Characterisation of the haemodynamics of the superior mesenteric artery

In contrast to its prevalence in the surrounding vasculature, occurrence of primary atherosclerotic disease in the superior mesenteric artery (SMA) is rare (Glagov et al., 1988. Hemodynamics and atherosclerosis, Insights and perspectives gained from studies of human arteries. Archives of Pathology and Laboratory Medicine 112(10), 1018-1031; Hansen et al., 2004. Mesenteric artery disease in the elderly. Journal of Vascular Surgery 40(1), 45-52). We hypothesise that this sparing might be attributed to more favourable haemodynamic characteristics in the SMA than in other vessels locally. Dynamic magnetic resonance imaging (MRI) images established that the SMA is highly mobile (Jeays, 2006. Investigation of blood flow in the superior mesenteric artery and its potential influence on atheroma and gut ischaemia. Ph.D. Thesis, University of Sheffield), and thus that an analysis based on rigid geometry might be inappropriate. This paper describes an efficient methodology for the construction of a patient-specific, time-dependent model of an arterial segment and reports the results of a haemodynamic characterisation of the SMA for one individual. A transient computational fluid dynamic (CFD) model was constructed by morphing a parametric mesh constructed from simple geometric primitives. This process has the merit that it is easy to control the element size distribution mapped onto the original geometric primitives. It is robust in operation, and is ideally suited to the generation of dynamic CFD meshes of arterial systems that are free from major pathology. Flow boundary conditions were determined based on phase contrast MRI velocity measurements. Comparative studies with rigid walls and with moving walls, based on the transient data, indicated that, despite the significant motion of the SMA (radial dilation of the order of 10% and translation of the order of the radius), the maximum (spatially and temporally-resolved) wall shear stresses changed by no more than 21.6% of a global norm, and the average change was less than 2.1%.     

The association of colour flow Doppler sonography and conventional ultrasonography improves the diagnosis of thyroid carcinoma

OBJECTIVE: In the present study, we compared the results of conventional ultrasonography (US) and colour flow Doppler sonography (CFDS) with those of US guided fine needle aspiration biopsy (FNAB) and of pathologic staging of resected thyroid nodules, to assess the relative importance of US and CFDS in discriminating malignant thyroid nodules. SUBJECTS AND STUDY DESIGN: We retrospectively reviewed records of 230 patients submitted to US-guided FNAB before surgery for solitary, not hot thyroid nodules. Before US guided FNAB, they were examined with conventional US and CFDS. Conventional US evaluated nodule size, echogenicity, presence of halo sign and microcalcifications. CFDS evaluated the vascular pattern classified as types I, II and III. Twenty-seven patients with inadequate cytology were excluded from this study (11.7%). RESULTS: Two hundred and three patients underwent surgery. At histology a thyroid carcinoma was found in 36 patients (17.7%) and a benign nodule was observed in 167 patients (82.3%). We did not find any difference in cancer prevalence between nodules with a primary tumour size < or =1 cm and those >1 cm (17.6 vs. 17.7%; p = 0.99). A solid echo texture was not statistically significant to suggest malignancy (p = 0.32). Microcalcifications were seen in 83.3% (30/36) of malignant nodules and in 33.5% (56/167) of benign nodules. These results were statistically significant (p < 0.0001). The type III flow as determined by CFDS was a statistically significant criterion to suggest malignant disease (p < 0.005). The most predictive findings of malignancy on conventional US was the combination of microcalcifications plus the absence of halo sign (sensitivity 75%, specificity 71.9%, p < 0.0001). The combination of an absence of halo sign on conventional US and a type III pattern on CFDS presented the higher sensitivity (83.3%) for malignancy with a specificity of 43.7%. Microcalcifications on US in combination with a type III CFDS pattern showed a lesser sensitivity (80.6%) with an improved specificity (75.4%). In our opinion, the better balanced combination of US and CFDS features was the absence of halo sign plus microcalcifications and a type III CDFS pattern (sensitivity 72.2%, specificity 77.2%). CONCLUSIONS: The combination of conventional US and CFDS provides benefits in increasing the screening sensitivity and accuracy in distinguishing malignant thyroid nodules.     

Polycystic renal diseases: morphology and genetic counseling

The designation "polycystic kidneys" is vague and causes considerable confusion. This term comprises a number of affections, characterized by the presence of renal cysts. Cystic kidneys may be hereditary or sporadic. The defect may be isolated or occur as part of a syndrome. The identification of the exact nature of the lesion is therefore of paramount importance, not only for the prognosis of the propositus, but especially for the correct genetic counselling of the family. In this context, the perinatal autopsy represents an irreplaceable method of investigation. Since the pathogenesis of many, if not all, types of polycystic kidneys remains unknown, a practical classification must be based on gross and microscopic pathologic study, clinical features, and family history. Osathanondh and Potter (1964) distinguished four varieties, based on morphological findings, revealed by microdissection. Unfortunately, not all types of cystic kidneys are included in this classification. Moreover, their type III cystic kidney collects a number of clearly different entities. Nevertheless, once one is familiar with its deficiencies, the Osathanondh and Potter classification is still very useful.     

Acute renal insufficiency in the rabbit by glycerol.

The appearance of an acute renal insufficiency in the rabbit, after glycerol injection (10, 13 or 15 ml/kg of a 50% solution) is investigated. After a 24 hours of intoxication, especially in the ten following days, cylinders, erythrocytes and renal cells appear in the urine sediment. Proteinuria appears after 24 hours and practically disappears after 72 h. Glucosuria persists from 24 hours to 6 days. Haemoglobinuria is intense after 24 and 48 hours and persists slightly about 6 days. Na, K and Cl elimination in urine diminishes clearly in all animals. Plasma K increases in non-surviving animals and does not change in those surviving. Plasma Na does not change in the dying ones, and decreases in those surviving. In non-surviving animals, pH, pCO2 and CO3H minus decrease sharply. In the surviving ones pCO2 decreases clearly after 24 hours, increasing afterwards slowly to normal values. pH increases, slightly during the first 48 hours, and then neatly during approximately 6 days. Standard CO2H minus does not change during the first 48 hours, increasing afterwards during 6 to 7 days. Histologically, the chief lesion is a vacuolar degeneration of the proximal tubule. The possible mechanisms of such alterations are discussed.     

Uterine artery blood flow and renal sympathetic nerve activity during exercise in rabbit pregnancy

The uterine artery blood flow (UtBF) and renal sympathetic nerve activity (SNA) responses to treadmill exercise were evaluated in 12 nonpregnant (NP) and 17 term pregnant (P) rabbits. UtBF was monitored continuously with a Transonic flowprobe. Rabbits underwent three exercise trials (5-min duration) that varied in absolute workload. The rise in renal SNA with exercise was intensity related. Pregnancy did not affect the average steady-state renal SNA response expressed relative to maximum activity (P 24 +/- 1% vs. NP 23 +/- 2% of maximum smoke-elicited activity) and increased the average renal SNA response expressed relative to resting activity (P +155 +/- 19% vs. NP +84 +/- 23% from rest, P = 0.03) At rest, UtBF (P 13 +/- 3 vs. NP 1.9 +/- 0.3 ml/min) and uterine artery conductance (UtC; P 22 +/- 5 vs. NP 2.8 +/- 0.5 ml. min-1.mmHg-1 x 10-2) were elevated in the P rabbits. The average exercise-related decreases in UtBF (P -16 +/- 4% vs. NP -48 +/- 4%) and UtC (P -27 +/- 4% vs. NP -54 +/- 4%) were attenuated in the P rabbits. Pregnancy does not impair the ability to raise renal SNA but attenuates the uterine artery constrictor response to moderate to heavy dynamic exercise in rabbits. Under normal conditions, the pregnant uterine circulatory bed may be relatively protected from exercise-related redistribution of blood flow.     

The formation and biotransformation of cysteine conjugates of halogenated ethylenes by rabbit renal tubules

The nephrotoxicity of chlorotrifluoroethylene (CTFE) was examined using isolated rabbit renal tubules suspensions. Exposure of the tubules to CTFE resulted in consumption of CTFE, formation of a glutathione conjugate and inhibition of active organic acid transport. Synthetic cysteine, N-acetylcysteine or glutathione conjugates of CTFE inhibited transport indicating S-conjugation as a possible toxic pathway. 1,2-dichlorovinyl glutathione (DCVG), a model synthetic glutathione conjugate, was used to examine the degradation and toxicity of these conjugates. DCVG inhibited rabbit renal tubule transport in vivo and in vitro. The DCVG was found to be degraded with the evolution of glutamine and glycine to produce the ultimate nephrotoxicant, dichlorovinyl cysteine. Dichlorovinyl cysteine is then bioactivated with the release of ammonia. This sequential degradation explains the latency of DCVG-induced renal transport inhibition relative to dichlorovinyl cysteine. It is now evident that certain halogenated ethylenes are capable of being biotransformed to glutathione conjugates in the kidney with their subsequent hydrolysis to nephrotoxic cysteine conjugates.     

Coccygeus and levator ani muscles in the rabbit: morphology and proprioceptive innervation

The Authors have studied the morphological features and the proprioceptive nervous component in the coccygeus and levator ani muscles of the rabbit, using Ruffini's and Barker-Ip's impregnations. The coccygeus muscle originates from ischiatic spine and inserts on the last three sacral vertebrae and on the first four or five caudal vertebrae. The levator ani muscle originates from the ischiatic spine and the coccygeus muscle aponeurosis and inserts directly on the caudal vertebrae 3-5 or 4-6. The proprioceptive innervation in both muscles is constituted by muscle spindles and Golgi tendon organs with a typical structure. Muscle spindles are more numerous than Golgi tendon organs and the spindle density is higher in the levator ani muscle.     

The effect of graded renal nerve stimulation on renal function in the anaesthetized rabbit

The renal nerves of the rabbit were stimulated to cause less than 5, 9 or 22% reduction in renal blood flow. Glomerular filtration rate was reduced by 0, 3 and 11% respectively when the renal nerves were stimulated at these increasing rates. At low and moderate rates of renal nerve stimulation absolute and fractional sodium excretions were reduced by between 17 and 22%, but at the highest rates they were reduced by 55 and 53% respectively. At increasing rates of renal nerve stimulation plasma renin activity was increased by 40, 70 and 180%.     

The adrenergic innervation of the renal artery and vein of the rat

Summary The adrenergic innervation of the extrarenal blood vessels of the rat left kidney was investigated by fluorescence histochemistry and by electron microscopy. The trunk of the renal artery proximal to the aorta is elastic and appears to be very sparsely innervated. In contrast, near the kidney the renal artery—which divides into 3 to 4 large branches of the muscular type possesses a dense adrenergic innervation. The adrenergic terminal axons are situated in the adventitia close to the external elastic lamella, but only rarely in close contact with smooth muscle cells. In most instances several terminal axons are grouped and enclosed by a Schwann cell, single axons being rare. All terminal axons are able to take up and to store 5-hydroxydopamine which strongly suggests that they are adrenergic. The innervation of the renal vein is more sparse than that of the muscular arteries but somewhat denser than that of the elastic artery. In addition, close to the origin of the renal artery the presence of small intensively fluorescent (SIF) cells as well as of some adrenergic ganglion cells is noted. The latter are situated in the adrenergic nonterminal axon bundles, which run parallel to the blood vessels.It is concluded that the uneven adrenergic innervation along the artery as well as individual variations in the branching of the artery are the main causes of the unusually high individual variations of the NA content of this organ such as used in pharmacological experiments.     

The accumulation and metabolism of [C]hypoxanthine by slices of rabbit renal medulla

The uptake of hypoxanthine by rabbit renal medulla has been studied with in vitro conditions. Unlike the uptake by renal cortex slices reported earlier, no evidence was found for involvement of an organic cation transport system. Medullary accumulation of the ¹⁴C-labeled material occurred in the absence of O₂ if glucose was present as substrate. Uptake of the ¹⁴C label was not supported by other sugars or metabolic intermediates, however. Metabolic inhibitors reduced both aerobic and anaerobic uptake. Tissue extracts were subjected to high-voltage electrophoresis and gel filtration for identification of possible metabolites. These studies indicated that most of the uptake of ¹⁴C-labeled material was accounted for by its conversion to inosine-like and/or inosinic acid-like compounds. That is, when experimental conditions were designed to retard slice metabolism of hypoxanthine, tissue to medium ratios for ¹⁴C approximated 1.0. A third metabolite was found occasionally, but remains unidentified.     

Unistellate spermatozoa of decapods: comparative evaluation and evolution of the morphology

Decapod unistellate spermatozoa are primarily characterized by the presence of a single appendage (spike) extending from the acrosome. Among decapods, this type of spermatozoon is found only in shrimps of the families Sicyoniidae, Penaeidae, and Solenoceridae (suborder Dendrobranchiata) and of the infraorder Caridea (suborder Pleocyemata). This review comparatively discusses the morphological diversity of unistellate spermatozoal ultrastructure among these decapods, as well as the role of the primary structures involved in the fertilization and spermatozoal capacitation. Furthermore, the use of the unistellate spermatozoal ultrastructure to support phylogenetic relationships and of the current phylogenetic evidences to investigate the evolution of spermatozoa of decapods is discussed. Morphologically, the main differences between caridean and dendrobranchiate unistellate spermatozoa are the shape of the main body (inverted cup-shaped, and spherical, bulged or elongate, respectively) and complexity of the acrosomal region. The latter is directly related to the type of fertilization. For example, dendrobranchiates have more complex acrosomal regions than that carideans, and fertilization involves a visible acrosome reaction, which is not observed in carideans. Ultrastructural changes of spermatozoa throughout capacitation are unknown in carideans, but for dendrobranchiates generally occur in the acrosomal vesicle and subacrosomal region throughout attachment of the spermatophore to the thelycum, enabling fertilization by the spermatozoa. Comparative evaluation of spermatozoal morphology and current phylogenetic evidences corroborates the hypothesis that the spermatozoal spike of carideans and dendrobranchiates is the result of convergent evolution.     

Accuracy of evaluation of ovarian structures by transrectal ultrasonography in ewes

The objective of this study was to assess the accuracy of estimating the size and number of corpora lutea (CL) and ovarian follicles by ultrasonography (US) of the ewe in standing position. US observations were compared with those made at subsequent postmortem examination of the ovaries. Corriedale ewes (n=50) of unknown reproductive history and at random stages of the oestrus cycle were used for the study. Transrectal US was performed using a 7.5 MHz transducer with the ewe in standing position. The ewes were slaughtered 12 h after the US examination and the ovaries collected, dissected and the number and size of the CL and follicles evaluated. CL were classified as functional or non-functional on the basis of their colour and follicles were classified by size (2, 3, 4 and > or =5 mm). Accuracy of US was assessed by calculating its positive predictive value and sensitivity. The data were evaluated by Pearson correlation and linear regression analysis. The predictive value and sensitivity of US was 100% for the presence and 96% for the absence of CL. In four out of five ewes with double ovulations, the presence of both CL was correctly diagnosed by US. For functional CL, the sensitivity of US was 100%. The regression coefficient for CL diameter was significant (P< or =0.001; r2=0.4; n=35). The size of 85 of 117 follicles was accurately determined. The correlation between numbers of follicles counted by US and postmortem increased with size of follicle from r=0.44 (P< or =0.01) for 2 mm to r=0.85 (P< or =0.001) for >or =5 mm diameter follicles. The regression between the diameter of follicles determined by the two methods was significant (P< or =0.001; r2=0.8; n=117). The predictive value of US for the number of follicles was high (98-100%) for all follicle sizes except for 3 mm diameter follicles (predictive value 71%). Similarly, the sensitivity was high for all sizes of follicles (90-95%) except for those of 2 mm diameter (62%). It was concluded that ultrasound scanning provides a highly accurate method for determining the number of CL and follicles > or =4 mm diameter but that its predictive value and sensitivity are lower for smaller diameter follicles. The regression equation for diameter measured by US on that evaluated postmortem explained more of the variation for follicles than for CL.     

The effect of nitrendipine on renal haemodynamics and tubular reabsorption and its neural control in anaesthetised rats with chronic renal failure.

This study examined the influence of a calcium channel antagonist, nitrendipine, on blood pressure and kidney function in a rat model of chronic renal failure. Additionally, the effects of low frequency renal nerve stimulation were studied in the presence and absence of nitrendipine. Male Wistar rats were fed a diet high in adenine for 4 weeks and then acutely anaesthetised and prepared for renal functional measurements. Blood pressure was elevated but renal blood flow and glomerular filtration rate were reduced, between 30 to 50%, urine flow and absolute sodium excretion were lower and fractional sodium excretion was two to three times higher than in normal rats. Nitrendipine (0.25 microg/kg/min i.v.) decreased blood pressure at 114+/-7 mm Hg, by 11% (P<0.05), increased left renal blood flow, at 1.3+/-0.2 ml/min(-1) g(-1), by 16% (P<0.01), and urine flow, absolute and fractional sodium excretions, by between 50-83% (all P<0.05). Renal nerves stimulation (0.7-1.3 Hz, 15V, 0.2 ms) decreased (P<0.02) left renal blood flow by 10% but had no effect on excretory variables, irrespective of nitrendipine administration. These results show that in renal failure rats the vascular and tubular responses to nitrendipine are preserved. However, the neural regulation of tubular reabsorption is abolished in this experimental model, irrespective of nitrendipine administration.