Intravenous leiomyomatosis of the uterus with extension to the right heart

A 42-year-old woman admitted with debilitation and engorgement both lower extremities. Transthoracic two-dimensional echocardiography, abdominal ultrasound and computerized tomography revealed a lobulated pelvic mass, a mass within right internal iliac vein, both common iliac vein, as well as the inferior vena cava, extending into the right atrium. In addition, echocardiography and abdominal ultrasound showed the tumor of right atrium and inferior vena cave has no stalk and has well-demarcated borders with the wall of right atrium and inferior vena cave. Hence, the presumptive diagnosis of IVL was made by echocardiography and abdominal ultrasound and the presumptive diagnosis of sarcoma with invasion in right internal iliac vein, both common iliac vein, the inferior vena cava, as well as the right atrium was made by multi-detector-row computerized tomography. The patient underwent a one-stage combined multidisciplinary thoraco-abdominal operation under general anaesthetic. Subsequently the pathologic report confirmed IVL

Distinctive Left-Sided Distribution of Adrenergic-Derived Cells in the Adult Mouse Heart

Adrenaline and noradrenaline are produced within the heart from neuronal and non-neuronal sources. These adrenergic hormones have profound effects on cardiovascular development and function, yet relatively little information is available about the specific tissue distribution of adrenergic cells within the adult heart. The purpose of the present study was to define the anatomical localization of cells derived from an adrenergic lineage within the adult heart. To accomplish this, we performed genetic fate-mapping experiments where mice with the cre-recombinase (Cre) gene inserted into the phenylethanolamine-n-methyltransferase (Pnmt) locus were cross-mated with homozygous Rosa26 reporter (R26R) mice. Because Pnmt serves as a marker gene for adrenergic cells, offspring from these matings express the β-galactosidase (βGAL) reporter gene in cells of an adrenergic lineage. βGAL expression was found throughout the adult mouse heart, but was predominantly (89%) located in the left atrium (LA) and ventricle (LV) (p<0.001 compared to RA and RV), where many of these cells appeared to have cardiomyocyte-like morphological and structural characteristics. The staining pattern in the LA was diffuse, but the LV free wall displayed intermittent non-random staining that extended from the apex to the base of the heart, including heavy staining of the anterior papillary muscle along its perimeter. Three-dimensional computer-aided reconstruction of XGAL+ staining revealed distribution throughout the LA and LV, with specific finger-like projections apparent near the mid and apical regions of the LV free wall. These data indicate that adrenergic-derived cells display distinctive left-sided distribution patterns in the adult mouse heart

Haemodynamics and flow modification stents for peripheral arterial disease:a review

Endovascular stents are widely used for the treatment of peripheral arterial disease (PAD). However, the development of in-stent restenosis and downstream PAD progression remain a challenge. Stent revascularisation of PAD causes arterial trauma and introduces abnormal haemodynamics, which initiate complicated biological processes detrimental to the arterial wall. The interaction between stent struts and arterial cells in contact, and the blood flow field created in a stented region, are highly affected by stent design. Spiral flow is known as a normal physiologic characteristic of arterial circulation and is believed to prevent the development of flow disturbances. This secondary flow motion is lost in atheromatous disease and its re-introduction after endovascular treatment of PAD has been suggested as a method to induce stabilised and coherent haemodynamics. Stent designs able to generate spiral flow may support endothelial function and therefore increase patency rates. This review is focused on secondary flow phenomena in arteries and the development of flow modification stent technologies for the treatment of PAD

Nanobiomaterial advances in cardiovascular tissue engineering

Myocardial infarction (MI) is projected to increase globally in the coming decades. The long-term outlook for patients with ischemic heart injury undergoing current treatment modalities is bleak, due to the lack of regenerative capacity of native heart tissue. Tissue engineering and regenerative medicine have developed numerous strategies to repair or replace injured myocardium. One of the most promising strategies to date is the attempt to engineer tissues and cells at the nanoscale by utilizing nanobiomaterials to mimic the native nanoscale structure of the heart. Nanobiomaterials have proliferated enormously in the past few decades and have great potential for creating biomimetic systems that can replace or repair injured myocardium. Tissue engineering scaffolds with precisely controlled nanotopography, electrically conductive nanomaterials with the potential for mimicking conductive pathways in the heart, and numerous nanocarriers for targeted cardiac drug delivery have now been achieved. In this chapter we review the rationale for engineering biological tissues at the nanoscale as well as recent applications in nanofabrication and nanomedicine for cardiac regeneration

Vascular Problems of the Pelvis

Regardless of the gender, the human pelvis represents a complex anatomic region shared by the organs of the gastrointestinal and genitourinary tracts and the reproductive system. All these structures are included in a rigid bone case which also harbors the intricate neurovascular network that crosses over the pelvic area in direction to the lower limbs. The adequate approach of the diseases arising in the pelvic vascular network is difficult requiring precise anatomical knowledge and often the collaboration of interdisciplinary teamwork. The present chapter describes in detail the pelvic vascular anatomy and also provides a full discussion of both the tumor-related and tumor-unrelated diseases affecting these vascular structures