Therapeutic Effect of Platinum Nanoparticles on Atherosclerosis Research Model Based on Microfluidics and Determination of Injury

The atherosclerosis (AS) microenvironment plays an important role in pathogenicity, including blood flow and blood pressure, high cholesterol, high blood sugar, angiotensin II, tumor necrosis factor, and the like. The AS microfluidic model was established, and the fluid shear stress and cyclic stretching were set to 5.07 Pa and 1.17 Hz to simulate normal blood flow, respectively. The effects of different biochemical environments on endothelial cells (ECs) and cardiomyocytes were analyzed. The results confirmed that different biochemical environments had significant damage to ECs and cardiomyocytes. Subsequently, the further effect of ECs on cardiomyocytes in AS microenvironment was studied, and the results proved that ECs caused further damage to cardiomyocytes under AS biochemical factors. We used Pt nanoparticles (Pt NPs) to study the anti-AS efficiency. The results showed that the addition of Pt NPs played a particular role in the AS treatment of ECs in the AS microenvironment, and the protection for myocardial cells was achieved.

CABG versus myotomy in symptomatic myocardial bridge patients : A systematic Review and Meta-analysis protocol

Review question / Objective: The aim of this study is to find which surgical intervention in myocardial bridge ( myotomy or CABG) is more effective in reducing adverse outcomes in symptomatic patients resistant to optimal medical therapy ? Condition being studied: Myocardial bridge : A myocardial bridge (MB) is a congenital heart defect in which a bridge of muscle fibers (myocardium) overlying a section of a coronary artery and the artery is squeezed and normal blood flow is disrupted. Most bridges don't seem to cause symptoms. However, some people can experience angina, or chest pain. In patients with symptoms, first line treatment is medication and if they have symptoms despite optimal medical treatment , invasive measures like CABG or myotomy should be taken.

Magnitude of menstrual problems among young females of medical and paramedical college

Background: Menstruation is described as the exclusive sign of femininity. The age of menarche is determined by general health, genetic, socio-economic, nutritional factors, geographic location, exposure to light and psychological state. Objective of current study was to determine the magnitude of menstrual problem among young females of age group17-25 years of medical and paramedical college. Methods: The present study has been conducted on 300 young female students studying in the department of obstetrics and gynaecology in collaboration with paramedical and nursing college, RIMS and R. Saifai, Etawah over a period of 18 months January 2015 to July 2016, with an objective to determine the magnitude of menstrual problem among on young female students of age group 17-25 years.Results: Mean age of the study population was 21.98 years. The mean age of menarche was found to be 13.50 years with standard deviation of 1.315. This was also in accordance with the results of previous studies. The average duration of menstrual blood loss was found to be 4.28 days with standard deviation of 1.092. The average duration of normal blood flow for reproductive age group as estimated is 2-5 days. The mean of menstrual cycle length came out to be 29.79 days with a standard deviation of 4.87. The average amount of blood loss during each menstrual cycle was found to be 65.39 ml with a standard deviation of 11.81. Conclusions: It was concluded that the mean age of menarche was found to be 13.50 years with standard deviation of 1.315. The average duration of normal blood flow for reproductive age group as estimated is 2-5 days.

The Role of the Plasminogen Activation System in Angioedema: Novel Insights on the Pathogenesis

The main physiological functions of plasmin, the active form of its proenzyme plasminogen, are blood clot fibrinolysis and restoration of normal blood flow. The plasminogen activation (PA) system includes urokinase-type plasminogen activator (uPA), tissue-type PA (tPA), and two types of plasminogen activator inhibitors (PAI-1 and PAI-2). In addition to the regulation of fibrinolysis, the PA system plays an important role in other biological processes, which include degradation of extracellular matrix such as embryogenesis, cell migration, tissue remodeling, wound healing, angiogenesis, inflammation, and immune response. Recently, the link between PA system and angioedema has been a subject of scientific debate. Angioedema is defined as localized and self-limiting edema of subcutaneous and submucosal tissues, mediated by bradykinin and mast cell mediators. Different forms of angioedema are linked to uncontrolled activation of coagulation and fibrinolysis systems. Moreover, plasmin itself can induce a potentiation of bradykinin production with consequent swelling episodes. The number of studies investigating the PA system involvement in angioedema has grown in recent years, highlighting its relevance in etiopathogenesis. In this review, we present the components and diverse functions of the PA system in physiology and its importance in angioedema pathogenesis.

IMPROVED NUMERICAL MODEL OF THE ARTERIAL WALL APPLIED FOR SIMULATIONS OF STENT DEPLOYMENT WITHIN PATIENT-SPECIFIC CORONARY ARTERIES

Arterial stenosis is the obstruction of normal blood flow that is caused by atherosclerosis. One of the endovascular treatment procedures in this case is the implantation of a stent to restore the blood flow. This study presented an improved numerical model that can precisely simulate the deformation of human arterial wall in coronary arteries, during the stent deployment process. The new model considered the arterial wall as an incompressible, isotropic and hyperelastic material. The material coefficients were defined according to experimental values presented in literature. The accuracy of the numerical model was investigated by comparing the results with follow up data obtained in clinical examination. The small relative and standard deviation error prove that this numerical model can be used to assist clinicians in decision making and treatment planning with reliable predictions of the outcome of the stent deployment procedure.

Restoration of Normal Blood Flow in Mouse Models of Sickle Cell Vaso-Occlusion Following Intravenous or Subcutaneous Administration of a Highly Potent E-Selectin Specific Inhibitor

Background: In sickle cell disease (SCD), recurrent episodes of vaso-occlusive crisis (VOC) contribute to morbidity and accelerated mortality. Analysis of the RESET Phase 3 study demonstrated that administration of the pan-selectin inhibitor, rivipansel, early in the course of VOC was associated with efficacy outcomes in favor of rivipansel, suggesting that reversal of vaso-occlusion may be achieved by treatment early in VOC. While both P- and L-selectin likely contribute to the underlying inflammatory cascade leading to VOC, previous studies have shown that E-selectin expression on the vascular luminal surface appears to be crucial for adhesion of sickled (SS)-RBC and leukocytes to the endothelium. GMI-1687 is an innovative potent E-selectin specific antagonist that demonstrates high bioavailability following subcutaneous (SC) administration. In the current investigation, we report on in vitro and in vivo studies evaluating the activity of GMI-1687 in SCD mouse models of VOC. Methods: Townes transgenic mice and nude mice transfused with human SS-RBC were used as in vivo models of SCD. VOC was initiated by TNF injection in both models. Adhesion to inflamed venules and development of VOC was recorded using intravital microscopy at sites of window chamber implants. The in vivo activity of E-selectin inhibition with GMI-1687 was assessed following IV injection in the nude mouse and Townes transgenic models, and SC injection in the nude mouse model of SCD. Results: In an initial study, IV treatment with saline or GMI-1687 was initiated 30 min post infusion of SS-RBC (t30) into TNF-treated mice, a time during which sickle cells are adherent to inflamed venules and VOC has initiated, and repeated 30 minutes later (t60). As expected, mice treated with saline alone showed marked adhesion of human SS-RBC to venules (61% occlusion of the total vessels recorded at t30) with evident blood stasis. Under these conditions, GMI-1687 at 40 μg/kg significantly reversed SS-RBC adhesion and VOC at both t30 and t60 (p=0.002 and 0.0073, respectively, compared to saline treatment). This led to restoration of blood flow in 85% of the venules in GMI-1687 treated mice vs. 18% of vessels with normal blood flow in the control saline treated group. Because of reduced sickle cell adhesion and VOC, the number of circulating SS-RBC increased by approximately 6-fold in mice treated with GMI-1687. Similar anti-adhesive and anti-VOC activities of GMI-1687 treatment were obtained in the Townes transgenic model of SCD where following IV administration of the E-selectin antagonist, adhesion of sickled RBCs was significantly diminished and as a result, the percentage of the total occluded vessel segments was reduced by 80-90%. We next assessed the activity of SC administration with 40 μg/kg GMI-1687 on human SS-RBC adhesion and development of VOC in the nude mouse model. Similar to the IV experiments, GMI-1687 initiated at t30 and t60 post SS-RBC infusion significantly reduced SS-RBC adhesion in inflamed vessels (69% reduction at t30, and 63% at t60, p=0.0001). The reduction in SS-RBC adhesion led to a lower incidence of VOC (2% compared to 30% of vessels in mice injected with saline), and a 5.1-fold improvement (p=0.0315) in the number of circulating human SS-RBC. It is noteworthy that the effective dose of GMI-1687 used in these IV and SC studies resulting in the restoration of normal blood flow was approximately 500-fold less than that reported for rivipansel. Conclusions: These data demonstrate that the administration of the potent and E-selectin specific compound GMI-1687 was effective in restoring blood flow in two mouse models of SCD, and support the development of GMI-1687 formulated for SC use and self-administration with the potential for early intervention of VOC. Disclosures Thamilarasan: GlycoMimetics: Research Funding. Fogler:GlycoMimetics: Current Employment, Current equity holder in publicly-traded company, Patents & Royalties. Magnani:GlycoMimetics, Inc.: Current Employment, Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties. Zennadi:GlycoMimetics: Research Funding.

Surgical Repair of Congenital Coronary Artery Fistula With Giant Aneurysm

A 67-year-old man with a 3-year history of dyspnea on exertion arrived to our institution with discontinuous palpitations and short breath. He was diagnosed with congenital coronary artery fistula (CAF). Angiography revealed 3 giant aneurysmal formations and coronary artery calcification. We report a case of successful repair of CAF with a giant coronary aneurysm by closing the orifice and resecting the aneurysm and reconstructing the left coronary artery. The surgical procedure included closure from within a vessel dilated by aneurysm and excision of the aneurysm. We were able to completely obliterate the fistula and preserve the normal blood flow through the coronary arteries post operation. The postoperative course was eventful, but the patient was discharged home. The patient was doing well at his 28-month follow-up visit.

Prevalence of Erectile Dysfunction among men of the Uzbek Population who were on the Inpatient Examination and Treatment

In order to study the prevalence of erectile dysfunction (ED) in men of the Uzbek population, an anonymous survey of men who were on a stationary examination and gave consent was conducted. 648 questionnaires were analyzed. It was found that ED symptoms were present in 587 (90.6%) men. Age-related symptoms (according to the AMS questionnaire) were detected in 259 (44.1%) patients, and most of them were aged 45-60 years. It is necessary to actively detect ED in men, since it can be one of the early manifestations of serious diseases. Erectile dysfunction (ED) - a continuing inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity. ED is a symptom complex that is part of the clinical picture of a number of somatic diseases, which in its severity directly depends on them. Numerous risk factors are known that create favorable conditions for the development of ED: systemic diseases (atherosclerosis, cardiovascular diseases, renal and liver failure), nervous diseases (neurosis, multiple sclerosis, Alzheimer's disease), mental illness (depression, astheno-depressive and hypochondria) endocrine diseases (diabetes mellitus, hypo- and hyperthyroidism, androgen deficiency, hyperprolactinemia). The risk of developing ED increases with age due to the process of increased comorbidity. ED is a common disorder affecting men of all ages; it often does not lend itself to proper diagnosis and treatment. There are numerous well-reasoned evidences that ED is functionally reversible damage to the arteries - endothelial dysfunction (EnD). Currently, EnD is considered as a functional stage in the development of atherosclerosis [1-3]. EnD is a generalized process that occurs due to: oxidative stress, impaired metabolism of nitric oxide, processes of redox phosphorylation of blood vessels, in particular endothelium. A manifestation of EnD can be disturbances in the mechanisms of normal blood flow in the pelvis, which can manifest as erectile dysfunction, lower urinary tract syndrome (LUTS), interstitial cystitis, and overactive bladder (OAB) [4]. EnD as a manifestation of endothelial dysfunction can be a predictor of cardivascular diseases, which means that it can be used as a screening assessment of the cardiovascular system in men after 35-40 years. The social and psychological discomfort of the modern world, the prevalence and increased mortality from cardiovascular disease (CVD), the increase in ED have become one of the main health problems of men of the XXI century. Keywords: Erectile dysfunction; Andrology; Male health

Сlinical case of pancreatic cancer

Description of a rare case of pancreas body tumor, which was grown into celiac trunk, is presented. The patient was saved due toanftomy of right hepatic artery, which was a branch of superior mesenteric artery. Patient Z.V, 60 years old, came to the clinic with such complaints as pain, heaviness in abdomen and waist area,weakness.4–5 cm tumor of pancreas body was detectedduring surgery. The tumor had grown into celiac trunk and into left adrenal gland. The friable tissue of hepato-duodenal ligament was dissected duringthe surgery.Thesurgeons mobilized duodenum usingKoxertechnique. As a result of this manipulation, the followingblood vesselswere visualized:inferior vena cava and abdominal aorta, celiac trunk, superior mesentericartery. Surgical team opened ligament of Treitz and excisedpancreas body2.5 cm away from thetumor proximally. The stump was sewed with “mattress stich”, celiac trunk was sectioned and entangled, surgeons also dissected common hepatic artery. After section they checked blood supply of liver. The pressure of blood flowing from gastro-duodenal and pancreato-duodenal artery was enough for providing normal blood flow in the left hepatic artery. Morphological result of the excisedtissue — Ductal adenocarcinoma (No 672). The patient’sstate was satisfactory when he left the clinic. He underwent medical check-up three times next year. He feels well, his state of health is normal. Patient is capable of working. This case is interesting due to the anatomy of right hepatic artery (which was a branch of superior mesenteric artery) that saved patient’s life.