Clinical Hemorheology and Microcirculation - Volume 77, issue 2

Authors: Zhong, Li-Chang | Yang, Tian | Gu, Li-Ping | Ma, Fang

Article Type: Research Article

Abstract: PURPOSE: To evaluate the diagnostic value of shear wave velocity (SWV) ratio for the differential diagnosis of benign and malignant breast lesions. MATERIAL AND METHODS: Our retrospective study included 151 breast lesions that were diagnosed by biopsy and surgical pathology. All of the breast lesions were detected by conventional ultrasound and Virtual Touch tissue quantification (VTQ) and mammography. The sonographic characteristics of the breast lesion, such as the internal echo, shape, margin, color flow, and calcification so on, were also observed. The SWV in lesions and surrounding parenchyma were measured and the SWV ratio between the lesion and …surrounding parenchyma was calculated. Pathological results were used as a diagnosis standard to compare the value of SWV ratio, VTQ, and mammography in the diagnosis of benign and malignant breast lesions. RESULTS: The 151 breast lesions included 96 benign lesions and 55 malignant lesions. The cutoff value of VTQ in the diagnosis of benign and malignant breast lesions was 5.01 m/s, of SWV ratio was 2.43, and mammography was BI-RADS 4B. The sensitivity, specificity, accuracy and the area under the ROC curve (AUC) of the SWV ratio were 78.2%, 86.5%, 83.4%, and 0.83 respectively. While of SWV ratio with mammography was 86.4%, 89.4%, 88.3% and 0.87, respectively. The sensitivity, specificity, accuracy, and AUC of SWV ratio and SWV ratio with mammography were statistically higher than those of mammography, no statistically higher than VTQ and VTQ with mammography. CONCLUSION: The SWV ratio can improve the sensitivity without sacrificing diagnostic specificity in the process of breast cancer diagnostic, provide a better diagnostic performance, and avoid unnecessary biopsy or surgery. Show more

Keywords: Breast cancer, virtual touch tissue quantification, SWV ratio, mammography

DOI: 10.3233/CH-200813

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 123-131, 2021

Authors: Yurtdaş, Mustafa | Asoğlu, Ramazan | Özaydın, Adnan | Doğan, Zeki

Article Type: Research Article

Abstract: BACKGROUND: Inflammation has an important role in the pathogenesis of atherosclerosis. Lymphocyte-to-monocyte ratio (LMR) is accepted as an indicator of inflammation. OBJECTIVE: Our aim was to scrutinize the relationship between LMR and subclinical atherosclerosis (SubAth) measured by carotid intima-media thickness (CIMT) in subclinical hypothyroidism (SubHT). METHODS: Newly identified 190 SubHT patients were prospectively included into the study. Blood samples were taken for measuring laboratory parameters. Then, CIMT was computed. Patients were seperated into 2 groups by their CIMT value (Group-1: ≤0.9 and Group-2: >0.9 mm), and then stratified into tertiles pursuant to LMR and thyroid-stimulating hormone (TSH) …levels, respectively. RESULTS: 59 patients had an increased CIMT value (Group-2), and 131 patients had a normal CIMT value (Group-1). Group-2 had a lower LMR and a greater high-sensitivity C-reactive protein (hsCRP), CIMT and TSH than Group-1 (for all, p  < 0.05). Patients in the lowest tertile of LMR had a higher hsCRP, TSH and CIMT than those in the highest tertile (for all, p  < 0.05). LMR was negatively associated with hsCRP, CIMT and TSH (for all, p  < 0.05). LMR and TSH were independent predictors of increased CIMT. CONCLUSIONS: Pre-ultrasonographic LMR, which is a simple and inexpensive inflammatory marker, may give additional predictive information to determine SubAth in SubHT. Show more

Keywords: Lymphocyte-to-monocyte ratio, carotid intima-media thickness, subclinical atherosclerosis, inflammation, subclinical hypothyroidism

DOI: 10.3233/CH-200820

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 133-142, 2021

Authors: Lian, Kai-Mei | Lin, Teng

Article Type: Research Article

Abstract: Purpose: The value of virtual touch tissue imaging (VTI) with support of Image-Pro Plus (IPP) for diagnosing malignant thyroid tumors was assessed in the present study. Methods: In this retrospective study, we enrolled 160 patients with 198 thyroid nodules. TI-RADS, VTI grade, and VTI with support of IPP (VTI-IPP) were underwent for each nodule. With the pathological diagnosis as the gold standard, the receiver-operating characteristic curve (ROC) was drawn to evaluate the diagnostic performance of VTI-IPP, VTI, TI-RADS, VTI-IPP combinate with TI-RADS in thyroid carcinoma. Results: VTI-IPP score >2, VTI score >3, TI-RADS score >1, and …VTI-IPP combine with TI-RADS score >4 expressed the highest diagnostic value for malignant thyroid nodules, the areas under the curve (AUC) were 0.939, 0.905, 0.925, and 0.967, respectively. The combination indicated the largest AUC, compared with VTI-IPP and TI-RADS, respectively (P  = 0.0054 and 0.0009). The performance of VTI-IPP in diagnosing thyroid carcinomas was better than VTI (P  = 0.0321). Conclusion: Compare with VTI, VTI-IPP exhibited more excellent value in distinguishing between benign and malignant thyroid nodules. The value of malignant thyroid nodules diagnosis can be improved when VTI-IPP combines with TI-RADS. Show more

Keywords: Thyroid nodules, virtual touch tissue image, thyroid imaging reporting and data system, Image-Pro Plus

DOI: 10.3233/CH-200983

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 143-151, 2021

Authors: Shen, Zijian | Li, Haigang

Article Type: Research Article

Abstract: BACKGROUND: Long non-coding RNAs (lncRNAs) are found to involve in modulating the development of atherosclerosis (AS). But the molecular mechanism of lncRNA growth-arrest specific transcript 5 (GAS5) in AS is not fully understood. METHODS: QRT-PCR was performed to measure the abundances of GAS5, miR-128-3p and fibulin 2 (FBLN2). Oxidized low-density lipoprotein (ox-LDL)-treated THP-1 cells were employed as cell models of AS. The cell proliferation and apoptosis were analyzed using CCK-8 and Flow cytometry assays, respectively. Levels of all protein were examined by western blot. The interaction among GAS5, miR-128-3p and FBLN2 was confirmed via dual-luciferase reporter and RNA …immunoprecipitation (RIP) assays. RESULTS: GAS5 was elevated and miR-128-3p was decreased in the serum of patients with AS and ox-LDL-stimulated THP-1 cells. Ox-LDL stimulation inhibited proliferation and induced apoptosis of THP-1 cells. Meanwhile, GAS5 directly targeted miR-128-3p and inversely modulated its expression. Importantly, GAS5 depletion facilitated cell proliferation and impaired apoptosis in ox-LDL-induced THP-1 cells. Additionally, GAS5 augmented FBLN2 expression through sponging miR-128-3p, and miR-128-3p facilitated proliferation and retarded apoptosis of ox-LDL-induced THP-1 cells by targeting FBLN2. CONCLUSION: GAS5 knockdown promoted the growth of ox-LDL-induced THP-1 cells through down-modulating FBLN2 and increasing miR-128-3p, suggesting the potential value of GAS5 for treatment of AS. Show more

Keywords: Atherosclerosis, ox-LDL, lncRNA GAS5, miR-128-3p, FBLN2

DOI: 10.3233/CH-200897

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 153-164, 2021

Authors: Zhang, Hui-Li | Meng, Hong-Bo | Li, Xiao-Long | Sun, Li-Ping | Lu, Feng | Xu, Hui-Xiong | Yu, Song-Yuan

Article Type: Research Article

Abstract: We described a patient with symptomatic giant hepatic hemangioma (GHH) treated with laparoscopic guided percutaneous microwave ablation (MWA). A 58 years’ old woman was referred to our hospital who presented with upper abdominal distension and appetite loss for more than 1 year. The medical history included untreated multiple hepatic hemangiomas (HH) that had been detected 13 years ago and hypertension for more than 12 years. Initial laboratory tests revealed D-dimer mild increase and negative tumor markers. Magnetic resonance (MR) imaging demonstrated multiple nodules of different sizes in the liver and the largest lesion was located on the left lobe (longest …diameter 12.8 cm), which replaced the whole enlarged left lobe and compressed the gastric body and inferior vena cava. Contrast-enhanced ultrasound (CEUS) and contrast-enhanced MR imaging both showed the typical enhancement pattern of hemangioma and abnormal perfusion was seen in the surrounding liver parenchyma. With the laparoscopy guidance, we performed microwave ablation till the whole tumor was seen atrophy. The total operation duration was 2 hours, with intra-operative blood loss less than 20 ml. The post-operative course was uneventful. The patient was discharged 3 days after the operation. Abdominal distension decreased, appetite improved, blood pressure controlled at normal level after the operation. MR revealed significant volume reduction of the tumor after the operation. Show more

DOI: 10.3233/CH-200922

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 165-171, 2021

Authors: Shao, Sihui | Yao, Minghua | Li, Xin | Li, Chunxiao | Chen, Jing | Li, Gang | Jia, Chao | Wu, Rong

Article Type: Research Article

Abstract: OBJECTIVES: To evaluate the efficacy of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in differential diagnosis of sclerosing adenosis (SA) from malignance and investigate the correlated features with pathology. METHODS: We retrospectively enrolled 103 pathologically confirmed SA. All lesions were evaluated with conventional US while 31 lesions with CEUS. Lesions were divided into SA with or without benign lesions (Group 1, n  = 81) and SA with malignancy (Group 2, n  = 22). Performance of two methods were analyzed. The ultrasonographic characteristics were compared between two groups with Student’s t -test for measurement and chi-squared or Fisher’s exact test for …count data. RESULTS: There were 22 lesions complicated with malignancy, and the mean age of Group 2 was higher than Group 1 (55.27 vs. 41.57, p  < 0.001). The sensitivity, specificity and accuracy of conventional US and CEUS were 95.45%, 46.91%, 57.28% and 100%, 62.5%, 70.97%. Angularity (p  < 0.001), spicules (p  = 0.023), calcification (p  = 0.026) and enlarged scope (p  = 0.012) or crab claw-like enhancement (p  = 0.008) in CEUS were more frequent detected in SA with malignancy. CONCLUSIONS: Though CEUS showed an improved accuracy, the performance of ultrasound in the diagnosis of SA was limited. Awareness and careful review of the histopathologically related imaging features can be helpful in the diagnosis of SA. Show more

Keywords: Adenosis of breast, breast cancer, breast ultrasonography

DOI: 10.3233/CH-200943

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 173-181, 2021

Authors: Pillai, Suresh | Davies, Gareth | Lawrence, Matthew | Whitley, Janet | Stephens, Jeffrey | Williams, Phylip Rhodri | Morris, Keith | Evans, Phillip Adrian

Article Type: Research Article

Abstract: BACKGROUND: Diabetic ketoacidosis (DKA) is a medical emergency with a high mortality rate and is associated with severe metabolic acidosis and dehydration. DKA patients have an increased risk of arterial and venous thromboembolism, however little is known about this metabolic derangement in the first 24 hours of admission and to assess its effect on coagulation. We therefore utilised a novel functional marker of clot microstructure (fractal dimension - df ) to assess these changes within the first 24 hours. METHODS: Prospective single centre observational study to demonstrate whether the tendency of blood clot formation differs in DKA …patients. RESULTS: 15 DKA patients and 15 healthy matched controls were recruited. Mean df in the healthy control group was 1.74±0.03. An elevated df of 1.78±0.07 was observed in patients with DKA on admission. The mean pH on admission was 7.14±0.13 and the lactate was 3.6±2.0. df changed significantly in response to standard treatment and was significantly reduced to 1.68±0.09 (2–6& h) and to 1.66±0.08 at 24& h (p  < 0.01 One-way ANOVA). df also correlated significantly with lactate and pH (Pearson correlation coefficient 0.479 and –0.675 respectively, p  < 0.05). CONCLUSIONS: DKA patients at presentation have a densely organising less permeable thrombogenic clot microstructure as evidenced by high df . These structural changes are due to a combination of dehydration and a profound metabolic acidosis, which was reversed with treatment. These changes were not mirrored in standard clinical markers of thromboge-nicity. Show more

Keywords: Diabetic ketoacidosis (DKA), haemorheology, fractal dimension, gel point

DOI: 10.3233/CH-200957

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 183-194, 2021

Authors: Xu, Jialiang | Yu, Sijian | Zhang, Fuhua

Article Type: Research Article

Abstract: Thrombotic thrombocytopenic purpura (TTP) in adults is rare thrombotic microangiopathy (TMA), which is closely related to the lack of specific proteases of von Willebrand factor (vWF) multimers. It is currently believed that both congenital TTP (cTTP) and acquired TTP (aTTP) can induce acute attack through pregnancy. We report a case of a 24-year-old woman who was diagnosed as TTP during early pregnancy. A novel mutation was detected: c.3667G>T (p.E1223*). She responded well to plasma therapy during pregnancy and had a child by cesarean section at 32 weeks. TTP is still recurrent in postpartum patients. The plasma transfusion was effective, but …caused a severe transfusion reaction. Cyclosporine was administered with the consent of the patient. This case showed cyclosporine-A (CSA) had a positive effect on ADAMTS13 activity. At 11-months follow-up, the patient’s blood cells and LDH status were stable and no symptom was seen. Our case suggests that the patient had an unreported genetic mutation that causes TTP, immune factors may be involved in the onset of cTTP during pregnancy, and the use of immunosuppressive agents is effective in preventing recurrence. Show more

Keywords: Thrombotic thrombocytopenic purpura, ADAMTS13, pregnancy, genetic mutations, CSA

DOI: 10.3233/CH-200970

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 195-200, 2021

Authors: Brunacci, Nadia | Wischke, Christian | Naolou, Toufik | Patzelt, Alexa | Lademann, Jürgen | Neffe, Axel T. | Lendlein, Andreas

Article Type: Research Article

Abstract: The size of particulate carriers is key to their transport and distribution in biological systems, and needs to be tailored in the higher submicron range to enable follicular uptake for dermal treatment. Oligodepsipeptides are promising nanoparticulate carrier systems as they can be designed to exhibit enhanced interaction with drug molecules. Here, a fabrication scheme for drug-loaded submicron particles from oligo[3-(S )-sec -butylmorpholine-2,5-dione]diol (OBMD) is presented based on an emulsion solvent evaporation method with cosolvent, surfactant, and polymer concentration as variable process parameters. The particle size (300–950 nm) increased with lower surfactant concentration and higher oligomer concentration. The addition of acetone increased …the particle size at low surfactant concentration. Particle size remained stable upon the encapsulation of models compounds dexamethasone (DXM) and Nile red (NR), having different physicochemical properties. DXM was released faster compared to NR due to its higher water solubility. Overall, the results indicated that both drug-loading and size control of OBMD submicron particles can be achieved. When applied on porcine ear skin samples, the NR-loaded particles have been shown to allow NR penetration into the hair follicle and the depth reached with the 300 nm particles was comparable to the one reached with the cream formulation. A potential benefit of the particles compared to a cream is their sustained release profile. Show more

Keywords: Submicron particles, oligodepsipeptide, formulation parameters, emulsion solvent evaporation, surfactant, release kinetics

DOI: 10.3233/CH-200977

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 201-219, 2021

Authors: Nugroho, Johanes | Wardhana, Ardyan | Mulia, Eka Prasetya | Maghfirah, Irma | Rachmi, Dita Aulia | A’yun, Maya Qurota | Septianda, Imanita

Article Type: Research Article

Abstract: INTRODUCTION: COVID-19 is a systemic infection with a significant impact on coagulation which manifests in thromboembolism. There is an unknown relationship of which coagulation profile parameter at presentation has an association with poor outcome in COVID-19. OBJECTIVE: This meta-analysis aimed to determine the relationship between fibrinogen and FDP with poor outcome in COVID-19 patients. METHODS: A systematic search of all observational studies or trials involving adult patients with COVID-19 that had any data fibrinogen or FDP on admission was carried out using the PubMed, Science Direct, Scopus, ProQuest, and MedRxiv databases. We assessed the methodological quality …assessment using the NIH Quality Assessment Tool. We performed random-effects inverse-variance weighting analysis using mean difference (MD). RESULTS: A total of 17 studies (1,654 patients) were included in this meta-analysis. It revealed a higher mean of fibrinogen levels on admission in patients with severe case compared to those with non-severe case (MD = 0.69, [95% CI: 0.44 to 0.94], p  < 0.05; I2 = 72%, p  < 0.05). Non-survivor group had a pooled higher mean difference of fibrinogen values on admission (MD = 0.48 [95% CI: 0.13 to 0.83], p  < 0.05; I2 = 38%, p  = 0.18). Higher FDP on admission was found in poor outcome (composite of severity, critically ill, and mortality) compared to good outcome (4 studies, MD = 4.84 [95% CI: 0.75 to 8.93], p  < 0.05; I2 = 86%, p  < 0.05). CONCLUSION: Elevated fibrinogen and FDP level on admission were associated with an increase risk of poor outcome in COVID-19 patients. Show more

Keywords: COVID-19, fibrinogen, fibrin degradation product, severity, mortality, prognostic factor

DOI: 10.3233/CH-200978

Citation: Clinical Hemorheology and Microcirculation, vol. 77, no. 2, pp. 221-231, 2021