Endoscopic ultrasonography (EUS) is commonly used to detect the depth of cancer invasion in the preoperative stage. Intrapapillary capillary loop (IPCL) patterns observed in magnification endoscopy with narrow band image are also known to well demonstrate cancer invasion depth. Here, we report a case of superficial esophageal cancer with massive submucosal invasion, which presented as a superficial esophageal cancer confined to the mucosal layer and with a coincidental hypoechoic submucosal tumor under EUS and IPCL evaluation.
Capillaries ; Carcinoma, Squamous Cell ; Endoscopy ; Endosonography ; Esophageal Neoplasms

PURPOSE: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deep venous thrombosis (DVT) after total knee arthroplasty in older adult patients. MATERIALS AND METHODS: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomly selected as research subjects and were divided into apixaban and LMWH groups (110 in each group). RESULTS: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activated partial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0 sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higher than those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were lower than those in the LMWH group. CONCLUSION: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the prevention and treatment of DVT after total knee arthroplasty in older adults.
Adult ; Arthroplasty, Replacement, Knee ; Blood Platelets ; Capillaries ; Erythrocyte Aggregation ; Fibrinogen ; Heparin, Low-Molecular-Weight ; Humans ; Incidence ; Plasma ; Prothrombin Time ; Research Subjects ; Thromboplastin ; Venous Thrombosis ; Viscosity

BACKGROUND: Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats. METHODS: McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining. RESULTS: Flap survival rate was 53.41%±5.43%, 58.16%±4.80%, 57.08%±5.91%, and 69.08%±3.20% in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was 41.70±8.40, 35.43±6.41, 37.23±7.15, and 27.20±4.24 cells/field in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group. CONCLUSION: FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.
Animals ; Capillaries ; Carbon Dioxide ; Carbon ; Lasers, Gas ; Lidocaine ; Neutrophils ; Rats ; Skin ; Survival Rate ; Vascular Endothelial Growth Factor A

PURPOSE: Control of metastatic spread of colorectal cancer (CRC) remains as a major therapeutic challenge. [V4 Q5 ]dDAVP is a vasopressin peptide analog with previously reported anticancer activity against carcinoma tumors. By acting as a selective agonist of arginine vasopressin type 2 membrane receptor (AVPR2) present in endothelial and tumor cells, [V⁴Q⁵]dDAVP is able to impair tumor aggressiveness and distant spread. Our aim was to evaluate the potential therapeutic benefits of [V⁴Q⁵]dDAVP on highly aggressive CRC disease using experimental models with translational relevance. MATERIALS AND METHODS: Murine CT-26 and human Colo-205 AVPR2-expressing CRC cell lines were used to test the preclinical efficacy of [V⁴Q⁵]dDAVP, both in vitro and in vivo. RESULTS: In syngeneic mice surgically implanted with CT-26 cells in the spleen, sustained intravenous treatment with [V⁴Q⁵]dDAVP (0.3 µg/kg) dramatically impaired metastatic progression to liver without overt signs of toxicity, and also reduced experimental lung colonization. The compound inhibited in vivo angiogenesis driven by Colo-205 cells in athymic mice, as well as in vitro endothelial cell migration and capillary tube formation. [V⁴Q⁵]dDAVP exerted AVPR2-dependent cytostatic activity in vitro (IC₅₀ 1.08 µM) and addition to 5-fluorouracil resulted in synergistic antiproliferative effects both in CT-26 and Colo-205 cells. CONCLUSION: The present preclinical study establishes for the first time the efficacy of [V⁴Q⁵]dDAVP on CRC. These encouraging results suggest that the novel second generation vasopressin analog could be used for the management of aggressive CRC as an adjuvant agent during surgery or to complement standard chemotherapy, limiting tumor angiogenesis and metastasis and thus protecting the patient from CRC recurrence.
Animals ; Arginine Vasopressin ; Capillaries ; Cell Line ; Colon ; Colorectal Neoplasms ; Complement System Proteins ; Drug Therapy ; Endothelial Cells ; Fluorouracil ; Humans ; In Vitro Techniques ; Liver ; Lung ; Membranes ; Mice ; Mice, Nude ; Models, Theoretical ; Neoplasm Metastasis ; Recurrence ; Robenidine ; Spleen ; Vasopressins

BACKGROUND: Diabetes mellitus (DM) causes macro- and microvasculopathy, but data on cardiac microvascular changes in large animals are scarce. We sought to determine the effect of DM on macro- and microvascular changes in diabetic pigs and humans. METHODS: Eight domestic pigs (4 with type I diabetes and 4 controls) underwent coronary angiography with optical coherence tomography (OCT; at baseline and 1 and 2 months), coronary computed tomography angiography, cardiac magnet resonance (CMR) imaging, and histologic examination. RESULTS: The diabetic pigs had more irregular capillaries with acellular capillaries and a smaller capillary diameter (11.7 ± 0.33 μm vs. 13.5 ± 0.53 μm; P < 0.001) than those of the control pigs. The OCT showed no significant epicardial stenosis in either group; however diabetic pigs had a greater intima-media thickness. CMR results showed that diabetic pigs had a lower relative upslope at rest (31.3 ± 5.9 vs. 37.9 ± 8.1; P = 0.011) and during stress (18.0 ± 3.0 vs. 21.6 ± 2.8; P = 0.007) than the control pigs, implying decreased myocardial perfusion. Among the 79 patients with ST elevation myocardial infarction, 25 had diabetes and they had lower myocardial perfusion on CMR as well. CONCLUSION: DM causes microvascular remodeling and a decrease in myocardial perfusion in large animals at a very early stage of the disease course. Early and effective interventions are necessary to interrupt the progression of vascular complications in diabetic patients.
Angiography ; Animals ; Capillaries ; Constriction, Pathologic ; Coronary Angiography ; Diabetes Mellitus ; Humans ; Hyperglycemia ; Myocardial Infarction ; Perfusion ; Sus scrofa ; Swine ; Tomography, Optical Coherence

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of systemic vasculitides, that are characterized by inflammation in the small vessels, ranging from capillaries to arterioles or venules. AAV is divided into three variants based on the clinical manifestations and histological findings such as microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic GPA (EGPA). MPA often induces rapid progressive necrotising glomerulonephritis, and occasionally induces diffuse alveolar hemorrhage. In contrast, GPA preferentially affects the respiratory tracts from the bronchus to the nasal cavity. GPA can also involve the kidneys, but the frequency of renal involvement is less than MPA. EGPA is based on allergic components such as asthma, peripheral eosinophilia, migratory eosinophilic pneumonia and eosinophil infiltration. Since 1982, when the association between ANCA and systemic vasculitis was first reported, several classification criteria for AAV have been proposed. This review describes the classification criteria for and nomenclature of AAV from the 1990 American College of Rheumatology (ACR) classification criteria to the 2012 revised Chapel Hill consensus conference (CHCC) nomenclature of Vasculitides. New classification trials for AAV such as AAV based on the ANCA-types (myeloperoxidase-ANCA vasculitis, proteinase 3-ANCA vasculitis and ANCA negative vasculitis) and the ACR/European League Against Rheumatism (EULAR) 2017 provisional classification criteria for GPA were also introduced. In addition, the histopathological classification of ANCA-associated glomerulonephritis and the revised 2017 international consensus on testing of ANCAs in GPA and MPA are also discussed.
Antibodies, Antineutrophil Cytoplasmic ; Arterioles ; Asthma ; Bronchi ; Capillaries ; Classification ; Consensus ; Cytoplasm ; Eosinophilia ; Eosinophils ; Glomerulonephritis ; Granulomatosis with Polyangiitis ; Hemorrhage ; Inflammation ; Kidney ; Microscopic Polyangiitis ; Nasal Cavity ; Pulmonary Eosinophilia ; Respiratory System ; Rheumatic Diseases ; Rheumatology ; Systemic Vasculitis ; Vasculitis ; Venules

Cerebral pericytes are perivascular cells that stabilize blood vessels. Little is known about the plasticity of pericytes in the adult brain in vivo. Recently, using state-of-the-art technologies, including two-photon microscopy in combination with sophisticated Cre/loxP in vivo tracing techniques, a novel role of pericytes was revealed in vascular remodeling in the adult brain. Strikingly, after pericyte ablation, neighboring pericytes expand their processes and prevent vascular dilatation. This new knowledge provides insights into pericyte plasticity in the adult brain.
Animals ; Brain ; blood supply ; physiology ; physiopathology ; Brain Diseases ; physiopathology ; Capillaries ; physiology ; Cellular Microenvironment ; Diabetic Retinopathy ; physiopathology ; Endothelial Cells ; physiology ; Humans ; Pericytes ; physiology ; Vascular Remodeling

OBJECTIVE: Assessing the severity of injury and predicting outcomes are essential in traumatic brain injury (TBI). However, the respiratory rate and Glasgow Coma Scale (GCS) of the Revised Trauma Score (RTS) are difficult to use in the prehospital setting. This investigation aimed to develop a new prehospital trauma score for TBI (NTS-TBI) to predict mortality and disability.METHODS: We used a nationwide trauma database on severe trauma cases transported by fire departments across Korea in 2013 and 2015. NTS-TBI model 1 used systolic blood pressure < 90 mmHg, peripheral capillary oxygen saturation < 90% measured via pulse oximeter, and motor component of GCS. Model 2 comprised variables of model 1 and age >65 years. We assessed discriminative power via area under the curve (AUC) value for in-hospital mortality and disability defined according to the Glasgow Outcome Scale with scores of 2 or 3. We then compared AUC values of NTS-TBI with those of RTS.RESULTS: In total, 3,642 patients were enrolled. AUC values of NTS-TBI models 1 and 2 for mortality were 0.833 (95% confidence interval [CI], 0.815 to 0.852) and 0.852 (95% CI, 0.835 to 0.869), respectively, while AUC values for disability were 0.772 (95% CI, 0.749 to 0.796) and 0.784 (95% CI, 0.761 to 0.807), respectively. AUC values of NTS-TBI model 2 for mortality and disability were higher than those of RTS (0.819 and 0.761, respectively) (P < 0.01).CONCLUSION: Our NTS-TBI model using systolic blood pressure, motor component of GCS, oxygen saturation, and age was feasible for prehospital care and showed outstanding discriminative power for mortality.
Anoxia ; Area Under Curve ; Blood Pressure ; Brain Injuries ; Capillaries ; Fires ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hospital Mortality ; Humans ; Hypotension ; Korea ; Mortality ; Observational Study ; Oxygen ; Quality Improvement ; Respiratory Rate

Peripheral giant cell granuloma (PGCG) is an benign non-neoplastic lesion most commonly occurring in oral cavity but extraoral PGCG is extremely rare. Recently, we experienced a case of an isolated PGCG in the parotid gland in 59-year-old man. FNAB findings and radiologic findings including CT and US were suggestive of Warthin's tumor. Partial parotidectomy was performed. Pathologic findings showed fibrillar connective tissue stroma with spindled, ovoid, and round histiocytes-like cells mixed with uneven multinuclear giant cells, small capillaries, hemorrhage, hemosiderin-laden macrophages, and necrosis which were consistent with giant cell granuloma. We report a case of an PGCG in parotid with a review of literature.
Capillaries ; Connective Tissue ; Giant Cells ; Granuloma, Giant Cell ; Hemorrhage ; Humans ; Macrophages ; Middle Aged ; Mouth ; Necrosis ; Parotid Gland

PURPOSE: To evaluate the vessel density of macula according to analysis area in health subjects using optical coherence tomography angiography (OCTA). METHODS: We retrospectively analyzed 30 eyes of 20 healthy people who underwent OCTA. We measured vessel density (VD) according to analysis area and foveal avascular zone (FAZ) size of superficial capillary plexus (SCP) and deep capillary plexus (DCP). The analysis areas were classified as 3 × 3 mm scan area (Box), Box area excluding FAZ (Box-FAZ), fovea centered 3 mm circle area (Circle), Circle area excluding FAZ (Circle-FAZ) and area between fovea centered 1 mm circle and 3 mm circle (Ring). RESULTS: The SCP VDs were Box 34.00 ± 3.97, Box-FAZ 35.37 ± 4.09, Circle 31.70 ± 4.56, Circle-FAZ 33.34 ± 4.72, and Ring 35.22 ± 5.09. The DCP VDs were Box 30.04 ± 3.51, Circle 29.49 ± 3.57, Box-FAZ 31.59 ± 3.65, Circle-FAZ 31.46 ± 3.72, and Ring 32.60 ± 4.00. There was a significant difference according to analysis area from both SCP and DCP (p < 0.001 and p < 0.001, respectively). Comparison of the vessel density between SCP and DCP in the same analysis area were different in all areas (p < 0.001, p = 0.001, p < 0.001, p = 0.005, p = 0.001, respectively). CONCLUSIONS: This study shows different results according to analysis area when measuring VD using OCTA. Therefore, when comparing studies related to VD, it is necessary to pay attention to the analysis area in the interpretation of the results.
Angiography ; Capillaries ; Healthy Volunteers ; Retrospective Studies ; Tomography, Optical Coherence