RESUMEN
AIM: The purpose of this study was to determine the long-term recurrence rates of greater saphenous vein (GSV) insufficiency after treatments for primary varicose veins, and to elucidate risk factors for recurrence. METHODS: This was a multicenter retrospective analysis of 376 limbs of 296 patients treated for primary varicose veins due to GSV insufficiency from January 1996 to December 1997. The recurrence-free rates after stripping surgery, saphenofemoral ligation, and sclerotherapy were estimated. The risk factors for the recurrence of primary varicose veins were estimated by multiple regression analysis. RESULTS: The follow-up period was 3.1+/-1.3 (mean+/-SD) years. The recurrence-free rates at 4 years after stripping, saphenofemoral ligation and sclerotherapy were 80.7%, 64.5%, and 51.3%, respectively. The saphenofemoral ligation group and sclerotherapy group had significantly higher recurrence rates than the stripping group (P=0.002, P<0.001, respectively). There was no difference in recurrence rates between the saphenofemoral ligation group and sclerotherapy group (P=0.074). Logistic regression analysis revealed that being female (P<0.029) and treatment without stripping (P<0.001) increased the recurrence rate. CONCLUSIONS: Stripping surgery may be the treatment of first choice for patients with varicose veins due to GSV insufficiency. Patients who have not received stripping surgery and female patients require closer follow-up.
Asunto(s)
Vena Safena , Várices/terapia , Insuficiencia Venosa/complicaciones , Anciano , Femenino , Humanos , Ligadura , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Modelos de Riesgos Proporcionales , Recurrencia , Factores de Riesgo , Escleroterapia , Resultado del Tratamiento , Várices/etiología , Várices/cirugíaRESUMEN
Homeobox-containing genes are expressed in spatiotemporal fashion during embryogenesis and act as master transcription-regulating factors which control the expression of a variety of genes involved in morphogenesis. They are also expressed in a tissue-specific manner in normal adult tissues and appear to give cells spatial information in the maintenance of their architectural integrity. We transfected a HOXD3 class I homeobox-containing gene into human lung cancer A549 cells and investigated alterations in gene expressions and phenotypes related to the maintenance of tissue architecture in HOXD3-overexpressing A549 cells. In the HOXD3-overexpressing cell lines, expression of E-cadherin was lost and plakoglobin was strongly repressed, whereas integrin alpha3 and beta3 were up-regulated and N-cadherin and integrin alpha4 were newly expressed. Compared with parental and control transfectant lines, the HOXD3-overexpressing cell lines showed highly motile and invasive activity. Blocking experiments using anti-integrin beta1 and beta3 suggested that the increased haptotaxis of the HOXD3-overexpressing cells to vitronectin resulted from increased expression and activation of integrin alphavbeta3, and that overexpression of the HOXD3 gene converted the integrin beta1-dependent haptotaxis to fibronectin into both integrin beta1- and beta3-dependent one. HOXD3 overexpression increased production of matrix-degrative enzymes including matrix metalloproteinase-2 and urokinase-plasminogen activator. When the tumor cells were intravenously injected into the tail veins of nude mice, HOXD3 transfectants formed a significantly large number of metastatic foci in lungs compared with the control transfectants. These findings suggest that HOXD3 can act as a metastasis-promoting gene in human lung cancer A549 cells.
Asunto(s)
Proteínas de Unión al ADN , Regulación Neoplásica de la Expresión Génica/genética , Genes Homeobox/genética , Proteínas de Homeodominio/genética , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Transactivadores , Antígenos CD/biosíntesis , Cadherinas/biosíntesis , Cadherinas/genética , Movimiento Celular/genética , Proteínas del Citoesqueleto/biosíntesis , Proteínas del Citoesqueleto/genética , Desmoplaquinas , Matriz Extracelular/metabolismo , Fibronectinas/fisiología , Vectores Genéticos , Proteínas de Homeodominio/biosíntesis , Humanos , Integrina alfa3 , Integrina beta3 , Integrinas/biosíntesis , Neoplasias Pulmonares/metabolismo , Invasividad Neoplásica , Metástasis de la Neoplasia , Glicoproteínas de Membrana Plaquetaria/biosíntesis , Receptores de Vitronectina/biosíntesis , Receptores de Vitronectina/fisiología , Factores de Transcripción , Transfección , Células Tumorales Cultivadas , Vitronectina/fisiología , alfa Catenina , beta Catenina , gamma CateninaRESUMEN
A seven-day-old neonate presented with respiratory distress and an early diagnosis was achieved through the echocardiographic studies which successfully visualized an anomalous origin of the right pulmonary artery arising from the ascending aorta. Subsequently a surgical correction with direct anastomosis of the right pulmonary artery to the main pulmonary trunk was accomplished in the neonatal period. The English literature in the last two decades is reviewed to discuss the characteristics, the diagnosis and treatment of neonatal cases with anomalous origin of the right pulmonary artery arising from the ascending aorta.
