Pineal region teratoma with high serum and CSF alpha-fetoprotein levels.

We report a patient with an immature teratoma of the pineal region with high levels of alpha-fetoprotein (AFP) in serum and cerebrospinal fluid. This is very rare and to the best our knowledge, the second case reported in the literature.     

Low serum albumin and high ferritin levels in chronic hemodialysis patients with major depression

We investigated the relationships between serum albumin and ferritin levels in chronic hemodialysis patients with or without major depression. During a 1-year period, a total of 107 chronic hemodialysis patients were recruited. The diagnosis of major depression in patients was made by one psychiatrist. The data showed that patients with major depression (n=15) had significantly lower albumin and higher ferritin levels than patients without major depression (n=92). Chronic hemodialysis patients with major depression might have a more severe inflammation reaction and greater oxidative damage than patients without major depression.     

Antioxidant status of serum bilirubin and uric acid in patients with polymyositis and dermatomyositis

Objective: Oxidative stress and variations in antioxidant status are implicated in the pathogenesis of inflammatory and autoimmune diseases. Polymyositis and dermatomyositis (PM/DM) are autoimmune diseases with inflammatory cells infiltrating into skeletal muscles, and the antioxidant status is still controversial. The aim of our study was to investigate the correlation between PM/DM and the antioxidant status of serum bilirubin (Tbil, Dbil and Ibil) and uric acid (UA). Materials and Methods: We measured serum concentrations of bilirubin (Tbil, Dbil and Ibil) and uric acid in 384 individuals, including 110 PM/DM patients and 274 healthy controls. Results: We found that PM/DM patients had significantly lower serum concentrations of bilirubin (Tbil and Ibil) and uric acid than healthy controls, whether male or female. Also, after separately adjusting the covariances of age and gender, Tbil, Dbil, Ibil and UA were all relevant factors for PM/DM. Moreover, there were no significant differences in serum antioxidant molecule levels between PM and DM subgroups. Conclusion: Our study demonstrated the low serum levels of bilirubin and uric acid in patients with PM/DM. This suggested low antioxidant status in PM/DM patients with excessive oxidative stress.     

Depressed serum high density lipoprotein cholesterol levels in veterans with spinal cord injury.

Cardiovascular diseases are the most frequent cause of death among persons with spinal cord injury (SCI), and these diseases are reported to occur prematurely in the disabled compared to the able bodied population. The mechanism of accelerated coronary heart disease (CHD) in persons with SCI may be partially explicable on the basis of the lipoprotein profile. We performed fasting lipoprotein determinations on 100 veterans with SCI, 50 with paraplegia and 50 with quadriplegia, and 50 veteran controls. The mean age of the subjects with SCI was 47.8 +/- 1.4 years with a duration of injury of 16.3 +/- 1.2 years. The mean serum high-density lipoprotein (HDL) cholesterol was depressed in subjects with paraplegia or quadriplegia compared to controls (37 +/- 1 or 40 +/- 1 versus 48 +/- 2 mg/dL, p < 0.0001). Although serum total cholesterol was lower (p < 0.01) in subjects with SCI than in controls, there was no significant difference in mean serum low-density lipoprotein (LDL) cholesterol. Thirty-seven percent of subjects with SCI have serum HDL cholesterol levels less than 35 mg/dL with no significant difference in lipoprotein distribution between high and low cord lesions. Eighteen percent of individuals with SCI have an absolute elevation of LDL cholesterol (greater than 160 mg/dL). About 40% of those with SCI and LDL cholesterol levels between 130 and 160 mg/dL also have serum HDL cholesterol values below 35 mg/dL, all of whom would have their serum HDL cholesterol level undetected if lipoprotein profiles were performed according to present recommendations--that is, only if the serum total cholesterol is elevated.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pathogenesis of pulmonary thrombosis in Duchenne muscular dystrophy; a consideration from changes in serum CK and LDH levels]

We assessed the hypercoagulative state in patients with Duchenne muscular dystrophy (DMD) by measuring peripheral blood creatine kinase (CK) and lactate dehydrogenase (LDH) levels. In 76 patients with DMD who had no complications during examination, the CK and LDH levels were examined in a total of 173 times. Both enzyme levels were elevated and highly correlated (R = 0.93). We examined the temporal alteration of serum CK and LDH levels during episodes of pulmonary thrombosis experienced in 7 DMD patients who fulfilled the following diagnostic criteria: 1. sudden onset of dyspnea, chest pain, and hypoxia; 2. abnormal coagulation profile or abnormal chest CT findings, such as peripheral wedged shaped shadow and; 3. pneumothorax ruled out from X-ray findings. Throughout the episode of pulmonary thrombosis, CK and LDH levels changed within the range of those from DMD patients who had no complications, however, the CK level was significantly elevated from the basal level (2.12 times, p = 0.0075) on the first day of the episode. The LDH level rose for several days, and subsequently both CK and LDH returned to the basal level. In patients with compartment syndrome, CK levels were reportedly elevated due to muscle fiber necrosis which lead a hypercoagulative state. Therefore, we propose that muscle fiber necrosis is one of causal factors in pulmonary thrombosis. In addition, elevated CK may be helpful in predicting pulmonary thrombosis.     

Long-term outcome of polymyositis treated with high single-dose alternate-day prednisolone therapy

Background: We previously reported no difference in the efficacies of high-dose alternate-day (ADT) and daily-dose (DDT) prednisolone therapies in myositis patients, but that the incidence of side effects was lower in the former. The aim of the present study was to compare the long-term outcomes of both treatments in polymyositis patients. Methods: We compared clinical courses, efficacies, adverse reactions, and outcomes of 115 consecutive, biopsy-proven polymyositis patients treated between 1970 and 2008 with ADT (32 patients) or DDT (83 patients). Results: Mean onset ages, disease severity, incidences of malignancy, and response rates did not differ between the ADT and DDT groups. Adverse reactions (incidence of diabetes) were significantly higher in the DDT group. In this group, the incidences of hyperlipidemia, infection, hypertension, and psychiatric symptoms were also slightly higher, but not significantly so. The 20-year survival rate of the ADT group (68%) was significantly higher (p = 0.0112) than that of the DDT group (37%). Conclusion: ADT might be useful as an initial treatment option for polymyositis.     

Serum immunogloblin levels in myasthenia gravis, polymyositis, and dermatomyositis.

Analyses of serum immunoglobulin (Ig) levels were performed in patients with myasthenia gravis, polymyositis and dermatomyositis, and in normal subjects. The mean IgG levels were elevated in the disease groups and there was minimal depression of serum IgM levels in nonthymectomized myasthenic patients. There was no consistent pattern with regard to selective immunoglobulin class abnormalities, effect of thymectomy in serial studies, and no evidence of gross humoral immunological deficiency as manifested by consistent depression of serum IgA, IgG, or IgM in the disease groups.     

Increased serum levels of high mobility group box 1 protein in patients with autistic disorder

Background

High mobility group box 1 (HMGB1) is a highly conserved, ubiquitous protein that functions as an activator for inducing the immune response and can be released from neurons after glutamate excitotoxicity. The objective of the present study was to measure serum levels of HMGB1 in patients with autistic disorder and to study their relationship with clinical characteristics.

Methods

We enrolled 22 adult patients with autistic disorder (mean age: 28.1 ± 7.7 years) and 28 age- and gender-matched healthy controls (mean age: 28.7 ± 8.1 years). Serum levels of HMGB1 were measured by enzyme-linked immunosorbent assay (ELISA).

Results

Compared with healthy subjects, serum levels of HMGB1 were significantly higher in patients with autistic disorder (10.8 ± 2.6 ng/mL versus 5.6 ± 2.5 ng/mL, respectively, P < 0.001). After adjustment for potential confounders, serum HMGB1 levels were independently associated with their domain A scores in the Autism Diagnostic Interview-Revised, which reflects their impairments in social interaction.

Conclusions

These results suggest that HMGB1 levels may be affected in autistic disorder. Increased HMGB1 may be a biological correlate of the impaired reciprocal social interactions in this neurodevelopmental disorder.     

多发性肌炎患者神经电生理特点分析

目的增进对多发性肌炎患者肌电图特点的认识,提高其检查的阳性率。方法对91例多发性肌炎患者进行肌电图(EMG)、神经传导速度测定。结果肌电图异常率为87.9%,肌源性损害者占79.1%,神经源性损害者占8.8%。其中插入电位延长、自发电位的阳性率分别为6%和52%,肱二头肌出现率较高,外展拇短肌出现率最低(p<0.05);运动单位电位(MUP)时限缩短的阳性率为71%,胫前肌出现率最高,外展拇短肌最低(p<0.05);MUP波幅降低的阳性率较低,仅为7%;多相波增多的阳性率为29%,胫前肌出现率最高,股四头肌最低(p<0.05);重收缩时波形异常的阳性率为26%,以股四头肌出现率最高;重收缩时峰值电压降低的阳性率为31%,胫前肌出现率最高,外展拇短肌最低(均p<0.05)。5例患者EMG呈神经源性损害,1例感觉神经传导速度减慢,2例运动神经传导速度减慢。肌电图正常组、肌源性损害组及神经源性损害组患者的病程、年龄无明显差异。结论 EMG对多发性肌炎诊断的阳性率为87.9%,其中以MUP时限缩短出现率最高为71%,其次为自发电位为52%。EMG异常最多见于肱二头肌、股四头肌和胫前肌。     

依达拉奉对急性脑梗死患者血清高敏感C反应蛋白及IL-8的影响

目的 通过观察依达拉奉对急性脑梗死患者血清高敏感C反应蛋白（highsensitive C-reactionprotein，hs—CRP），IL-8水平的影响及对神经功能的改善作用，探讨依达拉奉对急性脑梗死患者的疗效及其可能机制。方法选择60例急性脑梗死患者随机分为治疗组和对照组各30例，治疗组（30例）给予依达拉奉注射液30mg，2L4t／d。对照组给予丹参粉针400mg溶于生理盐250mL静滴，1次／d。连用15d。采用酶联免疫吸附实验检测治疗前、治疗后7d和15d的血清hs—CRP及IL-8水平变化，分别进行神经功能缺损程度评分。结果2组hs—CRP、IL-8水平在梗死后7d最高，随后逐渐降低。治疗组治疗前血清hs—CRP及IL-8水平和神经功能缺损总分与对照组比较，差异无统计学意义（P〉0．05）；治疗后7d及15d治疗组hs—CRP和IL-8水平及神经功能缺损总分均低于对照组（P〈0．01）。结论依达拉奉可降低患者血清hs—CRP水平和IL-8水平，减轻炎症反应，改善缺损的神经功能。通过降低血清hs—CRP和IL-8水平可能是其作用机制之一。     

Association of cerebral microbleeds in acute ischemic stroke with high serum levels of vascular endothelial growth factor

OBJECTIVE To determine whether vascular endothelial growth factor (VEGF) levels are associated with the presence of cerebral microbleeds (CMBs) in patients after acute ischemic stroke. DESIGN A cross-sectional study that used blood samples obtained within 24 hours of symptom onset from patients who experienced acute stroke to measure VEGF levels by enzyme immunoassay. A validated CMB rating scale was used to analyze acutely acquired magnetic resonance images, with the rater blind to clinical details and VEGF levels. SETTING Accident and Emergency Department at University College Hospital, London, England. PATIENTS Twenty patients who experienced acute ischemic stroke. MAIN OUTCOME MEASURES Presence of CMBs and serum level of VEGF. RESULTS Five of the 20 patients with acute ischemic stroke (25%) had CMBs. The median VEGF level in the CMB group was significantly higher than that in the group without CMBs (P?=?.003). CONCLUSION An increase in vascular permeability secondary to a raised VEGF level may have a role in the genesis of CMBs in patients with acute ischemic stroke.     

妊娠相关骨盆痛患者的行走步态与运动协调

背景：妊娠相关骨盆痛患者常常有不同程度的行走功能障碍,但具体发病机制尚未阐明。 目的：通过了解妊娠相关骨盆痛患者步行速度、步态与胸廓、骨盆和腰椎的运动协调的变化,探讨妊娠相关骨盆痛运动病理机制。 方法：比较12名健康孕妇和12名患有妊娠相关骨盆痛孕妇的步态运动,计算其胸廓、骨盆和腰椎在水平面上节段性旋转的幅度、各个节段旋转的时间差和节段间的相对相以及脊柱整体旋转的幅度。 结果与结论：妊娠相关骨盆痛患者的步行速度较对照组慢,并且与运动恐惧感呈负性相关。患者胸廓、骨盆和腰椎的旋转幅度较大,而且有较大的个体间差异。脊柱的旋转在两组间没有差别。患者快速步行时胸廓旋转的峰值出现在步态周期的早期而相对相却较小,也许这可以避免骶髂关节和脊柱过度旋转的转矩。     

A case of idiopathic pure sudomotor failure associated with prolonged high levels of serum carcinoembryonic antigen

We report a case of idiopathic pure sudomotor failure (IPSF) in which serum carcinoembryonic antigen (CEA) levels elevated at onset, and remained high while anhidrosis lasted. We considered that changes in serum levels of CEA were related to the disease activity of IPSF.