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Objective: To discuss the treatment for hemangiomas and vascular malformations. Methods: A retrospective study was conducted on 381 patients with hemangiomas and vascular malformations (January of 1998 to June of 2006). The patients consisted of 167 males and 214 females, with an age range from 1 year to 78 years (median age 16 years). According to the biological classification system introduced by Mulliken in 1982, 98 patients had hemangiomas, 38 had capillary malformations,203 had venous malformations, 27 had arteriovenous malformations and 15 had lymphatic malformations. In all patients with hemangiomas,71 patients were treated with intralesional steroids, 20 patients underwent surgical excision, 7 patients were carefully monitored by doctors. In 38 patients with capillary malformations, 27 underwent sclerosant, others were subjected to laser therapy or surgery. In 203 patients with venous malformation, 136 received sclerotherapy, 21 received surgical excision, and 11 underwent sclerotherapy conjunction plus surgical excision. Twenty-seven patients with arteriovenous malformations received sclerotherapy,interventional therapy,or sclerotherapy conjunction plus surgical excision. Fifteen patients with lymphatic malformations received sclerotherapy conjunction plus surgical excision. Results: All patients were followed-up for 0.5-6 years. Follow-up result showed that 199 patients were cured, 125 were greatly improved,and 46 were partly improved; 10 patients showed no obvious improvement; and 1 patient died. Conclusion: Correct diagnosis and the classification, along with correct treatment strategy, are the keys to increase the treatment outcome and decrease complication of patients with hemangiomas and vascular malformations.
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Objective: To examine the expression of Fas and Fas ligand(FasL) in cultured infantile hemangioma endothelial cells (IHECs). Methods: IHECs were isolated and cultured by explant combined with trypsin-digested techniques. Then the expression of Fas and FasL on cultured endothelial cells (ECs) were detected by flow cytometry (FCM) and fluorescent quantitative polymerase chain reaction (FQ-PCR) 2-ΔΔCT method,and the results in ECs were compared with those in Jurkat cells (positive control) and Human umbilical vein endothelial cells(HUVECs,negative control). Results: The positive rate of Fas in cultured IHECs was (90.97±2.36)% as detected by FCM,similar to that in the Jurkat cells ([93.87±1.64]%,P>0.05) and significantly higher than that in the HUVECs (P0.05); the ratio of IHECs to HUVECs (0.354±0.170) was 3.56 and there was significant difference between the 2 groups (P<0.01). The expression of FasL mRNA in cultured IHECs,Jurkat cells and HUVECs was too low as detected by FCM and FQ-RCR to have any biological significance. Conclusion: Fas mRNA is highly expressed in cultured IHECs and FasL is rarely expressed in IHECs, which indicates that apoptosis of IHECs is associated with high expression of Fas in IHECs.
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Objective: To explore a novel method for cultivation of the endothelial cells(EC) from infantile hemangiomas (IH) in vitro and observe the biological character of cultured endothelial cells. Methods: Fresh operative specimens were obtained from infantile hemangiomas. The endothelial cells of IH were cultured by explant combined with trypsin-digestion technique. Immunohistochemical staining of EnVision method was carried out to identify the cultured cells. The purity of endothelial cell was examined by flow cytometry analysis of FITC-CD34. The biologic characters of endothelial cells were observed under inverted phase contrast microscope. Results: Endothelial cells were successfully cultured from 8 IH specimens of all the 14 explants. The morphology of cultured endothelial cells included two types:polygonal cells and fusifourm cells. The cultured cells were homogenously positive for EC markers-vWF or CD34, indicating their EC origin. Tube formation was found in endothelial cells of 1H. The proportion of CD34+ cells was 76.28% in cultured endothelial cells as detected by flow cytometry analysis. Conclusion: ECs can be successfully isolated and cultured from infantile hemangiomas by explant combined with trypsin-digestion technique; the cultured cells have some characters of endothelial cells.
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Objective: To investigate the changes of local skin temperature in congenital arteriovenous malformations (CAVM) patients before and after treatment, and to assess the relationship between the changes of skin temperature and the outcomes of surgical treatment. Methods: From Sept. 2002 to Apr. 2006, skin temperatures around the lesions were measured in 22 CAVM patients with WMY-01 digital thermometer before and after surgical treatments, and the opposite side or adjacent skins were taken as controls. Furthermore, changes of flow signals and blood flow velocities in the lesions were measured by color Doppler ultrasonography pre- and post-operatively. Results: Skin temperatures of local lesions decreased from (35.58 ±0.68)°C pre-operatively to (34.76±0.63)°C post-operatively(P<0.01); however, the post-operative skin temperature of the lesions was still higher than that of normal skin(34.23±0.83)°C (P<0.05). Post-operatively, color Doppler flow image showed 100% occlusion of blood flow in 1 patient, more than 66.7% occlusion in 14 patients, more than 33.3% but less than 66.7% occlusion in 6 patients, and no occlusion in 1 patient; there was significant difference between those pre- and post-operation(P<0.01). The average blood flow velocity decreased from (80.86±6.97) cm/s pre-operatively to (50.72±5.85) cm/s post-operatively (P<0.01). Conclusion: A significant reduction of surface temperature in CAVMS lesions can be achieved by surgical treatment, and the temperature decrease of the lesion may be used as an indicator for the evaluation of treatment outcomes.