THE ROLE OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN A MURINE CHRONIC GRANULOMATOUS TISSUE AIR POUCH MODEL OF ANGIOGENESIS

Chronic granulomatous inflammation may be considered an angiogenic-dependent process. Recently it has been demonstrated that vascular endothelial growth factor (VEGF) or vascular permeability factor is essential for tumour angiogenesis. Its role in inflammation-mediated angiogenesis has yet to be determined. In this study, the murine chronic granulomatous air pouch model was used to investigate the role of VEGF in angiogenesis. Animals were treated twice weekly with 10 μ g per animal of neutralizing antibody to rh VEGF and the vascularity and granuloma dry weight were assessed after 7 days. This resulted in significant suppression of both angiogenesis and granuloma dry weight. Western blot analysis demonstrated the presence of VEGF; the levels of protein paralleled the angiogenic response. These results demonstrate for the first time that VEGF may be an important regulator of angiogenesis in inflammation.     

Worster-Drought syndrome: poorly recognized despite severe and persistent difficulties with feeding and speech

Aim  Worster-Drought syndrome (WDS), or congenital suprabulbar paresis, is a permanent movement disorder of the bulbar muscles causing persistent difficulties with swallowing, feeding, speech, and saliva control owing to a non-progressive disturbance in early brain development. As such, it falls within the cerebral palsies. The aim of this study was to describe the physical and neuropsychological profiles of children with WDS.
Method  Forty-two children with WDS (26 males, 16 females; mean age 7y 10mo, SD 3y 1mo; range 2y 6mo to 16y 5mo) were studied prospectively using a standard protocol.
Results  All of the children had severe bulbar dysfunction; 36 out of 42 had feeding difficulties and 23 of 38 had unintelligible speech, which was poorly compensated for by augmentative communication. There were accompanying disturbances in cognition (mean non-verbal IQ 59), behaviour (12/40 attention-deficit–hyperactivity disorder [ADHD]), social communication (8/42 autism), and epilepsy (12/39). The severity of bulbar dysfunction and impact of additional impairments made it difficult to use formal assessments.
Interpretation  WDS causes severe and persistent bulbar dysfunction that is often accompanied by additional impairments, as in other cerebral palsies. Speech prognosis is particularly poor. Early diagnosis with appreciation of the underlying neurology would encourage critical evaluation of interventions and long-term planning to improve outcome.     

Transesophageal Color Flow Echocardiographic Evaluation of Supravalve Mitral Ring in an Adult Patient

Supravalve mitral ring (SVMR) is an extremely rare form of congenital left ventricular inflow obstruction in which a left atrial membrane causes an obstruction keeping the left atrium from emptying into the left ventricle. Cardiac catheterization and angiography are not reliable means to diagnose this lesion. Transthoracic echocardiography (TTE) has proved to be the most sensitive tool for diagnosis of this form of left ventricular inflow obstruction; however, its diagnostic accuracy has been recently questioned. We report the complementary roles of TTE and transesophageal echocardiography in a case of SVMR in an adult patient. (ECHOCARDIOGRAPHY, Volume 11, May 1994)