There are conflicting reports as to whether the degree of angiogenesis as measured by microvessel density (MVD) has a prognostic value in astrocytic tumors. This may be due to the use of different antibodies against endothelial cells to highlight microvessels. It has been reported that unlike pan-endothelial antibodies, such as CD31, anti-CD105 antibodies preferentially react with endothelial cells in angiogenic tissues. To clarify the validity of anti-CD105 antibody in the evaluation of angiogenesis, we assessed MVD using an anti-CD105 monoclonal antibody (mAb) (CD105-MVD) and an anti-CD31 mAb (CD31-MVD) in a series of 50 astrocytic tumors, and correlated MVD with expression of the key angiogenic factor vascular endothelial growth factor (VEGF) and prognosis. The mean CD31-MVD and CD105-MVD was 36.7 and 24.8 for low-grade astrocytoma (LGA), 48.0 and 42.7 for anaplastic astrocytoma, 55.3 and 51.9 for glioblastoma multiforme (GBM), respectively. CD105-MVD was more closely correlated with VEGF expression than CD31-MVD. Patients with LGA and GBM showing higher CD105-MVD had a significantly shorter mean survival time (MST) than those with lower CD105-MVD tumors (P = 0.0381 and 0.0131, respectively). Whereas the MST of patients with higher CD31-MVD tumors seemed to be shorter than that of lower CD31-MVD patients within each tumor grade, the differences were not statistically significant. These findings suggest that anti-CD105 mAb may be a better marker than anti-CD31 mAb in evaluation of angiogenesis and prediction of prognosis in astrocytic tumors.

Oral malodour is associated with periodontal disease, and periodontal therapy combined with tongue cleaning is beneficial for oral pathogenic halitosis.

It is possible to subcategorize each grade of astrocytic tumours based on their VEGF and Flk-1 staining pattern, which may be crucial in predicting the biological behavior of tumours and thus provide useful information with regard to adequate treatment.

We report two patients with dural arteriovenous fistulas (DAVFs) who presented with pure progressive dementia. Both patients showed only slowly progressive dementia, without headache, papilledema and other neurologic signs associated with diffuse white matter changes in MRI. MR cerebral angiography showed sigmoid sinus DAVFs that were mainly supplied by the occipital artery, together with retrograde filling of the superior sagittal and straight sinus and dilated cortical veins. SPECT studies showed extensive blood flow reduction in the occipital and parieto-occipital areas and right temporal lobe in one patient. Selective embolization for treatment of the DAVF improved cognitive function associated with the abnormal white matter MRI signal. MRI and SPECT showed that severity of dementia correlated with diffuse white matter changes and regional cerebral blood flow. Our cases suggest that gradually impaired cerebral circulation due to venous hypertensive encephalopathy could be involved in slowly progressive dementia with leukoencephalopathy resulting from a DAVF. DAVFs may be particularly important for differential diagnosis in elderly patients with pure progressive dementia. Thus, early diagnosis of DAVFs and treatment by endovascular surgery is important as treatable or reversible dementia.

Lymphomatosis cerebri is a rare variant of primary central nervous system lymphoma. We present a case involving a 56-year-old immunocompetent woman who complained of rapid deterioration of her higher brain function over a 4-month period. Magnetic resonance imaging showed extensive white-matter lesions. During brain biopsy, a diffusely infiltrating lymphoma with distinctive immunohistochemical features was detected. Awareness of this unique presentation and early tissue diagnosis provide the best hope for instituting appropriate treatments.