Clinical Hemorheology and Microcirculation - Volume 82, issue 1

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

Article Type: Research Article

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

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

DOI: 10.3233/CH-211201

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 1-12, 2022

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

Article Type: Research Article

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

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

DOI: 10.3233/CH-221395

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 13-26, 2022

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

Article Type: Research Article

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

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

DOI: 10.3233/CH-221479

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 27-35, 2022

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

Article Type: Research Article

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

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

DOI: 10.3233/CH-221380

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 37-51, 2022

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

Article Type: Research Article

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

Keywords: Shear wave elastography, breast, ultrasound

DOI: 10.3233/CH-221471

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 53-62, 2022

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

Article Type: Research Article

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

Keywords: Contrast-enhanced imaging, abdominal wall endometriosis, microwave ablation

DOI: 10.3233/CH-211287

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 63-73, 2022

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

Article Type: Research Article

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

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

DOI: 10.3233/CH-211357

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 75-83, 2022

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

Article Type: Research Article

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

Keywords: Liver metastases, Breast cancer, contrast-enhanced ultrasound, Fusion imaging, thermal ablation

DOI: 10.3233/CH-221413

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 85-93, 2022

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

Article Type: Research Article

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

Keywords: Biliary cystadenocarcinoma, microwave ablation, cryoablation, sclerotherapy

DOI: 10.3233/CH-221466

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 95-105, 2022