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Microvascular Blood Flow (microvascular + blood_flow)
Selected AbstractsInfluence of Glucose Control and Improvement of Insulin Resistance on Microvascular Blood Flow and Endothelial Function in Patients with Diabetes Mellitus Type 2MICROCIRCULATION, Issue 7 2005THOMAS FORST ABSTRACT Objective: The study was performed to investigate the effect of improving metabolic control with pioglitazone in comparison to glimepiride on microvascular function in patients with diabetes mellitus type 2. Methods: A total of 179 patients were recruited and randomly assigned to one treatment group. Metabolic control (HbA1c), insulin resistance (HOMA index), and microvascular function (laser Doppler fluxmetry) were observed at baseline and after 3 and 6 months. Results: HbA1c improved in both treatment arms (pioglitazone: 7.52 ± 0.85% to 6.71 ± 0.89%, p < .0001; glimepiride: 7.44 ± 0.89% to 6.83 ± 0.85%, p < .0001). Insulin-resistance decreased significantly in the pioglitazone group (6.15 ± 4.05 to 3.85 ± 1.92, p < .0001) and remained unchanged in the glimepiride group. The microvascular response to heat significantly improved in both treatment groups (pioglitazone 48.5 [15.2; 91.8] to 88.8 [57.6; 124.1] arbitrary units [AU], p < .0001; glimepiride 53.7 [14.1; 91.9] to 87.9 [52.9, 131.0] AU, p < .0001, median [lower and upper quartile]). Endothelial function as measured with the acetylcholine response improved in the pioglitazone group (38.5 [22.2; 68.0] to 60.2 [36.9; 82.8], p = .0427) and remained unchanged in the glimepiride group. Conclusions: Improving metabolic control has beneficial effects in microvascular function in type 2 diabetic patients. Treatment of type 2 diabetic patients with pioglitazone exerts additional effects on endothelial function beyond metabolic control. [source] Microvascular blood flow of the optic nerve head and peripapillary retina in unilateral exfoliation syndromeACTA OPHTHALMOLOGICA, Issue 1 2004Ozcan Ocakoglu Abstract. Purpose:, To measure microvascular blood flow in patients with unilateral exfoliation syndrome (XFS) without glaucoma or ocular hypertension and to compare the values in the eyes with clinically detected exfoliation, their nonexfoliative fellow eyes of the same patients and control eyes. Methods:, Twenty-two patients with clinically detected unilateral XFS and 30 age-matched healthy subjects were included in this study. Group 1 consisted of 22 eyes with clinical XFS, and the nonexfoliative fellow eyes of the same patients formed Group 2. The control group (Group 3) comprised the randomly selected eyes of 30 age-matched healthy subjects. Ocular blood flow values (volume, flow and velocity) were recorded from the optic nerve head (ONH) and peripapillary retina (PPR) using the Heidelberg retinal flowmeter (HRF). The differences between the three groups were compared statistically. Results:, The mean values of blood flow obtained from the ONH and PPR in eyes with clinically detected exfoliation (Group 1) and their nonexfoliative fellow eyes (Group 2) were both significantly lower than the values for the control eyes (Group 3). The differences in ocular blood flow between the eyes with exfoliation and the nonexfoliative fellow eyes were not statistically significant [one-way analysis of variance (anova), Dunnett's T3 test, p , 0.05). Conclusion:, These findings suggest that the eyes with clinically detected unilateral XFS were associated with reduced blood flow values in both the ONH and the PPR. The nonexfoliative fellow eyes also have lower blood flow values than the control eyes. [source] Microcirculatory Responses To Electrical Spinal Cord Stimulation In Painful Diabetic Neuropathy And Other Painful ConditionsJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 3 2000Nd Harris Electrical spinal cord stimulation (ESCS) has been used to provide pain relief in a number of conditions, including painful diabetic neuropathy (PDN). ESCS has also been shown to increase microvascular blood flow in peripheral vascular disease. If nerve hypoxia contributes to pain in PDN, ESCS may relieve this by increasing nerve blood flow. We have therefore investigated skin and sural nerve microvascular responses to ESCS. We studied subjects implanted with ESCS for pain relief, 4 had PDN and 7 were controls with other painful conditions. Blood flow, before and during stimulation, was assessed using Laser Doppler flowmetry. Only one (PDN) subject showed a statistically significant increase in skin blood flow during stimulation. The three remaining PDN subjects showed significant reductions in skin blood flow, as did 3/7 of controls. Sural nerve blood flow was measured on a separate occasion. During stimulation nerve blood flow increased in 1 (control) subject, decreased in 1 (PDN) subject and did not change in the other 5 tested (3 PDN and 2 control). In summary, ESCS did not produce any consistent increase in skin or nerve microvascular blood flow. ESCS reduces pain in a variety of different conditions, however this does not appear to be mediated by changes in blood flow. Until a thorough understanding of the pathogenic mechanisms causing PDN is achieved, therapy will be limited to providing symptomatic relief. [source] Changes in renal hemodynamics and urodynamics in rats with chronic hyperoxaluria and after acute oxalate infusion: Role of free radicalsNEUROUROLOGY AND URODYNAMICS, Issue 2 2003Ho-Shiang Huang Abstract Aims The aim of this study was to evaluate possible changes in renal hemodynamic and urodynamic parameters in rats with chronic hyperoxaluria and after acute oxalate challenge. We also evaluated the possible association between free radical (FR) production, hyperoxaluria, and calcium oxalate (CaOx) calculi formation. Methods Chronic hyperoxaluria was induced by adding 0.75% ethylene glycol (EG) to the drinking water of male Wistar rats. After 7, 21, and 42 days of treatment, urinary biochemistry, oxalate levels, and lipid peroxides were measured. Kidney calculi were examined by polarizing microscopy. In the second part of the experiments, 1, 10, 20, and 30 mg kg,1 hr,1 oxalate was infused, by means of an intrarenal arterial catheter (IRA), into normal rats sequentially. Superoxide dismutase (SOD) infusion by means of IRA, in addition to oxalate, was also performed to check its influence on the altered renal function after oxalate infusion. In both the acute and chronic groups, renal blood flow (RBF), cortical microvascular blood flow (CMVBF), glomerular filtration rate (GFR), urine flow (UV), and urinary sodium excretion (UNaV) were measured, and chemiluminescence (CL) was examined in the renal venous blood. Results Levels of urinary lipid peroxides and enzymuria had increased since day 7, and increased the size of numbers of CaOx crystals in the kidney were noted beginning on day 21, but elevated CL was detectable only on day 7 after 0.75% EG treatment. Decreased UV and UNaV were noted in the 42-day EG group, although the 24-hr creatinine clearance values were normal in all experimental groups. On the other hand, RBF, GFR, and CMVBF were attenuated with elevated FR when the oxalate concentration was higher than 10 mg kg,1 hr,1 in the acute oxalate infusion group. With SOD pretreatment, the decreased RBF, GFR, and CMVBF could be reversed at 10 mg kg,1 hr,1 of oxalate, and be partially reversed at 20. FR also could be reduced significantly at 10 and 20 mg kg,1 hr,1 of oxalate. Conclusions Decreased urine flow and sodium excretion were the main renal functions affected by chronic hyperoxaluria. However, that only the 42-day EG group had a decreased tubular function cannot be fully explained by the persistent tubular enzymuria and increased lipid peroxides that began on day 7 after EG treatment. With acute oxalate infusion, the major insult to renal function was renal hemodynamics. Pretreated SOD could reverse the attenuated hemodynamics and reduce the elevated FR partly, which suggested that FR is responsible for oxalate toxicity. Neurourol. Urodynam. 22:176,182, 2003. © 2003 Wiley-Liss, Inc. [source] Diannexin, a Novel Annexin V Homodimer, Protects Rat Liver Transplants Against Cold Ischemia-Reperfusion InjuryAMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2007X.-D. Shen Ischemia/reperfusion injury (IRI) remains an important problem in clinical transplantation. Following ischemia, phosphatidylserine (PS) translocates to surfaces of endothelial cells (ECs) and promotes the early attachment of leukocytes/platelets, impairing microvascular blood flow. Diannexin, a 73 KD homodimer of human annexin V, binds to PS, prevents attachment of leukocytes/platelets to EC, and maintains sinusoidal blood flow. This study analyzes whether Diannexin treatment can prevent cold IRI in liver transplantation. Rat livers were stored at 4°C in UW solution for 24 h, and then transplanted orthotopically (OLT) into syngeneic recipients. Diannexin (200 ,g/kg) was infused into: (i) donor livers after recovering and before reperfusion, (ii) OLT recipients at reperfusion and day +2. Controls consisted of untreated OLTs. Both Diannexin regimens increased OLT survival from 40% to 100%, depressed sALT levels, and decreased hepatic histological injury. Diannexin treatment decreased TNF-,, IL-1,, IP-10 expression, diminished expression of P-selectin, endothelial ICAM-1, and attenuated OLT infiltration by macrophages, CD4 cells and PMNs. Diannexin increased expression of HO-1/Bcl-2/Bcl-xl, and reduced Caspase-3/TUNEL+ apoptotic cells. Thus, by modulating leukocyte/platelet trafficking and EC activation in OLTs, Diannexin suppressed vascular inflammatory responses and decreased apoptosis. Diannexin deserves further exploration as a novel agent to attenuate IRI, and thereby improve OLT function/increase organ donor pool. [source] Microvascular blood flow of the optic nerve head and peripapillary retina in unilateral exfoliation syndromeACTA OPHTHALMOLOGICA, Issue 1 2004Ozcan Ocakoglu Abstract. Purpose:, To measure microvascular blood flow in patients with unilateral exfoliation syndrome (XFS) without glaucoma or ocular hypertension and to compare the values in the eyes with clinically detected exfoliation, their nonexfoliative fellow eyes of the same patients and control eyes. Methods:, Twenty-two patients with clinically detected unilateral XFS and 30 age-matched healthy subjects were included in this study. Group 1 consisted of 22 eyes with clinical XFS, and the nonexfoliative fellow eyes of the same patients formed Group 2. The control group (Group 3) comprised the randomly selected eyes of 30 age-matched healthy subjects. Ocular blood flow values (volume, flow and velocity) were recorded from the optic nerve head (ONH) and peripapillary retina (PPR) using the Heidelberg retinal flowmeter (HRF). The differences between the three groups were compared statistically. Results:, The mean values of blood flow obtained from the ONH and PPR in eyes with clinically detected exfoliation (Group 1) and their nonexfoliative fellow eyes (Group 2) were both significantly lower than the values for the control eyes (Group 3). The differences in ocular blood flow between the eyes with exfoliation and the nonexfoliative fellow eyes were not statistically significant [one-way analysis of variance (anova), Dunnett's T3 test, p , 0.05). Conclusion:, These findings suggest that the eyes with clinically detected unilateral XFS were associated with reduced blood flow values in both the ONH and the PPR. The nonexfoliative fellow eyes also have lower blood flow values than the control eyes. [source] |