A Mock Circulation Loop for In Vitro Hemodynamic Evaluation of Aorta: Application in Aortic Dissection

Purpose Aortic dissection (AD) is a catastrophic disease with complex hemodynamic conditions, however, understandings regarding its perfusion characteristics were not sufficient. In this study, a mock circulation loop (MCL) that integrated the Windkessel element and patient-specific silicone aortic phantoms was proposed to reproduce the aortic flow environment in vitro. Materials and Methods Patient-specific normal and dissected aortic phantoms with 12 branching vessels were established and embedded into this MCL. Velocities for aortic branches based on 20 healthy volunteers were regarded as the standardized data for flow division. By altering boundary conditions, the proposed MCL could mimic normal resting and left-sided heart failure (LHF) conditions. Flow rates and pressure status of the aortic branches could be quantified by separate sensors. Results In normal resting condition, the simulated heart rate and systemic flow rate were 60 bpm and 4.85 L/minute, respectively. For the LHF condition, the systolic and diastolic blood pressures were 75.94±0.77 mmHg and 57.65±0.35 mmHg, respectively. By tuning the vascular compliance and peripheral resistance, the flow distribution ratio (FDR) of each aortic branch was validated by the standardized data in the normal aortic phantom (mean difference 2.4%±1.70%). By comparing between the normal and dissected aortic models under resting condition, our results indicated that the AD model presented higher systolic (117.82±0.60 vs 108.75±2.26 mmHg) and diastolic (72.38±0.58 vs 70.46±2.33 mmHg) pressures, the time-average velocity in the true lumen (TL; 36.95 cm/s) was higher than that in the false lumen (FL; 22.95 cm/s), and the blood transport direction between the TL and FL varied in different re-entries. Conclusions The proposed MCL could be applied as a research tool for in vitro hemodynamic analysis of the aorta diseases under various physical conditions.

​Erythrocyte Parameters as a Diagnostic Tool in Canine Medicine: A Review

The haematological analysis is one of the essential diagnostic and prognostic tools for the health practitioner. Routine hematology consists of erythrocyte, leucocyte and platelet parameters estimation. Erythrocyte parameters (RBC, RDW, haemoglobin, haematocrit, MCV, MCH, MCHC) estimation plays a crucial role in identifying anemia and several other acute and chronic conditions. Accurate and precise haematology results depend on correct blood collection procedures, suitable anticoagulants, proper storage and effective blood transport. The individual reference value variance can be due to age, sex, stress, diet, body condition, hydration status and reproductive status. Automatic haeamtology analyzer can yield quick and accurate results provided the sample is free from any artifacts. In conclusion, the accuracy of the result of automatic haematology analyzer in canine medicine is impeded by the lack of precise and rapid comparison procedure, instability and complexity of blood cells. Therefore the findings of the automatic haemotolyzer should always be corroborated with the clinical findings and another laboratory test.

Plasma Extracellular Vesicle α-Synuclein Level in Patients with Parkinson’s Disease

Background: The most established pathognomonic protein of Parkinson’s disease (PD), α-synuclein, is extensively investigated for disease diagnosis and prognosis; however, investigations into whether the free form of α-synuclein in the blood functions as a PD biomarker have not been fruitful. Extracellular vesicles (EVs) secreted from cells and present in blood transport molecules are novel platforms for biomarker identification. In blood EVs, α-synuclein originates predominantly from the brain without the interference of the blood–brain barrier. The present study investigated the role of plasma EV-borne α-synuclein as a biomarker of PD. Methods: Patients with mild to moderate stages of PD (n = 116) and individuals without PD (n = 46) were recruited to serve as the PD study group and the control group, respectively. Plasma EVs were isolated, and immunomagnetic reduction–based immunoassay was used to assess EV α-synuclein levels. Conventional statistical analysis was performed using SPSS 25.0, and p < 0.05 was considered significant. Results: Compared with controls, we observed significantly lower plasma EV α-synuclein levels in the patients with PD (PD: 56.0 ± 3.7 fg/mL vs. control: 74.5 ± 4.3 fg/mL, p = 0.009), and the significance remained after adjustment for age and sex. Plasma EV α-synuclein levels in the patients with PD did not correlate with age, disease duration, Part I and II scores of the Unified Parkinson’s Disease Rating Scale (UPDRS), or the Mini-Mental State Examination scores. However, such levels were significantly correlated with UPDRS Part III score, which assesses motor dysfunction. Furthermore, the severity of akinetic-rigidity symptoms, but not tremor, was inversely associated with plasma EV α-synuclein level. Conclusion: Plasma EV α-synuclein was significantly different between the control and PD group and was associated with akinetic-rigidity symptom severity in patients with PD. This study corroborates the possible diagnostic and subtyping roles of plasma EV α-synuclein in patients with PD, and it further provides a basis for this protein’s clinical relevance and feasibility as a PD biomarker.

Blood transportation using multi-vehicle systems; optimal blood transport temperature in terms of hemolysis

Recently, the use of drones has been proposed for blood transportation. Therefore, in this review, we first detailed the history of blood storage and transportation for red blood cell transfusion, and then presented ideas for creating rules to improve the safety of blood transportation, based on the idea that hemolysis is the problem for blood quality. In particular, it touches on the current logistics of blood transportation in which public transportation is not used, including the recent use of drones to transport blood, and points out the problems with this system. We discuss how instances of improper red blood cell transportation with inadequate temperature control are still observed, and that temperature control, vibration remain the major hindrances to appropriate blood transportation. Therefore, a set of rules that will contribute to appropriate and rapid blood transportation is warranted. Moreover, there are notable differences in blood storage rule between Japan and the US and UK, and there is no legal transportation rule in Japan. Based on our review and experience, we think that basic temperature control at 2–6°C should always be maintained to prevent blood deterioration even if unmanned aerial vehicle (drone) technologies are available.

Blood transportation using multi-vehicle systems; optimal blood transport temperature in terms of hemolysis

Recently, the use of drones has been proposed for blood transportation. Therefore, in this review, we first detailed the history of blood storage and transportation for red blood cell transfusion, and then presented ideas for creating rules to improve the safety of blood transportation, based on the idea that hemolysis is the problem for blood quality. In particular, it touches on the current logistics of blood transportation in which public transportation is not used, including the recent use of drones to transport blood, and points out the problems with this system. We discuss how instances of improper red blood cell transportation with inadequate temperature control are still observed, and that temperature control, vibration remain the major hindrances to appropriate blood transportation. Therefore, a set of rules that will contribute to appropriate and rapid blood transportation is warranted. Moreover, there are notable differences in blood storage rule between Japan and the US and UK, and there is no legal transportation rule in Japan. Based on our review and experience, we think that basic temperature control at 2–6°C should always be maintained to prevent blood deterioration even if unmanned aerial vehicle (drone) technologies are available.

Analysis of vortex ring formation in the heart chamber by instantaneous vortex deviation based on convolutional neural network

The formation of vortex rings during the left ventricle (LV) filling is an optimized mechanism for blood transport, and the vorticity is an important measure of a healthy heart and LV. There is a relationship between abnormal diastolic vortex structure and impaired LV, and hence vortex identification is vital for understanding the underlying physical mechanism of blood flow. However, due to lack of quantitative methods, defining, computing and mapping the left ventricular vortices has not been rigorously studied previously. In this paper, a novel method of vortex detection based on the convolutional neural network (CNN) is created, which enables determination of the boundary of vortex and integrates the local and global flow fields. We have used the CNN-based vortex identification and vector flow mapping (VFM) to quantify left ventricular vorticity. In the clinical application of our methodology to healthy subjects and uremic patients, we find differences in the strength and position of the vortices between healthy and patients with uremia cardiomyopathy. Our results can accurately indicate the role of vortex formation in intracardiac flow, and provide new insights into the blood flow within the heart structure.

Effects of passenger airplane transport on blood

Objective: We examined the effects of passenger air transport by regular airplanes for air transportation on blood for transfusion. Materials and methods: Irradiated red blood cell (RBC) solutions were transported by regular passenger airplanes which and were static in the cabin during the flight. Blood samples were evaluated visually and biochemically before and after transport. Hemolysis of the transported samples was compared to that of the non-transported ones. The vibration in the airplanes was also measured using a vibration data logger. Results: There was no significant hemolysis of RBCs during airplane transport. The vibration in the airplane was lower than that in automobiles. The temperature in the active transport refrigerator (ATR) room was maintained at 2−6°C. There was no significant hemolysis of RBCs during the two transport routes. Conclusion: Temperature-controlled air transport of blood transport in the ATR 700 airplane maintained a the blood at a good quality that rendered blood it fit for blood transfusion.