المؤلفين أشكر نينا Bispham للحصول على المساعدة الفنية لها. وأيد هذا العمل من قبل جمعية القلب الأمريكية (12POST11920023)، والمعاهد الوطنية للصحة (K23DK088833، K23DK087859).

يعلن الكتاب أنه ليس لديهم مصالح مالية المتنافسة.

الحصول على نتائج دقيقة لمرض الحمى القلاعية وBA aPWV يتطلب الحصول على صور الموجات فوق الصوتية عالية الجودة والطول الموجي الضغط، على التوالي. المركزية لهذا هو التدريب المناسب والمستمر واستخدام كل تقنية من قبل المشغل 44. بالإضافة إلى ذلك، فمن الأهمية بمكان للس?...

مرض مزمن في الكلى (كد) هو مصدر قلق كبير للصحة العامة التي وصلت إلى مستويات وبائية، والتي تؤثر ~ 11.5٪ من السكان في الولايات المتحدة وحدها 1. يتم زيادة خطر الموت القلب والأوعية الدموية أو الحدث القلب والأوعية الدموية في المرضى الذين يعانون من كد بكثير بالمقارنة مع عامة السكان 2-4. على الرغم من أن المرضى الذين يعانون من كد تظهر ارتفاع معدل انتشار عوامل الخطر التقليدية القلب والأوعية الدموية، وهذا يفسر جزءا فقط من لهم زيادة حدوث أمراض القلب والأوعية الدموية (الأمراض القلبية الوعائية) 5. ضعف الأوعية الدموية هو عامل خطر غير تقليدية القلب والأوعية الدموية المهم كسب اعتراف متزايد في مجال أمراض الكلى 6-9. بينما العديد من التغييرات من المرجح أن تسهم في تطوير ضعف الشرايين، من بين تلك الأكثر إثارة للقلق هي تطوير ضعف بطانة الأوعية الدموية، المقررة الأكثر شيوعا في قيمتها تعتمد على البطانة تمدد (EDD)، وتشنج لللاRGE الشرايين مرنة 10. توجد تقنيات مختلفة لتقييم EDD وتصلب الشرايين مرنة كبيرة، ولكن الأكثر شيوعا هي الشريان العضدي بوساطة تدفق تمدد الحمى القلاعية BA الأبهر وسرعة نبض الموجة (aPWV)، على التوالي. آخر تقنية تستخدم عادة لتقييم EDD يتم قياس استجابة الساعد تدفق الدم إلى وكلاء الدوائية مثل أستيل باستخدام الوريدي انسداد تخطيط التحجم 11،12. ومع ذلك، وهذا يتطلب منهجية القسطرة من الشريان العضدي، والتي هي أكثر الغازية من مرض الحمى القلاعية على درجة البكالوريوس، ويمكن بطلان في المرضى الذين يعانون من كد. تقنية بديلة لتقييم تصلب الشرايين هو لقياس الامتثال الشرياني المحلية (معكوس صلابة) من الشريان السباتي، على الرغم من أن هذه ليست كما تستخدم على نطاق واسع أو التأكد من صلاحيتها مع النهاية السريرية كما aPWV 13. المرضى الذين يعانون من كد تثبت على حد سواء ضعف الحمى القلاعية BA 14-16 الأبهر وزيادة نبض سرعة الموجة ا ف بWV 13،17،18، حتى قبل الحاجة لغسيل الكلى. الأهم من وجهة نظر سريرية، وكلاهما من هذه التدابير موسع ضعف الأوعية الدموية هي تنبئ مستقلة للأحداث القلب والأوعية الدموية في المستقبل على حد سواء والوفيات في المرضى الذين يعانون من كد 19-21، وكذلك في غيرهم من السكان 22-26. هذه التقنيات يمكن تطبيقها على دراسة مختلف السكان المعرضين لخطر الأمراض القلبية الوعائية، بما في ذلك المرضى الذين يعانون من كد. وغير مفهومة تماما الآليات الدقيقة التي ضعف الشرايين يتطور في كد؛ ومع ذلك، خفضت أكسيد النيتريك (NO) التوافر البيولوجي هو المساهم الحرجة 27-30 وآلية المشتركة لكلا ضعاف EDD وزيادة تصلب الشرايين 10،31. في كد، وزيادة الاكسدة ويساهم في خفض NO التوافر البيولوجي 32-34. يتم تعريف الاكسدة كما التوافر البيولوجي المفرط للأنواع الاكسجين التفاعلية (ROS) نسبة إلى الدفاعات المضادة للأكسدة. المنبهات الفسيولوجية، المؤتمر الوطني العراقيluding إشارات التهابات، وتعزيز نظم الانزيم المؤكسد لإنتاج ROS، بما في ذلك أنيون الفائق (O 2 ● -) (على سبيل المثال، انزيم أوكسيديز NADPH أكسدة.) 35. إنتاج الفائق يؤدي في النهاية إلى يقلل من التوافر البيولوجي من أكسيد النيتريك (NO). ضعاف NO التوافر الحيوي قد يساهم بدوره في تطوير كد، واختلال وظيفي البطانية هو مؤشرا مستقلا للحادث كد 36. وهذا يتفق مع البيانات الحيوانية مشيرا إلى أن ارتفاع ضغط الدم يؤدي الى تثبيط أنوش (النظامية والكبيبي)، نقص التروية الكبيبي، الكبيبات، وانبوبية الخلالي إصابة 37. في الواقع، يبدو خفض NO التوافر البيولوجي الضرورية لتطور وتقدم مرض الكلى التجريبية التي تحاكي الأمراض التي تصيب البشر، مما يشير إلى الدور الرئيسي لاختلال وظيفي البطانية في كد الإنسان 38،39. يمكن تقييم علامات الاكسدة الأوعية الدموية في الخامسascular الخلايا البطانية التي تم جمعها من الموضوعات البحثية الإنسان، وذلك باستخدام تقنية ضعت أصلا من قبل كولومبو وآخرون 40 وتعديل الأختام وآخرون 41-43. باستخدام 2 العقيمة J-الأسلاك، يتم جمع الخلايا من الوريد المرفقية، تعافى، ثابتة، وبعد ذلك حددت بشكل إيجابي كما الخلايا البطانية وتحليلها من أجل التعبير عن البروتينات ذات الاهتمام باستخدام المناعي. نحن نقدم هنا مناقشة هذه المنهجية التي يمكن استخدامها لأ) تدبير الحمى القلاعية BA؛ ب) قياس aPWV؛ ج) قياس الأوعية الدموية البطانية التعبير البروتين خلية من علامات الاكسدة. وينصب التركيز على المرضى الذين يعانون من كد، لا تتطلب غسيل الكلى المزمن.

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			<td height="20" style="height:20px;width:216px;">J-wire</td>
			<td style="width:109px;">St. Jude</td>
			<td style="width:244px;">404584</td>
			<td>2 per collection</td>
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			<td>Quick Medical&#160;</td>
			<td>4507</td>
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			<td>Includes custom ruler.&#160; An alternate system is the Sphygmocor</td>
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			<td>We use a G.E., but there are many companies and models</td>
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			<td>N/A</td>
			<td>custom made</td>
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			<td style="width:109px;">Hokanson</td>
			<td style="width:244px;">Model: Hokanson E20</td>
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			<td style="width:109px;">Hokanson</td>
			<td style="width:244px;">N/A</td>
			<td>custom cuff with 6.5 x 34 cm bladder&#160;</td>
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			<td>depends on specifications of microscpe&#160;</td>
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			<td height="40" style="height:40px;width:216px;">AF488</td>
			<td style="width:109px;">Life Technologies</td>
			<td>A11034</td>
			<td>depends on specifications of microscpe&#160;</td>
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			<td height="20" style="height:20px;width:216px;">Nitrotyrosine antibody&#160;</td>
			<td style="width:109px;">Abcam</td>
			<td>ab7048</td>
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			<td height="20" style="height:20px;width:216px;">NADPH oxidase antibody</td>
			<td>Upstate</td>
			<td>07-001</td>
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			<td height="20" style="height:20px;width:216px;">DAPI&#160;</td>
			<td style="width:109px;">Vector</td>
			<td style="width:244px;">H-1200</td>
			<td></td>
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			<td height="20" style="height:20px;width:216px;">Delicate task wipe (Kimwipe)&#160;</td>
			<td style="width:109px;">Fisher Scientific</td>
			<td>06-666-A&#160;</td>
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			<td height="20" style="height:20px;">Plastic paraffin film (parafilm)&#160;</td>
			<td style="width:109px;">Fisher Scientific</td>
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			<td height="20" style="height:20px;width:216px;">Confocal microscope&#160;</td>
			<td style="width:109px;">Olympus&#160;</td>
			<td>Model: FV1000 FCS/RICS</td>
			<td>many options exist&#160;</td>
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assessment of vascular function in patients with chronic kidney disease

المرضى الذين يعانون من مرض مزمن في الكلى (كد) قد زادت بشكل ملحوظ خطر الإصابة بأمراض القلب والأوعية الدموية بالمقارنة مع السكان عامة، ويفسر هذا جزئيا فقط عن عوامل خطر الأمراض القلبية الوعائية التقليدية. ضعف الأوعية الدموية هو عامل خطر غير التقليدية الهامة، والتي تتميز ضعف بطانة الأوعية الدموية (تقييم الأكثر شيوعا في قيمتها تعتمد على البطانة تمدد [EDD]) وتشنج الشرايين مرنة كبيرة. في حين وجود تقنيات مختلفة لتقييم EDD وتصلب الشرايين الكبيرة المرنة، والأكثر شيوعا هي الشريان العضدي بوساطة تدفق للدم (FMD BA) والأبهر سرعة نبض الموجة (aPWV)، على التوالي. كل من هذه التدابير موسع ضعف الأوعية الدموية هي تنبئ مستقلة للأحداث القلب والأوعية الدموية في المستقبل في المرضى الذين يعانون من أمراض الكلى وبدون. المرضى الذين يعانون من كد تثبت على حد سواء ضعف الحمى القلاعية على درجة البكالوريوس، وزيادة aPWV. في حين أن الآليات الدقيقة التي ضعف الأوعية الدموية ديفييشذب في كد وغير مفهومة، وزيادة الاكسدة وانخفاض لاحق في اكسيد النيتريك (NO) التوافر البيولوجي هي المساهمة الهامة. التغيرات الخلوية في الاكسدة يمكن تقييمها من خلال جمع خلايا بطانة الأوعية الدموية من الوريد المرفقية وقياس البروتين التعبير عن علامات الاكسدة باستخدام المناعي. نحن نقدم هنا مناقشة هذه الأساليب لقياس مرض الحمى القلاعية على درجة البكالوريوس، aPWV، والأوعية الدموية البطانية التعبير بروتين الخلية.

وكميا الحمى القلاعية BA كما تغير الذروة في قطر الشريان العضدي التالية تبيغ رد الفعل. وبالتالي، تتم مقارنة في بقية القطر لقطر بعد انتهاء فترة 5 دقائق ضغط الدم الكفة انسداد (الشكل 1). لوحة ويظهر صورة الموجات فوق الصوتية ممثل الشريان العضدي، وفريق B يعرض الر?...

Watch this Scientific Journal Video about Assessment of Vascular Function in Patients With Chronic Kidney Disease at JoVE.com

Assessment of Vascular Function in Patients With Chronic Kidney Disease

درجة ضعف الأوعية الدموية والمساهمة الآليات الفسيولوجية يمكن تقييمها في المرضى الذين يعانون من مرض الكلى المزمن عن طريق قياس العضدية الشريان تدفق بوساطة تمدد، الأبهر نبض سرعة الموجة، والأوعية الدموية البطانية التعبير بروتين الخلية.

تقييم وظيفة الأوعية الدموية في المرضى الذين يعانون من مرض الكلى المزمن

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this ...

assessment-vascular-function-patients-with-chronic-kidney

Research

JoVE Journal

Medicine

16.1K Views.  University of Colorado, Denver.  درجة ضعف الأوعية الدموية والمساهمة الآليات الفسيولوجية يمكن تقييمها في المرضى الذين يعانون من مرض الكلى المزمن عن طريق قياس العضدية الشريان تدفق بوساطة تمدد، الأبهر نبض سرعة الموجة، والأوعية الدموية البطانية التعبير بروتين الخلية. 

Video: Assessment of Vascular Function in Patients With Chronic Kidney Disease

Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer's Disease

Our laboratory uses event-related EEG potentials (ERPs) to understand and support behavioral investigations of episodic memory in patients with amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD). Whereas behavioral data inform us about the patients' performance, ERPs allow us to record discrete changes in brain activity. Further, ERPs can give us insight into the onset, duration, and interaction of independent cognitive processes associated with memory retrieval. In patient populations, these types of studies are used to examine which aspects of memory are impaired and which remain relatively intact compared to a control population. The methodology for collecting ERP data from a vulnerable patient population while these participants perform a recognition memory task is reviewed. This protocol includes participant preparation, quality assurance, data acquisition, and data analysis. In addition to basic setup and acquisition, we will also demonstrate localization techniques to obtain greater spatial resolution and source localization using high-density (128 channel) electrode arrays.

Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer&#039;s Disease

The methodology for collecting high-density event-related potential data while patients with Alzheimer's disease perform a recognition memory task is reviewed. This protocol will include subject preparation, quality assurance, data acquisition, and data analysis.

دراسة خصائص الذاكرة العرضية الحدث المتصلة باستخدام الإمكانيات في المرضى الذين يعانون من مرض الزهايمر

Our laboratory uses event-related EEG potentials (ERPs) to understand and support behavioral investigations of episodic memory in patients with amnestic ...

Spectral Karyotyping to Study Chromosome Abnormalities in Humans and Mice with Polycystic Kidney Disease

Conventional method to identify and classify individual chromosomes depends on the unique banding pattern of each chromosome in a specific species being analyzed 1, 2. This classical banding technique, however, is not reliable in identifying complex chromosomal aberrations such as those associated with cancer. To overcome the limitations of the banding technique, Spectral Karyotyping (SKY) is introduced to provide much reliable information on chromosome abnormalities.
SKY is a multicolor fluorescence in-situ hybridization (FISH) technique to detect metaphase chromosomes with spectral microscope 3, 4. SKY has been proven to be a valuable tool for the cytogenetic analysis of a broad range of chromosome abnormalities associated with a large number of genetic diseases and malignancies 5, 6. SKY involves the use of multicolor fluorescently-labelled DNA probes prepared from the degenerate oligonucleotide primers by PCR. Thus, every chromosome has a unique spectral color after in-situ hybridization with probes, which are differentially labelled with a mixture of fluorescent dyes (Rhodamine, Texas Red, Cy5, FITC and Cy5.5). The probes used for SKY consist of up to 55 chromosome specific probes 7-10.
The procedure for SKY involves several steps (Figure 1). SKY requires the availability of cells with high mitotic index from normal or diseased tissue or blood. The chromosomes of a single cell from either a freshly isolated primary cell or a cell line are spread on a glass slide. This chromosome spread is labeled with a different combination of fluorescent dyes specific for each chromosome. For probe detection and image acquisition,the spectral imaging system consists of sagnac interferometer and a CCD camera. This allows measurement of the visible light spectrum emitted from the sample and to acquire a spectral image from individual chromosomes. HiSKY, the software used to analyze the results of the captured images, provides an easy identification of chromosome anomalies. The end result is a metaphase and a karyotype classification image, in which each pair of chromosomes has a distinct color (Figure 2). This allows easy identification of chromosome identities and translocations. For more details, please visit Applied Spectral Imaging website (<a href="http://www.spectral-imaging.com/" target="_blank">http://www.spectral-imaging.com/</a>).
SKY was recently used for an identification of chromosome segregation defects and chromosome abnormalities in humans and mice with Autosomal Dominant Polycystic Kidney Disease (ADPKD), a genetic disease characterized by dysfunction in primary cilia 11-13. Using this technique, we demonstrated the presence of abnormal chromosome segregation and chromosomal defects in ADPKD patients and mouse models 14. Further analyses using SKY not only allowed us to identify chromosomal number and identity, but also to accurately detect very complex chromosomal aberrations such as chromosome deletions and translocations (Figure 2).

Spectral Karyotyping (SKY) is an advanced cytogenetics technique to identify genomic and chromosomal aberrations. This technique takes advantage of chromosome painting probes, which allow classification of all chromosomes. SKY can also identify complex chromosome aberrations and segregation defects in mice and humans with various diseases, including polycystic kidney disease.

الطيفية Karyotyping إلى دراسة حالة شذوذ الكروموسومات في البشر والفئران مع مرض الكلى المتعدد الكيسات

Conventional method to identify and classify individual chromosomes depends on the unique banding pattern of each chromosome in a specific species being ...

Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia

Transcranial magnetic stimulation (TMS) has been shown to significantly improve language function in patients with non-fluent aphasia1. In this experiment, we demonstrate the administration of low-frequency repetitive TMS (rTMS) to an optimal stimulation site in the right hemisphere in patients with chronic non-fluent aphasia. A battery of standardized language measures is administered in order to assess baseline performance. Patients are subsequently randomized to either receive real rTMS or initial sham stimulation. Patients in the real stimulation undergo a site-finding phase, comprised of a series of six rTMS sessions administered over five days; stimulation is delivered to a different site in the right frontal lobe during each of these sessions. Each site-finding session consists of 600 pulses of 1 Hz rTMS, preceded and followed by a picture-naming task. By comparing the degree of transient change in naming ability elicited by stimulation of candidate sites, we are able to locate the area of optimal response for each individual patient. We then administer rTMS to this site during the treatment phase. During treatment, patients undergo a total of ten days of stimulation over the span of two weeks; each session is comprised of 20 min of 1 Hz rTMS delivered at 90% resting motor threshold. Stimulation is paired with an fMRI-naming task on the first and last days of treatment. After the treatment phase is complete, the language battery obtained at baseline is repeated two and six months following stimulation in order to identify rTMS-induced changes in performance. The fMRI-naming task is also repeated two and six months following treatment. Patients who are randomized to the sham arm of the study undergo sham site-finding, sham treatment, fMRI-naming studies, and repeat language testing two months after completing sham treatment. Sham patients then cross over into the real stimulation arm, completing real site-finding, real treatment, fMRI, and two- and six-month post-stimulation language testing.

We explore the use of repetitive transcranial magnetic stimulation (rTMS) to improve language abilities in patients with chronic stroke and non-fluent aphasia. After identifying a site in the right frontal gyrus for each patient that responds optimally to stimulation, we target this site during ten days of rTMS treatment.

استخدام المتكرر تحفيز المغناطيسي عبر الجمجمة لتحسين وظيفة اللغة في مرضى السكتة الدماغية المزمنة مع فقدان القدرة على الكلام غير بطلاقة

Transcranial magnetic stimulation (TMS) has been shown to significantly improve language function in patients with non-fluent aphasia1. In this ...

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Chronic kidney disease (CKD) is a global problem. Slowing CKD progression is a major health priority. Since CKD is characterized by complex derangements of homeostasis, integrative animal models are necessary to study development and progression of CKD. To study development of CKD and novel therapeutic interventions in CKD, we use the 5/6th nephrectomy ablation model, a well known experimental model of progressive renal disease, resembling several aspects of human CKD. The gross reduction in renal mass causes progressive glomerular and tubulo-interstitial injury, loss of remnant nephrons and development of systemic and glomerular hypertension. It is also associated with progressive intrarenal capillary loss, inflammation and glomerulosclerosis. Risk factors for CKD invariably impact on endothelial function. To mimic this, we combine removal of 5/6th of renal mass with nitric oxide (NO) depletion and a high salt diet. After arrival and acclimatization, animals receive a NO synthase inhibitor (NG-nitro-L-Arginine) (L-NNA) supplemented to drinking water (20 mg/L) for a period of 4 weeks, followed by right sided uninephrectomy. One week later, a subtotal nephrectomy (SNX) is performed on the left side. After SNX, animals are allowed to recover for two days followed by LNNA in drinking water (20 mg/L) for a further period of 4 weeks. A high salt diet (6%), supplemented in ground chow (see time line Figure 1), is continued throughout the experiment. Progression of renal failure is followed over time by measuring plasma urea, systolic blood pressure and proteinuria. By six weeks after SNX, renal failure has developed. Renal function is measured using 'gold standard' inulin and para-amino hippuric acid (PAH) clearance technology. This model of CKD is characterized by a reduction in glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), hypertension (systolic blood pressure&gt;150 mmHg), proteinuria (&gt; 50 mg/24 hr) and mild uremia (&gt;10 mM). Histological features include tubulo-interstitial damage reflected by inflammation, tubular atrophy and fibrosis and focal glomerulosclerosis leading to massive reduction of healthy glomeruli within the remnant population (&lt;10%). Follow-up until 12 weeks after SNX shows further progression of CKD.

A two-stage method to establish chronic kidney disease (CKD) in the Lewis rat by surgically removing 5/6th of renal mass is described. Combination of the surgical procedure, NOS-inhibition and a high-salt diet leads to a model resembling human CKD, allowing study of causal mechanisms and development of novel therapeutic interventions.

5/6th استئصال الكلية في تركيبة مع حمية عالية الملح والنيتريك أوكسيد تثبيط سينسيز للحث على مرض الكلى المزمن في الفئران لويس

Chronic kidney disease (CKD) is a global problem. Slowing CKD progression is a major health priority. Since CKD is characterized by complex derangements ...

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic conditions. As part of a diagnostic assessment, the early detection of postural deficits is important so that appropriate and targeted interventions can be prescribed. The Sensory Organization Test (SOT) on the EquiTest determines an individual&#39;s use of the sensory systems (somatosensory, visual, and vestibular) that are responsible for postural control. Somatosensory and visual input are altered by the calibrated sway-referenced support surface and visual surround, which move in the anterior-posterior direction in response to the individual&#39;s postural sway. This creates a conflicting sensory experience. The Motor Control Test (MCT) challenges postural control by creating unexpected postural disturbances in the form of backwards and forwards translations. The translations are graded in magnitude and the time to recover from the perturbation is computed.
Intermittent claudication, the most common symptom of peripheral arterial disease, is characterized by a cramping pain in the lower limbs and caused by muscle ischemia secondary to reduced blood flow to working muscles during physical exertion. Claudicants often display poor balance, making them susceptible to falls and activity avoidance. The Ankle Brachial Pressure Index (ABPI) is a noninvasive method for indicating the presence of peripheral arterial disease and intermittent claudication, a common symptom in the lower extremities. ABPI is measured as the highest systolic pressure from either the dorsalis pedis or posterior tibial artery divided by the highest brachial artery systolic pressure from either arm. This paper will focus on the use of computerized dynamic posturography in the assessment of balance in claudicants.

Individuals with intermittent claudication exhibit poor balance compared to healthy controls. Computerized dynamic posturography is an objective method for measuring an individual's postural responses to balance disturbances. This provides an objective reflection of the person&#x2019;s ability to respond to situations under which sensory stimuli are altered and unexpected perturbations occur.

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic ...

Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet

An original piglet model of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) associated with chronic Right Ventricular (RV) dysfunction is described. Pulmonary Hypertension (PH) was induced in 3-week-old piglets by a progressive obstruction of the pulmonary vascular bed. A ligation of the left Pulmonary Artery (PA) was performed first through a mini-thoracotomy. Second, weekly embolizations of the right lower pulmonary lobe were done under fluoroscopic guidance with n-butyl-2-cyanoacrylate during 5 weeks. Mean Pulmonary Arterial Pressure (mPAP) measured by ritght heart catheterism, increased progressively, as well as Right Atrial pressure and Pulmonary Vascular Resistances (PVR) after 5 weeks compared to sham animals. Right Ventricular (RV) structural and functional remodeling were assessed by transthoracic echocardiography (RV diameters, RV wall thickness, RV systolic function). RV elastance and RV-pulmonary coupling were assessed by Pressure-Volume Loops (PVL) analysis with conductance method. Histologic study of the lung and the right ventricle were also performed. Molecular analyses on RV fresh tissues could be performed through repeated transcutaneous endomyocardial biopsies. Pulmonary microvascular disease in obstructed and unobstructed territories was studied from lung biopsies using molecular analyses and pathology. Furthermore, the reliability and the reproducibility was associated with a range of PH severity in animals. Most aspects of the human CTEPH disease were reproduced in this model, which allows new perspectives for the understanding of the underlying mechanisms (mitochondria, inflammation) and new therapeutic approaches (targeted, cellular or gene therapies) of the overloaded right ventricle but also pulmonary microvascular disease.

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) and Right Ventricular (RV) dysfunction were induced in piglets by progressive obstruction of the pulmonary arteries. Consequences were remarkably similar to those observed in CTEPH patients. This animal model would be a very useful tool for pathophysiology and therapeutic experiments on CTEPH and RV failure.

الانصمام الخثاري المزمن ارتفاع ضغط الدم الرئوي وتقييم الحق البطيني وظيفة في الخنزير الصغير

An original piglet model of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) associated with chronic Right Ventricular (RV) dysfunction is described. ...

Assessment of Kidney Function in Mouse Models of Glomerular Disease

The use of murine models to mimic human kidney disease is becoming increasingly common. Our research is focused on the assessment of glomerular function in diabetic nephropathy and podocyte-specific VEGF-A knock-out mice; therefore, this protocol describes the full kidney work-up used in our lab to assess these mouse models of glomerular disease, enabling a vast amount of information regarding kidney and glomerular function to be obtained from a single mouse. In comparison to alternative methods presented in the literature to assess glomerular function, the use of the method outlined in this paper enables the glomerular phenotype to be fully evaluated from multiple aspects. By using this method, the researcher can determine the kidney phenotype of the model and assess the mechanism as to why the phenotype develops. This vital information on the mechanism of disease is required when examining potential therapeutic avenues in these models. The methods allow for detailed functional assessment of the glomerular filtration barrier through measurement of the urinary albumin creatinine ratio and individual glomerular water permeability, as well as both structural and ultra-structural examination using the Periodic Acid Schiff stain and electron microscopy. Furthermore, analysis of the genes dysregulated at the mRNA and protein level enables mechanistic analysis of glomerular function. This protocol outlines the generic but adaptable methods that can be applied to all mouse models of glomerular disease.

This protocol describes a full kidney work-up that should be carried out in mouse models of glomerular disease. The methods allow for detailed functional, structural, and mechanistic analysis of glomerular function, which can be applied to all mouse models of glomerular disease.

تقييم لوظيفة الكلي في نماذج الماوس من المرض الكبيبي

The use of murine models to mimic human kidney disease is becoming increasingly common. Our research is focused on the assessment of glomerular function ...

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Approximately 40% of patients undergoing invasive coronary angiography for investigation of angina are found to have no obstructive coronary artery disease (ANOCA). Abnormal coronary function underlies coronary vasomotion syndromes including coronary endothelial dysfunction, microvascular angina, vasospastic angina, post-PCI angina and myocardial infarction with no obstructive coronary arteries (MINOCA). Each of these endotypes are distinct subgroups, characterized by specific disease mechanisms. Diagnostic criteria and linked therapy for these conditions are now established by expert consensus and clinical guidelines.
Coronary function tests are performed as an adjunctive interventional diagnostic procedure (IDP) in appropriately selected patients during coronary angiography. This aids differentiation of patients according to endotype. The IDP includes two distinct components: a diagnostic guidewire test and a pharmacological coronary reactivity test. The tests last approximately 5 minutes for the former and 10-15 minutes for the latter. Patient safety and staff education are key.
The diagnostic guidewire test measures parameters of coronary flow limitation (fractional flow reserve [FFR], coronary flow reserve [CFR], microvascular resistance [index of microvascular resistance (IMR)], basal resistance index, and vasodilator function [CFR, resistive reserve ratio (RRR)]).
The pharmacological coronary reactivity test measures the vasodilator potential and propensity to vasospasm of both the main coronary arteries and the micro-vessels. It involves intra-coronary infusion of acetylcholine and glyceryl trinitrate (GTN). Acetylcholine is not licensed for parenteral use and is therefore prescribed on a named-patient basis. Vasodilatation is the normal, expected response to infusion of physiological concentrations of acetylcholine. Vascular spasm represents an abnormal response, which supports the diagnosis of vasospastic angina.
The purpose of this practical guide is to provide information on the preparation and administration of the IDP in clinical practice. It discusses some key preparation and safety considerations, as well as tips for procedural success. The IDP supports stratified medicine for a personalized approach to health and wellbeing.

The purpose of this practical guide is to provide information on the preparation and administration of an interventional diagnostic procedure in clinical practice. It discusses some key preparation and safety considerations, as well as tips for procedural success.

إجراء التشخيص التدخلي: دليل عملي لتقييم وظيفة الأوعية الدموية التاجية

Approximately 40% of patients undergoing invasive coronary angiography for investigation of angina are found to have no obstructive coronary artery ...

Muscle Function Obtained with Motion Mode Ultrasound and Surface Electromyography during Core Endurance Exercise

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured between fascial borders at a given time point during an exercise. This selected time point produces a one-dimensional image resulting in real-time, live observation of anatomy. Ultrasound used during functional movement can be referred to as dynamic ultrasound; this is feasible and reliable with the use of a linear transducer, elastic belt, and foam block to secure consistent transducer placement. The lateral abdominal wall is commonly investigated using ultrasound due to the overlapping nature of the muscles. Surface electromyography (sEMG) can complement M-mode ultrasound imaging because it measures the electrical representation of muscle activation. There is minimal evidence using M-mode ultrasound and sEMG simultaneously during core exercise. Exercises that challenge the core musculature involve both isometric holds (e.g., side plank), as well as oscillatory extremity movements (e.g., dead bug). In this study, both instruments will be used simultaneously to measure core muscle function during exercise. Ultrasound measurements will be obtained using a linear transducer and ultrasound unit, and sEMG measurements will be acquired from a wireless sEMG system. To make comparisons between participants and exercises, normalization methods using static, exercise starting positions for both instruments will be used. An activation ratio will be used for ultrasound and calculated by dividing the contracted thickness (thickness during a time point of exercise) by the rested (starting position) thickness. Muscle thickness will be measured in centimeters from the superior inferior fascial border to inferior superior fascial border. These methods aim to offer an innovative and practical measurement of muscle function with M-mode ultrasound and sEMG during core endurance exercises.

This protocol uses motion mode ultrasound and surface electromyography simultaneously to measure muscle function of the core. Muscle thickness and activation of the local stabilizers (e.g., transverse abdominis, internal oblique) and global movers (e.g., external oblique) is achievable during specific time points of the side plank and dead bug exercises.

وظيفة العضلات التي تم الحصول عليها باستخدام الموجات فوق الصوتية لوضع الحركة وتخطيط كهربية العضل السطحي أثناء تمرين التحمل الأساسي

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured ...

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. Constipation that reduces the quality of life and triggers the risk of diseases is a common concomitant symptom in patients with COPD. Currently, western medical treatment does not achieve the desired results for patients. A high recurrence rate accompanies it, whereas traditional Chinese medicine (TCM) has a long history and rich experience in treating chronic diseases. Both acupoint application and acupoint massage are characteristic therapies of TCM, with minor side effects, high safety, simple operation, and outstanding advantages. They are effective in treating constipation for patients with COPD and are considered an ideal alternative therapy for patients with chronic constipation. The purpose of this article is to introduce the method of acupoint application combined with acupoint massage for the treatment of constipation in patients with COPD, including the selection of points, items, treatment time, and operation procedure.

Here we demonstrate acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease (COPD).