On 2014 Jan 11, Brett Snodgrass commented:

Dear Authors,

Thank you for publication of the excellent article that provides important knowledge about the incidence of VCCs in HLH and their effect on survival.

Please consider that if the VCC results from pathologic alteration of an arterioluminal vessel, then the VCC may not be synonymous with sinusoid as there is no sinusoid involved.

However, if the VCC results from pathologic alteration of an arteriosinusoidal vessel, then the term sinusoid would appropriately apply to only a segment of the VCC. The segment of the VCC closer to the epicardium is presumably derived from the "arterio" segment of the arterio*sinusoidal connection.

VCCs are often used synonymously with VCACs.

1. Ventriculocoronary connections (VCCs)

2. Ventriculocoronary arterial connections (VCACs)

Please provide your kind consideration to the following article published by Joseph Treolar Wearn in 1933. http://bit.ly/JTWearn

Wearn et al. described the myocardial sinusoids and noted that they connected to the arteriosinusoidal vessels but not to the arterioluminal vessels.

The vessels of Wearn include the arterioluminal and arteriosinusoidal vessels. Depending on consensus and further study, they may include a variable segment of the myocardial sinusoids.

Is it possible that some of the VCCs that you describe are not sinusoids but pathologically altered arterioluminal vessels?

My opinion is that we have probably have insufficient information to definitively conclude in every case whether an arteriosinusoidal or arterioluminal vessel is involved.

We have discussed these VCCs (VCACs)in relationship to the hypertensive right ventricle of PAIVS. The vessels of Wearn identified in PAIVS is presumably related to the VCCs that you report in the hypertensive left ventricle of MSAA.

http://www.ncbi.nlm.nih.gov/pubmed/23332812

The vessels of Wearn connect to both the atria and the ventricles. The vessels of Wearn include the VCC (VCACs) and atrio-coronary-connections (atrio-arterio-cameral connections).

If the reader is interested in additional commentary related to these connections, please see the following links:

https://twitter.com/BrettSnodgrass1/status/418829863609331712

https://twitter.com/BrettSnodgrass1/status/421401527035510784

https://twitter.com/BrettSnodgrass1/status/420281076070637568

https://twitter.com/BrettSnodgrass1/status/419599948368183296

My aim is to help produce accurate medical nomenclature and I proposed the term “vessels of Wearn” for the previously unnamed vessels. http://www.ncbi.nlm.nih.gov/pubmed/22704295

In summary, please consider that the term sinusoids may not always be related to the VCCs you describe, but the vessels of Wearn is probably applicable (arteriosinusoidal & arterioluminal connections).

My opinion is that accurate anatomic terminology is a basic principle underlying good medical science, and I ask others to consider whether the aforementioned definitions are appropriate. If this comment is not helpful, please let me know how it might be improved.

Comments and suggestions are welcome.

Thank you kindly.

On 2014 Jan 11, Brett Snodgrass commented:

Dear Authors,

Thank you for publication of the excellent article that provides important knowledge about the incidence of VCCs in HLH and their effect on survival.

Please consider that if the VCC results from pathologic alteration of an arterioluminal vessel, then the VCC may not be synonymous with sinusoid as there is no sinusoid involved.

However, if the VCC results from pathologic alteration of an arteriosinusoidal vessel, then the term sinusoid would appropriately apply to only a segment of the VCC. The segment of the VCC closer to the epicardium is presumably derived from the "arterio" segment of the arterio*sinusoidal connection.

VCCs are often used synonymously with VCACs.

1. Ventriculocoronary connections (VCCs)

2. Ventriculocoronary arterial connections (VCACs)

Please provide your kind consideration to the following article published by Joseph Treolar Wearn in 1933. http://bit.ly/JTWearn

Wearn et al. described the myocardial sinusoids and noted that they connected to the arteriosinusoidal vessels but not to the arterioluminal vessels.

The vessels of Wearn include the arterioluminal and arteriosinusoidal vessels. Depending on consensus and further study, they may include a variable segment of the myocardial sinusoids.

Is it possible that some of the VCCs that you describe are not sinusoids but pathologically altered arterioluminal vessels?

My opinion is that we have probably have insufficient information to definitively conclude in every case whether an arteriosinusoidal or arterioluminal vessel is involved.

We have discussed these VCCs (VCACs)in relationship to the hypertensive right ventricle of PAIVS. The vessels of Wearn identified in PAIVS is presumably related to the VCCs that you report in the hypertensive left ventricle of MSAA.

http://www.ncbi.nlm.nih.gov/pubmed/23332812

The vessels of Wearn connect to both the atria and the ventricles. The vessels of Wearn include the VCC (VCACs) and atrio-coronary-connections (atrio-arterio-cameral connections).

If the reader is interested in additional commentary related to these connections, please see the following links:

https://twitter.com/BrettSnodgrass1/status/418829863609331712

https://twitter.com/BrettSnodgrass1/status/421401527035510784

https://twitter.com/BrettSnodgrass1/status/420281076070637568

https://twitter.com/BrettSnodgrass1/status/419599948368183296

My aim is to help produce accurate medical nomenclature and I proposed the term “vessels of Wearn” for the previously unnamed vessels. http://www.ncbi.nlm.nih.gov/pubmed/22704295

In summary, please consider that the term sinusoids may not always be related to the VCCs you describe, but the vessels of Wearn is probably applicable (arteriosinusoidal & arterioluminal connections).

My opinion is that accurate anatomic terminology is a basic principle underlying good medical science, and I ask others to consider whether the aforementioned definitions are appropriate. If this comment is not helpful, please let me know how it might be improved.

Comments and suggestions are welcome.

Thank you kindly.