Clinical Hemorheology and Microcirculation - Volume 85, issue 1

Authors: Sinan, Mukaddes | Yalcin, Ozlem | Karakas, Zeynep | Goksel, Evrim | Ertan, Nesrin Zeynep

Article Type: Research Article

Abstract: BACKGROUND: Thalassemia patients have reduced red cell deformability and decreased plasma zinc levels in their blood. OBJECTIVE: This study aimed to evaluate the effects of zinc (Zn) on the hemorheological parameters and antioxidant enzyme activities in β -thalassemia major (TM) and healthy volunteers (HV). METHODS: Hemorheological parameters were measured using LORCA (laser-assisted optical rotational cell analyzer) after adjusting the hematocrit to 40%. Zinc sulfate (ZnSO4 .7H2 O) was used for Zn incubation with a concentration of 0.5μg/dl. Oxidative stress and antioxidant status were determined using commercial kits. RESULTS: Data showed that after Zn incubation, …EImax, the area under the EI-osmolarity curve (Area), and Omax decreased in TM. However, no significant difference was observed in the osmotic deformability parameters of HV. The increased elongation index was obtained at different shear stresses for TM and HV, and SS1/2 decreased in both groups. The AMP and aggregation index (AI) decreased in TM, and the required time for half of the maximum aggregation (t1/2 ) increased in HV. However, Zn did not affect oxidative parameters in both groups. CONCLUSIONS: This study showed that Zn incubation increased deformability and decreased aggregation in thalassemic erythrocytes. It means that Zn supplementation will contribute to microcirculation in thalassemia patients. Show more

Keywords: Thalassemia, zinc, erythrocyte aggregation, deformability, osmotic deformability, antioxidant

DOI: 10.3233/CH-221452

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 1-12, 2023

Authors: Zhu, LiJun | Yu, YuLong | Wang, HuiJun | Wang, MingCang | Chen, MinJuan

Article Type: Research Article

Abstract: Polymorphonuclear neutrophils (PMNs) exert significant roles in septic acute lung injury (ALI). Accumulating evidence suggests that PMN-derived exosomes (PMN-exo) are a novel subcellular entity that is the fundamental link between PMN-driven inflammation and tissue damage. However, the role of PMN-exo in septic ALI and the underlying mechanisms remain unclear. Tumor necrosis factor-α (TNF-α ), a key regulator of innate immunity in septic ALI, was used to induce PMN activation in vitro . Using an in vitro co-culture system, the rat alveolar macrophage cell line NR8383 was co-cultured with TNF-α -stimulated PMN-released exosomes (TNF-α -exo) to further confirm the …results of the in vitro studies and explore the underlying mechanisms involved. A septic lung injury model was established by cecal ligation and puncture surgery, and PMN-exo were injected into septic mice through the tail vein, and then lung injury, inflammatory release, macrophage polarization, and apoptosis were examined. The results reported that TNF-α -exo promoted the activation of M1 macrophages after i.p. injection in vivo or co-culture in vitro . Furthermore, TNF-α -exo affected alveolar macrophage polarization by delivering HCG18. Mechanistic studies indicated that HCG18 mediated the function of TNF-α -exo by targeting IL-32 in macrophages. In addition, tail vein injection of si-HCG18 in septic mice significantly reduced TNF-α -exo-induced M1 macrophage activation and lung macrophage death, as well as histological lesions. In conclusion, TNF-α -exo-loaded HCG18 contributes to septic ALI by regulating macrophage polarization. These findings may provide new insights into novel mechanisms of PMN-macrophage polarization interactions in septic ALI and may provide new therapeutic strategies for patients with sepsis. Show more

Keywords: Sepsis, acute lung injury, PMNs exosomes, LncRNA HCG18, macrophage polarization

DOI: 10.3233/CH-221624

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 13-30, 2023

Authors: Kaplangoray, Mustafa | Toprak, Kenan | Cekici, Yusuf | Yildirim, Arafat | Abacioglu, Ozge Ozcan

Article Type: Research Article

Abstract: BACKGROUND: İncreased whole blood viscosity (WBV) is associated with increased infarct area, impaired microvascular circulation and mortality in patients with ST-elevation myocardial infarction (STEMI). OBJECTIVES: We aimed to analyze the association between the WBV and thrombus burden (TB) in STEMI patients. METHODS: This cross-sectional study included 167 STEMI patients who received primary percutaneous coronary intervention. WBV values were assessed using hematocrit and total protein values, and low shear rate(LSR) and high shear rate(HSR) were calculated. Angiographic TB was assessed according to the definition of the Thrombolysis in Myocardial Infarction (TIMI) study group. The cases were dichotomized …into low TB (grade 1-3) (n  = 87) and high TB (grade 4-5) (n  = 80) groups. RESULTS: The mean HSR and LSR values of the high TB group were significantly increased compared to the low TB group (p  < 0.001, for each). In ROC analysis,for prediction of TB, a cut-off value of 3.83 WBV for HSR had a 71% sensitivity and a 60.7% specificity, and a cut-off value of 21 WBV for LSR had a 70% sensitivity and 59.9% specificity (p  < 0.001,for each). Multivariate regression analysis showed that both HSR (OR = 2.408;p=0.020) and LSR (OR = 1.055;p=0.021) were independent predictors for high TB. CONCLUSION: İncreased WBV was an independent predictor for the presence of high TB in patients with STEMI. Show more

Keywords: ST elevation myocardial infarction, blood viscosity, acute coronary syndrome, myocardial infarction, thrombosis

DOI: 10.3233/CH-231756

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 31-40, 2023

Authors: Caimi, Gregorio | Lo Presti, Rosalia | Carollo, Caterina | Montana, Maria | Carlisi, Melania

Article Type: Research Article

Abstract: BACKGROUND: In relation to the different and important roles of the beta2 integrins, we have revisited the expression of polymorphonuclear leukocyte CD18 in several clinical disorders, at baseline and after in vitro activation. SUBJECTS: we have examined subjects with type 1 diabetes mellitus, vascular atherosclerotic disease, type 2 diabetes mellitus without and with macrovascular complications, chronic renal failure on conservative treatment, essential hypertension, deep venous thrombosis, acute ischemic stroke and subjects with venous leg ulcers. METHODS: unfractioned leukocyte suspension was prepared according to the Mikita’s method, while the leukocyte were separated into mononuclear and polymorphonuclear …cells with a Ficoll-Hypaque medium. Using specific monoclonal antibody, the CD18 expression was evaluated with cytofluorimetric analysis, using FACScan (Becton Dickinson) be Cellquest software; the activation in vitro with PMA was effected according to modified Yasui and Masuda methods. RESULTS: in type 1 diabetes mellitus, at baseline CD18 is under expressed in comparison with normal control, and not changes after PMA activation were observed; in subjects with vascular atherosclerotic disease, in type 2 diabetes mellitus CD18 is over expressed at baseline but does not vary after activation; in subjects with chronic renal failure, essential hypertension and in subjects with acute ischemic stroke the CD18 up-regulate at baseline compared to normal control, and it increases further after activation; in subjects with deep venous thrombosis the CD18 expression is not different from control group at baseline, but it increases after activation; finally, in subjects with venous leg ulcers the CD18 is normally expressed at baseline, and it does not change after PMA activation. CONCLUSIONS: in the different clinical disorders, the trend of this integrin subunit provides some specific information, useful to select the best therapeutic strategy in clinical practice. Show more

Keywords: Polymorphonuclear CD18 expression, type 1 diabetes mellitus, vascular atherosclerotic disease, type 2 diabetes mellitus, chronic renal failure, essential hypertension, deep venous thrombosis, acute ischemic stroke, venous leg ulcers

DOI: 10.3233/CH-231771

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 41-58, 2023

Authors: Hong, Miao-Ping | Chen, Wei-Fen | Wu, Jie-Hao | Kang, Tai-Shan | He, Shun-Po | Yang, Qing-Wei

Article Type: Research Article

Abstract: OBJECTIVE: To investigate if there is a correlation between lipid-lowering treatment with statins and the occurrence, number, and location of cerebral microbleeds (CMBs) among patients with ischemic cerebrovascular disease (ICVD), and also to compare treatment with atorvastatin and rosuvastatin in terms of the occurrence of CMBs and their differences. METHODS: In this retrospective study, we included patients who were diagnosed with ICVD and underwent susceptibility weighted imaging (SWI) in a grade A tertiary hospital from October 1, 2014 to October 1, 2022. We collected information on previous statin use, past medical history, clinical test indicators, and imaging data. …RESULTS: We found that out of 522 patients, 310 patients (59.4%) had no CMB and 212 patients (40.6%) had CMBs. There was no statistically significant correlation between prior statin use, the occurrence, and number of CMBs in patients diagnosed with ICVD (P  < 0.05). As for the location of CMB, there was a statistically significant correlation between prior statin use and lobar CMBs (P  < 0.048). However, there was no statistically significant correlation between the use of atorvastatin and rosuvastatin and the occurrence of CMBs (P  > 0.05). CONCLUSION: There was no independent correlation between previous statin use, and the occurrence, and number of CMBs in patients with ICVD. As for CMBs in different locations, there was a correlation between previous use of statin and lobar CMBs. There was no significant difference between atorvastatin and rosuvastatin in the occurrence of CMBs in patients with ICVD. Show more

Keywords: Cerebral small vessel diseases, CMBs, statin

DOI: 10.3233/CH-231833

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 59-71, 2023

Authors: Zheng, Zijie | Zhang, Shen | Zheng, Cheng | Wang, Ruxue | Zhang, Yanping | Chen, Peixin | Zhou, Shanglan | Luo, Baoming | Di, Na

Article Type: Research Article

Abstract: PURPOSE: This research aims to present the findings of contrast-enhanced ultrasound (CEUS) in a series of patients with proven deep endometriosis (DE) and provide an updated literature review. MATERIALS AND METHODS: Between January 2018 and October 2022, seven patients with DE lesions had their imaging and medical records retrospectively reviewed. Clinical data, recorded images of a standardized conventional B-mode ultrasound, and Sonovue® CEUS were interpreted by two blinded, independent, experienced radiologists in consensus. The enhanced characteristics of the DE lesion on CEUS were also assessed using VueBox® software quantitatively. RESULTS: DE lesion appeared as irregular hypoechoic …or heterogeneous on conventional ultrasound with dotted blood flow signal on color Doppler. Six of seven DE lesions showed heterogeneous hypo-enhancement in arterial phases. All the lesions showed a heterogeneous washout rapidly that began in the late arterial phase. In quantified analysis, the mean relative peak enhancement compared with adjacent tissue was 0.47±0.25. CONCLUSION: Our findings and literature review suggested that CEUS could be a feasible and promising non-invasive modality for diagnosing DE. Show more

Keywords: Contrast-enhanced ultrasound, deep endometriosis, VueBox, quantified analysis

DOI: 10.3233/CH-231843

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 73-82, 2023

Authors: Rink, Maximilian | Jung, Ernst-Michael | Bohr, Christopher | Künzel, Julian

Article Type: Research Article

Abstract: In the head and neck area, a large proportion of clinically relevant fistulas occur in childhood. The present case describes the use of contrast enhanced ultrasound with intraductal administration of the contrast medium for preoperative visualization of the fistula duct in the case of a second brachial cleft fistula. This provided the surgeon with important additional information, such as the detailed course of the fistula and its relation to the large vessels of the neck. The method can help to improve surgical planning, reduce radiation exposure and to avoid imaging under general anesthesia, especially in children.

Keywords: Contrast enhanced ultrasound, CEUS, branchial cleft fistula, intraductal CEUS, CEUS fistulography

DOI: 10.3233/CH-231862

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 83-86, 2023

Authors: Schauer, Martin Ignaz | Jung, Ernst Michael | Hofmann, Hans-Stefan | Ried, Michael

Article Type: Research Article

Abstract: AIM: To apply intraoperative ultrasound (IO-US) for the first time using a laparascopic probe to detect malignancy-susceptible solitary pulmonary nodules (SPN) and assess macrovascularization using color-coded doppler sonography or power doppler. Description of technical feasibility. METHODS: Technical description on intrathoracic endoscopic ultrasound. A positive ethics vote from the local ethics committee and written patient consent were available. Intraoperative ultrasound was performed using a laparascopic probe (Lap 13-4cs, Mindray) on the T9 ultrasound machine (Mindray, China). B-scan was used to detect the SPN. Color-coded doppler sonography (CCS) and power doppler were used to assess macrovascularization. Primary end point was …the description of the technical performance of the Io-US. Secondary endpoints were the functions of Io-US in characterizing SPN. RESULTS: Io-US was successfully applied using (n  = 2) cases in video-assisted thoracic surgery. All SPN were successfully detected intraoperatively with the intrathoracically placed laparascopy probe using B-mode and examined using CCS or power Doppler (100%). Resection was sonography-guided with marking of the tumor area in all cases without complications. Histological workup revealed malignancy in both cases. CONCLUSION: Intrathoracic application of laparascopically guided Io-US was technically feasible. In addition to B-mode detection, Io-US using power doppler and color-coded doppler sonography provided initial evidence for characterization of SPN based on macrovascularization. Show more

Keywords: Intraoperative ultrasound in thoracic surgery, CEUS in thoracic surgery

DOI: 10.3233/CH-231718

Citation: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 87-92, 2023