglia, thalamus, corona radiata, and frontal lobe in the 4–7 days HIE group were lower than the normal group, and the differences were statistically significant (P  <  0.05). There were no significant differences in CBF values of different brain regions between the 8–15 days HIE and normal groups (P  >  0.05). CONCLUSION: Early hyperperfusion of the basal ganglia and thalamus is helpful for early diagnosis and prognosis of HIE. Show more

Keywords: Neonatal hypoxic-ischemic encephalopathy, arterial spin labeling imaging, magnetic resonance imaging, cerebral blood flow

DOI: 10.3233/CH-211324

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Sachdeva, Shivani | Saluja, Harish | Mani, Ameet | Phadnaik, M.B. | Mani, Shubhangi

Article Type: Research Article

Abstract: Lipoxins and ATL appear to be the first recognized members of a new class of endogenous mediator that are anti-inflammatory or serve for the “pro-resolution” of inflammation. PGE2 can and may display anti-inflammatory properties in certain settings, but in most cases, it enhances inflammation in vivo . This is likely the result of numerous receptor isoforms and differential coupled mechanisms for PGE2 and its diverse role in human physiology. Since the integrated response of the host is essential to health and disease, it is important to achieve a more complete understanding of the molecular and cellular events governing the …formation and actions of endogenous mediators of resolution that appear to control the magnitude and duration of inflammation. In view of the present body of evidence, it is not surprising that a protective action for inhibition of COX-2 was found in cardiovascular disease. Characterizing useful experimental systems with clinically relevant endpoints will also take a multidisciplinary approach and require a shift in our current thinking about inflammation and the role of lipid mediators. Show more

Keywords: Lipoxins, anti-inflammatory, chemical mediators

DOI: 10.3233/CH-211346

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-16, 2022

Authors: Jacoub, Khaldun | Al-Eisawi, Zaynab

Article Type: Research Article

Abstract: Beside the role of ABO group in immunohaematology, there is accumulating evidence that the ABO blood group also plays a key role in various human disorders. The interest in blood groups and their association with disease stems from the awareness that blood group antigens are incredibly important components in the process of cell maturation and control. Studies have indicated a link between cancer and the ABO blood group. The appearance or disappearance of blood type antigens is now considered a hallmark of malignancy in many common cancers. Several tumour markers are in fact known blood group antigens. The aim of …this review is to describe the history and possible functions of the ABO group and then summarize the association between blood groups and skin cancers. Show more

Keywords: ABO, blood group, cancer, skin

DOI: 10.3233/CH-211290

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-13, 2021