Anatomy Commons^™

Traumatic Brain Injury-Associated Epigenetic Changes And The Risk For Neurodegenerative Diseases, Paul Smolen, Pramod K Dash, John B Redell

Faculty, Staff and Student Publications

Epidemiological studies have shown that traumatic brain injury (TBI) increases the risk for developing neurodegenerative diseases (NDs). However, molecular mechanisms that underlie this risk are largely unidentified. TBI triggers widespread epigenetic modifications. Similarly, NDs such as Alzheimer's or Parkinson's are associated with numerous epigenetic changes. Although epigenetic changes can persist after TBI, it is unresolved if these modifications increase the risk of later ND development and/or dementia. We briefly review TBI-related epigenetic changes, and point out putative feedback loops that might contribute to long-term persistence of some modifications. We then focus on evidence suggesting persistent TBI-associated epigenetic changes may contribute …

More Management Is Needed To Improve The Effectiveness Of Artificial Grassland In Vegetation And Soil Restoration On The Three-River Headwaters Region Of China, Nengyu Wang, Jiayi Wan, Mingjun Ding, Hua Zhang, Shicheng Li, Linshan Liu, Yili Zhang

Faculty, Staff and Student Publications

Establishing an artificial grassland is a common measure employed to restore heavily degraded alpine grasslands for regional sustainability. The Three-River Headwaters Region in China has significant areas of black-soil-type grassland which is typified by heavy degradation; nearly 35% of the grassland regions in the Three-River Headwaters Region has degraded into this type. There are different plant community types of black-soil-type grasslands, however, it is not clear which restoration measures should be adopted for different kinds of black-soil-type grasslands. Here, we investigate the plant community characteristics and soil physicochemical properties of artificial grasslands, two types of black-soil-type grasslands, and native undegraded …

Sp1 Trans-Activates The Murine H+-K+-Atpase Α2-Subunit Gene, Xiaobo Wang, Yili Zhang, Xiuyun Zhou, Xiumei Xia, Weijun Teng, Lin Sheng, Jing Ding

Faculty, Staff and Student Publications

Acute lung injury (ALI) followed with severe inflammation and oxidative stress. Anti-inflammatory and antioxidant are the properties of aquaporin 1 (AQP1) and aquaporin 5 (AQP5). The goal of this study was to see if soy isoflavone can diminish lipopolysaccharide (LPS)-induced ALI and the underling mechanism. LPS-induced ALI was given to Sprague-Dawley rats 14 days following oophorectomy. One hour before the LPS challenge, estradiol (1 mg/kg) was administered subcutaneously as positive control and soy isoflavone was intragastric administration for 14 days prior to LPS challenge with different doses. Six hours after LPS challenge, the pulmonary edema, pathophysiology, inflammation, and the oxidative …

Early Systemic Glycolytic Shift After Aneurysmal Subarachnoid Hemorrhage Is Associated With Functional Outcomes, Aaron M Gusdon, Chenlian Fu, Vasanta Putluri, Atzhiry S Paz, Hua Chen, Xuefang Ren, Mohammed Khurshidul Hassan, Pramod Dash, Cristian Coarfa, Nagireddy Putluri, Huimahn A Choi, Jude P J Savarraj

Faculty, Staff and Student Publications

BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) leads to a robust systemic inflammatory response. We hypothesized that an early systemic glycolytic shift occurs after aSAH, resulting in a unique metabolic signature and affecting systemic inflammation.

METHODS: Control patients and patients with aSAH were analyzed. Samples from patients with aSAH were collected within 24 h of aneurysmal rupture. Mass spectrometry-based metabolomics was performed to assess relative abundance of 16 metabolites involved in the tricarboxylic acid cycle, glycolysis, and pentose phosphate pathway. Principal component analysis was used to segregate control patients from patients with aSAH. Dendrograms were developed to depict correlations between metabolites and …

Defective Synaptic Plasticity In A Model Of Coffin-Lowry Syndrome Is Rescued By Simultaneously Targeting Pka And Mapk Pathways, Rong-Yu Liu, Yili Zhang, Paul Smolen, Leonard J Cleary, John H Byrne

Faculty, Staff and Student Publications

Empirical and computational methods were combined to examine whether individual or dual-drug treatments can restore the deficit in long-term synaptic facilitation (LTF) of the Aplysia sensorimotor synapse observed in a cellular model of Coffin–Lowry syndrome (CLS). The model was produced by pharmacological inhibition of p90 ribosomal S6 kinase (RSK) activity. In this model, coapplication of an activator of the mitogen-activated protein kinase (MAPK) isoform ERK and an activator of protein kinase A (PKA) resulted in enhanced phosphorylation of RSK and enhanced LTF to a greater extent than either drug alone and also greater than their additive effects, which is termed …

Predicting Left Ventricular Assist Device Outcomes Utilizing The Stanford Integrated Psychosocial Assessment For Transplant Measure, Nicholas Chesher, Kristina L. Greenwood, Candace Fanale, Cody Gustaveson, Brian Jaski, Hirsch S. Mehta, Peter Hoagland, Kristine Ortiz, Marc Verlasky, Robert Adamson, Walter Dembitsky

The VAD Journal

Objective: Durable mechanical circulatory support is a proven therapy to extend survival for patients with end-stage heart failure (HF). The International Society for Heart and Lung Transplantation guidelines recommend a detailed psychosocial assessment when selecting candidates for durable mechanical circulatory support. Currently, there are no formally validated psychosocial evaluation tools for left ventricular assist device (LVAD) candidacy. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) uses a multidisciplinary algorithm to evaluate the impact of pre-transplant risk factors on post-transplant outcomes. Emerging literature suggests that the SIPAT might be useful for assessing psychosocial risk factors for LVAD outcomes.

Methods: A total …

Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (Lava-Ecmo): Percutaneous Bi-Atrial Drainage To Avoid Pulmonary Edema In A Patient With Left Ventricular Systolic Dysfunction, Kenneth R. Dulnuan, Joseph B. Zwischenberger, John G. Gurley, Maya Guglin

The VAD Journal

Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used in patients with severe cardiogenic shock refractory to medical therapy. During V-A ECMO, retrograde flow in the aorta towards the left ventricle (LV) causes increased left-sided filling pressures, which may lead to pulmonary edema. Different strategies have been proposed to decompress the left heart, including placement of an intraaortic balloon pump (IABP), Impella® (Abiomed), or TandemHeart® (Cardiac Assist). Percutaneous decompression of the left atrium via placement of a transseptal cannula incorporated into the existing venous limb had also been previously done. We describe the novel use of the VFEM venous femoral cannula …

Highlights Of The 2021 Brano Heart Failure Forum, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric

The VAD Journal

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The forum was postponed in 2020 due to the COVID-19 pandemic and then resumed in September of 2021 in Graz, Austria. It was attended by over 75 faculty from 13 countries. Due to the ongoing pandemic, 13 presentations were given virtually. Throughout the forum, 17 separate sessions focused …

Successful Percutaneous Management Of Lvad Outflow Graft Stenosis: Role Of Invasive Hemodynamics In Decision Making, Tarun Dalia, Amandeep Goyal, Harsh Mehta, Henedine C. Foster, Eric Hockstad, Aaron Rohr, Philip Johnson, Travis Abicht, Bhanu Gupta

The VAD Journal

Left ventricular assist device (LVAD) outflow graft stenosis (OGS) is a rare but lethal complication. We present a case of a 79-year-old male with pertinent past medical history of an LVAD implanted as destination therapy, stage III chronic kidney disease, and hypertension. He was admitted for low-flow alarms, and the echocardiogram showed stable right ventricle function and no pericardial effusion. Invasive hemodynamic assessments demonstrated a peak-to-peak gradient of 90 mm Hg in the outflow graft between the mid and distal ends of the graft on pullback. Contrast angiography confirmed OGS. The OGS was successfully treated with a VBX-covered stent (Gore). …

A Unique Case Of Inflow Cannula Obstruction By A Tissue Membrane, Roopa A. Rao, Kashif Saleem, Bistees George, Maya Guglin

The VAD Journal

The use of a left ventricular assist device has increased and is a primary surgical treatment for heart failure. However, one major complication of left ventricular assist device support is an obstruction in the blood flow pathway. Pump thrombosis and outflow graft occlusion are some of the common causes of such obstructions. Here, we describe a unique case of HeartMate II (Abbott Laboratories) inflow cannula obstruction from a membranous structure without evidence of thrombus. The histology showed evidence of fibrous tissue and heart muscle tissue in the membrane. The patient underwent a successful device exchange with a HeartMate 3 (Abbott …

Epigenetic Modifications And Their Potential Contribution To Traumatic Brain Injury Pathobiology And Outcome, Laura Zima, Rebecca West, Paul Smolen, Nobuhide Kobori, Georgene Hergenroeder, Huimahn A Choi, Anthony N Moore, John B Redell, Pramod K Dash

Faculty, Staff and Student Publications

Epigenetic information is not permanently encoded in the DNA sequence, but rather consists of reversible, heritable modifications that regulate the gene expression profile of a cell. Epigenetic modifications can result in cellular changes that can be long lasting and include DNA methylation, histone methylation, histone acetylation, and RNA methylation. As epigenetic modifications are reversible, the enzymes that add (epigenetic writers), the proteins that decode (epigenetic readers), and the enzymes that remove (epigenetic erasers) these modifications can be targeted to alter cellular function and disease biology. While epigenetic modifications and their contributions are intense topics of current research in the context …

Intra-Aortic Balloon Pump May Attenuate Adverse Hemodynamic Effects Of Negative Intrathoracic Pressure In Cardiogenic Shock, Faris Araj

The VAD Journal

High negative intrathoracic pressure (NIP), as occurs during obstructive sleep apnea or hiccups, results in adverse hemodynamic consequences, specifically a decrease in left ventricle (LV) performance. These untoward effects can potentially be catastrophic in the case of an already compromised LV in cardiogenic shock. The interplay of intra-aortic balloon pump counter pulsation during abrupt high NIP in cardiogenic shock is described.

Synaptic Origins Of The Complex Receptive Field Structure In Primate Smooth Monostratified Retinal Ganglion Cells, Andrea S Bordt, Sara S Patterson, James A Kuchenbecker, Marcus A Mazzaferri, Joel N Yearick, Emma R Yang, Judith Mosinger Ogilvie, Jay Neitz, David W Marshak

Faculty, Staff and Student Publications

Ganglion cells are the projection neurons of the retina. Intrinsically photosensitive retinal ganglion cells (ipRGCs) express the photopigment melanopsin and also receive input from rods and cones via bipolar cells and amacrine cells. In primates, multiple types of ipRGCs have been identified. The ipRGCs with somas in the ganglion cell layer have been studied extensively, but less is known about those with somas in the inner nuclear layer, the "displaced" cells. To investigate their synaptic inputs, three sets of horizontal, ultrathin sections through central macaque retina were collected using serial block-face scanning electron microscopy. One displaced ipRGC received nearly all …

Impact Of Atrial Fibrillation On Outcomes After Left Ventricular Assist Device Implantation: Systematic Review And Meta-Analysis, Chandan Buttar, Sofia Lakhdar, Mahmood Nassar, Nso Nso, Giovina Collura, Most Sirajum Munira

The VAD Journal

Background: Atrial fibrillation (AF) is a common finding in patients with heart failure and is well-known for its deleterious effects on cardiac function and hemodynamics; however, there are gaps in knowledge regarding the impact of AF on patients with left ventricular assist devices (LVADs).

Methods: In this study, we searched PubMed/Medline, Embase, and Cochrane Library databases through September 2021 to find articles that assessed the outcomes of AF in patients with LVADs.

Results: A total of 12 studies that underwent systematic review evaluated the outcomes of 7853 adult patients. The meta-analysis analyzed findings from a total of 1003 patients. Pooled …

The Role Of The Hypoxia-Inducible Factor 2 In Pancreatic Cancer: Mechanisms Of Tumor Immunosuppression And Intestinal Radioprotection, Carolina Garcia Garcia

Dissertations and Theses (Open Access)

Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with dismal prognosis. The only curative option for patients is surgery, but over 80% of patients are not surgical candidates. Unfortunately, PDAC is resistant to the three remaining options. PDAC is characterized by a profoundly hypoxic and immunosuppressive stroma, which contributes to its therapeutic recalcitrance. Alpha-smooth muscle actin+ (αSMA+) cancer-associated fibroblasts (CAFs) are the most abundant stromal component, as well as mediators of stromal deposition. The hypoxia-inducible factors (HIF1 and HIF2) coordinate responses to hypoxia, yet, despite their known association to poor patient outcomes, their functions within the PDAC tumor microenvironment (TME) …

Pulsatility Is A Predictive Marker Of Improved Cardiac Function In Patients With Liquid Matrix-Treated Left Ventricular Assist Devices, Philemon Mikail, Rinku Skaria, Marvin Slepian, Janny Garcia, Richard Smith, Zain Khalpey

The VAD Journal

Objective: Left ventricular assist devices (LVADs) are utilized as a bridge to transplant or as destination therapy for patients with end-stage heart failure. Although cardiac offloading from these devices rarely leads to complete remodeling and functional recovery, the use of mesenchymal cells to modulate heart failure has been explored in recent years due to its intrinsic regenerative properties. Current methods of evaluating cardiac function have too much variability, difficulty of access, or require too frequent follow up to create universal weaning protocols. We hypothesized that the administration of amniotic allograft liquid matrix (LM) containing amnion-derived mesenchymal stem cells (aMSCs) in …

Fondaparinux As An Alternative Anticoagulant Treatment In Patients With Left Ventricular Assist Devices And Recurrent Gastrointestinal Bleeding: Case Series, Daniela Piani, Andrea Lechiancole, Massimo Maiani, Igor Vendramin, Sandro Sponga, Elisabetta Auci, Ugolino Livi

The VAD Journal

Gastrointestinal bleeding (GIB) can occur in patients after left ventricular assist device (LVAD) implantation. In cases of recurrent GIB, the management of anticoagulation treatment represents a challenging situation in which the risk of bleeding recurrence and the need for long-term anticoagulation must be balanced. This case series describes the successful management of anticoagulation in three patients with recurrent GIB using fondaparinux.

To our knowledge, these are the first reported cases of recurrent GIB in which a single dose of subcutaneous fondaparinux was used instead of oral anticoagulation. None of the patients presented with signs of pump thrombosis or arterial embolism. …

My Journey With The Heartware Ventricular Assist Device- An Obituary, Georg M. Wieselthaler

The VAD Journal

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Computational Analysis Of Memory Consolidation Following Inhibitory Avoidance (Ia) Training In Adult And Infant Rats: Critical Roles Of Camkiia And Mecp2, Yili Zhang, Paul Smolen, Cristina M Alberini, Douglas A Baxter, John H Byrne

Faculty, Staff and Student Publications

Key features of long-term memory (LTM), such as its stability and persistence, are acquired during processes collectively referred to as consolidation. The dynamics of biological changes during consolidation are complex. In adult rodents, consolidation exhibits distinct periods during which the engram is more or less resistant to disruption. Moreover, the ability to consolidate memories differs during developmental periods. Although the molecular mechanisms underlying consolidation are poorly understood, the initial stages rely on interacting signaling pathways that regulate gene expression, including brain-derived neurotrophic factor (BDNF) and Ca²⁺/calmodulin-dependent protein kinase II α (CaMKIIα) dependent feedback loops. We investigated the ways …

What Did We Learn About Vads In 2021?, Maya Guglin

The VAD Journal

This is our 8th annual literature review on mechanical circulatory support (MCS) devices.

Our previous reports were well received by the readers. The full text of the reviews for 2014, 2015, 2016, 2017, 2018, 2019, and 2020^1-7 were downloaded 821, 861, 701, 869, 951, 272, and 365 times, respectively.

In this review, we summarized the most interesting and important, from our standpoint, publications from 2021. There may be some slight overlap with the end of 2020 because some papers were published online first, and the year of the publication changed when they became …

Pulseless Paradoxus: A Clue To The Presence Of Cardiac Tamponade During Continuous-Flow Mechanical Circulatory Support, Faris G. Araj

The VAD Journal

This letter to the editor is in response to the published article by by Akhtar et al.

More Than Just Statics: Static And Temporal Dynamic Changes In Intrinsic Brain Activity In Unilateral Temporal Lobe Epilepsy, Chengru Song, Xiaonan Zhang, Shaoqiang Han, Keran Ma, Kefan Wang, Xinyue Mao, Yajun Lian, Xianchang Zhang, Jinxia Zhu, Yong Zhang, Jingliang Cheng

Faculty, Staff and Student Publications

BACKGROUND: Temporal lobe epilepsy (TLE) is the most prevalent refractory focal epilepsy and is more likely accompanied by cognitive impairment. The fully understanding of the neuronal activity underlying TLE is of great significance.

OBJECTIVE: This study aimed to comprehensively explore the potential brain activity abnormalities affected by TLE and detect whether the changes were associated with cognition.

METHODS: Six static intrinsic brain activity (IBA) indicators [amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), degree centrality (DC), global signal correlation (GSCorr), and voxel-mirrored homotopic connectivity (VMHC)] and their corresponding dynamic indicators, such as dynamic ALFF (dALFF), dynamic fALFF …

Thyroidectomy In Mechanical Circulatory Support - A Salvage Treatment For Thyrotoxicosis-Induced Cardiogenic Shock: Case Series, Rody G. Bou Chaaya, Lauren M. Saint, Onyedika J. Ilonze Md, Mph

The VAD Journal

Amiodarone is frequently used to treat arrhythmias in patients supported with left ventricular assist devices. Long term amiodarone use can cause hyperthyroidism ultimately leading to cardiomyopathy and sometimes thyrotoxicosis-induced cardiogenic shock (CS). We describe two cases of thyrotoxicosis-induced CS rescued by successful thyroidectomy under mechanical circulatory support (MCS) – one with a Heartmate III (Abbott Laboratories) and another supported with veno-arterial extracorporeal membrane oxygenation (V-A ECMO). In refractory CS, the initiation of V-A ECMO as a bridge to recovery is critical. In thyrotoxicosis-induced CS that is refractory to medical therapy requiring MCS, thyroidectomy is feasible, and a growing body of …

Should Covid Vaccination Be Required In Heart Transplantation & Left Ventricular Assist Device Implantation?, Mustafa M. Ahmed, Manjula G. Ananthram, Susan M. Joseph

The VAD Journal

This letter to the editor does not have an abstract.

Cardiac Tamponade On Ecpella: A Case Report Of A Unique Hemodynamic Picture, Naveed Akhtar, Parth Savsani, Maya Guglin, Roopa Rao

The VAD Journal

Extracorporeal membrane oxygenation is rapidly becoming a preferred therapy for short-term hemodynamic support in cardiogenic shock, along with the use of devices such as Impella (Abiomed, Andover, MA). The two together can create unique hemodynamics resulting in altered presentation of common hemodynamic conditions such as tamponade. We present a case of a patient with fulminant myocarditis requiring veno-arterial extracorporeal membrane oxygenation and Impella support. The patient later developed a pericardial effusion with atypical tamponade physiology which masked the left ventricular systolic function recovery. We further highlight the complex hemodynamics of cardiac tamponade in patients with such mechanical circulatory support and …

Usability Of Abattoir-Acquired Pig Eyes For Refractive Excimer Laser Research, Marius Topka, Yao Zhang, Antonia Bock, Peter Riedel, Johannes Lörner, Alexander Hammer, Eva Maier, Friedrich Paulsen, Christian M Hammer

Faculty, Staff and Student Publications

The purpose of this study was to elucidate, under which conditions abattoir-acquired pig eyes are suitable for refractive excimer laser experiments. Porcine eyes from tunnel-scalded (n = 5) and tank-scalded (n = 10) pigs were compared to unscalded eyes (n = 5) and to eyes scalded in the laboratory (n = 5). The corneal epithelium was removed before an excimer laser was used to perform a - 8.0 D photoablation. Corneal thickness was measured by optical coherence topography before and after photoablation. The ablation depth was determined with a contour measuring station, the morphology of the ablated areas was characterized …

Off-Pump Heartmate Ii Exchange In A Patient With Severe Lower Extremity Peripheral Artery Disease: A Case Report, Mehmet H. Akay, Ismael A. Salas De Armas, Manish K. Patel, Rajko Radovancevic, Igor D. Gregoric

The VAD Journal

Thrombosis of left ventricular assist device (LVAD) pumps is a serious complication that often requires exchange of the device. A 66-year-old man with severe peripheral vascular disease presented with pump thrombosis of the HeartMate II (HMII) LVAD 1.5 years after implantation. The HMII was exchanged to another HMII through a subcostal incision and without the use of cardiopulmonary bypass. For safety, the patient was prepared for cardiopulmonary bypass by exposing the right subclavian artery and insertion of a 5 FR cannula in the left common femoral vein. The pump was exchanged through a subcostal incision made over the LVAD pump …

Left Ventricular Assist Device Thrombosis Treated With Intravenous Tissue Plasminogen Activator In A Patient With Covid-19 Infection, Simone A. Jarrett, Jafar Alzubi, Savalan Babapoor-Farrokhran, Zaid Ammari, Mohammad Al-Sarie, Zachary Port, Farhan Hasni, Behnam Bozorgnia, Raphael Bonita

The VAD Journal

Left ventricular assist device (LVAD) implantation is an established treatment for patients with end-stage, systolic heart failure as a bridge to heart transplantation or destination therapy. LVAD pump thrombosis is a life-threatening complication than can be triggered by prothrombotic conditions such as infection. Management of pump thrombosis presents as both a diagnostic and therapeutic challenge that is associated with a high morbidity and mortality. We report a case of pump thrombosis in a patient with a HeartMate II (Abbott Laboratories, Chicago, IL) and coronavirus (COVID-19) infection that was treated successfully with an intravenous thrombolytic, tissue plasminogen activator.

Feasibility Of The Use Of A Stereoscopic Camera In The Final Inclusion (Sci-Fi) Of Donor Organ Assessment Using Virtual Reality Technology, Ismael A. Salas De Armas, Juan E. Marcano, Jayeshkumar A. Patel, Mehmet H. Akay, Manish K. Patel, Bindu Akkanti, Marwan F. Jumean, Sachin Kumar, Rajko Radovancevic, Sriram Nathan, Biswajit Kar, Igor D. Gregoric

The VAD Journal

Objective: Donor organ assessment is challenging, particularly when physicians and surgeons have to make decisions remotely. To improve communication and preparation for the transplant process, we proposed that a versatile, secure, and transportable video presence would enable a detailed assessment of donor organs.

Methods: A virtual reality camera with a 360-degree visualization range was used with a smartphone receiver to enable integral assessment of the donor's heart in the operating room, with visualization of the organs in real time. Prospective, observational data was collected in two cases in this proof-of-concept study. An assessment physician evaluated the donor heart remotely, and …

Removal Of Impella In The Setting Of Left Ventricular Thrombus: A Potential Indication For Cerebral Embolic Protection Devices, Miro Asadourian, Avinash Sharma, Richard Kiel, Felice Lin, Manminder Bhullar

The VAD Journal

Successful percutaneous mechanical circulatory support (MCS) has been used for acute stabilization of cardiogenic shock (CS). Improved survival outcomes have been observed in patients with CS from an acute myocardial infarction (AMI) who undergo implantation of left ventricular (LV) to ascending aorta rotodynamic pumps, such as the Impella® device (Abiomed). However, thrombotic events are a known complication of such devices in poor flow states such as CS. There is limited evidence regarding the management of patients who develop an LV thrombus after Impella insertion. Currently, the Sentinel cerebral protection system (SCPS, Boston Scientific) is the only FDA-approved device for cerebral …