The Ambiguous "Internal Carotid Artery" - Ultrasound Diagnosis of One Case of Congenital Absence of The Internal Carotid Artery

Background Congenital absence of the internal carotid artery (ICA) is a very rare congenital anomaly of the ICA. Most reports in the literature are of individual cases, and most were diagnosed by computed tomographic angiography (CTA) or digital subtraction angiography (DSA). There are few reports on the diagnosis of congenital absence of the ICA by carotid Doppler ultrasound (CDUS). Case presentation: A 61-year-old male patient who was admitted to the hospital because of dizziness and showed no abnormality on CDUS conducted at another hospital. CDUS conducted at our hospital found maldevelopment of the right common carotid artery (RCCA) with normal a blood flow velocity and spectrum. A high-resistance frequency spectrum could be detected in the “ICA” that continued directly from the RCCA, and two adjacent small blood vessel branches were also observed. Superficial temporal artery tap and tracing of the courses of the small blood vessels confirmed that the RCCA directly continued to the external carotid artery (ECA). The final diagnosis was congenital absence of the ICA, which was confirmed during the clipping of an anterior communicating artery (ACoA) aneurysm. Conclusion CDUS, as a noninvasive and rapid screening tool for cervical vascular diseases, offers a new approach for the diagnosis of congenital absence of the ICA.

Ageing enhances cellular immunity to myeloperoxidase and experimental anti-myeloperoxidase glomerulonephritis

Objectives Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune disease characterised by small blood vessel inflammation, commonly affecting the kidneys and respiratory tract. It is unclear why the incidence of this condition increases with age. Previous studies in a passive antibody transfer system in aged mice have implicated innate effectors. To test the hypothesis that autoimmunity to myeloperoxidase, an autoantigen responsible for ANCA-associated vasculitis, increases with age, anti-myeloperoxidase autoimmunity was studied in murine models of active autoimmunity and disease induced by cellular immunity. Methods Young (8 weeks) and aged (either 15 or 22 month) mice were immunised with whole proteins or peptides from ovalbumin, as a model foreign antigen, or myeloperoxidase protein or peptides. Mice were subjected to a model of active anti-myeloperoxidase glomerulonephritis. Cellular and humoral immune responses and tissue inflammation were assessed. Results While cellular immunity to ovalbumin was diminished in aged mice, cellular autoimmunity to myeloperoxidase and its immunodominant CD4+ and CD8+ T cell epitopes was increased after immunization with either MPO peptides or whole MPO protein, assessed by peptide and antigen specific production of the pro-inflammatory cytokines interferon-γ and interleukin-17A. MPO-ANCA titres were not increased in aged mice compared with young mice. In experimental anti-MPO glomerulonephritis, cell mediated injury was increased, likely due to CD4+ and CD8+ T cells, innate immunity and the increased vulnerability of aged kidneys. Conclusion Heightened cellular immunity to MPO develops with ageing in mice and may contribute to the increased incidence and severity of ANCA-associated vasculitis in older people.

Quantifying frequency content in cross-sectional retinal scans of diabetics vs. controls

Purpose To examine subtle differences in the structure of diabetic vs. control retinas. Methods Spectral-domain optical coherence tomography (SD-OCT) images were compared for the retinas of 33 diabetic subjects who did not have clinical evidence of diabetic macular edema and age-matched controls, with central macular thicknesses of 275 and 276 microns, respectively. Cross-sectional retinal images through the fovea, called B-scans, were analyzed for spatial frequency content. The B-scans were processed to remove and smooth the portions of the retinal image not within regions of interest in the retina. The remaining retinal images were then quantified using a Fast Fourier Transform (FFT) approach that provided amplitude as a function of spatial frequency. Results The FFT analysis showed that diabetic retinas had spatial frequency content with significantly higher power compared to control retinas particularly for a deeper fundus layer at mid-range spatial frequencies, ranging from p = 0.0030 to 0.0497 at 16.8 to 18.2 microns/cycle. There was lower power at higher spatial frequencies, ranging from p = 0.0296 and 0.0482 at 27.4 and 29.0 microns/cycle. The range of mid-range frequencies corresponds to the sizes of small blood vessel abnormalities and hard exudates. Retinal thickness did not differ between the two groups. Conclusions Diabetic retinas, although not thicker than controls, had subtle but quantifiable pattern changes in SD-OCT images particularly in deeper fundus layers. The size range and distribution of this pattern in diabetic eyes were consistent with small blood vessel abnormalities and leakage of lipid and fluid. Feature-based biomarkers may augment retinal thickness criteria for management of diabetic eye complications, and may detect early changes.

COVID-19: ORF8 Synthesizes Nitric Oxide to Break the Blood-Brain/Testi Barrier and Damage the Reproductive System

Studies have reveal that the SARS-CoV-2 virus can break through the blood-brain/testi barrier and invade the human reproductive system, causing infertility or complications in patients. Excessive nitric oxide (NO) is a fundamental reason for breaking the Blood-Brain/Testi Barrier. Nitric oxide often relates the spread or replication of many viruses in the body. The nitric oxide synthase (NOS) that synthesizes NO in the human by binding heme to complete the oxygenase reaction. This study focused on the relationship between heme, NO, and the novel coronavirus using bioinformatics methods such as domain search and molecular docking. The results showed ORF8 had three domains similar to nitric oxide synthase : oxygenase, reductase, and calmodulin (CaM). ORF6 could bind to these three domains. The dimer of ORF8 was identical to the dimer of NOS enzyme. The oxygenase domain was in the core, and the reductase domain was on both sides. ORF8 could capture Heme, H4B, L-arginine, FAD, FMN, and NADPH, and bind with CaM protein to catalyze NO production. The heme bound by ORF8 mainly came from the attacked hemoglobin. ORF8 also attached to E protein and synthesized NO through the heme hunted by E protein. We believed NO synthesized by ORF8 inhibited SARS-CoV-2 from reinfecting infected cells and controlled the virus replication speed to avoid cell collapse because of exhaustion of resources. After the SARS-CoV-2 virus combined with an extensive ORF8, the produced NO stream permeably expanded blood vessels and broke the blood-brain/testi barrier. The SARS-CoV-2 virus spread to nearby tissues through small blood vessel holes created by NO stream. It would increase the tendency to bleed and the blood clotting of the tissue: blood clotting and viral infections severely damaged organs such as the respiratory, heart, nerve, reproductive. Short NO could not open vascular permeability dilation, causing high viral load in asymptomatic patients' blood. Excessive NO stimulated the reproductive organs and generated abnormal functions. It also made abnormal hormone regulation, such as excessive secretion of luteinizing hormone (LH). Much LH would hurt the reproductive organs, leading to infertility. Extreme NO also interfered with the human NO signaling pathway and damaged the immune nerve, metabolism, cardiovascular and other systems. This theory is for academic discussion only. We hope that this discovery will help block the virus’s transmission through the human circulatory system and help reproductive health management during the pandemic.

COVID-19: ORF8 Synthesizes Nitric Oxide to Break the Blood-Brain/Testi Barrier and Damage the Reproductive System

Studies have reveal that the SARS-CoV-2 virus can break through the blood-brain/testi barrier and invade the human reproductive system, causing infertility or complications in patients. Excessive nitric oxide (NO) is a fundamental reason for breaking the Blood-Brain/Testi Barrier. Nitric oxide often relates the spread or replication of many viruses in the body. The nitric oxide synthase (NOS) that synthesizes NO in the human by binding heme to complete the oxygenase reaction. This study focused on the relationship between heme, NO, and the novel coronavirus using bioinformatics methods such as domain search and molecular docking. The results showed ORF8 had three domains similar to nitric oxide synthase : oxygenase, reductase, and calmodulin (CaM). ORF6 could bind to these three domains. The dimer of ORF8 was identical to the dimer of NOS enzyme. The oxygenase domain was in the core, and the reductase domain was on both sides. ORF8 could capture Heme, H4B, L-arginine, FAD, FMN, and NADPH, and bind with CaM protein to catalyze NO production. The heme bound by ORF8 mainly came from the attacked hemoglobin. ORF8 also attached to E protein and synthesized NO through the heme hunted by E protein. We believed NO synthesized by ORF8 inhibited SARS-CoV-2 from reinfecting infected cells and controlled the virus replication speed to avoid cell collapse because of exhaustion of resources. After the SARS-CoV-2 virus combined with an extensive ORF8, the produced NO stream permeably expanded blood vessels and broke the blood-brain/testi barrier. The SARS-CoV-2 virus spread to nearby tissues through small blood vessel holes created by NO stream. It would increase the tendency to bleed and the blood clotting of the tissue: blood clotting and viral infections severely damaged organs such as the respiratory, heart, nerve, reproductive. Short NO could not open vascular permeability dilation, causing high viral load in asymptomatic patients' blood. Excessive NO stimulated the reproductive organs and generated abnormal functions. It also made abnormal hormone regulation, such as excessive secretion of luteinizing hormone (LH). Much LH would hurt the reproductive organs, leading to infertility. Extreme NO also interfered with the human NO signaling pathway and damaged the immune nerve, metabolism, cardiovascular and other systems. This theory is for academic discussion only. We hope that this discovery will help block the virus’s transmission through the human circulatory system and help reproductive health management during the pandemic.

Role of Panchakarma in the Management of Masavritavata w.r.t Dermatomyositis - A Case Study

Dermatomyositis (DM) is the most frequently occurring Idiopathic Inflammatory Myopathy (IIM) of skeletal muscles causing proximal muscles weakness. The average age at which this disease affects is 40 years and almost twice as many women are affected as men. Its prevalence rate is 2-10 per 1,00,000 in the general population. The actual cause is unknown but the disease has much common with autoimmune disorder in which your immune system mistakenly attacks our body tissue. Small blood vessel in muscular tissue are particularly affected in dermatomyositis. In this disease the ESR and CPK is usually raised. Due to similarity in the signs and symptoms, we can correlate this disease with Mamsavrita-Vata and its treatment can be planned according to it. Here is the case study of 40 years old female patient, diagnosed as Dermatomyositis since 3 months. Patient admitted in Panchakarma ward of Parul Ayurved Hospital, Vadodara. The Panchakarma procedures like Udvartana, Nitya Virechana, Basti Chikitsa, Shasti Shali Pinda Sweda and Shamana Aushadi like Cap Palsineuron and Guduchi Rasayana etc. are given. At the end of the treatment marked improvements were seen in the patient, like reduced ESR and CPK levels. Also the symptoms of the disease reduced significantly.

H-scan Subtraction Doppler Imaging: A Novel Ultrasound Small Blood Vessel Flow Characterization with Scattering and Reflection Identification

Ultrafast compound Doppler imaging (UCDI), which can be used to acquire Doppler information at very high spatial and temporal sampling rates, provides a great improvement to the characterization of the vasculature. The singular value decomposition (SVD) technique takes advantage of the different features of tissue and blood motion in terms of spatiotemporal coherence and strongly outperforms conventional clutter rejection filters in small animals. However, a major challenge of conventional UCDI with SVD clutter filtering for small vessel imaging is that it is not sensitive enough to detect the hemodynamic changes in deep tissue where the majority of the remaining signal is usually noise-saturated. In this study, with the first attempt to apply ultrasonic tissue characterization techniques to UCDI, we propose an H-scan subtraction Doppler imaging method to bypass the limitations associated with the high-order singular value thresholding selection and improve the image quality of fine vessels. The flow phantom experiments with different blood concentrations show that H-Scan is capable of estimating the relative size and spatial distribution of acoustic scattering objects. In the in vivo rabbit brain experiment, the H-Doppler method, together with the global and block-wise local SVD clutter filtering, are proposed to facilitate better power Doppler images with a significant improvement of background noise suppression. These results demonstrate that the contrast-to-noise-ratio (CNR) of the H-scan subtraction Doppler imaging is 15% to 65% higher than that of the conventional UCDI methods. Therefore, this approach can be potentially applied to the clinical applications of the functional ultrasound (fUS) imaging method.

Insulin-like Growth Factor and its Therapeutic Potential for Diabetes Complications Mechanisms and Metabolic Links: A Review

BACKGROUND: The insulin-like growth factor (IGF) system is an important system in normal physiological functioning of the body. In diabetes mellitus, alterations of IGF-binding protein (IGFBP) levels have been described, mainly in vascular complications. AIM: The aim of this review was to explore the role of the IGF system in reducing diabetes complications and its role as potential therapeutic target. RESULTS: IGF-1 plays a role in neuronal growth and developmental processes. Low concentrations of IGF-1 have been associated with neuropathy and other diabetes complications. Moreover, impaired IGF synthesis and function may result in cellular senescence and impaired vascular endothelial proliferation, adhesion, and integration. Of note, high IGF-1 bioavailability may prevent or delay the inception of diabetes-associated complications in diabetes patients. The mechanism of normal functioning IGF-1 is induced by increasing nitric oxide synthesis and potassium ion channel opening in cardiovascular physiology, which improves impaired small blood vessel function and reduces the occurrence of diabetes complications associated with reduced concentrations of IGF-1. CONCLUSIONS: IGF may be considered an alternative therapy for diabetes and diabetes-associated complications. Therefore, future studies should focus on the mechanism of action and therapeutic potential of IGFs in reducing the risk of development and progression of the disease in different clinical settings.