426 resultados para BRACHIAL PLEXUS


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AIM The autonomic innervation of the heart consists of sympathetic and parasympathetic nerve fibres, and fibres of the intrinsic ganglionated plexus with noradrenaline and acytylcholine as principal neurotransmitters. The fibres co-release neuropeptides to modulate intracardiac neurotransmission by specific presynaptic and postsynaptic receptors. The coexpression of angiotensin II in sympathetic fibres of the human heart and its role are not known so far. METHODS Autopsy specimens of human hearts were studied (n=3; ventricles). Using immunocytological methods, cryostat sections were stained by a murine monoclonal antibody (4B3) directed against angiotensin II and co-stained by polyclonal antibodies against tyrosine hydroxylase, a catecholaminergic marker. Visualisation of the antibodies was by confocal light microscopy or laser scanning microscopy. RESULTS Angiotensin II-positive autonomic fibres with and without a catecholaminergic cophenotype (hydroxylase-positive) were found in all parts of the human ventricles. In the epicardium, the fibres were grouped in larger bundles of up to 100 and more fibres. They followed the preformed anatomic septa and epicardial vessels towards the myocardium and endocardium where the bundles dissolved and the individual fibres spread between myocytes and within the endocardium. Generally, angiotensinergic fibres showed no synaptic enlargements or only a few if they were also catecholaminergic. The exclusively catechalominergic fibres were characterised by multiple beaded synapses. CONCLUSION The autonomic innervation of the human heart contains angiotensinergic fibres with a sympathetic efferent phenotype and exclusively angiotensinergic fibers representing probably afferents. Angiotensinergic neurotransmission may modulate intracardiac sympathetic and parasympathetic activity and thereby influence cardiac and circulatory function.

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AIMS Children conceived by assisted reproductive technology (ART) display vascular dysfunction. Its underlying mechanism, potential reversibility and long-term consequences for cardiovascular risk are unknown. In mice, ART induces arterial hypertension and shortens the life span. These problems are related to decreased vascular endothelial nitric oxide synthase (eNOS) expression and nitric oxide (NO) synthesis. The aim of this study was to determine whether ART-induced vascular dysfunction in humans is related to a similar mechanism and potentially reversible. To this end we tested whether antioxidants improve endothelial function by scavenging free radicals and increasing NO bioavailability. METHODS AND RESULTS In this prospective double-blind placebo controlled study in 21 ART and 21 control children we assessed the effects of a four-week oral supplementation with antioxidant vitamins C (1 g) and E (400 IU) or placebo (allocation ratio 2:1) on flow-mediated vasodilation (FMD) of the brachial artery and pulmonary artery pressure (echocardiography) during high-altitude exposure (3454 m), a manoeuver known to facilitate the detection of pulmonary vascular dysfunction and to decrease NO bioavailability by stimulating oxidative stress. Antioxidant supplementation significantly increased plasma NO measured by ozone-based chemiluminescence (from 21.7 ± 7.9 to 26.9 ± 7.6 µM, p = 0.04) and FMD (from 7.0 ± 2.1 to 8.7 ± 2.0%, p = 0.004) and attenuated altitude-induced pulmonary hypertension (from 33 ± 8 to 28 ± 6 mm Hg, p = 0.028) in ART children, whereas it had no detectable effect in control children. CONCLUSIONS Antioxidant administration to ART children improved NO bioavailability and vascular responsiveness in the systemic and pulmonary circulation. Collectively, these findings indicate that in young individuals ART-induced vascular dysfunction is subject to redox regulation and reversible.

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UNLABELLED Obstructive sleep apnea (OSA) is a frequent syndrome characterized by intermittent hypoxemia and increased prevalence of arterial hypertension and cardiovascular morbidity. In OSA, the presence of patent foramen ovale (PFO) is associated with increased number of apneas and more severe oxygen desaturation. We hypothesized that PFO closure improves sleep-disordered breathing and, in turn, has favorable effects on vascular function and arterial blood pressure. In 40 consecutive patients with newly diagnosed OSA, we searched for PFO. After initial cardiovascular assessment, the 14 patients with PFO underwent initial device closure and the 26 without PFO served as control group. Conventional treatment for OSA was postponed for 3 months in both groups, and polysomnographic and cardiovascular examinations were repeated at the end of the follow-up period. PFO closure significantly improved the apnea-hypopnea index (ΔAHI -7.9±10.4 versus +4.7±13.1 events/h, P=0.0009, PFO closure versus control), the oxygen desaturation index (ΔODI -7.6±16.6 versus +7.6±17.0 events/h, P=0.01), and the number of patients with severe OSA decreased significantly after PFO closure (79% versus 21%, P=0.007). The following cardiovascular parameters improved significantly in the PFO closure group, although remained unchanged in controls: brachial artery flow-mediated vasodilation, carotid artery stiffness, nocturnal systolic and diastolic blood pressure (-7 mm Hg, P=0.009 and -3 mm Hg, P=0.04, respectively), blood pressure dipping, and left ventricular diastolic function. In conclusion, PFO closure in OSA patients improves sleep-disordered breathing and nocturnal oxygenation. This translates into an improvement of endothelial function and vascular stiffening, a decrease of nighttime blood pressure, restoration of the dipping pattern, and improvement of left ventricular diastolic function. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01780207.

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Microbeam radiation therapy (MRT) is a new form of preclinical radiotherapy using quasi-parallel arrays of synchrotron X-ray microbeams. While the deposition of several hundred Grays in the microbeam paths, the normal brain tissues presents a high tolerance which is accompanied by the permanence of apparently normal vessels. Conversely, the efficiency of MRT on tumor growth control is thought to be related to a preferential damaging of tumor blood vessels. The high resistance of the healthy vascular network was demonstrated in different animal models by in vivo biphoton microscopy, magnetic resonance imaging, and histological studies. While a transient increase in permeability was shown, the structure of the vessels remained intact. The use of a chick chorioallantoic membrane at different stages of development showed that the damages induced by microbeams depend on vessel maturation. In vivo and ultrastructural observations showed negligible effects of microbeams on the mature vasculature at late stages of development; nevertheless a complete destruction of the immature capillary plexus was found in the microbeam paths. The use of MRT in rodent models revealed a preferential effect on tumor vessels. Although no major modification was observed in the vasculature of normal brain tissue, tumors showed a denudation of capillaries accompanied by transient increased permeability followed by reduced tumor perfusion and finally, a decrease in number of tumor vessels. Thus, MRT is a very promising treatment strategy with pronounced tumor control effects most likely based on the anti-vascular effects of MRT.

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Unique intercellular junctional complexes between the central nervous system (CNS) microvascular endothelial cells and the choroid plexus epithelial cells form the endothelial blood-brain barrier (BBB) and the epithelial blood-cerebrospinal fluid barrier (BCSFB), respectively. These barriers inhibit paracellular diffusion, thereby protecting the CNS from fluctuations in the blood. Studies of brain barrier integrity during development, normal physiology, and disease have focused on BBB and BCSFB tight junctions but not the corresponding endothelial and epithelial adherens junctions. The crosstalk between adherens junctions and tight junctions in maintaining barrier integrity is an understudied area that may represent a promising target for influencing brain barrier function.

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The role of endothelial progenitor cells (EPCs) in peripheral artery disease (PAD) remains unclear. We hypothesized that EPC mobilization and function play a central role in the development of endothelial dysfunction and directly influence the degree of atherosclerotic burden in peripheral artery vessels. The number of circulating EPCs, defined as CD34(+)/KDR(+) cells, were assessed by flow cytometry in 91 subjects classified according to a predefined sample size of 31 non-diabetic PAD patients, 30 diabetic PAD patients, and 30 healthy volunteers. Both PAD groups had undergone endovascular treatment in the past. As a functional parameter, EPC colony-forming units were determined ex vivo. Apart from a broad laboratory analysis, a series of clinical measures using the ankle-brachial index (ABI), flow-mediated dilatation (FMD) and carotid intima-media thickness (cIMT) were investigated. A significant reduction of EPC counts and proliferation indices in both PAD groups compared to healthy subjects were observed. Low EPC number and pathological findings in the clinical assessment were strongly correlated to the group allocation. Multivariate statistical analysis revealed these findings to be independent predictors of disease appearance. Linear regression analysis showed the ABI to be a predictor of circulating EPC number (p=0.02). Moreover, the functionality of EPCs was correlated by linear regression (p=0.017) to cIMT. The influence of diabetes mellitus on EPCs in our study has to be considered marginal in already disease-affected patients. This study demonstrated that EPCs could predict the prevalence and severity of symptomatic PAD, with ABI as the determinant of the state of EPC populations in disease-affected groups.

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OBJECTIVE Recent small single-center data indicate that the current hemodynamic parameters used to diagnose critical limb ischemia are insensitive. We investigated the validity of the societal guidelines-recommended hemodynamic parameters against core laboratory-adjudicated angiographic data from the multicenter IN.PACT DEEP (RandomIzed AmPhirion DEEP DEB vs StAndard PTA for the treatment of below the knee Critical limb ischemia) Trial. METHODS Of the 358 patients in the IN.PACT DEEP Trial to assess drug-eluting balloon vs standard balloon angioplasty for infrapopliteal disease, 237 had isolated infrapopliteal disease with an available ankle-brachial index (ABI), and only 40 of the latter had available toe pressure measurements. The associations between ABI, ankle pressure, and toe pressure with tibial runoff, Rutherford category, and plantar arch were examined according to the cutoff points recommended by the societal guidelines. Abnormal tibial runoff was defined as severely stenotic (≥70%) or occluded and scored as one-, two-, or three-vessel disease. A stenotic or occluded plantar arch was considered abnormal. RESULTS Only 14 of 237 patients (6%) had an ABI <0.4. Abnormal ankle pressure, defined as <50 mm Hg if Rutherford category 4 and <70 mm Hg if Rutherford category 5 or 6, was found only in 37 patients (16%). Abnormal toe pressure, defined as <30 mm Hg if Rutherford category 4 and <50 mm Hg if Rutherford category 5 or 6, was found in 24 of 40 patients (60%) with available measurements. Importantly, 29% of these 24 patients had an ABI within normal reference ranges. A univariate multinomial logistic regression found no association between the above hemodynamic parameters and the number of diseased infrapopliteal vessels. However, there was a significant paradoxic association where patients with Rutherford category 6 had higher ABI and ankle pressure than those with Rutherford category 5. Similarly, there was no association between ABI and pedal arch patency. CONCLUSIONS The current recommended hemodynamic parameters fail to identify a significant portion of patients with lower extremity ulcers and angiographically proven severe disease. Toe pressure has better sensitivity and should be considered in all patients with critical limb ischemia.

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Mutations disabling the retinoblastoma (Rb) pathway are among the most common in human cancers, including brain cancer. These mutations promote tumor development through deregulated control of the E2F family of transcription factors. E2F1 belongs to a class of E2F's identified as transcriptional activators and involved in the G1/S phase transition of the cell. However, E2F-1 presents with a paradox as it is considered to have membership in two gene classes, functioning as both an oncogene and a tumor suppressor. This unusual trait generates a degree of uncertainty on the role that E2F1 plays in the development or maintenance of any given tumor. Here we show that E2F1 functions as an oncogene in brain tumors through the generation of mice engineered to overexpress E2F1 specifically within glial cells and neuronal progenitors as directed by the GFAP promoter. Mice carrying the transgene develop with high penetrance a phenotype characterized by neurological deficits including paresia, ataxia, head tilt and seizures. MRI imagining of the tgE2F1 mice reveals a low incidence of mild hydrocephalus, and most notably, histological analysis demonstrates that 25% of tgE2F1 mice present with the spontaneous formation of malignant brain tumors. Overall these neoplasms show histological features from a wide range of aggressive brain cancers including medulloblastoma, choroid plexus carcinoma, primary neuroectodermic tumor and malignant gliomas. Isolation and characterization of astrocytes from the tgE2F1 animal reveals a highly proliferative population of cells with 55% ± 2.5 of the tgE2F1astrocytes, 35% ± 3.4 normal mouse astrocytes in S-phase and the acquired capacity to grow in anchorage independent conditions. Additionally tgE2F1 astrocytes show an aberrant phenotype with random chromosomal fusions and nearly all cells demonstrating polyploidy. Taken together, this model forces a comparison to human brain tumor formation. Mouse age as related to tumoral mimics the human scenario with juvenile tgE2F1 mice presenting embryonal tumors typically identified in children, and older tgE2F1 mice demonstrating gliomas. In this regard, this study suggests a global role for E2F1 in the formation and maintenance of multilineage brain tumors, irrefutably establishing E2F1 as an oncogene in the brain. ^

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The Neogene biostratigraphy presented here is based on the study of 230 samples through 737 m of pelagic sediment in Hole 806B. Sediment accumulation is interrupted only once in the uppermost lower Miocene (Zone N6), apparently coincident with a widespread deep-sea hiatus. Preservation of planktonic foraminifers through the section ranges from good to moderately poor. One hundred and ten species of planktonic foraminifers were identified; taxonomic notes on most species are included. All of the standard low-latitude Neogene foraminiferal zones are delineated, with the exceptions of Zones N8 and N9 because of a high first occurrence of Orbulina, and Zones N18 and N19 because of a high first occurrence of Sphaeroidinella dehiscens. Good agreement exists between the published account of the variation in planktonic foraminiferal species richness and the rates of diversification and turnover, and measurements of these evolutionary indexes in the record of Hole 806B. The global pattern of change in tropical/transitional species richness is paralleled in Hole 806B, with departures caused by either ecological conditions peculiar to the western equatorial Pacific or by inexactness in the estimation of million-year intervals in Hole 806B. Temporal changes in the relative abundance of taxa in the sediment assemblages, considered in light of their depth habitats, reveal a detailed picture of historical change in the structure of the upper water column over the Ontong Java Plateau. The dominance of surface dwellers (Paragloborotalia kugleri, P. mayeri, Dentoglobigerina altispira, Globigerinita glutinata, and Globigerinoides spp.) throughout the lower and middle Miocene is replaced by a more equitable distribution of surface (D. altispira and Globigerinoides spp.), intermediate (Globorotalia menardii plexus), and deep (Streptochilus spp.) dwellers in the late Miocene, following the closing of the Indo-Pacific Seaway and the initiation of large-scale glaciation in the Antarctic. The shoaling of the thermocline along the equator engendered by these climatic and tectonic events persisted through the Pliocene, when initial increases in the abundance of a new set of shallow, intermediate, and deep dwelling species of planktonic foraminifers coincide with the closing of the Panamanian Seaway.

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The Middle Eocene Climatic Optimum (MECO) is a major transient warming event that occurred at ~ 40 Ma and reversed a long-term cooling trend through the early and middle Eocene. We report the results of a high-resolution, quantitative study of siliceous microfossils at Ocean Drilling Program Sites 748 and 749 (Southern Kerguelen Plateau, Southern Ocean, ~ 58°S) across a ~ 1.4 myr interval spanning the MECO event. At both sites, a significant increase in biosiliceous sedimentation is associated with the MECO event. Rich siliceous planktonic microfossil assemblages in this interval are unusual in that they are dominated by ebridians, with radiolarians as a secondary major component. Silicoflagellates and diatoms comprise only a minor fraction of the assemblage, in contrast to siliceous microfossil assemblages that characterize modern Southern Ocean sediments. Based on our new siliceous microfossil records, we interpret two ~ 300 kyr periods of elevated nutrient availability in Southern Ocean surface waters which span the peak warming interval of the MECO and the post-MECO cooling interval. A diverse assemblage of large silicoflagellates belonging to the Dictyocha grandis plexus is linked to the rapid rise in sea-surface temperatures immediately prior to peak warmth, and a pronounced turnover is observed in both ebridian and silicoflagellate assemblages at the onset of peak warming. The interval of peak warmth is also characterized by high abundance of cosmopolitan ebridians (e.g., Ammodochium spp.) and silicoflagellates (e.g., Naviculopsis spp.), and increased abundance of tropical and subtropical diatom genera (e.g., Asterolampra and Azpeitia). These observations confirm the relative pattern of temperature change interpreted from geochemical proxy data at multiple Southern Ocean sites. Furthermore, rapid assemblage changes in both autotrophic and heterotrophic siliceous microfossil groups indicate a reorganization of Southern Ocean plankton communities in response to greenhouse warming during the MECO event.

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From the DSDP Legs 1, 11, 13, 17, 25, 27, 32, 36, 41, 43, 44, 50, and 62 the Lower Cretaceous foraminifers have been investigated for biostratigraphical, taxonomical, and palaeoecological purposes. An overview of the cored Lower Cretaceous sections of Leg 1-80 is given. In the Northern Atlantic Ocean characteristic foraminiferal faunas are missing from the Upper Tithonian to the Valanginian due to a marked regression which caused hiatuses. In areas without black shale conditions Valanginian to Barremian medium rich to poor microfaunas with Praedorothia ouachensis (Sigal) of the Praedorothia ouachensis Zone (Valanginian-Hauterivian). The Hauterivian-Aptian interval is characterized by zones of Gavelinella barrerniana, Gaudryina dividens, and Conorotalites aptiensis. During the Albian a world-wide fauna consisting of agglutinated and calcareous foraminifers of the Pseudoclavulina gaultina Zone is established in areas lacking the wide-spread black-shale conditions. The Upper Albian and the Cenomanian are represented by the Gavelinella eenomanica Zone. Some ornamented species of the nodosariids (Citharina, Lenticulina), Gavelinella, Conorotatites, Pleurostomella, Vatvulineria, and Osangularia are of some importance for the biostratigraphy of the Berriasian-Albian interval. The Berriasian to Albian zones introduced for the Tethys and the DSDP by Moullade (1984) could only be of some local importance due to the long stratigraphical range of the foraminiferal species used. In the Indian Ocean an exact stratigraphical age cannot be assigned to the few Neocomian foraminiferal faunas of a cooler sea water (Site 261). These faunas mainly contain primitive agglutinated foraminifers, because in most cases the calcareous tests are dissolved or redeposited. In the Pacific Ocean most of the Berriasian to Aptian microfaunas are of minor biostratigraphical and palaeoecological importance for reasons of poor core recoveries, contaminations or original foraminiferal poverty (black shales). Since the Albian there are somewhat higher-diverse faunas of calcareous and agglutinated foraminifers with index species of the Pseudoclavulina gaultina Zone. As a rule, the boundary Albian/Cenomanian is set by means of planktonic foraminifers because no other foraminifer has its first appearance datum during this interval, except Gavelinella cenornanica. During the Albian very uniform, world-wide foraminiferal faunas without a marked provincialism are obvious.

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Cores from Sites 689 and 690 of Ocean Drilling Program Leg 113 provide the most continuous Paleocene and Eocene sequence yet recovered by deep sea drilling in the high latitudes of the Southern Ocean. The nannofossil-foraminifer oozes and chalks recovered from Maud Rise at 65°S in the Weddell Sea provide a unique opportunity for biostratigraphic study of extremely high southern latitude carbonate sediments. The presence of warm water index fossils such as the discoasters and species of the Tribrachiatus plexus facilitate the application of commonly used low latitude calcareous nannofossil biostratigraphic zonation schemes for the upper Paleocene and lower Eocene intervals. In the more complete section at Site 690, Okada and Bukry Zones CP1 through CP10 can be identified for the most part with the possible exception of Zone CP3. Several hiatuses are present in the sequence at Site 689 with the most notable being at the Cretaceous/Tertiary and Paleocene/Eocene boundaries. Though not extremely diverse, the assemblage of discoasters in the upper Paleocene and lower Eocene calcareous oozes is indicative of warm, relatively equable climates during that interval. A peak in discoaster diversity in uppermost Paleocene sediments (Zone CP8) corresponds to a negative shift in 5180 values. Associated coccolith assemblages are quite characteristic of high latitudes with abundant Chiasmolithus, Prinsius, and Toweius. Climatic cooling is indicated for middle Eocene sediments by assemblages that contain very abundant Reticulofenestra, lack common discoasters and sphenoliths and are much less diverse overall. Two new taxa are described, Biscutum? neocoronum n. sp. and Amithalithina sigmundii n. gen., n. sp.

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The biostratigraphic distribution and abundance of middle Miocene to Pleistocene silicoflagellates is documented from Ocean Drilling Program (ODP) Leg 138 Holes 844B, 847B, 848B, 849B, 850B, 85 IB, 852B, and 854B from the eastern Equatorial Pacific Ocean. The silicoflagellates were generally abundant and well preserved and frequently exhibited an unusually large range of variation. The upper Miocene of near-equatorial sites includes an assemblage of Bachmannocena diodon nodosa, which includes a bridge across the width of the basal ring. Stratigraphically below this, at sites within 5° of the equator is a lengthy interval of specimens of Distephanus speculum tenuis, which have a fragile apical structure. Both the intervals of Bachmannocena diodon nodosa plexus and Distephanus speculum tenuis are biostratigraphically useful within 5° of the equator, but are less useful beyond that. An unusual range of variation also is observed for Dictyocha in the Pliocene sediments at about the point where D. perlaevis and D. messanensis appear in the geologic record. This variation may be explained by hybridization between diverging species.

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Miocene deep-sea sediments from ODP Site 744 (Kerguelen Plateau, southern Indian Ocean) contain abundant and diverse planktonic foraminiferal assemblages. Their analysis led to the identification of the interval between 17.0 and 14.2 Ma as a time of mid-Miocene warmth, which is investigated here in detail. This investigation includes reconstruction of trends in foraminiferal faunal composition and diversity through time, as well as in morphology and coiling direction within Globorotalia praescitula and Globorotalia zealandica plexi. These two large-globorotaliid plexi constitute the most characteristic component of the mid-Miocene foraminiferal faunas at ODP Site 744. Selected benthic (Cibicidoides sp.) and planktonic foraminifera were also analyzed for delta18O and delta13C ratios. Distinctive planktonic assemblages were the basis for identification of three foraminiferal biofacies between 17.0 and 14.2 Ma. The most prominent faunal changes took place between Biofacies 2 and 3 (15.5-15.0 Ma). Six of 11 macroperforate planktonic foraminifera from the >150-µm size fraction occur principally within Biofacies 3. Three other taxa are present throughout the interval analyzed. Moreover, both aforementioned globorotaliid plexi exhibit an increase in morphological diversity between Biofacies 2 and 3. Within the same interval, the G. zealandica plexus shows a switch from random coiling (50% sinistral) to clearly sinistral-dominated coiling. The faunal changes recognized are interpreted as the result of foraminiferal immigrations (increase in faunal diversity) and evolutionary trends (increase in morphological variability and change in coiling mode among the globorotaliid plexi). The stable isotopic results allow paleoenvironmental interpretation of these faunal changes. According to the delta18O values, no significant change in sea-surface temperature occurred between 17.0 and 14.2 Ma. However, the same data suggest an increase in ecological distance between various niches, which is expressed by a rising delta18O gradient recorded between various planktonic taxa upward within the section. This trend suggests niche-space availability as a likely factor responsible for the faunal changes recognized. Changes in the shape and depth of the thermocline, as well as in seasonality and eutrophication are considered as possible causes. Among these an increase in seasonality appears to have been responsible for the increase in species and morphological diversities between 15.5 and 15.0 Ma. The proposed scenario suggests that changes in seasonality may be an important factor driving faunal migrations and evolution. Variable seasonality may also affect the oxygen isotopic record of planktonic foraminiferal taxa.

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The biostratigraphic distribution and abundance of lower Oligocene and Miocene to Pleistocene silicoflagellates are documented from Ocean Drilling Program Leg 183 Holes 1138A and 1140A, on the Kerguelen Plateau. The Distephanus speculum speculum forma pseudofibula plexus is found in the upper Miocene in Hole 1138A, but other important biostratigraphic markers are not available. Diversity and abundance of silicoflagellates vary considerably in Hole 1138A, with silicoflagellates more abundant in the Pliocene and Pleistocene and some intervals of the Miocene barren of silicoflagellates or containing only limited numbers of specimens. The silicoflagellates of Hole 1140A include a new skeletal morphology, described here as Distephanus speculum speculum forma cylindrus. Silicoflagellates were generally abundant throughout the lower and middle Miocene in Hole 1140A.