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ABSTRACT: To determine the clinical features of hepatic myelopathy (HM), a rare condition associated with chronic liver disease (CLD), in patients in the city of Harbin, China.
The medical files of 13 patients with HM were selected from 500 randomly chosen files of CLD patients registered in four Harbin hospitals. General information on all cases was summarised and clinical features were compared between HM positive patients (HM group) and HM negative CLD patients (control group). Detailed analysis of the clinical characteristics of HM positive patients was undertaken.
The patients in the HM group ranged in age from 41-50 years, which did not differ significantly from the control group. However, the sex ratio in the HM group (12 males/1 female) was significantly higher (p<0.05) than in the control group (342 males/145 females).The most frequent underlying aetiology was post type B hepatitis (12 cases). All cases in the HM group had a history of relapsing hepatic encephalopathy (HE) before or after HM onset, and showed electroencephalographic (EEG) abnormalities; however, the results of spinal cord magnetic resonance imaging were negative, and cerebrospinal fluid analysis findings were normal. Except for clinical manifestations of bilateral lower limb spastic paralysis, the two groups did not differ significantly in regard to other symptoms or signs. Hypoproteinaemia (positive predictive value (PPV) 5.69%, negative predictive value (NPV) 99.65%), blood ammonia elevation (PPV 5.29%, NPV, 99.32%) and abnormal EEG (PPV 5.00%, NPV 100.00%) were sensitive and specific for HM diagnosis.
In Harbin, HM is found mainly among middle aged men with CLD caused by viral hepatitis and accompanied by relapsing onset of HE. Bilateral lower limb spastic paralysis with hypoproteinaemia, blood ammonia elevation and/or abnormal EEG are significant diagnostic indicators of HM.
Postgraduate medical journal 03/2009; 85(1000):64-8. · 1.38 Impact Factor
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ABSTRACT: Ischemic brain injury is acute local inflammation, leading to accumulation of pro-inflammatory cytokines. Cytokines influence the recruitment of leucocytes and play a key role in the inflammatory injury processes. Recently, a number of studies have demonstrated a close relationship between brain ischemia and cytokines. Interleukin-17 (IL-17) is a newly identified T-cell-specific cytokine. In this study, we evaluated the source and the action of IL-17 over the course of cerebral ischemia in rats (Sprague-Dawley) and humans. The levels of IL-17 in the ischemic hemisphere of the human brain, which was removed at necropsy, were assayed immunohistochemically. In rats, permanent middle cerebral artery occlusion (pMCAO) was obtained by inserting nylon monofilament into the right external carotid artery, occluding the right middle cerebral artery. The expression of IL-17 mRNA in rat was assayed using oligoprobe in situ hybridization. IL-17 production by neuroglial cells was assayed by double-staining using antibody glial fibrillary acidic protein (GFAP) and antibody IL-17. Levels of IL-17 were elevated in the ischemic hemispheres of human brain compared with the opposite normal hemispheres and peaked at days 3-5 after brain ischemia. The IL-17-positive cells were found in the ischemic lesion region. IL-17 mRNA was also elevated in ischemic hemispheres of pMCAO-operated rats, which were slightly elevated after 1 h and peaked at 6 days. IL-17 and GFAP double-stained were extensive in rat ischemic hemisphere. The ischemia-induced IL-17 expression in human brain reported here for the first time was very similar to that in rat model except that the peak was slightly earlier. We found for the first time that IL-17 was involved in an intense inflammatory reaction of brain ischemic injury in human. In pMCAO-operated rats, our findings suggest that IL-17 is produced by the neuroglial cells in the brain region undergoing ischemic insult. We suggest that in additional to T cells the neuroglial cell may be another cellular origin of IL-17 in later progression of brain ischemia.
Scandinavian Journal of Immunology 12/2005; 62(5):481-6. · 2.23 Impact Factor
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ABSTRACT: In search for genes associated with hepatocellular carcinoma (HCC) by cDNA microarray, we found that the transcription of TSPY, 'testis-specific protein Y-encoded', was upregulated in HCC. Investigation of a broad spectrum of normal and malignant tissues by RT-PCR revealed the TSPY transcript selectively expressed in normal testis, different histological types of human neoplastic tissues, and tumour cell lines. The expression of TSPY in cancer cells was further confirmed by in situ hybridisation. Indirect immunofluorescence microscopy analysis showed that TSPY was localised mainly in the cytoplasm of transiently transfected cells. Testis-specific protein Y-encoded was detected in 50% (16 of 32) of well- and moderately differentiated HCC patients, in 16% (four of 25) of poorly differentiated HCC patients, and in 5% (one of 19) of renal cell cancer patients. A serological survey revealed that 6.6% (seven of 106) HCC patients had anti-TSPY antibody response, demonstrating the immunogenicity of TSPY in humans. In conclusion, these data suggest that TSPY is a novel cancer/testis (CT) antigen and may be a potential candidate in vaccine strategy for immunotherapy in HCC patients.
British Journal of Cancer 09/2005; 93(4):458-63. · 5.04 Impact Factor
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ABSTRACT: To identify tumour and tumour-associated antigens in patients with hepatocellular carcinoma (HCC) one may find potential diagnostic markers and immunotherapeutic targets. In the current study, 30 distinct antigens reactive with serum IgG from HCC patients were identified by serological analysis of cDNA expression libraries (SEREX). The mRNA expression patterns of 14 of these 30 antigens were altered in cancer as further revealed by cDNA microarray, with upregulation for nine and downregulation for five antigens. One of the upregulated antigens was cancer-testis (CT) antigen (CAGE), which had been previously reported to be expressed exclusively in normal gametogenic tissues and aberrantly expressed in a variety of cancer cells. In our study, CAGE mRNA was expressed in 39.4% of HCC patients, 73.3% of patients with gastric cancer and 30.8% of patients with colorectal cancer. Antibodies against CAGE protein were detected in approximately 5.1% of the sera from HCC patients, 8.3% of that from gastric cancer patients and 7.3% of that from colorectal cancer patients. The relative high incidence of CAGE in cancer cells makes it a potential target for vaccine design. Another antigen of great interest is transgelin 2. The overexpression of transgelin 2 mRNA in a large per cent (69%) of HCC points to its potential as a diagnostic marker for HCC.
British Journal of Cancer 04/2005; 92(5):929-34. · 5.04 Impact Factor
