RESUMO
OBJECTIVE: To discuss the clinical characteristics and imaging findings so as to improve the understanding of vertebrobasilar dolichoectasia (VBD). METHODS: The clinical profiles of 25 VBD patients diagnosed by magnetic resonance imaging (MRI) were retrospectively collected during January 2009-January 2010. Their clinical characteristics and imaging findings were analyzed. RESULTS: (1) Clinical characteristics: Posterior circulation ischemia (84%) was predominant. Different degrees of dizziness (40%) was the most common clinical manifestation. (2) Imaging analysis: two cases (8%) had a missed diagnosis by head computerized tomography. The diagnostic accuracy rate of head MRI and MRA was 100%. The degree of bifurcation height or lateral deviation of basal artery was mainly of the 2nd degree according to the Smoke's criteria. The lateral deviation of basal artery was mostly of a rightward shift (60%). The medulla oblongata was often compressed to deformation (40%). Basal artery calcification (12%) and VBD-associated hydrocephalus (4%) were rare. VBD was usually complicated with arteriosclerosis plaques of intracranial arteries in posterior circulation (> 40%). (3) Follow-up results: three cases (12%) suffered serious brainstem infarction during a follow-up period of 0.5 - 1.5 years. Two (8%) of them were dead. The degree of bifurcation height or lateral deviation of basal artery was of the 3rd degree in 3 cases. CONCLUSION: The clinical manifestations of VBD are multiple. But posterior circulation ischemia is not rare, especially for the elderly patients. Because of a high rate of disability and mortality, early diagnosis is essential. MRI is of a great value in confirming the diagnosis and evaluating the prognosis.
Assuntos
Insuficiência Vertebrobasilar/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prognóstico , Tomografia Computadorizada por Raios X , Insuficiência Vertebrobasilar/diagnóstico por imagemRESUMO
BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is the most common subtype of adult renal neoplasm and has a poor prognosis owing to a limited understanding of the disease mechanisms. The aim of this study was to explore and identify the key genes and signaling pathways in ccRCC. METHODS: The GSE36895 gene expression profiles were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were then screened using software packages in R. After Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, a protein-protein interaction (PPI) network of DEGs was constructed with Cytoscape software, and submodules were subsequently analyzed using the MCODE plug-in. RESULTS: Twenty-nine ccRCC samples and 23 normal samples were incorporated into this study, and a total of 468 DEGs were filtered, consisting of 180 upregulated genes and 288 downregulated genes. The upregulated DEGs were significantly enriched in the immune response, response to wounding, inflammatory response, and response to hypoxia, whereas downregulated genes were mainly enriched in ion transport, anion transport, and monovalent inorganic cation transport biological processes (BPs). According to Molecular Complex Detection analysis in PPI, C1QA, C1QB, C1QC, CCND1 and EGF had higher degrees of connectivity and could participate in the majority of important pathways, such as cytokine-cytokine receptor interactions, the chemokine signaling pathway, and the complement and coagulation cascade pathways. CONCLUSIONS: Our study suggests that C1QA, C1QB, C1QC, CCND1 and EGF may play key roles in the progression of ccRCC, which will be useful for future studies on the underlying mechanisms of ccRCC.