Atherosclerosis ; complications ; pathology ; Humans ; Thrombosis ; complications ; pathology

Exosomes are subtypes of extracellur vesicles containing a variety of cell-specific proteins, lipids and nucleic acids released during cell activation or apoptosis, and play the role of intercellur communication mediators in different physiological and pathological processes. With the development of research in recent years, the role of platelet-derived exosomes in cardiovascular diseases has attracted extensive attention. This paper reviews the role of platelet-derived exosomes in atherosclerotic thrombosis and the potential role of platelet-derived exosomes as biomarkers for the diagnosis and treatment of atherosclerotic thrombotic disease and the problems to be solved.
Apoptosis ; Atherosclerosis/pathology* ; Blood Platelets/pathology* ; Exosomes/pathology* ; Humans ; Thrombosis

Humans ; Myocardial Infarction ; pathology ; physiopathology ; Thrombosis ; pathology ; physiopathology

An external thrombotic hemorrhoid is a very painful disease with a high incidence rate. The chief complaints encountered by the surgeon are protrusion and pain. However, because the spontaneous healing rate is very high, there is no consensus on whether conservative management or surgery is a more effective treatment policy. In an attempt to resolve this problem, we performed a clinical analysis of fifty patients with external thrombotic hemorrhoids who were treated by conservative management at Song-Do Colorectal Hospital from October 1996 to December 1996. We recorded the time required for the protrusion and the pain to disappear and performed manometry to check the sphincter pressure and tissue pathology to determine the pathogenesis of the external thrombotic hemorrhoid. The results are as follows: 1) Based on pathology, the cause of the external thrombotic hemorrhoids was venous thrombosis due to venous stasis, not a hematoma due to venous rupture. 2) Manometry showed that the resting sphincter pressure and the squeezing sphincter pressure for the patients with external thrombotic hemorrhoids was higher than those of the control group, which was the reason for the venous stasis. In conclusion, because an external thrombotic hemorrhoid is just a thrombosis due to venous stasis, the thrombosis can be improved by using methods such as a warm sitz bath and analgesics to decrease the sphincter pressure. Hence, conservative management should be the preferred treatment in almost all cases.
Analgesics ; Baths ; Consensus ; Hematoma ; Hemorrhoids ; Humans ; Incidence ; Manometry ; Pathology ; Rupture ; Thrombosis ; Venous Thrombosis

Cerebral Infarction ; complications ; Cerebral Veins ; pathology ; Humans ; Thrombosis ; Venous Thrombosis ; etiology

BACKGROUNDAn early identification of the composition of arterial thrombus may have diagnostic, therapeutic, and prognostic implications. The variation of magnetic resonance (MR) signal intensity between white and red thrombi, especially in the susceptibility sensitive MR sequence, remains unknown. Our research was to evaluate the feasibility of MRI in differentiating of white and red thrombi with a phantom study.

METHODSA total of 12 red and 12 white thrombi were prepared with the venous blood. Examination of the phantom was completed using a 3.0T MR unit, including fluid attenuated inversion recovery (FLAIR) T1, T2-weighted imaging (T2WI), FLAIR T2, T2 gradient echo (T2 GRE) imaging, and susceptibility weighted angiography sequences (SWAN). MR signal intensity patterns of the thrombi were objectively classified as hyperintensity, isointensity and hypointensity, compared with the background agar. The volume of thrombus was calculated and correlated with its signal intensity.

RESULTSFor white thrombi, 11/12 clots showed hyperintensity and 1/12 showed isointensity in FLAIR T1 images. In T2WI, 6/12 clots showed hyperintensity, 3/12 isointensity, and 3/12 hypointensity. In FLAIR T2, 8/12 clots showed hyperintensity and 4/12 showed isointensity. In T2 GRE, 3/12 clots showed hyperintensity and the remaining 9/12 clots showed isointensity. In SWAN, 5/12 clots demonstrated hyperintensity and 7/12 isointensity. For the red thrombus, 12/12 clots demonstrated hyperintensity in FLAIR T1, T2WI, and FLAIR T2 sequences. In T2 GRE and SWAN sequences, 3/12 clots displayed hypointensity and the remaining 9/12 clots showed slight hyperintensity. Thrombi with hypointensity displayed in T2 GRE and SWAN sequences were significantly larger than those with hyperintensity.

CONCLUSIONSDifferentiation of white and red thrombi with conventional MR sequence is unreliable, because both kinds of thrombi do not possess unique signal intensity features in these sequences. Red thrombus may or may not show hypointensity in the susceptibility sensitive MR sequences, depending on its size and time course.

Adult ; Coronary Aneurysm ; complications ; pathology ; Coronary Thrombosis ; complications ; Humans ; Male

OBJECTIVES: To observe the changes of the formation time of venous thrombus in rats, and to provide new ideas and methods for the estimation on thrombus formation time of the forensic cases died from thrombosis. METHODS: Totally 80 rats were randomly divided into 10 groups （0 h, 3 h, 6 h, 12 h, 1 d, 3 d, 1 week, 2 weeks, 3 weeks and 4 weeks after operation）. A vein thrombosis model was established by the "narrow" method. The processes of thrombosis, organization, recanalization and the features of change on hemosiderin and calcium salt were observed by HE stain, Perls stain and Von Kossa stain. The expression changes of CD61, α-SMA and CD34 were observed by immunohistochemical staining technique. RESULTS: Platelets adhered to the exposed blood vessel intima 3 h after operation, and platelet trabeculae were formed by the repeated accumulation of platelets 1 d after operation. The thrombus organization formed through the fibroblasts from vessel wall that grew into the interior of the thrombus 3 d after operation. Endothelial cells covered the surface of thrombus and then the new blood vessels were reformed, and the vessels were reconstructed. The expression of CD61 upregulated at the stages of the thrombus formation （3 h） and thrombus reformation （4 weeks）, and reached the peak 1 d after thrombus formation. The release of hemosiderin and the initial expression of α-SMA were detected 3 d later. Calcium deposit and expression of CD34 were observed 1 week later. CONCLUSIONS The hemosiderin, calcium salt, CD61, α-SMA and CD34 show time-dependent changing characteristics, which is expected to provide a reference for the estimation on thrombus formation time of the forensic cases died from thrombosis.
Animals ; Antigens, CD34/analysis* ; Hemosiderin/metabolism* ; Rats ; Venous Thrombosis/pathology*

Spontaneous total necrosis of hepatocellular carcinoma is extremely rare, with only 15 cases reported to date in the English literature, and the involved mechanism remains unresolved. This paper describes a case of spontaneous necrosis of hepatocellular carcinoma in a 70-year-old man with chronic hepatitis. The patient suffered epigastric pain on admission and computed tomography revealed a 4 cm mass with low density in the left lobe of the liver. Fine needle aspiration biopsy revealed a few scattered, naked and irregular nuclei exhibiting nuclear hyperchromasia in the dirty necrotic background, a finding highly suggestive of malignancy. The lobectomized liver revealed a 3.5 cm, well encapsulated, round, and nearly totally necrotic mass. On microscopic examination, the tumor was found to be composed of thick trabeculae of necrotic tumor cells, supporting the diagnosis of hepatocellular carcinoma. After surgery and throughout 13 months of follow up the patient has recovered well.
Aged ; Carcinoma, Hepatocellular/*pathology ; Case Report ; Human ; Liver Neoplasms/*pathology ; Male ; Necrosis ; Thrombosis/*pathology

Unexpectedly high rates of venous thromboembolic events (VTE) induced by highly effective immune modulating drugs thalidomide and lenalidomide for treatment of multiple myeloma have focused attention on the incidence and underlying pathophysiology of VTE in patients with plasma cell dyscrasias, and on thromboprophylaxis approaches. While bleeding complications are relatively uncommon in the patients with lymphoproliferative disorders, acquired von Willebrand syndrome, typically occurring in the patients with monoclonal gammopathy of unknown significance, and acquired coagulopathies associated with primary amyloidosis can present with haemorrhagic complications and both are challenges to the management. This review highlights these important haemostasis-related complications of plasma cell dyscrasias and provides an overview of other uncommon bleeding and thrombotic events that can affect diagnosis and therapeutic management of clonal plasma cell disorders. Due to the infrequency of most these haemostasis complications, available information is typically based on retrospective cases or series analysis.
Hemorrhage ; etiology ; pathology ; therapy ; Humans ; Paraproteinemias ; complications ; pathology ; Thrombosis ; etiology ; pathology ; prevention & control