Blood vessels

血管
  • 文章类型: Case Reports
    血管内乳头状内皮增生(IPEH)代表罕见的反应性内皮增生。一名46岁的男子右上颌骨体积增加,鼻翼的抬高,硬腭肿胀,带红色色调3个月。计算机断层扫描显示,与受影响的多余牙齿和经牙髓治疗的牙齿相关的扩张性低密度区域和皮质骨破坏。根据根性囊肿的鉴别诊断,牙质囊肿,成釉细胞瘤,进行了探查性抽吸和切开活检.这揭示了由内皮衬里的各种直径的血管的形成,形成CD-34阳性的血管内乳头。最终诊断为IPEH,患者接受栓塞和手术治疗。组织学分析证实存在与牙源性囊肿相关的IPEH。经过12个月的随访,未观察到复发.此外,我们回顾了IPEH影响上颌骨和下颌骨的病例报告。在上颌骨和下颌骨报告了14例骨内病例,偏爱男性,影响广泛的年龄范围。完全手术切除是首选的治疗方法,和复发没有报告。IPEH的发病机制是有争议的,可能源于创伤或炎症过程。据我们所知,这是IPEH与牙源性囊肿相关的第一份报告.强调了IPEH在颌骨骨内病变鉴别诊断中的重要性,术前需要进行符号操作以防止手术并发症。
    Intravascular papillary endothelial hyperplasia (IPEH) represents an uncommon reactive endothelial hyperplastic proliferation. A 46-year-old man experienced increased volume in the right maxilla, elevation of the nasal ala, and swelling of the hard palate with a reddish hue for 3 months. Computed tomography revealed an expansive hypodense region and cortical bone destruction associated with an impacted supernumerary tooth and an endodontically treated tooth. Under the differential diagnoses of a radicular cyst, dentigerous cyst, and ameloblastoma, an exploratory aspiration and incisional biopsy were performed. This revealed the formation of blood vessels of various diameters lined by endothelium, forming intravascular papillae positive for CD-34. The definitive diagnosis was IPEH, and the patient was treated by embolization and surgery. Histological analysis confirmed the presence of IPEH associated with an odontogenic cyst. After 12 months of follow-up, no recurrence was observed. Also, we reviewed case reports of IPEH affecting the maxilla and mandible. Fourteen intraosseous cases were reported in the maxilla and mandible, with a preference for males and affecting a wide age range. Complete surgical excision was the treatment of choice, and recurrences were not reported. The pathogenesis of IPEH is controversial and may originate from trauma or inflammatory processes. To the best of our knowledge, this is the first report of an association of IPEH with an odontogenic cyst. The importance of IPEH in the differential diagnosis of intraosseous lesions in the jaws is emphasized, and preoperative semiotic maneuvers are needed to prevent surgical complications.
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  • 文章类型: Journal Article
    目的:Dieulafoy病变(DL)是一种罕见但可能危及生命的胃肠道(GI)出血来源。它们约占所有急性非静脉曲张性消化道出血病例的1%-6.5%。这里,我们回顾性描述了临床和内镜特征,回顾内镜下出血DLs治疗的短期和长期结果,我们确定发生率和危险因素,我们内镜单元的复发和死亡率。
    方法:数据收集自2018年1月至2023年8月期间继发于DL的消化道出血患者。对患者的医疗记录和内镜数据库进行回顾性审查。人口统计数据,危险因素,出血部位,内窥镜技术的结果,考虑了复发率和死亡率.
    结果:1170例消化道出血,我们仅确定了7例涉及DL的病例。中位年龄是74岁,男女比例为2.5。75%的患者有明显的合并症,主要是心血管疾病。只有抗凝剂和抗血小板药物与DL显著相关。所有患者均以消化道出血为首发症状。最初的内窥镜检查导致85%的病例得到诊断。所有经内镜治疗的患者均获得了初始止血。然而,该研究显示,仅接受肾上腺素注射或氩离子凝固治疗的3例患者中有2例出现早期复发。相比之下,接受联合治疗的三名患者之一,经历了晚期复发(平均随访1年)。1例需要病理诊断。1例患者(14%)死于失血性休克。平均住院时间为3天。
    结论:虽然罕见,DL可能是活跃的,复发性和不明原因的消化道出血。由于内窥镜治疗的出现,复发率降低,预后明显改善。因此,内镜方法仍然是治疗出血DLs的首选方法.
    OBJECTIVE: Dieulafoy\'s lesions (DLs) are a rare but potentially life-threatening source of gastrointestinal (GI) haemorrhage. They are responsible for roughly 1%-6.5% of all cases of acute non-variceal GI bleeding.Here, we describe retrospectively the clinical and endoscopic features, review the short-term and long-term outcomes of endoscopic management of bleeding DLs and we identify rate and risk factors, of recurrence and mortality in our endoscopic unit.
    METHODS: Data were collected from patients presenting with GI haemorrhagic secondary to DLs between January 2018 and August 2023. Patients\' medical records as well as endoscopic databases were retrospectively reviewed. Demographic data, risk factors, bleeding site, outcomes of endoscopy techniques, recurrence and mortality rate were taken into account.
    RESULTS: Among 1170 cases of GI bleeding, we identified only seven cases involving DLs. Median age was 74 years, with a male-to-female ratio of 2.5. 75% of patients had significant comorbidities, mainly cardiovascular diseases. Only anticoagulant and antiplatelet agents were significantly associated with DLs. All patients were presented with GI bleeding as their initial symptom. The initial endoscopy led to a diagnosis in 85% of the cases. Initial haemostasis was obtained in all patients treated endoscopically. Nevertheless, the study revealed early recurrence in two out of three patients treated solely with epinephrine injection or argon plasma coagulation. In contrast, one of three patients who received combined therapy, experienced late recurrence (average follow-up of 1 year). Pathological diagnosis was necessary in one case. One patient (14%) died of haemorrhagic shock. Average length of hospital stay was 3 days.
    CONCLUSIONS: Although rare, DLs may be responsible for active, recurrent and unexplained GI bleeding. Thanks to the emergence of endoscopic therapies, the recurrence rate has decreased and the prognosis has highly improved. Therefore, the endoscopic approach remains the first choice to manage bleeding DLs.
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  • 文章类型: Journal Article
    心血管疾病(CVD)仍然是全球最重要的健康问题,需要不断探索创新的治疗策略。这篇综述调查了心血管治疗的最新进展,全面概述了有望改变疾病管理的新兴方法。该检查首先阐明了当前CVD的流行病学格局及其对医疗保健系统的经济挑战。它着手审查传统疗法的局限性,强调逐步干预的必要性。核心重点是新型药理干预措施,包括药物开发的进步,靶向治疗,并重新利用现有的药物。探索了基因治疗的新兴领域及其在解决心血管疾病遗传易感性方面的潜力。同时在风险评估和治疗优化方面整合人工智能和机器学习。非药物干预占据中心舞台,随着对数字健康技术的探索,可穿戴设备,和远程医疗作为心血管疾病管理的变革性工具。再生医学和干细胞疗法,提供组织修复和功能恢复的承诺,正在调查它们对心脏健康的潜在影响。这篇评论还深入研究了生活方式改变的相互作用,饮食,锻炼,和行为的变化,强调它们在心血管健康和疾病预防中的关键作用。随着精准医学的日益突出,这种新兴治疗模式的综合旨在指导临床医生和研究人员在心血管疾病管理的动态景观中导航,促进集体努力,减轻心血管疾病的全球负担,促进更健康的未来。
    Cardiovascular disease (CVD) remains a foremost global health concern, necessitating ongoing exploration of innovative therapeutic strategies. This review surveys the latest developments in cardiovascular therapeutics, offering a comprehensive overview of emerging approaches poised to transform disease management. The examination begins by elucidating the current epidemiological landscape of CVD and the economic challenges it poses to healthcare systems. It proceeds to scrutinize the limitations of traditional therapies, emphasizing the need for progressive interventions. The core focus is on novel pharmacological interventions, including advancements in drug development, targeted therapies, and repurposing existing medications. The burgeoning field of gene therapy and its potential in addressing genetic predispositions to cardiovascular disorders are explored, alongside the integration of artificial intelligence and machine learning in risk assessment and treatment optimization. Non-pharmacological interventions take center stage, with an exploration of digital health technologies, wearable devices, and telemedicine as transformative tools in CVD management. Regenerative medicine and stem cell therapies, offering promises of tissue repair and functional recovery, are investigated for their potential impact on cardiac health. This review also delves into the interplay of lifestyle modifications, diet, exercise, and behavioral changes, emphasizing their pivotal role in cardiovascular health and disease prevention. As precision medicine gains prominence, this synthesis of emerging therapeutic modalities aims to guide clinicians and researchers in navigating the dynamic landscape of cardiovascular disease management, fostering a collective effort to alleviate the global burden of CVD and promote a healthier future.
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  • 文章类型: Journal Article
    目的:血管系统的位置和姿势依赖性变形是一个相对未探索的领域。这项范围审查的目的是概述不同身体位置和姿势的现有血管成像方式,并解决随后的血管解剖结构变化。
    方法:Scopus,Medline,和Cochrane搜索了2000年1月1日至2022年6月30日之间发表的文献,包括以下类别:图像模态,解剖学,定位,和结果。
    结果:在2446篇筛选的文章中,我们包括108。大多数论文使用超声波(美国,n=74)在不同的身体位置和姿势下,以直径和横截面积(CSA)作为结果度量。磁共振成像(n=22)和计算机断层扫描(n=8)的使用频率较低,但可以用于研究其他几何测量,例如血管曲率和长度。静脉系统对姿势变化比动脉系统更敏感,这被认为是当从仰卧到易于站立的姿势时,心脏水平以下的静脉直径增加,反之亦然。
    结论:使用US主要探讨了身体位置和姿势对脉管系统的影响血管直径和CSA。对血管病变的(血管内)治疗可能感兴趣的姿势引起的变形和其他几何特征的报道有限。如动脉粥样硬化动脉的长度和曲率在膝盖弯曲后放置支架。位置变化最重要的临床意义是在诊断中发现的,手术计划,支架置入后随访。
    结论:本范围综述介绍了使用与临床诊断领域相关的各种成像方式对血管结构进行位置和姿势依赖性成像的现状和机会,手术计划,支架置入后随访。
    结论:•使用US主要研究了身体位置和姿势对脉管系统的影响血管直径和横截面积。•研究几何变形,如血管长度和曲率适应,对于血管病变的(血管内)治疗可能感兴趣的是限于不同的位置和姿势。•在诊断中发现姿势改变的最重要的临床意义,手术计划,支架置入后随访。
    OBJECTIVE: Position- and posture-dependent deformation of the vascular system is a relatively unexplored field. The goal of this scoping review was to create an overview of existing vascular imaging modalities in different body positions and postures and address the subsequent changes in vascular anatomy.
    METHODS: Scopus, Medline, and Cochrane were searched for literature published between January 1, 2000, and June 30, 2022, incorporating the following categories: image modality, anatomy, orientation, and outcomes.
    RESULTS: Out of 2446 screened articles, we included 108. The majority of papers used ultrasound (US, n = 74) in different body positions and postures with diameter and cross-sectional area (CSA) as outcome measures. Magnetic resonance imaging (n = 22) and computed tomography (n = 8) were less frequently used but allowed for investigation of other geometrical measures such as vessel curvature and length. The venous system proved more sensitive to postural changes than the arterial system, which was seen as increasing diameters of veins below the level of the heart when going from supine to prone to standing positions, and vice versa.
    CONCLUSIONS: The influence of body positions and postures on vasculature was predominantly explored with US for vessel diameter and CSA. Posture-induced deformation and additional geometrical features that may be of interest for the (endovascular) treatment of vascular pathologies have been limitedly reported, such as length and curvature of an atherosclerotic popliteal artery during bending of the knee after stent placement. The most important clinical implications of positional changes are found in diagnosis, surgical planning, and follow-up after stent placement.
    CONCLUSIONS: This scoping review presents the current state and opportunities of position- and posture-dependent imaging of vascular structures using various imaging modalities that are relevant in the fields of clinical diagnosis, surgical planning, and follow-up after stent placement.
    CONCLUSIONS: • The influence of body positions and postures on the vasculature was predominantly investigated with US for vessel diameter and cross-sectional area. • Research into geometrical deformation, such as vessel length and curvature adaptation, that may be of interest for the (endovascular) treatment of vascular pathologies is limited in different positions and postures. • The most important clinical implications of postural changes are found in diagnosis, surgical planning, and follow-up after stent placement.
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  • 文章类型: Review
    暂无摘要。
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  • 文章类型: Journal Article
    炎症性颌骨疾病在口腔医学中很常见,包括牙周炎,种植体周围炎,药物相关的颌骨坏死,颌骨放射性骨髓炎,与年龄有关的骨质疏松症,和其他特定感染。这些疾病可能导致牙齿脱落和颌面部畸形,严重影响患者的生活质量。多年来,由炎性疾病引起的颌骨缺损的重建已成为医学和社会经济挑战。因此,探索与颌骨相关的炎症性疾病的发病机制对于改善预后和开发新的靶向治疗方法至关重要。越来越多的证据表明,整合的骨形成和功能障碍是由多种细胞类型网络之间的复杂相互作用引起的。包括成骨细胞相关细胞,免疫细胞,血管,和淋巴管.然而,这些不同细胞在炎症过程中的作用以及它们相互作用的规律仍未被完全理解。尽管许多研究都集中在炎症性颌骨疾病的特定病理过程和分子事件,很少有文章提供了整合的视角。这里,我们回顾了各种细胞类型在炎症性颌骨疾病中的变化和机制,希望为推动这一领域的进一步研究提供见解。
    Inflammatory jaw bone diseases are common in stomatology, including periodontitis, peri-implantitis, medication-related osteonecrosis of the jaw, radiation osteomyelitis of the jaw, age-related osteoporosis, and other specific infections. These diseases may lead to tooth loss and maxillofacial deformities, severely affecting patients\' quality of life. Over the years, the reconstruction of jaw bone deficiency caused by inflammatory diseases has emerged as a medical and socioeconomic challenge. Therefore, exploring the pathogenesis of inflammatory diseases associated with jaw bones is crucial for improving prognosis and developing new targeted therapies. Accumulating evidence indicates that the integrated bone formation and dysfunction arise from complex interactions among a network of multiple cell types, including osteoblast-associated cells, immune cells, blood vessels, and lymphatic vessels. However, the role of these different cells in the inflammatory process and the \'rules\' with which they interact are still not fully understood. Although many investigations have focused on specific pathological processes and molecular events in inflammatory jaw diseases, few articles offer a perspective of integration. Here, we review the changes and mechanisms of various cell types in inflammatory jaw diseases, with the hope of providing insights to drive future research in this field.
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  • 文章类型: Journal Article
    人体生理学中的各种结构遵循树状形态,通常以非常精细的尺度表达复杂性。这种结构的例子是胸内气道,视网膜血管,还有肝血管.大的二维和三维图像集合已经通过医学成像模式,如磁共振成像(MRI),计算机断层扫描(CT),光学相干断层扫描(OCT)和超声,其中可以观察到空间排列。这些结构的分割在医学成像中是非常重要的,因为结构的分析提供了对疾病诊断的见解。治疗计划,和预后。由放射科医师手动标记大量数据通常是耗时且容易出错的。因此,在过去的二十年中,自动或半自动计算模型已成为医学成像的热门研究领域,到目前为止已经开发了许多。在这次调查中,我们的目标是对当前公开可用的数据集进行全面审查,分割算法,和评估指标。此外,讨论了当前面临的挑战和未来的研究方向。
    Various structures in human physiology follow a treelike morphology, which often expresses complexity at very fine scales. Examples of such structures are intrathoracic airways, retinal blood vessels, and hepatic blood vessels. Large collections of 2D and 3D images have been made available by medical imaging modalities such as magnetic resonance imaging (MRI), computed tomography (CT), Optical coherence tomography (OCT) and ultrasound in which the spatial arrangement can be observed. Segmentation of these structures in medical imaging is of great importance since the analysis of the structure provides insights into disease diagnosis, treatment planning, and prognosis. Manually labelling extensive data by radiologists is often time-consuming and error-prone. As a result, automated or semi-automated computational models have become a popular research field of medical imaging in the past two decades, and many have been developed to date. In this survey, we aim to provide a comprehensive review of currently publicly available datasets, segmentation algorithms, and evaluation metrics. In addition, current challenges and future research directions are discussed.
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  • 背景:高血压是一种慢性,以持续高血压为特征的多因素临床状况。它通常与靶器官的功能结构改变有关,其中包括心脏,大脑,肾脏,和脉管系统。
    目的:这项研究强调了最近免疫系统之间的相关性,高血压,及其对靶器官损伤的影响。
    方法:用于搜索研究的描述符是“高血压”,\"豁免权\",和“目标器官”。研究方法遵循PRISMA声明的主要建议。
    结果:对血管系统的损伤主要来自T细胞和单核细胞的迁移,这些T细胞和单核细胞在外膜中成为促炎的,释放TNF-α,IFN-γ,和IL-17,诱导内皮损伤并阻碍血管舒张。在肾脏方面,与高血压相关的炎症过程最终导致白细胞侵入肾脏,通过强烈的交感神经刺激机制导致该器官的损伤,激活肾素-血管紧张素系统,钠潴留,和氧化应激的加剧。在心脏方面,高血压会增加促炎因子的表达,比如B,T,和NK细胞,除了分泌IFN-γ,来自血管紧张素II的IL-17,IL-23和TNF-α,活性氧,还有醛固酮.这种促炎作用也通过SphK1参与脑损伤。鉴于上述情况,免疫系统参与高血压引起的损伤似乎是明确的.
    结论:因此,了解与高血压相关的多因素机制肯定可以在这种情况下进行更有效的干预,防止靶器官损伤。
    Hypertension is a chronic, multifactorial clinical condition characterized by sustained high blood pressure levels. It is often associated with functional-structural alterations of target organs, which include heart, brain, kidneys, and vasculature.
    This study highlights the recent correlation between the immune system and hypertension and its repercussions on target-organ damage.
    The descriptors used for the search of the study were \"hypertension\", \"immunity\", and \"target organs\". The methodology of the study followed the main recommendations of the PRISMA statement.
    The damage to the vasculature arises mainly from the migration of T cells and monocytes that become pro-inflammatory in the adventitia, releasing TNF-α, IFN-γ, and IL-17, which induce endothelial damage and hinder vascular relaxation. In the renal context, the inflammatory process associated with hypertension culminates in renal invasion by leukocytes, which contribute to the injury of this organ by mechanisms of intense sympathetic stimulation, activation of the reninangiotensin system, sodium retention, and aggravation of oxidative stress. In the cardiac context, hypertension increases the expression of pro-inflammatory elements, such as B, T, and NK cells, in addition to the secretion of IFN-γ, IL-17, IL-23, and TNF-α from angiotensin II, reactive oxygen species, and aldosterone. This pro-inflammatory action is also involved in brain damage through SphK1. In view of the above, the participation of the immune system in hypertension-induced injuries seems to be unequivocal.
    Therefore, understanding the multifactorial mechanisms related to hypertension will certainly allow for more efficient interventions in this condition, preventing target organ damage.
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  • 文章类型: Journal Article
    视网膜疾病如糖尿病性视网膜病(DR)是视力丧失的主要原因。在对眼病的早期认识中,视网膜图像中血管的分割起着重要的作用。可以通过眼动脉的几何特征来识别眼部疾病的不同症状。然而,由于血管的复杂结构和不同的厚度,分割视网膜图像是一项具有挑战性的任务。有许多算法可以帮助检测视网膜疾病。本文概述了2016年至2022年的论文,这些论文讨论了用于自动血管分割的机器学习和深度学习方法。这些方法分为两组:基于深度学习的,和经典的方法。算法,分类器,描述了每个组的预处理和具体技术,全面。根据在包容性表中的不同数据集中实现的准确性,比较了最近作品的性能。对DRIVE等最受欢迎的数据集的调查,STARE,本文还给出了HRF和CHASE_DB1。最后,结论部分列出了这项审查的结果。
    Retinal illnesses such as diabetic retinopathy (DR) are the main causes of vision loss. In the early recognition of eye diseases, the segmentation of blood vessels in retina images plays an important role. Different symptoms of ocular diseases can be identified by the geometric features of ocular arteries. However, due to the complex construction of the blood vessels and their different thicknesses, segmenting the retina image is a challenging task. There are a number of algorithms that helped the detection of retinal diseases. This paper presents an overview of papers from 2016 to 2022 that discuss machine learning and deep learning methods for automatic vessel segmentation. The methods are divided into two groups: Deep learning-based, and classic methods. Algorithms, classifiers, pre-processing and specific techniques of each group is described, comprehensively. The performances of recent works are compared based on their achieved accuracy in different datasets in inclusive tables. A survey of most popular datasets like DRIVE, STARE, HRF and CHASE_DB1 is also given in this paper. Finally, a list of findings from this review is presented in the conclusion section.
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  • 文章类型: Case Reports
    浅表血管黏液瘤(SA)是一种以广泛的粘液样间质为特征的良性肿瘤,许多小血管,稀疏的纺锤形成纤维细胞,和炎症细胞浸润。口腔SA极为罕见,通常表现为无痛,增长缓慢。我们在快速生长的下颌牙龈中经历了SA。该患者是一名15岁的女性,其主要主诉是下颌骨舌牙龈中的无痛性肿块,其大小在1个月内增加。在局部麻醉下进行切除活检。根据组织病理学检查,肿块被诊断为SA。由于切缘阳性,患者经历了两次复发。第二个复发性病变,包括骨膜,被切除,并且1年内没有观察到复发。快速增长的原因归因于舌头习惯或创伤性刺激引起的水肿变化。由于这种情况表现出反复的局部复发,需要仔细跟进。
    Superficial angiomyxoma (SA) is a benign tumor characterized by extensive myxoid stroma, numerous small blood vessels, sparse spindle-shaped fibroblastic cells, and inflammatory cell infiltrate. Oral cavity SA is extremely rare and typically presents as a painless, slow growth. We experienced SA in the mandibular gingiva that is rapidly growing. The patient was a 15-year-old female whose chief complaint was a painless mass in the lingual gingiva of the mandible that increased in size over 1 month. An excisional biopsy was performed under local anesthesia. According to histopathological examination, the mass was diagnosed as SA. The patient experienced recurrence twice because of positive margins. The second recurrent lesion, including periosteum, was resected, and no recurrence has been observed for 1 year. The cause of rapid growth was attributed to edematous changes due to tongue habit or traumatic stimuli. As this case exhibited repeated local recurrence, careful follow-up is required.
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