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Shannon B Spencer, Shigang Wang, Karl Woitas, Kristen Glass, Allen R Kunselman, Akif Ündar
The objective of this study was to evaluate an alternative neonatal extracorporeal life support (ECLS) circuit with a RotaFlow centrifugal pump and Better-Bladder (BB) for hemodynamic performance and gaseous microemboli (GME) capture in a simulated neonatal ECLS system. The circuit consisted of a Maquet RotaFlow centrifugal pump, a Quadrox-iD Pediatric diffusion membrane oxygenator, 8 Fr arterial cannula, and 10 Fr venous cannula. A "Y" connector was inserted into the venous line to allow for comparison between BB and no BB...
October 13, 2016: Artificial Organs
Matthew Schuldes, Jeffrey B Riley, Stephen G Francis, Sean Clingan
Gaseous microemboli (GME) are an abnormal physiological occurrence during cardiopulmonary bypass and extracorporeal membrane oxygenation (ECMO). Several studies have correlated negative sequelae with exposure to increased amounts of GME. Hypobaric oxygenation is effective at eliminating GME in hollow-fiber microporous membrane oxygenators. However, hollow-fiber diffusion membrane oxygenators, which are commonly used for ECMO, have yet to be validated. The purpose of this study was to determine if hypobaric oxygenation, compared against normobaric oxygenation, can reduce introduced GME when used on diffusion membrane oxygenators...
September 2016: Journal of Extra-corporeal Technology
William L Harryman, James P Hinton, Cynthia P Rubenstein, Parminder Singh, Raymond B Nagle, Sarah J Parker, Beatrice S Knudsen, Anne E Cress
A critical barrier for the successful prevention and treatment of recurrent prostate cancer is detection and eradication of metastatic and therapy-resistant disease. Despite the fall in diagnoses and mortality, the reported incidence of metastatic disease has increased 72% since 2004. Prostate cancer arises in cohesive groups as intraepithelial neoplasia, migrates through muscle and leaves the gland via perineural invasion for hematogenous dissemination. Current technological advances have shown cohesive-clusters of tumor (also known as microemboli) within the circulation...
September 24, 2016: Biochimica et Biophysica Acta
Yiyan Liu
Focal lung uptake without corresponding lesions or abnormalities on computed tomography (CT) scan poses a dilemma in the interpretation of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). A limited number of case reports have previously suggested an artifactual or iatrogenic nature of the uptake. In the present study, 8 relevant cases were included within a retrospective search of the database. Medical records were reviewed for follow-up radiological and pathologic information...
July 30, 2016: Current Problems in Diagnostic Radiology
Pascal Amedro, Camille Soulatges, Alain Fraisse
We report a case of late infective endocarditis in an 8-year-old boy 3 years after transcatheter closure of an atrial septal defect with the Amplatzer Atrial Septal Occluder Device. Echocardiography showed a very thick pannus lining the left atrial disc of the prosthesis, with some mobile elements. MRI showed several cerebral microemboli. The patient had dental caries and blood cultures found Staphylococcus aureus. Patient was treated with gentamicin and oxacillin before surgical removal of the prosthesis...
September 19, 2016: Catheterization and Cardiovascular Interventions
Juliane Jurga, Per Tornvall, Linda Dey, Jan van der Linden, Nondita Sarkar, Mia von Euler
Cerebral microemboli are frequently observed during coronary angiography (CA) and percutaneous coronary intervention (PCI), and their numbers have been related to the vascular access site used. Although cerebral microemboli can cause silent cerebral lesions, their clinical impact is debated. To study this, 93 patients referred for CA or PCI underwent serial cognitive testing using the Montreal Cognitive Assessment (MoCA) test to detect postprocedural cognitive impairment. Patients were randomized to radial or femoral access...
August 24, 2016: American Journal of Cardiology
Elizabeth Hitchner, Brittanie D Baughman, Salil Soman, Becky Long, Allyson Rosen, Wei Zhou
OBJECTIVE: Carotid interventions are important in helping to reduce the risk of stroke for patients with high-grade carotid artery stenosis; however, subclinical cerebral microemboli can occur during these procedures. Associations have been found between the incidence of microemboli and postoperative decline in memory. We therefore sought to determine whether this decline persisted long-term and to assess changes in other cognitive domains. METHODS: Patients were prospectively recruited under an Institutional Review Board-approved protocol at a single academic center...
September 12, 2016: Journal of Vascular Surgery
Ali Alawieh, Wenxue Wang, Aarti Narang, Stephen Tomlinson
Ischemic stroke is the fourth leading cause of death in the USA and a prominent cause of death globally. Besides thrombolytic therapy used in a small subset of patients, no alternative therapeutic strategy has been shown to improve the outcome of stroke patients. Preclinical models of ischemic stroke are an essential tool for investigating pathogenic processes that happen after the ischemic insult, as well as to screen for candidate therapeutic interventions. There are several models of rodent ischemic stroke including mechanical occlusion, thromboembolic stroke, and photothrombotic stroke...
2016: Methods in Molecular Biology
Bernd G Stegmayr
Patients on chronic hemodialysis have a shortened survival compared to the general population. There are multiple sources of morbidity and mortality unique to the dialysis population that account for this. Reasons include the effects of blood membrane interactions, intradialytic hypotension, myocardial stunning, excessive interdialytic weight gain, high-flow arteriovenous fistulae, and impaired lipid break down by anticoagulation administered during HD. Another risk factor, not well appreciated, is the occurrence of microemboli of air (microbubbles) during HD...
August 16, 2016: Seminars in Dialysis
Marco C Stehouwer, Kristina R Legg, Roel de Vroege, Johannes C Kelder, Erik Hofman, Bastian A de Mol, Peter Bruins
Gaseous microemboli (GME) may originate from the extracorporeal circuit and enter the arterial circulation of the patient. GME are thought to contribute to cerebral deficit and to adverse outcome after cardiac surgery. The arterial filter is a specially designed component for removing both gaseous and solid microemboli. Integration of an arterial filter with an oxygenator is a contemporary concept, reducing both prime volume and foreign surface area. This study aims to determine the air-handling properties of four contemporary oxygenator devices with an integrated arterial filter...
August 11, 2016: Perfusion
Hongzhou Duan, Liang Li, Yang Zhang, Jiayong Zhang, Ming Chen, Shengde Bao
Introduction. Transient global amnesia (TGA) following angiography is rare, and the pathogenesis has not been illustrated clearly till now. The aim of this research is to explore the pathogenesis of TGA following angiography by analyzing our data and reviewing the literature. Methods. We retrospectively studied 20836 cases with angiography in our hospital between 2007 and 2015 and found 9 cases with TGA following angiography. The data of these 9 cases were analyzed. Results. We found all 9 cases with TGA following neural angiography (5 in 4360) or cardiac angiography (4 in 8817) and no case with TGA following peripheral angiography (0 in 7659)...
2016: BioMed Research International
L M J Best, A C Webb, K S Gurusamy, S F Cheng, T Richards
OBJECTIVE: Identification of patients who will benefit from carotid endarterectomy is not entirely effective, primarily utilising degree of carotid stenosis. This study aimed at determining if microembolic signals (MES) detected by transcranial Doppler ultrasound (TCD) can provide clinically useful information regarding stroke risk in patients with carotid atherosclerosis. METHODS: A meta-analysis of prospective studies was performed. Three analyses were proposed investigating MES detection as a predictor of: stroke or TIA, stroke alone, and stroke or TIA but with an increased positivity threshold...
July 5, 2016: European Journal of Vascular and Endovascular Surgery
Laura C Price, Athol U Wells, Stephen J Wort
PURPOSE OF REVIEW: Pulmonary tumour thrombotic microangiopathy (PTTM) describes tumour cell microemboli with occlusive fibrointimal remodelling in small pulmonary arteries, veins and lymphatics. Progressive vessel occlusion ultimately results in pulmonary hypertension, which is often severe and rapid in onset. PTTM is associated with carcinomas, notably gastric carcinoma, with vascular endothelial growth factor and platelet-derived growth factor (PDGF) signalling implicated in driving the intimal remodelling...
September 2016: Current Opinion in Pulmonary Medicine
Yong Peng Yu, Lan Tan
Accurate definition and better understanding of the mechanisms of stroke are crucial as this will guide the effective care and therapy. In this paper, we review the previous basic and clinical researches on the causes or mechanisms of ischemic cerebrovascular diseases (ICVD) and interpret the correlation between embolism and hypoperfusion based on vascular stenosis and arterial intimal lesions. It was suggested that if there is no embolus (dynamic or in situ emboli), there might be no cerebral infarction. Three kinds of different clinical outcomes of TIA were theoretically interpreted based on its mechanisms...
2016: BioMed Research International
Tia Morosin, Bruce Ashford, Marie Ranson, Ruta Gupta, Jonathan Clark, N Gopalakrishna Iyer, Kevin Spring
BACKGROUND: Circulating tumour cells (CTCs) are increasingly being used in the surveillance of cancer, allowing for potential early detection and real-time monitoring of disease progression. The presence of CTCs in patients with metastatic cutaneous head and neck squamous cell carcinoma (cHNSCC) has not been evaluated. RESULTS: CTCs were detected in eight of ten patients with regional metastatic cHNSCC (80%; range 1-44 cells/9 mL blood). CTMs were detected in three of ten patients (30%, range 1-4 cells/9 mL blood)...
June 11, 2016: Oncotarget
X Zhou, S Kurowski, W Wu, K Desai, L Chu, D E Gutstein, D Seiffert, X Wang
UNLABELLED: Essentials Microembolic signal (MES) is an independent predictor of stroke risk in patients. A rabbit model of cerebral microembolic signals was established. Therapeutic efficacy was demonstrated for aspirin and clopidogrel on microembolic signals. Potential translational value of this preclinical model of MES was demonstrated. SUMMARY: Objectives Cerebral microembolic signals (MESs) detected by transcranial Doppler (TCD) ultrasound constitute an independent predictor of stroke risk and prognosis...
September 2016: Journal of Thrombosis and Haemostasis: JTH
Sean Wallace, Gaute Døhlen, Henrik Holmstrøm, Christian Lund, David Russell
The aim of this prospective study was to determine the frequency and composition of cerebral microemboli in a pediatric population, during transcatheter closure of patent ductus arteriosus (PDA). Multifrequency transcranial Doppler was used to monitor cerebral blood flow velocity (CBFV) and detect microembolic signals (MES) in the middle cerebral artery in 23 patients (median age 18 months). MES were automatically identified and differentiated according to composition; gaseous or solid. The procedure was divided into five periods: Arterial catheterization; venous catheterization; ductal catheterization; angiography; device placement and release...
August 2016: Pediatric Cardiology
Hai-Ming Zhang, Shi-Peng Li, Yao Yu, Zhen Wang, Jin-Dan He, Yan-Jie Xu, Rong-Xin Zhang, Jian-Jun Zhang, Zhi-Jun Zhu, Zhong-Yang Shen
The prognostic values of IRF-1 and Ki-67 for liver transplantation (LT) of hepatocellular carcinoma (HCC) were investigated, as well as the mechanisms of IRF-1 in tumor suppression. Adult orthotropic liver transplantation cases (N = 127) were involved in the analysis. A significant decreased recurrence free survival (RFS) was found in the Ki-67 positive groups. Ki-67, tumor microemboli, the Milan and UCSF criteria were found to be independent risk factors for RFS. In LT for HCC beyond the Milan criteria, a significant decrease in RFS was found in the IRF-1 negative groups...
May 13, 2016: Oncotarget
Jaroslav Pancak, Helena Wagnerova, Andrea Škultéty Szárazová, Andrej Blaho, Ondrej Durovsky, Judita Durovska
OBJECTIVES: Dementias are one of the most serious health and socioeconomic issues. Multi-infarct dementia (MID) and Alzheimer´s type dementia (AD) exhibit differences in cerebrovascular blood flow velocity profiles and in presence of microemboli, detected by transcranial Doppler sonography. MATERIAL AND METHODS: A group of 77 persons was divided into 4 subgroups: 1. subgroup of patients with MID (n=19; 10 male and 9 female, mean age was 74.32±8.30 years); 2. subgroup of patients with AD (n=19; 11 male and 8 female, mean age was 70...
2016: Neuro Endocrinology Letters
Shigang Wang, Allen R Kunselman, Akif Ündar
The Capiox RX25 and Quadrox-i Adult oxygenators are commonly used in clinical adult cardiopulmonary bypass circuits. This study was designed to test the effectiveness of two adult oxygenators in order to evaluate gaseous microemboli (GME) trapping capability and hemodynamic performance. A simulated adult CPB circuit was used and primed with Ringer's lactate and packed red blood cells (hematocrit 25%). All trials were conducted at flow rates of 2-5 L/min (1 L/min increments) with a closed and open arterial filter purge line at 35°C...
May 2016: Artificial Organs
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