HEREDITARY HEMORRHAGIC TELANGIECTASIA WITH MALIGNANT LYMPHOMA An Autopsy Case

A 60-year-old Japanese woman was diagnosed at autopsy as having had hereditary hemorrhagic telangiectasia (HHT) associated with systemic hemangiomas. In her repoduction period, premenstrual epistaxis frequently occurred. At the age of 60, the patient died of malignant lymphoma. At autopsy, multiple telangiectatic spots were noted on the face, limbs and trunk. The paraaortic lymph nodes, which were enlarged and irregularly conglomerated, were histologically diagnosed as malignant lymphoma of the diffuse large cell type. Submucosal telangiectatic lesions were found in the gastrointestinal system from the oral cavity to the rectum. Cavernous hemangiomas were present in various visceral organs including the liver, spleen, small and large intestines, rectum, appendix, uterus, and jejunal and colonic mesenteries. There was an arteriovenous fistula in the left lung. Examination of her family pedigree showed that the patient had an autosomal dominant trait of inheritance. The pathogenesis of the systemic visceral hemangiomas observed in this patient was considered to be similar to that of hamartoma.     

Spontaneous and oxidative stress-induced programmed cell death in lymphocytes from patients with ataxia telangiectasia (AT)

T cell lymphopenia in the peripheral blood lymphocytes (PBL) of patients with AT is mainly caused by a decrease of naive CD45RA+/CD4+ cells followed by a predominance of memory CD45RO+ lymphocytes. To relate these findings to the regulation of programmed cell death, we investigated the activation state and apoptotic level of PBL in 12 patients and healthy controls by flow cytometry. In accordance with previous investigations, the number of naive CD4+/CD45RA+ cells was significantly decreased in patients compared with healthy controls. This disturbed balance of CD45RA and CD45RO was also reflected in higher amounts of activated HLA-DR and CD95 expressing cells, with a concomitant decrease of Bcl-2 protected lymphocytes in the T cell population. With regard to its role in preventing oxidative-induced cell death, we analysed Bcl-2 expression and apoptosis in the presence of oxidative stress. In culture, cells of patients are more susceptible to spontaneous programmed cell death. However, in our stress-inducing system (hypoxanthine/xanthine oxidase system) the number of cells undergoing apoptosis was lower in patients' cell populations compared with controls. In addition, preliminary results suggest that Bcl-2 expression and level of spontaneous apoptosis in patients can be modified by IL-2 and interferon-gamma.     

AT基因突变与食管癌及结肠癌的关系

目的 :探讨共济失调毛细血管扩张症 (AT)基因突变与食管癌及结肠癌发病的关系。方法 :运用PCR SSCP及DNA同位素测序等技术 ,对 17例食管癌和 15例结肠癌患者的AT基因第 41～ 5 1外显子进行突变检测。结果 :15例结肠癌标本的SSCP带型与正常对照组织无差异 ;17例食管癌标本中有 1例SSCP带型比正常对照组织多一条带 ,测序发现 ,该例标本在AT基因第 49外显子发生单碱基缺失。结论 :AT基因突变可能与某些类型的食管癌发病有关 ,但尚不能判断与结肠癌的相关性     

Influence of environmental and genetic factors on variation in human response to DNA damaging agents

Exogenous DNA damaging agents must be considered in the context of endogenous reactive species which have the potential to damage DNA. Although a no-effect level for a DNA-damaging compound may not exist, it may be feasible to define a level where reducing exposure to the compound is no longer the most effective way of reducing human risk. Modifying environmental factors which affect human response to damage may be the better strategy. Although a number of rare human syndromes are associated with a reduced ability to repair DNA damage, it is not clear how wide is the range of genetic variation in repair capacity among normal individuals. Studies with DNA repair-deficient human syndromes indicate that processes other than mutation and DNA repair must be involved in the development of cancer, and these processes may represent new sources of variation in human response to genotoxic agents.     

Presumed capillary telangiectasia of the pons: MRI and follow-up

Capillary telangiectasia is a vascular abnormality primarily of the brainstem. The clinical relevance is unclear as is the association with clearly pathologic findings such as cavernous haemangioma. We report on four cases with capillary telangiectasia proven by follow-up und describe the imaging characteristics. T2 abnormality was only observed in half of the patients as was the presence of a discernable collecting vein. Whereas two cases were incidental findings in neurologically normal persons and one had symptoms clearly attributable to lacunar stroke, one patient may have had symptoms due to the vascular abnormality in the pons. Received: 26 January 1999; Revised: 24 August 1999; Accepted: 23 September 1999     

玉女煎加味治疗遗传性出血性毛细血管扩张症的疗效观察

目的　观察玉女煎加味治疗遗传性出血性毛细血管扩张症（hereditary hemorrhagic telangiectasia,HTT）的临床疗效。方法　收集北京同仁医院变态反应中心1年内就诊HTT患者7例,在鼻科填塞基础上,采用玉女煎随证加减治疗,观察治疗5周后对鼻部症状、鼻出血、生活质量的影响。结果　在治疗后患者的症状明显改善,鼻部视觉模拟评分（4.4±1.3;20.8±1.6）分、鼻出血评分（6.5±2.2;18.7±2.0）分、日常生活质量（9.3±1.6;29.7±5.0）分（P＜0.05）,总有效率达85.7%。此外,HTT鼻部症状与鼻出血具有一定的相关性（R 2=0.8444）,而中药对两者改善程度却无相关性（R 2=0.3905）,对鼻出血的改善程度优于鼻部 症状。结论　中药玉女煎加味明显改善HTT的鼻出血的症状和部分改善特征性毛细血管扩张症。     

ATDC蛋白在卵巢癌组织中的表达及其与β-catenin蛋白的关系

目的:通过分析ATDC蛋白在卵巢癌组织中的表达及其与β-catenin蛋白的关系,探讨ATDC蛋白及β-catenin蛋白在卵巢癌发生发展中的作用.方法:应用免疫组化SP法检测ATDC蛋白及β-catenin蛋白在卵巢癌、卵巢良性肿瘤及正常卵巢组织中的表达,分析ATDC蛋白及β-catenin蛋白与卵巢癌各种临床病理参...