Ischemic Stroke: Histological Thrombus Composition and Pre-Interventional CT Attenuation Are Associated with Intervention Time and Rate of Secondary Embolism

2017 ◽  
Vol 44 (5-6) ◽  
pp. 344-350 ◽  
Author(s):  
Peter B. Sporns ◽  
Uta Hanning ◽  
Wolfram Schwindt ◽  
Aglae Velasco ◽  
Boris Buerke ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Medical Center ◽  
White Blood Cells ◽  
Unaffected Side ◽  
Time Frequency ◽  
Ct Attenuation ◽  
The Impact ◽  
Interventional Ct

Background and Purpose: The introduction of stent retrievers has made the complete extraction and histological analysis of human thrombi possible. A number of large randomized trials have proven the efficacy of thrombectomy for ischemic stroke; however, thrombus composition could have an impact on the efficacy and risk of the intervention. We therefore investigated the impact of histologic thrombus features on interventional outcome and procedure-related embolisms. For a pre-interventional estimation of histologic features and outcome parameters, we assessed the pre-interventional CT attenuation of the thrombi. Methods: We prospectively included all consecutive patients with occlusion of the middle cerebral artery who underwent thrombectomy between December 2013 and February 2016 at our university medical center. Samples were histologically analyzed (H&amp;E, Elastica van Gieson, Prussian blue); additionally, immunohistochemistry for CD3, CD20, and CD68/KiM1P was performed. Main thrombus components (fibrin, erythrocytes, and white blood cells) were determined and compared to intervention time, frequency of secondary embolisms, as well as additional clinical and interventional parameters. Additionally, we assessed the pre-interventional CT attenuation of the thrombi in relation to the unaffected side (rHU) and their association with histologic features. Results: One hundred eighty patients were included; of these, in 168 patients (93.4%), complete recanalization was achieved and 27 patients (15%) showed secondary embolism in the control angiogram. We observed a significant association of high amounts of fibrin (p < 0.001), low percentage of red blood cells (p < 0.001), and lower rHU (p < 0.001) with secondary embolism. Higher rHU values were significantly associated with higher amounts of fibrin (p ≤ 0.001) and low percentage of red blood cells (p ≤ 0.001). Additionally, high amounts of fibrin were associated with longer intervention times (p ≤ 0.001), whereas thrombi with high amounts of erythrocytes correlated with shorter intervention times (p ≤ 0.001). ROC analysis revealed reliable prediction of secondary embolisms for low rHU (AUC = 0.746; p ≤ 0.0001), low amounts of RBC (AUC = 0.764; p ≤ 0.0001), and high amounts of fibrin (AUC = 0.773; p ≤ 0.0001). Conclusions: Fibrin-rich thrombi with low erythrocyte percentage are significantly associated with longer intervention times. Embolisms in the thrombectomy process occur more often in thrombi with a small fraction of red blood cells and a low CT-density, suggesting a higher fragility of these thrombi.

scholarly journals The impact of fetal load of biologically active substances of Hirudo verbana saline extract antigens on the morphometric and hematologic parameters of rats in the early stages of post-embryonic development

2016 ◽  
pp. 6-11
Author(s):  
R. Aminov ◽  
A. Frolov ◽  
Y. Fedotov
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Color Index ◽  
White Blood Cells ◽  
Medicinal Leech ◽  
Morphometric Parameters ◽  
The Body ◽  
Female Rats ◽  
Saline Extract ◽  
The Impact

The female rats of wild type 2 weeks before and 2 weeks after mating were administered intraperitoneally medicinal leech saline extract antigens (4 injection). Studied females after feeding the offspring and the offspring itself in dynamics at 1, 15, 30, 60 days. All animals were decapitated under anesthesia after measuring morphometric parameters of the body. Then we did the autopsy animals and studied morphometric parameters of immunogenic organs (spleen and thymus), laboratory parameters: total white blood cells count, red blood cells count, hemoglobin, color index, leukocyte formula. As a result of our investigations was found an immunostimulatory effect of antigens from saline extract of the medicinal leech on morphometric parameters of the body and major immunogenic organs of rats. Under the influence of medical leeches’ antigens from the first day increased the number of white blood cells, increased the number of red blood cells, increased hemoglobin, color index was in the normal range. Changes of morphological and hematological parameters indicate the immune-stimulating impact of medical leeches’ antigens on leucopoiesis, erythropoiesis and morphogenesis.

Abstract TP214: 3D-Electron Microscopy for the Analysis of the Microstructure of Acute Ischemic Stroke Clots

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Seán Fitzgerald ◽  
Daying Dai ◽  
Asim Rizvi ◽  
Karen M Doyle ◽  
Ramanathan Kadirvel ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Ischemic Stroke ◽  
Red Blood Cells ◽  
Acute Ischemic Stroke ◽  
Mayo Clinic ◽  
Blood Cells ◽  
White Blood Cells ◽  
Three Dimensional ◽  
3D Electron Microscopy

Introduction: Characterization of acute ischemic stroke thrombi has typically focused on the two dimensional (2D) histological characterization of the thrombus. Little is known about the three dimensional (3D) structure of these occlusive thrombi. Electron Microscopy (EM) can be used to obtain 3D information about the organization of clot components. Individual structures can be segmented and qualitative and quantitative information obtained from the clots. Methods: Following IRB approval from Mayo Clinic, acute ischemic stroke clot samples were collected from 10 patients treated at Mayo Clinic. Samples were immediately fixed in fresh modified Trumps fixative solution. A representative fragment of clot was taken and split longitudinally into two pieces; one piece was sent for 3D-EM analysis and the other for histological processing and analysis. Hematoxylin and eosin stain (H&E) and Martius Scarlett Blue (MSB) histological stains were used for conventional histopathology evaluation and components analysis. Immunohistochemical (IHC) staining using anti-CD42b (Platelets) was applied to confirm the presence of platelets in each clot. Serial block-face scanning electron microscopy was used to generate high-resolution three-dimensional images. Results: The 2D morphological features of the clot were identified using H&E, MSB and anti-CD42b staining. The 3D organization of thrombi varies greatly, both within and between clots depending on the constituents. Red Blood Cell-rich areas are mainly composed of Red Blood Cells packaged tightly together, with a small number of Fibrin strands interwoven between the cells. Fibrin-rich areas are characterized by dense networks of fibrin strands along with platelets and White Blood Cells with some sparse Red Blood Cells present. Platelet-rich areas are composed of large volumes of de-granulated platelets, some fibrin stands and white blood cells and an absence of Red Blood Cells. Conclusions: 3D electron microscopy can provide important information on the organization of components within thrombi. This could provide key information on the age and etiology of the thrombus. In addition, it may help to inform thrombolytic treatment and medical device design.

scholarly journals Characterization of the ‘White’ Appearing Clots that Cause Acute Ischemic Stroke

2020 ◽  
Author(s):  
Oana Madalina Mereuta ◽  
Seán Fitzgerald ◽  
Rosanna Rossi ◽  
Andrew Douglas ◽  
Abhay Pandit ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Red Blood Cells ◽  
Acute Ischemic Stroke ◽  
Blood Cells ◽  
White Blood Cells ◽  
Fatty Acid Binding ◽  
Blue Stain ◽  
Von Willebrand ◽  
Willebrand Factor

Abstract Background: Most clots retrieved from patients with acute ischemic stroke are ‘red’ in color and are predominantly composed of red blood cells and fibrin. ‘White’ clots represent a less common entity and their histological composition is largely unknown.The aim of this study was to investigate the composition, imaging and procedural characteristics of ‘white’ clots retrieved by mechanical thrombectomy.Materials and Methods:Nineteen ‘white’ thrombi selected by visual inspection from 293 cases were collected as part of the multi-institutional RESTORE registry. Non-contrast computed tomography (NCCT), histological and immunohistochemical analyses were performed. Components were quantified using Orbit Image Analysis.Results:Quantification of Martius Scarlett Blue stain identified platelets/other as the major component in ‘white’ clots’ (63%) followed by fibrin (26%), red blood cells (7%) and white blood cells (4%). ‘White’ clots presented significantly more platelets/other and less red blood cells compared to the ‘red’ clots which showed a mean of 23% and 44%, respectively. The mean platelet (CD42b) content in ‘white’ clots was 43%; von Willebrand Factor (vWF) mean expression was 38%.Collagen and calcification were associated in one case. Fatty acid binding protein 4 was expressed in two cases.‘White’ clots were also significantly smaller (9.5 versus 12 mm) and less hyperdense (52 versus 61 Hounsfield Units) on NCCT compared to the other cases.Conclusions:‘White’ clots represented 6% of our cohort and are platelet and vWF-rich. Calcification, collagen and adipocytes were found occasionally. ‘White’ clots differ from other clots in composition, size and density on NCCT.

The Effect of Red Blood Cells on the ADP-induced Aggregation of Human Platelets in Flow Through Tubes

1990 ◽  
Vol 63 (01) ◽  
pp. 112-121 ◽  
Author(s):  
David N Bell ◽  
Samira Spain ◽  
Harry L Goldsmith
Keyword(s):  
Platelet Aggregation ◽  
Shear Rate ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Platelet Rich Plasma ◽  
Mean Transit Time ◽  
White Blood Cells ◽  
Aggregate Size ◽  
Human Platelets ◽  
Induced Aggregation

SummaryThe effect of red blood cells, rbc, and shear rate on the ADPinduced aggregation of platelets in whole blood, WB, flowing through polyethylene tubing was studied using a previously described technique (1). Effluent WB was collected into 0.5% glutaraldehyde and the red blood cells removed by centrifugation through Percoll. At 23°C the rate of single platelet aggregtion was upt to 9× greater in WB than previously found in platelet-rich plasma (2) at mean tube shear rates Ḡ = 41.9,335, and 1,920 s−1, and at both 0.2 and 1.0 µM ADP. At 0.2 pM ADP, the rate of aggregation was greatest at Ḡ = 41.9 s−1 over the first 1.7 s mean transit time through the flow tube, t, but decreased steadily with time. At Ḡ ≥335 s−1 the rate of aggregation increased between t = 1.7 and 8.6 s; however, aggregate size decreased with increasing shear rate. At 1.0 µM ADP, the initial rate of single platelet aggregation was still highest at Ḡ = 41.9 s1 where large aggregates up to several millimeters in diameter containing rbc formed by t = 43 s. At this ADP concentration, aggregate size was still limited at Ḡ ≥335 s−1 but the rate of single platelet aggregation was markedly greater than at 0.2 pM ADP. By t = 43 s, no single platelets remained and rbc were not incorporated into aggregates. Although aggregate size increased slowly, large aggregates eventually formed. White blood cells were not significantly incorporated into aggregates at any shear rate or ADP concentration. Since the present technique did not induce platelet thromboxane A2 formation or cause cell lysis, these experiments provide evidence for a purely mechanical effect of rbc in augmenting platelet aggregation in WB.

Hematological condition of breeding bulls after a long winter period of operation in the conditions of the Udmurt Republic

2022 ◽  
pp. 67-73
Author(s):  
A. Abilov ◽  
A. Azhmyakov ◽  
I. Novgorodova ◽  
N. Bogolyubova
Keyword(s):  
Red Blood Cells ◽  
Reference Values ◽  
Blood Cells ◽  
Hematological Parameters ◽  
White Blood Cells ◽  
Winter Period ◽  
Black And White ◽  
Significant Difference ◽  
White Breed ◽  
Udmurt Republic

Purpose: to study hematological parameters of blood in bulls-producers of dairy breeds on the day of semen collection in the Udmurt Republic after a long winter period of operation, depending on the breeds, age and place of selection.Materials and methods. The work was performed at the Federal Research Center for Animal Husbandry named after Academy Member L. K. Ernst on the basis of AO "Udmurtplem" of the Udmurt Republic in the period from 2020 to 2021 on dairy bulls (n=20) aged 15-69 months, including a purebred Holstein breed of domestic selection (n=6), a Holstein black-and-white breed of European selection (the Netherlands, n=6), a black-and-white breed with blood transfusion on Holsteins on at the level of 94-98% (n=8). The content of white blood cells, red blood cells, hemoglobin and hematocrit, depending on age and breed, was studied on the ABC VET hematological analyzer on the day of taking the seed.Results. It was found that on average, in 20 bulls aged 15-69 months, the level of white blood cells was at the level of reference values of 8.8±0.25 x 109/l, red blood cells 10.3 x 1012/l, which is 50% more than the reference values. The concentration of hemoglobin is 128.0±2.92 g/l, hematocrit is on average 54.3%, with a norm of 24-46%. Breeding bulls at a reliable level, differing in age, showed that some animals had high indicators for red blood cells of 10.3±0.26 x 102, for hematocrit of 54.3% against 24-46% of reference values. Also, according to hematological indicators, there was a tendency to increase the concentration of hemoglobin and hematocrit in European-bred bulls.Conclusion. The study of the variability in hematological parameters depending on the selection showed that there is no significant difference in leukocytes and all indicators are at the level of reference values, and in erythrocytes more than 50% than the highest indicators. The highest hemoglobin values were at the level of 141-156 g/l instead of 128 g/l according to the highest reference values. Hematocrit also showed high max values in all groups in comparison with the reference values of 59-66% versus 46% in the norm. It is necessary when analyzing hematological blood parameters in addition to the average statistical indicators (M+m) also, monitor the variability (min-max) in order to obtain more objective information.

scholarly journals Impact of parity and gestational age of mothers with hypertension on birth weight, red blood cells and mode of delivery of their babies

1970 ◽  
Vol 19 (4) ◽  
pp. 3038-3044
Author(s):  
Helen Chioma Okoye ◽  
Chilota Chibuife Efobi ◽  
Josephat Maduabuchi Chinawa ◽  
Odutola Israel Odetunde ◽  
Awoere Tamunosiki Chinawa ◽  
...  
Keyword(s):  
Birth Weight ◽  
Red Blood Cells ◽  
Cell Volume ◽  
Gestational Age ◽  
Packed Cell Volume ◽  
Blood Cells ◽  
Mode Of Delivery ◽  
Poor Correlation ◽  
Hypertensive Group ◽  
The Impact

Background: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies.Objectives: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables.Methods: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20.Results: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927)For all subjects, there was poor correlation between gestational age and variables; birth weight , haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (χ2 =53.082, p <0.001) but none with having a family history of hypertension (χ2 =1.13, p = 0.287).Conclusion: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery.Keywords: Hypertension; neonate; gestational age; parity.

scholarly journals PO-283 Correlation Analysis between Blood Cell Viability, Five Elements and Competition Performance of Elite Men’s Rowers

2018 ◽  
Vol 1 (5) ◽  
Author(s):  
Junbei Bai
Keyword(s):  
Blood Cell ◽  
Red Blood Cells ◽  
Aerobic Capacity ◽  
Red Blood Cell ◽  
Iron Content ◽  
Blood Cells ◽  
White Blood Cells ◽  
Cell Activity ◽  
Ordinary People ◽  
Five Elements

Objective To observe the national elite male rowers blood, red blood cell activity and serum copper, zinc, calcium, magnesium and iron content of the five elements, and compared with the ordinary people. Aimed to investigate the between athletes, athletes and ordinary differences between the two sets of indicators and to explore the impact of element contents in red blood cell activity and five factors. Trying to bring two sets of indicators and specific combining ability, used in training on the monitoring function, and for the future to provide some references for further study. Methods It was included 22 athletes and 22 ordinary men, as the research object, in the collection of blood, measuring red blood cell activity in the blood content of the five elements, simultaneous measurement of physical indicators , will be doing all the data at the differences between the two groups compared to the group to do correlation analysis. The recent record of 2000m, 6000m rowing Dynamometer test results, and red blood cell activity associated with the five elements of content analysis. Results 1. Athletes indicators related to aerobic exercise were significantly higher than ordinary people. The white blood cells of athletes group were average.It shows that athletes have high aerobic capacity, while white blood cells are more stable than normal people. The members of the national rowing men's iron, magnesium content was significantly higher than ordinary group, the iron content is higher than the normal reference value; blood calcium levels were significantly lower than ordinary people, and lower than the normal reference value. The total number of red blood cells and the number of living cells was very significant positive correlation in two groups subjects; Red blood cell activity and red blood cell diameter is proportional, and red blood cell roundness in inverse proportion to the relationship; from this experiment a special ability to see red blood cell activity and there is no correlation. In both groups, hemoglobin was positively correlated with iron content, while iron was positively correlated with copper content. Conclusions 1. Increasing the number and volume of red blood cells can effectively increase the activity of red blood cells; red blood cell activity has no correlation with specific ability, and can not be used as an indicator to determine specific ability. The content of iron and magnesium in rowers is higher than that in ordinary people, which indicates that the adjustment of aerobic capacity and nerve control is very effective. The lower calcium content indicates that the injury caused by calcium loss should be prevented and the urgency of calcium supplementation should be emphasized. In training, we should pay attention to increasing hemoglobin content and aerobic capacity by supplementing iron. We can further consider the effect of supplementing copper to promote iron supplementation.

scholarly journals Effect of aspartame on biochemical and oxidative stress parameters in rat blood

2015 ◽  
Vol 67 (2) ◽  
pp. 535-545 ◽  
Author(s):  
Marko Prokic ◽  
Milica Paunovic ◽  
Milos Matic ◽  
Natasa Djordjevic ◽  
Branka Ognjanovic ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Biochemical Parameters ◽  
White Blood Cells ◽  
Lipid Peroxides ◽  
Hdl Cholesterol ◽  
Albino Rats ◽  
Total Body Mass ◽  
Antioxidative Status

Aspartame (ASP) is one of the most widely used nonnutritive sweeteners. This study investigates the chronic effects of ASP on hematological and biochemical parameters, and its effects on the oxidative/antioxidative status in the red blood cells of Wistar albino rats. Rats were provided with ASP (40 mg/kg/daily for six weeks) in drinking water. Increased food and fluid intake was observed in the ASP-treated rats. Total body mass was significantly decreased in the ASP-treated rats. Treatment with ASP caused an increase in the concentrations of glucose, cholesterol, LDL-cholesterol, and in the activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH), as well as a decrease in the levels of HDL-cholesterol in the serum. A significant decline in the number of white blood cells (WBC) was observed after ASP uptake. Based on the results we conclude that ASP induces oxidative stress, observed as an alteration of the glutathione redox status, which leads to increased concentrations of nitric oxide (NO) and lipid peroxides (LPO) in the red blood cells. Changes in biochemical parameters, lipid metabolism, as well as changes in the levels of oxidative stress markers and the appearance of signs of liver damage indicate that chronic use of ASP can lead to the development of hyperglycemia, hypercholesterolemia and associated diseases.

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