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Статті в журналах з теми "Tissu vascularisé"

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Автор: Grafiati

Опубліковано: 7 вересня 2022

Оновлено: 18 вересня 2022

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1

Hannen, Egied J. M., Jeroen A. W. M. van der Laak, Harold M. J. Kerstens, Vincent M. J. I. Cuijpers, Antonius G. J. M. Hanselaar, Johannes J. Manni, and Peter C. M. de Wilde. "Quantification of Tumour Vascularity in Squamous Cell Carcinoma of the Tongue Using CARD Amplification, a Systematic Sampling Technique, and True Colour Image Analysis." Analytical Cellular Pathology 22, no. 4 (2001): 183–92. http://dx.doi.org/10.1155/2001/780576.

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The aims of this study of head and neck tissue samples were to develop an immunohistochemical protocol based on the catalysed reporter deposition (CARD) technique to enhance staining results for use in automated true colour image analysis, to assess the reproducibility of systematic tissue sampling in the angiogenic hot spot selection, and quantification of microvessel density (MVD) and other vessel characteristics. The latter data were compared between six metastasised tongue squamous cell carcinomas, vs. four non-metastasised. In comparison to the standard immunohistochemical protocol with anti-CD34 antibodies, CARD amplification resulted in both more intensely stained and larger numbers of vessels. Averaging the 10 most vascularised fields of the 40 to 60 systematically sampled fields in a tissue section resulted in an overall acceptable interobserver reproducibility for most assessed vessel parameters (r≧ 0.76 andp≦ 0.01). The percentage vessels with diameter <5 μm was significantly higher in the non-metastasised tongue carcinomas (p= 0.02). However, for a number of tumours the effect of tissue sampling was significant. We conclude that CARD amplification is needed for reliable segmentation of vessels by image analysis systems, and that tumour heterogeneity is a limiting factor for all procedures in which tumour vascularity is assessed in a single tissue section.

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2

Nagahara, Kunihiko, Youichi Miyake, Takushi Aoyama, and Fumimaru Ogino. "Tissue Oxygen Tension in the Stria Vascularis." Acta Oto-Laryngologica 105, sup456 (January 1988): 137–42. http://dx.doi.org/10.3109/00016488809125091.

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3

PARKASH, S. "Simulated Testis Using Vascularised Autogenous Tissue." British Journal of Urology 59, no. 1 (January 1987): 97–98. http://dx.doi.org/10.1111/j.1464-410x.1987.tb04597.x.

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4

Morelon, Emmanuel, Jean Kanitakis, Olivier Thaunat, Palmina Petruzzo, and Lionel Badet. "Aspects immunologiques des greffes de tissus composites vascularisés." Soins 64, no. 839 (October 2019): 20–21. http://dx.doi.org/10.1016/j.soin.2019.09.006.

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5

Butterworth, Mark, and Peter E. M. Butler. "FLAP VASCULARITY AFTER FREE MUSCULOCUTANEOUS TISSUE TRANSFER." Plastic and Reconstructive Surgery 107, no. 3 (March 2001): 894–95. http://dx.doi.org/10.1097/00006534-200103000-00054.

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6

Machens, Hans-Günther. "FLAP VASCULARITY AFTER FREE MUSCULOCUTANEOUS TISSUE TRANSFER." Plastic and Reconstructive Surgery 107, no. 3 (March 2001): 895. http://dx.doi.org/10.1097/00006534-200103000-00055.

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7

Nettelblad, H., and E. Tarpila. "Abdominal Wall Reconstruction with Vascularised Autologous Tissue." Scandinavian Journal of Surgery 92, no. 4 (December 2003): 297–300. http://dx.doi.org/10.1177/145749690309200410.

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8

Williams, G., P. Butler, and N. Niranjan. "FLAP VASCULARITY AFTER FREE MUSCULOCUTANEOUS TISSUE TRANSFER." Plastic & Reconstructive Surgery 102, no. 5 (October 1998): 1781. http://dx.doi.org/10.1097/00006534-199810000-00104.

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9

Machens, H. G., N. Pallua, J. Pasel, P. Mailaender, J. Liebau, and A. Berger. "FLAP VASCULARITY AFTER FREE MUSCULOCUTANEOUS TISSUE TRANSFER." Plastic & Reconstructive Surgery 102, no. 5 (October 1998): 1782. http://dx.doi.org/10.1097/00006534-199810000-00105.

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10

Morritt, A. N., R. J. Dilley, J. Rickards, X. L. Han, D. McCombe, W. A. Morrison, and S. K. Bortolotto. "Tissue Engineering of Spontaneously Beating, Vascularised, Three-Dimensional Cardiac Tissue." Journal of Molecular and Cellular Cardiology 41, no. 4 (October 2006): 742. http://dx.doi.org/10.1016/j.yjmcc.2006.06.040.

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11

Maroudy, Daniel. "Allogreffe de tissus composites vascularisés : entre écueils et promesses." Soins 64, no. 839 (October 2019): 13–45. http://dx.doi.org/10.1016/j.soin.2019.09.004.

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12

Morelon, Emmanuel. "Enjeux et défis des transplantations de tissus composites vascularisés." Soins 64, no. 839 (October 2019): 43. http://dx.doi.org/10.1016/j.soin.2019.09.014.

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13

Kanitakis, J., P. Petruzzo, A. Gazarian, L. Badet, S. Testelin, B. Devauchelle, J. M. Dubernard, and E. Morelon. "Allogreffes de tissus composites vascularisés : suivi dermatopathologique à 15ans." Annales de Dermatologie et de Vénéréologie 142, no. 12 (December 2015): S488. http://dx.doi.org/10.1016/j.annder.2015.10.128.

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14

MERLE, M., and G. DAUTEL. "Vascularised Nerve Grafts." Journal of Hand Surgery 16, no. 5 (October 1991): 483–88. http://dx.doi.org/10.1016/0266-7681(91)90099-a.

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Since Taylor (1976) successfully performed the first vascularised free nerve graft, experimental and clinical data have not provided conclusive support for the superiority of this method of repairing loss of nerve substance. Experimental work yields conflicting results. Histologic results are in favour of vascularised grafts but non-vascularised fascicular grafts placed in a healthy bed recover sufficient neovascularisation within a short period of time (four to six days). In the field of brachial plexus repair, vascularised grafts give consistent results. However, if thrombosis of the anastomoses occurs, the grafts fail completely. In our experience, vascularised nerve grafts used for repairing digital nerves and arteries, have a high rate of thrombosis. There are few potential donor sites. A nerve graft cannot be considered to be physiologically vacularised if it relies only on an artery or on an arterialised vein. Given the present state of immunosuppressant treatments, vascularised allografts are not yet appropriate. Therefore, vascularised nerve grafts have limited applications. In general it is preferable to repair the tissue bed so as to promote revascularisation of conventional nerve grafts.

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15

Weinstein, Susan P., Emily F. Conant, Chandra M. Sehgal, Irene P. Woo, and Jill A. Patton. "Hormonal Variations in the Vascularity of Breast Tissue." Journal of Ultrasound in Medicine 24, no. 1 (January 2005): 67–72. http://dx.doi.org/10.7863/jum.2005.24.1.67.

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16

Dilley, Rodney, Andrew Morrit, Sebastien Tourbach, Susan Bortolotto, and Wayne Morrison. "In Vivo Cardiac Tissue Engineering in Vascularised Chambers." Heart, Lung and Circulation 17 (2008): S225. http://dx.doi.org/10.1016/j.hlc.2008.05.564.

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17

Laksanawimol, Parichart, Praneet Damrongphol, and Maleeya Kruatrachue. "Alteration of the brood pouch morphology during gestation of male seahorses, Hippocampus kuda." Marine and Freshwater Research 57, no. 5 (2006): 497. http://dx.doi.org/10.1071/mf05112.

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The brood pouch of seahorses can be divided into four sequential stages based on the characteristics of the altered tissue layers during gestation: the normal stage, the embryo-carrying stage, the embryo-release stage and the repair stage. The brood pouch is composed of a folded inner pseudostratified columnar epithelium and a smooth outer stratified cuboidal epithelium. Three tissue layers between the inner and the outer epithelia are an inner loose connective tissue layer, a middle smooth muscle layer and an outer dense irregular connective tissue layer. In the normal stage, the inner loose connective tissue layer is thick and vascularised with small blood vessels; the muscle layer consists of scattered unorganised muscle fibres. In the embryo-carrying stage, the inner epithelial and inner loose connective tissue layers become distended and highly vascularised with enlarged blood vessels. In the embryo-release stage, the inner loose connective tissue layer is extensively vascularised with very large blood vessels and the smooth muscle fibres invade the outer dense irregular connective tissue layer. Structures altered during gestation gradually resume their normal condition in the repair stage. Extensive vascularisation of the brood pouch during gestation suggests an intricate paternal–embryo relationship implying other significant roles besides protective function of the pouch.

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18

Yoshida, Tatuya, Ryohei Yokoyama, Naoyuki Kuga, and Koichi Chuma. "Reconstruction For Bone And Soft Tissue Tumor With Vascularised Composite Tissue Transfer." Orthopedics & Traumatology 53, no. 1 (2004): 55–58. http://dx.doi.org/10.5035/nishiseisai.53.55.

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19

Mignemi, Nicholas, Heather Cole, Masato Yausa, David Gailani, Jay L. Degen, and Jonathan G. Schoenecker. "Deficiency in Plasminogen Cause Decreased Vascularity in Sold Tissue Organs and Bone." Blood 118, no. 21 (November 18, 2011): 857. http://dx.doi.org/10.1182/blood.v118.21.857.857.

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Abstract Abstract 857 A sufficient vascular supply is critical for proper physiologic function of solid-tissue organs and bone. Tissue vascularity is mediated concomitantly through vascular patency and angiogenesis. Recently, numerous studies have associated plasminogen, the key fibrinolytic protease of the coagulation system, with maintaining vascular patency by preventing fibrin accumulation with in the vasculature. Additionally, plasminogen may also have a direct role in angiogenesis as it has been shown in vitro that inhibitors of plasmin(ogen) suppress formation of capillary structures from normal endothelial cells and cells cultured from plasmin(ogen) deficient mice have reduced capillary sprouting in response to the angiogenic stimulator VEGF-A. Therefore, we hypothesized that plasminogen is essential for developing and maintaining vascularity in solid-tissue organs and revascularization of bone fracture calluses. To determine if there was a discernable difference in vivo between the vascular supply of plasminogen deficient (plg−/−) and wild type mice we performed microfil profusion studies visualized using a Sanco 40 μCT. We determined that plg−/− mice have a diminished renal and hepatic vascularity compared to wild type mice at 3 and 20 weeks of age (Figure 1). Further, we show that plg−/− mice fail to develop a blood supply at the fracture site by week 2 post-fracture whereas the control mice exhibit a highly neovascularized capillary system (Figure 2). Plg −/− mice also fail to develop a mineralized callus around a two week old fracture site demonstrating a role for plasmin(ogen) in osteoblast minimization. These findings demonstrate that disruption of the fibrinolytic system's main proteolytic enzyme plasmin results in decreased vascularity of solid-tissue organs and revascularization of bone fracture calluses. While the role of plasmin(ogen) in vascularity is clear, further studies are warranted to elucidate its mechanisms of action. Studies investigating plasmin(ogen)'s role in vascularity may have importance in variety of biologic conditions and pathologies. For example, aging, diabetes and smoking, all of which are known to incur an acquired deficiency or dysfunction of fibrinolysis lead to complications of vascularity (cardiovascular disease) and are also associated with pathologic bone disease (osteoporosis and poor fracture healing). These data indicate that plasmin(ogen) and its biologic targets may provide future novel therapeutic targets for treatment of pathologies involving impaired vascularization.Figure 1:Vascularization of Kidney and Liver in Wild Type and Plasminogen Deficient Mice: Microfil of both kidney and liver of plasminogen −/− show decreased vascularity as compared to WT mice. Colors denote diameter of the vasculature. Red represent large diameter vessels while green represent smaller diameter.Figure 1:. Vascularization of Kidney and Liver in Wild Type and Plasminogen Deficient Mice: Microfil of both kidney and liver of plasminogen −/− show decreased vascularity as compared to WT mice. Colors denote diameter of the vasculature. Red represent large diameter vessels while green represent smaller diameter.Figure 2:Callus Formation and Vascularization of Transverse Femur Fractures in Wild Type and Plasminogen Deficient Mice: Transverse femur fractures of plasminogen −/− mice show a decrease in mineralizing callus formation as compared to wild type mice. Further, Microfil of transverse femur fracture shows plasminogen −/− mice have significantly less vascular invasion of their callus. Colors denote diameter of the vasculature. Red represent large diameter vessels while green represent smaller diameter.Figure 2:. Callus Formation and Vascularization of Transverse Femur Fractures in Wild Type and Plasminogen Deficient Mice: Transverse femur fractures of plasminogen −/− mice show a decrease in mineralizing callus formation as compared to wild type mice. Further, Microfil of transverse femur fracture shows plasminogen −/− mice have significantly less vascular invasion of their callus. Colors denote diameter of the vasculature. Red represent large diameter vessels while green represent smaller diameter. Disclosures: No relevant conflicts of interest to declare.

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20

Yanke, A., J. Hillyer, J. Killius, N. Isogai, S. Asamura, R. Jacquet, and W. Landis. "Vascularity of a Tissue-Engineered Model of Human Phalanges." Microscopy and Microanalysis 8, S02 (August 2002): 1024–25. http://dx.doi.org/10.1017/s143192760210300x.

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21

McGuigan, Alison P., and Michael V. Sefton. "DESIGN AND FABRICATION OF A VASCULARISED TISSUE-ENGINEERED CONSTRUCT." Cardiovascular Pathology 13, no. 3 (May 2004): 182. http://dx.doi.org/10.1016/j.carpath.2004.03.547.

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22

Caunce, S. L., A. R. T. Krause, F. C. F. Dias, G. P. Adams, and J. Singh. "4 Relationship Between Ovarian Vascularity, Cumulus–Oocyte Morphology and Luteal Development in Four-Month-Old Calves After FSH Stimulation." Reproduction, Fertility and Development 30, no. 1 (2018): 141. http://dx.doi.org/10.1071/rdv30n1ab4.

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The objectives of this study were to determine the effect of LH on the blood flow to the ovaries of 4-month-old calves after 2 FSH stimulation protocols, and to examine the relationship between ovarian vascularity after superstimulation to the morphology of the cumulus–oocyte complexes (COC) and luteal function. We hypothesise that ovarian vascularity (detected by 3-dimensional (3D) analysis of Doppler ultrasound cineloops) will increase in response to LH, and the magnitude of change in vascularity would be predictive of (1) a greater proportion of expanded COC, (2) greater development of luteal tissue volume and vascularity at 3 and 7 days after follicle aspiration, and (3) higher levels of plasma progesterone. Ovarian superstimulation was initiated at the beginning of an induced follicular wave in 4-month-old beef calves (n = 16), and beef cattle >16 months of age (control group, adults; n = 8) using either a traditional 4-day or an extended 7-day FSH protocol (n = 8 calves and n = 4 controls per group). Power Doppler ultrasound cineloops were recorded immediately before (i.e. 12 h after the last FSH treatment) and 24 h after LH treatment (before ultrasound-guided follicular aspiration for oocyte collection) to assess ovarian vascularity, and 3 and 7 days after follicular aspiration to assess luteal tissue volume and vascularity. Video segments were analysed in Fiji and Imaris software to obtain the 3D ovarian vascularity index (ratio of blood flow volume to tissue volume). The ovarian vascularity index tended to increase >1.7-fold in response to exogenous LH in both prepubertal calves (pre-LH 1.5 ± 0.4% v. post-LH 2.6 ± 0.7%; P = 0.08) and adult cattle (pre-LH 2.2 ± 0.6% v. post-LH 4.7 ± 0.9%; P = 0.07). Calves with a recovery of >75% of expanded COC had a higher ovarian vascularity index (10.7 ± 2.6% v. 4.8 ± 1.6%; P = 0.06) and luteal vascularity index (15.7 ± 4.5% v. 5.7 ± 2.1%; P < 0.05) 7 days after aspiration than those with <75% expanded COC. Calves in the 7-day FSH protocol had >10-fold higher concentration of plasma progesterone on Day 3 (12.7 ± 7.3 ng mL−1 v. 1.2 ± 0.4 ng mL−1; P < 0.05) and Day 5 (50.6 ± 28.0 ng mL−1 v. 4.5 ± 1.0 ng mL−1; P < 0.05), and ~2-fold higher luteal vascularity index at 7 days after follicle aspiration (13.7 ± 4.6% v. 7.7 ± 2.8%; P < 0.05) than calves in the 4-day FSH protocol, whereas no difference (P > 0.05) was found in control (adult) animals. In conclusion, there was an increase in ovarian vascularity resulting from LH treatment in prepubertal calves and adult cattle. A greater proportion of expansion of COC at 24 h after LH treatment (an indicator of follicular maturation) was related to higher ovarian and luteal vascularity on Day 7 after collection in prepubertal calves, but not in adults. Luteal vascularity on Day 3 was reflective of plasma progesterone concentration, and prepubertal calves in the 7-day FSH protocol had greater plasma progesterone than calves in the 4-day FSH protocol. The use of FSH in calves allows a greater number of follicles for oocyte collection as it does in adult cattle. Research was supported by an NSERC grant.

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23

Morii, Takeshi, Tomonori Kishino, Naoko Shimamori, Mitsue Motohashi, Hiroaki Ohnishi, Keita Honya, Takayuki Aoyagi, Takashi Tajima, and Shoichi Ichimura. "Preoperative Ultrasonographic Evaluation for Malignancy of Soft-Tissue Sarcoma: A Retrospective Study." Open Orthopaedics Journal 12, no. 1 (March 16, 2018): 75–83. http://dx.doi.org/10.2174/1874325001812010075.

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Background: Ultrasonography is useful for distinguishing between benign and malignant soft-tissue tumors. However, no study has focused on its usefulness in the differential diagnosis between low-grade and high-grade soft-tissue sarcomas. We conducted a retrospective study to determine the usefulness of the parameters of ultrasonograph and to develop a practical scoring system for distinguishing between high-grade and low-grade sarcomas. Methods: Twenty-two cases of low-grade and 43 cases of high-grade malignant soft-tissue sarcoma were enrolled. Ultrasonography parameters including the longest diameter, depth of the tumor, echogenicity, tumor margin, and vascularity defined according to Giovagnorio’s criteria were analyzed as factors to distinguish between the two types of sarcoma. Significant factors were entered into a multivariate model to define the scores for distinction according to the odds ratio. The usefulness of the score was analyzed via receiver operating characteristic analyses. Results: In univariate analysis, tumor margin, echogenicity, and vascularity were significantly different between low- and high-grade sarcomas. In the multivariate regression model, the odds ratio for high-grade vs. low-grade sarcoma was 8.8 for tumor margin, 69 for echogenicity, and 8.3 for vascularity. Scores for the risk factors were defined as follows: 1, ill-defined margin; 2, hypoechoic echogenicity; and 1, type IV in Giovagnorio’s criteria. The sum of each score was confirmed by receiver operating characteristic analysis. The area under the curve was 0.95, with a cut-off score of 3, indicating that the scoring system was useful. Conclusion: The ultrasonography parameters of tumor margin, echogenicity, and vascularity are useful for distinguishing between low- and high-grade sarcomas.

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24

Papagelopoulos, Panayiotis J., Andreas F. Mavrogenis, Dimitrios P. Mastorakos, Catherine Vlastou, John Vrouvas, and Panayotis N. Soucacos. "Free vascularised tissue transfer and brachytherapy for soft-tissue sarcomas of the extremities." Injury 39, no. 3 (September 2008): 83–89. http://dx.doi.org/10.1016/j.injury.2008.06.005.

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25

Yoo, Roh-Eul, Tae Jin Yun, Young Dae Cho, Jung Hyo Rhim, Koung Mi Kang, Seung Hong Choi, Ji-hoon Kim, et al. "Utility of arterial spin labeling perfusion magnetic resonance imaging in prediction of angiographic vascularity of meningiomas." Journal of Neurosurgery 125, no. 3 (September 2016): 536–43. http://dx.doi.org/10.3171/2015.8.jns151211.

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OBJECTIVE Arterial spin labeling perfusion-weighted imaging (ASL-PWI) enables quantification of tissue perfusion without contrast media administration. The aim of this study was to explore whether cerebral blood flow (CBF) from ASL-PWI can reliably predict angiographic vascularity of meningiomas. METHODS Twenty-seven patients with intracranial meningiomas, who had undergone preoperative ASL-PWI and digital subtraction angiography prior to resection, were included. Angiographic vascularity was assessed using a 4-point grading scale and meningiomas were classified into 2 groups: low vascularity (Grades 0 and 1; n = 11) and high vascularity (Grades 2 and 3; n = 16). Absolute CBF, measured at the largest section of the tumor, was normalized to the contralateral gray matter. Correlation between the mean normalized CBF (nCBF) and angiographic vascularity was determined and the mean nCBF values of the 2 groups were compared. Diagnostic performance of the nCBF for differentiating between the 2 groups was assessed. RESULTS The nCBF had a significant positive correlation with angiographic vascularity (ρ = 0.718; p < 0.001). The high-vascularity group had a significantly higher nCBF than the low-vascularity group (3.334 ± 2.768 and 0.909 ± 0.468, respectively; p = 0.003). At the optimal nCBF cutoff value of 1.733, sensitivity and specificity for the differential diagnosis of the 2 groups were 69% (95% CI 41%–89%) and 100% (95% CI 72%–100%), respectively. The area under the receiver operating characteristic curve was 0.875 (p < 0.001). CONCLUSIONS ASL-PWI may provide a reliable and noninvasive means of predicting angiographic vascularity of meningiomas. It may thus assist in selecting potential candidates for preoperative digital subtraction angiography and embolization in clinical practice.

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26

Narayan, K., M. W. Ashton, and G. I. Taylor. "2166 The effects of vascularised tissue transfer on re-irradiation." International Journal of Radiation Oncology*Biology*Physics 36, no. 1 (January 1996): 359. http://dx.doi.org/10.1016/s0360-3016(97)85741-0.

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27

Bigler, Steven A., Robert E. Deering, and Michael K. Brawer. "Comparison of microscopic vascularity in benign and malignant prostate tissue." Human Pathology 24, no. 2 (February 1993): 220–26. http://dx.doi.org/10.1016/0046-8177(93)90304-y.

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28

Kottamasu, Pavan, and Ira Herman. "Engineering a microcirculation for perfusion control of ex vivo–assembled organ systems: Challenges and opportunities." Journal of Tissue Engineering 9 (January 1, 2018): 204173141877294. http://dx.doi.org/10.1177/2041731418772949.

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Donor organ shortage remains a clear problem for many end-stage organ patients around the world. The number of available donor organs pales in comparison with the number of patients in need of these organs. The field of tissue engineering proposes a plausible solution. Using stem cells, a patient’s autologous cells, or allografted cells to seed-engineered scaffolds, tissue-engineered constructs can effectively supplement the donor pool and bypass other problems that arise when using donor organs, such as who receives the organ first and whether donor organ rejection may occur. However, current research methods and technologies have been unable to successfully engineer and vascularize large volume tissue constructs. This review examines the current perfusion methods for ex vivo organ systems, defines the different types of vascularization in organs, explores various strategies to vascularize ex vivo organ systems, and discusses challenges and opportunities for the field of tissue engineering.

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29

Kalra, Gurdayal Singh, Pradeep Goel, and Pradeep Kumar Singh. "Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases." Indian Journal of Plastic Surgery 46, no. 03 (September 2013): 543–48. http://dx.doi.org/10.4103/0970-0358.122013.

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ABSTRACT Introduction: The severe long bone defects usually follow high-energy trauma and are often associated with a significant soft-tissue injury. The goal of management of these open long bone defects is to provide stable fixation with maintenance of limb length and soft-tissue coverage. The purpose of this article is to present the clinic-radiological outcome, complications and treatment of post-traumatic long bone defect with vascularised fibula transfer. Materials and Methods: Retrospective records of 28 patients were analysed who presented with post-traumatic long bone defects and in whom reconstruction with vascularised free fibula was done. Demographic data were recorded and clinical and radiological assessment was done. Results: Out of 28 patients in whom vascularised free fibula transfer was carried out three flaps were lost while non-union occur in three patients. Three patients developed a stress fracture of transferred free fibula in the post-operative period. Few of the patients experienced some problems in the donor leg; however, all of them improved in subsequent follow-up. Discussion: It is clearly evident from this study that timing of surgery plays an important role in the micro-vascular reconstruction in trauma cases. All the complication like flap loss, non-union or delayed union occur in patients in whom reconstruction was delayed. Conclusion: The free vascularised fibula graft is a viable method for the reconstruction of skeletal defects of more than 6 cm, especially in cases of scarred and avascular recipient sites or in patients with combined bone and soft-tissue defects. Results are best when the reconstruction is done within 1 week of trauma.

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30

Kappelmann, Rick B., Jiri Prazma, and Harold C. Pillsbury. "Comparative Morphometric Analysis of Cochlear Vessels in Wistar-Kyoto Rats, Spontaneously Hypertensive Rats, and Aged Spontaneously Hypertensive Rats." Otolaryngology–Head and Neck Surgery 97, no. 6 (December 1987): 522–28. http://dx.doi.org/10.1177/019459988709700602.

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Vessel density and the ratio of the tissue area to the vessel surface area were studied by morphometric analysis techniques in normal rats, spontaneously hypertensive rats (SHR), and aged spontaneously hypertensive rats (aged SHR). Horseradish peroxidase was injected intravenously and the animals were killed 10 minutes later. The temporal bones were harvested, fixed in glutaraldehyde, and decalcified in 10% ethylenediamine tetraacetic acid (EDTA). After 7 days of decalcification, the cochleas were dissected and incubated with a diaminobenzidine tetrahydrochloride solution. Sections with stained vessels were projected onto the digitizing plate with the help of the camera lucida. The computer was used to calculate tissue area, vessel length, and vessel surface area. A statistically significant increase ( p < 0.05) in both the tissue area to vessel length ratio and the tissue area to vessel surface area ratio was demonstrated in the SHR and the aged SHR groups when compared to the WKY in the stria vascularis. No statistically significant difference was found between the two SHR groups. These data show a decrease of the vessel density in the capillary beds of the stria vascularis in spontaneously hypertensive rats. No statistically significant difference was found in the diameters of the capillary among the three groups.

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Mahajan, Aakanksha, Ishan Gupta, and Amrita Mishra. "Hypervascular retained products of conception: dilemma of diagnosis and management." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 10 (September 26, 2019): 4130. http://dx.doi.org/10.18203/2320-1770.ijrcog20194396.

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Retained products of conception (RPOC) are a partial retention of placental tissue after dilation and curettage (D&C) procedures or vaginal deliveries. Ultrasound scan reports sometimes mention the presence of increased endometrial / sub‐endometrial vascularity in the context of retained products of conception. This raises the possibility of serious intra‐operative haemorrhage because of the possibility of arterio‐venous malformation. The aim of this article is to discuss the diagnosis and management options of retained products of conception (RPOC) with increased vascularity where simple dilatation and curettage may lead to life threatening haemorrhage and endanger the life of the patient and to enlighten the importance of evaluation of vascularity in all cases of RPOC prior to dilatation and curettage in order to avoid the dreaded complication of massive haemorrhage.

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32

Hoos, A., K. Sperhake, N. Devereux, G. Bruning, and F. C. Beikert. "A painful, vascularised tumour of the calf." Phlebologie 44, no. 04 (July 2015): 177–79. http://dx.doi.org/10.12687/phleb2271-4-2015.

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SummaryThe case of a 39-year old female patient, presenting a painful, well-vascularized tumour located in the subcutaneous tissue of the right calf, is reported. Due to the painfulness and tumour size progression an excision with primary wound closure (by buried sutures) was performed. The tumour showed histological features characteristic for an angioleiomyoma. Particularly middle-aged women are affected by an angioleiomyoma which represents a benign, mesenchymal tumour mostly located on the lower extremities. Differential diagnosis in painful tumours of the skin should include this entity. Because of the painfulness of the tumour primary excision is mostly recommended. In the majority of cases the diagnosis is made histologically.

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Redondo, Patricia de Albuquerque Garcia, Fernanda Gubert, Camila Zaverucha-do-Valle, Tatiana Pereira Pena Dutra, Jackline de Paula Ayres-Silva, Natasha Fernandes, Antonio Augusto Peixoto de Souza, et al. "Lymphatic vessels in human adipose tissue." Cell and Tissue Research 379, no. 3 (November 27, 2019): 511–20. http://dx.doi.org/10.1007/s00441-019-03108-5.

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AbstractDespite being considered present in most vascularised tissues, lymphatic vessels have not been properly shown in human adipose tissue (AT). Our goal in this study is to investigate an unanswered question in AT biology, regarding lymphatic network presence in tissue parenchyma. Using human subcutaneous (S-) and visceral (V-) AT samples with whole mount staining for lymphatic specific markers and three-dimensional imaging, we showed lymphatic capillaries and larger lymphatic vessels in the human VAT. Conversely, in the human SAT, microcirculatory lymphatic vascular structures were rarely detected and no initial lymphatics were found.

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Lois, J. F., H. J. Fischer, J. M. Mirra, and A. S. Gomes. "Angiography of Histopathologic Variants of Synovial Sarcoma." Acta Radiologica. Diagnosis 27, no. 4 (July 1986): 449–54. http://dx.doi.org/10.1177/028418518602700416.

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Synovial sarcomas are rare soft tissue tumors which histopathologically can be divided into monophasic, biphasic and mixed variants. As part of a protocol for intra-arterial chemotherapy 12 patients with biopsy proven synovial sarcoma underwent angiography. The angiograms on these patients were reviewed to determine whether synovial sarcomas and their variants demonstrated a characteristic angiographic appearance. Synovial sarcomas appeared angiographically as soft tissue masses which showed a fine network of tumor vessels with an inhomogeneous capillary blush. Their degree of vascularity varied according to their histopathology. Monophasic synovial sarcomas demonstrated in general a higher degree of neovascularity than the biphasic form. This finding was also suggested by histopathologic analysis of the vessels in the tumor. Although angiography did not show a distinctive vascular pattern it may be useful to evaluate tumor size and vascularity.

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35

Nielsen, Inger M., Annette Riis, Henrik Jahn, and Finn Gottrup. "Measurements of Tissue Oxygen Tension in Vascularised Jejunal Autografts in Pigs." Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 29, no. 4 (January 1995): 297–302. http://dx.doi.org/10.3109/02844319509008963.

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36

Liu, Yuchun, Jing Lim, and Swee-Hin Teoh. "Review: Development of clinically relevant scaffolds for vascularised bone tissue engineering." Biotechnology Advances 31, no. 5 (September 2013): 688–705. http://dx.doi.org/10.1016/j.biotechadv.2012.10.003.

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37

Bass, Casie S., Dale A. Redmer, Samantha L. Kaminski, and Anna T. Grazul-Bilska. "Luteal function during the estrous cycle in arginine-treated ewes fed different planes of nutrition." Reproduction 153, no. 3 (March 2017): 253–65. http://dx.doi.org/10.1530/rep-16-0526.

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Functions of corpus luteum (CL) are influenced by numerous factors including hormones, growth and angiogenic factors, nutritional plane and dietary supplements such as arginine (Arg), a semi-essential amino acid and precursor for proteins, polyamines and nitric oxide (NO). The aim of this study was to determine if Arg supplementation to ewes fed different planes of nutrition influences: (1) progesterone (P4) concentrations in serum and luteal tissue, (2) luteal vascularity, cell proliferation, endothelial NO synthase (eNOS) and receptor (R) soluble guanylate cyclase β protein and mRNA expression and (3) luteal mRNA expression for selected angiogenic factors during the estrous cycle. Ewes (n = 111) were categorized by weight and randomly assigned to one of three nutritional planes: maintenance control (C), overfed (2× C) and underfed (0.6× C) beginning 60 days prior to onset of estrus. After estrus synchronization, ewes from each nutritional plane were assigned randomly to one of two treatments: Arg or saline. Serum and CL were collected at the early, mid and late luteal phases. The results demonstrated that: (1) nutritional plane affected ovulation rates, luteal vascularity, cell proliferation andNOS3,GUCY1B3, vascular endothelial growth factor (VEGF) andVEGFR2mRNA expression, (2) Arg affected luteal vascularity, cell proliferation andNOS3,GUCY1B3,VEGFandVEGFR2mRNA expression and (3) luteal vascularity, cell proliferation and the VEGF and NO systems depend on the stage of the estrous cycle. These data indicate that plane of nutrition and/or Arg supplementation can alter vascularization and expression of selected angiogenic factors in luteal tissue during the estrous cycle in sheep.

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38

Haacke, Mark E., Gwen Herigault, Daniel Kido, Karen Tong, Andre Obenaus, Yingjian Yu, and Juergen R. Reichenbach. "OBSERVING TUMOR VASCULARITY NONINVASIVELY USING MAGNETIC RESONANCE IMAGING." Image Analysis & Stereology 21, no. 2 (May 3, 2011): 107. http://dx.doi.org/10.5566/ias.v21.p107-113.

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A new approach to tumor discrimination using magnetic resonance imaging is reported. The susceptibility difference between venous blood and the surrounding tissue is used to generate contrast. This approach is able to exquisitely reveal small veins even those which are smaller than a voxel. Using this method, it is possible to visualize the primary draining veins within tumors better than contrast enhanced magnetic resonance imaging methods that require a contrast agent or even conventional angiography. The ability to highlight deoxygenated blood may lead to the possibility of differentiating benign from malignant tumors noninvasively.

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39

Iyer, Subramania. "Vascularised composite allotransplants: Transplant of upper extremities and face." Indian Journal of Plastic Surgery 48, no. 02 (May 2015): 111–18. http://dx.doi.org/10.4103/0970-0358.163037.

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ABSTRACTTransplantation of solid organs and bone marrow has become a highly acceptable and often the only available clinical solution in many situations. It has been practiced across the globe for quite a long time since the first kidney transplant in 1954. Transplantation of tissues other than these, which was termed composite tissue allotransplantation and currently as vascularised composite allotransplantation (VCA) is gaining acceptance as a solution for complex reconstructive problems. This involves the transfer of multiple types of tissue such as bone, muscle, nerve, skin and blood vessels. The advantage of these over the conventional reconstructive methods is its ability to give aesthetically and functionally superior equal composite substitute to the missing or deformed part. The composite tissues transplanted commonly include the upper extremities, face and abdominal wall. Among these, hand transplants were the first to be done and have been carried out more than any other VCA. This article reviews the current scenario of VCA especially of the hand and face, in the light of experience of the two bilateral hand transplants done recently in India.

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40

Hom, David B., Khawar Medhi, Steven K. Juhn, Girma Assefa, and Thomas P. Johnston. "Vascular Effects of Sustained-Release Fibroblast Growth Factors." Annals of Otology, Rhinology & Laryngology 105, no. 2 (February 1996): 109–16. http://dx.doi.org/10.1177/000348949610500205.

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Since the half-life of most angiogenic growth factors is several hours or less, sustained-release delivery would be optimal for their future clinical use. Two fibroblast growth factors, basic fibroblast growth factor (bFGF) and endothelial cell growth factor (ECGF), were delivered in two sustained-released modalities (poloxamer 407 and a gelatin sponge [Gelfoam]) to attempt to increase soft tissue vascularity. In vitro bioactivity of ECGF-poloxamer formulations was also tested on endothelial cell cultures. Among vascular-compromised skin flaps in rabbits, ECGF-poloxamer (N = 26), bFGF-poloxamer (N = 5), ECGF-poloxamer (N = 9, irradiated), and bFGF-Gelfoam flaps (N = 22) did not demonstrate significant differences in viability and vascularity compared to controls (p > .05). Irradiation had a detrimental effect on both flap vascularity and viability (p = .02). Future efforts for sustained delivery of angiogenic proteins are critical in order to make them clinically useful in wound healing.

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41

Chung, Ho Yun, Eun Jung Oh, Jin Hyun Choi, and Byung Chae Cho. "The Role of Endothelial Cells Differentiated from Bone Marrow Stem Cells in Cartilage and Bone Regeneration." Key Engineering Materials 342-343 (July 2007): 193–96. http://dx.doi.org/10.4028/www.scientific.net/kem.342-343.193.

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Mesenchymal stem cells (MSCs) from bone marrow seem to be the one of best candidates to regenerate injured tissue. However, recent advances in application of MSCs toward large tissue regeneration are faced with lack of vascularity. In this study, endothelial cells differentiated from MSCs were applied for constructing tissue-engineered bone and cartilage. It was found that endothelial cells from MSCs play an important role of providing vasculature.

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42

Sukmana, Irza. "Microvascular Guidance: A Challenge to Support the Development of Vascularised Tissue Engineering Construct." Scientific World Journal 2012 (2012): 1–10. http://dx.doi.org/10.1100/2012/201352.

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The guidance of endothelial cell organization into a capillary network has been a long-standing challenge in tissue engineering. Some research efforts have been made to develop methods to promote capillary networks inside engineered tissue constructs. Capillary and vascular networks that would mimic blood microvessel function can be used to subsequently facilitate oxygen and nutrient transfer as well as waste removal. Vascularization of engineering tissue construct is one of the most favorable strategies to overpass nutrient and oxygen supply limitation, which is often the major hurdle in developing thick and complex tissue and artificial organ. This paper addresses recent advances and future challenges in developing three-dimensional culture systems to promote tissue construct vascularization allowing mimicking blood microvessel development and function encounteredin vivo. Bioreactors systems that have been used to create fully vascularized functional tissue constructs will also be outlined.

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43

Tago, Chiaki, and Noriyuki Yanagita. "Cochlear and Renal Pathology in the Autoimmune Strain Mouse." Annals of Otology, Rhinology & Laryngology 101, no. 10_suppl (October 1992): 87–91. http://dx.doi.org/10.1177/0003489492101s1018.

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This study was designed to investigate the role of immunologic mechanisms in sensorineural hearing disorders and the relationship between inner ear and renal disorders. Autoimmune strain (NZB/kl) mice, in which autoimmune disease can be spontaneously induced, were used in this study. The mice were tested for acoustic brain stem responses, cochlear and renal disorders, and circulating immune complex serology by means of enzyme immunoassay. Pathologic studies consisted of observation of tissue changes following hematoxylin and eosin staining and indirect immunofluorescence staining under light microscopy. Compared to controls, the hearing was impaired in NZB/kl mice. Indirect fluorescence staining showed immunoglobulin G deposits in the stria vascularis. There was a correlation between the degree of hearing impairment and the severity of stria vascularis lesions. The NZB/kl mouse can provide a model for sensorineural hearing disorders secondary to immunologic disorders.

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44

Tinling, Steven P., Vishad Nabili, and Hilary A. Brodie. "Fine Structure Histopathology of Labyrinthitis Ossificans in the Gerbil Model." Annals of Otology, Rhinology & Laryngology 114, no. 2 (February 2005): 161–66. http://dx.doi.org/10.1177/000348940511400214.

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Labyrinthitis ossificans (LO) is the pathological deposition of new bone within the lumen of the cochlea and labyrinth. This process occurs most commonly as a result of infection or inflammation affecting the otic capsule. Trauma and vascular compromise can also lead to neo-ossification within the otic capsule. The mechanism that regulates this process remains unestablished. This study details the end-stage histopathology in high-resolution plastic thin sections. Twenty Mongolian gerbils were infected by intrathecal injection of Streptococcus pneumoniae type 3 followed by subcutaneous penicillin G procaine (8 days) and were painlessly sacrificed 3 months later. The cochleas were serially divided and sectioned for light and electron microscopy. Sixteen of 20 animals (27 of 40 cochleas) demonstrated LO. Cochlear damage was most extensive in the vestibule and basal turn and decreased toward the apex, which often appeared normal. The histopathologic findings consisted of 1) new bone, calcospherites, osteoid, and fibrosis without dense connective tissue or osteoblasts extending from the endosteal wall into the lumen of the vestibule and scala tympani; 2) areas of dense connective tissue and osteoid enclosed by epithelial cells conjoined with the organ of Corti, stria vascularis, spiral ligament, and vestibular (Reissner's) membrane; and 3) partial to complete loss of the organ of Corti, spiral ligament cell bodies, stria vascularis, and spiral ganglion cells. Osteoblastic activity was not demonstrated in end-stage ossification in LO in the gerbil model. Neoossification appears to occur by calcospherite deposition along collagen-like fibrils within osteoid. The destruction of the organ of Corti, spiral ganglion cells, stria vascularis, and cells of Reissner's membrane and the spiral ligament occurs even in the absence of ossification of the cochlear duct.

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45

Vongsavan, N., and B. Matthews. "The Vascularity of Dental Pulp in Cats." Journal of Dental Research 71, no. 12 (December 1992): 1913–15. http://dx.doi.org/10.1177/00220345920710121101.

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The fraction of the volume of the coronal pulp of cat canines that is occupied by blood vessels was estimated by measurement of the cross-sectional areas of all the vessels in a complete transverse section of the pulp from each of four teeth. The sections were taken 0.5 mm from the pulp comu. Overall, 14.4% of the area of the pulp was occupied by vessels. In the core of the pulp, the average value was 42.9%, and superficially, near the odontoblast layer, it was between 5 and 10%. The average capillary density was 1402 /mm2, which is higher than in most other tissues. Laser Doppler flow meters can be used for recording blood flow from the coronal pulp of intact teeth, but these instruments are linear only if the moving blood cells occupy no more than 1% of the tissue volume. The present results suggest that this figure is exceeded in pulp.

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46

Ali, Mohamed M., Chandra Hassan, Mario Masrur, Francesco M. Bianco, Dina Naquiallah, Imaduddin Mirza, Patrice Frederick, et al. "Adipose Tissue Hypoxia Correlates with Adipokine Hypomethylation and Vascular Dysfunction." Biomedicines 9, no. 8 (August 18, 2021): 1034. http://dx.doi.org/10.3390/biomedicines9081034.

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Obesity is characterized by the accumulation of dysfunctional adipose tissues, which predisposes to cardiometabolic diseases. Our previous in vitro studies demonstrated a role of hypoxia in inducing adipokine hypomethylation in adipocytes. We sought to examine this mechanism in visceral adipose tissues (VATs) from obese individuals and its correlation with cardiometabolic risk factors. We propose an involvement of the hypoxia-inducible factor, HIF1α, and the DNA hydroxymethylase, TET1. Blood samples and VAT biopsies were obtained from obese and non-obese subjects (n = 60 each) having bariatric and elective surgeries, respectively. The analyses of VAT showed lower vascularity, and higher levels of HIF1α and TET1 proteins in the obese subjects than controls. Global hypomethylation and hydroxymethylation were observed in VAT from obese subjects along with promoter hypomethylation of several pro-inflammatory adipokines. TET1 protein was enriched near the promotor of the hypomethylated adipokines. The average levels of adipokine methylation correlated positively with vascularity and arteriolar vasoreactivity and negatively with protein levels of HIF1α and TET1 in corresponding VAT samples, serum and tissue inflammatory markers, and other cardiometabolic risk factors. These findings suggest a role for adipose tissue hypoxia in causing epigenetic alterations, which could explain the increased production of adipocytokines and ultimately, vascular dysfunction in obesity.

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47

Kumta, Samir, Sudhir Warrier, Leena Jain, Rani Ummal, Manik Menezes, and Shrirang Purohit. "Medial femoral condyle vascularised corticoperiosteal graft: A suitable choice for scaphoid non-union." Indian Journal of Plastic Surgery 50, no. 02 (May 2017): 138–47. http://dx.doi.org/10.4103/ijps.ijps_62_17.

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ABSTRACT Introduction: Scaphoid fractures are not very common and frequently remain undiagnosed, presenting in non-union and persistent wrist pain. Options for scaphoid fracture treatment have been described over several decades, however, none with an optimal solution to achieve union along with good hand function. We describe here, the use of vascularised corticoperiosteal bone grafts from the medial femoral condyle (MFC) as a solution for the difficult problem of scaphoid fracture non-union. Materials and Methods: This series has 11 patients with non-union following a scaphoid fracture treated over 18 months ranging from January 2014 to January 2016 using a vascularised corticoperiosteal graft from the MFC. Bone graft fixation was done using K-wires and anastomosis was done with the radial vessels. Results: There were no cases of flap loss. Time of union was an average 3 months. All patients had a full range of movements. Discussion: MFC is an ideal site for harvesting vascularised corticoperiosteal grafts providing a large surface of tissue supplied by a rich periosteal plexus from the descending genicular artery. No significant donor site morbidities have been reported in any series in the past. The well-defined anatomy helps in a rather simple dissection. Corticoperiosteal grafts have a high osteogenic potential and hence, this vascularised graft seems ideal for small bone non-unions. Conclusion: Thin, pliable and highly vascularised corticocancellous grafts can be obtained from the MFC as an optimal treatment option for scaphoid non-unions.

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48

Akioka, Jiro, Kenji Kusumoto, Kazuhisa Bessho, Junya Sonobe, Shinji Kaihara, Yibiao Wang, Tadahiko Iizuka, and Yutaka Ogawa. "ANGIONEOGENESIS AROUND INDUCED BONE WITH RECOMBINANT HUMAN BMP-2 IN A LATISSIMUS DORSI MUSCLE FLAP." Journal of Musculoskeletal Research 06, no. 01 (March 2002): 17–21. http://dx.doi.org/10.1142/s021895770200071x.

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Bony tissue induced with recombinant human bone morphogenetic protein-2 (rhBMP-2) in the latissimus dorsi muscle flap (LDMF) of rats was investigated in angiography and histological examination. In five rats, rhBMP-2 with atelopeptide type I collagen (CL) as a carrier was implanted in the muscle pocket of LDMF. In five controls, only CL was implanted in the same manner. Three weeks after the implant, contrast medium was injected into the assending aorta. The LDMF was cut off at the base and exposed in soft X-ray. The implant and the surrounding tissue were then histologically examined. In the rhBMP-2-implant group, the vascularity was richer, especially around the implant, and radiated to the induced bony tissue. Contrast medium was observed in the vascular cavities of the marrow inside the trabeculae. In the controls, the vascularity was relatively poor and the remnant CL occupied the whole implant space. This study indicated that rhBMP-2 does not only induce trabeculae in muscle tissue, but also in the marrow, including vessels in the implant and the vascular system around the implant. Then, the induced bony tissue is supported in the circulation by the circulation by the vascular system, as a functional osseous tissue. This phenomenon may be highly beneficial in endogenous tissue engineering and regenerative medicene for skeletal reconstruction using BMP in the future.

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49

Segev, E., S. Wientroub, Y. Kollender, I. Meller, A. Amir, and E. Gur. "A Combined Use of a Free Vascularised Flap and an External Fixator for Reconstruction of Lower Extremity Defects in Children." Journal of Orthopaedic Surgery 15, no. 2 (August 2007): 207–10. http://dx.doi.org/10.1177/230949900701500217.

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Purpose. To describe a combined use of a free vascularised flap and an external fixator for reconstruction of lower extremity defects in children, and correction of equinus contracture developed after removal of the external fixator using a circular dynamic frame. Methods. Seven children (4 males) aged 4 to 12 (mean, 8) years were treated with 9 free vascularised flaps for 8 limbs (bilaterally in one patient and for a failed flap in another). Patient pathologies included: 3 soft tissue degloving injuries, one soft tissue and bone avulsion, one severe burn contracture, one resurfacing of soft tissue and bone necrosis, and one osteosarcoma resection defect. Free flap reconstruction was delayed in 6 patients (range, 3 weeks to 4 years). Static external fixators were used to stabilise the free vascularised flaps at the time of reconstruction, with the ankle in a neutral position. Results. The mean follow-up was 5 (1–10) years. All flaps but one survived; the failed one was immediately reconstructed with a contralateral, latissimus dorsi flap. One anastomosis following a Kirschner-wire injury was successfully revised. Six patients had pin tract infections and were treated with oral antibiotics. Two patients developed equinus contracture 6 and 3 years later, after removal of the external fixator, and were corrected by distraction, using a dynamic Ilizarov frame. Conclusion. The combined use of a free flap and an external fixator for salvage of lower extremities is useful in children. Late development of equinus contracture can be safely corrected by distraction, without compromising flap viability.

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50

Adair, T. H., W. J. Gay, and J. P. Montani. "Growth regulation of the vascular system: evidence for a metabolic hypothesis." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 259, no. 3 (September 1, 1990): R393—R404. http://dx.doi.org/10.1152/ajpregu.1990.259.3.r393.

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Prolonged imbalances between the perfusion capabilities of the blood vessels and the metabolic requirements of the tissue cells often lead to modification of the vasculature to satisfy the tissue needs. This homeostatic response appears to be bidirectional, since the vascularity of a tissue can increase or decrease in parallel with primary changes in metabolic rate. The factors that mediate the responses are not well understood, but oxygen has been implicated as a major control element, since vessel growth increases during hypoxic conditions and decreases during hyperoxic conditions. The following feedback control hypothesis may apply to many different physiological situations. Decreased oxygenation causes the tissues to become hypoxic, and this initiates a variety of signals that lead to the growth of blood vessels. The increase in vascularity promotes oxygen delivery to the tissue cells by decreasing diffusion distances, increasing capillary surface area, and increasing the maximum rate of blood flow. When the tissues receive adequate amounts of oxygen even during periods of peak activity, the intermediate effectors return to normal levels, and this negative signal, in turn, stops the further development of the vasculature. Although the effector mechanisms of the hypoxic stimulus are still being investigated, adenosine, which is produced in hypoxic tissues, appears to mediate hypoxia-induced increases in vascularity in some instances. Roles for fibroblast growth factor as well as mechanical factors associated with vasodilation and increased blood flow are postulated. Although blood vessel growth is a multifactorial process, a major influence in its regulation appears to be metabolic need. If this view is correct, it may be found that many of the quantitatively significant factors that control growth in a given vasculature are themselves modulated or controlled by metabolic signals reflecting the nutritional status of the tissues which that vasculature supplies.

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