Chronic venous diseases, including varicose veins, are characterized by hemodynamic disturbances due to valve defects, venous insufficiency, and orthostatism. Veins are physiologically low shear stress systems, and how altered hemodynamics drives focal endothelial dysfunction and causes venous remodeling is unknown. Here we demonstrate the occurrence of endothelial to mesenchymal transition (EndMT) in human varicose veins. Moreover, the BMP4-pSMAD5 pathway was robustly upregulated in varicose veins. In vitro flow-based assays using human vein, endothelial cells cultured in microfluidic chambers show that even minimal disturbances in shear stress as may occur in early stages of venous insufficiency induce BMP4-pSMAD5-based phenotype switching. Furthermore, low shear stress at uniform laminar pattern does not induce EndMT in venous endothelial cells. Targeting the BMP4-pSMAD5 pathway with small molecule inhibitor LDN193189 reduced SNAI1/2 expression in venous endothelial cells exposed to disturbed flow. TGFβ inhibitor SB505124 was less efficient in inhibiting EndMT in venous endothelial cells exposed to disturbed flow. We conclude that disturbed shear stress, even in the absence of any oscillatory flow, induces EndMT in varicose veins via activation of BMP4/pSMAD5-SNAI1/2 signaling. The present findings serve as a rationale for the possible use of small molecular mechanotherapeutics in the management of varicose veins.

Extraovarian papillary serous carcinoma of the peritoneum is a rare malignancy characterized by peritoneal carcinomatosis presenting with abdominal pain and ascites. This tumor is similar to serous ovarian carcinoma in context to its clinical presentation, histologic appearance, pattern of spread, treatment and prognosis. We hereby report two cases of extraovarian papillary serous carcinoma of the peritoneum and review of literature. How to cite this article Kalyani R, Narasimha A, Kumar HML, Narayanswamy S. Extraovarian Papillary Serous Carcinoma of the Peritoneum: A Report of Two Cases with Review of Literature. J South Asian Feder Obst Gynae 2013;5(1):42-44.

Abstract-Background:Mast cells are involved in multiple biological events. The significance of mast cells in non-neoplastic and neoplastic lesions of the cervix has been studied with conflicting results. Its presence in a tumor has been described as evidence of host immunologic antitumor response, angiogenesis and tumor invasion. Aims/Objectives: To study mast cell density in various cervical lesions using Toluidine blue stain. To compare the sections studied with conventional Toluidine blue staining and Toluidine blue staining by reducing the pH. Methodology: Cervical biopsy/hysterectomy specimens from archives of the Department of Pathology were considered for the study. The sections were studied for histomorphology and mast cell density. The mast cell density was assessed by Toluidine blue staining by conventional method and another method by reducing pH using weak HCL. The stained slides were reviewed for mast cell density under 10 high power field and statistically analyzed. Results: Total of 100 cases was studied. Normal cervix 7 cases with the mean age of 44.29 and the mean mast cell density of 45.43. Chronic cervicitis and polypoidal endocervicitis were 26 and 28 cases, the mean age of 45.38 years and 39.14 years and the mean mast cell count of 48.38 and 66.96 respectively. Intraepithelial lesions and malignancy were 23 and 16 cases, the mean age of 43.56 years and 52.26 years and the mean mast cell of 34.47and 34.6 respectively. The maximum number of mast cells was seen in polypoidal endocervicitis and the least number in squamous cell carcinoma of cervix. Conclusion: The role of mast cell differs in inflammatory and neoplastic lesions of cervix. Mast cells has an active role in inflammatory lesions.

Twin reversed arterial perfusion (TRAP) syndrome is a rare condition (0.3:10,000 births) that occurs in monochorionic twin pregnancies, resulting in coexistence of a normal "pump" twin and an acardiac twin. The acardiac twin is dependent upon the normal twin to provide circulation by means of vascular anastomosis. Many of the bizarre defects are felt to be caused by low oxygen tension and this causes dramatic alteration in the twin fetal physiology and high prenatal mortality. The acardiac twin is a parasite, putting the pump fetus at risk of high output cardiac failure. Overall only 50% of pump twins survive. We present a case in a twenty year female, gravida two, para one, living one, full term normal pregnancy, ultrasound showed twin pregnancy. Following delivery, the first fetus survived only for one day and the second fetus showed features of TRAP syndrome.

Sinonasal carcinomas are rare and account for 3% of all malignant tumours of head and neck. Squamous cell carcinoma is the commonest histological variant. We present a case of sinonasal squamous cell carcinoma in a 52-years-male and another rare case of intestinal type sinonasal adenocarcinoma in 50-years-male.