Right-sided varicocele is a relatively rare disease, which could be caused by retroperitoneal pathology, situs Inversus or ananomalous termination of the right internal spermatic vein into the right renal vein or the left renal vein. Herein we report a rare case of right-sided varicocele in a 31-year-old fertile man with situs inversus.
Adult ; Humans ; Pathology ; Rare Diseases ; Renal Veins ; Situs Inversus* ; Varicocele* ; Veins

PURPOSE: The advanced stage of chronic venous insufficiency (CVI) 4, 5, 6, which shown lipodermatosclerosis, venous ulcer might cause frustrating symptom compared with simple varicose vein. For successful treatment, precise anatomic, hemodynamic information of venous system is recommended. Although there is still controversy, duplex scan is the best way in evaluation of hemodynamic pathology. We studied key role of duplex scan in treatment of advanced CVI. METHOD: From November 1998, to February 2000, 125 patients were treated for CVI in our hospital. Of these 11 patients with class 4, 5, 6 were assessed by duplex scan, ascending venogram, hemodynamic functional studies. All venous segments were eagerly assessed for looking reflux. Except one patient who refuse surgery 10 patients received conventional surgical treatment and endoscopic perforator ligation. The one year follow up results were assessed. RESULT: 9 patients showed superficial venous reflux, 3 patients had deep venous reflux. In all 6 patients who had ulcer, incompetent perforator vein was identified. In 9 patients, stripping 8, high ligation 1, endoscopic perforator vein ligation 3 were done. During 1 year follow up clinical improvement was singificant in these 11 patients assessed with symptom scores. All ulcer were healed with average 25.3 days, and no recurrence. CONCLUSION: Although no single test was enough for perfect assessing CVI, scrupulous examination with duplex scan is best way for accomplishing successful outcome at presents.
Follow-Up Studies ; Hemodynamics ; Humans ; Ligation ; Pathology ; Recurrence ; Ulcer ; Varicose Ulcer ; Varicose Veins ; Veins ; Venous Insufficiency

OBJECTIVETo assess the effect of the autologous venous external stents on intimal hyperplasia of the vein grafts in rabbits.

METHODSThirty-six male New Zealand white rabbits, aged 5 months and weighing 2.8 to 3.0 kg, were randomly divided into 3 groups: group A, group B and group C, with 12 rabbits in each group. First, a section about 6 cm long of vein was cut from the right external jugular vein of each rabbit and severed to have 3 equal-length segments. Next, each distal segment prepared for anastomosis. The proximal segment invaginating middle segment in group A and only middle segment in group B were used for the external stent. Later, the left common carotid artery was separated from surrounding tissue, from it a section about 0.5 cm long was cut away. Finally, the vein graft was inverted and end-to-end anastomosed to the two ends of the artery with a 9-0 suture. After bloodstream re-established, the diameter of each vein graft was measured. At 2 and 4 weeks postoperative, the graft veins were cut off and histologically examined by the means of HE staining and Masson staining. The smooth muscle cells (SMC) proliferation was studied by the immunohistochemical detection of proliferating cell nuclear antigen.

RESULTSAfter bloodstream re-established, the diameters of vein graft of group A and group B and group C were (1.6 +/- 0.3) mm, (2.2 +/- 0.4) mm and (2.6 +/- 0.6) mm respectively (P < 0.05). At 4 weeks postoperative, the data of the ratio of intima to media thickness and the index of the proliferating cells of the intima were as follow: group A (1.01 +/- 0.07 and 6.84 +/- 1.98), group B (1.32 +/- 0.08 and 11.01 +/- 2.61), group C (1.55 +/- 0.03 and 14.96 +/- 4.14). Both the data of group A were obviously less than that in group B, and that of group B was less than group C (P < 0.05).

CONCLUSIONThe autologous venous two-layer external stents inhibit intimal hyperplasia of the vein grafts.

Animals ; Hyperplasia ; pathology ; prevention & control ; Male ; Rabbits ; Stents ; Transplantation, Autologous ; Tunica Intima ; pathology ; Veins ; pathology ; transplantation

BACKGROUND: Over the years many possible explanations for the development of varicose vein have been suggested. The main possible mechanisms are a valvular failure theory and a weak wall theory. However, the definite cause of varicose has not been determined yet. OBJECTIVE: The aims of this study are to observe the pathologic changes in the smooth muscle cells and extracellular matrix of the primary varicose vein. An understanding of the pathology may possibly help to understand the pathogenesis of varicose veins. METHODS: A total of 20 vein specimens of primary varicose vein were collected from 13 patients who underwent ambulatory phlebectomy. Among them, 16 specimens were thick segments and 4 specimens were thin segments of varicose veins. Control samples were collected from two patients with no history and clinical evidence of varicose vein. Each specimen was examined with a JEM 1200EX-II electron microscopy. Ultrastructural findings between thick and thin segments of varicose veins and normal veins were also compared semiquantitatively. RESULTS: The smooth muscle cells of varicose veins were abnormal in shape and lost their fusiform appearance with many vacuoles. Increased extracellular matrix shows the increase of degenerated collagen fibers and decrease of elastic fibers. Thin segments revealed more atrophic smooth muscle cells and phagocytosis than thickened segments. Thick segments showed increased collagen fiber. CONCLUSION: These ultrastructural changes may be not the primary cause of varicose veins but the secondary remodeling processes of vein walls by hemodynamic stress.
Collagen ; Elastic Tissue ; Extracellular Matrix ; Hemodynamics ; Humans ; Leg* ; Microscopy, Electron ; Myocytes, Smooth Muscle ; Pathology ; Phagocytosis ; Vacuoles ; Varicose Veins* ; Veins

Pulmonary vein thrombosis is a rare disease and is usually represented as a complication of atrial fibrillation, pulmonary tumors, and lobectomy. Although it is a potentially life threatening condition, the venous disease is easy to misdiagnose because of the non-specific symptoms. In this article, we present a 30-year-old patient who suffered from pulmonary vein thrombosis without any causes. He was diagnosed with other pulmonary disorders till the thrombus within the pulmonary vein extended into the left atrium. Left atrium mass resection and a left lower lobectomy were undertaken with relative urgency. The postoperative course was uneventful. The patient received a long course of oral anticoagulant therapy.
Adult ; Echocardiography, Transesophageal ; Heart Atria ; pathology ; Humans ; Male ; Pulmonary Veins ; Venous Thrombosis ; pathology ; surgery

OBJECTIVETo set up a venous congested flap model to study the mechanism of necrosis through long-term microcirculation observation.

METHODSA specially deviced chamber was assembled to one side of the ears in an adult white rabbit, about 7 approximately 10 days after the operation the congested flap model was made and the microcirculatory status of the flap was dynamically observed under a vivo-microscope for a long time.

RESULTSThe venous crisis phenomenon of flap was well studied and the microcirculation of the flap was observed carefully, finally the variational rule of the congestion flap microcirculation was made clear.

CONCLUSIONSThe model could well simulate the venous crisis flap in clinic, and the microcirculation could also be observed for a long time.

Animals ; Disease Models, Animal ; Female ; Male ; Microcirculation ; Rabbits ; Surgical Flaps ; blood supply ; pathology ; Veins ; pathology

OBJECTIVETo observe the pathological changes and morphological alterations of ECV304 cells after the infection by herpes simplex virus type 2 (HSV-2) in vitro.

METHODSPassaged ECV304 cells were infected with HSV-2, TCID50 and morphological changes were observed by optical microscopy and tissue staining.

RESULTSOne day after HSV-2 infection, swelling, rounding, and increase of thickened cytoplasmic granules occurred in the ECV304 cells, and on day 2, cell fusion was observed with weakened nuclear staining.

CONCLUSIONECV304 cells mostly undergo necrosis after HSV-2 infection without obvious evidence of cell apoptosis.

Cells, Cultured ; Endothelium, Vascular ; pathology ; virology ; Herpesviridae Infections ; pathology ; Herpesvirus 2, Human ; Humans ; Necrosis ; Umbilical Veins ; pathology

OBJECTIVETo study the duration of prourokinase gene expression in vein grafts and the role of the prourokinase gene in protecting vein grafts from neointimal hyperplasia.

METHODSFifty-four Wistar rats were used in this study. In each rat, the jugular vein was excised and distended for 30 minutes using a solution containing either Adv(5)-CMV (control group) or Adv(5)-CMV/Pro-UK (treatment group). Next, the jugular vein was reversed and interposed into the divided carotid artery of the same rat. On the 14th day after transfection, vein grafts of the control group were collected in order to perform a fibrinolysis test for prourokinase (Pro-UK) activity. On the 2nd, 7th, 14th, 28th, and 60th day, the vein grafts of the treatment group were likewise collected in order to detect prourokinase activity. On the 28th day, the vein grafts of both groups were explanted to evaluate the (3)H-TDR incorporation so that pathologic analysis could be performed.

RESULTSPro-UK activity could not be detected in the control group, while in the treatment group, the Pro-UK activity could be detected from the 2nd day onwards, peaking on the 7th day and declining from the 14th day, but yet persisting at a low level for a further month. The amount of (3)H-TDR incorporated in the control group was higher than that in the treatment group. Pathologic analysis demonstrated that vein grafts of both groups exhibited wall thickening, but that the degree of graft neointimal hyperplasia and reduction of the graft lumen was greater in the control group than that in the treatment group. The occlusion rate of grafts in the control group was 20%. All grafts in the treatment group were patent.

CONCLUSIONSPro-UK gene transfer before vein grafting in vitro results in a high level of gene expression in the vein graft from the 7th day to 14th day. And its gene expression in the vein graft could reduce neointimal hyperplasia in the vein graft.

Animals ; Gene Expression ; Gene Transfer Techniques ; Hyperplasia ; Jugular Veins ; transplantation ; Male ; Rats ; Rats, Wistar ; Recombinant Proteins ; genetics ; Tunica Intima ; pathology ; Urokinase-Type Plasminogen Activator ; genetics ; Veins ; pathology ; transplantation

We report a case of central venous stenosis due to a structural deformity caused by a tuberculosis-destroyed lung in a 65-year-old woman. The patient presented with left facial edema. She had a history of pulmonary tuberculosis, and the chest X-ray revealed a collapsed left lung. Angiography showed leftward deviation of the innominate vein leading to kinking and stenosis of the internal jugular vein. Stent insertion improved her facial edema.
Aged ; Brachiocephalic Veins/*pathology/radiography ; *Central Venous Pressure ; Constriction, Pathologic/*etiology/pathology/therapy ; Edema/therapy ; Female ; Humans ; Jugular Veins/pathology/radiography ; Stents ; Tuberculosis, Pulmonary/*complications/pathology/radiography ; Vascular Diseases/*etiology/pathology/therapy

Primary cardiac tumors are extremely rare and can originate within the heart or be the result of tumor spread from other sites. We report a female patient with a pulmonary vein tumor extending into the left atrium that had a suspicious primary malignant origin with a sacral metastatic carcinoma. The patient was admitted complaining of pain in her buttock area as a result of a sacral tumor. It was believed that the sacral tumor was a metastasis from the imaging study and clinical manifestation. The primary malignant origin was evaluated. The chest CT showed a left atrium thrombus-like lesion without a pulmonary abnormality. After a transesophageal echocardiogram, the patient was diagnosed with a pulmonary vein tumor extending to the left atrium. The patient was given palliative radiotherapy for the sacral pain. Initially, the clinical impression was a metastatic sacral tumor with a thromboembolism of the left atrium. However, this patient was finally diagnosed with a pulmonary vein tumor with a left atrium extension by a transesophageal echocardiogram.
Vascular Neoplasms/*diagnosis/pathology ; Thromboembolism/diagnosis ; Sacrococcygeal Region/pathology ; Pulmonary Veins/*pathology ; Palliative Care ; Humans ; Heart Neoplasms/*diagnosis/pathology ; Heart Atria/*pathology ; Female ; Diagnosis, Differential ; Aged