Diagnostic value of 18F-FDG PET/CT versus contrast-enhanced MRI for venous tumour thrombus and venous bland thrombus in renal cell carcinoma

The purpose of this study was to compare the ability of 18F-FDG PET/CT and contrast-enhanced MRI (CEMRI) to detect and grade venous tumour thrombus (VTT) and venous bland thrombus (VBT) in RCC and assess invasion of the venous wall by VTT. The PET/CT and CEMRI data of 41 patients with RCC were retrieved. The difference in maximum standardized uptake value (SUVmax) between VTT and VBT was analysed. According to their pathological diagnosis, the patients were divided into those with and without venous wall invasion. The PET/CT and CEMRI features, including the SUVmax of the primary lesion and VTT, maximum venous diameter, complete occlusion of the vein by VTT, and VTT morphology, were compared between the two groups. All 41 patients had VTT, and eleven of the 41 patients had VBT. The mean SUVmax of the VTT (6.33 ± 4. 68, n = 41) was significantly higher than that of the VBT (1.37 ± 0.26, n = 11; P < 0.001). Ten of the 11 cases of VBT were correctly diagnosed by 18F-FDG PET/CT, and all 11 were diagnosed by CEMRI. Both 18F-FDG PET/CT and CEMRI can effectively detect VTT and distinguish VTT from VBT. 18F-FDG PET/CT is less effective in grading VTT than CEMRI. Complete venous occlusion by VTT indicates venous wall invasion.

Estimation of a minimum laser power with wavelengths of 1.47, 1.56, and 1.68 μm for efficient obliteration of varicose veins

Experiments modelling endovenous laser obliteration (EVLO) are performed. As a result, laser radiation powers Pc at which collagen denaturation, tissue necrosis, and vasa vasorum destruction occur throughout the entire venous-wall thickness and, at the same time, the surrounding tissues are not subjected to unnecessary heating, are found. The main criterion for determining Pc is the achievement of 100% denaturation of venous-wall proteins, confirmed by morphological and calorimetric analysis. The Pc values for laser wavelengths of 1.47, 1.56, and 1.68 mm are found to be 6.0 ± 0.2, 5.0 ± 0.2, and 6.0 ± 0.2 W, respectively. It is established for all wavelengths in use that the temperature of the external venous-wall surface reaches 91 plusmn; 2 deg;C at the corresponding power Pc. We relate the dependence of Pc on the radiation wavelength to the formation of a coagulum on the optical fibre tip moving through a blood-filled vessel. The achievement of temperature necessary for coagulum formation is determined by the simultaneously occurring processes of energy absorption and its dissipation in the form of heat. These processes become more intense with an increase in the absorption coefficient of the medium. A mechanism is proposed to explain the relationship between the Pc value and laser wavelength, based on the influence of the absorption coefficient of medium (blood) on the temperature near the fibre tip.

Impact of statin treatment on patients diagnosed with chronic venous disease. Morphological analysis of the venous wall and clinical implications

Objectives The study evaluates the potential morphological changes that may occur in the venous wall in the case of the patients with chronic venous disease which associates treatment with statins for at least 2 years. Methods Operated patients with chronic venous disease in the CEAP C2-C3 stage were included in the study. 215 venous fragments, collected from 50 patients within the study group and 179 venous fragments collected from 52 patients within the control group were microscopically analysed, evaluating a series of morpho-anatomical parameters. Results In the study group, it was found that, venous reflux predominantly affects small veins, and also, a significant increase in collagen deposits in the adventitia and media tunics, proportional to the thickening of the venous wall. Conclusion Our results indicate possible effects of statins upon the venous morphology. Further studies are needed to determine the impact of these results on daily practice.

Endotelial dysfunction in condition of neoplastic intoxication

In patients with cancer, the risk of pulmonary embolism increases 4-7 times compared to other patients of the same age and similar concomitant diseases. The greatest risk exists after surgery and during chemotherapy. An increase in the risk of thrombosis in cancer patients is a multifactorial complex phenomenon, the causes of which are an increase in the number of platelets, changes in the rheological properties of blood, as well as reactive structural changes in the vascular wall, valves and endotheliocytes. The latter factor of pathogenesis is insufficiently studied and is not used to assess the risks of thrombosis and prevent thrombosis in cancer patients. However, this topic is promising in the search for opportunities to study the pathogenesis of pulmonary embolism, and, accordingly, to assess the risks in different groups of patients and methods of prevention and options for clinical tactics in cases of venous thrombosis.Objective. To find out the dynamics of the concentration of lipid peroxidation products, in particular the activity of phospholipase and catalase in experimental neoplastic intoxication. Material and methods. For the experiment, 12 sexually mature nonlinear male rats with a body weight of 170-180 g were selected. by injecting 7.2 mg/kg into the rat interscapular area at the rate of 0.1 ml of dimethylhydrazine hydrochloride (DMG) solution 1.2 – DMG (SIGMA-ALDRICH CHEMIE, Japan, D161802 series), previously diluted with isotonic sodium chloride solution per 10 grams of rat body weight, a tumor was modeled intoxication. On day 30 of the experiment, the animals were sacrificed, and the material of the venous wall of the lower extremities was studied for the morphological structure of the vascular wall.Results and Discussion. Morphological examination of the drug revealed platelet thinning, desquamation and microscopic reorganization of endotheliocytes, focal loss of endothelial layer integrity, and wavy thickening of the intima. This complex of phenomena can be the basis of the pathogenesis of thrombosis in combination with a violation of hemodynamics and rheological properties of blood. On day 30 of the experiment, a morphological study of the drug was performed on the venous wall of rats.Conclusions. Changes that were detected after modeling chronic tumor intoxication include endothelium changes in the form of desquamation and reorganization, violation of the integrity of the endothelial layer, wavy thickening of the intima, fibrotic changes in all the membranes of the vessel.

Venous discirculation and cognitive impairment

This article considers the aging impact on the functional and structural integrity of venous cerebral circulation from the standpoint of potential mechanisms involved in the pathogenesis of neurodegeneration and cognitive decline. It was reported about venous collagenosis in the brain with apparent leukoaraiosis that demonstrates the participation of pathological re-structure of the venous wall in impairment of white matter both in natural aging and in Alzheimer’s disease. It is likely that due to an age-related decrease in elasticity, the internal jugular vein loses its compensatory ability to increase transmural pressure and therefore results in venous hypertension in the cerebral venous system. Diosminum increases the tone of venous and lymphatic vessels, decreases venous and lymphatic stasis, strengthens the capillary walls and reduces their permeability, has anti-inflammatory, antiedemic, and analgesic effects, improves microcirculation and tissue trophicity, prevents thrombosis. Hesperidin strengthens the walls of small vessels that reduces their permeability and therefore decreases the edemas.

The expression of matrix metalloproteinases and their tissue inhibitors in the vein wall following superficial venous thrombosis

Objectives Superficial venous thrombosis (SVT) is the complications of varicose great saphenous veins (VGSVs), but its pathogenesis remains unclear. This study was designed to measure the changes in expression of matrix metalloproteinases (MMPs) and the tissue inhibitor of metalloproteinases (TIMPs) from SVT, VGSVs, and great saphenous veins (GSVs). Methods In the venous walls of the three groups, the expression of MMP-2, MMP-9, TIMP-1, and TIMP-2 proteins, protein-positive expression ratios, mRNA expression, and protein expression were determined by immunohistochemistry, polymerase chain reaction, and western blot. Results The MMP-2, MMP-9, TIMP-1, and TIMP-2 protein-positive expression ratios, mRNA and protein expression in the SVT group were significantly higher than those in the VGSV and the GSV groups. The corresponding expression in the VGSV group were significantly higher than those in the GSV group. Conclusion Disequilibrium of MMPs and TIMPs in SVT wall occurs due to underlying high hydrostatic pressure and inflammation. These results suggested that MMPs and TIMPs participate in the process of venous wall remodeling.

BIOENERGY ASPECTS OF FUNCTIONING OF VENOUS WALL COMPONENTS (DEMONSTRATION MATERIALS OF STUDENTS AND YOUNG SCIENTISTS)

The subject of the study – the wall of the venous vessels of the skin. The purpose of the work is to provide demonstration and text materials of the significance of bioenergetic mechanisms of vascular wall components. The vascular component is an integral part of the pathogenesis of most dermatoses. At the same time, the bioenergetic aspects of cell function and the extracellular matrix of the vascular wall, especially venous ones, are still insufficiently taken into account, as they are the most vulnerable to inflammatory dermatoses.Key words: vascular wall components, demonstration materials.

PRINCIPLES OF ANGIOCORRECTIVE THERAPY FOR DERMATOSES (PROBLEM LECTURE)

The subject of the research is the angiocorrective therapy of dermatoses. The goal is to classify methods of influencing the structures of the vascular (venous) wall in the treatment of dermatoses. The treatment of many dermatoses, in the pathogenesis of which vasopathy plays a role, requires an individual approach to the choice of means of angiocorrective therapy. In this case, one should take into account the peculiarities of the pathogenesis of the corresponding skin disease and determine the «target structures» of the vascular (venous) wall, the effects on which will provide the necessary clinical effect.Key words: angiocorrective therapy, structures of the venous wall.

Reorganization of the structural elements of the venous wall in oncogenic pathology

The objective: an identification of changes and reorganization of structural elements of the venous wall, their correlation with cancer processes in the organism; the establishment of the relationship between structural changes in the wall of the venous vessels and thrombosis, with the following complications; the determination of the necessity of the preventive measures to avoid complications. Materials and methods. Histological, submicroscopic and polarization data of the research of the veins of the hind limbs of 12 sexually mature nonlinear male rats weighing 170–180 g on the 30th day of chronic neoplastic intoxication were analyzed. A retrospective analysis of the autopsy protocols of cancer patients (n=54), the largest incidences – pulmonary embolism, during 2014-2018 in the Ternopil Regional Clinical Oncology Center was performed. The average age of women who died was 61.93±1.51 years and 62.44±2.61 years – for men.Results. As a result of morphological examination of the veins of the hind limbs of rats with experimental neoplastic intoxication revealed mainly submicroscopic reorganization of endothelial cells and their desquamation, as well as platelet aggregation that can be one of the links in the pathogenesis of thrombosis.According to a retrospective analysis of the autopsy protocols, the proportion of pulmonary embolism was higher among women (61.1 %) than men (38.9 %). The structure of oncopathology in this group of patients: bronchial and lung cancer (18.5 %); neoplasms of the uterine body (22.2 %); rectum cancer (13.0 %), colon cancer (7.4 %), rectosigmoid junction cancer (5.6 %); bladder cancer (9.3 %); gastric cancer (7.4 %); ovarian cancer (7.4 %); prostate cancer (5.6 %); thyroid cancer (1.8 %); pancreatic cancer (1.8 %). In all cases of autopsy phlebothrombosis of the deep veins of the leg and thigh with impaired blood flow caused by occlusion by blood clots of various manifestations of the structural organization was revealed. In five cases, fresh red blood clots were found, which were closely connected with the intima by fibrin threads, in five other cases – red blood clots were freely located in the lumen of the vein, swelling of all layers of the vein, fibrous structure and diffuse neutrophil infiltration were found. In the remaining 44 cases, vein occlusion was detected by already organized thrombi with signs of fibrosis, recanalization, and revascularization.Conclusions. The study of the morphology of rat hind limb veins with experimental neoplastic intoxication mainly revealed changes in the shape, structure and function of endotheliocytes, their desquamation and changes in all three layers of the venous wall as well as platelet ligation. The relationship between the presence of changes in the venous wall as a result of cancer and the formation of thrombosis was found. The number of thromboembolic complications emphasizes the necessity to prevent thrombosis in cancer patients.