scholarly journals Carotid smooth muscle contractility changes after severe burn

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kevin DeSpain ◽  
Charles R. Rosenfeld ◽  
Ryan Huebinger ◽  
Xiaofu Wang ◽  
Jayson W. Jay ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Ex Vivo ◽  
Total Body Surface Area ◽  
Male Rats ◽  
Severe Burn ◽  
Cross Sectional ◽  
Severe Burns ◽  
Force Relaxation

AbstractSevere burns result in cardiovascular dysfunction, but responses in the peripheral vasculature are unclear. We hypothesize that severe burns disturb arterial contractility through acute changes in adrenergic and cholinergic receptor function. To address this, we investigated the changes in carotid artery contractility and relaxation following a severe burn. Thirty-four adult Sprague–Dawley male rats received a 40% total body surface area (TBSA) scald burn and fluid resuscitation using the Parkland formula. Control animals received sham burn procedure. Animals were serially euthanized between 6 h and 14 days after burn and endothelium-intact common carotid arteries were used for ex vivo force/relaxation measurements. At 6 h after burn, carotid arteries from burned animals demonstrated a > 50% decrease in cumulative dose-responses to norepinephrine (p < 0.05) and to 10−7 M angiotensin II (p < 0.05). Notably, pre-constricted carotid arteries also demonstrated reduced relaxation responses to acetylcholine (p < 0.05) 6 h after burn, but not to sodium nitroprusside. Histologic examination of cross-sectional planes revealed significant increases in carotid artery wall thickness in burned rats at 6 h versus 3 days, with increased collagen expression in tunica media at 3 days (p < 0.05). Carotid artery dysfunction occurs within 6 h after severe burn, demonstrating decreased sensitivity to adrenergic- and angiotensin II-induced vasoconstriction and acetylcholine-induced relaxation.

scholarly journals Muscle Homeostasis Is Disrupted in Burned Adults

2019 ◽  
Vol 41 (1) ◽  
pp. 33-40
Author(s):  
Audra T Clark ◽  
Juquan Song ◽  
Xiao Yao ◽  
Deborah Carlson ◽  
Ryan M Huebinger ◽  
...  
Keyword(s):  
Cell Death ◽  
Muscle Tissue ◽  
Cell Activation ◽  
Injury Severity ◽  
Total Body Surface Area ◽  
Adverse Outcomes ◽  
Nuclear Antigen ◽  
Severe Burn ◽  
Cross Sectional ◽  
Significant Difference

Abstract Severe burn leads to substantial skeletal muscle wasting that is associated with adverse outcomes and protracted recovery. The purpose of our study was to investigate muscle tissue homeostasis in response to severe burn. Muscle biopsies from the right m. lateralis were obtained from 10 adult burn patients at the time of their first operation. Patients were grouped by burn size (total body surface area of &lt;30% vs ≥30%). Muscle fiber size and factors of cell death and muscle regeneration were examined. Muscle cell cross-sectional area was significantly smaller in the large-burn group (2174.3 ± 183.8 µm2 vs 3687.0 ± 527.2 µm2, P = .04). The expression of ubiquitin E3 ligase MuRF1 and cell death downstream effector caspace 3 was increased in the large-burn group (P &lt; .05). No significant difference was seen between groups in expression of the myogenic factors Pax7, MyoD, or myogenin. Interestingly, Pax7 and proliferating cell nuclear antigen (PCNA) expression in muscle tissue were significantly correlated to injury severity only in the smaller-burn group (P &lt; .05). In conclusion, muscle atrophy after burn is driven by apoptotic activation without an equal response of satellite cell activation, differentiation, and fusion.

scholarly journals A prospective observation on nutrition support in adult patients with severe burns

2019 ◽  
Vol 121 (09) ◽  
pp. 974-981 ◽  
Author(s):  
Fengmei Guo ◽  
Hua Zhou ◽  
Jian Wu ◽  
Yingzi Huang ◽  
Guozhong Lv ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Burn Injury ◽  
Early Stage ◽  
Energy Requirement ◽  
Total Body Surface Area ◽  
Nutrition Therapy ◽  
Nutrition Support ◽  
Burn Patients ◽  
Severe Burn ◽  
Severe Burns

AbstractNutrition therapy is considered an important treatment of burn patients. The aim of the study was to delineate the nutritional support in severe burn patients and to investigate association between nutritional practice and clinical outcomes. Severe burn patients were enrolled (n 100). In 90 % of the cases, the burn injury covered above 70 % of the total body surface area. Mean interval from injury to nutrition start was 2·4 (sd 1·1) d. Sixty-seven patients were initiated with enteral nutrition (EN) with a median time of 1 d from injury to first feed. Twenty-two patients began with parenteral nutrition (PN). During the study, thirty-two patients developed EN intolerance. Patients received an average of about 70 % of prescribed energy and protein. Patients with EN providing &lt;30 % energy had significantly higher 28- d and in-hospital mortality than patients with EN providing more than 30 % of energy. Mortality at 28 d was 11 % and in-hospital mortality was 45 %. Multiple regression analysis demonstrated that EN providing &lt;30 % energy and septic shock were independent risk factors for 28- d prognosis. EN could be initiated early in severe burn patients. Majority patients needed PN supplementation for energy requirement and EN feeding intolerance. Post-pyloric feeding is more efficient than gastric feeding in EN tolerance and energy supplement. It is difficult for severe burn patients to obtain enough feeding, especially in the early stage of the disease. More than 2 weeks of underfeeding is harmful to recovery.

Homocysteine Associated With Low Cognitive Function Independent of Asymptomatic Intracranial and Carotid Arteries Stenoses in Chinese Elderly Patients: An Outpatient-Based Cross-Sectional Study

2021 ◽  
pp. 089198872098891
Author(s):  
Xiaona Wang ◽  
Tian Qiao ◽  
Min Liu ◽  
Xiang Wang
Keyword(s):  
Cognitive Function ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Cerebral Blood Flow Velocity ◽  
Underlying Mechanism ◽  
Cross Sectional Study ◽  
Total Serum ◽  
Sectional Study ◽  
Cross Sectional ◽  
Thcy Level

Introduction: A high homocysteine (Hcy) concentration is correlated with cognitive impairment; however, the exact underlying mechanism is still not fully elucidated. The present study aimed to investigate whether asymptomatic intracranial and carotid arteries stenoses are involved in Hcy-related low cognitive function. Methods: This was a cross-sectional study in outpatient clinics. Residents aged ≥60 years, who came to the Stroke and Rehabilitation Clinic of Shandong Provincial Third Hospital in Jinan, Shandong Province from December 2019 to May 2020 to seek consultation due to abnormal transcranial Doppler reports (eg., increased cerebral blood flow velocity) were eligible. Information including demographics, medical history, lifestyle habits were collected. Fasting blood was used to detect total serum homocysteine level (tHcy). Cerebrovascular magnetic resonance angiography and neck vascular ultrasound examination were used to confirm the diagnosis of intracranial and carotid artery stenoses. The Mini-Mental State Examination was used to assess the cognitive function of each participant. Logistic regression was used to evaluate the relationship between tHcy levels and cognitive function. Results: This study included 236 participants (mean age: 64.0 (SD, 7.5) years, female: 58.1%). Multivariable analyses adjusted for several potential confounders, including creatinine and cardiovascular risk factors, showed that tHcy was associated with carotid artery stenosis (CAS). After adjusting for CAS, ICAS and several potential confounders, the association between tHcy level and low cognitive function remained significant (odds ratio: 1.09, 95% confidence interval: (1.03, 1.16), P = 0.032) . Conclusion: Increased serum tHcy level was associated with low cognitive function independent of asymptomatic intracranial and carotid arteries stenoses.

Angiotensin II does not alter ACTH responses to hypoglycemia in conscious dogs

1987 ◽  
Vol 252 (3) ◽  
pp. R526-R530
Author(s):  
M. Keller-Wood ◽  
B. Kimura ◽  
M. I. Phillips
Keyword(s):  
Angiotensin Ii ◽  
Mean Arterial Pressure ◽  
Carotid Artery ◽  
Arterial Pressure ◽  
Negative Feedback ◽  
Intravenous Infusion ◽  
Carotid Arteries ◽  
Plasma Aldosterone ◽  
Conscious Dogs ◽  
Ang Ii

These experiments were designed to test for an interaction between angiotensin II (ANG II) and stress in the control of plasma adrenocorticotropin hormone (ACTH), corticosteroids, and aldosterone. The stimulus to ACTH used in this study was insulin-induced hypoglycemia, a stimulus that does not increase plasma ANG II concentrations. Five trained dogs with exteriorized carotid arteries were studied. Each dog was infused with ANG II intravenously (10 ng X kg-1 X min-1) or into the carotid artery (1 ng X kg-1 X min-1) or with saline (iv) for 80 min. Twenty minutes after the start of the infusion, insulin (0.10 U/kg iv) was injected. Intravenous infusion of ANG II increased mean arterial pressure (MAP) and plasma aldosterone concentrations but did not increase ACTH or corticosteroid responses to hypoglycemia. Intracarotid infusion of ANG II did not increase MAP and also failed to increase ACTH and corticosteroid responses to hypoglycemia. Since ANG II infusions did not increase basal corticosteroids, the failure of ANG II to stimulate ACTH is not a result of steroid negative feedback. Thus it appears that increased plasma ANG II concentrations do not increase ACTH responses to hypoglycemic stress.

Optimized geometry of the carotid artery cross-section: Comparison between circular and elliptical approximations in B-mode ultrasound images

2020 ◽  
pp. 2150004
Author(s):  
Effat Soleimani ◽  
Hazhir Saberi ◽  
Niloofar Ayoobi-Yazdi
Keyword(s):  
Carotid Artery ◽  
Goodness Of Fit ◽  
Carotid Arteries ◽  
Computational Cost ◽  
Point Clouds ◽  
Pattern Search ◽  
Ultrasound Images ◽  
Relative Deviation ◽  
Cross Sectional ◽  
Atherosclerotic Stenosis

Cross-sectional area (CSA) measurement obtained from transverse ultrasound images is the general method used for carotid artery stenosis calculation which assumes a circular CS, however, atherosclerotic stenosis may change the CSA geometry and lead to miscalculation. This study aims to determine the accuracy of circular or elliptical approximation of the normal and stenosed carotid artery CSA. Sixty transverse B-mode ultrasound images (30 from healthy and 30 from stenosed carotid arteries) were recorded. Contours of the internal lumen of the arteries were segmented and the encompassed lumen area was calculated. Based on the fitting accuracy and computational cost effectiveness, pattern search (PS) optimization algorithm was selected by which the parameterized equations of the circular and elliptical geometries were fitted to the segmented point clouds. Goodness of fit analysis of two geometries was carried out using root mean square error (RMSE) and the relative deviation of the approximated CSA. Results of this study showed that elliptical approximation better fits to the artery CS of carotid arteries, with the average RMSE of [Formula: see text] and [Formula: see text] pixels in healthy and [Formula: see text] and [Formula: see text] pixels in stenosed carotid arteries, respectively, for circle and ellipse approximation. Mean values of the relative deviation of the approximated CSA by circle and ellipse geometries were 5.14%[Formula: see text]±[Formula: see text]4.53% and 3.89%[Formula: see text]±[Formula: see text]4.19% in normal arteries; and 12.18%[Formula: see text]±[Formula: see text]10.94% and 4.59%[Formula: see text]±[Formula: see text]3.75% in stenosed arteries, respectively. This study represented that elliptical approximation provides increased accuracy for carotid artery CSA for both normal and stenosed carotid arteries.

Altered Expression of microRNAs in Serum Extracellular Vesicles in Rats with Severe Burns during Shock Stage

2020 ◽  
Vol 20 ◽  
Author(s):  
Mengru Dong ◽  
Yanbin Gao ◽  
Minxiong Li ◽  
Lei Yang
Keyword(s):  
Extracellular Vesicles ◽  
Target Genes ◽  
Early Stage ◽  
Expression Profiles ◽  
Total Body Surface Area ◽  
Signal Pathways ◽  
Burn Shock ◽  
Severe Burn ◽  
Altered Expression ◽  
Severe Burns

Background: The shock stage of severe burns is a critical determinant of prognosis and the induction of systemic inflammatory response syndrome and multiple organ failure. Extracellular vesicles (EVs) containing abundant miRNAs are known to participate in various biological processes. Due to lack of researches in alternations of miRNAs in severe burns, our study analyzed the miRNA profiles of EVs in severe burns during shock stage. Methods: EVs were extracted from serum of rats with severe burns (30% of total body surface area, III°), and the expression of miRNAs in serum EVs was determined by next generation sequencing. Functional analysis of target genes of miRNAs that were significantly differentially expressed (DE) was performed using GO Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Results: Thirty-four DE miRNAs were identified at the early stage of severe burn shock and 63 at the late stage of severe burn shock. In addition, miRNA-339-5p, miRNA-1, miRNA-382-5p, miRNA134-5p, miRNA-133a-5p, and miRNA-365a5p were DE throughout the entire shock stage, based on P < 0.01 and |log2 (foldchange)| ≥ 1 criteria. GO and KEGG analysis revealed that the target genes of DE miRNAs mainly enriched metabolic process, immune system processes, and signal pathways. Conclusion: To our best knowledge, this is the first study demonstrating the miRNA expression profiles of EVs isolated from serum with severe burns during shock stage. There are significant differences in downregulation and upregulation. Thus, miRNAs have potential for novel biomarkers for the complication of severe burns.

Incidence and Prognostic Value of Acute Coagulopathy After Extensive Severe Burns

2020 ◽  
Vol 41 (3) ◽  
pp. 544-549 ◽  
Author(s):  
Kang Geng ◽  
Yonglin Liu ◽  
Yuting Yang ◽  
Xiaobin Ding ◽  
Xinli Tian ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Prognostic Value ◽  
Prognostic Significance ◽  
Total Body Surface Area ◽  
Fluid Replacement ◽  
Burn Severity ◽  
Severe Burn ◽  
Tissue Ischemia ◽  
Coagulation Profile ◽  
Severe Burns

Abstract Acute burn-induced coagulopathy (ABIC) occurs after severe burns. However, the incidence, prognostic value, and clinical significance of ABIC after an extensive severe burn remain inconclusive due to wide variances in burn severity and coagulation profile evaluation timings in previous studies. This retrospective study explored the incidence and clinical and prognostic significance of early phase ABIC in 129 adult patients with extensive burns (&gt;50% total body surface area [TBSA]) admitted to the burn centers of two hospitals within 10 hours postburn injury during 2009–2017. Demographics (age and sex) and clinical data (burn severity, vital signs, prehospital fluid replacement volume, hemodynamic parameters, coagulation profile, blood gas, and blood biochemical indicators) were collected upon admission. The incidence of ABIC in patients with severe burns and its relationship with their survival and clinical significance were analyzed. The average postburn interval was 5.7 ± 2.7 hours, and the incidence of ABIC was 31% (40/129). A logistic regression analysis identified ABIC as an independent predictor of 4-week severe mortality due to severe burn. The incidence of ABIC was significantly associated with the total burn area, lactic acid levels upon admission, and postburn admission interval, but not with the prehospital fluid replacement volume. In conclusion, approximately 30% of patients with severe burns developed ABIC within 10 hours postburn, and this condition strongly predicts 4-week mortality. Although burn severity and tissue ischemia/hypoxia are main risk factors for ABIC, the pathogenesis is not fully understood and should be explored in future studies.

scholarly journals AKTIVITAS SGOT, SGPT DI PENDERITA LUKA BAKAR SEDANG DAN BERAT

2018 ◽  
Vol 15 (1) ◽  
pp. 12
Author(s):  
Sri Nurul Hidayah ◽  
Mutmainnah . ◽  
H. Ibrahim Abd. Samad
Keyword(s):  
Burn Injury ◽  
Morbidity Rate ◽  
Special Treatment ◽  
Severe Burn ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Severe Burns ◽  
Significant Difference ◽  
Severe Burn Injuries ◽  
The Difference

Burn injury is a kind of trauma with the high mortality and morbidity rate that needs special treatment since the very first phaseup to the end. this study targeted medium to severe burns, limited to liver complications. the objective of this study is to calculate andobserve the difference Sgot, SgPt activities in medium and severe burns. the Methods of this study was Cross Sectional, we conductedon 42 subjects with medium to severe burns, Hospitalised during the period of June 2005 to May 2007 at DR.Wahidin Sudirohusodohospital of Makassar. the data were calculated and statistically analysed using the SPSS V.11.5. We obtained of 12 (28.6%) mediumburn injuries and 30 (71.4%) severe burn injuries. In medium burn subjects the got showed normal activities in 6 subjects (50%) andhigh activities in 6 subjects (50%), the gPt showed normal activities in 8 subjects (66,7%) and high activities in 4 subjects (33.3%).In severe burn subjects the got showed normal activities in 6 subjects (20%) and high activities in 24 subjects (80%), the gPt showednormal activities in 13 subjects (43.3%) and high activities in 17 subjects (56.7%). there was no significant difference in the increasingactivities of Sgot and SgPt in either medium or severe burns, where p > 0.05. Increased activities of SgPt and Sgot was higher insevere burns than in medium ones. It was also obtained that increasing Sgot activities was found more often than SgPt in patientswith either medium or severe burns.

scholarly journals Morphological Changes in Carotid Arteries in Stroke Cases

2013 ◽  
Vol 52 (189) ◽  
pp. 251-254 ◽  
Author(s):  
Guna Bahadur Thapa ◽  
Alin Sundas ◽  
Raj Kumar Rauniyar
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Morphological Changes ◽  
Cross Sectional ◽  
Ischemic Infarction ◽  
Atherosclerotic Plaque Formation ◽  
Ischemic Infarct ◽  
Medial Complex ◽  
Carotid Bulb ◽  
Soft Plaque

Introduction: Majority of stroke is due to ischemic infarction and occurs in carotid artery territory. The extra cranial parts of carotid arteries are the common sites for the atherosclerotic plaque formation. Ultrasonography is the first line of investigation for screening of the carotid artery diseases to localize and characterize the plaques. Objective was to study the morphological changes in extra cranial part of carotid arteries in cases of ischemic infarction using Ultrasonography. Methods: It was an institution based prospective study and convenience sampling method was used. Computed Tomography proven ischemic infarct, lacunar infarction and transient ischemic infarction cases were included in the study. Results: Fifty four cases were included in the study. Mean of Intimo-medial Complex Thickness was 0.89 mm and 0.88 mm in right and left side respectively. Sixty five percent cases had plaque in extra cranial part of carotid artery. Ninety three percent of plaque was found in and adjacent to the carotid bulb region. Ipsilateral plaque was found in 76% and 65% cases on right and left side respectively. Fifty three percent of cases had soft plaque. Majority of cases had less than 50% narrowing of the lumen diameter in term of cross-sectional area due to plaque. Thirteen (24%) cases had plaque in internal carotid artery. Conclusions: Carotid ultrasound can be used for screening of the asymptomatic but high-risk cases and following up of the symptomatic cases to plan for necessary management as required. Keywords: carotid artery, carotid ultrasonography, ischemic infarction, plaque.

Carotid Artery Dynamics during Head Movements: A Reason for Concern with Regard to Carotid Stenting?

2003 ◽  
Vol 10 (5) ◽  
pp. 862-869 ◽  
Author(s):  
A.W. Floris Vos ◽  
Matteus A.M. Linsen ◽  
J. Tim Marcus ◽  
Jos C. van den Berg ◽  
Jan Albert Vos ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Ex Vivo ◽  
Maximum Intensity Projection ◽  
Carotid Stenting ◽  
Head Position ◽  
Head Movements ◽  
Mobility Patterns ◽  
Left And Right ◽  
Configuration Changes

Purpose: To evaluate carotid artery mobility patterns during head movements following carotid angioplasty/stenting (CAS). Methods: In 7 patients (all men; mean age 69 years, range 65–76) who had undergone unilateral CAS, 3D time-of-flight magnetic resonance angiography was performed, visualizing both carotid arteries in 5 different head positions (neutral, turned left and right, and bent forward and backward). Maximum intensity projection reconstructions were obtained to measure angulation at the proximal and distal stent junction. Configuration changes of the stented section of the carotid artery and the unstented contralateral artery were judged. Secondly, transverse sections at the level of the carotid bifurcation and at the skull base were used to calculate torsion shear in the common and internal carotid arteries (CCA, ICA) during turned left and right head position. Results were expressed as median (range). Results: In neutral head position, maximal angulation at the distal stent junction was 34.3° (32.3°–55.6°). With the head bent forward, this angulation changed to 47.6° (42.6°–85.2°, p=0.028) and when bent backward to 26.5° (25.0°–48.7°, p=0.027). In all patients, configuration changes of the stented sections were absent. The contralateral unstented side showed diffuse configuration changes without specific angulation at one location. With the head turned left and right, the CCA on the stented side was subjected to 28.6° (13.6°–53.7°) and 24.9° (2.0°–50.6°) of torsion shear, respectively. Torsion of the ICA was subsequently 18.1° (12.7°–40.5°) and 15.2° (2.9°–69.4°). Conclusions: Following carotid stenting, sharp ICA angulations that are aggravated by forward bending of the head occur at the distal stent junction. The stented section of the carotid artery shows complete lack of flexibility despite highly flexible features of the stents ex vivo. Both the CCA and ICA are subjected to considerable torsion shear with the head turned left and right. This shear is not accommodated by the current stent designs.

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