PubMed · 13911473
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R S SHAW. 1962-02-15. Reconstructive vascular surgery.. https://doi.org/10.1056/nejm196202152660706
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Characteristic pathological features of multiple sclerosis (MS) include inflammation, demyelination and axonal and oligodendrocyte loss. In addition, lesions can also have a significant vascular component. In this review, morphological, biochemical and radiological evidence is presented suggesting angiogenesis as a potential focus for investigation in MS. We hypothesize that angiogenesis plays a significant role in the MS lesion, perpetuating disease progression. Thus, treatment strategies that inhibit angiogenesis may decrease clinical and pathological signs of disease. Several approaches for testing this hypothesis are outlined.
Blood vessels are the way for nutrients present outside the brain to gain access into the cerebral parenchyma. When neurons are diseased, for example by toxin exposure, reactive glial cells secrete local factors that induce microangiogenesis, probably as part of a spontaneous neuroprotective mechanism related to the increased metabolic demand. In Parkinson's disease (PD) and non human primate models of PD, nigral degeneration is associated with gliosis and microvascular proliferation. Interestingly, microangiogenesis also facilitates the entrance into the brain parenchyma of neurotoxins and harmful cytokine-releasing blood cells, both of which have been linked to neuronal cell death in PD. In the present review we discuss the potential implications of vascular-related phenomena with mechanisms of neuronal damage in PD.
Although increasing numbers of equivocal nodular lesions have been detected in patients with liver cirrhosis with the development of various diagnostic imaging modalities, the pathological diagnosis of small, well-differentiated hepatocellular carcinoma (HCC) in the early stage and of high-grade dysplastic nodules (DNs) is a controversial issue among both Japanese and Western pathologists. In particular, many of the vaguely nodular HCCs of well-differentiated HCC diagnosed by Japanese pathologists tend to be interpreted as high-grade DNs rather than HCC by Western pathologists. In contrast, many of the high-grade DNs diagnosed by Western pathologists are interpreted as well-differentiated HCC by Japanese pathologists. The reasons for the discrepancy between Japanese and Western pathologists can be explained by the following: for Western pathologists, most information comes from the study of HCC and advanced cirrhosis explanted at liver transplantation without detailed clinical information about the nodules; for Japanese pathologists, most information comes from the examination of surgical and biopsy materials together with detailed clinical information that includes meticulous follow-up data on the clinical course of the nodular lesions. To resolve the diagnostic confusion concerning equivocal nodular lesions in the cirrhotic liver, it is necessary to promote the active exchange of clinicopathologic information between Japan and Western countries.