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Sample records for carotid body type

  1. Measurements of intracellular Ca2+ in dissociated type I cells of the rabbit carotid body.

    PubMed Central

    Biscoe, T J; Duchen, M R; Eisner, D A; O'Neill, S C; Valdeolmillos, M

    1989-01-01

    1. The carotid body chemoreceptors are stimulated in situ by cyanide (CN-), which mimics the effect of hypoxia. We have shown that CN- increases a calcium-dependent potassium conductance (gK(Ca)) in single type I cells dissociated from the carotid body of the rabbit. We have now used the Ca2(+)-sensitive fluorophore, Fura-2, to measure intracellular Ca2+ directly in single type I cells. 2. CN- reversibly increased [Ca2+]i from approximately 90 nM to a mean of approximately 200 nM. Some of this Ca2+ originated from an intracellular store, which was depleted by exposure to Ca2(+)-free solutions. Prolonged application of CN- caused a sustained increase in [Ca2+]i, suggesting that CN- impairs the removal or sequestration of Ca2+. 3. pHi measured with the dye BCECF (2,7-bis(2-carboxyethyl)-5(and-6)-carboxyfluorescein) did not change consistently in response to CN-, although pHi changed predictably in response to both ammonium chloride and to acidification of the superfusate with CO2. 4. Potassium-induced depolarization (35 mM-K+) caused a large, cadmium-sensitive rise in [Ca2+]i. The K(+)-induced Ca2+ load was used to study the regulation of [Ca2+]i. 5. The clearance of a Ca2+ load was slowed either by removal of [Na+]o or by application of CN-. This shows that both a Na+-Ca2+ exchange and an energy-dependent process or processes contribute to the regulation of [Ca2+]i. 6. Carbachol (CCh, 10-100 microM), which also hyperpolarizes type I cells, caused a small transient rise in [Ca2+]i, indicating release from an exhaustible intracellular pool. The response to CN- was unaffected by prior or continued exposure to CCh, suggesting that the two stimuli operate by distinct mechanisms. 7. The increased gK(Ca) seen in type I cells in response to CN- thus reflects a change in cellular Ca2+ homeostasis. The rise in [Ca2+]i presumably underlies the documented increase in transmitter release from the carotid body in response to CN-. If chemotransduction is a consequence of the

  2. CaV3.2 T-type Ca²⁺ channels in H₂S-mediated hypoxic response of the carotid body.

    PubMed

    Makarenko, Vladislav V; Peng, Ying-Jie; Yuan, Guoxiang; Fox, Aaron P; Kumar, Ganesh K; Nanduri, Jayasri; Prabhakar, Nanduri R

    2015-01-15

    Arterial blood O2 levels are detected by specialized sensory organs called carotid bodies. Voltage-gated Ca(2+) channels (VGCCs) are important for carotid body O2 sensing. Given that T-type VGCCs contribute to nociceptive sensation, we hypothesized that they participate in carotid body O2 sensing. The rat carotid body expresses high levels of mRNA encoding the α1H-subunit, and α1H protein is localized to glomus cells, the primary O2-sensing cells in the chemoreceptor tissue, suggesting that CaV3.2 is the major T-type VGCC isoform expressed in the carotid body. Mibefradil and TTA-A2, selective blockers of the T-type VGCC, markedly attenuated elevation of hypoxia-evoked intracellular Ca(2+) concentration, secretion of catecholamines from glomus cells, and sensory excitation of the rat carotid body. Similar results were obtained in the carotid body and glomus cells from CaV3.2 knockout (Cacna1h(-/-)) mice. Since cystathionine-γ-lyase (CSE)-derived H2S is a critical mediator of the carotid body response to hypoxia, the role of T-type VGCCs in H2S-mediated O2 sensing was examined. Like hypoxia, NaHS, a H2S donor, increased intracellular Ca(2+) concentration and augmented carotid body sensory nerve activity in wild-type mice, and these effects were markedly attenuated in Cacna1h(-/-) mice. In wild-type mice, TTA-A2 markedly attenuated glomus cell and carotid body sensory nerve responses to hypoxia, and these effects were absent in CSE knockout mice. These results demonstrate that CaV3.2 T-type VGCCs contribute to the H2S-mediated carotid body response to hypoxia. PMID:25377087

  3. Effects of hypercapnia on membrane potential and intracellular calcium in rat carotid body type I cells.

    PubMed Central

    Buckler, K J; Vaughan-Jones, R D

    1994-01-01

    1. An acid-induced rise in the intracellular calcium concentration ([Ca2+]i) of type I cells is thought to play a vital role in pH/PCO2 chemoreception by the carotid body. In this present study we have investigated the cause of this rise in [Ca2+]i in enzymatically isolated, neonatal rat type I cells. 2. The rise in [Ca2+]i induced by a hypercapnic acidosis was inhibited in Ca(2+)-free media, and by 2 mM Ni2+. Acidosis also increased Mn2+ permeability. The rise in [Ca2+]i is dependent, therefore, upon a Ca2+ influx from the external medium. 3. The acid-induced rise in [Ca2+]i was attenuated by both nicardipine and methoxyverapamil (D600), suggesting a role for L-type Ca2+ channels. 4. Acidosis depolarized type I cells and often (approximately 50% of cells) induced action potentials. These effects coincided with a rise in [Ca2+]i. When membrane depolarization was prevented by a voltage clamp, acidosis failed to evoke a rise in [Ca2+]i. The acid-induced rise in [Ca2+]i is a consequence, therefore, of membrane depolarization. 5. Acidosis decreased the resting membrane conductance of type I cells. The reversal potential of the acid-sensitive current was about -75 mV. 6. A depolarization (30 mM [K+]o)-induced rise in [Ca2+]i was blocked by either the removal of extracellular Ca2+ or the presence of 2 mM Ni2+, and was also substantially inhibited by nicardipine. Under voltage-clamp conditions, [Ca2+]i displayed a bell-shaped dependence on membrane potential. Depolarization raises [Ca2+]i, therefore, through voltage-operated Ca2+ channels. 7. Caffeine (10 mM) induced only a small rise in [Ca2+]i (< 10% of that induced by 30 mM extracellular K+). Ca(2+)-induced Ca2+ release is unlikely, therefore, to contribute greatly to the rise in [Ca2+]i induced by depolarization. 8. Although the replacement of extracellular Na+ with N-methyl-D-glucamine (NMG), but not Li+, inhibited the acid-induced rise in [Ca2+]i, this was due to membrane hyperpolarization and not to the inhibition

  4. Effects of mitochondrial uncouplers on intracellular calcium, pH and membrane potential in rat carotid body type I cells

    PubMed Central

    Buckler, K J; Vaughan-Jones, R D

    1998-01-01

    Mitochondrial uncouplers are potent stimulants of the carotid body. We have therefore investigated their effects upon isolated type I cells. Both 2,4-dinitrophenol (DNP) and carbonyl cyanide p-trifluoromethoxyphenyl hydrazone (FCCP) caused an increase in [Ca2+]i which was largely inhibited by removal of extracellular Ca2+ or Na+, or by the addition of 2 mm Ni2+. Methoxyverapamil (D600) also partially inhibited the [Ca2+]i response. In perforated-patch recordings, the rise in [Ca2+]i coincided with membrane depolarization and was greatly reduced by voltage clamping the cell to −70 mV. Uncouplers also inhibited a background K+ current and induced a small inward current. Uncouplers reduced pHi by 0.1 unit. Alkaline media diminished this acidification but had no effect on the [Ca2+]i response. FCCP and DNP also depolarized type I cell mitochondria. The onset of mitochondrial depolarization preceded changes in cell membrane conductance by 3–4 s. We conclude that uncouplers excite the carotid body by inhibiting a background K+ conductance and inducing a small inward current, both of which lead to membrane depolarization and voltage-gated Ca2+ entry. These effects are unlikely to be caused by cell acidification. The inhibition of background K+ current may be related to the uncoupling of oxidative phosphorylation. PMID:9824720

  5. Effects of mitochondrial uncouplers on intracellular calcium, pH and membrane potential in rat carotid body type I cells.

    PubMed

    Buckler, K J; Vaughan-Jones, R D

    1998-12-15

    1. Mitochondrial uncouplers are potent stimulants of the carotid body. We have therefore investigated their effects upon isolated type I cells. Both 2,4-dinitrophenol (DNP) and carbonyl cyanide p-trifluoromethoxyphenyl hydrazone (FCCP) caused an increase in [Ca2+]i which was largely inhibited by removal of extracellular Ca2+ or Na+, or by the addition of 2 mM Ni2+. Methoxyverapamil (D600) also partially inhibited the [Ca2+]i response. 2. In perforated-patch recordings, the rise in [Ca2+]i coincided with membrane depolarization and was greatly reduced by voltage clamping the cell to -70 mV. Uncouplers also inhibited a background K+ current and induced a small inward current. 3. Uncouplers reduced pHi by 0.1 unit. Alkaline media diminished this acidification but had no effect on the [Ca2+]i response. 4. FCCP and DNP also depolarized type I cell mitochondria. The onset of mitochondrial depolarization preceded changes in cell membrane conductance by 3-4 s. 5. We conclude that uncouplers excite the carotid body by inhibiting a background K+ conductance and inducing a small inward current, both of which lead to membrane depolarization and voltage-gated Ca2+ entry. These effects are unlikely to be caused by cell acidification. The inhibition of background K+ current may be related to the uncoupling of oxidative phosphorylation. PMID:9824720

  6. Peripheral Chemoreceptors: Function and Plasticity of the Carotid Body

    PubMed Central

    Kumar, Prem; Prabhakar, Nanduri R.

    2014-01-01

    The discovery of the sensory nature of the carotid body dates back to the beginning of the 20th century. Following these seminal discoveries, research into carotid body mechanisms moved forward progressively through the 20th century, with many descriptions of the ultrastructure of the organ and stimulus-response measurements at the level of the whole organ. The later part of 20th century witnessed the first descriptions of the cellular responses and electrophysiology of isolated and cultured type I and type II cells, and there now exist a number of testable hypotheses of chemotransduction. The goal of this article is to provide a comprehensive review of current concepts on sensory transduction and transmission of the hypoxic stimulus at the carotid body with an emphasis on integrating cellular mechanisms with the whole organ responses and highlighting the gaps or discrepancies in our knowledge. It is increasingly evident that in addition to hypoxia, the carotid body responds to a wide variety of blood-borne stimuli, including reduced glucose and immune-related cytokines and we therefore also consider the evidence for a polymodal function of the carotid body and its implications. It is clear that the sensory function of the carotid body exhibits considerable plasticity in response to the chronic perturbations in environmental O2 that is associated with many physiological and pathological conditions. The mechanisms and consequences of carotid body plasticity in health and disease are discussed in the final sections of this article. PMID:23728973

  7. Hyperbaric Oxygen Therapy Improves Glucose Homeostasis in Type 2 Diabetes Patients: A Likely Involvement of the Carotid Bodies.

    PubMed

    Vera-Cruz, P; Guerreiro, F; Ribeiro, M J; Guarino, M P; Conde, S V

    2015-01-01

    The carotid bodies (CBs) are peripheral chemoreceptors that respond to hypoxia increasing minute ventilation and activating the sympathetic nervous system. Besides its role in ventilation we recently described that CB regulate peripheral insulin sensitivity. Knowing that the CB is functionally blocked by hyperoxia and that hyperbaric oxygen therapy (HBOT) improves fasting blood glucose in diabetes patients, we have investigated the effect of HBOT on glucose tolerance in type 2 diabetes patients. Volunteers with indication for HBOT were recruited at the Subaquatic and Hyperbaric Medicine Center of Portuguese Navy and divided into two groups: type 2 diabetes patients and controls. Groups were submitted to 20 sessions of HBOT. OGTT were done before the first and after the last HBOT session. Sixteen diabetic patients and 16 control individual were included. Fasting glycemia was143.5 ± 12.62 mg/dl in diabetic patients and 92.06 ± 2.99 mg/dl in controls. In diabetic patients glycemia post-OGTT was 280.25 ± 22.29 mg/dl before the first HBOT session. After 20 sessions, fasting and 2 h post-OGTT glycemia decreased significantly. In control group HBOT did not modify fasting glycemia and post-OGTT glycemia. Our results showed that HBOT ameliorates glucose tolerance in diabetic patients and suggest that HBOT could be used as a therapeutic intervention for type 2 diabetes. PMID:26303484

  8. Type I cell ROS kinetics under hypoxia in the intact mouse carotid body ex vivo: a FRET-based study.

    PubMed

    Bernardini, A; Brockmeier, U; Metzen, E; Berchner-Pfannschmidt, U; Harde, E; Acker-Palmer, A; Papkovsky, D; Acker, H; Fandrey, J

    2015-01-01

    Reactive oxygen species (ROS) mainly originating from NADPH oxidases have been shown to be involved in the carotid body (CB) oxygen-sensing cascade. For measuring ROS kinetics, type I cells of the mouse CB in an ex vivo preparation were transfected with the ROS sensor construct FRET-HSP33. After 2 days of tissue culture, type I cells expressed FRET-HSP33 as shown by immunohistochemistry. In one population of CBs, 5 min of hypoxia induced a significant and reversible decrease of type I cell ROS levels (n = 9 CBs; P < 0.015), which could be inhibited by 4-(2-aminoethyl)benzensulfonylfluorid (AEBSF), a highly specific inhibitor of the NADPH oxidase subunits p47(phox) and p67(phox). In another population of CBs, however, 5 min of hypoxia induced a significant and reversible increase of ROS levels in type I cells (n = 8 CBs; P < 0.05), which was slightly enhanced by administration of 3 mM AEBSF. These different ROS kinetics seemed to coincide with different mice breeding conditions. Type I cells of both populations showed a typical hypoxia-induced membrane potential (MP) depolarization, which could be inhibited by 3 mM AEBSF. ROS and MP closely followed the hypoxic decrease in CB tissue oxygen as measured with an O2-sensitive dye. We conclude that attenuated p47(phox) subunit activity of the NADPH oxidase under hypoxia is the physiological trigger for type I cell MP depolarization probably due to ROS decrease, whereas the observed ROS increase has no influence on type I cell MP kinetics under hypoxia. PMID:25318107

  9. Carotid body tumor: a 25-year experience.

    PubMed

    Metheetrairut, Choakchai; Chotikavanich, Chanticha; Keskool, Phawin; Suphaphongs, Nit

    2016-08-01

    Carotid body tumor is an uncommon hypervascular benign tumor in the head and neck region. It usually presents as a slow growing mass at the carotid bifurcation. Because of the high rate of neurovascular complications, resection of this tumor is considered challenging for otolaryngologists. Between 1988 and 2013, 40 carotid body tumors from 38 patients were diagnosed and underwent resection at Siriraj Hospital (25 female and 13 male patients). Their age ranged from 15 to 59 years. Seven patients had bilateral tumors simultaneously whereas six cases had familial history of carotid body tumor. Carotid angiography was performed in 29 cases; other additional diagnostic studies included CT scan, MRI, and MRA to detect the widening of carotid bifurcation, its extension, and multifocal tumors. All diagnosed tumors were successfully removed. However, internal carotid artery and carotid bifurcation were injured in 11 cases (27.5 %). Shamblin class III and previous biopsy history were considered risk factors for vascular injury. Postoperative cranial nerves deficit was found in 20 % of the cases and CNS complication occurred in two patients (5 %). There was no surgical mortality. Additionally, upon the mean follow-up period of 36 months, no recurrence or malignant transformation was detected in this study. Multidisciplinary approach, early tumor detection, meticulous preoperative evaluation, and modern vascular surgical technique are the key success factors for tumor removal. PMID:26233244

  10. Symptomatic carotid stenosis in the setting of bilateral disease and coexisting carotid body tumor: management with a carotid stent and staged excision.

    PubMed

    Smeds, Matthew; Jacobs, Donald

    2013-12-01

    The aim of the paper is to describe the management of a patient with bilateral carotid artery stenosis, symptomatic on the left, with coexisting left carotid body tumor with left carotid stenting followed by right carotid endarterectomy and excision of carotid body tumor. A 60-year-old man with significant bilateral carotid stenosis was referred to us with symptomatic left carotid disease and concomitant left carotid body tumor. A Precise nitinol carotid stent (Cordis Endovascular, Miami Lakes, FL, USA) was placed in his left carotid artery followed by interval carotid endarterectomy on the right. Excision of the carotid body tumor was then performed. Carotid stenting is a treatment option in patients with carotid stenosis and coexisting carotid body tumor. To our knowledge, this is the first reported carotid stent for symptomatic carotid stenosis in a patient with a concomitant carotid body tumor. PMID:23493283

  11. CaV3.2 T-type Ca2+ channels mediate the augmented calcium influx in carotid body glomus cells by chronic intermittent hypoxia.

    PubMed

    Makarenko, Vladislav V; Ahmmed, Gias U; Peng, Ying-Jie; Khan, Shakil A; Nanduri, Jayasri; Kumar, Ganesh K; Fox, Aaron P; Prabhakar, Nanduri R

    2016-01-01

    Chronic intermittent hypoxia (CIH) is a hallmark manifestation of sleep apnea. A heightened carotid body activity and the resulting chemosensory reflex mediate increased sympathetic nerve activity by CIH. However, the mechanisms underlying heightened carotid body activity by CIH are not known. An elevation of intracellular calcium ion concentration ([Ca(2+)]i) in glomus cells, the primary oxygen-sensing cells, is an essential step for carotid body activation by hypoxia. In the present study, we examined the effects of CIH on the glomus cell [Ca(2+)]i response to hypoxia and assessed the underlying mechanisms. Glomus cells were harvested from adult rats or wild-type mice treated with 10 days of either room air (control) or CIH (alternating cycles of 15 s of hypoxia and 5 min of room air; 9 episodes/h; 8 h/day). CIH-treated glomus cells exhibited an enhanced [Ca(2+)]i response to hypoxia, and this effect was absent in the presence of 2-(4-cyclopropylphenyl)-N-((1R)-1-[5-[(2,2,2-trifluoroethyl)oxo]-pyridin-2-yl]ethyl)acetamide (TTA-A2), a specific inhibitor of T-type Ca(2+) channels, and in voltage-gated calcium channel, type 3.2 (CaV3.2), null glomus cells. CaV3.2 knockout mice exhibited an absence of CIH-induced hypersensitivity of the carotid body. CIH increased reactive oxygen species (ROS) levels in glomus cells. A ROS scavenger prevented the exaggerated TTA-A2-sensitive [Ca(2+)]i response to hypoxia. CIH had no effect on CaV3.2 mRNA levels. CIH augmented Ca(2+) currents and increased CaV3.2 protein in plasma membrane fractions of human embryonic kidney-293 cells stably expressing CaV3.2, and either a ROS scavenger or brefeldin-A, an inhibitor of protein trafficking, prevented these effects. These findings suggest that CIH leads to an augmented Ca(2+) influx via ROS-dependent facilitation of CaV3.2 protein trafficking to the plasma membrane. PMID:26561606

  12. Association between adjunctive metformin therapy in young type 1 diabetes patients with excess body fat and reduction of carotid intima-media thickness.

    PubMed

    Burchardt, Paweł; Zawada, Agnieszka; Kaczmarek, Jolanta; Marcinkaniec, Justyna; Wysocki, Henryk; Wierusz-Wysocka, Bogna; Grzymisławski, Marian; Rzeźniczak, Janusz; Zozulińska-Ziółkiewicz, Dorota; Naskręt, Dariusz

    2016-08-25

    INTRODUCTION    Lipoprotein-associated phospholipase A2 (Lp-PLA2) and cholesteryl ester lipase (CEL) may oxidize low-density lipoproteins (oxLDL). OBJECTIVES    The aim of the study was to determine the influence of metformin on the metabolism of atherogenic lipid fractions in relation to Lp-PLA2 and CEL levels, as well as assess consequent improvement in the intima-media thickness (IMT) of the common carotid artery in young type 1 diabetes patients with excess body fat. PATIENTS AND METHODS    It was an open-label randomized clinical trial that lasted 6 months. It included a total of 84 people with metabolic decompensation (glycated hemoglobin >7.5%, >58.5 mmol/mol) of diabetes. Adjunctive metformin therapy (in addition to insulin) was administered in 42 patients, and the remaining 42 patients received insulin alone. Glycated low-density lipoproteins (LDLs), oxLDL, Lp-PLA2, and CEL were assessed by commercially available enzyme-linked immunosorbent assay kits. Cartoid IMT was measured using the Carotid Analyser for Research tool. Biochemical analyses were performed using routine laboratory techniques. RESULTS    The reduction of mean carotid IMT was observed in young type 1 diabetic adults treated additionally with metformin (0.6 ±0.1 cm vs 0.53 ±0.1 cm; P = 0.002). This effect was probably due to weight reduction (90 ±16 kg vs 87 ±15 kg, P = 0.054) and the decrease in atherogenic glycated LDL levels (1.5 ±0.5 mg/dl vs 1.6 ±1.046 mg/dl, P = 0.006). No such correlations were observed in patients treated with insulin alone. Additionally, in patients receiving metformin, glycated LDL levels were inversely correlated with Lp-PLA2 levels (r = -0.31, P <0.05). CONCLUSIONS    Additional use of metformin in young type 1 diabetic patients with excess body fat leads to a significant reduction of mean IMT in the common carotid artery. Concentrations of CEL and Lp-PLA2 were significantly increased in both study arms despite improved glucose metabolism

  13. Regulation of tyrosine hydroxylase gene expression in the rat carotid body by hypoxia.

    PubMed

    Czyzyk-Krzeska, M F; Bayliss, D A; Lawson, E E; Millhorn, D E

    1992-04-01

    The activity (Vmax) of tyrosine hydroxylase (TH; EC 1.14.16.2), the rate limiting enzyme in the synthesis of catecholamines, is increased in carotid body, superior cervical ganglion, and the adrenal medulla during hypoxia (i.e., reduced PaO2). The present study was undertaken to determine if the increase in TH activity in these tissues during hypoxia is regulated at the level of TH mRNA. Adult rats were exposed to hypoxia (10% O2) or room air for periods lasting from 1 to 48 h. The carotid bodies, superior cervical ganglia, and adrenals were removed and processed for in situ hybridization using 35S-labeled oligonucleotide probes. The concentration of TH mRNA was increased by hypoxia at all time points in carotid body type I cells, but not in cells of either superior cervical ganglion or adrenal medulla. The increase in TH mRNA in carotid body during hypoxia did not require innervation of the carotid body or intact adrenal glands. In addition, hypercapnia, another physiological stimulus of carotid body activity, failed to induce an increase in TH mRNA in type I cells. Our findings suggest that hypoxia stimulates TH gene expression in the carotid body by a mechanism that is intrinsic to type I cells. PMID:1347783

  14. A preliminary anatomical study on carotid body of Makouei sheep.

    PubMed

    Najafi, Gholamreza; Soltanalinejad, Farhad; Hasanzadeh, Hamed

    2013-01-01

    The carotid is a small mass of chemoreceptor's and sustentacular cells that detects changes in the composition of the arterial blood. The aim of the present study was to identify the size, color, location, blood and nerve supply of the carotid body in Makouei sheep. Fourteen heads of sheep from both sexes were collected from Urmia public slaughter-house. The exact situation and nerve supply of the carotid body was determined. Before dissection, blue latex was injected into right and left common carotid arteries. All the branches of the common carotid artery and the branch supplying carotid body were investigated. This study showed that, carotid body in sheep has been situated around the muscular branch of the occipital artery. The mean weight, width and length, thickness of carotid body were 0.01 g, 0.83 mm, 1.07 mm, and 1.06 mm respectively. Blood to the carotid body was supplied by glomic artery which was a branch of occipital artery. It was innervated by herring nerve which was a branch of glossopharyngeal nerve. PMID:25653785

  15. A preliminary anatomical study on carotid body of Makouei sheep

    PubMed Central

    Najafi, Gholamreza; Soltanalinejad, Farhad; Hasanzadeh, Hamed

    2013-01-01

    The carotid is a small mass of chemoreceptor's and sustentacular cells that detects changes in the composition of the arterial blood. The aim of the present study was to identify the size, color, location, blood and nerve supply of the carotid body in Makouei sheep. Fourteen heads of sheep from both sexes were collected from Urmia public slaughter-house. The exact situation and nerve supply of the carotid body was determined. Before dissection, blue latex was injected into right and left common carotid arteries. All the branches of the common carotid artery and the branch supplying carotid body were investigated. This study showed that, carotid body in sheep has been situated around the muscular branch of the occipital artery. The mean weight, width and length, thickness of carotid body were 0.01 g, 0.83 mm, 1.07 mm, and 1.06 mm respectively. Blood to the carotid body was supplied by glomic artery which was a branch of occipital artery. It was innervated by herring nerve which was a branch of glossopharyngeal nerve. PMID:25653785

  16. Radiation therapy of carotid body tumors

    SciTech Connect

    Valdagni, R.; Amichetti, M. )

    1990-02-01

    Chemodectomas of carotid artery bifurcation are generally managed with surgery, irradiation being reserved for inoperable, bulky, and recurrent tumors. Probably due to this pretreatment selection of patients, chemodectomas are anedoctally considered radioresistant tumors, although this concept is not supported by the recent literature. From 1968 to 1987, 13 carotid body tumors in seven patients were treated with irradiation as sole treatment (10 lesions) or as postoperative modality (three lesions). Familial occurrence and bilateral presentation were observed in 3 of 7 and in 6 of 7 patients, respectively. Total dose of irradiation was of 46-60 Gy (median 50 Gy, mean 52.25 Gy) with dose per fraction of 1.8-2.5 Gy. Local control (subjective or objective) was obtained in all the patients. Clinical results following World Health Organization (WHO) criteria were: 3 of 13 complete response, 7 of 13 partial response and 3 of 13 no change. Follow-up range is 1-19 years. Acute side effects were minimal and mid- or long-term toxicity was absent.32 references.

  17. Autoradiographic localization of alpha-bungarotoxin-binding sites in the carotid body of the rat.

    PubMed

    Chen, I; Mascorro, J A; Yates, R D

    1981-01-01

    Radioiodinated alpha-bungarotoxin (alpha-Bgt) was used to localize alpha-Bgt-acetylcholine receptors in the carotid body of the rat. The gamma spectrometer analyses indicated a high uptake of [125I] alpha-Bgt in carotid bodies incubated in vitro (1.51 fmole per organ). Incorporation of the isotope was effectively blocked by pretreatment of carotid bodies with d-tubocurarine and unlabeled alpha-Bgt, but not by atropine. Light microscopic autoradiography showed a heavy labeling of some parenchymal cells. Electron-microscopic autoradiography revealed that labeling was localized along the interface between parenchymal cells, especially where their cytoplasmic processes engage in complex interdigitations. The silver grain counts on electron-microscopic autoradiographs suggest that labelings are preferentially associated with the plasma membrane of certain Type I cells. It is suggested that these Type I cells in the rat's carotid body probably are provided with nicotinic acetylcholine receptors on their plasma membranes. PMID:7273116

  18. Carotid body tumor imitator: An interesting case of Castleman's disease

    PubMed Central

    Shakir, Hakeem J.; Diletti, Sara M.; Hart, Alexandra M.; Meyers, Joshua E.; Dumont, Travis M.; Siddiqui, Adnan H.

    2015-01-01

    Background: There are very few reports in the literature of Castleman's disease affecting the carotid artery and a single previous report of a case of Castleman's disease of the neck originally mistaken as a carotid body tumor. Case Description: We describe a rare case of Castleman's disease, manifesting with classic radiographic hallmarks of a carotid body tumor. The postoperative pathologic examination identified the resected mass as Castleman's lymphadenopathy. The management of this particular case is discussed, and the findings are highlighted. Conclusions: We present a unique case of a tumor initially and incorrectly diagnosed as a carotid body tumor. However, after comprehensive treatment with endovascular and surgical modalities and subsequent pathologic examination, the diagnosis of this rare entity was made. PMID:26677415

  19. Reflex carotid body chemoreceptor control of phrenic sympathetic neurons.

    PubMed

    Bałkowiec, A; Revenko, S; Szulczyk, P

    1993-04-01

    The reflex reaction of phrenic sympathetic neurons to stimulation of carotid body chemoreceptors was tested in chloralose-anesthetized and paralyzed cats with both vago-aortic nerves cut. During systemic hypoxia (animals ventilated with 10% O2 in N2) the sympathetic phrenic nerve activity increased from 100% in the control to 269%. This increase was markedly attenuated after cutting both sinus nerves. Reflex excitatory response in phrenic sympathetic neurons with the latency of 150 msec was evoked by electrical stimulation of the right carotid sinus nerve (3 pulses of 0.2 msec, 333 Hz). The central transmission time of the reflex was about 90 msec. Injecting 0.1 ml of 1 M NaHCO3 saturated with CO2 (in order to activate carotid body chemoreceptors) into the right or left carotid sinus, evoked excitatory responses in sympathetic neurons regardless of the side. The stimulation of carotid body chemoreceptors also increased somatic phrenic nerve activity. The three methods applied to the stimulation of carotid body chemoreceptors produced increase of phrenic nerve sympathetic activity. PMID:8390088

  20. Spexin is expressed in the carotid body and is upregulated by postnatal hyperoxia exposure.

    PubMed

    Porzionato, Andrea; Rucinski, Marcin; Macchi, Veronica; Stecco, Carla; Sarasin, Gloria; Sfriso, Maria M; Di Giulio, Camillo; Malendowicz, Ludwik K; De Caro, Raffaele

    2012-01-01

    Spexin is a recently identified peptide which is expressed in many different endocrine and nervous tissues. Due to the absence of data regarding spexin expression in the carotid body, the first aim of the present study was to investigate, through immunohistochemistry and Real-Time PCR, the expression and distribution of spexin in the rat and human carotid body. Moreover, the carotid body is known to undergo various structural and functional modifications in response to hyperoxic stimuli during the first postnatal period. Thus, we also evaluated if hyperoxia during the first postnatal weeks may produce changes in the spexin expression. Materials consisted of carotid bodies obtained at autopsy from five human adult subjects and sampled from 10 six-weeks old Sprague-Dawley rats. Five rats were maintained in normoxia for the first six postnatal weeks; five rats were exposed to 60% hyperoxia for 2 weeks and then maintained in normoxia for other 4 weeks. Diffuse anti-spexin immunoreactivity was found in type I cells of both humans and rats. No spexin immunoreactivity was visible in the type II cells. Hyperoxia exposure during the first 2 weeks of postnatal life caused a reduction of volume in the carotid body still apparent after 4 weeks of normoxia. Using real-time PCR, spexin expression was 6-7 times higher in hyperoxia-exposed rats than in normoxia-exposed ones. The expression of spexin in type I cells suggests a possible modulator role in peripheral chemoreception. Moreover, the ascertained role of spexin in the regulation of cell proliferation in other tissues (e.g., adrenal gland cortex) suggests a possible role of spexin also in the hyperoxia-induced plasticity of the carotid body. PMID:23080164

  1. Carotid body, insulin, and metabolic diseases: unraveling the links.

    PubMed

    Conde, Sílvia V; Sacramento, Joana F; Guarino, Maria P; Gonzalez, Constancio; Obeso, Ana; Diogo, Lucilia N; Monteiro, Emilia C; Ribeiro, Maria J

    2014-01-01

    The carotid bodies (CB) are peripheral chemoreceptors that sense changes in arterial blood O2, CO2, and pH levels. Hypoxia, hypercapnia, and acidosis activate the CB, which respond by increasing the action potential frequency in their sensory nerve, the carotid sinus nerve (CSN). CSN activity is integrated in the brain stem to induce a panoply of cardiorespiratory reflexes aimed, primarily, to normalize the altered blood gases, via hyperventilation, and to regulate blood pressure and cardiac performance, via sympathetic nervous system (SNS) activation. Besides its role in the cardiorespiratory control the CB has been proposed as a metabolic sensor implicated in the control of energy homeostasis and, more recently, in the regulation of whole body insulin sensitivity. Hypercaloric diets cause CB overactivation in rats, which seems to be at the origin of the development of insulin resistance and hypertension, core features of metabolic syndrome and type 2 diabetes. Consistent with this notion, CB sensory denervation prevents metabolic and hemodynamic alterations in hypercaloric feed animal. Obstructive sleep apnea (OSA) is another chronic disorder characterized by increased CB activity and intimately related with several metabolic and cardiovascular abnormalities. In this manuscript we review in a concise manner the putative pathways linking CB chemoreceptors deregulation with the pathogenesis of insulin resistance and arterial hypertension. Also, the link between chronic intermittent hypoxia (CIH) and insulin resistance is discussed. Then, a final section is devoted to debate strategies to reduce CB activity and its use for prevention and therapeutics of metabolic diseases with an emphasis on new exciting research in the modulation of bioelectronic signals, likely to be central in the future. PMID:25400585

  2. Carotid body, insulin, and metabolic diseases: unraveling the links

    PubMed Central

    Conde, Sílvia V.; Sacramento, Joana F.; Guarino, Maria P.; Gonzalez, Constancio; Obeso, Ana; Diogo, Lucilia N.; Monteiro, Emilia C.; Ribeiro, Maria J.

    2014-01-01

    The carotid bodies (CB) are peripheral chemoreceptors that sense changes in arterial blood O2, CO2, and pH levels. Hypoxia, hypercapnia, and acidosis activate the CB, which respond by increasing the action potential frequency in their sensory nerve, the carotid sinus nerve (CSN). CSN activity is integrated in the brain stem to induce a panoply of cardiorespiratory reflexes aimed, primarily, to normalize the altered blood gases, via hyperventilation, and to regulate blood pressure and cardiac performance, via sympathetic nervous system (SNS) activation. Besides its role in the cardiorespiratory control the CB has been proposed as a metabolic sensor implicated in the control of energy homeostasis and, more recently, in the regulation of whole body insulin sensitivity. Hypercaloric diets cause CB overactivation in rats, which seems to be at the origin of the development of insulin resistance and hypertension, core features of metabolic syndrome and type 2 diabetes. Consistent with this notion, CB sensory denervation prevents metabolic and hemodynamic alterations in hypercaloric feed animal. Obstructive sleep apnea (OSA) is another chronic disorder characterized by increased CB activity and intimately related with several metabolic and cardiovascular abnormalities. In this manuscript we review in a concise manner the putative pathways linking CB chemoreceptors deregulation with the pathogenesis of insulin resistance and arterial hypertension. Also, the link between chronic intermittent hypoxia (CIH) and insulin resistance is discussed. Then, a final section is devoted to debate strategies to reduce CB activity and its use for prevention and therapeutics of metabolic diseases with an emphasis on new exciting research in the modulation of bioelectronic signals, likely to be central in the future. PMID:25400585

  3. Surgical Excision of Carotid Body Tumor Through Modified Approach-A Case Report.

    PubMed

    Prabakaran, Sureshkannan; Subburayulu, Anand Shankar; Ravikumar, P T

    2016-06-01

    Paragangliomas arising from the carotid body in the carotid bifurcation are termed as carotid body tumors. They are usually slow growing and asymptomatic. Considering the anatomical location, invasion or pressure on the adjacent vascular and neural tissues, the importance of early diagnosis and management is critical. In this article a case of carotid body tumor excised through transverse neck skin crease incision is presented along with literature review on the diagnosis, grading and different surgical approaches. PMID:27298550

  4. Carotid body denervation prevents fasting hyperglycemia during chronic intermittent hypoxia

    PubMed Central

    Shin, Mi-Kyung; Yao, Qiaoling; Jun, Jonathan C.; Bevans-Fonti, Shannon; Yoo, Doo-Young; Han, Woobum; Mesarwi, Omar; Richardson, Ria; Fu, Ya-Yuan; Pasricha, Pankaj J.; Schwartz, Alan R.; Shirahata, Machiko

    2014-01-01

    Obstructive sleep apnea causes chronic intermittent hypoxia (IH) and is associated with impaired glucose metabolism, but mechanisms are unknown. Carotid bodies orchestrate physiological responses to hypoxemia by activating the sympathetic nervous system. Therefore, we hypothesized that carotid body denervation would abolish glucose intolerance and insulin resistance induced by chronic IH. Male C57BL/6J mice underwent carotid sinus nerve dissection (CSND) or sham surgery and then were exposed to IH or intermittent air (IA) for 4 or 6 wk. Hypoxia was administered by decreasing a fraction of inspired oxygen from 20.9% to 6.5% once per minute, during the 12-h light phase (9 a.m.–9 p.m.). As expected, denervated mice exhibited blunted hypoxic ventilatory responses. In sham-operated mice, IH increased fasting blood glucose, baseline hepatic glucose output (HGO), and expression of a rate-liming hepatic enzyme of gluconeogenesis phosphoenolpyruvate carboxykinase (PEPCK), whereas the whole body glucose flux during hyperinsulinemic euglycemic clamp was not changed. IH did not affect glucose tolerance after adjustment for fasting hyperglycemia in the intraperitoneal glucose tolerance test. CSND prevented IH-induced fasting hyperglycemia and increases in baseline HGO and liver PEPCK expression. CSND trended to augment the insulin-stimulated glucose flux and enhanced liver Akt phosphorylation at both hypoxic and normoxic conditions. IH increased serum epinephrine levels and liver sympathetic innervation, and both increases were abolished by CSND. We conclude that chronic IH induces fasting hyperglycemia increasing baseline HGO via the CSN sympathetic output from carotid body chemoreceptors, but does not significantly impair whole body insulin sensitivity. PMID:25103977

  5. Carotid body denervation prevents fasting hyperglycemia during chronic intermittent hypoxia.

    PubMed

    Shin, Mi-Kyung; Yao, Qiaoling; Jun, Jonathan C; Bevans-Fonti, Shannon; Yoo, Doo-Young; Han, Woobum; Mesarwi, Omar; Richardson, Ria; Fu, Ya-Yuan; Pasricha, Pankaj J; Schwartz, Alan R; Shirahata, Machiko; Polotsky, Vsevolod Y

    2014-10-01

    Obstructive sleep apnea causes chronic intermittent hypoxia (IH) and is associated with impaired glucose metabolism, but mechanisms are unknown. Carotid bodies orchestrate physiological responses to hypoxemia by activating the sympathetic nervous system. Therefore, we hypothesized that carotid body denervation would abolish glucose intolerance and insulin resistance induced by chronic IH. Male C57BL/6J mice underwent carotid sinus nerve dissection (CSND) or sham surgery and then were exposed to IH or intermittent air (IA) for 4 or 6 wk. Hypoxia was administered by decreasing a fraction of inspired oxygen from 20.9% to 6.5% once per minute, during the 12-h light phase (9 a.m.-9 p.m.). As expected, denervated mice exhibited blunted hypoxic ventilatory responses. In sham-operated mice, IH increased fasting blood glucose, baseline hepatic glucose output (HGO), and expression of a rate-liming hepatic enzyme of gluconeogenesis phosphoenolpyruvate carboxykinase (PEPCK), whereas the whole body glucose flux during hyperinsulinemic euglycemic clamp was not changed. IH did not affect glucose tolerance after adjustment for fasting hyperglycemia in the intraperitoneal glucose tolerance test. CSND prevented IH-induced fasting hyperglycemia and increases in baseline HGO and liver PEPCK expression. CSND trended to augment the insulin-stimulated glucose flux and enhanced liver Akt phosphorylation at both hypoxic and normoxic conditions. IH increased serum epinephrine levels and liver sympathetic innervation, and both increases were abolished by CSND. We conclude that chronic IH induces fasting hyperglycemia increasing baseline HGO via the CSN sympathetic output from carotid body chemoreceptors, but does not significantly impair whole body insulin sensitivity. PMID:25103977

  6. Expression of leptin and leptin receptor isoforms in the rat and human carotid body.

    PubMed

    Porzionato, Andrea; Rucinski, Marcin; Macchi, Veronica; Stecco, Carla; Castagliuolo, Ignazio; Malendowicz, Ludwik K; De Caro, Raffaele

    2011-04-18

    Leptin is known to play a role in the modulation of metabolism and control of breathing acting mainly on central nervous structures, although additional actions on peripheral arterial chemoreceptors have also been suggested in the literature. We therefore examined by means of immunohistochemistry the expression of leptin and leptin receptors in the carotid bodies of rats and humans. Leptin expression and relative expression of leptin receptor isoforms were also studied in rats by real-time PCR. No leptin or leptin receptor immunoreactivities were visible in the type II cells of either series. In rat carotid bodies, diffuse positive stainings for leptin and leptin receptors (both with antibody recognizing all receptor isoforms and antibody specific for Ob-Rb) were observed in type I cells. In human carotid bodies, the mean percentage (±standard error) of leptin immunoreactive type I cells was 39.4%±5.1% and the percentages of leptin receptor immunoreactive type I cells were 57.3%±3.9% with antibody recognizing all receptor isoforms and 33.3%±4.2% with antibody specific for isoform Ob-Rb. Double immunofluorescences with anti-tyrosine hydroxylase (type I cell marker) and anti-glial fibrillary acidic protein (type II cell markers) confirmed the selective location of leptin and Ob-Rb in type I cells. Real-time PCR showed the expression of leptin and Ob-Ra, Ob-Rb, Ob-Rc and Ob-Rf isoform mRNA in the rat carotid body, levels of expression being Ob-Rf>Ob-Rc>Ob-Ra>Ob-Rb. Ob-Re mRNA was not detected. The above findings suggest a role of circulating or locally produced leptin in the regulation of chemoreceptor discharge and/or metabolic sensing function, by means of direct action on type I cells. PMID:21334312

  7. Surgical complications of carotid body tumors surgery: a review.

    PubMed

    Amato, B; Serra, R; Fappiano, F; Rossi, R; Danzi, M; Milone, M; Quarto, G; Benassai, G; Bianco, T; Amato, M; Furino, E; Compagna, R

    2015-12-01

    Carotid body tumor (CBT) is a rare neoplasm, although it represents about 65% of head and neck paragangliomas. Surgical excision is considered the appropriate therapy for CBTs. The aim of this study was to evaluate surgical outcomes on a large scale. We reviewed 19 studies between 2004 to 2014 with a total of 625 procedures. We observed a higher number of cases in women (62%). Only 3 (0,48%) deaths were reported as surgical complication. Total cranial nerve injuries were 302 (48,32%) of which 194 (31,04%) were transient and 108 (17,28%) were permanent. We found a total of 174 (27,84%) arterial injuries, most of which are external carotid artery (ECA) injuries. Cerebrovascular accident due to surgery were 15 (2,4%). We concluded that surgical resection remains the treatment of choice for these disease despite the related morbidity. PMID:26498887

  8. Gene expression and function of adenosine A(2A) receptor in the rat carotid body.

    PubMed

    Kobayashi, S; Conforti, L; Millhorn, D E

    2000-08-01

    The present study was undertaken to determine whether rat carotid bodies express adenosine (Ado) A(2A) receptors and whether this receptor is involved in the cellular response to hypoxia. Our results demonstrate that rat carotid bodies express the A(2A) and A(2B) Ado receptor mRNAs but not the A(1) or A(3) receptor mRNAs as determined by reverse transcriptase-polymerase chain reaction. In situ hybridization confirmed the expression of the A(2A) receptor mRNA. Immunohistochemical studies further showed that the A(2A) receptor is expressed in the carotid body and that it is colocalized with tyrosine hydroxylase in type I cells. Whole cell voltage-clamp studies using isolated type I cells showed that Ado inhibited the voltage-dependent Ca(2+) currents and that this inhibition was abolished by the selective A(2A) receptor antagonist ZM-241385. Ca(2+) imaging studies using fura 2 revealed that exposure to severe hypoxia induced elevation of intracellular Ca(2+) concentration ([Ca(2+)](i)) in type I cells and that extracellularly applied Ado significantly attenuated the hypoxia-induced elevation of [Ca(2+)](i). Taken together, our findings indicate that A(2A) receptors are present in type I cells and that activation of A(2A) receptors modulates Ca(2+) accumulation during hypoxia. This mechanism may play a role in regulating intracellular Ca(2+) homeostasis and cellular excitability during hypoxia. PMID:10926550

  9. Carotid body remodelling in l-NAME-induced hypertension in the rat.

    PubMed

    Felix, A S; Rocha, V N; Nascimento, A L R; de Carvalho, J J

    2012-05-01

    The carotid body (CB) is a chemoreceptor organ located at the bifurcation of the common carotid artery. It is made up of the carotid glomus, a structure containing type 1 cells surrounded by type 2 cells. The aim of this study was to evaluate the morphological changes of the CB and carotid glomus in the rat model of l-NAME-induced hypertension. Male Wistar rats were divided in two groups: control untreated rats (C) and rats receiving l-NAME 40 mg/kg/day (LN) for 6 weeks. At the end of the experiment, the systolic blood pressure was 63% higher in the LN group compared with the C group. Morphometric analysis showed that the area of the CB was 29% greater in the LN group compared with the C group. The density of nuclei in the CB was similar between groups, but it was 31% less in the carotid glomus of the LN group. Cells in the CB of the LN group displayed cytoplasmic vacuolation and expressed several biogenic amines. There were more elastic fibres, proteoglycans and collagen fibres in the LN group compared with the C group. Immunohistochemistry showed increased expression of nuclear factor kB, substance P, vascular endothelial growth factor and neuronal nitric oxide synthase in the LN group, while expression of the protein gene product 9.5 was decreased. l-NAME alters cell morphology and the expression of extracellular matrix molecules in the CB and carotid glomus in rats with l-NAME-induced hypertension. PMID:21899859

  10. Presynaptic action of adenosine on a 4-aminopyridine-sensitive current in the rat carotid body

    PubMed Central

    Vandier, C; Conway, A F; Landauer, R C; Kumar, P

    1999-01-01

    Plasma adenosine concentration increases during hypoxia to a level that excites carotid body chemoreceptors by an undetermined mechanism. We have examined this further by determining the electrophysiological responses to exogenous adenosine of sinus nerve chemoafferents in vitro and of whole-cell currents in isolated type I cells.Steady-state, single-fibre chemoafferent discharge was increased approximately 5-fold above basal levels by 100 μM adenosine. This adenosine-stimulated discharge was reversibly and increasingly reduced by methoxyverapamil (D600, 100 μM), by application of nickel chloride (Ni2+, 2 mM) and by removal of extracellular Ca2+. These effects strongly suggest a presynaptic, excitatory action of adenosine on type I cells of the carotid body.Adenosine decreased whole-cell outward currents at membrane potentials above -40 mV in isolated type I cells recorded during superfusion with bicarbonate-buffered saline solution at 34–36 °C. This effect was reversible and concentration dependent with a maximal effect at 10 μM.The degree of current inhibition induced by 10 μM adenosine was voltage independent (45.39 ± 2.55% (mean ± s.e.m.) between −40 and +30 mV) and largely (∼75%), but not entirely, Ca2+ independent. 4-Aminopyridine (4-AP, 5 mM) decreased the amplitude of the control outward current by 80.60 ± 3.67% and abolished the effect of adenosine.Adenosine was without effect upon currents near the resting membrane potential of approximately −55 mV and did not induce depolarization in current-clamp experiments.We conclude that adenosine acts to inhibit a 4-AP-sensitive current in isolated type I cells of the rat carotid body and suggest that this mechanism contributes to the chemoexcitatory effect of adenosine in the whole carotid body. PMID:10050009

  11. Carotid body chemoreceptors, sympathetic neural activation, and cardiometabolic disease.

    PubMed

    Iturriaga, Rodrigo; Del Rio, Rodrigo; Idiaquez, Juan; Somers, Virend K

    2016-01-01

    The carotid body (CB) is the main peripheral chemoreceptor that senses the arterial PO2, PCO2 and pH. In response to hypoxemia, hypercapnia and acidosis, carotid chemosensory discharge elicits reflex respiratory, autonomic and cardiovascular adjustments. The classical construct considers the CB as the main peripheral oxygen sensor, triggering reflex physiological responses to acute hypoxemia and facilitating the ventilatory acclimation to chronic hypoxemia at high altitude. However, a growing body of experimental evidence supports the novel concept that an abnormally enhanced CB chemosensory input to the brainstem contributes to overactivation of the sympathetic nervous system, and consequent pathology. Indeed, the CB has been implicated in several diseases associated with increases in central sympathetic outflow. These include hypertension, heart failure, sleep apnea, chronic obstructive pulmonary disease and metabolic syndrome. Indeed, ablation of the CB has been proposed for the treatment of severe and resistant hypertension in humans. In this review, we will analyze and discuss new evidence supporting an important role for the CB chemoreceptor in the progression of autonomic and cardiorespiratory alterations induced by heart failure, obstructive sleep apnea, chronic obstructive pulmonary disease and metabolic syndrome. PMID:26920146

  12. Regulation of carotid body oxygen sensing by hypoxia-inducible factors.

    PubMed

    Prabhakar, Nanduri R; Semenza, Gregg L

    2016-01-01

    Oxygen (O2) sensing by the carotid body and its chemosensory reflex is critical for homeostatic regulation of breathing and blood pressure. Carotid body responses to hypoxia are not uniform but instead exhibit remarkable inter-individual variations. The molecular mechanisms underlying variations in carotid body O2 sensing are not known. Hypoxia-inducible factor-1 (HIF-1) and HIF-2 mediate transcriptional responses to hypoxia. This article reviews the emerging evidence that proper expression of the HIF-α isoforms is a key molecular determinant for carotid body O2 sensing. HIF-1α deficiency leads to a blunted carotid body hypoxic response, which is due to increased abundance of HIF-2α, elevated anti-oxidant enzyme activity, and a reduced intracellular redox state. Conversely, HIF-2α deficiency results in augmented carotid body sensitivity to hypoxia, which is due to increased abundance of HIF-1α, elevated pro-oxidant enzyme activity, and an oxidized intracellular redox state. Double heterozygous mice with equally reduced HIF-1α and HIF-2α showed no abnormality in redox state or carotid body O2 sensing. Thus, mutual antagonism between HIF-α isoforms determines the redox state and thereby establishes the set point for hypoxic sensing by the carotid body. PMID:26265380

  13. Dual effects of nitric oxide on cat carotid body chemoreception.

    PubMed

    Iturriaga, R; Villanueva, S; Mosqueira, M

    2000-09-01

    We studied the effects of nitric oxide (NO) released by NO donors on cat carotid body (CB) chemosensory activity during normoxia and hypoxia. CBs excised from pentobarbital sodium-anaesthetized cats were perfused with Tyrode at 38 degrees C and pH 7.40. The frequency of chemosensory discharges (f(x)) was recorded from the carotid sinus nerve, and changes of NO concentration were measured by a chronoamperometric technique, with NO-selective carbon-fiber microelectrodes inserted in the CB. During steady chemosensory excitation induced by hypoxia, bolus injections of NO (DeltaNO = 0. 5-12 microM), released by S-nitroso-N-acetylpenicillamine (SNAP) and 6-(2-hydroxy-1-methyl-nitrosohydrazino)-N-methyl-1-hexanamine++ + (NOC-9), transiently reduced f(x) in a dose-dependent manner. However, during normoxia, the same concentration of NO (DeltaNO = 0. 5-13 microM) released by the NO donors increased f(x) in a dose-dependent manner. The present results show a dual effect of NO on CB chemoreception that is dependent on the PO(2) levels. During hypoxia, NO is predominantly an inhibitor of chemoreception, whereas, in normoxia, NO increased f(x). The mechanisms by which NO produces chemosensory excitation during normoxia remain to be determined. PMID:10956344

  14. Progression of carotid-artery disease in type 2 diabetic patients: a cohort prospective study.

    PubMed

    Bosevski, Marijan; Stojanovska, Lily

    2015-01-01

    In order to assess the progression of carotid-artery disease in type 2 diabetic cohort (n=207 patients), the dynamic change in carotid intima-media thickness (CIMT) and the occurrence of plaques were followed for a period of 31.35±10.59 months. The mean CIMT at the beginning of the study was 0.9178±0.1447 mm, with a maximal value of 1.1210±0.2366 mm. The maximal value of CIMT changed by 0.07 mm/year. Progression of CIMT was noted in 86.8% and its regression in 7.8% of patients. The occurrence of carotid plaques was detected in 41.8% of patients. Multiple regression analysis revealed the maximal value of CIMT to be associated with diastolic blood pressure, despite mean CIMT being predicted by body mass index. The presence of peripheral arterial disease and hypo-high-density lipoproteinemia were found to be predictors for the occurrence of carotid plaques. Our data have clinical implications in predicting risk factors for the progression of carotid-artery disease in type 2 diabetic patients for their appropriate management. PMID:26527880

  15. Progression of carotid-artery disease in type 2 diabetic patients: a cohort prospective study

    PubMed Central

    Bosevski, Marijan; Stojanovska, Lily

    2015-01-01

    In order to assess the progression of carotid-artery disease in type 2 diabetic cohort (n=207 patients), the dynamic change in carotid intima-media thickness (CIMT) and the occurrence of plaques were followed for a period of 31.35±10.59 months. The mean CIMT at the beginning of the study was 0.9178±0.1447 mm, with a maximal value of 1.1210±0.2366 mm. The maximal value of CIMT changed by 0.07 mm/year. Progression of CIMT was noted in 86.8% and its regression in 7.8% of patients. The occurrence of carotid plaques was detected in 41.8% of patients. Multiple regression analysis revealed the maximal value of CIMT to be associated with diastolic blood pressure, despite mean CIMT being predicted by body mass index. The presence of peripheral arterial disease and hypo-high-density lipoproteinemia were found to be predictors for the occurrence of carotid plaques. Our data have clinical implications in predicting risk factors for the progression of carotid-artery disease in type 2 diabetic patients for their appropriate management. PMID:26527880

  16. Biophysical studies of the cellular elements of the rabbit carotid body.

    PubMed

    Duchen, M R; Caddy, K W; Kirby, G C; Patterson, D L; Ponte, J; Biscoe, T J

    1988-07-01

    The carotid body is a major sensor of oxygen partial pressure in the arterial blood, and plays a role in the control of respiration. Despite extensive investigation of the structure, the cellular basis of the transduction mechanism remains poorly understood. We have developed a preparation of freshly dissociated cells from the rabbit carotid body, in which two cell types may be identified using morphological criteria. The preparation allows application of the patch clamp technique to characterize the properties of the cells which have otherwise proved difficult to study in situ. Carotid bodies of rabbits were dissociated using a combination of enzymatic and mechanical procedures. The dissociated preparation obtained consisted of clusters of spherical or ovoid cells of 12-15 microns in diameter and a distinct population of spherical cells of 8-10 microns diameter. Electron microscopic techniques were used to identify the cells present in the preparation. Again two populations of cells could be distinguished. A population of cells 10-12 microns in diameter, often found in clusters, possessed the dense-cored vesicles characteristic of Type I cells, while a population of smaller cells (diameter 5-7 microns) had peripherally condensed nuclear chromatin and fine cytoplasmic surface extensions characteristic of Type II cells. Patch clamp study of the cells showed that they represent two electrophysiologically distinct populations. The larger cells, corresponding to Type I cells, were found to be excitable, generating fast, sodium-dependent action potentials that were recorded both in the cell attached and whole cell recording configurations. The smaller Type II cells did not generate action potentials. Voltage clamp study of Type I cells allowed definition of a range of voltage-gated currents. These included an inactivating, tetrodotoxin-sensitive inward sodium current, a high threshold sustained inward calcium current, and outward potassium currents. A component of the

  17. Revelations about carotid body function through its pathological role in resistant hypertension.

    PubMed

    Paton, Julian F R; Ratcliffe, Laura; Hering, Dagmara; Wolf, Jacek; Sobotka, Paul A; Narkiewicz, Krzysztof

    2013-08-01

    Much recent attention has been given to the carotid body because of its potential role in cardiovascular disease states. One disease, neurogenic hypertension, characterised by excessive sympathetic activity, appears dependent on carotid body activity that may or may not be accompanied by sleep-disordered breathing. Herein, we review recent literature suggesting that the carotid body acquires tonicity in hypertension. We predict that carotid glomectomy will be a powerful way to temper excessive sympathetic discharge in diseases such as hypertension. We propose a model to explain that signalling from the 'hypertensive' carotid body is tonic, and hypothesise that there will be a sub-population of glomus cells that channel separately into reflex pathways controlling sympathetic motor outflows. PMID:23828147

  18. Cerebral foreign body reaction after carotid aneurysm stenting.

    PubMed

    Lorentzen, Anastasia Orlova; Nome, Terje; Bakke, Søren Jacob; Scheie, David; Stenset, Vidar; Aamodt, Anne Hege

    2016-02-01

    Flow diverter stents are new important tools in the treatment of large, giant, or wide-necked aneurysms. Their delivery and positioning may be difficult due to vessel tortuosity. Common adverse events include intracranial hemorrhage and ischemic stroke, which usually occurs within the same day, or the next few days after the procedure. We present a case where we encountered an unusual intracerebral complication several months after endovascular treatment of a large left internal carotid artery aneurysm, and where brain biopsy revealed foreign body reaction to hydrophilic polymer fragments distally to the stent site. Although previously described, embolization of polymer material from intravascular equipment is rare. We could not identify any other biopsy verified case in the literature, with this particular presentation of intracerebral polymer embolization--a multifocal inflammation spread out through the white matter of one hemisphere without hemorrhage or ischemic changes. PMID:26510943

  19. KISS1 and KISS1R expression in the human and rat carotid body and superior cervical ganglion.

    PubMed

    Porzionato, A; Fenu, G; Rucinski, M; Macchi, V; Montella, A; Malendowicz, L K; De Caro, R

    2011-01-01

    KISS1 and its receptor, KISS1R, have both been found to be expressed in central nervous system, but few data are present in the literature about their distribution in peripheral nervous structures. Thus, the aim of the present study was to investigate, through immunohistochemistry, the expression and distribution of KISS1 and KISS1R in the rat and human carotid bodies and superior cervical ganglia, also with particular reference to the different cellular populations. Materials consisted of carotid bodies and superior cervical ganglia were obtained at autopsy from 10 adult subjects and sampled from 10 adult Sprague-Dawley rats. Immunohistochemistry revealed diffuse expression of KISS1 and KISS1R in type I cells of both human and rat carotid bodies, whereas type II cells were negative. In both human and rat superior cervical ganglia positive anti-KISS1 and -KISS1R immunostainings were also selectively found in ganglion cells, satellite cells being negative. Endothelial cells also showed moderate immunostaining for both KISS1 and KISS1R. The expression of both kisspeptins and kisspeptin receptors in glomic type I cells and sympathetic ganglion cells supports a modulatory role of KISS1 on peripheral chemoreception and sympathetic function. Moreover, local changes in blood flow have been considered to be involved in carotid body chemoreceptor discharge and kisspeptins and kisspeptin receptors have also been found in the endothelial cells. As a consequence, a possible role of kisspeptins in the regulation of carotid body blood flow and, indirectly, in chemoreceptor discharge may also be hypothesized. PMID:22193294

  20. KISS1 and KISS1R expression in the human and rat carotid body and superior cervical ganglion

    PubMed Central

    Porzionato, A.; Fenu, G.; Rucinski, M.; Macchi, V.; Montella, A.; Malendowicz, L.K.; De Caro, R.

    2011-01-01

    KISS1 and its receptor, KISS1R, have both been found to be expressed in central nervous system, but few data are present in the literature about their distribution in peripheral nervous structures. Thus, the aim of the present study was to investigate, through immunohistochemistry, the expression and distribution of KISS1 and KISS1R in the rat and human carotid bodies and superior cervical ganglia, also with particular reference to the different cellular populations. Materials consisted of carotid bodies and superior cervical ganglia were obtained at autopsy from 10 adult subjects and sampled from 10 adult Sprague-Dawley rats. Immunohistochemistry revealed diffuse expression of KISS1 and KISS1R in type I cells of both human and rat carotid bodies, whereas type II cells were negative. In both human and rat superior cervical ganglia positive anti-KISS1 and -KISS1R immunostainings were also selectively found in ganglion cells, satellite cells being negative. Endothelial cells also showed moderate immunostaining for both KISS1 and KISS1R. The expression of both kisspeptins and kisspeptin receptors in glomic type I cells and sympathetic ganglion cells supports a modulatory role of KISS1 on peripheral chemoreception and sympathetic function. Moreover, local changes in blood flow have been considered to be involved in carotid body chemoreceptor discharge and kisspeptins and kisspeptin receptors have also been found in the endothelial cells. As a consequence, a possible role of kisspeptins in the regulation of carotid body blood flow and, indirectly, in chemoreceptor discharge may also be hypothesized. PMID:22193294

  1. Angiotensin AT1 receptor-mediated excitation of rat carotid body chemoreceptor afferent activity.

    PubMed

    Allen, A M

    1998-08-01

    1. A high density of angiotensin II receptors was observed in the rat carotid body by in vitro autoradiography employing 125I-[Sar1, Ile8]-angiotensin II as radioligand. Displacement studies demonstrated that the receptors were of the AT1 subtype. 2. The binding pattern indicated that the AT1 receptors occurred over clumps of glomus cells, the principal chemoreceptor cell of the carotid body. Selective lesions of the sympathetic or afferent innervation of the carotid body had little effect on the density of receptor binding, demonstrating that the majority of AT1 receptors were intrinsic to the glomus cells. 3. To determine the direct effect of angiotensin II on chemoreceptor function, without the confounding effects of the vasoconstrictor action of angiotensin II, carotid sinus nerve activity was recorded from the isolated carotid body in vitro. The carotid body was superfused with Tyrode solution saturated with carbogen (95 % O2, 5 % CO2), maintained at 36 C, and multi-unit nerve activity recorded with a suction electrode. 4. Angiotensin II elicited a dose-dependent excitation of carotid sinus nerve activity (maximum increase of 36 +/- 11 % with 10 nM angiotensin II) with a threshold concentration of 1 nM. The response was blocked by the addition of an AT1 receptor antagonist, losartan (1 microM), but not by the addition of an AT2 receptor antagonist, PD123319 (1 microM). 5. In approximately 50 % of experiments the excitation was preceded by an inhibition of activity (maximum decrease of 24 +/- 8 % with 10 nM angiotensin II). This inhibitory response was markedly attenuated by losartan but not affected by PD123319. 6. These observations demonstrate that angiotensin II, acting through AT1 receptors located on glomus cells in the carotid body, can directly alter carotid chemoreceptor afferent activity. This provides a means whereby humoral information about fluid and electrolyte homeostasis might influence control of cardiorespiratory function. PMID:9660892

  2. Angiotensin AT1 receptor-mediated excitation of rat carotid body chemoreceptor afferent activity

    PubMed Central

    Allen, A M

    1998-01-01

    A high density of angiotensin II receptors was observed in the rat carotid body by in vitro autoradiography employing 125I-[Sar1,Ile8]-angiotensin II as radioligand. Displacement studies demonstrated that the receptors were of the AT1 subtype.The binding pattern indicated that the AT1 receptors occurred over clumps of glomus cells, the principal chemoreceptor cell of the carotid body. Selective lesions of the sympathetic or afferent innervation of the carotid body had little effect on the density of receptor binding, demonstrating that the majority of AT1 receptors were intrinsic to the glomus cells.To determine the direct effect of angiotensin II on chemoreceptor function, without the confounding effects of the vasoconstrictor action of angiotensin II, carotid sinus nerve activity was recorded from the isolated carotid body in vitro. The carotid body was superfused with Tyrode solution saturated with carbogen (95% O2, 5% CO2), maintained at 36 °C, and multi-unit nerve activity recorded with a suction electrode.Angiotensin II elicited a dose-dependent excitation of carotid sinus nerve activity (maximum increase of 36 ± 11% with 10 nm angiotensin II) with a threshold concentration of 1 nm. The response was blocked by the addition of an AT1 receptor antagonist, losartan (1 μm), but not by the addition of an AT2 receptor antagonist, PD123319 (1 μm).In approximately 50% of experiments the excitation was preceded by an inhibition of activity (maximum decrease of 24 ± 8% with 10 nm angiotensin II). This inhibitory response was markedly attenuated by losartan but not affected by PD123319.These observations demonstrate that angiotensin II, acting through AT1 receptors located on glomus cells in the carotid body, can directly alter carotid chemoreceptor afferent activity. This provides a means whereby humoral information about fluid and electrolyte homeostasis might influence control of cardiorespiratory function. PMID:9660892

  3. Magnetic resonance and computed tomography imaging of a carotid body tumor in a dog

    PubMed Central

    2012-01-01

    A 5-year-old castrated male Labrador Retriever was presented to a referring veterinarian for a swelling in the neck region. Based on the results of histopathology, a carotid body tumor, was diagnosed. The dog was referred to a medical imaging unit for further staging and follow up. This report describes the magnetic resonance (MR) and computed tomographic (CT) appearance of a carotid body tumor. PMID:22507757

  4. The Carotid Body and Arousal in the Fetus and Neonate

    PubMed Central

    2012-01-01

    Arousal from sleep is a major defense mechanism in infants against hypoxia and/or hypercapnia. Arousal failure may be an important contributor to SIDS. Areas of the brainstem that have been found to be abnormal in a majority of SIDS infants are involved in the arousal process. Arousal is sleep state dependent, being depressed during AS in most mammals, but depressed during QS in human infants. Repeated exposure to hypoxia causes a progressive blunting of arousal that may involve medullary raphe GABAergic mechanisms. Whereas CB chemoreceptors contribute heavily to arousal in response to hypoxia, serotonergic central chemoreceptors have been implicated in the arousal response to CO2. Pulmonary or chest wall mechanoreceptors also contribute to arousal in proportion to the ventilatory response and decreases in their input may contribute to depressed arousal during AS. Little is known about specific arousal pathways beyond the NTS. Whether CB chemoreceptor stimulation directly stimulates arousal centers or whether this is done indirectly through respiratory networks remains unknown. This review will focus on arousal in response to hypoxia and CO2 in the fetus and newborn and will outline what we know (and don’t know) about the involvement of the carotid body in this process. PMID:22684039

  5. Effects of specific carotid body and brain hypoxia on respiratory muscle control in the awake goat.

    PubMed Central

    Smith, C A; Engwall, M J; Dempsey, J A; Bisgard, G E

    1993-01-01

    1. We assessed the effects of specific brain hypoxia on the control of inspiratory and expiratory muscle electromyographic (EMG) activities in response to specific carotid body hypoxia in seven awake goats. We used an isolated carotid body perfusion technique that permitted specific, physiological, steady-state stimulation of the carotid bodies or maintenance of normoxia and normocapnia at the carotid bodies while varying the level of systemic, and therefore, brain oxygenation. 2. Isolated brain normocapnic hypoxia of up to 1.5 h duration increased inspired minute ventilation (VI) by means of increases in both tidal volume (VT) and respiratory frequency (fR). Electromyographic activities of both inspiratory and expiratory muscles were augmented as well. These responses were similar to those produced by low levels of whole-body normoxic hypercapnia. We conclude that moderate levels of brain hypoxia (Pa,O2 approximately 40 mmHg) in awake goats caused a net stimulation of ventilatory motor output. 3. Hypoxic stimulation of the carotid bodies alone caused comparable increases in VT and fR, and EMG augmentation of both inspiratory and expiratory muscles whether the brain was hypoxic or normoxic. These responses were quite similar to those obtained over a wide range of whole-body normoxic hypercapnia. We conclude that the integration of carotid body afferent information is not affected by moderate brain hypoxia in awake goats. 4. We found no evidence for an asymmetrical recruitment pattern of inspiratory vs. expiratory muscles in response to carotid body hypoxia or in response to brain hypoxia alone. 5. Our data support the concept that moderate brain hypoxia results in a net stimulation of respiratory motor output. These findings question the significance of 'central hypoxic depression' to the regulation of breathing under physiological levels of hypoxaemia in the awake animal. PMID:8487210

  6. Carotid body potentiation during chronic intermittent hypoxia: implication for hypertension.

    PubMed

    Del Rio, Rodrigo; Moya, Esteban A; Iturriaga, Rodrigo

    2014-01-01

    Autonomic dysfunction is involved in the development of hypertension in humans with obstructive sleep apnea, and animals exposed to chronic intermittent hypoxia (CIH). It has been proposed that a crucial step in the development of the hypertension is the potentiation of the carotid body (CB) chemosensory responses to hypoxia, but the temporal progression of the CB chemosensory, autonomic and hypertensive changes induced by CIH are not known. We tested the hypothesis that CB potentiation precedes the autonomic imbalance and the hypertension in rats exposed to CIH. Thus, we studied the changes in CB chemosensory and ventilatory responsiveness to hypoxia, the spontaneous baroreflex sensitivity (BRS), heart rate variability (HRV) and arterial blood pressure in pentobarbital anesthetized rats exposed to CIH for 7, 14, and 21 days. After 7 days of CIH, CB chemosensory and ventilatory responses to hypoxia were enhanced, while BRS was significantly reduced by 2-fold in CIH-rats compared to sham-rats. These alterations persisted until 21 days of CIH. After 14 days, CIH shifted the HRV power spectra suggesting a predominance of sympathetic over parasympathetic tone. In contrast, hypertension was found after 21 days of CIH. Concomitant changes between the gain of spectral HRV, BRS, and ventilatory hypoxic chemoreflex showed that the CIH-induced BRS attenuation preceded the HRV changes. CIH induced a simultaneous decrease of the BRS gain along with an increase of the hypoxic ventilatory gain. Present results show that CIH-induced persistent hypertension was preceded by early changes in CB chemosensory control of cardiorespiratory and autonomic function. PMID:25429271

  7. Role of the carotid bodies in chemosensory ventilatory responses in the anesthetized mouse.

    PubMed

    Izumizaki, Masahiko; Pokorski, Mieczyslaw; Homma, Ikuo

    2004-10-01

    We examined the effects of carotid body denervation on ventilatory responses to normoxia (21% O2 in N2 for 240 s), hypoxic hypoxia (10 and 15% O2 in N2 for 90 and 120 s, respectively), and hyperoxic hypercapnia (5% CO2 in O2 for 240 s) in the spontaneously breathing urethane-anesthetized mouse. Respiratory measurements were made with a whole body, single-chamber plethysmograph before and after cutting both carotid sinus nerves. Baseline measurements in air showed that carotid body denervation was accompanied by lower minute ventilation with a reduction in respiratory frequency. On the basis of measurements with an open-circuit system, no significant differences in O2 consumption or CO2 production before and after chemodenervation were found. During both levels of hypoxia, animals with intact sinus nerves had increased respiratory frequency, tidal volume, and minute ventilation; however, after chemodenervation, animals experienced a drop in respiratory frequency and ventilatory depression. Tidal volume responses during 15% hypoxia were similar before and after carotid body denervation; during 10% hypoxia in chemodenervated animals, there was a sudden increase in tidal volume with an increase in the rate of inspiration, suggesting that gasping occurred. During hyperoxic hypercapnia, ventilatory responses were lower with a smaller tidal volume after chemodenervation than before. We conclude that the carotid bodies are essential for maintaining ventilation during eupnea, hypoxia, and hypercapnia in the anesthetized mouse. PMID:15194670

  8. Carotid body chemoreflex: a driver of autonomic abnormalities in sleep apnoea.

    PubMed

    Prabhakar, Nanduri R

    2016-08-01

    What is the topic of this review? This article presents emerging evidence for heightened carotid body chemoreflex activity as a major driver of sympathetic activation and hypertension in sleep apnoea patients. What advances does it heighlight? This article discusses the recent advances on cellular, molecular and epigenetic mechanisms underlying the exaggerated chemoreflex in experimental models of sleep apnoea. The carotid bodies are the principal peripheral chemoreceptors for detecting changes in arterial blood oxygen concentration, and the resulting chemoreflex is a potent regulator of the sympathetic tone, blood pressure and breathing. Sleep apnoea is a disease of the respiratory system that affects several million adult humans. Apnoeas occur during sleep, often as a result of obstruction of the upper airway (obstructive sleep apnoea) or because of defective respiratory rhythm generation by the CNS (central sleep apnoea). Patients with sleep apnoea exhibit several co-morbidities, with the most notable among them being heightened sympathetic nerve activity and hypertension. Emerging evidence suggests that intermittent hypoxia resulting from periodic apnoea stimulates the carotid body, and the ensuing chemoreflex mediates the increased sympathetic tone and hypertension in sleep apnoea patients. Rodent models of intermittent hypoxia that simulate the O2 saturation profiles encountered during sleep apnoea have provided important insights into the cellular and molecular mechanisms underlying the heightened carotid body chemoreflex. This article describes how intermittent hypoxia affects the carotid body function and discusses the cellular, molecular and epigenetic mechanisms underlying the exaggerated chemoreflex. PMID:27474260

  9. Evidence for a carotid body homolog in the lizard Tupinambis merianae.

    PubMed

    Reichert, Michelle N; Brink, Deidre L; Milsom, William K

    2015-01-15

    The homolog to the mammalian carotid body has not yet been identified in lizards. Observational studies and evolutionary history provide indirect evidence for the existence of a chemoreceptor population at the first major bifurcation of the common carotid artery in lizards, but a chemoreceptive role for this area has not yet been definitively demonstrated. We explored this possibility by measuring changes in cardiorespiratory variables in response to focal arterial injections of the hypoxia mimic sodium cyanide (NaCN) into the carotid artery of 12 unanesthetized specimens of Tupinambis merianae. These injections elicited increases in heart rate (f(H); 101±35% increase) and respiratory rate (f(R); 620±119% increase), but not mean arterial blood pressure (MAP). These responses were eliminated by vagal denervation. Similar responses were elicited by injections of the neurotransmitters acetylcholine (ACh) and serotonin (5-HT) but not norepinephrine. Heart rate and respiratory rate increases in response to NaCN could be blocked or reduced by antagonists to ACh (atropine) and/or 5-HT (methysergide). Finally, using immunohistochemistry, we demonstrate the presence of putative chemoreceptive cells immunopositive for the cholinergic cell marker vesicular ACh transporter (VAChT) and 5-HT on internal lattice-like structures at the carotid bifurcation. These results provide evidence in lizards for the existence of dispersed chemoreceptor cells at the first carotid bifurcation in the central cardiovascular area that have similar properties to known carotid body homologs, adding to the picture of chemoreceptor evolution in vertebrates. PMID:25524981

  10. Carotid baroreceptor influence on forearm vascular resistance during low level lower body negative pressure

    NASA Technical Reports Server (NTRS)

    Thompson, Cynthia A.; Ludwig, David A.; Convertino, Victor A.

    1991-01-01

    The degree of forearm vasoconstriction induced by low levels of lower body negative pressure (LBNP) provides a measure of the responsiveness of the cardiopulmonary baroreflex. The validity of this measurement is based on the assumption that this vasoconstriction response is not influenced by unloading of carotid baroreceptors. To test the hypothesis that arterial baroreceptor unloading does not alter the degree of forearm vascular resistance during low levels of LBNP, 12 subjects were exposed to -15 and -20 mm Hg LBNP with and without additional artificial (+ 10 mm Hg neck pressure) unloading of the carotid baroreceptors. There was no measurable influence of carotid unloading on forearm vascular resistance at either level of LBNP. It is concluded that forearm vascular resistance measured during cardiopulmonary baroreceptor unloading is unaffected by carotid baroreceptor unloading within the magnitude encountered during low levels of LBNP.

  11. Carotid body overactivity induces respiratory neurone channelopathy contributing to neurogenic hypertension.

    PubMed

    Moraes, Davi J A; Machado, Benedito H; Paton, Julian F R

    2015-07-15

    Why sympathetic activity rises in neurogenic hypertension remains unknown. It has been postulated that changes in the electrical excitability of medullary pre-sympathetic neurones are the main causal mechanism for the development of sympathetic overactivity in experimental hypertension. Here we review recent data suggesting that enhanced sympathetic activity in neurogenic hypertension is, at least in part, dependent on alterations in the electrical excitability of medullary respiratory neurones and their central modulation of sympatho-excitatory networks. We also present results showing a critical role for carotid body tonicity in the aetiology of enhanced central respiratory modulation of sympathetic activity in neurogenic hypertension. We propose a novel hypothesis of respiratory neurone channelopathy induced by carotid body overactivity in neurogenic hypertension that may contribute to sympathetic excess. Moreover, our data support the notion of targeting the carotid body as a potential novel therapeutic approach for reducing sympathetic vasomotor tone in neurogenic hypertension. PMID:25900825

  12. Thermal effects on ventilation in cats: participation of carotid body chemoreceptors.

    PubMed

    Fadic, R; Larrain, C; Zapata, P

    1991-10-01

    In pentobarbitone anesthetized cats, raising body temperature from 37 to 40 degrees C by external heat increased respiratory frequency, tidal volume, frequency of spontaneous gasps and mean inspiratory flow. It reduced end-tidal CO2 pressure, together with inspiratory and expiratory durations. After bilateral section of the carotid nerves, raising body temperature still induced hyperventilation, but the increase in gasp frequency was less pronounced and no significant change in tidal volume was observed. In comparison to steady ventilatory values in the intact condition, significant reductions in tidal volume at 38 degrees C and in gasp frequency at 37, 39 and 40 degrees C were observed after bilateral carotid neurotomy. Brief hyperoxic tests induced transient decreases in tidal volume and increases in end-tidal CO2 pressure which were significantly larger at 40 degrees C than at 37 degrees C. These changes disappeared after bilateral carotid neurotomy. Anesthetic block of both carotid nerves produced transient reductions in tidal volume at any given temperature. We conclude that carotid body afferents contribute to the hyperventilation evoked by hyperthermia. After their interruption, such contribution is replaceable from other thermal afferents. PMID:1759053

  13. Inherent variations in CO-H2S-mediated carotid body O2 sensing mediate hypertension and pulmonary edema.

    PubMed

    Peng, Ying-Jie; Makarenko, Vladislav V; Nanduri, Jayasri; Vasavda, Chirag; Raghuraman, Gayatri; Yuan, Guoxiang; Gadalla, Moataz M; Kumar, Ganesh K; Snyder, Solomon H; Prabhakar, Nanduri R

    2014-01-21

    Oxygen (O2) sensing by the carotid body and its chemosensory reflex is critical for homeostatic regulation of breathing and blood pressure. Humans and animals exhibit substantial interindividual variation in this chemosensory reflex response, with profound effects on cardiorespiratory functions. However, the underlying mechanisms are not known. Here, we report that inherent variations in carotid body O2 sensing by carbon monoxide (CO)-sensitive hydrogen sulfide (H2S) signaling contribute to reflex variation in three genetically distinct rat strains. Compared with Sprague-Dawley (SD) rats, Brown-Norway (BN) rats exhibit impaired carotid body O2 sensing and develop pulmonary edema as a consequence of poor ventilatory adaptation to hypobaric hypoxia. Spontaneous Hypertensive (SH) rat carotid bodies display inherent hypersensitivity to hypoxia and develop hypertension. BN rat carotid bodies have naturally higher CO and lower H2S levels than SD rat, whereas SH carotid bodies have reduced CO and greater H2S generation. Higher CO levels in BN rats were associated with higher substrate affinity of the enzyme heme oxygenase 2, whereas SH rats present lower substrate affinity and, thus, reduced CO generation. Reducing CO levels in BN rat carotid bodies increased H2S generation, restoring O2 sensing and preventing hypoxia-induced pulmonary edema. Increasing CO levels in SH carotid bodies reduced H2S generation, preventing hypersensitivity to hypoxia and controlling hypertension in SH rats. PMID:24395806

  14. Role of. alpha. sub 2 -adrenergic receptors in the carotid body response to hypoxia

    SciTech Connect

    Kou, Y.R.; Ernsberger, P.; Cherniack, N.S.; Prabhakar, N.R. )

    1990-02-26

    Clonidine, which acts in part as an {alpha}{sub 2}-adrenergic receptor agonist, depresses ventilation. The authors examined the role of {alpha}{sub 2}-receptors in carotid chemoreceptor activity. The density of {alpha}{sub 2}-receptors was determined in membrane fractions of 18 cat carotid bodies using {sup 125}I-iodoclonidine with 0.1 mM epinephrine or 10 {mu}M SKF-86466 defining nonspecific binding. {alpha}{sub 2}-Adrenergic receptor density averaged 0.6{plus minus}0.1 fmol/carotid body (mean {plus minus} SEM) and was comparable to other sympathetic target tissues. The authors then studied the effects of an agonist (guanabenz) and an antagonist (SKF-86466; 6-Cl-N-methyl-2,3,4,5-tetrahydro-1-H3-benzazepine) specific for {alpha}{sub 2}-receptors on baseline and hypoxia-stimulated carotid body discharge, in 10 anesthetized, paralyzed and artificially ventilated cats. Intracarotid infusion of guanabenz for 5 minutes caused a dose-dependent depression of the baseline activity and reduced the chemoreceptor response to hypoxia by 88.0{plus minus}5.8% of the vehicle-injected controls. Intravenous administration of SKF-86466 reversed the effects of guanabenz on the carotid body activity. in contrast, chemoreceptor depression caused by dopamine was unaffected by SKF-86466. SKF-86466 alone increased baseline discharge and potentiated the chemoreceptor response to hypoxia by 34.0 {plus minus} 9.6% of the controls. These results demonstrate that {alpha}{sub 2}-adrenergic receptors are present in the cat carotid body and they exert an inhibitory influence on the chemoreceptor response to hypoxia.

  15. Towards the Sensory Nature of the Carotid Body: Hering, De Castro and Heymans†

    PubMed Central

    de Castro, Fernando

    2009-01-01

    The carotid body or glomus caroticum is a chemosensory organ bilaterally located between the external and internal carotid arteries. Although known by anatomists since the report included by Von Haller and Taube in the mid XVIII century, its detailed study started the first quarter of the XX. The Austro-German physiologist Heinrich E. Hering studied the cardio-respiratory reflexes searched for the anatomical basis of this reflex in the carotid sinus, while the Ghent School leaded by the physio-pharmacologists Jean-François Heymans and his son Corneille focussed in the cardio-aortic reflexogenic region. In 1925, Fernando De Castro, one of the youngest and more brilliant disciples of Santiago Ramón y Cajal at the Laboratorio de Investigaciones Biológicas (Madrid, Spain), profited from some original novelties in histological procedures to study the fine structure and innervation of the carotid body. De Castro unravelled them in a series of scientific papers published between 1926 and 1929, which became the basis to consider the carotid body as a sensory receptor (or chemoreceptor) to detect the chemical changes in the composition of the blood. Indeed, this was the first description of arterial chemoreceptors. Impressed by the novelty and implications of the work of De Castro, Corneille Heymans invited the Spanish neurologist to visit Ghent on two occasions (1929 and 1932), where both performed experiences together. Shortly after, Heymans visited De Castro at the Instituto Cajal (Madrid). From 1932 to 1933, Corneille Heymans focused all his attention on the carotid body his physiological demonstration of De Castro's hypothesis regarding chemoreceptors was awarded with the Nobel Prize in Physiology or Medicine in 1938, just when Spain was immersed in its catastrophic Civil War. PMID:20057927

  16. Carotid Body Chemoreflex Mediates Intermittent Hypoxia-Induced Oxidative Stress in the Adrenal Medulla

    PubMed Central

    Kumar, Ganesh K.; Peng, Ying-Jie; Nanduri, Jayasri; Prabhakar, Nanduri R.

    2016-01-01

    Intermittent hypoxia (IH) increases reactive oxygen species generation resulting in oxidative stress in the adrenal medulla (AM), a major end-organ of the sympathetic nervous system which facilitates catecholamine secretion by hypoxia. Here, we show that carotid body chemoreflex contributes to IH-induced oxidative stress in the AM. Carotid bodies were ablated by cryocoagulation of glomus cells, the putative O2 sensing cells. Carotid body ablated (CBA) and control rats were exposed to IH and the redox state of the AM was assessed biochemically. We found that IH raised reactive oxygen species levels along with an increase in NADPH oxidase (Nox), a pro-oxidant enzyme and a decrease in superoxide dismutase-2 (SOD2), an anti-oxidant enzyme. Further, IH increased hypoxia-inducible factor (HIF)-1α, whereas decreased HIF-2α, the transcriptional regulator of Nox and SOD-2, respectively. These IH-induced changes in the AM were absent in CBA rats. Moreover, IH increased splanchnic nerve activity and facilitated hypoxia-evoked catecholamine efflux from the AM and CBA prevented these effects. These findings suggest that IH-induced oxidative stress and catecholamine efflux in the AM occurs via carotid body chemoreflex involving HIF α isoform mediated imbalance in pro-, and anti-oxidant enzymes. PMID:26303481

  17. Immunohistochemical localization of dopamine D2 receptor in the rat carotid body.

    PubMed

    Wakai, Jun; Takayama, Anna; Yokoyama, Takuya; Nakamuta, Nobuaki; Kusakabe, Tatsumi; Yamamoto, Yoshio

    2015-10-01

    Dopamine modulates the chemosensitivity of arterial chemoreceptors, and dopamine D2 receptor (D2R) is expected to localize in the glomus cells and/or sensory nerve endings of the carotid body. In the present study, the localization of D2R in the rat carotid body was examined using double immunofluorescence for D2R with various cell markers. D2R immunoreactivity was mainly localized in glomus cells immunoreactive to tyrosine hydroxylase or dopamine β-hydroxylase (DBH), but not in S100B-immunoreactive sustentacular cells. Furthermore, D2R immunoreactivity was observed in petrosal ganglion cells and nerve bundles in the carotid body, but not in the nerve endings with P2X2 immunoreactivity. In the carotid ganglion, a few punctate D2R-immunoreactive products were detected in DBH-immunoreactive nerve cell bodies. These results showed that D2R was mainly distributed in glomus cells, and suggested that D2R plays a role in the inhibitory modulation of chemosensory activity in a paracrine and/or autocrine manner. PMID:26272445

  18. A case of congenital agenesis of the common carotid artery associated with an ectopic parathyroid adenoma mimicking a carotid body tumor.

    PubMed

    Malm, Ian-James; Olcott, Clara M; Chan, Jason Y K; Loyo, Myriam; Kim, Young J

    2013-01-01

    Ectopic parathyroid adenomas can be encountered during four gland explorations, but nearly 80% of adenomas are localized with ultrasound and sestamibi imaging. Ectopic adenomas are thought to arise from abnormal migration during development. As a cervical congenital anomaly, common carotid artery agenesis is an extremely rare anomaly characterized by separate origins of the internal and external carotid arteries directly from the aortic arch. Here we present a case of a 75 year old man with primary hyperparathyroidism who was found to have congenital agenesis of the common carotid artery associated with an ectopic parathyroid adenoma within the parapharyngeal space, which mimicked a carotid body tumor based on location and imaging. The successful identification and resection of the ectopic parathyroid adenoma presented here demonstrate the importance of preoperative imaging studies to allow appropriate operative planning as well as the utility of intraoperative parathyroid hormone assay in predicting cure during surgery. PMID:23993711

  19. Percutaneous Injection of Lidocaine Within the Carotid Body Area in Carotid Artery Stenting: An 'Old-New' Technique

    SciTech Connect

    Mourikis, Dimitrios; Chatoupis, Konstantinos; Katsenis, Konstantinos; Vlahos, Lampros; Chatziioannou, Achilles

    2008-07-15

    Severe bradycardia is a common untoward effect during balloon angioplasty when performing carotid artery stenting. Therefore atropine injection even before dilatation and the presence of an anesthesiologist are advocated in all patients. In the surgical literature, injection of a local anesthetic agent into the carotid sinus before carotid endarterectomy was performed in an attempt to ameliorate perioperative hemodynamic instability. This study was undertaken to test the hypothesis that percutaneous infiltration of the carotid sinus with local anesthetic immediately before balloon dilatation reduces bradycardia and ameliorates the need for atropine injection or the presence of an anesthesiologist. Infiltration of the carotid sinus with 5 ml of 1% lidocaine, 3 min before dilatation, was performed in 30 consecutive patients. No one exhibited any significant rhythm change that required atropine injection. The anesthesiologist did not face any hemodynamic instability during the carotid artery stenting procedure.

  20. The neurogenic niche in the carotid body and its applicability to antiparkinsonian cell therapy.

    PubMed

    López-Barneo, José; Pardal, Ricardo; Ortega-Sáenz, Patricia; Durán, Rocío; Villadiego, Javier; Toledo-Aral, Juan José

    2009-08-01

    The carotid body (CB) is a neural crest-derived organ whose major function is to sense changes in arterial O(2) tension to elicit hyperventilation during hypoxia. The CB is composed of clusters of neuron-like glomus, or type I, cells that are highly dopaminergic and contain large amounts of the glial cell line-derived neurotrophic factor (GDNF). Glomus cells are enveloped by glia-like sustentacular, or type II, cells. In chronic hypoxia the CB grows with increase in glomus cell number. This adaptive response depends on a collection of neural progenitors that can be isolated and induced to form clonal neurospheres in vitro. CB neurospheres contain numerous newly differentiated glomus cells, which maintain their functional properties and the ability to synthesize dopamine and GDNF. Intrastriatal CB transplants have been assayed in animal models of Parkinson's disease (PD) to test whether they increase the striatal dopamine levels and/or exert a neuroprotective action on the nigrostriatal pathway. Two pilot safety studies performed on PD patients subjected to CB autotransplantation have suggested that a major limitation of this technique is the small size of the organ. This could, however, be overcome by the in vitro formation of new CB tissue derived from adult CB stem cells. PMID:19263191

  1. Multidisciplinary Management of Carotid Body Tumors in a Tertiary Urban Institution

    PubMed Central

    Galyfos, George; Stamatatos, Ioannis; Kerasidis, Stavros; Stefanidis, Ioannis; Giannakakis, Sotirios; Kastrisios, Georgios; Geropapas, Georgios; Papacharalampous, Gerasimos; Maltezos, Chrisostomos

    2015-01-01

    Objective. Aim of this study is to present the experience of our institution in carotid body tumors (CBTs) treatment. Methods. All cases treated in a Vascular Surgery Department within 2.5 years (03/2013–09/2015) were retrospectively evaluated. Demographics, diagnostic, and treatment strategy were recorded. All patients with known CBT underwent ultrasound and magnetic resonance imaging preoperatively. All cases were classified according to the Shamblin type and evaluated by a radiologist, otolaryngologist, and anesthesiologist before and after surgery. Major outcomes included mortality, stroke, cranial nerve injury, and recurrence. Results. Overall, nine patients (mean age: 59.5 ± 16.3 years) with a total of ten CBTs were treated. There was no gender prevalence and most of the cases (55%) were asymptomatic. There were no functional or familial cases. There was only one bilateral case treated in a staged manner. No preoperative embolization of CBTs was performed. Mortality and stroke rates were null. No severe complication was observed in the early and late setting. No malignancy was recorded. Mean follow-up was 15.6 ± 7.8 months. Conclusions. Multidisciplinary management of patients with CBTs is imperative for optimal results, especially in type III tumors, bilateral or functional cases. After careful treatment planning and intraoperative manipulations, complications could be avoided even without preoperative embolization. PMID:26783464

  2. Do the carotid body chemoreceptors mediate cardiovascular and sympathetic adjustments induced by sodium overload in rats?

    PubMed

    Pedrino, Gustavo R; Mourão, Aline A; Moreira, Marina C S; da Silva, Elaine F; Lopes, Paulo R; Fajemiroye, James O; Schoorlemmer, Guss H M; Sato, Mônica A; Reis, Ângela A S; Rebelo, Ana C S; Cravo, Sergio L

    2016-05-15

    Acute plasma hypernatremia induces several cardiovascular and sympathetic responses. It is conceivable that these responses contribute to rapid sodium excretion and restoration of normal conditions. Afferent pathways mediating these responses are not entirely understood. The present study analyses the effects of acute carotid chemoreceptor inactivation on cardiovascular and sympathetic responses induced by infusion of hypertonic saline (HS). All experiments were performed on anesthetized male Wistar rats instrumented for recording of arterial blood pressure (ABP), renal blood flow (RBF) and renal sympathetic nerve activity (RSNA). Animals were subjected to sham surgery or carotid chemoreceptor inactivation by bilateral ligation of the carotid body artery (CBA). In sham rats (n=8), intravenous infusion of HS (3 M NaCl, 1.8 ml/kg b.wt.) elicited a transient increase (9±2mmHg) in ABP, and long lasting (30 min) increases in RBF (138±5%) and renal vascular conductance (RVC) (128±5%) with concurrent decrease in RSNA (-19±4%). In rats submitted to CBA ligation (n=8), the pressor response to HS was higher (24±2mmHg; p<0.05). However, RBF and RVC responses to HS infusion were significantly reduced (113±5% and 93±4%, respectively) while RSNA was increased (13±2%). When HS (3M NaCl, 200μl) was administrated into internal carotid artery (ICA), distinct sympathetic and cardiovascular responses were observed. In sham-group, HS infusion (3M NaCl, 200μl) into ICA promoted an increase in ABP (26±8mmHg) and RSNA (29±13%). In CBA rats, ABP (-3±5.6mmHg) remained unaltered despite sympathoinhibition (-37.6±5.4%). These results demonstrate that carotid body chemoreceptors play a role in the development of hemodynamic and sympathetic responses to acute HS infusion. PMID:27060222

  3. CT AND MRI FEATURES OF CAROTID BODY PARAGANGLIOMAS IN 16 DOGS.

    PubMed

    Mai, Wilfried; Seiler, Gabriela S; Lindl-Bylicki, Britany J; Zwingenberger, Allison L

    2015-01-01

    Carotid body tumors (paragangliomas) arise from chemoreceptors located at the carotid bifurcation. In imaging studies, this neoplasm may be confused with other neck neoplasms such as thyroid carcinoma. The purpose of this retrospective, cross-sectional study was to describe computed tomographic (CT) and magnetic resonance imaging (MRI) characteristics of confirmed carotid body tumors in a multi-institutional sample of dogs. A total of 16 dogs met inclusion criteria (14 examined using CT and two with MRI). The most common reason for imaging was a palpable cervical mass or respiratory signs (i.e., dyspnea or increased respiratory noises). The most commonly affected breed was Boston terrier (n = 5). Dogs were predominantly male castrated (n = 10) and the median age was 9 years [range 3-14.5]. Most tumors appeared as a large mass centered at the carotid bifurcation, with poor margination in six dogs and discrete margins in ten dogs. Masses were iso- to hypoattenuating to adjacent muscles in CT images and hyperintense to muscles in T1- and T2-weighted MRI. For both CT and MRI, masses typically showed strong and heterogeneous contrast enhancement. There was invasion into the adjacent structures in 9/16 dogs. In six of these nine dogs, the basilar portion of the skull was affected. The external carotid artery was entrapped in seven dogs. There was invasion into the internal jugular vein in three dogs, and into the external jugular, maxillary, and linguo-facial veins in one dog. Imaging characteristics helped explain some clinical presentations such as breathing difficulties, Horner's syndrome, head tilt, or facial nerve paralysis. PMID:25846946

  4. The Role of Hypoxia-Inducible Factors in Oxygen Sensing by the Carotid Body

    PubMed Central

    Prabhakar, Nanduri R.

    2013-01-01

    Chronic intermittent hypoxia (IH) associated with sleep-disordered breathing is an important cause of hypertension, which results from carotid body-mediated activation of the sympathetic nervous system. IH triggers increased levels of reactive oxygen species (ROS) in the carotid body, which induce increased synthesis and stability of hypoxia-inducible factor 1α (HIF-1α) and calpain-dependent degradation of HIF-2α. HIF-1 activates transcription of the Nox2 gene, encoding NADPH oxidase 2, which generates superoxide. Loss of HIF-2 activity leads to decreased transcription of the Sod2 gene, encoding manganese superoxide dismutase, which converts superoxide to hydrogen peroxide. Thus, IH disrupts the balance between HIF-1-dependent pro-oxidant and HIF-2-dependent anti-oxidant activities, and this loss of redox homeostasis underlies the pathogenesis of autonomic morbidities associated with IH. PMID:23080136

  5. Tasting arterial blood: what do the carotid chemoreceptors sense?

    PubMed Central

    Prabhakhar, Nanduri R.; Joyner, Michael J.

    2015-01-01

    The carotid bodies are sensory organs that detect the chemical composition of the arterial blood. The carotid body sensory activity increases in response to arterial hypoxemia and the ensuing chemoreflex regulates vital homeostatic functions. Recent studies suggest that the carotid bodies might also sense arterial blood glucose and circulating insulin levels. This review focuses on how the carotid bodies sense O2, glucose, and insulin and some potential implications of these sensory functions on physiological regulation and in pathophysiological conditions. Emerging evidence suggests that carbon monoxide (CO)-regulated hydrogen sulfide (H2S), stemming from hypoxia, depolarizes type I cells by inhibiting certain K+ channels, facilitates voltage-gated Ca2+ influx leading to sensory excitation of the carotid body. Elevated CO and decreased H2S renders the carotid bodies insensitive to hypoxia resulting in attenuated ventilatory adaptations to high altitude hypoxia, whereas reduced CO and high H2S result in hypersensitivity of the carotid bodies to hypoxia and hypertension. Acute hypoglycemia augments the carotid body responses to hypoxia but that a prolonged lack of glucose in the carotid bodies can lead to a failure to sense hypoxia. Emerging evidence also indicates that carotid bodies might sense insulin directly independent of its effect on glucose, linking the carotid bodies to the pathophysiological consequences of the metabolic syndrome. How glucose and insulin interact with the CO-H2S signaling is an area of ongoing study. PMID:25642193

  6. Peripheral chemoreceptors determine the respiratory sensitivity of central chemoreceptors to CO2 : role of carotid body CO2.

    PubMed

    Smith, Curtis A; Blain, Grégory M; Henderson, Kathleen S; Dempsey, Jerome A

    2015-09-15

    We asked if the type of carotid body (CB) chemoreceptor stimulus influenced the ventilatory gain of the central chemoreceptors to CO2 . The effect of CB normoxic hypocapnia, normocapnia and hypercapnia (carotid body PCO2 ≈ 22, 41 and 68 mmHg, respectively) on the ventilatory CO2 sensitivity of central chemoreceptors was studied in seven awake dogs with vascularly-isolated and extracorporeally-perfused CBs. Chemosensitivity with one CB was similar to that in intact dogs. In four CB-denervated dogs, absence of hyper-/hypoventilatory responses to CB perfusion with PCO2 of 19-75 mmHg confirmed separation of the perfused CB circulation from the brain. The group mean central CO2 response slopes were increased 303% for minute ventilation (V̇I)(P ≤ 0.01) and 251% for mean inspiratory flow rate (VT /TI ) (P ≤ 0.05) when the CB was hypercapnic vs. hypocapnic; central CO2 response slopes for tidal volume (VT ), breathing frequency (fb ) and rate of rise of the diaphragm EMG increased in 6 of 7 animals but the group mean changes did not reach statistical significance. Group mean central CO2 response slopes were also increased 237% for V̇I(P ≤ 0.01) and 249% for VT /TI (P ≤ 0.05) when the CB was normocapnic vs. hypocapnic, but no significant differences in any of the central ventilatory response indices were found between CB normocapnia and hypercapnia. These hyperadditive effects of CB hyper-/hypocapnia agree with previous findings using CB hyper-/hypoxia.We propose that hyperaddition is the dominant form of chemoreceptor interaction in quiet wakefulness when the chemosensory control system is intact, response gains physiological, and carotid body chemoreceptors are driven by a wide range of O2 and/or CO2 . PMID:26171601

  7. Research Report: Intermittent hypobaric hypoxia and hyperbaric oxygen on GAP-43 in the rat carotid body.

    PubMed

    Peng, Zhengwu; Fan, Juan; Liu, Ling; Kuang, Fang; Xue, Fen; Wang, Bairen

    2015-01-01

    Adaptive changes in the carotid body (CB) including the expression of the growth-associated protein-43 (GAP-43) have been studied in response to low, but not high, oxygen exposure. Expression of GAP-43 in the CB of rats under different atmospheric pressures and oxygen partial pressure (PO2) conditions was investigated. Mature male Sprague-Dawley rats were exposed to intermittent hypobaric hypoxia (IHH, 0, 1, 2 and 3 weeks), intermittent hyperbaric oxygen (IHBO2, 0, 1, 5 and 10 days, sacrificed six hours or 24 hours after the last HBO2 exposure), and intermittent hyperbaric normoxia (IHN, same treatment pattern as IHBO2). GAP-43 was highly expressed (mainly in type I cells) in the CB of normal rats. IHH u-regulated GAP-43 expression in the CB with significant differences (immunohistochemical staining [IHC]: F(3,15)=40.64, P < 0.01; western blot [WB]: F(3,16) = 53.52, P < 0.01) across the subgroups. GAP-43 expression in the CB was inhibited by IHBO2 (controls vs. IHBO2 groups, IHC: F(6,30) = 15.85, P < 0.01; WB: F(6,29) = 15.95, P < 0.01). No detectable changes in GAP-43 expression were found for IHN. These findings indicated that different PO2 conditions, but not air pressures, played an important role in the plasticity of the CB, and that GAP-43 might be a viable factor for the plasticity of the CB. PMID:26742253

  8. Opioid peptides in the rabbit carotid body: identification and evidence for co-utilization and interactions with dopamine.

    PubMed

    González-Guerrero, P R; Rigual, R; González, C

    1993-05-01

    The rabbit carotid body is a catecholaminergic organ that contains dopamine and norepinephrine in a proportion of nearly 5:1. Chronic (15 days) carotid sinus nerve denervation or superior cervical ganglionectomy did not modify the carotid body dopamine content (5-6 nmol/mg of protein, equivalent to 250 pmol per carotid body), but sympathectomy reduced by approximately 50% the norepinephrine content. The carotid body has also a very high content of opioid activity (250 equivalent pmol of Leu-enkephalin/mg of protein) as measured by a radioreceptor assay that detects preferentially delta-opioid activity. In the carotid body the degree of opioid posttranslational processing to low-molecular-weight peptides (mostly Leu- and Met-enkephalin) is nearly 80%. HPLC identification of opioid peptides revealed that the sequences of Met- and Leu-enkephalin were in a proportion of nearly 6:1, indicating that the main opioid precursor in the carotid body is proenkephalin A. Chronic denervations of the carotid body did not modify the levels or the degree of opioid precursor processing. Acute hypoxic exposure of the animals (8% O2 in N2; 3 h) resulted in a parallel decrease of dopamine and opioid activity, without any change in the degree of opioid processing. Norepinephrine levels were not affected by hypoxia. These findings suggest corelease of dopamine and opioids during natural hypoxic stimulation. In agreement with the analytical data, [D-Ala2, D-Leu5]enkephalin, but not [D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin, reduced the in vitro release of dopamine induced by low PO2, a high external K+ concentration, and dinitrophenol. Naloxone augmented the release response elicited by low PO2 stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8473894

  9. Effects of nitric oxide gas on cat carotid body chemosensory response to hypoxia.

    PubMed

    Iturriaga, R; Mosqueira, M; Villanueva, S

    2000-02-14

    It has been proposed that nitric oxide (NO) is an inhibitory modulator of carotid body (CB) chemoreception to hypoxia. However, the effects of NO gas on carotid chemoreception have not been tested yet. The role played by NO has been revealed by the use of pharmacological tools (i.e., NO donors and NO synthase inhibitors). Here, we studied the effects of NO gas (25 ppm in N(2)) on the chemosensory response to hypoxia (PO(2) approximately 30 Torr) in the cat CB perfused in vitro. During steady hypoxic chemoreceptor excitation, bolus injections or perfusion of Tyrode equilibrated with NO reduced the increased frequency of carotid chemosensory discharges (f(x)). Perfusion for 2 min of Tyrode equilibrated with NO also reduced the rate of the rise of the chemosensory response, as well as the maximal amplitude, as compared with the normal chemosensory response to hypoxia. Present results provide direct evidence that NO gas is an inhibitory modulator of CB hypoxic chemoreception. PMID:10677601

  10. Fractal analysis of the structural complexity of the connective tissue in human carotid bodies

    PubMed Central

    Guidolin, Diego; Porzionato, Andrea; Tortorella, Cinzia; Macchi, Veronica; De Caro, Raffaele

    2014-01-01

    The carotid body (CB) may undergo different structural changes during perinatal development, aging, or in response to environmental stimuli. In the previous literature, morphometric approaches to evaluate these changes have considered quantitative first order parameters, such as volumes or densities, while changes in spatial disposition and/or complexity of structural components have not yet been considered. In the present study, different strategies for addressing morphological complexity of CB, apart from the overall amount of each tissue component, were evaluated and compared. In particular, we considered the spatial distribution of connective tissue in the carotid bodies of young control subjects, young opiate-related deaths and aged subjects, through analysis of dispersion (Morisita's index), gray level co-occurrence matrix (entropy, angular second moment, variance, correlation), and fractal analysis (fractal dimension, lacunarity). Opiate-related deaths and aged subjects showed a comparable increase in connective tissue with respect to young controls. However, the Morisita's index (p < 0.05), angular second moment (p < 0.05), fractal dimension (p < 0.01), and lacunarity (p < 0.01) permitted to identify significant differences in the disposition of the connective tissue between these two series. A receiver operating characteristic (ROC) curve was also calculated to evaluate the efficiency of each parameter. The fractal dimension and lacunarity, with areas under the ROC curve of 0.9651 (excellent accuracy) and 0.8835 (good accuracy), respectively, showed the highest discriminatory power. They evidenced higher level of structural complexity in the carotid bodies of opiate-related deaths than old controls, due to more complex branching of intralobular connective tissue. Further analyses will have to consider the suitability of these approaches to address other morphological features of the CB, such as different cell populations, vascularization, and innervation

  11. Comparative gene expression profile of mouse carotid body and adrenal medulla under physiological hypoxia

    PubMed Central

    Ganfornina, MD; Pérez-García, MT; Gutiérrez, G; Miguel-Velado, E; López-López, JR; Marín, A; Sánchez, D; González, C

    2005-01-01

    The carotid body (CB) is an arterial chemoreceptor, bearing specialized type I cells that respond to hypoxia by closing specific K+ channels and releasing neurotransmitters to activate sensory axons. Despite having detailed information on the electrical and neurochemical changes triggered by hypoxia in CB, the knowledge of the molecular components involved in the signalling cascade of the hypoxic response is fragmentary. This study analyses the mouse CB transcriptional changes in response to low PO2 by hybridization to oligonucleotide microarrays. The transcripts were obtained from whole CBs after mice were exposed to either normoxia (21% O2), or physiological hypoxia (10% O2) for 24 h. The CB transcriptional profiles obtained under these environmental conditions were subtracted from the profile of control non-chemoreceptor adrenal medulla extracted from the same animals. Given the common developmental origin of these two organs, they share many properties but differ specifically in their response to O2. Our analysis revealed 751 probe sets regulated specifically in CB under hypoxia (388 up-regulated and 363 down-regulated). These results were corroborated by assessing the transcriptional changes of selected genes under physiological hypoxia with quantitative RT-PCR. Our microarray experiments revealed a number of CB-expressed genes (e.g. TH, ferritin and triosephosphate isomerase) that were known to change their expression under hypoxia. However, we also found novel genes that consistently changed their expression under physiological hypoxia. Among them, a group of ion channels show specific regulation in CB: the potassium channels Kir6.1 and Kcnn4 are up-regulated, while the modulatory subunit Kcnab1 is down-regulated by low PO2 levels. PMID:15890701

  12. Tetrodotoxin as a tool to elucidate sensory transduction mechanisms: the case for the arterial chemoreceptors of the carotid body.

    PubMed

    Rocher, Asuncion; Caceres, Ana Isabel; Obeso, Ana; Gonzalez, Constancio

    2011-12-01

    Carotid bodies (CBs) are secondary sensory receptors in which the sensing elements, chemoreceptor cells, are activated by decreases in arterial PO(2) (hypoxic hypoxia). Upon activation, chemoreceptor cells (also known as Type I and glomus cells) increase their rate of release of neurotransmitters that drive the sensory activity in the carotid sinus nerve (CSN) which ends in the brain stem where reflex responses are coordinated. When challenged with hypoxic hypoxia, the physiopathologically most relevant stimulus to the CBs, they are activated and initiate ventilatory and cardiocirculatory reflexes. Reflex increase in minute volume ventilation promotes CO(2) removal from alveoli and a decrease in alveolar PCO(2) ensues. Reduced alveolar PCO(2) makes possible alveolar and arterial PO(2) to increase minimizing the intensity of hypoxia. The ventilatory effect, in conjunction the cardiocirculatory components of the CB chemoreflex, tend to maintain an adequate supply of oxygen to the tissues. The CB has been the focus of attention since the discovery of its nature as a sensory organ by de Castro (1928) and the discovery of its function as the origin of ventilatory reflexes by Heymans' group (1930). A great deal of effort has been focused on the study of the mechanisms involved in O(2) detection. This review is devoted to this topic, mechanisms of oxygen sensing. Starting from a summary of the main theories evolving through the years, we will emphasize the nature and significance of the findings obtained with veratridine and tetrodotoxin (TTX) in the genesis of current models of O(2)-sensing. PMID:22363245

  13. Tetrodotoxin as a Tool to Elucidate Sensory Transduction Mechanisms: The Case for the Arterial Chemoreceptors of the Carotid Body

    PubMed Central

    Rocher, Asuncion; Caceres, Ana Isabel; Obeso, Ana; Gonzalez, Constancio

    2011-01-01

    Carotid bodies (CBs) are secondary sensory receptors in which the sensing elements, chemoreceptor cells, are activated by decreases in arterial PO2 (hypoxic hypoxia). Upon activation, chemoreceptor cells (also known as Type I and glomus cells) increase their rate of release of neurotransmitters that drive the sensory activity in the carotid sinus nerve (CSN) which ends in the brain stem where reflex responses are coordinated. When challenged with hypoxic hypoxia, the physiopathologically most relevant stimulus to the CBs, they are activated and initiate ventilatory and cardiocirculatory reflexes. Reflex increase in minute volume ventilation promotes CO2 removal from alveoli and a decrease in alveolar PCO2 ensues. Reduced alveolar PCO2 makes possible alveolar and arterial PO2 to increase minimizing the intensity of hypoxia. The ventilatory effect, in conjunction the cardiocirculatory components of the CB chemoreflex, tend to maintain an adequate supply of oxygen to the tissues. The CB has been the focus of attention since the discovery of its nature as a sensory organ by de Castro (1928) and the discovery of its function as the origin of ventilatory reflexes by Heymans group (1930). A great deal of effort has been focused on the study of the mechanisms involved in O2 detection. This review is devoted to this topic, mechanisms of oxygen sensing. Starting from a summary of the main theories evolving through the years, we will emphasize the nature and significance of the findings obtained with veratridine and tetrodotoxin (TTX) in the genesis of current models of O2-sensing. PMID:22363245

  14. [Intraventricular hemorrhage after carotid endarterectomy. Role of moyamoya-type collateral circulation].

    PubMed

    Masson, C; Martin, N; Masson, M; Cambier, J

    1986-01-01

    Stenotic lesions of the cervical arteries due to atherosclerosis or irradiation may provoke the development of a Moya-Moya type collateral network. Rupture of a vessel participating in this collateral circulation may be the cause of a hemorrhagic accident. The hemorrhage may be subarachnoid, intracerebral or more usually intraventricular. Intraventricular hemorrhage occurred in a patient who had developed a Moya-Moya type collateral circulation secondary to atherosclerotic stenosis of a carotid artery. The hemorrhagic incident occurred during carotid endarterectomy, suggesting a predisposing role for hemodynamic modifications resulting from the operation. PMID:3809859

  15. Effects of lifestyle modification on metabolic parameters and carotid intima-media thickness in patients with type 2 diabetes mellitus.

    PubMed

    Kim, So Hun; Lee, Suk Jeong; Kang, Eun Seok; Kang, Shinae; Hur, Kyu Yeon; Lee, Hyun Joo; Ahn, Chul Woo; Cha, Bong Soo; Yoo, Ji Soo; Lee, Hyun Chul

    2006-08-01

    The aim of this study was to examine the effects of a 6-month intensive lifestyle modification intervention on metabolic parameters and carotid intima-media thickness (IMT) in patients with type 2 diabetes mellitus. Fifty-eight subjects with type 2 diabetes mellitus were randomly assigned to the intervention group or the control group. The subjects in the intervention group participated in a 16-week intensive lifestyle modification program and subsequent monthly meetings during the 6-month study period. Control subjects received basic dietary education and usual care. Anthropometric data, metabolic parameters, and carotid IMT were examined before the intervention and after 6 months. Lifestyle modification intervention group patients showed a significant reduction in HbA1c (-1.0% +/- 1.3% vs +0.1% +/- 1.2%, P = .002), fasting blood glucose (-1.6 +/- 1.5 vs +0.3 +/- 2.5 mmol/L, P = .001), and 2-hour postprandial plasma glucose (-2.1 +/- 2.5 vs +0.8 +/- 4.4 mmol/L, P = .003) compared with control patients after 6 months. Body weight (-2.0 +/- 2.6 vs +0.2 +/- 1.7 kg, P = .001), body mass index (-0.8 +/- 1.0 vs 0.0 +/- 0.8 kg/m2, P = .003), and systolic blood pressure (-8.2 +/- 15.9 vs +0.4 +/- 14.1 mm Hg, P = .041) were significantly decreased in the intervention group. A significantly reduced carotid mean IMT progression was seen in the intervention group after 6 months (-0.040 +/- 0.136 vs +0.083 +/- 0.167 mm, P = .007). Changes in HbA1c (r = 0.34, P = .028), fasting plasma glucose (r = 0.31, P = .045), and 2-hour postprandial plasma glucose (r = 0.37, P = .015) correlated with the mean carotid IMT change after adjustment for age and sex. In conclusion, a 6-month intensive lifestyle modification intervention in patients with type 2 diabetes mellitus resulted in improved glycemic control and decreased progression of carotid IMT. PMID:16839841

  16. The human carotid body transcriptome with focus on oxygen sensing and inflammation – a comparative analysis

    PubMed Central

    Mkrtchian, Souren; Kåhlin, Jessica; Ebberyd, Anette; Gonzalez, Constancio; Sanchez, Diego; Balbir, Alexander; Kostuk, Eric W; Shirahata, Machiko; Fagerlund, Malin Jonsson; Eriksson, Lars I

    2012-01-01

    The carotid body (CB) is the key oxygen sensing organ. While the expression of CB specific genes is relatively well studied in animals, corresponding data for the human CB are missing. In this study we used five surgically removed human CBs to characterize the CB transcriptome with microarray and PCR analyses, and compared the results with mice data. In silico approaches demonstrated a unique gene expression profile of the human and mouse CB transcriptomes and an unexpected upregulation of both human and mouse CB genes involved in the inflammatory response compared to brain and adrenal gland data. Human CBs express most of the genes previously proposed to be involved in oxygen sensing and signalling based on animal studies, including NOX2, AMPK, CSE and oxygen sensitive K+ channels. In the TASK subfamily of K+ channels, TASK-1 is expressed in human CBs, while TASK-3 and TASK-5 are absent, although we demonstrated both TASK-1 and TASK-3 in one of the mouse reference strains. Maxi-K was expressed exclusively as the spliced variant ZERO in the human CB. In summary, the human CB transcriptome shares important features with the mouse CB, but also differs significantly in the expression of a number of CB chemosensory genes. This study provides key information for future functional investigations on the human carotid body. PMID:22615433

  17. Sclerosing paraganglioma of the carotid body: a potential pitfall of malignancy.

    PubMed

    Santi, Raffaella; Franchi, Alessandro; Saladino, Valeria; Trovati, Massimo; Cenacchi, Giovanna; Squadrelli-Saraceno, Massimo; Nesi, Gabriella

    2015-06-01

    Paragangliomas (PGs) of the head and neck region are typically benign, slow-growing neuroendocrine tumours. At times, they may exhibit unusual histological features, such as prominent stromal sclerosis (sclerosing PG), which may raise concerns of malignancy. We describe a case of sclerosing PG of the carotid body, emphasizing the value of immunohistochemical stains for differential diagnosis. A 43-year-old woman presented with a painless lump on the neck. A magnetic resonance imaging scan demonstrated a hypervascular lesion of the carotid body, which was surgically excised. Grossly, the lesion measured 1.8 cm at maximum diameter. On microscopic examination, irregular nests and tiny bundles of neoplastic cells were found between thick bands of fibrous tissue. Focal nuclear cytomegaly and marked pleomorphism were noted. Neoplastic cells proved to be immunoreactive for chromogranin, synaptophysin and neuron specific enolase, but negative for cytokeratins, smooth muscle actin and CD34. Ultrastructurally, numerous mitochondria, rough endoplasmic reticulum structures and endocrine granules were seen in the cytoplasm of the tumour cells. On consideration of the above-mentioned clinico-pathological and ultrastructural findings a diagnosis of sclerosing PG was established. Sclerosing PG is a rare entity which may mimic a malignant neoplasm. The recognition of this unusual morphological variant of PG, together with appropriate immunostains, leads to the correct diagnosis. PMID:25194351

  18. Peptide receptor radionuclide therapy with (177)Lu DOTATATE in a case of recurrent carotid body paraganglioma with spinal metastases.

    PubMed

    Gupta, Santosh Kumar; Singla, Suhas; Karunanithi, Sellam; Damle, Nishikant; Bal, Chandrasekhar

    2014-05-01

    Paragangliomas are rare benign neuroendocrine tumors, and 80% of all paragangliomas are either carotid body tumors or glomus jugulare tumors. We present a case of recurrent unresectable carotid body paraganglioma with nodal and T7 vertebral metastases in a 30-year-old man 6 years postsurgery detected with Ga DOTANOC PET/CT and was administered with peptide receptor radionuclide therapy using Lu DOTATATE. After 5 cycles of Lu DOTATATE (total cumulative activity of 750 mCi [27 GBq]), significant response at the primary site on Ga DOTANOC PET/CT and complete disappearance of nodal and T7 vertebral metastases were noted. PMID:24217545

  19. The relationship between distribution of body fat mass and carotid artery intima-media thickness in Korean older adults.

    PubMed

    Park, Jin-Kee; Park, Hyuntae; Kim, Kwi-Baek

    2015-10-01

    [Purpose] The aim of this study was to examine the relationships between the amount and distribution of body fat and the carotid intima-media thickness to explore whether coronary artery disease risk may be mediated through effects on the amount of fat mass in older adults. [Subjects and Methods] A total of 200 elderly females was participated. The percentage of body fat mass was measured by the bioelectrical impedance analysis method, and the carotid intima-media thickness was measured by B-mode ultrasound. Analysis of covariance was performed to assess independent associations between the four categories of percentage of body fat mass and the carotid intima-media thickness after multivariate adjustment. Logistic regression analyses were utilized to calculate odds ratios and 95% confidence intervals for examining independent associations between percentage of body fat mass and the estimated risk of coronary artery disease. [Results] Analysis of covariance showed that the carotid intima-media thickness was significantly thick in both obesity and overweight groups. When multivariate-adjusted OR for the estimated risk of coronary artery disease, the odds ratios for the obesity and overweight groups were 3.0 (95% confidence interval, 1.1 to 8.7) and 2.5 (95% confidence interval, 1.0 to 6.1), respectively. [Conclusion] This study demonstrates that elderly females with a high body fat mass are more likely to have the estimated risk of CAD than who fit body fat mass in elderly female. PMID:26633917

  20. The relationship between distribution of body fat mass and carotid artery intima-media thickness in Korean older adults

    PubMed Central

    Park, Jin-Kee; Park, Hyuntae; Kim, Kwi-Baek

    2015-01-01

    [Purpose] The aim of this study was to examine the relationships between the amount and distribution of body fat and the carotid intima-media thickness to explore whether coronary artery disease risk may be mediated through effects on the amount of fat mass in older adults. [Subjects and Methods] A total of 200 elderly females was participated. The percentage of body fat mass was measured by the bioelectrical impedance analysis method, and the carotid intima-media thickness was measured by B-mode ultrasound. Analysis of covariance was performed to assess independent associations between the four categories of percentage of body fat mass and the carotid intima-media thickness after multivariate adjustment. Logistic regression analyses were utilized to calculate odds ratios and 95% confidence intervals for examining independent associations between percentage of body fat mass and the estimated risk of coronary artery disease. [Results] Analysis of covariance showed that the carotid intima-media thickness was significantly thick in both obesity and overweight groups. When multivariate-adjusted OR for the estimated risk of coronary artery disease, the odds ratios for the obesity and overweight groups were 3.0 (95% confidence interval, 1.1 to 8.7) and 2.5 (95% confidence interval, 1.0 to 6.1), respectively. [Conclusion] This study demonstrates that elderly females with a high body fat mass are more likely to have the estimated risk of CAD than who fit body fat mass in elderly female. PMID:26633917

  1. H2S production by reactive oxygen species in the carotid body triggers hypertension in a rodent model of sleep apnea.

    PubMed

    Yuan, Guoxiang; Peng, Ying-Jie; Khan, Shakil A; Nanduri, Jayasri; Singh, Amritha; Vasavda, Chirag; Semenza, Gregg L; Kumar, Ganesh K; Snyder, Solomon H; Prabhakar, Nanduri R

    2016-01-01

    Sleep apnea is a prevalent respiratory disease in which episodic cessation of breathing causes intermittent hypoxia. Patients with sleep apnea and rodents exposed to intermittent hypoxia exhibit hypertension. The carotid body senses changes in blood O2 concentrations, and an enhanced carotid body chemosensory reflex contributes to hypertension in sleep apnea patients. A rodent model of intermittent hypoxia that mimics blood O2 saturation profiles of patients with sleep apnea has shown that increased generation of reactive oxygen species (ROS) in the carotid body enhances the chemosensory reflex and triggers hypertension. CO generated by heme oxygenase-2 (HO-2) induces a signaling pathway that inhibits hydrogen sulfide (H2S) production by cystathionine γ-lyase (CSE), leading to suppression of carotid body activity. We found that ROS inhibited CO generation by HO-2 in the carotid body and liver through a mechanism that required Cys(265) in the heme regulatory motif of heterologously expressed HO-2. We showed that ROS induced by intermittent hypoxia inhibited CO production and increased H2S concentrations in the carotid body, which stimulated its neural activity. In rodents, blockade of H2S synthesis by CSE, by either pharmacologic or genetic approaches, inhibited carotid body activation and hypertension induced by intermittent hypoxia. Thus, our results indicate that oxidant-induced inactivation of HO-2, which leads to increased CSE-dependent H2S production in the carotid body, is a critical trigger of hypertension in rodents exposed to intermittent hypoxia. PMID:27531649

  2. Effects of cyanide and uncouplers on chemoreceptor activity and ATP content of the cat carotid body.

    PubMed

    Obeso, A; Almaraz, L; Gonzalez, C

    1989-03-01

    In cat carotid bodies (c.b.'s) incubated in vitro with [3H]tyrosine to label the stores of catecholamines, it was found that CN promotes dose- and Ca2+-dependent release of [3H]dopamine (DA) from c.b. tissues in parallel to the increased electrical activity recorded from the carotid sinus nerve (c.s.n.). Two different uncouplers, dinitrophenol (DNP) and carbonyl-cyanide-m-chlorophenyl-hydrazone (CCCP), both activate also in a dose-dependent fashion, release of DA and electrical activity in the c.s.n. However, while cyanide (CN) (10(-4) M) applied during 5 min reduced the adenosine triphosphate (ATP) content of the c.b. by 45%, DNP (2.5 x 10(-4) M) and CCCP (10(-6) M) applied for the same period of time did not modify the ATP levels of the organ. At the above concentrations, the 3 agents increased about 8-fold the electrical activity recorded from the c.s.n. Thus, contrary to the postulates of the metabolic hypotheses, our findings indicate that the decrease in the ATP content in the c.b. is not a prerequisite for the activation of the chemoreceptors. We propose alternative mechanisms to explain the chemostimulant action of the metabolic poisons. PMID:2720379

  3. Inhibitory effects of NO on carotid body: contribution of neural and endothelial nitric oxide synthase isoforms.

    PubMed

    Valdés, Viviana; Mosqueira, Matías; Rey, Sergio; Del Rio, Rodrigo; Iturriaga, Rodrigo

    2003-01-01

    We tested the hypothesis that nitric oxide (NO) produced within the carotid body is a tonic inhibitor of chemoreception and determined the contribution of neuronal and endothelial nitric oxide synthase (eNOS) isoforms to the inhibitory NO effect. Accordingly, we studied the effect of NO generated from S-nitroso-N-acetylpenicillamide (SNAP) and compared the effects of the nonselective inhibitor N(omega)-nitro-l-arginine methyl ester (l-NAME) and the selective nNOS inhibitor 1-(2-trifluoromethylphenyl)-imidazole (TRIM) on chemosensory dose-response curves induced by nicotine and NaCN and responses to hypoxia (Po(2) approximately 30 Torr). CBs excised from pentobarbitone-anesthetized cats were perfused in vitro with Tyrode at 38 degrees C and pH 7.40, and chemosensory discharges were recorded from the carotid sinus nerve. SNAP (100 microM) reduced the responses to nicotine and NaCN. l-NAME (1 mM) enhanced the responses to nicotine and NaCN by increasing their duration, but TRIM (100 microM) only enhanced the responses to high doses of NaCN. The amplitude of the response to hypoxia was enhanced by l-NAME but not by TRIM. Our results suggest that both isoforms contribute to the NO action, but eNOS being the main source for NO in the cat CB and exerting a tonic effect upon chemoreceptor activity. PMID:12388352

  4. Carotid body chemosensory excitation induced by nitric oxide: involvement of oxidative metabolism.

    PubMed

    Mosqueira, Matias; Iturriaga, Rodrigo

    2002-08-01

    Nitric oxide (NO) produces a dual effect on carotid body (CB) oxygen chemoreception. At low concentration, NO inhibits chemosensory response to hypoxia, while in normoxia, medium and high [NO] increases the frequency of carotid chemosensory discharges (f(x)). Since NO and peroxynitrite inhibit mitochondrial respiration, it is plausible that the NO-induced excitation may depend on the mitochondrial oxidative metabolism. To test this hypothesis, we studied the effects of oligomycin, FCCP and antimycin A that produce selective blockade of hypoxic and NaCN-induced chemosensory responses, leaving nicotinic response less affected. CBs excised from pentobarbitone-anaesthetised cats were perfused in vitro with Tyrode (P(O(2)) approximately 125 Torr, pH 7.40 at 38 degrees C). Hypoxia (P(O(2)) approximately equal 30 Torr), NaCN and nicotine (1-100 microg) and S-nitroso-N-acetylpenicillamide (SNAP, 300-600 microg) increased f(x). Oligomycin (12.5-25 microg), antimycin A (10 microg) and FCCP (5 microM) transiently increased f(x). Subsequently, chemosensory responses to hypoxia, NaCN and SNAP were reduced or abolished, while the response to nicotine was less affected. The electron donor system tetramethyl-p-phenylene diamide and ascorbate that bypasses the electron chain blockade produced by antimycin A, restores the excitatory responses to NaCN and SNAP. Present results suggest that the chemoexcitatory effect of NO depends on the integrity of mitochondrial metabolism. PMID:12126919

  5. Hypoxic pulmonary vasoconstriction, carotid body function and erythropoietin production in adult rats perinatally exposed to hyperoxia

    PubMed Central

    Prieto-Lloret, Jesus; Ramirez, Maria; Olea, Elena; Moral-Sanz, Javier; Cogolludo, Angel; Castañeda, Javier; Yubero, Sara; Agapito, Teresa; Gomez-Niño, Angela; Rocher, Asuncion; Rigual, Ricardo; Obeso, Ana; Perez-Vizcaino, Francisco; González, Constancio

    2015-01-01

    Adult mammalians possess three cell systems that are activated by acute bodily hypoxia: pulmonary artery smooth muscle cells (PASMC), carotid body chemoreceptor cells (CBCC) and erythropoietin (EPO)-producing cells. In rats, chronic perinatal hyperoxia causes permanent carotid body (CB) atrophy and functional alterations of surviving CBCC. There are no studies on PASMC or EPO-producing cells. Our aim is to define possible long-lasting functional changes in PASMC or EPO-producing cells (measured as EPO plasma levels) and, further, to analyse CBCC functional alterations. We used 3- to 4-month-old rats born and reared in a normal atmosphere or exposed to perinatal hyperoxia (55–60% O2 for the last 5–6 days of pregnancy and 4 weeks after birth). Perinatal hyperoxia causes an almost complete loss of hypoxic pulmonary vasoconstriction (HPV), which was correlated with lung oxidative status in early postnatal life and prevented by antioxidant supplementation in the diet. O2-sensitivity of K+ currents in the PASMC of hyperoxic animals is normal, indicating that their inhibition is not sufficient to trigger HPV. Perinatal hyperoxia also abrogated responses elicited by hypoxia on catecholamine and cAMP metabolism in the CB. An increase in EPO plasma levels elicited by hypoxia was identical in hyperoxic and control animals, implying a normal functioning of EPO-producing cells. The loss of HPV observed in adult rats and caused by perinatal hyperoxia, comparable to oxygen therapy in premature infants, might represent a previously unrecognized complication of such a medical intervention capable of aggravating medical conditions such as regional pneumonias, atelectases or general anaesthesia in adult life. Key points Adult animals that have been perinatally exposed to oxygen-rich atmospheres (hyperoxia), recalling those used for oxygen therapy in infants, exhibit a loss of hypoxic pulmonary vasoconstriction, whereas vasoconstriction elicited by depolarizing agents is

  6. Acrolein inhalation alters arterial blood gases and triggers carotid body-mediated cardiovascular responses in hypertensive rats

    PubMed Central

    Perez, Christina M.; Hazari, Mehdi S.; Ledbetter, Allen D.; Haykal-Coates, Najwa; Carll, Alex P.; Cascio, Wayne E.; Winsett, Darrell W.; Costa, Daniel L.; Farraj, Aimen K.

    2016-01-01

    Context Air pollution exposure affects autonomic function, heart rate, blood pressure and left ventricular function. While the mechanism for these effects is uncertain, several studies have reported that air pollution exposure modifies activity of the carotid body, the major organ that senses changes in arterial oxygen and carbon dioxide levels, and elicits downstream changes in autonomic control and cardiac function. Objective We hypothesized that exposure to acrolein, an unsaturated aldehyde and mucosal irritant found in cigarette smoke and diesel exhaust, would activate the carotid body chemoreceptor response and lead to secondary cardiovascular responses in rats. Materials and methods Spontaneously hypertensive (SH) rats were exposed once for 3 h to 3 ppm acrolein gas or filtered air in whole body plethysmograph chambers. To determine if the carotid body mediated acrolein-induced cardiovascular responses, rats were pretreated with an inhibitor of cystathionine γ-lyase (CSE), an enzyme essential for carotid body signal transduction. Results Acrolein exposure induced several cardiovascular effects. Systolic, diastolic and mean arterial blood pressure increased during exposure, while cardiac contractility decreased 1 day after exposure. The cardiovascular effects were associated with decreases in pO2, breathing frequency and expiratory time, and increases in sympathetic tone during exposure followed by parasympathetic dominance after exposure. The CSE inhibitor prevented the cardiovascular effects of acrolein exposure. Discussion and conclusion Pretreatment with the CSE inhibitor prevented the cardiovascular effects of acrolein, suggesting that the cardiovascular responses with acrolein may be mediated by carotid body-triggered changes in autonomic tone. (This abstract does not reflect EPA policy.) PMID:25600140

  7. Volatile Anaesthetic Depression of the Carotid Body Chemoreflex-Mediated Ventilatory Response to Hypoxia: Directions for Future Research

    PubMed Central

    Pandit, J. J.

    2014-01-01

    In assessing whether volatile anaesthetics directly depress the carotid body response to hypoxia it is necessary to combine in meta-analysis studies of when it is “functionally isolated” (e.g., recordings are made from its afferent nerve). Key articles were retrieved (full papers in English) and subjected to quantitative analysis to yield an aggregate estimate of effect. Results from articles that did not use such methodology were assessed separately from this quantitative approach, to see what could be learned also from a nonquantitative overview. Just 7 articles met the inclusion criteria for hypoxia and just 6 articles for hypercapnia. Within these articles, the anaesthetic (mean dose 0.75, standard deviation (SD) 0.40 minimum alveolar concentration, MAC) statistically significantly depressed carotid body hypoxic response by 24% (P = 0.041), but a similar dose (mean 0.81 (0.42) MAC) did not affect the hypercapnic response. The articles not included in the quantitative analysis (31 articles), assessed qualitatively, also indicated that anaesthetics depress carotid body function. This conclusion helps direct future research on the anaesthetic effects on putative cellular/molecular processes that underlie the transduction of hypoxia in the carotid body. PMID:24808974

  8. Relevance of the Carotid Body Chemoreflex in the Progression of Heart Failure

    PubMed Central

    Andrade, David C.; Lucero, Claudia; Toledo, Camilo; Madrid, Carlos; Marcus, Noah J.; Schultz, Harold D.; Del Rio, Rodrigo

    2015-01-01

    Chronic heart failure (CHF) is a global health problem affecting millions of people. Autonomic dysfunction and disordered breathing patterns are commonly observed in patients with CHF, and both are strongly related to poor prognosis and high mortality risk. Tonic activation of carotid body (CB) chemoreceptors contributes to sympathoexcitation and disordered breathing patterns in experimental models of CHF. Recent studies show that ablation of the CB chemoreceptors improves autonomic function and breathing control in CHF and improves survival. These exciting findings indicate that alterations in CB function are critical to the progression of CHF. Therefore, better understanding of the physiology of the CB chemoreflex in CHF could lead to improvements in current treatments and clinical management of patients with CHF characterized by high chemosensitivity. Accordingly, the main focus of this brief review is to summarize current knowledge of CB chemoreflex function in different experimental models of CHF and to comment on their potential translation to treatment of human CHF. PMID:26779536

  9. Brainstem PCO2 modulates phrenic responses to specific carotid body hypoxia in an in situ dual perfused rat preparation

    PubMed Central

    Day, Trevor A; Wilson, Richard J A

    2007-01-01

    Inputs from central (brainstem) and peripheral (carotid body) respiratory chemoreceptors are coordinated to protect blood gases against potentially deleterious fluctuations. However, the mathematics of the steady-state interaction between chemoreceptors has been difficult to ascertain. Further, how this interaction affects time-dependent phenomena (in which chemoresponses depend upon previous experience) is largely unknown. To determine how central PCO2 modulates the response to peripheral chemostimulation in the rat, we utilized an in situ arterially perfused, vagotomized, decerebrate preparation, in which central and peripheral chemoreceptors were perfused separately (i.e. dual perfused preparation (DPP)). We carried out two sets of experiments: in Experiment 1, we alternated steady-state brainstem PCO2 between 25 and 50 Torr in each preparation, and applied specific carotid body hypoxia (60 Torr PO2 and 40 Torr PCO2) under both conditions; in Experiment 2, we applied four 5 min bouts (separated by 5 min) of specific carotid body hypoxia (60 Torr PO2 and 40 Torr PCO2) while holding the brainstem at either 30 Torr or 50 Torr PCO2. We demonstrate that the level of brainstem PCO2 modulates (a) the magnitude of the phrenic responses to a single step of specific carotid body hypoxia and (b) the magnitude of time-dependent phenomena. We report that the interaction between chemoreceptors is negative (i.e. hypo-additive), whereby a lower brainstem PCO2 augments phrenic responses resulting from specific carotid body hypoxia. A negative interaction may underlie the pathophysiology of central sleep apnoea in populations that are chronically hypocapnic. PMID:17082232

  10. EPAC signalling pathways are involved in low PO2 chemoreception in carotid body chemoreceptor cells

    PubMed Central

    Rocher, Asuncion; Caceres, Ana I; Almaraz, Laura; Gonzalez, Constancio

    2009-01-01

    Chemoreceptor cells of the carotid bodies (CB) are activated by hypoxia and acidosis, responding with an increase in their rate of neurotransmitter release, which in turn increases the electrical activity in the carotid sinus nerve and evokes a homeostatic hyperventilation. Studies in isolated chemoreceptor cells have shown that moderate hypoxias (≈ 46 mmHg) produces smaller depolarisations and comparable Ca2+ transients but a much higher catecholamine (CA) release response in intact CBs than intense acidic/hypercapnic stimuli (20% CO2, pH 6.6). Similarly, intense hypoxia (≈ 20 mmHg) produces smaller depolarizations and Ca2+ transients in isolated chemoreceptor cells but a higher CA release response in intact CBs than a pure depolarizing stimulus (30–35 mm external K+). Studying the mechanisms responsible for these differences we have found the following. (1) Acidic hypercapnia inhibited ICa (∼60%; whole cell) and CA release (∼45%; intact CB) elicited by ionomycin and high K+. (2) Adenylate cyclase inhibition (SQ-22536; 80 μm) inhibited the hypoxic release response (>50%) and did not affect acidic/hypercapnic release, evidencing that the high gain of hypoxia to elicit neurotransmitter release is cAMP dependent. (3) The last effect was independent of PKA activation, as three kinase inhibitors (H-89, KT 5720 and Rp-cAMP; ≥ 10 × IC50) did not alter the hypoxic release response. (4) The Epac (exchange protein activated by cAMP) activator (8-pCPT-2′-O-Me-cAMP, 100 μm) reversed the effects of the cyclase inhibitor. (5) The Epac inhibitor brefeldin A (100 μm) inhibited (54%) hypoxic induced release. Our findings show for the first time that an Epac-mediated pathway mediates O2 sensing/transduction in chemoreceptor cells. PMID:19581380

  11. Vitamin D, carotid intima–media thickness and bone structure in patients with type 2 diabetes

    PubMed Central

    Winckler, Karoline; Tarnow, Lise; Lundby-Christensen, Louise; Almdal, Thomas P; Wiinberg, Niels; Eiken, Pia; Boesgaard, Trine W

    2015-01-01

    Despite aggressive treatment of cardiovascular disease (CVD) risk factors individuals with type 2 diabetes (T2D) still have increased risk of cardiovascular morbidity and mortality. The primary aim of this study was to examine the cross-sectional association between total (25-hydroxy vitamin D (25(OH)D)) and risk of CVD in patients with T2D. Secondary objective was to examine the association between 25(OH)D and bone health. A Danish cohort of patients with T2D participating in a randomised clinical trial were analysed. In total 415 patients (68% men, age 60±9 years (mean±s.d.), duration of diabetes 12±6 years), including 294 patients (71%) treated with insulin. Carotid intima–media thickness (IMT) and arterial stiffness (carotid artery distensibility coefficient (DC) and Young's elastic modulus (YEM)) were measured by ultrasound scan as indicators of CVD. Bone health was assessed by bone mineral density and trabecular bone score measured by dual energy X-ray absorptiometry. In this cohort, 214 patients (52%) were vitamin D deficient (25(OH)D <50 nmol/l). Carotid IMT was 0.793±0.137 mm, DC was 0.0030±0.001 mmHg, YEM was 2354±1038 mmHg and 13 (3%) of the patients were diagnosed with osteoporosis. A 25(OH)D level was not associated with carotid IMT or arterial stiffness (P>0.3) or bone health (P>0.6) after adjustment for CVD risk factors. In conclusion, 25(OH)D status was not associated with carotid IMT, arterial stiffness or bone health in this cohort of patients with T2D. To explore these associations and the association with other biomarkers further, multicentre studies with large numbers of patients are required. PMID:25956908

  12. Carotid body denervation improves autonomic and cardiac function and attenuates disordered breathing in congestive heart failure

    PubMed Central

    Marcus, Noah J; Rio, Rodrigo; Schultz, Evan P; Xia, Xiao-Hong; Schultz, Harold D

    2014-01-01

    In congestive heart failure (CHF), carotid body (CB) chemoreceptor activity is enhanced and is associated with oscillatory (Cheyne–Stokes) breathing patterns, increased sympathetic nerve activity (SNA) and increased arrhythmia incidence. We hypothesized that denervation of the CB (CBD) chemoreceptors would reduce SNA, reduce apnoea and arrhythmia incidence and improve ventricular function in pacing-induced CHF rabbits. Resting breathing, renal SNA (RSNA) and arrhythmia incidence were measured in three groups of animals: (1) sham CHF/sham–CBD (sham–sham); (2) CHF/sham–CBD (CHF–sham); and (3) CHF/CBD (CHF–CBD). Chemoreflex sensitivity was measured as the RSNA and minute ventilatory () responses to hypoxia and hypercapnia. Respiratory pattern was measured by plethysmography and quantified by an apnoea–hypopnoea index, respiratory rate variability index and the coefficient of variation of tidal volume. Sympatho-respiratory coupling (SRC) was assessed using power spectral analysis and the magnitude of the peak coherence function between tidal volume and RSNA frequency spectra. Arrhythmia incidence and low frequency/high frequency ratio of heart rate variability were assessed using ECG and blood pressure waveforms, respectively. RSNA and responses to hypoxia were augmented in CHF–sham and abolished in CHF–CBD animals. Resting RSNA was greater in CHF–sham compared to sham–sham animals (43 ± 5% max vs. 23 ± 2% max, P < 0.05), and this increase was not found in CHF–CBD animals (25 ± 1% max, P < 0.05 vs. CHF–sham). Low frequency/high frequency heart rate variability ratio was similarly increased in CHF and reduced by CBD (P < 0.05). Respiratory rate variability index, coefficient of variation of tidal volume and apnoea–hypopnoea index were increased in CHF–sham animals and reduced in CHF–CBD animals (P < 0.05). SRC (peak coherence) was increased in CHF–sham animals (sham–sham 0.49 ± 0.05; CHF–sham 0.79

  13. Oxygen sensing by the carotid body: mechanisms and role in adaptation to hypoxia.

    PubMed

    López-Barneo, José; González-Rodríguez, Patricia; Gao, Lin; Fernández-Agüera, M Carmen; Pardal, Ricardo; Ortega-Sáenz, Patricia

    2016-04-15

    Oxygen (O2) is fundamental for cell and whole-body homeostasis. Our understanding of the adaptive processes that take place in response to a lack of O2(hypoxia) has progressed significantly in recent years. The carotid body (CB) is the main arterial chemoreceptor that mediates the acute cardiorespiratory reflexes (hyperventilation and sympathetic activation) triggered by hypoxia. The CB is composed of clusters of cells (glomeruli) in close contact with blood vessels and nerve fibers. Glomus cells, the O2-sensitive elements in the CB, are neuron-like cells that contain O2-sensitive K(+)channels, which are inhibited by hypoxia. This leads to cell depolarization, Ca(2+)entry, and the release of transmitters to activate sensory fibers terminating at the respiratory center. The mechanism whereby O2modulates K(+)channels has remained elusive, although several appealing hypotheses have been postulated. Recent data suggest that mitochondria complex I signaling to membrane K(+)channels plays a fundamental role in acute O2sensing. CB activation during exposure to low Po2is also necessary for acclimatization to chronic hypoxia. CB growth during sustained hypoxia depends on the activation of a resident population of stem cells, which are also activated by transmitters released from the O2-sensitive glomus cells. These advances should foster further studies on the role of CB dysfunction in the pathogenesis of highly prevalent human diseases. PMID:26764048

  14. Carotid artery intima-media thickness and distensibility in children and adolescents: reference values and role of body dimensions.

    PubMed

    Doyon, Anke; Kracht, Daniela; Bayazit, Aysun K; Deveci, Murat; Duzova, Ali; Krmar, Rafael T; Litwin, Mieczyslaw; Niemirska, Anna; Oguz, Berna; Schmidt, Bernhard M W; Sözeri, Betul; Querfeld, Uwe; Melk, Anette; Schaefer, Franz; Wühl, Elke

    2013-09-01

    Carotid intima-media thickness (cIMT) and carotid artery distensibility are reliable screening methods for vascular alterations and the assessment of cardiovascular risk in adult and pediatric cohorts. We sought to establish an international reference data set for the childhood and adolescence period and explore the impact of developmental changes in body dimensions and blood pressure (BP) on carotid wall thickness and elasticity. cIMT, the distensibility coefficient, the incremental modulus of elasticity, and the stiffness index β were assessed in 1155 children aged 6 to 18 years and sex-specific reference charts normalized to age or height were constructed from 1051 nonobese and nonhypertensive children. The role of body dimensions, BP, and family history, as well as the association between cIMT and distensibility, was investigated. cIMT increased and distensibility decreased with age, height, body mass index, and BP. A significant sex difference was apparent from the age of 15 years. Age- and height-normalized cIMT and distensibility values differed in children who are short or tall for their age. By stepwise multivariate analysis, standardized systolic BP and body mass index were independently positively associated with cIMT SD scores (SDS). Systolic BP SDS independently predicted all distensibility measures. Distensibility coefficient SDS was negatively and β SDS positively associated with cIMT SDS, whereas incremental modulus of elasticity was independent of cIMT. Morphological and functional aspects of the common carotid artery are particularly influenced by age, body dimensions, and BP. The reference charts established in this study allow to accurately compare vascular phenotypes of children with chronic conditions with those of healthy children. PMID:23817494

  15. Extracellular potassium and chemosensitivity in the rat carotid body, in vitro.

    PubMed Central

    Pepper, D R; Landauer, R C; Kumar, P

    1996-01-01

    1. The effects of raising extracellular potassium concentration ([K+]o) from 3.0 to 5.3, 9.5 or 16.8 mM on chemoreceptor responses to hypoxia, hypercapnia and asphyxia were examined in a superfused in vitro rat carotid body preparation. 2. Single-exponential functions with offset were fitted to the chemoreceptor discharge responses to ramp decreases in Po2. Increasing [K+]o was without effect upon the rate constants of the fitted exponential functions (P > 0.20). Increasing [K+]o, significantly increased the horizontal asymptote (chemoreceptor discharge in hyperoxia) in a non-linear fashion when all levels of [K+]o were included in the analysis (P < 0.001) but not when a comparison was made only between 3.0 and 5.3 mM Ko+ (P > 0.40). The rightward position of the response curves, as quantified by the Po2 at 50% maximum discharge, was linearly related to [K+]o but only when all levels of [K+]o were included in the analysis (P < 0.03). Chemoreceptor sensitivity to [K+]o increased non-linearly as [K+]o was increased but this effect was not dependent upon the Po2 (P > 0.90). 4. Increasing PCO2 in hyperoxia increased chemoreceptor discharge linearly at all levels of [K+]o. Whilst discharge at any level of PCO2 was elevated by increased levels of [K+]o, raising [K+]o did not increase CO2 sensitivity (P > 0.20). Similarly, increasing PCO2 did not increase chemosensitivity to [K+]o. The lack of effect of [K+]o upon CO2 chemosensitivity was also observed as Po2 was decreased to hypoxic levels (P > 0.10). 5. Our data demonstrate that an elevation of [K+]o can increase chemoreceptor discharge in the in vitro carotid body in a PO2- and PCO2-independent manner, suggesting that the PO2-dependent effects of [K+]o, previously reported in vivo may be due to other indirect effects of [K+]o or hypoxia. PMID:8799903

  16. Almitrine has no effect on gas exchange after bilateral carotid body resection in severe chronic airflow obstruction.

    PubMed

    De Backer, W; Vermeire, P; Bogaert, E; Janssens, E; Van Maele, R

    1985-01-01

    Using a double-blind cross-over design, a single dose of 100 mg almitrine bismesylate and placebo were administered orally to eight patients with chronic airflow obstruction having undergone bilateral carotid body resection (BCBR) up to two years earlier to alleviate their extreme dyspnoea. In an open study, two other patients have been given almitrine before and three weeks after BCBR. In all patients, arterial blood gases, ventilation and breathing patterns, neuromuscular drive and hypoxic responsiveness have been studied before and three hours after drug administration. Almitrine failed to improve gas exchange in the patients with BCBR, nor did it affect ventilation, ventilatory or hypoxic drive. In the patients studied before and after BCBR, almitrine only improved gas exchange significantly before BCBR. It is concluded that in man almitrine acts solely as a peripheral chemoreceptor agonist and that the well-documented improvement in V/Q relationship is mediated through carotid body stimulation. PMID:3904873

  17. Neuroprotective and reparative effects of carotid body grafts in a chronic MPTP model of Parkinson's disease.

    PubMed

    Muñoz-Manchado, Ana B; Villadiego, Javier; Suárez-Luna, Nela; Bermejo-Navas, Alfonso; Garrido-Gil, Pablo; Labandeira-García, José L; Echevarría, Miriam; López-Barneo, José; Toledo-Aral, Juan J

    2013-03-01

    Intrastriatal transplantation of dopaminergic carotid body (CB) cells ameliorates parkinsonism in animal models and, with less efficacy, in Parkinson's disease patients. CB-based cell therapy was initially proposed because of its high dopamine content. However, later studies suggested that its beneficial effect might be due to a trophic action exerted on nigrostriatal neurons. Compatible with this concept are the high levels of neurotrophic factors encountered in CB cells. To test experimentally this idea, unilateral striatal transplants were performed with a sham graft in the contralateral striatum, as a robust internal control. Thereafter, the dopaminergic neurotoxin 1-methyl-4-phenyl-1,2,3,6, -tetrahydropyridine was injected during 3 months. CB grafts protected from degeneration ipsilateral nigral dopaminergic neurons projecting to the transplant in a dose-dependent manner regarding size and glial cell line-derived neurotrophic factor expression. Grafts performed at different times after the onset of the neurotoxic treatment demonstrated with histological and behavioral methods protection and repair of the nigrostriatal pathway by CB transplants. This study provides a mechanistic explanation for the action of CB transplants on parkinsonian models. It should also help to improve cell therapy approaches to Parkinson's disease. PMID:22743091

  18. Histochemical demonstration of tripeptidyl aminopeptidase I in the rat carotid body.

    PubMed

    Atanasova, Dimitrinka; Lazarov, Nikolai

    2015-03-01

    Tripeptidyl aminopeptidase I (TPP I) is a lysosomal exopeptidase that is widely distributed throughout the central nervous system (CNS) and internal organs in many mammalian species. The enzyme is involved in the breakdown of collagen and different peptides. The carotid body (CB) is the main peripheral arterial chemoreceptor playing an important role in the control of breathing and the autonomic control of cardiovascular function. In response to hypoxia its neuron-like glomus cells release a variety of peptide transmitters that trigger an action potential through the afferent fibers, thus conveying the chemosensory information to the CNS. In the present study we investigated the histochemical localization of TPP I in the CB of rats. Enzyme histochemistry showed high activity of TPP I in CB glomeruli. In particular, the glomus cells contained many TPP I-positive granules, while the glial-like sustentacular cells displayed a slightly fainter reaction. The interglomerular connective tissue was also weakly stained. The results show that both the parenchymal cells of the rat CB express, albeit with different intensity, TPP I. Taken together with our previous enzyme histochemical investigations on the rat CB, it seems likely that the glomus cells possess enzymatic equipment necessary for the neuropeptide intracellular and collagen extracellular initial degradation. These findings also suggest that TPP I is involved in the general turnover of chemotransmitters between glomus cells and sensory nerve endings which emphasizes its importance for chemoreception under hypoxic conditions. PMID:25636608

  19. Central role of carotid body chemoreceptors in disordered breathing and cardiorenal dysfunction in chronic heart failure

    PubMed Central

    Marcus, Noah J.; Del Rio, Rodrigo; Schultz, Harold D.

    2014-01-01

    Oscillatory breathing (OB) patterns are observed in pre-term infants, patients with cardio-renal impairment, and in otherwise healthy humans exposed to high altitude. Enhanced carotid body (CB) chemoreflex sensitivity is common to all of these populations and is thought to contribute to these abnormal patterns by destabilizing the respiratory control system. OB patterns in chronic heart failure (CHF) patients are associated with greater levels of tonic and chemoreflex-evoked sympathetic nerve activity (SNA), which is associated with greater morbidity and poor prognosis. Enhanced chemoreflex drive may contribute to tonic elevations in SNA by strengthening the relationship between respiratory and sympathetic neural outflow. Elimination of CB afferents in experimental models of CHF has been shown to reduce OB, respiratory-sympathetic coupling, and renal SNA, and to improve autonomic balance in the heart. The CB chemoreceptors may play an important role in progression of CHF by contributing to respiratory instability and OB, which in turn further exacerbates tonic and chemoreflex-evoked increases in SNA to the heart and kidney. PMID:25505417

  20. Interleukin-1β promotes the neurogenesis of carotid bodies by stimulating the activation of ERK1/2.

    PubMed

    Xue, Fen; Liu, Ling; Fan, Juan; He, ShanShan; Li, Rui; Peng, Zheng-Wu; Wang, Bai-Ren

    2015-12-01

    The carotid body (CB) is a complex sensory organ that functions to sense homeostatic O2 in the blood. Previous studies have shown that CBs express interleukin (IL)-1 receptor type I and that the chemosensitivity of CBs is increased following stimulation with pro-inflammatory cytokines. However, the effects of pro-inflammatory cytokines, such as IL-1β, on the neurogenesis of CB are unclear. Thus, in this study, we aimed to assess the effects of IL-1β and intermittent hypobaric hypoxia (IHH) plus IL-1β on the phosphorylation of extracellular signal-regulated kinase (ERK) 1/2, tyrosine hydroxylase (TH) and the expression of nestin, a well-established stem cell marker in the nervous system. The results showed that TH, nestin expression and ERK1/2 phosphorylation were increased in the rat CB following intraperitoneal injection of IL-1β. Moreover, IL-1β had additive effects on IHH. These results suggested that the plasticity of CB was increased following treatment with IL-1β and that ERK1/2 may be involved in neurogenic signaling in CBs. PMID:26327233

  1. Carotid intima media thickness is associated with body fat abnormalities in HIV-infected patients

    PubMed Central

    2014-01-01

    Background HIV-infected patients may be at increased risk of cardiovascular (CV) events, and lipodystrophy is generally associated with proatherogenic metabolic disturbances. Carotid intima-media thickness (cIMT) has been used as a surrogate marker for atherosclerosis and it has been shown to be an independent risk factor for CV disease. Our objective was to evaluate cIMT in HIV-infected patients on combined anti-retroviral therapy (cART) with and without lipodystrophy defined by fat mass ratio (L-FMR), and to determine the association of lipodystrophy and visceral obesity [(visceral (VAT), subcutaneous adipose tissue (SAT) volume and VAT/SAT ratio, objectively evaluated by CT scan] with cIMT. Methods Cross-sectional study of 199 HIV-infected patients. Body composition by DXA and abdominal CT, lipids, blood pressure, inflammatory markers, and cIMT by ultrasonography were performed. L-FMR was defined as the ratio of the percentage of trunk fat mass to the percentage of lower limb fat mass by DXA. Categorical variables were compared using the chi-square or Fisher’s exact test. Spearman correlation coefficients were estimated to study the association between cIMT and clinical and metabolic characteristics. Means of cIMT, adjusted for age, were calculated, using generalized linear models. Results L-FMR was present in 41.2% of patients and cIMT was higher in these patients [0.81 (0.24) vs. 0.76 (0.25); p = 0.037)]. Lipodystrophic patients had higher VAT and VAT/SAT ratio and lower SAT. cIMT was associated with lipodystrophy evaluated by FMR, trunk fat, total abdominal fat, VAT and VAT/SAT ratio. No association was observed between cIMT and leg fat mass. Using generalized linear models, cIMT means were adjusted for age and no significant differences remained after this adjustment. The adjusted mean of cIMT was 0.787 (95% CI: 0.751-0.823) in patients without lipodystrophy, and 0.775 (95% CI: 0.732-0.817) in those with lipodystrophy (p = 0.671). Conclusions

  2. Pharmacology of pH effects on carotid body chemoreceptors in vitro.

    PubMed

    Eyzaguirre, C; Zapata, P

    1968-04-01

    1. The carotid body and the carotid nerve were removed from anaesthetized cats and placed in a small Perspex channel through which Locke solution (at various pH values and usually equilibrated with 50% O(2) in N(2)) was allowed to flow. The glomus was immersed in the flowing solution while the nerve was lifted into oil covering the saline. Sensory discharges were recorded from the nerve and their frequency was used as an index of receptor activity. At times, a small segment of carotid artery, containing pressoreceptor endings, was removed together with the glomus. In this case, pressoreceptor discharges were recorded from the nerve.2. The amplitude of either chemo- or pressoreceptor discharges was not changed by strong acid solutions. Acid decreased the frequency of the baroreceptor discharges only when pH fell to less than 4.0. Solutions at low pH increased the chemosensory discharge, but acid depressed the increased chemoreceptor discharge elicited by KCl. These experiments indicated that H(+) ions probably acted as membrane ;stabilizers' without depolarizing either the nerve fibres or endings.3. Acid solutions increased the action of acetylcholine chloride (AChCl) (100-200 mug) on chemoreceptors. This effect probably was due either to inactivation of tissue cholinesterase or to enhanced sensitivity of the sensory endings to ACh.4. Choline chloride (10(-3)M), which favours ACh synthesis, protected the preparation against decay during prolonged experimentation. Hemicholinium-3 (HC-3), which blocks ACh synthesis in low concentrations (10(-5)M), depressed the chemosensory response to acid and to hypoxia when such stimuli were applied repeatedly. This concentration of HC-3 did not change effects of applied ACh.5. Substances which affect ACh release markedly changed the chemoreceptor discharge increase induced by acidity and other forms of stimulation. In the absence of Ca(2+), acid, anoxia, and interruption of flow provoked receptor depression while receptor

  3. Urinary miR-29 Correlates with Albuminuria and Carotid Intima-Media Thickness in Type 2 Diabetes Patients

    PubMed Central

    Zhao, Wenbo; Wang, Cheng; Zhang, Jun; Liu, Xun; Li, Yuanqing; Paudel, Sujay Dutta; Wang, Qianqian; Lou, Tanqi

    2013-01-01

    Background Cell-free microRNAs stably and abundantly exist in body fluids and emerging evidence suggests cell-free microRNAs as novel and non-invasive disease biomarker. Deregulation of miR-29 is involved in the pathogenesis of diabetic nephropathy and insulin resistance thus may be implicated in diabetic vascular complication. Therefore, we investigated the possibility of urinary miR-29 as biomarker for diabetic nephropathy and atherosclerosis in patients with type 2 diabetes. Methods 83 patients with type 2 diabetes were enrolled in this study, miR-29a, miR-29b and miR-29c levels in urine supernatant was determined by TaqMan qRT-PCR, and a synthetic cel-miR-39 was added to the urine as a spike-in control before miRNAs extraction. Urinary albumin excretion rate and urine albumin/creatinine ratio, funduscopy and carotid ultrasound were used for evaluation of diabetic vascular complication. The laboratory parameters indicating blood glucose level, renal function and serum lipids were also collected. Results Patients with albuminuria (n = 42, age 60.62±12.00yrs) showed significantly higher comorbidity of diabetic retinopathy (p = 0.015) and higher levels of urinary miR-29a (p = 0.035) compared with those with normoalbuminuria (n = 41, age 58.54±14.40yrs). There was no significant difference in urinary miR-29b (p = 0.148) or miR-29c level (p = 0.321) between groups. Urinary albumin excretion rate significantly correlated with urinary miR-29a level (r = 0.286, p = 0.016), while urinary miR-29b significantly correlated with carotid intima-media thickness (cIMT) (r = 0.286, p = 0.046). Conclusion Urinary miR-29a correlated with albuminuria while urinary miR-29b correlated with carotid intima-media thickness (cIMT) in patients with type 2 diabetes. Therefore, they may have the potential to serve as alternative biomarker for diabetic nephropathy and atherosclerosis in type 2 diabetes. PMID:24349318

  4. Acute hypoxia modifies cAMP levels induced by inhibitors of phosphodiesterase-4 in rat carotid bodies, carotid arteries and superior cervical ganglia

    PubMed Central

    Nunes, Ana R; Batuca, Joana R; Monteiro, Emília C

    2010-01-01

    Background and purpose: Phosphodiesterase (PDE) inhibitors are useful to treat hypoxia-related diseases and are used in experiments studying the effects of oxygen on 3′-5′-cyclic adenosine monophosphate (cAMP) production. We studied the effects of acute hypoxia on cAMP accumulation induced by PDE inhibitors in oxygen-specific chemosensors, the carotid bodies (CBs) and in non-chemosensitive CB-related structures: carotid arteries (CAs) and superior cervical ganglia (SCG). Experimental approach: Concentration–response curves for the effects of a non-specific PDE inhibitor [isobutylmethylxanthine (IBMX) ], PDE4 selective inhibitors (rolipram, Ro 20-1724) and a PDE2 selective inhibitor (erythro-9-(2-hydroxy-3-nonyl)adenine) on cAMP levels were obtained in normoxic (20% O2/5% CO2) or hypoxic (5% O2/5% CO2) conditions. Key results: Responses to the PDE inhibitors were compatible with the presence of PDE4 in rat CBs, CAs and SCG but in the absence of PDE2 in CAs and CBs. Acute hypoxia enhanced the effects of IBMX and PDE4 inhibitors on cAMP accumulation in CAs and CBs. In SCG, acute hypoxia reduced cAMP accumulation induced by all the four PDE inhibitors tested. Differences between the effects of Ro 20-1724 and rolipram on cAMP were found in CAs and CBs during hypoxia. Conclusions and implications: The effects of PDE4 inhibitors could be potentiated or inhibited by acute hypoxia depending on the PDE isoforms of the tissue. The similarities between the characterization of PDE4 inhibitors at the CBs and CAs, under normoxia and hypoxia, did not support a specific role for cAMP in the oxygen-sensing machinery at the CB and suggested that no direct CB-mediated, hyperventilatory, adverse effects would be expected with administration of PDE4 inhibitors. PMID:20082613

  5. Intermittent Hypoxia-Induced Carotid Body Chemosensory Potentiation and Hypertension Are Critically Dependent on Peroxynitrite Formation

    PubMed Central

    Moya, Esteban A.; Arias, Paulina; Varela, Carlos; Oyarce, María P.; Del Rio, Rodrigo; Iturriaga, Rodrigo

    2016-01-01

    Oxidative stress is involved in the development of carotid body (CB) chemosensory potentiation and systemic hypertension induced by chronic intermittent hypoxia (CIH), the main feature of obstructive sleep apnea. We tested whether peroxynitrite (ONOO−), a highly reactive nitrogen species, is involved in the enhanced CB oxygen chemosensitivity and the hypertension during CIH. Accordingly, we studied effects of Ebselen, an ONOO− scavenger, on 3-nitrotyrosine immunoreactivity (3-NT-ir) in the CB, the CB chemosensory discharge, and arterial blood pressure (BP) in rats exposed to CIH. Male Sprague-Dawley rats were exposed to CIH (5% O2, 12 times/h, 8 h/day) for 7 days. Ebselen (10 mg/kg/day) was administrated using osmotic minipumps and BP measured with radiotelemetry. Compared to the sham animals, CIH-treated rats showed increased 3-NT-ir within the CB, enhanced CB chemosensory responses to hypoxia, increased BP response to acute hypoxia, and hypertension. Rats treated with Ebselen and exposed to CIH displayed a significant reduction in 3-NT-ir levels (60.8 ± 14.9 versus 22.9 ± 4.2 a.u.), reduced CB chemosensory response to 5% O2 (266.5 ± 13.4 versus 168.6 ± 16.8 Hz), and decreased mean BP (116.9 ± 13.2 versus 82.1 ± 5.1 mmHg). Our results suggest that CIH-induced CB chemosensory potentiation and hypertension are critically dependent on ONOO− formation. PMID:26798430

  6. An evaluation on management of carotid body tumour (CBT). A twelve years experience*

    PubMed Central

    BOSCARINO, G.; PARENTE, E.; MINELLI, F.; FERRANTE, A.; SNIDER, F.

    2014-01-01

    Summary Objectives Carotid Body Tumor (CBT) is a rare lesion of the neuroendocrine system but it is the most common form of head and neck paraganglioma (PGL). Our objective is to discuss the optimal management of these lesions to provide the best outcome of patients treated by surgical resection. Patients and Methods A retrospective evaluation was obtained by review of the records of 20 patients with 26 CBT treated at our institution between 2000 and 2012. Primary tumor characteristics, diagnostic protocols, surgical treatment, short and long-term outcomes were collected and analyzed. Results A total of 26 CBTs resections were performed on 20 patients; the age range was 21–89 years. There was a female prevalence (14 women-80% and 6 men-20%). Familial cases occurred in 6 patients (30%); of these, 3 patients had bilateral lesions and 1 patient multiple paragangliomas. In all cases no lymph node metastasis was found. All lesions were grouped into three groups according to the latero-lateral diameter: Group I < 3 cm; Group II 3<>5cm; Group III >5cm. All patients were managed by surgical resection of the CBT. There were no operative deaths. Overall we found transitory neurological impairment in 15,3% and permanent neurological deficit in 7,6% of cases. No complications occurred in all resections of Group I tumors. In Group II only 1 resection was followed by dysphonia by recurrent nerve palsy (after vagal nerve en-bloc resection). In Group III only 1 resection was followed by permanent vagus nerve palsy. Conclusions Surgical removal of the tumor is the only treatment that can ensure a complete eradication of the disease. Family screening is of great importance in patients with hereditary forms. Careful preoperative planning of surgical procedure by integrated diagnostic imaging and a full mastery of the surgical technique can minimize the risk of the most common postoperative complications. Lifelong follow-up is mandatory to make early diagnosis of recurrent disease

  7. Carotid Body Ablation Abrogates Hypertension and Autonomic Alterations Induced by Intermittent Hypoxia in Rats.

    PubMed

    Del Rio, Rodrigo; Andrade, David C; Lucero, Claudia; Arias, Paulina; Iturriaga, Rodrigo

    2016-08-01

    Chronic intermittent hypoxia (CIH), the main feature of obstructive sleep apnea, enhances carotid body (CB) chemosensory responses to hypoxia and produces autonomic dysfunction, cardiac arrhythmias, and hypertension. We tested whether autonomic alterations, arrhythmogenesis, and the progression of hypertension induced by CIH depend on the enhanced CB chemosensory drive, by ablation of the CB chemoreceptors. Male Sprague-Dawley rats were exposed to control (Sham) conditions for 7 days and then to CIH (5% O2, 12/h 8 h/d) for a total of 28 days. At 21 days of CIH exposure, rats underwent bilateral CB ablation and then exposed to CIH for 7 additional days. Arterial blood pressure and ventilatory chemoreflex response to hypoxia were measured in conscious rats. In addition, cardiac autonomic imbalance, cardiac baroreflex gain, and arrhythmia score were assessed during the length of the experiments. In separate experimental series, we measured extracellular matrix remodeling content in cardiac atrial tissue and systemic oxidative stress. CIH induced hypertension, enhanced ventilatory response to hypoxia, induced autonomic imbalance toward sympathetic preponderance, reduced baroreflex gain, and increased arrhythmias and atrial fibrosis. CB ablation normalized blood pressure, reduced ventilatory response to hypoxia, and restored cardiac autonomic and baroreflex function. In addition, CB ablation reduced the number of arrhythmias, but not extracellular matrix remodeling or systemic oxidative stress, suggesting that reductions in arrhythmia incidence during CIH were related to normalization of cardiac autonomic balance. Present results show that autonomic alterations induced by CIH are critically dependent on the CB and support a main role for the CB in the CIH-induced hypertension. PMID:27381902

  8. Study of the effects of age and body mass index on the carotid wall vibration: extraction methodology and analysis.

    PubMed

    Yousefi Rizi, Fereshteh; Setarehdan, Seyed Kamaledin; Behnam, Hamid; Alizadeh Sani, Zahra

    2014-07-01

    This study aims to non-invasively extract the vibrations of the carotid wall and evaluate the changes in the carotid artery wall caused by age and obesity. Such evaluation can increase the possibility of detecting wall stiffness and atherosclerosis in its early stage. In this study, a novel method that uses a phase-tracking method based on the continuous wavelet transform calculates the carotid wall motion from the ultrasound radio frequency signals. To extract the high-frequency components of the wall motion, wall vibration, the empirical mode decomposition was then used. The posterior wall (intima-media) motion and vibration were extracted for 54 healthy volunteers (mean age: 33.87 ± 14.73 years), including 13 overweight subjects (body mass index > 25) and 14 female participants using their radio frequency signals. The results showed that the dominant frequency of the wall vibration correlates with age (r = -0.5887, p < 0.001) and body mass index (r = -0.4838, p < 0.001). The quantitative analysis further demonstrated that the dominant frequency of the vibration in the radial direction of the carotid wall decreases by age and is lower in overweight subjects. Besides, the peak-to-peak amplitude of the wall vibration showed significant correlations with age (r = -0.5456, p < 0.001) and body mass index (r = -0.5821, p < 0.001). The peak-to-peak amplitude also decreases by age and is lower in overweight subjects. However, there were no significant correlations between these features of the wall vibrations and systolic/diastolic blood pressure and sex. Our proposed measures were certified using the calculated arterial stiffness indices. The average power spectrum of the elderly subjects'wall motion in the frequency range of the wall vibration (>100 Hz) is decreased more in comparison with the young subjects. Our results revealed that the proposed method may be useful for detecting the stiffness and distortion in the carotid wall that occur prior to wall thickening

  9. Properties of a transient K+ current in chemoreceptor cells of rabbit carotid body.

    PubMed Central

    López-López, J R; De Luis, D A; Gonzalez, C

    1993-01-01

    1. Adult rabbit carotid body chemoreceptor cells, enzymatically dispersed and short-term cultured, exhibit an inactivating outward K+ current that is reversibly inhibited by low PO2. In the present work we have characterized the biophysical and pharmacological properties of this current using the whole-cell voltage clamp recording technique. 2. Inactivating current was recorded after blockage of Ca2+ currents with extracellular Co2+, Cd2+, or after complete washing out of Ca2+ channels. 3. The threshold of activation of this inactivating current was about -40 mV. Current activated very quickly (mean rise time 4.8 +/- 0.42 ms at +60 mV) but inactivated more slowly. Inactivation was well fitted by two exponentials with time constants of 79.7 +/- 6.6 and 824 +/- 42.8 ms (at +40 mV). The inactivation process showed a little voltage dependence. 4. The steady-state inactivation was well fitted by a Boltzman function. Inactivation was fully removed at potentials negative to -80 mV and was complete at voltages near -10 mV; 50% inactivation occurred at -41 mV. 5. Recovery from inactivation had several components and was voltage dependent. Initial recovery was fast, but full recovery, even at -100 mV, required more than 30 s. 6. Inactivating current was selectively blocked by 4-aminopyridine (4-AP), in a dose-dependent manner (IC50, 0.2 mM). The duration of chemoreceptor cells action potentials was augmented by 1 mM 4-AP from 2.3 +/- 0.36 to 7.0 +/- 0.25 ms at 0 mV. Tetraethylamonium (TEA), at concentrations above 5 mM, blocked inactivating and non-inactivating components of the whole K+ current. 7. Inactivating current was modulated by cyclic AMP (cAMP). Bath application of 2 mM dibutyryl cAMP reduced peak amplitude by 18.7 +/- 2.9% (at +30 mV) and slowed down the rise time of the current. The effect was not voltage dependent. Forskolin (10-20 microM) also affected inactivating current, by accelerating the inactivation process. In the same preparations neither dibutyryl c

  10. Properties of ionic currents from isolated adult rat carotid body chemoreceptor cells: effect of hypoxia.

    PubMed Central

    López-López, J R; González, C; Pérez-García, M T

    1997-01-01

    1. The electrical properties of chemoreceptor cells from neonatal rat and adult rabbit carotid bodies (CBs) are strikingly different. These differences have been suggested to be developmental and/or species related. To distinguish between the two possibilities, the whole-cell configuration of the patch-clamp technique was used to characterize the ionic currents present in isolated chemoreceptor cells from adult rat CBs. Since hypoxia-induced inhibition of O2-sensitive K+ currents is considered a crucial step in O2 chemoreception, the effect of hypoxia on the adult rat chemoreceptor cell currents was also studied. 2. Outward currents were carried mainly by K+, and two different components could be distinguished: a Ca(2+)-dependent K+ current (IK(Ca)) sensitive to Cd2+ and charybdotoxin (CTX), and a Ca(2+)-insensitive, voltage-dependent K+ current (IK(V)). IK(V) showed a slow voltage-dependent activation (time constant (tau) of 87.4 ms at -20 mV and 8.8 ms at +60 mV) and a very slow inactivation, described by the sum of two exponentials (tau 1 = 684 +/- 150 ms and tau 2 = 4.96 +/- 0.76 s at + 30 mV), that was almost voltage insensitive. The kinetic and pharmacological properties of IK(V) are typical of a delayed rectifier K+ channel. 3. Voltage-dependent Ca2+ currents (ICa) were present in nineteen of twenty-seven cells. TTX-sensitive Na+ currents were also observed in about 10% of the cells. 4. Low PO2 (< 10 mmHg) reduced the whole outward current amplitude by 22.17 +/- 1.96% (n = 27) at +20 mV. This effect was absent in the presence of Cd2+. Since low PO2 did not affect ICa, we conclude that hypoxia selectively blocks IK(Ca). 5. The properties of the currents recorded in adult rat chemoreceptor cells, including the specific inhibition of IK(Ca) by hypoxia, are similar to those reported in neonatal rat CB cells, implying that the differences between rat and rabbit chemoreceptor cells are species related. PMID:9080372

  11. Endovascular Treatment of a Carotid Dissecting Pseudoaneurysm in a Patient with Ehlers-Danlos Syndrome Type IV with Fatal Outcome

    SciTech Connect

    Lim, Siok Ping Duddy, Martin J.

    2008-01-15

    We present a patient with Ehlers-Danlos syndrome type IV (EDS IV) with a carotid dissecting pseudoaneurysm causing severe carotid stenosis. This lesion was treated endovascularly. Unfortunately, the patient died of remote vascular catastrophes (intracranial hemorrhage and abdominal aortic rupture). This unique case illustrates the perils of endovascular treatment of EDS IV patients and the need for preoperative screening for concomitant lesions. It also shows that a dissecting pseudoaneurysm can feasibly be treated with a covered stent and that closure is effective using Angioseal in patients with EDS IV.

  12. Long-term influence of neonatal hypoxia on catecholamine activity in carotid bodies and brainstem cell groups of the rat.

    PubMed Central

    Soulier, V; Dalmaz, Y; Cottet-Emard, J M; Lagercrantz, H; Pequignot, J M

    1997-01-01

    1. In order to determine the long-term influence of neonatal hypoxia on catecholaminergic activity in peripheral arterial chemoreceptors and brainstem noradrenergic cell groups (A1, A2, A5 and A6), 1-day-old male rat pups were subjected to hypoxia (10% oxygen) for 6 days and then supplied with normal air. Control animals were kept at normoxia from birth. Rats were killed at either 3 or 8 weeks of age. 2. The content of dopamine and noradrenaline in carotid bodies of neonatally hypoxic rats was increased at both 3 and 8 weeks of age. 3. Noradrenaline turnover was selectively decreased in the caudal portion of A2 (located in the area of chemosensory afferent projection) at 8 weeks of age (-76 +/- 2%), while this turnover was unaffected in rostral A2 cells. Noradrenergic activity in A1, A5 and A6 was altered by neonatal hypoxia in an age-dependent fashion. 4. The data suggest that neonatal hypoxia induces long-term changes in the basal activity of the carotid body and brainstem noradrenergic cell groups. Such changes might contribute to neuronal regulation of the delayed respiratory, arousal and neural sequelae associated with neonatal hypoxia. These changes could also be involved in the early programming of respiratory and blood pressure control. PMID:9032699

  13. Lower body positive pressure application with an antigravity suit in acute carotid occlusion.

    PubMed

    Berthet, Karine; Lukaszewicz, Anne Claire; Bousser, Marie-Germaine; Payen, Didier

    2010-01-01

    The challenge in acute stroke is still to reperfuse as early as possible the ischemic territory. Since fibrinolytic therapies have a limited window with potential risk of bleeding, having a nonpharmacologic mean to recruit vessels in area surrounding necrosis might be useful. We propose here to use antigravity suit inflated at "venous" pressure levels to shift blood towards thoracic and brain territories. We report two cases of spectacular clinical recovery after acute carotid occlusion. PMID:20798842

  14. An unusual presentation of foreign body in the common carotid artery.

    PubMed

    Lahiri, Somdatta; Ghosh, Shibajyoti; Sengupta, Goutam; Bakshi, Udayan

    2011-12-01

    Penetrating trauma to neck resulting in arteriovenous (AV) fistula and aneurysms involving the carotid system are uncommon injuries with life-threatening consequences. We report here a case of a young factory worker who developed a traumatic AV fistula with false aneurysm, with however, no other complications. He was successfully operated when he presented to us two months after the injury and is doing well in follow-up. PMID:23204711

  15. Endovascular repair of direct carotid-cavernous fistula in Ehlers-Danlos type IV.

    PubMed

    Linfante, Italo; Lin, Eugene; Knott, Eric; Katzen, Barry; Dabus, Guilherme

    2014-01-01

    Ehlers-Danlos syndrome (EDS) type IV is a collagen vascular disease with an autosomal dominant inheritance caused by COL3A1 mutation. Patients with EDS type IV can present with organ rupture, spontaneous arterial dissections and ruptured aneurysms. Because of their propensity to form arterial dissections, aneurysms and rupture, they can develop carotid-cavernous fistula (CCF) after minor trauma or spontaneously. In EDS, it has been reported that even conventional catheter diagnostic angiography may result in large artery dissections and vessel rupture. In addition, the treatment of CCF in EDS type IV can result in up to 59% mortality after initial treatment, of which 23% is attributed to direct complications of treatment. We present the case of a patient with EDS type IV who previously had spontaneous dissection and multiple pseudoaneurysms of both the iliac and femoral arteries and the distal abdominal aorta. Several years later the patient developed a direct type A CCF which was successfully treated with endovascular embolization using a transvenous approach with detachable coils. The literature pertaining to CCF in EDS type IV and its treatment is reviewed. PMID:24385391

  16. Endovascular repair of direct carotid-cavernous fistula in Ehlers-Danlos type IV.

    PubMed

    Linfante, Italo; Lin, Eugene; Knott, Eric; Katzen, Barry; Dabus, Guilherme

    2015-01-01

    Ehlers-Danlos syndrome (EDS) type IV is a collagen vascular disease with an autosomal dominant inheritance caused by COL3A1 mutation. Patients with EDS type IV can present with organ rupture, spontaneous arterial dissections and ruptured aneurysms. Because of their propensity to form arterial dissections, aneurysms and rupture, they can develop carotid-cavernous fistula (CCF) after minor trauma or spontaneously. In EDS, it has been reported that even conventional catheter diagnostic angiography may result in large artery dissections and vessel rupture. In addition, the treatment of CCF in EDS type IV can result in up to 59% mortality after initial treatment, of which 23% is attributed to direct complications of treatment. We present the case of a patient with EDS type IV who previously had spontaneous dissection and multiple pseudoaneurysms of both the iliac and femoral arteries and the distal abdominal aorta. Several years later the patient developed a direct type A CCF which was successfully treated with endovascular embolization using a transvenous approach with detachable coils. The literature pertaining to CCF in EDS type IV and its treatment is reviewed. PMID:24401479

  17. Role of voltage-dependent calcium channels in stimulus–secretion coupling in rabbit carotid body chemoreceptor cells

    PubMed Central

    Rocher, Asunción; Geijo-Barrientos, Emilio; Cáceres, Ana Isabel; Rigual, Ricardo; González, Constancio; Almaraz, Laura

    2005-01-01

    We have defined Ca2+ channel subtypes expressed in rabbit carotid body (CB) chemoreceptor cells and their participation in the stimulus-evoked catecholamine (CA) release. Ca2+ currents (ICa) activated at –30 mV, peaked at +10 mV and were fully blocked by 200 μm Cd2+. L-type channels (sensitive to 2 μm nisoldipine) activated at –30 mV and carried 21 ± 2% of total ICa. Non-L-type channels activated at potentials positive to –10 mV and carried: N channels (sensitive to 1 μm ω-conotoxin-GVIA) 16 ± 1% of total ICa, P/Q channels (sensitive to 3 μm ω-conotoxin-MVIIC after nisoldipine plus GVIA) 23 ± 3% of total ICa and R channels (resistant to all blockers combined) 40 ± 3% of total ICa. CA release induced by hypoxia, hypercapnic acidosis, dinitrophenol (DNP) and high K+o in the intact CB was inhibited by 79–98% by 200 μm Cd2+. Hypoxia, hypercapnic acidosis and DNP, depolarized chemoreceptor cells and eventually generated repetitive action potential discharge. Nisoldipine plus MVIIC nearly abolished the release of CAs induced by hypoxia and hypercapnic acidosis and reduced by 74% that induced by DNP. All these secretory responses were insensitive to GVIA. 30 and 100 mm K+o brought resting membrane potential (Em) of chemoreceptor cells (–48.1 ± 1.2 mV) to –22.5 and +7.2 mV, respectively. Thirty millimolar K+o-evoked release was abolished by nisoldipine but that induced by 100 mm K+o was mediated by activation of L, N, and P/Q channels. Data show that tested stimuli depolarize rabbit CB chemoreceptor cells and elicit CA release through Ca2+ entry via voltage-activated channels. Only L and P/Q channels are tightly coupled to the secretion of CA. PMID:15528240

  18. Aggressive change of a carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV.

    PubMed

    Kojima, Atsuhiro; Saga, Isako; Tomio, Ryosuke; Kosho, Tomoki; Hatamochi, Atsushi

    2015-06-01

    The authors report a rare case of a carotid-cavernous fistula (CCF) secondary to Ehlers-Danlos syndrome (EDS) type IV which showed an aggressive angiographical change.A 59-year-old woman presented with headache, right pulsatile tinnitus, and diplopia on the right side. The diagnostic angiography demonstrated a right CCF. Accordingly transarterial embolization of the fistula was attempted 5 days later. The initial right internal carotid angiography showed an aneurysm on the petrous portion of the internal carotid artery (ICA) which was not recognized in the diagnostic angiography. Spontaneous reduction of the shunt flow and long dissection of the ICA were also revealed. The aneurysm was successfully occluded with coils, and only minor shunt flow was shown on the final angiogram. EDS type IV was diagnosed with a skin biopsy for a collagen abnormality. After the operation, the stenosis of the right ICA gradually progressed, although there was no recurrence of the CCF.Interventional treatment for patients with EDS can cause devastating vascular complication. We should be aware of the possibility of EDS type IV when a spontaneous CCF shows unusual angiographical change because early diagnosis of EDS type IV is crucial for determination of the optimum treatment option. PMID:26015525

  19. Carotid Endarterectomy

    MedlinePlus

    ... the carotid arteries. This limits or blocks the flow of oxygen-rich blood to your brain, which can lead to a stroke. Carotid Arteries Figure A shows ... normal carotid artery that has normal blood flow. Figure C show the inside of a carotid ...

  20. Body Type Attractiveness Preferences of the Aged.

    ERIC Educational Resources Information Center

    Portnoy, Enid J.

    A study explored the relationship between body types and four attraction dimensions (physical, social, task, and communication) as perceived by older adults (mean age 68). Subjects, 35 males and 73 females in private residences and senior citizen centers, were shown three same-sex body silhouettes representing the older ectomorph, mesomorph, and…

  1. Atorvastatin Treatment for Carotid Intima-Media Thickness in Chinese Patients With Type 2 Diabetes

    PubMed Central

    Fang, Na; Han, Wei; Gong, Dandan; Zou Chen; Fan, Yu

    2015-01-01

    Abstract Impact of atorvastatin on carotid intima-media thickness (CIMT) in patients with type 2 diabetes is still debating. The aim of our study is to investigate atorvastatin as adjuvant treatment on CIMT in Chinese patients with type 2 diabetes by conducting a meta-analysis based on the randomized controlled trials (RCTs). A systematic search of electronic database of the Pubmed, EMBASE, Cochrane Library, VIP database, China National Knowledge Infrastructure, and Wangfang up to January 2015 was conducted. Randomized controlled trials (RCTs) comparing atorvastatin adjuvant treatment to the hypoglycemic therapies or high-dose atorvastatin versus low-dose atorvastatin therapies for patients with type 2 diabetes were selected. A total of 14 RCTs involving 1345 patients were included. Adjuvant treatment with atorvastatin was associated with a significant reduction in CIMT (weighted mean difference [WMD] = −0.17 mm; 95% confidence interval [CI] −0.22 to −0.12). Compared with the low-dose atorvastatin, high-dose atorvastatin treatment was associated with a significant reduction in CIMT (WMD = −0.17 mm; 95% CI: −0.32 to −0.02). Adjuvant treatment with atorvastatin reduced serum total cholesterol, triglyceride, low-density lipoproteins, and high sensitivity C-reactive protein levels. However, atorvastatin had no significant impact on blood glucose levels. This meta-analysis demonstrated that treatment with atorvastatin significantly reduced CIMT in Chinese patients with type 2 diabetes. Moreover, high-dose atorvastatin appeared to have additional benefits in reducing CIMT than the low-dose atorvastatin. PMID:26554793

  2. Fatal Peritoneal Bleeding Following Embolization of a Carotid-Cavernous Fistula in Ehlers-Danlos Syndrome Type IV

    SciTech Connect

    Usinskiene, Jurgita; Mazighi, Mikael; Bisdorff, Annouk; Houdart, Emmanuel

    2006-12-15

    We report the case of a 25-year-old woman treated for a spontaneous carotid-cavernous fistula in a context of Ehlers-Danlos syndrome type IV. Embolization with a transvenous approach was achieved without complications; however, the patient died 72 hr later of massive intraperitoneal bleeding. At autopsy, no lesion of the digestive arteries was identified. Possible causes of this bleeding are discussed.

  3. Mannose-Binding Lectin Levels and Carotid Intima-Media Thickness in Type 2 Diabetic Patients

    PubMed Central

    Káplár, Miklós; Sweni, Shah; Kulcsár, Julianna; Cogoi, Barbara; Esze, Regina; Somodi, Sándor; Papp, Mária; Oláh, László; Magyar, Mária Tünde; Szabó, Katalin; Czuriga-Kovács, Katalin Réka; Hársfalvi, Jolán; Paragh, György

    2016-01-01

    Introduction. Mannose-binding lectin (MBL) activates complement system and has been suggested to play a role in vascular complications in diabetics. Carotid intima-media thickness (cIMT) detects subclinical atherosclerosis. We evaluated the association of MBL and IMT in type 2 diabetic (T2DM) patients. Methods. Serum MBL levels and cIMT were measured in a total of 103 diabetics and in 98 age-matched healthy controls. Results. There was no significant difference in MBL level in T2DM versus controls. As expected, IMT was significantly higher in T2DM patients than in controls (P = 0.001). In T2DM, the lowest cIMT was seen in patients with normal MBL level (500–1000) while cIMT continuously increased with both high MBL and absolute MBL deficiency states. This was especially significant in high MBL versus normal MBL T2DM patients (P = 0.002). According to multiple regression analysis the main predictors of IMT in T2DM are age (P < 0.003), ApoA level (P = 0.023), and the MBL (P = 0.036). Conclusions. Our results suggest a dual role of MBL as a risk factor for cIMT in T2DM. MBL may also be used as a marker of macrovascular disease, as both low and high levels indicate the susceptibility for atherosclerosis in T2DM. PMID:26640806

  4. Nonalcoholic Fatty Liver Disease is Associated with Increased Carotid Intima-Media Thickness in Type 1 Diabetic Patients

    PubMed Central

    Zhang, Lei; Guo, Kaifeng; Lu, Junxi; Zhao, Fangya; Yu, Haoyong; Han, Junfeng; Bao, Yuqian; Chen, Haibing; Jia, Weiping

    2016-01-01

    A growing body of evidence suggests that NAFLD is associated with an increased risk of incident CVD events both in patients without diabetes and in those with type 2 diabetes (T2DM). However, no published data are available regarding the association between NAFLD and C-IMT in T1DM. A total of 722 patients (371 men) with T1DM were included in this cross-sectional study. The main outcome measures were detection of NAFLD, C-IMT and classical risk factors. The mean age of the subjects was 46.2 years, and 51.1% were male. The prevalence of NAFLD was 15.9%. NAFLD patients had a markedly greater C-IMT (0.81 ± 0.25 vs. 0.69 ± 0.18 mm; p < 0.001) and frequency of carotid plaque (28.9% vs. 16.9%; p < 0.05) than those without fatty liver. Moreover, the differences in C-IMT remained after adjusting for potential confounders. A stepwise linear regression analysis revealed that age (standardized β, 0.326; p < 0.001), NAFLD (standardized β, 0.151, p < 0.001), and hsCRP (standardized β, 0.115, p = 0.008) were independently associated with C-IMT in all subjects. Our data show NAFLD is associated with elevated C-IMT in T1DM independent of conventional cardiovascular disease risk factors. PMID:27226159

  5. Sudden death due to rupture of the right internal carotid artery in neurofibromatosis type 1: A case report.

    PubMed

    Liang, Yue; Tong, Fang; Zhang, Lin; Li, Wenhe; Zhou, Yiwu

    2016-07-01

    Vascular involvement is a well-recognized manifestation of neurofibromatosis type 1 (NF1) which has the potential to be fatal when disrupted. We here present a case of sudden death due to the fatal arterial rupture resulted from infiltration of the neurofibromas. A 42-year-old man who suffered from NF1 presented a 1-h history of sudden onset of pain in his right cervical region. His condition worsened and became unconscious on his way to the emergency room. Despite resuscitation efforts, he died 30min later without regaining consciousness. Autopsy examination showed that a neurofibroma located around the right internal carotid artery, confirmed immunohistochemically with S-100, vimentin and CD34. Furthermore, proliferation of spindle cells positive for S-100 was seen in the wall of right internal carotid artery, which was disrupted and resulted in a hemorrhage. These findings suggest that the artery was disrupted by neurofibromas in the vascular wall, which led to fragility of the vessel. On the basis of these findings, we concluded that the cause of death was asphyxia resulting from airway obstruction compressed by the hematoma due to the arterial rupture. As the locality of the neurofibroma and hemorrhage were closed to the carotid baroreflex, we considered another possible mechanism of his sudden death, which could be cardiac inhibition induced by vagal stimulation. We hope this case will increase recognition of NF-1 vasculopathy when encountering any sudden death in NF1 patients. PMID:27497331

  6. Acute restraint stress increases carotid reactivity in type-I diabetic rats by enhancing Nox4/NADPH oxidase functionality.

    PubMed

    Moreira, Josimar D; Pernomian, Larissa; Gomes, Mayara S; Pernomian, Laena; Moreira, Rafael P; do Prado, Alejandro F; da Silva, Carlos H T P; de Oliveira, Ana M

    2015-10-15

    Hyperglycemia increases the generation of reactive oxygen species and affects systems that regulate the vascular tone including renin-angiotensin system. Stress could exacerbate intracellular oxidative stress during Diabetes upon the activation of angiotensin AT1/NADPH oxidase pathway, which contributes to the development of diabetic cardiovascular complications. For this study, type-I Diabetes was induced in Wistar rats by intraperitoneal injection of streptozotocin. 28 days after streptozotocin injection, the animals underwent to acute restraint stress for 3 h. Cumulative concentration-response curves for angiotensin II were obtained in carotid rings pre-treated or not with Nox or cyclooxygenase inhibitors. Nox1 or Nox4 expression and activity were assessed by Western blotting and lucigenin chemiluminescence, respectively. The role of Nox1 and Nox4 on reactive oxygen species generation was evaluated by flow cytometry and Amplex Red assays. Cyclooxygenases expression was assessed by real-time polymerase chain reaction. The contractile response evoked by angiotensin II was increased in diabetic rat carotid. Acute restraint stress increased this response in this vessel by mechanisms mediated by Nox4, whose local expression and activity in generating hydrogen peroxide are increased. The contractile hyperreactivity to angiotensin II in stressed diabetic rat carotid is also mediated by metabolites derived from cyclooxygenase-2, whose local expression is increased. Taken together, our findings suggest that acute restraint stress exacerbates the contractile hyperreactivity to angiotensin II in diabetic rat carotid by enhancing Nox4-driven generation of hydrogen peroxide, which evokes contractile tone by cyclooxygenases-dependent mechanisms. Finally, these findings highlight the harmful role played by acute stress in modulating diabetic vascular complications. PMID:26387612

  7. Congenital Absence of Internal Carotid Artery with Rare Type of Intercavernous Anastamosis and Ruptured Cerebral Aneurysm

    PubMed Central

    Alurkar, Anand; Oak, Sagar; Kori, Smita

    2016-01-01

    Congenital absence of Internal Carotid Artery (ICA) is a rare anomaly seen in <0.01% of the population. Various collateral circulations develop in these cases to maintain adequate cerebral perfusion. High incidence of aneurysms is reported in these cases. Complete evaluation is required to detect other abnormalities usually seen in these patients. We report a case of congenital absence of right ICA in a 39-year-old female who presented with Subarachnoid Haemorrhage (SAH) and had a Middle Cerebral Artery Aneurysm (MCA). The right MCA got supply from the intercavernous communication from the left internal carotid artery. Skull base Computed Tomogram (CT) confirmed the congenital absence of right ICA. She underwent successful surgical clipping for the aneurysm. The high incidence of aneurysms, collateral circulations, embryological development and postulated mechanisms of this anomaly were discussed. The exact aetiology behind the absence of ICA remains unclear. It is important to differentiate this condition from acquired stenosis/occlusion due to atherosclerosis and carotid dissection. Recognising the anomaly is important and gains even more significance during surgical planning in cases of direct aneurysm clipping, carotid endarterectomy and transphenoidal surgeries. PMID:27190916

  8. Carotid artery surgery

    MedlinePlus

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  9. The Effect of Sitagliptin on Carotid Artery Atherosclerosis in Type 2 Diabetes: The PROLOGUE Randomized Controlled Trial

    PubMed Central

    Oyama, Jun-ichi; Murohara, Toyoaki; Kitakaze, Masafumi; Ishizu, Tomoko; Sato, Yasunori; Kitagawa, Kazuo; Kamiya, Haruo; Ajioka, Masayoshi; Ishihara, Masaharu; Dai, Kazuoki; Sata, Masataka; Maemura, Koji; Tomiyama, Hirofumi; Higashi, Yukihito; Kaku, Kohei; Matsuhisa, Munehide; Yamashita, Kentaro; Bando, Yasuko K.; Kashihara, Naoki; Ueda, Shinichiro; Inoue, Teruo; Tanaka, Atsushi; Node, Koichi

    2016-01-01

    Background Experimental studies have suggested that dipeptidyl peptidase-4 (DPP-4) inhibitors provide cardiovascular protective effects. We performed a randomized study to evaluate the effects of sitagliptin added on to the conventional therapy compared with conventional therapy alone (diet, exercise, and/or drugs, except for incretin-related agents) on the intima-media thickness (IMT) of the carotid artery, a surrogate marker for the evaluation of atherosclerotic cardiovascular disease, in people with type 2 diabetes mellitus (T2DM). Methods and Findings We used a multicenter PROBE (prospective, randomized, open label, blinded endpoint) design. Individuals aged ≥30 y with T2DM (6.2% ≤ HbA1c < 9.4%) were randomly allocated to receive either sitagliptin (25 to 100 mg/d) or conventional therapy. Carotid ultrasound was performed at participating medical centers, and all parameters were measured in a core laboratory. Of the 463 enrolled participants with T2DM, 442 were included in the primary analysis (sitagliptin group, 222; conventional therapy group, 220). Estimated mean (± standard error) common carotid artery IMT at 24 mo of follow-up in the sitagliptin and conventional therapy groups was 0.827 ± 0.007 mm and 0.837 ± 0.007 mm, respectively, with a mean difference of −0.009 mm (97.2% CI −0.028 to 0.011, p = 0.309). HbA1c level at 24 mo was significantly lower with sitagliptin than with conventional therapy (6.56% ± 0.05% versus 6.72% ± 0.05%, p = 0.008; group mean difference −0.159, 95% CI −0.278 to −0.041). Episodes of serious hypoglycemia were recorded only in the conventional therapy group, and the rate of other adverse events was not different between the two groups. As it was not a placebo-controlled trial and carotid IMT was measured as a surrogate marker of atherosclerosis, there were some limitations of interpretation. Conclusions In the PROLOGUE study, there was no evidence that treatment with sitagliptin had an additional effect on the

  10. Carotid stenting and endarterectomy.

    PubMed

    Yip, Hon-Kan; Sung, Pei-Hsun; Wu, Chiung-Jen; Yu, Cheuk-Man

    2016-07-01

    Stroke, either ischemic or hemorrhagic, remains the second commonest cause of death worldwide in the last decade. Etiologies for ischemic stroke (IS) vary widely. Atherothrombotic occlusion is an essential cause to which carotid artery stenosis (CAS) is a major contributor. Administration of anti-platelet agent to patients with CAS has been shown to reduce incidence of long-term IS. In additional, in patients with symptomatic CAS, clinical trials have demonstrated that carotid endarterectomy (CEA) is superior to medical therapy for prevention of future CAS-related IS. However, CEA is not suitable for CAS post-radiotherapy or those located at higher level of the internal carotid artery; and major complications of this procedure including cranial nerve injuries have stimulated the interest of using percutaneous transfemoral carotid stenting as an alternative approach. Although transfemoral arterial approach of carotid stenting is not inferior to CEA in improving clinical outcomes, it has been reported to be associated with vascular complication and has its limitations in patients with athero-occlusive disease of abdominal aorta or bilateral iliac arteries, level II or III aortic arch, or bovine type carotid arterial anatomy. Therefore, transradial/transbrachial arterial approach has emerged as a novel method for carotid stenting. This article provides a critical review on interventional approaches for the treatment of CAS. PMID:27061654

  11. Regulation of hypoxia-inducible factor-α isoforms and redox state by carotid body neural activity in rats

    PubMed Central

    Peng, Ying-Jie; Yuan, Guoxiang; Khan, Shakil; Nanduri, Jayasri; Makarenko, Vladislav V; Reddy, Vaddi Damodara; Vasavda, Chirag; Kumar, Ganesh K; Semenza, Gregg L; Prabhakar, Nanduri R

    2014-01-01

    Previous studies reported that chronic intermittent hypoxia (CIH) results in an imbalanced expression of hypoxia-inducible factor-α (HIF-α) isoforms and oxidative stress in rodents, which may be due either to the direct effect of CIH or indirectly via hitherto uncharacterized mechanism(s). As neural activity is a potent regulator of gene transcription, we hypothesized that carotid body (CB) neural activity contributes to CIH-induced HIF-α isoform expression and oxidative stress in the chemoreflex pathway. Experiments were performed on adult rats exposed to CIH for 10 days. Rats exposed to CIH exhibited: increased HIF-1α and decreased HIF-2α expression; increased NADPH oxidase 2 and decreased superoxide dismutase 2 expression; and oxidative stress in the nucleus tractus solitarius and rostral ventrolateral medulla as well as in the adrenal medulla (AM), a major end organ of the sympathetic nervous system. Selective ablation of the CB abolished these effects. In the AM, sympathetic activation by the CB chemoreflex mediates CIH-induced HIF-α isoform imbalance via muscarinic acetylcholine receptor-mediated Ca2+ influx, and the resultant activation of mammalian target of rapamycin pathway and calpain proteases. Rats exposed to CIH presented with hypertension, elevated sympathetic activity and increased circulating catecholamines. Selective ablation of either the CB (afferent pathway) or sympathetic innervation to the AM (efferent pathway) abolished these effects. These observations uncover CB neural activity-dependent regulation of HIF-α isoforms and the redox state by CIH in the central and peripheral nervous systems associated with the chemoreflex. PMID:24973414

  12. Dissociation between blood pressure and heart rate response to hypoxia after bilateral carotid body removal in men with systolic heart failure.

    PubMed

    Niewinski, Piotr; Janczak, Dariusz; Rucinski, Artur; Tubek, Stanislaw; Engelman, Zoar J; Jazwiec, Przemyslaw; Banasiak, Waldemar; Sobotka, Paul A; Hart, Emma C J; Paton, Julian F R; Ponikowski, Piotr

    2014-03-01

    While the ventilatory response to hypoxia is known to be mediated by the carotid bodies, the origin of the haemodynamic alterations evoked by hypoxia is less certain. Bilateral carotid body removal (CBR) performed to treat congestive heart failure may serve as a model to improve our understanding of haemodynamic responses to hypoxia in humans. We studied six congestive heart failure patients before and 1 month after CBR [median (interquartile range): age, 58.5 (56-61) years old; and ejection fraction, 32 (25-34)%]. Peripheral chemosensitivity (hypoxic ventilatory response) was equated to the slope relating lowest oxygen saturation to highest minute ventilation following exposures to hypoxia. Likewise, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) slopes were calculated as slopes relating the lowest oxygen saturations to the highest SBP, DBP and HR responses. We found that CBR reduces the hypoxic ventilatory response (91%, P < 0.05), SBP (71%, P < 0.05) and DBP slopes (59%, P = 0.07). In contrast, the HR slope remained unchanged. The dissociation between the blood pressure and HR responses after CBR shows involvement of a different chemoreceptive site(s) maintaining the response to acute hypoxia. We conclude that carotid bodies are responsible for ventilatory and blood pressure responses, while the HR response might be mediated by the aortic bodies. The significant reduction of the blood pressure response to hypoxia after CBR suggests a decrease in sympathetic tone, which is of particular clinical relevance in congestive heart failure. PMID:24243836

  13. Bilateral carotid artery injury response in side impact using a vessel model integrated with a human body model.

    PubMed

    Danelson, Kerry A; Gayzik, F Scott; Yu, Mao M; Martin, R Shayn; Duma, Stefan M; Stitzel, Joel D

    2009-10-01

    In a far-side crash configuration, the occupant can experience severe excursion from the seat space. Given this challenge, there are research efforts focused on alternate restraints, such as four-point belts. A potential implication of this geometry would be interaction of the belt with the occupant's neck. This study examines the response of the carotid arteries using a Finite Element Model (FEM) in a far-side crash configuration with a reversed three-point restraint. A FEM of the carotid artery and neck fascia was developed and integrated with the Total Human Model for Safety (THUMS) version 1.44. This model was subjected to four test conditions simulating far-side crashes. Load conditions included a low velocity impact of approximately 4 m/s and a higher velocity impact of approximately 10 m/s. For each velocity, the model was restrained with a belt placed low on the neck and a belt placed higher on the neck. Strain data in each element of the carotid arteries was analyzed. The overall response of the vessel was examined to determine locations of high strain values. Low belt placement resulted in more head excursion, stretching the carotid on the non-struck side. High belt placement resulted in compression of the artery on the struck side due to direct loading of the vessel from the belt. Strain values in the carotid artery elements increased with increasing speed of impact. The lower and higher speed tests with a low belt configuration resulted in a maximum principal strains, at maximal belt engagement, of 0.223 and 0.459, respectively. Corresponding values for the high belt configuration were 0.222 and 0.563. In both belt configurations, the non-struck side vessel stretched more than the struck side vessel; however, the non-struck side vessel experienced higher compressive forces. Strain values measured during the simulations can be compared to a value of 0.31 to intimal failure in previous experimental tests. These results quantitatively illustrate the two

  14. Bilateral Carotid Artery Injury Response in Side Impact Using a Vessel Model Integrated with a Human Body Model

    PubMed Central

    Danelson, Kerry A.; Gayzik, F. Scott; Yu, Mao M.; Martin, R. Shayn; Duma, Stefan M.; Stitzel, Joel D.

    2009-01-01

    In a far-side crash configuration, the occupant can experience severe excursion from the seat space. Given this challenge, there are research efforts focused on alternate restraints, such as four-point belts. A potential implication of this geometry would be interaction of the belt with the occupant’s neck. This study examines the response of the carotid arteries using a Finite Element Model (FEM) in a far-side crash configuration with a reversed three-point restraint. A FEM of the carotid artery and neck fascia was developed and integrated with the Total Human Model for Safety (THUMS) version 1.44. This model was subjected to four test conditions simulating far-side crashes. Load conditions included a low velocity impact of approximately 4 m/s and a higher velocity impact of approximately 10 m/s. For each velocity, the model was restrained with a belt placed low on the neck and a belt placed higher on the neck. Strain data in each element of the carotid arteries was analyzed. The overall response of the vessel was examined to determine locations of high strain values. Low belt placement resulted in more head excursion, stretching the carotid on the non-struck side. High belt placement resulted in compression of the artery on the struck side due to direct loading of the vessel from the belt. Strain values in the carotid artery elements increased with increasing speed of impact. The lower and higher speed tests with a low belt configuration resulted in a maximum principal strains, at maximal belt engagement, of 0.223 and 0.459, respectively. Corresponding values for the high belt configuration were 0.222 and 0.563. In both belt configurations, the non-struck side vessel stretched more than the struck side vessel; however, the non-struck side vessel experienced higher compressive forces. Strain values measured during the simulations can be compared to a value of 0.31 to intimal failure in previous experimental tests. These results quantitatively illustrate the two

  15. Severe compression of a bailout self-expanding chimney stent for rescuing the miscoverage of left common carotid artery during TEVAR of a type B aortic dissection.

    PubMed

    Wang, Lixin; Guo, Daqiao; Jiang, Junhao; Shi, Zhenyu; Fu, Weiguo; Wang, Yuqi

    2014-04-01

    A 54-year-old man who suffered from paraplegia due to type B aortic dissection was treated with a Valiant stent-graft. However, attempts to gain secure proximal sealing resulted in an inadvertent coverage of the left common carotid artery by the endograft. The blood flow in the left common carotid artery was restored by a transcarotid Smart Control stent in a chimney fashion. At 6- and 18-month follow-up, computed tomography scan showed that the chimney stent was severely compressed by the stent graft, although the patient remained neurologically asymptomatic. PMID:24309751

  16. Carotid Ultrasound

    MedlinePlus

    ... plaque narrows the carotid arteries and reduces the flow of oxygen-rich blood to the brain. If the plaque ruptures, a blood clot can form on its surface. A clot can mostly or completely block blood flow through a carotid artery, which can cause a ...

  17. Heteromeric TASK-1/TASK-3 is the major oxygen-sensitive background K+ channel in rat carotid body glomus cells.

    PubMed

    Kim, Donghee; Cavanaugh, Eric J; Kim, Insook; Carroll, John L

    2009-06-15

    Carotid body (CB) glomus cells from rat express a TASK-like background K+ channel that is believed to play a critical role in the regulation of excitability and hypoxia-induced increase in respiration. Here we studied the kinetic behaviour of single channel openings from rat CB cells to determine the molecular identity of the 'TASK-like' K+ channels. In outside-out patches, the TASK-like background K+ channel in CB cells was inhibited >90% by a reduction of pH(o) from 7.3 to 5.8. In cell-attached patches with 140 mM KCl and 1 mM Mg2+ in the bath and pipette solutions, two main open levels with conductance levels of approximately 14 pS and approximately 32 pS were recorded at a membrane potential of -60 mV. The K+ channels showed kinetic properties similar to TASK-1 (approximately 14 pS), TASK-3 (approximately 32 pS) and TASK-1/3 heteromer (approximately 32 pS). The presence of three TASK isoforms was tested by reducing [Mg2+](o) to approximately 0 mM, which had no effect on the conductance of TASK-1, but increased those of TASK-1/3 and TASK-3 to 42 pS and 74 pS, respectively. In CB cells, the reduction of [Mg2+](o) to approximately 0 mM also caused the appearance of approximately 42 pS (TASK-1/3-like) and approximately 74 pS (TASK-3-like) channels, in addition to the approximately 14 pS (TASK-1-like) channel. The 42 pS channel was the most abundant, contributing approximately 75% of the current produced by TASK-like channels. Ruthenium red (5 microM) had no effect on TASK-1 and TASK-1/3, but inhibited TASK-3 by 87%. In CB cells, ruthenium red caused approximately 12% inhibition of TASK-like activity. Methanandamide reduced the activity of all three TASKs by 80-90%, and that of TASK-like channels in CB cell also by approximately 80%. In CB cells, hypoxia caused inhibition of TASK-like channels, including TASK-1/3-like channels. These results show that TASK-1, TASK-1/3 and TASK-3 are all functionally expressed in isolated CB cells, and that the TASK-1/3 heteromer

  18. Association of retinopathy and intima media thickness of common carotid artery in type 2 diabetic patients

    PubMed Central

    Momeni, Ali; Dyani, Mohamad Ali; Ebrahimi, Elnaz; Sedehi, Morteza; Naderi, Afsaneh

    2015-01-01

    Background: This study was carried out in order to evaluate the relationship between retinopathy and carotid intima-media thickness (CIMT). Materials and Methods: In a cross-sectional study, 154 diabetic patients who had a history of diabetic disease were evaluated in two equal groups of 77 patients with and without retinopathy, respectively. CIMT was evaluated in all of the patients. Results: Mean age of the patients was 59.65 ± 9.37 years. Mean CIMT of all patients was 0.84 ± 0.18. CIMT of patients with retinopathy was significantly greater than patients without retinopathy (P < 0.001). CIMT also correlated with age, duration of diabetes, systolic blood pressure, blood urea nitrogen, and serum creatinine. Conclusion: CIMT may be used as a simple, available and noninvasive method for screening of macro and microvascular complication of diabetic patients. PMID:26109997

  19. Transvenous Embolization for Carotid-Cavernous Fistula in a Patient with Vascular Type of Ehlers-Danlos Syndrome—Direct Superior Ophthalmic Vein Approach: Case Report

    PubMed Central

    TANAKA, Teppei; HAYAKAWA, Motoharu; SADATO, Akiyo; ADACHI, Kazuhide; WATABE, Takeya; MAEDA, Shingo; OHMURA, Masahiro; HIROSE, Yuichi

    2014-01-01

    The vascular type of Ehlers-Danlos syndrome (vEDS) is an autosomal dominant hereditary disease characterized by connective tissue fragility throughout the body, including the arteries, viscera, and gastrointestinal tract. We report a case in which we performed transvenous embolization (TVE) via direct superior ophthalmic vein (SOV) approach to treat a direct carotid-cavernous fistula (CCF) in a patient with Ehlers-Danlos syndrome (EDS). The patient was a 37-year-old woman who developed tinnitus in her left ear and a headache during examination in the outpatient clinic of another hospital in order to make a definitive diagnosis of vEDS, and she was referred to our hospital and examined. Based on the results of all of the studies she was diagnosed with a CCF. Conservative treatment was attempted, but was not very effective. Because of progressing aphasia, TVE was performed via the SOV direct cut. There were no intraoperative or postoperative complications. It has been reported that cerebral angiography is generally contraindicated in vEDS and that the morbimortality associated with endovascular treatment is very high. When performing treatment it is necessary to be sufficiently aware of the risks it entails. PMID:24418783

  20. Multiple strokes and bilateral carotid dissections: a fulminant case of newly diagnosed Ehlers-Danlos syndrome type IV.

    PubMed

    Dohle, C; Baehring, J M

    2012-07-15

    Ehlers-Danlos Syndrome is a rare group of inheritable disorders resulting in abnormal collagen production, leading to skin fragility, joint hypermobility and easy bruising. Six major subtypes have been identified, of which Type IV most often leads to neurovascular complications, may lead to inner organ rupture and overall has the worst prognosis. Early recognition followed by genetic testing is key, since this diagnosis will guide decision making in the management of complications, influence the choice of antiplatelet medications versus anticoagulants and allow for potentially affected family members to be identified, undergo genetic testing and reproductive counseling. We here report the case of a 50 year old woman with a fulminant presentation of Ehlers Danlos Syndrome Type IV, including bilateral carotid and vertebral artery dissection, multiple strokes and liver rupture. Of note, this patient did not have a known history or obvious clinical features of connective tissue disease. Genetic testing confirmed the diagnosis. Review of her family history revealed multiple family members with a history of aortic dissection or aneurysm rupture. This case illustrates that Ehlers Danlos Syndrome Type IV is an important differential diagnosis even in adult patients without a known history of connective tissue disease and no prior complications. PMID:22559935

  1. Microsurgical anatomy of the human carotid body (glomus caroticum): Features of its detailed topography, syntopy and morphology.

    PubMed

    Schulz, Sissy-Amelie; Wöhler, Aliona; Beutner, Dirk; Angelov, Doychin N

    2016-03-01

    The human glomus caroticum (GC) is not readily accessible during ordinary anatomical teaching courses because of insufficient time and difficulties encountered in the preparation. Accordingly, most anatomical descriptions of its location, relationship to neighboring structures, size and shape are supported only by drawings, but not by photographs. The aim of this study is to present the GC with all associated roots and branches. Following microscope-assisted dissection and precise photo-documentation, a detailed analysis of location, syntopy and morphology was performed. We carried out this study on 46 bifurcations of the common carotid artery (CCA) into the external (ECA) and internal (ICA) carotid arteries and identified the GC in 40 (91%) of them. We found significant variations regarding the location of the GC and its syntopy: GC was associated with CCA (42%), ECA (28%) and ICA (30%) lying on the medial or lateral surface (82% or 13%, respectively) or exactly in the middle (5%) of the bifurcation. The short and long diameter of its oval form varied from 1.0×2.0 to 5.0×5.0mm. Connections with the sympathetic trunk (100%), glossopharyngeal (93%), vagus (79%) and hypoglossal nerve (90%) could be established in 29 cadavers. We conclude that precise knowledge of this enormous variety might be very helpful not only to students in medicine and dentistry during anatomical dissection courses, but also to surgeons working in this field. PMID:26704358

  2. Atorvastatin Treatment for Carotid Intima-Media Thickness in Chinese Patients With Type 2 Diabetes: A Meta-Analysis.

    PubMed

    Fang, Na; Han, Wei; Gong, Dandan; Zou Chen; Fan, Yu

    2015-11-01

    Impact of atorvastatin on carotid intima-media thickness (CIMT) in patients with type 2 diabetes is still debating.The aim of our study is to investigate atorvastatin as adjuvant treatment on CIMT in Chinese patients with type 2 diabetes by conducting a meta-analysis based on the randomized controlled trials (RCTs).A systematic search of electronic database of the Pubmed, EMBASE, Cochrane Library, VIP database, China National Knowledge Infrastructure, and Wangfang up to January 2015 was conducted. Randomized controlled trials (RCTs) comparing atorvastatin adjuvant treatment to the hypoglycemic therapies or high-dose atorvastatin versus low-dose atorvastatin therapies for patients with type 2 diabetes were selected.A total of 14 RCTs involving 1345 patients were included. Adjuvant treatment with atorvastatin was associated with a significant reduction in CIMT (weighted mean difference [WMD] = -0.17 mm; 95% confidence interval [CI] -0.22 to -0.12). Compared with the low-dose atorvastatin, high-dose atorvastatin treatment was associated with a significant reduction in CIMT (WMD = -0.17 mm; 95% CI: -0.32 to -0.02). Adjuvant treatment with atorvastatin reduced serum total cholesterol, triglyceride, low-density lipoproteins, and high sensitivity C-reactive protein levels. However, atorvastatin had no significant impact on blood glucose levels.This meta-analysis demonstrated that treatment with atorvastatin significantly reduced CIMT in Chinese patients with type 2 diabetes. Moreover, high-dose atorvastatin appeared to have additional benefits in reducing CIMT than the low-dose atorvastatin. PMID:26554793

  3. The Combined Impact of Neutrophil-to-Lymphocyte Ratio and Type 2 Diabetic Mellitus on Significant Coronary Artery Disease and Carotid Artery Atherosclerosis

    PubMed Central

    Kim, Bong-Joon; Cho, Sang-Hoon; Kim, Hyun-Su; Heo, Jung-Ho; Cha, Tae-Joon

    2016-01-01

    Background Neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a new important inflammatory marker for predicting cardiovascular events. This study aimed to evaluate the combined impact of NLR and type 2 diabetes mellitus (T2DM) on significant coronary artery disease (CAD) and carotid artery atherosclerosis. Methods This study includes a total of 828 patients evaluated by coronary angiography and carotid ultrasonography. Significant CAD was defined as at least one vessel with stenosis greater than 50%. We employed logistic regression models to investigate the association of NLR and T2DM with significant CAD. The goodness-of-fit and discriminability of the models were assessed by the loglikelihood ratio test and C-index, respectively. Also, we investigated the clinical relevance of the categorized NLR that classifies patients into three risk groups (low, intermediate, high). Results According to logistic regression analysis, both NLR {adjusted odds ratio (OR) 1.31, p < 0.001} and T2DM (adjusted OR 2.46, p = 0.006) were independent risk factors of significant CAD. The addition of NLR and T2DM into a logistic regression model including conventional cardiovascular risk factors significantly improved the goodness-of-fit (p < 0.001) and the discriminability of the model (p = 0.004). Also, T2DM patients assigned into the high risk group (NLR > 2) showed the greater prevalence of significant CAD and carotid artery atherosclerosis compared with patients without T2DM or type 2 diabetic patients assigned into the low risk group (NLR ≤ 1). Conclusion Our results suggest that type 2 diabetic patients with high inflammatory state would be more vulnerable to significant CAD and carotid artery atherosclerosis. PMID:27358703

  4. A novel approach to the treatment of a direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV.

    PubMed

    Nakagawa, Ichiro; Park, Hun Soo; Wada, Takeshi; Takayama, Katsutoshi; Nakagawa, Hiroyuki; Kichikawa, Kimihiko; Nakase, Hiroyuki

    2016-01-01

    We report a case of a direct carotid-cavernous fistula (CCF) in a patient with Ehlers-Danlos syndrome type IV who presented with progressive chemosis and diplopia. To prevent potential lethal arterial wall injury due to the fragility of the arterial vessel wall, the ipsilateral carotid artery and internal jugular vein were surgically exposed for direct insertion of endovascular sheaths, and transvenous embolization was performed using triple microcatheters with detachable coils. The clinical course was uneventful, and chemosis and diplopia subsequently resolved. By the 6 month follow-up, MRI revealed no recurrence of the CCF. These techniques offer a unique access alternative for endovascular treatment, thereby reducing the risks associated with arterial dissection that often accompanies transfemoral access in this particular condition. PMID:25432980

  5. Direct Carotid Cavernous Fistula of an Adult-Type Persistent Primitive Trigeminal Artery with Multiple Vascular Variations

    PubMed Central

    Jin, Sung-Chul; Park, Hyun; Choi, Choong-Gon

    2011-01-01

    We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF. PMID:21607181

  6. Direct carotid cavernous fistula of an adult-type persistent primitive trigeminal artery with multiple vascular variations.

    PubMed

    Jin, Sung-Chul; Park, Hyun; Kwon, Do Hoon; Choi, Choong-Gon

    2011-04-01

    We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF. PMID:21607181

  7. A computer-graphic technique for the study of body size perception and body types.

    PubMed

    Benson, P J; Emery, J L; Cohen-Tovée, E M; Tovée, M J

    1999-08-01

    We present a novel approach for measuring body size estimation in normal and eating-disordered women and men. Clinical categories of body types were used as prototypes. By comparing the subjective appearance of a person's body with prototypes, we can understand how different attributes of his or her body shape contribute to perception of body size. After lifelike random distortions have been applied to parts of their body image, individuals adjust their body shapes until they converge on their perceived veridical appearance. Exaggeration and minimization of particular body areas measured with respect to their true shape and with different prototypes can be expressed as numerical deviations. In this way, perceived body size and body attractiveness can be appraised during the course of diagnosis and treatment of eating disorders. PMID:10502868

  8. Carotid Artery Disease

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Carotid Artery Disease? Carotid artery disease is a disease in ... blood to your face, scalp, and neck. Carotid Arteries Figure A shows the location of the right ...

  9. Distribution of transient receptor potential channels in the rat carotid chemosensory pathway.

    PubMed

    Buniel, Maria C F; Schilling, William P; Kunze, Diana L

    2003-09-22

    Glomus cells in the carotid body respond to decreases in oxygen tension of the blood and transmit this sensory information in the carotid sinus nerve to the brain via neurons in the petrosal ganglion. G-protein-coupled membrane receptors linked to phospholipase C may play an important role in this response through the activation of the cation channels formed by the transient receptor potential (TRP) proteins. In the present study, expression of TRPC proteins in the rat carotid body and petrosal ganglion was examined using immunohistochemical techniques. TRPC3, TRPC4, TRPC5, TRPC6, and TRPC7 were present in neurons throughout the ganglion. TRPC1 was expressed in only 28% of petrosal neurons, and of this population, 45% were tyrosine hydroxylase (TH)-positive, accounting for essentially all the TH-expressing neurons in the ganglion. Because TH-positive neurons project to the carotid body, this result suggests that TRPC1 is selectively associated with the chemosensory pathway. Confocal images through the carotid body showed that TRPC1/3/4/5/6 proteins localize to the carotid sinus nerve fibers, some of which were immunoreactive to an anti-neurofilament (NF) antibody cocktail. TRPC1 and TRPC3 were present in both NF-positive and NF-negative fibers, whereas TPRC4, TRPC5, and TRPC6 expression was primarily localized to NF-negative fibers. Only TRPC1 and TRPC4 were localized in the afferent nerve terminals that encircle individual glomus cells. TRPC7 was not expressed in sensory fibers. All the TRPC proteins studied were present in type I glomus cells. Although their role as receptor-activated cation channels in the chemosensory pathway is yet to be established, the presence of TRPC channels in glomus cells and sensory nerves of the carotid body suggests a role in facilitating and/or sustaining the hypoxic response. PMID:12900933

  10. Scandia-doped tungsten bodies for Sc-type cathodes

    NASA Astrophysics Data System (ADS)

    Wang, Jinshu; Wang, Yiman; Tao, Siwu; Li, Hongyi; Yang, Jiancan; Zhou, Meiling

    2003-06-01

    We systematically investigated scandium oxide-doped (and with small amount of rhenium-doped) tungsten bodies for Scandate-type cathodes. Homogeneous microstructure and uniform distribution of scandia were found in these bodies. Sub-micron granular porous bodies with greatly uniformly dispersed scandia are obtained by sintering Sc 2O 3 and Re doped tungsten powder. Such bodies are thought to be beneficial for emission uniformity. For Scandate-type cathodes with such bodies, a slight decrease of scandia was observed by "in situ" AES analysis after ion sputtering, but it recovers completely on reheating. It is assumed that film-like Sc 2O 3 coating over tungsten grains but leaving porous areas for diffusion of barium to the surface leads to good emission properties and high resistance to ion bombardment. Reprocucibility has been proved for the body manufactering process. This offers the possibility of improving the performance of these cathodes in applications such as CRT's.

  11. Spatial Distribution of Small Water Body Types across Indiana Ecoregions

    EPA Science Inventory

    Due to their large numbers and biogeochemical activity, small water bodies (SWB), such as ponds and wetlands, can have substantial cumulative effects on hydrologic, biogeochemical, and biological processes; yet the spatial distributions of various SWB types are often unknown. Usi...

  12. Anomalous course of the external carotid artery.

    PubMed

    Kawai, Katsushi

    2016-09-01

    The course and the branching patterns of the external carotid artery were investigated macroscopically in a total of 550 bodies or 1100 head sides of Japanese subjects, donated for student dissection at Kumamoto University from 1994 to 2014. With the exception of 14 head sides, the external carotid arteries running between the posterior belly of the digastric and stylohyoid muscles were found in 42 (3.87 %) out of 1086 head sides. Strictly speaking, they passed between the stylohyoid muscle and the stylohyoid branch of the facial nerve in 23 out of these 42 head sides. In the remaining 19 instances, the stylohyoid branch of the facial nerve was cut and its relationship to the external carotid artery was not clear. The external carotid artery running lateral to the intact stylohyoid branch of the facial nerve, medial to the digastric muscle was not found. The external carotid arteries running lateral to the digastric muscle were found in 4 (0.37 %) out of 1086 head sides. As a result, it is proposed that plural, potential courses of the external carotid artery originally exist and that some parts of such potential courses remain as branches of the external carotid artery in the usual instance, while the anomalous courses of the external carotid artery are induced mainly by anastomosis between the muscular branches supplying the wall of the head and neck in contrast to the usual external carotid artery induced mainly by the branches originally supplying the pharynx. PMID:26439732

  13. Gene Expression Profiling Supports the Neural Crest Origin of Adult Rodent Carotid Body Stem Cells and Identifies CD10 as a Marker for Mesectoderm-Committed Progenitors.

    PubMed

    Navarro-Guerrero, Elena; Platero-Luengo, Aida; Linares-Clemente, Pedro; Cases, Ildefonso; López-Barneo, José; Pardal, Ricardo

    2016-06-01

    Neural stem cells (NSCs) are promising tools for understanding nervous system plasticity and repair, but their use is hampered by the lack of markers suitable for their prospective isolation and characterization. The carotid body (CB) contains a population of peripheral NSCs, which support organ growth during acclimatization to hypoxia. We have set up CB neurosphere (NS) cultures enriched in differentiated neuronal (glomus) cells versus undifferentiated progenitors to investigate molecular hallmarks of cell classes within the CB stem cell (CBSC) niche. Microarray gene expression analysis in NS is compatible with CBSCs being neural crest derived-multipotent progenitor cells able to sustain CB growth upon exposure to hypoxia. Moreover, we have identified CD10 as a marker suitable for isolation of a population of CB mesectoderm-committed progenitor cells. CD10 + cells are resting in normoxia, and during hypoxia they are activated to proliferate and to eventually complete maturation into mesectodermal cells, thus participating in the angiogenesis necessary for CB growth. Our results shed light into the molecular and cellular mechanisms involved in CBSC fate choice, favoring a potential use of these cells for cell therapy. Stem Cells 2016;34:1637-1650. PMID:26866353

  14. Enhanced nitric oxide generation from nitric oxide synthases as the cause of increased peroxynitrite formation during acute restraint stress: Effects on carotid responsiveness to angiotensinergic stimuli in type-1 diabetic rats.

    PubMed

    Moreira, Josimar D; Pernomian, Larissa; Gomes, Mayara S; Moreira, Rafael P; do Prado, Alejandro F; da Silva, Carlos H T P; de Oliveira, Ana M

    2016-07-15

    Diabetes mellitus is associated with reactive oxygen and nitrogen species accumulation. Behavioral stress increases nitric oxide production, which may trigger a massive impact on vascular cells and accelerate cardiovascular complications under oxidative stress conditions such as Diabetes. For this study, type-1 Diabetes mellitus was induced in Wistar rats by intraperitoneal injection of streptozotocin. After 28 days, cumulative concentration-response curves for angiotensin II were obtained in endothelium-intact carotid rings from diabetic rats that underwent to acute restraint stress for 3h. The contractile response evoked by angiotensin II was increased in carotid arteries from diabetic rats. Acute restraint stress did not alter angiotensin II-induced contraction in carotid arteries from normoglycaemic rats. However acute stress combined with Diabetes increased angiotensin II-induced contraction in carotid rings. Western blot experiments and the inhibition of nitric oxide synthases in functional assays showed that neuronal, endothelial and inducible nitric oxide synthase isoforms contribute to the increased formation of peroxynitrite and contractile hyperreactivity to angiotensin II in carotid rings from stressed diabetic rats. In summary, these findings suggest that the increased superoxide anion generation in carotid arteries from diabetic rats associated to the increased local nitric oxide synthases expression and activity induced by acute restrain stress were responsible for exacerbating the local formation of peroxynitrite and the contraction induced by angiotensin II. PMID:27118175

  15. Carotid artery anatomy (image)

    MedlinePlus

    There are four carotid arteries, two on each side of the neck: right and left internal carotid arteries, and right and left external carotid arteries. The carotid arteries deliver oxygen-rich blood from the heart to the head and brain.

  16. Type-D personality and body image in men: the role of exercise status.

    PubMed

    Borkoles, Erika; Polman, Remco; Levy, Andrew

    2010-01-01

    The 'Distressed' or Type-D personality is described by the interaction between high levels of negative affectivity and social inhibition. This study investigated the prevalence of Type-D personality in men of different exercise status, the association between Type-D and body image perceptions, and the moderating effect of exercise status. Participants were 564 British males aged between 18 and 55 years. Of these 200 were classified as sedentary, 148 as active and 216 as weight trainers. Participants completed the DS14 and Multidimensional Body-Self Relations Questionnaire. Results showed that more individuals were classified as Type-D in the sedentary group (45%) than the two active groups, and in the weight training (24.5%) than the active (14.2%) group. Both Type-D and a sedentary lifestyle were associated with a significantly poorer body image. However, exercise mode was not associated with body image differences. Sedentary Type-D men scored significantly lower in Body Areas Satisfaction and higher in Self-Classified Weight than both active groups. Regular exercise might provide a pathway for Type-D men to develop a more positive body image. PMID:19945926

  17. Carotid artery stenting: current and emerging options

    PubMed Central

    Morr, Simon; Lin, Ning; Siddiqui, Adnan H

    2014-01-01

    Carotid artery stenting technologies are rapidly evolving. Options for endovascular surgeons and interventionists who treat occlusive carotid disease continue to expand. We here present an update and overview of carotid stenting devices. Evidence supporting carotid stenting includes randomized controlled trials that compare endovascular stenting to open surgical endarterectomy. Carotid technologies addressed include the carotid stents themselves as well as adjunct neuroprotective devices. Aspects of stent technology include bare-metal versus covered stents, stent tapering, and free-cell area. Drug-eluting and cutting balloon indications are described. Embolization protection options and new direct carotid access strategies are reviewed. Adjunct technologies, such as intravascular ultrasound imaging and risk stratification algorithms, are discussed. Bare-metal and covered stents provide unique advantages and disadvantages. Stent tapering may allow for a more fitted contour to the caliber decrement between the common carotid and internal carotid arteries but also introduces new technical challenges. Studies regarding free-cell area are conflicting with respect to benefits and associated risk; clinical relevance of associated adverse effects associated with either type is unclear. Embolization protection strategies include distal filter protection and flow reversal. Though flow reversal was initially met with some skepticism, it has gained wider acceptance and may provide the advantage of not crossing the carotid lesion before protection is established. New direct carotid access techniques address difficult anatomy and incorporate sophisticated flow-reversal embolization protection techniques. Carotid stenting is a new and exciting field with rapidly advancing technologies. Embolization protection, low-risk deployment, and lesion assessment and stratification are active areas of research. Ample room remains for further innovations and developments. PMID:25349483

  18. Carotid baroreflex responsiveness in heat-stressed humans

    NASA Technical Reports Server (NTRS)

    Crandall, C. G.

    2000-01-01

    The effects of whole body heating on human baroreflex function are relatively unknown. The purpose of this project was to identify whether whole body heating reduces the maximal slope of the carotid baroreflex. In 12 subjects, carotid-vasomotor and carotid-cardiac baroreflex responsiveness were assessed in normothermia and during whole body heating. Whole body heating increased sublingual temperature (from 36.4 +/- 0.1 to 37.4 +/- 0.1 degrees C, P < 0.01) and increased heart rate (from 59 +/- 3 to 83 +/- 3 beats/min, P < 0. 01), whereas mean arterial blood pressure (MAP) was slightly decreased (from 88 +/- 2 to 83 +/- 2 mmHg, P < 0.01). Carotid-vasomotor and carotid-cardiac responsiveness were assessed by identifying the maximal gain of MAP and heart rate to R wave-triggered changes in carotid sinus transmural pressure. Whole body heating significantly decreased the responsiveness of the carotid-vasomotor baroreflex (from -0.20 +/- 0.02 to -0.13 +/- 0.02 mmHg/mmHg, P < 0.01) without altering the responsiveness of the carotid-cardiac baroreflex (from -0.40 +/- 0.05 to -0.36 +/- 0.02 beats x min(-1) x mmHg(-1), P = 0.21). Carotid-vasomotor and carotid-cardiac baroreflex curves were shifted downward and upward, respectively, to accommodate the decrease in blood pressure and increase in heart rate that accompanied the heat stress. Moreover, the operating point of the carotid-cardiac baroreflex was shifted closer to threshold (P = 0.02) by the heat stress. Reduced carotid-vasomotor baroreflex responsiveness, coupled with a reduction in the functional reserve for the carotid baroreflex to increase heart rate during a hypotensive challenge, may contribute to increased susceptibility to orthostatic intolerance during a heat stress.

  19. Inhibition of [3H]catecholamine release and Ca2+ currents by prostaglandin E2 in rabbit carotid body chemoreceptor cells.

    PubMed Central

    Gómez-Niño, A; López-López, J R; Almaraz, L; González, C

    1994-01-01

    Basal release of [3H]catecholamine ([3H]CA) from rabbit carotid bodies (CBs), previously incubated in the presence of [3H]tyrosine, was not significantly modified by prostaglandin E2 (PGE2). On the contrary, PGE2 (3-300 nM) produced a dose-dependent inhibition of the low PO2-evoked release of [3H]CA. The inhibition was greatest (55%) at a low intensity of hypoxic stimulation (incubating solution PO2 approximately 66 mmHg) and decreased with increasing intensities of hypoxia. Chronic denervation of the CB did not modify the response to PGE2. The release of [3H]CA induced by incubating the CBs in a hypercapnic-acidic solution (PCO2 approximately 132 mmHg; pH = 6.60) and by dinitrophenol (100 microM) was not significantly modified by 300 nM PGE2. PGE2 (300 nM) inhibited the release of [3H]CA elicited by incubating the CBs in a high K+ (35 mM)-containing solution. The release response elicited by high K+ (25 mM) was strongly augmented by a dihydropyridine agonist of Ca2+ channels, Bay K 8644, at a concentration of 1 microM. The Bay K 8644 effect was partly inhibited by PGE2 (300 nM). Using whole-cell recordings in freshly dispersed or short-term cultured chemoreceptor cells from adult rabbits it was found that Ca2+ currents (ICa) were reversibly inhibited by bath application of PGE2. A good parallelism exits between the dose-response curves for PGE2 inhibition of ICa in isolated chemoreceptor cells and high extracellular [K+]- or hypoxia-evoked release of [3H]CA from the whole CB.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7519263

  20. Increase in cytosolic Ca2+ produced by hypoxia and other depolarizing stimuli activates a non-selective cation channel in chemoreceptor cells of rat carotid body

    PubMed Central

    Kang, Dawon; Wang, Jiaju; Hogan, James O; Vennekens, Rudi; Freichel, Marc; White, Carl; Kim, Donghee

    2014-01-01

    The current model of O2 sensing by carotid body chemoreceptor (glomus) cells is that hypoxia inhibits the outward K+ current and causes cell depolarization, Ca2+ influx via voltage-dependent Ca2+ channels and a rise in intracellular [Ca2+] ([Ca2+]i). Here we show that hypoxia (<5% O2), in addition to inhibiting the two-pore domain K+ channels TASK-1/3 (TASK), indirectly activates an ∼20 pS channel in isolated glomus cells. The 20 pS channel was permeable to K+, Na+ and Cs+ but not to Cl− or Ca2+. The 20 pS channel was not sensitive to voltage. Inhibition of TASK by external acid, depolarization of glomus cells with high external KCl (20 mm) or opening of the Ca2+ channel with FPL64176 activated the 20 pS channel when 1 mm Ca2+ was present in the external solution. Ca2+ (10 μm) applied to the cytosolic side of inside-out patches activated the 20 pS channel. The threshold [Ca2+]i for activation of the 20 pS channel in cell-attached patches was ∼200 nm. The reversal potential of the 20 pS channel was estimated to be −28 mV. Our results reveal a sequential mechanism in which hypoxia (<5% O2) first inhibits the K+ conductance and then activates a Na+-permeable, non-selective cation channel via depolarization-induced rise in [Ca2+]i. Our results suggest that inhibition of K+ efflux and stimulation of Na+ influx both contribute to the depolarization of glomus cells during moderate to severe hypoxia. PMID:24591572

  1. Solvable Many-Body Models of Goldfish Type with One-, Two- and Three-Body Forces

    NASA Astrophysics Data System (ADS)

    Bihun, Oksana; Calogero, Francesco

    2013-10-01

    The class of solvable many-body problems ''of goldfish type'' is extended by including (the additional presence of) three-body forces. The solvable N-body problems thereby identified are characterized by Newtonian equations of motion featuring 19 arbitrary ''coupling constants''. Restrictions on these constants are identified which cause these systems - or appropriate variants of them - to be isochronous or asymptotically isochronous, i.e. all their solutions to be periodic with a fixed period (independent of the initial data) or to have this property up to contributions vanishing exponentially as t→ ∞.

  2. Effects of biphasic, basal-bolus or basal insulin analogue treatments on carotid intima-media thickness in patients with type 2 diabetes mellitus: the randomised Copenhagen Insulin and Metformin Therapy (CIMT) trial

    PubMed Central

    Lundby-Christensen, Louise; Vaag, Allan; Tarnow, Lise; Almdal, Thomas P; Lund, Søren S; Wetterslev, Jørn; Gluud, Christian; Boesgaard, Trine W; Wiinberg, Niels; Perrild, Hans; Krarup, Thure; Snorgaard, Ole; Gade-Rasmussen, Birthe; Thorsteinsson, Birger; Røder, Michael; Mathiesen, Elisabeth R; Jensen, Tonny; Vestergaard, Henrik; Hedetoft, Christoffer; Breum, Leif; Duun, Elsebeth; Sneppen, Simone B; Pedersen, Oluf; Hemmingsen, Bianca; Carstensen, Bendix; Madsbad, Sten

    2016-01-01

    Objective To assess the effect of 3 insulin analogue regimens on change in carotid intima-media thickness (IMT) in patients with type 2 diabetes. Design and setting Investigator-initiated, randomised, placebo-controlled trial with a 2×3 factorial design, conducted at 8 hospitals in Denmark. Participants and interventions Participants with type 2 diabetes (glycated haemoglobin (HbA1c)≥7.5% (≥58 mmol/mol), body mass index >25 kg/m2) were, in addition to metformin versus placebo, randomised to 18 months open-label biphasic insulin aspart 1–3 times daily (n=137) versus insulin aspart 3 times daily in combination with insulin detemir once daily (n=138) versus insulin detemir alone once daily (n=137), aiming at HbA1c≤7.0% (≤53 mmol/mol). Outcomes Primary outcome was change in mean carotid IMT (a marker of subclinical cardiovascular disease). HbA1c, insulin dose, weight, and hypoglycaemic and serious adverse events were other prespecified outcomes. Results Carotid IMT change did not differ between groups (biphasic −0.009 mm (95% CI −0.022 to 0.004), aspart+detemir 0.000 mm (95% CI −0.013 to 0.013), detemir −0.012 mm (95% CI −0.025 to 0.000)). HbA1c was more reduced with biphasic (−1.0% (95% CI −1.2 to −0.8)) compared with the aspart+detemir (−0.4% (95% CI −0.6 to −0.3)) and detemir (−0.3% (95% CI −0.4 to −0.1)) groups (p<0.001). Weight gain was higher in the biphasic (3.3 kg (95% CI 2.7 to 4.0) and aspart+detemir (3.2 kg (95% CI 2.6 to 3.9)) compared with the detemir group (1.9 kg (95% CI 1.3 to 2.6)). Insulin dose was higher with detemir (1.6 IU/kg/day (95% CI 1.4 to 1.8)) compared with biphasic (1.0 IU/kg/day (95% CI 0.9 to 1.1)) and aspart+detemir (1.1 IU/kg/day (95% CI 1.0 to 1.3)) (p<0.001). Number of participants with severe hypoglycaemia and serious adverse events did not differ. Conclusions Carotid IMT change did not differ between 3 insulin regimens despite differences in HbA1c, weight gain and

  3. Carotid Artery Disease

    MedlinePlus

    ... brain with blood. If you have carotid artery disease, the arteries become narrow, usually because of atherosclerosis. ... one of the causes of stroke. Carotid artery disease often does not cause symptoms, but there are ...

  4. Carotid artery disease

    MedlinePlus

    ... you have had a stroke or TIA, a nervous system (neurological) exam will show other problems. You may also have the following tests: Blood cholesterol and triglycerides test Blood sugar (glucose) test Ultrasound of the carotid arteries ( carotid ...

  5. Carotid artery surgery - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000238.htm Carotid artery surgery - discharge To use the sharing features on this page, please enable JavaScript. You had carotid artery surgery to restore proper blood flow to your ...

  6. Carotid artery surgery - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100124.htm Carotid artery surgery - series To use the sharing features on ... 4 Normal anatomy Overview There are four carotid arteries, with a pair located on each side of ...

  7. Carotid sinus syndrome.

    PubMed

    Mallet, Mark

    2003-02-01

    This article reviews the recent literature about carotid sinus syndrome. It looks principally at the various ways in which it may present, the limited knowledge of its pathophysiology, and the role of carotid sinus massage in the investigation of carotid sinus syndrome. PMID:12619336

  8. Carotid endarterectomy or stenting?

    PubMed Central

    Ng, P Y

    2009-01-01

    The relative role of surgical or endovascular treatment in carotid stenosis remains controversial. Results of recent studies add even more confusion to the debate. Major clinical trials so far have shown a wide range of complication rates for carotid endarterectomy and carotid stenting. Only surgeons or interventionists who can maintain a complication rate of 3% or below should consider treating patients with asymptomatic disease.

  9. Molecular identification of Kvα subunits that contribute to the oxygen-sensitive K+ current of chemoreceptor cells of the rabbit carotid body

    PubMed Central

    Sanchez, Diego; López-López, Jose R; Pérez-García, M Teresa; Sanz-Alfayate, Gloria; Obeso, Ana; Ganfornina, Maria D; Gonzalez, Constancio

    2002-01-01

    Rabbit carotid body (CB) chemoreceptor cells possess a fast-inactivating K+ current that is specifically inhibited by hypoxia. We have studied the expression of Kvα subunits, which might be responsible for this current. RT-PCR experiments identified the expression of Kv1.4, Kv3.4, Kv4.1 and Kv4.3 mRNAs in the rabbit CB. There was no expression of Kv3.3 or Kv4.2 transcripts. Immunocytochemistry with antibodies to tyrosine hydroxylase (anti-TH) and to specific Kv subunits revealed the expression of Kv3.4 and Kv4.3 in chemoreceptor cells, while Kv1.4 was only found in nerve fibres. Kv4.1 mRNA was also found in chemoreceptor cells following in situ hybridization combined with anti-TH antibody labelling. Kv4.1 and Kv4.3 appeared to be present in all chemoreceptor cells, but Kv3.4 was only expressed in a population of them. Electrophysiological experiments applying specific toxins or antibodies demonstrated that both Kv3.4 and Kv4.3 participate in the oxygen-sensitive K+ current of chemoreceptor cells. However, toxin application experiments confirmed a larger contribution of members of the Kv4 subfamily. [Ca2+]i measurements under hypoxic conditions and immunocytochemistry experiments in dispersed CB cells demonstrated the expression of Kv3.4 and Kv4.3 in oxygen-sensitive cells; the presence of Kv3.4 in the chemoreceptor cell membrane was not required for the response to low PO2. In summary, three Kv subunits (Kv3.4, Kv4.1 and Kv4.3) may be involved in the fast-inactivating outward K+ current of rabbit CB chemoreceptor cells. The homogeneous distribution of the Kv4 subunits in chemoreceptor cells, along with their electrophysiological properties, suggest that Kv4.1, Kv4.3, or their heteromultimers, are the molecular correlate of the oxygen-sensitive K+ channel. PMID:12122138

  10. Association of Risk Estimates of Three Different Cardiovascular Risk Assessment Tools with Carotid Intima Media Thickness in Patients with Type 2 Diabetes

    PubMed Central

    Weerarathna, Thilak Priyantha; Dulanjalee, Ranasinghe Bethmi Arachige Thilini; Jayawardana, Madumekala Rupasinghe; Edirisingha, Udara Priyadarshani; Rathnayake, Madushanka

    2016-01-01

    Introduction Risk assessment tools used to calculate the Cardiovascular Disease (CVD) risk such as the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes study (UKPDS) risk engine and the World Health Organization (WHO) risk score have not been tested on their ability to detect subclinical atherosclerosis in most developing countries. Aim To study the association between the calculated CVD risk scores using each of these tools and Carotid Intima Medial Thickness (CIMT), a surrogate marker of atherosclerosis, in a group of patients with Type 2 diabetes (T2DM) in Sri Lanka. Materials and Methods We calculated CVD risk scores of 68 randomly selected patients with T2DM with no history or symptoms of CVD and measured their CIMT using B-mode ultrasonography (USS). Carotid USS was considered positive when the maximum carotid IMT was 0.9mm or when arteriosclerotic plaques were detected. The 10-year CVD risk was calculated using the FRS, the UKPDS risk engine and the WHO risk score. Pearson correlation was used to study the association between CVD risk scores with CIMT. Results Of the 68 patients studied, 50% were males and their mean age (SD) was 56.9 (±9.6) years. The mean age at onset and duration of diabetes were 44.3(±9.1) and 12.2(±7.6) years respectively. Of the scoring methods, UKPDS tool had weak, but significantly positive (r = 0.26, p < 0.05) and FRS had positive but not significant association (r= 0. 21) with CIMT. There was a negative association between CIMT and WHO risk score (r= - 0.07). Conclusion Of the three CVD risk assessment tools, both UKPDS risk engine and FRS have almost equal ability (former being marginally superior) in predicting underlying atherosclerotic vascular disease in patients with T2DM. Negative association of the WHO risk score with CIMT argues against its utility for CVD screening. These findings highlight the need for developing more sensitive and reliable CVD risk assessment tools for developing countries.

  11. Experimental aerodynamic study of a car-type bluff body

    NASA Astrophysics Data System (ADS)

    Conan, Boris; Anthoine, Jérôme; Planquart, Philippe

    2011-05-01

    The Ahmed body is used as a reference model for fundamental studies of car-type bluff body aerodynamics, in particular focused on the influence of the rear slant angle on the drag coefficient. The objectives of the present work are to obtain reliable drag coefficient comparable to the literature and to explain, based on the nature of the flow, its variation when changing the rear slant angle from 10° to 40°. The drag coefficients measured in both an open and a closed test sections differ by less than 0.5% which proves the reliability and reproducibility of the results. The sensitivity of the drag coefficient to some parameters such as the model roughness or the oncoming boundary layer and the lack of precise information on these parameters in the literature could explain the difference observed with the Ahmed drag coefficient data. The various types of measurement techniques used in the study underline their complementarity. The combination of particle image velocimetry and oil visualization provides a deeper understanding of the flow behaviour around the Ahmed body and a physical interpretation of the drag coefficient evolution.

  12. Data on carotid intima-media thickness and lipoprotein subclasses in type 1 diabetes from the Diabetes Control and Complications Trial and the Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC)

    PubMed Central

    Basu, Arpita; Jenkins, Alicia J.; Zhang, Ying; Stoner, Julie A.; Klein, Richard L.; Lopes-Virella, Maria F.; Timothy Garvey, W.; Lyons, Timothy J.

    2015-01-01

    Type 1 diabetes (T1DM) is associated with increased risk of macrovascular complications. We examined longitudinal associations of serum conventional lipids and nuclear magnetic resonance (NMR)-determined lipoprotein subclasses with carotid intima-media thickness (IMT) in adults with T1DM (n=455) enrolled in the Diabetes Control and Complications Trial (DCCT). Data on serum lipids and lipoproteins were collected at DCCT baseline (1983–89) and were correlated with common and internal carotid IMT determined by ultrasonography during the observational follow-up of the DCCT, the Epidemiology of Diabetes Interventions and Complications (EDIC) study, at EDIC ‘Year 1’ (199–1996) and EDIC ‘Year 6’ (1998–2000). This article contains data on the associations of DCCT baseline lipoprotein profiles (NMR-based VLDL & chylomicrons, IDL/LDL and HDL subclasses and ‘conventional’ total, LDL-, HDL-, non-HDL-cholesterol and triglycerides) with carotid IMT at EDIC Years 1 and 6, stratified by gender. The data are supplemental to our original research article describing detailed associations of DCCT baseline lipids and lipoprotein profiles with EDIC Year 12 carotid IMT (Basu et al. in press) [1]. PMID:26759826

  13. In vitro activation of cyclo-oxygenase in the rabbit carotid body: effect of its blockade on [3H]catecholamine release.

    PubMed Central

    Gómez-Niño, A; Almaraz, L; González, C

    1994-01-01

    The release of prostaglandin E2 (PGE2) from rabbit carotid bodies (CBs) incubated in basal conditions (PO2 approximately 132 mmHg; PCO2 approximately 33 mmHg; pH = 7.42) amounts to 94.4 +/- 10.1 pg (mg protein)-1 (10 min)-1 (mean +/- S.E.M.). Incubation of the CB in a hypoxic solution (PO2 approximately 46 mmHg) produced a significant 40% increase (P < 0.05) in the release of PGE2. Indomethacin (2 microM) prevented the hypoxia-induced release of PGE2. Sensory plus sympathetic denervation of the CB 4 days prior to the experiments did not modify either basal or low PO2-induced PGE2 release, indicating that intraglomic nerve endings are not significant sources for the PGE2 released. Incubation of the CB in an acidic-hypercapnic solution (PO2 approximately 132 mmHg; PCO2 approximately 132 mmHg; pH = 6.60) or in a high K(+)-containing solution (35 mM) was also effective in promoting an increase in the outflow of PGE2 from the organs. The release of [3H]catecholamines ([3H]CA) from the CB elicited by incubating the organs in low PO2 solutions (PO2 ranged between 66 and 13 mmHg) was potentiated by two inhibitors of cyclo-oxygenase, acetylsalicylic acid (ASA, 100 microM) and indomethacin (2 microM). The effect persisted after chronic denervation of the organ. The secretory response elicited by acidic stimuli was also augmented by cyclo-oxygenase inhibitors. Thus, [3H]CA release elicited by incubating the CBs in the acidic-hypercapnic solution increased by 300% in the presence of indomethacin (2 microM), and ASA (100 microM) more than doubled the release induced by dinitrophenol (100 microM), a protonophore that mimics an acidic stimulus. Indomethacin, but not ASA, moderately increased the high K(+)-evoked [3H]CA release. The effect of indomethacin on the release of [3H]CA elicited by acidic and hypoxic stimuli was reversed by PGE2 in a dose-dependent manner (0.3-300 nM). These results show that low PO2 and high PCO2-low pH, the natural stimuli to the CB, as well as high

  14. Living with Carotid Artery Disease

    MedlinePlus

    ... from the NHLBI on Twitter. Living With Carotid Artery Disease If you have carotid artery disease, you can take steps to manage the ... treatment plan, and getting ongoing care. Having carotid artery disease raises your risk of having a stroke . ...

  15. Another New Solvable Many-Body Model of Goldfish Type

    NASA Astrophysics Data System (ADS)

    Calogero, Francesco

    2012-07-01

    A new solvable many-body problem is identified. It is characterized by nonlinear Newtonian equations of motion (''acceleration equal force'') featuring one-body and two-body velocity-dependent forces ''of goldfish type'' which determine the motion of an arbitrary number N of unit-mass point-particles in a plane. The N (generally complex) values z_{n}( t) at time t of the N coordinates of these moving particles are given by the N eigenvalues of a time-dependent N× N matrix U( t) explicitly known in terms of the 2N initial data z_{n}( 0) and dot{z}_{n}(0) . This model comes in two different variants, one featuring 3 arbitrary coupling constants, the other only 2; for special values of these parameters all solutions are completely periodic with the same period independent of the initial data (''isochrony''); for other special values of these parameters this property holds up to corrections vanishing exponentially as t→ ∞ (''asymptotic isochrony''). Other isochronous variants of these models are also reported. Alternative formulations, obtained by changing the dependent variables from the N zeros of a monic polynomial of degree N to its N coefficients, are also exhibited. Some mathematical findings implied by some of these results - such as Diophantine properties of the zeros of certain polynomials - are outlined, but their analysis is postponed to a separate paper.

  16. [Carotid atherosclerosis and dementia].

    PubMed

    Harlé, Louise-Marine; Plichart, Matthieu

    2015-09-01

    Over the past decade a growing interest has been devoted to exploring the role of atherosclerosis in the development of dementia. Despite a well-known association between atherosclerosis risk factors in middle-life with later cognitive decline, the pathophysiological pathways underlying this association remain unclear. The current hypothesis is that neurodegenerative and vascular lesions coexist and have a synergistic role in the development of cognitive impairment and dementia. Carotid atherosclerosis (e.g. carotid plaques and intima-media thickness as measured by carotid ultrasonography) has been associated with cognitive decline and dementia and may help to better understand the complex interaction between the vascular and neurodegenerative processes. Furthermore, carotid atherosclerosis has been used in the recent field for dementia risk prediction. In this review, we discuss the physiopathological implications from the current available data on the relationship between carotid atherosclerosis and dementia as well as the interest of carotid biomarkers for individual dementia risk prediction. PMID:26395304

  17. Body type and performance of elite cuban baseball players.

    PubMed

    Carvajal, Wiliam; Ríos, Andrés; Echevarría, Ivis; Martínez, Miriam; Miñoso, Julio; Rodríguez, Dialvis

    2009-04-01

    Introduction Appropriate stature and adequate somatotype are not the only attributes determining athletic performance, but they are important prerequisites for sports participation and success. However, there is scant literature on baseball players' kinanthropometric profiles and their association with performance. Given that Cuban baseball players have been among the world's top performers in recent decades, characterization of their morphological features linked to their performance may contribute to developing the evidence base in this area. Objective Describe the kinanthropometric profile related to sports performance of elite Cuban baseball players, classified by playing position. Methods Body composition, somatotype, proportionality, and performance were measured in 100 elite baseball players grouped by playing position and performance. Data from the 2002-2003 baseball season was gathered for players participating in the 43rd Cuban National Baseball Series (November 2003-May 2004). Slugging percentage (SLG) was used to measure performance of all players except pitchers, whose performance was measured as end-of-season win-loss record. Mean and standard deviation values were calculated for anthropometric and performance results, presented in tables for comparison. ANOVA and MANOVA analyses were applied to determine magnitudes of difference between the variables studied, as well as statistical significance of the differences established (p≤0.05 and p≤0.01). Results Performance and body type varied by playing position, and statistically significant differences were found in performance, body composition and somatotype variables between some positions. No significant differences in proportionality were found. First basemen and outfielders (center, left, and right fielders) were the best offensive players with the highest mean SLG, body weight and muscle mass values. Infielders (second basemen, shortstops, and third basemen) had the lowest mean body weight and

  18. Altered body composition in type 2 diabetes mellitus

    PubMed Central

    Heshka, Stanley; Ruggiero, Andrea; Bray, George A.; Foreyt, John; Kahn, Stephen E.; Lewis, Cora E.; Saad, Mohammed; Schwartz, Ann V.

    2010-01-01

    Objective To identify differences in amount and distribution of fat and lean soft tissue in subjects with and without type 2 diabetes and to determine whether any differences are affected by race/ethnicity or sex. Design Overweight and obese (body mass index, BMI≥25 kg/m2) Black, White and Hispanic men (490) and women (825) with type 2 diabetes ([mean±SD] age 58.5±6.6; BMI 35.3±5.3) who had a baseline dual energy x-ray absorptiometry whole body scan at the time of enrollment in the Look Ahead clinical trial, and 242 healthy controls, 91 males and 151 females (age 55.3±8.6 y, BMI 30.7±4.2 kg/m2) who were participating in unrelated research and were scanned on the same densitometers. Results Adjusted for covariates, total fat mass was smaller in persons with type 2 diabetes than in controls (−1.4±0.3[SE]; 34.5 vs 35.8 kg, p<0.001) while trunk fat was larger (1.3±0.2[SE]; 19.9 vs 18.6 kg, p<0.001) and leg fat was smaller (−1.5±0.2[SE]; 10.7 vs 12.3 kg, p<0.001). The arms of subjects with type 2 diabetes did not have significantly less fat compared to controls. Adjusted trunk lean mass was larger in type 2 diabetes by 0.6 kg (28.4 vs 27.8 kg, p<0.001) while leg lean was smaller by 0.5 kg (18.1 vs 18.6 kg, p<0.001). Conclusions Type 2 diabetes is associated with less total fat, leg fat and leg lean mass and more truncal fat and lean mass than controls. The physiological processes producing these deviations in tissue distribution and their metabolic significance warrant further investigation. (ClinicalTrials.gov number, NCT00017953) PMID:18227843

  19. Serum carboxy-terminal telopeptide of type I collagen levels are associated with carotid atherosclerosis in patients with cardiovascular risk factors.

    PubMed

    Kondo, Takeshi; Endo, Itsuro; Aihara, Ken-Ichi; Onishi, Yukiyo; Dong, Bingzi; Ohguro, Yukari; Kurahashi, Kiyoe; Yoshida, Sumiko; Fujinaka, Yuichi; Kuroda, Akio; Matsuhisa, Munehide; Fukumoto, Seiji; Matsumoto, Toshio; Abe, Masahiro

    2016-04-25

    Carboxy-terminal telopeptide of type I collagen (ICTP) is generated through matrix metalloproteinase (MMP)-dependent type I collagen digestion, and has been widely utilized as a biomarker for bone turnover. The fact that atherosclerotic lesions are rich in both type I collagen and MMP-producing macrophages led to the hypothesis that serum ICTP concentrations may serve as a non-invasive clinical biomarker for atherosclerosis. Therefore, the association of serum ICTP concentrations with the maximum intima-media thickness (IMT) of carotid arteries, a surrogate index of systemic atherosclerosis, or brachial-ankle pulse wave velocity (baPWV) in patients with atherosclerotic risk factors was evaluated. A total of 52 male and 65 female (mean age: 62.8 yrs) patients without renal failure, malignancies or bone diseases known to affect serum ICTP concentrations were recruited. Patients with max IMTs ≥1.1 mm showed significantly higher serum ICTP concentrations compared with patients with max IMTs <1.1 mm (3.33 ± 0.97 vs 2.82 ± 0.65 ng/mL, p<0.05). Serum ICTP concentration was also positively correlated with max IMT (p<0.001) or baPWV values (p<0.05). Multivariate analyses also revealed that serum ICTP concentrations were correlated with max IMT (p<0.001; 95% CI 0.200 to 0.454). These results suggest that serum ICTP concentrations can be used as a non-invasive biomarker for systemic atherosclerosis. PMID:26877258

  20. Carotid Artery Disease

    MedlinePlus

    ... small balloon on its tip. They inflate the balloon at the blockage site in the carotid artery to flatten or compress the plaque against the artery wall. Carotid angioplasty is often combined with the placement of a small, metal, mesh-like device called a stent. When a stent is placed inside of a ...

  1. Body Type and Sex of Receiver: Their Effects on Source Credibility.

    ERIC Educational Resources Information Center

    Eckman, Bruce K.; Rancer, Andrew S.

    This study focused on whether actual or stereotypic associations with a speaker's body type would affect his or her credibility. Effects on the source-credibility ratings submitted by a total of 165 students were investigated for three different sources' body types. A significant main effect was found for body type but not for the blocked…

  2. Photoacoustic imaging of carotid artery atherosclerosis

    NASA Astrophysics Data System (ADS)

    Kruizinga, Pieter; van der Steen, Antonius F. W.; de Jong, Nico; Springeling, Geert; Robertus, Jan Lukas; van der Lugt, Aad; van Soest, Gijs

    2014-11-01

    We introduce a method for photoacoustic imaging of the carotid artery, tailored toward detection of lipid-rich atherosclerotic lesions. A common human carotid artery was obtained at autopsy, embedded in a neck mimicking phantom and imaged with a multimodality imaging system using interstitial illumination. Light was delivered through a 1.25-mm-diameter optical probe that can be placed in the pharynx, allowing the carotid artery to be illuminated from within the body. Ultrasound imaging and photoacoustic signal detection is achieved by an external 8-MHz linear array coupled to an ultrasound imaging system. Spectroscopic analysis of photoacoustic images obtained in the wavelength range from 1130 to 1250 nm revealed plaque-specific lipid accumulation in the collagen structure of the artery wall. These spectroscopic findings were confirmed by histology.

  3. Quantification of carotid vessel atherosclerosis

    NASA Astrophysics Data System (ADS)

    Chiu, Bernard; Egger, Micaela; Spence, J. D.; Parraga, Grace; Fenster, Aaron

    2006-03-01

    Atherosclerosis is characterized by the development of plaques in the arterial wall, which ultimately leads to heart attacks and stroke. 3D ultrasound (US) has been used to screen patients' carotid arteries. Plaque measurements obtained from these images may aid in the management and monitoring of patients, and in evaluating the effect of new treatment options. Different types of measures for ultrasound phenotypes of atherosclerosis have been proposed. Here, we report on the development and application of a method used to analyze changes in carotid plaque morphology from 3D US images obtained at two different time points. We evaluated our technique using manual segmentations of the wall and lumen of the carotid artery from images acquired in two US scanning sessions. To incorporate the effect of intraobserver variability in our evaluation, manual segmentation was performed five times each for the arterial wall and lumen. From this set of five segmentations, the mean wall and lumen surfaces were reconstructed, with the standard deviation at each point mapped onto the surfaces. A correspondence map between the mean wall and lumen surfaces was then established, and the thickness of the atherosclerotic plaque at each point in the vessel was estimated to be the distance between each correspondence pairs. The two-sample Student's t-test was used to judge whether the difference between the thickness values at each pair corresponding points of the arteries in the two 3D US images was statistically significant.

  4. Relationship between Carotid Intima-Media Thickness and Left Ventricular Mass in Type 1 Diabetes: results from the Epidemiology of Diabetes Interventions and Complications (EDIC) Study

    PubMed Central

    Chahal, Harjit; Backlund, Jye-Yu C.; Cleary, Patricia A.; Lachin, John M.; Polak, Joseph; Lima, Joao A.C.; Bluemke, David A.

    2012-01-01

    Introduction Type 1 diabetes mellitus is associated with early atherosclerosis and enhanced cardiovascular mortality. The relationship between carotid IMT (cIMT), a marker of subclinical atherosclerosis and left ventricular (LV) mass, an independent predictor of cardiovascular morbidity has not been previously studied in type 1 diabetics. Methods The Epidemiology of Diabetes Interventions and Complications (EDIC) study is a multicenter observational study designed to follow up the Diabetes Control and Complications Trial (DCCT) cohort. LV mass was measured with cardiac MRI at EDIC year 15 and common cIMT was assessed using B-mode ultrasound at EDIC year 12. Multivariable linear regression models were used to assess the relationship between cIMT at year 12 and LV mass at year 15. Results A total of 889 participants had both cardiac MRI and cIMT measures available for these analyses. At EDIC year 15, the mean age of the participants was 49 (±7) years; mean diabetes duration was 28 (±5) years and 52% were males. Spearman correlation coefficient (r) between LV mass and cIMT was 0.33 (p<0.0001). After adjusting for basic covariates (machine, reader, age and gender), a significant association between LV mass and cIMT (estimate 2.0 g/m2 per 0.1 mm cIMT increment, p < 0.0001) was observed. This association was diminished by the addition of systolic blood pressure in particular 1.15 g/m2 per 0.1 mm cIMT increment, p<0.0001) and to a lessor extent other cardiovascular disease (CVD) risk factors. The relationship observed between LV mass and cIMT was stronger (HOW MUCH) in patients with shorter diabetes duration. Conclusion In a well characterized population with type 1 diabetes, cIMT was an independent predictor of higher LV mass. These findings suggest a common pathway, possibly mediated by blood pressure dependent mechanisms, for vascular and myocardial structural change in T1DM. PMID:22884107

  5. Carotid artery surgery

    MedlinePlus

    ... Aspirin and heart disease Butter, margarine, and cooking oils Carotid artery surgery - discharge Cholesterol and ... by: Daniel Kantor, MD, Kantor Neurology, Coconut Creek, FL and Immediate Past President of the ...

  6. Angioplasty and stent placement - carotid artery

    MedlinePlus

    Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery; Carotid artery stenosis - angioplasty; ... Carotid angioplasty and stenting (CAS) is done using a small surgical cut. Your surgeon will make a surgical cut in your groin after using some ...

  7. [Evaluation of carotid stenosis by using carotid ultrasonography].

    PubMed

    Seike, Nahoko; Ito, Michiko; Yasaka, Masahiro

    2010-12-01

    Carotid stenosis is observed in several diseases such as atherosclerosis, moyamoya disease, and aortitis. Carotid stenosis can be assessed using computed tomography (CT), magnetic resonance angiography (MRA), ultrasonography, or cerebral angiography. Carotid ultrasonography is superior to other modalities because it is a noninvasive, repeatable, and easy method that does not involve much cost. The intima-media complex thickness (IMT) can be easily measured using carotid ultrasonography. The incidence of cerebral and cardiovascular events increases with increase in the thickness of the IMT. The percentage of stenosis was expressed using the NASCET, ECST, or area methods. The NASCET criterion of 70% stenosis for performing carotid endarterectomy for symptomatic carotid stenosis corresponded to 85% ECST stenosis, 90% area stenosis, and 200 cm/sec of peak systolic velocity. Carotid ultrasonography provides information on not only carotid stenosis but also unstable plaques such as ulcer, hypoechoic plaque, thin fibrous cap, and mobile plaque. In patients with moyamoya disease, carotid ultrasonography often reveals that the diameter of the internal carotid artery (ICA) is greatly reduced at the proximal portion above the bulbus (resembling a champagne bottle neck) and is less than 50% that of the common carotid artery (champagne bottle neck sign); the diameter of the ICA is smaller than that of the external carotid artery (diameter reversal sign). In patients with aortitis, IMT thickness is frequently observed at the common carotid artery (Macaroni sign) but not at the ICA. PMID:21139180

  8. Spatial Distribution of Small Water Body Types in Indiana Ecoregions

    EPA Science Inventory

    Due to their large numbers and biogeochemical activity, small water bodies (SWBs), such as ponds and wetlands, can have substantial cumulative effects on hydrologic and biogeochemical processes. Using updated National Wetland Inventory data, we describe the spatial distribution o...

  9. Post Tracheostomy Carotid-Tracheal Fistula.

    PubMed

    Shylendran, Sudhin; Baliyan, Vinit; Yadav, Ajay K; Kumar, Atin; Gamanagatti, Shivanand

    2016-03-01

    Tracheostomy is the life saving procedure in patients presenting with upper airway obstruction. The procedure is also performed in patients on chronic ventilatory support. It is generally considered a safe procedure with a low complication rate. Vascular injuries are the most serious and life threatening complications. Injury to a high lying innominate artery is the most frequent vascular injury in such cases. Injury to other vessels e.g. carotid arteries is less frequent. We are presenting one such rare type of vascular injury with a fistulous communication between trachea and carotid artery leading to massive hemoptysis. PMID:27066421

  10. Extramedullary plasmacytoma in the carotid space: Expanding the differential diagnosis

    PubMed Central

    Deshpande, Sneha Satish; Kane, Shubhada; Arya, Supreeta

    2014-01-01

    Plasma cell neoplasms have been classified into various types, with a range of clinical and radiological presentations. Extramedullary plasmacytoma (EMP) is a subset of plasma cell neoplasms which presents as an isolated non-osseous soft tissue mass. Though carotid space neoplasms are commonly encountered, EMP in the carotid space is rare and seldom considered in the initial differential diagnosis of a carotid space mass. These tumors can be treated by surgery or radiotherapy. On the other hand, the commonly encountered tumors in the carotid space are treated surgically. Also, it is mandatory to exclude multiple myeloma in the patients presenting with EMP. Hence, accurate and early diagnosis has therapeutic and prognostic implications. We report a rare case of EMP of the carotid space, describing the imaging features and the differential diagnoses with clues pointing to this rare entity. PMID:25489135

  11. Screening for Carotid Artery Stenosis

    MedlinePlus

    ... Task Force learned about the potential benefits and harms of screening for carotid artery stenosis: Health professionals ... blood flow through the arteries. Potential Benefits and Harms of Carotid Artery Stenosis Screening and Treatment The ...

  12. Basilar vascular system supplied by only right proatlantal intersegmentary artery type 1 with aneurysm and left internal carotid occlusion: a case report and review from the literature.

    PubMed

    Ferrone, Alessandro; Brogna, Barbara; Giliberti, Raffaele; Vassallo, Pasquale; De Magistris, Giuseppe

    2016-09-01

    Persistence of proatlantal artery (PA) is a rare condition. More than 40 cases were described in the literature. Aneurysm may involve the PA itself in approximately 2% of cases, most arising from the internal carotid artery (ICA) side of PA. This case was particular because the PA showed a saccular aneurysm on the posterior wall, probably due to atherosclerosis disease and other alterations: plaque ulcerative of ICA, occlusion of left ICA, and aberrant right VA. PMID:27594943

  13. 16 CFR 1112.11 - What are the types of third party conformity assessment bodies?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... assessment bodies? 1112.11 Section 1112.11 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS REQUIREMENTS PERTAINING TO THIRD PARTY CONFORMITY ASSESSMENT BODIES General Requirements Pertaining to Third Party Conformity Assessment Bodies § 1112.11 What are the types of third...

  14. Perceived Fashionability of a Garment as Inferred from the Age and Body Type of the Wearer.

    ERIC Educational Resources Information Center

    Clayton, Ruth; And Others

    1987-01-01

    Ninety college-aged females rated the fashionability of six garments worn by nine models representing three age levels and three body types. Results show respondents used age and body type cues as well as fashion detail to judge garment fashionability. (Author/CH)

  15. A cohort study of duplex Doppler examinations of the carotid artery in primary open angle glaucoma

    PubMed Central

    Marmion, Vincent J; Aldoori, Munther I; Woodcock, John P

    2014-01-01

    Objectives To explore the possibility of pathological change in the common carotid artery at the bifurcation and in the internal carotid artery beyond the bifurcation which could contribute to a reduced diastolic pressure as observed in primary open angle glaucoma. Design Duplex ultrasonic examinations of carotid bifurcations were conducted on 80 patients. Carotid artery defects were allocated into three types: no demonstrable flow defects, internal carotid artery abnormalities and disease in the carotid bulb. Setting Bristol Royal Infirmary Vascular Laboratory. Participants Eighty patients (mean age 69.6 years) providing a total of 160 sides to the analysis. Main outcome measures An estimated central retinal artery pressure, intraocular pressure and field loss were recorded for each side measured. Results Doppler investigations revealed significant levels of pathological change in the internal carotid distinct from changes at the carotid bulb. The disease revealed in the internal carotid artery was significantly associated with intraocular pressure (p = 0.032), with an effect small to medium in magnitude. The Q2 measure, derived from mean arterial pressure and intraocular pressure, was also substantively associated with disease in the internal carotid artery. Both intraocular pressure and the Q2 measure effectively discriminated between groups, with field loss providing rather less discriminating capability. There was a strong trend towards a higher intraocular pressures and a greater visual field loss with internal carotid artery disease. Conclusions Pathological changes in the extra cranial carotid artery in primary open angle glaucoma exceed those in the arteries classified as normal. The presence of disease specifically in the internal carotid artery emphasised the need for a mechanism for the evaluation of the internal carotid apart from the carotid bulb. A basis for clarifying the presence of an ischaemic zone is proposed. PMID:25289141

  16. Common Carotid Intima Media Thickness and Ankle-Brachial Pressure Index Correlate with Local but Not Global Atheroma Burden: A Cross Sectional Study Using Whole Body Magnetic Resonance Angiography

    PubMed Central

    Weir-McCall, Jonathan R.; Khan, Faisel; Lambert, Matthew A.; Adamson, Carly L.; Gardner, Michael; Gandy, Stephen J.; Ramkumar, Prasad Guntur; Belch, Jill J. F.; Struthers, Allan D.; Rauchhaus, Petra; Morris, Andrew D.; Houston, J. Graeme

    2014-01-01

    Background Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). Methods 50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR). The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50–70%, 3 = 70–99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated. Results The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045), however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01) with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β −0.39, p = 0.012), which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45), while the correlation between ABPI and atheroma burden persisted (β −0.45 p = 0.005). Conclusion ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral

  17. Aerodynamics on a transport aircraft type wing-body model

    NASA Technical Reports Server (NTRS)

    Schmitt, V.

    1982-01-01

    The DFLR-F4 wing-body combination is studied. The 1/38 model is formed by a 9.5 aspect ratio transonic wing and an Airbus A 310 fuselage. The F4 wing geometrical characteristics are described and the main experimental results obtained in the S2MA wind tunnel are discussed. Both wing-fuselage interferences and viscous effects, which are important on the wing due to a high rear loading, are investigated by performing 3D calculations. An attempt is made to find their limitations.

  18. Carotid Baroreflex Function During Prolonged Exercise

    NASA Technical Reports Server (NTRS)

    Raven, P. B.

    1999-01-01

    Astronauts are often required to work (exercise) at moderate to high intensities for extended periods while performing extra-vehicular activities (EVA). Although the physiologic responses associated with prolonged exercise have been documented, the mechanisms involved in blood pressure regulation under these conditions have not yet been fully elucidated. An understanding of this issue is pertinent to the ability of humans to perform work in microgravity and complies with the emphasis of NASA's Space Physiology and Countermeasures Program. Prolonged exercise at a constant workload is know to result in a progressive decrease in mean arterial pressure (MAP) concomitant with a decrease in stroke volume and a compensatory increase in heart rate. The continuous decrease in MAP during the exercise, which is related to the thermoregulatory redistribution of circulating blood volume to the cutaneous circulation, raises the question as to whether there is a loss of baroreflex regulation of arterial blood pressure. We propose that with prolongation of the exercise to 60 minutes, progressive increases on central command reflect a progressive upward resetting of the carotid baroreflex (CBR) such that the operating point of the CBR is shifted to a pressure below the threshold of the reflex rendering it ineffectual in correcting the downward drift in MAP. In order to test this hypothesis, experiments have been designed to uncouple the global hemodynamic response to prolonged exercise from the central command mediated response via: (1) continuous maintenance of cardiac filling volume by intravenous infusion of a dextran solution; and (2) whole body surface cooling to counteract thermoregulatory cutaneous vasodialation. As the type of work (exercise) performed by astronauts is inherently arm and upper body dependent, we will also examine the physiologic responses to prolonged leg cycling and arm ergometry exercise in the supine positions with and without level lower body negative

  19. Preferences for body type and body characteristics associated with attractive and unattractive bodies: Jackson and McGill revisited.

    PubMed

    Rosenfeld, L B; Stewart, S C; Stinnett, H J; Jackson, L A

    1999-10-01

    The present investigation replicates Jackson and McGill's study (1996) and extends it by considering the effects of respondents' own height, weight, and body mass on perceptions of attractiveness. Results, although generally supportive of those found by Jackson and McGill, point to the influence of respondents' own physical characteristics in the process of perceptions of attractiveness: only 1 of Jackson and McGill's 3 (of a possible 19) differences between responses of African- and Euro-American women was corroborated (the importance of silky hair for Euro-American women), whereas a second difference (the importance of round buttocks for African-American women) disappeared when controlling for respondents' weight, height, and body mass. Although differences between the two investigations may be attributed to regional differences in the surveyed students (Michigan and North Carolina), the small effect of one's own weight, height, and body mass in assessing an other-sex person's attractiveness may reflect adherence to norms learned very early in life that are subject to regional variations. PMID:10597583

  20. When are people interchangeable sexual objects? The effect of gender and body type on sexual fungibility.

    PubMed

    Gervais, Sarah J; Vescio, Theresa K; Allen, Jill

    2012-12-01

    The purpose of this research was to empirically examine the fungibility hypothesis derived from sexual objectification theory. Sexual objectification theorists have suggested that like objects, people, typically women, may be fungible or interchangeable with similar others. Despite its provocative nature and potential adverse psychological consequences, the fungibility hypothesis has yet to be empirically examined. We suggested that women, regardless of body types, but also men with body types that resemble the cultural ideal of attractiveness (e.g., large arms and chests and narrow waists), would be more fungible than men with body types that resemble the cultural average. Participants (n = 66) saw images of average and ideal women and men once before they completed a surprise matching task requiring that they match the bodies and faces that appeared together in the original images. Consistent with hypotheses, we found that women with ideal bodies, women with average bodies, and men with ideal bodies were more fungible (perceivers made more body-face pairing errors) than men with average bodies. Furthermore, it appears that when people are fungible they are interchangeable with people with similar body types. Implications and directions for future research on objectification and fungibility are discussed. PMID:23216316

  1. Urgent Intracranial Carotid Artery Decompression after Penetrating Head Injury

    PubMed Central

    Kim, Seong Joon

    2013-01-01

    We describe a case of intracranial carotid artery occlusion due to penetrating craniofacial injury by high velocity foreign body that was relieved by decompressive surgery. A 46-year-old man presented with a penetrating wound to his face. A piece of an electric angular grinder disc became lodged in the anterior skull base. Computed tomography revealed that the disc had penetrated the unilateral paraclinoid and suprasellar areas without flow of the intracranial carotid artery on the lesion side. The cavernous sinus was also compromised. Removal of the anterior clinoid process reopened the carotid blood flow, and the injection of glue into the cavernous sinus restored complete hemostasis during extraction of the fragment from the face. Digital subtraction angiography revealed complete recanalization of the carotid artery without any evidence of dissection. Accurate diagnosis regarding the extent of the compromised structures and urgent decompressive surgery with adequate hemostasis minimized the severity of penetrating damage in our patient. PMID:23634269

  2. Carotid Artery Disease

    MedlinePlus

    ... and efficacy continues to be studied in several medical centers. This procedure involves the placement of a small flexible tube (catheter) into an artery from the groin. The catheter is then directed to the neck to reach the carotid artery blockage. A balloon pushes open the artery wall and a stent ( ...

  3. Carotid Artery Screening

    MedlinePlus

    ... or radiologist then places the transducer on the skin in various locations, sweeping over the area of interest or angling the sound beam from a different location to better see an area of concern. Doppler sonography and Carotid IMT US are performed using the ...

  4. Altered body composition in type 2 diabetes mellitus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The styd objectives were to identify differences in amount and distribution of fat and lean soft tissue in a cross-sectional study of subjects with and without type 2 diabetes, and to determine whether any differences are affected by race/ethnicity or sex. Participants were overweight and obese (bod...

  5. The evaluation of body image in children with type 1 diabetes: A case-control study.

    PubMed

    Troncone, Alda; Prisco, Francesco; Cascella, Crescenzo; Chianese, Antonietta; Zanfardino, Angela; Iafusco, Dario

    2016-04-01

    This study evaluated the body image perception in children with type 1 diabetes in order to identify symptoms of disordered eating behaviours early. Children with type 1 diabetes and controls showed underestimation and dissatisfaction with body size. The patients, especially girls, were more accurate in their perception of body size than the control group. The study sheds light on some of the underlying factors that may contribute to the development of disordered eating behaviours in adolescence. The causes of the differences of perception of body size are discussed. PMID:24752557

  6. Hamiltonian Dynamics of Spider-Type Multirotor Rigid Bodies Systems

    SciTech Connect

    Doroshin, Anton V.

    2010-03-01

    This paper sets out to develop a spider-type multiple-rotor system which can be used for attitude control of spacecraft. The multirotor system contains a large number of rotor-equipped rays, so it was called a 'Spider-type System', also it can be called 'Rotary Hedgehog'. These systems allow using spinups and captures of conjugate rotors to perform compound attitude motion of spacecraft. The paper describes a new method of spacecraft attitude reorientation and new mathematical model of motion in Hamilton form. Hamiltonian dynamics of the system is investigated with the help of Andoyer-Deprit canonical variables. These variables allow obtaining exact solution for hetero- and homoclinic orbits in phase space of the system motion, which are very important for qualitative analysis.

  7. Body Image Distortion and Exposure to Extreme Body Types: Contingent Adaptation and Cross Adaptation for Self and Other.

    PubMed

    Brooks, Kevin R; Mond, Jonathan M; Stevenson, Richard J; Stephen, Ian D

    2016-01-01

    Body size misperception is common amongst the general public and is a core component of eating disorders and related conditions. While perennial media exposure to the "thin ideal" has been blamed for this misperception, relatively little research has examined visual adaptation as a potential mechanism. We examined the extent to which the bodies of "self" and "other" are processed by common or separate mechanisms in young women. Using a contingent adaptation paradigm, experiment 1 gave participants prolonged exposure to images both of the self and of another female that had been distorted in opposite directions (e.g., expanded other/contracted self), and assessed the aftereffects using test images both of the self and other. The directions of the resulting perceptual biases were contingent on the test stimulus, establishing at least some separation between the mechanisms encoding these body types. Experiment 2 used a cross adaptation paradigm to further investigate the extent to which these mechanisms are independent. Participants were adapted either to expanded or to contracted images of their own body or that of another female. While adaptation effects were largest when adapting and testing with the same body type, confirming the separation of mechanisms reported in experiment 1, substantial misperceptions were also demonstrated for cross adaptation conditions, demonstrating a degree of overlap in the encoding of self and other. In addition, the evidence of misperception of one's own body following exposure to "thin" and to "fat" others demonstrates the viability of visual adaptation as a model of body image disturbance both for those who underestimate and those who overestimate their own size. PMID:27471447

  8. Body Image Distortion and Exposure to Extreme Body Types: Contingent Adaptation and Cross Adaptation for Self and Other

    PubMed Central

    Brooks, Kevin R.; Mond, Jonathan M.; Stevenson, Richard J.; Stephen, Ian D.

    2016-01-01

    Body size misperception is common amongst the general public and is a core component of eating disorders and related conditions. While perennial media exposure to the “thin ideal” has been blamed for this misperception, relatively little research has examined visual adaptation as a potential mechanism. We examined the extent to which the bodies of “self” and “other” are processed by common or separate mechanisms in young women. Using a contingent adaptation paradigm, experiment 1 gave participants prolonged exposure to images both of the self and of another female that had been distorted in opposite directions (e.g., expanded other/contracted self), and assessed the aftereffects using test images both of the self and other. The directions of the resulting perceptual biases were contingent on the test stimulus, establishing at least some separation between the mechanisms encoding these body types. Experiment 2 used a cross adaptation paradigm to further investigate the extent to which these mechanisms are independent. Participants were adapted either to expanded or to contracted images of their own body or that of another female. While adaptation effects were largest when adapting and testing with the same body type, confirming the separation of mechanisms reported in experiment 1, substantial misperceptions were also demonstrated for cross adaptation conditions, demonstrating a degree of overlap in the encoding of self and other. In addition, the evidence of misperception of one's own body following exposure to “thin” and to “fat” others demonstrates the viability of visual adaptation as a model of body image disturbance both for those who underestimate and those who overestimate their own size. PMID:27471447

  9. Are Carotid Stent Fractures Clinically Significant?

    SciTech Connect

    Garcia-Toca, Manuel; Rodriguez, Heron E.; Naughton, Peter A.; Keeling, Aiofee; Phade, Sachin V.; Morasch, Mark D.; Kibbe, Melina R.; Eskandari, Mark K.

    2012-04-15

    Purpose: Late stent fatigue is a known complication after carotid artery stenting (CAS) for cervical carotid occlusive disease. The purpose of this study was to determine the prevalence and clinical significance of carotid stent fractures. Materials and Methods: A single-center retrospective review of 253 carotid bifurcation lesions treated with CAS and mechanical embolic protection from April 2001 to December 2009 was performed. Stent integrity was analyzed by two independent observers using multiplanar cervical plain radiographs with fractures classified into the following types: type I = single strut fracture; type II = multiple strut fractures; type III = transverse fracture; and type IV = transverse fracture with dislocation. Mean follow-up was 32 months. Results: Follow-up imaging was completed on 106 self-expanding nitinol stents (26 closed-cell and 80 open-cell stents). Eight fractures (7.5%) were detected (type I n = 1, type II n = 6, and type III n = 1). Seven fractures were found in open-cell stents (Precise n = 3, ViVEXX n = 2, and Acculink n = 2), and 1 fracture was found in a closed-cell stent (Xact n = 1) (p = 0.67). Only a previous history of external beam neck irradiation was associated with fractures (p = 0.048). No associated clinical sequelae were observed among the patients with fractures, and only 1 patient had an associated significant restenosis ({>=}80%) requiring reintervention. Conclusions: Late stent fatigue after CAS is an uncommon event and rarely clinically relevant. Although cell design does not appear to influence the occurrence of fractures, lesion characteristics may be associated risk factors.

  10. Carotid-cardiac baroreflex influence on forearm vascular resistance during low level LBNP

    NASA Technical Reports Server (NTRS)

    Ludwig, David

    1990-01-01

    Twelve healthy males were tested at low levels of lower body negative pressure (LBNP) with and without artificial stimulation of the carotid-cardiac baroreceptors. The carotid-cardiac baroreceptors were stimulated by applying a pressure of 10 mmHg to the carotid artery via a pressurized neck chamber. During the procedure, forearm blood flow (FBF) and forearm vascular resistance (FVR) were measured using a Whitney mercury silastic strain gauge technique. FBF decreased while FVR increased with increased intensity of LBNP. Both FBF and FVR were unaffected by carotid-cardiac baroreceptor stimulation.

  11. Experimental determination of circumferential properties of fresh carotid artery plaques.

    PubMed

    Lawlor, Michael G; O'Donnell, Michael R; O'Connell, Barry M; Walsh, Michael T

    2011-06-01

    Carotid endarterectomy (CEA) is currently accepted as the gold standard for interventional revascularisation of diseased arteries belonging to the carotid bifurcation. Despite the proven efficacy of CEA, great interest has been generated in carotid angioplasty and stenting (CAS) as an alternative to open surgical therapy. CAS is less invasive compared with CEA, and has the potential to successfully treat lesions close to the aortic arch or distal internal carotid artery (ICA). Following promising results from two recent trials (CREST; Carotid revascularisation endarterectomy versus stenting trial, and ICSS; International carotid stenting study) it is envisaged that there will be a greater uptake in carotid stenting, especially amongst the group who do not qualify for open surgical repair, thus creating pressure to develop computational models that describe a multitude of plaque models in the carotid arteries and their reaction to the deployment of such interventional devices. Pertinent analyses will require fresh human atherosclerotic plaque material characteristics for different disease types. This study analysed atherosclerotic plaque characteristics from 18 patients tested on site, post-surgical revascularisation through endarterectomy, with 4 tissue samples being excluded from tensile testing based on large width-length ratios. According to their mechanical behaviour, atherosclerotic plaques were separated into 3 grades of stiffness. Individual and group material coefficients were then generated analytically using the Yeoh strain energy function. The ultimate tensile strength (UTS) of each sample was also recorded, showing large variation across the 14 atherosclerotic samples tested. Experimental Green strains at rupture varied from 0.299 to 0.588 and the Cauchy stress observed in the experiments was between 0.131 and 0.779 MPa. It is expected that this data may be used in future design optimisation of next generation interventional medical devices for the

  12. How Can Carotid Artery Disease Be Prevented?

    MedlinePlus

    ... from the NHLBI on Twitter. How Can Carotid Artery Disease Be Prevented? Taking action to control your risk factors can help prevent or delay carotid artery disease and stroke . Your risk for carotid artery ...

  13. VO2 Max in Variable Type Exercise Among Well-Trained Upper Body Athletes.

    ERIC Educational Resources Information Center

    Seals, Douglas R.; Mullin, John P.

    1982-01-01

    The maximal oxygen consumption (VO2 max) of well-trained upper body athletes was compared to that of untrained individuals in four types of exercise: arm cranking, legs only cycling, graded treadmill running, and combined arm cranking and leg cycling. Results of the study showed that well-trained upper body athletes attained a significantly higher…

  14. Management of Carotid Artery Trauma

    PubMed Central

    Lee, Thomas S.; Ducic, Yadranko; Gordin, Eli; Stroman, David

    2014-01-01

    With increased awareness and liberal screening of trauma patients with identified risk factors, recent case series demonstrate improved early diagnosis of carotid artery trauma before they become problematio. There remains a need for unified screening criteria for both intracranial and extracranial carotid trauma. In the absence of contraindications, antithrombotic agents should be considered in blunt carotid artery injuries, as there is a significant risk of progression of vessel injury with observation alone. Despite CTA being used as a common screening modality, it appears to lack sufficient sensitivity. DSA remains to be the gold standard in screening. Endovascular techniques are becoming more widely accepted as the primary surgical modality in the treatment of blunt extracranial carotid injuries and penetrating/blunt intracranial carotid lessions. Nonetheless, open surgical approaches are still needed for the treatment of penetrating extracranial carotid injuries and in patients with unfavorable lesions for endovascular intervention. PMID:25136406

  15. Obesity and carotid artery remodeling

    PubMed Central

    Kozakova, M; Palombo, C; Morizzo, C; Højlund, K; Hatunic, M; Balkau, B; Nilsson, P M; Ferrannini, E

    2015-01-01

    Background/Objective: The present study tested the hypothesis that obesity-related changes in carotid intima-media thickness (IMT) might represent not only preclinical atherosclerosis but an adaptive remodeling meant to preserve circumferential wall stress (CWS) in altered hemodynamic conditions characterized by body size-dependent increase in stroke volume (SV) and blood pressure (BP). Subjects/Methods: Common carotid artery (CCA) luminal diameter (LD), IMT and CWS were measured in three different populations in order to study: (A) cross-sectional associations between SV, BP, anthropometric parameters and CCA LD (266 healthy subjects with wide range of body weight (24–159 kg)); (B) longitudinal associations between CCA LD and 3-year IMT progression rate (ΔIMT; 571 healthy non-obese subjects without increased cardiovascular (CV) risk); (C) the impact of obesity on CCA geometry and CWS (88 obese subjects without CV complications and 88 non-obese subjects matched for gender and age). Results: CCA LD was independently associated with SV that was determined by body size. In the longitudinal study, baseline LD was an independent determinant of ΔIMT, and ΔIMT of subjects in the highest LD quartile was significantly higher (28±3 μm) as compared with those in the lower quartiles (8±3, 16±4 and 16±3 μm, P=0.001, P<0.05 and P=0.01, respectively). In addition, CCA CWS decreased during the observational period in the highest LD quartile (from 54.2±8.6 to 51.6±7.4 kPa, P<0.0001). As compared with gender- and age-matched lean individuals, obese subjects had highly increased CCA LD and BP (P<0.0001 for both), but only slightly higher CWS (P=0.05) due to a significant increase in IMT (P=0.005 after adjustment for confounders). Conclusions: Our findings suggest that in obese subjects, the CCA wall thickens to compensate the luminal enlargement caused by body size-induced increase in SV, and therefore, to normalize the wall stress. CCA diameter in obesity could

  16. Management of carotid artery stenosis

    PubMed Central

    Louridas, George; Junaid, Asad

    2005-01-01

    OBJECTIVE To clarify the definition of carotid artery diseases, the appropriateness of screening for disease, investigation and management of patients presenting with transient ischemic attacks, and management of asymptomatic carotid bruits. SOURCES OF INFORMATION MEDLINE was searched using the terms carotid endarterectomy, carotid disease, and carotid stenosis. Most studies offer level II or III evidence. Consensus statements and guidelines from various neurovascular societies were also consulted. MAIN MESSAGE Patients with symptoms of hemispheric transient ischemic attacks associated with >70% stenosis of the internal carotid artery are at highest risk of major stroke or death. Risk is greatest within 48 hours of symptom onset; patients should have urgent evaluation by a vascular surgeon for consideration of carotid endarterectomy (CEA). Patients with 50% to 69% stenosis might benefit from urgent surgical intervention depending on clinical features and associated comorbidity. Patients with <50% stenosis do not benefit from surgery. Asymptomatic patients with >60% stenosis should be considered for elective CEA. CONCLUSION Symptomatic carotid artery syndromes need urgent carotid duplex evaluation to determine the need for urgent surgery. Those with the greatest degree of stenosis derive the greatest benefit from timely CEA. PMID:16060177

  17. Sintering of beta-type alumina bodies using alpha-alumina encapsulation

    DOEpatents

    McEntire, Bryan J.; Virkar, Anil V.

    1981-01-01

    A method of sintering a shaped green, beta-type alumina body comprising: (A) inserting said body into an open chamber prepared by exposing the interior surface of a container consisting essentially of at least about 50 weight percent of alpha-alumina and a remainder of other refractory material to a sodium oxide or sodium oxide producing environment; (B) sealing the chamber; and heating the chamber with the shaped body encapsulated therein to a temperature and for a time necessary to sinter said body to the desired density. The encapsulation chamber prepared as described above is also claimed.

  18. Spontaneous closure of posttraumatic high-flow carotid-cavernous fistula following cerebral angiography.

    PubMed

    Meena, Ugan Singh; Gupta, Pankaj; Shrivastava, Trilochan; Purohit, Devendra

    2016-01-01

    Traumatic carotid-cavernous fistula (TCCF) is a direct communication between cavernous portion of the internal carotid artery (ICA) and cavernous sinus due to tear in ICA. Most of the cases are treated by endovascular embolization. Spontaneous resolution of high-flow TCCFs is extremely rare. We report a case of posttraumatic, direct, high-flow carotid cavernous fistula (Barrow type A) that resolved spontaneously after cerebral angiography. PMID:27057229

  19. Spontaneous closure of posttraumatic high-flow carotid-cavernous fistula following cerebral angiography

    PubMed Central

    Meena, Ugan Singh; Gupta, Pankaj; Shrivastava, Trilochan; Purohit, Devendra

    2016-01-01

    Traumatic carotid-cavernous fistula (TCCF) is a direct communication between cavernous portion of the internal carotid artery (ICA) and cavernous sinus due to tear in ICA. Most of the cases are treated by endovascular embolization. Spontaneous resolution of high-flow TCCFs is extremely rare. We report a case of posttraumatic, direct, high-flow carotid cavernous fistula (Barrow type A) that resolved spontaneously after cerebral angiography. PMID:27057229

  20. Vision System To Identify Car Body Types For Spray Painting Robot

    NASA Astrophysics Data System (ADS)

    Uartlam, Peter; Neilson, Geoff

    1984-02-01

    The automation of car body spray booth operations employing paint spraying robots generally requires the robots to execute one of a number of defined routines according to the car body type. A vision system is described which identifies a car body type by its shape and provides an identity code to the robot controller thus enabling the correct routine to be executed. The vision system consists of a low cost linescan camera, a flucrescens light source and a microprocessor image analyser and is an example of a cost effective, reliable, industrially engineered robot vision system for a demanding production environment. Extension of the system with additional cameras will increase the application to the other automatic operations on a car assembly line where it becomes essential to reliably differentiate between up to 40 vatiations of body types.

  1. Carotid Artery Stenting versus Endarterectomy

    PubMed Central

    Gahremanpour, Amir; Perin, Emerson C.; Silva, Guilherme

    2012-01-01

    For about 2 decades, investigators have been comparing carotid endarterectomy with carotid artery stenting in regard to their effectiveness and safety in treating carotid artery stenosis. We conducted a systematic review to summarize and appraise the available evidence provided by randomized trials, meta-analyses, and registries comparing the clinical outcomes of the 2 procedures. We searched the MEDLINE, SciVerse Scopus, and Cochrane databases and the bibliographies of pertinent textbooks and articles to identify these studies. The results of clinical trials and, consequently, the meta-analyses of those trials produced conflicting results regarding the comparative effectiveness and safety of carotid endarterectomy and carotid stenting. These conflicting results arose because of differences in patient population, trial design, outcome measures, and variability among centers in the endovascular devices used and in operator skills. Careful appraisal of the trials and meta-analyses, particularly the most recent and largest National Institutes of Healthsponsored trial (the Carotid Revascularization Endarterectomy vs Stenting Trial [CREST]), showed that carotid stenting and endarterectomy were associated with similar rates of death and disabling stroke. Within the 30-day periprocedural period, carotid stenting was associated with higher risks of stroke, especially for patients aged >70 years, whereas carotid endarterectomy was associated with a higher risk of myocardial infarction. The slightly higher cost of stenting compared with endarterectomy was within an acceptable range by cost-effectiveness standards. We conclude that carotid artery stenting is an equivalent alternative to carotid endarterectomy when patient age and anatomy, surgical risk, and operator experience are considered in the choice of treatment approach. PMID:22949763

  2. Water-Body types identification in urban areas from radarsat-2 fully polarimetric SAR data

    NASA Astrophysics Data System (ADS)

    Xie, Lei; Zhang, Hong; Wang, Chao; Chen, Fulong

    2016-08-01

    This paper presents a novel method for supervised water-body extraction and water-body types identification from Radarsat-2 fully polarimetric (FP) synthetic aperture radar (SAR) data in complex urban areas. First, supervised water-body extraction using the Wishart classifier is performed, and the false alarms that are formed in built-up areas are removed using morphological processing methods and spatial contextual information. Then, the support vector machine (SVM), the classification and regression tree (CART), TreeBagger (TB), and random forest (RF) classifiers are introduced for water-body types (rivers, lakes, ponds) identification. In SAR images, certain other objects that are misclassified as water are also considered in water-body types identification. Several shape and polarimetric features of each candidate water-body are used for identification. Radarsat-2 PolSAR data that were acquired over Suzhou city and Dongguan city in China are used to validate the effectiveness of the proposed method, and the experimental results are evaluated at both the object and pixel levels. We compared the water-body types classification results using only shape features and the combination of shape and polarimetric features, the experimental results show that the polarimetric features can eliminate the misclassifications from certain other objects like roads to water areas, and the increasement of classification accuracy embodies at both the object and pixel levels. The experimental results show that the proposed methods can achieve satisfactory accuracies at the object level [89.4% (Suzhou), 95.53% (Dongguan)] and the pixel level [96.22% (Suzhou), 97.95% (Dongguan)] for water-body types classification, respectively.

  3. The Development of Carotid Stent Material

    PubMed Central

    He, Dongsheng; Liu, Wenhua; Zhang, Tao

    2015-01-01

    Endovascular angioplasty with stenting is a promising option for treating carotid artery stenosis. There exist a rapidly increasing number of different stent types with different materials. The bare-metal stent is the most commonly used stent with acceptable results, but it leaves us with the problems of thrombosis and restenosis. The drug-eluting stent is a breakthrough as it has the ability to reduce the restenosis rate, but the problem of late thrombosis still has to be addressed. The biodegradable stent disappears after having served its function. However, restenosis and degradation rates remain to be studied. In this article, we review every stent material with its characteristics, clinical results and complications and point out the standards of an ideal carotid stent. PMID:26019710

  4. Cervical carotid pseudoaneurysm: A carotid artery stenting complication

    PubMed Central

    Raso, Jair; Darwich, Rogerio; Ornellas, Carlos; Cariri, Gustavo

    2011-01-01

    Background: As carotid artery stenting becomes increasingly used, more complications are likely to occur. We present a case of Staphylococcus septicemia and pseudoaneurysm arising in the neck portion of the carotid artery after stenting. Case Description: A 51-year-old man was admitted with mild left hemiparesis. CT and MRI showed right hemisphere ischemia. Duplex Scan and MRA showed bilateral severe stenosis of the carotid arteries in the neck. A percutaneous angioplasty with stenting of the left carotid artery was performed. Two weeks after the procedure, he developed fever and swelling in the right leg and shoulder. An abscess, near where the groin had been punctured for the angioplasty was surgically drained. Blood samples were positive for S. aureus. After treatment the patient complained of a painful bulky pulsatile left cervical mass. Duplex scan and MRA showed a pseudoaneurysm of the left carotid artery. We excised the pseudoaneurysm and rebuilt the carotid artery with a saphenous vein graft. The postoperative period was uneventful, and the MRA revealed a patent saphenous graft. Conclusion: Mycotic pseudoaneurysm of the carotid artery is a rare complication of percutaneous angioplasty and stenting. Surgical treatment with saphenous vein graft is the treatment of choice. PMID:21748038

  5. Unexpected Radiologic Findings for a Casting Type of Radiolucent Colorectal Foreign Body Composed of Polyurethane Foam

    PubMed Central

    Tamamoto, Fumihiko; Ogawa, Shoichi; Sano, Maiko; Yoshimura, Tetsunori; Nozaki, Miwako

    2016-01-01

    Radiologic diagnosis of colorectal foreign bodies is usually not very difficult, because inserted materials are often clearly visible on plain abdominal radiographs. However, when they are radiolucent, a plain abdominal radiograph has been reported to be useless. As radiolucent colorectal foreign bodies appear as radiolucent artificial contours or air-trapped materials in the pelvis, almost always the diagnosis itself can be made by careful evaluation of plain abdominal radiographs. We encountered a case of casting type of radiolucent colorectal foreign body formed from polyurethane foam. It presented us with unexpected radiologic findings and led to diagnostic difficulties. PMID:27213072

  6. Unexpected Radiologic Findings for a Casting Type of Radiolucent Colorectal Foreign Body Composed of Polyurethane Foam.

    PubMed

    Sanjo, Emi; Tamamoto, Fumihiko; Ogawa, Shoichi; Sano, Maiko; Yoshimura, Tetsunori; Nozaki, Miwako

    2016-01-01

    Radiologic diagnosis of colorectal foreign bodies is usually not very difficult, because inserted materials are often clearly visible on plain abdominal radiographs. However, when they are radiolucent, a plain abdominal radiograph has been reported to be useless. As radiolucent colorectal foreign bodies appear as radiolucent artificial contours or air-trapped materials in the pelvis, almost always the diagnosis itself can be made by careful evaluation of plain abdominal radiographs. We encountered a case of casting type of radiolucent colorectal foreign body formed from polyurethane foam. It presented us with unexpected radiologic findings and led to diagnostic difficulties. PMID:27213072

  7. Effect of current glycemic control on qualitative body composition in sedentary ambulatory Type 2 diabetics

    PubMed Central

    Solanki, Jayesh Dalpatbhai; Makwana, Amit H.; Mehta, Hemant B.; Kamdar, Panna; Gokhale, Pradnya A.; Shah, Chinmay J.

    2016-01-01

    Background: Obesity and Type 2 diabetes mellitus are on rise with cause–effect relationship. Diabetics monitor blood sugar, neglecting qualitative body composition, leaving residual threat of ectopic fat unattended. We tried to correlate glycemic triad with parameters of body composition derived objectively by bioelectrical impedance analysis (BIA). Materials and Methods: A sample of 78 under treatment sedentary Type 2 diabetics of either sex with known glycemic and lipidemic control from our city. Following baseline assessment measurement was done by instrument Omron Karada Scan (Model HBF-510, China) using the principle of tetra poplar BIA to derive parameters of body composition. We tried to correlate glycemic triad with these parameters, both directly as well as after defining them as per established cutoff norms. Results: We found poor glycemic control in the study group (20% for Hb1AC), high body mass index, subcutaneous fat, visceral fat (VF), total body fat (TBF), and lesser mass of skeletal muscle in Type 2 diabetics. However, there were small, insignificant, and inconsistent difference of these parameters while directly correlating with the fasting blood sugar, postprandial blood sugar, and glycosylated hemoglobin. On qualitative assessment, the impact of glycemic control as per standard norms, the risk of high VF, high TBF, low skeletal muscle mass was though high (between 1 and 2) in Type 2 diabetics with poor glycemic control as compared to good glycemics, but each strength lacks statistical significance. Conclusion: BIA reveals that Type 2 diabetics have more ectopic fat on expense of skeletal muscle that do not correlate with current glycemic status, both quantitatively and qualitatively. Measurement of body composition can be included and subjects can be motivated for lifestyle modification strategies while managing metabolic derangements of Type 2 diabetes. PMID:27185972

  8. Type of body fat distribution in postmenopausal women and its related factors

    PubMed Central

    Noroozi, Mahnaz; Rastegari, Zahra; Paknahad, Zamzam

    2010-01-01

    BACKGROUND: The type of body fat distribution has an important role for identifying risk of diseases. One of the simple anthropometric indexes for estimating type of body fat distribution is waist circumference index. This study is aimed to determine the type of body fat distribution in postmenopausal women and its related factors. METHODS: This is a cross sectional descriptive analytical study. Samples were 278 postmenopausal women in Isfahan who were selected by stratified sampling and then were invited to 64 health centers of Isfahan. Data was gathered using a questionnaire and standard meter. Data was analyzed using SPSS software and descriptive and inferential statistics. RESULTS: Results showed that in postmenopausal women the mean of waist circumference index was 93.63 (10.66) and its range was 54 to 119 cm. There was a meaningful relation between job, educational status, total pregnancies, total deliveries, age of first pregnancy, lactation history and menopausal age with waist circumference index. CONCLUSIONS: Results showed that the type of body fat distribution of postmenopausal women is of android type. Considering side effects of this kind of distribution, necessary teachings about healthy eating, movement and exercises must be given to women of these ages. PMID:21589746

  9. Comparative analysis of the biaxial mechanical behavior of carotid wall tissue and biological and synthetic materials used for carotid patch angioplasty.

    PubMed

    Kamenskiy, Alexey V; Pipinos, Iraklis I; MacTaggart, Jason N; Kazmi, Syed A Jaffar; Dzenis, Yuris A

    2011-11-01

    Patch angioplasty is the most common technique used for the performance of carotid endarterectomy. A large number of patching materials are available for use while new materials are being continuously developed. Surprisingly little is known about the mechanical properties of these materials and how these properties compare with those of the carotid artery wall. Mismatch of the mechanical properties can produce mechanical and hemodynamic effects that may compromise the long-term patency of the endarterectomized arterial segment. The aim of this paper was to systematically evaluate and compare the biaxial mechanical behavior of the most commonly used patching materials. We compared PTFE (n  =  1), Dacron (n  =  2), bovine pericardium (n  =  10), autogenous greater saphenous vein (n  =  10), and autogenous external jugular vein (n  =  9) with the wall of the common carotid artery (n  =  18). All patching materials were found to be significantly stiffer than the carotid wall in both the longitudinal and circumferential directions. Synthetic patches demonstrated the most mismatch in stiffness values and vein patches the least mismatch in stiffness values compared to those of the native carotid artery. All biological materials, including the carotid artery, demonstrated substantial nonlinearity, anisotropy, and variability; however, the behavior of biological and biologically-derived patches was both qualitatively and quantitatively different from the behavior of the carotid wall. The majority of carotid arteries tested were stiffer in the circumferential direction, while the opposite anisotropy was observed for all types of vein patches and bovine pericardium. The rates of increase in the nonlinear stiffness over the physiological stress range were also different for the carotid and patching materials. Several carotid wall samples exhibited reverse anisotropy compared to the average behavior of the carotid tissue. A similar characteristic was

  10. Dynamics and associations of microbial community types across the human body.

    PubMed

    Ding, Tao; Schloss, Patrick D

    2014-05-15

    A primary goal of the Human Microbiome Project (HMP) was to provide a reference collection of 16S ribosomal RNA gene sequences collected from sites across the human body that would allow microbiologists to better associate changes in the microbiome with changes in health. The HMP Consortium has reported the structure and function of the human microbiome in 300 healthy adults at 18 body sites from a single time point. Using additional data collected over the course of 12-18 months, we used Dirichlet multinomial mixture models to partition the data into community types for each body site and made three important observations. First, there were strong associations between whether individuals had been breastfed as an infant, their gender, and their level of education with their community types at several body sites. Second, although the specific taxonomic compositions of the oral and gut microbiomes were different, the community types observed at these sites were predictive of each other. Finally, over the course of the sampling period, the community types from sites within the oral cavity were the least stable, whereas those in the vagina and gut were the most stable. Our results demonstrate that even with the considerable intra- and interpersonal variation in the human microbiome, this variation can be partitioned into community types that are predictive of each other and are probably the result of life-history characteristics. Understanding the diversity of community types and the mechanisms that result in an individual having a particular type or changing types, will allow us to use their community types to assess disease risk and to personalize therapies. PMID:24739969

  11. Intracytoplasmic inclusion bodies in the chondrocytes of type I lethal achondrogenesis.

    PubMed

    Yang, S S; Heidelberger, K P; Bernstein, J

    1976-11-01

    Lethal achondrogenesis in the past has been frequently confused with achondroplasia. Clinical and radiologic advances in the last decade have led to clear differentiation of this condition from other types of bone dysplasia. It is further separated into two types on the basis of radiographic and pathologic findings. Re-evaluation of the histologic features has led to the recognition of heretofore unrecognized intracytoplasmic inclusion bodies in the chondrocytes of type 1 achondrogenesis. The finding of inclusions strengthens the differentiation of the two types and may have implications for the pathogenesis of the form of chondrodystrophy. PMID:186383

  12. Dynamical evolution of Chelyabinsk-type bodies from sungrazing orbits to near-Earth space

    NASA Astrophysics Data System (ADS)

    Emel'yanenko, V. V.

    2015-12-01

    Studies of the orbital evolution show that, with a high probability, the Chelyabinsk object was near the Sun about 1 Myr ago. This is consistent with the estimate of a cosmic ray exposure age (Popova et al., 2013). Dynamical features of the flux of Chelyabinsk-type bodies have been studied by numerical integrations, assuming their origin near the Sun about 1 Myr ago. The most frequent fate of these bodies is solar collision. But about a quarter of all the original objects survive until the present epoch. The majority of the surviving bodies are typical near-Earth objects. The rate of their encounters with the Earth is almost constant for the last 0.5 Myr. About a third of the Chelyabinsk-type objects approach the Earth from the Sun direction.

  13. The influence of vibration type, frequency, body position and additional load on the neuromuscular activity during whole body vibration.

    PubMed

    Ritzmann, Ramona; Gollhofer, Albert; Kramer, Andreas

    2013-01-01

    This study aimed to assess the influence of different whole body vibration (WBV) determinants on the electromyographic (EMG) activity during WBV in order to identify those training conditions that cause highest neuromuscular responses and therefore provide optimal training conditions. In a randomized cross-over study, the EMG activity of six leg muscles was analyzed in 18 subjects with respect to the following determinants: (1) vibration type (side-alternating vibration (SV) vs. synchronous vibration (SyV), (2) frequency (5-10-15-20-25-30 Hz), (3) knee flexion angle (10°-30°-60°), (4) stance condition (forefoot vs. normal stance) and (5) load variation (no extra load vs. additional load equal to one-third of the body weight). The results are: (1) neuromuscular activity during SV was enhanced compared to SyV (P < 0.05); (2) a progressive increase in frequency caused a progressive increase in EMG activity (P < 0.05); (3) the EMG activity was highest for the knee extensors when the knee joint was 60° flexed (P < 0.05); (4) for the plantar flexors in the forefoot stance condition (P < 0.05); and (5) additional load caused an increase in neuromuscular activation (P < 0.05). In conclusion, large variations of the EMG activation could be observed across conditions. However, with an appropriate adjustment of specific WBV determinants, high EMG activations and therefore high activation intensities could be achieved in the selected muscles. The combination of high vibration frequencies with additional load on an SV platform led to highest EMG activities. Regarding the body position, a knee flexion of 60° and forefoot stance appear to be beneficial for the knee extensors and the plantar flexors, respectively. PMID:22538279

  14. Vacuolar ATPase regulates surfactant secretion in rat alveolar type II cells by modulating lamellar body calcium.

    PubMed

    Chintagari, Narendranath Reddy; Mishra, Amarjit; Su, Lijing; Wang, Yang; Ayalew, Sahlu; Hartson, Steven D; Liu, Lin

    2010-01-01

    Lung surfactant reduces surface tension and maintains the stability of alveoli. How surfactant is released from alveolar epithelial type II cells is not fully understood. Vacuolar ATPase (V-ATPase) is the enzyme responsible for pumping H(+) into lamellar bodies and is required for the processing of surfactant proteins and the packaging of surfactant lipids. However, its role in lung surfactant secretion is unknown. Proteomic analysis revealed that vacuolar ATPase (V-ATPase) dominated the alveolar type II cell lipid raft proteome. Western blotting confirmed the association of V-ATPase a1 and B1/2 subunits with lipid rafts and their enrichment in lamellar bodies. The dissipation of lamellar body pH gradient by Bafilomycin A1 (Baf A1), an inhibitor of V-ATPase, increased surfactant secretion. Baf A1-stimulated secretion was blocked by the intracellular Ca(2+) chelator, BAPTA-AM, the protein kinase C (PKC) inhibitor, staurosporine, and the Ca(2+)/calmodulin-dependent protein kinase II (CaMKII), KN-62. Baf A1 induced Ca(2+) release from isolated lamellar bodies. Thapsigargin reduced the Baf A1-induced secretion, indicating cross-talk between lamellar body and endoplasmic reticulum Ca(2+) pools. Stimulation of type II cells with surfactant secretagogues dissipated the pH gradient across lamellar bodies and disassembled the V-ATPase complex, indicating the physiological relevance of the V-ATPase-mediated surfactant secretion. Finally, silencing of V-ATPase a1 and B2 subunits decreased stimulated surfactant secretion, indicating that these subunits were crucial for surfactant secretion. We conclude that V-ATPase regulates surfactant secretion via an increased Ca(2+) mobilization from lamellar bodies and endoplasmic reticulum, and the activation of PKC and CaMKII. Our finding revealed a previously unrealized role of V-ATPase in surfactant secretion. PMID:20169059

  15. The Effect of Body Type and Camera Shot on Interpersonal Attraction and Source Credibility.

    ERIC Educational Resources Information Center

    McCain, Thomas A.; Divers, Lawrence

    In order to examine the effects of manipulating image size (i.e., relative size) and body type of speakers in a television context on source credibility and interpersonal attraction, a study was conducted at Illinois State University during the spring of 1973. Subjects were eighteen intact groups of students enrolled in speech communication class…

  16. The effects of vitamin D, K and calcium co-supplementation on carotid intima-media thickness and metabolic status in overweight type 2 diabetic patients with CHD.

    PubMed

    Asemi, Zatollah; Raygan, Fariba; Bahmani, Fereshteh; Rezavandi, Zohreh; Talari, Hamid Reza; Rafiee, Motahereh; Poladchang, Somayyeh; Darooghegi Mofrad, Manijeh; Taheri, Sara; Mohammadi, Ali Akbar; Esmaillzadeh, Ahmad

    2016-07-01

    This study was conducted to examine the effects of vitamin D, K and Ca co-supplementation on carotid intima-media thickness (CIMT) and metabolic status in overweight diabetic patients with CHD. This randomised, double-blind, placebo-controlled trial was conducted among sixty-six diabetic patients with CHD. Participants were randomly allocated into two groups to take either 5µg vitamin D, 90 µg vitamin K plus 500 mg Ca supplements (n 33) or placebo (n 33) twice a day for 12 weeks. Fasting blood samples were obtained at the beginning of the study and after the 12-week intervention period to determine related markers. Vitamin D, K and Ca co-supplementation resulted in a significant reduction in maximum levels of left CIMT (-0·04 (sd 0·22) v. +0·04 (sd 0·09) mm, P=0·02). Changes in serum vitamin D (+6·5 (sd 7·8) v. +0·4 (sd 2·2) ng/ml, P<0·001), Ca (+0·6 (sd 0·3) v. +0·1 (sd 0·1) mg/dl, P<0·001) and insulin concentrations (-0·9 (sd 3·1) v. +2·6 (sd 7·2) µIU/ml, P=0·01), homoeostasis model for assessment of estimated insulin resistance (-0·4 (sd 1·2) v. +0·7 (sd 2·3), P=0·01), β-cell function (-2·1 (sd 9·0) v. +8·9 (sd 23·7), P=0·01) and quantitative insulin sensitivity check index (+0·007 (sd 0·01) v. -0·006 (sd 0·02), P=0·01) in supplemented patients were significantly different from those in patients in the placebo group. Supplementation resulted in significant changes in HDL-cholesterol (+2·7 (sd 7·0) v. -2·5 (sd 5·7) mg/dl, P=0·002), high-sensitivity C-reactive protein (-1320·1 (sd 3758·3) v. +464·0 (sd 3053·3) ng/ml, P=0·03) and plasma malondialdehyde concentrations (-0·4 (sd 0·5) v. -1·0 (sd 1·1) µmol/l, P=0·007) compared with placebo. Overall, vitamin D, K and Ca co-supplementation for 12 weeks among diabetic patients with CHD had beneficial effects on maximum levels of left CIMT and metabolic status. The effect of vitamin D, K and Ca co-supplementation on maximum levels of left CIMT could be a chance

  17. Intracranial Pseudoaneurysms, Fusiform Aneurysms and Carotid-Cavernous Fistulas

    PubMed Central

    Lv, Xianli; Jiang, Chuhan; Li, Youxiang; Lv, Ming; Zhang, Jingbo; Wu, Zhongxue

    2008-01-01

    Summary The study assessed the effectiveness and safety of endovascular covered stents in the management of intracranial pseudoaneurysms, fusiform aneurysms and direct carotid-cavernous fistulas. Fourteen endovascular covered stents were used to repair three pseudoaneurysms, six fu-siform aneurysms and six direct carotid-cavernous fistulas. Aneurysms were in the carotid artery in seven cases, in the vertebral artery two cases. It was not possible to treat two additional cases transcutaneously for technical reasons
2/15. Percutaneous closure of the lesions with an endovascular covered stent was successful in 13 of 15 cases. Initial follow-up showed good stent patency. No complications were observed after stent implantation. During follow-up, stent thromboses were detected in two of nine patients with follow-up digital subtracted angiography. One carotid-cavernous fistula of Barrow Type A transformed into Barrow Type D at nine month follow-up study was cured with a procudure of Onyx-18 injection. Endovascular covered stents may be an option for percutaneous closure of intracranial pseudoaneurysms, fusiform aneurysms and direct carotid-cavernous fistulas. Endoluminal vascular repair with covered stents offers an alternative therapeutic approach to conventional modalities. PMID:20557743

  18. Body fat, fat distribution, and psychosocial factors among patients with Type 2 diabetes mellitus.

    PubMed

    Bell, R A; Summerson, J H; Spangler, J G; Konen, J C

    1998-01-01

    Diabetes, a risk factor for cardiovascular disease, requires lifestyle modifications (diet, exercise, weight loss). The relations between body mass index, waist-hip ratio (WHR), and psychosocial indicators, such as affect and stress, among 302 diabetic patients from a clinic and a neighborhood health center were analyzed. Data included stress and mood scale responses, body size (height, weight, and WHR) and potential confounders (physical activity, energy intake, and diabetes duration). In univariate analyses, body mass index was positively associated with stress and inversely associated with positive affect only in women. Multiple regression analyses indicated that stress was associated with body mass index and negative mood was associated with the WHR. The findings suggested that stress and affect may be important correlates of body fat among women with Type 2 diabetes, leading to more complications. Healthcare providers can help women with Type 2 diabetes lose weight and lower the risk of cardiovascular disease by recognizing and helping them deal with these psychosocial issues. PMID:9850808

  19. Protein dynamics in whole body and in splanchnic and leg tissues in type I diabetic patients.

    PubMed Central

    Nair, K S; Ford, G C; Ekberg, K; Fernqvist-Forbes, E; Wahren, J

    1995-01-01

    To elucidate the mechanism of insulin's anticatabolic effect in humans, protein dynamics were evaluated in the whole-body, splanchnic, and leg tissues in six C-peptide-negative type I diabetic male patients in the insulin-deprived and insulin-treated states using two separate amino acid models (leucine and phenylalanine). L-(1-13C,15N)leucine, L-(ring-2H5)phenylalanine, and L-(ring-2H2) tyrosine were infused intravenously, and isotopic enrichments of [1-13C,15N]-leucine, (13C)leucine, (13C)ketoisocaproate, (2H5)phenylalanine, [2H4]tyrosine, (2H2)tyrosine, and 13CO2 were measured in arterial, hepatic vein, and femoral vein samples. Whole-body leucine flux, phenylalanine flux, and tyrosine flux were decreased (< 0.01) by insulin treatment, indicating an inhibition of protein breakdown. Moreover, insulin decreased (< 0.05) the rates of leucine oxidation and leucine transamination (P < 0.01), but the percent rate of ketoisocaproate oxidation was increased by insulin (P < 0.01). Insulin also reduced (< 0.01) whole-body protein synthesis estimated from both the leucine model (nonoxidative leucine disposal) and the phenylalanine model (disposal of phenylalanine not accounted by its conversion to tyrosine). Regional studies demonstrated that changes in whole body protein breakdown are accounted for by changes in both splanchnic and leg tissues. The changes in whole-body protein synthesis were not associated with changes in skeletal muscle (leg) protein synthesis but could be accounted for by the splanchnic region. We conclude that though insulin decreases whole-body protein breakdown in patients with type I diabetes by inhibition of protein breakdown in splanchnic and leg tissues, it selectively decreases protein synthesis in splanchnic tissues, which accounted for the observed decrease in whole-body protein synthesis. Insulin also augmented anabolism by decreasing leucine transamination. Images PMID:7769135

  20. Worsening angle closure glaucoma and choroidal detachments subsequent to closure of a carotid cavernous fistula

    PubMed Central

    2012-01-01

    Background Carotid cavernous fistulas are abnormal communications between the cavernous sinus and the external or internal carotid arteries. Although rare, closure of carotid cavernous fistulas can lead to immediate ocular complications. To our knowledge, our case represents the first report of worsening angle closure glaucoma and choroidal detachments over an extended period of two months subsequent to closure of a carotid cavernous fistula. Case presentation A 70-year-old female with a history of primary angle closure glaucoma presented with 4 mm of proptosis, resistance to retropulsion, tortuous corkscrew blood vessels and an orbital bruit of the right eye. Diagnostic cerebral angiogram showed a small indirect Barrow type D right carotid cavernous fistula. Transarterial embolization was planned but repeat cerebral angiography prior to the procedure demonstrated spontaneous partial closure of the carotid cavernous fistula and the procedure was aborted. One month later, our patient was noted to have worsening vision and choroidal detachments of the right eye. She declined further testing and was thus started on self-administered manual carotid jugular compressions. One month later, she developed progressive worsening of her choroidal detachments and angle closure. She eventually opted for surgical intervention but repeat cerebral angiography showed significant thrombosis of the carotid cavernous fistula and no intervention was warranted. Examination two months later showed complete resolution of the choroidal detachments and open angles of both eyes. Conclusions Our patient demonstrated worsening angle closure glaucoma and choroidal detachments after spontaneous closure of her carotid cavernous fistula had been noted. Ocular complications, including acute angle closure, have been reported to occur immediately after closure of carotid cavernous fistulas, but not over months as in our patient. It is imperative that individuals who have undergone apparent closure

  1. Many-Body Effect in Spin Dephasing in n-Type GaAs Quantum Wells

    NASA Astrophysics Data System (ADS)

    Weng, Ming-Qi; Wu, Ming-Wei

    2005-03-01

    By constructing and numerically solving the kinetic Bloch equations we perform a many-body study of the spin dephasing due to the D'yakonov-Perel' effect in n-type GaAs (100) quantum wells for high temperatures. In our study, we include the spin-conserving scattering such as the electron-phonon, the electron-nonmagnetic impurity as well as the electron-electron Coulomb scattering into consideration. The dephasing obtained from our theory contains both the single-particle and the many-body contributions with the latter originating from the inhomogeneous broadening introduced by the DP term [J. Supercond.: Incorp. Novel Magn. 14 (2001) 245 Eur. Phys. J. B 18 (2000) 373]. Our result agrees very well with the experimental data [Phys. Rev. B 62 (2000) 13034] of Malinowski et al. We further show that in the case we study, the spin dephasing is dominated by the many-body effect.

  2. Lessons learnt from carotid artery trials.

    PubMed

    Van Damme, H; Limet, R

    2006-01-01

    The objective of the authors is to assess the natural history of carotid artery disease and the role of carotid intervention in preventing ipsilateral stroke. The development of endovascular techniques for correction of carotid artery stenoses made this less invasive technique very popular, with an inherent risk of unregulated overuse by a variety of medical specialists, who are not always well informed on the natural history of carotid artery disease. It re-opened the discussion on the value of carotid endarterectomy for stroke prophylaxis. This ongoing debate offers the opportunity to distil evidence-based guidelines for the management of extracranial carotid artery stenoses. In recent papers, some authors expressed doubts on the validity and general applicability of the results of the pivotal randomised trials of carotid endarterectomy. The excellent results in terms of operative outcome and long term stroke prevention would, according to certain comments, not be attainable in routine practice. Another criticism of carotid endarterectomy is its higher operative morbidity in terms of cranial nerve lesions and myocardial infarctions, compared to endovascular procedures. This consideration is, for some authors, the main reason to espouse carotid artery stenting as a better alternative to carotid endarterectomy. Any evidence supporting this point of view is missing. The supposed equivalence or non-inferiority of carotid artery stenting is purely speculative. The aim of this review paper is to summarize the crude data of carotid surgery trials. The authors aim to answer four questions. For which lesions is carotid endarterectomy most beneficial ? Are the results of randomised carotid surgery trials biased by the selection of patients ? Is operative morbidity, other than stroke, under-estimated ? Is carotid artery stenting safe and efficacious ? An in-depth review with a critical analysis is made of recently published and on-going trials, comparing carotid surgery

  3. Blunt carotid artery injury after minor facial trauma

    PubMed Central

    Murabit, Amera; Tredget, Edward E

    2012-01-01

    A healthy young man presented three days after suffering a punch to the face resulting in minimally displaced mandibular fractures. History revealed an episode of anterograde amnesia and a delayed episode of dysphonia. Apart from the fractured mandible, the physical examination was otherwise noncontributory. Imaging revealed severe luminal narrowing of the left cervical internal carotid artery distal to the carotid bifurcation, consistent with carotid dissection; and two focal hypodensities in the left frontal and parietal cortices, highly suggestive of acute secondary embolic infarcts. The patient was treated with systemic anticoagulation for three months and experienced no further neurological symptoms. His mandibular fractures, treated conservatively, healed without any complications. Blunt carotid artery injuries are uncommon and diverse. Neurological symptoms may develop in a delayed fashion, thus, a high index of suspicion based on knowledge of the injury mechanisms and patterns of associated injuries may enable earlier diagnosis and treatment. Angiographic imaging is essential for the diagnosis and classification of injury characteristics (eg, type, location, etc). Treatment must be considered on an individual patient basis depending on the presentation, grade and morphology of the lesion. Although no level I clinical trials exist on the topic, anticoagulation seems to be the treatment of choice in most cases and surgical intervention is not commonly indicated. Carotid artery dissection without complete thrombosis may be effectively treated with systemic anticoagulation or antiplatelet therapy in the majority of cases. PMID:23997588

  4. Blunt carotid artery injury after minor facial trauma.

    PubMed

    Murabit, Amera; Tredget, Edward E

    2012-01-01

    A healthy young man presented three days after suffering a punch to the face resulting in minimally displaced mandibular fractures. History revealed an episode of anterograde amnesia and a delayed episode of dysphonia. Apart from the fractured mandible, the physical examination was otherwise noncontributory. Imaging revealed severe luminal narrowing of the left cervical internal carotid artery distal to the carotid bifurcation, consistent with carotid dissection; and two focal hypodensities in the left frontal and parietal cortices, highly suggestive of acute secondary embolic infarcts. The patient was treated with systemic anticoagulation for three months and experienced no further neurological symptoms. His mandibular fractures, treated conservatively, healed without any complications. Blunt carotid artery injuries are uncommon and diverse. Neurological symptoms may develop in a delayed fashion, thus, a high index of suspicion based on knowledge of the injury mechanisms and patterns of associated injuries may enable earlier diagnosis and treatment. Angiographic imaging is essential for the diagnosis and classification of injury characteristics (eg, type, location, etc). Treatment must be considered on an individual patient basis depending on the presentation, grade and morphology of the lesion. Although no level I clinical trials exist on the topic, anticoagulation seems to be the treatment of choice in most cases and surgical intervention is not commonly indicated. Carotid artery dissection without complete thrombosis may be effectively treated with systemic anticoagulation or antiplatelet therapy in the majority of cases. PMID:23997588

  5. Chronic Interactions Between Carotid Baroreceptors and Chemoreceptors in Obesity Hypertension.

    PubMed

    Lohmeier, Thomas E; Iliescu, Radu; Tudorancea, Ionut; Cazan, Radu; Cates, Adam W; Georgakopoulos, Dimitrios; Irwin, Eric D

    2016-07-01

    Carotid bodies play a critical role in protecting against hypoxemia, and their activation increases sympathetic activity, arterial pressure, and ventilation, responses opposed by acute stimulation of the baroreflex. Although chemoreceptor hypersensitivity is associated with sympathetically mediated hypertension, the mechanisms involved and their significance in the pathogenesis of hypertension remain unclear. We investigated the chronic interactions of these reflexes in dogs with sympathetically mediated, obesity-induced hypertension based on the hypothesis that hypoxemia and tonic activation of carotid chemoreceptors may be associated with obesity. After 5 weeks on a high-fat diet, the animals experienced a 35% to 40% weight gain and increases in arterial pressure from 106±3 to 123±3 mm Hg and respiratory rate from 8±1 to 12±1 breaths/min along with hypoxemia (arterial partial pressure of oxygen=81±3 mm Hg) but eucapnia. During 7 days of carotid baroreflex activation by electric stimulation of the carotid sinus, tachypnea was attenuated, and hypertension was abolished before these variables returned to prestimulation values during a recovery period. After subsequent denervation of the carotid sinus region, respiratory rate decreased transiently in association with further sustained reductions in arterial partial pressure of oxygen (to 65±2 mm Hg) and substantial hypercapnia. Moreover, the severity of hypertension was attenuated from 125±2 to 116±3 mm Hg (45%-50% reduction). These findings suggest that hypoxemia may account for sustained stimulation of peripheral chemoreceptors in obesity and that this activation leads to compensatory increases in ventilation and central sympathetic outflow that contributes to neurogenically mediated hypertension. Furthermore, the excitatory effects of chemoreceptor hyperactivity are abolished by chronic activation of the carotid baroreflex. PMID:27160198

  6. Effects of Royal Jelly Supplementation on Body Weight and Dietary Intake in Type 2 Diabetic Females

    PubMed Central

    Pourmoradian, Samira; Mahdavi, Reza; Mobasseri, Majid; Faramarzi, Elnaz; Mobasseri, Mehrnoosh

    2012-01-01

    Background: The objective of the current study was to assess the effects of royal jelly supple-mentation on body weight, total daily energy and macronutrients intakes in type2 diabetic fe-males. Methods: In this randomized clinical trial, fifty female volunteers with type2 diabetes were as-signed into the supplemented (n=25) and placebo (n=25) groups, given a daily dose of 1000 mg royal jelly soft gel or placebo, for 8 weeks, respectively. Before and after the intervention, body weight and height of subjects were measured and body mass index was calculated. Dietary intake of patients was assessed using 24-hour food recall questionnaire for three non consecutive days (including 1 weekend day) and analyzed with Nutritionist IV software. The normally distributed data were compared using paired and independent t-tests, where appropriate. Results: Royal jelly supplementation significantly (P<0.01) decreased the mean body weight (72.45±4.42 vs. 71.00±6.44 kg) while it increased insignificantly in placebo group (73.02±6.44 vs 73.52±6.80 kg). Royal jelly supplementation resulted in significant decrease of mean daily total energy (P<0.01) and carbohydrate (P<0.01) intakes, while in placebo group the mean daily total energy and fat intakes were increased significantly (P<0.05). Conclusion: Supplementation with royal jelly may be beneficial in weight management of di-abetic patients. PMID:24688939

  7. The two types of stethoscope systems for respiration system diagnostics of the human body

    NASA Astrophysics Data System (ADS)

    Abashkin, Vladimir; Achimova, Elena

    2003-12-01

    An acoustic multimode fiber optic sensors for medical diagnostics based upon the shutter principle has been elaborated with semiconductor laser diode as light source. The construction and the method of component preparation are described. Other type of stethoscope is electrical one. Both stethoscopes are four channels. The kinetics and dynamic vibrations and sounds of the human body can be detected, acquired and then processing by personal computer for medical diagnostics.

  8. Sympathoinhibition and hypotension in carotid sinus hypersensitivity.

    PubMed

    Smith, M L; Ellenbogen, K A; Eckberg, D L

    1992-12-01

    Carotid sinus reflex hypersensitivity is a known cause of syncope in humans. The condition is characterized by cardioinhibition and vasodepression, each to varying degrees. The extent and importance of sympathoinhibition has not been determined in patients with carotid sinus hypersensitivity. This study reports on the extent of sympathoinhibition measured directly directly during carotid massage with and without atrioventricular sequential pacing, in a patient with symptomatic carotid sinus reflex hypersensitivity. Carotid massage elicited asystole, hypotension and complete inhibition of muscle sympathetic nerve activity. Carotid massage during atrioventricular pacing produced similar sympathoinhibition, but with minimal hypotension. Therefore, sympathoinhibition did not contribute importantly to the hypotension during carotid massage in the supine position in this patient. Further investigations are required to elucidate the relation of sympathoinhibition to hypotension in patients with carotid sinus hypersensitivity in the upright position. PMID:1290922

  9. How Is Carotid Artery Disease Treated?

    MedlinePlus

    ... Links Related Topics Atherosclerosis Carotid Endarterectomy Carotid Ultrasound Stents Stroke Send a link to NHLBI to someone ... outward against the wall of the artery. A stent (a small mesh tube) is then put in ...

  10. Sympathoinhibition and hypotension in carotid sinus hypersensitivity

    NASA Technical Reports Server (NTRS)

    Smith, M. L.; Ellenbogen, K. A.; Eckberg, D. L.

    1992-01-01

    Carotid sinus reflex hypersensitivity is a known cause of syncope in humans. The condition is characterized by cardioinhibition and vasodepression, each to varying degrees. The extent and importance of sympathoinhibition has not been determined in patients with carotid sinus hypersensitivity. This study reports on the extent of sympathoinhibition measured directly directly during carotid massage with and without atrioventricular sequential pacing, in a patient with symptomatic carotid sinus reflex hypersensitivity. Carotid massage elicited asystole, hypotension and complete inhibition of muscle sympathetic nerve activity. Carotid massage during atrioventricular pacing produced similar sympathoinhibition, but with minimal hypotension. Therefore, sympathoinhibition did not contribute importantly to the hypotension during carotid massage in the supine position in this patient. Further investigations are required to elucidate the relation of sympathoinhibition to hypotension in patients with carotid sinus hypersensitivity in the upright position.

  11. Should patients with asymptomatic significant carotid stenosis undergo simultaneous carotid and cardiac surgery?

    PubMed Central

    Ogutu, Peter; Werner, Raphael; Oertel, Frank; Beyer, Michael

    2014-01-01

    A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether patients with severe asymptomatic carotid and coronary artery diseases should undergo simultaneous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG). A total of 624 papers were found using the reported search, of which 20 represent the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study results of these papers are tabulated. Previous cohort studies showed mixed results, while advocating for the necessity of a randomized controlled trial (RCT). A recent RCT showed that patients undergoing prophylactic or simultaneous CEA + CABG had lower rates of stroke (0%) compared with delayed CEA 1–3 months after CABG (7.7%), without significant perioperative mortality difference. This study included patients with unilateral severe (>70%) asymptomatic carotid stenosis requiring CABG. An earlier partly randomized trial also showed better outcomes for patients undergoing simultaneous procedures (P = 0.045). Interestingly, systematic reviews previously failed to show compelling evidence supporting prophylactic CEA. This could be partly due to the fact that these reviews collectively analyse different cohort qualities. Neurological studies have, however, shown reduced cognitive and phonetic quality and function in patients with unilateral and bilateral asymptomatic carotid artery stenosis. Twenty-one RCTs comparing lone carotid artery stenting (CAS) and CEA informed the American Heart Association guidelines, which declared CAS comparable with CEA for symptomatic and asymptomatic carotid stenosis (CS). However, the risk of death/stroke for CAS alone is double that for CEA alone in the acute phase following onset of symptoms, while CEA alone is associated with a doubled risk of myocardial infarction. There is

  12. Spontaneous carotid cavernous fistula in Ehlers Danlos syndrome.

    PubMed Central

    Fox, R; Pope, F M; Narcisi, P; Nicholls, A C; Kendall, B E; Hourihan, M D; Compston, D A

    1988-01-01

    A patient is described with Ehlers Danlos syndrome presenting with spontaneous carotid cavernous fistula, in whom there was biochemical evidence for defective type III collagen synthesis. Despite the risks associated with arterial manipulation, the fistula was successfully closed by interventional neuroradiology and the patient has since remained well. This outcome is in contrast with the results in previous reports. Images PMID:3204406

  13. Multimodality Imaging of Carotid Stenosis

    PubMed Central

    Adla, Theodor; Adlova, Radka

    2015-01-01

    Four diagnostic modalities are used to image the following internal carotid artery: digital subtraction angiography (DSA), duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). The aim of this article is to describe the potentials of these techniques and to discuss their advantages and disadvantages. Invasive DSA is still considered the gold standard and is an indivisible part of the carotid stenting procedure. DUS is an inexpensive but operator-dependent tool with limited visibility of the carotid artery course. Conversely, CTA and MRA allow assessment of the carotid artery from the aortic arch to intracranial parts. The disadvantages of CTA are radiation and iodine contrast medium administration. MRA is without radiation but contrast-enhanced MRA is more accurate than noncontrast MRA. The choice of methods depends on the clinical indications and the availability of methods in individual centers. However, the general approach to patient with suspected carotid artery stenosis is to first perform DUS and then other noninvasive methods such as CTA, MRA, or transcranial Doppler US. PMID:26417185

  14. Carotid bruits as predictor for carotid stenoses detected by ultrasonography: an observational study

    PubMed Central

    Johansson, Elias P; Wester, Per

    2008-01-01

    Background Carotid surgery in asymptomatic subjects with carotid stenosis is effective to prevent ischemic stroke. There is, however, uncertainty how to find such persons at risk, because mass screening with carotid artery ultrasonography (US) is not cost-effective. Signs of carotid bruits corresponding to the carotid arteries may serve as a tool to select subjects for further investigation. This study is thus aimed at determining the usefulness of carotid bruits in the screening of carotid stenoses. Methods 1555 consecutive carotid ultrasonography investigations from 1486 cases done between January 2004 and March 2006 at Norrlands University Hospital, Sweden, were examined. 356 subjects, medium age 69 (27–88) years, had a significant (≥ 50%) US-verified carotid stenosis uni- or bilaterally, 291 had been examined for signs of carotid bruits. The likelihood ratios for carotid bruits to predict US-verified carotid stenoses were calculated and expressed as likelihood percentages. Results Thirty-one out of 100 persons (31%) with carotid bruit as an indication to perform carotid US had a significant (≥ 50%) carotid stenosis. 281 of the 356 (79%) cases with significant carotid stenoses were found among patients with cerebrovascular disease (CVD). 145 of 226 (64%) CVD patients with a significant carotid stenosis had a carotid bruit. In patients with 50–99% carotid stenoses carotid bruits had an accuracy of 75% (436/582), a sensitivity of 71% (236/334), a specificity of 81% (200/248), a positive likelihood ratio at 3.65 and a negative likelihood at 0.36. Patients with 70–99% stenoses had the highest sensitivity at 77% (183/238). In patients with 100% carotid stenoses, carotid bruits had a sensitivity of 26% (15/57) and a specificity of 49% (256/525). Conclusion Although carotid bruits are not accurate to confirm or to exclude significant carotid stenoses, these signs are appropriate for directed screening for further investigation with carotid US if the patient

  15. Carotid chemoreceptor “resetting” revisited

    PubMed Central

    Carroll, John L.; Kim, Insook

    2012-01-01

    Carotid body (CB) chemoreceptors transduce low arterial O2 tension into increased action potential activity on the carotid sinus nerves, which contributes to resting ventilatory drive, increased ventilatory drive in response to hypoxia, arousal responses to hypoxia during sleep, upper airway muscle activity, blood pressure control and sympathetic tone. Their sensitivity to O2 is low in the newborn and increases during the days or weeks after birth to reach adult levels. This postnatal functional maturation of the CB O2 response has been termed “resetting” and it occurs in every mammalian species studied to date. The O2 environment appears to play a key role; the fetus develops in a low O2 environment throughout gestation and initiation of CB “resetting” after birth is modulated by the large increase in arterial oxygen tension occurring at birth. Although numerous studies have reported age-related changes in various components of the O2 transduction cascade, how the O2 environment shapes normal CB prenatal development and postnatal “resetting” remains unknown. Viewing CB “resetting” as environment-driven (developmental) phenotypic plasticity raises important mechanistic questions that have received little attention. This review examines what is known (and not known) about mechanisms of CB functional maturation, with a focus on the role of the O2 environment. PMID:22982216

  16. Carotid Plaques Correlates in Patients With Familial Hypercholesterolemia.

    PubMed

    Waluś-Miarka, Małgorzata; Czarnecka, D; Wojciechowska, W; Kloch-Badełek, M; Kapusta, M; Sanak, M; Wójcik, M; Małecki, M T; Starzyk, J; Idzior-Waluś, B

    2016-05-01

    Patients with familial hypercholesterolemia (FH) are at increased risk of premature cardiovascular disease. We compared factors associated with the presence of carotid plaques and carotid intima-media thickness (cIMT), markers of subclinical atherosclerosis, in 241 patients with FH (98, 40.7% men; mean age 41 ± 18.4 years). Patients with FH having carotid plaques (36.5%) had mean age, apolipoprotein (apo) B, glucose, apoA1, systolic blood pressure (SBP) and diastolic BP, waist/hip ratio (WHR), and body mass index higher than patients without plaques. Logistic regression revealed that apoB (odds ratio [OR] per 1 unit change 1.03,P= .005), high-density lipoprotein cholesterol (HDL-C; OR per 1 standard deviation [SD] change 0.59,P= .015), and non-HDL-C (OR per 1SD change 1.53,P= .04) were significantly associated with the presence of plaques. The cIMT correlated with obesity parameters, BP, apoB, glucose, high-sensitivity C-reactive protein, creatinine, γ-glutamyl transpeptidase, and alanine transaminase (P< .001). Regression analysis revealed that cIMT was significantly associated with apoB, SBP, and WHR. These results confirm the role of apoB-containing lipoproteins and low HDL-C with the presence of carotid plaques and apoB, BP, and WHR with cIMT. PMID:26198473

  17. Type 2 Diabetes is a Delayed Late Effect of Whole-Body Irradiation in Nonhuman Primates

    PubMed Central

    Kavanagh, Kylie; Dendinger, Michael D.; Davis, Ashley T.; Register, Thomas C.; DeBo, Ryne; Dugan, Greg; Cline, J. Mark

    2015-01-01

    One newly recognized consequence of radiation exposure may be the delayed development of diabetes and metabolic disease. We document the development of type 2 diabetes in a unique nonhuman primate cohort of monkeys that were whole-body irradiated with high doses (6.5–8.4 Gy) 5–9 years earlier. We report here a higher prevalence of type 2 diabetes in irradiated monkeys compared to age-matched nonirradiated monkeys. These irradiated diabetic primates demonstrate insulin resistance and hypertriglyceridemia, however, they lack the typical obese presentation of primate midlife diabetogenesis. Surprisingly, body composition analyses by computed tomography indicated that prior irradiation led to a specific loss of visceral fat mass. Prior irradiation led to reductions in insulin signaling effectiveness in skeletal muscle and higher monocyte chemoattractant protein 1 levels, indicative of increased inflammation. However, there was an absence of large defects in pancreatic function with radiation exposure, which has been documented previously in animal and human studies. Monkeys that remained healthy and did not become diabetic in the years after irradiation were significantly leaner and smaller, and were generally smaller and younger at the time of exposure. Irradiation also resulted in smaller stature in both diabetic and nondiabetic monkeys, compared to nonirradiated age-matched controls. Our study demonstrates that diabetogenesis postirradiation is not a consequence of disrupted adipose accumulation (generalized or in ectopic depots), nor generalized pancreatic failure, but suggests that peripheral tissues such as the musculature are impaired in their response to insulin exposure. Ongoing inflammation in these animals appears to be a consequence of radiation exposure and can interfere with insulin signaling. The reasons that some animals remain protected from diabetes as a late effect of irradiation are not clear, but may be related to body size. The translational

  18. Regulation of body mass growth through activin type IIB receptor in teleost fish.

    PubMed

    Carpio, Yamila; Acosta, Jannel; Morales, Reynold; Santisteban, Yaimín; Sanchéz, Aniel; Estrada, Mario Pablo

    2009-01-15

    Myostatin is a TGF-beta family member that plays a key role in regulating skeletal muscle growth. Previous studies in mammals have demonstrated that myostatin is capable of binding the two activin type II receptors. Additionally, activin type II receptors have been shown to be capable of binding a number of other TGF-beta family members besides myostatin. An injection of a soluble form of activin type IIB receptor obtained from CHO cells into wild-type mice generated up to a 60% increase in muscle mass in 2 weeks. The knowledge on the role of activin receptors in fish is limited. In the present study, we examined the growth effect of administering a recombinant, soluble form of goldfish activin type IIB receptor extracellular domain to juvenile and larval goldfish (Carassius auratus), African catfish (Clarias gariepinus) larvae and tilapia (Oreochromis aureus) larvae. We have expressed the goldfish activin type IIB receptor extracellular domain in the yeast Pichia pastoris and we have demonstrated for the first time that this recombinant molecule stimulates growth in teleost fish in a dose-dependent manner. We provide evidence that this body weight increase is achieved by an increase in muscle mass and protein content. Histological analysis of the goldfish muscle revealed that treated fish exhibited hyperplasia as compared to controls. These findings contribute to the understanding of the mechanisms that regulate growth in non-mammalian vertebrates and suggest a powerful biotechnology approach to improving fish growth in aquaculture. PMID:19056390

  19. Perceived body image in men and women with type 2 diabetes mellitus: correlation of body mass index with the figure rating scale

    PubMed Central

    2009-01-01

    Background Body mass index (BMI) is often used as an objective surrogate estimate of body fat. Increased BMI is directly associated with an increase in metabolic disease, such as type 2 diabetes mellitus (T2DM). The Stunkard Figure Rating Scale (FRS) is a subjective measure of body fat, and self-perceptions of body image conceivably impact the development and treatment of T2DM. This study examined the self-perception of body image to various levels of BMI among those with T2DM. Methods Respondents (n = 13,887) to the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) 2006 survey self-reported their weight and height for BMI calculation. On the gender-specific Stunkard FRS, respondents selected the figure most closely resembling their body image. Spearman correlation was computed between perceived body image and BMI for men and women separately. Student's t-test analysis compared the mean BMI differences between respondents with and without T2DM. Results Men with T2DM did not significantly differ from men without diabetes mellitus in mean BMI per body image figure except at the extremes in body figures. Women with T2DM had a significantly higher BMI for the same body figure compared with women without diabetes mellitus for most figures (p < 0.05). Conclusions Individuals, particularly women, with T2DM may differ in their perception of body image compared with those without diabetes mellitus. It is unclear if these perceived differences increase the risk of T2DM, or if the diagnosis of T2DM alters body image perceptions. PMID:20003545

  20. Two novel classes of solvable many-body problems of goldfish type with constraints

    NASA Astrophysics Data System (ADS)

    Calogero, F.; Gómez-Ullate, D.

    2007-05-01

    Two novel classes of many-body models with nonlinear interactions 'of goldfish type' are introduced. They are solvable provided the initial data satisfy a single constraint (in one case; in the other, two constraints), i.e., for such initial data the solution of their initial-value problem can be achieved via algebraic operations, such as finding the eigenvalues of given matrices or equivalently the zeros of known polynomials. Entirely isochronous versions of some of these models are also exhibited, i.e., versions of these models whose nonsingular solutions are all completely periodic with the same period.

  1. Minimal nocturnal oxygen saturation predicts future subclinical carotid atherosclerosis: the Wisconsin sleep cohort.

    PubMed

    Gunnarsson, Sverrir I; Peppard, Paul E; Korcarz, Claudia E; Barnet, Jodi H; Hagen, Erika W; Hla, K Mae; Palta, Mari; Young, Terry; Stein, James H

    2015-12-01

    Previous data on the associations between nocturnal oxygen saturation parameters and carotid atherosclerosis are conflicting. We examined the prospective associations of nocturnal oxygen saturation (SaO2 ) and cardiovascular disease (CVD) risk factors with carotid intima-media thickness (IMT) and plaques. We used data on 689 Wisconsin sleep cohort participants who had baseline overnight polysomnography followed by carotid ultrasonography a mean (SD) of 7.8 (2.5) years later. Far wall common carotid IMT was measured using B-mode ultrasound. Bilateral common, bifurcation and internal carotid artery segments were evaluated for plaque score. Participants (8) were aged 56 years (55% male); 32% had hypertension and mean body mass index (BMI) was 31 (7) kg m(2). Mean and minimum nocturnal SaO2 were 95% (2) and 86% (7), respectively. Mean percentage sleep time with SaO2 < 90% was 2% (8). Both mean (odds ratio [OR]: 0.60 lower plaque count per 5% higher mean SaO2, 95% confidence interval [CI]: 0.38-0.96, P = 0.033) and minimum SaO2 (OR: 0.88 lower plaque count per 5% higher minimum SaO2, 95% CI: 0.80-0.97, P = 0.013) predicted carotid plaque score after adjusting for age, sex and BMI. Minimum SaO2 predicted future plaque score after adding adjustment for traditional CVD risk factors (OR: 0.90 lower plaque count per 5% higher minimum SaO2, 95% CI: 0.81-0.99, P = 0.038). Mean SaO2 was not associated with carotid IMT after CVD risk factor adjustment. We conclude that minimum nocturnal SaO2 is an independent predictor of future carotid plaque burden. Other nocturnal SaO2 parameters are not associated with future carotid IMT or plaques after adjusting for traditional CVD risk factors. PMID:26096939

  2. Taking your carotid pulse (image)

    MedlinePlus

    ... take oxygenated blood from the heart to the brain. The pulse from the carotids may be felt on either side of the front of the neck just below the angle of the jaw. This rhythmic "beat" is caused by varying volumes of blood being pushed out of the heart ...

  3. Scalable N-body Code for the Modeling of Early-type Galaxies

    NASA Astrophysics Data System (ADS)

    Jourdeuil, E.; Emsellem, E.

    Early-type galaxies exhibit a wealth of photometric and dynamical structures. These signatures are fossil records of their formation and evolution processes. In order to examine these structures in detail, we build models aimed at reproducing the observed photometry and kinematics. The developed method is a generalization of the one introduced by (12), consisting in an N-body representation, in which the weights of the particles are changing with time. Our code is adapted for integral-field spectroscopic data, and is able to reproduce the photometric as well as stellar kinematic data of observed galaxies. We apply this technique on SAURON data of early-type galaxies, and present preliminary results on NGC 3377

  4. The prevalence of carotid plaque with different stability and its association with metabolic syndrome in China: The Asymptomatic Polyvascular Abnormalities Community study.

    PubMed

    Wang, Anxin; Wu, Lingyun; Liu, Xiaoxue; Su, Zhaoping; Luo, Yanxia; Chen, Shuohua; Li, Haibin; Liu, Xiangtong; Tao, Lixin; Guo, Jin; Zhang, Feng; Cao, Yibin; Zhao, Xingquan; Wu, Shouling; Guo, Xiuhua

    2016-08-01

    Few studies have investigated the prevalence of carotid plaque with different stability in Chinese. As is well known, carotid atherosclerosis is tightly associated with metabolic syndrome (MetS); however, the data about the association between the presence of carotid plaque with different stability and MetS was limited. The aim of our study was to investigate the prevalence of carotid plaque with different stability and its potential association with MetS in general Chinese population.The Asymptomatic Polyvascular Abnormalities Community study is a community-based study to investigate the epidemiology of asymptomatic polyvascular abnormalities in Chinese adults. A total of 5393 participants were finally eligible and included in this study. The carotid plaque and its stability were assessed using ultrasonography. The MetS was defined using the criteria from US National Cholesterol Education Program-Adult Treatment Panel III. Data were analyzed with multivariate logistic regression models.Of the 5393 subjects, 1397 (25.9%) participants had stable carotid plaque, 1518 (28.1%) had unstable carotid plaque in participants, and 1456 (27.0%) had a MetS. MetS was, respectively, significantly associated with the prevalence of carotid plaque (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.07, 1.47), stable carotid plaque (OR: 1.23; 95% CI: 1.02,1.48), and unstable carotid plaque (OR: 1.27; 95% CI: 1.03,1.56) after adjusting for age, gender, level of education, income, smoking, drinking, physical activity, body mass index, low-density lipoprotein, and high-sensitivity C-reactive protein. With the number of MetS components, the prevalence of carotid plaque, stable carotid plaque, and unstable carotid plaque significantly increased (P for trend <0.0001), respectively.In summary, the prevalence of carotid plaque was 54.1%, stable carotid plaque was 25.9%, and unstable carotid plaque was 28.1%. Our study revealed that the prevalence of carotid plaque, stable carotid plaque

  5. Physician specialty and variation in carotid revascularization technique selected for Medicare patients

    PubMed Central

    Wallaert, Jessica B.; Nolan, Brian W.; Stone, David H.; Powell, Richard J.; Brown, Jeremiah R.; Cronenwett, Jack L.; Goodney, Philip P.

    2016-01-01

    Objective Carotid artery stenting (CAS) has become an alternative to carotid endarterectomy (CEA) for select patients with carotid atherosclerosis. We hypothesized that the choice of CAS vs CEA varies as a function of treating physician specialty, which would result in regional variation in the relative use of these treatment types. Methods We used Medicare claims (2002–2010) to calculate annual rates of CAS and CEA and examined changes by procedure type over time. To assess regional preferences surrounding CAS, we calculated the proportion of revascularizations by CAS, across hospital referral regions, defined according to the Dartmouth Atlas of Healthcare. We then examined relationships between patient factors, physician specialty, and regional use of CAS. Results The annual number of all carotid revascularization procedures decreased by 30% from 2002 to 2010 (3.2 to 2.3 per 1000; P = .005). Whereas rates of CEA declined by 35% during these 8 years (3.0 to 1.9 per 1000; P < .001), CAS utilization increased by 5% during the same interval (0.30 to 0.32 per 1000; P = .014). Variation in utilization of carotid revascularization varied across the Unites States, with some regions performing as few as 0.7 carotid procedure per 1000 beneficiaries (Honolulu, Hawaii) and others performing nearly 8 times as many (5.3 per 1000 in Houma, La). Variation in procedure type (CEA vs CAS) was evident as well, as the proportion of carotid revascularization procedures that were constituted by CAS varied from 0% (Casper, Wyo, and Meridian, Miss) to 53% (Bend, Ore). The majority of CAS procedures were performed by cardiologists (49% of all CAS cases), who doubled their rates of CAS during the study period from 0.07 per 1000 in 2002 to 0.15 per 1000 in 2010. Conclusions Variation in rates of carotid revascularization exists. Whereas rates of carotid revascularization have declined by more than 30% in recent years, utilization of CAS has increased. The proportion of all carotid

  6. Increased Vessel Depiction of the Carotid Bifurcation with a Specialized 16-Channel Phased Array Coil at 3T

    PubMed Central

    Tate, Quinn; Kim, Seong-Eun; Treiman, Gerald; Parker, Dennis L.; Hadley, J. Rock

    2012-01-01

    The purpose of this work was to design and construct a multi-channel receive-only RF coil for 3 Tesla magnetic resonance imaging of the human carotid artery and bifurcation with optimized signal to noise ratio in the carotid vessels along the full extent of the neck. A neck phantom designed to match the anatomy of a subject with a neck representing the body habitus often seen in subjects with carotid arterial disease, was constructed. Sixteen circular coil elements were arranged on a semi-rigid fiberglass former that closely fit the shape of the phantom, resulting in a 16-channel bilateral phased array coil. Comparisons were made between this coil and a typical 4-channel carotid coil in a study of 10 carotid vessels in 5 healthy volunteers. The 16-channel carotid coil showed a 73% average improvement in signal to noise ratio (SNR) at the carotid bifurcation. This coil also maintained an SNR greater than the peak SNR of the 4-channel coil over a vessel length of 10 cm. The resulting increase in SNR improved vessel depiction of the carotid arteries over an extended field of view, and demonstrated better image quality for higher parallel imaging reduction factors compared to the 4-channel coil. PMID:22777692

  7. Factor analytic reduction of the carotid-cardiac baroreflex parameters

    NASA Technical Reports Server (NTRS)

    Ludwig, David A.

    1989-01-01

    An accepted method for measuring the responsiveness of the carotid-cardiac baroreflex to arterial pressure changes is to artificially stimulate the baroreceptors in the neck. This is accomplished by using a pressurized neck cuff which constricts and distends the carotid artery and subsequently stimulates the baroreceptors. Nine physiological responses to this type of stimulation are quantified and used as indicators of the baroreflex. Thirty male humans between the ages 27 and 46 underwent the carotid-cardiac baroreflex test. The data for the nine response parameters were analyzed by principle component factor analysis. The results of this analysis indicated that 93 percent of the total variance across all nine parameters could be explained in four dimensions. Examination of the factor loadings following an orthogonal rotation of the principle components indicated four well defined dimensions. The first two dimensions reflected location points for R-R interval and carotid distending pressure respectively. The third dimension was composed of measures reflecting the gain of the reflex. The fourth dimension was the ratio of the resting R-R interval to R-R interval during simulated hypertension. The data suggests that the analysis of all nine baroreflex parameters is redundant.

  8. Carotid blood flow measured by an ultrasonic volume flowmeter in carotid stenosis and patients with dementia.

    PubMed Central

    Uematsu, S; Folstein, M F

    1985-01-01

    The volume flowmeter is a simple, noninvasive Doppler ultrasound technique that provides accurate measurement of carotid artery diameter and flow. The device provides a useful laboratory test that can aid significantly in diagnosis of carotid stenosis and dementia. PMID:2935592

  9. The haptoglobin 2-2 genotype is associated with inflammation and carotid artery intima-media thickness

    PubMed Central

    Dalan, Rinkoo; Liew, Huiling; Goh, Liuh Ling; Gao, Xiao; Chew, Daniel EK; Boehm, Bernhard O; Leow, Melvin Khee Shing

    2016-01-01

    The haptoglobin 2-2 genotype is associated with atherosclerosis in type 2 diabetes mellitus. We examined the associations of the haptoglobin 2-2 genotype with C-reactive protein (high-sensitivity C-reactive protein) and carotid artery intima-media thickness, adjusting for age, gender, ethnicity, type 2 diabetes mellitus, smoking status, body mass index, blood pressure, glycated haemoglobin, non-high-density lipoprotein cholesterol and medications via logistic multivariate regression in 200 subjects (160 type 2 diabetes mellitus versus 40 healthy individuals). The prevalence of the haptoglobin 2-2 genotype was 58% (115/200), higher in the Indians than in Chinese (72% versus 45%, p = 0.001). Multivariate analysis showed that the haptoglobin 2-2 genotype was associated with high-sensitivity C-reactive protein [mean: 3.5 ± 3.9 versus 2.2 ± 2.6 mg/L (non-haptoglobin 2-2), p < 0.001], haptoglobin concentration [mean: 116.9 ± 54.4.0 versus 147.2 ± 54.5 mg/dL (non-haptoglobin 2-2), p < 0.001] and average carotid artery intima-media thickness (multiplied by 10) [6.15 ± 1.22 versus 5.98 ± 1.20 mm (non-haptoglobin 2-2), p = 0.013]. This pilot study shows an association of the haptoglobin 2-2 genotype with low-grade inflammation, haptoglobin concentration and carotid artery intima-media thickness in multi-ethnic Singapore. PMID:27190085

  10. The haptoglobin 2-2 genotype is associated with inflammation and carotid artery intima-media thickness.

    PubMed

    Dalan, Rinkoo; Liew, Huiling; Goh, Liuh Ling; Gao, Xiao; Chew, Daniel Ek; Boehm, Bernhard O; Leow, Melvin Khee Shing

    2016-09-01

    The haptoglobin 2-2 genotype is associated with atherosclerosis in type 2 diabetes mellitus. We examined the associations of the haptoglobin 2-2 genotype with C-reactive protein (high-sensitivity C-reactive protein) and carotid artery intima-media thickness, adjusting for age, gender, ethnicity, type 2 diabetes mellitus, smoking status, body mass index, blood pressure, glycated haemoglobin, non-high-density lipoprotein cholesterol and medications via logistic multivariate regression in 200 subjects (160 type 2 diabetes mellitus versus 40 healthy individuals). The prevalence of the haptoglobin 2-2 genotype was 58% (115/200), higher in the Indians than in Chinese (72% versus 45%, p = 0.001). Multivariate analysis showed that the haptoglobin 2-2 genotype was associated with high-sensitivity C-reactive protein [mean: 3.5 ± 3.9 versus 2.2 ± 2.6 mg/L (non-haptoglobin 2-2), p < 0.001], haptoglobin concentration [mean: 116.9 ± 54.4.0 versus 147.2 ± 54.5 mg/dL (non-haptoglobin 2-2), p < 0.001] and average carotid artery intima-media thickness (multiplied by 10) [6.15 ± 1.22 versus 5.98 ± 1.20 mm (non-haptoglobin 2-2), p = 0.013]. This pilot study shows an association of the haptoglobin 2-2 genotype with low-grade inflammation, haptoglobin concentration and carotid artery intima-media thickness in multi-ethnic Singapore. PMID:27190085

  11. Empagliflozin reduces body weight and indices of adipose distribution in patients with type 2 diabetes mellitus

    PubMed Central

    Neeland, Ian J; McGuire, Darren K; Chilton, Robert; Crowe, Susanne; Lund, Søren S; Woerle, Hans J; Broedl, Uli C; Johansen, Odd Erik

    2016-01-01

    Aims: To determine the effects of empagliflozin on adiposity indices among patients with type 2 diabetes mellitus. Methods: Changes in weight, waist circumference, estimated total body fat, index of central obesity and visceral adiposity index were assessed using analysis of covariance and testing of treatment by strata for age, sex and baseline waist circumference in patients with type 2 diabetes mellitus randomized to blinded treatment with empagliflozin versus placebo in clinical trials of 12 weeks (cohort 1) or 24 weeks (cohort 2) duration. Results: This study comprised 3300 patients (cohort 1, N = 823; cohort 2, N = 2477). Empagliflozin reduced weight, waist circumference and adiposity indices versus placebo in both cohorts. Adjusted mean (95% confidence interval) change from baseline in empagliflozin versus placebo was −1.7 kg (−2.1 to −1.4 kg) and −1.9 kg (−2.1 to −1.7 kg) for body weight (p < 0.001); −1.3 cm (−1.8 to −0.7 cm) and −1.3 cm (−1.7 to −1.0 cm) for waist circumference (p < 0.001); −0.2% (−0.7% to 0.3%; p = 0.45) and −0.3% (−0.7% to 0.0%; p = 0.08) for estimated total body fat; −0.007 (−0.011 to −0.004) and −0.008 (−0.010 to −0.006) for index of central obesity (p < 0.001); and −0.3 (−0.5 to 0.0; p = 0.07) and −0.4 (−0.7 to −0.1; p = 0.003) for visceral adiposity index in cohorts 1 and 2, respectively. Adipose reductions were seen across most age, sex and waist circumference subgroups. Conclusion: Empagliflozin significantly reduced weight and adiposity indices with the potential to improve cardiometabolic risk among patients with type 2 diabetes mellitus. PMID:26873905

  12. The bacterial communities associated with fecal types and body weight of rex rabbits

    PubMed Central

    Zeng, Bo; Han, Shushu; Wang, Ping; Wen, Bin; Jian, Wensu; Guo, Wei; Yu, Zhiju; Du, Dan; Fu, Xiangchao; Kong, Fanli; Yang, Mingyao; Si, Xiaohui; Zhao, Jiangchao; Li, Ying

    2015-01-01

    Rex rabbit is an important small herbivore for fur and meat production. However, little is known about the gut microbiota in rex rabbit, especially regarding their relationship with different fecal types and growth of the hosts. We characterized the microbiota of both hard and soft feces from rex rabbits with high and low body weight by using the Illumina MiSeq platform targeting the V4 region of the 16S rDNA. High weight rex rabbits possess distinctive microbiota in hard feces, but not in soft feces, from the low weight group. We detected the overrepresentation of several genera such as YS2/Cyanobacteria, and Bacteroidales and underrepresentation of genera such as Anaeroplasma spp. and Clostridiaceae in high weight hard feces. Between fecal types, several bacterial taxa such as Ruminococcaceae, and Akkermansia spp. were enriched in soft feces. PICRUSt analysis revealed that metabolic pathways such as “stilbenoid, diarylheptanoid, gingerol biosynthesis” were enriched in high weight rabbits, and pathways related to “xenobiotics biodegradation” and “various types of N-glycan biosynthesis” were overrepresented in rabbit soft feces. Our study provides foundation to generate hypothesis aiming to test the roles that different bacterial taxa play in the growth and caecotrophy of rex rabbits. PMID:25791609

  13. The bacterial communities associated with fecal types and body weight of rex rabbits.

    PubMed

    Zeng, Bo; Han, Shushu; Wang, Ping; Wen, Bin; Jian, Wensu; Guo, Wei; Yu, Zhiju; Du, Dan; Fu, Xiangchao; Kong, Fanli; Yang, Mingyao; Si, Xiaohui; Zhao, Jiangchao; Li, Ying

    2015-01-01

    Rex rabbit is an important small herbivore for fur and meat production. However, little is known about the gut microbiota in rex rabbit, especially regarding their relationship with different fecal types and growth of the hosts. We characterized the microbiota of both hard and soft feces from rex rabbits with high and low body weight by using the Illumina MiSeq platform targeting the V4 region of the 16S rDNA. High weight rex rabbits possess distinctive microbiota in hard feces, but not in soft feces, from the low weight group. We detected the overrepresentation of several genera such as YS2/Cyanobacteria, and Bacteroidales and underrepresentation of genera such as Anaeroplasma spp. and Clostridiaceae in high weight hard feces. Between fecal types, several bacterial taxa such as Ruminococcaceae, and Akkermansia spp. were enriched in soft feces. PICRUSt analysis revealed that metabolic pathways such as "stilbenoid, diarylheptanoid, gingerol biosynthesis" were enriched in high weight rabbits, and pathways related to "xenobiotics biodegradation" and "various types of N-glycan biosynthesis" were overrepresented in rabbit soft feces. Our study provides foundation to generate hypothesis aiming to test the roles that different bacterial taxa play in the growth and caecotrophy of rex rabbits. PMID:25791609

  14. Does body mass index matter while selecting the flap type for pharyngeal reconstructions?

    PubMed

    Calli, Caglar; Teknos, Theodoros N; Agrawal, Amit; Schuller, David E; Ozer, Enver; Songu, Murat

    2014-05-01

    The aim of our study was to investigate the effect of patient-related factors, such as the body mass index (BMI) and tumor size, in selecting the flap type for the reconstruction of pharyngeal defects. This retrospective review included 182 patients with pharyngeal defect reconstructions with free and pedicled flaps at the Ohio State University from January 2005 to December 2008. We conducted a retrospective comparison of variety of different flap reconstruction techniques. We compared different flap reconstruction with BMI and tumor size without functional outcome such as swallowing and speech data. Although there was no statistically significant correlation (P > 0.05) when comparing the free flaps with pedicled flaps according to the BMI and tumor size, there was an obvious tendency to prefer radial forearm free flap over anterolateral thigh free flap in patients who are overweight and those with obesity with a ratio of 32:3. In the same group of patients, a similar tendency was observed to prefer fibular free flap over iliac crest free flap with a ratio of 14:5, whereas the ratio was becoming 3:5 in favor of iliac crest free flap over fibular free flap in patients with BMI of 24 or lower. Despite the fact that surgeons' experience with a certain flap type is one of the most important factors while determining which flap to reconstruct, BMI might have a significant impact while selecting the free flap types for the reconstruction of pharyngeal defects. PMID:24785755

  15. What Are the Signs and Symptoms of Carotid Artery Disease?

    MedlinePlus

    ... What Are the Signs and Symptoms of Carotid Artery Disease? Carotid artery disease may not cause signs or symptoms until it severely narrows or blocks a carotid artery. Signs and symptoms may include a bruit, a ...

  16. Left carotid steal. A new observation.

    PubMed

    Shumacker, H B; Isch, J H

    1975-04-01

    A patient had an occlusion of the left subclavian artery just proximal to the takeoff of a previously placed subclavian-carotid graft. This caused reversal of flow in the graft and a symptomatic steal of blood via to the intracranial arteries. An axilloaxillary graft restored forward flow. In a second patient, a steal occurred from the right carotid and vertebral systems into the distal carotid system of the left side that has been isolated by a proximal carotide artery occlusion from arteriosclerosis. A saphenous vein, used as a bypass from the subclavian to the carotid artery, restored normal flow. Thus, the carotide system may be the low-pressure area responsible for the steal, although this is rarer than the subclavian. PMID:1147756

  17. Atherosclerotic carotid stenosis and cognitive function.

    PubMed

    Wang, Tao; Mei, Bin; Zhang, Junjian

    2016-07-01

    Atherosclerosis carotid stenosis is associated with stroke and cognitive impairment. Progressive cognitive decline may be an even greater problem than stroke, but it has not been widely recognized and therefore must be adequately addressed. Although both Carotid Endarterectomy (CEA) and Carotid Artery Stenting (CAS) have been proven can prevent future stroke in patients with atherosclerotic carotid stenosis, the influence of CEA and CAS on cognitive function is not clear. In the first part of this review, we evaluated the literature concerning carotid stenosis and the risk of cognitive impairment. Studies have suggested that both symptomatic and asymptomatic carotid stenosis are associated with cognitive impairment. In the second part, we reviewed the impact of CEA and CAS on cognitive function, some studies have shown benefits, but others have not. PMID:27152468

  18. Aseptic polyurethane carotid patch rejection: complication, allergy or miraculous healing?

    PubMed

    Tshomba, Y; De Dominicis, D; Marone, E M; Mascia, D; Sanvito, F; Chiesa, R

    2011-12-01

    Carotid endarterectomy plays an important role in the prevention of ischemic stroke; patching could reduce the risk of intra- and postoperative complications and late restenosis among primary closure. Materials actually available for the patch tailoring are synthetic or biological: which is the best is still debated. We present the case of a polyurethane (PU) carotid patch rejection three years after its implant, with no evident arterial discontinuity and no sign of infection. Histopathological analysis on hematoxylin-eosin stained sections of the regenerated arterial wall tissue removed revealed plasma cell infiltration and clusters of foreign body giant cells. PU patch rejection has been seldom described in literature. This is an unusual late complication that should be considered at long-term follow-up evaluation of these patients. PMID:21750481

  19. Faddeev-type calculation of (d ,n ) transfer reactions in three-body nuclear systems

    NASA Astrophysics Data System (ADS)

    Deltuva, A.

    2015-12-01

    Exact Faddeev-type three-body equations are applied to the study of the proton transfer reactions (d ,n ) in the system consisting of a nuclear core and two nucleons. The integral equations for the three-body transition operators are solved in the momentum-space framework including the Coulomb interaction via the screening and renormalization method. For a weakly bound final nucleus the calculation of the (d ,n ) reaction is more demanding in terms of the screening radius as compared to the (d ,p ) reaction. Well-converged differential cross section results are obtained for 7Be (d ,n ) 8B, 12C (d ,n ) 13N, and 16O (d ,n ) 17$ reactions. A comparison with the corresponding (d ,p ) reactions is made. The calculations fail to reproduce the shape of the angular distribution for reactions on 12C but provide quite successful description for reactions on 16O, especially for the transfer to the 17F excited state 1 /2+ when using a nonlocal optical potential.

  20. Extraterrestrial Amino Acids in Orgueil and Ivuna: Tracing the Parent Body of CI Type Carbonaceous Chondrites

    NASA Technical Reports Server (NTRS)

    Meyer, Michael (Technical Monitor); Ehrenfreund, Pascale; Glavin, Daniel P.; Bota, Oliver; Cooper, George; Bada, Jeffrey

    2001-01-01

    Amino acid analyses using HPLC of pristine interior pieces of the CI carbonaceous chondrites Orgueil and Ivuna have found that beta-alanine, glycine, and gamma-amino-n-butyric acid (ABA) are the most abundant amino acids in these two meteorites, with concentrations ranging from approx. 600 to 2,000 parts per billion (ppb). Other alpha-amino acids such as alanine, alpha-ABA, alpha-aminoisobutyric acid (AIB), and isovaline are present only in trace amounts (less than 200 ppb). Carbon isotopic measurements of beta-alanine and glycine and the presence of racemic (D/L 1) alanine and beta-ABA in Orgueil suggest that these amino acids are extraterrestrial in origin. In comparison to the CM carbonaceous chondrites Murchison and Murray, the amino acid composition of the CIs is strikingly distinct, suggesting that these meteorites came from a different type of parent body, possibly an extinct comet, than did the CM carbonaceous chondrites.

  1. Body Composition and Basal Metabolic Rate in Women with Type 2 Diabetes Mellitus

    PubMed Central

    de Figueiredo Ferreira, Marina; Detrano, Filipe; Coelho, Gabriela Morgado de Oliveira; Barros, Maria Elisa; Serrão Lanzillotti, Regina; Firmino Nogueira Neto, José; Portella, Emilson Souza; Serrão Lanzillotti, Haydée; Soares, Eliane de Abreu

    2014-01-01

    Objective. The aim of this study was to determine which of the seven selected equations used to predict basal metabolic rate most accurately estimated the measured basal metabolic rate. Methods. Twenty-eight adult women with type 2 diabetes mellitus participated in this cross-sectional study. Anthropometric and biochemical variables were measured as well as body composition (by absorptiometry dual X-ray emission) and basal metabolic rate (by indirect calorimetry); basal metabolic rate was also estimated by prediction equations. Results. There was a significant difference between the measured and the estimated basal metabolic rate determined by the FAO/WHO/UNU (Pvalue < 0.021) and Huang et al. (Pvalue ≤ 0.005) equations. Conclusion. The calculations using Owen et al's. equation were the closest to the measured basal metabolic rate. PMID:25436144

  2. STAT3 Regulates ABCA3 Expression and Influences Lamellar Body Formation in Alveolar Type II Cells

    PubMed Central

    Matsuzaki, Yohei; Besnard, Valérie; Clark, Jean C.; Xu, Yan; Wert, Susan E.; Ikegami, Machiko; Whitsett, Jeffrey A.

    2008-01-01

    ATP-Binding Cassette A3 (ABCA3) is a lamellar body associated lipid transport protein required for normal synthesis and storage of pulmonary surfactant in type II cells in the alveoli. In this study, we demonstrate that STAT3, activated by IL-6, regulates ABCA3 expression in vivo and in vitro. ABCA3 mRNA and immunostaining were decreased in adult mouse lungs in which STAT3 was deleted from the respiratory epithelium (Stat3Δ/Δ mice). Consistent with the role of STAT3, intratracheal IL-6 induced ABCA3 expression in vivo. Decreased ABCA3 and abnormalities in the formation of lamellar bodies, the intracellular site of surfactant lipid storage, were observed in Stat3Δ/Δ mice. Expression of SREBP1a and 1c, SCAP, ABCA3, and AKT mRNAs was inhibited by deletion of Stat3 in type II cells isolated from Stat3Δ/Δ mice. The activities of PI3K and AKT were required for normal Abca3 gene expression in vitro. AKT activation induced SREBP expression and increased the activity of the Abca3 promoter in vitro, consistent with the role of STAT3 signaling, at least in part via SREBP, in the regulation of ABCA3. ABCA3 expression is regulated by IL-6 in a pathway that includes STAT3, PI3K, AKT, SCAP, and SREBP. Activation of STAT3 after exposure to IL-6 enhances ABCA3 expression, which, in turn, influences pulmonary surfactant homeostasis. PMID:18096869

  3. [Carotid endarterectomy and carotid stenting: a vascular surgeon's point of view].

    PubMed

    Beloyartsev, D F

    2016-01-01

    Presented in the article is a review of the literature related to comparing the outcomes of carotid endarterectomy and carotid stenting in treatment of atherosclerotic stenosis of the internal carotid artery. Special attention is paid to carefully considering the clinical situations wherein preference should be given to either method of intervention. PMID:27159933

  4. Carotid Stump Syndrome: Pathophysiology and Endovascular Treatment Options

    SciTech Connect

    Lakshminarayan, Raghuram; Scott, Paul M.; Robinson, Graham J.; Ettles, Duncan F.

    2011-02-15

    Carotid stump syndrome is one of the recognised causes of recurrent ipsilateral cerebrovascular events after occlusion of the internal carotid artery. It is believed that microemboli arising from the stump of the occluded internal carotid artery or the ipsilateral external carotid artery can pass into the middle cerebral artery circulation as a result of patent external carotid-internal carotid anastomotic channels. Different pathophysiologic causes of this syndrome and endovascular options for treatment are discussed.

  5. Medical decision-making system of ultrasound carotid artery intima-media thickness using neural networks.

    PubMed

    Santhiyakumari, N; Rajendran, P; Madheswaran, M

    2011-12-01

    The objective of this work is to develop and implement a medical decision-making system for an automated diagnosis and classification of ultrasound carotid artery images. The proposed method categorizes the subjects into normal, cerebrovascular, and cardiovascular diseases. Two contours are extracted for each and every preprocessed ultrasound carotid artery image. Two types of contour extraction techniques and multilayer back propagation network (MBPN) system have been developed for classifying carotid artery categories. The results obtained show that MBPN system provides higher classification efficiency, with minimum training and testing time. The outputs of decision support system are validated with medical expert to measure the actual efficiency. MBPN system with contour extraction algorithms and preprocessing scheme helps in developing medical decision-making system for ultrasound carotid artery images. It can be used as secondary observer in clinical decision making. PMID:21181487

  6. Case of Behçet's disease complicated by oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm.

    PubMed

    Yamaoka, Toshifumi; Murota, Hiroyuki; Katayama, Ichiro

    2015-03-01

    Behçet's disease (BD) is a relapsing systemic inflammatory disorder of unknown etiology involving systemic vasculitis. Vasculitis in BD results from the involvement of arteries, veins and blood vessels of all sizes, which leads to the three major manifestations of this condition: venous occlusion, arterial occlusion and aneurysm formation. Therefore, whole-body vascular involvement should always be considered in BD patients. Here, we describe the first appearance of an internal carotid-posterior communicating artery aneurysm, resulting in complete oculomotor nerve palsy in a BD patient. A 44-year-old Japanese man suffered from recurrent episodes of erythema nodosum that had presented on the lower extremities for the past 2 years. His condition was diagnosed as an incomplete type of BD based on relapsing oral and genital ulcers, skin eruptions, such as erythema nodosum and folliculitis, a positive pathergy test and systemic arthralgia. Ten years after his initial clinical presentation, he had manifestations of right-sided ptosis and cyclic dull pain in his right temporal region. Magnetic resonance imaging and angiography revealed a right internal carotid artery-posterior communicating artery aneurysm. Although oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm in a BD patient has not been reported previously, our report highlights the fact that this abnormal manifestation should be considered in those with vasculo-BD. PMID:25573207

  7. Risk Factors For Stroke, Myocardial Infarction, or Death Following Carotid Endarterectomy: Results From the International Carotid Stenting Study

    PubMed Central

    Doig, D.; Turner, E.L.; Dobson, J.; Featherstone, R.L.; de Borst, G.J.; Stansby, G.; Beard, J.D.; Engelter, S.T.; Richards, T.; Brown, M.M.

    2015-01-01

    Objectives Carotid endarterectomy (CEA) is standard treatment for symptomatic carotid artery stenosis but carries a risk of stroke, myocardial infarction (MI), or death. This study investigated risk factors for these procedural complications occurring within 30 days of endarterectomy in the International Carotid Stenting Study (ICSS). Methods Patients with recently symptomatic carotid stenosis >50% were randomly allocated to endarterectomy or stenting. Analysis is reported of patients in ICSS assigned to endarterectomy and limited to those in whom CEA was initiated. The occurrence of stroke, MI, or death within 30 days of the procedure was reported by investigators and adjudicated. Demographic and technical risk factors for these complications were analysed sequentially in a binomial regression analysis and subsequently in a multivariable model. Results Eight-hundred and twenty-one patients were included in the analysis. The risk of stroke, MI, or death within 30 days of CEA was 4.0%. The risk was higher in female patients (risk ratio [RR] 1.98, 95% CI 1.02–3.87, p = .05) and with increasing baseline diastolic blood pressure (dBP) (RR 1.30 per +10 mmHg, 95% CI 1.02–1.66, p = .04). Mean baseline dBP, obtained at the time of randomization in the trial, was 78 mmHg (SD 13 mmHg). In a multivariable model, only dBP remained a significant predictor. The risk was not related to the type of surgical reconstruction, anaesthetic technique, or perioperative medication regimen. Patients undergoing CEA stayed a median of 4 days before discharge, and 21.2% of events occurred on or after the day of discharge. Conclusions Increasing diastolic blood pressure was the only independent risk factor for stroke, MI, or death following CEA. Cautious attention to blood pressure control following symptoms attributable to carotid stenosis could reduce the risks associated with subsequent CEA. PMID:26460291

  8. Fitness, Body Habitus, and the Risk of Incident Type 2 Diabetes Mellitus in Korean Men.

    PubMed

    Jae, Sae Young; Franklin, Barry A; Choo, Jina; Yoon, Eun Sun; Choi, Yoon-Ho; Park, Won Hah

    2016-02-15

    The relative contributions of cardiorespiratory fitness (CRF) and body habitus to predict incident type 2 diabetes mellitus (T2DM) remain unclear. We prospectively investigated the relation of CRF and body habitus on the risk of developing T2DM in men. Participants included 3,770 apparently healthy men who initially presented without baseline evidence of diabetes, cardiovascular disease, and hypertension. Participants were divided into 3 groups as normal weight (18.5 to 24.9 kg/m(2)), obese I (25.0 to 29.9 kg/m(2)), and obese II (≥30.0 kg/m(2)). CRF was directly measured by peak oxygen uptake (VO2peak) and categorized into unfit and fit cohorts based on the median value of age-specific VO2peak. Diabetes was defined as a glycated hemoglobin >6.5% and/or a fasting glucose >126 mg/dl at baseline and follow-up examinations. During a median follow-up of 5 years, 170 men (4.5%) developed diabetes. After adjusting for age and fasting glucose, the relative risk and 95% confidence interval (CI) for incident T2DM were 1.52 (95% CI 1.11 to 2.07) for obese I and 3.11 (95% CI 1.35 to 7.16) for obese II versus normal weight and 0.69 (95% CI 0.51 to 0.95) for fit versus unfit. However, these associations were no longer statistically significant after adjusting for potential confounders with VO2peak (1.32; 95% CI 0.96 to 1.83 for obese I and 1.61, 95% CI 0.64 to 4.06 for obese II vs normal weight) or body mass index (0.75, 95% CI 0.54 to 1.05 for fit vs unfit). In the joint analysis, obese-unfit men had 1.81 times (95% CI 1.22 to 2.69) greater risk of incident T2DM, but obese-fit men were not at increased risk of incident T2DM (0.95, 95% CI 0.57 to 1.58) compared with fit-normal weight men. In conclusion, these results suggest that both CRF and obesity predict the incidence of T2DM independent of potential confounders; however, CRF appears to attenuate the risk of developing diabetes in obese men. PMID:26721657

  9. Use of Absorbable Sutures in Canine Carotid Arteries

    PubMed Central

    Rey, Alejandro R.; Carrillo-Farga, Joaquin; Velasco, Carlos O.; Valencia, Martin O.V.

    1990-01-01

    To study the functional and microstructural characteristics of polydioxanone sutures in vascular surgery, we created 48 vascular anastomoses in the right and left common carotid arteries of 24 mongrel dogs. In each animal, polydioxanone sutures were used in 1 carotid artery, and polypropylene sutures were used in the contralateral carotid artery. Twelve groups of 2 animals each were then formed. The 1st group was observed for 1 month, the 2nd for 2 months, the 3rd for 3 months, and so on until the 12th group, which was observed for 12 months. At the end of each observation period, reoperation was undertaken to evaluate the vascular anastomoses by means of angiography and microscopy. The polypropylene anastomoses showed a marked deformity, with tissue retraction and a foreign body reaction. In contrast, the polydioxanone anastomoses exhibited satisfactory healing, without deformity, and were well tolerated histologically. We believe that polydioxanone may be a useful, alternative vascular suture material. (Texas Heart Institute Journal 1990;17:99-102) Images PMID:15227391

  10. What to Expect After Carotid Endarterectomy

    MedlinePlus

    ... getting larger. As part of your long-term treatment, you can take steps to keep your carotid arteries healthy. One important step is to not smoke. Smoking increases the risk of carotid artery disease and stroke. If you smoke, ask your doctor about programs and products that can help you ...

  11. Blood flow reactivity to hypercapnia in strictly unilateral carotid disease: preliminary results.

    PubMed Central

    Levine, R L; Dobkin, J A; Rozental, J M; Satter, M R; Nickles, R J

    1991-01-01

    To show relationship between degree of carotid arterial stenosis and cerebral blood flow reactivity (RES%) to induced hypercapnia, fluorine-18-fluoromethane and positron emission tomography (PET) was used to study 18 patients with carotid distribution transient ischaemic attacks (TIA), all free of stroke, who had angiographic-proven unilateral arterial disease. Non-involved carotid arteries were either normal or had non-stenotic plaque. Either normal arteries or nonstenotic ulcerations in the symptomatic carotid arteries were present in five of 18 (28%), ipsilateral carotid stenosis from 50-99% was present in eight of 18 (44%), and ipsilateral internal carotid occlusion was present in five of 18 (28%) patients. In comparison with 14 normal controls, all patients with symptomatic middle cerebral artery (MCA) flow territories had significantly lower mean (SEM) RES% [5.0' (0.2) vs 4.0 (0.9), p less than 0.04]. Symptomatic anterior borderzone (ABZ) RES% was also significantly lower [4.6 (0.4) vs 3.3 (0.9), p less than 0.04], than controls. In patient subgroup comparisons, the 50-99% stenosis subgroup clearly had the lowest MCA RES% [3.4 (0.2)] as well as the lowest ABZ RES% [2.8 (0.4)] on their symptomatic sides. Age, expired pCO2, mean arterial blood pressure, serum glucose, serum haematocrit and number, type and estimated duration of TIAs were not significantly different between subgroups. Linear regression showed a significant relationship between RES% and both measured percentage-stenosis (p = 0.04) and residual luminal diameter (p = 0.05) in symptomatic MCA territories. This approached significance in symptomatic ABZ regions. This preliminary data set suggests that unilateral carotid stenosis can and does result in impaired CO2 reactivity following hypercapnia. The relative normality of CO2 reactivity in those with carotid occlusion is discussed. PMID:1903147

  12. Prevalence of Calcified Carotid Artery on Panoramic Radiographs in Postmenopausal Women

    PubMed Central

    Taheri, Jamileh Beigom; Moshfeghi, Mahkameh

    2009-01-01

    Background and aims This study was designed to evaluate the prevalence of calcified carotid artery in 50 year-old and older postmenopausal dental outpatients for early diagnosis of individuals at risk of stroke. Materials and methods This is a descriptive study of 200 panoramic radiographs. These radiographs included post-menopausal women referring to the Department of Oral Medicine at Shahid Beheshti Faculty of Dentistry during 2006-2007. The x-ray machine, developer and film type were the same for all the radiographs. Statistical analysis included chi-square test and Fisher’s exact test. Results We found 22 calcified carotid arteries. The left and right carotid arteries were involved in 7 and 9 cases, respec-tively. In 6 cases both carotid arteries were calcified. Four individuals had no vascular risk factor excluding age and others had at least one risk factor. We found significant statistical correlation between hypertension, past history of myocardial infarction, and hypercholesterolemia with calcified carotid artery on panoramic radiographs. Conclusion Under the limitations of the present study, prevalence of calcified carotid arteries is 11.0 % in 50 year-old and older postmenopausal dental outpatients. PMID:23230481

  13. Persistent trigeminal artery arising from the arterial ring/fenestration of the cavernous segment of the internal carotid artery.

    PubMed

    Uchino, Akira; Saito, Naoko; Kurita, Hiroki; Ishihara, Shoichiro

    2012-09-01

    A persistent trigeminal artery (PTA) is the most common carotid-vertebrobasilar anastomosis, usually arising from the cavernous or precavernous segment of the internal carotid artery (ICA) and connecting to the distal basilar artery. There are two types of PTA, lateral and medial. We present the first case of a lateral-type PTA arising from the large arterial ring/fenestration of the cavernous segment of the left ICA with findings from both magnetic resonance angiography and selective catheter angiography. PMID:22215430

  14. Traumatic Carotid Artery Dissection: A Different Entity without Specific Guidelines

    PubMed Central

    Galyfos, George; Filis, Konstantinos; Sigala, Fragiska; Sianou, Argiri

    2016-01-01

    According to literature data, there are no distinct guidelines regarding the proper diagnostic and therapeutic management of traumatic carotid artery dissection (TCAD). Although most of cases evaluated in research studies refer to spontaneous carotid artery dissection, traumatic cases demand special considerations as far as diagnosis and treatment are concerned. Although both types of dissection share some common characteristics, a patient with TCAD usually presents with several concomitant injuries as well as a higher bleeding risk, thus complicating decision making in such patients. Therefore, aim of this review is to present available data regarding epidemiology, clinical presentation, diagnostics and treatment strategy in cases with TCAD in order to produce useful conclusions for everyday clinical practice. PMID:27051653

  15. Symptomatic vs. asymptomatic plaque classification in carotid ultrasound.

    PubMed

    Acharya, Rajendra U; Faust, Oliver; Alvin, A P C; Sree, S Vinitha; Molinari, Filippo; Saba, Luca; Nicolaides, Andrew; Suri, Jasjit S

    2012-06-01

    Quantitative characterization of carotid atherosclerosis and classification into symptomatic or asymptomatic type is crucial in both diagnosis and treatment planning. This paper describes a computer-aided diagnosis (CAD) system which analyzes ultrasound images and classifies them into symptomatic and asymptomatic based on the textural features. The proposed CAD system consists of three modules. The first module is preprocessing, which conditions the images for the subsequent feature extraction. The feature extraction stage uses image texture analysis to calculate Standard deviation, Entropy, Symmetry, and Run Percentage. Finally, classification is performed using AdaBoost and Support Vector Machine for automated decision making. For Adaboost, we compared the performance of five distinct configurations (Least Squares, Maximum- Likelihood, Normal Density Discriminant Function, Pocket, and Stumps) of this algorithm. For Support Vector Machine, we compared the performance using five different configurations (linear kernel, polynomial kernel configurations of different orders and radial basis function kernels). SVM with radial basis function kernel for support vector machine presented the best classification result: classification accuracy of 82.4%, sensitivity of 82.9%, and specificity of 82.1%. We feel that texture features coupled with the Support Vector Machine classifier can be used to identify the plaque tissue type. An Integrated Index, called symptomatic asymptomatic carotid index (SACI), is proposed using texture features to discriminate symptomatic and asymptomatic carotid ultrasound images using just one index or number. We hope this SACI can be used as an adjunct tool by the vascular surgeons for daily screening. PMID:21243411

  16. Peer pressure to "Fat talk": Does audience type influence how women portray their body image?

    PubMed

    Craig, Ashley B; Martz, Denise M; Bazzini, Doris G

    2007-04-01

    "Fat talk" describes women discussing their bodies disparangingly for impression management while interacting with one another. This study examined whether college females deliberately alter their self-reported body image according to characteristics of their prospective audience. This study was a mixed experimental design with four audience conditions (private, public, female audience, male audience) as the between-subjects factor and time across trials as the within-subjects factor using college females as participants (N=100). Pre versus posttest changes on the Body Esteem Scale (BES) and the Body Weight Figure Assessment (BWFA) served as the dependent variables. It was hypothesized that body image would decrease to indicate self-derogation (fat talk) in the public audience and female audience conditions, whereas body image would increase in the male audience condition. These hypotheses were not supported using repeated measures ANOVA. Strengths and weaknesses of the study are discussed. PMID:17336794

  17. Future Management of Carotid Stenosis: Role of Urgent Carotid Interventions in the Acutely Symptomatic Carotid Patient and Best Medical Therapy for Asymptomatic Carotid Disease

    PubMed Central

    Bazan, Hernan A.; Smith, Taylor A.; Donovan, Melissa J.; Sternbergh, W. Charles

    2014-01-01

    Background Stroke is the fourth leading cause of death in the United States, leading to devastating disability. Most strokes are ischemic, and nearly one-third of these are caused by carotid disease. The primary mechanism of carotid-related stroke is an atheroembolic event from an unstable atherosclerotic plaque rupture. In the 1990s, randomized trials demonstrated the benefit of carotid endarterectomy (CEA) in reducing the risk of stroke in both symptomatic and asymptomatic carotid disease. Methods We review best medical therapy (BMT) for asymptomatic carotid disease and recent randomized trials comparing CEA and carotid angioplasty stenting (CAS), and we discuss the role of urgent carotid interventions in patients with acute neurologic symptoms. Results In 2010, 2 large trials demonstrated the efficacy of CAS in select patients, although CAS was associated with an increased procedural stroke risk compared to CEA. An age effect was observed; patients >75 years do worse with CAS compared to CEA. As BMT has evolved in the past decade, a future trial (CREST-2) will address whether BMT is equal to intervention (CEA or CAS) in asymptomatic carotid disease. In a subgroup of patients with asymptomatic carotid disease, CEA plus BMT will likely remain the mainstay therapy for carotid disease compared to BMT alone. CEA and CAS will continue to play complementary roles in the future, as CAS will be done in select patients in whom CEA cannot be undertaken because of high-risk anatomical or medical conditions. Finally, a role for urgent carotid interventions in a select group of patients who present with acute neurologic symptoms is developing as a way to prevent recurrent stroke after an initial carotid plaque rupture event. Conclusion CAS has an increasingly higher risk of stroke with advancing age. Patients treated with CAS have a 1.76-fold increased risk of stroke (95% CI, 1.35-2.31) with each 10-year increase in age. No such age effect is seen in patients treated with CEA

  18. [Pharmacological preconditioning in carotid endarterectomy].

    PubMed

    Kuznetsov, M R; Karalkin, A V; Fedin, A I; Virganskii, A O; Kunitsyn, N V; Kholopova, E A; Yumin, S M

    2015-01-01

    The study was aimed at examining efficacy of preoperative preparation (pharmacological preconditioning) for carotid endarterectomy in patients with chronic cerebrovascular insufficiency. For this purpose, we analysed the outcomes of surgical treatment in a total of 80 patients presenting with haemodynamically significant unilateral and bilateral lesions of carotid arteries. Of these, 40 patients were operated on immediately and a further 40 patients underwent surgery after pharmacological preconditioning with Actovegin taken at a daily dose of 1,200 mg for 1.5 months. It was demonstrated that preoperative preparation prior to surgery increases cerebral perfusion which is determined by means of single-photon emission computed tomography, thus substantially improving the outcomes of surgical treatment. Statistically significant differences in cognitive function of these groups of patients were revealed 7 days and 6 months after the operation. Improvement of cognitive functions was associated with fewer symptom-free postoperative cerebral ischaemic foci in various regions of the brain. A conclusion was made on a positive role of pharmacological preconditioning with Actovegin in surgical management of cerebrovascular insufficiency, first of all in relation to more complete restoration of cognitive functions. PMID:26355920

  19. Carotid Sheath Abscess Caused by a Tooth Decay Infection on the Opposite Side

    PubMed Central

    Tuncturk, F. Ruya; Uzun, Lokman; Kalcioglu, M. Tayyar; Egilmez, Oguz Kadir; Timurlenk, Emine; Erguven, Muferet

    2015-01-01

    Deep neck infections are mortal diseases that need emergency treatment. It can occur at any age but usually in pediatric ages. In this report, a left cervical carotid space abscess of a pediatric patient was discussed. It was interesting that the only origin of the left carotid sheath abscess was right inferior first molar tooth decay. Right neck spaces were all clean. Patient had no immunosupression and also there were no congenital masses such as branchial cleft cysts, foreign bodies, or masses suspicious for malignancies in cervical ultrasound and MRI. We discussed this rare condition under the light of the literature. PMID:25878916

  20. Gravity and Seismic Tomography Joint Inversion: A synthetic study modelling magmatic massive sulphide type bodies

    NASA Astrophysics Data System (ADS)

    Carter-McAuslan, Angela; Lelievre, Peter; Farquharson, Colin

    2013-04-01

    Gravity methods have long been used in mineral exploration. However, gravity methods have difficulty resolving small details. Seismic methods provide high resolving potential for use in mineral exploration. However, complicated hard-rock geology can make seismic data processing and interpretation difficult. By jointly inverting seismic tomography data with gravity data these difficulty may be overcome. We investigated the viability of deterministic minimum-structure style joint inversion of seismic traveltime and gravity data for the delineation of magmatic massive sulphide type geological targets. These tests also assessed the potential of employing borehole gravity. A number of synthetic Earth models were created. These models were built on triangular unstructured meshes, allowing for efficient generation of complicated, realistic geological structures. 2D models were based on conceptualized models of the magmatic massive sulphide body similar to the Eastern Deeps of the Voisey's Bay, Labrador, Canada. Single property and joint inversions were performed with seismic traveltimes and both ground-based and borehole gravity. There is a known relationship between seismic velocity and density for both silicate rocks and sulphide minerals for the models constructed; this lithological relationship was used to design an appropriate coupling strategy in the joint inversions. Joint inversions were able to successfully locate a buried high contrast target with a variety of survey designs. 2D inversions results provided guidance to 3D inversion. Experimentation with noise levels, mesh design, and various inversion parameters has led to a better understanding of how to practically apply joint inversion of traveltimes and gravity data to this and similar exploration problems.

  1. Food addiction symptomology, impulsivity, mood, and body mass index in people with type two diabetes.

    PubMed

    Raymond, Karren-Lee; Lovell, Geoff P

    2015-12-01

    This research explored how food addiction (FA) and impulsivity (non-planning, motor, and attentional) relate to body mass index (BMI) in a sample of people with type 2 diabetes (t2d). Participants with t2d (N = 334, Mage = 41.0, SDage = 9.5, 66% female, MBMI = 37.6 kg/m(2), SDBMI = 8.0 kg/m(2)) completed an online survey including the Depression Anxiety Stress Scale (DASS-21), the Barratt Impulsiveness Scale (BIS-II), and the Yale Food Addiction Scale (YFAS). Results demonstrated that over 70% of the sample with t2d met the YFAS criteria for FA. Results also demonstrated that participants classified as FA had significantly higher BMI, t (332) = 12.11, p < .001. The food addict classification group also had a significantly higher percentage of obese participants, χ(2) (2) = 87.1, p < .001, phi = .511. Utilising a cross-sectional design to predict BMI, significant forward stepwise multiple regression demonstrated that FA (β = .386) and impulsivity (non-planning) (β = .286) were significant predictors. In combination FA and impulsivity (non-planning) significantly explained 38% of BMI variance; however depression, anxiety, and stress did not significantly improve the model. These results suggest FA and impulsivity (non-planning) are more salient cross-sectional predictors of BMI, in people with t2d, than indices of depression, anxiety, stress and impulsivity (motor and attentional). These results, implicating FA in the development of obesity, have important ramifications for potential future treatment methods of t2d where FA symptomology could be routinely screened, and if present, treated via addiction models rather than purely attempting to treat the potential consequences of FA. PMID:26232140

  2. Psammoma bodies in two types of human ovarian tumours: a mineralogical study

    NASA Astrophysics Data System (ADS)

    Fanlu, Meng; Changqiu, Wang; Yan, Li; Anhuai, Lu; Fang, Mei; Jianying, Liu; Jingyun, Du; Yan, Zhang

    2015-06-01

    Psammoma body (PB) is a common form of calcification in pathological diagnosis and closely relevant to tumours. This paper focuses on the mineralogical characteristics of PBs in ovarian serous cancer and teratoma by using polarization microscope (POM), environmental scanning electron microscope (ESEM), micro-Fourier transform infrared spectroscopy (micro-FT-IR), transmission electron microscope (TEM), micro-area synchrotron radiation X-ray powder diffraction (μ-SRXRD) and fluorescence (μ-SRXRF). Both the PBs in tissues and separated from eight typical cases were investigated. POM and ESEM observation revealed the inside-out growth pattern of PBs. μ-SRXRD and micro-FT-IR results demonstrated the dominant mineral phase of PBs in ovarian serous cancer and teratoma was AB-type carbonate hydroxyapatite (Ca10[(PO4)6-x-y(CO3)x(HPO4 2-)y][(OH)2-u(CO3)u] with 0 ≤ x,y,u ≤ 2). As observed by ESEM and TEM, the layer-rich PBs in teratoma were up to 70 μm and mainly consisted of 5 nm-wide, 5-12 nm-long columnar crystals; the PBs in ovarian serous cancer with a maximum diameter of 35 μm were composed of slightly longer columnar crystals and granulates with 20-100 nm in diameter. The selected area electron diffraction patterns showed dispersed polycrystalline diffraction rings with arching behavior of (002) diffraction, indicating the aggregated nanocrystals grew in the preferred orientation of (002) face. The EDX and μ-SRXRF results together indicated the existence of Na, Mg, Zn and Sr in PBs. These detailed mineralogical characteristics may help uncover the nature of the pathological PBs in ovary.

  3. Erratum to: Psammoma bodies in two types of human ovarian tumours: a mineralogical study

    NASA Astrophysics Data System (ADS)

    Meng, Fanlu; Wang, Changqiu; Li, Yan; Lu, Anhuai; Mei, Fang; Liu, Jianying; Du, Jingyun; Zhang, Yan

    2015-06-01

    Psammoma body (PB) is a common form of calcification in pathological diagnosis and closely relevant to tumours. This paper focuses on the mineralogical characteristics of PBs in ovarian serous cancer and teratoma by using polarization microscope (POM), environmental scanning electron microscope (ESEM), micro-Fourier transform infrared spectroscopy (micro-FT-IR), transmission electron microscope (TEM), micro-area synchrotron radiation X-ray powder diffraction (μ-SRXRD) and fluorescence (μ-SRXRF). Both the PBs in tissues and separated from eight typical cases were investigated. POM and ESEM observation revealed the inside-out growth pattern of PBs. μ-SRXRD and micro-FT-IR results demonstrated the dominant mineral phase of PBs in ovarian serous cancer and teratoma was AB-type carbonate hydroxyapatite (Ca10[(PO4)6-x-y(CO3)x(HPO4)y][(OH)2-u(CO3)u] with 0 ≤ x,y,u ≤ 2). As observed by ESEM and TEM, the layer-rich PBs in teratoma were up to 70 μm and mainly consisted of 5 nm-wide, 5-12 nm-long columnar crystals; the PBs in ovarian serous cancer with a maximum diameter of 35 μm were composed of slightly longer columnar crystals and granulates with 20-100 nm in diameter. The selected area electron diffraction patterns showed dispersed polycrystalline diffraction rings with arching behavior of (002) diffraction, indicating the aggregated nanocrystals grew in the preferred orientation of (002) face. The EDX and μ-SRXRF results together indicated the existence of Na, Mg, Zn and Sr in PBs. These detailed mineralogical characteristics may help uncover the nature of the pathological PBs in ovary.

  4. The Effects of Body Mass Composition and Cushion Type on Seat-Interface Pressure in Spinal Cord Injured Patients

    PubMed Central

    Cho, Kang Hee; Beom, Jaewon; Yuk, Jee Hyun

    2015-01-01

    Objective To investigate the effects of body mass composition and cushion type on seat-interface pressure in spinal cord injured (SCI) patients and healthy subjects. Methods Twenty SCI patients and control subjects were included and their body mass composition measured. Seat-interface pressure was measured with participants in an upright sitting posture on a wheelchair with three kinds of seat cushion and without a seat cushion. We also measured the pressure with each participant in three kinds of sitting postures on each air-filled cushion. We used repeated measure ANOVA, the Mann-Whitney test, and Spearman correlation coefficient for statistical analysis. Results The total skeletal muscle mass and body water in the lower extremities were significantly higher in the control group, whilst body fat was significantly higher in the SCI group. However, the seat-interface pressure and body mass composition were not significantly correlated in both groups. Each of the three types of seat cushion resulted in significant reduction in the seat-interface pressure. The SCI group had significantly higher seatinterface pressure than the control group regardless of cushion type or sitting posture. The three kinds of sitting posture did not result in a significant reduction of seat-interface pressure. Conclusion We confirmed that the body mass composition does not have a direct effect on seat-interface pressure. However, a reduction of skeletal muscle mass and body water can influence the occurrence of pressure ulcers. Furthermore, in order to minimize seat-interface pressure, it is necessary to apply a method fitted to each individual rather than a uniform method. PMID:26798612

  5. Body condition and forage type influence intramuscular and rump fat, and reproductive performance of postpartum Brahman-influenced cows

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Multiparous Brahman-influenced cows were managed to achieve marginal (BCS = 4.9 ± 0.1; n = 55) or moderate (BCS = 6.5 ± 0.1; n = 55) body condition (BC) to determine the influence of forage type on estrous characteristics, intramuscular fat percentage (IMF), rump fat (RF), and reproductive performan...

  6. Mas-Mediated Antioxidant Effects Restore the Functionality of Angiotensin Converting Enzyme 2-Angiotensin-(1–7)-Mas Axis in Diabetic Rat Carotid

    PubMed Central

    Gomes, Mayara Santos; Restini, Carolina Baraldi Araujo

    2014-01-01

    We hypothesized that endothelial AT1-activated NAD(P)H oxidase-driven generation of reactive oxygen species during type I-diabetes impairs carotid ACE2-angiotensin-(1–7)-Mas axis functionality, which accounts for the impaired carotid flow in diabetic rats. We also hypothesized that angiotensin-(1–7) chronic treatment of diabetic rats restores carotid ACE2-angiotensin-(1–7)-Mas axis functionality and carotid flow. Relaxant curves for angiotensin II or angiotensin-(1–7) were obtained in carotid from streptozotocin-induced diabetic rats. Superoxide or hydrogen peroxide levels were measured by flow cytometry in carotid endothelial cells. Carotid flow was also determined. We found that endothelial AT1-activated NAD(P)H oxidase-driven generation of superoxide and hydrogen peroxide in diabetic rat carotid impairs ACE2-angiotensin-(1–7)-Mas axis functionality, which reduces carotid flow. In this mechanism, hydrogen peroxide derived from superoxide dismutation inhibits ACE2 activity in generating angiotensin-(1–7) seemingly by activating ICl,SWELL, while superoxide inhibits the nitrergic Mas-mediated vasorelaxation evoked by angiotensin-(1–7). Angiotensin-(1–7) treatment of diabetic rats restored carotid ACE2-angiotensin-(1–7)-Mas axis functionality by triggering a positive feedback played by endothelial Mas receptors, that blunts endothelial AT1-activated NAD(P)H oxidase-driven generation of reactive oxygen species. Mas-mediated antioxidant effects also restored diabetic rat carotid flow, pointing to the contribution of ACE2-angiotensin-(1–7)-Mas axis in maintaining carotid flow. PMID:24877125

  7. [A Case of Carotid Free-Floating Thrombus Treated by Carotid Ultrasonography-Guided Endovascular Approach].

    PubMed

    Otawa, Masato; Kinkori, Takeshi; Watanabe, Kenichi; Ando, Ryo; Tambara, Masao; Arima, Toru

    2016-06-01

    We experienced a case of carotid free-floating thrombus treated by carotid ultrasonography-guided endovascular approach. A 63-year-old man was brought to our hospital with the chief complaint of sudden onset left hemiplegia. MRI revealed acute infarction of the right MCA territory due to the right M1 occlusion. Carotid ultrasonography showed a pedunculated, polypoid mobile plaque floating with the cardiac beat. We attempted ultrasonography-guided endovascular treatment. Under proximal balloon protection, the floating plaque was successfully aspirated into the Penumbra aspiration catheter. Carotid stent was also placed to stabilize the residual pedicle of the plaque. Aspirated plaque was identified as fresh thrombus by pathological examination. Carotid ultrasonography-guided endovascular approach was effective for getting the picture of real-time dynamics of the carotid FFT. PMID:27270147

  8. Carotid stent infection: a rare but potentially fatal complication of carotid artery stenting.

    PubMed

    Son, Seungnam; Choi, Nack-Cheon; Choi, Dae Seob; Cho, Oh Hyun

    2015-04-01

    Infections involving endovascular devices are rare and, to our knowledge, only three cases of infection with an inserted carotid stent have ever been reported. A 68-year-old man underwent carotid artery stenting (CAS) of the left proximal internal carotid artery. Two days after CAS the patient developed a high fever and investigation showed that the inserted carotid stent was infected. The infection could not be controlled despite adequate antibiotic therapy. Eventually a rupture of the carotid artery occurred and the patient underwent emergency resection of the left carotid bifurcation in addition to stent removal and reconstruction with a saphenous vein interposition graft. The patient recovered fully without any neurological sequelae. PMID:24688061

  9. Skin Temperature Over the Carotid Artery, an Accurate Non-invasive Estimation of Near Core Temperature

    PubMed Central

    Imani, Farsad; Karimi Rouzbahani, Hamid Reza; Goudarzi, Mehrdad; Tarrahi, Mohammad Javad; Ebrahim Soltani, Alireza

    2016-01-01

    Background: During anesthesia, continuous body temperature monitoring is essential, especially in children. Anesthesia can increase the risk of loss of body temperature by three to four times. Hypothermia in children results in increased morbidity and mortality. Since the measurement points of the core body temperature are not easily accessible, near core sites, like rectum, are used. Objectives: The purpose of this study was to measure skin temperature over the carotid artery and compare it with the rectum temperature, in order to propose a model for accurate estimation of near core body temperature. Patients and Methods: Totally, 124 patients within the age range of 2 - 6 years, undergoing elective surgery, were selected. Temperature of rectum and skin over the carotid artery was measured. Then, the patients were randomly divided into two groups (each including 62 subjects), namely modeling (MG) and validation groups (VG). First, in the modeling group, the average temperature of the rectum and skin over the carotid artery were measured separately. The appropriate model was determined, according to the significance of the model’s coefficients. The obtained model was used to predict the rectum temperature in the second group (VG group). Correlation of the predicted values with the real values (the measured rectum temperature) in the second group was investigated. Also, the difference in the average values of these two groups was examined in terms of significance. Results: In the modeling group, the average rectum and carotid temperatures were 36.47 ± 0.54°C and 35.45 ± 0.62°C, respectively. The final model was obtained, as follows: Carotid temperature × 0.561 + 16.583 = Rectum temperature. The predicted value was calculated based on the regression model and then compared with the measured rectum value, which showed no significant difference (P = 0.361). Conclusions: The present study was the first research, in which rectum temperature was compared with that

  10. Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging

    SciTech Connect

    Blasel, Stella Hattingen, Elke; Berkefeld, Joachim; Kurre, Wiebke; Morawe, Gerald; Zanella, Friedhelm; Rochemont, Richard Du Mesnil de

    2009-07-15

    The detection of clinically silent ischemic lesions on postprocedural diffusion-weighted magnetic resonance images has become a preferred method for the description of embolic risks. The purpose of this single-center study was to evaluate whether diffusion-weighted imaging (DWI) could determine material related or technical risk factors of filter-protected carotid stenting. Eighty-four patients with symptomatic severe ({>=}60%) carotid artery stenoses received filter-protected carotid stenting. Standard DWI (b = 1000) was performed within 48 h before and after carotid stenting. The occurrence and load of new postinterventional DWI lesions were assessed. Multivariate analysis was performed to determine risk factors associated with DWI lesions, with emphasis on technical factors such as use of different access devices (guiding catheter method vs. long carotid sheath method), type of stent (open-cell nitinol stent vs. closed-cell Wallstent), and protective device (filters with 80-{mu}m vs. 110-120-{mu}m pore size). Markers for generalized atherosclerosis and for degree and site of stenosis were assessed to allow comparison of adequate risk profiles. Access, protective device, and stent type were not significantly associated with new embolic DWI lesions when we compared patients with equivalent risk profiles (long carotid sheath method 48% [11 of 23] vs. guiding catheter method 44% [27 of 61], Wallstent 47% [15 of 32] vs. nitinol stent 44% [23 of 52], and small pore size filter 61% [11 of 18] vs. large pore size filter 41% [27 of 66]). Single-center DWI studies with a moderate number of cases are inadequate for proper assessment of the embolic risk of technical- or material-related risk factors in carotid stenting. Larger multicenter studies with more cases are needed.

  11. Associations between bicycling and carotid arterial stiffness in adolescents: The European Youth Hearts Study.

    PubMed

    Ried-Larsen, M; Grøntved, A; Østergaard, L; Cooper, A R; Froberg, K; Andersen, L B; Møller, N C

    2015-10-01

    The aim of the study was to investigate the associations between bicycling and carotid arterial stiffness, independent of objectively measured moderate-and-vigorous physical activity. This cross-sectional study included 375 adolescents (age 15.7 ± 0.4 years) from the Danish site of the European Youth Heart Study. Total frequency of bicycle usage was assessed by self-report, and carotid arterial stiffness was assessed using B-mode ultrasound. After adjusting for pubertal status, body height, and objectively measured physical activity and other personal lifestyle and demographic factors, boys using their bicycle every day of the week displayed a higher carotid arterial compliance {standard beta 0.47 [95% confidence interval (CI) 0.07-0.87]} and distension [standard beta 0.38 (95% CI -0.04 to 0.81)]. Boys using their bicycle every day of the week furthermore displayed a lower Young's elastic modulus [standard beta -0.48 (95% CI -0.91 to -0.06)]. Similar trends were observed when investigating the association between commuter bicycling and carotid arterial stiffness. These associations were not observed in girls. Our observations suggest that increasing bicycling in adolescence may be beneficial to carotid arterial health among boys. PMID:25156494

  12. Identification of Atherosclerotic Plaques in Carotid Artery by Fluorescence Spectroscopy

    NASA Astrophysics Data System (ADS)

    Rocha, Rick; Villaverde, Antonio Balbin; Silveira, Landulfo; Costa, Maricília Silva; Alves, Leandro Procópio; Pasqualucci, Carlos Augusto; Brugnera, Aldo

    2008-04-01

    The aim of this work was to identify the presence of atherosclerotic plaques in carotid artery using the Fluorescence Spectroscopy. The most important pathogeny in the cardiovascular disorders is the atherosclerosis, which may affect even younger individuals. With approximately 1.2 million heart attacks and 750,000 strokes afflicting an aging American population each year, cardiovascular disease remains the number one cause of death. Carotid artery samples were obtained from the Autopsy Service at the University of São Paulo (São Paulo, SP, Brazil) taken from cadavers. After a histopathological analysis the 60 carotid artery samples were divided into two groups: normal (26) and atherosclerotic plaques (34). Samples were irradiated with the wavelength of 488 nm from an Argon laser. A 600 μm core optical fiber, coupled to the Argon laser, was used for excitation of the sample, whereas another 600 optical fiber, coupled to the spectrograph entrance slit, was used for collecting the fluorescence from the sample. Measurements were taken at different points on each sample and then averaged. Fluorescence spectra showed a single broad line centered at 549 nm. The fluorescence intensity for each sample was calculated by subtracting the intensity at the peak (550 nm) and at the bottom (510 nm) and then data were statistically analyzed, looking for differences between both groups of samples. ANOVA statistical test showed a significant difference (p<0,05) between both types of tissues, with regard to the fluorescence peak intensities. Our results indicate that this technique could be used to detect the presence of the atherosclerotic in carotid tissue.

  13. Wave transmission characteristics and anisotropy of canine carotid arteries

    NASA Technical Reports Server (NTRS)

    Moritz, W. E.; Anliker, M.

    1974-01-01

    A method was developed to generate and record three types of small amplitude waves (pressure, torsion and axial) in the exposed carotid artery of anesthetized dogs. The pressure waves were studied with the aid of miniature pressure transducers; electro-optical tracking units monitored the axial and circumferential surface displacements. Results from 6 dogs are presented in the form of the phase velocities and attenuation of three types of waves. The data demonstrate incompatibility with an isotropic elastic model for the mechanical behavior of the artery. The measured damping appears to be primarily due to the viscoelastic properties of the vessel wall material.

  14. Chemical zoning and homogenization of Pasamonte-type pyroxene and their bearing on thermal metamorphism of a howardite parent body

    NASA Technical Reports Server (NTRS)

    Miyamoto, M.; Duke, M. B.; Mckay, D. S.

    1985-01-01

    The Mg-Fe zoning of pyroxenes in Pasamonte and Juvinas eucrites is examined in order to gain a better understanding of the metamorphism in the surface layer of a eucrite/howardite parent body. Three distinct types of Ca-Mg-Fe zoning of Pasamonte pyroxenes are identified. The wide compositional range of the zoned pyroxenes suggests that Pasamonte is less metamorphosed than previously believed. It is also found that a Pasamonte-type pyroxene may yield a Juvinas-type pyroxene by thermal metamorphism. Calculations imply that the homogenization of Juvinas pyroxenes may have occurred during later reheating events rather than during initial cooling.

  15. Influence of chronic exercise on carotid atherosclerosis in marathon runners

    PubMed Central

    Taylor, Beth A; Zaleski, Amanda L; Capizzi, Jeffrey A; Ballard, Kevin D; Troyanos, Christopher; Baggish, Aaron L; D'Hemecourt, Pierre A; Dada, Marcin R; Thompson, Paul D

    2014-01-01

    Objectives The effect of habitual, high-intensity exercise training on the progression of atherosclerosis is unclear. We assessed indices of vascular health (central systolic blood pressure (SBP) and arterial stiffness as well as carotid intima-medial thickness (cIMT)) in addition to cardiovascular risk factors of trained runners versus their untrained spouses or partners to evaluate the impact of exercise on the development of carotid atherosclerosis. Setting field study at Boston Marathon. Participants 42 qualifiers (mean age±SD: 46±13 years, 21 women) for the 2012 Boston Marathon and their sedentary domestic controls (46±12 years, n=21 women). Outcomes We measured medical and running history, vital signs, anthropometrics, blood lipids, C reactive protein (CRP), 10 years Framingham risk, central arterial stiffness and SBP and cIMT. Results Multiple cardiovascular risk factors, including CRP, non-high-density lipoprotein cholesterol, triglycerides, heart rate, body weight and body mass index (all p<0.05), were reduced in the runners. The left and right cIMT, as well as central SBP, were not different between the two groups (all p>0.31) and were associated with age (all r≥0.41; p<0.01) and Framingham risk score (all r≥0.44; p<0.01) independent of exercise group (all p>0.08 for interactions). The amplification of the central pressure waveform (augmentation pressure at heart rate 75 bpm) was also not different between the two groups (p=0.07) but was related to age (p<0.01) and group (p=0.02) in a multiple linear regression model. Conclusions Habitual endurance exercise improves the cardiovascular risk profile, but does not reduce the magnitude of carotid atherosclerosis associated with age and cardiovascular risk factors. PMID:24531453

  16. Plexin D1 determines body fat distribution by regulating the type V collagen microenvironment in visceral adipose tissue

    PubMed Central

    Minchin, James E. N.; Dahlman, Ingrid; Harvey, Christopher J.; Mejhert, Niklas; Singh, Manvendra K.; Epstein, Jonathan A.; Arner, Peter; Torres-Vázquez, Jesús; Rawls, John F.

    2015-01-01

    Genome-wide association studies have implicated PLEXIN D1 (PLXND1) in body fat distribution and type 2 diabetes. However, a role for PLXND1 in regional adiposity and insulin resistance is unknown. Here we use in vivo imaging and genetic analysis in zebrafish to show that Plxnd1 regulates body fat distribution and insulin sensitivity. Plxnd1 deficiency in zebrafish induced hyperplastic morphology in visceral adipose tissue (VAT) and reduced lipid storage. In contrast, subcutaneous adipose tissue (SAT) growth and morphology were unaffected, resulting in altered body fat distribution and a reduced VAT:SAT ratio in zebrafish. A VAT-specific role for Plxnd1 appeared conserved in humans, as PLXND1 mRNA was positively associated with hypertrophic morphology in VAT, but not SAT. In zebrafish plxnd1 mutants, the effect on VAT morphology and body fat distribution was dependent on induction of the extracellular matrix protein collagen type V alpha 1 (col5a1). Furthermore, after high-fat feeding, zebrafish plxnd1 mutant VAT was resistant to expansion, and excess lipid was disproportionately deposited in SAT, leading to an even greater exacerbation of altered body fat distribution. Plxnd1-deficient zebrafish were protected from high-fat-diet-induced insulin resistance, and human VAT PLXND1 mRNA was positively associated with type 2 diabetes, suggesting a conserved role for PLXND1 in insulin sensitivity. Together, our findings identify Plxnd1 as a novel regulator of VAT growth, body fat distribution, and insulin sensitivity in both zebrafish and humans. PMID:25831505

  17. Plexin D1 determines body fat distribution by regulating the type V collagen microenvironment in visceral adipose tissue.

    PubMed

    Minchin, James E N; Dahlman, Ingrid; Harvey, Christopher J; Mejhert, Niklas; Singh, Manvendra K; Epstein, Jonathan A; Arner, Peter; Torres-Vázquez, Jesús; Rawls, John F

    2015-04-01

    Genome-wide association studies have implicated PLEXIN D1 (PLXND1) in body fat distribution and type 2 diabetes. However, a role for PLXND1 in regional adiposity and insulin resistance is unknown. Here we use in vivo imaging and genetic analysis in zebrafish to show that Plxnd1 regulates body fat distribution and insulin sensitivity. Plxnd1 deficiency in zebrafish induced hyperplastic morphology in visceral adipose tissue (VAT) and reduced lipid storage. In contrast, subcutaneous adipose tissue (SAT) growth and morphology were unaffected, resulting in altered body fat distribution and a reduced VAT:SAT ratio in zebrafish. A VAT-specific role for Plxnd1 appeared conserved in humans, as PLXND1 mRNA was positively associated with hypertrophic morphology in VAT, but not SAT. In zebrafish plxnd1 mutants, the effect on VAT morphology and body fat distribution was dependent on induction of the extracellular matrix protein collagen type V alpha 1 (col5a1). Furthermore, after high-fat feeding, zebrafish plxnd1 mutant VAT was resistant to expansion, and excess lipid was disproportionately deposited in SAT, leading to an even greater exacerbation of altered body fat distribution. Plxnd1-deficient zebrafish were protected from high-fat-diet-induced insulin resistance, and human VAT PLXND1 mRNA was positively associated with type 2 diabetes, suggesting a conserved role for PLXND1 in insulin sensitivity. Together, our findings identify Plxnd1 as a novel regulator of VAT growth, body fat distribution, and insulin sensitivity in both zebrafish and humans. PMID:25831505

  18. Oblique Axis Body Fracture: An Unstable Subtype of Anderson Type III Odontoid Fractures-Apropos of Two Cases.

    PubMed

    Takai, Hirokazu; Konstantinidis, Lukas; Schmal, Hagen; Helwig, Peter; Knöller, Stefan; Südkamp, Norbert; Hauschild, Oliver

    2016-01-01

    Purpose. Anderson type III odontoid fractures have traditionally been considered stable and treated conservatively. However, unstable cases with unfavorable results following conservative treatment have been reported. Methods. We present the cases of two patients who sustained minimally displaced Anderson type III fractures with a characteristic fracture pattern that we refer to as "oblique type axis body fracture." Results. The female patients aged 90 and 72 years, respectively, were both diagnosed with minimally displaced Anderson type III fractures. Both fractures had a characteristic "oblique type" fracture pattern. The first patient was treated conservatively with cervical spine immobilization in a semirigid collar. However, gross displacement was noted at the 6-week follow-up visit. The second patient was therefore treated operatively by C1-C3/4 posterior fusion and the course was uneventful. Conclusions. Oblique type axis body fractures resemble a highly unstable subtype of Anderson type III fractures with the potential of severe secondary deformity following conservative treatment, irrespective of initial grade of displacement. The authors therefore warrant a high index of suspicion for this injury and suggest early operative stabilization. PMID:27042372

  19. Evaluation of Carotid Plaque Using Ultrasound Imaging

    PubMed Central

    2016-01-01

    Traditional risk factors for predicting of cardiovascular disease are not always effective predictors for development of cardiovascular events. This review summarizes several newly developed noninvasive imaging techniques for evaluating carotid plaques and their role in cardiovascular disease risk. PMID:27358696

  20. Retained subintimal pellet in a carotid artery.

    PubMed

    Manousi, Maria; Sarantitis, Ioannis; Papadoulas, Spyros; Diamantopoulos, Athanasios; Kakkos, Stavros K; Lampropoulos, George; Tsolakis, Ioannis A

    2011-06-01

    A shotgun pellet is depicted in the present image in a carotid artery under the intima, which remained intact without local complications for up to six months. There is lack of data regarding the natural history of such a carotid pellet, but the experience from the myocardium is that, in the absence of infection, completely embedded missiles are usually asymptomatic, tolerated well and may be left in place. PMID:21860728

  1. "Blue bodies" in a case of cryptogenic fibrosing alveolitis (desquamative type) an ultra-structural study.

    PubMed Central

    Gardiner, I T; Uff, J S

    1978-01-01

    A patient with cryptogenic fibrosing alveolitis, with both mural and desquamative features, had two lung biopsies at the times of coronary artery surgery. These lung specimens were studied, using light and electron microscopy, with immunofluorescence techniques and electron microanalysis. In addition to the typical changes of cryptogenic fibrosing alveolitis previously reported, we found "blue-staining bodies" within alveolar macrophages and giant cells. These bodies were 15--25 micrometer in diameter with an iron rich outer rim and core of connective tissue mucin--possibly chondroitin sulphate or dermatan sulphate. It seems unlikely that these "blue bodies" were due to fibreglass dust to which the patients had had a trivial exposure, but their exact nature and significance remains unclear. Images PMID:218319

  2. Atherosclerotic risk stratification strategy for carotid arteries using texture-based features.

    PubMed

    Acharya, U Rajendra; Sree, S Vinitha; Krishnan, M Muthu Rama; Molinari, Filippo; Saba, Luca; Ho, Sin Yee Stella; Ahuja, Anil T; Ho, Suzanne C; Nicolaides, Andrew; Suri, Jasjit S

    2012-06-01

    Plaques in the carotid artery result in stenosis, which is one of the main causes for stroke. Patients have to be carefully selected for stenosis treatments as they carry some risk. Since patients with symptomatic plaques have greater risk for strokes, an objective classification technique that classifies the plaques into symptomatic and asymptomatic classes is needed. We present a computer aided diagnostic (CAD) based ultrasound characterization methodology (a class of Atheromatic systems) that classifies the patient into symptomatic and asymptomatic classes using two kinds of datasets: (1) plaque regions in ultrasound carotids segmented semi-automatically and (2) far wall gray-scale intima-media thickness (IMT) regions along the common carotid artery segmented automatically. For both kinds of datasets, the protocol consists of estimating texture-based features in frameworks of local binary patterns (LBP) and Law's texture energy (LTE) and applying these features for obtaining the training parameters, which are then used for classification. Our database consists of 150 asymptomatic and 196 symptomatic plaque regions and 342 IMT wall regions. When using the Atheromatic-based system on semiautomatically determined plaque regions, support vector machine (SVM) classifier was adapted with highest accuracy of 83%. The accuracy registered was 89.5% on the far wall gray-scale IMT regions when using SVM, K-nearest neighbor (KNN) or radial basis probabilistic neural network (RBPNN) classifiers. LBP/LTE-based techniques on both kinds of carotid datasets are noninvasive, fast, objective and cost-effective for plaque characterization and, hence, will add more value to the existing carotid plaque diagnostics protocol. We have also proposed an index for each type of datasets: AtheromaticPi, for carotid plaque region, and AtheromaticWi, for IMT carotid wall region, based on the combination of the respective significant features. These indices show a separation between symptomatic

  3. The relationship between carotid artery colour Doppler finding and cerebral oximetry

    PubMed Central

    Ardakani, Mohammad Sobhan; Heidari, Manouchehr; Moghaddam, Reza Nafisi; Haddadzadeh, Mahdi; Moshtaghion, Hossein; Rahimianfar, Ali Akbar

    2015-01-01

    Background: In some cases, permanent reduction in cerebral functioning affects a high percentage of patients undergoing cardiovascular surgery. We studied the relationship between the results of preoperative bilateral carotid artery colour Doppler sonography and regional cerebral oxygen saturation (rSO2) during coronary artery bypass graft surgery (CABG). Materials and Methods: This study was a cross-sectional analytical study conducted with 96 candidates for off-pump CABG. This study determined the percentage of the correlation of rSO2 with demographic information, diabetes, hyperlipidemia, hypertension, myocardial infraction (MI), and smoking, and also provided information on the presence and type of plaque, intima-media thickness (IMT), and percentage of stenosis of carotid artery detected through colour Doppler sonography. Data were analyzed by the t-test, the Chi-square test, and simple linear regression. Results: In this study, the mean value of rSO2 increased after intubation compared to the mean before intubation, the difference being statistically significant (P = 0.005). A comparison of the mean rSO2 of the right side of the brain and the percentage of right carotid obstruction (stenosis of less than 50% vs. stenosis with a range of 50-69%) revealed that the mean rSO2 at the time of the partial-clamp between carotid stenosis less than 50% and carotid stenosis with a range of 50-69% was statistically significant (P = 0.043). Conclusions: There is no statistically significant correlation between rSO2 and percentage of carotid artery stenosis less than 70%. It is advised that rSO2 and carotid stenosis of greater than 70% be studied in future. PMID:26015916

  4. Type II Diabetes Disparities in Diverse Women: The Potential Roles of Body Composition, Diet, and Physical Activity

    PubMed Central

    Crawford, Margaret A.; Mendoza-Vasconez, Andrea S.; Larsen, Britta A.

    2016-01-01

    The rates of diabetes in the U.S. are rapidly increasing, and vary widely across different racial/ethnic groups. This paper explores the potential contribution of body composition, diet, and physical activity in explaining diabetes disparities across women of different racial and ethnic backgrounds. For body composition, racial/ethnic groups differ widely by BMI, distribution of body mass, and quantity and type of adipose tissue. Dietary patterns that vary across race/ethnicity include consumption of meat, added sugars, high-glycemic carbohydrates, and fast food. Additionally, physical activity patterns of interest include aerobic vs. muscle-strengthening exercises, and the purpose of physical activity (leisure, occupation, or transportation). Overall, these variables provide a partial picture of the source of these widening disparities, and could help guide future research in addressing and reducing diabetes disparities. PMID:26648099

  5. Type II diabetes disparities in diverse women: the potential roles of body composition, diet and physical activity.

    PubMed

    Crawford, Margaret A; Mendoza-Vasconez, Andrea S; Larsen, Britta A

    2015-11-01

    The rates of diabetes in the USA are rapidly increasing, and vary widely across different racial/ethnic groups. This paper explores the potential contribution of body composition, diet and physical activity in explaining diabetes disparities across women of different racial and ethnic backgrounds. For body composition, racial/ethnic groups differ widely by BMI, distribution of body mass and quantity and type of adipose tissue. Dietary patterns that vary across race/ethnicity include consumption of meat, added sugars, high-glycemic carbohydrates and fast food. Additionally, physical activity patterns of interest include aerobic versus muscle-strengthening exercises, and the purpose of physical activity (leisure, occupation, or transportation). Overall, these variables provide a partial picture of the source of these widening disparities, and could help guide future research in addressing and reducing diabetes disparities. PMID:26648099

  6. Carotid artery stenting in recently symptomatic patients.

    PubMed

    Setacci, C; de Donato, G; Setacci, F; Sirignano, P; Galzerano, G; Borrelli, M P; Cappelli, A

    2013-02-01

    Treatment of acute stroke is time-dependent, with the best outcomes resulting from the earliest interventions. However, for patients with acute ischemic stroke due to a high-grade stenosis of the internal carotid artery, despite maximal medical treatment, an effective intervention to improve their neurologic symptoms and clinical outcome has not yet been established. There are two major concerns: first, cerebral revascularization in the acute stage remains challenging because of the possibility that hemorrhagic infarction or hyperperfusion syndrome will occur after revascularization; second, alarms about carotid artery stenting in patients with acute symptoms are related to the fact that, while with carotid endarterectomy the plaque is completely removed, after stenting it is only remodelled and its stabilization is essential to avoid embolic events during the procedure and in the post-operative period. Although level 1 evidence seems clearly in favor of carotid endarterectomy in symptomatic patients, carotid stenting has been proposed as a possible alternative in selected cases if the procedure is performed in high-volume center with documented low perioperative stroke and death rates. This review summarizes indications and results for carotid artery stenting in recently symptomatic patients. PMID:23296417

  7. Variation in sand body types on the eastern Bering Sea epicontinental shelf.

    USGS Publications Warehouse

    Nelson, C.H.; Dupre, W.R.; Field, M.E.; Howard, J.D.

    1982-01-01

    The eastern epicontinental shelf of the Bering Sea is characterized by variations in river and glacial sediment supply, wave energy, tidal range (microtidal to mesotidal), and tidal, geostrophic, and storm-induced currents. These factors, combined with the effect of the Holocene rise in sea level, have resulted in the formation of a complex assemblage of generally linear sand bodies of similar morphology anad lithology, but different origins. The sand bodies are large features found from the present shoreline to tens of kilometers offshore, in water depths up to 50m. -from Authors

  8. Oblique Axis Body Fracture: An Unstable Subtype of Anderson Type III Odontoid Fractures—Apropos of Two Cases

    PubMed Central

    Konstantinidis, Lukas; Schmal, Hagen; Helwig, Peter; Knöller, Stefan; Südkamp, Norbert; Hauschild, Oliver

    2016-01-01

    Purpose. Anderson type III odontoid fractures have traditionally been considered stable and treated conservatively. However, unstable cases with unfavorable results following conservative treatment have been reported. Methods. We present the cases of two patients who sustained minimally displaced Anderson type III fractures with a characteristic fracture pattern that we refer to as “oblique type axis body fracture.” Results. The female patients aged 90 and 72 years, respectively, were both diagnosed with minimally displaced Anderson type III fractures. Both fractures had a characteristic “oblique type” fracture pattern. The first patient was treated conservatively with cervical spine immobilization in a semirigid collar. However, gross displacement was noted at the 6-week follow-up visit. The second patient was therefore treated operatively by C1–C3/4 posterior fusion and the course was uneventful. Conclusions. Oblique type axis body fractures resemble a highly unstable subtype of Anderson type III fractures with the potential of severe secondary deformity following conservative treatment, irrespective of initial grade of displacement. The authors therefore warrant a high index of suspicion for this injury and suggest early operative stabilization. PMID:27042372

  9. Liraglutide reduces the body weight and waist circumference in Chinese overweight and obese type 2 diabetic patients

    PubMed Central

    Feng, Ping; Yu, De-min; Chen, Li-ming; Chang, Bao-cheng; Ji, Qiu-di; Li, Shu-ying; Zhu, Mei; Ding, Sheng-hua; Zhang, Bao-zhen; Wang, Su-li; Li, Hong-tao; Lin, Jing-na; Wang, Mao-jun; Guo, Jian-chao; Liu, Jie; Liu, Zhong-dong; Wu, Shen-tao; Yang, Ju-hong

    2015-01-01

    Aim: To investigate the effects of liraglutide, a glucagon-like peptide-1 (GLP-1) receptor activator, on body weight and waist circumference in Chinese overweight and obese type 2 diabetic patients. Methods: A total of 328 Chinese overweight and obese type 2 diabetic patients were included in this multi-center, open-labeled and self-controlled clinical study. The patients were subcutaneously injected with liraglutide once daily for 24 weeks as add-on therapy to their previous hypoglycemic treatments. Statistical analyses were performed using SPSS software package version 11.5 for Windows. Results: Liraglutide treatment caused significant reduction of the mean body weight (from 86.61±14.09 to 79.10±13.55 kg) and waist circumference (from 101.81±13.96 to 94.29±14.17 cm), resulting in body weight lose of 5%–10% in 43.67% patients, and body weight loss above 10% in 34.06% patients, who had significant lower plasma creatinine levels. Baseline waist circumference, BMI and HOMA-IR were independently correlated with the body weight loss. Furthermore, liraglutide treatment significantly decreased HbA1c levels (from 8.66%±2.17% to 6.92%±0.95%) with HbA1c<7.0% in 35.37% patients, who had a significantly lower baseline level of HbA1c, but higher baseline levels of C peptide and glucagon. Moreover, liraglutide treatment resulted in greater body weight loss in patients with a long duration of diabetes, and better glycemic control in patients with a short duration of diabetes. Conclusion: Liraglutide significantly reduces body weight and waist circumference in Chinese overweight and obese type 2 diabetic patients. Patients with apparent visceral obesity, insulin resistance and a long duration of diabetes may have greater body weight loss; whereas patients with high insulin-secreting ability, hyperglucagonemia, and short-duration diabetes may obtain better glycemic control with liraglutide. PMID:25619391

  10. Mechanical properties of elytra from Tribolium castaneum wild-type and body color mutant strains

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cuticle tanning in insects involves simultaneous cuticular hardening and pigmentation. The dynamic mechanical properties of the highly modified and cuticle-rich forewings (elytra) from Tribolium castaneum (red flour beetle) body color mutant strains were investigated to determine the relationship b...

  11. 9p21 locus rs10757278 is associated with advanced carotid atherosclerosis in a gender-specific manner.

    PubMed

    Zivotić, Ivan; Djurić, Tamara; Stanković, Aleksandra; Djordjević, Ana; Končar, Igor; Davidović, Lazar; Alavantić, Dragan; Zivković, Maja

    2016-06-01

    Single nucleotide polymorphisms from the chromosome locus 9p21 are reported to carry a risk for various cardiovascular diseases. One of the lead single nucleotide polymorphisms, rs10757278, was mostly investigated in association with coronary artery disease but rarely with carotid atherosclerosis. In this study, we aimed to analyze the association of rs10757278 A/G polymorphism with carotid plaque presence in advanced carotid atherosclerosis. The study included 803 participants, 486 patients with high-grade stenosis (>70%) who were undergoing carotid endarterectomy and 317 controls from Serbian population. Genotypes were determined using the real-time polymerase chain reaction. According to the recessive model of inheritance, GG genotype was significantly and independently associated with carotid plaque in females only (odds ratio 2.42, CI = 1.20-4.90, P = 0.013). Odds ratio was adjusted for age, body mass index, hypertension, TC, LDLC, HDLC and TG, and P value was corrected for multiple comparisons. Our preliminary findings suggest a gender-specific association of rs10757278 polymorphism with carotid plaque. Further studies on larger sample and in genetically and environmentally similar populations are needed. PMID:26941057

  12. Asteroid 6 Hebe: The probable parent body of the H-Type ordinary chondrites and the IIE iron meteorites

    NASA Astrophysics Data System (ADS)

    Gaffey, Michael J.; Gilbert, Sarah L.

    1998-11-01

    The S(IV)-type asteroid 6 Hebe is identified as the probable parent body of the H-type ordinary chondrites and of the IIE iron meteorites. The ordinary chondrites are the most common type of meteorites falling to Earth, but prior to the present study no large mainbelt source bodies have been confirmed. Hebe is located adjacent to both the (6 and 3:1 resonances, and has been previously suggested as a major potential source of the terrestrial meteorite flux. Hebe exhibits subtle rotational spectral variations indicating the presence of some compositional variations across its surface. The silicate portion of the surface assemblage of Hebe is consistent, both in overall average and in its range of variation, with the silicate components in the suite of H-type chondrites. The high albedo of Hebe rules out a lunar-style space weathering process to produce the weakened absorption features and reddish spectral slope in the S-type spectrum of Hebe. Linear unmixing models show that a typical nickel-iron metal spectrum is consistent with the component which modifies an H-chondrite spectrum to produce the S-type spectrum of Hebe. Based on the association between the H chondrites and the IIE iron meteorites, our model suggests that large impacts onto the relatively metal-rich H chondrite target produced melt bodies (sheets or pods) which differentiated to form thin, laterally extensive near-surface layers of NiFe metal. Fragments of the upper silicate portions of these melt bodies are apparently represented by some of the igneous inclusions in H-chondrite breccias. Alternately, masses of metal could have been deposited on the surface of Hebe by the impact of a core or core fragment from a differentiated parent body of H chondrite composition. Subsequent impacts preferentially eroded and depleted the overlying silicate and regolith components exposing and maintaining large masses of metal at the optical surface of Hebe. In this interpretation, the nonmagmatic IIE iron

  13. Carotid endarterectomy and prevention of cerebral ischemia in symptomatic carotid stenosis

    SciTech Connect

    Mayberg, M.R.; Eskridge, J.; Winn, H.R.; Eskridge, J. ); Wilson, S.E. ); Yatsu, F. ); Weiss, D.G. ); Messina, L. ); Hershey, L.A. ); Colling, C. ); Deykin, D. )

    1991-12-18

    The objective of this study was to determine whether carotid endarterectomy provides protection against subsequent cerebral ischemia in men with ischemic symptoms in the distribution of significant ipsilateral internal carotid artery stenosis. The study group was comprised of men who presented within 120 days of onset of symptoms that were consistent with transient ischemic attacks, transient monocular blindness, or recent small completed strokes between July 1988 and February 1991. Among 5,000 patients screened, 189 individuals were randomized with angiographic internal carotid artery stenosis greater than 50% ipsilateral to the presenting symptoms. Forty-eight eligible patients who refused entry were followed up outside of the trial. For a selected cohort of men with symptoms of cerebral or retinal ischemia in the distribution of a high-grade internal carotid artery stenosis, carotid endarterectomy can effectively reduce the risk of subsequent ipsilateral cerebral ischemia. The risk of cerebral ischemia in this subgroup of patients is considerably higher than previously estimated.

  14. Beneficial Autoimmunity at Body Surfaces – Immune Surveillance and Rapid Type 2 Immunity Regulate Tissue Homeostasis and Cancer

    PubMed Central

    Dalessandri, Tim; Strid, Jessica

    2014-01-01

    Epithelial cells (ECs) line body surface tissues and provide a physicochemical barrier to the external environment. Frequent microbial and non-microbial challenges such as those imposed by mechanical disruption, injury or exposure to noxious environmental substances including chemicals, carcinogens, ultraviolet-irradiation, or toxins cause activation of ECs with release of cytokines and chemokines as well as alterations in the expression of cell-surface ligands. Such display of epithelial stress is rapidly sensed by tissue-resident immunocytes, which can directly interact with self-moieties on ECs and initiate both local and systemic immune responses. ECs are thus key drivers of immune surveillance at body surface tissues. However, ECs have a propensity to drive type 2 immunity (rather than type 1) upon non-invasive challenge or stress – a type of immunity whose regulation and function still remain enigmatic. Here, we review the induction and possible role of type 2 immunity in epithelial tissues and propose that rapid immune surveillance and type 2 immunity are key regulators of tissue homeostasis and carcinogenesis. PMID:25101088

  15. Cell-Type-Specific Transcriptome Analysis in the Drosophila Mushroom Body Reveals Memory-Related Changes in Gene Expression.

    PubMed

    Crocker, Amanda; Guan, Xiao-Juan; Murphy, Coleen T; Murthy, Mala

    2016-05-17

    Learning and memory formation in Drosophila rely on a network of neurons in the mushroom bodies (MBs). Whereas numerous studies have delineated roles for individual cell types within this network in aspects of learning or memory, whether or not these cells can also be distinguished by the genes they express remains unresolved. In addition, the changes in gene expression that accompany long-term memory formation within the MBs have not yet been studied by neuron type. Here, we address both issues by performing RNA sequencing on single cell types (harvested via patch pipets) within the MB. We discover that the expression of genes that encode cell surface receptors is sufficient to identify cell types and that a subset of these genes, required for sensory transduction in peripheral sensory neurons, is not only expressed within individual neurons of the MB in the central brain, but is also critical for memory formation. PMID:27160913

  16. Yang Deficiency Body Constitution Acts as a Predictor of Diabetic Retinopathy in Patients with Type 2 Diabetes: Taichung Diabetic Body Constitution Study

    PubMed Central

    Lee, Cheng-Hung; Li, Tsai-Chung; Tsai, Chia-I; Lin, Shih-Yi; Lee, I-Te; Lee, Hsin-Jung; Wu, Ya-Chi; Su, Yi-Chang

    2015-01-01

    Objective. Diabetic retinopathy (DR), the most common microvascular complication of diabetes mellitus (DM), can cause severe visual impairment and blindness. To prevent the development of DR, identifying the associated risk factors for patient classification is critical. We conducted a cross-sectional study to determine whether body constitution (BC) is an independent predictor of DR. Method. 673 type 2 DM (T2DM) patients were recruited from a medical center, all received DR examination and body constitution questionnaire to assess BC. Other risk factors for DR were also recorded, including life style, history of diabetes, and blood pressure, etc. Multiple logistic regression analysis was conducted to calculate the odds ratios (ORs) for DR. Results. The prevalence of DR was significantly lower in Yang deficiency patients compared with non-Yang deficiency patients (24.69% versus 38.18% P = 0.02). After adjusting for other risk factors, we observed that patients exhibiting Yang deficiency BC were less likely to present with DR (OR = 0.531; 95% confidence interval = 0.312–0.903, P = 0.018). Conclusion. In addition to traditional risk factors, Yang deficiency BC might be an independent predictor of DR among T2DM patients and the results can be used as evidence for traditional Chinese medicine patient classification. PMID:26167195

  17. Internal carotid artery rupture caused by carotid shunt insertion

    PubMed Central

    Illuminati, Giulio; Caliò, Francesco G.; Pizzardi, Giulia; Vietri, Francesco

    2015-01-01

    Introduction Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. Presentation of case A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arterial rupture at the distal tip of the shunt was detected and was repaired via a small saphenous vein patch. Eversion CEA and subsequent CABG completed the procedure whose postoperative course was uneventful. Discussion Shunting during combined CEA-CABG may be advisable to assure cerebral protection from possible hypoperfusion due to potential hemodynamic instability of patients with severe coronary artery disease. Awareness and prompt management of possible shunt-related complications, including the newly reported one, may contribute to limiting their harmful effect. Conclusion Arterial wall rupture is a possible, previously not reported, shunt-related complication to be aware of when performing CEA. PMID:26255001

  18. Genome of the R-body producing marine alphaproteobacterium Labrenzia alexandrii type strain (DFL-11T)

    PubMed Central

    Fiebig, Anne; Pradella, Silke; Petersen, Jörn; Päuker, Orsola; Michael, Victoria; Lünsdorf, Heinrich; Göker, Markus; Klenk, Hans-Peter; Wagner-Döbler, Irene

    2013-01-01

    Labrenzia alexandrii Biebl et al. 2007 is a marine member of the family Rhodobacteraceae in the order Rhodobacterales, which has thus far only partially been characterized at the genome level. The bacterium is of interest because it lives in close association with the toxic dinoflagellate Alexandrium lusitanicum. Ultrastructural analysis reveals R-bodies within the bacterial cells, which are primarily known from obligate endosymbionts that trigger “killing traits” in ciliates (Paramecium spp.). Genomic traits of L. alexandrii DFL-11T are in accordance with these findings, as they include the reb genes putatively involved in R-body synthesis. Analysis of the two extrachromosomal elements suggests a role in heavy-metal resistance and exopolysaccharide formation, respectively. The 5,461,856 bp long genome with its 5,071 protein-coding and 73 RNA genes consists of one chromosome and two plasmids, and has been sequenced in the context of the Marine Microbial Initiative. PMID:24019989

  19. Roman v. Sans Serif Body Type; Readability and Reader Preference. News Research Bulletin No. 2.

    ERIC Educational Resources Information Center

    Hvistendahl, J. K.; Kahl, Mary R.

    Many typographers have already decided that sans serif type is more pleasing to readers and more functional than traditional roman type. The findings of this study, which was designed to assess the readability of, and reader preference for, these two styles, lead to the opposite conclusion. To determine preferences, 200 subjects of various ages…

  20. [Macroscopic and pathohistological investigation of endarterial plaque after intraoperative balloon dilatation of the carotid artery during carotid endarterectomy].

    PubMed

    Nishida, M; Shima, T; Okada, Y; Yamane, K; Hatayama, T; Yamanaka, C; Toyota, A; Nishida, T

    1998-12-01

    Twelve patients associated with stenosis of the extracranial carotid artery underwent intraluminal balloon dilatation during carotid endarterectomy (CEA). There were 11 men and 1 woman, and age ranged from 56 to 73 years old. The rate of stenosis, shown by angiography, in each patient was from 60 to 85% in width. After securing carotid blood flow by a T-shaped shunt tube, a balloon catheter was inserted from the exposed common carotid artery into the internal carotid artery. The balloon was inflated three or four times with 2.5-3.5 atm. for 30-40 seconds. Immediately after balloon dilatation, endoscopic investigation was performed (Wolf; hard type endoscope, 2.7 mm diameter). Then CEA was performed using the usual procedure. The removed endarterial plaque was investigated pathohistologically. In macroscopic and endoscopic findings, there were 6 patients with mural thrombosis, 4 patients with laceration of the intima, and one patient with outflow of atheroma from the intima. Only 3 patients had increase in lumen after balloon dilatation. In pathohistological appearance, all patients had a moderate degree of fibrosis, calcification, and atheroma in the cross section of the plaque. Ten patients had intramural hemorrhage. Three typical patients were revealed by the use of angiographical, ultrasonographical, endoscopic, and pathohistological presentation. Case 10 showed laceration of the intima by balloon dilatation, and had moderate increase in lumen size macroscopically and endoscopically. There were moderate cases of fibrosis, calcification, atheroma, and intramural hemorrhage. Dilatation of the lumen seemed to be accomplished by a decrease in thickness of the atheroma and intramural hemorrhage. Case 8 demonstrated an increase in lumen size, but also laceration of the intima and outflow of atheroma from the arterial wall. There were much atheroma and large intramural hemorrhage in the intima, which might become a source of enbolism. Case 7 revealed no laceration of

  1. Pulsatility index in carotid arteries is increased in levothyroxine-treated Hashimoto disease.

    PubMed

    Owecki, M; Sawicka-Gutaj, N; Owecki, M K; Ambrosius, W; Dorszewska, J; Oczkowska, A; Michalak, M; Fischbach, J; Kozubski, W; Ruchała, M

    2015-07-01

    The aim of this case-control study was to evaluate carotid hemodynamic variables and traditional cardiovascular risk factors in women with Hashimoto thyroiditis (HT). The study group consisted of 31 females with HT on levothyroxine (L-T4) and 26 euthyroid women with HT without L-T4 matched for age and body mass index (BMI) as controls. Carotid intima-media thickness (CIMT), carotid extra-media thickness (CEMT), and pulsatility indexes in common carotid artery (PI CCA) and in internal carotid artery (PI ICA) were measured. BMI, waist circumference, lipid profile, fasting glucose and insulin levels, and parameters of thyroid function [TSH, free thyroxine (FT4) and antithyroperoxidase antibodies (TPOAbs)] were assessed. The study and the control groups did not differ in age, BMI, waist circumference, lipid profile, fasting glucose, and insulin levels. Results are expressed as median (IQR). Treated HT group had higher FT4 levels than nontreated [17.13 (5.11) pmol/l vs. 14.7 (2.27) pmol/l; p=0.0011] and similar TSH [1.64 (2.08) IU/ml vs. 2.07 (3.14) IU/ml; p=0.5915]. PI CCA and PI ICA were higher in the study group than in controls (p=0.0224 and p=0.0477, respectively). The difference remained statistically significant for PI ICA and PI CCA after adjustment for other variables (coefficient=0.09487; standard error=0.04438; p=0.037 and coefficient=0.1786; standard error=0.0870; p=0.0449, respectively). CIMT and CEMT were similar in both groups (p=0.8746 and p=0.0712, respectively). Women with HT on L-T4 replacement therapy have increased PI in common and internal carotid arteries than nontreated euthyroid HT patients. Therefore, it seems that hypothyroidism, but not autoimmune thyroiditis per se, influences arterial stiffness. PMID:25671800

  2. Interaction of central venous pressure, intramuscular pressure, and carotid baroreflex function

    NASA Technical Reports Server (NTRS)

    Shi, X.; Foresman, B. H.; Raven, P. B.; Blomqvist, C. G. (Principal Investigator)

    1997-01-01

    Seven healthy volunteer men participated in an experiment involving lower body positive pressure (LBPP) of 30 Torr and acute volume expansions of 5-6% (VE-I) and 9-10% (VE-II) of their total blood volume (TBV) to differentiate the effect of increased intramuscular pressure and central venous pressure (CVP) on the maximal gain (Gmax) of the carotid baroreflex. During each experimental condition, the heart rate (HR), mean arterial pressure (MAP; intraradial artery or Finapres), and CVP (at the 3rd-4th intercostal space) were monitored continuously. Gmax was derived from the logistic modeling of the HR and MAP responses to ramped changes in carotid sinus transmural pressure using a protocol of pulsatile changes in neck chamber pressure from +40 to -65 Torr. The increase in CVP during +30-Torr LBPP was 1.5 mmHg (P < 0.05) and was similar to that observed during VE-I (1.7 mmHg, P > 0.05). The Gmax of the carotid baroreflex of HR and MAP was significantly decreased during LBPP by -0.145 +/- 0.039 beats x min(-1) x mmHg(-1) (38%) and -0.071 +/- 0.013 mmHg/mmHg (25%), respectively; however, VE-I did not affect Gmax. During VE-II, CVP was significantly greater than that elicited by LBPP, and the Gmax of the carotid baroreflex of the HR and MAP responses was significantly reduced. We conclude that carotid baroreflex responsiveness was selectively inhibited by increasing intramuscular pressure, possibly resulting in an activation of the intramuscular mechanoreceptors during LBPP. Furthermore, it would appear that the inhibition of the carotid baroreflex, via cardiopulmonary baroreceptor loading (increased CVP), occurred when a threshold pressure (CVP) was achieved.

  3. Periodontal Microbiota and Carotid Intima-Media Thickness

    PubMed Central

    Desvarieux, Moïse; Demmer, Ryan T.; Rundek, Tatjana; Boden-Albala, Bernadette; Jacobs, David R.; Sacco, Ralph L.; Papapanou, Panos N.

    2009-01-01

    Background Chronic infections, including periodontal infections, may predispose to cardiovascular disease. We investigated the relationship between periodontal microbiota and subclinical atherosclerosis. Methods and Results Of 1056 persons (age 69±9 years) with no history of stroke or myocardial infarction enrolled in the Oral Infections and Vascular Disease Epidemiology Study (INVEST), we analyzed 657 dentate subjects. Among these subjects, 4561 subgingival plaque samples were collected (average of 7 samples/subject) and quantitatively assessed for 11 known periodontal bacteria by DNA-DNA checkerboard hybridization. Extensive in-person cardiovascular risk factor measurements, a carotid scan with high-resolution B-mode ultrasound, white blood cell count, and C-reactive protein values were obtained. In 3 separate analyses, mean carotid artery intima-media thickness (IMT) was regressed on tertiles of (1) burden of all bacteria assessed, (2) burden of bacteria causative of periodontal disease (etiologic bacterial burden), and (3) the relative predominance of causative/over other bacteria in the subgingival plaque. All analyses were adjusted for age, race/ethnicity, gender, education, body mass index, smoking, diabetes, systolic blood pressure, and LDL and HDL cholesterol. Overall periodontal bacterial burden was related to carotid IMT. This relationship was specific to causative bacterial burden and the dominance of etiologic bacteria in the observed microbiological niche. Adjusted mean IMT values across tertiles of etiologic bacterial dominance were 0.84, 0.85, and 0.88 (P=0.002). Similarly, white blood cell values increased across tertiles of etiologic bacterial burden from 5.57 to 6.09 and 6.03 cells × 109/L (P=0.01). C-reactive protein values were unrelated to periodontal microbial status (P=0.82). Conclusions Our data provide evidence of a direct relationship between periodontal microbiology and subclinical atherosclerosis. This relationship exists independent

  4. Dynamic changes of carotid artery intima-media thickness and mortality in hemodialysis patients

    PubMed Central

    Stolic, R; Ilic, A; Jovanovic, A; Grbic, R; Odalovic, D; Smilic, Lj; Lazic, S; Krdzic, B; Nedovic, J

    2015-01-01

    Introduction Intima-media thickness (IMT) of the carotid artery is a widely accepted parameter for detection and quantification of atherosclerosis. The aim of the study was the evaluation of the impact of changes of IMT on the mortality of patients on hemodialysis. Methods The study was organized as a prospective and observational one. Intima-media thickness was determined by ultrasound in 194 patients who were evaluated every year during a three-year period. We analyzed the mortality rate of patients on hemodialysis in relation to their biochemical parameters, demographic and anthropometric characteristics, type of dialysis, smoking habits and statin therapy. Results Female gender and hemodiafiltration emerged as good predictors of long-term survival. Baseline IMT values were significantly lower than those at the end of the second (p <0.001) and third years of the study (p <0.001). The baseline values positively correlated with uric acid levels (p =0.027) and body mass index (p =0.024), while at the end of the second year, IMT positively correlated with LDL-cholesterol (p =0.037) and triglyceride levels (p =0.018) and body mass index (p =0.045). Patients on hemodiafiltration had significantly higher values for erythrocytes (p =0.047), hemoglobin (p =0.005), creatinine (p =0.048), Kt/V (p =0.026), albumin (p =0.012), LDL-cholesterol (p <0.001), body mass index (p <0.001),and lower IMT values at the end of the first year (p =0.039), compared to patients on bicarbonate hemodialysis. Predictors of death were the duration of hemodialysis (p <0.001), and IMT at the end of the first (p =0.008) and second years of the study (p =0.005). Conclusion Dynamic changes of IMT of the carotid arteries during the first two years were found in our study to be predictors of mortality in patients on hemodialysis. Hippokratia 2015; 19 (2):158-163. PMID:27418766

  5. Determinants of preclinical atherosclerosis are different in type 1 and type 2 diabetic women.

    PubMed

    Piťhová, P; Štechová, K; Piťha, J; Lánská, V; Kvapil, M

    2016-06-20

    Diabetes mellitus type 2 ranks among the strongest predictors of cardiovascular diseases (CVD) while the association of type 1 diabetes with CVD is more complex. We studied differences between type 1 and 2 diabetic women regarding association of cardiovascular risk factors with preclinical atherosclerosis expressed as intima-media thickness of common carotid (IMT CCA) and femoral arteries (IMT CFA) measured by high resolution ultrasound. Women with type 1 (n=203) and type 2 diabetes (n=123) were examined with regard to the presence of cardiovascular risk factors. In type 1 diabetic women strong association between IMT CCA and body mass index, waist circumference, and total body fat was found in contrast to type 2 diabetic women. In type 2 diabetic women strong association between IMT CCA and fasting glucose, glycated hemoglobin, and atherogenic index of plasma (log TG/HDL cholesterol) was observed in contrast to type 1 diabetic women. In type 1 diabetic women, IMT CFA was associated with body fat in contrast to type 2 diabetic women. Preclinical atherosclerosis in type 1 diabetic women was strongly associated with factors reflecting body fat and its distribution, while in type 2 diabetic women preclinical atherosclerosis was associated with markers reflecting glucose and lipid metabolic disorders. PMID:26447509

  6. Who Is at Risk for Carotid Artery Disease?

    MedlinePlus

    ... Prevention Living With Clinical Trials Links Related Topics Atherosclerosis Carotid Endarterectomy Carotid Ultrasound Stents Stroke Send a ... who don’t have diabetes. Family history of atherosclerosis . People who have a family history of atherosclerosis ...

  7. Stroke from an External Carotid: Lesion Pattern and Mechanisms.

    PubMed

    Nicolas, Kagan; Hubert, Lathelyse; Leclère, Franck Marie; Etienne, Marchand; Robert, Martinez

    2016-04-01

    Traditionally, patients with symptomatic external carotid stenosis present with neck or face pain, retinal ischemic symptoms or jaw claudication and rarely as ipsilateral cerebrovascular events. In this present case, our patient suffered a stroke from a paradoxical embolism from the external carotid, without involvement of the internal carotid artery. A plaque ulceration of the external carotid's origin was the cause of this cerebral emboli. Duplex ultrasound showed a pathologic left external carotid, with a floating thrombus in the internal carotid. The diagnostic was confirmed by a computerized tomography scan. An external carotid thromboendarterectomy was performed 6 days after symptom onset, and intraoperative findings confirmed the plaque rupture with an extensive clot in the carotid bifurcation. PMID:26802301

  8. The relationship between the angiographic findings and the clinical features of carotid artery plaque.

    PubMed

    Kim, D I; Lee, S J; Lee, B B; Kim, Y I; Chung, C S; Seo, D W; Lee, K H; Ko, Y H; Kim, D K; Do, Y S; Byun, H S

    2000-01-01

    The purpose of this study was to investigate the histological characteristics of atheromatous carotid plaque, and to analyze the relationship between the angiographic findings and the clinical features. We retrospectively reviewed 55 cases of carotid endarterectomy for extracranial internal carotid artery stenosis, who were treated at our institute from January 1995 to December 1997. The histological examination included hematoxylin-eosin staining, Masson-trichrome staining, and immunostaining for antismooth muscle antibody and anti-CD68 antibody. The main compositions of the carotid plaque included synthetic type vascular smooth muscle cells and extracellular matrix. The histological findings showed ulceration in 49 (89.1%) cases, calcium deposits in 42 (76.4%) cases, and an inflammatory reaction in 44 (80.0%) cases. Neurological abnormalities were strongly associated with plaque ulceration (P = 0.045) and an inflammatory reaction (P = 0.013), whereas no correlation existed regarding calcium deposits (P = 0.173). The angiographic findings showed ulceration in 46 (83.6%) cases. Plaque ulceration in the angiography findings showed no statistically significant correlation with the histologic findings (P = 0.410) and preoperative neurologic abnormalities (P = 0.059). All of the atherosclerotic risk factors such as hypertension, smoking, diabetes mellitus, hyperlipidemia, and myocardial infarction had no statistically significant correlation with the histological features of the carotid plaque. In conclusion, the main compositions of carotid plaque were synthetic-type vascular smooth muscle cells and extracellular matrix. The histological ulceration and inflammatory reaction of the plaque showed a statistically significant correlation with the preoperative neurologic symptoms, whereas no correlation was seen in the calcium deposits. Angiographic ulceration showed no correlation with the histological findings or preoperative neurologic abnormalities. In addition, the

  9. [Outcomes of carotid endarterectomy performed in acute stage of ischaemic stroke].

    PubMed

    Shatravka, A V; Sokurenko, G Yu; Suvorov, S A; Rizakhanova, M R; Loginov, I A; Alekseeva, N V

    2016-01-01

    Recent years have witnessed several studies concerning optimal terms of performing carotid endarterectomy after endured acute cerebral circulation disorder (ACCD). However up to now there is no common opinion regarding feasibility and safety of performing carotid endarterectomy in the acute period of ischaemic stroke. The 2013 Russian National Guidelines on surgical management of diseases of extracranial arteries point to feasibility of performing carotid endarterectomy at terms within up to 2 weeks after endured ischaemic stroke (level B evidence). At the same time, there is no data concerning possibility of performing this type of operation in patients with neurological deficit scoring 4 points according to the Rankin scale. Analysing the results of 110 carotid endarterectomies performed in patients with haemodynamically meaningful stenosis of carotid arteries at terms varying from 2 to 14 days after the development of ipsilateral ACCD showed safety of the operation (the rate of postoperative cerebral circulation disorders amounted to 0.9% - 1 patient) and its efficacy in prevention of recurrent ischaemic complications, also determining regression of neurological symptomatology in the overwhelming majority - 86 (78%) patients. Despite the absence of recommendations on possibility to perform carotid endarterectomy in patients after endured ACCD with neurological deficiency scoring 4 points according to the modified Rankin scale we proved efficiency and feasibility of performing this type of operation in the cohort of patients concerned. There was not a single case of transformation of the ischaemic focus into haemorrhagic one. One patient developed fatal ACCD. During the follow up period (12 months) regression of neurological symptomatology was observed in 16 (66.7%) patients of 24 operated patients with baseline deficit of stage 4 according to the Rankin scale. PMID:27336345

  10. Carotid artery disease following external cervical irradiation

    SciTech Connect

    Elerding, S.C.; Fernandez, R.N.; Grotta, J.C.; Lindberg, R.D.; Causay, L.C.; McMurtrey, M.J.

    1981-01-01

    A retrospective study of 910 patients surviving at least five years after cervical irradiation for Hodgkin's disease, non-Hodgkin's lymphoma, or primary head an neck neoplasms showed the incidence of stroke following cervical irradiation was 63 of 910 patients (6.3%) during a mean period of observation of nine years. This represents a trend toward an increased risk for this population observed over the same period of time (p . 0.39). A prospective study of 118 similar patients currently living five years after cervical radiotherapy was performed to determine the incidence of carotid artery disease occurring as a consequence of neck irradiation. Abnormal carotid phonangiograms (CPA) were found in 25% of the patients and abnormal oculoplethysmographs (OPG) were found in 17%. These studies represent significant carotid lesions that are not expected in such a population. It is concluded that the carotid stenoses demonstrated are most likely a consequence of prior irradiation. Patients that are five-year survivors of cervical irradiation should have noninvasive vascular laboratory studies performed as part of their routine follow-up examinations in order to detect these carotid lesions while they are occult.

  11. Carotid intraplaque neovascularization quantification software (CINQS).

    PubMed

    Akkus, Zeynettin; van Burken, Gerard; van den Oord, Stijn C H; Schinkel, Arend F L; de Jong, Nico; van der Steen, Antonius F W; Bosch, Johan G

    2015-01-01

    Intraplaque neovascularization (IPN) is an important biomarker of atherosclerotic plaque vulnerability. As IPN can be detected by contrast enhanced ultrasound (CEUS), imaging-biomarkers derived from CEUS may allow early prediction of plaque vulnerability. To select the best quantitative imaging-biomarkers for prediction of plaque vulnerability, a systematic analysis of IPN with existing and new analysis algorithms is necessary. Currently available commercial contrast quantification tools are not applicable for quantitative analysis of carotid IPN due to substantial motion of the carotid artery, artifacts, and intermittent perfusion of plaques. We therefore developed a specialized software package called Carotid intraplaque neovascularization quantification software (CINQS). It was designed for effective and systematic comparison of sets of quantitative imaging biomarkers. CINQS includes several analysis algorithms for carotid IPN quantification and overcomes the limitations of current contrast quantification tools and existing carotid IPN quantification approaches. CINQS has a modular design which allows integrating new analysis tools. Wizard-like analysis tools and its graphical-user-interface facilitate its usage. In this paper, we describe the concept, analysis tools, and performance of CINQS and present analysis results of 45 plaques of 23 patients. The results in 45 plaques showed excellent agreement with visual IPN scores for two quantitative imaging-biomarkers (The area under the receiver operating characteristic curve was 0.92 and 0.93). PMID:25561454

  12. The Effect of Breakfast Type on Total Daily Energy Intake and Body Mass Index Among Thai School Children.

    PubMed

    Purttiponthanee, Sasiumphai; Rojroongwasinkul, Nipa; Wimonpeerapattana, Wanphen; Thasanasuwan, Wiyada; Senaprom, Sayamon; Khouw, Ilse; Deurenberg, Paul

    2016-07-01

    The study investigated the association between breakfast types consumed, daily energy intake, and body mass index for age Z-score (BAZ). Cross-sectional data from 1258 children aged 7 to 12.9 years were analyzed for breakfast type, nutrient intakes, BAZ, and proportion of overweight or obesity. Analysis of covariance was used to compare energy and nutrient intakes, BAZ, and proportion of overweight/obese children between breakfast groups. Only 19% of children had adequate energy intake from breakfast. Those consuming snacks had a significantly lower BAZ (Z = -0.73), with 5% of them being overweight/obese. Those consuming beverages and desserts had the lowest total daily energy intake (1314 kcal) and lowest protein intake (8.4 g). The results suggest that breakfast type is associated with daily energy intake and BAZ. Most breakfasts are not adequate. School-based nutrition education programs involving families, teachers, and health professionals can contribute to improve this situation. PMID:27183975

  13. Assessment of STR Typing Success Rate in Soft Tissues from Putrefied Bodies Based on a Quantitative Grading System for Putrefaction.

    PubMed

    Courts, Cornelius; Sauer, Eva; Hofmann, Yaiza; Madea, Burkhard; Schyma, Christian

    2015-07-01

    To date, there is no systematic investigation of the association of short tandem repeat (STR) typing success rate in soft tissues with different signs of putrefaction. Herein, putrefaction was rated using a newly developed 19-parameter system in soft tissues from a collective of 68 decaying bodies, and DNA yield was determined in 408 samples. DNA integrity was rated using a self-devised pentaplex PCR generating an "integrity score" (Si). STR typing success rate was then assessed for selected cases. DNA yield and Si differed significantly between tissues with kidney on average exhibiting the highest Si values. Statistical analysis revealed that nine parameters were significantly and positively correlated with Si . The observed values for each of these nine parameters were summed up to generate a putrefaction score (Sp) for each sample. Our results show that STR typing success rate can be predicted based on Sp before expensive multiplex STR profiling is performed. PMID:25808732

  14. Many-body Localization Transition in Rokhsar-Kivelson-type wave functions

    NASA Astrophysics Data System (ADS)

    Chen, Xiao; Yu, Xiongjie; Cho, Gil Young; Clark, Bryan; Fradkin, Eduardo

    We construct a family of many-body wave functions to study the many-body localization phase transition. The wave functions have a Rokhsar-Kivelson form, in which the weight for the configurations are chosen from the Gibbs weights of a classical spin glass model, known as the Random Energy Model, multiplied by a random sign structure to represent a highly excited state. These wave functions show a phase transition into an MBL phase. In addition, we see three regimes of entanglement scaling with subsystem size: scaling with entanglement corresponding to an infinite temperature thermal phase, constant scaling, and a sub-extensive scaling between these limits. Near the phase transition point, the fluctuations of the Renyi entropies are non-Gaussian. We find that Renyi entropies with different Renyi index transition into the MBL phase at different points and have different scaling behavior, suggesting a multifractal behavior. This work was supported in part by DMR-1064319 and DMR-1408713 (XC,GYC,EF) at the University of Illinois, PHY11-25915 at KITP (EF), DOE, SciDAC FG02-12ER46875 (BKC and XY), and the Brain Korea 21 PLUS Project of Korea Government (GYC).

  15. Hidden keys to survival: the type, density, pattern and functional role of emperor penguin body feathers.

    PubMed

    Williams, Cassondra L; Hagelin, Julie C; Kooyman, Gerald L

    2015-10-22

    Antarctic penguins survive some of the harshest conditions on the planet. Emperor penguins breed on the sea ice where temperatures drop below -40°C and forage in -1.8°C waters. Their ability to maintain 38°C body temperature in these conditions is due in large part to their feathered coat. Penguins have been reported to have the highest contour feather density of any bird, and both filoplumes and plumules (downy feathers) are reported absent in penguins. In studies modelling the heat transfer properties and the potential biomimetic applications of penguin plumage design, the insulative properties of penguin plumage have been attributed to the single afterfeather attached to contour feathers. This attribution of the afterfeather as the sole insulation component has been repeated in subsequent studies. Our results demonstrate the presence of both plumules and filoplumes in the penguin body plumage. The downy plumules are four times denser than afterfeathers and play a key, previously overlooked role in penguin survival. Our study also does not support the report that emperor penguins have the highest contour feather density. PMID:26490794

  16. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Carotid sinus nerve stimulator. 870.3850 Section... nerve stimulator. (a) Identification. A carotid sinus nerve stimulator is an implantable device used to decrease arterial pressure by stimulating Hering's nerve at the carotid sinus. (b) Classification....

  17. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Carotid sinus nerve stimulator. 870.3850 Section... nerve stimulator. (a) Identification. A carotid sinus nerve stimulator is an implantable device used to decrease arterial pressure by stimulating Hering's nerve at the carotid sinus. (b) Classification....

  18. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Carotid sinus nerve stimulator. 870.3850 Section... nerve stimulator. (a) Identification. A carotid sinus nerve stimulator is an implantable device used to decrease arterial pressure by stimulating Hering's nerve at the carotid sinus. (b) Classification....

  19. Ipragliflozin Improves Hepatic Steatosis in Obese Mice and Liver Dysfunction in Type 2 Diabetic Patients Irrespective of Body Weight Reduction.

    PubMed

    Komiya, Chikara; Tsuchiya, Kyoichiro; Shiba, Kumiko; Miyachi, Yasutaka; Furuke, Shunsaku; Shimazu, Noriko; Yamaguchi, Shinobu; Kanno, Kazuo; Ogawa, Yoshihiro

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is associated with a high incidence of non-alcoholic fatty liver disease (NAFLD) related to obesity and insulin resistance. Currently, medical interventions for NAFLD have focused on diet control and exercise to reduce body weight, and there is a requirement for effective pharmacological therapies. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are oral antidiabetic drugs that promote the urinary excretion of glucose by blocking its reabsorption in renal proximal tubules. SGLT2 inhibitors lower blood glucose independent of insulin action and are expected to reduce body weight because of urinary calorie loss. Here we show that an SGLT2 inhibitor ipragliflozin improves hepatic steatosis in high-fat diet-induced and leptin-deficient (ob/ob) obese mice irrespective of body weight reduction. In the obese mice, ipragliflozin-induced hyperphagia occurred to increase energy intake, attenuating body weight reduction with increased epididymal fat mass. There is an inverse correlation between weights of liver and epididymal fat in ipragliflozin-treated obese mice, suggesting that ipragliflozin treatment promotes normotopic fat accumulation in the epididymal fat and prevents ectopic fat accumulation in the liver. Despite increased adiposity, ipragliflozin ameliorates obesity-associated inflammation and insulin resistance in epididymal fat. Clinically, ipragliflozin improves liver dysfunction in patients with T2DM irrespective of body weight reduction. These findings provide new insight into the effects of SGLT2 inhibitors on energy homeostasis and fat accumulation and indicate their potential therapeutic efficacy in T2DM-associated hepatic steatosis. PMID:26977813

  20. Ipragliflozin Improves Hepatic Steatosis in Obese Mice and Liver Dysfunction in Type 2 Diabetic Patients Irrespective of Body Weight Reduction

    PubMed Central

    Komiya, Chikara; Tsuchiya, Kyoichiro; Shiba, Kumiko; Miyachi, Yasutaka; Furuke, Shunsaku; Shimazu, Noriko; Yamaguchi, Shinobu; Kanno, Kazuo; Ogawa, Yoshihiro

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is associated with a high incidence of non-alcoholic fatty liver disease (NAFLD) related to obesity and insulin resistance. Currently, medical interventions for NAFLD have focused on diet control and exercise to reduce body weight, and there is a requirement for effective pharmacological therapies. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are oral antidiabetic drugs that promote the urinary excretion of glucose by blocking its reabsorption in renal proximal tubules. SGLT2 inhibitors lower blood glucose independent of insulin action and are expected to reduce body weight because of urinary calorie loss. Here we show that an SGLT2 inhibitor ipragliflozin improves hepatic steatosis in high-fat diet-induced and leptin-deficient (ob/ob) obese mice irrespective of body weight reduction. In the obese mice, ipragliflozin-induced hyperphagia occurred to increase energy intake, attenuating body weight reduction with increased epididymal fat mass. There is an inverse correlation between weights of liver and epididymal fat in ipragliflozin-treated obese mice, suggesting that ipragliflozin treatment promotes normotopic fat accumulation in the epididymal fat and prevents ectopic fat accumulation in the liver. Despite increased adiposity, ipragliflozin ameliorates obesity-associated inflammation and insulin resistance in epididymal fat. Clinically, ipragliflozin improves liver dysfunction in patients with T2DM irrespective of body weight reduction. These findings provide new insight into the effects of SGLT2 inhibitors on energy homeostasis and fat accumulation and indicate their potential therapeutic efficacy in T2DM-associated hepatic steatosis. PMID:26977813

  1. Evaluation oF Epicardial Fat and Carotid Intima-Media Thickness in Obese Children

    PubMed Central

    Elshorbagy, Hatem Hamed; Fouda, ElSaeed R.; Kamal, Naglaa M.; Bassiouny, Mohammed M.; Fathi, Waleed M.

    2016-01-01

    Background: Epicardial fat has a role in cardiovascular diseases. Objectives: To assess epicardial fat and its relation with carotid intima-media thickness (IMT) in obese adolescents with metabolic syndrome (MetS). Patients and Methods: The study included 60 obese adolescents and 25 control subjects. According to the presence or absence of MetS, obese subjects were divided into two subgroups. We measured weight, height, calculated Body Mass Index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure and biochemical parameters (fasting glucose, total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol, High sensitivity C-reactive protein, fasting insulin, a homeostasis model assessment index of insulin resistance. plus an echocardiographic examination with measurement of epicardial adipose tissue thickness (EATT). Results: Left ventricular mass index measurements were significantly higher in MetS group than both non-MS and control groups. The MetS and non-MetS obese patients had significantly higher carotid IMT in comparison to the control group. Carotid IMT measurements were significantly higher in MetS group had than both non-MetS and control groups. Also, EATT was significantly increased in patients with MetS compared to control group. Among MetS obese group, EATT was positively correlated with body mass index-standard deviation score, waist circumference, fasting glucose, fasting insulin, insulin resistance, triglyceride levels, left ventricular thickness, left ventricular mass index and myocardial performance index. EATT was found to be the only predictor of carotid IMT. Conclusions: EATT is closely related to carotid IMT and early cardiac dysfunction in obese adolescents with MetS. PMID:26848373

  2. Do Differences in Chemical Composition of Stem and Cap of Amanita muscaria Fruiting Bodies Correlate with Topsoil Type?

    PubMed Central

    Deja, Stanisław; Wieczorek, Piotr P.; Halama, Marek; Jasicka-Misiak, Izabela; Kafarski, Paweł; Poliwoda, Anna; Młynarz, Piotr

    2014-01-01

    Fly agaric (Amanita muscaria) was investigated using a 1H NMR-based metabolomics approach. The caps and stems were studied separately, revealing different metabolic compositions. Additionally, multivariate data analyses of the fungal basidiomata and the type of soil were performed. Compared to the stems, A. muscaria caps exhibited higher concentrations of isoleucine, leucine, valine, alanine, aspartate, asparagine, threonine, lipids (mainly free fatty acids), choline, glycerophosphocholine (GPC), acetate, adenosine, uridine, 4-aminobutyrate, 6-hydroxynicotinate, quinolinate, UDP-carbohydrate and glycerol. Conversely, they exhibited lower concentrations of formate, fumarate, trehalose, α- and β-glucose. Six metabolites, malate, succinate, gluconate, N-acetylated compounds (NAC), tyrosine and phenylalanine, were detected in whole A. muscaria fruiting bodies but did not show significant differences in their levels between caps and stems (P value>0.05 and/or OPLS-DA loading correlation coefficient <0.4). This methodology allowed for the differentiation between the fruiting bodies of A. muscaria from mineral and mineral-organic topsoil. Moreover, the metabolomic approach and multivariate tools enabled to ascribe the basidiomata of fly agaric to the type of topsoil. Obtained results revealed that stems metabolome is more dependent on the topsoil type than caps. The correlation between metabolites and topsoil contents together with its properties exhibited mutual dependences. PMID:25437454

  3. Do differences in chemical composition of stem and cap of Amanita muscaria fruiting bodies correlate with topsoil type?

    PubMed

    Deja, Stanisław; Wieczorek, Piotr P; Halama, Marek; Jasicka-Misiak, Izabela; Kafarski, Paweł; Poliwoda, Anna; Młynarz, Piotr

    2014-01-01

    Fly agaric (Amanita muscaria) was investigated using a 1H NMR-based metabolomics approach. The caps and stems were studied separately, revealing different metabolic compositions. Additionally, multivariate data analyses of the fungal basidiomata and the type of soil were performed. Compared to the stems, A. muscaria caps exhibited higher concentrations of isoleucine, leucine, valine, alanine, aspartate, asparagine, threonine, lipids (mainly free fatty acids), choline, glycerophosphocholine (GPC), acetate, adenosine, uridine, 4-aminobutyrate, 6-hydroxynicotinate, quinolinate, UDP-carbohydrate and glycerol. Conversely, they exhibited lower concentrations of formate, fumarate, trehalose, α- and β-glucose. Six metabolites, malate, succinate, gluconate, N-acetylated compounds (NAC), tyrosine and phenylalanine, were detected in whole A. muscaria fruiting bodies but did not show significant differences in their levels between caps and stems (P value>0.05 and/or OPLS-DA loading correlation coefficient <0.4). This methodology allowed for the differentiation between the fruiting bodies of A. muscaria from mineral and mineral-organic topsoil. Moreover, the metabolomic approach and multivariate tools enabled to ascribe the basidiomata of fly agaric to the type of topsoil. Obtained results revealed that stems metabolome is more dependent on the topsoil type than caps. The correlation between metabolites and topsoil contents together with its properties exhibited mutual dependences. PMID:25437454

  4. Current status of carotid ultrasound in atherosclerosis

    PubMed Central

    2016-01-01

    Cardiovascular disease (CVD) primarily caused by atherosclerosis is a major cause of death and disability in developed countries. Sonographic carotid intima-media thickness (CIMT) is widely studied as a surrogate marker for detecting subclinical atherosclerosis for risk prediction and disease progress to guide medical intervention. However, there is no standardized CIMT measurement methodology in clinical studies resulting in inconsistent findings, thereby undermining the clinical value of CIMT. Increasing evidences show that CIMT alone has weak predictive value for CVD while CIMT including plaque presence consistently improves the predictive power. Quantification of plaque burden further enhances the predictive power beyond plaque presence. Sonographic carotid plaque characteristics have been found to be predictive of cerebral ischaemic events. With advances in ultrasound technology, enhanced assessment of carotid plaques is feasible to detect high-risk/vulnerable plaques, and provide risk assessment for ischemic stroke beyond measurement of luminal stenosis. PMID:27429912

  5. Reinterventions in vascular and endovascular carotid surgery.

    PubMed

    Setacci, F; Borrelli, M P; De Donato, G; Galzerano, G; Setacci, C

    2014-12-01

    In recent years the number of carotid revascularization has increased steadily. This increased has inevitably resulted in an increase (relative) in complications, both after carotid endarterectomy (CEA) and carotid stenting (CAS), despite the technical evolutions of new available materials and the expertise of the operators. So, complications which may potentially require operative intervention, although not very frequent, are possible. However, after diagnosis, immediate management should be undertaken in order to avoid sequelae which are often irreversible and potentially fatal. To minimize this risk, it's important that these procedures are performed by skilled operators in high-volume Centers of activity. The aim of this review is to assess local complications which can lead to re-interventions after CEA and CAS. PMID:25069448

  6. Carotid Atherosclerosis Does Not Predict Coronary, Vertebral, or Aortic Atherosclerosis in Patients with Acute Stroke Symptoms

    PubMed Central

    2010-01-01

    PURPOSE The purpose of this study was to determine whether significant atherosclerotic disease in the carotid arteries predicts significant atherosclerotic disease in the coronary arteries, vertebral arteries, or aorta in patients with symptoms of acute ischemic stroke. METHODS Atherosclerotic disease was imaged using computed tomography angiography (CTA) in a prospective study of 120 consecutive patients undergoing emergent CT evaluation for symptoms of stroke. Using a comprehensive CTA protocol that captured the carotid arteries, coronary arteries, vertebral arteries, and aorta, we evaluated these arteries for the presence and severity of atherosclerotic disease. Significant atherosclerotic disease was defined as > 50% stenosis in the carotid, coronary, and vertebral arteries, or ≥ 4mm thickness and encroaching in the aorta. Presence of any and significant atherosclerotic disease were compared in the different types of arteries assessed. RESULTS Of these 120 patients, 79 had CTA exams of adequate image quality and were evaluated in this study. Of these 79 patients, 33 had significant atherosclerotic disease. In 26 of these 33 patients (79%), significant disease was isolated to one type of artery, most often to the coronary arteries (N = 14; 54%). Non-significant atherosclerotic disease was more systemic and involved multiple arteries. CONCLUSIONS Significant atherosclerotic disease in the carotid arteries does not predict significant atherosclerotic disease in the coronary arteries, vertebral arteries, or aorta in patients with symptoms of acute ischemic stroke. Significant atherosclerotic disease is most often isolated to one type of artery in these patients, while non-significant atherosclerotic disease tends to be more systemic. PMID:20595672

  7. Place of drug therapy in the treatment of carotid stenosis.

    PubMed

    Andaluz, Norberto; Zuccarello, Mario

    2005-01-01

    Carotid stenosis is an important cause of transient ischaemic attacks and stroke. The cause of carotid stenosis is most often atherosclerosis; contributing to the pathogenesis of the lesion are endothelial injury, inflammation, lipid deposition, plaque formation, fibrin, platelets and thrombin. Carotid stenosis accounts for 10-20% of cases of brain infarction, depending on the population studied. Despite successful treatment of selected patients who have had an acute ischaemic stroke with tissue plasminogen activator and the promise of other experimental therapies, prevention remains the best approach to reducing the impact of ischaemic stroke. High-risk or stroke-prone patients can be identified and targeted for specific interventions. At this juncture, treatment of carotid stenosis is a well established therapeutic target and a pillar of stroke prevention. There are two main strategies for the treatment of carotid stenosis. The first approach is to stabilise or halt the progression of the carotid plaque through risk factor modification and medication. Hypertension, diabetes mellitus, smoking, obesity and high cholesterol levels are closely associated with carotid stenosis and stroke; control of these factors may decrease the risk of plaque formation and progression. The second approach is to eliminate or reduce carotid stenosis through carotid endarterectomy or carotid angioplasty and stenting. Carotid endarterectomy, which is the mainstay of therapy for severe carotid stenosis, is beyond the scope of this review. Anticoagulants seem to play little role (if any) in the medical (i.e. non-surgical) treatment of carotid stenosis. Adoption of a healthy lifestyle combined with the reduction of risk factors has been shown to lead to a reduction in the extent of carotid stenosis. The medical treatment of carotid stenosis should be based on the triad of the reduction of risk factors, patient education, and use of antiplatelet agents. PMID:15984896

  8. Bilateral carotid aneurysms unmasked by severe hypopituitarism.

    PubMed Central

    Michils, A.; Balériaux, D.; Mockel, J.

    1991-01-01

    We describe a patient who initially presented with severe hyponatraemia and grand mal seizures, without any focal neurological symptoms. The final diagnosis was that of giant bilateral carotid aneurysms extending into the sella turcica with anterior hypopituitarism. To the best of our knowledge, this is the first case report of symmetrical carotid aneurysms manifested exclusively by an acute endocrine emergency with none of the concomitant usual focal signs such as headache, failing vision, oculomotor palsy or subarachnoid hemorrhage. Images p286-a Figure 1 PMID:2062778

  9. Acute carotid artery dissection treated with stenting and hematoma aspiration guided by ultrasonography.

    PubMed

    Geng, Liming; Zha, Changsong; Liu, Hao; Xu, Jianjun; Xiang, Yuexia; Zou, Zhongmin

    2013-10-01

    We report the successful treatment of dissection with stenosis of the carotid artery by stenting and aspiration of hematoma. A male patient, presenting with acute blurred vision and weakness and numbness of the right side of his body, was diagnosed with common carotid artery (CCA) dissection and severe stenosis of the internal carotid artery and CCA by digital subtraction arteriography and color Doppler ultrasonography (CDU). Two stents were separately implanted into the left internal carotid artery and CCA to restore blood flow and seal the opening of the dissection. The hematoma inside the CCA dissection was transcutaneously aspirated under CDU guidance after thrombolysis with tissue plasminogen activator. Three days after the operation, the dissection was still sealed. The patient was discharged 1 week later without any signs or symptoms. Follow-up examination at 70 days confirmed complete healing of the CCA dissection. Transcutaneous intradissection hematoma aspiration with CDU guidance may be applicable in treating arterial dissection, especially when conservative treatments cannot be expected to improve severe flow disturbances. PMID:22941665

  10. An Integrated Backscatter Ultrasound Technique for the Detection of Coronary and Carotid Atherosclerotic Lesions

    PubMed Central

    Kawasaki, Masanori

    2015-01-01

    The instability of carotid and coronary plaques has been reported to be associated with acute coronary syndrome, strokes and other cerebrovascular events. Therefore, recognition of the tissue characteristics of carotid and coronary plaques is important to understand and prevent coronary and cerebral artery disease. Recently, an ultrasound integrated backscatter (IB) technique has been developed. The ultrasound IB power ratio is a function of the difference in acoustic characteristic impedance between the medium and target tissue, and the acoustic characteristic impedance is determined by the density of tissue multiplied by the speed of sound. This concept allows for tissue characterization of carotid and coronary plaques for risk stratification of patients with coronary and cerebral artery disease. Two- and three-dimensional IB color-coded maps for the evaluation of tissue components consist of four major components: fibrous, dense fibrosis, lipid pool and calcification. Although several ultrasound techniques using special mathematical algorithms have been reported, a growing body of literature has shown the reliability and usefulness of the IB technique for the tissue characterization of carotid and coronary plaques. This review summarizes concepts, experimental procedures, image reliability and the application of the IB technique. Furthermore, the IB technique is compared with other techniques. PMID:25574937

  11. Effects of partial neuromuscular blockade on carotid baroreflex function during exercise in humans.

    PubMed

    Gallagher, K M; Fadel, P J; Strømstad, M; Ide, K; Smith, S A; Querry, R G; Raven, P B; Secher, N H

    2001-06-15

    1. This investigation was designed to determine the contribution of central command to the resetting of the carotid baroreflex during static and dynamic exercise in humans. 2. Thirteen subjects performed 3.5 min of static one-legged exercise (20 % maximal voluntary contraction) and 7 min dynamic cycling (20 % maximal oxygen uptake) under two conditions: control (no intervention) and with partial neuromuscular blockade (to increase central command influence) using Norcuron (curare). Carotid baroreflex function was determined at rest and during steady-state exercise using a rapid neck pressure/neck suction technique. Whole-body Norcuron was repeatedly administered to effectively reduce hand-grip strength by approximately 50 % of control. 3. Partial neuromuscular blockade increased heart rate, mean arterial pressure, perceived exertion, lactate concentration and plasma noradrenaline concentration during both static and dynamic exercise when compared to control (P < 0.05). No effect was seen at rest. Carotid baroreflex resetting was augmented from control static and dynamic exercise by partial neuromuscular blockade without alterations in gain (P < 0.05). In addition, the operating point of the reflex was relocated away from the centring point (i.e. closer to threshold) during exercise by partial neuromuscular blockade (P < 0.05). 4. These findings suggest that central command actively resets the carotid baroreflex during dynamic and static exercise. PMID:11410641

  12. An integrated backscatter ultrasound technique for the detection of coronary and carotid atherosclerotic lesions.

    PubMed

    Kawasaki, Masanori

    2015-01-01

    The instability of carotid and coronary plaques has been reported to be associated with acute coronary syndrome, strokes and other cerebrovascular events. Therefore, recognition of the tissue characteristics of carotid and coronary plaques is important to understand and prevent coronary and cerebral artery disease. Recently, an ultrasound integrated backscatter (IB) technique has been developed. The ultrasound IB power ratio is a function of the difference in acoustic characteristic impedance between the medium and target tissue, and the acoustic characteristic impedance is determined by the density of tissue multiplied by the speed of sound. This concept allows for tissue characterization of carotid and coronary plaques for risk stratification of patients with coronary and cerebral artery disease. Two- and three-dimensional IB color-coded maps for the evaluation of tissue components consist of four major components: fibrous, dense fibrosis, lipid pool and calcification. Although several ultrasound techniques using special mathematical algorithms have been reported, a growing body of literature has shown the reliability and usefulness of the IB technique for the tissue characterization of carotid and coronary plaques. This review summarizes concepts, experimental procedures, image reliability and the application of the IB technique. Furthermore, the IB technique is compared with other techniques. PMID:25574937

  13. Unilateral Direct Carotid Cavernous Fistula Causing Bilateral Ocular Manifestation

    PubMed Central

    Demartini Jr., Zeferino; Liebert, Fernando; Gatto, Luana Antunes Maranha; Jung, Thiago Simiano; Rocha Jr., Carlos; Santos, Alex Marques Borges; Koppe, Gelson Luis

    2015-01-01

    Unilateral carotid cavernous fistula presents with ipsilateral ocular findings. Bilateral presentation is only seen in bilateral fistulas, usually associated with indirect (dural) carotid cavernous fistulas. Direct carotid cavernous fistulas are an abnormal communication between the internal carotid artery and the cavernous sinus. They typically begin with a traumatic disruption in the artery wall into the cavernous sinus, presenting with a classic triad of unilateral pulsatile exophthalmos, cranial bruit and episcleral venous engorgement. We report the case of a 38-year-old male with traumatic right carotid cavernous sinus fistula and bilateral ocular presentation successfully treated by interventional neuroradiology. PMID:26955353

  14. Improving imaging to optimize screening strategies for carotid artery stenosis.

    PubMed

    Pandya, Ankur; Gupta, Ajay

    2016-01-01

    Carotid stenosis is a major risk factor for ischemic stroke. Recently, the United States Preventive Services Task Force issued a recommendation against screening for carotid stenosis in the general population. There is the potential for efficient risk-stratifying or staged screening approaches that identify individuals at highest risk for carotid stenosis and stroke, but these tools have yet to be proven effective in external validation studies. In this paper, we review how medical imaging can be used to detect carotid stenosis and highlight several areas that could be improved to identify potentially efficient screening strategies for carotid stenosis. PMID:26275846

  15. Concurrence of the tortuosity of bilateral common and left internal carotid arteries in a case with common origin of the innominate trunk and left common carotid artery.

    PubMed

    Yildiz, Sema; Cece, Hasan; Karayol, Sibel; Ziylan, Zeki

    2010-10-01

    Anatomical variations of carotid arterial system, which are not infrequently encountered, have great impact on the surgical approaches of the neck. Although few reports on common carotid artery tortuosity have been published, no case of symptomatic concurrent common carotid and internal carotid artery tortuosity has been reported. Herein, we report the first case with concurrent common origin of the innominate trunk and left common carotid artery and common and internal carotid artery tortuosity presenting with an oropharyngeal mass. PMID:20407773

  16. Usage Position and Virtual Keyboard Design Affect Upper-Body Kinematics, Discomfort, and Usability during Prolonged Tablet Typing

    PubMed Central

    Lin, Ming-I Brandon; Hong, Ruei-Hong; Chang, Jer-Hao; Ke, Xin-Min

    2015-01-01

    Purpose The increase in tablet usage allows people to perform computer work in non-traditional office environments. The aim of this study was to assess the effects of changes in tablet keyboard design on postures of the upper extremities and neck, discomfort, and usability under different usage positions during prolonged touch-typing. Methods Eighteen healthy participants familiar with touch-screen devices were randomized into three usage positions (desk, lap, and bed) and completed six, 60-minute typing sessions using three virtual keyboard designs (standard, wide, split). Electrogoniometers continuously measured the postures of the wrists, elbow, and neck. Body discomfort and system usability were evaluated by questionnaires before and immediately after each typing session. Results Separate linear mixed effects models on various postural measures and subjective ratings are conducted with usage position as the between-subject factors, keyboard design and typing duration as the with-in subject factors were conducted. Using the tablet in bed led to more extended wrists but a more natural elbow flexion than the desk position. The angled split virtual keyboard significantly reduced the extent of wrist ulnar deviation than the keyboard with either standard or wide design. However, little difference was observed across the usage position and keyboard design. When the postural data were compared between the middle and end of typing sessions, the wrists, elbow, and neck all exhibited a substantially increased range of joint movements (13% to 38%). The discomfort rating also increased significantly over time in every upper body region investigated. Additionally, the split keyboard design received a higher usability rating in the bed position, whereas participants had more satisfactory experience while using the wide keyboard in the traditional desk setting. Conclusions Prolonged use of tablets in non-traditional office environments may result in awkward postures in the

  17. Replication at body temperature selects a neurovirulent herpes simplex virus type 2.

    PubMed Central

    Thompson, R L; Stevens, J G

    1983-01-01

    A prototype strain of herpes simplex virus type 2 (HG-52) replicated at 31 degrees C was avirulent when inoculated intracranially into mice. This property was not altered after serial passage of the agent at 31 degrees C, but the virus became virulent after passage at 37.5 degrees C. The selection was not merely for an agent which replicated more efficiently at the higher temperature, but for viruses with enhanced capacity to replicate in the brains of mice. Virulent descendants of plaque-purified avirulent stocks were obtained in each instance attempted. PMID:6307887

  18. A surgical case of paraclinoid carotid aneurysm associated with ipsilateral cervical internal carotid artery dissection.

    PubMed

    Takeuchi, Satoru; Wada, Kojiro; Sakakibara, Fumihiro; Mori, Kentaro

    2012-01-01

    This report presents a 60-year-old with a large paraclinoid carotid aneurysm associated with cervical interal carotid artery (ICA) dissection (CICAD). She had a fall while riding a bicycle and hit her head on the ground. Computed tomography scan done at another facility showed a round mass lesion near the sella. Her medical history revealed gradual decrease in left eye vision since two years. Left carotid artery digital subtraction angiography demonstrated a CICAD with an intimal flap and a large paraclinoid aneurysm (15.5 mm in size). She underwent a high-flow bypass with a so-called double-insurance bypass and proximal ligation of the cervical ICA and the postoperative course was uneventful. She was discharged without any new neurological deficits. We suggest that the possible nature of carotid artery dissection (CAD)-related hemodynamic changes should be taken into consideration in cases of intracranial aneurysm associated with CAD. PMID:23135031

  19. Lactobacillus casei reduces susceptibility to type 2 diabetes via microbiota-mediated body chloride ion influx

    PubMed Central

    Zhang, Yong; Guo, Xiao; Guo, Jianlin; He, Qiuwen; Li, He; Song, Yuqin; Zhang, Heping

    2014-01-01

    Gut microbiota mediated low-grade inflammation is involved in the onset of type 2 diabetes (T2DM). In this study, we used a high fat sucrose (HFS) diet-induced pre-insulin resistance and a low dose-STZ HFS rat models to study the effect and mechanism of Lactobacillus casei Zhang in protecting against T2DM onset. Hyperglycemia was favorably suppressed by L. casei Zhang treatment. Moreover, the hyperglycemia was connected with type 1 immune response, high plasma bile acids and urine chloride ion loss. This chloride ion loss was significantly prevented by L. casei via upregulating of chloride ion-dependent genes (ClC1-7, GlyRα1, SLC26A3, SLC26A6, GABAAα1, Bestrophin-3 and CFTR). A shift in the caecal microflora, particularly the reduction of bile acid 7α-dehydroxylating bacteria, and fecal bile acid profiles also occurred. These change coincided with organ chloride influx. Thus, we postulate that the prevention of T2DM onset by L. casei Zhang may be via a microbiota-based bile acid-chloride exchange mechanism. PMID:25133590

  20. Lactobacillus casei reduces susceptibility to type 2 diabetes via microbiota-mediated body chloride ion influx.

    PubMed

    Zhang, Yong; Guo, Xiao; Guo, Jianlin; He, Qiuwen; Li, He; Song, Yuqin; Zhang, Heping

    2014-01-01

    Gut microbiota mediated low-grade inflammation is involved in the onset of type 2 diabetes (T2DM). In this study, we used a high fat sucrose (HFS) diet-induced pre-insulin resistance and a low dose-STZ HFS rat models to study the effect and mechanism of Lactobacillus casei Zhang in protecting against T2DM onset. Hyperglycemia was favorably suppressed by L. casei Zhang treatment. Moreover, the hyperglycemia was connected with type 1 immune response, high plasma bile acids and urine chloride ion loss. This chloride ion loss was significantly prevented by L. casei via upregulating of chloride ion-dependent genes (ClC1-7, GlyRα1, SLC26A3, SLC26A6, GABAAα1, Bestrophin-3 and CFTR). A shift in the caecal microflora, particularly the reduction of bile acid 7α-dehydroxylating bacteria, and fecal bile acid profiles also occurred. These change coincided with organ chloride influx. Thus, we postulate that the prevention of T2DM onset by L. casei Zhang may be via a microbiota-based bile acid-chloride exchange mechanism. PMID:25133590

  1. Reverse-correlating mental representations of sex-typed bodies: the effect of number of trials on image quality

    PubMed Central

    Lick, David J.; Carpinella, Colleen M.; Preciado, Mariana A.; Spunt, Robert P.; Johnson, Kerri L.

    2013-01-01

    Sex categorization is a critical process in social perception. While psychologists have long theorized that perceivers have distinct mental representations of men and women that help them to achieve efficient sex categorizations, researchers have only recently begun using reverse-correlation to visualize the content of these mental representations. The present research addresses two issues concerning this relatively new methodological tool. First, previous studies of reverse-correlation have focused almost exclusively on perceivers' mental representations of faces. Our study demonstrates that this technique can also be used to visualize mental representations of sex-typed bodies. Second, most studies of reverse-correlation have employed a relatively large number of trials (1000+) to capture perceivers' mental representations of a given category. Our study demonstrated that, at least for sex-typed representations of bodies, high quality reverse-correlation images can be obtained with as few as 100 trials. Overall, our findings enhance knowledge of reverse-correlation methodology in general and sex categorization in particular, providing new information for researchers interested in using this technique to understand the complex processes underlying social perception. PMID:23908637

  2. The L-type voltage-dependent Ca2+ channel EGL-19 controls body wall muscle function in Caenorhabditis elegans

    PubMed Central

    Jospin, Maëlle; Jacquemond, Vincent; Mariol, Marie-Christine; Ségalat, Laurent; Allard, Bruno

    2002-01-01

    Caenorhabditis elegans is a powerful model system widely used to investigate the relationships between genes and complex behaviors like locomotion. However, physiological studies at the cellular level have been restricted by the difficulty to dissect this microscopic animal. Thus, little is known about the properties of body wall muscle cells used for locomotion. Using in situ patch clamp technique, we show that body wall muscle cells generate spontaneous spike potentials and develop graded action potentials in response to injection of positive current of increasing amplitude. In the presence of K+ channel blockers, membrane depolarization elicited Ca2+ currents inhibited by nifedipine and exhibiting Ca2+-dependent inactivation. Our results give evidence that the Ca2+ channel involved belongs to the L-type class and corresponds to EGL-19, a putative Ca2+ channel originally thought to be a member of this class on the basis of genomic data. Using Ca2+ fluorescence imaging on patch-clamped muscle cells, we demonstrate that the Ca2+ transients elicited by membrane depolarization are under the control of Ca2+ entry through L-type Ca2+ channels. In reduction of function egl-19 mutant muscle cells, Ca2+ currents displayed slower activation kinetics and provided a significantly smaller Ca2+ entry, whereas the threshold for Ca2+ transients was shifted toward positive membrane potentials. PMID:12391025

  3. Mixing in the human carotid artery during carotid drug infusion studied with PET.

    PubMed

    Junck, L; Koeppe, R A; Greenberg, H S

    1989-10-01

    The safety and efficacy of drug infusion into the carotid artery require adequate mixing of the infused solution with carotid blood. Using positron emission tomography (PET), we studied the mixing of solutions infused into the human carotid artery in seven patients by analyzing the distribution of [15O]H2O infused into the carotid artery and by vein. At four infusion rates ranging from 0.5 to 10 ml/min, the variability in distribution averaged 16.5-17.8% among the pixels in a large volume of interest, without dependence on the infusion rate. The overall correlation between [15O]H2O influx with arterial infusion and [15O]H2O influx with venous injection was 0.78-0.82 at the four infusion rates, with no trend toward higher correlations at the faster infusion rates. The distribution into the anterior, middle, and posterior cerebral artery territories differed from distribution throughout the entire carotid territory by an average of 6.2-9.6% at the four infusion rates, with no trend toward smaller differences at the faster infusion rates. Infusions performed into a vinyl tube simulating the carotid artery indicated that at 0.5 ml/min, the velocity of fluid exiting the catheter makes no apparent contribution to mixing. We conclude that with infusions at the carotid bifurcation, mixing in the human carotid artery is complete or nearly complete over a wide range of infusion rates. The mixing appears to result from the patterns of blood flow within the artery, and not from jet effects at the catheter tip. PMID:2789230

  4. The role of the solitary and paramedian reticular nuclei in mediating cardiovascular reflex responses from carotid baro- and chemoreceptors

    PubMed Central

    Miura, Mitsuhiko; Reis, Donald J.

    1972-01-01

    1. With dye-filled micro-electrodes single neurones in the medulla of anaesthetized paralysed cats were identified which: (a) fired rhythmically in synchrony with or were modulated by the cardiac cycle, and which ceased firing with occlusion of the ipsilateral common carotid artery (carotid sinus baroreceptor neurones); (b) were excited by stimulation of carotid body chemoreceptors by close intra-arterial injection of lobeline into the thyroid artery (carotid body chemoreceptor neurones). 2. Twelve carotid baroreceptor neurones were identified, in thirty-three cats, nine of which were localized in the intermediate area of the nucleus of the solitary tract (NTS) within 1 mm ahead of or behind the obex; three units were located either in the parahypoglossal area or the dorsal portion of the paramedian reticular nucleus (PRN). 3. Of the twenty-one carotid chemoreceptor neurones which were identified, thirteen were localized in the NTS, three in the parahypoglossal area and four in the dorsal PRN. 4. Bilateral lesions of the paramedian reticular area of medulla destroying the PRN, abolished or reversed the depressor response to electrical stimulation of myelinated fibres of the carotid sinus nerve (CSN), attenuated the depressor response to carotid sinus stretch and augmented the pressor response to chemoreceptor stimulation by lobeline. Such lesions did not significantly alter the reflex heart rate responses. 5. Small lesions of the NTS within an area 1 mm rostral to the obex abolished all reflex blood pressure and heart rate responses to electrical stimulation of the CSN or natural stimulation of carotid baro- or chemoreceptors. 6. Baroreceptors and chemoreceptors of the CSN project both to the intermediate zone of the NTS and to more medial areas of the medulla, particularly the dorsal PRN and parahypoglossal area. 7. The PRN serves to mediate the reflex depressor, but not cardio-vagal, response from myelinated baroreceptors and buffers the pressor responses from

  5. A multi-tissue type genome-scale metabolic network for analysis of whole-body systems physiology

    PubMed Central

    2011-01-01

    Background Genome-scale metabolic reconstructions provide a biologically meaningful mechanistic basis for the genotype-phenotype relationship. The global human metabolic network, termed Recon 1, has recently been reconstructed allowing the systems analysis of human metabolic physiology and pathology. Utilizing high-throughput data, Recon 1 has recently been tailored to different cells and tissues, including the liver, kidney, brain, and alveolar macrophage. These models have shown utility in the study of systems medicine. However, no integrated analysis between human tissues has been done. Results To describe tissue-specific functions, Recon 1 was tailored to describe metabolism in three human cells: adipocytes, hepatocytes, and myocytes. These cell-specific networks were manually curated and validated based on known cellular metabolic functions. To study intercellular interactions, a novel multi-tissue type modeling approach was developed to integrate the metabolic functions for the three cell types, and subsequently used to simulate known integrated metabolic cycles. In addition, the multi-tissue model was used to study diabetes: a pathology with systemic properties. High-throughput data was integrated with the network to determine differential metabolic activity between obese and type II obese gastric bypass patients in a whole-body context. Conclusion The multi-tissue type modeling approach presented provides a platform to study integrated metabolic states. As more cell and tissue-specific models are released, it is critical to develop a framework in which to study their interdependencies. PMID:22041191

  6. Emergency carotid thromboendarterectomy: safe and effective.

    PubMed

    Schneider, C; Johansen, K; Königstein, R; Metzner, C; Oettinger, W

    1999-11-01

    Whether to perform emergency carotid thromboendarterectomy (CTEA) in the presence of crescendo transient ischemic attacks or stroke-in-evolution is controversial, with the operative mortality in some reports exceeding 20% and improvement in neurologic deficit of less than 40% in others. Our anecdotal experience with emergency CTEA for acute, persistent, or crescendo neurologic deficit had been strikingly better than published reports. Accordingly, we carried out a restrospective comparison of 43 such patients undergoing emergency CTEA with 237 patients concurrently undergoing elective CTEA for conventional indications. A standard protocol followed in emergency CTEA patients included carotid Doppler ultrasonography, computed cerebral tomography (CT), four-vessel cerebral arteriography, and intravenous heparin. Exclusions from emergency CTEA included coma or cerebral CT scan evidence for either hemorrhagic or ischemic infarction with edema. Operative techniques included standard carotid endarterectomy with Dacron patch or direct suture, eversion endarterectomy, or shortening resection. No mortality or central neurologic complications resulted among the 43 emergency CTEA patients, in comparison to no deaths and one temporary hemiparesis (0.4% central neurologic morbidity) in the 237 elective CTEA patients. Our results suggest that in the absence of coma or cerebral CT scan evidence for an unstable blood-brain barrier, emergency carotid reconstruction can be performed safely and with excellent outcome notwithstanding the magnitude and severity of the acute preoperative neurologic deficit. PMID:10501879

  7. Effect of clothing type on body composition in adults across a wide range of body mass index (BMI) using air displacement plethysmography (ADP)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    ADP, using Bod Pod, is a popular method to assess body composition. For valid results, however, the manufacturer warrants tight-fitting clothing (swimsuit or spandex), which may be uncomfortable or impractical for overweight (O) and obese (OB) persons or those with negative body image. This study c...

  8. Associations of Forest Type, Parasitism and Body Condition of Two European Passerines, Fringilla coelebs and Sylvia atricapilla

    PubMed Central

    Lüdtke, Bruntje; Moser, Isabelle; Santiago-Alarcon, Diego; Fischer, Markus; Kalko, Elisabeth KV.; Schaefer, H. Martin; Suarez-Rubio, Marcela; Tschapka, Marco; Renner, Swen C.

    2013-01-01

    Human-induced forest modification can alter parasite-host interactions and might change the persistence of host populations. We captured individuals of two widespread European passerines (Fringilla coelebs and Sylvia atricapilla) in southwestern Germany to disentangle the associations of forest types and parasitism by haemosporidian parasites on the body condition of birds. We compared parasite prevalence and parasite intensity, fluctuating asymmetries, leukocyte numbers, and the heterophil to lymphocyte ratio (H/L-ratio) among individuals from beech, mixed-deciduous and spruce forest stands. Based on the biology of bird species, we expected to find fewer infected individuals in beech or mixed-deciduous than in spruce forest stands. We found the highest parasite prevalence and intensity in beech forests for F. coelebs. Although, we found the highest prevalence in spruce forests for S. atricapilla, the highest intensity was detected in beech forests, partially supporting our hypothesis. Other body condition or health status metrics, such as the heterophil to lymphocyte ratio (H/L-ratio), revealed only slight differences between bird populations inhabiting the three different forest types, with the highest values in spruce for F. coelebs and in mixed-deciduous forests for S. atricapilla. A comparison of parasitized versus non-parasitized individuals suggests that parasite infection increased the immune response of a bird, which was detectable as high H/L-ratio. Higher infections with blood parasites for S. atricapilla in spruce forest indicate that this forest type might be a less suitable habitat than beech and mixed-deciduous forests, whereas beech forests seem to be a suboptimal habitat regarding parasitism for F. coelebs. PMID:24339923

  9. Container Type Influences the Relative Abundance, Body Size, and Susceptibility of Ochlerotatus triseriatus (Diptera: Culicidae) to La Crosse Virus.

    PubMed

    Bara, Jeffrey J; Muturi, Ephantus J

    2015-05-01

    Ochlerotatus triseriatus (Say), the primary vector of La Crosse virus (LAC), develops in a variety of natural and artificial aquatic containers where it often co-occurs with larvae of other mosquito species. We conducted a field study at two woodlots (South Farms and Trelease Woods) in Urbana, IL, to examine how container type influences vector abundance, body size, and susceptibility to LAC. Mosquito pupae were collected from tree holes, plastic bins, and waste tires, and eclosing adults were identified to species morphologically. Oc. triseriatus and Ochlerotatus japonicus (Theobald) females were orally challenged with LAC and midgut infection rate, disseminated infection rate, and body titer were determined by reverse-transcriptase real-time PCR. Oc. triseriatus was the dominant species collected in tree holes while Oc. japonicus and Culex restuans (Theobald) were mostly dominant in artificial containers. Female Oc. triseriatus and Oc. japonicus collected from plastic bins were significantly larger than those collected from tree holes or waste tires. Oc. japonicus females from South Farms were also significantly larger than those from Trelease Woods. Oc. triseriatus females collected from plastic bins and waste tires were significantly more susceptible to LAC infection relative to females collected from tree holes. In addition, Oc. triseriatus females from waste tires had significantly higher LAC titer relative to Oc. triseriatus from tree holes. For each container type and study site, wing length was not correlated to infection or dissemination rates. These findings suggest that the container type in which Oc.triseriatus develop may contribute to the spatial and temporal dynamics of LAC transmission. PMID:26334821

  10. D2 Dopamine receptor Taq1A polymorphism, body weight, and dietary intake in type 2 diabetes

    PubMed Central

    Barnard, Neal D.; Noble, Ernest P.; Ritchie, Terry; Cohen, Joshua; Jenkins, David J.A.; Turner-McGrievy, Gabrielle; Gloede, Lise; Ferdowsian, Hope

    2008-01-01

    OBJECTIVE Certain D2 dopamine receptor Taq 1A genotypes (A1A1, A1A2) have been associated with obesity and substance abuse. We hypothesized that their presence would be associated with reduced efficacy of dietary interventions in individuals with type 2 diabetes. RESEARCH METHODS & PROCEDURES In the course of a randomized clinical trial in an outpatient research center in which 93 adults with type 2 diabetes were assigned to a low-fat vegan diet or a diet following 2003 American Diabetes Association guidelines for 74 weeks, Taq 1A genotype was determined. Nutrient intake, body weight, and hemoglobin A1c (A1c) were measured over 74 weeks. RESULTS The A1 allele was highly prevalent, occurring in 47% of white participants (n = 49), which was significantly higher than the 29% prevalence previously reported in nondiabetic whites (P=0.01). The A1 allele was found in 55% of black participants (n = 44). Black participants with A1+ genotypes had significantly greater mean body weight (11.2 kg heavier, P=0.05), and greater intake of fat (P=0.002), saturated fat (P=0.01) and cholesterol (P=0.02), compared with A2A2 (A1-) individuals; dietary changes during the study did not favor one genotype group. Among whites, baseline anthropometric and nutrient differences between gene groups were small. However, among whites in the vegan group, A1+ individuals reduced fat intake (P=0.04) and A1c (P=0.01) significantly less than did A1- individuals. CONCLUSIONS The A1 allele appears to be highly prevalent among individuals with type 2 diabetes. Potential influences on diet, weight, and glycemic control merit further exploration. PMID:18834717

  11. Pseudo-Orbital Apex Syndrome in the Acute Trauma Setting Due to Ipsilateral Dissection of Internal Carotid Artery.

    PubMed

    Anders, Ursula M; Taylor, Elise J; Martel, Joseph R; Martel, James B

    2016-01-01

    Traumatic causes of orbital apex and superior orbital fissure syndrome are uncommon. The authors present the first case of a traumatic superior orbital fissure syndrome simulating orbital apex syndrome, with loss of vision from posterior ischemic optic neuropathy. A 35-year-old man was initially felt to have a right orbital apex syndrome with left craniofacial and orbital trauma. CT revealed left orbital fractures, a right superior orbital fissure fracture, a retained metallic foreign body in the right sphenoid sinus, and a right frontoparietal subdural hematoma. CT angiography showed a secondary dissection and occlusion of the right internal carotid artery from osseous erosion of the posterolateral wall of the sphenoid sinus. Internal carotid artery dissection is a possible, though rare, cause of ischemic optic neuropathy. The right pseudo-orbital apex syndrome resulted from a mechanical superior orbital fissure syndrome and posterior ischemic optic neuropathy from an internal carotid artery dissection. PMID:25216200

  12. Automated carotid artery intima layer regional segmentation

    NASA Astrophysics Data System (ADS)

    Meiburger, Kristen M.; Molinari, Filippo; Rajendra Acharya, U.; Saba, Luca; Rodrigues, Paulo; Liboni, William; Nicolaides, Andrew; Suri, Jasjit S.

    2011-07-01

    Evaluation of the carotid artery wall is essential for the assessment of a patient's cardiovascular risk or for the diagnosis of cardiovascular pathologies. This paper presents a new, completely user-independent algorithm called carotid artery intima layer regional segmentation (CAILRS, a class of AtheroEdge™ systems), which automatically segments the intima layer of the far wall of the carotid ultrasound artery based on mean shift classification applied to the far wall. Further, the system extracts the lumen-intima and media-adventitia borders in the far wall of the carotid artery. Our new system is characterized and validated by comparing CAILRS borders with the manual tracings carried out by experts. The new technique is also benchmarked with a semi-automatic technique based on a first-order absolute moment edge operator (FOAM) and compared to our previous edge-based automated methods such as CALEX (Molinari et al 2010 J. Ultrasound Med. 29 399-418, 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CULEX (Delsanto et al 2007 IEEE Trans. Instrum. Meas. 56 1265-74, Molinari et al 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CALSFOAM (Molinari et al Int. Angiol. (at press)), and CAUDLES-EF (Molinari et al J. Digit. Imaging (at press)). Our multi-institutional database consisted of 300 longitudinal B-mode carotid images. In comparison to semi-automated FOAM, CAILRS showed the IMT bias of -0.035 ± 0.186 mm while FOAM showed -0.016 ± 0.258 mm. Our IMT was slightly underestimated with respect to the ground truth IMT, but showed uniform behavior over the entire database. CAILRS outperformed all the four previous automated methods. The system's figure of merit was 95.6%, which was lower than that of the semi-automated method (98%), but higher than that of the other automated techniques.

  13. Intracranial Carotid Calcification on Cranial Computed Tomography

    PubMed Central

    Subedi, Deepak; Zishan, Umme Sara; Chappell, Francesca; Gregoriades, Maria-Lena; Sudlow, Cathie; Sellar, Robin

    2015-01-01

    Background and Purpose— Intracranial internal carotid artery calcification is associated with cerebrovascular risk factors and stroke, but few quantification methods are available. We tested the reliability of visual scoring, semiautomated Agatston score, and calcium volume measurement in patients with recent stroke. Methods— We used scans from a prospective hospital stroke registry and included patients with anterior circulation ischemic stroke or transient ischemic stroke whose noncontrast cranial computed tomographic scans were available electronically. Two raters measured semiautomatic quantitative Agatston score, and calcium volume, and performed qualitative visual scoring using the original 4-point Woodcock score and a modified Woodcock score, where each image on which the internal carotid arteries appeared was scored and the slice scores summed. Results— Intra- and interobserver coefficient of variations were 8.8% and 16.5% for Agatston, 8.8% and 15.5% for calcium volume, and 5.7% and 5.4% for the modified Woodcock visual score, respectively. The modified Woodcock visual score correlated strongly with both Agatston and calcium volume quantitative measures (both R2=0.84; P<0.0001); calcium volume increased by 0.47-mm/point increase in modified Woodcock visual score. Intracranial internal carotid artery calcification increased with age by all measures (eg, visual score, Spearman ρ=0.4; P=0.005). Conclusions— Visual scores correlate highly with quantitative intracranial internal carotid artery calcification measures, with excellent observer agreements. Visual intracranial internal carotid artery scores could be a rapid and practical method for epidemiological studies. PMID:26251250

  14. Management of carotid stenosis. History and today

    PubMed Central

    Jargiełło, Tomasz; Drelich-Zbroja, Anna

    2013-01-01

    Internal carotid stenosis constitutes a significant clinical challenge, since it is the cause of 20–25% of ischemic brain strokes. The management of the internal carotid stenosis for many years has been raising controversies amongst neurologists, vascular surgeons and interventional radiologists mainly due to the introduction of endovascular stenting as an alternative to surgical treatment. Its application, however, requires knowledge of specific selection criteria for this kind of treatment as well as of the methods of monitoring patients after stent implantation into the internal carotid artery. Duplex Doppler ultrasound examination is currently a basis for the diagnosis of the arterial stenosis of precranial segments of the carotid arteries. It allows a reliable assessment of not only the course and morphology of the walls, but also of the hemodynamics of blood flow. Interventional treatment is applicable in patients with internal carotid stenosis of ≥70%, which is accompanied by an increase of the systolic flow velocity above 200 cm/s and the end-diastolic velocity above 50–60 cm/s in the stenotic lumen. In most cases, such a diagnosis in duplex Doppler ultrasound examination does not require any confirmation by additional diagnostic methods and if neurological symptoms are also present, it constitutes a single indication for interventional treatment. When deciding about choice of surgical or endovascular method of treatment, the following factors are of crucial importance: morphology of atherosclerotic plaque, its size, echogenicity, homogeneity of its structure, its surface and outlines. By means of ultrasound examinations, patients can be monitored after endovascular stent implantation. They enable evaluation of the degree of stent patency and allow for an early detection of symptoms indicating stenosis recurrence or presence of in-stent thrombosis. When interpreting the findings of the US checkup, it is essential to refer to the initial examination

  15. Long-Term Aircraft Noise Exposure and Body Mass Index, Waist Circumference, and Type 2 Diabetes: A Prospective Study

    PubMed Central

    Hilding, Agneta; Pyko, Andrei; Bluhm, Gösta; Pershagen, Göran; Östenson, Claes-Göran

    2014-01-01

    Background: Long-term aircraft noise exposure may increase the risk of cardiovascular disease, but no study has investigated chronic effects on the metabolic system. Objectives: The aim of this study was to investigate effects of long-term aircraft noise exposure on body mass index (BMI), waist circumference, and type 2 diabetes. Furthermore, we explored the modifying effects of sleep disturbance. Methods: This prospective cohort study of residents of Stockholm County, Sweden, followed 5,156 participants with normal baseline oral glucose tolerance tests (OGTT) for up to 10 years. Exposure to aircraft noise was estimated based on residential history. Information on outcomes and confounders was obtained from baseline and follow-up surveys and examinations, and participants who developed prediabetes or type 2 diabetes were identified by self-reported physician diagnosis or OGTT at follow-up. Adjusted associations were assessed by linear, logistic, and random-effects models. Results: The mean (± SD) increases in BMI and waist circumference during follow-up were 1.09 ± 1.97 kg/m2 and 4.39 ± 6.39 cm, respectively. The cumulative incidence of prediabetes and type 2 diabetes was 8% and 3%, respectively. Based on an ordinal noise variable, a 5-dB(A) increase in aircraft noise was associated with a greater increase in waist circumference of 1.51 cm (95% CI: 1.13, 1.89), fully adjusted. This association appeared particularly strong among those who did not change their home address during the study period, which may be a result of lower exposure misclassification. However, no clear associations were found for BMI or type 2 diabetes. Furthermore, sleep disturbances did not appear to modify the associations with aircraft noise. Conclusions: Long-term aircraft noise exposure may be linked to metabolic outcomes, in particular increased waist circumference. Citation: Eriksson C, Hilding A, Pyko A, Bluhm G, Pershagen G, Östenson CG. 2014. Long-term aircraft noise exposure and

  16. [Pulse pressure and common carotid arterial wall thickness assessed by ultrasonography].

    PubMed

    Kawamoto, R; Doi, T

    2000-06-01

    This study was conducted on a total of 358 normotensive (mean blood pressure < 107 mmHg) inpatients (182 men and 176 women, mean age: 67.8 years) who had no cardiorenal or nutrition disorders that would affect blood pressure, lipid and glucose metabolism and who had not been given depressors or antilipidemic agents during the four years from September 1995 to August 1999. In addition to the known risk factors for atherosclerosis, the effects of pulse pressure and mean blood pressure on sclerotic changes of the carotid arteries were examined. These sclerotic changes were assessed by measuring the thickness of the combined intima-media of the common carotid artery (carotid arterial wall thickness) by ultrasonography (Hitachi EUB-565) and linear probe (7.5 MHz). When the patients were divided into three groups based on pulse pressure (PP1, lower than 51 mmHg: PP2, 51-65 mmHg; PP3, higher than 65 mmHg), the age of the group with higher pulse pressure was significantly higher (p = 0.0011), women more (p = 0.0315). However there were no differences in background factors such as body mass index, Brinkman index, lipid metabolism, uric acid, and glucose metabolism. There was observed a positive correlation between the mean blood pressure and the pulse pressure for both men and women (r = 0.31, p < 0.001, respectively). As for the relation between the pulse pressures and the blood pressure parameters, the systolic blood pressure, pulse pressure and the mean blood pressure were significantly higher in the group with higher pulse pressure (p < 0.001, respectively), but the diastolic blood pressure was significantly lower (p = 0.0275). As for the relation between the pulse pressure and the carotid wall thickness, the groups of both men and women with higher pulse pressures had significantly greater carotid arterial wall thickness (p < 0.001, p = 0.0042, respectively). Logistic regression analysis of the carotid arterial wall thickness (defined as hypertrophic if greater than 1

  17. Typing performance and body discomfort among overweight and obese office workers: A pilot study of keyboard modification.

    PubMed

    Smith, Matthew Lee; Pickens, Adam W; Ahn, SangNam; Ory, Marcia G; DeJoy, David M; Young, Kristi; Bishop, Gary; Congleton, Jerome J

    2015-01-01

    Obesity in the workplace is associated with loss of productivity, high medical care expenses, and increased rates of work-related injuries and illness. Thus, effective, low-cost interventions are needed to accommodate the size of today's obese office worker while alleviating potential physical harm associated with musculoskeletal disorders. Utilizing a sample of 22 overweight and obese office workers, this pilot study assessed the impact of introducing an alternative, more ergonomically-sound keyboard on perceptions about design, acceptability, and usability; self-reported body discomfort; and typing productivity. Data were collected using self-reported questionnaires and objective typing tests administered before and after the intervention. The intervention duration was six weeks. After switching from their standard work keyboard to an alternative keyboard, all participants reported significant decreases in lower back discomfort (t = 2.14, P = 0.044); although obese participants reported significant decreases in both upper (t = 2.46, P = 0.032) and lower (t = 2.39, P = 0.036) back discomfort. No significant changes were observed in overall typing performance scores from baseline to follow-up. Findings suggest that such interventions may be introduced into the workforce with positive gains for workers without reducing short-term worker productivity. PMID:25082778

  18. Anatomical Considerations on Surgical Anatomy of the Carotid Bifurcation

    PubMed Central

    Michalinos, Adamantios; Chatzimarkos, Markos; Arkadopoulos, Nikolaos; Safioleas, Michail

    2016-01-01

    Surgical anatomy of carotid bifurcation is of unique importance for numerous medical specialties. Despite extensive research, many aspects such as precise height of carotid bifurcation, micrometric values of carotid arteries and their branches as their diameter, length, and degree of tortuosity, and variations of proximal external carotid artery branches are undetermined. Furthermore carotid bifurcation is involved in many pathologic processes, atheromatous disease being the commonest. Carotid atheromatous disease is a major predisposing factor for disabling and possibly fatal strokes with geometry of carotid bifurcation playing an important role in its natural history. Consequently detailed knowledge of various anatomic parameters is of paramount importance not only for understanding of the disease but also for design of surgical treatment, especially selection between carotid endarterectomy and carotid stenting. Carotid bifurcation paragangliomas constitute unique tumors with diagnostic accuracy, treatment design, and success of operative intervention dependent on precise knowledge of anatomy. Considering those, it becomes clear that selection and application of proper surgical therapy should consider anatomical details. Further research might ameliorate available treatment options or even lead to innovative ones. PMID:27047690

  19. Highstand shelf fans: The role of buoyancy reversal in the deposition of a new type of shelf sand body

    USGS Publications Warehouse

    Steel, Elisabeth; Simms, Alexander R.; Warrick, Jonathan; Yokoyama, Yusuke

    2016-01-01

    Although sea-level highstands are typically associated with sediment-starved continental shelves, high sea level does not hinder major river floods. Turbidity currents generated by plunging of sediment-laden rivers at the fluvial-marine interface, known as hyperpycnal flows, allow for cross-shelf transport of suspended sand beyond the coastline. Hyperpycnal flows in southern California have deposited six subaqueous fans on the shelf of the northern Santa Barbara Channel in the Holocene. Using eight cores and nine grab samples, we describe the deposits, age, and stratigraphic architecture of two fans in the Santa Barbara Channel. Fan lobes have up to 3 m of relief and are composed of multiple hyperpycnite beds ∼5 cm to 40 cm thick. Deposit architecture and geometry suggest the hyperpycnal flows became positively buoyant and lifted off the seabed, resulting in well-sorted, structureless, elongate sand lobes. Contrary to conventional sequence stratigraphic models, the presence of these features on the continental shelf suggests that active-margin shelves may locally develop high-quality reservoir sand bodies during sea-level highstands, and that such shelves need not be solely the site of sediment bypass. These deposits may provide a Quaternary analogue to many well-sorted sand bodies in the rock record that are interpreted as turbidites but lack typical Bouma-type features.

  20. In-body tissue-engineered aortic valve (Biovalve type VII) architecture based on 3D printer molding.

    PubMed

    Nakayama, Yasuhide; Takewa, Yoshiaki; Sumikura, Hirohito; Yamanami, Masashi; Matsui, Yuichi; Oie, Tomonori; Kishimoto, Yuichiro; Arakawa, Mamoru; Ohmuma, Kentaro; Tajikawa, Tsutomu; Kanda, Keiichi; Tatsumi, Eisuke

    2015-01-01

    In-body tissue architecture--a novel and practical regeneration medicine technology--can be used to prepare a completely autologous heart valve, based on the shape of a mold. In this study, a three-dimensional (3D) printer was used to produce the molds. A 3D printer can easily reproduce the 3D-shape and size of native heart valves within several processing hours. For a tri-leaflet, valved conduit with a sinus of Valsalva (Biovalve type VII), the mold was assembled using two conduit parts and three sinus parts produced by the 3D printer. Biovalves were generated from completely autologous connective tissue, containing collagen and fibroblasts, within 2 months following the subcutaneous embedding of the molds (success rate, 27/30). In vitro evaluation, using a pulsatile circulation circuit, showed excellent valvular function with a durability of at least 10 days. Interposed between two expanded polytetrafluoroethylene grafts, the Biovalves (N = 3) were implanted in goats through an apico-aortic bypass procedure. Postoperative echocardiography showed smooth movement of the leaflets with minimal regurgitation under systemic circulation. After 1 month of implantation, smooth white leaflets were observed with minimal thrombus formation. Functional, autologous, 3D-shaped heart valves with clinical application potential were formed following in-body embedding of specially designed molds that were created within several hours by 3D printer. PMID:24764308

  1. Body composition is the main determinant for the difference in type 2 diabetes pathophysiology between Japanese and Caucasians.

    PubMed

    Møller, Jonas B; Pedersen, Maria; Tanaka, Haruhiko; Ohsugi, Mitsuru; Overgaard, Rune V; Lynge, Jan; Almind, Katrine; Vasconcelos, Nina-Maria; Poulsen, Pernille; Keller, Charlotte; Ueki, Kohjiro; Ingwersen, Steen H; Pedersen, Bente K; Kadowaki, Takashi

    2014-01-01

    OBJECTIVE This cross-sectional clinical study compared the pathophysiology of type 2 diabetes in Japanese and Caucasians and investigated the role of demographic, genetic, and lifestyle-related risk factors for insulin resistance and β-cell response. RESEARCH DESIGN AND METHODS A total of 120 Japanese and 150 Caucasians were enrolled to obtain comparable distributions of high/low BMI values across glucose tolerance states (normal glucose tolerance, impaired glucose tolerance, and type 2 diabetes), which were assessed by oral glucose tolerance tests. BMI in the two cohorts was distributed around the two regional cutoff values for obesity. RESULTS Insulin sensitivity was higher in Japanese compared with Caucasians, as indicated by the homeostatic model assessment of insulin resistance and Matsuda indices, whereas β-cell response was higher in Caucasians, as measured by homeostatic model assessment of β-cell function, the insulinogenic indices, and insulin secretion ratios. Disposition indices were similar for Japanese and Caucasians at all glucose tolerance states, indicating similar β-cell response relative to the degree of insulin resistance. The main determinants for differences in metabolic indices were measures of body composition, such as BMI and distribution of adipose tissue. Differences in β-cell response between Japanese and Caucasians were not statistically significant following adjustment by differences in BMI. CONCLUSIONS Our study showed similar disposition indices in Japanese and Caucasians and that the major part of the differences in insulin sensitivity and β-cell response between Japanese and Caucasians can be explained by differences in body composition. PMID:24130359

  2. Structure and functioning of Mediterranean lagoon fish assemblages: A key for the identification of water body types

    NASA Astrophysics Data System (ADS)

    Franco, Anita; Franzoi, Piero; Torricelli, Patrizia

    2008-09-01

    Knowledge on the structure and functioning variability of transitional water fish assemblages may help in finding out the main descriptors for identifying different water body types for which specific biological reference conditions can be reliably derived. Fish assemblages from 19 Mediterranean lagoons were therefore investigated by evaluating the variability of their structure and functioning, and by relating it to the lagoons' environmental features. Fish assemblage structure was measured by its species richness. Functioning was measured by categorizing fish species into functional categories (or guilds) according to their use of lagoon habitat, feeding and reproduction, and by defining the functional structure of fish assemblages as the relative number of species per guild in each lagoon. Mediterranean lagoons' fish assemblages were found to be more similar to each other in their functional structure than in the taxonomical composition, thus confirming a shared functional role of these environments for biological communities. Lagoon local features, such as the lagoon area, its habitat heterogeneity and average salinity, significantly affected the total species richness and the different use that fish make of the lagoon environment, hence playing a primary role in the assessment of these water body types. Latitude also influenced the variability of fish assemblages in the Mediterranean lagoons investigated, with particular regard to their functioning as feeding and reproductive grounds for fish. These results are compared with previous studies and, although this limited the investigation to structural aspects only, were found to confirm in part the previous results and also added new insights about the key factors affecting the functioning of transitional water systems.

  3. Usefulness of contrast-enhanced ultrasound for detection of carotid plaque ulceration in patients with symptomatic carotid atherosclerosis.

    PubMed

    ten Kate, Gerrit L; van Dijk, Anouk C; van den Oord, Stijn C H; Hussain, Burhan; Verhagen, Hence J M; Sijbrands, Eric J G; van der Steen, Antonius F W; van der Lugt, Aad; Schinkel, Arend F L

    2013-07-15

    Previous data have indicated that carotid plaque ulceration is a strong predictor of cerebrovascular events. Standard ultrasound and color Doppler ultrasound (CDUS) scans have poor diagnostic accuracy for the detection of carotid plaque ulceration. The aim of the present prospective study was to assess the value of contrast-enhanced ultrasound (CEUS) scans for the detection of carotid plaque ulceration. The Institutional Ethics Committee approved the study protocol, and all patients provided informed consent. The patients had symptomatic stenosis of the internal carotid artery and underwent carotid computed tomographic angiography as part of their clinical evaluation. All patients underwent a CDUS examination in conjunction with CEUS. Carotid plaque ulceration was defined as the presence of ≥1 disruptions in the plaque-lumen border ≥1 × 1 mm. Carotid computed tomographic angiography was used as reference technique. The study population consisted of 20 patients (mean age 64 ± 9 years, 80% men), and 39 carotid arteries were included in the present analysis. Computed tomographic angiography demonstrated that the plaque surface was smooth in 15 (38%), irregular in 7 (18%) and ulcerated in 17 (44%) carotid arteries. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CDUS for the detection of ulceration was 29%, 73%, 54%, 46%, and 57%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CEUS for the detection of ulceration was 88%, 59%, 72%, 63%, and 87%, respectively. CEUS had superior sensitivity and diagnostic accuracy for the assessment of carotid plaque ulceration compared with CDUS. CEUS improved the intrareader and inter-reader variability for the assessment of carotid plaque ulceration compared with CDUS. In conclusion, CEUS could be an additional method for the detection of carotid plaque ulceration. The role of CDUS for the assessment of carotid

  4. Carotid Stiffness: A Novel Cerebrovascular Disease Risk Factor

    PubMed Central

    van Sloten, Thomas T.; Stehouwer, Coen D.A.

    2016-01-01

    Carotid stiffening is considered an important element in the pathogenesis of cerebrovascular diseases. These include stroke as well as vascular dementia and depression. However, results of individual studies evaluating the association between carotid stiffening and incident stroke have been inconsistent. Therefore, we have conducted a systematic review and meta-analysis, showing that carotid stiffening is associated with incident stroke independently of cardiovascular risk factors and aortic stiffness. In addition, carotid stiffening improved stroke risk prediction beyond the Framingham stroke risk factors and aortic stiffness. Other studies have shown that carotid stiffening is associated with a higher incidence of vascular dementia and depressive symptoms. This suggests that carotid stiffness is a potential separate target for prevention strategies of cerebrovascular disease. PMID:27493900

  5. Definition of Best Medical Treatment in Asymptomatic and Symptomatic Carotid Artery Stenosis.

    PubMed

    Paraskevas, Kosmas I; Mikhailidis, Dimitri P; Veith, Frank J; Spence, J David

    2016-05-01

    Implementation of best medical treatment (BMT) is the cornerstone of the management of patients with either asymptomatic or symptomatic carotid artery stenosis. We review the literature to define the components of BMT. Smoking cessation, maintaining a healthy body weight, moderate exercise, and a Mediterranean diet are essential lifestyle measures. Moderate alcohol consumption may also be beneficial but recommending it to patients may be hazardous if they consume too much. The importance of lifestyle measures is largely underestimated by both physicians and patients. Blood pressure and diabetes control, antiplatelet agents, and lipid-lowering treatment with statins/ezetimibe comprise the pharmacological components of BMT. Initiation of an intensive regimen of BMT is a sine qua non for patients with carotid artery stenosis whether or not they are offered or undergo an invasive revascularization procedure. PMID:26721504

  6. Optical body fat measurement might contribute to the search for a predictor of type-2 diabetes mellitus

    NASA Astrophysics Data System (ADS)

    Tafeit, Erwin; Horejsi, Renate; Sudi, Karl; Berg, Aloys; Reibnegger, Gilbert; Moeller, Reinhard

    2001-10-01

    The optical device LIPOMETER allows for non-invasive, quick, precise and safe determination of subcutaneous fat distribution, so-called subcutaneous adipose tissue topography (SAT-Top). Previously we showed how the high-dimensional SAT-Top information of women with type-2 diabetes mellitus (NIDDM) and a health control group can be analysed and represented in low-dimensional plots by applying special artificial neural networks (ANNs). Three top-down sorted subcutaneous adipose tissue compartments were determined (upper trunk, lower trunk, legs). NIDDM women provided significantly higher upper trunk obesity and significantly lower leg obesity (apple type), as compared with their healthy control group. Now we apply those ANN results on SAT-Top measurements of young and healthy women, comparing their individual subcutaneous fat pattern to the body fat distribution of NIDDM women and to the normal fat development of healthy women. Some of these young and healthy women provide a subcutaneous fat distribution very similar to the SAT-Top results of NIDDM women, which might increase their risk for this disease later in life.

  7. Morse Index and Linear Stability of the Lagrangian Circular Orbit in a Three-Body-Type Problem Via Index Theory

    NASA Astrophysics Data System (ADS)

    Barutello, Vivina; Jadanza, Riccardo D.; Portaluri, Alessandro

    2016-01-01

    It is well known that the linear stability of the Lagrangian elliptic solutions in the classical planar three-body problem depends on a mass parameter β and on the eccentricity e of the orbit. We consider only the circular case ( e = 0) but under the action of a broader family of singular potentials: α-homogeneous potentials, for α in (0, 2), and the logarithmic one. It turns out indeed that the Lagrangian circular orbit persists also in this more general setting. We discover a region of linear stability expressed in terms of the homogeneity parameter α and the mass parameter β, then we compute the Morse index of this orbit and of its iterates and we find that the boundary of the stability region is the envelope of a family of curves on which the Morse indices of the iterates jump. In order to conduct our analysis we rely on a Maslov-type index theory devised and developed by Y. Long, X. Hu and S. Sun; a key role is played by an appropriate index theorem and by some precise computations of suitable Maslov-type indices.

  8. Binary CMOS image sensor with a gate/body-tied MOSFET-type photodetector for high-speed operation

    NASA Astrophysics Data System (ADS)

    Choi, Byoung-Soo; Jo, Sung-Hyun; Bae, Myunghan; Kim, Sang-Hwan; Shin, Jang-Kyoo

    2016-05-01

    In this paper, a binary complementary metal oxide semiconductor (CMOS) image sensor with a gate/body-tied (GBT) metal oxide semiconductor field effect transistor (MOSFET)-type photodetector is presented. The sensitivity of the GBT MOSFET-type photodetector, which was fabricated using the standard CMOS 0.35-μm process, is higher than the sensitivity of the p-n junction photodiode, because the output signal of the photodetector is amplified by the MOSFET. A binary image sensor becomes more efficient when using this photodetector. Lower power consumptions and higher speeds of operation are possible, compared to the conventional image sensors using multi-bit analog to digital converters (ADCs). The frame rate of the proposed image sensor is over 2000 frames per second, which is higher than those of the conventional CMOS image sensors. The output signal of an active pixel sensor is applied to a comparator and compared with a reference level. The 1-bit output data of the binary process is determined by this level. To obtain a video signal, the 1-bit output data is stored in the memory and is read out by horizontal scanning. The proposed chip is composed of a GBT pixel array (144 × 100), binary-process circuit, vertical scanner, horizontal scanner, and readout circuit. The operation mode can be selected from between binary mode and multi-bit mode.

  9. Endovascular Treatment of Extracranial Internal Carotid Aneurysms Using Endografts

    SciTech Connect

    Baldi, Sebastian Rostagno, Roman D.; Zander, Tobias; Llorens, Rafael; Schonholz, Claudio; Maynar, Manuel

    2008-03-15

    Aneurysms of the extracranial internal carotid artery (EICA) are infrequent. They are difficult to treat with conventional surgery because of their distal extension into the skull base. We report three cases of EICA aneurysms in two symptomatic patients successfully treated with polytetrafluoroethylene self-expanding endografts using an endovascular approach. The aneurysms were located distal to the carotid bifurcation and extended to the subpetrous portion of the internal carotid artery.

  10. Successful Reconstruction of Asymptomatic Bilateral External Carotid Artery Aneurysms.

    PubMed

    Loja, Melissa N; Pevec, William C

    2016-04-01

    True aneurysms of the external carotid artery (ECA) are extremely rare with an unknown incidence and natural history. We present the successful operative management of an asymptomatic 65-year-old man found to have bilateral internal carotid artery stenosis and bilateral ECA aneurysms. His bilateral carotid arteries were reconstructed with bifurcated interposition grafts in a staged fashion. The patient recovered without sequelae and continues to be asymptomatic 1 year after reconstruction. We present the operative management of this rare case. PMID:26802292

  11. Internal Carotid Artery Aneurysm Mimicking Peritonsillar Abscess

    PubMed Central

    Brzost, Jacek; Waniewska, Martyna; Szczepanski, Miroslaw J.

    2015-01-01

    The extracranial internal carotid artery aneurysm (EICAA) is an uncommon arterial lesion. Patients typically present with neurologic symptoms resulting from impaired cerebral perfusion and compression symptoms of cranial nerves. Often EICAA presents as a pulsatile neck mass, which is otherwise asymptomatic. We present a case of an 84-year-old female, who was initially referred to the Emergency Department for Otolaryngology with suspected peritonsillar abscess. The patient had a history of recent upper airway infection and cardiovascular comorbidities, including hypertension and ischaemic stroke complicated by extensive neurologic deficits. Physical examination revealed a compact, nonpulsatile mass in the lateral parapharyngeal space and local erythema of the mucosa. Duplex Doppler Ultrasonography and Computed Tomography revealed an atherosclerotic aneurysm of the right internal carotid artery, measuring 63 × 55 × 88 mm, stretching from the skull base to the angle of the mandible. PMID:26124973

  12. [Carotid surgery, indications, results and perspectives].

    PubMed

    Kün, P; Battino, J; Cloarec, M; Witchitz, S; Vanet, R; Mergy, R

    1985-01-01

    A series of 215 patients who had undergone 250 carotid artery operations were followed up for a mean of 30 months. Perioperative mortality was 2%, neurologic morbidity was 7% but with permanent sequelae in 1.39% of cases. Recurrence of stenosis was detected in 0.8% of patients but there were no cases of postoperative thrombosis. Indications for surgery were based on the existence of hemispheric ischemic accidents corresponding to the territory supplied by the artery operated upon, and on anatomic and evolutive arguments drawn from results of non-invasive review examinations: ultrasonography and Doppler. Results obtained: 81.9% of patients were asymptomatic after 30 months, appear to be superior to those of the natural history of carotid artery lesions. PMID:4056617

  13. Carotid-cardiac baroreflex response and LBNP tolerance following resistance training

    NASA Technical Reports Server (NTRS)

    Tatro, D. L.; Dudley, G. A.; Convertino, V. A.

    1992-01-01

    The purpose of this study was to examine the effect of lower body resistance training on cardiovascular control mechanisms and blood pressure maintenance during an orthostatic challenge. Lower body negative pressure (LBNP) tolerance, carotid-cardiac baroreflex function (using neck chamber pressure), and calf compliance were measured in eight healthy males before and after 19 wk of knee extension and leg press training. Resistance training sessions consisted of four or five sets of 6-12 repetitions of each exercise, performed two times per week. Training increased strength 25 +/- 3 (SE) percent (P = 0.0003) and 31 +/- 6 percent (P = 0.0004), respectively, for the leg press and knee extension exercises. Average fiber size in biopsy samples of m. vastus lateralis increased 21 +/- 5 percent (P = 0.0014). Resistance training had no significant effect on LBNP tolerance. However, calf compliance decreased in five of the seven subjects measured, with the group average changing from 4.4 +/- 0.6 ml.mm Hg-1 to 3.9 +/- 0.3 ml.mm Hg-1 (P = 0.3826). The stimulus-response relationship of the carotid-cardiac baroreflex response shifted to the left on the carotid pressure axis as indicated by a reduction of 6 mm Hg in baseline systolic blood pressure (P = 0.0471). In addition, maximum slope increased from 5.4 +/- 1.3 ms.mm Hg-1 before training to 6.6 +/- 1.6 ms.mm Hg-1 after training (P = 0.0141). Our results suggest the possibility that high resistance, lower extremity exercise training can cause a chronic increase in sensitivity and resetting of the carotid-cardiac baroreflex.

  14. Interaction of semicircular canal stimulation with carotid baroreceptor reflex control of heart rate

    NASA Technical Reports Server (NTRS)

    Convertino, V. A.

    1998-01-01

    The carotid-cardiac baroreflex contributes to the prediction of orthostatic tolerance; experimental attenuation of the reflex response leads to orthostatic hypotension in humans and animals. Anecdotal observations indicate that rotational head movements about the vertical axis of the body can also induce orthostatic bradycardia and hypotension through increased parasympathetic activity. We therefore measured the chronotropic response to carotid baroreceptor stimulation in 12 men during varying conditions of vestibulo-oculomotor stimulation to test the hypothesis that stimulation of the semicircular canals associated with head movements in the yaw plane inhibits cardioacceleration through a vagally mediated baroreflex. Carotid-cardiac baroreflex response was assessed by plotting R-R intervals (ms) at each of 8 neck pressure steps with their respective carotid distending pressures (mmHg). Calculated baroreflex gain (maximal slope of the stimulus-response relationship) was measured under 4 experimental conditions: 1) sinusoidal whole-body yaw rotation of the subject in the dark without visual fixation (combined vestibular-oculomotor stimulation); 2) yaw oscillation of the subject while tracking a small head-fixed light moving with the subject (vestibular stimulation without eye movements); 3) subject stationary while fixating on a small light oscillating in yaw at the same frequency, peak acceleration, and velocity as the chair (eye movements without vestibular stimulation); and 4) subject stationary in the dark (no eye or head motion). Head motion alone and with eye movement reduced baseline baroreflex responsiveness to the same stimulus by 30%. Inhibition of cardioacceleration during rotational head movements may have significant impact on functional performance in aerospace environments, particularly in high-performance aircraft pilots during high angular acceleration in aerial combat maneuvers or in astronauts upon return from spaceflight who already have

  15. Carotid artery aneurysm: last among equals.

    PubMed

    Dhillon, Ajit Kaur; Rowlands, Timothy; McMahon, Greg

    2016-01-01

    A 66-year-old man presented initially with a swelling in the left side of the neck, which was confirmed to be a carotid artery aneurysm on ultrasonography. He was subsequently admitted reporting intermittent episodes of visual loss in the left eye and right arm weakness. Further imaging confirmed multiple, small acute infarcts in the left cerebral hemisphere. The patient underwent open repair of the aneurysm and made an uncomplicated recovery with no persisting neurological deficit. PMID:27190119

  16. Psychometric and EEG changes after carotid endarterectomy.

    PubMed

    Valenti, Pietro; Ortelli, Paola; Zanon, Antonio; Schiff, Sami; Montagnese, Sara; Avruscio, Giampietro; Del Piccolo, Franco; Mapelli, Daniela; Puato, Massimo; Rattazzi, Marcello; Amodio, Piero; Pauletto, Paolo

    2015-02-01

    The influence of carotid stenosis and its surgical treatment on brain function is still poorly defined. We therefore performed a study to assess psychometric and quantified EEG findings after carotid endarterectomy (CEA). Sixty-nine non-demented patients (aged 72 ± 7 years) with severe carotid stenosis (≥ 70%) eligible for CEA were studied. Forty patients (group A) had unilateral stenosis, and 29 patients (group B) had bilateral stenosis. Before and 5 months after CEA all the patients were evaluated by the Trail Making Test A, the Symbol Digit Test, and spectral EEG analysis. At baseline, compared to group A, group B patients performed slowly the Trail Making Test A (Z: 1.45 ± 1.4 vs. 0.76 ± 1.3; p <  0.05), but not the Symbol Digit Test (Z: 0.83 ± 1.38 vs. 0.64 ± 1.26; p = 0.59). Altogether, the patients with at least one abnormal psychometric test were 29% (group A: 26%; group B: 33%, p = 0.56). The EEG did not differ significantly between patients of group A compared to group B. After CEA, psychometric tests improved (mean Z score from 0.73 ± 1.12 to 0.45 ± 1.15, p <  0.05). The improvement was similar in group A and B. The EEG mean dominant frequency improved only in group B patients and it was related to the improvement in psychometric tests (r = 0.43, p = 0.05). Low psychometric performance was detectable in about 1/ 3 of non-demented patients with severe carotid stenosis. CEA improved mental performance and, in patients with severe bilateral stenosis, accelerated the EEG frequency. PMID:25034456

  17. Aterofisiol® in carotid plaque evolution

    PubMed Central

    Amato, Bruno; Compagna, Rita; Amato, Maurizio; Gallelli, Luca; de Franciscis, Stefano; Serra, Raffaele

    2015-01-01

    Background In patients with carotid stenosis, the risk of plaque rupture is related to the composition of the atherosclerotic plaque rather than to its magnitude. In this regard, we evaluated the effects of a supplement, Aterofisiol,® containing omega-3 (EPA [eicosapen acid] DHA [docosahexaenoic acid]), vitamin K2, vitamin B6, vitamin B12, oligomeric proanthocyanidins (OPC) and resveratrol on the composition of atherosclerotic plaque and on neurological symptoms in patients with carotid stenosis undergoing carotid endarterectomy. Methods The study was randomized, prospective, and double-blinded. Eligible patients were of both sexes, with carotid stenosis >70% who underwent endarterectomy. Enrolled patients were randomly allocated to receive either one tablet of acetylsalicylic acid 100 mg (Cardioaspirin®) + one tablet of Aterofisiol every 24 hours or one tablet of Cardioaspirin + one tablet of placebo every 24 hours. Each treatment was started 30 days before the surgery and was stopped 5 days before the surgery. The plaques were removed “en bloc” using standard surgical technique. Results During the study period, 214 patients (135 men and 79 women) were enrolled for intent-to-treat and randomized in two groups: Group A: 107 patients (68 men and 39 women) were treated with Cardioaspirin + Aterofisiol. Group B: 107 patients (67 men and 40 women) were treated with Cardioaspirin + placebo. At the end of the study, 202 patients participated fully (103 patients in Group A and 99 patients in Group B), making up the protocol evaluation population (94.4%). The mean lipid content of removed plaques was significantly lower (P<0.05) in Group A. We recorded a significantly lower incidence of neurological symptoms in Group A in comparison with Group B (P<0.05). Conclusion In the study, Aterofisiol showed to be effective in reducing the amounts of cholesterol and lipids in the plaques and in reducing adverse neurological events in the study group with respect to controls

  18. Hippocampal sclerosis in Lewy body disease is a TDP-43 proteinopathy similar to FTLD-TDP Type A.

    PubMed

    Aoki, Naoya; Murray, Melissa E; Ogaki, Kotaro; Fujioka, Shinsuke; Rutherford, Nicola J; Rademakers, Rosa; Ross, Owen A; Dickson, Dennis W

    2015-01-01

    Hippocampal sclerosis (HpScl) is frequent in frontotemporal lobar degeneration with TDP-43 pathology (FTLD-TDP), but it also occurs in dementia of the elderly with or without accompanying Alzheimer type pathology. HpScl has been hypothesized to be a neurodegenerative process given its association with TDP-43 pathology, but this is still controversial. TDP-43 pathology is found in Lewy body disease (LBD), but no study has focused on the pathologic and genetic characteristics of HpScl in LBD. We found HpScl in 5.2% of 669 LBD cases (289 transitional and 380 diffuse). Older age, higher Braak neurofibrillary tangle (NFT) stage, and presence of TDP-43 pathology were associated with HpScl. There was no difference in the frequency of HpScl between transitional and diffuse LBD, suggesting that Lewy-related pathology appears to have no direct association with HpScl. All HpScl cases had TDP-43 pathology consistent with Type A pattern. HpScl cases harbored genetic variation in TMEM106B that has been previously associated with FTLD-TDP. Interestingly, the severity of TDP-43-positive fine neurites in CA1 sector, a possible pathologic precursor of HpScl, was associated with the TMEM106B variant. These results demonstrate HpScl in LBD is a TDP-43 proteinopathy and is similar to FTLD-TDP Type A. Furthermore, a subset of LBD cases without HpScl ("pre-HpScl") had similar pathologic and genetic characteristics to typical HpScl, suggesting that the spectrum of HpScl pathology may be wider than previously thought. Some cases with many extracellular NFTs also had a similar profile. We suggest that HpScl is "masked" in these cases. PMID:25367383

  19. Hippocampal sclerosis in Lewy body disease is a TDP-43 proteinopathy similar to FTLD-TDP Type A

    PubMed Central

    Aoki, Naoya; Murray, Melissa E.; Ogaki, Kotaro; Fujioka, Shinsuke; Rutherford, Nicola J.; Rademakers, Rosa; Ross, Owen A.; Dickson, Dennis W.

    2014-01-01

    Hippocampal sclerosis (HpScl) is frequent in frontotemporal lobar degeneration with TDP-43 pathology (FTLD-TDP), but it also occurs in dementia of the elderly with or without accompanying Alzheimer type pathology. HpScl has been hypothesized to be a neurodegenerative process given its association with TDP-43 pathology, but this is still controversial. TDP-43 pathology is found in Lewy body disease (LBD), but no study has focused on the pathologic and genetic characteristics of HpScl in LBD. We found HpScl in 5.2% of 669 LBD cases (289 transitional and 380 diffuse). Older age, higher Braak neurofibrillary tangle (NFT) stage, and presence of TDP-43 pathology were associated with HpScl. There was no difference in the frequency of HpScl between transitional and diffuse LBD, suggesting that Lewy related pathology appears to have no direct association with HpScl. All HpScl cases had TDP-43 pathology consistent with Type A pattern. HpScl cases harbored genetic variation in TMEM106B that has been previously associated with FTLD-TDP. Interestingly, the severity of TDP-43-positive fine neurites in CA1 sector, a possible pathologic precursor of HpScl, was associated with the TMEM106B variant. These results demonstrate HpScl in LBD is a TDP-43 proteinopathy and is similar to FTLD-TDP Type A. Furthermore, a subset of LBD cases without HpScl (“pre-HpScl”) had similar pathologic and genetic characteristics to typical HpScl, suggesting that the spectrum of HpScl pathology may be wider than previously thought. Some cases with many extracellular NFTs also had a similar profile. We suggest that HpScl is “masked” in these cases. PMID:25367383

  20. The first derivative of the carotid displacement pulse.

    NASA Technical Reports Server (NTRS)

    Khan, A. H.; Spodick, D. H.

    1972-01-01

    The amplitude and time relationships of the carotid derivative in normal individuals and unselected cardiac patients is investigated together with the effects of different contraction strengths in patients with pulsus alternans and subjects challenged with isoproterenol and propranolol. Data regarding the relationship between the preejection period (PEP) and the ratio of peak to total amplitude of the carotid displacement pulse derivative are presented. It is found that cardiac abnormality tends to reduce the rate of rise of the carotid displacement pulse. The results obtained show that the PEP is a somewhat more sensitive index of the changes studied than the carotid displacement derivative.

  1. Carotid Stump Syndrome: Case Report and Endovascular Treatment.

    PubMed

    Dakhoul, Lara Toufic; Tawk, Rabih

    2014-01-01

    Objectives. To highlight the case of a patient with multiple transient ischemic attacks and visual disturbances diagnosed with carotid stump syndrome and managed with endovascular approach. Case Presentation. We present the case of a carotid stump syndrome in an elderly patient found to have moderate left internal carotid artery stenosis in response to an advertisement for carotid screening. After a medical therapeutic approach and a close follow-up, transient ischemic attacks recurred. Computed tomographic angiography showed an occlusion of the left internal carotid artery and the presence of moderate stenosis in the right internal carotid artery, which was treated by endovascular stenting and balloon insertion. One month later, the patient presented with visual disturbances due to the left carotid stump and severe stenosis of the left external carotid artery that was reapproached by endovascular stenting. Conclusion. Considerations should be given to the carotid stump syndrome as a source of emboli for ischemic strokes, and vascular assessment could be used to detect and treat this syndrome. PMID:26425620

  2. Complete carotid and coronary revascularization in brain malperfusion.

    PubMed

    Aramendi, Claudia; Cubero, Alain; Cortés, Andrés; Rivas, Daniel; Crespo, Alejandro; Aramendi, José I

    2016-09-01

    A 54-year-old man presented with unstable angina and stroke with right hemiplegia and aphasia due to left main coronary plus 3-vessel disease, severe stenosis of bilateral internal carotid, proximal left common carotid, and proximal left subclavian arteries. Simultaneous complete revascularization was undertaken with the use of conventional cardiopulmonary bypass and moderate hypothermia (25℃). The left internal mammary artery and two saphenous vein grafts were used for coronary artery bypass, and brain revascularization consisted of a left aorta-to-common carotid Dacron graft and bilateral carotid endarterectomy. Recovery was good. PMID:26980597

  3. [An integrated segmentation method for 3D ultrasound carotid artery].

    PubMed

    Yang, Xin; Wu, Huihui; Liu, Yang; Xu, Hongwei; Liang, Huageng; Cai, Wenjuan; Fang, Mengjie; Wang, Yujie

    2013-07-01

    An integrated segmentation method for 3D ultrasound carotid artery was proposed. 3D ultrasound image was sliced into transverse, coronal and sagittal 2D images on the carotid bifurcation point. Then, the three images were processed respectively, and the carotid artery contours and thickness were obtained finally. This paper tries to overcome the disadvantages of current computer aided diagnosis method, such as high computational complexity, easily introduced subjective errors et al. The proposed method could get the carotid artery overall information rapidly, accurately and completely. It could be transplanted into clinical usage for atherosclerosis diagnosis and prevention. PMID:24195385

  4. Carotid Stenting for Restenosis after Endarterectomy

    SciTech Connect

    Counsell, Andrew; Ghosh, Jonathan McCollum, Charles C. N.; Ashleigh, Raymond

    2011-06-15

    Introduction: Restenosis after carotid endarterectomy (CEA) has been described in 8-19% of patients, 14-23% of whom become symptomatic. This study analyzes our experience with carotid artery stenting (CAS) for post-CEA recurrent stenoses.MethodRetrospective database and case-note review. Results: Between January 2000 and September 2008, a total of 27 patients (15 symptomatic) with hemodynamically significant internal carotid artery post-CEA restenosis underwent CAS. Median stenosis of target vessels was 90% (range 75-95%). There was one periprocedural death (3.7%); no others occurred during the median 34-month follow-up (range 0.1-84 months). There was one late transient ischemic attack 12 months after CAS that was not associated with in-stent restenosis. One 90% restenosis and one occlusion were detected during follow-up at 38 and 57 months after CAS. The remaining patients had no evidence of further restenosis and remained free from cerebrovascular symptoms. Conclusion: CAS offers a feasible option for the management of carefully selected patients with symptomatic and asymptomatic restenosis after CEA.

  5. Early carotid endarterectomy in selected stroke patients.

    PubMed

    Kahn, M B; Patterson, H K; Seltzer, J; Fitzpatrick, M; Smullens, S; Bell, R; DiMuzio, P; Carabasi, R A

    1999-09-01

    Although there are several reports suggesting the safety of performing carotid endarterectomy (CE) within 4 weeks (early) of a nondisabling stroke, at many institutions it is not standard practice. Benefits of early surgery may include reduction in the number of strokes or carotid occlusions during the time between stroke and surgery, as well as a reduction in the cost of medical care due to the elimination of interval anticoagulation and close follow-up. This review examines the outcomes of early CE in selected patients after a nondisabling stroke. A total of 1065 CEs were performed between November 1991 and April 1998. Seventy-five patients were identified by computerized hospital record and office chart review as having CE after a nondisabling stroke. Criteria for early surgery included 1) nondisabling stroke ipsilateral to a carotid stenosis >50%, 2) neurological stability, and 3) no evidence of hemorrhagic stroke or significant cerebral edema by CT/MRI evaluation. This review suggests that early CE can be performed in selected patients with an acceptable perioperative morbidity and mortality. PMID:10466988

  6. Carotid artery rupture and cervicofacial actinomycosis.

    PubMed

    Kummer, Anne; Lhermitte, Benoît; Ödman, Micaela; Grabherr, Silke; Mangin, Patrice; Palmiere, Cristian

    2012-11-01

    Cervicofacial actinomycosis is an uncommon, progressive infection caused by bacilli of the Actinomyces genus. Actinomyces are common commensal saprophytes in the oral cavity which may have medical importance as facultative pathogens. Subsequent to local injuries to the oral mucosa, they may penetrate the deep tissues and be responsible for suppurative or granulomatous infections. We herein report a case of a 65-year-old man who underwent surgery followed by chemotherapy and radiotherapy for a tonsillar carcinoma. An ulcerous lesion in the base of the tongue developed and spread to the carotid artery wall. The man died of a massive hemorrhage due to left carotid artery rupture. Postmortem computed tomography angiography performed prior to autopsy allowed the precise localization of the source of bleeding to be detected. Postmortem biochemical investigations confirmed the presence of inflammation associated with local bacterial infection. Histological investigations revealed the rupture of the left carotid artery surrounded by numerous colonies of Actinomyces. Acute and chronic inflammation with tissue necrosis as well as post-actinic, fibrotic changes were also found in the tissues surrounding the ruptured artery wall. PMID:22819527

  7. Routine ultrasound surveillance after carotid endarterectomy.

    PubMed

    Pratesi, C; Pulli, R; Ferlaino, E; Michelagnoli, S; Bernacchi, R; Borgioloi, F; Nuzzaci, G

    1996-02-01

    Ultrasounds (US) are employed in preoperative carotid disease diagnosis and in carotid endarterectomy (CEA) follow-up. The authors present their experience about postoperative modifications in CEA site with US evaluation with particular interest in restenosis. Clinical and instrumental examinations were performed at intervals 1, 3, 6, 12, and 24 months following surgery. Follow-up data were available on 189 CEAs. In 58 cases a primary closure was performed, whereas in the other 131 cases, a patch was applied. 15 restenosis (7.9%) were seen during the follow-up control period with 2 cases of haemodynamic restenosis (1%). Good results were recorded with PTFE patch angioplasty (restenosis 4.4%), instead of vein (restenosis 14.2%) and a biosynthetic material called Omniflow (restenosis 9.5%). A vein patch dilatation was encountered in 13 applications (30.9%). In conclusion the routine application of US after carotid endarterectomy allowed us to monitor the evolution of the repair processes and of the stenotic lesions from the very beginning. PMID:8606212

  8. Body Composition and Epicardial Fat in Type 2 Diabetes Patients Following Insulin Detemir Versus Insulin Glargine Initiation.

    PubMed

    Elisha, B; Azar, M; Taleb, N; Bernard, S; Iacobellis, G; Rabasa-Lhoret, R

    2016-01-01

    The aim of the study was to compare body composition and epicardial fat thickness changes in insulin-naïve inadequately controlled patients with type 2 diabetes following basal insulin initiation with detemir vs. glargine. Six-month, open-label, interventional randomized pilot study was conducted. Dual-energy X-ray absorptiometry and echocardiography were used to estimate the body composition and epicardial fat thickness respectively. Thirty-six patients in the detemir group and 20 in the glargine group completed the study. Study groups baseline characteristics were comparable. At 6 months, for similar glycemic control, those on detemir significantly gained less total weight (0.6±2.5 vs. 4.2±4.1 kg, p=0.004), total fat mass (0.9±2.2 vs. 2.9±2.4 kg, p=0.02), and truncal fat mass (0.8±1.5 vs. 2.1±1.7 kg, p=0.02), with a loss in truncal lean mass (- 0.8±1.9 kg vs. 0.3±1.7 kg; p=0.02). EFT significantly decreased from baseline in both group (detemir - 1.7±0.52-mm, glargine - 1.1±1.6-mm; p<0.05, without significant difference inter-groups). Within the detemir group, epicardial fat thickness change correlated with truncal fat and total fat mass changes (r=0.65, p=0.06 and r=0.60, p=0.07). In conclusion, detemir resulted in less fat mass gain, a trend for a more pronounced epicardial fat thickness reduction when compared with glargine. PMID:26340704

  9. Numerical Simulations Of Catastrophic Disruption Of Porous Bodies: Application To Dark-type Asteroids And Kuiper-belt Family Formation

    NASA Astrophysics Data System (ADS)

    Michel, Patrick; Jutzi, M.; Richardson, D. C.; Benz, W.

    2010-10-01

    Asteroids of dark (e.g. C, D) taxonomic classes as well as Kuiper Belt objects and comets are believed to have high porosity, not only in the form of large voids but also in the form of micro-pores. The presence of such microscale porosity introduces additional physics in the impact process. We have enhanced our 3D SPH hydrocode, used to simulate catastrophic breakups, with a model of porosity [1] and validated it at small scale by comparison with impact experiments on pumice targets [2]. Our model is now ready to be applied to a large range of problems. In particular, accounting for the gravitational phase of an impact, we can study the formation of dark-type asteroid families, such as Veritas, and Kuiper-Belt families, such as Haumea. Recently we characterized for the first time the catastrophic impact energy threshold, usually called Q*D, as a function of the target's diameter, porosity, material strength and impact speed [3]. Regarding the mentioned families, our preliminary results show that accounting for porosity leads to different outcomes that may better represent their properties and constrain their definition. In particular, for Veritas, we find that its membership may need some revision [4]. The parameter space is still large, many interesting families need to be investigated and our model will be applied to a large range of cases. PM, MJ and DCR acknowledge financial support from the French Programme National de Planétologie, NASA PG&G "Small Bodies and Planetary Collisions" and NASA under Grant No. NNX08AM39G issued through the Office of Space Science, respectively. [1] Jutzi et al. 2008. Icarus 198, 242-255; [2] Jutzi et al. 2009. Icarus 201, 802-813; [3] Jutzi et al. 2010. Fragment properties at the catastrophic disruption threshold: The effect of the parent body's internal structure, Icarus 207, 54-65; [4] Michel et al. 2010. Icarus, submitted.

  10. Statistics over features for internal carotid arterial disorders detection.

    PubMed

    Ubeyli, Elif Derya

    2008-03-01

    The objective of the present study is to extract the representative features of the internal carotid arterial (ICA) Doppler ultrasound signals and to present the accurate classification model. This paper presented the usage of statistics over the set of the extracted features (Lyapunov exponents and the power levels of the power spectral density estimates obtained by the eigenvector methods) in order to reduce the dimensionality of the extracted feature vectors. Since classification is more accurate when the pattern is simplified through representation by important features, feature extraction and selection play an important role in classifying systems such as neural networks. Mixture of experts (ME) and modified mixture of experts (MME) architectures were formulated and used as basis for detection of arterial disorders. Three types of ICA Doppler signals (Doppler signals recorded from healthy subjects, subjects having stenosis, and subjects having occlusion) were classified. The classification results confirmed that the proposed ME and MME has potential in detecting the arterial disorders. PMID:18179791

  11. Anterior segment ischemia secondary to carotid occlusive disease.

    PubMed

    Mills, R P

    1989-09-01

    The ischemic signs of carotid occlusive disease in the anterior segment can be summarized as follows: vasodilation in the conjunctiva, episclera, and iris; neovascularization in the iris and the anterior chamber angle with consequent neovascular glaucoma, with or without elevation of intraocular pressure; and noninflammatory uveitis with corneal edema, keratitic precipitates, flare and cells in the anterior chamber, and late development of cataract. A questionnaire was sent to neuro-ophthalmology and glaucoma specialists regarding their perceptions of this condition. On average, approximately 1 case per specialist per year was seen. One third of the respondents had seen significant ocular pressure increase in patients with rubeosis following successful vascular surgery. Most felt that panretinal photocoagulation, though not as effective as in diabetic rubeosis, did cause regression of iris and angle neovascularization. The visual prognosis following all types of treatment was not good and was insufficient to justify a clear recommendation about the advisability of aggressive management of this condition. PMID:2529282

  12. Carotid bypass using the Gore Hybrid Vascular Graft as a rescue technique for on-table failed carotid endarterectomy.

    PubMed

    Valenti, Domenico; Sayed, Saiqa; Mistry, Hiren; Rashid, Hisham; Gambhir, Raghvinder; Slim, Hani

    2016-07-01

    Carotid endarterectomy (CEA) remains the "gold standard" for atherosclerotic lesions involving the carotid bifurcation. Carotid bypass grafting using either polytetrafluoroethylene or long saphenous vein is a suitable alternative technique, especially in challenging endarterectomy and on-table failed CEA. We report our initial experience of using the Gore Hybrid Vascular Graft (W. L. Gore & Associates, Flagstaff, Ariz) in six patients as a rescue technique when standard CEA failed. PMID:26409841

  13. 41 CFR 102-117.340 - What other types of assistance may GSA provide agencies in dealing with regulatory bodies?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... assistance may GSA provide agencies in dealing with regulatory bodies? 102-117.340 Section 102-117.340 Public... MANAGEMENT REGULATION TRANSPORTATION 117-TRANSPORTATION MANAGEMENT Representation Before Regulatory Body... bodies? (a) GSA has oversight of all public utilities used by the Federal Government...

  14. 41 CFR 102-117.340 - What other types of assistance may GSA provide agencies in dealing with regulatory bodies?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... assistance may GSA provide agencies in dealing with regulatory bodies? 102-117.340 Section 102-117.340 Public... MANAGEMENT REGULATION TRANSPORTATION 117-TRANSPORTATION MANAGEMENT Representation Before Regulatory Body... bodies? (a) GSA has oversight of all public utilities used by the Federal Government...

  15. 41 CFR 102-117.340 - What other types of assistance may GSA provide agencies in dealing with regulatory bodies?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... assistance may GSA provide agencies in dealing with regulatory bodies? 102-117.340 Section 102-117.340 Public... MANAGEMENT REGULATION TRANSPORTATION 117-TRANSPORTATION MANAGEMENT Representation Before Regulatory Body... bodies? (a) GSA has oversight of all public utilities used by the Federal Government...

  16. 41 CFR 102-117.340 - What other types of assistance may GSA provide agencies in dealing with regulatory bodies?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... assistance may GSA provide agencies in dealing with regulatory bodies? 102-117.340 Section 102-117.340 Public... MANAGEMENT REGULATION TRANSPORTATION 117-TRANSPORTATION MANAGEMENT Representation Before Regulatory Body... bodies? (a) GSA has oversight of all public utilities used by the Federal Government...

  17. 41 CFR 102-117.340 - What other types of assistance may GSA provide agencies in dealing with regulatory bodies?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... assistance may GSA provide agencies in dealing with regulatory bodies? 102-117.340 Section 102-117.340 Public... MANAGEMENT REGULATION TRANSPORTATION 117-TRANSPORTATION MANAGEMENT Representation Before Regulatory Body... bodies? (a) GSA has oversight of all public utilities used by the Federal Government...

  18. Temporary axillary-carotid shunting for unusual instances of carotid stenosis.

    PubMed

    Shumacker, H B; Isch, J H; Jolly, W W

    1976-07-01

    A method has been developed which entails the introduction of the larger end of a Javid shunt tube in the axillary artery and the other in the internal carotid with only momentary interruption of blood flow. The method of closing the incision after the thromboendarterectomy almost entirely eliminates a second period of carotid occlusion. This procedure may be useful in unusual instances in which it is believed advantageous to avoid even the relatively short occlusion periods usually necessary when using the standard intraluminal shunt technique. PMID:936041

  19. Surgical Exposure to Control the Distal Internal Carotid Artery at the Base of the Skull during Carotid Aneurysm Repair.

    PubMed

    Davis, Laura; Zeitouni, Anthony; Makhoul, Nicholas; Steinmetz, Oren K

    2016-07-01

    Extracranial carotid artery aneurysms are rare. Treatment options for these lesions include endovascular interventions, such as coiling and stenting, or surgical reconstruction, such as resection and primary reanastomosis, or interposition bypass grafting. In this report, we describe the surgical technique used to perform surgical repair of an internal carotid artery aneurysm extending up to the base of the skull. Anterior exposure of the infratemporal fossa and distal control of the carotid artery at the level of the carotid canal was achieved through a transcervical approach, performing double mandibular osteotomies with superior reflection of the middle mandibular section. PMID:26902936

  20. Evaluation of serum lipid profile, body mass index, and waistline in Chinese patients with type 2 diabetes mellitus

    PubMed Central

    Cui, Rongtao; Qi, Zhiming; Zhou, Lin; Li, Zuohong; Li, Qing; Zhang, Junyong

    2016-01-01

    Objective People with type 2 diabetes are at an increased risk of hypertension, arteriosclerosis, heart disease, and stroke. Glucose intolerance (insulin resistance) is the main feature of type 2 diabetes. Obesity leads to insulin resistance, dyslipidemia, etc. The aim of this study was to assess the biochemical parameters and measures of obesity in type 2 diabetes mellitus (T2DM). Methods A total of 2,273 males and 6,547 females previously healthy volunteers (aged 41–95 years old) were recruited by open invitation. The basic information, including age, sex, height, weight, body mass index (BMI), waistline, hipline, menstrual cycle, and medical history, was collected by questionnaire survey and physical examination. Serum lipid profile, liver transaminase, blood glucose, postprandial blood glucose, and hemoglobin A1c were obtained after 12 hours of fasting. Results According to our results, diabetic patients presented serum lipid abnormality. Elevated triglyceride (TG) levels (≥1.7 mmol/L) were noted in 19.69% of males and 20.40% of females, and reduced high-density lipoprotein cholesterol (HDL-C) levels (≤1.15 mmol/L) were noted in 21.96% of males and 15.74% of females. The combination of elevated TG and reduced HDL-C was the most prevalent of the combined lipid abnormalities. In contrast, no differences were observed in the levels of low-density lipoprotein cholesterol and total cholesterol. Moreover, there were statistically significant differences in the levels of BMI and waistline between T2DM and non-T2DM participants. After adjustment for BMI, logistic regression analysis revealed that the subjects with BMI ≤20 kg/m2 and >30 kg/m2 had a significantly elevated hazard ratio of T2DM compared with participants having a BMI range of 20–30 kg/m2 in both males and females. However, there was a significant difference between T2DM patients and non-T2DM patients in waistline (χ2=8.57, P<0.001) than in BMI parameter (χ2=6.29, P<0.001). Conclusion The

  1. Carotid artery stenting versus endarterectomy: a systematic review.

    PubMed

    Gahremanpour, Amir; Perin, Emerson C; Silva, Guilherme

    2012-01-01

    For about 2 decades, investigators have been comparing carotid endarterectomy with carotid artery stenting in regard to their effectiveness and safety in treating carotid artery stenosis. We conducted a systematic review to summarize and appraise the available evidence provided by randomized trials, meta-analyses, and registries comparing the clinical outcomes of the 2 procedures. We searched the MEDLINE, SciVerse Scopus, and Cochrane databases and the bibliographies of pertinent textbooks and articles to identify these studies. The results of clinical trials and, consequently, the meta-analyses of those trials produced conflicting results regarding the comparative effectiveness and safety of carotid endarterectomy and carotid stenting. These conflicting results arose because of differences in patient population, trial design, outcome measures, and variability among centers in the endovascular devices used and in operator skills. Careful appraisal of the trials and meta-analyses, particularly the most recent and largest National Institutes of Health-sponsored trial (the Carotid Revascularization Endarterectomy vs Stenting Trial [CREST]), showed that carotid stenting and endarterectomy were associated with similar rates of death and disabling stroke. Within the 30-day periprocedural period, carotid stenting was associated with higher risks of stroke, especially for patients aged >70 years, whereas carotid endarterectomy was associated with a higher risk of myocardial infarction. The slightly higher cost of stenting compared with endarterectomy was within an acceptable range by cost-effectiveness standards. We conclude that carotid artery stenting is an equivalent alternative to carotid endarterectomy when patient age and anatomy, surgical risk, and operator experience are considered in the choice of treatment approach. PMID:22949763

  2. Effect of telenursing (telephone follow-up) on glycemic control and body mass index (BMI) of type 2 diabetes patients

    PubMed Central

    Borhani, Fariba; Lashkari, Tahereh; Sabzevari, Sakineh; Abbaszadeh, Abbas

    2013-01-01

    Background: Telenursing includes every nursing and care-giving services conducted remotely. In telenursing, telephone as a device, which is available for most of the people, is being used increasingly. In a telephone-based system, patients are being contacted by health care providers on regular bases and they would be provided with some information about their illness and their treatment method. This study was conducted to determine the effect of phone-based follow-ups on diabetes patients’ metabolic control in the city of Kerman in Iran. Materials and Methods: This is a quasi-experimental study conducted on 50 type II diabetes patients in Kerman during 2011. Data were collected using a demographic questionnaire and also by taking physiological measurement of fasting blood suger (FBS), Glycated Hemoglobin (HbA1c), and postprandial glucose (PPG). Participants’ body mass index (BMI) was calculated by measuring height and weight. Patients completed the questionnaire at the beginning of the study and 12 weeks later. The patients were randomly divided into two groups of experiment and control. Patients in the experimental group received phone calls by the researcher for 12 weeks, and the follow-ups included instructions on self-care and advices to follow their diets, exercise, and insulin titration. Data analysis was done using descriptive and inferential statistical methods (chi-square, analysis of variance [ANOVA], independent t-test, and paired t-test). Results: The decrease of HbA1c and PPG was significantly more in the intervention group compared with the controls (P < 0.001). However, there was no significant difference between the mean of FBS (P = 0.42), and BMI (P = 0.31) in both groups after the intervention. Conclusions: According to the results of this study, telenursing was able to improve the metabolic indices of the patients. Therefore, using this method is recommended for patients with type II diabetes. PMID:24554942

  3. Novel methodology for 3D reconstruction of carotid arteries and plaque characterization based upon magnetic resonance imaging carotid angiography data.

    PubMed

    Sakellarios, Antonis I; Stefanou, Kostas; Siogkas, Panagiotis; Tsakanikas, Vasilis D; Bourantas, Christos V; Athanasiou, Lambros; Exarchos, Themis P; Fotiou, Evangelos; Naka, Katerina K; Papafaklis, Michail I; Patterson, Andrew J; Young, Victoria E L; Gillard, Jonathan H; Michalis, Lampros K; Fotiadis, Dimitrios I

    2012-10-01

    In this study, we present a novel methodology that allows reliable segmentation of the magnetic resonance images (MRIs) for accurate fully automated three-dimensional (3D) reconstruction of the carotid arteries and semiautomated characterization of plaque type. Our approach uses active contours to detect the luminal borders in the time-of-flight images and the outer vessel wall borders in the T(1)-weighted images. The methodology incorporates the connecting components theory for the automated identification of the bifurcation region and a knowledge-based algorithm for the accurate characterization of the plaque components. The proposed segmentation method was validated in randomly selected MRI frames analyzed offline by two expert observers. The interobserver variability of the method for the lumen and outer vessel wall was -1.60%±6.70% and 0.56%±6.28%, respectively, while the Williams Index for all metrics was close to unity. The methodology implemented to identify the composition of the plaque was also validated in 591 images acquired from 24 patients. The obtained Cohen's k was 0.68 (0.60-0.76) for lipid plaques, while the time needed to process an MRI sequence for 3D reconstruction was only 30 s. The obtained results indicate that the proposed methodology allows reliable and automated detection of the luminal and vessel wall borders and fast and accurate characterization of plaque type in carotid MRI sequences. These features render the currently presented methodology a useful tool in the clinical and research arena. PMID:22617149

  4. The causal relevance of body mass index in different histological types of lung cancer: A Mendelian randomization study

    PubMed Central

    Carreras-Torres, Robert; Haycock, Philip C.; Relton, Caroline L.; Martin, Richard M.; Smith, George Davey; Kraft, Peter; Gao, Chi; Tworoger, Shelley; Le Marchand, Loïc; Wilkens, Lynne R.; Park, Sungshim L.; Haiman, Christopher; Field, John K.; Davies, Michael; Marcus, Michael; Liu, Geoffrey; Caporaso, Neil E.; Christiani, David C.; Wei, Yongyue; Chen, Chu; Doherty, Jennifer A.; Severi, Gianluca; Goodman, Gary E.; Hung, Rayjean J.; Amos, Christopher I.; McKay, James; Johansson, Mattias; Brennan, Paul

    2016-01-01

    Body mass index (BMI) is inversely associated with lung cancer risk in observational studies, even though it increases the risk of several other cancers, which could indicate confounding by tobacco smoking or reverse causality. We used the two-sample Mendelian randomization (MR) approach to circumvent these limitations of observational epidemiology by constructing a genetic instrument for BMI, based on results from the GIANT consortium, which was evaluated in relation to lung cancer risk using GWAS results on 16,572 lung cancer cases and 21,480 controls. Results were stratified by histological subtype, smoking status and sex. An increase of one standard deviation (SD) in BMI (4.65 Kg/m2) raised the risk for lung cancer overall (OR = 1.13; P = 0.10). This was driven by associations with squamous cell (SQ) carcinoma (OR = 1.45; P = 1.2 × 10−3) and small cell (SC) carcinoma (OR = 1.81; P = 0.01). An inverse trend was seen for adenocarcinoma (AD) (OR = 0.82; P = 0.06). In stratified analyses, a 1 SD increase in BMI was inversely associated with overall lung cancer in never smokers (OR = 0.50; P = 0.02). These results indicate that higher BMI may increase the risk of certain types of lung cancer, in particular SQ and SC carcinoma. PMID:27487993

  5. Type II PI4-kinases control Weibel-Palade body biogenesis and von Willebrand factor structure in human endothelial cells

    PubMed Central

    Lopes da Silva, Mafalda; O'Connor, Marie N.; Kriston-Vizi, Janos; White, Ian J.; Al-Shawi, Raya; Simons, J. Paul; Mössinger, Julia; Haucke, Volker

    2016-01-01

    ABSTRACT Weibel-Palade bodies (WPBs) are endothelial storage organelles that mediate the release of molecules involved in thrombosis, inflammation and angiogenesis, including the pro-thrombotic glycoprotein von Willebrand factor (VWF). Although many protein components required for WPB formation and function have been identified, the role of lipids is almost unknown. We examined two key phosphatidylinositol kinases that control phosphatidylinositol 4-phosphate levels at the trans-Golgi network, the site of WPB biogenesis. RNA interference of the type II phosphatidylinositol 4-kinases PI4KIIα and PI4KIIβ in primary human endothelial cells leads to formation of an increased proportion of short WPB with perturbed packing of VWF, as exemplified by increased exposure of antibody-binding sites. When stimulated with histamine, these cells release normal levels of VWF yet, under flow, form very few platelet-catching VWF strings. In PI4KIIα-deficient mice, immuno-microscopy revealed that VWF packaging is also perturbed and these mice exhibit increased blood loss after tail cut compared to controls. This is the first demonstration that lipid kinases can control the biosynthesis of VWF and the formation of WPBs that are capable of full haemostatic function. PMID:27068535

  6. The causal relevance of body mass index in different histological types of lung cancer: A Mendelian randomization study.

    PubMed

    Carreras-Torres, Robert; Haycock, Philip C; Relton, Caroline L; Martin, Richard M; Smith, George Davey; Kraft, Peter; Gao, Chi; Tworoger, Shelley; Le Marchand, Loïc; Wilkens, Lynne R; Park, Sungshim L; Haiman, Christopher; Field, John K; Davies, Michael; Marcus, Michael; Liu, Geoffrey; Caporaso, Neil E; Christiani, David C; Wei, Yongyue; Chen, Chu; Doherty, Jennifer A; Severi, Gianluca; Goodman, Gary E; Hung, Rayjean J; Amos, Christopher I; McKay, James; Johansson, Mattias; Brennan, Paul

    2016-01-01

    Body mass index (BMI) is inversely associated with lung cancer risk in observational studies, even though it increases the risk of several other cancers, which could indicate confounding by tobacco smoking or reverse causality. We used the two-sample Mendelian randomization (MR) approach to circumvent these limitations of observational epidemiology by constructing a genetic instrument for BMI, based on results from the GIANT consortium, which was evaluated in relation to lung cancer risk using GWAS results on 16,572 lung cancer cases and 21,480 controls. Results were stratified by histological subtype, smoking status and sex. An increase of one standard deviation (SD) in BMI (4.65 Kg/m(2)) raised the risk for lung cancer overall (OR = 1.13; P = 0.10). This was driven by associations with squamous cell (SQ) carcinoma (OR = 1.45; P = 1.2 × 10(-3)) and small cell (SC) carcinoma (OR = 1.81; P = 0.01). An inverse trend was seen for adenocarcinoma (AD) (OR = 0.82; P = 0.06). In stratified analyses, a 1 SD increase in BMI was inversely associated with overall lung cancer in never smokers (OR = 0.50; P = 0.02). These results indicate that higher BMI may increase the risk of certain types of lung cancer, in particular SQ and SC carcinoma. PMID:27487993

  7. Impact of cardiovascular risk factors on carotid intima–media thickness: sex differences

    PubMed Central

    Łoboz-Rudnicka, Maria; Jaroch, Joanna; Bociąga, Zbigniew; Rzyczkowska, Barbara; Uchmanowicz, Izabella; Polański, Jacek; Dudek, Krzysztof; Szuba, Andrzej; Łoboz-Grudzień, Krystyna

    2016-01-01

    Background and purpose There has been growing interest in the sex-related differences in the impact of cardiovascular (CV) risk factors on carotid intima–media thickness (CIMT). Therefore, we aimed at examining the influence of CV risk factors on CIMT in men and women and identifying differences between males and females in the risk profiles affecting CIMT. Patients and methods The study group consisted of 256 patients (mean age 54.7 years), including 134 females (52%), with the following CV risk factors: arterial hypertension, type 2 diabetes mellitus, dyslipidemia, nicotine addiction, overweight, and obesity. Subjects with the history of any overt CV disease were excluded. CIMT was measured through B-mode ultrasound examination of the right common carotid artery. In the analysis of CIMT values at different ages, the patients were divided into three age groups: 1) <45 years, 2) 45–60 years, and 3) >60 years. Regression analysis was used to examine the influence of CV risk factors on CIMT in men and women. Results CIMT increased with age in both men and women. Women had lower values of CIMT than men (0.54 mm vs 0.60 mm, P=0.011). The analysis in three age subgroups revealed that CIMT values were comparable in men and women in group 1 (0.48 mm vs 0.48 mm, P=0.861), but over the age of 45 years, CIMT values became significantly lower in women compared to men (group 2: 0.51 mm vs 0.63 mm, P=0.005; group 3: 0.63 mm vs 0.72 mm, P=0.020). Significant differences were observed between the sexes in terms of risk factor impact on CIMT. In men, only three factors significantly affected CIMT: age (b=+0.009, P<0.0001), hypertension (b=+0.067, P<0.05), and type 2 diabetes (b=+0.073, P<0.05). In women, apart from age (b=+0.008, P<0.0001) and type 2 diabetes (b=+0.111, P<0.01), significant factors were pulse pressure (PP; b=+0.005, P<0.0001), body mass index (b=+0.007, P<0.05), increased waist circumference (b=+0.092, P<0.01), and metabolic syndrome (b=+0.071, P<0.05). In the

  8. Petrology of Mafic Bodies Associated with the Eocene "A-type" Golden Horn Batholith, North Cascades, WA

    NASA Astrophysics Data System (ADS)

    Berkelhammer, S.; Tepper, J. H.; Petro, G. T.; Eckles, E. H.

    2012-12-01

    The 49 Ma Golden Horn batholith, the only "A-type" granite in the WA Cascades, is associated with coeval mafic bodies that represent samples of mantle-derived magmas that were present during melting and emplacement of the batholith. The most voluminous mafic rocks are dikes up to 10 m wide that occur in a NW-trending 48 Ma swarm roughly parallel to (but outside of) the SW margin of the batholith. Dike lithologies include hornblende lamprophyres, biotite-hornblende diorites, and hornblende-biotite tonalites. Mafic rocks also occur as plutons within the batholith, one studied example being the 48.4 Ma olivine-bearing pyroxene diorite at Cutthroat Peak. All of the Golden Horn mafic rocks have spidergrams with HFSE depletions that suggest an arc setting. They can be divided on the basis of chemistry into 5 types: low-silica adakites (LSA), high-silica adakites (HSA), Nb-enriched basalts (NEB), high-Nb basalts (HNB), and "typical" arc basalts (TAB). HSA traits (800-1400 ppm Sr, La/Ybn = 11-23, low HREE contents, SiO2 >60 wt. %) are consistent with an eclogite (slab) source. Conversely, the LSA (860-1100 ppm Sr, La/Ybn = 21-25, up to 650 ppm Cr, SiO2 <60 wt. %), NEB and HNB (both with 380-550 ppm Cr, 22-57 ppm Nb, La/Ybn = 13-26) require contributions from both eclogite and peridotite sources. Traits of the TAB, represented by the Cutthroat Peak diorite (46-50 wt. % SiO2; La/Ybn = 3.5-6.1) suggest derivation from a mantle wedge without slab melt (eclogite) involvement. We suggest that the LSA, NEB, and HNB originated by melting of mantle wedge that had been enriched with (or assimilated by) slab melts, the latter possibly represented by the HSA. Elevated temperatures necessary for slab melting are associated with slab windows, and plate motion reconstructions (Engebretson et al., 1985) are compatible with migration of the Kula-Farallon slab window beneath the Golden Horn area during the mid-Eocene. Passage of this slab window provides an explanation for adakite formation

  9. Effects of bovine cytochrome P450 single-nucleotide polymorphism, forage type and body condition on production traits in cattle.

    PubMed

    Sales, M A; Larson, M J; Reiter, S T; Brown, A H; Brown, M A; Looper, M L; Coffey, K P; Rosenkrans, C F

    2012-08-01

    Relating single-nucleotide polymorphisms (SNP) to cows with acceptable productivity could benefit cattle breeders in areas where tall fescue is the predominant forage. This study aimed to (i) identify SNPs in bovine cytochrome P450 3A28 (CYP3A28) and (ii) determine the associations between SNP genotype, forage and cow body condition (BC). Genotype (CC, CG or GG) and forage [Kentucky-31 wild-type endophyte-infected tall fescue (KY+) vs. bermudagrass] effects on milk volume and quality were determined in Herd 1 cows (123 cows); in Herd 2 (99 cows), genotype and BC (low vs. moderate) effects on ovarian follicle size, calving date and calving per cent were determined; and in Herd 3 (114 cows), effects of genotype and fescue cultivar [KY+ vs. non-toxic endophyte-infected tall fescue (HiMag4)] were related to calving per cent, calving date and weaning weights of both cow and her calf. A cytosine (C) to guanine (G) transversion at base 994 (C994G) in CYP3A28 was identified. There was a genotype × forage type interaction (p < 0.05) on milk protein in Herd 1 cows; CC cows grazing bermudagrass had greater milk protein percentage in relation to other cows in the herd. In Herd 2, BC and genotype × BC tended (p < 0.10) to influence follicle size and Julian calving date respectively. Diameter of the largest follicle tended to be larger in moderate BC than in low-BC cows; whereas, CC and CG cows in moderate BC and homozygous (CC and GG) cows in low BC tended to calve 14 days earlier in relation to CG cows in low BC. In Herd 3, there was a genotype × forage type interaction (p < 0.05) on calving per cent, Julian calving date and calf weaning weight. In this study, genetic alterations (G allele at C994G) coupled with nutritional factors (low BC and toxic tall fescue) resulted in overall lower productivity in cows. PMID:21668515

  10. Body Signals.

    ERIC Educational Resources Information Center

    Gurley-Dilger, 'Laine

    1986-01-01

    Describes an activity in which students observe pairs of students engaged in conversation. Observations of "body language" are made, shifts in stance, and duration of stance. Discusses the application of this type of study to other species. (TW)

  11. Body lice

    MedlinePlus

    ... also get lice from infected clothing, towels, or bedding. Body lice are bigger than other types of ... last if you: Bathe regularly Wash clothes and bedding at least once a week Placing clothes in ...

  12. Static elastic studies of lathyritic rabbit carotid arteries and thoracic aorta.

    PubMed

    Terpin, T; Roach, M R

    1983-05-01

    Sixteen New Zealand White rabbits with an average initial weight of 1.6 kg were used to determine if lathyrism altered the static elastic properties of the aorta and carotid arteries. Eight were given 1% beta-aminopropionitrile in their drinking water for the same period. All were fed regular rabbit chow. Blood pressures and body weights were taken twice weekly. Blood pressure was not significantly different between the two groups but the lathyritic animals did lose weight while the controls gained. The rabbits were sacrificed at the end of 4 weeks with an overdose of sodium pentobarbital (Nembutal) and the carotid arteries and thoracic aorta were removed for pressure--volume experiments. From these experiments tension--strain curves, elasticities, and slack of the collagen were obtained. The longitudinal distensibility curves for the aortas and carotid arteries for both groups were almost identical. The longitudinal elasticities of elastin and collagen, and the slack were not significantly different between the two groups. The circumferential-distensibility curves for the same arteries showed few differences, however, the elasticities of elastin and collagen, and the slack decreased indicating an alteration in the elastin and a decrease in collagen fibres or a defect in the intramolecular cross-links of collagen. PMID:6883203

  13. Relation between visceral fat and carotid intimal media thickness in Mexican postmenopausal women: a preliminary report

    PubMed Central

    Azpilcueta, Yessica Mireya Moreno; Ortiz, Sergio Rosales

    2016-01-01

    Aim of the study To investigate the relationship between visceral fat and carotid IMT (intima media thickness) in Mexican postmenopausal women. Material and methods In 71 postmenopausal women divided in two groups: group 1, IMT > 1 mm and group 2, IMT ≤ 1 mm, blood pressure, body mass index (BMI), waist hip ratio (WHR), visceral and subcutaneous fats and carotid IMT were analyzed. Descriptive statistics were used and the comparison among those with abnormal and normal IMT was carried out using Mann-Whitney U test; also Spearman's correlation analysis was done. Results When comparing group 1 (n = 9, 12.7%) with group 2 (n = 62, 87.3%), it was found that the subcutaneous fat, visceral fat and systolic blood pressure were significantly greater in group 1 (p < 0.018, p < 0.001 and p < 0.006, respectively), and also in this group there was a correlation between BMI and subcutaneous fat (ρ = 0.686, p < 0.041) and between visceral fat and the systolic blood pressure (ρ = 0.712, p < 0.031). In group 2, there was a correlation between IMT and diastolic blood pressure (ρ = 0.251, p < 0.049). Conclusion Subcutaneous and visceral fat have an unfavorable effect in the carotid IMT and in blood pressure. PMID:27582681

  14. Choosing Wisely for Syncope: Low‐Value Carotid Ultrasound Use

    PubMed Central

    Scott, John W.; Schwartz, Aaron L.; Gates, Jonathan D.; Gerhard‐Herman, Marie; Havens, Joaquim M.

    2014-01-01

    Background The United States spends more than $750 billion annually on tests and procedures that do not benefit patients. Although there is no physiological indication for carotid ultrasound in “simple” syncope in the absence of focal neurological signs or symptoms suggestive of stroke, there is concern that this practice remains common for routine syncope workups. Methods and Results We used a 5% random‐sample Medicare claims database to evaluate large‐scale national trends in utilization of low‐value carotid ultrasound imaging for simple syncope. We found that 16.5% of all Medicare beneficiaries with simple syncope underwent carotid imaging and 6.5% of all carotid ultrasounds ordered in 2009 were for this low‐value indication. These findings were complemented by a manual chart review of 313 patients at a large academic medical center who underwent carotid ultrasound for simple syncope over a 5‐year period. For the 48 (15.4%) of 313 patients with stenosis ≥50%, carotid ultrasound did not yield a causal diagnosis. Only 2% of the 313 patients imaged experienced a change in medications after a positive study, and <1% of patients underwent a carotid revascularization procedure. Conclusions These data suggest that carotid ultrasound for patients with uncomplicated syncope are still commonly ordered and may be an easy target for institutions striving to curtail low‐value care. PMID:25122665

  15. Is carotid duplex scanning sufficient as the sole investigation prior to carotid endarterectomy?

    PubMed

    Collins, P; McKay, I; Rajagoplan, S; Bachoo, P; Robb, O; Brittenden, J

    2005-11-01

    Carotid endarterectomy (CEA) is the accepted treatment for certain patients who have had, or who are at risk of having, a stroke if they have a significant narrowing of the internal carotid artery. Rapid and accurate classification of the degree of stenosis is important as the benefit of surgery is highly dependent on this. The aim of this study was to assess whether the addition of angiography to duplex scanning resulted in a change in patient management in a unit where duplex scanning was used as the sole imaging investigation prior to CEA. The study population consisted of 64 patients with significant internal carotid artery stenosis on duplex scanning who were suitable for, and wished to be considered for, CEA. All patients underwent an angiogram. In this study 9 (14%) patients did not proceed to surgery on the basis of angiography and in a further 11 (17%) patients insufficient views of the distal vessel were obtained on duplex scanning. Three of these patients had extensive disease which excluded surgery. One patient experienced a transient ischaemic attack (TIA) at the time of angiography. In conclusion, this audit has highlighted the limitations in performing duplex scanning alone, and the costs that this can incur on the patient who may undergo an unnecessary operation. We cannot recommend duplex scanning as the sole investigation prior to CEA. There is need to evaluate the role of additional non-invasive carotid imaging such as magnetic resonance angiography or CT angiography in the assessment of these patients. PMID:16249605

  16. Numerical simulation of blood flow and plaque progression in carotid-carotid bypass patient specific case.

    PubMed

    Filipovic, Nenad; Saveljic, Igor; Nikolic, Dalibor; Milosevic, Zarko; Kovacevic, Pavle; Velicki, Lazar

    2015-01-01

    This study describes computer simulation of blood flow and plaque progression pattern in a patient who underwent surgical treatment for infected carotid prosthetic tube graft using carotid-carotid cross-over bypass. The 3D blood flow is governed by the Navier-Stokes equations, together with the continuity equation. Mass transfer within the blood lumen and through the arterial wall is coupled with the blood flow and is modelled by the convection-diffusion equation. Low-density lipoprotein (LDL) transport in lumen of the vessel is described by Kedem-Katchalsky equations. The inflammatory process is solved using three additional reaction-diffusion partial differential equations. Calculation based on a computer simulation showed that flow distribution in the left carotid artery (CA) was around 40-50% of the total flow in the right common CA. Also, the left CA had higher pressure gradient after surgical intervention. Plaque progression simulation predicted development of the atherosclerotic plaque in the position of the right common CA and the left internal CA. A novel way of atherosclerotic plaque progression modelling using computer simulation shows a potential clinical benefit with significant impact on the treatment strategy optimization. PMID:26291584

  17. Direct traumatic carotid cavernous fistula: angiographic classification and treatment strategies. Study of 172 cases.

    PubMed

    Chi, Cuong Tran; Nguyen, Dang; Duc, Vo Tan; Chau, Huynh Hong; Son, Vo Tan

    2014-01-01

    We report our experience in treatment of traumatic direct carotid cavernous fistula (CCF) via endovascular intervention. We hereof recommend an additional classification system for type A CCF and suggest respective treatment strategies. Only type A CCF patients (Barrow's classification) would be recruited for the study. Based on the angiographic characteristics of the CCF, we classified type A CCF into three subtypes including small size, medium size and large size fistula depending on whether there was presence of the anterior carotid artery (ACA) and/or middle carotid artery (MCA). Angiograms with opacification of both ACA and MCA were categorized as small size fistula. Angiograms with opacification of either ACA or MCA were categorized as medium size fistula and those without opacification of neither ACA nor MCA were classified as large size fiatula. After the confirm angiogram, endovascular embolization would be performed impromptu using detachable balloon, coils or both. All cases were followed up for complication and effect after the embolization. A total of 172 direct traumatic CCF patients were enrolled. The small size fistula was accountant for 12.8% (22 cases), medium size 35.5% (61 cases) and large size fistula accountant for 51.7% (89 cases). The successful rate of fistula occlusion under endovascular embolization was 94% with preservation of the carotid artery in 70%. For the treatment of each subtype, a total of 21/22 cases of the small size fistulas were successfully treated using coils alone. The other single case of small fistula was defaulted. Most of the medium and large size fistulas were cured using detachable balloons. When the fistula sealing could not be obtained using detachable balloon, coils were added to affirm the embolization of the cavernous sinus via venous access. There were about 2.9% of patient experienced direct carotid artery puncture and 0.6% puncture after carotid artery cut-down exposure. About 30% of cases experienced

  18. GENETIC STUDIES USING THE ORANGE BODY COLOR TYPE OF NEZARA VIRIDULA (HEMIPTERA:PENTATOMIDAE): INHERITANCE, SPERM PRECEDENCE, AND DISASSORTATIVE MATING

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nezara viridula (L.) has body color polymorphisms. Nezara viridula f. smaragdula is the common green morph, whereas the rare morph N. viridula f. aurantiaca is uniformly orange. Crossing studies were conducted to determine the inheritance of the orange body color trait. Mendelian genetic analysis su...

  19. Common genetic variants highlight the role of insulin resistance and body fat distribution in type 2 diabetes, independent of obesity.

    PubMed

    Scott, Robert A; Fall, Tove; Pasko, Dorota; Barker, Adam; Sharp, Stephen J; Arriola, Larraitz; Balkau, Beverley; Barricarte, Aurelio; Barroso, Inês; Boeing, Heiner; Clavel-Chapelon, Françoise; Crowe, Francesca L; Dekker, Jacqueline M; Fagherazzi, Guy; Ferrannini, Ele; Forouhi, Nita G; Franks, Paul W; Gavrila, Diana; Giedraitis, Vilmantas; Grioni, Sara; Groop, Leif C; Kaaks, Rudolf; Key, Timothy J; Kühn, Tilman; Lotta, Luca A; Nilsson, Peter M; Overvad, Kim; Palli, Domenico; Panico, Salvatore; Quirós, J Ramón; Rolandsson, Olov; Roswall, Nina; Sacerdote, Carlotta; Sala, Núria; Sánchez, María-José; Schulze, Matthias B; Siddiq, Afshan; Slimani, Nadia; Sluijs, Ivonne; Spijkerman, Annemieke M W; Tjonneland, Anne; Tumino, Rosario; van der A, Daphne L; Yaghootkar, Hanieh; McCarthy, Mark I; Semple, Robert K; Riboli, Elio; Walker, Mark; Ingelsson, Erik; Frayling, Tim M; Savage, David B; Langenberg, Claudia; Wareham, Nicholas J

    2014-12-01

    We aimed to validate genetic variants as instruments for insulin resistance and secretion, to characterize their association with intermediate phenotypes, and to investigate their role in type 2 diabetes (T2D) risk among normal-weight, overweight, and obese individuals. We investigated the association of genetic scores with euglycemic-hyperinsulinemic clamp- and oral glucose tolerance test-based measures of insulin resistance and secretion and a range of metabolic measures in up to 18,565 individuals. We also studied their association with T2D risk among normal-weight, overweight, and obese individuals in up to 8,124 incident T2D cases. The insulin resistance score was associated with lower insulin sensitivity measured by M/I value (β in SDs per allele [95% CI], -0.03 [-0.04, -0.01]; P = 0.004). This score was associated with lower BMI (-0.01 [-0.01, -0.0]; P = 0.02) and gluteofemoral fat mass (-0.03 [-0.05, -0.02; P = 1.4 × 10(-6)) and with higher alanine transaminase (0.02 [0.01, 0.03]; P = 0.002) and γ-glutamyl transferase (0.02 [0.01, 0.03]; P = 0.001). While the secretion score had a stronger association with T2D in leaner individuals (Pinteraction = 0.001), we saw no difference in the association of the insulin resistance score with T2D among BMI or waist strata (Pinteraction > 0.31). While insulin resistance is often considered secondary to obesity, the association of the insulin resistance score with lower BMI and adiposity and with incident T2D even among individuals of normal weight highlights the role of insulin resistance and ectopic fat distribution in T2D, independently of body size. PMID:24947364

  20. Algal Lipid Bodies: Stress Induction, Purification, and Biochemical Characterization in Wild-Type and Starchless Chlamydomonas reinhardtii▿ †

    PubMed Central

    Wang, Zi Teng; Ullrich, Nico; Joo, Sunjoo; Waffenschmidt, Sabine; Goodenough, Ursula

    2009-01-01

    When the unicellular green soil alga Chlamydomonas reinhardtii is deprived of nitrogen after entering stationary phase in liquid culture, the cells produce abundant cytoplasmic lipid bodies (LBs), as well as abundant starch, via a pathway that accompanies a regulated autophagy program. After 48 h of N starvation in the presence of acetate, the wild-type LB content has increased 15-fold. When starch biosynthesis is blocked in the sta6 mutant, the LB content increases 30-fold, demonstrating that genetic manipulation can enhance LB production. The use of cell wall-less strains permitted development of a rapid “popped-cell” microscopic assay to quantitate the LB content per cell and permitted gentle cell breakage and LB isolation. The highly purified LBs contain 90% triacylglycerol (TAG) and 10% free fatty acids (FFA). The fatty acids associated with the TAGs are ∼50% saturated (C16 and C18) fatty acids and ∼50% unsaturated fatty acids, half of which are in the form of oleic acid (C18:1). The FFA are ∼50% C16 and ∼50% C18. The LB-derived TAG yield from a liter of sta6 cells at 107 cells/ml after starvation for 48 h is calculated to approach 400 mg. The LB fraction also contains low levels of charged glycerolipids, with the same profile as whole-cell charged glycerolipids, that presumably form LB membranes; chloroplast-specific neutral glycerolipids (galactolipids) are absent. Very low levels of protein are also present, but all matrix-assisted laser desorption ionization-identified species are apparent contaminants. Nitrogen stress-induced LB production in C. reinhardtii has the hallmarks of a discrete pathway that should be amenable to additional genetic and culture condition manipulation. PMID:19880756

  1. Ion observations close to Phobos: A new type of the solar wind interaction with a planetary body

    NASA Astrophysics Data System (ADS)

    Futaana, Y.; Barabash, S.; Holstrom, M.; Nilsson, H.

    2009-04-01

    During the close Phobos flyby on July 23, 2008, ASPERA-3/IMA (Ion Mass Analyser) on board Mars Express (MEX) was carrying out ion observations. The flyby occurred in the upstream solar wind far away from the Martian bow shock where no interference with/from the Martian plasma environment is expected. In the vicinity of Phobos, IMA detected unusual signatures in the proton fluxes. Because MEX do not have a magnetometer on board it is not possible to directly back trace the trajectories of the observed protons. Thus, it is difficult to decide if those protons came from Phobos. However, after careful analyses, we conclude that the origin of these protons is indeed Phobos. The reasons are: 1. The energy of the observed protons is slightly less than the solar wind proton energy, and the energy spectrum have a low energy tail. Therefore, the protons can be interpreted as backscattered solar wind protons as was observed by the Japanese Kaguya mission [Y. Saito et al, GRL, 2008] at the Moon. 2. We conducted test particle backtracing assuming that the protons originate from Phobos under various magnetic field conditions. A unique solution for all independent observations was found. We conclude that the observed protons are solar wind protons backscattered from Phobos. The Kaguya observations at the Moon suggest a backscatter efficiency of 0.1 - 1%. Therefore, Phobos and any other atmosphereless body injects into the solar wind a substantial flux of protons. The interaction of the these ions with the solar wind flow results in a specific type of the interaction.

  2. Congenital Absence of the Internal Carotid Artery

    SciTech Connect

    Florio, Francesco; Balzano, Silverio; Nardella, Michele; Strizzi, Vincenzo; Cammisa, Mario; Bozzini, Vincenzo; Catapano, Giuseppe; D'Angelo, Vincenzo

    1999-01-15

    We report three cases of congenital absence of an internal carotid artery (ICA), diagnosed incidentally by digital subtraction angiography. The analysis of the cases is based on the classification of segmental ICA agenesis proposed by Lasjaunias and Berenstein. Usually the patients with this rare vascular anomaly are asymptomatic; some may have symptoms related to cerebrovascular insufficiency, compression by enlarged intracranial collateral vessels, or complications associated with cerebral aneurysms. Diagnosis of congenital absence of ICA is made by skull base computed tomography (CT) scan, CT and magnetic resonance angiography, and conventional or digital subtraction angiography.

  3. Concomitant Carotid and Coronary Artery Reconstruction

    PubMed Central

    Craver, Joseph M.; Murphy, Douglas A.; Jones, Ellis L.; Curling, Patrick E.; Bone, David K.; Smith, Robert B.; Perdue, Garland D.; Hatcher, Charles R.; Kandrach, Michael

    1982-01-01

    Data are presented on 68 patients who underwent concomitant carotid endarterectomy (CE) and coronary artery bypass surgery (CAB) at Emory University Hospital from January 1974 to February 1981. This group is then compared with a randomly selected, matched population without known carotid disease who underwent CAB alone. Asymptomatic bruit was the reason for investigation in 40 patients (59%); another 23 patients (34%) experienced transient cerebral ischemic attacks (TIAs); and five patients (7%) had TIA and prior stroke. Carotid stenoses (>75% luminal narrowing) were demonstrated as follows: isolated left, 24 patients; isolated right, 27 patients; and bilateral lesions, 16 patients. One patient had innominate artery stenosis. Associated total occlusion of one or both vertebral arteries was demonstrated in six patients. Ninety-seven per cent of patients had disabling angina pectoris prior to operation; the angina was unstable in 57%, 15% had congestive heart failure, and 54% had had at least one prior myocardial infarction (MI). Single-vessel coronary disease was present in 12.5% of patients, double in 37.5%, triple in 41.1%, and left main stenosis in 9%; 43% of patients had abnormal ventricular contractility. CE was performed on 67 patients (36 left and 31 right); aortocarotid bypass was performed on one. The CE procedures were performed immediately prior to the sternotomy for CAB under the same anesthesia. CAB consisted of single bypass in eight patients (11.8%); double in 16 patients (23.5%); triple in 22 patients (32.4%); and quadruple or more in 22 patients (32.4%) (mean = 2.9 grafts per patient). There was no hospital mortality. Perioperative MI occurred in 2.0% and stroke with residual deficit in 1.3%. Cumulative survival is 98.5% at two years. Sixty-three patients (92%) reported improvement or elimination of anginal symptoms after operation. Rehospitalization for stroke was necessary in 3.7% patients. Postoperative activity levels are; self-care only, 3

  4. Recommendations for Carotid Stenting in Korea

    PubMed Central

    Chang, Hyuk Won; Suh, Sang-il; Jeong, Hae Woong; Suh, Dae Chul

    2015-01-01

    Carotid artery angioplasty with stenting (CAS) is being performed in many hospitals in Korea. Most of the guidelines which are being used are similar, but the practical aspects such as techniques are different between hospitals. For example, usage of various protective devices, the oral antiplatelet regimen prior to procedure and placing of temporary pacemaker to prevent bradycardia are different between hospitals. In this article, we summarize and propose the guidelines for CAS which is currently being accepted in Korea. These guidelines may be helpful in providing protocol to neurointerventionalist who perform CAS and to standardize the process including reporting of CAS in the future comparative trials in Korea. PMID:25763292

  5. Management of Extracranial Carotid Artery Disease

    PubMed Central

    Ooi, Yinn Cher

    2015-01-01

    Stroke is the third leading cause of death in developed nations. Up to 88% of strokes are ischemic in nature. Extracranial carotid artery atherosclerotic disease is the third leading cause of ischemic stroke in the general population and the second most common non-traumatic cause among adults <45 years of age. The aim of this paper is to provide comprehensive, evidence-based recommendations for the management of extracranial atherosclerotic disease, including imaging for screening and diagnosis, medical management and interventional management. PMID:25439328

  6. L-arginine mediated renaturation enhances yield of human, α6 type IV collagen non-collagenous domain from bacterial inclusion bodies

    PubMed Central

    Gunda, Venugopal; Boosani, Chandra Shekhar; Verma, Raj Kumar; Guda, Chittibabu; Akul Sudhakar, Yakkanti

    2012-01-01

    The anti-angiogenic, carboxy terminal non-collagenous domain (NC1) derived from human Collagen type IV alpha 6 chain, [α6(IV)NC1] or hexastatin, was earlier obtained using different recombinant methods of expression in bacterial systems. However, the effect of L-arginine mediated renaturation in enhancing the relative yields of this protein from bacterial inclusion bodies has not been evaluated. In the present study, direct stirring and on-column renaturation methods using L-arginine and different size exclusion chromatography matrices were applied for enhancing the solubility in purifying the recombinant α6(IV)NC1 from bacterial inclusion bodies. This methodology enabled purification of higher quantities of soluble protein from inclusion bodies, which inhibited endothelial cell proliferation, migration and tube formation. Thus, the scope for L-arginine mediated renaturation in obtaining higher yields of soluble, biologically active NC1 domain from bacterial inclusion bodies was evaluated. PMID:22512648

  7. Successful Endovascular Treatment of a Left Common Carotid Artery Aneurysm Following Failed Surgery of a Right Common Carotid Artery Aneurysm

    SciTech Connect

    Cil, Barbaros E. Ucar, Ibrahim; Ozsoy, Fatma; Arat, Anil; Yorgancioglu, Cem; Boeke, Erkmen

    2005-04-15

    Aneurysm of the common carotid artery is a rare and serious disease requiring prompt treatment in order to avoid neurologic complications. A 39-year-old man presented with voice impairment and a pulsatile mass at the right side of his neck and was found by color Doppler examination to have bilateral common carotid artery aneurysms of unknown origin. The right-sided large aneurysm was treated with placement of an 8 mm interposition Gore-Tex graft between the right common and internal carotid arteries. The surgical graft thrombosed 7 days after the surgery but the left-sided aneurysm was successfully treated by a Jostent peripheral stent-graft. Color Doppler examination showed a patent stent and no filling of the aneurysm on his first and sixth-month follow-up. Bilateral common carotid artery aneurysm is an exceptionally unusual condition and endovascular treatment of carotid artery aneurysms with covered stents may become an effective treatment alternative for these lesions.

  8. Access to the carotid artery bifurcation: Cadaveric study with application to nasotracheal intubation as a technique to improve access to a high carotid artery bifurcation.

    PubMed

    Foreman, Paul M; Harrigan, Mark R; Griessenauer, Christoph J; Loukas, Marios; Tubbs, R Shane

    2015-12-01

    Carotid endarterectomy (CEA) is a common and efficacious surgical procedure for the prevention of ischemic stroke due to atherosclerosis of the internal carotid artery (ICA). A high common carotid artery bifurcation can make CEA technically difficult due to limited carotid artery exposure. A cadaveric study was performed to evaluate the efficacy of nasotracheal intubation for improving access to a high carotid artery bifurcation. Based on this study, nasotracheal intubation does not improve access to a high carotid artery bifurcation as compared with orotracheal intubation. PMID:26312946

  9. Relationship Between Carotid Artery Calcification Detected in Dental Panoramic Images and Hypertension and Myocardial Infarction

    PubMed Central

    Moshfeghi, Mahkameh; Taheri, Jamileh Beigom; Bahemmat, Nika; Evazzadeh, Mohammad Ebrahim; Hadian, Hoora

    2014-01-01

    Background: Carotid artery calcification may be related to cerebrovascular accident, which may result in death or physical and mental disabilities in survivors. Objectives: Our purpose is to study the association of carotid artery calcification (CAC) on dental panoramic radiographs and two risk factors of cerebrovascular accident (CVA) including hypertension and myocardial infarction (MI). Patients and Methods: Panoramic images of 200 patients that were all women above 50 years of age (a population suffering from vascular diseases) were investigated. All panoramic images were provided under similar conditions in terms of the type of panoramic radiograph equipment, type of applied films and the automatic film processor. Then, the patients answered questions about MI history and taking antihypertensive drugs. We also measured the blood pressure of patients in two separate surveys. Data analysis was performed by SPSS statistical program. We used Exact Fisher test and Chi-Square test at a significant level of less than 0.05 to study the effect of these variables on the occurrence of carotid artery calcification. Results: Among 200 studied samples, 22 of the patients (11%) had carotid artery calcification on the dental panoramic radiograph. In total, 52 patients (26%) had hypertension and four people (2%) had a history of MI. Eleven individuals among patients suffering from hypertension (21.2%) and three individuals among patients with a history of MI (75%) demonstrated CAC on dental panoramic images . Conclusions: The relationship between CAC found on dental panoramic radiographs and two CVA risk factors--hypertension and MI-- was significant. Therefore, it seems that detection of CAC on panoramic images of dental patients must be considered by dentists. PMID:25763086

  10. Does training-induced orthostatic hypotension result from reduced carotid baroreflex responsiveness?

    NASA Technical Reports Server (NTRS)

    Pawelczyk, James A.; Raven, Peter B.

    1994-01-01

    As manned space travel has steadily increased in duration and sophistication, the answer to a simple, relevant question remains elusive. Does endurance exercise training - high intensity rhythmic activity, performed regularly for extended periods of time - alter the disposition to, or severity of, postflight orthostatic hypotension? Research results continue to provide different views; however, data are difficult to compare because of the following factors that vary between investigations: the type of orthostatic stress imposed (+Gz, lower body negative pressure (LBNP), head-up tilt); pretest perturbations used (exercise, heat exposure, head-down tilting, bed rest, water immersion, hypohydration, pharmacologically-induced diuresis); the length of the training program used in longitudinal investigations (days versus weeks versus months); the criteria used to define fitness; and the criteria used to define orthostatic tolerance. Generally, research results indicate that individuals engaged in aerobic exercise activities for a period of years have been reported to have reduced orthostatic tolerance compared to untrained control subjects, while the results of shorter term longitudinal studies remain equivocal. Such conclusions suggest that chronic athletic training programs reduce orthostatic tolerance, whereas relatively brief (days to weeks) training programs do not affect orthostatic tolerance to any significant degree (increase or decrease). A primary objective was established to identify the alterations in blood pressure control that contribute to training-induced orthostatic hypotension (TIOH). Although any aspect of blood pressure regulation is suspect, current research has been focused on the baroreceptor system. Reductions in carotid baroreflex responsiveness have been documented in exercise-trained rabbits, reportedly due to an inhibitory influence from cardiac afferent, presumably vagal, nerve fibers that is abolished with intrapericardiac denervation. The

  11. Glaucoma Management in Carotid Cavernous Fistula.

    PubMed

    Calafiore, Silvia; Perdicchi, Andrea; Scuderi, Gianluca; Contestabile, Maria Teresa; Abdolrahimzadeh, Solmaz; Recupero, Santi Maria

    2016-01-01

    Carotid cavernous fistulas (CCF) are vascular communications between the carotid artery and the cavernous sinus. Ophthalmologists are called to diagnose and manage the condition in cases that present with ocular features. A 73-year-old female was referred to our glaucoma center clinic. Eight years before, she had started receiving medication for glaucoma and had undergone laser iridotomy, but a satisfactory management of intraocular pressure (IOP) had not been achieved. The patient was complaining of intermittent diplopia, bilateral proptosis, and conjunctival chemosis over the past 6 months. Best-corrected visual acuity in the right (OD) and left eye (OS) was 9/10 and 10/10, respectively. Visual field testing showed slight paracentral field defects mostly in OS. IOP was 20 mm Hg in OD and 34 mm Hg in OS. We referred the patient to neuroradiology, and MRI angiography revealed a CCF with angiographic classification of Cognard grade 2. Closure of the CCF by transarterial embolization was performed in the neuroradiology department. One week following the procedure, the clinical signs of diplopia, proptosis, and conjunctival chemosis had greatly improved, and IOP was reduced to 12 mm Hg OD and 19 mm Hg in OS. Glaucoma treatment was maintained with topical brimatoprost, brinzolamide, and timolol. Owing to the risk of vision loss associated with vascular stasis, retinal ischemia, and high IOP, ophthalmologists must be aware of the clinical features of CCF and should request appropriate imaging studies such as MRI angiography in order to confirm the diagnosis and plan multidisciplinary treatment. PMID:27462258

  12. Stenting of Extracranial Carotid Artery Stenosis

    PubMed Central

    Koshimae, N.; Morimoto, T.; Nagata, K.

    2003-01-01

    Summary The purpose of this study is to evaluate our cases of cervical internal carotid artery stenosis for safty stenting. We investigate the preoperative internal carotid artery stenosis using by integrated backscatter (IBS) method of ultra sonography, comparing with the thirty five surgical specimens as to their nature, histological structure, thickness of fibrous cap. We choose the protection method according to plaque structure, and placed Easy-Wall stent or Smart stent after prePTA. We added post PTA according to the extent of expansion and IVUS findings. Calibrated IBS = IBS value (ROI) /intinal IBS value of ‘bleeding’, ‘lipiď, ‘thrombus’, fiber, ‘hyalinization’ were -27.5, -22.5, -15.2, -11.1, +2.1. That of the thin fibrous cap were -10.9*, that of thic fibrous cap were -2.4 (*p < 0.001). There was a good coleration between the extent of expansion and expected histological findings. All conplications were two cases of small cerebral infarction and a case of bleeding from the complicated lung cancer. The protection at prePTA lead to no complications in case of acute cerebral infarctions. It is very important to check the histological specimen carefully for safty stenting. PMID:20591243

  13. Glaucoma Management in Carotid Cavernous Fistula

    PubMed Central

    Calafiore, Silvia; Perdicchi, Andrea; Scuderi, Gianluca; Contestabile, Maria Teresa; Abdolrahimzadeh, Solmaz; Recupero, Santi Maria

    2016-01-01

    Carotid cavernous fistulas (CCF) are vascular communications between the carotid artery and the cavernous sinus. Ophthalmologists are called to diagnose and manage the condition in cases that present with ocular features. A 73-year-old female was referred to our glaucoma center clinic. Eight years before, she had started receiving medication for glaucoma and had undergone laser iridotomy, but a satisfactory management of intraocular pressure (IOP) had not been achieved. The patient was complaining of intermittent diplopia, bilateral proptosis, and conjunctival chemosis over the past 6 months. Best-corrected visual acuity in the right (OD) and left eye (OS) was 9/10 and 10/10, respectively. Visual field testing showed slight paracentral field defects mostly in OS. IOP was 20 mm Hg in OD and 34 mm Hg in OS. We referred the patient to neuroradiology, and MRI angiography revealed a CCF with angiographic classification of Cognard grade 2. Closure of the CCF by transarterial embolization was performed in the neuroradiology department. One week following the procedure, the clinical signs of diplopia, proptosis, and conjunctival chemosis had greatly improved, and IOP was reduced to 12 mm Hg OD and 19 mm Hg in OS. Glaucoma treatment was maintained with topical brimatoprost, brinzolamide, and timolol. Owing to the risk of vision loss associated with vascular stasis, retinal ischemia, and high IOP, ophthalmologists must be aware of the clinical features of CCF and should request appropriate imaging studies such as MRI angiography in order to confirm the diagnosis and plan multidisciplinary treatment. PMID:27462258

  14. Hypothermia during Carotid Endarterectomy: A Safety Study

    PubMed Central

    Candela, Serena; Dito, Raffaele; Casolla, Barbara; Silvestri, Emanuele; Sette, Giuliano; Filippi, Federico; Taurino, Maurizio; Brancadoro, Domitilla; Orzi, Francesco

    2016-01-01

    Background CEA is associated with peri-operative risk of brain ischemia, due both to emboli production caused by manipulation of the plaque and to potentially noxious reduction of cerebral blood flow by carotid clamping. Mild hypothermia (34–35°C) is probably the most effective approach to protect brain from ischemic insult. It is therefore a substantial hypothesis that hypothermia lowers the risk of ischemic brain damage potentially associated with CEA. Purpose of the study is to test whether systemic endovascular cooling to a target of 34.5–35°C, initiated before and maintained during CEA, is feasible and safe. Methods The study was carried out in 7 consecutive patients referred to the Vascular Surgery Unit and judged eligible for CEA. Cooling was initiated 60–90 min before CEA, by endovascular approach (Zoll system). The target temperature was maintained during CEA, followed by passive, controlled rewarming (0.4°C/h). The whole procedure was carried out under anesthesia. Results All the patients enrolled had no adverse events. Two patients exhibited a transient bradycardia (heart rate 30 beats/min). There were no significant differences in the clinical status, laboratory and physiological data measured before and after CEA. Conclusions Systemic cooling to 34.5–35.0°C, initiated before and maintained during carotid clamping, is feasible and safe. Trial Registration ClinicalTrials.gov NCT02629653 PMID:27058874

  15. Treatment of Traumatic Carotid-Cavernous Fistula

    PubMed Central

    Wu, Z.; Zhang, Y.; Wang, C.; YANG, X.; Li, Y.

    2000-01-01

    Summary From 1986 to the end of 1998, 482 cases of traumatic carotid-cavernous fistula (TCCF) were treated by means of intravascular embolisation technique. The experience is overviewed in this article. Many kinds of detachable balloon catheters (including Chinese made detachable balloon catheters), coils and cyano aery late were used as embolic materials. Transcervical, transfemoral, anterior communicating artery, posterior communicating artery approach, or transvenous approach were selected according to conditions. A combination of different approaches or materials was used for complex TCCF. We found that the special sign, named “bileakage sign”, indicated multileakage of TCCF and was not mentioned before. All 482 cases of TCCF were embolised successfully, of which 405 cases maintained the patency of internal carotid artery (ICA). No death related to the treatment occurred in our group and the symptoms or signs in 462 cases were relieved after embolisation. Emergency embolisation was needed in some conditions such as serious epistaxis, delayed or repeatedly subdural haematoma and rapid visual impairment. Endovascular treatment of TCCF is a safe and efficient method. The time of operation, approach, and materials for embolisation must be carefully selected in order to obtain the best result. PMID:20667206

  16. Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study

    PubMed Central

    2011-01-01

    Background Directed ultrasonic screening for carotid stenosis is cost-effective in populations with > 5% prevalence of the diagnosis. Occasionally, calcifications in the area of the carotid arteries are incidentally detected on odontological panoramic radiographs. We aimed to determine if directed screening for carotid stenosis with ultrasound is indicated in individuals with such calcifications. Methods This was a cross-sectional study. Carotid ultrasound examinations were performed on consecutive persons, with findings of calcifications in the area of the carotid arteries on panoramic radiography that were otherwise eligible for asymptomatic carotid endarterectomy. Results Calcification in the area of the carotid arteries was seen in 176 of 1182 persons undergoing panoramic radiography. Of these, 117 fulfilled the inclusion criterion and were examined with carotid ultrasound. Eight persons (6.8%; 95% CI 2.2-11.5%) had a carotid stenosis - not significant over the 5% pre-specified threshold (p = 0.232, Binomial test). However, there was a significant sex difference (p = 0.008), as all stenoses were found in men. Among men, 12.5% (95%CI 4.2-20.8%) had carotid stenosis - significantly over the 5% pre-specified threshold (p = 0.014, Binomial test). Conclusions The incidental finding of calcification in the area of the carotid arteries on panoramic radiographs should be followed up with carotid screening in men that are otherwise eligible for asymptomatic carotid endarterectomy. Trial Registration The study was registered at http://www.clinicaltrials.gov; NCT00514644 PMID:21752238

  17. Changes in liraglutide-induced body composition are related to modifications in plasma cardiac natriuretic peptides levels in obese type 2 diabetic patients

    PubMed Central

    2014-01-01

    Background and aims Liraglutide treatment can improve glycemic control with a concomitant weight loss, but the underlying mechanism on weight loss is not completely understood. Cardiac natriuretic peptides (NPs) can resist body fat accumulation through increasing adipocytes lypolysis. In this study, we tested the hypothesis that liraglutide-induced weight loss was associated with increased plasma NPs concentrations. Methods Thirty-one outpatients with type 2 diabetes (T2D) treated with metformin and other oral antidiabetic drugs except for thiazolidinediones (TZDs) were subcutaneously administered with liraglutide for 12 weeks. Body composition, abdominal visceral adipose tissue areas (VAT) and subcutaneous adipose tissue areas (SAT) were assessed at pre- and post-treatment by dual-energy X-ray absorptiometry (DXA) scanning and abdominal computerized tomography (CT). Plasma atrial natriuretic peptides (ANP) and B-type ventricular natriuretic peptides (BNP) concentrations were tested by commercial ELISA Kit quantitatively. Results Following 12-week liraglutide treatment, body weight, waist circumference, total fat and lean mass, fat percentage, SAT and VAT areas were significantly reduced from baseline. Concurrently, plasma ANP and BNP levels were significantly increased following 12-week liraglutide treatment. There were significant correlations between the reductions in body compositions and the increases in both plasma ANP and BNP levels. Conclusions There were significant correlations between increases in both plasma ANP and BNP levels and changes in liraglutide-induced body composition. Our data implied that increases in plasma NPs may add a novel dimension to explain how liraglutide induces weight loss. PMID:24498905

  18. [A Novel, Less Invasive Protection Method for Carotid Artery Stenting].

    PubMed

    Ohshima, Tomotaka; Goto, Shunsaku; Yamamoto, Taiki; Imai, Tasuku; Nishizawa, Toshihisa; Shimato, Shinji; Kato, Kyozo

    2016-07-01

    Purpose: We present a novel, less invasive protection method for carotid artery stenting. Case presentation: A 67-year-old man presented with symptomatic severe left carotid artery stenosis. A transfemoral approach was dangerous because of an abdominal aortic aneurysm. A 6Fr Axcelguide Simmonds catheter was inserted into the right brachial artery, and advanced into the left common carotid artery. Next, a 6Fr Optimo 100-cm catheter was coaxially navigated into the left common carotid artery. A PercuSurge GuardWire 300-cm was coaxially navigated into the left external carotid artery. Under flow reversal with the 2 balloons, another PercuSurge GuardWire 300-cm was navigated into the distal left internal carotid artery through the lesion. After both PercuSurge GuardWire balloons were inflated, the 6Fr Optimo was deflated and retrieved using a catheter exchange technique. Then, under distal double-balloon protection, routine stenting was performed. Conclusions: This technique is safer and less invasive than previous methods, especially in cases with difficult femoral access and vulnerable carotid plaque. PMID:27384116

  19. Overexpression of MLN51 triggers P-body disassembly and formation of a new type of RNA granules.

    PubMed

    Cougot, Nicolas; Daguenet, Elisabeth; Baguet, Aurélie; Cavalier, Annie; Thomas, Daniel; Bellaud, Pascale; Fautrel, Alain; Godey, Florence; Bertrand, Edouard; Tomasetto, Catherine; Gillet, Reynald

    2014-11-01

    Metastatic lymph node 51 (MLN51, also known as CASC3) is a core component of the exon junction complex (EJC), which is loaded onto spliced mRNAs and plays an essential role in determining their fate. Unlike the three other EJC core components [eIF4AIII, Magoh and Y14 (also known as RBM8A)], MLN51 is mainly located in the cytoplasm, where it plays a key role in the assembly of stress granules. In this study, we further investigated the cytoplasmic role of MLN51. We show that MLN51 is a new component of processing bodies (P-bodies). When overexpressed, MLN51 localizes in novel small cytoplasmic foci. These contain RNA, show directed movements and are distinct from stress granules and P-bodies. The appearance of these foci correlates with the process of P-body disassembly. A similar reduction in P-body count is also observed in human HER2-positive (HER2(+)) breast cancer cells overexpressing MLN51. This suggests that P-body disassembly and subsequent mRNA deregulation might correlate with cancer progression. PMID:25205763

  20. Preserved structural and functional characteristics of common carotid artery in properly treated normoglycemic women with gestational diabetes mellitus.

    PubMed

    Vastagh, Ildikó; Horváth, T; Garamvölgyi, Z; Rosta, K; Folyovich, A; Rigó, J; Kollai, M; Bereczki, D; Somogyi, A

    2011-09-01

    Women with gestational diabetes mellitus (GDM) are at high risk of subsequently developing type 2 diabetes mellitus which is an important cardiovascular risk factor. We have evaluated whether preclinical morphological and functional arterial changes are present in GDM. Diameter, intima-media thickness (IMT), intima-media cross-section area (IMCSA) and elasticity features (compliance, distensibility coefficient, circumferential strain, stiffness index (SI) α and β, incremental elastic modulus) of the common carotid arteries (CCA) were studied in the 3rd trimester in 25 women with GDM, and 17 normal pregnant women matched for age and body mass index using an ultrasonographic vessel wall-movement tracking system and applanation tonometry. Mean IMT, IMCSA and SI α tended to be larger, whereas compliance was smaller in women with GDM but none of these differences were significant. Serum glucose (4.99 ± 0.51 vs. 4.79 ± 0.61 mmol/L, p=0.37) and HbA1c (5.33 ± 0.27 vs. 5.36 ± 0.47 mmol/L, p=0.85) proved normoglycemia in both groups. In conclusion, by the combination of methods we applied in this case control study, neither morphological nor functional characteristics of large elastic arteries differ significantly between well-treated normoglycemic women with GDM and non-diabetic pregnant women in the 3rd trimester. PMID:21893468

  1. Readmissions after Carotid Artery Revascularization in the Medicare Population

    PubMed Central

    Al-Damluji, Mohammed Salim; Dharmarajan, Kumar; Zhang, Weiwei; Geary, Lori; Stilp, Erik; Dardik, Alan; Mena-Hurtado, Carlos; Curtis, Jeptha P.

    2015-01-01

    Background In appropriately selected patients with severe carotid stenosis, carotid revascularization reduces ischemic stroke. Prior clinical research has focused on the efficacy and safety of carotid revascularization, but few investigators have considered readmission as a clinically important outcome. Objectives To examine frequency, timing, and diagnoses of 30-day readmission following carotid revascularization; to assess differences in 30-day readmission between patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS); to describe hospital variation in risk-standardized readmission rates (RSRR); and to examine whether hospital variation in procedural choice (CEA vs. CAS) was associated with differences in RSRRs. Methods We used Medicare fee-for-service administrative claims data to identify acute care hospitalizations for CEA and CAS from 2009–2011. We calculated crude 30-day all-cause hospital readmissions following carotid revascularization. To assess differences in readmission after CAS compared with CEA, we used Kaplan-Meier survival curves and fitted mixed-effect logistic regression. We estimated hospital RSRRs using hierarchical generalized logistic regression. We stratified hospitals into 5 groups by their proportional CAS use and compared hospital group median RSRRs. Results Of 180,059 revascularizations from 2,287 hospitals, CEA and CAS were performed in 81.5% and 18.5% of cases, respectively. The unadjusted 30-day readmission rate following carotid revascularization was 9.6%. Readmission risk after CAS was higher than after CEA. There was modest hospital-level variation in 30-day RSRRs (Median: 9.5%, Range: 7.5%–12.5%). Variation in proportional use of CAS was not associated with differences in hospital RSRR (range of median RSRR across hospital quartiles: 9.49%–9.55%, P 0.771). Conclusions Almost 10% of Medicare patients undergoing carotid revascularization were readmitted within 30-days of discharge. Compared with CEA

  2. High Agatston Calcium Score of Intracranial Carotid Artery

    PubMed Central

    Kao, Hung-Wen; Liou, Michelle; Chung, Hsiao-Wen; Liu, Hua-Shan; Tsai, Ping-Huei; Chiang, Shih-Wei; Chou, Ming-Chung; Peng, Giia-Sheun; Huang, Guo-Shu; Hsu, Hsian-He; Chen, Cheng-Yu

    2015-01-01

    Abstract The effect of intracranial internal carotid artery (ICA) calcification on cognitive impairment is uncertain. Our objective was to investigate whether intracranial ICA calcification is a significant cognitive predictor for cognitive impairment. Global cognition and degrees of intracranial ICA calcification of 579 subjects were assessed with Mini-Mental State Examination (MMSE) and Agatston calcium scoring method, respectively. Other risk factors for cognitive impairment, including age, education level, hypertension, diabetes mellitus, smoking, hyperlipidemia, and body mass index, were documented and analyzed for their associations with cognitive function. In univariate analyses, older age, lower education level, hypertension, diabetes mellitus, and higher intracranial ICA Agatston scores were significantly associated with cognitive impairment. In ordinal logistic regression, only age and total intracranial ICA Agatston score were significant risk factors for cognitive impairment. After adjustment for the other documented risk factors, subjects were 7% (95% CI: 5–10; P < 0.001) and 6% (95% CI: 0–13; P = 0.04) more likely to have lower cognitive category with every year increment of age and every 100-point increment of the total intracranial ICA Agatston score respectively. These results suggest an important role of the intracranial ICA calcification on cognitive impairment. PMID:26426620

  3. Utility of Combining PET and MR Imaging of Carotid Plaque.

    PubMed

    Vesey, Alex T; Dweck, Marc R; Fayad, Zahi A

    2016-02-01

    By harnessing the versatility and soft tissue imaging capabilities of MR imaging alongside the unmatched sensitivity and biomolecular flexibility of PET, the potential to provide detailed multiparametric plaque characterization in the carotid arteries is clear. The ability to acquire simultaneous, and dynamic multimodal data is perhaps PET/MR's greatest strength that will be of major interest to researchers investigating carotid and coronary atherosclerosis alike. This review summarizes the current status of dedicated hybrid PET/MR imaging; to crystallize the rationale for and advantages of this technique with resp