3D-Reconstruction of the human conventional outflow system by ribbon scanning confocal microscopy

PURPOSE

The risk for glaucoma is driven by the microanatomy and function of the anterior segment. We performed a computation-intense, high-resolution, full-thickness ribbon-scanning confocal microscopy (RSCM) of the outflow tract of two human eyes. We hypothesized this would reveal important species differences when compared to existing data of porcine eyes, an animal that does not spontaneously develop glaucoma.

METHODS

After perfusing two human octogenarian eyes with lectin-fluorophore conjugate and optical clearance with benzyl alcohol benzyl benzoate (BABB), anterior segments were scanned by RSCM and reconstructed in 3D for whole-specimen rendering. Morphometric analyses of the outflow tract were performed for the trabecular meshwork (TM), limbal, and perilimbal outflow structures and compared to existing porcine data.

RESULTS

RSCM provided high-resolution data for IMARIS-based surface reconstruction of outflow tract structures in 3D. Different from porcine eyes with an abundance of highly interconnected, narrow, and short collector channels (CCs), human eyes demonstrated fewer CCs which had a 1.5x greater cross-sectional area (CSA) and 2.6x greater length. Proximal CC openings at the level of Schlemm's canal (SC) had a 1.3x larger CSA than distal openings into the scleral vascular plexus (SVP). CCs were 10.2x smaller in volume than the receiving SVP vessels. Axenfeld loops, projections of the long ciliary nerve, were also visualized.

CONCLUSION

In this high-resolution, volumetric RSCM analysis, human eyes had far fewer outflow tract vessels than porcine eyes. Human CCs spanned several clock-hours and were larger than in porcine eyes. These species differences may point to factors downstream of the TM that increase our vulnerability to glaucoma.

Structure and tensile properties of the forewing costal vein of the honeybee Apis mellifera

In this study, we investigated the morphological features and tensile properties of the forewing costal vein of the honeybee (Apis mellifera) under fresh, dry and in vitro-time varied conditions. The costal vein is composed of an outer sub-vein and an inner vein starting from the wing base to nearly 50% of the wing span and then they are fused into one vein extending to the wing tip. Confocal laser scanning microscopy revealed that the outer sub-vein with red autofluorescence is stiffer than the inner one with green autofluorescence, and the membrane in the gap between the sub-veins exhibited a long blue-autofluorescence resilin stripe. Considering the irregular cross-sectional shape of the costal vein, cross-sections of the tested specimens after tensile failure were analysed using scanning electron microscopy, to precisely calculate their cross-sectional areas by a customized MATLAB program. The Young's modulus and tensile strength of fresh specimens were ∼4.78 GPa and ∼119.84 MPa, which are lower than those of dry specimens (∼9.08 GPa and ∼154.45 MPa). However, the tensile strain had the opposite relationship (fresh: ∼0.031, dry: ∼0.018). Thus, specimen desiccation results in increasing stiffness and brittleness. The morphological features and material properties of the costal vein taken together represent a tradeoff between both deformability and stiffness. Our study provides guidance for material selection and bionic design of the technical wings of flapping micro aerial vehicles.

Vascular Supply of the Human Spiral Ganglion: Novel Three-Dimensional Analysis Using Synchrotron Phase-Contrast Imaging and Histology

Human spiral ganglion (HSG) cell bodies located in the bony cochlea depend on a rich vascular supply to maintain excitability. These neurons are targeted by cochlear implantation (CI) to treat deafness, and their viability is critical to ensure successful clinical outcomes. The blood supply of the HSG is difficult to study due to its helical structure and encasement in hard bone. The objective of this study was to present the first three-dimensional (3D) reconstruction and analysis of the HSG blood supply using synchrotron radiation phase-contrast imaging (SR-PCI) in combination with histological analyses of archival human cochlear sections. Twenty-six human temporal bones underwent SR-PCI. Data were processed using volume-rendering software, and a representative three-dimensional (3D) model was created to allow visualization of the vascular anatomy. Histologic analysis was used to verify the segmentations. Results revealed that the HSG is supplied by radial vascular twigs which are separate from the rest of the inner ear and encased in bone. Unlike with most organs, the arteries and veins in the human cochlea do not follow the same conduits. There is a dual venous outflow and a modiolar arterial supply. This organization may explain why the HSG may endure even in cases of advanced cochlear pathology.

A simple ex vivo model of human renal allograft preservation using the gonadal vein

INTRODUCTION

Hypothermic machine perfusion, an organ preservation modality, involves flow of chilled preservation fluid through an allograft's vasculature. This study describes a simple, reproducible, human model that allows for interrogation of flow effects during ex vivo organ perfusion.

MATERIALS AND METHODS

Gonadal veins from deceased human renal allografts were subjected to either static cold storage or hypothermic machine perfusion for up to 24 hours. Caspase-3, Krüppel-like factor 2 expression and electron microscopic analysis were compared between 'flow' and 'no-flow' conditions, with living donor gonadal vein sections serving as negative controls.

RESULTS

The increase in caspase-3 expression was less pronounced for hypothermic machine-perfused veins compared with static cold storage (median-fold increase 1.2 vs 2.3; P < 0.05). Transmission electron microscopy provided ultrastructural corroboration of endothelial cell apoptosis in static cold storage conditions. For static cold storage preserved veins, Krüppel-like factor 2 expression diminished in a time-dependent manner between baseline and 12 hours (P < 0.05) but was abrogated and reversed by hypothermic machine perfusion (P < 0.05).

CONCLUSIONS

Our methodology is a simple, reproducible and successful model of ex vivo perfusion in the context of human organ preservation. To demonstrate the model's utility, we establish that two widely used markers of endothelial health (caspase-3 and Krüppel-like factor 2) differ between the flow and no-flow conditions of the two predominant kidney preservation modalities. These findings suggest that ex vivo perfusion may mediate the induction of a biochemically favourable endothelial niche which may contribute tohypothermic machine perfusion's association with improved renal transplantation outcomes.

Morphology of hindwing veins in the shield bug Graphosoma italicum (Heteroptera: Pentatomidae)

Light, fluorescence, and electron microscopy were applied to cross sections and -breakage and whole-mount preparations of the anterior hindwing vein of the shield bug Graphosoma italicum. These analyses were complemented by investigations of the basal part of the forewing Corium and Clavus. The integration of structural, histological, and fluorescence data revealed a complex arrangement of both rigid and elastic structures in the wall of wing veins and provided insights into the constitution of transition zones between rigid and elastic regions. Beneath the exocuticular layers, which are continuous with the dorsal and ventral cuticle of the wing membrane, the lumen of the veins is encompassed by a mesocuticular layer, an internal circular exocuticular layer, and an internal longitudinal endocuticular layer. Separate parallel lumina within the anterior longitudinal vein of the hindwing, arranged side-by-side rostro-caudally, suggest that several veins have fused in the phylogenetic context of vein reduction in the pentatomid hindwing. Gradual structural transition zones and resilin enrichment between sclerotized layers of the vein wall and along the edges of the claval furrow are interpreted as mechanical adaptations to enhance the reliability and durability of the mechanically stressed wing veins.

Morphological and mechanical properties of flexible resilin joints on damselfly wings (Rhinocypha spp.)

Resilin functions as an elastic spring that demonstrates extraordinary extensibility and elasticity. Here we use combined techniques, laser scanning confocal microscopy (LSCM) and scanning electron microscopy (SEM) to illuminate the structure and study the function of wing flexibility in damselflies, focusing on the genus Rhinocypha. Morphological studies using LSCM and SEM revealed that resilin patches and cuticular spikes were widespread along the longitudinal veins on both dorsal and ventral wing surfaces. Nanoindentation was performed by using atomic force microscopy (AFM), where the wing samples were divided into three sections (membrane of the wing, mobile and immobile joints). The resulting topographic images revealed the presence of various sizes of nanostructures for all sample sections. The elasticity range values were: membrane (0.04 to 0.16 GPa), mobile joint (1.1 to 2.0 GPa) and immobile joint (1.8 to 6.0 GPa). The elastomeric and glycine-rich biopolymer, resilin was shown to be an important protein responsible for the elasticity and wing flexibility.

Self-Organized, Tubular Hybrid Vascular Tissue Composed of Vascular Cells and Collagen for Low-Pressure-Loaded Venous System

A tubular, hierarchically structured hybrid vascular tissue composed of vascular cells and collagen was prepared. First, a cold mixed solution of bovine aortic smooth muscle cells (SMCs) and Type I collagen was poured into a tubular glass mold composed of a mandrel and a sheath (example of dimensions: inner diameter, 1.5 mm; outer diameter, 7 mm; length, 7 cm). Upon incubation at 37°C, an SMC-incorporated collagenous gel was formed. After the sheath was removed, the resulting fragile tissue, when cultured in medium, thinned in a time-dependent manner to form an opaque, dense tissue. Higher SMC seeding density and lower initial collagen concentration induced more rapid and prominent shrinkage of the tissue. Morphologic investigation showed that over time, bipolarly elongated SMCs and collagen fiber bundles became positioned around the mandrel. Both components became circumferentially oriented. When the mandrel was removed, a tubular hybrid medial tissue was formed. A hybrid vascular tissue with a hierarchical structure was constructed by seeding endothelial cells onto the inner surface of the hybrid medial tissue. Prepared tissues tolerated luminal pressures as great as 100 mmHg and mechanical stress applied during an anastomotic procedure. This method allowed us to prepare a tubular hybrid medial tissue of predetermined size (inner diameter, wail thickness, and length) by selecting appropriate mold design, initial collagen concentration, and SMC seeding density. Such hybrid vascular tissues may provide physiological functions when implanted into the venous system.

[Vascular morphological and microdensity changes of corneal neovascularization induced by topical bevacizumab and sunitinib in an animal model]

OBJECTIVE

To evaluate the effects of topical bevacizumab and topical sunitinib on vascular microdensity and morphology of corneal neovascularization (NV).

METHODS

A total of 33 rabbits were distributed into 3 groups: group 1 (control; n=11): saline; group 2 (n=11): bevacizumab 5mg/ml; and group 3 (n=11): sunitinib 0.5mg/ml. A corneal NV model was used, based on sutures in the right eye of each rabbit. Each treatment was administered topically 3 times daily for 14 days. Corneas were then processed for the study of vascular microdensity (6 eyes) and vascular morphology analysis (5 eyes) using enzymatic staining histological techniques

RESULTS

The vascular response in group 3 was limited to small-sized tree formations with various vascular axes compared with the extensive, lush and directional corneal NV of group 1 and 2. In the histological sections near the limb, there were no differences in vascular microdensity studies between the three groups. However, the mean sectional area of vessels (MSAV) in group 3 was 41.88% lower than in group 1 and 19.19% lower than in group 2. In distal sections, there were no differences between groups 1 and 2. However, group 3 was characterized by absence of vessels.

CONCLUSIONS

Bevacizumab produced no changes in the morphology of the vessels or the vascular microdensity. Sunitinib reduced the size of the new vessels and induced changes in the vascular tree.

Bridging peripheral nerve defects with muscle–vein combined guides

Various tubulization techniques can be used to bridge peripheral nerve lesions with substance loss. Among the different materials that have been used so far in alternative to traditional fresh nerve autografts, fresh muscle-vein combined conduits (made by a vein segment filled with fresh skeletal muscle) proved to be particularly effective. In this study, nerve repair of 10-mm long nerve defects by means of muscle-vein combined tubes was compared with repair by means of traditional nerve autografts in the rat sciatic nerve experimental model. Results did not reveal any significant difference between the two groups of regenerated nerves with respect to the total number, mean density and mean size of myelinated nerve fibers. In addition, we also report the results of an experimental study in the rabbit sciatic nerve model, which showed that fresh skeletal muscle enrichment of the vein segment made it possible to bridge 55-mm long nerve gaps. These results provide further evidence of the effectiveness of fresh muscle-vein combined grafts and support the view that this type of conduit can be used also for repairing long nerve gaps.

The use of dynamic tracer concentration in veins for quantitative DCE-MRI kinetic analysis in head and neck

BACKGROUND

Head and neck Magnetic Resonance (MR) Images are vulnerable to the arterial blood in-flow effect. To compensate for this effect and enhance accuracy and reproducibility, dynamic tracer concentration in veins was proposed and investigated for quantitative dynamic contrast-enhanced (DCE) MRI analysis in head and neck.

METHODOLOGY

21 patients with head and neck tumors underwent DCE-MRI at 3T. An automated method was developed for blood vessel selection and separation. Dynamic concentration-time-curves (CTCs) in arteries and veins were used for the Tofts model parameter estimations. The estimation differences by using CTCs in arteries and veins were compared. Artery and vein voxels were accurately separated by the automated method. Remarkable inter-slice tracer concentration differences were found in arteries while the inter-slice concentration differences in veins were moderate. Tofts model fitting by using the CTCs in arteries and veins produced significantly different parameter estimations. The individual artery CTCs resulted in large (>50% generally) inter-slice parameter estimation variations. Better inter-slice consistency was achieved by using the vein CTCs.

CONCLUSIONS

The use of vein CTCs helps to compensate for arterial in-flow effect and reduce kinetic parameter estimation error and inconsistency for head and neck DCE-MRI.

Vascular architecture of the human uterine cervix, as assessed in light- and scanning electron microscopy

BACKGROUND

The aim of this study was to visualise and describe the vasculature of the human uterine cervix.

MATERIAL AND METHODS

The material for this study was obtained from women (age between 20 to 45 years) during autopsy. The material was collected not later than 24 h post-mortem. This study was performed using uteri from cadavers of menstruating nulliparas (33 uteri) and menstruating multiparas (27 uteri). Collected uteri were perfused via the afferent vessels with Mercox resin (for corrosion-casting and SEM assessment) or acrylic paint solution (light microscopy assessment). The research protocol was approved by the Jagiellonian University Ethics Committee (registry KBET/121/8/2007).

RESULTS

In all cases bilateral cervical branches (1-4), originating from the uterine artery, were found. Both in the vaginal and supravaginal parts of the cervix, four distinct vascular zones were found. In the pericanalar zone ran small veins, responsible for draining the mucosal capillaries. Both in the muscular layer, as well as in the pericanalar zone, arterioles, and venules passed close to each other, often adjoining.

CONCLUSIONS

This study does not confirm the existence of a single cervicovaginal artery, but shows that the vascular supply of the cervix comes from several vessels. It also introduces the idea of two systems, responsible for draining blood from the mucosal capillaries. Neither assessment in light microscopy nor in SEM revealed any differences between multiparas and nulliparas, regarding the vascular architecture of the cervix.

Fluid flow along venous adventitia in rabbits: is it a potential drainage system complementary to vascular circulations?

Background

Our previous research and other studies with radiotracers showed evidence of a centripetal drainage pathway, separate from blood or lymphatic vessels, that can be visualized when a small amount of low molecular weight tracer is injected subcutaneously into a given region on skin of humans. In order to further characterize this interesting biological phenomenon, animal experiments are designed to elucidate histological and physiologic characteristics of these visualized pathways.

Methods

Multiple tracers are injected subcutaneously into an acupuncture point of KI3 to visualize centripetal pathways by magnetic resonance imaging or fluorescein photography in 85 healthy rabbits. The pathways are compared with venography and indirect lymphangiography. Fluid flow through the pathways is observed by methods of altering their hydrated state, hydrolyzing by different collagenases, and histology is elucidated by optical, fluorescein and electron microscopy.

Results

Histological and magnetic imaging examinations of these visualized pathways show they consist of perivenous loose connective tissues. As evidenced by examinations of tracers’ uptake, they appear to function as a draining pathway for free interstitial fluid. Fluorescein sodium from KI3 is found in the pathways of hind limbs and segments of the small intestines, partial pulmonary veins and results in pericardial effusion, suggesting systematical involvement of this perivenous pathway. The hydraulic conductivity of these pathways can be compromised by the collapse of their fiber-rich beds hydrolyzed by either of collagenase type I, III, IV or V.

Conclusions

The identification of pathways comprising perivenous loose connective tissues with a high hydraulic conductivity draining interstitial fluid in hind limbs of a mammal suggests a potential drainage system complementary to vascular circulations. These findings may provide new insights into a systematically distributed collagenous connective tissue with a circulatory function and their potential relevance to the nature of acupuncture meridians.

The great brain versus vein debate

From the earliest fMRI experiments, it was quickly appreciated by those working with BOLD at high field that the signal change originated from visible veins whose spatial localization was relatively coarse ("the macrovasculature"), and smaller vessels ("the microvasculature") that were not individually visible in BOLD images. It was expected that a functional brain imaging technique that was predominantly sensitive to the macrovasculature would not have the same effective resolution as one sensitive to the microvasculature. Elimination of the venous signal and enhancement of the microvascular one offered the tantalizing ability to image columnar and lamellar structures in the brain and distinguished fMRI from its predecessor techniques. This article reviews a brief history of how these signal sources were first identified and separated and some of the controversy associated with the "brain versus vein" debate.

Distinct Patterns of Microvascular Endothelial Cell Morphology Are Determined by Extracellular Matrix Composition

Endothelial interactions with the extracellular matrix (ECM) play important roles in angiogenesis but whether specific ECM signals can determine specific cellular morphologies is unclear. The authors compared in vitro ECM-induced morphological responses of the phenotypically distinct human placental microvascular endothelial cells (HPMECs) with large vessel endothelial cells (HUVECs). HPMECs showed distinct patterns of reorganization in response to collagen-I or collagen-IV (monolayer disruption, sprouting, migration) and Matrigel or laminin-A (intussusception, cord formation, tubulogenesis), and an intermediate response to fibrin; whereas HUVECs responded similarly to collagen-1 and Matrigel (elongation, lattice formation, vacuolation) and showed little response to fibrin. Although the extent of collagen and Matrigel responses of HPMECs were increased by serum, acidic or basic fibroblast growth factor (aFGF, bFGF), or vascular endothelial growth factor (VEGF), and varied with matrix protein concentration, the basic patterns were matrix specific, and were independent of fibronectin. The collagen responses correlated with disruption of adherens and tight junctions and the formation of filopodial protrusions. Matrigel responses were associated with up-regulated junctional localization of VE-cadherin, and tubulogenesis developed mainly through paracellular remodeling rather than intracellular vacuolation. Overall, these findings suggest that distinct ECM interactions stimulate specific morphological responses. These signals may regulate morphological behaviour in the angiogenesis cycle, switching endothelial cells between migratory and vasculogenic phenotypes.

Angioarchitecture of the ventral surface of the tongue from Wistar rats

The goal of this study was to describe the angioarchitecture of the ventral surface of the tongue from Wistar rats using a vascular corrosion casting technique associated with scanning electron microscopy (SEM). Six Wistar rats were used for the vascular casting method with Mercox resin. Following the resin polymerization, the tongue of each animal was dissected and corroded in a 5% sodium hydroxide solution. Once the corrosion and drying of the specimens were completed, the specimens were mounted on aluminum stubs, coated with carbon and gold and analyzed under SEM. The results showed that the ventral surface of the tongue presents simple, even and abundant vasculature constituted by a vascular plexus consisting of a superficial vascular network and by the ranine veins. The superficial vascular network, made up of the ascending and descending branches, presents as a loose network, with little morphological variation between the capillary loops.

Nerve regeneration along bioengineered scaffolds

Tissue engineering has recently seen great advancements in many medical fields, including peripheral nerve reconstruction. In the rat median nerve model, we investigated nerve repair by means of bioengineered tissue scaffolds (muscle-vein-combined tubes) focusing on changes in the neuregulin-1/ErbB-receptor system which represents one of the main regulatory systems of axo-glial interaction in peripheral nerves. Repaired nerves were withdrawn at 5, 15, and 30 days postoperative and processed for morphological and retro-transcriptase polymerase chain reaction (RT-PCR) analysis. Results revealed an early and progressive increase in the expression of NRG1alpha isoform only, while the appearance of the beta isoform of NRG1, which is normally present in peripheral nerves, was delayed. In regards to ErbB2 and ErbB3 receptors, their expression increased progressively inside the muscle-vein-combined scaffolds, though with different kinetics. Taken together, these results suggest that variations in neuregulin-1/ErbB system activation play a key role in peripheral nerve regeneration along bioengineered muscle-vein-combined scaffolds. Since similar variations are also detectable in denervated skeletal muscles, it can be hypothesized that the existence of a NRG1's autocrine/paracrine trophic loop shared by both glial and muscle fibers could be responsible for the effectiveness of muscle-vein-combined conduits for repairing nerve defects.

Morphological differences between guinea pig aortic and venous endothelial cells in situ

Endothelial cells (ECs) respond to fluid shear stress. They reveal shear stress related morphological changes in both their cell shape and cytoskeletal organization. Little is known about the cytoskeletal organization of ECs in situ. We studied, together with the living ultrasound high resolution imaging system, the distribution of stress fibers (SFs), certain focal adhesion (FA) and signal transduction associated proteins in guinea pig aortic and venous ECs. Although SFs present in the basal portion of venous ECs ran along the direction of the blood flow, their size was smaller and their number was fewer than those of aortic ECs. Venous ECs were elongated to the direction of flow than in aortic ECs exposed over normal shear stress (SS). Since fluid SS in the vein is low, a sustained and uni-directional low SS over a long period might thus cause these structural features observed in venous ECs.

Correlation between inertial cavitation dose and endothelial cell damage in vivo

Previous in vivo studies have demonstrated that vascular endothelial damage can result when vessels containing gas-based microbubble ultrasound contrast agent (UCA) are exposed to MHz-frequency pulsed ultrasound (US) of sufficient pressure amplitudes, presumably as a result of inertial cavitation (IC). The hypothesis guiding this research was that IC is the primary mechanism by which the vascular endothelium (VE) is damaged when a vessel is exposed to pulsed 1-MHz frequency US in the presence of circulating UCA. The expectation was that a correlation should exist between the magnitude and duration of IC activity and the degree of VE damage. Rabbit auricular vessels were exposed in vivo to 1.17-MHz focused US of variable peak rarefaction pressure amplitude (1, 3, 6.5 or 9 MPa), using low duty factors (0.04% or 0.4%), pulse lengths of 500 or 5000 cycles, with varying treatment durations and with or without infusion of a shelled microbubble contrast agent. A broadband passive cavitation detection system was used to measure IC activity in vivo within the targeted segment of the blood vessel. The magnitude of the detected IC activity was quantified using a previously reported measure of IC dose. Endothelial damage was assessed via scanning electron microscopy image analysis. The results supported the hypothesis and demonstrate that the magnitude of the measured IC dose correlates with the degree of VE damage when UCA is present. These results have implications for therapeutic US-induced vascular occlusion.

The three-dimensional microvascular architecture of the human Kaposi sarcoma implanted in nude mice: a SEM corrosion casting study

The human Kaposi sarcoma represents one of the most common skin lesions associated with AIDS. Its clinical presentation and anatomopathological structure seem to demonstrate a particularly rich vascularity. The latest therapies aim to limit its intrinsic angiogenic activity in an attempt to reduce vascular density and the formation of new vessels. For these reasons, we decided to study the microvascular architecture of Kaposi sarcoma in three dimensions. We used a corrosion casting technique applied to nude mice previously transplanted subcutaneously with human modified neoplastic Kaposi sarcoma cells. The cooption of host vessels made by the tumor was demonstrated by three-dimensional scanning electron microscopy (SEM) images. At high magnification several angiogenic patterns were observed in the form of potato-shaped vessels, sprouts, intussusceptions and mouse tailed end tipped capillaries along with some ultrastructural features such as intercellular extravasations and endothelial cell modifications. Our investigation allowed us to build a detailed map of tumor vasculature in human Kaposi sarcoma. Furthermore, this study want to shed light on the sharp morphological three-dimensional conformation of angiogenic sprouts so to be able to better understand their modifications occurred during time and after antiangiogenic experimental therapies, by now observed only by immunohistochemical or immunofluorescent assays.

Leishmaniosis--a report about the microvascular and cellular architecture of the infected spleen in Canis familiaris

Leishmaniosis is an anthropozoonosis caused by an intracellular protozoan parasite that causes a wide spectrum of diseases in humans and dogs worldwide. In the Mediterranean basin, Portugal, Central and South America, and in the Middle East, visceral leishmaniosis is caused by Leishmania infantum. In these areas, dogs are believed to be the natural reservoirs of this parasite. In the case of visceral leishmaniosis, the spleen is one of the several hematopoietic and immunocompetent organs involved. Since this viscera is a blood filter, the authors investigated the expression of the morphological and microvascular environment and modifications of the spleen cell population related to immunological responses to this parasitic condition. The tools used to perform this study were scanning electronic microscopy of intact tissue and corrosion casts, transmission electronic microscopy, histology and immunohistochemistry. The results reveal three important modifications concerning the spleen's microvascular architecture when compared with its normal pattern, independently of the serological titer obtained with indirect immunofluorescence. (1) A marked scarcity of the sinusoidal system sheet that surrounds the central artery/arteriole of the white pulp; (2) A huge development of pulp venules and veins; (3) The presence of a surprising development of reticular fibers. The authors postulate that independent of the virulence of the parasite involved and the type of immunity prevalent in a particular host, the spleen develops blood dynamic conditions that permit reduction in the speed of blood flow so that cells involved in immunological processes can proliferate and differentiate, and also contributes to trapping lymphocytes within the area through the differentiation of characteristics that resemble those of HEV endothelial cells.

Three-dimensional reconstruction of the angioarchitecture of the ciliary body of the West Indian manatee (Trichechus manatus)

OBJECTIVE

To examine the angioarchitecture of the ciliary body in the West Indian manatee (Trichechus manatus), through the use of three-dimensional reconstruction.

PROCEDURE

Specimens from West Indian manatee were preserved in 10% buffered formalin, embedded in paraffin, serial sectioned and stained by Masson trichrome for light microscopic three-dimensional reconstruction and evaluation.

RESULTS

The network of blood vessels in the ciliary processes of the West Indian manatee is fed by the major arterial circle that lies mostly near the base of the iris. The branching arterioles give rise to a capillary-sinusoidal bed that extends internally along each process, emptying into two sets of veins, one being elevated. The elevated and nonelevated veins join posteriorly before emptying into the choroidal venous system.

CONCLUSIONS

The angioarchitecture of the ciliary body of the West Indian manatee is clearly unique when compared to those previously examined in land mammals. Three-dimensional reconstruction of paraffin sections is an effective means to evaluate vascular patterns in ocular specimens, especially those unavailable for corrosion casting.

Schwann cell behavior after nerve repair by means of tissue-engineered muscle-vein combined guides

Schwann cells play a critical role in peripheral nerve regeneration. When a non-nervous conduit is used to bridge a nerve defect, the conduit is soon colonized by a number of Schwann cells that make a pathway for regrowing axons. By using electron microscopy, immunohistochemistry, and reverse transcriptase-polymerase chain reaction analysis, we have investigated the behavior of migratory glial cells along a particular type of autologous tissue-engineered conduit made of a vein filled with fresh skeletal muscle, using the rat sciatic nerve model. With this particular type of autograft, our data show that many Schwann cells soon take up a close relationship with grafted muscle fibers, and especially with their basal lamina, which appears to serve as a migration pathway for them. The early and massive colonization of the conduit is sustained by both Schwann cell migration and proliferation, as demonstrated by PCNA immunostaining. Later, as they meet regenerating axons, Schwann cells become closely associated with them and eventually lose their connections with grafted muscle fibers because of the formation of perineurial envelopes. Because previous studies showed that alpha(2a-2b) NRG1 is overexpressed at early stages along the muscle-vein combined tubes, we have also investigated mRNA expression of its two receptors, erbB2 and erbB3. Both messengers are overexpressed, although with different time courses. Overall, our results provide some morphological and biochemical bases for explaining the effectiveness of fresh muscle-vein combined nerve guides and throw an interesting light on the possible role of alpha(2a-2b) NRG1 through the erbB2/erbB3 heterodimer receptor for nerve regeneration inside non-nervous conduits.

Evidence of Rickettsia spp. infection in Sweden: a clinical, ultrastructural and serological study

Sweden is an area potentially endemic for spotted fever rickettsioses. Rickettsia helvetica has been isolated from its tick vector Ixodes ricinus, and in a handful of cases linked to human disease. This study demonstrates for the first time in Sweden the transmission of rickettsial infection after a tick bite and the attack rate in an endemic area. We present three cases of documented rickettsial infection and a prospective serological study of Swedish recruits who were trained in the area where the patients lived and showed seroconversion to spotted fever rickettsiae. All patients showed a four-fold increase in antibody titer to the spotted fever rickettsia, R. helvetica, and immunohistochemical examination revealed rickettsia-like organisms in the walls of skin capillaries and veins. Electron microscopy showed organisms resembling R. helvetica and immunogold labeling with two anti-rickettsial antibodies demonstrated specific labeling of the rickettsial organisms in the skin biopsy specimens. Eight of the thirty-five recruits showed a four-fold increase in IgG titer reflecting a high rate of exposure. The results of this study demonstrate that spotted fever rickettsioses should be taken into consideration in the diagnosis of tick-transmitted infections in Sweden.

Venous sphincters in the choroidea of spontaneously hypertensive rats

Ocular vasculopathy resulting from severe systemic hypertension affects retina, choroidea, and the optic nerve. While the pathologic changes of the arterial system, including luminal narrowing, are well documented, little is known about the ocular venous vessels in hypertension. Adult 18-week-old spontaneously hypertensive rats (SHRs) were untreated (control) or treated with lisinopril for 4 weeks; normotensive Wistar-Kyoto (WKY) rats were additional controls. The mean systemic blood pressure (MSP) was monitored chronically using telemetry. The ocular microvasculature was examined using scanning electron microscopy (SEM) of corrosion casts, histology of serial sections, and computer-based 3D reconstruction. The MSP in control SHRs (145 +/- 11.9 mmHg) was decreased to 68.1 +/- 4.9 mmHg (P < 0.001) following treatment, which was even below the baseline level of WKY (96.7 +/- 5.8) rats (P < 0.05). In addition to media thickening in arteries, the venous plexus of the choroidea in control SHRs revealed multiple tufts of smooth muscle cells (sphincters) that narrowed the lumen. Correlating to histology, SEM of casts and 3D reconstruction showed numerous constrictions and muscular tufts in veins of the choroidea, narrowing the vascular lumen up to 47%. Following antihypertensive treatment, the percentage of sphincter constriction was decreased to 6% (P < 0.001). The depth of venous sphincter contraction correlated significantly with MSP (r = 0.87). To our knowledge, these results indicate for the first time that venous sphincters occur in the choroidea of the SHRs, and that their muscularity correlates with MSP. Venous sphincters might be involved in the pathophysiology of hypertension-related ocular changes.

[Angioarchitecture of the endometrial venous system of human myomatous uteri--scanning electron microscopy study]

OBJECTIVES

The venous system of endometrium of myomatous uteri was examined.

MATERIAL AND METHODS

The studies were carried out on 20 uteri obtained from autopsies. Corrosion casts were studied using scanning electron microscopy.

RESULTS

The specimens revealed a chaotic network of tortuous and distended veins, venules and venous capillaries. The so-called venous lakes were observable in the whole length of the functional layer of the endometrium.

CONCLUSIONS

Veins of the endometrium do not go in a company with arteries. No arterio-venous anastomoses were found.

The corrupted feedback hypothesis

This paper argues that varicose veins are caused by a feedback malfunction. The feedback in question regulates the tone of the vein by dilating it as needed, using noradrenaline (NA), tapped from the circulating pool, for the purpose. The drug, though conventionally classified as a venoconstrictor, dilates the vein when it diffuses from the vasa venarum of the vein into the vein's media; the drug having reached the vasa by reflux from the vein lumen. A varicosity is created when a factor increases the volume of reflux, and, therefore, the quantity of NA, perfusing a unit of the vasa network, selectively. The resultant, exaggerated, localised, dilator effect that the NA has on a section of the vein, constitutes the varicosity radix. In brief, a varicosity, when first created, is seen as being an exaggerated, but appropriate, dilator response of a section of a normal vein to an inappropriate, corrupted, feedback signal. The acute varicosity is believed to transform into the permanent type seen in varicose veins if the factor responsible for it persists long enough.

Vascular Organization of the Hystricomorph Placenta: a Comparative Study in the Agouti, Capybara, Guinea Pig, Paca and Rock Cavy

The placental vasculature of five hystricomorph rodents was examined by latex injection of the blood vessels, immunohistochemistry and scanning electron microscopy of vessel casts. The pattern of branching of the vessels is described at the level of fine structure. The placenta is divided into lobes separated by interlobular trophoblast. Fetal arteries course through the interlobular areas and give rise to capillaries from which blood drains into veins at the centre of the lobes. Maternal blood reaches the placenta through spiral arteries that pass around the perimeter of the subplacenta. They supply large maternal blood sinuses, lined by trophoblast, which run through the interlobular areas and into the centre of the lobes. Here they supply fine channels that run parallel to the fetal capillaries, so that maternal blood flows from the centre of the lobe to the periphery. This arrangement provides the morphological basis for countercurrent exchange. The maternal channels of the labyrinth drain into spaces formed by the latticework of the interlobular trophoblast and thence through venous lacunae to a basal venous lacunar ring. The subplacenta is supplied by a single fetal artery. The vessels within the subplacenta pursue a tortuous course with dilatations and constrictions as in an endocrine gland.

Vascular anatomy of the gills in a high energy demand teleost, the skipjack tuna (Katsuwonus pelamis)

Tunas (family: Scombridae, Tribe: Thunnini) exhibit anatomical, physiological, and biochemical adaptations that dramatically increase the ability of their cardiorespiratory systems to transfer oxygen from the water to the tissues. In the present study the vascular anatomy of the skipjack tuna, Katsuwonus pelamis, gill was examined by light and scanning electron microscopic analysis of methyl methacrylate vascular corrosion replicas prepared under physiological pressure. The gill filament contains three distinct blood pathways, respiratory, interlamellar, and nutrient. The respiratory, or arterio-arterial (AA) pathway, is the site of gas exchange and consists of the afferent and efferent filamental arteries (AFA and EFA) and arterioles (ALA and ELA) and the lamellae. Each ALA in the basal filament supplies ten or more lamellae and they anastomose with their neighbor to form a continuous vascular arcade. Four modifications in the lamellar circulation appear to enhance gas exchange efficiency. 1) The ALA deliver blood directly to the outer margin of the lamellae where unstirred boundary layer effects are predicted to be minimal and water PO2 highest. 2) Pillar cells are closely aligned along the outer boundary of the inlet side and the inner boundary of the outlet side of the lamellae to form multiple distributing and receiving blood channels. 3) Elsewhere in the lamella, pillar cells are aligned to form diagonal channels that direct blood from the outer to the inner lamellar margins, thereby reducing vascular resistance. 4) The lamellar sinusoid is especially widened near the efferent end to augment oxygen saturation of blood flowing through the inner margin. These adaptations, plus the presence of a bow-shaped interlamellar septum, and a thinned filament core appear to decrease gill vascular resistance and maximize gas-exchange efficiency. The interlamellar (IL) and nutrient systems originate from post-lamellar vessels and are arterio-venous (AV) pathways. IL vessels form an extensive ladder-like lattice on both sides of the filamental cartilage and are supplied in part by narrow-bore vessels from the medial wall of the EFA. Their function is unknown. Nutrient vessels are formed from the confluence of a myriad of tortuous, narrow-bore vessels arising from the basal region of the EFA and from efferent branchial arteries. They re-enter the filament and eventually drain into the IL system or filamental veins. As these AV pathways are retained despite considerable reduction in filamental tissue, it is evident that they are integral components of other non-respiratory homeostatic activities of the gill.

Remodeling of suspended small intestinal submucosa venous valve: an experimental study in sheep to assess the host cells' origin

PURPOSE

To investigate the origin of host cells during remodeling of small intestinal submucosa (SIS) square stent-based bicuspid venous valves (VVs).

MATERIALS AND METHODS

Suspended VVs (SVVs) were developed by suspending VVs within bare square stents so the valve elements would not contact the vein wall after deployment. Eight SVVs were placed within the intrahepatic and infrahepatic inferior venae cavae (IVCs) of four adult female sheep. Eight standard VVs were implanted in the external jugular veins of these animals for comparison. At 5 weeks after placement, the devices were examined for stability and patency and the animals were killed. Gross, histologic, and scanning electron microscopic (SEM) examinations were performed.

RESULTS

Follow-up spot radiographs and venography showed no migration of the devices, venous occlusion, or thrombus formation. All SVVs were intact without contact with the IVC wall. Six VVs were competent and two were slightly tilted with some reflux. Histologic study showed remodeling of SVVs and VVs with newly formed collagen fibers; fibroblasts and inflammatory cells were found penetrating the SIS leaflets and endothelial cells on the surface. SIS neovascularization was also present. There was no difference regarding SIS remodeling between SVVs and the free part of VV leaflets. The VV leaflets' bases were thicker compared to their free parts (P <.01). SEM examination showed endothelial cells on both sides of the SVVs and VVs. Endothelialization of the SVV central leaflet surfaces and both surfaces of the VV leaflets was more complete than that of the peripheral surfaces of the SVV leaflets.

CONCLUSION

SIS-based valve remodeling occurs independently of vessel wall contact by recruitment of cells directly from the circulation.

Embryonic development of coronary vasculature in rats: corrosion casting studies

The aim of this study was to analyze the development of coronary vessels at different stages of embryonic life in rats using corrosion casts and scanning electron microscopy (SEM). We studied morphologic details of vessel maturation, expansion, and pattern formation from the stage of development when the coronary system forms patent connections with the aorta and the right atrium (embryonic day 16 (ED16)) to full-term fetus (ED21). The internal surface morphologies of the arterial and venous vessel walls were different and were dependent on the distance from the orifice and the capillary system. They also depended on the maturation state of a given vessel. In various branches of the coronary system we demonstrated round, fusiform or polygonal, endothelial cell imprints. The capillary network was dense, however, at the early stages of development, it formed a thin layer over the myocardium. By ED21 capillaries assumed an orientation parallel to the long axes of the cardiac myocytes. During all stages of development, different forms of angiogenesis by intussusceptive growth were observed. Splitting of the vessel wall occurred in two or three points along the vessel, forming two- or three-link chains. Certain areas of vessels resembled doughnuts, from which several sister vessels originated. The coronary arteries were situated deep within the myocardial wall. The major coronary veins were mostly located on the surface of the capillary plexuses of the myocardial wall. In conclusion, this method of vessel casting enables the detection of angiogenesis by intussusceptive growth, and the visualization of a capillary's position to the myocardial wall, thickness of the capillary plexuses, and the internal surface morphology of major vessels.

The human testicular artery and the pampiniform plexus--where is the connection?

The aim of the study was the microscopic evaluation of the human spermatic cord vessels, with special attention to the connection between the testicular artery and the veins of the pampiniform plexus. We used the corrosive cast method to visualise the angioarchitecture of the spermatic cord. Casts were evaluated using a scanning electron microscope. We observed that there is a narrow space (previously filled with the testicular artery wall), between the casts of the testicular artery and the veins of the pampiniform plexus. This area contains a capillary vessel net, which connects the testicular artery with the veins of the pampiniform plexus. There were no direct anastomoses between the testicular artery and the pampiniform plexus. We hypothesise that the capillary net described is the means of connection between the testicular artery and the pampiniform plexus, and that there can be a testicular artery net of its own vessels (vasa vasorum).

Cellular localization of the endothelin receptor subtypes ET(A) and ET(B) in the rat heart and their differential expression in coronary arteries, veins, and capillaries

In the heart, the endothelin (ET)/endothelin-receptor system is markedly involved in pathophysiological mechanisms underlying various cardiac diseases. Based upon pharmacological studies both ET-receptor subtypes take part in the regulation of coronary vascular tone, however, their detailed cellular distribution in the coronary vascular bed based upon direct mRNA and protein detection is unknown. This issue was addressed in the rat heart by means of non-radioactive in situ hybridization, RT-PCR, and immunohistochemistry. Expression of vascular ET(A)-receptors was detected in arterial smooth muscle and capillary endothelium while ET(B)-receptors were present in arterial, venous, and capillary endothelium, and in arterial and venous smooth muscle cells. This differential distribution of the ET-receptor subtypes supports the concept that ET(A)- as well as ET(B)-receptors mediate arterial vasoconstriction, while postcapillary vascular resistance is exclusively regulated by ET(B)-receptors. The observed capillary endothelial expression of the ET(A)-receptor correlates with the known ability of ET(A)-receptor antagonists to attenuate increases in cardiac microvascular permeability during endotoxin shock and ischemia/reperfusion injury.

Development of the coronary blood supply: changing concepts and current ideas

Earlier views of the development of the coronary vasculature included angiogenic budding and growth of arteries from the aortic sinuses and veins from the coronary sinus. The current concept begins with the establishment of the epicardium from the proepicardial organ, an outgrowth of the dorsal wall of the pericardial cavity. Capillaries form in a subepicardial mesenchymal population, extending as a plexus toward the truncus arteriosus and the atria. Multiple vessels grow from a peritruncal ring of capillaries, preferentially invading the newly formed aorta. In a process involving apoptotic changes of both the aortic wall and the invading capillaries, orifices open at the level of the aortic sinuses. Smooth muscle cells and pericytes, recruited from the surrounding mesenchyme, contribute to the vessel walls, and the definitive coronary artery pattern is established. Similar events are occurring on the venous side of the coronary circulation, following a slightly earlier time course. Multiple factors govern this process, including VEGF and FGF-1 stimulating vasculogenesis and angiogenesis, and the angiopoietins and their tyrosine kinase receptors modulating interactions between endothelial cells and the mural components. As remodeling of the capillary plexus and the coronary orifices progresses, TGF beta released by apoptotic cells or from other sources likely modulates VEGF and FGF-1, and also contributes to further apoptotic changes. A better appreciation of the controls of the mechanisms of coronary vessel development may direct further research in the prevention of arteriosclerosis and ischemic tissue injuries.

Corrosion cast demonstration of choroidal vasculature in normal Wistar Kyoto rat

No previous attempt has been made so to demonstrate the details of the choroid vascularization in the rat. This paper describes the choroidal vascular pattern of the normal Wistar Kyoto rat using the corrosion cast method. 6-month-old normal Wistar Kyoto rats were used. Vascular casts prepared by our previously described technique were observed with a Hitachi S-2360N scanning electron microscope. Corrosion casts of the entire choroidal vasculature showed that the ophthalmic artery branched into two main ciliary arteries: the nasal and temporal arteries, which extend forward to form the iridociliary circle. Further the inferior ciliary artery arises from the temporal ciliary artery. In the posterior eye segment these arteries form four to seven branches supplying the adjacent choriocapillaris. There are different arrangements of choriocapillaris. The larger veins formed four vortex veins, one in each quadrant, draining blood from the anterior region of the choroid or iris. Venous blood from the central region, peripapillary choroid and sometimes optic nerve head is drained by smaller veins, which run more or less directly into the posterior ciliary veins. In conclusion corrosion casts and SEM can show the details of the choroidal vascular architecture. These three-dimensional (3-D) findings of choroidal vessels of the rat are very useful for the study of choroid vascular abnormalities in various pathological conditions.

Pathological morphology alteration of the splanchnic vascular wall in portal hypertensive patients

OBJECTIVE

To investigate the pathological morphology alteration of the splanchnic vascular wall in portal hypertensive patients.

METHODS

Splenic arteries, veins and gastric coronary veins from portal hypertensive patients (n = 50) were removed during esophagogastric devascularization with splenectomy and were observed under optic and electron microscopes. The expression of iNOS in the splenic artery wall was analysed with immunohistochemistry.

RESULTS

The internal elastic membrane and medial elastic fibers of the splenic artery wall were broken and degenerated. Atrophy, apoptosis and phenotypic changes were seen in smooth muscle cells of splenic arteries. Positive staining for iNOS was seen in the cytoplasm of smooth muscle cells and iNOS activity was elevated compared with the non-cirrhotic patients (P < 0.01). In the splenic and gastric coronary veins of cirrhotic patients, we found proliferative intima, extensive thrombi adhering to the venous wall, mimicked arteriosclerosis plaques accompanied with hypertrophy of smooth muscle cells, and thickened muscle fibers of veins with increase in extracellular matrix.

CONCLUSION

Portal hypertension may be complicated by splanchnic arterial and venous vasculopathy. There may be an interactive relationship among portal hypertension, splanchnic hyperdynamic disturbances and splanchnic vasculopathy in the pathogenesis of portal hypertension.

Deformation-induced endothelin B receptor-mediated smooth muscle cell apoptosis is matrix-dependent

To maintain normal blood flow, pressure overload in both arteries and veins requires a structural adaptation of the vessel wall (remodelling) that involves smooth muscle cell (SMC) hypertrophy and/or hyperplasia. Due to its potent vasoconstrictor and growth-promoting effects, endothelin-1 (ET-1) is a likely candidate to initiate and/or promote remodelling in blood vessels exposed to a chronic increase in blood pressure. To test this hypothesis, isolated segments of the rabbit carotid artery and jugular vein were perfused at different levels of intraluminal pressure. In both types of segments, pressure overload (160 and 20 mmHg, respectively) resulted in an increase in endothelial prepro-ET-1 and SMC endothelin B receptor (ETB-R) expression. Moreover, in pressurised segments from the carotid artery an ETB-R antagonist-sensitive increase in SMC apoptosis in the media was observed, while in the vein medial SMC started to proliferate. Isolated SMC from these rabbit blood vessels as well as from the aorta and vena cava of the rat, when cultured on a collagen or laminin matrix, uniformly revealed an ETB-R-mediated increase in apoptosis upon exposure to mechanical deformation plus exogenous ET-1 (10 nmol/L). However, when grown on a fibronectin matrix, the cultured SMC did not respond with an increase in apoptosis under otherwise identical experimental conditions. These findings suggest that deformation-induced activation of the endothelin system in the vessel wall not only plays a crucial role in remodelling, but that the structural components of the vessel wall, in particular the cell-matrix interaction, determine how SMC respond phenotypically to these changes in gene expression.

The human ductus venosus between 13 and 17 weeks of gestation: histological and morphometric studies

BACKGROUND

Doppler studies of the ductus venosus are increasingly being integrated in the assessment of fetal well-being. Establishing the precise morphology and structure of the ductus venosus would provide a better understanding of Doppler findings during fetal adaptation. There is conflicting evidence from previous studies about the structure of the ductus venosus, especially with regard to the presence of a sphincter at the ductus venosus inlet. The aim of this study was to examine the morphology and histological structure of the ductus venosus wall and surrounding tissues at 13-17 weeks' gestation.

DESIGN

This was a prospective study on 28 fetuses obtained from medical termination of pregnancies between 13 and 17 weeks' gestation. Scanning electron microscopy and histological and immunohistochemical studies were carried out on ductus venosus sections obtained from different spatial planes.

RESULTS

The inlet of the ductus venosus contained a shelf which was rich in elastin, but devoid of any evidence of a smooth muscle sphincter. The isthmus of the ductus venosus above the inlet was narrowed, giving the lumen of the vessel an hourglass appearance. The endothelial surface of the ductus venosus, above the level of the inlet, showed longitudinal corrugations along its entire length. Longitudinally arranged elastin fibers were also seen along the length of the ductus venosus. A single layer of longitudinally arranged smooth muscle cells was present along the entire length of the ductus venosus, with occasional individual nerve cells visible in this layer.

CONCLUSIONS

The presence of an elastin-rich shelf and a narrow ductus venosus inlet orifice may act to accelerate flow from the portal sinus into a high-velocity system in the ductus venosus. The abundant elastin fibers in the adventitia of the ductus venosus may help antegrade wave propagation by elastic recoil. This study clearly demonstrates the lack of an anatomical smooth muscle sphincter at the ductus venosus inlet. However, the combination of endothelial corrugations and innervated smooth muscle support the hypothesis that the ductus venosus is an actively regulated vessel with the capacity to rapidly change diameter along its entire length in response to certain stimuli.

Corrosion casts and scanning electron microscopy of choroidal vasculature in rats with inherited hypercholesterolemia

PURPOSE

The purpose of the present study is to determine the specific morphological changes in choroidal vasculature due to hypercholesterolemia.

METHODS

The choroidal vessels of rats with inherited hypercholesterolemia (RICO) were examined by the corrosion cast technique and electron microscopy.

RESULTS

In 18-month-old RICO rats, corrosion casts and scanning electron microscopy showed severe tortuosity, caliber irregularity and generalized dilatation of the large choroidal arteries and veins. The branch arterioles and draining venules were also tortuous and dilated. The ampullae of the vortex veins were wide, but no arteriovenous anastomoses, crossing defects or obstruction were seen. However, there were many venular collateral channels and venulo-venular anastomoses. The choriocapillaries appeared normal. Transmission electron microscopy of the choroidal vessels showed hypertrophy of smooth muscle cells and irregular thickening of the basement membrane. The RPE and Bruch's membrane were intact.

CONCLUSION

These findings indicate that the choroidal vascular changes are probably related to hypercholesterolemia. The results of the present study will be useful in the interpretation of the changes seen in hypertensive, diabetic and aged choroids.

Microvascular architecture of the rat choroid: corrosion cast study

This study presents the details of the microvasculature of the rat choroid visualized by scanning electron microscopy of vascular corrosion casts. Wistar Kyoto rats were anesthetized with intraperitoneal sodium pentobarbital. The vascular system was perfused with heparinized saline, and Mercox resin was injected into the cannulated carotid arteries. After polymerization of the resin, the vascular casts were macerated with potassium hydroxide, washed with water, and freeze dried. The casts were examined with a Hitachi S-2360N scanning electron microscope (SEM). Corrosion casts of the entire choroidal vasculature revealed that the two long posterior ciliary arteries supplied the entire uveal vasculature. In the posterior choroid, these arteries formed five to seven branches on each side supplying the adjacent choriocapillaris. No interarterial or arteriovenous anastomoses were seen. The choriocapillaris appeared as a nonhomogeneous and nonlobular monolayer capillary network, consisting of dense honeycomb and irregular patterns. There are two distinct venous systems in the rat choroid. The venous blood from the central region, peripapillary choroid, and sometimes the optic nerve head drain into the posterior ciliary vein. The venous blood from the iris, ciliary body, anterior choroid, and half of the posterior choroid drain into the vortex veins. Corrosion casts and the SEM have shown details of the choroidal vascular architecture. These three-dimensional observations indicate that the rat choroidal vasculature has different features from those of humans and other primates. Despite these interspecies differences, the establishment of a thorough baseline concept of choroidal vasculature should permit additional studies of the choroidal pathology and enable the proper interpretation of results from rat experimental models for extrapolation to humans.

Incompetent Perforating Veins are Associated with Recurrent Varicose Veins

AIMS

we suspected incompetent perforating veins of having a role in the development of recurrent varicose veins in some patients. The aim was to look for an association between perforators and recurrent varicose veins.

METHODS

a consecutive group of patients presenting with varicose veins were examined using colour duplex ultrasonography by an experienced vascular technologist. Pathological perforating veins were defined as those exhibiting bi-directional flow and a diameter of 4 mm or greater at the fascia.

RESULTS

between September 1998 and July 1999, 204 patients were examined. Primary varicose veins were found in 198 legs (135 patients) and recurrent varicose veins in 91 legs (69 patients). In patients with primary varicose veins, 88 (44%) had incompetent perforators compared to 57 (63%) of those with recurrent varicose veins (Chi-squared, p <0.005). Also, for recurrent varicose veins, the percentage of patients with any given number of incompetent perforators was higher than for primary varicose veins. Overall, there was a higher number of incompetent perforators in those with recurrent veins compared to primary veins and this difference was significant at 95% confidence interval.

CONCLUSION

patients with recurrent varicose veins have both a higher prevalence and a greater number of incompetent perforating veins than patients with primary varicose veins.

Tissue response to an expanded polytetrafluoroethylene external valve support device: a histologic study in dogs

Expanded polytetrafluoroethylene (ePTFE) external valve support devices (EVS) have been used successfully in patients to restore valve function in leg veins with incompetent valves when incompetence is due to dilatation of the vein walls or elongation of the valve leaflet edges. To assess tissue response to these devices, the authors implanted 12 of them in dogs, wrapping the devices around veins in the head and neck. The dogs recovered from the implantation procedure uneventfully, and the veins remained patent on color flow Doppler scanning. Gross and histologic evaluations of vein segments and attached EVS devices after sacrifice of the dogs 30 days postoperatively showed that the ePTFE devices did not affect vein patency or the cellular composition or architecture of vein walls. There were no adverse tissue reactions to the EVS and no thrombus formation in the veins to which the EVS had been applied. Tissue attachment to the EVS was apparent in all specimens. These histologic results support clinical experiences indicating that the ePTFE EVS device is safe to use in external valvuloplasty for the treatment of venous incompetence.

Distinct vascular zones in the canine prostate

The vascular bed of canine prostate was studied and detailed distinct vascular zones were visualized on corrosion casts by scanning electron microscopy. This study was performed because of scarce information about the zonal vascularization of the prostate gland in dogs. There are no studies for three-dimensional microvascular distribution of the capsular vessels and the capsular microvascular trabeculae. SEM (vascular corrosion casting method) was used to show 3D angioarchitecture of the prostate gland. The lobules on the dorsal and lateral surface of the gland were numerous but small. Their small size is probably due to the abundant blood supply in the region. Few but large ventral lobules were observed. Three prostatic zones were clearly defined: capsular, parenchyma, and urethral. The diameter of the venous blood vessel compared to arterial vessels of the capsule was smaller. Two types of arteries were observed in trabeculae: direct and branched. The direct arteries were straight, with only a few branches. The branched arteries contained many bifurcations, with the vessel's diameter decreasing gradually. The trabeculae capillary network formed loops, with frequent sphincter-like constrictions and pouch-like protuberances.

Morphological and clinical aspects of scapular fasciocutaneous free flap transfer for treatment of venous insufficiency in the lower extremity

We have recently shown that free scapular fasciocutaneous flaps transferred to the lower extremities of patients with chronic venous insufficiency and cutaneous ulcers have resulted in improvement in venous refilling times measured by photoplethysmography in the flap areas and that recurrent ulceration does not recur for up to 7 years. We hypothesized that the transferred flaps contained valves in their microvascular bed, which facilitated venous return, and using scanning electron microscopy of vascular corrosion casts and light and transmission electron microscopy of tissue sections prepared from human dorsal thoracic fascia, we showed that valves were most abundant in veins with a luminal diameter of 30-120 microm (59.3% of 905 valves). The depth of these valves increased with venous diameter, but the size of valve sinuses was not different for individual valves. Except for veins > 1,000 microm in diameter, there was no significant difference in the number of valves in different parts of an individual flap or between different flaps. Most valves were bicuspid; only in the vein Category 30-120 microm were unicuspid valves encountered. Valves were sometimes located in series in a short segment of a vein; occasionally they were found at the merging of two veins. Transmission electron microscopy showed that valve leaflets had collagen fibers that ascended toward the tip of the leaflet and were occasionally accompanied by elastic fibers. Myofibroblasts were regularly present in the valve leaflets. The present report reviews and updates these anatomic data about the human scapular region, focusing on venous valvular microstructure, and suggests that the high number of smaller-size valves contributes to improved hemodynamic of the leg and thus the clinical success of free scapular flaps used to treat cutaneous ulcerations in the lower extremity.

An absorbable pinned-ring device for microvascular anastomosis of vein grafts: experimental studies

In the rabbit, posterior facial vein segments were grafted to the femoral arteries using either conventional suture technique or a mechanical absorbable pinned-ring device. The purpose of this study was to compare patency rates and anastomotic times for the two different methods. The anastomoses were evaluated macroscopically and using light and scanning electron microscopy. The grafts anastomosed with the absorbable rings exhibited 100% patency, while only 83% of the sutured grafts were patent. The mean anastomotic time using the mechanical pinned-ring device was 18.1 min (range 9.8-30 min). The conventionally sutured anastomoses were completed in a mean time of 60 min (range 50-75 min). The experiment has confirmed that the absorbable pinned-ring device provides a safe and fast way to perform microvascular anastomosis.

Morphological analysis of peripheral nerve regenerated by means of vein grafts filled with fresh skeletal muscle

Clinical data have shown that a vein segment filled with fresh skeletal muscle can be considered a good autologous grafting conduit for the repair of peripheral nerve lesions. In this study, the long-term morphological organization of rat sciatic nerve fibers regenerated along a muscle-vein-combined graft conduit is further analysed by light and electron microscopy. Regenerated nerve fibers were organized into fascicles of various sizes that were clearly delimited by perineurial-like shells made by long and thin cytoplasmic processes of perineurial-like bipolar cells and by densely packed collagen fibrils. Grafted skeletal muscle fibers were still detectable among nerve fiber fascicles. However, in spite of the persistence of skeletal muscle along the graft, regenerated nerve fibers showed a good morphological pattern of regeneration, providing further evidence that the muscle-vein-combined grafting technique represents an effective surgical alternative to the classical fresh nerve autograft for the repair of peripheral nerve defects.

Scanning electron microscopic studies of the vascular smooth muscle cells and pericytes in the rat heart

The cytoarchitecture of smooth muscle cells and pericytes in the rat cardiac vessels was studied by scanning electron microscopy after the removal of connective tissue matrices using a modified KOH-collagenase digestion method. The initial stem of the coronary arteries had groups of smooth muscle cells which ran in various directions on the outermost layer of the media. Although smooth muscle cells in coronary arteries of more than 100 microm in the outer diameter were arranged in a rough circle around the vessel axis, oblique and/or longitudinal muscle bundles were often present in the medio-adventitial border of the vessels. The presence of irregularly oriented muscular bundles is probably connected with resistance against the stretching force induced by the beating of the heart. As the vessel size decreased toward the periphery, almost all of the smooth muscle cells became spindle-shaped with several tiny processes and ran circularly or helicaly to the vessel axis. In the precapillary arterioles (6-12 microm), smooth muscle cells acquired various cytoplasmic processes which helicaly surrounded endothelial cells. Unmyelinated nerves were often associated with arterioles. Blood capillaries were morphologically divided into three segments: arterial capillaries which had pericytes with wide and circularly oriented processes, true capillaries whose pericytes extended long and thin primary processes bilaterally along the vessel axis, and venous capillaries surrounded irregularly and loosely by wide pericytic processes. The stellate pericytes in the postcapillary venules (10-30 microm) gradually changed into flat tape-like smooth muscle cells, which ran circularly in the collecting venules and veins (30-200 microm). The large collecting veins were finally overwhelmed by superficial thin layer of the myocardium, their own smooth muscle cells being very sparse. This suggests that large veins have poor ability to contract by themselves but are influenced by the surrounding myocardial cells.

[Ultrastructural changes of veins in several variants of cryopreservation]

The findings of ultrastructural analysis demonstrated essential changes in connective tissue cells and noncellular elements of veins after their cryopreservation at -50 degrees C and -196 degrees C. Contraction and round-up of endotheliocytes, disruption of their connections with basement membrane leading to subendothelial space widening, cytoplasm vacuolization and focal destruction of luminal plasmalemma are typical and general changes caused by cryopreservation. Dystrophy of different grades developed in connective tissues of media and adventitia. Deeper freezing negatively affects structural integrity of venous tissues. After the use of conserving solutions (Eurocollins and Scientific Research Institute of Traumatology and Orthopaedics) necrotized endotheliocytes were absent and endothelial lining was preserved in major part of the vein surface studied even following its deep freezing which supports the conclusion on the cryoprotective effect of the solutions.

Morphological features of the spermatic cord in the musk shrew (Suncus murinus) with special reference to extratesticular Leydig cells

Morphological features of the testicular artery and vein in the spermatic cord of the musk shrew (Suncus murinus) were evaluated by light microscopy, transmission electron microscopy, corrosion cast technique combined with scanning electron microscopy and immunohistochemistry. The vascular architecture in the spermatic cord of the musk shrew was simple. The testicular artery in the musk shrew was straight and accompanied by 1 to 3 branches of testicular vein. The testicular vein was also straight and anastomosed with each other in some points along its length, but it did not form a delicate pampiniform plexus. In the middle and distal portions of the spermatic cord, the tunica adventitia of the artery and vein was joined together to form a single connective tissue septum. Clusters of cells were found in this connective tissue septum in the middle portion of the cord. These cells were located close to the arterial wall and nerve endings, but they did not appear inside of neurium. They showed several typical characteristics similar to Leydig cells, and they were positive for 3beta hydroxysteroid dehydrogenase (HSD) antibody. Ultrastructural and immunohistochemical studies also indicated that the cells in cluster found in the vascular wall of the musk shrew spermatic cord may be equivalent to Leydig cells in testes. These extratesticular Leydig cells had characteristics of the active steroid-producing cell and seemed to be another source of testosterone.