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  • ISSN: 2378-9344
    Volume 9, Issue 1
    Research Article
    Andrea Azzaretti*, Giovanni Bonalumi, Giuseppe Mazzotta, Irene Maria Beneggi, Antonio Stabile, and Anna Giulia Carnabuci
    Background: Treatment of graft limb occlusion can be challenging but the multifunctionality of the GoBack crossing e reentry device helps to overcome difficult situations and prevents alternative approaches to the endovascular one.
    This novel device allows direction-change inside hard plaque and crossing of tough lesions ensures an excellent pushability.
    Case Presentation: A 74-year-old male with a long occlusion of the right common iliac artery, due to a graft folding. After several failed crossing attempts, recanalization and flow restoration in the common femoral artery on both sides were performed with the GoBack crossing catheter.
    Conclusions: The GoBack crossing catheter should be consider the preferred catheter to deal with tough occlusions being a well-grounded complementary interventional instrumentation tool.
    José Manuel López-Álvarez*, Olivia Pérez-Quevedo, Joaquín Naya-Esteban, Alonso-Graña López-Manteola, Teresa Ramirez-Lorenzo, and Dionisio Lorenzo Lorenzo-Villegas
    Objective: To analyze the factors associated to Ultrasound Guided Vessel Cannulation (UGVC) as conducted by inexperienced operators in a pediatric training model.
    ethods: Descriptive observational study carried out by 25 healthcare professionals in the Pediatric Intensive Care Unit (PICU) of a level-III Hospital. After theoretical-practical training session on vascular ultrasound and ultrasound guided vessel puncture, the operators punctured the vascular structure of the simulation model and the success rate, procedural time, number of trials, complication rate were analyzed.
    Results: 300 ultrasound guided vessel punctures were carried out (12 punctures per participant), uniformly distributed along the longitudinal axis/in-plane (LA/IP) and the transverse axis/out-of-plane (TA/OP). The success rate was 79.7% and it was associated to: a) larger vessel diameter: 0.42 (0.10) cm vs. 0.37 (0.09) cm, p<0.001; b) less trials required to successful cannulation: 1.49 (0.81) vs. 3.0 (1.72), p<0.001; c) shorter procedural time 87.69 (88.81) sec. vs. 225.09 (138.90) sec. p<0.001; d) better needle visibility (NV): 86.1% vs. 45.8%, p<0.001 and d) lower frequency of vessel perforation/incorrect guidewire positioning (VP/IGP): 34.2% vs. 65.8%, p<0.001.
    Conclusion: In this theoretical-practical UGVC training program for inexperienced operators using a simulation model, the success rate increased with the diameter of the vascular structure to be punctured and with needle visibility, thus resulting in less trials needed to successful cannulation and lower complication rate.
    Rishal Reshin Brayin Pokkantakath* and Shesnia Salim Padikkalakandy Cheriyath
    Intra-cerebral hemorrhage is one of the most disabling forms of stroke even though it accounts for only 15% of all strokes.
    Review Article
    Amalia Tri Utami*
    Introduction: The COVID-19 contamination which developed in December 2019 is caused by the infection SARS-CoV-2. Contamination with this infection can lead to serious respiratory sickness; in any case, myocarditis has too been detailed. The reason of this ponder is to distinguish the clinical highlights of myocarditis in immunized COVID-19 patients.
    Method: This study using systematic review that search using keyword heart inflammation, myocarditis and Covid-19 Vaccination in Google Scholar, PubMed, and CrossRef. After final screening the author analysize 7 articles.
    Result: COVID-19 myocarditis influenced patients over the age of 50 and rates among both sexes were similarly detailed. Patients displayed with dyspnea, hack, fever with hypotension and chest torment. Research facility tests uncovered leukocytosis with expanded C-reactive protein, whereas blood vessel blood gas investigation illustrated respiratory acidosis. All cardiac markers were raised. Radiographic imaging of the chest appeared respective ground glass opacities or reciprocal invades, whereas cardiac attractive reverberation imaging created late gadolinium upgrades. Electrocardiography illustrated ST-segment height or altered T waves, whereas echocardiography uncovered decreased cleared out ventricular launch division with cardiomegaly or expanded divider thickness. Administration with corticosteroids was favored in most cases, taken after by antiviral medicine. The lion’s share of thinks about detailed either recuperation or no encourages clinical disintegration.
    Conclusion: Be that as it may, current prove illustrates myocardial aggravation with or without coordinate cardiomyocyte harm, proposing distinctive pathophysiology components mindful of COVID-mediated myocarditis. Built up clinical approaches ought to be sought after until future prove bolster distinctive activities. Huge multicentre registries are prudent to illustrate assist.
    Syamasundar Rao P*
    Congenital malformations of the tricuspid valve, namely, Ebstein’s malformation of the tricuspid valve, and Ebstein’s type of anomaly of the morphologic tricuspid valve on the left-side in subjects with congenital corrected transposition of the great arteries are reviewed. The pathologic and pathophysiologic features of these lesions are enumerated followed by a discussion of techniques of diagnosis and management methods. It was concluded that these congenital abnormalities of the tricuspid valve can be effectively diagnosed with the currently available non-invasive and invasive investigative techniques and these defects can successfully be managed with the existing therapeutic medical and surgical methods.
    Review Article
    Syamasundar Rao P*
    Most commonly encountered congenital malformations of the tricuspid valve are tricuspid atresia, Ebstein’s malformation of the tricuspid valve, and Ebstein’s type of anomaly of the morphologic tricuspid valve on the left-side in subjects with congenital corrected transposition of the great arteries. In this Part I of this series tricuspid atresia is reviewed. The pathologic and pathophysiologic features of tricuspid atresia are enumerated followed by a discussion of techniques of diagnosis and management methods. It was concluded that congenital tricuspid atresia can be effectively diagnosed with the currently available non-invasive and invasive investigative techniques and this defect can successfully be managed with the existing therapeutic medical and surgical methods.
    Ritman EL*
    This overview of direct measurement and 3D micro-CT image data to measure transmural distribution of myocardial perfusion, compression arterial branching geometry and the transmural locations of the terminal arterioles. From those data, blood flow, flow transit times to those terminal arterioles and their transmural locations were estimated. Several putative regional intra-myocardial compression due to myocardial contraction are shown to combine with the micro-CT derived data to result in a transmural perfusion gradient and their impact on the vulnerability of that perfusion to sub-endocardial myocardium. This analysis addresses the interplaying roles of the following:
    1) The branching geometry of the intra-myocardial arteriolar microcirculation and distribution of myocardial terminal arterioles.
    2) The transmural distribution of intra-myocardial compression.
    3) Interplay of the myocardial electro-mechanical activation, contraction and perfusion sequences within a single cardiac cycle.
    Research Article
    Jorge Arturo Santos-Franco*, Carlos Antonio Cruz-Argüelles, Fernando Agustín-Aguilar, Enrique De Font-Réaulx, Adrián Alejandro Abrego-Salinas, and Martín Roberto Casas-Martínez
    Background: Pediatric intracranial aneurysms (PIAs) are uncommon. Flow diverters (FDs) have shown to be effective in the treatment of selected aneurysms.
    Patients and methods: We retrospectively describe 10 cases of PIAs which were treated with FDs at one medical center in Mexico, from April 2015 to April 2020.
    Results: Out of 230 patients treated with FDs, 10 (4.3%) were pediatric. Average age was 9.4 years (R:6-15). Two (20%) had a subarachnoid hemorrhage, 3 had epilepsy (30%), 3 had clinical signs of cranial nerve compression (30%) and 4 (40%) had cephalea.
    Two patients were in 1a grade of Hunt and Kosnik scale. Out of the non-ruptured aneurysms, 7 (70%) had a Glasgow Coma Scale (GCS) of 15 and 1 (10%) of 13. Treatment was performed without complications; nevertheless, in one case the distal deployment was not achieved.
    Upon discharged, nine patients had a Glasgow Outcome Scale of 5. All patients were submitted to CT angiography or digital subtraction angiography at 1, 3, 6 and 12 months, including two patients (20%) that had a 2-year follow-up and 3 patients (30%) with 3-year follow-up. According to Kamran grading scale, 9 patients (90%) were classified as grade 4 and 10%) as 3.
    Conclusions: Although is a small population since this is an uncommon disease, it suggests that FDs are useful to treat properly selected PIAs. Our study has consecutive imaging assessment of more than 1-year follow-up and through which it was observed that in 90% of patients there was evidence of results durability.
    Original Article
    Grace Kelly Lee, Hae-Yeong Kim and Jong Hwan Park*
    Peroxisome proliferator-activated receptor gamma 2 (PPARγ2) has currently been considered as molecular target for angiogenesis signaling. Here, we investigated the effect of 24-methylenecycloartanyl ferulate (24-MCF) induced PPARγ2 on expression of angiogenesis-related genes in MCF7 cells. cDNA microarray, real-time PCR revealed that 24-MCF mediated the expression of genes related to angiogenesis in MCF-7 cells. We identified PPAR-response elements (PPRE) located in the LIF promoter regions (-1192 to -802), and VEGF (-452 to +1). Luciferase reporter assay demonstrated that activation of the LIF gene, an anti-angiogenesis factor, was increased upon both 24-MCF treatment and PPARγ2 overexpression; whereas activation of VEGF promoters, known pro-angiogenesis factors, was decreased upon 24-MCF treatment and PPARγ2 overexpression. While these mutations individually appeared to have no effect. Treatment with 24-MCF also decreased VEGF production in MCF7 cells and PMA-stimulated tube formation in HUVECs. Our findings suggest that 24-MCF induces PPARγ2-mediated regulation of angiogenesis-related genes via PPRE motifs.
    Mini Review
    Susumu Matsukuma, Shinya Yoshimatsu and Ayano Matsunaga
    Intraarticular loose bodies (ILBs) are not uncommon orthopedic disease. ILBs are caused by various osteoarthritic or joint diseases, some of which are associated with the joint-related vasculature. However, non-specific additional changes can occur in ILBs associated with or without the vasculature. The former represents revascularized enchondral ossification due to re-attachment of ILBs to the synovium, and the latter includes gullying of cartilaginous matrix, secondary synovial chondromatosis, and fatty metaplasia. Histopathological examination of ILBs in considering such relationship with the vasculature can be useful for assessment of the source and/or etiology of ILBs.
    Mini Review
    Jili Zhao#, Hui Xue#, Xin He, and Wenping Xiang*
    Objective: The disadvantages of traditional teaching mode of application in rehabilitation after musculotendinous cuff injury, so it is necessary to explore new teaching mode and teaching method.
    Methods: In clinical teaching, the teaching method of “Hand as Foot” was adopted to simulate application in rehabilitation after musculotendinous cuff injury
    Results: In clinical teaching, the teaching method of “Hand as Foot” was adopted to explain the application in rehabilitation after musculotendinous cuff injury. The students had a more vivid understanding of application in rehabilitation after musculotendinous cuff injury, which strengthened the interaction between students and achieved a good teaching effect.
    Conclusion: Application in rehabilitation after musculotendinous cuff injury teaching, “Hand as Foot” teaching method highlights its advantages; it is worth further exploration and promotion.
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