Diabetes mellitus and experimental vein graft structure and function

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Presentation transcript:

Diabetes mellitus and experimental vein graft structure and function Mark G. Davies, MD, FRCSI, Jay H. Kim, MD, Michael L. Klyachkin, MD, Lizzie Barber, BSN, Helge Dalen, PhD, Einar Svendsen, MD, PhD, Cully C. Carson, MD, Per-Otto Hagen, PhD Journal of Vascular Surgery Volume 19, Issue 6, Pages 1031-1043 (June 1994) DOI: 10.1016/S0741-5214(94)70215-2 Copyright © 1994 Terms and Conditions

Fig. 1 Random blood sugars in diabetic animals over 3 months of study. Values are mean ± SEM mmol/L. Blood sugars were significantly greater than control (p < 0.01) at all time points. Journal of Vascular Surgery 1994 19, 1031-1043DOI: (10.1016/S0741-5214(94)70215-2) Copyright © 1994 Terms and Conditions

Fig. 2 Representative scanning electron micrograph of endothelial surface of external jugular vein from control (A) and diabetic (B) animals. Endothelium of jugular veins from both control and diabetic animals shows normal architecture with oval-shaped endothelial cells, distinct intercellular junctions and no adherent blood elements. (Original magnification x 600.) Journal of Vascular Surgery 1994 19, 1031-1043DOI: (10.1016/S0741-5214(94)70215-2) Copyright © 1994 Terms and Conditions

Fig. 3 Composite photomicrograph shows cross section from wall of control vein (A), diabetic vein (B), control vein graft (C), and diabetic vein graft (D). H is intimal hyperplasia, M is media, and A is adventitia. (Original magnification x 100.) Both vein grafts developed intimal hyperplasia; however, this was much greater in diabetic vein grafts. Results of dimensional analysis are shown in Table II. Journal of Vascular Surgery 1994 19, 1031-1043DOI: (10.1016/S0741-5214(94)70215-2) Copyright © 1994 Terms and Conditions

Fig. 4 Representative scanning electron micrographs of endothelial surface of vein graft from control and diabetic vein grafts. Control vein graft (A) has intact endothelial cells with faint intercellular junctions and some minor stomata present (arrowheads). Diabetic vein graft (B) has sharply outlined endothelial cells with numerous stomata (arrowheads) in intercellular junctions. Furthermore, there are occasional clefts between endothelial cells (arrows). (Original magnification x 620.) Journal of Vascular Surgery 1994 19, 1031-1043DOI: (10.1016/S0741-5214(94)70215-2) Copyright © 1994 Terms and Conditions

Fig. 5 Representative transmission electron micrographs of wall of control vein graft (A) and diabetic vein graft (B). Endothelial cells (EC) of diabetic vein grafts appeared relatively thicker compared with those observed in control vein grafts. Unlike control grafts, endothelial cells of diabetic grafts showed narrow contact points between adjacent endothelial cells (arrowheads). This feature was noted on all sections, and in addition in several sections actual gaps were observed between adjacent endothelial cells (not shown), which were also observed in scanning electron microscopy (Fig. 5B). Both control and diabetic vein grafts are characterized by numerous layers of smooth muscle cells (SMC), which are surrounded by scattered unorganized and electron dense material of unknown origin. These layers, which are most numerous in diabetic vein grafts, rest on top of well-organized connective tissue matrix. Smooth muscle cells are similar in appearance to both groups of vein grafts. C is collagen and F is fibroblasts. (Original magnification for Ax 6000; original magnification for B x 5500.) Journal of Vascular Surgery 1994 19, 1031-1043DOI: (10.1016/S0741-5214(94)70215-2) Copyright © 1994 Terms and Conditions

Fig. 6 Mean intimal and medial thicknesses of vein graft wall from control and diabetic groups at 28 days. Values are mean thickness in micrometers. There is significant difference (p = 0.02) in intimal thickness between control and diabetic grafts but no significant changes in medial thicknesses. Journal of Vascular Surgery 1994 19, 1031-1043DOI: (10.1016/S0741-5214(94)70215-2) Copyright © 1994 Terms and Conditions

Fig. 7 Actual and standardized maximal contractions generated to potassium chloride (KCL), norepinephrine (NE), serotonin (5-HT), bradykinin (BK), and histamine (Hist) by control and diabetic jugular veins and vein grafts. Jugular veins do not respond to serotonin. Values are mean ± SEM actual force generated in mg (A) and mean ± SEM of contractile ratio (B). Jugular veins: # p < 0.01 compared with control vein; vein grafts: * p < 0.05 and ** p < 0.01 compared with control vein graft. Journal of Vascular Surgery 1994 19, 1031-1043DOI: (10.1016/S0741-5214(94)70215-2) Copyright © 1994 Terms and Conditions

Fig. 7 Actual and standardized maximal contractions generated to potassium chloride (KCL), norepinephrine (NE), serotonin (5-HT), bradykinin (BK), and histamine (Hist) by control and diabetic jugular veins and vein grafts. Jugular veins do not respond to serotonin. Values are mean ± SEM actual force generated in mg (A) and mean ± SEM of contractile ratio (B). Jugular veins: # p < 0.01 compared with control vein; vein grafts: * p < 0.05 and ** p < 0.01 compared with control vein graft. Journal of Vascular Surgery 1994 19, 1031-1043DOI: (10.1016/S0741-5214(94)70215-2) Copyright © 1994 Terms and Conditions