• Journal of Korean Neurosurgical Society
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• 제48권6호
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• pp.528-531
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• 2010

Ehlers-Danlos syndrome (EDS) type IV is characterized by its clinical manifestations, which are easy bruising, thin skin with visible veins, and rupture of arteries, uterus, or intestines. Arterial complications are the leading cause of death in vascular EDS because they are unpredictable and surgical repair is difficult due to tissue fragility. The authors report a case presented with cervical radiculopathy due to a segmental fusiform aneurysm of the cervical vertebral artery. Transfemoral cerebral angiography (TFCA) was done to verify the aneurysmal dilatation. However, during TFCA, bleeding at the puncture site was not controlled, skin and underlying muscle was disrupted and profound bleeding occurred during manual compression after femoral catheter removal. Accordingly, surgical repair of the injured femoral artery was performed. At this time it was possible to diagnose it as an EDS with fusiform aneurysm on cervical vertebral artery. Particularly, cervical fusiform aneurysm is rare condition, and therefore, connective tissue disorder must be considered in such cases. If connective tissue disorder is suspected, the authors suggest that a noninvasive imaging modality, such as, high quality computed tomography angiography, be used to evaluate the vascular lesion to avoid potential arterial complications.

• Archives of Plastic Surgery
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• 제32권5호
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• pp.648-652
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• 2005

In 1940, Kasabach and Merritt first described the association of a large vascular tumor and thrombocytopenia and termed this Kasabach-Merritt(KM) syndrome. It is characterized by a rapidly enlarging vascular anomaly and consumptive coagulopathy with thrombocytopenia, prolonged prothrombin time and partial thromboplastin time, hypofibrinogenemia, and the presence of D-dimer and fibrin split product, with or without microangiopathic hemolytic anemia. This is a potentially life-threatening condition with mortality rates from 20 to 30% as a result of severe sepsis, coagulopathy, or invasion of vital organs. Treatment modalities are corticosteroids, interferon alfa-2a or 2b, chemotherapy(vincristine, cyclophosphamide, etc.), aspirin, dipyridamole, com- pression, radiation therapy, embolization of feeding vessels and surgical excision. A standard treatment regimen for KM syndrome has not been established and most reports on definitive management of these complex vascular lesions have been anecdotal, involving small numbers of patients. The authors have successfully treated a patient of KM syndrome with actively bleeding huge hemangioma by surgical excision. They present it with the review of articles.

• Journal of Chest Surgery
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• 제44권4호
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• pp.314-317
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• 2011

A bronchial artery aneurysm (BAA) is uncommon and usually associated with chronic inflammatory lung disease or a systemic vascular condition, which is rarely the etiology of mediastinal hemorrhage. A middle-aged person presented with spontaneous hemothorax and hemomediastinum. A diagnostic evaluation identified a bronchial artery aneurysm as the source. To prevent further rupture, we performed a bronchial artery embolization. In the absence of trauma or other causes for hemothorax and mediastinal hemorrhage, the possibility of a BAA should be considered. A bronchial artery aneurysm can be managed by interventional techniques as well as surgery.

• 대한수의학회지
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• 제6권1호
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• pp.76-81
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• 1966

This study was conducted to observe the condition of the ramification of the bronchus and pulmonary blood vascular system by injection of vinylite into the bronchial tree and pulmonary blood vessels in normal adult swines. The results obtained were summarized as follows. 1. Lungs of swine were composed of the same pulmonary territories as in lungs of human and dog. 2. Bronchial tree of swine also were axial divergency in the patterns. 3. Ramification of the left and right apical lobes are especially complex patterns but cardiac and diaphragmatic lobes are a little monotonous. 4. Intermediate lobe corresponding to mediobasalis branch of human lungs formed only one lobe in swine lung. 5. Pulmonary artery of right apical lobe was mono branch form in all case by authors observation. 6. $B._2$ streched into the seg. dorsalis of the right apical lobe was especially developed compare to $B._1$, $B._3$ of the seg, apicalis and seg, ventralis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권2호
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• pp.66-73
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• 2009

Tumor angiogenesis is a process leading to formation of blood vessels within tumors and is crucial for maintaining a supply of oxygen and nutrients to support tumor growth and metastasis. Vascular endothelial growth factor(VEGF) plays a key role in tumor angiogenesis including induction of endothelial cell proliferation, migration, survival and capillary tube formation. VEGF binds to two distinct receptors on endothelial cells. VEGFR-2 is considered to be the dominant signaling receptor for endothelial cell permeability, proliferation, and differentiation. Bevacizumab(Avastin, Genetech, USA) is a monoclonal antibody against vascular endothelial growth factor. It is used in the treatment of cancer, where it inhibits tumor growth by blocking the formation of new blood vessels. The goal of this study is to identify the anti-tumor effect of Bevacizumab(Avastin) for oral squamous cell carcinoma cell lines. Human squamous cell carcinoma cell line(HN4) was used in this study. We examined the sensitivity of HN4 cell line to Bevacizumab(Avastin) by using in vitro proliferation assays. The results were as follows. 1. In the result of MTT assay according to concentration of Bevacizumab(Avastin), antiproliferative effect for oral squamous cell carcinoma cell lines was observed. 2. The growth curve of cell line showed the gradual growth inhibition of oral squamous cell carcinoma cell lines after exposure of Bevacizumab(Avastin). 3. In the apoptotic index, groups inoculated Bevacizumab(Avastin) were higher than control groups. 4. In condition of serum starvation, VEGFR-2 did not show any detectable autophosphorylation, whereas the addition of VEGF activated the receptor. Suppression of phosphorylated VEGFR-2 and phosphorylated MAPK was observed following treatment with Bevacizumab(Avastin) in a dose-dependent manner. 5. In TEM view, dispersed nuclear membrane, scattered many cytoplasmic vacuoles and localized chromosomal margination after Bevacizumab(Avastin) treatment were observed. These findings suggest that Bevacizumab(Avastin) has the potential to inhibit MAPK pathway in proliferation of oral squamous cell carcinoma cell lines via inhibition of VEGF-dependent tumor growth.

• Journal of Ginseng Research
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• 제44권2호
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• pp.300-307
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• 2020

Background: Emerging evidence suggests that endothelial-to-mesenchymal transition (EndMT) in endothelial dysfunction due to persistent inflammation is a key component and emerging concept in the pathogenesis of vascular diseases. Ginsenoside Rg3 (Rg3), an active compound from red ginseng, has been known to be important for vascular homeostasis. However, the effect of Rg3 on inflammation-induced EndMT has never been reported. Here, we hypothesize that Rg3 might reverse the inflammation-induced EndMT and serve as a novel therapeutic strategy for vascular diseases. Methods: EndMT was examined under an inflammatory condition mediated by the NOD1 agonist, γ-d-glutamyl-meso-diaminopimelic acid (iE-DAP), treatment in human umbilical vein endothelial cells. The expression of EndMT markers was determined by Western blot analysis, real-time polymerase chain reaction, and immunocytochemistry. The underlying mechanisms of Rg3-mediated EndMT regulation were investigated by modulating the microRNA expression. Results: The NOD1 agonist, iE-DAP, led to a fibroblast-like morphology change with a decrease in the expression of endothelial markers and an increase in the expression of the mesenchymal marker, namely EndMT. On the other hand, Rg3 markedly attenuated the iE-DAP-induced EndMT and preserved the endothelial phenotype. Mechanically, miR-139 was downregulated in cells with iE-DAP-induced EndMT and partly reversed in response to Rg3 via the regulation of NF-κB signaling, suggesting that the Rg3-miR-139-5p-NF-κB axis is a key mediator in iE-DAP-induced EndMT. Conclusion: These results suggest, for the first time, that Rg3 can be used to inhibit inflammation-induced EndMT and may be a novel therapeutic option against EndMT-associated vascular diseases.

• 생명과학회지
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• 제22권12호
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• pp.1595-1599
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• 2012

혈관 증식 질환에서 세포주기 활성화와 진행은 중요한 치료 목적으로 사용된다. Luteolin는 glycosylated 형태로 샐러리, 후추, 들깨 잎 그리고 카밀레 차에 존재하며 항돌연변이, 항종양, 항산화 그리고 항염증을 나타낸다. 본 연구에서는 흰쥐 동맥으로부터 분리한 혈관평활근세포를 배양하여 소태아혈청으로 유도된 증식에서 luteolin 효과에 대해 조사했다. Luteolin이 5% 소태아혈청으로 유도된 흰쥐의 혈관평활근세포 증식과 DNA 합성을 5, 20 그리고 $50{\mu}M$에서 억제했다. 혈관평활근세포 증식을 각각 29.6, 50.8 그리고 83.1% 억제했고 DNA 합성은 각각 25.8, 57.6 그리고 81.0% 억제했다. 게다가, 유세포분석 결과 소태아혈청으로 유도된 혈관평활근세포의 세포주기는 luteolin에 의해 차단되었다. 이러한 결과는 세포독성에 의해서도 나타날 수 있기 때문에 WST-1 분석으로 세포독성을 확인한 결과 세포독성 없이 세포주기를 차단하는 효과임을 확인했다. 이상의 결과들은 luteolin이 혈관스텐트와 동맥경화의 치료를 위한 의미있는 항증식 물질임을 보여준다.

• Archives of Plastic Surgery
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• 제48권4호
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• pp.395-403
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• 2021

Background Groin wounds occurring after vascular surgical site infection, oncologic resection, or occasionally orthopedic surgery and trauma may represent a surgical challenge. Reconstruction of these defects by the usual workhorse flaps may be contraindicated following previous surgery and in patients with lower limb lymphedema or extreme morbidity. Methods This study included 15 consecutive patients presenting with inguinal wounds after vascular or general surgery that required debridement and soft tissue coverage. All cases had absolute or relative contraindications to conventional reconstructive techniques, including a compromised deep femoral artery network, limb lymphedema, scarring of potential flap harvesting sites, or poor overall condition. Abdominal adipocutaneous excess enabled the performance of adipocutaneous advancement flaps in an abdominoplasty-like fashion. Immediate and long-term outcomes were analyzed. Results Soft tissue coverage was effective in all cases. Two patients required re-intervention due to flap-related complications (venous congestion and partial flap necrosis). All patients fully recovered over a mean±standard deviation follow-up of 2.4±1.5 years. Conclusions Abdominal flaps can be an effective and simple alternative technique for inguinal coverage with reproducible outcomes. In our experience, the main indications are a compromised deep femoral artery network and poor thigh tissue quality. Relative contraindications, such as previous open abdominal surgery, should be considered.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.115-120
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• 2022

Background In addition to vascular endothelial cells, vascular smooth muscle cells (VSMCs) are subject to continuous shear stress because of blood circulation. The angiogenic properties of VSMCs in extracranial arteriovenous malformations (AVMs) may exceed those of normal blood vessels if the body responds more sensitively to mechanical stimuli. This study was performed to investigate the hypothesis that rapid angiogenesis may be achieved by mechanical shear stress. Methods VSMCs were obtained from six patients who had AVMs and six normal controls. The target genes were set to angiopoietin-2 (AGP2), aquaporin-1 (AQP1), and transforming growth factor-beta receptor 1 (TGFBR1). Reverse-transcriptase polymerase chain reaction (RT-PCR) and real-time PCR were implemented to identify the expression levels for target genes. Immunofluorescence was also conducted. Results Under the shear stress condition, mean relative quantity values of AGP2, AQP1, and TGFBR1 in AVM tissues were 1.927±0.528, 1.291±0.031, and 2.284±1.461 when compared with neutral conditions. The expression levels of all three genes in AVMs were higher than those in normal tissue except for AQP1 under shear stress conditions. Immunofluorescence also revealed increased staining of shear stress-induced genes in the normal tissue and in AVM tissue. Conclusions Shear stress made the VSMCs of AVMs more sensitive. Although the pathogenesis of AVMs remains unclear, our study showed that biomechanical stimulation imposed by shear stress may aggravate angiogenesis in AVMs.

• Journal of Chest Surgery
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• 제40권4호
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• pp.264-272
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• 2007

배경: 혈관내피 성장인자(vascular endothelial growth factor, VEGF)는 혈관평활근세포(vascular smooth muscle cell)의 증식과 이동을 촉진함으로써 혈관신생에 중요한 역할을 한다. 당뇨병은 VEGF의 발현과 연관되어 정상 혈당상태에서 보다 세포의 증식을 더욱 촉진시킨다. 당뇨병쥐에서 VEGF 수용체의 선택적 차단이 손상된 혈관에서 신내막 형성과 혈관평활근세포의 이동에 미치는 영향에 대해 알아보고자 했다. 대상 뜻 방법: 당뇨병 쥐의 경동맥 풍선손상 모델에서 위약을 투여하거나, 혈관내피 성장 인자 수용체-1(VEGFR-1)에 선택적으로 작용하는 항-Flt-1 펩타이드(anti-Flt-1 peptide; Gly-Asn-Gln-Trp-Phe-Ile)를 풍선손상 2일 전부터 0.5mg/kg의 용량으로 2주간 매일 투여한 군으로 나누어 Hematoxylin-Eosin 염색을 하여 신내막의 형성정도와 혈관내강의 협착정도를 비교하였으며, proliferative cell nuclear antigen (PCNA)에 대한 면역조직화학염색법을 시행하여 세포의 증식정도를 관찰하였다. 혈관평활근세포를 고혈당환경에서 배양하고 transwell assay를 시행하여 혈관평활근세포의 이동 정도를 측정하였다. 고혈당 환경에서 자라고 있는 혈관평활근세포에 50ng/mL의 VEGF를 단독 또는 3ug/mL의 항-Flt-1 펩타이드와 함께 처리하고 일정시간이 지난 후 matrigel filter를 통과한 세포를 세어 아무런 처치를 받지 않은 세포가 이동한 정도와 비교하였다. 또한, 혈관평활근세포에 세포이동 정도 측정 시와 같은 처리를 한 후, RNA를 분리하고 reverse transcription-polymerase chain reaction (RT-PCR)을 시행하여 기질금속단백분해효소(matrix metalloprotenase, MMP)의 발현 정도를 관찰하였다. 결과: 신내막의 면적은 위약 투여 쥐는 $0.24{\pm}0.03 mm^2$이었으나, 항-Flt-1 펩타이드의 처리에 의해 $0.15{\pm}0.04 mm^2$로 유의하게 감소하였으며(p<0.01), 신내막 형성에 따른 내강의 협착 정도도 위약 투여 쥐는 $61.85{\pm}5.11%$, 항-Flt-1 펩타이드 투여 쥐는 $36.03{\pm}3.78%$로 항-Flt-1 펩타이드 투여에 의하여 유의하게 감소하였다(p<0.01). 신내막의 전체 세포수에 대한 PCNA(+)인 세포를 백분율로 구하였으며, 위약 투여 쥐와 항- Flt-1 펩타이드 투여 쥐에서 각각 $52.82{\pm}4.20%,\;38.11{\pm}6.89%$로 나타나 항-Flt-1 펩타이드를 투여한 쥐에서 PCNA(+)인 세포가 유의하게 적음을 보이고 있다(p<0.05). 혈관평활근세포의 이동 정도 측정에서는 항-Flt-1 펩타이드 처리에 의하여 VEGF에 의한 혈관평활근 세포의 이동이 유의하게 감소하였다(p<0.01). 또한, 항-Flt-1 펩타이드 처리에 의하여 VEGF에 의한 MMP-3와 MMP-9 mRNA의 발현 증가가 억제되었다. 결론: 항-Flt-1 펩타이드는 당뇨병쥐의 경동맥손상모델에서 신내막 형성을 억제하였으며, 고혈당 환경에서 배양된 혈관평활근세포의 이동과, MMP-3와 MMP-9의 활성을 억제하였다.