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International Journal of Surgical... 2020Malignant involvement of circumferential resection margin (CRM) and longitudinal resection margin (LRM) after surgical resection of colorectal cancer (CRC) are...
BACKGROUND
Malignant involvement of circumferential resection margin (CRM) and longitudinal resection margin (LRM) after surgical resection of colorectal cancer (CRC) are associated with higher rates of recurrence and development of distant metastasis. This can influence the overall patient's prognosis. The aim of the current study was to identify pathological factors as predictors for the involvement of resection margins in early T3 CRC. Fifty patients radiologically diagnosed to have cT3a/b (CRC) were included in the study. After resection, the pathological examination was performed to identify patients with positive CRM and/or LRM. Relations between the different pathological parameters and the CMR and LRM involvements were assessed.
RESULTS
Positive CRM was present in 17 cases (34%), while positive LRM was found in 6 cases (12%). The involvement of both margins was significantly associated with rectal tumors and tumors with infiltrative gross appearance, grade III, deeper invasion, and positive lymph node metastases. Also, there was a significant association between both margins' positivity and other pathological parameters as signet ring carcinoma, tumor budding, perineural and vascular invasion, high microvessel density (MVD), and sinusoidal vascular pattern, while the presence of necrosis and infiltrative advancing tumor front was significantly associated with CRM involvement only. The depth of tumor invasion and signet ring carcinoma were identified as independent predictor factors for positive CRM and LRM, respectively.
CONCLUSION
Preoperative identification of these pathological parameters can be a guide to tailor the management plan accordingly.
Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Aged; Carcinoma, Signet Ring Cell; Colectomy; Colonic Neoplasms; Female; Humans; Logistic Models; Lymphatic Metastasis; Male; Margins of Excision; Middle Aged; Multivariate Analysis; Neoplasm Recurrence, Local; Neoplasm Staging; Proctectomy; Prognosis
PubMed: 32685211
DOI: 10.1155/2020/6789709 -
Frontiers in Pediatrics 2023The article describes a successful clinical outcome in the case of a 5-month old female with a diagnosis of incomplete vascular ring of aberrant right subclavian artery...
The article describes a successful clinical outcome in the case of a 5-month old female with a diagnosis of incomplete vascular ring of aberrant right subclavian artery and ostium secundum atrial septal defect associated with partial anomalous pulmonary venous return of scimitar syndrome type, coexisting with right pulmonary sequestration. During hospitalization, surgical correction of the heart defect and resection of the lung sequestration were performed. To the best of our knowledge, described constellation of defects is a unique phenomenon, posing a challenge for complex treatment and disease management.
PubMed: 37534199
DOI: 10.3389/fped.2023.1214900 -
Stem Cell Research & Therapy Jan 2021The therapeutic effect of mesenchymal stem cells (MSCs) from human adipose tissue on renal interstitial fibrosis has been demonstrated by several groups. However, the...
BACKGROUND
The therapeutic effect of mesenchymal stem cells (MSCs) from human adipose tissue on renal interstitial fibrosis has been demonstrated by several groups. However, the way to enhance the renoprotective effect of adipose-derived mesenchymal stem cells (AMSCs) and the possible mechanisms are still unclear. The present study aimed to determine whether glial cell line-derived neurotrophic factor (GDNF)-modified AMSCs hold an enhanced protective effect on renal fibrosis.
METHODS
AMSCs were isolated and purified for culture. The gene GDNF has been constructed to transfect into AMSCs. The ability of GFP-AMSCs and GDNF-AMSCs supernatants to promote tube formation of endothelial cells, repair damaged endothelial cell junctions, and improve endothelial cell function was compared by using tube formation assay, immunofluorescence techniques, and vascular ring assay, respectively. Furthermore, HE and Masson staining were used to observe the histological morphology of the kidney in vivo. Peritubular capillary changes were detected and analyzed by fluorescence microangiography (FMA). Meanwhile, the hypoxia, oxidative stress, fibrotic markers, and PI3K/Akt pathway proteins were measured by western blot or qRT-PCR technics.
RESULTS
Compared with GFP-AMSCs only, GDNF-AMSCs could enhance the repair of injured endothelial cells and promote angiogenesis through secreting more growth factors in the supernatant of GDNF-AMSC culture media demonstrated in vitro studies. Studies in vivo, unilateral ureteral obstruction (UUO)-induced mice were injected with transfected AMSCs through their tail veins. We showed that enhanced homing of AMSCs was observed in the GDNF-AMSC group compared with the GFP-AMSC group. The animals treated with GDNF-AMSCs exhibited an improvement of capillary rarefaction and fibrosis induced by obstructed kidney compared with the GFP-AMSC group. Furthermore, we reported that GDNF-AMSCs protect renal tissues against microvascular injuries via activation of the PI3K/Akt signaling pathway. Therefore, GDNF-AMSCs further ameliorated the tissue hypoxia, suppressed oxidative stress, and finally inhibited endothelial to mesenchymal transition noting by decreased coexpression of endothelial cell (CD31) and myofibroblast (a-SMA) markers.
CONCLUSION
Collectively, our data indicated that the GDNF gene enhances the ability of AMSCs in improving renal microcirculation through PI3K/Akt/eNOS signaling pathway and afterward inhibit the EndMT process and kidney fibrogenesis, which should have a vast of implications in designing future remedies for chronic kidney disease (CKD) treatment.
Topics: Animals; Endothelial Cells; Fibrosis; Glial Cell Line-Derived Neurotrophic Factor; Mesenchymal Stem Cells; Mice; Phosphatidylinositol 3-Kinases
PubMed: 33413640
DOI: 10.1186/s13287-020-02049-z -
Protein and Peptide Letters 2020Lymphatic vessel formation (lymphangiogenesis) plays important roles in cancer metastasis, organ rejection, and lymphedema, but the underlying molecular events remain...
BACKGROUND
Lymphatic vessel formation (lymphangiogenesis) plays important roles in cancer metastasis, organ rejection, and lymphedema, but the underlying molecular events remain unclear. Furthermore, despite significant overlap in the molecular families involved in angiogenesis and lymphangiogenesis, little is known about the crosstalk between these processes. The ex vivo aortic ring assay and lymphatic ring assay have enabled detailed studies of vessel sprouting, but harvesting and imaging clear thoracic duct samples remain challenging. Here we present a modified ex vivo dual aortic ring and thoracic duct assay using tissues from dual fluorescence reporter Prox1- GFP/Flt1-DsRed (PGFD) mice, which permit simultaneous visualization of blood and lymphatic endothelial cells.
OBJECTIVE
To characterize the concurrent sprouting of intrinsically fluorescent blood and lymphatic vessels from harvested aorta and thoracic duct samples.
METHODS
Dual aorta and thoracic duct specimens were harvested from PGFD mice, grown in six types of endothelial cell growth media (one control, five that each lack a specific growth factor), and visualized by confocal fluorescence microscopy. Linear mixed models were used to compare the extent of vessel growth and sprouting over a 28-day period.
RESULTS
Angiogenesis occurred prior to lymphangiogenesis in our assay. The control medium generally induced superior growth of both vessel types compared with the different modified media formulations. The greatest decrease in lymphangiogenesis was observed in vascular endothelial growth factor-C (VEGF-C)-devoid medium, suggesting the importance of VEGF-C in lymphangiogenesis.
CONCLUSION
The modified ex vivo dual aortic ring and thoracic duct assay represents a powerful tool for studying angiogenesis and lymphangiogenesis in concert.
Topics: Animals; Aorta; Biosensing Techniques; Endothelial Cells; Female; Homeodomain Proteins; Humans; Imaging, Three-Dimensional; Lymphangiogenesis; Lymphatic Vessels; Male; Mice; Mice, Transgenic; Neovascularization, Physiologic; Optical Imaging; Organ Specificity; Thoracic Duct; Tumor Suppressor Proteins; Vascular Endothelial Growth Factor C; Vascular Endothelial Growth Factor Receptor-1
PubMed: 31553284
DOI: 10.2174/0929866526666190925145842 -
The Canadian Veterinary Journal = La... Aug 2021An 8-month-old spayed female Labrador retriever dog was evaluated for regurgitation 6 months after surgery for a suspected vascular ring anomaly. The dog had a history...
An 8-month-old spayed female Labrador retriever dog was evaluated for regurgitation 6 months after surgery for a suspected vascular ring anomaly. The dog had a history of regurgitation and slow development as a puppy. An initial left-sided exploratory thoracotomy was unsuccessful in identifying and treating a vascular ring anomaly. The dog was subsequently presented to the PennVet Emergency Service for regurgitation. Thoracic radiography showed cranial thoracic esophageal dilation and an esophageal foreign body that was then removed endoscopically. Subsequent computed tomographic (CT) angiography revealed a double aortic arch. A left 4th intercostal space thoracotomy was performed. The smaller left aortic arch and a left ligamentum arteriosum were ligated and transected. The dog recovered uneventfully and was healthy at the 1-month follow-up visit. This is the 5th reported successful surgical correction of a double aortic arch in a dog. Computed tomographic angiography was essential in diagnosis and surgical planning. Key clinical message: Although uncommon, double aortic arches can occur and present a diagnostic and surgical challenge when a persistent right aortic arch is suspected. Computed tomographic angiography provides an accurate preoperative diagnosis and allows for surgical planning.
Topics: Angiography; Animals; Aorta, Thoracic; Dog Diseases; Dogs; Esophagus; Female; Thoracotomy; Vascular Ring
PubMed: 34341603
DOI: No ID Found -
The Journal of Thoracic and... Oct 2014Kommerell's diverticulum is a rare congenital aortic arch anomaly. Various surgical techniques have been reported; however, the surgical strategy is still controversial....
OBJECTIVE
Kommerell's diverticulum is a rare congenital aortic arch anomaly. Various surgical techniques have been reported; however, the surgical strategy is still controversial. In our institute, total arch replacement (TAR) and anatomic reconstruction of the subclavian artery (SCA) has been selected for the treatment of Kommerell's diverticulum to release the vascular ring completely and prevent postoperative complications, including dissection, rupture, hand ischemia, and subclavian steal syndrome.
METHODS
From 2000 to 2012, 4 patients (aged 38-72 years) underwent TAR and anatomic reconstruction of the SCA for Kommerell's diverticulum. All patients had a right aortic arch with an aberrant left SCA. The indications for surgery were dysphagia and dilatation of Kommerell's diverticulum. TAR, using hypothermic cardiopulmonary bypass and circulatory arrest, was performed through a median sternotomy and right anterolateral thoracotomy. After resection of Kommerell's diverticulum, the SCA was reconstructed with a graft.
RESULTS
No hospital deaths or major complications occurred, but a 72-year-old patient required prolonged hospitalization for respiratory failure. All patients were discharged from the hospital and were free of symptoms, rupture, dissection, hand ischemia, and subclavian steal syndrome at 5 months to 11 years postoperatively.
CONCLUSIONS
TAR is a reasonable surgical technique for Kommerell's diverticulum, because it enables the vascular ring to be completely released, preventing recurrence, rupture, and dissection. Anatomic reconstruction of the SCA was effective to prevent hand ischemia and subclavian steal syndrome.
Topics: Adult; Aged; Aneurysm; Aorta, Thoracic; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Cardiopulmonary Bypass; Cardiovascular Abnormalities; Deglutition Disorders; Diverticulum; Female; Humans; Male; Middle Aged; Sternotomy; Subclavian Artery; Thoracotomy; Treatment Outcome
PubMed: 24365271
DOI: 10.1016/j.jtcvs.2013.11.026 -
The New Phytologist Oct 2016Little is known about the transport mechanism of intracellular auxin. Here, we report two vacuole-localized proteins, Oryza sativa OsCONTINUOUS VASCULAR RING-LIKE 1...
Little is known about the transport mechanism of intracellular auxin. Here, we report two vacuole-localized proteins, Oryza sativa OsCONTINUOUS VASCULAR RING-LIKE 1 (OsCOLE1) and OsCOLE1-INTERACTING PROTEIN (OsCLIP), that regulate intracellular auxin transport and homoeostasis. Overexpression of OsCOLE1 markedly increased the internode length and auxin content of the stem base, whereas these parameters were decreased in RNA interference (RNAi) plants. OsCOLE1 was localized on the tonoplast and preferentially expressed in mature tissues. We further identified its interacting protein OsCLIP, which was co-localized on the tonoplast. Protein-protein binding assays demonstrated that the N-terminus of OsCOLE1 directly interacted with OsCLIP in yeast cells and the rice protoplast. Furthermore, (3) H-indole-3-acetic acid ((3) H-IAA) transport assays revealed that OsCLIP transported IAA into yeast cells, which was promoted by OsCOLE1. The results indicate that OsCOLE1 affects rice development by regulating intracellular auxin transport through interaction with OsCLIP, which provides a new insight into the regulatory mechanism of intracellular transport of auxin and the roles of vacuoles in plant development.
Topics: Biological Transport; Indoleacetic Acids; Intracellular Space; Naphthaleneacetic Acids; Oryza; Phenotype; Plant Proteins; Plant Stems; Plants, Genetically Modified; Protein Binding; Saccharomyces cerevisiae; Subcellular Fractions; Vacuoles
PubMed: 27265035
DOI: 10.1111/nph.14021 -
The Journal of Extra-corporeal... Dec 2021Circulatory arrest and left heart bypass are the most common approaches to manage perfusion during distal arch surgery. We report a novel perfusion technique utilized in...
Circulatory arrest and left heart bypass are the most common approaches to manage perfusion during distal arch surgery. We report a novel perfusion technique utilized in the treatment of aneurysmal Komerrell's diverticulum (KD) and aberrant subclavian artery (ASA) that allows for a reliable conduct of perfusion. From 2016 to 2020, 12 adult patients with aneurysmal KD and ASA underwent repair of distal arch through lateral thoracotomy ipsilateral to the arch side using central partial bypass. Once the patients were fully heparinized the lower thoracic aorta and the right atrium were cannulated. The cannulas were connected to the cardiopulmonary bypass (CPB) circuit with an oxygenator. Partial bypass was initiated. Ventilation via anesthesia was continued as the mode of gas exchange to the upper body while the CPB circuit provided gas exchange to the lower body. In all patients, CPB was initiated allowing the patient to maintain a mean arterial pressure >60 mmHg in the femoral artery and a mean arterial pressure (MAP) >80 mmHg in the radial artery to allow adequate native ejection into the proximal circulation. The venous line was partially occluded to control the radial pressure. The aorta was cross clamped proximal and distal to the KD to isolate the aorta to be replaced. KD was excised in all patients having performed contralateral subclavian to carotid transposition previously. Once the aorta was reconstructed, clamps were released and the patients were weaned off CPB. All were extubated on the same day and there was no early mortality.
Topics: Adult; Aorta, Thoracic; Cardiopulmonary Bypass; Cardiovascular Abnormalities; Humans; Perfusion; Subclavian Artery
PubMed: 34992323
DOI: 10.1182/ject-2100025 -
The International Journal of... Dec 2021To study the different characteristics of arterial duct (AD) in a series of prenatally detected right aortic arch (RAA). Out of 832 congenital heart diseases (CHD)...
To study the different characteristics of arterial duct (AD) in a series of prenatally detected right aortic arch (RAA). Out of 832 congenital heart diseases (CHD) referred to a tertiary center, 98 cases had RAA. Based on anatomical landmarks we identified 7 types of AD: type 1 left-sided, transverse; type 2 left-sided, vertical; type 3 from the underside of aortic arch (AA), vertical; type 4 right-sided, mirror-image "V", transverse; type 5 right-sided, "H" shaped, transverse; type 6 bilateral; type 7 absent or unidentifiable. For each type of AD the incidence of associated major CHD was calculated and chi-square test was applied to verify the null hypothesis with significance level of p < 0.05. Type 1 occurred in 43% of cases including 4 with CHD and no cases with pulmonary outflow obstruction (POO). Symptoms of vascular ring were present in 41% of survivors. Type 2, 3 and 7 AD were associated with tetralogy of Fallot (TOF) or equivalents. No type 5 AD with CHD had POO and 3 isolated cases had asymptomatic hypoplasia of left pulmonary artery (LPA). Two type 6 AD had disconnection of LPA. Type 1 occurred more often as an isolated finding (p < 0.001), whereas types 2 (p = 0.0026), 3 (p = 0.0045), 4 (p = 0.0325) and 7 (p = 0.0001) were frequently associated with major CHD. In RAA, type 1 (U-shaped) is usually an isolated finding (p < 0.001) which includes all symptomatic vascular rings. POO is always present when the AD is vertical or absent but not when it lies on a transverse plane. Bilateral AD is rare and brings the risk of functionary loss of left lung if not identified.
Topics: Aorta, Thoracic; Aortic Arch Syndromes; Ductus Arteriosus; Female; Humans; Predictive Value of Tests; Pregnancy; Ultrasonography, Prenatal
PubMed: 34236571
DOI: 10.1007/s10554-021-02325-w -
Journal of Clinical Ultrasound : JCU Nov 2017Chronic tracheal obstruction has been associated with learning deficits; hence, early surgical intervention has been suggested.
BACKGROUND
Chronic tracheal obstruction has been associated with learning deficits; hence, early surgical intervention has been suggested.
AIM
To evaluate the relationship between learning performance and vascular ring caused by an isolated aberrant right subclavian artery.
METHODS
Participants included 1,685 undergraduate students (ie, students of medical informatics and medical/public health students) in Central Taiwan. The diagnostic period was from 2005 to 2010. Vascular ring was diagnosed by two-dimensional echocardiographic screening and was validated by esophagogram. The reference group (medical students) was associated with higher learning performance, whereas the comparison group (students of medical informatics and public health) was associated with lower learning performance. Multiple logistic regression was used for analysis.
RESULTS
The prevalence of vascular ring among the reference and comparison groups was 0.48 and 2.03%, respectively. The odds ratio for the vascular ring was 4.90 (95% confidence interval: 1.30-18.40) after adjusting for potential confounders.
CONCLUSIONS
This study suggests that vascular ring can impact learning efficiency and advocates for larger dedicated studies. © 2017 The Authors Journal of Clinical Ultrasound Published by Wiley Periodicals, Inc. J Clin Ultrasound 45:556-560, 2017.
Topics: Adult; Cross-Sectional Studies; Echocardiography; Female; Humans; Learning; Male; Students; Students, Medical; Taiwan; Vascular Ring
PubMed: 28555926
DOI: 10.1002/jcu.22502