This research was conducted to compare differences in colon cancer lymphatic vessel invasion (LVI) with D2-40 antibody labeling and regular HE staining, blood vessel invasion (BVI) with CD34 antibody labeling and HE staining and to assess the possibility of using D2-40-LVI/CD34-BVI in combination for predicting stage II colon cancer prognosis and guiding adjuvant chemotherapy.Anti-D2-40 and anti-CD34 antibodies were applied to tissue samples of 220 cases of stage II colon cancer to label lymphatic vessels and small blood vessels, respectively. LVI and BVI were assessed and multivariate COX regression analysis was performed for associations with colon cancer prognosis. Regular HE staining proved unable to differentiate lymphatic vessels from blood vessels, while D2-40 selectively labeled lymphatic endothelial cell cytosol and CD34 was widely expressed in large and small blood vessels of tumors as well as normal tissues. Compared to regular HE staining, D2-40-labeling for LVI and CD34-labeling for BVI significantly increased positive rate (22.3% vs 10.0% for LVI, and 19.1% vs 9.1% for BVI). Multivariate analysis indicated that TNM stage, pathology tissue type, post-surgery adjuvant chemotherapy, D2-40-LVI, and CD34-BVI were independent factors affecting whole group colon cancer prognosis, while HE staining-BVI, HE staining-LVI were not significantly related. When CD34-BVI/D2-40-LVI were used in combination for detection, the risk of death for patients with two or one positive results was 5.003 times that in the LVI(-)&BVI(-) group (95% CI 2.365 - 9.679). D2-40 antibody LVI labeling and CD34 antibody BVI labeling have higher specificity and accuracy than regular HE staining and can be used as molecular biological indicators for prognosis prediction and guidance of adjuvant chemotherapy for stage II colon cancer.
Ciudad, Pedro;Escandon, Joseph M.;Manrique, Oscar J.;Bustos, Valeria P.
Archives of Plastic Surgery
/
v.49
no.2
/
pp.227-239
/
2022
Complications experienced during lymphatic surgery have not been ubiquitously reported, and little has been described regarding how to prevent them. We present a review of complications reported during the surgical management of lymphedema and our experience with technical considerations to reduce morbidity from lymphatic surgery. A comprehensive search across different databases was conducted through November 2020. Based on the complications identified, we discussed the best approach for reducing the incidence of complications during lymphatic surgery based on our experience. The most common complications reported following lymphovenous anastomosis were re-exploration of the anastomosis, venous reflux, and surgical site infection. The most common complications using groin vascularized lymph node transfer (VLNT), submental VLNT, lateral thoracic VLNT, and supraclavicular VLNT included delayed wound healing, seroma and hematoma formation, lymphatic fluid leakage, iatrogenic lymphedema, soft-tissue infection, venous congestion, marginal nerve pseudoparalysis, and partial flap loss. Regarding intra-abdominal lymph node flaps, incisional hernia, hematoma, lymphatic fluid leakage, and postoperative ileus were commonly reported. Following suction-assisted lipectomy, significant blood loss and transient paresthesia were frequently reported. The reported complications of excisional procedures included soft-tissue infections, seroma and hematoma formation, skin-graft loss, significant blood loss, and minor skin flap necrosis. Evidently, lymphedema continues to represent a challenging condition; however, thorough patient selection, compliance with physiotherapy, and an experienced surgeon with adequate understanding of the lymphatic system can help maximize the safety of lymphatic surgery.
The hemal nodes of the Korean native cattle were studied by gross anatomy and light microscopy. Hemal nodes were spherical or ovoid in shape, and red or black in colors. A hemal node consisted of a thick capsule and a hilum, and had extensive subcapsular and deep sinuses distended by a great number of erythrocytes. Although a few lymphatic nodules and tissues were seen in the parenchyma, no typical cortex and medulla was defined. Blood vessels occurred, but lymph vessel was not observed in nodes. The stroma of the hemal node was composed of reticular cells and fibers. The parenchyma consisted of many erythrocytes and lymphocytes, and a few macrophages and megakaryocytes. The capsule and trabecula was a collagenous connective tissue with smooth muscle cells. B-lymphocytes were principally located in the lymphatic nodules of the hemal node. T-lymphocytes were scattered in the diffuse lymphatic tissues of the hemal node.
This study was performed to investigate the gross anatomical features and microscopical structures of the hemal nodes and the hemolymph nodes in the water deer (Hydropotes inermis) found in Kangwon-do, Korea. The hemal nodes and hemolymph nodes were observed mainly in the periphery of the thoracic and abdominal aortae of the animals. The size of hemal nodes was generally smaller than that of the hemolymph nodes, and the shape of the both organs was spherical or ovoid. The color of the hemal nodes was red or black while that of the hemolymph nodes was gray with red bands. The hemal nodes were surrounded by a thin connective tissue capsule and there were extensive subcapsular and deep sinuses distended by a great number of erythrocytes. Although a few number of lymphatic nodules and small areas of diffuse lymphatic tissues were observed in the parenchyma, no typical cortex and medulla were defined in the hemal node. Small numbers of blood vessels were found at the connective tissue capsule but lymph vessel was not observed microscopically in this organ. The hemolymph nodes were covered by a relatively thick connective tissue capsule and there was a hilus in each node. The parenchyma was divided into cortex and medulla. The cortex was composed of a few numbers of lymphatic nodules and some diffuse lymphatic tissues. The medulla comprised medullary sinus and cords. Afferent and efferent lymph vessels were observed at the periphery of the capsule and the hilus, respectively. The subcapsular and medullary sinuses were not extensive but filled with small numbers of erythrocytes. The stroma of hemal node and hemolymph node was composed of reticular cells and fibers, and the capsule and trabecula consisted of collagenous fibers with smooth muscle fibers.
Deer hemal nodes were studied by gross anatomy and light microscopy. Hemal nodes were scattered in the periphery of thoracic and abdominal aortae, and spherical or avoid in shape. A hemal node consisted of a thin capsule and a hilum, and had numerous small subcapsular and deep sinuses distended by a great number of erythrocytes. Although a few lymphatic nodules and tissues were seen in the parenchyma, no typical cortex and medulla was defined. Blood vessels occurred, but lymph vessel was not observed in nodes. The parenchyma of the hemal node consisted of many erythrocytes and lymphocytes, and a few granulocytes, plasma cells megakaryocytes and macrophages. The stroma was composed of reticular cells and fibers. The capsule and trabecula was a collagenous connective tissue with smooth myofibers. The above findings suggest that the hemal nodes are involved in blood storage, blood filtration and immune reaction.
Background Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. Methods Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. Results Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. Conclusions Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.
Park, Cheol-beom;Seong, Je-kyung;Lee, In-se;Lee, Heungshik S.;Lee, Joon-sup;Yoon, Yeo-sung
Korean Journal of Veterinary Research
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v.41
no.3
/
pp.287-292
/
2001
It has been known that the hemolymph node is one of the lymphoid organs found normally in ruminants and some rodents, and this organ shares morphological and functional characteristics of lymph node and spleen. To clanify the rigorous definition of morphological structures and functions of the hemolymph node in Wistar Kyoto(WKY)rats, we examined these organs of WKY rats gross anatomically and light microscopically. The hemolymph nodes were normally found in the abdominal cavity and in the neck of WKY rats. This organ was surrounded by a thin connective tissue capsule and there was a hilus. The parenchyma comprised a cortex of lymphatic nodules and diffuse lymphatic tissues, and a medulla of diffuse lymphatic tissues arranged in cords. Afferent and efferent lymph vessels were observed but there was no extensive subcapsular and medullary sinuses. These sinuses were filled with erythrocytes. The stroma of hemolymph nodes was composed of reticular cells and fibers, and many lymphocytes, granulocytes, erythrocytes, plasma cells, macrophages and megakaryocytes were supported by the reticular network. The above findings suggest that the hemolymph nodes of WKY rats may take part in blood formation, blood filtration and immune reaction.
Park, Cheol-beom;Seong, Je-kyung;Lee, In-se;Lee, Heungshik S.;Lee, Joon-sup;Yoon, Yeo-sung
Korean Journal of Veterinary Research
/
v.40
no.4
/
pp.671-675
/
2000
It has been known that the hemolymph node is one of the lymphoid organs found normally in ruminants and some rodents, and this organ shares morphological and functional characteristics of lymph node and spleen. To clarify the rigorous definition of morphological structures and functions of the hemolymph node in Sprague-Dawley(SD) rats, we examined these organs of SD rats gross anatomically and light microscopically. The hemolymph nodes were normally found in the abdominal cavity and in the neck of SD rats. This organ was surrounded by a thin connective tissue capsule and there was a hilus. The parenchyma comprised a cortex of lymphatic nodules and diffuse lymphatic tissues, and a medulla of diffuse lymphatic tissues arranged in cords. Afferent and efferent lymph vessels were observed but there was no extensive subcapsular and medullary sinuses. These sinuses were filled with erythrocytes. The stroma of hemolymph nodes was composed of reticular cells and fibers, and many lymphocytes, granulocytes, erythrocytes, plasma cells, macrophages and megakaryocytes were supported by the reticular network. The above findings suggest that the hemolymph nodes of SD rats may take part in blood formation, blood filtration and immune reaction.
Hemolymph nodes of the Korean native cattle were observed gross anatomically and light microscopically in this study. Hemolymph nodes of the Korean native cattle were found mainly at the periphery of the thoracic and abdominal aortae although there were some other parts to observe these small organs. These organs were small in size and spherical or ovoid in shape, and color of them was dark red or gray in common with red band. The hemolymph nodes were surrounded by a relatively thick connective tissue capsules composed of dense collagen fibers with many scattered smooth muscle fibers and there was a hilus in each node. The parenchyma was divided into an outer cortex and an inner medulla. A few primary and secondary lymph nodules were observed in the cortex and there were diffuse lymphatic tissues among them. The medullary cords consisted of diffuse lymphatic tissues were separated by the medullary sinuses which filled with erythrocytes. The afferent and efferent lymph vessels were observed at the periphery of the capsule and the hilus area, respectively. The stroma of the hemolymph nodes was composed of reticular cells and fibers, and the meshwork of the stroma was filled with many lymphocytes and erythrocytes, and a few macrophages and megakaryocytes etc. These findings suggest that the hemolymph node of the Korean native cattle is involved in blood filtration and immune reaction.
Hemal nodes and hemolymph nodes are lymphoid organs which share morphologic and functional characteristics of lymph nodes and spleens. Hemal nodes and hemolymph nodes are normally present in Korean native goats. Hemal nodes bad extensive subcapsular and deep sinuses distended by a great number of erythrocytes, and no typical cortex and medulla were observed. Blood vessels commonly occurred, but lymph vessel was not observed in the hemal node. Hemolymph nodes had distinct cortex and medulla, and also had afferent and efferent lymph vessels. The aim of the present study was to obtain new information on the distinct morphological structures of hemal nodes and hemolymph nodes according to ages, and have the basic data for their functions. Goats are divided into 5 groups, consisting of 3 animals aged 1, 3, 6, 10, and 12 months. The morphological studies of the organs were carried out by gross anatomy, light microscopy and immunohistochemistry. During aging, there was an increase in the size of the organs, while there were no significant changes of their numbers, locations and colors. As the goat got older, the lymphatic nodules of hemal nodes were more developed, and the number of macrophage containing phagocytosed erythrocytes was more increased. As the goat was younger, the lymphatic tissues of hemolymph nodes were less developed. There was no difference in distribution of T- and B- lymphocytes according to ages.
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