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Sample records for early arterial enhancement

  1. The Autophagy Enhancer Spermidine Reverses Arterial Aging

    PubMed Central

    LaRocca, Thomas J.; Gioscia-Ryan, Rachel A.; Hearon, Christopher M.; Seals, Douglas R.

    2013-01-01

    Arterial aging, characterized by stiffening of large elastic arteries and the development of arterial endothelial dysfunction, increases cardiovascular disease (CVD) risk. We tested the hypothesis that spermidine, a nutrient associated with the anti-aging process autophagy, would improve arterial aging. Aortic pulse wave velocity (aPWV), a measure of arterial stiffness, was ~20% greater in old (O, 28 months) compared with young C57BL6 mice (Y, 4 months, P < 0.05). Arterial endothelium-dependent dilation (EDD), a measure of endothelial function, was ~25% lower in O (P < 0.05 vs. Y) due to reduced nitric oxide (NO) bioavailability. These impairments were associated with greater arterial oxidative stress (nitrotyrosine), superoxide production, and protein cross-linking (advanced glycation end-products, AGEs) in O (all P < 0.05). Spermidine supplementation normalized aPWV, restored NO-mediated EDD and reduced nitrotyrosine, superoxide, AGEs and collagen in O. These effects of spermidine were associated with enhanced arterial expression of autophagy markers, and in vitro experiments demonstrated that vascular protection by spermidine was autophagy-dependent. Our results indicate that spermidine exerts a potent anti-aging influence on arteries by increasing NO bioavailability, reducing oxidative stress, modifying structural factors and enhancing autophagy. Spermidine may be a promising nutraceutical treatment for arterial aging and prevention of age-associated CVD. PMID:23612189

  2. The autophagy enhancer spermidine reverses arterial aging.

    PubMed

    LaRocca, Thomas J; Gioscia-Ryan, Rachel A; Hearon, Christopher M; Seals, Douglas R

    2013-01-01

    Arterial aging, characterized by stiffening of large elastic arteries and the development of arterial endothelial dysfunction, increases cardiovascular disease (CVD) risk. We tested the hypothesis that spermidine, a nutrient associated with the anti-aging process autophagy, would improve arterial aging. Aortic pulse wave velocity (aPWV), a measure of arterial stiffness, was ~20% greater in old (O, 28 months) compared with young C57BL6 mice (Y, 4 months, P<0.05). Arterial endothelium-dependent dilation (EDD), a measure of endothelial function, was ~25% lower in O (P<0.05 vs. Y) due to reduced nitric oxide (NO) bioavailability. These impairments were associated with greater arterial oxidative stress (nitrotyrosine), superoxide production, and protein cross-linking (advanced glycation end-products, AGEs) in O (all P<0.05). Spermidine supplementation normalized aPWV, restored NO-mediated EDD and reduced nitrotyrosine, superoxide, AGEs and collagen in O. These effects of spermidine were associated with enhanced arterial expression of autophagy markers, and in vitro experiments demonstrated that vascular protection by spermidine was autophagy-dependent. Our results indicate that spermidine exerts a potent anti-aging influence on arteries by increasing NO bioavailability, reducing oxidative stress, modifying structural factors and enhancing autophagy. Spermidine may be a promising nutraceutical treatment for arterial aging and prevention of age-associated CVD. PMID:23612189

  3. Early detection of pulmonary arterial hypertension.

    PubMed

    Lau, Edmund M T; Humbert, Marc; Celermajer, David S

    2015-03-01

    Pulmonary arterial hypertension (PAH) remains an incurable disease associated with an unacceptably high early mortality, despite advances in therapeutic options. The disease is clinically silent until late in its natural history, when most of the distal pulmonary arteries have been obliterated. Early diagnosis of PAH is associated with improved long-term survival, and screening of at-risk populations is, therefore, a rational strategy to improve outcomes in this condition. Doppler echocardiography is the most widely used screening tool in current clinical practice. The role of evidence-based screening strategies has been clarified by research such as the DETECT study in patients with systemic sclerosis. A multimodal approach, using a range of noninvasive tests, improves the performance of screening algorithms. Right heart catheterization is mandatory to confirm a diagnosis of PAH. Uncertainties exist about the definition and prognostic relevance of pulmonary hypertension during exercise, but accumulating evidence suggests that stress testing of the pulmonary circulation can unmask clinically important early disease. Novel tools for the early detection of pulmonary vascular disease are urgently needed, given the substantial limitations of currently available techniques. PMID:25421168

  4. Who might benefit from early aspirin after coronary artery surgery?

    PubMed

    Gukop, Philemon; Gutman, Nadav; Bilkhu, Rajdeep; Karapanagiotidis, Georgios T

    2014-09-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether early administration of aspirin might optimize vein graft patency. More than 250 papers were found using the reported search, of which 4 new papers in addition to the previous 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Early postoperative aspirin administered within 6 h following coronary artery bypass grafting (CABG) has been shown to be optimal for prevention of vein graft occlusion. Early aspirin has significant benefit in reducing vein graft occlusion, mortality, myocardial infarction, stroke, renal failure and bowel infarction. The efficacy of early postoperative aspirin on vein graft patency diminishes the later it is administered. It has optimal benefit at 6 h, some benefit at 24 h and no benefit after 48 h post CABG. ACC/AHA, EACTS and ACCP have issued guidelines recommending administration of early aspirin or an alternative (clopidogrel, ticlopidine and indobufen) at 6 h or soon after bleeding has settled as the standard of care for optimization of vein graft patency. The ACCP guideline has also suggested that optimal prevention of cardiovascular complication should have higher value than prevention of postoperative bleeding. Several randomized, controlled studies, including a meta-analysis, have shown that early administration of aspirin following CABG is not associated with increased blood loss or transfusion requirement. Postoperative bleeding has been identified as a significant reason for non administration of early aspirin in a prospective study. It is essential to define/quantify the postoperative blood loss that precludes administration of early aspirin. This will enhance prompt administration in some cases and guide judgement, especially in patients with high-risk factors for vein graft thrombosis. Administration at 6 h is the optimal time to give aspirin as long as bleeding has settled. PMID:24871533

  5. Prognosis, screening, early detection and differentiation of arterial pulmonary hypertension.

    PubMed

    Domenighetti, Guido

    2007-06-16

    Pulmonary hypertension (PH) has been partially reclassified during the 2003 Third World Symposium on Pulmonary Arterial Hypertension held in Venice. PH is a common disorder that may complicate a variety of cardiopulmonary diseases, including severe COPD, left ventricular failure and chronic thromboembolic obstruction of the pulmonary arteries. Pulmonary arterial hypertension (PAH) is an increase in pulmonary arterial pressure which is not due to classical coexistent cardiopulmonary disease. PAH usually occurs in the absence of an evident cause (idiopathic or familial) or it may be associated with connective tissue disease, HIV infection, chronic liver disease, congenital systemic-to-pulmonary shunts, venous or capillary involvement, thyroid or myeloproliferative disorders as well as a result of the use of toxic agents and anorexigens. The actuality of developed disease-specific treatments over the past decade, emphasises the importance of an early screening and detection of PH which, even optimally treated in advanced stages, still remains a progressive lethal disease in most of its forms. Early identification represents a real challenge for the clinician: in fact, it is believed that an early recognition and, thus, an early treatment, might be associated with improved survival. In this review, after a short introduction on disease prognosis, we will focus on screening and early recognition of some categories of PH, based on a sequential approach that includes clinical suspicion, detection and differentiation of pulmonary hypertension. This strategy should consent to reach an assessment of severity, ultimately providing the best selective use of therapies. PMID:17629802

  6. Pregnancy Enhances the Effects of Hypercholesterolemia on Posterior Cerebral Arteries

    PubMed Central

    Schreurs, Malou P. H.

    2013-01-01

    In preeclampsia, hyperlipidemia is enhanced compared to normal pregnancy that could adversely affect vascular function. In the cerebral vasculature, this could lead to dysregulation of cerebral blood flow and neurological complications. Here, we examined the effect of excessive hyperlipidemia, as seen in preeclampsia, on cerebral artery function and expression of inflammatory markers in pregnancy. Pregnant and nonpregnant rats received a 14-day high-cholesterol diet or normal chow and posterior cerebral artery function was compared. High cholesterol significantly increased sensitivity of posterior cerebral arteries to the nitric oxide donor sodium nitroprusside that was accompanied by a ~12-fold increased messenger RNA (mRNA) expression of inducible nitric oxide synthase in late-pregnant rats only. Further, high cholesterol significantly increased peroxynitrite-induced dilation and decreased myogenic tone in cerebral arteries from late pregnant compared to nonpregnant animals. These results suggest that pathologically high levels of cholesterol in pregnancy enhance inflammatory responses and peroxynitrite generation in cerebral arteries. PMID:23171682

  7. Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

    PubMed Central

    Schmitto, Jan D; Kolat, Philipp; Ortmann, Philipp; Popov, Aron F; Coskun, Kasim O; Friedrich, Martin; Sossalla, Samuel; Toischer, Karl; Mokashi, Suyog A; Tirilomis, Theodor; Baryalei, Mersa M; Schoendube, Friedrich A

    2009-01-01

    Background Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE), it is still used as an adjunct to coronary artery bypass grafting (CABG). This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed. Methods Patient demographic information, operative details and outcome data of 104 patients with diffuse calcified coronary artery disease were retrospectively analyzed with respect to functional capacity (NYHA), angina pectoris (CCS) and mortality. Actuarial survival was reported using a Kaplan-Meyer analysis. Results Between August 2001 and March 2005, 104 patients underwent coronary artery bypass grafting (CABG) with adjunctive coronary endarterectomy (CE) in the Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen. Four patients were lost during follow-up. Data were gained from 88 male and 12 female patients; mean age was 65.5 9 years. A total of 396 vessels were bypassed (4 0.9 vessels per patient). In 98% left internal thoracic artery (LITA) was used as arterial bypass graft and a total of 114 vessels were endarterectomized. CE was performed on right coronary artery (RCA) (n = 55), on left anterior descending artery (LAD) (n = 52) and circumflex artery (RCX) (n = 7). Ninety-five patients suffered from 3-vessel-disease, 3 from 2-vessel- and 2 from 1-vessel-disease. Closed technique was used in 18%, open technique in 79% and in 3% a combination of both. The most frequent endarterectomized localization was right coronary artery (RCA = 55%). Despite the severity of endstage atherosclerosis, hospital mortality was only 5% (n = 5). During follow-up (24.5 13.4 months), which is 96% complete (4 patients were lost caused by unknown address) 8 patients died (cardiac failure: 3; stroke: 1; cancer: 1; unknown reasons: 3). NYHA-classification significantly improved after CABG with CE from 2.2 0.9 preoperative to 1.7 0.9 postoperative. CCS also changed from 2.4 1.0 to 1.5 0.8 Conclusion Early results of coronary endarterectomy are acceptable with respect to mortality, NYHA & CCS. This technique offers a valuable surgical option for patients with endstage coronary artery disease in whom complete revascularization otherwise can not be obtained. Careful patient selection will be necessary to assure the long-term benefit of this procedure. PMID:19772645

  8. Arterial Wall Imaging in Symptomatic Carotid Stenosis: Delayed Enhancement on MDCT Angiography

    PubMed Central

    Ha, Su Min; Seo, Woo-Keun; Seol, Hae Young

    2016-01-01

    Objective To evaluate progressive enhancement in the carotid arterial wall overlying plaque in the symptomatic side for patients with cerebrovascular symptoms until delayed phase using MDCTA. Materials and Methods Twenty-one patients (all men; ages, 49-82 years; mean, 67.8 ± 8.4 years) with recent stroke and severe extracranial carotid stenosis were retrospectively analyzed. Pre-, early- and delayed phase images of MDCTA were obtained, and Hounsfield units (HU) of carotid walls were measured. We also measured HU of the asymptomatic contralateral carotid arterial wall for comparison. Friedman's test and Wilcoxon signed-rank test were used to evaluate the differences between groups. Results The averaged HU of the carotid wall in the symptomatic side was higher on the delayed phase (65.8 ± 14.2 HU) compared to early arterial phase (54.2 ± 12.6 HU). The averaged HU difference of wall enhancement between pre-contrast and delayed phase (28.0 ± 14.8 HU) was significantly higher than the between pre-contrast and early arterial phase (16.4 ± 12.1 HU) with P < 0.05. In analysis of the contralateral asymptomatic side, the HU difference between pre-contrast and delayed phase (15.5 ± 12.0 HU) showed no significant higher value than between pre-contrast and early arterial phase (14.9 ± 10.9 HU). Conclusion The pronounced enhancement of the carotid wall in the delayed phase on MDCTA was demonstrated in symptomatic patients with severe internal carotid artery stenosis. In the future, we need more comparative studies to verify this finding as one of risk stratification. PMID:26958408

  9. Management of early hepatic artery occlusion after liver transplantation with failed rescue

    PubMed Central

    Hsiao, Chih-Yang; Ho, Cheng-Maw; Wu, Yao-Ming; Ho, Ming-Chih; Hu, Rey-Heng; Lee, Po-Huang

    2015-01-01

    Hepatic artery thrombosis is a serious complication after liver transplantation which often results in biliary complications, early graft loss, and patient death. It is generally thought that early hepatic artery thrombosis without urgent re-vascularization or re-transplantation almost always leads to mortality, especially if the hepatic artery thrombosis occurs within a few days after transplantation. This series presents 3 cases of early hepatic artery thrombosis after living donor liver transplantation, in which surgical or endovascular attempts at arterial re-vascularization failed. Unexpectedly, these 3 patients survived with acceptable graft function after 32 mo, 11 mo, and 4 mo follow-up, respectively. The literatures on factors affecting this devastating complication were reviewed from an anatomical perspective. The collective evidence from survivors indicated that modified nonsurgical management after liver transplantation with failed revascularization may be sufficient to prevent mortality from early hepatic artery occlusion. Re-transplantation may be reserved for selected patients with unrecovered graft function. PMID:26640351

  10. Gadolinium Enhanced MR-angiography Results in Patients With Peripheral Arterial Disease: Positive Predictive Value Compared to Surgery

    PubMed Central

    Mirsharifi, Seyed Rasool; Noparast, Morteza; Khazravi, Mona; Ghanaati, Hossein; Shakiba, Majid; Sharifi, Amirsina

    2014-01-01

    Background: Peripheral arterial disease (PAD) represents systematic atherosclerosis of great vessels. PAD affects approximately 10-20 % of patients older than 60 years and is associated with high mortality and morbidity rate debilitating individuals’ life. Objectives: To compare the results of Gadolinium enhanced MR-Angiography and surgery in patients suspected to have peripheral arterial disease. Materials and Methods: In this prospective cohort study, 30 consecutive patients matching the inclusion criteria were enrolled and MR-Angiography was performed prior to surgery for each one. Results: 22 patients were male (73.3%) and the mean age was 60.3 ± 10.6 years in our study group. The most common artery for cut off and run off was superior femoral artery in both assessments. Proximal section of each artery was the most common anatomical section for cut off and run off. There was a same report of cut off artery by MR-Angiography and surgery (kappa coefficient of agreement was 0.96, P value < 0.001) and positive predictive value was 0.97 (95% CI: 0.83-0.99). Conclusions: According to our findings MR-angiography is an appropriate alternative imaging modality for patients suspected to have peripheral arterial disease and it facilitates the early diagnosis proposed by the clinical findings. Also beneficial characteristics of this method such as low exposure to ionizing radiation, repeatability, and low risk of contrast agent-induced nephropathy make it a modality of choice in patients with renal impairment. PMID:25763247

  11. Early Outcomes of Radial Artery Use in All-Arterial Grafting of the Coronary Arteries in Patients 65 Years and Older

    PubMed Central

    Erdil, Nevzat; Nisanoglu, Vedat; Eroglu, Tamer; Fansa, Iyad; Cihan, Hasan Berat; Battaloglu, Bektas

    2010-01-01

    We retrospectively evaluated early clinical results of coronary revascularization using none but arterial grafts in patients aged 65 years and older. The cases of 449 consecutive patients who had undergone isolated myocardial revascularization were divided into 2 groups: the arterial conduit group (n=107) received a left internal mammary artery (LIMA) graft and 1 or both radial arteries (RAs), while the mixed-conduit group (n=342) received a LIMA graft and 1 or more saphenous vein grafts (SVGs), with or without an RA. There was no significant difference between the groups' rates of mortality. The arterial conduit group had a significantly shorter overall postoperative hospital stay than did the mixed-conduit group (mean, 6.6 0.9 vs 7.2 5 days; P=0.04). Linear regression analysis revealed that the presence of hypertension (?=0.13; 95% confidence interval [CI], 0.0540.759; P=0.02) and high EuroSCORE (?=0.24; 95% CI, 0.0530.283; P=0.004) were the major predicting factors for long hospital stay. Graft-harvest-site infection was statistically more frequent in the mixed-conduit group than in the arterial conduit group (6.4% vs 0, respectively; P=0.007). Angiography was performed postoperatively (mean, 24.9 16.3 mo; range, 1165 mo) in 21 patients. In these patients, all LIMA grafts were patent, as were 86.9% of the SVGs and 90.9% of the RA grafts. Myocardial revascularization using all arterial grafts (at least 50% RAs) in patients aged 65 years and older is safe and reliable, produces short-term results equal to those of saphenous vein grafting, and can reduce graft-harvest-site infections. PMID:20548806

  12. Signal and image processing for early detection of coronary artery diseases: A review

    NASA Astrophysics Data System (ADS)

    Mobssite, Youness; Samir, B. Belhaouari; Mohamad Hani, Ahmed Fadzil B.

    2012-09-01

    Today biomedical signals and image based detection are a basic step to diagnose heart diseases, in particular, coronary artery diseases. The goal of this work is to provide non-invasive early detection of Coronary Artery Diseases relying on analyzing images and ECG signals as a combined approach to extract features, further classify and quantify the severity of DCAD by using B-splines method. In an aim of creating a prototype of screening biomedical imaging for coronary arteries to help cardiologists to decide the kind of treatment needed to reduce or control the risk of heart attack.

  13. Pulmonary Arterial Hypertension: Use of Delayed Contrast-Enhanced Cardiovascular Magnetic Resonance in Risk Assessment

    PubMed Central

    Bessa, Luiz Gustavo Pignataro; Junqueira, Flvia Pegado; Bandeira, Marcelo Luiz da Silva; Garcia, Marcelo Iorio; Xavier, Srgio Salles; Lavall, Guilherme; Torres, Diego; Waetge, Daniel

    2013-01-01

    Background Pulmonary arterial hypertension is a severe and progressive disease. Its early diagnosis is the greatest clinical challenge. Objective To evaluate the presence and extension of the delayed myocardial contrast-enhanced cardiovascular magnetic resonance, as well as to verify if the percentage of the myocardial fibrosis mass is a severity predictor. Methods Cross-sectional study with 30 patients with pulmonary arterial hypertension of groups I and IV, subjected to clinical, functional and hemodynamic evaluation, and to cardiac magnetic resonance. Results The mean age of patients was 52 years old, with female predominance (77%). Among the patients, 53% had right ventricular failure at diagnosis, and 90% were in functional class II/III. The mean of the 6-minute walk test was 395m. In hemodynamic study with right catheterism, the mean average pulmonary arterial pressure was 53.3mmHg, of the cardiac index of 2.1L/ min.m2, and median right atrial pressure was 13.5 mmHg. Delayed myocardial contrast enhanced cardiovascular magnetic resonance was found in 28 patients. The mean fibrosis mass was 9.9 g and the median percentage of fibrosis mass was 6.17%. The presence of functional class IV, right ventricular failure at diagnosis, 6-minute walk test < 300 meters and right atrial pressure ? 15 mmHg, with cardiac index < 2.0 L/ min.m2, there was a relevant association with the increased percentage of myocardial fibrosis. Conclusion The percentage of the myocardial fibrosis mass indicates a non-invasive marker with promising perspectives in identifying patients with high risk factors for pulmonary hypertension. PMID:23979779

  14. Busulphan-Cyclophosphamide Cause Endothelial Injury, Remodeling of Resistance Arteries and Enhanced Expression of Endothelial Nitric Oxide Synthase

    PubMed Central

    Al-Hashmi, Sulaiman; Boels, Piet J. M.; Zadjali, Fahad; Sadeghi, Behnam; Sällström, Johan; Hultenby, Kjell; Hassan, Zuzana; Arner, Anders; Hassan, Moustapha

    2012-01-01

    Stem cell transplantation (SCT) is a curative treatment for malignant and non malignant diseases. However, transplantation-related complications including cardiovascular disease deteriorate the clinical outcome and quality of life. We have investigated the acute effects of conditioning regimen on the pharmacology, physiology and structure of large elastic arteries and small resistance-sized arteries in a SCT mouse model. Mesenteric resistance arteries and aorta were dissected from Balb/c mice conditioned with busulphan (Bu) and cyclophosphamide (Cy). In vitro isometric force development and pharmacology, in combination with RT-PCR, Western blotting and electron microscopy were used to study vascular properties. Compared with controls, mesenteric resistance arteries from the Bu-Cy group had larger internal circumference, showed enhanced endothelium mediated relaxation and increased expression of endothelial nitric oxide synthase (eNOS). Bu-Cy treated animals had lower mean blood pressure and signs of endothelial injury. Aortas of treated animals had a higher reactivity to noradrenaline. We conclude that short-term consequences of Bu-Cy treatment divergently affect large and small arteries of the cardiovascular system. The increased noradrenaline reactivity of large elastic arteries was not associated with increased blood pressure at rest. Instead, Bu-Cy treatment lowered blood pressure via augmented microvascular endothelial dependent relaxation, increased expression of vascular eNOS and remodeling toward a larger lumen. The changes in the properties of resistance arteries can be associated with direct effects of the compounds on vascular wall or possibly indirectly induced via altered translational activity associated with the reduced hematocrit and shear stress. This study contributes to understanding the mechanisms that underlie the early effects of conditioning regimen on resistance arteries and may help in designing further investigations to understand the late effects on vascular system. PMID:22303468

  15. Intra-arterial contrast-enhanced spiral CT: adjunct to angiography for localizing obscure gastrointestinal bleed.

    PubMed

    Sreekumar, K P; Moorthy, Srikanth; Prabhu, Nirmal K; Pillai, Anil K

    2002-01-01

    We report two patients with obscure GI bleed in whom we performed intra-arterial contrast-enhanced spiral CT scan of abdomen with the angiography catheter in the superior mesenteric artery (SMA). The technique localized the lesions to the mid jejunum and distal duodenum. PMID:12546178

  16. Digital capillaroscopy as important tool for early diagnostics of arterial hypertension

    NASA Astrophysics Data System (ADS)

    Gurfinkel, Yu. I.; Sasonko, M. L.; Priezzhev, A. V.

    2015-03-01

    The study is aimed to determine the digital capillaroscopy possibilities in early diagnostics of an arterial hypertension. A total of 123 adult persons were examined in the study. The first group consisted of 40 patients with prehypertension (BP 130-139/85-89 mm Hg). The second group included 36 patients with 1-2 stage of hypertension (mean systolic BP 152.712 mm Hg). Patients in both groups did not receive regular drug therapy. The group of volunteers (n=47) included healthy adults without signs of cardiovascular pathology. The capillary circulation was examined on the nailbed using the optical digital capillaroscope developed by the company "AET", Russia. Diameters of the arterial and venous segments, perivascular zone size, capillary blood velocity, the degree of arterial loops narrowing and the density of the capillary network were estimated. In patients with arterial hypertension and even in patients with prehypertension remodeling and rarefaction of capillaries and the expressed narrowing their arterial loops were manifested. The results of the study revealed the presence of abnormalities of microcirculation parameters in patients of both groups. The capillaries density in both groups of patients was significantly lower than in healthy persons. The significant narrowing of arterial loops was revealed in patients with both arterial hypertension and prehypertension, in comparison with healthy volunteers. Capillary blood velocity did not differ significantly between healthy volunteers group and the group of prehypertensive patients. However in patients with hypertension this parameter was significantly lower in comparison with control group.

  17. Surface Roughness Detection of Arteries via Texture Analysis of Ultrasound Images for Early Diagnosis of Atherosclerosis

    PubMed Central

    Niu, Lili; Qian, Ming; Yang, Wei; Meng, Long; Xiao, Yang; Wong, Kelvin K. L.; Abbott, Derek; Liu, Xin; Zheng, Hairong

    2013-01-01

    There is a strong research interest in identifying the surface roughness of the carotid arterial inner wall via texture analysis for early diagnosis of atherosclerosis. The purpose of this study is to assess the efficacy of texture analysis methods for identifying arterial roughness in the early stage of atherosclerosis. Ultrasound images of common carotid arteries of 15 normal mice fed a normal diet and 28 apoE?/? mice fed a high-fat diet were recorded by a high-frequency ultrasound system (Vevo 2100, frequency: 40 MHz). Six different texture feature sets were extracted based on the following methods: first-order statistics, fractal dimension texture analysis, spatial gray level dependence matrix, gray level difference statistics, the neighborhood gray tone difference matrix, and the statistical feature matrix. Statistical analysis indicates that 11 of 19 texture features can be used to distinguish between normal and abnormal groups (p<0.05). When the 11 optimal features were used as inputs to a support vector machine classifier, we achieved over 89% accuracy, 87% sensitivity and 93% specificity. The accuracy, sensitivity and specificity for the k-nearest neighbor classifier were 73%, 75% and 70%, respectively. The results show that it is feasible to identify arterial surface roughness based on texture features extracted from ultrasound images of the carotid arterial wall. This method is shown to be useful for early detection and diagnosis of atherosclerosis. PMID:24146940

  18. Sensitivity of Hyperdense Basilar Artery Sign on Non-Enhanced Computed Tomography

    PubMed Central

    Ernst, Marielle; Romero, Javier M.; Buhk, Jan-Hendrik; Cheng, Bastian; Herrmann, Jochen; Fiehler, Jens; Groth, Michael

    2015-01-01

    Purpose The hyperdense basilar artery sign (HBAS) is an indicator of vessel occlusion on non contrast-enhanced computer tomography (NECT) in acute stroke patients. Since basilar artery occlusion (BAO) is associated with a high mortality and morbidity, its early detection is of great clinical value. We sought to analyze the influence of density measurement as well as a normalized ratio of Hounsfield unit/hematocrit (HU/Hct) ratio on the detection of BAO on NECT in patients with suspected BAO. Materials and Methods 102 patients with clinically suspected BAO were examined with NECT followed immediately by Multidetector computed tomography Angiography. Two observers independently analyzed the images regarding the presence or absence of HBAS on NECT and performed HU measurements in the basilar artery. Receiver operating characteristic curve analysis was performed to determine the optimal density threshold for BAO using attenuation measurements or HU/Hct ratio. Results Sensitivity of visual detection of the HBAS on NECT was relatively low 81% (95%-CI, 5495%) while specificity was high 91% (95%-CI, 8296%). The highest sensitivity was achieved by the combination of visual assessment and additional quantitative attenuation measurements applying a cut-off value of 46.5 HU with 94% sensitivity and 81% specificity for BAO. A HU/Hct ratio >1.32 revealed sensitivity of 88% (95%-CI, 6098%) and specificity of 84% (95%-CI, 7490%). Conclusion In patients with clinically suspected acute BAO the combination of visual assessment and additional attenuation measurement with a cut-off value of 46.5 HU is a reliable approach with high sensitivity in the detection of BAO on NECT. PMID:26479718

  19. Differential effects of estradiol on carotid artery inflammation when administered early vs. late after surgical menopause

    PubMed Central

    Sophonsritsuk, Areepan; Appt, Susan E.; Clarkson, Thomas B.; Shively, Carol A.; Espeland, Mark A.; Register, Thomas C.

    2015-01-01

    Objective To determine the effects of estrogen therapy (ET) on carotid artery inflammation when initiated early and late relative to surgical menopause. Methods and Results Female cynomolgus macaques consuming atherogenic diets were ovariectomized and randomized to control or oral estradiol (E2, human equivalent dose of 1 mg/d micronized E2) initiated at 1 month (Early menopause, n=24) or 54 months, (Late menopause, n=40) post-ovariectomy. Treatment period was 8 months. Carotid artery expression of markers of monocyte/macrophages (CD68, CD163), dendritic cells (CD83), NK cells (NCAM-1), and IFN-? was significantly lower in the E2-treated animals in the early but not late menopause group (p<0.05). In contrast, carotid artery transcripts for T cell markers (CD3, CD4, CD8, and CD25), interleukin (IL)-10, type I collagen, MCP-1, MMP-9, and TNF-? were lower in E2-treated monkeys regardless of menopausal stage (p<0.05). Conclusions ET initiated soon after menopause inhibited macrophage accumulation in the carotid artery, an effect not observed when E2 was administered after several years of estrogen deficiency. No evidence for pro-inflammatory effects of late ET was observed. The results provide support for the timing hypothesis of postmenopausal ET with implications for interpretation of outcomes in the Womens Health Initiative. PMID:23615645

  20. Doppler Ultrasound Detection of Preclinical Changes in Foot Arteries in Early Stage of Type 2 Diabetes

    PubMed Central

    Leoniuk, Jolanta; ?ukasiewicz, Adam; Szorc, Ma?gorzata; Sackiewicz, Izabela; Janica, Jacek; ?ebkowska, Urszula

    2014-01-01

    Summary Background There are few reports regarding the changes within the vessels in the initial stage of type 2 diabetes. The aim of this study was to estimate the hemodynamic and morphological parameters in foot arteries in type 2 diabetes subjects and to compare these parameters to those obtained in a control group of healthy volunteers. Material/Methods Ultrasound B-mode, color Doppler and pulse wave Doppler imaging of foot arteries was conducted in 37 diabetic patients and 36 non-diabetic subjects to determine their morphological (total vascular diameter and flow lumen diameter) and functional parameters (spectral analysis). Results In diabetic patients, the overall vascular diameter and wall thickness were statistically significantly larger when compared to the control group in the right dorsalis pedis artery (P=0.01; P=0.001), left dorsalis pedis artery (P=0.007; P=0.006), right posterior tibial artery (P=0.005; P=0.0005), and left posterior tibial artery (P=0.007; P=0.0002). No significant differences were observed in both groups in flow lumen diameters and blood flow parameters (PSV, EDV, PI, RI). In the diabetic group, the level of HbA1c positively correlated with flow resistance index in the right dorsalis pedis artery (r=0.38; P=0.02), right posterior tibial artery (r=0.38; P=0.02) and left posterior tibial artery (r=0.42; P=0.009). The pulsatility index within the dorsalis pedis artery decreased with increased trophic skin changes (r=0.431, P=0.009). Conclusions In the diabetic group, overall artery diameters larger than and flow lumina comparable to the control group suggest vessel wall thickening occurring in the early stage of diabetes. Doppler flow parameters are comparable in both groups. In the diabetic group, the level of HbA1c positively correlated with flow resistance index and negative correlation was observed between the intensity of trophic skin changes and the pulsatility index. PMID:25202434

  1. Attenuation Correction and Normalisation for Quantification of Contrast Enhancement in Ultrasound Images of Carotid Arteries.

    PubMed

    Cheung, Wing Keung; Gujral, Dorothy M; Shah, Benoy N; Chahal, Navtej S; Bhattacharyya, Sanjeev; Cosgrove, David O; Eckersley, Robert J; Harrington, Kevin J; Senior, Roxy; Nutting, Christopher M; Tang, Meng-Xing

    2015-07-01

    An automated attenuation correction and normalisation algorithm was developed to improve the quantification of contrast enhancement in ultrasound images of carotid arteries. The algorithm first corrects attenuation artefact and normalises intensity within the contrast agent-filled lumen and then extends the correction and normalisation to regions beyond the lumen. The algorithm was first validated on phantoms consisting of contrast agent-filled vessels embedded in tissue-mimicking materials of known attenuation. It was subsequently applied to in vivo contrast-enhanced ultrasound (CEUS) images of human carotid arteries. Both in vitro and in vivo results indicated significant reduction in the shadowing artefact and improved homogeneity within the carotid lumens after the correction. The error in quantification of microbubble contrast enhancement caused by attenuation on phantoms was reduced from 55% to 5% on average. In conclusion, the proposed method exhibited great potential in reducing attenuation artefact and improving quantification in contrast-enhanced ultrasound of carotid arteries. PMID:25843515

  2. Troubleshooting Arterial-Phase MR Images of Gadoxetate Disodium-Enhanced Liver

    PubMed Central

    Huh, Jimi; Yeh, Benjamin M.; Lee, Seung Soo; Kim, Kyoung Won; Wu, En-Haw; Wang, Z. Jane; Zhao, Li-qin; Chang, Wei Chou

    2015-01-01

    Gadoxetate disodium is a widely used magnetic resonance (MR) contrast agent for liver MR imaging, and it provides both dynamic and hepatobiliary phase images. However, acquiring optimal arterial phase images at liver MR using gadoxetate disodium is more challenging than using conventional extracellular MR contrast agent because of the small volume administered, the gadolinium content of the agent, and the common occurrence of transient severe motion. In this article, we identify the challenges in obtaining high-quality arterial-phase images of gadoxetate disodium-enhanced liver MR imaging and present strategies for optimizing arterial-phase imaging based on the thorough review of recent research in this field. PMID:26576109

  3. Prediction of early and late preeclampsia by flow-mediated dilation of the brachial artery*

    PubMed Central

    Brando, Augusto Henriques Fulgncio; Evangelista, Aline Aaro; Martins, Raphaela Menin Franco; Leite, Henrique Vtor; Cabral, Antnio Carlos Vieira

    2014-01-01

    Objective To assess the accuracy in the prediction of both early and late preeclampsia by flow-mediated dilation of the brachial artery (FMD), a biophysical marker for endothelial dysfunction. Materials and Methods A total of 91 patients, considered at high risk for development of preeclampsia were submitted to brachial artery FMD between 24 and 28 weeks of gestation. Results Nineteen out of the selected patients developed preeclampsia, 8 in its early form and 11 in the late form. With a cut-off value of 6.5%, the FMD sensitivity for early preeclampsia prediction was 75.0%, with specificity of 73.3%, positive predictive value (PPV) of 32.4% and negative predictive value (NPV) of 91.9%. For the prediction of late preeclampsia, sensitivity = 83.3%, specificity = 73.2%, PPV = 34.4% and NPV = 96.2% were observed. And for the prediction of all associated forms of preeclampsia, sensitivity = 84.2%, specificity = 73.6%, PPV = 45.7% and NPV = 94.6% were observed. Conclusion FMD of the brachial artery is a test with good accuracy in the prediction of both early and late preeclampsia, which may represent a positive impact on the follow-up of pregnant women at high risk for developing this syndrome. PMID:25741086

  4. Early and mid-term results of minimally invasive coronary artery bypass grafting

    PubMed Central

    Pande, Shantanu; Agarwal, Surendra K.; Gupta, Devendra; Mohanty, Satayapriya; Kapoor, Aditya; Tewari, Satyendra; Bansal, Anubhav; Ambesh, Sushil P.

    2014-01-01

    Introduction Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. This technique coupled with use of off pump technique of surgical revascularization makes it truly less invasive. This method is highly effective even in high-risk patients. Results of this procedure are comparable to standard off pump technique and are better than percutaneous coronary intervention utilizing drug-eluting stent. We present an early and mid-term result of the use of this technique. Method We enrolled 33 patients for analysis operated between 2008 and 2012. Operation was performed utilizing off-pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Median follow up of 2.5 years (6 months–4 years) is available. Results Median age was 58.5 years (41–77) and all were male. Single vessel disease was present in 7, double vessel in 14 and triple vessel disease in 12 patients. All the patients had normal left ventricular size and function. There was no operative and 30-day mortality. Conversion to median sternotomy to complete the operation was done in 6.6% (2 out of 33 patients). One patient had acute myocardial infarction and there were no deaths during follow up. Conclusion MICABG is a safe and effective method of revascularization in low risk candidates for coronary artery bypass grafting. PMID:24814114

  5. Diffuse Infantile Hepatic Hemangioendothelioma With Early Central Enhancement in an Adult

    PubMed Central

    Dong, Aisheng; Dong, Hui; Zuo, Changjing; He, Tianlin

    2015-01-01

    Abstract Infantile hepatic hemangioendothelioma (IHH) is the most common vascular tumor of the liver in infancy. Adult with IHH is extremely rare. We presented a diffuse IHH in an adult patient with computed tomography (CT) and magnetic resonance image (MRI) findings. A 39-year-old man was admitted to our hospital because of a 2-year history of abnormal liver function tests and a 7-day history of jaundice. Physical examination revealed enlarged liver. Unenhanced abdominal CT showed enlargement of the liver with diffuse hypodensity. Enhanced CT on the arterial phase revealed multiple centrally enhanced lesions diffusely involved the enlarged liver. The enhanced areas of the lesions became larger on the portal phase and all the lesions became homogeneous enhanced on the delayed phase. These lesions showed heterogeneously hyperintense on T2-weighted image, hypointense on T1-weighted image, and early centrally enhanced on dynamic gadolinium-enhanced MRI, with complete tumor enhancement after 180?s. The patient underwent orthotopic liver transplantation. IHH type 2 was confirmed by pathology. The patient died of tumor recurrence in the liver 4 months after transplantation. Unlike the previously described imaging appearances of IHH, this case showed diffuse nodules with early central enhancement on CT and MRI. Considering the importance of the ability to differentiate IHH from other hepatic tumors, radiologists should be aware of these imaging appearances to establish knowledge of the entire spectrum of IHH. PMID:26705232

  6. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke.

    PubMed

    Särkämö, Teppo; Tervaniemi, Mari; Laitinen, Sari; Forsblom, Anita; Soinila, Seppo; Mikkonen, Mikko; Autti, Taina; Silvennoinen, Heli M; Erkkilä, Jaakko; Laine, Matti; Peretz, Isabelle; Hietanen, Marja

    2008-03-01

    We know from animal studies that a stimulating and enriched environment can enhance recovery after stroke, but little is known about the effects of an enriched sound environment on recovery from neural damage in humans. In humans, music listening activates a wide-spread bilateral network of brain regions related to attention, semantic processing, memory, motor functions, and emotional processing. Music exposure also enhances emotional and cognitive functioning in healthy subjects and in various clinical patient groups. The potential role of music in neurological rehabilitation, however, has not been systematically investigated. This single-blind, randomized, and controlled trial was designed to determine whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke. In the acute recovery phase, 60 patients with a left or right hemisphere middle cerebral artery (MCA) stroke were randomly assigned to a music group, a language group, or a control group. During the following two months, the music and language groups listened daily to self-selected music or audio books, respectively, while the control group received no listening material. In addition, all patients received standard medical care and rehabilitation. All patients underwent an extensive neuropsychological assessment, which included a wide range of cognitive tests as well as mood and quality of life questionnaires, one week (baseline), 3 months, and 6 months after the stroke. Fifty-four patients completed the study. Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups. The music group also experienced less depressed and confused mood than the control group. These findings demonstrate for the first time that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood. The neural mechanisms potentially underlying these effects are discussed. PMID:18287122

  7. Early detection of microstructural white matter changes associated with arterial pulsatility

    PubMed Central

    Jolly, Todd A. D.; Bateman, Grant A.; Levi, Christopher R.; Parsons, Mark W.; Michie, Patricia T.; Karayanidis, Frini

    2013-01-01

    Increased cerebral blood flow pulsatility is common in vascular dementia and is associated with macrostructural damage to cerebral white matter or leukoaraiosis (LA). In this study, we examine whether cerebral blood flow pulsatility is associated with macrostructural and microstructural changes in cerebral white matter in older adults with no or mild LA and no evidence of dementia. Diffusion Tensor Imaging was used to measure fractional anisotropy (FA), an index of the microstructural integrity of white matter, and radial diffusivity (RaD), a measure sensitive to the integrity of myelin. When controlling for age, increased arterial pulsation was associated with deterioration in both measures of white matter microstructure but not LA severity. A stepwise multiple linear regression model revealed that arterial pulsatility index was the strongest predictor of FA (R = 0.483, adjusted R2 = 0.220), followed by LA severity, but not age. These findings suggest that arterial pulsatility may provide insight into age-related reduction in white matter FA. Specifically, increased arterial pulsatility may increase perivascular shear stress and lead to accumulation of damage to perivascular oligodendrocytes, resulting in microstructural changes in white matter and contributing to proliferation of LA over time. Changes in cerebral blood flow pulsatility may therefore provide a sensitive index of white matter health that could facilitate the early detection of risk for perivascular white matter damage and the assessment of the effectiveness of preventative treatment targeted at reducing pulsatility. PMID:24302906

  8. Cerebrospinal Fluid from Patients with Subarachnoid Haemorrhage and Vasospasm Enhances Endothelin Contraction in Rat Cerebral Arteries

    PubMed Central

    Assenzio, Barbara; Martin, Erica L.; Stankevicius, Edgaras; Civiletti, Federica; Fontanella, Marco; Boccaletti, Riccardo; Berardino, Maurizio; Mazzeo, AnnaTeresa; Ducati, Alessandro; Simonsen, Ulf; Mascia, Luciana

    2015-01-01

    Introduction Previous studies have suggested that cerebrospinal fluid from patients with subarachnoid hemorrhage (SAH) leads to pronounced vasoconstriction in isolated arteries. We hypothesized that only cerebrospinal fluid from SAH patients with vasospasm would produce an enhanced contractile response to endothelin-1 in rat cerebral arteries, involving both endothelin ETA and ETB receptors. Methods Intact rat basilar arteries were incubated for 24 hours with cerebrospinal fluid from 1) SAH patients with vasospasm, 2) SAH patients without vasospasm, and 3) control patients. Arterial segments with and without endothelium were mounted in myographs and concentration-response curves for endothelin-1 were constructed in the absence and presence of selective and combined ETA and ETB receptor antagonists. Endothelin concentrations in culture medium and receptor expression were measured. Results Compared to the other groups, the following was observed in arteries exposed to cerebrospinal fluid from patients with vasospasm: 1) larger contractions at lower endothelin concentrations (p<0.05); 2) the increased endothelin contraction was absent in arteries without endothelium; 3) higher levels of endothelin secretion in the culture medium (p<0.05); 4) there was expression of ETA receptors and new expression of ETB receptors was apparent; 5) reduction in the enhanced response to endothelin after ETB blockade in the low range and after ETA blockade in the high range of endothelin concentrations; 6) after combined ETA and ETB blockade a complete inhibition of endothelin contraction was observed. Conclusions Our experimental findings showed that in intact rat basilar arteries exposed to cerebrospinal fluid from patients with vasospasm endothelin contraction was enhanced in an endothelium-dependent manner and was blocked by combined ETA and ETB receptor antagonism. Therefore we suggest that combined blockade of both receptors may play a role in counteracting vasospasm in patients with SAH. PMID:25629621

  9. Effects of Resistance Exercise Applied Early After Coronary Artery Bypass Grafting: a Randomized Controlled Trial

    PubMed Central

    Ximenes, Nayana Nazar Pessoa Sousa; Borges, Daniel Lago; Lima, Reijane Oliveira; Silva, Mayara Gabrielle Barbosa e; da Silva, Luan Nascimento; Costa, Marina de Albuquerque Gonalves; Baldez, Thiago Eduardo Pereira; Nina, Vincius Jos da Silva

    2015-01-01

    OBJECTIVE To evaluate the effects of resistance exercise applied early after coronary artery bypass grafting. METHODS It is a randomized controlled trial with 34 patients undergoing coronary artery bypass grafting between August 2013 and May 2014. Patients were randomized into two groups by simple draw: a control group (n=17), who received conventional physical therapy and an intervention group (n=17), who received, additionally, resistance exercise. Pulmonary function and functional capacity were evaluated in preoperative period and hospital discharge by spirometry and the six-minute walk test. For statistical analysis, we used the following tests: Shapiro-Wilk, Mann-Whitney, Student's t and Fisher's exact. Variables with P<0.05 were considered significant. RESULTS Groups were homogeneous in terms of demographic, clinical and surgical variables. Resistance exercise exerted no effect on pulmonary function of intervention group compared to control group. However, intervention group maintained functional capacity at hospital discharge measured by percentage of predict distance in 6MWT (54.122.7% vs. 52.515.5%, P=0.42), while control group had a significant decrease (59.211.1% vs. 50.69.9%, P<0.016). CONCLUSION Our results indicate that resistance exercise, applied early, may promote maintenance of functional capacity on coronary artery bypass grafting patients, having no impact on pulmonary function when compared to conventional physical therapy.

  10. Impact of admission triglyceride for early outcome in diabetic patients with stable coronary artery disease

    PubMed Central

    2014-01-01

    Background The role of triglyceride (TG) in predicting the outcomes in diabetic patients with coronary artery disease (CAD) has not been well investigated. Methods A total of 329 cases with stable angina pectoris (SAP) were prospectively enrolled and followed up for an average of 12months. They were classified into the two groups according to the cut-off values of predicting early outcome of fasting TG level (low group <1.2mmol/L, n?=?103; High group ?1.2mmol/L, n?=?226). The relationship between the TG levels and early outcomes were evaluated. Results High TG group showed severer lipid profile and elevated inflammatory markers. During an average of 12-month follow-up, 47 out of 329 patients suffered from pre-specified outcomes. Area under the receivers operating characteristic curve suggested that TG, similar to serum Hemoglobin A1C (HbA1C), was a significant predictor of early outcome for diabetic patients with SAP (P?=?0.002). In Cox regression models, after adjusted age, gender, body mass index, other lipid parameters, fasting blood glucose, high sensitivity C-reactive protein, neutrophil count and HbA1C, TG remained as an independent predictor of adverse prognosis. Conclusions High level of fasting TG (?1.2mmol/L) was an independent predictor for early outcome of diabetic patients with SAP as like as HBA1c and number of affected coronary arteries in the era of revascularization and statin therapeutics. PMID:24766776

  11. Enhancing Thinking Skills in Early Childhood

    ERIC Educational Resources Information Center

    Aubrey, Carol; Ghent, Kathryn; Kanira, Eleni

    2012-01-01

    A case study approach was adopted to investigate two thinking skills programmes for a maximum variation sample of five- to six-year-olds in four schools, in two local authorities (LAs), in England and Wales, using multiple methods. School staff interviewed felt that thinking skills programmes enhanced critical thinking skills and improved use of

  12. Diode laser anastemoses of medium-size arteries with indocyanine green dye-enhanced albumine

    NASA Astrophysics Data System (ADS)

    Weng, Guo-Xing; Williamson, Warren; Aretz, H. Thomas

    1998-11-01

    In order to achieve a better long-term patency result and solve the problem of tensile strength in laser artery anastomoses, diode laser and Indocyanine Green (ICG) enhanced albumin were applied to medium-size artery anastomoses with three different methods, that is, direct laser vascular anastomoses, direct method enforced with ICG albumin, and laser welding with ICG albumin as 'solder'. Internal mammary artery (IMA) harvested from patients undergoing coronary bypass procedures, in vivo rat abdominal artery, and in vitro swine heart and IMA were chosen as the experimental materials. The results revealed that only 3.15 +/- 0.36 minutes were required for each anastomosis; the bursting pressure and tensile strength were greater in the groups enforced with ICG albumin and laser welding than that with direct laser anastomoses. In the laser soldering group, the thermal damage was limited in the adventitial layer, only at a depth of 200 micrometers . There was also a satisfied result in the in vivo laser welding rat's abdominal adventitial layer, only at a depth of 200 micrometers . There was also a satisfied result in the in vivo laser welding rat's abdominal arteries. However, end-to-side laser welding of IMA soronary artery with ICG albumin needs further investigation about its tensile strength in an in vivo model.

  13. Ultrasound-enhanced drug delivery in a perfused ex vivo artery model

    NASA Astrophysics Data System (ADS)

    Hitchcock, Kathryn E.

    Acoustically driven stable cavitation may improve treatments of diseases in which passive penetration of drug into the target tissue is poor. Examples include atherosclerosis, in which the endothelium can prevent penetration of therapeutics into the plaque, and ischemic stroke, in which pathologically low flow of blood impedes the delivery of intravenous drugs to the clot. Understanding the way in which ultrasound cavitation agents nucleate cavitation in flowing blood-mimicking solutions is an important step in optimizing ultrasound-enhanced drug delivery. The use of a perfused, living ex vivo artery model permitted study of this phenomenon while still providing information on arterial bioeffects. Cavitation-enhanced delivery of anti-ICAM-1-targeted echogenic liposomes into and beyond the ex vivo murine aortic endothelium was demonstrated using 1-MHz continuous wave ultrasound. Acoustic cavitation had no apparent effect on the health of the murine arterial tissue. A method of maximizing the energy of stable cavitation through the use of intermittent 120-kHz ultrasound with quiescent periods to allow contrast agent inflow was developed. Using this insonificaiton method, sonothrombolysis was studied in ex vivo porcine carotid arteries using a 120-kHz center frequency and 0.44 MPa peak-to-peak pressure amplitude. Clot mass loss was used as a metric of thrombolytic efficacy. Clots exposed to recombinant tissue plasminogen activator and the ultrasound contrast agent, DefinityRTM in flowing porcine plasma without ultrasound experienced 34% mass loss. When robust stable cavitation was induced via 120-kHz insonation, the mean clot mass loss rose to 83%, which constituted a significant improvement (n = 6, p<0.0001). Without DefinityRTM there was no thrombolytic enhancement by ultrasound exposure alone at the same insonation pressure (n = 6, p<0.0001). Significant loss of endothelium occurred in 64% of the porcine carotid arteries, possibly due to poor oxygen delivery by the low flow of plasma. However, no correlation was observed between arterial tissue damage and treatment type. In this perfused ex vivo artery model, acoustic stable cavitation was shown to enhance both the delivery of endothelium-targeted therapeutics into the arterial wall and the lysis of whole blood clots in the presence of rt-PA.

  14. Use of arterial to equilibrium enhancement washout to predict viability in liver cancers treated with transcatheter arterial chemoembolization

    NASA Astrophysics Data System (ADS)

    Choi, Seung Joon; Kim, Hyung Sik; Kim, Jeong Ho; Choi, Hye Young; Park, Hyunjin

    2013-04-01

    Liver cancers are very common in Korea and Computed Tomography (CT) imaging is commonly used to diagnose them. This study improves the diagnosis of liver cancer by using a novel parametric image combining various phases of dynamic CT imaging. The objective of this study is to investigate the diagnostic value of arterial to equilibrium enhancement washout (AEEW) obtained by image registration and dynamic subtraction in predicting tumor viability in a hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE). Forty patients who had forty-seven iodized-oil defect areas (IODAs) in HCCs treated with TACE were included. These patients were divided into two groups, one group with viable tumors (n = 27) and the other group with non-viable tumors (n = 20) in the IODAs. All the patients underwent triple-phase CT before and after TACE. The attenuation differences of the IODAs between the arterial and the equilibrium phases were measured and compared between two groups. Quantitative AEEW color maps of the whole liver were created from the triple-phase CT image by using prototype research software. Two radiologists independently analyzed following two sets of image: one with standard tri-phase CT images and the other with tri-phase CT images and quantitative AEEW color map images. The diagnostic performances in terms of mean sensitivity, specificity, and accuracy for identifying viable or non-viable tumors by using quantitative AEEW color map images in addition to tri-phase CT was larger than the performance obtained using tri-phase CT only. In conclusion, quantitative AEEW color map images improve the diagnostic performances of multiphasic CT for determining the viability of the IODA in a HCC treated with TACE.

  15. Cardioprotective effects of early and late aerobic exercise training in experimental pulmonary arterial hypertension.

    PubMed

    Moreira-Gonçalves, Daniel; Ferreira, Rita; Fonseca, Hélder; Padrão, Ana Isabel; Moreno, Nuno; Silva, Ana Filipa; Vasques-Nóvoa, Francisco; Gonçalves, Nádia; Vieira, Sara; Santos, Mário; Amado, Francisco; Duarte, José Alberto; Leite-Moreira, Adelino F; Henriques-Coelho, Tiago

    2015-11-01

    Clinical studies suggest that aerobic exercise can exert beneficial effects in pulmonary arterial hypertension (PAH), but the underlying mechanisms are largely unknown. We compared the impact of early or late aerobic exercise training on right ventricular function, remodeling and survival in experimental PAH. Male Wistar rats were submitted to normal cage activity (SED), exercise training in early (EarlyEX) and in late stage (LateEX) of PAH induced by monocrotaline (MCT, 60 mg/kg). Both exercise interventions resulted in improved cardiac function despite persistent right pressure-overload, increased exercise tolerance and survival, with greater benefits in EarlyEX+MCT. This was accompanied by improvements in the markers of cardiac remodeling (SERCA2a), neurohumoral activation (lower endothelin-1, brain natriuretic peptide and preserved vascular endothelial growth factor mRNA), metabolism and mitochondrial oxidative stress in both exercise interventions. EarlyEX+MCT provided additional improvements in fibrosis, tumor necrosis factor-alpha/interleukin-10 and brain natriuretic peptide mRNA, and beta/alpha myosin heavy chain protein expression. The present study demonstrates important cardioprotective effects of aerobic exercise in experimental PAH, with greater benefits obtained when exercise training is initiated at an early stage of the disease. PMID:26463598

  16. Early Rehabilitation Therapy Is Beneficial for Patients With Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery.

    PubMed

    Dong, Zehua; Yu, Bangxu; Zhang, Quanfang; Pei, Haitao; Xing, Jinyan; Fang, Wei; Sun, Yunbo; Song, Zhen

    2016-03-22

    We investigated the effects of early rehabilitation therapy on prolonged mechanically ventilated patients after coronary artery bypass surgery (CABG).A total of 106 patients who underwent CABG between June 2012 and May 2015 were enrolled and randomly assigned into an early rehabilitation group (53 cases) and a control group (53 cases). The rehabilitation therapy consisted of 6 steps including head up, transferring from supination to sitting, sitting on the edge of bed, sitting in a chair, transferring from sitting to standing, and walking along a bed. The patients received rehabilitation therapy in the intensive care unit (ICU) after CABG in the early rehabilitation group. The control group patients received rehabilitation therapy after leaving the ICU.The results showed that the early rehabilitation therapy could significantly decrease the duration of mechanical ventilation (early rehabilitation group: 8.1 ± 3.3 days; control group: 13.9 ± 4.1 days, P < 0.01), hospital stay (early rehabilitation group: 22.0 ± 3.8 days; control group: 29.1 ± 4.6 days, P < 0.01), and ICU stay (early rehabilitation group: 11.7 ± 3.2 days; control group: 18.3 ± 4.2 days, P < 0.01) for patients requiring more than 72 hours prolonged mechanical ventilation. The results of Kaplan-Meier analysis showed that the proportions of patients remaining on mechanical ventilation in the early rehabilitation group were larger than that in the control group after 7 days of rehabilitation therapy (logrank test: P < 0.01).The results provide evidence for supporting the application of early rehabilitation therapy in patients requiring prolonged mechanical ventilation after CABG. PMID:26973269

  17. Mechanisms of arterial graft failure. 1. Role of cellular proliferation in early healing of PTFE prostheses.

    PubMed Central

    Clowes, A. W.; Gown, A. M.; Hanson, S. R.; Reidy, M. A.

    1985-01-01

    Failure of long-term synthetic arterial bypass grafts has been attributed in part to anastomotic stenosis, but the pathologic basis for this has not been determined. Which cells participate in the formation of the stenosis and the relationship between normal healing and the pathologic development of anastomotic narrowing have not been delineated. In this study we have examined early wound healing in 4-mm polytetrafluorethylene arterial bypass grafts placed in baboons. In this primate model, endothelium and smooth muscle cells (SMCs) derived from the cut ends of adjacent artery form the new intima and migrate together along the luminal surface of the graft at approximately 0.2 mm/day. Both cell types proliferate in association with the growing edge. In addition, both endothelium and SMCs located discretely over anastomoses continue to proliferate despite complete endothelial coverage. Intimal cross-sectional area in this region is always greater than over adjacent graft. Fibroblasts are invariably found in graft matrix and adventitia and do not contribute to formation of intima. It is hypothesized that anastomotic narrowing might be due to chronic endothelial injury and turnover associated with continued SMC proliferation and intimal thickening. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 PMID:3966536

  18. Molecular Imaging Insights into Early Inflammatory Stages of Arterial and Aortic Valve Calcification

    PubMed Central

    New, Sophie E. P.; Aikawa, Elena

    2011-01-01

    Traditional imaging modalities such as computed tomography, although perfectly adept at identifying and quantifying advanced calcification, cannot detect the early stages of this disorder and offer limited insight into the mechanisms of mineral dysregulation. This review presents optical molecular imaging as a promising tool that simultaneously detects pathobiological processes associated with inflammation and early stages of calcification in vivo at the (sub)cellular levels. Research into treatment of cardiovascular calcification is lacking, as shown by clinical trials that have failed to demonstrate the reduction of calcific aortic stenosis. Hence the need to elucidate the pathways that contribute to cardiovascular calcification and to develop new therapeutic strategies to prevent or reverse calcification has driven investigations into the use of molecular imaging. This review discusses studies that have used molecular imaging methods to advance knowledge of cardiovascular calcification, focusing in particular on the inflammation-dependent mechanisms of arterial and aortic valve calcification. PMID:21617135

  19. A novel vascular homing peptide strategy to selectively enhance pulmonary drug efficacy in pulmonary arterial hypertension.

    PubMed

    Toba, Michie; Alzoubi, Abdallah; O'Neill, Kealan; Abe, Kohtaro; Urakami, Takeo; Komatsu, Masanobu; Alvarez, Diego; Jrvinen, Tero A H; Mann, David; Ruoslahti, Erkki; McMurtry, Ivan F; Oka, Masahiko

    2014-02-01

    A major limitation in the pharmacological treatment of pulmonary arterial hypertension (PAH) is the lack of pulmonary vascular selectivity. Recent studies have identified a tissue-penetrating homing peptide, CARSKNKDC (CAR), which specifically homes to hypertensive pulmonary arteries but not to normal pulmonary vessels or other tissues. Some tissue-penetrating vascular homing peptides have a unique ability to facilitate transport of co-administered drugs into the targeted cells/tissues without requiring physical conjugation of the drug to the peptide (bystander effect). We tested the hypothesis that co-administered CAR would selectively enhance the pulmonary vascular effects of i.v. vasodilators in Sugen5416/hypoxia/normoxia-exposed PAH rats. Systemically administered CAR was predominantly detected in cells of remodeled pulmonary arteries. Intravenously co-administered CAR enhanced pulmonary, but not systemic, effects of the vasodilators, fasudil and imatinib, in PAH rats. CAR increased lung tissue imatinib concentration in isolated PAH lungs without increasing pulmonary vascular permeability. Sublingual CAR was also effective in selectively enhancing the pulmonary vasodilation by imatinib and sildenafil. Our results suggest a new paradigm in the treatment of PAH, using an i.v./sublingual tissue-penetrating homing peptide to selectively augment pulmonary vascular effects of nonselective drugs without the potentially problematic conjugation process. CAR may be particularly useful as an add-on therapy to selectively enhance the pulmonary vascular efficacy of any ongoing drug treatment in patients with PAH. PMID:24401613

  20. Arterial Blood Pressure Management during Carotid Endarterectomy and Early Cognitive Dysfunction

    PubMed Central

    Heyer, Eric J.; Mergeche, Joanna L.; Anastasian, Zirka H.; Kim, Minjae; Mallon, Kaitlin A.; Connolly, E. Sander

    2014-01-01

    Background A common practice during cross-clamp of carotid endarterectomy (CEA) is to manage mean arterial pressure (MAP) above baseline to optimize collateral cerebral blood flow and reduce risk of ischemic stroke. Objective To determine whether MAP management ?20% above baseline during cross-clamp is associated with lower risk of early cognitive dysfunction, a subtler form of neurologic injury than stroke. Methods One hundred eighty-three patients undergoing CEA were enrolled in this ad hoc study. All patients had radial arterial catheters placed prior to induction of general anesthesia. MAP was managed at the discretion of the anesthesiologist. All patients were evaluated with a battery of neuropsychometric tests pre-operatively and 24hrs post-operatively. Results Overall, 28.4% of CEA patients exhibited early cognitive dysfunction (eCD). Significantly fewer patients with MAP ?20% above baseline during cross-clamp exhibited eCD than those managed <20% above (11.6% vs. 38.6%, P<0.001). In a multivariate logistic regression model, MAP ?20% above baseline during the cross-clamp period was associated with significantly lower risk of eCD (OR: 0.18 [0.070.40], P<0.001), while diabetes mellitus (OR: 2.73 [1.146.61], P=0.03) and each additional year of education (OR: 1.19 [1.061.34], P=0.003) were associated with significantly higher risk of eCD. Conclusion The observations of this study suggest MAP management ?20% above baseline during cross-clamp of the carotid artery may be associated with lower risk of eCD after CEA. More prospective work is necessary to determine whether MAP ?20% above baseline during cross-clamp can improve the safety of this commonly performed procedure. PMID:24335822

  1. Altered left ventricular-arterial coupling precedes pump dysfunction in early heart failure.

    PubMed

    Prabhu, Sumanth D

    2007-05-01

    The objective of this study was to define alterations in ventricular-arterial (V-A) coupling early in the development of tachycardia-induced heart failure (HF). Although HF is characterized by impaired V-A coupling, the temporal relationship of these derangements to overt left ventricular (LV) dysfunction is unknown. Six anesthetized dogs instrumented with LV manometers and piezoelectric crystals were studied before and after 24 h of rapid ventricular pacing (RVP). V-A coupling was indexed by the ratio between the end-systolic pressure-volume relation slope (endsystolic elastance, E(ES)) and effective arterial elastance (E(A)), and mechanical efficiency by the ratio of stroke work (SW) to pressure-volume area (PVA). After RVP, there was no significant depression of LV function, but E(A) and total peripheral resistance (R(T)) were increased (P < 0.05), indicating increased arterial load. After RVP, E(ES)/E(A) and SW/PVA were maintained during unstressed conditions, but upon changes in load induced by phenylephrine, E(ES)/E(A) declined more precipitously with equivalent increases in R (T) (slope E(ES)/E(A)-R(T) relation -16.7 +/- 4.6 vs -5.8 +/- 4.0 ml/mmHg.min, P < 0.025). Furthermore, after RVP there was significant (P < 0.05) blunting of dobutamine-induced augmentation of E(ES), E(ES)/E(A), and SW/PVA. Thus, after RVP there was a distinct loss of V-A coupling reserve during afterload and catecholamine stress. V-A coupling defects occur early in the development of tachycardia-induced HF prior to significant pump dysfunction, and are manifested primarily during hemodynamic and inotropic stress. PMID:17533521

  2. The effect of early external X-ray radiation on arterial restenosis post percutaneous transluminal angioplasty

    PubMed Central

    Cheng, Jun; Liu, Bujin; Yu, Huarong; Fu, Qining; Li, Fenghe; Zhao, Yu

    2015-01-01

    Background: Arterial restenosis after percutaneous transluminal angioplasty (PTA) significantly reduces its therapeutic efficacy in treating lower extremity atherosclerotic occlusive diseases (LEAOD). Early external X-ray external radiation has demonstrated positive effects on restenosis; however, effective dosing and the mechanism(s) underlying its efficacy remain unknown. This study explored the effect of early external X-ray radiation on preventing post-PTA restenosis in an iliac intimal injury model. Methods: Twenty rabbits underwent iliac intimal injury via PTA and received five different radiation doses: 0 Gy (n = 4), 3 Gy (n = 4), 6 Gy (n = 4), 9 Gy (n = 4), and 12 Gy (n = 4). Four rabbits were used as controls. All subjects were fed a high-fat diet prior to PTA and for an additional four-week period post-PTA and then sacrificed for immunohistochemical and Western blotting analysis. Results: Arterial stenosis was significantly improved post-PTA. Alpha smooth muscle actin (?-SMA) expression in the 0 Gy to 9 Gy groups was significantly increased post-PTA. Cytochrome C (Cyt C) expression was significantly increased post-PTA and was positively correlated with radiation intensity. Proliferating cell nuclear antigen (PCNA) expression was significantly increased post-PTA with the 0 Gy group showing significantly higher expression than the 3 Gy group. No significant differences were found in CD34 levels between the groups. Conclusions: Early external X-ray radiation at 6-24 Gy doses effectively restrained VSMC hyperplasia post-PTA, likely through inducing VSMC apoptosis via mitochondrial Cyt C release. However, this technique did not significantly affect the integrity of the vascular endothelium. Therefore, early external X-ray radiation shows promise in preventing post-PTA restenosis. PMID:26380003

  3. Effect of early external X-ray radiation on arterial restenosis post percutaneous transluminal angioplasty

    PubMed Central

    Cheng, Jun; Liu, Bujin; Yu, Huarong; Fu, Qining; Li, Fenghe; Zhao, Yu

    2015-01-01

    Background: Arterial restenosis after percutaneous transluminal angioplasty (PTA) significantly reduces its therapeutic efficacy in treating lower extremity atherosclerotic occlusive diseases (LEAOD). Early external X-ray external radiation has demonstrated positive effects on restenosis; however, effective dosing and the mechanism(s) underlying its efficacy remain unknown. This study explored the effect of early external X-ray radiation on preventing post-PTA restenosis in an iliac intimal injury model. Methods: Twenty rabbits underwent iliac intimal injury via PTA and received five different radiation doses: 0 Gy (n=4), 3 Gy (n=4), 6 Gy (n=4), 9 Gy (n=4), and 12 Gy (n=4). Four rabbits were used as controls. All subjects were fed a high-fat diet prior to PTA and for an additional four-week period post-PTA and then sacrificed for immunohistochemical and Western blotting analysis. Results: Arterial stenosis was significantly improved post-PTA. Alpha smooth muscle actin (?-SMA) expression in the 0 Gy to 9 Gy groups was significantly increased post-PTA. Cytochrome C (Cyt C) expression was significantly increased post-PTA and was positively correlated with radiation intensity. Proliferating cell nuclear antigen (PCNA) expression was significantly increased post-PTA with the 0 Gy group showing significantly higher expression than the 3 Gy group. No significant differences were found in CD34 levels between the groups. Conclusions: Early external X-ray radiation at 6-24 Gy doses effectively restrained VSMC hyperplasia post-PTA, likely through inducing VSMC apoptosis via mitochondrial Cyt C release. However, this technique did not significantly affect the integrity of the vascular endothelium. Therefore, early external X-ray radiation shows promise in preventing post-PTA restenosis. PMID:26628976

  4. Efficient sampling of early signal arrival for estimation of perfusion and transit time in whole-brain arterial spin labeling.

    PubMed

    Lee, Wayne; Janik, Rafal; Scouten, Amy; Stefanovic, Bojana; Sled, John G

    2012-07-01

    Arterial spin labeling can be used to measure both cerebral perfusion and arterial transit time. However, accurate estimation of these parameters requires adequate temporal sampling of the arterial spin labeling difference signal. In whole-brain multislice acquisitions, two factors reduce the accuracy of the parameter estimates: saturation of labeled blood in transit and inadequate sampling of early difference signal in superior slices. Label saturation arises when slices are acquired inferior-to-superior such that slice selection in proximal slices spoils the label for a distal slice. Inadequate sampling arises when the time spent acquiring inferior slices is too long to allow early sampling of the difference signal in superior slices. A novel approach to multislice imaging is proposed to address these two issues. In round-robin arterial spin labeling, slices are acquired in a different order after every pair of control-label acquisitions. Round-robin arterial spin labeling enables the acquisitions of all slices across the same range of postlabel delays in a descending superior-to-inferior order. This eliminates the temporal sampling problem and greatly reduces label saturation. Arterial transit time estimates obtained for the whole brain with round-robin arterial spin labeling show better agreement with a single-slice acquisition than do conventional multislice acquisitions. PMID:22189961

  5. Reading Acquisition Enhances an Early Visual Process of Contour Integration

    ERIC Educational Resources Information Center

    Szwed, Marcin; Ventura, Paulo; Querido, Luis; Cohen, Laurent; Dehaene, Stanislas

    2012-01-01

    The acquisition of reading has an extensive impact on the developing brain and leads to enhanced abilities in phonological processing and visual letter perception. Could this expertise also extend to early visual abilities outside the reading domain? Here we studied the performance of illiterate, ex-illiterate and literate adults closely matched

  6. On contrast-enhanced magnetic resonance angiography of the aortoiliac arteries.

    PubMed

    Wikstrm, J

    2001-12-01

    In contrast-enhanced MR angiography (CE-MRA), vascular signal is produced by the acquisition of a T1-weighted MR imaging scan while the presence of a contrast agent induces a low T1 in blood. In this thesis, CE-MRA of the aortoiliac arteries was evaluated. Different contrast agents and techniques for synchronisation of the scan with the contrast bolus passage were assessed. In 30 patients with clinically suspected iliac artery stenoses, CE-MRA was compared with duplex ultrasound scanning (DUS) and digital subtraction X-ray angiography (DSA), with intra-arterial pressure measurements as reference. No statistically significant differences in sensitivity or specificity were observed between the techniques regarding detection of haemodynamically significant iliac stenoses. The use of multiplanar reformat and source images in the MRA examinations was of value for differentiation between highgrade stenoses and occlusions. With DSA as reference method, MRA had significantly higher sensitivity and specificity than DUS for detection of > or = 50% stenoses. In 14 patients who underwent iliac artery MRA, differences in contrast arrival time of up to 7 s were observed between the aorta and the common femoral artery. A dual-station timing technique adjusting for this difference was found feasible. Compared with a fluoroscopically triggered technique (n = 13), which is used in clinical routine, the dual-station technique was more reliable for the visualisation of distal vessels. In a clinical phase II study comparing doses of the contrast agent gadobenate dimeglumine from 0.0125 to 0.2 mmol/kg b.w. for enhancement of iliac artery MRA, significant improvement in subjective diagnostic quality compared with time-of-flight-MRA was found at all doses from 0.025 mmol/kg b.w. An increasing trend with dose was observed up to a dose of 0.05-0.1 mmol/kg b.w. In a phase I clinical study on the intravascular iron oxide contrast agent NC100150 Injection, a positive dose response was observed for abdominal vascular enhancement, with the highest contrast-to-noise ratio observed at 4.0 mg Fe/kg b.w. at 1.5 T and at 2.5-4 mg Fe/kg b.w. at 0.5 T. At 1.5 T higher calculated R2* values were found for the aorta than for the inferior vena cava. PMID:12040856

  7. Early CT findings of acute cerebral infarction in the middle cerebral artery territory.

    PubMed

    Ying, K S; Pang, K K; Huang, J K; Lin, J C

    1992-04-01

    For an early and definitive diagnosis of acute cerebral infarction by computed tomography (CT), we retrospectively analyzed the initial CT findings of 14 patients with proven acute middle cerebral artery (MCA) infarction within 4 hours after stroke onset. The following results were obtained: (a) abnormal CT findings could be recognized quite early in 13 patients (92.9%), (b) the most common and earliest finding was loss of defination of the gray-white interface at the lateral margins of the insula. This sign was recognized in 12 patients (85.7%) and could be detected as early as 1 hour after stroke onset, (c) the next common finding was narrowing or blurring of the Sylvian fissure in 10 patients (71.4%) and could be detected 1.5 hours after stroke onset, (d) an obscured outline or partial disappearance of the lentiform nucleus was recognized in 7 patients (50%) and could be detected 1.5 hours after stroke onset, (e) effacement of the cerebral sulci was found in 6 patients (42.9%) and could be detected 2.5 hours after stroke onset, (f) increased density in MCA or its major branches was not seen in our patients. PMID:1318145

  8. Mycotic Aneurysm of the Common Carotid Artery as a Presenting Symptom for Early Colorectal Malignancy.

    PubMed

    Chan, Yiu-Che; Cheng, Stephen W

    2016-01-01

    Mycotic carotid aneurysms are rare vascular conditions that are associated with high mortality if left untreated. We present a gentleman who had a progressively enlarging tender pulsatile swelling on the right side of neck. Emergency computed tomography scan showed a large mycotic aneurysm arising from the right common carotid artery, and he underwent emergency open exploration with interposition bypass graft. Bacteroides fragilis species, which signified gastrointestinal-related sepsis, was isolated from the thrombus culture. Subsequently search of systemic septic source showed an early rectal adenocarcinoma. This is the first case in the world's literature of a patient who had B. fragilis mycotic carotid aneurysm as a presenting complaint of his occult rectal malignancy. PMID:26363427

  9. How safe are carotid endarterectomy and carotid artery stenting in the early period after carotid-related cerebral ischemia?

    PubMed

    Rantner, B

    2015-12-01

    Timing of treatment in carotid artery disease is still a matter of debate. So far there is controversial literature available concerning the safety of rapid treatment after a qualifying neurological event. Carotid endarterectomy turned out to be more effective in stroke prevention when carried out closer after the onset of symptoms. The initial "two weeks" cut off for surgery meanwhile turned into a "as soon as possible" treatment policy. In case of a cerebral infarction it seems reasonable, however, to delay surgery. Less evidence exists about the ideal timing of carotid artery stenting. Data analysis from the Carotid Stenosis Trialists' Collaboration showed that the early days after plaque rupture carry a high risk for periprocedural complications after carotid artery stenting. The analysis of a large register series showed, that carotid artery stenting carried a significantly higher risk for complications in patients with and without cerebral infarction when performed within 48 hours after the onset of symptoms. PMID:26184569

  10. Pulmonary artery banding for neonates and early infants with low body weight.

    PubMed

    Nagashima, Mitsugi; Okamura, Toru; Shikata, Fumiaki; Chisaka, Toshiyuki; Takata, Hidemi; Ohta, Masaaki; Yamamoto, Eiichi; Higaki, Takashi

    2011-01-01

    Open heart surgery for infants with low body weight (BW) remains still a challenge. Pulmonary artery banding (PAB) is a useful surgical palliation for small neonates and early infants with excessive pulmonary blood flow who are unable to withstand a heart surgery. This study retrospectively reviewed neonates and infants who underwent PAB to assess the surgical results and the validity of our PAB. We selected 38 acyanotic infants and neonates and divided them into 2 groups: low BW (< 2.5 kg, n = 15, group L) and normal or high BW (≥ 2.5 kg, n = 23, group NH). The average BW at the time of PAB was 2.8 ± 1.1 kg (range, 1.2-5.8 kg), and the average age at the time of PAB was 41.8 ± 44.8 days (range, 2-151 days). Using a 3-mm-wide polyester tape, we tightened the main pulmonary artery to obtain the circumference of (19 mm + 1 mm for each kg of BW). There was no early death but one late death in each group. Postoperative BW continuously increased 1 month after PAB in both groups, although BW was significantly lower in group L than in group NH. Intracardiac repair (ICR) was accomplished in 31 patients (13 in group L and 18 in group NH) at average ages of 1.5 years, while the remaining 5 patients are awaiting ICR. In conclusion, PAB using our formula for the infants even weighing < 2.5 kg has low mortality and is effective as a bridge to ICR. PMID:22095252

  11. Early detection and differentiation of venous and arterial occlusion in skin flaps using visible diffuse reflectance spectroscopy and autofluorescence spectroscopy

    PubMed Central

    Zhu, Caigang; Chen, Shuo; Chui, Christopher Hoe-Kong; Tan, Bien-Keem; Liu, Quan

    2016-01-01

    Our previous preclinical study demonstrated that both visible diffuse reflectance and autofluorescence spectroscopy, each of which yields a different set of physiological information, can predict skin flap viability with high accuracy in a MacFarlane rat dorsal skin flap model. In this report, we further evaluated our technique for the early detection and differentiation of venous occlusion and arterial occlusion in a rat groin flap model. We performed both diffuse reflectance and autofluorescence measurements on the skin flap model and statistically differentiated between flaps with and without occlusions as well as between flaps with venous occlusion and those with arterial occlusion based on these non-invasive optical measurements. Our preliminary results suggested that visible diffuse reflectance and autofluorescence spectroscopy can be potentially used clinically to detect both venous and arterial occlusion and differentiate one from the other accurately at an early time point. PMID:26977363

  12. Early results from an angiosome-directed open surgical technique for venous arterialization in patients with critical lower limb ischemia

    PubMed Central

    Houlind, Kim; Christensen, Johnny; Hallenberg, Christian; Jepsen, Jrn M.

    2013-01-01

    Background Patients with critical lower limb ischemia without patent pedal arteries cannot be treated by the conventional arterial reconstruction. Venous arterialization has been suggested to improve limb salvage in this subgroup of patients but has not gained wide acceptance. We report our early experience after implementing deep and superficial venous arterialization of the lower limb. Materials and methods Ten patients with critical ischemia and without crural or pedal arteries available for conventional bypass surgery or angioplasty were treated with distal venous arterialization. Inflow was from the most distal unobstructed segment. Run-off was the dorsal pedal venous arch (n=5), the dorsal pedal venous arch and a concomitant vein of the posterior tibial artery (n=3), or the dorsal pedal venous arch and a concomitant vein of the common plantar artery (n=2) depending on the location of the ischemic lesion. Venous valves were destroyed using antegrade valvulotomes, guide wires, knob needles, or retrograde valvulotomes via an extra incision. Results Seven of the operated limbs were amputated after 23 (1256) days (median [range]). The main reasons for amputation were lack of healing of either the original wound, of incisional wounds on the foot, or persisting pain at rest. In three cases, the bypass was open at the time of amputation. Two patients experienced complete wound healing after 231 and 342 days, respectively. By the end of follow-up, the last patient was ambulating with slow wound healing but without pain 309 days after surgery. Conclusion Venous arterialization may be used as a treatment of otherwise unsalveable limbs. The success rate is, however, limited. Technical optimization of the technique is warranted. PMID:24358432

  13. Nogo-B expression, in arterial intima, is impeded in the early stages of atherosclerosis in humans.

    PubMed

    Drożdż, Katarzyna; Grzegorek, Irmina; Chmielewska, Magdalena; Gomułkiewicz, Agnieszka; Jabłońska, Karolina; Piotrowska, Aleksandra; Karczewski, Maciej; Janczak, Dariusz; Patrzałek, Dariusz; Dzięgiel, Piotr; Szuba, Andrzej

    2014-09-01

    Nogo-B (Reticulon 4B) is considered to be a novel vascular marker, which may have a protective role in injury-induced neointima formation and atherosclerosis. Nogo A/B is found to be crucial for monocyte/macrophage recruitment in acute inflammation and it is expressed in CD68 + macrophages. We hypothesize that macrophage infiltration in atherosclerosis is not dependent on Nogo-B expression in arterial wall. We have assessed Nogo-B expression and macrophage accumulation in the iliac arteries of healthy organ donors and organ donors with cardiovascular risk factors. Paraffin sections of 66 iliac arteries, from 44 deceased organ donors (17 women and 27 men), were studied. The healthy and cardiovascular risk (CVR) subgroups were created. With regard to staging of the atherosclerotic process, the thickness of arterial intima was measured in digitalized images of H+E stained tissue sections. Immunohistochemical reactions (Nogo-B and CD68) were carried out in all arteries (66 samples). Western blotting (WB-19 samples) and real-time PCR (27 samples) were performed on selected arteries. Significantly higher Nogo-B expression was demonstrated in the intima of the healthy subjects' subgroup, using immunohistochemistry. WB and real-time PCR revealed a trend toward lower Nogo-B expression in the adventitia of the CVR subgroup. Furthermore, the thickness of the intima was found to negatively correlate with the expression of Nogo-B in the intima and media (r = -0.32; p < 0.05; r = -0.32; p < 0.05). Macrophage infiltrates were more prominent in intima of CVR subjects (0.65 vs 3.52 a.u.; p < 0.01). Macrophage density in intima increased with atherosclerosis progression (r = 0.37; p < 0.01). CD68 macrophages density in adventitia was lower in CVR arteries than in healthy arteries. The expression of Nogo-B, in arterial intima, is impeded in the early stages of atherosclerosis. Accumulation of arterial intimal CD68 macrophages has been shown to progress; however, the overall macrophage density in the adventitia is reduced in arteries shown to have intimal thickening. Macrophage infiltration is not accompanied by Nogo-B expression in atherosclerotic arteries. PMID:24372562

  14. Magnetically enhanced cell delivery for accelerating recovery of the endothelium in injured arteries.

    PubMed

    Adamo, Richard F; Fishbein, Ilia; Zhang, Kehan; Wen, Justin; Levy, Robert J; Alferiev, Ivan S; Chorny, Michael

    2016-01-28

    Arterial injury and disruption of the endothelial layer are an inevitable consequence of interventional procedures used for treating obstructive vascular disease. The slow and often incomplete endothelium regrowth after injury is the primary cause of serious short- and long-term complications, including thrombosis, restenosis and neoatherosclerosis. Rapid endothelium restoration has the potential to prevent these sequelae, providing a rationale for developing strategies aimed at accelerating the reendothelialization process. The present studies focused on magnetically guided delivery of endothelial cells (EC) functionalized with biodegradable magnetic nanoparticles (MNP) as an experimental approach for achieving rapid and stable cell homing and expansion in stented arteries. EC laden with polylactide-based MNP exhibited strong magnetic responsiveness, capacity for cryopreservation and rapid expansion, and the ability to disintegrate internalized MNP in both proliferating and contact-inhibited states. Intracellular decomposition of BODIPY558/568-labeled MNP monitored non-invasively based on assembly state-dependent changes in the emission spectrum demonstrated cell proliferation rate-dependent kinetics (average disassembly rates: 6.60.8% and 3.60.4% per day in dividing and contact-inhibited EC, respectively). With magnetic guidance using a transient exposure to a uniform 1-kOe field, stable localization and subsequent propagation of MNP-functionalized EC, markedly enhanced in comparison to non-magnetic delivery conditions, were observed in stented rat carotid arteries. In conclusion, magnetically guided delivery is a promising experimental strategy for accelerating endothelial cell repopulation of stented blood vessels after angioplasty. PMID:26704936

  15. Enhancer RNA facilitates NELF release from immediate early genes.

    PubMed

    Schaukowitch, Katie; Joo, Jae-Yeol; Liu, Xihui; Watts, Jonathan K; Martinez, Carlos; Kim, Tae-Kyung

    2014-10-01

    Enhancer RNAs (eRNAs) are a class of long noncoding RNAs (lncRNA) expressed from active enhancers, whose function and action mechanism are yet to be firmly established. Here we show that eRNAs facilitate the transition of paused RNA polymerase II (RNAPII) into productive elongation by acting as a decoy for the negative elongation factor (NELF) complex upon induction of immediate early genes (IEGs) in neurons. eRNAs are synthesized prior to the culmination of target gene transcription and interact with the NELF complex. Knockdown of eRNAs expressed at neuronal enhancers impairs transient release of NELF from the specific target promoters during transcriptional activation, coinciding with a decrease in target mRNA induction. The enhancer-promoter interaction was unaffected by eRNA knockdown. Instead, chromatin looping might enable eRNAs to act locally at a specific promoter. Our findings highlight the spatiotemporally regulated action mechanism of eRNAs during early transcriptional elongation. PMID:25263592

  16. Brachial Artery Endothelial Responses during Early Recovery from an Exercise Bout in Patients with Coronary Artery Disease

    PubMed Central

    Currie, Katharine D.; McKelvie, Robert S.; MacDonald, Maureen J.

    2014-01-01

    This study examined the acute endothelial responses to an exercise bout in coronary artery disease (CAD) patients. Nineteen males with CAD (63 8 years) were assessed at rest and 15 minutes following a submaximal exercise bout (recovery). Brachial artery endothelial-dependent function was assessed using flow-mediated dilation (FMD). Brachial artery diameters and velocities were measured using Duplex ultrasound at baseline, and for 3 minutes following a 5-minute ischemic period. Endothelial-independent function was assessed using a 0.4?mg dose of nitroglycerin (NTG). FMD responses were unchanged from rest to recovery; however, there were 2 types of responses: negative and positive FMD responders. Post-hoc analysis revealed that positive responders had lower resting FMD compared to negative responders (3.2 1.7 versus 6.0 2.5%, P < 0.05). NTG-mediated dilation was reduced in recovery (22.0 5.6 versus 14.4 5.7%, P < 0.001 for rest versus recovery). In conclusion, acute endothelial-dependent responses to submaximal exercise are affected by the degree of resting endothelial dysfunction. The observation of attenuated NTG-mediated dilation during recovery is novel and warrants the investigation of possible mechanisms and clinical significance. Furthermore, it highlights the necessity of both endothelial-dependent and endothelial-independent assessments when evaluating endothelial function changes with an intervention. PMID:24724088

  17. A genomewide scan for early-onset coronary artery disease in 438 families: the GENECARD Study.

    PubMed

    Hauser, Elizabeth R; Crossman, David C; Granger, Christopher B; Haines, Jonathan L; Jones, Christopher J H; Mooser, Vincent; McAdam, Brendan; Winkelmann, Bernhard R; Wiseman, Alan H; Muhlestein, J Brent; Bartel, Alan G; Dennis, Charles A; Dowdy, Elaine; Estabrooks, Susan; Eggleston, Karen; Francis, Sheila; Roche, Kath; Clevenger, Paula W; Huang, Liling; Pedersen, Bonnie; Shah, Svati; Schmidt, Silke; Haynes, Carol; West, Sandra; Asper, Donny; Booze, Michael; Sharma, Sanjay; Sundseth, Scott; Middleton, Lefkos; Roses, Allen D; Hauser, Michael A; Vance, Jeffery M; Pericak-Vance, Margaret A; Kraus, William E

    2004-09-01

    A family history of coronary artery disease (CAD), especially when the disease occurs at a young age, is a potent risk factor for CAD. DNA collection in families in which two or more siblings are affected at an early age allows identification of genetic factors for CAD by linkage analysis. We performed a genomewide scan in 1,168 individuals from 438 families, including 493 affected sibling pairs with documented onset of CAD before 51 years of age in men and before 56 years of age in women. We prospectively defined three phenotypic subsets of families: (1) acute coronary syndrome in two or more siblings; (2) absence of type 2 diabetes in all affected siblings; and (3) atherogenic dyslipidemia in any one sibling. Genotypes were analyzed for 395 microsatellite markers. Regions were defined as providing evidence for linkage if they provided parametric two-point LOD scores >1.5, together with nonparametric multipoint LOD scores >1.0. Regions on chromosomes 3q13 (multipoint LOD = 3.3; empirical P value <.001) and 5q31 (multipoint LOD = 1.4; empirical P value <.081) met these criteria in the entire data set, and regions on chromosomes 1q25, 3q13, 7p14, and 19p13 met these criteria in one or more of the subsets. Two regions, 3q13 and 1q25, met the criteria for genomewide significance. We have identified a region on chromosome 3q13 that is linked to early-onset CAD, as well as additional regions of interest that will require further analysis. These data provide initial areas of the human genome where further investigation may reveal susceptibility genes for early-onset CAD. PMID:15272420

  18. Diffuse Infantile Hepatic Hemangioendothelioma With Early Central Enhancement in an Adult: A Case Report of CT and MRI Findings.

    PubMed

    Dong, Aisheng; Dong, Hui; Zuo, Changjing; He, Tianlin

    2015-12-01

    Infantile hepatic hemangioendothelioma (IHH) is the most common vascular tumor of the liver in infancy. Adult with IHH is extremely rare. We presented a diffuse IHH in an adult patient with computed tomography (CT) and magnetic resonance image (MRI) findings.A 39-year-old man was admitted to our hospital because of a 2-year history of abnormal liver function tests and a 7-day history of jaundice. Physical examination revealed enlarged liver. Unenhanced abdominal CT showed enlargement of the liver with diffuse hypodensity. Enhanced CT on the arterial phase revealed multiple centrally enhanced lesions diffusely involved the enlarged liver. The enhanced areas of the lesions became larger on the portal phase and all the lesions became homogeneous enhanced on the delayed phase. These lesions showed heterogeneously hyperintense on T2-weighted image, hypointense on T1-weighted image, and early centrally enhanced on dynamic gadolinium-enhanced MRI, with complete tumor enhancement after 180?s. The patient underwent orthotopic liver transplantation. IHH type 2 was confirmed by pathology. The patient died of tumor recurrence in the liver 4 months after transplantation.Unlike the previously described imaging appearances of IHH, this case showed diffuse nodules with early central enhancement on CT and MRI. Considering the importance of the ability to differentiate IHH from other hepatic tumors, radiologists should be aware of these imaging appearances to establish knowledge of the entire spectrum of IHH. PMID:26705232

  19. New phenotypic aspects of the decidual spiral artery wall during early post-implantation mouse pregnancy

    SciTech Connect

    Elia, Artemis; Charalambous, Fotini; Georgiades, Pantelis

    2011-12-09

    Highlights: Black-Right-Pointing-Pointer Spiral artery (SA) wall remodeling (SAR) is ill-defined and clinically important. Black-Right-Pointing-Pointer SA muscular phenotype prior to and during SAR in mice is underexplored. Black-Right-Pointing-Pointer SA muscular wall consists of contractile and non-contractile components. Black-Right-Pointing-Pointer SA wall non-contractile component may be synthetic smooth muscle. Black-Right-Pointing-Pointer Timing and extent of SA wall contractile component loss is revealed. -- Abstract: During pregnancy the walls of decidual spiral arteries (SAs) undergo clinically important structural modifications crucial for embryo survival/growth and maternal health. However, the mechanisms of SA remodeling (SAR) are poorly understood. Although an important prerequisite to this understanding is knowledge about the phenotype of SA muscular wall prior to and during the beginning of mouse SAR, this remains largely unexplored and was the main aim of this work. Using histological and immunohistochemical techniques, this study shows for the first time that during early mouse gestation, from embryonic day 7.5 (E7.5) to E10.5, the decidual SA muscular coat is not a homogeneous structure, but consists of two concentric layers. The first is a largely one cell-thick sub-endothelial layer of contractile mural cells (positive for {alpha}-smooth muscle actin, calponin and SM22{alpha}) with pericyte characteristics (NG2 positive). The second layer is thicker, and evidence is presented that it may be of the synthetic/proliferative smooth muscle phenotype, based on absence ({alpha}-smooth muscle actin and calponin) or weak (SM22{alpha}) expression of contractile mural cell markers, and presence of synthetic smooth muscle characteristics (expression of non-muscle Myosin heavy chain-IIA and of the cell proliferation marker PCNA). Importantly, immunohistochemistry and morphometrics showed that the contractile mural cell layer although prominent at E7.5-E8.5, becomes drastically reduced by E10.5 and is undetectable by E12.5. In conclusion, this study reveals novel aspects of the decidual SA muscular coat phenotype prior to and during early SAR that may have important implications for understanding the mechanisms of SAR.

  20. Vessel-selective, non-contrast enhanced, time-resolved MR angiography with vessel-selective arterial spin labeling technique (CINEMA-SELECT) in intracranial arteries.

    PubMed

    Nakamura, Masanobu; Yoneyama, Masami; Tabuchi, Takashi; Takemura, Atsushi; Obara, Makoto; Tatsuno, Satoshi; Sawano, Seishi

    2013-07-01

    We demonstrate the feasibility of the vessel-selective, non-contrast, time-resolved magnetic resonance angiography (MRA) technique, "contrast inherent inflow enhanced multi-phase angiography combining vessel-selective arterial spin labeling technique (CINEMA-SELECT)". This sequence consists of two major techniques: pulsed star labeling of arterial regions (PULSAR) and Look-Locker sampling. We hypothesize that this technique allows selective labeling of single intracranial arteries, consisting of high-resolution four-dimensional data with a wide coverage of the brain. In this study, a new vessel-selective, time-resolved angiographic technique is demonstrated that can produce individual angiograms non-invasively by labeling the principal arterial vessels proximal to the circle of Willis. Clear vessel delineation is achieved, and the separation of the three vessels is evident in healthy volunteers. This technique could play an important role in the assessment of the structure and hemodynamics of intracranial arteries without the use of contrast agents. PMID:23475783

  1. Sequence Comparison for Non-Enhanced MRA of the Lower Extremity Arteries at 7 Tesla

    PubMed Central

    Johst, Sören; Orzada, Stephan; Fischer, Anja; Schäfer, Lena C.; Nassenstein, Kai; Umutlu, Lale; Lauenstein, Thomas C.; Ladd, Mark E.; Maderwald, Stefan

    2014-01-01

    In this study three sequences for non-contrast-enhanced MRA of the lower extremity arteries at 7T were compared. Cardiac triggering was used with the aim to reduce signal variations in the arteries. Two fast single-shot 2D sequences, a modified Ultrafast Spoiled Gradient Echo (UGRE) sequence and a variant of the Quiescent-Interval Single-Shot (QISS) sequence were triggered via phonocardiogram and compared in volunteer examinations to a non-triggered 2D gradient echo (GRE) sequence. For image acquisition, a 16-channel transmit/receive coil and a manually positionable AngioSURF table were used. To tackle B1 inhomogeneities at 7T, Time-Interleaved Acquisition of Modes (TIAMO) was integrated in GRE and UGRE. To compare the three sequences quantitatively, a vessel-to-background ratio (VBR) was measured in all volunteers and stations. In conclusion, cardiac triggering was able to suppress flow artifacts satisfactorily. The modified UGRE showed only moderate image artifacts. Averaged over all volunteers and stations, GRE reached a VBR of 4.18±0.05, UGRE 5.20±0.06, and QISS 2.72±0.03. Using cardiac triggering and TIAMO imaging technique was essential to perform non-enhanced MRA of the lower extremities vessels at 7T. The modified UGRE performed best, as observed artifacts were only moderate and the highest average VBR was reached. PMID:24454963

  2. Enhancing the pulse contour analysis-based arterial stiffness estimation using a novel photoplethysmographic parameter.

    PubMed

    Jang, Dae-Geun; Park, Seung-Hun; Hahn, Minsoo

    2015-01-01

    In this paper, we propose a novel method for enhancing pulse contour analysis-based arterial stiffness estimation using a simple and low-complexity photoplethysmographic parameter (P2Ocd). The method first eliminates baseline wanders in the digital volume pulse (DVP) by applying a simple morphological filter. The filtered DVP signal is then transformed into a slope sum function signal to simplify the pulse peak detection process by enhancing the upslope of the DVP signal while suppressing its downslope. An adaptive thresholding scheme is applied to detect pulse peaks from the transformed signal. Pulse onsets are then identified as the minimum values between consecutive pulse peaks. The P2Ocd is finally calculated by dividing the time interval between the pulse peak and the pulse onset by the pulse length. In order to assess the agreement of the P2Ocd with an established technique, brachial-ankle pulse wave velocity, we performed Bland-Altman and correlation analyses. Furthermore, we evaluated the P2Ocd-based arterial stiffness estimation in terms of prediction accuracy (% error rate) and repeatability (coefficient of variation). The results show that the proposed measurement agrees well with the established technique and shows a high repeatability; it also has a better predictive accuracy than that of conventional methods. In addition, we show that the proposed parameter further improves the predictive accuracy by combining it with age. The proposed method is therefore highly applicable to small ubiquitous healthcare applications. PMID:25561448

  3. Selective enhancement of endothelial BMPR-II with BMP9 reverses pulmonary arterial hypertension

    PubMed Central

    Long, Lu; Ormiston, Mark L.; Yang, Xudong; Southwood, Mark; Grf, Stefan; Machado, Rajiv D.; Mueller, Matthias; Kinzel, Bernd; Yung, Lai Ming; Wilkinson, Janine M.; Moore, Stephen D.; Drake, Kylie M.; Aldred, Micheala A.; Yu, Paul; Upton, Paul D.; Morrell, Nicholas W.

    2015-01-01

    Genetic evidence implicates the loss of bone morphogenetic protein type II receptor (BMPR-II) signaling in the endothelium as an initiating factor in pulmonary arterial hypertension (PAH). However, selective targeting of this signaling pathway using BMP ligands has not yet been explored as a therapeutic strategy. We identified BMP9 as the preferred ligand for preventing apoptosis and enhancing monolayer integrity in both pulmonary arterial endothelial cells and blood outgrowth endothelial cells from subjects with PAH bearing mutations in BMPR-II. In vivo, we report the spontaneous generation of PAH in a mouse model bearing a heterozygous knock-in of a human BMPR-II mutation, R899X. Administration of BMP9 reversed established PAH in Bmpr2+/R899X mice, as well as in models of disease developed in response to either monocrotaline or VEGF receptor inhibition combined with chronic hypoxia. These results demonstrate the promise of direct enhancement of endothelial BMP signaling as a novel therapeutic strategy for PAH. PMID:26076038

  4. Early Identification of Asymptomatic Pulmonary Embolism Proximal to the Subsegmental Arteries After Gynecologic Surgery.

    PubMed

    Okadome, Masao; Saito, Toshiaki; Shimamoto, Kumi; Ogahara, Rihoko; Akiyoshi, Hiromi; Fujimoto, Minoru; Shinozaki, Kenji

    2016-01-01

    Few studies have assessed whether cases of asymptomatic pulmonary embolism (PE) in the early postoperative phase are subsegmental versus more proximal. In this study, we investigated whether asymptomatic PE occurring just after gynecologic surgery was subsegmental, and we examined the background characteristics of patients who experienced PE within 2 months postoperatively. All hospital records were reviewed, yielding a total of 2052 women who had undergone surgeries performed by the gynecologic oncology team between 2003 and 2013 in the National Kyushu Cancer Center. Asymptomatic and symptomatic postoperative PE cases diagnosed by multidetector computed tomography angiography or lung scan were identified; after excluding 2 cases of preoperative PE, there were 15 (0.73%) cases of postoperative PE among 2050 women. Of the 15 cases, 9 (60%) were diagnosed on postoperative day 1 or 2. Of the 9 women, 4 had no or minor symptoms/signs other than decreased oxygen saturation as measured by pulse oximetry (Spo 2), and PE was segmental or more proximal in 3 cases. Only 1 of the 9 cases showed dyspnea. The remaining 4 cases showed dizziness or perspiration, suggesting PE. Univariate analysis showed age, operation time, hypertension, and preoperative d-dimer elevation to be associated with postoperative PE. Multivariate analysis demonstrated that a high (?1 g/mL) preoperative d-dimer level was associated with postoperative PE (odds ratio, 6.331; 95% confidence interval, 1.567-25.589). Most asymptomatic PE cases occurring within 2 days postoperatively were segmental or more proximal. Identification of early, asymptomatic postoperative PE may be clinically significant because most of these emboli are proximal to the subsegmental arteries. PMID:25948635

  5. Dealing with Coronary Artery Disease in Early Encountering: A Qualitative Study

    PubMed Central

    Mojalli, Mohammad; Karimi Moonaghi, Hossein; Khosravan, Shahla; Mohammadpure, Ali

    2014-01-01

    Background: The prevalence of cardiovascular diseases is rising in industrial and developing countries. Coronary Artery Disease (CAD) is the most common cardiovascular disease. Thus, understanding the signs and risk factors of CAD from the patients perspective and their ways of dealing with this disease is of vital importance. Objectives: This qualitative study aimed to explore the Iranian patients viewpoints about CAD and how they dealt with it in their first encounter. Patients and Methods: This study was a qualitative content analysis conducted on 18 patients with CAD. The data were collected through semi-structured interviews. Initially, purposeful sampling was performed followed by maximum variety. Sampling continued until data saturation. Then, all the interviews were recorded and transcribed verbatim. After all, the data were analyzed by constant comparative analysis using MAXQUDA2010 software. Results: The themes manifested in this study included invasion of disease with subthemes of warning signs and risk factors and confrontation strategies with subthemes of seeking for information, follow-up, and control measures. Conclusions: The results of this study described the patients perceptions of CAD and how they dealt with this disorder in early encountering. Based on the results, physicians and nurses should focus on empowerment of patients by facilitating this process as well as by educating them with regards to dealing with CAD. PMID:25614861

  6. Early repolarization is associated with significant coronary artery stenosis in asymptomatic adults.

    PubMed

    Suh, Beomseok; Park, Sehhoon; Shin, Dong Wook; Ahn, Hongkeun; Cho, Seongcheol; Lee, Seung-Pyo; Park, Eun-Ah; Lee, Hyejin; Park, Jin Ho; Cho, BeLong

    2016-02-01

    The aim of our study was to investigate the relationship between early repolarization (ERP) and coronary heart disease (CHD) by evaluating its association with coronary artery stenosis and plaques. Consecutive asymptomatic adults aged 30 or more without CHD were investigated (n=3100). Adjusting for major cardiovascular risk factors, ERP was significantly associated with significant coronary stenosis with incremental predictive value (aOR 1.71, 95% CI 1.13-2.60; ROC AUC 0.763 vs. 0.723, P<0.001; NRI 4.86%, P=0.042; IDI 0.0030, P=0.040), specifically in intermediate risk group (aOR 2.33, 95% CI 1.29-4.20; ROC AUC 0.753 vs. 0.708, P=0.001). ERP was shown to be especially associated with significant coronary stenosis with non-calcified plaque (aOR 2.26, 95% CI 1.28-3.98). Our study is the first to directly show the association of ERP with CHD. Future studies are needed to replicate our results and investigate whether it would be beneficial to include ERP in risk algorithms for CHD screening. PMID:26694693

  7. Use of Intra-Arterial Carbon-Dioxide-Enhanced Ultrasonography for Guidance of Radiofrequency Ablation and Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma

    SciTech Connect

    Ohmoto, Kenji Yoshioka, Naoko; Tomiyama, Yasuyuki; Shibata, Norikuni; Kawase, Tomoya; Yoshida, Koji; Kuboki, Makoto; Yamamoto, Shinichiro

    2006-12-15

    A 73-year-old man with hepatitis-C-related cirrhosis and an elevated alpha-fetoprotein level and tumor in segment 3 of his liver was referred for interventional radiologic treatment. He was not a candidate for surgical resection due to impaired liver function and his personal preferences. On conventional ultrasonography no lesion could be detected, but the tumor was clearly depicted by intra-arterial carbon-dioxide-enhanced ultrasonography. Radiofrequency ablation was performed safely and accurately under the guidance of carbon-dioxide-enhanced ultrasonography. By concomitant performance of transcatheter arterial chemoembolization with radiofrequency ablation, extensive necrosis was obtained and adequate tumor volume reduction achieved with only one treatment session.

  8. The vascular-disrupting agent, combretastatin-A4-phosphate, enhances neurogenic vasoconstriction in rat small arteries.

    PubMed

    Su, Junjing; Laursen, Britt E; Eskildsen-Helmond, Yvonne; Horsman, Michael R; Simonsen, Ulf

    2012-11-15

    Combretastatin-A4-phosphate (CA4P/CA4), an anti-cancer drug, induces tumour hypoxia by destabilizing the cytoskeleton in tumour endothelial cells. Hypertensive side effects have been observed. We hypothesized that CA4P/CA4 lead to endothelial dysfunction followed by increased vasoconstriction. Mesenteric small arteries and femoral arteries isolated from male Wistar rats were mounted in microvascular myographs for isometric tension recordings and electrical field stimulation (EFS). Immunoblotting of endothelial nitric oxide synthase (eNOS) was performed on human umbilical vein endothelial cells (HUVECs). CA4P failed per se to change vascular tone. In femoral arteries, endothelial cell removal, l-nitro-arginine (l-NNA, an inhibitor of eNOS) and CA4P enhanced phenylephrine-induced vasoconstriction, while in mesenteric arteries only l-NNA leftward shifted concentration-response curves for phenylephrine. CA4P enhanced vasoconstriction induced by low frequency (0.5-4Hz) EFS in femoral arteries, but not in mesenteric arteries. Neurogenic contractions were inhibited by prazosin, an α(1)-adrenoceptor antagonist. In mesenteric arteries, CA4P and l-NNA inhibited vasorelaxation induced by vanadate, a tyrosine phosphatase inhibitor. CA4P did not affect acetylcholine-induced relaxation. In HUVECs, CA4P increased phosphorylation at eNOS-Thr(495), a negative regulatory site, while the positive phosphorylation site eNOS-Ser(1177) was not affected. CA4 neither influenced the actions of phenylephrine, vanadate nor acetylcholine in femoral and mesenteric arteries. In conclusion, our findings suggest that CA4P, but not CA4, enhances sympathetic adrenergic vasoconstriction probably by increasing eNOS-Thr(495) phosphorylation, in a tissue selective manner. These findings encourage further investigation to show that the hypertension and regional organ ischemia induced by CA4P can be avoided by concomitant treatment with an α(1)-adrenoceptor antagonist. PMID:22981665

  9. Postmortem computed tomography with the use of air for blood vessel enhancement-Early experience.

    PubMed

    Borowska-Solonynko, Aleksandra; Solonynko, Bohdan; Fudalej, Marcin; Żyłkowski, Jarosław

    2016-04-01

    Postmortem computed tomography (PMCT) is gaining popularity in forensic medicine. Computed tomography routinely performed in clinical medicine involves intravenous contrast administration. Unfortunately, postmortem examinations are typically limited to uncontrasted CT scans, where blood vessels and their potential injury sites are invisible. One serious problem is the fact that due to the process of decomposition, contrast agents used for vessel visualization in the living cannot be used in cadavers. Therefore, a special contrast agent designed for cadavers has been developed. This contrast agent has a high density and is lipophilic. Its use ensures very good visualization of blood vessels it is, however, associated with high costs and may alter findings of a later histopathological examination. This study presents early experience with the air as negative contrast agent to enhance all blood vessels in the body. The carbon dioxide (CO2) gas has been used as a contrast agent in live individuals with contraindications against the use of iodinated contrast. In corpses with advanced postmortem changes, putrefaction gases also considerably enhance the visibility of blood vessels and organs they fill. There have also been some positive effects with the use of gas in postmortem angiography of coronary vessels. These findings encouraged us to attempt air administration via catheters introduced into the femoral artery or a central venous access site in the superior vena cava. The gas distributed easily throughout the body and surprisingly well contrasted both arteries and veins of various caliber. The presence of the air administered into vessels did not cause any apparent, significant alterations in autopsy findings. Although optimization of the gas administration technique requires further studies, we can already say that this is a promising direction in postmortem angiography. PMID:26921814

  10. Metformin does not Enhance Insulin-Stimulated Vasodilation in Skeletal Muscle Resistance Arteries of the OLETF Rat

    PubMed Central

    CRISSEY, JACQUELINE M.; PADILLA, JAUME; JENKINS, NATHAN T.; MARTIN, JEFFREY S.; RECTOR, RANDY SCOTT; THYFAULT, JOHN P.; LAUGHLIN, MAURICE HAROLD

    2015-01-01

    Objective To test the hypothesis that chronic metformin treatment enhances insulin-induced vasodilation in skeletal muscle resistance arteries and arterioles. Methods We assessed the effect of metformin treatment (from 20 to 32 weeks of age) of obese Otsuka Long Evans Tokushima Fatty (OLETF) rats and lean LETO rats (300 mg/kg) on insulin-stimulated vasodilation in isolated skeletal muscle feed arteries and arterioles. Results Metformin treatment significantly lowered food intake, body weight, percent body fat, and HbA1c in OLETF rats. Metformin resulted in a ~30% reduction in insulin-induced vasodilation of soleus feed arteries (SFA) from OLETF rats. Inhibition of endothelin-1 (ET-1) signaling produced 20% dilation and eliminated the difference between metformin-treated and untreated OLETF rats in insulin-induced dilation of SFA. In contrast to the SFA, metformin did not alter insulin-stimulated vasodilation in gastrocnemius feed arteries (GFA), or second-order arterioles in the red (G2A-R) or white (G2A-W) portions of the gastrocnemius muscle of OLETF rats. Metformin had no effects on vasomotor responses of arteries from LETO. Conclusions Although metformin exerts favorable effects on body composition and HbA1c, it does not enhance the vasodilatory responses to insulin in the skeletal muscle feed arteries or arterioles of the obese OLETF rat. PMID:23879830

  11. Maternal Characteristics, Mean Arterial Pressure and Serum Markers in Early Prediction of Preeclampsia

    PubMed Central

    Kuc, Sylwia; Koster, Maria P. H.; Franx, Arie; Schielen, Peter C. J. I.; Visser, Gerard H. A.

    2013-01-01

    Objectives In a previous study, we have described the predictive value of first-trimester Pregnancy-Associated Plasma Protein-A (PAPP-A), free ?-subunit of human Chorionic Gonadotropin (f?-hCG), Placental Growth Factor (PlGF) and A Disintegrin And Metalloprotease 12 (ADAM12) for early onset preeclampsia (EO-PE; delivery <34 weeks). The objective of the current study was to obtain the predictive value of these serum makers combined with maternal characteristics and first-trimester maternal mean arterial blood pressure (MAP) in a large series of patients, for both EO-PE and late onset PE (LO-PE; delivery ? 34 weeks). Methods This was a nested case-control study, using stored first-trimester maternal serum from women who developed EO-PE (n?=?68) or LO-PE (n?=?99), and 500 uncomplicated singleton pregnancies. Maternal characteristics, MAP, and pregnancy outcome were collected for each individual woman and used to calculate prior risks for PE in a multiple logistic regression model. Models containing prior PE risks, serum markers, and MAP were developed for the prediction of EO-PE and LO-PE. The model-predicted detection rates (DR) for fixed 10% false-positive rates were calculated for EO-PE and LO-PE with or without the presence of a small-for-gestational age infant (SGA, birth weight <10th centile). Results The best prediction model included maternal characteristics, MAP, PAPP-A, ADAM12, and PlGF, with DR of 72% for EO-PE and 49% for LO-PE. Prediction for PE with concomitant SGA was better than for PE alone (92% for EO-PE and 57% for LO-PE). Conclusion First-trimester MAP, PAPP-A, ADAM12, and PlGF combined with maternal characteristics and MAP are promising markers in the risk assessment of PE, especially for EO-PE complicated by SGA. PMID:23717445

  12. Coronary artery calcium quantification from contrast enhanced CT using gemstone spectral imaging and material decomposition.

    PubMed

    Fuchs, Tobias A; Stehli, Julia; Dougoud, Svetlana; Sah, Bert-Ram; Bull, Sacha; Clerc, Olivier F; Possner, Mathias; Buechel, Ronny R; Gaemperli, Oliver; Kaufmann, Philipp A

    2014-10-01

    To explore the feasibility of coronary artery calcium (CAC) measurement from low-dose contrast enhanced coronary CT angiography (CCTA) as this may obviate the need for an unenhanced CT scan. 52 patients underwent unenhanced cardiac CT and prospectively ECG triggered contrast enhanced CCTA (Discovery HD 750, GE Healthcare, Milwaukee, WI, USA). The latter was acquired in single-source dual-energy mode [gemstone spectral imaging (GSI)]. Virtual unenhanced images were generated from GSI CCTA by monochromatic image reconstruction of 70 keV allowing selective iodine material suppression. CAC scores from virtual unenhanced CT were compared to standard unenhanced CT including a linear regression model. After iodine subtraction from the contrast enhanced CCTA the attenuation in the ascending aorta decreased significantly from 359 61 to 54 8 HU (P < 0.001), the latter comparing well to the value of 64 55 HU found in the standard unenhanced CT (P = ns) confirming successful iodine subtraction. After introducing linear regression formula the mean values for Agatston, Volume and Mass scores of virtual unenhanced CT were 187 321, 72 114 mm(3), and 27 46 mg/cm(3), comparing well to the values from standard unenhanced CT (187 309, 72 110 mm(3), and 27 45 mg/cm(3)) yielding an excellent correlation (r = 0.96, r = 0.96, r = 0.92; P < 0.001). Mean estimated radiation dose revealed 0.83 0.02 mSv from the unenhanced CT and 1.70 0.53 mSv from the contrast enhanced CCTA. Single-source dual-energy scanning with GSI allows CAC quantification from low dose contrast enhanced CCTA by virtual iodine contrast subtraction. PMID:24993390

  13. Pharmacogenomics of estrogens on changes in carotid artery intima-medial thickness and coronary arterial calcification: Kronos Early Estrogen Prevention Study.

    PubMed

    Miller, Virginia M; Jenkins, Gregory D; Biernacka, Joanna M; Heit, John A; Huggins, Gordon S; Hodis, Howard N; Budoff, Matthew J; Lobo, Rogerio A; Taylor, Hugh S; Manson, JoAnn E; Black, Dennis M; Naftolin, Frederick; Harman, S Mitchell; de Andrade, Mariza

    2016-01-01

    Prior to the initiation of menopausal hormone treatment (MHT), genetic variations in the innate immunity pathway were found to be associated with carotid artery intima-medial thickness (CIMT) and coronary arterial calcification (CAC) in women (n = 606) enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). Whether MHT might affect these associations is unknown. The association of treatment outcomes with variation in the same 764 candidate genes was evaluated in the same KEEPS participants 4 yr after randomization to either oral conjugated equine estrogens (0.45 mg/day), transdermal 17?-estradiol (50 ?g/day), each with progesterone (200 mg/day) for 12 days each month, or placebo pills and patch. Twenty SNPs within the innate immunity pathway most related with CIMT after 4 yr were not among those associated with CIMT prior to MHT. In 403 women who completed the study in their assigned treatment group, single nucleotide polymorphisms (SNPs) within the innate immunity pathway were found to alter the treatment effect on 4 yr change in CIMT (i.e., significant interaction between treatment and genetic variation in the innate immunity pathway; P < 0.001). No SNPs by treatment effects were observed with changes of CAC >5 Agatston units after 4 yr. Results of this study suggest that hormonal status may interact with genetic variants to influence cardiovascular phenotypes, specifically, the pharmacogenomic effects within the innate immunity pathway for CIMT. PMID:26508701

  14. Hepatic Arterial Vasodilation Is Independent of Portal Hypertension in Early Stages of Cirrhosis

    PubMed Central

    Moeller, Miriam; Thonig, Antje; Pohl, Sabine; Ripoll, Cristina; Zipprich, Alexander

    2015-01-01

    Introduction The compensatory increase in hepatic arterial flow with a decrease in portal venous flow is known as the hepatic arterial buffer response. In cirrhosis with elevated portal pressure, the vascular resistance of the hepatic artery is decreased. Whether this lower resistance of the hepatic artery is a consequence of portal hypertension or not remains unknown. Study Aim The aim of the study was to investigate the hepatic arterial resistance and response to vasoconstriction in cirrhosis without portal hypertension (normal portal resistance). Methods Cirrhosis was induced by CCl4-inhalation for 8 weeks (8W, normal portal resistance) and for 1214 weeks (12W, elevated portal resistance). Bivascular liver perfusion was performed at 8W or 12W and dose response curves of methoxamine were obtained in the presence or absence of LNMMA (nitric oxide synthase blocker). Vascular resistances of the hepatic artery (HAR), portal vein (PVR) and sinusoids (SVR) were measured. Western Blot (WB) and Immunohistochemistry (IHC) were done to measure eNOS and HIF 1a expression. Results HAR in both groups of cirrhotic animals (8W and 12W) were lower compared to controls. Dose response curves to methoxamine revealed lower HAR in both cirrhotic models (8W and 12W) regardless the magnitude of portal resistance. LNMMA corrected the dose response curves in cirrhosis (8W and 12W) to control. WB and IHC show increased protein expression of eNOS and HIF1a in 8W and 12W. Conclusion Hepatic arterial resistance is decreased in cirrhosis independent of portal resistance. Vasodilation of the hepatic artery in cirrhosis seems to be influenced by hypoxia rather than increase in portal resistance. Nitric oxide is the main vasodilator. PMID:25793622

  15. Relation of Subclinical Coronary Artery Atherosclerosis to Cerebral White Matter Disease in Healthy Individuals from Families with Early-Onset Coronary Artery Disease

    PubMed Central

    Kral, Brian G.; Nyquist, Paul; Vaidya, Dhananjay; Yousem, David; Yanek, Lisa R.; Fishman, Elliot K.; Becker, Lewis C.; Diane M., Becker

    2013-01-01

    White matter disease (WMD) of the brain is associated with incident stroke. Similarly subclinical calcified coronary artery plaque has been associated with incident coronary artery disease (CAD) events. Although atherogenesis in both vascular beds may share some common mechanisms, the extent to which subclinical CAD is associated with WMD across age ranges in individuals with a family history of early onset CAD remains unknown. We screened 405 apparently healthy participants in the Genetic Study of Atherosclerotic Risk (GeneSTAR) for CAD risk factors, and for the presence of noncalcified and calcified coronary plaque using dual-source multi-detector cardiac CT angiography. The presence and volumes of WMD were assessed by 3 Tesla brain MRI. Participants were 60% female, 36% African American; mean age 51.6 10.6 years. The prevalence of coronary plaque overall was 43.0%. Individuals with coronary plaque had significantly higher WMD volumes (median 1222 mm3, IQR [448 to 3871]) compared to those without coronary plaque (median 551 mm3, IQR [105 to 1523], p<0.001). In multivariable regression analysis, adjusting for age, sex, race, traditional risk factors, total brain volume, and intrafamilial correlations, the presence of coronary plaque was independently associated with WMD volume (p=0.05). This study shows a significant association between WMD and noncalcified and calcified coronary plaque in healthy individuals, independent of age and risk factors. In conclusion, these findings support the premise of possible shared causal pathways in two vascular beds in families at increased risk for early-onset vascular disease. PMID:23742943

  16. Assessment of Vascular Geometry for Bilateral Carotid Artery Ligation to Induce Early Basilar Terminus Aneurysmal Remodeling in Rats.

    PubMed

    Tutino, Vincent Matthew; Liaw, Nicholas; Spernyak, Joseph Andrew; Ionita, Ciprian Nicolae; Siddiqui, Adnan Hussain; Kolega, John; Meng, Hui

    2016-01-01

    Bilateral common carotid artery (CCA) ligation in rabbits is a model for basilar terminus (BT) aneurysm formation. We asked if this model could be replicated in rats. Fourteen female Sprague Dawley rats underwent bilateral CCA ligation (n=8) or sham surgery (n=6). After 7 days, 5 ligated and 3 sham rats were euthanized for histological evaluation of BT aneurysm formation, while the remaining rats were imaged with magnetic resonance angiography, euthanized, and subjected to corrosion casting of the Circle of Willis (CoW). 3D micro computed tomography images of CoW casts were used for flow simulations at the rat BT, and electron micrographs of the casts were analyzed for aneurysmal and morphological changes. Results from these analyses were compared to rabbit model data (n=10 ligated and n=6 sham). Bilateral CCA ligation did not produce aneurysmal damage at the rat BT. While the surgical manipulation increased rat basilar artery flow, fluid dynamics simulations showed that the initial hemodynamic stress at the rat BT was significantly less than in rabbits. Rats also exhibited fewer morphological and pathological changes (minor changes only occurred in the posterior CoW) than rabbits, which had drastic changes throughout the CoW. A comparison of CoW anatomies demonstrated a greater number of branching arteries at the BT, larger CoW arteries in relation to basilar artery, and a steeper BT bifurcation angle in the rat. These differences could account for the lower hemodynamic stress at the BT and in the cerebrovasculature of the rat. In conclusion, bilateral CCA ligation in rats does not recapitulate the rabbit model of early flow-induced BT aneurysm. We suspect that the different CoW morphology of the rat lessens hemodynamic insults, thereby diminishing flow-induced aneurysmal remodeling. PMID:26503026

  17. Umbilical artery pH at birth and neurobehavioral outcome in early preterm infants: A cohort study

    PubMed Central

    Seth, Bhavna; Datta, Vikram; Bhakhri, Bhanu Kiran

    2014-01-01

    Objective: The objective of the following study is to determine the effect of umbilical artery pH at birth on early neurobehavioral outcome of preterm infants as assessed by Neurobehavioral Assessment of Preterm Infants (NAPI) tool. Materials and Methods: Prospective cohort study conducted at the neonatal unit in a tertiary care center in North India. Preterm neonates < 34 weeks of gestation were enrolled at birth and divided into cases (umbilical artery pH < 7.2) and controls (umbilical artery pH > 7.2). At 34 weeks postconceptional age, the motor development and vigor (MDV) and alertness and orientation (AO) domains of neurobehavior were assessed by NAPI and compared among groups. Results: Hundred preterm neonates were enrolled in the study out of which 76 (30 cases and 46 controls) were finally analyzed. The groups were comparable in terms of gestational age, mode of delivery, birth weight and requirement of resuscitative measures at birth. There was no significant difference in incidence of meningitis, intraventricular hemorrhage, jaundice and hypoxic ischemic encephalopathy among the groups; however hypoglycemia was observed more commonly among cases. The MDV score (mean standard deviation [SD] [95% confidence interval]) was found to be significantly lower among cases compared to controls (37.0713 13.616 [32.099-42.0431] vs. 47.506 14.0692 [43.367-51.655]) (P = 0.002). Similarly, lower AO scores were observed among the cases. Conclusion: A low umbilical artery pH at birth is a predictor of poor early neurobehavioral outcome in preterm neonates. PMID:24891894

  18. Clopidogrel Use and Early Outcomes among Older Patients Receiving a Drug Eluting Coronary Artery Stent

    PubMed Central

    Roth, Gregory A.; Morden, Nancy E.; Zhou, Weiping; Malenka, David J.; Skinner, Jonathan

    2011-01-01

    Background Clopidogrel use following drug eluting coronary artery stent (DES) implant is essential for prevention of early in-stent thrombosis, but clopidogrel use among older DES recipients has not been widely studied. We sought to identify characteristics associated with failure to fill a clopidogrel prescription and to examine the relationship between a clopidogrel prescription fill and hospitalization for acute myocardial infarction (AMI) or death. Methods and Results Retrospective analysis of administrative data (20% sample) for 15,996 Medicare Part D enrollees receiving a DES 20062007. We modeled the adjusted probability and odds of clopidogrel prescription fill within 7 and 90 days of discharge and its association with AMI hospitalization or death. 19.7% of individuals did not fill a clopidogrel prescription within 7 days of discharge, falling to 13.3% by day 90. The adjusted probability of filling a clopidogrel prescription within 7 or 90 days of discharge was lower for patient with dementia (20.2% less likely, 95% CI 10.430.1%), depression (10.7% less likely, 95% CI 6.914.5%), age >84 compared to age 6569 (10.6% less likely, 95% CI 8.612.7%), black race (6.6% less likely, 95% CI 4.29.0%), intermediate levels of medication cost-share (5.2% less likely, 95% CI 2.97.6%), and female sex (3.3% less likely, 95% CI 2.14.5%). It was higher for patients initially hospitalized for an AMI (12.5% more likely, 95% CI 11.313.6%). Failure to fill a clopidogrel prescription within 7 days of discharge was associated with a higher adjusted odds ratio of death during days 890 (OR 2.44, 95% CI 1.763.38) but was not associated with an increased risk of hospitalization for AMI. Conclusions One in five patients failed to fill a prescription for clopidogrel following DES at 7 days and one in seven failed by 3 months. Individual characteristics available at the time of hospital discharge were associated with a clopidogrel prescription fill. Those mostly strongly associated with nonadherence, including age >84, not having an AMI, depression, and dementia, may guide clinicians and health systems seeking to target this high-risk population and improve health outcomes following percutaneous coronary intervention (PCI). PMID:22147885

  19. The effect of gender on the early results of coronary artery bypass surgery in the younger patients' group

    PubMed Central

    Uncu, Hasan; Acipayam, Mehmet; Altinay, Levent; Do?an, Pinar; Davarc?, Isil; zsyler, ?brahim

    2014-01-01

    Introduction In this retrospective study, we aimed to determine the risk factors for coronary artery bypass surgery in patients under 45 years of age, and evaluate the early postoperative results and the effect of gender. Methods A total of 324 patients under 45 years of age who undergone on-pump coronary artery bypass surgery between April 12, 2004 and January 10, 2012 were included to the study. Patients divided into groups as follows: Group 1 consisted of 269 males (mean age 41.3), Group 2 consisted of 55 females (mean age 41.6). Preoperative risk factors, intraoperative and postoperative data and early mortality rates of the groups were compared. Results Smoking rate was significantly higher in Group 1. Diabetes mellitus incidence and body mass index were significantly higher in Group 2 (P values P=0.01; P=0.0001; P=0.04 respectively). The aortic cross-clamping and cardiopulmonary bypass time and number of grafts per patient were significantly higher in Group 1 (P values P=0.04; P=0.04; P=0.002 respectively). There were no deaths in either group. Conclusion We found that gender has no effect on early mortality rates of the coronary bypass surgery patients under 45 years. PMID:25714211

  20. Enhancing early engagement with mental health services by young people.

    PubMed

    Burns, Jane; Birrell, Emma

    2014-01-01

    International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and - ultimately - to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence-based approach, dedicated advocacy and, critically, the inclusion of young people in service design, development, and ongoing evaluation to ensure that services can be continuously improved. PMID:25473320

  1. Enhancing early engagement with mental health services by young people

    PubMed Central

    Burns, Jane; Birrell, Emma

    2014-01-01

    International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence-based approach, dedicated advocacy and, critically, the inclusion of young people in service design, development, and ongoing evaluation to ensure that services can be continuously improved. PMID:25473320

  2. Cutting-Balloon Angioplasty in Transplant Renal Artery Stenosis as First-Line Treatment in the Early Postoperative Period

    SciTech Connect

    Ucar, Adem; Yahyayev, Aghakishi; Bakkaloglu, Huseyin; Agayev, Ayaz; Aydin, Ali Emin; Rozanes, Izzet

    2011-02-15

    Percutaneous transluminal angioplasty has been successfully used for the treatment of transplant renal artery stenosis (RAS). Cutting-balloon angioplasty (CBA) is being used as a second option in pressure-resistant stenosis. It is thought that CBA is less traumatic and therefore restenosis occurs less frequently than in conventional angioplasty. This case report describes the unusual use of a cutting balloon in transplant RAS as a first option in the early postoperative period. Long-term follow-up data are also presented.

  3. Automated quantification of carotid artery stenosis on contrast-enhanced MRA data using a deformable vascular tube model.

    PubMed

    Suinesiaputra, Avan; de Koning, Patrick J H; Zudilova-Seinstra, Elena; Reiber, Johan H C; van der Geest, Rob J

    2012-08-01

    The purpose of this study was to develop and validate a method for automated segmentation of the carotid artery lumen from volumetric MR Angiographic (MRA) images using a deformable tubular 3D Non-Uniform Rational B-Splines (NURBS) model. A flexible 3D tubular NURBS model was designed to delineate the carotid arterial lumen. User interaction was allowed to guide the model by placement of forbidden areas. Contrast-enhanced MRA (CE-MRA) from 21 patients with carotid atherosclerotic disease were included in this study. The validation was performed against expert drawn contours on multi-planar reformatted image slices perpendicular to the artery. Excellent linear correlations were found on cross-sectional area measurement (r = 0.98, P < 0.05) and on luminal diameter (r = 0.98, P < 0.05). Strong match in terms of the Dice similarity indices were achieved: 0.95 0.02 (common carotid artery), 0.90 0.07 (internal carotid artery), 0.87 0.07 (external carotid artery), 0.88 0.09 (carotid bifurcation) and 0.75 0.20 (stenosed segments). Slight overestimation of stenosis grading by the automated method was observed. The mean differences was 7.20% (SD = 21.00%) and 5.2% (SD = 21.96%) when validated against two observers. Reproducibility in stenosis grade calculation by the automated method was high; the mean difference between two repeated analyses was 1.9 7.3%. In conclusion, the automated method shows high potential for clinical application in the analysis of CE-MRA of carotid arteries. PMID:22160666

  4. Genetic polymorphisms associated with carotid artery intima-media thickness and coronary artery calcification in women of the Kronos Early Estrogen Prevention Study.

    PubMed

    Miller, Virginia M; Petterson, Tanya M; Jeavons, Elysia N; Lnu, Abhinita S; Rider, David N; Heit, John A; Cunningham, Julie M; Huggins, Gordon S; Hodis, Howard N; Budoff, Matthew J; Santoro, Nanette; Hopkins, Paul N; Lobo, Rogerio A; Manson, JoAnn E; Naftolin, Frederick; Taylor, Hugh S; Harman, S Mitchell; de Andrade, Mariza

    2013-01-15

    Menopausal hormone treatment (MHT) may limit progression of cardiovascular disease (CVD) but poses a thrombosis risk. To test targeted candidate gene variation for association with subclinical CVD defined by carotid artery intima-media thickness (CIMT) and coronary artery calcification (CAC), 610 women participating in the Kronos Early Estrogen Prevention Study (KEEPS), a clinical trial of MHT to prevent progression of CVD, were genotyped for 13,229 single nucleotide polymorphisms (SNPs) within 764 genes from anticoagulant, procoagulant, fibrinolytic, or innate immunity pathways. According to linear regression, proportion of European ancestry correlated negatively, but age at enrollment and pulse pressure correlated positively with CIMT. Adjusting for these variables, two SNPs, one on chromosome 2 for MAP4K4 gene (rs2236935, ? = 0.037, P value = 2.36 10(-06)) and one on chromosome 5 for IL5 gene (rs739318, ? = 0.051, P value = 5.02 10(-05)), associated positively with CIMT; two SNPs on chromosome 17 for CCL5 (rs4796119, ? = -0.043, P value = 3.59 10(-05); rs2291299, ? = -0.032, P value = 5.59 10(-05)) correlated negatively with CIMT; only rs2236935 remained significant after correcting for multiple testing. Using logistic regression, when we adjusted for waist circumference, two SNPs (rs11465886, IRAK2, chromosome 3, OR = 3.91, P value = 1.10 10(-04); and rs17751769, SERPINA1, chromosome 14, OR = 1.96, P value = 2.42 10(-04)) associated positively with a CAC score of >0 Agatston unit; one SNP (rs630014, ABO, OR = 0.51, P value = 2.51 10(-04)) associated negatively; none remained significant after correcting for multiple testing. Whether these SNPs associate with CIMT and CAC in women randomized to MHT remains to be determined. PMID:23188791

  5. Genetic polymorphisms associated with carotid artery intima-media thickness and coronary artery calcification in women of the Kronos Early Estrogen Prevention Study

    PubMed Central

    Petterson, Tanya M.; Jeavons, Elysia N.; Lnu, Abhinita S.; Rider, David N.; Heit, John A.; Cunningham, Julie M.; Huggins, Gordon S.; Hodis, Howard N.; Budoff, Matthew J.; Santoro, Nanette; Hopkins, Paul N.; Lobo, Rogerio A.; Manson, JoAnn E.; Naftolin, Frederick; Taylor, Hugh S.; Harman, S. Mitchell; de Andrade, Mariza

    2013-01-01

    Menopausal hormone treatment (MHT) may limit progression of cardiovascular disease (CVD) but poses a thrombosis risk. To test targeted candidate gene variation for association with subclinical CVD defined by carotid artery intima-media thickness (CIMT) and coronary artery calcification (CAC), 610 women participating in the Kronos Early Estrogen Prevention Study (KEEPS), a clinical trial of MHT to prevent progression of CVD, were genotyped for 13,229 single nucleotide polymorphisms (SNPs) within 764 genes from anticoagulant, procoagulant, fibrinolytic, or innate immunity pathways. According to linear regression, proportion of European ancestry correlated negatively, but age at enrollment and pulse pressure correlated positively with CIMT. Adjusting for these variables, two SNPs, one on chromosome 2 for MAP4K4 gene (rs2236935, ? = 0.037, P value = 2.36 10?06) and one on chromosome 5 for IL5 gene (rs739318, ? = 0.051, P value = 5.02 10?05), associated positively with CIMT; two SNPs on chromosome 17 for CCL5 (rs4796119, ? = ?0.043, P value = 3.59 10?05; rs2291299, ? = ?0.032, P value = 5.59 10?05) correlated negatively with CIMT; only rs2236935 remained significant after correcting for multiple testing. Using logistic regression, when we adjusted for waist circumference, two SNPs (rs11465886, IRAK2, chromosome 3, OR = 3.91, P value = 1.10 10?04; and rs17751769, SERPINA1, chromosome 14, OR = 1.96, P value = 2.42 10?04) associated positively with a CAC score of >0 Agatston unit; one SNP (rs630014, ABO, OR = 0.51, P value = 2.51 10?04) associated negatively; none remained significant after correcting for multiple testing. Whether these SNPs associate with CIMT and CAC in women randomized to MHT remains to be determined. PMID:23188791

  6. Splenic artery transposition graft usage for the supply of the right hepatic artery: a case report.

    PubMed

    Odabasi, Mehmet; Eris, Cengiz; Yildiz, Mehmet Kamil; Abuoglu, Hasan; Akbulut, Sami; Saglam, Abdullah

    2013-01-01

    Hepatic artery aneurysms are responsible for 12% to 20% of all visceral arterial aneurysms. Because most patients are asymptomatic, this disease is generally diagnosed incidentally during radiologic examination. Aneurysm rupture develops in 14% to 80% of cases, depending on the aneurysmatic segment's diameter and location, as well as other etiologic factors. Mortality rates associated with rupture range between 20% and 70%. Thus, early diagnosis and timely initiation of medical interventions are critical to improve survival rates. Here, we present a male patient, age 69 years, with a hepatic artery aneurysm that was detected incidentally. The 3-cm aneurysm was detected on contrast-enhanced computed tomography and extended from the common hepatic artery to the hepatic trifurcation. A laparotomy was performed using a right subcostal incision. After dissection of the hepatoduodenal ligament, the common, right, and left hepatic arteries, as well as the gastroduodenal artery, were suspended separately. Then, the aneurysmatic hepatic artery segment was resected, and the gastroduodenal artery stump was ligated. An end-to-end anastomosis was formed between the left and common hepatic arteries, followed by an end-to-end anastomosis formed between the right hepatic artery and splenic artery using a splenic artery transposition graft. Postoperative follow-up examinations showed that both hepatic arterial circulations were good, and no splenic infraction had developed. PMID:23971784

  7. Early experimental hypertension preserves the myocardial microvasculature but aggravates cardiac injury distal to chronic coronary artery obstruction

    PubMed Central

    Urbieta Caceres, Victor Hugo; Lin, Jing; Zhu, Xiang-Yang; Favreau, Frederic D.; Gibson, Matthew E.; Crane, John A.; Lerman, Amir

    2011-01-01

    Coronary artery disease is a leading cause of death. Hypertension (HT) increases the incidence of cardiac events, but its effect on cardiac adaptation to coexisting coronary artery stenosis (CAS) is unclear. We hypothesized that concurrent HT modulates microvascular function in chronic CAS and aggravates microvascular remodeling and myocardial injury. Four groups of pigs (n = 6 each) were studied: normal, CAS, HT, and CAS+HT. CAS and HT were induced by placing local irritant coils in the left circumflex coronary artery and renal artery, respectively. Six weeks later multidetector computerized tomography (CT) was used to assess systolic and diastolic function, microvascular permeability, myocardial perfusion, and responses to adenosine in the area at risk. Microvascular architecture, inflammation, and fibrosis were then explored in cardiac tissue. Basal myocardial perfusion was similarly decreased in CAS and CAS+HT, but its response to adenosine was significantly more attenuated in CAS. Microvascular permeability in CAS+HT was greater than in CAS and was accompanied by amplified myocardial inflammation, fibrosis, and microvascular remodeling, as well as cardiac systolic and diastolic dysfunction. On the other hand, compared with normal, micro-CT-derived microvascular (20200 ?m) transmural density decreased in CAS but not in HT or CAS+HT. We conclude that the coexistence of early renovascular HT exacerbated myocardial fibrosis and vascular remodeling distal to CAS. These changes were not mediated by loss of myocardial microvessels, which were relatively preserved, but possibly by exacerbated myocardial inflammation and fibrosis. HT modulates cardiac adaptive responses to CAS and bears cardiac functional consequences. PMID:21131477

  8. Coronary endothelial dysfunction in patients with early coronary artery disease is associated with the increase in intravascular lipid core plaque

    PubMed Central

    Choi, Byoung-Joo; Prasad, Abhiram; Gulati, Rajiv; Best, Patricia J.; Lennon, Ryan J.; Barsness, Gregory W.; Lerman, Lilach O.; Lerman, Amir

    2013-01-01

    Aims Endothelial dysfunction is considered to play a key role in the development of atherosclerosis. However, only a limited number of human imaging studies have been available to demonstrate this hypothesis. The present study used near-infrared spectroscopy (NIRS) to investigate whether coronary endothelial dysfunction is associated with the lipid core plaque (LCP) in patients with early coronary artery disease. Methods and results A total of 32 patients with chest pain who had diameter stenosis <30% were enrolled. All patients underwent coronary endothelial function assessment using intracoronary acetylcholine infusion and NIRS of the proximal left anterior descending artery. The lipid core burden index (LCBI), LCBI/L (LCBI divided by the length of scanned artery), maxLCBI4 mm (maximum value of LCBI for any of the 4-mm segment) and block chemogram (yellow: probability of LCP presence >0.98, tan: 0.84 ? P ? 0.98, orange: 0.57 ? P ? 0.84, red: P < 0.57) were measured. The mean percentage of yellow, tan, and orange colour blocks in patients with epicardial endothelial dysfunction was significantly higher than in those with normal epicardial endothelial function (9.5 11.4 vs. 3.1 6.5%, P = 0.042). There was a significant correlation between LCBI (r = ?0.460, P = 0.008), LCBI/L (r = ?0.453, P = 0.009), and maxLCBI4 mm (r = ?0.431, P = 0.014) and the degree of epicardial endothelial function. However, there was no significant correlation between LCBI (r = ?0.101, P = 0.58), LCBI/L (r = ?0.099, P = 0.59), and maxLCBI4 mm (r = ?0.063, P = 0.73) and the degree of microvascular endothelial function. Conclusion Patients with early coronary artery disease and endothelial dysfunction had a higher lipid content in the vascular wall than patients with normal endothelial function. The result of the present study supports the hypothesis that endothelial dysfunction is associated with pathogenesis of early atherosclerosis PMID:23569198

  9. Is Early Onset Androgenic Alopecia a Marker of Metabolic Syndrome and Carotid Artery Atherosclerosis in Young Indian Male Patients?

    PubMed Central

    Banger, Harmeet Singh; Malhotra, Suresh Kumar; Singh, Sohan; Mahajan, Mridula

    2015-01-01

    Background: Androgenic alopecia (AGA) is a common cosmetically and psychosocially distressing condition. High androgen level contributes to the development of atherosclerosis, thrombosis leading to hypertension and hypercholesterolemia. Objectives: To study the clinico-epidemiological profile of AGA and the presence of metabolic syndrome (MetS) and carotid artery atherosclerosis in male patients with early onset AGA as compared to controls. Materials and Methods: In this case-control study, 100 male patients of age 18-35 years with AGA and an equal number of age-matched healthy controls attending skin and STD OPD were included. Assessment of the degree of hair loss, evaluation of MetS and carotid artery color Doppler for the atherosclerotic plaque was done in all patients. Results: Statistically significant number of patients with early onset AGA 22/100 (22%) (P < 0.05) fulfilled the criteria for MetS compared to 8/100 (8%) in the control group. There were statistically significant differences in mean values of waist circumference, serum triglycerides, serum cholesterol, systolic blood pressure, diastolic blood pressure, fasting glucose concentration, and very low-density lipoprotein (LDL). However, no significant differences were observed in the mean values of high-density lipoprotein cholesterol and LDL cholesterol. The atherosclerotic plaque was found in two patients of the study group, and no plaque was found in control patients. Conclusion: We suggest that all men with AGA should be thoroughly investigated, and lifestyle changes should be started in the early period of life so as to reduce the risk of various problems associated with MetS. AGA can be considered as an early marker for MetS. PMID:26903742

  10. Operational real-time GPS-enhanced earthquake early warning

    NASA Astrophysics Data System (ADS)

    Grapenthin, R.; Johanson, I. A.; Allen, R. M.

    2014-10-01

    Moment magnitudes for large earthquakes (Mw?7.0) derived in real time from near-field seismic data can be underestimated due to instrument limitations, ground tilting, and saturation of frequency/amplitude-magnitude relationships. Real-time high-rate GPS resolves the buildup of static surface displacements with the S wave arrival (assuming nonsupershear rupture), thus enabling the estimation of slip on a finite fault and the event's geodetic moment. Recently, a range of high-rate GPS strategies have been demonstrated on off-line data. Here we present the first operational system for real-time GPS-enhanced earthquake early warning as implemented at the Berkeley Seismological Laboratory (BSL) and currently analyzing real-time data for Northern California. The BSL generates real-time position estimates operationally using data from 62 GPS stations in Northern California. A fully triangulated network defines 170+ station pairs processed with the software trackRT. The BSL uses G-larmS, the Geodetic Alarm System, to analyze these positioning time series and determine static offsets and preevent quality parameters. G-larmS derives and broadcasts finite fault and magnitude information through least-squares inversion of the static offsets for slip based on a priori fault orientation and location information. This system tightly integrates seismic alarm systems (CISN-ShakeAlert, ElarmS-2) as it uses their P wave detections to trigger its processing; quality control runs continuously. We use a synthetic Hayward Fault earthquake scenario on real-time streams to demonstrate recovery of slip and magnitude. Reanalysis of the Mw7.2 El Mayor-Cucapah earthquake tests the impact of dynamic motions on offset estimation. Using these test cases, we explore sensitivities to disturbances of a priori constraints (origin time, location, and fault strike/dip).

  11. Findings of non-pathologic perfusion defects by CT arterial portography and non-pathologic enhancement of CT hepatic arteriography

    PubMed Central

    Li, Li; Wu, Pei-Hong; Lin, Hao-Gao; Li, Jin-Qing; Mo, Yun-Xian; Zheng, Lie; Lu, Li-Xia; Ruan, Chao-Mei; Chen, Lin

    1998-01-01

    AIM: To recognize the characteristic findings of non-pathologic perfusion defects with CT arterial portography (CTAP) and nonpathologic enhancement found in CT hepatic arteriography (CTHA). METHONDS: The manifestations of nonpathologic perfusion defects with CTAP and non-pathologic enhancement found in CTHA were analyzed in 50 patients with primary hepatocellular carcinoma. RESULTS: The false-positive rate of perfusion defects detected in CTAP was 15.1%. The shapes of perfusion defects were peripheral wedge, small, round, and patchy. The occurrence rate of non-pathologic enhancement found in CTHA was 22.0%. The shapes of non-pathologic enhancement were small, round, irregular, and wedge. CONCLUSION: There was high frequency of non-pathologic perfusion defects detected with CTAP and non-pathologic enhancement found in CTHA. The simultaneous use of both procedures may help decrease the false-positive rate, and increase the veracity of diagnosis for hepatocellular carcinoma. PMID:11819358

  12. Maternal alcohol consumption in pregnancy enhances arterial stiffness and alters vasodilator function that varies between vascular beds in fetal sheep

    PubMed Central

    Parkington, Helena C; Kenna, Kelly R; Sozo, Foula; Coleman, Harold A; Bocking, Alan; Brien, James F; Harding, Richard; Walker, David W; Morley, Ruth; Tare, Marianne

    2014-01-01

    While the impact of alcohol consumption by pregnant women on fetal neurodevelopment has received much attention, the effects on the cardiovascular system are not well understood. We hypothesised that repeated exposure to alcohol (ethanol) in utero would alter fetal arterial reactivity and wall stiffness, key mechanisms leading to cardiovascular disease in adulthood. Ethanol (0.75 g (kg body weight)–1) was infused intravenously into ewes over 1 h daily for 39 days in late pregnancy (days 95–133 of pregnancy, term ∼147 days). Maternal and fetal plasma ethanol concentrations at the end of the hour were ∼115 mg dl−1, and then declined to apparent zero over 8 h. At necropsy (day 134), fetal body weight and fetal brain–body weight ratio were not affected by alcohol infusion. Small arteries (250–300 μm outside diameter) from coronary, renal, mesenteric, femoral (psoas) and cerebral beds were isolated. Endothelium-dependent vasodilatation sensitivity was reduced 10-fold in coronary resistance arteries, associated with a reduction in endothelial nitric oxide synthase mRNA (P = 0.008). Conversely, vasodilatation sensitivity was enhanced 10-fold in mesenteric and renal resistance arteries. Arterial stiffness was markedly increased (P = 0.0001) in all five vascular beds associated with an increase in elastic modulus and, in cerebral vessels, with an increase in collagen Iα mRNA. Thus, we show for the first time that fetal arteries undergo marked and regionally variable adaptations as a consequence of repeated alcohol exposure. These alcohol-induced vascular effects occurred in the apparent absence of fetal physical abnormalities or fetal growth restriction. PMID:24756643

  13. Hyperoxia enhanced the production of plasminogen activator by cultured pulmonary artery endothelial cells

    SciTech Connect

    Phillips, P.G.; Ryan, T.J.; Birnby, L.; Tsan, M.F. New York State Health Lab., Albany )

    1990-02-26

    Pulmonary artery endothelial cell (EC) monolayers exposed to hyperoxia show increased permeability to albumin and marked alterations in actin filament distribution. The mechanism for these cytoskeletal changes is unknown. The authors now report that cells exposed to hyperoxia (95% O{sub 2}) produce significant quantities of urokinase-type plasminogen activators (u-PA). Zymographic analysis revealed that plasminogen-dependent caseinolytic activity in conditioned media from O{sub 2}-exposed cells was several fold higher than controls, especially at 48 hr. Cell-associated lytic activity was markedly increased at 48 and 72 hr when oxidative effects on the cytoskeleton were most apparent. Amidolytic assays confirmed these findings. (1) Conditioned media, CTA U/ml (mean {+-} SEM): Control 0.73{+-}0.05 vs 48 hr O{sub 2} 2.09{+-}0.50, (2) Cell-associated activity (preparations enriched for adhesion plaques), CTA mU/10{sup 6} cells: Control 0.17{+-}0.06; O{sub 2}: 24 hr 0.18{+-}0.07; 48 hr 0.46{+-}0.08; 72 hr 0.48{+-}0.08; O{sub 2} 48 hr or 72 hr vs Control. Immunocytochemical analysis demonstrated breakdown and restructuring of fibronectin and collagen components of the extracellular matrix at 48 and 72 hours. They conclude that hyperoxia enhanced both PA production and dismantling of matrix by EC. These changes may in part be responsible for some of the actin filament alterations which occur in conjunction with O{sub 2}-induced permeability increases.

  14. Osteoprotegerin is Associated With Endothelial Function and Predicts Early Carotid Atherosclerosis in Patients With Coronary Artery Disease.

    PubMed

    Morisawa, Taichirou; Nakagomi, Akihiro; Kohashi, Keiichi; Kosugi, Munenori; Kusama, Yoshiki; Atarashi, Hirotsugu; Shimizu, Wataru

    2015-12-01

    Osteoprotegerin (OPG) is a soluble glycoprotein belonging to the tumor necrosis factor receptor superfamily and is linked to vascular atherosclerosis and calcification. The carotid intima-media thickness (CIMT) correlates with carotid atherosclerosis and is a significant predictor of cardiovascular events. The OPG levels are associated with the CIMT in coronary artery disease (CAD) patients. However, the pathophysiological mechanisms underlying this pathway remain unclear. We investigated 114 CAD patients (89 men, 25 women; mean age: 68.7 10.3 years) and measured the Gensini score (a marker of the extent of coronary atherosclerosis), the mean CIMT and the plasma levels of OPG and asymmetric dimethylarginine (ADMA; a marker of endothelial function). Early carotid atherosclerosis was defined as a mean CIMT > 1.0 mm. Only 33 of the 114 patients (28.9%) had early carotid atherosclerosis. Patients with early carotid atherosclerosis had higher OPG levels than those without. The OPG levels were found to be significantly associated with ADMA (r = 0.191, P = 0.046) and the mean CIMT (r = 0.319, P = 0.001), but not with the Gensini score. A receiver operating curve analysis revealed the optimal cut-off value of the OPG levels for predicting early carotid atherosclerosis to be 100 pmol/L. A multivariate logistic regression analysis showed OPG ? 100 pmol/L to be significantly and independently associated with early carotid atherosclerosis (odds ratio: 2.98, 95% confidence interval: 1.22-7.20, P = 0.017). These data indicate that OPG is significantly associated with endothelial function and predicts early carotid atherosclerosis in patients with CAD. PMID:26549398

  15. Selective Ophthalmic Artery Infusion Chemotherapy for Advanced Intraocular Retinoblastoma: CCHMC Early Experience.

    PubMed

    Michaels, Samantha T; Abruzzo, Todd A; Augsburger, James J; Corra, Zlia M; Lane, Adam; Geller, James I

    2016-01-01

    Selective ophthalmic artery infusion chemotherapy (SOAIC) is increasingly used to treat retinoblastoma. We report the toxicities and outcome of 19 eyes in 17 patients with retinoblastoma receiving SOAIC treatment between 2008 and 2013. From the 87 treatments, mild local reactions were common. Myelosuppression was more common after triple-agent SOAIC (melphalan, carboplatin, and topotecan) than single-agent melphalan. Ocular salvage was achieved in 11 of 19 eyes and associated with triple-agent therapy. SOAIC is a effective therapy for some retinoblastoma with manageable toxicity; however, systemic toxicity increases with increasing therapeutic intensity of SOAIC. PMID:26583615

  16. Resistance to erythropoiesis-stimulating agents is associated with arterial microcalcification in early hemodialysis patients.

    PubMed

    Won, Hye Sung; Choi, Su Jin; Yun, Yu Seon; Shin, Ok-Ran; Ko, Yoon Ho; Kim, Young Soo; Yoon, Sun Ae; Kim, Young Ok

    2014-01-01

    The aim of this study was to evaluate the relationship between arterial microcalcification (AMiC) and erythropoiesis-stimulating agents (ESA) hyporesponsiveness in hemodialysis patients. The presence of AMiC was confirmed by pathologic examination of von Kossa-stained arterial specimens acquired during vascular access surgery. We assessed the ESA hyporesponsiveness index (EHRI), defined as the weekly ESA dose per kilogram body weight divided by the hemoglobin level. AMiC was detected in 33 (40.2%) of 82 patients. Patients with diabetes had a higher incidence of AMiC than patients without diabetes. The serum levels of albumin and cholesterol were higher in patients without AMiC than in patients with AMiC. The serum levels of intact parathyroid hormone were lower in patients with AMiC than in patients without AMiC. The serum levels of phosphate and calcium-phosphorus product did not differ between the two groups. The mean EHRI value was higher in patients with AMiC than in patients without AMiC. In multivariate analyses, ESA hyporesponsiveness and diabetes showed a significant association with AMiC. In conclusion, ESA hyporesponsiveness may be a clinical relevant parameters related to AMiC in hemodialysis patients. PMID:24772434

  17. Common Variants in Promoter of ADTRP Associate with Early-Onset Coronary Artery Disease in a Southern Han Chinese Population

    PubMed Central

    Huang, Lei; Wu, Qiu-Ping; Tang, Shuang-Bo; Luo, Bin; Liu, Shui-Ping; Liu, Xiao-Shan; Li, Zhao-Hui; Quan, Li; Li, Yue; Shi, He; Lv, Guo-Li; Zhao, Jian; Cheng, Jian-Ding; Liu, Chao

    2015-01-01

    The first genome-wide association study for coronary artery disease (CAD) in the Han Chinese population, we reported recently, had identified rs6903956 in gene ADTRP on chromosome 6p24.1 as a novel susceptibility locus for CAD. The risk allele of rs6903956 was associated with decreased mRNA expression of ADTRP. To further study the correlation of ADTRP expression and CAD, in this study we evaluated the associations of eight common variants in the expression-regulating regions of ADTRP with CAD in the Southern Han Chinese population. Rs169790 in 3UTR, rs2076189 in 5UTR, four SNPs (rs2076188, rs7753407, rs11966356 and rs1018383) in promoter, and two SNPs (rs3734273, rs80355771) in the last intron of ADTRP were genotyped in 1716 CAD patients and 1572 controls. The correlations between these loci and total or early-onset CAD were investigated. None of these loci was discovered to associate with total CAD (P > 0.05). However, with early-onset CAD, significant both allelic and genotypic associations of rs7753407, rs11966356 and rs1018383 were identified, after adjustment for risk factors of age, gender, hypertension, diabetes, lipid profiles and smoking (adjusted P < 0.05). A haplotype AGCG (constructed by rs2076188, rs7753407, rs11966356 and rs1018383) was identified to protect subjects from early-onset CAD (OR = 0.332, 95% CI = 0.1050.879, adjusted P = 0.010). Real-time quantitative reverse transcription polymerase chain reaction assay showed that the risk alleles of the associated loci were significantly associated with decreased expression of ADTRP mRNA. Moreover, the average level of ADTRP mRNA expression in early-onset CAD cases was significantly lower than that in controls. Our results provide new evidence supporting the association of ADTRP with the pathogenesis of early-onset CAD. PMID:26375920

  18. Clinical value of gadoxetic acid-enhanced magnetic resonance imaging in surgery for hepatocellular carcinoma - with a special emphasis on early hepatocellular carcinoma

    PubMed Central

    Matsuda, Masanori

    2015-01-01

    Gadoxetic acid- or gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) achieves excellent lesion detection and characterization for both hypervascular hepatocellular carcinoma (HCC) in arterial phase imaging and hypovascular early HCC (small well-differentiated HCC of the vaguely nodular type) in hepatobiliary phase imaging, and has become an indispensable imaging modality in the treatment of HCC. Early HCCs have been detected more frequently since the introduction of EOB-MRI into daily clinical practice. Early HCC is known to progress to conventional hypervascular HCC, and many risk factors have been identified for the hypervascularization of early HCC including the diameter of the tumor, presence of fat, and imaging findings of EOB-MRI. The rate of the development of hypervascular HCC was previously reported to be high in patients with chronic liver disease and early HCC. The presence of early HCC is regarded as a predictor for the recurrence of HCC following hepatic resection. On the other hand, although early HCC itself is currently not regarded as a target lesion for hepatic resection, early HCC at high risk of hypervascularity needs to be treated by local ablation therapy. If concomitant early HCC with progressed HCC is at high risk of hypervascularization and the functional liver reserve of a patient is sufficient, its simultaneous treatment at the time of hepatic resection for progressed HCC is recommended. Further studies on larger numbers of patients are needed before this strategy is adopted. PMID:26730272

  19. Enhancing international collaboration among early-career researchers

    PubMed Central

    Carroll, Jennifer K; Albada, Akke; Farahani, Mansoureh; Lithner, Maria; Neumann, Melanie; Sandhu, Harbinder; Shepherd, Heather L

    2010-01-01

    Objective The European Association of Communication in Healthcare (EACH) Early Career Researchers Network (ECRN) aims are to (1) promote international collaboration among young investigators and (2) provide a support network for future innovative communication research projects. In October 2009, Miami, USA at a workshop facilitated by the ECRN at the International Conference on Communication in Healthcare (ICCH) hosted by the American Academy of Communication in Healthcare we explored common facilitators and challenges faced by early career researchers in health communication research. Methods Attendees introduced themselves, their research area(s) of interest, and listed one facilitator and one barrier for their career development. EACH ECRN members then led a discussion of facilitators and challenges encountered in communication research projects and career development. We discussed potential collaboration opportunities, future goals, and activities. Results Having supportive collegial relationships, institutional support, job security, and funding are critical facilitators for early career investigators. Key challenges include difficulty with time management and prioritizing, limited resources, and contacts. Conclusion International collaboration among early career researchers is a feasible and effective means to address important challenges, by increasing opportunities for professional support and networking, problem-solving, discussion of data, and ultimately publishing. Practice Implications Future AACH-EACH Early Career Researcher Networks should continue to build collaborations by developing shared research projects, papers, and other scholarly products. PMID:20663630

  20. B cells enhance early innate immune responses during bacterial sepsis.

    PubMed

    Kelly-Scumpia, Kindra M; Scumpia, Philip O; Weinstein, Jason S; Delano, Matthew J; Cuenca, Alex G; Nacionales, Dina C; Wynn, James L; Lee, Pui Y; Kumagai, Yutaro; Efron, Philip A; Akira, Shizuo; Wasserfall, Clive; Atkinson, Mark A; Moldawer, Lyle L

    2011-08-01

    Microbes activate pattern recognition receptors to initiate adaptive immunity. T cells affect early innate inflammatory responses to viral infection, but both activation and suppression have been demonstrated. We identify a novel role for B cells in the early innate immune response during bacterial sepsis. We demonstrate that Rag1(-/-) mice display deficient early inflammatory responses and reduced survival during sepsis. Interestingly, B cell-deficient or anti-CD20 B cell-depleted mice, but not ?/? T cell-deficient mice, display decreased inflammatory cytokine and chemokine production and reduced survival after sepsis. Both treatment of B cell-deficient mice with serum from wild-type (WT) mice and repletion of Rag1(-/-) mice with B cells improves sepsis survival, suggesting antibody-independent and antibody-dependent roles for B cells in the outcome to sepsis. During sepsis, marginal zone and follicular B cells are activated through type I interferon (IFN-I) receptor (IFN-?/? receptor [IFNAR]), and repleting Rag1(-/-) mice with WT, but not IFNAR(-/-), B cells improves IFN-I-dependent and -independent early cytokine responses. Repleting B cell-deficient mice with the IFN-I-dependent chemokine, CXCL10 was also sufficient to improve sepsis survival. This study identifies a novel role for IFN-I-activated B cells in protective early innate immune responses during bacterial sepsis. PMID:21746813

  1. Use of Sonicated Albumin (Infoson) to Enhance Arterial Spectral and Color Doppler Imaging

    SciTech Connect

    Abildgaard, Andreas; Egge, Tor S.; Klow, Nils-Einar; Jakobsen, Jarl A.

    1996-04-15

    Purpose: To examine the effect of an ultrasound contrast medium (UCM), Infoson, on Doppler examination of stenotic arteries. Methods: Stenoses were created in the common carotid artery of six piglets, and examined with spectral Doppler and color Doppler imaging during UCM infusion in the left ventricle. Results: UCM caused a mean increase in recorded maximal systolic and end-diastolic velocities of 5% and 6%, respectively, while blood flow remained constant. Increased spectral intensity with UCM was accompanied by spectral broadening. Reduction of spectral intensity by adjustment of Doppler gain counteracted the velocity effects and the spectral broadening. With color Doppler, UCM caused dose-dependent color artifacts outside the artery. Flow in narrow stenoses could be visualized with UCM. Conclusion: The effects of UCM on velocity measurements were slight, and were related to changes in spectral intensity. With color Doppler, UCM may facilitate flow detection, but color artifacts may interfere.

  2. Enhancement of Early Childhood Professional Status as a Bridge to Positive Parent Perception and Respect for Early Childhood Educators.

    ERIC Educational Resources Information Center

    Fields, Doreatha J.

    This practicum was designed to enhance the perception of the early childhood professional among parents of children at an on-site child development center in a medical center. A pattern was documented of negative communication and lack of respect for the goals and policies of the child care center. The practicum's goal was to replace the parental

  3. The usefulness of contrast-enhanced ultrasonography in the early detection of hepatocellular carcinoma viability after transarterial chemoembolization: pilot study

    PubMed Central

    Cho, Youn Zoo; Park, So Yeon; Choi, Eun Hee; Baik, Soon Koo; Kwon, Sang Ok; Kim, Young Ju

    2015-01-01

    Background/Aims The therapeutic effect of transarterial chemoembolization (TACE) against hepatocellular carcinoma (HCC) is usually assessed using multidetector computed tomography (MDCT). However, dense lipiodol depositions can mask the enhancement of viable HCC tissue in MDCT. Contrast-enhanced ultrasonography (CEUS) could be effective in detecting small areas of viability and patency in vessels. We investigated whether arterial enhancement in CEUS after treatment with TACE can be used to detect HCC viability earlier than when using MDCT. Methods Twelve patients received CEUS, MDCT, and gadoxetic-acid-enhanced dynamic magnetic resonance imaging (MRI) at baseline and 4 and 12 weeks after TACE. The definition of viable HCC was defined as MRI positivity after 4 or 12 weeks. Results Eight of the 12 patients showed MRI positivity at 4 or 12 weeks. All patients with positive CEUS findings at 4 weeks (n=8) showed MRI positivity and residual viable HCC at 4 or 12 weeks. Five of the eight patients with positive CEUS findings at 4 weeks had negative results on the 4-week MDCT scan. Four (50%) of these eight patients did not have MRI positivity at 4 weeks and were ultimately confirmed as having residual HCC tissue at the 12-week MRI. Kappa statistics revealed near-perfect agreement between CEUS and MRI (?=1.00) and substantial agreement between MDCT and MRI (?=0.67). Conclusions In the assessment of the response to TACE, CEUS at 4 weeks showed excellent results for detecting residual viable HCC, which suggests that CEUS can be used as an early additive diagnosis tool when deciding early additional treatment with TACE. PMID:26157754

  4. Two functional polymorphisms of ROCK2 enhance arterial stiffening through inhibiting its activity and expression.

    PubMed

    Liao, Yi-Chu; Liu, Ping-Yen; Lin, Hsiu-Fen; Lin, Wen-Yi; Liao, James K; Juo, Suh-Hang H

    2015-02-01

    Derangement of Rho-associated kinases (ROCKs) has been related to coronary artery disease and stroke. ROCK2, rather than ROCK1, plays a predominant role in vascular contractility. The present study aims to test (1) the associations between ROCK2 single nucleotide polymorphisms (SNPs) and arterial stiffness, and (2) the molecular mechanism accounting for their effects. Stiffness parameters including beta (?), elasticity modulus (Ep) and pulse wave velocity (PWV) were obtained by carotid ultrasonography. Seven tagging SNPs of ROCK2 were initially genotyped in 856 subjects and significant SNPs were replicated in another group of 527 subjects. Two SNPs in complete linkage disequilibrium were found to be significantly associated with arterial stiffness. The major alleles of rs978906 (A allele) and rs9808232 (C allele) were associated with stiffer arteries. SNP rs978906 was predicted to influence microRNA(miR)-1183 binding to ROCK2, while rs9808232 causes amino acid substitution. To determine their functional impact, plasmid constructs carrying different alleles of the significant SNPs were created. Compared to rs978906G-allele constructs, cells transfected with rs978906A-allele constructs had higher baseline luciferase activities and were less responsive to miR-1183 changes. Oxidized-low density lipoprotein (Ox-LDL) suppressed miR-1183 levels and increased ROCK2 protein amounts. For rs9808232, cells transfected with C-allele constructs had significantly higher ROCK activities than those with A-allele constructs. Leukocyte ROCK activities were further measured in 52 healthy subjects. The average ROCK activity was highest in human subjects with CC genotype at rs9808232, followed by those with AC and lowest in AA. Taken together, the present study showed that two functional SNPs of ROCK2 increase susceptibility of arterial stiffness in the Chinese population. Non-synonymous SNP rs9808232 influences ROCK2 activity, while 3' UTR SNP rs978906 affects the ROCK2 protein synthesis by interfering miR-1183 binding. PMID:25481646

  5. Reproducibility of rest and exercise stress contrast-enhanced calf perfusion magnetic resonance imaging in peripheral arterial disease

    PubMed Central

    2013-01-01

    Background The purpose was to determine the reproducibility and utility of rest, exercise, and perfusion reserve (PR) measures by contrast-enhanced (CE) calf perfusion magnetic resonance imaging (MRI) of the calf in normal subjects (NL) and patients with peripheral arterial disease (PAD). Methods Eleven PAD patients with claudication (ankle-brachial index 0.67 0.14) and 16 age-matched NL underwent symptom-limited CE-MRI using a pedal ergometer. Tissue perfusion and arterial input were measured at rest and peak exercise after injection of 0.1 mM/kg of gadolinium-diethylnetriamine pentaacetic acid (Gd-DTPA). Tissue function (TF) and arterial input function (AIF) measurements were made from the slope of time-intensity curves in muscle and artery, respectively, and normalized to proton density signal to correct for coil inhomogeneity. Perfusion index (PI)?=?TF/AIF. Perfusion reserve (PR)?=?exercise TF/ rest TF. Intraclass correlation coefficient (ICC) was calculated from 11 NL and 10 PAD with repeated MRI on a different day. Results Resting TF was low in NL and PAD (mean??SD 0.25??0.18 vs 0.35??0.71, p?=?0.59) but reproducible (ICC 0.76). Exercise TF was higher in NL than PAD (5.5??3.2 vs. 3.4??1.6, p?=?0.04). Perfusion reserve was similar between groups and highly variable (28.6??19.8 vs. 42.6??41.0, p?=?0.26). Exercise TF and PI were reproducible measures (ICC 0.63 and 0.60, respectively). Conclusion Although rest measures are reproducible, they are quite low, do not distinguish NL from PAD, and lead to variability in perfusion reserve measures. Exercise TF and PI are the most reproducible MRI perfusion measures in PAD for use in clinical trials. PMID:23343398

  6. Review of Source Images is Necessary for the Evaluation of Gadolinium-Enhanced MR Angiography for Renal Artery Stenosis

    SciTech Connect

    Wehrschuetz, M. Aschauer, M.; Portugaller, H.; Stix, A.; Wehrschuetz-Sigl, E.; Hausegger, K.; Ebner, F.

    2004-09-15

    The purpose of this study was to assess interobserver variability and accuracy in the evaluation of renal artery stenosis (RAS) with gadolinium-enhanced MR angiography (MRA) and digital subtraction angiography (DSA) in patients with hypertension. The authors found that source images are more accurate than maximum intensity projection (MIP) for depicting renal artery stenosis. Two independent radiologists reviewed MRA and DSA from 38 patients with hypertension. Studies were postprocessed to display images in MIP and source images. DSA was the standard for comparison in each patient. For each main renal artery, percentage stenosis was estimated for any stenosis detected by the two radiologists. To calculate sensitivity, specificity and accuracy, MRA studies and stenoses were categorized as normal, mild (1-39%), moderate (40-69%) or severe ({>=}70%), or occluded. DSA stenosis estimates of 70% or greater were considered hemodynamically significant. Analysis of variance demonstrated that MIP estimates of stenosis were greater than source image estimates for both readers. Differences in estimates for MIP versus DSA reached significance in one reader. The interobserver variance for MIP, source images and DSA was excellent (0.80< {kappa}{<=} 0.90). The specificity of source images was high (97%) but less for MIP (87%); average accuracy was 92% for MIP and 98% for source images. In this study, source images are significantly more accurate than MIP images in one reader with a similar trend was observed in the second reader. The interobserver variability was excellent. When renal artery stenosis is a consideration, high accuracy can only be obtained when source images are examined.

  7. Early experience of Cued Speech enhances speechreading performance in deaf.

    PubMed

    Aparicio, Mario; Peigneux, Philippe; Charlier, Brigitte; Neyrat, Charlotte; Leybaert, Jacqueline

    2012-02-01

    It is known that deaf individuals usually outperform normal hearing subjects in speechreading; however, the underlying reasons remain unclear. In the present study, speechreading performance was assessed in normal hearing participants (NH), deaf participants who had been exposed to the Cued Speech (CS) system early and intensively, and deaf participants exposed to oral language without Cued Speech (NCS). Results show a gradation in performance with highest performance in CS, then in NCS, and finally NH participants. Moreover, error analysis suggests that speechreading processing is more accurate in the CS group than in the other groups. Given that early and intensive CS has been shown to promote development of accurate phonological processing, we propose that the higher speechreading results in Cued Speech users are linked to a better capacity in phonological decoding of visual articulators. PMID:21995589

  8. Regional Coronary Endothelial Function is Closely Related to Local Early Coronary Atherosclerosis in Patients with Mild Coronary Artery Disease: A Pilot Study

    PubMed Central

    Hays, Allison G.; Kelle, Sebastian; Hirsch, Glenn A.; Soleimanifard, Sahar; Yu, Jing; Agarwal, Harsh K.; Gerstenblith, Gary; Schr, Michael; Stuber, Matthias; Weiss, Robert G.

    2012-01-01

    Background Coronary endothelial function (endoFx) is abnormal in patients with established coronary artery disease (CAD) and was recently shown by MRI to relate to the severity of luminal stenosis. Recent advances in MRI now allow the non-invasive assessment of both anatomic and functional (endoFx) changes that previously required invasive studies. We tested the hypothesis that abnormal coronary endoFx is related to measures of early atherosclerosis such as increased coronary wall thickness (CWT). Methods and Results Seventeen arteries in fourteen healthy adults and seventeen arteries in fourteen patients with non-obstructive CAD were studied. To measure endoFx, coronary MRI was performed before and during isometric handgrip exercise, an endothelial-dependent stressor and changes in coronary cross-sectional area (CSA) and flow were measured. Black blood imaging was performed to quantify CWT and other indices of arterial remodeling. The mean stress-induced change in CSA was significantly higher in healthy adults (13.5%12.8%, meanSD, n=17) than in those with mildly diseased arteries (-2.26.8%, p<0.0001, n=17). Mean CWT was lower in healthy subjects (0.90.2mm) than in CAD patients (1.40.3mm, p<0.0001). In contrast to healthy subjects, stress-induced changes in CSA, a measure of coronary endoFx, correlated inversely with CWT in CAD patients (r= -0.73, p=0.0008). Conclusions There is an inverse relationship between coronary endothelial function and local CWT in CAD patients but not in healthy adults. These findings demonstrate that local endothelial-dependent functional changes are related to the extent of early anatomic atherosclerosis in mildly diseased arteries. This combined MRI approach enables the anatomic and functional investigation of early coronary disease. PMID:22492483

  9. Noncalcified Coronary Plaque Volumes in Healthy People with a Family History of Early-Onset Coronary Artery Disease

    PubMed Central

    Kral, Brian G.; Becker, Lewis C.; Vaidya, Dhananjay; Yanek, Lisa R.; Qayyum, Rehan; Zimmerman, Stefan L.; Dey, Damini; Berman, Daniel S.; Moy, Taryn F.; Fishman, Elliot K.; Becker, Diane M.

    2015-01-01

    Background Although age and sex distributions of calcified plaque (CCP) have been well described in the general population, noncalcified plaque (NCP) distributions remain unknown. This is important because NCP is a putative precursor for clinical CAD and could serve as a sentinel for aggressive primary prevention, especially in higher risk populations. We examined the distributions of NCP and CCP in healthy 30-74 year old individuals from families with early-onset coronary artery disease (CAD). Methods and Results Participants in the GeneSTAR family study (N=805), mean age 51.1 10.8 years, 56% female, were screened for CAD risk factors and for coronary plaque using dual-source CT angiography. Plaque volumes (mm3) were quantified using a validated automated method. The prevalence of coronary plaque was 57.8% in males and 35.8% in females (p<0.0001). NCP volume increased with age (p<0.001) and was higher in males than females (p<0.001). Although NCP, as a percent of total plaque, was inversely related to age (p<0.01), NCP accounted for most of the total plaque volume at all ages, especially in males and females <55 years (>70% and >80%, respectively). Higher Framingham risk was associated with the number of affected vessels (p<0.01) but 44% of males and 20.8% of females considered intermediate risk had left main and/or 3-vessel disease involvement. Conclusions The majority of coronary plaque was noncalcified, particularly in younger individuals. These findings support the importance of assessing family history and suggest that early primary prevention interventions may be warranted at younger ages in families with early onset CAD. PMID:24577355

  10. Early Postnatal EEG Features of Perinatal Arterial Ischaemic Stroke with Seizures

    PubMed Central

    Low, Evonne; Mathieson, Sean R.; Stevenson, Nathan J.; Livingstone, Vicki; Ryan, C. Anthony; Bogue, Conor O.; Rennie, Janet M.; Boylan, Geraldine B.

    2014-01-01

    Background Stroke is the second most common cause of seizures in term neonates and is associated with abnormal long-term neurodevelopmental outcome in some cases. Objective To aid diagnosis earlier in the postnatal period, our aim was to describe the characteristic EEG patterns in term neonates with perinatal arterial ischaemic stroke (PAIS) seizures. Design Retrospective observational study. Patients Neonates >37 weeks born between 2003 and 2011 in two hospitals. Method Continuous multichannel video-EEG was used to analyze the background patterns and characteristics of seizures. Each EEG was assessed for continuity, symmetry, characteristic features and sleep cycling; morphology of electrographic seizures was also examined. Each seizure was categorized as electrographic-only or electroclinical; the percentage of seizure events for each seizure type was also summarized. Results Nine neonates with PAIS seizures and EEG monitoring were identified. While EEG continuity was present in all cases, the background pattern showed suppression over the infarcted side; this was quite marked (>50% amplitude reduction) when the lesion was large. Characteristic unilateral bursts of theta activity with sharp or spike waves intermixed were seen in all cases. Sleep cycling was generally present but was more disturbed over the infarcted side. Seizures demonstrated a characteristic pattern; focal sharp waves/spike-polyspikes were seen at frequency of 1–2 Hz and phase reversal over the central region was common. Electrographic-only seizure events were more frequent compared to electroclinical seizure events (78 vs 22%). Conclusions Focal electrographic and electroclinical seizures with ipsilateral suppression of the background activity and focal sharp waves are strong indicators of PAIS. Approximately 80% of seizure events were the result of clinically unsuspected seizures in neonates with PAIS. Prolonged and continuous multichannel video-EEG monitoring is advocated for adequate seizure surveillance. PMID:25051161

  11. Photonic crystal enhanced fluorescence for early breast cancer biomarker detection.

    PubMed

    Cunningham, Brian T; Zangar, Richard C

    2012-08-01

    Photonic crystal surfaces offer a compelling platform for improving the sensitivity of surface-based fluorescent assays used in disease diagnostics. Through the complementary processes of photonic crystal enhanced excitation and enhanced extraction, a periodic dielectric-based nanostructured surface can simultaneously increase the electric field intensity experienced by surface-bound fluorophores and increase the collection efficiency of emitted fluorescent photons. Through the ability to inexpensively fabricate photonic crystal surfaces over substantial surface areas, they are amenable to single-use applications in biological sensing, such as disease biomarker detection in serum. In this review, we will describe the motivation for implementing high-sensitivity, multiplexed biomarker detection in the context of breast cancer diagnosis. We will summarize recent efforts to improve the detection limits of such assays though the use of photonic crystal surfaces. Reduction of detection limits is driven by low autofluorescent substrates for photonic crystal fabrication, and detection instruments that take advantage of their unique features. PMID:22736539

  12. Photonic Crystal Enhanced Fluorescence for Early Breast Cancer Biomarker Detection

    PubMed Central

    Cunningham, Brian T.; Zangar, Richard C.

    2013-01-01

    Photonic crystal surfaces offer a compelling platform for improving the sensitivity of surface-based fluorescent assays used in disease diagnostics. Through the complementary processes of photonic crystal enhanced excitation and enhanced extraction, a periodic dielectric-based nanostructured surface can simultaneously increase the electric field intensity experienced by surface-bound fluorophores and increase the collection efficiency of emitted fluorescent photons. Through the ability to inexpensively fabricate photonic crystal surfaces over substantial surface areas, they are amenable to single-use applications in biological sensing, such as disease biomarker detection in serum. In this review, we will describe the motivation for implementing high-sensitivity, multiplexed biomarker detection in the context of breast cancer diagnosis. We will summarize recent efforts to improve the detection limits of such assays though the use of photonic crystal surfaces. Reduction of detection limits is driven by low autofluorescent substrates for photonic crystal fabrication, and detection instruments that take advantage of their unique features. PMID:22736539

  13. 77 FR 13513 - Enhanced Prudential Standards and Early Remediation Requirements for Covered Companies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... Requirements for Covered Companies, 77 FR 594 (Jan. 5, 2012). FOR FURTHER INFORMATION CONTACT: Molly E. Mahar... CFR Part 252 RIN 7100-AD-86 Enhanced Prudential Standards and Early Remediation Requirements for... notice of proposed rulemaking for public comment to implement the enhanced prudential standards...

  14. Peptide-Coated Liposomal Fasudil Enhances Site Specific Vasodilation in Pulmonary Arterial Hypertension

    PubMed Central

    2015-01-01

    This study sought to develop a liposomal delivery system of fasudil—an investigational drug for the treatment of pulmonary arterial hypertension (PAH)—that will preferentially accumulate in the PAH lungs. Liposomal fasudil was prepared by film-hydration method, and the drug was encapsulated by active loading. The liposome surface was coated with a targeting moiety, CARSKNKDC, a cyclic peptide; the liposomes were characterized for size, polydispersity index, zeta potential, and storage and nebulization stability. The in vitro drug release profiles and uptake by TGF-β activated pulmonary arterial smooth muscle cells (PASMC) and alveolar macrophages were evaluated. The pharmacokinetics were monitored in male Sprague–Dawley rats, and the pulmonary hemodynamics were studied in acute and chronic PAH rats. The size, polydispersity index (PDI), and zeta potential of the liposomes were 206–216 nm, 0.058–0.084, and −20–42.7 mV, respectively. The formulations showed minimal changes in structural integrity when nebulized with a commercial microsprayer. The optimized formulation was stable for >4 weeks when stored at 4 °C. Fasudil was released in a continuous fashion over 120 h with a cumulative release of 76%. Peptide-linked liposomes were taken up at a higher degree by TGF-β activated PASMCs; but alveolar macrophages could not engulf peptide-coated liposomes. The formulations did not injure the lungs; the half-life of liposomal fasudil was 34-fold higher than that of plain fasudil after intravenous administration. Peptide-linked liposomal fasudil, as opposed to plain liposomes, reduced the mean pulmonary arterial pressure by 35–40%, without influencing the mean systemic arterial pressure. This study establishes that CAR-conjugated inhalable liposomal fasudil offers favorable pharmacokinetics and produces pulmonary vasculature specific dilatation. PMID:25333706

  15. Enhancer repertoires are reshaped independently of early priming and heterochromatin dynamics during B cell differentiation

    PubMed Central

    Choukrallah, Mohamed-Amin; Song, Shuang; Rolink, Antonius G.; Burger, Lukas; Matthias, Patrick

    2015-01-01

    A widely accepted model posits that activation of enhancers during differentiation goes through a priming step prior to lineage commitment. To investigate the chronology of enhancer repertoire establishment during hematopoiesis, we monitored epigenome dynamics during three developmental stages representing hematopoietic stem cells, B-cell progenitors and mature B-cells. We find that only a minority of enhancers primed in stem cells or progenitors become active at later stages. Furthermore, most enhancers active in differentiated cells were not primed in earlier stages. Thus, the enhancer repertoire is reshaped dynamically during B-cell differentiation and enhancer priming in early stages does not appear to be an obligate step for enhancer activation. Furthermore, our data reveal that heterochromatin and Polycomb-mediated silencing have only a minor contribution in shaping enhancer repertoires during cell differentiation. Together, our data revisit the prevalent model about epigenetic reprogramming during hematopoiesis and give insights into the formation of gene regulatory networks. PMID:26477271

  16. Infarcts in the anterior choroidal artery territory. Anatomical distribution, clinical syndromes, presumed pathogenesis and early outcome.

    PubMed

    Hupperts, R M; Lodder, J; Heuts-van Raak, E P; Kessels, F

    1994-08-01

    From a prospective registry of all consecutive patients with a supratentorial ischaemic stroke, those with a compatible CT lesion were selected to study topographical relationship, clinical syndrome, vascular risk factors, signs of large-vessel disease or cardiogenic embolism, and mortality in cases with an infarct in the anterior choroidal artery (AChA) territory in comparison with other infarct subtypes. First we identified the area supplied by the AChA: in accordance with the consensus in the literature the posterior two-thirds of the posterior leg of the internal capsule was considered as certain AChA territory. After reviewing CT scans, all presumed small deep AChA territory infarcts were displayed in a schematic composite picture of super-imposed areas of infarction in different shades of grey. Infarcts that were located largely outside the generally included territory were presumed to belong to a different vascular territory. Thus, 77 small deep infarcts were considered to be located within, and 83 outside the AChA territory. Twenty-nine AChA infarcts extended from the internal capsule upwards into the posterior paraventricular corona radiata region. Furthermore, the composite representation of 26 infarcts restricted to the posterior part of the paraventricular corona radiata region showed almost complete overlap with the area occupied by AChA infarcts that extended upwards. We therefore concluded that the posterior paraventricular area is most likely supplied by the AChA. The frequency of a clinical lacunar or a cortical syndrome did not differ between small deep AChA and remaining small deep infarcts. Comparison of vascular risk factors by way of multivariate regression analysis only showed that a significant carotid stenosis was more frequent (adjusted odds ratio 8.87; 95% confidence interval 1.44-54.50), and a cardioembolic source was less frequent (odds ratio 0.24; 95% confidence interval 0.07-0.92) in AChA infarcts than in the other small deep infarcts. Carotid stenosis and cardiac embolism were less frequent in AChA infarcts than in superficial infarcts (odds ratio 0.33, 0.23, respectively; 95% confidence interval 0.15-0.74, 0.09-0.52, respectively). One month and one year mortality were lower in small deep infarcts compared with superficial infarcts, but most favourable in the AChA group. However, this was probably related to younger age in the AChA patients. Larger AChA infarcts were infrequent in our series; six of such cases did not differ in any respect from superficial infarcts. We conclude that the posterior paraventricular corona radiata region is most likely supplied by the AChA, and that AChA infarcts do not constitute a separate brain infarct entity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7922468

  17. The Relationships between Fatigue and Early Postoperative Recovery Outcomes Over Time in Elderly Coronary Artery Bypass Graft (CABG) Surgery Patients

    PubMed Central

    Barnason, Susan; Zimmerman, Lani; Nieveen, Janet; Schulz, Paula; Miller, Connie; Hertzog, Melody; Rasmussen, Doris

    2008-01-01

    BACKGROUND Despite successful coronary artery bypass graft (CABG) surgery, some patients continue to experience fatigue following their surgery. OBJECTIVE The purpose of this secondary analysis study was to examine the relationships of fatigue and early recovery outcomes (psychosocial and physiological functioning, and physical activity) over time (6-weeks and 3-months) among older adult subjects, age 65 years and older, following CABG surgery. Comparison groups were those subjects who had fatigue at 3-weeks after surgery and non-fatigued subjects. DESIGN A prospective, comparative design was used for this secondary analysis study. SAMPLE Subjects in this study were drawn from the control group of subjects enrolled in the larger, parent study. Subjects (N=119) were dichotomized into fatigue (n=66) and non-fatigued (n=53) groups based on their 3-week self-report of postoperative fatigue. RESULTS At 6-weeks after surgery, fatigued subjects had significantly (p<.05) more impaired psychosocial functioning, [role-emotional (t=1.9), social (t=2.6), and mental (t=1.9) functioning], based Medical Outcome Study short form-36 (MOS SF-36). They had significantly (p<.005) higher anxiety (t= ?3.6) and depression (t= ?2.9) mean Hospital Anxiety and Depression subscale (HADS) scores. Anxiety (t= ?2.3, p<.05) remained significantly (p<.05) impaired at 3-months. At 6-weeks, role physical functioning, measured by the MOS SF-36, was significantly impaired (t=2.4, p<.01). There were no significant differences in physical activity variables as measured by a RT3 accelerometer and self-report diary. CONCLUSIONS Persistent fatigue can hamper early recovery following CABG surgery. Tailored interventions are needed to address fatigue management and improve patient outcomes. PMID:18620100

  18. Relative importance of patient, procedural and anatomic risk factors for early vein graft thrombosis after coronary artery bypass graft surgery

    PubMed Central

    MCLEAN, R. C.; NAZARIAN, S. M.; GLUCKMAN, T. J.; SCHULMAN, S. P.; THIEMANN, D. R.; SHAPIRO, E. P.; CONTE, J. V.; THOMPSON, J. B.; SHAFIQUE, I.; MCNICHOLAS, K. W.; VILLINES, T. C.; LAWS, K. M.; RADE, J. J.

    2015-01-01

    Aim The aim of the present study was to investigate the relative importance of a wide array of patient demographic, procedural, anatomic and perioperative variables as potential risk factors for early saphenous vein graft (SVG) thrombosis after coronary artery bypass graft (CABG) surgery. Methods The patency of 611 SVGs in 291 patients operated on at four different hospitals enrolled in the Reduction in Graft Occlusion Rates (RIGOR) study was assessed six months after CABG surgery by multidetector computed tomography coronary angiography or clinically-indicated coronary angiography. The odds of graft occlusion versus patency were analyzed using multilevel multivariate logistic regression with clustering on patient. Results SVG failure within six months of CABG surgery was predominantly an all-or-none phenomenon with 126 (20.1%) SVGs totally occluded, 485 (77.3%) widely patent and only 16 (2.5%) containing high-grade stenoses. Target vessel diameter ?1.5 mm (adjusted OR 2.37, P=0.003) and fetnale gender (adjusted OR 2.46, P=0.01) were strongly associated with early SVG occlusion. In a subgroup analysis of 354 SVGs in which intraoperative graft blood flow was measured, lower mean flow was also significantly associated with SVG occlusion when analyzed as a continuous variable (adjusted OR 0.984, P=0.006) though not when analyzed dichotomously, <40 mL/min versus ?40 mL/min (adjusted OR 1.86, P=0.08). Conclusion Small target vessel diameter, female gender and low mean graft blood flow are significant risk factors for SVG thrombosis within six months of CABG surgery in patients on postoperative aspirin therapy. This information may be useful in guiding revascularization strategies in selected patients. PMID:22051997

  19. Serum uric acid and its relationship with cardiovascular risk profile in Chinese patients with early-onset coronary artery disease.

    PubMed

    Dai, Xiao-Min; Wei, Lei; Ma, Li-Li; Chen, Hui-Yong; Zhang, Zhuo-Jun; Ji, Zong-Fei; Wu, Wan-Long; Ma, Ling-Ying; Kong, Xiu-Fang; Jiang, Lin-Di

    2015-09-01

    The prevalence of coronary artery disease (CAD) is growing in the young population. We aimed to investigate the association between serum uric acid (SUA) levels and cardiovascular involvement in individuals under 45 years old diagnosed with early-onset CAD (EOCAD). Seven hundred eighty-six EOCAD patients were recruited and stratified into four groups by SUA levels. General information, serum indicators, and results of coronary angiography and echocardiography were recorded. The associations between SUA levels were explored by univariate and multivariate logistic regressions. With the increasing of SUA levels, the prevalence of hypertension and hyperlipidemia, triple branches involved, heart failure, and cardiac enlargement of left ventricle (LV), left atrium (LA), and right ventricle (RV) were significantly higher (all P?8 mg/dl) had the highest proportions than other groups (all P?8 mg/dl were 2.345 for triple branches involved (95 % confidence interval (CI) 1.335-4.119), 4.168 for heart failure (95 % CI 1.599-10.862), and 4.122 for LV enlargement (95 % CI 1.874-9.065) (P?8 mg/dl was independently associated with triple branches involvement, heart failure and LV enlargement in Chinese EOCAD patients. Higher SUA level might play an important role in cardiac dysfunction and severity of EOCAD. PMID:25630308

  20. Toward early diagnosis of arteriosclerotic diseases: collaborative detection of carotid artery calcifications by computer and dentists on dental panoramic radiographs

    NASA Astrophysics Data System (ADS)

    Muramatsu, Chisako; Takahashi, Ryo; Hara, Takeshi; Hayashi, Tatsuro; Katsumata, Akitoshi; Zhou, Xiangrong; Fujita, Hiroshi

    2014-03-01

    Several studies have reported the presence of carotid artery calcifications (CACs) on dental panoramic radiographs (DPRs) as a possible sign of arteriosclerotic diseases. However, CACs are not easily visible at the common window level for dental examinations, and dentists, in general, are not looking for CACs. Computerized detection of CACs may help dentists in referring patients with a risk of arteriosclerotic diseases to have a detailed examination at a medical clinic. Downside of our previous method was a relatively large number of false positives (FPs). In this study, we attempted to reduce FPs by including an additional feature and selecting effective features for the classifier. A hundred DPRs including 34 cases with calcifications were included. Initial candidates were detected by thresholding the output of top-hat operation. For each candidate, 10 features and a new feature characterizing the relative position of a CAC with reference to the lower mandible edge were determined. After the rule-based FP reduction, candidates were classified into CACs and FPs by a support vector machine. Based on the leave-one-out cross-validation evaluations, an average number of FPs was 3.1 per image at 90.4% sensitivity using seven features selected. Compared to our previous method, the number of FPs was reduced by 38% at the same sensitivity level. The proposed method has a potential in identifying patients with a risk of arteriosclerosis early via general dental examinations.

  1. Can venous base excess replace arterial base excess as a marker of early shock and a predictor of survival in trauma?

    PubMed Central

    Wijaya, Ramesh; Ng, Jia Hui; Ong, Lester; Wong, Andrew Siang Yih

    2016-01-01

    INTRODUCTION Arterial base excess is an established marker of shock and predictor of survival in trauma patients. However, venous blood is more quickly and easily obtained. This study aimed to determine if venous base excess could replace arterial base excess as a marker in trauma patients at presentation and if venous base excess is predictive of survival at 24 hours and one week. METHODS This was a prospective study of 394 trauma patients presenting to the emergency department of a tertiary hospital over a 17-month period. Data on base excess at presentation, vital signs, shock index (SI), injury severity score (ISS), and mortality at 24 hours and one week was collected and analysed. RESULTS Arterial and venous blood gas tests were performed on 260 and 134 patients, respectively. Patients were stratified into groups based on their SI and ISS for analysis. There was no statistical difference between mean venous blood gas and arterial blood gas levels at presentation when SI > 0.7, regardless of ISS (p > 0.05). The mortality rate was 4.57%. Both venous and arterial base excess was lower in nonsurvivors compared to survivors (p < 0.05). However, at 24 hours and one week, the difference in base excess values at presentation between survivors and nonsurvivors was greater when using venous base excess compared to arterial base excess (11.53 vs. 4.28 and 11.41 vs. 2.66, respectively). CONCLUSION In conclusion, venous base excess can replace arterial base excess in trauma patients as a means of identifying and prognosticating early shock. PMID:26892937

  2. Language experience enhances early cortical pitch-dependent responses

    PubMed Central

    Krishnan, Ananthanarayan; Gandour, Jackson T.; Ananthakrishnan, Saradha; Vijayaraghavan, Venkatakrishnan

    2014-01-01

    Pitch processing at cortical and subcortical stages of processing is shaped by language experience. We recently demonstrated that specific components of the cortical pitch response (CPR) index the more rapidly-changing portions of the high rising Tone 2 of Mandarin Chinese, in addition to marking pitch onset and sound offset. In this study, we examine how language experience (Mandarin vs. English) shapes the processing of different temporal attributes of pitch reflected in the CPR components using stimuli representative of within-category variants of Tone 2. Results showed that the magnitude of CPR components (Na-Pb and Pb-Nb) and the correlation between these two components and pitch acceleration were stronger for the Chinese listeners compared to English listeners for stimuli that fell within the range of Tone 2 citation forms. Discriminant function analysis revealed that the Na-Pb component was more than twice as important as Pb-Nb in grouping listeners by language affiliation. In addition, a stronger stimulus-dependent, rightward asymmetry was observed for the Chinese group at the temporal, but not frontal, electrode sites. This finding may reflect selective recruitment of experience-dependent, pitch-specific mechanisms in right auditory cortex to extract more complex, time-varying pitch patterns. Taken together, these findings suggest that long-term language experience shapes early sensory level processing of pitch in the auditory cortex, and that the sensitivity of the CPR may vary depending on the relative linguistic importance of specific temporal attributes of dynamic pitch. PMID:25506127

  3. Elastin-derived peptides stimulate trophoblast migration and invasion: a positive feedback loop to enhance spiral artery remodelling.

    PubMed

    Desforges, Michelle; Harris, Lynda K; Aplin, John D

    2015-01-01

    Elastin breakdown in the walls of uterine spiral arteries during early pregnancy facilitates their transformation into dilated, high-flow, low-resistance channels. Elastin-derived peptides (EDP) can influence cell migration, invasion and protease activity, and so we hypothesized that EDP released during elastolysis promote extravillous trophoblast (EVT) invasion and further elastin breakdown. Treatment of the trophoblast cell line SGHPL4 with the elastin-derived matrikine VGVAPG (1 ?g/ml) significantly increased total elastase activity, promoted migration in a wound healing assay and increased invasion through Matrigel-coated transwells compared with vehicle control (0.1% DMSO) or the scrambled sequence VVGPGA. Furthermore, treatment of first-trimester placental villous explants with this EDP significantly increased both the area of trophoblast outgrowth and distance of migration away from the villous tips. Primary first-trimester cytotrophoblast exposed to VGVAPG (1 ?g/ml) for 30 min showed increased phosphorylation of endothelial nitric oxide synthase and activation of the mitogen activated protein kinase pathway, events also associated with tumour cell migration and invasion. These in vitro observations suggest liberation of bioactive EDP during induction of elastolysis in the uterine spiral arteries may orchestrate a positive feedback loop that promotes EVT invasion and further elastin breakdown, contributing to the process of vascular remodelling. PMID:25245255

  4. Early increase of retinal arterial and venous blood flow velocities at color Doppler imaging in brittle type 1 diabetes after islet transplant alone.

    PubMed

    Venturini, Massimo; Fiorina, Paolo; Maffi, Paola; Losio, Claudio; Vergani, Andrea; Secchi, Antonio; Del Maschio, Alessandro

    2006-05-15

    Little information is currently available about the role of islet transplantation alone (ITA) on the retinal microcirculation. Our purpose was to investigate with color-Doppler-imaging the effect of ITA after one year on the blood flow velocities of central retinal artery and vein. Central retinal arteries and veins of both eyes of 10 ITA patients were evaluated with color-Doppler-imaging before and one year after transplant. Peak systolic velocity (psv), end diastolic velocity (edv) for arteries and maximum velocity (maxv), minimum velocity (minv) for veins were recorded and compared with a control group of type 1 diabetic patients. At one year, a statistically significant increase of blood flow velocities of central retinal arteries (psv: 6.09+/-0.46 vs. 10.12+/-1.20 cm/s, P=0.01) and veins (maxv: 3.12+/-0.28 vs. 6.12+/-1.00 cm/s, P=0.01) was found only in the ITA patients. An early, significant increase of arterial and venous retinal blood flow velocities was found after ITA. PMID:16699454

  5. Medullary hemangioblastoma in a child with von Hippel-Lindau disease: vascular tumor perfusion depicted by arterial spin labeling and dynamic contrast-enhanced imaging.

    PubMed

    Goo, Hyun Woo; Ra, Young-Shin

    2015-07-01

    Medullary hemangioblastoma is very rare in children. Based on small nodular enhancement with peritumoral edema and without dilated feeding arteries on conventional MRI, hemangioblastoma, pilocytic astrocytoma, oligodendroglioma, and ganglioglioma were included in the differential diagnosis of the medullary tumor. In this case report, the authors emphasize the diagnostic value of arterial spin labeling and dynamic contrast-enhanced MRI in demonstrating vascular tumor perfusion of hemangioblastoma in a 12-year-old boy who was later found to have von Hippel-Lindau disease. PMID:25885801

  6. Enhancement of Autophagy by Simvastatin through Inhibition of Rac1-mTOR Signaling Pathway in Coronary Arterial Myocytes

    PubMed Central

    Wei, Yu-Miao; Li, Xiang; Xu, Ming; Abais, Justine M.; Chen, Yang; Riebling, Christopher R.; Boini, Krishna M.; Li, Pin-Lan; Zhang, Yang

    2013-01-01

    Background/Aims In addition to their action of lowering blood cholesterol levels, statins modulate biological characteristics and functions of arterial myocytes such as viability, proliferation, apoptosis, survival and contraction. The present study tested whether simvastatin, as a prototype statin, enhances autophagy in coronary arterial myocytes (CAMs) to thereby exert their beneficial effects in atherosclerosis. Methods and Results Using flow cytometry, we demonstrated that simvastatin significantly increased the autophagsome formation in CAMs. Western blot analysis confirmed that simvastatin significantly increased protein expression of typical autophagy markers LC3B and Beclin1 in these CAMs. Confocal microscopy further demonstrated that simvastatin increased fusion of autophagosomes with lysosomes, which was blocked by autophagy inhibitor 3-methyladenine or silencing of Atg7 genes. Simvastatin reduced mammalian target of rapamycin (mTOR) activity, which was reversed by Rac1-GTPase overexpression and the mTOR agonist phosphatidic acid. Moreover, both Rac1-GTPase overexpression and activation of mTOR by phosphatidic acid drastically blocked simvastatin-induced autophagosome formation in CAMs. Interestingly, simvastatin increased protein expression of a contractile phenotype marker calponin in CAMs, which was blocked by autophagy inhibitor 3-methyladenine. Simvastatin markedly reduced proliferation of CAMs under both control and proatherogenic stimulation. However, this inhibitory effect of simvastatin on CAM proliferation was blocked by by autophagy inhibitor 3-methyladenine or silencing of Atg7 genes. Lastly, animal experiments demonstrated that simvastatin increased protein expression of LC3B and calponin in mouse coronary arteries. Conclusion Our results indicate that simvastatin inhibits the Rac1-mTOR pathway and thereby increases autophagy in CAMs which may stabilize CAMs in the contractile phenotype to prevent proliferation and growth of these cells. PMID:23817226

  7. Coronary artery remodeling in non-contrast CT images

    NASA Astrophysics Data System (ADS)

    Xu, Haiyong; Zheng, Mingna; Yang, Yanhua; Carr, J. Jeffery; Ge, Yaorong

    2012-03-01

    A significant cause of coronary artery disease is the coronary atherosclerosis which leads to stenosis of coronary arteries. It has been shown in recent studies, using intravascular ultrasound and contrast-enhanced CT, that early atherosclerosis causes positive coronary artery remodeling, defined as increases in the cross-sectional area. It is hypothesized that detection of artery remodeling using non-contrast CT can be an important factor in sub-clinical assessment of cardiac risk for asymptomatic subjects. However, measuring remodeling in coronary arteries in non-contrast CT images is a challenging task because coronary arteries are small and the intensity of coronary arteries is similar to that of surrounding tissues. Automatic segmentation algorithms that have been successful in segmenting coronary arteries in contrast-enhanced images do not perform well. To overcome these difficulties, we developed an interactive application to enable effective measurement of coronary artery remodeling in non-contrast CT images. This application is an extension to the 3D Slicer image analysis platform. It allows users to visualize and trace the centerline of arteries in cross sectional views. The artery centerlines are displayed in a three dimensional view overlaid on the original image volume and color-coded according to the artery labels. Using this 3D artery model, the user can sample the cross-sectional area of the arteries at selected points for remodeling assessment. Initial validation has demonstrated the effectiveness of this method. A pilot study also showed positive correlation of large coronary artery remodeling with highest lifetime risks. Further evaluation is underway using larger study size and more measurement points.

  8. Impaired LRP6-TCF7L2 Activity Enhances Smooth Muscle Cell Plasticity and Causes Coronary Artery Disease.

    PubMed

    Srivastava, Roshni; Zhang, Jiasheng; Go, Gwang-Woong; Narayanan, Anand; Nottoli, Timothy P; Mani, Arya

    2015-10-27

    Mutations in Wnt-signaling coreceptor LRP6 have been linked to coronary artery disease (CAD) by unknown mechanisms. Here, we show that reduced LRP6 activity in LRP6(R611C) mice promotes loss of vascular smooth muscle cell (VSMC) differentiation, leading to aortic medial hyperplasia. Carotid injury augmented these effects and led to partial to total vascular obstruction. LRP6(R611C) mice on high-fat diet displayed dramatic obstructive CAD and exhibited an accelerated atherosclerotic burden on LDLR knockout background. Mechanistically, impaired LRP6 activity leads to enhanced non-canonical Wnt signaling, culminating in diminished TCF7L2 and increased Sp1-dependent activation of PDGF signaling. Wnt3a administration to LRP6(R611C) mice improved LRP6 activity, led to TCF7L2-dependent VSMC differentiation, and rescued post-carotid-injury neointima formation. These findings demonstrate the critical role of intact Wnt signaling in the vessel wall, establish a causal link between impaired LRP6/TCF7L2 activities and arterial disease, and identify Wnt signaling as a therapeutic target against CAD. PMID:26489464

  9. Intense adrenal enhancement in patients with acute pancreatitis and early organ failure.

    PubMed

    Bollen, T L; van Santvoort, H C; Besselink, M G H; van Ramshorst, B; van Es, H W; Gooszen, H G

    2007-10-01

    Intense adrenal enhancement has previously been reported in patients with hypovolemic and septic shock. The purpose of this study was to assess whether this computed tomography (CT) finding is also observed in patients presenting with severe acute pancreatitis and early organ failure. A retrospective analysis of a prospectively collected database was performed. Out of 38 consecutive patients with predicted severe acute pancreatitis, 3 patients showed intense bilateral adrenal enhancement on early CT. All patients had early multiple organ failure and subsequently died. In two cases, pathologic correlation was obtained. Intense adrenal enhancement may be a new prognostic indicator in patients with acute pancreatitis, particularly when organ failure is present at the time of CT examination. Further studies are necessary to confirm this observation. PMID:17594117

  10. Dual-mode microwave system to enhance early detection of cancer

    NASA Technical Reports Server (NTRS)

    Carr, K. L.; El-Mahdi, A. M.; Shaeffer, J.

    1981-01-01

    A dual-mode microwave system has been developed that will permit early detection of cancer. The system combines the use of the passive microwave radiometer with an active transmitter. The active transmitter will provide localized heating to enhance early detection by taking advantage of the differential heating (i.e., tumor temperature with respect to surrounding tissue) associated with the thermal characteristics of tumors.

  11. cAMP facilitates EDHF-type relaxations in conduit arteries by enhancing electrotonic conduction via gap junctions

    PubMed Central

    Griffith, Tudor M.; Chaytor, Andrew T.; Taylor, Hannah J.; Giddings, Beverley D.; Edwards, David H.

    2002-01-01

    We have investigated the role of cAMP in NO- and prostanoid-independent relaxations that are widely attributed to an endothelium-derived hyperpolarizing factor (EDHF). Under control conditions EDHF-type relaxations evoked by acetylcholine (ACh) in rabbit iliac arteries were transient, but in the presence of the cAMP phosphodiesterase inhibitor isobutylmethylxanthine (IBMX) or the cell permeant cAMP analog 8-bromo-cAMP, relaxations became sustained with their maxima potentiated ?2-fold. Relaxation was associated with transient ?1.5-fold elevations in smooth muscle cAMP levels with both mechanical and nucleotide responses being abolished by interrupting gap junctional communication with the connexin-mimetic peptide Gap 27 and by endothelial denudation. However, IBMX induced a sustained endothelium-independent ?2-fold rise in cAMP levels, which was not further amplified by ACh, suggesting that the contribution of cAMP to the EDHF phenomenon is permissive. After selective loading of the endothelium with calcein AM, direct transfer of dye from the endothelium to the media was enhanced by IBMX or 8-bromo-cAMP, but not by 8-bromo-cGMP, whereas Gap 27 promoted sequestration within the intima. ACh-induced hyperpolarizations of subintimal smooth muscle in arterial strips with intact endothelium were abolished by Gap 27 and the adenylyl cyclase inhibitor 2?,5?-dideoxyadenosine but were unaffected by IBMX. By contrast, in strips partially denuded of endothelium, IBMX enhanced the transmission of hyperpolarization from the endothelium to remote smooth muscle cells. These findings support the hypothesis that endothelial hyperpolarization underpins the EDHF phenomenon, with cAMP governing subsequent electrotonic signaling via both myoendothelial and homocellular smooth muscle gap junctions. PMID:11972050

  12. Comprehensive Population-Averaged Arterial Input Function for Dynamic Contrast–Enhanced vMagnetic Resonance Imaging of Head and Neck Cancer

    SciTech Connect

    Onxley, Jennifer D.; Yoo, David S.; Muradyan, Naira; MacFall, James R.; Brizel, David M.; Craciunescu, Oana I.

    2014-07-01

    Purpose: To generate a population-averaged arterial input function (PA-AIF) for quantitative analysis of dynamic contrast-enhanced MRI data in head and neck cancer patients. Methods and Materials: Twenty patients underwent dynamic contrast-enhanced MRI during concurrent chemoradiation therapy. Imaging consisted of 2 baseline scans 1 week apart (B1/B2) and 1 scan after 1 week of chemoradiation therapy (Wk1). Regions of interest (ROIs) in the right and left carotid arteries were drawn on coronal images. Plasma concentration curves of all ROIs were averaged and fit to a biexponential decay function to obtain the final PA-AIF (AvgAll). Right-sided and left-sided ROI plasma concentration curves were averaged separately to obtain side-specific AIFs (AvgRight/AvgLeft). Regions of interest were divided by time point to obtain time-point-specific AIFs (AvgB1/AvgB2/AvgWk1). The vascular transfer constant (K{sub trans}) and the fractional extravascular, extracellular space volume (V{sub e}) for primaries and nodes were calculated using the AvgAll AIF, the appropriate side-specific AIF, and the appropriate time-point-specific AIF. Median K{sub trans} and V{sub e} values derived from AvgAll were compared with those obtained from the side-specific and time-point-specific AIFs. The effect of using individual AIFs was also investigated. Results: The plasma parameters for AvgAll were a{sub 1,2} = 27.11/17.65 kg/L, m{sub 1,2} = 11.75/0.21 min{sup −1}. The coefficients of repeatability (CRs) for AvgAll versus AvgLeft were 0.04 min{sup −1} for K{sub trans} and 0.02 for V{sub e}. For AvgAll versus AvgRight, the CRs were 0.08 min{sup −1} for K{sub trans} and 0.02 for V{sub e}. When AvgAll was compared with AvgB1/AvgB2/AvgWk1, the CRs were slightly higher: 0.32/0.19/0.78 min{sup −1}, respectively, for K{sub trans}; and 0.07/0.08/0.09 for V{sub e}. Use of a PA-AIF was not significantly different from use of individual AIFs. Conclusion: A PA-AIF for head and neck cancer was generated that accounts for differences in right carotid artery versus left carotid artery, day-to-day fluctuations, and early treatment-induced changes. The small CRs obtained for K{sub trans} and V{sub e} indicate that side-specific AIFs are not necessary. However, a time-point-specific AIF may improve pharmacokinetic accuracy.

  13. Enhancing early child care quality and learning for toddlers at risk: the responsive early childhood program.

    PubMed

    Landry, Susan H; Zucker, Tricia A; Taylor, Heather B; Swank, Paul R; Williams, Jeffrey M; Assel, Michael; Crawford, April; Huang, Weihua; Clancy-Menchetti, Jeanine; Lonigan, Christopher J; Phillips, Beth M; Eisenberg, Nancy; Spinrad, Tracy L; de Villiers, Jill; de Villiers, Peter; Barnes, Marcia; Starkey, Prentice; Klein, Alice

    2014-02-01

    Despite reports of positive effects of high-quality child care, few experimental studies have examined the process of improving low-quality center-based care for toddler-age children. In this article, we report intervention effects on child care teachers' behaviors and children's social, emotional, behavioral, early literacy, language, and math outcomes as well as the teacher-child relationship. The intervention targeted the use of a set of responsive teacher practices, derived from attachment and sociocultural theories, and a comprehensive curriculum. Sixty-five childcare classrooms serving low-income 2- and 3-year-old children were randomized into 3 conditions: business-as-usual control, Responsive Early Childhood Curriculum (RECC), and RECC plus explicit social-emotional classroom activities (RECC+). Classroom observations showed greater gains for RECC and RECC+ teachers' responsive practices including helping children manage their behavior, establishing a predictable schedule, and use of cognitively stimulating activities (e.g., shared book reading) compared with controls; however, teacher behaviors did not differ for focal areas such as sensitivity and positive discipline supports. Child assessments demonstrated that children in the interventions outperformed controls in areas of social and emotional development, although children's performance in control and intervention groups was similar for cognitive skills (language, literacy, and math). Results support the positive impact of responsive teachers and environments providing appropriate support for toddlers' social and emotional development. Possible explanations for the absence of systematic differences in children's cognitive skills are considered, including implications for practice and future research targeting low-income toddlers. PMID:23772822

  14. Endothelin-1 contributes to endothelial dysfunction and enhanced vasoconstriction through augmented superoxide production in penile arteries from insulin-resistant obese rats: role of ETA and ETB receptors

    PubMed Central

    Sánchez, A; Martínez, P; Muñoz, M; Benedito, S; García-Sacristán, A; Hernández, M; Prieto, D

    2014-01-01

    Background and Purpose We assessed whether endothelin-1 (ET-1) inhibits NO and contributes to endothelial dysfunction in penile arteries in a model of insulin resistance-associated erectile dysfunction (ED). Experimental Approach Vascular function was assessed in penile arteries, from obese (OZR) and lean (LZR) Zucker rats, mounted in microvascular myographs. Changes in basal and stimulated levels of superoxide (O2−) were detected by lucigenin-enhanced chemiluminescence and ET receptor expression was determined by immunohistochemistry. Key Results ET-1 stimulated acute O2− production that was blunted by tempol and the NADPH oxidase inhibitor, apocynin, but markedly enhanced in obese animals. ET-1 inhibited the vasorelaxant effects of ACh and of the NO donor S-nitroso-N-acetyl-DL-penicillamine in arteries from both LZR and OZR. Selective ETA (BQ123) or ETB receptor (BQ788) antagonists reduced both basal and ET-1-stimulated superoxide generation and reversed ET-1-induced inhibition of NO-mediated relaxations in OZR, while only BQ-123 antagonized ET-1 actions in LZR. ET-1-induced vasoconstriction was markedly enhanced by NO synthase blockade and reduced by endothelium removal and apocynin. In endothelium-denuded penile arteries, apocynin blunted augmented ET-1-induced contractions in OZR. Both ETA and ETB receptors were expressed in smooth muscle and the endothelial layer and up-regulated in arteries from OZR. Conclusions and Implications ET-1 stimulates ETA-mediated NADPH oxidase-dependent ROS generation, which inhibits endothelial NO bioavailability and contributes to ET-1-induced contraction in healthy penile arteries. Enhanced vascular expression of ETB receptors contributes to augmented ROS production, endothelial dysfunction and increased vasoconstriction in erectile tissue from insulin-resistant obese rats. Hence, antagonism of ETB receptors might improve the ED associated with insulin-resistant states. PMID:25091502

  15. Modulation of the effects of norepinephrine uptake inhibitors on the norepinephrine-induced contractile response of the porcine uterine artery during early pregnancy.

    PubMed Central

    Laporte, R; DeRoth, L

    1997-01-01

    The effects of norepinephrine (NE) uptake inhibitors on the porcine uterine artery's contractile response to NE and their potential alteration during early pregnancy (Day 13 postcoitus; day of coitus = Day 0) in comparison with the end of the luteal phase (Days 11-14; first day of behavioral estrus = Day 0) was investigated. This pregnancy time point is characterized by a transient increase in resting uterine blood flow dependent on the presence of blastocysts, an increased endometrial vascular permeability, and the beginning of the endometrial attachment of the blastocysts. A cumulative concentration-response curve (CCRC) to NE was produced in isometrically-mounted rings. Cocaine (5 microM) was used to inhibit neuronal NE uptake and hydrocortisone (30 microM) was used to inhibit extraneuronal NE uptake. Either drug alone induced a leftward shift of the CCRC to NE without affecting the maximal response. This shift had the same amplitude at the end of the luteal phase and in early pregnancy. However, the leftward shift induced by cocaine was larger than that induced by hydrocortisone only in early pregnancy, and the leftward shift induced by exposure to both hydrocortisone and cocaine was larger in early pregnancy than at the end of the luteal phase. These results suggest that a significant sensitization of the contractile response of the porcine uterine artery to NE is induced by neuronal and extraneuronal uptake inhibitors and that this effect is altered in early pregnancy, possibly reflecting the existence of a mechanism protecting the uterine artery against excessive sympathetic stimulation. PMID:9243002

  16. Pseudoaneurysm Formation Following Intrasphenoid Rupture of an Idiopathic Intracavernous Carotid Artery Aneurysm: Coil Migration and Early Recurrence after Endovascular Treatment

    PubMed Central

    De Blasi, R.; Bracciolini, E.; Chiumarulo, L.; Salvati, A.; Monetti, C.; Federico, F.; Carella, A.

    2010-01-01

    Summary Intrasphenoid rupture of a non-traumatic aneurysm of the cavernous carotid artery is rare. We describe a patient in whom this condition manifested with epistaxis and led to the formation of a pseudoaneurysm occupying the right sphenoid sinus. The lesion recurred after repeated attempts at conservative endovascular therapy. Eventually the patient was treated with endovascular occlusion of the right internal carotid artery. Our report emphasizes the relapsing behaviour of a non-traumatic aneurysm of the cavernous portion of the internal carotid artery ruptured into the sphenoid sinus. PMID:21162775

  17. 78 FR 13294 - Enhanced Prudential Standards and Early Remediation Requirements for Foreign Banking...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ... proposed rule published December 28, 2012 (77 FR 76628) is extended from March 31, 2013 to April 30, 2013... Requirements for Foreign Banking Organizations and Foreign Nonbank Financial Companies, 77 FR 76628 (December... CFR Part 252 RIN 7100-AD-86 Enhanced Prudential Standards and Early Remediation Requirements...

  18. Development of the Play Experience Model to Enhance Desirable Qualifications of Early Childhood

    ERIC Educational Resources Information Center

    Panpum, Watchara; Soonthornrojana, Wimonrat; Nakunsong, Thatsanee

    2015-01-01

    The objectives of this research were to develop the play experience model and to study the effect of usage in play experience model for enhancing the early childhood's desirable qualification. There were 3 phases of research: 1) the document and context in experience management were studied, 2) the play experience model was developed, and 3) the…

  19. Development of the Play Experience Model to Enhance Desirable Qualifications of Early Childhood

    ERIC Educational Resources Information Center

    Panpum, Watchara; Soonthornrojana, Wimonrat; Nakunsong, Thatsanee

    2015-01-01

    The objectives of this research were to develop the play experience model and to study the effect of usage in play experience model for enhancing the early childhood's desirable qualification. There were 3 phases of research: 1) the document and context in experience management were studied, 2) the play experience model was developed, and 3) the

  20. Feedback Seeking in Early Adolescence: Self-Enhancement or Self-Verification?

    ERIC Educational Resources Information Center

    Rosen, Lisa H.; Principe, Connor P.; Langlois, Judith H.

    2013-01-01

    The authors examined whether early adolescents ("N" = 90) solicit self-enhancing feedback (i.e., positive feedback) or self-verifying feedback (i.e., feedback congruent with self-views, even when these views are negative). Sixth, seventh, and eighth graders first completed a self-perception measure and then selected whether to receive…

  1. Feedback Seeking in Early Adolescence: Self-Enhancement or Self-Verification?

    ERIC Educational Resources Information Center

    Rosen, Lisa H.; Principe, Connor P.; Langlois, Judith H.

    2013-01-01

    The authors examined whether early adolescents ("N" = 90) solicit self-enhancing feedback (i.e., positive feedback) or self-verifying feedback (i.e., feedback congruent with self-views, even when these views are negative). Sixth, seventh, and eighth graders first completed a self-perception measure and then selected whether to receive

  2. Enhancing Early Child-Parent Relationships: Implications of Adult Attachment Research.

    ERIC Educational Resources Information Center

    Berlin, Lisa J.; Cassidy, Jude

    2001-01-01

    After reviewing attachment research, this article argues enhancing early child-parent relationships involves two principle tasks: helping parents identify children's needs and parents' responses to these needs; and helping parents gain insight into how their "states of mind with respect to attachment" influence their parenting behaviors and their…

  3. Enhancing early bladder cancer detection with fluorescence-guided endoscopic optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Pan, Y. T.; Xie, T. Q.; Du, C. W.; Bastacky, S.; Meyers, S.; Zeidel, M. L.

    2003-12-01

    We report an experimental study of the possibility of enhancing early bladder cancer diagnosis with fluorescence-image-guided endoscopic optical coherence tomography (OCT). After the intravesical instillation of a 10% solution of 5-aminolevulinic acid, simultaneous fluorescence imaging (excitation of 380-420 nm, emission of 620-700 nm) and OCT are performed on rat bladders to identify the photochemical and morphological changes associated with uroepithelial tumorigenesis. The preliminary results of our ex vivo study reveal that both fluorescence and OCT can identify early uroepithelial cancers, and OCT can detect precancerous lesions (e.g., hyperplasia) that fluorescence may miss. This suggests that a cystoscope combining 5-aminolevulinic acid fluorescence and OCT imaging has the potential to enhance the efficiency and sensitivity of early bladder cancer diagnosis.

  4. Music and speech listening enhance the recovery of early sensory processing after stroke.

    PubMed

    Srkm, Teppo; Pihko, Elina; Laitinen, Sari; Forsblom, Anita; Soinila, Seppo; Mikkonen, Mikko; Autti, Taina; Silvennoinen, Heli M; Erkkil, Jaakko; Laine, Matti; Peretz, Isabelle; Hietanen, Marja; Tervaniemi, Mari

    2010-12-01

    Our surrounding auditory environment has a dramatic influence on the development of basic auditory and cognitive skills, but little is known about how it influences the recovery of these skills after neural damage. Here, we studied the long-term effects of daily music and speech listening on auditory sensory memory after middle cerebral artery (MCA) stroke. In the acute recovery phase, 60 patients who had middle cerebral artery stroke were randomly assigned to a music listening group, an audio book listening group, or a control group. Auditory sensory memory, as indexed by the magnetic MMN (MMNm) response to changes in sound frequency and duration, was measured 1 week (baseline), 3 months, and 6 months after the stroke with whole-head magnetoencephalography recordings. Fifty-four patients completed the study. Results showed that the amplitude of the frequency MMNm increased significantly more in both music and audio book groups than in the control group during the 6-month poststroke period. In contrast, the duration MMNm amplitude increased more in the audio book group than in the other groups. Moreover, changes in the frequency MMNm amplitude correlated significantly with the behavioral improvement of verbal memory and focused attention induced by music listening. These findings demonstrate that merely listening to music and speech after neural damage can induce long-term plastic changes in early sensory processing, which, in turn, may facilitate the recovery of higher cognitive functions. The neural mechanisms potentially underlying this effect are discussed. PMID:19925203

  5. Enhanced response to AVP in the interlobular artery from the spontaneously hypertensive rat.

    PubMed

    Hansen, Frank H; Vgnes, yvind B; Iversen, Bjarne M

    2005-05-01

    Arginine vasopressin (AVP) induces exaggerated intracellular free calcium (Cai2+) responses in preglomerular smooth muscle cells from young spontaneously hypertensive rats (SHR) due to increased density of the AVP V1a receptor. The intention of the present paper was to examine the relative contribution of afferent arterioles (AA) and interlobular artery (ILA) in AVP- and norepinephrine-induced calcium signaling. The kidneys were perfused with agar solution in vivo, and thin cortical slices were enzyme digested to produce isolated agar-filled vascular fragments. Calcium responses were recorded in fura 2-loaded cells by Ca2+ imaging. Diameter changes were measured after AVP stimulation and mRNA for V1a was measured on isolated vessel fragments. SHR had a significantly higher baseline calcium ratio and lower resting diameter compared with normotensive Wistar-Kyoto rats (WKY). Stimulation with AVP (10(-7) M) in ILA fragments from SHR induced a ratio increase of 0.49 +/- 0.09, significantly higher than the ratio increase in AA from SHR (0.20 +/- 0.03, P < 0.01) and in ILA from WKY (0.24 +/- 0.03, P < 0.01). Stimulation with norepinephrine (10(-7) M) induced responses homogeneously distributed between the segments and strains. Nifedipine treatment or removal of external calcium (Cao2+) reduced the norepinephrine-induced peak response. Both norepinephrine- and AVP-induced sustained responses were abolished after Cao2+ removal in SHR and WKY (P < 0.01). Measurements of V1a receptor mRNA on isolated segments showed a threefold increase in ILA from SHR. The present findings indicate that the exaggerated Ca2+ and contractile response to AVP in SHR is mainly mediated through ILA vasoconstriction. PMID:15598845

  6. Grey scale enhancement by a new self-made contrast agent in early cirrhotic stage of rabbit liver

    PubMed Central

    Zhang, Li; Duan, Yun-You; Yin, Ji-Kai; Cui, Ji-Hong; Zhang, Yong; Cao, Tie-Sheng

    2007-01-01

    Background The development of new ultrasound contrast agents (UCAs) has become one of the most promising fields in ultrasound medicine. This paper evaluates a new self-made contrast agent enhancement effect developed to study the fibrotic stages of the liver in perfusion models in vivo. Methods We constructed experimental models of hepatic fibrosis involving five stages from F0 to F4 via administration of CCL4 (0.01 ml/kg BW) every 3 days for 3 months. The intrahepatic circulatory time of the contrast agent was analyzed via an image and Cine-loop display. Calculations of the perfusion-related parameters including the peak signal intensity (PSI) and peak signal intensity time (PIT) of the portal vein and parenchyma were obtained from an analysis of the time-acoustic intensity curve. Results Hepatic artery to vein transmit time (HA-HVTT) was significantly shorter at F4 stage (mean 5.1 seconds) compared with those in other stages (mean 8.3 s, 7.5 s, 6.9 s, 6.6 s, P < 0.01). The average PSI difference of PV-parenchyma was 13.62 dB in F4 stage, demonstrating significant differences between F4 stage and other early stages (P < 0.001). Conclusion These results indicate that the new self-made contrast agent is capable of indicating intrahepatic hemodynamic changes. HA-HVTT and the PSI difference of the microbubble perfusion in liver parenchyma and PV were considered to differentiate the degree of hepatic fibrosis between F4 and other early stages. PMID:17686161

  7. Natural History of the Early Repolarization Pattern in a Biracial Cohort: CARDIA (Coronary Artery Risk Development in Young Adults) Study

    PubMed Central

    Walsh, Joseph A.; Ilkhanoff, Leonard; Soliman, Elsayed Z.; Prineas, Ronald; Liu, Kiang; Ning, Hongyan; Lloyd-Jones, Donald M.

    2013-01-01

    Objectives The objective of this analysis was to determine the natural history and prospective association of cardiovascular risk factors with early repolarization (ER). Background ER is common and has been suggested to increase risk for cardiovascular mortality in middle-aged adults. Data are sparse regarding the natural history of ER from young adulthood to middle age. Methods We examined 5,069 participants (mean age 25 years at baseline; 40% black) from the CARDIA (Coronary Artery Risk Development in Young Adults) cohort over 20 years. Electrocardiograms were recorded at years 0 (Y0), 7 (Y7), and 20 (Y20) and coded as either definite, probable, possible, or no ER. Logistic regression was used to determine the association of cardiovascular risk factors with the presence of ER cross-sectionally and prospectively. Results A total of 941 of the 5,069 participants (18.6%) had definite ER at baseline, and only 119 of 2,505 participants (4.8%) at the Y20 examination still demonstrated the presence of ER. Younger age, black race, male sex, longer exercise duration and QRS duration, and lower body mass index (BMI), heart rate, QT index, and Cornell voltage were associated cross-sectionally with the presence of ER. Predictors of maintenance of ER from Y0 to Y20 were black race (odds ratio [OR]: 2.62; 95% CI; 1.61 to 4.25), BMI (OR: 0.62 per 1 SD; 95% CI: 0.40 to 0.94), serum triglyceride levels (OR: 0.66 per 1 SD; 95% CI: 0.45 to 0.98), and QRS duration (OR: 1.68 per 1 SD; 95% CI: 1.37 to 2.06) at baseline. Conclusions The prevalence of ER was significantly higher than previous estimates among asymptomatic young adults, and the majority of ER regressed by middle age. Black race, lower BMI, lower serum triglyceride levels, and longer QRS duration were independently associated with maintenance of ER over time. PMID:23428218

  8. Cerebrospinal Fluid Enhancement on Fluid Attenuated Inversion Recovery Images After Carotid Artery Stenting with Neuroprotective Balloon Occlusions: Hemodynamic Instability and Blood-Brain Barrier Disruption

    SciTech Connect

    Ogami, Ryo Nakahara, Toshinori; Hamasaki, Osamu; Araki, Hayato; Kurisu, Kaoru

    2011-10-15

    Purpose: A rare complication of carotid artery stenting (CAS), prolonged reversible neurological symptoms with delayed cerebrospinal fluid (CSF) space enhancement on fluid attenuated inversion recovery (FLAIR) images, is associated with blood-brain barrier (BBB) disruption. We prospectively identified patients who showed CSF space enhancement on FLAIR images. Methods: Nineteen patients-5 acute-phase and 14 scheduled-underwent 21 CAS procedures. Balloon catheters were navigated across stenoses, angioplasty was performed using a neuroprotective balloon, and stents were placed with after dilation under distal balloon protection. CSF space hyperintensity or obscuration on FLAIR after versus before CAS indicated CSF space enhancement. Correlations with clinical factors were examined. Results: CSF space was enhanced on FLAIR in 12 (57.1%) cases. Postprocedural CSF space enhancement was significantly related to age, stenosis rate, acute-stage procedure, and total occlusion time. All acute-stage CAS patients showed delayed enhancement. Only age was associated with delayed CSF space enhancement in scheduled CAS patients. Conclusions: Ischemic intolerance for severe carotid artery stenosis and temporary neuroprotective balloon occlusion, causing reperfusion injury, seem to be the main factors that underlie BBB disruption with delayed CSF space enhancement shortly after CAS, rather than sudden poststenting hemodynamic change. Our results suggest that factors related to hemodynamic instability or ischemic intolerance seem to be associated with post-CAS BBB vulnerability. Patients at risk for hemodynamic instability or with ischemic intolerance, which decrease BBB integrity, require careful management to prevent intracranial hemorrhagic and other post-CAS complications.

  9. Persistently high venous-to-arterial carbon dioxide differences during early resuscitation are associated with poor outcomes in septic shock

    PubMed Central

    2013-01-01

    Introduction Venous-to-arterial carbon dioxide difference (Pv-aCO2) may reflect the adequacy of blood flow during shock states. We sought to test whether the development of Pv-aCO2 during the very early phases of resuscitation is related to multi-organ dysfunction and outcomes in a population of septic shock patients resuscitated targeting the usual oxygen-derived and hemodynamic parameters. Methods We conducted a prospective observational study in a 60-bed mixed ICU in a University affiliated Hospital. 85 patients with a new septic shock episode were included. A Pv-aCO2 value ? 6 mmHg was considered to be high. Patients were classified in four predefined groups according to the Pv-aCO2 evolution during the first 6 hours of resuscitation: (1) persistently high Pv-aCO2 (high at T0 and T6); (2) increasing Pv-aCO2 (normal at T0, high at T6); (3) decreasing Pv-aCO2 (high at T0, normal at T6); and (4) persistently normal Pv-aCO2 (normal at T0 and T6). Multiorgan dysfunction at day-3 was compared for predefined groups and a Kaplan Meier curve was constructed to show the survival probabilities at day-28 using a log-rank test to evaluate differences between groups. A Spearman-Rho was used to test the agreement between cardiac output and Pv-aCO2. Finally, we calculated the mortality risk ratios at day-28 among patients attaining normal oxygen parameters but with a concomitantly increased Pv-aCO2. Results Patients with persistently high and increasing Pv-aCO2 at T6 had significant higher SOFA scores at day-3 (p < 0.001) and higher mortality rates at day-28 (log rank test: 19.21, p < 0.001) compared with patients who evolved with normal Pv-aCO2 at T6. Interestingly, a poor agreement between cardiac output and Pv-aCO2 was observed (r2 = 0.025, p < 0.01) at different points of resuscitation. Patients who reached a central venous saturation (ScvO)2 ? 70% or mixed venous oxygen saturation (SvO2) ? 65% but with concomitantly high Pv-aCO2 at different developmental points (i.e., T0, T6 and T12) had a significant mortality risk ratio at day-28. Conclusion The persistence of high Pv-aCO2 during the early resuscitation of septic shock was associated with more severe multi-organ dysfunction and worse outcomes at day-28. Although mechanisms conducting to increase Pv-aCO2 during septic shock are insufficiently understood, Pv-aCO2 could identify a high risk of death in apparently resuscitated patients. PMID:24330804

  10. Disseminated arterial calcification and enhanced myogenic response are associated with Abcc6 deficiency in a mouse model of pseudoxanthoma elasticum

    PubMed Central

    Kauffenstein, G; Pizard, A; Le Corre, Y; Vessières, E; Grimaud, L; Toutain, B; Labat, C; Mauras, Y; Gorgels, TG; Bergen, AA; Le Saux, O; Lacolley, P; Lefthériotis, G; Henrion, D; Martin, L

    2015-01-01

    Objective Pseudoxanthoma elasticum (PXE) is an inherited metabolic disorder due to ABCC6 gene mutations. It is characterized by progressive calcification and fragmentation of elastic fibers in the skin, retina and the arterial wall. Despite calcium accumulation in the arteries of PXE patients, functional consequences remain unknown. In the present study, we investigated arterial structure and function in Abcc6−/− mice, a model of the human disease. Approach and Results Arterial calcium accumulation was evaluated using alizarin red stain and atomic absorption spectrometry. Expression of genes involved in osteochondrogenic differenciation was measured by PCR. Elastic arterial properties were evaluated by carotid echo-tracking. Vascular reactivity was evaluated using wire and pressure myography and remodeling using histomorphometry. Arterial calcium accumulation was 1.5–2-fold higher in Abcc6−/− than in WT mice. Calcium accumulated locally leading to punctuate pattern. Old Abcc6−/− arteries expressed markers of both osteogenic (Runx2, osteopontin) and chondrogenic lineage (Sox9, type II collagen). Abcc6−/− arteries displayed slight increase in arterial stiffness and vasoconstrictor tone in vitro tended to be higher in response to phenylephrine and thromboxane A2. Pressure-induced (myogenic) tone was significantly higher in Abcc6−/− arteries than in WT. Arterial blood pressure was not significantly changed in Abcc6−/−, despite higher variability. Conclusions Scattered arterial calcium depositions are probably due to osteochondrogenic transdifferentiation of vascular cells. Lower elasticity and increased myogenic tone without major changes in agonist-dependent contraction evidenced in aged Abcc6−/− mice suggest a reduced control of local blood flow, which in turn may alter vascular homeostasis in the long term. PMID:24675664

  11. Routine Use of Three-Dimensional Contrast-Enhanced Moving-Table MR Angiography in Patients with Peripheral Arterial Occlusive Disease: Comparison with Selective Digital Subtraction Angiography

    SciTech Connect

    Deutschmann, Hannes A.; Schoellnast, Helmut; Portugaller, Horst R.; Preidler, Klaus W.; Reittner, Pia; Tillich, Manfred; Pilger, Ernst; Szolar, Dieter H. M.

    2006-10-15

    Purpose. To compare the diagnostic accuracy of contrast-enhanced (CE) three-dimensional (3D) moving-table magnetic resonance (MR) angiography with that of selective digital subtraction angiography (DSA) for routine clinical investigation in patients with peripheral arterial occlusive disease. Methods. Thirty-eight patients underwent CE 3D moving-table MR angiography of the pelvic and peripheral arteries. A commercially available large-field-of-view adapter and a dedicated peripheral vascular phased-array coil were used. MR angiograms were evaluated for grade of arterial stenosis, diagnostic quality, and presence of artifacts. MR imaging results for each patient were compared with those of selective DSA. Results. Two hundred and twenty-six arterial segments in 38 patients were evaluated by both selective DSA and MR angiography. No complications related to MR angiography were observed. There was agreement in stenosis classification in 204 (90.3%) segments; MR angiography overgraded 16 (7%) segments and undergraded 6 (2.7%) segments. Compared with selective DSA, MR angiography provided high sensitivity and specificity and excellent interobserver agreement for detection of severe stenosis (97% and 95%, {kappa} = 0.9 {+-} 0.03) and moderate stenosis (96.5% and 94.3%, {kappa} = 0.9 {+-} 0.03). Conclusion. Compared with selective DSA, moving-table MR angiography proved to be an accurate, noninvasive method for evaluation of peripheral arterial occlusive disease and may thus serve as an alternative to DSA in clinical routine.

  12. Combination of early and delayed ischemic postconditioning enhances brain-derived neurotrophic factor production by upregulating the ERK-CREB pathway in rats with focal ischemia

    PubMed Central

    WU, HUI; YANG, SHAO-FENG; DAI, JIONG; QIU, YONG-MING; MIAO, YI-FENG; ZHANG, XIAO-HUA

    2015-01-01

    Ischemic postconditioning, including early and delayed ischemic postconditioning, has been recognized as a simple and promising strategy in the treatment of stroke. However, the effects of the combination of early and delayed ischemic postconditioning, and the mechanisms underlying these effects, remain unclear. The aim of the present study was to determine whether the combination of early and delayed ischemic postconditioning offers greater protection against stroke, and enhances the production of brain-derived neurotrophic factor (BDNF). A combination of early and delayed ischemic postconditioning was established by repeated, transient occlusion and reperfusion of the ipsilateral common carotid artery in a rat model of middle cerebral artery occlusion. Infarct size, motor function, cerebral blood flow and brain edema were then evaluated, in order to confirm the effects of combinative ischemic postconditioning. TUNEL staining was used to analyze the rate of apoptosis of cells in the penumbral area. BDNF, extracellular signal-regulated kinases 1/2 (ERK1/2) and cAMP response element-binding protein (CREB) expression was detected using immunofluorescence staining and western blot analysis. The results of the present study indicated that the combination of early and delayed ischemic postconditioning further reduced the infarct volume, stabilized cerebral blood disturbance and attenuated neuronal apoptosis, compared with either alone. However, combinative postconditioning exerted the same effect on neurological function and brain edema, compared with early or delayed ischemic postconditioning alone. Further investigation indicated that combinative ischemic postconditioning increased the expression of BDNF, and a significantly higher number of BDNF-positive cells was observed in neurons and astrocytes from the combined group than in the early or delayed groups. Combinative ischemic postconditioning also induced the phosphorylation of ERK1/2 and CREB in the cortex, following focal ischemia. The results of the present study suggest that the combination of early and delayed ischemic postconditioning may further reduce brain ischemic reperfusion injury following focal ischemia, compared with either treatment alone. In addition, it induces the production of BDNF in neurons and astrocytes. Furthermore, the effects of combinative ischemic postconditioning may be mediated by the activation of ERK1/2 and CREB. PMID:26398857

  13. Combination of early and delayed ischemic postconditioning enhances brain-derived neurotrophic factor production by upregulating the ERK-CREB pathway in rats with focal ischemia.

    PubMed

    Wu, Hui; Yang, Shao-Feng; Dai, Jiong; Qiu, Yong-Ming; Miao, Yi-Feng; Zhang, Xiao-Hua

    2015-11-01

    Ischemic postconditioning, including early and delayed ischemic postconditioning, has been recognized as a simple and promising strategy in the treatment of stroke. However, the effects of the combination of early and delayed ischemic postconditioning, and the mechanisms underlying these effects, remain unclear. The aim of the present study was to determine whether the combination of early and delayed ischemic postconditioning offers greater protection against stroke, and enhances the production of brain‑derived neurotrophic factor (BDNF). A combination of early and delayed ischemic postconditioning was established by repeated, transient occlusion and reperfusion of the ipsilateral common carotid artery in a rat model of middle cerebral artery occlusion. Infarct size, motor function, cerebral blood flow and brain edema were then evaluated, in order to confirm the effects of combinative ischemic postconditioning. TUNEL staining was used to analyze the rate of apoptosis of cells in the penumbral area. BDNF, extracellular signal‑regulated kinases 1/2 (ERK1/2) and cAMP response element‑binding protein (CREB) expression was detected using immunofluorescence staining and western blot analysis. The results of the present study indicated that the combination of early and delayed ischemic postconditioning further reduced the infarct volume, stabilized cerebral blood disturbance and attenuated neuronal apoptosis, compared with either alone. However, combinative postconditioning exerted the same effect on neurological function and brain edema, compared with early or delayed ischemic postconditioning alone. Further investigation indicated that combinative ischemic postconditioning increased the expression of BDNF, and a significantly higher number of BDNF‑positive cells was observed in neurons and astrocytes from the combined group than in the early or delayed groups. Combinative ischemic postconditioning also induced the phosphorylation of ERK1/2 and CREB in the cortex, following focal ischemia. The results of the present study suggest that the combination of early and delayed ischemic postconditioning may further reduce brain ischemic reperfusion injury following focal ischemia, compared with either treatment alone. In addition, it induces the production of BDNF in neurons and astrocytes. Furthermore, the effects of combinative ischemic postconditioning may be mediated by the activation of ERK1/2 and CREB. PMID:26398857

  14. Polymorphisms in IL-10 and INF-? genes are associated with early atherosclerosis in coronary but not in carotid arteries: A study of 122 autopsy cases of young adults.

    PubMed

    Esperana, Jos Carlos P; Miranda, William R R; Netto, Jos B; Lima, Fabiane S; Baumworcel, Leonardo; Chimelli, Leila; Silva, Rosane; rmnyi, Turn P; Cabello, Pedro H; Rondinelli, Edson; Faffe, Dbora S

    2015-06-01

    Atherosclerosis is a complex disease, involving both genetic and environmental factors. However, the influence of genetic variations on its early development remains unclear. This study examined the association of 12 different polymorphisms with atherosclerosis severity in anterior descending coronary (DA, n=103) and carotid arteries (CA, n=66) of autopsied young adults (<30years old). Histological sections (H-E) were classified according to the American Heart Association. Polymorphisms in ACE, TNF-? (-308G/A and -238G/A), IFN-? (+874 A/T), MMP-9 (-1562 C/T), IL-10 (-1082 A/G and -819 C/T), NOS3 (894G/T), ApoA1 (rs964184), ApoE (E2E3E4 isoforms), and TGF-? (codons 25 and 10) genes were genotyped by gel electrophoresis or automatic DNA sequencing. Firearm projectile or car accident was the main cause of death, and no information about classical risk factors was available. Histological analysis showed high prevalence of type III atherosclerotic lesions in both DA (69%) and CA (39%) arteries, while severe type IV and V lesions were observed in 14% (DA) and 33% (CA). Allele frequencies and genotype distributions were determined. Among the polymorphisms studied, IFN-? and IL-10 (-1082 A/G) were related to atherosclerosis severity in DA artery. No association between genotypes and lesion severity was found in CA. In conclusion, we observed that the high prevalence of early atherosclerosis in young adults is associated with IFN-? (p<0.001) and IL-10 (p=0.013) genotypes. This association is blood vessel dependent. Our findings suggest that the vascular system presents site specialization, and specific genetic variations may provide future biomarkers for early disease identification. PMID:26674973

  15. Gadolinium-Enhanced Angiography for Diagnosis and Interventional Treatment of Subclavian Artery Stenosis Prior to Fistula Creation

    SciTech Connect

    Termote, Bruno; Maleux, Geert Heye, Sam; Fourneau, Inge; Claes, Kathleen

    2008-07-15

    We report the use of gadolinium-based contrast agent for both diagnostic and interventional subclavian angiography in two azotemic patients, presenting with an asymptomatic, high-grade stenosis of the left subclavian artery, ipsilateral to the site of choice for native fistula creation. Angiographic imaging performed with diluted gadolinium-based contrast material was clear enough to perform successful subclavian artery stenting, resulting in normalization of the arterial blood pressure in the afferent artery of the dialysis fistula. Clinically, no decrease in residual renal function and no other complication were noted immediately or a longer period after the interventional treatment.

  16. Polycomb Binding Precedes Early-Life Stress Responsive DNA Methylation at the Avp Enhancer

    PubMed Central

    Murgatroyd, Chris; Spengler, Dietmar

    2014-01-01

    Early-life stress (ELS) in mice causes sustained hypomethylation at the downstream Avp enhancer, subsequent overexpression of hypothalamic Avp and increased stress responsivity. The sequence of events leading to Avp enhancer methylation is presently unknown. Here, we used an embryonic stem cell-derived model of hypothalamic-like differentiation together with in vivo experiments to show that binding of polycomb complexes (PcG) preceded the emergence of ELS-responsive DNA methylation and correlated with gene silencing. At the same time, PcG occupancy associated with the presence of Tet proteins preventing DNA methylation. Early hypothalamic-like differentiation triggered PcG eviction, DNA-methyltransferase recruitment and enhancer methylation. Concurrently, binding of the Methyl-CpG-binding and repressor protein MeCP2 increased at the enhancer although Avp expression during later stages of differentiation and the perinatal period continued to increase. Overall, we provide evidence of a new role of PcG proteins in priming ELS-responsive DNA methylation at the Avp enhancer prior to epigenetic programming consistent with the idea that PcG proteins are part of a flexible silencing system during neuronal development. PMID:24599304

  17. Polycomb binding precedes early-life stress responsive DNA methylation at the Avp enhancer.

    PubMed

    Murgatroyd, Chris; Spengler, Dietmar

    2014-01-01

    Early-life stress (ELS) in mice causes sustained hypomethylation at the downstream Avp enhancer, subsequent overexpression of hypothalamic Avp and increased stress responsivity. The sequence of events leading to Avp enhancer methylation is presently unknown. Here, we used an embryonic stem cell-derived model of hypothalamic-like differentiation together with in vivo experiments to show that binding of polycomb complexes (PcG) preceded the emergence of ELS-responsive DNA methylation and correlated with gene silencing. At the same time, PcG occupancy associated with the presence of Tet proteins preventing DNA methylation. Early hypothalamic-like differentiation triggered PcG eviction, DNA-methyltransferase recruitment and enhancer methylation. Concurrently, binding of the Methyl-CpG-binding and repressor protein MeCP2 increased at the enhancer although Avp expression during later stages of differentiation and the perinatal period continued to increase. Overall, we provide evidence of a new role of PcG proteins in priming ELS-responsive DNA methylation at the Avp enhancer prior to epigenetic programming consistent with the idea that PcG proteins are part of a flexible silencing system during neuronal development. PMID:24599304

  18. Haploinsufficiency of insulin gene enhancer protein 1 (ISL1) is associated with d-transposition of the great arteries

    PubMed Central

    Osoegawa, Kazutoyo; Schultz, Kathleen; Yun, Kenneth; Mohammed, Nebil; Shaw, Gary M; Lammer, Edward J

    2014-01-01

    Congenital heart defects are the most common malformation, and are the foremost causes of mortality in the first year of life. Among congenital heart defects, conotruncal defects represent about 20% and are severe malformations with significant morbidity. Insulin gene enhancer protein 1 (ISL1) has been considered a candidate gene for conotruncal heart defects based on its embryonic expression pattern and heart defects induced in Isl1 knockout mice. Nevertheless no mutation of ISL1 has been reported from any human subject with a heart defect. From a population base of 974,579 births during 19992004, we used multiplex ligation-dependent probe amplification to screen for microdeletions/duplications of ISL1 among 389 infants with tetralogy of Fallot or d-transposition of the great arteries (d-TGA). We also sequenced all exons of ISL1. We identified a novel 20-kb microdeletion encompassing the entire coding region of ISL1, but not including either flanking gene, from an infant with d-TGA. We confirmed that the deletion was caused by nonhomologous end joining mechanism. Sequencing of exons of ISL1 did not reveal any subject with a novel nonsynonymous mutation. This is the first report of an ISL1 mutation of a child with a congenital heart defect. PMID:25077177

  19. Enhanced Cellular Responses and Distinct Gene Profiles in Human Fetoplacental Artery Endothelial Cells under Chronic Low Oxygen1

    PubMed Central

    Jiang, Yi-Zhou; Wang, Kai; Li, Yan; Dai, Cai-Feng; Wang, Ping; Kendziorski, Christina; Chen, Dong-Bao; Zheng, Jing

    2013-01-01

    ABSTRACT Fetoplacental endothelial cells are exposed to oxygen levels ranging from 2% to 8% in vivo. However, little is known regarding endothelial function within this range of oxygen because most laboratories use ambient air (21% O2) as a standard culture condition (SCN). We asked whether human umbilical artery endothelial cells (HUAECs) that were steadily exposed to the physiological chronic normoxia (PCN, 3% O2) for ∼20–25 days differed in their proliferative and migratory responses to FGF2 and VEGFA as well as in their global gene expression compared with those in the SCN. We observed that PCN enhanced FGF2- and VEGFA-stimulated cell proliferation and migration. In oxygen reversal experiments (i.e., when PCN cells were exposed to SCN for 24 h and vice versa), we found that preexposure to 21% O2 decreased the migratory ability, but not the proliferative ability, of the PCN-HUAECs in response to FGF2 and VEGFA. These PCN-enhanced cellular responses were associated with increased protein levels of HIF1A and NOS3, but not FGFR1, VEGFR1, and VEGFR2. Microarray analysis demonstrated that PCN up-regulated 74 genes and down-regulated 86, 14 of which were directly regulated by hypoxia-inducible factors as evaluated using in silico analysis. Gene function analysis further indicated that the PCN-regulated genes were highly related to cell proliferation and migration, consistent with the results from our functional assays. Given that PCN significantly alters cellular responses to FGF2 and VEGFA as well as transcription in HUAECs, it is likely that we may need to reexamine the current cellular and molecular mechanisms controlling fetoplacental endothelial functions, which were largely derived from endothelial models established under ambient O2. PMID:24152727

  20. Lactulose enhances neuroplasticity to improve cognitive function in early hepatic encephalopathy.

    PubMed

    Yang, Nan; Liu, He; Jiang, Yao; Zheng, Ji; Li, Dong-Mei; Ji, Chao; Liu, Yan-Yong; Zuo, Ping-Ping

    2015-09-01

    Lactulose is known to improve cognitive function in patients with early hepatic encephalopathy; however, the underlying mechanism remains poorly understood. In the present study, we investigated the behavioral and neurochemical effects of lactulose in a rat model of early hepatic encephalopathy induced by carbon tetrachloride. Immunohistochemistry showed that lactulose treatment promoted neurogenesis and increased the number of neurons and astrocytes in the hippocampus. Moreover, lactulose-treated rats showed shorter escape latencies than model rats in the Morris water maze, indicating that lactulose improved the cognitive impairments caused by hepatic encephalopathy. The present findings suggest that lactulose effectively improves cognitive function by enhancing neuroplasticity in a rat model of early hepatic encephalopathy. PMID:26604907

  1. Lactulose enhances neuroplasticity to improve cognitive function in early hepatic encephalopathy

    PubMed Central

    Yang, Nan; Liu, He; Jiang, Yao; Zheng, Ji; Li, Dong-mei; Ji, Chao; Liu, Yan-yong; Zuo, Ping-ping

    2015-01-01

    Lactulose is known to improve cognitive function in patients with early hepatic encephalopathy; however, the underlying mechanism remains poorly understood. In the present study, we investigated the behavioral and neurochemical effects of lactulose in a rat model of early hepatic encephalopathy induced by carbon tetrachloride. Immunohistochemistry showed that lactulose treatment promoted neurogenesis and increased the number of neurons and astrocytes in the hippocampus. Moreover, lactulose-treated rats showed shorter escape latencies than model rats in the Morris water maze, indicating that lactulose improved the cognitive impairments caused by hepatic encephalopathy. The present findings suggest that lactulose effectively improves cognitive function by enhancing neuroplasticity in a rat model of early hepatic encephalopathy. PMID:26604907

  2. Magnetic field enriched surface enhanced resonance Raman spectroscopy for early malaria diagnosis

    NASA Astrophysics Data System (ADS)

    Yuen, Clement; Liu, Quan

    2012-01-01

    Hemozoin is a by-product of malaria infection in erythrocytes, which has been explored as a biomarker for early malaria diagnosis. We report magnetic field-enriched surface-enhanced resonance Raman spectroscopy (SERRS) of ?--hematin crystals, which are the equivalent of hemozoin biocrystals in spectroscopic features, by using magnetic nanoparticles with iron oxide core and silver shell (Fe3O4@Ag). The external magnetic field enriches ?--hematin crystals and enhances the binding between ?--hematin crystals and magnetic nanoparticles, which provides further improvement in SERRS signals. The magnetic field-enriched SERRS signal of ?--hematin crystals shows approximately five orders of magnitude enhancement in the resonance Raman signal, in comparison to about three orders of magnitude improvement in the SERRS signal without the influence of magnetic field. The improvement has led to a ?--hematin detection limit at a concentration of 5 nM (roughly equivalent to 30 parasites/?l at the early stages of malaria infection), which demonstrates the potential of magnetic field-enriched SERRS technique in early malaria diagnosis.

  3. Enhanced nicotine reward in adulthood after exposure to nicotine during early adolescence in mice.

    PubMed

    Kota, Dena; Robinson, Susan E; Imad Damaj, M

    2009-10-01

    Approximately one million adolescents begin smoking cigarettes every year. Studies show that adolescents may be particularly vulnerable to various aspects of nicotine dependence. Work on rodents demonstrates parallel findings showing that adolescence is a time of changed sensitivity to both rewarding and aversive effects of nicotine. However, it is unclear if these effects are long-lasting and whether they contribute to a lifetime of nicotine addiction. In this study we have characterized the effects of adolescent nicotine exposure on the rewarding properties of nicotine in adulthood using the CPP model. Specifically, we have addressed whether the phase of adolescence (early, middle, or late adolescence) plays a role in the susceptibility to the enhanced rewarding effects of nicotine. Furthermore, we have investigated the long-term effects of adolescent nicotine exposure on nicotine reward in adulthood and have correlated these behavioral adaptations with possible molecular mechanisms. We observed that early adolescence in the mouse is a unique phase for elevated sensitivity to nicotine reward using a CPP model. In addition, exposure to nicotine during this phase, but not during late adolescence or adulthood, resulted in a lasting enhancement of reward in adulthood. Finally, we have shown that early adolescent nicotine exposure significantly elevates nAChR function in adulthood. Overall, we demonstrate that early adolescence represents a period of development, distinct from middle and late adolescence, during which nicotine exposure can cause persistent changes in behavior and molecular adaptations. PMID:19576867

  4. Impaired decidual natural killer cell regulation of vascular remodelling in early human pregnancies with high uterine artery resistance

    PubMed Central

    Fraser, Rupsha; Whitley, Guy StJ; Johnstone, Alan P; Host, Amanda J; Sebire, Neil J; Thilaganathan, Baskaran; Cartwright, Judith E

    2012-01-01

    During human pregnancy, natural killer (NK) cells accumulate in the maternal decidua, but their specific roles remain to be determined. Decidual NK (dNK) cells are present during trophoblast invasion and uterine spiral artery remodelling. These events are crucial for successful placentation and the provision of an adequate blood supply to the developing fetus. Remodelling of spiral arteries is impaired in the dangerous pregnancy complication pre-eclampsia. We studied dNK cells isolated from pregnancies at 914 weeks' gestation, screened by uterine artery Doppler ultrasound to determine resistance indices which relate to the extent of spiral artery remodelling. dNK cells were able to promote the invasive behaviour of fetal trophoblast cells, partly through HGF. Cells isolated from pregnancies with higher resistance indices were less able to do this and secreted fewer pro-invasive factors. dNK cells from pregnancies with normal resistance indices could induce apoptotic changes in vascular smooth muscle and endothelial cells in vitro, events of importance in vessel remodelling, partly through Fas signalling. dNK cells isolated from high resistance index pregnancies failed to induce vascular apoptosis and secreted fewer pro-apoptotic factors. We have modelled the cellular interactions at the maternal-fetal interface and provide the first demonstration of a functional role for dNK cells in influencing vascular cells. A potential mechanism contributing to impaired vessel remodelling in pregnancies with a higher uterine artery resistance is presented. These findings may be informative in determining the cellular interactions contributing to the pathology of pregnancy disorders where remodelling is impaired, such as pre-eclampsia. Copyright 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. PMID:22653829

  5. Posterior Circulation Acute Stroke Prognosis Early Computed Tomography Score Using Hypointense Vessels on Susceptibility Weighted Imaging Independently Predicts Outcome in Patients with Basilar Artery Occlusion

    PubMed Central

    Mundiyanapurath, S.; Mhlenbruch, M.; Ringleb, P. A.; Bsel, J.; Wick, W.; Bendszus, M.; Radbruch, A.

    2015-01-01

    Purpose Appearance of hypointense vessels on susceptibility weighted imaging (SWI) has been reported to correlate with outcome in patients with ischemia of the anterior circulation. This study investigates the correlation between the appearance of hypointense vessels on SWI after recanalization therapy and outcome in patients with basilar artery occlusion. Methods Patients with basilar artery occlusion who were treated with endovascular recanalization or intravenous alteplase and received an MRI including SWI after therapy were retrieved from the hospital database for retrospective analysis. Posterior circulation Acute Stroke Prognosis Early Computed Tomography Score (pcASPECTS) was calculated based on regions displaying hypointense vessels on SWI and compared to lesions on diffusion weighted imaging (DWI). Subsequently, SWI based pcASPECTS was correlated with outcome determined with modified Rankin Scale (mRS), categorized as favorable outcome (mRS 0-2) or unfavorable outcome (3-6). Results Twenty-two MRI of patients with basilar artery occlusion were analyzed. In seven out of eight areas of the pcASPECTS hypointense vessels on SWI were significantly correlated to areas of restricted diffusion on DWI. In univariate analysis median pcASPECTS on SWI was significantly higher in patients with favorable outcome (7.5 vs. 5, p=0.02). In a multivariate analysis pcASPECTS on SWI was an independent predictor of favorable outcome (OR 2.02; CI [1.02;3,99]; p=0.04). Conclusion pcASPECTS based on hypointense vessels on SWI after therapy predicts outcome in patients with basilar artery occlusion and might potentially be used as an additional imaging biomarker in the management of patients with stroke in the posterior circulation. This needs to be confirmed in larger prospective clinical trials. PMID:26176682

  6. Fully automated segmentation of carotid and vertebral arteries from contrast enhanced CTA

    NASA Astrophysics Data System (ADS)

    Cuisenaire, Olivier; Virmani, Sunny; Olszewski, Mark E.; Ardon, Roberto

    2008-03-01

    We propose a method for segmenting and labeling the main head and neck vessels (common, internal, external carotid, vertebral) from a contrast enhanced computed tomography angiography (CTA) volume. First, an initial centerline of each vessel is extracted. Next, the vessels are segmented using 3D active objects initialized using the first step. Finally, the true centerline is identified by smoothly deforming it away from the segmented mask edges using a spline-snake. We focus particularly on the novel initial centerline extraction technique. It uses a locally adaptive front propagation algorithm that attempts to find the optimal path connecting the ends of the vessel, typically from the lowest image of the scan to the Circle of Willis in the brain. It uses a patient adapted anatomical model of the different vessels both to initialize and constrain this fast marching, thus eliminating the need for manual selection of seed points. The method is evaluated using data from multiple regions (USA, India, China, Israel) including a variety of scanners (10, 16, 40, 64-slice; Brilliance CT, Philips Healthcare, Cleveland, OH, USA), contrast agent dose, and image resolution. It is fully successful in over 90% of patients and only misses a single vessel in most remaining cases. We also demonstrate its robustness to metal and dental artifacts and anatomical variability. Total processing time is approximately two minutes with no user interaction, which dramatically improves the workflow over existing clinical software. It also reduces patient dose exposure by obviating the need to acquire an unenhanced scan for bone suppression as this can be done by applying the segmentation masks.

  7. Coronary Arteries

    MedlinePLUS

    ... and animations for grades K-6. The Coronary Arteries | Share Coronary Circulation The heart muscle, like every ... into two main coronary blood vessels (also called arteries). These coronary arteries branch off into smaller arteries, ...

  8. Arterial embolism

    MedlinePLUS

    ... the artery (arterial bypass) to create a second source of blood supply Clot removal through a balloon catheter placed into the affected artery or through open surgery on the artery (embolectomy) Opening of the ...

  9. Early and long-term results of cardiosurgical treatment of coronary artery disease and aortic stenosis in patients over 80 years old

    PubMed Central

    Buczkowski, Piotr; Perek, Bartłomiej; Katyńska, Izabela; Jemielity, Marek

    2014-01-01

    Background In recent years, patients over 80 years of age have been a growing group of individuals referred to cardiac surgeons. They pose a serious challenge and usually require a multidisciplinary approach. Aim The aim of this study was to evaluate the early and late outcomes of cardiosurgical treatment of patients over 80 years of age suffering from coronary artery disease and aortic stenosis. Material and methods The study involved 96 patients aged over 80 years treated between January, 2004 and December, 2012. The mortality and morbidity in the early postoperative period, as well as throughout the follow-up period, were analyzed. Results The majority of patients underwent isolated coronary artery bypass grafting (CABG) (58.3%; Group I), while 29.2% of them underwent an isolated aortic valve replacement (AVR) (Group II). Combined procedures (CABG + AVR) were carried out in 12.5% of patients (Group III). The mean operational risk calculated according to the logistic EuroSCORE was 11.6%, 11.9%, and 9.5%, respectively in Group I, Group II and in Group III. In the early postoperative period, 4 patients died (all from Group I). The 30-day mortality rate was 4.2% and the morbidity rate was 56.3%. During the post-discharge follow-up period that lasted from 1 to 100 months, 4 patients died (2 from Group I and 2 from Group III). The 2-year probability of survival was 91.9 ± 3.0%. During the last follow-up clinical assessment, half of the patients were asymptomatic. Conclusions The perioperative mortality of the patients is acceptably and markedly lower than that predicted by the logistic EuroSCORE calculator. However, the complication rate, particularly in the early postoperative period, is relatively high. PMID:26336430

  10. Comparing the diagnostic accuracy of contrast-enhanced computed tomographic angiography and gadolinium-enhanced magnetic resonance angiography for the assessment of hemodynamically significant transplant renal artery stenosis.

    PubMed

    Gaddikeri, Santhosh; Mitsumori, Lee; Vaidya, Sandeep; Hippe, Daniel S; Bhargava, Puneet; Dighe, Manjiri K

    2014-01-01

    To compare diagnostic accuracy of contrast-enhanced computed tomographic angiography (CTA) and gadolinium-enhanced magnetic resonance angiography (MRA) for the assessment of hemodynamically significant transplant renal artery stenosis (TRAS). After institutional review board approval, records of 27 patients with TRAS confirmed on digital subtraction angiography (DSA) were retrospectively reviewed. A total of 13 patients had MRA and 14 had CTA before DSA. Two board-certified fellowship-trained radiologists, one each from interventional radiology and body imaging blindly reviewed the DSA and CTA or MRA data, respectively. Sensitivity (SN), specificity (SP), positive predictive value, and negative predictive value of MRA and CTA were estimated using 50% stenosis as the detection threshold for significant TRAS. These parameters were compared between modalities using the Fisher exact test. Bias between MRA or CTA imaging and DSA was tested using the Wilcoxon signed-rank test. Two patients were excluded from the MRA group owing to susceptibility artifacts obscuring the TRAS. The correlation between MRA and DSA measurements of stenosis was r = 0.57 (95% CI:-0.02, 0.87; P = 0.052) and between CTA and DSA measurements was r = 0.63 (95% CI: 0.14, 0.87; P = 0.015); the difference between the 2 techniques was not significant (P = 0.7). Both imaging modalities tended to underestimate the degree of stenosis when compared with DSA. MRA group (SN and SP: 56% and 100%, respectively) and CTA group (SN and SP: 81% and 67%, respectively). There were no significant differences in detection performance between modalities (P>0.3 for all measures). We did not find that either modality had any advantage over the other in terms of measuring or detecting significant stenosis. Accordingly, MRA may be preferred over CTA after positive color Doppler ultrasound screening when not contraindicated owing to lack of ionizing radiation or nephrotoxic iodinated contrast. However, susceptibility of artifacts owing to surgical clips at the anastomosis may limit diagnostic utility of MRA as found in 2 of 13 patients. Trend towards no significant difference between the CTA and enhanced MRA in the detection of hemodynamically significant TRAS. PMID:24948209

  11. Enhanced Mesenteric Arterial Responsiveness to Angiotensin II Is Androgen Receptor-Dependent in Prenatally Protein-Restricted Adult Female Rat Offspring1

    PubMed Central

    Sathishkumar, Kunju; Balakrishnan, Meena P.; Yallampalli, Chandrasekhar

    2014-01-01

    ABSTRACT Gestational protein restriction results in intrauterine growth restriction and hypertension in adult female growth-restricted rats. Enhanced vascular responsiveness to angiotensin II is observed, and blockade of the renin-angiotensin system abolishes hypertension in adult growth-restricted rats, suggesting that the renin-angiotensin system contributes to intrauterine growth restriction-induced hypertension. Moreover, growth-restricted adult rats have higher plasma testosterone levels, and antiandrogen treatment abolishes hypertension, indicating an important role for testosterone. We hypothesized that androgens may play a pivotal role in the enhanced responsiveness to Ang II and hypertension. Female offspring of pregnant rats fed 20% protein (control) or 6% protein diet (protein restricted), at 6 mo of age, were studied. Plasma testosterone and mean arterial pressure in protein-restricted offspring were significantly higher compared to controls. Flutamide treatment (10 mg/kg/day subcutaneously for 10 days) reduced mean arterial pressure in protein-restricted offspring but was without significant effect in controls. Vascular Agtr1/Agtr2 ratio was significantly higher in protein-restricted offspring, an effect that was reversed by flutamide. Flutamide treatment did not have any effect on Agtr1/Agtr2 ratio in controls. Enhanced contractile response to angiotensin II in mesenteric arteries was observed in protein-restricted offspring compared with control. Flutamide treatment reversed the enhanced contractile response to angiotensin II in protein-restricted offspring without significant effect in controls. Vascular reactivity to phenylephrine was similar between the control and protein-restricted offspring with and without flutamide treatment, suggesting that enhanced contractile response and flutamide's reversal effect is specific to angiotensin II. These results suggest that prenatally protein-restricted rats exhibit an enhanced responsiveness to angiotensin II that is testosterone-dependent. PMID:25550341

  12. Accuracy of Non-Enhanced CT in Detecting Early Ischemic Edema Using Frequency Selective Non-Linear Blending

    PubMed Central

    Bier, Georg; Bongers, Malte N.; Ditt, Hendrik; Bender, Benjamin; Ernemann, Ulrike; Horger, Marius

    2016-01-01

    Purpose Ischemic brain edema is subtle and hard to detect by computed tomography within the first hours of stroke onset. We hypothesize that non-enhanced CT (NECT) post-processing with frequency-selective non-linear blending (“best contrast”/BC) increases its accuracy in detecting edema and irreversible tissue damage (infarction). Methods We retrospectively analyzed the NECT scans of 76 consecutive patients with ischemic stroke (exclusively middle cerebral artery territory—MCA) before and after post-processing with BC both at baseline before reperfusion therapy and at follow-up (5.73±12.74 days after stroke onset) using the Alberta Stroke Program Early CT Score (ASPECTS). We assessed the differences in ASPECTS between unprocessed and post-processed images and calculated sensitivity, specificity, and predictive values of baseline NECT using follow-up CT serving as reference standard for brain infarction. Results NECT detected brain tissue hypoattenuation in 35 of 76 patients (46.1%). This number increased to 71 patients (93.4%) after post-processing with BC. Follow-up NECT confirmed brain infarctions in 65 patients (85.5%; p = 0.012). Post-processing increased the sensitivity of NECT for brain infarction from 35/65 (54%) to 65/65 (100%), decreased its specificity from 11/11 (100%) to 7/11 (64%), its positive predictive value (PPV) from 35/35 (100%) to 65/69 (94%) and increased its accuracy 46/76 (61%) to 72/76 (95%). Conclusions This post-hoc analysis suggests that post-processing of NECT with BC may increase its sensitivity for ischemic brain damage significantly. PMID:26809010

  13. Mechanisms of enhanced basal tone of brain parenchymal arterioles during early postischemic reperfusion: role of ET-1-induced peroxynitrite generation

    PubMed Central

    Cipolla, Marilyn J; Sweet, Julie G; Gokina, Natalia I; White, Sheryl L; Nelson, Mark T

    2013-01-01

    The contributions of vasoconstrictors (endothelin-1 (ET-1), peroxynitrite) and endothelium-dependent vasodilatory mechanisms to basal tone were investigated in parenchymal arterioles (PAs) after early postischemic reperfusion. Transient middle cerebral artery occlusion (tMCAO) was induced for 2 hours with 30 minutes reperfusion in male Wistar rats and compared with ischemia alone (permanent MCAO (pMCAO); 2.5 hours) or sham controls. Changes in lumen diameter of isolated and pressurized PAs were compared. Quantitative PCR was used to measure endothelin type B (ETB) receptors. Constriction to intravascular pressure (‘basal tone') was not affected by tMCAO or pMCAO. However, constriction to inhibitors of endothelial cell, small- (SK) and intermediate- (IK) conductance, Ca2+-sensitive K+ channels (apamin and TRAM-34, respectively) were significantly enhanced in PAs from tMCAO compared with pMCAO or sham. Addition of the ETB agonist sarafotoxin caused constriction in PAs from tMCAO but not from sham animals (21±4% versus 3±3% at 1 nmol/L; P<0.01) that was inhibited by the peroxynitrite scavenger FeTMPyP (5,10,15,20-tetrakis (N-methyl-4′-pyridyl) porphinato iron (III) chloride) (100 μmol/L). Expression of ETB receptors was not found on PA smooth muscle, suggesting that constriction to sarafotoxin after tMCAO was due to peroxynitrite and not ETB receptor expression. The maintenance of basal tone in PAs after tMCAO may restrict flow to the ischemic region and contribute to infarct expansion. PMID:23778163

  14. Mechanisms of enhanced basal tone of brain parenchymal arterioles during early postischemic reperfusion: role of ET-1-induced peroxynitrite generation.

    PubMed

    Cipolla, Marilyn J; Sweet, Julie G; Gokina, Natalia I; White, Sheryl L; Nelson, Mark T

    2013-10-01

    The contributions of vasoconstrictors (endothelin-1 (ET-1), peroxynitrite) and endothelium-dependent vasodilatory mechanisms to basal tone were investigated in parenchymal arterioles (PAs) after early postischemic reperfusion. Transient middle cerebral artery occlusion (tMCAO) was induced for 2 hours with 30 minutes reperfusion in male Wistar rats and compared with ischemia alone (permanent MCAO (pMCAO); 2.5 hours) or sham controls. Changes in lumen diameter of isolated and pressurized PAs were compared. Quantitative PCR was used to measure endothelin type B (ETB) receptors. Constriction to intravascular pressure ('basal tone') was not affected by tMCAO or pMCAO. However, constriction to inhibitors of endothelial cell, small- (SK) and intermediate- (IK) conductance, Ca(2+)-sensitive K(+) channels (apamin and TRAM-34, respectively) were significantly enhanced in PAs from tMCAO compared with pMCAO or sham. Addition of the ETB agonist sarafotoxin caused constriction in PAs from tMCAO but not from sham animals (21 4% versus 3 3% at 1 nmol/L; P<0.01) that was inhibited by the peroxynitrite scavenger FeTMPyP (5,10,15,20-tetrakis (N-methyl-4'-pyridyl) porphinato iron (III) chloride) (100 ?mol/L). Expression of ETB receptors was not found on PA smooth muscle, suggesting that constriction to sarafotoxin after tMCAO was due to peroxynitrite and not ETB receptor expression. The maintenance of basal tone in PAs after tMCAO may restrict flow to the ischemic region and contribute to infarct expansion. PMID:23778163

  15. Ultrasmall superparamagnetic iron oxide to enhance MRA of the renal and coronary arteries: Studies in human patients

    SciTech Connect

    Stillman, A.E.; Wilke, N.; Li, D.; Haacke, E.M.; McLachlan, S.

    1996-01-01

    Our goal was to determine the feasibility of using an intravascular MR contrast agent to improve 3D MRA. Three-dimensional TOF MRA was performed in nine patients both prior to and following the administration of an ultrasmall particle superparamagnetic iron oxide contrast agent (AMI 227). The lengths of both renal arteries were measured from the maximum intensity projection (MIP) images as well as the individual partitions. Seven of these patients also were studied by a 3D coronary artery MRA sequence. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements of the right coronary artery were determined both prior to and following the administration of AMI 227. Statistical analysis of both renal artery lengths and right coronary SNR and CNR was performed using a one tailed paired t test comparing pre- and postcontrast images. The renal artery lengths significantly increased (right renal artery: 30%, p = 0.001; left renal artery: 25%, p < 0.008) when measured from the individual axial slice partitions. No significant increase in length was observed on the MIP images following contrast. In the right coronary artery, the SNR increased by an average of 80% (p = 0.008) and CNR increased by an average of 109% (p = 0.007). Increased background signal and superimposed venous structures reduced the measurable lengths of the renal arteries from the MIP images. These studies support the hypothesis that 3D MRA in the body will benefit from the use of intravascular contrast agents. Nevertheless, conventional MIP processing is unable to reveal the full advantage of the contrast improvement. 14 refs., 6 figs., 2 tabs.

  16. [Follow-up study of coronary artery bypass grafting after Kawasaki disease--early and late postoperative evaluation].

    PubMed

    Ohara, K; Yagihara, T; Kishimoto, H; Isobe, F; Yamamoto, F; Nabuchi, A; Kito, Y; Fujita, T; Suzuki, A; Kamiya, T

    1989-01-01

    In our hospital, 22 patients with severe coronary arterial lesion after Kawasaki disease underwent coronary artery bypass grafting (CABG) since 1982. The age of the cases at surgery ranged from 1 year to 19 years. Mean age was 8.3 years. Fifteen cases were bypassed using internal mammary artery (IMA) and 5 cases using IMA and autologous saphenous vein (SVG). Two cases were bypassed using only SVG. They have been examined until now by catheterization, by Treadmill test, and by Tl-201 myocardial imaging, around 1 month (Study 1) and around 1 year (Study 2) after surgery for the evaluation of results of CABG. One patient died from acute myocardial infarction 3 months after surgery and one patient shows return of anginal attack due to graft stenosis. Other patients are almost uneventful. In the study 1,20 (100%) IMA were patent, and 7 (88%) SVG were patent. In the study 2, 11 (92%) IMA and 6 (67%) SVG remained patent. Development of left anterior descending artery distal to IMA anastomosis was shown in 8 cases in the study 2. On the follow-up study with TI-201 myocardial imaging, disappearance or decrease of perfusion defect was seen in 7 cases (59%) in the study 1 and 9 cases (75%) in the study 2. On the Treadmill test, disappearance or improvement of ischemic change was seen in 15 cases (88%) in the study 1 and 10 cases (84%) in the study 2. These results suggest that IMA is more preferable for than SVG for young children who has an indication of CABG after Kawasaki disease. PMID:2786537

  17. Carotid Endothelial VCAM-1 Is an Early Marker of Carotid Atherosclerosis and Predicts Coronary Artery Disease in Swine

    PubMed Central

    Masseau, I.; Bowles, D. K.

    2015-01-01

    Objective The aim was to determine if endothelial VCAM-1 (eVCAM-1) expression in the common carotid artery (CCA) would correlate with predictive markers of atherosclerotic disease, would precede reduction of markers of endothelial cell function and would predict coronary artery disease (CAD). Methods and results Carotid arterial segments (bifurcation, proximal and distal CCA) were harvested from 14 and 24 month-old male castrated familial hypercholesterolemic (FH) swine, a model of spontaneous atherosclerosis. Quantification of local expression of eVCAM-1, intimal macrophage accumulation, oxidative stress, intima-media (I/M) ratio, intima-media thickness (IMT), endothelial nitric oxide synthase (eNOS) and phosphorylated eNOS (p-eNOS) in selected regions of the carotids revealed a relationship between local inflammation and atheroscle-rotic plaque progression. Importantly, inflammation was not uniform throughout the CCA. Endo-thelial VCAM-1 expression was the greatest at the bifurcation and increased with age. Finally, eV-CAM-1 best estimated the severity of CAD compared to blood levels of glucose, hypercholestero-lemia, carotid IMT, and p-eNOS. Conclusion Our data suggested that eVCAM-1 was closely associated with atherosclerotic plaque progression and preceded impairment of EDD. Thus, this study supported the use of carotid VCAM-1 targeting agents to estimate the severity of CAD.

  18. Investigation of the Saturation Pulse Artifact in Non-Enhanced MR Angiography of the Lower Extremity Arteries at 7 Tesla

    PubMed Central

    Johst, Sören; Maderwald, Stefan; Fischer, Anja; Quick, Harald H.; Ladd, Mark E.; Orzada, Stephan

    2015-01-01

    When performing non-enhanced time-of-flight MR angiography of the lower extremity arteries at 7 T with cardiac triggering, the acquisition time is a crucial consideration. Therefore, in previous studies, saturation RF pulses were applied only every second TR. In the axial source images a slight artifact with an appearance similar to aliasing could be observed. The purpose of this study was to investigate the origin of this artifact. The reason for the artifact is supposed to be related to the two effective TRs during acquisition caused by the sparsely applied saturation RF pulse. Several sequence variants were simulated and implemented within the sequence source code to examine this hypothesis. An adaptation of the excitation flip angles for each TR as well as a correction factor for the k-space data was calculated. Additionally, a different ordering of the k-space data during acquisition was implemented as well as the combination of the latter with the k-space correction factor. The observations from the simulations were verified using both a static and a flow phantom and, finally, in a healthy volunteer using the same measurement setup as in previous volunteer and patient studies. Of all implemented techniques, only the reordering of the k-space was capable of suppressing the artifact almost completely at the cost of creating a ringing artifact. The phantom measurements showed the same results as the simulations and could thus confirm the hypothesis regarding the origin of the artifact. This was additionally verified in the healthy volunteer. The origin of the artifact could be confirmed to be the periodic signal variation caused by two effective TRs during acquisition. PMID:25785837

  19. ETS factors regulate Vegf-dependent arterial specification

    PubMed Central

    Wythe, Joshua D.; Dang, Lan T. H.; Devine, W. Patrick; Boudreau, Emilie; Artap, Stanley T.; He, Daniel; Schachterle, William; Stainier, Didier Y.R.; Oettgen, Peter; Black, Brian L.; Bruneau, Benoit G.; Fish, Jason E.

    2013-01-01

    Summary Vegf signaling specifies arterial fate during early vascular development by inducing the transcription of Delta-like 4 (Dll4), the earliest Notch ligand gene expressed in arterial precursor cells (aPCs). Dll4 expression precedes that of Notch receptors in arteries, and factors that direct its arterial-specific expression are not known. To identify the transcriptional program that initiates arterial Dll4 expression we characterized an arterial-specific and Vegf-responsive enhancer of Dll4. Our findings demonstrate that Notch signaling is not required for initiation of Dll4 expression in arteries, and suggest that Notch instead functions as a maintenance factor. Importantly, we find that Vegf signaling activates MAP kinase (MAPK)-dependent ETS factors in the arterial endothelium to drive expression of Dll4, as well as Notch4. These findings identify a Vegf/MAPK-dependent transcriptional pathway that specifies arterial identity by activating Notch signaling components, and illustrate how signaling cascades can modulate broadly expressed transcription factors to achieve tissue-specific transcriptional outputs. PMID:23830865

  20. Evolution of complete arterial grafting. For coronary artery disease.

    PubMed Central

    Buxton, B F; Fuller, J A; Tatoulis, J

    1998-01-01

    Arterial grafting for the correction of coronary artery disease preceded the use of saphenous vein grafts, but the overwhelming popularity of the saphenous vein from 1970 to 1985 left the development of arterial grafting dormant. Excellent graft patency results from pedicled internal thoracic artery grafting and continued saphenous vein graft failure prompted our unit to explore complete arterial grafting with internal thoracic artery and radial artery grafts. One thousand and fifty-three patients who received a combination of internal thoracic artery and radial artery grafts were compared with 1,156 patients who received internal thoracic artery and saphenous vein grafts. All patients underwent primary coronary artery bypass surgery between 1995 and 1998. The early mortality and morbidity and the probability of survival at 2 years were similar in both groups of patients. Early graft patency studies of 35 radial artery grafts showed 33 (94%) were patent at a mean of 12 months. Complete arterial grafting using internal thoracic and radial arteries is safe and may provide a long-term benefit. Images PMID:9566058

  1. Thrombosis of splenic artery pseudoaneurysm complicating pancreatitis.

    PubMed Central

    De Ronde, T; Van Beers, B; de Cannire, L; Trigaux, J P; Melange, M

    1993-01-01

    The natural history of pseudoaneurysms complicating pancreatitis is unknown. A patient with chronic pancreatitis is described in whom thrombosis of a splenic artery pseudoaneurysm occurred. Early diagnosis and radical treatment of a bleeding pseudoaneurysm are mandatory. When elective treatment is considered, however, contrast enhanced computed tomography may be useful just before surgery as thrombosis may occur. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:8406167

  2. Extraction of Functional Binding Sites from Unique Regulatory Regions: The Drosophila Early Developmental Enhancers

    PubMed Central

    Papatsenko, Dmitri A.; Makeev, Vsevolod J.; Lifanov, Alex P.; Régnier, Mireille; Nazina, Anna G.; Desplan, Claude

    2002-01-01

    The early developmental enhancers of Drosophila melanogaster comprise one of the most sophisticated regulatory systems in higher eukaryotes. An elaborate code in their DNA sequence translates both maternal and early embryonic regulatory signals into spatial distribution of transcription factors. One of the most striking features of this code is the redundancy of binding sites for these transcription factors (BSTF). Using this redundancy, we explored the possibility of predicting functional binding sites in a single enhancer region without any prior consensus/matrix description or evolutionary sequence comparisons. We developed a conceptually simple algorithm, Scanseq, that employs an original statistical evaluation for identifying the most redundant motifs and locates the position of potential BSTF in a given regulatory region. To estimate the biological relevance of our predictions, we built thorough literature-based annotations for the best-known Drosophila developmental enhancers and we generated detailed distribution maps for the most robust binding sites. The high statistical correlation between the location of BSTF in these experiment-based maps and the location predicted in silico by Scanseq confirmed the relevance of our approach. We also discuss the definition of true binding sites and the possible biological principles that govern patterning of regulatory regions and the distribution of transcriptional signals. PMID:11875036

  3. Does the mode of exercise influence recovery of functional capacity in the early postoperative period after coronary artery bypass graft surgery? A randomized controlled trial

    PubMed Central

    Hirschhorn, Andrew D.; Richards, David A.B.; Mungovan, Sean F.; Morris, Norman R.; Adams, Lewis

    2012-01-01

    OBJECTIVES The purpose of this study was to compare the effectiveness of moderate-intensity stationary cycling and walking exercise programmes in the early postoperative period after first-time coronary artery bypass graft surgery. METHODS In this prospective trial, 64 patients (57 men, 7 women, mean age = 669 years) performed twice daily, moderate-intensity exercise sessions, of 10-min duration, from postoperative day 3 until discharge from hospital. Patients were randomly assigned to stationary cycling or walking exercise intervention groups. Preoperative and discharge functional exercise capacity and health-related quality of life were assessed using 6-min walk and cycle assessments and the SF-36 version 2.0 questionnaire. Compliance with exercise was calculated as the proportion of scheduled exercise sessions completed. RESULTS There were no significant differences between intervention groups at hospital discharge for 6-min walk distance (cyclists: 40293m vs walkers: 41786m, P=0.803), 6-min cycle work (cyclists: 15.06.4kJ vs walkers: 14.06.3kJ, P=0.798) or health-related quality of life. There was no significant difference between intervention groups for postoperative length of hospital stay (P=0.335). Compliance rates for intervention groups were cyclists: 185/246 (75%) scheduled exercise sessions completed vs walkers: 199/242 (82%) scheduled exercise sessions completed (P=0.162). CONCLUSIONS Stationary cycling provides a well-tolerated and clinically effective alternative to walking in the early postoperative period after coronary artery bypass graft surgery. The optimal frequency, intensity and duration of exercise in the early postoperative period require further investigation. (Clinical trials register: Australian New Zealand Clinical Trials Registry; identification number: ACTRN12608000359336; http://www.anzctr.org.au/trial_view.aspx?ID=82978). PMID:22976996

  4. Attentional enhancement for positive and negative tones at an early stage of auditory processing.

    PubMed

    Folyi, Tmea; Liesefeld, Heinrich Ren; Wentura, Dirk

    2016-02-01

    We report an event-related potential (ERP) study based on the hypothesis that valenced (i.e., positive and/or negative) tones are prioritized over neutral ones at an early, perceptual stage of auditory processing. In order to avoid perceptual confounds, we induced valence experimentally during a learning phase by assigning positive, negative, and neutral valences to tone-frequencies in a balanced design. In a subsequent test phase, EEG was recorded while these tones were entirely task-irrelevant. The amplitude of the auditory N1 was increased for valenced compared with neutral tones, indicating enhanced attention. While behavioral results of the learning phase, and both implicit and explicit measures of tone evaluation indicated differentiation between positive and negative valence, there was no such differentiation on the N1 amplitude. Our results suggest that it is the general relevance of the valenced tones that governs early attentional processes. PMID:26678665

  5. Does Early Post-operative Administration of Aspirin Influence the Risk of Bleeding After Coronary Artery Bypass Graft Surgery? A Prospective Observational Study

    PubMed Central

    Nouraei, Seyed Mahmood; Gholipour Baradari, Afshin; Emami Zeydi, Amir

    2015-01-01

    Background: Aspirin has a proven role in preventing thrombotic diseases. However, given its anti-platelet activity, it is often assumed that its early post-operative administration significantly increase the amount of post-operative bleeding. Aim: The aim of this study was to determine whether early post-operative administration of aspirin influence the risk of bleeding in patients undergoing coronary artery bypass graft (CABG) surgery. Methods: In a prospective observational study, 100 consecutive patients undergoing first time elective CABG surgery were include in the study. Patients received a low dose of aspirin (75-150 mg per day) either 1 hours (the early aspirin group; n=43) or 6 hours after surgery (the late aspirin group; n=57). Total mediastinal blood drainage, blood drainage after 6 hours, incidences of re-operation for the control of bleeding and transfusion of red blood cells (RBCs) and blood products were recorded and followed until chest tube removal. Results: The groups were found to be matched for the confounding variables and no significant differences were found between post-aspirin bleeding (p=0.37), RBCs and blood product usage (p=0.90) or incidences of re-operation for control of bleeding (p=1.00) between the two groups. Conclusions: Early administration (1 hour after surgery) of aspirin did not appear to increase the risk of post-operative bleeding in patients undergoing CABG. Thereby, its early administration in such cases may be considered. Although further well-designed randomized controlled trials to confirm the safety and efficacy of early administration of aspirin after CABG surgery are warranted. PMID:26843729

  6. Associative Learning during Early Adulthood Enhances Later Memory Retention in Honeybees

    PubMed Central

    Arenas, Andrés; Fernández, Vanesa M.; Farina, Walter M.

    2009-01-01

    Background Cognitive experiences during the early stages of life play an important role in shaping the future behavior in mammals but also in insects, in which precocious learning can directly modify behaviors later in life depending on both the timing and the rearing environment. However, whether olfactory associative learning acquired early in the adult stage of insects affect memorizing of new learning events has not been studied yet. Methodology Groups of adult honeybee workers that experienced an odor paired with a sucrose solution 5 to 8 days or 9 to 12 days after emergence were previously exposed to (i) a rewarded experience through the offering of scented food, or (ii) a non-rewarded experience with a pure volatile compound in the rearing environment. Principal Findings Early rewarded experiences (either at 1–4 or 5–8 days of adult age) enhanced retention performance in 9–12-day-conditioned bees when they were tested at 17 days of age. The highest retention levels at this age, which could not be improved with prior rewarded experiences, were found for memories established at 5–8 days of adult age. Associative memories acquired at 9–12 days of age showed a weak effect on retention for some pure pre-exposed volatile compounds; whereas the sole exposure of an odor at any younger age did not promote long-term effects on learning performance. Conclusions The associative learning events that occurred a few days after adult emergence improved memorizing in middle-aged bees. In addition, both the timing and the nature of early sensory inputs interact to enhance retention of new learning events acquired later in life, an important matter in the social life of honeybees. PMID:19956575

  7. Addendum to `numerical modeling of an enhanced very early time electromagnetic (VETEM) prototype system'

    USGS Publications Warehouse

    Cui, T.J.; Chew, W.C.; Aydiner, A.A.; Wright, D.L.; Smith, D.V.; Abraham, J.D.

    2000-01-01

    Two numerical models to simulate an enhanced very early time electromagnetic (VETEM) prototype system that is used for buried-object detection and environmental problems are presented. In the first model, the transmitting and receiving loop antennas accurately analyzed using the method of moments (MoM), and then conjugate gradient (CG) methods with the fast Fourier transform (FFT) are utilized to investigate the scattering from buried conducting plates. In the second model, two magnetic dipoles are used to replace the transmitter and receiver. Both the theory and formulation are correct and the simulation results for the primary magnetic field and the reflected magnetic field are accurate.

  8. Coronary Artery Imaging in Children

    PubMed Central

    2015-01-01

    Coronary artery problems in children usually have a significant impact on both short-term and long-term outcomes. Early and accurate diagnosis, therefore, is crucial but technically challenging due to the small size of the coronary artery, high heart rates, and limited cooperation of children. Coronary artery visibility on CT and MRI in children is considerably improved with recent technical advancements. Consequently, CT and MRI are increasingly used for evaluating various congenital and acquired coronary artery abnormalities in children, such as coronary artery anomalies, aberrant coronary artery anatomy specific to congenital heart disease, Kawasaki disease, Williams syndrome, and cardiac allograft vasculopathy. PMID:25741188

  9. A cohesin-OCT4 complex mediates Sox enhancers to prime an early embryonic lineage.

    PubMed

    Abboud, Nesrine; Moore-Morris, Thomas; Hiriart, Emilye; Yang, Henry; Bezerra, Hudson; Gualazzi, Maria-Giovanna; Stefanovic, Sonia; Gunantin, Anne-Claire; Evans, Sylvia M; Pucat, Michel

    2015-01-01

    Short- and long-scales intra- and inter-chromosomal interactions are linked to gene transcription, but the molecular events underlying these structures and how they affect cell fate decision during embryonic development are poorly understood. One of the first embryonic cell fate decisions (that is, mesendoderm determination) is driven by the POU factor OCT4, acting in concert with the high-mobility group genes Sox-2 and Sox-17. Here we report a chromatin-remodelling mechanism and enhancer function that mediate cell fate switching. OCT4 alters the higher-order chromatin structure at both Sox-2 and Sox-17 loci. OCT4 titrates out cohesin and switches the Sox-17 enhancer from a locked (within an inter-chromosomal Sox-2 enhancer/CCCTC-binding factor CTCF/cohesin loop) to an active (within an intra-chromosomal Sox-17 promoter/enhancer/cohesin loop) state. SALL4 concomitantly mobilizes the polycomb complexes at the Soxs loci. Thus, OCT4/SALL4-driven cohesin- and polycombs-mediated changes in higher-order chromatin structure mediate instruction of early cell fate in embryonic cells. PMID:25851587

  10. Enhancing Peer Cultures of Academic Effort and Achievement in Early Adolescence: Promotive Effects of the Seals Intervention

    ERIC Educational Resources Information Center

    Hamm, Jill V.; Farmer, Thomas W.; Lambert, Kerrylin; Gravelle, Maggie

    2014-01-01

    Peer cultures of effort and achievement influence early adolescents' academic adjustment. A randomized controlled trials design was used to test the extent to which aspects of peer cultures of effort and achievement were enhanced following teachers' participation in the Supporting Early Adolescents' Learning and Social Success

  11. Enhancing Peer Cultures of Academic Effort and Achievement in Early Adolescence: Promotive Effects of the Seals Intervention

    ERIC Educational Resources Information Center

    Hamm, Jill V.; Farmer, Thomas W.; Lambert, Kerrylin; Gravelle, Maggie

    2014-01-01

    Peer cultures of effort and achievement influence early adolescents' academic adjustment. A randomized controlled trials design was used to test the extent to which aspects of peer cultures of effort and achievement were enhanced following teachers' participation in the Supporting Early Adolescents' Learning and Social Success…

  12. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results from a 2-Year Randomized Trial

    ERIC Educational Resources Information Center

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2011-01-01

    Objective: To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and

  13. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results from a 2-Year Randomized Trial

    ERIC Educational Resources Information Center

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2011-01-01

    Objective: To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and…

  14. Noncontrast-enhanced peripheral MRA: technical optimization of flow-spoiled fresh blood imaging for screening peripheral arterial diseases.

    PubMed

    Nakamura, Katsumi; Miyazaki, Mitsue; Kuroki, Kiyomi; Yamamoto, Akiyoshi; Hiramine, Akihiro; Admiraal-Behloul, Faiza

    2011-02-01

    Flow-spoiled fresh blood imaging, a noncontrast peripheral MR angiography technique, allows the depiction of the entire tree of peripheral arteries by utilizing the signal difference between systolic- and diastolic-triggered data. The image quality of the technique relies on selecting the right triggering delay times and flow-dependent read-out spoiler gradient pulses. ECG triggering delays were verified using manual subtraction and automated software. The read-out spoiler gradients pulses were optimized on volunteers before utilizing the flow-spoiled fresh blood imaging technique to screen for peripheral arterial disease. Thirteen consecutive patients with suspected peripheral arterial disease underwent both flow-spoiled fresh blood imaging and 16-detector-row computed tomography angiography examinations. A total of 23 segments were evaluated in the arterial vascular system. Using computed tomography angiography as the reference standard, 56 diseased segments were detected with 22 nonsignificant stenoses (<50%) and 34 significant stenoses, 15 of which were totally occluded. Flow-spoiled fresh blood imaging had a sensitivity of 97%, a specificity of 96%, an accuracy of 96%, a positive predictive value of 88%, and a negative predictive value of 99%. With such a high negative predictive value, flow-spoiled fresh blood imaging has the potential to become the safest noninvasive screening tool for peripheral arterial disease, especially for patients with impaired renal function. PMID:20872867

  15. Enhanced musical rhythmic perception in Turkish early and late learners of German

    PubMed Central

    Roncaglia-Denissen, M. Paula; Schmidt-Kassow, Maren; Heine, Angela; Vuust, Peter; Kotz, Sonja A.

    2013-01-01

    As language rhythm relies partly on general acoustic properties, such as intensity and duration, mastering two languages with distinct rhythmic properties (i.e., stress position) may enhance musical rhythm perception. We investigated whether competence in a second language (L2) with different rhythmic properties than a L1 affects musical rhythm aptitude. Turkish early (TELG) and late learners (TLLG) of German were compared to German late L2 learners of English (GLE) regarding their musical rhythmic aptitude. While Turkish and German present distinct linguistic rhythm and metric properties, German and English are rather similar in this regard. To account for inter-individual differences, we measured participants' short-term and working memory (WM) capacity, melodic aptitude, and time they spent listening to music. Both groups of Turkish L2 learners of German perceived rhythmic variations significantly better than German L2 learners of English. No differences were found between early and late learners' performance. Our findings suggest that mastering two languages with different rhythmic properties enhances musical rhythm perception, providing further evidence of shared cognitive resources between language and music. PMID:24065946

  16. Enhanced Early Posterior Negativity to Fearful Faces in Patients with Anxiety Disorder.

    PubMed

    Yoon, Sunkyung; Shim, Miseon; Kim, Hyang Sook; Lee, Seung-Hwan

    2016-03-01

    Patients with anxiety disorders (AnDs) have distinct patterns of threat-related emotional processing compared to healthy controls (HCs). The current study investigated the temporal course of emotional processing in AnDs by examining Event-related potential (ERP) components. Twenty-three AnDs and twenty-four age- and gender-matched HCs viewed emotional (fearful, happy) and neutral faces while their electroencephalograms were recorded. Early (P100, N170), middle (early posterior negativity; EPN), and late ERP components late positive potential were analyzed. To localize ERP source activity, standardized low-resolution brain electromagnetic tomography (sLORETA) was used. AnDs displayed significantly enhanced mean amplitude of the EPN compared to HCs when fearful faces were presented. In addition, the EPN's mean amplitude elicited by fearful faces was more pronounced than for happy and neutral faces in AnDs, whereas in HCs the EPN elicited by fearful faces was only augmented compared to neutral faces. Finally, sLORETA analysis revealed that the source activity of the EPN (fearful minus happy face condition) was increased in the cuneus and precuneus in AnDs compared to HCs. Our results indicate that the EPN is a distinct ERP component modulated by facial emotional processing in AnDs. Furthermore, the results show that anxiety symptoms enhance selective attention for fearful faces. Finally, it revealed that the cuneus and precuneus are involved in fearful face processing in AnDs. PMID:26476635

  17. Guanfacine enhances inhibitory control and attentional shifting in early abstinent cocaine-dependent individuals

    PubMed Central

    Fox, Helen; Sofuoglu, Mehmet; Sinha, Rajita

    2015-01-01

    Objectives Attenuation of adrenergic drive and cognitive enhancement, via stimulation of alpha2 pre- and post-synaptic receptors, may selectively enhance executive performance in early abstinent cocaine-dependent individuals. As these cognitive processes underpin important treatment-related behaviors, the alpha2 agonist, guanfacine HCl, may represent an effective pharmaco-therapeutic intervention. Methods Twenty-five early abstinent cocaine-dependent individuals were administered a battery of neurocognitive tasks on entry into treatment (baseline) and again following 3 weeks of either placebo or guanfacine treatment (up to 3 mg). Tasks included: Stop Signal, Stroop, 3-Dimentional Intra-dimensional/Extra-dimensional (IDED) task, Spatial Working Memory (SWM), Paired Associates Learning (PAL), Verbal Fluency and the Rey Auditory Verbal Learning Test (RAVLT). Results Compared with placebo, the guanfacine group demonstrated attenuated anxiety and negative affect as well as improved performance on selective executive tests. This included fewer directional errors on the stop signal task, fewer errors on the extra-dimensional shift component of the IDED task and better attentional switching during verbal fluency. Guanfacine did not improve strategic working memory or peripheral memory. Conclusion Guanfacine improves selective cognitive processes which may underlie salient treatment-related regulatory behaviors. Alpha2 agonists may therefore represent important agents for cocaine dependence. PMID:25567555

  18. Linear contrast enhancement at the operative site on early post-operative CT after removal of brain tumors.

    PubMed

    Nicoletti, G F; Barone, F; Passanisi, M; Mancuso, P; Albanese, V

    1994-06-01

    It is unclear whether a linear contrast enhancement at the edges of the operative site on early CT scan indicates a residual tumor or rather reflects postoperative changes. We have studied 15 patients treated with surgical removal of malignant brain tumor, submitted to periodic CT scan. The enhancement of linear contrast was due to a residual tumor, when seen on very early CT scan (within 24 hours after surgery). If occurring later, this enhancement was either generated by a residual tumor or by post-operative changes. PMID:7891195

  19. The contrast-enhanced Doppler ultrasound with perfluorocarbon exposed sonicated albumin does not improve the diagnosis of renal artery stenosis compared with angiography

    PubMed Central

    Teixeira, Odila UN; Bortolotto, Luiz A; Silva, Hlio Bernardes

    2004-01-01

    There are no studies investigating the effect of the contrast infusion on the sensitivity and specificity of the main Doppler criteria of renal artery stenosis (RAS). Our aim was to evaluate the accuracy of these Doppler criteria prior to and following the intravenous administration of perfluorocarbon exposed sonicated albumin (PESDA) in patients suspected of having RAS. Thirty consecutive hypertensive patients (13 males, mean age of 57 10 years) suspected of having RAS by clinical clues, were submitted to ultrasonography (US) of renal arteries before and after enhancement using continuous infusion of PESDA. All patients underwent angiography, and haemodynamically significant RAS was considered when ?50%. At angiography, it was detected RAS ?50% in 18 patients, 5 with bilateral stenosis. After contrast, the examination time was slightly reduced by approximately 20%. In non-enhanced US the sensitivity was better when based on resistance index (82.9%) while the specificity was better when based on renal aortic ratio (89.2%). The predictive positive value was stable for all indexes (74.0%88.0%) while negative predictive value was low (44%51%). The specificity and positive predictive value based on renal aortic ratio increased after PESDA injection respectively, from 89 to 97.3% and from 88 to 95%. In hypertensives suspected to have RAS the sensitivity and specificity of Duplex US is dependent of the criterion evaluated. Enhancement with continuous infusion of PESDA improves only the specificity based on renal aortic ratio but do not modify the sensitivity of any index. PMID:15380022

  20. Quantitative assessment of regional cerebral blood flow by dynamic susceptibility contrast-enhanced MRI, without the need for arterial blood signals

    NASA Astrophysics Data System (ADS)

    Enmi, Jun-ichiro; Kudomi, Nobuyuki; Hayashi, Takuya; Yamamoto, Akihide; Iguchi, Satoshi; Moriguchi, Tetsuaki; Hori, Yuki; Koshino, Kazuhiro; Zeniya, Tsutomu; Shah, Nadim Jon; Yamada, Naoaki; Iida, Hidehiro

    2012-12-01

    In dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI), an arterial input function (AIF) is usually obtained from a time-concentration curve (TCC) of the cerebral artery. This study was aimed at developing an alternative technique for reconstructing AIF from TCCs of multiple brain regions. AIF was formulated by a multi-exponential function using four parameters, and the parameters were determined so that the AIF curves convolved with a model of tissue response reproduced the measured TCCs for 20 regions. Systematic simulations were performed to evaluate the effects of possible error sources. DSC-MRI and positron emission tomography (PET) studies were performed on 14 patients with major cerebral artery occlusion. Cerebral blood flow (CBF) images were calculated from DSC-MRI data, using our novel method alongside conventional AIF estimations, and compared with those from 15O-PET. Simulations showed that the calculated CBF values were sensitive to variations in the assumptions regarding cerebral blood volume. Nevertheless, AIFs were reasonably reconstructed for all patients. The difference in CBF values between DSC-MRI and PET was -2.2 7.4 ml/100 g/min (r = 0.55, p < 0.01) for our method, versus -0.2 8.2 ml/100 g/min (r = 0.47, p = 0.01) for the conventional method. The difference in the ratio of affected to unaffected hemispheres between DSC-MRI and PET was 0.07 0.09 (r = 0.82, p < 0.01) for our method, versus 0.07 0.09 (r = 0.83, p < 0.01) for the conventional method. The contrasts in CBF images from our method were the same as those from the conventional method. These findings suggest the feasibility of assessing CBF without arterial blood signals.

  1. Value of Single-Dose Contrast-Enhanced Magnetic Resonance Angiography Versus Intraarterial Digital Subtraction Angiography in Therapy Indications in Abdominal and Iliac Arteries

    SciTech Connect

    Schaefer, Philipp J. Schaefer, Fritz K. W.; Mueller-Huelsbeck, Stefan; Both, Markus; Heller, Martin; Jahnke, Thomas

    2007-06-15

    The objective of the study was to prove the value of single-dose contrast-enhanced magnetic resonance angiography [three-dimensional (3D) ceMRA] in abdominal and iliac arteries versus the reference standard intra-arterial digital subtraction angiography (i.a.DSA) when indicating a therapy. Patients suspected of having abdominal or iliac artery stenosis were included in this study. A positive vote of the local Ethics Committee was given. After written informed consent was obtained, 37 patients were enrolled, of which 34 were available for image evaluation. Both 3D ceMRA and i.a. DSA were performed for each patient. The dosage for 3D ceMRA was 0.1 mmol/kg body weight in a 1.5-T scanner with a phased-array coil. The parameters of the 3D-FLASH sequence were as follows: TR/TE 4.6/1.8 ms, effective thickness 3.5 mm, matrix 512 x 200, flip angle 30{sup o}, field of view 420 mm, TA 23 s, coronal scan orientation. Totally, 476 vessel segments were evaluated for stenosis degree by two radiologists in a consensus fashion in a blinded read. For each patient, a therapy was proposed, if clinically indicated. Sensitivity, specificity, positive and negative predictive values, and accuracy for stenoses {>=}50% were 68%, 92%, 44%, 97%, and 90%, respectively. In 13/34 patients, a discrepancy was found concerning therapy decisions based on MRA findings versus therapy decisions based on the reference standard DSA. The results showed that the used MRA imaging technique of abdominal and iliac arteries is not competitive to i.a. DSA, with a high rate of misinterpretation of the MRAs resulting in incorrect therapies.

  2. Resting early peak diastolic filling rate: a sensitive index of myocardial dysfunction in patients with coronary artery disease

    SciTech Connect

    Polak, J.F.; Kemper, A.J.; Bianco, J.A.; Parisi, A.F.; Tow, D.E.

    1982-06-01

    Resting first-pass radionuclide angiocardiography (RNA) was used to derive left-ventricular (LV) peak diastolic filling rates (PFR) in normals (Group 1:N . 12) and in patients with coronary artery disease (CAD), both without (Group 2:N . 27) and with previous myocardial infarction (Group 3:N . 23). Resting peak filling rates were significantly depressed in both Group 2 (1.61 +/- 0.36; p less than 0.01) and Group 3 (1:35 +/- 0.26; p less than 0.001) patients when compared with Group 1, normals (2.14 +/- 0.63). Even though LV systolic function of Group 2 patients was normal and comparable to that in Group 1 (EF . 0.55 +/- 0.06 against EF 0.55 +/- 0.06 NS), diastolic dysfunction (PFR less than 1.61 end diastolic volume/sec (EDV/sec)) was present at rest in 14 of 27 (52%). Depressed PFR values was also seen in 20 of 23 Group 3 patients (87%). It appears that (a) resting PFR is a sensitive and easily obtainable parameter of the diastolic dysfunction associated with CAD; (b) abnormal PFR values are seen in almost all patients with previous myocardial damage, and (c) a significant proportion of CAD patients without any evidence of abnormal systolic function have depressed resting PFR of the LV.

  3. The Impact of a Pulmonary-Artery-Catheter-Based Protocol on Fluid and Catecholamine Administration in Early Sepsis

    PubMed Central

    Bethlehem, Carina; Groenwold, Frouwke M.; Buter, Hanneke; Kingma, W. Peter; Kuiper, Michael A.; de Lange, Fellery; Elbers, Paul; Groen, Henk; van Roon, Eric N.; Boerma, E. Christiaan

    2012-01-01

    Objective. The pulmonary artery catheter (PAC) remains topic of debate. Despite abundant data, it is of note that many trials did not incorporate a treatment protocol. Methods. We retrospectively evaluated fluid balances and catecholamine doses in septic patients after the introduction of a PAC-based treatment protocol in comparison to historic controls. Results. 2 70 patients were included. The first day the PAC group had a significantly higher positive fluid balance in comparison to controls (6.1 2.6 versus 3.8 2.4 litre, P < 0.001). After 7 days the cumulative fluid balance in the PAC group was significantly lower than in controls (9.4 7.4 versus 13 7.6 litre, P = 0.001). Maximum dose of norepinephrine was significantly higher in the PAC group. Compared to controls this was associated with a significant reduction in ventilator and ICU days. Conclusions. Introduction of a PAC-based treatment protocol in sepsis changed the administration of fluid and vasopressors significantly. PMID:22454764

  4. Brachial-ankle pulse wave velocity and ankle-brachial index are complementary tools for transcranial Doppler ultrasonography in early diagnosis of intracranial arterial stenosis/occlusion in patients with acute ischemic stroke.

    PubMed

    Xuan, Zhenghao; Zhou, Jingjing; Yi, Li; Zhang, Qian; Li, Li

    2015-12-15

    The aim of this study was to explore whether brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) are suitable to serve as complementary tools for TCD in early diagnosis of intracranial arterial stenosis/occlusion in patients with acute ischemic stroke (AIS). A total of 52 patients with AIS onset and 52 age-matched healthy controls were included in this study. All participants received TCD detection, and baPWV and ABI were measured. Computed topography (CT)/magnetic resonance imaging (MRI) was applied to confirm diagnosis. TCD data from all participants was collected and reviewed to diagnose stenosis and occlusion of the major intracranial arteries. Receiver operating characteristic (ROC) analysis and logistic regression analysis were used to assess and compare the diagnostic accuracy of the various diagnostic approaches. We found that a combination of TCD with either baPWV or ABI, or a combination of the three provided a significantly higher area under the curve (AUC) in detecting stenosis or occlusion in various intracranial arteries, excluding the anterior cerebral artery (ACA), when compared to TCD alone, thereby demonstrating that these combined approaches provide improved diagnostic accuracy. In conclusion, our findings suggest that both baPWV and ABI are suitable complementary tools for TCD in early diagnosis of intracranial arterial stenosis/occlusion in AIS patients and that these combinations may assist in facilitating the diagnostic process associated with this disease. PMID:26671137

  5. Enhancements to angioplasty for peripheral arterial occlusive disease: systematic review, cost-effectiveness assessment and expected value of information analysis.

    PubMed Central

    Simpson, Emma L; Kearns, Benjamin; Stevenson, Matthew D; Cantrell, Anna J; Littlewood, Chris; Michaels, Jonathan A

    2014-01-01

    BACKGROUND There have been rapid technological developments aimed at improving short- and long-term results of percutaneous transluminal balloon angioplasty (PTA) in peripheral arterial occlusive disease (PAD). OBJECTIVES To assess current clinical effectiveness and cost-effectiveness evidence of additional techniques to standard PTA for PAD, develop a health economic model to assess cost-effectiveness and to identify where further research is needed. DATA SOURCES Relevant electronic databases, including MEDLINE, EMBASE and The Cochrane Library were searched from inception to 2011, between May and October 2011. METHODS Systematic reviews were conducted of clinical effectiveness and cost-effectiveness. The population was participants with symptomatic PAD undergoing endovascular treatment for disease distal to the inguinal ligament. Interventions were modifications of and adjuncts to PTA in the peripheral circulation, compared with conventional PTA. Outcomes included measures of clinical effectiveness and costs. Data were extracted from randomised controlled trials (RCTs), which were quality assessed using standard criteria. Where appropriate, meta-analyses using fixed- and random-effects methods produced relative risks (RRs). A discrete-event simulation model was developed to assess the relative cost-effectiveness of the interventions from a NHS perspective over a lifetime. The patient populations of intermittent claudication (IC) and critical limb ischaemia (CLI) were modelled separately. Univariate and probabilistic sensitivity analyses were undertaken. RESULTS In total, 40 RCTs were included, many of which had small sample sizes. Significantly reduced restenosis rates were shown in meta-analyses of self-expanding stents (SES) {RR 0.67 [95% confidence interval (CI) 0.52 to 0.87]}, endovascular brachytherapy (EVBT) [RR 0.63 (95% CI 0.48 to 0.83)] at 12 months and drug-coated balloons (DCBs) at 6 months [RR 0.40 (95% CI 0.23 to 0.69)], and single studies of stent-graft or drug-eluting stent (DES), compared with PTA; a single study showed improvements with DES versus bare-metal stents (BMSs). Compared with PTA, walking capacity was not significantly affected by cutting balloon, balloon-expandable stents or EVBT; in SES, there was evidence of improvement in walking capacity after up to 12 months. The use of DCBs dominated both the assumed standard practice of PTA with bailout BMS and all other interventions because it lowered lifetime costs and improved quality of life (QoL). These results were seen for both patient populations (IC and CLI). Sensitivity analyses showed that the results were robust to different assumptions about the clinical benefits attributable to the interventions, suggesting that the use of DCBs is cost-saving. LIMITATIONS Differing definitions of restenosis made direct comparison across trials difficult. There were few data available for walking capacity and QoL. CONCLUSIONS The evidence showed a significant benefit to reducing restenosis rates for self-expanding and DESs, stent-graft, EVBT and DCBs. If it is assumed that patency translates into beneficial long-term clinical outcomes, then DCB and bail-out DES are most likely to be the cost-effective enhancements to PTA. A RCT comparing current recommended practice (PTA with bail-out BMS) with DCB and bail-out DES could assess long-term follow-up and cost-effectiveness. Data relating patency status to the need for reintervention and to the probability of symptoms returning should be collected, as should health-related QoL measures [European Quality of Life-5 Dimensions (EQ-5D) and maximum walking distance]. STUDY REGISTRATION This study is registered as PROSPERO CRD42012002014. FUNDING The National Institute for Health Research Health Technology Assessment programme. PMID:24524731

  6. Enhancing early attachment: Design and pilot study of an intervention for primary health care dyads.

    PubMed

    Leigh, Francisca Figueroa; Vergara, Victoria Binda; Santelices, Mara Pa

    2012-11-16

    The attachment style of an infant with his caregiver can greatly influence his future development. Many interventions have been proposed to enhance early secure attachment styles, but few have characteristics that make them suitable for primary health care. The objective of the study wasto design a complex intervention for promoting secure attachment in dyads detected in Primary Health Care with altered patterns of attachment styles. The methodology proposed by the UK Medical Research Council was used: (1) theoretical phase: literature review; (2) modelling phase: the main components of the intervention were defined through qualitative research; and (3) exploration phase: pilot study of the preliminary intervention. The attachment style of the dyads was evaluated using the Massie-Campbell scale prior to and four months after the pilot intervention. The preliminary intervention was designed: a group workshop (five to seven dyads, with children aged between 6 and 12 months and two health care professional monitors) structured around various activities that specifically dealt with the skills associated with parental sensitivity and addressed relevant issues to child rearing. The intervention was then tested in a pilot study of 11 dyads in two primary health care centres. The analysis was done with nine dyads (two were lost in the second evaluation), and showed an improvement of 33 per cent in the secure attachment style in the dyads (not statistically significant). An original intervention is designed and proposed for dyads who have early indicators of altered styles of attachment in primary health care. PMID:23162050

  7. Conditional Cripto overexpression in satellite cells promotes myogenic commitment and enhances early regeneration

    PubMed Central

    Prezioso, Carolina; Iaconis, Salvatore; Andolfi, Gennaro; Zentilin, Lorena; Iavarone, Francescopaolo; Guardiola, Ombretta; Minchiotti, Gabriella

    2015-01-01

    Skeletal muscle regeneration mainly depends on satellite cells, a population of resident muscle stem cells. Despite extensive studies, knowledge of the molecular mechanisms underlying the early events associated with satellite cell activation and myogenic commitment in muscle regeneration remains still incomplete. Cripto is a novel regulator of postnatal skeletal muscle regeneration and a promising target for future therapy. Indeed, Cripto is expressed both in myogenic and inflammatory cells in skeletal muscle after acute injury and it is required in the satellite cell compartment to achieve effective muscle regeneration. A critical requirement to further explore the in vivo cellular contribution of Cripto in regulating skeletal muscle regeneration is the possibility to overexpress Cripto in its endogenous configuration and in a cell and time-specific manner. Here we report the generation and the functional characterization of a novel mouse model for conditional expression of Cripto, i.e., the Tg:DsRedloxP/loxPCripto-eGFP mice. Moreover, by using a satellite cell specific Cre-driver line we investigated the biological effect of Cripto overexpression in vivo, and provided evidence that overexpression of Cripto in the adult satellite cell compartment promotes myogenic commitment and differentiation, and enhances early regeneration in a mouse model of acute injury. PMID:26052513

  8. Effect of Warfarin Treatment on Survival of Patients With Pulmonary Arterial Hypertension (PAH) in the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL)

    PubMed Central

    Preston, Ioana R.; Roberts, Kari E.; Miller, Dave P.; Sen, Ginny P.; Selej, Mona; Benton, Wade W.; Hill, Nicholas S.

    2015-01-01

    Background— Long-term anticoagulation is recommended in idiopathic pulmonary arterial hypertension (IPAH). In contrast, limited data support anticoagulation in pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc-PAH). We assessed the effect of warfarin anticoagulation on survival in IPAH and SSc-PAH patients enrolled in Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL), a longitudinal registry of group I PAH. Methods and Results— Patients who initiated warfarin on study (n=187) were matched 1:1 with patients never on warfarin, by enrollment site, etiology, and diagnosis status. Descriptive analyses were conducted to compare warfarin users and nonusers by etiology. Survival analyses with and without risk adjustment were performed from the time of warfarin initiation or a corresponding quarterly update in matched pairs to avoid immortal time bias. Time-varying covariate models were used as sensitivity analyses. Mean warfarin treatment was 1 year; mean international normalized ratios were 1.9 (IPAH) and 2.0 (SSc-PAH). Two-thirds of patients initiating warfarin discontinued treatment before the last study assessment. There was no survival difference with warfarin in IPAH patients (adjusted hazard ratio, 1.37; P=0.21) or in SSc-PAH patients (adjusted hazard ratio, 1.60; P=0.15) in comparison with matched controls. However, SSc-PAH patients receiving warfarin within the previous year (hazard ratio, 1.57; P=0.031) or any time postbaseline (hazard ratio, 1.49; P=0.046) had increased mortality in comparison with warfarin-naïve patients. Conclusions— No significant survival advantage was observed in IPAH patients who started warfarin. In SSc-PAH patients, long-term warfarin was associated with poorer survival than in patients not receiving warfarin, even after adjusting for confounders. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00370214. PMID:26510696

  9. Changes in Early Cortical Visual Processing Predict Enhanced Reactivity in Deaf Individuals

    PubMed Central

    Bottari, Davide; Caclin, Anne; Giard, Marie-Hlne; Pavani, Francesco

    2011-01-01

    Individuals with profound deafness rely critically on vision to interact with their environment. Improvement of visual performance as a consequence of auditory deprivation is assumed to result from cross-modal changes occurring in late stages of visual processing. Here we measured reaction times and event-related potentials (ERPs) in profoundly deaf adults and hearing controls during a speeded visual detection task, to assess to what extent the enhanced reactivity of deaf individuals could reflect plastic changes in the early cortical processing of the stimulus. We found that deaf subjects were faster than hearing controls at detecting the visual targets, regardless of their location in the visual field (peripheral or peri-foveal). This behavioural facilitation was associated with ERP changes starting from the first detectable response in the striate cortex (C1 component) at about 80 ms after stimulus onset, and in the P1 complex (100150 ms). In addition, we found that P1 peak amplitudes predicted the response times in deaf subjects, whereas in hearing individuals visual reactivity and ERP amplitudes correlated only at later stages of processing. These findings show that long-term auditory deprivation can profoundly alter visual processing from the earliest cortical stages. Furthermore, our results provide the first evidence of a co-variation between modified brain activity (cortical plasticity) and behavioural enhancement in this sensory-deprived population. PMID:21980501

  10. Transcatheter Arterial Embolization for Spontaneous Rupture of the Omental Artery

    SciTech Connect

    Matsumoto, Tomohiro; Yamagami, Takuji; Morishita, Hiroyuki; Iida, Shigeharu; Tazoe, Jun; Asai, Shunsuke; Masui, Koji; Ikeda, Jun; Nagata, Akihiro; Sato, Osamu; Nishimura, Tsunehiko

    2011-02-15

    We encountered a rare case of spontaneous rupture of the omental artery. A 25-year-old man without any episode of abdominal trauma or bleeding disorders came to the emergency unit with left upper abdominal pain. Hematoma with extravasation of the greater omentum and a hemoperitoneum was confirmed on abdominal contrast-enhanced computed tomography. Bleeding from the omental artery was suspected based on these findings. Transcatheter arterial embolization was successfully performed after extravasation of the omental artery, which arises from the left gastroepiploic artery, was confirmed on arteriography. Partial ometectomy was performed 10 days after transcatheter arterial embolization, revealing that the hematoma measured 10 cm in diameter in the greater omentum. Pathological examination showed rupture of the branch of an omental artery without abnormal findings, such as an aneurysm or neoplasm. Thus, we diagnosed him with spontaneous rupture of the omental artery. The patient recovered and was discharged from the hospital 10 days after the surgery, with a favorable postoperative course.

  11. Exercise training enhances insulin-stimulated nerve arterial vasodilation in rats with insulin-treated experimental diabetes.

    PubMed

    Olver, T Dylan; McDonald, Matthew W; Gris, Kenneth N; Dey, Adwitia; Allen, Matti D; Medeiros, Philip J; Lacefield, James C; Jackson, Dwayne N; Rice, Charles L; Melling, C W James; Noble, Earl G; Shoemaker, J Kevin

    2014-06-15

    Insulin stimulates nerve arterial vasodilation through a nitric oxide (NO) synthase (NOS) mechanism. Experimental diabetes reduces vasa nervorum NO reactivity. Studies investigating hyperglycemia and nerve arterial vasodilation typically omit insulin treatment and use sedentary rats resulting in severe hyperglycemia. We tested the hypotheses that 1) insulin-treated experimental diabetes and inactivity (DS rats) will attenuate insulin-mediated nerve arterial vasodilation, and 2) deficits in vasodilation in DS rats will be overcome by concurrent exercise training (DX rats; 75-85% VO2 max, 1 h/day, 5 days/wk, for 10 wk). The baseline index of vascular conductance values (VCi = nerve blood flow velocity/mean arterial blood pressure) were similar (P ? 0.68), but peak VCi and the area under the curve (AUCi) for the VCi during a euglycemic hyperinsulinemic clamp (EHC; 10 mUkg(-1)min(-1)) were lower in DS rats versus control sedentary (CS) rats and DX rats (P ? 0.01). Motor nerve conduction velocity (MNCV) was lower in DS rats versus CS rats and DX rats (P ? 0.01). When compared with DS rats, DX rats expressed greater nerve endothelial NOS (eNOS) protein content (P = 0.04). In a separate analysis, we examined the impact of diabetes in exercise-trained rats alone. When compared with exercise-trained control rats (CX), DX rats had a lower AUCi during the EHC, lower MNCV values, and lower sciatic nerve eNOS protein content (P ? 0.03). Therefore, vasa nervorum and motor nerve function are impaired in DS rats. Such deficits in rats with diabetes can be overcome by concurrent exercise training. However, in exercise-trained rats (CX and DX groups), moderate hyperglycemia lowers vasa nervorum and nerve function. PMID:24740656

  12. Bacteria Present in Carotid Arterial Plaques Are Found as Biofilm Deposits Which May Contribute to Enhanced Risk of Plaque Rupture

    PubMed Central

    Lanter, Bernard B.; Sauer, Karin

    2014-01-01

    ABSTRACT Atherosclerosis, a disease condition resulting from the buildup of fatty plaque deposits within arterial walls, is the major underlying cause of ischemia (restriction of the blood), leading to obstruction of peripheral arteries, congestive heart failure, heart attack, and stroke in humans. Emerging research indicates that factors including inflammation and infection may play a key role in the progression of atherosclerosis. In the current work, atherosclerotic carotid artery explants from 15 patients were all shown to test positive for the presence of eubacterial 16S rRNA genes. Density gradient gel electrophoresis of 5 of these samples revealed that each contained 10 or more distinct 16S rRNA gene sequences. Direct microscopic observation of transverse sections from 5 diseased carotid arteries analyzed with a eubacterium-specific peptide nucleic acid probe revealed these to have formed biofilm deposits, with from 1 to 6 deposits per thin section of plaque analyzed. A majority, 93%, of deposits was located proximal to the internal elastic lamina and associated with fibrous tissue. In 6 of the 15 plaques analyzed, 16S rRNA genes from Pseudomonas spp. were detected. Pseudomonas aeruginosa biofilms have been shown in our lab to undergo a dispersion response when challenged with free iron in vitro. Iron is known to be released into the blood by transferrin following interaction with catecholamine hormones, such as norepinephrine. Experiments performed in vitro showed that addition of physiologically relevant levels of norepinephrine induced dispersion of P. aeruginosa biofilms when grown under low iron conditions in the presence but not in the absence of physiological levels of transferrin. PMID:24917599

  13. Self-Reported Menopausal Symptoms, Coronary Artery Calcification and Carotid Intima-Media Thickness in Recently Menopausal Women Screened for the Kronos Early Estrogen Prevention Study (KEEPS)

    PubMed Central

    Wolff, Erin Foran; He, Yunxiao; Black, Dennis M.; Brinton, Eliot A.; Budoff, Mathew J.; Cedars, Marcelle I.; Hodis, Howard N.; Lobo, Rogerio A.; Manson, JoAnn E.; Merriam, George R.; Miller, Virginia M.; Naftolin, Fredrick; Pal, Lubna; Santoro, Nanette; Zhang, Heping; Harman, S. Mitchell; Taylor, Hugh S.

    2012-01-01

    Objective To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis. Setting Multi-center, randomized controlled trial. Patients Recently menopausal women (n=868) screened for the Kronos Early Estrogen Prevention Study (KEEPS). Design Cross sectional analysis. Interventions None Main Outcome Measures Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum estradiol (E2) levels and measures of atherosclerosis were assessed. Atherosclerosis was quantified using Coronary Artery Calcium (CAC) Agatston scores (n=771) and Carotid Intima-Media Thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, estradiol (E2), CAC, and CIMT were assessed. Results In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations (p=0.09) and depression (p=0.07) approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness and E2. Conclusions Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine if baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease. PMID:23312232

  14. Enhanced steroid dosing reduces seizures during antiparasitic treatment for cysticercosis and early after

    PubMed Central

    Garcia, Hector H.; Gonzales, Isidro; Lescano, Andres G.; Bustos, Javier A.; Pretell, E. Javier; Saavedra, Herbert; Nash, Theodore E.

    2014-01-01

    SUMMARY Objective Neurocysticercosis is a major cause of seizures and epilepsy in endemic countries. Antiparasitic treatment of brain cysts leads to seizures due to the hosts inflammatory reaction, requiring concomitant steroids. We hypothesized that increased steroid dosing will reduce treatment-associated seizures. Methods Open-label randomized trial comparing 6 mg/d dexamethasone for 10 days (conventional) with 8 mg/d for 28 days followed by a 2 week taper (enhanced) in neurocysticercosis patients receiving albendazole. Follow up included active seizure surveillance and brain imaging. Study outcomes were seizure days and patients with seizures, both measured in days 11-42. Additional analyses compared days 1-10, 11-21, 22-32, 33-42, 43-60, and 61-180. Results Thirty-two individuals were randomized into each arm, two did not complete follow up. From days 11 to 42, 59 partial and 6 generalized seizure days occurred in 20 individuals, non-significantly fewer in the enhanced arm (12 versus 49, p=0.114). The numbers of patients with seizures in this period showed similar non-significant differences. In the enhanced steroid arm there were significantly fewer days and individuals with seizures during antiparasitic treatment (days 1-10: 4 versus 17, p=0.004, and 1 versus 10, p=0.003, number needed to treat 4.6, relative risk 0.1013, 95%CI: 0.01 0.74) and early after dexamethasone cessation (days 11-21: 6 versus 27, p=0.014, and 4 versus 12, p=0.021, NNT 4.0, RR 0.33, 95%CI: 0.12 0.92) but not after day 21. There were no significant differences in antiparasitic efficacy or relevant adverse events. Significance Increased dexamethasone dosing results in fewer seizures for the first 21 days during and early after antiparasitic treatment for viable parenchymal neurocysticercosis but not during the first 11-42 days, which was the primary predetermined time of analysis. PMID:25092547

  15. A magnetic-field enriched surface-enhanced resonance Raman spectroscopy strategy towards the early diagnosis of malaria

    NASA Astrophysics Data System (ADS)

    Yuen, Clement; Liu, Quan

    2012-03-01

    Early malaria diagnosis is important because malaria disease can develop into fatal illness within hours upon the appearance of the first symptom. The low concentration of the diagnosis biomarker, hemozoin, at the early stage of malaria disease makes early diagnosis difficult. In this paper, we present a magnetic field-enriched surface-enhanced resonance Raman spectroscopy (SERRS) strategy for the sensitive detection of ? - hematin crystals, which is equivalent to hemozoin in the characteristics of Raman spectrum, by using magnetic nanoparticles. We observe several orders of magnitude enhancement in the SERRS signal of enriched ? - hematin in comparison to the Raman signal of ? - hematin in the cases of SERRS alone or magnetic enrichment alone, showing the great potential of this method towards early malaria diagnosis.

  16. A magnetic-field enriched surface-enhanced resonance Raman spectroscopy strategy towards the early diagnosis of malaria

    NASA Astrophysics Data System (ADS)

    Clement, Yuen; Liu, Quan

    2012-02-01

    Early malaria diagnosis is important because malaria disease can develop into fatal illness within hours upon the appearance of the first symptom. The low concentration of the diagnosis biomarker, hemozoin, at the early stage of malaria disease makes early diagnosis difficult. In this paper, we present a magnetic field-enriched surface-enhanced resonance Raman spectroscopy (SERRS) strategy for the sensitive detection of ? - hematin crystals, which is equivalent to hemozoin in the characteristics of Raman spectrum, by using magnetic nanoparticles. We observe several orders of magnitude enhancement in the SERRS signal of enriched ? - hematin in comparison to the Raman signal of ? - hematin in the cases of SERRS alone or magnetic enrichment alone, showing the great potential of this method towards early malaria diagnosis.

  17. Complementary tumor vascularity imaging in a single PET-CT routine using FDG early dynamic blood flow and contrast-enhanced CT texture analysis

    NASA Astrophysics Data System (ADS)

    Carmi, Raz; Yefremov, Nikolay; Bernstine, Hanna; Groshar, David

    2014-03-01

    A feasibility study of improved PET-CT tumor imaging approach is presented. A single PET-CT routine includes three different techniques: 18F-FDG early dynamic blood flow intended for perfusion assessment; standard late 18F-FDG uptake; and high-resolution contrast-enhanced CT enabling tissue texture analysis. Both PET protocols utilize the same single standard radiotracer dose administration. Quantitative volumetric arterial perfusion maps are derived from the reconstructed dynamic PET images corresponding to successive acquisition time intervals of 3 seconds only. For achieving high accuracy, the analysis algorithm differentiates the first-pass arterial flow from other interfering dynamic effects, and a noise reduction scheme based on adaptive total-variation minimization aims to provide appreciable quantitative map in physical conditions of high noise and low spatial resolution. The CT texture analysis comprises a practical and robust method for generating volumetric tissue irregularity maps. A local map value is represented by the entropy function which is derived from a weighted co-occurrence matrix histogram of the corresponding image voxel three-dimensional vicinity. Unique entropy scaling scheme and parameter optimization process, as well as appropriate scaling for varying image noise levels and contrast agent concentrations, improve the results toward quantitative absolute measure with respect to diverse scanning conditions and key analysis parameters. Representative imaging results are demonstrated on several clinical cases involving different organs and cancer types. In these cases, significant tumor characterization relative to the normal surrounding tissues is seen on the quantitative maps of all three imaging techniques. This proof of concept can lead the way to a new practical diagnostic imaging application.

  18. [ANALYSIS OF THE ASSOCIATIONS BETWEEN ANGIOTENSIN-CONVERTING ENZYME GENE POLYMORPHISM AND ARTERIAL HYPOTENSION IN PREMATURE INFANTS WITH EARLY ONSET BACTERIAL INFECTIONS].

    PubMed

    Kovaleva, E; Pokhylko, V; Chernyavskaya, Yu; Kalyuzka, E; Poltoropavlov, V

    2015-11-01

    The rate of neonatal sepsis is not reduced varying inversely proportional to the gestational age at birth, and may reach 60% in the most immature infants. The high mortality rate of this disease and adverse neurological effects are associated with the development of cardiovascular changes and shock. The main leadership role in the regulation of blood pressure and blood volume in the body plays a renin-angiotensin system. Synthesis of angiotensin-converting enzyme is regulated by the ACE gene. The aim of the study was to identify and analyze the associations between the development of arterial hypotension in premature infants and insertion-deletion (I/D) polymorphism of the ACE gene. We conducted a prospective cohort study, which included 118 prematurely born children with early onset bacterial infections (n=57 with clinical manifestations in the form of hypotension, n=61 without hypotension). Both groups were genotyped to determine the insertion-deletion polymorphism ACE gene. We compared the clinical, laboratory and instrumental parameters in premature infants with hypotension and II, ID, DD genotype of the ACE gene. Also an analysis of the associations between different genotypes of ACE gene and the development of arterial hypotension in prematurely born children was conducted. The distribution of neonates in relation to the three polymorphic variants of ACE gene with respect to I/D polymorphism was identical among the study groups. The study found that children with a variety of I/D polymorphic variants of ACE gene had no significant differences in hemodynamic parameters. The rate of hemodynamic support use did not differ in both groups. The study of the associations between the ACE gene polymorphism and major ultrasound, Doppler indices that characterized both systemic and organ hemodynamics, revealed no significant differences in mean values ??of all the criteria that have been studied. It can be concluded no effect of I/D polymorphism of ACE gene on the occurrence of hemodynamic disorders in premature born children with early onset bacterial infections. PMID:26656553

  19. ElarmS Earthquake Early Warning System Enhancements and Performance Evaluation

    NASA Astrophysics Data System (ADS)

    Henson, I. H.; Neuhauser, D. S.; Allen, R. M.

    2013-12-01

    ElarmS is an earthquake early warning system that contributes alerts to CISN ShakeAlert, a prototype end-to-end earthquake early warning system being developed and tested by the California Integrated Seismic Network (CISN). ElarmS is one of several systems based on independent methodologies that contribute to CISN ShakeAlert. The UC Berkeley ElarmS system consists of multiple continuous-waveform processors and trigger-association processors running at three geographical locations and communicating via the Apache ActiveMQ Messaging system. Recent enhancements to the ElarmS system include reductions in trigger report times, reductions in trigger association and event alert times, and the development and testing of redundant processing and communication architectures. To enable redundant processing, ElarmS trigger associators handle duplicate trigger information arriving from duplicate waveform processors via different transmission paths. We have developed performance monitoring tools that report system component latencies and earthquake hypocenter parameter accuracy. Statistics for hypocenter and origin time accuracy and alert times latencies can be computed for different time periods, magnitude ranges and geographic regions. Individual earthquake processing histories can be examined, including details of the transmission and processing latencies associated with individual P-wave triggers, from arrival detection through several stages of processing to the association with an individual earthquake alert. Detailed event information includes latencies associated with the transmission of individual waveform packets from station to processing centers, waveform processing queues, trigger message queues, trigger message transmissions, trigger association and hypocenter location cpu times. Changes to the ElarmS algorithm and system architecture are frequently tested by running multiple versions of ElarmS simultaneously. A web browser interface to the performance monitoring tools includes tabular, mapping, and statistical analysis graphical components (generated by the R-Statistics System) that make it easy to compare different development versions of ElarmS.

  20. Enhanced brain signal variability in children with autism spectrum disorder during early childhood.

    PubMed

    Takahashi, Tetsuya; Yoshimura, Yuko; Hiraishi, Hirotoshi; Hasegawa, Chiaki; Munesue, Toshio; Higashida, Haruhiro; Minabe, Yoshio; Kikuchi, Mitsuru

    2016-03-01

    Extensive evidence shows that a core neurobiological mechanism of autism spectrum disorder (ASD) involves aberrant neural connectivity. Recent advances in the investigation of brain signal variability have yielded important information about neural network mechanisms. That information has been applied fruitfully to the assessment of aging and mental disorders. Multiscale entropy (MSE) analysis can characterize the complexity inherent in brain signal dynamics over multiple temporal scales in the dynamics of neural networks. For this investigation, we sought to characterize the magnetoencephalography (MEG) signal variability during free watching of videos without sound using MSE in 43 children with ASD and 72 typically developing controls (TD), emphasizing early childhood to older childhood: a critical period of neural network maturation. Results revealed an age-related increase of brain signal variability in a specific timescale in TD children, whereas atypical age-related alteration was observed in the ASD group. Additionally, enhanced brain signal variability was observed in children with ASD, and was confirmed particularly for younger children. In the ASD group, symptom severity was associated region-specifically and timescale-specifically with reduced brain signal variability. These results agree well with a recently reported theory of increased brain signal variability during development and aberrant neural connectivity in ASD, especially during early childhood. Results of this study suggest that MSE analytic method might serve as a useful approach for characterizing neurophysiological mechanisms of typical-developing and its alterations in ASD through the detection of MEG signal variability at multiple timescales. Hum Brain Mapp 37:1038-1050, 2016. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:26859309

  1. Elevated temperature enhances normal early embryonic development in the coral Platygyra acuta under low salinity conditions

    NASA Astrophysics Data System (ADS)

    Chui, Apple Pui Yi; Ang, Put

    2015-06-01

    To better understand the possible consequences of climate change on reef building scleractinian corals in a marginal environment, laboratory experiments were conducted to examine the interactive effects of changes in salinity and temperature on percent fertilization success and early embryonic development of the coral Platygyra acuta. In the present study, a salinity of 24 psu (ambient 32 psu) reduced fertilization success by 60 %. Normal embryonic development was reduced by >80 % at 26 psu (ambient 33 psu) with 100 % abnormal development at 22 psu under ambient temperature. Elevated temperature (+3 °C) above the ambient spawning temperature did not show any negative effects on fertilization success. However, there was a trend for more abnormal embryos to develop at elevated temperature in the 2 d of the spawning event. The interactive effects between salinity and temperature are statistically significant only on normal embryonic development of P. acuta, but not on its fertilization success. Salinity was revealed to be the main factor affecting both fertilization success and normal embryonic development. Interestingly, the much lower fertilization success (76 %) observed in the second day of spawning (Trial 2) under ambient temperature recovered to 99 % success under elevated (+3 °C) temperature conditions. Moreover, elevated temperature enhanced normal early embryonic development under lowered salinity (26 psu). This antagonistic interactive effect was consistently observed in two successive nights of spawning. Overall, our results indicate that, in terms of its fertilization success and embryonic development, P. acuta is the most tolerant coral species to reduced salinity thus far reported in the literature. Elevated temperature, at least that within the tolerable range of the corals, could apparently alleviate the potential negative effects from salinity stresses. This mitigating role of elevated temperature appears not to have been reported on corals before.

  2. Early assessment of chronic kidney dysfunction using contrast-enhanced ultrasound: a pilot study

    PubMed Central

    Dong, Y; Cao, J; Fan, P; Lin, X

    2014-01-01

    Objective: We performed a prospective study to evaluate the value of contrast-enhanced (CE) ultrasound in quantitative evaluation of renal cortex perfusion in patients with chronic kidney dysfunction (CKD Stage I–II). Methods: The present study was approved by the institutional ethics committee. The study focused on 41 consecutive patients (males, 32; females, 9; mean age, 55.0 ± 5.0 years) with clinical suspicion of CKD (Stages I–II). For both kidneys, CE ultrasound was performed after intravenous bolus injection of 1.0 ml SonoVue® (Bracco Imaging S.p.A., Milan, Italy). Time–intensity curves (TICs) and quantitative indexes were created with Qlab software (Philips, Bothell, WA). 45 healthy volunteers were included as control group. All statistical analyses were performed with SPSS® v. 15.0 software package (SPSS, Chicago, IL). A difference was considered statistically significant with p < 0.05. Results: Patients with CKD (Stages I–II) had no obvious change in the shape of TICs. Among all quantitative indexes, the changes of area under the curve (AUC), derived peak intensity (DPI) and slope rate of elevation curve (A) were statistically significant (p < 0.05). DPI <12 dB, A >2 and AUC >1300 dB s had high utility in the evaluation of CKD, with 81%, 73% and 78% specificities and 76%, 73% and 77% sensitivities. Conclusion: CE ultrasound might be valuable in the early evaluation of CKD. AUC, A and DPI might be valuable quantitative indexes. Advances in knowledge: Quantitative CE ultrasound analysis can be used for the standardized and early evaluation of renal dysfunction. PMID:25060882

  3. Arterial Baroreflex Control of Cardiac Vagal Outflow in Older Individuals Can Be Enhanced by Aerobic Exercise Training

    PubMed Central

    Deley, Gaelle; Picard, Glen; Taylor, J. Andrew

    2009-01-01

    Maintained cardiac vagal function is critical to cardiovascular health in human aging. Aerobic exercise training has been thought an attractive intervention to increase cardiovagal baroreflex function however, the data are equivocal. Moreover, if regular exercise does reverse the age-related decline in cardiovagal baroreflex function, it is unknown how this might be achieved. Therefore, we assessed the effects of a 6-month aerobic training program on baroreflex gain and its mechanical and neural components in older individuals (5 women and 7 men, aged 5571 years). We assessed baroreflex function using pharmacologic pressure changes (bolus nitroprusside followed by bolus phenylephrine) and estimated the integrated gain (?R-R interval/?systolic blood pressure) and mechanical (? diameter/? pressure) and neural (?R-R interval/? diameter) components via measurements of carotid artery diameter in previously sedentary older individuals before and after 6-months of aerobic training. There was a significant 26% increase in baroreflex gain that was directly related to the amount of exercise performed and that derived mainly from an increase in the neural component of the arterial baroreflex (p<0.05). We did find changes in the mechanical component but unlike integrated gain and the neural component, these were not related to the magnitude of the exercise stimulus. These results suggest that exercise training can have a powerful effect on cardiovagal baroreflex function, but a sufficient stimulus is necessary to produce the effect. Moreover, adaptations in the afferent efferent baroreflex control of cardiac vagal outflow may be crucial for the improvement in arterial baroreflex function in older humans. PMID:19332656

  4. Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma with Portal Vein Thrombosis: Impact of Early Response to 4 Weeks of Treatment

    PubMed Central

    Lin, Chen-Chun; Hung, Chien-Fu; Chen, Wei-Ting; Lin, Shi-Ming

    2015-01-01

    Aim The aim of the study was to investigate the impact of early response (ER) to hepatic arterial infusion chemotherapy (HAIC) on outcomes of patients with advanced hepatocellular carcinoma (HCC) complicated with major portal vein tumor thrombosis (PVTT). Methods Thirty-nine patients receiving HAIC with low-dose cisplatin, 5-fluorouracil (5FU), and leucovorin were enrolled. One course of HAIC consisted of 5 days of treatment and 2 days rest per week for 4 consecutive weeks. ER was categorized as complete response, partial response, or minor response and was determined by World Health Organization criteria with dynamic computed tomography findings performed within 1 week after the first course of HAIC. Results Thirteen (33%) patients achieved an ER. Twelve (92.3%) of these 13 ER patients achieved a higher overall response than all but one (3.8%) of the 26 non-early responders (NERs) (p<0.001). ER was the exclusive independent favorable factor for survival (p=0.003). Downstaging of tumors was noted in 76.9% of ERs, and these patients could proceed to locoregional therapies. ER patients subsequently had a higher 1-year survival (76.9% vs. 3.8%, p<0.001) and 6-month progression-free survival (PFS) (84.6% vs. 15.4%, p<0.001) than those for NERs. Only 8% of patients experienced grade 3 or higher toxicity during the first 4-week course of HAIC. Conclusions HAIC can yield a satisfactory ER for advanced HCC with PVTT. Moreover, achievement of ER after HAIC in advanced HCC with PVTT is strongly associated with better overall survival and PFS. PMID:26734578

  5. Predictors and outcomes of early coronary angiography in patients with prior coronary artery bypass surgery presenting with non-ST elevation myocardial infarction

    PubMed Central

    Asrar ul Haq, Muhammad; Rudd, Nima; Mian, Mueed; Castles, Anastasia; Mogilevski, Tamara; Mutha, Vivek; Van Gaal, William J

    2014-01-01

    Introduction The best strategy in patients with prior coronary artery bypass graft surgery (CABG) who present with non-ST elevation myocardial infarction (NSTEMI) remains less well defined. We compare the characteristics, therapeutic interventions and outcomes of patients with prior CABG presenting with NSTEMI. Methods All patients who presented to our hospital during 20072012 with available electronic records were analysed retrospectively. Outcomes were compared between patients who underwent coronary angiography or percutaneous coronary intervention (PCI) versus those who were treated medically. Results A total of 117 patients were analysed. Of that, 79 patients were managed medically while 38 underwent early angiography, of which only 11 (9.5%) received PCI. Patients treated medically (did not undergo angiography) were older (7410 vs708; p=0.05). ECG changes were the only independent predictor for early angiography (OR 0.4, 95% CI 0.15 to 0.99; p=0.05) while recurrent chest pain (OR 0.2, 95% CI 0.05 to 0.97; p=0.05) predicted PCI on multivariate analysis. The PCI group had higher Global Registry of Acute Cardiac Events (GRACE) score (17629 vs 15031; p=0.01). No significant difference was found in readmission rates, morbidity (unstable angina pectoris, NSTEMI, ST elevation myocardial infarction (STEMI), or combination) or mortality at 12?months between the groups who underwent angiography, PCI, or treated medically on univariate and multivariate analysis. Conclusions The opportunity to intervene in prior CABG patients presenting with NSTEMI is often low. Initial medical management may be a reasonable option in carefully selected patients particularly in the absence of ongoing symptoms, ECG changes or very high GRACE scores. Further studies are required to evaluate the safety of non-invasive strategies in managing this population. PMID:25332800

  6. Effect of anti-platelet factor-4/heparin antibody induction on early saphenous vein graft occlusion after coronary artery bypass surgery

    PubMed Central

    GLUCKMAN, T. J.; SEGAL, J. B.; SCHULMAN, S. P.; SHAPIRO, E. P.; KICKLER, T. S.; PRECHEL, M. M.; CONTE, J. V.; WALENGA, J. M.; SHAFIQUE, I.; RADE, J. J.

    2010-01-01

    Summary Background Antibodies to complexes of heparin and platelet factor 4 (PF4) are capable of causing heparin-induced thrombocytopenia (HIT). Recent evidence suggests that anti-PF4/heparin antibodies may be prothrombogenic even in the absence of thrombocytopenia and clinically-recognized HIT. Objectives To determine if induction of anti-PF4/heparin antibodies is an independent risk factor for early saphenous vein graft (SVG) occlusion or adverse clinical outcome after coronary artery bypass graft (CABG) surgery. Patients/Methods Anti-PF4/heparin antibody titers were measured in 368 patients prior to and then 4 days, 6 weeks and 6 months after CABG surgery. Serotonin release assay (SRA) and antibody isotype analysis were also performed on 6-week samples. SVG patency was determined in 297 patients 6 months after surgery by multidetector computed tomography coronary angiography. Results Six weeks after surgery, 52% of patients were anti-PF4/heparin seropositive and 9% were SRA positive. Six months after surgery, neither the percentage of occluded SVG (19% vs. 20%, P = NS), the percentage of patients with an occluded SVG (33% vs. 33%, P = NS) nor the incidence of adverse clinical events (21% vs. 24%, P = NS) differed between seropositive and seronegative groups. Neither IgG isotype nor SRA positivity was additionally predictive of SVG occlusion or adverse clinical outcome. Conclusion Induction of anti-PF4/heparin antibodies, even those capable of heparin-dependent platelet activation, is not independently associated with early SVG occlusion or adverse clinical outcomes after CABG surgery. PMID:19552638

  7. The bradykinin B2 receptor is a delayed early response gene for platelet-derived growth factor in arterial smooth muscle cells.

    PubMed

    Dixon, B S; Sharma, R V; Dennis, M J

    1996-06-01

    Bradykinin and platelet-derived growth factor (PDGF) are inflammatory mediators important in the response to vascular injury. Based upon the known effect of oncogenic Ras to increase bradykinin receptor expression and the ability of PDGF to stimulate Ras, we examined whether PDGF regulates bradykinin B2 receptor expression in cultured arterial smooth muscle cells. Treatment with PDGF (AB and BB, but not AA) produced a dose- and time-dependent increase in both mRNA (6-7-fold increase at 2-4 h) and cell surface receptors (2-4-fold at 6-12 h) for the B2 receptor. There was a 60-min delay between exposure to PDGF and the initial increase in B2 receptor mRNA. Transcriptional inhibitors, actinomycin D or 5, 6-dichloro-1-beta-D-ribofuranosylbenzimidazole, completely blocked the increase in B2 receptor mRNA when added up to 60 min after stimulation with PDGF. However, protein synthesis was not required, as treatment with cycloheximide did not block but rather superinduced the PDGF-induced increase in B2 receptor mRNA. Comparison with the immediate early response gene c-fos demonstrated that the increase in B2 receptor mRNA was similarly inhibited by the tyrosine kinase inhibitor, tyrphostin, as well as staurosporine. However, stimulation of c-fos was slightly more sensitive to genistein, while the B2 receptor mRNA was more sensitive to inhibition by the protein kinase C inhibitor, calphostin C. The increase in cell surface B2 receptors were functionally coupled to an increase in phosphoinositide-specific phospholipase C, and the effects of PDGF were selective as there was no increase in either angiotensin II- or arginine vasopressin-induced inositol phosphate formation or intracellular calcium release. Taken together, these results demonstrate that the B2 receptor is a delayed early response gene for PDGF in vascular smooth muscle cells. PMID:8662783

  8. Lumen segmentation and motion estimation in B-mode and contrast-enhanced ultrasound images of the carotid artery in patients with atherosclerotic plaque.

    PubMed

    Carvalho, Diego D B; Akkus, Zeynettin; van den Oord, Stijn C H; Schinkel, Arend F L; van der Steen, Antonius F W; Niessen, Wiro J; Bosch, Johan G; Klein, Stefan

    2015-04-01

    In standard B-mode ultrasound (BMUS), segmentation of the lumen of atherosclerotic carotid arteries and studying the lumen geometry over time are difficult owing to irregular lumen shapes, noise, artifacts, and echolucent plaques. Contrast enhanced ultrasound (CEUS) improves lumen visualization, but lumen segmentation remains challenging owing to varying intensities, CEUS-specific artifacts and lack of tissue visualization. To overcome these challenges, we propose a novel method using simultaneously acquired BMUS&CEUS image sequences. Initially, the method estimates nonrigid motion (NME) from the image sequences, using intensity-based image registration. The motion-compensated image sequence is then averaged to obtain a single "epitome" image with improved signal-to-noise ratio. The lumen is segmented from the epitome image through an intensity joint-histogram classification and a graph-based segmentation. NME was validated by comparing displacements with manual annotations in 11 carotids. The average root mean square error (RMSE) was 11273 ?m . Segmentation results were validated against manual delineations in the epitome images of two different datasets, respectively containing 11 (RMSE 19143 ?m) and 10 (RMSE 351176 ?m ) carotids. From the deformation fields, we derived arterial distensibility with values comparable to the literature. The average errors in all experiments were in the inter-observer variability range. To the best of our knowledge, this is the first study exploiting combined BMUS&CEUS images for atherosclerotic carotid lumen segmentation. PMID:25423650

  9. Detection of buried targets using a new enhanced very early time electromagnetic (VETEM) prototype system

    USGS Publications Warehouse

    Cui, T.J.; Chew, W.C.; Aydiner, A.A.; Wright, D.L.; Smith, D.V.

    2001-01-01

    In this paper, numerical simulations of a new enhanced very early time electromagnetic (VETEM) prototype system are presented, where a horizontal transmitting loop and two horizontal receiving loops are used to detect buried targets, in which three loops share the same axis and the transmitter is located at the center of receivers. In the new VETEM system, the difference of signals from two receivers is taken to eliminate strong direct-signals from the transmitter and background clutter and furthermore to obtain a better SNR for buried targets. Because strong coupling exists between the transmitter and receivers, accurate analysis of the three-loop antenna system is required, for which a loop-tree basis function method has been utilized to overcome the low-frequency breakdown problem. In the analysis of scattering problem from buried targets, a conjugate gradient (CG) method with fast Fourier transform (FFT) is applied to solve the electric field integral equation. However, the convergence of such CG-FFT algorithm is extremely slow at very low frequencies. In order to increase the convergence rate, a frequency-hopping approach has been used. Finally, the primary, coupling, reflected, and scattered magnetic fields are evaluated at receiving loops to calculate the output electric current. Numerous simulation results are given to interpret the new VETEM system. Comparing with other single-transmitter-receiver systems, the new VETEM has better SNR and ability to reduce the clutter.

  10. Numerical modeling of an enhanced very early time electromagnetic (VETEM) prototype system

    USGS Publications Warehouse

    Cui, T.J.; Chew, W.C.; Aydiner, A.A.; Wright, D.L.; Smith, D.V.; Abraham, J.D.

    2000-01-01

    In this paper, two numerical models are presented to simulate an enhanced very early time electromagnetic (VETEM) prototype system, which is used for buried-object detection and environmental problems. Usually, the VETEM system contains a transmitting loop antenna and a receiving loop antenna, which run on a lossy ground to detect buried objects. In the first numerical model, the loop antennas are accurately analyzed using the Method of Moments (MoM) for wire antennas above or buried in lossy ground. Then, Conjugate Gradient (CG) methods, with the use of the fast Fourier transform (FFT) or MoM, are applied to investigate the scattering from buried objects. Reflected and scattered magnetic fields are evaluated at the receiving loop to calculate the output electric current. However, the working frequency for the VETEM system is usually low and, hence, two magnetic dipoles are used to replace the transmitter and receiver in the second numerical model. Comparing these two models, the second one is simple, but only valid for low frequency or small loops, while the first modeling is more general. In this paper, all computations are performed in the frequency domain, and the FFT is used to obtain the time-domain responses. Numerical examples show that simulation results from these two models fit very well when the frequency ranges from 10 kHz to 10 MHz, and both results are close to the measured data.

  11. A Case Study of the Use of Internet Photobook Technology to Enhance Early Childhood "Scientist" Identity

    NASA Astrophysics Data System (ADS)

    Katz, Phyllis

    2011-10-01

    There are many influences on a child's identity. Photobook technology purposefully prepared around science explorations presents a modern opportunity to repeatedly trigger memories that reinforce the "me, as scientist" viewpoint. Semi-structured interviews at 6 and 8 years of age were conducted with a child who was the subject of a photobook of everyday science activities to gain insights into his thinking about the nature of science and how he interprets his younger self participating. Interview data were recorded, transcribed and analyzed using dimensions from the previously established parameters for the nature of science. The child's statements about his participation in the photos were matched to these dimensions to consider how he sees himself "doing science" through his early years. Preliminary findings suggest that the child recognizes elements of science and regards himself as an active participant. In both interviews, the child reinforces these views by the opportunity to revisit the experiences in the photobook. Affective components may motivate further science involvement as well: the child enjoyed the time and attention that the photos and discussion provided; the child took pride in being the subject of a book. This case study suggests that there is a fertile field of research to investigate how, for whom, and in what ways internet photobook technology may enhance a child's developing identity as capable science explorer.

  12. Early age strength enhancement of blended cement systems by CaCl{sub 2} and diethanol-isopropanolamine

    SciTech Connect

    Riding, Kyle; Silva, Denise A.; Scrivener, Karen

    2010-06-15

    The enhancement of the 1 day strength of cementitious systems by a combination of calcium chloride (CaCl{sub 2}) and diethanol-isopropanolamine (DEIPA) was studied, particularly in blended cement systems. A combination of quantitative X-ray diffraction with Rietveld refinement (QXRD), scanning electron microscopy (SEM)/backscattered electron image analysis, thermogravimetric analysis (TGA), and isothermal calorimetry were used to investigate the mechanism of strength enhancement by the additives. The additives were found to increase the early age mortar strength by enhancing the cement hydration, with the DEIPA enhancing primarily the aluminate hydration. DEIPA also affected the morphology of portlandite which was formed as thin plates. In parallel, the calcium-to-silica ratio of the C-S-H was found to increase with the use of DEIPA, possibly because of the inclusion of microcrystalline portlandite. After 48 h DEIPA was found to directly enhance the rate of reaction of granulated blast-furnace slag and fly ash.

  13. Vasodilator responses of rat isolated tail artery enhanced by oxygen- dependent, photochemical release of nitric oxide from iron-sulphur-nitrosyls.

    PubMed Central

    Flitney, F. W.; Megson, I. L.; Thomson, J. L.; Kennovin, G. D.; Butler, A. R.

    1996-01-01

    1. The vasodilator properties and photochemical decomposition of two synthetic iron-sulphur-nitrosyl clusters (cluster A: [Fe4S4(NO)4], tetranitrosyl-tetra-mu 3-sulphido-tetrahedro-tetrairon; and B:[Fe4S3 (NO)7]-1, heptanitrosyl-tri-mu 3-thioxotetraferrate(-1)) have been investigated. Experiments were carried out on isolated, internally-perfused segments of rat tail artery. 2. Bolus injections (10 microliters) of A or B ( > 0.25 mM) delivered into the internal perfusate generated sustained (or S-type) vasodilator responses, characterized by a persistent plateau of reduced tone due to NO released from clusters which enter and become trapped within endothelial cells. Clusters were therefore irradiated with visible laser light (lambda = 457.9 or 514.5 nm) either (a) in solution, while passing through a glass tube en route to the artery; or (b) when retained within the endothelium, by illuminating the artery directly during the plateau of an S-type response. Irradiation produced an additional vasodilator response, the magnitude of which depended upon wavelength and laser beam energy. 3. The nitric oxide synthase inhibitor, NG-monomethyl-L-arginine (100 microM), had no effect on light-induced vasodilator responses. However, they were (a) blocked entirely by adding oxyhaemoglobin (5 microM) to the internal perfusate; and (b) greatly enhanced by the enzyme superoxide dismutase (150 u ml-1). 4. Photolysis of cluster B was measured by absorption spectroscopy and by detecting NO released with an electrochemical sensor. The photochemical reaction was found to be oxygen-dependent. The half-time for inactivation of cluster-derived NO was measured by interposing different lengths of tubing (i.e. time delays) between the photolysis tube and NO sensor. The steady-state probe current decayed exponentially with increasing delay time, with a t 1/2 of 21 s. The amplitudes of vasodilator responses of the tail artery also decreased exponentially by increasing the time delay (t 1/2 = 58 s). Superoxide dismutase (150 u ml-1) prevented this from happening, showing that "inactivation' of cluster-derived NO was caused by reaction with superoxide anions formed during photolysis. 5. We conclude that potentiation of vasodilator responses to iron-sulphur-nitrosyl clusters by visible light is due to an oxygen-dependent photochemical reaction which accelerates the release of ligated nitrosyl groups as free NO. Based on our measurements, we estimate that ca 100 pM NO is sufficient to produce a just-detectable additional vasodilatation and that the ED50 dose is ca 3.7 nM. PMID:8730753

  14. Assessing the end-organ in peripheral arterial occlusive disease—from contrast—enhanced ultrasound to blood-oxygen-level-dependent MR imaging

    PubMed Central

    Partovi, Sasan; Jacobi, Bjoern; Fergus, Nathan; Schulte, Anja-Carina; Robbin, Mark R.; Bilecen, Deniz; Staub, Daniel

    2014-01-01

    Peripheral arterial occlusive disease (PAOD) is a result of atherosclerotic disease which is currently the leading cause of morbidity and mortality in the western world. Patients with PAOD may present with intermittent claudication or symptoms related to critical limb ischemia. PAOD is associated with increased mortality rates. Stenoses and occlusions are usually detected by macrovascular imaging, including ultrasound and cross-sectional methods. From a pathophysiological view these stenoses and occlusions are affecting the microperfusion in the functional end-organs, such as the skin and skeletal muscle. In the clinical arena new imaging technologies enable the evaluation of the microvasculature. Two technologies currently under investigation for this purpose on the end-organ level in PAOD patients are contrast-enhanced ultrasound (CEUS) and blood-oxygen-level-dependent (BOLD) MR imaging (MRI). The following article is providing an overview about these evolving techniques with a specific focus on skeletal muscle microvasculature imaging in PAOD patients. PMID:24834413

  15. Early treatment response to sorafenib for rabbit VX2 orthotic liver tumors: evaluation by quantitative contrast-enhanced ultrasound.

    PubMed

    Kong, Wen-Tao; Yuan, Hai-Xia; Cai, Hao; Wang, Wen-Ping; Tang, Yang; Zhang, Xiao-Long

    2015-04-01

    The aim of our study was to investigate the application of contrast-enhanced ultrasound (CEUS) and its quantification analysis for the prediction of early treatment response of sorafenib on rabbit VX2 liver tumor model. Rabbits were implanted VX2 tumor mass to establish a liver tumor model. Fourteen days after tumor implantation, rabbits presented with single liver tumor were randomly divided into two groups. Rabbits in treatment group were given by gavage once a day for 14 days with sorafenib suspension at a dose of 30 mg/kg, whereas rabbits in control group were given saline by gavage of the same volume. CEUS was performed before treatment and 3, 7, 14 days after treatment for the analysis of tumor size, enhancement pattern, and necrosis range. The time intensity curve (TIC) was used to obtain quantitative parameters of enhancement patterns. Before sorafenib administration, tumor volumes ranged from 0.24 to 0.75 cm(3) (mean 0.49??0.18 cm(3)) in treatment group and 0.24 to 0.44 cm(3) (mean 0.30??0.12 cm(3)) in control group. The dynamic enhancement patterns of tumors were homogeneous hyper-enhancement (n?=?8), heterogeneous hyper-enhancement (n?=?4), and peripheral rim-like enhancement (n?=?2). All tumors of the treatment group presented with peripheral rim-like enhancement with large necrotic area after sorafenib administration, whereas tumors of the control group showed heterogeneous hyper-enhancement (n?=?5) and peripheral rim-like enhancement (n?=?2). There was a significant difference in area under the curve (AUC) before and after sorafenib treatment (P?=?0.045). CEUS may be of value in the evaluation of early therapeutic response after sorafenib administration. PMID:25448880

  16. Impact of Chronic Renal Insufficiency on the Early and Late Clinical Outcomes of Carotid Artery Stenting Using Serum Creatinine vs Glomerular Filtration Rate

    PubMed Central

    AbuRahma, Ali F; Alhalbouni, Saadi; Abu-Halimah, Shadi; Dean, L Scott; Stone, Patrick A

    2015-01-01

    Background This study analyzed the impact of chronic renal insufficiency (CRI) on early and late clinical outcomes of carotid artery stenting (CAS) using serum creatinine and glomerular filtration rate (GFR). Study Design There were 313 CAS patients classified into 3 groups: normal (serum creatinine <1.5 mg/dL or GFR ? 60 mL/min/1.73 m2); moderate CRI, and severe CRI (serum creatinine ?3 or GFR < 30 mL/min/1.73 m2). Major adverse events ([MAE] stroke, death, and myocardial infarction) were compared for all groups. Results Using serum creatinine, perioperative stroke rates for normal, moderate, and severe CRI were: 5%, 0%, and 25%, respectively, (p = 0.05) vs 4.6%, 3.7%, and 11.1%, respectively, (p = 0.44) using GFR. The perioperative MAE rates for symptomatic patients were 9.3% and 0% (p = 0.355) and 2% and 5.9% (p = 0.223) for asymptomatic patients for normal and moderate/severe CRI, respectively, using serum creatinine vs 8.1% and 7.8%, respectively, for symptomatic patients and 2.5% and 3%, respectively, for asymptomatic patients using GFR. At a mean follow-up of 21 months, late MAE rates in normal vs moderate/severe CRI patients were 8.2% and 14%, respectively, (p = 0.247) using serum creatinine vs 6.6% and 13.3%, respectively, (p = 0.05) using GFR. Late MAE rates for symptomatic patients in normal vs moderate/severe CRI were: 8.7% vs 27%, respectively, (p = 0.061) using serum creatinine and 5.7% vs 18.8%, respectively, (p = 0.026) using GFR. Late death rate was 0.55% in normal vs 7.6% (p = 0.002) for moderate/severe CRI. Freedom from MAE at 3 years in symptomatic patients was 81% in normal and 46% in moderate/severe CRI (p = 0.0198). A multivariate Cox regression analysis showed that a GFR of < 60 mL/min/1.73 m2 had an odds ratio of 1.6 (p = 0.222) of having a MAE after CAS. Conclusions The GFR was more sensitive in detecting late MAE after CAS. Carotid artery stenting in moderate CRI patients can be done with a satisfactory perioperative outcome; however, late death was significant. PMID:24655873

  17. Arterial insufficiency

    MedlinePLUS

    ... the most common causes of arterial insufficiency is atherosclerosis or "hardening of the arteries." Fatty material (called ... Hansson GK, Hamsten A. Atherosclerosis, thrombosis, and vascular ... Medicine . 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011: ...

  18. Arterial Catheterization

    MedlinePLUS

    ... The arterial catheter allows accurate, second-to-second measurement of the blood pressure; repeated meas- urement is ... pressure must be lowered gradually in steps, and measurements with an arterial catheter help guide the treatment. ■ ...

  19. Plasma Levels of MicroRNA-499 Provide an Early Indication of Perioperative Myocardial Infarction in Coronary Artery Bypass Graft Patients

    PubMed Central

    Yao, Youxiu; Du, Juan; Cao, Xiaoqing; Wang, Yang; Huang, Yaohua; Hu, Shengshou; Zheng, Zhe

    2014-01-01

    Background Recent studies indicated that microRNAs (miRNAs, miRs) were important for many biological and pathological processes, and they might be potential biomarkers for cardiovascular diseases. The present study aims to determine the release patterns of miRNAs in cardiac surgery and to analyze the ability of miRs to provide early prediction of perioperative myocardial infarction (PMI) in patients undergoing coronary artery bypass graft (CABG) surgery. Methodology/Principal Findings Thirty on-pump CABG patients were recruited in this study; and miR-499, miR-133a and miR-133b, cardiac troponin I (cTnI) were selected for measurement. Serial plasma samples were collected at seven perioperative time points (preoperatively, and 1, 3, 6, 12, 24, and 48 hours after declamping) and were tested for cTnI and miRs levels. Importantly, miR levels peaked as early as 13 hours, whereas cTnI levels peaked at 6 hours after declamping. Peak plasma concentrations of miRs correlated significantly with cTnI (miR-499, r?=?0.583, P?=?0.001; miR-133a, r?=?0.514, P?=?0.006; miR-133b, r?=?0.437, P?=?0.05), indicating the degree of myocardial damage. In addition, 30 off-pump CABG patients were recruited; miR-499 and miR-133a levels were tested, which were significantly lower in off-pump group than in on-pump group. A prospective cohort of CABG patients (n?=?120) was recruited to study the predictive power of miRs for PMI. The diagnosis of PMI strictly adhered to the principles of universal definition of myocardial infarction. The data analysis revealed that miR-499 had higher sensitivity and specificity than cTnI, and indicated that miR-499 could be an independent risk factor for PMI. Conclusion Our results demonstrate that circulating miR-499 is a novel, early biomarker for identifying perioperative myocardial infarction in cardiac surgery. PMID:25111390

  20. Pregnancy-related rupture of arterial aneurysms.

    PubMed

    Barrett, J M; Van Hooydonk, J E; Boehm, F H

    1982-09-01

    Over 50 per cent of ruptured arterial aneurysms in women under the age of 40 are pregnancy-related. The hemodynamic and endocrine changes of pregnancy appear to be the cause of arterial alterations which may lead to new aneurysm formation and/or weakening of preexisting aneurysms. The most commonly reported arteries to have aneurysms rupture during pregnancy are the aorta, cerebral arteries, splenic artery, renal artery, coronary artery, and ovarian artery. In many instances, the rupture of an arterial aneurysm will initially simulate other less serious disease processes, thus delaying the correct diagnosis until a catastrophic event occurs. Early diagnosis and treatment of a ruptured arterial aneurysm are imperative in order to give optimal chances of survival to the mother and fetus. PMID:6752786

  1. Pretreatment Dynamic Contrast-Enhanced MRI Improves Prediction of Early Distant Metastases in Patients With Nasopharyngeal Carcinoma

    PubMed Central

    Chin, Shy-Chyi; Lin, Chien-Yu; Huang, Bing-Shen; Tsang, Ngan-Ming; Fan, Kang-Hsing; Ku, Yi-Kang; Hsu, Cheng-Lung; Chan, Sheng-Chieh; Huang, Shiang-Fu; Li, Cheng-He; Tseng, Hsiao-Jung; Liao, Chun-Ta; Liu, Ho-Ling; Sung, Kyunghyun

    2016-01-01

    Abstract The identification of early distant metastases (DM) in patients with newly diagnosed, previously untreated nasopharyngeal carcinoma (NPC) plays an important role in selecting the most appropriate treatment approach. Here, we sought to investigate the predictive value of distinct MRI parameters for the detection of early DM. Between November 2010 and June 2011, a total of 51 newly diagnosed NPC patients were included. All of the study participants were followed until December 2014 at a single institution after completion of therapy. DM was defined as early when they were detected on pretreatment FDG-PET scans or within 6 months after initial diagnosis. The following parameters were tested for their ability to predict early DM: pretreatment FDG-PET standardized uptake value (SUV), MRI-derived AJCC tumor staging, tumor volume, and dynamic contrast-enhanced (DCE) values. The DCE-derived ve was defined as the volume fraction of the extravascular, extracellular space. Compared with patients without early DM, patients with early DM had higher SUV, tumor volume, DCE mean (median) ve, ve skewness, ve kurtosis, and the largest mean ve selected among sequential slices (P < 0.05). No differences were identified when early DM were defined only according to the results of pretreatment FDG-PET. Among different quantitative DCE parameters, the mean ve had the highest area under curve (AUC, 0.765). However, the AUCs of SUV, tumor volume, mean ve, ve skewness, ve kurtosis, or the largest mean ve selected among the sequential slices did not differ significantly from one another (P = 0.82). Taken together, our results suggest that DCE-derived ve may be a useful parameter in combination with SUV and tumor volume for predicting early DM. Dynamic contrast-enhanced MRI may be complementary to FDG-PET for selecting the most appropriate treatment approach in NPC patients. PMID:26871776

  2. Pretreatment Dynamic Contrast-Enhanced MRI Improves Prediction of Early Distant Metastases in Patients With Nasopharyngeal Carcinoma.

    PubMed

    Chin, Shy-Chyi; Lin, Chien-Yu; Huang, Bing-Shen; Tsang, Ngan-Ming; Fan, Kang-Hsing; Ku, Yi-Kang; Hsu, Cheng-Lung; Chan, Sheng-Chieh; Huang, Shiang-Fu; Li, Cheng-He; Tseng, Hsiao-Jung; Liao, Chun-Ta; Liu, Ho-Ling; Sung, Kyunghyun

    2016-02-01

    The identification of early distant metastases (DM) in patients with newly diagnosed, previously untreated nasopharyngeal carcinoma (NPC) plays an important role in selecting the most appropriate treatment approach. Here, we sought to investigate the predictive value of distinct MRI parameters for the detection of early DM.Between November 2010 and June 2011, a total of 51 newly diagnosed NPC patients were included. All of the study participants were followed until December 2014 at a single institution after completion of therapy. DM was defined as early when they were detected on pretreatment FDG-PET scans or within 6 months after initial diagnosis. The following parameters were tested for their ability to predict early DM: pretreatment FDG-PET standardized uptake value (SUV), MRI-derived AJCC tumor staging, tumor volume, and dynamic contrast-enhanced (DCE) values. The DCE-derived ve was defined as the volume fraction of the extravascular, extracellular space.Compared with patients without early DM, patients with early DM had higher SUV, tumor volume, DCE mean (median) ve, ve skewness, ve kurtosis, and the largest mean ve selected among sequential slices (P < 0.05). No differences were identified when early DM were defined only according to the results of pretreatment FDG-PET. Among different quantitative DCE parameters, the mean ve had the highest area under curve (AUC, 0.765). However, the AUCs of SUV, tumor volume, mean ve, ve skewness, ve kurtosis, or the largest mean ve selected among the sequential slices did not differ significantly from one another (P = 0.82).Taken together, our results suggest that DCE-derived ve may be a useful parameter in combination with SUV and tumor volume for predicting early DM. Dynamic contrast-enhanced MRI may be complementary to FDG-PET for selecting the most appropriate treatment approach in NPC patients. PMID:26871776

  3. Folic Acid Enhances Early Functional Recovery in a Piglet Model of Pediatric Head Injury

    PubMed Central

    Naim, Maryam Y.; Friess, Stuart; Smith, Colin; Ralston, Jill; Ryall, Karen; Helfaer, Mark A.; Margulies, Susan S.

    2011-01-01

    For stroke and spinal cord injury, folic acid supplementation has been shown to enhance neurodevelopment and to provide neuroprotection. We hypothesized that folic acid would reduce brain injury and improve neurological outcome in a neonatal piglet model of traumatic brain injury (TBI), using 4 experimental groups of 3- to 5-day-old female piglets. Two groups were intubated, anesthetized and had moderate brain injury induced by rapid axial head rotation without impact. One group of injured (Inj) animals received folic acid (Fol; 80 μg/kg) by intraperitoneal (IP) injection 15 min following injury, and then daily for 6 days (Inj + Fol; n = 7). The second group of injured animals received an IP injection of saline (Sal) at the same time points (Inj + Sal; n = 8). Two uninjured (Uninj) control groups (Uninj + Fol, n = 8; Uninj + Sal, n = 7) were intubated, anesthetized and received folic acid (80 μg/kg) or saline by IP injection at the same time points as the injured animals following a sham procedure. Animals underwent neurobehavioral and cognitive testing on days 1 and 4 following injury to assess behavior, memory, learning and problem solving. Serum folic acid and homocysteine levels were collected prior to injury and again before euthanasia. The piglets were euthanized 6 days following injury, and their brains were perfusion fixed for histological analysis. Folic acid levels were significantly higher in both Fol groups on day 6. Homocysteine levels were not affected by treatment. On day 1 following injury, the Inj + Fol group showed significantly more exploratory interest, and better motor function, learning and problem solving compared to the Inj + Sal group. Inj + Fol animals had a significantly lower cognitive composite dysfunction score compared to all other groups on day 1. These functional improvements were not seen on day 4 following injury. Axonal injury measured by β-amyloid precursor protein staining 6 days after injury was not affected by treatment. These results suggest that folic acid may enhance early functional recovery in this piglet model of pediatric head injury. This is the first study to describe the application of complex functional testing to assess an intervention outcome in a swine model of TBI. PMID:21212637

  4. Folic acid enhances early functional recovery in a piglet model of pediatric head injury.

    PubMed

    Naim, Maryam Y; Friess, Stuart; Smith, Colin; Ralston, Jill; Ryall, Karen; Helfaer, Mark A; Margulies, Susan S

    2010-01-01

    For stroke and spinal cord injury, folic acid supplementation has been shown to enhance neurodevelopment and to provide neuroprotection. We hypothesized that folic acid would reduce brain injury and improve neurological outcome in a neonatal piglet model of traumatic brain injury (TBI), using 4 experimental groups of 3- to 5-day-old female piglets. Two groups were intubated, anesthetized and had moderate brain injury induced by rapid axial head rotation without impact. One group of injured (Inj) animals received folic acid (Fol; 80 ?g/kg) by intraperitoneal (IP) injection 15 min following injury, and then daily for 6 days (Inj + Fol; n = 7). The second group of injured animals received an IP injection of saline (Sal) at the same time points (Inj + Sal; n = 8). Two uninjured (Uninj) control groups (Uninj + Fol, n = 8; Uninj + Sal, n = 7) were intubated, anesthetized and received folic acid (80 ?g/kg) or saline by IP injection at the same time points as the injured animals following a sham procedure. Animals underwent neurobehavioral and cognitive testing on days 1 and 4 following injury to assess behavior, memory, learning and problem solving. Serum folic acid and homocysteine levels were collected prior to injury and again before euthanasia. The piglets were euthanized 6 days following injury, and their brains were perfusion fixed for histological analysis. Folic acid levels were significantly higher in both Fol groups on day 6. Homocysteine levels were not affected by treatment. On day 1 following injury, the Inj + Fol group showed significantly more exploratory interest, and better motor function, learning and problem solving compared to the Inj + Sal group. Inj + Fol animals had a significantly lower cognitive composite dysfunction score compared to all other groups on day 1. These functional improvements were not seen on day 4 following injury. Axonal injury measured by ?-amyloid precursor protein staining 6 days after injury was not affected by treatment. These results suggest that folic acid may enhance early functional recovery in this piglet model of pediatric head injury. This is the first study to describe the application of complex functional testing to assess an intervention outcome in a swine model of TBI. PMID:21212637

  5. Right Pulmonary Artery Distensibility Index (RPAD Index). A field study of an echocardiographic method to detect early development of pulmonary hypertension and its severity even in the absence of regurgitant jets for Doppler evaluation in heartworm-infected dogs.

    PubMed

    Venco, Luigi; Mihaylova, Liliya; Boon, June A

    2014-11-15

    Despite the term "heartworm disease" Dirofilaria immitis infection in dogs should be considered a pulmonary arterial disease that might only involve the right heart structures in its late stage. Chronic infection by adult heartworms in dogs results in proliferative endoarteritis leading to progressively increasing pulmonary artery pressure due to reduced elasticity. Elasticity allows the pulmonary arteries to stretch in response to each pulse and helps maintain a relatively constant pressure in the arteries despite the pulsating nature of the blood flow. Pulmonary artery distensibility for both acute and chronic pulmonary hypertension has been investigated in humans using MRI and has been correlated with the severity of hypertension and its outcome and treatment response. The aim of the present study was to investigate whether echocardiographic measurement of the percentage change in diameter of the right pulmonary artery in systole and diastole (distensibility) may be of value in assessing the presence and severity of pulmonary hypertension in heartworm-infected dogs. The Right Pulmonary Artery Distensibility Index (RPAD Index) (which is calculated as the difference in diameter of the right pulmonary artery in systole and diastole) was calculated in healthy and naturally infected heartworm-positive dogs. The right pulmonary artery was chosen because it is usually affected earlier and to a greater degree. Data were obtained from healthy heartworm-free dogs without any clinical, radiographic, or echocardiographic signs of pulmonary hypertension; naturally infected heartworm-positive dogs in different stages of the disease in which pulmonary pressure could be measured by Doppler echocardiography (using tricuspid and or pulmonary regurgitation velocity and pressure gradient); and naturally infected heartworm-positive dogs in different stages of the disease (with or without tricuspid and or pulmonary regurgitation) in which the pulmonary pressure was measured invasively and noninvasively if possible. Results of these evaluations indicated that RPAD Index is a valuable method for early detection of the presence and severity of pulmonary hypertension in heartworm-infected dogs even in the absence of regurgitant jets for Doppler evaluation and that there is a strong correlation between the RPAD Index and the level of pulmonary hypertension. PMID:25218885

  6. Visual orientation processing in autism spectrum disorder: No sign of enhanced early cortical function.

    PubMed

    Shafai, Fakhri; Armstrong, Kimberly; Iarocci, Grace; Oruc, Ipek

    2015-11-01

    It has been suggested that enhanced perceptual processing underlies some of the social difficulties associated with autism spectrum disorder (ASD). While a variety of visual tasks have been reported in which individuals with ASD outperform neurotypical individuals in control groups, the precise origin of such effects within the visual pathway remains unclear. It has recently been established that visual acuity is intact yet unremarkable in ASD. This suggests that the earliest levels of retinal processing are an unlikely candidate as the source of differences. The next potential levels for divergent visual processing are those involved in processing simple aspects of visual stimuli, such as orientation and spatial frequency, considered to be functions of early visual cortex. Here we focused on the basic processing of orientation. In three experiments, we assessed three basic aspects of orientation processing-discrimination, veridical perception, and detection-in participants with ASD in comparison to age-, gender-, and IQ-matched adults without ASD. Each experiment allowed for both qualitative and quantitative comparisons between the two groups. These provided a dense array of data indicating that participants with ASD perceive orientation of low-level stimuli in a qualitatively (as well as quantitatively) similar manner to participants without ASD in control groups, with no evidence of superior processing in detection, precision, or accuracy aspects of orientation perception. These results suggest that the source for altered perceptual abilities should be sought elsewhere, possibly in specific subgroups of people with ASD, other aspects of low-level vision such as spatial frequency, or subsequent levels of visual processing. PMID:26605847

  7. Prematurely Elevating Estradiol in Early Baboon Pregnancy Suppresses Uterine Artery Remodeling and Expression of Extravillous Placental Vascular Endothelial Growth Factor and ?1?1 and ?5?1 Integrins

    PubMed Central

    Bonagura, Thomas W.; Babischkin, Jeffery S.; Aberdeen, Graham W.; Pepe, Gerald J.

    2012-01-01

    We previously showed that advancing the increase in estradiol levels from the second to the first third of baboon pregnancy suppressed placental extravillous trophoblast (EVT) invasion and remodeling of the uterine spiral arteries. Cell culture studies show that vascular endothelial cell growth factor (VEGF) plays a central role in regulating EVT migration and remodeling of the uterine spiral arteries by increasing the expression/action of certain integrins that control extracellular matrix remodeling. To test the hypothesis that the estradiol-induced reduction in vessel remodeling in baboons is associated with an alteration in VEGF and integrin expression, extravillous placental VEGF and integrin expression was determined on d 60 of gestation (term is 184 d) in baboons in which uterine artery transformation was suppressed by maternal estradiol administration on d 2559. EVT uterine spiral artery invasion was 5-fold lower (P < 0.01), and VEGF protein expression, quantified by in situ proximity ligation assay, was 50% lower (P < 0.05) in the placenta anchoring villi of estradiol-treated than in untreated baboons. ?1?1 and ?5?1 mRNA levels in cells isolated by laser capture microdissection from the anchoring villi and cytotrophoblastic shell of estradiol-treated baboons were over 2-fold (P < 0.01) and 40% (P < 0.05) lower, respectively, than in untreated animals. In contrast, placental extravillous ?v?3 mRNA expression was unaltered by estradiol treatment. In summary, extravillous placental expression of VEGF and ?1?1 and ?5?1 integrins was decreased in a cell- and integrin-specific manner in baboons in which EVT invasion and remodeling of the uterine spiral arteries were suppressed by prematurely elevating estradiol levels in early pregnancy. We propose that estrogen normally controls the extent to which the uterine arteries are transformed by placental EVT in primate pregnancy by regulating expression of VEGF and particular integrin extracellular remodeling molecules that mediate this process. PMID:22495671

  8. THE EFFECT OF HELIUM-ENHANCED STELLAR POPULATIONS ON THE ULTRAVIOLET-UPTURN PHENOMENON OF EARLY-TYPE GALAXIES

    SciTech Connect

    Chung, Chul; Yoon, Suk-Jin; Lee, Young-Wook

    2011-10-20

    Recent observations and modeling of globular clusters (GCs) with multiple populations strongly indicate the presence of super-helium-rich subpopulations in old stellar systems. Motivated by this, we have constructed new population synthesis models with and without helium-enhanced subpopulations to investigate their impact on the UV-upturn phenomenon of quiescent early-type galaxies (ETGs). We find that our models with helium-enhanced subpopulations can naturally reproduce the strong UV-upturns observed in giant elliptical galaxies assuming an age similar to that of old GCs in the Milky Way. The major source of far-UV (FUV) flux, in this model, is relatively metal-poor and helium-enhanced hot horizontal-branch stars and their progeny. The Burstein et al. relation of the FUV - V color with metallicity is also explained either by the variation of the fraction of helium-enhanced subpopulations or by the spread in mean age of stellar populations in ETGs.

  9. Glycosylated hemoglobin A1c as a marker predicting the severity of coronary artery disease and early outcome in patients with stable angina

    PubMed Central

    2014-01-01

    Background Glycosylated hemoglobin A1C (HbA1c) has been widely recognized as a marker for predicting the severity of diabetes mellitus (DM) and several cardiovascular diseases. However, whether HbA1c could predict the severity and clinical outcomes in patients with stable coronary artery disease (CAD) remains largely unknown. We determine relationship of HbA1c with severity and outcome in patients with stable CAD. Methods We enrolled 1433 patients with stable angina who underwent coronary angiography and were followed up for an average 12months. The patients were classified into three groups by tertiles of baseline HbA1c level (low group <5.7%, n?=?483; intermediate group 5.7 - 6.3%, n?=?512; high group >6.3%, n?=?438). The relationships between the plasma HbA1c and severity of CAD and early clinical outcomes were evaluated. Results High HbA1c was associated with three-vessel disease. Area under the receivers operating characteristic curve (AUC?=?0.67, 95% CI: 0.63-0.71, P?

  10. Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning

    SciTech Connect

    Abraham, R.D.; Freedman, S.B.; Dunn, R.F.; Newman, H.; Roubin, G.S.; Harris, P.J.; Kelly, D.T.

    1986-09-01

    Exercise electrocardiography and thallium scanning were performed a mean of 24 days after uncomplicated acute myocardial infarction in 103 patients, aged 36 to 60 years, who also underwent coronary angiography. The purpose of the study was to determine the ability of the noninvasive tests to predict multivessel coronary artery disease (CAD) and prognosis. Patients were followed up to document medical complications (incidence 12%: 3 deaths, 1 resuscitated cardiac arrest, 4 recurrent infarctions, 4 admissions with unstable angina) and combined events (medical events or bypass surgery, incidence 23%). The sensitivity, specificity and predictive accuracy for predicting multivessel CAD were 64%, 77% and 64% for a positive exercise electrocardiographic (ECG) response, 64%, 88% and 80% for a remote thallium defect, and 42%, 96% and 88% for a combination of the 2 tests. With 2 tests yielding negative findings the probability of multivessel CAD was 13%. No variable (positive exercise ECG response, remote thallium defect and presence of multivessel CAD) predicted medical events, although there were nonsignificant trends to more events in patients with any of those findings. The relative risk of combined events was 2.5 (p less than 0.05) for a positive exercise ECG response; 1.8 (NS) for a remote thallium defect; 2.6 (p less than 0.05) for multivessel CAD; and 3.1 (p less than 0.025) for both positive ECG response and remote defect. A combination of exercise electrocardiography and thallium scanning early after acute myocardial infarction helps to identify subsets of patients with high and low probabilities of multivessel CAD and combined medical or surgical events.

  11. Extensive complement-dependent enhancement of HIV-1 by autologous non-neutralising antibodies at early stages of infection

    PubMed Central

    2011-01-01

    Background Non-neutralising antibodies to the envelope glycoprotein are elicited during acute HIV-1 infection and are abundant throughout the course of disease progression. Although these antibodies appear to have negligible effects on HIV-1 infection when assayed in standard neutralisation assays, they have the potential to exert either inhibitory or enhancing effects through interactions with complement and/or Fc receptors. Here we report that non-neutralising antibodies produced early in response to HIV-1 infection can enhance viral infectivity. Results We investigated this complement-mediated antibody-dependent enhancement (C'-ADE) of early HIV infection by carrying out longitudinal studies with primary viruses and autologous sera derived sequentially from recently infected individuals, using a T cell line naturally expressing the complement receptor 2 (CR2; CD21). The C'-ADE was consistently observed and in some cases achieved infection-enhancing levels of greater than 350-fold, converting a low-level infection to a highly destructive one. C'-ADE activity declined as a neutralising response to the early virus emerged, but later virus isolates that had escaped the neutralising response demonstrated an increased capacity for enhanced infection by autologous antibodies. Moreover, sera with autologous enhancing activity were capable of C'ADE of heterologous viral isolates, suggesting the targeting of conserved epitopes on the envelope glycoprotein. Ectopic expression of CR2 on cell lines expressing HIV-1 receptors was sufficient to render them sensitive to C'ADE. Conclusions Taken together, these results suggest that non-neutralising antibodies to the HIV-1 envelope that arise during acute infection are not 'passive', but in concert with complement and complement receptors may have consequences for HIV-1 dissemination and pathogenesis. PMID:21401915

  12. Real-Time 12-Lead High-Frequency QRS Electrocardiography for Enhanced Detection of Myocardial Ischemia and Coronary Artery Disease

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Kulecz, Walter B.; DePalma, Jude L.; Feiveson, Alan H.; Wilson, John S.; Rahman, M. Atiar; Bungo, Michael W.

    2004-01-01

    Several studies have shown that diminution of the high-frequency (HF; 150-250 Hz) components present within the central portion of the QRS complex of an electrocardiogram (ECG) is a more sensitive indicator for the presence of myocardial ischemia than are changes in the ST segments of the conventional low-frequency ECG. However, until now, no device has been capable of displaying, in real time on a beat-to-beat basis, changes in these HF QRS ECG components in a continuously monitored patient. Although several software programs have been designed to acquire the HF components over the entire QRS interval, such programs have involved laborious off-line calculations and postprocessing, limiting their clinical utility. We describe a personal computer-based ECG software program developed recently at the National Aeronautics and Space Administration (NASA) that acquires, analyzes, and displays HF QRS components in each of the 12 conventional ECG leads in real time. The system also updates these signals and their related derived parameters in real time on a beat-to-beat basis for any chosen monitoring period and simultaneously displays the diagnostic information from the conventional (low-frequency) 12-lead ECG. The real-time NASA HF QRS ECG software is being evaluated currently in multiple clinical settings in North America. We describe its potential usefulness in the diagnosis of myocardial ischemia and coronary artery disease.

  13. Real-time 12-lead high-frequency QRS electrocardiography for enhanced detection of myocardial ischemia and coronary artery disease.

    PubMed

    Schlegel, Todd T; Kulecz, Walter B; DePalma, Jude L; Feiveson, Alan H; Wilson, John S; Rahman, M Atiar; Bungo, Michael W

    2004-03-01

    Several studies have shown that diminution of the high-frequency (HF; 150-250 Hz) components present within the central portion of the QRS complex of an electrocardiogram (ECG) is a more sensitive indicator for the presence of myocardial ischemia than are changes in the ST segments of the conventional low-frequency ECG. However, until now, no device has been capable of displaying, in real time on a beat-to-beat basis, changes in these HF QRS ECG components in a continuously monitored patient. Although several software programs have been designed to acquire the HF components over the entire QRS interval, such programs have involved laborious off-line calculations and postprocessing, limiting their clinical utility. We describe a personal computer-based ECG software program developed recently at the National Aeronautics and Space Administration (NASA) that acquires, analyzes, and displays HF QRS components in each of the 12 conventional ECG leads in real time. The system also updates these signals and their related derived parameters in real time on a beat-to-beat basis for any chosen monitoring period and simultaneously displays the diagnostic information from the conventional (low-frequency) 12-lead ECG. The real-time NASA HF QRS ECG software is being evaluated currently in multiple clinical settings in North America. We describe its potential usefulness in the diagnosis of myocardial ischemia and coronary artery disease. PMID:15008608

  14. Intra-Section Analysis of Human Coronary Arteries Reveals a Potential Role for Micro-Calcifications in Macrophage Recruitment in the Early Stage of Atherosclerosis

    PubMed Central

    Chatrou, Martijn L. L.; Cleutjens, Jack P.; van der Vusse, Ger J.; Roijers, Ruben B.; Mutsaers, Peter H. A.; Schurgers, Leon J.

    2015-01-01

    Background Vascular calcification is associated with poor cardiovascular outcome. Histochemical analysis of calcification and the expression of proteins involved in mineralization are usually based on whole section analysis, thereby often ignoring regional differences in atherosclerotic lesions. At present, limited information is available about factors involved in the initiation and progression of atherosclerosis. Aim of This Study This study investigates the intra-section association of micro-calcifications with markers for atherosclerosis in randomly chosen section areas of human coronary arteries. Moreover, the possible causal relationship between calcifying vascular smooth muscle cells and inflammation was explored in vitro. Technical Approach To gain insights into the pathogenesis of atherosclerosis, we performed analysis of the distribution of micro-calcifications using a 3-MeV proton microbeam. Additionally, we performed systematic analyses of 30 to 40 regions of 12 coronary sections obtained from 6 patients including histology and immuno-histochemistry. Section areas were classified according to CD68 positivity. In vitro experiments using human vascular smooth muscle cells (hVSMCs) were performed to evaluate causal relationships between calcification and inflammation. Results From each section multiple areas were randomly chosen and subsequently analyzed. Depositions of calcium crystals at the micrometer scale were already observed in areas with early pre-atheroma type I lesions. Micro-calcifications were initiated at the elastica interna concomitantly with upregulation of the uncarboxylated form of matrix Gla-protein (ucMGP). Both the amount of calcium crystals and ucMGP staining increased from type I to IV atherosclerotic lesions. Osteochondrogenic markers BMP-2 and osteocalcin were only significantly increased in type IV atheroma lesions, and at this stage correlated with the degree of calcification. From atheroma area type III onwards a considerable number of CD68 positive cells were observed in combination with calcification, suggesting a pro-inflammatory effect of micro-calcifications. In vitro, invasion assays revealed chemoattractant properties of cell-culture medium of calcifying vascular smooth muscle cells towards THP-1 cells, which implies pro-inflammatory effect of calcium deposits. Additionally, calcifying hVSMCs revealed a pro-inflammatory profile as compared to non-calcifying hVSMCs. Conclusion Our data indicate that calcification of VSMCs is one of the earliest events in the genesis of atherosclerosis, which strongly correlates with ucMGP staining. Our findings suggest that loss of calcification inhibitors and/or failure of inhibitory capacity is causative for the early precipitation of calcium, with concomitant increased inflammation followed by osteochondrogenic transdifferentiation of VSMCs. PMID:26555788

  15. Early outcome of Coronary Artery Bypass Graft Surgery in patients with significant Left Main Stem stenosis at a tertiary cardiac care center

    PubMed Central

    Sher-i-Murtaza, Muhammad; Baig, Mirza Ahmad Raza; Raheel, Hafiz Muhammad Azam

    2015-01-01

    Objective: Primary objective of this study was to evaluate the impact of significant left main stem (LMS) stenosis on the early outcome of coronary artery bypass graft (CABG) surgery. Methods: A Retrospective non-randomized analytical study was conducted in Cardiac surgery department, Chaudhary Pervaiz Elahi Institute of Cardiology (CPEIC) Multan, Pakistan. The data of patients who underwent isolated CABG at our institution from February 2008 to March 2014 were analyzed. Two thousand six hundred two (2602) patients of isolated CABG were divided into 2 groups according to the LMS disease. Group I (n=2088): without significant LMS disease and Group II (n=514): with LMS disease. Data was analyzed using SPSS V16. The groups were compared using Students t-test for numeric variables. Chi-square test and Fishers Exact test were used for categorical variables. P-value ? 0.05 was considered as significant difference. Results: Out of two thousand six hundred two, 2088 patients were in Non.LMS group (Control Group) and five hundred fourteen were in LMS Group (Study Group). Patients with LMS disease were older. In both groups there was no statistically significant difference regarding gender distribution, risk factors of IHD, pre-operative renal function and preoperative CKMB levels. Significant number 50 (9.7%) of patients were unstable in LMS group and they needed urgent surgery (p-value <0.0001). Need and duration for inotropic support and intra-aortic balloon counter-pulsation support were significantly high in LMS group (p-value <0.0001, 0.002, 0.003 respectively). Similarly Mechanical ventilation time and hospital stay were higher in LMS group. Incidence of pulmonary complications and operative mortality were significantly higher in LMS group (p-value 0.005 and 0.001 respectively). Mortality of CABG patients with significant left main coronary stenosis was 13 out of five hundred fourteen (2.5%) as compared to just 17 out of two thousand eighty eight (0.8%) in control group. Conclusion: This study showed that significant LMS disease is an independent risk factor for early cardiopulmonary morbidity and mortality after CABG surgery. PMID:26430428

  16. Acute arterial occlusion - kidney

    MedlinePLUS

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...

  17. Can late gadolinium enhancement by cardiovascular magnetic resonance identify coronary artery disease as the etiology of new onset congestive heart failure?

    PubMed Central

    Schietinger, Brian J.; Voros, Szilard; Isbell, David C.; Meyer, Craig H.; Christopher, John M.; Kramer, Christopher M.

    2010-01-01

    Background New left ventricular systolic dysfunction affects 500,000 Americans and coronary artery disease (CAD) is responsible for two-thirds of cases. Identifying CAD has both prognostic and therapeutic implications. We evaluated the ability of late gadolinium enhancement (LGE) by cardiovascular magnetic resonance imaging (CMR) to detect CAD as the etiology of recent onset congestive heart failure (CHF). Methods CMR and LGE were performed in 26 patients with new onset left ventricular systolic dysfunction. All patients received an x-ray angiography for identification of CAD. Patients with an acute coronary syndrome with troponin I > 1.0 ng/ml or a history of CAD were excluded. The presence and distribution of LGE was evaluated. Results Significant coronary stenoses were present in 5 of 26 patients (19%). LGE in an infarct pattern was found in 2 of the 5 patients with CAD. Of the 21 patients without CAD, 2 had midwall enhancement but none had evidence of LGE in an infarct pattern. Conclusions When present, LGE in an infarct pattern suggests CAD as the etiology of new onset CHF. However, the absence of LGE does not exclude CAD as the underlying etiology. A small proportion of patients with a nonischemic cause of new onset CHF have LGE limited to the midwall. PMID:17216123

  18. Carotid Artery Atherosclerosis: Effect of Intensive Lipid Therapy on the Vasa VasorumEvaluation by Using Dynamic Contrast-enhanced MR Imaging

    PubMed Central

    Dong, Li; Chen, Huijun; Chu, Baocheng; Underhill, Hunter R.; Neradilek, Moni Blazej; Hatsukami, Thomas S.; Yuan, Chun; Zhao, Xue-Qiao

    2011-01-01

    Purpose: To investigate whether short-term, intensive lipid therapy leads to changes in microvascular characteristics, as measured by using dynamic contrast materialenhanced (DCE) magnetic resonance (MR) imaging. Materials and Methods: Institutional review board approval and informed consent were obtained for this HIPAA-compatible study. Subjects with established coronary artery disease or carotid artery stenosis of 15% or greater determined by using ultrasonography and with levels of apolipoprotein B of 120 mg/dL (1.2 g/L) or greater were enrolled in an ongoing study (clinical trial NCT00715273). All received intensive lipid therapy to achieve targeted high- and low-density lipoprotein cholesterol levels and underwent serial serum monitoring including high-sensitivity C-reactive protein (HsCRP) level measurements. Carotid artery MR imaging examinations including morphologic and DCE MR images were obtained at baseline and 1 year after treatment. In subjects with advanced lesions (>2 mm thick), MR image analysis was performed, including measurement of lipid-rich necrotic core size and kinetic modeling of DCE MR images to assess changes in the transfer constant (Ktrans). The differences in Ktrans between baseline and 1-year follow-up were compared by using the Wilcoxon signed rank test, and associations were assessed by using the Spearman rank correlation coefficient. Results: Twenty-eight subjects with interpretable DCE MR imaging results at both baseline and 1-year follow-up were included. After 1 year of treatment, a significant reduction was found in mean Ktrans (0.085 min?1 0.037 [standard deviation] to 0.067 min?1 0.028, P = .02). Reduction in Ktrans was not significantly correlated with observed reductions in lipid-rich necrotic core size or reductions in HsCRP level. Conclusion: These findings suggest that DCE MR imaging may be a useful imaging method for the assessment of the therapeutic response of the vasa vasorum in patients with atherosclerotic plaque. Clinical trial registration no. NCT00715273. RSNA, 2011 PMID:21493792

  19. Three-dimensional isotropic contrast-enhanced MR angiography of the carotid artery using sensitivity-encoding and random elliptic centric k-space filling: technique optimization.

    PubMed

    Riedy, G; Golay, X; Melhem, E R

    2005-09-01

    We present a study that helped optimize a three-dimensional isotropic contrast-enhanced MR angiographic (CE-MRA) technique, using sensitivity encoding (SENSE) and random elliptic centric k-space filling. Two-dimensional gradient-echo sequence (TR/TE/flip angle 3.4/0.97/40 degrees ) was used to generate time-intensity curves in porcine carotid arteries for a fixed dose of Gd-DTPA (0.02 mmol/kg) at the following intravenous injection rates: 0.1, 0.3, 0.5, 1.0, 1.5, 2.0, and 3.0 ml/s. The time of contrast arrival and time to peak were recorded. Based on the time-intensity curves, three-dimensional high-resolution isotropic (1 mm3) CE-MRA sequence (TR/TE/flip angle: 4.9/2.4/30 degrees ), using SENSE (reduction factor of 2) and random elliptic centric k-space filling, was initiated twice for each of the above injection rates: first at the time of contrast arrival and second at the time of peak contrast. The three-dimensional CE-MRA images were analyzed for artifacts, signal-to-noise ratio, and venous contamination. For the three-dimensional CE-MRA acquisitions that were initiated at the time of contrast arrival, there was a gradual improvement in signal-to-noise ratio (SNR) in the carotid arteries with increasing injection rate. The same trend was not observed for the acquisitions that were initiated at the time of peak contrast. SENSE combined with random elliptic k-space acquisition in CE-MRA allows for higher SNR with fewer ringing artifacts at faster contrast injection rates. PMID:16012823

  20. Enhancing the Early Childhood Development System in Yakutia (Russia): Meeting the Challenges

    ERIC Educational Resources Information Center

    Kotnik, Jure; Shmis, Tigran

    2011-01-01

    The Yakutia Republic is currently working to update its early childhood development (ECD) system. Its goal is to ensure a high quality environment for early learning and child care and to enable higher enrolment levels. Currently, a high priority for the Government of Yakutia is to increase access to pre-school education, given the significant…

  1. Enhancing Research and Practice in Early Childhood through Formative and Design Experiments

    ERIC Educational Resources Information Center

    Bradley, Barbara A.; Reinking, David

    2011-01-01

    This article describes formative and design experiments and how they can advance research and instructional practices in early childhood education. We argue that this relatively new approach to education research closes the gap between research and practice, and it addresses limitations that have been identified in early childhood research. We

  2. Enhanced linkage of a locus on chromosome 2 to premature coronary artery disease in the absence of hypercholesterolemia.

    PubMed

    Nsengimana, Jrmie; Samani, Nilesh J; Hall, Alistair S; Balmforth, Anthony J; Mangino, Massimo; Yuldasheva, Nadira; Maqbool, Azhar; Braund, Peter; Burton, Paul; Bishop, D Timothy; Ball, Stephen G; Barrett, Jennifer H

    2007-03-01

    Linkage studies of complex diseases have so far had limited success in producing significant and replicable results, in part owing to genetic heterogeneity. We recently reported the results of a large genome-wide linkage scan for coronary artery disease (CAD) based on 1933 families. The greatest evidence for linkage was to a region of chromosome 2, with a logarithm of odds (LOD) score of 1.86, based on the non-parametric S(ALL) statistic, which did not reach genome-wide significance (P>0.3). Inclusion of a covariate in linkage analysis can be a powerful method of accounting for disease heterogeneity. As CAD is a heterogeneous disease, we carried out a linkage analysis of chromosome 2 incorporating covariates. Increased evidence for linkage was found when hypercholesterolemia was considered (LOD score including covariate of 4.4) reaching genome-wide significance as assessed by simulation (P=0.04). Results showed that the original evidence for linkage was largely attributable to the subset of 108 non-hypercholesterolemic affected sibling pairs. In separate linkage analyses of subsets of hypercholesterolemic and non-hypercholesterolemic sibling pairs, the maximum LOD scores were 1.09 in the former group and 3.74 in the latter. This result illustrates the potential to increase the power of linkage analysis in the presence of heterogeneity by inclusion of covariates. This linked locus on chromosome 2 should now be investigated further to identify the gene(s) influencing risk of CAD in subjects with a normal level of total cholesterol. Candidate genes include the interleukin 1 cluster and two potential regulators of high-density lipoprotein cholesterol level, PLA2R1 and OSBPL6. PMID:17149386

  3. Improving Early Adaptation Following Long Duration Spaceflight by Enhancing Vestibular Information

    NASA Technical Reports Server (NTRS)

    Mulavara, Ajitkumar; Kofman, Igor; DeDios, Yiri E.; Galvan, Raquel; Miller, Chris; Peters, Brian; Cohen, Helen; Jeevarajan, Jerome; Reschke, Millard; Wood, Scott; Bloomberg, Jacob

    2014-01-01

    Crewmember adapted to the microgravity state may need to egress the vehicle within a few minutes for safety and operational reasons after g-transitions. The transition from one sensorimotor state to another consists of two main mechanisms: strategic and plastic-adaptive and have been demonstrated in astronauts returning after long duration space flight. Strategic modifications represent "early adaptation" -immediate and transitory changes in control that are employed to deal with short-term changes in the environment. If these modifications are prolonged then plastic-adaptive changes are evoked that modify central nervous system function, automating new behavioral responses. More importantly, this longer term adaptive recovery mechanism was significantly associated with their strategic ability to recover on the first day after return to Earth G. We are developing a method based on stochastic resonance (SR) to enhance information transfer by improving the brain's ability to detect vestibular signals especially when combined with balance training exercises for rapid improvement in functional skill, for standing and mobility. The countermeasure to improve post-flight balance and locomotor disturbances is a stimulus delivery system that is wearable/portable providing low imperceptible levels of white noise based binaural bipolar electrical stimulation of the vestibular system (stochastic vestibular stimulation, SVS). The techniques for improving signal detection using SVS may thus provide additional information to improve such strategic abilities and thus help in significantly reducing the number of days required to recover functional performance to preflight levels after long duration space flight. We have conducted a series of studies to document the efficacy of SVS stimulation on balance/locomotion tasks on unstable surfaces and motion tracking tasks during intra-vestibular system conflicts. In an initial study, we showed that SVS improved overall balance performance while standing on an unstable surface indicating that SVS may be sufficient to provide a comprehensive countermeasure approach for improving postural stability. In a second study, we showed that SVS improved locomotor performance on a treadmill mounted on an oscillating platform indicating that SVS may also be used to maximize locomotor performance during walking in unstable environments. In a third study, SVS was evaluated during an otolith-canal conflict scenario in a variable radius centrifuge at low frequency of oscillation (0.1 Hz) on both eye movements and perceptual responses (using a joystick) to track imposed oscillations. The variable radius centrifuge provides a selective tilting sensation that is detectable only by the otolith organs providing conflicting information from the canal organs of the vestibular system (intra-vestibular conflict). Results show that SVS significantly reduced the timing difference between both the eye movement responses as well as the perceptual tracking responses with respect to the imposed tilt sensations. These results indicate that SVS can improve performance in sensory conflict scenarios like that experienced during space flight. Such a SR countermeasure will act synergistically along with the pre-and in-flight adaptability training protocols providing an integrated, multi-disciplinary countermeasure capable of fulfilling multiple requirements making it a comprehensive and cost effective countermeasure approach to enhance sensorimotor capabilities following long-duration space flight.

  4. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results From a Two-Year Randomized Trial

    PubMed Central

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2013-01-01

    Objective To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method Early course schizophrenia outpatients (N = 58) were randomly assigned to Cognitive Enhancement Therapy (CET) or an Enriched Supportive Therapy (EST) control and treated for two years. Comprehensive data on cognition and employment were collected annually. Results Individuals treated with CET were significantly more likely to be competitively employed, had greater earnings from employment, and were more satisfied with their employment status by the end of treatment compared to EST recipients. Mediator analyses revealed that improvements in both social and non-social cognition mediated the CET effects on employment. Conclusion CET can help facilitate employment in early schizophrenia, by addressing the cognitive impairments that limit functioning in the disorder. Inclusion of cognitive rehabilitation in social work practice can support more optimal functional recovery from schizophrenia. PMID:23885163

  5. Fish-Free Diet in Patients with Phenylketonuria Is Not Associated with Early Atherosclerotic Changes and Enhanced Platelet Activation

    PubMed Central

    Htun, Patrik; Nee, Jens; Ploeckinger, Ursula; Eder, Klaus; Geisler, Tobias; Gawaz, Meinrad; Bocksch, Wolfgang; Fateh-Moghadam, Suzanne

    2015-01-01

    Background and Purpose Since patients with phenylketonuria (PKU) have to follow a lifelong restriction of natural protein to lower phenylalanine-intake, they never eat fish. This diet may lead to a chronic deficit of omega-3 and omega-6 fatty acids with the risk of early atherosclerotic changes. The aim of the study was to analyse the fatty acid profile of PKU patients and to correlate the results with surrogate markers of early atherosclerotic changes [enhanced carotid intima media thickness (CIMT) and ß-stiffness index] and platelet activation. Methods In 43 PKU patients and in 58 healthy controls we prospectively examined the fatty acid profile, CIMT, ß-stiffness index and platelet activation (flow cytometric determination of markers of platelet activation). CIMT was measured bilaterally by ultrasound. CIMT mean was defined as the mean value of the sum of CIMT left and CIMT right. Results Despite of lower HDL-cholesterol and higher triglyceride concentrations in the PKU group, there was no significant difference in the omega-6 or omega-3 fatty acid profile, CIMT, ß-stiffness index between both groups. Platelet activation was not enhanced in the PKU group. Conclusions Fish-free diet does not induce early atherosclerotic changes or enhanced platelet activation in PKU patients. PMID:26291823

  6. Popliteal artery war injuries.

    PubMed

    Davidovi?, L; Lotina, S; Kosti?, D; Velimirovi?, D; Duki?, P; Cinara, I; Vranes, M; Markovi?, M

    1997-02-01

    The early postoperative results of 44 surgically treated popliteal arterial injuries from the Yugoslav civil war are reported. Of these patients, 41 (93%) were males and three (7%) were females, average age was 28 (range 6-45) years. Twenty patients (45%) had gunshot wounds and 24 (55%) explosive wounds. Twelve (28%) suffered isolated vascular damage, while 32 (72%) suffered concomitant bone fractures. Isolated arterial lesions were found in 24 (55%) cases, and concomitant arterial and venous lesions in 20 (45%). Twenty-four (55%) had primary reconstructions after haemostasis in the initial war hospital, and 20 (45%) secondary reconstructions after inadequate primary reconstruction in a regional war hospital. Artery procedures included 19 reverse saphenous vein graft interpositions, 10 reverse saphenous vein bypasses, 12 'in situ' saphenous vein bypasses and five lateral subcutaneous saphenous vein bypasses. The early graft patency rate was 100%, and limb salvage 72%. Major amputation was performed in 28%. Concomitant bone fractures, secondary reconstructions, secondary haemorrhage from an infected graft, and explosion wounds significantly increased the amputation rate (P < 0.01). Eleven amputations were performed after an anatomic, and only one after an extra-anatomic reconstruction (P < 0.01). The authors recommend an in situ or lateral subcutaneous reconstruction in cases of complicated popliteal artery injuries, such as concomitant bone fractures accompanied by massive soft tissue damage, and this type of reconstruction should also be used if infection is present or the procedure is delayed. PMID:9158121

  7. Arterial embolism

    PubMed Central

    Lyaker, Michael R.; Tulman, David B.; Dimitrova, Galina T.; Pin, Richard H.; Papadimos, Thomas J.

    2013-01-01

    Surgical and intensive care patients are at a heightened risk for arterial embolization due to pre-existing conditions such as age, hypercoagulability, cardiac abnormalities and atherosclerotic disease. Most arterial emboli are clots that originate in the heart and travel to distant vascular beds where they cause arterial occlusion, ischemia, and potentially infarction. Other emboli form on the surface of eroded arterial plaque or within its lipid core. Thromboemboli are large clots that dislodge from the surface of athesclerotic lesions and occlude distal arteries causing immediate ischemia. Atheroemboli, which originate from fracturing the lipid core tend to cause a process of organ dysfunction and systemic inflammation, termed cholesterol embolization syndrome. The presentation of arterial emboli depends on the arterial bed that is affected. The most common manifestations are strokes and acute lower limb ischemia. Less frequently, emboli target the upper extremities, mesenteric or renal arteries. Treatment involves rapid diagnosis, which may be aided by precise imaging studies and restoration of blood flow. The type of emboli, duration of presentation, and organ system affected determines the treatment course. Long-term therapy includes supportive medical care, identification of the source of embolism and prevention of additional emboli. Patients who experienced arterial embolism as a result of clots formed in the heart should be anticoagulated. Arterial emboli from atherosclerotic disease of the aorta or other large arteries should prompt treatment to reduce the risk for atherosclerotic progression, such as anti-platelet therapy and the use of statin drugs. The use of anticoagulation and surgical intervention to reduce the risk of arterial embolization from atherosclerotic lesions is still being studied. PMID:23724391

  8. Enhancing Drought Early Warning System for Sustainable Water Resources and Agricultural Management through Apllication of Space Science - Nigeria in Perspective

    NASA Astrophysics Data System (ADS)

    Okpara, J. N.; Akeh, L. E.; Anuforom, A. C.; Aribo, P. B.; Olayanju, S. O.

    Enhancing Drought Early Warning System for Sustainable Water Resources and Agriculture Management through Application of Space Science - Nigeria in Perspective BY J N Okpara L E Akeh Anuforom P B Aribo and S O Olayanju Directorate of Applied Meteorological Services Nigerian Meteorological Agency NIMET P M B 615 Garki Abuja Nigeria e-mail underline Juddy Okpara yahoo co uk and underline tonycanuforom yahoo com underline Abstract This paper attempts to highlight the importance of drought early warning system in water resources and agricultural management in Nigeria Various studies have shown that the negative impacts of droughts and other forms of extreme weather phenomena can be substantially reduced by providing early warning on any impending weather extremes X-rayed in this study are the various techniques presently used by the Nigerian Meteorological Agency NIMET in generating information for meteorological Early Warning System EWS which are based on models that make use of ground-based raingauge data and sea surface temperatures SST Komuscu standardized precipitation index SPI inclusive These methods are often limited by such factors as network density of stations limited communication infrastructure human inefficiency etc NIMET is therefore embarking on the development of a new Satellite Agrometeorological Information System SAMIS-Nigeria for famine and drought early warning The system combines satellite data with raingauge data to give a range of

  9. [The biological reaction of inflammation, methylglyoxal of blood plasma, functional and structural alterations in elastic type arteries at the early stage of hypertension disease].

    PubMed

    Titov, V N; Dmitriev, V A; Oshchepkov, E V; Balakhonova, T V; Tripoten', M I; Shiriaeva, Iu K

    2012-08-01

    The article deals with studying of the relationship between biologic reaction of inflammation with glycosylation reaction and content of methylglyoxal in blood serum. The positive correlation between pulse wave velocity and content of methylglyoxal, C-reactive protein in intercellular medium and malleolar brachial index value was established. This data matches the experimental results concerning involvement of biological reaction of inflammation into structural changes of elastic type arteries under hypertension disease, formation of arteries' rigidity and increase of pulse wave velocity. The arterial blood pressure is a biological reaction of hydrodynamic pressure which is used in vivo by several biological functions: biological function of homeostasis, function of endoecology, biological function of adaptation and function of locomotion. The biological reaction of hydrodynamic (hydraulic) pressure is a mode of compensation of derangement of several biological functions which results in the very high rate of hypertension disease in population. As a matter of fact, hypertension disease is a syndrome of lingering pathological compensation by higher arterial blood pressure of the biological functions derangements occurring in the distal section at the level of paracrine cenoses of cells. The arterial blood pressure is a kind of in vivo integral indicator of deranged metabolism. The essential hypertension disease pathogenically is a result of the derangement of three biological functions: biological function of homeostasis, biological function of trophology - nutrition (biological reaction of external feeding - exotrophia) and biological function of endoecology. In case of "littering" of intercellular medium in vivo with nonspecific endogenic flogogens a phylogenetically earlier activation of biological reactions of excretion, inflammation and hydrodynamic arterial blood pressure occur. In case of derangement of biological function of homeostasis, decreasing of perfusion even in single paracrine cenoses and derangement of biological function of endoecology ("purity" of intercellular medium) the only response always will be the increase of arterial blood pressure. PMID:23097982

  10. Alterations of Voltage-Dependent Calcium Channel Currents in Basilar Artery Smooth Muscle Cells at Early Stage of Subarachnoid Hemorrhage in a Rabbit Model

    PubMed Central

    Shi, Xianqing; Fu, Yongjian; Liao, Daqing; Chen, Yanfang; Liu, Jin

    2014-01-01

    Objective To investigate the changes in the currents of voltage-dependent calcium channels (VDCCs) in smooth muscle cells of basilar artery in a rabbit model of subarachnoid hemorrhage (SAH). Methods New Zealand white rabbits were randomly divided into five groups: sham (C), normal (N), 24 hours (S1), 48 hours (S2) and 72 hours (S3) after SAH. Non-heparinized autologous arterial blood (1ml/kg) was injected into the cisterna magna to create SAH after intravenous anesthesia, and 1 ml/kg of saline was injected into cisterna magna in the sham group. Rabbits in group N received no injections. Basilar artery in S1, S2, S3 group were isolated at 24, 48, 72 hours after SAH. Basilar artery in group C was isolated at 72 hours after physiological saline injection. Basilar artery smooth muscle cells were isolated for all groups. Whole-cell patch-clamp technique was utilized to record cell membrane capacitance and VDCCs currents. The VDCCs antagonist nifedipine was added to the bath solution to block the Ca++ channels currents. Results There were no significant differences in the number of cells isolated, the cell size and membrane capacitance among all the five groups. VDCC currents in the S1S3 groups had higher amplitudes than those in control and sham groups. The significant change of current amplitude was observed at 72 hours after SAH, which was higher than those of 24 and 48 hours. The VDCCs were shown to expression in human artery smooth muscle cells. Conclusions The changes of activation characteristics and voltage-current relationship at 72 hours after SAH might be an important event which leads to a series of molecular events in the microenvironment of the basilar artery smooth muscle cells. This may be the key time point for potential therapeutic intervention against subarachnoid hemorrhage. PMID:24392110

  11. Early methylphenidate exposure enhances cocaine self-administration but not cocaine-induced conditioned place preference in young adult rats

    PubMed Central

    Crawford, Cynthia A.; Baella, Shelley A.; Farley, Cristal M.; Herbert, Matthew S.; Horn, Leslie R.; Campbell, Rachel H.; Zavala, Arturo R.

    2010-01-01

    Rationale Previous studies in rodents show that early exposure to methylphenidate alters later responsiveness to drugs of abuse. An interesting feature of these studies is that early methylphenidate treatment decreases the rewarding value of cocaine when measured by conditioned place preference (CPP), but the same treatment increases cocaine self-administration. Objective The goal of the present study was to examine the effects of early methylphenidate exposure on cocaine-induced responding using both reward paradigms. Methods Rats were treated with methylphenidate (0, 2, or 5 mg/kg) from postnatal day (PD) 11 to PD 20 and then cocaine-induced CPP or cocaine self-administration was measured in separate groups of rats in adulthood. The CPP procedure included eight days of acquisition training, eight days of extinction training, and a reinstatement test. Rats were conditioned with 0, 10 or 20 mg/kg cocaine. Reinstatement was assessed after a priming dose of cocaine (10 mg/kg). For the self-administration experiment, a jugular catheter was implanted and rats were trained to press a lever reinforced with cocaine (0.25 or 0.75 mg/kg/infusion) on a fixed ratio (FR) 1 schedule. Rats were gradually moved from an FR1 to an FR10 schedule and, after criterion was reached, rats were placed on a progressive ratio schedule for five days. Results Cocaine produced robust rewarding effects as determined by both the CPP and self-administration experiments; however, early methylphenidate exposure only enhanced the reinforcing effects of cocaine on the self-administration paradigm. Interestingly, this methylphenidate enhancement was only seen in male rats. Conclusions These data suggest that in males methylphenidate enhances the reinforcing value of cocaine, but not cocaine-associated cues. PMID:20848087

  12. Early visual processing is enhanced in the midluteal phase of the menstrual cycle.

    PubMed

    Lusk, Bethany R; Carr, Andrea R; Ranson, Valerie A; Bryant, Richard A; Felmingham, Kim L

    2015-12-01

    Event-related potential (ERP) studies have revealed an early attentional bias in processing unpleasant emotional images in women. Recent neuroimaging data suggests there are significant differences in cortical emotional processing according to menstrual phase. This study examined the impact of menstrual phase on visual emotional processing in women compared to men. ERPs were recorded from 28 early follicular women, 29 midluteal women, and 27 men while they completed a passive viewing task of neutral and low- and high- arousing pleasant and unpleasant images. There was a significant effect of menstrual phase in early visual processing, as midluteal women displayed significantly greater P1 amplitude at occipital regions to all visual images compared to men. Both midluteal and early follicular women displayed larger N1 amplitudes than men (although this only reached significance for the midluteal group) to the visual images. No sex or menstrual phase differences were apparent in later N2, P3, or LPP. A condition effect demonstrated greater P3 and LPP amplitude to highly-arousing unpleasant images relative to all other stimuli conditions. These results indicate that women have greater early automatic visual processing compared to men, and suggests that this effect is particularly strong in women in the midluteal phase at the earliest stage of visual attention processing. Our findings highlight the importance of considering menstrual phase when examining sex differences in the cortical processing of visual stimuli. PMID:26366674

  13. Functionalized magnetic nanochains with enhanced MR imaging: A novel nanosystem for targeting and inhibition of early glioma.

    PubMed

    Zhang, Yi; Huang, Zhongbing; Wu, Zhi; Yin, Guangfu; Wang, Lei; Gao, Fabao

    2016-04-01

    Absence of efficient targeting limits the application of magnetic nanochains (NCs) in the diagnosis of early brain cancer. Herein, dextran-coated NCs (more than 100nm length and ∼10nm cores diameter), which were modified by cyclic pentapeptide c(RGDyC) or chlorotoxin (CTX) as the targeting molecules, were fabricated via carbodiimide chemistry and thiol technique. The analysis results revealed that the obtained slender NCs exhibited good biocompatibility, superparamagnetic property, high transverse relaxivity (R2) and longer blood circulation time. The test results of human umbilical vein endothelial cells and U251 human glioma cells indicated that the conjugation of c(RGDyC) could obviously increase the cyto-internalization of c(RGDyC)-NCs, however, CTX modification could significantly enhance accumulation of CTX-NCs in U251 cells, leading to cellular apoptosis. The results of in vivo biodistribution tests and in vivo magnetic resonance (MR) imaging indicated that, although the c(RGDyC)-NCs could target early glioma to some extent and obviously enhance the contrast of MR imaging, CTX-NCs possessed higher tumor-targeting ability and good inhibition effect than the c(RGDyC)-NCs, suggesting that CTX-NCs are promising candidates for the diagnosis and therapy of early glioma. PMID:26803007

  14. Musicians' Enhanced Neural Differentiation of Speech Sounds Arises Early in Life: Developmental Evidence from Ages 3 to 30

    PubMed Central

    Strait, Dana L.; O'Connell, Samantha; Parbery-Clark, Alexandra; Kraus, Nina

    2014-01-01

    The perception and neural representation of acoustically similar speech sounds underlie language development. Music training hones the perception of minute acoustic differences that distinguish sounds; this training may generalize to speech processing given that adult musicians have enhanced neural differentiation of similar speech syllables compared with nonmusicians. Here, we asked whether this neural advantage in musicians is present early in life by assessing musically trained and untrained children as young as age 3. We assessed auditory brainstem responses to the speech syllables /ba/ and /ga/ as well as auditory and visual cognitive abilities in musicians and nonmusicians across 3 developmental time-points: preschoolers, school-aged children, and adults. Cross-phase analyses objectively measured the degree to which subcortical responses differed to these speech syllables in musicians and nonmusicians for each age group. Results reveal that musicians exhibit enhanced neural differentiation of stop consonants early in life and with as little as a few years of training. Furthermore, the extent of subcortical stop consonant distinction correlates with auditory-specific cognitive abilities (i.e., auditory working memory and attention). Results are interpreted according to a corticofugal framework for auditory learning in which subcortical processing enhancements are engendered by strengthened cognitive control over auditory function in musicians. PMID:23599166

  15. Musicians' enhanced neural differentiation of speech sounds arises early in life: developmental evidence from ages 3 to 30.

    PubMed

    Strait, Dana L; O'Connell, Samantha; Parbery-Clark, Alexandra; Kraus, Nina

    2014-09-01

    The perception and neural representation of acoustically similar speech sounds underlie language development. Music training hones the perception of minute acoustic differences that distinguish sounds; this training may generalize to speech processing given that adult musicians have enhanced neural differentiation of similar speech syllables compared with nonmusicians. Here, we asked whether this neural advantage in musicians is present early in life by assessing musically trained and untrained children as young as age 3. We assessed auditory brainstem responses to the speech syllables /ba/ and /ga/ as well as auditory and visual cognitive abilities in musicians and nonmusicians across 3 developmental time-points: preschoolers, school-aged children, and adults. Cross-phase analyses objectively measured the degree to which subcortical responses differed to these speech syllables in musicians and nonmusicians for each age group. Results reveal that musicians exhibit enhanced neural differentiation of stop consonants early in life and with as little as a few years of training. Furthermore, the extent of subcortical stop consonant distinction correlates with auditory-specific cognitive abilities (i.e., auditory working memory and attention). Results are interpreted according to a corticofugal framework for auditory learning in which subcortical processing enhancements are engendered by strengthened cognitive control over auditory function in musicians. PMID:23599166

  16. Enhanced Virus Clearance by Early Inducible Lymphocytic Choriomeningitis Virus-Neutralizing Antibodies in Immunoglobulin-Transgenic Mice

    PubMed Central

    Seiler, Peter; Kalinke, Ulrich; Rlicke, Thomas; Bucher, Etienne M.; Bse, Christian; Zinkernagel, Rolf M.; Hengartner, Hans

    1998-01-01

    Following infection of mice with lymphocytic choriomeningitis virus (LCMV), virus-neutralizing antibodies appear late, after 30 to 60 days. Such neutralizing antibodies play an important role in protection against reinfection. To analyze whether a neutralizing antibody response which developed earlier could contribute to LCMV clearance during the acute phase of infection, we generated transgenic mice expressing LCMV-neutralizing antibodies. Transgenic mice expressing the immunoglobulin ? heavy chain of the LCMV-neutralizing monoclonal antibody KL25 (H25 transgenic mice) mounted LCMV-neutralizing immunoglobulin M (IgM) serum titers within 8 days after infection. This early inducible LCMV-neutralizing antibody response significantly improved the hosts capacity to clear the infection and did not cause an enhancement of disease after intracerebral (i.c.) LCMV infection. In contrast, mice which had been passively administered LCMV-neutralizing antibodies and transgenic mice exhibiting spontaneous LCMV-neutralizing IgM serum titers (HL25 transgenic mice expressing the immunoglobulin ? heavy and the ? light chain) showed an enhancement of disease after i.c. LCMV infection. Thus, early-inducible LCMV-neutralizing antibodies can contribute to viral clearance in the acute phase of the infection and do not cause antibody-dependent enhancement of disease. PMID:9499083

  17. Three-Dimensional Micro-MRI Analysis of Cerebral Artery Development in Mouse Embryos

    PubMed Central

    Berrios-Otero, Cesar A.; Wadghiri, Youssef Zaim; Nieman, Brian J.; Joyner, Alexandra L.; Turnbull, Daniel H.

    2010-01-01

    Vascular system development involves a complex, three-dimensional branching process that is critical for normal embryogenesis. In the brain, the arterial systems appear to develop in a stereotyped fashion, but no detailed quantitative analyses of the mouse embryonic cerebral arteries have been described. In this study, a gadolinium-based contrast perfusion method was developed to selectively enhance the cerebral arteries in fixed mouse embryos. Three-dimensional magnetic resonance micro-imaging (micro-MRI) data were acquired simultaneously from multiple embryos staged between 10 and 17 days of gestation, and a variety of image analysis methods was used to extract and analyze the cerebral arterial patterns. The results show that the primary arterial branches in the mouse brain are very similar between individuals, with the patterns established early and growth occurring by extension of the segments, while maintaining the underlying vascular geometry. To investigate the utility of this method for mutant mouse phenotype analysis, contrast-enhanced micro-MRI data were acquired from Gli2-/- mutant embryos and their wild-type littermates, showing several previously unreported vascular phenotypes in Gli2-/- embryos, including the complete absence of the basilar artery. These results demonstrate that contrast-enhanced micro-MRI provides a powerful tool for analyzing vascular phenotypes in a variety of genetically engineered mice. PMID:19859945

  18. In vivo Mn-enhanced MRI for early tumor detection and growth rate analysis in a mouse medulloblastoma model.

    PubMed

    Suero-Abreu, Giselle A; Praveen Raju, G; Aristizbal, Orlando; Volkova, Eugenia; Wojcinski, Alexandre; Houston, Edward J; Pham, Diane; Szulc, Kamila U; Colon, Daniel; Joyner, Alexandra L; Turnbull, Daniel H

    2014-12-01

    Mouse models have increased our understanding of the pathogenesis of medulloblastoma (MB), the most common malignant pediatric brain tumor that often forms in the cerebellum. A major goal of ongoing research is to better understand the early stages of tumorigenesis and to establish the genetic and environmental changes that underlie MB initiation and growth. However, studies of MB progression in mouse models are difficult due to the heterogeneity of tumor onset times and growth patterns and the lack of clinical symptoms at early stages. Magnetic resonance imaging (MRI) is critical for noninvasive, longitudinal, three-dimensional (3D) brain tumor imaging in the clinic but is limited in resolution and sensitivity for imaging early MBs in mice. In this study, high-resolution (100 ?m in 2 hours) and high-throughput (150 ?m in 15 minutes) manganese-enhanced MRI (MEMRI) protocols were optimized for early detection and monitoring of MBs in a Patched-1 (Ptch1) conditional knockout (CKO) model. The high tissue contrast obtained with MEMRI revealed detailed cerebellar morphology and enabled detection of MBs over a wide range of stages including pretumoral lesions as early as 2 to 3 weeks postnatal with volumes close to 0.1 mm(3). Furthermore, longitudinal MEMRI allowed noninvasive monitoring of tumors and demonstrated that lesions within and between individuals have different tumorigenic potentials. 3D volumetric studies allowed quantitative analysis of MB tumor morphology and growth rates in individual Ptch1-CKO mice. These results show that MEMRI provides a powerful method for early in vivo detection and longitudinal imaging of MB progression in the mouse brain. PMID:25499213

  19. Mechanisms of Functional Improvement in a Two-Year Trial of Cognitive Enhancement Therapy for Early Schizophrenia

    PubMed Central

    Eack, Shaun M.; Pogue-Geile, Michael F.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2013-01-01

    Background Cognitive rehabilitation has emerged as an effective treatment for addressing cognitive impairments and functional disability in schizophrenia; however, the degree to which changes in various social and non-social cognitive processes translate into improved functioning during treatment remains unclear. This research sought to identify the neurocognitive and social-cognitive mechanisms of functional improvement during a two-year trial of Cognitive Enhancement Therapy (CET) for early course schizophrenia. Method Patients in the early course of schizophrenia were randomly assigned to CET (n = 31) or an Enriched Supportive Therapy control (n = 27) and treated for up to two years. A comprehensive neurocognitive assessment battery and the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) were completed annually, along with measures of functioning. Mediator analyses using mixed-effects growth models were conducted to examine the effects of neurocognitive and social-cognitive improvement on functional change. Results Two-year improvement in neurocognition and the emotion management branch of the MSCEIT were found to be significantly related to improved functional outcome in early course schizophrenia patients. Neurocognitive improvement, primarily in executive functioning, and social-cognitive change in emotion management also mediated the robust effects of CET on functioning. Conclusions Improvements in neurocognition and social cognition that result from cognitive rehabilitation are both significant mediators of functional improvement in early course schizophrenia. Cognitive rehabilitation programs for schizophrenia may need to target deficits in both social and non-social cognition to achieve an optimal functional response. PMID:20860867

  20. Enhanced detection of proximal right coronary artery stenosis with the additional analysis of right ventricular thallium-201 uptake in stress scintigrams

    SciTech Connect

    Gutman, J.; Brachman, M.; Rozanski, A.; Maddahi, J.; Waxman, A.; Berman, D.S.

    1983-05-01

    The value of right ventricular thallium-201 analysis in detecting proximal right coronary artery stenosis in exercise myocardial scintigraphy was analyzed in 52 patients, 27 with and 25 without proximal right coronary artery stenosis. For the detection of proximal right coronary artery stenosis, the sensitivity and specificity of thallium scintigraphic analysis were 59 and 88% for a right ventricular abnormality, 67 and 68% for a left ventricular inferior wall abnormality, and 93 and 56% for an abnormality of either. When both right and left ventricular thallium images were abnormal, all 9 patients had proximal right coronary artery stenoses, and when both were normal, 26 of 28 patients had a normal proximal right coronary artery. The sensitivity and specificity of blood pool scintigraphic variables during exercise (right ventricular ejection fraction and left ventricular inferior wall motion) were not significantly different for detection of proximal right coronary artery stenosis. Thus, the additional analysis of the right ventricle on thallium-201 stress scintigrams can improve the detection of proximal right coronary artery stenosis. When both right ventricular and left ventricular thallium scintigrams are abnormal (or normal), the ability to predict the presence (or absence) of proximal right coronary artery stenosis is very high.

  1. A model-constrained Monte Carlo method for blind arterial input function estimation in dynamic contrast-enhanced MRI: I. Simulations

    NASA Astrophysics Data System (ADS)

    Schabel, Matthias C.; Fluckiger, Jacob U.; DiBella, Edward V. R.

    2010-08-01

    Widespread adoption of quantitative pharmacokinetic modeling methods in conjunction with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has led to increased recognition of the importance of obtaining accurate patient-specific arterial input function (AIF) measurements. Ideally, DCE-MRI studies use an AIF directly measured in an artery local to the tissue of interest, along with measured tissue concentration curves, to quantitatively determine pharmacokinetic parameters. However, the numerous technical and practical difficulties associated with AIF measurement have made the use of population-averaged AIF data a popular, if sub-optimal, alternative to AIF measurement. In this work, we present and characterize a new algorithm for determining the AIF solely from the measured tissue concentration curves. This Monte Carlo blind estimation (MCBE) algorithm estimates the AIF from the subsets of D concentration-time curves drawn from a larger pool of M candidate curves via nonlinear optimization, doing so for multiple (Q) subsets and statistically averaging these repeated estimates. The MCBE algorithm can be viewed as a generalization of previously published methods that employ clustering of concentration-time curves and only estimate the AIF once. Extensive computer simulations were performed over physiologically and experimentally realistic ranges of imaging and tissue parameters, and the impact of choosing different values of D and Q was investigated. We found the algorithm to be robust, computationally efficient and capable of accurately estimating the AIF even for relatively high noise levels, long sampling intervals and low diversity of tissue curves. With the incorporation of bootstrapping initialization, we further demonstrated the ability to blindly estimate AIFs that deviate substantially in shape from the population-averaged initial guess. Pharmacokinetic parameter estimates for Ktrans, kep, vp and ve all showed relative biases and uncertainties of less than 10% for measurements having a temporal sampling rate of 4 s and a concentration measurement noise level of ? = 0.04 mM. A companion paper discusses the application of the MCBE algorithm to DCE-MRI data acquired in eight patients with malignant brain tumors.

  2. Enhancing Potato System Sustainability: Microclimate, Early Blight and Late Blight Potential

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Crop and soil management may modify canopy and below ground microclimate; however, their effects on potential development and control of early and late blight are not well documented. Crop management systems (Status Quo (SQ), Soil Conserving (SC), Soil Improving (SI), Disease Suppressive (DS), and c...

  3. Enhancing Collaboration between Occupational Therapists and Early Childhood Educators Working with Children on the Autism Spectrum

    ERIC Educational Resources Information Center

    Hart Barnett, Juliet E.; O'shaughnessy, Kaitlin

    2015-01-01

    Autism spectrum disorders (ASD) are on the rise. With this increase in prevalence and in related inclusive placements comes the need for research-based, collaborative, and high-quality early intervention strategies to promote the learning of children with ASD. Occupational therapists (OTs) are uniquely positioned to address many of the

  4. Statewide Efforts to Enhance Early Childhood Personnel Preparation Programs to Support Inclusion: Overview and Lessons Learned

    ERIC Educational Resources Information Center

    Winton, Pam; Catlett, Camille

    2009-01-01

    Inclusion is a federal and state mandate, making it critical that early childhood teachers have adequate preparation in their preservice program for serving young children with disabilities. One of the challenges states face in increasing the availability of high-quality inclusive programs is ensuring adequate numbers of confident, competent

  5. The Transition Process in the Early Years: Enhancing Speech-Language Pathologists' Perspectives.

    ERIC Educational Resources Information Center

    Prendeville, Jo-Anne; Ross-Allen, Jane

    2002-01-01

    This article provides information from a speech-language perspective pertaining to transitions in the early years, especially between preschool settings and kindergarten. It highlights challenges in transition and delineates critical components of transition planning including family-school partnerships, collaboration, and written policies and

  6. Enhancing Student Services at Owens Community College: Early Results from the Opening Doors Demonstration in Ohio

    ERIC Educational Resources Information Center

    Scrivener, Susan; Pih, Michael

    2007-01-01

    MDRC launched Opening Doors in 2003 to study the effects of community college programs designed to help students persist in school and earn a credential. This report presents early results from the Opening Doors program at Owens Community College in Toledo, Ohio, which operated from 2004 through 2006. The two-semester program served students whose

  7. Enhancing Collaboration between Occupational Therapists and Early Childhood Educators Working with Children on the Autism Spectrum

    ERIC Educational Resources Information Center

    Hart Barnett, Juliet E.; O'shaughnessy, Kaitlin

    2015-01-01

    Autism spectrum disorders (ASD) are on the rise. With this increase in prevalence and in related inclusive placements comes the need for research-based, collaborative, and high-quality early intervention strategies to promote the learning of children with ASD. Occupational therapists (OTs) are uniquely positioned to address many of the…

  8. Enhancing Potato System Sustainability: Microclimate, Early Blight and Late Blight Potential

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Crop and soil management may modify canopy and below ground microclimate; however, their effects on potential development and control of early and late blight are not well documented. Crop management systems (Status Quo (SQ), Soil Conserving (SC), Soil Improving (SI), Disease Suppressive (DS), and ...

  9. Enhanced spontaneous functional connectivity of the superior temporal gyrus in early deafness.

    PubMed

    Ding, Hao; Ming, Dong; Wan, Baikun; Li, Qiang; Qin, Wen; Yu, Chunshui

    2016-01-01

    Early auditory deprivation may drive the auditory cortex into cross-modal processing of non-auditory sensory information. In a recent study, we had shown that early deaf subjects exhibited increased activation in the superior temporal gyrus (STG) bilaterally during visual spatial working memory; however, the changes in the organization of the STG related spontaneous functional network, and their cognitive relevance are still unknown. To clarify this issue, we applied resting state functional magnetic resonance imaging on 42 early deafness (ED) and 40 hearing controls (HC). We also acquired the visual spatial and numerical n-back working memory (WM) information in these subjects. Compared with hearing subjects, the ED exhibited faster reaction time of visual WM tasks in both spatial and numerical domains. Furthermore, ED subjects exhibited significantly increased functional connectivity between the STG (especially of the right hemisphere) and bilateral anterior insula and dorsal anterior cingulated cortex. Finally, the functional connectivity of STG could predict visual spatial WM performance, even after controlling for numerical WM performance. Our findings suggest that early auditory deprivation can strengthen the spontaneous functional connectivity of STG, which may contribute to the cross-modal involvement of this region in visual working memory. PMID:26984611

  10. Enhancing the Australian Early Childhood Teacher Education Curriculum about Very Young Children

    ERIC Educational Resources Information Center

    Garvis, Susanne; Lemon, Narelle

    2015-01-01

    Research has shown that the care and education of infants and toddlers is an under-represented area in early childhood teacher education. This is also the case in Australia, meaning that pre-service teachers have few opportunities for learning about infants and toddlers and thus tend to have limited theoretical and practical knowledge about…

  11. Enhancing Early Numeracy by Promoting the Abstract Thought Involved in the Oddity Principle, Seriation, and Conservation

    ERIC Educational Resources Information Center

    Kidd, Julie K.; Pasnak, Robert; Gadzichowski, Marinka; Ferral-Like, Melissa; Gallington, Debbie

    2008-01-01

    Although many students who enter kindergarten are cognitively ready to meet the demands of the kindergarten mathematics curriculum, some students arrive without the early abstract reasoning abilities necessary to benefit from the instruction provided. Those who do not possess key cognitive abilities, including understandings of conservation,…

  12. Enhanced spontaneous functional connectivity of the superior temporal gyrus in early deafness

    PubMed Central

    Ding, Hao; Ming, Dong; Wan, Baikun; Li, Qiang; Qin, Wen; Yu, Chunshui

    2016-01-01

    Early auditory deprivation may drive the auditory cortex into cross-modal processing of non-auditory sensory information. In a recent study, we had shown that early deaf subjects exhibited increased activation in the superior temporal gyrus (STG) bilaterally during visual spatial working memory; however, the changes in the organization of the STG related spontaneous functional network, and their cognitive relevance are still unknown. To clarify this issue, we applied resting state functional magnetic resonance imaging on 42 early deafness (ED) and 40 hearing controls (HC). We also acquired the visual spatial and numerical n-back working memory (WM) information in these subjects. Compared with hearing subjects, the ED exhibited faster reaction time of visual WM tasks in both spatial and numerical domains. Furthermore, ED subjects exhibited significantly increased functional connectivity between the STG (especially of the right hemisphere) and bilateral anterior insula and dorsal anterior cingulated cortex. Finally, the functional connectivity of STG could predict visual spatial WM performance, even after controlling for numerical WM performance. Our findings suggest that early auditory deprivation can strengthen the spontaneous functional connectivity of STG, which may contribute to the cross-modal involvement of this region in visual working memory. PMID:26984611

  13. Brief Report: Can Metrics of Reporting Bias Enhance Early Autism Screening Measures?

    ERIC Educational Resources Information Center

    Taylor, Cora M.; Vehorn, Alison; Noble, Hylan; Weitlauf, Amy S.; Warren, Zachary E.

    2014-01-01

    The goal of the current study was to develop and pilot the utility of two simple internal response bias metrics, over-reporting and under-reporting, in terms of additive clinical value within common screening practices for early detection of autism spectrum disorder risk. Participants were caregivers and children under 36 months of age (n = 145)…

  14. Enhancing the Australian Early Childhood Teacher Education Curriculum about Very Young Children

    ERIC Educational Resources Information Center

    Garvis, Susanne; Lemon, Narelle

    2015-01-01

    Research has shown that the care and education of infants and toddlers is an under-represented area in early childhood teacher education. This is also the case in Australia, meaning that pre-service teachers have few opportunities for learning about infants and toddlers and thus tend to have limited theoretical and practical knowledge about

  15. Brief Report: Can Metrics of Reporting Bias Enhance Early Autism Screening Measures?

    ERIC Educational Resources Information Center

    Taylor, Cora M.; Vehorn, Alison; Noble, Hylan; Weitlauf, Amy S.; Warren, Zachary E.

    2014-01-01

    The goal of the current study was to develop and pilot the utility of two simple internal response bias metrics, over-reporting and under-reporting, in terms of additive clinical value within common screening practices for early detection of autism spectrum disorder risk. Participants were caregivers and children under 36 months of age (n = 145)

  16. Fiber optic probe enabled by surface-enhanced Raman scattering for early diagnosis of potential acute rejection of kidney transplant

    NASA Astrophysics Data System (ADS)

    Chi, Jingmao; Chen, Hui; Tolias, Peter; Du, Henry

    2014-06-01

    We have explored the use of a fiber-optic probe with surface-enhanced Raman scattering (SERS) sensing modality for early, noninvasive and, rapid diagnosis of potential renal acute rejection (AR) and other renal graft dysfunction of kidney transplant patients. Multimode silica optical fiber immobilized with colloidal Ag nanoparticles at the distal end was used for SERS measurements of as-collected urine samples at 632.8 nm excitation wavelength. All patients with abnormal renal graft function (3 AR episodes and 2 graft failure episodes) who were clinically diagnosed independently show common unique SERS spectral features in the urines collected just one day after transplant. SERS-based fiber-optic probe has excellent potential to be a bedside tool for early diagnosis of kidney transplant patients for timely medical intervention of patients at high risk of transplant dysfunction.

  17. Early interleukin-10 treatment improves survival and enhances immune function only in males after hemorrhage and subsequent sepsis.

    PubMed

    Kahlke, Volker; Dohm, Christoph; Mees, Torge; Brtzmann, Kerstin; Schreiber, Stefan; Schrder, Jrg

    2002-07-01

    Recent studies have demonstrated gender differences in the immune response following hemorrhagic shock with an enhanced immune function and lower mortality following subsequent sepsis in females. Early interleukin-10 (IL-10) treatment has been shown to have beneficial effects on the depressed immune function in males, but not in females following shock. However, it remains unclear if the observed gender-related effect of IL-10 treatment results in an advantage following subsequent polymicrobial sepsis. To study this, male and female CBA/J mice (age 2-3 months) were subjected to hemorrhage (35 +/- 5 mmHg for 90 min and fluid resuscitation). At resuscitation, each received either 10 microg of recombinant murine IL-10 or placebo i.p.. At 48 h after resuscitation, either peritoneal macrophages (pMphi) and plasma were harvested, or polymicrobial sepsis was induced by cecal ligation and puncture (CLP). Following CLP, either survival over 10 days was measured, or pMphi and plasma were harvested 4 h after CLP to assess TNF-alpha, IL-6, IL-10, and prostaglandin E2 (PGE2) release of pMphi and plasma levels of IL-10, free testosteron, and 17-beta estradiol. Early IL-10 treatment restored depressed proinflammatory immune response in males (TNF-alpha and PGE2), which was associated with an enhanced survival (P < 0.05) following subsequent sepsis as compared with placebo-treated mice (8/20 and 1/20, respectively). In contrast, the immune response and survival in females receiving IL-10 was not significantly changed, although females treated with IL-10 had a trend towards higher mortality (7/15 and 2/15, respectively; P = 0.08). Thus, early IL-10 anti-inflammatory treatment following hemorrhage has potential beneficial effects only in males associated with enhanced survival following subsequent sepsis. PMID:12095129

  18. Paclitaxel enhances early dendritic cell maturation and function through TLR4 signaling in mice

    PubMed Central

    Pfannenstiel, Lukas W.; Lam, Samuel S. K.; Emens, Leisha A.; Jaffee, Elizabeth M.; Armstrong, Todd D.

    2010-01-01

    Subclinical doses of Paclitaxel (PTX) given 1 day prior to a HER-2/neu (neu)-targeted, granulocyte-macrophage colony stimulating factor (GM-CSF)-secreting whole-cell vaccine enhances neu-specific T cell responses and slows neu+ tumor growth in tolerized HER-2/neu (neu-N) mice. We demonstrate that co-administration of PTX and Cyclophosphamide (CY) synergizes to slow tumor growth, and that in vitro, DC precursors exposed to PTX before LPS maturation results in greater co-stimulatory molecule expression, IL-12 production, and the ability to induce CD8+ T cells with enhanced lytic activity against neu+ tumors. PTX treatment also enhances maturation marker expression on CD11c+ DCs isolated from vaccine-draining lymph nodes. Ex vivo, these DCs activate CD8+ T cells with greater lytic capability than DCs from vaccine alone-treated neu-N mice. Finally, PTX treatment results in enhanced antigen-specific, IFN-?-secreting CD8+ T cells in vivo. Thus, administration of PTX with a tumor vaccine improves T cell priming through enhanced maturation of DC. PMID:20346445

  19. Evaluation of meglumine gadoterate-enhanced MR angiography (MRA) compared with time-of-flight MRA in the diagnosis of clinically significant non-coronary arterial disease: a pooled analysis of data from two clinical trials

    PubMed Central

    Shah, D J; Lim, T-H

    2012-01-01

    Objectives We analysed pooled data from two clinical trials to assess the diagnostic accuracy and safety of meglumine gadoterate (Gd-DOTA)-enhanced MR angiography (MRA) relative to those of non-enhanced time-of-flight (TOF) MRA for non-coronary arterial disease. Both techniques were compared with X-ray angiography as the gold standard. Methods Patients were of both sexes, were aged at least 18 years and had suspected non-coronary arterial disease. Each patient was his/her own control and underwent TOF MRA followed by Gd-DOTA-enhanced MRA, and then X-ray angiography. MRA was performed at 1.5 T (USA study) or 3 T (Republic of Korea study). The primary criterion used to evaluate efficacy was the degree to which the MRA examination agreed with X-ray angiography in assessing non-coronary arterial lesions. The performance of Gd-DOTA over TOF was assessed using a one-sided paired t-test. We also evaluated the specificity, sensitivity, image quality, examination duration and clinical safety of both MRA procedures. Results In total, 192 patients were enrolled and received Gd-DOTA. In the intent-to-treat population (n=162), within-patient accuracy was significantly greater for Gd-DOTA than for TOF (85.819.8% agreement between Gd-DOTA and X-ray angiography compared with 78.324.9% agreement between TOF and X-ray angiography; p=0.0001). The sensitivity, specificity, image quality and examination duration were also better for Gd-DOTA than for TOF. There were no serious drug-related adverse events. Conclusion We conclude that Gd-DOTA-enhanced MRA is a safe and accurate procedure for detecting arterial stenosis at both 1.5 T and 3 T. PMID:22167518

  20. Enhanced early-life nutrition promotes hormone production and reproductive development in Holstein bulls.

    PubMed

    Dance, Alysha; Thundathil, Jacob; Wilde, Randy; Blondin, Patrick; Kastelic, John

    2015-02-01

    Holstein bull calves often reach artificial insemination centers in suboptimal body condition. Early-life nutrition is reported to increase reproductive performance in beef bulls. The objective was to determine whether early-life nutrition in Holstein bulls had effects similar to those reported in beef bulls. Twenty-six Holstein bull calves were randomly allocated into 3 groups at approximately 1 wk of age to receive a low-, medium-, or high-nutrition diet, based on levels of energy and protein, from 2 to 31 wk of age. Calves were on their respective diets until 31 wk of age, after which they were all fed a medium-nutrition diet. To evaluate secretion profiles and concentrations of blood hormones, a subset of bulls was subjected to intensive blood sampling every 4 wk from 11 to 31 wk of age. Testes of all bulls were measured once a month; once scrotal circumference reached 26cm, semen collection was attempted (by electroejaculation) every 2 wk to confirm puberty. Bulls were maintained until approximately 72 wk of age and then slaughtered at a local abattoir. Testes were recovered and weighed. Bulls fed the high-nutrition diet were younger at puberty (high=324.3 d, low=369.3 d) and had larger testes for the entire experimental period than bulls fed the low-nutrition diet. Bulls fed the high-nutrition diet also had an earlier and more substantial early rise in LH than those fed the low-nutrition diet and had increased concentrations of insulin-like growth factor-I (IGF-I) earlier than the bulls fed the low-nutrition diet. Furthermore, we detected a temporal association between increased IGF-I concentrations and an early LH rise in bulls fed the high-nutrition diet. Therefore, we inferred that IGF-I had a role in regulating the early gonadotropin rise (in particular, LH) and thus reproductive development of Holstein bulls. Overall, these results support our hypothesis that Holstein bull calves fed a high-nutrition diet reach puberty earlier and have larger testes than those fed a low-nutrition diet, and they provide clear evidence that nutritional modulation of Holstein bull calves during early life has profound effects on reproductive development. PMID:25497791

  1. Corona Enhancement and Mosaic Architecture for Prognosis and Selection Between of Liver Resection Versus Transcatheter Arterial Chemoembolization in Single Hepatocellular Carcinomas >5 cm Without Extrahepatic Metastases

    PubMed Central

    Li, Meng; Xin, Yongjie; Fu, Sirui; Liu, Zaiyi; Li, Yong; Hu, Baoshan; Chen, Shuting; Liang, Changhong; Lu, Ligong

    2016-01-01

    Abstract Corona enhancement and mosaic architecture are 2 radiologic features of hepatocellular carcinoma (HCC). However, neither their prognostic values nor their impacts on the selection of liver resection (LR) versus transcatheter arterial chemoembolization (TACE) as treatment modalities have been established. We retrospectively analyzed 275 patients with a single HCC lesion >5 cm without extrahepatic metastasis treated with LR or TACE. In LR patients, the overall survival (OS) and time to progression (TTP) were compared between corona enhancement negative (corona−) versus positive (corona+) and mosaic architecture negative (mosaic−) versus positive (mosaic+) patients. Furthermore, by the combination of corona and mosaic, LR patients were divided into negative for both corona and mosaic patterns (LR−/−), positive for only 1 feature (LR+/−), and positive for both (LR+/+); their OS and TTP were compared to those of the TACE group. Cox regression was performed to identify independent factors for OS. In the survival plots for LR, corona− had better OS and TTP than corona+, and mosaic− had better OS than mosaic+. There was no significant difference in TTP between the subgroups. On Cox regression analysis, corona enhancement, but not mosaic architecture, was a significant factor for OS, whereas neither were a significant factor for TTP. In TACE patients, neither corona nor mosaic patterns had significant correlations with OS or TTP. In the whole population, LR−/ and LR+/− subgroups had similar OS, which was better than the LR+/+ and TACE groups. Moreover, LR−/− and LR+/− patients had better TTP than TACE patients, but there were no differences between the LR−/− versus LR+/−, LR−/ versus LR+/+, LR+/− versus LR+/+, and LR+/+ versus TACE groups. On Cox regression analysis, the presence of corona/mosaic patterns was an independent prognostic factor for OS. Our results showed that, for patients with a single HCC >5 cm without extrahepatic metastasis, corona and mosaic patterns are indicators of limited LR efficacy. When both of the features are present, TACE can be used instead of LR with no negative influence on survival. PMID:26765441

  2. Detection of early carious lesions using contrast enhancement with coherent light scattering (speckle imaging)

    NASA Astrophysics Data System (ADS)

    Deana, A. M.; Jesus, S. H. C.; Koshoji, N. H.; Bussadori, S. K.; Oliveira, M. T.

    2013-07-01

    Currently, dental caries still represent one of the chronic diseases with the highest prevalence and present in most countries. The interaction between light and teeth (absorption, scattering and fluorescence) is intrinsically connected to the constitution of the dental tissue. Decay induced mineral loss introduces a shift in the optical properties of the affected tissue; therefore, study of these properties may produce novel techniques aimed at the early diagnosis of carious lesions. Based on the optical properties of the enamel, we demonstrate the application of first-order spatial statistics in laser speckle imaging, allowing the detection of carious lesions in their early stages. A highlight of this noninvasive, non-destructive, real time and cost effective approach is that it allows a dentist to detect a lesion even in the absence of biofilm or moisture.

  3. Interpersonal Psychotherapy With a Parenting Enhancement Adapted for In-Home Delivery in Early Head Start

    PubMed Central

    Beeber, Linda S.; Schwartz, Todd A.; Holditch-Davis, Diane; Canuso, Regina; Lewis, Virginia; Matsuda, Yui

    2015-01-01

    Formidable barriers prevent low-income mothers from accessing evidence-based treatment for depressive symptoms that compromise their ability to provide sensitive, responsive parenting for their infant or toddler. Interpersonal psychotherapy (IPT), an evidence-based psychotherapy for depression, was tailored for in-home delivery to mothers navigating economic hardship and other intense stressors, and for Latina mothers with limited English language proficiency. Psychiatric-mental health nurses delivered the adapted IPT in randomized clinical trials that were conducted in partnership with Early Head Start (EHS). The authors discuss the results of these studies and the impacts on EHS staff members and programs, and they provide additional implications for current early childhood-focused programs. PMID:26617430

  4. Climatic effects of enhanced CO2 levels in Mars early atmosphere

    NASA Technical Reports Server (NTRS)

    Kasting, James F.

    1987-01-01

    Results are presented of one-dimensional radiation convection modeling of the early Mars atmosphere. Up to 5 bars of CO2 would have been required to raise the surface temperature (orbitally and globally averaged) above the freezing point, although at the equator at perihelion, 1 bar would have sufficed. Such an atmospheric CO2 invertory, the author argued, is not inconsistent with any known constraint on Mars' degassed volatile inventory.

  5. Enhancing Alphabet Knowledge Instruction: Research Implications and Practical Strategies for Early Childhood Educators

    ERIC Educational Resources Information Center

    Jones, Cindy D.; Clark, Sarah K.; Reutzel, D. Ray

    2013-01-01

    Alphabet knowledge is consistently recognized as the strongest, most durable predictor of later literacy achievement. Recent research offers practical implications for increased effectiveness of teaching alphabet knowledge to young children. In this article, we outline Enhanced Alphabet Knowledge instruction (EAK), a method of practical

  6. The probiotic Escherichia coli Nissle 1917 enhances early gastrointestinal maturation in young turkey poults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Concerns over the use of antibiotics as growth promoters has led to interest in finding alternative growth promoters such as natural compounds and probiotics. Supplementing feed with probiotics has shown to enhance the gastrointestinal tract (GIT) development of chickens and turkeys. The human pro...

  7. Chlamydia trachomatis Infection of Endocervical Epithelial Cells Enhances Early HIV Transmission Events

    PubMed Central

    Buckner, Lyndsey R.; Amedee, Angela M.; Albritton, Hannah L.; Kozlowski, Pamela A.; Lacour, Nedra; McGowin, Chris L.; Schust, Danny J.; Quayle, Alison J.

    2016-01-01

    Chlamydia trachomatis causes a predominantly asymptomatic, but generally inflammatory, genital infection that is associated with an increased risk for HIV acquisition. Endocervical epithelial cells provide the major niche for this obligate intracellular bacterium in women, and the endocervix is also a tissue in which HIV transmission can occur. The mechanism by which CT infection enhances HIV susceptibility at this site, however, is not well understood. Utilizing the A2EN immortalized endocervical epithelial cell line grown on cell culture inserts, we evaluated the direct role that CT-infected epithelial cells play in facilitating HIV transmission events. We determined that CT infection significantly enhanced the apical-to-basolateral migration of cell-associated, but not cell-free, HIVBaL, a CCR5-tropic strain of virus, across the endocervical epithelial barrier. We also established that basolateral supernatants from CT-infected A2EN cells significantly enhanced HIV replication in peripheral mononuclear cells and a CCR5+ T cell line. These results suggest that CT infection of endocervical epithelial cells could facilitate both HIV crossing the mucosal barrier and subsequent infection or replication in underlying target cells. Our studies provide a mechanism by which this common STI could potentially promote the establishment of founder virus populations and the maintenance of local HIV reservoirs in the endocervix. Development of an HIV/STI co-infection model also provides a tool to further explore the role of other sexually transmitted infections in enhancing HIV acquisition. PMID:26730599

  8. The Role of an Early Intervention on Enhancing the Quality of Mother-Infant Interaction.

    ERIC Educational Resources Information Center

    Wendland-Carro, Jaqueline; Piccinini, Cesar A.; Millar, W. Stuart

    1999-01-01

    Evaluated an intervention designed to influence mothers' sensitive responsiveness toward their infant by presenting information about the newborn's competence to interact and promoting affectionate handling and interaction. Found that the enhancement group showed greater frequency of co-occurrences involving vocal exchanges, looking to the

  9. Enhanced Handling and Positioning in Early Infancy Advances Development throughout the First Year

    ERIC Educational Resources Information Center

    Lobo, Michele A.; Galloway, James C.

    2012-01-01

    Behaviors emerge, in part, from the interplay of infant abilities and caregiver-infant interactions. Cross-cultural and developmental studies suggest caregiver handling and positioning influence infant development. In this prospective, longitudinal study, the effects of 3 weeks of enhanced handling and positioning experiences provided to 14

  10. Musical Training during Early Childhood Enhances the Neural Encoding of Speech in Noise

    ERIC Educational Resources Information Center

    Strait, Dana L.; Parbery-Clark, Alexandra; Hittner, Emily; Kraus, Nina

    2012-01-01

    For children, learning often occurs in the presence of background noise. As such, there is growing desire to improve a child's access to a target signal in noise. Given adult musicians' perceptual and neural speech-in-noise enhancements, we asked whether similar effects are present in musically-trained children. We assessed the perception and

  11. The Role of an Early Intervention on Enhancing the Quality of Mother-Infant Interaction.

    ERIC Educational Resources Information Center

    Wendland-Carro, Jaqueline; Piccinini, Cesar A.; Millar, W. Stuart

    1999-01-01

    Evaluated an intervention designed to influence mothers' sensitive responsiveness toward their infant by presenting information about the newborn's competence to interact and promoting affectionate handling and interaction. Found that the enhancement group showed greater frequency of co-occurrences involving vocal exchanges, looking to the…

  12. Musical Training during Early Childhood Enhances the Neural Encoding of Speech in Noise

    ERIC Educational Resources Information Center

    Strait, Dana L.; Parbery-Clark, Alexandra; Hittner, Emily; Kraus, Nina

    2012-01-01

    For children, learning often occurs in the presence of background noise. As such, there is growing desire to improve a child's access to a target signal in noise. Given adult musicians' perceptual and neural speech-in-noise enhancements, we asked whether similar effects are present in musically-trained children. We assessed the perception and…

  13. A Report on the Technological Enhancements Project Evaluation: Deepening Early Learning Experiences through Technology

    ERIC Educational Resources Information Center

    Hupert, Naomi; Cervantes, Francisco; DeGroof, Emily

    2010-01-01

    As part of the "Ready to Learn" Initiative, Education Development Center, Inc. (EDC), was charged with addressing the evaluation of Technological Enhancements for the outreach efforts of three producers: Out of the Blue's Super WHY! Technology Add-On; Sesame Workshop's The Electric Company School's Initiative Curriculum; and WordWorld's eBook

  14. Short-term stress enhances cellular immunity and increases early resistance to squamous cell carcinoma.

    PubMed

    Dhabhar, Firdaus S; Saul, Alison N; Daugherty, Christine; Holmes, Tyson H; Bouley, Donna M; Oberyszyn, Tatiana M

    2010-01-01

    In contrast to chronic/long-term stress that suppresses/dysregulates immune function, an acute/short-term fight-or-flight stress response experienced during immune activation can enhance innate and adaptive immunity. Moderate ultraviolet-B (UV) exposure provides a non-invasive system for studying the naturalistic emergence, progression and regression of squamous cell carcinoma (SCC). Because SCC is an immunoresponsive cancer, we hypothesized that short-term stress experienced before UV exposure would enhance protective immunity and increase resistance to SCC. Control and short-term stress groups were treated identically except that the short-term stress group was restrained (2.5h) before each of nine UV-exposure sessions (minimum erythemal dose, 3-times/week) during weeks 4-6 of the 10-week UV exposure protocol. Tumors were measured weekly, and tissue collected at weeks 7, 20, and 32. Chemokine and cytokine gene expression was quantified by real-time PCR, and CD4+ and CD8+ T cells by flow cytometry and immunohistochemistry. Compared to controls, the short-term stress group showed greater cutaneous T-cell attracting chemokine (CTACK)/CCL27, RANTES, IL-12, and IFN-gamma gene expression at weeks 7, 20, and 32, higher skin infiltrating T cell numbers (weeks 7 and 20), lower tumor incidence (weeks 11-20) and fewer tumors (weeks 11-26). These results suggest that activation of short-term stress physiology increased chemokine expression and T cell trafficking and/or function during/following UV exposure, and enhanced Type 1 cytokine-driven cell-mediated immunity that is crucial for resistance to SCC. Therefore, the physiological fight-or-flight stress response and its adjuvant-like immuno-enhancing effects, may provide a novel and important mechanism for enhancing immune system mediated tumor-detection/elimination that merits further investigation. PMID:19765644

  15. Arterial stick

    MedlinePLUS

    ... within the body. Blood also helps control body temperature, fluids, and the balance of chemicals. Blood is ... venous blood) mainly in its content of dissolved gases . Testing arterial blood shows the makeup of the ...

  16. Enhancing the passing moments: An educational criticism of family visits to an early childhood science exhibition

    NASA Astrophysics Data System (ADS)

    Munroe, Elizabeth Ann

    This educational criticism describes and interprets the nature of family visits to an early childhood science exhibition, Working Wonders, at The Science Centre in Calgary, Alberta. The specific exhibits are described and features that contributed to exhibit popularity are examined. Examples of visitors' interactions with each exhibit are given. The visit experiences of four families are described in detail and analyzed. Typical family visitors' reactions, expectations, and experiences are summarized. Because one of the mutual expectations of the granting agency, The Science Centre, and the adult visitors was that a visit to the exhibition would be educational, the family visits are examined for instances of learning and analyzed to determine the factors that influenced the learning. Constructivism forms the basis for understanding the process of learning during family visits. The analysis is supported by reference to research from the fields of museum studies, education, and environmental design. The analysis of the educational significance and potential of family visits to an early childhood exhibition leads to the conclusion that specific features may facilitate learning in such an environment. Those features are represented in a set of guidelines for the development and evaluation of early childhood exhibitions. The guidelines suggest attention must be given to the ambience of the space, the general layout of the space, the exhibits, the copy and graphics, additional programs and information, the subtle influences of the building and the staff, and the learning processes of young children, adults, and intergenerational groups. The guidelines suggest specific issues to consider to develop a space that is stimulating and memorable, responsive to the needs of the two distinct visitor groups (young children and adults), and conducive to learning.

  17. A promising method of enhancement for early detection of ischemic stroke

    PubMed Central

    Sajjadi, Mehdi; Karami, Mehdi; Amirfattahi, Rassoul; Bateni, Vahid; Ahamadzadeh, Mohammad R.; Ebrahimi, Bahareh

    2012-01-01

    Background: Computed Tomography (CT) scan without contrast is the modality of choice for diagnosis of stroke. However, routine brain CT scan, with linear processing has some limitations in early diagnosis of ischemic stroke. The aim of this study was to evaluate and compare the sensitivity and specificity of processed CT images with conventional ones in early diagnosis of cerebrovascular attack (CVA). Patients and Methods: This was a self-controlled study conducted in a university referal hospital from 2010 to 2011. Seventy CT scans underwent a process using Laplacian Pyramid transform. Thirty five of participants were diagnosed with CVA while others had only headache and no ischemic stroke diagnosis based on the first and follow-up CT scans. A neuroradiologist made diagnosis with and without the help of processed CT scans. The McNemar and Wilcoxon analysis were used to compare the sensitivity, specificity, positive and negative predictive values of two methods. Results: The sensitivity (% 65.7 vs. %31.4, P value = 0.001), positive predictive value (% 85.2 vs. % 61, P value = 0.03) and negative predictive value (% 73.9% vs. %49, P value = 0.01) of the processed method were significantly higher than the routine one, while no difference was seen in specificity (% 88.6 vs. %77.1, P value = 0.15). Moreover, the accuracy of the processed method was significantly better than the linear one (P value < 0.001). Conclusions: It was concluded that nonlinear modified Laplacian Pyramid method can composed CT scans which can be more helpful in early detection of ischemic stroke. PMID:23826011

  18. Emotion-associated tones attract enhanced attention at early auditory processing: magnetoencephalographic correlates.

    PubMed

    Brckelmann, Ann-Kathrin; Steinberg, Christian; Elling, Ludger; Zwanzger, Peter; Pantev, Christo; Junghfer, Markus

    2011-05-25

    Emotionally significant objects and events in our environment attract attention based on their motivational relevance for survival. Such kind of emotional attention is thought to lead to affect-specific amplified processing that closely resembles effects of directed attention. Although there has been extensive research on prioritized processing of visual emotional stimuli, the spatio-temporal dynamics of motivated attention mechanisms in auditory processing are less clearly understood. We investigated modulatory effects of emotional attention at early auditory processing stages using time-sensitive whole-head magnetoencephalography. A novel associative learning procedure involving multiple conditioned stimuli (CSs) per affective category was introduced to specifically test whether affect-specific modulation can proceed in a rapid and highly differentiating fashion in humans. Auditory evoked fields (AEFs) were recorded in response to 42 different ultrashort, click-like sounds before and after affective conditioning with pleasant, unpleasant, or neutral auditory scenes. As hypothesized, emotional attention affected neural click tone processing at time intervals of the P20-50m (20-50 ms) and the N1m (100-130 ms), two early AEF components sensitive to directed selective attention (Woldorff et al., 1993). Distributed source localization revealed amplified processing of tones associated with aversive or pleasant compared with neutral auditory scenes at auditory sensory, frontal and parietal cortex regions. Behavioral tests did not indicate any awareness for the contingent CS-UCS (unconditioned stimulus) relationships in the participants, suggesting affective associative learning in absence of contingency awareness. Our findings imply early and highly differentiating affect-specific modulation of auditory stimulus processing supported by neural mechanisms and circuitry comparable with those reported for directed auditory attention. PMID:21613493

  19. Enhanced Dentinogenesis of Pulp Progenitors by Early Exposure to FGF2.

    PubMed

    Sagomonyants, K; Kalajzic, I; Maye, P; Mina, M

    2015-11-01

    Members of the fibroblast growth factor (FGF) family play essential and important roles in primary and reparative dentinogenesis. Although there appears to be a general agreement on the effects of FGF signaling on the proliferation of pulp cells, there are conflicting results regarding its effects on odontoblast differentiation. We recently examined the effects of continuous exposure of dental pulp cells to FGF2 and showed that the effects of FGF2 on differentiation of progenitor cells into odontoblasts were stage specific and dependent on the stage of cell maturity. The purpose of this study was to gain further insight into cellular and molecular mechanisms regulating the stimulatory effects of FGF2 on odontoblast differentiation. To do so, we examined the effects of early and limited exposure of pulp cells from a series of green fluorescent protein (GFP) reporter transgenic mice that display stage-specific activation of transgenes during odontoblast differentiation to FGF2. Our results showed that early and limited exposure of pulp cells to FGF2 did not have significant effects on the extent of mineralization but induced significant increases in the expression of Dmp1 and Dspp and the number of DMP1-GFP(+) and DSPP-Cerulean(+) odontoblasts. Our results also showed that the stimulatory effects of FGF2 on odontoblast differentiation were mediated through FGFR/MEK/Erk1/2 signaling, increases in Bmp2, and activation of the BMP/BMPR signaling pathway. These observations show that early and limited exposure of pulp cells to FGF2 alone promotes odontoblast differentiation and provides critical insight for applications of FGF2 in dentin regeneration. PMID:26276371

  20. Developmental enhancers revealed by extensive DNA methylome maps of zebrafish early embryos

    PubMed Central

    Lee, Hyung Joo; Lowdon, Rebecca F; Maricque, Brett; Zhang, Bo; Stevens, Michael; Li, Daofeng; Johnson, Stephen L; Wang, Ting

    2015-01-01

    DNA methylation undergoes dynamic changes during development and cell differentiation. Recent genome-wide studies discovered that tissue-specific differentially methylated regions (DMRs) often overlap tissue-specific distal cis-regulatory elements. However, developmental DNA methylation dynamics of the majority of the genomic CpGs outside gene promoters and CpG islands has not been extensively characterized. Here we generate and compare comprehensive DNA methylome maps of zebrafish developing embryos. From these maps we identify thousands of developmental stage-specific DMRs (dsDMR) across zebrafish developmental stages. The dsDMRs contain evolutionarily conserved sequences, are associated with developmental genes, and are marked with active enhancer histone post-translational modifications. Their methylation pattern correlates much stronger than promoter methylation with expression of putative target genes. When tested in vivo using a transgenic zebrafish assay, 20 out of 20 selected candidate dsDMRs exhibit functional enhancer activities. Our data suggest that developmental enhancers are a major target of DNA methylation changes during embryogenesis. PMID:25697895

  1. Elastography and Contrast-enhanced Ultrasonography in the Early Detection of Hepatocellular Carcinoma in an Experimental Model of Nonalcoholic Steatohepatitis

    PubMed Central

    Carvalho, Cibele F.; Chammas, Maria C.; Souza de Oliveira, Claudia P.M.; Cogliati, Bruno; Carrilho, Flair J.; Cerri, Giovanni G.

    2013-01-01

    Background/objective The early detection of focal hepatic lesions using ultrasound scanning is challenging, and this challenge becomes even greater in the presence of diffuse parenchymal disease. This study aimed to evaluate the diagnostic performance of elastography and contrast-enhanced ultrasonography (CEUS) in the early detection of hepatocellular lesions in an experimental rat model of nonalcoholic steatohepatitis (NASH). Methods B-mode and Doppler ultrasonography was performed weekly in 30 rats divided into a NASH group (n=20) and a group without liver disease (n=10). The animals underwent elastography and CEUS and were then euthanized. Liver nodules were assessed by histopathology. Results Doppler mapping results of lesions with vascularization were considered indicative of malignancy, with a sensitivity of 29% before and 71% after contrast injection. The specificity was 71% before and 96% after CEUS. Elastograms of positive lesions showed areas of high stiffness, which were indicative of malignancy. This malignancy was confirmed by the histologic evaluation, with a sensitivity of 90% and a specificity of 60%. After CEUS analysis, 4 nodules were identified that were not observed on B-mode ultrasonography. Early wash-in was significantly associated with malignancy (sensitivity of 88% and specificity of 67%). Conclusions Both techniques allow for the correct diagnosis of well-differentiated to moderately differentiated hepatocellular carcinomas with good accuracy in an experimental rat model of NASH. PMID:25755482

  2. High Calcium Bioglass Enhances Differentiation and Survival of Endothelial Progenitor Cells, Inducing Early Vascularization in Critical Size Bone Defects

    PubMed Central

    Nguyen Ngoc, Christina; Meier, Simon; Nau, Christoph; Schaible, Alexander; Marzi, Ingo; Henrich, Dirk

    2013-01-01

    Early vascularization is a prerequisite for successful bone healing and endothelial progenitor cells (EPC), seeded on appropriate biomaterials, can improve vascularization. The type of biomaterial influences EPC function with bioglass evoking a vascularizing response. In this study the influence of a composite biomaterial based on polylactic acid (PLA) and either 20 or 40% bioglass, BG20 and BG40, respectively, on the differentiation and survival of EPCs in vitro was investigated. Subsequently, the effect of the composite material on early vascularization in a rat calvarial critical size defect model with or without EPCs was evaluated. Human EPCs were cultured with β-TCP, PLA, BG20 or BG40, and seeding efficacy, cell viability, cell morphology and apoptosis were analysed in vitro. BG40 released the most calcium, and improved endothelial differentiation and vitality best. This effect was mimicked by adding an equivalent amount of calcium to the medium and was diminished in the presence of the calcium chelator, EGTA. To analyze the effect of BG40 and EPCs in vivo, a 6-mm diameter critical size calvarial defect was created in rats (n = 12). Controls (n = 6) received BG40 and the treatment group (n = 6) received BG40 seeded with 5×105 rat EPCs. Vascularization after 1 week was significantly improved when EPCs were seeded onto BG40, compared to implanting BG40 alone. This indicates that Ca2+ release improves EPC differentiation and is useful for enhanced early vascularization in critical size bone defects. PMID:24244419

  3. Enhancing the Design Process for Complex Space Systems through Early Integration of Risk and Variable-Fidelity Modeling

    NASA Technical Reports Server (NTRS)

    Mavris, Dimitri; Osburg, Jan

    2005-01-01

    An important enabler of the new national Vision for Space Exploration is the ability to rapidly and efficiently develop optimized concepts for the manifold future space missions that this effort calls for. The design of such complex systems requires a tight integration of all the engineering disciplines involved, in an environment that fosters interaction and collaboration. The research performed under this grant explored areas where the space systems design process can be enhanced: by integrating risk models into the early stages of the design process, and by including rapid-turnaround variable-fidelity tools for key disciplines. Enabling early assessment of mission risk will allow designers to perform trades between risk and design performance during the initial design space exploration. Entry into planetary atmospheres will require an increased emphasis of the critical disciplines of aero- and thermodynamics. This necessitates the pulling forward of EDL disciplinary expertise into the early stage of the design process. Radiation can have a large potential impact on overall mission designs, in particular for the planned nuclear-powered robotic missions under Project Prometheus and for long-duration manned missions to the Moon, Mars and beyond under Project Constellation. This requires that radiation and associated risk and hazards be assessed and mitigated at the earliest stages of the design process. Hence, RPS is another discipline needed to enhance the engineering competencies of conceptual design teams. Researchers collaborated closely with NASA experts in those disciplines, and in overall space systems design, at Langley Research Center and at the Jet Propulsion Laboratory. This report documents the results of this initial effort.

  4. HIV-1 induces the formation of stable microtubules to enhance early infection

    PubMed Central

    Sabo, Yosef; Walsh, Derek; Barry, Denis S.; Tinaztepe, Sedef; de los Santos, Kenia; Goff, Stephen P.; Gundersen, Gregg G.; Naghavi, Mojgan H.

    2013-01-01

    Summary Stable microtubule (MT) subsets form distinct networks from dynamic MTs and acquire distinguishing posttranslational modifications, notably detyrosination and acetylation. Acting as specialized tracks for vesicle and macromolecular transport, their formation is regulated by the end-binding protein, EB1, which recruits proteins that stabilize MTs. We show that HIV-1 induces the formation of acetylated and detyrosinated stable MTs early in infection. Although the MT depolymerizing agent nocodazole affected dynamic MTs, HIV-1 particles localized to nocodazole-resistant stable MTs and infection was minimally affected. EB1 depletion or expression of an EB1 carboxy-terminal fragment that acts as a dominant negative inhibitor of MT stabilization, prevented HIV-1-induced stable MT formation and suppressed early viral infection. Furthermore, we show that the HIV-1 matrix protein targets the EB1-binding protein, Kif4 to induce MT stabilization. Our findings illustrate how specialized MT-binding proteins mediate MT stabilization by HIV-1 and the importance of stable MT subsets in viral infection. PMID:24237699

  5. Early Maternal Deprivation Enhances Voluntary Alcohol Intake Induced by Exposure to Stressful Events Later in Life

    PubMed Central

    Peñasco, Sara; Mela, Virginia; López-Moreno, Jose Antonio; Viveros, María-Paz; Marco, Eva M.

    2015-01-01

    In the present study, we aimed to assess the impact of early life stress, in the form of early maternal deprivation (MD, 24 h on postnatal day, pnd, 9), on voluntary alcohol intake in adolescent male and female Wistar rats. During adolescence, from pnd 28 to pnd 50, voluntary ethanol intake (20%, v/v) was investigated using the two-bottle free choice paradigm. To better understand the relationship between stress and alcohol consumption, voluntary alcohol intake was also evaluated following additional stressful events later in life, that is, a week of alcohol cessation and a week of alcohol cessation combined with exposure to restraint stress. Female animals consumed more alcohol than males only after a second episode of alcohol cessation combined with restraint stress. MD did not affect baseline voluntary alcohol intake but increased voluntary alcohol intake after stress exposure, indicating that MD may render animals more vulnerable to the effects of stress on alcohol intake. During adolescence, when animals had free access to alcohol, MD animals showed lower body weight gain but a higher growth rate than control animals. Moreover, the higher growth rate was accompanied by a decrease in food intake, suggesting an altered metabolic regulation in MD animals that may interact with alcohol intake. PMID:25821601

  6. Surface enhanced Raman spectroscopic (SERS) study of saliva in the early detection of oral cancer

    NASA Astrophysics Data System (ADS)

    Kho, Kiang W.; Malini, Olivo; Shen, Ze Xiang; Soo, Khee Chee

    2005-03-01

    Worldwide, oral cancer is the sixth most common cancer for both sexes. In Singapore, the 5-year survival rate of oral cancer is about 50%. The high mortality rate has been attributed to the difficulties in detecting the disease in an early treatable stage. Currently, the standard screening procedures for oral cancer are histopathology examination of biopsied tissues and exfoliative cytological assessment. These techniques, unfortunately, are low in sensitivity. In this study, we exploit the high amplification factor of SERS to investigate on the possibility of utilising molecular vibrational information from saliva samples to detect oral cancer early. All raw saliva samples were centrifuged at 13,000 krpm for 5 minutes to remove unwanted particles prior to SERS measurements. The purified saliva samples were then applied directly on gold particle films, followed by excitation with a 633 nm HeNe laser. SERS spectrum can be obtained in less than 2 minutes for each sample. We have studied the saliva spectra acquired from 5 normal individuals and 5 patients with oral cancer. In addition, we also observe new peaks at 1097 cm-1 and 1627 cm-1 in some of the abnormal samples. These peaks are not present in the spectra acquired from the normal samples. Preliminary measurements will be presented. This study may lead to the development of a sensitive and portable diagnostics system for oral cancer.

  7. Enhanced tocopherol levels during early germination events in Chamaerops humilis var. humilis seeds.

    PubMed

    Siles, Laura; Alegre, Leonor; Tijero, Vernica; Munn-Bosch, Sergi

    2015-10-01

    Most angiosperms accumulate vitamin E in the form of tocopherols in seeds, exerting a protective antioxidant role. However, several palm trees principally accumulate tocotrienols, rather than tocopherols, in seeds, as it occurs in other monocots. To unravel the protective role of either tocopherols or tocotrienols against lipid peroxidation during seed germination in Chamaerops humilis var. humilis; seed viability, natural and induced germination capacity, seed water content, malondialdehyde levels (as an indicator of the extent of lipid peroxidation) and vitamin E levels (including both tocopherols and tocotrienols) were examined at various germination phases in a simulated, natural seed bank. At the very early stages of germination (operculum removal), malondialdehyde levels increased 2.8-fold, to decrease later up to 74%, thus indicating a transient lipid peroxidation at early stages of germination. Tocopherol levels were absent in quiescent seeds and did not increase during operculum removal, but increased later presumably dampening malondialdehyde accumulation. Thereafter, tocopherols continued increasing, while lipid peroxidation levels decreased. By contrast, tocotrienols levels remained constant or even decreased as germination progressed, showing no correlation with lipid peroxidation levels. We hypothesize that despite their high tocotrienol content, seeds synthesize tocopherols during germination to protect lipids from peroxidation events. PMID:26241488

  8. High spatial resolution contrast-enhanced MR angiography of the supraaortic arteries using the quadrature body coil at 3.0T: a feasibility study.

    PubMed

    Willinek, Winfried A; Bayer, Thomas; Gieseke, Jrgen; von Falkenhausen, Marcus; Sommer, Torsten; Hoogeveen, Romhild; Wilhelm, Kai; Urbach, Horst; Schild, Hans H

    2007-03-01

    To examine whether the the increased signal-to-noise (S/N) available at 3.0T would permit the use of the quadrature body coil for high spatial resolution contrast-enhanced (CE) MR angiography (MRA), and whether the large FOV that was used in our routine 1.5T protocol would also be feasible at 3.0T. In a prospective study, 43 patients and five volunteers were examined on a clinical whole-body 3.0T MR unit (Intera, Philips Medical Systems, Best, The Netherlands) after institutional review board approval and informed consent. Three-dimensional CE MRA (T1 gradient echo-sequence with TR/TE = 5.7/1.93 msec.; acquisition time, 1:54 min.) using randomly segmented central k-space ordering (CENTRA) was acquired with the quadrature body coil, using over a FOV of 350 mm. A high-image matrix of 432x432 yielded a non-zero filled voxel size of 0.81 mm x 0.81 mm x 1.0 mm (0.66 mm(3)). For quantitative analysis, contrast ratios (CR) between vessels (S) and signal in surrounding tissue (ST) were calculated [(S-ST)/(S+ST)]. For qualitative analysis, image quality and presence of artifacts were rated by two radiologists in consensus on a five-point scale (1=excellent to 5=nondiagnostic). Digital subtraction angiography (DSA) served as the standard of reference in patients with vascular disease. In the five volunteers, 1.5T CE MRA using a phased array neurovascular coil was available for intraindividual comparison. 3.0T CE MRA was successfully performed in 48/48 subjects (100%). Mean CR+/- SD were 0.76 (139.30/182.42) and 0.87 (235.18/270.14) at 3.0T and 1.5T respectively . Mean image quality was 3.82+/-0.86. Intraindividual comparison between 1.5T and 3.0T CE MRA in the volunteers revealed no significant difference in image quality (4.2+/-0.74 vs 4.6+/-0.80; p>0.05). Vascular disease was correctly identified in 13/13 patients with DSA correlation. CE MRA of the supraaortic arteries is feasible at 3.0T using a large FOV of 350 mm. The signal gain at 3.0T enables high spatial resolution contrast-enhanced MR angiography by using the built-in quadrature body coil only. PMID:16944161

  9. Late Rather Than Early Onset Bubbles in the Pulmonary Artery During Altitude Exposures Correlate Better with the Onset of "Pain-Only" Decompression Illness

    NASA Technical Reports Server (NTRS)

    Conkin, J.; Gernhardt, M. L.; Powell, M. R.

    2005-01-01

    Mechanistic insight about "pain-only" decompression illness (DCI) is limited given indirect information about venous gas emboli (VGE) detected in the pulmonary artery with Doppler ultrasound. However, we show that VGE first detected late in an altitude exposure are closely associated with subsequent symptom onset. Knowing that VGE occur late is an indication that a symptom will occur soon, but this is not a sufficient condition to guarantee that a symptom will occur.

  10. Early-Onset Osteoarthritis, Charcot-Marie-Tooth Like Neuropathy, Autoimmune Features, Multiple Arterial Aneurysms and Dissections: An Unrecognized and Life Threatening Condition

    PubMed Central

    Aubart, Mlodie; Gobert, Delphine; Aubart-Cohen, Fleur; Detaint, Delphine; Hanna, Nadine; dIndya, Hyacintha; Lequintrec, Janine-Sophie; Renard, Philippe; Vigneron, Anne-Marie; Dieud, Philippe; Laissy, Jean-Pierre; Koch, Pierre; Muti, Christine; Roume, Joelle; Cusin, Veronica; Grandchamp, Bernard; Gouya, Laurent; LeGuern, Eric; Papo, Thomas; Boileau, Catherine; Jondeau, Guillaume

    2014-01-01

    Background Severe osteoarthritis and thoracic aortic aneurysms have recently been associated with mutations in the SMAD3 gene, but the full clinical spectrum is incompletely defined. Methods All SMAD3 gene mutation carriers coming to our centre and their families were investigated prospectively with a structured panel including standardized clinical workup, blood tests, total body computed tomography, joint X-rays. Electroneuromyography was performed in selected cases. Results Thirty-four SMAD3 gene mutation carriers coming to our centre were identified and 16 relatives were considered affected because of aortic surgery or sudden death (total 50 subjects). Aortic disease was present in 72%, complicated with aortic dissection, surgery or sudden death in 56% at a mean age of 45 years. Aneurysm or tortuosity of the neck arteries was present in 78%, other arteries were affected in 44%, including dissection of coronary artery. Overall, 95% of mutation carriers displayed either aortic or extra-aortic arterial disease. Acrocyanosis was also present in the majority of patients. Osteoarticular manifestations were recorded in all patients. Joint involvement could be severe requiring surgery in young patients, of unusual localization such as tarsus or shoulder, or mimicking crystalline arthropathy with fibrocartilage calcifications. Sixty eight percent of patients displayed neurological symptoms, and 9 suffered peripheral neuropathy. Electroneuromyography revealed an axonal motor and sensory neuropathy in 3 different families, very evocative of type II Charcot-Marie-Tooth (CMT2) disease, although none had mutations in the known CMT2 genes. Autoimmune features including Sjogrens disease, rheumatoid arthritis, Hashimotos disease, or isolated autoantibodies- were found in 36% of patients. Interpretation SMAD3 gene mutations are associated with aortic dilatation and osteoarthritis, but also autoimmunity and peripheral neuropathy which mimics type II Charcot-Marie-Tooth. PMID:24804794

  11. [In hospital observation of patients with acute coronary syndrome without ST elevation and multivessels coronary artery disease treated with early invasive strategy. Comparison of results of percutaneous coronary intervention and coronary artery by-pass grafting].

    PubMed

    Szygu?a-Jurkiewicz, Bozena; Wilczek, Krzysztof; Szafron, Bartosz; Przybylski, Roman; Chudzik, Bartosz; Osuch, Marcin; Zebala, Marian; Polo?ski, Lech

    2004-08-01

    Acute coronary syndromes (ACS) without persistent ST-segment elevation are the main cause of hospitalization, morbidity and mortality. The objective of this study was to compare clinical and angiographic parameters as well as in-hospital results of treating 307 consecutive patients with ACS without persistent ST-segment elevation with either PCI or CABG. Inclusion criteria were: rest angina within the last 24 hours, ST-segment depression (> 0.5 mm), T-wave inversion (> 1 mm) in at least two leads, positive serum cardiac markers. PCI was performed in 75.9% of patients and 24.1% of patients underwent CABG. Both groups did not differ as to age, sex, history of diabetes, arterial hypertension, heart failure, smoking and ejection fraction. Positive troponin was significantly more frequent in the PCI group. 51% of PCI patients and 80% of CABG patients had complete revascularization (p = 0.00001). Independent predictors of in-hospital death in the CABG group were: inability to determine culprit vessel during coronary angiography due to lesions' severity (OR 13.65; 95% CI 9.40-15.20; p = 0.007) and heart failure (OR 15.58; 95% CI 12.29-18.01; p = 0.003). In the PCI group these independent predictors were: Braunwald's IIIC unstable angina (OR 5.48; 95% CI 3.10-7.17; p = 0.04) and diabetes (OR 2.22; 95% CI 1.07-3.90; p = 0.003). In-hospital mortality rate was significantly higher in the CABG group (8.1% vs 1.7% p < 0.01). Patients with multivessel coronary artery disease and ACS without ST-segment elevation treated with PCI have better in-hospital outcome than patients assigned to CABG, but the rate of complete revascularization is lower. PMID:15675265

  12. Enhanced algal abundance in northwest Ontario (Canada) lakes during the warmer early-to mid-Holocene period

    NASA Astrophysics Data System (ADS)

    Karmakar, Moumita; Leavitt, Peter R.; Cumming, Brian F.

    2015-09-01

    This study investigates regional changes in primary producers in boreal head-water lakes during the warmer early-to-mid-Holocene (EMH) period, across the present-day boreal forest in northwest Ontario, a region that is adjacent to the prairie-forest ecotone. We quantified changes in algal abundance and composition over the Holocene period using pigments, spectrally-inferred chlorophyll a and diatom assemblages in well-dated sediment cores from three lakes. All three indicators showed a coherent pattern of enhanced primary producers in two of the study lakes (Gall Lake and Lake 239) during the EMH, whereas only diatom assemblages suggested higher levels of nutrients in Meekin Lake. Overall, this study supports a regional pattern of enhanced primary producers during the EMH, likely as a function of lower water-levels and warmer temperatures. Elevated concentrations of cyanobacterial pigments also occurred in two of the three lakes during the EMH, whereas pigments from purple-sulphur bacteria provide evidence of enhanced deep-water anoxia in one lake. These findings suggest that future climatic warming in boreal regions could include regional eutrophication and associated increases in cyanobacteria.

  13. 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 ...

  14. High dietary taurine reduces apoptosis and atherosclerosis in the left main coronary artery: association with reduced CCAAT/enhancer binding protein homologous protein and total plasma homocysteine but not lipidemia.

    PubMed

    Zulli, Anthony; Lau, Eza; Wijaya, Bagus P P; Jin, Xin; Sutarga, Komang; Schwartz, Grace D; Learmont, Jonathon; Wookey, Peter J; Zinellu, Angelo; Carru, Ciriaco; Hare, David L

    2009-06-01

    We sought to determine whether taurine could specifically protect against coronary artery disease during an atherogenic diet and whether taurine affects the lipid profile, metabolites of methionine, and endothelial atherogenic systems. Rabbits were fed one of the following diets for 4 weeks: (1) control diet; (2) 0.5% cholesterol+1.0% methionine; or (3) 0.5% cholesterol+1.0% methionine+2.5% taurine. Endothelial function was examined, and the left main coronary artery atherosclerosis was quantified by stereology and semiquantitative immunohistochemistry to determine the endothelial expression of proteins related to the NO, renin-angiotensin, endoplasmic reticulum, and oxidative stress systems, as well as apoptosis. Taurine normalized hyperhomocysteinemia (P<0.05) and significantly reduced hypermethioninemia (P<0.05) but not lipidemia. The intima:media ratio was reduced by 28% (P=0.034), and atherosclerosis was reduced by 64% (P=0.012) and endothelial cell apoptosis by 30% (P<0.01). Endothelial cell CCAAT/enhancer binding protein homologous protein was normalized (P<0.05). Taurine failed to improve hyperlipidemia, endothelial function, or endothelial proteins related to the NO, renin-angiotensin, and oxidative stress systems. Taurine reduces left main coronary artery wall pathology associated with decreased plasma total homocysteine, methionine, apoptosis, and normalization of CCAAT/enhancer binding protein homologous protein. These results elucidate the antiapoptotic and antiatherogenic properties of taurine, possibly via normalization of endoplasmic reticulum stress. PMID:19398656

  15. Lithium-isotope evidence for enhanced silicate weathering during OAE 1a (Early Aptian Selli event)

    NASA Astrophysics Data System (ADS)

    Lechler, Maria; Pogge von Strandmann, Philip A. E.; Jenkyns, Hugh C.; Prosser, Giacomo; Parente, Mariano

    2015-12-01

    An abrupt rise in temperature, forced by a massive input of CO2 into the atmosphere, is commonly invoked as the main trigger for Oceanic Anoxic Events (OAEs). Global warming initiated a cascade of palaeoenvironmental perturbations starting with increased continental weathering and an accelerated hydrological cycle that delivered higher loads of nutrients to coastal areas, stimulating biological productivity. The end-result was widespread anoxia and deposition of black shales: the hallmarks of OAEs. In order to assess the role of weathering as both an OAE initiator and terminator (via CO2 sequestration) during the Early Aptian OAE 1a (Selli Event, ∼120 Ma) the isotopic ratio of lithium isotopes was analysed in three sections of shallow-marine carbonates from the Pacific and Tethyan realms and one basinal pelagic section from the Tethyan domain. Because the isotopic composition of lithium in seawater is largely controlled by continental silicate weathering and high- and low-temperature alteration of basaltic material, a shift to lighter δ7Li values is expected to characterize OAEs. The studied sections illustrate this phenomenon: δ7Li values decrease to a minimum coincident with the negative carbon-isotope excursion that effectively records the onset of OAE 1a. A second negative δ7Li excursion occurs coeval with the minimum in strontium isotopes after the event. The striking similarity to the strontium-isotope record argues for a common driver. The formation and destruction (weathering) of an oceanic LIP could account for the parallel trend in both isotope systems. The double-spike in lithium isotopes is probably related to a change in weathering congruencies. Such a chemostratigraphy is consistent with the hypothesis that an increase in silicate weathering, in conjunction with organic-carbon burial, led to drawdown of atmospheric CO2 during the early Aptian OAE 1a.

  16. Novel Polypyrrole-Coated Polylactide Scaffolds Enhance Adipose Stem Cell Proliferation and Early Osteogenic Differentiation

    PubMed Central

    Pelto, Jani; Bjrninen, Miina; Plli, Aliisa; Talvitie, Elina; Hyttinen, Jari; Mannerstrm, Bettina; Suuronen Seppanen, Riitta; Kellomki, Minna; Miettinen, Susanna; Haimi, Suvi

    2013-01-01

    An electrically conductive polypyrrole (PPy) doped with a bioactive agent is an emerging functional biomaterial for tissue engineering. We therefore used chondroitin sulfate (CS)-doped PPy coating to modify initially electrically insulating polylactide resulting in novel osteogenic scaffolds. In situ chemical oxidative polymerization was used to obtain electrically conductive PPy coating on poly-96L/4D-lactide (PLA) nonwoven scaffolds. The coated scaffolds were characterized and their electrical conductivity was evaluated in hydrolysis. The ability of the coated and conductive scaffolds to enhance proliferation and osteogenic differentiation of human adipose stem cells (hASCs) under electrical stimulation (ES) in three-dimensional (3D) geometry was compared to the noncoated PLA scaffolds. Electrical conductivity of PPy-coated PLA scaffolds (PLA-PPy) was evident at the beginning of hydrolysis, but decreased during the first week of incubation due to de-doping. PLA-PPy scaffolds enhanced hASC proliferation significantly compared to the plain PLA scaffolds at 7 and 14 days. Furthermore, the alkaline phosphatase (ALP) activity of the hASCs was generally higher in PLA-PPy seeded scaffolds, but due to patient variation, no statistical significance could be determined. ES did not have a significant effect on hASCs. This study highlights the potential of novel PPy-coated PLA scaffolds in bone tissue engineering. PMID:23126228

  17. EXCESS OPTICAL ENHANCEMENT OBSERVED WITH ARCONS FOR EARLY CRAB GIANT PULSES

    SciTech Connect

    Strader, M. J.; Mazin, B. A.; Spiro Jaeger, G. V.; Gwinn, C. R.; Meeker, S. R.; Szypryt, P.; Van Eyken, J. C.; Marsden, D.; Walter, A. B.; Ulbricht, G.; Johnson, M. D.; O'Brien, K.; Stoughton, C.; Bumble, B.

    2013-12-10

    We observe an extraordinary link in the Crab pulsar between the enhancement of an optical pulse and the timing of the corresponding giant radio pulse. At optical through infrared wavelengths, our observations use the high time resolution of ARray Camera for Optical to Near-IR Spectrophotometry, a unique superconducting energy-resolving photon-counting array at the Palomar 200 inch telescope. At radio wavelengths, we observe with the Robert C. Byrd Green Bank Telescope and the Green Bank Ultimate Pulsar Processing Instrument backend. We see an 11.3% ± 2.5% increase in peak optical flux for pulses that have an accompanying giant radio pulse arriving near the peak of the optical main pulse, in contrast to a 3.2% ± 0.5% increase when an accompanying giant radio pulse arrives soon after the optical peak. We also observe that the peak of the optical main pulse is 2.8% ± 0.8% enhanced when there is a giant radio pulse accompanying the optical interpulse. We observe no statistically significant spectral differences between optical pulses accompanied by and not accompanied by giant radio pulses. Our results extend previous observations of optical-radio correlation to the time and spectral domains. Our refined temporal correlation suggests that optical and radio emission are indeed causally linked, and the lack of spectral differences suggests that the same mechanism is responsible for all optical emission.

  18. A model-constrained Monte Carlo method for blind arterial input function estimation in dynamic contrast-enhanced MRI: II. In vivo results

    NASA Astrophysics Data System (ADS)

    Schabel, Matthias C.; DiBella, Edward V. R.; Jensen, Randy L.; Salzman, Karen L.

    2010-08-01

    Accurate quantification of pharmacokinetic model parameters in tracer kinetic imaging experiments requires correspondingly accurate determination of the arterial input function (AIF). Despite significant effort expended on methods of directly measuring patient-specific AIFs in modalities as diverse as dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), dynamic positron emission tomography (PET), and perfusion computed tomography (CT), fundamental and technical difficulties have made consistent and reliable achievement of that goal elusive. Here, we validate a new algorithm for AIF determination, the Monte Carlo blind estimation (MCBE) method (which is described in detail and characterized by extensive simulations in a companion paper), by comparing AIFs measured in DCE-MRI studies of eight brain tumor patients with results of blind estimation. Blind AIFs calculated with the MCBE method using a pool of concentration-time curves from a region of normal brain tissue were found to be quite similar to the measured AIFs, with statistically significant decreases in fit residuals observed in six of eight patients. Biases between the blind and measured pharmacokinetic parameters were the dominant source of error. Averaged over all eight patients, the mean biases were +7% in K trans, 0% in kep, -11% in vp and +10% in ve. Corresponding uncertainties (median absolute deviation from the best fit line) were 0.0043?min-1 in K trans, 0.0491 min-1 in kep, 0.29% in vp and 0.45% in ve. The use of a published population-averaged AIF resulted in larger mean biases in three of the four parameters (-23% in K trans, -22% in kep, -63% in vp), with the bias in ve unchanged, and led to larger uncertainties in all four parameters (0.0083 min-1 in K trans, 0.1038 min-1 in kep, 0.31% in vp and 0.95% in ve). When blind AIFs were calculated from a region of tumor tissue, statistically significant decreases in fit residuals were observed in all eight patients despite larger deviations of these blind AIFs from the measured AIFs. The observed decrease in root-mean-square fit residuals between the normal brain and tumor tissue blind AIFs suggests that the local blood supply in tumors is measurably different from that in normal brain tissue and that the proposed method is able to discriminate between the two. We have shown the feasibility of applying the MCBE algorithm to DCE-MRI data acquired in brain, finding generally good agreement with measured AIFs and decreased biases and uncertainties relative to the use of a population-averaged AIF. These results demonstrate that the MCBE algorithm is a useful alternative to direct AIF measurement in cases where acquisition of high-quality arterial input function data is difficult or impossible.

  19. Early life antibiotic-driven changes in microbiota enhance susceptibility to allergic asthma

    PubMed Central

    Russell, Shannon L; Gold, Matthew J; Hartmann, Martin; Willing, Benjamin P; Thorson, Lisa; Wlodarska, Marta; Gill, Navkiran; Blanchet, Marie-Renée; Mohn, William W; McNagny, Kelly M; Finlay, Brett B

    2012-01-01

    Allergic asthma rates have increased steadily in developed countries, arguing for an environmental aetiology. To assess the influence of gut microbiota on experimental murine allergic asthma, we treated neonatal mice with clinical doses of two widely used antibiotics—streptomycin and vancomycin—and evaluated resulting shifts in resident flora and subsequent susceptibility to allergic asthma. Streptomycin treatment had little effect on the microbiota and on disease, whereas vancomycin reduced microbial diversity, shifted the composition of the bacterial population and enhanced disease severity. Neither antibiotic had a significant effect when administered to adult mice. Consistent with the ‘hygiene hypothesis', our data support a neonatal, microbiota-driven, specific increase in susceptibility to experimental murine allergic asthma. PMID:22422004

  20. ElarmS Earthquake Early Warning System Enhancements and Performance Evaluation

    NASA Astrophysics Data System (ADS)

    Henson, I. H.; Neuhauser, D. S.; Allen, R. M.

    2014-12-01

    ElarmS is an earthquake early warning system that contributes alerts to CISN ShakeAlert, a prototype end-to-end earthquake early warning system being developed and tested by the California Integrated Seismic Network (CISN). ElarmS is one of several systems that contribute to CISN ShakeAlert. The UC Berkeley ElarmS system consists of multiple continuous-waveform processors and trigger-association processors running at three geographical locations and communicating via the Apache ActiveMQ Messaging system. With performance monitoring tools, we review the system component latencies and earthquake hypocenter estimations. Statistics are presented for hypocenter and origin time accuracy and alert times latencies for the previous year by geographic regions. We are also testing the ElarmS system by replaying the raw waveform data for historical earthquakes of interest. This allows us to check the signal detection algorithm, the trigger associator and the magnitude estimator. Over the last year, ElarmS successfully alerted on all significant earthquakes (M>=4.5, 10 earthquakes) and generated no false alarms. This includes events in Los Angeles, Santa Rosa, offshore Eureka, and the southern Sierra. The magnitude estimates were within 0.5 magnitude units in all cases. The largest event was the M6.8 event offshore of Eureka. The initial ElarmS magnitude estimate was M6.3 with a location 7 km from the true (offshore) location. ElarmS also alerted on all of the larger (M>=4.5) aftershocks. The speed of the alert depends on the quality of the seismic network around the epicenter. For the M5.1 Los Angeles Le Habra event the alert was 4.2 sec after the origin time, this is typical for events in the LA region. For the Santa Rosa event the alert was 6.8 sec after the origin time, 10.8 for the southern Sierra event, and 25.7 for the (offshore) Eureka earthquake. Comparing the performance of ElarmS across the state for a wider range of magnitudes (M>=3) the effect of variable seismic network quality is very apparent. The performance is good to excellent in the SF Bay and LA areas where station coverage is densest. In the greater SF Bay Area of the 38 M>=3.0 events reported by the ANSS, 5 were missed (all in the Geysers Geothermal Area) and there were no false events. In the LA region, of the 35 M>=3.0 events, 4 were missed and there were 2 false events.

  1. Enhanced release of IgE-dependent early phase mediators from nasal polyp tissue

    PubMed Central

    Patou, Joke; Holtappels, Gabriele; Affleck, Karen; Gevaert, Philippe; Perez-Novo, Claudina; Van Cauwenberge, Paul; Bachert, Claus

    2009-01-01

    Background The mast cell is a crucial effector cell in allergic rhinitis and other inflammatory diseases. During the acute allergic reaction preformed mediators such as histamine, but also de novo produced mediators such as leukotrienes (LTC4/D4/E4) and prostaglandins (PGD2) are released. Mast cells represent targets for therapeutic intervention, and thus a human ex-vivo model to stimulate mast cells taken from mucosal sites would be instrumental for drug intervention studies. We have aimed to activate mast cells within ex-vivo human nasal tissue by IgE/anti-IgE specific (? chain specific) stimulations and in this respect to test the usability of nasal polyps versus inferior turbinates Methods Biopsy samples were collected from patients with nasal polyps and inferior turbinates from patients who underwent sinus or septal surgery. Tissue fragments were primed with IgE 1 ?g/ml for 60 minutes and then stimulated for 30 minutes with tissue culture medium (negative control), anti-IgE 10 ?g/ml, anti-IgE 30 ?g/ml and ionomycin 10 ?M (positive control). Histamine, leukotrienes and PGD2 were measured in supernatants. To help provide an understanding of the extent of the response, the number of tryptase and Fc?RI? positive cells was evaluated by means of immunohistochemistry and the Fc?RI?-chain was measured by means of quantitative PCR in the nasal polyp and inferior turbinate tissues. Finally, the correlation between IgE concentrations in the nasal tissue and the release of mediators was analysed. Results Stimulations with anti-IgE on IgE-primed nasal tissue fragments lead to a concentration-dependent release of histamine, leukotrienes and PGD2. The release of these early phase mediators was significantly higher in nasal polyps compared to inferior turbinates, although tryptase, Fc?RI? positive cells and Fc?RI?-chain transcripts were equally present in both groups. No correlation was found between baseline concentrations of IgE, and the release of histamine, LTC4/LTD4/LTE4 and PGD2 after stimulation. Conclusion This human nasal challenge model mimics the allergic early phase reaction. The release of histamine, cys-leukotrienes and PGD2 was significantly higher in nasal polyps versus inferior turbinates, however, this observation could not be explained by differences in mast cell or Fc?RI+ cell numbers. PMID:19379488

  2. Arterial endothelial function measurement method and apparatus

    DOEpatents

    Maltz, Jonathan S; Budinger, Thomas F

    2014-03-04

    A "relaxoscope" (100) detects the degree of arterial endothelial function. Impairment of arterial endothelial function is an early event in atherosclerosis and correlates with the major risk factors for cardiovascular disease. An artery (115), such as the brachial artery (BA) is measured for diameter before and after several minutes of either vasoconstriction or vasorelaxation. The change in arterial diameter is a measure of flow-mediated vasomodification (FMVM). The relaxoscope induces an artificial pulse (128) at a superficial radial artery (115) via a linear actuator (120). An ultrasonic Doppler stethoscope (130) detects this pulse 10-20 cm proximal to the point of pulse induction (125). The delay between pulse application and detection provides the pulse transit time (PTT). By measuring PTT before (160) and after arterial diameter change (170), FMVM may be measured based on the changes in PTT caused by changes in vessel caliber, smooth muscle tone and wall thickness.

  3. Idiopathic infantile arterial calcification: unusual features.

    PubMed

    Vera, J; Lucaya, J; Garcia Conesa, J A; Aso, C; Balaguer, A

    1990-01-01

    Idiopathic infantile arterial calcification (IIAC) is a rare disease of unknown etiology, which causes widespread arterial calcification and usually leads to early death from coronary arterial occlusion. Periarticular calcification has been reported in some cases. Two new cases are reported. In addition to the usual features of the disease, one was found to have ear-lobe calcification and the other an aortic aneurysm and coarctation of the aorta. Therapy with diphosphonate was apparently successful in one patient. PMID:2251001

  4. Brief Report: Can Metrics of Reporting Bias Enhance Early Autism Screening Measures?

    PubMed Central

    Vehorn, Alison; Noble, Hylan; Weitlauf, Amy S.; Warren, Zachary E.

    2014-01-01

    The goal of the current study was to develop and pilot the utility of two simple internal response bias metrics, over-reporting and under-reporting, in terms of additive clinical value within common screening practices for early detection of autism spectrum disorder risk. Participants were caregivers and children under 36 months of age (n = 145) participating in first-time diagnostic appointments across our clinical research center due to developmental concerns. Caregivers were asked to complete the Modified Checklist for Autism in Toddlers (MCHAT) as well as a questionnaire embedding six response bias indicator questions. These questions were items that in previous clinical studies had been endorsed by an overwhelming majority of parents within clinically identified populations. Results indicated that removal of self-reports indicative of potential response bias dramatically reduced both false positives and false negatives on the MCHAT within this sample. This suggests that future work developing internal metrics of response bias may be promising in addressing limits of current screening measures and practices. PMID:24682706

  5. Early life adversity reduces stress reactivity and enhances impulsive behavior: Implications for health behaviors

    PubMed Central

    Lovallo, William R.

    2012-01-01

    Altered reactivity to stress, either in the direction of exaggerated reactivity or diminished reactivity, may signal a dysregulation of systems intended to maintain homeostasis and a state of good health. Evidence has accumulated that diminished reactivity to psychosocial stress may signal poor health outcomes. One source of diminished cortisol and autonomic reactivity is the experience of adverse rearing during childhood and adolescence. The Oklahoma Family Health Patterns Project has examined a cohort of 426 healthy young adults with and without a family history of alcoholism. Regardless of family history, persons who had experienced high degrees of adversity prior to age 16 had a constellation of changes including reduced cortisol and heart rate reactivity, diminished cognitive capacity, and unstable regulation of affect, leading to behavioral impulsivity and antisocial tendencies. We present a model whereby this constellation of physiological, cognitive, and affective tendencies is consistent with altered central dopaminergic activity leading to changes in brain function that may foster impulsive and risky behaviors. These in turn may promote greater use of alcohol other drugs along with adopting poor health behaviors. This model provides a pathway from early life adversity to low stress reactivity that forms a basis for risky behaviors and poor health outcomes. PMID:23085387

  6. Hemodynamic effects of proximal supra-aortic artery stenosis on anterior cerebral artery.

    PubMed

    Lpez-Hernndez, Nicols; Garca-Escriv, Alejandro; Ballenilla, Federico; Gallego-Leon, Jose Ignacio

    2015-05-01

    Alternating flow in the anterior cerebral artery is a rare finding, associated with innominate artery stenosis. We present a series of four patients with this finding on transcranial color coded sonography, under basal conditions. In all of these patients, vascular studies detected an ipsilateral proximal stenosis, three in the innominate artery and, for the first time, one at the left common carotid artery origin. Successful angioplasties with stenting were performed, resulting for the first time in the normalization of orthograde flow in all cases. We conclude that an early systolic hemodynamic compromise in the first segment of the anterior cerebral artery, in the form of alternating flow, is an indirect indicator of ipsilateral proximal stenosis in the supra-aortic arteries, either in the innominate artery or at the origin of the left common carotid artery. PMID:25641601

  7. An early rehabilitation intervention to enhance recovery during hospital admission for an exacerbation of chronic respiratory disease: randomised controlled trial

    PubMed Central

    Williams, Johanna E A; Hussain, Syed F; Harvey-Dunstan, Theresa C; Bankart, M John; Chaplin, Emma J; Vincent, Emma E; Chimera, Rudo; Morgan, Mike D; Singh, Sally J; Steiner, Michael C

    2014-01-01

    Objective To investigate whether an early rehabilitation intervention initiated during acute admission for exacerbations of chronic respiratory disease reduces the risk of readmission over 12 months and ameliorates the negative effects of the episode on physical performance and health status. Design Prospective, randomised controlled trial. Setting An acute cardiorespiratory unit in a teaching hospital and an acute medical unit in an affiliated teaching district general hospital, United Kingdom. Participants 389 patients aged between 45 and 93 who within 48 hours of admission to hospital with an exacerbation of chronic respiratory disease were randomised to an early rehabilitation intervention (n=196) or to usual care (n=193). Main outcome measures The primary outcome was readmission rate at 12 months. Secondary outcomes included number of hospital days, mortality, physical performance, and health status. The primary analysis was by intention to treat, with prespecified per protocol analysis as a secondary outcome. Interventions Participants in the early rehabilitation group received a six week intervention, started within 48 hours of admission. The intervention comprised prescribed, progressive aerobic, resistance, and neuromuscular electrical stimulation training. Patients also received a self management and education package. Results Of the 389 participants, 320 (82%) had a primary diagnosis of chronic obstructive pulmonary disease. 233 (60%) were readmitted at least once in the following year (62% in the intervention group and 58% in the control group). No significant difference between groups was found (hazard ratio 1.1, 95% confidence interval 0.86 to 1.43, P=0.4). An increase in mortality was seen in the intervention group at one year (odds ratio 1.74, 95% confidence interval 1.05 to 2.88, P=0.03). Significant recovery in physical performance and health status was seen after discharge in both groups, with no significant difference between groups at one year. Conclusion Early rehabilitation during hospital admission for chronic respiratory disease did not reduce the risk of subsequent readmission or enhance recovery of physical function following the event over 12 months. Mortality at 12 months was higher in the intervention group. The results suggest that beyond current standard physiotherapy practice, progressive exercise rehabilitation should not be started during the early stages of the acute illness. Trial registration Current Controlled Trials ISRCTN05557928. PMID:25004917

  8. INTRAUTERINE EXPOSURE TO LEAD MAY ENHANCE SENSITIZATION TO COMMON INHALANT ALLERGENS IN EARLY CHILDHOOD. A PROSPECTIVE PREBIRTH COHORT STUDY

    PubMed Central

    Jedrychowski, Wieslaw; Perera, Frederica; Maugeri, Umberto; Miller, Rachel L.; Rembiasz, Maria; Flak, Elzbieta; Mroz, Elzbieta; Majewska, Renata; Zembala, Marek

    2010-01-01

    Background Several in vivo and in vitro studies have shown that metal-rich particles may enhance allergic responses to house dust mites and induce an increased release of allergy-related cytokines. Objectives The main goal of this analysis is to define the possible association of intrauterine exposure to lead and mercury with the occurrence of skin sensitization to common aeroallergens in early childhood. Material and Methods The present study refers to a sample of 224 women in the second trimester of pregnancy recruited from Krakow inner city area who had full term pregnancies and whose children underwent skin prick testing (SPT) at the age of 5. Lead and mercury levels were assessed in cord blood and retested in children at age of 5 years. Aeroallergen concentrations in house dust were measured at the age of 3 years. The main health outcome (atopic status) was defined as the positive SPT to at least one common aeroallergen (Der f1, Der p1, Can f1 and Fel d1) at the age of 5 years. In the statistical analysis of the association between atopic status of children and exposure to metals, the study considered a set of covariates such as maternal characteristics (age, education, atopy), childs gender, number of older siblings, prenatal (measured via cord blood cotinine) and postnatal environmental tobacco smoke together with exposure to polycyclic aromatic hydrocarbons (PAH) as measured by PAH-DNA adducts. Results and conclusion In the binary regression analysis, which controlled for the confounders, the risk ratio (RR) estimate for atopic sensitization was significantly associated with the lead exposure (RR =2.25, 95%CI: 1.214.19). In conclusion, the data suggest that even very low-level of prenatal lead exposure may be implicated in enhancing sensitization to common aeroallergens in early childhood. PMID:21094490

  9. Enhanced Glycogen Storage of a Subcellular Hot Spot in Human Skeletal Muscle during Early Recovery from Eccentric Contractions

    PubMed Central

    Nielsen, Joachim; Farup, Jean; Rahbek, Stine Klejs; de Paoli, Frank Vincenzo; Vissing, Kristian

    2015-01-01

    Unaccustomed eccentric exercise is accompanied by muscle damage and impaired glucose uptake and glycogen synthesis during subsequent recovery. Recently, it was shown that the role and regulation of glycogen in skeletal muscle are dependent on its subcellular localization, and that glycogen synthesis, as described by the product of glycogen particle size and number, is dependent on the time course of recovery after exercise and carbohydrate availability. In the present study, we investigated the subcellular distribution of glycogen in fibers with high (type I) and low (type II) mitochondrial content during post-exercise recovery from eccentric contractions. Analysis was completed on five male subjects performing an exercise bout consisting of 15 x 10 maximal eccentric contractions. Carbohydrate-rich drinks were subsequently ingested throughout a 48 h recovery period and muscle biopsies for analysis included time points 3, 24 and 48 h post exercise from the exercising leg, whereas biopsies corresponding to prior to and at 48 h after the exercise bout were collected from the non-exercising, control leg. Quantitative imaging by transmission electron microscopy revealed an early (post 3 and 24 h) enhanced storage of intramyofibrillar glycogen (defined as glycogen particles located within the myofibrils) of type I fibers, which was associated with an increase in the number of particles. In contrast, late in recovery (post 48 h), intermyofibrillar, intramyofibrillar and subsarcolemmal glycogen in both type I and II fibers were lower in the exercise leg compared with the control leg, and this was associated with a smaller size of the glycogen particles. We conclude that in the carbohydrate-supplemented state, the effect of eccentric contractions on glycogen metabolism depends on the subcellular localization, muscle fiber’s oxidative capacity, and the time course of recovery. The early enhanced storage of intramyofibrillar glycogen after the eccentric contractions may entail important implications for muscle function and fatigue resistance. PMID:25996774

  10. Arterial input function of an optical tracer for dynamic contrast enhanced imaging can be determined from pulse oximetry oxygen saturation measurements

    NASA Astrophysics Data System (ADS)

    Elliott, Jonathan T.; Wright, Eric A.; Tichauer, Kenneth M.; Diop, Mamadou; Morrison, Laura B.; Pogue, Brian W.; Lee, Ting-Yim; St. Lawrence, Keith

    2012-12-01

    In many cases, kinetic modeling requires that the arterial input function (AIF)—the time-dependent arterial concentration of a tracer—be characterized. A straightforward method to measure the AIF of red and near-infrared optical dyes (e.g., indocyanine green) using a pulse oximeter is presented. The method is motivated by the ubiquity of pulse oximeters used in both preclinical and clinical applications, as well as the gap in currently available technologies to measure AIFs in small animals. The method is based on quantifying the interference that is observed in the derived arterial oxygen saturation (SaO2) following a bolus injection of a light-absorbing dye. In other words, the change in SaO2 can be converted into dye concentration knowing the chromophore-specific extinction coefficients, the true arterial oxygen saturation, and total hemoglobin concentration. A simple error analysis was performed to highlight potential limitations of the approach, and a validation of the method was conducted in rabbits by comparing the pulse oximetry method with the AIF acquired using a pulse dye densitometer. Considering that determining the AIF is required for performing quantitative tracer kinetics, this method provides a flexible tool for measuring the arterial dye concentration that could be used in a variety of applications.

  11. Arterial input function of an optical tracer for dynamic contrast enhanced imaging can be determined from pulse oximetry oxygen saturation measurements.

    PubMed

    Elliott, Jonathan T; Wright, Eric A; Tichauer, Kenneth M; Diop, Mamadou; Morrison, Laura B; Pogue, Brian W; Lee, Ting-Yim; St Lawrence, Keith

    2012-12-21

    In many cases, kinetic modeling requires that the arterial input function (AIF)--the time-dependent arterial concentration of a tracer--be characterized. A straightforward method to measure the AIF of red and near-infrared optical dyes (e.g., indocyanine green) using a pulse oximeter is presented. The method is motivated by the ubiquity of pulse oximeters used in both preclinical and clinical applications, as well as the gap in currently available technologies to measure AIFs in small animals. The method is based on quantifying the interference that is observed in the derived arterial oxygen saturation (SaO?) following a bolus injection of a light-absorbing dye. In other words, the change in SaO? can be converted into dye concentration knowing the chromophore-specific extinction coefficients, the true arterial oxygen saturation, and total hemoglobin concentration. A simple error analysis was performed to highlight potential limitations of the approach, and a validation of the method was conducted in rabbits by comparing the pulse oximetry method with the AIF acquired using a pulse dye densitometer. Considering that determining the AIF is required for performing quantitative tracer kinetics, this method provides a flexible tool for measuring the arterial dye concentration that could be used in a variety of applications. PMID:23190567

  12. Coronary Artery Bypass Grafting

    MedlinePLUS

    ... from the NHLBI on Twitter. What Is Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is ... bypass multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of ...

  13. Carotid artery anatomy (image)

    MedlinePLUS

    ... 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.

  14. Improving theatre efficiency and utilisation through early identification of trauma patients and enhanced communication between teams

    PubMed Central

    Roberts, Simon; Saithna, Adnan; Bethune, Rob

    2015-01-01

    Surgical departments are increasingly put under pressure to improve services, cut waiting lists, increase efficiency and save money. At a district general hospital in the west-midlands we approached the challenge of improving efficiency and optimising the services available in our orthopaedic theatres. Data was collected on: anaesthetic start times, operation start and finish times, and reasons for delay in our trauma theatre over a period from October 2014 to January 2015. During this period a change was implemented to improve the start time of the first operation of each day in the trauma theatre. Through adaptation of a method developed by Javed S et al, a patient was pre-selected by the on-call team and given the name the golden patient the day before they were due to be operated upon. This nominated patient would then be fixed at the start of the trauma theatre list the following day. The list would only then change if a life or limb threatening case was admitted overnight. The on-call team would prioritise that this patient was optimised for theatre and the theatre staff would ensure the surgical instruments were prepared. A PDSA cycle method was used, collecting data on 80 orthopaedic trauma cases during the period, and demonstrated a 59 minute (95% CI 45-72) improvement in start times from 10:49 AM to 9:50 AM with a p-value of 0.00024 with the intervention of early allocation of the first patient on the trauma list. A relatively simple intervention tool designed to improve communication within and between health-care teams can have a significant impact on the efficiency of a complex environment such as a trauma theatre. PMID:26734340

  15. Engineered Microporosity: Enhancing the Early Regenerative Potential of Decellularized Temporomandibular Joint Discs

    PubMed Central

    Juran, Cassandra M.; Dolwick, M. Franklin

    2015-01-01

    The temporomandibular joint (TMJ) disc is susceptible to numerous pathologies that may lead to structural degradation and jaw dysfunction. The limited treatment options and debilitating nature of severe temporomandibular disorders has been the primary driving force for the introduction and development of TMJ disc tissue engineering as an approach to alleviate this important clinical issue. This study aimed to evaluate the efficacy of laser micropatterning (LMP) ex vivo-derived TMJ disc scaffolds to enhance cellular integration, a major limitation to the development of whole tissue implant technology. LMP was incorporated into the decellularized extracellular matrix scaffold structure using a 40 W CO2 laser ablation system to drill an 8×16 pattern with a bore diameter of 120 μm through the scaffold thickness. Disc scaffolds were seeded with human neonatal-derived umbilical cord mesenchymal stem cells differentiated into chondrocytes at a density of 900 cells per mm2 and then assessed on days 1, 7, 14, and 21 of culture. Results derived from histology, PicoGreen DNA quantification, and cellular metabolism assays indicate that the LMP scaffolds improve cellular remodeling compared to the unworked scaffold over the 21-day culture period. Mechanical analysis further supports the use of the LMP showing the compressive properties of the LMP constructs closely represent native disc mechanics. The addition of an artificial path of infiltration by LMP culminated in improved chondrocyte adhesion, dispersion, and migration after extended culture aiding in recapitulating the native TMJ disc characteristics. PMID:25319941

  16. Polyamidoamine (PAMAM) dendrimers modified with short oligopeptides for early endosomal escape and enhanced gene delivery.

    PubMed

    Thuy, Le Thi; Mallick, Sudipta; Choi, Joon Sig

    2015-08-15

    Recently, non-viral vectors have become a popular research topic in the field of gene therapy. In this study, we conjugated short oligopeptides to polyamidoamine-generation 4 (PAMAM G4) to achieve higher transfection efficiency. Previous reports have shown that the PAMAM G4-histidine (H)-arginine (R) dendrimer enhances gene delivery by improving cell penetration and internalization mechanisms. Therefore, we synthesized PAMAM G4-H phenylalanine (F) R, PAMAM G4-FHR and PAMAM G4-FR derivatives to determine the best gene carrier with the lowest toxicity. Physicochemical studies were performed to determine mean diameters and surface charge of PAMAM derivatives/pDNA polyplexes. DNA condensation was confirmed using a gel retardation assay. Cytotoxicity and transfection efficiency were analyzed using human cervical carcinoma (HeLa) and human liver carcinoma (HepG2) cells. Similar levels of transfection were achieved in both cell lines by using gold standard transfection reagent PEI 25 kD. Therefore, our results show that these carriers are promising and may help achieve higher transfection with negligible cytotoxicity. PMID:26187169

  17. Engineered microporosity: enhancing the early regenerative potential of decellularized temporomandibular joint discs.

    PubMed

    Juran, Cassandra M; Dolwick, M Franklin; McFetridge, Peter S

    2015-02-01

    The temporomandibular joint (TMJ) disc is susceptible to numerous pathologies that may lead to structural degradation and jaw dysfunction. The limited treatment options and debilitating nature of severe temporomandibular disorders has been the primary driving force for the introduction and development of TMJ disc tissue engineering as an approach to alleviate this important clinical issue. This study aimed to evaluate the efficacy of laser micropatterning (LMP) ex vivo-derived TMJ disc scaffolds to enhance cellular integration, a major limitation to the development of whole tissue implant technology. LMP was incorporated into the decellularized extracellular matrix scaffold structure using a 40 W CO2 laser ablation system to drill an 816 pattern with a bore diameter of 120??m through the scaffold thickness. Disc scaffolds were seeded with human neonatal-derived umbilical cord mesenchymal stem cells differentiated into chondrocytes at a density of 900 cells per mm(2) and then assessed on days 1, 7, 14, and 21 of culture. Results derived from histology, PicoGreen DNA quantification, and cellular metabolism assays indicate that the LMP scaffolds improve cellular remodeling compared to the unworked scaffold over the 21-day culture period. Mechanical analysis further supports the use of the LMP showing the compressive properties of the LMP constructs closely represent native disc mechanics. The addition of an artificial path of infiltration by LMP culminated in improved chondrocyte adhesion, dispersion, and migration after extended culture aiding in recapitulating the native TMJ disc characteristics. PMID:25319941

  18. High-mobility group box 1 accelerates early acute allograft rejection via enhancing IL-17+ ?? T-cell response.

    PubMed

    Xia, Quansong; Duan, Lihua; Shi, Lifeng; Zheng, Fang; Gong, Feili; Fang, Min

    2014-04-01

    Th17 and ?? T cells are the dominant IL-17-producing cell. We previously reported that high-mobility group box 1 (HMGB1) is critical in inducing IL-17-producing alloreactive T cells during early stage of acute allograft rejection. However, the role of ?? T cells during this process and its implication in HMGB1-mediated allograft rejection are not fully understood. Here, we use a murine model of cardiac allograft transplantation to further study the role of HMGB1 and IL-17-producing ?? T cells in acute allograft rejection. It was found that the expression of HMGB1 was increased in allograft, while blockade of HMGB1 suppressed IL-17(+) ?? T-cell response and inhibited the gene transcription of IL-23 and IL-1?. Furthermore, in vitro HMGB1 indirectly promoted the development of IL-17(+) ?? T cells by stimulating dendritic cells to produce IL-23 and IL-1?, meanwhile depletion of ?? T cells in vivo prolonged allograft survival and reduced the level of IL-17 in serum. In conclusion, our findings inferred that increased HMGB1 expression could enhance IL-17(+) ?? T-cell response by promoting the secretion of IL-23 and IL-1?, while IL-17(+) ?? T cells contribute to the early stage of acute allograft rejection. PMID:24410759

  19. ZD7288 Enhances Long-Term Depression at Early Postnatal Medial Perforant Path-Granule Cell Synapses

    PubMed Central

    Guli, Xiati; Tokay, Tursonjan; Rohde, Marco; Bender, Roland A.; Khling, Rdiger; Kirschstein, Timo

    2012-01-01

    Hyperpolarization-activated, cyclic nucleotide-gated nonselective (HCN) channels modulate both membrane potential and resistance and play a significant role in synaptic plasticity. We compared the influence of HCN channels on long-term depression (LTD) at the medial perforant path-granule cell synapse in early postnatal (P915) and adult (P3060) rats. LTD was elicited in P915 slices using low-frequency stimulation (LFS, 900 pulses, 1?Hz; 80 4% of baseline). Application of the specific HCN channel blocker ZD7288 (10??M) before LFS significantly enhanced LTD (62 4%; P < 0.01), showing HCN channels restrain LTD induction. However, when ZD7288 was applied after LFS, LTD was similar to control values and significantly different from the values obtained with ZD7288 application before LFS (81 5%; P < 0.01), indicating that HCN channels do not modulate LTD expression. LTD in slices from adult rats were only marginally lower compared to those in P915 slices (85 6%), but bath application of ZD7288 prior to LFS resulted in the same amount of LTD (85 5%). HCN channels in adult tissue hence lose their modulatory effect. In conclusion, we found that HCN channels at the medial perforant path-granule cell synapse compromise LFS-associated induction, but not expression of LTD in early postnatal, but not in adult, rats. PMID:22792490

  20. Arterial grafts: clinical classification and pharmacological management

    PubMed Central

    2013-01-01

    In comparison with standard saphenous vein grafts, use of the internal mammary artery (IMA) as a coronary artery bypass graft has achieved superior long-term results. This is related to the differences in the biological characteristics between the venous and arterial grafts. However, even arterial grafts are not uniform in their biological characteristics. The variation in the perioperative behavior of the grafts and in their long-term patency may be related to different characteristics. These factors should be taken into account in the use of arterial grafts, some of which are subjected to more active pharmacological intervention during and after the operation to obtain satisfactory results. To better understand the biological behavior of the grafts, their common features and their differences, a clinical classification may be useful for a practicing surgeon. Based on experimental studies of their vasoreactivity combined with anatomical, physiological and embryological considerations, we have proposed a functional classification for arterial grafts that may be useful clinically. Our classification suggests that there are three types of arterial grafts: Type Isomatic arteries; Type IIsplanchnic arteries; and Type IIIlimb arteries. Type I arteries have enhanced endothelial function and release more nitric oxide and other relaxing factors. Type II arteries, such as the gastro-epiploic artery, and Type III arteries, such as the radial artery (RA), have higher pharmacological reactivity to vasoconstrictors. This classification explains why the IMA has the best long-term patency. Because Type II and III arteries are prone to spasms due to higher contractility, they require more active pharmacological interventions. Furthermore, the harvesting technique of the conduits, including the saphenous vein and IMA, are described and discussed in this article. Prevention of spasms using two cocktails of medications (verapamil + nitroglycerin and nicardipine + nitroglycerin) during harvesting of the conduits is described. These solutions have been demonstrated to be clinically effective. PMID:23977630

  1. Enhanced characterization of contractility in cardiomyocytes during early drug safety assessment.

    PubMed

    Butler, Larissa; Cros, Caroline; Oldman, Karen L; Harmer, Alex R; Pointon, Amy; Pollard, Christopher E; Abi-Gerges, Najah

    2015-06-01

    We sought to investigate whether drug-induced changes in contractility were affected by pacing rates that represent the range of heart rates encountered in vivo. Using the cell geometry measurement system (IonOptix), we paced dog cardiomyocytes at different cycle lengths (CLs) of 2000, 1000, 500, and 333.3 ms, before and after exposure to 13 inotropic drugs. Time course data using vehicle control (0.1% dimethyl sulfoxide (DMSO)) demonstrated stability of the system at all CLs tested. Seven positive inotropes (eg isoproterenol) exerted rate-dependent increases in sarcomere shortening (Sarc. short.; maximal effect at a CL of 333.3 ms [0.1 µM isoproterenol increased Sarc. short. by 41.1% and 145.9% at 2000 and 333.3 ms, respectively]). Omecamtiv mecarbil showed an atypical profile (increased Sarc. short. at 2000 ms [106.9%] and decreased at 333.3 ms [IC(50) = 0.64 µM]). Four negative inotropes (eg flecainide) showed rate-independent inhibition of Sarc. short. (IC(50)s: 3.3 µM [2000 ms] versus 2.3 µM [333.3 ms]). The remaining negative inotropes, verapamil, and BTS (N-benzyl-p-toluene sulphonamide) produced an increase (IC(50)s: 3.9 µM [2000 ms] versus 0.043 µM [333.3ms]) and decrease (IC(50)s: 18.3 µM [2000 ms] versus 34.0 µM [333.3 ms]) in potency, respectively. Negative inotropes (eg flecainide, BTS, and verapamil) decreased the area of the Ca(2+) transient versus Sarc. short. hysteresis loop, although rate dependency was seen with verapamil only. Positive inotropes (eg isoproterenol and levosimendan) induced a rate-dependent increase in the area, however Omecamtiv mecarbil increased and decreased the area at CLs of 2000 and 333.3 ms, respectively. Thus, the use of different pacing rates may improve the detection of inotropes in early drug discovery and illustrate the potential for finger-printing different mechanisms of action. PMID:25820236

  2. Early-Stage Imaging of Nanocarrier-Enhanced Chemotherapy Response in Living Subjects by Scalable Photoacoustic Microscopy

    PubMed Central

    2015-01-01

    Conventional evaluation methods of chemotherapeutic efficacy such as tissue biopsy and anatomical measurement are either invasive with potential complications or dilatory to capture the rapid pathological changes. Here, a sensitive and resolution-scalable photoacoustic microscopy (PAM) with theranostic nanoformulation was developed to noninvasively monitor the therapy response in a timely manner. Ultrasmall graphene oxide nanosheets were designed as both drug-loading vehicle and photoacoustic signal amplifier to the tumor. With the signal enhancement by the injected contrast agents, the subtle microvascular changes of the chemotherapy response in tumor were advantagely revealed by our PAM system, which was much earlier than the morphological measurement by standard imaging techniques. High tumor uptake of the enhanced nanodrug with Cy5.5 labeling was validated by fluorescence imaging. At different observation scales, PAM offered unprecedented sensitivity of optical absorption and high spatial resolution over optical imaging. Our studies demonstrate the PAM system with synergistic theranostic strategy to be a multiplexing platform for tumor diagnosis, drug delivery, and chemotherapy response monitoring at a very early stage and in an effective way. PMID:25406986

  3. Chromatin dynamics and the role of G9a in gene regulation and enhancer silencing during early mouse development

    PubMed Central

    Zylicz, Jan J; Dietmann, Sabine; Günesdogan, Ufuk; Hackett, Jamie A; Cougot, Delphine; Lee, Caroline; Surani, M Azim

    2015-01-01

    Early mouse development is accompanied by dynamic changes in chromatin modifications, including G9a-mediated histone H3 lysine 9 dimethylation (H3K9me2), which is essential for embryonic development. Here we show that genome-wide accumulation of H3K9me2 is crucial for postimplantation development, and coincides with redistribution of enhancer of zeste homolog 2 (EZH2)-dependent histone H3 lysine 27 trimethylation (H3K27me3). Loss of G9a or EZH2 results in upregulation of distinct gene sets involved in cell cycle regulation, germline development and embryogenesis. Notably, the H3K9me2 modification extends to active enhancer elements where it promotes developmentally-linked gene silencing and directly marks promoters and gene bodies. This epigenetic mechanism is important for priming gene regulatory networks for critical cell fate decisions in rapidly proliferating postimplantation epiblast cells. DOI: http://dx.doi.org/10.7554/eLife.09571.001 PMID:26551560

  4. Chronic morphine treatment enhances sciatic nerve stimulation-induced immediate early gene expression in the rat dorsal horn.

    PubMed

    Bojovic, Ognjen; Bramham, Clive R; Tjlsen, Arne

    2015-01-01

    Synaptic plasticity is a property of neurons that can be induced by conditioning electrical stimulation (CS) of afferent fibers in the spinal cord. This is a widely studied property of spinal cord and hippocampal neurons. CS has been shown to trigger enhanced expression of immediate early gene proteins (IEGPs), with peak increases observed 2 hour post stimulation. Chronic morphine treatment has been shown to promoteinduce opioid-induced hyperalgesia, and also to increase CS-induced central sensitization in the dorsal horn. As IEGP expression may contribute to development of chronic pain states, we aimed to determine whether chronic morphine treatment affects the expression of IEGPs following sciatic nerve CS. Changes in expression of the IEGPs Arc, c-Fos or Zif268 were determined in cells of the lumbar dorsal horn of the spinal cord. Chronic Morphine pretreatment over 7 days led to a significant increase in the number of IEGP positive cells observed at both 2 h and 6 h after CS. The same pattern of immunoreactivity was obtained for all IEGPs, with peak increases occurring at 2 h post CS. In contrast, morphine treatment alone in sham operated animals had no effect on IEGP expression. We conclude that chronic morphine treatment enhances stimulus-induced expression of IEGPs in the lumbar dorsal horn. These data support the notion that morphine alters gene expression responses linked to nociceptive stimulation and plasticity. PMID:26581386

  5. Rapid and early α-fetoprotein and des-γ-carboxy prothrombin responses to initial arterial infusion chemotherapy predict treatment outcomes of advanced hepatocellular carcinoma

    PubMed Central

    OYAMA, KENJI; KODA, MASAHIKO; SUGIHARA, TAKAAKI; KISHINA, MANABU; MIYOSHI, KENICHI; OKAMOTO, TOSHIAKI; HODOTSUKA, MASANORI; FUJISE, YUKI; MATONO, TOMOMITSU; TOKUNAGA, SHIHO; OKAMOTO, KINYA; HOSHO, KEIKO; OKANO, JUNICHI; MURAWAKI, YOSHIKAZU

    2015-01-01

    The aim of the present study was to predict the effects of transarterial infusion (TAI) chemotherapy based on early changes in α-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) in patients with advanced hepatocellular carcinoma (HCC). Seventy-four patients who underwent TAI with cisplatin, 5-fluorouracil, mitomycin C and epirubicin for advanced HCC were enrolled. Antitumor responses were evaluated 6 months after TAI. Rapid and early responses were defined as the ratio of AFP or DCP after 1 week and 1 month compared to baseline. A total of 5, 10, 17 and 42 patients had complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD), respectively. Early AFP response was significantly lower in the CR+PR compared to the SD+PD groups (P<0.01). The early DCP response was significantly lower in the CR+PR compared to the SD+PD. The sensitivity and specificity of rapid and early AFP responses in the CR+PR were 0.78 and 0.72, and 0.80 and 0.73, respectively, and those of rapid and early DCP responses were 0.67 and 0.65, and 0.77 and 0.71, respectively. The combination of AFP and DCP responses had higher specificity compared to AFP or DCP alone responses. Patients were divided into responder and non-responder groups to evaluate the prediction of survival outcome. Early responders of AFP, DCP and AFP+DCP, who were divided based on the cut-off values of CR+PR survived significantly longer than the non-responders (P<0.05). In conclusion, rapid or early responses of AFP and/or DCP levels 1 and 4 weeks after TAI chemotherapy helped to predict the treatment effects. PMID:26137283

  6. Preradiotherapy Calcium Scores of the Coronary Arteries in a Cohort of Women With Early-Stage Breast Cancer: A Comparison With a Cohort of Healthy Women

    SciTech Connect

    Mast, Mirjam E.; Heijenbrok, Mark W.; Petoukhova, Anna L.; Scholten, Astrid N.; Schreur, Joop H.M.; Struikmans, Henk

    2012-07-01

    Purpose: Breast cancer radiotherapy has been associated with an increased risk of cardiac toxicity. However, no data are available on the probability of developing coronary artery disease (CAD) in breast cancer patients when compared with healthy women. Therefore, baseline coronary artery calcium (CAC) scores, as an accepted tool to predict CAD, were determined and compared with the CAC scores of a healthy, asymptomatic cohort, the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Methods and Materials: Eighty consecutive patients with ductal carcinoma in situ or infiltrative breast cancer referred for radiotherapy after breast-conserving surgery were included in our study. Their cardiovascular risk profile was registered, and a 64 multislice CT scan was performed. The CAC scores of an unselected (Caucasian only) Radiotherapy Centre West (RCWEST) cohort, as well as of those of a selected (comorbidity and race adjusted) RCWEST cohort, were determined. The scores of both cohorts were compared with those of the female (Caucasian only) MESA cohort. Results: For the unselected RCWEST cohort (n = 62) we found significant (p < .01) higher scores for women in the 55-64 age category compared with those of the MESA cohort. In the selected cohort (n = 55) the CAC scores of the women in the age category 55-64 were significantly (p = .02) higher compared with the MESA cohort. No significant differences were noted in the other age categories. Conclusion: Both cohorts revealed that CAC scores in the 55-64 age category were significantly higher than the CAC scores in the asymptomatic (female) MESA population. These data suggest that breast cancer patients bear a higher risk of developing coronary heart disease before the start of radiotherapy. Therefore, measures to decrease cardiac dose further in breast cancer radiotherapy are even more important.

  7. Renal Infarction Caused by Isolated Spontaneous Renal Artery Intramural Hematoma

    PubMed Central

    Park, Sihyung; Lee, Ga Hee; Jin, Kyubok; Park, Kang Min; Kim, Yang Wook; Park, Bong Soo

    2015-01-01

    Patient: Male, 46 Final Diagnosis: Renal infarction Symptoms: Flank pain Medication: Clinical Procedure: CT Specialty: Nephrology Objective: Rare disease Background: Acute renal infarction is an uncommon condition resulting from an obstruction or a decrease in renal arterial blood flow. Isolated spontaneous renal artery intramural hematoma is a rare cause of renal infarction. Case Report: A 46-year-old healthy man presented to our emergency room because of sudden onset of severe right flank pain. An enhanced abdominal computed tomography scan showed a low-attenuated lesion in the lateral portion of the right kidney but no visible thromboembolisms in the main vessels. Computed tomography angiography revealed acute infarction resulting from intramural hematoma of the anterior segmental artery of the right kidney, with distal occlusion. Conclusions: The rarity and non-specific clinical presentation of renal infarction often lead to a delayed diagnosis that may result in impaired renal function. Clinical suspicion is important in the early diagnosis, and intramural hematoma of the renal artery should be considered the cause of renal infarction even in healthy patients without pre-disposing factors. PMID:26596500

  8. Recombinant Modified Vaccinia Virus Ankara Generating Excess Early Double-Stranded RNA Transiently Activates Protein Kinase R and Triggers Enhanced Innate Immune Responses

    PubMed Central

    Wolfersttter, Michael; Schweneker, Marc; Spth, Michaela; Lukassen, Susanne; Klingenberg, Marieken; Brinkmann, Kay; Wielert, Ursula; Lauterbach, Henning; Hochrein, Hubertus; Chaplin, Paul; Suter, Mark

    2014-01-01

    ABSTRACT Double-stranded RNA (dsRNA) is an important molecular pattern associated with viral infection and is detected by various extra- and intracellular recognition molecules. Poxviruses have evolved to avoid producing dsRNA early in infection but generate significant amounts of dsRNA late in infection due to convergent transcription of late genes. Protein kinase R (PKR) is activated by dsRNA and triggers major cellular defenses against viral infection, including protein synthesis shutdown, apoptosis, and type I interferon (IFN-I) production. The poxviral E3 protein binds and sequesters viral dsRNA and is a major antagonist of the PKR pathway. We found that the highly replication-restricted modified vaccinia virus Ankara (MVA) engineered to produce excess amounts of dsRNA early in infection showed enhanced induction of IFN-? in murine and human cells in the presence of an intact E3L gene. IFN-? induction required a minimum overlap length of 300 bp between early complementary transcripts and was strongly PKR dependent. Excess early dsRNA produced by MVA activated PKR early but transiently in murine cells and induced enhanced systemic levels of IFN-?, IFN-?, and other cytokines and chemokines in mice in a largely PKR-dependent manner. Replication-competent chorioallantois vaccinia virus Ankara (CVA) generating excess early dsRNA also enhanced IFN-I production and was apathogenic in mice even at very high doses but showed no in vitro host range defect. Thus, genetically adjuvanting MVA and CVA to generate excess early dsRNA is an effective method to enhance innate immune stimulation by orthopoxvirus vectors and to attenuate replicating vaccinia virus in vivo. IMPORTANCE Efficient cellular sensing of pathogen-specific components, including double-stranded RNA (dsRNA), is an important prerequisite of an effective antiviral immune response. The prototype poxvirus vaccinia virus (VACV) and its derivative modified vaccinia virus Ankara (MVA) produce dsRNA as a by-product of viral transcription. We found that inhibition of cellular dsRNA recognition established by the virus-encoded proteins E3 and K3 can be overcome by directing viral overexpression of dsRNA early in infection without compromising replication of MVA in permissive cells. Early dsRNA induced transient activation of the cellular dsRNA sensor protein kinase R (PKR), resulting in enhanced production of interferons and cytokines in cells and mice. Enhancing the capacity of MVA to activate the innate immune system is an important approach to further improve the immunogenicity of this promising vaccine vector. PMID:25297997

  9. Three-dimensional Dynamic Contrast-enhanced US Imaging for Early Antiangiogenic Treatment Assessment in a Mouse Colon Cancer Model.

    PubMed

    Wang, Huaijun; Hristov, Dimitre; Qin, Jiale; Tian, Lu; Willmann, Jrgen K

    2015-11-01

    Purpose To evaluate feasibility and reproducibility of three-dimensional (3D) dynamic contrast material-enhanced (DCE) ultrasonographic (US) imaging by using a clinical matrix array transducer to assess early antiangiogenic treatment effects in human colon cancer xenografts in mice. Materials and Methods Animal studies were approved by the Institutional Administrative Panel on Laboratory Animal Care at Stanford University. Three-dimensional DCE US imaging with two techniques (bolus and destruction-replenishment) was performed in human colon cancer xenografts (n = 38) by using a clinical US system and transducer. Twenty-one mice were imaged twice to assess reproducibility. Seventeen mice were scanned before and 24 hours after either antiangiogenic (n = 9) or saline-only (n = 8) treatment. Data sets of 3D DCE US examinations were retrospectively segmented into consecutive 1-mm imaging planes to simulate two-dimensional (2D) DCE US imaging. Six perfusion parameters (peak enhancement [PE], area under the time-intensity curve [AUC], time to peak [TTP], relative blood volume [rBV], relative blood flow [rBF], and blood flow velocity) were measured on both 3D and 2D data sets. Percent area of blood vessels was quantified ex vivo with immunofluorescence. Statistical analyses were performed with the Wilcoxon rank test by calculating intraclass correlation coefficients and by using Pearson correlation analysis. Results Reproducibility of both 3D DCE US imaging techniques was good to excellent (intraclass correlation coefficient, 0.73-0.86). PE, AUC, rBV, and rBF significantly decreased (P ? .04) in antiangiogenic versus saline-treated tumors. rBV (r = 0.74; P = .06) and rBF (r = 0.85; P = .02) correlated with ex vivo percent area of blood vessels, although the statistical significance of rBV was not reached, likely because of small sample size. Overall, 2D DCE-US overestimated and underestimated treatment effects from up to 125-fold to170-fold compared with 3D DCE US imaging. If the central tumor plane was assessed, treatment response was underestimated up to threefold or overestimated up to 57-fold on 2D versus 3D DCE US images. Conclusion Three-dimensional DCE US imaging with a clinical matrix array transducer is feasible and reproducible to assess tumor perfusion in human colon cancer xenografts in mice and allows for assessment of early treatment response after antiangiogenic therapy. () RSNA, 2015. PMID:26020439

  10. The enhanced value of combining conventional and "omics" analyses in early assessment of drug-induced hepatobiliary injury.

    PubMed

    Ellinger-Ziegelbauer, Heidrun; Adler, Melanie; Amberg, Alexander; Brandenburg, Arnd; Callanan, John J; Connor, Susan; Fountoulakis, Michael; Gmuender, Hans; Gruhler, Albrecht; Hewitt, Philip; Hodson, Mark; Matheis, Katja A; McCarthy, Diane; Raschke, Marian; Riefke, Bjrn; Schmitt, Christina S; Sieber, Max; Sposny, Alexandra; Suter, Laura; Sweatman, Brian; Mally, Angela

    2011-04-15

    The InnoMed PredTox consortium was formed to evaluate whether conventional preclinical safety assessment can be significantly enhanced by incorporation of molecular profiling ("omics") technologies. In short-term toxicological studies in rats, transcriptomics, proteomics and metabolomics data were collected and analyzed in relation to routine clinical chemistry and histopathology. Four of the sixteen hepato- and/or nephrotoxicants given to rats for 1, 3, or 14days at two dose levels induced similar histopathological effects. These were characterized by bile duct necrosis and hyperplasia and/or increased bilirubin and cholestasis, in addition to hepatocyte necrosis and regeneration, hepatocyte hypertrophy, and hepatic inflammation. Combined analysis of liver transcriptomics data from these studies revealed common gene expression changes which allowed the development of a potential sequence of events on a mechanistic level in accordance with classical endpoint observations. This included genes implicated in early stress responses, regenerative processes, inflammation with inflammatory cell immigration, fibrotic processes, and cholestasis encompassing deregulation of certain membrane transporters. Furthermore, a preliminary classification analysis using transcriptomics data suggested that prediction of cholestasis may be possible based on gene expression changes seen at earlier time-points. Targeted bile acid analysis, based on LC-MS metabonomics data demonstrating increased levels of conjugated or unconjugated bile acids in response to individual compounds, did not provide earlier detection of toxicity as compared to conventional parameters, but may allow distinction of different types of hepatobiliary toxicity. Overall, liver transcriptomics data delivered mechanistic and molecular details in addition to the classical endpoint observations which were further enhanced by targeted bile acid analysis using LC/MS metabonomics. PMID:20888850

  11. The enhanced value of combining conventional and 'omics' analyses in early assessment of drug-induced hepatobiliary injury

    SciTech Connect

    Ellinger-Ziegelbauer, Heidrun; Adler, Melanie; Amberg, Alexander; Brandenburg, Arnd; Callanan, John J.; Connor, Susan; Fountoulakis, Michael; Gmuender, Hans; Gruhler, Albrecht; Hodson, Mark; Matheis, Katja A.; McCarthy, Diane; Raschke, Marian; Riefke, Bjoern; Schmitt, Christina S.; Sieber, Max; Sposny, Alexandra; Suter, Laura; Sweatman, Brian

    2011-04-15

    The InnoMed PredTox consortium was formed to evaluate whether conventional preclinical safety assessment can be significantly enhanced by incorporation of molecular profiling ('omics') technologies. In short-term toxicological studies in rats, transcriptomics, proteomics and metabolomics data were collected and analyzed in relation to routine clinical chemistry and histopathology. Four of the sixteen hepato- and/or nephrotoxicants given to rats for 1, 3, or 14 days at two dose levels induced similar histopathological effects. These were characterized by bile duct necrosis and hyperplasia and/or increased bilirubin and cholestasis, in addition to hepatocyte necrosis and regeneration, hepatocyte hypertrophy, and hepatic inflammation. Combined analysis of liver transcriptomics data from these studies revealed common gene expression changes which allowed the development of a potential sequence of events on a mechanistic level in accordance with classical endpoint observations. This included genes implicated in early stress responses, regenerative processes, inflammation with inflammatory cell immigration, fibrotic processes, and cholestasis encompassing deregulation of certain membrane transporters. Furthermore, a preliminary classification analysis using transcriptomics data suggested that prediction of cholestasis may be possible based on gene expression changes seen at earlier time-points. Targeted bile acid analysis, based on LC-MS metabonomics data demonstrating increased levels of conjugated or unconjugated bile acids in response to individual compounds, did not provide earlier detection of toxicity as compared to conventional parameters, but may allow distinction of different types of hepatobiliary toxicity. Overall, liver transcriptomics data delivered mechanistic and molecular details in addition to the classical endpoint observations which were further enhanced by targeted bile acid analysis using LC/MS metabonomics.

  12. Early Prediction of Preeclampsia

    PubMed Central

    Poon, Leona C.; Nicolaides, Kypros H.

    2014-01-01

    Effective screening for the development of early onset preeclampsia (PE) can be provided in the first-trimester of pregnancy. Screening by a combination of maternal risk factors, uterine artery Doppler, mean arterial pressure, maternal serum pregnancy-associated plasma protein-A, and placental growth factor can identify about 95% of cases of early onset PE for a false-positive rate of 10%. PMID:25136369

  13. Antegrade flow in Anomalous Left Coronary Artery from Pulmonary Artery: Clinical implications

    PubMed Central

    Sedky, Yasser; Hosny, Hatem; Donya, Mohamed; AbdElsalam, Sherin; Yacoub, Magdi

    2014-01-01

    Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually presents in childhood. It results in left ventricular (LV) ischemia with resulting LV dysfunction. This ischemia results from retrograde flow into the pulmonary artery which can act as a coronary steal. We here report antegrade flow detected in ALCAPA caused by severe pulmonary hypertension. Anatomic correction of ALCAPA is the preferred surgical option and should be performed as early as possible. PMID:25763380

  14. Antegrade flow in Anomalous Left Coronary Artery from Pulmonary Artery: Clinical implications.

    PubMed

    Sedky, Yasser; Hosny, Hatem; Donya, Mohamed; AbdElsalam, Sherin; Yacoub, Magdi

    2014-01-01

    Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually presents in childhood. It results in left ventricular (LV) ischemia with resulting LV dysfunction. This ischemia results from retrograde flow into the pulmonary artery which can act as a coronary steal. We here report antegrade flow detected in ALCAPA caused by severe pulmonary hypertension. Anatomic correction of ALCAPA is the preferred surgical option and should be performed as early as possible. PMID:25763380

  15. Enhancing hippocampal blood flow after cerebral ischemia and vasodilating basilar arteries: in vivo and in vitro neuroprotective effect of antihypertensive DDPH

    PubMed Central

    Sun, Li; Li, Qin; Wang, Wei-ting; Chen, Yu-hua; Guo, Lian-jun

    2015-01-01

    1-(2,6-Dimethylphenoxy)-2-(3,4-dimethoxyphenylethylamino)-propane hydrochloride (DDPH) is a novel antihypertensive agent based on structural characteristics of mexiletine and verapamine. We investigated the effect of DDPH on vasodilatation and neuroprotection in a rat model of cerebral ischemia in vivo, and a rabbit model of isolated basilar arteries in vitro. Our results show that DDPH (10 mg/kg) significantly increased hippocampal blood flow in vivo in cerebral ischemic rats, and exerted dose-dependent relaxation of isolated basilar arteries contracted by histamine or KCl in the in vitro rabbit model. DDPH (3 105 M) also inhibited histamine-stimulated extracellular calcium influx and intracellular calcium release. Our findings suggest that DDPH has a vasodilative effect both in vivo and in vitro, which mediates a neuroprotective effect on ischemic nerve tissue. PMID:26170819

  16. High Power Pulsed Plasma Enhanced Chemical Vapor Deposition: A Brief Overview of General Concepts and Early Results

    NASA Astrophysics Data System (ADS)

    Lundin, Daniel; Pedersen, Henrik

    The general concepts of the emerging plasma enhanced chemical vapor deposition (PECVD) technique High Power Pulsed PECVD (HiPP-PECVD) are outlined; the main feature of HiPP-PECVD is the use of a power scheme characterized by high power pulses with a duty cycle of a few percent or less to generate a process plasma with a significantly higher plasma density compared to traditional PECVD. The higher plasma density leads to a more reactive plasma chemistry, which results in a higher rate of dissociation of the precursor molecules, i.e. a more efficient use of the source material. The high plasma density also leads to a higher degree of ionization of the growth species, enabling the possibility to guide the growth species to the substrate or applying an energetic bombardment of the growing film by applying a substrate bias. Early results on HiPP-PECVD have shown that HiPP-PECVD enables deposition of phase pure ?-Al2O3 at substrate temperatures as low as 560 C with mechanical properties comparable to standard thermal CVD grown material. Also, deposition of amorphous, copper containing carbon films at deposition rates higher than 30 ?m/h has been demonstrated together with results showing the more efficient plasma chemistry. It is suggested that HiPP- PECVD is a promising tool for low temperature deposition of films with tailored properties for e.g. the hard coatings industry.

  17. Expression of Rice Chitinase Gene in Genetically Engineered Tomato Confers Enhanced Resistance to Fusarium Wilt and Early Blight.

    PubMed

    Jabeen, Nyla; Chaudhary, Zubeda; Gulfraz, Muhammad; Rashid, Hamid; Mirza, Bushra

    2015-09-01

    This is the first study reporting the evaluation of transgenic lines of tomato harboring rice chitinase (RCG3) gene for resistance to two important fungal pathogens Fusarium oxysporum f. sp. lycopersici (Fol) causing fusarium wilt and Alternaria solani causing early blight (EB). In this study, three transgenic lines TL1, TL2 and TL3 of tomato Solanum lycopersicum Mill. cv. Riogrande genetically engineered with rice chitinase (RCG 3) gene and their R1 progeny was tested for resistance to Fol by root dip method and A. solani by detached leaf assay. All the R0 transgenic lines were highly resistant to these fungal pathogens compared to non-transgenic control plants. The pattern of segregation of three independent transformant for Fol and A. solani was also studied. Mendelian segregation was observed in transgenic lines 2 and 3 while it was not observed in transgenic line 1. It was concluded that introduction of chitinase gene in susceptible cultivar of tomato not only enhanced the resistance but was stably inherited in transgenic lines 2 and 3. PMID:26361473

  18. Gallium-67 uptake in the lung of asbestos exposed sheep: early association with enhanced macrophage-derived fibronectin accumulation

    SciTech Connect

    Begin, R.; Bisson, G.; Lambert, R.; Cote, Y.; Fabi, D.; Martel, M.; Lamoureux, G.; Rola-Pleszczynski, M.; Boctor, M.; Dalle, D.

    1986-04-01

    To evaluate the time course and mechanisms of enhanced /sup 67/Ga lung uptake in asbestosis, we exposed two groups of sheep every 2 wk to either 100 ml saline (controls) or 100 mg UICC chrysotile fibers in 100 ml saline. The sheep were evaluated periodically by pulmonary function tests (PFT), thoracic radiograph (TR), /sup 67/Ga lung scan, bronchoalveolar lavage (BAL), and transbronchial lung biopsy (TLB). By month 24 of the study, 9/15 exposed sheep had developed the initial alveolitis and had significant changes in PFT, TR, and TLB. The other six exposed sheep differed from controls only by a 75% increase in BAL fibronectin until month 30, where significant changes in albumin occurred and /sup 67/Ga scan score increased. The nine sheep with alveolitis had significant sustained increases in /sup 67/Ga scan and BAL levels from month 6, associated with a 150% increase in BAL fibronectin and other parameters of disease activity changed from month 18 to 30. We concluded that in the sheep model of asbestosis, significant changes in /sup 67/Ga scan, /sup 67/Ga BAL counts, and excessive elevation of BAL fibronectin preceded other parameters of disease activity. The data suggest that excessively activated macrophages are primarily responsible for the early /sup 67/Ga lung uptake.

  19. CCAAT/enhancer-binding protein ? expressed by bone marrow mesenchymal stromal cells regulates early B-cell lymphopoiesis.

    PubMed

    Yoshioka, Satoshi; Miura, Yasuo; Yao, Hisayuki; Satake, Sakiko; Hayashi, Yoshihiro; Tamura, Akihiro; Hishita, Terutoshi; Ichinohe, Tatsuo; Hirai, Hideyo; Takaor-Kondo, Akifumi; Maekawa, Taira

    2014-03-01

    The transcription factor CCAAT/enhancer-binding protein ? (C/EBP?) regulates the differentiation of a variety of cell types. Here, the role of C/EBP? expressed by bone marrow mesenchymal stromal cells (BMMSCs) in B-cell lymphopoiesis was examined. The size of the precursor B-cell population in bone marrow was reduced in C/EBP?-knockout (KO) mice. When bone marrow cells from C/EBP?-KO mice were transplanted into lethally irradiated wild-type (WT) mice, which provide a normal bone marrow microenvironment, the size of the precursor B-cell population was restored to a level equivalent to that generated by WT bone marrow cells. In coculture experiments, BMMSCs from C/EBP?-KO mice did not support the differentiation of WT c-Kit(+) Sca-1(+) Lineage(-) hematopoietic stem cells (KSL cells) into precursor B cells, whereas BMMSCs from WT mice did. The impaired differentiation of KSL cells correlated with the reduced production of CXCL12/stromal cell-derived factor-1 by the cocultured C/EBP?-deficient BMMSCs. The ability of C/EBP?-deficient BMMSCs to undergo osteogenic and adipogenic differentiation was also defective. The survival of leukemic precursor B cells was poorer when they were cocultured with C/EBP?-deficient BMMSCs than when they were cocultured with WT BMMSCs. These results indicate that C/EBP? expressed by BMMSCs plays a crucial role in early B-cell lymphopoiesis. PMID:24115241

  20. Expression of Rice Chitinase Gene in Genetically Engineered Tomato Confers Enhanced Resistance to Fusarium Wilt and Early Blight

    PubMed Central

    Jabeen, Nyla; Chaudhary, Zubeda; Gulfraz, Muhammad; Rashid, Hamid; Mirza, Bushra

    2015-01-01

    This is the first study reporting the evaluation of transgenic lines of tomato harboring rice chitinase (RCG3) gene for resistance to two important fungal pathogens Fusarium oxysporum f. sp. lycopersici (Fol) causing fusarium wilt and Alternaria solani causing early blight (EB). In this study, three transgenic lines TL1, TL2 and TL3 of tomato Solanum lycopersicum Mill. cv. Riogrande genetically engineered with rice chitinase (RCG 3) gene and their R1 progeny was tested for resistance to Fol by root dip method and A. solani by detached leaf assay. All the R0 transgenic lines were highly resistant to these fungal pathogens compared to non-transgenic control plants. The pattern of segregation of three independent transformant for Fol and A. solani was also studied. Mendelian segregation was observed in transgenic lines 2 and 3 while it was not observed in transgenic line 1. It was concluded that introduction of chitinase gene in susceptible cultivar of tomato not only enhanced the resistance but was stably inherited in transgenic lines 2 and 3. PMID:26361473

  1. Early stage effect of ischemic preconditioning for patients undergoing on-pump coronary artery bypass grafts surgery: systematic review and meta-analysis

    PubMed Central

    Chai, Qing; Liu, Jin

    2014-01-01

    Background: During the on-pump coronary artery bypass grafts surgery, ischemia/reperfusion injury would happen. Ischemia preconditioning could increase the tolerance against subsequent ischemia and reduce the ischemia/reperfusion injury. However the clinical outcomes of the available trials were different. Methods : We searched the Cochrane Central Register of Controlled Trials on The Cochrane Library (Issue 3, 2013), the Medline/PubMed and CNKI in March 2013. RevMan 5.1.6 and GRADEprofiler 3.6 were used for statistical analysis and evidence quality assessment. Heterogeneity was evaluated with significance set at P?0.10. Results: Eighteen randomized controlled trials were included. There were no differences on in-hospital mortality, postoperative myocardial infarction morbidity between ischemia preconditioning and control groups. The heterogeneity of creatine kinase-MB level 24 hours after surgery was obvious. The differences of 72 hours area under the curve of cardiac troponin T (mean differences of -14.50, 95% confidence interval of -21.71 to -7.28) and troponin I (mean differences -181.79, 95% confidence interval of -270.07 to -93.52) after surgery were observed. Conclusion s : All the 18 trails, the positive and the negative results were equal. The meta-analysis results should be interpreted with caution due to limited effective data. Because of high cost-effectiveness, ischemia preconditioning could not be denied completely. Large-scale randomized studies are needed, with the operation procedures and included criteria being more specific. PMID:24948996

  2. Negative associations between arterial stiffness parameter evaluated by cardio-ankle vascular index and serum low-density lipoprotein cholesterol concentration in early-stage atherosclerosis.

    PubMed

    Homma, Satoki; Kato, Kiyoe; Hayashi, Junichi; Yamamoto, Minoru

    2015-02-01

    The cardio-ankle vascular index (CAVI), calculated values from cardio-ankle pulse wave velocity and blood pressure, corresponds predominantly to the stiffness of the aorta and peripheral arteries of the lower limbs. However, the reported associations between CAVI and serum low-density lipoprotein cholesterol (LDL-C) levels remain inconsistent. A cross-sectional study of 1878 consecutive patients (mean age: 59.2 years) who underwent general health checkup showed a negative association between CAVI and serum LDL-C or non-high-density lipoprotein cholesterol (non-HDL-C) concentrations with age-adjusted correlation and multiple regression analysis. Using the similar analyses divided by the status of risk factors and degree of maximum carotid intima-media thickness (maxIMT), negative correlations between CAVI and LDL-C or non-HDL-C levels were observed only in nonrisk groups including nondiabetics patients or patients with maxIMT <1.0 mm, in those with expected low extent of advanced atherosclerotic lesions. In contrast, such a correlation was not found in each comparable risk-loaded group. PMID:24402322

  3. Enhanced subendocardial perfusion distal to a flow-limiting coronary artery stenosis in dogs: comparative effects of nicorandil, a potential new antianginal agent, and nitroglycerin.

    PubMed

    Gross, G J; Warltier, D C; Hardman, H F; Lamping, K A

    1985-01-01

    The purpose of this study was to compare the effects of nicorandil [SG-75; 2-nicotinamidoethyl nitrate (ester)] and nitroglycerin on the distribution of blood flow between subendocardium and subepicardium [endocardial/epicardial blood flow ration (endo/epi)] distal to a proximal flow-limiting coronary artery stenosis in anesthetized dogs. Myocardial blood flow distribution was determined by use of 15-micron radioactive microspheres. Various indices of reactive hyperemia (peak flow, duration, volume) and poststenotic coronary pressures were used to assess the severity of ischemia in the area distal to the stenosis. Partial ischemia was produced by a 10-s total left circumflex coronary occlusion followed by 110 s of reflow to 50-60% of the control flow. Microspheres were injected during steady-state conditions during the partial reflow period. In the absence of drug, coronary artery stenosis produced marked underperfusion of the subendocardium (endo/epi, 0.55 +/- 0.05). Following administration of nicorandil (60 micrograms/kg i.v.) or nitroglycerin (15 micrograms/kg i.v.), the endo-epi during a subsequent partial reflow (stenosis present) period was significantly increased (0.67 +/- 0.06). The duration of reactive hyperemia and reactive hyperemic flow were also decreased by both compounds following release of the stenosis. These results suggest that nicorandil and nitroglycerin reduce subendocardial ischemia distal to a flow-limiting coronary artery stenosis. This beneficial effect may partially explain the efficacy of these two compounds in the therapy of angina pectoris. PMID:2413311

  4. A Caliber Persistent Artery (Dieulafoys Lesion) which is Associated with an Early-Stage Gastric Stump Cancer Following a Distal Gastrectomy

    PubMed Central

    Gurzu, Simona; Copotoiu, Constantin; Azamfirei, Leonard; Jung, Ioan

    2013-01-01

    A 75years old man was hospitalized with symptoms which suggested gastric cancer. Thirty-eight years ago, he had undergone a Billroth-II gastric reconstruction for a peptic ulcer. At the present admission, he had presented with an eight-month history of recurrent haematemesis, epigastric pain, vomiting, and fatigue. The emergent endoscopy showed a type 0-IIc (superficial depressed) early gastric stump cancer in the anastomotic area and total removal of the gastric remnant and the jejunal segment was performed. The histological examination of the surgical specimen showed a gastric adenocarcinoma that invaded the mucosa and the submucosa, without lymph node metastases (pT1bN0 stage). Besides the tumour, enlarged vessels were observed in the submucosa and the muscularis propria, some of which were thrombotic. The surrounding normal gastric wall also presented submucosal oversized vascular spaces, some of which were protruding through the muscularis mucosae in the mucosal layer. Based on these characteristics and the recurrent haematemesis, a final diagnosis of early gastric stump carcinoma which was associated with Dieulafoys lesion was made. This association has not yet been reported in the literature and it allowed us to diagnose the gastric stump cancer in a very early stage. PMID:24086889

  5. Pulmonary Artery Denervation Reduces Pulmonary Artery Pressure and Induces Histological Changes in an Acute Porcine Model of Pulmonary Hypertension

    PubMed Central

    Arnold, Nadine D.; Chang, William; Watson, Oliver; Swift, Andrew J.; Condliffe, Robin; Elliot, Charlie A.; Kiely, David G.; Suvarna, S. Kim; Gunn, Julian; Lawrie, Allan

    2015-01-01

    Background— Pulmonary arterial hypertension is a devastating disease with high morbidity and mortality and limited treatment options. Recent studies have shown that pulmonary artery denervation improves pulmonary hemodynamics in an experimental model and in an early clinical trial. We aimed to evaluate the nerve distribution around the pulmonary artery, to determine the effect of radiofrequency pulmonary artery denervation on acute pulmonary hypertension induced by vasoconstriction, and to demonstrate denervation of the pulmonary artery at a histological level. Methods and Results— Histological evaluation identified a circumferential distribution of nerves around the proximal pulmonary arteries. Nerves were smaller in diameter, greater in number, and located in closer proximity to the luminal aspect of the pulmonary arterial wall beyond the pulmonary artery bifurcation. To determine the effect of pulmonary arterial denervation acute pulmonary hypertension was induced in 8 pigs by intravenous infusion of thromboxane A2 analogue. Animals were assigned to either pulmonary artery denervation, using a prototype radiofrequency catheter and generator, or a sham procedure. Pulmonary artery denervation resulted in reduced mean pulmonary artery pressure and pulmonary vascular resistance and increased cardiac output. Ablation lesions on the luminal surface of the pulmonary artery were accompanied by histological and biochemical alteration in adventitial nerves and correlated with improved hemodynamic parameters. Conclusions— Pulmonary artery denervation offers the possibility of a new treatment option for patients with pulmonary arterial hypertension. Further work is required to determine the long-term efficacy and safety. PMID:26553697

  6. A method to identify early ventricular dysfunction using resting gated blood pool scans (GBPS) in patients with coronary artery disease (CAD)

    SciTech Connect

    Schwarzberg, R.J.; Seldin, D.W.; Johnson, L.L.; Alderson, P.O.

    1984-01-01

    To determine the sensitivity of regional 1st and 2nd time derivative (1DV, 2DV) images to assess ventricular function (VF) in CAD, the resting GBPS of 8 normal patients (pts) and 20 pts with CAD who had coronary angiography and contrast ventriculography (CV) were analyzed. The 1DV and 2DV of the systolic time-activity curve were determined for each left ventricular pixel in the GBPS. These values were displayed as functional images that were reviewed by three readers to determine the presence of regional abnormalities. No regional abnormalities were seen in the conventional GBPS or 1DV or 2DV images of the 8 normal pts. Regional GBPS and DV image abnormalities were seen in all 10 pts with CAD and abnormal wall motion by CV. The DV image abnormalities were in the distribution of 18/22 coronary arteries (CA) with greater than or equal to50% stenoses; 2 of these regions showed normal wall motion by CV and conventional GBPS. DV images were abnormal in 2/8 CAs without significant stenoses. In addition, regional DV image abnormalities were present in 9 of 10 pts with CAD who had normal wall motion and global ejection fraction by both CV and resting GBPS. These 10 pts showed regional abnormalities in the distribution of 13/15 CAs with significant stenoses and 2/15 CAs without such stenoses. The results suggest that time derivative functional images derived from resting GBPS provide a more sensitive means for detecting regional left ventricular dysfunction than several other current methods, especially in pts with mild CAD.

  7. Clipping of anterior communicating artery aneurysms in the early post-rupture stage via transorbital keyhole approach-Chinese neurosurgical experience.

    PubMed

    Wang, Hui; Luo, Lun; Ye, Zhuopeng; Li, Wensheng; Chen, Chuan; Ba, Yueyang; Ning, Xinjie; Guo, Ying

    2015-10-01

    The anterior communicating artery (AComA) complex is the site at which intracranial aneurysms occur most frequently. At present, effective treatments for AComA aneurysms are yet to be developed. Here, we present our experience in successfully managing AComA aneurysms via the transorbital keyhole approach. A total of 52 patients having a history of aneurysm rupture received surgery. All patients were assigned a Hunt-Hess grade prior to surgery. The cistern was opened to expose the AComA complex using a keyhole approach, and aneurysms were then surgically clipped with the assistance of neuroendoscopy or indocyanine green angiography. Surgery outcomes were confirmed using computed tomography angiography (CTA). Each of the 52 AComA aneurysms was successfully clipped with a single operation. Three of these patients experienced intraoperative aneurysm rupture. Five had postoperative hydrocephalus which was successfully treated with ventriculoperitoneal shunt. All patients survived the surgical procedure. Using the Glasgow Outcome Scale scores for evaluation, 39 patients (75.0%) had good recovery, 9 (17.3%) had moderate disability, 2 (3.8%) had severe disability, and 2 patients who had been in preoperative comas (3.8%) remained in a vegetative state. During the follow-up period, CTA showed no recurrence of rupture or bleeding in all cases. Results of logistic analysis indicated that the transorbital keyhole approach was feasible based on the patients' preoperative Hunt-Hess grades, which should be considered a priority in using this approach in the treatment of ruptured AComA aneurysms. PMID:25968329

  8. Anomalous origin of the ophthalmic artery from the anterior cerebral artery.

    PubMed

    Li, Yuhui; Horiuchi, Tetsuyoshi; Yako, Takehiro; Ishizaka, Shigetoshi; Hongo, Kazuhiro

    2011-01-01

    A 39-year-old woman presented with left visual disturbance and diplopia. Magnetic resonance imaging revealed a well-enhanced tumor in the left tentorium, cavernous sinus, and suprasellar region. Angiography demonstrated an abnormal origin of the ophthalmic artery from the anterior cerebral artery. The tumor was partially removed by left frontotemporal craniotomy with orbitozygomatic osteotomy. Intraoperatively, the anomalous origin of the ophthalmic artery was confirmed. This anatomical variation is extremely rare. PMID:21869580

  9. 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 ...

  10. Mesenteric artery ischemia

    MedlinePLUS

    Mesenteric artery ischemia occurs when there is a narrowing or blockage of one or more of the three major arteries that ... that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to the intestines ...

  11. 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 ...

  12. Coronary artery disease (image)

    MedlinePLUS

    ... through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the coronary arteries narrow, the flow of blood to the ...

  13. Coronary Artery Bypass Surgery

    MedlinePLUS

    In coronary artery disease (CAD), the arteries that supply blood and oxygen to your heart muscle grow hardened and narrowed. ... these treatments don't help, you may need coronary artery bypass surgery. The surgery creates a new path ...

  14. Coronary artery fistula (image)

    MedlinePLUS

    A coronary artery fistula generally occurs when one of the coronary arteries fails to form properly during the development of the baby. Coronary artery fistula is an abnormal connection between one of ...

  15. Peripheral arterial line (image)

    MedlinePLUS

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of blood pressure ...

  16. Influence of an Early Recovery Telehealth Intervention on Physical Activity and Functioning following Coronary Artery Bypass Surgery (CABS) among Older Adults with High Disease Burden

    PubMed Central

    Barnason, Susan; Zimmerman, Lani; Schulz, Paula; Tu, Chunhao

    2009-01-01

    Background Older adults with poor functioning preoperatively are at risk for delayed recovery and more impaired outcomes following CABS. Purpose To determine if a 6-week early recovery telehealth intervention, designed to improve self-efficacy and management related to symptoms following CABS, was effective in improving outcomes (physical activity, physiological and psychological functioning) for older adults (> 65 years old) with higher disease burden. Design A descriptive, repeated measures experimental design was used. Follow-up data was collected at 3- and 6-weeks and 3-months after CABS. Sample Subjects were drawn from a larger randomized clinical trial (RCT). Parent study subjects who had high disease burden preoperatively [physical component score of <50 on the Medical Outcome Study Short Form 36 (MOS SF-36) and a RISKO score of > 6], were included (N=55); with 23 subjects in the early recovery intervention group and 31 subjects in the usual care group (n=31). Subjects ranged from 6585 years old (M=71.6 + 5.1). Findings There was a significant main effect by group [F(1,209)=4.66, p<.05), the intervention group had a least square means of 27.9 kcal/kg/day of energy expenditure compared to the usual care group of 26.6 kcal/kg/day per the RT3 accelerometer. Both groups had significantly improved physical [F(2,171)=3.26, p<.05] and role-physical [F(2,171)=6.64, p<.005] functioning over time. Conclusions The subgroup of CABS subjects with high disease burden was responsive to an early recovery telehealth intervention. Improving patients physical activity and functioning can reduce morbidity and mortality associated with poor functioning after cardiac events. PMID:19944870

  17. Mindfulness-Oriented Recovery Enhancement for Chronic Pain and Prescription Opioid Misuse: Results from an Early Stage Randomized Controlled Trial

    PubMed Central

    Garland, Eric L.; Manusov, Eron G.; Froeliger, Brett; Kelly, Amber; Williams, Jaclyn M.; Howard, Matthew O.

    2014-01-01

    Objective Opioid pharmacotherapy is now the leading treatment for chronic pain, a problem that affects nearly one-third of the United States population. Given the dramatic rise in prescription opioid misuse and opioid-related mortality, novel behavioral interventions are needed. The purpose of this study was to conduct an early stage randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), a multimodal intervention designed to simultaneously target mechanisms underpinning chronic pain and opioid misuse. Method Chronic pain patients (N=115; mean age = 4814; 68% female) were randomized to 8 weeks of MORE or a Support Group (SG). Outcomes were measured at pre- and post-treatment, and at 3-month follow-up. The Brief Pain Inventory assessed changes in pain severity and interference. Changes in opioid use disorder status were measured by the Current Opioid Misuse Measure. Desire for opioids, stress, nonreactivity, reinterpretation of pain sensations, and reappraisal were also evaluated. Results MORE participants reported significantly greater reductions in pain severity (p = .038) and interference (p = .003) than SG participants, which were maintained by 3-month follow-up and mediated by increased nonreactivity and reinterpretation of pain sensations. Compared with SG participants, participants in MORE evidenced significantly less stress arousal (p = .034) and desire for opioids (p = .027), and were significantly more likely to no longer meet criteria for opioid use disorder immediately following treatment (p = .05); however, these effects were not sustained at follow-up. Conclusions Findings demonstrate preliminary feasibility and efficacy of MORE as a treatment for co-occurring prescription opioid misuse and chronic pain. PMID:24491075

  18. Endovascular Treatment of a Coronary Artery Bypass Graft to Pulmonary Artery Fistula with Coil Embolization

    SciTech Connect

    Nielson, Jeffery L. Kang, Preet S.

    2006-04-15

    Fistula formation between a coronary artery bypass graft (CABG)and the pulmonary arterial circulation represents a rare cause of recurrent angina in patients following bypass grafting. Therapy has traditionally involved surgical ligation by open thoracotomy. We describe a case of left internal mammary artery-left upper lobe pulmonary artery fistula presenting as early recurrent angina following CABG. The fistula was embolized using platinum coils, resulting in symptomatic relief and improvement in myocardial perfusion on cardiac perfusion scintigraphy. Coil embolization should be considered a therapeutic option in patients with coronary-pulmonary steal syndrome.

  19. Surface?enhanced Raman spectral biomarkers correlate with Ankle Brachial Index and characterize leg muscle biochemical composition of patients with peripheral arterial disease

    PubMed Central

    Cluff, Kim; Kelly, Abby M.; Koutakis, Panagiotis; He, Xiang N.; Huang, Xi; Lu, Yong Feng; Pipinos, Iraklis I.; Casale, George P.; Subbiah, Jeyamkondan

    2014-01-01

    Abstract Peripheral arterial disease (PAD) is characterized by atherosclerotic blockages of the arteries supplying the lower extremities, which cause a progressive accumulation of ischemic injury to the skeletal muscles of the lower limbs. This injury includes altered metabolic processes, damaged organelles, and compromised bioenergetics in the affected muscles. The objective of this study was to explore the association of Raman spectral signatures of muscle biochemistry with the severity of atherosclerosis in the legs as determined by the Ankle Brachial Index (ABI) and clinical presentation. We collected muscle biopsies from the gastrocnemius (calf muscle) of five patients with clinically diagnosed claudication, five patients with clinically diagnosed critical limb ischemia (CLI), and five control patients who did not have PAD. A partial least squares regression (PLSR) model was able to predict patient ABI with a correlation coefficient of 0.99 during training and a correlation coefficient of 0.85 using a full cross?validation. When using the first three PLS factor scores in combination with linear discriminant analysis, the discriminant model was able to correctly classify the control, claudicating, and CLI patients with 100% accuracy, using a full cross?validation procedure. Raman spectroscopy is capable of detecting and measuring unique biochemical signatures of skeletal muscle. These signatures can discriminate control muscles from PAD muscles and correlate with the ABI and clinical presentation of the PAD patient. Raman spectroscopy provides novel spectral biomarkers that may complement existing methods for diagnosis and monitoring treatment of PAD patients. PMID:25247767

  20. Effectiveness of Platelet-Rich Plasma to Enhance Healing of Diabetic Foot Ulcers in Patients With Concomitant Peripheral Arterial Disease and Critical Limb Ischemia.

    PubMed

    Kontopodis, Nikolaos; Tavlas, Emmanouhl; Papadopoulos, George; Pantidis, Dimitrios; Kafetzakis, Alexandros; Chalkiadakis, George; Ioannou, Christos

    2016-03-01

    We sought to investigate the effect of autologous platelet-rich plasma (PRP) on the healing rate of diabetic foot ulcers in patients with diabetes and concomitant peripheral arterial disease (PAD). Diabetic patients with foot ulceration presenting with PAD who were treated with local growth factors in a single center, during a 24-month period from May 2009 to April 2011, were retrospectively reviewed. Based on the severity of PAD, subjects were divided into groups A (Fontaine classification stages I, IIa, and IIb) and B (Fontaine classification stages III and IV), with those included in the latter being considered to suffer from critical limb ischemia (CLI). End points of the analysis were clinical improvement, limb salvage, and amputation rate. Outcome was compared between groups A and B. Overall, 72 patients were evaluated, 30 with CLI. Ulcer area reduction >50% was observed in 58/72 patients while reduction >90% was achieved in 52/72 patients. There were 14 (19%) major and minor amputations, whereas the limb salvage rate was 89%. This variable was significantly different between groups A and B (100% vs 73%, P < .001), as is rate of reduction in ulcer area >90% (83% vs 56%, P = .02). Reduction of ulcer area >50% was observed in the majority of patients in both groups (group A 86% vs group B 73%, P = .23). In conclusion, PRP could serve as a useful adjunct during management of diabetic foot ulcers even in diabetic patients with unreconstructable arterial disease. PMID:25795280

  1. Pathways: A Training & Resource Guide for Enhancing Skills in Early Intervention Service Coordination [Training Guide and Videotape].

    ERIC Educational Resources Information Center

    Rosin, Peggy; And Others

    Service coordination in early intervention for infants and toddlers with disabilities is the focus of this training guide and accompanying videotape. Section 1 describes service coordination as defined by Part H of the Individuals with Disabilities Education Act, the various models or approaches to service coordination, the history of early

  2. Preoperative Evaluation of the Right Upper Lobe Pulmonary Artery by 3D-CT Pulmonary Angiography vs. Thin-Section Multiplanar Reconstruction Images Obtained by Contrast-Enhanced Multidetector-Row CT.

    PubMed

    Murota, Makiko; Yamamoto, Yuka; Satoh, Katashi; Ishimura, Mariko; Gotoh, Masashi; Nishiyama, Yoshihiro

    2015-12-01

    We compared the effectiveness of 3-dimensional computed tomography pulmonary angiography (3D-CTPA) and thin-section multiplanar reconstruction (MPR) images obtained using contrast-enhanced multidetector row CT (MDCT), in the evaluation of pulmonary artery (PA) branches of the right upper lobe. We studied 127 patients suspected of having lung cancer of the right upper lobe who underwent contrast-enhanced MDCT scans and a right upper lobectomy. We compared the intraoperative findings of the PA branches of the right upper lobe obtained with 3D-CTPA and thin-section MPR images. In 125 (97.7%) patients, one or more PA branches arose from arteries other than the superior trunk. Among 10 (7.9%) patients, a PA branch arose from the middle lobe in one patient and from the superior segment of the lower lobe in the other 9 patients. According to the intraoperative findings, 97.2% and 99.7% of the PA branches were identified by 3D-CTPA and thin-section MPR images, respectively (p?0.03). The single branch missed by both imaging modalities was 1.0mm in dia. The 8 branches missed only by 3D-CTPA were?1.4mm in dia. Both the 3D-CTPA and thin-section MPR images provided precise preoperative information regarding PA branches of the right upper lobe. However, the thin-section MPR images appeared to contribute more to the evaluation of smaller PA branches. PMID:26690242

  3. Nitrate reductase-mediated early nitric oxide burst alleviates oxidative damage induced by aluminum through enhancement of antioxidant defenses in roots of wheat (Triticum aestivum).

    PubMed

    Sun, Chengliang; Lu, Lingli; Liu, Lijuan; Liu, Wenjing; Yu, Yan; Liu, Xiaoxia; Hu, Yan; Jin, Chongwei; Lin, Xianyong

    2014-03-01

    Nitric oxide (NO) is an important signaling molecule involved in the physiological processes of plants. The role of NO release in the tolerance strategies of roots of wheat (Triticum aestivum) under aluminum (Al) stress was investigated using two genotypes with different Al resistances. An early NO burst at 3 h was observed in the root tips of the Al-tolerant genotype Jian-864, whereas the Al-sensitive genotype Yang-5 showed no NO accumulation at 3 h but an extremely high NO concentration after 12 h. Stimulating NO production at 3 h in the root tips of Yang-5 with the NO donor relieved Al-induced root inhibition and callose production, as well as oxidative damage and ROS accumulation, while elimination of the early NO burst by NO scavenger aggravated root inhibition in Jian-864. Synthesis of early NO in roots of Jian-864 was mediated through nitrate reductase (NR) but not through NO synthase. Elevated antioxidant enzyme activities were induced by Al stress in both wheat genotypes and significantly enhanced by NO donor, but suppressed by NO scavenger or NR inhibitor. These results suggest that an NR-mediated early NO burst plays an important role in Al resistance of wheat through modulating enhanced antioxidant defense to adapt to Al stress. PMID:24237306

  4. Early fluid loading in acute respiratory distress syndrome with septic shock deteriorates lung aeration without impairing arterial oxygenation: a lung ultrasound observational study

    PubMed Central

    2014-01-01

    Introduction The study was designed to assess the impact of fluid loading on lung aeration, oxygenation and hemodynamics in patients with septic shock and acute respiratory distress syndrome (ARDS). Methods During a 1-year period, a prospective observational study was performed in 32 patients with septic shock and ARDS. Cardiorespiratory parameters were measured using Swan Ganz (n = 29) or PiCCO catheters (n = 3). Lung aeration and regional pulmonary blood flows were measured using bedside transthoracic ultrasound. Measurements were performed before (T0), at the end of volume expansion (T1) and 40 minutes later (T2), consisting of 1-L of saline over 30 minutes during the first 48 h following onset of septic shock and ARDS. Results Lung ultrasound score increased by 23% at T2, from 13 at baseline to 16 (P < 0.001). Cardiac index and cardiac filling pressures increased significantly at T1 (P < 0.001) and returned to control values at T2. The increase in lung ultrasound score was statistically correlated with fluid loading-induced increase in cardiac index and was not associated with increase in pulmonary shunt or regional pulmonary blood flow. At T1, PaO2/FiO2 significantly increased (P < 0.005) from 144 (123 to 198) to 165 (128 to 226) and returned to control values at T2, whereas lung ultrasound score continued to increase. Conclusions Early fluid loading transitorily improves hemodynamics and oxygenation and worsens lung aeration. Aeration changes can be detected at the bedside by transthoracic lung ultrasound, which may serve as a safeguard against excessive fluid loading. PMID:24887155

  5. Vapor resistant arteries

    NASA Technical Reports Server (NTRS)

    Shaubach, Robert M. (Inventor); Dussinger, Peter M. (Inventor); Buchko, Matthew T. (Inventor)

    1989-01-01

    A vapor block resistant liquid artery structure for heat pipes. A solid tube artery with openings is encased in the sintered material of a heat pipe wick. The openings are limited to that side of the artery which is most remote from the heat source. The liquid in the artery can thus exit the artery through the openings and wet the sintered sheath, but vapor generated at the heat source is unlikely to move around the solid wall of the artery and reverse its direction in order to penetrate the artery through the openings. An alternate embodiment uses finer pore size wick material to resist vapor entry.

  6. Arterial Stiffness, Distensibility, and Strain in Asthmatic Children

    PubMed Central

    Özkan, Esra Akyüz; Serin, Halil İbrahim; Khosroshahi, Hashem E.; Kılıç, Mahmut; Ekim, Meral; Beysel, Perihan; Geçit, U. Aliye; Domur, Esra

    2016-01-01

    Background We hypothesized that since asthma is a chronic inflammatory disease, it could lead to the early development of atherosclerosis in childhood-onset asthma. The aim of this study was to investigate arterial stiffness, distensibility, and strain of different peripheral arteries, the parameters of which can be used to detect atherosclerosis in asthmatic children. Material/Methods We studied 22 pediatric patients with asthma and 18 healthy children. Fasting blood glucose and cholesterol levels were evaluated to exclude children with diabetes and hyperlipidemia, which are risk factors for atherosclerosis. Renal, carotid, and brachial arteries diameters were measured. Using the measured data, stiffness, distensibility, and strain of the arteries of all children were calculated. Results Pulse pressure, systolic and diastolic blood pressure, heart rate, cholesterols, and glucose levels of the obese individuals were similar to the controls. In carotid arteries there were no statistical differences regarding stiffness, distensibility, and strain. According to multiple ANCOVA analysis, distensibility and strain of right and left brachial arteries and right renal artery were higher, whereas right renal artery stiffness was lower in asthmatic children than in controls. Approximately one-fifth of the change in the left and right brachial arteries and right renal artery distensibility and strain and a small portion of the change in the right renal artery stiffness were associated with asthma. In contrast, left renal artery distensibility, strain, and stiffness were not associated with asthma. Conclusions Peripheral arteries had higher distensibility and strain, and lower stiffness in asthmatic children than in controls. PMID:26803723

  7. Arterial Stiffness, Distensibility, and Strain in Asthmatic Children.

    PubMed

    Akyz zkan, Esra; Serin, Halil ?brahim; Khosroshahi, Hashem E; K?l?, Mahmut; Ekim, Meral; Beysel, Perihan; Geit, U Aliye; Domur, Esra

    2016-01-01

    BACKGROUND We hypothesized that since asthma is a chronic inflammatory disease, it could lead to the early development of atherosclerosis in childhood-onset asthma. The aim of this study was to investigate arterial stiffness, distensibility, and strain of different peripheral arteries, the parameters of which can be used to detect atherosclerosis in asthmatic children. MATERIAL AND METHODS We studied 22 pediatric patients with asthma and 18 healthy children. Fasting blood glucose and cholesterol levels were evaluated to exclude children with diabetes and hyperlipidemia, which are risk factors for atherosclerosis. Renal, carotid, and brachial arteries diameters were measured. Using the measured data, stiffness, distensibility, and strain of the arteries of all children were calculated. RESULTS Pulse pressure, systolic and diastolic blood pressure, heart rate, cholesterols, and glucose levels of the obese individuals were similar to the controls. In carotid arteries there were no statistical differences regarding stiffness, distensibility, and strain. According to multiple ANCOVA analysis, distensibility and strain of right and left brachial arteries and right renal artery were higher, whereas right renal artery stiffness was lower in asthmatic children than in controls. Approximately one-fifth of the change in the left and right brachial arteries and right renal artery distensibility and strain and a small portion of the change in the right renal artery stiffness were associated with asthma. In contrast, left renal artery distensibility, strain, and stiffness were not associated with asthma. CONCLUSIONS Peripheral arteries had higher distensibility and strain, and lower stiffness in asthmatic children than in controls. PMID:26803723

  8. Gastrointestinal arterial fibromuscular dysplasia of childhood.

    PubMed

    Meredith, J T; Cerezo, L; Alvarez, M; Price, G; Bourgeois, S

    1988-08-01

    An unusual case of a progressive, noninflammatory stenosing vasculopathy, arterial fibromuscular dysplasia is presented. The distinctive features of this particular case include onset in early childhood with a predominant involvement of the gastrointestinal system, sparing of the renal arteries, lack of hypertension, and no cutaneous features of progressive systemic sclerosis. We discuss the clinical history over a decade and the pathologic features, including routine and electron microscopic findings of biopsy and autopsy tissues, and review the literature. PMID:3395221

  9. Science Education in Early Childhood Teacher Education: Putting Forward a Case to Enhance Student Teachers' Confidence and Competence

    NASA Astrophysics Data System (ADS)

    Garbett, Dawn

    2003-08-01

    New Zealand is moving towards increased qualification requirements for early childhood educators. There is an underlying assumption that there is a correlation between quality early childhood education, teacher qualifications and quality practices in teaching and learning. Two fields of literature, early childhood pedagogy and science specific pedagogy, are reviewed briefly to provide a framework with which to consider why student teachers' attitudes, misunderstandings and misconceptions in science can limit their ability and willingness to create quality teaching and learning opportunities. The study reported in this paper highlights, in general, that early childhood student teachers' subject knowledge in science was poor. It also emerged that the student teachers were unaware of how little they knew and how this might affect their ability to provide appropriate science experiences for young children.

  10. Pulmonary artery CTA.

    PubMed

    Schoepf, U Joseph

    2006-12-01

    The latest with the introduction of multidetector row computed tomography (MDCT), CT has been firmly established as the modality of choice for imaging the pulmonary arteries, particularly as the de facto first line test for imaging patients with suspected acute pulmonary embolism (PE). Before the introduction of MDCT, remaining concerns regarding CTs accuracy for diagnosis of isolated peripheral emboli had prevented the unanimous acceptance of this test as the reference standard for imaging PE. After a decade of uncertainty, there is now conclusive evidence that CT, if positive, provides reliable confirmation of the presence of PE and, more importantly, if negative effectively rules out clinically significant PE. Current endeavors to streamline and facilitate workflow for CT diagnosis of PE will further improve the acceptance, utility, and importance of this test. Examples include improvements in workflow, CT derivation of right ventricular function parameters for triage and prognostication of patients with acute PE and the comprehensive assessment of patients with acute chest pain for PE, coronary disease, aortic disease, and pulmonary disease by means of a single, contrast enhanced, ECG-synchronized CT scan. Although the diagnosis or exclusion of acute PE is the most common and important application of CT pulmonary angiography, the ease of scan acquisition and the high spatial resolution of modern CT techniques make this test ideally suited for the greatest majority of congenital and acquired, acute and chronic disorders of the pulmonary arteries. PMID:17709083

  11. The history of arterial revascularization: from Kolesov to Tector and beyond

    PubMed Central

    Galvin, Sean D.

    2013-01-01

    Coronary artery bypass grafting (CABG) is the one of the most effective revascularization strategies for patients with obstructive coronary artery disease. Total arterial revascularization using one or both internal thoracic and radial arteries has been shown to improve early outcomes and reduce long-term cardiovascular morbidity. Although CABG has evolved from an experimental procedure in the early 1900s to become one of the most commonly performed surgical procedures, there is still significant variation in grafting strategies amongst surgeons. We review the history and development of CABG with a particular emphasis on the early pioneers and the evolution of arterial grafting. PMID:23977617

  12. A rare case of unilateral variations of forearm arteries: anatomy, embryology and clinical implications

    PubMed Central

    Kumka, Myroslava; Purkiss, Sheila

    2015-01-01

    This study documents the existence and topographic anatomy of a rare case of variant forearm arteries found in the left upper limb of a 68-year-old male cadaver. The arteries of the arm followed typical courses, but both the radial and ulnar arteries in the forearm followed a superficial course. The common interosseous artery and recurrent ulnar arteries branched from the radial, not the ulnar, artery. The radial artery was larger than the ulnar artery and was the major source of blood supply to the forearm. Clinical implications for single superficial forearm arteries are reviewed. A person with both superficial radial and superficial ulnar arteries would be at a substantially increased risk of injury or iatrogenic effects that could compromise blood supply to the hand. This study will enhance clinicians awareness of potential arterial variations, so they can provide adequate assessment, diagnosis and treatment of upper limb lesions. PMID:26500359

  13. Validity of Acute Stroke Lesion Volume Estimation by Diffusion-Weighted Imaging–Alberta Stroke Program Early Computed Tomographic Score Depends on Lesion Location in 496 Patients With Middle Cerebral Artery Stroke

    PubMed Central

    Schröder, Julian; Cheng, Bastian; Ebinger, Martin; Köhrmann, Martin; Wu, Ona; Kang, Dong-Wha; Liebeskind, David S.; Tourdias, Thomas; Singer, Oliver C.; Christensen, Soren; Campbell, Bruce; Luby, Marie; Warach, Steven; Fiehler, Jens; Fiebach, Jochen B.; Gerloff, Christian; Thomalla, Götz

    2016-01-01

    Background and Purpose Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) has been used to estimate diffusion-weighted imaging (DWI) lesion volume in acute stroke. We aimed to assess correlations of DWI-ASPECTS with lesion volume in different middle cerebral artery (MCA) subregions and reproduce existing ASPECTS thresholds of a malignant profile defined by lesion volume ≥100 mL. Methods We analyzed data of patients with MCA stroke from a prospective observational study of DWI and fluid-attenuated inversion recovery in acute stroke. DWI-ASPECTS and lesion volume were calculated. The population was divided into subgroups based on lesion localization (superficial MCA territory, deep MCA territory, or both). Correlation of ASPECTS and infarct volume was calculated, and receiver-operating characteristics curve analysis was performed to identify the optimal ASPECTS threshold for ≥100-mL lesion volume. Results A total of 496 patients were included. There was a significant negative correlation between ASPECTS and DWI lesion volume (r=−0.78; P<0.0001). With regards to lesion localization, correlation was weaker in deep MCA region (r=−0.19; P=0.038) when compared with superficial (r=−0.72; P<0.001) or combined superficial and deep MCA lesions (r=−0.72; P<0.001). Receiver-operating characteristics analysis revealed ASPECTS≤6 as best cutoff to identify ≥100-mL DWI lesion volume; however, positive predictive value was low (0.35). Conclusions ASPECTS has limitations when lesion location is not considered. Identification of patients with malignant profile by DWI-ASPECTS may be unreliable. ASPECTS may be a useful tool for the evaluation of noncontrast computed tomography. However, if MRI is used, ASPECTS seems dispensable because lesion volume can easily be quantified on DWI maps. PMID:25316278

  14. Cooled artery extension

    NASA Technical Reports Server (NTRS)

    Gernert, Nelson J. (Inventor)

    1990-01-01

    An artery vapor trap. A heat pipe artery is constructed with an extension protruding from the evaporator end of the heat pipe beyond the active area of the evaporator. The vapor migrates into the artery extension because of gravity or liquid displacement, and cooling the extension condenses the vapor to liquid, thus preventing vapor lock in the working portion of the artery by removing vapor from within the active artery. The condensed liquid is then transported back to the evaporator by the capillary action of the artery extension itself or by wick located within the extension.

  15. High Spinal Anesthesia Enhances Anti-Inflammatory Responses in Patients Undergoing Coronary Artery Bypass Graft Surgery and Aortic Valve Replacement: Randomized Pilot Study

    PubMed Central

    Lee, Trevor W. R.; Kowalski, Stephen; Falk, Kelsey; Maguire, Doug; Freed, Darren H.; HayGlass, Kent T.

    2016-01-01

    Background Cardiac surgery induces many physiologic changes including major inflammatory and sympathetic nervous system responses. Here, we conducted a single-centre pilot study to generate hypotheses on the potential immune impact of adding high spinal anaesthesia to general anaesthesia during cardiac surgery in adults. We hypothesized that this strategy, previously shown to blunt the sympathetic response and improve pain management, could reduce the undesirable systemic inflammatory responses caused by cardiac surgery. Methods This prospective randomized unblinded pilot study was conducted on 14 patients undergoing cardiac surgery for coronary artery bypass grafting and/or aortic valve replacement secondary to severe aortic stenosis. The primary outcome measures examined longitudinally were serum pro-inflammatory (IL-6, IL-1b, CCL2), anti-inflammatory (IL-10, TNF-RII, IL-1Ra), acute phase protein (CRP, PTX3) and cardiovascular risk (sST2) biomarkers. Results The kinetics of pro- and anti-inflammatory biomarker was determined following surgery. All pro-inflammatory and acute phase reactant biomarker responses induced by surgical stress were indistinguishable in intensity and duration between control groups and those who also received high spinal anaesthesia. Conversely, IL-10 levels were markedly elevated in both intensity and duration in the group receiving high spinal anesthesia (p = 0.005). Conclusions This hypothesis generating pilot study suggests that high spinal anesthesia can alter the net inflammatory response that results from cardiac surgery. In appropriately selected populations, this may add incremental benefit by dampening the net systemic inflammatory response during the week following surgery. Larger population studies, powered to assess immune, physiologic and clinical outcomes in both acute and longer term settings, will be required to better assess potential benefits of incorporating high spinal anesthesia. Trial Registration ClinicalTrials.gov NCT00348920 PMID:26930568

  16. Enhancing Student Services at Lorain County Community College: Early Results from the Opening Doors Demonstration in Ohio

    ERIC Educational Resources Information Center

    Scrivener, Susan; Au, Jenny

    2007-01-01

    In 2003, MDRC and a consortium of funders launched the Opening Doors demonstration to test reforms in six community colleges aimed at helping students stay in school and earn credentials. This report presents early results from the Opening Doors program at Lorain County Community College in Elyria, Ohio. The program provided intensive advising and…

  17. Quantitative in vivo measurement of early axonal transport deficits in a triple transgenic mouse model of Alzheimers disease using manganese-enhanced MRI

    PubMed Central

    Kim, Jieun; Choi, In-Young; Michaelis, Mary L.; Lee, Phil

    2011-01-01

    Impaired axonal transport has been linked to the pathogenic processes of Alzheimers disease (AD) in which axonal swelling and degeneration are prevalent. The development of non-invasive neuroimaging methods to quantitatively assess in vivo axonal transport deficits would be enormously valuable to visualize early, yet subtle, changes in the AD brain, to monitor the disease progression and to quantify the effect of drug intervention. A triple transgenic mouse model of AD closely resembles human AD neuropathology. In this study, we investigated age-dependent alterations in the axonal transport rate in a longitudinal assessment of the triple transgenic mouse olfactory system, using fast multi-sliced T1 mapping with manganese-enhanced MRI. The data show that impairment in axonal transport is a very early event in AD pathology in these mice, preceding both deposition of A? plaques and formation of Tau fibrils. PMID:21338698

  18. Traumatic Axillary Artery Dissection with Radial Artery Embolism

    SciTech Connect

    Chung, Hwan-Hoon; Cha, Sang Hoon Cho, Sung Bum; Kim, Jung Hyuck; Lee, Seung Hwa; Shin, Jae Seung; Park, Sang Woo

    2006-04-15

    This report describes a case of pathologically proven traumatic arterial dissection, presenting as complete occlusion of the axillary artery with radial artery embolism. Occlusion of the axillary artery by traumatic dissection mimicked transection and radial artery embolism mimicked congenital absence of the radial artery on the initial angiogram, but these were correctly diagnosed with the following sonogram.

  19. Corona Enhancement and Mosaic Architecture for Prognosis and Selection Between of Liver Resection Versus Transcatheter Arterial Chemoembolization in Single Hepatocellular Carcinomas >5?cm Without Extrahepatic Metastases: An Imaging-Based Retrospective Study.

    PubMed

    Li, Meng; Xin, Yongjie; Fu, Sirui; Liu, Zaiyi; Li, Yong; Hu, Baoshan; Chen, Shuting; Liang, Changhong; Lu, Ligong

    2016-01-01

    Corona enhancement and mosaic architecture are 2 radiologic features of hepatocellular carcinoma (HCC). However, neither their prognostic values nor their impacts on the selection of liver resection (LR) versus transcatheter arterial chemoembolization (TACE) as treatment modalities have been established.We retrospectively analyzed 275 patients with a single HCC lesion >5?cm without extrahepatic metastasis treated with LR or TACE. In LR patients, the overall survival (OS) and time to progression (TTP) were compared between corona enhancement negative (corona-) versus positive (corona+) and mosaic architecture negative (mosaic-) versus positive (mosaic+) patients. Furthermore, by the combination of corona and mosaic, LR patients were divided into negative for both corona and mosaic patterns (LR-/-), positive for only 1 feature (LR+/-), and positive for both (LR+/+); their OS and TTP were compared to those of the TACE group. Cox regression was performed to identify independent factors for OS.In the survival plots for LR, corona- had better OS and TTP than corona+, and mosaic- had better OS than mosaic+. There was no significant difference in TTP between the subgroups. On Cox regression analysis, corona enhancement, but not mosaic architecture, was a significant factor for OS, whereas neither were a significant factor for TTP. In TACE patients, neither corona nor mosaic patterns had significant correlations with OS or TTP. In the whole population, LR-/ and LR+/- subgroups had similar OS, which was better than the LR+/+ and TACE groups. Moreover, LR-/- and LR+/- patients had better TTP than TACE patients, but there were no differences between the LR-/- versus LR+/-, LR-/ versus LR+/+, LR+/- versus LR+/+, and LR+/+ versus TACE groups. On Cox regression analysis, the presence of corona/mosaic patterns was an independent prognostic factor for OS.Our results showed that, for patients with a single HCC >5?cm without extrahepatic metastasis, corona and mosaic patterns are indicators of limited LR efficacy. When both of the features are present, TACE can be used instead of LR with no negative influence on survival. PMID:26765441

  20. Enhanced long term potentiation and decreased AMPA receptor desensitization in the acute period following a single kainate induced early life seizure.

    PubMed

    O'Leary, Heather; Bernard, Paul B; Castano, Anna M; Benke, Tim A

    2016-03-01

    Neonatal seizures are associated with long term disabilities including epilepsy and cognitive deficits. Using a neonatal seizure rat model that does not develop epilepsy, but develops a phenotype consistent with other models of intellectual disability (ID) and autism spectrum disorders (ASD), we sought to isolate the acute effects of a single episode of early life seizure on hippocampal CA1 synaptic development and plasticity. We have previously shown chronic changes in glutamatergic synapses, loss of long term potentiation (LTP) and enhanced long term depression (LTD), in the adult male rat ~50days following kainic acid (KA) induced early life seizure (KA-ELS) in post-natal (P) 7day old male Sprague-Dawley rats. In the present work, we examined the electrophysiological properties and expression levels of glutamate receptors in the acute period, 2 and 7days, post KA-ELS. Our results show for the first time enhanced LTP 7days after KA-ELS, but no change 2days post KA-ELS. Additionally, we report that ionotropic α-amino-3-hydroxy-5-methyl-isoxazole-propionic acid type glutamate receptor (AMPAR) desensitization is decreased in the same time frame, with no changes in AMPAR expression, phosphorylation, or membrane insertion. Inappropriate enhancement of the synaptic connections in the acute period after the seizure could alter the normal patterning of synaptic development in the hippocampus during this critical period and contribute to learning deficits. Thus, this study demonstrates a novel mechanism by which KA-ELS alters early network properties that potentially lead to adverse outcomes. PMID:26706598

  1. Occlusive Peripheral Arterial Disease

    MedlinePLUS

    ... artery. Such people should seek medical care immediately. Did You Know... When people suddenly develop a painful, ... In This Article Animation 1 Peripheral Arterial Disease Did You Know 1 Did You Know... Figure 1 ...

  2. Coronary Artery Disease

    MedlinePLUS

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death ... both men and women. CAD happens when the arteries that supply blood to heart muscle become hardened ...

  3. Coronary artery disease

    MedlinePLUS Videos and Cool Tools

    ... heart muscle itself. Damage to or blockage of a coronary artery can result in injury to the heart. Normally, blood flows through a coronary artery unimpeded. However, a process called atherosclerosis ...

  4. Retinal artery occlusion

    MedlinePLUS

    ... prevent other blood vessel (vascular) diseases, such as coronary artery disease , may decrease the risk of retinal artery occlusion. These include: Eating a low-fat diet Exercising Stopping smoking Losing weight if you are ...

  5. Uterine artery embolization

    MedlinePLUS

    ... are noncancerous (benign) tumors that develop in the uterus (womb). During the procedure, the blood supply of ... uterine artery. This artery supplies blood to the uterus. Small plastic or gelatin particles are injected through ...

  6. Radial artery graft vasospasm.

    PubMed

    Gabe, E D; Figal, J C; Wisner, J N; Laguens, R

    2001-01-01

    We report an unusual case of vasospasm of a grafted radial artery complicated with ventricular fibrillation during the postoperative course of coronary artery bypass graft surgery. To our knowledge this is the first documented case of a radial artery graft spasm leading to a severe arrhythmia. The arrhythmia resolved spontaneously. Radial artery graft spasm was demonstrated by angiography and was successfully resolved by intravenous nitroglycerin administration. PMID:11163573

  7. Retinal artery embolization: a rare presentation of calcific aortic stenosis.

    PubMed

    Reimers, C D; Williams, R J; Berger, M; Wisnicki, H J; Tranbaugh, R F

    1996-03-01

    Retinal artery embolization is an unusual but serious complication of calcific aortic stenosis. However, it is rare for retinal embolization to be the presenting feature of aortic stenosis. This report describes a young patient who presented with an acute retinal artery occlusion secondary to calcific aortic valve disease, and discusses the rationale for early surgical intervention. PMID:8674266

  8. 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 ( ...

  9. Ocean Warming Enhances Malformations, Premature Hatching, Metabolic Suppression and Oxidative Stress in the Early Life Stages of a Keystone Squid

    PubMed Central

    Rosa, Rui; Pimentel, Marta S.; Boavida-Portugal, Joana; Teixeira, Tatiana; Trbenbach, Katja; Diniz, Mrio

    2012-01-01

    Background The knowledge about the capacity of organisms early life stages to adapt to elevated temperatures is very limited but crucial to understand how marine biota will respond to global warming. Here we provide a comprehensive and integrated view of biological responses to future warming during the early ontogeny of a keystone invertebrate, the squid Loligo vulgaris. Methodology/Principal Findings Recently-spawned egg masses were collected and reared until hatching at present day and projected near future (+2C) temperatures, to investigate the ability of early stages to undergo thermal acclimation, namely phenotypic altering of morphological, behavioural, biochemical and physiological features. Our findings showed that under the projected near-future warming, the abiotic conditions inside the eggs promoted metabolic suppression, which was followed by premature hatching. Concomitantly, the less developed newborns showed greater incidence of malformations. After hatching, the metabolic burst associated with the transition from an encapsulated embryo to a planktonic stage increased linearly with temperature. However, the greater exposure to environmental stress by the hatchlings seemed to be compensated by physiological mechanisms that reduce the negative effects on fitness. Heat shock proteins (HSP70/HSC70) and antioxidant enzymes activities constituted an integrated stress response to ocean warming in hatchlings (but not in embryos). Conclusions/Significance The stressful abiotic conditions inside eggs are expected to be aggravated under the projected near-future ocean warming, with deleterious effects on embryo survival and growth. Greater feeding challenges and the lower thermal tolerance limits of the hatchlings are strictly connected to high metabolic demands associated with the planktonic life strategy. Yet, we found some evidence that, in the future, the early stages might support higher energy demands by adjusting some cellular functional properties to increase their thermal tolerance windows. PMID:22701620

  10. Early Life Stress and Trauma and Enhanced Limbic Activation to Emotionally Valenced Faces in Depressed and Healthy Children

    PubMed Central

    Suzuki, Hideo; Luby, Joan L.; Botteron, Kelly N.; Dietrich, Rachel; McAvoy, Mark P.; Barch, Deanna M.

    2014-01-01

    Objective Previous studies have examined the relationships between structural brain characteristics and early life stress in adults. However, there is limited evidence for functional brain variation associated with early life stress in children. We hypothesized that early life stress and trauma would be associated with increased functional brain activation to negative emotional faces in children with and without a history of depression. Method Psychiatric diagnosis and life events in children (starting at ages 35) were assessed in a longitudinal study. A follow-up magnetic resonance imaging (MRI) study acquired data (N = 115 at ages 712, 51% female) on functional brain response to fearful, sad, and happy faces relative to neutral faces. We used a region of interest (ROI) mask within cortico-limbic areas and conducted regression analyses and repeated-measures analysis of covariance (ANCOVA). Results Greater activations to fearful, sad, and happy faces in the amygdala and its neighboring regions were found in children with higher life stress. Moreover, an association between life stress and left hippocampal and globus pallidus activity depended on children's diagnostic status. Finally, all children with higher life trauma showed greater bilateral amygdala and cingulate activity specific to sad faces, but not the other emotional faces, although right amygdala activity was moderated by psychiatric status. Conclusions These findings may suggest that limbic hyperactivity is a biomarker of early life stress and trauma in children and may have implications in the risk trajectory for depression and other stress-related disorders. However, this pattern varied based on emotion type and history of psychopathology. PMID:24954829

  11. 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

  12. Early-life reproduction is associated with increased mortality risk but enhanced lifetime fitness in pre-industrial humans.

    PubMed

    Hayward, Adam D; Nenko, Ilona; Lummaa, Virpi

    2015-04-01

    The physiology of reproductive senescence in women is well understood, but the drivers of variation in senescence rates are less so. Evolutionary theory predicts that early-life investment in reproduction should be favoured by selection at the cost of reduced survival and faster reproductive senescence. We tested this hypothesis using data collected from preindustrial Finnish church records. Reproductive success increased up to age 25 and was relatively stable until a decline from age 41. Women with higher early-life fecundity (ELF; producing more children before age 25) subsequently had higher mortality risk, but high ELF was not associated with accelerated senescence in annual breeding success. However, women with higher ELF experienced faster senescence in offspring survival. Despite these apparent costs, ELF was under positive selection: individuals with higher ELF had higher lifetime reproductive success. These results are consistent with previous observations in both humans and wild vertebrates that more births and earlier onset of reproduction are associated with reduced survival, and with evolutionary theory predicting trade-offs between early reproduction and later-life survival. The results are particularly significant given recent increases in maternal ages in many societies and the potential consequences for offspring health and fitness. PMID:25740893

  13. Sand remobilization enhanced complexity to mounded geometry, Early Tertiary deep water sand reservoirs, Balder Oil Field North Sea

    SciTech Connect

    Bergslien, D.; Rye-Larsen, M.; Jenssen, A.I. )

    1996-01-01

    Sand remobilization played a major role in generating the high relief mounded geometries that trap oil in the early Tertiary reservoirs at Balder Field in Norwegian North Sea blocks 25/10 and 25/11. The thick massive submarine-fan sandstones were shed from the East Shetland Platform and deposited from high density turbidity currents. These thick massive sandstones lie in the distal portions of the fan system on the northwestern margin of the Utsira High. An intricate interaction between deposition and soft sediment deformation processes generated the complex cluster of thick mounded sand geometries comprising the Balder oil field. Slumping, sliding and sand remobilization with associated sand injections into overlying shales were the dominant deformation processes that mainly occurred during the early Eocene. The field is comprised of three reservoirs, the Paleocene Heimdal and Hermod Formations and the Early Eocene Balder Formation. The sandstones, which have excellent reservoir properties, share a common pressure system and oil-water contact. This is probably related to the soft-sediment deformation and associated sand injections establishing cross-stratal communication.

  14. Sand remobilization enhanced complexity to mounded geometry, Early Tertiary deep water sand reservoirs, Balder Oil Field North Sea

    SciTech Connect

    Bergslien, D.; Rye-Larsen, M.; Jenssen, A.I.

    1996-12-31

    Sand remobilization played a major role in generating the high relief mounded geometries that trap oil in the early Tertiary reservoirs at Balder Field in Norwegian North Sea blocks 25/10 and 25/11. The thick massive submarine-fan sandstones were shed from the East Shetland Platform and deposited from high density turbidity currents. These thick massive sandstones lie in the distal portions of the fan system on the northwestern margin of the Utsira High. An intricate interaction between deposition and soft sediment deformation processes generated the complex cluster of thick mounded sand geometries comprising the Balder oil field. Slumping, sliding and sand remobilization with associated sand injections into overlying shales were the dominant deformation processes that mainly occurred during the early Eocene. The field is comprised of three reservoirs, the Paleocene Heimdal and Hermod Formations and the Early Eocene Balder Formation. The sandstones, which have excellent reservoir properties, share a common pressure system and oil-water contact. This is probably related to the soft-sediment deformation and associated sand injections establishing cross-stratal communication.

  15. Exercise-induced arterial hypoxemia.

    PubMed

    Dempsey, J A; Wagner, P D

    1999-12-01

    Exercise-induced arterial hypoxemia (EIAH) at or near sea level is now recognized to occur in a significant number of fit, healthy subjects of both genders and of varying ages. Our review aims to define EIAH and to critically analyze what we currently understand, and do not understand, about its underlying mechanisms and its consequences to exercise performance. Based on the effects on maximal O(2) uptake of preventing EIAH, we suggest that mild EIAH be defined as an arterial O(2) saturation of 93-95% (or 3-4% arterial PO(2) difference (A-a DO(2)) (>25-30 Torr) and inadequate compensatory hyperventilation (arterial PCO(2) >35 Torr) commonly contribute to EIAH, as do acid- and temperature-induced shifts in O(2) dissociation at any given arterial PO(2). In turn, expiratory flow limitation presents a significant mechanical constraint to exercise hyperpnea, whereas ventilation-perfusion ratio maldistribution and diffusion limitation contribute about equally to the excessive A-a DO(2). Exactly how diffusion limitation is incurred or how ventilation-perfusion ratio becomes maldistributed with heavy exercise remains unknown and controversial. Hypotheses linked to extravascular lung water accumulation or inflammatory changes in the "silent" zone of the lung's peripheral airways are in the early stages of exploration. Indirect evidence suggests that an inadequate hyperventilatory response is attributable to feedback inhibition triggered by mechanical constraints and/or reduced sensitivity to existing stimuli; but these mechanisms cannot be verified without a sensitive measure of central neural respiratory motor output. Finally, EIAH has detrimental effects on maximal O(2) uptake, but we have not yet determined the cause or even precisely identified which organ system, involved directly or indirectly with O(2) transport to muscle, is responsible for this limitation. PMID:10601141

  16. External artery heat pipe

    NASA Technical Reports Server (NTRS)

    Gernert, Nelson J. (Inventor); Ernst, Donald M. (Inventor); Shaubach, Robert M. (Inventor)

    1989-01-01

    An improved heat pipe with an external artery. The longitudinal slot in the heat pipe wall which interconnects the heat pipe vapor space with the external artery is completely filled with sintered wick material and the wall of the external artery is also covered with sintered wick material. This added wick structure assures that the external artery will continue to feed liquid to the heat pipe evaporator even if a vapor bubble forms within and would otherwise block the liquid transport function of the external artery.

  17. Jet pump assisted artery

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A procedure for priming an arterial heat pump is reported; the procedure also has a means for maintaining the pump in a primed state. This concept utilizes a capillary driven jet pump to create the necessary suction to fill the artery. Basically, the jet pump consists of a venturi or nozzle-diffuser type constriction in the vapor passage. The throat of this venturi is connected to the artery. Thus vapor, gas, liquid, or a combination of the above is pumped continuously out of the artery. As a result, the artery is always filled with liquid and an adequate supply of working fluid is provided to the evaporator of the heat pipe.

  18. CT of coronary artery disease.

    PubMed

    Herzog, Christopher; Zangos, Stefan; Zwerner, Peter; Costello, Philip; Vogl, Thomas J; Schoepf, U Joseph

    2007-02-01

    The clinical relevance of coronary artery disease has considerably driven the recent development of radiologic tools for noninvasive cardiac imaging. Modern multidetector row computed tomographic (MDCT) systems combine high temporal and spatial resolution, electrocardiographic synchronization, and ease of use. In cardiac imaging, MDCT has not only replaced electron-beam CT, but also challenges competing methods such as magnetic resonance imaging, echocardiography, or even coronary catheterization. Noncontrast material-enhanced assessment of atherosclerotic plaques (CT calcium scoring) seems useful for the cardiac risk stratification in asymptomatic patients and monitoring of medical (statin) therapy. Contrast material-enhanced CT coronary angiography has become established as a valuable method for several clinical indications such as evaluation of coronary artery anomalies, bypass patency, or preoperative planning. Particularly, the high negative predictive value of a normal CT coronary angiogram allows reliable exclusion of coronary artery stenosis. Plaque characterization is another promising area of research in MDCT cardiac imaging. However, with current technology a reliable distinction between atheroma and fibroatheroma is impaired by restrictions in spatial resolution. Recent studies indicate that CT angiography may also be suited for other clinical applications such as triage of patients with acute coronary syndrome and inconclusive clinical presentation, patients with symptomatic chest pain, and intermediate risk profile or cardiac risk stratification in asymptomatic patients. PMID:17325575

  19. Enhanced G2 chromatid radiosensitivity, an early stage in the neoplastic transformation of human epidermal keratinocytes in culture

    SciTech Connect

    Gantt, R.; Sanford, K.K.; Parshad, R.; Price, F.M.; Peterson, W.D. Jr.; Rhim, J.S.

    1987-03-01

    A deficiency in DNA repair, manifest as enhanced chromatid radiosensitivity during the G2 phase of the cell cycle, together with a proliferative stimulus such as that provided by active oncogenes may be necessary and sufficient for the malignant neoplastic transformation of human keratinocytes in culture. Normal epidermal keratinocytes established as continuous cell lines by transfection with pSV3-neo or infection with adeno 12-SV40 hybrid virus developed enhanced G2 chromatid radiosensitivity after 18 passages in culture. In contrast to cells from primary or secondary culture, these cells could be transformed to malignant neoplastic cells by infection with Kirsten murine sarcoma virus containing the Ki-ras oncogene or in one line by the chemical carcinogen, N-methyl-N'-nitro-N-nitrosoguanidine; both of these agents produced a marked proliferative response. Cytological heterogeneity and karyotypic instability characterized the cells during their progression to neoplasia. These results are interpreted in terms of a mechanism for neoplastic transformation.

  20. Effect of Enhanced External Counterpulsation and Cardiac Rehabilitation on Quality of Life, Plasma Nitric Oxide, Endothelin 1 and High Sensitive CRP in Patients With Coronary Artery Disease: A Pilot Study

    PubMed Central

    Shakouri, Seyed Kazem; Razavi, Zeynab; Eslamian, Fariba; Sadeghi-Bazargani, Homayoun; Ghaffari, Samad

    2015-01-01

    Objective To investigate the effect of enhanced external counterpulsation (EECP) on plasma nitric oxide (NO), Endothelin 1 (ET1), high sensitive C-reactive protein (HSCRP) and quality of life (QoL) in patients with coronary artery disease (CAD). Methods We conducted a pilot randomized clinical trial in order to evaluate plasma NO, ET1, HSCRP and QoL before and after twenty sessions of EECP (group A) and cardiac rehabilitation (CR, group B) in 42 patients with CAD (21 in each group). Results Forty-two patients (33 male and 9 female) were included in the study. The mean age was 58.210 years. The mean HSCRP was 1.520.7 in the EECP group and it was reduced to 1.270.4 after intervention. The reduction in HSCRP was not statistically significant in EECP and CR groups with p=0.33 and p=0.27, respectively. There was not significant improvement of NO, ET1, and QoL in the EECP and CR groups shortly after therapy (p>0.05). Conclusion Although the short-term EECP treatment in CAD patients improved HSCRP, NO, ET1, and QoL compared with the baseline those improvements are not statistically significant. Further studies are necessary with large study groups and more sessions. PMID:25932415

  1. The natural course of traumatic myocardial infarction in a young patient with angiographically normal coronary arteries.

    PubMed

    Yang, Shi-Wei; Zhou, Yu-Jie; Guo, Zhen-Feng; Hu, Da-Yi

    2012-05-01

    A 23-year-old man with no history of heart disease was admitted to Beijing Anzhen Hospital Affiliated to Capital Medical University for an abnormal electrocardiogram of ST-T changes mimicking myocardial infarction. Catheterization revealed normal coronary and peripheral arteries. The echocardiogram and delayed enhancement cardiovascular magnetic resonance imaging indicated a markedly reduced left ventricular function and enlarged left ventricular cavity with evidence of fibrous tissue. Given the patient's history of multiple blunt trauma 7 years previously and acute myocardial infarction diagnosis at that time, he was diagnosed with traumatic myocardial infarction (TMI). We describe the natural course of such a patient with TMI. There is a possibility of spontaneous healing of coronary artery dissection induced by trauma. Although early revascularization may be helpful for preventing cardiac remodeling after TMI in some cases, more data are needed to compare the long-term outcome among different interventions in large sample cases. PMID:22014643

  2. [Role of endothelin in the hypertrophic remodeling of small arteries induced by exogenous norepinephrine].

    PubMed

    Dao, H H; McMartens, F; Zaor, A; de Champlain, J; Moreau, P

    1999-08-01

    In a subset of hypertensive patients, activity of the sympathetic nervous system (SNS) is enhanced. Hypertension is also associated with an adaptative process where small arteries (lumen < 300 microns) are subjected to structural changes (eutrophic or hypertrophic remodeling). Since, it has been shown that norepinephrine (NE) can induced proliferation of vascular smooth muscle cells, the purpose of the present study was to determine the effect of a chronic treatment with NE, mimicking hyperactivity of SNS, on small artery structure. The role of endothelin (ET) in the process was also evaluated. To achieve these goals, control rats were compared with rats receiving NE 2.5 micrograms/kg/min alone or in combination with LU135252 30 mg/kg/d (ET-receptor antagonist, affinity ETA/ETB approximately equal to 100) for 2 weeks. Blood pressure was measured intra-arterially in conscious rats prior to sacrifice. Geometric parameters of the basilar artery were determined in pressurized and perfused conditions with calcium free Krebs solution. Plasma NE and arterial mesenteric ET levels were determined by HPLC and RIA respectively. Blood pressured was not altered following exogenous administration of NE for 2 weeks. However, media thickness increased while the lumen diameter was reduced at the level of the basilar artery, leading to elevated media:lumen ratio (p < 0.05). This morphological alteration was associated with a significant augmentation of the basilar artery cross-sectional area (CSA). Co-administration of LU135252 with NE prevented partially the increase of M/L while the elevation of CSA was completely blunted. Plasma levels of NE were significantly and similarly elevated in groups receiving NE but, interestingly, mesenteric ET levels were not modified by any treatment. These results suggest that chronic NE administration induced an hypertrophic inward remodeling of small arteries independently from blood pressure, which required the participation of ET as an obligatory intermediate. Furthermore, the local production of ET is probably enhanced transiently in the first days of NE administration and come back to control level at 2 weeks. Thus, early therapy initiation with an ET-receptor antagonist prevents vascular remodeling in conditions of SNS hyperactivity, which may contribute to lower risks of end-organ damage. PMID:10486665

  3. Lessons from Animal Models of Arterial Aneurysm

    PubMed Central

    Gertz, S. David; Mintz, Yoav; Beeri, Ronen; Rubinstein, Chen; Gilon, Dan; Gavish, Leah; Berlatzky, Yacov; Appelbaum, Liat; Gavish, Lilach

    2013-01-01

    We review the results from the most common animal models of arterial aneurysm, including recent findings from our novel, laparoscopy-based pig model of abdominal aortic aneurysm, that contribute important insights into early pathogenesis. We emphasize the relevance of these findings for evaluation of treatment protocols and novel device prototypes for mechanism-based prevention of progression and rupture. PMID:26798701

  4. Vitamin A supplementation enhances Senegalese sole (Solea senegalensis) early juvenile's immunocompetence: New insights on potential underlying pathways.

    PubMed

    Fernndez, Ignacio; Lpez-Joven, Carmen; Andree, Karl B; Roque, Ana; Gisbert, Enric

    2015-10-01

    Senegalese sole (Solea senegalensis) has been considered since the 1990's to be a promising flatfish species for diversifying European marine aquaculture. However, pathogen outbreaks leading to high mortality rates can impair Senegalese sole commercial production at the weaning phase. Different approaches have been shown to improve fish immunocompetence; with this in mind the objective of the work described herein was to determine whether increased levels of dietary vitamin A (VA) improve the immune response in early juveniles of Senegalese sole. For this purpose, Senegalese sole were reared and fed with Artemia metanauplii containing increased levels of VA (37,000; 44,666; 82,666 and 203,000 total VA IU Kg(-1)) from 6 to 60 days post-hatch (early juvenile stage). After an induced bacterial infection with a 50% lethal dose of Photobacterium damselae subsp. damselae, survival rate, as well as underlying gene expression of specific immune markers (C1inh, C3, C9, Lgals1, Hamp, LysC, Prdx1, Steap4 and Transf) were evaluated. Results showed that fish fed higher doses of dietary VA were more resistant to the bacterial challenge. The lower mortality was found to be related with differential expression of genes involved in the complement system and iron availability. We suggest that feeding metamorphosed Senegalese sole with 203,000 total VA IU Kg(-1) might be an effective, inexpensive and environmentally friendly method to improve Senegalese sole immunocompetence, thereby improving survival of juveniles and reducing economic losses. PMID:26272637

  5. Magnetic treatment of irrigation water and snow pea and chickpea seeds enhances early growth and nutrient contents of seedlings.

    PubMed

    Grewal, Harsharn S; Maheshwari, Basant L

    2011-01-01

    The effects of magnetic treatment of irrigation water and snow pea (Pisum sativum L var. macrocarpon) and Kabuli chickpea (Cicer arietinum L) seeds on the emergence, early growth and nutrient contents of seedlings were investigated under glasshouse conditions. The treatments included (i) magnetic treatment of irrigation water (MTW), (ii) magnetic treatment of seeds (MTS), (iii) magnetic treatment of irrigation water and seeds (MTWS) and (iv) no magnetic treatment of irrigation water or seeds as control treatment. A magnetic treatment device with two permanent magnets (magnetic induction: 3.5-136 mT) was used for the above treatments. Seeds were sown in washed sand and seedlings were harvested at 20 days. The results showed that MTW led to a significant (P < 0.05) increase in emergence rate index (ERI; 42% for snow pea and 51% for chickpea), shoot dry weight (25% for snow pea and 20% for chickpea) and contents of N, K, Ca, Mg, S, Na, Zn, Fe and Mn in both seedling varieties compared to control seedlings. Likewise, there were significant increases in ERI (33% for snow peas and 37% for chickpea), shoot dry weight (11% for snow pea and 4% for chickpea) and some nutrients of snow pea and chickpea seedlings with MTS in comparison with the controls. The results of this study suggest that both MTW and MTS have the potential to improve the early seedling growth and nutrient contents of seedlings. PMID:20925062

  6. High-mobility group box 1 promotes early acute allograft rejection by enhancing IL-6-dependent Th17 alloreactive response.

    PubMed

    Duan, Lihua; Wang, Cong-Yi; Chen, Jie; Gong, Quan; Zhu, Ping; Zheng, Fang; Tan, Zheng; Gong, Feili; Fang, Min

    2011-01-01

    Previously, we reported that extracellular high-mobility group box 1 (HMGB1) functions as an innate alarmin implicated in cardiac allograft acute rejection. We now present evidence suggesting that HMGB1 is pivotal in inducing interleukin-17 (IL-17)-producing alloreactive T cells by stimulating dendritic cells secretion of IL-6. Those IL-17(+) T cells are likely to be the major effector cells responsible for the early stage of cardiac allograft rejection through mediating an influx of neutrophils into allografts, and therefore, blockade of IL-17A significantly prolonged murine cardiac allograft survival. In contrast to the classical model for a dominant role of IFN-?(+)-Th1 cells have in acute allograft rejection, our data suggest that IFN-?(+)-Th1 cells are responsible for the late stage of graft destruction by inducing monocyte infiltration when IL-17(+) T-cell response recedes. Blockade of HMGB1 significantly decreased splenic alloreactive Th17 cells and IFN-?-producing CD8(+) T cells in the recipients, leading to less infiltration of neutrophils along with lower IL-6 and IL-17 expression levels in the grafts as well as prolongation of cardiac allograft survival. Together, these data support a novel model in which HMGB1 induces IL-17-producing alloreactive T cells to mediate early stage of allograft rejection, whereas IFN-?-producing alloreactive Th1 cells provoke graft destruction after Th17 response recedes. PMID:20714327

  7. The 2014 Mw 6.0 Napa Earthquake, California: Observations from Real-time GPS-enhanced Earthquake Early Warning

    NASA Astrophysics Data System (ADS)

    Johanson, I. A.; Grapenthin, R.; Allen, R. M.

    2014-12-01

    Recently, progress has been made to demonstrate feasibility and benefits of including real-time GPS (rtGPS) in earthquake early warning and rapid response systems. While most concepts have yet to be integrated into operational environments, the Berkeley Seismological Laboratory is currently running an rtGPS based finite fault inversion scheme in true real-time, which is triggered by the seismic-based ShakeAlert system and then sends updated earthquake alerts to a test receiver. The Geodetic Alarm System (G-larmS) was online and responded to the 2014 Mw6.0 South Napa earthquake in California. We review G-larmS' performance during this event and for 13 aftershocks, and we present rtGPS observations and real-time modeling results for the main shock. The first distributed slip model and a magnitude estimate of Mw5.5 were available 24 s after the event origin time, which could be reduced to 14 s after a bug fix (~8 s S-wave travel time, ~6 s data latency). The system continued to re-estimate the magnitude once every second: it increased to Mw5.9 3 s after the first alert and stabilized at Mw5.8 after 15 s. G-larmS' solutions for the subsequent small magnitude aftershocks demonstrate that Mw~6.0 is the current limit for alert updates to contribute back to the seismic-based early warning system.

  8. The 2014 Mw 6.0 Napa earthquake, California: Observations from real-time GPS-enhanced earthquake early warning

    NASA Astrophysics Data System (ADS)

    Grapenthin, Ronni; Johanson, Ingrid; Allen, Richard M.

    2014-12-01

    Recently, progress has been made to demonstrate feasibility and benefits of including real-time GPS (rtGPS) in earthquake early warning and rapid response systems. Most concepts, however, have yet to be integrated into operational environments. The Berkeley Seismological Laboratory runs an rtGPS-based finite fault inversion scheme in real time. This system (G-larmS) detected the 2014 Mw 6.0 South Napa earthquake in California. We review G-larmS' performance during this event and 13 aftershocks and present rtGPS observations and real-time modeling results for the main shock. The first distributed slip model and magnitude estimates were available 24s after the event origin time, which, after optimizations, was reduced to 14s (?8s S wave travel time, ?6s data latency). G-larmS' solutions for the aftershocks (that had no measurable surface displacements) demonstrate that, in combination with the seismic early warning magnitude, Mw 6.0 is our current resolution limit.

  9. The Society of Thoracic Surgeons Clinical Practice Guidelines on Arterial Conduits for Coronary Artery Bypass Grafting.

    PubMed

    Aldea, Gabriel S; Bakaeen, Faisal G; Pal, Jay; Fremes, Stephen; Head, Stuart J; Sabik, Joseph; Rosengart, Todd; Kappetein, A Pieter; Thourani, Vinod H; Firestone, Scott; Mitchell, John D

    2016-02-01

    Internal thoracic arteries (ITAs) should be used to bypass the left anterior descending (LAD) artery when bypass of the LAD is indicated (class of recommendation [COR] I, level of evidence [LOE] B). As an adjunct to left internal thoracic artery (LITA), a second arterial graft (right ITA or radial artery [RA]) should be considered in appropriate patients (COR IIa, LOE B). Use of bilateral ITAs (BITAs) should be considered in patients who do not have an excessive risk of sternal complications (COR IIa, LOE B). To reduce the risk of sternal infection with BITA, skeletonized grafts should be considered (COR IIa, LOE B), smoking cessation is recommended (COR I, LOE C), glycemic control should be considered (COR IIa, LOE B), and enhanced sternal stabilization may be considered (COR IIb, LOE C). As an adjunct to LITA to LAD (or in patients with inadequate LITA grafts), use of a RA graft is reasonable when grafting coronary targets with severe stenoses (COR IIa, LOE: B). When RA grafts are used, it is reasonable to use pharmacologic agents to reduce acute intraoperative and perioperative spasm (COR IIa, LOE C). The right gastroepiploic artery may be considered in patients with poor conduit options or as an adjunct to more complete arterial revascularization (COR IIb, LOE B). Use of arterial grafts (specific targets, number, and type) should be a part of the discussion of the heart team in determining the optimal approach for each patient (COR I, LOE C). PMID:26680310

  10. Epidermal growth factor containing culture supernatant enhances intestine development of early-weaned pigs in vivo: potential mechanisms involved.

    PubMed

    Bedford, Andrea; Chen, Tao; Huynh, Evanna; Zhu, Cuilan; Medeiros, Samantha; Wey, Doug; de Lange, Cornelis; Li, Julang

    2015-02-20

    We have previously generated epidermal factor expressing Lactococcus lactis (EGF-LL) using a bioengineering approach, and shown that EGF-LL fermentation supernatant enhanced newly weaned pigs growth. The objective of the current study was to further understand the mechanisms behind this improved performance. Sixty-four piglets were weaned at 3 weeks of age and then fed ad libitum according to a 2-phase feeding program. Four pens with 8 pigs per pen were assigned to each of two treatments for 3 weeks: (1) EGF containing supernatant from EGF-LL culture (SuperEGF) or (2) blank M17GE media (Control). Consistent with previous findings, SuperEGF pigs had an increased average daily gain during week 3 post-weaning (433.4 10.86 vs 388.7 7.76 g; P<0.05) and overall gain:feed ratio (0.757 0.03 vs 0.677 0.01 kg/kg, P < 0.05). Moreover, jejunal structure development was enhanced, and inflammation index was minimized in SuperEGF pigs as indicated by increased villi height (P<0.05), decreased lamina propria width (P<0.05), and higher expression of anti-inflammatory cytokine, IL-13 (P<0.05). Further, goblet cell numbers and Muc2 levels were increased in SuperEGF pigs. Interestingly, the weaning-induced decrease of glucose cotransporter sodium-glucose linked transporter 1 (SGLT1) and glucagon-like peptide-2 (GLP2) levels was reversed by SuperEGF supplementation. Our findings add to our understanding of the mechanisms behind enhancing piglet performance by EGF containing fermentation product. PMID:25615942

  11. Estrogen and progesterone replacement therapy reduces low density lipoprotein accumulation in the coronary arteries of surgically postmenopausal cynomolgus monkeys.

    PubMed Central

    Wagner, J D; Clarkson, T B; St Clair, R W; Schwenke, D C; Shively, C A; Adams, M R

    1991-01-01

    The effect of estrogen and progesterone replacement therapy on the initiating events in atherogenesis was studied in surgically postmenopausal cynomolgus monkeys. Monkeys were ovariectomized and divided randomly into two groups, one receiving 17 beta-estradiol and cyclic progesterone treatment (n = 9) and ovariectomized controls receiving no hormone replacement therapy (n = 8). The monkeys were fed a moderately atherogenic diet for 18 wk to accelerate the early pathogenic processes but not to be of sufficient duration to produce grossly visible atherosclerotic lesions. Sex hormone replacement therapy decreased the accumulation of LDL and products of LDL degradation in the coronary arteries by greater than 70% while having no significant effect on plasma lipid, lipoprotein, or apoprotein concentrations. Arterial intimal lesions were small with no difference between groups. The reduction in arterial LDL metabolism occurred very early in the pathogenesis of atherosclerosis and was independent of indices of endothelial cell injury, such as enhanced endothelial cell turnover or leukocyte adhesion to the endothelium. Results of this study suggest that one mechanism by which sex hormone treatment inhibits the initiation of atherosclerosis is a direct effect at the level of the arterial wall by suppressing the uptake and/or degradation of LDL. Images PMID:1752958

  12. Trial participants experiences of early enhanced speech and language therapy after stroke compared with employed visitor support: a qualitative study nested within a randomized controlled trial

    PubMed Central

    Gomersall, Timothy; Bowen, Audrey

    2013-01-01

    Objectives: To explore trial participants experiences of the process and outcomes of early, enhanced speech and language therapy after stroke with support from an employed visitor. Design: Qualitative study nested within a randomized controlled trial. Participants: Twney-two people who, after stroke, had a diagnosis of aphasia (12), dysarthria (5) or both (5) and who participated in the ACT NoW study. Setting: Eight English NHS usual care settings. Method: Individual interviews. Thematic content analysis assisted by a bespoke data transformation protocol for incorporating non-verbal and semantically ambiguous data. Results: Participants highly regarded regular and sustained contact with someone outside of immediate family/friends who engaged them in deliberate activities/communication in the early months after stroke. Participants identified differences in the process of intervention between speech and language therapists and employed visitors. But no major discriminations were made between the impact or value of this contact according to whether provided by a speech and language therapist or employed visitor. Participant-defined criteria for effectiveness of contact included: impact on mood and confidence, self-recognition of progress and the meeting of individual needs. Conclusions: As in the randomized controlled trial, participants reported no evidence of added benefit of early communication therapy beyond that from attention control. The findings do not imply that regular contact with any non-professional can have beneficial effects for someone with aphasia or dysarthria in the early weeks following a stroke. The study points to specific conditions that would have to be met for contact to have a positive effect. PMID:22837542

  13. The Critical Role of Pulmonary Arterial Compliance in Pulmonary Hypertension.

    PubMed

    Thenappan, Thenappan; Prins, Kurt W; Pritzker, Marc R; Scandurra, John; Volmers, Karl; Weir, E Kenneth

    2016-02-01

    The normal pulmonary circulation is a low-pressure, high-compliance system. Pulmonary arterial compliance decreases in the presence of pulmonary hypertension because of increased extracellular matrix/collagen deposition in the pulmonary arteries. Loss of pulmonary arterial compliance has been consistently shown to be a predictor of increased mortality in patients with pulmonary hypertension, even more so than pulmonary vascular resistance in some studies. Decreased pulmonary arterial compliance causes premature reflection of waves from the distal pulmonary vasculature, leading to increased pulsatile right ventricular afterload and eventually right ventricular failure. Evidence suggests that decreased pulmonary arterial compliance is a cause rather than a consequence of distal small vessel proliferative vasculopathy. Pulmonary arterial compliance decreases early in the disease process even when pulmonary artery pressure and pulmonary vascular resistance are normal, potentially enabling early diagnosis of pulmonary vascular disease, especially in high-risk populations. With the recognition of the prognostic importance of pulmonary arterial compliance, its impact on right ventricular function, and its contributory role in the development and progression of distal small-vessel proliferative vasculopathy, pulmonary arterial compliance is an attractive target for the treatment of pulmonary hypertension. PMID:26848601

  14. Branched-chain amino acids increase arterial blood ammonia in spite of enhanced intrinsic muscle ammonia metabolism in patients with cirrhosis and healthy subjects.

    PubMed

    Dam, Gitte; Keiding, Susanne; Munk, Ole Lajord; Ott, Peter; Buhl, Mads; Vilstrup, Hendrik; Bak, Lasse Kristoffer; Waagepetersen, Helle Snderby; Schousboe, Arne; Mller, Niels; Srensen, Michael

    2011-08-01

    Branched-chain amino acids (BCAA) are used in attempts to reduce blood ammonia in patients with cirrhosis and intermittent hepatic encephalopathy based on the hypothesis that BCAA stimulate muscle ammonia detoxification. We studied the effects of an oral dose of BCAA on the skeletal muscle metabolism of ammonia and amino acids in 14 patients with cirrhosis and in 7 healthy subjects by combining [(13)N]ammonia positron emission tomography (PET) of the thigh muscle with measurements of blood flow and arteriovenous (A-V) concentrations of ammonia and amino acids. PET was used to measure the metabolism of blood-supplied ammonia and the A-V measurements were used to measure the total ammonia metabolism across the thigh muscle. After intake of BCAA, blood ammonia increased more than 30% in both groups of subjects (both P < 0.05). Muscle clearance of blood-supplied ammonia (PET) was unaffected (P = 0.75), but the metabolic removal rate (PET) increased significantly because of increased blood ammonia in both groups (all P < 0.05). The total ammonia clearance across the leg muscle (A-V) increased by more than 50% in both groups, and the flux (A-V) of ammonia increased by more than 45% (all P < 0.05). BCAA intake led to a massive glutamine release from the muscle (cirrhotic patients, P < 0.05; healthy subjects, P = 0.12). In conclusion, BCAA enhanced the intrinsic muscle metabolism of ammonia but not the metabolism of blood-supplied ammonia in both the patients with cirrhosis and in the healthy subjects. PMID:21636533

  15. Differences in histamine H1 and H2 receptor responses in several rabbit arteries

    SciTech Connect

    Robinson, C.P.; Maxson, S.

    1982-06-01

    Responses of helically cut segments from six different rabbit arteries to the selective histamine H1 receptor agonist 2-pyridylethylamine (PEA) and, in strips contracted by 10-4 M phenylephrine, to the selective histamine H2 agonist dimaprit have been determined. 10-3 M PEA contracted the renal artery, 96 +/- 2%; mesenteric artery, 92 +/- 2%; coeliac artery, 88 +/- 11% aorta 75 +/- 4%' ear artery 64 +/- 10% and pulmonary artery 48 +/- 5% of the maximal contraction to norepinephrine. 10-3 M dimaprit relaxed the phenylephrine contracted ear artery 48 +/- 8%; renal artery, 43 +/- 8%; coeliac artery 41 +/- 8%; mesenteric artery 36 +/- 5%; aorta 16 +/- 3%; and pulmonary artery 11 +/- 1% of the initial contractile tension. Strips in which histamine H1 receptors are blocked by 7 X 10-6 M mepyramine which are contracted by phenylephrine are partially relaxed by histamine. Cooling these strips markedly enhanced relaxations of the mesenteric and coeliac arteries but not those of the other four vessels. Exposure of the strips to dibenamine potentiated relaxations of all of the arteries except the ear artery and pulmonary artery. Thus there is heterogeneity among the arteries in their responses to histamine H1 and H2 receptor activation.

  16. Maternal Smoking History Enhances the Expression of Placental Growth Factor in Invasive Trophoblasts at Early Gestation Despite Cessation of Smoking

    PubMed Central

    Kawashima, Akihiro; Koide, Keiko; Hasegawa, Junichi; Arakaki, Tatsuya; Takenaka, Shin; Maruyama, Daisuke; Matsuoka, Ryu; Sekizawa, Akihiko

    2015-01-01

    Maternal smoking during early pregnancy is associated with a reduced risk for preeclampsia even after smoking cessation during pregnancy. Although the pathophysiology of preeclampsia has not been established, placental growth factor (PlGF) is believed to be a key factor. The aim of this study was to assess the effect of maternal smoking on the PlGF expression in invasive trophoblasts at early gestation. We collected villous tissues from women requesting surgical termination due to non-medical reasons at 7-8 weeks of gestation. The maternal smoking status was evaluated by measuring the serum cotinine level and patients were divided into two groups: active smokers and non-smokers. After separating invasive trophoblasts from villous tissues cultured initially under 2% O2 for 24 hours, the separated invasive trophoblasts were cultured under 2% or 8% O2 for 48 hours. The expression levels of the PlGF gene in villous tissue specimens and in invasive trophoblasts cultured after the conditions were quantified using qRT-PCR. The levels of PlGF protein in the medium were quantified using an ELISA. The gene expression level of PlGF in the villi in the active-smokers was significantly higher than that of the non-smokers. In comparison of the invasive trophoblasts under normoxia and oxygenated conditions, the ratio of PlGF gene expression and protein expression under oxygenation (2% O2+8% O2 / 2% O2+2% O2) in the active-smokers were both significantly higher than in the non-smokers. Maternal smoking history appears to stimulate PlGF expression in invasive trophoblasts under oxygenated conditions. This may be one of several causes leading to the protective effect of maternal smoking on preeclampsia. PMID:26214510

  17. Helical Carbon Nanotubes Enhance the Early Immune Response and Inhibit Macrophage-Mediated Phagocytosis of Pseudomonas aeruginosa

    PubMed Central

    Walling, Brent E.; Kuang, Zhizhou; Hao, Yonghua; Estrada, David; Wood, Joshua D.; Lian, Feifei; Miller, Lou Ann; Shah, Amish B.; Jeffries, Jayme L.; Haasch, Richard T.; Lyding, Joseph W.; Pop, Eric; Lau, Gee W.

    2013-01-01

    Aerosolized or aspirated manufactured carbon nanotubes have been shown to be cytotoxic, cause pulmonary lesions, and demonstrate immunomodulatory properties. CD-1 mice were used to assess pulmonary toxicity of helical carbon nanotubes (HCNTs) and alterations of the immune response to subsequent infection by Pseudomonas aeruginosa in mice. HCNTs provoked a mild inflammatory response following either a single exposure or 2X/week for three weeks (multiple exposures) but were not significantly toxic. Administering HCNTs 2X/week for three weeks resulted in pulmonary lesions including granulomas and goblet cell hyperplasia. Mice exposed to HCNTs and subsequently infected by P. aeruginosa demonstrated an enhanced inflammatory response to P. aeruginosa and phagocytosis by alveolar macrophages was inhibited. However, clearance of P. aeruginosa was not affected. HCNT exposed mice depleted of neutrophils were more effective in clearing P. aeruginosa compared to neutrophil-depleted control mice, accompanied by an influx of macrophages. Depletion of systemic macrophages resulted in slightly inhibited bacterial clearance by HCNT treated mice. Our data indicate that pulmonary exposure to HCNTs results in lesions similar to those caused by other nanotubes and pre-exposure to HCNTs inhibit alveolar macrophage phagocytosis of P. aeruginosa. However, clearance was not affected as exposure to HCNTs primed the immune system for an enhanced inflammatory response to pulmonary infection consisting of an influx of neutrophils and macrophages. PMID:24324555

  18. A rare marginal tentorial artery to ophthalmic artery anastomosis.

    PubMed

    Tonetti, Daniel A; Jadhav, Ashutosh P; Ducruet, Andrew F

    2015-04-01

    We report a patient with a marginal tentorial artery to ophthalmic artery anastomosis. A middle-aged man presented with subarachnoid hemorrhage and underwent angiography, where selective microcatheter injection of the meningohypophyseal trunk and marginal tentorial artery revealed a collateral to the distal ophthalmic artery. The radiological findings, embryology behind ophthalmic artery anastomoses and the neurosurgical and neurovascular relevance are discussed. PMID:25669118

  19. Targeted Deletion of FGL2 Leads to Increased Early Viral Replication and Enhanced Adaptive Immunity in a Murine Model of Acute Viral Hepatitis Caused by LCMV WE

    PubMed Central

    Khattar, Ramzi; Luft, Olga; Yavorska, Nataliya; Shalev, Itay; Phillips, M. James; Adeyi, Oyedele; Gao, Darrin; Bartczak, Agata; Urbanellis, Peter; Shyu, Wendy; Zhang, Jianhua; Manuel, Justin; Levy, Gary A.; Selzner, Nazia

    2013-01-01

    Mounting effective innate and adaptive immune responses are critical for viral clearance and the generation of long lasting immunity. It is known that production of inhibitory factors may result in the inability of the host to clear viruses, resulting in chronic viral persistence. Fibrinogen-like protein 2 (FGL2) has been identified as a novel effector molecule of CD4+CD25+ Foxp3+ regulatory T (Treg) cells that inhibits immune activity by binding to FC?RIIB expressed primarily on antigen presenting cells (APC). In this study, we show that infection of mice with Lymphocytic Choriomeningitis Virus WE (LCMV WE) leads to increased plasma levels of FGL2, which were detected as early as 2 days post-infection (pi) and persisted until day 50 pi. Mice deficient in FGL2 (fgl2?/?) had increased viral titers of LCMV WE in the liver early p.i but cleared the virus by day 12 similar to wild type mice. Dendritic cells (DC) isolated from the spleens of LCMV WE infected fgl2?/? had increased expression of the DC maturation markers CD80 and MHC Class II compared to wild type (fgl2+/+). Frequencies of CD8+ and CD4+ T cells producing IFN? in response to ex vivo peptide re-stimulation isolated from the spleen and lymph nodes were also increased in LCMV WE infected fgl2 ?/? mice. Increased frequencies of CD8+ T cells specific for LCMV tetramers GP33 and NP396 were detected within the liver of fgl2?/? mice. Plasma from fgl2?/? mice contained higher titers of total and neutralizing anti-LCMV antibody. Enhanced anti-viral immunity in fgl2?/? mice was associated with increased levels of serum alanine transaminase (ALT), hepatic necrosis and inflammation following LCMV WE infection. These data demonstrate that targeting FGL2 leads to early increased viral replication but enhanced anti-viral adaptive T & B cell responses. Targeting FGL2 may enhance the efficacy of current anti-viral therapies for hepatotropic viruses. PMID:24146739

  20. Growing collateral arteries on demand.

    PubMed

    Oh, Charles C; Klein, Jason D; Migrino, Raymond Q; Thornburg, Kent L

    2011-09-01

    Recent studies have significantly advanced our understanding of arteriogenesis, raising hope that therapies to increase collateral arterial formation may become important new tools in the treatment of ischemic disease. The most important initiating trigger for arteriogenesis is the marked increase in shear stress which is sensed by the endothelium and leads to characteristic changes. Intracellularly, it was shown that platelet endothelial cell adhesion molecule (PECAM-1) becomes tyrosine-phosphorylated in response to increased shear stress, suggesting a role as a possible mechanoreceptor for dynamic and continual monitoring of shear stress. The signal generated by PECAM-1 leads to the activation of the Rho pathway among others. More than 40 genes have been shown to have a shear stress responsive element. The Rho pathway is activated early and appears to be essential to the arteriogenic response as inhibiting it abolished the effect of fluid shear stress. Overexpression of a Rho pathway member, Actin-binding Rho protein (Abra), led to a 60% increase in collateral perfusion over simple femoral artery occlusion. A patent for the Abra gene has been filed recently. It may be a harbinger of a future where collateral arteries grown on demand may become an effective treatment for ischemic vascular disease. PMID:21861827