Pathological and Preventive Nutritional Studies on Environmental Factors of Cerebrovascular Dementia in the Japanese, from Neutritional Pathogenesis of Cerebrovascular Diseases.

我们应用新的免疫组织化学技术，按照标准化的研究方案，对脑血管疾病的发病特点进行了研究：从卒中和/或脑血管性痴呆尸检病例死后5小时内，取脑标本(1*1*0.5 cm)，包括穿支动脉和皮质动脉，经甲醇-Carnoy‘s固定剂固定，石蜡包埋，经苏木毒素、伊红、Masson、Azan-Mallory和Elastica van Gieson染色后常规病理检查，并进行免疫过氧化物酶染色。利用抗肌动蛋白和抗巨噬细胞的单抗，我们证实了动脉穿通层的变性和坏死始于动脉的外层，并伴有Virchow-Robin间隙的巨噬细胞的浸润和胶原的增殖，在晚期，巨噬细胞穿透内皮细胞并聚集在内皮下间隙，导致血管病变。这些发现支持了紊乱在日本中风和脑血管性痴呆发病机制中的重要性。这一方面也得到了我们对日本移民营养的比较流行病学调查的支持，这些移民的中风发病率低于日本人。

We studied the pathogenetic feature of cerebrovascular diseases by applying new immunohistochemical techniques according to the well-standardized study protocol among collaborating investigators : Brain specimens (1*1*0.5cm)including perforating and cortical arteries from autopsied cases of stroke and/or cerebrovascular dementia were obtained within 5 hours after death were fixed in methonal-Carnoy's fixative, embedded in paraffin and sectioned for routine pathalogical examination after Hematoxilin, Eosin, Masson, Azan-Mallory and Elastica van Gieson stains as well as for immunoperoxidase staining, using monoclonal antibodies against antiactin and antimacrophage antibodies.We demonstrated the degeneration and necrosis started at the outer layr of smooth muscle cells of perforating arteries with the infiltration of macrophages from Virchow-Robin's space and collagen proliferation, and at the advanced stage macrophages penetrated through endothelial cells and accumulated in the subendothelial space to induce occlusive lesions like vascular lesions in stroke-prone SHR.These findings support the importance of disturbance in the pathogenesis of cerebrovascular diseases in stroke and cerebrovascular dementia in the Japanese.This aspect was also supported by our comparative epidemiological survey on the nutrition of Japanese immigrants who had less incidence of stroke than the Japanese in Japan.