A Case of Extensive Spinal Cysticercosis Involving the Whole Spinal Canal in a Patient with a History of Cerebral Cysticercosis

Although cysticercosis is the most common parasitic disease affecting the central nervous system, spinal cysticercosis is rare. A rare form of spinal cysticercosis involving the whole spinal canal is presented. A 45-year-old Korean male had a history of intracranial cysticercosis and showed progressive paraparesis. Spinal magnetic resonance scan showed multiple cysts compressing the spinal cord from C1 to L1. Three different levels (C1-2, T1-3, and T11-L1) required operation. Histopathological examination confirmed cysticercosis. The patient improved markedly after surgery.     

Spinal intramedullary cysticercosis: a case report and literature review

Neurocysticercosis, involvement of the central nervous system by taenia solium, is one of the most common parasitic diseases of the CNS. However, spinal involvement by neurocysticercosis is uncommon. Here, we reported a 40-year-old woman with intramedullary cysticercosis in the thoracic spinal cord. MRI revealed two well-defined round intramedullary lesions at T4 and T5 vertebral levels, which were homogeneously hypointense on T1WI and hyperintense on T2WI with peripheral edema. Since the patient had progressive neurological deficits, surgery was performed to decompress the spinal cord. Histopathology examination of the removed lesion proved it was intramedullary cysticercosis. In this report, we also discussed the principles of diagnosis and treatment of intramedullary cysticercosis in combination of literature review.     

Toward development of a Taenia solium paramyosin-based vaccine against porcine cysticercosis

Taenia solium paramyosin (TPmy) is a prominent 100 kDa antigen in human and porcine cysticercosis. TPmy is an alpha-helical coiled coil protein present in muscle and tegumentary structures of T. solium cysticerci. TPmy has the property of binding C1q resulting in inhibition of the complement cascade. TPmy probably binds C1q through its collagen-like domains and could be involved in a parasite strategy to modulate host immune response. Humoral immune response against TPmy is prefrentially directed against carboxyl terminal end in humans and mice, whereas amino terminal end of TPmy preferentially induces a Th1-related cellular immune response. Protection studies in murine model of cysticercosis showed that the amino terminal end fragment of TPmy induces approximately 60% protection against an i.p. challenge with Taenia crassiceps cysts when mice are immunized with recombinant fragments of TPmy. Initial protection studies using genetic immunization showed that amino terminal end fragment of TPmy cloned into a plasmid expression vector with a cytomegalovirus promoter, together with IL-12-expressing plasmids induced 79% protection, suggesting that this kind of TPmy-immunization might result in development of a cost-effective vaccine against cysticercosis.     

Changing trends in ocular cysticercosis over two decades: an analysis of 118 surgically excised cysts

PURPOSE: To evaluate the frequency of ocular cysticercosis and to demonstrate the changing trends in localisation of ocular cysticercosis along with a brief review of literature. METHODS: A retrospective analysis of histology proven ocular cysticercosis cases seen over a period of 20 years (1981 through 2000) was done. The pathology record forms were reviewed for demographics, clinical features with specific reference to the location of cysts in four subgroups: subconjunctival; intraocular orbit and eyelid. The distribution of cases in four five-year periods namely group A: 1981-1985, group B: 1986-1990, group C: 1991-1995 and group D: 1996-2000 and the changing trends in the location of cysts was evaluated. RESULTS: One hundred eighteen cysts from 118 patients aged 4-72 (mean 17.1) years were submitted to the pathology service of S D Eye Hospital, Hyderabad. Male to female ratio was 1: 1.2. Total number of cases in groups A, B, C and D were 33, 41, 16 and 25 respectively. Location of cysts was subconjunctival - 74 (62.7%); intraocular-31 (26.3%); orbital-8 (7%) and lid-5 (4%). In last 20 years, significant decrease (P =0.0001) was noted in subconjunctival cases (85% vs. 28%) with a significant rise (P =0.0001) in intraocular cysticercosis (6% vs. 60%). CONCLUSIONS: Frequency of surgically excised ocular cysticercosis remained constant over last two decades with an increasing manifestation of intravitreal cysticercosis in the recent years. This could imply either improved diagnostic modalities, available expertise in vitreo-retinal surgery or ineffective medical treatment for intraocular parasitic infection. The relative decrease in extraocular cysticercosis is probably due to the increased preference and success with medical management.     

CD4+ TCRαβ T cells are critically involved in the control of experimental murine cysticercosis in C57BL/6J mice

Taenia crassiceps cysticerci develop in the peritoneal cavity of BALB/cAnN mice and, to a lesser extent, in C57BL/6J mice. The mechanisms involved in the immunity to this murine cysticercosis seem to be mainly mediated by T cells. To gain further insight into the mechanisms of cysticercal immunity, the susceptibility of mice deficient in different immunologically relevant genes was compared with that of the respective wild type. Mice were classified according to the parasite load and survival after infection: highly susceptible (HS), with an increased parasite load and mortality rate (CD4-/-, TCRalpha-/-, TCRbeta-/-, RAG1-/-), susceptible, with only increased parasite load (TCRdelta-/-, BALB/cAnN), and relatively resistant, with a lower number of parasites (CD8-/-, WT). Neither specific proliferative response nor Th2 cytokine or antibody responses were observed in HS mice. These data strongly suggest that CD4+TCRalphabeta+ T cells have a critical role in the control of T. crassiceps murine cysticercosis.     

Akt对哮喘小鼠下呼吸道及内脏感觉传入部位IL-1β表达的影响

目的探讨在哮喘发病机制中,PKB/Akt对哮喘小鼠肺组织及C7-T5段脊神经节和相应节段脊髓后角IL-1β表达的调节作用。方法BALB/c小鼠30只,按随机数字表法均分为正常对照组、哮喘组、PKB/Akt阻断组,免疫组织化学检测各组小鼠肺组织及C7-T5节段脊神经节和相应节段脊髓后角IL-1β的表达,Western blot方法检测各组小鼠肺组织及C7-T5节段脊神经IL-1β的表达。结果免疫组织化学结果显示,哮喘组肺、C7-T5段脊神经节和相应节段脊髓后角IL-1β阳性产物的平均光密度值(MOD)显著高于正常对照组(P<0.01);而PKB/Akt阻断组与哮喘组相比MOD值明显降低(P<0.05)。Western blot结果显示:与正常对照组比较,哮喘组小鼠肺、C7～T5段脊神经中IL-1β的IDV(integrated density value)与β-actin IDV的比值均明显升高(P<0.01),而PKB/Akt阻断组明显低于哮喘组(P<0.05)。结论NGF介导的Akt通路的激活可上调IL-1β的表达,介导哮喘气道高反应和炎症反应。     

Anatomic variation of the spinal origins of lateral and medial pectoral nerves

Lateral and medial pectoral nerves are distributed to the pectoralis major and minor muscles. The purpose of this study was to identify the spinal origins of lateral and medial pectoral nerves and to evaluate the participating amounts of each spinal nerve composing both pectoral nerves. Two types of spinal origins appeared in lateral pectoral nerves. The first type was composed of nerve fibers from C5, C6, and C7 with a frequency of 50.0% and the second type was composed of nerve fibers from C6 and C7 at a frequency of 50.0%. Regarding the average participating diameter to the lateral pectoral nerve, C7 was the thickest with a value of 1.60 +/- 0.35 mm (mean +/- SD), next was C6 at 0.83 +/- 0.18 mm, and C5 was the third at 0.42 +/- 0.24 mm. Three types of spinal origin appeared in the medial pectoral nerve. The first type was comprised of nerve fibers from C8 and T1 in 73.3% of cases. The second type was comprised of C8 only in 23.4% of cases, and the third type was comprised of T1 only in 3.3% of cases. The average participating diameter was 0.71 +/- 0.22 mm from C8 and 0.52 +/- 0.17 mm from T1. These results show that the spinal origins of the both pectoral nerves were various. Participating amounts of the lateral pectoral nerve appeared sequentially in the order of C7, C6, and C5. In the medial pectoral nerve, C8 participated more amounts than T1.     

Two epitopes shared by Taenia crassiceps and Taenia solium confer protection against murine T. crassiceps cysticercosis along with a prominent T1 response

Taenia crassiceps recombinant antigens KETc1 and KETc12 have been shown to induce high level of protection against experimental murine T. crassiceps cysticercosis, an experimental model successfully used to test candidate antigens for use in vaccination against porcine Taenia solium cysticercosis. Based on the deduced amino acid sequence, KETc1 and KETc12 were chemically synthesized in linear form. Immunization with KETc1 induced 66.7 to 100% protection against murine cysticercosis, and immunization with KETc12 induced 52.7 to 88.1% protection. The elicited immune response indicated that both peptides contain at least one B-cell epitope (as demonstrated by their ability to induce specific antibodies) and one T-cell epitope that strongly stimulated the proliferation of T cells primed with either the free peptide or total cysticercal T. crassiceps antigens. The high percentage of spleen cells expressing inflammatory cytokines points to the likelihood of a T1 response being involved in protection. The protective capacity of the peptides and their presence in all developmental stages of T. solium point to these two epitopes as strong candidates for inclusion in a polyepitopic synthetic vaccine against T. solium pig cysticercosis.     

A rare case of disseminated cysticercosis: case report and literature review

Cysticercosis is a common tropical disease. One of the uncommon manifestations of cysticercosis and a rare complication is its disseminated form. We report an immunocompetent patient with disseminated cysticercosis who had involvement of the brain, subcutaneous tissues, lungs and skeletal muscles and presented with arthritis. He was otherwise asymptomatic in spite of the extensive involvement of multiple organs. A planned approach to therapy is necessary to prevent complications.     

Induction of protection against porcine cysticercosis by vaccination with recombinant oncosphere antigens

Two recombinant Taenia solium oncosphere antigens, designated TSOL18 and TSOL45-1A, were investigated as vaccines to prevent transmission of the zoonotic disease cysticercosis through pigs. Both antigens were effective in inducing very high levels of protection (up to 100%) in three independent vaccine trials in pigs against experimental challenge infection with T. solium eggs, which were undertaken in Mexico and Cameroon. This is the highest level of protection that has been achieved against T. solium infection in pigs by vaccination with a defined antigen. TSOL18 and TSOL45-1A provide the basis for development of a highly effective practical vaccine that could assist in the control and, potentially, the eradication of human neurocysticercosis.     

Specific innervation of guinea-pig superior cervical ganglion cells by preganglionic fibres arising from different levels of the spinal cord.

1. The synaptic contribution of preganglionic nerve fibres arising from the last cervical (C8) and the first seven thoracic spinal cord segments (T1-T7) to neurones of the guinea-pig superior cervical ganglion has been studied by means of intracellular recording during ventral root stimulation in vitro. 2. The majority of neurones received innervation from the middle segments (T2 and T3) of the length of spinal cord from which preganglionic fibres derive; an intermediate number of ganglion cells were innervated by fibres from the segments adjacent to these (T1, T4, and T5), and relatively few neurones by fibres from the most rostral and caudal segments supplying innervation to the ganglion (C8, T6 and T7). 3. Each neurone received preganglionic terminals from multiple thoracic segments (range 1-7, mean = 4-0). The estimated minimum number of preganglionic fibres contacting each neurone was 10, on average. 4. As a rule, the spinal segments innervating a neurone were contiguous. Thus we rarely encountered neurones innervated by segments located both rostrally and caudally to a segment which failed to provide innervation. 5. Neurones tended to be innervated predominantly by axons arising from a single spinal segment, with adjacent segments contributing a synaptic influence that diminished as a function of their distance from the dominant segment. All segments provided dominant innervation to at least some neurones. 6. Stimulating the ventral roots of C8-T7 in vivo showed that the axons arising from each segment produced a characteristic pattern of peripheral effects. Thus different populations of neurones in the superior cervical ganglion of the guinea-pig are innervated by preganglionic axons from different levels of the spinal cord, as originally suggested by Langley (1892) for the cat, dog, and rabbit. 7. On the basis of our in vitro studies we conclude that underlying the specificity of innervation of neurones of the superior cervical ganglion that can be inferred from in vivo experiments is a tendency for individual neurones to be innervated in a systematically graded fashion by a contiguous subset of the eight spinal segments which provide innervation to the ganglion.     

Towards a Taenia solium cysticercosis vaccine: an epitope shared by Taenia crassiceps and Taenia solium protects mice against experimental cysticercosis

The Taenia crassiceps recombinant antigen KETc7 has been shown to be effective as a vaccine against experimental murine cysticercosis, a laboratory model used to test potentially promising molecules against porcine Taenia solium cysticercosis. Based on the deduced amino acid sequence of this proline-rich polypeptide, three fragments, GK-1, GK-2, and GK-3, were chemically synthesized in linear form. Of the three peptides, only GK-1 induced sterile protection against T. crassiceps cysticercosis in 40 to 70% of BALB/cAnN male mice. GK-1 is an 18-amino-acid peptide which contains at least one B-cell epitope, as demonstrated by its ability to induce an antibody response to the peptide and T. crassiceps antigen without need of a carrier protein. Immunofluorescence studies revealed that anti-GK1 antibodies strongly react with the native protein in the tegument of T. crassiceps and also with anatomical structures of T. solium eggs, oncospheres, cysticercus, and tapeworm. GK-1 also contains at least one T-cell epitope, capable of stimulating the proliferation of CD8(+) and to a lower extent CD4(+) T cells primed either with the free peptide or T. crassiceps total antigen. The supernatant of the stimulated cells contained high levels of gamma interferon and low levels of interleukin-4. Similar results were obtained with T cells tested for intracellular cytokine production, an indication of the peptide's capacity to induce an inflammatory response. The remarkable protection induced by GK-1 immunization, its physicochemical properties, and its presence in all developmental stages of T. solium point to this synthetic peptide as a strong candidate in the construction of a synthetic vaccine against T. solium pig cysticercosis.     

海南汉族人群九个纤维蛋白原基因多态性及其与血浆纤维蛋白原水平的关系

目的 调查海南汉族健康人群αTaqⅠ和βBclⅠ、HinfⅠA／C、448G／A、βBsmA ⅠG／C、＋1689T／G、-148C／T、-249C／T、-455G／A多态性的等位基因频率及其与血浆纤维蛋白原（fibrinogen，Fg）水平的关系。方法 用比浊法测定238名健康个体的血浆Fg浓度，用PCR-限制性片段长度多态性方法及测序法分析多态性基因型，并用协方差分析比较9个位点的基因型与血浆Fg水平的关系。结果 海南汉族人群αTaqⅠ、βBclⅠ、HinfⅠA／C、C448、βBsmAⅠG／C、＋1689T／G、-148C／T、-249C／T、-455G／A稀有位点的等位基因频率分别为0．445、0．239、0．134、0．235、0．273、0．241、0．265、0．441、0．254，9个位点之间存在连锁不平衡；在总人群中，-455GA和AA基因型、-148CT和TT基因型、αTaqⅠT1T1基因型组的血浆Fg水平比野生型组高（P值均〈0．01）；在男性人群中，-455GA和AA基因型、-148CT和TT基因型、αTaqⅠT1T1、αTaqⅠT1T2基因型组的血浆Fg水平比野生型组高（P值均〈0．01）。在女性人群中，携带稀有位点A^-455、T^-148、αTaⅠT1的基因型组与野生型组之间的血浆赡水平差异无统计学意义。结论 在9个多态性位点之间存在连锁不平衡；A^-455、T^-148、αTaqⅠT1位点与血浆Fg水平增高关联，β-Fg-455G／A、-148C／T及α-TaqⅠ多态性与男性血浆Fg水平关联。     

Treatment of spontaneous cervical spinal subdural hematoma with methylprednisolone pulse therapy

We report herein a case of hyperacute onset of spontaneous cervical spinal subdural hematoma treated with methylprednisolone pulse therapy that showed good results. A 57-year-old man was admitted for posterior neck pain and paraparesis which occurred an hour ago. MRI revealed a ventral subdural hematoma distributed from the level of C1 down to T3, compressing the spinal cord. Conservative management with methylprednisolone pulse therapy was administered considering the patient's poor general condition. Although emergent surgical decompression is necessary in most cases of spinal subdural hematoma, conservative management with steroid therapy could be effective.     

磁共振扩散张量成像序列对脊髓型颈椎病的诊断价值

目的:分析3.0T磁共振（MR）扩散张量成像（DTI）序列对脊髓型颈椎病（CSM）的诊断价值。方法:选择福建中医药大学附属康复医院收治的30例CSM患者纳入观察组,另选择同期体检人群中年龄匹配的30例健康志愿者为对照组,均运用常规MRI序列及DTI技术进行扫描,运用DTI技术测量FA及ADC值,进行图像后处理及数据分析,观察组患者根据MR平扫结果分为A组（n=10,单纯硬膜囊受压）、B组（n=14,颈髓受压,信号正常）和C组（n=6,颈髓受压,T2WI高信号）,分析各组FA及DA值差异,评价DTI诊断脊髓型颈椎病的诊断价值。结果:对照组脊髓C2-3、C3-4、C4-5、C5-6、C6-7节段的ADC值与FA比较差异无统计学意义（P>0.05）;对照组与A、B、C组的ADC值、FA值存在显著性差异（P<0.05）,B组、C组的ADC值显著高于对照组（P<0.05）,FA值显著低于对照组（P<0.05）,A组ADC值、FA值与对照组比较差异无统计学意义（P>0.05）;从A组到C组,ADC值呈升高趋势,FA值呈降低趋势,差异显著（P<0.05）;MR T2WI、DTI序列扫描FA值、MR DTI序列扫描ADC值诊断扫描诊断CSM的敏感度与特异度为20.00%（6/30）与80.00%（24/30）,80.00%（24/30）与20.00%（6/30）,66.67%（20/30）与30.00%（9/30）。结论:DTI较常规MRI能更早期而准确地诊断CSM,是一种显示CSM病变和观察病变修复过程的有效手段。