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The developmental origin of blood-forming hematopoietic stem cells (HSCs) is a longstanding question. Here, our non-invasive genetic lineage tracing in mouse embryos pinpoints that artery endothelial cells generate HSCs. Arteries are transiently competent to generate HSCs for 2.5 days (∼E8.5-E11) but subsequently cease, delimiting a narrow time frame for HSC formation in vivo. Guided by the arterial origins of blood, we efficiently and rapidly differentiate human pluripotent stem cells (hPSCs) into posterior primitive streak, lateral mesoderm, artery endothelium, hemogenic endothelium, and >90% pure hematopoietic progenitors within 10 days. hPSC-derived hematopoietic progenitors generate T, B, NK, erythroid, and myeloid cells in vitro and, critically, express hallmark HSC transcription factors HLF and HOXA5-HOXA10, which were previously challenging to upregulate. We differentiated hPSCs into highly enriched HLF+ HOXA+ hematopoietic progenitors with near-stoichiometric efficiency by blocking formation of unwanted lineages at each differentiation step. hPSC-derived HLF+ HOXA+ hematopoietic progenitors could avail both basic research and cellular therapies.

Large‐conductance, calcium‐activated potassium channels (BK channels) and the Na/K‐ATPase are expressed universally in vascular smooth muscle. The Na/K‐ATPase may act via changes in the intracellular Ca2+ concentration mediated by the Na/Ca exchanger (NCX) and via Src kinase. Both pathways are known to regulate BK channels. Whether BK channels functionally interact in vascular smooth muscle cells with the Na/K‐ATPase remains to be elucidated. Thus, this study addressed the hypothesis that BK channels limit ouabain‐induced vasocontraction. Rat mesenteric arteries were studied using isometric myography, FURA‐2 fluorimetry and proximity ligation assay. The BK channel blocker iberiotoxin potentiated methoxamine‐induced contractions. The cardiotonic steroid, ouabain (10−5 M), induced a contractile effect of IBTX at basal tension prior to methoxamine administration and enhanced the pro‐contractile effect of IBTX on methoxamine‐induced contractions. These facilitating effects of ouabain were prevented by the inhibition of either NCX or Src kinase. Furthermore, inhibition of NCX or Src kinase reduced the BK channel‐mediated negative feedback regulation of arterial contraction. The effects of NCX and Src kinase inhibition were independent of each other. Co‐localization of the Na/K‐ATPase and the BK channel was evident. Our data suggest that BK channels limit ouabain‐induced vasocontraction by a dual mechanism involving the NCX and Src kinase signaling. The data propose that the NCX and the Src kinase pathways, mediating the ouabain‐induced activation of the BK channel, act in an independent manner. [ABSTRACT FROM AUTHOR]

Background & Aims: Heart diseases stand out as a leading cause of death. Specific enzymes are active eliminators of toxic substances from the body. One of the crucial enzymes in this process is Glutathione S-Transferase (GST). In this study, GST activities were determined in individuals with and without coronary artery, and the relationship between some biochemistry tests and GST activity was examined. Materials & Methods: This case-control study was conducted on 54 patients with CAD and 54 people without CAD with matched age and sex as control group. Biochemical parameters were measured on an autoanalyzer, and GST enzyme activity was measured on a spectrophotometer. All parameters were examined statistically in line with the data obtained. Data were analyzed by SPSS v.20. A p-value less than 0.05 was considered statistically significant Results: Accordingly, while there was a statistically significant difference in the GST enzyme activity and HDL-C levels, there was no statistically significant difference in total cholesterol, triglycerides, LDL-C, urea, creatinine and CRP levels. GST enzyme activity level, total cholesterol, triglycerideç LDL-C and CRP levels were found to be higher in thr patient group than the control group, while HDL-C, urea and creatinine levels were found to be higher in the control group than the patient group (Ps

Arteries and veins develop different types of occlusive diseases and respond differently to injury. The biological reasons for this discrepancy are not well understood, which is a limiting factor for the development of vein-targeted therapies. This study contrasts human peripheral arteries and veins at the single-cell level, with a focus on cell populations with remodeling potential. Upper arm arteries (brachial) and veins (basilic/cephalic) from 30 organ donors were compared using a combination of bulk and single-cell RNA sequencing, proteomics, flow cytometry, and histology. The cellular atlases of six arteries and veins demonstrated a 7.8× higher proportion of contractile smooth muscle cells (SMCs) in arteries and a trend toward more modulated SMCs. In contrast, veins showed a higher abundance of endothelial cells, pericytes, and macrophages, as well as an increasing trend in fibroblasts. Activated fibroblasts had similar proportions in both types of vessels but with significant differences in gene expression. Modulated SMCs and activated fibroblasts were characterized by the upregulation of MYH10, FN1, COL8A1, and ITGA10. Activated fibroblasts also expressed F2R, POSTN, and COMP and were confirmed by F2R/CD90 flow cytometry. Activated fibroblasts from veins were the top producers of collagens among all fibroblast populations from both types of vessels. Venous fibroblasts were also highly angiogenic, proinflammatory, and hyper-responders to reactive oxygen species. Differences in wall structure further explain the significant contribution of fibroblast populations to remodeling in veins. Fibroblasts are almost exclusively located outside the external elastic lamina in arteries, while widely distributed throughout the venous wall. In line with the above, ECM-targeted proteomics confirmed a higher abundance of fibrillar collagens in veins vs. more basement ECM components in arteries. The distinct cellular compositions and transcriptional programs of reparative populations in arteries and veins may explain differences in acute and chronic wall remodeling between vessels. This information may be relevant for the development of antistenotic therapies. [ABSTRACT FROM AUTHOR]

AbstractTransferring biological fluid through arteries is a topic that has garnered serious interest in recent times, especially when it pertains to applications such as drug delivery. In our body, arteries serve as the primary conduits for blood flow and this study aims to model the blood flow in this situation. The working fluid is essentially pure blood, which acts as a base fluid, supplemented with nanoparticles of Titanium Dioxide (TiO2) and Gold (Au). Nanoparticles could change the thermal and rheological properties of blood which might be particularly advantageous for ensuring smoother flow or optimal distribution of drug molecules within the bloodstream. In the present work, a porous channel is considered with parallel walls that exhibit varying permeability on boundaries. Such a design enables the nanoblood to enter and exit the channel, mimicking certain natural processes like transvascular fluid exchange. Additionally, the variable height of the channel that expands and squeezes uniformly could be reminiscent of the pulsatile nature of blood flow seen in our arteries due to heartbeats. To understand the dynamics of this hybrid nanoblood flow, the governing equations are converted into a set of nonlinear ordinary differential equations using the similarity transformation approach. For solving these transformed equations, the research harnesses the BVP4C built-in function in MATLAB software. Through this computational approach, the research provides insights into the velocity and temperature profile of the fluid, the distribution of normal pressure, wall shear stress, and the Nusselt number concerning various parameters. The findings of the present study can be significant and useful in biological sciences and technologies and the detailed results are presented completely in the article’s body. [ABSTRACT FROM AUTHOR]

Transradial Access (TRA) is the suggested method when performing coronary procedures. TRA has several advantages over the transfemoral approach, but also some restrictions. The present study compared the efficacy and safety of the traditional proximal transradial approach (pTRA) with a newer technique known as the distal transradial approach (dTRA) for performing a coronary angiography (CAG) and percutaneous coronary intervention (PCI). Patients (n = 700) were placed into one of two categories (dTRA or pTRA) based on a random technique. The primary endpoint was RAO at follow-up. The secondary endpoints included the time required for sheath insertion, the rate of successful sheath insertion, rate of successful completion of CAG and PCI, total procedure time, total fluoroscopy time, total radiation dose, total contrast volume used, pain perception (visual analog scale 0–10), and hemostasis duration. dTRA patients had more skin punctures, failed punctures, failed wiring, overlap of access sites, sheath insertion time, and pain evaluation scale, while the pTRA group had more hemostasis time and first-time cannulation. RAO and pseudoaneurysm (PseA) were lower in the dTRA group. In this randomized study, dTRA had lower RAO and PseA than pTRA. However, multicenter, larger-patient trials are needed to provide definitive evidence. [ABSTRACT FROM AUTHOR]

Regarding the studied species, the literature has shown a variety of topographic, origin and distribution differences of the arterial supply compared to mammals, although they are not fully identified. The aim of this article is the macroscopical study of the arterial supply of the digestive tract of Gallus domesticus. The biological material was represented by 12 adult chicken bodies with an average weight of 2 kg. After procurement of the biological material, the feathers, skin, muscles and sternum were removed for easy access to the heart. After left ventricular cannulation, epoxy resin mixed with red dye was injected. The body was immersed in 5% formaldehyde for 24 hours. Next, stratigraphic dissection was performed. The celiac artery erupted from the right face of the descending aorta, on a level with the junction of the esophagus and the proventriculus. It gave off the Aa. esophageales, A. proventricularis dorsalis, then bifurcated into left and right branches. The left branch of the celiac artery gave off A. proventricularis ventralis and A. gastrica ventralis then continued with the A. gastrica sinistra. [ABSTRACT FROM AUTHOR]

Background/Objectives: Aneurysms and dissections of the iliac artery (ADIAs) are significant vascular conditions often associated with aortic pathologies. Despite their importance, reports on isolated iliac artery pathologies are rare. This study aimed to investigate the epidemiology of ADIA in Switzerland including treatment incidence and hospital outcomes. Methods: A retrospective analysis of diagnosis-related group (DRG) statistics from 2011 to 2018 in Switzerland was conducted, identifying all cases of ADIA while excluding those with concomitant treatment of aortic pathologies. Age-standardized incidence rates and treatment outcomes were assessed, with multivariable logistic regression performed to identify factors associated with hospital mortality. Results: From 2011 to 2018, 1037 ADIA cases were hospitalized in Switzerland. Incidence rates for elective treatment were significantly higher in men than women, increasing in men from 1.5 to 2.4 cases per 100,000 men (p = 0.007), while remaining stable in women at around 0.2 cases per 100,000 women. Acute treatment incidence rates were lower but still higher in men, at 0.9 cases per 100,000 men and 0.2 cases per 100,000 women. Crude hospital mortality rates were lower for endovascular repair than open surgical repair in both elective (0.8% vs. 3.1%, p = 0.023) and emergency treatment (6.7% vs. 18.4%, p = 0.045). Multivariable analysis showed that endovascular repair was associated with significantly reduced hospital mortality compared to open repair (OR 0.27, 95%-CI: 0.10 to 0.66, p = 0.006). Conclusions: This nationwide study of iliac artery pathologies shows that the treatment incidence was about 10 times higher in men than in women for elective procedures, but only about five times higher for emergency treatment. Endovascular procedures were associated with significantly lower hospital mortality than open procedures, while hospital mortality rates were comparable for men and women. [ABSTRACT FROM AUTHOR]

The occurrence of variations in human arterial branching of the upper limb has been commonly reported in peer-reviewed literature. However, the variability of upper limb arterial patterns may be underappreciated in medical practice, which can result in clinical and surgical errors. Here we report a case of a rare, unilateral arterial variation of the left upper limb of a 76-year-old Caucasian male cadaver, discovered during a routine educational dissection. Observed characteristics of the variation include a high brachial artery bifurcation into a superficial brachioulnoradial artery and brachial artery continuing as the interosseous artery and then a bifurcation of the superficial brachioulnoradial artery into a superficial radial and a superficial ulnar artery, which eventually contribute to the formation of the superficial palmar arch. The anatomical characteristics, prevalence, embryological origin, and clinical significance of the variation are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery disease (CAD) is a major and multifaceted health problem but also the first cause of death in modern Western societies. Furthermore, myocardial infarction (MI) constitutes a challenge for analysis in the field of molecular mechanisms, early diagnosis and therapeutic approaches, as its incidence increases every year worldwide. Concerning the histopathological diagnosis in the corresponding cases, a variety of immunohistochemistry (IHC) markers and methods are available to support conventional histology diagnosis. Immunohistochemistry techniques are effective for use in forensic pathology, expanding the limits of differential diagnoses in borderline cases, as they can be applied to tissue samples fixed in formalin and embedded in paraffin. Objective: The purpose of the current review was to explore the role of connexin 43 (gene locus: 6q22.31) as a reliable biomarker of myocardial disease/infarction and its impact on MI pathology. Material and method: A systematic review of the literature was carried out based on the international database PubMed. The majority of medical data referred to articles published after the year 2020, whereas specific references of great importance and value were also included. The following keywords were used: coronary, artery, myocardial, infarction, connexin and immunohistochemistry. Results: A pool of 38 significant articles focused on the mechanisms and novel experimental biomarkers was selected for the present study at the basis of combining molecular knowledge with new clinical features in CAD, and MI histodiagnosis. Conclusions: The role of connexin 43 -- as a significant gap junction intermediate protein -- in MI pathology, clinical symptoms and prognosis is critical because its dysfunction is involved in myocardial conduction and the onset of ventricular arrhythmias due to a crucial interruption of the intra-cardiomyocyte's conjunction. [ABSTRACT FROM AUTHOR]

Background: Arterial punctures are a common procedure used to obtain blood samples for lab tests that guide treatment of neonatal patients. These punctures can be painful and have associated risks, emphasizing the importance of keeping attempts to a minimum. Purpose: The purpose of this quality improvement initiative was to determine whether using transillumination to visualize arteries before and while obtaining a blood sample would improve outcomes in neonatal patients. Methods: Quantitative data were collected pre- and postimplementation of education for the use of a transillumination device for arterial punctures on neonates in a level III neonatal intensive care unit (NICU). Outcomes followed included the success rate, average time to obtain a blood sample, and the average number of sticks to obtain a blood sample. Data were collected on 47 blood draw attempts in the control group (preimplementation) and 19 blood draw attempts in the experimental group (postimplementation). Results: A statistical analysis concluded that the use of the studied transillumination device does positively affect the incidence of successful blood draws, particularly for the novice NICU nurse. In addition, the average number of sticks to obtain a blood sample significantly decreased in the experimental group. Finally, the average time to obtain a blood sample using the device was not impacted in this study. Implications for Practice and Research: Use of a transillumination device does appear to result in improved outcomes for arterial punctures in neonatal patients. More research is needed to confirm these findings due to the small sample size of the study. [ABSTRACT FROM AUTHOR]

The Scimitar-horned Oryx (Oryx dammah) is a large terrestrial mammal native to Africa. Since the year 2000, it is classified as extinct in the wild. It is a subject of various conservation projects. The aim of this study was to describe the arterial vascularization of the brain in this species of oryx. Three different anatomical methods were used to obtain a complete arterial pattern - latex injection, corrosion cast, and computed tomography. The arterial vascularization of the brain was described. The main components of the cerebral arterial circle were the rostral cerebral arteries and the caudal communicating arteries. These vessels were created from the intracranial part of the internal carotid artery, that emerged from the rostral epidural rete mirabile. In the juvenile specimen, the whole internal carotid artery was observed. The anatomical pathways of the blood supply to the brain are important during medical procedures in cases of congestion and fainting caused by inadequate brain blood perfusion. [ABSTRACT FROM AUTHOR]

The common pheasant has been the subject of scientific research, although it has not yet been analysed as thoroughly as other domestic birds. It has spread to many parts of the world and adapted to diverse environments. A study was conducted on 30 carcasses of female common pheasants. The aim of the study was a comparative analysis of the anatomy of vessels supplying the digestive system of the pheasant. The anatomical study of the arteries revealed that the celiac artery originates from the right part of the descending aorta. Its branches include the proventriculus artery, which supplies blood to the proventriculus and oesophagus and also supplies the spleen, the duodenum, and the initial segment of the large intestine. Both the left and right branches of the celiac artery give off numerous branches that reach different areas of the intestines and stomach, forming a complex network of vessels. The cranial mesenteric artery is a crucial vessel supplying the small and large intestines, while the caudal mesenteric artery supplies the final segment of the large intestine and cloaca. Additionally, the pudendal arteries are responsible for the vascularization of the cloaca and surrounding structures in this species. These detailed anatomical observations are important for understanding blood circulation in pheasants. [ABSTRACT FROM AUTHOR]

Objectives: COVID-19 associated arterial thrombosis has been attributed to multiple inflammation and coagulation mechanisms. The aim of this study was to report the experience of a tertiary center on COVID-19 patients managed for acute peripheral arterial thrombosis. Methods: A single-center case series was conducted, including retrospectively collected data from all COVID-19 patients presenting arterial thrombosis, from March 2020 to February 2022. Intensive care unit (ICU) and non-ICU cases were included. The primary outcomes were mortality, successful revascularization, and amputation at 30 days. Results: Twenty patients presented peripheral arterial thrombosis (90% males, mean age 65 years (16–82 years)). Eighteen were diagnosed with the Delta variant and none was previously vaccinated. All cases presented acute lower limb ischemia; in 20% with bilateral involvement. Nine patients were hospitalized in the ward while 11 in the ICU. From the non-ICU cases, five presented Rutherford IIb and four cases, Rutherford's IIa ischemia. Six cases underwent revascularization (67%). Two of them were finally amputated (33%) and two died during hospitalization (33%). Two revascularizations were considered successful (33%). The ICU group presented mainly with Rutherford's III ischemia (54.5%). The mortality in the ICU cohort was 72.7%. Only one patient underwent successful revascularization and two were amputated in this subgroup. Early mortality was 50% for the total cohort while the type of management was not related to mortality. Conclusions: Covid-19 related arterial thrombosis in non-vaccinated population is associated with 50% early mortality; increased up to 72% in the ICU patients. The amputation rate was 20% while only 40% of the revascularizations were considered successful. [ABSTRACT FROM AUTHOR]

Background: The lung is a respiratory organ in which steady development begins during the embryonic period at 0–7 weeks’ gestation and continues into early childhood. Cardiothoracic surgeries and procedures such as lobectomy, segmental resection of bronchoscopy, require a thorough knowledge of the anatomy of the lung. Study of length, fissures and lobes of the lung can guide the surgeons for the above procedures and help them to prevent undue complications during surgery. Many variations are noted by researchers till date in both the lungs in regards to length, breadth, fissures, and lobes. In the current study, we have also observed variations in fissures of lung. Aims and Objectives: To study the normal length, breadth, and thickness of both sides of lungs, variations in the length, breadth, and thickness of both sides of the lungs. To study the normal fissures, lobes and their variations, of both right and left lungs, and also to study the number of bronchi, pulmonary artery, and pulmonary vein. Materials and Methods: 50 Right and 50 left lungs were obtained from embalmed cadavers, used for dissection in the Department of Anatomy, King George’s Medical University, Lucknow, UP, by using measuring tape and measuring scale. Photography was done by a DSLR camera. Results: The left lung shows maximum variations in the hilum. Out of 50 left lungs, 6 showed the absence of oblique fissures, 2 lungs had 2 arteries, 2 lungs had 2 Veins, and 1 had 2 bronchi. Out of 50 right lungs, 2 lungs showed 2 arteries, 2 lungs had 2 veins, and 2 had 3 bronchi. Conclusion: Knowledge of normal measurements of both sides of the lungs and their variations may help cardiothoracic surgeons avoid complications during surgery and it may help radiologists resolve uncertain radiographic findings.

Central retinal artery occlusion(CRAO)refers to occlusion of the central retinal artery(CRA), which acts as the primary blood supply to the inner neurosensory retina, and leads to an acute loss of vision and permanent visual disability. The natural history of visual prognosis in CRAO is generally poor. Despite a variety of treatment options have been studied, such as ocular massage, anterior chamber paracentesis, hyperbaric oxygen therapy(HBOT)and intra-arterial infusion of tissue plasminogen activator(tPA), but there is currently no evidence-based management strategies for the treatment of CRAO. Furthermore, the efficacy of all available managements is debatable and many have uncertain risks. This review will offer a summary of the currently known treatment options for CRAO and probe into their safety and efficacy on the prognosis of CRAO.

Abstract Objectives Computed tomographic perfusion (CTP) can play an auxiliary role in the selection of patients with acute ischemic stroke for endovascular treatment. However, data on CTP in non-stroke patients with intracranial arterial stenosis are scarce. We aimed to investigate images in patients with asymptomatic intracranial arterial stenosis to determine the detection accuracy and interpretation time of large/medium-artery stenosis or occlusion when combining computed tomographic angiography (CTA) and CTP images. Methods We retrospectively reviewed 39 patients with asymptomatic intracranial arterial stenosis from our hospital database from January 2021 to August 2023 who underwent head CTP, head CTA, and digital subtraction angiography (DSA). Head CTA images were generated from the CTP data, and the diagnostic performance for each artery was assessed. Two readers independently interpreted the CTA images before and after CTP, and the results were analyzed. Results After adding CTP maps, the accuracy (area under the curve) of diagnosing internal carotid artery (R1: 0.847 vs. 0.907, R2: 0.776 vs. 0.887), middle cerebral artery (R1: 0.934 vs. 0.933, R2: 0.927 vs. 0.981), anterior cerebral artery (R1: 0.625 vs. 0.750, R2: 0.609 vs. 0.750), vertebral artery (R1: 0.743 vs. 0.764, R2: 0.748 vs. 0.846), and posterior cerebral artery (R1: 0.390 vs. 0.575, R2: 0.390 vs. 0.585) occlusions increased for both readers (p

Abstract Background The most prevalent cyanotic congenital heart disease is Tetralogy of Fallot (TOF). It has a variety of presentations and is made up of four anatomic abnormalities. Documented literature shows an incidence of 13–20% of a right aortic arch with an anomalous left subclavian artery among individuals diagnosed with TOF. This is the first case that discusses the rare occurrence of overriding of the aortic arch along with the left aberrant subclavian artery and vertebral defect in a 3-week-old girl. Timely identification and management are pivotal in ensuring the best possible outcomes for these young patients. Case presentation A 3-week-old female child came with complaints of dyspnea, dysphagia, fatigue, and cyanosis on extreme crying, feeding, and moderate activity. Echocardiography revealed severe pulmonary stenosis with right ventricular dilatation and ventricular septal defect (VSD); a chest computed tomography was performed that revealed four characteristic features of TOF (pulmonary artery stenosis, VSD, right aortic root deviation, and concentric right ventricular hypertrophy) along with overriding of the aortic arch accompanied with the left aberrant subclavian artery (compressing the trachea and infundibulum) and vertebral defect (butterfly vertebra). Conclusions The case of this 3-week-old female infant emphasizes the importance of early and accurate diagnosis in congenital heart diseases, particularly when faced with complex presentations such as the TOF. It serves as a testament to the valuable role of advanced diagnostic imaging techniques in unraveling the complexity of congenital heart conditions.

In this article, we review previous studies of modeling problems for blood flow with or without transport of a solute in a section of arterial blood flow and in the presence of atherosclerosis. Moreover, we review problems of bio-fluid dynamics within the field of biophysics. In most modeling cases, the presence of red blood cells in the plasma is taken into account either by using a two-phase flow approach, where blood plasma is considered as one phase and red blood cells are counted as another phase, or by using a variable viscosity formula that accounts for the amount of hematocrit within the blood. Both analytical and computational methods were implemented to solve the governing equations for blood flow in the presence of solute transport, which, depending on the type of the investigated problem, could contain momentum, mass conservation, and solute concentration, which were mostly subjected to reasonable approximations. The form of atherosclerosis implemented in the modeling system either was either based on the experimental data for an actual human or was due to a reasonable mathematical modeling for both steady and unsteady atherosclerosis cases. For the wall of the artery itself, which is elastic in nature, modeling equations for the displacement of the artery wall has previously been used, even though their effects on the blood flow inside the artery were shown to be rather small. In some cases, thermal effects were also taken into account by including a temperature equation in the investigation. In the case of the presence of solutes in the blood, various blood flow parameters such as blood pressure force, blood speed, and solute transport were mostly determined or approximated for different values of the parameters that could represent hematocrit, solute diffusion, atherosclerosis height, solute reaction, and pulse frequency. In some studies, available experimental results and data were used in the modeling system that resulted in a more realistic outcome for the blood flow parameters, such as blood pressure force and blood flow resistance. Results have been found for variations of blood flow parameters and solute transport when compared to different values of the parameters. Effects that can increase or decrease the blood flow parameters and solute transport in the artery have mostly been determined, with particular applications for further understanding efforts to improve the patients' health care.

Bronchiectasis, one of the most neglected chronic lung conditions, has a high individual disease burden and economic cost and causes poor quality of life in children/adolescents and adults. Advances in image quality and a dramatic reduction in acquisition times, multiple high-resolution chest tomography (HRCT) acquisitions, and reconstructions of the lung have resulted in accurate categorization and determination of the extent of lung parenchyma and airway abnormality. For bronchiectasis, the diagnosis is confirmed using the key feature of abnormally increased broncho-arterial (B.A.) ratio (BAR), with or without other abnormalities, e.g., bronchial wall thickening, lack of bronchial tapering, and mucus plugging. Most of these features require shape analysis of the airway and artery regions to perform various assessments that can have inter-rater variability and are time-consuming. This challenge is amplified in pediatric patients due to age-related anatomical variations. The anatomical differences and variations in airway structures between Infants, Early Childhood, and middle Childhood can impact how the images can be processed and analyzed. To address this, we proposed two novel image-processing methods to detect and measure the B.A. pairs. The first method uses an optimized connected component labelling (CCL) algorithm to construct bounding boxes around the objects (airway, artery) and extract the regions of interest (ROIs) for potential B.A. pairs. The second method allows us to calculate 4 or 6 diameters for each object in the ROIs and use their mean value as the final diameter, demonstrating agreement with manual readings. Evaluating against a diverse set of HRCT scans from various categories validates the significance and practical utility of our proposed methods in detecting and measuring the disjointed B.A. pairs to assess increased BAR.

Background: The lung is a respiratory organ in which steady development begins during the embryonic period at 0–7 weeks’ gestation and continues into early childhood. Cardiothoracic surgeries and procedures such as lobectomy, segmental resection of bronchoscopy, require a thorough knowledge of the anatomy of the lung. Study of length, fissures and lobes of the lung can guide the surgeons for the above procedures and help them to prevent undue complications during surgery. Many variations are noted by researchers till date in both the lungs in regards to length, breadth, fissures, and lobes. In the current study, we have also observed variations in fissures of lung. Aims and Objectives: To study the normal length, breadth, and thickness of both sides of lungs, variations in the length, breadth, and thickness of both sides of the lungs. To study the normal fissures, lobes and their variations, of both right and left lungs, and also to study the number of bronchi, pulmonary artery, and pulmonary vein. Materials and Methods: 50 Right and 50 left lungs were obtained from embalmed cadavers, used for dissection in the Department of Anatomy, King George’s Medical University, Lucknow, UP, by using measuring tape and measuring scale. Photography was done by a DSLR camera. Results: The left lung shows maximum variations in the hilum. Out of 50 left lungs, 6 showed the absence of oblique fissures, 2 lungs had 2 arteries, 2 lungs had 2 Veins, and 1 had 2 bronchi. Out of 50 right lungs, 2 lungs showed 2 arteries, 2 lungs had 2 veins, and 2 had 3 bronchi. Conclusion: Knowledge of normal measurements of both sides of the lungs and their variations may help cardiothoracic surgeons avoid complications during surgery and it may help radiologists resolve uncertain radiographic findings. [ABSTRACT FROM AUTHOR]

AbstractDuring robot-assisted reduction of pelvic fracture, blood vessels are susceptible to tensile and shear forces, making them prone to injury. Considering the impact of pelvic reduction on the risk of arterial injury, the biomechanical characteristics of arteries during the pelvic fracture reduction process are studied, and a refined coupled composite model of the damaged pelvic structure is established. Dynamic simulations of pelvic fracture reduction are conducted based on the planned reduction path. The simulation results show that during the reduction process, when the affected side is rotated, the stress and strain of the artery are maximum, particularly at the locations of the iliac common artery, internal iliac artery, and the superior gluteal artery arch endure significant stress and strain. After reduction, the maximum stress is observed in the right superior gluteal artery, and the maximum strain occurs at the intersection of the right iliac common artery. The stretch ratio of both the left and right iliac common arteries is considerable. Therefore, it can be concluded that the superior gluteal artery and the internal iliac artery are prone to injury, particularly the segment from the origin of the superior gluteal artery to its passage around the greater sciatic notch. After reduction, substantial traction on the iliac common artery, which makes it more susceptible to deformation, carries a risk of arterial rupture and aneurysm formation. This study provides a reference for planning the safe reduction path of pelvic fracture surgery and improving safety. [ABSTRACT FROM AUTHOR]

Background: The most prevalent cyanotic congenital heart disease is Tetralogy of Fallot (TOF). It has a variety of presentations and is made up of four anatomic abnormalities. Documented literature shows an incidence of 13–20% of a right aortic arch with an anomalous left subclavian artery among individuals diagnosed with TOF. This is the first case that discusses the rare occurrence of overriding of the aortic arch along with the left aberrant subclavian artery and vertebral defect in a 3-week-old girl. Timely identification and management are pivotal in ensuring the best possible outcomes for these young patients. Case presentation: A 3-week-old female child came with complaints of dyspnea, dysphagia, fatigue, and cyanosis on extreme crying, feeding, and moderate activity. Echocardiography revealed severe pulmonary stenosis with right ventricular dilatation and ventricular septal defect (VSD); a chest computed tomography was performed that revealed four characteristic features of TOF (pulmonary artery stenosis, VSD, right aortic root deviation, and concentric right ventricular hypertrophy) along with overriding of the aortic arch accompanied with the left aberrant subclavian artery (compressing the trachea and infundibulum) and vertebral defect (butterfly vertebra). Conclusions: The case of this 3-week-old female infant emphasizes the importance of early and accurate diagnosis in congenital heart diseases, particularly when faced with complex presentations such as the TOF. It serves as a testament to the valuable role of advanced diagnostic imaging techniques in unraveling the complexity of congenital heart conditions. [ABSTRACT FROM AUTHOR]

An otherwise healthy 9-month-old infant was treated for a true aneurysm of the proximal brachial artery. The swelling was first noted at seven months of age. An ultrasound scan showed a 2 cm × 2 cm aneurysm of the left brachial artery at the level of the mid-upper arm. Whole-body magnetic resonance angiography (MRA) confirmed this was a true aneurysm of the brachial artery; there was good distal runoff and no other aneurysms elsewhere. Vasculitis screen was negative. Surgical excision of the aneurysm and reconstruction of the brachial artery was performed with a reversed cephalic vein graft. The patient made an uneventful recovery and was discharged home. We present an overview of the workup report and emphasise that a multi-disciplinary team approach is imperative for assessing and managing this rare condition. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the differences in FDG accumulation in arteries throughout the body between digital and standard PET/CT. Methods: Forty-six people who had FDG-PET examinations with a digital PET/CT scanner for health screening between April 2020 and March 2021 and had previous examinations with a standard PET/CT scanner were the study participants. FDG accumulation in arteries throughout the body was visually assessed in each segment. Scan was considered positive when arterial FDG accumulation was equal to or greater than that of the liver. The positivity rates for general arteries and each arterial segment were compared between the two kinds of scanners. If any one of the arterial segments was considered positive, the general arteries were classified as positive. Moreover, the rate of change in results from the standard PET/CT to the digital scanner in the same individual (negative to positive, positive to negative) was examined. Results: In the evaluation of general arteries, the positivity rates were 21.7% (10 cases) for the standard PET/CT, whereas positive rates were 97.8% (45 cases) for the digital PET/CT (p < 0.001). In all arterial segments, the positivity rate was significantly higher with the digital PET/CT compared to the standard PET/CT; those with the digital PET/CT were, respectively, 95.7%, 87.0%, 73.9%, 37.0%, 34.8%, and 21.7% in the femoral, brachial, aortic, subclavian, iliac, and carotid arteries. On the other hand, those with the standard PET/CT were 13.0%, 13.0%, 19.6%, 2.2%, 0%, and 4.4% in segments in the above order. Changes from negative to positive were shown in many cases; 35 cases (76.0%) of general arteries, 38 cases (82.6%) for the femoral artery, and 34 cases (73.9%) for the brachial artery. The exception was one case in which a change from positive to negative was confirmed in the carotid artery. In all arteries considered to be positive, FDG accumulation was not greater than but was equal to that in the liver with both scanners. Conclusions: Arterial FDG accumulation was significantly higher with digital PET/CT compared to conventional PET/CT. With digital PET/CT, an arterial FDG accumulation equal to the liver may not to be considered as abnormal accumulation. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the actions of advanced glycated end‐products (AGE), their receptors (RAGE), and NAD(P)H oxidase (Nox) subtypes 1, 2, and 4 on mechanisms of endothelium‐dependent dilation of the rat cremaster muscle artery (CMA). Methods: Immunofluorescence studies were used to examine expression of RAGE in rat arteries. ROS accumulation was measured using luminescence and fluorescence assays. Functional studies were performed using pressure myography. Results: High levels of RAGE expression were shown in the endothelial cells of the CMA, compared with low endothelial expression in middle cerebral and mesenteric arteries and the aorta. Exogenous AGE (in vitro glycated bovine serum albumin) stimulated H2O2 accumulation in CMA, which was prevented by the RAGE antagonist FPS‐ZM1, the NAD(P)H oxidase (Nox) inhibitor apocynin and inhibited by the Nox1/4 inhibitor setanaxib, but not the Nox2 inhibitor GSK2795039. In functional studies, AGE inhibited vasodilation of CMA stimulated by acetylcholine, sodium nitroprusside, and the BKCa activator NS1619, but not adenosine‐induced dilation. FPS‐ZM1, apocynin, and setanaxib prevented the inhibitory effects of AGE on responses to acetylcholine and NS‐1619. Conclusion: These observations suggest RAGE are constitutively expressed in the endothelium of the rat CMA and may be activated by AGE to stimulate Nox1/4 and ROS formation with resulting inhibition of NO and BKCa‐mediated endothelium‐dependent dilation. [ABSTRACT FROM AUTHOR]

In this article, we review previous studies of modeling problems for blood flow with or without transport of a solute in a section of arterial blood flow and in the presence of atherosclerosis. Moreover, we review problems of bio-fluid dynamics within the field of biophysics. In most modeling cases, the presence of red blood cells in the plasma is taken into account either by using a two-phase flow approach, where blood plasma is considered as one phase and red blood cells are counted as another phase, or by using a variable viscosity formula that accounts for the amount of hematocrit within the blood. Both analytical and computational methods were implemented to solve the governing equations for blood flow in the presence of solute transport, which, depending on the type of the investigated problem, could contain momentum, mass conservation, and solute concentration, which were mostly subjected to reasonable approximations. The form of atherosclerosis implemented in the modeling system either was either based on the experimental data for an actual human or was due to a reasonable mathematical modeling for both steady and unsteady atherosclerosis cases. For the wall of the artery itself, which is elastic in nature, modeling equations for the displacement of the artery wall has previously been used, even though their effects on the blood flow inside the artery were shown to be rather small. In some cases, thermal effects were also taken into account by including a temperature equation in the investigation. In the case of the presence of solutes in the blood, various blood flow parameters such as blood pressure force, blood speed, and solute transport were mostly determined or approximated for different values of the parameters that could represent hematocrit, solute diffusion, atherosclerosis height, solute reaction, and pulse frequency. In some studies, available experimental results and data were used in the modeling system that resulted in a more realistic outcome for the blood flow parameters, such as blood pressure force and blood flow resistance. Results have been found for variations of blood flow parameters and solute transport when compared to different values of the parameters. Effects that can increase or decrease the blood flow parameters and solute transport in the artery have mostly been determined, with particular applications for further understanding efforts to improve the patients' health care. [ABSTRACT FROM AUTHOR]

Activity of many proteins and hence of the mechanisms of vascular tone regulation depend on medium acidity. A decrease of pH (in uncompensated acidosis) typically causes vasorelaxation of blood vessels, which is studied in sufficient detail in an adult organism. However, the effect of acidosis on the mechanisms of vascular tone regulation in the early postnatal period remains almost completely unexplored. The aim of this work was to study the effect of extracellular metabolic acidosis on the functional contribution of KATP and TASK-1 potassium channels to vascular tone regulation in the early postnatal period. We modeled uncompensated extracellular metabolic acidosis (pH 6.8, equimolar NaHCO3 substitution in a solution for NaCl) and studied isometric contractile responses of the saphenous artery in adult rats aged 3–4 months and rat pups aged 12–15 days. Arterial contraction to the α1-adrenergic agonist methoxamine at pH 6.8 was reduced compared to normal pH 7.4 in both 3–4-month- and 12–15-day-old rats. The KATP channel blocker glibenclamide did not alter arterial responses to methoxamine at either pH 7.4 or pH 6.8 in both age groups. The TASK-1 channel blocker AVE1231 did not alter arterial contractile responses at any pH in 3–4-month-old rats. However, in 12–15-day-old rat pups, the AVE1231-induced increase in contractile responses to methoxamine was less at pH 6.8 than at pH 7.4. Thus, acidosis reduces arterial contractile activity in both 3–4-month-old rats and animals in early postnatal ontogenesis, while in the latter, the anticontractile role of TASK-1 channels decreases, and KATP channels do not affect vascular tone regulation at either normal or acidic pH values in any of the age groups. [ABSTRACT FROM AUTHOR]

Infants with congenital diaphragmatic hernia (CDH) often develop pulmonary hypertension but frequently fail to respond to vasodilator therapy, for instance because of an altered pulmonary vasoreactivity. Investigating such alterations in vivo is impossible. We hypothesised that these alterations are also present in fetoplacental vessels, since both vasculatures are exposed to the same circulating factors (e.g. endothelin-1) and respond similarly to certain stimuli (e.g. hypoxia). As proof-of-concept, we compared fetoplacental vasoreactivity between healthy and CDH-affected placentas. Fetoplacental vascular function of healthy and antenatally diagnosed left-sided CDH fetuses was assessed by wire myography. Placental expression of enzymes and receptors involved in the altered vasoreactive pathways was measured using quantitative PCR. CDH arteries (n = 6) constricted more strongly to thromboxane A2 agonist U46619 (p < 0.001) and dilated less to bradykinin (p = 0.01) and nitric oxide (NO)-donor sodium nitroprusside (p = 0.04) than healthy arteries (n = 8). Vasodilation to prostacyclin analogue iloprost and adenylate cyclase stimulator forskolin, and vasoconstriction to endothelin-1 were not different between both groups. Angiotensin II did not induce vasoconstriction. Phosphodiesterase inhibitors sildenafil and milrinone did not affect responses to sodium nitroprusside, forskolin, or U46619. The mRNA expression of guanylate cyclase 1 soluble subunit alpha 1 (p = 0.003) and protein kinase cyclic guanine monophosphate (cGMP)-dependent 1 (p = 0.02) were reduced in CDH versus healthy placentas. The identified changes in the thromboxane and NO-cGMP pathways in the fetoplacental vasculature correspond with currently described alterations in the pulmonary vasculature in CDH. Therefore, fetoplacental arteries may provide an opportunity to predict pulmonary therapeutic responses in infants with CDH. • Fetoplacental vasoreactivity is altered in congenital diaphragmatic hernia (CDH). • Vasoconstriction through the thromboxane A2 receptor is enhanced in CDH placentas. • CDH fetoplacental arteries show less vasodilation through the NO–cGMP pathway. • Fetoplacental alterations correspond with known pulmonary alterations in CDH. • CDH placentas exhibit reduced gene expression of GUCY1A1 and PRKG1. [ABSTRACT FROM AUTHOR]

Background: The internal and external carotid arterial systems are generally separate regarding branching patterns. However, these two systems do form collateral circulations with their terminal parts. On rare occasions, branches that belong to one arterial system may arise from the other. Case Description: We present a rare variant of a middle meningeal artery, generally derived from the external carotid artery, arising from the internal carotid artery and entering the floor of the middle cranial fossa by traveling through a small unnamed foramen. This anatomy and embryology and other variants of the middle meningeal and petrous carotid systems are discussed. Conclusion: Embryologically, this variant anatomy signifies an atypical regression of the distal stapedial artery and its connection to the external carotid artery. Surgeons who operate on the skull base, vascular interventionalists, and radiologists should be aware of this potential anatomical variation of the skull base. [ABSTRACT FROM AUTHOR]

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Calcific aortic valve disease (CAVD) and coronary artery disease (CAD) are related cardiovascular diseases in which common mechanisms lead to tissue calcification. Oxidative stress plays a key role in these diseases and there is also evidence that the redox state of serum albumin exerts a significant influence on these conditions. To further explore this issue, we used multimarker scores (OxyScore and AntioxyScore) to assess the global oxidative status in patients with CAVD, with and without CAD, also evaluating their plasma thiol levels. In addition, valvular interstitial cells were treated with reduced, oxidized, and native albumin to study how this protein and its modifications affect cell calcification. The differences we found suggest that oxidative status is distinct in CAVD and CAD, with differences in redox markers and thiol levels. Importantly, the in vitro interstitial cell model revealed that modified albumin affects cell calcification, accelerating this process. Hence, we show here the importance of the redox system in the development of CAVD, emphasizing the relevance of multimarker scores, while also offering evidence of how the redox state of albumin influences vascular calcification. These data highlight the relevance of understanding the overall redox processes involved in these diseases, opening the door to new studies on antioxidants as potential therapies for these patients. [ABSTRACT FROM AUTHOR]

Segmental arterial mediolysis (SAM) is an asymptomatic, non-atherosclerotic and noninflammatory disease of unknown etiology. It affects medium-sized arteries and is characterized by vacuolization and lysis at the level of the media which can lead to dissection, steno-occlusion, or an aneurysm. In this article, a simulation of fluid-structure interaction in an artery altered by segmental mediolysis was reported. The study showed that the reduction in elasticity of the media layer of the artery due to the deterioration of collagen has little influence on the velocity field, the pressure field as well as on the deformations of the artery, thus conferring a silent and asymptomatic character to the pathology. The Von-Mises stress is very high at the level of the intima which can lead to arterial dissection with the appearance of a false channel. An increase in the Von-Mises stress of around 375 % was predicted by the COMSOL code. The combined effect of mediolysis and the increase in blood pressure causes increases in the Von-Mises stress at the level of the intima and the adventitia which are respectively 6.10 and 4.62 times greater than those of the healthy artery, which demonstrates that hypertension could be a determining factor in triggering arterial dissection. [ABSTRACT FROM AUTHOR]

Purpose: To increase the number of images that can be acquired in MR examinations using quantitative parameters, we developed a method for obtaining arterial and venous images with mapping of proton density (PD), RF inhomogeneity (B1), longitudinal relaxation time (T1), apparent transverse relaxation time (T2*), and magnetic susceptibility through calculation, all with the same spatial resolution. Methods: The proposed method uses partially RF-spoiled gradient echo sequences to obtain 3D images of a subject with multiple scan parameters. The PD, B1, T1, T2*, and magnetic susceptibility maps are estimated using the quantification method we previously developed. Arterial images are obtained by adding images using optimized weights to emphasize the arteries. A morphology filter is used to obtain venous images from the magnetic susceptibility maps. For evaluation, images obtained from four out of five healthy volunteers were used to optimize the weights used in the arterial-image calculation, and the optimized weights were applied to the images from the fifth volunteer to obtain an arterial image. Arterial images of the five volunteers were calculated using the leave-one-out method, and the contrast between the arterial and background regions defined using the reference time-of-flight (TOF) method was evaluated using the area under the receiver operation characteristic curve (AUC). The contrast between venous and background regions defined by a reference quantitative susceptibility mapping (QSM) method was also evaluated for the venous image. Results: The AUC to discriminate blood vessels and background using the proposed method was 0.905 for the arterial image and 0.920 for the venous image. Conclusion: The results indicate that the arterial images and venous images have high signal intensity at the same region as determined from the reference TOF and QSM methods, demonstrating the possibility of acquiring vasculature images with quantitative parameter mapping through calculation in an integrated manner. [ABSTRACT FROM AUTHOR]

El síndrome del martillo hipotenar es una patología vascular poco frecuente que produce una degeneración aneurismática de la arteria cubital a su paso por el canal de Guyon. Se suele dar en trabajadores expuestos a microtraumatismos de repetición en eminencia hipotenar; por ello, algunos autores lo consideran una enfermedad profesional. La clínica varía según el tamaño del aneurisma y la inestabilidad de su contenido. Para el diagnóstico, es necesario realizar una adecuada anamnesis y exploración física del paciente, así como tener un elevado índice de sospecha. Su tratamiento varía desde el médico conservador hasta la cirugía reconstructiva, dependiendo de la permeabilidad y de la integridad vascular del arco palmar. Se presenta un caso clínico de varón de 67 años con aparición de tumoración pulsátil dolorosa en eminencia hipotenar tras realizar trabajos de reforma. Mediante angiorresonancia, se confirmó la sospecha clínica, y se procedió a la resección del aneurisma parcialmente trombosado con posterior reconstrucción arterial.

Peripheral artery disease (PAD) continues to increase in prevalence worldwide due to risk factors such as advanced age, diabetes mellitus, and obesity. Critical limb ischemia (CLTI) is the advanced form of PAD that can result in a lack of healing and limb loss as the most devastating consequence. Patients with PAD, especially CLTI, benefit from multidisciplinary care to optimize outcomes by reducing cardiovascular morbidity and mortality and preventing lower extremity amputation. Collaboration between various specialties allows a focus on problems involved in treating the patient with PAD including prevention, screening, medical care, wound care, infection, and revascularization when needed. Although there is no clear definition or consensus on the structure of the PAD team, certain guidelines are applicable to most clinical scenarios emphasizing “provider champions” in leading a clinical program. A vascular specialist (vascular surgery, interventional radiology, interventional cardiology) and a soft tissue specialist (podiatry, plastic surgery) are the typical “champions,” often involving orthopedics, general surgery, vascular medicine, diabetology/endocrinology, infectious disease, nephrology, and rehabilitation medicine. The team should also include wound nurses, nutritionists, occupational therapists, orthotists, pharmacists, physical therapists, prosthetists, and social workers. This paper presents a brief overview of the structure of the multidisciplinary team with key components and functions of such a team to optimize treatment outcomes for PAD and CLTI.

Stem cell research endeavors to generate specific subtypes of classically defined cell types. Here, we generate >90% pure human artery or vein endothelial cells from pluripotent stem cells within 3-4 days. We specified artery cells by inhibiting vein-specifying signals and vice versa. These cells modeled viral infection of human vasculature by Nipah and Hendra viruses, which are extraordinarily deadly (∼57%-59% fatality rate) and require biosafety-level-4 containment. Generating pure populations of artery and vein cells highlighted that Nipah and Hendra viruses preferentially infected arteries; arteries expressed higher levels of their viral-entry receptor. Virally infected artery cells fused into syncytia containing up to 23 nuclei, which rapidly died. Despite infecting arteries and occupying ∼6%-17% of their transcriptome, Nipah and Hendra largely eluded innate immune detection, minimally eliciting interferon signaling. We thus efficiently generate artery and vein cells, introduce stem-cell-based toolkits for biosafety-level-4 virology, and explore the arterial tropism and cellular effects of Nipah and Hendra viruses.

Arteria lusoria (AL) is a rare embryological variant that may have variable presentation ranging from asymptomatic to respiratory, abdominal, or both. Increasing incidence of radial access for coronary angiogram may lead to the incidental diagnosis of AL. Knowledge about this anatomical variation is essential for cardiologists, interventional radiologists, otorhinolaryngologists, cardiothoracic surgeons, and primary physicians. The symptomatic patient should undergo definite repair through either surgery or endovascular techniques. We present a case of incidentally diagnosed, asymptomatic AL along with ascending aortic aneurysm while evaluating for ischemic heart disease. [ABSTRACT FROM AUTHOR]

Continuous monitoring of artery and vein vessels in the human eye to prevent the loss of eyesight is essential in the diagnosis of diabetic retinopathy. The progression of diabetic retinopathy is echoed by the internal anatomical changes of the retina, such as changes in the artery vein ratio, formation of fake vessels, tortuosity, lesion formation, etc. Among these symptoms, calculation of the artery vein ratio is still a challenging task since the visibility of the artery and vein changes over different regions in the fundus image. The proposed Atrous Depth Concatenated neural network with the enriched encoder (EEDCFCNN) architecture for artery vein classification is based on the deep semantic segmentation architecture. The proposed architecture can achieve an improved result on the public databases DRIVE, INSPIRE, and IOSTAR. [ABSTRACT FROM AUTHOR]

Background: Understanding the anatomical structure of the human kidney, particularly its zonal and segmental organization, is crucial for both theoretical knowledge and practical applications in surgical procedures. That is why the purpose of the article was to study the variants of the zonal and segmental structure of human kidneys. Methods: 116 corrosive preparations of the arterial system of the human kidney served as the material for the study. The authors identified their extra-organ branches: a) the number of arterial vessels in the kidney hilum; b) the topographic and anatomical features of the renal artery trunks. In a 3D projection, zones of local zonal blood supply to areas of the renal parenchyma were identified, depending on the di- and trichotomic variants of the division of the main renal artery, A. renalis (I). Results: It was found that some lines of the passage of the zones of natural divisibility of the kidneys with different variants of the division of A. renalis (I). There were from 5 to 7 (6 ± 1) segments in the kidneys on average. It is possible that if a four-zone blood supply system with corresponding zones of natural kidney divisibility is found in the kidneys, where the zones mostly don’t coincide with the boundaries of the passage of segments in their classical version, the number of segments will be even greater. Conclusion: The results of the conducted study show that considering the generally accepted zones and boundaries of the passage of segments with zones of natural divisibility, which were not previously considered, the kidneys have an individual segmental structure, which requires revision. The authors believe that the generally accepted classical five-segment kidney model is outdated. [ABSTRACT FROM AUTHOR]

Small soft tissue defects of the distal tibia and hindfoot resulting from traumatic, operative, or neoplastic conditions and chronic ulcers can be successfully dealt with the use of the reverse sural artery flap (RSAF). This study aimed to know the association between the successful outcome of the flap and the selected factors.Our retrospective study included 40 patients who had soft tissue defect in the distal third of the leg, heel, ankle and dorsum of the foot. Detailed history was obtained, thorough clinical examination performed, necessary preoperative investigations done and reverse sural artery fasciocutaneous flap cover performed.All the patients selected in the study group underwent reverse sural artery flap cover in a satisfactory way. Majority of the patients were discharged with no complications and a minor group of them with minimal complications.Reverse sural artery flap is a versatile and reliable flap for the coverage of soft tissue defects of distal lower extremity. The leading independent factors which contribute to the success of the flap are trauma as the aetiology, distal third of the leg, and dorsum of the foot being the site of the defect and flap size of 24 sq. cm in comparison to the rest of the factors in the study. [ABSTRACT FROM AUTHOR]

The kidney vasculature has a complex architecture that is essential for renal function. The molecular mechanisms that direct development of kidney blood vessels are poorly characterized. We identified a regionally restricted, stroma-derived signaling molecule, netrin 1 (Ntn1), as a regulator of renal vascular patterning in mice. Stromal progenitor (SP)-specific ablation of Ntn1 (Ntn1SPKO) resulted in smaller kidneys with fewer glomeruli, as well as profound defects of the renal artery and transient blood flow disruption. Notably, Ntn1 ablation resulted in loss of arterial vascular smooth muscle cell (vSMC) coverage and in ectopic SMC deposition at the kidney surface. This was accompanied by dramatic reduction of arterial tree branching that perdured postnatally. Transcriptomic analysis of Ntn1SPKO kidneys revealed dysregulation of vSMC differentiation, including downregulation of Klf4, which we find expressed in a subset of SPs. Stromal Klf4 deletion similarly resulted in decreased smooth muscle coverage and arterial branching without, however, the disruption of renal artery patterning and perfusion seen in Ntn1SPKO. These data suggest a stromal Ntn1-Klf4 axis that regulates stromal differentiation and reinforces stromal-derived smooth muscle as a key regulator of renal blood vessel formation. [ABSTRACT FROM AUTHOR]

Vasculature within the human body is arranged in a hierarchical manner, beginning with large macrovessels that taper into smaller mesovessels, and finally into the smallest microvessels. Replicating this hierarchical vasculature within engineered tissue constructs is a critical hurdle for the clinical translation of engineered tissues and organs. A major limitation to the development of hierarchical vasculature are the distinct and diverse fabrication strategies required for creating vasculature at each scale. New advances in fabrication strategies, particularly 3D bioprinting, are enabling the engineering of a multiscale vascular hierarchy within a single 3D tissue construct. Multidisciplinary collaboration and cooperation between experts in academia, industry, and government will be essential to address this grand challenge and further propel hierarchical vasculature toward clinical and commercial success. In human vascular anatomy, blood flows from the heart to organs and tissues through a hierarchical vascular tree, comprising large arteries that branch into arterioles and further into capillaries, where gas and nutrient exchange occur. Engineering a complete, integrated vascular hierarchy with vessels large enough to suture, strong enough to withstand hemodynamic forces, and a branching structure to permit immediate perfusion of a fluidic circuit across scales would be transformative for regenerative medicine (RM), enabling the translation of engineered tissues of clinically relevant size, and perhaps whole organs. How close are we to solving this biological plumbing problem? In this review, we highlight advances in engineered vasculature at individual scales and focus on recent strategies to integrate across scales. [ABSTRACT FROM AUTHOR]

The occurrence of arterial dissection (AD) is the result of multiple factors. Wall shear force (WSS), an important initiating factor for AD, is the friction between blood flow and vessel wall. Abnormal WSS can cause pathological changes of arterial wall (intima, media, adventitia) through various mechanisms, such as endothelial cell structure and dysfunction, internal elastic lamina injury, reduction and phenotypic transformation of smooth muscle cells, extracellular matrix degradation, and eventually lead to the occurrence of AD. In order to better understand the pathogenesis of AD, this article reviews the regulatory mechanisms of pathological changes in each layer of arterial wall caused by abnormal WSS. [ABSTRACT FROM AUTHOR]

Three systemic biological systems, i.e., the nervous, the immune, and the cardiovascular systems, form a mutually responsive and forward-acting tissue network to regulate acute and chronic cardiovascular function in health and disease. Two sub-circuits within the cardiovascular system have been described, the artery brain circuit (ABC) and the heart brain circuit (HBC), forming a large cardiovascular brain circuit (CBC). Likewise, the nervous system consists of the peripheral nervous system and the central nervous system with their functional distinct sensory and effector arms. Moreover, the immune system with its constituents, i.e., the innate and the adaptive immune systems, interact with the CBC and the nervous system at multiple levels. As understanding the structure and inner workings of the CBC gains momentum, it becomes evident that further research into the CBC may lead to unprecedented classes of therapies to treat cardiovascular diseases as multiple new biologically active molecules are being discovered that likely affect cardiovascular disease progression. Here, we weigh the merits of integrating these recent observations in cardiovascular neurobiology into previous views of cardiovascular disease pathogeneses. These considerations lead us to propose the Neuroimmune Cardiovascular Circuit Hypothesis. [ABSTRACT FROM AUTHOR]