Clinical Hemorheology and Microcirculation - Volume 67, issue 2

Authors: Xia, Jia-Jing | Li, Meng-Sen | Zheng, Li | Shi, You-Zhen

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate whether thyroid nodule depth and other ultrasound features can predict nondiagnostic cytological results on ultrasound-guided fine needle aspiration. MATERIAL AND METHODS: This retrospective study included 412 thyroid nodules that underwent ultrasound-guided fine needle aspiration from 2014 to 2015. The nodules were classified as nondiagnostic and diagnostic by the cytopathological results. Clinical information of the patients (ie., age, sex) and ultrasound features (ie., size, depth, calcification, cystic content, vascularity) of the nodules were recorded and compared between the nondiagnostic group and diagnostic group. RESULTS: Age and sex were not significantly different between the nondiagnostic …group and diagnostic group (P  > 0.05). Nodule depth >15 mm (OR, 7.128; P  < 0.001), peripheral rim calcification (OR, 5.725; P  = 0.01) and cystic content >50% (OR, 2.995; P  = 0.018) were factors for the nondiagnostic ultrasound-guided fine needle aspiration cytopathological results. Macrocalcification in the nodule sized 5–10 mm was associated with the nondiagnostic results (P  = 0.04). Nodule size and vascularity were not associated with the nondiagnostic results (P  > 0.05). CONCLUSIONS: Nodule depth >15 mm, peripheral rim calcification and cystic content >50% were three independent predictors of the nondiagnostic cytopathological results. Macrocalcification in the nodule sized 5–10 mm was also associated with the nondiagnostic results. Show more

Keywords: Ultrasound-guided fine needle aspiration, thyroid nodules, nondiagnostic cytopathology

DOI: 10.3233/CH-170283

Citation: Clinical Hemorheology and Microcirculation, vol. 67, no. 2, pp. 115-124, 2017

Authors: Koch, Matthias | Ehrenreich, Tobias | Koehl, Gudrun | Pattappa, Girish | Pfeifer, Christian | Loibl, Markus | Müller, Michael | Nerlich, Michael | Angele, Peter | Zellner, Johannes

Article Type: Research Article

Abstract: BACKGROUND: Meniscus regeneration is observed within the peripheral, vascularized zone but decreases in the inner two thirds alongside the vascularization. Within this avascular area, cell-based tissue-engineering-approaches appear to be a promising strategy for the treatment of meniscal defects. OBJECTIVE: Evaluation of the angiogenic potential of cell-based tissue-engineering-products for meniscus healing. METHODS: Evaluation of angiogenesis induced by rabbit meniscus-pellets, meniscus-cells (MC) or mesenchymal stem-cells (MSC) in cell-based tissue-engineering-products within a rabbit meniscus-ring was performed using a transparent dorsal skin fold chamber in nude mice. Observations were undertaken during a 14 days period. Cell preconditioning differed between experimental …groups. Immunohistochemical analysis of the regenerated tissue in the meniscus-ring induced by cell loaded composite scaffolds for differentiation and anti-angiogenic factors were performed. RESULTS: Meniscus-pellets and MSC-/MC-based tissue-engineering-products induced angiogenesis. An accelerated vascularization was detected in the group of meniscus-pellets derived from the vascularized zone compared to avascular meniscus-pellets. In terms of cell-based tissue-engineering-products, chondrogenic preconditioning resulted in significantly increased vessel growth. MSC-constructs showed an accelerated angiogenesis. Immunohistochemical evaluation showed a progressive differentiation and lower content for anti-angiogenic endostatin in the precultured group. CONCLUSIONS: Preconditioning of MC-/MSC-based tissue-engineering-products is a promising tool to influence the angiogenic potential of tissue-engineering-products and to adapt these properties according to the aimed tissue qualities. Show more

Keywords: Angiogenesis, meniscus, meniscus vascularization, meniscus regeneration

DOI: 10.3233/CH-17085

Citation: Clinical Hemorheology and Microcirculation, vol. 67, no. 2, pp. 125-140, 2017

Authors: Lemonne, Nathalie | Möckesch, Berenike | Charlot, Keyne | Garnier, Yohann | Waltz, Xavier | Lamarre, Yann | Antoine-Jonville, Sophie | Etienne-Julan, Maryse | Hardy-Dessources, Marie-Dominique | Romana, Marc | Connes, Philippe

Article Type: Research Article

Abstract: The aim of the present study was to test the effects of hydroxyurea (HU) therapy on clinical, hematological and hemorheological parameters in adult patients with sickle cell anemia (SCA). Hematological and hemorheological parameters were measured in 28 SCA patients before HU therapy (i.e., baseline) and at 6, 12 and 24 months of treatment. RBC deformability was determined by ektacytometry at 30 Pa. RBC aggregation properties were investigated by light-backscatter method. Blood viscosity was measured at 225 s–1 by a cone-plate viscometer. The rates of vaso-occlusive crises and acute chest syndrome were lower at 1 and 2 years of HU therapy compared …to baseline. The proportion of patients with leg ulcers tended to decrease after 2 years of treatment. Hemoglobin oxygen saturation improved with HU therapy. HU therapy induced a decrease of platelet and white blood cell counts and a rise in fetal hemoglobin level and mean cell volume. While hemoglobin concentrations increased under HU, blood viscosity remained unchanged all along the study. RBC deformability increased over baseline values at 6 months of HU therapy and continued to rise until the end of the follow-up period. In conclusion, the improvement in RBC deformability probably compensates the increase of hemoglobin on blood viscosity and participates to the improvement of the clinical status of patients. Show more

Keywords: Hydroxyurea, blood rheology, sickle cell disease, clinical severity

DOI: 10.3233/CH-170280

Citation: Clinical Hemorheology and Microcirculation, vol. 67, no. 2, pp. 141-148, 2017

Authors: Zheng, Zhifang | Wan, Yu | Liu, Yishu | Zhu, Lulu | Tang, Jianbing | Huang, Wenhua | Cheng, Biao

Article Type: Research Article

Abstract: BACKGROUND: Sympathetic denervation and impaired angiogenesis cause skin diseases. However, the relationship between the sympathetic nervous system and vascular cell turnover in normal skin remains unclear. OBJECTIVE: To determine the effects of sympathetic denervation on vascular cell turnover in normal skin. METHODS: Rats underwent bilateral L2–4 sympathetic trunk resection (sympathectomy group) or sham operation (control). Hindfoot plantar skin was analyzed 2 weeks and 3 months postoperatively. RESULTS: Mural cell marker (α-smooth muscle actin; p  < 0.001, and desmin; p  = 0.047) expression decreased 2 weeks after sympathectomy, but recovered 3 months after sympathectomy (p  > 0.05). CD31 …levels were lower in the experimental group than in the control group at 2 weeks (p  = 0.009), but not at 3 months. Von Willebrand factor, vascular endothelial growth factor, and angiopoietin-2 expression were not significantly different between the groups (p  > 0.05). Angiopoietin-1 expression levels were higher in the experimental group than in the control group at 2 weeks (p  = 0.035), but not at 3 months. CONCLUSIONS: Lumbar sympathectomy regulates vascular cell turnover in rat hindfoot plantar skin by inhibiting mural cell proliferation and increasing angiopoietin-1 expression. Sympathetic nerves therefore play an important role in plantar skin vascular cell turnover. Show more

Keywords: Vascular cell turnover, angiopoietin-1, mural cells, skin, sympathectomy

DOI: 10.3233/CH-170257

Citation: Clinical Hemorheology and Microcirculation, vol. 67, no. 2, pp. 149-157, 2017

Authors: Majumdar, Suvankar | Patil, Chetan N. | Ladner-Threadgill, Tammy | Randolph, Erica | Burgreen, Greg W. | Kermode, John C.

Article Type: Research Article

Abstract: BACKGROUND: Interaction of von Willebrand factor (VWF) with circulating platelets is the trigger for thrombosis in a region of arterial stenosis. These events are typically studied in vitro under conditions where platelets adhere to a VWF-coated surface. Our approach assesses platelet responses in the absence of adhesion. OBJECTIVE: To characterize extent of platelet activation and erythrocyte lysis in an artificial stenosis model. METHODS: Whole blood is perfused through a length of polyetheretherketone tubing that includes an artificial stenosis, comprising narrow-bore (89–381 μm) tubing. Secretion of [14 C] serotonin and hemoglobin release was measured to evaluate …platelet activation and hemolysis respectively at various perfusion rates and different stenosis dimensions. RESULTS: Platelet activation and erythrocyte lysis increased progressively with increasing perfusion rate and decreasing stenosis diameter; the length of the stenosis had negligible influence. Modest platelet activation (5–10% secretion of [14 C] serotonin) occurred without significant erythrocyte lysis under a limited range of perfusion conditions (4–6 mL/min flow through a 127 μm stenosis). CONCLUSIONS: Our experimental approach mimics conditions in severe arterial stenosis or a mechanical heart valve. It could be a valuable aid in the development of novel drugs to treat arterial thrombosis and in the design of heart valves. Show more

Keywords: Arterial stenosis, erythrocyte, platelet, shear stress, thrombosis

DOI: 10.3233/CH-170256

Citation: Clinical Hemorheology and Microcirculation, vol. 67, no. 2, pp. 159-172, 2017

Authors: Han, Xinxiao | Li, Hongyi | Hua, Wenda | Dai, Luru | Ao, Zhuo | Liao, Fulong | Han, Dong

Article Type: Research Article

Abstract: BACKGROUND: Tissue channels as a part of microcirculation system have been proposed over three decades, playing an important role in fluid transportation as reported. Adventitia of inferior vena cava (IVC) is a typical hierarchical porous media with abundant tissue channels. Its fluid transportation behaviors attract massive research interest. However, the mechanism of the driving force and microstructure was lack of deep research. OBJECTIVE: This study was to investigate the microstructural basis of fluid transportation within inferior vena cava (IVC). METHODS: Rat IVC samples were extracted and fixed on a gelatin substrate. Four samples were …randomly used as 4 cases: Case 1 with AFM loading and the fluorescent tracer adding; Case 2 with fluorescent tracer adding only; Case 3 with AFM loading only as the control group; Case 4 with no treatment. The movement of fluorescent tracer was observed by two-photon fluorescent microscope and analyzed by self-made Matlab program. The microscopic structure was characterized by high resolution TEM. RESULTS: The fluorescent tracer in Case 1 exhibited faster and longer transportation comparing to other cases, while in Case 2 diffused normally following Fick’s law. Case 3 with only AFM loading demonstrated that collagen bundles twisting along the fluid orientation, while the bundles in Case 4 with no treatment were straggling. The brush-like macromolecule structure of collagen microfibril was found on the bundle surfaces under TEM. CONCLUSIONS: Transportation within loose connective tissues is observed ex vivo . AFM loading, as the mechanical stimulation resemblance to muscle constrictions and blood pulsations, can facilitate the transportation as the driving force. The brush-like glycosaminoglycan macromolecules on the surfaces of the collagen bundles can be considered as a type of hierarchical porous media, which might form the transport pathway for fluids. The possible mechanism was conducted regarding the conformation of the superficial macromolecule brushes. Show more

Keywords: Tissue channels, loose connective tissue, fluid transportation, periodic press, atomic force microscopy

DOI: 10.3233/CH-170284

Citation: Clinical Hemorheology and Microcirculation, vol. 67, no. 2, pp. 173-182, 2017

Authors: Lang, Siegmund | Herrmann, Marietta | Pfeifer, Christian | Brockhoff, Gero | Zellner, Johannes | Nerlich, Michael | Angele, Peter | Prantl, Lukas | Gehmert, Sebastian | Loibl, Markus

Article Type: Research Article

Abstract: BACKGROUND: Platelet-rich Plasma (PRP) is suggested as xenoprotein-free cell-culture medium replacement for animal-derived supplements. OBJECTIVE: The aim of this study was to investigate PRP-triggered signaling in adipose derived mesenchymal stem cells (ASCs). METHODS: PRP was obtained from 4 male patients. We incubated ASCs in α -MEM with different Platelet derived growth factor (PDGF) subtypes or 10% or 20% pooled PRP or 20% fetal calf serum (FCS) prior to determination of the S-phase fraction (SPF). To investigate the influence of PDGF signaling on ASCs, PDGF receptor β inhibitor was added, and protein expression of ASCs was measured. …RESULTS: ASCs exposed to 20% PRP, PDGF-AB and – BB demonstrated significant higher SPF in comparison to PDGF-AA and 20% FCS after 48 hours (all P  < 0.05). PDGF receptor β inhibition diminished the PRP-induced SPF increase of ASCs significantly after 48 hours (P  < 0.01). ASCs with PDGF receptor β inhibition showed significant higher PDGF receptor β and significant lower c-MYC expression compared to untreated cells in presence of 20% PRP after 48 hours (both P  < 0.05). CONCLUSIONS: The proliferation promoting effect of PRP on ASCs is mediated by PDGF signaling and is associated with c-MYC overexpression. Show more

Keywords: Platelet-rich Plasma, mesenchymal stem cells, PDGF receptor β inhibition, proliferation, cell culture

DOI: 10.3233/CH-170246

Citation: Clinical Hemorheology and Microcirculation, vol. 67, no. 2, pp. 183-196, 2017

Authors: Kim, Doosang | Cho, Daniel J. | Cho, Young I.

Article Type: Research Article

Abstract: AIMS: Critical limb ischemia (CLI) patients are characterized by intractable pain in spite of medication, non-healing ulcers, and gangrene. The objective of this study was to investigate whether or not isovolemic hemodilution treatment can reduce the rate of major amputations in CLI. METHODS: 28 patients were studied who had tissue loss on Rutherford Grade III, Category 5 or 6. The subjects were divided into two arms: standard-of-care, conventional therapy (CT) (n  = 15) as a control group and hemodilution therapy (HT) (n  = 13) as a study group. For the HT group, weekly isovolemic hemodilution was performed over 4 consecutive …weeks, removing 250 ml of whole blood with the infusion of hydroxyl-ethyl starch solution. Blood viscosity, hematocrit, hemoglobin, ankle-brachial index, VA pain scale, time-to-amputation from admission, and survival time were measured. RESULTS: The mean Hct gradually decreased from 36.6 to 35.1, whereas the WBV at a shear rate of 1 s–1 significantly decreased from 18.2 to 10.5 during the same period. Subsequently, tissue oxygen delivery index, defined as the ratio of Hct to WBV at a shear rate of 1 s–1 , increased from 24.4 to 37.0 by 51.7%, suggesting improvements in oxygen delivery in the patients. The average rate of lower limb major amputation in the control group was 93% (14/15), whereas that in the study group was 31% (4/13) (p  = 0.001). Amputation-free median survival time and amputation-free 5-year survival rate in the control group were 1.2 months and 7%, while those in the study group were 30.2 months and 44% (p  = 0.001). There were no adverse effects from repetitive hemodilution in the study group. CONCLUSIONS: Isovolemic hemodilution treatment of CLI patients was found to be well-tolerated and reduced the rate of major amputation resulting from the deterioration of CLI. Show more

Keywords: Isovolemic hemodilution, critical limb ischemia, hemorheology, blood viscosity, tissue oxygen delivery index

DOI: 10.3233/CH-120108

Citation: Clinical Hemorheology and Microcirculation, vol. 67, no. 2, pp. 197-208, 2017