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Price: EUR 185.00Authors: Shi, Li-Tao | Kong, Fan-Qiang
Article Type: Research Article
Abstract: OBJECTIVE: This study involved an analysis of preoperative deep vein thrombosis (DVT) incidence and changes in coagulation function among elderly patients suffering from hip fractures. The objective was to offer guidance on the prevention and management of preoperative DVT in the lower extremities of elderly individuals with hip fractures. METHODS: A total of 282 elderly individuals with a hip fracture were enrolled and divided into two groups based on the location of the fracture: femoral intertrochanteric fracture (FIF, 161 individuals) and femoral neck fracture (FNF, 121 individuals). The two groups were compared with respect to baseline …characteristics, including gender, age, and comorbid chronic diseases. Furthermore, the analysis encompassed the incidence of preoperative DVT in both lower extremities, along with seven coagulation parameters and platelet count before the surgical procedure. RESULTS: There was no significant difference in baseline information between the two groups. The incidence of preoperative DVT in the FIF group was higher than that in the FNF group, along with a significantly higher percentage of patients exhibiting increased levels of D-dimer and fibrinogen/fibrin degradation products (FDPs). CONCLUSION: Preoperative hypercoagulability and a greater prevalence of DVT were observed in elderly individuals with FIF compared to individuals with FNF. This indicates that clinicians should pay attention to elderly patients with FIFs, especially those with increased D-dimer and FDP levels. Show more
Keywords: Coagulation, deep vein thrombosis, D-dimer, elderly, femoral intertrochanteric fracture, femoral neck fracture, fibrinogen/fibrin degradation products, hip fracture
DOI: 10.3233/CH-242122
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Zhao, Qiannan | Ji, Zhengbiao | Chen, Yanling | Wang, Kun | Qiu, Yijie | Tian, Xiaofan | Zhu, Yuli | Qin, Hong | Han, Hong | Yuan, Haixia | Dong, Yi | Wang, Wenping
Article Type: Research Article
Abstract: BACKGROUND: Hepatic sarcomatoid carcinoma (HSC) is a rare malignancy of the liver. The ultrasound and clinical features of HSC have not been determined. OBJECTIVE: To investigate and compare the ultrasound and clinical features of HSC and hepatocellular carcinoma (HCC), and to reveal the valuable features of HSC. METHODS: The ultrasound features and clinical data of pathologically proven HSC (n = 37) were compared with HCC (n = 92) in a matching ratio of 1:4 using the propensity score (age, gender and tumor size). RESULTS: The HSC patients were more likely to accompany …with clinical symptoms and vascular invasion than HCC patients (40.5% vs 17.4%, 24.3% vs 6.5%, P < 0.05). The size of HSCs was significantly larger than that of HCCs (P < 0.05). The proportion of patients with elevated alpha-fetoprotein was significantly lower in HSC (35.1% vs 54.3%, P < 0.05). On gray-scale ultrasound images, the HSCs were more likely to demonstrate as indistinct margin and irregular shape lesions compared to HCCs (78.4% vs 48.8% ; 70.3% vs 23.9%, P < 0.05). Under color Doppler flow imaging (CDFI), the blood flow signals were more frequently detected in HSC lesions (75.7% vs 56.5%, P < 0.05). Resistance index (RI) was higher in HSCs than in HCCs [0.78 (0.70,0.82) vs 0.70 (0.62,0.76), P < 0.05]. On contrast-enhanced ultrasound (CEUS), HSCs mainly showed entirety heterogeneous hyper-enhancement (48.6%), entirety homogeneous enhancement (18.9%), peripheral and internal septal enhancement (18.9%). The incidence of non-enhanced areas inside HSC lesions was higher than that inside HCC lesions (56.8% vs 31.5%, P < 0.05). During the portal venous and late phases, most of the lesions revealed hypo-enhancement in both groups, whereas earlier washout was observed in HSCs [43.0 s (30.5,58.0) vs 60.0 s (46.3,100.0), P < 0.05]. CONCLUSIONS: CEUS features are useful in preoperative and non-invasive differentiation of hepatic sarcomatoid carcinoma and hepatocellular carcinoma. Show more
Keywords: Hepatic sarcomatoid carcinoma (HSC), hepatocellular carcinoma (HCC), gray-scale ultrasound, color Doppler flow imaging (CDFI), contrast-enhanced ultrasound (CEUS)
DOI: 10.3233/CH-231944
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Zeng, Yan-hao | Yang, Yu-ping | Liu, Li-juan | Xie, Jun | Dai, Hai-xia | Zhou, Hong-lian | Huang, Xing | Huang, Rong-li | Liu, Er-qiu | Deng, Yi-jing | LI, Hua-juan | Wu, Jia-jian | Zhang, Guo-li | Liao, Man-li | Xu, Xiao-hong
Article Type: Research Article
Abstract: OBJECTIVE: To explore the discriminatory diagnostic value of multimodal ultrasound(US) combined with blood cell analysis(BCA) for Granulomatous Lobular Mastitis (GLM) and Invasive Ductal Carcinoma(IDC) of the breast. METHODS: A total of 157 breast disease patients were collected and divided into two groups based on postoperative pathological results: the GLM group(57 cases with 57 lesions) and the IDC group(100 cases with 100 lesions). Differences in multimodal ultrasound features and the presence of BCA were compared between the two groups. The receiver operating characteristic(ROC) curve was used to calculate the optimal cutoff values, sensitivity, specificity, 95% confidence interval(CI), …and the area under the curve(AUC) for patient age, lesion size, lesion resistive index(RI), and white blood cell(WBC) count in BCA. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and AUC were calculated for different diagnostic methods. RESULTS: There were statistically significant differences(P < 0.05) observed between GLM and IDC patients in terms of age, breast pain, the factors in Conventional US(lesion size, RI, nipple delineation, solitary/multiple lesions, margin, liquefaction area, growth direction, microcalcifications, posterior echogenicity and abnormal axillary lymph nodes), the factors in CEUS(contrast agent enhancement intensity, enhancement pattern, enhancement range, and crab-like enhancement) and the factors in BCA(white blood cells, neutrophils, lymphocytes and monocytes). ROC curve analysis results showed that the optimal cutoff values for distinguishing GLM from IDC were 40.5 years for age, 7.15 cm for lesion size, 0.655 for lesion RI, and 10.525*109 /L for white blood cells. The diagnostic accuracy of conventional US combined with CEUS(US-CEUS) was the highest(97.45%). The diagnostic performance AUCs for US-CEUS, CEUS, and US were 0.965, 0.921 and 0.832, respectively. CONCLUSION: Multifactorial analysis of multimodal ultrasound features and BCA had high clinical application value in the differential diagnosis of GLM and IDC. Show more
Keywords: Ultrasound, blood cell analysis, granulomatous lobular mastitis, invasive ductal carcinoma
DOI: 10.3233/CH-231999
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Absatirova, Venera | Shandaulov, Assylbek | Khamchiyev, Kureysh | Shukurov, Firuz | Khalimova, Fariza
Article Type: Research Article
Abstract: BACKGROUND: The impact of gravity on the existence of all living things has long been of interest to scientists. The force of the Earth’s gravity combined with hypoxia significantly affects blood circulation and blood accumulation in various parts of the human and animal body. To date, the relationship between body position and blood circulation in pulmonary circulation under hypobaric hypoxia has not been sufficiently studied. OBJECTIVES: Therefore, the research aims to determine the possibility of changing the body position in space on the reactions in the pulmonary circulation in the plains and highlands. METHODS: …For this purpose, research was conducted on male Wistar rats, 44 of whom spent 150 days at an altitude of 3200 m above sea level, and 25 representatives of the control group - at an altitude of 164 m. RESULTS: The study revealed that gravitational redistribution of blood in mountainous conditions is less pronounced compared to the control group. This is explained by the remodeling of the vascular wall and an increase in its stiffness. It was found that a change in pulmonary artery pressure at the time of a change in body position was recorded both on the plains and in the highlands. On the plains, when the body position of rats was changed to passive orthostatic, a decrease in systolic and diastolic pulmonary artery pressure was noted, and when the body position was changed to passive anti-orthostatic, an increase in pulmonary artery pressure was observed. The increase in pulmonary artery pressure was a compensatory mechanism due to the increased stiffness of the pulmonary vasculature. CONCLUSIONS: The practical significance of this research is to expand the understanding of the pathogenesis of pulmonary hypertension in high-altitude hypoxia. Show more
Keywords: Pressure, hypoxia, blood supply, postural reactions, pulmonary artery
DOI: 10.3233/CH-231910
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Uygur, Lutfiye | Kabasakal Ilter, Merve | Helvacı, Nazlı | Mokresh, Muhammed Edib | Kahya, Muhammed | Muvaffak, Emir | Elmuhammed, Muhammet Huzeyfe | Ayhan, Isil | Kumru, Pınar
Article Type: Research Article
Abstract: BACKGROUND: Pregnancy is a dynamic process associated with changes in vascular and rheological resistance. Maternal maladaptation to these changes is the leading cause of pregnancy complications such as preeclampsia. OBJECTIVE: This study aimed to assess the hemorheological alterations in pregnancies with a high risk for preeclampsia in the first trimester. METHODS: Ninety-two pregnant women were allocated into the high preeclampsia risk group (37 cases) and control groups (55 cases). Plasma and whole blood viscosity and red blood cell morphodynamic properties, including deformability and aggregation were assessed by Brookfield viscometer and laser-assisted optical rotational cell analyzer (LORRCA) …at 11–14 gestational weeks. RESULTS: Whole blood viscosity was significantly higher in the high-risk group at all shear rates. Plasma viscosity and hematologic factors showed no differences between the groups. Hematocrit levels positively correlated with high blood viscosity only in the high-risk group. There were no significant changes in the other deformability and aggregation parameters. CONCLUSIONS: Changes in the whole blood viscosity of pregnant women with high preeclampsia risk refer to impaired microcirculation beginning from the early weeks of gestation. We suggest that the whole blood viscosity is consistent with the preeclampsia risk assessment in the first trimester, and its measurement might be promising for identifying high-preeclampsia-risk pregnancies. Show more
Keywords: Erythrocyte aggregation, preeclampsia, red blood cell deformability, whole blood viscosity
DOI: 10.3233/CH-232026
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Kokkinidou, D. | Kaliviotis, E. | Shammas, C. | Anayiotos, A. | Kapnisis, K.
Article Type: Research Article
Abstract: BACKGROUND: Even though cardiovascular stenting is widely used for the treatment of coronary artery disease, information on how it can affect the hematological and hemorheological profile is scarce in the literature. Most of the work on this issue is based on theoretical or computational fluid dynamics models, lacking in-depth in vitro and in vivo experimental verification. OBJECTIVE: This work investigates, in an in vivo setting, the effects of stenting and the implantation time-course on hematological and hemorheological parameters that could potentially compromise the device’s functionality and longevity. METHODS: Custom-made self-expanding nitinol stents were …implanted in the common carotid artery of male CD1 mice. Whole blood samples were collected from control (non-stented) and stented animals at 5 and 10 weeks post-implantation. Hematological measurements and blood viscosity, red blood cell aggregation, and deformability were performed using standard techniques. RESULTS: Implant-induced changes were observed in some of the hematological and hemorheological indices. Blood viscosity seems to have been negatively affected by an increased hematocrit and reduced RBC deformability, at 10 weeks post-implantation, despite a slight decrease in RBC aggregation. CONCLUSIONS: Although the alterations observed may be the result of the peri-implant inflammatory response, the physiological consequences due to hemorheological changes need to be further investigated. Show more
Keywords: Stents, mouse implantation model, hematology, red blood cell biomechanics, hemorheology
DOI: 10.3233/CH-231921
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-15, 2023
Authors: Michael, Grynkiewicz | Maciej, Wiewióra
Article Type: Research Article
Abstract: Recently diagnostic field in medicine was enriched by advances in ultrasonography (US) technology, which led to establishment of novel modalities, one of which is micro-ultrasound. Results demonstrated by early studies have been promising, simultaneously rising a question if those new modalities could become an alternative in diagnosis of prostatic carcinoma (PCa). To answer this question, several studies have been conducted where micro-ultrasound have been compared to standard diagnostic tools, such as conventional TRUS or mpMRI. Nevertheless, new technology presents with some limitations, which include inconsistent results, necessity for specialized equipment, need of training for investigators to understand the findings, and …external validation. In this publication, we have identified studies that provided evaluation of the accuracy and efficiency of the micro-ultrasound technology. Additionally, analysis of the results provided a better understanding of the novel imaging tool when compared standard modalities in diagnosis of PCa. Increasing number of studies demonstrated that micro-ultrasound carries high detection rate of PCa and clinically significant prostatic cancer (csPCa), suggesting a similar performance to mpMRI and even showing superiority over conventional TRUS. Recent studies have also showed that micro-ultrasound takes active role in improving the detection of csPCa and guidance for prostate biopsy (PBx) as well as further treatment. Moreover, certain practical aspects such as lower costs, decreased waiting time, real-time imaging and application of the imaging tool for patients that are not suitable for mpMRI (contrast allergy, prosthetics etc.) are significant advantages. Analysis of the results still does not provide clear answer whether micro-ultrasound outperforms mpMRI. Further studies are necessary in order to completely understand the potential of this new technology. Show more
Keywords: Prostate cancer, micro-ultrasound 2 imaging
DOI: 10.3233/CH-232024
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Chatlaong, Matthew A. | Stanford, Daphney M. | Miller, William M. | Davidson, Chance J. | Jessee, Matthew B.
Article Type: Research Article
Abstract: BACKGROUND: Post-occlusive reactive hyperemia (PORH) typically requires caffeine abstinence. For habitual users, it is unknown if abstinence affects PORH. OBJECTIVE: Compare PORH after habitual users consume or abstain from caffeine. METHODS: On separate visits (within-subject), PORH was measured in 30 participants without abstinence from typical caffeine doses (CAFF) and with abstinence (ABS). Measurements included baseline and peak hyperemic velocity, tissue saturation index slopes during ischemia (Slope 1) and following cuff deflation (Slope 2), resting arterial occlusion pressure (AOP), heart rate (HR), systolic (SBP), and diastolic (DBP) blood pressure. All variables were compared using …Bayesian paired t -tests. BF10 = likelihood of alternative vs null. Results are mean±SD. RESULTS: Comparing baseline velocity (cm/s) between CAFF (9.3±4.8) and ABS (7.5±4.9) yielded anecdotal evidence (BF10 = 1.0). Peak hyperemic velocity (cm/s) was similar (CAFF = 77.3±16.7; ABS = 77.6±19.0, BF10 = 0.20). For slopes (TSI% /s), CAFF Slope 1 = –0.11±0.04 and Slope 2 = 1.9±0.46 were similar (both BF10 ≤0.20) to ABS Slope 1 = –0.12±0.03 and Slope 2 = 1.8±0.42. SBP and DBP (mmHg) were both similar (CAFF SBP = 116.0±9.8, DBP = 69.6±5.8; ABS SBP = 115.5±10.7, DBP = 69.5±5.4; both BF10 ≤0.22). Comparing AOP (mmHg) (CAFF = 146.6±15.0; ABS = 143.0±16.4) yielded anecdotal evidence (BF10 = 0.46). HR (bpm) was similar (CAFF = 66.5±12.3; ABS = 66.9±13.0; BF10 = 0.20). CONCLUSIONS: In habitual users, consuming or abstaining from typical caffeine doses does not appear to affect post-occlusive reactive hyperemia. Show more
Keywords: Blood velocity, tissue saturation index, methylxanthine, vascular, cardiovascular
DOI: 10.3233/CH-232036
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Al-Smadi, Mohammad Walid | Fazekas, Laszlo Adam | Varga, Adam | Matrai, Adam Attila | Aslan, Siran | Beqain, Anas | Al-Khafaji, Mustafa Qais Muhsin | Bedocs-Barath, Barbara | Novak, Laszlo | Nemeth, Norbert
Article Type: Research Article
Abstract: BACKGROUND: Arteriovenous malformations (AVMs) are vascular anomalies characterized by abnormal shunting between arteries and veins. The progression of the AVMs and their hemodynamic and rheological relations are poorly studied, and there is a lack of a feasible experimental model. OBJECTIVE: To establish a model that cause only minimal micro-rheological alterations, compared to other AV models. METHODS: Sixteen female Sprague Dawley rats were randomly divided into control and AVM groups. End-to-end anastomoses were created between the saphenous veins and arteries to mimic AVM nidus. Hematological and hemorheological parameters were analyzed before surgery and on …the 1st , 3rd , 5th , 7th , 9th , and 12th postoperative weeks. RESULTS: Compared to sham-operated Control group the AVM group did not show important alterations in hematological parameters nor in erythrocyte aggregation and deformability. However, slightly increased aggregation and moderately decreased deformability values were found, without significant differences. The changes normalized by the 12th postoperative week. CONCLUSIONS: The presented rat model of a small-caliber AVM created on saphenous vessels does not cause significant micro-rheological changes. The alterations found were most likely related to the acute phase reactions and not to the presence of a small-caliber shunt. The model seems to be suitable for further studies of AVM progression. Show more
Keywords: Arteriovenous malformation, experimental model, microsurgery, hemorheology
DOI: 10.3233/CH-231825
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Zhang, Shen | Liu, Yunyun | Zhou, Bangguo | Xu, Huixiong
Article Type: Research Article
Abstract: OBJECTIVE: To evaluate the efficacy and safety of percutaneous ultrasound-guided thermal ablation in the treatment of cervical metastatic lymph nodes (LNs) from papillary thyroid carcinoma (PTC). MATERIALS AND METHODS: A total of 77 patients with 79 LNs ablated by microwave ablation (MWA) or radiofrequency ablation (RFA) between September 2018 and October 2022 were enrolled in this study. After treatment, patients were followed up with measurement of diameters of LNs and serum thyroglobulin (s-Tg) at 1, 3, 6, and 12 months and annually thereafter. The paired t-test was used to compare the changes of s-Tg level, diameters of LNs …before and after ablation. RESULTS: There were no serious complications related to ablation while one case of incomplete ablation in MWA was found during follow-up. The mean longest and shortest diameter of the ablated LNs reduced from 11.6 ± 4.3 mm to 5.0 ± 4.1 mm (p < 0.001), and from 6.1 ± 1.9 mm to 3.0 ± 2.5 mm (p < 0.001) at the last follow-up visit. Besides, the final volume reduction rate (VRR) was 61.8 ± 56.4% (range, –67.0 –100%). The complete disappearance rate was 46.8%, but there were 4 (5.1%) LNs becoming bigger than before. The average s-Tg level was 9.2 ± 26.6 ng/mL, a data significantly decreased to 3.7 ± 7.0 ng/mL at the last follow-up, but no statistical difference was shown. CONCLUSION: Thermal ablation is an effective and safe modality for the treatment of metastatic LNs from PTC. Show more
Keywords: Ultrasound, thermal ablation, papillary thyroid carcinoma, lymph nodes
DOI: 10.3233/CH-231998
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Kordi, Negin | Saydi, Ali | Karami, Sajad | Bagherzadeh-Rahmani, Behnam | Marzetti, Emanuele | Jung, Friedrich | Stockwell, Brent R.
Article Type: Research Article
Abstract: Ferroptosis is a form of programmed cell death that plays a significant role in causing several diseases such as heart attack and heart failure, through alterations in fat, amino acid, and iron metabolism. Comprehending the regulatory mechanisms of ferroptosis signaling is critical because it has a considerable effect on the elderly’s mortality. Conversely, age-related changes in substrate metabolism and metabolite levels are recognized to give rise to obesity. Furthermore, research has proposed that aging and obesity-related changes in substrate metabolism may aggravate ferroptosis. The suppression of ferroptosis holds potential as a successful therapeutic approach for managing different diseases, including sarcopenia, …cardiovascular diseases, and central nervous system diseases. However, the pathologic and biological mechanisms behind the function of ferroptosis are not fully comprehended yet. Physical activity could affect lipid, amino acid, and iron metabolism to modulate ferroptosis. The aim of this study is to showcase the current understanding of the molecular mechanisms leading to ferroptosis and discuss the role of aging and physical activity in this phenomenon. Show more
Keywords: Aerobic training, elderly, iron metabolism, amino acid metabolism, lipid metabolism
DOI: 10.3233/CH-232076
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-20, 2024
Authors: Hammer, Simone | Nunes, Danilo Weber | Hammer, Michael | Zeman, Florian | Akers, Michael | Götz, Andrea | Balla, Annika | Doppler, Michael Christian | Fellner, Claudia | Platz Batista da Silva, Natascha | Thurn, Sylvia | Verloh, Niklas | Stroszczynski, Christian | Wohlgemuth, Walter Alexander | Palm, Christoph | Uller, Wibke
Article Type: Research Article
Abstract: BACKGROUND: Differentiation of high-flow from low-flow vascular malformations (VMs) is crucial for therapeutic management of this orphan disease. OBJECTIVE: A convolutional neural network (CNN) was evaluated for differentiation of peripheral vascular malformations (VMs) on T2-weighted short tau inversion recovery (STIR) MRI. METHODS: 527 MRIs (386 low-flow and 141 high-flow VMs) were randomly divided into training, validation and test set for this single-center study. 1) Results of the CNN’s diagnostic performance were compared with that of two expert and four junior radiologists. 2) The influence of CNN’s prediction on the radiologists’ performance and diagnostic …certainty was evaluated. 3) Junior radiologists’ performance after self-training was compared with that of the CNN. RESULTS: Compared with the expert radiologists the CNN achieved similar accuracy (92% vs. 97%, p = 0.11), sensitivity (80% vs. 93%, p = 0.16) and specificity (97% vs. 100%, p = 0.50). In comparison to the junior radiologists, the CNN had a higher specificity and accuracy (97% vs. 80%, p < 0.001; 92% vs. 77%, p < 0.001). CNN assistance had no significant influence on their diagnostic performance and certainty. After self-training, the junior radiologists’ specificity and accuracy improved and were comparable to that of the CNN. CONCLUSIONS: Diagnostic performance of the CNN for differentiating high-flow from low-flow VM was comparable to that of expert radiologists. CNN did not significantly improve the simulated daily practice of junior radiologists, self-training was more effective. Show more
Keywords: Vascular malformation, deep learning, magnetic resonance imaging
DOI: 10.3233/CH-232071
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Yildiz, Yasemin | Mutlu, Emre | Arihan, Okan | Yagcioglu, A. Elif Anil | Dikmenoglu Falkmarken, Neslihan H.
Article Type: Research Article
Abstract: BACKGROUND: Hemorheological parameters have been reported to be altered in cardiovascular disease. Major depression has been associated with increased risk of cardiovascular disease. OBJECTIVE: Our hypothesis is that hemorheological parameters are disturbed in major depressive disorder. METHODS: Major depressive disorder and control groups consisted of 50 subjects. Plasma viscosity, erythrocyte aggregation, erythrocyte deformability, hematological parameters and hematological parameters were examined. RESULTS: Plasma viscosity was statistically significantly higher, erythrocyte elongation index at 0.53 Pa and 0.95 Pa was lower, and MCV, MCH, and MCHC values were also lower in the major depression group …(P < 0.05). Elongation index and plasma viscosity were correlated with depressive symptomatology. CONCLUSIONS: The increased plasma viscosity and decreased elongation index of erythrocytes indicate an unfavorable hemorheological situation in patients with major depressive disorder compared with healthy controls. The results of this study confirm the findings of studies finding a potential threat to cardiovascular health from major depressive disorder. Increased plasma viscosity and decreased erythrocyte elongation index in depressed patients may be risk factors for cardiovascular events and provide data on the causality of the association between depression and cardiovascular disease. Show more
Keywords: Hemorheology, depression, cardiovascular disease, plasma viscosity, erythrocyte deformability
DOI: 10.3233/CH-232061
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Sachsamanis, Georgios | Delgado, Julio Perez | Oikonomou, Kyriakos | Schierling, Wilma | Pfister, Karin | Zuelke, Carl | Betz, Thomas
Article Type: Research Article
Abstract: BACKGROUND: Prophylactic mesh implantation following open surgical repair of abdominal aortic aneurysm is a debatable subject. OBJECTIVE: To assess the efficacy of a self-gripping polyester mesh used in on-lay technique to prevent incisional hernia after open abdominal aortic aneurysm repair. METHODS: We retrospectively reviewed the records of 495 patients who underwent aortic surgery between May 2017 and May 2021. Patients included in the study underwent open surgical repair for infrarenal abdominal aortic aneurysm (AAA) with closure of the abdominal wall with either small bite suture technique or prophylactic mesh reinforcement. Primary endpoint of …the study was the occurrence of incisional hernia during a two-year follow-up period. Secondary endpoints were mesh-related complications. RESULTS: Mesh implantation with the on-lay technique was successful in all cases. No patient in the mesh group developed an incisional hernia during the 24-month follow-up period. Two patients in the non-mesh group developed a symptomatic incisional hernia during the follow-up period at 6 months. Three cases of post-operative access site complications were observed in the mesh group. CONCLUSIONS: Application of a self-gripping polyester mesh using the on-lay technique demonstrates acceptable early-durability after open surgical repair of abdominal aortic aneurysms. However, it appears to be associated with a number of post-operative access site complications. Show more
Keywords: ProGrip, polyester mesh, onlay technique, incisional hernia, abdominal aortic aneurysm repair
DOI: 10.3233/CH-232008
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Men, Xingping | Hu, Aizhen | Xu, Tingting
Article Type: Research Article
Abstract: Atherosclerosis (AS) is a major chronic non-communicable disease and a primary cause of cardiovascular disease. Recent studies have shown that circRNAs are potential epigenetic factors that regulate vascular endothelial inflammatory responses and AS progression. Therefore, identification of the circRNAs that regulate ox-LDL levels is a critical step to understanding the pathology of AS. Our study is aim to investigate how circLZIC regulates atherosclerosis (AS) via the Micro-330-5p/NOTCH2 regulatory axis. The results showed that CircLZIC and NOTCH2 are highly expressed in human AS clinical samples, while Micro-330-5p is expressed locally. The CCK-8 experiment results showed that circLZIC promotes the proliferation of …HUVECS cells. Flow cytometry analysis showed that circLZIC act as an inhibitor of HUVEC cell apoptosis. The expression level of Micro-330-5p can be up-regulated by transfection of small interfering RNA against circLZIC. Further, Starbase predicted that Micro-330-5p could target and regulate NOTCH2. Next, we confirmed that overexpression of Micro-330-5p could significantly reduce the expression of fluorescein using the double Luciferase reporter assay. RIP-qRT-PCR experiment showed that Micro-330-5p and NOTCH2 mRNAs are effectively enriched by ago2 protein. Further, we found that knocking down circLZIC increases the expression of Micro-330-5p and promotes cell apoptosis, while inhibiting the expression of NOTCH2 and cell activity. On the other hand, co-transfection of Micro-330-5p inhibitor decreases Micro-330-5p expression and inhibit cell apoptosis, while increasing NOTCH2 expression and cell activity. In conclusion, CircLZIC regulates HUVEC cell activity by the Micro-330-5p/NOTCH2 signaling pathway, suggesting that circLZIC plays a key role in atherosclerosis development. Show more
Keywords: CircLZIC, atherosclerosis, Micro-330-5p/NOTCH2, proliferation, apoptosis
DOI: 10.3233/CH-232063
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Zou, Xiuli | Li, Ying | Yang, Jilan | Miao, Juan | Li, Yuan | Ling, Wenwu
Article Type: Case Report
Abstract: BACKGROUND: Acute stroke poses a serious threat to people’s health. The occurrence of a thrombus following the rupture of vulnerable plaques in the carotid artery is a significant contributor to the development of stroke. In previous case reports, it has been challenging to visualize tiny ulcerations within carotid artery plaques using computed tomography angiography (CTA) and digital subtraction angiography (DSA), even when the rupture of the plaque leads to the formation of a free-floating thrombus (FFT). However, in this particular case, contrast-enhanced ultrasound (CEUS) was able to overcome this limitation and provide a more precise assessment, confirming that the FFT …formation was indeed a result of plaque rupture rather than any other potential causes. Cases that utilize CEUS to visualize the formation of ulcers and FFT resulting from plaque rupture are even more rare. As such, we present this case to shed light on this infrequent phenomenon. CASE SUMMARY: In this case study, we present a 65-year-old male patient who was admitted to the hospital due to headache and abnormal mental behavior for one day. During the routine cervical artery ultrasound examination upon admission, we detected the presence of plaque in the right internal carotid artery of the patient, resulting in luminal stenosis. Additionally, we observed suspected hypoechoic material at the distal end of the plaque. After undergoing CEUS examination, it was definitively determined that an ulcer had formed and a FFT had developed due to the rupture of carotid artery plaque. Subsequent CTA and DSA examinations further confirmed the presence of the FFT. The magnetic resonance imaging (MRI) reveals an acute lacunar infarction in the head of the right caput nuclei caudate, which strengthens the potential link between the patient’s neurological and psychiatric symptoms observed during admission. The patient received prompt antiplatelet therapy and underwent cervical artery stenting surgery with the assistance of a distal embolic protection device. Following the procedure, the patient was discharged on the fourth day and experienced a complete recovery. CONCLUSION: CEUS is a valuable tool for visualizing FFT resulting from the rupture of vulnerable plaques in the carotid artery. Show more
Keywords: Contrast-enhanced ultrasound, vulnerable plaque, rupture, plaque ulceration, free-floating thrombus, stroke
DOI: 10.3233/CH-232037
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Zhang, Qiubing | Gou, Fang | Shi, Ping | Xu, Zhe | Yan, Zhitao | He, Mingfang | Yin, Xiaohong | He, Yuanjun | Zhang, Jun
Article Type: Research Article
Abstract: BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) were reported to protect from hypoxia-induced oxidative stress in coronary endothelial cells (CECs) after acute myocardial infarction (AMI). Nrf2 shows a protective effect in hypoxia-induced CECs after AMI. Plasmalemma vesicle-associated protein (PLVAP) plays a pivotal role in angiogenesis after AMI. AIM: To explore the protective effect of ACEIs and the involved mechanisms under hypoxia challenge. METHODS: Human coronary endothelial cells (HCAECs) were used to establish hypoxia-induced oxidative stress injury in vitro . Flow cytometry was used to evaluate the protective effect of ACEI on hypoxia conditions.ET-1, NO, ROS, and VEGF were …detected by ELISA. HO-1, Nrf2, and Keap-1, the pivotal member in the Nrf2 signaling pathway, eNOS and PLVAP were detected in HEAECs treated with ACEI by immunofluorescence, qPCR, and western blotting. RESULTS: The hypoxia ACEI or Nrf2 agonist groups showed higher cell viability compared with the hypoxia control group at 24 (61.75±1.16 or 61.23±0.59 vs. 44.24±0.58, both P < 0.05) and 48 h (41.85±1.19 or 59.64±1.13 vs. 22.98±0.25, both P < 0.05). ACEI decreased the levels of ET-1 and ROS under hypoxia challenge at 24 and 48 h (all P < 0.05); ACEI increased the VEGF and NO levels (all P < 0.05). ACEI promoted the expression level of eNOS, HO-1, Nrf2 and PLVAP but inhibited Keap-1 expression at the mRNA and protein levels (all P < 0.05). Blockade of the Nrf2 signaling pathway significantly decreased the expression level of PLVAP. CONCLUSION: ACEI protects hypoxia-treated HEAECs by activating the Nrf2 signaling pathway and upregulating the expression of PLVAP. Show more
Keywords: Acute myocardial infarction, angiotensin-converting enzyme inhibitor, nuclear factor erythroid 2 signaling pathway, human coronary endothelial cells, plasmalemma vesicle-associated protein
DOI: 10.3233/CH-232007
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-30, 2024
Authors: Betz, Thomas | Pfister, Karin | Schierling, Wilma | Sachsamanis, Georgios | Radunski, Jörn | Nolte Ernsting, Claus | Stehr, Alexander
Article Type: Research Article
Abstract: BACKGROUND: The popliteal artery is highly exposed to biomechanical stress, which is the primary factor associated with stent failure. However, information on the optimal endovascular treatment for the popliteal artery is lacking. OBJECTIVE: To report the efficacy of the GORE® TIGRIS® Vascular Stent for the endovascular treatment of popliteal artery lesions. METHODS: Retrospective analysis of all patients with symptoms of peripheral artery occlusive disease (PAD) and popliteal artery lesions who underwent implantation of a GORE® TIGRIS® Vascular Stent between August 2012 and August 2014 at a tertiary vascular centre. RESULTS: …Between August 2012 and August 2014, 48 patients (32 men, aged 75±8 years) were treated with a GORE® TIGRIS® Vascular Stent. The technical success rate was 100% . At 12 months, the primary and secondary patency rates were 74% and 85%, respectively. During follow-up, no stent fracture was observed. No major amputations were performed. CONCLUSIONS: Our study showed that isolated popliteal artery lesions in patients with symptomatic PAD could easily be treated with the GORE® TIGRIS® Vascular Stent, as good short-term results were achieved at 12 months. Therefore, the discontinuation of this product removed a useful tool with a simple release mechanism from the endovascular armamentarium of vascular specialists. Show more
Keywords: Popliteal artery lesion, GORE® TIGRIS® vascular stent, endovascular therapy, self-expandable nitinol stent
DOI: 10.3233/CH-231993
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Chen, Keke | Wang, Feihang | Deng, Minying | Yuan, Kai | Wang, Xi | Zhao, Qiannan | Dong, Yi | Wang, Wenping
Article Type: Case Report
Abstract: BACKGROUND: Hepatic reactive lymphoid hyperplasia (RLH) is a rare benign lymphoproliferative lesion and a poorly understood disease. It is usually asymptomatic and incidental, but it is difficult to distinguish from hepatocellular carcinoma and metastatic liver tumor on imaging, and percutaneous biopsy is not sufficient to distinguish from low-grade malignant lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), making diagnosis difficult. CASE SUMMARY: A 69-year-old woman came to our hospital for reexamination of pulmonary nodules followed by liver occupation. The lesions showed “wash-in and wash-out” on contrast-enhanced ultrasonography and magnetic resonance imaging. Enhanced …magnetic resonance also showed annular envelope enhancement and limited diffusion on the ADC map during the delay period. Imaging revealed metastatic liver cancer, and the patient underwent a partial hepatectomy. However, the final histopathological diagnosis was RLH. CONCLUSION: If small isolated nodules are found in the liver of middle-aged and elderly female patients with no risk factors for liver malignancy, when the enhanced imaging suggests “wash-in and wash-out”, further focus should be placed on whether the enhanced imaging shows perinodular enhancement and whether the DWI shows limited diffusion in MRI, in order to emphasize the possibility of liver RLH diagnosis. Show more
Keywords: Reactive lymphoid hyperplasia, pseudo lymphoma, ultrasound, MRI, CT, pathology, case report
DOI: 10.3233/CH-232087
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
Authors: Zhang, Wei | Liu, Yilun | Wu, Qiong | Wei, Xiaoer | Liu, Beibei | Jiao, Qiong | Zhang, Rui | Hu, Bing | Li, Yi | Ying, Tao
Article Type: Research Article
Abstract: OBJECTIVE: This article aims to clarify pitfalls and find strategies for the detecting and diagnosing hyperechoic liver metastases (LMs) using Sonazoid-contrast enhanced ultrasonography (Sonazoid-CEUS). METHODS: This study was a prospective self-controlled study. Patients with hepatic lesions suspected as LMs or benign lesions were included in the study. Baseline ultrasonography (BUS) and Sonazoid-CEUS were performed on every patient. Characteristics of LMs and benign nodules were compared by chi-square test and fisher test. Factors influenced the CEUS were demonstrated by univariate analysis and multivariate logistic regression analysis. RESULTS: 54 patients were included in this study. …CEUS found additional 75 LMs from 19 patients in Kupffer phase. We found hyperechoic focal liver lesions and deep seated in liver are main confounding factors in CEUS diagnosis. Sensitivity would be improved from 16.67% to 78.57%, negative predictive value (NPV) would be improved from 28.57% to 76.92% and accuracy would be improved from 37.5% to 87.50% when using rapid “wash-in” and “wash-out” as main diagnostic criteria. CONCLUSIONS: Hyperechoic LMs especially deeply seated ones are usually not shown typical “black hole” sign in Kupffer phase. Quickly “wash-in and wash out” shows high accuracy in diagnosing malignant nodules. We highly recommend CEUS as a routing exam to detect and diagnose LMs. Show more
Keywords: Contrast enhanced ultrasonography, focal liver lesion, liver metastases, Kupffer phase
DOI: 10.3233/CH-231995
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Greiner, Barbara | Kaiser, Ulrich | Maurer, Katharina | Stroszczynski, Christian | Jung, Ernst Michael
Article Type: Research Article
Abstract: BACKGROUND: Rapid evolution of ultrasound technology has allowed widespread use of handheld ultrasound devices (HHUDs) for many possible applications. Along with the adult population, the use of HHUDs for Point of Care Ultrasound (POCUS) in pediatric medicine has been increasing over the last few years. However, pediatric-specific literature is still scarce on mobile vascular ultrasound. OBJECTIVE: To evaluate diagnostic capabilities of Vscan Air™ in comparison with high-end ultrasound for the assessment of the internal jugular vein in children and adolescents. METHODS: 42 Internal Jugular Veins (IJVs) of 21 pediatric patients were scanned by …an experienced examiner using a WLAN-supported handheld ultrasound device (Vscan Air™) and high-end cart-based ultrasound (LOGIQ E9) as reference. B-Mode and Color-coded Doppler (CCDS) were performed and compared. Image quality was assessed using a score of 0 to 5 and statistically analyzed. Results were interpreted independently by two readers in consensus. RESULTS: 21 patients (2–17 years; mean 11,00±4,5 years; female n = 11, male n = 10) were examined. The rating score never dropped below 3 for both devices. The median score evaluation of B-Mode and CCDS for the high-end device was 5.00, of Vscan Air™ 5.00 for B-Mode and 4.00 for CCDS. A significant difference was shown between the two devices in the evaluation of CCDS. CONCLUSIONS: Vscan Air™ ultrasound device allows sufficient assessability of the IJV in pediatric patients, opening up new possibilities for fast and mobile POCUS of cervical veins and potential guidance of central venous catheter placement. Show more
Keywords: Handheld ultrasound, Vscan Air, POCUS, internal jugular vein, pediatric
DOI: 10.3233/CH-231981
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Wang, Nan | Yan, Xueliang | Zhang, Zhiqi | Liu, Luping | Zhu, Ju | Huang, Xiao | Nie, Fang
Article Type: Research Article
Abstract: OBJECTIVE: To explore whether the use of intravenous contrast-enhanced ultrasound (CEUS) can improve the diagnostic accuracy of T stage of gastric cancer on the basis of oral contrast-enhanced ultrasound (OCEUS). METHODS: Eighty-one patients with gastric cancer who underwent preoperative CEUS. Criteria for T staging was AJCC Stage 8th Edition. To compare the diagnostic accuracy, sensitivity and specificity of OCEUS and CEUS for T staging of gastric cancer using pathological results as the gold standard. RESULTS: There were differences in the diagnostic accuracy of T2 (P = 0.048), T3(P = 0.002) and T4 (P = 0.000) between OCEUS and CEUS. …And there was no difference in diagnostic accuracy for T1 (P = 0.118). CEUS significantly improved diagnostic sensitivity and specificity in T3 (42.86% to 61.90% for sensitivity, 86.96% to 93.75% for specificity), and T4 (64.71% to 76.47% for sensitivity, 78.33% to 95.74% for specificity). CONCLUSION: Compared with OCEUS, CEUS did improve the diagnostic accuracy of T2, T3, and T4 stages of gastric cancer. Show more
Keywords: T staging, ultrasonography, gastric cancer, intravenous contrast-enhanced ultrasound
DOI: 10.3233/CH-231949
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Neira Agonh, Daniel | Scott, Cassidy | Trivedi, Purvi | Dickson, Kayle | White, Hannah | Zhou, Juan | Lehmann, Christian
Article Type: Research Article
Abstract: BACKGROUND: Pentobarbital and isoflurane are commonly used veterinary anesthetics. Due to the dangers of overdose by repeat-bolus regimen of pentobarbital, isoflurane has been recommended. However, literature suggests isoflurane-induced inhibition of cytokine and adhesion molecule release, impacting leukocyte adhesion. OBJECTIVE: This study aims to characterize the impacts of pentobarbital versus isoflurane on leukocyte interactions within the intestinal microcirculation with and without endotoxin challenge. METHODS: Female BALB/c mice were subjected to pentobarbital or isoflurane (N = 20) and challenged with endotoxin or saline by intraperitoneal injection. The mice were kept under anesthesia for 2 hours. Fluorochromes, rhodamine-6 G and fluorescein isothiocyanate, …were injected intravenously. To visualize leukocyte adhesion within the intestinal microcirculation, laparotomy and intravital microscopy was performed. Leukocyte rolling and adhesion was quantified offline in a blinded fashion. RESULTS: Within collecting venules, leukocyte rolling and adhesion showed no significant differences between pentobarbital and isoflurane anesthesia under basal conditions. Endotoxin challenge caused a similar response in both anesthetic groups. Within postcapillary venules, no statistical differences between the two anesthetics were found for adhering leukocytes under basal conditions or following endotoxin challenge either. However, leukocyte rolling after LPS-challenge was significantly decreased in postcapillary venules during isoflurane anesthesia compared to pentobarbital anesthesia. CONCLUSIONS: Isoflurane anesthesia showed only minor differences in the immune response to endotoxin within the intestinal microcirculation compared to pentobarbital anesthesia. Due to the superior safety profile of volatile anesthetics, immunological studies may choose isoflurane over pentobarbital as the veterinary anesthetic of choice. Show more
Keywords: Intravital microscopy, pentobarbital, isoflurane, leukocytes, microcirculation
DOI: 10.3233/CH-231989
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Luo, Nan | Liang, Xiao-yu | Li, Lu | Zhang, Xiao | Zang, Chun-mei | Liu, Xi | Fan, Xiao-zhou
Article Type: Research Article
Abstract: A rare foreign body accompanied by thrombosis in the right internal jugular vein was accidentally observed. We collected the medical history of this special patient, analyzed the causes and characteristics of the foreign body and thrombosis formation, and subsequently observed the changes in thrombosis. Finally, we discussed the diagnostic value of ultrasound for such rare intravascular lesions.
Keywords: Ultrasound, internal jugular vein, foreign body, thrombosis
DOI: 10.3233/CH-231988
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-5, 2023
Authors: Pan, Yanghong | Liu, Delin | Liang, Fei | Kong, Zixiang | Zhang, Xu | Ai, Qinqin
Article Type: Research Article
Abstract: BACKGROUND: No studies have been retrieved comparing perfluorobutane with sulfur hexafluoride for microwave ablation (MWA) in small hepatocellular carcinoma(sHCC). OBJECTIVE: To retrospective investigate the value of perfluorobutane ultrasonography contrast agent in ultrasonography (US)-guided MWA of sHCC. METHODS: We conducted a retrospective clinical controlled study about US-guided percutaneous MWA in patients with sHCC, and in patients undergoing intra-operative treatment with perfluorobutane or sulfur hexafluoride. In both groups, a contrast agent was injected to clear the tumor and then a needle was inserted. A 5-point needle prick difficulty score was developed to compare needle prick difficulty in the …two groups of cases. RESULTS: A total of 67 patients were included: 25 patients in group perfluorobutane, aged 41–82 (60.64±9.46), tumor size 1.1–2.8 (1.78±0.45) cm. 42 patients in group sulfur hexafluoride, aged 38–78 (62.26±9.27), with tumor size of 1.1–3.0 (1.89±0.49) cm. There was no significant difference in age or tumor size in both groups (P > 0.05). Puncture difficulty score (5-point): 2.0–2.7 (2.28±0.29) in group perfluorobutane, and 2.0–4.7 (2.95±0.85) in group sulfur hexafluoride, and the difference between the two groups was statistically significant (P < 0.05). Enhanced imaging results within 3 months after surgery: complete ablation rate was 100% (25/25) in the group perfluorobutane, 95.2% (40/42 in the group sulfur hexafluoride), with no significant difference between the two groups (P > 0.05). CONCLUSION: Perfluorobutane kupffer phase can make the operator accurately deploy the ablation needle and reduce the difficulty of operation. Show more
Keywords: Contrast-enhanced ultrasonography (CEUS), liver cancer, perfluorobutane (Sonazoid), kupffer, microwave ablation (MWA)
DOI: 10.3233/CH-232055
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Tzirakis, Konstantinos | Kontopodis, Nikolaos | Ioannou, Christos V.
Article Type: Research Article
Abstract: PURPOSE: To compare the hemodynamic performance of three (Bottom Up non-ballet, Top-Down non-ballet, Top Down ballet) idealized stent graft configurations used during endovascular repair of abdominal aortic aneurysms, under the influence of various rheological models. METHODS: Ten rheological models are assumed and a commercial finite volume solver is employed for the simulation of blood flow under realistic boundary conditions. An appropriate mesh convergence study is performed and five hemodynamic variables are computed: the time average wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), endothelial cell activation potential and displacement force (DF) for all three …configurations. RESULTS: The choice of blood flow model may affect results, but does not constitute a significant determinant on the overall performance of the assumed stent grafts. On the contrary, stent graft geometry has a major effect. Specifically, the Bottom Up non-ballet type is characterized by the least favorable performance presenting the lowest TAWSS and the highest OSI, RRT and ECAP values. On the other hand, the Top Down ballet type presents hemodynamic advantages yielding the highest TAWSS and lowest OSI, RRT and ECAP average values. Furthermore, the ballet type is characterized by the lowest DF, although differences observed are small and their clinical relevance uncertain. CONCLUSIONS: The effect of the assumed rheological model on the overall performance of the grafts is not significant. It is thus relatively safe to claim that it is the type of stent graft that determines its overall performance rather than the adopted blood flow model. Show more
Keywords: Non-Newtonian blood flow, idealized stent graft, computational fluid dynamics, finite volume method, hemodynamic parameters
DOI: 10.3233/CH-232058
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Yao, Miao-Miao | Lin, Ting-Ting | Shi, Xu | Chen, Mei-Gui | Wu, Jia-Xiang | Zhao, Yan-Ping | Lin, Bao-Shan
Article Type: Research Article
Abstract: OBJECTIVE: Deep vein thrombosis (DVT) formation of lower extremities can lead to serious complications including pulmonary embolism (PE) and chronic post-thrombotic syndrome (PTS). We aimed to explore the relationship between the ratio of thrombotic density and the occurrence of PE and PTS in patients with DVT of the lower extremities. METHODS: A retrospective analysis was conducted in patients who performed computed tomography venography, dividing into DVT with PE group (54 patients) and DVT-alone group (34 patients), The clinical data were recorded. Univariate and multivariate logistic regression analysis were used to analysis variables associated with PE. The ability of …thrombosis density ratio and Wells score to diagnose PE was evaluated by using the receiver operating characteristic curve (ROC) area under the curve (AUC). According to the treatment and follow-up results, subgroup analysis was performed, and the Villata score was used to determine the presence or absence of PTS and its severity. RESULTS: Compare with the DVT-alone group, more patients had dyspnea and chest pain in the DVT with PE group. DVT with PE group had lower the percentage of neutrophils, white blood cell count and platelet count, while had higher blood cell count, D-dimer, wells score, thrombus and thrombus density ratio. Multivariate logistic analysis showed that percentage of neutrophils (OR(95% CIs)=1.15 (1.01,1.31), P = 0.040), platelets (OR(95% CIs)=0.96 (0.93,0.99), P = 0.011), and thrombus density ratio (OR(95% CIs)=5.99 (1.96,18.35), P = 0.002) are independent predictors of PE. The Wells score and thrombosis density ratio were consistent in the diagnostic efficacy of PE. In the subgroup analysis, there was a relevance between the ratio of thrombosis density and the Villalta score. CONCLUSION: Percentage of neutrophils, platelets, and thrombus density ratio are independent predictors of PE. The thrombosis density of DVT patients may be an index to predict the risk of PE and PTS in DVT patients. Show more
Keywords: Deep vein thrombosis of lower limbs, thrombotic density ratio, pulmonary embolism, post-thrombotic syndrome
DOI: 10.3233/CH-231778
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Article Type: Research Article
Abstract: OBJECTIVE: The present study probes into the role and mechanism of ubiquitin specific peptidase 14 (USP14) in coronary heart disease (CHD)-triggered endothelial cell pyroptosis. METHODS: An in vitro CHD model was established by inducing human coronary artery endothelial cells (HCAECs) with oxidized low-density lipoprotein (ox-LDL). HCAECs were transfected with si-USP14, followed by evaluation of cell viability by CCK-8 assay, detection of lactate dehydrogenase (LDH) activity by assay kit, detection of USP14, miR-15b-5p, NLRP3, GSDMD-N, and Cleaved-Caspase-1 expressions by qRT-PCR or Western blot, as well as IL-1β and IL-18 concentrations by ELISA. Co-IP confirmed the binding between USP14 …and NLRP3. The ubiquitination level of NLRP3 in cells was measured after protease inhibitor MG132 treatment. Dual-luciferase reporter assay verified the targeting relationship between miR-15b-5p and USP14. RESULTS: USP14 and NLRP3 were highly expressed but miR-15b-5p was poorly expressed in ox-LDL-exposed HCAECs. USP14 silencing strengthened the viability of ox-LDL-exposed HCAECs, reduced the intracellular LDH activity, and diminished the NLRP3, GSDMD-N, Cleaved-Caspase-1, IL-1β, and IL-18 expressions. USP14 bound to NLRP3 protein and curbed its ubiquitination. Repression of NLRP3 ubiquitination counteracted the inhibitory effect of USP14 silencing on HCAEC pyroptosis. miR-15b-5p restrained USP14 transcription and protein expression. miR-15b-5p overexpression alleviated HCAEC pyroptosis by suppressing USP14/NLRP3. CONCLUSION: USP14 stabilizes NLRP3 protein expression through deubiquitination, thereby facilitating endothelial cell pyroptosis in CHD. miR-15b-5p restrains endothelial cell pyroptosis by targeting USP14 expression. Show more
Keywords: Coronary heart disease, endothelial cell pyroptosis, USP14, miR-15b-5p, NLRP3
DOI: 10.3233/CH-232003
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Yang, Yun-Ping | Chiu, Ching-Tang | Chao, Anne | Yeh, Yu-Chang | Sun, Wei-Zen | Liu, Chih-Min | Chan, Wing-Sum
Article Type: Research Article
Abstract: OBJECTIVE: This study measured normal ranges of microcirculatory parameters in healthy individuals and investigated differences in parameters by age and sex. METHODS: Participants were enrolled into three groups with equal numbers of male and female: young (20–39 years), middle-aged (40–59 years), and elderly (60–79 years). Sublingual microcirculation images were obtained using the incident dark field (IDF). RESULTS: A total of 75 female and 75 male healthy individuals were enrolled. The elderly group had a higher TVD (26.5 [2 ] vs. 25.2 [1.8 ]; p = 0.019) and a lower PPV (97 [2 ] vs. 98 [3 ]; …p = 0.03) than did the young group. In the elderly group, systolic blood pressure (SBP) and mean arterial pressure (MAP) were moderately and positively correlated with MFI score (r = 0.407, p < 0.05, and r = 0.403, p < 0.05, respectively). The female participants had a lower MFI score than did the male participants (2.9 [2.8–3 ] vs. 3.0 [2.9–3 ]; p = 0.015). CONCLUSIONS: This study revealed the range of microcirculatory parameters between different ages and sexes in healthy individuals. We found that blood pressure levels were correlated with microcirculatory parameters, especially in elders and female. Show more
Keywords: microcirculation, healthy individuals, sublingual
DOI: 10.3233/CH-231807
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Astapenko, David | Zrzavecky, Marek | Gorskaja, Diana | Hyspler, Radomir | Ticha, Alena | Radochova, Vera | Lehmann, Christian | Malbrain, Manu L.N.G. | Cerny, Vladimir | Hahn, Robert G.
Article Type: Research Article
Abstract: BACKGROUND: Endothelial glycocalyx (EG) plays a crucial role in maintaining the plasma proteins within the intravascular space. OBJECTIVE: We studied whether exogenous albumin protects the EG in an experimental model of EG enzymatic damage in rats. METHODS: Rats were divided into three groups of 10 animals that received (1) Evans blue (2) Evans blue + hyaluronidase, or (3) Evans blue + hyaluronidase + 20% human albumin via the tail vein. Spectrophotometric analysis was performed 2 h later to quantify the leakage of Evans blue-labeled albumin into the heart, lungs, brain, kidneys, liver, small intestine, spleen, and skeletal muscle. RESULTS: Administration of …hyaluronidase numerically increased the capillary leakage of Evans blue in all examined tissues. Co-administration of albumin decreased the leakage of albumin in all tissues except the heart. In the lungs, the ratio between the absorbance and dry organ weight decreased from 5.3 ± 2.4 to 1.7 ± 0.5 (mean ± SD) (P < 0.002), and in the liver, the absorbance decreased from 2.2 ± 0.7 to 1.5 ± 0.4 (P < 0.011). CONCLUSION: Exogenous albumin decreased the capillary leakage of albumin which was interpreted as a sign of maintained EG integrity. Show more
Keywords: Albumin, endothelial glycocalyx, microcirculation, evans blue, spectrophotometry
DOI: 10.3233/CH-232027
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Cavalcante dos Santos, Elaine | Creteur, Jacques | Taccone, Fabio Silvio
Article Type: Letter
Abstract: Alterations in skin blood flow (SBF) may help to detect occult hypoperfusion in critically ill patients after fluid resuscitation. In this study, SBF is globally unaltered by red blood cell transfusion (RBCT) in non-bleeding critically ill patients after initial resuscitation; however, 37.5% of patients showed a significant increase in SBF. No correlation between relative changes in SBF and systemic variables after RBCT was observed.
Keywords: Tissue perfusion, red blood cell transfusions, skin laser Doppler
DOI: 10.3233/CH-232091
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-6, 2024
Authors: Zhang, Ao-Yi | Dong, Ya-Xin | Tan, Yan-Di | Dian-Shen, | Heng-Sun, | Nie, Shu-Ting | Shao, Yuan-Yuan | Feng-Xian, | Hu, Wen-Shu | Li, Xin-YI | Tao-Xu, | Li, An-Ni | Chang-Zhou, | Liang-Xu,
Article Type: Research Article
Abstract: OBJECTIVE: To investigate predictors of anticoagulation efficacy in deep venous thrombosis (DVT) by ultrasound elastography (UE). METHODS: The basic clinical, laboratory and ultrasound treatment data of fifty-eight patients with DVT were collected and analyzed. Then the results of ultrasound after 3-month anticoagulation treatment were compared among different groups. Multiple logistic regression analysis was used to identify independent risk factors that affected anticoagulation efficacy. The predictive efficacy of each independent risk factor was accessed by drawing operating characteristic (ROC) curves. RESULTS: According to the regression analysis, the elastic modulus (OR = 0.631, P = 0.001) and strain …rate ratio (OR = 0.332, P = 0.006) were identified as independent risk factors for the effectiveness of anticoagulation therapy in patients with DVT. According to the ROC curves, elastic modulus and strain rate ratio could predict effective anticoagulation therapy for DVT, and the optimal threshold values were 22.10 kPa and 1.80 respectively. The corresponding AUC values were 0.879 and 0.854, with a sensitivity of 71.4% and 59.5%, a specificity of 93.7%, and a Youden index of 65.1% and 62.7%, respectively. CONCLUSIONS: The elastic modulus (≤22.10 kPa) or strain rate ratio (≤1.80) of the thrombus were independent predictors for the effectiveness of anticoagulation therapy. Show more
Keywords: Elastography, deep vein thrombosis, anticoagulation
DOI: 10.3233/CH-232031
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Qiao, Qi | Wang, Bingshuang | Xu, Minzhe | Qi, Zhengqin
Article Type: Research Article
Abstract: OBJECTIVE: To evaluate plaque vulnerability by carotid contrast-enhanced ultrasound (CEUS) and to analyze the correlation between plaque vulnerability and peripheral blood leukocyte classification. MATERIALS AND METHODS: 135 patients with carotid plaque were examined by contrast-enhanced ultrasound. Plaque vulnerability was assessed by semiquantitative visual classification. Baseline clinical data and peripheral leukocyte classification were collected. Ordered logistic regression was used to analyze the correlation between plaque neovascularization grade and peripheral leukocyte classification count. RESULTS: There were significant differences in leukocyte, monocyte, neutrophil, mean platelet volume, lymphocyte, and neutrophil counts between different neovascular plaque grades and …peripheral blood (P < 0.05). Correlation analysis showed that leukocyte, monocyte, and neutrophil counts were significantly positively correlated. CONCLUSION: The increase in plaque neovascularization is associated with an increase in circulating leukocytes, monocytes, and neutrophils. Therefore, CEUS combined with peripheral blood leukocytes may serve as an early warning of plaque vulnerability and provide a theoretical basis for clinical treatment. Show more
Keywords: Contrast-enhanced ultrasound, carotid plaque, leukocyte, inflammation
DOI: 10.3233/CH-232034
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Javakhishvili, I. | Sanikidze, T. | Mardaleishvili, K. | Momtselidze, N. | Urdulashvili, T. | Mantskava, M. | Prantl, L. | Jung, F.
Article Type: Research Article
Abstract: BACKGROUND: The functioning of the thyroid gland is a multi-component process that in some conditions may undergo alterations. The thyroid gland is part of the endocrine system that produces the iodine-containing hormones thyroxine and triiodothyronine. Thyroid hormones, control metabolism and energy, growth processes, maturation of tissues and organs, regulation of blood flow, and, therefore, providing vital functions of the body. The role of thyroid hormones in the regulation of blood flow is determined by the intensity of their production and the quantity in the blood. Presumably, in case of oncological and non-oncological diseases of the thyroid gland, the fluidity of …the blood, which depends on the rheological properties, will be different. OBJECTIVE: Our aim was investigating rheological characteristics for studying of changes of rheology in patients with thyrotoxicosis, with benign tumor pathology of the thyroid gland, with thyroid cancer and finding possible diagnostic markers for differentiating benign and malignant thyroid tumors METHODS: In this regard, we examined, using modern methods accepted in clinical practice, a standard list of recommended diagnostic tests in the group of patients (thyrotoxicosis: n = 25; benign tumor: n = 47), thyroid cancer: n = 35) and control group (n = 15), and with new original methods, parameters that describe the rheological properties of the blood, such as blood rheological index, volume, thickness, surface area of erythrocytes, erythrocyte aggregation index, deformation index, plasma viscosity, hematocrits. RESULTS: Against the background of relative changes in the studied values, it is necessary to pay attention to the fact that erythrocyte aggregation in patients with a benign form and control, as well as in patients with a malignant form and control, differ significantly from each other, in addition, there is a significant difference between aggregation in the group of patients with benign and control aggregation. malignant forms of the disease. It is significant that aggregability differs in patients with thyrotoxicosis and in controls. This indicates that erythrocyte aggregation is particularly informative. The blood rheological index most clearly demonstrated the difference between benign and malignant forms of the disease. Significantly changed compared to control in various forms of thyroid diseases. CONCLUSION: Additional diagnostic markers for differentiating benign and malignant thyroid tumors may be consideredeerythrocyte aggregation index and blood rheological index. Show more
Keywords: Thyroid gland, rheology, oncology
DOI: 10.3233/CH-249102
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Xu, Ya-Dan | Tang, Yang | Zhang, Qi | Zhao, Zheng-Yong | Zhao, Chong-Ke | Fan, Pei-Li | Jin, Yun-Jie | Ji, Zheng-Biao | Han, Hong | Xu, Hui-Xiong | Shi, Yi-Lei | Xu, Ben-Hua | Li, Xiao-Long
Article Type: Research Article
Abstract: BACKGROUND: At present, most articles mainly focused on the diagnosis of thyroid nodules by using artificial intelligence (AI), and there was little research on the detection performance of AI in thyroid nodules. OBJECTIVE: To explore the value of a real-time AI based on computer-aided diagnosis system in the detection of thyroid nodules and to analyze the factors influencing the detection accuracy. METHODS: From June 1, 2022 to December 31, 2023, 224 consecutive patients with 587 thyroid nodules were prospective collected. Based on the detection results determined by two experienced radiologists (both with more than 15 years …experience in thyroid diagnosis), the detection ability of thyroid nodules of radiologists with different experience levels (junior radiologist with 1 year experience and senior radiologist with 5 years experience in thyroid diagnosis) and real-time AI were compared. According to the logistic regression analysis, the factors influencing the real-time AI detection of thyroid nodules were analyzed. RESULTS: The detection rate of thyroid nodules by real-time AI was significantly higher than that of junior radiologist (P = 0.013), but lower than that of senior radiologist (P = 0.001). Multivariate logistic regression analysis showed that nodules size, superior pole, outside (near carotid artery), close to vessel, echogenicity (isoechoic, hyperechoic, mixed-echoic), morphology (not very regular, irregular), margin (unclear), ACR TI-RADS category 4 and 5 were significant independent influencing factors (all P < 0.05). With the combination of real-time AI and radiologists, junior and senior radiologist increased the detection rate to 97.4% (P < 0.001) and 99.1% (P = 0.015) respectively. CONCLUSONS: The real-time AI has good performance in thyroid nodule detection and can be a good auxiliary tool in the clinical work of radiologists. Show more
Keywords: Artificial intelligence, thyroid, nodule, ultrasonography
DOI: 10.3233/CH-242099
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Yan, Wentao | He, Xiuhua | Wang, Guanjun | Hu, Guochao | Cui, Bin
Article Type: Research Article
Abstract: INTRODUCTION: Visceral adipose tissue-derived serine protease inhibitor (vaspin) is an adipokine. It has been reported that decreased serum vaspin levels are significantly associated with stroke severity and prognosis. PURPOSE: This article aims to explore the theoretical feasibility of vaspin supplementation for cerebral ischemia-reperfusion (I/R) injury. METHODS: The I/R mouse models were constructed by the middle cerebral artery occlusion (MCAO) method, and the effects of vaspin on cerebral infarction, neurological function, angiogenesis and endoplasmic reticulum (ER) stress were explored. To verify the mediation of ER stress in the regulation of vaspin, human brain microvascular …endothelial cells (HBMECs) were subjected to ER stress agonist tunicamycin in vitro . The impacts of vaspin and tunicamycin on oxygen glucose deprivation/ recovery (OGD/R)-induced cell viability, apoptosis, and angiogenesis were examined. RESULTS: Vaspin inhibited blood-brain barrier breakdown and infarction occurred in the brain tissue of the I/R mice. Vaspin also enhanced cerebral neovascularization and reduced the apoptosis. Additional tunicamycin increased the apoptosis of HBMECs and inhibited angiogenesis, reversing the protective effect of vaspin on cells. CONCLUSION: Together, this study reveals that vaspin supplementation reduces cerebral infarction and works against neurological dysfunction. It maintains the survival and angiogenesis capacity of HBMECs by inhibiting ER stress. Show more
Keywords: Vaspin, ER stress, I/R injury, OGD/R, microvascular endothelial cell
DOI: 10.3233/CH-232077
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: He, Yu-Chuan | Yuan, Guo-Dong | Li, Nan | Ren, Mei-Fang | Qian-Zhang, | Deng, Kai-Ning | Wang, Le-Chuan | Xiao, Wei-Ling | Ma, Nan | Stamm, Christof | Felthaus, Oliver | Prantl, Lukas | Nie, Jia | Wang, Gang
Article Type: Research Article
Abstract: Myocardial infarction refers to the ischemic necrosis of myocardium, characterized by a sharp reduction or interruption of blood flow in the coronary arteries due to the coronary artery occlusion, resulting in severe and prolonged ischemia in the corresponding myocardium and ultimately leading to ischemic necrosis of the myocardium. Given its high risk, it is considered as one of the most serious health threats today. In current clinical practice, multiple approaches have been explored to diminish myocardial oxygen consumption and alleviate symptoms, but notable success remains elusive. Accumulated clinical evidence has showed that the implantation of mesenchymal stem cell for treating …myocardial infarction is both effective and safe. Nevertheless, there persists controversy and variability regarding the standardizing MSC transplantation protocols, optimizing dosage, and determining the most effective routes of administration. Addressing these remaining issues will pave the way of integration of MSCs as a feasible mainstream cardiac treatment. Show more
Keywords: Myocardial infarction, mesenchymal stem cells, nanomaterials
DOI: 10.3233/CH-249101
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Magnusson, Marine M. M. | Schüpbach-Regula, Gertraud | Rieger, Juliane | Plendl, Johanna | Marin, Ilka | Drews, Barbara | Kaessmeyer, Sabine
Article Type: Research Article
Abstract: Objective: BACKGROUND: The use of endothelial cell cultures has become fundamental to study angiogenesis. Recent advances in artificial intelligences (AI) offer opportunities to develop automated assessment methods in medical research, analyzing larger datasets. Objective: OBJECTIVE: The aim of this study was to compare the application of AI with a manual method to morphometrically quantify in vitro angiogenesis. Objective: METHODS: Co-cultures of human microvascular endothelial cells and fibroblasts were incubated mimicking endothelial capillary-beds. An AI-software was trained for segmentation of endothelial capillaries on anti-CD31-labeled light microscope crops. Number of capillaries …and branches and average capillary diameter were measured by the AI and manually on 115 crops. Objective: RESULTS: The crops were analyzed faster by the AI than manually (3 minutes vs 1 hour per crop). Using the AI, systematically more capillaries (mean 48/mm2 vs 27/mm2 ) and branches (mean 23/mm2 vs 11/mm2 ) were counted than manually. Both methods had a strong linear relationship in counting capillaries and branches (r-capillaries = 0.88, r-branches = 0.89). No correlation was found for measurements of the diameter (r-diameter = 0.15). Objective: CONCLUSIONS: The present AI reduces the time required for quantitative analysis of angiogenesis on large datasets, and correlates well with manual analysis. Show more
Keywords: Artificial intelligence, HMVEC, machine learning, endothelial cells, angiogenesis
DOI: 10.3233/CH-242157
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Rother, D. | Gehron, J. | Brenck, F. | Hudel, H. | Böning, A. | Wenzel, F.
Article Type: Research Article
Abstract: INTRODUCTION: COVID-19 causes a considerable degradation of pulmonary function to the point of an acute respiratory distress syndrome (ARDS). Over the course of the disease the gas exchange capability of the lung can get impaired to such an extent that extracorporeal membrane oxygenation (ECMO) is needed as a life-saving intervention. In patients COVID-19 as well as ECMO may cause severe coagulopathies which manifest themselves in micro and macro thrombosis. Previous studies established D-dimers as a marker for critical thrombosis of the ECMO system while on admission increased D-dimers are associated with a higher mortality in COIVD-19 patients. It is …therefore crucial to determine if COVID-19 poses an increased risk of early thrombosis of the vital ECMO system. METHODS: 40 patients who required ECMO support were enrolled in a retrospective analysis and assigned into 2 groups. The COVID group consist of 20 COVID-19 patients who required ECMO support (n = 20), whereas 20 ECMO patients without COVID-19 were assigned to the control group. D-dimers, fibrinogen, antithrombin III (AT III), lactate dehydrogenase (LDH) and platelet count were analysed using locally weighted scatterplot smoothing and MANOVAs. RESULTS: The analysis of both groups shows highly significant differences in the dynamics of hemostasis. The increase in D-dimers that is associated with thrombosis of the ECMO systems occurs in COVID-19 patients around 2 days earlier (p = 2,8115 10–11 ) while fibrinogen is consumed steadily. In the control group fibrinogen levels increase rapidly after ten days with a plateau phase of around five days (p = 1,407 10–3 ) . Both groups experience a rapid increase in AT III after start of support by ECMO (p = 5,96 10–15 ). In the COVID group platelet count decreased from 210 giga/l to 130 giga/l within eight days, while in the same time span in the control group platelets decreased from 180 giga/l to 105 giga/l (p = 1,1 10–15 ). In both groups a marked increase in LDH beyond 5000 U/l occurs (p = 3,0865 10–15 ). CONCLUSION: The early increase in D-dimers and decrease in fibrinogen suggests that COVID-19 patients bear an increased risk of early thrombosis of the ECMO system compared to other diseases treated with ECMO. Additionally, the control group shows signs of severe inflammation 10 days after the start of ECMO which were absent in COVID-19 patients. Show more
DOI: 10.3233/CH-229105
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Bagherzadeh-Rahmani, Behnam | Marzetti, Emanuele | Karami, Esmail | Campbell, Bill I. | Fakourian, Ali | Haghighi, Amir Hossein | Mousavi, Seyyed Hossein | Heinrich, Katie M. | Brazzi, Luca | Jung, Friedrich | Baker, Julien S. | Patel, Darpan I.
Article Type: Research Article
Abstract: OBJECTIVES: The purpose of this study was to investigate the effects of 6 weeks of resistance training (RT) combined with aerobic training (AT) and Tirzepatide supplementation on lipid profiles, insulin resistance, anthropometric characteristics and physical fitness in prediabetic obese soldiers. METHODS: 61 obese men were randomly divided into six groups: Placebo; Tirzepatide 5 mg (T5); Tirzepatide 2.5 mg (T2.5); Hypertrophy, Strength, Power-Circuit Training+Placebo (Ex+P); Hypertrophy, Strength, Power-Circuit Training+Tirzepatide 5 mg (Ex+T5); Hypertrophy, Strength, Power-Circuit Training+Tirzepatide 2.5 mg (Ex+T2.5). All training groups performed aerobic training (AT) after resistance training. Subjects trained for six weeks, three sessions per week. Before and after …the intervention period, the participants were evaluated for anthropometric measures, body composition [body weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and fat mass (FM)], cardiorespiratory fitness (VO2 max), and muscle strength (chest press 1RM and leg press 1RM). Blood biochemistry evaluations included triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), insulin level and insulin resistance (HOMA-IR). To evaluate the differences between the groups, ANCOVA statistical method was used along with Bonferroni’s post hoc test, and the significance level was P < 0.05. RESULTS: Body weight, BMI, WC, FM, FBG, LDL-C, TC, TG and HOMA-IR were significantly decreased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo, T5 and T2.5 groups. WHR significantly decreased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo group. HDL-C, chest press and leg press significantly increased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo, T5 and T2.5 groups. VO2 max significantly increased and insulin significantly decreased in Ex+P group compared to Placebo, T5 and T2.5 groups. FM, FBG and TG were significantly decreased in both the T2.5 and T5 groups compared to Placebo group. HOMA-IR, LDL-C and TC significantly decreased in the T5 group compared to Placebo group. Also, leg press significantly increased in Ex+P group compared to all other groups. CONCLUSIONS: Performing six weeks of combined resistance and aerobic training in the form of RT+AT alone is more effective than the simultaneous use of Tirzepatide on cardiorespiratory fitness, strength, and modulating insulin levels. Taking Tirzepatide in doses of 5 mg and 2.5 mg in combination with exercise training did not have a significant advantage over exercise training alone. Finally, taking Tirzepatide in doses of 5 mg or 2.5 mg in combination with exercise training is not significantly superior to each other. Show more
Keywords: Obesity, combined training, GIP, GLP-1, Tirzepatide
DOI: 10.3233/CH-242134
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-16, 2024
Authors: Chen, Jianfei | Guan, Peishan | Sun, Pei | Yu, Qing | Yuan, Haixia
Article Type: Research Article
Abstract: As a rare biliary tract tumor, intraductal papillary neoplasm of the bile duct (IPNB) is most common in elderly men and can progress to cholangiocarcinoma- (CCa) if left untreated. It is reported that IPNB usually communicates with the bile duct. As a result, the downstream bile ducts are imaged asymmetrically dilated. However, a case of IPNB that we report here is different. Enhanced MRI revealed a lack of connectivity with the bile duct in this case. Based on this, the purpose of this case study is to suggest that the majority of imaging doctors should widely understand the various imaging …manifestations of the disease to avoid misdiagnosis. In addition, although this feature was not indicated by ultrasound in this case, given previous studies and considering the convenience and non-ionizing radiation damage of CEUS, we recommend its use as a screening method for IPNB to improve diagnostic accuracy. Show more
Keywords: Intraductal papillary neoplasm of the bile duct, cholangiocarcinoma, contrast-enhanced ultrasound
DOI: 10.3233/CH-242167
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-6, 2024
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