VENOUS SOURCE FOR BLEEDING IN GERMINAL MATRIX HEMORRHAGE

生发基质出血的静脉源

• 批准号: 2892321
• 负责人: DIXON M MOODY
• 金额: $ 26.44万
• 依托单位: WAKE FOREST UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-07-03 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2892321
• 关键词: alkaline phosphatase; capillary; cerebrovascular system; disease /disorder etiology; hemorrhagic disease of newborn; histochemistry /cytochemistry; histopathology; human tissue; low birth weight infant human; pathologic process; postmortem; premature infant human; stainings; vascular endothelium; veins

DESCRIPTION (Adapted from Applicant's Abstract): Germinal matrix hemorrhage (GMH) occurs in approximately 45% of very low birth weight neonates. Slightly more than 1% of live births in the U.S. weigh less that 1.5_kg, thus it can be estimated that GMH affects 10,000 neonates annually. These babies will account for 30% of patients who will later exhibit cerebral palsy. GMH will continue to be a perplexing medical problem due to technological advances allowing survival of very premature babies, and socioeconomic conditions associated with their births. Little is known concerning specific factors and mechanisms involved in the development of GMH. Recent discussion of the physiologic factors predisposing to GMH concern unstable arterial blood pressure, ischemic brain injury, and wide swings in venous pressure. Certain large, fragile germinal matrix (GM) periventricular vascular "channels" from which bleeding often occurs have been characterized as "veins," "capillary sinusoids," or "a vascular rete." Previous investigations of the vascular anatomy of the GM are flawed. In ordinary neuropathological techniques, the sections are too thin to trace vessels; furthermore, veins cannot be discriminated from arteries because these immature vessels do not have mural smooth muscle or collagen. Studies employing intravascular injection into cadaveric vasculature produce an unintelligible mass of vessels and artifacts. Errors in this basic concept may have adversely influenced strategies for the salvage of these babies. Clearly, innovative techniques are required to investigate the nature of vascular morphology and pathology in the neonate with GMH. The native alkaline phosphatase (AP) ectoenzyme, present in the endothelial plasma cell membrane of small arteries, arterioles, and capillaries, but not of venule/veins, can be exploited to differentially stain the GM vasculature in thick celloidin sections. This histochemical technique is superior to injection methods of outlining vasculature because it avoids artifacts of injection and the background tissue can be examined with counterstains. The broad objective of this study is to characterize the GM angioarchitecture, identify the precise site(s) of bleeding, and determine the ultimate fate of the immature GM sinusoids with AP staining and thick celloidin sections in the brains from 40 pediatric subjects ranging from 22- to 40-weeks' post-conception age.

描述（改编自申请人的摘要）：生发基质出血 (GMH) 发生在大约 45% 的极低出生体重新生儿中。 在美国，略高于 1% 的活产婴儿体重低于 1.5 公斤， 因此可以估计，GMH 每年影响 10,000 名新生儿。 这些 婴儿将占后来出现脑病的患者的 30% 麻痹。 GMH 将继续成为一个令人困惑的医学问题，因为 技术进步使早产儿得以生存，以及 与其出生相关的社会经济条件。 鲜为人知 涉及发展的具体因素和机制 GMH。 最近对诱发 GMH 的生理因素的讨论 关注不稳定的动脉血压、缺血性脑损伤和广泛的 静脉压波动。 某些大而脆弱的生发基质（GM）脑室周围血管 经常发生出血的“通道”被描述为 “静脉”、“毛细血管正弦波”或“血管网”。 以前的 对 GM 血管解剖学的研究是有缺陷的。 在普通情况下 神经病理学技术，切片太薄，无法追踪血管； 此外，不能将静脉与动脉区分开来，因为这些 未成熟的血管没有壁平滑肌或胶原蛋白。 研究 采用血管内注射到尸体脉管系统中产生 难以理解的大量船只和文物。 这个基本概念的错误 可能对抢救这些婴儿的策略产生了不利影响。 显然，需要创新技术来研究 GMH 新生儿的血管形态和病理学。 当地人 碱性磷酸酶 (AP) 胞外酶，存在于内皮浆细胞中 小动脉、小动脉和毛细血管的膜，但不是 小静脉/静脉，可用于对 GM 脉管系统进行差异染色 厚的赛璐珞切片。 该组织化学技术优于 轮廓脉管系统的注射方法，因为它避免了伪影 注射和背景组织可以用复染剂进行检查。 本研究的主要目标是描述 GM 的特征 血管结构，确定出血的精确部位，并确定 未成熟 GM 血窦的最终命运，AP 染色和厚 40 名儿科受试者的大脑中的赛璐珞切片，年龄范围从 22 岁到 至受孕后 40 周的年龄。