Background and Aims Gastrointestinal ultrasound is useful in the assessment of patients with Crohn’s disease, but its application in ulcerative colitis [UC] is less well established. Here we systematically review the role of gastrointestinal ultrasound in patients with UC. Methods Searches of the PUBMED and EMBASE databases were performed with the following search strategy: [ultrasound OR sonography] AND [intestinal OR bowel] AND [ulcerative colitis OR inflammatory bowel disease]. The final search was performed in August 2019. Results Of 6769 studies identified in the search with a further two studies found from other sources, 50 studies met the inclusion criteria. Increased bowel wall thickness and detection of increased blood flow by colour Doppler were the most often applied criteria for defining disease activity and distribution. When compared with other reference investigations, gastrointestinal ultrasound accurately determined disease extent, severity and response to medical therapy. While further information can be obtained from haemodynamic measurements of the abdominal vessels and contrast-enhanced ultrasound, their clinical value was uncertain. Likewise, hydrocolonic sonography has few advantages over standard gastrointestinal ultrasound examination. Of several scoring systems proposed, there is disparity between the measures and a general lack of validation. There has been limited application of gastrointestinal ultrasound in acute severe ulcerative colitis with toxic megacolon, and, while performing well in children, normal limits differ from those in adults. Conclusion Current evidence indicates that gastrointestinal ultrasound has utility in the non-invasive assessment of patients with UC. Continued advances in technology with better image resolution, validation of scoring systems and application at the point of care by gastroenterologists are likely to contribute to increased use of gastrointestinal ultrasound in routine clinical practice.

The term angiogenesis arose in the 18th century. Several studies over the next 100 years laid the groundwork for initial studies performed by the Folkman laboratory, which were at first met with some opposition. Once overcome, the angiogenesis field has flourished due to studies on tumor angiogenesis and various developmental models that can be genetically manipulated, including mice and zebrafish. In addition, new discoveries have been aided by the ability to isolate primary endothelial cells, which has allowed dissection of various steps within angiogenesis. This review will summarize the molecular events that control angiogenesis downstream of biochemical factors such as growth factors, cytokines, chemokines, hypoxia-inducible factors (HIFs), and lipids. These and other stimuli have been linked to regulation of junctional molecules and cell surface receptors. In addition, the contribution of cytoskeletal elements and regulatory proteins has revealed an intricate role for mobilization of actin, microtubules, and intermediate filaments in response to cues that activate the endothelium. Activating stimuli also affect various focal adhesion proteins, scaffold proteins, intracellular kinases, and second messengers. Finally, metalloproteinases, which facilitate matrix degradation and the formation of new blood vessels, are discussed, along with our knowledge of crosstalk between the various subclasses of these molecules throughout the text. Compr Physiol 8:153-235, 2018.

During angiogenesis, endothelial cells (ECs) use both soluble and insoluble cues to expand the existing vascular network to meet the changing trophic needs of the tissue. Fundamental to this expansion are physical interactions between ECs and extracellular matrix (ECM) that influence sprout migration, lumen formation and stabilization. These physical interactions suggest that ECM mechanical properties may influence sprouting ECs and, therefore, angiogenic responses. In a three-dimensional angiogenic model in which a monolayer of ECs is induced to invade an underlying collagen matrix, angiogenic responses were measured as a function of collagen matrix stiffness by inducing collagen crosslinking with microbial transglutaminase (mTG). By biaxial mechanical testing, stiffer collagen matrices were measured with both mTG treatment and incubation time. Using two-photon excited fluorescence (TPF) and second harmonic generation (SHG), it was shown that collagen TPF intensity increased with mTG treatment, and the TPF/SHG ratio correlated with biaxially tested mechanical stiffness. SHG and OCM were further used to show that other ECM physical properties such as porosity and pore size did not change with mTG treatment, thus verifying that matrix stiffness was tuned independently of matrix density. The results showed that stiffer matrices promote more angiogenic sprouts that invade deeper. No differences in lumen size were observed between control and mTG stiffened matrices, but greater remodeling was revealed in stiffer gels using SHG and OCM. The results of this study show that angiogenic responses are influenced by stiffness and suggest that ECM properties may be useful in regenerative medicine applications to engineer angiogenesis.

. Improvement in diastolic intraventricular pressure gradients in patients with HOCM after ethanol septal reduction. Am J Physiol Heart Circ Physiol 285: H2492-H2499, 2003. First published August 21, 2003 10.1152/ajpheart.00265.2003We sought to validate measurement of intraventricular pressure gradients (IVPG) and analyze their change in patients with hypertrophic obstructive cardiomyopathy (HOCM) after ethanol septal reduction (ESR). Quantitative analysis of color M-mode Doppler (CMM) images may be used to estimate diastolic IVPG noninvasively. Noninvasive IVPG measurement was validated in 10 patients undergoing surgical myectomy. Echocardiograms were then analyzed in 19 patients at baseline and after ESR. Pulsed Doppler data through the mitral valve and pulmonary venous flow were obtained. CMM was used to obtain the flow propagation velocity (V p) and to calculate IVPG off-line. Left atrial pressure was estimated with the use of previously validated Doppler equations. Data were compared before and after ESR. CMM-derived IVPG correlated well with invasive measurements obtained before and after surgical myectomy [r ϭ 0.8, P Ͻ 0.01, ⌬(CMM Ϫ invasive IVPG) ϭ 0.09 Ϯ 0.45 mmHg]. ESR resulted in a decrease of resting LVOT systolic gradient from 62 Ϯ 10 to 29 Ϯ 5 mmHg (P Ͻ 0.001). There was a significant increase in the V p and IVPG (from 48 Ϯ 5 to 74 Ϯ 7 cm/s and from 1.5 Ϯ 0.2 to 2.6 Ϯ 0.3 mmHg, respectively, P Ͻ 0.001 for both). Estimated left atrial pressure decreased from 16.2 Ϯ 1.1 to 11.5 Ϯ 0.9 mmHg (P Ͻ 0.001). The increase in IVPG correlated with the reduction in the LVOT gradient (r ϭ 0.6, P Ͻ 0.01). Reduction of LVOT obstruction after ESR is associated with an improvement in diastolic suction force. Noninvasive measurements of IVPG may be used as an indicator of diastolic function improvement in HOCM. echocardiography; diastolic function; hypertrophic obstructive cardiomyopathy HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY (HOCM) is a common disorder associated with significant morbidity and mortality (22,26). While many symptomatic patients with dynamic left ventricular (LV) outflow tract (LVOT) obstruction may be treated medically, surgical management is often required to control persistent symptoms (14,27). Recently, nonsurgical reduction of the interventricular septum using ethanol septal reduction (ESR) has emerged as an alternative treatment. It successfully decreases the LVOT gradient and improves symptoms (19,23).HOCM patients have preserved LV systolic function, but their diastolic function, in particular, LV relaxation, is frequently impaired (14,15,22). Doppler echocardiography is commonly used to evaluate diastolic function in these patients. However, standard Doppler indexes of LV filling are not always accurate in assessing relaxation in HOCM patients because these indexes are also affected by preload (23). Recently, color M-mode Doppler has been utilized for noninvasive evaluation of LV relaxation (1,15,23,24). We have demonstrated that in contrast to pulsed Doppler LV filling indexes, color M-mo...

Objective: To report the outcome of horses engaged in Western performance disciplines after stifle arthroscopy and identify prognostic factors for return to performance. Study design: Retrospective case series.Sample population: Eighty-two Western performance horses undergoing stifle arthroscopy. Methods: Medical records were reviewed for horses involved in athletic performance/training for various Western performance disciplines and undergoing arthroscopy for lameness localized to the stifle. Follow-up was obtained ≥2 years postoperatively by telephone interviews with the owners. Preoperative and intraoperative findings as well as postoperative treatment were analyzed for their association with return to athletic performance as the primary outcome of interest. Results: The most common disciplines represented were cutting (n = 38), Western pleasure (n = 13), and reining (n = 13). Approximately 40% (32/82) of horses returned to intended use after surgery. Increased age, higher degree of lameness, longer duration of lameness, and the presence of partial-thickness cartilage lesions decreased the odds of returning to athletic performance. Postoperative therapies (intra-articular: stem cells, corticosteroids, interleukin-1 receptor antagonist protein, hyaluronic acid/polysulfated glycosaminoglycans; systemic: nonsteroid antiinflammatory drugs, hyaluronic acid/polysulfated glycosaminoglycans, oral joint supplements) did not affect the odds of returning to intended use. Conclusion: Less than half of the Western performance horses that underwent stifle arthroscopy returned to intended use. Older age, longer duration of lameness, and presence of partial-thickness cartilage lesions affected the odds of a horse returning to intended use. Postoperative therapies did not affect the outcome in this population. Clinical significance: The prognosis of Western performance horses undergoing stifle arthroscopy is as guarded as that previously reported in horses of other disciplines.