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  • 1
    Electronic Resource
    Electronic Resource
    Cyclosporine A-associated fatal central nervous system angiopathy in a bone marrow transplant recipient: an autopsy case (2000)
    Springer
    Acta neuropathologica 99 (2000), S. 680-684 
    Details
    ISSN: 1432-0533
    Keywords: Key words Basilar artery ; Vasoconstriction ; Cyclosporine A ; Bone marrow transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report here the case of a 32-year-old woman who suffered from a unique angiopathy in the central nervous system (CNS). She died of multiple infarcts in the brain stem and cerebellum during treatment with cyclosporine A after bone marrow transplantation for refractory anemia with excess of blasts. The autopsy findings showed segmental narrowing of the basilar artery, in which circumferential dissection of the internal elastic lamina had occurred. The distal portion of the basilar artery was obstructed by upward dislocation of the dissected intima. Similar angiopathy was also observed at multiple sites along the basilar artery branches. These findings suggest endothelial damage, including vasoconstriction and dissection of the CNS arteries.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010051179
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  • 2
    Electronic Resource
    Electronic Resource
    The Influence of Vascular Pressure and Angiographic Characteristics on Haemorrhage from Arteriovenous Malformations (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 39-43 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Arteriovenous malformation; haemorrhage; vascular pressure.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Background. The present study was designed to determine whether there is a physiological explanation for the predisposition of patients with certain angiographic characteristics to haemorrhage from cerebral arteriovenous malformations (AVMs).  Methods. Intra-operative measurement of feeding artery pressure (FAP) and intravascular pressures in the draining venous system [draining vein pressure (DVP) and cranial sinus pressure (SP)] were performed for 30 AVM cases using direct puncture of the vessels. The correlation between pressures and previously described angiographic characteristics predisposing to haemorrhage were evaluated.  Findings. Small nidus size and only one draining vein increased the risk of haemorrhage. FAP and DVP are both inversely related to the number of draining veins and the size of the AVMs. DVP was significantly higher in AVMs with haemorrhage (23.1±8.7 mmHg) than in those without (13.5±4.4), as was FAP (58.6±12.8 as opposed to 38.7±4.7) (p〈0.05). Moreover, the difference between systemic blood pressure and the FAP with haemorrhagic AVMs (17.0±9.5 mmHg) was significantly lower than that in nonhaemorrhagic cases (33.7±5.5) (p〈0.05). The pressure difference between the feeding artery and draining vein was not significant between the haemorrhagic and nonhaemorrhagic groups. There was no significant difference of SP between haemorrhagic and nonhaemorrhagic patients.  Interpretation. The present study suggests that a high DVP probably induced by high resistance in the venous drainage system, as well as a high FAP, may contribute to the development of haemorrhage from AVMs, and physiologically supports previous reports that small AVMs and AVMs with only one draining vein are susceptible to haemorrhage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050005
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  • 3
    Electronic Resource
    Electronic Resource
    Growth of Incidental Meningiomas (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 507-511 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Meningioma; incidental tumour; growth rate; multivariate analysis.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ The aim of this study was to assess the growth of incidental meningiomas, to establish a strategy for dealing with these tumours.  The cases of 37 patients with a meningioma revealed incidentally by computerized tomography or magnetic resonance imaging, who were followed at least once by an additional imaging study, were reviewed. The tumour volume was calculated, to estimate the annual growth rate of the incidental meningiomas. Nine of the 37 patients (24.3%) showed a considerable increase (the annual growth rate〉1 cu cm/year) in their tumour volume (tumour growth). There was no significant difference in the follow-up period, age, or the volume of tumour between the patients with and without tumour growth. However, a multivariate analysis revealed that the likelihood of tumour growth independently and significantly increased according to a decrease in the age of the patients (Odds ratio 0.18 for one-standard-deviation change (1SD) 12.6 years, p=0.042) and according to an increase in the volume of the tumour (Odds ratio 3.64 for 1SD 4.46 cu cm, p=0.042).  The majority of patients with incidental meningioma can be apparently observed without any surgical intervention, because their annual growth rates are generally less than 1 cu cm/year. However, clinical and radiological observations would be advisable for these patients (especially young patients and patients with a large tumour), in view of the presence of rapidly growing tumours in some of the patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050463
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  • 4
    Electronic Resource
    Electronic Resource
    Numerical, morphological and phenotypic changes in Langerhans cells in the course of murine graft-versus-host disease (2001)
    Oxford, UK : Blackwell Science, Ltd
    British journal of dermatology 145 (2001), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background In the course of graft-versus-host disease (GVHD) or diseases that histologically mimic GVHD (e.g. toxic epidermal necrolysis, Stevens–Johnson syndrome), it is known that epidermal Langerhans cells (LCs) are depleted from the epidermis. However, the mechanism and significance of LC depletion is not well known. Objectives To investigate the numerical, morphological and phenotypic changes in LCs and apoptosis of LCs in the course of GVHD using a non-irradiated mouse GVHD model. Methods BALB/c nu/nu mice and C57BL/6 mice were used as recipients and donors, respectively. Recipient mice were injected with T-cell-enriched donor spleen cells. Skin samples were harvested at various times after the inoculation. The numerical and morphological changes were examined by an immunofluorescence study of epidermal sheets. Apoptosis was studied by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling method and flow cytometric analysis using annexin V. Phenotypic change was studied by flow cytometric analysis of epidermal cell suspensions. The mixed epidermal cell lymphocyte reaction (MELR) was performed to examine functional changes in the epidermal cells. Results Five days after inoculation, a graft-versus-host reaction occurred. Epidermal LCs began to decrease from the sixth day. On the fifth day, the LCs became larger and had prominent dendrites. Immediately before the LCs began to decrease, many LCs became round in shape, with scanty dendrites. LC apoptosis was not observed in the epidermis either on the fifth or seventh day. Phenotypically, the expression of CD40, CD80, CD86 and major histocompatibility complex class II antigen on the LCs was upregulated on the fifth and seventh day. Epidermal cells from GVHD mice showed an increased allostimulatory capacity in the secondary MELR. Conclusions These results suggest that at early GVHD onset, most LCs may not undergo apoptosis in the epidermis but are phenotypically activated, resulting in further activation of alloreactive T cells and aggravation of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2001.04539.x
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