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1.
Angiol Sosud Khir ; 25(4): 116-122, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31855208

RESUMO

The purpose of the study was to work out a Russian-made, simple-to-manufacture, safe, inexpensive and efficient device for performing endovasal laser obliteration (EVLO) of varicose veins, with the underlying principle of endoluminal distribution of the total laser energy into several flows. The development of this device was based on the principle of dividing the total laser radiation into two energy flows. One flow has a shape of circularly formed, continuous field of laser radiation of specified width within the angular range from 50 to 90°, which ensures the main energetic contribution to thermal impact on the vascular wall. The second energetic flow is formed in the part of the tip having a shape of a truncated cone, along the axis of the optical fibre within the angular range from 10 to 50°, which ensures additional thermal effect of radiation on the narrowing walls of the venous channel. Starting from 2016, EVLO with the use of the developed device was performed in a total of 50 patients with class C2-C3 varicose veins. The morphogenesis of the occurring restructuring of the venous wall was studied intraoperatively and in various time periods. Tissue specimens obtained intraoperatively demonstrated in the majority of cases complete or partial intimal detachment, swelling, disorganization of the middle membrane, adventitial loosening with thrombosis of the elements of the vasa vasorum in the majority of portions. The histological specimens harvested at 10 to 14 days were found to contain in the venous wall clear-cut distinct evidence of actively commensing connective-tissue proliferation. At 1 month of follow up the specimens of the veins treated with EVLO using the developed device showed the beginning of collagenisation of the wall, with finally fibrous restructuring and wall hyalinosis by month 3 after EVLO. The proposed device for EVLO of varicose veins makes it possible to act upon the venous wall simultaneously with two energy flows which excludes negative thermal action of excess energy of laser radiation on the vascular wall while using unidirectional radiation in the form of one or even two, but thin rings and, thus, dramatically decreasing reducing the risk for the development of complications. Implementation of the new device into the phlebological practice in Russia in conditions of complete import substitution has significant economic benefit.


Assuntos
Terapia a Laser/instrumentação , Varizes/cirurgia , Veias/cirurgia , Humanos , Varizes/patologia , Veias/patologia
2.
Khirurgiia (Mosk) ; (11): 24-28, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31714526

RESUMO

OBJECTIVE: To study the causes of recirculation syndrome and optimize surgical correction. MATERIAL AND METHODS: There were 2329 procedures of formation and restoration of permanent vascular access in 2109 patients for the period from 1998 to 2018. Recirculation syndrome occurred in 66 (3.1%) patients. Instrumental diagnosis of the causes of recirculation syndrome included Doppler ultrasound of permanent vascular access (100%) and angiography in accordance with indications. All patients were divided into 4 groups. The first group included 39 (59.1%) patients with native arteriovenous fistula. The second group included 12 (18.2%) patients with high arteriovenous fistula (between the brachial artery and the cephalic vein). The third group included 10 (15.1%) patients with major vein transposition. Synthetic prosthesis to create an arteriovenous fistula was used in the fourth group (n=5, 7.6%). RESULTS: In the first group, recirculation syndrome was caused by the presence of a large branch in close proximity to the arteriovenous anastomosis, its combination with significant stenosis of the anastomosis, hypoplasia of the outflow pathways of the fistulous vein. In the second group, the reasons were subclavian vein stenosis and dilated tributaries of the saphenous veins. In the third group, the main cause of recirculation syndrome was major vein stenosis in the upper third of the shoulder. In the fourth group, recirculation syndrome was caused by stenosis of the prosthetic-venous anastomosis. CONCLUSION: Recirculation syndrome in hemodialysis patients is usually caused by malfunction of permanent vascular access. Ultrasound or angiography may be successfully used to diagnose dysfunction. Effective treatment of this problem implies surgical or endovascular correction of permanent vascular access.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Constrição Patológica/complicações , Falência Renal Crônica/terapia , Diálise Renal , Derivação Arteriovenosa Cirúrgica/métodos , Humanos , Fluxo Sanguíneo Regional , Síndrome , Resultado do Tratamento , Grau de Desobstrução Vascular , Veias/patologia
3.
Ned Tijdschr Geneeskd ; 1632019 09 05.
Artigo em Holandês | MEDLINE | ID: mdl-31556494

RESUMO

An 82-year-old woman attended our outpatient clinic because of a swollen right arm and hoarseness. Upon raising both arms, the patient developed a red and swollen face (Pemberton's sign). An MRI of the thorax showed a large intrathoracic goitre, which compressed venous structures and limited blood flow even when she lowered her arms.


Assuntos
Bócio Subesternal/diagnóstico por imagem , Rouquidão/diagnóstico por imagem , Doenças Vasculares Periféricas/diagnóstico por imagem , Idoso de 80 Anos ou mais , Braço/irrigação sanguínea , Braço/diagnóstico por imagem , Constrição Patológica , Feminino , Bócio Subesternal/fisiopatologia , Rouquidão/etiologia , Rouquidão/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Doenças Vasculares Periféricas/complicações , Doenças Vasculares Periféricas/fisiopatologia , Pressão , Tórax/diagnóstico por imagem , Veias/patologia
4.
Angiol Sosud Khir ; 25(3): 129-134, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31503257

RESUMO

Surgical management of patients with tumour invasion of major veins by means of their resection and simultaneous reconstruction is an actively developing trend in modern surgery. The article describes a clinical case report concerning treatment of a patient presenting with disseminated neuroendocrine cancer of the pancreatic head and subjected to pancreatoduodenal resection with a complicated variant of mesenteric-portal reconstruction and the use of a graft made of porous polytetrafluoroethylene, followed by relapse-free survival of more than 5 years. In our case report, despite complexity of forming a proximal anastomosis, the findings of multislice computed tomography with 3D-reconstruction 4 months after the operation demonstrated uneven circular thickening of the graft's wall by 1-2 mm, which might be interpreted as neointimal hyperplasia. The maximum thickness amounted to 2 mm in the area of the distal anastomosis. Thus, the internal diameter of the graft varied from 8 to 9 mm. The minimum thickness was observed in the middle portion of the graft, amounting to 1 mm. The findings of computed tomography at 60 postoperative months demonstrated no evidence of the disease's progression, the portal system of the liver contrasted evenly, the mesenteric-portal graft fully patent, showing parietally a thin uneven low-density strip 1-2 mm thick (with the maximum thickness observed in the area of anastomoses and the minimum thickness in the centre of the graft). Thus, the obtained findings are suggestive of high efficacy, safety, and feasibility of using polytetrafluoroethylene grafts for reconstruction of major veins in clinical practice. More randomized studies are necessary to confirm our conclusions.


Assuntos
Invasividade Neoplásica , Politetrafluoretileno , Próteses e Implantes , Procedimentos Cirúrgicos Vasculares , Humanos , Hiperplasia , Sistema Porta , Veias/patologia , Veias/cirurgia
6.
Brain Struct Funct ; 224(7): 2467-2485, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31278570

RESUMO

The vascular organization of the human brain can determine neurological and neurophysiological functions, yet thus far it has not been comprehensively mapped. Aging and diseases such as dementia are known to be associated with changes to the vasculature and normative data could help detect these vascular changes in neuroimaging studies. Furthermore, given the well-known impact of venous vessels on the blood oxygen level dependent (BOLD) signal, information about the common location of veins could help detect biases in existing datasets. In this work, a quantitative atlas of the venous vasculature using quantitative susceptibility maps (QSM) acquired with a 0.6-mm isotropic resolution is presented. The Venous Neuroanatomy (VENAT) atlas was created from 5 repeated 7 Tesla MRI measurements in young and healthy volunteers (n = 20, 10 females, mean age = 25.1 ± 2.5 years) using a two-step registration method on 3D segmentations of the venous vasculature. This cerebral vein atlas includes the average vessel location, diameter (mean: 0.84 ± 0.33 mm) and curvature (0.11 ± 0.05 mm-1) from all participants and provides an in vivo measure of the angio-architectonic organization of the human brain and its variability. This atlas can be used as a basis to understand changes in the vasculature during aging and neurodegeneration, as well as vascular and physiological effects in neuroimaging.


Assuntos
Mapeamento Encefálico , Encéfalo/irrigação sanguínea , Neuroimagem , Veias/fisiologia , Adulto , Mapeamento Encefálico/métodos , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética/métodos , Masculino , Veias/patologia
7.
Gynecol Obstet Fertil Senol ; 47(7-8): 582-590, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31255836

RESUMO

Extra-uterine leiomyomatosis is a rare pathology defined by the presence of benign smooth uterine muscle cells in unusual localizations, including different entities. It mainly affects premenopausal women with a medical history of uterine myoma with or without surgical treatment. Three main types are discribed: intraveinous leiomyomatosis, benign metastatisizing leiomyoma and leiomyomatosis peritonealis disseminata. The diagnosis may be complex with many differential diagnosis, and relies on histology. The treatment depends on multiple factors such as age, localization, size, symptoms and associated comorbidities. It is based on surgical resection and hormonal privation, surgical (adnexectomy) or medical (hormonotherapy). There is a high risk of recurrence. Some malignant evolutions have been reported, mostly leiomyosarcoma following peritoneal disseminated leiomyomatosis. Long term follow-up of these patients is mandatory. A particular manifestation of extra-uterine leiomyomatosis is the hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome. It is an autosomal dominant disorder which confers an increased risk of cutaneous and uterine leiomyomas and renal cell cancer, with a poor prognosis due to the urologic tumor.


Assuntos
Leiomiomatose/patologia , Feminino , Humanos , Leiomiomatose/tratamento farmacológico , Leiomiomatose/genética , Leiomiomatose/cirurgia , Metástase Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Síndromes Neoplásicas Hereditárias/genética , Síndromes Neoplásicas Hereditárias/patologia , Neoplasias Peritoneais/patologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Neoplasias Uterinas/genética , Neoplasias Uterinas/patologia , Neoplasias Vasculares/patologia , Veias/patologia
8.
Clin Exp Nephrol ; 23(9): 1100-1108, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31214872

RESUMO

BACKGROUND: Patients with uremia have an excessive mortality from cardiovascular disease (CVD). Arterial remodeling is mainly responsible for uremia-induced CVD and has been well studied, yet venous remodeling is poorly understood. Here we investigate the histopathology and proteomic profiles of venous remodeling in uremic patients. METHODS: Forearm cephalic veins were isolated from nine uremic patients during surgeries for arteriovenous fistula, and from nine healthy controls when applying surgical debridement. Hematoxylin-eosin, Masson's trichrome, von Kossa, and immunohistochemistry (IHC) against proliferating cell nuclear antigen were stained for histopathology. Isobaric tags for relative and absolute quantitation (iTRAQ) proteomic analysis was executed to explore the proteome of the veins. The core regulatory protein was validated by western blot, IHC, and immunofluorescence. RESULTS: Phlebosclerosis, characterized by intimal rarefaction and medial thickening with disordered proliferation of vascular smooth muscle cells (VSMCs), was the prominent pathological manifestation of peripheral veins in uremic patients, while inflammatory cell infiltration, atherosclerosis or calcification were not obviously detected. iTRAQ analysis showed that 350 proteins were significantly changed in phlebosclerosis of uremic patients compared with healthy controls, of which integrin-ß1 (ITGß1) exhibited the strongest regulatory ability by intermolecular interaction network analysis. The enhanced ITGß1 expression was mainly co-expressed with the disordered proliferation of VSMCs while a little with vascular endothelial cells in the forearm cephalic veins of uremic patients. CONCLUSIONS: Phlebosclerosis is the prominent pathological manifestation in peripheral veins of uremic patients. This pathological alteration mainly attributes to the disordered proliferation of VSMCs, which is potentially mediated by ITGß1.


Assuntos
Antebraço/irrigação sanguínea , Integrina beta1/análise , Doenças Vasculares Periféricas/etiologia , Proteômica/métodos , Uremia/complicações , Remodelação Vascular , Veias/química , Veias/patologia , Estudos de Casos e Controles , Proliferação de Células , Células Endoteliais/química , Células Endoteliais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Liso Vascular/química , Músculo Liso Vascular/patologia , Miócitos de Músculo Liso/química , Miócitos de Músculo Liso/patologia , Doenças Vasculares Periféricas/metabolismo , Doenças Vasculares Periféricas/patologia , Esclerose , Uremia/diagnóstico
9.
Rev Gastroenterol Peru ; 39(1): 84-87, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31042243

RESUMO

Vascular abnormalities of the gastrointestinal tract are a common cause of gastrointestinal bleeding. Most of them are located within the reach of the upper endoscopy or colonoscopy, although once discarded, it forces to consider small bowel as the source of bleeding. The successful management of a gastrointestinal bleeding depends mainly on the timely location of the source of bleeding. Nevertheless this task can be difficult when the cause is not within the reach of conventional methods. We present a case of a 21 year-old men in which the diagnosis of bleeding yeyunal phlebectasia was made by the findings of the capsule endoscopy and laparoscopy.


Assuntos
Angiodisplasia/complicações , Hemorragia Gastrointestinal/etiologia , Doenças do Jejuno/complicações , Angiodisplasia/diagnóstico por imagem , Angiodisplasia/cirurgia , Endoscopia por Cápsula , Dilatação Patológica , Humanos , Doenças do Jejuno/diagnóstico por imagem , Doenças do Jejuno/cirurgia , Jejuno/irrigação sanguínea , Laparoscopia , Masculino , Trombose/etiologia , Úlcera/etiologia , Veias/patologia , Adulto Jovem
10.
AJR Am J Roentgenol ; 213(3): 575-585, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31063424

RESUMO

OBJECTIVE. The purpose of this article is to perform a systematic review and meta-analysis regarding the diagnostic test accuracy of MRI for detecting extramural venous invasion (EMVI) in patients with colorectal cancer. MATERIALS AND METHODS. PubMed and EMBASE were searched up to November 9, 2018. We included diagnostic accuracy studies that used MRI for EMVI detection in patients with colorectal cancer, using pathologic analysis as the reference standard. The methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and plotted in a hierarchic summary ROC plot. Metaregression analysis using several clinically relevant covariates was performed. RESULTS. Fourteen studies (n = 1751 patients) were included. Study quality was moderate in general. Pooled sensitivity was 0.61 (95% CI, 0.49-0.71), and pooled specificity was 0.87 (95% CI, 0.79-0.92). There was substantial heterogeneity according to the Cochran Q test (p < 0.01) and Higgins I2 heterogeneity index (98% and 95% for sensitivity and specificity, respectively). Publication bias was present (p = 0.01). Higher rates of advanced T category, use of high-resolution MRI, and use of antispasmodic drugs were shown to significantly affect heterogeneity (p < 0.01). Location of primary tumor, preoperative treatment status, study design, definition of reference standard, magnetic field strength, and use of functional MRI were not statistically significant (p = 0.17-0.92). CONCLUSION. MRI shows moderate sensitivity and good specificity for the detection of EMVI in colorectal cancer. The use of high-resolution MRI may improve diagnostic performance.


Assuntos
Neoplasias Colorretais/patologia , Imagem por Ressonância Magnética/métodos , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/patologia , Veias/diagnóstico por imagem , Veias/patologia , Humanos
11.
Eur J Vasc Endovasc Surg ; 57(5): 719-728, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31000459

RESUMO

BACKGROUND: The arteriovenous fistula (AVF) is central to haemodialysis treatment, but up to half of surgically created AVF fail to mature. Chronic kidney disease often leads to mineral metabolism disturbances that may interfere with AVF maturation through adverse vascular effects. This study tested associations between mineral metabolism markers and vein histology at AVF creation and unassisted and overall clinical AVF maturation. METHODS: Concentrations of fibroblast growth factor 23, parathyroid hormone, calcium, phosphate, and vitamin D metabolites: 1,25(OH)2D, 24,25(OH)2D, 25(OH)D, and bioavailable 25(OH)D were measured in pre-operative serum samples from 562 of 602 participants in the Haemodialysis Fistula Maturation Study, a multicentre, prospective cohort study of patients undergoing surgical creation of an autologous upper extremity AVF. Unassisted and overall AVF maturation were ascertained for 540 and 527 participants, respectively, within nine months of surgery or four weeks of dialysis initiation. Study personnel obtained vein segments adjacent to the portion of the vein used for anastomosis, which were processed, embedded, and stained for measurement of neointimal hyperplasia, calcification, and collagen deposition in the medial wall. RESULTS: Participants in this substudy were 71% male, 43% black, and had a mean age of 55 years. Failure to achieve AVF maturation without assistance occurred in 288 (53%) participants for whom this outcome was determined. In demographic and further adjusted models, mineral metabolism markers were not significantly associated with vein histology characteristics, unassisted AVF maturation failure, or overall maturation failure, other than a biologically unexplained association of higher 24,25(OH)2D with overall failure. This exception aside, associations were non-significant for continuous and categorical analyses and relevant subgroups. CONCLUSIONS: Serum concentrations of measured mineral metabolites were not substantially associated with major histological characteristics of veins in patients undergoing AVF creation surgery, or with AVF maturation failure, suggesting that efforts to improve AVF maturation rates should increase attention to other processes such as vein mechanics, anatomy, and cellular metabolism among end stage renal disease patients.


Assuntos
Derivação Arteriovenosa Cirúrgica , Falência Renal Crônica/sangue , Falência Renal Crônica/terapia , Minerais/sangue , Diálise Renal/métodos , Remodelação Vascular , Adulto , Idoso , Biomarcadores/sangue , Calcificação Fisiológica , Cálcio/sangue , Feminino , Fatores de Crescimento de Fibroblastos/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Veias/metabolismo , Veias/patologia , Vitamina D/sangue
12.
Biomed Res Int ; 2019: 7934328, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30984784

RESUMO

Varicocele, a vascular event, is associated with infertility due to testicular damage that causes abnormal spermatogenesis in males. The goal of this study is to ascertain the diagnostic significance of scrotal color Doppler ultrasonography (CDUS) by measuring peak systolic value (PSV) and resistive index (RI) of the arteries supplying blood to the testis and their association with semen quality attributes. Sixty prospective patients (age: 20-50 years) undergoing microsurgical varicocelectomy at a teaching hospital were included in the study. Semen parameters and CDUS were recorded and testicular blood flow was determined as PSV and RI of subcapsular artery and intraparenchymal artery of the testes. Nonparametric statistics was applied to test the correlation/association of the semen quality with the PSV, RI, and other variables. Results revealed a significant negative correlation (r = -0.28; p < 0.05) between progressive motility of spermatozoa and resistive index of the intraparenchymal arterial blood flow. Furthermore, it was noticed that the progressive motility of spermatozoa was tended to be negatively correlated (r = -0.236) with resistive index of subcapsular arterial blood flow. In conclusion, this study has revealed that progressive motility of sperms has correlation with the intraparenchymal blood flow of testes. The progressive motility of sperms could be correlated with RI of testicular blood flow. The apparent lack of association between diameter of varicocele vein and semen quality signifies the need of investigating some other factors that may be involved in pathogenicity of varicocele. The diagnostic value of CDUS may be carefully interpreted and clinically correlated in assessment of severity of varicocele.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Infertilidade Masculina/sangue , Testículo/irrigação sanguínea , Varicocele/sangue , Adulto , Hemodinâmica , Humanos , Infertilidade Masculina/patologia , Infertilidade Masculina/cirurgia , Masculino , Microcirurgia , Pessoa de Meia-Idade , Paquistão , Sêmen/metabolismo , Análise do Sêmen , Motilidade Espermática/fisiologia , Espermatogênese/fisiologia , Testículo/patologia , Testículo/cirurgia , Varicocele/patologia , Varicocele/cirurgia , Veias/patologia , Veias/cirurgia , Adulto Jovem
13.
Comput Methods Biomech Biomed Engin ; 22(8): 797-805, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30931623

RESUMO

Acute subdural hematoma (ASDH) sometimes occurred in judo because of the bridging veins' failure by rotation of the brain in the skull. However, the relationship between intracranial behaviour and the motion of the body on occiput impact has not yet been clarified. In this study, we developed an intracranial mechanical model based on multibody dynamics and compared it with experimental results. The results show the importance of modelling bridging veins and cerebral spinal fluid to the relative displacement between brain and skull. The proposed model will contribute to accident analyses or the optimum design of supporting devices.


Assuntos
Encéfalo/patologia , Artes Marciais , Modelos Biológicos , Encéfalo/irrigação sanguínea , Cadáver , Simulação por Computador , Módulo de Elasticidade , Feminino , Cabeça , Humanos , Veias/patologia
14.
Medicine (Baltimore) ; 98(13): e14678, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30921180

RESUMO

RATIONALE: Intermuscular hemangioma (IH) usually occurs in the muscles of the limbs and trunk, but can rarely occur in the occipital region. IH in the occipital region is easily misdiagnosed as arteriovenous malformation (AVM). PATIENT CONCERNS: A 31-year-old woman had a right occipital mass for 5 months without pulsation. DIAGNOSIS: Head computered tomography angiography (CTA) and digital substraction angiography (DSA) examinations showed that the lesion was mainly vascular, approximately 3 × 5 cm in size, and supplied by occipital arteries and the muscular branches of vertebral arteries. The venous drainage of the lesions communicated with the suboccipital vein plexus and the paravertebral vein in the venous phase, indicating AVM. Postoperative histological investigation showed the lesion was a hemangioma. INTERVENTIONS: It was recommended for surgical removal. The surgery was carried out under general anesthesia. The lesion showed a clear boundary. The occipital artery touched the anterior margin of the lesion, was exposed and ligated, and was removed around the lesion. The lesion consisted of massive blood vessels, and the surrounding muscles were swollen, indicating IH.After the lesion was removed, the normal muscle tissue around the lesion was also removed. OUTCOMES: The patient achieved a good recovery after surgery, and pathology confirmed IH. A postoperative 1-year CTA review was performed and showed partial residual, then the radiotherapy was recommended. She refused further radiotherapy, follow-up 2 years later showed no enlargement of the lesion. LESSONS: Although IH rarely occurs in the occipital region, this can occur. Due to the complexity of the drainage veins in the occipital region, these IH are prone to misdiagnosis as AVM.


Assuntos
Hemangioma/patologia , Malformações Arteriovenosas Intracranianas/patologia , Músculo Esquelético/patologia , Lobo Occipital/patologia , Adulto , Angiografia por Tomografia Computadorizada/métodos , Erros de Diagnóstico , Feminino , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Lobo Occipital/irrigação sanguínea , Lobo Occipital/diagnóstico por imagem , Resultado do Tratamento , Veias/anormalidades , Veias/patologia
16.
Nat Commun ; 10(1): 1430, 2019 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-30926774

RESUMO

Although clinically apparent metastasis is associated with late stages of cancer development, micro-metastatic dissemination may be an early event. However, the fate of these early disseminated tumor cells (DTC) remains elusive. We show that despite their capacity to disseminate into secondary organs, 4T1 tumor models develop overt metastasis while EMT6-tumor bearing mice clear DTCs shed from primary tumors as well as those introduced by intravenous (IV) injection. Following the surgical resection of primary EMT6 tumors, mice do not develop detectable metastasis and reject IV-injected tumor cells. In contrast, these cells readily grow and metastasize in immuno-deficient athymic or Rag2-/- mice, an effect mimicked by CD8+ T-cell depletion in immunocompetent mice. Furthermore, recombinant G-CSF or adoptive transfer of granulocytic-MDSCs isolated from 4T1 tumor-bearing mice, induce metastasis by suppressing CD8+ T-cells in EMT6-primed mice. Our studies support the concept of immune surveillance providing molecular insights into the immune mechanisms during tumor progression.


Assuntos
Imunidade , Neoplasias/imunologia , Neoplasias/patologia , Animais , Linfócitos T CD8-Positivos/imunologia , Linhagem Celular Tumoral , Proliferação de Células , Modelos Animais de Doenças , Humanos , Subpopulações de Linfócitos/imunologia , Camundongos , Modelos Biológicos , Invasividade Neoplásica , Metástase Neoplásica , Análise de Sobrevida , Cauda/irrigação sanguínea , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/imunologia , Neoplasias de Mama Triplo Negativas/cirurgia , Veias/patologia
17.
BMC Gastroenterol ; 19(1): 37, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30819091

RESUMO

BACKGROUND: Endoscopic injection sclerotherapy (EIS) is a life-saving procedure for pediatric patients with bleeding gastric varices (GV) associated with advanced liver cirrhosis and severe portal hypertension. Because of the lack of an endoscopic banding ligation device for pediatric patients, EIS is usually performed for bleeding esophageal varices (EV) in infants with congenital biliary atresia. CASE PRESENTATION: We present a case of a 15-month-old female infant with type I biliary atresia with jaundice (total serum bilirubin, 22.2 mg/dL), hypoalbuminemia (serum albumin level, 2.58 g/dL), coagulopathy (prothrombin time > 20 s compared with that of a normal control), ascites, splenomegaly, portal hypertension (portal vein velocity, 3.9-5.6 cm/sec of hepatopetal flow), and repeated bleeding of the varices after receiving three doses of intravascularly administered Histoacryl 1 ampoule mixed with Lipiodol UF 8 mL in the EV. Prominent GV and EV were occluded by EIS. The sclerosing agent was also present in the main portal vein, splenic mesenteric junction, and splenic vein, causing an engorged inferior mesenteric vein. The patient underwent total hepatectomy and living donor liver transplantation (LDLT) by left lateral segment graft (segments 2, 3, and 4 of the middle hepatic vein trunk) and left portal vein graft to the recipient inferior mesenteric vein anastomosis. Portal vein stent placement via segment 4 of the portal vein stump was performed from the inferior mesenteric vein to the umbilical portion of the left portal vein. The patient is still alive and doing well after the LDLT. CONCLUSIONS: EIS is a life-saving procedure in cases involving bleeding EV complicated by gastric, main portal vein, splenic mesenteric junction, and splenic vein occlusions; hence, it should be kept in mind as a treatment for EV complications in pediatric patients.


Assuntos
Endoscopia Gastrointestinal , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/terapia , Técnicas Hemostáticas , Escleroterapia/métodos , Insuficiência Venosa/etiologia , Atresia Biliar/complicações , Feminino , Humanos , Lactente , Oclusão Vascular Mesentérica/etiologia , Veias Mesentéricas/patologia , Veia Porta/patologia , Veia Esplênica/patologia , Estômago/irrigação sanguínea , Veias/patologia
19.
Brain Struct Funct ; 224(3): 1301-1314, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30706162

RESUMO

Microglia represent resident immune cells of the central nervous system (CNS), which have been shown to be involved in the pathophysiology of practically every neuropathology. As microglia were described to participate in the formation of the astroglial glia limitans around CNS vessels, they are part of the neurovascular unit (NVU). Since the NVU is a highly specialized structure, being functionally and morphologically adapted to differing demands in the arterial, capillary, and venous segments, the present study was aimed to systematically investigate the microglial contribution to the glia limitans along the vascular tree. Thereby, the microglial participation in the glia limitans was demonstrated for arteries, capillaries, and veins by immunoelectron microscopy in wild-type mice. Furthermore, analysis by confocal laser scanning microscopy revealed the highest density of microglial endfeet contacting the glial basement membrane around capillaries, with significantly lower densities around arteries and veins. Importantly, this pattern appeared to be unaltered in the setting of experimental autoimmune encephalomyelitis (EAE) in CX3CR1CreERT2:R26-Tomato reporter mice, although perivascular infiltrates of blood-borne leukocytes predominantly occur at the level of post-capillary venules. However, EAE animals exhibited significantly increased contact sizes of individual microglial endfeet around arteries and veins. Noteworthy, under EAE conditions, the upregulation of MHC-II was not limited to microglia of the glia limitans of veins showing infiltrates of leukocytes, but also appeared at the capillary level. As a microglial contribution to the glia limitans was also observed in human brain tissue, these findings may help characterizing microglial alterations within the NVU in various neuropathologies.


Assuntos
Artérias/patologia , Capilares/patologia , Encefalomielite Autoimune Experimental/patologia , Neuroglia/patologia , Veias/fisiologia , Actinas/metabolismo , Animais , Artérias/metabolismo , Artérias/fisiologia , Artérias/ultraestrutura , Encéfalo , Receptor 1 de Quimiocina CX3C/genética , Receptor 1 de Quimiocina CX3C/metabolismo , Proteínas de Ligação ao Cálcio/metabolismo , Proteínas de Ligação ao Cálcio/ultraestrutura , Capilares/metabolismo , Capilares/ultraestrutura , Colágeno Tipo IV/metabolismo , Modelos Animais de Doenças , Encefalomielite Autoimune Experimental/genética , Feminino , Proteínas de Fluorescência Verde/genética , Proteínas de Fluorescência Verde/metabolismo , Humanos , Laminina/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Proteínas dos Microfilamentos/metabolismo , Proteínas dos Microfilamentos/ultraestrutura , Microscopia Eletrônica , Microscopia de Fluorescência , Neuroglia/metabolismo , Neuroglia/ultraestrutura , Veias/metabolismo , Veias/patologia , Veias/ultraestrutura
20.
J Vasc Interv Radiol ; 30(1): 54-60, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30409475

RESUMO

Between September 2008 and August 2017, 36 patients (mean age 56 y; range, 30-89 y) underwent transvenous biopsy of suspected tumor thrombus or perivascular tumor. Intravascular biopsy was pursued because of inaccessible percutaneous access in 9 patients (25%) and as part of a planned revascularization procedure in 27 patients (75%). Histopathologic results showed malignancy in 26 patients (72%) and benign etiologies in 10 patients (28%). No patients required repeat biopsy. There were no complications related to the biopsy procedure. The present series suggests that transvenous biopsy is a safe and accurate method of intravascular and perivascular mass tissue sampling.


Assuntos
Cateterismo Periférico , Procedimentos Endovasculares , Trombose/patologia , Neoplasias Vasculares/patologia , Veias/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Cateterismo Periférico/efeitos adversos , Angiografia por Tomografia Computadorizada , Procedimentos Endovasculares/efeitos adversos , Humanos , Michigan , Pessoa de Meia-Idade , Invasividade Neoplásica , Flebografia/métodos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Trombose/diagnóstico por imagem , Ultrassonografia de Intervenção , Neoplasias Vasculares/diagnóstico por imagem , Veias/diagnóstico por imagem
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