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[先天性弓形虫病的脑部病变。9例个人病例及文献中61例病例的研究]

[The cerebral lesions in congenital toxoplasmosis. Study of 9 personal cases and 61 cases in the literature].

作者信息

Weber F

出版信息

Helv Paediatr Acta Suppl. 1983;48:1-51.

PMID:6575004
Abstract

This study is a review of 70 cases of congenital toxoplasmosis; all of the patients were dead between birth and the age of nine. The anatomo-pathological examination of 9 personal cases (6 acute, 1 subacute, 2 chronic) is presented and compared with that of 61 cases from the literature. After a parasitological survey concerning the infectious agent, the author summarizes the macroscopic and the microscopic lesions of his personal cases. Those data are subsequently confronted to those referred to in the literature. The author makes an attempt to entangle the terminological confusion that exists between the different terms: cyst, pseudocyst, microglial nodule and granuloma. The frequency, the localization and the mechanisms of the main alterations - granuloma, necrosis, calcification, hydrocephaly - are studied as well as the vulnerability factors and the resistance of the subjects. The presence in 8 of the 9 chronic cases of calcified scar lesions in the inferior portion of the external wall of the lateral ventricles suggests a particular vulnerability of the spongioblasts in that area. In the acute cases the extensive necroses in the cerebral hemispheres seem to result from immunological reactions in an immature organism rather than from vascular thromboses that appear to be more a secondary phenomenon.

摘要

本研究对70例先天性弓形虫病病例进行了回顾;所有患者均在出生至9岁之间死亡。本文呈现了9例个人病例(6例急性、1例亚急性、2例慢性)的解剖病理学检查结果,并与文献中的61例病例进行了比较。在对感染病原体进行寄生虫学调查后,作者总结了其个人病例的宏观和微观病变。随后将这些数据与文献中提及的数据进行对比。作者试图理清不同术语之间存在的术语混淆:囊肿、假囊肿、小胶质结节和肉芽肿。研究了主要病变——肉芽肿、坏死、钙化、脑积水——的发生率、定位及机制,以及受试者的易患因素和抵抗力。9例慢性病例中有8例在侧脑室外壁下部存在钙化瘢痕病变,这表明该区域的成神经胶质细胞具有特殊的易损性。在急性病例中,大脑半球广泛坏死似乎是由于未成熟机体中的免疫反应所致,而非血管血栓形成,血管血栓形成似乎更是一种继发现象。

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