Prominent Vessels Research Articles

Propranolol modulates the collateral vascular responsiveness to vasopressin via a Gα-mediated pathway in portal hypertensive rats

Gastro-oesophageal variceal haemorrhage is one of the most dreadful complications of portal hypertension and can be controlled with vasoconstrictors. Nevertheless, sympathetic tone abnormality and vascular hyporesponsiveness in portal hypertension may impede the haemostatic effects of vasoconstrictors. Propranolol, a β-blocker binding the G-protein-coupled adrenoceptor, is a portal hypotensive agent. However, whether propranolol influences the collateral vasoresponse is unknown. Portal hypertension was induced by PVL (portal vein ligation) in Sprague-Dawley rats. In an acute study with an in situ perfusion model, the collateral responsiveness to AVP (arginine vasopressin) was evaluated with vehicle, propranolol (10 μmol/l), propranolol plus suramin (100 μmol/l, a G(α) inhibitor) or suramin pre-incubation. G(α) mRNA expression in the splenorenal shunt, the most prominent intra-abdominal collateral vessel, was measured. In the chronic study, rats received DW (distilled water) or propranolol (10 mg x kg(-1) of body weight x day(-1)) for 9 days. Then the concentration-response relationship of AVP and G(α) mRNA expression were assessed. Propranolol pre-incubation elevated the perfusion pressure changes of collaterals in response to AVP, which was inhibited by suramin. The splenorenal shunt G(αq) and G(α11) mRNA expression were enhanced by propranolol. The group treated with propranolol plus suramin had a down-regulation of G(α11) as compared with the propranolol group. Chronic propranolol treatment reduced mean arterial pressure, PP (portal pressure) and the perfusion pressure changes of collaterals to AVP. G(αs) expression was up-regulated. In conclusion, propranolol pre-incubation enhanced the portal-systemic collateral AVP responsiveness in portal hypertensive rats, which was related to G(αq) and G(α11) up-regulation. In contrast, the attenuated AVP responsiveness by chronic propranolol treatment was related to G(αs) up-regulation. The G(α) signalling pathway may be a therapeutic target to control variceal bleeding and PP in portal hypertension.

Use of the KTP DermaStat for Recurrent Anterior Epistaxis

Objective: Assess the efficacy of the potassium-titanyl phosphate (KTP) laser DermaStat handpiece in treating prominent anterior septal vessels that cause recurrent epistaxes. The handpiece is reusable, unlike the traditional disposable light fiber, facilitating more cost-effective use of KTP technology, with potential for more widespread use in the office setting. Method: A UK-based, single-center retrospective and prospective case series. From 2004 onward 37 patients with recurrent epistaxes and prominent anterior septal vessels with/without previous cauterization (age 4-80 years; M:F 21:16) underwent a single laser treatment. The primary outcome measure was continued cessation of epistaxis after two months. Results: A total of 89% of patients attended follow-up at 2 months, and 88% of these had experienced complete cessation of bleeding. The remaining 12% subjectively experienced a reduction in the frequency of epistaxes. No undesirable side-effects of the treatment were experienced or evident at follow-up. Conclusion: The “Jain technique” using the DermaStat handpiece with the KTP laser is an effective method of controlling recurrent anterior epistaxes. The technique is safe, with no observed complications, and the re-usability of the hand piece facilitates more widespread and cost-effective use of KTP technology.

The pathology of visible blood vessels on the nasal septum in children with epistaxis

Objective Epistaxis is common in children, but its cause remains unknown. About half the children who present with epistaxis have prominent vessels on the nasal septum. The aim of this study was to determine the pathological nature of the prominent septal vessels in children with recurrent epistaxis. Methods 4 mm punch biopsies of the nasal septal mucosa were taken from 5 children undergoing nasal cautery under general anaesthesia. Results Histology showed that the prominent vessels were thin-walled arterioles and capillaries with a surrounding inflammatory infiltrate. There was no evidence of venous varicosities or arterial microaneurysms. Conclusion We postulate a mechanism for septal neovascularisation due to chronic low-grade inflammation as a cause for recurrent epistaxis in children.

The clinicopathologic observation of eosinophilic hyperplastic lymphogranuloma in the orbit

To improve the knowledge of the clinicopathologic features of eosinophilic hyperplastic lymphogranuloma (Kimura disease) in the orbit. It was a retrospective case series study. The clinical and pathological characteristic of 9 cases of Kimura disease from the pathology department of Tianjin Eye Hospital were reviewed, immunohistochemical staining was performed, including for CD20, D79a, CD3, CD45Ro, CD34, Ki67 and IgE. In the 9 cases, 7 cases were male, 2 cases were female; the age of onset were from 13 to 62 years, medium age was 25 years; 7 cases were simple, 2 case were bilateral orbit. These lesions occurred in the superior or superotemporal quadrant of the orbit and the majority of cases extended into deep orbital tissues, 6 cases involved the lacrimal gland, 5 case involved the lateral rectus muscle. The clinical features mainly included lid swelling, eye redness, proptosis and palpable mass, and the disease course ranged from 6 months to 15 years. 3 lymph node enlargements in the submandibular regions and 1 subcutaneous nodule on the bilateral elbow were found in one case. The documentation of peripheral-blood eosinophilia (11% - 14%) was found in 3 cases. The pathological characteristics of Kimura disease were lymphoid tissue hyperplasia with prominent lymphoid follicles, conspicuous eosinophils infiltration and capillary proliferation. Immunohistochemical study in our cases revealed B cells in lymphoid follicles and mostly T cells in the interfollicular regions. Kimura disease of orbit is an uncommon lymphoid hyperplasia with prominent eosinophils infiltration and capillary vessels, which commonly occur superotemporal quadrant of the orbit, easy to involve lacrimal gland and lateral rectus muscle.

MUC4 Is a Highly Sensitive and Specific Marker for Low-grade Fibromyxoid Sarcoma

Low-grade fibromyxoid sarcoma (LGFMS) is a distinctive fibroblastic neoplasm that is characterized by alternating collagenous and myxoid areas, deceptively bland spindle cell morphology, a whorling architecture, and a t(7;16) translocation involving FUS and CREB3L2. Owing to variable morphology and a lack of discriminatory markers, LGFMS can be difficult to distinguish from benign mesenchymal tumors and other low-grade sarcomas. Gene expression profiling has identified differential upregulation of the mucin 4 (MUC4) gene in LGFMS compared with histologically similar tumors. MUC4 is a transmembrane glycoprotein that functions in cell growth signaling pathways; aberrant MUC4 expression has been reported in various carcinomas. We investigated MUC4 protein expression by immunohistochemistry in LGFMS and in other soft tissue tumors to determine the potential diagnostic use of this novel marker. Whole-tissue sections of 309 tumors were evaluated: 49 LGFMSs (all with FUS gene rearrangement confirmed by fluorescence in situ hybridization), 40 soft tissue perineuriomas, 40 myxofibrosarcomas, 20 cellular myxomas, 20 solitary fibrous tumors, 20 low-grade malignant peripheral nerve sheath tumors, 20 cases of desmoid fibromatosis, 20 neurofibromas, 20 schwannomas, 20 monophasic synovial sarcomas, 20 cases of dermatofibrosarcoma protuberans, 10 myxoid liposarcomas, and 10 extraskeletal myxoid chondrosarcomas. The LGFMS cases included 7 with marked hypercellularity, 4 with prominent hemangiopericytoma-like vessels, 3 with giant collagen rosettes, 3 with epithelioid morphology, 2 with focal nuclear pleomorphism, and 2 with areas of sclerosing epithelioid fibrosarcoma. All 49 LGFMS cases (100%) showed cytoplasmic staining for MUC4, which was usually diffuse and intense. All the other tumor types were negative for MUC4, apart from 6 (30%) monophasic synovial sarcomas. In conclusion, MUC4 is a highly sensitive and quite specific immunohistochemical marker for LGFMS, and can be helpful to distinguish this tumor type from histologic mimics.

Nasal chondromesenchymal hamartoma: correlation of typical MR, CT and pathological findings

Sir, We read with great interest the case report on nasal chrondromesenchymal hamartoma (NCMH) by Johnson et al. [1]. They presented the spectrum of CT findings of this rare, benign pathological entity that can be locally aggressive and mimic malignancy. We would like to highlight the MR appearance of NCMH, which correlates with known CT and pathological features, as well as findings seen with intraorbital and intracranial extension. The described CT findings include internal calcifications, bony remodeling, variable enhancement, cystic components, local extension into the orbit, paranasal sinuses and, rarely, intracranial compartment [1–5] (Fig. 1). The imaging spectrum reflects the histology of NCMH, which is composed of different mesenchymal elements, the most prominent being sheets/fascicles of spindled cells in a fibrous or myxoid background. Other components include well-demarcated islands of cartilage and prominent vessels often with perivascular fibrosis or prominent collagen deposition. Reactive bone may be seen in some of them, which is mainly reactive bone remodeling. Areas of mineralization, within the matrix of the cartilaginous components of the lesion, are better visualized on CT but correlate with areas of T2 hypointensity and low gradient signal seen on MRI. Additionally, areas of fibrosis would have expected hypointensity on T2-weighted images. Cystic and myxoid components are poorly discernible as areas of low density on CT but are more clearly defined on MRI by characteristic, discrete areas of marked T2 hyperintensity (Fig. 2). A companion case of NCMH confined to the nasal cavity demonstrates similar MR findings (Figs. 3 and 4). As

T-cell-rich angiomatoid polypoid pseudolymphoma of the skin: a clinicopathologic study of 17 cases and a proposed nomenclature

We describe a series of previously unreported, distinctive, polypoid solitary T-cell-rich cutaneous pseudolymphomas. The clinicopathologic features were examined in 17 cases. Patient ages ranged from 16 to 71 years (mean = 38.5) with a female predominance (female : male = 14 : 3). All lesions, clinically diagnosed most often as pyogenic granuloma, presented as a solitary, polypoid, erythematous, papule ranging in size from 2.5 to 7.5 mm (mean = 5.8). Most occurred on the head and neck (7) and trunk (6) with other sites including the thigh (1), shoulder (1) and knee (1). A dense dermal infiltrate composed of mildly atypical lymphocytes with variable numbers of admixed plasma cells and histiocytes was prototypical. Commonly, there was an associated epidermal collarette (16/17), Grenz zone (11/17) or admixed eosinophils (8/17). Prominent vessels lined by plump endothelial cells, reminiscent of high endothelial venules of lymph nodes, were universal and some degree of telangiectasia was also common (12/17). CD3-positive T-cells consisted of an admixture of CD4-positive and CD8-positive forms (15/16). Multiple studies suggested polyclonality (seven cases). No recurrences after lesional excision were noted in the 17 patients with a follow-up range from 24 to 120 months (mean = 46.6). Although these lesions share histopathologic features of the so-called acral pseudolymphomatous angiokeratoma of children (APACHE), they occur in a completely different clinical setting, present in solitary and polypoid fashion and are T-cell rich. We propose the diagnostic label T-cell-rich angiomatoid polypoid pseudolymphoma for this distinctive but presumably reactive lesion.

Susceptibility Weighted Imaging and Cerebrovascular Disorders

To investigate the correlation between the SWI findings and prognosis of the cerebrovascular disorders. From July 2008 to July 2010, 299 ischemic stroke patients were found in our hospital. The gender ratio is as male and female being 157 to 142. The mean age of all patients is 65.4, mean female age is 69.1, and mean male age is 62.6. There were 86 patients who had satisfactory pre-and post-treatment of CT, MRI with SWI. 23 of these 86 patients had catheter cerebral angiography. 50 of these 86 patients had MR angiogram or CT angiogram. 13 of these 86 patients did not have angiogram. We have also collected 7 severe cardiac arrested and cessation of cerebral circulation and 2 patients with chronic venous hypertension. Among the 86 patients, 23 patients who had negative with deoxygenated vessel on SWI were with small infarction on DWI. Thirty-one patients had negative on initial CT head scan. CT finding did not accord with presence of hypointense vessel on SWI. Sixty-three patients had varied degree of abnormal hypointense vessels on SWI as deoxygenated vessels. The initial small foci on DWI may result with a larger infarction if there were with prominent hypointense vessels.

Calcaneal Conundrums

An 11-month-old female was referred for evaluation of “knots on feet” since birth. The child had no pain, yet her mother was concerned that the lesions might affect her daughter’s ability to walk. Past medical history was non-contributory, although a cousin had similar nodules on both heels. The result of physical examination was unremarkable except for soft, rubbery, 1-cm nodules on the anterior-medial aspects of both heels. The nodules were skin-colored and non-tender. The child cruised without difficulty and experienced no discomfort when standing. Precalcaneal congenital fibrolipomatous hamartomas (PCFH) (Figure 1) are benign lesions of unknown cause that often present in the first few months of life or are present at birth.1Laetsch Semadeni B. Mainetti C. Itin P. Lautenschlager S. Precalcaneal congenital fibrolipomatous hamartomas: report of 3 additional cases and discussion of the differential diagnosis.Dermatology. 2009; 218: 260-264Crossref PubMed Scopus (17) Google Scholar The incidence may be as high as 5% in newborns and 39% in infants.2Greenberg S. Krafchik B.R. Infantile pedal papules.J Am Acad Dermatol. 2005; 53: 333-334Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar The lesions are symmetric, bilateral, painless, flesh-colored nodules on the medial aspects of the heels. Although usually asymptomatic, PCFH have been reported to be mildly tender or to cause minor gait abnormalities.1Laetsch Semadeni B. Mainetti C. Itin P. Lautenschlager S. Precalcaneal congenital fibrolipomatous hamartomas: report of 3 additional cases and discussion of the differential diagnosis.Dermatology. 2009; 218: 260-264Crossref PubMed Scopus (17) Google Scholar, 3Aaron D.M. Dinulos G.H. Storm C.A. Bilateral plantar nodules in an infant: diagnosis.Arch Dermatol. 2005; 141: 1161-1166PubMed Google Scholar Although biopsy is unnecessary, PCFH are characterized by lobulated adipose tissue separated by fibrous septa with prominent capillary vessels.4Warren R.B. Verbov J.L. Ashworth M. Precalcaneal congenital Fibrolipomatous hamartomas.Pediatr Dermatol. 2007; 24: 74-75Crossref PubMed Scopus (9) Google Scholar PCFH should not be confused with adult piezogenic pedal papules (Figure 2), which, unlike PCFH, accentuate with standing.Figure 2Piezogenic pedal papules.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Management should consist of reassurance and observation, because PCFH often regress over time.5Flann S. Munn S.E. Precalcaneal fibrolipomatous hamartomas.Clin Exp Dermatol. 2009; 34: 495-496Crossref PubMed Scopus (5) Google Scholar Surgery should not be considered unless the lesions are problematic.

Heterotopic Ossification in the Middle Finger: A Case Report

A case of heterotopic ossification developed after traumatic laceration of the middle finger. It is extremely rare for heterotopic ossification to locate in the finger. The diagnosis was accomplished with plain radiographs as well as with MRI and confirmatory study with histopathological microscopic examination which demonstrated nubbin of bone surrounded by fibrovascular connective tissue, and the marrow was predominantly fatty with prominent ectatic vessels and patchy mild lymphocytic infiltrate and gross appearance of partly calcified bony tissue.

Exposure to gold nanoparticles produces cardiac tissue damage that depends on the size and duration of exposure

BackgroundCurrent research focuses on cancer therapy, diagnostics and imaging, although many challenges still need to be solved. However, for the application of gold nanoparticles (GNPs) in therapy and diagnostics it is necessary to know the bioaccumulation and local or systemic toxicity associated to them. The aim of the present study was to investigate the effects of intraperitoneal administration of GNPs on the histological alterations of the heart tissue of rats in an attempt to cover and understand the toxicity and the potential role of GNPs in the therapeutic and diagnostic applications.MethodsAnimals were randomly divided into 3 GNPs-treated rats groups and one control group (CG). The 10, 20 and 50 nm GNPs were administered intraperitonealy at the rate of 3 or 7 days as follows: Group 1: received infusion of 100 μl GNPs of size 10 nm for 3 or 7 days; Group 2: received infusion of 100 μl GNPs of size 20 nm for 3 or 7 days; Group 3: received infusion of 100 μl GNPs of size 50 nm for 3 or 7 days. Control group: received no GNPs.ResultsIn comparison with the respective control rats, GNPs-treated rat received 100 μl of 10 and 20 nm particles for 3 days or 7 days demonstrating congested heart muscle with prominent dilated blood vessels, scattered and extravasations of red blood cells, focus of muscle hyalinosis, disturbed muscle fascicles, dense prominent focus of inflammatory cells infiltrate by small lymphocytes and few plasma cells while GNPs-treated rat received 100 μl of 50 nm particles for 3 or 7 days demonstrating benign normal looking heart muscle with normal muscle direction and fascicles, and very few scattered small lymphocytes.ConclusionsThe histological alterations induced by intraperitoneal administration of GNPs were size-dependent with smaller ones induced more affects and related with time exposure of GNPs. This study suggests that interaction of GNPs with proteins and various cell types might be evaluated as part of the toxicological assessment in addition to further experiments related to tissues antioxidant enzymes, oxidative parameters, lipid peroxidation, production of free radicals and/or ROS and cytokine, histomorphologcal and ultrastrucural will be performed to cover and understand the toxicity and the potential use of GNPs as therapeutic and diagnostic tool.

Is Routine Nasoendoscopy Warranted in Epistaxis Patients after Removal of Nasal Packing?

Fiberoptic nasoendoscopy (FNE) is a powerful investigative tool in ear, nose, and throat practice in which its use in the management of epistaxis is varied among clinicians. The practice of assessing the nasal cavity after removal of nasal packs is common but its usefulness has not been evaluated. Therefore, we assessed the benefits of routine FNE after removal of nasal packs in epistaxis patients. Our study was performed retrospectively involving 62 adult patients admitted over a 6-month period between 2005 and 2006. Data regarding the emergent management of epistaxis cases on presentation, the use of FNE, and the final diagnosis and outcome of each patient were specifically investigated during the study. Anterior rhinoscopy was performed in 27 patients at initial presentation, of whom 45% (10/27) had anterior bleeding points identified. FNE examination after removal of nasal packs in eight patients yielded evidence of a posterior bleeding point in only one case (12.5%). Of those patients in whom anterior rhinoscopy revealed no anterior bleeding point at presentation (17/27), 12 patients went on to have FNE after removal of their nasal packs, and of these, 33% (4/12) of patients were found to have a posterior bleeding vessel. Overall, FNE was performed in 24 patients, of whom only 1 (1/24) had an active posterior bleeding vessel needing nasal repacking. Four patients (4/24) had prominent posterior vessels that required no intervention, 1 patient (1/24) had new pathology identified, and in the remaining 18 cases (18/24), FNE yielded no additional information to modify management. The routine performance of FNE in all epistaxis patients after pack removal does not appear to convey any additional benefit. We advocate the use of FNE when anterior bleeding has been excluded or bleeding is persistent and that careful nasal examination by anterior rhinoscopy should be the cornerstone of assessment.

Intra-arterial Targeted Islet-specific Expression of Sirt1 Protects β Cells From Streptozotocin-induced Apoptosis in Mice

Gene therapy provides a promising approach to curing diabetes. However, an effective route for islet-specific targeting has yet to be established. Toward this end, the pancreatic blood circulation system in Balb/c mice was determined by the injection of rhodamine-containing beads. The efficiency of islet targeting was then measured by the injection of adenoviral vectors carrying a green fluorescence gene via the celiac trunk (C.T.). The results showed that >95% of islets and about 60% of β cells within the pancreatic body and tail could be labeled 3 days after surgery. α-Cell labeling was not as efficient, whereas labeling of nonendocrine tissues was barely detectable. For proof of principle, adenoviral vectors carrying a Sirtuin transgene were injected similarly to test the islet protection effect in the streptozotocin (STZ)-induced type 1 diabetic model. The results demonstrated that overexpression of Sirtuin in STZ-treated mice reduced the level of β-cell death and extent of glucose intolerance. This study reports on efficient islet-specific targeting by using adenoviral injection. This procedure could be invaluable to the treatment of diabetes and the study of islet biology.

Restrictive Dermopathy in a Turkish Newborn

A 4-day-old boy presented with tight, translucent skin, prominent vessels, skin erosions, and dysmorphic findings, including hypertelorism, antimongoloid axis, sparse eyelashes and eyebrows, pinched nose, natal teeth, microretrognathia, and an "o-shaped" mouth. Multiple joint contractures, dysplastic clavicles, and thin ribs were also observed. He died at 2 weeks of age of respiratory distress. The patient was diagnosed as being affected with restrictive dermopathy, which is a rare, lethal genodermatosis caused by recessive mutations of the zinc metalloproteinase ZMPSTE24 gene or less frequently, by dominant lamin A/C gene mutations. Direct sequencing of the ZMPSTE24 gene was performed, and the most common, homozygous, inactivating mutation in exon 9 was identified in the patient (c.1085_1086insT; p.Leu362PhefsX19). Autosomal recessive transmission was confirmed by parental DNA analysis. After genetic counseling, a prenatal diagnosis could be performed during the subsequent pregnancy. ZMPSTE24 screening was performed by direct sequencing and fluorescent fragment analysis on DNA derived from a chorionic villus sample after exclusion of maternal contamination. The fetus had inherited both normal parental alleles, avoiding the recurrence of the disease.

Identification of Low Molecular Weight Pyroglutamate Aβ Oligomers in Alzheimer Disease: A NOVEL TOOL FOR THERAPY AND DIAGNOSIS

N-terminally truncated Aβ peptides starting with pyroglutamate (AβpE3) represent a major fraction of all Aβ peptides in the brain of Alzheimer disease (AD) patients. AβpE3 has a higher aggregation propensity and stability and shows increased toxicity compared with full-length Aβ. In the present work, we generated a novel monoclonal antibody (9D5) that selectively recognizes oligomeric assemblies of AβpE3 and studied the potential involvement of oligomeric AβpE3 in vivo using transgenic mouse models as well as human brains from sporadic and familial AD cases. 9D5 showed an unusual staining pattern with almost nondetectable plaques in sporadic AD patients and non-demented controls. Interestingly, in sporadic and familial AD cases prominent intraneuronal and blood vessel staining was observed. Using a novel sandwich ELISA significantly decreased levels of oligomers in plasma samples from patients with AD compared with healthy controls were identified. Moreover, passive immunization of 5XFAD mice with 9D5 significantly reduced overall Aβ plaque load and AβpE3 levels, and normalized behavioral deficits. These data indicate that 9D5 is a therapeutically and diagnostically effective monoclonal antibody targeting low molecular weight AβpE3 oligomers.

Multiple Septic Bursitis and Spontaneous Achilles Tendon Tear in Systemic Lupus Erythematosus

A 27-year-old woman presented 6 weeks after an uncomplicated lower segment caesarean section with excessive bleeding per vagina. On examination, she had mild pallor with a pulse rate of 86 beats per minute and blood pressure of 116/80 mm Hg, uterus well involuted with closed cervical os and bleeding demonstrated through the cervix. A transvaginal ultrasonography with colour Doppler revealed a normal size uterus with an empty cavity and a hypoechoic area with blood flow within it in the left side of the uterus with a prominent arterial feeder vessel. A CT angiogram confirmed the diagnosis of a 1.3×0.7 cm pseudoaneurysm of the uterine artery near the left cornua of the uterus. After failed attempts to control the bleeding with antifibrinolytics, bilateral uterine arteries were embolised using gel foam. Post procedure, bleeding resolved immediately. A follow-up transvaginal ultrasound after a year revealed no evidence of the pseudoaneurysm and her fertility was preserved.

Unilateraler Irisgefäßtumor

We report the case of a 69-year-old asymptomatic woman who presented with the incidental diagnosis of a prominent, vascular, reddish tumor of the iris. The tumor displayed significant regression within months but reappeared years later with a similar morphology. Fluorescence angiography of the iris revealed a hypofluorescent area without intrinsic vasculature or prominent feeder vessels. In ultrasound biomicroscopy a solid, hypoechogenic iris mass was demonstrated most probably caused by varices of the iris which are a rare finding and difficult to differentiate from a cavernous hemangioma clinically.

Simvastatin effects on portal‐systemic collaterals of portal hypertensive rats

Portal-systemic collateral vascular resistance and vasoconstrictor responsiveness are crucial in portal hypertension and variceal bleeding control. Statins enhance vasodilators production, but their influence on collaterals is unknown. This study aimed to survey the effect of simvastatin on collaterals. Partially portal vein-ligated rats received oral simvastatin (20 mg/kg/day) or distilled water from -2 to +7 day of ligation. After hemodynamic measurements on the eighth postoperative day, baseline perfusion pressure (i.e. an index of collateral vascular resistance) and arginine vasopressin (AVP, 0.1 nM-0.1 microM) responsiveness were evaluated with an in situ perfusion model for collateral vascular beds. RT-PCR of endothelial NO synthase (eNOS), inducible NOS (iNOS), cyclooxygenase-1 (COX-1), COX-2, thromboxane A(2) synthase (TXA(2)-S) and prostacyclin synthase genes was performed in parallel groups for splenorenal shunt (SRS), the most prominent intra-abdominal collateral vessel. To determine the acute effects of simvastatin, collateral AVP response was assessed with vehicle or simvastatin. SRS RT-PCR of eNOS, iNOS, COX-1, COX-2 and TXA(2)-S, and measurements of perfusate nitrite/nitrate, 6-keto-PGF1(alpha) and TXB(2) levels were performed in parallel groups without AVP. Acute simvastatin administration enhanced SRS eNOS expression and elevated perfusate nitrite/nitrate and 6-keto-PGF1(alpha) concentrations. Chronic simvastatin treatment reduced baseline collateral vascular resistance and portal pressure and enhanced SRS eNOS, COX-2 and TXA(2)-S mRNA expression. Neither acute nor chronic simvastatin administration influenced collateral AVP responsiveness. Simvastatin reduces portal-systemic collateral vascular resistance and portal pressure in portal hypertensive rats. This may be related to the enhanced portal-systemic collateral vascular NO and prostacyclin activities.

Solitary Oral Fibromas of the Tongue Show Similar Morphologic Features to Fibrous Papule of the Face: A Study of 31 Cases

The morphologic similarities between fibrous papules of the face and multiple oral fibromas were mentioned long ago, mainly in the context of phakomatoses. Both lesions have been considered to be different types of angiofibromas. Nonetheless, this interpretation is not accepted by all authors. We tried to investigate if solitary oral fibromas also share morphologic features with fibrous papules of the face. For this purpose, we designed a retrospective study retrieving 31 fibromas of the tongue from 30 different patients and studied a control group of 20 fibrous papules of the face from 20 different patients. From the oral fibromas, 15 lesions presented as dome shape, whereas 16 lesions presented as polypoid. Lesion size varied between 2 and 7 mm. In all the lesions, we found a common pattern: a fibrous and collagenized stroma, with prominent vessels. Inflammatory infiltrate was mild. Also, we specifically searched for 4 morphologic features: dilated blood vessels, concentric perivascular fibrosis, multinucleated cells, and mast cells. Multinucleated cells and dilated blood vessels were a common feature. On the contrary, concentric perivascular fibrosis was not a prominent feature. Thick collagen bundles (keloid like) were also occasionally found. Mitoses were rare. These findings were similar to the ones described in fibrous papules of the face, which were also present in our control group of 20 fibrous papules. Therefore, we conclude that the sporadic type of fibroma shares many morphologic features with the fibrous papules of the face. This would be similar to the morphologic relation, already described, between fibrous papules of the face and oral fibromas of phakomatoses.

Angiomatoid Intradermal Melanocytic Nevus or Chimeric Nevus?: A Potential Diagnostic Pitfall

Angiomatoid Intradermal Melanocytic Nevus or Chimeric Nevus?: A Potential Diagnostic Pitfall