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Selective central perfusion

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https://www.readbyqxmd.com/read/28121874/comparison-of-a-small-central-versus-a-large-peripheral-perforator-in-a-rat-model-of-extended-dorsal-three-vascular-territory-perforator-flap
#1
Jian Ding, Xiaoliang Feng, Weiyang Gao, Hede Yan, Xianyao Tao, Long Wang, Maolin Tang
BACKGROUND: Selection of suitable perforators is critical for satisfactory postreconstructive surgery outcome. This study aims to compare a small central versus a large peripheral perforator flap in a rat extended dorsal three-vascular territory perforator flap model. METHODS: An extended intercostal artery perforator flap with three vascular territories was used to model a small central perforator flap. An extended deep circumflex iliac artery flap with three vascular territories was used to model a large peripheral perforator flap...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28097916/exploring-the-first-rimonabant-analog-opioid-peptide-hybrid-compound-as-bivalent-ligand-for-cb1-and-opioid-receptors
#2
Adriano Mollica, Sveva Pelliccia, Valeria Famiglini, Azzurra Stefanucci, Giorgia Macedonio, Annalisa Chiavaroli, Giustino Orlando, Luigi Brunetti, Claudio Ferrante, Stefano Pieretti, Ettore Novellino, Sandor Benyhe, Ferenc Zador, Anna Erdei, Edina Szucs, Reza Samavati, Szalbolch Dvrorasko, Csaba Tomboly, Rino Ragno, Alexandros Patsilinakos, Romano Silvestri
Cannabinoid (CB) and opioid systems are both involved in analgesia, food intake, mood and behavior. Due to the co-localization of µ-opioid (MOR) and CB1 receptors in various regions of the central nervous system (CNS) and their ability to form heterodimers, bivalent ligands targeting to both these systems may be good candidates to investigate the existence of possible cross-talking or synergistic effects, also at sub-effective doses. In this work, we selected from a small series of new Rimonabant analogs one CB1R reverse agonist to be conjugated to the opioid fragment Tyr-D-Ala-Gly-Phe-NH2...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28060193/imaging-in-chronic-thromboembolic-pulmonary-hypertension
#3
Rahul D Renapurkar, Sankaran Shrikanthan, Gustavo A Heresi, Charles T Lau, Deepa Gopalan
Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the potentially curable causes of pulmonary hypertension and is definitively treated with pulmonary thromboendartectomy. CTEPH can be overlooked, as its symptoms are nonspecific and can be mimicked by a wide range of diseases that can cause pulmonary hypertension. Early diagnosis of CTEPH and prompt evaluation for surgical candidacy are paramount factors in determining future outcomes. Imaging plays a central role in the diagnosis of CTEPH and patient selection for pulmonary thromboendartectomy and balloon pulmonary angioplasty...
January 2, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28047962/tu-h-206-03-characterizing-b1-inhomogeneities-in-dce-mri
#4
H Gach, N Mason
PURPOSE: Dynamic Contrast Enhanced (DCE) MRI is a valuable technique for measuring perfusion and permeability characteristics of tumors. Exogenous contrast concentrations are calculated based on changes in T1 measured using fast 3D gradient echo (FLASH) sequences. However, the slab selective pulses used in 3D MRI may result in B1 inhomogeneities across the volume of interest that can lead to errors in T1 and thus the estimated gadolinium concentration. We compared three FLASH DCE sequences (GRE, TWIST, and VIBE) to determine their signal homogeneity across slices and the accuracy in calculating T1 using acquisitions with variable flip angles...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28024557/acute-right-ventricle-failure-in-the-intensive-care-unit-assessment-and-management
#5
REVIEW
Carmen Hrymak, Johann Strumpher, Eric Jacobsohn
Caring for the critically ill patient with acute right ventricle (RV) failure is a diagnostic and management challenge. A thorough understanding of normal RV anatomy and physiology is essential to manage RV failure. Despite the fact that the RV is essentially a volume chamber that ejects into a low-pressure system, the left ventricle contributes significantly to RV function through maintenance of the transseptal gradient (TSG). Preserving systemic mean arterial pressure maintains the TSG and RV perfusion. Various pathological states cause acute RV failure by decreasing the TSG and RV perfusion and/or increasing pulmonary vascular resistance...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27959471/lumbar-sympathectomy-techniques-for-critical-lower-limb-ischaemia-due-to-non-reconstructable-peripheral-arterial-disease
#6
REVIEW
Veena Kl Karanth, Tulasi Kota Karanth, Laxminarayan Karanth
BACKGROUND: Critical lower limb ischaemia (CLI) is a manifestation of peripheral arterial disease (PAD) that is seen in patients with typical chronic ischaemic rest pain or patients with ischaemic skin lesions - ulcers or gangrene - for longer than 2 weeks. Critical lower limb ischaemia is the most severe form of PAD, and interventions to improve arterial perfusion become necessary. Although surgical bypass has been the gold standard for revascularisation, the extent or the site of disease may be such that the artery cannot be reconstructed or bypassed...
13, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27929741/cerebral-microvascular-dysfunction-and-inflammation-are-improved-by-centrally-acting-antihypertensive-drugs-in-metabolic-syndrome
#7
Vanessa Estato, Alessandro Nascimento, Barbara Antunes, Fabiana Gomes, Laura Coelho, Raquel Rangel, Luciana Garzoni, Anissa Daliry, Pascal Bousquet, Eduardo Tibiriçá
BACKGROUND: We aimed to investigate the effects of chronic oral treatment with centrally acting antihypertensive drugs, such as clonidine (CLO), an α2-adrenoceptor agonist, or LNP599, a selective I1 imidazoline receptor agonist, on brain microvascular function in rats with high-fat diet (HFD)-induced metabolic syndrome. METHODS: Male Wistar Kyoto rats were maintained on a normal diet (CON) or a HFD for 20 weeks. After this period, the HFD group received oral CLO (0...
February 2017: Metabolic Syndrome and related Disorders
https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#8
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27901279/dopamine-agonists-for-preventing-ovarian-hyperstimulation-syndrome
#9
REVIEW
Huilin Tang, Selma Mourad, Suo-Di Zhai, Roger J Hart
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of ovarian stimulation in assisted reproduction technology (ART). It is characterised by enlarged ovaries and an acute fluid shift from the intravascular space to the third space, resulting in bloating, increased risk of venous thromboembolism and decreased organ perfusion. Most cases are mild, but forms of moderate or severe OHSS appear in 3% to 8% of in vitro fertilisation (IVF) cycles. The dopamine agonist cabergoline was introduced as a secondary prevention intervention for OHSS in women at high risk of OHSS undergoing ART treatment...
30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27891754/patients-with-barrett-s-esophagus-are-hypersensitive-to-acid-but-hyposensitive-to-other-stimuli-compared-with-healthy-controls
#10
C Lottrup, A L Krarup, H Gregersen, P Ejstrud, A M Drewes
BACKGROUND: Esophageal hyposensitivity has been observed in Barrett's esophagus and may contribute to its pathophysiology. However, studies are few, in particular those assessing different sensory modalities. We aimed to compare esophageal sensitivity to multimodal stimulation in patients with Barrett's esophagus and in healthy controls. METHODS: Twenty-three patients with Barrett's esophagus and 12 healthy controls were examined. A multimodal probe was placed in the lower esophagus...
November 27, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27822669/asl-and-susceptibility-weighted-imaging-contribution-to-the-management-of-acute-ischaemic-stroke
#11
REVIEW
Sébastien Verclytte, Olivier Fisch, Lucie Colas, Olivier Vanaerde, Manuel Toledano, Jean-François Budzik
: Magnetic resonance imaging (MRI) plays a central role in the early diagnosis of cerebral vascular events. Today, MRI is used not only for the detection of acute ischaemic lesions, but also to fine tune the diagnosis and improve patient selection for early therapeutic decision-making. In this perspective, new tools such as arterial spin labelling (ASL) and susceptibility-weighted imaging (SWI) sequences have been developed. These MRI sequences enable noninvasive assessment of brain damage, providing important diagnostic and prognostic information: evaluation of cerebral parenchymal perfusion; detection and aetiological assessment of thrombi; ruling out differential diagnoses...
February 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/27784240/biohybrid-membrane-systems-and-bioreactors-as-tools-for-in-vitro-drug-testing
#12
Simona Salerno, Loredana De Bartolo
In drug development, in vitro human model systems are absolutely essential prior to the clinical trials, considering the increasing number of chemical compounds in need of testing, and, keeping in mind that animals cannot predict all the adverse human health effects and reactions, due to the species-specific differences in metabolic pathways. The liver plays a central role in the clearance and biotransformation of chemicals and xenobiotics. In vitro liver model systems by using highly differentiated human cells could have a great impact in preclinical trials...
October 25, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27765887/total-aortic-arch-replacement-advantages-of-varied-techniques
#13
REVIEW
Ryan C Shelstad, Justin G Reeves, Katsuhiro Yamanaka, T Brett Reece
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique-each having its own advantages...
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27712796/metastasis-in-adult-brain-tumors
#14
REVIEW
Ramon Francisco Barajas, Soonmee Cha
Metastatic cancer to the central nervous system is primarily deposited by hematogenous spread in various anatomically distinct regions: calvarial, pachymeningeal, leptomeningeal, and brain parenchyma. A patient's overall clinical status and the information needed to make treatment decisions are the primary considerations in initial imaging modality selection. Contrast-enhanced MR imaging is the preferred imaging modality. Morphologic MR imaging is limited to delineating anatomic deraignment of tissues. Dynamic susceptibility contrast-enhanced perfusion and diffusion-weighted physiology-based MR imaging sequences have been developed that complement morphologic MR imaging by providing additional diagnostic information...
November 2016: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/27652257/the-effect-of-esmolol-on-tissue-perfusion-and-clinical-prognosis-of-patients-with-severe-sepsis-a-prospective-cohort-study
#15
Xiuling Shang, Kaiyu Wang, Jingqing Xu, Shurong Gong, Yong Ye, Kaihua Chen, Fayang Lian, Wei Chen, Rongguo Yu
Purpose. This study was aimed at investigating the effect of esmolol on tissue perfusion and the clinical prognosis of patients with severe sepsis. Materials and Methods. One hundred fifty-one patients with severe sepsis were selected and divided into the esmolol group (n = 75) or the control group (n = 76), who received conventional antiseptic shock treatment. The esmolol group received a continuous infusion of esmolol via a central venous catheter, and their heart rate (HR) was maintained at 70-100 bpm over 72 hours...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27650344/temporary-extracorporeal-bypass-modalities-during-aortic-surgery
#16
REVIEW
Levi Bassin, David Bell
The key to aortic surgery is protection of the brain, heart, spinal cord, and viscera. For operations involving the aortic arch, the focus is on cerebral protection, while for pathology involving the descending thoracic aorta, the focus is on spinal protection. Optimal cerebral and spinal protection requires an extensive knowledge of the operative steps and an understanding of the cardiopulmonary bypass modalities that are possible. A bloodless field is required when operating on the aorta. As a result, periods of ischemia to the central nervous system and end-organ viscera are often unavoidable...
September 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27586188/crossing-the-blood-brain-barrier-glutathione-conjugated-poly-ethylene-imine-for-gene-delivery
#17
Christoph Englert, Anne-Kristin Trützschler, Martin Raasch, Tanja Bus, Philipp Borchers, Alexander S Mosig, Anja Traeger, Ulrich S Schubert
The targeted drug delivery to the central nervous system represents one of the major challenges in pharmaceutical formulations since it is strictly limited through the highly selective blood-brain barrier (BBB). l-Glutathione (GSH), a tripeptide and well-known antioxidant, has been studied in the last years as potential candidate to facilitate the receptor-mediated transcytosis of nanocarriers. We thus tested whether GSH decoration of a positively charged polymer, poly(ethylene imine), with this vector enables the transport of genetic material and, simultaneously, the passage through the BBB...
November 10, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/27488910/diphenhydramine-as-a-selective-probe-to-study-h-antiporter-function-at-the-blood-brain-barrier-application-to-11c-diphenhydramine-positron-emission-tomography-imaging
#18
Sylvain Auvity, Hélène Chapy, Sébastien Goutal, Fabien Caillé, Benoit Hosten, Maria Smirnova, Xavier Declèves, Nicolas Tournier, Salvatore Cisternino
Diphenhydramine, a sedative histamine H1-receptor (H1R) antagonist, was evaluated as a probe to measure drug/H(+)-antiporter function at the blood-brain barrier. In situ brain perfusion experiments in mice and rats showed that diphenhydramine transport at the blood-brain barrier was saturable, following Michaelis-Menten kinetics with a Km = 2.99 mM and Vmax = 179.5 nmol s(-1) g(-1) In the pharmacological plasma concentration range the carrier-mediated component accounted for 77% of diphenhydramine influx while passive diffusion accounted for only 23%...
August 3, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27488764/nitrates-for-the-prevention-of-cardiac-morbidity-and-mortality-in-patients-undergoing-non-cardiac-surgery
#19
REVIEW
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
August 4, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27484681/fluid-overload-in-the-icu-evaluation-and-management
#20
Rolando Claure-Del Granado, Ravindra L Mehta
BACKGROUND: Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients. DISCUSSION: In critically ill patients, in order to restore cardiac output, systemic blood pressure and renal perfusion an adequate fluid resuscitation is essential...
August 2, 2016: BMC Nephrology
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