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R Cuthbert, C Deutsch, A Roy, P Stimpson, H Patel
Introduction The free jejunal flap represents the gold standard for circumferential defects in upper digestive tract reconstruction. It is a technically demanding procedure with significant failure rates. Unrecognised failure leads to flap necrosis and potentially fatal sequelae, including sepsis and carotid artery bleed. Despite these catastrophic consequences, however, there remains no consensus on an optimum method for postoperative flap monitoring. Our unit has pioneered the use of external colour duplex ultrasound to monitor flap vascularity...
March 15, 2018: Annals of the Royal College of Surgeons of England
C G Hart, B E Voelz, K E Brockus, C O Lemley
Production from the corpus luteum (CL) and/or hepatic steroid inactivation impacts peripheral concentrations of P4, which can alter reproductive performance. Our primary objective was to examine hepatic steroid inactivating enzymes, portal blood flow, and luteal blood perfusion at 10 days post-insemination in pregnant versus non-pregnant beef and dairy cows. Twenty early lactation Holstein cows and 20 lactating commercial beef cows were utilized for this study. At day 10 post-insemination, hepatic portal blood flow and CL blood perfusion were measured via Doppler ultrasonography...
March 14, 2018: Reproduction in Domestic Animals, Zuchthygiene
Serhat Tozburun, Cedric Blatter, Meena Siddiqui, Eelco F J Meijer, Benjamin J Vakoc
We present a swept-wavelength optical coherence tomography (OCT) system with a 19 MHz laser source and electronic phase-locking of the source, acquisition clock, and beam scanning mirrors. The laser is based on stretched-pulse active mode-locking using an electro-optic modulator. Beam scanning in the fast axis uses a resonant micro-electromechanical systems (MEMS) -based mirror at ~23.8 kHz. Acquisition is performed at 1.78 Gigasamples per second using an external fixed clock. Phase sensitive imaging without need for k-clocking, A-line triggers, or phase-calibration methods is demonstrated...
March 1, 2018: Biomedical Optics Express
Xuanliang Pan, Guoxian Chen, Pan Wu, Chunmao Han, Jon Kee Ho
Skin perfusion pressure (SPP) is the blood pressure that is the requisite for the restoration of microcirculatory or capillary flow following controlled occlusion and subsequent flow return. The purpose of the current review was to evaluate the value of SPP for the prediction of wound healing in patients with limb ischemia. Articles published up to January 31, 2017 were searched in the PubMed database and Chinese database CNKI, using the keywords of 'skin perfusion pressure', 'limb ischemia' and 'wound healing'...
April 2018: Biomedical Reports
Cristian V Francavilla, Francesco Sessa, Monica Salerno, Giuseppe D Albano, Ines Villano, Giovanni Messina, Fabio Triolo, Lorenzo Todaro, Maria Ruberto, Gabriella Marsala, Orazio Cascio, Maria P Mollica, Vincenzo Monda, Giuseppe Cibelli, Anna Valenzano, Christian Zammit, Marcellino Monda, Antonietta Messina
Background: After long-term intensive training, considerable morphological and functional heart changes occur in professional athletes. Such changes arise progressively and regress upon interruption of the physical activity. Morphological and functional alterations on heart are known as "Athlete's heart" condition. Objective: This study aims to compare echocardiographic parameters in two different groups of professional athletes. Furthermore, a prospective study is performed analyzing the echocardiographic changes occurring in 12 professional players in 3 years of follow-up...
2018: Frontiers in Physiology
Qinghai Peng, Shi Zeng, Qichang Zhou, Wen Deng, Tao Wang, Ya Tan, Yushan Liu
To observe Doppler changes in the three main cerebral arteries in fetuses with congenital heart defects (CHDs). The pulsatility index (PI) values of the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) were prospectively compared in 78 CHD fetuses and 78 normal control fetuses. Correlations between the cerebral artery PIs and the neurodevelopment scores (psychomotor development index [PDI] and mental development index [MDI]) were assessed. The MCA-PI was decreased significantly in fetuses with hypoplastic left heart syndrome (HLHS)...
March 14, 2018: Scientific Reports
Pavol Sajgalik, Vaclav Kremen, Vratislav Fabian, Simon Maltais, John M Stulak, Sudhir S Kushwaha, Lyle D Joyce, John A Schirger, Bruce D Johnson
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique, does not provide systolic blood pressure (SBP) and diastolic blood pressure (DBP) and may limit therapy outcomes. To improve patient care, we tested specifically designed experimental BP (ExpBP) monitor and the Doppler technique by comparing noninvasive measures to the intraarterial (I-A) BP in 31 patients with end-stage heart failure (4 females) 2.6 ± 3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare)...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Marc Schmid, S Morteza Seyed Jafari, Luzian Haug, Carsten Surke, Robert E Hunger, Dimitri Van De Ville, Bettina Juon Personeni, Maziar Shafighi, Esther Voegelin
BACKGROUND: Despite various exisiting monitoring methods, there is still a need for new technologies to improve the quality of post-operative evaluation of digital replantation. The purpose of the study is using a laser Doppler imaging device (Easy-LDI) as an additional tool to assess perfusion. In this method, the changes in the frequency of the laser ligth provide information regarding perfusion of the monitored tissue. PATIENTS AND METHODS: This study included seven patients (10 fingers; age of patients: 21-57 years) who suffered from a total (n = 6) or subtotal amputation (n = 4) due to accidents...
March 14, 2018: Microsurgery
Antonietta Gigante, Luca Navarini, Domenico Margiotta, Biagio Barbano, Antonella Afeltra, Edoardo Rosato
OBJECTIVES: In systemic sclerosis (SSc), vascular injury leads to endothelial dysfunction with reduced capillary blood flow and tissue hypoxia. In SSc the angiogenesis is impaired and implicated in the microvascular damage. In severe vascular damage VEGF is reduced and endostatin is increased. Aim of this study was to evaluate the correlation between endostatin serum levels and microvascular and digital arteries damage. METHODS: Seventeen SSc patients were enrolled in this study...
March 14, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Anne-Sophie Zenses, Morgane A Evin, Viktória Stanová, Marie-Annick Clavel, Paul Barragan, Josep Rodés-Cabau, Jean-François Obadia, Philippe Pibarot, Régis Rieu
AIMS: Valve-in-Valve (ViV) procedure has become a valuable alternative for the treatment of failed surgical bioprostheses (BP) in high risk patients. However, in small BPs, the clinical outcomes have been suboptimal due to high post-procedural gradients. We aimed at examining the effect of size and position of the self-expanding transcatheter heart valve (THV) CoreValve on the hemodynamics of ViV within small BPs. METHODS AND RESULTS: Sizes 23 and 26 mm of the CoreValve were implanted in sizes 19 and 21 mm of 3 BP models: Trifecta, Mitroflow and Epic Supra...
March 13, 2018: EuroIntervention
Gulsum Uysal, Hatice Akkaya, Fulya Cagli, Sadan Tutus, Ahter T Tayyar
Pain relief of two different oral contraceptive pills (OCPs) in severe primary dysmenorrhoea (PD) was compared. Sixty-six nulliparous patients with severe PD requiring contraception were evaluated. Group 1 comprised 33 healthy controls. Patients with severe PD were divided into two groups. Patients in Group 2 were administered oestradiol valerate/dienogest and patients in Group 3 were administered ethinylestradiol/drospirenone. Doppler indices of both uterine arteries (left and right) including systolic/diastolicrates (S/D), pulsatility index (PI) and resistance index (RI) were measured, and a visual analogue scale (VAS) was applied to patients before treatment...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Volha Dziadzko, Marie-Annick Clavel, Mikhail Dziadzko, Jose R Medina-Inojosa, Hector Michelena, Joseph Maalouf, Vuyisile Nkomo, Prabin Thapa, Maurice Enriquez-Sarano
BACKGROUND: Mitral regurgitation is the most common valve disease worldwide but whether the community-wide prevalence, poor patient outcomes, and low rates of surgical treatment justify costly development of new therapeutic interventions remains uncertain. Therefore, we did an observational cohort study to assess the clinical characteristics, outcomes, and degree of undertreatment of mitral regurgitation in a community setting. METHODS: We used data from Mayo Clinic electronic health records and the Rochester Epidemiology Project to identify all cases of moderate or severe isolated single-valvular mitral regurgitation (with no other severe left-sided valvular disease or previous mitral surgery) diagnosed during a 10-year period in the community setting in Olmsted County (MN, USA)...
March 10, 2018: Lancet
Misun Hwang, Matthew A Thimm, Anthony L Guerrerio
PURPOSE: Cavernous transformation of the portal vein can be missed on color Doppler exam or arterial phase cross-sectional imaging due to their slow flow and delayed enhancement. Contrast-enhanced ultrasound (CEUS) offers many advantages over other imaging techniques and can be used to successfully detect cavernous transformations of the portal vein. METHODS: A 10-month-old female was followed for repeat episodes of hematemesis. Computed tomography angiography (CTA) and magnetic resonance arteriogram (MRA) and portal venography were performed...
March 13, 2018: Journal of Ultrasound
Daniel Høyer Iversen, Lasse Løvstakken, Geirmund Unsgård, Ingerid Reinertsen
PURPOSE: In neurosurgery, reliable information about blood vessel anatomy and flow direction is important to identify, characterize, and avoid damage to the vasculature. Due to ultrasound Doppler angle dependencies and the complexity of the vascular architecture, clinically valuable 3-D flow direction information is currently not available. In this paper, we aim to clinically validate and demonstrate the intraoperative use of a fully automatic method for estimation of 3-D blood flow direction from freehand 2-D Doppler ultrasound...
March 13, 2018: International Journal of Computer Assisted Radiology and Surgery
C Löffler, H Sattler, U Löffler, B K Krämer, R Bergner
OBJECTIVE: In distinguishing urate arthritis (UA) from non-crystal-related arthritides, joint sonography including the detection of the double contour sign (DCS) and hypervascularization using power Doppler ultrasound (PDUS) is an important step in the diagnostic process. But are these sonographic features equally reliable in every accessible joint under real-life conditions? METHODS: We retrospectively analyzed 362 patients with acute arthritis and evaluated the DCS and the degree of PDUS hypervascularization in patients with gout and in those with arthritis other than urate arthritis (non-UA)...
March 13, 2018: Zeitschrift Für Rheumatologie
Sujith S Pereira, Stephen T Kempley, David F Wertheim, Ajay K Sinha, Joan K Morris, Divyen K Shah
Background: Cerebral electrical activity in extremely preterm infants is affected by various factors including blood gas and circulatory parameters. Objective: To investigate whether continuously measured invasive mean arterial blood pressure (BP) is associated with electroencephalographic (EEG) discontinuity in extremely preterm infants. Study design: This prospective observational study examined 51 newborn infants born <29 weeks gestation in the first 3 days after birth...
2018: Frontiers in Neurology
Bin Bai, Jiadela Teliewubai, Yuyan Lu, Shikai Yu, Jing Xiong, Chen Chi, Yiwu Zhou, Hongwei Ji, Ximin Fan, Jacques Blacher, Jue Li, Yi Zhang, Yawei Xu
This study aimed to investigate the discrepancy between pulse wave velocity (PWV) and pulse pressure amplification (PPA) in association with hypertensive target organ damage (TOD) in the elderly. From June 2014 to August 2015, 1599 participants aged >65 years old from communities located in northern Shanghai were recruited. Carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TOD indicators, including the ratio of the early ventricular filling velocity (E) to the peak velocity of the tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (CIMT), estimated glomerular filtration rate (eGFR), and urinary albumin-creatinine ratio (ACR), were determined for each participant...
March 13, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Patrício Aguiar, Olga Azevedo, Rui Pinto, Jacira Marino, Carlos Cardoso, Nuno Sousa, Damião Cunha, Derralynn Hughes, José Luís Ducla Soares
BACKGROUND: Cardiomyopathy is a major determinant of overall Fabry disease (FD) prognosis, with the worst outcomes in patients with myocardial fibrosis. Late gadolinium enhancement is currently the gold standard for evaluation of replacement myocardial fibrosis; however, this event is irreversible, thus identification of biomarkers of earlier diffuse fibrosis is paramount. METHODS AND RESULTS: Type I collagen synthesis and degradation biomarkers (PICP [carboxyterminal propeptide of procollagen type I], ICTP [carboxyterminal telopeptide of type I collagen], and MMP1 [matrix metalloproteinase 1] and MMP2) and markers of bone synthesis and degradation were evaluated (to adjust type I collagen metabolism to bone turnover) in FD patients and controls...
March 13, 2018: Journal of the American Heart Association
Neil D Patel, Patrick M Sullivan, Cheryl M Takao, Sarah Badran, Joseph Ahdoot, Frank F Ing
BACKGROUND: One indication for intervention in coarctation of the aorta is a peak-to-peak gradient >20 mmHg. Gradients may be masked in patients under general anaesthesia and may be higher during exercise. Isoproterenol was given during cardiac catheterisation to simulate a more active physiologic state. OBJECTIVES: We aimed to describe the haemodynamic effects of isoproterenol in patients with coarctation and the impact of intervention on the elicited gradients...
March 14, 2018: Cardiology in the Young
Shunta Hori, Mitsuru Tomizawa, Fumisato Maesaka, Takuya Owari, Yosuke Morizawa, Yasushi Nakai, Makito Miyake, Tatsuo Yoneda, Nobumichi Tanaka, Katsunori Yoshida, Kiyohide Fujimoto
BACKGROUND: Page kidney phenomenon is caused by strong renal parenchymal compression and leads to renal hypoperfusion and microvascular ischemia, resulting in renal dysfunction and hypertension. Although the development of Page kidney phenomenon in allograft is rare, most of its cases are induced by allograft biopsy or trauma. We observed a case of Page kidney phenomenon that was induced by unusual causes immediately after kidney transplantation. CASE PRESENTATION: A 66-year-old man, whose wife donated a kidney, underwent ABO-compatible living kidney transplantation...
March 13, 2018: BMC Nephrology
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