New approach to management of intraaortic balloon pumps in patients with peripheral vascular disease: Case reports of four patients requiring urgent IABP insertion

Four selected cases of emergent IABP insertion in PV patients are presented. After angiographic documentation of critical iliac stenosis, conservative peripheral angioplasty was performed prior to IABP insertion. No patient experienced a peripheral ischemic event associated with IABP use. © 1992 Wiley-Liss, Inc.     

Analysis of Vascular Endothelial Growth Factor (VEGF) and a receptor subtype (KDR/flk-1) in the liver of rats exposed to riddelliine: a potential role in the development of hemangiosarcoma

Riddelliine alters hepatocellular and endothelial cell kinetics and function including stimulating an increase in hepatocytic vascular endothelial growth factor (VEGF) in the absence of increased serological levels of VEGF (Nyska etal. 2002). The objective of this study was to further assess hepatic VEGF and KDR/flk-1 synthesis and expression by hepatic cells under riddelliine treatment conditions. Forty-two male F344/N rats were dosed by gavage with riddelliine (0, 1.0, and 2.5 mg/kg/day) for 6 weeks. Seven animals/group were sacrificed after 8 consecutive daily doses; remaining rats were terminated after 30 daily doses, excluding weekends. Hepatic tissues were evaluated by immunohistochemistry and in situ hybridization. The results showed that VEGF mRNA expression was observed in control and treated animals; however, qualitative differences were noted. Treated animals exhibited VEGF mRNA in clustered, focal hepatocytes and bile duct epithelium, whereas VEGF mRNA in hepatocytes from vehicle control rats was distributed evenly across all hepatocytes. Results evaluating the distribution of the VEGF cognate receptor, KDR/flk-1 showed that randomly distributed, rare sinusoidal endothelium, including those demonstrating karyomegaly and cytomegaly expressed KDR/flk-1. Phosphorylation of KDR/flk-1 at pTyr996 and pTyr1054/1059, but not pTyr951, was also detected, evidence that endothelial cell KDR/flk-1 was activated. These results suggest that both hepatocytes and endothelial cells are targets of riddelliine-induced injury. We speculate that damage to both populations of cells may lead to dysregulated VEGF synthesis by hepatocytes and activation of KDR/flk-1 by endothelium leading to the induction of sustained endothelial cell proliferation, culminating in the development of hepatic hemangiosarcoma.     

Gadolinium-based balloon angioplasty for pulmonary artery stenosis in an infant with a right isomerism.

We report here the first described case of utilizing gadolinium-based contrast material as the contrast agent during a catheter intervention treatment for pulmonary artery stenosis. The patient, a male infant with complex heart disease associated with a right isomerism, had a history of severe allergic reaction to iodine-containing contrast agents. A combination of digital subtraction angiography and a gadolinium contrast agent, however, provided us with good-quality images both before and after balloon angioplasty without any associated complications. This method should therefore be considered as an alternative angiographic procedure in children with a high risk of iodine-related allergic complications.     

松花粉抗衰老作用的实验研究

目的　观察松花粉的抗衰老作用。方法　用含松花粉的饲料喂养衰老小鼠 ,测定小鼠血清中超氧化物歧化酶 (SOD)、过氧化氢酶 (CAT)、谷胱甘肽过氧化物酶 (GSH Per)的活性 ,测定脑组织中丙二醛 (MDA)含量及脑组织和肝脏中的脂褐质 (Lf)含量 ,同时测定胸腺和脾脏的重量及网状内皮系统的吞噬功能。结果　松花粉能明显增加衰老小鼠血清中SOD、CAT、GSH Per活性 ,降低脑组织中MDA含量及脑组织和肝脏中的Lf含量 ,并增加胸腺和脾脏质量 ,提高网状内皮系统吞噬功能。结论　松花粉具有抗衰老作用     

肝脏单形性上皮样血管平滑肌脂肪瘤的影像表现

目的提高对肝脏单形性上皮样血管平滑肌脂肪瘤（HMEA）影像表现的认识和诊断准确率。方法对经手术病理证实的4例HMEA进行回顾性分析，讨论影像表现和病理之间的联系。结果4例HMEA中，2例误诊为肝细胞癌，1例误诊为局灶性结节增生，1例诊断正确。影像表现主要为：（1）平扫呈等低或等稍高密度的HMEA2例，强化模式呈“快进慢出”。病理特点足瘤内有丰富的窦隙状薄壁分隔微血管网，无分化成熟的脂肪细胞，1例伴厚壁的血管。（2）平扫呈低密度或低信号的HMEA2例，强化模式呈“快进快出”，中央可见粗大的动脉。病理特点为瘤中央有畸形粗大厚壁的动脉，无脂肪细胞夹杂其间。结论HMEA影像表现与病理结构直接相关，根据影像表现结合临床资料可对该病作出初步诊断，但确诊仍依赖病理组织学检查。     

Recommendations for the diagnosis and management of Alzheimer's disease and other disorders associated with dementia: EFNS guideline

The aim of this international guideline on dementia was to present a peer-reviewed evidence-based statement for the guidance of practice for clinical neurologists, geriatricians, psychiatrists, and other specialist physicians responsible for the care of patients with dementia. It covers major aspects of diagnostic evaluation and treatment, with particular emphasis on the type of patient often referred to the specialist physician. The main focus is Alzheimer's disease, but many of the recommendations apply to dementia disorders in general. The task force working group considered and classified evidence from original research reports, meta-analysis, and systematic reviews, published before January 2006. The evidence was classified and consensus recommendations graded according to the EFNS guidance. Where there was a lack of evidence, but clear consensus, good practice points were provided. The recommendations for clinical diagnosis, blood tests, neuroimaging, electroencephalography (EEG), cerebrospinal fluid (CSF) analysis, genetic testing, tissue biopsy, disclosure of diagnosis, treatment of Alzheimer's disease, and counselling and support for caregivers were all revised when compared with the previous EFNS guideline. New recommendations were added for the treatment of vascular dementia, Parkinson's disease dementia, and dementia with Lewy bodies, for monitoring treatment, for treatment of behavioural and psychological symptoms in dementia, and for legal issues. The specialist physician plays an important role together with primary care physicians in the multidisciplinary dementia teams, which have been established throughout Europe. This guideline may contribute to the definition of the role of the specialist physician in providing dementia health care.     

肺腺癌VEGF-C、VEGF-D的表达与MVD、MLVD及淋巴转移的关系

目的探讨肺腺癌中VEGF-C、VEGF-D与微淋巴管密度MLVD（VEGFR-3）、微血管密度MVD （CD34）及淋巴结转移之间的关系。方法免疫组化检测48例肺腺癌组织中VEGF-C、VEGF-D、MLVD、MVD蛋白的表达。结果VEGF-C、VEGF-D蛋白阳性率分别为70．8％（34／48例）、58．3％（28／48例）,肿瘤周边部位显著高于肿瘤中心部位,具有统计学意义,其表达与肿瘤分化程度无关,与肿瘤的TNM分期有关,Ⅲ～Ⅳ期显著高于Ⅰ～Ⅱ期。在VEGF-C蛋白阳性组,MVD高于阴性组（P=0．016）,MLVD显著高于阴性组（P=0．006）,淋巴结转移（P=0．042）增多;而VEGF-D蛋白阳性组与阴性组相比MVD无显著差异（P=0．943）, MLVD高于阴性组（P〈0．01）,淋巴结转移（P=0．012）增加。结论VEGF-C的表达与肺腺癌血管生成及淋巴管生成和淋巴结转移关系密切,而VEGF-D的表达只与淋巴管生成和淋巴结转移关系密切,与血管生成无关。     

Pathogenesis of diabetic retinopathy and the renin-angiotensin system.

Despite the beneficial effects of good glycaemic control, loss of vision because of diabetic retinopathy (DR) still occurs. Recent studies have suggested that hypertension is a risk factor for the development and progression of DR and that blood pressure reduction can delay the progression of retinopathy. The renin-angiotensin system is activated by chronic hyperglycaemia, and the vitreous fluid level of angiotensin II (AII) is elevated in patients with proliferative diabetic retinopathy and diabetic macular oedema. AII increases vascular permeability and promotes neovascularization. It has been suggested that an autocrine-paracrine relationship may exist between AII and vascular endothelial growth factor in the ocular tissues. Accordingly, angiotensin-converting enzyme inhibitors or AII Type 1 (AT1) receptor blockers may be useful therapeutic agents for preventing the progression of DR.