Pain and Power Doppler Ultrasonographic Evaluation according to Bursal Preservation after Arthroscopic Rotator Cuff Repair: Comparison between Complete and Minimal Bursectomy in Early 3 Months / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to compare the clinical and power Doppler ultrasonographic results of arthroscopic rotator cuff repair (ARCR) between using a complete and a minimal bursectomy. Moreover, we aimed to evaluate the pain-relief and neoangiogenesis according to bursal preservation. MATERIALS AND METHODS: Between December 2015 and August 2016, we performed a retrospective review of 78 consecutive patients who underwent ARCR due to full thickness rotator cuff tear (small-large sized tear). Thirty-six patients received ARCR using minimal bursectomy (Group A), while 42 patients received ARCR via complete bursectomy (Group B). The mean age was 57.8 years and the average symptom duration period was 20.3 months. Clinical result was assessed using a visual analogue scale (VAS) pain score due to evaluate the pain-relief and power Doppler ultrasonographic result was classified according to the modified Newman classification due to evaluate the neoangiogenesis. RESULTS: There was no statistically significant difference in operation time, pain-relief, and neoangiogenesis in accordance with bursal preservation between the two groups. Compared to the preoperative values, pain was significantly increased two weeks postoperatively in both groups (Group A: −1.8±1.4, p=0.000; Group B: −1.4±1.7, p=0.000). Compared to the preoperative values using the power Doppler ultrasound, neoangiogenesis was significantly improved at the postoperative 6 weeks (Group A: 0.7±0.9, p=0.000; Group B: 0.9±1.1, p=0.000) and 3 months (Group A: 0.9±1.0, p=0.000; Group B: 1.0±1.1, p=0.000) in both groups. CONCLUSION: Serial follow-up by power Doppler ultrasound before and after ARCR showed a neoangiogenesis of up to 3 months in both groups, but there was no difference in pain-relief and neoangiogenesis between the two groups.

Identification of Novel Drug Targets for the Treatment of Diabetic Retinopathy

Vision loss in diabetic retinopathy (DR) is attributable to retinal vascular disorders that result in macular edema and neoangiogenesis. In addition to laser photocoagulation therapy, intraocular injections of antivascular endothelial growth factor drugs have contributed to the treatment of these disease conditions. Nonetheless, the clinical feasibility of intraocular drug administration has raised an increasing demand to develop alternative drugs that can fundamentally ameliorate the retinal vascular dysfunctions in DR. For this purpose, experimental animal models that reproduce human DR would be of clinical benefit. Despite the unavailability of DR models in rats or mice, pharmacological and genetic manipulations without hyperglycemia have successfully recapitulated retinal edema and neoangiogenesis in postnatal mouse retinas, thereby enabling the understanding of the pathophysiology underlying DR. This article highlights the utility of experimental mouse models of retinal vascular abnormalities and discusses cellular and molecular mechanisms responsible for the onset and progression of DR. These approaches will lead to the identification of novel drug targets for the restoration of vascular integrity and regeneration of functional capillaries in DR.

Expression of ERα, its ERαΔ3 Splice Variant and γ-SYNUCLEIN in Ovarian Cancer: A Pilot Study.

Aims: Ovarian cancer has the highest mortality of any gynaecological malignancy; this is due to rapid peritoneal spread of tumour cells and neovascularization. Understanding the mechanisms underlying this is critical to developing early diagnostic or treatment strategies. We devised a pilot study to examine the role of g-SYNUCLEIN (g-SYN), oestrogen receptor (ER)a, and the splice variant ERaΔ3. Methodology: With ethical approval, ovarian tissue was collected from patients (n=24) undergoing oopherectomy for non-ovarian pathology or primary surgery for suspected ovarian cancer. Quantitative gene expression analysis was employed for g-SYN, ERa, and ERaΔ3. To identify the in situ localization, immunofluorescence for g-syn was carried out. Results: Ovarian tumour tissue exhibited an elevated expression of g-SYN and high-grade tumours had an elevated ERaΔ3:ERa ratio compared with benign tissue. The majority of previous studies point to the g-syn protein being present in epithelial cells of high-grade disease. Our study supports this, but additionally we conclusively identify its presence in the endothelial cells of vasculature surrounding low-grade disease; immunofluorescence was strongest in the apical cells surrounding the lumen. Conclusion: Our results demonstrate for the first time that there are readily-expressed levels of g-SYN and ERaΔ3 in normal ovarian tissue and ovarian tumours. In high-grade disease, g-syn and an elevated ERaΔ3:ERa ratio might confer metastatic potential to the tumourigenic cells and promote neoangiogenesis. Future in vitro studies might be necessary to delineate such a mechanism, which could potentially be the basis of early intervention.

The Adjacent Vessel Sign on Breast MRI: New Data and a Subgroup Analysis for 1,084 Histologically Verified Cases

OBJECTIVE: The adjacent vessel sign (AVS) is a descriptor for differentiating malignant from benign breast lesions on breast MRI (bMRI). This investigation was designed to verify the previous reports on the diagnostic accuracy of AVS and to assess correlation between AVS, histopathological diagnosis, lesion size and lesion grade. MATERIALS AND METHODS: This study was approved by the local ethical committee. Experienced radiologists evaluated 1,084 lesions. The exclusion criteria were no histological verification after bMRI and breast interventions that were done up to one year before bMRI (surgery, core biopsy, chemo- or radiation therapy). The native and dynamic contrast-enhanced T1-weighted series were acquired using standardized protocols. The AVS was rated positive if a vessel leading to a lesion could be visualized. Prevalence of an AVS was correlated with the lesions' size, grade and histology using Chi-square-tests. RESULTS: The AVS was significantly associated with malignancy (p 2 cm more often presented with an AVS than did those malignant lesions < 2 cm (p < 0.0001; sensitivity: 65%, PPV: 90%). There was no correlation of the AVS with the tumor grade. The prevalence of an AVS didn't significantly differ between invasive lobular carcinomas versus ductal carcinomas. In situ cancers were less frequently associated with an AVS (p < 0.001). CONCLUSION: The adjacent vessel sign was significantly associated with malignancy. Thus, it can be used to accurately assess breast lesions on bMRI. In this study, the AVS was particularly associated with advanced and invasive carcinomas.

Tendinopatía del mango rotador: análisis histológico e inmunohistoquímico / Shoulder rotator cuff tendinopathy: histological and immunohistochemical analysis

We reviewed 45 biopsies obtained from surgical patients underwent open rotator cuff tear repairs. Routine stains included Hematoxylin_Eosin (which conform the basis for scoring into Riley´s Classification to 64 percent corresponding to type III and 36 percent to type IV), Alcian Blue stain and Masson Tri-Chrome stain; in ten cases we applied immuno-histochemical techniques for PCNA, CD14, CD34 and Tenascin-C markers, using semi-quantitative methods for it analysis. Percentage vascular area measurement was 15 percent (average) for tendinopathy type Riley III and this value lessening progressively according more degenerative lesions appears in type Riley IV. Analysis of neo-angiogenesis foci indicates: a diffuse pattern of appearance, damage in pericyte sheath of neo-vessels with probabilities of developing microhaemorraghes and many inactive neo-blood-vessels. In tendinopathy Riley type IV, greatest expression of chondroid metaplasia, acellularityof tendon tissue and absence of blood vessels were common findings, notshowing signs of repair. Immunohistochemical results showed PCNA+ index in cells equivalent to 35 percent in average, but much lower index were characteristic for type IV; Tenascin-C markation was in correspondence with PCNA+ intensitystain. CD14-CD34 staining was incomplete and weak in areas of neo-angiogenesis. Overall results indicate a progressive compromise of repair capabilities according classification degree.

Se revisan 45 biopsias obtenidas de pacientes operados con cirugía abierta por ruptura completa del mango rotador. Las tinciones utilizadas incluyen H-E (utilizada para clasificar las tendinopatías en la Clasificación de Riley, 64 por ciento tipo III y 36 por ciento tipo IV), tinción de Azul Alcian y Tricrómica de Masson. 10 biopsias fueron tratadas con técnicas inmuno-histoquímicas para PCNA, CD14, CD34 y Tenascin-C y se aplicaron métodos semicuantitativos de análisis. La medición de porcentaje de área vascular mostró un 15 por ciento (promedio) para las tipo III, valor que disminuye de acuerdo a la aparición de lesiones degenerativas en las tipo IV. El análisis de los focos de neoangiogenesis indica un patrón difuso, infiltrativo, con daño en la cubierta de pericitos de los neovasos y tendencia a las micro-hemorragias, con muchos vasos inactivos. En la tendinopatía tipo IV, la aparición de mayor metaplasma condroídea, zonas acelulares y ausencia de vasos sanguíneos fueron hallazgos frecuentes y no se apreciaron signos de reparación. Los resultados inmunohistoquímicos mostraron un índice PCNA+ de 35 por ciento en promedio, encontrándose valores muy inferiores en las tipo IV. La marcación para Tenascin-C estuvo en correspondencia con el índice de PCNA+ y las marcas CD14-34 fueron incompletas y débiles en las áreas de neoangiogénesis. Evaluados en conjunto estos resultados indican un daño progresivo en la capacidad de reparación tisular a medida que transita del tipo Riley III al Riley IV.

The Relationship Between p16 Expression and Angiogenesis as well as Value of CT Enhancment in Peripheral Lung Cancer / 实用放射学杂志

Objective To study the relationship between expression of p16 and tumor angiogenesis as well as value of CT enhancement in peripheral lung cancer. Methods twenty-three patients with peripheral lung cancer were examed with dynamic CT scan before surgery.The MVD、protein expression of VEGF and p16 were measured immunohistochemically on speciments of resected tumors.Results There were negative correlation tendency between expressions of p16 and VEGF,but the difference were no significant.During the course of delaying 30 s from injecting contrast dose,the relating coefficient was the highest between enhanced CT value and MVD,P=0.9364.The mean value of MVD and CT enhancement in the course of delaying 30 s in p16 negative expression group were higher than that in the group of p16 positive expression with no significant.Conclusion p16 negative expression may improve angiogenesis in peripheral lung cancer.