The St. George's dementia bed investigation study: a comparison of clinical and pathological diagnosis.

Sixty-four elderly patients who had been admitted to the St. George's Hospital Alzheimer's disease evaluation project during 1981-1989 were followed up to postmortem examination. Comparison between clinical diagnoses and neuropathological diagnoses indicated positive predictive values for the antemortem diagnoses of 50-67%. Existing clinical criteria may not be accurate enough to permit firm antemortem diagnosis of older people for either research or clinical purposes.     

彩色多普勒超声图指导风湿性心脏病二尖瓣狭窄球囊扩张术91例

目的：应用彩色多普勒超声心动图指导经皮二尖瓣球囊成形术(PBMV)治疗风湿性二尖瓣狭窄的价值、方法：运用彩超对行PBMV的患进行术前术后检查，观察二尖瓣钙化程度及部位、开口形状、瓣口面积、二尖瓣返流(MR)程度、瓣下病变、左房左室大小、左房有无血栓．结果：91例PBMV术后患中，术后MR72例，其中MR新出现19例，MR加重8例、与术前对比，术后二尖瓣开放幅度、二尖瓣口面积、二尖瓣跨瓣压、二尖瓣压差半降时间较术前有明显改善趋势，左房内径、肺动脉内径较术前有缩小趋势．同时，术后左房压、右室压及肺动脉压也有下降趋势。结论：彩超能明确PBMV治疗二尖瓣狭窄的效果。影响：PBMV效果的因素较多，但二尖瓣钙化的程度、部位和瓣膜形态较为重要。     

肝素联合VEGF预处理对人工血管内皮细胞生长及贴附率的影响

目的联合应用肝素及血管内皮细胞生长因子(VEGF)预处理以提高人工血管移植物内皮细胞(EC)生长及贴附率.方法联合应用肝素及血管内皮细胞生长因子预处理人工血管移植物,比较各组EC生长曲线和贴附率.结果肝素在体外与VEGF联合应用,可显著增加EC在人工血管内壁的贴附率,并对EC的增殖有一定的持续影响.结论肝素与VEGF联用,能促进EC在人工血管的增殖和贴附率.     

人脑胶质瘤中P53和VEGF 的表达及意义

目的 探讨胶质瘤组织中血管内皮生长因子(VEGF)和P53蛋白的表达及其临床意义。方法 应用免疫组织化学技术对50例胶质瘤组织进行P53、VEGF表达的检测。结果 P53、VEGF的表达均随胶质瘤病理级别的升高而升高。Ⅰ～Ⅳ级病理分级中P53阳性率分别为22．22％(4／18)，65％(13／20)，75％(9／12)；VEGF阳性率分别为27．78％(5／18)，90％(18／20)，100％(12／12)。P53、VEGF的表达均与胶质瘤病理分级显著相关(P＜0．01)，P53和VEGF阳性表达符合率为76％(38／50)，两者的表达有显著性相关(P＜0．01)。结论 P53和VEGF蛋白的表达是判断胶质瘤生物学行为的重要指标；胶质瘤组织突变的P53基因可上调VEGF的表达，促进血管生成，进而影响胶质瘤的进展。     

大鼠脑多梗死性栓塞痴呆模型的建立

 目的建立大鼠脑多梗死性痴呆(MID)模型及观察指标,评价药物对该模型的作用。方法采用从颈外动脉逆行注入微血栓颗粒的方法,制备MID模型,通过对术后大鼠的苏醒时间测定、倾斜板实验、神经症状评分3个方面评价动物的一般状态;采用大鼠穿梭箱实验、水迷宫实验检测各组大鼠学习记忆能力;并测定脑中丙二醛(MDA)的含量及超氧化物歧化酶(SOD)的活性,考察MID大鼠的行为学异常以及其作用机制。结果MID大鼠与正常组、假手术组比较,苏醒时间明显延长,在倾斜板上停留的时间显著变短,神经症状评分有显著差异;穿梭箱实验中电击时间明显延长,水迷宫实验学习记忆潜伏期延长;同时脑组织中MDA含量明显升高,SOD活力显著降低。给予药物氢化麦角碱(商品名:喜得镇)治疗后症状有所改善。结论该造模方法能显著造成大鼠脑多梗死性痴呆的多项体征,符合临床病理过程,为进一步判定一些药物是否具有治疗MID的前景打下基础。     

双能量胸部DR对筛查冠状动脉钙化的意义:与多排螺旋CT的比较性研究

目的探讨胸部双能量DR骨骼像在筛查冠脉钙化中的意义。方法35例患者分别行右前斜位胸部双能量DR检查及多排螺旋CT(MDCT)冠状动脉扫描并记录照射后射线的体表入射剂量ESD(mGy)。2位高年资放射科医师及2位低年资医师分析双能量胸片骨骼像,对LAD、LCX、RCA共105条血管的钙化情况进行评估。CT扫描图像进行钙化积分分析。以钙化积分>300为金标准,对双能量DR的结果进行ROC分析。结果DR胸片平均阳性率27.6%(29/105),其中LAD阳性率48.5%(17/35);LCX22.8%(8/35);RCA 11.4%(4/35)。4位医师的ROC结果显示曲线下面积分别为0.866、0.854、0.725、0.642。胸部DR照射平均体表入射剂量为(0.469±0.22)mGy;多排CT入射剂量为(12.29±1.40)mGy。两者经配对t检验有显著差异。结论DR骨骼片可以检出较明显的冠状动脉钙化,对冠心病的筛查和病情的检测有一定的临床意义。     

CADASIL or CADVaSIL?

In the present study, morphological examination of patients from two unrelated Polish families with CADASIL was performed. Using light microscopy, there were evident changes characteristic to the disease. On electron microscopy, deposits of granular osmiophillic material (GOM) were found not only in cerebral arteries and veins but also in cerebral capillaries and vessels of the internal organs. These findings indicate that pathological process in CADASIL is generalized and involves also small vessels devoid of smooth muscle cells. Therefore, we propose to consider a replacement for the name CADASIL that better reflects the morphological picture of the disease like, for example, cerebral autosomal dominant vasculopathy with subcortical infarcts and leukoencephalopathy (CADVaSIL) or, to preserve the commonly known acronym, cerebral autosomal dominant angiopathy with subcortical infarcts and leukoencephalopathy.     

Geometric Resistance and Microvascular Network Architecture of Human Colorectal Carcinoma

Objective : To measure the geometric resistance to blood flow in human colorectal carcinoma. Although tumor blood flow is of central importance in both the detection and the treatment of cancer, the determinants of blood flow through the neoplastic circulation are poorly understood. Methods : Human colorectal carcinomas (tissue weight = 272 g ± 43 g (SD), n = 6) were perfused ex vivo with a buffered physiological salt solution of known viscosity at flow rates ranging from 2.5 to 40 ml/min and perfusion pressures from 8 to 100 mm Hg. The geometric resistance was determined from the slope of the pressure-flow curve. For examination of the principal determinant of geometric resistance, the vascular architecture, one of the tumors was perfused with Batson's No. 17 polymer and macerated in KOH to produce a positive vascular cast that was used for measurement of vascular branching patterns and dimensions. Results : The pressure-flow relationship was linear at perfusion pressures above 40 mm Hg, and the geometric resistance, z₀, was constant at approximately 6.5 ± 10⁹g/cm³. Below 40 mm Hg, z₀ increased rapidly. The architecture of the arteriolar and capillary networks of human colorectal carcinoma is similar to those of experimental rodent tumors. Capillaries in planar and nonplanar mesh-works had mean segment diameters of 11 ± 2 and 9.6 ± 2 μm, lengths of 46 ± 24 and 107 ± 40 μm, and intercapillary distances of 46 ± 13 and 74 ± 24 μm, respectively. Conclusions : The geometric flow resistance in neoplastic tissue is 1–2 orders of magnitude higher than that observed in normal tissues. A decrease in functional vascular cross-sectional area may explain the additional increase in resistance at small perfusion pressures. The observed flow resistance may be due to the specialized arteriolar and capillary network architecture, pressures exerted by proliferating cancer cells, and/or coupling between vascular and extravascular flow. These observations demonstrate that tumor vascularity alone may not be indicative of flow resistance or tumor susceptibility to blood-borne therapeutic agents.     

超声观察银屑病中医分型的血管变化研究

目的　探讨银屑病中医分型皮损处与正常皮肤处血管血流的变化情况。方法　将 3 0例寻常型斑片状银屑病按中医辨证分型 ,超声观察患者正常皮肤处及皮损处浅层动脉血管、静脉血管血流情况。结果　“血热型”皮损处及正常皮肤处动脉血管增大、扩张、血流加快 ;“血瘀型”及“血燥型”未发现异常。结论　银屑病动脉血管及静脉血管增大、扩张、血流加快与中医分型“血热型”密切相关 ,这些将有助于临床根据中医分型进行辨证施治     

Patterns of angiogenesis in neural transplant models: I. Autonomic tissue transplants

Functional vascular connections must form rapidly to prevent ischemic damage to grafted neural tissues. The temporal sequence by which transplant circulation is re-established provides information about the angiogenic capacity of either intact or damaged CNS blood vessels. This study compares the time course and mechanism of vascular reperfusion in allografts of superior cervical ganglia or adrenal medulla inserted either into the fourth ventricle or directly into the parietal cortex of perinatal rats. Tritiated thymidine was administered to recipients to determine angiogenic patterns at various postoperative time periods. After processing for light microscopic autoradiography, host and graft endothelial labelling indices were determined in order to establish the temporal sequence and location of vascular proliferation. Correlative electron microscopy depicted the morphological changes in transplant vasculature. Some recipients were prelabelled with 3H thymidine prior to transplantation to determine if host vessels invaded the grafts. Intraventricular graft vessels initially collapsed but sustained minimal ischemic damage and were completely reperfused by 24 hours postoperative. Adjacent intact host vessels attained peak 3H thymidine incorporation at 20 hours. Intrinsic graft vessels were radioactively labelled only after 48 hours. Intraparenchymal transplants surrounded by minimal trauma exhibited a similar temporal sequence of reperfusion and host endothelial proliferation. Intrinsic graft vessels in intraparenchymal grafts sustained more severe damage. With increased trauma, a concomitant delay in graft reperfusion time was observed. Grafts within prelabelled hosts rarely contained any labelled endothelium, indicating that anastomotic connections were made between original, intrinsic graft vessels and nearby host vascular sprouts. This study demonstrates that mature autonomic tissue stimulates the growth of adjacent host vessels when transplanted to undamaged brain surfaces. The anastomosis of nascent host vessels with pre-existing graft vessels is responsible for the rapid re-establishment of circulation within the transplants. A similar mechanism occurs within intraparenchymal grafts, although the rapidity of reperfusion appears to be predicated on the amount of trauma present at the graft site.