Background Venous malformation damages the local tissue severely because of the progressive development and often presents with invasive biological behavior.Galectin-3 (Gal-3) is proved to be closely associated with local invasion of malignant tumor.Studying the role of Gal-3 on tissue invasion in venous malformation of ocular region is of important clinical significance.Objective This study was to explore the role of Gal-3 protein and mRNA expression in venous malformation of ocular region.Methods One hundred and eighteen pathological sections were collected from ocular venous malformation patients who received surgery in Department of Hemangioma Surgery,People's Hospital of Henan Province and Henan Eye Institute from June 2009 to June 2014.The specimens were further diagnosed by histopathological examination.Then the expressions of Gal-3 protein and mRNA in venous malformation of ocular region were detected by using immunohistochemistry and in situ hybridization and compared with 20 pieces of distal cutting edge specimens which were evidently normal.The associations of Gal-3 positive expressions with invasion and configuration of lesions were analyzed.Results Pathological examination showed that venous malformations tissues contain many big blood vessels lacuna, lined with fiat endothelial cells.Immunochemistry and in situ hybridization exhibited that Gal-3 protein and mRNA were expressed in the cytoplasm and nuclei.The positive expression rates of Gal-3 protein and mRNA in the venous malformation tissues were 55.93％ (66/118) and 59.32％ (70/118) , but those in the normal tissue were 15.00％ (3/20) and 20.00％ (4/20) ,showing significant differences between them (x2 =11.461, 10.633, both at P＜0.05).No significant differences were seen in the positive expression rates of Gal-3 protein and mRNA between the patients aged ≤ 12 years and ＞12 years or different genders (age: x2 =0.334,0.128;both at P＞0.05.gender:x2 =0.606,1.155;both at P ＞0.05).The incidence rate of invading ocular deep tissues was significantly higher in the Gal-3-positive groups than that in the Gal-3-negative groups of protein and mRNA (protein :x2 =32.688, P＜0.05;mRNA : x2 =23.695, P＜0.05).In the Gal-3-negative groups,96.15％ (Gal-3 protein negative group) and 97.92％ (Gal-3 mRNA negative group) lesions showed the spherical shape with clear boundaries.The lesions texture with the fuzzy boundaries and the incidences of vague structure in lesions were significantly higher in the Gal-3-positive groups than that in the Gal-3-negative groups of protein and mRNA (protein :x2 =28.255, P＜0.05;mRNA : 28.186, P＜0.05).Conclusions Gal-3 expression rate is raised in the deep tissue-invaded and texture disorder ocular venous malformation.These results suggest that invasion and damage of ocular venous malformation are associated with the up-regulation of Gal-3.

OBJECTIVETo explore the therapeutic effect of radiofrequency ablation for tongue venous malformation( VM).

METHODSFrom July 2013 to July 2014, 30 cases with tongue VM (local or diffuse) were retrospectively analyzed. 23 cases underwent radiofrequency ablation treatment. The radiofrequency electrode tip(0. 5 mm in diameter) was inserted into the lesion 1 mm below the bottom with 25 W in power and 15-30 s of pulse. The treatment was repeated when the electrode tip was removed back every 1 mm. Multi-point treatment was performed.

RESULTS15 cases with unilateral VM were completely healed after one-stage radiofrequency ablation. 8 cases with bilateral VM received two-stage radiofrequency ablation with a 3-6 months of interval. Among the 8 cases, completely healing was achieved in 5 cases, partial VM residue happened in 3 cases due to its diffuse lesion and reservation of tongue function. 23 cases were followed up for 3 month to 1.5 years. Good cosmetic and functional results was achieved in 20 cases with no relapse. Partial VM residue was left in 3 cases.

CONCLUSIONSRadiofrequency ablation can effectively treat tongue VM with minimal morbidity and good cosmetic appearance. It also avoids the disadvantages of surgery.

Catheter Ablation ; instrumentation ; methods ; Electrodes ; Humans ; Retrospective Studies ; Tongue ; blood supply ; Treatment Outcome ; Vascular Malformations ; surgery ; Veins ; abnormalities

Objective: To detect the expression level of Galectin-3 in the ocular Venous Malformation (VM) tissue, and explore its associations with the occurrence and development of ocular VM. Methods: 12 fresh ocular VM tissue samples and 12 simplex great saphenous vein varices tissue samples were collected. The mRNA and protein expression levels of Galectin-3 gene were detected by RT-PCR and Western Blot. Results: The relative mRNA and protein levels of Galectin-3 in VM and control group were 5.26×10^-3±8.78×10^-4, 4.89×10^-4±5.37×10^-5 and 0.861±0.394, 0.223±0.206, respectively; Galectin-3 expressions in both mRNA and protein levels in ocular VM tissue were obviously higher than those in control group (P<0.05), and an increasing trend was accompanied with aggravating pathological changes in both degree and range of ocular VM. Conclusions Galectin-3 is highly expressed in ocular VM tissue in both mRNA and protein levels, which may be closely related to ocular VM development and prognosis, and can be used to determine the degree of local invasion of ocular VM. The pathogenesis of ocular VM may be related to Galectin-3, which can be further investigated through gene chip techniques.

Objective: To evaluate the role of Galectin-3 protein and mRNA in venous malformation of ocular region after urea injection treatment. Methods: 108 cases with venous malformation of ocular region were randomly divided into two groups: 53 cases did not receive urea injection before operation, the other 55 cases were treated by injection of urea. The expressions of Galectin-3 protein and mRNA were detected using by immunohistochemical staining and in situ hybridization in 108 cases of venous malformation of ocular region and 20 normal tissue from distal surgical margin.The difference of Galectin-3 expression with and without the intervention of urea was analyzed, as well as the relationship between Galectin-3 and clinicopathological features. Results: The positive rate of Galectin-3 protein and mRNA were 52.83%(28/53) and 58.49%(31/53) in venous malformation of ocular region tissue without the urea intervention respectively, whereas the epithelial cells of ocular region tissue from the distant cutting margin had weak reactivity which were 10%(2/20) and 15%(3/20) respectively (P<0.05). With the urea intervention, the positive value were 23.64%(13/55) and 30.91%(17/55) (P>0.05). Compared with no urea intervention treatment group, the positive rate expression of Galectin-3 protein and mRNA decreased markedly in urea intervention group (P<0.05). Conclusions Galectin-3 may promote neovascularization and play an important role in the development of the ocular venous malformation. Meanwhile, it may also serve as a valuable detect marker in venous malformation evolution.Urea intervention can control and relieve the Galectin-3 protein and mRNA for the development of the ocular venous malformations.

Giant lymphatic vascular malformation combined with intracapsular hemorrhage is not common, and the treatment is quite difficult. In November 2018, an eleven-month-old boy with intracapsular hemorrhage was diagnosed and treated by hemangioma surgery of the Third Affiliated Hospital of Zhengzhou University. Needle shaped ablation electrode assisted surgery was used to remove giant lymphatic vascular malformation complicated with intracapsular hemorrhage, which achieved a radical cure and good result. After 24 months of follow-up, no recurrence was found.

Giant lymphatic vascular malformation combined with intracapsular hemorrhage is not common, and the treatment is quite difficult. In November 2018, an eleven-month-old boy with intracapsular hemorrhage was diagnosed and treated by hemangioma surgery of the Third Affiliated Hospital of Zhengzhou University. Needle shaped ablation electrode assisted surgery was used to remove giant lymphatic vascular malformation complicated with intracapsular hemorrhage, which achieved a radical cure and good result. After 24 months of follow-up, no recurrence was found.

Objective: To analyze the pain caused by intramuscular venous malformation, so as to avoid misdiagnosis. Methods: We retrospectively analyzed 173 patients who received surgical treatments in our department between Jan.2012 to Dec.2014, with the main complaint of local pain and were diagnosed as intramuscular venous malformation. The mechanisms of the local pain, based on the image data, intra-operative findings, pathology reports and the comparison of the Visual Analogue Scale(VAS) data before and after operation were summarized. The surgical interventions included simple excision or excision + adhesiolysis or excision + adhesiolysis + nerve decompression. Results: The reasons of local pain can be divided into 4 categories: ①lesion located in the tendon insertions; ②lesion involving the local nerve, inducing the thickening and tensing of its epineurium and the increasing of its diameter; ③lesion infiltrated to the periosteum; ④phlebolith in it. All the 173 patients received surgical treatments and got varying degrees of relieving from local pain. 63 patients got a decrease of the VAS by 5 or more, and 95 cases′ VAS number decreased by 3-4, the rest 15 patients′ VAS cut down by 1-2. Conclusions Intramuscular venous malformation is an important reason for local pain and should not be neglected. Surgical treatment can be an effective method to remove the lesion and relieve local pain.

Objective: To explore the treatment of the ocular arteriovenous malformation using urea injection combined with surgical procedures and evaluate clinical effects. Methods: 42 cases withocular arteriovenous malformation combined with fistula were retrospectively analyzed between January 2011 and December 2016. Individual treatments were formulated according to leision areas and severity. 3 cases with diffuse malformations were excluded from the study, because no surgical procedures were performed. 39 cases underwent local injection with 40% urea before resection. The urea was injected locally into vein malformation area by means ofmulti-point injection on a basis of 30 seconds, 3-6 ml for each treatment, once a day.The injection was performed for successive 7-10 days.The therapeutic effects and cosmetic result were recorded. Results: 23 cases occurred intheright ocular area and 16 cases in left.21 cases were removed radically in single operation.No recurrenceoccurredin any case with follow-ups of 3 months to 1.5 years.Cosmetic result with ocularbilateral symmetrywere satisfactory. Conclusions Combined treatment with urea injection and surgical procedure could effectively treat ocular arteriovenous malformation with arteriovenousfistula.

Objective:To investigate the effect of radiofrequency ablation in the treatment of severe tongue′s lymphatic vascular malformation, and evaluate the value and aesthetics of the operation.Methods:The 33 cases′ data of lingual lymphatic vascular malformation from February 2018 to February 2019 in Department of Hemangioma Surgery of Third Affiliated Hospital of Zhengzhou University were analyzed retrospectively. There were 18 males and 15 females, aged from 1 month to 50 years old, with a median age of 5 years. From unilateral lesions to diffuse and extensive lesions, 33 of them received radiofrequency ablation.24 cases were unilateral and 9 cases were bilateral. 18G radiofrequency ablation needle was selectedwithworking tip diameter of 1mm and heating 5 mm tip , and the power was adjusted to 25 W. Monitoring by color Doppler ultrasound, the working tip was inserted into the bottom of the lesion part which is about 1 mm from the deepest part. The ablation was performed for 5-20 s after being electrified. Then the electrode needle was withdrawn 1 mm in turn until it was 1 mm from the lesion surface, and respectively performed multi-point ablation withinterval of 5 mm.Results:One-stage radiofrequency ablation was performed in 24 patients with unilateral lesions and 9 patients with bilateral lesions. One-stage radiofrequency ablation was performed in one side of the lesions. After three to six months later, two-stage radiofrequency ablation was performed in most of the lesions. 33 cases were followed up from 6 months to 2 years.18 cases of unilateral lesions and 6 cases of bilateral lesions had no recurrence, and the tongue was symmetrical on both sides; 9 cases of full-thickness involvement of the tongue (6 cases on one side and 3 cases on both sides) had a small amount of lesions near the lingual artery, which were asymptomatic, nearly cured, without obvious scars, and satisfactory in appearance.Conclusions:Radiofrequency ablation is an important supplement for the treatment of lingual lymphatic vascular malformation, which makes up for the shortcomings of traditional surgery. Clinically, it can primarily achieve the treatment′s goal, with unobvious complication and aesthetical outcome.

Objective:To investigate the outcomes of therapeutic radiofrequency ablation (RFA) in unilateral intra-articular venous malformations (IAVMs) of the knee.Methods:The clinical data of 15 patients with intravascular venous malformation in the Third Affiliated Hospital of Zhengzhou University from February 2018 to May 2019 were retrospectively analyzed. There were 7 males and 8 females with an average age of 16 years (range, 5—25 years). All patients had unilateral knee involvement, ranging from localized lesions to diffuse extensive lesions. The radiofrequency ablation electrode needle with a diameter of 0.5 mm was selected and the power was adjusted to 25 W. Under the guidance of color ultrasound monitoring, the whole operation was carried out. The RFA electrode needle was inserted into the deepest site of the lesion and extracted by 1-mm graded movements until a point 1 mm from the surface of the lesion. Each ablation point was ablated for 10 to 30 seconds and multi-point ablation was done until the lesions were completely eliminated. Patients were followed up for 6 months to 1 year. Treatment outcomes were evaluated by functional activity, including extension, flexion, abduction, and adduction at the knee joint, and MRI findings, including intensity, shape, boundary, and degree of aggressiveness in the intra- and extraarticular cavities.Results:Included 15 patients; 12 had VMs in the knee joint cavity, and 3 had VMs involving both the intraarticular and extraarticular cavities (1 from the joint cavity to the calf, 1 from the joint cavity to the lower femur, and 1 from the intraarticular to the extraarticular cavity). All subjects underwent RFA, and the lesions were completely ablated and eradicated in a single operation. No recurrence was reported in the 6 months to 1 year follow-up. The knee joint remained symmetrical with the contralateral knee joint, without scarring, after the RFA.Conclusions:Radiofrequency ablation for the treatment of intra-articular venous malformation of the knee joint is a valuable minimally invasive surgical method with complete ablation, no complications, good prognosis and aesthetic appearance.