Anatomical considerations in the pathology of stenosis of the cerebral aqueduct.
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Spastic constriction of intracerebral arterioles was identified in clinical (P. falciparum) and experimental (P. berghei) cerebral malaria. Morphological criteria were used to characterize pathologically spastic constriction of arterioles. The significance of spastic constriction of intracerebral arterioles for microcirculatory disturbance in relation to development of cerebral malaria is discussed.
During gestation endothelium induces decreases in vascular responses to vasopressor agents but endothelium disease is followed by hypertension and enhanced vascular reactivity during preeclampsia. In a rat model of preeclampsia induced by NO synthase inhibition we study here isolated aortic contractions. From day 13 of gestation 2 groups of Wistar female rats were fed control (C) or nitro-arginine enriched diets (0.063%, i.e. 30 mg/kg/d) (treated) (T). On gestational day 20 systolic blood pressure (SBP, mmHg) is measured by tail cuff method and isolated thoracic ring aorta contractions are studied after depolarisation (KCl 60 mM) or norepinephrine (cumulative concentrations 10-9 M-10-5 M). After chronic NOS inhibition, hypertension develops: SBP is 154 +/- 2.17 in T and 116 +/- 3.75 in C, p < 0.01 and significant proteinuria (mg/d) appears: T, 63.4 +/- 21.6 versus C 3.08 +/- 0.48, p < 0.01. NO synthase inhibition in treated rats impairs the depressed contractile response obtained in the presence of endothelium in control rats but addition of L-arginine suppresses the effect of nitroarginine. Taking in account our results and those described in literature it appears that L-arginine treatment could ameliorate some pathologic pregnancies.
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Segmental ischemic disease consists of segmental infarctions and ischemic stenoses. Vasculitis (LES, polyarteritis nodosa, Schönlein-Henoch syndrome), thrombosis, arteriosclerotic changes, mechanical obstructions (adhesions, hernia, volvulus, traumas), hemorrhagic disorders are the most common causes of these intestinal lesions. The authors report their experience achieved during three years on 428 small bowel examinations; among these, 197 were double contrast enemas. Ten patients showed roentgenographic features referred to vascular diseases: 1 LES, 1 Schönlein-Henoch syndrome, 3 polyarteritis nodosa, 5 spontaneous hemorrhagic disorders or due to treatment with anticoagulants. The authors, after a review of the radiological findings, emphasize the high sensitivity and low specificity of double contrast small bowel enema. Furthermore they underline the usefulness of this method in demonstrating and monitoring intestinal pathologic changes.
Viral esophageal infection is common in immunocompromised patients. Twelve patients with esophagitis secondary to herpes viruses are described. Odynophagia, dysphagia, and gastrointestinal bleeding were the most common symptoms. Multiple infections particularly with candida were present in three of the 12 cases (25%). Typical "volcano ulcers" at endoscopy and discrete diffusely scattered shallow ulcers seen on double contrast esophagram are highly suggestive of herpetic esophagitis. Single contrast esophagram plays no specific role in the diagnosis of herpetic esophagitis. An analysis of clinical, endoscopic, radiological, and pathological features is presented.
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