Lege Artis Medicinae

[CEREBRAL AMYLOID ANGIOPATHY - A FATAL CASE OF RECURRENT MULTIFOCAL CEREBRAL HEMORRHAGE]

POGÁNY Péter, HERMANN Zsuzsa

DECEMBER 20, 2003

Lege Artis Medicinae - 2003;13(08)

[Atherosclerosis and hypertension are the leading etiological factors in the pathogenesis of cerebral hemorrhage. With old age though, several other factors may appear of which cerebral amyloid angiopathy (CAA) is of major importance. This condition is characterized by the deposition of β-amyloid in the leptomeningeal vessels as well as in the small and medium sized arteries of the cerebral cortex and it is not associated with systemic amyloidosis. This pathological protein is also seen in the brains of otherwise healthy older individuals and may also appear in other diseases such as Alzheimer disease, Down-syndrome, vascular malformations, spongiform encephalopathy and dementia pugilistica. The condition may be asymptomatic but it may also cause cerebral hemorrhage, dementia or various transient neurological symptoms. Most cases are sporadic, but familial subtypes have also been described.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Nobel Prize in Medicine for the Pioneers of MR Imaging]

MARTOS János

Lege Artis Medicinae

[A New Solution in the Treatment of Cerebral Edema in Patients Requiring Decompressive Craniectomy Formation of a Vascular Channel in the Treatment of Cerebral Edema in Posttraumatic and Ischemic Stroke Patients Requiring Decompressive Craniectomy]

CSÓKAY András, EGYÜD László, PATAKI Gergely

Lege Artis Medicinae

[THE VALUE OF RENAL BIOPSY IN DIABETES]

NAGY Judit, DEGRELL Péter, EKNOYAN Garabed, WITTMANN István

[The relentless increase of patients with kidney failure requiring renal replacement therapy has been documented world-wide. Recently, diabetic renal diseases has become the major cause of end-stage renal disease in the United States and in western Europe and is forecasted to become the most frequent cause of end-stage renal disease in Hungary. The most common renal lesion in type 1 as well as in type 2 diabetes is diabetic nephropathy. However, in the last few years numerous studies have demonstrated that there is a difference between patients with type 1 and those with type 2 diabetes in the expression and frequency of their renal disease. In type 1 diabetes a histological examination should only be made when a patient has features atypical of diabetic nephropathy and the indications of renal biopsy are well known. At the same time there is no agreement on renal biopsy indications in type 2 diabetes. In this review, we will summarise the characteristic features of diabetic nephropathy and other kidney alterations in the diabetic patient. Furthermore, we will raise the question of the renal biopsy indications and the more extensive use of the renal biopsy in type 2 diabetic patients for more effective prevention and treatment strategies.]

Lege Artis Medicinae

[EUROPA]

NAGY Viktor

Lege Artis Medicinae

[PRESENTATION OF DIFFUSE INTERSTITIAL LUNG DISEASES BY THE NEW CLINICORADIOLOGICAL- PATHOLOGICAL ASPECT]

SZOLNOKI Erzsébet, DÉVÉNYI Katalin, DANKÓ Enikő, DEZSŐ Balázs, SZILASI Mária

[The aim of the authors was to overview the different forms of diffuse interstitial lung disease based on newly established radiological (HRCT) pattern and histopathological analysis beyond the clinical picture. Idiopathic pulmonary fibrosis is emphasized having also historical importance and possible therapeutic antifibrotic interventions are discussed as well.]

All articles in the issue

Related contents

Clinical Neuroscience

[The role of β-amyloid and mitochondrial dysfunction in the pathogenesis of Alzheimer’s disease]

SZARKA András

[Alzheimer’s disease is the most common form of dementia in mid- and late life. The 7-10% of the population over 65 and the 50-60% of the population over 85 are affected by this disease. On the contrary of its prevalence the pathogenesis of the disease is not well defined and there is no effective neuroprotective therapeutic agent. Three predominant neuropathological features of the Alzheimer’s disease brain are intracellular neurofibrillary tangles consisting mainly of the hyperphosphorylated protein t; the extracellular amyloid deposits (neuritic plaques) consisting of amyloid b peptide; and the extensive neuronal cell loss in the hippocampus and in portions of the cerebral cortex. The possible reason of the extensive neuronal cell loss can be the mitochondrial dysfunction observed in Alzheimer’s disease. Beyond the unclarified pathogenesis the causality of these characteristic neuropathologic phenomena are still unknown. In this study we would like to deal with two actual hypotheses, with the amyloid cascade and with the mitochondrial cascade hypotheses. We try to give an overview of these two hypotheses and to depict their interrelationship.]

Clinical Neuroscience

[β-amyloid peptide-induced intracellular calcium level changes in Alzheimer fibroblasts]

PALOTÁS András, KÁLMÁN János, LASKAY Gábor, JUHÁSZ Anna, JANKA Zoltán, PENKE Botond

[Rationale - β-amyloid peptides, comprising the major neuropathological lesions of Alzheimer's disease, have been found to form depositions in various peripheral tissues, including the skin. Neurons in the disorder succumb to the altered ionic homeostasis and some other factors caused by this toxic peptide. In line with these findings, our study aimed to find differences in biochemical processes of cultured cutaneous fibroblasts derived from sporadic Alzheimer patients and from agematched control individuals that may mirror changes in the central nervous system. Methods - Intracellular ionic homeostasis of Alzheimer and control fibroblasts was measured in Fura-2AMloaded human fibroblasts by dual wavelength spectrofluorimetry. Results - Cells derived from Alzheimer patients exhibited lower intracellular free calcium levels as compared to the control cultures. Exposure of fibroblasts to β-amyloid resulted in increased calcium concentrations of the control cells, but not of Alzheimer ones. Conclusion - Our findings indicate that Alzheimer’s disease is a systemic disorder that, among others, affects the calcium homeostasis of fibroblasts. Even though it is unknown whether the diminished ionic response of Alzheimer fibroblasts is a disease or actual status marker, it could prove to be a useful model for the analysis of Alzheimer specific changes.]

Clinical Neuroscience

[The connection between the socioeconomic status and stroke in Budapest]

VASTAGH Ildikó, SZŐCS Ildikó, OBERFRANK Ferenc, AJTAY András, BERECZKI Dániel

[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]