Hippocampal vascular injury and cognitive impairment in a mixed mouse models of Alzheimer's disease and type 2 diabetes mellitus / 解剖学报

Objective To study the effect of type 2 diabetes mellitus (T2DM) on the cerebral blood vessels in Alzheimer's disease (AD), and to explore its mechanism of influence on the pathogenesis of Alzheimer's disease. Methods To generate a mouse model with AD complicated with long-term T2DM, forty 6-month-old APP/PS1 transgenic mice were fed with high-sugar and high-fat diet for 6 months, that was, when mice at 12 months of age, they were intraperitoneally injected with 1% streptozotocin solution for 4 consecutive days. Then, mice were randomly divided into 4 groups: the normal control group, AD model group, T2DM model group and AD complicated with T2DM model group, 10 mice were used in each group. The learning and memory ability of the mice were tested by the mouse step-down assay, and the vascular morphology of the mice's hippocampal CAI area was observed by ink perfusion. Then oil red 0 staining and immunofluorescent staining were applied to test the pathological indices of the hippocampal area in the model. Results Compared with the control group, AD combined with T2DM mice showed decreasing significantly abilities in the learning and memory (P<0.05), and the blood vessels in the hippocampus became thinner and the vascular density decreased. Moreover, T2DM promoted lipid deposits and vascular leak in the hippocampus of the model. Additionally, the expression of β-site amyloid precursor protein cleaving enzyme-1 (BACE-1), nuclear factor (NF)-κB and matrix metalloproteinase (MMP) -9 were increased compared with the controls in the hippocampal CAI region. Conclusion T2DM plays a negative regulatory role on learning and memory functions of mice, accelerates the onset of AD and result in cerebrovascular lesions. In addition, the abnormal expression of MMP-9 may also be one of the causes of AD vascular lesions.

Effect of Puerarin Combined with Tanshinone ⅡA on t-PA, PAI-1 and Oxidative Stress in DM Rats with Vascular Lesions / 中国实验方剂学杂志

Objective:To observe the protective effect and mechanism of combination of puerarin combined with tanshinone ⅡA on diabetes mellitus (DM) rats with vascular lesions. Method:The SD rats (fed with high-fat diet) were administrated with streptozotocin(STZ) through intravenous injection to make the model of diabetic vascular lesions. The successfully modeled rats were randomly divided into the model control group, the high-dose group (0.5 g·kg-1+1.0 g·kg-1), the middle-dose group (0.25 g·kg-1+0.5 g·kg-1), the low-dose group (0.05 g·kg-1+0.1 g·kg-1), the puerarin group (0.25 g·kg-1), the tanshinone ⅡA group (0.5 g·kg-1) and the positive control group (Metformin, 0.09 g·kg-1). Each group was administrated with drugs respectively by gavage for 70 days. After intervention in each group, the general conditions and body weight of the rats were observed. The contents of blood grucose and blood lipids were determined by automatic biochemical analyzer. The contents of insulin, advanced glycation end products (AGEs), superoxide dismutase(SOD), glutathione peroxidase (GSH-Px) in serum, the contents of tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and thromboxane B2 (TXB2) in plasma, as well as the contents of AGEs and oxidized low-density lipoprotein(ox-LDL) in aorta homogenate were detected by enzyme-linked immunosorbent assay(ELISA). The content of malondialdehyde(MDA) in serum was determined by chemical colorimetry. Pathological changes of coronary tissue were observed by htoxylin eosin(HE) staining. The expression of PAI-1 protein of aorta was observed by immunohistochemistry. Result:Compared with the normal control group, in the model group, the levels of blood grucose and blood lipids (PPPP2 in plasma (PPPPPPPPP2 in plasma (PPPPPPPConclusion:Puerarin combined with Tanshinone ⅡA could relieve vascular lesions of DM rats. The mechanisms may be related to the reduction of oxidative stress and the regulation of coagulation-fibrinolysis system.

Rigidez arterial como marcador de daño vascular en pacientes con hipertensión arterial controlada / Arterial stiffness as marker of vascular damage in patients with controlled arterial hypertension

Se realizó un estudio observacional, descriptivo y transversal de 27 adultos con hipertensión arterial controlada, seleccionados aleatoriamente en el Consultorio del Médico de la Familia No. 6 del Policlínico Docente Armando García Aspurú en Santiago de Cuba, durante el periodo de septiembre de 2015 a igual mes de 2016, con vistas a determinar la alteración de la rigidez arterial en ellos. En la serie se obtuvo un predominio del sexo femenino (69,2 por ciento) en relación con el masculino (30,7 por ciento) y la edad media fue de 48,96 años; igualmente, se identificó un elevado porcentaje con obesidad premórbida (48,1), a la cual le siguió el sobrepeso, con 33,3 por ciento), y el peso normal, con 18,3 por ciento). Se encontró 19,0 por ciento) con índice de rigidez grave; condición más sensible y alarmante que el índice tobillo-brazo como marcador de daño vascular.

An observational, descriptive and cross-sectional study of 27 adults with controlled hypertension, ramdomly selected in the family's physician No. 6 of Armando García Aspurú Teaching Polyclinic in Santiago de Cuba was carried out during the period of September, 2015 to same month in 2016, aimed at determining the change of arterial stiffness in them. In the series a prevalence of the female sex was obtained (69.2 percent) in connection with the male sex (30.7 percent) and the mean age was of 48.96 years; equally, a high percentage was identified with premorbid obesity (48.1), followed by overweight, with 33.3 percent, and normal weight, 18.3 percent. A 19.0 percent with severe stiffness index was found; a more sensitive and alarming condition than the index ankle-arm as marker of vascular damage.

Luxación expuesta de rodilla: ¿Qué hemos aprendido en los últimos 20 años? / Open knee dislocations: what have we learn about it in the last 20 years?

INTRODUCCIÓN: La luxación expuesta de rodilla es compleja, de incidencia baja con grandes secuelas funcionales. Existen escasos reportes de series en la literatura relativos a su manejo y resultados. OBJETIVO: El objetivo de este trabajo fue describir los resultados obtenidos de todos los pacientes con luxación expuesta de rodilla tratados durante las últimas dos décadas en nuestro hospital bajo un mismo estándar de tratamiento. MÉTODO: Estudio descriptivo retrospectivo en una serie quirúrgica de 11 pacientes con luxación expuesta de rodilla, tratados entre 1994 y 2015. Todos fueron estudiados y manejados según esquema estandarizado: Angiografía/ angioTC, aseo quirúrgico, fijador externo y reparación neurovascular en casos necesarios. Revisión de registros clínicos e imagenológicos consignando datos demográficos, lesiones concomitantes, número y tipo de cirugías, y complicaciones asociadas. Seguimiento promedio fue de 10,7 años con evaluación mediante encuesta funcionales SF-12/IKDC durante el mes de marzo de 2015. RESULTADOS: Diez pacientes eran hombres, 1 mujeres. Edad promedio al accidente 38,6 años. Mecanismo lesional de alta energía; como referencia la clasificación de Schenck, 1 lesión III-M, 4 tipo IV y los 6 restantes una tipo V. 4 lesiones vasculares (36.4%) y 7 lesiones neurológicas (63.6%). Tratamiento definitivo consistió en 4 reconstrucciones ligamentarias, 2 prótesis, 3 artrodesis y 2 amputaciones supracondíleas. Evaluaciones funcionales dieron como resultados un puntaje promedio de 37 y 48,5 para SF-12 físico y mental respectivamente, y de 44,1 para IKDC. CONCLUSIÓN: La luxación expuesta de rodilla es una lesión infrecuente, muy compleja, asociada a accidentes de alta energía, con complicaciones severas, lo que determina resultados funcionales relativamente malos. La estandarización permite sistematizar las distintas etapas de atención, racionalizar los recursos disponibles evitando la improvisación en momentos críticos, lo que podría incidir en la obtención de resultados.

INTRODUCTION: Open knee dislocation is a complex lesion of low incidence and large functional sequelae. There are few series reports in the literature regarding its management and outcomes. OBJECTIVE: Describe the results obtained from all patients with open knee dislocation treated during the last two decades in our hospital under the same treatment standard. METHOD: Retrospective descriptive study in a surgical series of 11 patients with open knee dislocation, treated between 1994 and 2015. All were studied and managed according to a standardized protocol: Angiography/angioCT, surgical debridement, external fixation and neurovascular repair in necessary cases. Review of clinical and imaging records, recording demographic data, concomitant injuries, number and type of surgeries and associated complications. Average follow-up was 10.7 years, with an evaluation through functional surveys SF-12/IKDC during March 2015. RESULTS: 10 patients were men, 1 woman. Average age at accident 38.6 years. High-energy trauma mechanism of injury; Schenk classification as reference, 1 lesion type III-M, 4 type IV and the remaining 6 type V. 4 vascular lesions (41.7%) and 7 neurological lesions (63.6%). Definitive treatment consisted in 4 ligamentous reconstructions, 2 prostheses, 3 arthrodesis and 3 supracondylar amputations. Functional evaluations showed an average score of 37 and 48.5 for SF-12 physical and mental respectively, and 44.1 for IKDC. CONCLUSION: Open knee dislocation is a rare, very complex, associated to high-energy trauma, with severe complications, which determines relatively poor functional outcomes. Standardization allows to systematize the different stages of attention and rationalize available resources avoiding improvisation at critical moments, which could affect the results.

Manejo de las lesiones vasculares en zona I del cuello. Presentación de casos / Handling vascular lesions in the zone I of the neck. Case presentation

RESUMEN Se estima que al menos del 5 al 10 % de todas las lesiones traumáticas del organismo afectan el cuello. En el 30 % de los casos se afecta alguna estructura importante de esta zona del cuerpo humano. Las estructuras vasculares aparecen lesionadas en el 20 % mientras que las estructuras aerodigestivas en un 10%. Las lesiones de la zona I por diversas razones anatómicas y los órganos que incluye son de difícil manejo. Se presentan dos pacientes con lesiones vasculares de la zona I del cuello. Se realizó una revisión del tratamiento de las lesiones traumáticas del cuello con especial énfasis en las de la zona I. Se abordan diferentes tendencias actuales en el manejo de estos pacientes (AU).

ABSTRACT It is appraised that at least 5 to 10 % of all the organism trauma lesions involve the neck. In 30 % of the cases, any main structure of this zone is hurt. Vascular structures are damaged in 20 % while airway-digestive structures are injured in 10 %. The zone I lesions are difficult to handle because of several anatomic reasons and the organs they include. The cases of two patients with vascular lesions in the neck zone I are presented. A review of the treatment of neck trauma lesions was carried out, making special emphasis on the ones in zone I. Several current tendencies in these patients handling are dealt with (AU).

Research progress of lncRNAs in diabetic neuropathy and vascular disease / 中国药理学通报

Long noncoding RNA is a functional RNA fragment that is not involved in translation of proteins. Many reports showed that lncRNA was closely related to diabetes. This review summarizes the pathogenesis and the role of lncRNAs in diabetic neuropathy and vascular disease,so as to provide the basis for prevention and treatment of diabetes.

Paciente con lesiones por balística terminal / Patient with terminal ballistics lesions

Se presenta un paciente masculino de 25 años de edad que recibe herida por proyectil de arma de fuego de baja velocidad que le ocasionó lesión de estructuras de la boca y el cuello, así como oclusión trombótica de la arteria carótida interna derecha, que se expresó por hemiparesia izquierda. El lesionado recibió tratamiento quirúrgico de urgencia. El paciente egresó vivo con la secuela neurológica ya descrita y fue enviado a centro de rehabilitación. Se realiza una revisión del tema a propósito de este caso(AU)

A 25-year-old male patient is received with a closed vascular lesion caused by a low-speed gunshot to the mouth and neck area, which provoked a stroke 48 hours after the lesion due to the right carotid artery thrombotic occlusion expressed by left hemiparesis. The patient received surgical treatment and was discharged with the previously mentioned neurologic deficit. He continued treatment in a rehabilitation center. This subject was reviewed from the occurrence of this case(AU)

A Case of Microvenular Hemangioma on the Scalp / 대한피부과학회지

Microvenular hemangioma is a relatively rare, acquired, and slow-growing benign vascular lesion that usually arises as a small, reddish papule or plaque in young to middle-aged individuals. It commonly occurs on the arms, trunk, or legs. Histologically, it consists of irregular branching capillaries and venules involving the full thickness of the reticular dermis. A 38-year-old woman presented for 3 years with a solitary reddish nodule on the scalp. Histological examination showed irregular venules throughout the dermis. We report this case of microvenular hemangioma developing on the scalp, an unusual location.

Influence of Yiqi Yangyin Huoxue Method on Plasma sTM and sEPCR in Rats with Type 2 Diabetes Mellitus / 世界科学技术-中医药现代化

This study was aimed to observe the effect of Danzhi Jiangtang Capsule ( DJC ) on expression of solu-ble thrombomodulin ( sTM ) and soluble endothelial cell protein C receptor ( sEPCR ) in experimental rats of type 2 diabetes mellitus (T2DM). This study also explored possible mechanisms of Yiqi Yangyin Huoxue method on vascular endothelial tissue and discussed mechanisms of prevention and management of T2DM vascular lesions . A total of 60 male Sprague-Dawley ( SD ) rats were fed for one week and then randomly divided into the nor-mal control group ( group N , n = 12 , rats were fed with routine food ) and diabetes mellitus group ( n = 48 , rats were fed with high-fat diet). After 4 weeks, rats in the diabetes mellitus group were injected with strepto-zotocin ( STZ ) to induce T2DM . According to the blood glucose level , rats were divided into three groups , wh ich were the model group (group M), pioglitazone (group P), and pioglitazone combined with DJC (group D). Group P was treated with pioglitazone (10 mg?kg-1?d-1), group D was given pioglitazone (10 mg?kg-1?d-1) and DJC ( 0 . 47 g?kg-1?d-1 ) . The group N and group M were treated with sodium chloride ( 5 mL?kg -1?d-1 ) . After four-week drug administration , the levels of sTM , sEPCR , PT , APTT and FIB in each group were tested . The results showed that compared with the control group , the levels of sTM , sEPCR and FIB in group M , group P and group D were significantly increased ( P < 0 . 05 ) , and the levels of PT and APTT were obviously reduced ( P < 0 . 05 ) . Compared with group P , the levels of sTM , sEPCR , FIB of group D were significantly reduced ( P< 0 . 01 ) , and the level of APTT was significantly increased ( P < 0 . 05 ) . However , there was no significant dif-ference in the increasing of PT. It was concluded that the Yiqi Yangyin Huoxue method can reduce the levels of sTM and sEPCR , and effectively improve coagulation . The possible mechanisms of protective effect on the vascular endothelium can be from reducing levels of sTM and sEPCR in order to enhance the activity of anti-coagulation and fibrinolysis , regulate the function of blood coagulation to improve hypercoagulable state .

Bile duct injuries associated with vascular injuries in laparoscopic cholecystectomy / 中华肝胆外科杂志

Vascular injury is a severe complication when combined with biliary injuries in laparoscopic cholecystectomy. The most frequent injury is damage to the right branch of the hepatic artery. The incidence ranges between 6. 7% and 61.1%. When bile duct transection is combined with vascular injury, the clinical course is complicated by liver ischaemia or necrosis, biliary stricture, and liver lobar atrophy which sometimes necessitating liver resection or even transplantation. Reconstruction of vascular injury is helpful when the injury is identified early.

Clinicopathologic characteristics, classification and outcome in lupus nephritis patients with thrombotic microangiopathy / 中华肾脏病杂志

Objective To investigate the clinicopathologic characteristics, classification and outcome in lupus nephritis(LN)patients with thrombotic microangiopathy(TMA). Methods LN patients with TMA proven by renal biopsy, from January 2000 to February 2009 in our hospital were enrolled. They were classified as poly-immunocomplex deposit group(n =35)and pauci-immunocomplex deposit group(n=25). Their clinicopathologic features and outcome were analyzed retrospectively. Results(l)The incidence of TMA in lupus nephritis was 9.2%(n=62), which presented severe hypertension, prominently elevated serum creatinine, anemia, thrombocytopenia, and was also the poorest prognosis of all the vascular lesion types. The incidence of death/end stage renal disease(ESRD)was 25.0%, with a mortality rate of 13.6%.(2)According to immunocomplex deposit in renal tissue, LN complicated with TMA could be classified as "poly immunocomplex deposit subtype" and "pauci-immunocomplex deposit subtype". The former presented better response to steroid and immunosuppressant therapy, in spite of more active clinicopathologic manifestations. The incidences of death/ESRD of poly subtype and pauci subtype were 8.8% and 32.0% respectively. Conclusions TMA presenting severe manifestations and the poorest prognosis is not rare in LN. LN with TMA may be classified as poly-immunocomplex deposit subtype and pauci-immunocomplex deposit subtype. This classification may be helpful in prognosis because the latter shows bad response to steroid-immunosuppressant therapy.

Primary Splenic Vascular Lesions: A Clinicopathologic, Immunophenotypic and Radiopathologic Correlation Study of 40 Cases

BACKGROUND: Primary splenic vascular lesions include the tumor and the inflammatory condition. A primary splenic vascular tumor is rare but is the most common tumor of the benign primary splenic tumors. METHODS: We describe the clinicopathological, radiological, and immunophenotypical findings of 40 cases of primary vascular lesions identified at our hospital from 1996 to 2009. RESULTS: The patients included 18 men and 22 women, aged 12 to 74 years, with a mean of 43.3-years and median of 40-years. They comprised 14 hemangiomas (35%), 13 lymphangiomas (32.5%), three hamartomas (7.5%), three littoral cell angiomas (7.5%), three sclerosing angiomatoid nodular transformations (SANT, 7.5%) and four angiosarcomas (10%). The majority of the patients (65%) were asymptomatic. Some of the patients (32.5%) complained of abdominal pain, and 2.5% of the patients presented with fever. Metastases were identified in 75% of the patients with an angiosarcoma at the initial work-up. One angiosarcoma patient died of the disease despite adjuvant chemoradiotherapy. The radiological findings for hamartoma, littoral cell angioma, and SANT were nonspecific. Microscopically, six types of vascular lesions showed classic morphological and immunophenotypical features of their type. CONCLUSIONS: One should be aware of rare splenic vascular lesions when radiological findings are nonspecific. Histomorphological and immunophenotypical features are helpful for the differential diagnosis.

A Case of Atypical Vascular Lesion of the Skin following Radiotherapy for Breast Carcinoma / 대한피부과학회지

"Atypical vascular lesions" is the term which was first used in 1994 by Fineberg and Rosen for vascular lesions after radiation therapy except for cutaneous angiosarcoma. Vascular lesions mostly occur after radiation therapy in breast cancer patients who have undergone mastectomy. The lesions are 5 mm or less, red or red-brown papules, histologically dilated vascular channels extended as the superficial and mid-dermis are observed. Post-radiation vascular lesions tend to follow a benign course with metastasis or death not having been reported yet. The lesions look histologically similar to well differentiated cutaneous angiosarcoma occurring after radiation therapy and breast reconstruction, indeed it is possible for post-radiation vascular lesions to become cutaneous angiosarcoma. Atypical vascular lesions have recently become a new issue for concern in some countries. Within Korea however, until now, a case it had not yet been reported. The patient was 50 year-old female who had chemotherapy after Modified Radical Mastectomy and salpingoophorectomy for breast cancer and endometriosis, atypical vascular lesions in the field of radiation therapy occurred. We report an interesting case of atypical vascular lesion.

Angioqueratoma circunscrito interglúteo: reporte de un caso / Intergluteal angiokeratoma circumscriptum: report of one case

Introducción: el término angioqueratoma se aplica a un conjunto de enfermedades con una base clínica de lesiones vasculares comunes. El objetivo de este reporte es comunicar el hallazgo de un angioqueratoma interglúteo. Caso clínico: hombre de 26 años quien desde la infancia presentó tumoración interglútea, manejada en varias ocasiones sin resultados. Cuando acudió a la consulta que motivó este reporte, presentaba tumoración verrucosa interglútea dolorosa y sangrante de 7 x 4 cm, de contornos irregulares. Se efectuó resección quirúrgica amplia. Los resultados histopatológicos indicaron angioqueratoma circunscrito con bordes libres de tumor. Discusión: de los cinco tipos de angioqueratomas descritos en la literatura (corporal difuso, de Mibelli, de Fordyce, solitario y corporal circunscrito), en nuestro caso se identificó angioqueratoma circunscrito por las características físicas y anatomopatológicas de la tumoración. El diagnóstico diferencial debe establecerse con el hemangioma verrucoso y la enfermedad de Fabry tipo II (angioqueratoma corporal difuso). Conclusiones: la patogénesis del angioqueratoma es desconocida y el tratamiento recomendado es el quirúrgico.

BACKGROUND: The term angiokeratoma is applied to several diseases with cutaneous vascular lesions. CLINICAL CASE: A 26-year-old male presented with an intergluteal tumor from childhood until the present time, which was treated on several occasions without results. The patient presented to the hospital complaining of a painful and bleeding intergluteal tumor. DISCUSSION: Five types of angiokeratomas have been described (angiokeratoma corporis diffusum, angiokeratoma of Mibelli, angiokeratoma of Fordyce, solitary angiokeratoma and angiokeratoma corporal circumscriptum). This patient was identified with an angiokeratoma circumscriptum by pathological and physical characteristics of the tumor. Differential diagnosis is with verrucous hemangioma and the Fabry disease type II (angiokeratoma corporis diffusum). CONCLUSION: Pathogenesis is unknown and surgery is the recommended treatment.

Pathogenesy and Therapeutic Prospect of Diabetes Mellitus Accompanied Lower Limb Vascular Lesion / 中国普外基础与临床杂志

Objective To investigate pathogenesy and therapeutic prospect of diabetes mellitus accompanied lower limb vascular lesion. Methods Relevant literatures of recent years were reviewed. Results Diabetes mellitus is one of the main risk factor causing peripheral artery disease. The site of vascular lesion often occur in major blood vessel and micrangium. The arterial sclerosis and decreased blood supply in microcirculation are important factors of lower limb ischemia. Lower limb ischemia in patients with diabetes mellitus is a common complication. Medical treatment and surgical treatment are the methods to improve symptoms of the complication. Conclusion Surgical therapy is an effective method for the treatment of diabetes mellitus accompanied lower limb vascular lesion.

High expression of ERK5 in pancreatic acinus of diabetic rats and its significance / 第三军医大学学报

Objective To investigate the expression and significance of big mitogen-activated protein kinase 1(BMK1 or ERK5)in the pancreatic acinus of diabetic rats.MethodsTwenty SD rats were randomly divided into normal control group(n=10)and streptozotocin(STZ)-induced diabetic group(n=10).At the end of 14 weeks inducement,all rats were sacrificed and venous blood and pancreatic tissues were collected.The levels of fasting blood glucose,insulin and blood fat were determined to identify the establishment of diabetic rat model.The specimens of pancreas were fixed and embedded.Hematoxylin-eosin staining was performed to observe the morphological changes.Periodic acid-Schiff(PAS)staining was carried out for the vascular changes.The expressions of type Ⅰ and Ⅳ collagen were determined by inmmunohistochemical method.BMK1/ERK5-mRNA was detected by in situ hybridization.ResultsCompared with the control,in diabetic group the vascular wall was thickening,inflammatory cells were infiltrated in perivascular area,local acinus was atrophy and the expression of type Ⅳ collagen was mainly expressed in vascular basement membrane,while type Ⅰ collagen was in local atrophy acinus tissue with inflammation(P

Acute abdomen caused by mesenteric vascular lesions 8 cases report / 临床外科杂志

Objective In order to recognize the high risk of acute abdomen caused by mesenteric vascular lesions and to improve the treatment.Method 8 cases have been followed and analyzed in clinic features,curative methods and effects.Results 6 patients were operated on and the diagnosis was confirmed pathologically.Most of patients suffered the acute abdominal,pain and signs were in the disorder.5 patients misdiagnosed, 1 diagnosed preoperatively, 2 cases with mesenteric vascular insufficiency were diagnosed by CT, celiac arteriography and cured with drugs,7 cured, 1 died.Conclusions Mesenteric vascular diseases are uncommon,accurate diagnosis should not rely on symptoms and signs which were nonspecific.Ultrasonography,CT were the sensitive examinations and benefitted to diagnosis.Early operation for the resection of bowel gangrene involving their mesentery,early application of anticoagulant therapy is essential to reduce the mortality and recurrence.

Contribution of angiography to the diagnosis of the vascular lesion due to trauma in Viet Duc Hospital

20 patients with vascular lesion due to trauma diagnosed by the angiography in ViÖt §øc hospital in 1998. The position of lesions included the popliteal artery (8), femoral artery (4), iliac artery (3), subclavian artery (1), bronchial artery (1), and the arteries in the leg (3). In these cases, the angiography helped the timely indication before occurring the irreversible ischemia

Immunologic Abnormalities in Kawasaki Disease and the Effect of Intravenous Immunoglobulin

PURPOSE: It has been suggested that immunologic abnormalities play a role in the pathogenesis of vascular injury in Kawasaki disease and the immunologic abnormalities could be regulated by high-dose intravenous immunoglobulin(IVIG). We investigated the peripheral blood lymphocyte subsets, the serum levels of interleukin-6(IL-6) and tumor necrosis factor-alpha(TNF-alpha) and the effect of high- dose IVIG(400 mg/kg/day for 5 days) on these factors during acute stage of Kawasaki disease. METHODS: Thirty patients, aged 4 months to 5 years, who met the diagnostic criteria for Kawasaki disease were enrolled in this study. Patients were divided into two groups, Kawasaki disease with coronary vascular lesion(KD-CVL) and without coronary vascular lesion (KD-NCVL). Percentages of peripheral blood lymphocyte subsets were measured by flow-cytometry and the serum levels of IL-6 and TNF-alpha were measured by ELISA on 1 day before and 1 day after IVIG administration and compared with normal control group(n=15). RESULTS: The results were as follows 1) Before IVIG administration, the percentages of CD3+ lymphocyte and CD8+ lymphocyte in both KD-CVL and KD-NCVL were significantly lower than those in control group. The percentages of CD19+ lymphocyte and CD4+/CD8+ ratio in both groups were significantly higher than those in control group. There was no significant differences between the percentages of CD4+ lymphocyte in both groups and that in control group. 2) After IVIG administration, the percentages of CD3+ lymphocyte and CD8+ lymphocyte in both KD-CVL and KD-NCVL were significantly increased. The percentages of CD19+ lymphocyte and CD4+/CD8+ ratio in both KD-CVL and KD-NCVL were significantly decreased. The percentages of CD4+ lymphocyte were not changed. 3) Before IVIG administration, the detection rate of serum IL-6 and TNF-alpha in both groups was significantly higher than that in control group. After IVIG administration, the detection rate of serum IL-6 in both groups was still higher than that in control group. In KD-CVL, the detection rate of serum TNF-alpha was still higher than that in control group but there was no significant difference between the detection rate of TNF-alpha in KD-NCVL and that in control group. 4) Before IVIG administration, the serum levels of IL-6 in Kawasaki disease were significantly higher than that in control group but there was no significant difference between those in KD-CVL and KD-NCVL. After IVIG administration, the serum level of IL-6 in KD-CVL was not decreased. In KD-NCVL, it was decreased significantly but it was still higher than that in control group after IVIG administration. Before IVIG administration, the serum levels of TNF-alpha in Kawasaki diseases were significantly higher than that in control group and that in KD-CVL was significantly higher than that in KD-NCVL. After IVIG administration, the serum level of TNF-alpha in KD-CVL was not decreased but in KD-NCVL, it was decreased significantly to the level of control group. CONCLUSIONS: Immunologic abnormalities including decreased percentage of CD3+ lymphocyte, CD8+ lymphocyte, increased percentage of CD19+ lymphocyte and CD4+/ CD8+ ratio and increased levels of IL-6 and TNF-alpha were noted in the acute stage of Kawasaki diseases. But there were no difference of above immunologic abnormalities between KD-CVL and KD-NCVL. After IVIG administration, the abnormal percentages of peripheral blood lymphocyte subsets were changed to normal but in the cases of IL-6 and TNF-alpha, the levels were continuously elevated except TNF-alpha in KD-NCVL. Therefore the immunologic abnormalities including abnormal percentages of peripheral blood lymphocyte subsets and increased production of IL-6 and TNF-alpha might be involved in the pathogenesis of Kawasaki disease. And IVIG has some effects on the change of these kinds of immunologic abnormalities.

The Use of the Copper Vapor Laser for Vascular Lesion Treatment

BACKGROUND: While the effect of the flashlamp pumped dye laser in the treatment of telangiectasia and other vascular disease has been reported by many authors, there have been a few reports on the therapeutic effect of the copper vapor laser(CVL) on telangiectasia and other vascular lesions. OBJECTIVE: Our purpose was to assess the clinical results in Korean patients who had cutaneous vascular disorders that were treated with the CVL at 578 nm. METHODS: A total of 23 patients with vascular lesions such as telangiectasia were involved. The effect of the laser treatment was evaluated 3 months after the last treatment. RESULTS: Of the 15 patients with telangiectasia, 12 patients showed good or excellent responses. 2 out of 3 patients with strawberry hemangioma showed good results. As for the other lesions, 2 out of the remaining patients 5 showed excellent results. CONCLUSION: The CVL has a beneficial effect and is a good alternative treatment modality for vascular lesions.