Abnormal vascular coiling of the umbilical cord in gestational diabetes mellitus

The objective of this study was to identify abnormal vascular coiling of the umbilical cord in neonates of mothers with gestational diabetes mellitus. The umbilical cords of 57 neonates of gestational diabetic mothers were examined and the coiling index determined by dividing the total number of complete vascular coils by the length of the cord in centimeters. Obstetric history, delivery data and neonatal outcome were also evaluated. These variables were compared with those obtained for 389 normal pregnancies. The frequency distribution of umbilical coiling index in the control population and gestational diabetic mothers were normal (10th and 90th percentiles = 0.17 and 0.37; mean +/- SD = 0.26 +/- 0.09 and 0.24 +/- 0.12 coils/cm, respectively). Non-coiling and hyper-coiling were significantly more frequent with diabetic than with normal pregnancy (p = 0.004; p = 0.008, respectively). Both abnormalities of umbilical vascular coiling were also significantly associated with adverse perinatal outcome (p = 0.04) and emergency cesarean delivery (p < 0.0001) in the diabetic and control (p = 0.03; p < 0.0001, respectively) groups. Neonates of gestational diabetic mothers are therefore more likely to have hyper-coiled or non-coiled umbilical blood vessels. Perinatal morbidity and emergency cesarean delivery are increased in this subgroup.     

Umbilical blood flow and the effects of premature severance in the neonatal horse

Thirteen randomly assigned Quarter Horse foals were used in a study to determine the presence of umbilical blood flow immediately post partum and to determine if premature severance of the umbilical cord would alter significantly the hematology of the horse neonate. Packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), hemoglobin concentration (Hgb), red blood cell count (RBC), plasma protein (PP), and heart and respiratory rates were determined every 30 min for the first 6 h of life for both control and treated foals. Control foals had their umbilical cords measured for the presence of umbilical blood flow. Treated foals had their umbilical cords separated after birth and any free flow of blood collected and a volume measure determined. The umbilicus was separated within 10 sec post partum.No blood flow was detected in the control group of foals within 2 min post partum. The blood obtained from the separated umbilicus of the treatment group measured less than 125 cc. PCV, MCV, MCHC, Hgb, RBC, and PP were not significantly different between the two groups (P > 0.05). Except for MCHC and PP, all parameters studied decreased over the first 6 h of life. Heart rate and respiration rates did not significantly differ from each other (P > 0.05) and decreased over the first 6 h of life.     

Comparison of pressure losses in steady non-Newtonian flow through experimental tapered and cylindrical arterial prostheses

The use of an arterial prosthesis with a tapered lumen has several important advantages; for example, improved stability of flow, increased wall shear and better matching of its size with that of the host vessel. Tapering may, however, lead to increased energy losses, particularly if the angle of taper is large and the flow is high. This study is concerned with the determination of pressure drop for steady and laminar converging flow through rigid wall models of tapered arterial grafts. The angles of taper examined ranged from 0.5° to 1.0°. Aqueous solutions of polyacrylamide, with non-Newtonian viscous properties similar to those of blood, were used. The pressure drops across the tapered tubes were measured and the data were measured and the data were related to the pressure loss in cylindrical tubes of equivalent dimensions. Expressions for the ratio of the pressure drop in a tapered tube to that in a cylindrical tube for steady flow of a power law fluid were derived; there was good agreement between the predicted and the measured pressure drop ratios over a wide range of flows. The results of this study may be applied to the design of tapered arterial grafts. The pressure losses to be expected in tapered bypass grafts having various dimensions can easily be computed.     

Simultaneous isolation of endothelial and smooth muscle cells from human umbilical artery or vein and their growth response to low-density lipoproteins

In the pathogenesis of atherosclerosis the interplay of endothelial cells (ECs) and smooth muscle cells (SMCs) is disturbed. Oxidatively modified low-density lipoproteins (oxLDLs), important stimulators of atherosclerotic plaque formation in vessels, modify the growth response of both cell types. To compare growth responses of ECs and SMCs of the same vessel with oxLDLs, we developed a method to isolate both cell types from the vessel walls of umbilical cords by enzymatic digestion. The method further allowed the simultaneous isolation of venous and arterial cells from a single umbilical cord. In culture, venous ECs showed an elongated appearance compared with arterial ECs, whereas SMCs of artery and vein did not look different. Smooth muscle cells of both vessel types responded to oxLDLs (60 microg/ml) with an increase in their [(3)H]-thymidine incorporation into DNA. On the contrary, ECs of artery or vein decreased [(3)H]-thymidine incorporation and cell number in the presence of oxLDLs (60 microg/ml) of increasing oxidation grade. Thus, human umbilical SMCs and ECs of the same vessel show a disparate growth response toward oxLDLs. But the physiologically more relevant minimal oxLDLs did not decrease proliferation in venous ECs but only in arterial ECs. This difference in tolerance toward minimal oxLDLs should be taken into account while using venous or arterial ECs of umbilical cord for research in atherosclerosis. Further differences of venous and arterial ECs in tolerance toward minimal oxLDLs could be of clinical relevance for coronary artery bypass grafts.     

Network Scale Modeling of Lymph Transport and Its Effective Pumping Parameters

The lymphatic system is an open-ended network of vessels that run in parallel to the blood circulation system. These vessels are present in almost all of the tissues of the body to remove excess fluid. Similar to blood vessels, lymphatic vessels are found in branched arrangements. Due to the complexity of experiments on lymphatic networks and the difficulty to control the important functional parameters in these setups, computational modeling becomes an effective and essential means of understanding lymphatic network pumping dynamics. Here we aimed to determine the effect of pumping coordination in branched network structures on the regulation of lymph flow. Lymphatic vessel networks were created by building upon our previous lumped-parameter model of lymphangions in series. In our network model, each vessel is itself divided into multiple lymphangions by lymphatic valves that help maintain forward flow. Vessel junctions are modeled by equating the pressures and balancing mass flows. Our results demonstrated that a 1.5 s rest-period between contractions optimizes the flow rate. A time delay between contractions of lymphangions at the junction of branches provided an advantage over synchronous pumping, but additional time delays within individual vessels only increased the flow rate for adverse pressure differences greater than 10.5 cmH₂O. Additionally, we quantified the pumping capability of the system under increasing levels of steady transmural pressure and outflow pressure for different network sizes. We observed that peak flow rates normally occurred under transmural pressures between 2 to 4 cmH₂O (for multiple pressure differences and network sizes). Networks with 10 lymphangions per vessel had the highest pumping capability under a wide range of adverse pressure differences. For favorable pressure differences, pumping was more efficient with fewer lymphangions. These findings are valuable for translating experimental measurements from the single lymphangion level to tissue and organ scales.     

Effect of prostaglandins A1, A2, B1, B2, E2 and F2 alpha on human umbilical cord vessels

Human umbilical blood vessels have the ability to close spontaneously following delivery at term. It has been suggested that prostaglandins may have a possible physiological role in its closure. This study investigates the effects of 6 naturally occurring prostaglandins (A1, A2, B1, B2, E2, F2a) on the umbilical blood vessels. Umbilical cords were collected from cases of normal spontaneous vaginal deliveries and cesarian section at term. A total of 41 strips of umbilical arteries and 26 strips of umbilical veins from 24 cords were used. A 4-point bioassay method was used to compare the potency of prostaglandins A1, A2, B1 and F2a with PGE2. The effect of Polyphloretin Phosphate (PPP) on prostaglandin-induced contractions was studied on umbilical artery strips from 12 cords. The 6 prostaglandins exerted a stimulant effect on the isolated strips of human umbilical arteries. Prostaglandin B2 was the most potent compound on the umbilical vein, followed by PGA2. PPP in the concentration range of 10 to 40 mcg/ml completely eliminated the responses of PGE2, F2a, A1, A2, and B1. Responses to PGB2 were considerably but not completely abolished. PPP (up to 40 mcg/ml) did not affect contractions induced by 5-hydroxytryptamine, suggesting the presence of discrete receptor sites in the blood vessels for different pharmacologically active compounds. This is the first report of the constrictor effect of PGA and PGB compounds. These naturally occuring prostaglandins with high potencies (compared with other prostaglandins and other vasoactive substances) may play a role in spontaneous closure of umbilical vessels. PGE1, E2, F1 and F2a are found in umbilical blood vessels obtained at term.     

A rapid screening test for HIV-1 antibodies: application to biological studies on human tissue

Human umbilical cord vessels are commonly used as a source of human vascular tissue for physiological studies and as a source of endothelial and smooth muscle cells. Blood samples from 236 umbilical cords were tested for the presence of HIV-1 antibodies to access the prevalence of HIV-1 infection and to evaluate possible methods for screening umbilical cords. Ten of the 236 samples were HIV-1 antibody positive by ELISA whereas 3 were positive by Western blot and a new method, the Quick-Western blot. Two of the 3 positive samples contained antibody bands against gp160, gp120, gp41, and p24 HIV-1 proteins, and one sample had antibodies against only gp160, gp120 and gp41. The Quick-Western blot required only 45 minutes for the analysis while the ELISA and Western blot took 3 hours and 18 hours, respectively. These data indicate that HIV-1 infection in mothers may present a hazard to researchers using human umbilical cords as a source of vascular tissue. The Quick-Western blot method is a simple, portable, rapid and accurate method that may be used to screen blood. The short analysis time of the Quick-Western blot allows the identification of infected blood before the tissue deteriorates as a source of cells or vascular tissue for experimental studies.     

Innervation of the umbilical vessels

Summary Umbilical vessels of guinea-pig fetuses were studied shortly before birth. In all umbilical cords investigated an innervation of the umbilical vessels is lacking. The intrafetal parts of the umbilical vessels on the other hand are richly innervated. A marked difference in the amount of nerve fibres and the pattern of innervation is found between artery and vein. The artery is supplied by a dense nerve plexus which spins around the media and which originates from nerve bundles within the outer adventitial layers. The comparatively scanty innervation of the vein exhibits a more coarsely meshed net pattern. The nerve bundles in the vein exhibit a close affinity to the vasa vasorum.Number and type of the close contacts between the muscle cells are different in the various sections of the umbilical vessels. Similar to the distribution of nerves they are almost absent in the vessels of the umbilical cord, numerously, however, in the intrafetal parts. Contrary to the innervation, the close contacts in the vein are developed more numerously and more broadly than in the corresponding artery.     

Characterization of the in vivo wall shear stress environment of human fetus umbilical arteries and veins

The endothelial cells of the umbilical vessels are frequently used in mechanobiology experiments. They are known to respond to wall shear stress (WSS) of blood flow, which influences vascular growth and remodeling. The in vivo environment of umbilical vascular WSS, however, is not well characterized. In this study, we performed detailed characterization of the umbilical vascular WSS environments using clinical ultrasound scans combined with computational simulations. Doppler ultrasound scans of 28 normal human fetuses from 32nd to 33rd gestational weeks were investigated. Vascular cross-sectional areas were quantified through 3D reconstruction of the vascular geometry from 3D B-mode ultrasound images, and flow velocities were quantified through pulse wave Doppler. WSS in umbilical vein was computed with Poiseuille’s equation, whereas WSS in umbilical artery was obtained via computational fluid dynamics simulations of the helical arterial geometry. Results showed that blood flow velocity for umbilical artery and vein did not correlate with vascular sizes, suggesting that velocity had a very weak trend with or remained constant over vascular sizes. Average WSS for umbilical arteries and vein was 2.81 and 0.52 Pa, respectively. Umbilical vein WSS showed a significant negative correlation with the vessel diameter, but umbilical artery did not show any correlation. We hypothesize that this may be due to differential regulation of vascular sizes based on WSS sensing. Due to the helical geometry of umbilical arteries, bending of the umbilical cord did not significantly alter the vascular resistance or WSS, unlike that in the umbilical veins. We hypothesize that the helical shape of umbilical arteries may be an adaptation feature to render a higher constancy of WSS and flow in the arteries despite umbilical cord bending.     

脐带间充质干细胞——组织工程的新视角

目的 从脐带中分离培养脐带间充质干细胞(mesenchymal stem cell, MSC) 并进行鉴定,阐明其多向分化的潜在作用.方法 收集健康胎儿脐带,分离培养脐带中的间充质干细胞,以流式细胞仪对培养的间充质干细胞进行细胞表面标志检测,多种成分联合诱导其向脂肪、成骨方向分化,细胞化学染色检测诱导后的细胞变化.结果 脐带中分离培养的间充质干细胞不表达造血细胞系的标志CD34、CD45、HLA-DR,强表达CD105、CD44、CD90,在适当的诱导条件下可向脂肪及成骨方向分化.结论 脐带中存在具有多向分化潜能的间充质干细胞.     

Current Perspectives on Umbilical Cord Abnormalities Including Blood Flow Parameters Based on Ultrasound Observations

The umbilical cord is a vital structure between the fetus and placenta for the growth and well-being of the fetus. Although the umbilical cord may be the only organ that dies at the beginning of life, it is one of the most important parts of the feta-placental unit and plays a role in determining how life begins. In general, the prenatal examination of the umbilical cord is limited to the observation of the number of vessels and the evaluation of umbilical artery blood flow parameters. Pathologists have done more research on the morphological characteristics of the umbilical cord and linked them to perinatal outcomes. The introduction of advanced imaging technology makes it possible to study the characteristics of fetal umbilical cord from early to late gestation. Many studies have shown that the changes of umbilical cord structure may be related to pathological conditions, such as preeclampsia, fetal growth restriction. Prenatal morphometric umbilical cord characteristics and arterial blood flow parameters in normal and pathologic conditions are discussed in this review.     

Effects of elastic compression stockings on wall shear stress in deep and superficial veins of the calf

The purpose of this study was to estimate wall shear stress (WSS) in individual vessels of the venous circulation of the calf and quantify the effects of elastic compression based on change of vessel geometry and velocity waveform. The great saphenous vein and either a peroneal or posterior tibial vein have been imaged in four healthy subjects using magnetic resonance imaging, with and without the presence of a grade 1 medical stocking. Flow through image-based reconstructed geometries was numerically simulated for both a range of steady flow rates and ultrasound-derived transient velocity waveforms, scaled to give a standardized time averaged flow rate. For steady flow, the stocking produced an average percentage increase in mean WSS of approximately 100% in the great saphenous vein across a range of 0.125-1.25 ml/s. The percentage increase in the peroneal/posterior tibial veins varied from 490 to 650% across a range of 0.5-5 ml/s. In addition, application of the stocking eliminated periods of very low or zero flow from the transient waveforms. The average minimum value of WSS in all vessels without the stocking was <0.1 Pa. With the stocking, this was increased to 0.7 Pa in the great saphenous and 0.9 Pa in the peroneal/posterior tibial veins. The pathophysiological effects of these changes are discussed. In conclusion, the flight stocking was effective in raising venous WSS levels in prone subjects, and this effect was much more pronounced in the deep vessels. The stocking also tended to prevent cessation of flow during periods of increased downstream pressure produced by respiration.     

Flow in a catheterized curved artery with stenosis

The fluid mechanics of blood flow in a catheterized curved artery with stenosis is studied through a mathematical analysis. Blood is modelled as an incompressible Newtonian fluid and the flow is assumed to be steady and laminar. An approximate analytic solution to the problem is obtained through a double series perturbation analysis for the case of small curvature and mild stenosis. The effect of catheterization on various physiologically important flow characteristics (i.e. the pressure drop, impedance and the wall shear stress) is studied for different values of the catheter size and Reynolds number of the flow. It is found that all these flow characteristics vary markedly across a stenotic lesion. Also, increase in the catheter size leads to a considerable increase in their magnitudes. These results are used to obtain the estimates of increased pressure drop across an arterial stenosis when a catheter is inserted into it. Our calculations, based on the geometry and flow conditions existing in coronary arteries, suggest that, in the presence of curvature and stenosis, and depending on the value of k (ratio of catheter size to vessel size) ranging from 0.1 to 0.4, the pressure drop increases by a factor ranging from 1.60 to 5.16. But, in the absence of curvature and stenosis, with the same range of catheter size, this increased factor is about 1.74-4.89. These estimates for the increased pressure drop can be used to correct the error involved in the measured pressure gradients using catheters. The combined effects of stenosis and curvature on flow characteristics are also studied in detail. It is found that the effect of stenosis is more dominant than that of the curvature. Due to the combined effect of stenosis, curvature and catheterization, the secondary streamlines are modified in a cross-sectional plane. The insertion of a catheter into the artery leads to the formation of increased number of secondary vortices.     

Pulsed magnetohydrodynamic blood flow in a rigid vessel under physiological pressure gradient

Blood flow in a steady magnetic field has been of great interest over recent years. Many researchers have examined the effects of magnetic fields on velocity profiles and arterial pressure, and major studies have focused on steady or sinusoidal flows. In this paper, we present a solution for pulsed magnetohydrodynamic blood flow with a somewhat realistic physiological pressure wave obtained using a Windkessel lumped model. A pressure gradient is derived along a rigid vessel placed at the output of a compliant module which receives the ventricle outflow. Then, velocity profile and flow rate expressions are derived in the rigid vessel in the presence of a steady transverse magnetic field. As expected, results showed flow retardation and flattening. The adaptability of our solution approach allowed a comparison with previously addressed flow cases and calculations presented a good coherence with those well established solutions.     

Pressure drop increase by biofilm accumulation in spiral wound RO and NF membrane systems: role of substrate concentration,flow velocity,substrate load and flow direction

In an earlier study, it was shown that biofouling predominantly is a feed spacer channel problem. In this article, pressure drop development and biofilm accumulation in membrane fouling simulators have been studied without permeate production as a function of the process parameters substrate concentration, linear flow velocity, substrate load and flow direction. At the applied substrate concentration range, 100–400 μg l^?1 as acetate carbon, a higher concentration caused a faster and greater pressure drop increase and a greater accumulation of biomass. Within the range of linear flow velocities as applied in practice, a higher linear flow velocity resulted in a higher initial pressure drop in addition to a more rapid and greater pressure drop increase and biomass accumulation. Reduction of the linear flow velocity resulted in an instantaneous reduction of the pressure drop caused by the accumulated biomass, without changing the biofilm concentration. A higher substrate load (product of substrate concentration and flow velocity) was related to biomass accumulation. The effect of the same amount of accumulated biomass on the pressure drop increase was related to the linear flow velocity. A decrease of substrate load caused a gradual decline in time of both biomass concentration and pressure drop increase. It was concluded that the pressure drop increase over spiral wound reverse osmosis (RO) and nanofiltration (NF) membrane systems can be reduced by lowering both substrate load and linear flow velocity. There is a need for RO and NF systems with a low pressure drop increase irrespective of the biomass formation. Current efforts to control biofouling of spiral wound membranes focus in addition to pretreatment on membrane improvement. According to these authors, adaptation of the hydrodynamics, spacers and pressure vessel configuration offer promising alternatives. Additional approaches may be replacing heavily biofouled elements and flow direction reversal.     

A problem in the mathematical biophysics of blood circulation: II. Relation between pressure and flow of a viscous fluid in an elastic distensible tube

In an elastic distensible tube, like a blood vessel, the radius is determined by the equality of the hydrostatic pressure and the elastic forces. If a viscous fluid flows through such a tube, there is a pressure drop along the line of flow. This results in a variation of the radius of the tube along the axis. An approximate expression, valid within a limited range of values, is derived for the radius of the tube as a function of the distance along the axis. Another approximate expression is derived for the relation between pressure drop and total flow in such a case. For sufficiently high rates of flow the pressure drop does not vary linearly with the flow, as in the usual poiseuille's law, but more rapidly.     

A model of a radially expanding and contracting lymphangion

The lymphatic system is an extensive vascular network featuring valves and contractile walls that pump interstitial fluid and plasma proteins back to the main circulation. Immune function also relies on the lymphatic system's ability to transport white blood cells. Failure to drain and pump this excess fluid results in edema characterized by fluid retention and swelling of limbs. It is, therefore, important to understand the mechanisms of fluid transport and pumping of lymphatic vessels. Unfortunately, there are very few studies in this area, most of which assume Poiseuille flow conditions. In vivo observations reveal that these vessels contract strongly, with diameter changes of the order of magnitude of the diameter itself over a cycle that lasts typically 2-3s. The radial velocity of the contracting vessel is on the order of the axial fluid velocity, suggesting that modeling flow in these vessels with a Poiseuille model is inappropriate. In this paper, we describe a model of a radially expanding and contracting lymphatic vessel and investigate the validity of assuming Poiseuille flow to estimate wall shear stress, which is presumably important for lymphatic endothelial cell mechanotransduction. Three different wall motions, periodic sinusoidal, skewed sinusoidal and physiologic wall motions, were investigated with steady and unsteady parabolic inlet velocities. Despite high radial velocities resulting from the wall motion, wall shear stress values were within 4% of quasi-static Poiseuille values. Therefore, Poiseuille flow is valid for the estimation of wall shear stress for the majority of the lymphangion contractile cycle.     

Angiogenesis and vascular remodelling in normal and cancerous tissues

Vascular development and homeostasis are underpinned by two fundamental features: the generation of new vessels to meet the metabolic demands of under-perfused regions and the elimination of vessels that do not sustain flow. In this paper we develop the first multiscale model of vascular tissue growth that combines blood flow, angiogenesis, vascular remodelling and the subcellular and tissue scale dynamics of multiple cell populations. Simulations show that vessel pruning, due to low wall shear stress, is highly sensitive to the pressure drop across a vascular network, the degree of pruning increasing as the pressure drop increases. In the model, low tissue oxygen levels alter the internal dynamics of normal cells, causing them to release vascular endothelial growth factor (VEGF), which stimulates angiogenic sprouting. Consequently, the level of blood oxygenation regulates the extent of angiogenesis, with higher oxygenation leading to fewer vessels. Simulations show that network remodelling (and de novo network formation) is best achieved via an appropriate balance between pruning and angiogenesis. An important factor is the strength of endothelial tip cell chemotaxis in response to VEGF. When a cluster of tumour cells is introduced into normal tissue, as the tumour grows hypoxic regions form, producing high levels of VEGF that stimulate angiogenesis and cause the vascular density to exceed that for normal tissue. If the original vessel network is sufficiently sparse then the tumour may remain localised near its parent vessel until new vessels bridge the gap to an adjacent vessel. This can lead to metastable periods, during which the tumour burden is approximately constant, followed by periods of rapid growth.