Clinical Hemorheology and Microcirculation - Volume 83, issue 1

Authors: Wenzel, C. | Brix, E. | Heidekrueger, P. | Lonic, D. | Lamby, P. | Klein, S.M. | Anker, A. | Taeger, C. | Prantl, L. | Kehrer, A.

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: In complex hand traumas nerves and vessels are often destructed without the possibility for primary repair. For bridging defects of nerves, veins and arteries grafts are necessary. Commonly nerve and vein grafts from adjacent donor sites as the wrist, forearm or cubital region are harvested. METHODS: This study is a retrospective cohort study. Between 2017 and 2019, 10 patients with complex hand injuries were treated. There were 8 males and 2 females, with an average age of 39 years (range 8–63 years). In all cases grafts were used of the dorsum of the foot for …reconstructing of the severed digital nerves and arteries. All donor sites could be closed primarily. RESULTS: In 100% of cases nerves and veins of the dorsum of the foot showed a good size match as well as adequate length for a sufficient repair. The overall Hand Injury Severity Score (HISS) was determined with a median of 86 (range 57 to 286). In the area of the donor site no relevant complications were seen. CONCLUSIONS: In complex hand injuries the dorsum of the foot is a favorable donor site for nerve and vein graft harvest. Show more

Keywords: Complex hand injuries, hand trauma, nerve graft, vein graft, donor site, nerve interposition, microsurgery

DOI: 10.3233/CH-211135

Citation: Clinical Hemorheology and Microcirculation, vol. 83, no. 1, pp. 1-10, 2023

Authors: Kruit, Anne Sophie | Hummelink, Stefan | Eshuis, Lilian | Kusters, Benno | Ulrich, Dietmar

Article Type: Research Article

Abstract: BACKGROUND: Extracorporeal perfusion (ECP) is a promising technique for prolonged tissue preservation, but might have side effects. For instance, increased radical oxygen species or capillary endothelial damage. OBJECTIVE: To assess ultra-morphological muscle damage during 36-hour ECP of porcine musculocutaneous flaps, hypothesizing that it would delay the onset of damage compared to static cold storage (SCS). METHODS: Bilateral flaps were retrieved from three Dutch Landrace pigs. Three flaps were preserved for 36 hours by hypothermic storage 4-6°C (control group) and three flaps by ECP with cooled University of Wisconsin solution. Muscle biopsies were taken at 0 h, 12 h …and 36 h and assessed with transmission electron microscopy. RESULTS: Muscle architecture was best preserved by ECP, with a delayed onset and decreased severity of muscle damage. After 36 hours, damage was two-fold lower in ECP-flaps compared to SCS-flaps. Myofibril architecture was best preserved. Mitochondria were greatly preserved with swelling being the most prominent feature. Capillaries were moderately but differently damaged during ECP, with focal endothelial thinning as opposed to luminal obstruction in SCS-preserved flaps. CONCLUSIONS: This experiment described favourable cellular preservation of skeletal muscle flaps during ECP compared to SCS. Results showed less severe ultra-morphological damage and a later onset of damage. Show more

Keywords: Ischemia-reperfusion injury, ex-vivo preservation, machine perfusion, organelles, hypothermic storage

DOI: 10.3233/CH-211262

Citation: Clinical Hemorheology and Microcirculation, vol. 83, no. 1, pp. 11-18, 2023

Authors: Glazkov, A.A. | Ulbashev, D.S. | Borshchev, G.G. | Pulin, A.A. | Glazkova, P.A. | Kulikov, D.A.

Article Type: Research Article

Abstract: BACKGROUND: Endothelial dysfunction and microvascular disturbances are suggested to play a key role in higher morbidity and worse prognosis in patients with COVID-19 and cardiometabolic diseases. OBJECTIVE: Study was aimed to establish relationships between the skin microcirculation parameters and various clinical and laboratory indicators. METHODS: The study included 18 patients with moderate disease according to WHO criteria. Skin microcirculation measurements were performed by laser Doppler flowmetry using a heating test on the hairy skin of the right forearm. RESULTS: Baseline perfusion only correlated with C-reactive protein (Rs = 0.5, p  = 0.034). Microcirculation indices characterising the development …of hyperaemia during the first minute of heating (LTH1 and AUC60 ) showed significant correlations (Rs from 0.48 to 0.67, p  < 0.05) with indices of general blood analysis and blood coagulation (fibrinogen, D-dimer, haemoglobin, erythrocyte count and haematocrit). Indexes characterising the dynamics of hyperaemia development over longer time intervals showed correlation with the glomerular filtration rate (Rs = 0.6, p  = 0.009). CONCLUSION: Known COVID-19 risk factors (haemorheological parameters, age) are correlated with the microvascular reactivity to heating in patients with COVID 19. We suggest that, prospectively, the method of laser Doppler flowmetry could be used for non-invasive instrumental assessment of microcirculatory disorders in patients with COVID-19. Show more

Keywords: COVID-19, microcirculation, local thermal hyperaemia, Laser Doppler flowmetry, haemorheology

DOI: 10.3233/CH-221431

Citation: Clinical Hemorheology and Microcirculation, vol. 83, no. 1, pp. 19-29, 2023

Authors: Jung, Ernst Michael | Moran, Valentina Ocaña | Engel, Martin | Krüger-Genge, Anne | Stroszczynski, Christian | Jung, Friedrich

Article Type: Research Article

Abstract: AIM: To examine to what extent the high frame rate contrast-enhanced ultrasound (HiFR) diagnostic enables the conclusive diagnosis of liver changes with suspected malignancy. MATERIAL/METHODS: Ultrasound examinations were performed by an experienced examiner using a multifrequency probe (SC6-1) on a high-end ultrasound system (Resona 7, Mindray) to clarify liver changes that were unclear on the B-scan. A bolus of 1–2.4 ml of the Sulphur hexafluoride ultrasound microbubbles contrast agent SonoVue™ (Bracco SpA, Italy) was administered with DICOM storage of CEUS examinations from the early arterial phase (5–15 s) to the late phase (5–6 min). Based on the image files stored …in the PACS, an independent reading was performed regarding image quality and finding-related diagnostic significance (0 not informative/non-diagnostic to 5 excellent image quality/confident diagnosis possible). References were clinical follow-up, if possible, comparison to promptly performed computed tomography or magnetic resonance imaging, in some cases also to histopathology. RESULTS: We examined 100 patients (42 women, 58 men, from 18 years to 90 years, mean 63±13 years) with different entities of focal and diffuse liver parenchymal changes, which could be detected in all cases with sufficient image quality with CEUS and with high image quality with HiFR-CEUS. Proportionally septate cysts were found in n  = 19 cases, scars after hemihepatectomy with local reduced fat in n  = 5 cases, scars after microwave ablation in n  = 19 cases, hemangiomas in n  = 9 cases, focal nodular hyperplasia in n  = 8 cases, colorectal metastases in n  = 15 cases, hepatocellular carcinoma (HCC) in n  = 11 cases, Osler disease in n  = 8 cases. The size of lesions ranged from 5 mm to 200 mm with a mean value of 33.1±27.8 mm. Conclusive diagnoses could be made by the experienced investigator in 97/100 cases with CEUS, confirmed by reference imaging, in parts by histopathology or follow-up. The image quality for HiFR CEUS was rated with a score of 3 to 5; 62 cases were assessed with an average of good (4 points), 27 cases with very good (5 points), and in 11 cases (3 points) still satisfactory despite aggravated acoustic conditions. The specificity of HIFR-CEUS was 97%, the sensitivity 97%, the positive predictive value 94%, the negative predictive value 99% and the accuracy 97%. CONCLUSION: HIFR-CEUS has demonstrated has demonstrated an improved image quality resulting in a high diagnostic accuracy. In the hands of an experienced investigator, HiFR-CEUS allows the assessment of focal and diffuse unclear liver parenchymal changes on B-scan and dynamic assessment of microcirculation in solid and vascular changes. Show more

Keywords: Contrast-enhanced ultrasound sonography –CEUS –high frame rate contrast-enhanced (HiFR) –liver cancer

DOI: 10.3233/CH-221449

Citation: Clinical Hemorheology and Microcirculation, vol. 83, no. 1, pp. 31-46, 2023

Authors: Zhu, Lingfeng | Zhao, Ping | Meng, Xianwei | Jin, Hong | Tuo, Baojuan

Article Type: Research Article

Abstract: BACKGROUND: Endothelial dysfunction is considered to be an important factor in the pathogenesis of atherosclerosis. Circular RNAs (circRNAs) have been confirmed to participate in the development of atherosclerosis. Nevertheless, the role and mechanism of circ_0091822 in atherosclerosis have not been studied yet. METHODS: The expression of circ_0091822, miR-661 and RAB22A were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were estimated by enzyme-linked immunosorbent assay (ELISA). Cell viability was analyzed by Cell Counting Kit-8 (CCK-8) assay, cell proliferation was evaluated by EdU assay, and cell apoptosis was gauged …by flow cytometry. Western blot was performed to assess the protein levels of Bax, Cleaved-caspase-3 and RAB22A. The interaction among miR-661 and circ_0091822 or RAB22A was verified by dual-luciferase reporter assay RESULTS: Ox-LDL enhanced the expression of circ_0091822 in HUVECs. It also constrained proliferation, promotes apoptosis and inflammation in HUVECs, and down-regulation of circ_0091822 attenuated these effects. Mechanically, circ_0091822 could serve as a sponge of miR-661, miR-661 interference rescued circ_0091822 inhibition-mediated effect on the biological functions in ox-LDL-induced HUVECs. Additionally, RAB22A was a target of miR-661, and its overexpression could partially overturn the negative regulation of miR-661 on ox-LDL-treated HUVECs injury. Importantly, circ_0091822 sponged miR-661 to positively regulate RAB22A expression. CONCLUSION: Circ_0091822 contributed to cell injury by targeting miR-661/RAB22A axis in ox-LDL-stimulated HUVECs. Show more

Keywords: AS, circ_0091822, miR-661, RAB22A

DOI: 10.3233/CH-221453

Citation: Clinical Hemorheology and Microcirculation, vol. 83, no. 1, pp. 47-59, 2023

Authors: Li, Qi | Nie, Fang | Yang, Dan | Dong, Tiantian | Liu, Ting

Article Type: Research Article

Abstract: OBJECTIVES: To explore the feasibility of contrast-enhanced ultrasound (CEUS) as a new tool for characterizing vascularization of primary peripheral lung cancer. METHODS: 315 consecutive patients with definite primary peripheral lung cancers underwent CEUS examination from November 2016 to March 2022. CEUS parameters including time to enhancement (TE), time to peak (TP), time to wash-out (TW), distribution of vessels (DV), extent of enhancement (EE) and homogeneity of enhancement (HE) were obtained. RESULTS: The lesions were grouped on the basis of TE which reflects tumor vascularization: early enhancement (pulmonary arterial vascularization) (n  = 91) and delayed enhancement group (bronchial …arterial vascularization) (n  = 224). Overall, lung tumors commonly (71.1%) manifested a delayed enhancement which indicating blood supply originated from bronchial arteries, while an early enhancement was present in less than a third of the cases. Tumors with bronchial vascularization tended to show a delayed, reduced and heterogeneous enhancement. Correspondingly, it is characterized by a shorter TE, marked EE and a relatively infrequent occurrence of necrosis in tumors with pulmonary vascularization. CONCLUSIONS: Providing micro-perfusion information, CEUS is a potentially imaging tool for evaluating blood supply in primary peripheral lung cancer. Show more

Keywords: Contrast-enhanced ultrasound, tumor vascularization, lung cancers

DOI: 10.3233/CH-221484

Citation: Clinical Hemorheology and Microcirculation, vol. 83, no. 1, pp. 61-68, 2023

Authors: Chkhitauri, Lela | Sanikidze, Tamar | Giorgadze, Elene | Asatiani, Ketevan | Kipiani, Nana | Momtselidze, Nana | Mantskava, Maka

Article Type: Research Article

Abstract: BACKGROUND: Prevention of Type 2 diabetes mellitus (T2DM) requires a modifying effect on the pathological processes inducing the β-cell dysfunction. OBJECTIVES: the comprehensive study of the violation of rheological parameters in patients with different stages of diabetes and identification of possible links between these alterations with the intensity of the oxidative stress in the patient’s body. METHODS: 60 patients with IR, prediabetes, T2DM and healthy volunteers were included. Full range of the rheological parameters of the patients’ blood - the indicators of erythrocytes aggregation index (EAI), the relative deformability of the erythrocytes membranes (ERDI), blood plasma …viscosity (BPV), and oxidative stress intensity (OSI) were examined. RESULTS: In patients with insulin resistance (IR), prediabetes, and T2DM the ERDI was statistically significantly lower and BPV - higher compared to control; a significant increase in EAI was detected in the patient group with prediabetes and T2DM compared to the control. CONCLUSION: The level of rheological disorders in patients increases with the increase of the level of carbohydrate metabolism disorders and intensity of oxidative stress and reaches a maximum during manifested diabetes. Diagnosis of hemorheological disorders and OSI in T2DM can serve as an early marker of target organ damage possibility. Show more

Keywords: Insulin resistance, prediabetes, Type 2 diabetes mellitus (T2DM), rheological parameters, oxidative stress

DOI: 10.3233/CH-221512

Citation: Clinical Hemorheology and Microcirculation, vol. 83, no. 1, pp. 69-79, 2023

Authors: Bai, Chen | Wang, Jiangang | Li, Jingxing

Article Type: Research Article

Abstract: BACKGROUND: Atherosclerosis (AS) is defined as a chronic inflammatory disorder underly the pathogenesis of cardiovascular diseases (CVDs). Endothelial pyroptosis is associated with AS-like diseases and other CVDs. OBJECTIVE: This work was designed to expound on the effect of GATA-binding protein 1 (GATA1) on pyroptosis of human coronary artery endothelial cells (HCAECs) in AS. METHODS: HCAECs were treated with oxidized-low density lipoprotein (ox-LDL) to establish HCAEC injury models. Plasmids for overexpressing GATA1 or silencing retinoic acid-related orphan receptor α (RORα) were transfected into HCAECs. Thereafter, the mRNA levels of GATA1 and RORα in HCAECs were detected using …real-time quantitative polymerase chain reaction. HCAEC viability was examined using the cell counting kit-8 method. The levels of pyroptosis-related proteins NOD-like receptor protein 3 (NLRP3), cleaved-Caspase-1, N-terminal of gasdermin D (GSDMD-N), and pyroptosis-related inflammatory cytokines interleukin (IL)-1β and IL-18 were determined using Western blot and enzyme-linked immunosorbent assays, respectively. The targeting relationship between GATA1 and RORα was verified using the chromatin-immunoprecipitation assay. Then, the rescue experiment was conducted to explore the effect of RORα on pyroptosis of ox-LDL-treated HCAECs. RESULTS: In ox-LDL-treated HCAECs, GATA1 and RORα expressions were decreased, HCAEC viability was reduced, and the levels of NLRP3, cleaved-Caspase1, GSDMD-N, IL-1β, and IL-18 were elevated. GATA1 overexpression increased HCAEC viability and attenuated pyroptosis. GATA1 bound to the RORα promoter region to stimulate RORα transcription, and RORα suppression facilitated ox-LDL-induced pyroptosis of HCAECs. CONCLUSIONS: GATA1 activated RORα transcription and therefore limited pyroptosis of ox-LDL-treated HCAECs. Show more

Keywords: GATA1, RORα, HCAEC, ox-LDL, pyroptosis, NLRP3, GSDMD-N, cleaved-Caspase-1

DOI: 10.3233/CH-221536

Citation: Clinical Hemorheology and Microcirculation, vol. 83, no. 1, pp. 81-92, 2023