This book covers core concepts in the structure and function of vascular smooth muscle cells in health and disease. Supplemental reading may be drawn from the extensive number of references listed at the end of each chapter. Vascular smooth muscle cell is the major cell type in blood vessels. Dysfunction of vascular smooth muscle cells is an important cause of vascular diseases — for example, atherosclerosis, hypertension, and circulatory shock. Vascular smooth muscle cells are phenotypically plastic, capable of switching between two major phenotypes — contractile/differentiated phenotype and invasive/ proliferative phenotype — in response to environmental clues. This book is organized in three sections. Section I (chapters 2 to 4) addresses the structure and function of the contractile/differentiated phenotype of vascular smooth muscle cell. Section II (chapters 5 and 6) addresses the developmental basis of vascular smooth muscle cell phenotype and structure and function of podosomes (invasive organelles) in the invasive/proliferative phenotype of vascular smooth muscle cell. Section III (chapters 7 to 9) addresses the role of vascular smooth muscle cell dysfunction in three vascular diseases — atherosclerosis, hypertension, and circulatory shock.

Fine needle aspiration (FNA) is a reliable, minimally invasive, cost effective technique for obtaining samples from superficial and deep mass lesions for pathologic evaluation. Despite these advantages, physicians in the USA have been slow to embrace FNA as a primary diagnostic modality in the pediatric population . Obstacles to the acceptance and use of FNA include diagnostic challenges posed by the overall rarity and spectrum of tumors seen in children and adolescents, the experience and biases of clinicians and pathologists, and practical and technical considerations. Cytopathologists who are experienced in the performance and interpretation of FNAs may have limited familiarity with the spectrum and morphologic appearances of tumors seen in the pediatric population. Conversely, pediatric pathologists who are familiar with the histologic features and differential diagnosis of tumors encountered in children and adolescents often have little experience performing and/or interpreting FNAs. Likewise, clinicians who have extensive experience performing endoscopic or endobronchial ultrasound guided FNAs may have little experience with endoscopy or bronchoscopy of pediatric patients, and vice versa. These factors can impact the quality of the specimen and/or interpretation and lead to the need for a second procedure in order to arrive at a definitive diagnosis, thereby limiting the value of FNA as a diagnostic modality . Practical considerations include the cognitive and emotional maturity of the child or adolescent, and the need for immobilization, sedation, or anesthesia. Alone or in combination, these and other challenges and limitations have contributed to reluctance on the part of both pathologists and clinicians to promote the use of FNA as a primary diagnostic modality in the pediatric population.

Although seizures have been described since ancient times, it is surprising how scant are the descriptions of what today is clearly identified as status epilepticus (SE). Perhaps the earliest reference to the condition of epilepsy and prolonged, ongoing seizure activity—SE—may be found in the Sakikku Cuneiform Tablet , which notes: If the possessing demon possesses him many times during the middle watch of the night, and at the time of his possession his hands and feet are cold, he is much darkened, keeps opening and shutting his mouth, is brown and yellow as to the eye. It may go on for some time, but he will die. (XXV–XXVI Tablet Obverse 629–539 BC) Caelius Aurelianus notes that “fits can recur … even in the same day,” and comments further on the mortality when “the attack extends into the second day.” Saul, while prophesying at Ramah, was to be diagnosed as having status epilepticus . During the Renaissance period, Thomas Willis in England noted (in Pathologiae cerebri et nervosi generis specimen. In quo agitur de morbis convulsivis et de scrobuto, 1667, Pordage S, translator, 1681.) : [W]hen as fits are often repeated, and every time grow more cruel, the animal function is quickly debilitated; and from thence, but the taint, by degrees brought on the spirits, and the Nerves serving the Praecordia, the vital function is by little and little enervated, till at length, the whole body languishing, and the pulse loosened, and at length ceasing, at last the vital flame is extinguished.Although seizures have been described since ancient times, it is surprising how scant are the descriptions of what today is clearly identified as status epilepticus (SE). Perhaps the earliest reference to the condition of epilepsy and prolonged, ongoing seizure activity—SE—may be found in the Sakikku Cuneiform Tablet , which notes: If the possessing demon possesses him many times during the middle watch of the night, and at the time of his possession his hands and feet are cold, he is much darkened, keeps opening and shutting his mouth, is brown and yellow as to the eye. It may go on for some time, but he will die. (XXV–XXVI Tablet Obverse 629–539 BC) Caelius Aurelianus notes that “fits can recur … even in the same day,” and comments further on the mortality when “the attack extends into the second day.” Saul, while prophesying at Ramah, was to be diagnosed as having status epilepticus . During the Renaissance period, Thomas Willis in England noted (in Pathologiae cerebri et nervosi generis specimen. In quo agitur de morbis convulsivis et de scrobuto, 1667, Pordage S, translator, 1681.) : [W]hen as fits are often repeated, and every time grow more cruel, the animal function is quickly debilitated; and from thence, but the taint, by degrees brought on the spirits, and the Nerves serving the Praecordia, the vital function is by little and little enervated, till at length, the whole body languishing, and the pulse loosened, and at length ceasing, at last the vital flame is extinguished.