ABSTRACT
We have evaluated the relationship between carotid atherosclerotic change and periventricular hyper intensity (PVH). PVH was studied in 66 cases with cerebral thrombosis, comparing them with another group of age-matched controls, which consisted of 29 cases with hypertension, diabetes, and hypercholesteremia. MRI (fluid attenuated inversion recovery) and B-mode carotid ultrasonography of each lesion were analyzed. Thrombosis lesions, compatible with neurological manifestation were divided into two types, cerebral cortical type (including centrum semiovale type) and small infarction in the deep subcortical type. PVH was classified into 4 grades, none, rims/caps, patchy and diffuse. Smooth PVH was, adjoining the anterior/posterior angles and the margins of the lateral ventricles, were defined as caps and rims. Irregular PVH areas, confluent with each other, were defined as patchy, while diffuse PVH areas extending below the cortex beyond the level of the corpus callosum were defined as diffuse. Carotid atherosclerosis was evaluated using B-mode carotid ultrasonography. The severity of carotid atherosclerosis was assessed by using two indicators; incidence of carotid atherosclerosis and maximum percentage diameter of the stenosis areas. Patchy and diffuse type PVH was frequent in the thrombosis group. On B-mode carotid ultrasonography, diffuse PVH was prominent in patients with stenotic change and high maximum percentage of stenosis, but none/rims/caps PVH was accompanied by variable B-mode carotid ultrasonographical findings. Six patients had ulcerated plaques and they suffered more frequently with diffuse PVH. Diffuse PVH was more frequent in cases with severe carotid stenosis than in other PVH types. These findings suggested that large vessel atherosclerosis could result in diffuse PVH.
Subject(s)
Carotid Artery Diseases/diagnostic imaging , Carotid Artery, External , Cerebral Ventricles/pathology , Intracranial Arteriosclerosis/diagnostic imaging , Magnetic Resonance Imaging , Aged , Aged, 80 and over , Carotid Artery Diseases/diagnosis , Diabetes Mellitus/diagnosis , Female , Humans , Hypercholesterolemia/diagnosis , Hypertension/diagnosis , Intracranial Arteriosclerosis/diagnosis , Male , Middle Aged , UltrasonographyABSTRACT
Fibroblast growth factor receptor (FGFR) 4 possesses high affinity to acidic and basic fibroblast growth factors (FGFs). The authors focused on FGFR 4 expression in astrocytoma because the FGF expression increases as the tumor malignancy progresses. Forty-one astrocytoma specimens were examined by immunohistochemistry and polymerase chain reaction-Southern blot. FGFR 4 was negative in all seven Grade II astrocytomas by immunohistochemistry, while positive in four among 15 Grade III and in 13 among 19 Grade IV astrocytomas. The median survival time of Grade III astrocytoma patients was 22.3 months in FGFR 4 negative group and 14.5 months in positive group (p < 0.05). Those of Grade IV patients were 14.2 months in FGFR 4 negative group and 11.9 months in positive group (p > 0.05, not significant). However, FGFR 4 mRNA was detected in all specimens suggesting activated translation system of FGFR 4 in progression of the tumor malignancy. Histologically diagnosed Grade III astrocytoma patients can be divided into two groups; one with median survival time close to those with Grade II astrocytoma patients, and the other similar to that of glioblastoma patients. The authors concluded that FGFR 4 must be an important factor which predicts short survival Grade III astrocytoma patients, who require strict adjuvant therapy in accordance with glioblastoma.
