Sample records for maul vascular injury

  1. Vascular injuries after bear attacks: Incidence, surgical challenges and outcome

    Wani Mohd


    Full Text Available Background : Bear mauling is rarely reported in medical literature due to its rare occurrence. Present study was undertaken to describe the pattern and management of bear maul vascular injuries in Kashmir. Methods : Study of patients with bear maul vascular injury from 1st Jan 2004 to 31st Dec. 2008. Fifteen patients with bear maul vascular injury were studied. All patients of bear maul without vascular injury were excluded from the study. Results : Most of the patients were treated by reverse saphenous vein graft or end to end anastomosis. Most common complication was wound infection (20% followed by graft occlusion (13.33%. There was no operative death. Conclusion : Bear attacks are very common in Kashmir. Vascular injury due to bear maul needs prompt resuscitation and revascularization. Results are very good provided timely intervention for revascularization is done.

  2. Vascular Injury in Orthopedic Trauma.

    Mavrogenis, Andreas F; Panagopoulos, George N; Kokkalis, Zinon T; Koulouvaris, Panayiotis; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios; Mantas, George; Moulakakis, Konstantinos G; Sfyroeras, George S; Lazaris, Andreas; Soucacos, Panayotis N


    Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma. Spasm can occur after either blunt or penetrating trauma to an extremity and is more common in young patients. Clinical presentation of vascular injury may not be straightforward. Physical examination can be misleading or initially unimpressive; a normal pulse examination may be present in 5% to 15% of patients with vascular injury. Detection and treatment of vascular injuries should take place within the context of the overall resuscitation of the patient according to the established principles of the Advanced Trauma Life Support (ATLS) protocols. Advances in the field, made mostly during times of war, have made limb salvage the rule rather than the exception. Teamwork, familiarity with the often subtle signs of vascular injuries, a high index of suspicion, effective communication, appropriate use of imaging modalities, sound knowledge of relevant technique, and sequence of surgical repairs are among the essential factors that will lead to a successful outcome. This article provides a comprehensive literature review on a subject that generates significant controversy and confusion among clinicians involved in the care of trauma patients. [Orthopedics. 2016; 39(4):249-259.].

  3. Outcomes of truncal vascular injuries in children.

    Allison, Nathan D; Anderson, Christopher M; Shah, Shinil K; Lally, Kevin P; Hayes-Jordan, Andrea; Tsao, Kuo-Jen; Andrassy, Richard J; Cox, Charles S


    Pediatric truncal vascular injuries occur infrequently and have a reported mortality rate of 30% to 50%. This report examines the demographics, mechanisms of injury, associated trauma, and outcome of patients presenting for the past 10 years at a single institution with truncal vascular injuries. A retrospective review (1997-2006) of a pediatric trauma registry at a single institution was undertaken. Seventy-five truncal vascular injuries occurred in 57 patients (age, 12 +/- 3 years); the injury mechanisms were penetrating in 37%. Concomitant injuries occurred with 76%, 62%, and 43% of abdominal, thoracic, and neck vascular injuries, respectively. Nonvascular complications occurred more frequently in patients with abdominal vascular injuries who were hemodynamically unstable on presentation. All patients with thoracic vascular injuries presenting with hemodynamic instability died. In patients with neck vascular injuries, 1 of 2 patients who were hemodynamically unstable died, compared to 1 of 12 patients who died in those who presented hemodynamically stable. Overall survival was 75%. Survival and complications of pediatric truncal vascular injury are related to hemodynamic status at the time of presentation. Associated injuries are higher with trauma involving the abdomen.

  4. Missile vascular injuries: 19-year experience.

    Ahanger, Abdul Gani; Wani, Mohd Lateef; Lone, Reyaz Ahmad; Singh, Shyam; Hussain, Zahur; Mir, Ishtiyak A; Irshad, Ifat; Ashraf, Hakeem Zubair; Dar, Abdul Majeed; Lone, Ghulam Nabi; Bhat, Mohammad Akbar; Sharma, Mukand Lal


    Missile vascular injuries have reached an epidemic proportion in Kashmir valley since the eruption of militancy. The present study was undertaken to analyze the mode, pattern, presentation, and management of missile vascular injuries. A retrospective study of patients with missile vascular injury from January 1990 to October 2008 was undertaken. Five hundred eighty patients with missile vascular injury were studied. All patients with vascular injury due to causes other than missiles were excluded from the study. Most of the patients were treated by interpositional saphenous vein graft or end-to-end anastomosis. The most common complication was wound infection (22.7%) followed by graft occlusion (3.8%). The amputation rate was 3.3% and was higher in patients with a delay of >6 hours to revascularization and associated fractures. Missile vascular injury requires prompt resuscitation and revascularization. Preoperative angiography is seldom necessary. Doppler study may sometimes be needed to aid in the diagnosis.

  5. Vascular injury in the United kingdom.

    Stannard, Adam; Brohi, Karim; Tai, Nigel


    Surgeons working within the United Kingdom's National Health Service have an established history of clinical innovation, research, and development in the field of vascular surgery but lack a unified trauma system to deliver optimal care for patients with vascular injury. The low incidence of vascular trauma, combined with lack of regional trauma systems, works against optimal delivery of care to the polytrauma patient. Providing care, robust data capture, and opportunities for training and education in vascular injury lag behind other elective domains of vascular practice. The challenge is to define ideal care pathways, referral networks, and standards of practice and to integrate the care of such patients. In 2010, a trauma system for London was introduced; it has provided vascular surgeons with a unique opportunity to study and advance the care of patients with vascular injury. This article discusses developing trauma network issues, particularly the organization and evolution of vascular trauma services in the United Kingdom.

  6. Missed vascular injuries: presentation and outcome.

    Siddique, Muhammad Khalid; Majeed, Shahid; Irfan, Muhammad; Ahmad, Nisar


    To describe the different presentation, diagnostic evaluation, management and outcome of complications of missed vascular injuries. A case series. Combined Military Hospital, Rawalpindi and Combined Military Hospital, Kharian Cantt, from June 2009 to June 2012. All the patients with vascular injuries missed at the time of causative trauma who reported during this study period were included. Patients presented with acute vascular injuries and iatrogenic aneurysm at the vascular anastomosis site were excluded. All cases were evaluated with either CT or conventional angiography and managed with various open vascular surgical techniques and their results were assessed. Twenty eight patients with missed vascular injury underwent various vascular repairs. Age of patients ranged from 16 to 78 years (mean = 33.7 ± 15.4 years). Male to female ratio was 6:1. Twelve (42.8%) patients presented with pseudoaneurysm alone, 10 (35.7%) with traumatic arteriovenous fistulae, 4 (14.3%) with post-traumatic thrombosis and occlusion and 2 (7.1%) with pseudoaneurysm and hemorrhage. Penetrating injuries were the commonest cause in 19 (67.8%). The time interval between injury and presentation in hospital ranged from 2 to 1300 weeks (mean 228 weeks). Lower limb vessels were affected in 20 (71.4%), the upper limb in 5 (17.8%) and neck vessels in 3 (10.7%). Superficial femoral artery was the most frequently involved artery in 9 (32.1%) cases. Interposition reverse autogenous saphenous vein graft was most common type of repair in all types of missed vascular injuries. One (3.5%) patient had amputation after secondary hemorrhage. Low velocity penetrating trauma was the common cause of missed vascular injury. Pseudoaneurysm was the most common presentation.

  7. Assessment of Vascular Injuries and Reconstruction.

    Baghi, Iraj; Herfatkar, Mohammad Rasool; Shokrgozar, Leila; Poor-Rasuli, Zahra; Aghajani, Fatemeh


    Trauma is the third leading cause of death. In this regard, vascular injury plays a leading role in of morbidity and mortality rates. The present study aimed to assess the prevalence of vascular injuries and results of vascular reconstruction at a referral hospital in northern Iran. A retrospective observational study assessed 88 consecutive patients with vascular injury admitted to Poursina Hospital, Rasht in northern Iran, from October 2007 to October 2009. All study information was collected retrospectively from hospital charts. Most of the affected patients (87/88) were male with a mean age of 29.12 ± 11.20 years. The mechanism of injury in 39.8% was blunt trauma and penetrating trauma in the rest. Of the 53 injured by penetrating trauma (60.2%), the most common cause was stabbing (94.3%). The most common cause of blunt trauma was road traffic accidents (93.1%). The most common mechanism for vascular injuries in upper extremities was penetrating trauma (86.0%) and in lower extremities was blunt trauma (60.0%). Fasciotomy was performed in 16 patients (18.2%) mostly in the lower extremities. Major amputation was required in 10% of the patients. In upper extremities, the most common type of revascularization was end to end anastomosis, followed by inter-position graft. The most common type of reconstruction in the lower extremity was bypass graft. All patients who underwent major amputation were admitted to the center with a delay of more than 6 hours after injury. Major vascular injuries in our center occurred in young men, frequently because of stab wounds. Popliteal injuries mostly caused by motor vehicle accidents was the second most common arterial injury, followed by combined ulnar and radial injuries. Vascular reconstruction in the first hours after trauma may prevent many unnecessary and preventable amputation procedures.

  8. Treatment of subclavian vascular injuries in 15 cases

    WANG Zi-ming; WANG Ai-min; SUN Hong-zhen; DU Quan-yin; GUO Qing-shan; YIN Liang-jun; WU Si-yu; TANG Ying


    @@ Subclavian vascular injury accounts for 1%-5 % of all vascular injuries. If not found in time or managed swiftly, subclavian vascular injury is likely to cause hemorrhagic shock and even death. From March of 1998 through August of 2003, a total of 15 cases with subclavian vascular injury were treated in our department. The details are described in this report.

  9. Complications of extremity vascular injuries in conflict.

    Brown, Kate V; Ramasamy, Arul; Tai, Nigel; MacLeod, Judith; Midwinter, Mark; Clasper, Jon C


    The extremities remain the most common sites of wounding in conflict, are associated with a significant incidence of vascular trauma, and have a high complication rate (infection, secondary amputation, and graft thrombosis). The purpose of this study was to study the complication rate after extremity vascular injury. In particular, the aim was to analyze whether this was influenced by the presence or absence of a bony injury. A prospectively maintained trauma registry was retrospectively reviewed for all UK military casualties with extremity injuries (Abbreviated Injury Score >1) December 8, 2003 to May 12, 2008. Demographics and the details of their vascular injuries, management, and outcome were documented using the trauma audit and medical notes. Thirty-four patients (34%)--37 limbs (30%)--had sustained a total of 38 vascular injuries. Twenty-eight limbs (22.6%) had an associated fracture, 9 (7.3%) did not. Twenty-nine limbs (23.4%) required immediate revascularization to preserve their limb: 16 limbs (13%) underwent an initial Damage Control procedure, and 13 limbs (10.5%) underwent Definitive Surgery. Overall, there were 25 limbs (20.2%) with complications. Twenty-two were in the 28 limbs with open fractures, 3 were in the 9 limbs without a fracture (p vascular trauma if there is an associated fracture, probably due to higher energy transfer and greater tissue damage.

  10. Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

    Marcello Barbosa Barros

    Full Text Available CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

  11. "Mauled by a Bear": narrative analysis of self-injury among adolescents in US news, 2007-2012.

    Bareiss, Warren


    Self-injury among adolescents has been widely documented in the United States, Canada, Europe, and Asia; however, news coverage of self-injury has not been examined. This study analyzes 78 news accounts of self-injury among adolescents in the United States from 2007 to 2012, using critical cultural studies as a theoretical foundation and a methodology informed by Kenneth Burke's dramatism. Narrative elements within the sample are examined in relationship to one another in order to reveal implicit meanings within the news stories. Looking across the sample, I then use a framework developed by Labov and Waletzky to examine a dominant meta-narrative that downplays social causes of self-injury-notably, various forms of trauma such as childhood sexual abuse-and instead frames self-injury as a personal choice. As a result, the remedy to the problem is not constructed as redress of contemporary pressures placed upon young people, but rather, as the responsibility of adolescents to conform to the social system that causes them to hurt themselves.

  12. Pediatric vascular injuries: patterns of injury, morbidity, and mortality.

    Klinkner, Denise B; Arca, Marjorie J; Lewis, Brian D; Oldham, Keith T; Sato, Thomas T


    The purpose of this study was to identify the patterns of injury and associated morbidity/mortality related to pediatric vascular trauma. A retrospective review of children and adolescents treated between 1993 and 2005 was performed. Patients were identified by International Classification of Diseases, Ninth Revision codes within an institutional pediatric trauma registry. One hundred seventy-six patients with vascular injury were identified. Those with injuries isolated to the digits and unspecified vessels were excluded (n = 73). The remaining 103 patients were evaluable and are the basis for subsequent comparisons. Seventy-four percent of injuries occurred in male patients. The average age of the male patients was 11.3 years and that of the female patients was 9.1 years (range, 1-18 years; overall, 10.7 years). Penetrating wounds caused 68% of the injuries, followed by blunt trauma (31%) and burns (0.97%). Anatomical locations of injury included the head/neck (19.4%), torso (13.5%), and extremities (67%). Amputation was required in 11 (10.7%) patients. The average hospital length of stay of the patients was 12.1 days (range, 1-155 days). The overall mortality was 9.7%. Nonoperative management was given to 9.7% of the patients; one death caused by carotid injury occurred. Overall, 24 patients underwent arteriography, with 1 patient receiving definitive treatment in interventional radiology. Of the 103 patients, 29.1% were managed by pediatric surgeons, 38.8% were managed by extremity specialists, 17% were managed by vascular surgeons, 5.8% were managed by neurosurgeons, and 9.3% were managed by others. Despite the available multidisciplinary diagnostic and treatment modalities at tertiary care pediatric trauma centers, traumatic vascular injuries in children and adolescents are associated with significant morbidity and mortality in contemporary surgical practice.

  13. Selective vascular injury during cutaneous laser therapy

    Tunnell, James William

    Pulsed laser irradiation in conjunction with cryogen spray cooling (CSC) can induce selective vascular injury to remove cutaneous hypervascular malformations such as port wine stains (PWS), hemangiomas, and facial veins. In this group of studies, we characterized the cryogen heat removal process and determined the effects of pulsed laser irradiation in conjunction with cryogen spray cooling of human skin. First, we employed an inverse heat conduction algorithm to measure the thermal boundary condition due to CSC in in vitro skin phantoms. Second, we developed a mathematical model of laser irradiation in conjunction with CSC in human skin. We determined tissue damage and temperature profiles due to varying combinations of laser pulse duration, radiant exposure, and CSC application times. Finally, we used ex vivo and in vivo human skin to determine the effects of high radiant exposures and CSC on epidermal and vascular injury. CSC induces a dynamic cooling effect, removing heat from the skin both during and following the spurt application time. Residual cryogen, deposited on the skin surface during the cryogen spurt, remains on the skin surface several times as long as the as cryogen spurt itself. The heat removal rate during the cryogen spurt is greatest; however, the total energy removed following the cryogen spurt is also substantial (approximately half as much as during the spurt application time). CSC was effective in protecting the human skin epidermis in light to moderately pigmented skin. Mathematical modeling, ex vivo, and in vivo studies showed that the epidermal damage threshold could be increased by a factor of approximately two. Increased radiant exposures increased the risk of non-selective vascular injury observed in histology as injury to the epidermis and perivascular collagen; however, proper choice of cryogen cooling durations resulted in the elimination of epidermal injury as well as perivascular tissue injury. In addition, higher radiant

  14. Vascular dysfunctions following spinal cord injury.

    Popa, Constantin; Popa, Florian; Grigorean, Valentin Titus; Onose, Gelu; Sandu, Aurelia Mihaela; Popescu, Mihai; Burnei, Gheorghe; Strambu, Victor; Sinescu, Crina


    The aim of this article is to analyze the vascular dysfunctions occurring after spinal cord injury (SCI). Vascular dysfunctions are common complications of SCI. Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI. Neuroanatomy and physiology of autonomic nervous system, sympathetic and parasympathetic, is reviewed. SCI implies disruption of descendent pathways from central centers to spinal sympathetic neurons, originating in intermediolateral nuclei of T1-L2 cord segments. Loss of supraspinal control over sympathetic nervous system results in reduced overall sympathetic activity below the level of injury and unopposed parasympathetic outflow through intact vagal nerve. SCI associates significant vascular dysfunction. Spinal shock occurs during the acute phase following SCI and it is a transitory suspension of function and reflexes below the level of the injury. Neurogenic shock, part of spinal shock, consists of severe arterial hypotension and bradycardia. Autonomic dysreflexia appears during the chronic phase, after spinal shock resolution, and it is a life-threatening syndrome of massive imbalanced reflex sympathetic discharge occurring in patients with SCI above the splanchnic sympathetic outflow (T5-T6). Arterial hypotension with orthostatic hypotension occurs in both acute and chronic phases. The etiology is multifactorial. We described a few factors influencing the orthostatic hypotension occurrence in SCI: sympathetic nervous system dysfunction, low plasma catecholamine levels, rennin-angiotensin-aldosterone activity, peripheral alpha-adrenoceptor hyperresponsiveness, impaired function of baroreceptors, hyponatremia and low plasmatic volume, cardiovascular deconditioning, morphologic changes in sympathetic neurons, plasticity within spinal circuits, and motor deficit leading to loss of skeletal muscle pumping activity. Additional associated cardiovascular concerns in SCI, such as deep vein

  15. Evaluating Peripheral Vascular Injuries: Is Color Doppler Enough for Diagnosis?

    Mohd Lateef Wani


    Full Text Available Background:: Vascular injury poses a serious threat to limb and life. Thus, diagnosis should be made immediately with minimally invasive methods. Doppler is a good aid in diagnosis of vascular injury. Methods:: The present prospective study was conducted on 150 patients who presented with soft signs (the signs which are suggestive but not confirmatory of vascular injury. They were subjected to color Doppler examination before exploration. The patients with the features of vascular injury on color Doppler were subjected to exploration. On the other hand, those who had normal Doppler were subjected to CT- angiography. Then, the findings of the exploration were matched with those of color Doppler. The data were analyzed using the SPSS statistical software. Results:: Out of the 150 Doppler examinations, 110 (73.33% were reported as positive, while 40 were reported as negative for vascular injury. These were subjected to CT-angiography and seven of them had the features of vascular injury on CT-angiography. All the patients with positive Doppler or CT angiography findings were subjected to exploration. Doppler had a sensitivity of 94% and specificity of 82.5% in diagnosis of vascular injury using Binary classification test. Conclusions:: Color Doppler is an easily available, reliable, and handy method of diagnosing a vascular injury. It has a very high sensitivity and specificity in diagnosis of vascular injuries.

  16. Pediatric peripheral vascular injuries: a review of our experience.

    Shah, Sohail R; Wearden, Peter D; Gaines, Barbara A


    This study evaluated peripheral vascular injuries in a pediatric trauma population to identify injury patterns, to identify diagnostic and therapeutic modalities used, and to understand the role of pediatric surgical subspecialists. A retrospective review of children treated for trauma between 2000 and 2006 at a Level I Pediatric Trauma Center was performed. Patients with vascular injury were identified through an institutional trauma registry. There were 42 vascular injuries identified during the study period. The average age was 9.8 years, with 64% occurring in males. The mechanism of injury was almost equally distributed between penetrating (55%) and blunt (45%) trauma. Forty-eight percent of patients had an associated fracture. Seventeen diagnostic angiograms were performed. Ninety-eight percent of patients were taken to the operating room for definitive management of one or more of their trauma injuries. Sixty-seven percent underwent operative management specifically for their vascular injury. Twenty-six percent of patients were diagnosed with vasospasm, and all were conservatively managed. Of the 42 patients, 23% were managed by pediatric surgeons, 43% by extremity specialists (orthopedic or plastic surgeons), and 29% by adult vascular surgeons. Pediatric traumatic vascular injuries are associated with a higher rate of penetrating trauma than other pediatric trauma and have a relatively high rate of operative intervention. Diagnosis and treatment of pediatric vascular injuries can be made difficult by a high rate of vasospasm. Additionally, traumatic vascular injuries in the pediatric population present a unique challenge in the overlap of their management by many different surgical subspecialists.

  17. Vascular injuries to the extremities in a suburban trauma center.

    Diamond, Scott; Gaspard, Donald; Katz, Steven


    The purpose of this study was to examine the experience with extremity vascular injuries of a level II suburban trauma center. A retrospective chart review was undertaken to include all patients admitted in a 6-year period with vascular injuries to the extremities. The vessels injured were identified along with the mechanism of injury. The method of repair was recorded. All associated neurologic injuries were investigated. Follow-up records, when available, were reviewed. Between January 1, 1996, and November 30, 2002, 48 patients were admitted with 56 vascular injuries to the extremities. Blunt trauma was the mechanism in 24 patients while penetrating trauma was the mechanism in the other 24 patients. The limb salvage rate was 95 per cent. Of the 28 injuries to upper extremity vessels, 24 were associated with neurologic injuries. In contrast, only 3 neurologic injuries were found in patients with lower extremity vascular injuries. In contrast to most urban centers, the distribution of vascular injuries to the extremities in a suburban setting was equally divided between blunt and penetrating injuries. The majority of functional impairment was related to neurologic injury rather than tissue ischemia from vascular injury.

  18. [Arterial vascular injuries in fractures and dislocations].

    Piatek, S; Bürger, T; Halloul, Z; Westphal, T; Holmenschlager, F; Winckler, S


    We analyzed reasons, numbers and results of arterial lesions accompanying fractures (n = 21) and luxations (n = 6) in a 6-year-period (1993-1998) retrospectively. Traffic accidents were in nearly 50% responsible for the injuries. 8 patients had suffered multiple injuries. In 17 patients the lower, and in 10 patients the upper extremities were affected. The vascular wall was completely disrupted or severed in 74%. In 7 cases (26%), patients had suffered blunt or indirect arterial trauma with intima- and media-lacerations due to subcapital fracture of the humerus (n = 2), fractured femoral bone (n = 1), luxation of the knee joint (n = 3) or the elbow (n = 1). The mean preoperative time period was 6 hours and 20 minutes (2 to 16 hours) in patients with complete ischaemia. Vascular reconstruction was performed by interposition of an autologous vein graft or an autologous venous bypass (n = 20), by direct reconstruction and primary suturing (n = 2), by use of a venous patch plasty (n = 2) and, in a single case, by autologous bypass procedure. In one case, a crural artery was ligated, in another case with a Mangled Extremity Severity Score (MESS) of 7 points a primary amputation of the lower leg was necessary. In 5 patients (19%) secondary amputations were performed. No patient died. The final outcome is mostly influenced by the preoperative period of ischaemia.

  19. Emergency intervention therapy for renal vascular injury

    LIU Feng-yong; WANG Mao-qiang; FAN Qing-sheng; WANG Zhi-jun; DUAN Feng; SONG Peng


    Objective: To evaluate the efficacy and safety of the interventional techniques in the treatment of renal vascular injury.Methods: A total of 16 patients with renal vascular injuries were treated by superselective arterial embolization.The renal injuries resulted from renal biopsy in 7 patients,endovascular intervention in 2.percutaneous puncture and pyelostomy in 2.local resection of renal tumor in 1 and trauma in 4.With regards to clinical manifestations,there was hemorrhagic shock in 8 patients,severe flank pain in 14,and hematuria in 14.CT and ultrasonography confmued that 15 Patients had perirenal hematoma.The embolization was performed with microcoils in 13 and standard stainless steel coils in 3 patients,associated with polyvinyl alcohol particles (PVA) in 9,and gelfoam particles in 6 cases.Results: Renal angiogram revealed arteriovenous fistula in renal parenchyma in 9 cases,pseudoaneurysm in 3 and extravasation of contrast media in 4.The arterial embolization was successful in all 16 cases in a single session.The angiography at the end of therapy showed that abnormal vessels had disappeared without other major intrarenal arterial branch occlusion.In 13 patients with hemodynamical compromise,blood loss-related symptoms were immediately relieved after blood transfusion.In 14 patients with severe flank pain,the pain was progressively relieved.Hematuda ceased in 14 patients 2-14 days after the embolization procedures.The renal function was impaired after the procedure in 6 cases,in which preoperative renal insufficiency was exacerbated in 3 and developed new renal dysfunction in 3.2 of whom received hemodialysis.The ultrasonography showed that perirenal hematoma was gradually absorbed within 2.6 mortths after the procedure.A11 patients were followed up in 6-78 months (mean,48 months).Six patients died of primary diseases (5 cases of renal failure and multiple organ failure and 1 case of malignant tumor).Ten patients survived without bleeding and further

  20. Outcomes after External Iliac and Femoral Vascular Injuries.

    Kim, Jerry J; Alipour, Hamid; Yule, Arthur; Plurad, David S; Koopmann, Matthew; Putnam, Brant; de Virgilio, Christian; Kim, Dennis Y


    Vascular injuries occurring at the junction of the trunk and lower extremity are uncommon yet challenging because of their location and potential for associated truncal injuries. The purpose of this study was to examine and compare outcomes among patients sustaining external iliac and femoral vascular injuries. We performed a 13-year retrospective analysis of our level 1 trauma center database to identify and compare patients with external iliac and femoral vessel injuries. Multiple logistic regression analysis was performed to identify independent predictors for mortality. During the study period, 135 patients with a median (interquartile range [IQR]) age of 25 (20-35) years were identified with external iliac (n = 29) and femoral vascular injuries (n = 106). The majority were male (85.9%) with a penetrating mechanism (84.5%), and the median (IQR) Injury Severity Score (ISS) was 16 (11-26). The overall mortality rate was 14.1%. In comparison with patients with femoral vascular injuries, patients with external iliac injuries presented with higher ISS (25 vs. 16, P vascular injuries, external iliac vascular injuries are associated with higher blood loss, more intense resuscitation, higher disability and mortality in patients sustaining junctional groin injuries. Early recognition and application of damage control techniques and resuscitative practices may result in improved outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Joint Global War on Terror (GWOT) Vascular Injury Study 2


    surveillance program design and identified Service Members who incurred vascular injury. She has left the study. Name: Andrea Russell Project...Role: Research Nurse Nearest person month worked: 36 Contribution to Project: Ms. Andrea Russell assisted in developing the surveillance...program design and continues to identify Service Members who incurred vascular injury for inclusion in the study. Ms. Russell also oversees all

  2. [Prehospital care in extremity major vascular injuries].

    Samokhvallov, I M; Reva, V A; Pronchenko, A A; Seleznev, A B


    The problem of temporary hemorrhage control is one of the most important issues of modern war surgery and surgery of trauma. It is a review of literature devoted to prehospital care in extremity major vascular injuries, embraced up-to-date domestic materials as well as the modern foreign papers in this area. The most important historical landmarks of temporary hemorrhage control system are considered. We paid special attention to the most usable methods and means of hemorrhage control which are utilized at the modern time: pressure bandages, tourniquets, local haemostatic agents. The comprehensive analysis of the contamporary haemostatic means concerning U.S. Army has done. The experience of foreign colleagues in development of prehospital care for the injured, creation and progress of new haemostatic methods, application of temporary hemorrhage control system is analyzed.

  3. Endovascular Management of Vascular Injury during Transsphenoidal Surgery.

    Cinar, C; Bozkaya, H; Parildar, M; Oran, I


    Vascular injury is an unusual and serious complication of transsphenoidal surgery. We aimed to define the role of angiography and endovascular treatment in patients with vascular injuries occurring during transsphenoidal surgery. During the last ten-year period, we retrospectively evaluated nine patients with vascular injury after transsphenoidal surgery. Eight patients were symptomatic due to vascular injury, while one had only suspicion of vascular injury during surgery. Four patients presented with epistaxis, two with subarachnoid hemorrhage, one with exophthalmos, and one with hemiparesia. Emergency angiography revealed a pseudoaneurysm in four patients, contrast extravasation in two, vessel dissection in one, vessel wall irregularity in one, and arteriovenous fistula in one. All patients but one were treated successfully with parent artery occlusion, with one covered stent implantation, one stent-assisted coiling method, while one patient was managed conservatively. One patient died due to complications related to the primary insult without rebleeding. Vascular injuries suspected intra or postoperatively must be investigated rapidly after transsphenoidal surgery. Endovascular treatment with parent artery occlusion is feasible with acceptable morbidity and mortality rates in the treatment of vascular injuries occurring in transsphenoidal surgery.

  4. Terror attacks increase the risk of vascular injuries.

    Heldenberg, Eitan; Givon, Adi; Simon, Daniel; Bass, Arie; Almogy, Gidon; Peleg, Kobi


    Extensive literature exists about military trauma as opposed to the very limited literature regarding terror-related civilian trauma. However, terror-related vascular trauma (VT), as a unique type of injury, is yet to be addressed. A retrospective analysis of the Israeli National Trauma Registry was performed. All patients in the registry from 09/2000 to 12/2005 were included. The subgroup of patients with documented VT (N = 1,545) was analyzed and further subdivided into those suffering from terror-related vascular trauma (TVT) and non-terror-related vascular trauma (NTVT). Both groups were analyzed according to mechanism of trauma, type and severity of injury and treatment. Out of 2,446 terror-related trauma admissions, 243 sustained TVT (9.9%) compared to 1302 VT patients from non-terror trauma (1.1%). TVT injuries tend to be more complex and most patients were operated on. Intensive care unit admissions and hospital length of stay was higher in the TVT group. Penetrating trauma was the prominent cause of injury among the TVT group. TVT group had a higher proportion of patients with severe injuries (ISS ≥ 16) and mortality. Thorax injuries were more frequent in the TVT group. Extremity injuries were the most prevalent vascular injuries in both groups; however NTVT group had more upper extremity injuries, while the TVT group had significantly much lower extremity injuries. Vascular injuries are remarkably more common among terror attack victims than among non-terror trauma victims and the injuries of terror casualties tend to be more complex. The presence of a vascular surgeon will ensure a comprehensive clinical care.

  5. Factors Associated with Amputation after Popliteal Vascular Injuries.

    Keeley, Jessica; Koopmann, Matthew; Yan, Huan; DeVirgilio, Christian; Putnam, Brant; Y Kim, Dennis; Plurad, David


    Popliteal artery trauma has the highest rate of limb loss of all peripheral vascular injuries. The objectives of this study were to evaluate outcomes after popliteal vascular injury and to identify predictors of amputation. Retrospective data over a 14-year period were collected for patients with popliteal artery with or without vein injuries. Patient demographics, mechanism of injury, Injury Severity Score (ISS), Mangled Extremity Severity Score (MESS), and physiologic parameters were extracted. Time to operative intervention, operative time, type of vascular repair, need for concomitant orthopedic procedures, and outcomes including amputation rate, and in-hospital mortality were recorded. Fifty-one patients were found to have popliteal artery injuries, with a median age of 25 (range 10-70 years). The median ISS was 9, and the mean extremity Abbreviated Injury Severity score was 3. The mechanism of injury was blunt for 43% and penetrating for 57%. Fasciotomies were performed in 74% of patients and 64% of patients underwent combined orthopedic and vascular procedures. Overall, 66% of these patients had their vascular procedure performed first. Ten patients required amputation: 1 immediate and 9 after attempted limb salvage (20%). We found that those patients requiring amputation had a higher incidence of blunt trauma (80% vs. 35%, P = 0.014) and higher MESS score (7.1 vs. 4.7, P = 0.02). There was no difference in the incidence of amputation for those who underwent orthopedic fixation before vascular repair (P = 0.68). Popliteal vascular injuries continue to be associated with a high risk of amputation. Those patients undergoing attempted limb salvage should be revascularized expediently, but selected patients may undergo orthopedic stabilization before vascular repair without increased risk of limb loss. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Joint Global War on Terror (GWOT) Vascular Injury Study 2


    AWARD NUMBER: W81XWH-13-2-0014 TITLE: Joint Global War on Terror (GWOT) Vascular Injury Study 2 PRINCIPAL INVESTIGATOR: MAJ Zachary...SUBTITLE Joint Global War on Terror (GWOT) Vascular Injury Study 2 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-13-2-0014 5c. PROGRAM ELEMENT NUMBER...effort by Col Rasmussen and has taken leadership of the protocol . HRPO approval was obtained September 9, 2014. Research staff has attempted to

  7. An experimental study on vascular changes in renal biopsy injury

    Lim, Jae Hoon; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    An experimental study on the vascular alternations of the kidney following biopsy procedure was carried out in 47 kidneys from 28 rabbits to clarify their nature and frequency by renal arteriography and microangiography together with histopathologic investigation. Renal arteriography and microangiography were performed immediately 2 days, 1 week, and 2 weeks after percutaneous biopsy and the findings were correlated with histological nature. The results are summarized as follows: 1. Important biopsy injuries verified by renal arteriography and microangiography were arterial spasm, perfusion defect, arteriovenous fistula, injury to vasa rectae and renal tubules, intrarenal and extrarenal extravasation of contrast media, and arterial obstruction, in order of frequency. 2. Arterial spasm observed in majority of the cases were relieved during the period of 2 weeks. 3. Detectability of perfusion detect was 57% and 72% angiography and microangiography, respectively, and this perfusion defect seemed to be mostly caused by renal infraction due to vascular injury, such as arteriovenous fistula, arterial obstruction and other vascular injuries. 4. Arteriovenous fistula was detected in 28% by angiography and 50% by microangiography. Many of the arteriovenous fistulae appeared to be closed spontaneous within a week. Above findings suggest that renal biopsy procedure results in various degree of vascular injuries with their sequential modification, and that microangiography is assumed the most effective approach in analysis of biopsy injuries such as small arteriovenous fistula, perfusion defect, injury to vasa recta and renal tubules, overcoming the limitation of traditional angiography.

  8. Extremities--indications and techniques for treatment of extremity vascular injuries.

    Doody, O; Given, M F; Lyon, S M


    Traumatic vascular injuries involving the extremity are rare and penetrating trauma accounts for the majority of such injuries. The remaining arterial injuries are as a result of either blunt or iatrogenic injuries. The rapid detection, localisation and characterisation of vascular injuries in patients who have a traumatic extremity injury is essential for the effective management and treatment of such injuries. This review will discuss the expanding role of multi-detector computed tomography angiography in diagnosing vascular injuries and its implications on conventional diagnostic angiography. The roles of other non-invasive imaging modalities are reviewed. The presentation and types of vascular injuries in blunt and penetrating injuries are discussed. While surgery remains the gold standard in the management of vascular extremity injuries it has significant morbidity rates. Endovascular techniques are increasingly being used for the treatment of vascular traumatic injuries and various techniques including balloon occlusion, embolisation and stent/stent graft placement are discussed.

  9. Compartment syndrome and popliteal vascular injury complicating unicompartmental knee arthroplasty

    Kort, Nanne Pieter; Van Raay, Jos J. J. A. M.; van Horn, Jim R.


    Popliteal vascular injury and the compartment syndrome of the leg are rare but important complications of knee arthroplasties. Early diagnosis and treatment are of paramount importance in preventing the devastating complications of these conditions. To our knowledge, these complications have not bee

  10. [Peripheral nerve injuries complicating extracranial vascular surgery (author's transl)].

    Grobe, T; Raithel, D


    Peripheral nerve injuries may complicate extracranial vascular surgery. Pareses of the recurrent and hypoglossal nerves are clinically important. The nervus laryngeus superior, the ramus marginalis mandibulae of the facial nerve and the brachial plexus may be involved. Horner's syndrom indicating damage of sympathetic fibers may also appear. Lesions of the glossopharyngeal, vagus and phrenic nerves are rather seldom.

  11. A case of acute bilateral femur fracture with vascular injury

    Slavisa Zagorac; Aleksandar Lesic; Marko Bumbasirevic


    The femoral fractures remain the great challenge for orthopedic surgeons regarding time of fixation and appropriate fixation techniques. There is a bimodal distribution of fractures occurring most frequently in young males after high-energy trauma (motor vehicle accidents) and in elderly females after falls from standing. Young patients with femoral fracture are under the great risk of multiple injuries. Hence, the great significance is optimal time of fixation. We present a case of unusual pattern of injury and fixation technique of bilateral proximal femur fracture associated with vascular injury, with very satisfied outcome.

  12. A case of acute bilateral femur fracture with vascular injury

    Slavisa Zagorac


    Full Text Available The femoral fractures remain the great challenge for orthopedic surgeons regarding time of fixation and appropriate fixation techniques. There is a bimodal distribution of fractures occurring most frequently in young males after high-energy trauma (motor vehicle accidents and in elderly females after falls from standing. Young patients with femoral fracture are under the great risk of multiple injuries. Hence, the great significance is optimal time of fixation. We present a case of unusual pattern of injury and fixation technique of bilateral proximal femur fracture associated with vascular injury, with very satisfied outcome.




    Dec 1, 2000 ... infected end-to-end anastomosis of popliteal artery injury. The other was a case ... increased risk of delayed union and non-union(24). Some of the ... compromise and amputation after intramedullary nailing of a tibia fracture.

  14. Vascular injuries after blunt chest trauma: diagnosis and management

    O'Connor, James V; Byrne, Christopher; Scalea, Thomas M; Griffith, Bartley P; Neschis, David G


    Background Although relatively rare, blunt injury to thoracic great vessels is the second most common cause of trauma related death after head injury. Over the last twenty years, the paradigm for management of these devastating injuries has changed drastically. The goal of this review is to update the reader on current concepts of diagnosis and management of blunt thoracic vascular trauma. Methods A review of the medical literature was performed to obtain articles pertaining to both blunt injuries of the thoracic aorta and of the non-aortic great vessels in the chest. Articles were chosen based on authors' preference and clinical expertise. Discussion Blunt thoracic vascular injury remains highly lethal, with most victims dying prior to reaching a hospital. Those arriving in extremis require immediate intervention, which may include treatment of other associated life threatening injuries. More stable injuries can often be medically temporized in order to optimize definitive management. Endovascular techniques are being employed with increasing frequency and can often significantly simplify management in otherwise very complex patient scenarios. PMID:19751511

  15. Analysis of peripheral vascular injuries: A social catastrophe

    Süleyman Yazıcı


    Full Text Available Objective:In the current study, peripheral vascular injuries caused from weapons and the associated clinical outcomes were retrospectively investigated. Methods:Two hundred patients who received a surgical procedure for a vascular injury between January 2009 and December 2011 were included in the study. The patients were evaluated retrospectively; type of injury, localization, characteristics, and type of surgical application were classified. Results: Weapon-related penetrating injuries were classified as gunshot injuries (n=55, 28%, stab wounds (n =143, 71%, and mine injuries (n= 2, 1%. There were 77 interposition applications (71 arterial and 6 venous with saphene vein grafts, 16 arterial interposition applications with polytetrafluoroethylene grafts, and 11 venous ligations. A total of 170 direct repairs (134 arterial and 36 venous were performed. Postoperative amputation was required in none of the cases, advanced intensive care unit follow-up was required for four patients (2%; two cases were referred with hypovolemic shock and two case were referred with asystole, and a postoperative follow-up period for any mortality was not observed. Conclusion:Some regions contain higher levels of warinjuries. Therefore, these regions require specialized intervention centres. A large amount of these injuries arevascular, and surgery and rapid interventions are essential for reducing mortality and morbidity rates. Successful results can be obtained in these cases through the collaboration of various medical disciplines.

  16. Crucial role of hyaluronan in neointimal formation after vascular injury.

    Yuichiro Kashima

    Full Text Available BACKGROUND: Hyaluronan (HA is a primary component of the extracellular matrix of cells, and it is involved in the pathogenesis of atherosclerosis. The purpose of this study was to investigate the role of HA in neointimal formation after vascular injury and determine its tissue-specific role in vascular smooth muscle cells (VSMCs by using a cre-lox conditional transgenic (cTg strategy. METHODS AND RESULTS: HA was found to be expressed in neointimal lesions in humans with atherosclerosis and after wire-mediated vascular injury in mice. Inhibition of HA synthesis using 4-methylumbelliferone markedly inhibited neointimal formation after injury. In vitro experiments revealed that low-molecular-weight HA (LMW-HA induced VSMC activation, including migration, proliferation, and production of inflammatory cytokines, and reactive oxygen species (ROS. The migration and proliferation of VSMCs were mediated by the CD44/RhoA and CD44/ERK1/2 pathways, respectively. Because HA synthase 2 (HAS2 is predominantly expressed in injured arteries, we generated cTg mice that overexpress the murine HAS2 gene specifically in VSMCs (cHAS2/CreSM22α mice and showed that HA overexpression markedly enhanced neointimal formation after cuff-mediated vascular injury. Further, HA-overexpressing VSMCs isolated from cHAS2/CreSM22α mice showed augmented migration, proliferation, and production of inflammatory cytokines and ROS. CONCLUSION: VSMC-derived HA promotes neointimal formation after vascular injury, and HA may be a potential therapeutic target for cardiovascular disease.

  17. Immune mechanisms in hypertension and vascular injury.

    Schiffrin, Ernesto L


    Over the last 20 years it has become recognized that low-grade inflammation plays a role in cardiovascular disease. More recently, participation of the innate and the adaptive immune response in mechanisms that contribute to inflammation in cardiovascular disease has been reported in atherosclerosis and hypertension. Different subsets of lymphocytes and their cytokines are involved in vascular remodelling in hypertension, chronic kidney disease and heart disease. Effector T-cells include Th1 (interferon-γ-producing) and Th2 (interleukin-4 producing) lymphocytes, as well as Th17 (which produce interleukin-17) and T-suppressor lymphocytes such as T(reg)-cells (regulatory T-cells), which express the transcription factor Foxp3 (forkhead box P3) and participate respectively as pro- and anti-inflammatory cells. Pro-inflammatory T-lymphocytes participate in mechanisms of cardiovascular disease in part by mediating the effects of angiotensin II and mineralocorticoids. Involvement of immune mechanisms in cardiac, vascular and renal changes in hypertension has been demonstrated in many experimental models, an example being the Dahl-salt sensitive rat and the spontaneously hypertensive rat. How activation of immunity is triggered remains unknown, but neo-antigens could be generated by elevated blood pressure through damage-associated molecular pattern receptors or other mechanisms. Once activated, Th1 cells may contribute to blood pressure elevation by affecting the kidney, vascular remodelling of blood vessels directly via the effects of the cytokines produced or through their effects on perivascular fat. T(reg)-cells protect from blood pressure elevation by acting upon similar targets. Recent data suggests that participation of these mechanisms that have been demonstrated already in murine models also occurs in humans. These novel findings may open the way for new therapeutic approaches to improve outcomes in hypertension and cardiovascular disease in humans.

  18. Characteristics and treatment of vascular injuries: a review of 387 cases at a Chinese center

    Li, Zhui; Zhao, Liang; Wang, Kaizhen; Cheng, Jun; Zhao, Yu; Ren, Wei


    Objective: To assess clinical characteristics and treatment outcomes of patients with vascular injuries. Materials and methods: We retrospectively reviewed the medical records of 378 consecutive patients with vascular injuries treated at our hospital from January 2000 to December 2012. Basic characteristics (such as gender; age; cause, site, and type of injury; and concomitant injuries) were recorded, and efficacy was compared between treatments for same type/site injuries. Results: Vascular ...

  19. Bilateral near-infrared spectroscopy for detecting traumatic vascular injury.

    Van Haren, Robert M; Ryan, Mark L; Thorson, Chad M; Namias, Nicholas; Livingstone, Alan S; Proctor, Kenneth G


    Extremity wounds account for most battlefield injuries. Clinical examination may be unreliable by medics or first responders, and continuous assessment by experienced practitioners may not be possible on the frontline or during transport. Near-infrared spectroscopy (NIRS) provides continuous, noninvasive monitoring of tissue oxygen saturation (StO2), but its use is limited by inter-patient and intra-patient variability. We tested the hypothesis that bilateral NIRS partially addresses the variability problem and can reliably identify vascular injury after extremity trauma. This prospective study consisted of 30 subjects: 20 trauma patients with extremity injury and 10 healthy volunteers. Bilateral StO2 tissue sensors were placed on the thenar eminence or medial plantar surface. Injured and non-injured extremities within the same patient (ΔStO2) were compared using Wilcoxon signed ranks test. Receiver operating characteristic curves were generated and areas under the curve (AUCs) were calculated for ΔStO2 of 6, 10, and 15. Values are expressed as median (interquartile range). Trauma patients were age 31 y (23 y), 85% male, with injury severity score of 9 (5). There were seven arterial and three venous injuries. Most involved the lower extremity (n = 16; 80%) and resulted from a penetrating mechanism (n = 14; 70%). ΔStO2 between limbs was 20.4 (10.4) versus 2.4 (3.0) (P vascular injury versus patients and volunteers with no vascular injury. ΔStO2 reliably identified any vascular injury (AUC, 0.975; P < 0.001), whereas pulse examination alone or in combination with Doppler exam could detect only arterial injury. A ΔStO2 of 6 had the greatest sensitivity and specificity (AUC, 0.900; P < 0.001). Continuous monitoring of bilateral limbs with NIRS detects changes in perfusion resulting from arterial or venous injury and may offer advantages over serial manual measurements of pulses or Doppler signals. This technique may be most relevant in military and disaster

  20. Craniofacial gunshot injuries: an unrecognised risk factor for blunt cervical vascular injuries?

    Steenburg, Scott D; Sliker, Clint W


    To review our institutional experience with cervical arterial injuries remote from the penetrating tract seen in the setting of craniofacial gunshot injuries. Institutional Review Board approval was obtained. Our institutional trauma registry was queried over a 5-year period for patients with cervical arterial injuries due to penetrating craniofacial gunshot wounds who underwent CT angiography. Imaging results and clinical notes were reviewed. A total of 427 patients sustained gunshot wounds to the head, face and/or neck, of whom 222 underwent CT angiography yielding 56 patients with 78 vascular injuries. There were five internal carotid artery injuries remote from the wound tract. The incidence of these "indirect" cervical arterial injuries in our patient population was 1.2%, or 2.8% of patients who underwent CT angiography. The incidence of "indirect" cervical arterial injuries with craniofacial gunshot wounds is comparable to or slightly higher than those seen in pure blunt trauma. Screening patients with craniofacial gunshot injuries with CT angiography may yield unexpected cervical vascular injuries remote from the penetrating tract. The significance and optimal therapy of these injuries are unknown. Additional experience will be needed to determine the significance of "indirect" cervical arterial injuries in the setting of craniofacial gunshot wounds.

  1. Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement

    Dencker, Ditte; Taudorf, Mikkel; Luk, N H Vincent;


    Vascular access and closure remain a challenge in transcatheter aortic valve replacement (TAVR). This single-center study aimed to report the incidence, predictive factors, and clinical outcomes of access-related vascular injury and subsequent vascular intervention. During a 30-month period, 365...

  2. Drinking citrus fruit juice inhibits vascular remodeling in cuff-induced vascular injury mouse model.

    Ohnishi, Arika; Asayama, Rie; Mogi, Masaki; Nakaoka, Hirotomo; Kan-No, Harumi; Tsukuda, Kana; Chisaka, Toshiyuki; Wang, Xiao-Li; Bai, Hui-Yu; Shan, Bao-Shuai; Kukida, Masayoshi; Iwanami, Jun; Horiuchi, Masatsugu


    Citrus fruits are thought to have inhibitory effects on oxidative stress, thereby attenuating the onset and progression of cancer and cardiovascular disease; however, there are few reports assessing their effect on vascular remodeling. Here, we investigated the effect of drinking the juice of two different citrus fruits on vascular neointima formation using a cuff-induced vascular injury mouse model. Male C57BL6 mice were divided into five groups as follows: 1) Control (water) (C), 2) 10% Citrus unshiu (CU) juice (CU10), 3) 40% CU juice (CU40), 4) 10% Citrus iyo (CI) juice (CI10), and 5) 40% CI juice (CI40). After drinking them for 2 weeks from 8 weeks of age, cuff injury was induced by polyethylene cuff placement around the femoral artery. Neointima formation was significantly attenuated in CU40, CI10 and CI40 compared with C; however, no remarkable preventive effect was observed in CU10. The increases in levels of various inflammatory markers including cytokines such as monocyte chemotactic protein-1, interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α in response to vascular injury did not differ significantly between C, CU10 and CI10. The increases in cell proliferation and superoxide anion production were markedly attenuated in CI10, but not in CU10 compared with C. The increase in phosphorylated ERK expression was markedly attenuated both in CU10 and CI10 without significant difference between CU10 and CI10. Accumulation of immune cells did not differ between CU10 and CI10. These results indicate that drinking citrus fruit juice attenuates vascular remodeling partly via a reduction of oxidative stress. Interestingly, the preventive efficacy on neointima formation was stronger in CI than in CU at least in part due to more prominent inhibitory effects on oxidative stress by CI.

  3. Vascular Injury Accompanying Displaced Proximal Humeral Fractures: Two Cases and a Review of the Literature

    Martijn Hofman


    Full Text Available We present two cases in which displaced proximal humeral fractures are accompanied by vascular injury. These Injuries are very rare but severe and the accompanying vascular impairment can have great clinical consequences. Therefore, we try to emphasize on the importance of thorough and accurate diagnostics, because it is obligatory for early diagnosis and improving the eventual outcome of these injuries. The specific order in treatment (internal fixation first or vascular repair first depends on the severity of the accompanying vascular injury. The increasing use of endovascular procedures to treat vascular lesions is a very interesting development with several advantages, especially in elderly and multimorbid patients.

  4. Risk factors for amputation in extremity vascular injuries in Saudi Arabia.

    Al Wahbi, Abdullah; Aldakhil, Salman; Al Turki, Saud; El Kayali, Abdulrahman; Al Kohlani, Hussein; Al Showmer, Abdulaziz


    Amputation is most closely associated with blunt, lower limb injuries associated with vascular trauma. These vascular injuries require a special attention to prevent life and limb loss. Patient outcomes can also be improved by organizing vascular trauma data into appropriate systems to facilitate future studies.

  5. Vascular injuries of the upper extremity Lesões vasculares de membros superiores

    Raafat Shalabi


    Full Text Available OBJECTIVE: This study analyzes the causes of injuries, presentations, surgical approaches, outcome and complications of vascular trauma of the upper limbs, in spite of limited hospital resources. METHODS: A 5-year retrospective analysis. From 01/01/2001 to 31/12/2005, 165 patients were operated for vascular injuries at King Fahd Hospital, Medina, Saudi Arabia. Of all peripheral vascular trauma patients (115, upper limb trauma was present in 58. Diagnosis was made by physical examination and hand-held Doppler alone or in combination with Doppler scan/angiography. Primary vascular repair was performed whenever possible; otherwise, the interposition vein graft was used. Fasciotomy was considered when required. Patients with unsalvageable lower extremity injury requiring primary amputation were excluded from the study. RESULTS: Fifty patients were male (86% and eight were female (14%, aged between 2.5-55 years (mean 23 years. Mean duration of presentation was 8 h after the injury. The most common etiological factor was road traffic accidents, accounting for 50.5% in the blunt trauma group and 33% among all penetrating and stab wound injuries. Incidence of concomitant orthopedic injuries was very high in our study (51%. The brachial artery was the most affected (51%. Interposition vein grafts were used in 53% of the cases. Limb salvage rate was 100%. CONCLUSION: Patients who suffer vascular injuries of the upper extremities should be transferred to vascular surgery centers as soon as possible. Decisive management of peripheral vascular trauma will maximize patient survival and limb salvage. Priorities must be established in the management of associated injuries, and delay must be avoided when ischemic changes are present.OBJETIVO: Este estudo analisa as causas de lesões, apresentação, abordagens cirúrgicas, desfechos e complicações do trauma vascular de membros superiores, apesar de recursos hospitalares limitados. MÉTODOS: An

  6. Paediatric extremity vascular injuries - experience from a large urban trauma centre in India.

    Jaipuria, Jiten; Sagar, Sushma; Singhal, Maneesh; Bagdia, Amit; Gupta, Amit; Kumar, Subodh; Mishra, Biplab


    Paediatric extremity vascular injuries are infrequent, and management protocols draw significantly from adult vascular trauma experience necessitating a continuous review of evidence. A retrospective registry review of all consecutive patients younger than 18 years age treated for extremity vascular trauma from 2007 to 2012 was carried out. Diagnostic algorithm relied little on measurement of pressure indices. Data was collected about demographics, time since injury, pattern of injury, ISS, initial GCS and presence of shock, results of diagnostic modality and treatment given with associated complications. Patients completing 2 years follow up were assessed for functional disability and vascular patency. A multivariable regression model was used to evaluate effects of - ISS, presence of orthopaedic injury, soft tissue injury, neural injury and arterial patency at the end of 2 years - on outcome of functional disability. Paediatric extremity vascular injuries accounted for 0.68% hospital admissions with a median delay of 8h from injury. 82 patients were included with 50 cases examined for long term outcome. Patient cohort was overwhelmingly male, with 'fall', 'road traffic injury' and 'glass cut' being most common injury mechanisms. CT angiography and duplex scan based diagnostic algorithm performed satisfactorily further identifying missed injuries and aiding complex orthopaedic reconstruction. Brachial and femoral vessels were most commonly injured. Lower extremity vascular injury was found associated with significantly higher ISS and requirement for fasciotomy. Upper extremity vascular injury was associated with higher odds of neural injury. Younger children were at higher risk of combined radial and ulnar vessel injury. No patient satisfactorily complied with post-operative anticoagulant/antithrombotic prophylaxis. 28 patients had good functional outcome with unsatisfactory functional outcome found associated with significantly higher ISS, presence of orthopaedic

  7. Tourniquet use for peripheral vascular injuries in the civilian setting.

    Passos, Edward; Dingley, Brittany; Smith, Andrew; Engels, Paul T; Ball, Chad G; Faidi, Samir; Nathens, Avery; Tien, Homer


    Haemorrhage in peripheral vascular injuries may cause life-threatening exsanguination. Tourniquets are used extensively by the military, with increased interest in the civilian setting to prevent deaths. This is a retrospective study of trauma patients at two large Canadian trauma centres with arterial injury after isolated extremity trauma. We hypothesized that tourniquet use may decrease mortality rate and transfusion requirements if applied early. The study group was all adult patients at two Level 1 Trauma Centres in two Canadian cities in Canada, who had arterial injuries from extremity trauma. The study period was from January 2001 to December 2010. We excluded patients with significant associated injuries. The intervention in this study was prehospital tourniquet use. The main outcome was in-hospital mortality. Secondary outcomes were length of stay, compartment syndrome, amputation, and blood product transfusion. 190 patients were included in the study, and only 4 patients had a prehospital tourniquet applied. They arrived directly from the scene of injury, had improvised tourniquets by police or bystanders, and showed a trend to be more hypotensive and acidotic. Four other patients had tourniquets applied in the trauma bay within 1h of injury. There were no differences in age, sex, injury severity or physiologic presentation between patients who had an early tourniquet applied and those who died without a tourniquet. However, six patients died without a tourniquet, and all bled to death. Of the eight patients who had early tourniquets applied, none died. Tourniquets may prevent exsanguination in the civilian setting for patients suffering either blunt or penetrating trauma to the extremity. Future studies will help determine the utility of deploying tourniquets in the civilian setting, given the rarity of exsanguinating haemorrhage from isolated extremity trauma in this setting. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  8. Risk factors for amputation in extremities vascular injuries in Saudi Arabia

    Al Wahbi A


    Full Text Available Abdullah Al Wahbi, Salman Aldakhil, Saud Al Turki, Abdulrahman El Kayali, Hussein Al Kohlani , Abdulaziz Al Showmer Department of Surgery, Division of Vascular Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia Abstract: Amputation is most closely associated with blunt, lower limb injuries associated with vascular trauma. These vascular injuries require a special attention to prevent life and limb loss. Patient outcomes can also be improved by organizing vascular trauma data into appropriate systems to facilitate future studies. Keywords: vascular injuries, extremities trauma, amputation, ischemia

  9. Body representation in patients after vascular brain injuries.

    Razmus, Magdalena


    Neuropsychological literature suggests that body representation is a multidimensional concept consisting of various types of representations. Previous studies have demonstrated dissociations between three types of body representation specified by the kind of data and processes, i.e. body schema, body structural description, and body semantics. The aim of the study was to describe the state of body representation in patients after vascular brain injuries and to provide evidence for the different types of body representation. The question about correlations between body representation deficits and neuropsychological dysfunctions was also investigated. Fifty patients after strokes and 50 control individuals participated in the study. They were examined with tasks referring to dynamic representation of body parts positions, topological body map, and lexical and semantic knowledge about the body. Data analysis showed that vascular brain injuries result in deficits of body representation, which may co-occur with cognitive dysfunctions, but the latter are a possible risk factor for body representation deficits rather than sufficient or imperative requisites for them. The study suggests that types of body representation may be separated on the basis not only of their content, but also of their relation with self. Principal component analysis revealed three factors, which explained over 66% of results variance. The factors, which may be interpreted as types or dimensions of mental model of a body, represent different degrees of connection with self. The results indicate another possibility of body representation types classification, which should be verified in future research.

  10. Iatrogenic vascular injuries in Sweden. A nationwide study 1987-2005.

    Rudström, H; Bergqvist, D; Ogren, M; Björck, M


    To study the epidemiology of vascular injuries, with special focus on iatrogenic vascular injuries (IVIs) and time-trends. From the Swedish national vascular registry, Swedvasc, prospectively registered data on vascular injuries during 1987-2005 were analysed and cross-referenced for mortality against the population registry. Of 1853 injuries, 48% were caused by iatrogenic, 29% penetrating and 23% blunt trauma. In the three groups median age was 68, 35 and 40 years, respectively. The annual incidence of procedures for vascular injuries increased from 1.2-1.6 per 100 000 inhabitants and the proportion of IVIs increased from 41 to 51%, during the period. Mortality was higher after IVI (4.9%) compared to non-IVI (2.5%). Patients with IVI also had more co-morbidities; 58% cardiac disease, 44% hypertension, and 18% renal dysfunction. Among 888 IVIs, right femoral arterial injury was the most frequent (37%). The most common vascular reconstruction was direct suture (39%) followed by by-pass or interposition graft (19%, of which prosthetics were used in over half the cases). Endovascular repair increased from 4.6% to 15% between 1987 and 2005. Vascular injuries, in particular iatrogenic ones, appear to be increasing. Iatrogenic injuries affect vulnerable patients with co-morbidities and are associated with a high mortality.

  11. Management of traumatic popliteal vascular injuries in a level I trauma center: A 6-year experience.

    Sciarretta, Jason D; Macedo, Francisco Igor B; Otero, Christian A; Figueroa, Jose N; Pizano, Louis R; Namias, Nicholas


    Popliteal vascular trauma remains a challenging entity, and carries the greatest risk of limb loss among the lower extremity vascular injuries. Operative management of traumatic popliteal vascular injuries continues to evolve. We aim at describing our experience with such complex injuries, with associated patterns of injury, diagnostic and therapeutic challenges, and outcomes. From January 2006 to September 2011, 191 adult trauma patients presented to an urban level I trauma center in Miami, Florida with traumatic lower extremity vascular injuries. Variables collected included age, gender, mechanism of injury, and clinical status at presentation. Surgical data included vessel injury, technical aspects of repair, associated complications and outcomes. Forty-seven (24.6%) patients were diagnosed with traumatic popliteal vascular injuries. Mean age was 38.1 ± 16.1 years, and the majority of patients were males (43 patients, 91.4%). There were 21 (44.7%) penetrating injuries, and 26 (55.3%) blunt injuries. Vascular repair with saphenous venous interposition graft and PTFE (polytetrafluoroethylene) grafting were performed in 36 (70.7%) and 2 (3.9%) patients, respectively. Blunt popliteal injuries were significantly more associated with major tissue loss, and length of hospital and intensive care unit (ICU) stays. The risk for amputation is increased with longer ICU stays and the use of PTFE grafting for vascular repair. The overall mortality rate in this series was 8.5%. Blunt popliteal vascular injuries are associated with increased morbidity compared to penetrating trauma. Early restoration of blood perfusion, frequent use of interposition grafts with autogenous saphenous vein, and liberal use of fasciotomies play important role to achieve acceptable outcomes. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  12. Wartime vascular injuries in the pediatric population of Iraq and Afghanistan: 2002-2011


    Vascular trauma in infants and children. J Trauma 1979;19(7):532–6. [14] Cox C, Black C, Duke J, et al. Operative treatment of truncal vascular...Accepted 4 October 2013 Key words: Vascular injury Trauma Children Pediatric Wartime Reconstruction Background: Contemporary war-related studies focus...vascular trauma at US military hospitals in wartime Iraq and Afghanistan. Methods: Review of the Department of Defense Trauma Registry (DoDTR) (2002

  13. Vascular Injuries Caused by Tear Gas Shells: Surgical Challenge and Outcome

    Mohd Lateef Wani


    Full Text Available Background: Tear gas shells are used to disperse the mob during any type of street protests. Vascular injuries due to tear gas shells have not been reported. The present study was un-dertaken to analyse the pattern, presentation, management and outcome of vascular injury due to tear gas shells. Methods: Eighteen patients with vascular injury caused by tear gas shells from 1st Jan. 2008 to 31st Dec 2009 were studied. Patients with vascular injuries caused by causes other than tear gas shells were excluded from the study. Results: All patients were treated with reverse saphenous vein graft as segmental loss was less than 2.5 cm. Wound infection was the most common complication, followed by graft occlusion. Amputation rate was 16.66%. Associated nerve injury occurred in 44.44% of the patients. Conclusion: Tear gas shell injuries should not be taken lightly. They can cause injuries as serious as vascular injuries. Vascular injuries cased by tear gas shells require prompt revascularisation to improve limb salvage. De-spite proper revascularisation, patients have significant morbidity and need proper rehabilitation in the follow ups.

  14. Transcranial Doppler investigation of hemodynamic alterations associated with blunt cervical vascular injuries in trauma patients.

    Purvis, Dianna L; Crutchfield, Kevin; Trickey, Amber W; Aldaghlas, Tayseer; Rizzo, Anne; Sikdar, Siddhartha


    Blunt cervical vascular injuries, often missed with current screening methods, have substantial morbidity and mortality, and there is a need for improved screening. Elucidation of cerebral hemodynamic alterations may facilitate serial bedside monitoring and improved management. Thus, the objective of this study was to define cerebral flow alterations associated with single blunt cervical vascular injuries using transcranial Doppler sonography and subsequent Doppler waveform analyses in a trauma population. In this prospective pilot study, patients with suspected blunt cervical vascular injuries had diagnoses by computed tomographic angiography and were examined using transcranial Doppler sonography to define cerebral hemodynamics. Multiple vessel injuries were excluded for this analysis, as the focus was to identify hemodynamic alterations from isolated injuries. The inverse damping factor characterized altered extracranial flow patterns; middle cerebral artery flow velocities, the pulsatility index, and their asymmetries characterized altered intracranial flow patterns. Twenty-three trauma patients were evaluated: 4 with single internal carotid artery injuries, 5 with single vertebral artery injuries, and 14 without blunt cervical vascular injuries. All internal carotid artery injuries showed a reduced inverse damping factor in the internal carotid artery and dampened ipsilateral mean flow and peak systolic velocities in the middle cerebral artery. Vertebral artery injuries produced asymmetry of a similar magnitude in the middle cerebral artery mean flow velocity with end-diastolic velocity alterations. These data indicate that extracranial and intracranial hemodynamic alterations occur with internal carotid artery and vertebral artery blunt cervical vascular injuries and can be quantified in the acute injury phase by transcranial Doppler indices. Further study is required to elucidate cerebral flow changes resulting from a single blunt cervical vascular injury

  15. Traumatic vascular injuries of the lower extremity: report of the Iranian National Trauma Project.

    Rasouli, Mohammad R; Moini, Majid; Khaji, Ali; Heidari, Pedram; Anvari, Arash


    This study aimed to determine the pattern of traumatic lower extremity vascular injuries in Iran. Patients with vascular injury of the lower extremity were selected from the Iranian National Trauma Project. This project was conducted in eight major cities during 2000-2004 and consisted of more than 17000 patients. Sixty-three subjects (54 men) with a total of 92 vascular injuries of the lower extremity were identified. Mean age of the patients was 25.87 +/- 13.37 years. Blunt trauma was more frequent than penetrating (62% vs. 38%). In 36 cases (57%), road traffic crash (RTC) was the cause of injury. In 21% of the patients (n=24), vascular injury resulted from occupational trauma. Workers (n=23, 20%) were the most frequently affected group. Three patients (5%) died due to severity of the associated injuries. Our results revealed that RTC is the most frequent cause of lower extremity vascular injuries in Iran. Our findings also showed that occupational injuries have considerable prevalence. Establishment of preventive strategies to reduce the frequency of these injuries is recommended.

  16. Natural history of splenic vascular abnormalities after blunt injury: A Western Trauma Association multicenter trial.

    Zarzaur, Ben L; Dunn, Julie A; Leininger, Brian; Lauerman, Margaret; Shanmuganathan, K; Kaups, Krista; Zamary, Kirellos; Hartwell, Jennifer L; Bhakta, Ankur; Myers, John; Gordy, Stephanie; Todd, Samuel R; Claridge, Jeffrey A; Teicher, Erik; Sperry, Jason; Privette, Alicia; Allawi, Ahmed; Burlew, Clay Cothren; Maung, Adrian A; Davis, Kimberly A; Cogbill, Thomas; Bonne, Stephanie; Livingston, David H; Coimbra, Raul; Kozar, Rosemary A


    Following blunt splenic injury (BSI) there is conflicting evidence regarding the natural history and appropriate management of patients with vascular injuries of the spleen such as pseudoaneurysms or blushes. The purpose of this study was to describe the current management and outcomes of patients with PSA or BLUSH. Data was collected on adult (≥18) patients with BSI and a splenic vascular injury from 17 trauma centers. Demographic, physiologic, radiographic, and injury characteristics were gathered. Management and outcomes were collected. Univariate and multivariable analyses were used to determine factors associated with splenectomy. Two hundred patients with a vascular abnormality on CT scan were enrolled. Of those, 14.5% were managed with early splenectomy. Of the remaining, 59% underwent angiography and embolization (ANGIO) and 26.5% were observed. Of those who underwent ANGIO, 5.9% had a repeat ANGIO and 6.8% had splenectomy. Of those observed, 9.4% had a delayed ANGIO and 7.6% underwent splenectomy. There were no statistically significant differences between those observed and those who underwent ANGIO. There were 111 CT scans with splenic vascular injuries available for review by an expert trauma radiologist. The concordance between the original classification of the type of vascular abnormality and the expert radiologist's interpretation was 56.3%. Based on expert review the presence of an actively bleeding vascular injury was associated with a 40.9% risk of splenectomy. This was significantly higher than those with a non-bleeding vascular injury. In this series, the vast majority of patients are managed with ANGIO and usually embolization while splenectomy remains a rare event. However, patients with a bleeding vascular injury of the spleen are at high risk of non-operative failure no matter the strategy used for management. This group may warrant closer observation or an alternative management strategy. Prognostic Level III.

  17. MicroRNA changes in rat mesentery and serum associated with drug-induced vascular injury

    Thomas, Roberta A., E-mail:; Scicchitano, Marshall S.; Mirabile, Rosanna C.; Chau, Nancy T.; Frazier, Kendall S.; Thomas, Heath C.


    Regulatory miRNAs play a role in vascular biology and are involved in biochemical and molecular pathways dysregulated during vascular injury. Collection and integration of functional miRNA data into these pathways can provide insight into pathogenesis at the site of injury; the same technologies applied to biofluids may provide diagnostic or surrogate biomarkers. miRNA was analyzed from mesentery and serum from rats given vasculotoxic compounds for 4 days. Fenoldopam, dopamine and midodrine each alter hemodynamics and are associated with histologic evidence of vascular injury, while yohimbine is vasoactive but does not cause histologic evidence of vascular injury in rat. There were 38 and 35 miRNAs altered in a statistically significant manner with a fold change of 2 or greater in mesenteries of fenoldopam- and dopamine-dosed rats, respectively, with 9 of these miRNAs shared. 10 miRNAs were altered in rats given midodrine; 6 were shared with either fenoldopam or dopamine. In situ hybridization demonstrated strong expression and co-localization of miR-134 in affected but not in adjacent unaffected vessels. Mesenteric miRNA expression may provide clarity or avenues of research into mechanisms involved in vascular injury once the functional role of specific miRNAs becomes better characterized. 102 miRNAs were altered in serum from rats with drug-induced vascular injury. 10 miRNAs were commonly altered in serum from dopamine and either fenoldopam or midodrine dosed rats; 18 of these 102 were also altered in mesenteries from rats with drug-induced vascular injury, suggesting their possible utility as peripheral biomarkers. -- Highlights: ► Mesentery and serum were examined from rats given vasoactive compounds for 4 days. ► 72 miRNAs were altered in mesenteries from rats with vascular injury. ► miR-134 was localized to affected but not adjacent unaffected vessels. ► 102 miRNAs were changed in serum from rats with vascular injury. ► 18 miRNAs changed in both

  18. Deficiency of Long Pentraxin PTX3 Promoted Neointimal Hyperplasia after Vascular Injury.

    Ishino, Mitsunori; Shishido, Tetsuro; Suzuki, Satoshi; Katoh, Shigehiko; Sasaki, Toshiki; Funayama, Akira; Netsu, Shunsuke; Hasegawa, Hiromasa; Honda, Shintaro; Takahashi, Hiroki; Arimoto, Takanori; Miyashita, Takehiko; Miyamoto, Takuya; Watanabe, Tetsu; Takeishi, Yasuchika; Kubota, Isao


    Pentraxin 3 (PTX3) is a novel marker for the primary local activation of innate immunity and inflammatory responses. Although clinical and experimental evidence suggests that PTX3 is associated with atherosclerosis, the relationship between PTX3 and vascular remodeling after wall injury remains to be determined. We investigated the effects of PTX3 on neointimal hyperplasia following wire vascular injury. PTX3 systemic knockout (PTX3-KO) mice and wild-type littermate (WT) mice were subjected to wire-mediated endovascular injury. At four weeks after wire-mediated injury, the areas of neointimal and medial hyperplasia were evaluated. The PTX3-KO mice exhibited higher hyperplasia/media ratios than the WT mice after wire injury, and the degree of Mac-3-positive macrophage accumulation was significantly higher in the PTX3-KO mice than in the WT mice. Furthermore, the PTX3-KO mice showed a much greater increase in the number of PCNA-stained cells in the vascular wall than that observed in the WT mice. A deficiency of PTX3 results in deteriorated neointimal hyperplasia after vascular injury via the effects of macrophage accumulation and vascular smooth muscle cell proliferation and migration.

  19. Management of Combat Vascular Injuries Using Modern Imaging: Are We Getting Better?

    Samy S. Nitecki


    Full Text Available Background. Vascular injuries often result in life threatening hemorrhage or limb loss. When they present with a single entry or exit wound, surgery is immediately indicated. With multiple injuries, however, imaging such as CTA is necessary for diagnosis and choice of treatment. Methods. For all combat-related vascular cases admitted to our medical center during the Lebanon wars in 1982 and 2006, we compiled and compared presenting signs and symptoms, means of diagnosis, treatments, and results. Results. 126 patients with vascular injuries were admitted (87 in 1982, 39 in 2006. 90% were male; mean age of 29 years (range 20–53. All injuries were accompanied by insult to soft tissue, bones, and viscera. 75% presented with injury to arteries in the extremities. 75% of these patients presented with limb ischemia, and 25% sustained massive blood loss. Treatments included venous interposition graft, end-to-end anastomosis, venous patch, endovascular technique (only in 2006, and ligation/observation. Complications included thrombosis and wound infections. Mortality and amputations occurred only in 1982, and this may be attributed to the use of imaging, advanced technique, and shorter average time from injury to hospital (7 hours. Conclusions. We recommend CTA as the first line modality for diagnosis of vascular injuries, as its liberal use allowed for early and appropriate treatment. Treatment outcomes improved with fast and effective resuscitation, liberal use of tourniquets and fasciotomies, and meticulous treatment by a multidisciplinary team.

  20. Variations of vascular distribution in the mandibular anterior lingual region: a high risk of vascular injury during implant surgery.

    Fujita, Shuhei; Ide, Yoshinobu; Abe, Sinichi


    To clarify variations of vascular distribution around the mandibular anterior tooth lingual region, an area in which vascular injuries have often been reported during dental implant surgery. The reasons for such injuries in this region are discussed from an anatomical perspective. Anatomical dissections were performed on 100 sides of 50 cadavers used for anatomy education. Ten sides of 5 cadavers were injected intravascularly with methyl methacrylate, and penetration of the mandible was closely evaluated. In the mandibular anterior tooth lingual region, both the sublingual and submental arteries showed various distribution patterns. Distal branches basically penetrated the bone. In the mandibular anterior tooth lingual region, the sublingual and submental arteries traveled from the vicinity of the mylohyoid muscle attachment along the bone surface in an anterosuperior direction. Many of these blood vessels penetrated the alveolar mucosa in the anterior tooth region, and many distal branches of the vessels also finally penetrated the bone. This seems to explain why many vascular injuries are encountered around the mandibular anterior tooth lingual region during implant surgery.

  1. Vascular injuries after minor blunt upper extremity trauma: pitfalls in the recognition and diagnosis of potential "near miss" injuries

    Bravman Jonathan T


    Full Text Available Abstract Background Low energy trauma to the upper extremity is rarely associated with a significant vascular injury. Due to the low incidence, a high level of suspicion combined with appropriate diagnostic algorithms are mandatory for early recognition and timely management of these potentially detrimental injuries. Methods Review of the pertinent literature, supported by the presentation of two representative "near miss" case examples. Results A major diagnostic pitfall is represented by the insidious presentation of significant upper extremity arterial injuries with intact pulses and normal capillary refill distal to the injury site, due to collateral perfusion. Thus, severe vascular injuries may easily be missed or neglected at the upper extremity, leading to a long-term adverse outcome with the potential need for a surgical amputation. Conclusion The present review article provides an outline of the diagnostic challenges related to these rare vascular injuries and emphasizes the necessity for a high level of suspicion, even in the absence of a significant penetrating or high-velocity trauma mechanism.

  2. Civilian traumatic vascular injuries of the upper extremity:report of the Iranian national trauma project.

    Rasouli, Mohammad R; Moini, Majid; Khaji, Ali


    The determination of the pattern of traumatic vascular injuries of the upper extremity in Iran was the aim of this study. Data of the Iranian national trauma project were used to identify patients with upper extremity vascular injuries. This project was conducted in 8 major cities from 2000-2004. A total of 113 cases with 130 vascular injuries were found, including 2 axillary, 18 brachial, and 69 radial and ulnar arteries. In 91 cases (81%), penetrating trauma was responsible. Associated nerve and/or upper extremity fractures were seen in 20% and 18% of cases, respectively. End-to-end anastomosis, interposition of saphenous graft, and ligation were used for the management of 44%, 28%, and 17%, respectively, of brachial artery injuries. Ulnar and radial artery injuries had been either ligated (n = 36; 52%) or sutured (n = 33; 48%). Median, ulnar, and radial nerve injuries, except for one, had all been sutured primarily. No patients needed fasciotomy. Amputation and mortality resulting from associated injuries occurred in 3 (2.6%) and 5 (4.4%) patients, respectively. This study revealed that stabbings are the most frequent causes of these injuries in Iran, in spite of the management of patients in level 3 trauma centers; the rate of amputation is acceptable. However, this study does not provide limb functions of the patients.

  3. Vascular Injury in the Wars in Iraq and Afghanistan


    demographic, injury and treatment data acquired at all levels of care in both theaters of war. The JTTS and registry are housed and maintained at the...above the knee in the lower extremity or at or above the elbow in the upper extremity. Torso and cervical injuries were also categorized as major...and cervical ). Numbers of recorded injuries are presented after each anatomic location with a percentage which reflects the whole number in the

  4. Major vascular injury from high-pressure water jet.

    Harvey, R L; Ashley, D A; Yates, L; Dalton, M L; Solis, M M


    High-pressure water jets are used in industry as a cleaning and cutting tool. Penetrating injuries by these devices can produce minimal external evidence of extensive internal damage. We report a literature review and the case of a limb-threatening injury to the lower extremity caused by such a device.

  5. Ethyl Pyruvate Prevents Methyglyoxal-Induced Retinal Vascular Injury in Rats

    Junghyun Kim


    Full Text Available Pyruvate is an endogenous antioxidant substance. The aim of this study was to investigate the protective effects of ethyl pyruvate (EP on retinal vascular injury in diabetic retinopathy. To investigate the protective effect of EP on vascular cell apoptosis and blood-retinal barrier (BRB breakage, we have used intravitreally methylglyoxal-(MGO- injected rat eyes. Apoptosis of the retinal vascular cell that was stimulated by the intravitreal injection of MGO was evidently attenuated by the EP treatment. EP exerts inhibitory effect on MGO-induced vascular cell apoptosis by blocking oxidative injury. In addition, EP treatment prevented MGO-induced BRB breakage and the degradation of occludin, an important tight junction protein. These observations suggest that EP acts through an antioxidant mechanism to protect against oxidative stress-induced apoptosis in retinal vessels.

  6. UK combat-related pelvic junctional vascular injuries 2008-2011: implications for future intervention.

    Walker, N M; Eardley, W; Clasper, J C


    In a recent publication, 297 of 6450 (4.6%) military coalition deaths over ten years were reported to be due to junctional bleeding. The authors suggested that some of these deaths could have been avoided with a junctional haemorrhage control device. Prospectively collected data on all injuries sustained in Afghanistan by UK military personnel from 1 August 2008 to 31 July 2011 period were reviewed, using the UK Joint Theatre Trauma Registry. All fatalities with significant pelvic injuries were identified and analysed, and the cause of death established to assess the potential role for a junctional haemorrhage control device. Significant upper thigh, groin or pelvic injuries were recorded in 124 casualties, of which 93 died. Of these the pelvic injury was the cause of death in 37, but only 1 casualty with potentially survivable injuries was identified where death was due to a vascular injury below the inguinal ligament, not controlled by a CAT. This represents vascular injury between the aortic bifurcation and the inguinal ligament. Eight of these survived to a medical facility but subsequently died of their wounds. These represent a subset in which vascular control proximal to the inguinal ligament could have altered the outcome. Some potentially survivable deaths due to exsanguination may be amenable to proximal vascular control. Our study does not substantiate previous conclusions that this can be achieved through use of a groin junctional tourniquet. We believe there may be a role for more proximal vascular control of pelvic bleeding, and this merits further research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Characterization of nicardipine hydrochloride-induced cell injury in human vascular endothelial cells.

    Ochi, Masanori; Kawai, Yoshiko; Tanaka, Yoshiyuki; Toyoda, Hiromu


    Nicardipine hydrochloride (NIC), a dihydropyridine calcium-channel blocking agent, has been widely used for the treatment of hypertension. Especially, nicardipine hydrochloride injection is used as first-line therapy for emergency treatment of abnormally high blood pressure. Although NIC has an attractive pharmacological profile, one of the dose-limiting factors of NIC is severe peripheral vascular injury after intravenous injection. The goal of this study was to better understand and thereby reduce NIC-mediated vascular injury. Here, we investigated the mechanism of NIC-induced vascular injury using human dermal microvascular endothelial cells (HMVECs). NIC decreased cell viability and increased percent of dead cells in a dose-dependent manner (10-30 μg/mL). Although cell membrane injury was not significant over 9 hr exposure, significant changes of cell morphology and increases in vacuoles in HMVECs were observed within 30 min of NIC exposure (30 μg/mL). Autophagosome labeling with monodansylcadaverine revealed increased autophagosomes in the NIC-treated cells, whereas caspase 3/7 activity was not increased in the NIC-treated cells (30 μg/mL). Additionally, NIC-induced reduction of cell viability was inhibited by 3-methyladenine, an inhibitor of autophagosome formation. These findings suggest that NIC causes severe peripheral venous irritation via induction of autophagic cell death and that inhibition of autophagy could contribute to the reduction of NIC-induced vascular injury.

  8. Endovascular Management of Extra-cranial Supra-aortic Vascular Injuries

    Almazedi, Bahir, E-mail:; Lyall, Harpreet; Bhatnagar, Priya [Leeds and West Yorkshire Radiology Academy, Leeds General Infirmary (United Kingdom); Kessel, David; McPherson, Simon; Patel, Jai V.; Puppala, Sapna [The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Department of Vascular and Interventional Radiology (United Kingdom)


    Supra-aortic vessel injuries are uncommon but can be life-threatening and surgically challenging. Trauma to these vessels may be blunt or penetrating, including iatrogenic trauma following the insertion of central venous lines, which may be preventable. Recent advances in technology have resulted in endovascular therapy becoming a common first-line treatment, and interventional radiologists now play a major role in the management of these vascular injuries. We review the literature on the endovascular management of these types of injuries and describe a spectrum of case-based extra-cranial supra-aortic vascular injuries managed at our institution and the range of imaging appearances, including active contrast extravasation, traumatic vessel occlusion, true aneurysms, pseudoaneurysms, and arteriovenous fistulae.

  9. The association between vibration and vascular injury in rheumatic diseases: a review of the literature.

    Wang, Yu-Jie; Huang, Xiao-Lei; Yan, Jun-Wei; Wan, Ya-Nan; Wang, Bing-Xiang; Tao, Jin-Hui; Chen, Bing; Li, Bao-Zhu; Yang, Guo-Jun; Wang, Jing


    Vascular manifestations can be seen early in the pathogenesis of inflammatory rheumatic diseases. Animal experiments, laboratory and clinical findings indicated that acute or long-term vibration exposure can induce vascular abnormalities. Recent years, in addition to Raynaud's phenomenon (RP), vibration as a risk factor for other rheumatic diseases has also received corresponding considered. This review is concentrated upon the role of vibration in the disease of systemic sclerosis (SSc). In this review, we are going to discuss the main mechanisms which are thought to be important in pathophysiology of vascular injury under the three broad headings of "vascular", "neural" and "intravascular". Aspects on the vibration and vascular inflammation are briefly discussed. And the epidemiological studies related to vibration studies in SSc and other rheumatic diseases are taken into account.

  10. Management of traumatic vascular injuries to the neck: a 7-year experience at a Level I trauma center.

    Simmons, Jon D; Ahmed, Naveed; Donnellan, Kimberly A; Schmieg, Robert E; Porter, John M; Mitchell, Marc E


    Injury to the carotid artery results in significant mortality and morbidity. The general consensus is to repair all injuries to the common and internal carotid arteries. Ligation is usually reserved for neurologic or hemodynamic instability. We report our experience at a Level I trauma center with vascular injuries to the neck. Retrospective chart review of all patients with vascular injuries in the neck resulting from either blunt or penetrating trauma treated at a Level I trauma center between January 2000 and February 2007. Demographics and outcomes were collected from a chart review. Twenty-five patients with vascular injuries to the neck were identified. There were 13 carotid artery injuries (CAI), five internal jugular vein (IJV) injuries, and 13 external jugular vein (EJV) injuries. Of the carotid artery injuries, six (50%) underwent operative repair (4 primary repairs and 2 bypasses), five (38%) were managed nonoperatively, and one was treated using endovascular techniques. No patient had a postoperative decrease in Glasgow Coma Scale score. There were five isolated IJV injuries (3 primary repair and 2 ligations). Four of the venous injuries (all internal jugular veins) were repaired and the remaining 13 were ligated. Vascular injuries to the neck have significant mortality and morbidity. Treatment of these injuries must be individualized. All CAI in noncomatose patients should be repaired if hemodynamically stable. All IJV injuries should be repaired but may be ligated if hemodynamically unstable. All EJV injuries can be ligated without reservation regardless of neurological status.

  11. OCT imaging of acute vascular changes following mild traumatic brain injury in mice (Conference Presentation)

    Chico-Calero, Isabel; Shishkov, Milen; Welt, Jonathan; Blatter, Cedric; Vakoc, Benjamin J.


    While most people recover completely from mild traumatic brain injuries (mTBIs) and concussions, a subset develop lasting neurological disorders. Understanding the complex pathophysiology of these injuries is critical to developing improved prognostic and therapeutic approaches. Multiple studies have shown that the structure and perfusion of brain vessels are altered after mTBI. It is possible that these vascular injuries contribute to or trigger neurodegeneration. Intravital microscopy and mouse models of TBI offer a powerful platform to study the vascular component of mTBI. Because optical coherence tomography based angiography is based on perfusion contrast and is not significantly degraded by vessel leakage or blood brain barrier disruption, it is uniquely suited to studies of brain perfusion in the setting of trauma. However, existing TBI imaging models require surgical exposure of the brain at the time of injury which conflates TBI-related vascular changes with those caused by surgery. In this work, we describe a modified cranial window preparation based on a flexible, transparent polyurethane membrane. Impact injuries were delivered directly through this membrane, and imaging was performed immediately after injury without the need for additional surgical procedures. Using this model, we demonstrate that mTBI induces a transient cessation of flow in the capillaries and smaller vessels near the injury point. Reperfusion is observed in all animals within 3 hours of injury. This work describes new insight into the transient vascular changes induced by mTBI, and demonstrates more broadly the utility of the OCT/polyurethane window model platform in preclinical studies of mTBI.

  12. Inhibition of Smooth Muscle β-Catenin Hinders Neointima Formation After Vascular Injury.

    Riascos-Bernal, Dario F; Chinnasamy, Prameladevi; Gross, Jordana N; Almonte, Vanessa; Egaña-Gorroño, Lander; Parikh, Dippal; Jayakumar, Smitha; Guo, Liang; Sibinga, Nicholas E S


    Smooth muscle cells (SMCs) contribute to neointima formation after vascular injury. Although β-catenin expression is induced after injury, whether its function is essential in SMCs for neointimal growth is unknown. Moreover, although inhibitors of β-catenin have been developed, their effects on SMC growth have not been tested. We assessed the requirement for SMC β-catenin in short-term vascular homeostasis and in response to arterial injury and investigated the effects of β-catenin inhibitors on vascular SMC growth. We used an inducible, conditional genetic deletion of β-catenin in SMCs of adult mice. Uninjured arteries from adult mice lacking SMC β-catenin were indistinguishable from controls in terms of structure and SMC marker gene expression. After carotid artery ligation, however, vessels from mice lacking SMC β-catenin developed smaller neointimas, with lower neointimal cell proliferation and increased apoptosis. SMCs lacking β-catenin showed decreased mRNA expression of Mmp2, Mmp9, Sphk1, and S1pr1 (genes that promote neointima formation), higher levels of Jag1 and Gja1 (genes that inhibit neointima formation), decreased Mmp2 protein expression and secretion, and reduced cell invasion in vitro. Moreover, β-catenin inhibitors PKF118-310 and ICG-001 limited growth of mouse and human vascular SMCs in a dose-dependent manner. SMC β-catenin is dispensable for maintenance of the structure and state of differentiation of uninjured adult arteries, but is required for neointima formation after vascular injury. Pharmacological β-catenin inhibitors hinder growth of human vascular SMCs. Thus, inhibiting β-catenin has potential as a therapy to limit SMC accumulation and vascular obstruction. © 2017 American Heart Association, Inc.

  13. Interferon Regulatory Factor-1 Exerts Inhibitory Effect on Neointimal Formation after Vascular Injury

    Zhen Li; Zhong-gao Wang; Ce Bian; Xiao-dong Chen; Jian-wen Li; Xiu Chen; Bing Han; Gao-feng Hou; Jian Chu; Qi Cui


    To investigate the effect of interferon regulatory factors (IRFs) on neointimal formation after vascular injury in the mouse, and its possible mechanism.Methods Vascular injury was induced by polyethylene cuff placement around the left femoral artery of IRF-1-deficient mice and C57BL/6J mice. The mRNA expressions of IRF-1, IRF-2, angiotensin Ⅱ type 2 (AT) receptor, interleukin-1β converting enzyme (ICE), inducible nitric oxide synthase (iNOS) were detected by RT-PCR and immunohistochemical staining.Results Neointimal formation after vascular injury was significantly greater in IRF-1-deficient mice than that in C57BL/6J mice (P<0.05). In contrast, TUNEL-positive nuclei to total nuclei in the neointima and media in vascular smooth muscle cell (VSMC) in the injured artery significantly attenuated in IRF-1-deficient mice compared to C57BL/6J mice (P<0.05). The expressions of AT2 receptor as well as pro-apoptotic genes such as ICE and iNOS in C57BL/6J mice were up-regulated in response to vascular injury, but this upregulation was attenuated in IRF-1-deficient mice.Conclusions Our results suggest that IRF-1 induces VSMC apoptosis and inhibits neointimal formation after vascular injury at least partly due to the upregulation of AT2 receptor, ICE and iNOS expressions. These results indicate that IRF-1 exerts an inhibitory effect on neointimal formation through the induction of apoptosis inVSMCs.

  14. Secondary abdominal compartment syndrome after complicated traumatic lower extremity vascular injuries.

    Macedo, F I B; Sciarretta, J D; Otero, C A; Ruiz, G; Ebler, D J; Pizano, L R; Namias, N


    Secondary abdominal compartment syndrome (ACS) can occur in trauma patients without abdominal injuries. Surgical management of patients presenting with secondary ACS after isolated traumatic lower extremity vascular injury (LEVI) continues to evolve, and associated outcomes remain unknown. From January 2006 to September 2011, 191 adult trauma patients presented to the Ryder Trauma Center, an urban level I trauma center in Miami, Florida with traumatic LEVIs. Among them 10 (5.2 %) patients were diagnosed with secondary ACS. Variables collected included age, gender, mechanism of injury, and clinical status at presentation. Surgical data included vessel injury, technical aspects of repair, associated complications, and outcomes. Mean age was 37.4 ± 18.0 years (range 16-66 years), and the majority of patients were males (8 patients, 80 %). There were 7 (70 %) penetrating injuries (5 gunshot wounds and 2 stab wounds), and 3 blunt injuries with mean Injury Severity Score (ISS) 21.9 ± 14.3 (range 9-50). Surgical management of LEVIs included ligation (4 patients, 40 %), primary repair (1 patient, 10 %), reverse saphenous vein graft (2 patients, 20 %), and PTFE interposition grafting (3 patients, 30 %). The overall mortality rate in this series was 60 %. The association between secondary ACS and lower extremity vascular injuries carries high morbidity and mortality rates. Further research efforts should focus at identifying parameters to accurately determine resuscitation goals, and therefore, prevent such a devastating condition.

  15. Segmental pulmonary vascular resistances during oleic acid lung injury in rabbits.

    Maarek, J M; Grimbert, F


    We studied in isolated rabbit lungs the effects of oleic acid (OA) injury on the segmental distribution of vascular resistance. Vascular occlusion pressures were measured in control and OA-injured preparations over 90 min. Capillary filtration coefficient KF,C increased from 0.61 (+/- 0.10) to 0.91 (+/- 0.14) g.min-1.mmHg-1.(100 g)-1 in OA-injured lungs whereas it remained constant in control lungs. Total pulmonary vascular resistance changed little in both control and OA-injured lungs. OA injury resulted in a 15% increase of the double occlusion capillary pressure. In addition, the contribution of the microvascular to the total vascular resistance rose from 8% to 22%. The increase in microvascular resistance was significant 15 min after OA on the arteriolar side and became significant 30 min later on the venular side. Oleic acid injury does not change the total pulmonary vascular resistance but alters the distribution of segmental resistances in the isolated rabbit lung, thereby contributing to the accumulation of lung water in this model of low pressure permeability edema.

  16. Reperfusion Strategies in the Management of Extremity Vascular Injury with Ischaemia


    Spencer JR, Rasmussen TE. A large animal survival model (Sus scrofa ) of extremity ischemia/reperfusion and neuromuscular outcomes assessment: a pilot...on neuromuscular recovery in a porcine (Sus scrofa ) survival model of extremity vascular injury. J Vasc Surg 2011; 53: 165–173. 32 Rasmussen TE

  17. Autophagy activation aggravates neuronal injury in the hippocampus of vascular dementia rats

    Bin Liu; Jing Tang; Jinxia Zhang; Shiying Li; Min Yuan; Ruimin Wang


    It remains unclear whether autophagy affects hippocampal neuronal injury in vascular dementia. In the present study, we investigated the effects of autophagy blockade on hippocampal neuro-nal injury in a rat model of vascular dementia. In model rats, hippocampal CA1 neurons were severely damaged, and expression of the autophagy-related proteins beclin-1, cathepsin B and microtubule-associated protein 1 light chain 3 was elevated compared with that in sham-oper-ated animals. These responses were suppressed in animals that received a single intraperitoneal injection of wortmannin, an autophagy inhibitor, prior to model establishment. The present results conifrm that autophagy and autophagy-related proteins are involved in the pathological changes of vascular dementia, and that inhibition of autophagy has neuroprotective effects.

  18. Mitigation of Radiation Induced Pulmonary Vascular Injury by Delayed Treatment with Captopril

    MOLTHEN, Robert C.; WU, Qingping; FISH, Brian L.; MOULDER, John E.; JACOBS, Elizabeth R.; MEDHORA, Meetha M.


    Background and objective A single dose of 10 Gy radiation to the thorax of rats results in decreased total lung angiotensin-converting enzyme (ACE) activity, pulmonary artery distensibility and distal vascular density while increasing pulmonary vascular resistance (PVR) at 2-months post-exposure. In this study we evaluate the potential of a renin-angiotensin system (RAS) modulator, the ACE inhibitor captopril, to mitigate this pulmonary vascular damage. Methods Rats exposed to 10 Gy thorax only irradiation and age-matched controls were studied 2-months after exposure, during the development of radiation pneumonitis. Rats were treated, either immediately or 2-weeks after radiation exposure, with 2 doses of the ACE inhibitor, captopril, dissolved in their drinking water. To determine pulmonary vascular responses, we measured pulmonary hemodynamics, lung ACE activity, pulmonary arterial distensibility, and peripheral vessel density. Results Captopril, given at a vasoactive but not a lower dose, mitigated radiation-induced pulmonary vascular injury. More importantly these beneficial effects were observed even if drug therapy was delayed for up to two weeks after exposure. Conclusions Captopril resulted in a reduction in pulmonary vascular injury that supports its use as a radiomitigator after an unexpected radiological event such as a nuclear accident. PMID:22882664

  19. Pattern, presentation and management of vascular injuries due to pellets and rubber bullets in a conflict zone

    Mohd L Wani


    Full Text Available Background: Rubber bullets and pellet guns are considered non-lethal low-velocity weapons. They are used to disperse a mob during street protests. The present study was undertaken to analyze the pattern, presentation and management of vascular injuries caused by these weapons. Patients and Methods: This was a prospective study of patients with features of vascular injuries due to pellets and rubber bullets from June 2010 to November 2010. All patients with features of vascular injuries due to these non-lethal weapons were included in the study. Vascular injuries caused by other causes were excluded from the study. Results: A total of 35 patients who presented with features of vascular injury during this period were studied. All of them were males. The mean age was 22 years. Fifteen patients were revascularized primarily, 19 patients needed reverse saphenous vein graft and, in one, patient lateral repair was done. There were two mortalities in our series. Wound infection was the most common complication. The amputation rate was around 6%. Conclusion: Pellet and rubber bullets can cause serious life-threatening injuries. Vascular injury caused by these weapons need no different approach than other vascular injuries. Early revascularization and prompt resuscitation prevents the loss of limb or life.

  20. Avoiding and managing vascular injury during robotic-assisted radical prostatectomy.

    Sotelo, René; Nunez Bragayrac, Luciano A; Machuca, Victor; Garza Cortes, Roberto; Azhar, Raed A


    There has been an increase in the number of urologic procedures performed robotically assisted; this is the case for radical prostatectomy. Currently, in the USA, 67% of prostatectomies are performed robotically assisted. With this increase in robotic urologic surgery it is clear that there are more surgeons in their learning curve, where most of the complications occur. Among the complications that can occur are vascular injuries. These can occur in the initial stages of surgery, such as in accessing the abdominal cavity, as well as in the intraoperative or postoperative setting. We present the most common vascular injuries in robot-assisted radical prostatectomy, as well as their management and prevention. We believe that it is of vital importance to be able to recognize these injuries so that they can be prevented.

  1. Immune-Mediated Vascular Injury and Dysfunction in Transplant Arteriosclerosis

    Anna evon Rossum


    Full Text Available Solid organ transplantation is the only treatment for end-stage organ failure but this life-saving procedure is limited by immune-mediated rejection of most grafts. Blood vessels within transplanted organs are targeted by the immune system and the resultant vascular damage is a main contributor to acute and chronic graft failure. The vasculature is a unique tissue with specific immunological properties. This review discusses the interactions of the immune system with blood vessels in transplanted organs and how these interactions lead to the development of transplant arteriosclerosis, a leading cause of heart transplant failure.

  2. Exendin-4, a glucagon-like peptide-1 receptor agonist, reduces intimal thickening after vascular injury

    Goto, Hiromasa [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Nomiyama, Takashi, E-mail: [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Mita, Tomoya; Yasunari, Eisuke; Azuma, Kosuke; Komiya, Koji; Arakawa, Masayuki; Jin, Wen Long; Kanazawa, Akio [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Kawamori, Ryuzo [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Sportology Center, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Center for Beta Cell Biology and Regeneration, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Fujitani, Yoshio; Hirose, Takahisa [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Watada, Hirotaka, E-mail: [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Sportology Center, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan)


    Research highlights: {yields} Exendin-4 reduces neointimal formation after vascular injury in a mouse model. {yields} Exendin-4 dose not alter metabolic parameters in non-diabetic, non-obese mouse model. {yields} Exendin-4 reduces PDGF-induced cell proliferation in cultured SMCs. {yields} Exendin-4 may reduces neointimal formation after vascular injury at least in part through its direct action on SMCs. -- Abstract: Glucagon-like peptide-1 is a hormone secreted by L cells of the small intestine and stimulates glucose-dependent insulin response. Glucagon-like peptide-1 receptor agonists such as exendin-4 are currently used in type 2 diabetes, and considered to have beneficial effects on the cardiovascular system. To further elucidate the effect of glucagon-like peptide-1 receptor agonists on cardiovascular diseases, we investigated the effects of exendin-4 on intimal thickening after endothelial injury. Under continuous infusion of exendin-4 at 24 nmol/kg/day, C57BL/6 mice were subjected to endothelial denudation injury of the femoral artery. Treatment of mice with exendin-4 reduced neointimal formation at 4 weeks after arterial injury without altering body weight or various metabolic parameters. In addition, in vitro studies of isolated murine, rat and human aortic vascular smooth muscle cells showed the expression of GLP-1 receptor. The addition of 10 nM exendin-4 to cultured smooth muscle cells significantly reduced their proliferation induced by platelet-derived growth factor. Our results suggested that exendin-4 reduced intimal thickening after vascular injury at least in part by the suppression of platelet-derived growth factor-induced smooth muscle cells proliferation.

  3. Should blunt segmental vascular renal injuries be considered an American Association for the Surgery of Trauma Grade 4 renal injury?

    Malaeb, Bahaa; Figler, Brad; Wessells, Hunter; Voelzke, Bryan B


    Renal segmental vascular injury (SVI) following blunt abdominal trauma is not part of the original American Association for the Surgery of Trauma (AAST) renal injury grading system. Recent recommendations support classifying SVI as an AAST Grade 4 (G4) injury. Our primary aim was to compare outcomes following blunt renal SVI and blunt renal collecting system lacerations (CSLs). We hypothesize that renal SVI fare well with conservative management alone and should be relegated a less severe renal AAST grade. We retrospectively identified patients with SVI and G4 CSL admitted to a Level 1 trauma center between 2003 and 2010. Penetrating trauma was excluded. Need for surgical intervention, length of stay, kidney salvage (>25% renal preservation on renography 6-12 weeks after injury), and delayed complication rates were compared between the SVI and CSL injuries. Statistical analysis used χ, Fisher's exact, and t tests. A total of 56 patients with SVI and 88 patients with G4 CSL sustained blunt trauma. Age, Injury Severity Score (ISS), and length of stay were similar for the two groups. Five patients in each group died of concomitant, nonrenal injuries. In the G4 CSL group, 15 patients underwent major interventions, and 32 patients underwent minor interventions. Only one patient in the SVI group underwent a major intervention. The renal salvage rate was 85.7% following SVI versus 62.5% following CSL (p = 0.107). Overall, surgical interventions are significantly lower among the SVI cohort than the G4 CSL cohort. Further analysis using a larger cohort of patients is recommended before revising the current renal grading system. Adding SVI as a G4 injury could potentially increase the heterogeneity of G4 injuries and decrease the ability of the AAST renal injury grading system to predict outcomes, such as nephrectomy rate. Epidemiologic study, level IV.




    Full Text Available We studied the various injury patterns in bear mauling and outcome of management in CIMS from 2010 to 2014. A total of 20 cases evaluated which were predominantly male (95%. It is obvious that involvement of head, neck face and upper limb was in maximum cases. The age wise study shows that there was equal involvement of people from young, middle aged and older ones. It was a retrospective analysis of the reported cases. Most victims suffered from multiple injuries. Percentage wise distribution of the injuries and involvement of different body parts amongst observed cases were head neck face 75%, thorax and abdomen 40%, upper limb 75%, buttocks and genitals 30% , lower limb 50%. We observed that in 75% of cases of mutilation over h ead neck and face, it was most common site of bear mauling. Probably, it is because usually the attacks by bear is mainly on standing posture with hind limbs. All the patients were treated by a team led by surgeons including dental cum oral surgeon, otorhinolaryngologist, ophthalmologist and orthopedician. Surgical repair was done under all aseptic precaution and analgesia. Because of severe anatomical distortion of face and multiple fractures of facial bones with unstable and hanging mandible, in number of cases urgent tracheostomy was performed to restore the airways and for induction of general anesthesia. This also prevents aspiration and regurgitation. The excell ent blood supply of the face makes infection a rare occurrence with good antibiotic coverage. However, the injury may cause sufficient disfigurement and require extensive reconstruction. We also observed eye globe rupture in some cases and enucleation was inevitable. We conclude that multidisciplinary approach and follow up reduced the rate of infection and morbidity and mortality.

  5. Exposure to experimental preeclampsia in mice enhances the vascular response to future injury.

    Pruthi, Dafina; Khankin, Eliyahu V; Blanton, Robert M; Aronovitz, Mark; Burke, Suzanne D; McCurley, Amy; Karumanchi, S Ananth; Jaffe, Iris Z


    Cardiovascular disease (CVD) remains the leading killer of women in developed nations. One sex-specific risk factor is preeclampsia, a syndrome of hypertension and proteinuria that complicates 5% of pregnancies. Although preeclampsia resolves after delivery, exposed women are at increased long-term risk of premature CVD and mortality. Pre-existing CVD risk factors are associated with increased risk of developing preeclampsia but whether preeclampsia merely uncovers risk or contributes directly to future CVD remains a critical unanswered question. A mouse preeclampsia model was used to test the hypothesis that preeclampsia causes an enhanced vascular response to future vessel injury. A preeclampsia-like state was induced in pregnant CD1 mice by overexpressing soluble fms-like tyrosine kinase-1, a circulating antiangiogenic protein that induces hypertension and glomerular disease resembling human preeclampsia. Two months postpartum, soluble fms-like tyrosine kinase-1 levels and blood pressure normalized and cardiac size and function by echocardiography and renal histology were indistinguishable in preeclampsia-exposed compared with control mice. Mice were then challenged with unilateral carotid injury. Preeclampsia-exposed mice had significantly enhanced vascular remodeling with increased vascular smooth muscle cell proliferation (180% increase; Ppreeclampsia. These data support a new model in which vessels exposed to preeclampsia retain a persistently enhanced vascular response to injury despite resolution of preeclampsia after delivery. This new paradigm may contribute to the substantially increased risk of CVD in woman exposed to preeclampsia.

  6. Seatbelt triad: severe abdominal wall disruption, hollow viscus injury, and major vascular injury.

    Kulvatunyou, Narong; Albrecht, Roxie M; Bender, Jeffrey S; Friese, Randy S; Joseph, Bellal; Latifi, Rifat; O'Keefe, Terrance; Wynn, Julie L; Rhee, Peter M


    The triad of seatbelt-related severe abdominal wall disruption, hollow viscus injury, and distal abdominal aortic injury after a motor vehicle collision is uncommon. We present a small case series involving those three clinical features with the goal of preventing a future missed diagnosis of the distal abdominal aortic injury in particular.

  7. 78 FR 49207 - Airworthiness Directives; Maule Aerospace Technology, Inc. Airplanes


    ... in paragraph (i)(1) of this AD, before further flight, apply corrosion inhibitor to each wing lift strut. Apply the corrosion inhibitor following the INSTRUCTIONS section in PART I of Maule SB No. 11... requirements in the Appendix to this AD are met, before further flight apply corrosion inhibitor to each...

  8. Healing arterial ulcers: Endothelial lining regeneration upon vascular denudation injury.

    McDonald, Austin I; Iruela-Arispe, M Luisa


    Thrombosis and restenosis are the most prevalent late complications of coronary artery stenting. Current standards of clinical care focus on prevention of smooth muscle cell proliferation by the use of drug-eluting stents able to release anti-proliferative drugs. Unfortunately, these drugs also block endothelial cell proliferation and, in this manner, prevent recovery of endothelial cell coverage. Continued lack of endothelial repair leaves the root cause of thrombosis and restenosis unchanged, creating a vicious cycle where drug-mediated prevention of restenosis simultaneously implies promotion of thrombosis. In this issue of Vascular Pharmacology, Hussner and colleagues provide in vitro evidence and a mechanistic basis for the use of atorvastatin in stents as a way to bypass this roadblock. Here we review the pathological mechanisms and therapeutic approaches to restore flow in occluded arteries. We argue that rational design of drug eluting stents should focus on specific inhibition of smooth muscle cell proliferation with concurrent stimulation of endothelial regeneration. We comment on the current poor understanding of the cellular and molecular regulation of endothelial cell proliferation in the context of a functional artery, and on the pitfalls of extrapolating from the well-studied process of neovascularization by sprouting vessel formation.

  9. Matrix metalloproteinases limit functional recovery after spinal cord injury by modulation of early vascular events.

    Noble, Linda J; Donovan, Frances; Igarashi, Takuji; Goussev, Staci; Werb, Zena


    Inflammation in general and proteinases generated as a result are likely mediators of early secondary pathogenesis after spinal cord injury. We report that matrix metalloproteinase-9 (MMP-9) plays an important role in blood-spinal cord barrier dysfunction, inflammation, and locomotor recovery. MMP-9 was present in the meninges and neurons of the uninjured cord. MMP-9 increased rapidly after a moderate contusion spinal cord injury, reaching a maximum at 24 hr, becoming markedly reduced by 72 hr, and not detectable at 7 d after injury. It was seen in glia, macrophages, neutrophils, and vascular elements in the injured spinal cord at 24 hr after injury. The natural tissue inhibitors of MMPs were unchanged over this time course. MMP-9-null mice exhibited significantly less disruption of the blood-spinal cord barrier, attenuation of neutrophil infiltration, and significant locomotor recovery compared with wild-type mice. Similar findings were observed in mice treated with a hydroxamic acid MMP inhibitor from 3 hr to 3 d after injury, compared with the vehicle controls. Moreover, the area of residual white matter at the lesion epicenter was significantly greater in the inhibitor-treated group. This study provides evidence that MMP-9 plays a key role in abnormal vascular permeability and inflammation within the first 3 d after spinal cord injury, and that blockade of MMPs during this critical period attenuates these vascular events and leads to improved locomotor recovery. Our findings suggest that early inhibition of MMPs may be an efficacious strategy for the spinal cord-injured patient.

  10. Diagnosis and management of evacuated casualties with cervical vascular injuries resulting from combat-related explosive blasts.

    Meghoo, Colin A; Dennis, James W; Tuman, Caroline; Fang, Raymond


    Explosive blasts are common in the modern military environment. These blasts incorporate a concussive component (primary blast injury) and a penetrating component (secondary blast injury). Penetrating injuries are the leading cause of death and injury in these attacks. This review characterizes the vascular injuries associated with penetrating blast injuries to the neck and provides recommendations on the early management of these casualties for the surgeon unfamiliar with these injuries. The Landstuhl Regional Medical Center Trauma Registry was queried for admissions from January 1, 2006, to June 30, 2010, coded for a penetrating injury to the neck caused by a blast mechanism. Medical records were abstracted from the patient's initial presentation and care through the deployed military medical system. We recorded the vascular injuries, diagnostic studies, operative events, and early postinjury course for all identified patients. Query of the Landstuhl Regional Medical Center Trauma Registry initially identified 252 patients, of which 53 were excluded because their injuries arose from other mechanisms or were only superficial. Among the remaining 199 patients, 38 (19.1%) sustained 44 vascular injuries requiring treatment. Compelling physical examination findings ("hard signs") were present in 15 (7.5%), who underwent immediate neck exploration. Another 12 patients also underwent neck exploration without any prior imaging studies. Computed tomography (CT) or CT angiography (CTA) examinations were done in 172 patients without hard-sign physical examination findings. Of these, the result of the imaging study was negative in 106 patients, and no further investigation or treatment for cervical vascular trauma was initiated. Of 66 patients who underwent CT/CTA before operative neck exploration, CT/CTA identified a vascular injury in 26 that was later confirmed on neck exploration. The combination of physical examination and CT/CTA resulted in a sensitivity of 96.3% and a

  11. Monocytes form a vascular barrier and participate in vessel repair after brain injury

    Glod, John; Kobiler, David; Noel, Martha; Koneru, Rajeth; Lehrer, Shoshana; Medina, Daniel; Maric, Dragan; Fine, Howard A.


    Subpopulations of bone marrow-derived cells can be induced to assume a number of endothelial properties in vitro. However, their ability to form a functional vascular barrier has not been demonstrated. We report that human CD14+ peripheral blood monocytes cultured under angiogenic conditions develop a number of phenotypic and functional properties similar to brain microvascular endothelial cells. These cells express the tight junction proteins zonula occludens 1 (ZO-1) and occludin and form a barrier with a transcellular electrical resistance (TCER) greater than 100 ohm cm2 and low permeability to 4 kDa and 20 kDa dextrans. The TCER of the cellular barrier is decreased by bradykinin and histamine. We also demonstrate that these cells associate with repairing vasculature in areas of brain and skin injury. Our data suggest that CD14+ peripheral blood monocytes participate in the repair of the vascular barrier after brain injury. PMID:16204319

  12. Increased Intimal Hyperplasia After Vascular Injury in Male Androgen Receptor-Deficient Mice

    Wilhelmson, Anna S; Fagman, Johan B; Johansson, Inger


    replacement to castrated male mice increased p27 mRNA in an AR-dependent manner. In conclusion, AR deficiency in male mice increases intimal hyperplasia in response to vascular injury, potentially related to the effects of androgens/AR to inhibit proliferation and migration of smooth muscle cells......., there was no difference in the reendothelialization in ARKO compared with control mice. Ex vivo, we observed increased outgrowth of vascular smooth muscle cells from ARKO compared with control aortic tissue explants; the number of outgrown cells was almost doubled in ARKO. In vitro, stimulation of human aortic vascular...... smooth muscle cells with a physiological T concentration inhibited both migration and proliferation of the cells. Analyzing the expression of central regulators of cell proliferation and migration, we found that mRNA and protein levels of p27 were lower in uninjured arteries from ARKO mice and that T...

  13. The role of eNOS phosphorylation in causing drug-induced vascular injury.

    Tobin, Grainne A McMahon; Zhang, Jun; Goodwin, David; Stewart, Sharron; Xu, Lin; Knapton, Alan; González, Carlos; Bancos, Simona; Zhang, Leshuai; Lawton, Michael P; Enerson, Bradley E; Weaver, James L


    Previously we found that regulation of eNOS is an important part of the pathogenic process of Drug-induced vascular injury (DIVI) for PDE4i. The aims of the current study were to examine the phosphorylation of eNOS in mesentery versus aorta at known regulatory sites across DIVI-inducing drug classes and to compare changes across species. We found that phosphorylation at S615 in rats was elevated 35-fold 2 hr after the last dose of CI-1044 in mesentery versus 3-fold in aorta. Immunoprecipitation studies revealed that many of the upstream regulators of eNOS activation were associated with eNOS in 1 or more signalosome complexes. Next rats were treated with drugs from 4 other classes known to cause DIVI. Each drug was given alone and in combination with SIN-1 (NO donor) or L-NAME (eNOS inhibitor), and the level of eNOS phosphorylation in mesentery and aorta tissue was correlated with the extent of vascular injury and measured serum nitrite. Drugs or combinations produced altered serum nitrite levels as well as vascular injury score in the mesentery. The results suggested that phosphorylation of S615 may be associated with DIVI activity. Studies with the species-specific A2A adenosine agonist CI-947 in rats versus primates showed a similar pattern.

  14. Trends and outcomes of endovascular therapy in the management of civilian vascular injuries.

    Branco, Bernardino C; DuBose, Joseph J; Zhan, Luke X; Hughes, John D; Goshima, Kay R; Rhee, Peter; Mills, Joseph L


    The rapid evolution of endovascular surgery has greatly expanded management options for a wide variety of vascular diseases. Endovascular therapy provides a less invasive alternative to open surgery for critically ill patients who have sustained arterial injuries. The purpose of this study was to evaluate recent trends in the management of arterial injuries in the United States with specific reference to the use of endovascular strategies and to examine the outcomes of endovascular vs open therapy for the treatment of civilian arterial traumatic injuries. A 9-year analysis of the National Trauma Data Bank was performed to identify all patients who sustained arterial injuries. Demographics, clinical data, interventions, and outcomes were extracted. Propensity scores were used to match endovascular patients to those undergoing open operation. Patient outcomes were compared according to treatment approach. A total of 23,105 patients were available for analysis. Overall, there was a significant increase in the use of endovascular procedures during 9 years (from 0.3% in 2002 to 9.0% in 2010; P trauma patients (from 0.4% in 2002 to 13.2% in 2010; P trauma (42.9% in 2002 to 35.8% in 2010; P trauma patients. Endovascular therapy was associated with improved in-hospital mortality and lower rates of sepsis. Copyright © 2014 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.




    Hyperpermeability is a crux of pathogenesis of sudden lung edema in many pulmooary disorders,espe=cially in acute lung injury and adult respiratory distress syndrome(ARDS). Using our modified method for assessment of pulmonary vascular permeability,we observed the effects of xanthine with xanthine oxi-dase (X-XO) perfused in rat pulmonary artery and the protection of vasoactive intestinal polypeptide (VIP) against the injury of pulmonary vascular permesbility.After addition of xanthine oxidase in the perfusate reservoir containing xanthine,125I-albumin leak index (125IALI) was remarkably increased while peak airway pressure (Paw) was not significantly increased,and perfusion pressure of pulmonary artery (Ppa) and lung wet/dry weight ratio (W/D) were only slightly increased.Xanthine plus xanthine oxi-dase also increased thromboxane B2(TX B2) and 6-keto-prostaglandin F1α(6-keto-PGF1α) in the perfusat-e.Treatment with VIP obviously reduced or totally prevented all signs of injury.Simultaneously,VIP also diminished or abolished the associated generation of arachidonate products.The results indicated that VIP bas potent protective activity against injury of pulmonary vasculat permeability and may be a physiological modulator of inflammatory damage to vaseular eodothelium associated with toxic oxygen metabolites.

  16. Exendin-4, a glucagon-like peptide-1 receptor agonist, reduces intimal thickening after vascular injury.

    Goto, Hiromasa; Nomiyama, Takashi; Mita, Tomoya; Yasunari, Eisuke; Azuma, Kosuke; Komiya, Koji; Arakawa, Masayuki; Jin, Wen Long; Kanazawa, Akio; Kawamori, Ryuzo; Fujitani, Yoshio; Hirose, Takahisa; Watada, Hirotaka


    Glucagon-like peptide-1 is a hormone secreted by L cells of the small intestine and stimulates glucose-dependent insulin response. Glucagon-like peptide-1 receptor agonists such as exendin-4 are currently used in type 2 diabetes, and considered to have beneficial effects on the cardiovascular system. To further elucidate the effect of glucagon-like peptide-1 receptor agonists on cardiovascular diseases, we investigated the effects of exendin-4 on intimal thickening after endothelial injury. Under continuous infusion of exendin-4 at 24 nmol/kg/day, C57BL/6 mice were subjected to endothelial denudation injury of the femoral artery. Treatment of mice with exendin-4 reduced neointimal formation at 4weeks after arterial injury without altering body weight or various metabolic parameters. In addition, in vitro studies of isolated murine, rat and human aortic vascular smooth muscle cells showed the expression of GLP-1 receptor. The addition of 10nM exendin-4 to cultured smooth muscle cells significantly reduced their proliferation induced by platelet-derived growth factor. Our results suggested that exendin-4 reduced intimal thickening after vascular injury at least in part by the suppression of platelet-derived growth factor-induced smooth muscle cells proliferation. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Testosterone replacement attenuates intimal hyperplasia development in an androgen deficient model of vascular injury.

    Freeman, Brian M; Univers, Junior; Fisher, Richard K; Kirkpatrick, Stacy S; Klein, Frederick A; Freeman, Michael B; Mountain, Deidra J H; Grandas, Oscar H


    Androgen deficiency (AD) is associated with increased risk of vascular disease. Dysfunctional remodeling of the vessel wall and atypical proliferative potential of vascular smooth muscle cells (VSMCs) are fundamental processes in the development of intimal hyperplasia (IH). We have demonstrated an inverse relationship between dihydrotestosterone (DHT) levels, matrix metalloproteinase activity, and VSMC migration and proliferation in vitro. Here, we investigated the role of AD and testosterone (TST) replacement in IH development in an animal model of vascular injury to elucidate mechanisms modulated by AD that could be playing a role in the development of vascular pathogenesis. Aged orchiectomized male rats underwent TST supplementation via controlled release pellet (0.5-35 mg). Young adult and middle-age adult intact (MI) and orchiectomized placebo (Plac) groups served as controls. All groups underwent balloon angioplasty of the left common carotid at a 14-d post-TST. Carotid tissue was collected at a 14-d post-balloon angioplasty and subjected to morphologic and immunohistochemical analyses. Human male VSMCs were treated with DHT (0-3000 nM) for 24 h then subjected to quantitative PCR for gene expression analyses and costained for F-actin and G-actin for visualization of cytoskeletal organization. I:M ratio was increased in Plac, subphysiological, low-physiological, and high pharmacologic level TST animals compared with MI controls but was decreased with high-physiological TST supplementation. Injury-induced expression of previously defined matrix metalloproteinase remodeling enzymes was not significantly affected by TST status. Urotensin (UTS) receptor (UTSR) staining was low in injured vessels of all young adult intact, MI, and Plac controls but was significantly upregulated in all groups receiving exogenous TST supplementation, irrespective of dose. In vitro DHT exposure increased the expression of UTSR in VSMCs in a dose-dependent manner. However, this did

  18. A novel decision tree approach based on transcranial Doppler sonography to screen for blunt cervical vascular injuries.

    Purvis, Dianna; Aldaghlas, Tayseer; Trickey, Amber W; Rizzo, Anne; Sikdar, Siddhartha


    Early detection and treatment of blunt cervical vascular injuries prevent adverse neurologic sequelae. Current screening criteria can miss up to 22% of these injuries. The study objective was to investigate bedside transcranial Doppler sonography for detecting blunt cervical vascular injuries in trauma patients using a novel decision tree approach. This prospective pilot study was conducted at a level I trauma center. Patients undergoing computed tomographic angiography for suspected blunt cervical vascular injuries were studied with transcranial Doppler sonography. Extracranial and intracranial vasculatures were examined with a portable power M-mode transcranial Doppler unit. The middle cerebral artery mean flow velocity, pulsatility index, and their asymmetries were used to quantify flow patterns and develop an injury decision tree screening protocol. Student t tests validated associations between injuries and transcranial Doppler predictive measures. We evaluated 27 trauma patients with 13 injuries. Single vertebral artery injuries were most common (38.5%), followed by single internal carotid artery injuries (30%). Compared to patients without injuries, mean flow velocity asymmetry was higher for single internal carotid artery (P = .003) and single vertebral artery (P = .004) injuries. Similarly, pulsatility index asymmetry was higher in single internal carotid artery (P = .015) and single vertebral artery (P = .042) injuries, whereas the lowest pulsatility index was elevated for bilateral vertebral artery injuries (P = .006). The decision tree yielded 92% specificity, 93% sensitivity, and 93% correct classifications. In this pilot feasibility study, transcranial Doppler measures were significantly associated with the blunt cervical vascular injury status, suggesting that transcranial Doppler sonography might be a viable bedside screening tool for trauma. Patient-specific hemodynamic information from transcranial Doppler assessment has the potential to alter

  19. Computed tomographic angiography as the primary diagnostic modality in penetrating lower extremity vascular injuries: a level I trauma experience.

    Wallin, Dina; Yaghoubian, Arezou; Rosing, David; Walot, Irving; Chauvapun, Joe; de Virgilio, Christian


    Computed tomographic angiography (CTA) has been established as a valid modality for the assessment of extremity vascular injury. Over the last several years at our institution, CTA has evolved as the primary diagnostic modality for penetrating extremity injuries, largely replacing diagnostic angiography. The purpose of this study was to evaluate the outcomes with this imaging modality at a high-volume Level I trauma center. A retrospective review was conducted of all patients presenting with penetrating lower extremity trauma between 2008 and 2009. Patient factors collected included demographics, mechanism of injury, injury severity, presence of hard signs of vascular injury, radiologic studies, operative intervention, and outcomes. There were 132 patients with penetrating lower extremity trauma. The average age of the patients was 25 years, with an average injury severity score of 10. The injuries were primarily gunshot wounds (89%). In all, 59 patients (45%) underwent CTA. CTA of the extremity was performed as a continuation of a computed tomography of the chest/abdomen/pelvis in 28 (47%) versus a targeted CTA of the extremity in 31 (53%) patients. In all, 34 (58%) CTAs were negative for vascular injury, 19 (32%) were positive, and six (10%) were indeterminate. Of the 34 patients with a normal CTA, none went to the operating room for repair of a major vascular injury; similarly, of the 19 patients with an abnormal CTA, there were no negative operative explorations. A total of 28 (21%) patients required operative intervention for the injured extremity; procedures performed included fasciotomy, venous and arterial ligation, primary repair, and interposition grafting. There were no amputations and no mortalities. Our results support the use of CTA as the primary imaging modality in evaluating penetrating lower extremity injury. Because of its proven accuracy in detecting major vascular injury, cost-effectiveness, and ease and rapidity of administration and

  20. Salter-Harris II injury of the proximal tibial epiphysis with both vascular compromise and compartment syndrome: a case report.

    Clement, Nicholas D; Goswami, Anukul


    We present a case of a Salter-Harris II injury to the proximal tibia associated with both vascular compromise and compartment syndrome. The potential complications of this injury are limb threatening and the neurovasular status of the limb should be continually monitored. Maintaining anatomic reduction is difficult and fixation may be needed to achieve optimal results.

  1. Salter-Harris II injury of the proximal tibial epiphysis with both vascular compromise and compartment syndrome: a case report

    Clement Nicholas D; Goswami Anukul


    Abstract We present a case of a Salter-Harris II injury to the proximal tibia associated with both vascular compromise and compartment syndrome. The potential complications of this injury are limb threatening and the neurovasular status of the limb should be continually monitored. Maintaining anatomic reduction is difficult and fixation may be needed to achieve optimal results.

  2. Salter-Harris II injury of the proximal tibial epiphysis with both vascular compromise and compartment syndrome: a case report

    Clement Nicholas D


    Full Text Available Abstract We present a case of a Salter-Harris II injury to the proximal tibia associated with both vascular compromise and compartment syndrome. The potential complications of this injury are limb threatening and the neurovasular status of the limb should be continually monitored. Maintaining anatomic reduction is difficult and fixation may be needed to achieve optimal results.

  3. Delayed presentation of compartment syndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete

    Moo Ing How


    Conclusion: A high index of suspicion for compartment syndrome is needed in all severe quadriceps contusion. Vascular injury can cause thigh compartment syndrome in sports trauma. MRI findings of deep thigh muscle swelling and “blow-out” tear of the vastus lateralis are strongly suggestive of severe quadriceps injury, and may be a harbinger of delayed thigh compartment syndrome.

  4. Statin use is associated with early recovery of kidney injury after vascular surgery and improved long-term outcome

    G.M.J.M. Welten (Gijs); M. Chonchol (Michel); O. Schouten (Olaf); S.E. Hoeks (Sanne); J.J. Bax (Jeroen); R.T. van Domburg (Ron); M.R.H.M. van Sambeek (Marc); D. Poldermans (Don)


    textabstractBackground. Acute kidney injury (AKI) after major vascular surgery is an important risk factor for adverse long-term outcomes. The pleiotropic effects of statins may reduce kidney injury caused by perioperative episodes of hypotension and/or suprarenal clamping and improve long-term

  5. Traumatic aortic injuries associated with major visceral vascular injuries in major blunt trauma patients.

    Mosquera, Victor X; Marini, Milagros; Cao, Ignacio; Gulías, Daniel; Muñiz, Javier; Herrera-Noreña, José M; Cuenca, José J


    The objectives of this study were to report the clinical and radiological characteristics and outcomes of a series of acute traumatic aortic injuries (ATAIs) with associated injury to major aortic abdominal visceral branches (MAAVBs). From January 2000 to August 2011, 10 consecutive major blunt trauma patients with associated ATAI and injury to MAAVBs (group A) and 42 major blunt trauma patients presenting only an ATAI without MAAVB injuries (group B) were admitted to our institution. Overall in-hospital mortality was 32.7%. In-hospital mortality in group A was 40% and in group B it was 31% (p = 0.86). Observed in-hospital mortality was slightly lower than the expected in-hospital mortality in both groups. Mean peak creatine phosphokinase was significantly higher in group A than in group B patients (23,008 ± 33,400 vs. 3,970 ± 3,495 IU/L; p trauma patients seem to present in a different clinical scenario. These patients present increased risk of rhabdomyolysis, visceral ischemia, and acute renal failure, as well as higher in-hospital mortality. A multidisciplinary approach combining endovascular and open surgical techniques for a staged treatment of these life-threatening aortic and MAAVB injuries is mandatory in this critical subset of trauma patients.

  6. Mononuclear Phagocyte-Derived Microparticulate Caspase-1 Induces Pulmonary Vascular Endothelial Cell Injury.

    Srabani Mitra

    Full Text Available Lung endothelial cell apoptosis and injury occurs throughout all stages of acute lung injury (ALI/ARDS and impacts disease progression. Lung endothelial injury has traditionally been focused on the role of neutrophil trafficking to lung vascular integrin receptors induced by proinflammatory cytokine expression. Although much is known about the pathogenesis of cell injury and death in ALI/ARDS, gaps remain in our knowledge; as a result of which there is currently no effective pharmacologic therapy. Enzymes known as caspases are essential for completion of the apoptotic program and secretion of pro-inflammatory cytokines. We hypothesized that caspase-1 may serve as a key regulator of human pulmonary microvascular endothelial cell (HPMVEC apoptosis in ALI/ARDS. Our recent experiments confirm that microparticles released from stimulated monocytic cells (THP1 induce lung endothelial cell apoptosis. Microparticles pretreated with the caspase-1 inhibitor, YVAD, or pan-caspase inhibitor, ZVAD, were unable to induce cell death of HPMVEC, suggesting the role of caspase-1 or its substrate in the induction of HPMVEC cell death. Neither un-induced microparticles (control nor direct treatment with LPS induced apoptosis of HPMVEC. Further experiments showed that caspase-1 uptake into HPMVEC and the induction of HPMVEC apoptosis was facilitated by caspase-1 interactions with microparticulate vesicles. Altering vesicle integrity completely abrogated apoptosis of HPMVEC suggesting an encapsulation requirement for target cell uptake of active caspase-1. Taken together, we confirm that microparticle centered caspase-1 can play a regulator role in endothelial cell injury.

  7. Knockdown of connexin 43 attenuates balloon injury-induced vascular restenosis through the inhibition of the proliferation and migration of vascular smooth muscle cells.

    Han, Xiao-Jian; He, Dan; Xu, Liang-Jing; Chen, Min; Wang, Yi-Qi; Feng, Jiu-Geng; Wei, Min-Jun; Hong, Tao; Jiang, Li-Ping


    Coronary artery disease (CAD) or atherosclerotic heart disease is one of the most common types of cardiovascular disease. Although percutaneous coronary intervention [PCI or percutaneous transluminal coronary angioplasty (PTCA)] is a mature, well-established technique used to treat atherosclerotic heart disease, its long‑term therapeutic effects are compromised by a high incidence of vascular restenosis (RS) following angioplasty. In our previous study, we found that the principal gap junction protein, connexin 43 (Cx43), in vascular smooth muscle cells (VSMCs) was involved in the development of vascular RS following angioplasty-induced balloon injury. However, the exact role action of Cx43 in vascular RS remains unclear. In the present study, we aimed to further examine whether the knockdown of Cx43 attenuates the development of vascular RS through the inhibition of the proliferation and migration of VSMCs. We found that the use of a lentiviral vector expressing shRNA targeting Cx43 (Cx43‑RNAi-LV) efficiently silenced the mRNA and protein expression of Cx43 in cultured VSMCs. In addition, MTT and Transwell assays were used to examined the proliferation and migration of the VSMCs, respectively. The results revealed that the knockdown of Cx43 by Cx43-RNAi-LV at a multiplicity of infection (MOI) of 100 significantly inhibited the proliferation and migration of the VSMCs in vitro. Notably, the knockdown of Cx43 also effectively attenuated the development of vascular RS and intimal hyperplasia following balloon injury in vivo. Taken together, our data suggest that Cx43 is involved in the development of vascular RS and intimal hyperplasia through the regulation of the proliferation and migration of VSMCs. Thus, the present study provides new insight into the pathogenesis of vascular RS, and suggests that further comfirms that Cx43 may well be a novel potential pharmacological target for preventing vascular RS following PCI.

  8. Quantification of Adventitial Vasa Vasorum Vascularization in Double-injury Restenotic Arteries

    Meng Ye; Bai-Gen Zhang; Lan Zhang; Hui Xie; Hao Zhang


    Background:Accumulating evidence indicates a potential role of adventitial vasa vasorum (VV) dysfunction in the pathophysiology of restenosis.However,characterization ofVV vascularization in restenotic arteries with primary lesions is still missing.In this study,we quantitatively evaluated the response of adventitial VV to vascular injury resulting from balloon angioplasty in diseased arteries.Methods:Primary atherosclerotic-like lesions were induced by the placement of an absorbable thread surrounding the carotid artery of New Zealand rabbits.Four weeks following double-injury induced that was induced by secondary balloon dilation,three-dimensional patterns of adventitial VV were reconstructed;the number,density,and endothelial surface of VV were quantified using micro-computed tomography.Histology and immunohistochemistry were performed in order to examine the development of intimal hyperplasia.Results:Results from our study suggest that double injured arteries have a greater number of VV,increased luminal surface,and an elevation in the intima/media ratio (I/M),along with an accumulation ofmacrophages and smooth muscle cells in the intima,as compared to sham or single injury arteries.I/M and the number of VV were positively correlated (R2 =0.82,P < 0.001).Conclusions:Extensive adventitial VV neovascularization occurs in injured arteries after balloon angioplasty,which is associated with intimal hyperplasia.Quantitative assessment of adventitial VV response may provide insight into the basic biological process of postangioplasty restenosis.

  9. Role of TRPM7 channels in hyperglycemia-mediated injury of vascular endothelial cells.

    Huawei Sun

    Full Text Available This study investigated the change of transient receptor potential melastatin 7 (TRPM7 expression by high glucose and its role in hyperglycemia induced injury of vascular endothelial cells. Human umbilical vein endothelial cells (HUVECs were incubated in the presence or absence of high concentrations of D-glucose (HG for 72 h. RT-PCR, Real-time PCR, Western blotting, Immunofluorescence staining and whole-cell patch-clamp recordings showed that TRPM7 mRNA, TRPM7 protein expression and TRPM7-like currents were increased in HUVECs following exposure to HG. In contrast to D-glucose, exposure of HUVECs to high concentrations of L-glucose had no effect. HG increased reactive oxygen species (ROS generation, cytotoxicity and decreased endothelial nitric oxide synthase protein expression, which could be attenuated by knockdown of TRPM7 with TRPM7 siRNA. The protective effect of silencing TRPM7 against HG induced endothelial injury was abolished by U0126, an inhibitor of the extracellular signal-regulated kinase signaling pathway. These observations suggest that TRPM7 channels play an important role in hyperglycemia-induced injury of vascular endothelial cells.

  10. ETS transcription factor ETV2/ER71/Etsrp in Hematopoietic and Vascular Development, Injury and Regeneration.

    Zhao, Haiyong; Xu, Canxin; Lee, Taejin; Liu, Fang; Choi, Kyunghee


    Editorial Notice: ETS transcription factor ETV2/ER71/Etsrp in Hematopoietic and Vascular Development, Injury and Regeneration. Haiyong Zhao, Canxin Xu, Taejin Lee, Fang Liu and Kyunghee Choi. Accepted manuscript online: 27 DEC 2016 | DOI: 10.1002/dvdy.24483. The above article, published as an Accepted Article online on Dec 27, 2016, in Wiley Online Library (, has been temporarily withdrawn by agreement between the authors, the journal Editor in Chief, Parker B. Antin, and Wiley Periodicals, Inc. The temporary withdrawal has been agreed due to a delay in publication of an article which is referenced in the above manuscript. This article is protected by copyright. All rights reserved.

  11. Cyclosporin A Inhibits Smooth Muscle Proliferation in the Vascular Response to Injury

    Jonasson, Lena; Holm, Jan; Hansson, Goran K.


    The arterial response to injury is dominated by proliferation of smooth muscle cells and infiltration of blood-borne cells in the vascular intima. Arterial smooth muscle cell proliferation is under growth factor control, but how this regulation operates in vivo is unclear. We studied the effect on arterial response to mechanical injury of cyclosporin A, a drug that inhibits T-lymphocyte activation. Cyclosporin A treatment at surgery caused a persistent inhibition of the intimal proliferative lesion. Cyclosporin A also inhibited expression of Ia antigens on smooth muscle cells in situ but had no direct effects on smooth muscle cell proliferation in culture. Therefore, the inhibition of intimal cell proliferation appears to be mediated via the immune system.

  12. Agmatine induces gastric protection against ischemic injury by reducing vascular permeability in rats

    Abeer A Al Masri; Eman El Eter


    AIM:To investigate the effect of administration of agmarine (AGM) on gastric protection against ischemia reperfusion (I/R)injury.METHODS:Three groups of rats (6/group); sham,gastric I/R injury,and gastric I/R + AGM (100 mg/kg,i.p.given 15 min prior to gastric ischemia) were recruited.Gastric injury was conducted by ligating celiac artery for 30 rmin and reperfusion for another 30 min.Gastric tissues were histologically studied and immunostained with angiopoietin 1 (Ang-1) and Ang-2.Vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein-1 (MCP-1) were measured in gastric tissue homogenate.To assess whether AKt/phosphatidyl inositol-3-kinase (PI3K) mediated the effect of AGM,an additional group was pretreated with Wortmannin (WM) (inhibitor of Akt/PI3K,15 μg/kg,i.p.),prior to ischemic injury and AGM treatment,and examined histologically and immunostained.Another set of experiments was run to study vascular permeability of the stomach using Evan's blue dye.RESULTS:AGM markedly reduced Evan's blue dye extravasation (3.58 ± 0.975 μg/stomach vs 1.175 ±0.374 μg/stomach,P < 0.05),and VEGF (36.87 ± 2.71 pg/100 mg protein vs 48.4 ± 6.53 pg/100 mg protein,P < 0.05) and MCP-1 tissue level (29.5 ± 7 pg/100 mg protein vs 41.17 ± 10.4 pg/100 mg protein,P < 0.01).It preserved gastric histology and reduced congestion.Ang-1 and Ang-2 immunostaining were reduced in stomach sections of AGM-treated animals.The administration of WM abolished the protective effects of AGM and extensive hemorrhage and ulcerations were seen.CONCLUSION:AGM protects the stomach against I/R injury by reducing vascular permeability and inflammation.This protection is possibly mediated by Akt/PI3K.

  13. Captopril attenuates hypertension and renal injury induced by the vascular endothelial growth factor inhibitor sorafenib

    Nagasawa, Tasuku; Khan, Abdul Hye; Imig, John D


    SUMMARY Vascular endothelial growth factor inhibitors (VEGFi) are known to cause hypertension and renal injury that severely limits their use as an anticancer therapy. We hypothesized that the angiotensin-converting enzyme inhibitor captopril not only prevents hypertension, but also decreases renal injury caused by the VEGFi sorafenib.Rats were administered sorafenib (20 mg/kg per day) alone or in combination with captopril (40 mg/kg per day) for 4 weeks. Sorafenib administration increased blood pressure, which plateaued by day 10.Concurrent treatment with captopril for 4 weeks resulted in a 30 mmHg decrease in blood pressure compared with sorafenib alone (155 ± 5 vs 182 ± 6 mmHg, respectively; P captopril treatment reduced albuminuria by 50% compared with sorafenib alone (20 ± 8 vs 42 ± 9 mg/day, respectively; P captopril-treated rats administered sorafenib. Renal autoregulatory efficiency was determined by evaluating the afferent arteriolar constrictor response to ATP. Sorafenib administration attenuated the vasoconstriction to ATP, whereas concurrent captopril treatment improved ATP reactivity.In conclusion, captopril attenuated hypertension and renal injury and improved renal autoregulatory capacity in rats administered sorafenib. These findings indicate that captopril treatment, in addition to alleviating the detrimental side-effect of hypertension, decreases the renal injury associated with anticancer VEGFi therapies such as sorafenib. PMID:22443474

  14. Dual-phase CT for the assessment of acute vascular injuries in high-energy blunt trauma: the imaging findings and management implications.

    Iacobellis, Francesca; Ierardi, Anna M; Mazzei, Maria A; Magenta Biasina, Alberto; Carrafiello, Gianpaolo; Nicola, Refky; Scaglione, Mariano


    Acute vascular injuries are the second most common cause of fatalities in patients with multiple traumatic injuries; thus, prompt identification and management is essential for patient survival. Over the past few years, multidetector CT (MDCT) using dual-phase scanning protocol has become the imaging modality of choice in high-energy deceleration traumas. The objective of this article was to review the role of dual-phase MDCT in the identification and management of acute vascular injuries, particularly in the chest and abdomen following multiple traumatic injuries. In addition, this article will provide examples of MDCT features of acute vascular injuries with correlative surgical and interventional findings.

  15. Sensorineural hearing loss and ischemic injury: Development of animal models to assess vascular and oxidative effects.

    Olivetto, E; Simoni, E; Guaran, V; Astolfi, L; Martini, A


    Hearing loss may be genetic, associated with aging or exposure to noise or ototoxic substances. Its aetiology can be attributed to vascular injury, trauma, tumours, infections or autoimmune response. All these factors could be related to alterations in cochlear microcirculation resulting in hypoxia, which in turn may damage cochlear hair cells and neurons, leading to deafness. Hypoxia could underlie the aetiology of deafness, but very few data about it are presently available. The aim of this work is to develop animal models of hypoxia and ischemia suitable for study of cochlear vascular damage, characterizing them by electrophysiology and gene/protein expression analyses. The effects of hypoxia in infarction were mimicked in rat by partial permanent occlusion of the left coronary artery, and those of ischemia in thrombosis by complete temporary carotid occlusion. In our models both hypoxia and ischemia caused a small but significant hearing loss, localized at the cochlear apex. A slight induction of the coagulation cascade and of oxidative stress pathways was detected as cell survival mechanism, and cell damages were found on the cuticular plate of outer hair cells only after carotid ischemia. Based on these data, the two developed models appear suitable for in vivo studies of cochlear vascular damage. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Subfailure overstretch injury leads to reversible functional impairment and purinergic P2X7 receptor activation in intact vascular tissue

    Weifeng Luo


    Full Text Available Vascular stretch injury is associated with blunt trauma, vascular surgical procedures, and harvest of human saphenous vein for use in vascular bypass grafting. A model of subfailure overstretch in rat abdominal aorta was developed to characterize surgical vascular stretch injury. Longitudinal stretch of rat aorta was characterized ex vivo. Stretch to the haptic endpoint where the tissues would no longer lengthen, occurred at twice the resting length. The stress produced at this length was greater than physiologic mechanical forces but well below the level of mechanical disruption. Functional responses were determined in a muscle bath and this subfailure overstretch injury led to impaired smooth muscle function that was partially reversed by treatment with purinergic receptor (P2X7R antagonists. These data suggest that vasomotor dysfunction caused by subfailure overstretch injury may be due to activation of P2X7R. These studies have implications for our understanding of mechanical stretch injury of blood vessels and offer novel therapeutic opportunities.

  17. Detection of vascular injuries in patients with blunt pelvic trauma by using 64-channel multidetector CT.

    Kertesz, Jennifer L; Anderson, Stephan W; Murakami, Akira M; Pieroni, Sabrina; Rhea, James T; Soto, Jorge A


    Vascular injuries are a major source of morbidity and mortality in patients with blunt pelvic trauma. Digital subtraction angiography (DSA) has traditionally been used to detect pelvic arterial injuries and to treat active arterial hemorrhage. Improvements in the technology of computed tomography (CT) have facilitated the implementation of CT angiography, which is beginning to replace DSA in the evaluation of patients with acute trauma. Pelvic CT angiography can reliably depict various pelvic arterial injuries and can help differentiate arterial hemorrhage from venous hemorrhage on the basis of multiphasic acquisitions, a method that may be used to tailor the subsequent clinical approach. With the use of a 64-channel multidetector CT scanner, multiphasic pelvic CT angiography can be integrated into the evaluation of trauma patients by using 1.25-mm reconstructed section thickness, pitch of 1:0.987, and gantry revolution time of 0.5 second to achieve near-isotropic results. A standard dose of 100 mL intravenous contrast material is injected at a rate of 5 mL/sec, and 30 mL saline solution, also at 5 mL/sec, is injected as a "chasing" bolus to follow the contrast material. (c) RSNA, 2009.

  18. Role of Nitric Oxide Isoforms in Vascular and Alveolar Development and Lung Injury in Vascular Endothelial Growth Factor Overexpressing Neonatal Mice Lungs.

    Mansoor A Syed

    Full Text Available The role of vascular endothelial growth factor (VEGF-induced 3 different nitric oxide synthase (NOS isoforms in lung development and injury in the newborn (NB lung are not known. We hypothesized that VEGF-induced specific NOS pathways are critical regulators of lung development and injury.We studied NB wild type (WT, lung epithelial cell-targeted VEGF165 doxycycline-inducible overexpressing transgenic (VEGFTG, VEGFTG treated with a NOS1 inhibitor (L-NIO, VEGFTG x NOS2-/- and VEGFTG x NOS3+/- mice in room air (RA for 7 postnatal (PN days. Lung morphometry (chord length, vascular markers (Ang1, Ang2, Notch2, vWF, CD31 and VE-cadherin, cell proliferation (Ki67, vascular permeability, injury and oxidative stress markers (hemosiderin, nitrotyrosine and 8-OHdG were evaluated.VEGF overexpression in RA led to increased chord length and vascular markers at PN7, which were significantly decreased to control values in VEGFTG x NOS2-/- and VEGFTG x NOS3+/- lungs. However, we found no noticeable effect on chord length and vascular markers in the VEGFTG / NOS1 inhibited group. In the NB VEGFTG mouse model, we found VEGF-induced vascular permeability in the NB murine lung was partially dependent on NOS2 and NOS3-signaling pathways. In addition, the inhibition of NOS2 and NOS3 resulted in a significant decrease in VEGF-induced hemosiderin, nitrotyrosine- and 8-OHdG positive cells at PN7. NOS1 inhibition had no significant effect.Our data showed that the complete absence of NOS2 and partial deficiency of NOS3 confers protection against VEGF-induced pathologic lung vascular and alveolar developmental changes, as well as injury markers. Inhibition of NOS1 does not have any modulating role on VEGF-induced changes in the NB lung. Overall, our data suggests that there is a significant differential regulation in the NOS-mediated effects of VEGF overexpression in the developing mouse lung.

  19. Delayed presentation of compartment syndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete.

    How, Moo Ing; Lee, Puah Ken; Wei, Tan See; Chong, Chua Tai


    Compartment syndrome isolated to the anterior thigh is a rare complication of soccer injury. Previous reports in the English literature on sports trauma-related compartment syndrome of the thigh are vague in their description of the response of thigh musculature to blunt trauma, magnetic resonance imaging (MRI) findings of high-risk features of compartment syndrome, vascular injury in quadriceps trauma, and the role of vascular study in blunt thigh injury. We present herein the rare case of a 30-year-old man who developed thigh compartment syndrome 8 days after soccer injury due to severe edema of vastus intermedius and large thigh hematoma secondary to rupture of the profunda femoris vein. MRI revealed "blow-out" rupture of the vastus lateralis. Decompressive fasciotomy and vein repair performed with subsequent split-skin grafting of the wound defect resulted in a good functional outcome at 2-years follow-up. A high index of suspicion for compartment syndrome is needed in all severe quadriceps contusion. Vascular injury can cause thigh compartment syndrome in sports trauma. MRI findings of deep thigh muscle swelling and "blow-out" tear of the vastus lateralis are strongly suggestive of severe quadriceps injury, and may be a harbinger of delayed thigh compartment syndrome. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Recovery of renal function after administration of adipose-tissue-derived stromal vascular fraction in rat model of acute kidney injury induced by ischemia/reperfusion injury.

    Lee, Chunwoo; Jang, Myoung Jin; Kim, Bo Hyun; Park, Jin Young; You, Dalsan; Jeong, In Gab; Hong, Jun Hyuk; Kim, Choung-Soo


    Acute kidney injury (AKI) induced by ischemia/reperfusion (I/R) injury is a major challenge in critical care medicine. The purpose of this study is to determine the therapeutic effects of the adipose-tissue-derived stromal vascular fraction (SVF) and the optimal route for SVF delivery in a rat model of AKI induced by I/R injury. Fifty male Sprague-Dawley rats were randomly divided into five groups (10 animals per group): sham, nephrectomy control, I/R injury control, renal arterial SVF infusion and subcapsular SVF injection. To induce AKI by I/R injury, the left renal artery was clamped with a nontraumatic vascular clamp for 40 min, and the right kidney was removed. Rats receiving renal arterial infusion of SVF had a significantly reduced increase in serum creatinine compared with the I/R injury control group at 4 days after I/R injury. The glomerular filtration rate of the renal arterial SVF infusion group was maintained at a level similar to that of the sham and nephrectomy control groups at 14 days after I/R injury. Masson's trichrome staining showed significantly less fibrosis in the renal arterial SVF infusion group compared with that in the I/R injury control group in the outer stripe (P renal arterial SVF infusion and subcapsular SVF injection groups compared with the I/R injury control group in the outer stripe (P renal function is effectively rescued from AKI induced by I/R injury through the renal arterial administration of SVF in a rat model.

  1. Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury

    McKinney, Alexander M.; Thompson, Linda R.; Truwit, Charles L.; Velders, Scott; Karagulle, Ayse; Kiragu, Andrew [University of Minnesota Medical School, Department of Radiology, Hennepin County Medical Center, Minneapolis, MN (United States)


    authorities obtained a confession of inflicted injury in one and a partial confession in the second (which did not fit the extent of injury). Five other children with HIE (based on DWI) were found during this period who had not suffered head trauma; all were bilateral insults. HIE associated with AHT might present with largely unilateral white matter injury on DWI following extensive cortical infarction. We propose that unilateral HIE in a young child might be a sign of AHT and might result from cervical vascular compression, whether from kinking during hyperflexion/hyperextension or from direct strangulation. (orig.)

  2. Vascular remodeling and mobilization of bone marrow-derived cells in cuff-induced vascular injury in LDL receptor knockout muce


    Background Vascular remodeling is an important pathologic process in vascular injury for various vascular disorders such as atherosclerosis,postangioplasty restenosis and transplant arteriopathy.Recently,pathologic change and the role of bone marrow derived cells were wildly studied in atherosclerosis and restenosis.But the manner of lesion formation in neointima and cell recruitment in vascular remodeling lesion in the present of hypercholesterolemia is not Vet fully understood. Methods Double-transgenic mice knockout of LDL receptor gene (LDL-/-) and expressing ubiquitously green fluorescent protein (GFP) were obtained by cross-breeding LDL-/-mice with the GFP-expressing transgenic mice. LDL-/- mice (22-24 weeks of age) fed high fat diet containing 1.25% (w/w) cholesterol were subjected to 9Gy irradiation and received bone marrow (BM) cells from the double-transgenic mice.Four weeks later,a nonconstrictive cuff was Dlaced around the right femoral artery.After another 2 weeks,both right and left femoral arteries were harvested and subjected to histochemical analysis.Apoptosis was analyzed in situ using TUNEL assay.Resuits Two weeks after cuff placement,atherosclerotic lesions developed in the intima consisting of a massive accumulation of foam cells, The tissue stained with anti-α smooth muscle actin (SMA) antibody,showed a number of SMA-positive cells in the intimal lesion area.They were also positive for GFP,indicating that BM-derived cells can differentiate to SMCs in the intima in cuff-induced vascular remodeling lesions.Numerous small vessels in the adventitia as well as the endothelial lining of the intima were positive both for CD31 and GFP.The intima and media showed a larae number of TUNEL-positive signals after 2 weeks cuff injury,indicating the presence of apoptosis in vascular remodelina.Conclusions Atherosclerotic lesions in mice can be developed in the intima after 2 weeks of cuff-induced vascular inJury under the hypercholesterolemic conditions

  3. Soluble receptor for advanced glycation end products as an indicator of pulmonary vascular injury after cardiac surgery

    S. Tuinman (Sietske); A.D. Cornet (Alexander); M.T. Kuipers (Maria); A.P.J. Vlaar (Alexander); M.J. Schultz (Marcus); A. Beishuizen (Auke); A.B.J. Groeneveld (Johan); N.P. Juffermans (Nicole)


    textabstractBackground: Cardiac surgery is frequently complicated by an acute vascular lung injury and this may be mediated, at least in part, by the (soluble) receptor for advanced glycation end products (sRAGE).Methods: In two university hospital intensive care units, circulating sRAGE was measure

  4. Dimethylfumarate attenuates restenosis after acute vascular injury by cell-specific and Nrf2-dependent mechanisms

    Chang Joo Oh


    Full Text Available Excessive proliferation of vascular smooth muscle cells (VSMCs and incomplete re-endothelialization is a major clinical problem limiting the long-term efficacy of percutaneous coronary angioplasty. We tested if dimethylfumarate (DMF, an anti-psoriasis drug, could inhibit abnormal vascular remodeling via NF−E2-related factor 2 (Nrf2-NAD(PH quinone oxidoreductase 1 (NQO1 activity. DMF significantly attenuated neointimal hyperplasia induced by balloon injury in rat carotid arteries via suppression of the G1 to S phase transition resulting from induction of p21 protein in VSMCs. Initially, DMF increased p21 protein stability through an enhancement in Nrf2 activity without an increase in p21 mRNA. Later on, DMF stimulated p21 mRNA expression through a process dependent on p53 activity. However, heme oxygenase-1 (HO-1 or NQO1 activity, well-known target genes induced by Nrf2, were dispensable for the DMF induction of p21 protein and the effect on the VSMC proliferation. Likewise, DMF protected endothelial cells from TNF-α-induced apoptosis and the dysfunction characterized by decreased eNOS expression. With knock-down of Nrf2 or NQO1, DMF failed to prevent TNF-α-induced cell apoptosis and decreased eNOS expression. Also, CD31 expression, an endothelial specific marker, was restored in vivo by DMF. In conclusion, DMF prevented abnormal proliferation in VSMCs by G1 cell cycle arrest via p21 upregulation driven by Nrf2 and p53 activity, and had a beneficial effect on TNF-α-induced apoptosis and dysfunction in endothelial cells through Nrf2–NQO1 activity suggesting that DMF might be a therapeutic drug for patients with vascular disease.

  5. LESIONES VASCULARES TRAUMÁTICAS DE CUELLO, TÓRAX Y ABDOMEN / Traumatic vascular injuries of the neck, thorax and abdomen

    Luis Reinerio Rodríguez Delgado


    Full Text Available Introduction and Objectives: Vascular injuries have been described since the ancient times. They represent 3 percent of traumatisms; and the most worrisome aspect is their dangerousness, because more than half of the patients die within the first 24 hours due to the hemorrhages they cause. This investigation was carried out with the objective of determining the incidence of the different types of vascular injuries at the Arnaldo Milian Castro Hospital. Method: A retrospective study in 21 patients who were hospitalized with diagnoses of vascular injuries in the neck, thorax and abdomen was carried out. The medical histories of the patients were analyzed, as well as the surgery reports and the necropsy protocols in the case of the deceased. Results: There was a predominance of penetrating wounds in the abdomen (38.9 % and in the thorax (19.05 %, as well as thoracic and abdominal closed traumas. The accidental cause was present in 57.2 percent of the patients. The most affected anatomical region was the abdomen (42.86 %, and the most used surgical procedure was the exploratory laparotomy (76.2 %. An average of 1.21 procedures per patient was carried out. The hypovolemic shock was the complication with the highest incidence, because it appeared in 11 patients (52.38 %, this represents 68.75 percent of all complications. Eleven patients (52.38 % stayed less than 3 days in hospital. The lesions of the spleen and its vascular pedicle appeared in 23.81 percent of the patients. Conclusions: Penetrating wounds in the abdomen, accidents as a cause of them, and the exploratory laparotomy were predominant. The most affected anatomical area was the abdomen and the hypovolemic shock was the most common complication.

  6. Disturbance of copper homeostasis is a mechanism for homocysteine-induced vascular endothelial cell injury.

    Daoyin Dong

    Full Text Available Elevation of serum homocysteine (Hcy levels is a risk factor for cardiovascular diseases. Previous studies suggested that Hcy interferes with copper (Cu metabolism in vascular endothelial cells. The present study was undertaken to test the hypothesis that Hcy-induced disturbance of Cu homeostasis leads to endothelial cell injury. Exposure of human umbilical vein endothelial cells (HUVECs to concentrations of Hcy at 0.01, 0.1 or 1 mM resulted in a concentration-dependent decrease in cell viability and an increase in necrotic cell death. Pretreatment of the cells with a final concentration of 5 µM Cu in cultures prevented the effects of Hcy. Hcy decreased intracellular Cu concentrations. HPLC-ICP-MS analysis revealed that Hcy caused alterations in the distribution of intracellular Cu; more Cu was redistributed to low molecular weight fractions. ESI-Q-TOF detected the formation of Cu-Hcy complexes. Hcy also decreased the protein levels of Cu chaperone COX17, which was accompanied by a decrease in the activity of cytochrome c oxidase (CCO and a collapse of mitochondrial membrane potential. These effects of Hcy were all preventable by Cu pretreatment. The study thus demonstrated that Hcy disturbs Cu homeostasis and limits the availability of Cu to critical molecules such as COX17 and CCO, leading to mitochondrial dysfunction and endothelial cell injury.

  7. Stent graft repair of subclavian and axillary vascular injuries: The Groote Schuur experience.

    Naidoo, N G; Navsaria, P; Beningfield, S J; Natha, B; Cloete, N; Gill, H


    Trauma-related subclavian and axillary vascular injuries (SAVIs) are generally associated with high morbidity and mortality rates in the surgical literature. There is an emerging trend towards increasing use of stent grafts (covered stents) for repair, with evidence limited to small case series and case reports. To report on the clinical and device-related outcomes of stent graft repair of trauma-related SAVIs at a single institution. A retrospective chart review of all patients with trauma-related SAVIs requiring stent graft repair was performed. Outcome measures included technical success, mortality, amputation rate, device-related complications (early and late), and reintervention rates (early and late). A total of 31 patients was identified between June 2008 and October 2013 (30 males, 1 female). Mean age was 27.9 years (range 19-51). All 31 patients sustained a penetrating injury (93.5% stab, 6.5% gunshot injuries). There were 21 subclavian and 10 axillary artery injuries. Five patients (16%) were HIV-positive. Nine patients (29%) were shocked on presentation. Early results (30 days): There were no periprocedural deaths. Primary technical success was 83.9% (26/31). Five patients required adjunctive interventional or operative procedures. There were no early procedure-related complications, reinterventions or open conversions in this study. Overall, suboptimal results were seen in five patients (one type I endoleak and four type II endoleaks). Follow-up results (>30 days): Nineteen patients (61.3%) were available for follow-up. Mean duration of follow-up was 55.7 weeks (range 4 - 240). Overall stent graft patency was 89.5% (17/19). Four patients (21.1%) had an occluded stent graft. Stent graft salvage was possible in two patients. Three type II endoleaks were seen on follow-up. Late reinterventions were performed in five patients (26.3%). Conversion to an open procedure was not required in any patient. There was one late death and one major amputation of a

  8. Vascular endothelial growth factor induced angiogenesis following focal cerebral ischemia/reperfusion injury in rabbits

    Huaijun Liu; Jiping Yang; Fenghai Liu; Qiang Zhang; Hui Li


    BACKGROUND: Therapeutic angiogenesis has opened up new pathway for the treatment of ischemic cerebrovascular disease in recent years. The exploration of the effect of vascular endothelial growth factor (VEGF) on inducing angiogenesis following ischemia/reperfusion injury can provide better help for the long-term treatment of cerebrovascular disease in clinic.OBJECTIVE: To observe the effect of VEGF on inducing angiogenesis following focal cerebral ischemia/reperfusion injury in rabbits through the angiogenesis of microvessels reflected by the expression of the factors of vascular pseudohemophilia.DESIGN: A randomized controlled animal trial.SETTING: Department of Medical Imaging, Second Hospital of Hebei Medical University.MATERIALS: Sixty-five healthy male New Zealand rabbits of clean degree, weighing (2.6±0.2) kg, aged4.5-5 months, were used. The polyclonal antibody against vascular pseudohemophilia (Beijing Zhongshan Company), recombinant VEGF165 (Peprotech Company, USA), biotinylated second antibody and ABC compound (Wuhan Boster Company) were applied.METHODS: The experiments were carried out in the Laboratory of Neuromolecular Imaging and Neuropathy,Second Hospital of Hebei Medical University from May to August in 2005. ① The rabbits were randomly divided into three groups: sham-operated group (n=15), control group (n=25) and VEGF-treated group(n=25). In the control group and VEGF-treated group, models were established by middle cerebral artery occlusion (MCAO) induced focal cerebral ischemia/reperfusion. In the VEGF-treated group, VEGF165(2.5 mg/L) was stereotactically injected into the surrounding regions of the infarcted sites immediately after the 2-hour ischemia/reperfusion; Saline of the same dosage was injected in the control group. But the rabobserved on the 3rd, 7th, 14th, 28th and 70th days of the experiment respectively, 3 rabbits in the sham-operated group and 5 in the control group and VEGF-treated group were observed at each time point. The

  9. The Outcomes of Salvage Surgery for Vascular Injury in The Extremities: A Special Consideration For Delayed Revascularization

    Jagdish Krishnan


    Full Text Available A seven years retrospective study was performed in 45 consecutive vascular injuries in the extremities to investigate the pattern of injuries, managements and outcomes. Motor-vehicle accidents were the leading cause of injuries (80%, followed by industrial injuries (11.1% and iatrogenic injuries (4.4%. Popliteal and brachial artery injuries were commonly involved (20%. Fifteen (33.3% patients had fractures, dislocation or fracture dislocation around the knee joint and 6 (13.3% patients had soft tissue injuries without fracture. Traumatic arterial transection accounted for 34 (75.6% cases, followed by laceration in 7 (15.6% and 9 (6.7% contusions. Associated nerve injuries were seen in 8 (17.8 % patients using intra-operative findings as the gold standard, both conventional angiogram (CA and computerized tomography angiogram (CTA had 100% specificity and 100% sensitivity in determining the site of arterial injuries. The mean ischemic time was 25.31 hours (4 - 278 hours. Thirty-three (73.3 % patients were treated more than 6 hours after injury and 6 patients underwent revascularization after 24 hours; all had good collateral circulation without distal pulses or evidence of ischemic neurological deficit. The mean ischemic time in 39 patients who underwent revascularization within 24 hours was 13.2 hours. Delayed amputation was performed in 5 patients (11.1%. Of the 6 patients who underwent delayed revascularization, one patient had early amputation, one -had delayed amputation following infection and multiple flap procedures while the rest of the patients’ limbs survived. Joint stiffness was noted in 10 patients (22.2% involving the knee joint, elbow and shoulder in two patients each. Infection was also noted in 5 patients (11.1% with two of them were due to infected implants. Other complications encountered included nonunion (2 patients, 4.4%, delayed union (1 patient, 2.2%, limb length discrepancy (1 patient, 2.2%, hematoma (1 patient, 2.2% and

  10. Accelerated neointima formation after vascular injury in mice with stromelysin-3 (MMP-11) gene inactivation.

    Lijnen, H R; Van Hoef, B; Vanlinthout, I; Verstreken, M; Rio, M C; Collen, D


    The hypothesis that stromelysin-3 (MMP-11), a unique member of the matrix metalloproteinase (MMP) family, plays a role in neointima formation was tested with the use of a vascular injury model in wild-type (MMP-11(+/+)) and MMP-11-deficient (MMP-11(-/-)) mice. Neointima formation 2 to 3 weeks after electric injury of the femoral artery was significantly enhanced in MMP-11(-/-) as compared with MMP-11(+/+) mice, in both mice of a pure 129SV genetic background (0.014 versus 0.0010 mm(2) at 2 weeks, P<0.001) and those of a 50/50 mixed 129SV/BL6 background (0.030 versus 0.013 mm(2) at 3 weeks, P<0.05). The medial areas were comparable, resulting in intima/media ratios that were significantly increased in MMP-11(-/-) as compared with MMP-11(+/+) arteries, in mice of both the 129SV (1. 0 versus 0.18, P<0.001) and mixed (1.5 versus 0.70, P<0.05) backgrounds. Nuclear cell counts in cross-sectional areas of the intima of the injured region were higher in arteries from MMP-11(-/-) mice than in those from MMP-11(+/+) mice (210 versus 48, P<0.001, in pure 129SV mice and 290 versus 150, P<0.01, in mice of the mixed genetic background). Immunocytochemical analysis revealed that alpha-actin-positive and CD45-positive cells were more abundant in intimal sections of MMP-11(-/-) mice. Degradation of the internal elastic lamina was more extensive in arteries of MMP-11(-/-) mice than in those of MMP-11(+/+) mice (39% versus 6.8% at 3 weeks, P<0. 005). The mechanisms by which MMP-11 could impair elastin degradation and cellular migration in this model remain, however, unknown.

  11. Pulmonary microvascular hyperpermeability and expression of vascular endothelial growth factor in smoke inhalation- and pneumonia-induced acute lung injury.

    Lange, Matthias; Hamahata, Atsumori; Traber, Daniel L; Connelly, Rhykka; Nakano, Yoshimitsu; Traber, Lillian D; Schmalstieg, Frank C; Herndon, David N; Enkhbaatar, Perenlei


    Acute lung injury (ALI) and sepsis are major contributors to the morbidity and mortality of critically ill patients. The current study was designed further evaluate the mechanism of pulmonary vascular hyperpermeability in sheep with these injuries. Sheep were randomized to a sham-injured control group (n=6) or ALI/sepsis group (n=7). The sheep in the ALI/sepsis group received inhalation injury followed by instillation of Pseudomonas aeruginosa into the lungs. These groups were monitored for 24 h. Additional sheep (n=16) received the injury and lung tissue was harvested at different time points to measure lung wet/dry weight ratio, vascular endothelial growth factor (VEGF) mRNA and protein expression as well as 3-nitrotyrosine protein expression in lung homogenates. The injury induced severe deterioration in pulmonary gas exchange, increases in lung lymph flow and protein content, and lung water content (P<0.01 each). These alterations were associated with elevated lung and plasma nitrite/nitrate concentrations, increased tracheal blood flow, and enhanced VEGF mRNA and protein expression in lung tissue as well as enhanced 3-nitrotyrosine protein expression (P<0.05 each). This study describes the time course of pulmonary microvascular hyperpermeability in a clinical relevant large animal model and may improve the experimental design of future studies. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  12. The Use of Temporary Vascular Shunts as a Damage Control Adjunct in the Management of Wartime Vascular Injury


    Lippincott Williams & Wilkins, Inc. The views expressed in this report are those of the authors and do not reflect the official policy of the Department...Surg Gyn and Obst . 1971;132:67–70. 9. Hossny A. Blunt popliteal artery injury with complete lower limb ischemia: is routine use of temporary

  13. Effects of rosuvastatin on expression of angiotensin-converting enzyme 2 after vascular balloon injury in rats

    Yong-Hong Li; Qi-Xin Wang; Jing-Wei Zhou; Xian-Ming Chu; Yu-Lin Man; Ping Liu; Bei-Bei Ren; Ting-Ru Sun; Yi An


    Objective To investigate the effects and mechanisms of rosuvastatin on angiotensin -converting enzyme 2 (ACE2) in the process of neointimal formation after vascular balloon injury in rats, and to explore the effects of ACE2 and rosuvastatin in restenosis. Methods Thirty-six Wistar rats were randomly allocated into three groups: control group (n = 12), surgery group (n = 12), and statin group (n = 12). Aortic endothelial denudation of rats was performed using 2F balloon catheters. At days 14 and 28 after injury, aortic arteries were harvested to examine the following. Intimal thickening was examined by hematoxylin and eosin staining. We measured angiotensin II (Ang II) and angiotensin 1-7 (Ang-[1–7]) levels by a radioimmunological method or enzyme-linked immunosorbent assay. Protein and mRNA expression of ACE2 and Ang II type 1 receptor (AT1) were investigated by immunohistochemistry, Western blots, and Reverse transcriptase-polymerase chain reaction (RT-PCR). We measured changes in proliferating cell nuclear antigen (PCNA) by immunohistochemistry. The level of phosphorylated extracellular signal regulated kinase 1/2 (P-ERK1/2) was evaluated by Western blotting. Results Proliferation of vascular smooth muscle cells (VSMC) and intimal thickening were higher at day 14 after vascular balloon injury in the surgery group compared with the control group. Proliferation of VSMC was decreased by day 28 after injury, while intimal thickening continued. With rosuvastatin treatment, the extent of VSMC proliferation and intimal thickening was reduced at day 14 and 28 after injury. Ang II and P-ERK levels were significantly increased, Ang-(1–7) levels were significantly decreased, mRNA and protein expressions of ACE2 were significantly decreased, and AT1 expression was significantly increased at days 14 and 28 after vascular balloon injury in the surgery group compared with the control group. PCNA expression was higher in the surgery group than in the control group, and it

  14. Lentivirus-mediated RNAi knockdown of the gap junction protein, Cx43, attenuates the development of vascular restenosis following balloon injury.

    Han, Xiao-Jian; Chen, Min; Hong, Tao; Zhu, Ling-Yu; He, Dan; Feng, Jiu-Geng; Jiang, Li-Ping


    Percutaneous coronary intervention [PCI or percutaneous transluminal coronary angioplasty (PTCA)] has been developed into a mature interventional treatment for atherosclerotic cardiovascular disease. However, the long-term therapeutic effect is compromised by the high incidence of vascular restenosis following angioplasty, and the underlying mechanisms of vascular restenosis have not yet been fully elucidated. In the present study, we investigated the role of the gap junction (GJ) protein, connexin 43 (Cx43), in the development of vascular restenosis. To establish vascular restenosis, rat carotid arteries were subjected to balloon angioplasty injury. At 0, 7, 14 and 2 days following balloon injury, the arteries were removed, and the intimal/medial area of the vessels was measured to evaluate the degree of restenosis. We found that the intimal area gradually increased following balloon injury. Intimal hyperplasia and restenosis were particularly evident at 14 and 28 days after injury. In addition, the mRNA and protein expression of Cx43 was temporarily decreased at 7 days, and subsequently increased at 14 and 28 days following balloon injury, as shown by RT-PCR and western blot analysis. To determine the involvement of Cx43 in vascular restenosis, the lentivirus vector expressing shRNA targeting Cx43, Cx43-RNAi-LV, was used to silence Cx43 in the rat carotid arteries. The knockdown of Cx43 effectively attenuated the development of intimal hyperplasia and vascular restenosis following balloon injury. Thus, our data indicate the vital role of the GJ protein, Cx43, in the development of vascular restenosis, and provide new insight into the pathogenesis of vascular restenosis. Cx43 may prove to be a novel potential pharmacological target for the prevention of vascular restenosis following PCI.

  15. Comparison of polyurethane with cyanoacrylate in hemostasis of vascular injury in guinea pigs.

    Kubrusly, Luiz Fernando; Formighieri, Marina Simões; Lago, José Vitor Martins; Graça, Yorgos Luiz Santos de Salles; Sobral, Ana Cristina Lira; Lago, Marianna Martins


    To evaluate the behavior of castor oil-derived polyurethane as a hemostatic agent and tissue response after abdominal aortic injury and to compare it with 2-octyl-cyanoacrylate. Twenty-four Guinea Pigs were randomly divided into three groups of eight animals (I, II, and III). The infrarenal abdominal aorta was dissected, clamped proximally and distally to the vascular puncture site. In group I (control), hemostasis was achieved with digital pressure; in group II (polyurethane) castor oil-derived polyurethane was applied, and in group III (cyanoacrylate), 2-octyl-cyanoacrylate was used. Group II was subdivided into IIA and IIB according to the time of preparation of the hemostatic agent. Mean blood loss in groups IIA, IIB and III was 0.002 grams (g), 0.008 g, and 0.170 g, with standard deviation of 0.005 g, 0.005 g, and 0.424 g, respectively (P=0.069). The drying time for cyanoacrylate averaged 81.5 seconds (s) (standard deviation: 51.5 seconds) and 126.1 s (standard deviation: 23.0 s) for polyurethane B (P=0.046). However, there was a trend (P=0.069) for cyanoacrylate to dry more slowly than polyurethane A (mean: 40.5 s; SD: 8.6 s). Furthermore, polyurethane A had a shorter drying time than polyurethane B (P=0.003), mean IIA of 40.5 s (standard deviation: 8.6 s). In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001). Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate. There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.

  16. Taurine antagonized oxidative stress injury induced by homocysteine in rat vascular smooth muscle cells

    Lin CHANG; Jian-xin XU; Jing ZHAO; Yong-zheng PANG; Chao-shu TANG; Yong-fen QI


    AIM: To observe protective effects of taurine on reactive oxygen species generation induced by homocysteine in rat vascular smooth muscle cells (VSMC). METHODS: Rat VSMC was incubated with various concentrations of homocysteine and taurine. The lactate dehydrogenase (LDH) activity which released into culture medium was elevated as an indicator for VSMC injury. The reactive oxygen species (ROS) - hydrogen peroxide (H2O2) and superoxide anion (O2- )were measured with luminol or lucigenin chemiluminescences method, and the mitochondria Mn-superoxide dismutase (Mn-SOD) and catalase (CAT) were also measured in treated VSMC. RESULTS: LDH leakage from cultured VSMC treated with homocystenie, was increased (P<0.01 vs control), and it was markedly inhibited when co-incubated with taurine (P<0.01). Homocysteine induced H2O2 generation from VSMC in a concentration dependent manner (P<0.01 vs control). However, taurine (5, 10, and 20 mmol/L) significantly antagonized 0.5 mmol/L homocysteine-induced H2O2 generation in VSMC in a concentration dependent manner (P<0.01 vs homocysteine alone group), although taurine itself did not alter the H2O2 generation in VSMC (P>0.05 vs control).In this study, the superoxide anion in VSMC was not detectable by chemiluminent method. In addition, treatment of VSMC with taurine increased mitochondria Mn-SOD and CAT activity in a concentration dependent manner (P<0.05), but homocysteine decreased mitochondria Mn-SOD and CAT activity (P<0.01 vs control). In addition,co-administration of taurine markedly ameliorated homocysteine-induced inhibition of Mn-SOD and CAT activity in VSMC (P<0.01 vs homocysteine alone group). CONCLUSION: Taurine antagonized the effects of homocysteine on ROS generation and anti-oxidant enzyme activities in rat VSMC in vitro.

  17. The Soluble Epoxide Hydrolase Inhibitor AR9281 Decreases Blood Pressure, Ameliorates Renal Injury and Improves Vascular Function in Hypertension

    Sean Shaw


    Full Text Available Soluble epoxide hydrolase inhibitors (sEHIs are demonstrating promise as potential pharmaceutical agents for the treatment of cardiovascular disease, diabetes, inflammation, and kidney disease. The present study determined the ability of a first-inclass sEHI, AR9281, to decrease blood pressure, improve vascular function, and decrease renal inflammation and injury in angiotensin hypertension. Rats were infused with angiotensin and AR9281 was given orally during the 14-day infusion period. Systolic blood pressure averaged 180 ± 5 mmHg in vehicle treated and AR9281 treatment significantly lowered blood pressure to 142 ± 7 mmHg in angiotensin hypertension. Histological analysis demonstrated decreased injury to the juxtamedullary glomeruli. Renal expression of inflammatory genes was increased in angiotensin hypertension and two weeks of AR9281 treatment decreased this index of renal inflammation. Vascular function in angiotensin hypertension was also improved by AR9281 treatment. Decreased afferent arteriolar and mesenteric resistance endothelial dependent dilator responses were ameliorated by AR9281 treatment of angiotensin hypertensive rats. These data demonstrate that the first-in-class sEHI, AR9281, lowers blood pressure, improves vascular function and reduces renal damage in angiotensin hypertension.

  18. Alleviation of hyperglycemia induced vascular endothelial injury by exenatide might be related to the reduction of nitrooxidative stress.

    Zhao, Qian; Xu, Chun-ling; Xiong, Hai-yan; Huang, Wen; Zhang, Mei; Wang, Yun; Wang, Si-yu; Wang, Wen


    We will investigate the effects of exenatide on vascular endothelial injury and nitrooxidative stress in hyperglycemia both in vivo and in vitro and explore the role of nitrooxidative stress in endothelium-protective action of exenatide. Healthy male Wistar rats were randomly divided into 4 groups: control, diabetes mellitus (DM) model, low dose of exenatide treatment, and high dose of exenatide treatment. In vitro study showed that, compared with control group, the DM rats exhibited a lowered endothelium-dependent relaxation and damaged structural integrity of thoracic aortas, and there was a significant increase in plasma nitrotyrosine concentration. These parameters were improved after treatment with either low dose or high dose of exenatide for 45 days. In vitro study showed that exendin-4 (the active ingredient of exenatide) attenuated HUVECs injury induced by high glucose, with improving cell viability and attenuating cell apoptosis. Exendin-4 also significantly alleviated the increased malondialdehyde (MDA), nitrotyrosine content, and inducible nitric oxide synthase (iNOS) expression induced by high glucose in HUVECs. In conclusion, this study demonstrates that exenatide treatment can alleviate the vascular endothelial injury, as well as attenuating the nitrooxidative stress in hyperglycemia, implying that the endothelium-protective effect of exenatide might be related to the reduction of nitrooxidative stress.

  19. GWOT Vascular Injury Study 2 Supplemental Project: Impact of Prophylactic Fasciotomy


    injury characteristics, complications , other injures, and limb salvage information. Information regarding fasciotomy wound management and iatrogenic... complications of fasciotomy will be obtained from individual patient records. Information specific for return-to-duty and long-term disability will be...injury will be used to determine fasciotomy rates, wound management, and iatrogenic complications . The impact of injury and fasciotomy on the

  20. 血管损伤的诊断和救治策略%Diagnosis and treatment strategy of vascular injury

    王深明; 王冕


    The incidence of vascular trauma is growing as a result of the development of transportation industry,frequent natural disaster,modern war and increasing terrorist violence. Burstiness and stealthiness are important characteristics of vascular trauma. However,the early diagnosis and intervention of vascular trauma remains difficult. Delayed and improper management might lead to the likelihood of catastrophe. Thus, attaching attention to diagnosis and surgical treatment strategy for vascular injury is necessary.%随着各种自然灾害的频发,交通运输业的发展和战争的存在,以及暴恐事件的发生,近年来血管损伤发生率显著增加。血管损伤具有突发性和隐匿性的特点,诊断和处理有一定难度,如得不到及时正确的诊治,可能导致灾难性后果。因此,有必要重视血管损伤的外科救治策略研究。


    Thromboses can result from venous stasis, vascular injury or hypercoagulability, and those involving the deep veins proximal to the knee are linked to an increased risk of PE.2 .... tool for DVT in hospitalised patients, where higher scores.

  2. Alleviation of Hyperglycemia Induced Vascular Endothelial Injury by Exenatide Might Be Related to the Reduction of Nitrooxidative Stress

    Qian Zhao


    of exenatide treatment. In vitro study showed that, compared with control group, the DM rats exhibited a lowered endothelium-dependent relaxation and damaged structural integrity of thoracic aortas, and there was a significant increase in plasma nitrotyrosine concentration. These parameters were improved after treatment with either low dose or high dose of exenatide for 45 days. In vitro study showed that exendin-4 (the active ingredient of exenatide attenuated HUVECs injury induced by high glucose, with improving cell viability and attenuating cell apoptosis. Exendin-4 also significantly alleviated the increased malondialdehyde (MDA, nitrotyrosine content, and inducible nitric oxide synthase (iNOS expression induced by high glucose in HUVECs. In conclusion, this study demonstrates that exenatide treatment can alleviate the vascular endothelial injury, as well as attenuating the nitrooxidative stress in hyperglycemia, implying that the endothelium-protective effect of exenatide might be related to the reduction of nitrooxidative stress.

  3. Vascular Injuries to the Neck After Penetrating Trauma: Diagnostic Performance of 40- and 64-MDCT Angiography.

    Bodanapally, Uttam K; Dreizin, David; Sliker, Clint W; Boscak, Alexis R; Reddy, Ramachandra P


    The purposes of this study were to assess the diagnostic performance of 40- and 64-MDCT angiography with digital subtraction angiography as the reference standard in the detection of arterial injuries in patients at high risk after penetrating neck trauma and to perform a separate analysis of injuries to the external carotid artery. In a retrospective evaluation of 53 sets of angiograms from 51 patients with penetrating neck injury, three reviewers unaware of the digital subtraction angiographic findings reviewed the CT angiographic (CTA) images to discern the presence or absence of arterial injuries. Sensitivity and specificity of CTA were calculated per injury, and a separate analysis of external carotid artery injuries was performed. Sensitivity of CTA for detecting arterial injuries ranged from 75.7% (95% CI, 62.3-86.9%) to 82.2% (95% CI, 69.5-92.1%). Specificity ranged from 96.4% (95% CI, 94.0-98.4%) to 98.4% (95% CI, 96.0-100%). CTA was highly sensitive for detection of the subgroup of injuries involving the large-caliber vessels that contribute to cerebral circulation. These sensitivities ranged from 92.8% (95% CI, 66-98.8%) to 100% (95% CI, 76.6-100%) for internal carotid artery injuries and from 88.9% (95% CI, 65.2-98.3%) to 94.4% (95% CI, 72.6-99.0%) for vertebral artery injuries. In contrast, sensitivity of CTA was limited for external carotid artery injuries, ranging from 63.4% (95% CI, 45.5-79.5%) to 70.0% (95% CI, 52.0-85.0%). CTA can be used for initial evaluation and may help guide management decisions if an external carotid artery injury is detected. Negative findings should not preclude close clinical follow-up, repeat CTA evaluation, or, in the presence of high suspicion of arterial injury due to clinical findings or wound trajectory, evaluation with digital subtraction angiography.

  4. The dangers of damage control orthopedics: a case report of vascular injury after femoral fracture external fixation

    Staeheli Gregory R


    Full Text Available Abstract Background Placement of external fixation frames is an expedient and minimally invasive method of achieving bone and joint stability in the setting of severe trauma. Although anatomic safe zones are established for placement of external fixation pins, neurovascular structures may be at risk in the setting of severe trauma. Case report We present a case of a 21-year-old female involved in a high speed motorcycle accident who sustained a Type IIIB open segmental femur fracture with significant thigh soft tissue injury. Damage control orthopedic principals were applied and a spanning external fixator placed for provisional femoral stabilization. Intraoperative vascular examination noted absent distal pulses, however an intraoperative angiogram showed arterial flow distal to the trifurcation. Immediately postoperatively the dorsalis pedis pulse was detected using Doppler ultrasound but was then non-detectable over the preceding 12-hours. Femoral artery CT angiogram revealed iatrogenic superficial femoral artery occlusion due to kinking of the artery around an external fixator pin. Although the pin causing occlusion was placed under direct visualization, the degree of soft tissue injury altered the appearance of the local anatomy. The pin was subsequently revised allowing the artery to travel in its anatomic position, restoring perfusion. Conclusion This case highlights the dangers associated with damage control orthopedics, especially when severe trauma alters normal local anatomy. Careful assessment of external fixator pin placement is crucial to avoiding iatrogenic injury. We recommend a thorough vascular examination pre-operatively and prior to leaving the operating room, which allows any abnormalities to be further evaluated while the patient remains in a controlled environment. When an unrecognized iatrogenic injury occurs, serial postoperative neurovascular examinations allow early recognition and corrective actions.

  5. Far-infrared protects vascular endothelial cells from advanced glycation end products-induced injury via PLZF-mediated autophagy in diabetic mice

    Chen, Cheng-Hsien; Chen, Tso-Hsiao; Wu, Mei-Yi; Chou, Tz-Chong; Chen, Jia-Rung; Wei, Meng-Jun; Lee, San-Liang; Hong, Li-Yu; Zheng, Cai-Mei; Chiu, I-Jen; Lin, Yuh-Feng; Hsu, Ching-Min; Hsu, Yung-Ho


    The accumulation of advanced glycation end products (AGEs) in diabetic patients induces vascular endothelial injury. Promyelocytic leukemia zinc finger protein (PLZF) is a transcription factor that can be activated by low-temperature far-infrared (FIR) irradiation to exert beneficial effects on the vascular endothelium. In the present study, we investigated the influence of FIR-induced PLZF activation on AGE-induced endothelial injury both in vitro and in vivo. FIR irradiation inhibited AGE-induced apoptosis in human umbilical vein endothelial cells (HUVECs). PLZF activation increased the expression of phosphatidylinositol-3 kinases (PI3K), which are important kinases in the autophagic signaling pathway. FIR-induced PLZF activation led to autophagy in HUVEC, which was mediated through the upregulation of PI3K. Immunofluorescence staining showed that AGEs were engulfed by HUVECs and localized to lysosomes. FIR-induced autophagy promoted AGEs degradation in HUVECs. In nicotinamide/streptozotocin-induced diabetic mice, FIR therapy reduced serum AGEs and AGEs deposition at the vascular endothelium. FIR therapy also reduced diabetes-induced inflammatory markers in the vascular endothelium and improved vascular endothelial function. These protective effects of FIR therapy were not found in PLZF-knockout mice. Our data suggest that FIR-induced PLZF activation in vascular endothelial cells protects the vascular endothelium in diabetic mice from AGE-induced injury. PMID:28071754

  6. New vascular tissue rapidly replaces neural parenchyma and vessels destroyed by a contusion injury to the rat spinal cord.

    Casella, Gizelda T B; Marcillo, Alexander; Bunge, Mary Bartlett; Wood, Patrick M


    Blood vessels identified by laminin staining were studied in uninjured spinal cord and at 2, 4, 7, and 14 days following a moderate contusion (weight drop) injury. At 2 days after injury most blood vessels had been destroyed in the lesion epicenter; neurons and astrocytes were also absent, and few ED1+ cells were seen infiltrating the lesion center. By 4 days, laminin associated with vessel staining was increased and ED1+ cells appeared to be more numerous in the lesion. By 7 days after injury, the new vessels formed a continuous cordon oriented longitudinally through the lesion center. ED1+ cells were abundant at this time point and were found in the same area as the newly formed vessels. Astrocyte migration from the margins of the lesion into the new cordon was apparent. By 14 days, a decrease in the number of vessels in the lesion center was observed; in contrast, astrocytes were more prominent in those areas. In addition to providing a blood supply to the lesion site, protecting the demise of the newly formed vascular bridge might provide an early scaffold to hasten axonal regeneration across the injury site. (c) 2002 Elsevier Science.

  7. Effect of large decompressive craniectomy combined with vascular reconstruction on cerebral perfusion in patients with severe brain injury

    Liang-zhen HUANG


    Full Text Available Objective To compare the efficacies of large decompressive craniectomy combined with vascular reconstruction and traditional decompressive craniectomy in treatment of severe brain injury. Methods Forty-eight patients with severe brain injury, which was dominated by brain contusion to the frontoparietal lobes, admitted to our hospital from March 2012 to March 2014 were divided equally into experimental group and control group. The patients in the experimental group underwent large decompressive craniectomy combined with vascular reconstruction, and the patients in the control group received traditional decompressive craniectomy. The hemodynamic changes including cerebral blood flow (CBF, cerebral blood volume (CBV, mean transit time (MTT, time to peak (TTP and the ratios of these values (rCBF, rCBV, rMTT and rTTP on two sides were observed by CT perfusion imaging, and the Glasgow outcome score (GOS was analyzed 6 months after operation. Results The CBF and CBV scores in experimental group were higher than those in the control group at 1 week and 1 month after the operation (P0.05. The rate of satisfactory recovery (including good recovery and moderate disability was higher in the experimental group than in the control group, while the rate of poor recovery (including severe disability, vegetative state and death was lower in the experimental group than in the control group (P<0.05. Conclusion The large decompressive craniectomy combined with vascular reconstruction can not only decrease the intracranial pressure, but also recover the blood supply of brain, thus deserving the clinical application and popularization. DOI: 10.11855/j.issn.0577-7402.2015.11.15

  8. Risk of injury to vascular-nerve bundle after calcaneal fracture: comparison among three techniques

    Labronici, Pedro José; Reder, Vitor Rodrigues; de Araujo Marins Filho, Guilherme Ferreira; Pires, Robinson Esteves Santos; Fernandes, Hélio Jorge Alvachian; Mercadante, Marcelo Tomanik


    Objective To ascertain whether the number of screws or pins placed in the calcaneus might increase the risk of injury when three different techniques for treating calcaneal fractures. Method 126 radiographs of patients who suffered displaced calcaneal fractures were retrospectively analyzed. Three surgical techniques were analyzed on an interobserver basis: 31 radiographs of patients treated using plates that were not specific for the calcaneus, 48 using specific plates and 47 using an external fixator. The risk of injury to the anatomical structures in relation to each Kirschner wire or screw was determined using a graded system in accordance with the Licht classification. The total risk of injury to the anatomical structures through placement of more than one wire/screw was quantified using the additive law of probabilities for the product, for independent events. Results All of the models presented high explanatory power for the risk evaluated, since the coefficient of determination values (R2) were greater than 98.6 for all the models. Therefore, the set of variables studied explained more than 98.6% of the variations in the risks of injury to arteries, veins or nerves and can be classified as excellent models for prevention of injuries. Conclusion The risk of injury to arteries, veins or nerves is not defined by the total number of pins/screws. The region and the number of pins/screws in each region define and determine the best distribution of the risk. PMID:27069891

  9. Curcumin Attenuates Rapamycin-induced Cell Injury of Vascular Endothelial Cells.

    Guo, Ning; Chen, Fangyuan; Zhou, Juan; Fang, Yuan; Li, Hongbing; Luo, Yongbai; Zhang, Yong


    Although drug-eluting stents (DES) effectively improve the clinical efficacy of percutaneous coronary intervention, a high risk of late stent thrombosis and in-stent restenosis also exists after DES implantation. Anti-smooth muscle proliferation drugs, such as rapamycin, coating stents, not only inhibit the growth of vascular smooth muscle cells but also inhibit vascular endothelial cells and delay the reendothelialization. Therefore, the development of an ideal agent that protects vascular endothelial cells from rapamycin-eluting stents is of great importance for the next generation of DES. In this study, we demonstrated that rapamycin significantly inhibited the growth of rat aortic endothelial cells in both dose- and time-dependent manner in vitro. Cell apoptosis was increased and migration was decreased by rapamycin treatments in rat aortic endothelial cells in vitro. Surprisingly, treatment with curcumin, an active ingredient of turmeric, significantly reversed these detrimental effects of rapamycin. Moreover, curcumin increased the expression of vascular nitric oxide synthases (eNOS), which was decreased by rapamycin. Furthermore, caveolin-1, the inhibitor of eNOS, was decreased by curcumin. Knockdown of eNOS by small interfering RNA significantly abrogated the protective effects of curcumin. Taken together, our results suggest that curcumin antagonizes the detrimental effect of rapamycin on aortic endothelial cells in vitro through upregulating eNOS. Therefore, curcumin is a promising combined agent for the rescue of DES-induced reendothelialization delay.

  10. Combat related vascular injuries : Dutch experiences from a role 2 MTF in Afghanistan

    Van Dongen, Thijs T C F; Idenburg, Floris J.; Tan, Edward C T H; Rasmussen, Todd E.; Hamming, Jaap F.; Leenen, Luke P H; Hoencamp, Rigo


    Background In a combat environment, major vascular trauma endures as the leading cause of death. The Dutch role 2 Medical Treatment Facility (MTF), provided supportive care during the mission in Uruzgan, Afghanistan. Aim of this study was to conduct detailed analysis of the admitted major

  11. Combat related vascular injuries: Dutch experiences from a role 2 MTF in Afghanistan

    Dongen, T.T. van; Idenburg, F.J.; Tan, E.C.T.H.; Rasmussen, T.E.; Hamming, J.F.; Leenen, L.P.; Hoencamp, R.


    BACKGROUND: In a combat environment, major vascular trauma endures as the leading cause of death. The Dutch role 2 Medical Treatment Facility (MTF), provided supportive care during the mission in Uruzgan, Afghanistan. Aim of this study was to conduct detailed analysis of the admitted major

  12. Thalidomide Ameliorates Inflammation and Vascular Injury but Aggravates Tubular Damage in the Irradiated Mouse Kidney

    Scharpfenecker, Marion; Floot, Ben; Russell, Nicola S.; Coppes, Rob P.; Stewart, Fiona A.


    Purpose: The late side effects of kidney irradiation include vascular damage and fibrosis, which are promoted by an irradiation-induced inflammatory response. We therefore treated kidney-irradiated mice with the anti-inflammatory and angiogenesis-modulating drug thalidomide in an attempt to prevent

  13. Case Report: Industrial X-Ray Injury Treated With Non-Cultured Autologous Adipose-Derived Stromal Vascular Fraction (SVF).

    Iddins, C J; Cohen, S R; Goans, R E; Wanat, R; Jenkins, M; Christensen, D M; Dainiak, N


    Local cutaneous injuries induced by ionizing radiation (IR) are difficult to treat. Many have reported local injection of adipose-derived stromal vascular fraction (SVF), often with additional therapies, as an effective treatment of IR-induced injury even after other local therapies have failed. The authors report a case of a locally recurrent, IR-induced wound that was treated with autologous, non-cultured SVF without other concurrent therapy. A nondestructive testing technician was exposed to 130 kVp x rays to his non-dominant right thumb on 5 October 2011. The wound healed 4 mo after initial conservative therapy with oral/topical α-tocopherol, oral pentoxifylline, naproxen sodium, low-dose oral steroids, topical steroids, hyperbaric oxygen therapy (HBOT), oral antihistamines, and topical aloe vera. Remission lasted approximately 17 mo with one minor relapse in July 2012 after minimal trauma and subsequent healing. Aggressive wound breakdown during June 2013 required additional therapy with HBOT. An erythematous, annular papule developed over the following 12 mo (during which time the patient was not undergoing prescribed treatment). Electron paramagnetic resonance (EPR) done more than 2 mo after exposure to IR revealed dose estimates of 14 ± 3 Gy and 19 ± 6 Gy from two centers using different EPR techniques. The patient underwent debridement of the 0.5 cm papular area, followed by SVF injection into and around the wound bed and throughout the thumb without complication. Eleven months post SVF injection, the patient has been essentially asymptomatic with an intact integument. These results raise the possibility of prolonged benefit from SVF therapy without the use of cytokines. Since there is currently no consensus on the use of isolated SVF therapy in chronic, local IR-induced injury, assessment of this approach in an appropriately powered, controlled trial in experimental animals with local radiation injury appears to be indicated.

  14. Jellyfish Envenomation Resulting In Vascular Insufficiency And Neurogenic Injury of Upper Limb

    Choong CYL


    Full Text Available Following a week after a jellyfish sting, a young man presented with regional cyanosis and threat of distal gangrene secondary to vascular spasm in the forearm. The patient also suffered from transient paresis and numbness of the affected upper limb. Contrasted imaging revealed unopacified vessels in the distal forearm and worsening swelling warranted emergency surgical fasciotomy for impending compartment syndrome. This case highlights the occurrence of jellyfish envenomation and the need for early treatment.

  15. Thalidomide Ameliorates Inflammation and Vascular Injury but Aggravates Tubular Damage in the Irradiated Mouse Kidney

    Scharpfenecker, Marion, E-mail: [Division of Biological Stress Response, The Netherlands Cancer Institute, Amsterdam (Netherlands); Floot, Ben [Division of Biological Stress Response, The Netherlands Cancer Institute, Amsterdam (Netherlands); Russell, Nicola S. [Division of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Coppes, Rob P. [Departments of Radiation Oncology and Cell Biology, University Medical Centre Groningen, University of Groningen, Groningen (Netherlands); Stewart, Fiona A. [Division of Biological Stress Response, The Netherlands Cancer Institute, Amsterdam (Netherlands)


    Purpose: The late side effects of kidney irradiation include vascular damage and fibrosis, which are promoted by an irradiation-induced inflammatory response. We therefore treated kidney-irradiated mice with the anti-inflammatory and angiogenesis-modulating drug thalidomide in an attempt to prevent the development of late normal tissue damage and radiation nephropathy in the mouse kidney. Methods and Materials: Kidneys of C57Bl/6 mice were irradiated with a single dose of 14 Gy. Starting from week 16 after irradiation, the mice were fed with thalidomide-containing chow (100 mg/kg body weight/day). Gene expression and kidney histology were analyzed at 40 weeks and blood samples at 10, 20, 30, and 40 weeks after irradiation. Results: Thalidomide improved the vascular structure and vessel perfusion after irradiation, associated with a normalization of pericyte coverage. The drug also reduced infiltration of inflammatory cells but could not suppress the development of fibrosis. Irradiation-induced changes in hematocrit and blood urea nitrogen levels were not rescued by thalidomide. Moreover, thalidomide worsened tubular damage after irradiation and also negatively affected basal tubular function. Conclusions: Thalidomide improved the inflammatory and vascular side effects of kidney irradiation but could not reverse tubular toxicity, which probably prevented preservation of kidney function.

  16. Systemic vascular resistance is increased and associated with accelerated arterial stiffening change in patients with chronic cervical spinal cord injury.

    Huang, S C; May-Kuen Wong, A; Lien, H Y; Fuk-Tan Tang, S; Fu, T C; Lin, Y; Wang, J S


    Despite of stiffening change of conduit arteries, how total peripheral resistance (TPR) is adapted to chronic spinal cord injury (SCI) remains unclear. To investigate how chronic cervical SCI influences hemodynamic characteristics Cross-sectional, case-control study. Rehabilitation department in the tertiary medical center. Twenty-one male patients with traumatic SCI resulting from cervical spine fracture were recruited. The injury occurred three to 289 months (46 months in average) previously. Twenty-one healthy male participants with matched age and body mass index were enrolled as control group. The subjects were asked to maintain supine rest (SR) and then head-up tilt (HUT) at 60 degree for five minutes, respectively. A novel noninvasive bio-reactance device was employed to measure cardiac hemodynamics, whereas heart rate variability was used to determine cardiac autonomic activity. Additionally, the digital volume pulse analysis was applied to calculate arterial stiffness index (SI) and arteriolar reflection index (RI). SCI patients revealed less stroke volume and cardiac output (CO), as well as, greater total peripheral resistance (TPR) and SI during SR than normal subjects did. Moreover, the positive correlation between TPR and SI was observed in SCI patients rather than normal subjects. In SCI patients, HUT (1) markedly decreased TPR while CO and cardio-acceleration responses remained intact and (2) decreased HF power value but failed to change LF/HF ratio. Furthermore, the degree of orthostatic hypotension was correlated with the TPRHUT/TPRSR ratio but not the COHUT/COSR ratio. Chronic cervical SCI leads to a progressively accelerated increase in vascular stiffness, which is associated with increase in systemic vascular resistance. Furthermore, the cervical SCI-related orthostatic hypotension lies in the impairment of vasoconstriction without cardiac dysfunction. Clinical Rehabilitation Impact. SI, rather than blood pressure, reflects not only

  17. Effects of chromium picolinate on vascular reactivity and cardiac ischemia-reperfusion injury in spontaneously hypertensive rats.

    Abebe, Worku; Liu, Jun Yao; Wimborne, Hereward; Mozaffari, Mahmood S


    Chromium picolinate [Cr(pic)(3)] is a nutritional supplement widely promoted to exert beneficial metabolic effects in patients with type 2 diabetes/impaired glucose tolerance. Frequent comorbidities in these individuals include systemic hypertension, abnormal vascular function and ischemic heart disease, but information on the effects of the supplement on these aspects is sparse. Utilizing male spontaneously hypertensive rats (SHR), we examined the potential impact of Cr(pic)(3) on blood pressure, vascular reactivity and myocardial ischemia-reperfusion injury (IRI). Dietary Cr(pic)(3) supplementation (as 10 mg chromium/kg diet for six weeks) did not affect blood pressure of the SHR. Also, neither norepinephrine (NE) and potassium chloride (KCl)-induced contractility nor sodium nitroprusside (SNP)-induced relaxation of aortic smooth muscle from the SHR was altered by Cr(pic)(3) treatment. However, Cr(pic)(3) augmented endothelium-dependent relaxation of aortas, produced by acetylcholine (ACh), and this effect was abolished by N-nitro-L-arginine methyl ester (L-NAME), suggesting induction of nitric oxide (NO) production/release. Treatment with Cr(pic)(3) did not affect baseline coronary flow rate and rate-pressure-product (RPP) or infarct size following regional IRI. Nonetheless, Cr(pic)(3) treatment was associated with improved coronary flow and recovery of myocardial contractility and relaxation following ischemia-reperfusion insult. In conclusion, dietary Cr(pic)(3) treatment of SHR alters neither blood pressure nor vascular smooth muscle reactivity but causes enhancement of endothelium-dependent vasorelaxation associated with NO production/release. Additionally, while the treatment does not affect infarct size, it improves functional recovery of the viable portion of the myocardium following IRI.

  18. Rapid vascular adaptations to training and detraining in persons with spinal cord injury.

    Thijssen, D.H.J.; Ellenkamp, R.; Smits, P.; Hopman, M.T.E.


    OBJECTIVE: To assess the time course of arterial adaptations during 6 weeks of functional electric stimulation (FES) training and 6 weeks of detraining in subjects with spinal cord injury (SCI). DESIGN: Intervention study (before-after trial). SETTING: University medical center. PARTICIPANTS: Volunt

  19. Improving on army field gauze for lethal vascular injuries: a progress report

    Uncontrolled hemorrhage is the leading cause of death on the battlefield and second leading cause of death in civilian trauma. Recent animal testing using a lethal arterial injury model compared a variety of woven and non woven products with granular products, and found only one product (WoundStat)...

  20. Vitamin D deficiency contributes to vascular damage in sustained ischemic acute kidney injury.

    de Bragança, Ana C; Volpini, Rildo A; Mehrotra, Purvi; Andrade, Lúcia; Basile, David P


    Reductions in renal microvasculature density and increased lymphocyte activity may play critical roles in the progression of chronic kidney disease (CKD) following acute kidney injury (AKI) induced by ischemia/reperfusion injury (IRI). Vitamin D deficiency is associated with tubulointerstitial damage and fibrosis progression following IRI-AKI We evaluated the effect of vitamin D deficiency in sustained IRI-AKI, hypothesizing that such deficiency contributes to the early reduction in renal capillary density or alters the lymphocyte response to IRI Wistar rats were fed vitamin D-free or standard diets for 35 days. On day 28, rats were randomized into four groups: control, vitamin D deficient (VDD), bilateral IRI, and VDD+IRI Indices of renal injury and recovery were evaluated for up to 7 days following the surgical procedures. VDD rats showed reduced capillary density (by cablin staining), even in the absence of renal I/R. In comparison with VDD and IRI rats, VDD+IRI rats manifested a significant exacerbation of capillary rarefaction as well as higher urinary volume, kidney weight/body weight ratio, tissue injury scores, fibroblast-specific protein-1, and alpha-smooth muscle actin. VDD+IRI rats also had higher numbers of infiltrating activated CD4(+) and CD8(+) cells staining for interferon gamma and interleukin-17, with a significant elevation in the Th17/T-regulatory cell ratio. These data suggest that vitamin D deficiency impairs renal repair responses to I/R injury, exacerbates changes in renal capillary density, as well as promoting fibrosis and inflammation, which may contribute to the transition from AKI to CKD.

  1. Seatbelt sign as an indication for four-vessel computed tomography angiogram of the neck to diagnose blunt carotid artery and other cervical vascular injuries.

    Dhillon, Ramandeep Singh; Barrios, Cristobal; Lau, Cecilia; Pham, Jacqueline; Bernal, Nicole; Kong, Allen; Lekawa, Michael; Dolich, Matthew


    Computed tomography angiography (CTA) of the neck has become the most common modality for diagnosing blunt carotid artery injury (BCAI). The protocol at our institution includes CTA on trauma patients with a seatbelt sign. The purpose of this study is to evaluate whether a solitary seatbelt sign is an indication for CTA of the neck to diagnose BCAI. We conducted a retrospective review of patients from 2000 to 2010 who received CTAs as a result of a seatbelt sign performed at our Level I trauma center. Four hundred eighteen patients received CTAs based on the presence of a seatbelt sign. Two hundred twenty-six had skeletal injuries, obvious soft tissue injuries, and/or positive findings on imaging, including 11 positive vascular findings with two BCAIs found. Patients with noncarotid vascular injuries on CTA had a higher Injury Severity Score than patients with solitary seatbelt signs (11.4 ± 7.6 vs 3.4 ± 4.2, P injuries and/or positive findings on standard trauma imaging. This suggests that a protocol for CTA of the neck for patients with a seatbelt sign can be reserved for those with associated injuries on physical examination and/or findings on standard trauma imaging.

  2. Sixty-four-slice CT angiography to determine the three dimensional relationships of vascular and soft tissue wounds in lower extremity war time injuries.

    Smith, Jennifer M; Fox, Charles J; Brazaitis, Michael P; Via, Kathy; Garcia, Roman; Feuerstein, Irwin M


    This article analyzes the use and benefits of the 64-slice CT scanner in determining the 3D relationships of vascular and soft tissue wounds in lower extremity war time injuries. A brief overview of CT scanning is given as well as the techniques used to produce the images needed for diagnosis. The series follows two similar cases of war time injury patients at the Walter Reed Army Medical Center. The first case is a 30-year-old active duty male, who presented with multiple trauma from a motor vehicle accident because of an improvised explosive device (IED) blast, sustaining substantial lower extremity injuries. The second case is a 34-year-old active duty male, who presented with multiple trauma blast injuries. Both cases were of interest because the vasculature was found to be very close to the surface of the wound, which put the arteries at risk for rupture and for iatrogenic injury during repeated debridements.

  3. Postcardiac injury syndrome following vascular interventional radiofrequency ablation for paroxysmal atrial fibrillation

    Shungo Yukumi


    Full Text Available Postcardiac injury syndrome (PCIS occurs following a pericardial or myocardial injury. On the other hand, PCIS following cardiac catheter intervention is rare and can be difficult to diagnose because of its delayed onset. A 24-year-old man underwent radiofrequency ablation (RFA for paroxysmal atrial fibrillation and suffered from general fatigue and left-sided pleural effusion three months after the procedure. His symptoms and effusion were effectively treated within a month by administrating nonsteroidal anti-inflammatory drugs. However, seven months later, he developed left-sided chest pain and low-grade fever. Computed tomography showed a thickening of the parietal pleura and reccurence of the pleural effusion. Pleural biopsy by video-assisted thoracoscopy demonstrated chronic pleuritis with a non-necrotizing granulomatous reaction. Given the previous RFA, and in the absence of infection or malignant disease, he was diagnosed with PCIS and treated with colchicine.

  4. Immune endocrinological evaluation in patients with severe vascular acquired brain injuries: therapeutical approaches.

    Amico, Angelo Paolo; Terlizzi, Annamaria; Annamaria, Terlizzi; Megna, Marisa; Marisa, Megna; Megna, Gianfranco; Gianfranco, Megna; Damiani, Sabino; Sabino, Damiani


    It is known that in severe acquired brain injuries there is process of neuroinflammation, with the activation of a local and general stress response. In our study we considered six patients with disorders of consciousness (five in vegetative state and one in minimal consciousness state) in subacute phase, which had both a clinical assessment and a functional imaging (fMRI): in all these patients we analised blood levels of osteopontin (OPN), a cytokin involved in neuroinflammation but also in neurorepair with a still discussed role. Besides we studied the lymphocyte subsets and blood levels of some hormones (ADH, ACTH, PRL, GH, TSH, fT3, fT4). We found a positive correlation between the levels of serum osteopontin (higher than normal in all subjects) and the severity of the brain injury, especially for prognosis: actually, the patient with the lowest level has emerged from minimal consciousness state, while the one with the highest level has died a few days after the evaluation. The lymphocyte subset was altered, with a general increase of CD4+/CD3+ ratio, but without a so strict correlation with clinical severity; the only hormone with a significant increase in the worse patients was prolactin. In fMRI we detected some responses to visual and acoustic stimuli also in vegetative states, which had no clinical response to this kind of stimulation but generally have had a better prognosis. So we conclude that osteopontin could be a good marker of neuroinflammation and relate to a worse prognosis of brain injuries; the lymphocyte alterations in these disorders are not clear, but we suspect an unbalance of CD4 towards Th2; PRL is the best endocrinological marker of brain injury severity; fMRI surely plays an important role in the detection of subclinical responses and in prognostic stratification, that is still to define with more studies and statistical analysis.

  5. Effects of rosiglitazone on contralateral iliac artery after vascular injury in hypercholesterolemic rabbits

    Baroncini Liz


    Full Text Available Abstract Background The objective was to evaluate the effects of rosiglitazone on iliac arteries of hypercholesterolemic rabbits undergoing balloon catheter injury in the contralateral iliac arteries. Methods White male rabbits were fed a hypercholesterolemic diet for 6 weeks and divided into two groups as follows: rosiglitazone group, 14 rabbits treated with rosiglitazone (3 mg/Kg body weight/day during 6 weeks; and control group, 18 rabbits without rosiglitazone treatment. All animals underwent balloon catheter injury of the right iliac artery on the fourteenth day of the experiment. Results There was no significant difference in intima/media layer area ratio between the control group and the rosiglitazone group. Rosiglitazone did not reduce the probability of lesions types I, II, or III (72.73% vs. 92.31%; p = 0.30 and types IV or V (27.27% vs. 7.69%; p = 0.30. There were no differences in the extent of collagen type I and III deposition or in the percentage of animals with macrophages in the intima layer. The percentage of rabbits with smooth muscle cells in the intima layer was higher in rosiglitazone group (p = 0.011. Conclusion These findings demonstrate that rosiglitazone given for 6 weeks did not prevent atherogenesis at a vessel distant from the injury site.

  6. Permanent fore-arc extension and seismic segmentation: Insights from the 2010 Maule earthquake, Chile

    Aron, Felipe; Allmendinger, Richard W.; Cembrano, José; GonzáLez, Gabriel; YáñEz, Gonzalo


    Geologists have long known that young normal faults are an important structural element of the Andean Coastal Cordillera, but their relationship to the subduction seismic cycle is still unclear. Some of the largest aftershocks of the 2010 Mw 8.8 Maule earthquake in central Chile were nucleated on upper plate normal faults, including the Mw 6.9 and 7.0 events of the Pichilemu earthquake sequence. We use the available coseismic GPS displacements, moment tensor sums, and slip distribution models for the Maule earthquake to compute the static strain and stress fields imposed on the upper plate by slip on the subduction interface. The extensional strains calculated from coseismic GPS and from a moment tensor sum of the Pichilemu events have similar orientations and orders of magnitude. The normal Coulomb stress increment (CSI) on the Pichilemu fault has maximum positive stresses as high as 4.9 MPa. Regionally, the Maule event produced a semi-elliptical, radial pattern of static extension and deviatoric tension (CSI > 1.5 MPa) along the Coastal Cordillera enclosing the rupture area. This elliptical pattern mimics the trends of the major upper-crustal structures. The static deformation field produced by a great subduction earthquake is an effective mechanism for generating permanent extension above the seismogenic zone, reactivating suitably oriented, long-lived normal faults. We suggest that the semi-elliptical outline of the first-order structures along the Coastal Cordillera may define the location of a characteristic, long-lived megathrust segment. This observation implies a persistence at least over the Quaternary of great subduction ruptures along the Maule segment.

  7. Physical exam and occult post-traumatic vascular lesions: implications for the evaluation and management of arterial injuries in modern warfare in the endovascular era.

    Johnson, O N; Fox, C J; White, P; Adams, E; Cox, M; Rich, N; Gillespie, D L


    Based on complexity of extremity wounds sustained in recent combat, arteriography had been used routinely in evaluations for delayed or occult arterial injuries. This report aims to quantitatively analyze the sensitivity and specificity of physical exam (PE) in predicting the presence of these injuries. United States service members sustaining extremity trauma in the Global War on Terrorism were evacuated to our medical center and evaluated by a senior vascular surgeon. Those with an abnormal PE, at risk based on wounding patterns, or previously treated for vascular injury underwent arteriography. Data from each patient were prospectively entered into a Vascular Injury registry. Comprehensive information about the injuries, interventions, arteriogram results, and any periprocedural complications were analyzed. Twenty-five endovascular or open surgical interventions were performed in forty-six of 99 patients that had lesions on arteriography. Seventy-three patients had a normal PE, of which 36 had lesions that prompted 6 subsequent interventions. Twenty-two of 26 patients with an abnormal PE had lesions that prompted 19 interventions. For PE, sensitivity was 38%, specificity was 90%, and positive predictive value (PPV) and negative predictive value (NPV) were 85% and 51%, respectively. In proximity injuries, PPV improved to 100%, but was only 15% sensitive with a NPV of 60%. In conclusion normal PE did not reliably predict post-traumatic arterial lesions in these military extremity injuries. These lesions are amenable to endovascular therapies, and should be considered in cases of complex trauma involving high amounts of energy, penetrating mechanisms, or wounding patterns in proximity to named vessels.

  8. Vascular injuries in the state of Pará, Brazil, 2011-2013 and their relation with demographic and clinical variables

    Ludmylla Teixeira Soares


    Full Text Available BACKGROUND:Vascular traumas are associated with high morbidity rates.OBJECTIVE: To report the characteristics of vascular traumas in the Brazilian state of Pará, in trauma victims treated at the Hospital Metropolitano de Urgência e Emergência (HMUE, from 2011 to 2013.METHOD: This was a descriptive, cross-sectional, retrospective and quantitative study that analyzed data on sex, age group, geographical origin, time waiting for care, mechanism of trauma, clinical status, anatomic site of injury, prevalence of associated fractures, vascular structures injured, types of vascular injury, principal types of surgery, early postoperative outcomes, level of amputation, number of deaths, length of hospital stay and multidisciplinary care for 264 medical records.RESULTS: The majority of victims were male and the most common age group was from 16 to 30 years. The majority of cases were from towns other than the state capital, accounting for 169 cases (64.02%. The principal mechanism of injury was firearm wounding - 110 (41.67% followed by cold weapon wounds - 65 (24.62% and traffic accidents - 42 (15.91%. The segments of the body and the vascular structures most often injured were lower limbs - 120 (45.45% and injuries to the popliteal and femoral arteries and veins. The most common clinical presentation at admission was hemorrhage - 154 (58.33%. The most common surgeries were ligatures of veins and arteries. There were 163 (61.74% hospital discharges and 33 (12.5% deaths.CONCLUSIONS: The greatest prevalence observed was related to traumas caused by urban violence. Victims were most frequently male, of working age and from towns other than the capital of the state of Pará.

  9. Enlarged pulmonary artery is predicted by vascular injury biomarkers and is associated with WTC-Lung Injury in exposed fire fighters: a case–control study

    Schenck, Edward J; Echevarria, Ghislaine C; Girvin, Francis G; Kwon, Sophia; Comfort, Ashley L; Rom, William N; Prezant, David J; Weiden, Michael D; Nolan, Anna


    Objectives We hypothesise that there is an association between an elevated pulmonary artery/aorta (PA/A) and World Trade Center-Lung Injury (WTC-LI). We assessed if serum vascular disease biomarkers were predictive of an elevated PA/A. Design Retrospective case-cohort analysis of thoracic CT scans of WTC-exposed firefighters who were symptomatic between 9/12/2001 and 3/10/2008. Quantification of vascular-associated biomarkers from serum collected within 200 days of exposure. Setting Urban tertiary care centre and occupational healthcare centre. Participants Male never-smoking firefighters with accurate pre-9/11 forced expiratory volume in 1 s (FEV1) ≥75%, serum sampled ≤200 days of exposure was the baseline cohort (n=801). A subcohort (n=97) with available CT scans and serum biomarkers was identified. WTC-LI was defined as FEV1≤77% at the subspecialty pulmonary evaluation (n=34) and compared with controls (n=63) to determine the associated PA/A ratio. The subcohort was restratified based on PA/A≥0.92 (n=38) and PA/AWTC dust that was associated with WTC-LI. The secondary outcome was to identify serum biomarkers predictive of the PA/A ratio using logistic regression. Results PA/A≥0.92 was associated with WTC-LI, OR of 4.02 (95% CI 1.21 to 13.41; p=0.023) when adjusted for exposure, body mass index and age at CT. Elevated macrophage derived chemokine and soluble endothelial selectin were predictive of PA/A≥0.92, (OR, 95% CI 2.08, 1.05 to 4.11, p=0.036; 1.33, 1.06 to 1.68, p=0.016, respectively), while the increased total plasminogen activator inhibitor 1 was predictive of not having PA/A≥0.92 (OR 0.88, 0.79 to 0.98; p=0.024). Conclusions Elevated PA/A was associated with WTC-LI. Development of an elevated PA/A was predicted by biomarkers of vascular disease found in serum drawn within 6 months of WTC exposure. Increased PA/A is a potentially useful non-invasive biomarker of WTC-LI and warrants further study. PMID:25270856

  10. Enlarged pulmonary artery is predicted by vascular injury biomarkers and is associated with WTC-Lung Injury in exposed fire fighters: a case-control study.

    Schenck, Edward J; Echevarria, Ghislaine C; Girvin, Francis G; Kwon, Sophia; Comfort, Ashley L; Rom, William N; Prezant, David J; Weiden, Michael D; Nolan, Anna


    We hypothesise that there is an association between an elevated pulmonary artery/aorta (PA/A) and World Trade Center-Lung Injury (WTC-LI). We assessed if serum vascular disease biomarkers were predictive of an elevated PA/A. Retrospective case-cohort analysis of thoracic CT scans of WTC-exposed firefighters who were symptomatic between 9/12/2001 and 3/10/2008. Quantification of vascular-associated biomarkers from serum collected within 200 days of exposure. Urban tertiary care centre and occupational healthcare centre. Male never-smoking firefighters with accurate pre-9/11 forced expiratory volume in 1 s (FEV1)≥75%, serum sampled ≤200 days of exposure was the baseline cohort (n=801). A subcohort (n=97) with available CT scans and serum biomarkers was identified. WTC-LI was defined as FEV1≤77% at the subspecialty pulmonary evaluation (n=34) and compared with controls (n=63) to determine the associated PA/A ratio. The subcohort was restratified based on PA/A≥0.92 (n=38) and PA/AWTC dust that was associated with WTC-LI. The secondary outcome was to identify serum biomarkers predictive of the PA/A ratio using logistic regression. PA/A≥0.92 was associated with WTC-LI, OR of 4.02 (95% CI 1.21 to 13.41; p=0.023) when adjusted for exposure, body mass index and age at CT. Elevated macrophage derived chemokine and soluble endothelial selectin were predictive of PA/A≥0.92, (OR, 95% CI 2.08, 1.05 to 4.11, p=0.036; 1.33, 1.06 to 1.68, p=0.016, respectively), while the increased total plasminogen activator inhibitor 1 was predictive of not having PA/A≥0.92 (OR 0.88, 0.79 to 0.98; p=0.024). Elevated PA/A was associated with WTC-LI. Development of an elevated PA/A was predicted by biomarkers of vascular disease found in serum drawn within 6 months of WTC exposure. Increased PA/A is a potentially useful non-invasive biomarker of WTC-LI and warrants further study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  11. Vascular pharmacology of acute lung injury and acute respiratory distress syndrome.

    Groeneveld, A B Johan


    Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) following sepsis, major trauma and surgery are leading causes of respiratory insufficiency, warranting artificial ventilation in the intensive care unit. It is caused by an inflammatory reaction in the lung upon exogenous or endogenous etiologies eliciting proinflammatory factors, and results in increased alveolocapillary permeability and protein-rich alveolar edema. The interstitial and alveolar inflammation and edema alter ventilation perfusion matching, gas exchange and mechanical properties of the lung. The current therapy of the condition is supportive, paying careful attention to fluid balance, relieving the increased work of breathing and improving gas exchange by mechanical ventilation, but in vitro, animal and some clinical research is done to evaluate the value of anti-inflammatory therapies on morbidity and outcome, including inflammatory cell-stabilizing corticosteroids, xanthine derivates, prostanoids and inhibitors, O(2) radical scavenging factors such as N-acetylcysteine, surfactant replacement, vasodilators including inhaled nitric oxide, vasoconstrictors such as almitrine, and others. None of these compounds has been proven to benefit survival in patients, however, even though carrying a physiologic benefit, except perhaps for steroids that may improve outcome in the later stage of ARDS. This partly relates to the difficulty to assess the lung injury at the bedside, to the multifactorial pathogenesis and the severity of comorbidity, adversely affecting survival.

  12. Seismotectonic framework of the 2010 February 27 Mw 8.8 Maule, Chile earthquake sequence

    Hayes, Gavin P.; Bergman, Eric; Johnson, Kendra J.; Benz, Harley M.; Brown, Lucy; Meltzer, Anne S.


    After the 2010 Mw 8.8 Maule earthquake, an international collaboration involving teams and instruments from Chile, the US, the UK, France and Germany established the International Maule Aftershock Deployment temporary network over the source region of the event to facilitate detailed, open-access studies of the aftershock sequence. Using data from the first 9-months of this deployment, we have analyzed the detailed spatial distribution of over 2500 well-recorded aftershocks. All earthquakes have been relocated using a hypocentral decomposition algorithm to study the details of and uncertainties in both their relative and absolute locations. We have computed regional moment tensor solutions for the largest of these events to produce a catalogue of 465 mechanisms, and have used all of these data to study the spatial distribution of the aftershock sequence with respect to the Chilean megathrust. We refine models of co-seismic slip distribution of the Maule earthquake, and show how small changes in fault geometries assumed in teleseismic finite fault modelling significantly improve fits to regional GPS data, implying that the accuracy of rapid teleseismic fault models can be substantially improved by consideration of existing fault geometry model databases. We interpret all of these data in an integrated seismotectonic framework for the Maule earthquake rupture and its aftershock sequence, and discuss the relationships between co-seismic rupture and aftershock distributions. While the majority of aftershocks are interplate thrust events located away from regions of maximum co-seismic slip, interesting clusters of aftershocks are identified in the lower plate at both ends of the main shock rupture, implying internal deformation of the slab in response to large slip on the plate boundary interface. We also perform Coulomb stress transfer calculations to compare aftershock locations and mechanisms to static stress changes following the Maule rupture. Without the

  13. Silence of STIM1 attenua=tes the proliferation and migration of EPCs after vascular injury and its mechanism

    Xin-Peng Cong; Wen-Hui Wang; Xi Zhu; Can Jin; Liang Liu; Xin-Min Li


    Objective:To investigate the effect of stromal interaction molecule1(STIM1) knockdown on the proliferation and migration of endothelial progenitor cells(EPCs) after vascular injury and its mechanism.Methods:The rat bone marrow derivedEPCs were divided into three groups: adenovirus negative control(groupNSC), ratSTIM1 adenovirus vector transfection group (group si/rSTIM1) and rat &human recombinantSTIM1adenovirus transfection group(group si/rSTIM1+hSTIM1).TheSTIM1 expressions in each group were detected by reverse transcription PCR after transfection; the cell proliferation was tested by [3H] thymidine incorporation assay(3H-TdR);Cell cycle was analyzed by flow cytometry; the cells’ migration activity was detected by Boyden assay;Calcium ion concentration was detected by using laser confocal method.Results:48 h later after transfection, the expression level ofSTIM1 in si/rSTIM1 cells was significantly lower than that inNSC group(0.21±0.12vs1.01±0.01,P<0.05);EPCs that stayed inG1 phase in si/rSTIM1 group [(93.31±0.24)%] were significantly more than that inNSC group [(78.03±0.34)%, P<0.05];EPCs’ migration activity in si/rSTIM1 group(10.03±0.33) was significantly lower than that inNSC group:(32.11±0.54,P<0.05);EPCs calcium ion concentration changes inEPCs in si/rSTIM1 group(38.03±0.13) was significantly lower than that inNSC group(98.11±0.34,P<0.05).While there was no significant difference between si/rSTIM1+hSTIM1 group andNSC group on the four indexes above.Conclusions:Silence ofSTIM1 attenuatesEPCs proliferation and migration after vascular injury, by mediating the calcium ion concentration inEPCs.

  14. [Therapeutic approach in vascular injuries of the lower extremity: Amputation or limb salvage].

    Ozal, E; Us, M H; Bingöl, H; Oz, B S; Kuralay, E; Tatar, H


    The management of lower extremity trauma with vasculary involvement should be directed toward to the salvage of the extremity or to the primary amputation according to the additional pathologies, parameters of the patient and the extremity. We investigated the efficiency of Mangled Extremity Severity Score (MESS) system which is proposed as an grading system to evaluate the change to extremity salvage or the risk for onset of systemic complications. 81 patients with lower extremity trauma were analyzed according to MESS criteria. 79 of the patients were men and mean age was 23 +/- 4. Fourteen patients had higher MESS score. (MESS > 7). Seven of them were older than 50 years. Primary amputation was performed in four of these 7 patients. Vascular repair was performed in three of patients. Multiorgan failure was developed in two of them and both patients died. Secondary amputation was performed to another patients underwent vasculary repair who had MESS > 7 score. Primary amputation was not performed directly in young patients who had MESS > 7. Secondary amputation was required in two of these patients. MESS scoring system can easily predict amputation in older patients but may cause unnecessary amputation in young patients.

  15. Inhibition of vascular endothelial growth factor signaling facilitates liver repair from acute ethanol-induced injury in zebrafish

    Changwen Zhang


    Full Text Available Alcoholic liver disease (ALD results from alcohol overconsumption and is among the leading causes of liver-related morbidity and mortality worldwide. Elevated expression of vascular endothelial growth factor (VEGF and its receptors has been observed in ALD, but how it contributes to ALD pathophysiology is unclear. Here, we investigated the impact of VEGF signaling inhibition on an established zebrafish model of acute alcoholic liver injury. Kdrl activity was blocked by chemical inhibitor treatment or by genetic mutation. Exposing 4-day-old zebrafish larvae to 2% ethanol for 24 h induced hepatic steatosis, angiogenesis and fibrogenesis. The liver started self-repair once ethanol was removed. Although inhibiting Kdrl did not block the initial activation of hepatic stellate cells during ethanol treatment, it suppressed their proliferation, extracellular matrix protein deposition and fibrogenic gene expression after ethanol exposure, thus enhancing the liver repair. It also ameliorated hepatic steatosis and attenuated hepatic angiogenesis that accelerated after the ethanol treatment. qPCR showed that hepatic stellate cells are the first liver cell type to increase the expression of VEGF ligand and receptor genes in response to ethanol exposure. Both hepatic stellate cells and endothelial cells, but not hepatic parenchymal cells, expressed kdrl upon ethanol exposure and were likely the direct targets of Kdrl inhibition. Ethanol-induced steatosis and fibrogenesis still occurred in cloche mutants that have hepatic stellate cells but lack hepatic endothelial cells, and Kdrl inhibition suppressed both phenotypes in the mutants. These results suggest that VEGF signaling mediates interactions between activated hepatic stellate cells and hepatocytes that lead to steatosis. Our study demonstrates the involvement of VEGF signaling in regulating sustained liver injuries after acute alcohol exposure. It also provides a proof of principle of using the

  16. [Long-term results of peripheral vascular injuries in patients' limbs following reconstructive surgical procedures and influence on the quality of life].

    Deja, Włodzimierz; Wieczorek, Dariusz; Deja, Agata; Lasek, Jerzy; Kawecka, Aleksandra; Marks, Wojciech


    Major vascular injuries in extremities are rare and constitute problems for surgeons and their sequelae strongly influence remote future of the patients. The aim of study is to evaluate surgical treatment of vascular injuries in extremities and some aspects of quality of life. Since 1983 until 2002 sixty four patients with vascular limbs injuries were treated in the department. Remote evaluation has been performed in 33 persons. Severity of limb injuries was measured by Mangled Extremity Severity Score (MESS). In 20 patients (60.6%) very good and good recent results were obtained, satisfactory in 24.2% and bad results in 15.2% persons. Evaluation of functional status has been made by means of locomotion test and Jebsen-Taylor's test, social approval questionnaire, depression Beck's scale, the scale of hypochondria and by an original questionnaire to evaluate the quality of life. As considerable interdependence has been found between the functional status and the following factors: injury severity expressed in MESS (p < 0.01), clinic reception procedure (p < 0.001), ischemia time (p < 0.01), coincidence of other injuries (fractures and dislocations, muscle, tendon and nerve lesions) (p < 0.01), limb amputation (p < 0.01). Hand function significantly influences the quality of life. Patients who were in shock after trauma in the remote assessment showed susceptibility to the lowered mood and depression (p < 0.05). Quality of life is strongly connected with the features of personality, correlating mainly with the mood and tendencies of concentration upon somatic symptoms. Function of the hand influences strongly the quality of life. Amputated patients may in spite of their crippling limitations are able to adapt to everyday life.

  17. A study of vascular response to thermal injury on hairless mice by fibre optic confocal imaging, laser doppler flowmetry and conventional histology.

    Vo, L T; Papworth, G D; Delaney, P M; Barkla, D H; King, R G


    Burn injury causes vascular thrombosis and occlusion by thermal damage to the vascular network in the dermis. In this study, fibre optic confocal imaging (FOCI) and laser doppler flowmetry were used to detect changes in vascular morphology and local dermal blood flux over 4 h, in three defined zones after a thermal burn (50 degrees C, 20 s duration, 3 mm in diameter) was induced on fully anaesthetised hairless mice. FITC-dextran (i.v.) was used to enable FOCI of vascular morphology including three-dimensional imaging of the burn site and its surrounding areas. Samples of the affected areas were collected for conventional histology, including Masson's trichrome. There was vascular damage in the zone of coagulation which showed no change during the 4 h period. The zone of stasis showed an initial reduction in blood flux and confocal imaging of the area indicated significant vessel leakage during the first 2 h which later improved. The zone of hyperaemia showed an initial increase in total blood flux and confocal imaging of the area showed initial blood vessel dilatation. This study demonstrates that FOCI is a useful non-invasive tool in the assessment of vascular changes in thermal burns in vivo, and compares the findings of FOCI with those from laser doppler flowmetry and histology.

  18. Barnidipine ameliorates the vascular and renal injury in L-NAME-induced hypertensive rats.

    Alp Yildirim, F Ilkay; Eker Kizilay, Deniz; Ergin, Bülent; Balci Ekmekçi, Özlem; Topal, Gökçe; Kucur, Mine; Demirci Tansel, Cihan; Uydeş Doğan, B Sönmez


    The present study was aimed to investigate the influence of Barnidipine treatment on early stage hypertension by determining the function and morphology of the mesenteric and renal arteries as well as the kidney in N(ω)-Nitro-L-Arginine Methyl Ester (L-NAME)-induced hypertensive rats. Barnidipine (3 mg/kg/day p.o) was applied to rats after 2 weeks of L-NAME (60 mg/kg/day) administration, and continued for the next 3 weeks concomitantly with L-NAME. The systolic blood pressure (SBP) of rats was determined to decrease significantly in Barnidipine treated hypertensive group when compared to that of rats received L-NAME alone. Myograph studies demonstrated that the contractile reactivity to noradrenaline were significantly reduced in both of the resistance arteries while endothelium-dependent relaxations to acethylcholine were significantly diminished particularly in the mesenteric arteries of L-NAME-induced hypertensive rats. The impaired contractile and endothelial responses were completely restored by concomitant treatment of Barnidipine with L-NAME. Histopathological examinations verified structural alterations in the arteries as well as the kidney. Moreover, a decrease in endothelial nitric oxide synthase (eNOS) expression was presented both in the arteries and kidney of hypertensive rats which were increased following Barnidipine treatment. Elevated plasma levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were also reduced in Barnidipine treated hypertensive rats. In conclusion, besides to its efficacy in reducing the elevated SBP, amelioration of vascular function, modulation of arterial and renal eNOS expressions as well as reduction of the plasma levels of oxidative and inflammatory biomarkers are possible supportive mechanisms mediating the favorable implications of Barnidipine in L-NAME-induced hypertension model.

  19. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function [Retraction

    Wang L


    Full Text Available Wang L, Jiang Y, Jiang Z, Han L. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function. Neuropsychiatr Dis Treat. 2016 Aug 31;12:2189–2198. doi: 10.2147/NDT.S82864.This article was found to have plagiarized the content of:Low-energy extracorporeal shock wave therapy promotes vascular endothelial growth factor expression and improves locomotor recovery after spinal injury published in the Journal of Neurosurgery in 2014 (J Neurosurg. 121: 1514–1525, 2014.Accordingly, Dr Pinder, Editor-in-Chief of Neuropsychiatric Disease and Treatment has decided to issue a Retraction notice and advise the academic supervisors of Dr Wang et al of this matter. This Retraction relates to

  20. The use of intra-operative blood gas analysis in the investigation of suspected iatrogenic vascular injury.

    Walcott, Brian P; Kahle, Kristopher T; Nahed, Brian V; Coumans, Jean-Valery C E; Asaad, Wael F


    Iatrogenic injury to the vertebral artery during posterior cervical fusion is a rare and potentially disastrous complication. Differentiating arterial from brisk venous bleeding would be ideal to assist in the intra-operative management. Definitive angiography is typically not feasible during most routine spine surgery. We describe the case of a patient undergoing an occipitocervical fusion, where brisk bleeding was encountered during dissection of the CB lateral mass. While the dissection was thought to be superficial to critical structures, the nature of the hemorrhage could not be definitely determined by visual inspection by two senior surgeons. The hemorrhage did not readily cease with standard maneuvers such as, the application of various hemostatic agents. Simultaneous blood gas analysis was performed on samples obtained from the patient's radial artery and from the hemorrhage in the operative bed. Comparative analysis concluded that the bleeding encountered in the surgical field was venous in nature. Blood gas analysis can be a useful adjunct in determining the nature of hemorrhage from vascular structures in spine surgery when visual inspection is indeterminate.

  1. Effect of systemic piracetam treatment on flap survival and vascular endothelial growth factor expression after ischemia-reperfusion injury.

    Tuncer, Serhan; Ayhan, Suhan; Findikcioglu, Kemal; Ergun, Hakan; Tuncer, Ilhan


    The effects of piracetam on flap survival, ischemia-reperfusion (I/R) injury, and vascular endothelial growth factor (VEGF) expression were evaluated in this study. Unipedicled epigastric flap model was used in 36 rats and was evaluated within 4 groups. The flap was elevated and untreated in Group 1. Postoperative piracetam treatment was given for 7 days in Group 2. In Group 3, 4 hours of ischemia and 2 hours of reperfusion were applied. I/R was applied to Group 4 and piracetam was given 30 minutes before reperfusion and postoperatively for 7 days. Laser Doppler flowmetry was used to measure blood flow changes. VEGF expression was determined using immunohistochemical methods on tissue samples taken after the completion of 2 hours reperfusion in groups 3 and 4. Flap necrosis was measured on the day 7 in all groups. Blood flow rates did not show significant difference between piracetam treated and untreated I/R groups. Piracetam significantly reduced necrosis area both in ischemic and nonischemic flaps ( P piracetam-treated Group 4 compared with Group 3 ( P = 0.005). This experimental study demonstrates that systemic piracetam treatment improves survival of pedicled flaps, reduces necrosis amounts, and increases VEGF expression in I/R induced flaps. © Thieme Medical Publishers.

  2. Anti-inflammatory effect of cerivastatin in vascular injury independent of serum cholesterol and blood pressure lowering effects in mouse model

    陈小东; 李震; 李建文


    Objective: To observe the anti-inflammatory effect of cerivastatin in a mouse model of vascular injury and its cholesterol-lowering effect. Methods: We developed a mouse model of vascular remodeling induced by polyethylene cuff placement and determined the anti-inflammatory effects of cerivastatin in wild mice. Cerivastatin was given by Alzet micro-osmotic minipumps implanted intraperitoneally at the same time as cuff placement at doses of 0.1 mg/kg, 0.5 mg/kg and 1 mg/kg per day, respectively for 2 weeks after cuff placement. The insufficient doses of Cerivastatin to lower serum cholesterol and systolic blood pressure through the neointimal formation and BrdU index were investigated in mouse femoral injury artery induced by cuff-placement. Results: There was a little change in serum cholesterol by the treatment with cerivastatin, the cross-sectional area of intima of injured femoral artery was significantly increased, the neointima formation was significantly increased by the cuff-induced vascular injury at day 14. The neointimal formation and BrdU index were inhibited in the 1 mg/kg cerivastatin, but not in the 0.1 mg/kg and 0.5 mg/kg cerivastatin. Furthermore, 1 mg/kg of cerivastatin significantly inhibited the expression of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) without lowering serum cholesterol.Conclusions: These results suggest that cerivastatin can inhibit vascular inflammation and the proliferation of vascular smooth muscle cells (VSMCs) through its lipid-lowering independent action. Such effects of cerivastatin may be an important mechanism, by which it prevents the development of atherosclerotic lesions.

  3. The functional outcome of lower-extremity fractures with vascular injury.

    Lin, C H; Wei, F C; Levin, L S; Su, J I; Yeh, W L


    Salvage of lower-extremity Gustilo type IIIC fractures is difficult, time-consuming for the patients and physicians, and not universally successful because of poor functional outcomes. Even if successful with limb salvage, the functional result may be unsatisfactory because of mutilating injuries to muscle and nerve, bone loss, and the presence of chronic infection. From July 1991 until July 1994, revascularizations of open IIIC fractures were attempted for wounds with Mangled Extremity Severity Score (MESS) MESS was able to predict the secondary amputation rate and the functional result. Sixteen of the 17 limb-salvaged patients with MESS MESS = 8 to 10 failed to achieve minimal functional requirements at the 2-year follow-up. Using statistical analysis, we found that the salvaged limbs with MESS MESS > 9. Using our protocol for treatment for IIIC fractures, the threshold for immediate amputation can be raised from MESS = 7 to MESS = 9. Our conclusions are (1) more severely injured limbs have poor functional results, (2) every patient needs subsequent reconstructive surgery, and (3) the MESS may be helpful in decision-making.

  4. Safety Evaluation of New Hemostatic Agents, Smectite Granules, and Kaolin-Coated Gauze in a Vascular Injury Wound Model in Swine


    histologic slides were done by a board-certified veterinarian pathologist (J.S.E.) who was initially blinded to the treatment of the samples. The blood...significant. RESULTS The baseline hemodynamic and hematological param- eters measured before vascular injuries were within normal ranges and not different...agents (Table 4). The total compression time to achieve hemostasis with each TABLE 1. Baseline Physiological and Hematological Measurements of the

  5. A pilot trial to examine the association between circulating endothelial cell levels and vascular injury in patients with diabetes and chronic kidney disease [version 1; referees: 2 approved

    Shayan Shirazian


    Full Text Available Objective While albuminuria is a marker for progressive chronic kidney disease (CKD in patients with type 2 diabetes (T2DM, both albuminuric and normoalbuminuric patients appear prone to vascular injury. This pilot study examines the association between circulating endothelial cell (CEC levels and vascular injury in patients with T2DM and CKD. Methods In this cross-sectional study, eligible adult patients had T2DM, and stage 3 CKD (estimated glomerular filtration rate between 30 and 60 mL/min/1.73m2. CEC levels were tested by Janssen Diagnostics, LLC using an immuno-magnetic bead-based assay. CEC levels were compared to levels in a previously tested normal population. Correlations between CEC levels and other vascular injury markers (urine albumin, von-Willebrand factor antigen, hs-CRP, uric acid were performed. Results Patients included 40 adults of which nineteen were normoalbuminuric.  Mean CEC levels (38.7, SD 38.1 cells were significantly higher than the normal population (M = 21±18 cells, p<0.001; N = 249, including in the normoalbuminuric subgroup (M = 42.9±42.5 cells, p<0.001. CEC levels were significantly correlated with uric acid levels (r=0.33, p=0.039. Conclusions CEC levels in patients with T2DM and CKD, both albuminuric and normoalbuminuric, are significantly higher than a normal population, suggesting the presence of vascular injury in both groups. Future studies are needed to evaluate the role of CECs as a biomarker to predict outcomes in normoalbuminuric patients with CKD.

  6. Peroxynitrite-mediated pulmonary vascular injury induced by endotoxin and protective role of cholecystokinin


    In this study we found: 1\\, There was endogenous ONOO- formation in lungs in the early stage of endotoxic shock. Exogenous ONOO- led to increase in microvascular permeability, severe lung pathological changes and enhanced MDA content. 2\\, It was, for the first time, found that responses of isolated pulmonary artery preincubated with ONOO- showed abnormal manifestations. (1) Low dose of ONOO- let to the inhibition of endothelial dependent relaxation, but enhacement of contractile response, both of which were similar to changes of reactivity in isolated pulmonary artery induced by LPS. (2) High dose of ONOO- reduced contractile response to PE and relaxation to SNP. 3\\, ONOO- had direct effect for relaxation of precontracted isolated pulmonary artery. The relaxing action of ONOO- was weak and was negtively regulated by endothelial cells, supporting the notion that ONOO- may be involved in pulmonary hypertension in the early stage of endotoxic shock. 4\\, It was, for the first time, found that LPS-induced increase in endogenous ONOO- generation in BPAEC and that endogenous ONOO- mediated injury to BPAEC induced by LPS, which may be a novel mechanism for endotoxin-elicited damage to endothelial cells. 5\\, Exposure of pulmonary artery to LPS led to reduction in endothelial dependent relaxation but enhancement in contractile response, both of which were reversed by concomitant exposure to CCK and LPS. 6\\, CCK protected cultured BPAEC against the detrimental effects of LPS such as lipoperoxide damages and cellular apoptosis as well as LPS-induced endogenous ONOO- formation. The underlying mechanism of CCK for cytoprotection may be mediated by its receptors and related to its reduced ability of endothelia to generate ONOO- induced by LPS.

  7. Protective effect and mechanism of vascular endothelial growth factor in vascular endothelial cell injury%VEGF对血管内皮细胞损伤的拮抗作用及作用机制

    夏裕银; 包楠迪; 樊荣; 迟素敏; 陈景元; 裴建明; 刘亚莉


    Freezing cold injury is based on pathological changes of freezing and then melting processes in the injury. Many investigators have confirmed that vascular endothelial cells (VEC) with the barrier and membrane transport functions are larger endocrine organs in the body, which participate in a variety of life activities and play an important role in the balance and stability of the internal environment. VEC in the frostbite process can promote thrombus formation that may result in microcirculatory disturbance and cause irreversible reperfusion injury after blood rewarming and flowing. Mitigating the damage of endothelial cells can reduce the microcirculation thrombosis, thereby reducing the reperfusion injury. As an important vascular growth factor, vascular endothelial growth factor ( VEGF) has some type of protective effect on VEC injury in frostbite. VEGF can provide a new approach for prevention and treatment of frostbite by exerting protective effects on vessels through promoting angiogenesis, inhibiting excessive growth of vascular smooth muscle, and anti-thrombosis or anti-inflammatory functions.%冻结性冷损伤是以组织冻结再融化过程的病理改变为基础的损伤.已经证实,血管内皮细胞(VECs)除有屏障和膜转运功能外,还具有内分泌功能,主动参与了多种生命活动,对维持体内环境的平衡与稳定具有重要作用.冻伤过程中VECs的损伤,可促进微循环血栓形成造成微循环障碍;待到复温后,血液恢复流动又可导致不可逆的再灌注损伤.因此,减轻内皮细胞损伤,可以减少微循环血栓形成,从而减轻再灌注对机体造成的损伤.血管内皮细胞生长因子(VEGF)作为重要的血管生长因子,在冻伤时对VECs损伤具有拮抗作用,可通过促进血管再生、抗血栓形成、抑制血管平滑肌过度生长及抗炎的作用等实现的对血管的保护作用,为临床防治冻伤提供了新的思路.

  8. Modeling codling moth (Lepidoptera: Tortricidae phenology and predicting egg hatch in apple orchards of the Maule Region, Chile

    Wilson Barros-Parada


    Full Text Available Studies were conducted in the Maule Region to characterize the phenology of the codling moth, Cydia pomonella (L. The Predictive Extension Timing Estimator (PETE and a logistic phenological model were validated with eight data sets of cumulative moth catches in sex pheromone (PH and kairomone-baited traps and the cumulative occurrence of fruit injuries from apple (Malus domestica Borkh. orchards during the 2009-2011 seasons. Second, the start of egg hatch was predicted from the first sustained male and female moth catches (biofix in traps baited with pear ester (PE, PE+acetic acid (AA, PE+PH, and PH alone. Both phenological models fit data well except that the logistic provided a better fit than the PETE model of the phenology of egg hatch of the codling moth in the first generation, with a difference of 11 d between models in the prediction of 50% egg hatch. No significant difference was found between biofix dates established for males using either PH or PE+PH lures or for the biofix date based on female catches with PE+AA or PH+PE. The biofix established with the sustained female catch occurred nearly 11 d later than the male-based biofix. The use of a female biofix provided on average a 4-d improvement in the prediction of first egg hatch compared with the traditional use of a male biofix, but this difference was not significant. The use of PE+AA lures increased the proportion of cases when a female-based biofix could be established compared with the use of the PH+PE lure.

  9. Thermal evolution of a hyperextended rift basin, Mauléon Basin, western Pyrenees

    Hart, Nicole R.; Stockli, Daniel F.; Lavier, Luc L.; Hayman, Nicholas W.


    Onshore and offshore geological and geophysical observations and numerical modeling have greatly improved the conceptual understanding of magma-poor rifted margins. However, critical questions remain concerning the thermal evolution of the prerift to synrift phases of thinning ending with the formation of hyperextended crust and mantle exhumation. In the western Pyrenees, the Mauléon Basin preserves the structural and stratigraphic record of Cretaceous extension, exhumation, and sedimentation of the proximal-to-distal margin development. Pyrenean shortening uplifted basement and overlying sedimentary basins without pervasive shortening or reheating, making the Mauléon Basin an ideal locality to study the temporal and thermal evolution of magma-poor hyperextended rift systems through coupling bedrock and detrital zircon (U-Th)/He thermochronometric data from transects characterizing different structural rifting domains. These new data indicate that the basin was heated during early rifting to >180°C with geothermal gradients of 80-100°C/km. The proximal margin recorded rift-related exhumation/cooling at circa 98 Ma, whereas the distal margin remained >180°C until the onset of Paleocene Pyrenean shortening. Lithospheric-scale numerical modeling shows that high geothermal gradients, >80°C/km, and synrift sediments >180°C, can be reached early in rift evolution via heat advection by lithospheric depth-dependent thinning and blanketing caused by the lower thermal conductivity of synrift sediments. Mauléon Basin thermochronometric data and numerical modeling illustrate that reheating of basement and synrift strata might play an important role and should be considered in the future development of conceptual and numerical models for hyperextended magma-poor continental rifted margins.

  10. Post-crisis analysis of an ineffective tsunami alert: the 2010 earthquake in Maule, Chile.

    Soulé, Bastien


    Considering its huge magnitude and its location in a densely populated area of Chile, the Maule seism of 27 February 2010 generated a low amount of victims. However, post-seismic tsunamis were particularly devastating on that day; surprisingly, no full alert was launched, not at the national, regional or local level. This earthquake and associated tsunamis are of interest in the context of natural hazards management as well as crisis management planning. Instead of focusing exclusively on the event itself, this article places emphasis on the process, systems and long-term approach that led the tsunami alert mechanism to be ineffectual. Notably, this perspective reveals interrelated forerunner signs of vulnerability.

  11. The small fibrinopeptide Bβ15-42 as renoprotective agent preserving the endothelial and vascular integrity in early ischemia reperfusion injury in the mouse kidney.

    Anja Urbschat

    Full Text Available Disruption of the renal endothelial integrity is pivotal for the development of a vascular leak, tissue edema and consequently acute kidney injury. Kidney ischemia amplifies endothelial activation and up-regulation of pro-inflammatory mechanisms. After restoring a sufficient blood flow, the kidney is damaged through complex pathomechanisms that are classically referred to as ischemia and reperfusion injury, where the disruption of the inter-endothelial connections seems to be a crucial step in this pathomechanism. Focusing on the molecular cell-cell interaction, the fibrinopeptide Bβ15-42 prevents vascular leakage by stabilizing these inter-endothelial junctions. The peptide associates with vascular endothelial-cadherin, thus preventing early kidney dysfunction by preserving blood perfusion efficacy, edema formation and thus organ dysfunction. We intended to demonstrate the early therapeutic benefit of intravenously administered Bβ15-42 in a mouse model of renal ischemia and reperfusion. After 30 minutes of ischemia, the fibrinopeptide Bβ15-42 was administered intravenously before reperfusion was commenced for 1 and 3 hours. We show that Bβ15-42 alleviates early functional and morphological kidney damage as soon as 1 h and 3 h after ischemia and reperfusion. Mice treated with Bβ15-42 displayed a significantly reduced loss of VE-cadherin, indicating a conserved endothelial barrier leading to less neutrophil infiltration which in turn resulted in significantly reduced structural renal damage. The significant reduction in tissue and serum neutrophil gelatinase-associated lipocalin levels reinforced our findings. Moreover, renal perfusion analysis by color duplex sonography revealed that Bβ15-42 treatment preserved resistive indices and even improved blood velocity. Our data demonstrate the efficacy of early therapeutic intervention using the fibrinopeptide Bβ15-42 in the treatment of acute kidney injury resulting from ischemia and

  12. A study of radiation-induced cerebral vascular injury in nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis.

    Jianhong Ye

    Full Text Available PURPOSE: To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC patients. METHODS AND MATERIALS: Fifty eight NPC patients with radiation-induced temporal lobe necrosis (TLN were recruited in the study. Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT and occurrence of plaque formation. Flow velocities of bilateral middle cerebral arteries (MCAs, internal carotid arteries (ICAs and basal artery (BA were estimated through Transcranial Color Doppler (TCD. The results were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals. RESULTS: Significant differences in IMT, occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after radiotherapy and healthy individuals (p<0.05. IMT had positive correlation with post radiation interval (p = 0.049. Compared with results from patients without radiation-induced TLN, the mean IMT was significantly thicker in patients with TLN (p<0.001. Plaques were more common in patients with TLN than patients without TLN (p = 0.038. In addition, flow velocities of MCAs and ICAs in patients with TLN were much faster (p<0.001, p<0.001. Among patients with unilateral TLN, flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (p = 0.001. CONCLUSION: Thickening of IMT, occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy, especially in those with TLN, compared with healthy individuals.

  13. Blast-Associated Shock Waves Result in Increased Brain Vascular Leakage and Elevated ROS Levels in a Rat Model of Traumatic Brain Injury.

    Shushi Kabu

    Full Text Available Blast-associated shock wave-induced traumatic brain injury (bTBI remains a persistent risk for armed forces worldwide, yet its detailed pathophysiology remains to be fully investigated. In this study, we have designed and characterized a laboratory-scale shock tube to develop a rodent model of bTBI. Our blast tube, driven by a mixture of oxygen and acetylene, effectively generates blast overpressures of 20-130 psi, with pressure-time profiles similar to those of free-field blast waves. We tested our shock tube for brain injury response to various blast wave conditions in rats. The results show that blast waves cause diffuse vascular brain damage, as determined using a sensitive optical imaging method based on the fluorescence signal of Evans Blue dye extravasation developed in our laboratory. Vascular leakage increased with increasing blast overpressures and mapping of the brain slices for optical signal intensity indicated nonhomogeneous damage to the cerebral vasculature. We confirmed vascular leakage due to disruption in the blood-brain barrier (BBB integrity following blast exposure. Reactive oxygen species (ROS levels in the brain also increased with increasing blast pressures and with time post-blast wave exposure. Immunohistochemical analysis of the brain sections analyzed at different time points post blast exposure demonstrated astrocytosis and cell apoptosis, confirming sustained neuronal injury response. The main advantages of our shock-tube design are minimal jet effect and no requirement for specialized equipment or facilities, and effectively generate blast-associated shock waves that are relevant to battle-field conditions. Overall data suggest that increased oxidative stress and BBB disruption could be the crucial factors in the propagation and spread of neuronal degeneration following blast injury. Further studies are required to determine the interplay between increased ROS activity and BBB disruption to develop effective

  14. Coseismic seafloor deformation in the trench region during the Mw8.8 Maule megathrust earthquake

    Maksymowicz, A.; Chadwell, C. D.; Ruiz, J.; Tréhu, A. M.; Contreras-Reyes, E.; Weinrebe, W.; Díaz-Naveas, J.; Gibson, J. C.; Lonsdale, P.; Tryon, M. D.


    The Mw 8.8 megathrust earthquake that occurred on 27 February 2010 offshore the Maule region of central Chile triggered a destructive tsunami. Whether the earthquake rupture extended to the shallow part of the plate boundary near the trench remains controversial. The up-dip limit of rupture during large subduction zone earthquakes has important implications for tsunami generation and for the rheological behavior of the sedimentary prism in accretionary margins. However, in general, the slip models derived from tsunami wave modeling and seismological data are poorly constrained by direct seafloor geodetic observations. We difference swath bathymetric data acquired across the trench in 2008, 2011 and 2012 and find ~3-5 m of uplift of the seafloor landward of the deformation front, at the eastern edge of the trench. Modeling suggests this is compatible with slip extending seaward, at least, to within ~6 km of the deformation front. After the Mw 9.0 Tohoku-oki earthquake, this result for the Maule earthquake represents only the second time that repeated bathymetric data has been used to detect the deformation following megathrust earthquakes, providing methodological guidelines for this relatively inexpensive way of obtaining seafloor geodetic data across subduction zone.

  15. Expansion duroplasty improves intraspinal pressure, spinal cord perfusion pressure, and vascular pressure reactivity index in patients with traumatic spinal cord injury: injured spinal cord pressure evaluation study.

    Phang, Isaac; Werndle, Melissa C; Saadoun, Samira; Varsos, Georgios; Czosnyka, Marek; Zoumprouli, Argyro; Papadopoulos, Marios C


    We recently showed that, after traumatic spinal cord injury (TSCI), laminectomy does not improve intraspinal pressure (ISP), spinal cord perfusion pressure (SCPP), or the vascular pressure reactivity index (sPRx) at the injury site sufficiently because of dural compression. This is an open label, prospective trial comparing combined bony and dural decompression versus laminectomy. Twenty-one patients with acute severe TSCI had re-alignment of the fracture and surgical fixation; 11 had laminectomy alone (laminectomy group) and 10 had laminectomy and duroplasty (laminectomy+duroplasty group). Primary outcomes were magnetic resonance imaging evidence of spinal cord decompression (increase in intradural space, cerebrospinal fluid around the injured cord) and spinal cord physiology (ISP, SCPP, sPRx). The laminectomy and laminectomy+duroplasty groups were well matched. Compared with the laminectomy group, the laminectomy+duroplasty group had greater increase in intradural space at the injury site and more effective decompression of the injured cord. In the laminectomy+duroplasty group, ISP was lower, SCPP higher, and sPRx lower, (i.e., improved vascular pressure reactivity), compared with the laminectomy group. Laminectomy+duroplasty caused cerebrospinal fluid leak that settled with lumbar drain in one patient and pseudomeningocele that resolved completely in five patients. We conclude that, after TSCI, laminectomy+duroplasty improves spinal cord radiological and physiological parameters more effectively than laminectomy alone.

  16. Anti—inflammatory effect of cerivastatin in vascular injury independent of serum cholesterol and blood pressure lowering effects in mouse model

    陈小东; 李震; 等


    Objective:To observe the anti-inflammatory effect of cerivastatin in a mouse model of vascular injury and its cholesterol-lowering effect.Methods:We developed a mouse model of vascular remodeling induced by polyethylene cuff placement and determined the anti-inflannatory effects of cerivastatin in wild mice.Cerivastatin was given by Alzet micro-osmotic minipumps implanted intraperitoneally at the same time as cuff placement at doses of 0.1mg/kg,0.5mg/kgand1mg/kgper day,respectively for 2weeks after cuff placement.The insufficient doses of Cerivastatin to lower serum cholesterol and systolic blood pressue through the neointimal formation and BrdUindex were investigated in mouse formation and BrdUindex were investigated in the 1mg/kg cerivastatin,but not in the 0.1mg/kgand0.5mg/kg cerivastatin,Furthermore,1mg/kg of cerivastatin significantly inhibited the expression of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)without lowering serum cholesterol.Conclusions:These results suggest that cerivastatin can inhitit vascular inflammation and ahe proliferation of vascular smooth muscle cells(VSMCs)through its lipid-lowering independent action.Such effects of cerivastatin may be an important mechanism,by which it prevents the development of atherosclerotic lesions.

  17. Modeling Cerebral Vascular Injury


    The EXODUS II file format was developed at Sandia National Laboratories specifically to store and retrieve data for finite element analyses . To...vasospasm and pseudoaneurysm can lead to further damage to the brain over time. Intracranial hemorrhages and hematomas can be life threatening and...flow within the arteries and the corresponding internal pressure of the vessels. Also, since it uses a 1-D approximation of the vessels, any damage

  18. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function

    Wang, Lei; Jiang, Yuquan; Jiang, Zheng; Han, Lizhang


    Background Latest studies show that low-energy extracorporeal shock wave therapy (ESWT) can upregulate levels of vascular endothelial growth factor (VEGF). VEGF can ease nervous tissue harm after spinal cord injury (SCI). This study aims to explore whether low-energy ESWT can promote expression of VEGF, protect nervous tissue after SCI, and improve motor function. Methods Ninety adult female rats were divided into the following groups: Group A (simple laminectomy), Group B (laminectomy and low-energy ESWT), Group C (spinal cord injury), and Group D (spinal cord injury and low-energy ESWT). Impinger was used to cause thoracic spinal cord injury. Low-energy ESWT was applied as treatment after injury three times a week, for 3 weeks. After SCI, the Basso, Beattie, and Bresnahan (BBB) scale was used to evaluate motor function over a period of 42 days at different time points. Hematoxylin and eosin (HE) staining was used to evaluate nerve tissue injury. Neuronal nuclear antigen (NeuN) staining was also used to evaluate loss of neurons. Polymerase chain reaction was used to detect messenger RNA (mRNA) expression of VEGF and its receptor fms-like tyrosine kinase 1 (Flt-1). Immunostaining was used to evaluate VEGF protein expression level in myeloid tissue. Results BBB scores of Groups A and B showed no significant result related to dyskinesia. HE and NeuN staining indicated that only using low-energy ESWT could not cause damage of nervous tissue in Group B. Recovery of motor function at 7, 35, and 42 days after SCI in Group D was better than that in Group C (Ptherapy for spinal injury. PMID:27621630

  19. Separating the roles of nitrogen and oxygen in high pressure-induced blood-borne microparticle elevations, neutrophil activation, and vascular injury in mice.

    Yang, Ming; Bhopale, Veena M; Thom, Stephen R


    An elevation in levels of circulating microparticles (MPs) due to high air pressure exposure and the associated inflammatory changes and vascular injury that occur with it may be due to oxidative stress. We hypothesized that these responses arise due to elevated partial pressures of N2 and not because of high-pressure O2. A comparison was made among high-pressure air, normoxic high-pressure N2, and high-pressure O2 in causing an elevation in circulating annexin V-positive MPs, neutrophil activation, and vascular injury by assessing the leakage of high-molecular-weight dextran in a murine model. After mice were exposed for 2 h to 790 kPa air, there were over 3-fold elevations in total circulating MPs as well as subgroups bearing Ly6G, CD41, Ter119, CD31, and CD142 surface proteins-evidence of neutrophil activation; platelet-neutrophil interaction; and vascular injury to brain, omentum, psoas, and skeletal muscles. Similar changes were found in mice exposed to high-pressure N2 using a gas mixture so that O2 partial pressure was the same as that of ambient air, whereas none of these changes occurred after exposures to 166 kPa O2, the same partial pressure that occurs during high-pressure air exposures. We conclude that N2 plays a central role in intra- and perivascular changes associated with exposure to high air pressure and that these responses appear to be a novel form of oxidative stress.

  20. GSK-3Beta-Dependent Activation of GEF-H1/ROCK Signaling Promotes LPS-Induced Lung Vascular Endothelial Barrier Dysfunction and Acute Lung Injury.

    Yi, Lei; Huang, Xiaoqin; Guo, Feng; Zhou, Zengding; Chang, Mengling; Huan, Jingning


    The bacterial endotoxin or lipopolysaccharide (LPS) leads to the extensive vascular endothelial cells (EC) injury under septic conditions. Guanine nucleotide exchange factor-H1 (GEF-H1)/ROCK signaling not only involved in LPS-induced overexpression of pro-inflammatory mediator in ECs but also implicated in LPS-induced endothelial hyper-permeability. However, the mechanisms behind LPS-induced GEF-H1/ROCK signaling activation in the progress of EC injury remain incompletely understood. GEF-H1 localized on microtubules (MT) and is suppressed in its MT-bound state. MT disassembly promotes GEF-H1 release from MT and stimulates downstream ROCK-specific GEF activity. Since glycogen synthase kinase (GSK-3beta) participates in regulating MT dynamics under pathologic conditions, we examined the pivotal roles for GSK-3beta in modulating LPS-induced activation of GEF-H1/ROCK, increase of vascular endothelial permeability and severity of acute lung injury (ALI). In this study, we found that LPS induced human pulmonary endothelial cell (HPMEC) monolayers disruption accompanied by increase in GSK-3beta activity, activation of GEF-H1/ROCK signaling and decrease in beta-catenin and ZO-1 expression. Inhibition of GSK-3beta reduced HPMEC monolayers hyper-permeability and GEF-H1/ROCK activity in response to LPS. GSK-3beta/GEF-H1/ROCK signaling is implicated in regulating the expression of beta-catenin and ZO-1. In vivo, GSK-3beta inhibition attenuated LPS-induced activation of GEF-H1/ROCK pathway, lung edema and subsequent ALI. These findings present a new mechanism of GSK-3beta-dependent exacerbation of lung micro-vascular hyper-permeability and escalation of ALI via activation of GEF-H1/ROCK signaling and disruption of intracellular junctional proteins under septic condition.

  1. Salvage treatment for eighty-eight cases of abdominal large vascular injuries%腹部大血管损伤88例救治体会

    梁绍诚; 黎雁; 邓润钦; 黄海; 骆剑华; 郑富强; 张焕彬; 刘国良


    Objective To summarize the experience of salvage treatment of abdominal large vascular injuries, trying to improve the management. Methods Retrospective analysis was made on the clinical data and the operation way of abdominal large vascular injuries with the main operative methods including primary repair of abdominal aorta and synthetic prosthesis interposition. Results Of the eighty-eight patients, sixty-three survived, twenty-five died. The successful rate of emergency treatment was 71. 6% and death rate 28. 4% . The main reason of death was hemorrhagic shock. Conclusions Evaluating the conditon of patients, effective resuscitation,controlling shock and emergency laparohemostasis are the key to successful emergency treatment for abdominal large vascular injuries. Comprehensive exploration , simple and effective repair could save patients life.%目的 总结腹部大血管损伤的救治经验,提高救治水平.方法 回顾性分析88例腹部大血管损伤患者的临床资料及手术方法,88例患者分别采取单纯修补、人工血管移植等手术治疗.结果 本组患者88例,存活63例,死亡25例,抢救成功率71.6%,病死率28.4%,主要死亡原因是失血性休克.结论 对于腹部大血管损伤患者,判断伤情,有效复苏,控制休克,紧急剖腹止血是抢救成功的关键.术中应注意全面探查,视伤情尽量采用简单而合理的术式.

  2. Surgical management for the first 48 h following blunt chest trauma: state of the art (excluding vascular injuries).

    de Lesquen, Henri; Avaro, Jean-Philippe; Gust, Lucile; Ford, Robert Michael; Beranger, Fabien; Natale, Claudia; Bonnet, Pierre-Mathieu; D'Journo, Xavier-Benoît


    This review aims to answer the most common questions in routine surgical practice during the first 48 h of blunt chest trauma (BCT) management. Two authors identified relevant manuscripts published since January 1994 to January 2014. Using preferred reporting items for systematic reviews and meta-analyses statement, they focused on the surgical management of BCT, excluded both child and vascular injuries and selected 80 studies. Tension pneumothorax should be promptly diagnosed and treated by needle decompression closely followed with chest tube insertion (Grade D). All traumatic pneumothoraces are considered for chest tube insertion. However, observation is possible for selected patients with small unilateral pneumothoraces without respiratory disease or need for positive pressure ventilation (Grade C). Symptomatic traumatic haemothoraces or haemothoraces >500 ml should be treated by chest tube insertion (Grade D). Occult pneumothoraces and occult haemothoraces are managed by observation with daily chest X-rays (Grades B and C). Periprocedural antibiotics are used to prevent chest-tube-related infectious complications (Grade B). No sign of life at the initial assessment and cardiopulmonary resuscitation duration >10 min are considered as contraindications of Emergency Department Thoracotomy (Grade C). Damage Control Thoracotomy is performed for either massive air leakage or refractive shock or ongoing bleeding enhanced by chest tube output >1500 ml initially or >200 ml/h for 3 h (Grade D). In the case of haemodynamically stable patients, early video-assisted thoracic surgery is performed for retained haemothoraces (Grade B). Fixation of flail chest can be considered if mechanical ventilation for 48 h is probably required (Grade B). Fixation of sternal fractures is performed for displaced fractures with overlap or comminution, intractable pain or respiratory insufficiency (Grade D). Lung herniation, traumatic diaphragmatic rupture and pericardial rupture are life


    王晓红; 杨军; 佟利家; 苏静怡; 唐朝枢; 刘乃奎


    Objective. In a model of balloon injury of rat aortic endothelium, the effects of C-type natriuretic peptide(CNP) on al-adrenoreceptar and inositol 1,4,5-triphosphate (IP3) receptor were studied. Methods. Aortic injuries were produced by vascular endothelium-denudation, αl- adrenoreceptor in smooth muscle sarcolemma and IP3 receptor in smooth muscle sarcoplasmic reticulum in the rat aorta were assayed by radioactive analysis method. Results. It was found that neoinfma was formed and the coraents of DNA, collagen and elastin of each intimamedia were significantly increased in 7 days and 21 days after balloon injury of rat aorta, α1-adrenoreceptor in smooth muscle sarcolemma and IP3 receptor in sarcoplasmic reticulum were also upwodated. Results also showed that the administration of CNP i.p significantly decreased the contents of DNA, collagen and elaslin of each iraima-media, and inhibited the up-regulation of α1-adrenoreceptor and IP3 receptor. Conelusion. The inhibition of the up-regulation of α1-adrenoreceptor and IP3 receptor by CNP might be one of the mechanisms of its suppressive action on intimal proliferation.

  4. Nitric oxide inhibits neointimal hyperplasia following vascular injury via differential, cell-specific modulation of SOD-1 in the arterial wall.

    Bahnson, Edward S M; Koo, Nathaniel; Cantu-Medellin, Nadiezhda; Tsui, Aaron Y; Havelka, George E; Vercammen, Janet M; Jiang, Qun; Kelley, Eric E; Kibbe, Melina R


    Superoxide (O2(•-)) promotes neointimal hyperplasia following arterial injury. Conversely, nitric oxide ((•)NO) inhibits neointimal hyperplasia through various cell-specific mechanisms, including redox regulation. What remains unclear is whether (•)NO exerts cell-specific regulation of the vascular redox environment following arterial injury to inhibit neointimal hyperplasia. Therefore, the aim of the present study was to assess whether (•)NO exerts cell-specific, differential modulation of O2(•-) levels throughout the arterial wall, establish the mechanism of such modulation, and determine if it regulates (•)NO-dependent inhibition of neointimal hyperplasia. In vivo, (•)NO increased superoxide dismutase-1 (SOD-1) levels following carotid artery balloon injury in a rat model. In vitro, (•)NO increased SOD-1 levels in vascular smooth muscle cells (VSMC), but had no effect on SOD-1 in endothelial cells or adventitial fibroblasts. This SOD-1 increase was associated with an increase in sod1 gene expression, increase in SOD-1 activity, and decrease in O2(•-) levels. Lastly, to determine the role of SOD-1 in (•)NO-mediated inhibition of neointimal hyperplasia, we performed the femoral artery wire injury model in wild type and SOD-1 knockout (KO) mice, with and without (•)NO. Interestingly, (•)NO inhibited neointimal hyperplasia only in wild type mice, with no effect in SOD-1 KO mice. In conclusion, these data show the cell-specific modulation of O2(•-) by (•)NO through regulation of SOD-1 in the vasculature, highlighting its importance on the inhibition of neointimal hyperplasia. These results also shed light into the mechanism of (•)NO-dependent redox balance, and suggest a novel VSMC redox target to prevent neointimal hyperplasia.

  5. Bone marrow-derived cells mobilized by granulocyte-colony stimulating factor facilitate vascular regeneration in mouse kidney after ischemia/reperfusion injury.

    Akihama, Susumu; Sato, Kazunari; Satoh, Shigeru; Tsuchiya, Norihiko; Kato, Tetsuro; Komatsuda, Atsushi; Hirokawa, Makoto; Sawada, Kenichi; Nanjo, Hiroshi; Habuchi, Tomonori


    Bone marrow-derived cells (BMDC) play crucial roles in tissue regeneration. Granulocyte-colony stimulating factor (G-CSF) mobilizes BMDC and may facilitate the repair of kidney tissues after ischemia/reperfusion (I/R) injury. The tissue protective action of resveratrol, an antioxidant, might modify the regenerating potential of BMDC in I/R renal injury. This study examined whether G-CSF and/or resveratrol affect the recruitment of BMDC into vascular endothelial cells and renal tubular cells and the kidney function after I/R injury. I/R renal injury was induced in female mice that had been lethally irradiated and transplanted with male bone marrow cells. The mice were given saline, resveratrol or G-CSF, daily for 7 days. Non-irradiated and non-bone-marrow-transplanted female mice, which underwent the same kidney injury, were included as control. White blood cell (WBC) count and serum creatinine were monitored. Immunohistologic evaluation for renal tubular cells (cytokeratin) and endothelial cells (factor VIII-related antigen), and fluorescence in situ hybridization for mouse Y chromosome were performed. Although WBC was significantly higher in the G-CSF group, there was no significant difference in creatinine levels among all groups. Factor VIII-related antigen-positive cells with a Y-chromosome signal were identified in the capillary wall between renal tubuli and most frequently seen in the G-CSF group (p cells having a Y-chromosome signal were identified. In conclusion, BMDC are recruited into endothelial cell in I/R renal injury without apparent renal tubular cell regeneration, and G-CSF facilitates the endothelial cell regeneration.

  6. HCdc14A is involved in cell cycle regulation of human brain vascular endothelial cells following injury induced by high glucose, free fatty acids and hypoxia.

    Su, Jingjing; Zhou, Houguang; Tao, Yinghong; Guo, Zhuangli; Zhang, Shuo; Zhang, Yu; Huang, Yanyan; Tang, Yuping; Hu, Renming; Dong, Qiang


    Cell cycle processes play a vital role in vascular endothelial proliferation and dysfunction. Cell division cycle protein 14 (Cdc14) is an important cell cycle regulatory phosphatase. Previous studies in budding yeast demonstrated that Cdc14 could trigger the inactivation of mitotic cyclin-dependent kinases (Cdks), which are required for mitotic exit and cytokinesis. However, the exact function of human Cdc14 (hCdc14) in cell cycle regulation during vascular diseases is yet to be elucidated. There are two HCdc14 homologs: hCdc14A and hCdc14B. In the current study, we investigated the potential role of hCdc14A in high glucose-, free fatty acids (FFAs)-, and hypoxia-induced injury in cultured human brain vascular endothelial cells (HBVECs). Data revealed that high glucose, FFA, and hypoxia down-regulated hCdc14A expression remarkably, and also affected the expression of other cell cycle-related proteins such as cyclin B, cyclin D, cyclin E, and p53. Furthermore, the combined addition of the three stimuli largely blocked cell cycle progression, decreased cell proliferation, and increased apoptosis. We also determined that hCdc14A was localized mainly to centrosomes during interphase and spindles during mitosis using confocal microscopy, and that it could affect the expression of other cycle-related proteins. More importantly, the overexpression of hCdc14A accelerated cell cycle progression, enhanced cell proliferation, and promoted neoplastic transformation, whereas the knockdown of hCdc14A using small interfering RNA produced the opposite effects. Therefore, these findings provide novel evidence that hCdc14A might be involved in cell cycle regulation in cultured HBVECs during high glucose-, FFA-, and hypoxia-induced injury.

  7. Effect of low-energy extracorporeal shock wave on vascular regeneration after spinal cord injury and the recovery of motor function

    Wang L


    Full Text Available Lei Wang, Yuquan Jiang, Zheng Jiang, Lizhang Han Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, People’s Republic of China Background: Latest studies show that low-energy extracorporeal shock wave therapy (ESWT can upregulate levels of vascular endothelial growth factor (VEGF. VEGF can ease nervous tissue harm after spinal cord injury (SCI. This study aims to explore whether low-energy ESWT can promote expression of VEGF, protect nervous tissue after SCI, and improve motor function.Methods: Ninety adult female rats were divided into the following groups: Group A (simple laminectomy, Group B (laminectomy and low-energy ESWT, Group C (spinal cord injury, and Group D (spinal cord injury and low-energy ESWT. Impinger was used to cause thoracic spinal cord injury. Low-energy ESWT was applied as treatment after injury three times a week, for 3 weeks. After SCI, the Basso, Beattie, and Bresnahan (BBB scale was used to evaluate motor function over a period of 42 days at different time points. Hematoxylin and eosin (HE staining was used to evaluate nerve tissue injury. Neuronal nuclear antigen (NeuN staining was also used to evaluate loss of neurons. Polymerase chain reaction was used to detect messenger RNA (mRNA expression of VEGF and its receptor fms-like tyrosine kinase 1 (Flt-1. Immunostaining was used to evaluate VEGF protein expression level in myeloid tissue.Results: BBB scores of Groups A and B showed no significant result related to dyskinesia. HE and NeuN staining indicated that only using low-energy ESWT could not cause damage of nervous tissue in Group B. Recovery of motor function at 7, 35, and 42 days after SCI in Group D was better than that in Group C (P<0.05. Compared with Group C, number of NeuN-positive cells at 42 days after SCI increased significantly (P<0.05. The mRNA levels of VEGF and Flt-1 and VEGF expression at 7 days after SCI in Group D were significantly higher than those in Group C (P<0

  8. Angiotensin II type 2 receptor expression after vascular injury: differing effects of angiotensin-converting enzyme inhibition and angiotensin receptor blockade.

    Barker, Thomas A; Massett, Michael P; Korshunov, Vyacheslav A; Mohan, Amy M; Kennedy, Amy J; Berk, Bradford C


    It has been suggested that the effects of angiotensin II type 1 receptor (AT1R) blockers are in part because of angiotensin II type 2 receptor (AT2R) signaling. Interactions between the AT2R and kinins modulate cardiovascular function. Because AT2R expression increases after vascular injury, we hypothesized that the effects on vascular remodeling of the AT1R blocker valsartan and the ACE inhibitor benazepril require AT2R signaling through the bradykinin 1 and 2 receptors (B1R and B2R). To test this hypothesis, Brown Norway rats were assigned to 8 treatments (n=16): valsartan, valsartan+PD123319 (AT2R inhibitor), valsartan+des-arg9-[Leu8]-bradykinin (B1R inhibitor), valsartan+HOE140 (B2R inhibitor), benazepril, benazepril+HOE140, amlodipine, and vehicle. After 1 week of treatment, carotid balloon injury was performed. Two weeks later, carotids were harvested for morphometry and analysis of receptor expression by immunohistochemistry and Western blotting. Valsartan and benazepril significantly reduced the intima:media ratio compared with vehicle. Blockade of AT2R, B1R, or B2R in the presence of valsartan prevented the reduction seen with valsartan alone. B2R blockade inhibited the effect of benazepril. Injury increased AT1R, AT2R, B1R, and B2R expression. Treatment with valsartan but not benazepril significantly increased intima AT2R expression 2-fold compared with vehicle, which was not reversed by inhibition of AT2R, B1R, and B2R. Functionally, valsartan increased intimal cGMP levels compared with vehicle, and this increase was inhibited by blocking the AT2R, B1R, and B2R. Results suggest that AT2R expression and increased cGMP represent a molecular mechanism that differentiates AT1R blockers, such as valsartan, from angiotensin-converting enzyme inhibitors like benazepril.

  9. Pelvic injuries in combination with vascular lesions of branches from the iliac artery: Outcome - Incidence - Treatment strategy

    Schmal, H.; Klemt, C.; Uhrmeister, P.


    with combined bony and arterial pelvic injuries. Data include all patients with pelvic injury treated at the Department of Traumatology of the University of Freiburg/Germany between 1991 and 1999 (5 years prospectively, 4 years retrospectively recorded). 17 (3.74%) of 454 patients with pelvic trauma suffered...... hemoglobin or initial systolic blood pressure appear not to be valuable as prognostic factors. In contrast, amount of necessary transfusions within the first 24 hours in the subgroup of patients that died was almost twice as high when compared to all patients with pelvic injury suggesting that fast...

  10. Repetitive hypoglycemia increases circulating adrenaline level with resultant worsening of intimal thickening after vascular injury in male Goto-Kakizaki rat carotid artery.

    Yasunari, Eisuke; Mita, Tomoya; Osonoi, Yusuke; Azuma, Kosuke; Goto, Hiromasa; Ohmura, Chie; Kanazawa, Akio; Kawamori, Ryuzo; Fujitani, Yoshio; Watada, Hirotaka


    Hypoglycemia associated with diabetes management is a potential risk for cardiovascular diseases. However, the effect of hypoglycemic episodes including a surge of sympathetic activity on the progression of neointima formation after vascular injury remains largely unknown. In this study, insulin was injected intraperitoneally into nonobese diabetic Goto-Kakizaki (GK) rats, once every 3 days for 4 weeks after balloon injury of carotid artery to induce hypoglycemia. Then, we evaluated balloon injury-induced neointima formation. Insulin treatment enhanced neointima formation and increased the number of proliferating cell nuclear antigen (PCNA)-positive cells in the carotid artery. Injection of glucose with insulin prevented hypoglycemia and abrogated intimal thickening. Also, bunazosin, an α1 adrenergic receptor antagonist, prevented intimal thickening and accumulation of PCNA-positive cells induced by insulin treatment despite the presence of concomitant hypoglycemia and high adrenaline levels. Incubation of cultured smooth muscle cells with adrenaline resulted in a significant increase in their proliferation and G0/G1 to S phase progression, which was associated with activation of extracellular signal-regulated kinase, enhanced expression of cell cycle regulatory molecules such as cyclin D1, and cyclin E, and phosphorylation of retinoblastoma protein. These adrenaline-induced effects were abrogated by bunazosin. Our data indicated that increased adrenaline induced by repetitive hypoglycemia promotes intimal thickening and smooth muscle cell proliferation after endothelial denudation in GK rats.

  11. Endovascular repair of inadvertent arterial injury induced by central venous catheterization using a vascular closure device: A case report

    Kim, So Hee; Jang, Woo Jin; Oh, Ju Heyon; Song, Yun Gyu [Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (Korea, Republic of)


    Central venous catheterization can cause various complications. Inadvertent subclavian artery catheterization was performed during insertion of a central venous catheter in a 73-year-old man suffering from panperitonitis due to small-bowel perforation. Endovascular treatment was conducted to treat the injured subclavian artery with a FemoSeal vascular closure device.

  12. Vascular injuries in intestinal obstruction. The role of computed tomography; Complicazioni vascolari nelle occlusioni intestinali: ruolo della tomografia computerizzata

    Vinci, R.; Angelelli, G.; Stabile Ianora, A.A.; Gaballo, A.; Rotondo, A. [Bari Univ., Bari (Italy). Dipt. di Medicina Interna e Medicina Pubblica, Serv. di Diagnostica per Immagini


    The paper investigates computerized tomography capabilities in showing vascular complications secondary to intestinal obstruction and for assessing the site and cause of obstruction. [Italian] Scopo del lavoro e' lo studio dell'uso della tomografia computerizzata nel riconoscimento di complicanze vascolari secondarie ad occlusione intestinale e della presenza, della natura e della sede dell'ostacolo alla canalizzazione intestinale.

  13. Causes and treatment strategies for laparoscopic vascular injuries%腹腔镜手术大血管损伤的原因及处理对策

    茅夏娃; 张大宏; 刘锋; 祁小龙; 章越龙; 朱岳华; 张琦


    目的 探讨腹腔镜手术大血管损伤的原因及处理对策.方法 回顾2006年3月至2011年2月1858例行腹腔镜手术患者的临床资料,术中发生大血管损伤10例,男6例,女4例.年龄21 ~78岁,平均49岁.其中主动脉损伤2例,腔静脉损伤2例,肾静脉损伤4例,骼外静脉损伤1例,骼外动脉损伤1例.血管损伤原因包括:解剖认识不足造成损伤2例,建立第1个穿刺孔时损伤1例,术中用力过猛致损伤2例,解剖变异致损伤2例,手术粘连分离困难致损伤3例.处理方法:保持气腹压力,短时间出血量较大时可迅速增加至20 mm Hg(1 mm Hg=0.133 kPa),用吸引器吸尽创面出血,仔细辨认出血部位,必要时增加穿刺孔,让助手协助暴露.若为静脉破裂出血可用4-0无损伤血管缝线根据破口大小行8字或连续缝合血管破口.若为动脉破裂出血,先用动脉血管钳夹闭血管破口上下两端,控制出血,然后同静脉破裂出血方式缝合破口.结果 10例患者7例腹腔镜下止血成功,3例中转开放手术止血.7例腹腔镜下止血成功者修补血管时间8~ 25 min,平均14 min;术中出血150 ~1600 ml,平均530 ml.破口大小0.2~1.0cm.1例主动脉损伤术后局部有较大血肿,术后3个月复查血肿完全吸收,余9例术后无气栓、继发出血等并发症.结论 腹腔镜手术大血管损伤由多种原因引起,良好的心态和精细的缝合是止血的关键,术中助手良好的配合也起着重要作用.%Objective To summarize the causes and treatment strategies for laparoscopic vascular injuries.Methods We had retrospectively reviewed 1858 cases of laparoscopic surgeries from March 2006 to February 2011.There were 10 cases (6 males and 4 females) had intraoperative vascular injuries.The mean age of these 10 patients was 49 years (ranged from 21 to 78 years).2 cases were aortic injuries,2 cases were vena cava injuries,4 cases were renal vein injuries,1 case was iliac vein injury and 1 case was

  14. [Vascular injury as a complication of knee arthroscopic surgery. Report of two cases and review of the literature].

    Enríquez-Vega, María Elizabeth; Cruz-Castillo, Juan Ernesto; Pacheco-Pittaluga, Ernesto; Solorio-Rosette, Hugo; Linarte-Márquez, Lizbeth; Iturburu-Enríquez, Alessandra


    Antecedentes: la artroscopia de rodilla es uno de los procedimientos más seguros, con tasas de complicaciones que van de 0.56 a 8.2%. Las complicaciones vasculares son aún más raras (0.0032%) y generalmente se relacionan con lesiones en la arteria poplítea. Casos clínicos: reportamos los casos de dos pacientes con complicaciones no sospechadas de lesiones vasculares post artroscopia. Ambos casos tenían lesión vascular posterior a cirugía electiva de artroscopia de rodilla. El primer caso es el de un paciente con pseudoaneurisma trombosado de la arteria poplítea y sección completa de la vena poplítea, desafortunadamente el diagnóstico se estableció 72 horas después de la artroscopia de rodilla y requirió amputación. El segundo caso tenía una fistula arteriovenosa a nivel poplíteo y se trató exitosamente con desmantelamiento de la fístula y reparación directa de la arteria y la vena. Conclusiones: aunque es extremadamente infrecuente, la lesión vascular postartroscopia de rodilla debe tenerse en mente como una posible complicación postquirúrgica porque su bajo índice de sospecha puede causar una desafortunada e inoportuna demora en el diagnóstico y tratamiento, con un riesgo potencial de amputación de la extremidad y muerte.

  15. Cobalt protoporphyrin pretreatment protects human embryonic stem cell-derived cardiomyocytes from hypoxia/reoxygenation injury in vitro and increases graft size and vascularization in vivo.

    Luo, Jun; Weaver, Matthew S; Cao, Baohong; Dennis, James E; Van Biber, Benjamin; Laflamme, Michael A; Allen, Margaret D


    Human embryonic stem cell-derived cardiomyocytes (hESC-CMs) can regenerate infarcted myocardium. However, when implanted into acutely infarcted hearts, few cells survive the first week postimplant. To improve early graft survival, hESC-CMs were pretreated with cobalt protoporphyrin (CoPP), a transcriptional activator of cytoprotective heme oxygenase-1 (HO-1). When hESC-CMs were challenged with an in vitro hypoxia/reoxygenation injury, mimicking cell transplantation into an ischemic site, survival was significantly greater among cells pretreated with CoPP versus phosphate-buffered saline (PBS)-pretreated controls. Compared with PBS-pretreated cells, CoPP-pretreated hESC-CM preparations exhibited higher levels of HO-1 expression, Akt phosphorylation, and vascular endothelial growth factor production, with reduced apoptosis, and a 30% decrease in intracellular reactive oxygen species. For in vivo translation, 1 × 10(7) hESC-CMs were pretreated ex vivo with CoPP or PBS and then injected intramyocardially into rat hearts immediately following acute infarction (permanent coronary ligation). At 1 week, hESC-CM content, assessed by quantitative polymerase chain reaction for human Alu sequences, was 17-fold higher in hearts receiving CoPP- than PBS-pretreated cells. On histomorphometry, cardiomyocyte graft size was 2.6-fold larger in hearts receiving CoPP- than PBS-pretreated cells, occupying up to 12% of the ventricular area. Vascular density of host-perfused human-derived capillaries was significantly greater in grafts composed of CoPP- than PBS-pretreated cells. Taken together, these experiments demonstrate that ex vivo pretreatment of hESC-CMs with a single dose of CoPP before intramyocardial implantation more than doubled resulting graft size and improved early graft vascularization in acutely infarcted hearts. These findings open the door for delivery of these, or other, stem cells during acute interventional therapy following myocardial infarction or ischemia.

  16. Vascular Cures

    ... Contact Us Vascular Disease What is Vascular Disease? Education and Awareness Vascular Diseases Abdominal Aortic Aneurysm Aortic Dissection Arteriovenous Malformation Atherosclerosis Buerger's Disease Carotid Artery Disease ...

  17. Rupture process and coseismic deformations of the 27 February 2010 Maule earthquake, Chile

    Pulido, Nelson; Yagi, Yuji; Kumagai, Hiroyuki; Nishimura, Naoki


    We estimated the spatial and temporal slip distribution for the 27 February 2010 Maule earthquake from teleseismic body wave data. To obtain a stable inversion solution, we used the data covariance matrix from the observation and modeling errors, incorporated smoothing constraints and determined their optimal values by using the Akaike Bayesian Information Criterion (ABIC). The fault rupture can be divided into three stages. For the first 30 s the rupture started as an elliptical crack elongated in the in-plane direction along the dip. After 30 s the rupture propagated bi-laterally along strike reaching the maximum moment release rate at around 50 s near the hypocenter. Finally the rupture propagated mainly to the north reaching another peak of moment release rate at 80 s and 130 km north-east from the hypocenter. Main rupture lasted for about 110 s. In order to evaluate our source model, we calculated the predicted coseismic vertical displacements and compare them with observed uplift/subsidence values measured along the coastline, as well as displacements obtained from strong ground motion and high-sampling GPS records in Concepción. Our model provides good estimations of the static displacements in the northern source region, but under-estimates the coseismic uplifts in the southern region.

  18. [Organophosphate pesticides and neuropsychological and motor effects in the Maule Region, Chile].

    Muñoz-Quezada, María Teresa; Lucero, Boris; Iglesias, Verónica; Muñoz, María Pía; Achú, Eduardo; Cornejo, Claudia; Concha, Carlos; Grillo, Angela; Brito, Ana María


    To evaluate organophosphate pesticide exposure and neuropsychological and motor performance in agricultural and non-agricultural workers in the Maule Region in Chile. Analytic cross-sectional study in 93 exposed farm workers and 84 unexposed non-agricultural workers. A battery of four neuropsychological tests was administered together with a neuro-motor physical examination. On the Weschler adult intelligence scale (WAIS-IV), exposed agricultural workers exhibited poorer performance than non-agricultural workers in verbal comprehension (β=-3.2; p=0.034) and processing speed (β=-4.4; p=0.036) and in the full scale (β=-4; p=0.016), as well as in discrimination sensitivity (β=1, p=0,009), adjusted by years of schooling and/or age. We suggest the development of policies and regulations for the control, sale and use of organophosphate pesticides and intervention strategies on safety measures aimed at the exposed population. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. Postseismic uplift of the Andes following the 2010 Maule earthquake: Implications for mantle rheology

    Li, Shaoyang; Moreno, Marcos; Bedford, Jonathan; Rosenau, Matthias; Heidbach, Oliver; Melnick, Daniel; Oncken, Onno


    Postseismic surface deformation associated with great subduction earthquakes is controlled by asthenosphere rheology, frictional properties of the fault, and structural complexity. Here by modeling GPS displacements in the 6 years following the 2010 Mw 8.8 Maule earthquake in Chile, we investigate the impact of heterogeneous viscosity distribution in the South American subcontinental asthenosphere on the 3-D postseismic deformation pattern. The observed postseismic deformation is characterized by flexure of the South America plate with peak uplift in the Andean mountain range and subsidence in the hinterland. We find that, at the time scale of observation, over 2 orders of magnitude gradual increase in asthenosphere viscosity from the arc area toward the cratonic hinterland is needed to jointly explain horizontal and vertical displacements. Our findings present an efficient method to estimate spatial variations of viscosity, which clearly improves the fitting to the vertical signal of deformation. Lateral changes in asthenosphere viscosity can be correlated with the thermomechanical transition from weak subvolcanic arc mantle to strong subcratonic mantle, thus suggesting a stationary heterogeneous viscosity structure. However, we cannot rule out a transient viscosity structure (e.g., power law rheology) with the short time span of observation.

  20. Cooperative Role of Mineralocorticoid Receptor and Caveolin-1 in Regulating the Vascular Response to Low Nitric Oxide-High Angiotensin II-Induced Cardiovascular Injury.

    Pojoga, Luminita H; Yao, Tham M; Opsasnick, Lauren A; Siddiqui, Waleed T; Reslan, Ossama M; Adler, Gail K; Williams, Gordon H; Khalil, Raouf A


    Aldosterone interacts with mineralocorticoid receptor (MR) to stimulate sodium reabsorption in renal tubules and may also affect the vasculature. Caveolin-1 (cav-1), an anchoring protein in plasmalemmal caveolae, binds steroid receptors and also endothelial nitric oxide synthase, thus limiting its translocation and activation. To test for potential MR/cav-1 interaction in the vasculature, we investigated if MR blockade in cav-1-replete or -deficient states would alter vascular function in a mouse model of low nitric oxide (NO)-high angiotensin II (AngII)-induced cardiovascular injury. Wild-type (WT) and cav-1 knockout mice (cav-1(-/-)) consuming a high salt diet (4% NaCl) received Nω-nitro-l-arginine methyl ester (L-NAME) (0.1-0.2 mg/ml in drinking water at days 1-11) plus AngII (0.7-2.8 mg/kg per day via an osmotic minipump at days 8-11) ± MR antagonist eplerenone (EPL) 100 mg/kg per day in food. In both genotypes, blood pressure increased with L-NAME + AngII. EPL minimally changed blood pressure, although its dose was sufficient to block MR and reverse cardiac expression of the injury markers cluster of differentiation 68 and plasminogen activator inhibitor-1 in L-NAME+AngII treated mice. In aortic rings, phenylephrine and KCl contraction was enhanced with EPL in L-NAME+AngII treated WT mice, but not cav-1(-/-) mice. AngII-induced contraction was not different, and angiotensin type 1 receptor expression was reduced in L-NAME + AngII treated WT and cav-1(-/-) mice. In WT mice, acetylcholine-induced relaxation was enhanced with L-NAME + AngII treatment and reversed with EPL. Acetylcholine relaxation in cav-1(-/-) mice was greater than in WT mice, not modified by L-NAME + AngII or EPL, and blocked by ex vivo L-NAME, 1H-(1,2,4)oxadiazolo(4,3-a)quinoxalin-1-one (ODQ), or endothelium removal, suggesting the role of NO-cGMP. Cardiac endothelial NO synthase was increased in cav-1(-/-) versus WT mice, further increased with L-NAME + AngII, and not affected by EPL

  1. Ultrasound -- Vascular

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Vascular Vascular ultrasound uses sound waves to evaluate ... the limitations of Vascular Ultrasound? What is Vascular Ultrasound? Ultrasound is safe and painless, and produces pictures ...

  2. Ultrasound -- Vascular

    ... Physician Resources Professions Site Index A-Z Ultrasound - Vascular Vascular ultrasound uses sound waves to evaluate the ... are the limitations of Vascular Ultrasound? What is Vascular Ultrasound? Ultrasound is safe and painless, and produces ...

  3. Folic Acid Attenuates Vascular Endothelial Cell Injury Caused by Hypoxia via the Inhibition of ERK1/2/NOX4/ROS Pathway.

    Cheng, Fei; Lan, Jun; Xia, Wenhao; Tu, Chang; Chen, Benfa; Li, Shicheng; Pan, Weibiao


    Coronary artery disease is a disease with high morbidity and mortality, in which vascular endothelial dysfunction plays an important role. Hypoxia leads to the inflammation and oxidative stress in endothelial cells, which results in the endothelial injury. The present study was designed to investigate the protective effect and mechanism of folic acid on hypoxia-induced injury in human umbilical vein endothelial cells (HUVEC). Cell counting Kit was used to detect cell survival rate, and apoptotic cells were detected by Hoechst 33258 staining. Intracellular reactive oxygen species (ROS) level was measured using dichloro-dihydro-fluorescein diacetate staining. Western blot was used to determine the protein expressions of extracellular signal protein kinase 1/2 (ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2), NOX4 subunit of NAPDH and endothelial nitric oxide synthase (eNOS). Folic acid significantly increased the cell survival rate and decreased the apoptosis of HUVECs treated with folic acid compared with hypoxia-treated HUVEC. Folic acid also decreased ROS level, while it increased the nitrite content in HUVECs. In addition, folic acid decreased protein expressions of NOX4 and p-ERK1/2, while it increased the protein expression of eNOS in HUVECs. Furthermore, N-acetyl cysteine (NAC), the antioxidant, had similar effect on the cell survival rate and the apoptosis. In addition, DPI (NOX4 inhibitor) and U0126 (ERK1/2 inhibitor) rather than NAC decreased the protein expression of NOX4. NAC, DPI, and U0126 increased the protein expression of eNOS. Furthermore, U0126 rather than DPI and NAC decreased the protein expression of p-ERK1/2. Taken together, the results suggested that hypoxia decreased the cell survival rate and induced apoptosis via ERK1/2/NOX4/ROS pathway, which could be the target of folic acid in protecting the HUVECs from injury caused by hypoxia.

  4. Fasciotomy Reduces Compartment Pressures and Improves Recovery in a Porcine Model of Extremity Vascular Injury and Ischemia/Reperfusion


    oxygen mixture of 40 to 60% by facemask until endotracheal intubation was performed. The animal was then placed in the supine position on the...operative day 14 the animals were endotracheally intubated prior to the studies being performed. Compartment Pressure Measurement Anterior...animal model revealed that a shunt placed in less than three hours from injury had a lower circulating ischemia index , with good shunt patency over

  5. Prevention and treatment of iatrogenic vascular injury in inguinal herniorrhaphy%腹股沟疝手术中医源性血管损伤的防范及处理

    赵渝; 王学虎; 刘洪


    Iatrogenic vascular injury is relatively common in clinic and it usually happens nearby blood vessels area. In the past,the occurrence of iatrogenic vascular injury in the traditional (tension) inguinal hernia repair operation is rare. But in recent,with the popularity of tension free hernia repair with the mesh repair material,especially in the preperitoneal repair,the vascular injury is more than before. To avoid vascular injury,surgeons must be familiar with vascular anatomy of the groin area and all kinds of inguinal hernia repair operation. Once the complications happen,such as vascular injury,surgeons should know the reasons and treat it in time,to reduce the iatrogenic vascular injury of inguinal hernia to a minimum.%医源性血管损伤相对比较常见,多见于邻近血管区域的各类手术,而在以往传统的(有张力)腹股沟疝修补术中,血管损伤的发生比较少见。近年来随着无张力疝修补术的普及,网片修补材料的应用,尤其是应用网片的腹膜前间隙疝修补术,时有血管损伤的发生,严重者导致死亡。避免血管损伤需要术者熟悉腹股沟区血管解剖,正确掌握各种腹股沟疝修补术式及网片应用,一旦手术导致血管损伤等并发症,及时分析原因并正确处理,均能将腹股沟疝手术中医源性血管损伤的危害降到最低。

  6. Viabilidad económica de la producción de espárrago en la Región del Maule, Chile Economic viability of asparagus production in the Maule Region, Chile

    Germán L Andrade


    Full Text Available En esta investigación se estimaron indicadores de viabilidad y de eficiencia económica de la producción de espárrago (Asparagus officinalis L. en Chile. Los coeficientes técnicos fueron tomados de los registros históricos de un predio localizado en la zona de Linares, Región del Maule, Chile. Los indicadores de viabilidad calculados fueron el valor actual neto (VAN, tasa interna de retorno (TIR, índice de valor actual neto (IVAN, razón beneficio-costo (RBC, y período de recuperación del capital (PRC. Los indicadores de eficiencia económica fueron el costo medio total (CMET, margen unitario ponderado (MUP y la rentabilidad sobre capital (RSC. Como unidad de análisis se consideró una hectárea. Para productores con tierra, los resultados obtenidos en la situación estándar fueron: Ch$1,52 millones (VAN, 12,1% (TIR, 0,3 (IVAN, 1,1 (RBC y 10 años (PRC. Para la etapa de producción se proyectó un CMET mínimo de Ch $317,8 kg-1, un MUP máximo de Ch$407 kg-1 y una RSC de 20,3%. La principal conclusión es que el cultivo de espárrago en la región del Maule, en Chile, es viable para los productores con tierra.Viability and economic efficiency indicators for asparagus (Asparagus officinalis L. production in Chile were evaluated. Technical parameters were obtained from an historical farm located in Linares area, Maule Region, Chile. Viability was assessed by means of net present value (VAN, internal rate of return (TIR, net present value index (IVAN, cost-benefit ratio (RBC, and investment recovery period (PRC. Economic efficiency was assessed through production average cost (CMET, weighted unit margin (MUP, and return on equity (RSC. The analysis was based upon one hectare. Results for producers who own their land were US$ 2,529 ha-1 (VAN, 12.14% (TIR, 0.25 (IVAN, and 1.1 (RBC. The minimum CMET was estimated at US$ 0.53 kg-1 the maximum MUP at US$ 0.68 kg-1, and RSC until 20.3%. The main conclusion is that asparagus production in the

  7. HIV, Vascular and Aging Injuries in the Brain of Clinically Stable HIV-Infected Adults: A 1H MRS Study

    Cysique, Lucette A.; Moffat, Kirsten; Moore, Danielle M.; Lane, Tammy A.; Davies, Nicholas W. S.; Carr, Andrew; Brew, Bruce J.; Rae, Caroline


    Background Cardiovascular disease (CVD) and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND) in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers remain unclear. Methods 92 HIV− infected (HIV+) adults stable on combined antiretroviral therapy (cART) and 30 age-comparable HIV-negative (HIV−) subjects underwent 1H Magnetic Resonance Spectroscopy (MRS) of the frontal white matter (targeting HIV, normal aging or CVD-related neurochemical injury), caudate nucleus (targeting HIV neurochemical injury), and posterior cingulate cortex (targeting normal/pathological aging, CVD-related neurochemical changes). All also underwent standard neuropsychological (NP) testing. CVD risk scores were calculated. HIV disease biomarkers were collected and cerebrospinal fluid (CSF) neuroinflammation biomarkers were obtained in 38 HIV+ individuals. Results Relative to HIV− individuals, HIV+ individuals presented mild MRS alterations: in the frontal white matter: lower N-Acetyl-Aspartate (NAA) (pHIV*age interaction was associated with lower frontal white matter NAA. CVD risk factors were associated with lower posterior cingulate cortex and caudate NAA in both groups. Past acute CVD events in the HIV+ group were associated with increased mIo in the posterior cingulate cortex. HIV duration was associated with lower caudate NAA; greater CNS cART penetration was associated with lower mIo in the posterior cingulate cortex and the degree of immune recovery on cART was associated with higher NAA in the frontal white matter. CSF neopterin was associated with higher mIo in the posterior cingulate cortex and frontal white matter. Conclusions In chronically HIV+ adults with long-term viral suppression, current CVD risk, past CVD and age are independent factors for neuronal injury and inflammation. This suggests a tripartite model of HIV, CVD and age likely driven by


    Xiao-lin He; Zhi Liu; Shu-yue Xia


    Objective To study endothelial damage by observing changes of circulating endothelial cells (CECs) in blood, coagulation and fibrinolysis index in patients with acute respiratory distress syndrome.Methods CECs were separated by isopycnic centrifugation method in 14 patients with acute lung injury (ALI), 7patients with acute respiratory distress syndrome (ARDS), 10 intensive care unit (ICU) controls, and 15 healthy controls.Plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FG), fibrin degradation products (FDP), and D-dimer were examined simultaneously. Acute physiology and chronic health evaluation (APACHE) Ⅱ and lung injury score (LIS) were recorded to evaluate severity of illness and lung injury.Results (1) The number of CECs in ALI (10.4 ± 2.3 ) and ARDS groups ( 16.1 ± 2.7) was higher than that in the healthy (1.9 ± 0.5) (P < 0.01). In both ALI and ARDS, the number of CECs correlated with APACHE Ⅱ (r = 0.55, P < 0.05 and r =0.62, P < 0.05, respectively) and LIS (r = 0.60, P < 0.05 and r = 0.53, P < 0.05, respectively). CEC number was negatively correlated with PaO2 in ALI and ARDS (r=-0.49, P< 0.05 and r=-0.64, P< 0.05, respectively). (2) The level of FDP and D-dirmer were higher in ALI and ARDS patients than that in ICU and healthy control groups (P<0.05). The level of FG in ARDS group was significantly higher than in the ICU and healthy control groups (P < 0.05). But in ALI group, the level of FG was significantly higher than only healthy control group (P < 0.05).Conclusions Endothelial cell damage occurs in ARDS patients, which may play a major role in the pathophysiology of ARDS. Changes of endothelial cell activation and damage markers, such as CECs, plasma coagulation and fibrinolysis index,to some extent reflect severity of illness and lung injury in ARDS.

  9. Neuron-specific enolase expression in a rat model of radiation-induced brain injury following vascular endothelial growth factor-modified neural stem cell transplantation

    Songhua Xiao; Chaohui Duan; Qingyu Shen; Yigang Xing; Ying Peng; Enxiang Tao; Jun Liu


    BACKGROUND:Previous studies have shown that transplantation of vascular endothelial growth factor (VEGF)-modified neural stem cells (NSC) provides better outcomes,compared with neural stem cells,in the treatment of brain damage.OBJECTIVE:To compare the effects of VEGF-modified NSC transplantation and NSC transplantation on radiation-induced brain injury,and to determine neuron-specific enolase (NSE) expression in the brain.DESIGN,TIME,AND SETTING:The randomized,controlled study was performed at the Linbaixin Experimental Center,Second Affiliated Hospital,Sun Yat-sen University,China from November 2007 to October 2008.MATERIALS:VEGF-medified C17.2 NSCs were supplied by Harvard Medical School,USA.Streptavidin-biotin-peroxidase-complex kit (Boster,China) and 5,6-carboxyfluorescein diacetate succinimidyl ester (Fluka,USA) were used in this study.METHODS:A total of 84 Sprague Dawley rats were randomly assigned to a blank control group (n=20),model group (n=20),NSC group (n=20),and a VEGF-modified NSC group (n=24).Rat models of radiation-induced brain injury were established in the model,NSC,and VEGF-modified NSC groups.At 1 week following model induction,10 μL (5×10~4 cells/μL) VEGF-modified NSCs or NSCs were respectively infused into the striatum and cerebral cortex of rats from the VEGF-modified NSC and NSC groups.A total of 10 μL saline was injected into rats from the blank control and model groups.MAIN OUTCOME MEASURES:NSE expression in the brain was detected by immunohistochemistry following VEGF-modified NSC transplantation.RESULTS:NSE expression was significantly decreased in the brains of radiation-induced brain injury rats (P<0.05).The number of NSE-positive neurons significantly increased in the NSC and VEGF-modified NSC groups,compared with the model group (P<0.05).NSE expression significantly increased in the VEGF-modified NSC group,compared with the NSC group,at 6 weeks following transplantation (P<0.05).CONCLUSION:VEGF-modified NSC

  10. Attenuation tomography in the rupture area of the 2010 M8.8 Maule, Chile, earthquake

    Heather-Smith, Helen; Rietbrock, Andreas


    In recent years several seismological studies have developed a detailed image of the megathrust interface between the subducting Nazca plate and and the overriding South American plate in the rupture area of the 2010 M8.8 Maule, Chile, earthquake. Hicks et al. (2014) have published a high resolution 3D seismic tomography model and characterised the different regimes acting along the interface based on their seismic properties. A more detailed study by Moreno et al. (2014) showed that the seismic Vp/Vs ratio and inter-seismic locking determined from GPS measurements are correlated. Together these observations open up the possibility to map the rupture potential of possible future earthquakes, although the underlying processes are yet not fully understood and a more in depth analysis of other physical properties is needed. 3D seismic attenuation structure as well as seismic stress-drop distribution based on the aftershock seismicity are providing independent data sets to better constrain the physical processes acting along the subduction zone interface. As seismic attenuation is particularly sensitive to fluid saturation it opens up the possibility to study more directly the influence of fluids on aftershock activity as compared to standard velocity tomography studies. Based on our event catalogue of approximately 30,000 aftershocks we are currently selecting the most appropriate data set for the staggered 3D attenuation tomography. The inverted attenuation model will then be used to calculate seismic stress drop values for the complete aftershock catalogue. We will present our preliminary 3D attenuation model together with our stress drop estimates and compare our finding to the 3D velocity structure and slip distribution.

  11. Dynamics of a large, restless, rhyolitic magma system at Laguna del Maule, southern Andes, Chile

    Singer, Brad S.; Andersen, Nathan L.; Le Mével, Hélène; Feigl, Kurt L.; DeMets, Charles; Tikoff, Basil; Thurber, Clifford H.; Jicha, Brian R.; Cardonna, Carlos; Córdova, Loreto; Gil, Fernando; Unsworth, Martyn J.; Williams-Jones, Glyn; Miller, Craig W.; Fierstein, Judith; Hildreth, Edward; Vazquez, Jorge A.


    Explosive eruptions of large-volume rhyolitic magma systems are common in the geologic record and pose a major potential threat to society. Unlike other natural hazards, such as earthquakes and tsunamis, a large rhyolitic volcano may provide warning signs long before a caldera-forming eruption occurs. Yet, these signs—and what they imply about magma-crust dynamics—are not well known. This is because we have learned how these systems form, grow, and erupt mainly from the study of ash flow tuffs deposited tens to hundreds of thousands of years ago or more, or from the geophysical imaging of the unerupted portions of the reservoirs beneath the associated calderas. The Laguna del Maule Volcanic Field, Chile, includes an unusually large and recent concentration of silicic eruptions. Since 2007, the crust there has been inflating at an astonishing rate of at least 25 cm/yr. This unique opportunity to investigate the dynamics of a large rhyolitic system while magma migration, reservoir growth, and crustal deformation are actively under way is stimulating a new international collaboration. Findings thus far lead to the hypothesis that the silicic vents have tapped an extensive layer of crystal-poor, rhyolitic melt that began to form atop a magmatic mush zone that was established by ca. 20 ka with a renewed phase of rhyolite eruptions during the Holocene. Modeling of surface deformation, magnetotelluric data, and gravity changes suggest that magma is currently intruding at a depth of ~5 km. The next phase of this investigation seeks to enlarge the sets of geophysical and geochemical data and to use these observations in numerical models of system dynamics.

  12. Heat Shock Protein A12B Protects Vascular Endothelial Cells Against Sepsis-Induced Acute Lung Injury in Mice.

    Chen, Yi; Wang, Lei; Kang, Qiuxiang; Zhang, Xu; Yu, Guifang; Wan, Xiaojian; Wang, Jiafeng; Zhu, Keming


    Pulmonary endothelial injury is a critical process in the pathogenesis of acute lung injury (ALI) during sepsis. Heat shock protein A12B (HSPA12B) is mainly expressed in endothelial cells and protects against several harmful factors. However, the effects of HSPA12B in sepsis-induced ALI and its potential mechanisms of action remain unclear. For in vivo experiments, C57BL/6 mice were randomly divided into four groups (n=15): a sham operation group, a cecal ligation and puncture (CLP) group, a HSPA12B siRNA-CLP group and a negative control (NC) siRNA-CLP group. The mice were treated by nasal inhalation of 2-OMe-modified HSPA12B siRNA or NC siRNA. Sepsis was induced by CLP. Samples were harvested 24 and 48 hours post-CLP surgery. Pathological changes and scoring of lung tissue samples were monitored using hematoxylin and eosin staining. Levels of pro-inflammatory cytokines (e.g., interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and IL-6) and myeloperoxidase activity in bronchoalveolar lavage fluid were analyzed by ELISA. Pulmonary edema was assessed using a wet-to-dry weight ratio. Neutrophils and alveolar macrophages were counted using flow cytometry. Pulmonary endothelial cell apoptosis was detected by TUNEL staining. Expression levels of MAPK family signaling molecules and caspase-3 were measured by Western blot analysis. In addition, 7-day survival was recorded. For in vitro experiments, human umbilical vein endothelial cells were pre-transfected with HSPA12B siRNA or pIRES2-EGFP-HSPA12B-Flag plasmid and treated with lipopolysaccharide; subsequently, the expression levels of MAPK family signaling molecules and caspase-3 were measured by Western blotting. Nasal inhalation of nano-polymer-encapsulated HSPA12B siRNA specifically downregulated mRNA and protein expression levels of HSPA12B in lung tissues. The administration of HSPA12B siRNA aggravated lung pathological injury, upregulated pro-inflammatory cytokine (e.g., IL-1β, TNF-α, and IL-6) expression, and

  13. Cigarette Smoking-Induced Cardiac Hypertrophy, Vascular Inflammation and Injury are Attenuated by Antioxidant Supplementation in An Animal Model

    Moustafa Al Hariri


    Full Text Available BackgroundCardiovascular diseases are the leading causes of morbidity and mortality worldwide. Cigarette smoking remains a global health epidemic with associated detrimental effects on the cardiovascular system. In this work, we investigated the effects of cigarette smoke exposure on cardiovascular system in an animal model. The study then evaluated the effects of antioxidants (AO, represented by pomegranate juice, on cigarette smoke induced cardiovascular injury. This study aims at evaluating the effect of pomegranate juice supplementation on the cardiovascular system of an experimental rat model of smoke exposure.Methods Adult rats were divided into four different groups: Control, Cigarette smoking (CS, AO, and CS + AO. Cigarette smoke exposure was for 4 weeks (5 days of exposure/week and AO group received pomegranate juice while other groups received placebo. Assessment of cardiovascular injury was documented by assessing different parameters of cardiovascular injury mediators including: 1 cardiac hypertrophy, 2 oxidative stress (OS, 3 expression of inflammatory markers, 3 expression of Bradykinin receptor 1 (Bdkrb1, Bradykinin receptor 2 (Bdkrb2, and 4 altered expression expression of fibrotic/atherogenic markers [(Fibronectin (Fn1 and leptin receptor (ObR].ResultsData from this work demonstrated that cigarette smoke exposure induced cardiac hypertrophy, which was reduced upon administration of pomegranate in CS + AO group. Cigarette smoke exposure was associated with elevation in oxidative stress, significant increase in the expression of IL-1β, TNFα, Fn1 and ObR in rat’s aorta. In addition, an increase in aortic calcification was observed after one month of Cigarette smoke exposure. Furthermore, Cigarette smoke induced a significant up regulation in Bdkrb1 and Bdkrb2 expression levels. Finally, pomegranate supplementation exhibited cardiovascular protection assessed by the above findings and partly contributed to ameliorating cardiac

  14. HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1H MRS study.

    Lucette A Cysique

    Full Text Available BACKGROUND: Cardiovascular disease (CVD and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers remain unclear. METHODS: 92 HIV- infected (HIV+ adults stable on combined antiretroviral therapy (cART and 30 age-comparable HIV-negative (HIV- subjects underwent (1H Magnetic Resonance Spectroscopy (MRS of the frontal white matter (targeting HIV, normal aging or CVD-related neurochemical injury, caudate nucleus (targeting HIV neurochemical injury, and posterior cingulate cortex (targeting normal/pathological aging, CVD-related neurochemical changes. All also underwent standard neuropsychological (NP testing. CVD risk scores were calculated. HIV disease biomarkers were collected and cerebrospinal fluid (CSF neuroinflammation biomarkers were obtained in 38 HIV+ individuals. RESULTS: Relative to HIV- individuals, HIV+ individuals presented mild MRS alterations: in the frontal white matter: lower N-Acetyl-Aspartate (NAA (p<.04 and higher myo-inositol (mIo (p<.04; in the caudate: lower NAA (p = .01; and in the posterior cingulate cortex: higher mIo (p<.008- also significant when Holm-Sidak corrected and higher Choline/NAA (p<.04. Regression models showed that an HIV*age interaction was associated with lower frontal white matter NAA. CVD risk factors were associated with lower posterior cingulate cortex and caudate NAA in both groups. Past acute CVD events in the HIV+ group were associated with increased mIo in the posterior cingulate cortex. HIV duration was associated with lower caudate NAA; greater CNS cART penetration was associated with lower mIo in the posterior cingulate cortex and the degree of immune recovery on cART was associated with higher NAA in the frontal white matter. CSF neopterin was associated with higher mIo in the posterior cingulate cortex and frontal

  15. G-CSF protects human brain vascular endothelial cells injury induced by high glucose, free fatty acids and hypoxia through MAPK and Akt signaling.

    Jingjing Su

    Full Text Available Granulocyte-colony stimulating factor (G-CSF has been shown to play a neuroprotective role in ischemic stroke by mobilizing bone marrow (BM-derived endothelial progenitor cells (EPCs, promoting angiogenesis, and inhibiting apoptosis. Impairments in mobilization and function of the BM-derived EPCs have previously been reported in animal and human studies of diabetes where there is both reduction in the levels of the BM-derived EPCs and its ability to promote angiogenesis. This is hypothesized to account for the pathogenesis of diabetic vascular complications such as stroke. Here, we sought to investigate the effects of G-CSF on diabetes-associated cerebral vascular defect. We observed that pretreatment of the cultured human brain vascular endothelial cells (HBVECs with G-CSF largely prevented cell death induced by the combination stimulus with high glucose, free fatty acids (FFA and hypoxia by increasing cell viability, decreasing apoptosis and caspase-3 activity. Cell ultrastructure measured by transmission electron microscope (TEM revealed that G-CSF treatment nicely reduced combination stimulus-induced cell apoptosis. The results from fluorescent probe Fluo-3/AM showed that G-CSF greatly suppressed the levels of intracellular calcium ions under combination stimulus. We also found that G-CSF enhanced the expression of cell cycle proteins such as human cell division cycle protein 14A (hCdc14A, cyclinB and cyclinE, inhibited p53 activity, and facilitated cell cycle progression following combination stimulus. In addition, activation of extracellular signal-regulated kinase1/2 (ERK1/2 and Akt, and deactivation of c-Jun N terminal kinase (JNK and p38 were proved to be required for the pro-survival effects of G-CSF on HBVECs exposed to combination stimulus. Overall, G-CSF is capable of alleviating HBVECs injury triggered by the combination administration with high glucose, FFA and hypoxia involving the mitogen-activated protein kinases (MAPK and Akt

  16. G-CSF Protects Human Brain Vascular Endothelial Cells Injury Induced by High Glucose, Free Fatty Acids and Hypoxia through MAPK and Akt Signaling

    Tao, Yinghong; Guo, Jingchun; Guo, Zhuangli; Zhang, Shuo; Zhang, Yu; Huang, Yanyan; Tang, Yuping; Dong, Qiang; Hu, Renming


    Granulocyte-colony stimulating factor (G-CSF) has been shown to play a neuroprotective role in ischemic stroke by mobilizing bone marrow (BM)-derived endothelial progenitor cells (EPCs), promoting angiogenesis, and inhibiting apoptosis. Impairments in mobilization and function of the BM-derived EPCs have previously been reported in animal and human studies of diabetes where there is both reduction in the levels of the BM-derived EPCs and its ability to promote angiogenesis. This is hypothesized to account for the pathogenesis of diabetic vascular complications such as stroke. Here, we sought to investigate the effects of G-CSF on diabetes-associated cerebral vascular defect. We observed that pretreatment of the cultured human brain vascular endothelial cells (HBVECs) with G-CSF largely prevented cell death induced by the combination stimulus with high glucose, free fatty acids (FFA) and hypoxia by increasing cell viability, decreasing apoptosis and caspase-3 activity. Cell ultrastructure measured by transmission electron microscope (TEM) revealed that G-CSF treatment nicely reduced combination stimulus-induced cell apoptosis. The results from fluorescent probe Fluo-3/AM showed that G-CSF greatly suppressed the levels of intracellular calcium ions under combination stimulus. We also found that G-CSF enhanced the expression of cell cycle proteins such as human cell division cycle protein 14A (hCdc14A), cyclinB and cyclinE, inhibited p53 activity, and facilitated cell cycle progression following combination stimulus. In addition, activation of extracellular signal-regulated kinase1/2 (ERK1/2) and Akt, and deactivation of c-Jun N terminal kinase (JNK) and p38 were proved to be required for the pro-survival effects of G-CSF on HBVECs exposed to combination stimulus. Overall, G-CSF is capable of alleviating HBVECs injury triggered by the combination administration with high glucose, FFA and hypoxia involving the mitogen-activated protein kinases (MAPK) and Akt signaling

  17. Associations of Circulating Growth Differentiation Factor-15 and ST2 Concentrations With Subclinical Vascular Brain Injury and Incident Stroke

    Andersson, Charlotte; Preis, Sarah R; Beiser, Alexa;


    .04). Higher GDF-15 concentrations were also associated with greater log-transformed white-matter hyperintensity volumes (β for Q4 versus Q1=0.19; P=0.01). Prospectively, a total of 203 (6%) individuals developed incident stroke/transient ischemic attack during follow-up. After multivariable adjustment, sST2...... remained significantly associated with stroke/transient ischemic attack, hazard ratio for Q4 versus Q1 of 1.76, 95% confidence interval of 1.06 to 2.92, and P=0.03. CONCLUSIONS: Circulating GDF-15 and sST2 are associated with subclinical brain injury and cognitive impairment. Higher sST2 concentrations...

  18. Oxidative stress and modification of renal vascular permeability are associated with acute kidney injury during P. berghei ANKA infection.

    Elias, Rosa Maria; Correa-Costa, Matheus; Barreto, Claudiene Rodrigues; Silva, Reinaldo Correia; Hayashida, Caroline Y; Castoldi, Angela; Gonçalves, Giselle Martins; Braga, Tarcio Teodoro; Barboza, Renato; Rios, Francisco José; Keller, Alexandre Castro; Cenedeze, Marcos Antonio; Hyane, Meire Ioshie; D'Império-Lima, Maria Regina; Figueiredo-Neto, Antônio Martins; Reis, Marlene Antônia; Marinho, Cláudio Romero Farias; Pacheco-Silva, Alvaro; Câmara, Niels Olsen Saraiva


    Malaria associated-acute kidney injury (AKI) is associated with 45% of mortality in adult patients hospitalized with severe form of the disease. However, the causes that lead to a framework of malaria-associated AKI are still poorly characterized. Some clinical studies speculate that oxidative stress products, a characteristic of Plasmodium infection, as well as proinflammatory response induced by the parasite are involved in its pathophysiology. Therefore, we aimed to investigate the development of malaria-associated AKI during infection by P. berghei ANKA, with special attention to the role played by the inflammatory response and the involvement of oxidative stress. For that, we took advantage of an experimental model of severe malaria that showed significant changes in the renal pathophysiology to investigate the role of malaria infection in the renal microvascular permeability and tissue injury. Therefore, BALB/c mice were infected with P. berghei ANKA. To assess renal function, creatinine, blood urea nitrogen, and ratio of proteinuria and creatininuria were evaluated. The products of oxidative stress, as well as cytokine profile were quantified in plasma and renal tissue. The change of renal microvascular permeability, tissue hypoxia and cellular apoptosis were also evaluated. Parasite infection resulted in renal dysfunction. Furthermore, we observed increased expression of adhesion molecule, proinflammatory cytokines and products of oxidative stress, associated with a decrease mRNA expression of HO-1 in kidney tissue of infected mice. The measurement of lipoprotein oxidizability also showed a significant increase in plasma of infected animals. Together, our findings support the idea that products of oxidative stress, as well as the immune response against the parasite are crucial to changes in kidney architecture and microvascular endothelial permeability of BALB/c mice infected with P. berghei ANKA.

  19. Oxidative Stress and Modification of Renal Vascular Permeability Are Associated with Acute Kidney Injury during P. berghei ANKA Infection

    Elias, Rosa Maria; Correa-Costa, Matheus; Barreto, Claudiene Rodrigues; Silva, Reinaldo Correia; Hayashida, Caroline Y.; Castoldi, Ângela; Gonçalves, Giselle Martins; Braga, Tarcio Teodoro; Barboza, Renato; Rios, Francisco José; Keller, Alexandre Castro; Cenedeze, Marcos Antonio; Hyane, Meire Ioshie; D'Império-Lima, Maria Regina; Figueiredo-Neto, Antônio Martins; Reis, Marlene Antônia; Marinho, Cláudio Romero Farias; Pacheco-Silva, Alvaro; Câmara, Niels Olsen Saraiva


    Malaria associated-acute kidney injury (AKI) is associated with 45% of mortality in adult patients hospitalized with severe form of the disease. However, the causes that lead to a framework of malaria-associated AKI are still poorly characterized. Some clinical studies speculate that oxidative stress products, a characteristic of Plasmodium infection, as well as proinflammatory response induced by the parasite are involved in its pathophysiology. Therefore, we aimed to investigate the development of malaria-associated AKI during infection by P. berghei ANKA, with special attention to the role played by the inflammatory response and the involvement of oxidative stress. For that, we took advantage of an experimental model of severe malaria that showed significant changes in the renal pathophysiology to investigate the role of malaria infection in the renal microvascular permeability and tissue injury. Therefore, BALB/c mice were infected with P. berghei ANKA. To assess renal function, creatinine, blood urea nitrogen, and ratio of proteinuria and creatininuria were evaluated. The products of oxidative stress, as well as cytokine profile were quantified in plasma and renal tissue. The change of renal microvascular permeability, tissue hypoxia and cellular apoptosis were also evaluated. Parasite infection resulted in renal dysfunction. Furthermore, we observed increased expression of adhesion molecule, proinflammatory cytokines and products of oxidative stress, associated with a decrease mRNA expression of HO-1 in kidney tissue of infected mice. The measurement of lipoprotein oxidizability also showed a significant increase in plasma of infected animals. Together, our findings support the idea that products of oxidative stress, as well as the immune response against the parasite are crucial to changes in kidney architecture and microvascular endothelial permeability of BALB/c mice infected with P. berghei ANKA. PMID:22952850

  20. Vascular Cognitive Impairment.

    Dichgans, Martin; Leys, Didier


    Cerebrovascular disease typically manifests with stroke, cognitive impairment, or both. Vascular cognitive impairment refers to all forms of cognitive disorder associated with cerebrovascular disease, regardless of the specific mechanisms involved. It encompasses the full range of cognitive deficits from mild cognitive impairment to dementia. In principle, any of the multiple causes of clinical stroke can cause vascular cognitive impairment. Recent work further highlights a role of microinfarcts, microhemorrhages, strategic white matter tracts, loss of microstructural tissue integrity, and secondary neurodegeneration. Vascular brain injury results in loss of structural and functional connectivity and, hence, compromise of functional networks within the brain. Vascular cognitive impairment is common both after stroke and in stroke-free individuals presenting to dementia clinics, and vascular pathology frequently coexists with neurodegenerative pathology, resulting in mixed forms of mild cognitive impairment or dementia. Vascular dementia is now recognized as the second most common form of dementia after Alzheimer's disease, and there is increasing awareness that targeting vascular risk may help to prevent dementia, even of the Alzheimer type. Recent advances in neuroimaging, neuropathology, epidemiology, and genetics have led to a deeper understanding of how vascular disease affects cognition. These new findings provide an opportunity for the present reappraisal of vascular cognitive impairment. We further briefly address current therapeutic concepts.

  1. Management of vascular trauma from dog bites

    Akingba, A George; Robinson, Eric A; Jester, Andrea L; Rapp, Brian M; Tsai, Anthony; Motaganahalli, Raghu L; Dalsing, Michael C; Murphy, Michael P


    Vascular trauma from large-dog bites present with a combination of crush and lacerating injuries to the vessel, as well as significant adjacent soft tissue injury and a high potential for wound complications...

  2. Transplantation of bone marrow stromal cells overexpressing human vascular endothelial growth factor 165 enhances tissue repair in a rat model of radiation-induced injury

    Wang Tao; Liao Tian'an; Wang Hong; Deng Wei; Yu Dahai


    Background The multilineage differentiation potential ability of bone marrow stromal cells (BMSCs) showed great potential in tissue engineering,while vascular endothelial growth factor 165 (VEGF165) promotes vasculogenesis and further promotes tissue regeneration.This study aimed to assess the ability of rat BMSCs expressing human VEGFA165 (hVEGF165) to promote tissue repair in rat model of radiation-induced injury.Methods Rat BMSCs were isolated from the tibia.Plasmid DNA expressing hVEGF165 was stably transfected into BMSCs using liposomes.The right hindlimb muscle of 40 rats was irradiated using a 60Co y source (total dose 30 Gy).The animals were divided into four groups (n=10):not injected with BMSCs (control; group 1) or intramuscularly injected two times (once in 2 weeks) with pcDNATM3.1-transfected BMSCs (group 2),untransfected BMSCs (group 3),or hVEGF165-transfected BMSCs (group 4).Angiography was performed 1 week after the last injection of BMSCs; samples of the hindlimb muscle were subjected to transmission electron microscopy,ultrastructural analysis,reverse transcription-PCR (RT-PCR),Western blotting,and immunohistochemistry.Results Rat BMSCs with multipotent differentiation capacity were isolated,hVEGF165-transfected BMSCs overexpressed hVEGF165 mRNA and protein.Injection of BMSCs (groups 2-4) increased the average vessel number,density,diameter,and cross-sectional area; mRNA expression of the myogenic markers including myoblast determination protein,myogenin,and α-smooth muscle actin; and CD31 protein expression; and promoted the repair of blood vessels and myofibers after radiation-induced injury compared to group 1; each of these parameters and hVEGF165 mRNA or protein expression were markedly improved in rats injected with hVEGF165-transfected BMSCs compared to groups 2 and 3.Conclusions BMSCs expressing hVEGF165 enhanced the repair of radiation-induced tissue injury by promoting vasculogenesis and muscle fiber regeneration.BMSCs expressing h

  3. Vascular Cures

    ... is Possible EVERY DOLLAR SAVES LIVES. Donate Now Vascular Cures innovates patient-centered research, catalyzes breakthrough collaborations and empowers people in their vascular health journey. what is vascular disease PATIENTS see ...

  4. Vascular ring

    ... subclavian and left ligamentum ateriosus; Congenital heart defect - vascular ring; Birth defect heart - vascular ring ... Vascular ring is rare. It accounts for less than 1% of all congenital heart problems. The condition ...

  5. Magnetotelluric Studies of the Laguna del Maule Volcanic Field, Central Chile

    Cordell, D. R.; Unsworth, M. J.; Diaz, D.; Pavez, M.; Blanco, B.


    Geodetic data has shown that the surface of the Laguna del Maule (LdM) volcanic field in central Chile has been moving upwards at rates >20 cm/yr since 2007 over a 200 km2 area. It has been hypothesized that this ground deformation is due to the inflation of a magma body at ~5 km depth beneath the lake (2.8 km b.s.l.). This magma body is a likely source for the large number of rhyolitic eruptions at this location over the last 25 ka. A dense broadband magnetotelluric (MT) array was collected from 2009 to 2015 and included data from a geothermal exploration project. MT phase tensor analysis indicates that the resistivity structure of the region is largely three-dimensional for signals with periods longer than 1 s, which corresponds to depths >5 km. The MT data were inverted using the ModEM inversion algorithm to produce a three-dimensional electrical resistivity model which included topography. Four primary features were identified in the model: 1) A north-south striking, 10 km by 5 km, low-resistivity zone (inflation centre at a depth of ~5 km (2.8 km b.s.l.) is interpreted as a zone of partial melt which may be supplying material via conduits to account for the observed ground deformation; 2) A shallow low-resistivity feature ~400 m beneath the lake surface (1.8 km a.s.l.) and spatially coincident with the inflation centre is interpreted to be a zone of hydrothermal alteration; 3) A thin, low-resistivity feature to the west of LdM at a depth of ~250 m (2.2 km a.s.l.) is interpreted to be the clay cap of a potential geothermal prospect; 4) A large, low-resistivity zone beneath the San Pedro-Tatara Volcanic Complex to the west of LdM at a depth of ~10 km (8 km b.s.l.) is interpreted to be a zone of partial melt. Further MT data collection is planned for 2016 which will expand the current grid of MT stations to better constrain the lateral extent of the observed features and give greater insight into the dynamics of this restless magma system.

  6. Postseismic deformation after Maule earthquake and the mechanical properties of the asthenosphere and subduction interface

    Klein, Emilie; Fleitout, Luce; Vigny, Christophe


    The interseismic and postseismic deformations preceding and following the large subduction earthquake of Maule (Chile, Mw8.8, 2010) have been closely monitored with GPS from 70 km up to 2000 km away from the trench. Post-seismic deformations exhibit a behavior generally similar to that already observed after the Aceh and Tohoku-Oki earthquakes: vertical uplift is observed on the oceanward side of the volcanic arc. A moderate large scale subsidence is associated with sizeable horizontal deformation in the far-field (500-2000km from the trench). In addition, near-field data (70-200km from the trench) feature a rather complex deformation pattern. A 3D FE code (Zebulon Zset) is used to relate these deformations to the mechanical properties of the mantle and of the subduction interface. The mesh features a spherical shell-portion from the core-mantle boundary to the Earth's surface, extending over more than 60 degrees in latitude and longitude. The overridding and subducting plates are elastic, and the asthenosphere is viscoelastic. We test the presence and shape of two low viscosity areas in the mantle : a low viscosity wedge (LVW) above the subducting plate extending beneath the volcanic arc, and a narrow low viscosity channel (LVCh) along the lower part of the subduction interface, and potentially deeper. All the viscoelastic regions feature a Burgers rheology and we invert for their mechanical properties and geometrical characteristics. Our best fitting models present, (i) an asthenosphere extending down to 270km, with a 'long-term' viscosity of the order of 3.1018Pa.s; (ii) a LVCh along the plate interface extending from depths of 50 to 150 km with viscosities slightly below 1018 Pa.s; (iii) a LVW restricted to the base of the lithosphere below the volcanic arc, with viscosities of a few 1018 Pa.s. Increased horizontal velocities are due to relaxation in both the asthenosphere and the LVCh. A deep channel is necessary to produce enough uplift in the middle

  7. Lithium chloride inhibits vascular smooth muscle cell proliferation and migration and alleviates injury-induced neointimal hyperplasia via induction of PGC-1α.

    Zhuyao Wang

    Full Text Available The proliferation and migration of vascular smooth muscle cells (VSMCs contributes importantly to the development of in-stent restenosis. Lithium has recently been shown to have beneficial effects on the cardiovascular system, but its actions in VSMCs and the direct molecular target responsible for its action remains unknown. On the other hand, PGC-1α is a transcriptional coactivator which negatively regulates the pathological activation of VSMCs. Therefore, the purpose of the present study is to determine if lithium chloride (LiCl retards VSMC proliferation and migration and if PGC-1α mediates the effects of lithium on VSMCs. We found that pretreatment of LiCl increased PGC-1α protein expression and nuclear translocation in a dose-dependent manner. MTT and EdU incorporation assays indicated that LiCl inhibited serum-induced VSMC proliferation. Similarly, deceleration of VSMC migration was confirmed by wound healing and transwell assays. LiCl also suppressed ROS generation and cell cycle progression. At the molecular level, LiCl reduced the protein expression levels or phosphorylation of key regulators involved in the cell cycle re-entry, adhesion, inflammation and motility. In addition, in vivo administration of LiCl alleviated the pathophysiological changes in balloon injury-induced neointima hyperplasia. More importantly, knockdown of PGC-1α by siRNA significantly attenuated the beneficial effects of LiCl on VSMCs both in vitro and in vivo. Taken together, our results suggest that LiCl has great potentials in the prevention and treatment of cardiovascular diseases related to VSMC abnormal proliferation and migration. In addition, PGC-1α may serve as a promising drug target to regulate cardiovascular physiological homeostasis.

  8. Genetic variation in the association of air pollutants with a biomarker of vascular injury in children and adolescents in Isfahan, Iran

    Parinaz Poursafa


    Full Text Available Background: Some experimental studies revealed that exposure to air pollution increases the expression of tissue factor (TF in atherosclerotic lesions. We aimed to investigate the role of TF +5466A>G (rs3917643 polymorphism in the association of air pollution on serum levels of TF as a biomarker of vascular injury in children. Methods: This cross-sectional study was conducted among 110 children, consisting of 58 (52.8% girls and 52 (47.2% boys with a mean age of 12.7 + 2.3 years, living in Isfahan, Iran. Enzyme-linked immunosorbent assay were used for measurement of serum TF. Genotype of +5466A>G (rs3917643 polymorphism was determined by the polymerase chain reaction-restriction length fragment polymorphism (PCR-RFLP method. Results: We identified 2 individuals with +5466AG genotype and 108 homozygous for the +5466A allele (no +5466GG homozygotes. The mean pollution standards index (PSI value was at moderate level, the mean particular matter measuring up to 10 μm (PM 10 was more than twice the normal level. Multiple linear regression analysis showed that after adjustment for confounding factors (weight status, dietary and physical activity pattern, serum TF level had significant relationship with PSI (beta: 0.55, SE: 0.07, p<0.000 and PM 10 (beta: 0.51, SE: 0.03, p=0.001. Conclusions: In spite of similar genetic polymorphism of TF, air pollutants might have an independent association with systemic inflammatory and coagulation responses. The harmful effects of air pollutants on the first stages of atherosclerosis in the pediatric age group should be underscored in primordial and primary prevention of chronic diseases.

  9. The epidemiology of schoolboy rugby injuries.

    Roux, C E; Goedeke, R; Visser, G R; van Zyl, W A; Noakes, T D


    During one 18-week season, in which players from 26 high schools played 3,350 rugby matches, 495 injuries prevented players from participating in rugby for at least 1 week; 71% occurred during matches and 29% during practices. Injury was more common during the first 4 weeks of the season and again in the same time period after the mid-season vacation. At all ages, A-team players suffered the greatest number of injuries. The safest playing positions were tight-forward and scrum-half; the most dangerous loose-forward and in the back-line excluding the scrum-half. Overall, eightmen were the most often injured players. Of all injuries 55% occurred while the player was tackling or being tackled and 18% during the loose scrum/maul. The lower limb (37%), the head and neck (29%) and the upper limb (20%) were most commonly injured, and fractures (27%), ligament/tendon injuries (25%) and muscle injuries (17%) were commonest. However, concussion injuries were underreported in 19 of the 26 schools. This study shows: that monitoring rugby injuries through correspondence results in underreporting of injuries; that rugby injuries show specific trends with age, team level, playing position, time of the season and phase of play; and that players in the different positions suffer specific injuries in predictable phases of the game. Speed of play may be the most important aetiological factor in the majority of rugby injuries.

  10. Plaguicidas organofosforados y efecto neuropsicológico y motor en la Región del Maule, Chile


    Objetivo: Evaluar la exposición a plaguicidas organofosforados y el desempeño neuropsicológico y motor de trabajadores/as agrícolas y no agrícolas de la Región del Maule, Chile. Método: Estudio transversal analítico con 93 trabajadores/as agrícolas expuestos/as a plaguicidas organofosforados y 84 trabajadores/as no agrícolas no expuestos/as. Se administró una batería de cuatro pruebas neuropsicológicas junto con un examen físico neuromotor. Resultados: Los/las trabajadores/as agrícolas ...

  11. Exposure to organophosphate (OP) pesticides and health conditions in agricultural and non-agricultural workers from Maule, Chile.

    Muñoz-Quezada, María Teresa; Lucero, Boris; Iglesias, Verónica; Levy, Karen; Muñoz, María Pía; Achú, Eduardo; Cornejo, Claudia; Concha, Carlos; Brito, Ana María; Villalobos, Marcos


    The objective was to evaluate the characteristics of exposure to OP pesticides and health status in Chilean farm workers from the Maule Region. An occupational health questionnaire was administered in 207 agricultural and non-agricultural workers. For the group of agricultural workers, we asked about specific occupational exposure history and symptoms of OP pesticide poisoning. The main health problem of the exposed group was previous OP pesticide poisoning (p < 0.001). Fifty-six percent of agricultural workers reported symptoms consistent with acute OP pesticide poisoning. The use of respiratory personal protective equipment and younger age were protective against these symptoms, and number of years of OP pesticide exposure was positively associated with reporting symptoms of poisoning. Of the pesticide applicators 47 % reported using chlorpyrifos. The regulations regarding use and application of pesticides should be strengthened, as should training and intervention with workers to improve the use of personal protective equipment.

  12. Laguna del Maule magma feeding system and construction of a shallow silicic magma reservoir

    Cáceres, Francisco; Castruccio, Ángelo; Parada, Miguel; Scheu, Bettina


    Laguna del Maule Volcanic Field is composed by at least 130 basaltic-to-rhyolitic eruptive vents that erupted more than 350 km3 of lavas and pyroclasts since Pleistocene in the Chilean Andes. It has captivated attention because of its current high accelerated uplift suggested to be formed by a growing shallow rhyolitic magma reservoir beneath the zone of deformation. Studying six Holocene post-glacial andesitic-to-rhyolitic lavas and one dome that partially overlap the ground-inflation zone, we determined the architecture and steps of construction of the magma feeding system that generated its post-glacial effusive volcanism. Further we suggest a possible origin for the rhyolitic magma that generated the ring of rhyolites encircling the lake and remain active causing the uplift. Mineral chemistry and textures suggest the same provenance of magma for the studied units, as well as complex magmatic history before eruptions. Similar temperatures, pressures, H2O and fO2 conditions for amphibole crystallisation in first stages indicate a common ˜17 km deep original reservoir that differentiated via in-situ crystallisation. The chemistry of the amphiboles present in all not-rhyolitic units shows trends that indicate a temperature domain on their crystallisation over other thermodynamic parameters such as pressure, water activity or chemistry of co-crystallising phases. All this supports a mush-like reservoir differentiating interstitial magma while crystallisation occurs. P-T conditions for amphibole crystallisation indicate that only amphiboles from rhyodacites show a non-adiabatic decompression that give rise to a polybaric and polythermal evolution trend from ˜450-200 MPa and ˜1030-900 ˚ C. In addition, unbuffered fO2 conditions were calculated for rhyodacite amphibole crystallisation upon cooling from melts with rather constant H2O contents. We propose that a large part of these rhyodacite amphiboles were formed during a non-adiabatic magma ascent similar to that

  13. Estimates of stress drop and crustal tectonic stress from the 27 February 2010 Maule, Chile, earthquake: Implications for fault strength

    Luttrell, Karen M.; Tong, Xiaopeng; Sandwell, David T.; Brooks, Benjamin A.; Bevis, Michael G.


    The great 27 February 2010 Mw 8.8 earthquake off the coast of southern Chile ruptured a ˜600 km length of subduction zone. In this paper, we make two independent estimates of shear stress in the crust in the region of the Chile earthquake. First, we use a coseismic slip model constrained by geodetic observations from interferometric synthetic aperture radar (InSAR) and GPS to derive a spatially variable estimate of the change in static shear stress along the ruptured fault. Second, we use a static force balance model to constrain the crustal shear stress required to simultaneously support observed fore-arc topography and the stress orientation indicated by the earthquake focal mechanism. This includes the derivation of a semianalytic solution for the stress field exerted by surface and Moho topography loading the crust. We find that the deviatoric stress exerted by topography is minimized in the limit when the crust is considered an incompressible elastic solid, with a Poisson ratio of 0.5, and is independent of Young's modulus. This places a strict lower bound on the critical stress state maintained by the crust supporting plastically deformed accretionary wedge topography. We estimate the coseismic shear stress change from the Maule event ranged from -6 MPa (stress increase) to 17 MPa (stress drop), with a maximum depth-averaged crustal shear-stress drop of 4 MPa. We separately estimate that the plate-driving forces acting in the region, regardless of their exact mechanism, must contribute at least 27 MPa trench-perpendicular compression and 15 MPa trench-parallel compression. This corresponds to a depth-averaged shear stress of at least 7 MPa. The comparable magnitude of these two independent shear stress estimates is consistent with the interpretation that the section of the megathrust fault ruptured in the Maule earthquake is weak, with the seismic cycle relieving much of the total sustained shear stress in the crust.

  14. [Effects of controlled-release N and K fertilizers on N, P, and K use efficiency of mauls (Manlus robusta)].

    Shao, Lei; Wang, Li-xia; Zhang, Min; Sun, Zhi-jun


    A pot experiment was conducted to study the effects of controlled-release N and K fertilizers on mauls seedlings growth, their P and K use efficiency, and the N balance in soil-plant system. The results showed that the nutrient release from controlled-release fertilizers accorded well with the nutrient requirement of mauls seedlings. Controlled-release N fertilizer significantly increased the K use efficiency, and controlled-release K fertilizer significantly increased the N use efficiency. Under the same K application rate, the plant height and stem diameter under the application of controlled-release N fertilizer (CN) and controlled-release N and K fertilizers (NK) had no significant difference, while those under the application of common fertilizer (SF) were all higher. The plant dry mass and the P and K use efficiency were in the order of NK>CN>SF. Under the application of NK, the application rate of K had no significant effects on the plant height and stem diameter, but significantly affected the plant dry mass. The P use efficiency increased with increasing application rate of controlled-release K fertilizer, but was less affected by application rate common K fertilizer. The K use efficiency decreased with increasing application rate of K. The N use efficiency was in the order of NK>CN>SF, while the N loss rate was in adverse. The residual rate of NK and CN had no significant difference, but was higher than that of SF. The application rate of controlled-release K fertilizer had significant effects on the N use efficiency and N loss rate, but no significant effects on N residual rate.

  15. Antibacterial Activity, Antioxidant Effect and Chemical Composition of Propolis from the Región del Maule, Central Chile

    Nélida Nina


    Full Text Available Propolis is commercialized in Chile as an antimicrobial agent. It is obtained mainly from central and southern Chile, but is used for the same purposes regardless of its origin. To compare the antimicrobial effect, the total phenolic (TP, the total flavonoid (TF content and the phenolic composition, 19 samples were collected in the main production centers in the Región del Maule, Chile. Samples were extracted with MeOH and assessed for antimicrobial activity against Gram (+ and Gram (− bacteria. TP and TF content, antioxidant activity by the DPPH, FRAP and TEAC methods were also determined. Sample composition was assessed by HPLD-DAD-ESI-MS/MS. Differential compounds in the samples were isolated and characterized. The antimicrobial effect of the samples showed MICs ranging from 31.5 to > 1000 µg/mL. Propolis from the central valley was more effective as antibacterial than those from the coastal area or Andean slopes. The samples considered of interest (MIC ≤ 62.5 µg/mL showed effect on Escherichia coli, Pseudomonas sp., Yersinia enterocolitica and Salmonella enteritidis. Two new diarylheptanoids, a diterpene, the flavonoids pinocembrin and chrysin were isolated and elucidated by spectroscopic and spectrometric means. Some 29 compounds were dereplicated by HPLC-MS and tentatively identified, including nine flavones/flavonol derivatives, one flavanone, eight dihydroflavonols and nine phenyl-propanoids. Propolis from the Región del Maule showed large variation in antimicrobial effect, antioxidant activity and composition. So far the presence of diarylheptanoids in samples from the coastal area of central Chile can be considered as a marker of a new type of propolis.

  16. Shear Wave Splitting Intensity of the Maule, Chile Rupture Zone: Results from Teleseismic and Local Aftershock Datasets

    Torpey, M. E.; Russo, R. M.; Chevrot, S.


    We calculated the shear wave splitting intensity (SI) of the Maule, Chile rupture zone (32°S-39°S) to constrain the seismic anisotropy of the region. Our data are from 80 of the temporary seismometers deployed as part of the IMAD (International Maule Aftershock Deployment) geophysical networks to capture the aftershocks of the Mw 8.8 megathrust event in 2010. We implemented the multichannel analysis method of Chevrot (2000) to measure the SI of 64 teleseismic SKS phases in addition to the fast orientations ϕ and splitting delays δt measured with the method of Silver & Chan (1991). To measure the SI of local aftershocks, we modified the method to allow for use of the upgoing S phase from local events in and above the Nazca slab after correcting for the initial event polarization. We compared our results with other measurement methods (Silver and Chan 1991, Wolfe and Silver 1998) that solve for splitting parameters to examine the robustness of the shear wave splitting intensity method, particularly for local datasets. The results we obtained using the splitting intensity method for the teleseismic data show an overall fast direction that is parallel to the absolute plate motion of the Nazca plate that is subducting beneath the South American plate. These results are consistent with the results we calculated using the Wolfe and Silver method. SI deriving from S waves that originate in the Nazca slab or deeper SA lithosphere are likely to reveal patterns of crustal fabric, and hence differ from the SI of the teleseismic shear waves.

  17. Vascular grafts made of expanded polytetrafluoroethylene for repair of peripheral arterial injuries%膨体聚四氟乙烯人工血管修复四肢干动脉缺损的效果

    张汉江; 王志维


    BACKGROUND:Vascular grafts made of expanded polytetrafluoroethylene have been shown to have highly hydrophobic surface characterized by resistance to water penetration and biological durability. OBJECTIVE:To investigate the effects of vascular grafts made of expanded polytetrafluoroethylene for repair of peripheral arterial injuries. METHODS:Thirty-eight patients with peripheral arterial injuries, consisting of 30 males and 8 females, aged 17-61 years, were included in this study. After conventional fluid infusion, anti-shock treatment, anti-inflammation, and debridement, they received implantation of vascular grafts made of expanded polytetrafluoroethylene. A 12-month folow-up observation was performed to investigate the recovery of affected limbs and vascular patency in patients. RESULTS AND CONCLUSION:After implantation of vascular grafts made of expanded polytetrafluoroethylene, al vessels were unblocked and no cases died or had limbs amputated. Blood supply of al affected limbs recovered to normal and there was no vascular anastomotic infection. Imaging results showed that vascular patency rate was 100%. Ultrasound examination results showed that at the end of the folow-up period, the inner wal of the vascular grafts was smooth, obvious mural thrombus or anastomotic stenosis did not occur in any case, vascular patency rate was 92% (35/38), and no adverse reactions related to artificial vessels were observed. These findings suggest that vascular grafts made of expanded polytetrafluoroethylene for repair of peripheral arterial injuries exhibit striking surface anticoagulant property and long-term patency.%背景:研究已证明膨体聚四氟乙烯人工血管具有良好的疏水性表面、抗水渗透性及生物耐久性。目的:观察膨体聚四氟乙烯人工血管移植修复创伤性四肢干动脉缺损的效果。方法:纳入38例创伤性四肢干动脉缺损患者,其中男30例,女8例,年龄17-61岁,予以常规补液、抗休克

  18. Vascular Diseases

    The vascular system is the body's network of blood vessels. It includes the arteries, veins and capillaries that carry ... to and from the heart. Problems of the vascular system are common and can be serious. Arteries ...

  19. Vascular Vertigo

    Mazyar Hashemilar; Masoud Nikanfar; Dariush Savadi Oskoui


    Vertigo is a common complaint in neurology and medicine. The most common causes of vertigo are benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, and vascular disorders. Vertigo of vascular origin is usually limited to migraine, transient ischemic attacks, and ischemic or hemorrhagic stroke. Vascular causes lead to various central or peripheral vestibular syndromes with vertigo. This review provides an overview of epidemiology and clinical syndromes of vascular vert...

  20. 大隐静脉曲张手术所致严重血管损伤的治疗%The management of severe vascular injuries caused by stripping of great saphenous vein varicosis

    程志华; 王宏飞; 陈光; 赵文光; 王嘉桔


    目的 总结大隐静脉曲张手术导致严重血管损伤并发症的治疗经验.方法 回顾性分析2004年12月至2009年4月收治的4例(5条肢体)大隐静脉曲张手术发生严重血管损伤患者的临床资料.对1条股总动脉末端至胫后动脉上段动脉被剥脱的肢体应用人工血管行动脉重建术,术后肢体坏疽行膝上截肢术;对3条股浅动脉被剥脱10~15 cm的肢体取自体大隐静脉行动脉重建术,术后5 d对1条坏死肢体行膝上截肢术.1条股浅静脉被切除2 cm的肢体取自体大隐静脉行股浅静脉重建术.结果 4例患者中,围手术期无死亡病例,4条动脉损伤肢体中2条肢体(50%)行膝上截肢术;2条肢体(50%)得到保伞,随访12~46个月,平均29个月,血管通畅良好.1例股浅静脉损伤患者恢复良好.结论 提高对医源性血管损伤的认识,术中规范操作,辨明解剖,可以减少和预防严重血管并发症的发生;一旦有血管损伤应早期而有效的处理.%Objective To summarize our experience on the treatment for severe vascular injuries in the operation of great saphenous varicose vein. Methods The clinical data of 4 cases (5 lower limbs) from December 2004 to April 2009 of severe vascular injuries were retrospectively analyzed. For the lower limbs in which from the end of femoral artery to the upper part of posterior tibial artery were stripped, reconstruction operation using blood vessel prothesis was performed, above knee amputation was performed because of limb gangrene. For three limbs in which 10 cm to 15 cm superficial femoral artery were stripped, reconstruction operation using autologous saphenous vein were performed, above knee amputation was performed for one limb 5 days after the operation. For the limb in which 2 cm superficial femoral vein were cut, reconstruction operation using autologous saphenous vein were performed. Results No cases died perioperatively,for four limbs of injuried artery, ampution were performed

  1. Vascular trauma in geriatric patients: a national trauma databank review.

    Konstantinidis, Agathoklis; Inaba, Kenji; Dubose, Joe; Barmparas, Galinos; Lam, Lydia; Plurad, David; Branco, Bernardino C; Demetriades, Demetrios


    The epidemiology of vascular injuries in the geriatric patient population has not been described. The purpose of this study was to examine nationwide data on vascular injuries in the geriatric patients and to compare this with the nongeriatric adult patients with respect to the incidence, injury mechanisms, and outcomes. Geriatric patients aged 65 or older with at least one traumatic vascular injury were compared with an adult cohort aged 16 years to 64 years with a vascular injury using the National Trauma Databank version 7.0. During the study period, 29,736 (1.6%) patients with a vascular injury were identified. Of those, geriatric patients accounted for 7.6% (2,268) and the nongeriatric adult patients accounted for 83.1% (n=24,703). Compared with the nongeriatric adult patients, the geriatric vascular patients had a significantly higher Injury Severity Score (26.6±17.0 vs. 21.3±16.7; pvascular injuries (adjusted odds ratio, 3.9; 95% confidence interval, 3.32-4.58; pVascular trauma is rare in the geriatric patient population. These injuries are predominantly blunt, with the thoracic aorta being the most commonly injured vessel. Although vascular injuries occur less frequently than in the nongeriatric cohort, in the geriatric patient, vascular injury is associated with a fourfold increase in adjusted mortality.

  2. Extremity-preserving efficacy of vascular prosthesis grafting in repairing arterial injuries of extremities%人造血管移植修复四肢血管损伤的保肢功效

    杜全印; 王爱民; 赵玉峰; 王子明; 郭庆山; 尹良军; 吴思宇; 唐颖


    背景:四肢血管损伤常伴血管缺损,常用自体血管移植修复,但存在来源有限和创伤等缺点.目的:回顾性分析29例人造血管移植修复四肢大血管损伤的保肢功效.设计:回顾性分析.单位:解放军第三军医大学大坪医院野战外科研究所全军战创伤中心骨创伤科.对象:选择解放军第三军医大学大坪医院野战外科研究所全军战创伤中心骨创伤科1989-01/2000-12采用人造血管移植修复四肢主要血管损伤患者29例.男23例,女6例.损伤部位:锁骨下动脉9例,腋动脉6例,肱动脉2例,股动脉10例,股静脉1例,腘动脉1例.合并休克11例,占37.9%.合并骨折、脱位8例,周围神经损伤5例,感染3例.方法:采用人造血管与修整后的血管行端端间断吻合.感染性动脉损伤3例在手术中采用旁路迂回感染区,人造血管经过非炎性区再桥接,肌瓣和肌皮瓣覆盖感染区的方法.术后2周及1年随访时采用肢体运动功能评定标准(MAS)评分方法评价肢体功能.主要观察指标:移植血管通畅率和保肢情况.结果:29例均进入结果分析.保肢功效:肢体全部保存住,其中1例由于肢体缺血时间长达12 h已出现神经损害,后期出现足底溃疡.术后2周Doppler血流探测移植血管通畅率100%,1年复查时通畅率96.5%,肢体功能评定优良率为89%.结论:采用人造血管移植修复四肢主要血管损伤是保住肢体及其功能的方法之一,其优势为术后短期评估血管通畅率及肢体功能优良率均较好.%BACKGROUND: Vascular injuries of the extremitiesy are frequently concomitant with vascular defects and are usually repaired by autologous vessel grafting. However, the source of autologous vessels is limited and the preparation of them is traumatic.OBJECTIVE: To retrospectively evaluate the extremity-preserving efficacy of vascular prosthesis grafting in repairing major vascular injuries of the extremities in 29 cases.DESIGN: A retrospective

  3. Low-energy extracorporeal shock wave therapy for promotion of vascular endothelial growth factor expression and angiogenesis and improvement of locomotor and sensory functions after spinal cord injury.

    Yahata, Kenichiro; Kanno, Haruo; Ozawa, Hiroshi; Yamaya, Seiji; Tateda, Satoshi; Ito, Kenta; Shimokawa, Hiroaki; Itoi, Eiji


    OBJECTIVE Extracorporeal shock wave therapy (ESWT) is widely used to treat various human diseases. Low-energy ESWT increases expression of vascular endothelial growth factor (VEGF) in cultured endothelial cells. The VEGF stimulates not only endothelial cells to promote angiogenesis but also neural cells to induce neuroprotective effects. A previous study by these authors demonstrated that low-energy ESWT promoted expression of VEGF in damaged neural tissue and improved locomotor function after spinal cord injury (SCI). However, the neuroprotective mechanisms in the injured spinal cord produced by low-energy ESWT are still unknown. In the present study, the authors investigated the cell specificity of VEGF expression in injured spinal cords and angiogenesis induced by low-energy ESWT. They also examined the neuroprotective effects of low-energy ESWT on cell death, axonal damage, and white matter sparing as well as the therapeutic effect for improvement of sensory function following SCI. METHODS Adult female Sprague-Dawley rats were divided into the SCI group (SCI only) and SCI-SW group (low-energy ESWT applied after SCI). Thoracic SCI was produced using a New York University Impactor. Low-energy ESWT was applied to the injured spinal cord 3 times a week for 3 weeks after SCI. Locomotor function was evaluated using the Basso, Beattie, and Bresnahan open-field locomotor score for 42 days after SCI. Mechanical and thermal allodynia in the hindpaw were evaluated for 42 days. Double staining for VEGF and various cell-type markers (NeuN, GFAP, and Olig2) was performed at Day 7; TUNEL staining was also performed at Day 7. Immunohistochemical staining for CD31, α-SMA, and 5-HT was performed on spinal cord sections taken 42 days after SCI. Luxol fast blue staining was performed at Day 42. RESULTS Low-energy ESWT significantly improved not only locomotion but also mechanical and thermal allodynia following SCI. In the double staining, expression of VEGF was observed in Neu

  4. Monocytes harboring cytomegalovirus: interactions with endothelial cells, smooth muscle cells, and oxidized low-density lipoprotein. Possible mechanisms for activating virus delivered by monocytes to sites of vascular injury.

    Guetta, E; Guetta, V; Shibutani, T; Epstein, S E


    Cytomegalovirus (CMV) infection and its periodic reactivation from latency may contribute to atherogenesis and restenosis. It is unknown how CMV is delivered to the vessel wall and is reactivated. We examined the following hypothesis: CMV, present in monocytes recruited to sites of vascular injury, is activated by endothelial cell (EC) or smooth muscle cell (SMC) contact and by oxidized low-density lipoproteins (oxLDLs). The CMV major immediate-early promoter (MIEP) controls immediate-early (IE) gene expression, and thereby viral replication. To determine whether elements of the vessel wall can activate CMV present in monocytes, we transiently transfected the promonocytic cell line HL-60 with a chloramphenicol acetyltransferase reporter gene construct driven by MIEP. MIEP activity increased 1.7 +/- 0.5-fold (P = .02) when the transfected HL-60 cells were cocultured with ECs, 4.5 +/- 1.5-fold when cocultured with SMCs (P = .03), and 2.0 +/- 0.5-fold (P = .01) when exposed to oxLDL. The combination of oxLDL and EC coculture increased MIEP activity over 7-fold. We also found that freshly isolated human monocytes, infected with endothelium-passaged CMV, were capable of transmitting infectious virus to cocultured ECs or SMCs. CMV-related progression of atherosclerosis or restenosis may, at least in part, involve monocyte delivery of the virus to the site of vascular injury, where the vascular milieu, ie, contact with ECs, SMCs, and oxLDL, can contribute to viral reactivation and/or replication by enhancing CMV IE gene expression. The virus may then infect neighboring ECs or SMCs, initiating a cascade of events predisposing to the development of atherogenesis-related processes.

  5. From hyper-extended rifts to orogens: the example of the Mauléon rift basin in the Western Pyrenees (SW France)

    Masini, E.; Manatschal, G.; Tugend, J.


    An integral part of plate tectonic theory is that the fate of rifted margins is to be accreted into mountain belts. Thus, rift-related inheritance is an essential parameter controlling the evolution and architecture of collisional orogens. Although this link is well accepted, rift inheritance is often ignored. The Pyrenees, located along the Iberian and European plate boundary, can be considered as one of the best places to study the reactivation of former rift structures. In this orogen the Late Cretaceous and Tertiary convergence overprints a Late Jurassic to Lower Cretaceous complex intracontinental rift system related to the opening of the North Atlantic. During the rifting, several strongly subsiding basins developed in the axis of the Pyrenees showing evidence of extreme crustal extension and even locale mantle exhumation to the seafloor. Although the exact age and kinematics of rifting is still debated, these structures have an important impact in the subsequent orogenic overprint. In our presentation we discuss the example of the Mauléon basin, which escaped from the most pervasive deformations because of its specific location at the interface between the western termination of the chain and the Bay of Biscay oceanic realm. Detailed mapping combined with seismic reflection, gravity data and industry wells enabled to determine the 3D rift architecture of the Mauléon basin. Two major diachronous detachment systems can be mapped and followed through space. The Southern Mauléon Detachment (SMD) develops first, starts to thin the crust and floors the Southern Mauléon sub-Basin (SMB). The second, the Northern Mauléon Detachment (SMD) is younger and controls the final crustal thinning and mantle exhumation to the north. Both constitute the whole Mauléon basin. Like at the scale of the overall Pyrenees, the reactivation of the Mauléon Basin increases progressively from west to east, which enables to document the progressive reactivation of an aborted hyper

  6. What Is Vascular Disease?

    ... Donors Corporate Sponsors Donor Privacy Policy What Is Vascular Disease? What Is Vascular Disease? Vascular disease is any abnormal condition of ... steps to prevent vascular disease here. Understanding the Vascular System Your vascular system – the highways of the ...

  7. Shoulder injuries in rugby players: mechanisms, examination, and rehabilitation.

    Helgeson, Kevin; Stoneman, Paul


    The sport of rugby is growing in popularity for players at the high school and collegiate levels. This article will provided the sports therapist with an introduction to the management of shoulder injuries in rugby players. Rugby matches results in frequent impacts and leveraging forces to the shoulder region during the tackling, scrums, rucks and maul components of the game. Rugby players frequently sustain contusion and impact injuries to the shoulder region, including injuries to the sternoclavicular, acromioclavicular (AC), and glenohumeral (GH) joints. Players assessed during practices and matches should be screened for signs of fracture, cervical spine and brachial plexus injuries. A three phase program will be proposed to rehabilitate players with shoulder instabilities using rugby specific stabilization, proprioception, and strengthening exercises. A plan for return to play will be addressed including position-specific activities. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Pediatric vs adult vascular trauma: a National Trauma Databank review.

    Barmparas, Galinos; Inaba, Kenji; Talving, Peep; David, Jean-Stephane; Lam, Lydia; Plurad, David; Green, Donald; Demetriades, Demetrios


    The purpose of this study was to examine nationwide data on vascular injuries in children and to compare pediatric and adult patients with respect to the incidence, injury mechanisms, and outcomes. This is a National Trauma Databank analysis based on dataset version 7.0 (spanning a 5-year period ending December 2006). Pediatric patients under the age of 16 with at least one reported diagnosis of a vascular injury were compared to the adult cohort aged 16 and greater with a vascular injury. During the study period, of 251,787 injured patients younger than 16 years, 1138 (0.6%) had a vascular injury. The incidence in patients 16 years or older was significantly higher, at 1.6% (P vascular patients, pediatric patients had a significantly lower Injury Severity Score (16.8 +/- 14.9 vs 26.3 +/- 16.7, P vascular injuries (adjusted odds ratio, 0.60; 95% CI, 0.45-0.79; P vascular injuries. Vascular trauma in the pediatric population is uncommon, occurring in only 0.6% of all pediatric trauma patients. Although less frequent than adults, a significant proportion was due to penetrating injury. Vessels of the upper extremity were the most commonly injured and were associated with low mortality. Injuries of the thoracic aorta are rare. Overall, pediatric patients had an improved adjusted mortality when compared to adults. Copyright 2010 Elsevier Inc. All rights reserved.

  9. [Vascular dementia

    Leeuw, H.F. de; Gijn, J. van


    Vascular dementia is one of the most frequently occurring dementia syndromes. Its prevalence is about 5% among subjects above 85 years of age. Elevated blood pressure and atherosclerosis are the most important risk factors. According to international criteria, vascular dementia usually occurs within

  10. Vascular rings.

    Backer, Carl L; Mongé, Michael C; Popescu, Andrada R; Eltayeb, Osama M; Rastatter, Jeffrey C; Rigsby, Cynthia K


    The term vascular ring refers to congenital vascular anomalies of the aortic arch system that compress the esophagus and trachea, causing symptoms related to those two structures. The most common vascular rings are double aortic arch and right aortic arch with left ligamentum. Pulmonary artery sling is rare and these patients need to be carefully evaluated for frequently associated tracheal stenosis. Another cause of tracheal compression occurring only in infants is the innominate artery compression syndrome. In the current era, the diagnosis of a vascular ring is best established by CT imaging that can accurately delineate the anatomy of the vascular ring and associated tracheal pathology. For patients with a right aortic arch there recently has been an increased recognition of a structure called a Kommerell diverticulum which may require resection and transfer of the left subclavian artery to the left carotid artery. A very rare vascular ring is the circumflex aorta that is now treated with the aortic uncrossing operation. Patients with vascular rings should all have an echocardiogram because of the incidence of associated congenital heart disease. We also recommend bronchoscopy to assess for additional tracheal pathology and provide an assessment of the degree of tracheomalacia and bronchomalacia. The outcomes of surgical intervention are excellent and most patients have complete resolution of symptoms over a period of time. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Caracterización y monitoreo de paisaje semiárida en la Región del Maule mediante datos satelitales Characterization and monitoring of semi-arid landscape in the Maule region from satellite data

    Carlos M. Frau


    Full Text Available El objetivo del trabajo es aplicar la técnica Rotación Radiométrica Controlada por Eje de No-cambio (RCEN en imágenes Landsat TM de los años 2004 y 2008, para la región semi-árida del Maule, Chile. Esta aplicación tiene el fin de obtener la distribución espacial de los cambios del paisaje forestal. El procedimiento de RCEN permite el uso de imágenes sin corrección atmosférica, combinado a un método empírico para seccionar y legendar la imagen de cambio basado en las observaciones de campo. El índice Kappa para la imagen temática del cambio fue 0.74 indicando que, durante el período considerado por la detección, los porcentajes de recuperación y la degradación la vegetación fueron 17 y 5% respectivamente. Datos altimétricos de SRTM (Shuttle Radar Topography Mission fueron utilizados para obtener la pendiente y la distribución de las clases de cambios en relación a esta. La mayor parte de la superficie de la clase no-cambio está localizada en altas y bajas declividades. En la categoría de recuperación de la vegetación, la mayor proporción tiene lugar en el rango de declividad 10 a 50%. Por otra parte, la pérdida de vegetación es uniformemente distribuida en todos los gradientes de declividad.The objective of this research is to apply the Radiometric Rotation Controlled by No-change Axis (RCNA technique on Landsat TM images, 2004 and 2008, covering the coastal dry land of the Region of Maule, Chile, in order to obtain the spatial distribution of changes and degradation in the forest landscape. The RCNA procedure allows the use of images without atmospheric calibrations, whose empirical method for the label was based on field observations. The Kappa Index for the change thematic image was 0.74, showing that the recovery and loss of vegetation were 17 and 5%, respectively. SRTM (Shuttle Radar Topography Mission data were used to derive slope angle, where the major proportion of no-change surface occurs in areas of high

  12. Evaluation of emergency revascularisation in vascular trauma.

    Khan, Mohammad Iqbal; Khan, Najam; Abbasi, Shafquat Ali; Baqai, Mohammad Tariq; ur Rehman, Bashir; Wayne, Abdul


    Vascular trauma is a common life threatening injury leading to serious consequences if not timely and efficiently managed. We evaluated early surgical interventions aimed at revascularization and thus salvaging limb/organ in life threatening vascular injuries. Aims of our study were to evaluate the outcome of available diagnostic modalities, earliest possible surgical intervention and rate of related complications with particular reference to our existing situation. Emergency diagnostic workup based mainly on clinical evaluations and required laboratory and imaging parameters leading to revascularisation was performed in 48 patients in Combined Military Hospital (CMH) Muzaffarabad and Islamic Medical College Hospitals between June 1997 and December 2001. Data was collected on pre-designed computerized proforma's which were completed by the treating surgeon and data was entered and analyzed accordingly. Out of the total 48 patients who sustained major vascular injuries during this period, 14 (29.2%) were having injury to upper limb vessels, 26 (54.2%) patients had injury to the lower limb vessels, 6 (12.5%) patients reported with injury to abdominal vessels. One (2%) patient had injury to common carotid artery, while an other patient to thoracic aorta respectively (2%). Penetrating trauma caused 38 (79%) and blunt trauma caused 10 (21%) major vascular injuries. Out of 48 patients, 41 (85.4%) patients were successful managed by vascular reconstruction without any residual disability. Speedy diagnostic work up and early revascularization yields favourable outcome in vast majority of patients requiring vascular repair. Selections of surgical technique including use of autologous vein graft or artificial vascular graft can save many limbs. In order to achieve good results the time lapse between injury and revascularisation should be less than 6 hours.

  13. Distinctive effects of CD34- and CD133-specific antibody-coated stents on re-endothelialization and in-stent restenosis at the early phase of vascular injury

    Wu, Xue; Yin, Tieying; Tian, Jie;


    It is not clear what effects of CD34- and CD133-specific antibody-coated stents have on re-endothelialization and in-stent restenosis (ISR) at the early phase of vascular injury. This study aims at determining the capabilities of different coatings on stents (e.g. gelatin, anti-CD133 and anti-CD34......-coated stents, the time of cells adhesion was longer and earlier present in the anti-CD133 antibody-coated stents and anti-CD133 antibody-coated stents have superiority in re-endothelialization and inhibition of ISR. In conclusion, this study demonstrated that anti-CD133 antibody as a stent coating...... for capturing EPCs is better than anti-CD34 antibody in promoting endothelialization and reducing ISR....

  14. Distinctive effects of CD34- and CD133-specific antibody-coated stents on re-endothelialization and in-stent restenosis at the early phase of vascular injury

    Wu, Xue; Yin, Tieying; Tian, Jie


    It is not clear what effects of CD34- and CD133-specific antibody-coated stents have on re-endothelialization and in-stent restenosis (ISR) at the early phase of vascular injury. This study aims at determining the capabilities of different coatings on stents (e.g. gelatin, anti-CD133 and anti-CD34...... experiment using a rabbit model in which the coated stents with different substrates were implanted showed that anti-CD34 and anti-CD133 antibody-coated stents markedly reduced the intima area and restenosis than bare mental stents (BMS) and gelatin-coated stents. Compared with the anti-CD34 antibody...

  15. Vascular Dementia

    ... that includes enjoyable activities well within the comfort zone of the person with vascular dementia. New situations, ... your cholesterol in check. A healthy, low-fat diet and cholesterol-lowering medications if you need them ...

  16. vascular hemiplegia

    Voto Bernales, Jorge; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú


    The vascular hemiplegia is the functional disorder of a lateral half of the body produced by alterations of cerebral vessels. Should review the concepts of this common condition, with the dual aim of expanding its nosographic value and considering the hemiplegic patient as worthy of the highest professional care La hemiplejia vascular, es el trastorno funcional de una mitad lateral del cuerpo producido por alteraciones de los vasos cerebrales. Conviene revisar los conceptos sobre esta frec...

  17. vascular hemiplegia

    Voto Bernales, Jorge; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú


    The vascular hemiplegia is the functional disorder of a lateral half of the body produced by alterations of cerebral vessels. Should review the concepts of this common condition, with the dual aim of expanding its nosographic value and considering the hemiplegic patient as worthy of the highest professional care La hemiplejia vascular, es el trastorno funcional de una mitad lateral del cuerpo producido por alteraciones de los vasos cerebrales. Conviene revisar los conceptos sobre esta frec...

  18. On the spatial correlation between areas of high coseismic slip and aftershock clusters of the Maule earthquake Mw=8.8

    Contreras-Reyes, Javier E


    We study the spatial distribution of clusters associated to the aftershocks of the megathrust Maule earthquake MW 8.8 of 27 February 2010. We used a recent clustering method which hinges on a nonparametric estimation of the underlying probability density function to detect subsets of points forming clusters associated to high density areas. In addition, we estimate the probability density function using a nonparametric kernel method for each of these clusters. This allow us to identify a set of regions where there is an association between frequency of events and pre-seismic locking. Specifically, our results suggest that high coseismic slip spatially correlates with high aftershock frequency.




    El objetivo principal de esta tesis es la propuesta de una estrategia de gestión tecnológica para la pequeña y mediana empresa en la industria procesadora de madera en la región del maule; en la oportunidad de convertir sus ventajas comparativas contenidas en el conocimiento único del productor y demás factores identificados, en una ventaja competitiva que le sirva de oportunidad para incursionar en mercados interesados en un producto o servicio innovador. El sector forestal en la región d...

  20. Fault zone controlled seafloor methane seepage in the rupture area of the 2010 Maule earthquake, Central Chile

    Geersen, Jacob; Scholz, Florian; Linke, Peter; Schmidt, Mark; Lange, Dietrich; Behrmann, Jan H.; Völker, David; Hensen, Christian


    Seafloor seepage of hydrocarbon-bearing fluids has been identified in a number of marine fore arcs. However, temporal variations in seep activity and the structural and tectonic parameters that control the seepage often remain poorly constrained. Subduction zone earthquakes, for example, are often discussed to trigger seafloor seepage but causal links that go beyond theoretical considerations have not yet been fully established. This is mainly due to the inaccessibility of offshore epicentral areas, the infrequent occurrence of large earthquakes, and challenges associated with offshore monitoring of seepage over large areas and sufficient time periods. Here we report visual, geochemical, geophysical, and modeling results and observations from the Concepción Methane Seep Area (offshore Central Chile) located in the rupture area of the 2010 Mw. 8.8 Maule earthquake. High methane concentrations in the oceanic water column and a shallow subbottom depth of sulfate penetration indicate active methane seepage. The stable carbon isotope signature of the methane and hydrocarbon composition of the released gas indicate a mixture of shallow-sourced biogenic gas and a deeper sourced thermogenic component. Pristine fissures and fractures observed at the seafloor together with seismically imaged large faults in the marine fore arc may represent effective pathways for methane migration. Upper plate fault activity with hydraulic fracturing and dilation is in line with increased normal Coulomb stress during large plate-boundary earthquakes, as exemplarily modeled for the 2010 earthquake. On a global perspective our results point out the possible role of recurring large subduction zone earthquakes in driving hydrocarbon seepage from marine fore arcs over long timescales.

  1. Preliminary Seismic Velocity Structure Results from Ambient Noise and Teleseismic Tomography: Laguna del Maule Volcanic Field, Chile

    Wespestad, C.; Thurber, C. H.; Zeng, X.; Bennington, N. L.; Cardona, C.; Singer, B. S.


    Laguna del Maule Volcanic Field is a large, restless, rhyolitic system in the Southern Andes that is being heavily studied through several methods, including seismology, by a collaborative team of research institutions. A temporary array of 52 seismometers from OVDAS (the Southern Andean Volcano Observatory), PASSCAL (Portable Array Seismic Studies of the Continental Lithosphere), and the University of Wisconsin-Madison was used to collect the 1.3 years worth of data for this preliminary study. Ambient noise tomography uses surface wave dispersion data obtained from noise correlation functions (NCFs) between pairs of seismic stations, with one of each pair acting as a virtual source, in order to image the velocity structure in 3-D. NCFs were computed for hour-long time windows, and the final NCFs were obtained with phase-weighted stacking. The Frequency-Time Analysis technique was then utilized to measure group velocity between station pairs. NCFs were also analyzed to detect temporal changes in seismic velocity related to magmatic activity at the volcano. With the surface wave data from ambient noise, our small array aperture limits our modeling to the upper crust, so we employed teleseismic tomography to study deeper structures. For picking teleseismic arrivals, we tested two different correlation and stacking programs, which utilize adaptive stacking and multi-channel cross-correlation, to get relative arrival time data for a set of high quality events. Selected earthquakes were larger than magnitude 5 and between 30 and 95 degrees away from the center of the array. Stations that consistently show late arrivals may have a low velocity body beneath them, more clearly visualized via a 3-D tomographic model. Initial results from the two tomography methods indicate the presence of low-velocity zones at several depths. Better resolved velocity models will be developed as more data are acquired.

  2. Diosmin alleviates retinal edema by protecting the blood-retinal barrier and reducing retinal vascular permeability during ischemia/reperfusion injury.

    Nianting Tong

    Full Text Available BACKGROUND AND PURPOSE: Retinal swelling, leading to irreversible visual impairment, is an important early complication in retinal ischemia/reperfusion (I/R injury. Diosmin, a naturally occurring flavonoid glycoside, has been shown to have antioxidative and anti-inflammatory effects against I/R injury. The present study was performed to evaluate the retinal microvascular protective effect of diosmin in a model of I/R injury. METHODS: Unilateral retinal I/R was induced by increasing intraocular pressure to 110 mm Hg for 60 min followed by reperfusion. Diosmin (100 mg/kg or vehicle solution was administered intragastrically 30 min before the onset of ischemia and then daily after I/R injury until the animals were sacrificed. Rats were evaluated for retinal functional injury by electroretinogram (ERG just before sacrifice. Retinas were harvested for HE staining, immunohistochemistry assay, ELISA, and western blotting analysis. Evans blue (EB extravasation was determined to assess blood-retinal barrier (BRB disruption and the structure of tight junctions (TJ was examined by transmission electron microscopy. RESULTS: Diosmin significantly ameliorated the reduction of b-wave, a-wave, and b/a ratio in ERG, alleviated retinal edema, protected the TJ structure, and reduced EB extravasation. All of these effects of diosmin were associated with increased zonular occluden-1 (ZO-1 and occludin protein expression and decreased VEGF/PEDF ratio. CONCLUSIONS: Maintenance of TJ integrity and reduced permeability of capillaries as well as improvements in retinal edema were observed with diosmin treatment, which may contribute to preservation of retinal function. This protective effect of diosmin may be at least partly attributed to its ability to regulate the VEGF/PEDF ratio.

  3. Rugby injuries to the cervical spine and spinal cord: a 10-year review.

    Scher, A T


    A 10-year review (1987-1996) of injuries sustained to the spine and spinal cord in rugby players with resultant paralysis has been undertaken. This article reviews that the incidence of serious rugby spine and spinal cord injuries in South Africa has increased over the 10-year period reviewed, despite stringent new rules instituted in an attempt to decrease the incidence of these injuries. The mechanisms of injury, as previously reported, remain the same as well as the phases of game responsible for injury of the tight scrum, tackle, rucks, and mauls. Two new observations are reported: the first is related to the occurrence of spinal cord concussion with transient paralysis, and the second is related to the increased incidence of osteoarthritis of the cervical spine in rugby players.

  4. Crustal deformation and magmatic processes at Laguna del Maule volcanic field (Chile): Geodetic measurements and numerical models

    Le Mével, Hélène

    The Laguna del Maule (LdM) volcanic field in Chile is an exceptional example of postglacial rhyolitic volcanism in the Southern Volcanic Zone of the Andes. Since 2007, LdM has experienced an unrest episode characterized by high rates of deformation measured by interferometric analysis of synthetic aperture radar (SAR) images acquired between 2007 and 2016, and data from the Global Positioning System (GPS) recorded since 2012 at five stations. The inflating region includes most of the 16--km-by--14--km ring of rhyolitic domes and coulees. The fastest-moving GPS station (MAU2) has a velocity vector of [[special character omited]72 +/- 4, 19 +/- 1, 194 +/- 3] mm/yr between 2012 and 2016 for the eastward, northward, and upward components, respectively. First, we model the InSAR observations assuming a rectangular dislocation in a half space with uniform elastic properties. The best time function for modeling the InSAR data set is a double exponential model with rates increasing from 2007 through 2010 and decreasing slowly since 2011. Modeling of historical uplift at Yellowstone, Long Valley, and Three Sisters volcanic fields suggests a common temporal evolution of vertical displacement rates. We hypothesize that magma intruding into an existing silicic magma reservoir is driving the surface deformation and present a new dynamic model to describe this process. A Newtonian fluid characterized by its viscosity, density, and pressure flows through a vertical conduit, intruding into a reservoir embedded in an elastic domain and leading to time-dependent surface deformation. Using a grid-search optimization, we minimize the misfit to the InSAR displacement data by varying the three parameters governing the analytical solution: the characteristic timescale tauP for magma propagation, the injection pressure, and the inflection time when the acceleration switches from positive to negative. For a spheroid with semi-major axis a = 6200 m, semi-minor axis c = 100 m, located at a

  5. 3D gravity inversion and thermodynamic modelling reveal properties of shallow silicic magma reservoir beneath Laguna del Maule, Chile

    Miller, Craig A.; Williams-Jones, Glyn; Fournier, Dominique; Witter, Jeff


    Active, large volume, silicic magma systems are potentially the most hazardous form of volcanism on Earth. Knowledge of the location, size, and physical properties of silicic magma reservoirs, is therefore important for providing context in which to accurately interpret monitoring data and make informed hazard assessments. Accordingly, we present the first geophysical image of the Laguna del Maule volcanic field magmatic system, using a novel 3D inversion of gravity data constrained by thermodynamic modelling. The joint analysis of gravity and thermodynamic data allows for a rich interpretation of the magma system, and highlights the importance of considering the full thermodynamic effects on melt density, when interpreting gravity models of active magmatic systems. We image a 30 km3, low density, volatile rich magma reservoir, at around 2 km depth, containing at least 85% melt, hosted within a broader 115 km3 body interpreted as wholly or partially crystallised (>70% crystal) cumulate mush. Our model suggests a magmatic system with shallow, crystal poor magma, overlying deeper, crystal rich magma. Even though a large density contrast (-600 kg/m3) with the surrounding crust exists, the lithostatic load is 50% greater than the magma buoyancy force, suggesting buoyancy alone is insufficient to trigger an eruption. The reservoir is adjacent to the inferred extension of the Troncoso fault and overlies the location of an intruding sill, driving present day deformation. The reservoir is in close proximity to the 2.0 km3 Nieblas (rln) eruption at 2-3 ka, which we calculate tapped approximately 7% of the magma reservoir. However, we suggest that the present day magma system is not large enough to have fed all post-glacial eruptions, and that the location, or size of the system may have migrated or varied over time, with each eruption tapping only a small aliquot of the available magma. The presence of a shallow reservoir of volatile rich, near liquidus magma, in close

  6. Deep Tectonic Tremor in Haiti triggered by the 2010/02/27 Mw8.8 Maule, Chile earthquake

    Aiken, C.; Peng, Z.; Douilly, R.; Calais, E.; Deschamps, A.; Haase, J. S.


    Tectonic tremors have been observed along major plate-boundary faults around the world. In most of these regions, tremors occur spontaneously (i.e. ambient) or as a result of small stress perturbations from passing surface waves (i.e. triggered). Because tremors are located below the seismogenic zone, a detailed study of their behavior could help to better understand how tectonic movement is accommodated in the deep root of major faults, and the relationship with large earthquakes. Here, we present evidence of triggered tremor in southern Haiti around the aftershock zone of the 2010/01/12 Mw7.0 Haiti earthquake. Following the January mainshock, several groups have installed land and ocean bottom seismometers to record aftershock activity (e.g., De Lepinay et al., 2011). In the following month, the 2010/02/27 Mw8.8 Maule, Chile earthquake occurred and was recorded in the southern Haiti region by these seismic stations. We apply a 5-15 Hz band-pass filter to all seismograms to identify local high-frequency signals during the Chile teleseismic waves. Tremor is identified as non-impulsive bursts with 10-20 s durations that is coherent among different stations and is modulated by surface waves. We also convert the seismic data into audible sounds and use them to distinguish between local aftershocks and deep tremor. We locate the source of the tremor bursts using an envelope cross-correlation method based on travel time differences. Because tremor depth is not well constrained with this method, we set it to 20 km, close to the recent estimate of Moho depth in this region (McNamara et al., 2012). Most tremors are located south of the surface expression of the Enriquillo-Plantain Garden Fault (EPGF), a high-angle southward dipping left-lateral strike-slip fault that marks the boundary between the Gonave microplate and the Caribbean plate, although the location errors are large. Tremor peaks are mostly modulated by Love wave velocity, which is consistent with left

  7. Aftershock mechanisms from the 2010 Mw 8.8 Maule, Chile earthquake: detailed analysis using full waveform inversion

    Rietbrock, A.; Hicks, S. P.; Chagas, B.; Detzel, H. A.


    Since the earthquake rupture process is extremely heterogeneous, it is vital to understand how structural variations in the overriding plate and downgoing slab may control slip style along the subduction megathrust. The large-scale 3-D geometry of subduction plate boundaries is rapidly becoming well understood; however, the nature of any finer-scale structure along the plate interface remains elusive. A detailed study of earthquake source mechanisms along a megathrust region can shed light on the nature of fine-scale structures along the megathrust. The Mw 8.8 Maule earthquake that struck central Chile in 2010 is the sixth largest earthquake ever recorded. Following the earthquake, there was an international deployment of seismic stations in the rupture area, making this one of the best datasets of an aftershock sequence following a large earthquake. This dataset provides a unique opportunity to perform a detailed study of megathrust earthquake source mechanisms. Based on a high-resolution 3-D velocity model and robust earthquake locations [Hicks et al., 2014], we calculate regional moment tensors using the ISOLA software package [Sokos & Zahradnik, 2008]. We incorporate accelerometer recordings, important for constraining solutions of large earthquakes in the overriding plate. We also validate the robustness of our solutions by assessing the consistency of mechanisms with P-wave polarities observed at both onshore and offshore seismic stations, and compare them to already published solutions. We find that accurate earthquake locations are vital for the fine-scale interpretation of focal mechanisms, particularly for offshore events. Our results show that most moment tensor solutions with thrusting mechanisms have a nodal plane dipping parallel to the subducting plate interface. Interestingly, we also find earthquakes with normal faulting mechanisms lying along to the megathrust plate interface in the south of the rupture area. This finding suggests that megathrust

  8. Rapid uplift in Laguna del Maule volcanic field of the Andean Southern Volcanic zone (Chile) 2007-2012

    Feigl, Kurt L.; Le Mével, Hélène; Tabrez Ali, S.; Córdova, Loreto; Andersen, Nathan L.; DeMets, Charles; Singer, Bradley S.


    The Laguna del Maule (LdM) volcanic field in Chile is an exceptional example of postglacial rhyolitic volcanism in the Southern Volcanic Zone of the Andes. By interferometric analysis of synthetic aperture radar (SAR) images acquired between 2007 and 2012, we measure exceptionally rapid deformation. The maximum vertical velocity exceeds 280 mm yr-1. Although the rate of deformation was negligible from 2003 January to 2004 February, it accelerated some time before 2007 January. Statistical testing rejects, with 95 per cent confidence, four hypotheses of artefacts caused by tropospheric gradients, ionospheric effects, orbital errors or topographic relief, respectively. The high rate of deformation is confirmed by daily estimates of position during several months in 2012, as measured by analysis of signals transmitted by the Global Positioning System (GPS) and received on the ground at three stations around the reservoir forming the LdM. The fastest-moving GPS station (MAU2) has a velocity vector of [-180 ± 4, 46 ± 2, 280 ± 4] mm yr-1 for the northward, eastward and upward components, respectively, with respect to the stable interior of the South America Plate. The observed deformation cannot be explained by changes in the gravitational load caused by variations in the water level in the reservoir. For the most recent observation time interval, spanning 44 d in early 2012, the model that best fits the InSAR observations involves an inflating sill at a depth of 5.2 ± 0.3 km, with length 9.0 ± 0.3 km, width 5.3 ± 0.4 km, dip 20 ± 3° from horizontal and strike 14 ± 5° clockwise from north, assuming a rectangular dislocation in a half-space with uniform elastic properties. During this time interval, the estimated rate of tensile opening is 1.1 ± 0.04 m yr-1, such that the rate of volume increase in the modelled sill is 51 ± 5 million m3 yr-1 or 1.6 ± 0.2 m3 s-1. From 2004 January to 2012 April the total increase in volume was at least 0.15 km3 over the 5.2-yr

  9. Vascular emergencies.

    Semashko, D C


    This article reviews the initial assessment and emergent management of several common as well as uncommon vascular emergencies. Aortic dissection, aneurysms, and arterial occlusive disease are familiar but challenging clinical entities. Less frequently encountered conditions are also discussed including an aortic enteric fistula, mesenteric venous thrombosis, phlegmasia alba dolens, and subclavian vein thrombosis.

  10. Vascular Disease Foundation

    ... Contact Us Vascular Disease What is Vascular Disease? Education and Awareness Vascular Diseases Abdominal Aortic Aneurysm Aortic Dissection Arteriovenous Malformation Atherosclerosis Buerger's Disease Carotid Artery Disease ...

  11. What Is Vascular Disease?

    ... Contact Us Vascular Disease What is Vascular Disease? Education and Awareness Vascular Diseases Abdominal Aortic Aneurysm Aortic Dissection Arteriovenous Malformation Atherosclerosis Buerger's Disease Carotid Artery Disease ...


    朱庆棠; 向剑平; 刘小林; 郑灿镔; 戚剑; 顾立强; 傅国; 秦本刚; 王东; 李平; 李智勇


    目的 报告临时血管转流术(temporary intravascular shunts,TIVS)用于快速重建肢体血供的初步体会. 方法 2009年8月-2011年3月,对6例8条肢体大血管因外伤(4例5条)或肿瘤切除(2例3条)需行血管移植且预期肢体缺血时间较长者,术中采用TIVS重建肢体远端血供,转流方式包括颈外动脉-锁骨下动脉、腋动脉-腋动脉、腋静脉-锁骨下静脉、肱动脉-肱动脉、肱静脉-肱静脉、肱动脉-桡动脉、股动脉-腘动脉、腘动脉-胫后动脉.然后行彻底清创、骨折复位固定或肿瘤切除,再移除转流管,其中6条血管取自体大隐静脉移植重建,1条血管直接无张力吻合,1条血管采用人造血管移植修复. 结果 患者均成功置入转流管,建立血管转流时间为5~10 min,平均8.2 min;转流时间67~210 min.建立转流后,肢体远端血循环改善.移除转流管时,除1条转流管内有血栓形成、部分堵塞外,其余均保持通畅.术中未发生转流管松脱、大出血等相关并发症.1例因术后软组织坏死、感染,行肘上截肢术,其余5例均保肢成功,术后随访2~15个月,受累肢体血供良好. 结论 TIVS操作简便、快捷,可快速重建血管损伤肢体的血供,缩短肢体缺血时间.%Objective To report clinical experience in the use of temporary intravascular shunts (TIVS) for quick restoration of perfusion to the extremity with major vascular injury. Methods Between August 2009 and March 2011, TIVS was applied temporarily to restore blood perfusion to the extremity in 6 patients with major extremity vascular structure injury secondary to trauma (4 patients) or tumor resection (2 patients), who would received vascular transplantation and underwent long ischemia. The patterns of vascular shunts included external carotid artery-subdavian artery, axillary artery-axillary artery, axillary vein-subclavian vein, brachial artery-brachial artery, brachial vein-brachial vein, brachial artery

  13. The mechanism of protective effect of shikonin on vascular smooth muscle cells to chemotherapy injury%紫草素对血管平滑肌细胞化疗性损伤保护作用的机制

    宋晓坤; 于明欣; 杜春双; 康毅; 娄建石


    目的:探讨紫草素对血管平清肌细胞(VSMC)化疗性损伤产生预防性保护及治疗作用的机制.方法:培养兔血管平滑肌细胞,以硫酸长春新碱建立化疗性损伤模型,采用噻唑兰(MTT)法测定细胞活性,并测定细胞乳酸脱氮酶(LDH)和细胞内游离Ca2+浓度,使用流式细胞术比较各组间细胞周期的改变.结果:紫草素用于预防或治疗时,实验组的细胞活性、LDH的水平及细胞内游离C2+浓度与模型组比较差异均有极显著性(P0.05);紫草素可消除化疗药物对细胞有丝分裂阻滞作用,使G2期细胞比例恢复正常,单药时可提高正常细胞S期比例.结论:紫草素片VSMC化疗损伤具有预防性保护作用和损伤后的修复作用.%OBJECTIVE To explore the mechanism of protect effect shikonin on vascular smooth muscle cells damaged by chemotherapy. METHODS Chemotherapy injury model was made of rabbit vascular smooth muscle cells with the vincristine sulfate, the changes of cytoactive by shikonin was measured by methyl thiszolyl tetrazolium(MTT),and the level of lactate dehydrogenase(LDH) and free Ca2 + in VSMC were determined, and the changes of VSMC cell cycle between all groups was compared by the flow cytometry(FCM). RESULTS There was significant difference in cytoactivty and LDH level and free Ca2+ between experimental group and model group(P<0. 01 or P<0. 05),and the data of experimental group got close to the control group, there was no signficant difference; Shikonin could abscise the blocking on the mitosis of chemotherapeutics, put right the ratio of G2 phase, and the ratio of S phase when shikonin used alone. CONCLUSION Shikonin had obviously prophylactic protection on demaged and regeneration on injury of VSMC coused by chemotherapy.

  14. The clinical usefulness of extravascular lung water and pulmonary vascular permeability index to diagnose and characterize pulmonary edema: a prospective multicenter study on the quantitative differential diagnostic definition for acute lung injury/acute respiratory distress syndrome


    Introduction Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is characterized by features other than increased pulmonary vascular permeability. Pulmonary vascular permeability combined with increased extravascular lung water content has been considered a quantitative diagnostic criterion of ALI/ARDS. This prospective, multi-institutional, observational study aimed to clarify the clinical pathophysiological features of ALI/ARDS and establish its quantitative diagnostic criteria. Methods The extravascular lung water index (EVLWI) and the pulmonary vascular permeability index (PVPI) were measured using the transpulmonary thermodilution method in 266 patients with PaO2/FiO2 ratio ≤ 300 mmHg and bilateral infiltration on chest radiography, in 23 ICUs of academic tertiary referral hospitals. Pulmonary edema was defined as EVLWI ≥ 10 ml/kg. Three experts retrospectively determined the pathophysiological features of respiratory insufficiency by considering the patients' history, clinical presentation, chest computed tomography and radiography, echocardiography, EVLWI and brain natriuretic peptide level, and the time course of all preceding findings under systemic and respiratory therapy. Results Patients were divided into the following three categories on the basis of the pathophysiological diagnostic differentiation of respiratory insufficiency: ALI/ARDS, cardiogenic edema, and pleural effusion with atelectasis, which were noted in 207 patients, 26 patients, and 33 patients, respectively. EVLWI was greater in ALI/ARDS and cardiogenic edema patients than in patients with pleural effusion with atelectasis (18.5 ± 6.8, 14.4 ± 4.0, and 8.3 ± 2.1, respectively; P edema or pleural effusion with atelectasis patients (3.2 ± 1.4, 2.0 ± 0.8, and 1.6 ± 0.5; P edema patients. A PVPI value of 2.6 to 2.85 provided a definitive diagnosis of ALI/ARDS (specificity, 0.90 to 0.95), and a value < 1.7 ruled out an ALI/ARDS diagnosis (specificity, 0.95). Conclusion

  15. Vascular Shunts in Civilian Trauma

    Abou Ali, Adham N.; Salem, Karim M.; Alarcon, Louis H.; Bauza, Graciela; Pikoulis, Emmanuel; Chaer, Rabih A.; Avgerinos, Efthymios D.


    Experience with temporary intravascular shunts (TIVS) for vessel injury comes from the military sector and while the indications might be clear in geographically isolated and under resourced war zones, this may be an uncommon scenario in civilian trauma. Data supporting TIVS use in civilian trauma have been extrapolated from the military literature where it demonstrated improved life and limb salvage. Few non-comparative studies from the civilian literature have also revealed similar favorable outcomes. Still, TIVS placement in civilian vascular injuries is uncommon and by some debatable given the absence of clear indications for placement, the potential for TIVS-related complications, the widespread resources for immediate and definitive vascular repair, and the need for curtailing costs and optimizing resources. This article reviews the current evidence and the role of TIVS in contemporary civilian trauma management. PMID:28775985

  16. Vascular Endothelial Cell Injury Is an Important Factor in the Development of Encapsulating Peritoneal Sclerosis in Long-Term Peritoneal Dialysis Patients.

    Mitsuhiro Tawada

    Full Text Available Encapsulating peritoneal sclerosis (EPS is a rare but serious and life-threatening complication of peritoneal dialysis (PD. However, the precise pathogenesis remains unclear; in addition, predictors and early diagnostic biomarkers for EPS have not yet to be established.Eighty-three peritoneal membrane samples taken at catheter removal were examined to identify pathological characteristics of chronic peritoneal deterioration, which promotes EPS in patients undergoing long-term PD treatment with low occurrence of peritonitis.According to univariable logistic regression analysis of the pathological findings, thickness of the peritoneal membrane (P = 0.045, new membrane formation score (P = 0.006, ratio of luminal diameter to vessel diameter (L/V ratio, P<0.001, presence of CD31-negative vessels (P = 0.021, fibrin deposition (P<0.001, and collagen volume fraction (P = 0.018 were associated with EPS development. In analyses of samples with and without EPS matched for PD treatment period, non-diabetes, and PD solution, univariable analysis identified L/V ratio (per 0.1 increase: odds ratio (OR 0.44, P = 0.003 and fibrin deposition (OR 6.35, P = 0.027 as the factors associated with EPS. L/V ratio was lower in patients with fibrin exudation than in patients without fibrin exudation.These findings suggest that damage to vascular endothelial cells, as represented by low L/V ratio, could be a predictive finding for the development of EPS, particularly in long-term PD patients unaffected by peritonitis.

  17. Rapid GNSS and Data Communication System Deployments In Chile and Argentina Following the M8.8 Maule Earthquake

    Blume, F.; Meertens, C. M.; Brooks, B. A.; Bevis, M. G.; Smalley, R.; Parra, H.; Baez, J.


    Because the signal is so big, great earthquakes allow us to make quantum leaps in our understanding of Earth deformation process and material properties. The Maule earthquake, with its occurrence near a large subaerial landmass and the large numbers of instruments available to study it, will surely become one of the most important geophysical events in modern memory. Much of the important signal, however, decays and changes rapidly in the short-term following the event and so a rapid response is necessary. Actually delivering the data from the CGPS response stations, however, represents an intellectual challenge in terms of properly matching the engineering realities with the scientific desiderata. We expect multiple major science advances to come from these data: (1) Understanding earthquake and tsunami-genesis via use of the coseismic displacement field to create the most well-constrained fault slip and tsunami-genesis models. (2) The role of stress loading on both the principal thrust plane and subsidiary planes. (3) The relationship between fault afterslip to the main event as well as to the distribution of aftershocks (4) Study of large aftershocks jointly using conventional seismology and high-rate GPS coseismic displacement seismogram. (5) Rheological behavior of the fault interface. (6) The mechanical response of the bulk earth to large stress perturbations. Within 10 days of the earthquake 20 complete GPS systems were delivered by UNAVCO personnel to IGM and OSU staff in Santiago, and 5 were shipped via diplomatic pouch to Argentina. Consisting of of 10 Trimble NetRS and 15 Topcon GB-1000 receivers, the units were deployed througout the affected area during the following three weeks, using welded-in-place steel tripod monuments driven into soil or drilled into bedrock, or steel masts. Additional GPS hardware was procured from cooperating institutions and donated by GPS manufacturers, and a total of 43 post-earthquake GPS stations are continuously operating

  18. [Foot defect with vascular and neural injury due to freshwater stingray sting: reconstruction with a lesser saphenous vein adipo-fascial flap].

    Moutran, M; Mojallal, A; Chekaroua, K; Martin, E; Braye, F


    The emergency care to stingrays envenomation permits, in the majority of cases, to limit the damage caused. In the case of delayed medical care, we can meet deep and extensive lesions that need to be thoroughly explored in order to better address their reconstruction. We report the case of a patient injured by freshwater stingray. He presented a necrotic defect of 6 cm in diameter under the right medial malleolus with bone exposure and neurovascular injury. We opted for a therapeutic strategy in two steps. The first step consisted in a large debridement of the necrotic defect, under appropriate antibiotics and negative pressure therapy. Three weeks later, we covered the defect with a distally based lesser saphenous vein veno-fascia-subcutaneous flap, covered with a split-thickness graft. The coverage of the defect was satisfactory. The infection was controlled with antibiotics, which we prolonged for one month. The patient presented, initially, hypoesthesia of the upper lateral foot in relation with a neurapraxis of the sural nerve. The symptoms resolved at two months. The foot edema due to venous stasis also resolved at two months. The donor site healed without complications. The ability to wear normal shoes was preserved. The patient resumed his daily activities promptly.

  19. 2010 Maule, Chile Images

    National Oceanic and Atmospheric Administration, Department of Commerce — As of May 2010, the number of confirmed deaths stood at 521, with 56 persons still missing. Estimates of economic damage are around $30 billion. According to...

  20. 脊髓损伤后血管内皮生长因子的表达及细胞凋亡%The expression of vascular endothelial growth factor and apoptosis after spinal cord injury

    林斌; 何永志; 黄其龙; 卢志有


    目的 观察大鼠急性脊髓损伤后不同时间点血管内皮生长因子(VEGF)的表达及局部脊髓组织细胞凋亡的情况,进一步了解脊髓损伤后的病理变化情况.方法 雌性SD大鼠,随机分为对照组(A组)、脊髓损伤组(B组),每组各30只.所有大鼠行T12节段椎板切除开窗,暴露脊髓.A组只打开椎板,不打击脊髓.B组按改良Allen法(以10 g×6 cm力撞击脊髓)制作大鼠急性脊髓损伤模型.各组分别于伤后1、3、5、7、14、28 d随机处死5只,损伤部位取材,VEGF、细胞凋亡免疫组化染色及在光镜下观察,计算VEGF阳性细胞数及凋亡细胞数.结果 A组脊髓中央管周围和脊髓软脊膜见少量VEGF表达,其它部位未见表达;B组脊髓损伤后VEGF在脊髓损伤及损伤周边区高表达,5 d达高峰,7 d和14 d表达仍较明显,28 d见少量表达;B组各时间点VEGF表达和A组相比差异均有统计学意义(P<0.05).A组各时间点凋亡细胞少见,B组则较明显,凋亡细胞在脊髓损伤后逐渐增多,1 d达高峰,3 d和5 d仍较多,7、14、28 d仍有表达;B组各时间点细胞凋亡和A组相比差异均有统计学意义(P<0.05).结论 VEGF参与急性脊髓损伤后系列病理改变,且持续时间较长.急性脊髓损伤后较长时间内存在着继发性细胞凋亡现象.%Objective To observe the expression level of vascular endothelial growth factor ( VEGF ) and cells apoptosis at different time points after rats suffering acute spinal cord injury, further in-depth understanding of the pathological changes after spinal cord injury. Methods Female SD rats, which were randomly divided into control group ( A group ), spinal cord injury group ( B group ), with 30 animals in each group. The 60 rats were surgically removed the vertebral lamina of T12 segment to expose the spinal cord. And then in A group, the spinal cord was untouched; in B group, the spinal cord was hit by power of 10 g × 6 cm according to the improved Allen's method to

  1. Revealing the deep structure and rupture plane of the 2010 Maule, Chile earthquake (Mw = 8.8) using wide angle seismic data

    Moscoso, Eduardo; Grevemeyer, Ingo; Contreras-Reyes, Eduardo; Flueh, Ernst R.; Dzierma, Yvonne; Rabbel, Wolfgang; Thorwart, Martin


    The 27 February, 2010 Maule earthquake (Mw = 8.8) ruptured ~ 400 km of the Nazca-South America plate boundary and caused hundreds of fatalities and billions of dollars in material losses. Here we present constraints on the fore-arc structure and subduction zone of the rupture area derived from seismic refraction and wide-angle data. The results show a wedge shaped body ~ 40 km wide with typical sedimentary velocities interpreted as a frontal accretionary prism (FAP). Landward of the imaged FAP, the velocity model shows an abrupt velocity-contrast, suggesting a lithological change which is interpreted as the contact between the FAP and the paleo accretionary prism (backstop). The backstop location is coincident with the seaward limit of the aftershocks, defining the updip limit of the co-seismic rupture and seismogenic zone. Furthermore, the seaward limit of the aftershocks coincides with the location of the shelf break in the entire earthquake rupture area (33°S-38.5°S), which is interpreted as the location of the backstop along the margin. Published seismic profiles at the northern and southern limit of the rupture area also show the presence of a strong horizontal velocity gradient seismic backstop at a distance of ~ 30 km from the deformation front. The seismic wide-angle reflections from the top of the subducting oceanic crust constrain the location of the plate boundary offshore, dipping at ~ 10°. The projection of the epicenter of the Maule earthquake onto our derived interplate boundary yielded a hypocenter around 20 km depth, this implies that this earthquake nucleated somewhere in the middle of the seismogenic zone, neither at its updip nor at its downdip limit.

  2. 2D+1D Runup Estimations compared with field data of the three recent Chilean Events; the 2010 Maule, the 2014 Iquique and the 2015 Illapel tsunamis

    Wronna, Martin; Kanoǧlu, Utku; Baptista, Maria Ana


    In tsunami sciences, it is a desirable goal to forecast the inundation areas quickly after an event. A promising approach is to combine numerical modelling by applying nonlinear shallow water wave equations with one-dimensional (1-D) analytical solution. Here we use synthetic waveforms as input for 1-D analytical runup estimation and compare the results with the measured runup values of the 2010 Mw 8.8 Maule, the 2014 Mw 8.2 Iquique and the 2015 Mw 8.3 Illapel tsunamis. The three earthquakes occurred along the Peru-Chile Trench with the most damaging Maule event on February 27th, 2010 on the southern part between the Nazca and South American plate. After that event, maximum runup values reach 29 m at the city of Constitutiòn. We compute the waveforms of the events using their co-seismic deformations as the initial conditions in the nonlinear shallow water numerical model. We trace profiles orthogonal to the source at the points of runup measurements and extract the synthetic waveform and the slope of the bathymetry. We then use the synthetic waveforms and bathymetric profiles as input for the 1-D long wave runup theory. The comparison reveals that the 2D+1D runup estimations deliver reasonable results compared to measured runup. But in some cases over- and underestimation occurs. Especially underestimation is a critical issue for early warning purposes, and additional fine tuning of the methodology is needed. This study received funding from project ASTARTE- Assessment Strategy and Risk Reduction for Tsunamis in Europe a collaborative project Grant 603839, FP7-ENV2013 6.4-3.

  3. Serious neck injuries in U19 rugby union players: an audit of admissions to spinal injury units in Great Britain and Ireland.

    MacLean, James G B; Hutchison, James D


    To obtain data regarding admissions of U19 rugby players to spinal injury units in Great Britain and Ireland and to compare this with a recent peak in presentation in Scotland. To assess the current state of data collection and subsequent analysis of serious neck injuries. To analyse the mechanism of injury in this group of at-risk players. Retrospective case series. Spinal injury units in Great Britain and Ireland. Annual frequency of serious neck injuries. Analysis of injury types, neurological deficit and mechanism of injury. 36 Injuries were recorded. 10 Of these occurred in Scotland since 1996 of which six have occurred in the past 4 years. This compared with 14 in Ireland over the same period. 12 Cases were traced in England and Wales since 2000; records were not available before this date. No prospective collation of data is performed by the home unions and inconsistency of data collection exists. The mean age was 16.2 years. 16 Of the 36 admissions had complete neurological loss, 9 had incomplete neurological injury and 11 had cervical column injury without spinal cord damage. The mechanism of injury was tackle in 17 (47%), scrum in 13 (36%), two each due to the maul and collision, and one each due to a kick and a ruck. Some degree of spinal cord injury occurred in 92% of scrum injuries (61% complete) and 53% of tackle injuries (29% complete). U19 rugby players continue to sustain serious neck injuries necessitating admission to spinal injury units with a low but persistent frequency. The recent rate of admission in Scotland is disproportionately high when the respective estimated playing populations are considered. While more injuries were sustained in the tackle, spinal cord injury was significantly more common in neck injury sustained in the scrum (pscrum engagement and the tackle can be made safer.

  4. Management of civilian and military vascular trauma: lessons learned.

    Nguyen, Tony; Kalish, Jeffrey; Woodson, Jonathan


    Management of vascular trauma has evolved tremendously since the turn of the 20(th) century. The lessons from each major military conflict over the past 100 years have refined our understanding of how to care for soldiers and civilians with vascular injuries. The recent wars in Iraq and Afghanistan have likewise improved our strategy for treating victims of vascular trauma. Understanding the principles that guide management of vascular injuries will result in preservation of life and limb. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Prevention of vascular smooth muscle cell proliferation and injury-induced neointimal hyperplasia by CREB-mediated p21 induction: An insight from a plant polyphenol.

    Sun, Lan; Zhao, Rui; Zhang, Li; Zhang, Weiku; He, GuoRong; Yang, Shengqian; Song, Junke; Du, Guanhua


    Cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/cAMP response element (CRE)-binding protein (CREB) signaling cascade negatively regulates platelet-derived growth factor BB (PDGF-BB)-induced smooth muscle cell (SMC) proliferation, which is a critical event in the initiation and development of restenosis and atherosclerotic lesions. Salvianolic acid A (SAA) is one of the most abundant polyphenols extracted from salvia. The aim of this study is to investigate whether SAA exerts an action on PDGF-BB-induced proliferation via cAMP/PKA/CREB mechanism. SAA blunts PDGF-BB-induced human umbilical artery smooth muscle cell (hUASMC) proliferation via p21 induction, as evidenced by its increased mRNA and protein expression levels. The SAA-induced upregulation of p21 involves the cAMP/PKA signaling pathway; a cAMP analog mimicked the effects of SAA and a specific cAMP/PKA inhibitor opposed these effects. SAA also activated CREB, including phosphorylation at Ser133, and induced its nuclear translocation. Deletion and mutational analysis of p21 promoters, co-immunoprecipitation, and western blot analysis showed that CRE is essential for SAA-induced p21 protein expression. Transfection of dominant-negative CREB (mutated Ser133) plasmids into hUASMCs attenuated SAA-stimulated p21 expression. SAA upregulated p21 expression and activated CREB in the neointima of balloon-injured arteries in vivo. Our results indicate that SAA promotes p21 expression in SMCs through the cAMP/PKA/CREB signaling cascade in vitro and prevents injury-induced neointimal hyperplasia.

  6. Contact events in rugby union and their propensity to cause injury.

    Fuller, Colin W; Brooks, John H M; Cancea, Rebecca J; Hall, John; Kemp, Simon P T


    The objective of this study was to determine the incidence of contact events in professional rugby union matches and to assess their propensity to cause injury. The study was a two-season (2003/2004 and 2005/2006) prospective cohort design. It included 645 professional rugby union players from 13 English Premiership rugby union clubs. The main outcome measures were: incidence of match contact events (events per game); incidence (injuries per 1000 player-hours and per 1000 contact events), risk (days lost per 1000 player-hours and per 1000 contact events) and diagnosis of injury; referee's decision. Risk factors were player-player contact, position on pitch and period of play. Tackles (221.0 events/game) and rucks (142.5 events/game) were the most common events and mauls (13.6%) and scrums (12.6%) the most penalised. Tackles (701.6 days/1000 player-hours) were responsible for the greatest loss of time but scrums (213.2 days lost/1000 events) and collisions (199.8 days lost/1000 events) presented the highest risk per event. Tackles were the game event responsible for the highest number of injuries and the greatest loss of time in rugby union because they were by far the most common contact event. Collisions were 70% more likely to result in an injury than a tackle and scrums carried a 60% greater risk of injury than a tackle. The relative propensities for contact events to cause injury were rated as: lineout--very low; ruck--low; maul and tackle--average; collision and scrum--high.

  7. Acute vascular abdomen. General outlook and algorithms.

    Miani, S; Boneschi, M; La Penna, A; Erba, M; De Monti, M; Giordanengo, F


    Acute vascular abdomen is a severe and life-threatening pathology due to arterial degeneration, leading to hemorrhage or arterial occlusion leading to ischemia. Differential diagnosis of patients with severe abdominal pain and/or shock include several vascular and traumatic diseases, the most common being rupture of abdominal aortic aneurysm (AAA), or less frequently rupture of visceral artery aneurysm. Also acute aortic dissection, iatrogenic injury and acute mesenteric ischemia may lead to acute vascular abdomen. Clinical evaluation of the haemodynamic status of the patient may be very difficult, and may require airway maintenance and ventilation with a rapid treatment of hemorrhagic shock. In the stable patient with an uncertain diagnosis, CT scan, NMR and selective angiography may be helpful in diagnosis before vascular repair. On the contrary, the unstable patient, after hemodynamic resuscitation, must be operated on expeditiously. We present our vascular algorithms, to assess timing of diagnosis and treatment of this severe acute disease.

  8. Using Polymeric Scaffolds for Vascular Tissue Engineering

    Alida Abruzzo


    Full Text Available With the high occurrence of cardiovascular disease and increasing numbers of patients requiring vascular access, there is a significant need for small-diameter (<6 mm inner diameter vascular graft that can provide long-term patency. Despite the technological improvements, restenosis and graft thrombosis continue to hamper the success of the implants. Vascular tissue engineering is a new field that has undergone enormous growth over the last decade and has proposed valid solutions for blood vessels repair. The goal of vascular tissue engineering is to produce neovessels and neoorgan tissue from autologous cells using a biodegradable polymer as a scaffold. The most important advantage of tissue-engineered implants is that these tissues can grow, remodel, rebuild, and respond to injury. This review describes the development of polymeric materials over the years and current tissue engineering strategies for the improvement of vascular conduits.

  9. Proatherogenic pathways leading to vascular calcification

    Mazzini, Michael J. [Department of Cardiology, Boston University Medical Center, Boston, MA (United States); Schulze, P. Christian [Department of Medicine, Boston University Medical Center, Boston, MA (United States)]. E-mail:


    Cardiovascular disease is the leading cause of morbidity and mortality in the western world and atherosclerosis is the major common underlying disease. The pathogenesis of atherosclerosis involves local vascular injury, inflammation and oxidative stress as well as vascular calcification. Vascular calcification has long been regarded as a degenerative process leading to mineral deposition in the vascular wall characteristic for late stages of atherosclerosis. However, recent studies identified vascular calcification in early stages of atherosclerosis and its occurrence has been linked to clinical events in patients with cardiovascular disease. Its degree correlates with local vascular inflammation and with the overall impact and the progression of atherosclerosis. Over the last decade, diverse and highly regulated molecular signaling cascades controlling vascular calcification have been described. Local and circulating molecules such as osteopontin, osteoprogerin, leptin and matrix Gla protein were identified as critical regulators of vascular calcification. We here review the current knowledge on molecular pathways of vascular calcification and their relevance for the progression of cardiovascular disease.

  10. Incidence of vascular complications during lateral lumbar interbody fusion: an examination of the mini-open access technique.

    Kueper, Janina; Fantini, Gary A; Walker, Brendon R; Aichmair, Alexander; Hughes, Alexander P


    This article examines the incidence and management of vascular injury during Lateral Lumbar Interbody Fusion (LLIF). The details of the mini-open access technique are presented. A total of 900 patients who underwent a LLIF at an average 1.94 levels (range: 1-5 levels) by one of six fellowship trained surgeons on 1,754 levels from 2006 to 2013 were identified. The incidence of intraoperative vascular injury was retrospectively determined from the Operative Records. The management of vascular injury was evaluated. The mini-open access adapted by our institution for LLIF is described. The incidence of major vascular complication in our series was 1/900. The incidence of minor vascular injury was 4/900. The overall incidence of vascular injury was calculated to be 0.056 % per case and 0.029 % per level. All minor vascular injuries were identified to be segmental vessel lacerations, which were readily ligated under direct visualization without further extension of the incision with no clinical sequelae. The laceration of the abdominal aorta, the major vascular complication of this series, was emergently repaired through an exploratory laparotomy. None of the patients suffered long-term sequelae from their intraoperative vascular injuries. The mini-open lateral access technique for LLIF provides for minimal risk of vascular injury to the lumbar spine. In the rare event of minor vascular injury, the mini-open access approach allows for immediate visualization, confirmation and repair of the vessel with no long-term sequelae.

  11. Our vascular surgery experiences in Syrian civil war

    İyad Fansa


    Full Text Available Objective: Due to the ongoing civil war in Syria, numerous vascular injured patients are admitted to our hospital with gunshot wounds. In this study, patients who admitted our hospital, diagnosed with vascular trauma due to gunshot were evaluated with the respect of injury site, additional injuries, surgical interventions and outcomes. Methods: The study included 58 patients wounded in Syrian war and admitted to our hospital between 01.01.2012 and 01.09.2014. Results= There were 5.1% (n=3 female and 94.9% (n=55 male patients. Age range is 5-75 years and the average of age was identified as 28.61. In 12.1% (n=7 of patients with extensive tissue defects of the muscle-nerve-bone injury has been identified, despite the vascular interventions in these patients, 8.6% (n=5 of patients, the limb has been amputated. Totally 15.5% (n=9 of 58 operated patients died. Two patients died because of major vascular injury with intra-abdominal organ injuries. In one patient; infection induced sepsis and multi organ failure was detected. Six patients were lost due to hypovolemic shock as a result of late arriving. Conclusion: In patients admitted with gunshot vascular injury arrival time, the presence of additional injuries and the location of injury affect mortality rates.

  12. Outcome after vascular trauma in a deployed military trauma system.

    Stannard, A; Brown, K; Benson, C; Clasper, J; Midwinter, M; Tai, N R


    Military injuries to named blood vessels are complex limb- and life-threatening wounds that pose significant difficulties in prehospital and surgical management. The aim of this study was to provide a comprehensive description of the epidemiology, treatment and outcome of vascular injury among service personnel deployed on operations in Afghanistan and Iraq. Data from the British Joint Theatre Trauma Registry were combined with hospital records to review all cases of vascular trauma in deployed service personnel over a 5-year interval ending in January 2008. Of 1203 injured service personnel, 110 sustained injuries to named vessels; 66 of them died before any surgical intervention. All 25 patients who sustained an injury to a named vessel in the abdomen or thorax died; 24 did not survive to undergo surgery and one casualty in extremis underwent a thoracotomy, but died. Six of 17 patients with cervical vascular injuries survived to surgical intervention; two died after surgery. Of 76 patients with extremity vascular injuries, 37 survived to surgery with one postoperative death. Interventions on 38 limbs included 19 damage control procedures (15 primary amputations, 4 vessel ligations) and 19 definitive limb revascularization procedures (11 interposition vein grafts, 8 direct repairs), four of which failed necessitating three amputations. In operable patients with extremity injury, amputation or ligation is often required for damage control and preservation of life. Favourable limb salvage rates are achievable in casualties able to withstand revascularization. Despite marked progress in contemporary battlefield trauma care, torso vascular injury is usually not amenable to surgical intervention.

  13. Adipose-derived mesenchymal stem cell therapy for radiation-induced vascular injury in small intestine of rat%脂肪干细胞修复辐射诱导的肠血管损伤研究

    常鹏宇; 崔爽; 姜新; 曲超; 蒋鑫萍; 罗景华; 曲雅勤; 董丽华


    目的:评价人源脂肪干细胞对辐射诱导的肠血管损伤的修复作用。方法选用成年雄性SD大鼠,共34只,给予全腹部15 Gy X射线照射。造模后,取其中17只给予P6代人源脂肪干细胞腹腔注射治疗( Ad-MSC治疗组);另17只大鼠给予双磷酸盐缓冲液( PBS)腹腔注射治疗( PBS溶剂对照组)。照射后第10天,流式细胞分析绒毛内CD31阳性内皮细胞的数量,免疫荧光染色分析新生的血管内皮细胞,免疫组织化学染色分析血管结构的连续性;并提取受照小肠组织总RNA,实时荧光定量PCR检测受照组织内基质细胞起源因子-1(SDF-1)、血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)以及血管内皮细胞生长因子受体(Flk-1)的表达量。检测Ad-MSC治疗组的受损小肠内新生的内皮细胞来源。结果与PBS溶剂对照组相比,Ad-MSC能够显著增加受损组织内CD31阳性内皮细胞数量(t=12�15,P<0�05),提高受损组织内的血管密度(20 d:t=10�33,P<0.05;30 d:t=32�85,P<0�05),上调血管生成基因VEGF、bFGF、Flk-1以及SDF-1的表达量(t=10�34、11�25、6�73、6�73,P<0�05)。维持受损部位小肠绒毛内的血管完整,并促进CD31阳性造血干/祖细胞向血管内皮细胞的分化,加速受损部位血管的新生。结论人源脂肪干细胞通过发挥促血管新生的作用来修复辐射诱导的肠血管损伤。%Objective To assess the therapeutic effect of human adipose-derived mesenchymal stem cells on radiation-induced vascular injury in the small intestine of rat. Methods A total of 34 male Sprague-Dawley rats were enrolled in this study. To establish a model of radiation-induced intestinal injury, each rat was irradiated with 15 Gy in whole abdomen. 17 rats were randomly selected and infused intraperitoneally with passage 6 ( P6 ) Ad-MSCs, and the other 17

  14. Cardiovascular risk factors regulate the expression of vascular endothelin receptors

    Xu, Cang-Bao; Sun, Yang; Edvinsson, Lars


    , cigarette smoking and hypertension (both strongly related to arterial wall injury), inflammation and atherosclerosis. The vascular endothelin receptors are a protein family that belongs to the larger family of G-protein coupled receptors. They mediate vascular smooth muscle contraction, proliferation......-activated protein kinase pathways and downstream transcription factors such as nuclear factor-kappaB. Understanding the mechanisms involved in vascular endothelin receptor upregulation during cardiovascular disease may provide novel therapeutic approaches....

  15. Collapsed scrums and collision tackles: what is the injury risk?

    Roberts, Simon P; Trewartha, Grant; England, Mike; Stokes, Keith A


    To establish the propensity for specific contact events to cause injury in rugby union. Medical staff at participating English community-level rugby clubs reported any injury resulting in the absence for one match or more from the day of the injury during the 2009/2010 (n=46), 2010/2011 (n=67) and 2011/2012 (n=76) seasons. Injury severity was defined as the number of matches missed. Thirty community rugby matches were filmed and the number of contact events (tackles, collision tackles, rucks, mauls, lineouts and scrums) recorded. Of 370 (95% CI 364 to 378) contact events per match, 141 (137 to 145) were tackles, 115 (111 to 119) were rucks and 32 (30 to 33) were scrums. Tackles resulted in the greatest propensity for injury (2.3 (2.2 to 2.4) injuries/1000 events) and the greatest severity (16 (15 to 17) weeks missed/1000 events). Collision tackles (illegal tackles involving a shoulder charge) had a propensity for injury of 15 (12.4 to 18.3) injuries/1000 events and severity was 92 (75 to 112) weeks missed/1000 events, both of which were higher than any other event. Additional scrum analysis showed that only 5% of all scrums collapsed, but the propensity for injury was four times higher (2.9 (1.5 to 5.4) injuries/1000 events) and the severity was six times greater (22 (12 to 42) weeks missed/1000 events) than for non-collapsed scrums. Injury prevention in the tackle should focus on technique with strict enforcement of existing laws for illegal collision tackles. The scrum is a relatively controllable event and further attempts should be made to reduce the frequency of scrum collapse. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  16. Seismicity at Uturuncu Volcano, Bolivia: Volcano-Tectonic Earthquake Swarms Triggered by the 2010 Maule, Chile Earthquake and Non-Triggered Background Activity

    Christensen, D. H.; Chartrand, Z. A.; Jay, J.; Pritchard, M. E.; West, M. E.; McNutt, S. R.


    We find that the 270 ky dormant Uturuncu Volcano in SW Bolivia exhibits relatively high rates of shallow, volcano-tectonic seismicity that is dominated by swarm-like activity. We also document that the 27 February 2010 Mw 8.8 Maule, Chile earthquake triggered an exceptionally high rate of seismicity in the seconds to days following the main event. Although dormant, Uturuncu is currently being studied due to its large-scale deformation rate of 1-2 cm/yr uplift as revealed by InSAR. As part of the NASA-funded Andivolc project to investigate seismicity of volcanoes in the central Andes, a seismic network of 15 stations (9 Mark Products L22 short period and 6 Guralp CMG40T intermediate period sensors) with an average spacing of about 10 km was installed at Uturuncu from April 2009 to April 2010. Volcano-tectonic earthquakes occur at an average rate of about 3-4 per day, and swarms of 5-60 events within a span of minutes to hours occur a few times per month. Most of these earthquakes are located close to the summit at depths near and above sea level. The largest swarm occurred on 28 September 2009 and consisted of 60 locatable events over a time span of 28 hours. The locations of volcano-tectonic earthquakes at Uturuncu are oriented in a NW-SE trend, which matches the dominant orientation of regional faults and suggests a relationship between the fault system at Uturuncu and the regional tectonics of the area; a NW-SE trending fault beneath Uturuncu may serve to localize stresses that are accumulating over the broad area of uplift. Based on automated locations, the maximum local magnitude of these events is approximately M = 4 and the average magnitude is approximately M = 2. An initial estimate of the b-value is about b = 1.2. The Mw 8.8 Maule earthquake on 27 February 2010 triggered hundreds of local volcano-tectonic events at Uturuncu. High-pass filtering of the long period surface waves reveals that the first triggered events occurred with the onset of the Rayleigh

  17. Application example: Preliminary Results of ISOLA use to find moment tensor solutions and centroid depth applied to aftershocks of Mw=8.8 February 27 2010, Maule Earthquake

    Nacif, S. V.; Sanchez, M. A.


    We selected seven aftershocks from Maule earthquake between 33.5°S to 35°S from May to September to find single source inversion. The data were provided by XY Chile Ramp Experiment* which was deployed after great Maule earthquake. Waveform data are from 13 broad band stations chosen from the 58 broad band stations deployed by IRIS-PASCAL from April to September 2010. Stations are placed above the normal subduction section south of ~33.5°S. Events were located with an iterative software called Hypocenter using one dimensional local model, obtained above for the forearc region between 33°S to 35°S. We used ISOLA which is a fortran code with a Matlab interface to obtain moment tensors solutions, optimum position and time of the subevents. Values depth obtained by a grid search of centroid position show range values which are compatibles with the interplate seismogenic zone. Double-Couple focal mechanism solutions (Figure 1) show 4 thrust events which can be associated with that zone. However, only one of them has strike, dip and rake of 358°, 27° and 101 respectively, appropriate to be expected for interplate seismogenic zone. On the other hand, the other 3 events show strike and normal double-couple focal mechanism solutions (Figure 1). This last topic makes association to those events to the contact of the Nazca and South American plate difficult. Nevertheless, in a first stage, their depths may allow possibility of an origin there. * The facilities of the IRIS Data Management System, and specifically the IRIS Data Management Center, were used for access to waveform, metadata or products required in this study. The IRIS DMS is funded through the National Science Foundation and specifically the GEO Directorate through the Instrumentation and Facilities Program of the National Science Foundation under Cooperative Agreement EAR-0552316. Some activities of are supported by the National Science Foundation EarthScope Program under Cooperative Agreement EAR-0733069

  18. Evaluation and management of acute vascular trauma.

    Salazar, Gloria M M; Walker, T Gregory


    With the technical advances and the increasing availability of sophisticated imaging equipment, techniques, and protocols, and with continually evolving transcatheter endovascular therapies, minimally invasive imaging and treatment options are being routinely used for the clinical management of trauma patients. Thus, the primary treatment algorithm for managing acute vascular trauma now increasingly involves the interventional radiologist or other endovascular specialist. Endovascular techniques represent an attractive option for both stabilizing and definitively treating patients who have sustained significant trauma, with resultant vascular injury. Endovascular treatment frequently offers the benefit of a focused definitive therapy, even in the presence of massive hemorrhage that allows for preservation of major vessels or injured solid organs and serves as an alternative to an open surgical intervention. This article presents an overview of various endovascular techniques that can be used for trauma patients presenting with vascular injuries.

  19. Percepción de la motivación de los directivos intermedios en tres hospitales de la Región del Maule, Chile Motivation perception measurement of intermediate directors in three complex hospitals of the Region of the Maule, Chile

    Miguel Alejandro Bustamante-Ubilla


    Full Text Available OBJETIVO: En este trabajo se diseña un cuestionario y se cuantifican las percepciones de motivación-desmotivación de los jefes intermedios de tres hospitales de la Región del Maule, Chile. MATERIAL Y MÉTODOS: El trabajo de campo se realizó entre septiembre y octubre de 2006, se aplicó un cuestionario con 57 afirmaciones de medición de actitudes que se calificó de acuerdo con una escala tipo Likert de cinco puntos. La población objeto de la investigación fue de 125 profesionales bajo cuya supervisión se encuentran alrededor de 3 800 funcionarios. RESULTADOS: Se identificaron 10 variables, cinco motivacionales y cinco desmotivacionales. Entre las primeras destacan vocación y espíritu de servicio; entre las segundas falta de reconocimiento y falta de compromiso. DISCUSIÓN: Se confirma que tanto las variables motivacionales como las desmotivacionales son esencialmente cualitativas y que las variables económica y de sueldos son menos relevantes y de inferior jerarquía.OBJECTIVE: In this work, a questionnaire was designed and perceptions of motivation and demotivation of middle managers in three hospitals in the Region del Maule, Chile were measured. MATERIAL AND METHODS: The fieldwork was carried out between September and October, 2006. A questionnaire that included 57 statements to measure attitude was administered and qualified according to a five-point Likert-type scale. The population studied included l25 professionals that supervise roughly 3 800 employees. RESULTS: Ten variables were identified, 5 motivational and 5 demotivational. Notable among the motivational variables are vocation and service-oriented spirit; among the demotivational variables are lack of recognition and commitment. DISCUSSION: It is affirmed that both motivational variables as well as demotivational variables are essentially qualitative and that economic and salary variables are less relevant and less hierarchical.

  20. Vascular development in Arabidopsis.

    Ye, Zheng-Hua; Freshour, Glenn; Hahn, Michael G; Burk, David H; Zhong, Ruiqin


    Vascular tissues, xylem and phloem, form a continuous network throughout the plant body for transport of water, minerals, and food. Characterization of Arabidopsis mutants defective in various aspects of vascular formation has demonstrated that Arabidopsis is an ideal system for investigating the molecular mechanisms controlling vascular development. The processes affected in these mutants include initiation or division of procambium or vascular cambium, formation of continuous vascular cell files, differentiation of procambium or vascular cambium into vascular tissues, cell elongation, patterned secondary wall thickening, and biosynthesis of secondary walls. Identification of the genes affected by some of these mutations has revealed essential roles in vascular development for a cytokinin receptor and several factors mediating auxin transport or signaling. Mutational studies have also identified a number of Arabidopsis mutants defective in leaf venation pattern or vascular tissue organization in stems. Genetic evidence suggests that the vascular tissue organization is regulated by the same positional information that determines organ polarity.

  1. Hemorrhage Control for Major Traumatic Vascular Injuries


    to publish results in any of the key peer- reviewed journals . For further information write to or call 713-500- 7909...n=19, 5%), and abdominal visceral veins including the portal vein (n=33, 9%), had no representation in the ENDO group. Specific OPEN procedures...2.1% 0 0.0% Innominate vein 1 2.1% 0 0.0% Retro-hepatic inferior vena cava 1 2.1% 2 6.7% Portal vein 1 2.1% 0 0.0% Supra-renal/Sub-hepatic

  2. Aftershock seismicity of the 2010 Maule Mw=8.8 Chile, earthquake: Correlation between co-seismic slip models and aftershock distribution?

    Rietbrock, A.; Ryder, I.; Hayes, G.; Haberland, C.; Comte, D.; Roecker, S.


    The 27 February 2010 Maule, Chile (Mw=8.8) earthquake is one of the best instrumentally observed subduction zone megathrust events. Here we present locations, magnitudes and cumulative equivalent moment of the first -2 months of aftershocks, recorded on a temporary network deployed within 2 weeks of the occurrence of the mainshock. Using automatically-determined onset times and a back projection approach for event association, we are able to detect over 30,000 events in the time period analyzed. To further increase the location accuracy, we systematically searched for potential S-wave arrivals and events were located in a regional 2D velocity model. Additionally, we calculated regional moment tensors to gain insight into the deformation history of the aftershock sequence. We find that the aftershock seismicity is concentrated between 40 and 140 km distance from the trench over a depth range of 10 to 35 km. Focal mechanisms indicate a predominance of thrust faulting, with occasional normal faulting events. Increased activity is seen in the outer-rise region of the Nazca plate, predominantly in the northern part of the rupture area. Further down-dip, a second band of clustered seismicity, showing mainly thrust motion, is located at depths of 40–45 km. By comparing recent published mainshock source inversions with our aftershock distribution, we discriminate slip models based on the assumption that aftershocks occur in areas of rapid transition between high and low slip, surrounding high-slip regions of the mainshock.

  3. Branding of vascular surgery.

    Perler, Bruce A


    The Society for Vascular Surgery surveyed primary care physicians (PCPs) to understand how PCPs make referral decisions for their patients with peripheral vascular disease. Responses were received from 250 PCPs in 44 states. More than 80% of the respondents characterized their experiences with vascular surgeons as positive or very positive. PCPs perceive that vascular surgeons perform "invasive" procedures and refer patients with the most severe vascular disease to vascular surgeons but were more than twice as likely to refer patients to cardiologists, believing they are better able to perform minimally invasive procedures. Nevertheless, PCPs are receptive to the notion of increasing referrals to vascular surgeons. A successful branding campaign will require considerable education of referring physicians about the totality of traditional vascular and endovascular care increasingly provided by the contemporary vascular surgical practice and will be most effective at the local grassroots level.

  4. Unique fatality due to claw injuries in a tiger attack: a case report.

    Pathak, Hrishikesh; Dixit, Pradeep; Dhawane, Shailendra; Meshram, Satin; Shrigiriwar, Manish; Dingre, Niraj


    This paper describes a unique case of a fatal tiger attack in the wild. In the present case, a tiger fatally mauled a 34-year-old female with its claws, instead of the usual mechanism of killing by the bite injury to the neck. The autopsy revealed multiple fatal and non-fatal injuries caused by the tiger claws. The characteristic injuries due to the tooth impacts were absent as the teeth of the offending tiger were either fallen or non-functional. To the best of our knowledge, probably this rare case would be the first reported human fatality due to the tiger claw injuries in the world. The purpose of the present article is to highlight the fatal injuries due to the tiger claws, as the claw-induced fatal injuries in a tiger attack are not reported in the medico-legal literature. Moreover, this report would be an illustrative one for differentiation between the fatal injuries due to the claws and tooth impacts in a tiger attack. Furthermore, the present report establishes the importance of the tiger claws as a source of fatal injuries in a tiger attack.

  5. tion of vascular malformations

    classification of vascular anomalies outside of the central ... The current classification of CNS vascular ... tural proteins within the wall of caver- .... ing (or established) loss of function or a threat to ..... natural history of the strawberry nevus. Arch.

  6. Society for Vascular Medicine

    ... Certification with this new online course from the Society for Vascular Medicine. Learn more. Looking for a ... jobs are listed right now. Copyright © 2016 The Society for Vascular Medicine. All Rights Reserved.

  7. Collagen vascular disease

    ... page: // Collagen vascular disease To use the sharing features on this ... previously said to have "connective tissue" or "collagen vascular" disease. We now have names for many specific ...

  8. Research Advance of Preeclampsia Vascular Endothelial Injury and the Related Physical Examination to Predict Preeclampsia%子痫前期血管内皮损伤与其相关物理检查预测子痫前期的研究进展



    子痫前期是妊娠期特有的疾病,是孕产妇及围生儿患病及死亡的主要原因之一.因此众多学者致力于子痫前期预测的研究,以期早期预测、早期干预,降低母婴的患病率及病死率.目前的研究表明,孕妇全身血管内皮损伤是子痫前期发病的中心环节.现就近年来针对子痫前期血管内皮损伤与相关物理检查预测子痫前期的研究进展予以综述.%Preeclampsia is a pregnancy-specific disease. It remains a leading cause of maternal and perinatal mortality and morbidity. A lot of scholars are engaged in the study of preeclampsia for early prediction and intervention of the disease to decrease the incidence and mortaity of mother and infant. Current research shows that maternal systemic vascular endothelial injury is the pathogenesis center link of preeclampsia. Here is to review the research progress of early preeclampsia vascular endothelial injury and related physical tests for the prediction.

  9. Vascular grading of angiogenesis

    Hansen, S; Grabau, D A; Sørensen, Flemming Brandt;


    was moderately reproduced (kappa = 0.59). Vascular grade was significantly associated with axillary node involvement, tumour size, malignancy grade, oestrogen receptor status and histological type. In univariate analyses vascular grade significantly predicted recurrence free survival and overall survival for all...... patients (P analysis showed that vascular grading contributed with independent prognostic value in all patients (P

  10. Modeling strong‐motion recordings of the 2010 Mw 8.8 Maule, Chile, earthquake with high stress‐drop subevents and background slip

    Frankel, Arthur


    Strong‐motion recordings of the Mw 8.8 Maule earthquake were modeled using a compound rupture model consisting of (1) a background slip distribution with large correlation lengths, relatively low slip velocity, and long peak rise time of slip of about 10 s and (2) high stress‐drop subevents (asperities) on the deeper portion of the rupture with moment magnitudes 7.9–8.2, high slip velocity, and rise times of slip of about 2 s. In this model, the high‐frequency energy is not produced in the same location as the peak coseismic slip, but is generated in the deeper part of the rupture zone. Using synthetic seismograms generated for a plane‐layered velocity model, I find that the high stress‐drop subevents explain the observed Fourier spectral amplitude from about 0.1 to 1.0 Hz. Broadband synthetics (0–10 Hz) were calculated by combining deterministic synthetics derived from the background slip and asperities (≤1  Hz) with stochastic synthetics generated only at the asperities (≥1  Hz). The broadband synthetics produced response spectral accelerations with low bias compared to the data, for periods of 0.1–10 s. A subevent stress drop of 200–350 bars for the high‐frequency stochastic synthetics was found to bracket the observed spectral accelerations at frequencies greater than 1 Hz. For most of the stations, the synthetics had durations of the Arias intensity similar to the observed records.

  11. Long-term responses of sandy beach crustaceans to the effects of coastal armouring after the 2010 Maule earthquake in South Central Chile

    Rodil, Iván F.; Jaramillo, Eduardo; Acuña, Emilio; Manzano, Mario; Velasquez, Carlos


    Earthquakes and tsunamis are large physical disturbances frequently striking the coast of Chile with dramatic effects on intertidal habitats. Armouring structures built as societal responses to beach erosion and shoreline retreat are also responsible of coastal squeeze and habitat loss. The ecological implications of interactions between coastal armouring and earthquakes have recently started to be studied for beach ecosystems. How long interactive impacts persist is still unclear because monitoring after disturbance generally extends for a few months. During five years after the Maule earthquake (South Central Chile, February 27th 2010) we monitored the variability in population abundances of the most common crustacean inhabitants of different beach zones (i.e. upper, medium, and lower intertidal) at two armoured (one concrete seawall and one rocky revetment) and one unarmoured sites along the sandy beach of Llico. Beach morphology changed after the earthquake-mediated uplift, restoring upper- and mid-shore armoured levels that were rapidly colonized by typical crustacean species. However, post-earthquake increasing human activities affected the colonization process of sandy beach crustaceans in front of the seawall. Lower-shore crab Emerita analoga was the less affected by armouring structures, and it was the only crustacean species present at the three sites before and after the earthquake. This study shows that field sampling carried out promptly after major disturbances, and monitoring of the affected sites long after the disturbance is gone are effective approaches to increase the knowledge on the interactive effects of large-scale natural phenomena and artificial defences on beach ecology.


    Yony Ormazábal


    Full Text Available In general, the Mediterranean forests have suffered high levels of fragmentation, mainly by anthropogenic action, as result of the productive activities of agriculture and livestock, human settlements and forest plantations of fast growing exotic species, leading to loss of continuity of natural forests, and thus a decrease of biodiversity. In this context, the objective of this study was to evaluate the potential use of satellite images and Geographic Information Systems (GIS to quantify and characterize the spatial evolution of native forests in a semi-arid landscape area at the Region of Maule, Chile. The study was conducted with Landsat-5 TM images of 2004 and 2008, which were classified by the supervised method where it was previously necessary to apply the atmospheric and the geometric corrections to reduce errors of interpretation and measurement. Within the analysis, it was incorporated digital thematic information of land use of the National Forestry Corporation (CONAF and also it was joined one of the latest techniques derived from remote sensing for studying changes in land cover, that is called Radiometric Rotation Controlled by No-Change Axis (RCNA. Finally, the fragmentation indexes were estimated for characterizing the spatial configuration of landscape. From the results of the digital classification it was possible to estimate landscape metrics that show significant differences in the structure of the study area between the two periods. In addition, it was generated an image of change 2004/2008 that allowed to evaluate the consistency of the RCEN technique, demonstrating the feasibility of using this alternative methodology for the detection of changes in terms of degradation and recovery of woodlands.

  13. High-frequency seismic radiation from Maule earthquake (Mw 8.8, 2010 February 27) inferred from high-resolution backprojection analysis

    Palo, M.; Tilmann, F.; Krüger, F.; Ehlert, L.; Lange, D.


    The Maule earthquake (2010 February 27, Mw 8.8, Chile) broke the subduction megathrust along a previously locked segment. Based on an international aftershock deployment, catalogues of precisely located aftershocks have become available. Using 23 well-located aftershocks, we calibrate the classic teleseismic backprojection procedure to map the high-frequency seismic radiation emitted during the earthquake. The calibration corrects traveltimes in a standard earth model both with a static term specific to each station, and a `dynamic' term specific to each combination of grid point and station. The second term has been interpolated over the whole slipping area by kriging, and is about an order of magnitude smaller than the static term. This procedure ensures that the teleseismic images of rupture development are properly located with respect to aftershocks recorded with local networks and does not depend on accurate hypocentre location of the main shock. We track a bilateral rupture propagation lasting ˜160 s, with its dominant branch rupturing northeastwards at about 3 km s-1. The area of maximum energy emission is offset from the maximum coseismic slip but matches the zone where most plate interface aftershocks occur. Along dip, energy is preferentially released from two disconnected interface belts, and a distinct jump from the shallower belt to the deeper one is visible after about 20 s from the onset. However, both belts keep on being active until the end of the rupture. These belts approximately match the position of the interface aftershocks, which are split into two clusters of events at different depths, thus suggesting the existence of a repeated transition from stick-slip to creeping frictional regime.

  14. Magma injection into a long-lived reservoir to explain geodetically measured uplift: Application to the 2007-2014 unrest episode at Laguna del Maule volcanic field, Chile

    Le Mével, Hélène; Gregg, Patricia M.; Feigl, Kurt L.


    Moving beyond the widely used kinematic models for the deformation sources, we present a new dynamic model to describe the process of injecting magma into an existing magma reservoir. To validate this model, we derive an analytical solution and compare its results to those calculated using the Finite Element Method. A Newtonian fluid characterized by its viscosity, density, and overpressure (relative to the lithostatic value) flows through a vertical conduit, intruding into a reservoir embedded in an elastic domain, leading to an increase in reservoir pressure and time-dependent surface deformation. We apply our injection model to Interferometric Synthetic Aperture Radar (InSAR) data from the ongoing unrest episode at Laguna del Maule (Chile) volcanic field that started in 2007. Using a grid search optimization, we minimize the misfit to the InSAR displacement data and vary the three parameters governing the analytical solution: the characteristic timescale τP for magma propagation, the maximum injection pressure, and the inflection time when the acceleration switches from positive to negative. For a spheroid with semimajor axis a = 6200 m, semiminor axis c = 100 m, located at a depth of 4.5 km in a purely elastic half-space, the best fit to the InSAR displacement data occurs for τP=9.5 years and an injection pressure rising up to 11.5 MPa for 2 years. The volume flow rate increased to 1.2 m3/s for 2 years and then decreased to 0.7 m3/s in 2014. In 7.3 years, at least 187 × 106 m3 of magma was injected.

  15. Preferencias y disposición a pagar por uva de mesa orgánica en la región del Maule, Chile

    Arcadio Alberto Cerda Urrutia


    Full Text Available El presente estudio tuvo como objetivo determinar las preferencias y disposición a pagar por consumo de uva de mesa orgánica. Específicamente, se buscó determinar la utilidad y jerarquizar los atributos más importantes que consideran los individuos al momento de la elección de uva de mesa y determinar la disposición a pagar por uva de mesa orgánica en la Región del Maule, Chile. Se aplicó una encuesta a una muestra probabilística y estratificada por niveles socioeconómico en los hogares en los principales centros urbanos de la región. Se utilizó el método de análisis conjunto a fin de determinar las preferencias de los individuos por los distintos atributos y el método de valoración contingente para determinar el monto medio de sobreprecio que una persona está dispuesta a pagar por un kilo de uva orgánica. Igualmente se calculó la disposición a pagar marginal vía el método de análisis conjunto. Se determinó que el atributo más importante a la hora de adquirir este bien es el precio, mientras que la mezcla de atributos que más tiene utilidad por orden de importancia es el sabor dulce, de producción orgánica, que no posea semillas y de piel delgada.Además, se estimó que las personas están dispuestas a pagar un sobreprecio por la uva de mesa orgánica, abriendo nuevas oportunidades de negocios para el sector frutícola.

  16. Extremity vascular trauma. A 7-year experience in Lahore, Pakistan.

    Hussain, Muhammad I; Zahid, Muhammad; Khan, Abdul-Waheed; Askri, Hasan; Khan, AbulFazal A


    To determine the outcome of various techniques of vascular repair in terms of repair related complications and limb salavagibility. From January 1999 to December 2005, this retrospective study was conducted in the Department of General Surgery, Lahore General Hospital, Lahore, Pakistan. The patients, who underwent various surgical interventions for extremity vascular trauma, were included in this study. Those, who underwent primary amputation due to non-salvageable injuries or who presented with late complications of vascular injuries were excluded. Ninety-three patients underwent different surgical procedures for extremity vascular trauma. Majority of the patients were young, (mean, 29.4 years) male (91.3%). Penetrating trauma was the most common mode of injury (77.4%). The median time interval between injury and repair was 4.5 hours. Superficial femoral artery was the most frequently injured artery (26.8%). Graft repair was carried out in 41 patients (46.6%), while (34.1%) of the patients had end-to-end anastomosis. Wound infection was the most common complication (18.2%). Seven patients (7.5%) had secondary amputations and 3 (3.2%) died from other injuries. Vascular reconstruction was successful in 89.3% of the patients. Early revascularization by employing simple repair or interposition autogenous vein graft repair results in successful limb salvage with acceptable complication rate.

  17. 番茄红素对血管内皮细胞损伤的保护作用%Protection of Lycopene Against the Injury of Vascular Endothelial Cells

    宁静; 张松; 张余杭


    Objective To study the protective effect of lycopene on vascular endothelial cell injury by cigarette smoke extract ( CSE) . Methods CSE was prepared and the human umbilical vein endothelial cells ( HUVECs) were assigned into four groups, cells in control were untreated, and cells in other three groups were treated by 10%CSE, 10%CSE+1. 0 μmol·L-1 lycopene and 1. 0 μmol·L-1 lycopene, respectively. Cell viability was evaluated using MTT assay. The intracelluar reactive oxygen species ( ROS) level was detected by ROS assay kits. Cell cycle and apoptosis were analyzed by flow cytometry. SIRT1 expression was detected by real-time fluorescence quantification PCR ( qRT-PCR) and Western blot. Results Cell viability in 10%CSE group, 10%CSE+1. 0 μmol·L-1 lycopene or 1. 0 μmol·L-1 lycopene group was (56. 7±5. 1)%,(75. 6±7. 1)% and (95. 5± 9. 7)%, respectively. ROS assay showed that the relative fluorescence intensity in the control was 25. 3±3. 9, however, in 10%CSE group, 10%CSE+1. 0 μmol·L-1 lycopene group or 1. 0 μmol·L-1 lycopene group were 67. 3±4. 6, 45. 3±3. 9 and 20. 8±2. 9, respectively. 10%CSE could induce G2 arrested and which could be antagonized by 1. 0 μmol·L-1 lycopene. The apoptosis rate in the control, 10%CSE group, 10%CSE+1. 0 μmol·L-1 lycopene group or 1. 0 μmol·L-1 lycopene group was (6. 2±0. 5)%, (30.8±4.3)%, (18. 3±1. 9)% and (7. 6±0. 4)%, respectively. As shown in qRT-PCT testing, compared with the control, mRNA of SIRT1 in 10%CSE group, 10%CSE+1. 0 μmol·L-1 lycopene group and 1. 0 μmol·L-1 lycopene group was (0. 51± 0. 03) fold, (0. 84±0. 05) fold, and (1. 31±0. 08) fold compared to the control, the data from western blot were consistent with qRT-PCR results. Conclusion Lycopene can prevent HUVECs from injury induced by CSE by upregulation of SIRT1.%目的:研究番茄红素对香烟烟雾提取物致血管内皮细胞损伤的保护作用。方法将人脐周静脉血管内皮细胞( HUVEC )分为4组,对

  18. Systemic complement activation, lung injury, and products of lipid peroxidation.

    Ward, P. A.; Till, G O; Hatherill, J. R.; Annesley, T M; Kunkel, R G


    Previously we have demonstrated that systemic activation of the complement system after intravenous injection of cobra venom factor (CVF) results in acute lung injury as reflected by increases in the vascular permeability of the lung as well as by morphologic evidence of damage to lung vascular endothelial cells. In using the vascular permeability of the lung as the reference, the current studies show a quantitative correlation between lung injury and the appearance in plasma of lipid peroxid...

  19. Back Injuries

    ... extending from your neck to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, ... back is the most common site of back injuries and back pain. Common back injuries include Sprains ...

  20. Electrical Injuries

    ... it can pass through your body and cause injuries. These electrical injuries can be external or internal. You may have one or both types. External injuries are skin burns. Internal injuries include damage to ...

  1. Lightning and thermal injuries.

    Sanford, Arthur; Gamelli, Richard L


    Electrical burns are classified as either high voltage (1000 volts and higher) or low voltage (Lightning strikes may conduct millions of volts of electricity, yet the effects can range from minimal cutaneous injuries to significant injury comparable to a high-voltage industrial accident. Lightning strikes commonly result in cardiorespiratory arrest, for which CPR is effective when begun promptly. Neurologic complications from electrical and lightning injuries are highly variable and may present early or late (up to 2 years) after the injury. The prognosis for electricity-related neurologic injuries is generally better than for other types of traumatic causes, suggesting a conservative approach with serial neurologic examinations after an initial CT scan to rule out correctable causes. One of the most common complications of electrical injury is a cardiac dysrhythmia. Because of the potential for large volumes of muscle loss and the release of myoglobin, the presence of heme pigments in the urine must be evaluated promptly. Presence of these products of breakdown of myoglobin and hemoglobin puts the injured at risk for acute renal failure and must be treated. The exact mechanism of nerve injury has not been explained, but both direct injury by electrical current overload or a vascular cause receive the most attention. Because electrical injuries carry both externally visible cutaneous injuries and possible hidden musculoskeletal damage, conventional burn resuscitation formulas based on body surface area injured may not provide enough fluid to maintain urine output. Damaged muscle resulting in swelling within the investing fascia of an extremity may result in compartment syndromes, requiring further attention. If myoglobin has been detected in the urine, treatment is aggressive volume resuscitation and possibly alkalinization of the urine or mannitol is given IV push to minimize pigment precipitation in the renal tubules. Approximately 15% of electrical burn victims

  2. Outer rise seismicity related to the Maule, Chile 2010 megathrust earthquake and hydration of the incoming oceanic lithosphere Sismicidad 'outer rise' relacionada con el mega terremoto de Maule, Chile en el 2010 e hidratación de la litósfera oceánica subductante

    Eduardo Moscoso


    Full Text Available Most of the recent published geodetic models of the 2010 Maule, Chile mega-thrust earthquake (Mw=8.8 show a pronounced slip maximum of 15-20 m offshore Iloca (~35°S, indicating that co-seismic slip was largest north of the epicenter of the earthquake rupture area. A secondary slip maximum 8-10 m appears south of the epicenter west of the Arauco Peninsula. During the first weeks following the main shock and seaward of the main slip maximum, an outer rise seismic cluster of >450 events, mainly extensional, with magnitudes Mw=4-6 was formed. In contrast, the outer rise located seaward of the secondary slip maximum presents little seismicity. This observation suggests that outer rise seismicity following the Maule earthquake is strongly correlated with the heterogeneous coseismic slip distribution of the main megathrust event. In particular, the formation of the outer-rise seismic cluster in the north, which spatially correlates with the main maximum slip, is likely linked to strong extensional stresses transfered from the large slip of the subducting oceanic plate. In addition, high resolution bathymetric data reveals that bending-related faulting is more intense seaward of the main maximum slip, where well developed extensional faults strike parallel to the trench axis. Also published seismic constraints reveal reduced P-wave velocities in the uppermost mantle at the trench-outer rise region (7.5-7.8 km/s, which suggest serpentinization of the uppermost mantle. Seawater percolation up to mantle depths is likely driven by bending related-faulting at the outer rise. Water percolation into the upper mantle is expected to be more efficient during the co-seismic and early post-seismic periods of large megathrust earthquakes when intense extensional faulting of the oceanic lithosphere facilitates water infiltration seaward of the trench.La mayoría de los modelos geodésicos del terremoto de 2010 en la Región del Maule, Chile (Mw=8.8 muestran un

  3. Aldosterone and vascular damage.

    Duprez, D; De Buyzere, M; Rietzschel, E R; Clement, D L


    Although the aldosterone escape mechanism is well known, aldosterone has often been neglected in the pathophysiologic consequences of the activated renin-angiotensin-aldosterone system in arterial hypertension and chronic heart failure. There is now evidence for vascular synthesis of aldosterone aside from its secretion by the adrenal cortex. Moreover, aldosterone is involved in vascular smooth muscle cell hypertrophy and hyperplasia, as well as in vascular matrix impairment and endothelial dysfunction. The mechanisms of action of aldosterone may be either delayed (genomic) or rapid (nongenomic). Deleterious effects of aldosterone leading to vascular target-organ damage include (besides salt and water retention) decreased arterial and venous compliance, increased peripheral vascular resistance, and impaired autonomic vascular control due to baroreflex dysfunction.

  4. Positioning Vascularized Composite Allotransplantation in the Spectrum of Transplantation


    AWARD NUMBER: W81XWH-13-2-0058 TITLE: Positioning Vascularized Composite Allotransplantation in the Spectrum of Transplantation PRINCIPAL...2016 4. TITLE AND SUBTITLE Positioning Vascularized Composite Allotransplantation in the Spectrum of Transplantation 5a. CONTRACT NUMBER test if peri- transplant immunotherapy will allow long-term VCA survival without development of chronic injury; Task 4 involves testing the ability

  5. Investigation of the high-frequency attenuation parameter, κ (kappa), from aftershocks of the 2010 Mw 8.8 Maule, Chile earthquake

    Neighbors, Corrie; Liao, E. J.; Cochran, Elizabeth S.; Funning, G. J.; Chung, A. I.; Lawrence, J. F.; Christensen, C. M.; Miller, M.; Belmonte, A.; Sepulveda, H. H. Andrés


    The Bío Bío region of Chile experienced a vigorous aftershock sequence following the 2010 February 27 Mw 8.8 Maule earthquake. The immediate aftershock sequence was captured by two temporary seismic deployments: the Quake Catcher Network Rapid Aftershock Mobilization Program (QCN RAMP) and the Incorporated Research Institutions for Seismology CHile Aftershock Mobilization Program (IRIS CHAMP). Here, we use moderate to large aftershocks (ML ≥ 4.0) occurring between 2010 March 1 and June 30 recorded by QCN RAMP and IRIS CHAMP stations to determine the spectral decay parameter, kappa (κ). First, we compare waveforms and κ estimates from the lower-resolution QCN stations to the IRIS CHAMP stations to ensure the QCN data are of sufficient quality. We find that QCN stations provide reasonable estimates of κ in comparison to traditional seismic sensors and provide valuable additional observations of local ground motion variation. Using data from both deployments, we investigate the variation in κ for the region to determine if κ is influenced primarily by local geological structure, path attenuation, or source properties (e.g. magnitude, mechanism and depth). Estimates of κ for the Bío Bío region range from 0.0022 to 0.0704 s with a mean of 0.0295 s and are in good agreement with κ values previously reported for similar tectonic environments. κ correlates with epicentral distance and, to a lesser degree, with source magnitude. We find little to no correlation between the site kappa, κ0, and mapped geology, although we were only able to compare the data to a low-resolution map of surficial geology. These results support an increasing number of studies that suggest κobservations can be attributed to a combination of source, path and site properties; additionally, measured κ are often highly scattered making it difficult to separate the contribution from each of these factors. Thus, our results suggest that contributions from the site

  6. Afterslip and Viscoelastic Relaxation Model Inferred from the Large Scale Postseismic Deformation Following the 2010 Mw 8,8 Maule Earthquake (Chile)

    Vigny, C.; Klein, E.; Fleitout, L.; Garaud, J. D.


    Postseismic deformation following the large subduction earthquake of Maule (Chile, Mw8.8, February 27th 2010) have been closely monitored with GPS from 70 km up to 2000 km away from the trench. They exhibit a behavior generally similar to that already observed after the Aceh and Tohoku-Oki earthquakes. Vertical uplift is observed on the volcanic arc and a moderate large scale subsidence is associated with sizeable horizontal deformation in the far-field (500-2000km from the trench). In addition, near-field data (70-200km from the trench) feature a rather complex deformation pattern. A 3D FE code (Zebulon Zset) is used to relate these deformation to slip on the plate interface and relaxation in the mantle. The mesh features a spherical shell-portion from the core-mantle boundary to the Earth's surface, extending over more than 60 degrees in latitude and longitude. The overridding and subducting plates are elastic, and the asthenosphere is viscoelastic. A viscoelastic Low Viscosity Channel (LVC) is also introduced along the plate interface. Both the asthenosphere and the channel feature Burger's rheologies and we invert for their mechanical properties and geometrical characteristics simultaneously with the afterslip distribution. The horizontal deformation pattern requires relaxation both in i) the asthenosphere extending down to 270km, with a 'long-term' viscosity of the order of 4.8.1018 Pa.s and ii) in the channel, that has to extend from depth of 50 to 150 km with viscosities slightly below 1018 Pa.s, to fit well the vertical velocity pattern (intense and quick uplift over the Cordillera). Aseismic slip on the plate interface, at shallow depth, is necessary to explain all the characteristics of the near-field displacements. We then detect two main patches of high slip, one updip of the coseismic slip distribution in the northernmost part of the rupture zone, and the other one downdip, at the latitude of Constitucion (35°S). We finally study the temporel

  7. Outcomes of arterial vascular extremity trauma in pediatric patients.

    Kirkilas, Mary; Notrica, David M; Langlais, Crystal S; Muenzer, Jared T; Zoldos, Jozef; Graziano, Kathleen


    Vascular trauma in children, although rare, carries significant risk for repair. Here we report outcomes from a single trauma center for children with extremity vascular trauma, proximal to the digits. Retrospective chart review of patients less than age 18years with an acute, non-iatrogenic traumatic arterial vascular injury of the upper and/or lower extremity between January 2008 and December 2013. Abstracted patient demographics, injury characteristics, surgical management, and disposition were summarized and compared with nonparametric methods. 23 children comprised the study cohort: median age of 8years (IQR: 4.6-12), 61% (n=14) males, 100% survival. Penetrating injuries were the predominate mechanism (n=17, 74%). The median time to presentation was 154min (IQR: 65-330). Acute operations for revascularization included a primary repair (n=15, 65%) or reversed vein graft (n=7, 30%). Fasciotomies were done for 3 (13%) patients. Three amputations were done for failed revascularization. Upper extremity vascular injury (n=15, 65%) was more common. The rate of associated extremity fracture was similar between upper (21%) and lower (33%) extremities (p=0.643). Eight (35%) patients required additional surgery most commonly for debridement, washouts and dressing changes. Three patients' hospital stays were complicated by infection. Impaired function was the most common short- and long-term complication (60%, 75%). Pediatric vascular injuries are commonly associated with penetrating injuries and male gender and occurred more frequently in the upper extremities. Overall patency rates after repair were 87%. Fasciotomies were done in 13% of patients, and the overall surgical amputation rate was 13%. There was no mortality in this cohort; however, multiple operations are commonly required, including the return to OR for washouts, debridements and dressing changes. The most common short- and long-term complication was impaired function. Overall good results are achievable in

  8. Comparison of Temporary Open Arterial Revascularization Using Stent Grafts vs. Standard Vascular Shunts in a Porcine (Sus scrofa) Model


    standard temporary vascular shunts. We sought to characterize patency and flow characteristics of these grafts compared to standard shunts in a...survival model of porcine vascular injury. Methods: 12 Yorkshire-cross swine received a 2cm long near-circumferential defect in the iliac arteries. A14...shunts was greater than that of the stent grafts. Conclusion: Open sutureless direct site repair using stent grafts to treat vascular injury is a

  9. Training activities and injuries in English youth academy and schools rugby union.

    Palmer-Green, Deborah S; Stokes, Keith A; Fuller, Colin W; England, Michael; Kemp, Simon P T; Trewartha, Grant


    All rugby training activities carry an injury risk, but in the training environment these injury risks should be more controllable than during matches. To (1) describe the incidence, severity, anatomic location, and type of youth rugby training injuries; (2) determine the injury events and type of training activities associated with injuries; and (3) compare 2 levels of play (professional academy vs school) within English youth rugby union. Cohort study; Level of evidence, 2. A 2-season (2006-2007 and 2007-2008) study recorded exposure to training activities and time-loss injuries in male youth rugby union players (age range, 16-18 years) from 12 English Premiership academies (250 player-seasons) and 7 schools (222 player-seasons). Players from the Premiership academies, associated with the top-level professional clubs in England, represented the elite level of youth rugby; the school players were from established rugby-playing schools but were overall considered at a lower level of play. There was a trend for training injury incidence to be lower for the academy group (1.4/1000 player-hours; 95% CI, 1.0-1.7) compared with the school group (2.1/1000 player-hours; 95% CI, 1.4-2.9) (P = .06). Injuries to the ankle/heel and thigh were most common in academy players and injuries to the lumbar spine and ankle/heel region most common in school players. The training activities responsible for injury differed between the 2 groups: technical skills (scrummaging) for school players and contact skills (defense and ruck/maul drills) for academy players. For injury risk management in youth rugby, coaches of school players should focus on the development of the correct technique during practice of technical skills such as scrummaging, weight training, and skills training, and coaches of academy players should consider the extent to which contact drills are necessary during training. © 2014 The Author(s).

  10. Vascular oxidant stress and inflammation in hyperhomocysteinemia.

    Papatheodorou, Louisa; Weiss, Norbert


    Elevated plasma levels of homocysteine are a metabolic risk factor for atherosclerotic vascular disease, as shown in numerous clinical studies that linked elevated homocysteine levels to de novo and recurrent cardiovascular events. High levels of homocysteine promote oxidant stress in vascular cells and tissue because of the formation of reactive oxygen species (ROS), which have been strongly implicated in the development of atherosclerosis. In particular, ROS have been shown to cause endothelial injury, dysfunction, and activation. Elevated homocysteine stimulates proinflammatory pathways in vascular cells, resulting in leukocyte recruitment to the vessel wall, mediated by the expression of adhesion molecules on endothelial cells and circulating monocytes and neutrophils, in the infiltration of leukocytes into the arterial wall mediated by increased secretion of chemokines, and in the differentiation of monocytes into cholesterol-scavenging macrophages. Furthermore, it stimulates the proliferation of vascular smooth muscle cells followed by the production of extracellular matrix. Many of these events involve redox-sensitive signaling events, which are promoted by elevated homocysteine, and result in the formation of atherosclerotic lesions. In this article, we review current knowledge about the role of homocysteine on oxidant stress-mediated vascular inflammation during the development of atherosclerosis.

  11. Vascular Complications of Pancreatitis: Role of Interventional Therapy

    Barge, Jaideep U.; Lopera, Jorge E. [University of Texas Health Science Center, San Antonio (United States)


    Major vascular complications related to pancreatitis can cause life-threatening hemorrhage and have to be dealt with as an emergency, utilizing a multidisciplinary approach of angiography, endoscopy or surgery. These may occur secondary to direct vascular injuries, which result in the formation of splanchnic pseudoaneurysms, gastrointestinal etiologies such as peptic ulcer disease and gastroesophageal varices, and post-operative bleeding related to pancreatic surgery. In this review article, we discuss the pathophysiologic mechanisms, diagnostic modalities, and treatment of pancreatic vascular complications, with a focus on the role of minimally-invasive interventional therapies such as angioembolization, endovascular stenting, and ultrasound-guided percutaneous thrombin injection in their management.

  12. Nursing assistance during endovascular reconstruction using balloon occlusion of the abdominal aorta for patients with severe pelvic trauma and vascular injury%严重骨盆外伤合并血管损伤应用腹主动脉球囊阻断技术的护理配合

    钱维明; 杜丽丽; 项海燕


    This paper summarizes the experience of nursing assistance during endovascular reconstruction using balloon occlusion of the abdominal aorta for patients with severe pelvic trauma and vascular injury in traffic accidents. Measures of nursing assistance included preoperative preparation,maintaining vascular access,monitoring urine volume,bilateral dorsalis pedis arterial pulses and the change of blood pressure during the operation. Postoperative nursing focused on effective compression on femoral artery after withdrawal of catheter,observation of urine volume,and local hematoma and skin temperature of lower extremities. The four patients got through the perioperative period safely and were discharged with recovery.%总结了4例因车祸致严重骨盆外伤合并血管损伤的急诊患者应用腹主动脉球囊阻断技术的护理配合经验.护理配合重点包括:完善术前准备,术中确保动静脉通路畅通,准确观察尿量,密切观察双侧足背动脉的搏动,监测血压的变化,穿刺侧肢体拔管后予有效压迫,观察尿量、局部血肿及肢体皮温.4例患者均安全度过围手术期,痊愈出院.

  13. 联合运用维生素D3和动物油建立小鼠钙化性血管损伤模型%Combination of vitamin D3 and animal oil induces calcified vascular injury in mice

    谢爱媚; 司徒永立; 吴铁


    背景:现有的小鼠血管损伤模型难以使小鼠主动脉同时出现钙化和损伤这两种病理变化.目的:联合运用超生理剂量维生素D3和动物油建立小鼠钙化性血管损伤模型.方法:连续4 d灌胃给予小鼠3×105 U/(kg · d)维生素D3,第5~42天灌胃给予5 mL/(kg · D)动物油,建立小鼠钙化性血管损伤模型.结果与结论:模型小鼠血脂、血钙和血磷水平均无显著变化(P > 0.05),ICP等离子发射光谱仪检测显示模型小鼠腹主动脉钙、磷含量升高(P 0.05). Meanwhile, the calcium and phosphorus contents in the abdominal aorta were significantly increased in the model group (P < 0.05). Hematoxylin-eosin staining revealed the pathological changes of the thoracic aorta, such as obvious calcification plaques, which appeared on the vessel walls and might rupture and result in defects, then the neointimal forming. Besides, eastic fibers presented with lower ductility and breakage. Apoptosis was induced greatly in media vascular smooth muscle cells, and fibrous plaques were locally present due to the proliferation of vascular smooth muscle cells. The calcified vascular injury model in mice can be established by a combination of vitamin D3 and animal oil.

  14. Poikiloderma vasculare atrophicans

    Padmavathy L


    Full Text Available A 65 year old lady presented with generalised pruritus and discolouration of skin and mucous membranes of 5 years duration. The histopathology from the cutaneous lesions revealed features suggestive of poikiloderma vasculare atrophicans (PVA. Investigations did not reveal any underlying connective tissue disease,lymphoma or systemic disease. A diagnosis of idiopathic poikiloderma vasculare atrophicans was made.

  15. [Vascular factors in glaucoma].

    Mottet, B; Aptel, F; Geiser, M; Romanet, J P; Chiquet, C


    The exact pathophysiology of glaucoma is not fully understood. Understanding of the vascular pathophysiology of glaucoma requires: knowing the techniques for measuring ocular blood flow and characterizing the topography of vascular disease and the mechanisms involved in this neuropathy. A decreased mean ocular perfusion pressure and a loss of vascular autoregulation are implicated in glaucomatous disease. Early decrease in ocular blood flow has been identified in primary open-angle glaucoma and normal pressure glaucoma, contributing to the progression of optic neuropathy. The vascular damage associated with glaucoma is present in various vascular territories within the eye (from the ophthalmic artery to the retina) and is characterized by a decrease in basal blood flow associated with a dysfunction of vasoregulation.

  16. Chemerin Regulates Crosstalk Between Adipocytes and Vascular Cells Through Nox.

    Neves, Karla Bianca; Nguyen Dinh Cat, Aurelie; Lopes, Rheure Alves Moreira; Rios, Francisco Jose; Anagnostopoulou, Aikaterini; Lobato, Nubia Souza; de Oliveira, Ana Maria; Tostes, Rita C; Montezano, Augusto C; Touyz, Rhian M


    Adipocytes produce adipokines, including chemerin, a chemoattractant that mediates effects through its ChemR23 receptor. Chemerin has been linked to endothelial dysfunction and vascular injury in pathological conditions, such as obesity, diabetes mellitus, and hypertension. Molecular mechanisms underlying this are elusive. Here we assessed whether chemerin through redox-sensitive signaling influences molecular processes associated with vascular growth, apoptosis, and inflammation. Human microvascular endothelial cells and vascular smooth muscle cells were stimulated with chemerin (50 ng/mL). Chemerin increased generation of reactive oxygen species and phosphorylation of mitogen-activated protein kinases, effects that were inhibited by ML171, GKT137831 (Nox inhibitors), and N-acetylcysteine (reactive oxygen species scavenger). Chemerin increased mRNA expression of proinflammatory mediators in vascular cells and increased monocyte-to-endothelial cell attachment. In human vascular smooth muscle cells, chemerin induced phosphorylation of mitogen-activated protein kinases and stimulated proliferation (increased proliferating cell nuclear antigen expression [proliferation marker] and BrdU incorporation [proliferation assay]). Chemerin decreased phosphatidylinositol 3-kinase/protein kinase B activation and increased TUNEL-positive human vascular smooth muscle cells. In human microvascular endothelial cells, chemerin reduced endothelial nitric oxide synthase activity and nitric oxide production. Adipocyte-conditioned medium from obese/diabetic mice (db/db), which have elevated chemerin levels, increased reactive oxygen species generation in vascular smooth muscle cells, whereas adipocyte-conditioned medium from control mice had no effect. Chemerin actions were blocked by CCX 832, a ChemR23 inhibitor. Our data demonstrate that chemerin, through Nox activation and redox-sensitive mitogen-activated protein kinases signaling, exerts proapoptotic, proinflammatory, and

  17. Micro-negocios asociativos campesinos: análisis económico de un sistema de producción ovina, Región del Maule, Chile Undertaking associative small holding business: economic analysis of the sheep production system, Maule region, Chile

    Germán Lobos Andrade


    Full Text Available El objetivo de esta investigación fue evaluar la rentabilidad económica de un sistema de producción ovina para un grupo de 20 productores agropecuarios, cuyos predios se encuentran localizados en la zona de secano interior de la provincia de Linares, Región del Maule, Chile. El trabajo en terreno se realizó durante el periodo noviembre del 2002 a junio 2003, el cual permitió caracterizar a los productores en cuatro grupos homogéneos entre sí, en función del número de cabezas del rebaño ovino. Para estimar la rentabilidad económica del sistema propuesto, bajo distintos escenarios de precios de venta, se usó el Valor Actual Neto (VAN, la Tasa Interna de Retorno (TIR y el Índice de Valor Actual Neto (IVAN. El valor promedio del rebaño ovino fue estimado entre 0,26 a $ 1,45 millones y el valor promedio de la tierra entre 6,3 y $ 12,8 millones, dependiendo del tamaño del predio agrícola (hectáreas. Para el escenario normal de precios, se obtuvo un VAN (10,8% de $ 4,12 millones, la TIR se estimó en 14,5% y el IVAN en 0,37. La principal conclusión sugiere que el emprendimiento asociativo a micro-escala puede contribuir a mejorar las condiciones de vida de los pequeños productores.The aim of this research was to assess the economic profitability of a associative sheep husbandry business system for 20 agricultural small holdings, located in the inner unirrigated Linares area, in the Maule region, Chile. Data from the period of November 2002 until June 2003 were recollected, for characterizing the producers in four quite homogeneous sub-groups, according to the size of their herd. Profitability for a proposal system, under different price scenarios, was assessed by means of traditional indicators: Net Present Value (VAN, Internal Rate of Return (TIR and Net Present Value Index (IVAN. The average value of the sheep herd was estimated from 0.26 to $ 1.45 millions and the average value of land from 6.3 to $ 12.8 millions, depending on

  18. Vascular trauma in Western Australia: a comparison of two study periods over 15 years.

    Friend, Jikol; Rao, Sudhakar; Sieunarine, Kishore; Woodroof, Paul


    Royal Perth Hospital (RPH) has become Western Australia's only designated adult major trauma facility since a previous study of vascular trauma was conducted in 2001 at the same facility. The aim of this study is to identify changes in vascular trauma patterns over the two study periods and compare these changes with international literature. All individuals presenting to RPH between January 2000 and December 2010 with vascular injury were identified from a prospective trauma database for this descriptive study. Injuries were classified using the Abbreviated Injury Score (AIS). The incidence of vascular trauma as a percentage of total trauma increased over the two study periods. The current 10-year study included 45 164 patients on the trauma database, of which 1205 patients (2.6%) sustained 1335 vascular injuries, an increase from 1% in the previous 5-year study at the same facility. Males aged 20-29 years were more frequently injured. Blunt trauma occurred more frequently than penetrating. The extremities, particularly the upper limbs were most commonly injured. The most common causes of injury for each region were as follows; motorbike crash (MBC), motor vehicle crash (MVC) and stabbing (neck, thorax and abdomen), MBC and MVC (lower limb) and piercing injuries (upper limb). Injury Severity Score (ISS) and mortality 43% (32 of 75) were highest for thoracic injuries, particularly thoracic aorta injury. Mortality rate has decreased. Vascular injuries in Western Australia are increasing. MVC are the most common cause of life threatening injury. Road safety interventions targeting young males are likely to reduce trauma. © 2013 Royal Australasian College of Surgeons.

  19. Eye Injuries

    The structure of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or ...

  20. Sports Injuries

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper ... can also lead to injuries. The most common sports injuries are Sprains and strains Knee injuries Swollen ...

  1. Injury Statistics

    ... Certification Import Safety International Recall Guidance Civil and Criminal Penalties Federal Court Orders & Decisions Research & Statistics Research & Statistics Technical Reports Injury Statistics NEISS Injury ...

  2. Inherited complement regulatory protein deficiency predisposes to human disease in acute injury and chronic inflammatory statesthe examples of vascular damage in atypical hemolytic uremic syndrome and debris accumulation in age-related macular degeneration.

    Richards, Anna; Kavanagh, David; Atkinson, John P


    In this chapter, we examine the role of complement regulatory activity in atypical hemolytic uremic syndrome (aHUS) and age-related macular degeneration (AMD). These diseases are representative of two distinct types of complement-mediated injury, one being acute and self-limited, the other reflecting accumulation of chronic damage. Neither condition was previously thought to have a pathologic relationship to the immune system. However, alterations in complement regulatory protein genes have now been identified as major predisposing factors for the development of both diseases. In aHUS, heterozygous mutations leading to haploinsufficiency and function-altering polymorphisms in complement regulators have been identified, while in AMD, polymorphic haplotypes in complement genes are associated with development of disease. The basic premise is that a loss of function in a plasma or membrane inhibitor of the alternative complement pathway allows for excessive activation of complement on the endothelium of the kidney in aHUS and on retinal debris in AMD. These associations have much to teach us about the host's innate immune response to acute injury and to chronic debris deposition. We all experience cellular injury and, if we live long enough, will deposit debris in blood vessel walls (atherosclerosis leading to heart attacks and strokes), the brain (amyloid proteins leading to Alzheimer's disease), and retina (lipofuscin pigments leading to AMD). These are three common causes of morbidity and mortality in the developed world. The clinical, genetic, and immunopathologic understandings derived from the two examples of aHUS and AMD may illustrate what to anticipate in related conditions. They highlight how a powerful recognition and effector system, the alternative complement pathway, reacts to altered self. A response to acute injury or chronic debris accumulation must be appropriately balanced. In either case, too much activation or too little regulation promotes

  3. Local vascular adaptations after hybrid training in spinal cord-injured subjects.

    Thijssen, D.H.J.; Heesterbeek, P.; Kuppevelt, D. van; Duysens, J.E.J.; Hopman, M.T.E.


    PURPOSE: Studies investigating vascular adaptations in non-exercised areas during whole body exercise training show conflicting results. Individuals with spinal cord injury (SCI) provide a unique model to examine vascular adaptations in active tissue vs adjacent inactive areas. The purpose of this s

  4. Proximal tibial and fibular physeal fracture causing popliteal artery injury and peroneal nerve injury: A case report and review of literature

    Uday Guled; Nirmal Raj Gopinathan; Vijay G.Goni; Arjun Rhh; Rakesh John; Prateek Behera


    Either proximal tibial or tibial physeal injuries are rare.The combination of both is even rarer,let alone causes a vascular injury.Early intervention is the key for management.We hereby present an interesting case of simultaneous proximal tibiofibular physeal injury with popliteal arterial occlusion and common peroneal nerve injury.The present case is important in two aspects:firstly it reports a very rare occurrence of simultaneous proximal tibiofibular physeal injury associated with vascular insult and common peroneal nerve injury;secondly it highlights that with timely intervention excellent results can be achieved in paediatric patients.

  5. Targeting heme oxygenase-1 in vascular disease.

    Durante, William


    Heme oxygenase-1 (HO-1) metabolizes heme to generate carbon monoxide (CO), biliverdin, and iron. Biliverdin is subsequently metabolized to bilirubin by biliverdin reductase. HO-1 has recently emerged as a promising therapeutic target in the treatment of vascular disease. Pharmacological induction or gene transfer of HO-1 ameliorates vascular dysfunction in animal models of atherosclerosis, post-angioplasty restenosis, vein graft stenosis, thrombosis, myocardial infarction, and hypertension, while inhibition of HO-1 activity or gene deletion exacerbates these disorders. The vasoprotection afforded by HO-1 is largely attributable to its end products: CO and the bile pigments, biliverdin and bilirubin. These end products exert potent anti-inflammatory, antioxidant, anti-apoptotic, and anti-thrombotic actions. In addition, CO and bile pigments act to preserve vascular homeostasis at sites of arterial injury by influencing the proliferation, migration, and adhesion of vascular smooth muscle cells, endothelial cells, endothelial progenitor cells, or leukocytes. Several strategies are currently being developed to target HO-1 in vascular disease. Pharmacological induction of HO-1 by heme derivatives, dietary antioxidants, or currently available drugs, is a promising near-term approach, while HO-1 gene delivery is a long-term therapeutic goal. Direct administration of CO via inhalation or through the use of CO-releasing molecules and/or CO-sensitizing agents provides an attractive alternative approach in targeting HO-1. Furthermore, delivery of bile pigments, either alone or in combination with CO, presents another avenue for protecting against vascular disease. Since HO-1 and its products are potentially toxic, a major challenge will be to devise clinically effective therapeutic modalities that target HO-1 without causing any adverse effects.

  6. Carbon monoxide and bile pigments: surprising mediators of vascular function.

    Durante, William


    Heme oxygenase (HO) catalyzes the degradation of heme to CO, iron, and biliverdin. Biliverdin is subsequently metabolized to bilirubin by the enzyme biliverdin reductase. Although long considered irrelevant byproducts of heme catabolism, recent studies indicate that CO and the bile pigments biliverdin and bilirubin may play an important physiological role in the circulation. The release of CO by vascular cells may modulate blood flow and blood fluidity by inhibiting vasomotor tone, smooth muscle cell proliferation, and platelet aggregation. CO may also maintain the integrity of the vessel wall by directly blocking vascular cell apoptosis and by inhibiting the release of pro-apoptotic inflammatory cytokines from the vessel wall. These effects of CO are mediated via multiple pathways, including activation of soluble guanylate cyclase, potassium channels, p38 mitogen-activated protein kinase, or inhibition of cytochrome P450. In addition, the release of bile pigments may serve to sustain vascular homeostasis by protecting vascular cells from oxidative stress and by inhibiting the adhesion and infiltration of leukocytes into the vessel wall. Induction of HO-1 gene expression and the subsequent release of CO and bile pigments are observed in numerous vascular disorders and may provide an important adaptive mechanism to preserve homeostasis at sites of vascular injury. Thus, the HO-catalyzed formation of CO and bile pigments by vascular cells may function as a critical endogenous vasoprotective system. Moreover, pharmacological or genetic approaches targeting HO-1 to the vessel wall may represent a novel therapeutic approach in treating vascular disease.

  7. Congenital Vascular Malformation

    ... also be effective for small, localized birthmarks (port wine stains). Patients with a rare venous malformation (Kleppel– ... 3) non-profit organization focused on providing public education and improving awareness about vascular diseases. For more ...

  8. Vascular Effects of Histamine


    effects of histamine are mediated via H1 and H2 receptors and the actions are modulated by H3 receptor subtype ... Keywords: Histamine, Vascular smooth muscle, Endothelium .... responses to histamine, but not those to acetylcholine, were.

  9. Intracranial Vascular Treatments

    ... full size with caption Related Articles and Media Gamma Knife Linear Accelerator Catheter Embolization Angioplasty and Vascular Stenting Proton Therapy Radiation Dose in X-Ray and CT Exams Stereotactic ...

  10. Arterial vascular properties in individuals with spina bifida.

    Boot, C.R.L.; Langen, H. van; Hopman, M.T.E.


    STUDY DESIGN: Observational cross-sectional study. OBJECTIVE: To assess the vascular characteristics of the arterial circulation in individuals with spina bifida (SB) in comparison with individuals with spinal cord injury (SCI) and able-bodied controls (C). SETTING: University Medical Centre, Nijmeg

  11. Vascular and neuronal ischemic damage in cryonics patients.

    Best, Benjamin P


    Cryonics technology seeks to cryopreserve the anatomical basis of the mind so that future medicine can restore legally dead cryonics patients to life, youth, and health. Most cryonics patients experience varying degrees of ischemia and reperfusion injury. Neurons can survive ischemia and reperfusion injury more than is generally believed, but blood vessels are more vulnerable, and such injury can impair perfusion of vitrifying cryoprotectant solution intended to eliminate ice formation in the brain. Forms of vascular and neuronal damage are reviewed, along with means of mitigating that damage. Recommendations are also made for preventing such damage.

  12. Ageing and vascular ageing


    There is an age related decline in various physiological processes. Vascular ageing is associated with changes in the mechanical and the structural properties of the vascular wall, which leads to the loss of arterial elasticity and reduced arterial compliance. Arterial compliance can be measured by different parameters like pulse wave velocity, augmentation index, and systemic arterial compliance. There is evidence that arterial compliance is reduced in disease states such as hypertension, di...

  13. [Complex vascular access].

    Mangiarotti, G; Cesano, G; Thea, A; Hamido, D; Pacitti, A; Segoloni, G P


    Availability of a proper vascular access is a basic condition for a proper extracorporeal replacement in end-stage chronic renal failure. However, biological factors, management and other problems, may variously condition their middle-long term survival. Therefore, personal experience of over 25 years has been critically reviewed in order to obtain useful information. In particular "hard" situations necessitating complex procedures have been examined but, if possible, preserving the peripherical vascular features.

  14. Vascular compression syndromes.

    Czihal, Michael; Banafsche, Ramin; Hoffmann, Ulrich; Koeppel, Thomas


    Dealing with vascular compression syndromes is one of the most challenging tasks in Vascular Medicine practice. This heterogeneous group of disorders is characterised by external compression of primarily healthy arteries and/or veins as well as accompanying nerval structures, carrying the risk of subsequent structural vessel wall and nerve damage. Vascular compression syndromes may severely impair health-related quality of life in affected individuals who are typically young and otherwise healthy. The diagnostic approach has not been standardised for any of the vascular compression syndromes. Moreover, some degree of positional external compression of blood vessels such as the subclavian and popliteal vessels or the celiac trunk can be found in a significant proportion of healthy individuals. This implies important difficulties in differentiating physiological from pathological findings of clinical examination and diagnostic imaging with provocative manoeuvres. The level of evidence on which treatment decisions regarding surgical decompression with or without revascularisation can be relied on is generally poor, mostly coming from retrospective single centre studies. Proper patient selection is critical in order to avoid overtreatment in patients without a clear association between vascular compression and clinical symptoms. With a focus on the thoracic outlet-syndrome, the median arcuate ligament syndrome and the popliteal entrapment syndrome, the present article gives a selective literature review on compression syndromes from an interdisciplinary vascular point of view.

  15. Research progress on the protection of vascular endothelial injury by Danhong Injection%丹红注射液对血管内皮损伤保护作用的研究进展

    赵涛; 赵步长; 伍海勤; 赵明中


    Vascular endothelial dysfunction is a main factor causing cardiovascular disease like atherosclerosis, etc.. Maintain integrity of vascular endothelial structure and function is a premise to effectively protect endothelial cells and restore their injured functions. Therefore, in recent years multi-link and multi-target protection of endothelial cells has become a key point in research. Compound herbal formulae based on relatively complex composition have unique advantage on exerting drug efficacy in multi-target way. Danhong Injection as a kind of herbal compound preparation has role in protecting vascular endothelial function according to basic and clinical research. The article makes a review of Danhong Injection's endothelial injure protection in the aspects of anti-inflammatory, anti-thrombosis, and antioxidant in order to provide new ideas for prevention and treatment of atherosclerosis and other cardiovascular diseases by compound herbal formula.%血管内皮功能障碍是导致动脉粥样硬化等心血管疾病发生的重要因素,保持血管内皮结构与功能完整性是有效保护内皮细胞、恢复受损内皮功能的前提,因此对内皮细胞多环节、多靶点保护成为近年来研究关键.而中药复方基于组方相对复杂性,在多靶点发挥药物疗效方面显现独特优势.丹红注射液作为中药复方制剂,基础及临床研究提示其对血管内皮功能具有保护作用.本文从抗炎、抗血栓、抗氧化作用等方面对丹红注射液的内皮损伤保护作用作一综述,为中药复方对动脉粥样硬化等心血管疾病的防治提供新的思路.

  16. Baicalin inhibits PDGF-BB-stimulated vascular smooth muscle cell proliferation through suppressing PDGFRβ-ERK signaling and increase in p27 accumulation and prevents injury-induced neointimal hyperplasia

    Li-Hua Dong; Jin-Kun Wen; Sui-Bing Miao; Zhenhua Jia; Hai-Juan Hu; Rong-Hua Sun; Yiling Wu; Mei Han


    The authors would like to clarify a deficiency in our paper recently published in Cell Research (CR) (2010;20:1252-1262).We did not reference the results in the first part of our paper reporting the effect of baicalin on vascular smooth muscle cells (VSMCs) in vitro which we had previously published in the Chinese language only Chinese Journal of Cell Biology (CJCB) (2010; 32(1):91-96); the overlap includes the re-use of some western blot data from the CJCB paper (including those in upper panels of Figures 2D, 3A and 3C; and ICAM1 and VCAM-1 of Figure 5B).These results suggest that baicalin inhibits PDGF-BB-induced expression of genes related to cell proliferation and migration, and blocks cell cycle progression.

  17. Renovascular hypertension causes cerebral vascular remodeling

    Yamei Tang; Xiangpen Li; Yi Li; Qingyu Shen; Xiaoming Rong; Ruxun Huang; Ying Peng


    Renovascular hypertensive rats (RHRs) were developed using the 2-kidney, 2-clip method. All RHRs at 10 weeks displayed high permeability of the cerebral surface blood vessels. Vascular casts of the RHRs showed that the vascular network was sparse. The arterioles of the RHRs at 10 weeks had smaller lumen diameters, but thicker vessel walls with hyalinosis formation compared with control animals. The endothelial cell membrane appeared damaged, and microthrombus formed. After ischemia, the infarction size was larger in RHRs than in control animals. These results suggest that cerebral arterioles in RHRs underwent structural remodeling. High blood pressure may aggravate the severity of brain injury in cerebral ischemia and affect the recovery of ischemia.

  18. Visceral injuries.

    Wisner, D H; Blaisdell, F W


    Abdominal visceral injuries are encountered by every surgeon who deals with trauma. It is simple and useful to divide abdominal visceral injuries into those caused by penetrating mechanisms of injury and those due to blunt mechanisms. Determination of the need for operative intervention is generally easier after penetrating trauma. Gunshot wounds to the abdomen should be explored, as should stab wounds to the anterior abdomen that penetrate the fascia. A midline incision is the standard approach to abdominal visceral injuries because of its ease and versatility. Abdominal exploration should be consistent and systemic so as not to miss significant injuries. Hollow viscus injury is most common after penetrating injury, while blunt injury most often results in injury to solid viscera. Diagnostic and operative aspects of the treatment of specific visceral injuries are reviewed.

  19. Carbon monoxide inhalation increases microparticles causing vascular and CNS dysfunction.

    Xu, Jiajun; Yang, Ming; Kosterin, Paul; Salzberg, Brian M; Milovanova, Tatyana N; Bhopale, Veena M; Thom, Stephen R


    We hypothesized that circulating microparticles (MPs) play a role in pro-inflammatory effects associated with carbon monoxide (CO) inhalation. Mice exposed for 1h to 100 ppm CO or more exhibit increases in circulating MPs derived from a variety of vascular cells as well as neutrophil activation. Tissue injury was quantified as 2000 kDa dextran leakage from vessels and as neutrophil sequestration in the brain and skeletal muscle; and central nervous system nerve dysfunction was documented as broadening of the neurohypophysial action potential (AP). Indices of injury occurred following exposures to 1000 ppm for 1h or to 1000 ppm for 40 min followed by 3000 ppm for 20 min. MPs were implicated in causing injuries because infusing the surfactant MP lytic agent, polyethylene glycol telomere B (PEGtB) abrogated elevations in MPs, vascular leak, neutrophil sequestration and AP prolongation. These manifestations of tissue injury also did not occur in mice lacking myeloperoxidase. Vascular leakage and AP prolongation were produced in naïve mice infused with MPs that had been obtained from CO poisoned mice, but this did not occur with MPs obtained from control mice. We conclude that CO poisoning triggers elevations of MPs that activate neutrophils which subsequently cause tissue injuries.

  20. Racial disparities after vascular trauma are age-dependent.

    Hicks, Caitlin W; Canner, Joseph K; Zarkowsky, Devin S; Arhuidese, Isibor; Obeid, Tammam; Malas, Mahmoud B


    Different racial disparities exist between white and black all-cause trauma patients depending on their age group; however, the effects of race and age on outcomes after vascular trauma are unknown. We assessed whether the previously described age-dependent racial disparities after all-cause trauma persist in the vascular trauma population. Vascular trauma patients were identified from the Nationwide Inpatient Sample (January 2005 to December 2012) using International Classification of Diseases-Ninth Edition codes. Univariable and multivariable analyses were used to compare in-hospital mortality and amputation for blacks vs whites for younger (16-64 years) and older (≥65 years) age groups. Black patients (n = 937) were younger, more frequently male, without insurance, and suffered from more penetrating and nonaccidental injuries than white patients (n = 1486; P vascular trauma appear to be related to a higher prevalence of nonaccidental penetrating injuries in the younger black population. Race was the single greatest predictor of poor outcomes in the older population (P ≤ .008). Older black patients are nearly five-times more likely to experience death or amputation after vascular trauma than their white counterparts. Contrary to reports suggesting that younger white patients have better outcomes after all-cause trauma than younger black patients, racial disparities among patients with traumatic vascular injuries appear to be confined to the older age group after risk adjustment. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  1. Antioxidants and vascular health.

    Bielli, Alessandra; Scioli, Maria Giovanna; Mazzaglia, Donatella; Doldo, Elena; Orlandi, Augusto


    Oxygen free radicals and other reactive oxygen species (ROS) are common products of normal aerobic cellular metabolism, but high levels of ROS lead to oxidative stress and cellular damage. Increased production of ROS favors vascular dysfunction, inducing altered vascular permeability and inflammation, accompanied by the loss of vascular modulatory function, the imbalance between vasorelaxation and vasoconstriction, and the aberrant expression of inflammatory adhesion molecules. Inflammatory stimuli promote oxidative stress generated from the increased activity of mitochondrial nicotinamide adenine dinucleotide phosphate oxidase, particularly of the Nox4 isoform, with the consequent impairment of mitochondrial β-oxidation. Vascular dysfunction due to the increase in Nox4 activity and ROS overproduction leads to the progression of cardiovascular diseases, diabetes, inflammatory bowel disease, and neurological disorders. Considerable research into the development of effective antioxidant therapies using natural derivatives or new synthetic molecules has been conducted. Antioxidants may prevent cellular damage by reducing ROS overproduction or interfering in reactions that involve ROS. Vitamin E and ascorbic acid are well known as natural antioxidants that counteract lipid peroxidative damage by scavenging oxygen-derived free radicals, thus restoring vascular function. Recently, preliminary studies on natural antioxidants such as goji berries, thymus, rosemary, green tea ginseng, and garlic have been conducted for their efficacy in preventing vascular damage. N-acetyl-cysteine and propionyl-L-carnitine are synthetic compounds that regulate ROS production by replacing endogenous antioxidants in both endothelial and smooth muscle cells. In this review, we consider the molecular mechanisms underlying the generation of oxidative stress-induced vascular dysfunction as well as the beneficial effects of antioxidant therapies.

  2. Pulmonary manifestations of the collagen vascular diseases.

    Wiedemann, H P; Matthay, R A


    The collagen vascular diseases are a heterogeneous group of immunologically mediated inflammatory disorders. The organs and tissues that compose the respiratory system are frequently affected by these diseases. Potential targets of the inflammation and injury include the lung parenchyma, tracheobronchial tree, pulmonary vasculature, pleura, larynx, and respiratory muscles. In this article, the spectrum of respiratory disease caused by systemic lupus erythematosus, rheumatoid arthritis, scleroderma, polymyositis/dermatomyositis, mixed connective tissue disease, ankylosing spondylitis, relapsing polychondritis, and Sjögren's syndrome is reviewed. Where appropriate, therapeutic options are discussed.

  3. Oxidative Stress and Vascular Damage in Hypertension: Role of Angiotensin II

    Agostino Virdis


    Full Text Available Reactive oxygen species are oxygen derivates and play an active role in vascular biology. These compounds are generated within the vascular wall, at the level of endothelial and vascular smooth muscle cells, as well as by adventitial fibroblasts. In healthy conditions, ROS are produced in a controlled manner at low concentrations and function as signaling molecules regulating vascular contraction-relaxation and cell growth. Physiologically, the rate of ROS generation is counterbalanced by the rate of elimination. In hypertension, an enhanced ROS generation occurs, which is not counterbalanced by the endogenous antioxidant mechanisms, leading to a state of oxidative stress. In the present paper, major angiotensin II-induced vascular ROS generation within the vasculature, and relative sources, will be discussed. Recent development of signalling pathways whereby angiotensin II-driven vascular ROS induce and accelerate functional and structural vascular injury will be also considered.

  4. Coastal uplift and tsunami effects associated to the 2010 Mw8.8 Maule earthquake in Central Chile Levantamiento cosísmico e impacto del tsunami a lo largo de la costa de Chile central asociado al terremoto del Maule Mw8.8 de 2010

    Gabriel Vargas


    Full Text Available On February 27, 2010 at 03:34:08 AM an Mw8.8 earthquake, with epicenter located off Cobquecura (73.24°W; 36.29°S, severely hit Central Chile. The tsunami waves that followed this event affected the coastal regions between the cities of Valparaíso and Valdivia, with minor effects as far as Coquimbo. The earthquake oceurred along the subduction of the Nazca oceanic plate beneath the South American plate. Coseismic coastal uplift was estimated through observations of bleached lithothamnioids crustose coralline algae, which were exposed after the mainshock between 34.13°S and 38.34°S, suggesting the latitudinal distribution of the earthquake rupture. The measured coastal uplift values varied between 240±20 cm at sites closerto the trench along the western coast of the Arauco peninsulaand 15±10 cm at sites located farther east. A maximum valué of 260±50 cm was observed at the western coast of Santa María Island, which is similar to the reported uplift associated with the 1835 earthquake at Concepción. Land subsidence values on the order of 0.5 m to 1 m evidenced a change in polarity and position of the coseismic hinge at 110-120 km from the trench. In four sites along the coast we observed a close match between coastal uplift values deduced from bleached lithothamnioids algae and GPS measurements. According to field observations tsunami heights reached ca. 14 m in the coastal area of the Maule region immediately north of the epicenter, and diminished progressively northwards to 4-2 m near Valparaíso. Along the coast of Cobquecura, tsunami height values were inferior to 2-4 m. More variable tsunami heights of 6-8 m were measured at Dichato-Talcahuano and Tirúa-Puerto Saavedra, in the Biobío and Arauco regions, respectively, to the south of the epicenter. According to eyewitnesses, the tsunami reached the coast between 12 to 20 and 30 to 45 minutes in areas located closer and faraway from the earthquake rupture zone, respectively

  5. Cell-free vascular grafts: Recent developments and clinical potential.

    Row, Sindhu; Santandreu, Ana; Swartz, Daniel D; Andreadis, Stelios T


    Recent advances in vascular tissue engineering have led to the development of cell-free grafts that are available off-the-shelf for on demand surgery. Challenges associated with cell-based technologies including cell sourcing, cell expansion and long-term bioreactor culture motivated the development of completely cell-free vascular grafts. These are based on decellularized arteries, decellularized cultured cell-based tissue engineered grafts or biomaterials functionalized with biological signals that promote in situ tissue regeneration. Clinical trials undertaken to demonstrate the applicability of these grafts are also discussed. This comprehensive review summarizes recent developments in vascular graft technologies, with potential applications in coronary artery bypass procedures, lower extremity bypass, vascular injury and trauma, congenital heart diseases and dialysis access shunts, to name a few.

  6. A decade of civilian vascular trauma in Kosovo

    Jaha Luan


    Full Text Available Abstract Purpose We sought to analyze the results of arterial injury management in a busy metropolitan vascular unit and risk factors associated with mortality and morbidity. Patients and methods We analyzed 120 patient with arterial injury treated between year 2000 and 2010 at the University Clinical Center of Kosovo. Seven of these years were prospective and three retrospective study. Results The mechanism of arterial injury was stabbing 46.66%, gunshot wounds in 31.66%, blunt in 13.33%, and landmine in 8.33%. The most frequently injured vessel was the superficial femoral artery (25%, followed by the brachial artery (20.9%, crural arteries (13.1%, forearm arteries (14.3%, iliac arteries (7.5%, abdominal aorta (3.3%, common femoral artery (3.3% and popliteal artery (3.3%. Associated injuries including bone, nerve and remote injury (affecting the head, chest, or abdomen were present in 24.2% of patients. The decision to operate was made based on the presence of “hard signs” of vascular trauma. Arterial reconstruction was performed in 90.8% of patients, 5.8% of patients underwent primary amputation and 3.2% died on the operation table. Overall survival rate was 95.8%. Conclusion Injuries to the arteries are associated with significant mortality and morbidity. Mechanism of injury (blunt, gunshot, landmine or stub, hemodynamic stability at the admission, localization of injury, time from injury to flow restitution, associated injuries to the structures in the region and remote organs are critical factors influencing outcome.

  7. Carbon monoxide inhalation increases microparticles causing vascular and CNS dysfunction

    Xu, Jiajun; Yang, Ming [Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States); Kosterin, Paul [Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States); Salzberg, Brian M. [Department of Physiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States); Milovanova, Tatyana N.; Bhopale, Veena M. [Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States); Thom, Stephen R., E-mail: [Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States)


    We hypothesized that circulating microparticles (MPs) play a role in pro-inflammatory effects associated with carbon monoxide (CO) inhalation. Mice exposed for 1 h to 100 ppm CO or more exhibit increases in circulating MPs derived from a variety of vascular cells as well as neutrophil activation. Tissue injury was quantified as 2000 kDa dextran leakage from vessels and as neutrophil sequestration in the brain and skeletal muscle; and central nervous system nerve dysfunction was documented as broadening of the neurohypophysial action potential (AP). Indices of injury occurred following exposures to 1000 ppm for 1 h or to 1000 ppm for 40 min followed by 3000 ppm for 20 min. MPs were implicated in causing injuries because infusing the surfactant MP lytic agent, polyethylene glycol telomere B (PEGtB) abrogated elevations in MPs, vascular leak, neutrophil sequestration and AP prolongation. These manifestations of tissue injury also did not occur in mice lacking myeloperoxidase. Vascular leakage and AP prolongation were produced in naïve mice infused with MPs that had been obtained from CO poisoned mice, but this did not occur with MPs obtained from control mice. We conclude that CO poisoning triggers elevations of MPs that activate neutrophils which subsequently cause tissue injuries. - Highlights: • Circulating microparticles (MPs) increase in mice exposed to 100 ppm CO or more. • MPs are lysed by infusing the surfactant polyethylene glycol telomere B. • CO-induced MPs cause neutrophil activation, vascular leak and CNS dysfunction. • Similar tissue injuries do not arise with MPs obtained from air-exposed, control mice.

  8. Research on the Treatment of SD Rats Vascular Balloon Injury with Salvia and Panax Notoginseng Different Ethanol Extracts%三七与丹参不同洗脱部位对大鼠血管球囊损伤再狭窄的治疗作用研究

    王云飞; 潘从泽; 高秀梅; 王升启


    Objective: To investigate the treatment of SD rats vascular balloon injury with Salvia and Panax Notoginseng different ethanol extracts. Methods:84 SD rats were randomly divided into 14 groups:normal group,model group,sham operation group, Alpha statin calcium group(3 mg·kg-1·d-1) ,Fufang Danshen tablet group(300 mg·kg-1·d-1 ) ,50% Elution position high intermediate low dose group(300 mg·kg-1·d-1,150mg·kg-1·d-1 ,75 mg·kg-1·d-1) ,80% Elution position high intermediate low dose group(300mg·kg-1·d-1,150mg·kg-1·d-1,75 mg·kg-1·d-1 ) ,95% Elution position high intermediate low dose group(300 mg·kg-1·d-1,150 mg·kg-1·d-1,75 mg·kg-1·d-1 ) ,with intragastric administration. The balloon catheter injury method was used to establish model of intimal hyperplasia of rats carotid artery. After seven days,the serum SOD, NO and MDA levels were measured. The endometrium ( NIA) and the membrane ( MA) area ratio were calculated. Immunohisto-chemical detection of vascular injury in PCNA,VEGF and NF - κb expressions were observed. Results:50% Elution position intermediate dose group and 95% Elution position high dose group SOD compared with model group have significant difference. Conclusion:Salvia and Panax Notoginseng 50% as well as 95% elution position( 150 mg·kg-1·d-1)can inhibit the SD rat carotid artery balloon injury hyperplasia.%目的:探讨三七与丹参不同提取部位对SD大鼠左侧颈总动脉球囊损伤再狭窄的治疗作用.方法:SD大鼠,雄性,82只,分为正常组、模型组、假手术组、阿伐脱他汀钙片组(3 mg· kg-1·d-1)、复方丹参片组(300mg·kg-1·d-1)、50%洗脱部位高中低剂量组(300、150、75 mg·kg-1·d-1)、80%洗脱部位高中低剂量组(300、150、75 mg·kg-1·d-1)、95%洗脱部位高中低洗脱部位(300、150、75 mg·kg-1·d-1)灌胃.用球囊导管损伤建立大鼠颈总动脉内膜增生模型,7天后,测其血清中SOD、NO、MDA水平,计算其内膜(NIA

  9. Ageing and vascular ageing

    Jani, B; Rajkumar, C


    There is an age related decline in various physiological processes. Vascular ageing is associated with changes in the mechanical and the structural properties of the vascular wall, which leads to the loss of arterial elasticity and reduced arterial compliance. Arterial compliance can be measured by different parameters like pulse wave velocity, augmentation index, and systemic arterial compliance. There is evidence that arterial compliance is reduced in disease states such as hypertension, diabetes, and end stage renal failure. Changes in arterial compliance can be present before the clinical manifestation of cardiovascular disease. Pharmacological and non‐pharmacological measures have been shown to improve arterial compliance. Arterial compliance may constitute an early cardiovascular risk marker and may be useful in assessing the effects of drugs on the cardiovascular system. Pharmacogenetics and genetics of arterial compliance in the future will improve our knowledge and understanding about vascular ageing. PMID:16754702

  10. Knee Dislocation: A Case Report, Diagnostic Vascular Work-Up, and Literature Review

    Burg, Michael D.; Dijkstra, Björn L.


    Knee dislocation is an uncommon, potentially limb-threatening, knee injury. Most often caused by high-velocity trauma, it can also result from low- or even ultra-low-velocity trauma. Rapid identification of the injury, reduction, and definitive management are necessary to minimize neurovascular damage. We present a case of rotatory anterolateral knee dislocation sustained during a twisting sports-related event. Special emphasis is placed on diagnosing vascular injuries associated with knee dislocations. PMID:28321343

  11. Garroteamento da artéria coronária na revascularização do miocárdio: Relação entre o grau de aterosclerose e a lesão vascular: estudo experimental Occlusion of coronary artery in myocardial revascularization: Relationship between the degree of atherosclerosis and vascular injury: an experimental study

    Luís Roberto Gerola


    Full Text Available As anastomoses safena ou mamária-coronária, sendo suturas realizadas em vasos de fino calibre, necessitam de condições ideais para sua realização. Mesmo em circulação extracorpórea e pinçamento aórtico, pode persistir sangramento pela arteriotomia coronária, obrigando o cirurgião a realizar algumas manobras, entre elas os garroteamentos proximal e distai, para conseguir um campo exangue. Mais recentemente, face à possibilidade de se executar a revascularização miocárdica sem circulação extracorpórea, tornou-se fundamental dispor-se de um método que possibilite a oclusão temporária da artéria coronária para a realização das anastomoses. Com esta preocupação, foi realizado um estudo experimental, procurando avaliar seis métodos de hemostasia temporária, aplicados em artérias com graus variáveis de aterosclerose. O modelo experimental utilizado foi a artéria coronária direita, em cadáver. O estudo histológico, aplicando as colorações de hematoxilina-ecosina, Weigert e hematoxilina fosfotúngstica, permitiu a determinação objetiva da intensidade da aterosclerose na artéria coronária e os padrões e graus de lesões causados à parede arterial pelos métodos utilizados para sua oclusão temporária. Nessa amostra, os resultados sugerem uma tendência de relacionamento direto entre a gravidade da lesão arterial induzida pelo garroteamento e a severidade da aterosclerose coronária, independente do tipo de dispositivo utilizado para a interrupção do fluxo coronário.Coronary artery surgery, specially when performed without cardiopulmonary bypass, needs an "atraumatic" method that allows temporary coronary occlusion with minimal injury to the vessel wall. An experimental study was performed using the right coronary artery of cadaver hearts in order to evaluate the methods of "atraumatic" clamping of arteries with variable degrees of atherosclerosis. The vessels were evaluated histologically both for

  12. The imaging of stab injuries

    Vries, Coert S. de; Africa, Mogoeemang; Gebremariam, Fekade A.; Rensburg, J. Janse van; Otto, Susan F.; Potgieter, Henrik F. (Dept. of Diagnostic Radiology, Faculty of Health Sciences, Univ. of the Free State and Academic Health Complex, Free State Province Dept. of Health, Bloemfontein (South Africa)), e-mail:


    In the trauma unit of the Bloemfontein Academic Complex, the total number of stab wounds seen represents approximately 70.5% of penetrating injuries, which is 6.4% of 5004 trauma cases seen in a period of 1 year. The other cases are gunshot wounds and pedestrian or motor vehicle accidents. Specific guidelines and protocols are followed for penetrating trauma management. All imaging modalities are utilized, with chest radiography the mainstay of thoracic imaging in patients having sustained sharp penetrating chest injuries. Computed tomography (CT) is being used more frequently as the primary imaging modality in the evaluation of hemodynamically stable patients with penetrating injuries. The improved speed of data acquisition and superior image reconstruction of multidetector CT (MDCT) has further driven this change in imaging approach. Although digital subtraction angiography (DSA) has been the reference standard for the diagnosis of traumatic vascular injuries, it is giving way to faster, less invasive, and less personnel-intensive imaging techniques, e.g., MDCT angiography. Given the fact that we work in an academic environment and that we have a dedicated interventional unit, arteriography is still frequently performed and still has its place as the 'gold standard' in the diagnosis of vascular injuries. Penetrating chest injuries suspected of traversing the mediastinum or extending near the posterior mediastinal structures dictate esophageal and tracheal evaluation. Although radiology has a role to play, direct visualization (esophagoscopy, bronchoscopy) remains the most reliable method of excluding injuries to these structures. Transthoracic ultrasound (echocardiography) has become indispensable in helping to evaluate injuries to the heart and the ascending and descending aortas. More recent work has demonstrated that ultrasonography can also be used to detect hemothoraces and pneumothoraces with accuracy

  13. Amorphous silica nanoparticles trigger vascular endothelial cell injury through apoptosis and autophagy via reactive oxygen species-mediated MAPK/Bcl-2 and PI3K/Akt/mTOR signaling

    Guo C


    Full Text Available Caixia Guo,1,2 Man Yang,2,3 Li Jing,2,3 Ji Wang,2,3 Yang Yu,2,3 Yang Li,2,3 Junchao Duan,2,3 Xianqing Zhou,2,3 Yanbo Li,2,3 Zhiwei Sun2,3 1Department of Occupational and Environmental Health, School of Public Health, 2Beijing Key Laboratory of Environmental Toxicology, 3Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, People’s Republic of China Abstract: Environmental exposure to silica nanoparticles (SiNPs is inevitable due to their widespread application in industrial, commercial, and biomedical fields. In recent years, most investigators focus on the evaluation of cardiovascular effects of SiNPs in vivo and in vitro. Endothelial injury and dysfunction is now hypothesized to be a dominant mechanism in the development of cardiovascular diseases. This study aimed to explore interaction of SiNPs with endothelial cells, and extensively investigate the exact effects of reactive oxygen species (ROS on the signaling molecules and cytotoxicity involved in SiNPs-induced endothelial injury. Significant induction of cytotoxicity as well as oxidative stress, apoptosis, and autophagy was observed in human umbilical vein endothelial cells following the SiNPs exposure (P<0.05. The oxidative stress was induced by ROS generation, leading to redox imbalance and lipid peroxidation. SiNPs induced mitochondrial dysfunction, characterized by membrane potential collapse, and elevated Bax and declined bcl-2 expression, ultimately leading to apoptosis, and also increased number of autophagosomes and autophagy marker proteins, such as LC3 and p62. Phosphorylated ERK, PI3K, Akt, and mTOR were significantly decreased, but phosphorylated JNK and p38 MAPK were increased in SiNPs-exposed endothelial cells. In contrast, all of these stimulation phenomena were effectively inhibited by N-acetylcysteine. The N-acetylcysteine supplement attenuated SiNPs-induced endothelial toxicity through inhibition of apoptosis

  14. Thenar reversed island flap combined with thumb dorsoulnar neurocutaneous vascular flap for repairing of distal thumb degloving injury%大鱼际逆行岛状皮瓣联合拇指尺背侧皮神经营养血管皮瓣修复拇指末节套脱伤

    沈泳; 施海峰; 钱俊; 吴柯; 芮永军


    目的 介绍大鱼际逆行岛状皮瓣联合拇指尺背侧皮神经营养血管皮瓣修复拇指末节套脱伤的方法,并评价其临床疗效.方法 自2010年3月至2012年6月,我们采用大鱼际逆行岛状皮瓣联合拇指尺背侧皮神经营养血管皮瓣修复拇指末节套脱伤12例.大鱼际逆行岛状皮瓣切取面积为2.5 cm× 1.0 cm~4.0 cm× 3.0 cm,修复拇指掌侧创面;拇指尺背侧皮神经营养血管皮瓣切取面积为2.0 cm× 1.2 cm~3.5 cm× 2.5 cm,修复拇指背侧创面;供区直接缝合或全厚皮片植皮修复.结果 本组12例皮瓣全部存活,术后随访时间为6~18个月,平均10个月,皮瓣均无臃肿,色泽正常,外形满意,感觉及运动功能恢复良好,根据中华医学会手外科学会上肢部分功能评定试用标准评定:优8例,良3例,可1例.指腹的大鱼际逆行岛状皮瓣两点分辨觉为6.5~9.5 mm,平均7.8 mm;指背的拇指尺背侧皮神经营养血管皮瓣两点分辨觉为7.0~11.0 mm,平均8.5 mm;按英国医学研究会(BMRC)评级标准评定为S2~S4,平均S3+.结论 大鱼际逆行岛状皮瓣联合拇指尺背侧皮神经营养血管皮瓣修复拇指末节套脱伤,手术操作简单,无需深部解剖,不破坏知名血管,手术创伤小、时间短,术后疗效满意.%Objective To introduce a new surgical procedure for repairing distal thumb degloving injury with thenar reversed island flap in combination with the thumb dorsoulnar neurocutaneous vascular flap and evaluate the clinical outcomes.Methods From March 2010 to June 2012,12 cases of degloving injury of the distal thumb were treated with combined transfer of thenar reversed island flap and dorsoulnar neurocutaneous vascular flap from the thumb.The thenar reversed island flaps ranged from 2.5 cm × 1.0 cm to 4.0 cm × 3.0 cm in size and were used to cover volar aspect of the thumb.The dorsoulnar neurocutaneous vascular flaps ranged from 2.0 cm × 1.2 cm to 3.5 cm × 2.5 cm in size and were

  15. Protective effects of aqueous extract of arctium lappa root on vascular endothelial cell injury of hypertensive rats%牛蒡根水提物对高血压大鼠血管内皮损伤的保护作用

    赵娜; 马维红; 苏赢; 翟振丽; 覃晓莹


    related to inflammato⁃ry factors were detected including C-reactive protein (CRP) and interleukin (IL)-6. The intercellular adhesion molecule-1 (ICAM-1) level was detected by taking samples of thoracic aorta. Results (1) The systolic blood pressure level at tail ar⁃tery was significantly lower in aqueous extract of arctium lappa root group than that of model control group ( P<0.05). (2) The aqueous extract of arctium lappa root can significantly improve the vascular endothelial cell injury, suppress vascular endo⁃thelial cell loss and blood cell adhesion, and cell proliferation with collagen fibers in muscle membrane. ( 3) The serum levels of IL-6, CRP and vascular endothelial ICAM-1 were significantly reduced in aqueous extract of arctium lappa root group than that of model control group (P<0.05). Conclusion Aqueous extract of arctium lappa root can significantly improve vascular endothelial cell injury in hypertensive rats. The mechanism may be related to the inhibition of inflammatory cyto⁃kines like IL-6, CRP and the expression of ICAM-1, and the improvement of chronic inflammatory response in vascular en⁃dothelium of hypertensive rats.

  16. Head Injuries

    ... ATV) Safety Balance Disorders Knowing Your Child's Medical History First Aid: Falls First Aid: Head Injuries Preventing Children's Sports Injuries Getting Help: Know the Numbers Concussions Stay Safe: Baseball Concussions Concussions: Getting Better Sports and Concussions Dealing ...

  17. Ear Injury

    ... Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and ... Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and ...

  18. Birth Injury

    ... Are Up to Date Additional Content Medical News Birth Injury By Arthur E. Kopelman, MD, Professor of ... Problems in Newborns Overview of Problems in Newborns Birth Injury Prematurity Postmaturity Small for Gestational Age (SGA) ...

  19. Injury Prevention

    ... Visits Prevent Poison! ACEP Observes 50th National Poison Prevention Week Small, Shiny and Dangerous: ACEP Puts the Spotlight on Children Swallowing Objects Like Magnets, Coins or Batteries School & Sports Injuries Safety Helmets Save Lives, Prevent Traumatic Brain Injury ...

  20. Knee Injuries

    ... bursitis . Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of ... injury without the aid of a television screen. Physical Therapy Depending on the type of knee injury ...

  1. Inhalation Injuries

    ... you can inhale that can cause acute internal injuries. Particles in the air from fires and toxic ... and lung diseases worse. Symptoms of acute inhalation injuries may include Coughing and phlegm A scratchy throat ...

  2. Spinal injury

    ... this page: // Spinal injury To use the sharing features on this page, ... move anyone who you think may have a spinal injury, unless it is absolutely necessary. For example, if ...

  3. Genital injury

    ... each side of a bar, such as a monkey bar or the middle of a bicycle Symptoms ... Names Scrotal trauma; Straddle injury; Toilet seat injury Images Female reproductive anatomy Male reproductive anatomy Normal female ...

  4. Turmeric Fried after Vascular Injury in Rat PECAM-1 and Hif-1 oα Expression Meaning%姜黄煎对大鼠血管损伤后PECAM-1与hif-1α表达影响意义

    邱丽君; 昌艳艳


    目的:探讨姜黄煎对大鼠血管损伤后血小板内皮细胞黏附分子PECAM-1与hif-1α表达影响.方法:将144只大鼠随机分成4组,姜黄煎干预组,生理盐水干预组,假手术组和正常组(对照),每组36只.模拟PCI术,采用组织形态学镜下观察急性损伤后大鼠血管内膜结构的变化,电镜下观察细胞凋亡情况,ELISA法检测血清中PECAM-1与hif-1 α含量.结果:(1)姜黄煎组、生理盐水组PECAM-1与hif-1 α含量与假手术组、正常组比较差异明显(P<0.05);(2)假手术组PECAM-1与hif-1 α水平含量接近于正常对照组,差异不明显(P>0.05);(3)姜黄煎组与生理盐水干预组、假手术组比较有明显差异(P<0.05),与正常对照组比较差异不明显(P>0.05);(4)通过血管内皮形态,可见大鼠动脉球囊损伤后内膜增生在术后早期(3~7天)就已达到高峰,姜黄煎组可抑制内膜增厚.结论:姜黄煎可上调大鼠hif-1 α蛋白表达,使PECAM-1的蛋白表达明显下降,说明hif-1α过量表达,PECAM-1/hif-1α的比值减小,能抑制内皮细胞过度凋亡,有助于评估血管损后凋亡因子对血管内皮功能和结构的影响.%Objective: To investigate the effect of turmeric fried platelet endothelial cell adhesion molecule PECAM-1 and hif-1 α expression in vascular injury rat. Methods: A total of 144 rats were randomly allocated to four groups, 36 of each group, including fried turmeric intervention group, saline treated group, sham group and normal group (control). Analog PCI was applied and morphology were observed in rats after acute injury intimal changes in the structure. Apoptosis and serum content of PECAM-1 and hif-1 α were detected by Electron microscope and ELISA, respectively. Results: ( 1 ) Levels of PECAM-1 and hif-1α , in turmeric fried group, saline group, sham group, were significantly different ( P<0.05 ) compared with the control group. ( 2 ) There were no significant differences ( P>0.05 ) between sham group

  5. Hipervolemia mais tríplice oclusão vascular no tratamento da lesão traumática da veia cava retro-hepática e veias hepáticas Hypervolemia and triple vessel occlusion in the treatment of traumatic retrohepatic vena and hepatic vein injuries

    Wilson Luiz Abrantes


    Full Text Available BACKGROUND: Liver vascular isolation is essential for the treatment of the retrohepatic vena cava and hepatic veins. Triple vessel occlusion (TVO - occlusion of the portal triad, the inferior vena cava above the renal veins and within the pericardium is the easiest isolation method for the surgeon. Unfortunately, this technique cannot be applied to hypovolemic and/or shock (cardiac arrest patients as it compromises venous return. OBJECTIVES: Our objective is to demonstrate that in the above mentioned patients, establishing a previous hypervolemic state allows the safe use of TVO. METHODS: The method includes efficient injury tamponade with aggressive fluid replacement until normal blood volume is reached (resuscitation. Normal blood volume is recognized by a return of arterial blood pressure to normal levels, inferior vena cava filling and an increase in aortic wall tension. Following this procedure, hypervolemia is obtained by the rapid additional infusion of 1.500 to 2.000 ml of fluids. TVO in this situation does not alter the heart rhythm and maintains a clear operative field which is essential for hepatotomy, venorrhaphy and or venous ligation. RESULTS: Three patients were successfully operated.

  6. Plant vascular development

    Rybel, De Bert; Mähönen, Ari Pekka; Helariutta, Yrjö; Weijers, Dolf


    Vascular tissues in plants are crucial to provide physical support and to transport water, sugars and hormones and other small signalling molecules throughout the plant. Recent genetic and molecular studies have identified interconnections among some of the major signalling networks that regulate

  7. Hypercholesterolaemia and vascular dementia.

    Appleton, Jason P; Scutt, Polly; Sprigg, Nikola; Bath, Philip M


    Vascular dementia (VaD) is the second commonest cause of dementia. Stroke is the leading cause of disability in adults in developed countries, the second major cause of dementia and the third commonest cause of death. Traditional vascular risk factors-diabetes, hypercholesterolaemia, hypertension and smoking-are implicated as risk factors for VaD. The associations between cholesterol and small vessel disease (SVD), stroke, cognitive impairment and subsequent dementia are complex and as yet not fully understood. Similarly, the effects of lipids and lipid-lowering therapy on preventing or treating dementia remain unclear; the few trials that have assessed lipid-lowering therapy for preventing (two trials) or treating (four trials) dementia found no evidence to support the use of lipid-lowering therapy for these indications. It is appropriate to treat those patients with vascular risk factors that meet criteria for lipid-lowering therapy for the primary and secondary prevention of cardiovascular and cerebrovascular events, and in line with current guidelines. Managing the individual patient in a holistic manner according to his or her own vascular risk profile is recommended. Although the paucity of randomized controlled evidence makes for challenging clinical decision making, it provides multiple opportunities for on-going and future research, as discussed here. © 2017 The Author(s).

  8. Renal posttransplant's vascular complications

    Bašić Dragoslav


    Full Text Available INTRODUCTION Despite high graft and recipient survival figures worldwide today, a variety of technical complications can threaten the transplant in the postoperative period. Vascular complications are commonly related to technical problems in establishing vascular continuity or to damage that occurs during donor nephrectomy or preservation [13]. AIM The aim of the presenting study is to evaluate counts and rates of vascular complications after renal transplantation and to compare the outcome by donor type. MATERIAL AND METHODS A total of 463 kidneys (319 from living related donor LD and 144 from cadaveric donor - CD were transplanted during the period between June 1975 and December 1998 at the Urology & Nephrology Institute of Clinical Centre of Serbia in Belgrade. Average recipients' age was 33.7 years (15-54 in LD group and 39.8 (19-62 in CD group. Retrospectively, we analyzed medical records of all recipients. Statistical analysis is estimated using Hi-squared test and Fischer's test of exact probability. RESULTS Major vascular complications including vascular anastomosis thrombosis, internal iliac artery stenosis, internal iliac artery rupture obliterant vasculitis and external iliac vein rupture were analyzed. In 25 recipients (5.4% some of major vascular complications were detected. Among these cases, 22 of them were from CD group vs. three from LD group. Relative rate of these complications was higher in CD group vs. LD group (p<0.0001. Among these complications dominant one was vascular anastomosis thrombosis which occurred in 18 recipients (17 from CD vs. one from LD. Of these recipients 16 from CD lost the graft, while the rest of two (one from each group had lethal outcome. DISCUSSION Thrombosis of renal allograft vascular anastomosis site is the most severe complication following renal transplantation. In the literature, renal allograft thrombosis is reported with different incidence rates, from 0.5-4% [14, 15, 16]. Data from the

  9. Orienteering injuries

    Folan, Jean M.


    At the Irish National Orienteering Championships in 1981 a survey of the injuries occurring over the two days of competition was carried out. Of 285 individual competitors there was a percentage injury rate of 5.26%. The article discusses the injuries and aspects of safety in orienteering.

  10. Gymnastics injuries.

    Caine, Dennis J; Nassar, Larry


    The purpose of this chapter is to review the distribution and determinants of injury rates as reported in the pediatric gymnastics injury literature, and to suggest measures for the prevention of injury and directions for further research. An extensive search of Pubmed was conducted using the Text and MeSH words "gymnastics" and "injury" and limited to the pediatric population (0-18 years). The review focused on studies using denominator-based designs and on those published in the English language. Additional references were obtained from hand searches of the reference lists. Unpublished injury data from the USA Gymnastics National Women's Artistic Gymnastics Championships during 2002-04 were also analyzed. Comparison of study results was compromised due to the diversity of study populations, variability of injury definition across studies, and changes in rules and equipment across years. Notwithstanding, this review of the literature reveals a reasonably consistent picture of pediatric gymnastics injuries. The incidence and severity of injuries is relatively high, particularly among advanced level female gymnasts. Body parts particularly affected by injury vary by gender and include the ankle, knee, wrist, elbow, lower back, and shoulder. Ankle sprains are a particular concern. Overuse and nonspecific pain conditions, particularly the wrist and low back, occur frequently among advanced-level female gymnasts. Factors associated with an increased injury risk among female gymnasts include greater body size and body fat, periods of rapid growth, and increased life stress. Above all, this overview of the gymnastics injury literature underscores the need to establish large-scale injury surveillance systems designed to provide current and reliable data on injury trends in both boys and girls gymnastics, and to be used as a basis for analyzing injury risk factors and identifying dependable injury preventive measures.

  11. Vascular lesions secondary to osteotomy by corticotomy.

    Spinelli, Francesco; Spinelli, Renato; Stilo, Francesco; De Caridi, Giovanni; Mirenda, Francesco


    Management of vascular traumas is frequently delayed. Vascular injuries after elective operation for bone lengthening or correction of a deformity are very'rare situations. We describe 3 cases. Case 1: male, aged 22, undergoing corticotomy for bone lengthening; immediately presented acute limb ischaemia due to a partial lesion of the popliteal artery, documented by U.S. After 7 h, direct reconstruction of the artery and fasciotomies were performed. Case 2: male, aged 27, undergoing directional osteotomy for genu varus correction. For 30 days, constant increase in leg volume and decrease in function. US showed an important haematoma at the popliteal level; arteriography documented a partial lesion of the infra-genicular popliteal artery and a voluminous false aneurysm. Direct correction of the artery and fasciotomies were performed. Case 3: male, aged 22, undergoing corticotomy for leg lengthening; immediately presented leg pain with decreased distal pulses. After 4h, there was an increase in leg volume, and arteriography showed a total lesion of the infra-genicular popliteal artery and an arteriovenous fistula. Popliteo-tibial bypass with the contralateral greater saphenous vein and fasciotomies were performed. After 1 month endovascular closure of the fistula was obtained. All patients had recovered after two months with only minor leg insufficiency. Patency of the bypass and absence of infections or delayed false aneurysms were achieved. Vascular injuries after elective orthopaedic procedures are very rare situations. Such lesions are caused by an osteotomy via corticotomy performed percutaneously. The variety of clinical presentations accounts for the difficulty in diagnosing such lesions and for the delays in implementing treatment. It is very important to obtain an early diagnosis complete with an arteriography.

  12. Engineering vascularized skeletal muscle tissue

    Levenberg, Shulamit; Rouwkema, Jeroen; Macdonald, Mara; Garfein, Evan S.; Kohane, Daniel S.; Darland, Diane C.; Marini, Robert; van Blitterswijk, Clemens; Mulligan, Richard C.; D'Amore, Patricia A.; Langer, Robert


    One of the major obstacles in engineering thick, complex tissues such as muscle is the need to vascularize the tissue in vitro. Vascularization in vitro could maintain cell viability during tissue growth, induce structural organization and promote vascularization upon implantation. Here we describe

  13. National trauma databank analysis of mortality and limb loss in isolated lower extremity vascular trauma.

    Kauvar, David S; Sarfati, Mark R; Kraiss, Larry W


    interval, 1.7-15.6; P = .003), and fracture (odds ratio, 2.2; 95% confidence interval, 1.1-4.2; P = .02) independently predicted amputation, while the presence of nerve injury and soft tissue disruption did not. Isolated lower extremity trauma with vascular injury has a nearly 10% rate of mortality or limb loss. Mortality is associated with penetrating mechanism and early shock, likely resulting from prehospital proximal arterial hemorrhage. In contrast, early limb loss is more common with blunt distal vascular injury, especially to the popliteal and tibial arteries. Neither nerve nor soft tissue injury predicted limb loss but may result in delayed amputations not captured in this acute outcomes dataset. Copyright © 2011 Society for Vascular Surgery. All rights reserved.

  14. Bicycling injuries.

    Silberman, Marc R


    Bicycling injuries can be classified into bicycle contact, traumatic, and overuse injuries. Despite the popularity of cycling, there are few scientific studies regarding injuries. Epidemiological studies are difficult to compare due to different methodologies and the diverse population of cyclists studied. There are only three studies conducted on top level professionals. Ninety-four percent of professionals in 1 year have experienced at least one overuse injury. Most overuse injuries are mild with limited time off the bike. The most common site of overuse injury is the knee, and the most common site of traumatic injury is the shoulder, with the clavicle having the most common fracture. Many overuse and bicycle contact ailments are relieved with simple bike adjustments.

  15. Traumatic bilateral ECCA injury in a roller coaster enthusiast.

    Stahlfeld, Kurt R; Roozrokh, Hootan C


    Vascular and trauma surgeons have seen a marked increase in the incidence of traumatic injury of the ECCA. Making the diagnosis is straightforward, but requires a high index of suspicion. This patient's injury is from hyperextension/flexion trauma that occurred from repetitive rides on roller coasters.

  16. Urologic surgery laparoscopic access: vascular complications

    Branco, Anibal Wood


    ABSTRACT Vascular injury in accidental punctures may occur in large abdominal vessels, it is known that 76% of injuries occur during the development of pneumoperitoneum. The aim of this video is to demonstrate two cases of vascular injury occurring during access in laparoscopic urologic surgery. The first case presents a 60-year old female patient with a 3cm tumor in the superior pole of the right kidney who underwent a laparoscopic partial nephrectomy. After the Verres needle insertion, output of blood was verified. During the evaluation of the cavity, a significant hematoma in the inferior vena cava was noticed. After the dissection, a lesion in the inferior vena cava was identified and controlled with a prolene suture, the estimated bloos loss was 300ml. The second case presents a 42-year old female live donor patient who had her right kidney selected to laparoscopic live donor nephrectomy. After the insertion of the first trocar, during the introduction of the 10mm scope, an active bleeding from the mesentery was noticed. The right colon was dissected and an inferior vena cava perforation was identified; a prolene suture was used to control the bleeding, the estimated blood loss was 200mL, in both cases the patients had no previous abdominal surgery. Urologists must be aware of this uncommon, serious, and potentially lethal complication. Once recognized and in the hands of experienced surgeons, some lesions may be repaired laparoscopically. Whenever in doubt, the best alternative is the immediate conversion to open surgery to minimize morbidity and mortality. PMID:28124541

  17. [Vascular endothelial Barrier Function].

    Ivanov, A N; Puchinyan, D M; Norkin, I A


    Endothelium is an important regulator of selective permeability of the vascular wall for different molecules and cells. This review summarizes current data on endothelial barrier function. Endothelial glycocalyx structure, its function and role in the molecular transport and leukocytes migration across the endothelial barrier are discussed. The mechanisms of transcellular transport of macromolecules and cell migration through endothelial cells are reviewed. Special section of this article addresses the structure and function of tight and adherens endothelial junction, as well as their importance for the regulation of paracellular transport across the endothelial barrier. Particular attention is paid to the signaling mechanism of endothelial barrier function regulation and the factors that influence on the vascular permeability.

  18. Plant Vascular Biology 2010

    Ding, Biao


    This grant supported the Second International Conference on Plant Vascular Biology (PVB 2010) held July 24-28, 2010 on the campus of Ohio State University, Columbus, Ohio. Biao Ding (Ohio State University; OSU) and David Hannapel (Iowa State University; ISU) served as co-chairs of this conference. Biao Ding served as the local organizer. PVB is defined broadly here to include studies on the biogenesis, structure and function of transport systems in plants, under conditions of normal plant growth and development as well as of plant interactions with pathogens. The transport systems cover broadly the xylem, phloem, plasmodesmata and vascular cell membranes. The PVB concept has emerged in recent years to emphasize the integrative nature of the transport systems and approaches to investigate them.

  19. Neurobiology of Vascular Dementia

    Ana-Maria Enciu


    Full Text Available Vascular dementia is, in its current conceptual form, a distinct type of dementia with a spectrum of specific clinical and pathophysiological features. However, in a very large majority of cases, these alterations occur in an already aged brain, characterized by a milieu of cellular and molecular events common for different neurodegenerative diseases. The cell signaling defects and molecular dyshomeostasis might lead to neuronal malfunction prior to the death of neurons and the alteration of neuronal networks. In the present paper, we explore some of the molecular mechanisms underlying brain malfunction triggered by cerebrovascular disease and risk factors. We suggest that, in the age of genetic investigation and molecular diagnosis, the concept of vascular dementia needs a new approach.

  20. Injury - kidney and ureter

    Kidney damage; Toxic injury of the kidney; Kidney injury; Traumatic injury of the kidney; Fractured kidney; Inflammatory injury of the kidney; Bruised kidney; Ureteral injury; Pre-renal failure - injury, ...

  1. Adhesion in vascular biology


    The vasculature delivers vital support for all other tissues by supplying oxygen and nutrients for growth and by transporting the immune cells that protect and cure them. Therefore, the microvasculature developed a special barrier that is permissive for gasses like oxygen and carbon dioxide, while fluids are kept inside and pathogens are kept out. While maintaining this tight barrier, the vascular wall also allows immune cells to exit at sites of inflammation or damage, a process that is call...

  2. Vascular Remodelling and Mesenchymal Transition in Systemic Sclerosis

    Pier Andrea Nicolosi


    Full Text Available Fibrosis of the skin and of internal organs, autoimmunity, and vascular inflammation are hallmarks of Systemic Sclerosis (SSc. The injury and activation of endothelial cells, with hyperplasia of the intima and eventual obliteration of the vascular lumen, are early features of SSc. Reduced capillary blood flow coupled with deficient angiogenesis leads to chronic hypoxia and tissue ischemia, enforcing a positive feed-forward loop sustaining vascular remodelling, further exacerbated by extracellular matrix accumulation due to fibrosis. Despite numerous developments and a growing number of controlled clinical trials no treatment has been shown so far to alter SSc natural history, outlining the need of further investigation in the molecular pathways involved in the pathogenesis of the disease. We review some processes potentially involved in SSc vasculopathy, with attention to the possible effect of sustained vascular inflammation on the plasticity of vascular cells. Specifically we focus on mesenchymal transition, a key phenomenon in the cardiac and vascular development as well as in the remodelling of injured vessels. Recent work supports the role of transforming growth factor-beta, Wnt, and Notch signaling in these processes. Importantly, endothelial-mesenchymal transition may be reversible, possibly offering novel cues for treatment.

  3. Mechanisms for suppressing NADPH oxidase in the vascular wall

    Gregory J Dusting


    Full Text Available Oxidative stress underlies many forms of vascular disease as well as tissue injury following ischemia and reperfusion. The major source of oxidative stress in the artery wall is an NADPH oxidase. This enzyme complex as expressed in vascular cells differs from that in phagocytic leucocytes both in biochemical structure and functions. The crucial flavin-containing catalytic subunits, Nox1 and Nox4, are not found in leucocytes, but are highly expressed in vascular cells and upregulated with vascular remodeling, such as that found in hypertension and atherosclerosis. The difference in catalytic subunits offers the opportunity to develop "vascular specific" NADPH oxidase inhibitors that do not compromise the essential physiological signaling and phagocytic functions carried out by reactive oxygen and nitrogen species. Nitric oxide and targeted inhibitors of NADPH oxidase that block the source of oxidative stress in the vasculature are more likely to prevent the deterioration of vascular function that leads to stroke and heart attack, than are conventional antioxidants. The roles of Nox isoforms in other inflammatory conditions are yet to be explored.

  4. Peroneal tendons well vascularized: results from a cadaveric study.

    van Dijk, Pim A D; Madirolas, F Xavier; Carrera, Ana; Kerkhoffs, Gino M M J; Reina, Francisco


    Peroneal tendon tears are relatively common injuries that seem to have a poor healing tendency. The discussion goes that peroneal tendons have avascular zones, contributing to the poor healing of those tears. The purpose of this study was to provide evidence on the vascularization pattern of the peroneal tendons. Ten adult fresh-frozen cadavers were obtained from a university-affiliated body donation programme. The femoral artery was injected with natural coloured latex at the level of the knee. Macroscopic and microscopic dissections were performed to visualize the vascularization towards the peroneal tendons. To expose intratendinous vascularity, the tendons were cleared using a modified Spälteholz technique. In all specimens, blood was mainly supplied by the peroneal artery through a posterolateral vincula connecting both tendons. Branches were bifurcated every 3.9 ± 1.8 cm, starting 24 ± 5.3 cm proximal to the tip of the fibula. Eight out of 10 (80%) specimens had poor vascularized zones in the peroneus longus tendon. No avascular zones were found in the peroneus brevis tendon. The peroneal tendons are well vascularized by the peroneal artery, via vessels running through a common vincula for both tendons. In the peroneus brevis, no avascular zones were found. To keep the tendons well vascularized and therefore improve tendon healing, surgeons should be careful leaving the vincula intact during surgical procedures.

  5. Tsunami Characteristics Along the Peru-Chile Trench: Analysis of the 2015 Mw8.3 Illapel, the 2014 Mw8.2 Iquique and the 2010 Mw8.8 Maule Tsunamis in the Near-field

    Omira, R.; Baptista, M. A.; Lisboa, F.


    Tsunamis occur quite frequently following large magnitude earthquakes along the Chilean coast. Most of these earthquakes occur along the Peru-Chile Trench, one of the most seismically active subduction zones of the world. This study aims to understand better the characteristics of the tsunamis triggered along the Peru-Chile Trench. We investigate the tsunamis induced by the Mw8.3 Illapel, the Mw8.2 Iquique and the Mw8.8 Maule Chilean earthquakes that happened on September 16th, 2015, April 1st, 2014 and February 27th, 2010, respectively. The study involves the relation between the co-seismic deformation and the tsunami generation, the near-field tsunami propagation, and the spectral analysis of the recorded tsunami signals in the near-field. We compare the tsunami characteristics to highlight the possible similarities between the three events and, therefore, attempt to distinguish the specific characteristics of the tsunamis occurring along the Peru-Chile Trench. We find that these three earthquakes present faults with important extensions beneath the continent which result in the generation of tsunamis with short wavelengths, relative to the fault widths involved, and with reduced initial potential energy. In addition, the presence of the Chilean continental margin, that includes the shelf of shallow bathymetry and the continental slope, constrains the tsunami propagation and the coastal impact. All these factors contribute to a concentrated local impact but can, on the other hand, reduce the far-field tsunami effects from earthquakes along Peru-Chile Trench.

  6. Identifying the dynamic characteristics of a dual core-wall and frame building in Chile using aftershocks of the 27 February 2010 (Mw=8.8) Maule, Chile, earthquake

    Çelebi, Mehmet; Sereci, Mark; Boroschek, Ruben; Carreño, Rodrigo; Bonelli, Patricio


    Following the 27 February 2010 (Mw = 8.8) Offshore Maule, Chile earthquake, a temporary, 16-channel, real-time data streaming array was installed in a recently constructed building in Viña del Mar to capture its responses to aftershocks. The cast-in-place, reinforced concrete building is 16 stories high, with 3 additional basement levels, and has dual system comprising multiple structural walls and perimeter frames. This building was not damaged during the main-shock, but other buildings of similar design in Viña del Mar and other parts of Chile were damaged, although none collapsed. Dynamic characteristics of the building identified from the low-amplitude (PGA of about 2 Gal) response recordings of aftershocks are found to compare well with those determined from modal analyses using a design level FEM model. Distinct “major-axes” translational and torsional fundamental frequencies, as well as frequencies of secondary modes, are identified. Evidence of beating is consistently observed in the response data for each earthquake. Results do not match well with U.S. code formulas.

  7. Spatial Variations of Aftershock Parameters and their Relation to Geodetic Slip Models for the 2010 Mw8.8 Maule and the 2011 Mw9.0 Tohoku-oki Earthquakes

    Zakharova, O.; Hainzl, S.; Lange, D.; Enescu, B.


    Recent development in analysis tools and deployments of the geodetic and seismic instruments give an opportunity to investigate aftershock sequences at local scales, which is important for the seismic hazard assessment. In particular, we study the dependencies between aftershock sequences properties and deformational/geological data on a scale of the rupture extension of megathrust earthquakes. For this goal we use, on one hand, published models of inter-, co- and postseismic slip and geological information and, on the other hand, aftershock parameters, obtained by fitting a modified Epidemic Type Aftershock Sequence (ETAS) model. The altered ETAS model takes into account the mainshock rupture extension and it distinguishes between primary and the secondary aftershock triggering involved in the total seismicity rate. We estimate the Spearman correlation coefficients between the spatially distributed aftershock parameters estimated by the modified ETAS model and crustal physical properties for the Maule 2010 Mw8.8 and the Tohoku-oki 2011 Mw9.0 aftershock sequences. We find that: (1) modified ETAS model outperforms the classical one, when the mainshock rupture extension cannot be neglected and represented as a point source; (2) anomalous aftershock parameters occur in the areas of the reactivated fault systems; (3) aftershocks, regardless of their generation, tend to occur in the areas of high coseismic slip gradient, afterslip and interseismic coupling; (4) aftershock seismic moment releases preferentially in regions of large coseismic slip, coseismic slip gradient and interseismically locked areas; (5) b value tends to be smaller in interseismically locked regions.

  8. Nuclear factor of activated T cells c1 mediates p21-activated kinase 1 activation in the modulation of chemokine-induced human aortic smooth muscle cell F-actin stress fiber formation, migration, and proliferation and injury-induced vascular wall remodeling.

    Kundumani-Sridharan, Venkatesh; Singh, Nikhlesh K; Kumar, Sanjay; Gadepalli, Ravisekhar; Rao, Gadiparthi N


    Recent literature suggests that cyclin-dependent kinases (CDKs) mediate cell migration. However, the mechanisms were not known. Therefore, the objective of this study is to test whether cyclin/CDKs activate Pak1, an effector of Rac1, whose involvement in the modulation of cell migration and proliferation is well established. Monocyte chemotactic protein 1 (MCP1) induced Pak1 phosphorylation/activation in human aortic smooth muscle cells (HASMCs) in a delayed time-dependent manner. MCP1 also stimulated F-actin stress fiber formation in a delayed manner in HASMCs, as well as the migration and proliferation of these cells. Inhibition of Pak1 suppressed MCP1-induced HASMC F-actin stress fiber formation, migration, and proliferation. MCP1 induced cyclin D1 expression as well as CDK6 and CDK4 activities, and these effects were dependent on activation of NFATc1. Depletion of NFATc1, cyclin D1, CDK6, or CDK4 levels attenuated MCP1-induced Pak1 phosphorylation/activation and resulted in decreased HASMC F-actin stress fiber formation, migration, and proliferation. CDK4, which appeared to be activated downstream of CDK6, formed a complex with Pak1 in response to MCP1. MCP1 also activated Rac1 in a time-dependent manner, and depletion/inhibition of its levels/activation abrogated MCP1-induced NFATc1-cyclin D1-CDK6-CDK4-Pak1 signaling and, thereby, decreased HASMC F-actin stress fiber formation, migration, and proliferation. In addition, smooth muscle-specific deletion of NFATc1 led to decreased cyclin D1 expression and CDK6, CDK4, and Pak1 activities, resulting in reduced neointima formation in response to injury. Thus, these observations reveal that Pak1 is a downstream effector of CDK4 and Rac1-dependent, NFATc1-mediated cyclin D1 expression and CDK6 activity mediate this effect. In addition, smooth muscle-specific deletion of NFATc1 prevented the capacity of vascular smooth muscle cells for MCP-1-induced activation of the cyclin D1-CDK6-CDK4-Pak1 signaling axis, affecting

  9. Role of Mitochondria in Cerebral Vascular Function: Energy Production, Cellular Protection, and Regulation of Vascular Tone.

    Busija, David W; Rutkai, Ibolya; Dutta, Somhrita; Katakam, Prasad V


    Mitochondria not only produce energy in the form of ATP to support the activities of cells comprising the neurovascular unit, but mitochondrial events, such as depolarization and/or ROS release, also initiate signaling events which protect the endothelium and neurons against lethal stresses via pre-/postconditioning as well as promote changes in cerebral vascular tone. Mitochondrial depolarization in vascular smooth muscle (VSM), via pharmacological activation of the ATP-dependent potassium channels on the inner mitochondrial membrane (mitoKATP channels), leads to vasorelaxation through generation of calcium sparks by the sarcoplasmic reticulum and subsequent downstream signaling mechanisms. Increased release of ROS by mitochondria has similar effects. Relaxation of VSM can also be indirectly achieved via actions of nitric oxide (NO) and other vasoactive agents produced by endothelium, perivascular and parenchymal nerves, and astroglia following mitochondrial activation. Additionally, NO production following mitochondrial activation is involved in neuronal preconditioning. Cerebral arteries from female rats have greater mitochondrial mass and respiration and enhanced cerebral arterial dilation to mitochondrial activators. Preexisting chronic conditions such as insulin resistance and/or diabetes impair mitoKATP channel relaxation of cerebral arteries and preconditioning. Surprisingly, mitoKATP channel function after transient ischemia appears to be retained in the endothelium of large cerebral arteries despite generalized cerebral vascular dysfunction. Thus, mitochondrial mechanisms may represent the elusive signaling link between metabolic rate and blood flow as well as mediators of vascular change according to physiological status. Mitochondrial mechanisms are an important, but underutilized target for improving vascular function and decreasing brain injury in stroke patients. © 2016 American Physiological Society. Compr Physiol 6:1529-1548, 2016.

  10. Paragliding injuries.

    Krüger-Franke, M; Siebert, C H; Pförringer, W


    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during st...

  11. Early Detection System of Vascular Disease and Its Application Prospect

    Huan Liu


    Full Text Available Markers of imaging, structure, and function reflecting vascular damage, integrating a long time accumulation effect of traditional and unrecognized cardiovascular risk factors, can be regarded as surrogate endpoints of target organ damage before the occurrence of clinical events. Prevention of cardiovascular disease requires risk stratification and treatment of traditional risk factors, such as smoking, hypertension, hyperlipidemia, and diabetes. However, traditional risk stratification is not sufficient to provide accurate assessment of future cardiovascular events. Therefore, vascular injury related parameters obtained by ultrasound or other noninvasive devices, as a surrogate parameter of subclinical cardiovascular disease, can improve cardiovascular risk assessment and optimize the preventive treatment strategy. Thus, we will summarize the research progress and clinical application of early assessment technology of vascular diseases in the present review.

  12. TLR4/NF-κB signal pathway mediates pioglitazone protecting human vascular endothelial cells against visfantin-induced injury%TLR4/NF-κB信号转导通路介导吡格列酮在内脂素诱导内皮细胞炎症损伤过程中作用机制的探讨

    何晓乐; 刘军; 张航向; 王宁; 徐荣; 杨洁; 王晓明


    Objective To determine the effect of pioglitazone on visfantin-induced inflammatory injury in human vascular endothelial cells and investigate the underlying signal pathway of pioglitazone in improving endothelial functions. Methods Human umbilical vein endothelial cells (HUVECs) were treated by different concentrations of visfantin. Then Western blotting was used to detect the expression of Toll-like receptor4 (TLR4), intercellular cell adhesion molecule-1 (ICAM-1), nuclear factor-κB (NF-κB) and inhibitor of NK- κB-α (IκB-α). Their expression levels were measured again after the cells were respectively exposed to the agonist of peroxisome proliferator activated receptor gamma (PPARγ), pioglitazone. Results Compared with the control group, visfantin enhanced the expression of ICAM-1 in a dose-dependent manner, and also induced TLR4 up-regulation and IκB-α down-regulation (P<0.05), with visfantin at dose of 1×10-5mol/L showing the strongest effect. However, pioglitazone inhibited the above effects of visfatin in a dose-dependent manner, with dose of 20 µmol/L having the maximal effect. Conclusion Pioglitazone exerts protective effect on visfantin-induced inflammatory injury in human vascular endothelial cells, which may be due to its blocking TLR4/NF-κB signal pathway.%目的:观察吡格列酮对内脂素诱导人脐静脉内皮细胞(HUVECs)炎症损伤过程中的影响,探讨吡格列酮改善内皮功能的信号转导机制。方法将HUVECs随机分组,给予不同浓度的内脂素进行诱导,运用蛋白印迹法(Western blotting)检测各组细胞Toll样受体4(TLR4)、细胞间黏附分子-1(ICAM-1)、核因子-κB(NF-κB)和NK-κB抑制蛋白α(IκB-α)的表达;再给予过氧化物酶体增殖物激活受体γ(PPARγ)激动剂吡格列酮,观察各组指标表达变化。结果与正常对照组相比,内脂素呈浓度依赖性地增加ICAM-1含量,下调IκB-α蛋白的表达,同时上调TLR4

  13. Multicenter evaluation of temporary intravascular shunt use in vascular trauma.

    Inaba, Kenji; Aksoy, Hande; Seamon, Mark J; Marks, Joshua A; Duchesne, Juan; Schroll, Rebecca; Fox, Charles J; Pieracci, Fredric M; Moore, Ernest E; Joseph, Bellal; Haider, Ansab A; Harvin, John A; Lawless, Ryan A; Cannon, Jeremy; Holland, Seth R; Demetriades, Demetrios


    The indications and outcomes associated with temporary intravascular shunting (TIVS) for vascular trauma in the civilian sector are poorly understood. The objective of this study was to perform a contemporary multicenter review of TIVS use and outcomes. Patients sustaining vascular trauma, requiring TIVS insertion (January 2005 to December 2013), were retrospectively identified at seven Level I trauma centers. Clinical demographics, operative details, and outcomes were abstracted. A total of 213 injuries (2.7%; 94.8% arterial) requiring TIVS were identified in 7,385 patients with vascular injuries. Median age was 27.0 years (range, 4-89 years), 91.0% were male, Glasgow Coma Scale (GCS) score was 15.0 (interquartile range, 4.0), Injury Severity Score (ISS) was 16.0 (interquartile range, 15.0), 26.0% had an ISS of 25 or greater, and 71.1% had penetrating injuries. The most common mechanism was gunshot wound (62.7%), followed by auto versus pedestrian (11.4%) and motor vehicle collision (6.5%). Shunts were placed for damage control in 63.4%, staged repair for combined orthopedic and vascular injuries in 36.1%, and for insufficient surgeon skill set in 0.5%. The most common vessel shunted was the superficial femoral artery (23.9%), followed by popliteal artery (18.8%) and brachial artery (13.2%). An argyle shunt (81.2%) was the most common conduit, followed by Pruitt-Inahara (9.4%). Dwell time was less than 6 hours in 61.4%, 24 hours in 86.5%, 48 hours in 95.9%, with only 4.1% remaining in place for more than 48 hours. Of the patients, 81.6% survived to definitive repair, and 79.6% survived overall. Complications included shunt thrombosis (5.6%) and dislodgment (1.4%). There was no association between dwell time and shunt thrombosis. The use of a noncommercial shunt (chest tube/feeding tube) did not impact shunt thrombosis but was an independent risk factor for subsequent graft failure. The limb salvage rate was 96.3%. No deaths could be attributed to a shunt

  14. Paragliding injuries.

    Krüger-Franke, M; Siebert, C H; Pförringer, W


    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries.


    Ivan Jovanović


    Full Text Available Liver is the largest parenchymatous organ, well vascularized, weighing approximately 1.8-3.0% of the whole body weight. Among all abdominal traumas liver injuries account for 25%. For more serious liver injuries the mortality is around 40% in children below 10 years of age. For lesions of the juxtahepatic veins (three major hepatic veins or the retrohepatic portion of v. cava or for complex, combined intra abdominal injuries, the mortality is even up to 70%.This work analyzed the period 1988-2000 during which there were 19 children admitted and treated for blunt liver injuries at the Clinic of Pediatric Surgery and Orthopedics in Nis; I, II and III scale injuries prevailed (17 cases; 89.4%. These injuries were surgically treated for the most part (17 cases; 89.4%. In 7 children (36.8% there were combined injuries. The lethality was 26.3%-5 cases, with three major complications: two intrahepatic hematomas and one biliary fistula associated with biliary peritonitis and biloma formation.

  16. Prevention of vascular inflammation by nanoparticle targeting of adherent neutrophils

    Wang, Zhenjia; Li, Jing; Cho, Jaehyung; Malik, Asrar B.


    Inflammatory diseases such as acute lung injury and ischaemic tissue injury are caused by the adhesion of a type of white blood cell--polymorphonuclear neutrophils--to the lining of the circulatory system or vascular endothelium and unchecked neutrophil transmigration. Nanoparticle-mediated targeting of activated neutrophils on vascular endothelial cells at the site of injury may be a useful means of directly inactivating neutrophil transmigration and hence mitigating vascular inflammation. Here, we report a method employing drug-loaded albumin nanoparticles, which efficiently deliver drugs into neutrophils adherent to the surface of the inflamed endothelium. Using intravital microscopy of tumour necrosis factor-α-challenged mouse cremaster post-capillary venules, we demonstrate that fluorescently tagged albumin nanoparticles are largely internalized by neutrophils adherent to the activated endothelium via cell surface Fcɣ receptors. Administration of albumin nanoparticles loaded with the spleen tyrosine kinase inhibitor, piceatannol, which blocks `outside-in' β2 integrin signalling in leukocytes, detached the adherent neutrophils and elicited their release into the circulation. Thus, internalization of drug-loaded albumin nanoparticles into neutrophils inactivates the pro-inflammatory function of activated neutrophils, thereby offering a promising approach for treating inflammatory diseases resulting from inappropriate neutrophil sequestration and activation.

  17. Burn Injuries: Burn Depth, Physiopathology and Type of Burns

    Kemalettin Koltka


    Full Text Available A significant burn injury is a serious and mortal event. The most important threat to life is hypovolemic shock with complex pathophysiologic mechanisms. Burn depth is classified as first, second, or third degree. Local inflammatory response results a vasodilatation and an increase in vascular permeability. A burn injury is a three dimensional ischemic wound. Zone of coagulation is the zone with maximum damage. Zone of stasis consists of damaged but viable tissues, the tissue is salvageable. In zone of hyperemia tissue perfusion is increased. At the beginning, cardiac output falls and systemic vascular resistance increases; cardiac performance improves as hypovolemia is corrected with fluid resuscitation. While cardiac output increases systemic vascular resistance falls below normal values and a hypermetabolic state develops. Pulmonary vascular resistance increases immediately after thermal injury and this is more prolonged. To avoid secondary pulmonary complications, the smallest resuscitation volume of fluids that maintains adequate tissue perfusion should be given. Changes parallel to the cardiovascular response develop in other organ systems. The reasons of burn injury can be thermal, electrical, chemical or radiation. It is important to know the exact mechanism of burn injury because of different therapies for a specific cause. In this review information about burn depth, local and systemic responses to burn injury and major causes of burn injury are presented. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl:1-6

  18. Rowing injuries.

    Rumball, Jane S; Lebrun, Constance M; Di Ciacca, Stephen R; Orlando, Karen


    Participation in the sport of rowing has been steadily increasing in recent decades, yet few studies address the specific injuries incurred. This article reviews the most common injuries described in the literature, including musculoskeletal problems in the lower back, ribs, shoulder, wrist and knee. A review of basic rowing physiology and equipment is included, along with a description of the mechanics of the rowing stroke. This information is necessary in order to make an accurate diagnosis and treatment protocol for these injuries, which are mainly chronic in nature. The most frequently injured region is the low back, mainly due to excessive hyperflexion and twisting, and can include specific injuries such as spondylolysis, sacroiliac joint dysfunction and disc herniation. Rib stress fractures account for the most time lost from on-water training and competition. Although theories abound for the mechanism of injury, the exact aetiology of rib stress fractures remains unknown. Other injuries discussed within, which are specific to ribs, include costochondritis, costovertebral joint subluxation and intercostal muscle strains. Shoulder pain is quite common in rowers and can be the result of overuse, poor technique, or tension in the upper body. Injuries concerning the forearm and wrist are also common, and can include exertional compartment syndrome, lateral epicondylitis, deQuervain's and intersection syndrome, and tenosynovitis of the wrist extensors. In the lower body, the major injuries reported include generalised patellofemoral pain due to abnormal patellar tracking, and iliotibial band friction syndrome. Lastly, dermatological issues, such as blisters and abrasions, and miscellaneous issues, such as environmental concerns and the female athlete triad, are also included in this article.Pathophysiology, mechanism of injury, assessment and management strategies are outlined in the text for each injury, with special attention given to ways to correct

  19. The Danish Vascular Registry, Karbase

    Eldrup, Nikolaj; Cerqueira, Charlotte; de la Motte, Louise


    AIM: The Danish Vascular Registry (DVR), Karbase, is monitoring arterial and advanced vein interventions conducted at all vascular departments in Denmark. The main aim of the DVR is to improve the quality of treatment for patients undergoing vascular surgery in Denmark by using the registry...... for quality assessment and research. STUDY POPULATION: All patients undergoing vascular interventions (surgical and endovascular) at any vascular department in Denmark are registered in the DVR. The DVR was initiated in 1989, and each year, ∼9,000 procedures are added. By January 2016, >180,000 procedures...... are submitted. Variables for medical treatment (antithrombotic and statin treatment), amputation, and survival are extracted from nationwide, administrative registers. CONCLUSION: The DVR reports outcome on key indicators for monitoring the quality at all vascular departments in Denmark for the purpose...

  20. MRI evaluation of vascular dementia

    Yicheng Liu; Hongxing Zhang; Wei Huang; Wenjun Wan; Hongfen Peng


    OBJECTTVE: To explain the association between vascular dementia and the cranial MRI manifestations, and recognize the value of cranial MRI in the early diagnosis of vascular dementia and the assessment of disease conditions.DATA SOURCES: Pubmed database was searched to identify articles about the cranial MRI manifestations of patients with vascular dementia published in English from January 1992 to June 2006 by using the key words of "MRI, vascular dementia". Others were collected by searching the name of journals and title of articles in the Chinese full-text journal database.STUDY SELECTTON: The collected articles were primarily checked, those correlated with the cranial MRI manifestations of patients with vascular dementia were selected, while the obviously irrelative ones were excluded, and the rest were retrieved manually, the full-texts were searched.DATA EXTRACTION: Totally 255 articles were collected, 41 of them were involved, and the other 214 were excluded.DATA SYNTHESIS: MRI can be taken as one of the effective methods for the early diagnosis and disease evaluation of vascular dementia. White matter lesions are the important risk factors of vascular dementia.Vascular dementia is accompanied by the atrophy of related brain sites, but further confirmation is needed to investigate whether there is significant difference. MRI can be used to quantitatively investigate the infarcted sites and sizes of patients with vascular dementia after infarction, but there is still lack of systematic investigation on the association of the infarcted sites and sizes with the cognitive function of patients with vascular dementia.CONCLUSTON: Cranial MRI can detect the symptoms of vascular dementia at early period, so that corresponding measures can be adopted to prevent and treat vascular dementia in time.

  1. Vascular complications following therapeutic and diagnostic cardiac catheterisation by the femoral artery

    Bitsch, M; Liisberg-Larsen, Ole Christian; Schroeder, T V


    Twenty-one of 6327 (0.33%) patients undergoing cardiac catheterisation via the femoral artery had an acute vascular complication requiring surgical intervention. The complication rate was 0.1% after coronary angiography, 2% after PTCA and 6% after aortic ballon dilatation. The size of the cathete...... and evaluation of vascular injuries following diagnostic and therapeutic invasive interventions could have a self limitating effect on the complication rate....

  2. Ocular Injury

    ... eye and face protection is essential to prevent injuries. Sports such as hockey, baseball, racquet ball, squash, and shooting require protective goggles or full face mask wear at all times. Do fireworks still cause eye injuries? Each year hundreds of individuals (often children) sustain ...

  3. Whiplash injuries.

    Malanga, Gerard; Peter, Jason


    Whiplash injuries are very common and usually are associated with rear-end collisions. However, a whiplash injury can be caused by any event that results in hyperextension and flexion of the cervical spine. These injuries are of serious concern to all consumers due to escalating cost of diagnosis, treatment, insurance, and litigation. Most acute whiplash injury cases respond well to conservative treatments, which result in resolution of symptoms usually within weeks to a few months after the injury occurred. Chronic whiplash injuries often are harder to diagnose and treat and often result in poor outcomes. Current research shows that various structures in the cervical spine receive nociceptive innervation and potentially may be the cause of chronic pain symptoms. One potential pain generator showing promise is the facet or zygapophyseal joints. Various researchers have proven that these joints are injured during whiplash injuries and that diagnosis and temporary pain relief can be obtained with facet joint injections. The initial evaluation of any patient should follow an organized and stepwise approach, and more serious causes of neck pain must first be ruled out through the history, physical examination, and diagnostic testing. Treatment regimens should be evidence-based, focusing on treatments that have proven to be effective in treating acute and chronic whiplash injuries.

  4. CT in vascular pathologies

    Bartolozzi, C.; Neri, E.; Caramella, D. [Diagnostic and Interventional Radiology Department of Oncology, University of Pisa, Via Roma 67, I-56100 Pisa (Italy)


    Since the introduction of helical scanners, CT angiography (CTA) has achieved an essential role in many vascular applications that were previously managed with conventional angiography. The performance of CTA is based on the accurate selection of collimation width, pitch, reconstruction spacing and scan delay, which must be modulated on the basis of the clinical issue. However, the major improvement of CT has been provided by the recent implementation of many post-processing techniques, such as multiplanar reformatting, shaded surface display, maximum intensity projections, 3D perspectives of surface and volume rendering, which simulate virtual intravascular endoscopy. The integration of the potentialities of the scanner and of the image processing techniques permitted improvement of: (a) the evaluation of aneurysms, dissection and vascular anomalies involving the thoracic aorta; (b) carotid artery stenosis; (c) aneurysms of abdominal aorta; (d) renal artery stenosis; (e) follow-up of renal artery stenting; and (f) acute or chronic pulmonary embolism. Our experience has shown that the assessment of arterial pathologies with CTA requires the integration of 3D post-processing techniques in most applications. (orig.) With 4 figs., 34 refs.

  5. Vascular dysfunction in preeclampsia.

    Brennan, Lesley J; Morton, Jude S; Davidge, Sandra T


    Preeclampsia is a complex disorder which affects an estimated 5% of all pregnancies worldwide. It is diagnosed by hypertension in the presence of proteinuria after the 20th week of pregnancy and is a prominent cause of maternal morbidity and mortality. As delivery is currently the only known treatment, preeclampsia is also a leading cause of preterm delivery. Preeclampsia is associated with maternal vascular dysfunction, leading to serious cardiovascular risk both during and following pregnancy. Endothelial dysfunction, resulting in increased peripheral resistance, is an integral part of the maternal syndrome. While the cause of preeclampsia remains unknown, placental ischemia resulting from aberrant placentation is a fundamental characteristic of the disorder. Poor placentation is believed to stimulate the release of a number of factors including pro- and antiangiogenic factors and inflammatory activators into the maternal systemic circulation. These factors are critical mediators of vascular function and impact the endothelium in distinctive ways, including enhanced endothelial oxidative stress. The mechanisms of action and the consequences on the maternal vasculature will be discussed in this review.

  6. Incidence and outcomes of intraoperative vascular surgery consultations.

    Danczyk, Rachel C; Coleman, Jake; Allensworth, Jordan; Azarbal, Amir F; Mitchell, Erica L; Liem, Timothy K; Landry, Gregory J; Moneta, Gregory L


    Vascular surgeons may aid in primarily nonvascular procedures. Such activity has not been quantified, and hospital administrators may be unaware of the importance of vascular surgeons to support other hospital-based surgical programs. This study reviewed intraoperative consultations by vascular surgeons to support other surgical services. Intraoperative vascular consultations were reviewed from January 2006 to January 2014 for consulting service, indication, and whether consultation occurred with advanced notice. Patient demographics, operative times, estimated blood loss, length of stay, and relative value units (RVUs) assigned for each consultation were also assessed. Consultations for trauma and iatrogenic injuries occurring outside the operating theater were excluded. Vascular surgeons performed 225 intraoperative consultations in support of procedures by nonvascular surgeons. Requesting services were surgical oncology (46%), orthopedics (17%), urology (11%), otolaryngology (7%), and others (19%). Reasons for consultation overlapped and included vascular reconstruction (53%), control of hemorrhage (39%), and assistance with difficult dissections (43%). Seventy-four percent were for intra-abdominal procedures, and venous (53%) and arterial (50%) problems were encountered equally with some overlap. Most patients were male (59%), overweight (56%; body mass index ≥25 kg/m(2)), had previous surgery (72%) and were undergoing elective procedures (89%). Mean total procedural anesthesia time was 9.4 hours, mean procedural operating time was 7.9 hours, and mean total and vascular-related estimated blood loss was 1702 mL and 327 mL, respectively. Mean length of stay was 14.7 days, mean intensive care unit stay was 2.9 days, and 30-day mortality was 6.2%. Mean nonvascular RVUs per operation were 46.0, and mean vascular RVUs per operation were 30.9. Unexpected intraoperative need for vascular surgical expertise occurs often enough that vascular surgeons should be regarded

  7. Vascular Remodeling in Experimental Hypertension

    Norma R. Risler


    Full Text Available The basic hemodynamic abnormality in hypertension is an increased peripheral resistance that is due mainly to a decreased vascular lumen derived from structural changes in the small arteries wall, named (as a whole vascular remodeling. The vascular wall is an active, flexible, and integrated organ made up of cellular (endothelial cells, smooth muscle cells, adventitia cells, and fibroblasts and noncellular (extracellular matrix components, which in a dynamic way change shape or number, or reorganize in response to physiological and pathological stimuli, maintaining the integrity of the vessel wall in physiological conditions or participating in the vascular changes in cardiovascular diseases such as hypertension. Research focused on new signaling pathways and molecules that can participate in the mechanisms of vascular remodeling has provided evidence showing that vascular structure is not only affected by blood pressure, but also by mechanisms that are independent of the increased pressure. This review will provide an overview of the evidence, explaining some of the pathophysiologic mechanisms participating in the development of the vascular remodeling, in experimental models of hypertension, with special reference to the findings in spontaneously hypertensive rats as a model of essential hypertension, and in fructose-fed rats as a model of secondary hypertension, in the context of the metabolic syndrome. The understanding of the mechanisms producing the vascular alterations will allow the development of novel pharmacological tools for vascular protection in hypertensive disease.

  8. 抑制microRNA-22可通过调节SIRT1表达减轻氧化应激引起的血管内皮细胞损伤%Inhibition of microRNA-22 Could Antagonize the Injury Casedby Oxidative Stress in Vascular Endothelial Cells Via Targeting Sirt1

    李陶; 庞琪; 刘永斌


    Objective To investigate the change of SIRT1 and microRNA-22 expression in vascular endothelial cel injury induced by oxidative stress.Methods 20 μmol/L t-BHP was used to induce oxidative stress injury. The proliferation and apoptosis of HUVEC under oxidative stress were detected with cell tilter blue assay and flow cytometry. The change of level SIRT1 was determined with Western blot. The level of microRNA-22 in HUVEC under oxidative stress was detected with qRT-PCR assay. The down-regulate of microRNA-22 in HUVEC,microRNA-22 inhibitor was transfected followed with cell tilter blue assay,the effect of microRNA-22 inhibition on HUVEC proliferation was observed. Results The oxidative stress caused by t-BHP could inhibit proliferation of HUVEC. Also,the level of SIRT1 decreased in HUVEC after treated with t-BHP. A high expression of microRNA-22 was observed in HUVEC under oxidative stress. Inhibition of microRNA-22 could recover the expression of SIRT1. Moreover, down-regulation of microRNA-22 could antagonize the proliferation inhibition induced by oxidative stress. Conclusion MicroRNA-22 could play a role in the HUVEC injury caused by oxidative stress via regulate SIRT1. It can be a potential therapy target for atherosclerosis.%目的:探讨SIRT1及microRNA-22在氧化应激引起的血管内皮细胞损伤过程中的表达变化和机制。方法使用20µmol/L叔丁基过氧化氢(t-BHP)诱导人脐周静脉血管内皮细胞株(HUVEC)的氧化应激。Cel Tilter Blue细胞活性分析试验及流式细胞术检测氧化应激对HUVEC增殖及凋亡的影响。Western blot检测氧化应激状态下HUVEC SIRT1蛋白水平的变化,同时qRT-PCR分析氧化应激对HVEC microRNA-22水平的影响。通过转染microRNA-22 inhibitor抑制HUVEC的microRNA-22表达,并观察microRNA-22抑制对氧化应激状态下HUVEC SIRT1表达及细胞增殖的影响。结果 t-BHP诱导的氧化应激可诱导HUVEC的增殖抑制,且降低SIRT1的表达。氧

  9. Current status of vascularized composite tissue allotransplantation

    Karoline Edtinger


    Full Text Available Vascularized composite tissue allotransplantation (VCA offers treatment options of complex functional deficiencies that cannot be repaired with conventional reconstructive methods. VCAs consist of blocks of functional units comprising different tissue types such as skin, bone, muscle, nerves, blood vessels, tendons, ligaments and others, and are thus substantially different from the composition of organ transplants. The field of VCA has made fascinating progresses in the recent past. Among other VCAs, numerous successful hand, face and limb transplants have been performed in the world. At the same time, specific questions in regard to innate and adaptive immunity, consequences of ischemia/reperfusion injury, immunosuppression, preservation, and regenerative capacity remain. In spite of this, the field is poised to make significant advances in the near future.

  10. Critical role of nucleotide-binding oligomerization domain-like receptor 3 in vascular repair

    Schlaweck, Sebastian; Zimmer, Sebastian; Struck, Rafael [Department of Medicine/Cardiology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn (Germany); Bartok, Eva [Institute for Clinical Chemistry and Clinical Pharmacology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn (Germany); Werner, Nikos [Department of Medicine/Cardiology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn (Germany); Bauernfeind, Franz [Institute for Clinical Chemistry and Clinical Pharmacology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn (Germany); Latz, Eicke [Institute of Innate Immunity, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn (Germany); Nickenig, Georg [Department of Medicine/Cardiology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn (Germany); Hornung, Veit [Institute for Clinical Chemistry and Clinical Pharmacology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn (Germany); Ghanem, Alexander, E-mail: [Department of Medicine/Cardiology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn (Germany)


    Highlights: {yields} NLRP3 is not required for systemic cardiovascular function in healthy mice. {yields} NLRP3 deficiency itself does not affect the functional cardiovascular phenotype and that it does not alter peripheral differential blood counts. {yields} NLRP3 is critical in neointima formation following vascular injury. -- Abstract: Vascular remodeling characterized by hyperproliferative neointima formation is an unfavorable repair process that is triggered by vascular damage. This process is characterized by an increased local inflammatory and proliferative response that critically involves the pro-inflammatory cytokine interleukin-1{beta} (IL-1{beta}). IL-1{beta} is expressed and cytosolically retained as a procytokine that requires additional processing prior to exerting its pro-inflammatory function. Maturation and release of pro IL-1{beta} is governed by a cytosolic protein scaffold that is known as the inflammasome. Here we show that NLRP3 (NOD-like receptor family, pryin domain containing 3), an important activating component of the inflammasome, is involved in neointima formation after vascular injury. NLRP3 deficiency itself does not affect the functional cardiovascular phenotype and does not alter peripheral differential blood counts. However, neointima development following wire injury of the carotid artery was significantly decreased in NLRP3-deficient mice as compared to wild-type controls. In all, NLRP3 plays a non-redundant role in vascular damage mediated neointima formation. Our data establish NLRP3 as a key player in the response to vascular damage, which could open new avenues to therapeutic intervention.

  11. Additive Manufacturing of Vascular Grafts and Vascularized Tissue Constructs.

    Elomaa, Laura; Yang, Yunzhi Peter


    There is a great need for engineered vascular grafts among patients with cardiovascular diseases who are in need of bypass therapy and lack autologous healthy blood vessels. In addition, because of the severe worldwide shortage of organ donors, there is an increasing need for engineered vascularized tissue constructs as an alternative to organ transplants. Additive manufacturing (AM) offers great advantages and flexibility of fabrication of cell-laden, multimaterial, and anatomically shaped vascular grafts and vascularized tissue constructs. Various inkjet-, extrusion-, and photocrosslinking-based AM techniques have been applied to the fabrication of both self-standing vascular grafts and porous, vascularized tissue constructs. This review discusses the state-of-the-art research on the use of AM for vascular applications and the key criteria for biomaterials in the AM of both acellular and cellular constructs. We envision that new smart printing materials that can adapt to their environment and encourage rapid endothelialization and remodeling will be the key factor in the future for the successful AM of personalized and dynamic vascular tissue applications.

  12. Curcumin and folic acid abrogated methotrexate induced vascular endothelial dysfunction.

    Sankrityayan, Himanshu; Majumdar, Anuradha S


    Methotrexate, an antifolate drug widely used in rheumatoid arthritis, psoriasis, and cancer, is known to cause vascular endothelial dysfunction by causing hyperhomocysteinemia, direct injury to endothelium or by increasing the oxidative stress (raising levels of 7,8-dihydrobiopterin). Curcumin is a naturally occurring polyphenol with strong antioxidant and anti-inflammatory action and therapeutic spectra similar to that of methotrexate. This study was performed to evaluate the effects of curcumin on methotrexate induced vascular endothelial dysfunction and also compare its effect with that produced by folic acid (0.072 μg·g(-1)·day(-1), p.o., 2 weeks) per se and in combination. Male Wistar rats were exposed to methotrexate (0.35 mg·kg(-1)·day(-1), i.p.) for 2 weeks to induce endothelial dysfunction. Methotrexate exposure led to shedding of endothelium, decreased vascular reactivity, increased oxidative stress, decreased serum nitrite levels, and increase in aortic collagen deposition. Curcumin (200 mg·kg(-1)·day(-1) and 400 mg·kg(-1)·day(-1), p.o.) for 4 weeks prevented the increase in oxidative stress, decrease in serum nitrite, aortic collagen deposition, and also vascular reactivity. The effects were comparable with those produced by folic acid therapy. The study shows that curcumin, when concomitantly administered with methotrexate, abrogated its vascular side effects by preventing an increase in oxidative stress and abating any reduction in physiological nitric oxide levels.

  13. Reactive oxygen species and vascular biology: implications in human hypertension.

    Touyz, Rhian M; Briones, Ana M


    Increased vascular production of reactive oxygen species (ROS; termed oxidative stress) has been implicated in various chronic diseases, including hypertension. Oxidative stress is both a cause and a consequence of hypertension. Although oxidative injury may not be the sole etiology, it amplifies blood pressure elevation in the presence of other pro-hypertensive factors. Oxidative stress is a multisystem phenomenon in hypertension and involves the heart, kidneys, nervous system, vessels and possibly the immune system. Compelling experimental and clinical evidence indicates the importance of the vasculature in the pathophysiology of hypertension and as such much emphasis has been placed on the (patho)biology of ROS in the vascular system. A major source for cardiovascular, renal and neural ROS is a family of non-phagocytic nicotinamide adenine dinucleotide phosphate (NADPH) oxidases (Nox), including the prototypic Nox2 homolog-based NADPH oxidase, as well as other Noxes, such as Nox1 and Nox4. Nox-derived ROS is important in regulating endothelial function and vascular tone. Oxidative stress is implicated in endothelial dysfunction, inflammation, hypertrophy, apoptosis, migration, fibrosis, angiogenesis and rarefaction, important processes involved in vascular remodeling in hypertension. Despite a plethora of data implicating oxidative stress as a causative factor in experimental hypertension, findings in human hypertension are less conclusive. This review highlights the importance of ROS in vascular biology and focuses on the potential role of oxidative stress in human hypertension.

  14. HABP2 is a Novel Regulator of Vascular Integrity

    Mambetsariev, N.; Mirzapoiazova, T.; Mambetsariev, B.; Sammani, S.; Lennon, F.E.; Garcia, J.G.N.; Singleton, P.A.


    Objective We evaluated the role of the extracellular serine protease, Hyaluronic Acid Binding Protein 2 (HABP2), in vascular barrier regulation. Methods and Results Using immunoblot and immunohistochemical analysis, we observed that lipopolysaccharide (LPS)-induces HABP2 expression in murine lung endothelium in vivo and in human pulmonary microvascular endothelial cell (HPMVEC) in vitro. High molecular weight hyaluronan (HMW-HA, ~1 million Da) decreased HABP2 protein expression in HPMVEC and decreased purified HABP2 enzymatic activity whereas low MW HA (LMW-HA, ~2,500 Da) increased these activities. The effects of LMW-HA on HABP2 activity, but not HMW-HA, were inhibited with a peptide of the polyanion binding domain (PABD) of HABP2. Silencing (siRNA) HABP2 expression augmented HMW-HA-induced EC barrier enhancement and inhibited LPS and LMW-HA-mediated EC barrier disruption, results which were reversed with overexpression of HABP2. Silencing PAR receptors 1 and 3, RhoA or ROCK expression attenuated LPS, LMW-HA and HABP2-mediated EC barrier disruption. Utilizing murine models of acute lung injury, we observed that LPS- and ventilator-induced pulmonary vascular hyper-permeability were significantly reduced with vascular silencing (siRNA) of HABP2. Conclusions HABP2 negatively regulates vascular integrity via activation of PAR receptor/RhoA/ROCK signaling and represents a potentially useful therapeutic target for syndromes of increased vascular permeability. PMID:20042707

  15. High-frequency seismic radiation during Maule earthquake (Chile, 27/02/2010, Mw 8.8) inferred by backprojection of P waves: evidence of activation of two distinct zones at the downdip part of the plate interface

    Palo, M.; Tilmann, F. J.; Krueger, F.; Ehlert, L.; Lange, D.; Rietbrock, A.; Jenkins, J.; Hicks, S. P.


    We back-project the seismic radiation released by Maule earthquake (Chile, 27/02/2010, Mw 8.8) in three frequency bands: 0.4-3 Hz, 1-4 Hz, 2-8 Hz. We measure the coherence of the seismic traces at 557 stations of US array by semblance. Travel times are estimated starting from a 1D global velocity model (ak135) corrected by two terms: a static correction and a dynamic correction. Static corrections are the mean time corrections to the 1D velocity model, and dynamic corrections are finer time shifts depending on the source-receiver path. Both terms are extracted from the time shifts between different receivers of P-phases of 23 high-magnitude calibration aftershocks, most of which have high precision locations based on the temporary deployment following the Maule earthquake (IMAD). The dynamic corrections are extended over a fine source grid by kriging interpolation. This procedure makes the backprojection results independent of the main shock catalog hypocentre and allows coherent imaging to higher frequencies. During the first 20 seconds of the rupture process, the source is stable nearby the nucleation point, which is close to epicentre proposed by Vigny et al (Science, 2011) based on high rate GPS motion. Afterwards, it moves bilaterally, with the northern front moving with an average velocity of ˜3 km/s. Most of the energy is emitted from the northern patch of the bi-lateral rupture (˜70%), with sporadic emissions from the southern patch. The maximum of stacked energy is located about 150 km north-eastwards from the epicenter and a relative maximum appears south of Arauco peninsula. In the dip direction, energy is mostly emitted from the down-dip edge of the co-seismic area, roughly matching the aftershock distribution. Specifically, we find that coherent radiation is emitted from two distinct belts nearly parallel to the trench. The position of these belts is in good agreement with the location of the aftershocks, which also are arranged in two disconnected

  16. Value of computed tomographic angiography in neck and extremity pediatric vascular trauma.

    Hogan, Anthony R; Lineen, Edward B; Perez, Eduardo A; Neville, Holly L; Thompson, William R; Sola, Juan E


    We sought to define the sensitivity and specificity of computed tomographic angiography (CTA) in pediatric vascular injuries. All neck and extremity CTAs performed in pediatric patients at a level 1 trauma center were reviewed from 2001 to 2007. Overall, 78 patients were identified with an average age of 15.0 +/- 4.0 (0-18 years). Males outnumbered females 3.6:1. CTA was performed for 41 penetrating and 37 blunt traumas. Most penetrating injuries were due to missile wounds (71%) or stab wounds (17%). Eleven major vascular injuries resulted from penetrating trauma. For penetrating trauma, CTA was 100% sensitive and 93% specific. CTA for penetrating trauma had a positive predictive value (PPV) of 85% and negative predictive value (NPV) of 100%. Most blunt injuries were due to motor vehicle accidents (57%), followed by pedestrian hit by car (27%). Eight major vascular injuries resulted from blunt trauma. For blunt trauma, CTA was 88% sensitive and 100% specific. CTA for blunt trauma had a PPV of 100% and an NPV of 97%. The accuracy for penetrating and blunt trauma was 95% and 97%, respectively. CTA is highly sensitive, specific, and accurate for pediatric neck and extremity vascular trauma.

  17. An anatomic study of vascularized fibular grafts

    ZHU Yue-liang; XU Yong-qing; YANG Jun; Li Jun; LAN Xiu-fu


    Objective: To study the applied anatomy of the vascular and muscular innervations related to vascularized fibular grafts.Methods: Thirty-four cadaveric lower extremities were dissected for this study.The observations included fibular length,fibular nutrient artery,arcuate arteries,and innervation of fibular muscles.The fibulas were averagely divided into four segments and the locations of relevant vessels and nerves were ascertained.Results: All specimens had 1 fibular nutrient artery and 4-9 arcuate arteries except 1 specimen which had only 1 arcuate artery.The fibular nutrient artery and the first threearcuate arteries were constantly located between the distal half of the 1/4 segment and 2/4 segment of the fibula.The muscular branch of the superficial peroneal nerve passed through the surface of the periosteum in the 2/4 segment of the fibula.Conclusions: The most proximal osteotomy point locates at the midpoint of the 1/4 segment by which it ensure the maximal potential for preserving the nutrient vessels.The muscular branch of the superficial peroneal nerve is fragile to injury at the 2/4 segment of the fibula.

  18. Vascular hemichorea: case report and review

    Bárbara Martínez Alfonzo


    Full Text Available Chorea rarely complicates ischemic or hemorrhagic cerebral vascular lesions. Clinical symptoms usually involve one side of the body while the injury is situated on the contralateral cerebral hemisphere. Spontaneous remission is the norm, but sometimes symptomatic treatment is required. A 58-year-old male patient who suffers from untreated high blood pressure, type II obesity, smokes 6 packs of cigarettes per year and has a moderate intake of alcohol is presented. The patient’s recent history began three days before he appeared at the Emergency Department. His symptoms were ceaseless, involuntary movements in his left arm and foot during day and night with no restriction of voluntary movements. Physical examination and laboratory tests revealed no other findings. Magnetic resonance imaging of the brain showed hyperintensity in the right posterolateral thalamic region consistent with ischemic cerebrovascular disease. Symptomatic therapy was indicated and his underlying conditions were addressed. The importance of this case lies on the low prevalence as well as the scarcity of publications regarding vascular causes of hemichorea, including diagnosis, therapy and prognosis.

  19. Relation between aftershock parameters and geodetic slip models: Case study of the 2010 Mw8.8 Maule (Chile) and the 2011 Mw9.0 Tohoku-oki (Japan) earthquakes

    Zakharova, Olga; Hainzl, Sebastian; Lange, Dietrich; Enescu, Bogdan


    The distribution of local stresses, which represents as well crustal heterogeneity, is the main factor for aftershock triggering. Though neither local stresses nor crustal heterogeneity are known in detail, some information of their distribution is implicitly represented by slip and coupling values on the mainshock fault interface. Taking these two concepts as the main assumptions, we perform a comprehensive analysis of the relation between aftershock characteristics and geodetic measurements on the mainshock fault interface. As a case study we select two megathrust events, the 2010 Mw8.8 Maule (Chile) and the 2011 Mw9.0 Tohoku-oki (Japan), due to the availability of rich aftershock data as well as of geodetic inversion models. To investigate the dependency between these data sets we firstly estimated the aftershock parameter distribution, using a modified ETAS model, which allows to take into account the mainshock rupture extension. Secondly we calculate the correlation between aftershock parameters and coseismic/postseismic slip and interseismic coupling. We find: (1) aftershocks tend to occur in the areas of high coseismic slip gradient, afterslip and interseismic coupling; (2) aftershock seismic moment is released preferentially in regions of large coseismic slip, coseismic slip gradient and interseismically locked areas; (3) anomalous aftershock parameters occur in the areas of reactivated fault systems. Moreover, we show that modified ETAS model outperforms the classical one in the cases when the mainshock rupture extension cannot be neglected and represented as a point source. One of the main restriction in the presented analysis is related to the large uncertainties of the inversion models, which limit the significance of our results.

  20. Isolated Vascular Vertigo


    Strokes in the distribution of the posterior circulation may present with vertigo, imbalance, and nystagmus. Although the vertigo due to a posterior circulation stroke is usually associated with other neurologic symptoms or signs, small infarcts involving the cerebellum or brainstem can develop vertigo without other localizing symptoms. Approximately 11% of the patients with an isolated cerebellar infarction present with isolated vertigo, nystagmus, and postural unsteadiness mimicking acute peripheral vestibular disorders. The head impulse test can differentiate acute isolated vertigo associated with cerebellar strokes (particularly within the territory of the posterior inferior cerebellar artery) from more benign disorders involving the inner ear. Acute audiovestibular loss may herald impending infarction in the territory of anterior inferior cerebellar artery. Appropriate bedside evaluation is superior to MRIs for detecting central vascular vertigo syndromes. This article reviews the keys to diagnosis of acute isolated vertigo syndrome due to posterior circulation strokes involving the brainstem and cerebellum. PMID:25328871

  1. Malaria and Vascular Endothelium

    Alencar, Aristóteles Comte Filho de, E-mail: [Universidade Federal do Amazonas, Manaus, AM (Brazil); Lacerda, Marcus Vinícius Guimarães de [Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, AM (Brazil); Okoshi, Katashi; Okoshi, Marina Politi [Faculdade de Medicina de Botucatu (Unesp), Botucatu, SP (Brazil)


    Involvement of the cardiovascular system in patients with infectious and parasitic diseases can result from both intrinsic mechanisms of the disease and drug intervention. Malaria is an example, considering that the endothelial injury by Plasmodium-infected erythrocytes can cause circulatory disorders. This is a literature review aimed at discussing the relationship between malaria and endothelial impairment, especially its effects on the cardiovascular system. We discuss the implications of endothelial aggression and the interdisciplinarity that should guide the malaria patient care, whose acute infection can contribute to precipitate or aggravate a preexisting heart disease.

  2. Dynamic adaption of vascular morphology

    Okkels, Fridolin; Jacobsen, Jens Christian Brings


    The structure of vascular networks adapts continuously to meet changes in demand of the surrounding tissue. Most of the known vascular adaptation mechanisms are based on local reactions to local stimuli such as pressure and flow, which in turn reflects influence from the surrounding tissue. Here ...

  3. Vascularity in the reptilian spectacle.

    Mead, A W


    Vascularization of the spectacle or brille of the reptile was demonstrated by biomicroscopy, histology, fluorescein (in vivo), and Microfil silicone rubber (in situ) injections. This unusual vascularity provides new evidence for reassessment of the origin and development of this structure, and a useful tool with which to do so.

  4. The vascular secret of Klotho

    Lewin, Ewa; Olgaard, Klaus


    Klotho is an evolutionarily highly conserved protein related to longevity. Increasing evidence of a vascular protecting effect of the Klotho protein has emerged and might be important for future treatments of uremic vascular calcification. It is still disputed whether Klotho is locally expressed ...

  5. Dynamic adaption of vascular morphology

    Okkels, Fridolin; Jacobsen, Jens Christian Brings


    The structure of vascular networks adapts continuously to meet changes in demand of the surrounding tissue. Most of the known vascular adaptation mechanisms are based on local reactions to local stimuli such as pressure and flow, which in turn reflects influence from the surrounding tissue. Here we...

  6. Caffeine's Vascular Mechanisms of Action

    Darío Echeverri


    Full Text Available Caffeine is the most widely consumed stimulating substance in the world. It is found in coffee, tea, soft drinks, chocolate, and many medications. Caffeine is a xanthine with various effects and mechanisms of action in vascular tissue. In endothelial cells, it increases intracellular calcium stimulating the production of nitric oxide through the expression of the endothelial nitric oxide synthase enzyme. Nitric oxide is diffused to the vascular smooth muscle cell to produce vasodilation. In vascular smooth muscle cells its effect is predominantly a competitive inhibition of phosphodiesterase, producing an accumulation of cAMP and vasodilation. In addition, it blocks the adenosine receptors present in the vascular tissue to produce vasoconstriction. In this paper the main mechanisms of action of caffeine on the vascular tissue are described, in which it is shown that caffeine has some cardiovascular properties and effects which could be considered beneficial.

  7. Social media in vascular surgery.

    Indes, Jeffrey E; Gates, Lindsay; Mitchell, Erica L; Muhs, Bart E


    There has been a tremendous growth in the use of social media to expand the visibility of various specialties in medicine. The purpose of this paper is to describe the latest updates on some current applications of social media in the practice of vascular surgery as well as existing limitations of use. This investigation demonstrates that the use of social networking sites appears to have a positive impact on vascular practice, as is evident through the incorporation of this technology at the Cleveland Clinic and by the Society for Vascular Surgery into their approach to patient care and physician communication. Overall, integration of social networking technology has current and future potential to be used to promote goals, patient awareness, recruitment for clinical trials, and professionalism within the specialty of vascular surgery. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  8. Inhibitive effects of anti-oxidative vitamins on mannitol-induced apoptosis of vascular endothelial cells

    Pan, Kai-yu; Shen, Mei-ping; Ye, Zhi-Hong; Dai, Xiao-na; Shang, Shi-qiang


    Objective: Study blood vessel injury and gene expression indicating vascular endothelial cell apoptosis induced by mannitol with and without administration of anti-oxidative vitamins. Methods: Healthy rabbits were randomly divided into four groups. Mannitol was injected into the vein of the rabbit ear in each animal. Pre-treatment prior to mannitol injection was performed with normal saline (group B), vitamin C (group C) and vitamin E (group D). Blood vessel injury was assessed under electron...

  9. Impact of associated injuries in the Floating knee: A retrospective study

    Yesupalan Rajam S


    Full Text Available Abstract Background Floating knee injuries are usually associated with other significant injuries. Do these injuries have implications on the management of the floating knee and the final outcome of patients? Our study aims to assess the implications of associated injuries in the management and final outcome of floating knee. Methods 29 patients with floating knees were assessed in our institution. A retrospective analysis of medical records and radiographs were done and all associated injuries were identified. The impact of associated injuries on delay in initial surgical management, delay in rehabilitation & final outcome of the floating knee were assessed. Results 38 associated injuries were noted. 7 were associated with ipsilateral knee injuries. Lower limb injuries were most commonly associated with the floating knee. Patients with some associated injuries had a delay in surgical management and others a delay in post-operative rehabilitation. Knee ligament and vascular injuries were associated with poor outcome. Conclusion The associated injuries were quite frequent with the floating knee. Some of the associated injuries caused a delay in surgical management and post-operative rehabilitation. In assessment of the final outcome, patients with associated knee and vascular injuries had a poor prognosis. Majority of the patients with associated injuries had a good or excellent outcome.

  10. Citicoline in vascular cognitive impairment and vascular dementia after stroke.

    Alvarez-Sabín, Jose; Román, Gustavo C


    Cognitive decline after stroke is more common than stroke recurrence. Stroke doubles the risk of dementia and is a major contributor to vascular cognitive impairment and vascular dementia. Neuropathological studies in most cases of dementia in the elderly reveal a large load of vascular ischemic brain lesions mixed with a lesser contribution of neurodegenerative lesions of Alzheimer disease. Nonetheless, few pharmacological studies have addressed vascular cognitive impairment and vascular dementia after stroke. Citicoline has demonstrated neuroprotective effects in acute stroke and has been shown to improve cognition in patients with chronic cerebrovascular disease and in some patients with Alzheimer disease. A recent trial lasting 6 months in patients with first-ever ischemic stroke showed that citicoline prevented cognitive decline after stroke with significant improvement of temporal orientation, attention, and executive function. Experimentally, citicoline exhibits neuroprotective effects and enhances neural repair. Citicoline appears to be a safe and promising alternative to improve stroke recovery and could be indicated in patients with vascular cognitive impairment, vascular dementia, and Alzheimer disease with significant cerebrovascular disease.

  11. Head Injuries

    ... object that's stuck in the wound. previous continue Concussions Concussions — the temporary loss of normal brain function due ... also a type of internal head injury. Repeated concussions can permanently damage the brain. In many cases, ...

  12. ACL Injuries

    ... while doing things like skiing, playing soccer or football, and jumping on a trampoline.When you injure your ACL, it can be a partial or full tear. Other injuries can occur at the same time. These include ...

  13. [Popliteal and infrapopliteal vascular injuries. A surgical challenge].

    Zorita, A; Vázquez, J G; Morán, C F; Samos, R F; Alonso, J; Ramos, M; Vaquero, F


    Prospective study of 11 patients with lower limbs traumatisms, affecting vessels under Hunter canal. The results of surgical treatment (no prosthesis) are analyzed. In all cases there was bony and/o articular lesion.

  14. civilian vascular injuries in an urban african referral institution


    Dec 12, 2013 ... in pattern and document management challenges in a resource challenged environment. Design: A ... paucity of material and human resources and poor transportation and .... J Malaysia 2002;57:426-432. 3. Adebo O. Limb ...

  15. Magnetic nanoparticles for targeted vascular delivery.

    Chorny, Michael; Fishbein, Ilia; Forbes, Scott; Alferiev, Ivan


    Magnetic targeting has shown promise to improve the efficacy and safety of different classes of therapeutic agents by enabling their active guidance to the site of disease and minimizing dissemination to nontarget tissues. However, its translation into clinic has proven difficult because of inherent limitations of traditional approaches inapplicable for deep tissue targeting in human subjects and a need for developing well-characterized and fully biocompatible magnetic carrier formulations. A novel magnetic targeting scheme based on the magnetizing effect of deep-penetrating uniform fields is presented as an example of a strategy providing a potentially clinically viable solution for preventing injury-triggered reobstruction of stented blood vessels (in-stent restenosis). The design of optimized magnetic carrier formulations and experimental results showing the feasibility of uniform field-controlled targeting for site-specific vascular delivery of small-molecule pharmaceuticals, biotherapeutics, and cells are discussed in the context of antirestenotic therapy. The versatility of this approach applicable to different classes of therapeutic agents exerting their antirestenotic effects through distinct mechanisms prompts exploring the utility of uniform field-mediated magnetic stent targeting for combination therapies with enhanced efficiencies and improved safety profiles. Additional improvements in terms of site specificity and protracted carrier retention at the site of injury may be expected from the development and use of magnetic carriers exhibiting affinity for arterial wall-specific antigens. Copyright © 2011 Wiley Periodicals, Inc.

  16. The spectrum of injuries in buttock stab wounds.

    Campion, T; Cross, S


    Buttock stab wounds are a surprisingly common and increasing source of presentations to emergency departments. These injuries can have a significant impact on quality of life, and there are a number of often subtle, but significant, injuries that the radiologist must be alert to when interpreting computed tomography examinations in these patients. In this review, we will examine briefly the sociological reasons for the increase in these injuries, discuss appropriate imaging techniques, and provide imaging examples of the clinically important injuries that may be encountered in this region. These injuries include rectal or colonic perforation; genito-urinary trauma, for example urethral injury; injury to the sciatic nerve; and a spectrum of vascular trauma including transection and pseudoaneurysm or arteriovenous fistula formation. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Mechanisms of oxidative stress and vascular dysfunction

    Nedeljkovic, Z; Gokce, N; Loscalzo, J


    The endothelium regulates vascular homoeostasis through local elaboration of mediators that modulate vascular tone, platelet adhesion, inflammation, fibrinolysis, and vascular growth. Impaired vascular function contributes to the pathogenesis of atherosclerosis and acute coronary syndromes. There is growing pathophysiological evidence that increased generation of reactive oxygen species and oxidative stress participates in proatherogenic mechanisms of vascular dysfunction and atherothrombosis. In this review, the role of oxidative stress in mechanisms of vascular dysfunction is discussed, and potential antioxidant strategies are reviewed. PMID:12743334

  18. VEGF Production by Ly6C+high Monocytes Contributes to Ventilator-Induced Lung Injury

    Shi, Chung-Sheng; Huang, Tzu-Hsiung; Lin, Chin-Kuo; Li, Jhy-Ming; Chen, Mei-Hsin; Tsai, Mei-Ling; Chang, Chih-Ching


      Background Mechanical ventilation is a life-saving procedure for patients with acute respiratory failure, although it may cause pulmonary vascular inflammation and leakage, leading to ventilator-induced lung injury (VILI). Ly6C...

  19. Reduced Ischemia-Reoxygenation Injury in Rat Intestine After Luminal Preservation With a Tailored Solution

    Roskott, A.M.; Nieuwenhuijs, V.B.; Leuvenink, H.G.D.; Dijkstra, G.; Ottens, P.; de Jager, M.H.; Pereira, P.G.D.; Fidler, V.; Groothuis, G.M.M.; Ploeg, R.J.; de Graaf, I.A.M.


    Background. The intestine is extremely sensitive to ischemic preservation and reoxygenation injury. Current vascular perfusion and cold storage with University of Wisconsin (UW) solution neglect the intestinal lumen and the ongoing mucosal metabolism during hypothermia. This study was designed to

  20. Development and Characterization of VEGF165-Chitosan Nanoparticles for the Treatment of Radiation-Induced Skin Injury in Rats

    Daojiang Yu


    Full Text Available Radiation-induced skin injury, which remains a serious concern in radiation therapy, is currently believed to be the result of vascular endothelial cell injury and apoptosis. Here, we established a model of acute radiation-induced skin injury and compared the effect of different vascular growth factors on skin healing by observing the changes of microcirculation and cell apoptosis. Vascular endothelial growth factor (VEGF was more effective at inhibiting apoptosis and preventing injury progression than other factors. A new strategy for improving the bioavailability of vascular growth factors was developed by loading VEGF with chitosan nanoparticles. The VEGF-chitosan nanoparticles showed a protective effect on vascular endothelial cells, improved the local microcirculation, and delayed the development of radioactive skin damage.

  1. [The future of vascular medicine].

    Kroeger, K; Luther, B


    In the future vascular medicine will still have a great impact on health of people. It should be noted that the aging of the population does not lead to a dramatic increase in patient numbers, but will be associated with a changing spectrum of co-morbidities. In addition, vascular medical research has to include the intensive care special features of vascular patients, the involvement of vascular medicine in a holistic concept of fast-track surgery, a geriatric-oriented intensive monitoring and early geriatric rehabilitation. For the future acceptance of vascular medicine as a separate subject area under delimitation of cardiology and radiology is important. On the other hand, the subject is so complex and will become more complex in future specialisations that mixing of surgery and angiology is desirable, with the aim to preserve the vascular surgical knowledge and skills on par with the medical and interventional measures and further develop them. Only large, interdisciplinary guided vascular centres will be able to provide timely diagnosis and therapy, to deal with the growing multi-morbidity of the patient, to perform complex therapies even in an acute emergency and due to sufficient number of cases to present with well-trained and experienced teams. These requirements are mandatory to decrease patients' mortality step by step.

  2. Contemporary vascular smartphone medical applications.

    Carter, Thomas; O'Neill, Stephen; Johns, Neil; Brady, Richard R W


    Use of smartphones and medical mHealth applications (apps) within the clinical environment provides a potential means for delivering elements of vascular care. This article reviews the contemporary availability of apps specifically themed to major vascular diseases and the opportunities and concerns regarding their integration into practice. Smartphone apps relating to major vascular diseases were identified from the app stores for the 6 most popular smartphone platforms, including iPhone, Android, Blackberry, Nokia, Windows, and Samsung. Search terms included peripheral artery (arterial) disease, varicose veins, aortic aneurysm, carotid artery disease, amputation, ulcers, hyperhydrosis, thoracic outlet syndrome, vascular malformation, and lymphatic disorders. Forty-nine vascular-themed apps were identified. Sixteen (33%) were free of charge. Fifteen apps (31%) had customer satisfaction ratings, but only 3 (6%) had greater than 100. Only 13 apps (27%) had documented medical professional involvement in their design or content. The integration of apps into the delivery of care has the potential to benefit vascular health care workers and patients. However, high-quality apps designed by clinicians with vascular expertise are currently lacking and represent an area of concern in the mHealth market. Improvement in the quality and reliability of these apps will require the development of robust regulation. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Factors affecting morbidity and mortality in pancreatic injuries.

    Bozdag, Z; Kapan, M; Ulger, B V; Turkoglu, A; Uslukaya, O; Oğuz, A; Aldemir, M


    Difficulties in the detection of pancreatic damage result in morbidity and mortality in cases of pancreatic trauma. This study was performed to determine factors affecting morbidity and mortality in pancreatic trauma. The records of 33 patients who underwent surgery for pancreatic trauma between January 2004 and December 2013 were analyzed retrospectively. The types of injury were penetrating injury and blunt abdominal trauma in 75.8 and 24.2 % of all cases, respectively. Injuries were classified as stage 1 in 6 cases (18.2 %), stage 2 in 18 cases (54.5 %), stage 3 in 5 cases (15.2 %), and stage 4 in 4 cases (12.1 %). The average injury severity scale (ISS) value was 25.70 ± 9:33. Six patients (18.2 %) had isolated pancreatic injury, 27 (81.2 %) had additional intraabdominal organ injuries and 10 patients (30.3 %) had extraabdominal organ injuries. The mean length of hospital stay was 13.24 ± 9 days. Various complications were observed in eight patients (24.2 %) and mortality occurred in three (9.1 %). Complications were more frequent in patients with high pancreatic damage scores (p = 0.024), additional organ injuries (p = 0.05), and blunt trauma (p = 0.026). Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality. Complications were significantly more common in injuries with higher pancreatic damage scores, additional organ injuries, and blunt abdominal trauma. Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality.

  4. Traumatismos vasculares revisão de 5 anos Vascular Trauma a five year review

    Luís F. Antunes


    Full Text Available O presente trabalho pretende avaliar a casuística dos traumatismos vasculares agudos admitidos no Serviço de Cirurgia Vascular dos Hospitais da Universidade de Coimbra (HUC durante o período de 5 anos, compreendido entre Julho de 2004 e Junho de 2009. Foram avaliados 97 doentes, sendo a principal causa de traumatismo as lesões iatrogénicas, seguida dos acidentes de viação. No grupo de doentes não relacionados com procedimentos coronários percutâneos verificou-se que no membro superior as artérias umeral e radial foram as mais afectadas, enquanto no membro inferior foram as artérias femoral superficial e poplítea. A isquémia aguda foi a principal forma de apresentação. Relativamente ao tratamento deste grupo de doentes, a RATT (ressecção e anastomose topo-topo e o enxerto foram os mais utlizados no membro superior, enquanto a trombectomia e o bypass foram as técnicas mais aplicadas a nível do membro inferior. Não houve mortalidade mas a morbilidade foi elevada, predominando as lesões neurológicas nos traumatismos do membro superior, e a amputação nos do membro inferior. Os resultados deste trabalho foram concordantes com o que está publicado na literatura em que se demonstra um aumento progressivo dos traumatismos de origem iatrogénica.This review intended to evaluate the series of acute vascular trauma in the Vascular Surgery Service of the Coimbra University Hospital in the period between July 2004 and June 2009. A total of 97 patients were evaluated with iatrogenic lesions being the main cause of trauma injuries, followed by traffic accidents. In group of patients not related with percutaneous coronary angioplasty, it was found that brachial and radial arteries were the most affected in upper limb, while in the lower limb were the superficial femoral and popliteal arteries. The main clinical manifestation was acute ischemic limb. In this group, resection with end-to-end anastomosis and grafts were the main treatment

  5. Defining excellence in vascular neurosurgery.

    Sanai, Nader; Spetzler, Robert F


    Success as a vascular neurosurgeon almost always begins with passion, an inherent love for the work that drives an insatiable desire for personal improvement. A personal definition of excellence in vascular neurosurgery includes several fundamental qualities: mastery of the basics, refinement of technique, advancement of technology, investigative study, advanced decision making, microsurgical innovation, a well-rounded surgical armamentarium, and a lifelong commitment to teaching. Ultimately, the reward for these efforts is the ability to influence generations to come, particularly as one follows the rising careers of former trainees, each redefining the term "excellence" in vascular neurosurgery.

  6. Lower limb landmine injuries.

    Necmioglu, S; Subasi, M; Kayikci, C; Young, D B


    The medical records of 186 patients seeking treatment for landmine injuries in the authors' region between 1993 and 2001 were evaluated. Of these patients 13 died of accompanying complications. Ten (10) patients with general body trauma and upper limb trauma were excluded from the study. Of 163 patients with lower-limb injuries included in the study, 21 with traumatic amputation underwent surgical amputation at different levels. Patients without traumatic amputation were divided into 2 groups. There were 41 patients (29%) in Group I who were treated by limb salvage procedures. Treatments used in Group I including wound debridement, tendon repair, skin approximation, minimal osteosynthesis, external fixation of long bones and secondary wound coverage. In Group II, there were 101 patients (71%) with primary amputation. Trans-tibial amputation was performed in 52 cases (51.4%), ankle disarticulation in 24 (23.7%), trans-femoral amputation in 9 (8.9%), partial foot amputation in 8 (7.9%), knee disarticulation in 7 (6.9%) and hip disarticulation in 1 case. In Group I, there was infection in 21 patients (51.2%), revision in 27 (65.8%), and amputation in 15 (36.5%). In Group II, there was infection in 28 patients (27.7%), revision in 17 (16.8%), and amputation at a higher level in 8 (7%). In crush injuries such as those resulting from landmines, soft tissue, vascular, and neurological assessment must be performed with utmost care. Even so, the desired success in interventions intended to save a limb is complicated by a high infection rate, soft tissue complications, and high revision amputation rates. Therefore, a decision to amputate in the early term based on an accurate preoperative assessment is crucial.

  7. Trauma vascular, visión del cirujano vascular

    Dr. D. Cristián Salas


    Full Text Available El 3% de todas las lesiones en trauma tiene un componente