Thickened Blood Vessels Research Articles

Genotoxic Response and Histological Alterations in Rat Lungs Exposed to Gasoline Generator Exhaust

The epileptic power supply in Nigeria has caused a surge in the production of energy from other sources, including gasoline generator sets. The air pollution caused by the exhaust from these engines has been implicated in a variety of metabolic disorders and diseases, including cancer. This study aims at understanding the genotoxic and histopathological effects of gasoline generator exhaust exposure on the DNA and lungs of adult male wistar rats. Forty- eight (48) adult wistar rats were divided into four categories, each with 12 rats. The control rats were not exposed to gasoline generator exhaust while the test groups were exposed at 2, 4, and 8-hour intervals for a duration of 4, 8, and, 12 weeks respectively. Animals were euthanized using cervical dislocation and blood samples were obtained for genotoxic analysis via cardiac puncture while the lungs were preserved for 72 hours in 10% neutral buffered formalin and further processed for histological studies. The Olive Tail Moment (OTM) of the exposed rats showed significant variation across the exposure time points when compared to the unexposed control, indicating that exposure to gasoline generator exhaust negatively impacts the DNA. Additionally, histological investigations also indicated some cytopathic characteristics, such as peribronchiolar and perivascular infiltration by inflammatory cells, congestion, and thickening of blood vessels. The findings of this study showed that exposure to gasoline generator exhaust induces genotoxic damage with the severity of the damage occurring in a time/exposure-dependent manner. Keywords: Air pollution; Nigeria; Gasoline; Generator; Genotoxicity.

Molecular Mechanisms Underlying Vascular Remodeling in Hypertension.

Hypertension, a common cardiovascular disease, is primarily characterized by vascular remodeling. Recent extensive research has led to significant progress in understanding its mechanisms. Traditionally, vascular remodeling has been described as a unidirectional process in which blood vessels undergo adaptive remodeling or maladaptive remodeling. Adaptive remodeling involves an increase in vessel diameter in response to increased blood flow, while maladaptive remodeling refers to the narrowing or thickening of blood vessels in response to pathological conditions. However, recent research has revealed that vascular remodeling is much more complex. It is now understood that vascular remodeling is a dynamic interplay between various cellular and molecular events. This interplay process involves different cell types, including endothelial cells, smooth muscle cells, and immune cells, as well as their interactions with the extracellular matrix. Through these interactions, blood vessels undergo intricate and dynamic changes in structure and function in response to various stimuli. Moreover, vascular remodeling involves various factors and mechanisms such as the renin-angiotensin-aldosterone system (RAS), oxidative stress, inflammation, the extracellular matrix (ECM), sympathetic nervous system (SNS) and mechanical stress that impact the arterial wall. These factors may lead to vascular and circulatory system diseases and are primary causes of long-term increases in systemic vascular resistance in hypertensive patients. Additionally, the presence of stem cells in adventitia, media, and intima of blood vessels plays a crucial role in vascular remodeling and disease development. In the future, research will focus on examining the underlying mechanisms contributing to hypertensive vascular remodeling to develop potential solutions for hypertension treatment. This review provides us with a fresh perspective on hypertension and vascular remodeling, undoubtedly sparking further research efforts aimed at uncovering more potent treatments and enhanced preventive and control measures for this disease.

Giant Epithelioid Angiomyolipoma of Kidney - A Rare Case Report

Renal angiomyolipoma is a benign mesenchymal neoplasm of kidney and composed of varied proportions of adipose tissue, smooth muscle cells- spindled or epithelioid and dysmorphic thickened or hyalinised blood vessels. Epithelioid angiomyolipoma is one of the rare variants of angiomyolipoma with high degree of complications, recurrence and metastasis. Whereas classic angiomyolipoma does not show metastasis and recurrence. Giant epithelioid angiomyolipoma means tumor size measuring greater than10 cm, very few cases have been reported in literature. Epithelioid angiomyolipoma of size greater than 20 cm is extremely rare. Here we report a rare case of giant epithelioid renal angiomyolipoma of size greater than 20 cm in a 21-year-old female, presented with complaints of right flank pain and hematuria. The patient underwent nephrectomy with probability of malignancy given in ultrasonography and specimen was sent for histopathological examination. Gross examination revealed enlarged kidney of size 22×18×10 cm and cut section shows grey white to yellow lesion measuring 21×17×10 cm almost occupying entire kidney. Microscopic examination revealed interlacing fascicles of spindle cells, lobules of adipocytes and thickened blood vessels. Foci of pleomorphic epithelioid cells with illdefined cell borders, pleomorphic vesicular nucleus and prominent nucleoli are noted. Keywords: Epithelioid, angiomyolipoma, mesenchymal, giant, kidney

Modeling Colorectal Cancer-Induced Liver Portal Vein Microthrombus on a Hepatic Lobule Chip.

Colorectal cancer is one of the most common malignant tumors. At the advanced stage of colorectal cancer, cancer cells migrate with the blood to the liver from the hepatic portal vein, eventually resulting in a portal vein tumor thrombus (PVTT). To date, the progression of the early onset of PVTT [portal vein microthrombus (PVmT) induced by tumors] is unclear. Herein, we developed an on-chip PVmT model by loading the spheroid of colorectal cancer cells into the portal vein of a hepatic lobule chip (HLC). On the HLC, the progression of PVmT was presented, and early changes in metabolites of hepatic cells and in structures of hepatic plates and sinusoids induced by PVmT were analyzed. We replicated intrahepatic angiogenesis, thickened blood vessels, an increased number of hepatocytes, disordered hepatic plates, and decreased concentrations of biomarkers of hepatic cell functions in PVmT progression on a microfluidic chip for the first time. In addition, the combined therapy of thermo-ablation and chemo-drug for PVmT was preliminarily demonstrated. This study provides a promising method for understanding PVTT evolution and offers a valuable reference for PVTT therapy.

Increased Blood Pressure As A Prediction Factor Of Stroke Incidence In Tulungagung District

Stroke is a sudden neurologic disorder that occurs due to restriction or cessation of blood flow through the arterial supply system. High blood pressure causes an increase in peripheral blood pressure, causing a poor hemodynamic system and thickening of blood vessels and hypertrophy of the heart muscle. The aim of this research is to analyze the relationship between blood pressure and stroke events at the Karangrejo Health Center.The research was conducted on 10-13 November 2022. The type of research was correlation, analytic design with a cross-sectional approach and the research instrument was a questionnaire. The study population is a portion of stroke patients at the Karangrejo Health Center. Samples were taken by purposive sampling technique of 30 respondents. Blood pressure independent variable, stroke incident dependent variable. Data were analyzed with the Spearman rho test.The results showed that more than half of the respondents had blood pressure in the Severe Hypertension category, namely 13 respondents (43.3%). Most of the respondents had a history of Non-Hemorrhagic Stroke, namely 20 respondents (66.7%). Spearman Rho statistical test obtained P Value = 0.000 <0.05 so that H1 is accepted, which means there is a relationship between blood pressure and stroke events at the Karangrejo Health Center, Karangrejo District, Tulungagung Regency. Blood pressure is very closely related to the incidence of stroke. This proves that it is important to control blood pressure in hypertensive patients so that they can anticipate complications of stroke.

Anti-galectin-3 antibodies induce skin vascular inflammation via promoting local production of IL-1β in systemic lupus erythematosus

Vascular inflammation could occur in all organs and tissues in patients with systematic lupus erythematosus (SLE), of which skin is the most frequent one. Our previous research identified anti-galectin-3 (Gal3) antibodies (Abs) as an important mediator of lupus cutaneous vasculopathy. Herein, we showed that anti-Gal3 Abs dysregulated the function of vascular endothelial cells with higher transcript levels of IL-1β and increased expression of mature IL-1β. The enhanced production of IL-1β secreted by endothelial cells was dependent on NLRP3 inflammasome. Intradermal injection of anti-Gal3 Abs in mice induced local inflammation with perivascular infiltration of T cells and neutrophils, which was inhibited by IL-1β blockade. Induction of anti-Gal3 Abs in circulation by immunization of Gal3 antigen not only led to histopathologic changes in the skin, including focal keratinocytes vacuolization and thickening of blood vessels, but also a systemic autoimmune phenotype that involves autoantibody production and kidney damage. Intriguingly, local overexpression of IL-1β was primarily associated with skin lesions but not with other internal organs in mice. Finally, we showed that the serum levels of IL-1β were comparable between SLE patients and healthy donors. Whilst the expression of IL-1β was enriched in local area with perivascular inflammation in lupus skin lesion compared to healthy normal skin. The results strongly suggest that IL-1β plays an important role in mediating anti-Gal3 Ab-induced skin vascular inflammation and raised the prospect for using IL-1β blocking therapies to treat lupus cutaneous damage.

HGG-55. An adolescent with a High-Grade Glioma: persuing a specific diagnosis

BACKGROUND: Recognizing the value of molecular parameters provides evidence with repercussions on diseases classification. CLINICAL CASE: A thirteen-year-old girl was admitted in coma at the Intensive Care Unit due to a hemorrhagic stroke. CT revealed an expansive left frontal lobe lesion with perilesional edema and compression signs by an extensive hematoma. She underwent an emergency decompressive craniotomy for hematoma drainage, and the lesion was biopsied. The subsequent MRI showed a large heterogeneous mass with a cystic component. A first subtotal resection of the lesion was performed considering the language area. The histopathological examination showed tumor cells organized in perivascular pseudorosettes around the central hyalinized thickened blood vessel throughout the tumor, a pattern typically encountered in astroblastoma. Immunochemistry stains revealed a positive reactivity for GFAP, Olig2, and synaptophysin. The molecular study found a BRAFV600E mutation and homozygous CDKN2A e CDKN2B deletions; no TERT amplification, BCORL1, nor MN1 gene rearrangements were identified. She completed six weeks of radiotherapy without neurological signs/symptoms. A new surgical intervention was done 12 weeks later due to a slight increase of residual lesion. The rapid growth and the presence of viable tumor cells justified the therapy with irinotecan and bevacizumab, with mild adverse effects. One year after diagnosis, the adolescent is clinically well, without neurologic deficits and the MRI without evidence of residue or tumor recurrence. DISCUSSION: We began therapy based on morphological diagnosis. Complete resection and radiotherapy proved to be beneficial as in other high-grade gliomas, but the value of other therapies is still unknown. The BRAF gene variant would allow treatment with dabrafenib (in association with trametinib) or vemurafenib; however, she presents molecular findings associated with poor prognosis (CDKN2A deletion) that may impair the effectiveness of these therapies. According to the new WHO classification, the absence of MN1 alterations precludes the diagnosis of astroblastoma.

Progressive ascending telangiectasias

Progressive ascending telangiectasias

Histological Studies on Ageing Changes in the Retina of Buffaloes (Bubalus bubalis)

Background: Affections of eye are commonly encountered in all the species of animals. The age-related changes of the retina primarily cause loss of visual acuity as well as reduction of the visual field. Hence, the current study was carried out to establish basic data related to ageing changes in the retina of buffaloes. Methods: The study was conducted on 63 eye balls of locally available buffaloes of different breeds. These buffaloes were categorized into 3 groups i.e., group I (1-5 yrs), group II (6-10 yrs) and group III (11 yrs and above). The eyeballs were isolated and fixed with Davidson’s fluid. The paraffin sections were subjected for routine histological study. Result: The thickness of retinal pigment epithelium was increased from group I to III buffaloes from 6.06±0.18 to 8.44±0.32 and the quantity of melanin pigment was decreased with advancement of age. Rod and cone cells of the photoreceptor layer were tightly packed in young age, loosely arranged in old animals. The mean thickness (µm) of photoreceptors and outer nuclear layers together was decreased from 64.22±1.84 to 58.72±2.1 with age advancement. The displacement of nuclei from outer nuclear layer into outer plexiform layer was significantly decreased in old animals. The outer limiting membrane was continuous and uninterrupted throughout the life. The thickness of outer plexiform layer was increased with advancement of age from 8.78±0.58 to 10±0.51 due to enhancement of synaptic fibers density. As age advances the number and density of horizontal, bipolar and amacrine cells were decreased and also the mean thickness (µm) of this layer was decreased from 30.83±1.48 to 22.56±0.62 in the inner nuclear layer. The thickness of inner plexiform layer was increased from 42.44±2.23 to 45.39±0.81 with advancement of age due to increased cystoids spaces and thickening of retinal blood vessels. In ganglionic cell layer, the number of α-ganglion cells were more than the β-ganglion cells, their common number were decreased approximately from 16-20 cells/sq.mm to 7-10 cells/sq.mm, whereas the average size was increased from 4.72±0.49 to 15.83±0.83 with advancement of age. In aged buffaloes nerve fiber layer showed corpora amylacea and thickened blood vessels. The inner limiting membrane became thick and uninterrupted in old buffaloes. The total thickness (µm) of retina in group I, II and III buffaloes were 235.5±7.25, 184.33±3.64 and 201.05±5.15 respectively.

Type 2 diabetes and the clinically normal pulp: An in vitro study.

AimThe aim of this study was to investigate the effect of type 2 diabetes (T2D) on clinically normal dental pulp tissue by using special stains and immunohistochemistry (IHC) to determine the morphology of the coronal pulp and distribution of immune markers in non‐T2D and T2D groups.MethodologyEthics approval for this in vitro pilot study was obtained from the University of Otago Human Ethics Committee (16/069). Twenty extracted permanent molar teeth diagnosed as having clinically normal pulp status were collected. Ten teeth were from participants with well‐controlled T2D and ten from participants without diabetes (non‐T2D). Each tooth was sectioned transversely at the cemento‐enamel junction before the crowns were decalcified and embedded in paraffin. Sections were stained with haematoxylin and eosin, Massons trichrome, and van Gieson stains for histological and morphological evaluation. IHC using anti‐CD4, anti‐CD68 and anti‐CD83 and anti‐IL1β, anti‐IL6, anti‐IL17, anti‐TNF‐α, anti‐TLR2, anti‐TLR4 and anti‐FOXP3 identified proteins of interest. Qualitative and semi‐quantitative analyses evaluated the morphology of the dental pulp and protein expression. Data analyses were performed with GraphPad Prism, using Student's t‐test and multiple regression using SPSS at p < .05.ResultsSpecial stains demonstrated morphological differences in the T2D dental pulp compared with non‐T2D. Qualitative analysis indicated that the pulp in the T2D samples was consistently less cellular, less vascular, showed evidence of thickened blood vessel walls, increased pulp calcification and collagen deposition. Semi‐quantitative analysis of IHC samples showed the T2D pulp had significantly increased expression of macrophage and dendritic cell markers CD68 (p < .001) and CD83 (p = .04), and there was significantly greater expression of inflammatory cytokines IL1β (p = .01), IL6 (p < .0001), IL17 (p < .0001) and TNF‐α (p = .01). T2D samples showed a significant increase in markers of innate inflammation, TLR2 (p < .001) and TLR4 (p < .001) and decreased expression of regulatory T‐cell marker, FOXP3 (p = .01). Multiple regression showed that age‐corrected differences were statistically significant.ConclusionPreliminary findings suggest that T2D may exert a similar response in the pulp to complications in other body sites. Hyperglycaemia is associated with changes in the morphology of the clinically normal dental pulp with altered immune cell and cytokine expression.

Exploring the role of the combination of propolis and vitamin D3 on VCAM-1 and Caspase-3 expression in preventing atherosclerosis in chronic kidney disease rats

Background: Increased blood pressure that occurs in chronic kidney disease (CKD) is influenced by the occurrence of thickening of blood vessels. This study evaluates the utilization of propolis which acts as an anti-inflammatory and vitamin D3 which plays a role in calcium-phosphate metabolism, that when combined are expected to prevent atherosclerosis. Methods: This experimental research used a post-test only group design with a total of 24 male rats divided into 3 groups. Subjects were induced to develop CKD with unilateral ureteral obstruction. A combination of 50mg/kgBW of propolis and 0.126mcg/kgBW of vitamin D3 was given orally every morning in the intervention group. Hemodynamics and atherosclerosis status were observed using sonography until week 4. Inflammatory markers with vascular cell adhesion molecule 1 (VCAM-1) and Caspase-3 were evaluated weekly via plasma and target organ samples were immunohistochemically examined at the study’s end. Results: Propolis and vitamin D3 significantly reduced blood pressure from 156 mmHg at the beginning of the study to 117mmHg at week 4 (p=0.000). Thickening of the aorta occurred in the control and intervention groups but the thickening in the control group (0.90mm) was statistically significantly (p=0.000) higher than the intervention group (0.30mm). There were decreased VCAM-1 and Caspase-3 levels in the intervention group compared to the control group, both in plasma and target organ levels Conclusion: Utilization of propolis and vitamin D3 combined has a good effect on lowering inflammation, improving hemodynamics and preventing atherosclerosis in chronic kidney disease rat models.

Endocan, a Soluble Marker of Endothelial Cell Activation Is a Molecular Marker of Disease Severity in Women with Preeclampsia.

Endocan is a proteoglycan secreted by activated endothelium that regulates angiogenesis via interaction with hepatocyte growth factor (HGF). We hypothesized that women diagnosed with preeclampsia (PE) and/or fetal growth restriction (FGR) have elevated circulating endocan concentrations in direct relationship with severity of clinical manifestations. Serum concentration of endocan and HGF were analyzed in 224 women grouped as healthy pregnant controls (P-CRL, n = 77), PE with severe features (sPE, n = 83), chronic hypertension (crHTN: n = 36), idiopathic FGR (n = 18), and healthy non-pregnant controls (NP-CRL, n = 7). Endocan and HGF measured by immunoassay were analyzed along with markers of inflammation, angiogenesis, and protein misfolding (urine congophilia). Endocan expression in the placenta and/or myometrium was studied by immunohistochemistry and real-time PCR. Compared to gestational age-matched P-CRL, women with early-onset sPE had higher circulating endocan concentrations. Among women with PE and/or FGR, endocan concentration correlated with soluble endoglin and urine congophilia but not with HGF or markers of inflammation or angiogenesis. In the placenta, endocan was expressed in villous and extravillous trophoblasts and endothelium. Intense endocan immunostaining was observed in plaque-like aggregations of sPE placentas complicated with FGR. In addition, thickened blood vessels in the myometrium of sPE patients stained positive for endocan. Women with early-onset sPE have elevated serum endocan likely reflecting chronic endothelial activation. Enhanced expression and/or deposition of endocan at the sites of placental injury and in remodeled maternal blood vessels supports a role for endocan in either vascular rescue or as a contributor to FGR and perhaps long-term cardiovascular morbidity.

Influence of age on the pathology of hippocampus and variation in the number of neurons of the hilar region in the brain of dogs

Brain is a vital organ that always has high oxygen demands and is highly vulnerable to injury caused by reactive oxygen species (ROS). The hippocampus is a complex structure seen deep in the temporal lobe which is constituted by the dentate gyrus, hippocampus proper (Cornu Ammonis- CA1-CA4) and subiculum. The important functions of the hippocampus are learning and memory. Age-influenced pathological lesions in the hippocampus and variation in the number of neurons in the hilus are the main discussion of this study. The major gross lesions observed in the brain of both younger and older dogs were cerebral congestion, thickened meninges and cerebral edema. The major histopathological findings in the hippocampus were thickened blood vessels, accumulation of lipofuscin pigments in the neuronal cytoplasm, satellitosis, gliosis, neurons with the vesicular nucleus, chromatolysis and neuronophagia. A statistically significant reduction in the number of neurons in the hilar region of the hippocampus was observed in aged dogs.

Histological Aspects Regarding Dental Pulp of Diabetic Patients

Background: The possible histological changes in dental pulp in teeth of diabetic patients are important to be understood, as the clinician will consider the best treatment choice for those teeth, especially if they are affected by decay. The aim of this paper is to assess if there are effects of diabetes-associated hyperglycemia on the nervous and vascular system of the dental pulp. Methods: Twenty-three dental pulp specimens of patients aged 36–70 years old were analyzed. All patients had been diagnosed with type 2 diabetes for at least 5 years. Results: Most of the patients had poorly controlled hyperglycemia, deep caries, but no clinical signs of pulpitis. The histological aspects of pulp specimens included frequently seen inflammatory infiltrate, degeneration of the nerves, thickened blood vessel walls, pulp sclerosis and frequent pulp calcifications, and even small necrotic areas. Conclusion: The analyzed dental pulp specimens of carious teeth of type 2 diabetic patients show fibrotic transformation of the dental pulp, with the presence of calcifications, arteriosclerosis and inflammatory infiltrate. In this situation, the attitude of the dentist in pulp vitality preservation in the case of carious teeth of diabetic patients should be limited.

The aortic wall thickness of diabetes mellitus rat models after routine physical exercise

Background and Aims: Diabetes mellitus can cause the thickening of blood vessels' walls. Routine physical exercise is one of the treatments for diabetes mellitus, reducing incidences of complications caused by high blood sugar levels. This study aims to determine the thickness of the blood vessel walls in rat models with diabetes mellitus after routine physical exercise.

Suspected SARS-CoV-2 infection with fever and coronary heart disease: A case report

BACKGROUNDThe coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Suspected cases accounted for a large proportion in the early stage of the COVID-19 outbreak. The deviation of the nucleic acid test by throat swab (the current gold standard of COVID-19) caused by variation in sampling techniques and reagent kits and coupled with nonspecific clinical manifestations make confirmation of the suspected cases difficult. Proper management of the suspected cases of COVID-19 is crucial for disease control.CASE SUMMARYA 65-year-old male presented with fever, lymphopenia, and chest computed tomography (CT) images similar to COVID-19 after percutaneous coronary intervention. The patient was diagnosed as having bacterial pneumonia with cardiogenic pulmonary edema instead of COVID-19. This was based on four negative results for throat swab detection of SARS-CoV-2 nucleic acid using reverse transcriptase-polymerase chain reaction assay and one negative result for serological antibody of SARS-CoV-2 with the serological assay. Additionally, the distribution of ground-glass opacities and thickened blood vessels from the CT images differed from COVID-19 features, which further supported the exclusion of COVID-19.CONCLUSIONDistinguishing COVID-19 patients from those with bacterial pneumonia with cardiogenic pulmonary edema can be difficult. Therefore, it requires serious identification.

Analysis of 4 imaging features in patients with COVID-19

BackgroundThe aim of this was to analyze 4 chest CT imaging features of patients with coronavirus disease 2019 (COVID-19) in Shenzhen, China so as to improve the diagnosis of COVID-19.MethodsChest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. Analyses were performed to investigate the pathological basis of four imaging features(“feather sign”,“dandelion sign”,“pomegranate sign”, and “rime sign”) and to summarize the follow-up results.ResultsThere were 22 patients (65.2%) with typical “feather sign”and 18 (52.9%) with “dandelion sign”, while few patients had “pomegranate sign” and “rime sign”. The “feather sign” and “dandelion sign” were composed of stripe or round ground-glass opacity (GGO), thickened blood vessels, and small-thickened interlobular septa. The “pomegranate sign” was characterized as follows: the increased range of GGO, the significant thickening of the interlobular septum, complicated with a small amount of punctate alveolar hemorrhage. The “rime sign” was characterized by numerous alveolar edemas. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis and partial hyaline degeneration were observed. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients.Conclusion“Feather sign” and “dandelion sign” were typical chest CT features in patients withCOVID-19; “pomegranate sign” was an atypical feature, and “rime sign” was a severe feature. In clinical work, accurate identification of various chest CT signs can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.

A Pilot Study on Thickened Blood Vessels in Endometrial Curettage in Dysfunctional Uterine Bleeding

Background: Dysfunctional uterine bleeding (DUB) is a common disease. About 10% of patients registered with DUB in Gynecology OPD for treatment in developing countries. There has been a change in the rhythmic cyclic menstruation that causes excessive and irregular bleeding. Lack of ovulation or oligo-ovulation leads to permanent estrogenic effects without opposing the progesterone effects. Other causes of the estrogen domain may have similar effects. The relative estrogen domain causes several changes in the uterine vascular system that causes menstrual bleeding.&#x0D; Objective: To determine the frequency and significance of thickened blood vessels in curettage of the endometrium in dysfunctional uterine bleeding.&#x0D; Materials and methods: It was a Retrospective cross-sectional pilot study conducted at Department of Gynecology and Obstetrics, Jinnah Hospital Lahore for one-year duration from January 2017 to December 2017.Hematoxylin and eosin (H&amp;E) stained sections 30 consecutive incident cases of endometrial curettage due to dysfunctional uterine bleeding were examined by an optical microscope, with particular regard to the number of thickened blood vessels. All patients with history of endometrial curettage with dysfunctional uterine bleeding were included while curettage of uterine mucosa in patients with a specific etiology, such as endometritis, atypical hypertrophy, retained products, intrauterine devices (intrauterine device) were excluded.&#x0D; Results: Over 50% of patients were perimenopausal, i.e. 40-55 years of age. All endometrial procedures included thickened blood vessels. On average, there were about 8 blood vessels thickened by curettage of the endometrium.&#x0D; Conclusion: Estrogen-induced vascular lesions result in greater permeability, which can lead to the accumulation of various plasma proteins with increased intramural vascular thickening. These thickened veins may not contract properly, causing excessive bleeding and prolongation.

Necrobiosis Lipoidica Affecting the Leg: What Is the Best Treatment in a Patient with Very High Aesthetic Demand?

Summary:Necrobiosis Lipoidica (NL) is a rare necrotising disorder of the skin characterized by collagen degeneration, thickening of blood vessels, and granulomatous inflammatory process. Its main clinical features are brownish-red papules and yellowish plaques with atrophic central areas. NL affects 0.3% -1.2% of the diabetic population, mostly women (female/male ratio is 3:1). Management of NL is challenging, especially for large lesions refractory to medical therapy, thus requiring surgical excision as an alternative option. Due to the rare occurrence of this condition no treatment guidelines exist and individualized treatment mostly depends on the severity of the lesion, location and patient's expectations. A case of a 30-year-old diabetic woman with very high aesthetic expectations was succesfully treated with staged resections of a giant NL to the leg and reconstruction with dermal template and full thickness skin grafts. Grafts were taken from the groin region bilaterally and from the lower abdomen after a cosmetic mini-abdominoplasty procedure. This approach allowed for a stable and very satisfactory aesthetic result with no donor site exposed scars.

Investigation of a family cluster outbreak of COVID-19 indicates the necessity of CT screening for asymptomatic family members in close contact with confirmed patients.

BackgroundTo investigate whether asymptomatic close-contact family members of patients diagnosed with coronavirus disease (COVID-19) should immediately undergo CT screening in addition to the viral nucleic acid test.MethodsWe retrospectively analyzed the data of a family cluster of 8 individuals, of whom 1 family member (Patient 3) had an epidemiologic history of having visited Guangzhou from Hubei Province on January 20, 2020. Her father (Patient 1) developed a fever and respiratory system symptoms and was confirmed COVID-19-positive on February 4–5, 2020 at Zengcheng People’s Hospital, Guangzhou, China. Seven close-contact family members of the patients were then screened for COVID-19 on February 5–6 at the hospital. The CT imaging manifestation and laboratory tests of this family cluster were investigated and reported.ResultsFive (62.5%) of the 8 family members were confirmed COVID-19-positive. Except for Patient 1, who had fever, cough, fatigue, and dizziness, the remaining four (4/5, 80%) COVID-19-positive family members (Patients 2–5) had no clinical symptoms. Among the 5 patients, 2 had leukopenia (2/5, 40%), 1 had low absolute neutrophil counts (1/5, 20%), and 2 had increased high-sensitivity C-reactive protein (2/5, 40%). Ground-glass opacity (GGO) was found on chest CT imaging in all 5 patients (5/5, 100%), with interlobular septal thickening. Thickened blood vessel shadows were seen in 3 patients (3/5, 60%). The 3 COVID-19-negative family members (Family Members 1–3) did not have CT abnormalities, and they showed negative reverse transcription-polymerase chain reaction (RT-PCR) results twice.ConclusionsCT screening is necessary in close-contact family members of a confirmed COVID-19 pneumonia case, regardless of the presence of clinical symptoms.