A mathematical model for wave propagation in elastic tubes with inhomogeneities: Application to blood waves propagation

We study the propagation of waves in an elastic tube filled with an inviscid fluid. We consider the case of inhomogeneity whose mechanical and geometrical properties vary in space. We deduce a system of equations of the Boussinesq type as describing the wave propagation in the tube. Numerical simulations of these equations show that inhomogeneities prevent separation of right-going from left-going waves. Then reflected and transmitted coefficients are obtained in the case of localized constriction and localized rigidity. Next we focus on wavetrains incident on various types of anomalous regions. We show that the existence of anomalous regions modifies the wavetrain patterns. (c) 2007 Elsevier B.V. All rights reserved.

Controle do fornecimento e da utilização de substratos energéticos no encéfalo

Correspondendo a apenas 2% do peso corpóreo, o cérebro apresenta taxa metabólica superior à maioria dos demais órgãos e sistemas. A maior parte do consumo energético encefálico ocorre no transporte iônico para manutenção do potencial de membrana celular. Praticamente desprovido de estoques, os substratos energéticos para o encéfalo são fornecidos necessariamente pela circulação sanguínea.O suprimento desses substratos sofre também a ação seletiva da barreira hemato-encefálica (BHE). O principal substrato, que é a glicose, tem uma demanda de 150 g/dia (0,7 mM/g/min). A metabolização intracelular parece ser controlada pela fosfofrutoquinase. A manose e os produtos intermediários do metabolismo (frutose 1,6 bifosfato, piruvato, lactato e acetato) podem substituir, em parte, a glicose, quando os níveis sangüíneos desta encontram-se elevados. Quando oxidado, o lactato chega a responder por 21% do consumo cerebral de Ov em situações de isquemia e inflamação infecciosa, o tecido cerebral passa de consumidor a produtor de lactato. Os corpos cetônicos também podem reduzir as necessidades cerebrais de glicose desde que oferecidos em quantidades suficientes ao encéfalo. Entretanto, devem ser considerados como um substrato complementar e nunca alternativo da glicose, pois comprometem a produção cerebral de succinil CoA e GTP. Quanto aos demais substratos, embora apresentem condições metabólicas, não existem demonstrações consistentes de que o cérebro produza energia a partir dos ácidos graxos sistêmicos, mesmo em situações de hipoglicemia. de maneira análoga, etanol e glicerol são considerados apenas a nível de experimentação. A utilização dos aminoácidos é dependente da sua captação, limitada tanto pela baixa concentração sangüínea, como pela seletividade da BHE. A maior captação ocorre para os de cadeia ramificada e destes, a valina. A menor captação é a de aminoácidos sintetizados no cérebro (aspartato,gluconato e alanina). Todos podem ser oxidados a CO, e H(2)0. Entretanto, mesmo com o consumo de glicose reduzido a 50%, a contribuição energética dos aminoácidos não ultrapassa 10%. Para manter o suprimento adequado de glicose e oxigênio, o fluxo sangüíneo cerebral é da ordem de 800 ml/min (15% do débito cardíaco). O consumo de O, pelo cérebro é equivalente a 20% do total consumido pelo corpo. Esses mecanismos, descritos como controladores da utilização de substratos energéticos pelo cérebro, sofrem a influência da idade apenas no período perinatal, com a oxidação do lactato na fase pré-latente e dos corpos cetônicos, no início da amamentação.

Hypoxic pulmonary vasoconstriction in reptiles: a comparative study of four species with different lung structures and pulmonary blood pressures

Low O-2 levels in the lungs of birds and mammals cause constriction of the pulmonary vasculature that elevates resistance to pulmonary blood flow and increases pulmonary blood pressure. This hypoxic pulmonary vasoconstriction (HPV) diverts pulmonary blood flow from poorly ventilated and hypoxic areas of the lung to more well-ventilated parts and is considered important for the local matching of ventilation to blood perfusion. In the present study, the effects of acute hypoxia on pulmonary and systemic blood flows and pressures were measured in four species of anesthetized reptiles with diverse lung structures and heart morphologies: varanid lizards (Varanus exanthematicus), caimans (Caiman latirostris), rattlesnakes (Crotalus durissus), and tegu lizards (Tupinambis merianae). As previously shown in turtles, hypoxia causes a reversible constriction of the pulmonary vasculature in varanids and caimans, decreasing pulmonary vascular conductance by 37 and 31%, respectively. These three species possess complex multicameral lungs, and it is likely that HPV would aid to secure ventilation-perfusion homogeneity. There was no HPV in rattlesnakes, which have structurally simple lungs where local ventilation-perfusion inhomogeneities are less likely to occur. However, tegu lizards, which also have simple unicameral lungs, did exhibit HPV, decreasing pulmonary vascular conductance by 32%, albeit at a lower threshold than varanids and caimans (6.2 kPa oxygen in inspired air vs. 8.2 and 13.9 kPa, respectively). Although these observations suggest that HPV is more pronounced in species with complex lungs and functionally divided hearts, it is also clear that other components are involved.

Atividade antiinflamatória e neuroprotetora da Edaravona no córtex sensóriomotor primário de ratos adultos submetidos à isquemia focal experimental

O acidente vascular encefálico (AVENC) é uma desordem neural iniciada a partir da redução ou interrupção do fluxo sanguíneo, tornando inadequada a demanda energética para a região, promovendo assim um dano tecidual. O AVENC é classificado em hemorrágico ou isquêmico. O AVENC isquêmico tem maior prevalência e pode ocorrer por trombose ou embolismo. A patologia isquêmica tem múltiplos eventos interrelacionados como excitotoxicidade, despolarização periinfarto, estresse oxidativo e nitrosativo, inflamação e apoptose. Um elemento de fundamental importância na patologia isquêmica é a célula microglial, cuja atividade está intimamente ligada à progressão do ambiente lesivo. Uma alternativa terapêutica no tratamento do AVENC é um pirazolona denominada Edaravona. O presente trabalho avaliou a o efeito neuroprotetor da Edaravona na dose de 3mg/kg no córtex sensóriomotor primário após lesão isquêmica focal. A indução isquêmica foi induzida através da administração de 40pM do peptídeo vasoconstritor endotelina 1 diretamente sobre o córtex sensóriomotor primário. Foram avaliados animais tratados com Edaravona (N=10) e animais tratados com Água Destilada (N=10) nos tempos de sobrevida 1 e 7 dias após o evento isquêmico. O tratamento com edaravona evidenciou através da análise histopatológica com violeta de cresila uma redução de 49% e 66% na área de infarto nos animais nos tempo de sobrevida 1 e 7 dias respectivamente. Os estudos imunohistoquímicos para micróglia/macrófagos ativos (ED1⁺) demostraram uma redução na presença de células ED1⁺ em 35% e 41% para os tempos de sobrevida 1 e 7 dias respectivamente. A redução na presença de neutrófilos (MBS-1⁺) foi significativa apenas nos animais com tempo de sobrevida de 24h onde se observou a redução em 56% na presença dessas células. A análise estatística foi feita por análise de variância com correção a posteriori de Tukey com p <0,05.

Validação da técnica de angiotomografia helicoidal cerebral em cães hígidos

Pós-graduação em Medicina Veterinária - FMVZ

Determinação dos mecanismos de ação envolvidos no efeito antiulcerogênico, antidiarreico e anti-inflamatório da Insulina Vegetal (Cissus sicyoides Linneu) em modelos animais

Pós-graduação em Ciências Biológicas (Farmacologia) - IBB

Involvement of the median preoptic nucleus in blood pressure control

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Manutenção da prática de atividade física e indicadores hemodinâmicos, metabólicos e inflamatório em adultos: análise transversal e coorte de 12 meses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Brazilian guidelines for the application of transcranial ultrasound as a diagnostic test for the confirmation of brain death

Neurosonological studies, specifically transcranial Doppler (TCD) and transcranial color-coded duplex (TCCD), have high level of specificity and sensitivity and they are used as complementary tests for the diagnosis of brain death (BD). A group of experts, from the Neurosonology Department of the Brazilian Academy of Neurology, created a task force to determine the criteria for the following aspects of diagnosing BD in Brazil: the reliability of TCD methodology; the reliability of TCCD methodology; neurosonology training and skills; the diagnosis of encephalic circulatory arrest; and exam documentation for BD. The results of this meeting are presented in the current paper.

Chronic hypoxia increases blood pressure and noradrenaline spillover in healthy humans

[EN] Chronic hypoxia is associated with elevated sympathetic activity and hypertension in patients with chronic pulmonary obstructive disease. However, the effect of chronic hypoxia on systemic and regional sympathetic activity in healthy humans remains unknown. To determine if chronic hypoxia in healthy humans is associated with hyperactivity of the sympathetic system, we measured intra-arterial blood pressure, arterial blood gases, systemic and skeletal muscle noradrenaline (norepinephrine) spillover and vascular conductances in nine Danish lowlanders at sea level and after 9 weeks of exposure at 5260 m. Mean blood pressure was 28 % higher at altitude (P < 0.01) due to increases in both systolic (18 % higher, P < 0.05) and diastolic (41 % higher, P < 0.001) blood pressures. Cardiac output and leg blood flow were not altered by chronic hypoxia, but systemic vascular conductance was reduced by 30 % (P < 0.05). Plasma arterial noradrenaline (NA) and adrenaline concentrations were 3.7- and 2.4-fold higher at altitude, respectively (P < 0.05). The elevation of plasma arterial NA concentration was caused by a 3.8-fold higher whole-body NA release (P < 0.001) since whole-body noradrenaline clearance was similar in both conditions. Leg NA spillover was increased similarly (x 3.2, P < 0.05). These changes occurred despite the fact that systemic O2 delivery was greater after altitude acclimatisation than at sea level, due to 37 % higher blood haemoglobin concentration. In summary, this study shows that chronic hypoxia causes marked activation of the sympathetic nervous system in healthy humans and increased systemic arterial pressure, despite normalisation of the arterial O2 content with acclimatisation.

Effect of blood haemoglobin concentration on V(O2,max) and cardiovascular function in lowlanders acclimatised to 5260 m

[EN] The principal aim of this investigation was to determine the influence of blood haemoglobin concentration ([Hb]) on maximal exercise capacity and maximal O(2) consumption (V(O(2),max)) in healthy subjects acclimatised to high altitude. Secondarily, we examined the effects of [Hb] on the regulation of cardiac output (CO), blood pressure and muscular blood flow (LBF) during exercise. Eight Danish lowlanders (three females and five males; 24 +/- 0.6 years, mean +/- S.E.M.) performed submaximal and maximal exercise on a cycle ergometer after 9 weeks at an altitude of 5260 m (Mt Chacaltaya, Bolivia). This was done first with the high [Hb] resulting from acclimatisation and again 2-4 days later, 1 h after isovolaemic haemodilution with Dextran 70 to near sea level [Hb]. After measurements at maximal exercise while breathing air at each [Hb], subjects were switched to hyperoxia (55 % O(2) in N(2)) and the measurements were repeated, increasing the work rate as tolerated. Hyperoxia increased maximal power output and leg V(O(2),max), showing that breathing ambient air at 5260 m, V(O(2),max) is limited by the availability of O(2) rather than by muscular oxidative capacity. Altitude increased [Hb] by 36 % from 136 +/- 5 to 185 +/- 5 g l(-1) (P < 0.001), while haemodilution (replacing 1 l of blood with 1 l of 6 % Dextran) lowered [Hb] by 24 % to 142 +/- 6 g l(-1) (P < 0.001). Haemodilution had no effect on maximal pulmonary or leg V(O(2),max), or power output. Despite higher LBF, leg O(2) delivery was reduced and maximal V(O(2)) was thus maintained by higher O(2) extraction. While CO increased linearly with work rate irrespective of [Hb] or inspired oxygen fraction (F(I,O(2))), both LBF and leg vascular conductance were systematically higher when [Hb] was low. Close and significant relationships were seen between LBF (and CO) and both plasma noradrenaline and K(+) concentrations, independently of [Hb] and F(I,O(2)). In summary, under conditions where O(2) supply limits maximal exercise, the increase in [Hb] with altitude acclimatisation does not improve maximal exercise capacity or V(O(2),max), and does not alter peak CO. However, LBF and vascular conductance are higher at altitude when [Hb] is lowered to sea level values, with both relating closely to catecholamine and potassium concentrations. This suggests that the lack of effect of [Hb] on V(O(2),max) may involve reciprocal changes in LBF via local metabolic control of the muscle vasculature.

Differential roles for endothelial ICAM-1, ICAM-2, and VCAM-1 in shear-resistant T cell arrest, polarization, and directed crawling on blood-brain barrier endothelium

Endothelial ICAM-1 and ICAM-2 were shown to be essential for T cell diapedesis across the blood-brain barrier (BBB) in vitro under static conditions. Crawling of T cells prior to diapedesis was only recently revealed to occur preferentially against the direction of blood flow on the endothelial surface of inflamed brain microvessels in vivo. Using live cell-imaging techniques, we prove that Th1 memory/effector T cells predominantly crawl against the direction of flow on the surface of BBB endothelium in vitro. Analysis of T cell interaction with wild-type, ICAM-1-deficient, ICAM-2-deficient, or ICAM-1 and ICAM-2 double-deficient primary mouse brain microvascular endothelial cells under physiological flow conditions allowed us to dissect the individual contributions of endothelial ICAM-1, ICAM-2, and VCAM-1 to shear-resistant T cell arrest, polarization, and crawling. Although T cell arrest was mediated by endothelial ICAM-1 and VCAM-1, T cell polarization and crawling were mediated by endothelial ICAM-1 and ICAM-2 but not by endothelial VCAM-1. Therefore, our data delineate a sequential involvement of endothelial ICAM-1 and VCAM-1 in mediating shear-resistant T cell arrest, followed by endothelial ICAM-1 and ICAM-2 in mediating T cell crawling to sites permissive for diapedesis across BBB endothelium.

Myocardial blood volume and coronary resistance during and after coronary angioplasty

Animal experiments have shown that the coronary circulation is pressure distensible, i.e., myocardial blood volume (MBV) increases with perfusion pressure. In humans, however, corresponding measurements are lacking so far. We sought to quantify parameters reflecting coronary distensibility such as MBV and coronary resistance (CR) during and after coronary angioplasty. Thirty patients with stable coronary artery disease underwent simultaneous coronary perfusion pressure assessment and myocardial contrast echocardiography (MCE) of 37 coronary arteries and their territories during and after angioplasty. MCE yielded MBV and myocardial blood flow (MBF; in ml · min(-1) · g(-1)). Complete data sets were obtained in 32 coronary arteries and their territories from 26 patients. During angioplasty, perfusion pressure, i.e., coronary occlusive pressure, and MBV varied between 9 and 57 mmHg (26.9 ± 11.9 mmHg) and between 1.2 and 14.5 ml/100 g (6.7 ± 3.7 ml/100 g), respectively. After successful angioplasty, perfusion pressure and MBV increased significantly (P < 0.001 for both) and varied between 64 and 118 mmHg (93.5 ± 12.8 mmHg) and between 3.7 and 17.3 ml/100 g (9.8 ± 3.4 ml/100 g), respectively. Mean MBF increased from 31 ± 20 ml · min(-1) · g(-1) during coronary occlusion, reflecting collateral flow, to 121 ± 33 ml · min(-1) · g(-1) (P < 0.01), whereas mean CR, i.e., the ratio of perfusion pressure and MBF, decreased by 20% (P < 0.001). In conclusion, the human coronary circulation is pressure distensible. MCE allows for the quantification of CR and MBV in humans.

Repeated laser-assisted high-flow bypass for recurrent giant intracranial aneurysm

The treatment of intracranial aneurysms is changing as endovascular obliteration possibilities and long-term results are being published in regard to outcome. However, not all aneurysms are amenable to direct endovascular or surgical treatment. In such situations, a high flow bypass for flow preservation can be considered as indirect treatment alternative, enabling a trapping of the aneurysm or occlusion of the feeding artery. We present the case history of a 57 year-old patient suffering of a recurrent giant intracranial carotid aneurysm. The aneurysm could be excluded using a new cerebral high-flow bypass technique for which no temporary occlusion of any intracranial vessels is required. This technique reduces the risks of perioperative neurological complications.

Collateral-flow measurements in humans by myocardial contrast echocardiography: validation of coronary pressure-derived collateral-flow assessment

AIMS: Myocardial blood flow (MBF) is the gold standard to assess myocardial blood supply and, as recently shown, can be obtained by myocardial contrast echocardiography (MCE). The aims of this human study are (i) to test whether measurements of collateral-derived MBF by MCE are feasible during elective angioplasty and (ii) to validate the concept of pressure-derived collateral-flow assessment. METHODS AND RESULTS: Thirty patients with stable coronary artery disease underwent MCE of the collateral-receiving territory during and after angioplasty of 37 stenoses. MCE perfusion analysis was successful in 32 cases. MBF during and after angioplasty varied between 0.060-0.876 mL min(-1) g(-1) (0.304+/-0.196 mL min(-1) g(-1)) and 0.676-1.773 mL min(-1) g(-1) (1.207+/-0.327 mL min(-1) g(-1)), respectively. Collateral-perfusion index (CPI) is defined as the rate of MBF during and after angioplasty varied between 0.05 and 0.67 (0.26+/-0.15). During angioplasty, simultaneous measurements of mean aortic pressure, coronary wedge pressure, and central venous pressure determined the pressure-derived collateral-flow index (CFI(p)), which varied between 0.04 and 0.61 (0.23+/-0.14). Linear-regression analysis demonstrated an excellent agreement between CFI(p) and CPI (y=0.88 x +0.01; r(2)=0.92; P<0.0001). CONCLUSION: Collateral-derived MBF measurements by MCE during angioplasty are feasible and proved that the pressure-derived CFI exactly reflects collateral relative to normal myocardial perfusion in humans.