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Objective

We aimed to determine the levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) in patients admitted to the emergency department with impaired consciousness due to metabolic or neurological reasons.

Materials – methods

The study included 80 patients with ischemic stroke (IS), 40 patients with intracranial hemorrhage (ICH), 80 patients with metabolic disorder induced impaired consciousness (MDIC) and 40 healthy controls.

Results

The levels of UCH-L1 [median (IQR)] were as follows: 5.59 ng/mL (3.90–9.37) in IS, 5.44 ng/ml (4.01–13.98) in ICH, 3.34 ng/ml (2.29–5.88) in MDIC and 3.94 ng/ml (3.31–7.95) in healthy volunteers. Significantly higher levels were detected in IS and ICH than in MDIC and healthy volunteers. In ROC curve analysis, we detected 63.75% sensitivity and 62.5% specificity (AUC = 0.626, p < 0.0199, 95% CI: 0.533–0.713) with a cutoff value of 4.336 ng/ml for IS and 75% sensitivity and 55% specificity (AUC = 0.664, p < 0.0071, 95% CI: 0.549–0.766) with a cut-off value of 4.036 ng/ml for ICH. However, the sensitivity and specificity for MDIC was 36.25% and 77.5%, respectively, with a cut-off value of 3.256 ng/ml (AUC = 0.525, p = 0.6521, 95% CI: 0.432–0.617). UCH-L1 levels were found to increase significantly with increasing time between the onset of symptoms and blood sampling (r = 0.345, p < 0.001). However, no correlation was found between UCH-L1 levels and age (r = 0.014, p = 0.833), GCS (r = ? 0.115, p = 0.074), mRS (r = 0.063, p = 0.475) and NIHSS (r = 0.056, p = 0.520).

Conclusion

In this study, we detected significantly higher levels of UCH-L1 in patients with IS and ICH compared to patients with MDIC and healthy volunteers.  相似文献   
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Extracts of Ginkgo biloba (EGb) are among the most prescribed drugs in France and Germany. EGb is claimed to be effective in peripheral arterial disorders and in "cerebral insufficiency." The mechanism of action is not yet well understood. Three of the ingredients of the extract have been isolated and found to be pharmacologically active, but which one alone or in combination is responsible for clinical effects is unknown. The recommended daily dose (3 x 40 mg extract) is based more on empirical data than on clinical dose-findings studies. However, despite these, according to double-blind, placebo-controlled clinical trials, EGb has therapeutic effects, at least, on the diagnostic entity of "cerebral insufficiency," which is used in Europe as synonymous with early dementia. To determine whether EGb has significant pharmacological effects on the human brain, a pharmacodynamic study was conducted using the Quantitative Pharmacoelectroencephalogram (QPEEG(R)) method. It was established that the pharmacological effects (based on a predetermined 7.5--13.0-Hz alpha frequency band in a computer-analyzed electroencephalogram = CEEG(R)) of EGb on the central nervous system (CNS) are significantly different than placebo, and the high and low doses could be discriminated from each other. The 120-mg, but particularly the 240-mg, single doses showed the most consistent CNS effects with an earlier onset (1 h) and longer duration (7 h). Furthermore, it was established that the electrophysiological effects of EGb in CNS are similar to those of well-known cognitive activators such as "nootropics" as well as tacrine, the only marketed "antidementia" drug currently available in the United States.  相似文献   
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Intracardiac tuberculomas are extremely rare, and cardiac involvement in tuberculosis accounts for only 0.5% of extrapulmonary tuberculosis. We report for the first time incremental value of live/real time three‐dimensional transesophageal echocardiography over two‐dimensional transesophageal echocardiography in the assessment of a tuberculoma involving the left atrium and left atrial appendage.  相似文献   
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