• Title/Summary/Keyword: Small Vessels

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The role of needle-based confocal laser endomicroscopy in the diagnosis of pancreatic neuroendocrine tumors

  • Masanori Yamada;Kazuo Hara;Nobumasa Mizuno;Shin Haba;Takamichi Kuwahara;Nozomi Okuno;Yasuhiro Kuraishi;Takafumi Yanaidani;Sho Ishikawa;Tsukasa Yasuda;Toshitaka Fukui
    • Clinical Endoscopy
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    • v.57 no.3
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    • pp.393-401
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    • 2024
  • Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a highly accurate method for diagnosing pancreatic neuroendocrine tumors (PNETs); however, some PNETs are difficult to diagnose. Recently, the efficacy of needle-based confocal laser endomicroscopy (nCLE) in diagnosing solid pancreatic masses has been reported. However, the efficacy of nCLE in the diagnosis of PNETs remains unknown and only a small number of cases have been reported. Hence, this study aimed to evaluate the efficacy of nCLE in the diagnosis of PNETs. Methods: This single-center retrospective study evaluated 30 consecutive patients with suspected PNETs on contrast-enhanced computed tomography, who consented to nCLE combined with EUS-FNA and were diagnosed using EUS-FNA or surgical resection. The diagnostic criteria for PNETs using nCLE were based on the nesting and trabecular and glandular arrangement of tumor cell clusters surrounded by capillary vessels and fibrosis, as reported in previous studies. Results: The diagnosis using nCLE was classified into three categories: misdiagnosis in three cases (10%), non-diagnostic in six cases (20%), and diagnostic in 21 cases (70%). nCLE was able to diagnose PNET in one of the two cases with inconclusive EUS-FNA. Conclusions: Although further development of the resolution and optimization of the diagnostic criteria are required, nCLE may constitute a useful diagnostic option in cases of inconclusive EUS-FNA for PNETs.

Airway Inflammation and Responses in the Bronchial Asthma Model in Sprague-Dawley Rats Sensitized by Ovalbumin (백서 기관지 천식 모텔에서 난황에 의한 기도염증과 기도반응)

  • Na, Moon-Jun;Lee, Byoung-Hoon;An, Chang-Hyeok;Kim, Jae-Yeol;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.33-44
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    • 2000
  • Background: To evaluate airway responses and inflammation to antigen in Sprague-Dawley rat asthma model, we examined airway responses, serial histologic changes of the lung, and the relationship between airway responses and airway inflammation after antigen airway challenge. Methods: Sprague-Dawley rats were sensitized with subcutaneous injection of 10 ${\mu}g$ ovalbumin(OA). Antigen airway challenges were done 14~16 days after sensitization and the sensitized rats were sacrificed 1h($A_E$), 6~8h($A_L$) and 1day($A_D$) after airway challenge, to examine the histologic changes of the lung. Airway responses were measured by body plethysmograph and recorded by enhanced pause(Penh) as an index of airway obstruction 6~8h after antigen challenges. Nonsensitized controls(10 rats) were also challenged with antigen and sacrificed 1 day later. Histopathologic examination of two trachea, large bronchi, small bronchi, and vessels was performed to evaluate the severity of inflammation and eosinophilic infiltration with H&E stain. Results: In 17 of 20 rats(85%) in both groups, we observed airway responses. Among them, an early response(ER) in 15 rats(75%), an dual response in 5(25%), and an late response(LR) only in 2 rats(10%) displayed. There were no significant differences in the severity of inflammation among the trachea, large bronchi, small bronchi and vessels in all groups after antigen challenge(p>0.05) and between early and late responders. The significant eosinophil infiltration was observed in 5 rats(50%) of AL(p<0.05) compared with in AE and controls. Also, eosinophil infiltration was observed in higher trend in LR(57.1%) compared to ER(40%)(p>0.05). Conclusion: Sprague-Dawley rats sensitized with subcutaneous injection of OA showed a significant airway responses to antigen challenge. But antigen challenges caused a little eosinophil infiltration and no significant airway inflammation. Asthma model of Sprague-Dawley rats could be useful for antigen-induced airway responses, but this model has a limitation for the study of human asthma because of no significant pathologic change.

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Anatomical studies on pattern of branches of portal veins in Korean native cattle (한우문맥(韓牛門脈)의 분지(分枝)에 관한 해부학적(解剖學的) 연구(硏究))

  • Kim, Chong-sup
    • Korean Journal of Veterinary Research
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    • v.29 no.2
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    • pp.1-9
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    • 1989
  • The distribution of portal veins within the liver in 30 Korean native cattle were observed. Vinylite solution was injected into portal veins of eighteen specimens for cast preparation. The angiography was prepared in twelve specimens by injecting 30% barium sulfate solution into portal veins, and then radiographed on a X-ray apparatus(Shimadzu 800MA 120Kvp). The results were summarized as follow: 1. The Vena portae was divided immediately upon entering the liver into a very short Truncus dexter venae portae($14.75{\pm}4.86$ : 6.9~23.1mm) and a long Truncus sinister venae portae($94.16{\pm}9.62$ : 110~150mm). 2. The Truncus sinister venae portae runs of first in the long axis of the liver from the Porta hepatis toward the left lobe. At the boundary between the quadrate and left lobes it bends sharply 50 to 80 degrees toward the Incisura ligamentum teretis, and after a course of 36. 5 to 54.mm between the quadrate and left lobes, ends abruptly. The Truncus sinister venae portae is divided for description into the Pars transversa, from the Porta hepatis to the flexure, and the Pars umbilicalis, from the flexure to the end. 3. The branches of Venae portae were Ramus ventralis lobi sinistri, Ramus intermedius lobi sinistri, Ramus dorsalis lobi sinistri, Ramus lobi quadratii, Ramus ventralis lobi dextri, Ramus intermedius lobi dextri, Ramus dorsalis lobi dextri, Rami processus caudatorum and Rami processus papillarum. 4. The Ramus intermedius lobi sinistri was arised from the left surface of the Pars umbilicalis, and was origined on the common trunk with Ramus dorsalis lobi sinistri(3 cases, 10%) or Ramus ventralis lobi sinistri(3 cases, 10%). 5. The Rami lobi quadratii consisted of the vein(15 cases, 50%) or two veins(15 cases, 50%), and was observed on the arched-shaped at 2 cases (6.6%) of the liver. 6. The Rami processus caudatorum consisted of one vein(28 cases, 93.3%) or two veins(2 cases, 6.6%). The former were formed common trunk with R, dorsalis lobi dextri(7 cases, 23.3%) or R. ventralis lobi dextri (2 cases, 6.6%). 7. The Rami processus papillarum were arised from the dorsal border of Pars transversa, and also gave off many small branches supplied papillary process of the caudate lobe. 8. The anastomosis on the branches of Vena portae was observed in the intralobar and interlobar areas. 9. The Truncus dexter venae portae and Truncus sinister venae were ramified many secondary branches that were radiated within the liver. 10. On the diaphragmatic surface, small vessels of the portal veins were observed, while there were big ones on the visceral surface. 11. The ramified angles at Ramus dorsalis lobi dextri, Rami processus papillarum, Ramus dorsalis lobi sinistri, Ramus intermedius lobi sinistri, Ramus ventralis lobi sinistri, Rami lobi quadratii, Rami processus caudatorum, Ramus ventralis lobi dextri and Ramus intermedius were 10~50, 70~110, 100~150, 140~170, 185~220, 270~330, 240~300, 270~320 and 340~10 degrees, respectively.

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Twisting Effect on Supermicroanastomosis of the Superficial Inferior Epigastric Artery in a Rat Model (혈관 비틀림이 백서 천층하복부 동맥의 초미세문합에 미치는 효과)

  • Seo, Mi-Hyun;Kim, Soung-Min;Eo, Mi-Young;Kang, Ji-Young;Myoung, Hoon;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.375-384
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    • 2011
  • Purpose: The advent of microsurgical technique and instruments, particularly in the field of perforator flap and supermicrosurgery, which have expanded the scope of microsurgery. However, supermicroanastomosis without any compression, tension, or distortions must be achieved to reach successful outcomes. Small-caliber vessels, such as those with an internal diameter less than 0.2 mm, are susceptible to inadvertent twisting of the anastomosis. In this study, using the superficial inferior epigastric artery (SIEA)-based flap model in Sprague-Dawley (SD) rats, we evaluated the acceptable limits of twisting effects on supermicroanastomotic sites. Methods: A total of 20 supermicroanastomoses were performed using the SIEA-based flap model in 10 male SD rats, 10-weeks-of-age, weighing 300~350 g. Rats were divided into five groups of two with four flaps as follows: 1) sham, 2) control group with end to end SIEA arterial supermicroanastomosis, 3) experimental I (EA1) with $90^{\circ}$ twisting, 4) experimental II (EA2) with $180^{\circ}$ twisting, and 5) experimental III (EA3) with $270^{\circ}$ twisting of the supermicroanastomosis. Each SIEA was anastomosed using six 11-0 $Ethilon^{(R)}$ (Ethicon Inc. Co., NJ, USA) stitches except in the sham group where the SIEA was only clamped with Supermicro vascular $clamps^{(R)}$ (S&T, Neuhausen, Switzerland) for 20 minutes. Results: The anastomosed arterial patency showed no remarkable changes according to doppler waveforms measured with a Smardop 45 Doppler System (Hadeco Inc., Kawasaki, Japan). The pulsatility index (PI) was increased at postoperative day 10 in the EA2 and EA3 groups, and the resistance index (RI) showed no statistically significant difference between preoperative and postoperative values at 10 days. Histologic specimens from the EA3 group showed increased tunica media necrosis, convolution of the internal elastic lamina, densely packed platelets, fibrin, and erythrocytes. Flap viability and anastomosed vessel patency were not significantly affected by the degree of arterial twisting in this study, other than in the EA3 group where minor effects on arterial patency of the microanastomoses were encountered. Conclusion: It appears that minor twisting on small caliber arteries, used in supermicroanastomoses, can be tolerated. However, twisting should be avoided as much as possible, and more than $180^{\circ}$ twisting must be prevented in clinical practice.

RalA-binding Protein 1 is an Important Regulator of Tumor Angiogenesis (Tumor angiogenesis에 있어서 RLIP76의 중요성)

  • Lee, Seunghyung
    • Journal of Life Science
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    • v.24 no.5
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    • pp.588-593
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    • 2014
  • Tumor angiogenesis is important in tumorigenesis and therapeutic interventions in cancer. To know inhibitor and effector of tumor angiogenesis in cancer, the specific gene of tumor and angiogenesis may develop the mechanisms of cancer suppression and therapy. Recently, we described the role of RalA-binding protein 1 (RLIP76) in tumor angiogenesis. Tumor vascular volumes were diminished, and vessels were fewer in number, shorter, and narrower in RLIP76 knockout mice than in wild-type mice. Moreover, angiogenesis in basement membrane matrix plugs was blunted in the knockout mice in the absence of tumor cells, with endothelial cells isolated from the lungs of these animals exhibiting defects in migration, proliferation, and cord formation in vitro. RLIP76 is expressed in most human tissues and is overexpressed in many tumor types. In addition, the protein regulates tumorigenesis and angiogenesis in vivo and in vitro. As the export of chemotherapy agents is a prominent cellular function of RLIP76, it is a major factor in mechanisms of drug resistance. Moreover, RLIP76 acts as a selective effector of the small GTPase, R-Ras, and regulates R-Ras signaling, leading to cell spreading and migration. Furthermore, in skin carcinogenesis, RLIP76 knockout mice are resistant, with tumors that form showing diminished angiogenesis. Thus, RLIP76 is required for efficient endothelial cell function and angiogenesis in solid tumors.

Pathological Studies on Ovaries, Thyroid Glands and Hypophyses of Rabbits Following Administration of Sulfadimethoxine (Sulfadimethoxine(SDM) 투여(投與) 가토(家兎)의 난소(卵巢), 갑상선(甲狀腺) 및 뇌하수체(雷下垂體)에 관한 병리학적(病理學的) 연구(硏究))

  • Rim, Byung Moo
    • Korean Journal of Veterinary Research
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    • v.16 no.1
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    • pp.77-96
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    • 1976
  • In order to investigate the effects and acting mechanism on ovaries, thyroid glands and hypophyses of rabbits in short term administration of sulfadimethoxine (SDM) as medical dose, a total of 90 virgin albino rabbits (mean body weight, 1,362g) were selected at random and alloted to two groups. Rabbits in one group served as controls and the others were administered SDM of 50 mg/kg/day for 5 weeks, and then reared without medication for 4 weeks. Pathological changes of the three organs were observed each week for 9 weeks and the results obtained were summarized as follows: 1. Mean body weights of both groups manifested slow increasing tendency but mean hypophysis weights fluctuated throughout the experimental term. Mean ovary weights of experiments were decreased significantly from the 3rd to 6th week but mean thyroid weights of experiments were increased significantly from the 1st to 6th week compared with those of controls. 2. Many ovarian follicles of each developing stage showed follicular atresia accompanying atrophy or necrosis of oocytes and of disintegrated follicular cells. Theca interna cells and sudanophilic interstitial cells showed atrophy and diminished sudanophilic granules and also liquor folliculi were diminished. These changes icreased from the 1st week, remaining so for 5 weeks and returned to normal status in the 8th or 9th week. 3. The thyroid gland showed a typical hyperplastic goiter. Hypertrophic and hyperplastic epithelia follicular manifested cuboidal or columnar form showing tiny or small vacuoles in cytoplasm. The follicles showed atrophy and decreasing colloidal materials. Necrotic and regenerative changes were also present. The interfollicular vessels showed congestion and hemorrhage. These changes increased from the 1st week, remaining so for 5 weeks and returned to normal status in the 9th week. 4. The rates of differential cell counts of hypophyses revealed increase of basophils (gonadotrophs and thyrotrophs) and decrease of chromophobes. Basophils which had diminished granules stainable with HE, PAS and AF revealed hypertrophy, hyperplasia, and increasing of tiny or small vacuoles in cytoplasm. These changes increased from the 1st week, remaining so for 5 weeks and returned to normal status in the 8th or 9th week. As summarized above histologically, administration of SDM led thyrotrophs and gonadotrophs of pituitary glands to hyperactivity but revealed retrogressive and compensatory changes with functional disturbance in ovaries and thyroid glands. These changes were transitional and attributed to direct actions of the drugs on the ovaries and thyroid glands.

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Revisit of the Extended Indications and Clinical Utilities of Arterialized Venous Flap for Hand Reconstruction (수부 재건을 위한 동맥화 정맥 피판의 확장된 적응증과 임상적 유용성의 재조명)

  • Woo, Sang-Hyun;Kim, Kyung-Chul;Lee, Gi-Jun;Ha, Seung-Han;You, Sun-O;Kim, Joo-Sung
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.1-13
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    • 2005
  • Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

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Ultrastructures of Zinc-containing Mast Cells Found in the Rat Hindpaw after an Inflammatory Stimuli: Zinc Selenium Autometallography (랫드 발바닥 염증부위에서 관찰된 zinc함유 비만세포의 미세구조: 조직화학적 염색을 중심으로)

  • Lee, Bo-Ye;Kim, Yi-Suk;Lee, Boeb-Y.;Lee, Hyun-Sook;Tak, Gye-Rae;Lee, Young-Il;Lee, Jeoug-Yeol;Jo, Seung-Mook
    • Applied Microscopy
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    • v.36 no.4
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    • pp.271-277
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    • 2006
  • Mast cells (MCs) are granulated cells that play a pivotal role in allergic reaction and inflammation. The granules of mast cells are known to be rich in zinc (Zn). Male Sprague-Dawley rats were used. We injected $200{\mu}L$ of complete Freund's adjuvant (CFA) subcutaneously in the dorsal aspect of one hindpaw Finally, zinc selenium autometallography(AMG) was done by Danscher's method. The present study showed the ultrastructures of zinc-containing mast cells found in inflammatory area following an complete freund's adjuvant (CFA) inoculation into the rat hindpaw. At light microscopic level, mast cells were round or oval, at average $12{\mu}m$ in diameter, with many filopodia extending from the cell surface. Because the rather small and spherical nucleus was centrally placed; it was frequently obscured by the cytoplasmic granules, it sometimes could not be seen. Mast cells were distributed chiefly in the vicinity of small blood vessels. In most preparation many mast cells were ruptured and their granules escaped into the surrounding tissue. In electron micrographs, The secretory granules were at average $0.5{\mu}m$ in diameter and were limited by a membrane. The cell surface contained numerous microvilli and folds. Their interior was heterogenous in appearance. The nucleus was surrounded by large numbers of prominent vesicels and a well developed Golgi apparatus, but scant endoplasmic reticulum.

A study of Tumor Angiogenesis in Human Lung Cancer by Immunohistochemical Stain (Human Lung Cancer에서 면역세포화학적 방법을 이용한 Tumor Angiogenesis에 관한 연구)

  • Cheon, Seon Hee;Kim, Sung Sook;Rha, Sun Young;Chung, Hyun Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.894-902
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    • 1996
  • Background : Tumor angiogenesis is the growth of new vessels toward and within tumor. It has been demonstrated that the growth of tumor beyond a certain size requires angiogenesis and it is closely involved in tumor progression and metastasis. The finding that intensity of neovascularization correlates independently with metastasis may lead to identification of patients in whom radical surgery should be supplemented by systemic treatment. Method : We have collected paraffin blocks of bronchoscopic biopsy of patients with non-small cell lung cancer. We highlighted the vessel by staining endothelial cell with JC70 monoclonal antibody(to CD31) immunohistochemically and counted microvessels under 200 X field using light microscopy. Results : 1) The mean microvessel count was $32.7{\pm}20.8$ (9-96) in total 29 cases. 2) There were no correlations between microvessel counts and pathologic cell type, T staging, node melastasis(N) and hematogenous metastasis(M) (p>0.05). 3) The median follow-up duration was 15 months(2-46) and there was no correlation between the microvessel counts and survival rate of lung cancer patients (p>0.05). Conclusion : Tumor angiogenesis seems to be an important prognostic factor suggesting the probability of metastasis. But the microvessel count in the bronchoscopic biopsy specimen was inadequate and very limited. There has been no data about angiogenesis of lung cancer in korea yet So the study of tumor angiogenesis using resected lung tumor specimen would be demanded.

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Development of a Korean Type Totally Implantable TAH (한국형 완전이식 인공심장의 개발)

  • Min, B.G.;Choi, W.W.;Ahn, J.M.;Park, S.K.;Park, C.Y.;Chang, J.K.;Kim, J.W.;Kim, H.C.;Kim, W.K.;Roh, R.J.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.05
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    • pp.199-202
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    • 1996
  • Artificial hearts are intended for use in patients with severe forms of heart disease for which no surgical repair is possible. The moving-actuator pump was developed to decrease the overall volume size of the electromechanical total artificial heart (TAH) by eliminating the occupied space of the fixed-actuator in the conventional pusher-plate type pump. In our pump, the actuator moves back and forth for alternative ejections of left and right ventricles. The problem of fitting the TAH to atrial remnants and arterial vessels could also be improved by circular or penduluous mot ion of the actuator instead of linear mot ion of the pusher-plate in the conventional pumps. We have evaluated two types of moving- actuator pump; one is a rolling cylinder type, and the other a pendulum type pump. In the rolling cylinder pump, frictional energy loss exists between the pump housing's guide bars and the actuator's end caps, while the bottom rack under the cylindrical actuator increases the height of the pump, the pump is therefor not implantable inside the small chest of human-sized animals with a body weight of less than 70kg. The new human type pump has a penduluous mot ion actuator to correct the above problems while maintaining the advantage of the moving- actuator's small total volume. The totally implantable TAH is composed of a blood pump, a control system and pheriperal equipments. The blood pump, which is constructed by a moving actuator, a right and left blood sac, and four artificial valves, is implanted in the thoracic. In 1988, the first implantation of the rolling cylinder TAH was performed into a female calf weighing 100kg, and the cal f recovered to the degree of voluntary standing and eat ing and survived to 100 hrs. We then survived two female sheep weighing about 63kg with the new human type TAH for three days.

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