Neuroimaging in alcoholism: CT and MRI results and clinical correlates

The objectives of our work are to develop methodologies capable of identifying the potential environmental health hazards of chemicals. These techniques are particularly useful when it is necessary to evaluate molecules that have not been synthesized as yet, or for which there is little or no toxicological information known. With the help of MULTICASE, an artificial intelligence program capable of uncovering the relationship between the presence of specific substructures in a molecule and its toxicity, and TOX II, a program capable of identifying the existence of such substructures in a new molecule, it is now possible to predict with a reasonable degree of certainty whether a new molecule will be toxic. TOX II will uncover any functionality previously found to be related to toxicity in any organic molecule. The evaluation is extensive and may include its automatically generated metabolites. The scope of TOX II is vast as more than 70 toxicological endpoints can be evaluated.     

MRI correlates of cognitive impairment in childhood-onset multiple sclerosis.

Objective: Brain MRI measures were correlated with neuropsychological function in 35 pediatric-onset multiple sclerosis (MS) patients and 33 age- and sex-matched healthy controls. Method: Mean age of MS patients was 16.3 ± 2.3 years with average disease duration of 4.3 ± 3.1 years. Cortical gray matter, thalamic, and global brain volumes were calculated for all participants using a scaling factor computed using normalization of atrophy method to normalize total and regional brain volumes for head size. T1- and T2-weighted lesion volumes were calculated for MS patients. Results: Cognitive impairment (CI) was identified in 29% of the MS cohort. Cognitive deficits predominantly involved attention and processing speed, expressive language, and visuomotor integration. Relative to controls, the MS group showed significantly lower thalamic volume (p p p p     

A case of Paragonimus Miyazaki with pleuritis and meningoencephalitis

A 35-year-old man was admitted to our hospital with fever and headache. Chest X-ray revealed right pleural effusion. Lab tests revealed increase of eosinophils in his serum and pleural effusion. After admission he complained of doplopia and neck stiffness. Lumber puncture revealed eosinophilia in the cerbrospinal fluid. Brain CT and MRI showed characteristic images of meningoencephalitis. The patient had eaten raw Potamon dehaani and the case was diagnosed as paragonimus miyazaki after administration of intradermal reaction and Ouchterony's double diffusion test. The patient was successfully treated with praziqantel. It revealed that the pleural effusion and brain edema disappeared chest X-ray and brain MRI. This case can be considered as a characteristic example of Paragonimus Miyazaki with pleuritis and meningoencephalitis.     

Etiology and outcome in 42 children with acute nonbacterial meningoencephalitis

In a prospective study of 42 cases of childhood meningoencephalitis occurring in 1974 and 1975, a diagnosis of an infectious agent was made in 30 (71%). California virus infections were most common; they were serious illnesses but had few sequelae. Benign illnesses with enteroviruses were also common. Miscellaneous and unknown agents accounted for the most seriously ill patients and for both deaths. Persistent neurologic deficits were unusual. Headaches, malaise, and changes in behavior were common but transient.     

Trimethoprim resistance and susceptibility genes in Staphylococcus epidermidis

OBJECTIVES: This study was performed to assess the acute effects of the new angiotensin II antagonist, candesartan cilexetil, on systemic and renal haemodynamics in patients with sustained essential hypertension [diastolic blood pressure (DBP) 95-114 mmHg]. METHODS: After 4 weeks of placebo treatment, systemic and renal haemodynamics were investigated in 17 patients with a mean age of 62 years and a mean systolic and diastolic blood pressure of 170/98 mmHg, just before (baseline) and for 4 h after administration of a single oral dose of candesartan cilexetil, 16 mg. Plasma concentrations of candesartan (the active compound formed from the pro-drug candesartan cilexetil), angiotensin II (Ang II), as well as plasma renin activity (PRA), were measured before and after dosing. RESULTS: At 2, 3 h and 4 h after dosing with candesartan cilexetil, systolic blood pressure (SBP) and DBP, as well as mean arterial pressure (MAP), were significantly lower than at baseline. The mean reduction in MAP 4 h after dosing was 8.8 mmHg (-6.5%). This effect was due to a fall in total peripheral resistance (TPR), while heart rate (HR), stroke volume (SV) and cardiac output (CO) were virtually unchanged. After 4 h there was a marked reduction in renal vascular resistance (RVR) of 0.0273 mmHg x ml(-1) x min (-16%), resulting in an increased renal plasma flow of 64.9 ml x min(-1) (14%). The glomerular filtration rate was increased by 7.75 ml x min(-1) (8%), and the filtration fraction (FF) was not significantly changed. There was no apparent relationship between the changes observed in systemic and renal haemodynamic variables and plasma concentrations of candesartan. Plasma renin activity increased over the study period, but in general the patients had low PRA. Changes in plasma concentrations of angiotensin II were inconsistent between patients. CONCLUSION: A single oral tablet of candesartan cilexetil, 16 mg, induced systemic and renal arterial vasodilatation and blood pressure reduction, without compromising renal perfusion or filtration or affecting cardiac performance. Plasma renin activity which was low in general, increased over the study period, but changes in plasma concentrations of angiotensin II were inconsistent.     

Histopathologic correlates of white matter changes on MRI in Alzheimer''s disease and normal aging

Human lipoproteins after their intestinal or hepatic synthesis undergo within vascular compartment important remodeling through the agency of endothelial lipases, Lecithin: Cholesterol Acyl Transferase and lipid transfer proteins, Cholesteryl Ester Transfer Protein (CETP) and Phospholipid Transfer Protein (PLTP). Following CETP and PLTP characteristics presentation, transfer proteins activities and role were described specifying notably mechanism and kinetic models of cholesteryl ester transfer reaction (shuttle and ternary collision complex mechanisms). Comparative study of Phospholipid Transfer Activities mediated by CETP and PLTP has shown that phospholipid transfer activities of PLTP and CETP are different and might rely on distinct mechanisms. PLTP mediated phospholipid transfers modulate cholesteryl ester transfer activity of CETP. In vivo PLTP is responsible for the net mass transfer of phospholipid from triglyceride rich lipoprotein towards HDL. Whereas PLTP has no intrinsic cholesteryl ester transfer activity, it enhances the transfer of cholesteryl ester from HDL to VLDL and LDL. Thus PLTP might be a determinant factor in modulating the CETP mediated redistribution of cholesteryl esters between pro-(LDL) and anti-(HDL) atherogenic lipoproteins.     

The intra-aortic antibacterial therapy of wounded patients with gunshot meningoencephalitis

The original decision of permanent introduction of antibacterial means to tissues of brain at gunshot meningoencephalitis is offered. For antibacterial therapy the intra-aortal catheter with diameter of 2,5 mm (through a.femoralis) was introduced. After washing the catheter by solution of crystalloid with heparin the various combinations of preparations in 5% solution of glucose were introduced: cephalosporin--8 g/day; hentamicin and brumacilin--240 mg/day accordingly, amicacin--1500 mg/day. Speed of introduction--20-50 mg/h, total volume--500 ml. The catheter was in aorta not more than 10 days, maximum--14 days. A described technique was applied in Burdenko Main Military Clinical Hospital on 34 wounded in head. At computer tomography of brain of all wounded intracranially the splinters and bullets were revealed, clinically--meningoencephalitis. Foreign bodies have been extracted after cupping of clinical and laboratory signs of meningoencephalitis. The authors consider, that the technique is effective not only at wounds of brain, but also at suppurative meningoencephalitis of other etiology.     

Bacterial meningoencephalitis. Case report and differential diagnosis

Products of cleavage of beta-carotene and certain apocarotenoids (beta-apo-4', 8', 10', and 12'-carotenols and citranaxanthol) were studied, and the dynamics of their generation in the presence of an enzyme preparation isolated from rabbit intestinal mucosa was determined. The data suggest that metabolism of beta-apocarotenols involves the production of retinal and beta-apo-14'-carotenal mediated by enzymes different from beta-carotene-15,15'-dioxygenase, which converts beta-carotene to retinal. A scheme of metabolic conversion of beta-carotene is discussed.     

Accumulation of hypointense lesions ("black holes") on T1 spin-echo MRI correlates with disease progression in multiple sclerosis

MRI findings are increasingly used as outcome measures in therapeutic trials in MS. The discrepancy between the extent of the lesions on conventional T2 images and the clinical condition of the patient is one of the problems encountered in such studies. This clinical-radiological paradox prevents the use of MRI data as surrogate markers of disability in MS. A recent pilot study suggested a relationship between hypointense lesions on T1 MRI and disability. To assess in more detail the correlation of changes in hypointense lesion load on T1-weighted spin-echo MR images ("black holes") with changes in disability in MS, we studied 46 patients with clinically definite MS at baseline and after a median follow-up of 40 months. There was a significant correlation between baseline disability and hypointense lesion load (Spearman rank correlation coefficient [SRCC] = 0.46, p = 0.001). In secondary progressive patients, the rate of accumulation of these "black holes" was significantly related to progression rate (SRCC = 0.81, p < 0.0001). We speculate that the appearance of hypointense lesions is the MRI equivalent of a failure of remission. Overall, T1 lesion load measurements correlated better with clinical assessments than T2 lesion load measurements. Quantification of hypointense lesion load on T1-weighted spin-echo MRI helps to resolve the clinical-radiological paradox between disability and MRI and has the potential to be a surrogate marker of disability in MS.     

Active vaccination against early summer meningoencephalitis

TBE is a rather rare disease (incidence in Switzerland 0.46/1,000,000 population per year). Acquisition occurs only in well known endemic areas through bites of infected ticks. The course of the disease is not trivial: 0.5-2% of cases are fatal, 2.7% have persistent serious paralysis and some 33% a postencephalitic syndrome. There is no specific therapy. An active vaccine is commercially available which is reliably immunogenic (99% of vaccinated persons develop protective antibodies) and involve only a few mild side effects. Mass vaccination seems not to be cost-effective but would be epidemiologically efficient, as a vaccination campaign in Austria has shown. Because of the increasing importance of leisure-acquired TBE infections, the Swiss recommendations could be formulated more liberally: active vaccination is recommended for everyone who regularly spends time in forests in an endemic area, be it for work or leisure.     

The development of hydrocephalus after intracranial hemorrhage in an infant with meningoencephalitis

The present paper describes the case of hydrocephalic infant resulting from the intracranial haemorrhage with coexisting meningitis. The evolution of brain changes in sonography is shown.     

Suspected bacterial meningoencephalitis in two adult horses

Bacterial infections (such as meningitis or meningoencephalitis) of the central nervous system are rare in horses. They are most prevalent in neonates as a result of septicaemia. A few cases have been reported in the adult and most have been fatal. Streptococcal species appear to be the organism most commonly identified in these cases. Thus, this disease may be a secondary complication of upper respiratory tract infections. Clinical signs are extremely variable making diagnosis difficult. In most cases, postmortem has been the definite diagnostic procedure. This paper describes the clinical course of disease, diagnosis and successful treatment of two presumptive cases of meningoencephalitis in adult horses.     

Probable acanthamoeba meningoencephalitis in a Korean child

A 5-year-old Korean boy developed multiple subcutaneous, nontuberculous granulomas and died with meningoencephalitis. Autopsy disclosed amebic granulomas in subcutaneous tissue, the left adrenal gland, and the pancreas, with more acute inflammatory lesions in the liver, kidney, and brain. The causative organism is believed to be an Acanthamoeba sp.     

Trimethoprim resistance plasmids: transferability and incompatibility groups (author's transl)

Over a three year period, 119 strains of enterobacteria isolated from patients have been found resistant to trimethoprim (TMP) and sulfonamides (Su); 11 strains were resistant to TMP only. MIC of TMP were between 32 and 2048 microng/ml. Three groups of strains are described: (1) thymineless variants (2 strains); (2) TMP resistance non-transferable into Escherichia coli K12 (95 strains); (3) TMP resistance transferable into E. coli K12 (33 strains). TMP marker and Su marker have been transferred independantly from 13 strains; they were cotransferred from 20 strains. The incompatibility group of 31 plasmids has been determined: 10 belong to the fi+ type, group FII; 21 belong to the fi--type, group 6, group 7, group 10, group N and group I1. Epidemiological implications of such a wide range of incompatibility groups among a small number of plasmids specifying TMP resistance are discussed.     

Concomitant infection with tick-borne encephalitis virus and Borrelia burgdorferi sensu lato in patients with acute meningitis or meningoencephalitis

Chronic lymphocytic leukemia involves the skin in a small percentage of patients and may portend an ominous prognosis in some patients. We report a series of eight biopsies from seven different patients in which the cutaneous leukemic infiltrate was confined exclusively to the region immediately surrounding primary epithelial neoplasms including squamous cell carcinoma (6), basal cell carcinoma (1) and actinic keratosis (1). The malignant lymphocytes appear to constitute a host response to these neoplasms and do not appear to suggest a rapid downhill course for these patients. These observations serve to 1) suggest a new pattern of cutaneous involvement by leukemic cells and 2) offer some insights into potential cellular trafficking patterns of these neoplastic cells.