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

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

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

Raynaud's phenomenon (RP) is a reversible vasospasm that is aggravated by cold or emotional stress. Before confirming RP, it is essential to consider other possible causes including compressive neuropathy, sensori-neuropathy, thyroid disease, hematologic conditions and offending drugs. RP is typically characterized by the three-step color change that turns pallor (white), cyanosis (blue), and then erythema (red) of reperfusion. Once RP is diagnosed, it is important to determine whether it is primary or secondary RP. To distinguish primary from the secondary RP, the specialized tests performing in clinical practice are antinuclear antibody (ANA) and nailfold capillary microscopy (NFC). The combination of ANA and NFC is most helpful for discriminating secondary RP due to autoimmune rheumatic disease. Thereby, normal findings of NFC in primary RP distinguished from secondary RP should be understood. Patients with primary RP usually improves with symptomatic treatment focused on lifestyle modification and patient education, but those with secondary RP should be treated together with associated disease or causes.
Antibodies, Antinuclear ; Capillaries ; Cyanosis ; Erythema ; Humans ; Life Style ; Microscopic Angioscopy ; Microscopy ; Pallor ; Patient Education as Topic ; Reperfusion ; Rheumatic Diseases ; Stress, Psychological ; Thyroid Diseases

PURPOSE: To compare retinal layer thickness and chorioretinal vascular density (VD) between acute and chronic branch retinal vein occlusion (BRVO). METHODS: This study included patients with BRVO. The VD of the superficial capillary plexus (VDs), the VD of the deep capillary plexus (VDd), and VD of the choriocapillaris were obtained using optical coherence tomography angiography. Acute and chronic BRVO data were compared to assess differences between the involved and uninvolved areas. RESULTS: We included 17 eyes with acute BRVO and 23 eyes with chronic BRVO. The VDs in the involved area were not significantly different between the involved area and in the uninvolved area in acute BRVO (p = 0.551). However, the difference was significant in chronic BRVO (p = 0.013). The VDd in the involved area was lower than in the uninvolved area in both acute and chronic BRVO (p = 0.020, p = 0.003, respectively). In addition, the VD of the choriocapillaris values did not differ significantly between acute and chronic BRVO, or between involved and uninvolved areas. The VDs in the involved area in chronic BRVO were lower than in acute BRVO (p = 0.047), and the VDd did not differ between acute and chronic BRVO in all areas. CONCLUSIONS: Vascular impaired patterns in the retinal layer differed between acute and chronic BRVO. These results may suggest that vascular change and remodeling develops differently in acute and chronic phases in BRVO.
Angiography ; Capillaries ; Humans ; Retinal Vein Occlusion ; Retinal Vein ; Retinaldehyde ; Tomography, Optical Coherence

PURPOSE: To investigate the foveal avascular zone (AVZ), superficial and deep foveal and parafoveal vessel density (VD) changes related to diabetic retinopathy. METHODS: Forty-nine type 2 diabetes mellitus (DM) and 45 healthy control subjects were included in this study. The demographic data (age and sex), disease duration, and level of glycated hemoglobin were collected. Superficial VD (%), superficial AVZ area (mm2), deep VD (%) and deep AVZ area (mm2) were evaluated via optic coherence tomography angiography. RESULTS: Superficial AVZ was 0.438 ± 0.05 mm2 in the DM group, 0.246 ± 0.022 mm2 in the control group (p < 0.001). Deep AVZ was 0.732 ± 0.06 mm2 in the DM group, and 0.342 ± 0.022 mm2 in the control group (p < 0.001). Superficial foveal VD was 29.45 ± 0.76 mm2 in the DM group, and 34.86 ± 0.75 mm2 in the control group (p < 0.001). Deep foveal VD was 24.85 ± 1.08 mm2 in the DM group, and 33.47 ± 0.56 mm2 in the control group (p < 0.001). CONCLUSIONS: In this study, we demonstrated an enlargement in the foveal AVZ along with a reduction in the vascular density of the superficial and deep capillary network in the foveal and parafoveal area using optic coherence tomography angiography in patients with nonproliferative diabetic retinopathy. This technique can be used to monitor the progression of the disease and to evaluate the response to treatment.
Angiography ; Capillaries ; Diabetes Mellitus, Type 2 ; Diabetic Retinopathy ; Hemoglobin A, Glycosylated ; Humans ; Ischemia ; Tomography, Optical Coherence

PURPOSE: Comparison between lung ultrasound (LUS) score and indices of respiratory severity in very preterm infants born at 28 to 31 weeks' gestation. METHODS: We retrospectively reviewed medical records of 32 very preterm infants born at 28 to 31 weeks' gestation at Keimyung University Dongsan Medical Center. Before surfactant administration, bedside LUS in the neonatal intensive care unit was recorded within the first hour of life. Partial pressure of capillary oxygen to fraction of inspired oxygen ratio (PcO2)/FiO2, alveolar-arterial gradient (A-aO2), modified oxygenation index (OI), and arterial to alveolar ratio were calculated. Correlation between LUS score and indices of respiratory severity were analyzed between the intubation and nasal continuous positive airway pressure (NCPAP) groups depending on the presence or absence of endotracheal intubation. RESULTS: Mean LUS scores, A-aO2, and modified OI in the intubation group were significantly higher than those in the NCPAP group. Conversely, PcO2/FiO2 and arterial to alveolar ratios in the intubation group were significantly lower than those in the NCPAP group. LUS score was found to be significantly correlated with A-aO2 (r=0.448, P>0.05) and modified OI (r=0.453, P>0.05), but not with PcO2/FiO2 ratio (r=−0.205, P<0.05) and arterial to alveolar ratio (r=−0.190, P>0.05). CONCLUSION: The LUS score is well correlated with indices of respiratory severity in very preterm infants born at 28 to 31 weeks' gestation. Further investigation is needed to use LUS as an alternative tool in infants with respiratory distress.
Capillaries ; Continuous Positive Airway Pressure ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Intubation ; Intubation, Intratracheal ; Lung ; Medical Records ; Oxygen ; Partial Pressure ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies ; Ultrasonography

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