A5051644010- Central Venous Catheters and Hemodialysis
- Vascular Malformations Diagnosis and Treatment
- Vascular anomalies and interventions
- Renal and Vascular Pathologies
- Intracranial Aneurysms: Treatment and Complications
- Cardiac, Anesthesia and Surgical Outcomes
- Vascular Procedures and Complications
- Aortic aneurysm repair treatments
- Mass Spectrometry Techniques and Applications
- Amino Acid Enzymes and Metabolism
- Health and Medical Research Impacts
- Enzyme Structure and Function
- Diversity and Career in Medicine
- Artificial Intelligence in Healthcare and Education
- Systemic Lupus Erythematosus Research
- Infectious Aortic and Vascular Conditions
- Surgical Simulation and Training
- Acute Myocardial Infarction Research
- Trauma and Emergency Care Studies
- Vascular Anomalies and Treatments
- Atherosclerosis and Cardiovascular Diseases
- Cardiac Arrhythmias and Treatments
- DNA Repair Mechanisms
- Porphyrin Metabolism and Disorders
- Dental Education, Practice, Research
Yale University
2023-2025
VA Connecticut Healthcare System
2023
Gastroenterology Center of Connecticut
2023
Baylor University
2016-2018
BACKGROUND: Arteriovenous fistulae (AVF) are the preferred vascular access for hemodialysis in patients with end-stage kidney disease. Chronic disease (CKD) is associated endothelial injury, impaired AVF maturation, and reduced patency, as well utilization. Because CKD characterized by multiple pathophysiological processes that induce endothelial-to-mesenchymal transition (EndMT), we hypothesized promotes EndMT during venous remodeling disruption of TGF (transforming growth factor)-β...
End-stage kidney disease (ESKD) impacts over 740,000 individuals in the U.S., with many patients relying on arteriovenous fistulae (AVF) for hemodialysis due to superior patency and reduced infections. However, AVF is by thrombosis neointimal hyperplasia, yielding a one-year of only 40-50%. were created wildtype (WT) Tnc knockout ( -/- ) mice, proteomic analyses conducted identify protein changes between sham WT tissue. Immunofluorescence Western blot assays compared venous tissue from mice....
After arteriovenous fistula creation, females have lower rates of maturation and higher failure than males. In a mouse model venous adaptation that recapitulates human maturation, sex hormones may be mechanisms the sexual dimorphism: testosterone is associated with reduced shear stress, whereas estrogen increased immune cell recruitment. Modulating or downstream effectors suggests sex-specific therapies could address disparities in differences clinical outcomes.
Clinical failure of arteriovenous neointimal hyperplasia (NIH) fistulae (AVF) is frequently due to juxta-anastomotic NIH (JANIH). Although the mouse AVF model recapitulates human maturation, previous studies focused on outflow vein distal anastomosis. We hypothesized that area (JAA) has increased compared with vein. was created in C57BL/6 mice without or chronic kidney disease (CKD). Temporal and spatial changes JAA were examined using histology immunofluorescence. Computational techniques...
IntroductionFemale vascular surgeons constitute 15% of the workforce. Despite an increased pipeline female surgeons, representation in leadership positions nationally has not maintained pace. We hypothesized that are underrepresented as leaders clinical trials United States (U.S.) for several conditions germane to our specialty.MethodsClinical registered U.S. were reviewed using ClinicalTrials.gov index conditions: abdominal aortic aneurysm, carotid disease, hemodialysis access, venous...
A central arteriovenous fistula (AVF) has been proposed as a potential novel solution to treat patients with refractory hypertension. We hypothesized that venous remodeling after AVF creation in the hypertensive environment reduces systemic blood pressure but results increased wall thickness compared normotensive environment. was performed C57BL6/J mice previously made Angiotensin II (Ang II); were sacrificed on postoperative day 7 or 21. In treated AngII alone, mean systolic from 90 ± 5...
Anticoagulation and antiplatelet therapy effectively inhibit neointimal hyperplasia (NIH) in both arterial venous systems but not arteriovenous fistulae (AVF). The main site of AVF failure is the juxta-anastomotic area that characterized by disturbed flow compared with laminar inflow outflow.
A growing body of evidence supports a steric exclusion and wrapping model for DNA unwinding in which hexameric helicases interact with the excluded single-stranded (ssDNA) addition to encircled strand. Interactions ssDNA have been shown be mediated primarily by electrostatic interactions, but base stacking surface-exposed tyrosine residues is an alternative hypothesis. Here, we mutated several external positively charged from full-length Sulfolobus solfataricus MCM along proposed path strand...
Clinical outcomes of arteriovenous fistulae (AVF) for hemodialysis remain inadequate since biological mechanisms AVF maturation and failure are still poorly understood. Aortocaval fistula creation (AVF group) or a sham operation (sham was performed in C57BL/6 mice. Venous limbs were collected on postoperative day 7 total RNA extracted high throughput sequencing bioinformatic analysis. Genes metabolic pathways significantly downregulated the AVF, whereas significant sex differences not...
Objectives: Arteriovenous fistulae (AVF) are the preferred vascular access for patients with end-stage renal disease (ESRD) but have high rates of primary failure. Models AVF using mice chronic kidney (CKD) show diminished maturation and increased failure compared to wild type mice. Since CKD TGF-β1 expression activity in model, signaling can alter autophagy, we hypothesized that increases autophagy during maturation, whereas inhibition smooth muscle cell (SMC) TGF-β receptor would attenuate...
Introduction: Arteriovenous fistula (AVF) failure is a clinical problem for end stage renal patients seeking durable long term dialysis access. AVF not fully understood, but linked to neointimal hyperplasia (NH). Understanding the hemodynamic factors that may trigger NH response important minimizing this problem. Methods: A validated murine model defined geometry and boundary conditions computational model. Anesthetized mice underwent laparotomy aorta-IVC puncture. Ultrasound specified blood...
The 2023 Vascular Research Initiatives Conference (VRIC) was held in Boston, Massachusetts, and coincided with the first day of Discovery 2023, hosted by American Heart Association. VRIC attracts vascular clinicians, surgeon-scientists, basic science researchers to a common arena facilitate exchange translational stimulate inspire participants study find solutions conditions. theme conference this year "Structural Immune Cells Disease." Abstract sessions focused on venous disease,...
Objectives: Failure of arteriovenous fistulas (AVF) for dialysis access remains a persistent problem. The reason failure is largely unknown. Computational models AVF have not been validated in parallel with animal experiments. We propose computational model that predicts venous geometric remodeling. hypothesize remodeling may precede failure. Methods: First, we use murine to define the parameters and boundary conditions our model. Anesthetized mice undergo laparotomy aortocaval puncture....
Objectives: Arteriovenous fistulae (AVF) are the optimal conduit for hemodialysis access in patients with end-stage chronic kidney disease (CKD); however, AVF have high rates of failure due to aggressive neointimal hyperplasia (NIH) caused by vascular inflammation and endothelial-to-mesenchymal transition (EndMT). Since endothelial glucocorticoid receptor is a negative regulator inflammation, we hypothesized that inhibition would promote EndMT accelerate NIH. Methods: Aortocaval were created...