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Utero-Placental and Fetal Circulation in Intrauterine Growth Retardation
Published in Asim Kurjak, John M. Beazley, Fetal Growth Retardation: Diagnosis and Treatment, 2020
Asim Kurjak, Žarko Alfirević, Giuseppe Rizzo, Domenico Arduini
Studies of human fetal cerebral circulation using Doppler ultrasound equipment were first reported in 1984 by Marŝal and co-workers32 who recorded velocity waveforms from common carotid artery. Recordings of velocity waveforms from common carotid artery are obtained by performing a longitudinal scan of the fetal head and neck. In that section, the common carotid artery appears in its longitudinal axis from the aortic arch origin (Figure 17). However, in our experience, the common carotid artery is difficult to visualize, due to the usually curved position of fetal neck. Furthermore, the common carotid artery divides into the internal and external carotid arteries, and is therefore only partially representative of cerebral blood flow. For the above-mentioned reasons the analysis of fetal blood flow at this level has not been extensively applied.
Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The thoracic aorta commences at the aortic valve and passes into the abdomen by passing through the diaphragmatic hiatus at the level of the T12 vertebral body. It is divided into the ascending aorta, aortic arch and descending aorta. Major vessels arise from the ascending aorta and arch. The right and left coronary arteries arise from the root of the ascending aorta close to the aortic valve cusps. The aortic arch gives rise to three large vessels that supply the head and neck region and the upper limbs: the brachiocephalic artery (also known as the brachiocephalic trunk or innominate artery), the left common carotid artery and the left subclavian artery. The brachiocephalic artery divides and give rise to the right common carotid and right subclavian arteries. Each common carotid artery divides into the internal and external carotid arteries. The vertebral artery arises as the first branch of the subclavian artery on each side. The subclavian artery passes laterally to continue as the axillary artery at the lateral border of the first rib. The axillary artery continues down the arm and at the inferior margin of the teres major muscle it becomes the brachial artery. At the cubital fossa the brachial artery divides into the radial and ulnar arteries, which continue down the forearm to the hand.
Brachiocephalic interventions
Published in Peter A. Schneider, Endovascular Skills: Guidewire and Catheter Skills for Endovascular Surgery, 2019
In the TCAR approach, the proximal common carotid artery is accessed through an open cutdown and proximal protection is achieved with a clamp on the common carotid artery and a reversed flow circuit with flow into the femoral vein. The procedure may be performed under local or general anesthesia. A short, approximately 1-inch (2.5 cm) incision is performed, usually transverse and just superior to the clavicle. The dissection is carried down through the platysma and in between the sternal head and the clavicular head of the sternocleidomastoid muscle. It is usually best to dissect between the muscle heads rather than divide them. The jugular vein is identified and retracted laterally. The common carotid artery is usually just deep to the jugular vein. The common carotid artery is identified and dissected out. A 5-0 prolene purse-string suture is placed along the anterior wall of the artery at the location where the sheath access will be placed. A small self-retaining retractor is usually helpful. Anatomic specifications require that the distance between the clavicle and the carotid bifurcation lesion should be 5 cm or more. If the patient has a very thick neck or a deep neck, a distance of more than 5 cm is better.
CircNUFIP2 overexpression induces GDF11 to ameliorate oxygen-glucose deprivation-induced hippocampal neuron cell apoptosis and oxidative stress after cerebral ischemia
Published in Neurological Research, 2023
Zhujun Mei, LinLing Huang, Wei Rao
All assay procedures in this part were permitted by the Ethics Committee of Jiangxi Provincial People’s Hospital, the First Affiliated Hospital of Nanchang Medical College. Twenty male C57BL/6 J mice weighing 20–25 g and aged 5–7 weeks were purchased from Huafukang Biotechnology Co., Ltd. (Beijing, China), and housed in pathogen-free facilities with free access to food and water. These mice received MCAO surgery inferring to the reported method [15]. In brief, all mice were anesthetized using pentobarbital sodium (40 mg/kg) and connected to a ventilator (the breathing ratio was 1:1, the breathing frequency was 120 times each time, and the tidal volume was 0.15 mL) to sustain life. An arteriotomy was implemented after exposure of the right common carotid artery. Then, blood in this carotid artery was occluded using 4–0 nylon filaments. Meanwhile, sham operation (without MCAO operation) was carried out on control mice. Twenty-four hours later, the non-sham mice were treated with adeno-associated viral vector introduced with pCD5-ciR or circNUFIP2 sequence in the left lateral ventricle. After 48 h, these mice were euthanized by CO2 inhalation, and brains were harvested for the analysis of cerebral infarction, sensation, movement, reflex activity as well as balance.
Chlorogenic acid promotes angiogenesis and attenuates apoptosis following cerebral ischaemia-reperfusion injury by regulating the PI3K-Akt signalling
Published in Pharmaceutical Biology, 2022
Yong Fan, Yongkun Li, Yongkai Yang, Kunzhe Lin, Qingqiang Lin, Shenghui Luo, Xiaohui Zhou, Qun Lin, Fan Zhang
The 8-week-old male C57BL/6J mice were purchased from Charles River Laboratories (Beijing, China), and divided into three groups (n = 6 per group): sham, MCAO and MCAO + CGA groups following 1-week housing in a controlled condition with free access to food and water. The MCAO model was established referring to the previously reported protocols (Ni et al. 2022). In brief, a midline incision was created in the anaesthetized mice by 2% isoflurane. After that, the right common carotid artery and external carotid artery were isolated, and then the internal carotid artery was clamped, followed by inserting a nylon suture to occlude the middle cerebral artery. MCAO was conducted for 2 h, and reperfusion was performed for 72 h. In the sham group, mice suffered from similar surgeries without occlusion of the middle cerebral artery. In MCAO + CGA group, 30 mg/kg CGA were administered orally to mice daily for 3 consecutive days after MCAO. After the MCAO for 3 days, all mice were euthanized by 5% isoflurane and cervical dislocation. The brain tissues were collected for infarct volume analysis using 2-, 3-, 5-triphenyltetrazolium chloride (TTC) staining. The apoptosis- and angiogenesis-related proteins in cerebral cortex samples were detected by western blot analysis. The experiments were approved by the Animal Experimentation Ethics Committee of The Affiliated Fuzhou First Hospital of Fujian Medical University.
CT findings in aggressive Takayasu arteritis
Published in Acta Cardiologica, 2022
Benjamín Roque Rodríguez, Luis Enrique Lezcano Gort, María Victoria Mogollón Jiménez, Ignacio Díaz Villalonga, Sergio Moyano Calvente, Zineb Kounka
A 52-year-old woman was referred to our hospital with grade-2 dyspnoea without intermittent claudication. She complained of self-limiting episodes of fever, asthenia, and myalgias since the adolescence. Physical examination revealed a loud panfocal systolic murmur (IV/VI), and large inter-arm blood pressure difference (180/80-120/70 mmHg in right and left arm respectively). Treponema pallidum serological-test and autoantibodies were negative, and acute phase reactants were normal. Doppler echocardiogram reveals doubtful patent ductus arteriosus. CT angiography with multiplanar (Figure 1, panels 1 and 4) and volumen-rendered reformatted images (Figure 1, panels 2 and 3) showed severe narrowing of the middle segment of the descending thoracic/abdominal aorta (a), and both iliac arteries, with intima-media thickening in all of them (b). Collaterals have been developed, like a huge and tortuous right internal mammary artery which anastomoses with branches of the epigastric arteries (c). We found severe stenosis in common carotid arteries (critical in left common carotid artery) (d) and in both subclavian arteries at the ostia of vertebral arteries(e). On the basis of clinical and angiographic abnormalities, the diagnosis of Takayasu arteritis (TA) was made. TA is a large-vessel granulomatous vasculitis that primarily affects the aorta and its primary branches, specially supraaortic trunk and subclavian artery. It principally affects young women. The patient refused to take any treatment or perform new tests. Actually, she remains asymptomatic.