Impaired drainage through capillary-venous networks contributes to age-related white matter loss.

The gradual loss of cerebral white matter contributes to cognitive decline during aging. However, microvascular networks that support the metabolic demands of white matter remain poorly defined. We used in vivo deep multi-photon imaging to characterize microvascular networks that perfuse cortical layer 6 and corpus callosum, a highly studied region of white matter in the mouse brain. We show that these deep tissues are exclusively drained by sparse and wide-reaching venules, termed principal cortical venules, which mirror vascular architecture at the human cortical-U fiber interface. During aging, capillary networks draining into deep branches of principal cortical venules are selectively constricted, reduced in density, and diminished in pericyte numbers. This causes hypo-perfusion in deep tissues, and correlates with gliosis and demyelination, whereas superficial tissues become relatively hyper-perfused. Thus, age-related impairment of capillary-venular drainage is a key vascular deficit that contributes to the unique vulnerability of cerebral white matter during brain aging.

The elusive brain perivascular fibroblast: a potential role in vascular stability and homeostasis.

In the brain, perivascular fibroblasts (PVFs) reside within the perivascular spaces (PVSs) of arterioles and large venules, however their physiological and pathophysiological roles remain largely unknown. PVFs express numerous extracellular matrix proteins that are found in the basement membrane and PVS surrounding large diameter vessels. PVFs are sandwiched between the mural cell layer and astrocytic endfeet, where they are poised to interact with mural cells, perivascular macrophages, and astrocytes. We draw connections between the more well-studied PVF pro-fibrotic response in ischemic injury and the less understood thickening of the vascular wall and enlargement of the PVS described in dementia and neurodegenerative diseases. We postulate that PVFs may be responsible for stability and homeostasis of the brain vasculature, and may also contribute to changes within the PVS during disease.

Capillary regression leads to sustained local hypoperfusion by inducing constriction of upstream transitional vessels.

In the brain, a microvascular sensory web coordinates oxygen delivery to regions of neuronal activity. This involves a dense network of capillaries that send conductive signals upstream to feeding arterioles to promote vasodilation and blood flow. Although this process is critical to the metabolic supply of healthy brain tissue, it may also be a point of vulnerability in disease. Deterioration of capillary networks is a hallmark of many neurological disorders and how this web is engaged during vascular damage remains unknown. We performed in vivo two-photon microscopy on young adult mural cell reporter mice and induced focal capillary injuries using precise two-photon laser irradiation of single capillaries. We found that ∼63% of the injuries resulted in regression of the capillary segment 7-14 days following injury, and the remaining repaired to re-establish blood flow within 7 days. Injuries that resulted in capillary regression induced sustained vasoconstriction in the upstream arteriole-capillary transition (ACT) zone at least 21 days post-injury in both awake and anesthetized mice. This abnormal vasoconstriction involved attenuation of vasomotor dynamics and uncoupling from mural cell calcium signaling following capillary regression. Consequently, blood flow was reduced in the ACT zone and in secondary, uninjured downstream capillaries. These findings demonstrate how capillary injury and regression, as often seen in age-related neurological disease, can impair the microvascular sensory web and contribute to cerebral hypoperfusion. SIGNIFICANCE: Deterioration of the capillary network is a characteristic of many neurological diseases and can exacerbate neuronal dysfunction and degeneration due to poor blood perfusion. Here we show that focal capillary injuries can induce vessel regression and elicit sustained vasoconstriction in upstream transitional vessels that branch from cortical penetrating arterioles. This reduces blood flow to broader, uninjured regions of the same microvascular network. These findings suggest that widespread and cumulative damage to brain capillaries in neurological disease may broadly affect blood supply and contribute to hypoperfusion through their remote actions.

Acute and chronic HBV infection in central Argentina: High frequency of sub-genotype F1b, low detection of clinically relevant mutations and first evidence of HDV.

Introduction: Genomic analysis of hepatitis B virus (HBV) identifies phylogenetic variants, which may lead to distinct biological and clinical behaviors. The satellite hepatitis D virus (HDV) may also influence clinical outcomes in patients with hepatitis B. The aim of this study was to investigate HBV genetic variants, including clinically relevant mutations, and HDV infection in acute and chronic hepatitis B patients in central Argentina. Methods: A total of 217 adult HBV infected patients [acute (AHB): n = 79; chronic (CHB): n = 138] were studied; 67 were HBV/human immunodeficiency virus (HIV) coinfected. Clinical and demographic data were obtained from medical records. Serological markers were determined. Molecular detection of HBV and HDV was carried out by RT-Nested PCR, followed by sequencing and phylogenetic analysis. Results: Overall, genotype (gt) F [sub-genotype (sgt) F1b] was the most frequently found. In AHB patients, the gts/sgts found were: F1b (74.7%) > A2 (13.9%) > F4 (7.6%) > C (2.5%) > A1 (1.3%). Among CHB patients: F1b (39.1%) > A2 (23.9%) > F4 (18.2%) > D (9.4%) > C and F6 (3.6% each) > A1, A3 and B2 (0.7% each). The distribution of sgt A2 and gt D was significantly different between HBV mono and HBV/HIV coinfected patients [A2: 15.9% vs. 35.7% (p < 0.05), respectively and D: 14.6% vs. 1.8% (p < 0.05), respectively]. Mutation frequency in basal core promoter/pre-Core (BCP/pC) region was 35.5% (77/217) [AHB: 20.3% (16/79), CHB: 44.2% (61/138)]. In the open reading frame (ORF) S, mutations associated with vaccine escape and diagnostic failure were detected in 7.8% of the sequences (17/217) [AHB: 3.8% (3/79), CHB: 10.1% (14/138)]. ORF-P amino acid substitutions associated with antiviral resistance were detected in 3.2% of the samples (7/217) [AHB: 1.3% (1/79), CHB 4.3%, (6/138)]. The anti-HDV seropositivity was 5.2% (4/77); one sample could be sequenced, belonging to gt HDV-1 associated with sgt HBV-D3. Discussion: We detected an increase in the circulation of genotype F in Central Argentina, particularly among AHB patients, suggesting transmission advantages over the other genotypes. A low rate of mutations was detected, especially those with antiviral resistance implications, which is an encouraging result. The evidence of HDV circulation in our region, reported for the first time, alerts the health system for its search and diagnosis.

Vagus Nerve Stimulation Paired With Rehabilitative Training Enhances Motor Recovery After Bilateral Spinal Cord Injury to Cervical Forelimb Motor Pools.

Closed-loop vagus nerve stimulation (VNS) paired with rehabilitative training has emerged as a strategy to enhance recovery after neurological injury. Previous studies demonstrate that brief bursts of closed-loop VNS paired with rehabilitative training substantially improve recovery of forelimb motor function in models of unilateral and bilateral contusive spinal cord injury (SCI) at spinal level C5/6. While these findings provide initial evidence of the utility of VNS for SCI, the injury model used in these studies spares the majority of alpha motor neurons originating in C7-T1 that innervate distal forelimb muscles. Because the clinical manifestation of SCI in many patients involves damage at these levels, it is important to define whether damage to the distal forelimb motor neuron pools limits VNS-dependent recovery. In this study, we assessed recovery of forelimb function in rats that received a bilateral incomplete contusive SCI at C7/8 and underwent extensive rehabilitative training with or without paired VNS. The study design, including planned sample size, assessments, and statistical comparisons, was preregistered prior to beginning data collection ( https://osf.io/ysvgf/ ). VNS paired with rehabilitative training significantly improved recovery of volitional forelimb strength compared to equivalent rehabilitative training without VNS. Additionally, VNS-dependent enhancement of recovery generalized to 2 similar, but untrained, forelimb tasks. These findings indicate that damage to alpha motor neurons does not prevent VNS-dependent enhancement of recovery and provides additional evidence to support the evaluation of closed-loop VNS paired with rehabilitation in patients with incomplete cervical SCI.

Estrategia quirúrgica en herida hepática grave por arma de fuego. Reporte de caso / Surgical strategy in serious liver injuty caused by gunshot

El traumatismo hepático grave representa uno de los problemas más severos en la cirugía de urgencia del trauma abdominal. Se presenta un paciente de 40 años de edad con traumatismo abdominal por arma de fuego con lesión hepática, descompensado hemodinámicamente. Se utiliza un «packing¼ abdominal para controlar la hemorragia y se lo traslada a unidad de terapia intensiva para corregir la inestabilidad hemodinámica y evitar la coagulopatía, hipotermia y acidosis. Se completa el procedimiento con una reintervención quirúrgica programada para retirar el packing y resolver definitivamente las lesiones. Se analizaron las distintas maneras de actuar frente a un caso como el que se plantea, tanto en el momento inicial en el que se presenta el paciente en sala de urgencias como, las posibles estrategias quirúrgicas en la cirugía definitiva.

Severe hepatic injury is one of the most serious problems in emergency abdominal trauma surgery. A 40 year old, hemodynamically unstable, male patient was admitted with abdominal trauma caused by a gunshot liver injury. An abdominal «packing¼ was used to control abdominal bleeding and then the patient was transferred to the intensive care unit for correcting the hemodynamic instability and preventing coagulopathy, hypothermia, and acidosis. The procedure was completed with further non-emergency surgery to remove the packing and finally resolve the injuries. The different ways of acting in a case like this in the initial moment when the patient is admitted at the emergency room and the possible surgical strategies in final surgery were analyzed.

Effect of protease EPg222 obtained from Penicillium chrysogenum isolated from dry-cured ham in pieces of pork loins.

The fungal protease EPg222 obtained from Penicillium chrysogenum Pg222 isolated from dry-cured ham, was assayed for proteolytic activity in a meat model system based on sterile pieces of pork loins for 32 days. Treated samples showed a significative reduction of total high ionic strength-soluble proteins during the incubation period, as compared with a control incubated without enzyme, both on the surface and in the depth. SDS-PAGE analysis of this protein fraction showed higher hydrolysis of the main myofibrillar proteins H-meromyosin, actin, and tropomyosin in treated samples. Non-protein and amino acidic nitrogen were detected in higher amounts in enzyme-added than in control pieces of loins, both on the surface and in the depth. Thus, addition of enzyme EPg222 to whole pieces of meat results in an increase of protein hydrolysis. The effect of this enzyme could be of great interest for stimulating proteolysis in whole dry-cured meat pieces.

Production of cyclopiazonic acid by Penicillium commune isolated from dry-cured ham on a meat extract-based substrate.

Penicillium commune, a mold frequently found on dry-cured meat products, is able to synthesize the mycotoxin cyclopiazonic acid (CPA). To evaluate the hazard due to CPA on such foods, the ability of P. commune to grow and produce CPA at water activities (a(w)) in the range of 0.99 to 0.90 with a meat extract-based medium from 12 to 30 degrees C was determined. CPA was quantified by high-pressure liquid chromatography and mass spectrometry. P. commune was able to grow at every a(w) and temperature tested. The optimal environmental conditions for growth were 20 to 25 degrees C, at 0.97 to 0.96 a(w), but the highest amount of CPA was produced at 30 degrees C, 0.96 a(w). No direct correlation between growth rate and CPA production was assessed. Temperature seems to be the most important factor influencing CPA production. However, there was an interaction between temperature and a(w) that significantly (P < 0.001) affected growth and CPA production. An a(w) of 0.90 had a marked effect, depressing growth and CPA production. Meat extract-based medium proved to be an appropriate substrate for CPA biosynthesis by P. commune under a wide range of conditions.