The antithrombotic effect of dextran-40 in man is due to enhanced fibrinolysis in vivo

BACKGROUND: Dextran-40 is effective in reducing postoperative Doppler-detectable embolization in patients undergoing carotid endarterectomy (CEA). Dextrans are thought to have antithrombotic and antiplatelet effects. The mode of action is unclear. In rats, dextran blocks uptake of tissue plasminogen activator (tPA) by mannose-binding receptors. Because this would have the effect of enhancing endogenous fibrinolysis, we explored this effect of dextran-40 on fibrinolysis in man. METHODS: Twenty patients undergoing endovascular stenting for abdominal aortic aneurysm were randomized to receive 100 mL of 10% dextran-40 or saline, over 1 hour, during their operation in addition to heparin. Blood samples were taken preoperatively, intraoperatively (immediately after operative procedure), and 24 hours postoperatively. Thrombi were formed in a Chandler loop and used to assess endogenous fibrinolysis over 24 hours, measured as the fall in thrombus weight, and the release of fluorescently labelled fibrinogen from the thrombus. Plasma samples were analyzed for markers of fibrinolysis; plasmin-antiplasmin (PAP), PAI-1, and t-PA, and for functional von Willebrand factor (vWF). Platelet response to thrombin and other agonists was measured by flow cytometry. RESULTS: Thrombi formed ex vivo from the intraoperative blood samples from the dextran-treated patients exhibited significantly greater fibrinolysis vs preoperative samples, seen both as a significantly greater percentage reduction in thrombus weight (from 34.7% to 70.6% reduction) and as an 175% increase in the release of fluorescence (P < .05). Fibrinolysis returned to baseline levels the next day. No change was seen in the saline-treated group. Plasma levels of PAP and PAI-1 increased significantly postoperatively in the dextran-treated group vs the saline group (P < .05). The postoperative level of functional VWF was significantly lower in the dextran-treated group vs controls. A specific reduction occurred in the platelet response to thrombin, but not to other agonists, in the intraoperative samples from the dextran-treated group (11.1% vs 37.1%; P = .022), which was not seen in the controls. CONCLUSIONS: These data are consistent with a rise in plasmin due to dextran blockade of tPA uptake in vivo, leading to enhanced fibrinolysis, cleavage of vWF and of the platelet protease-activated receptor-1 (PAR-1) thrombin receptor. This suggests that dextran exerts a combined therapeutic effect, enhancing endogenous fibrinolysis, whilst also reducing platelet adhesion to vWF and platelet activation by thrombin. The proven antithrombotic efficacy of low-dose dextran in carotid surgery may be applicable to wider therapeutic use.

Comparison of D-region Doppler drift winds measured by the SuperDARN Finland HF radar over an annual cycle using the Kiruna VHF meteor radar

The SuperDARN chain of oblique HF radars has provided an opportunity to generate a unique climatology of horizontal winds near the mesopause at a number of high latitude locations, via the Doppler shifted echoes from sources of ionisation in the D-region. Ablating meteor trails form the bulk of these targets, but other phenomena also contribute to the observations. Due to the poor vertical resolution of the radars, care must be taken to reduce possible biases from sporadic-E layers and Polar Mesospheric Summer echoes that can affect the effective altitude of the geophysical parameters being observed. Second, there is strong theoretical and observational evidence to suggest that the radars are picking up echoes from the backward looking direction that will tend to reduce the measured wind strengths. The effect is strongly frequency dependent, resulting in a 20% reduction at 12 MHz and a 50% reduction at 10 MHz. A comparison of the climatologies observed by the Super-DARN Finland radar between September 1999 and September 2000 and that obtained from the adjacent VHF meteor radar located at Kiruna is also presented. The agreement between the two instruments was very good. Extending the analysis to the SuperDARN Iceland East radar indicated that the principles outlined above could be applied successfully to the rest of the SuperDARN network.

The effect of the magnetic field of the secondary star in dwarf novae

We investigate the effect of a secondary star magnetic field on the accretion disc dynamics of dwarf novae. Simulations have been carried out with a particle code and a dipolar magnetic field structure. The magnetic field acts to remove angular momentum from the disc material, increasing the inward mass flow. This makes the accretion disc more centrally condensed, causing a reduction in the recurrence time for dwarf nova outbursts. We have produced Doppler tomograms and light curves which may be compared with observations. These tomograms are significantly different from those produced in the absence of a magnetic field on the secondary. We derive an upper limit to the magnetic moment of the secondary star in UGem of mu_2<2x10^32 A m^2. The magnetic truncation of the accretion disc produces resonance phenomena similar to those seen in the superoutbursts of SUUMa systems. While these have not been observed for systems like UGem, observations of the SUUMa systems provide us with a useful diagnostic of the disc-field interaction. We are able to place an upper limit on the magnetic moment of the secondary in ZCha of mu_2<1x10^30 A m^2.

Convective updraught evaluation in high-resolution NWP simulations using single-Doppler radar measurements

This study presents an evaluation of the size and strength of convective updraughts in high-resolution simulations by the UK Met Office Unified Model (UM). Updraught velocities have been estimated from range–height indicator (RHI) Doppler velocity measurements using the Chilbolton advanced meteorological radar, as part of the Dynamical and Microphysical Evolution of Convective Storms (DYMECS) project. Based on mass continuity and the vertical integration of the observed radial convergence, vertical velocities tend to be underestimated for convective clouds due to the undetected cross-radial convergence. Velocity fields from the UM at a resolution corresponding to the radar observations are used to scale such estimates to mitigate the inherent biases. The analysis of more than 100 observed and simulated storms indicates that the horizontal scale of updraughts in simulations tend to decrease with grid length; the 200 m grid length agreed most closely with the observations. Typical updraught mass fluxes in the 500 m grid length simulations were up to an order of magnitude greater than observed, and greater still in the 1.5 km grid length simulations. The effect of increasing the mixing length in the sub-grid turbulence scheme depends on the grid length. For the 1.5 km simulations, updraughts were weakened though their horizontal scale remained largely unchanged. Progressively more so for the sub-kilometre grid lengths, updraughts were broadened and intensified; horizontal scale was now determined by the mixing length rather than the grid length. In general, simulated updraughts were found to weaken too quickly with height. The findings were supported by the analysis of the widths of reflectivity patterns in both the simulations and observations.

Rotation effect on geodesic and zonal flow modes in tokamak plasmas with isothermal magnetic surfaces

The electrostatic geodesic mode oscillations are investigated in rotating large aspect ratio tokamak plasmas with circular isothermal magnetic surfaces. The analysis is carried out within the magnetohydrodynamic model including heat flux to compensate for the non-adiabatic pressure distribution along the magnetic surfaces in plasmas with poloidal rotation. Instead of two standard geodesic modes, three geodesic continua are found. The two higher branches of the geodesic modes have a small frequency up-shift from ordinary geodesic acoustic and sonic modes due to rotation. The lower geodesic continuum is a newzonal flowmode (geodesic Doppler mode) in plasmas with mainly poloidal rotation. Limits to standard geodesic modes are found. Bifurcation of Alfven continuum by geodesic modes at the rational surfaces is also discussed. Due to that, the frequency of combined geodesic continuum extends from the poloidal rotation frequency to the ion-sound band that can have an important role in suppressing plasma turbulence.

Effect of maternal hydration on the increase of amniotic fluid index

The objective of this study was to determine the effect of maternal hydration with oral isotonic solution and water on the amniotic fluid (AF) index of women with normohydramnios. Women with a normal AF index and gestational age between 33 and 36 weeks without maternal complications were randomized into three groups [isotonic solution (Gatorade (R)), water, control]. The isotonic solution and water groups were instructed to drink 1.5 L of the respective solution and the control group was instructed to drink 200 mL water over a period of 2 to 4 h. AF index was measured before and after hydration by Doppler ultrasonography. The investigator performing the AF index measurement was blind to the subject's group. Ninety-nine women completed the study without any adverse maternal effects. The median increase in AF index after hydration was significantly greater for the isotonic solution and water groups than for the control group. There was no significant difference between the isotonic solution and water groups. Hydration with isotonic solution and water caused a 10-fold (95% CI: 2.09-49.89) and 6-fold (95% CI: 1.16-30.95) increase in the chance of a 20% increase of AF index, respectively. Maternal hydration with isotonic solution or water increased the AF index in women with normohydramnios.

Efeito da brimonidina na circulação retrobulbar em pacientes com glaucoma: estudo com Doppler colorido

Objetivo: Avaliar o efeito do tartarato de brimonidina a 0,2% tópico, instilado de 12/12 horas, na circulação retrobulbar em pacientes portadores de glaucoma. Métodos: Foram estudados os 2 olhos de 16 pacientes portadores de glaucoma primário de ângulo aberto e glaucoma crônico de ângulo estreito com iridotomia. Usando o Doppler colorido foram avaliados: velocidade sistólica máxima, velocidade diastólica final e índice de resistência das artéria central da retina, artéria ciliar posterior curta temporal e artéria oftálmica. As avaliações foram feitas antes e depois do uso da brimonidina. Resultados: O tartarato de brimonidina a 0,2% aumentou significativamente a velocidade sistólica máxima (28,24 para 34,23 cm/seg) e velocidade diastólica final (6,62 para 8,10 cm/seg) no olho direito e reduziu o índice de resistência (0,75 para 0,71) no olho esquerdo da artéria oftálmica. Conclusão: O tartarato de brimonidina 0,2% 2x/dia aumentou significativamente a velocidade sistólica máxima e velocidade diastólica final e reduziu índice de resistência da artéria oftálmica de pacientes glaucomatosos. Este efeito sugere que a brimonidina pode beneficiar pacientes glaucomatosos com insuficiência vascular na cabeça do nervo óptico.

Effect of total abdominal hysterectomy on ovarian blood supply in women of reproductive age

Objective. The purpose of this study was to evaluate the effect of total abdominal hysterectomy on ovarian blood supply using transvaginal color Doppler ultrasonography in women of reproductive age. Methods. This prospective study included 61 women aged 40 years or younger who were divided into 2 groups: group 1, comprising 31 patients who underwent total abdominal hysterectomy (TAH), and group 2, comprising 30 women with no abnormalities. Inclusion criteria included normal ovarian function at baseline, with basal follicle-stimulating hormone levels of less than 15 mUI/mL, normal body weight, no tobacco use, and no history of laparotomy or ovarian disease. Ovarian arterial blood supply by determination of the pulsatility index (PI) on Doppler analysis and ovarian volume on transvaginal ultrasonography were assessed at baseline and at 6 and 12 postoperative months. The Student t test, profile analysis, and Friedman and Mann-Whitney tests were used in the statistical analysis of data. Results. Statistical analysis of baseline data revealed that both groups were homogeneous. At months 6 and 12, greater ovarian volumes and lower PI values were observed in patients who underwent TAH (P < .05). By the end of the study, in 8 of the 31 patients who underwent TAH (25.5%), benign ovarian cysts were observed. in the control group, all the parameters studied remained unchanged. Conclusions. The reduced PI values observed on Doppler ultrasonography suggested a decrease in the resistance flow in the ovarian arteries in women of reproductive age who underwent TAH.

Effect of testicular thermoregulation on the quality of buffalo sperm

The process of spermatic division and differentiation (spermatogenesis) occurs with intratesticular temperature lower that the corporal temperature and for that is essential that the testicular thermoregulation mechanism occurs properly. For evaluation of the scrotal surface temperature can be used the infrared thermography or testicular sensors, besides that, can be evaluated the blood flux in the spermatic cord through the Doppler ultrasonography. Thus, the aim of this study is to analyze the testicular thermoregulation in adult buffaloes through scrotal thermography and Doppler ultrasound of testicular artery and verify its effect on sperm quality. For that were used seven healthy buffaloes, with age of 3 and 4 years, of the Murrah breed. The animals were subjected to 3 semen collections using artificial vagina, with one day of interval. In addiction, the retal temperature measurement (RT) with dry bulb thermometer, the measurement of scrotal surface temperature (SST) and body surface temperature (BST) through infrared thermography and the pulsatility (PI) and resistivity (RI) index of testicular artery by Doppler ultrasonography, were performed using 2 distinct moments: animals previously placed to shade (M1) and animals subjected to 4 hours of sun (M2). All parameters were compared by T test and the correlations were performed by Pearson test using the In Stat Graph Pad 3 (R) program. The significant level considered was 5%. There was an increase (p<0,05) of RT, SST, SNT and RI in M2. increasing trend was observed (0,05>p>0,01) PI and RI between M1 and M2. There was a low correlation between SST and semen quality. The results of this study allow us to conclude that adult buffaloes have low ability to perform body and testicular thermoregulation in situations of enviromental heat stress. However, this low capacity of testicular temperature maintenance demonstrated no correlation with the sperm kinetic parameters and sperm morphological defects in buffalo spermatozoa.

Effect of phototherapy with light-emitting diodes (890 nm) on tendon repair: an experimental model in sheep

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da pressão arterial sistêmica em cães obesos: comparação entre os métodos oscilométrico e doppler ultrassônico

Obesity is the most common nutritional problem in dogs and it can cause various harmful effects on animal health. However, the effect of this condition on systolic blood pressure (SBP) in obese dogs is controversial. The indirect method of measuring PAS is the most commonly used in veterinary medicine for the diagnosis of systemic hypertension, because it is more practical and easy to access. There is little scientific information about the comparison of the two non- invasive methods of measurement of blood pressure in obese dogs. Therefore, the objective of this study was to evaluate the SBP in obese dogs by comparing both indirect methods of measuring blood pressure, with oscillometric and doppler vascular in order to verify the differences in blood pressure values, but also the best method to assess the SBP dogs in this body score condition. The study complain blood pressure measurement of 50 dogs, with were divided in obese dogs with mean body condition score (BCS) of 8.42 +/- 0.50 (n = 25) and dogs with ideal BCS of 4.56 +/- 0.51 (n = 25). At comparison of blood pressure values, SBP values obtained by doppler method (152 +/- 16mmHg) were higher than the oscillometric (136 +/- 11mmHg). Correspondence analysis determined by multivariate statistical analysis showed correlation between body condition and the procedure of the SBP. These findings suggest that the indirect method doppler can better reflect the SBP in obese dogs.

Effect of age and endometrial degenerative changes on uterine blood flow during early gestation in mares

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

Use of power doppler for the assessment of vascularization in equine tendinitis treated with mesenchymal stem cells

Tendinous lesions are very common in athlete horses. The process of tendon healing is slow and the quality of the new tissue is often inferior to the original, leading in many cases to recurrence of the lesion. One of the main reasons for the limited healing capacity of tendons is its poor vascularization. At present, cell therapy is used in equine practice for the treatment of several disorders including tendinitis, desmitis and joint disease. However, there is little information regarding the mechanisms of action of these cells during tissue repair. It is known that Mesenchymal Stem Cells (MSCs) release several growth factors at the site of implantation, some of which promote angiogenesis. Comparison of blood flow using power Doppler ultrasonography was performed after the induction superficial digital flexor tendon tendinitis and implantation of adipose tissue-derived MSCs in order to analyze the effect of cell therapy on tendon neovascularization. For quantification of blood vessel histopathological examinations were conducted. Increased blood flow and number of vessels was observed in treated tendons up to 30 days after cell implantation, suggesting promotion of angiogenesis by the cell therapy.

The contrast-enhanced Doppler ultrasound with perfluorocarbon exposed sonicated albumin does not improve the diagnosis of renal artery stenosis compared with angiography

There are no studies investigating the effect of the contrast infusion on the sensitivity and specificity of the main Doppler criteria of renal artery stenosis (RAS). Our aim was to evaluate the accuracy of these Doppler criteria prior to and following the intravenous administration of perfluorocarbon exposed sonicated albumin (PESDA) in patients suspected of having RAS. Thirty consecutive hypertensive patients (13 males, mean age of 57 ± 10 years) suspected of having RAS by clinical clues, were submitted to ultrasonography (US) of renal arteries before and after enhancement using continuous infusion of PESDA. All patients underwent angiography, and haemodynamically significant RAS was considered when ≥50%. At angiography, it was detected RAS ≥50% in 18 patients, 5 with bilateral stenosis. After contrast, the examination time was slightly reduced by approximately 20%. In non-enhanced US the sensitivity was better when based on resistance index (82.9%) while the specificity was better when based on renal aortic ratio (89.2%). The predictive positive value was stable for all indexes (74.0%–88.0%) while negative predictive value was low (44%–51%). The specificity and positive predictive value based on renal aortic ratio increased after PESDA injection respectively, from 89 to 97.3% and from 88 to 95%. In hypertensives suspected to have RAS the sensitivity and specificity of Duplex US is dependent of the criterion evaluated. Enhancement with continuous infusion of PESDA improves only the specificity based on renal aortic ratio but do not modify the sensitivity of any index.

Co2-dependent vasomotor reactivity of cerebral arteries in patients with severe traumatic brain injury: time course and effect of augmentation of cardiac output with dobutamine

Failing cerebral blood flow (CBF) autoregulation may contribute to cerebral damage after traumatic brain injury (TBI). The purpose of this study was to describe the time course of CO(2)-dependent vasoreactivity, measured as CBF velocity in response to hyperventilation (vasomotor reactivity [VMR] index). We included 13 patients who had had severe TBI, 8 of whom received norepinephrine (NE) based on clinical indication. In these patients, measurements were also performed after dobutamine administration, with a goal of increasing cardiac output by 30%. Blood flow velocity was measured with transcranial Doppler ultrasound in both hemispheres. All patients except one had an abnormal VMR index in at least one hemisphere within the first 24 h after TBI. In those patients who did not receive catecholamines, mean VMR index recovered within the first 48 to 72 h. In contrast, in patients who received NE within the first 48 h period, VMR index did not recover on the second day. Cardiac output and mean CBF velocity increased significantly during dobutamine administration, but VMR index did not change significantly. In conclusion, CO(2) vasomotor reactivity was abnormal in the first 24 h after TBI in most of the patients, but recovered within 48 h in those patients who did not receive NE, in contrast to those eventually receiving the drug. Addition of dobutamine to NE had variable but overall insignificant effects on CO(2) vasomotor reactivity.