ABSTRACT
BACKGROUND: The herpes simplex encephalitis (HSE) represents one of the most severe infectious diseases of the central nervous system. As effective antiviral drugs are available, rapid and reliable diagnosis has become important. OBJECTIVES: To evaluate retrospectively the usefulness of polymerase chain reaction (PCR) as well as serological procedures for the diagnosis of HSE. STUDY DESIGN: 631 cerebrospinal fluids (CSF) from patients with clinical suspicion of encephalitis were tested for type-specific herpes simplex virus (HSV) DNA using PCR. Virus-specific antibodies including their intrathecal synthesis were measured in 624 CSF and 2409 serum samples of 2711 patients suspected of having encephalitis. RESULTS: Positive results were obtained by PCR in eight patients (1. 3%) for HSV-1 and in seven (1.1%) for HSV-2. Intrathecal antibody synthesis was estimated in 24 (3.8%) patients. In general, no intrathecal antibodies could be measured in patients with positive PCR results and vice versa the intrathecal immune response became positive when CSF was cleared from the HSV. Results of the antibody detection in serum specimens revealed an active HSV infection in 268 out of 2367 patients (11.3%). CONCLUSIONS: The detection of HSV-DNA by PCR is the method of choice for diagnosis of HSE in the early phase of the disease. During the later stage, it has to be diagnosed by the estimation of intrathecally synthesized antibodies.
Subject(s)
Encephalitis, Herpes Simplex/diagnosis , Encephalitis, Herpes Simplex/virology , Herpesvirus 1, Human/isolation & purification , Herpesvirus 2, Human/isolation & purification , Adolescent , Adult , Aged , Antibodies, Viral/blood , Cerebrospinal Fluid/immunology , Cerebrospinal Fluid/virology , Child , Child, Preschool , DNA, Viral/analysis , Herpesvirus 1, Human/genetics , Herpesvirus 1, Human/immunology , Herpesvirus 2, Human/genetics , Herpesvirus 2, Human/immunology , Humans , Infant , Infant, Newborn , Middle Aged , Polymerase Chain Reaction , Retrospective Studies , Species SpecificityABSTRACT
Angiosarcomas are rare malignant mesenchymal tumours, characterized morphologically by anastomosing vascular channels lined by atypical and proliferative active endothelial cells. An epithelioid cytomorphology of tumour cells is often seen focally in angiosarcoma, whereas purely epithelioid angiosarcomas are rare. Although angiosarcomas show a vascular differentiation they are almost never confined to pre-existing blood vessels. We describe three cases of intravascular epithelioid angiosarcoma arising in the carotid artery of a 60-year-old man, in the infrarenal part of the abdominal aorta and both renal arteries of a 69-year-old woman, and in the abdominal aorta of a 68-year-old man. In all cases malignant tumour tissue was found incidentally after disobliteration of thrombosed vessels. Histologically, purely epithelioid angiosarcoma composed of solid sheets of epithelioid tumour cells was seen; immunohistochemistry confirmed the endothelial differentiation of neoplastic cells. The reported cases show that angiosarcoma can occasionally arise within a pre-existing vessel.
Subject(s)
Aorta/pathology , Carotid Arteries/pathology , Hemangiosarcoma/pathology , Renal Artery/pathology , Tunica Intima/pathology , Vascular Neoplasms/pathology , Aged , Angiography , Biomarkers, Tumor/metabolism , Carotid Arteries/diagnostic imaging , Constriction, Pathologic/etiology , Female , Hemangiosarcoma/complications , Hemangiosarcoma/metabolism , Humans , Immunohistochemistry , Male , Middle Aged , Neoplasm Recurrence, Local , Recurrence , Tunica Intima/metabolism , Vascular Neoplasms/complications , Vascular Neoplasms/metabolismABSTRACT
The vascular endothelial growth factor (VEGF) has been shown to be upregulated in acute hypoxia. Although an increase in blood vessel number has been described in severe chronic brain hypoxia, it is unclear whether VEGF is upregulated in this condition. We therefore investigated male inbred Wistar rats, which were exposed for 9 to 13 weeks to decreasing amounts of oxygen, down to 7% O2 (15%: 15 days; 12%, 10%, respectively; 8%: 1 day, 3 weeks, respectively; 7%: 4 weeks). The expression of VEGF was studied by Northern analysis and in situ hybridization in frozen sections of cerebral cortex, hippocampus and cerebellum in six chronic hypoxic and two control rats. We found a marked upregulation of VEGF mRNA in all brain regions investigated, being strongest in cerebral cortex and cerebellum. Our results suggest a potential role of VEGF for vascular growth and vascular permeability observed in chronic cerebral hypoxia.
Subject(s)
Endothelial Growth Factors/metabolism , Hypoxia, Brain/metabolism , Lymphokines/metabolism , Animals , Blotting, Northern , Chronic Disease , In Situ Hybridization , Male , Rats , Rats, Wistar , Up-Regulation , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth FactorsABSTRACT
In a multicentre study patients with liver metastases stratified to the histology of the primary tumour were investigated. A total of 102 patients with colorectal adenocarcinoma, non-small-cell lung cancer, pancreatic cancer, primary liver carcinoma and malignant melanoma were treated with the thioether lipid ilmofosine. The drug was administered orally as a tablet at a dosage of 150-300 mg/day (75 mg/tablet). The tolerability of ilmofosine was poor. There was a dose-limiting gastrointestinal toxicity with nausea, vomiting and loss of appetite (WHO grade II-IV) in 67% of patients. During the period of therapy (1-29 weeks, 8.5 weeks mean) no complete remission and no partial response were observed. We thus conclude that treatment with oral ilmofosine is not effective in patients with liver metastases due to various malignancies.
