Том 13, брой 1 - 2017/ Vol. 13, No. 1 - 2017

Neurosonology and Cerebral Hemodynamics 13, 2017:35–41

Ts. Koleva 1, E. Titianova 1,2

1 Clinic of Functional Diagnostics of Nervous System, Military Medical Academy – Sofia
2 Faculty of Medicine, Sofia University “St. Kliment Ohridski” – Sofia, Bulgaria

Abstract

Three-dimensional bioprinting is a new method for identical reproduction of biological tissues and organs by layering living cells. The technological process consists of three stages: (1) pre-bioprinting includes biopsy of the desired organ or tissue, depiction by computer (CT) or magnetic resonance imaging (MRI), creation of a virtual model, selection of cell culture, broths and technology; (2) bioprinting – setting a mixture of selected cells, broths and bioink in a special printer (Inkjet, Microextrusion or Laser-assisted), incubation and conversion of the mixture into a tissue with a subsequent nano-dimensional multi-layer printing of the target CT/MRI image; (3) post-bioprinting – a process of a biological stabilization of the resulting organ or tissue. The creation of biomaterials is achieved through different approaches: biomimicry (cultivation of identical microcellular and extracellular structures), autonomous self-assembly (through embryonic embedded replication of the corresponding cells, tissues and organs) and building “mini tissues” by integrating miniature structural and functional components. Nowadays, the application of the method is mostly experimental (for testing drugs, analyzing chemical, biological and toxic agents) and clinically limited in transplantology. It has been shown that a skin, bone, cartilage, and other tissues and some organs (ear, trachea, heart valves, blood vessels, etc.) can be successfully bioprinted. Recently the first human embryonic neural stem cells, GABAergic neurons and spontaneously active neural networks have been also reproduced. However the full bioprinting of liver and kidney is still incomplete.
Regardless the advantages of 3D-bioprinting (greater resistance of the organ, no risk of rejection and no need for immunosuppressive therapy), the method is still not routinely used mainly because of its very high price and the need for highly qualified multidisciplinary team. In the future, it is expected 3D-bioprintig to be combined with mini-invasive personalized robotic systems.

Neurosonology and Cerebral Hemodynamics 13, 2017:5–11

H. Budinčević 1,2,  M. Meter 3, P. Črnac 1, K. Kordić 4, L. Marjanović 5, E. Galić 2,3, V. Govori 6, V. Demarin 7

1 Stroke and Intensive Care Unit, Department of Neurology, Sveti Duh University Hospital – Zagreb, Croatia
2 School of Medicine, Josip Juraj Strossmayer University – Osijek, Croatia
3 Department of Cardiology, Sveti Duh University Hospital – Zagreb, Croatia
4 Department of Cardiology, Sestre Milosrdnice University Hospital Center – Zagreb, Croatia
5 School of Medicine, University of Zagreb – Zagreb, Croatia 
6 Department of Neurology, University Clinical Center, Univerity of Pristina – Pristina, Kosovo
7 International Institute for Brain Health – Zagreb, Croatia

Abstract

Objective: The aim of this study was to evaluate the relationship between common carotid artery intima-media thickness and risk factors in patients who underwent coronary artery bypass grafting surgery (CABG) based on extent of coronary artery disease.
Material and Methods: This study included all patients with coronary artery disease hospitalized in the Department of Cardiology during the period from 2007 to 2014, who underwent CABG. Two groups were formed: patients who underwent CABG of three and more vessels (CABG 3+) and patients who underwent CABG of two or less vessels (CABG 2-). Carotid intima-media thickness (C-IMT) was assessed by carotid ultrasound according to the Mannheim Carotid Intima-Media Thickness Consensus.
Results: The study included 66 patients. There were 35 patients in the CABG3+ group and 31 patients in the CABG2- group. We found no statistically significant difference in the mean intima-media thickness of the common carotid artery between these two groups (p= 0.5637), neither between C-IMT and the extent of the coronary artery disease (p=0.82612). The CABG 3+ group had higher incidence of arterial hypertension (p=0.0298) and hyperlipidemia (p=0.0388). No statistically significant difference was found between age, gender, previous ischemic stroke, and smoking between groups.
Discussion: Our study did not show statistically significant relationship between common carotid artery (CCA) IMT and the extent of CABG surgery and coronary artery disease. Arterial hypertension and hyperlipidemia are more important risk factors, more commonly present in patients with greater extent of CABG surgery.

Neurosonology and Cerebral Hemodynamics 13, 2017:12–21

F. Todua 1, D. Gachechiladze 2, M. Beraia 2
1 Academy member, The Research Institute of Clinical Medicine
2 The Research Institute of Clinical Medicine – Tbilisi, Georgia

Abstract

Objective: The aim of our study was to evaluate the relationship between collateral flow via different pathways and cerebral hemodynamic parameters in patients with unilateral high-grade internal carotid artery (ICA) changes.
Material and Methods: 41 patients with severe stenosis and 30 patients with occlusion of ICA underwent brain MRT, 3D TOF-MR-angiography, Color Doppler of extra- and intracranial vessels to investigate collateral flow via the circle of Willis and via the ophthalmic artery (OphA). Maps of the cerebral perfusion parameters were calculated.
Results: In 50 (70%) cases “symptomatic” cerebral ischemia was noted. In symptomatic patients cortical middle cerebral artery (MCA) infarctions – 13 (26%), and border-zone infarctions – 10 (20%) prevailed. In cases of unilateral ICA occlusion compensatory dilatation of contralateral ICA and enhancement of flow volume by 60%, additional enhancement of the flow in vertebral arteries by 18% was observed. Thirteen patients (85%) without collateral flow via the circle of Willis or flow via the PComA only have a higher incidence of brain infarction and impaired hemodynamic parameters in the MCA (V mean-38cm/s, PI-0.69), than patients with collateral flow via the AComA (2 infarctions, Vmean-44cm/s, PI-0.77). Patients with reversed OphA could prove an additional risk for infarction.
Discussion: Patients with collateral flow via the PComA and reversed OphA flow have more impaired hemodynamic parameters and a higher risk of brain infarctions, than patients with collateral flow via the AComA. Complex use of TCCD, 3D TOF-MR-angiography and PWI gives all necessary information about the type and hemodynamic parameters of collateral supply in high-grade ICA changes.

Neurosonology and Cerebral Hemodynamics 13, 2017:22–34.

M. Mijajlovic 1*,V. Aleksic 2*, N. Sternic 1, N. Bornstein 3,4 
Neurology Clinic, Clinical Center of Serbia and School of Medicine University of Belgrade – Serbia
Department of Neurosurgery, Clinical Hospital Center Zemun – Belgrade, Serbia
Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv University – Tel-Aviv, Israel 
Shaare Zedek Medical Center – Jerusalem, Israel 
*M. Mijajlovic and V. Aleksic equally contributed to this work

Abstract

Significant number of patients with acute ischemic stroke suffers from hypertension, hyperglycemia or hyperthermia, particularly in hyper acute stage of ischemic stroke. These conditions dramatically influence early and late outcome of acute ischemic stroke. That is why early recognition and adequate treatment of hypertension, hyperglycemia and hyperthermia are very important. This review paper summarizes recent knowledge on association between acute ischemic stroke and hypertension, hyperglycemia and hyperthermia as well as emphasizes current treatment recommendations.

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