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Background: Patients with acute coronary syndrome (ACS) have a higher incidence of recurrent ischemic events. The aim of this study was to compare the plaque characteristics of nonculprit lesions between ACS and non-ACS patients using optical coherence tomography (OCT) imaging., Methods and Results: Patients who had 3-vessel OCT imaging were selected from the Massachusetts General Hospital (MGH) OCT Registry. MGH registry is a multicenter registry of patients undergoing OCT. The prevalence and characteristics of nonculprit plaques were compared between ACS and non-ACS patients. A total of 248 nonculprit plaques were found in 104 patients: 45 plaques in 17 ACS patients and 203 plaques in 87 non-ACS patients. Compared with plaques of non-ACS patients, plaques of ACS patients had a wider lipid arc (147.3 ± 29.5° versus 116.2 ± 33.7°, P<0.001), a longer lipid length (10.7 ± 5.9 mm versus 7.0 ± 3.7 mm, P=0.002), a larger lipid volume index [averaged lipid arc×lipid length] (1605.5 ± 1013.1 versus 853.4 ± 570.8, P<0.001), and a thinner fibrous cap (70.2 ± 20.2 µm versus 103.3 ± 46.8 µm, P<0.001). Moreover, thin-cap fibroatheroma (64.7% versus 14.9%, P<0.001), macrophage (82.4% versus 37.9%, P=0.001), and thrombus (29.4% versus 1.1%, P<0.001) were more frequent in ACS patients. Although the prevalence of microchannel did not differ between the groups, the closest distance from the lumen to microchannel was shorter in ACS subjects than in non-ACS (104.6 ± 67.0 µm versus 198.3 ± 133.0 µm, P=0.027)., Conclusions: Nonculprit lesions in patients with ACS have more vulnerable plaque characteristics compared with those with non-ACS. Neovascularization was more frequently located close to the lumen in patients with ACS.

Purpose: The aim of the study was to compare nail fold capillaroscopic findings of the fingers with those of the toes in patients with systemic sclerosis (SSc)., Methods: Thirty-six patients with SSc were included in the study: 30 patients had limited SSc, 5 patients had diffuse SSc, and 1 patient had an overlap syndrome. Of these 36 patients, 30 were women and 6 were men (mean [SD] age, 56 [14] years). The severity of the Raynaud phenomenon (RP), the presence of digital ulcers, and skin scores at the fingers and feet were assessed. Nail fold capillaroscopy was performed with a videocapillaroscope (Videocap 3.0; DS Medica)., Results: All 36 patients (100%) reported about symptoms of RP in the hands and 34 (94.4%) reported episodes of RP in the feet; the difference is not significant (P > 0.05). In most patients with RP symptoms of both hands and feet, the symptoms were more severe at the hands (82%, 28/34). Digital ulcers of the fingers were found in 36% (13/36) of the case and those of the toes were found in 8.3% (3/36) of the cases. Nail fold capillaroscopy of the hands showed the classic "scleroderma"-type capillaroscopic pattern in 97.2% (35/36) of the patients. In the toes, a scleroderma-type capillaroscopic pattern was found only in 66.7% (24/36) of patients (P < 0.05). With respect to distinct differences, in the toes, the dilated capillaries were found in 72.2% (26/36) of the cases, giant capillaries in 30.6% (11/36) of the cases, hemorrhages in 8.3% (3/36) of the cases, avascular areas in 41.7% (15/36) of the cases, and neoangiogenesis in 22.1% (8/36) of the cases. This difference in frequency of the findings regarding the toes and the fingers of patients with SSc was statistically significant for all parameters., Conclusions: Capillaroscopy of the toes of SSc also shows patterns characteristic of SSc. However, these patterns differ from the respective patterns of the fingers, which is probably related to less-severe RP and lower skin score at the feet.

Study Design: This study measured the frequency of lumbar intervertebral disc nucleus pulposus microscopic calcification and angiogenesis in adult patients undergoing discectomy compared to normal cadavers., Objective: The results were compared to determine the relationship between disc microscopic calcification with disc degeneration type, histopathological angiogenesis, patients' age, gender, and duration of symptoms., Summary of Background Data: True frequency of microscopic calcification in normal or degenerated lumbar discs have not been fully defined nor linked to disc degeneration type and angiogenesis. Some studies demonstrated that angiogenesis and calcification are related to each other in several another tissues., Methods: The frequency of microscopic calcification in specimens of disc nucleus pulpous obtained from 2 groups were measured: specimens were obtained during surgery from 90 consecutive patients of 15 to 50 years old suffering from disc herniation in single level of L4-L5 or L5-S1 between 2005 and 2006, 60 additional specimens of lumbar disc nucleus pulposus were obtained from normal cadavers of the same ages. Calcification was determined microscopically by Von Kossa staining and angiogenesis by H/E, and type of degeneration radiologically by Modic classification., Results: Frequency of microscopic calcification was significantly higher in degenerated disc than normal cadaveric (54.4% vs. 6.7%) and was higher in Modic type III than type I (III: 95.0%, II: 57.4%, I: 13.0%), also prevalence of angiogenesis was significantly higher in patients than cadaveric discs (41.0% vs. 6.7%) and in calcified than noncalcified discs (59.2% vs. 19.5%) (P < 0.001). There was no relationship between disc calcification and patients' gender and level of discectomy., Conclusion: Disc nucleus pulposus microscopic calcification is a common event occurring in adult patients suffering from lumbar disc herniation. Mechanisms that link disc degeneration, angiogenesis, and calcification remain a focus for further researches that may be useful in future medical treatments before surgical treatment of lumbar disc herniation.

Background: Vascular invasion (VI) is the strongest risk factor for recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT). However, unlike macroscopic VI, microscopic VI has not been acknowledged as a predictor of recurrence in individual patients. This study aimed to determine whether immunohistochemical staining of the vessels could change the judgment on microscopic VI in such a way as to confer clinical relevance to the feature., Methods: Antibodies against the CD34 antigen (endothelial cell marker of hepatocarcinogenesis) were applied to sections from all the HCC nodules found in 136 patients who underwent LT for HCC arising from cirrhosis between 1990 and 2000. Microscopic VI at the periphery of the nodules was searched blindly by the same pathologist who had already examined hematoxylin-eosin slides. Several characteristics of the patients and of the cancers were analyzed to define their respective influence on recurrence., Results: Recurrent HCC was diagnosed in nine patients. Although 6 of the 22 patients in whom microscopic VI had been detected by hematoxylin-eosin staining developed recurrence, 8 of the 16 in whom microscopic VI was detected by anti-CD34 immunohistochemistry developed recurrence, accounting for 5-year cumulative incidences of recurrence of 34% and 70%, respectively. At multivariate analysis, relative risk for recurrence was the highest for microscopic VI found with anti-CD34 antibodies., Conclusions: Microscopic VI detected by anti-CD34 immunohistochemistry implies an extremely high risk for HCC to recur after LT. Trials focusing on patients with evidence of microscopic VI are needed to test the efficacy of adjuvant therapies to prevent recurrence.