ABSTRACT
Dipeptidyl-peptidase-like protein 6 (DPPX) antibody-associated encephalitis, mediated by DPPX antibodies in serum and/or cerebrospinal fluid, is a novel autoimmune encephalitis. It presents with multifocal and diverse neurological disorders characterized by the triad of prodromal weight loss and/or gastrointestinal symptoms (diarrhea predominately), cognitive-mental dysfunction, and central nervous system hyperexcitability. Brain magnetic resonance imaging shows non-specific abnormalities. Immunotherapy can result in clinical improvements, but the disease is prone to relapse.
ABSTRACT
Autoimmune glial fibrillary acidic protein astrocytopathy is a curable autoimmune inflammatory disease of the central nervous system. Meninges, brain, spinal cord and optic nerve are mainly involved. Radial paraventricular enhancement and/or long segment lesions of spinal cord with central enhancement can be seen on magnetic resonance imaging. Brain biopsy shows perivascular inflammation with microglia activation. The disease is sensitive to steroid therapy. Glial fibrillary acidic protein antibody is considered as a specific biomarker of the disease.
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Objective@#To investigate the treatment of auricle and periauricular arteriovenous malformations.@*Methods@#This is a retrospective study of 30 patients with auricle and periauricular arteriovenous malformations in Changfeng Hospital from February 2012 to March 2017. First, the patients were treated with anhydrous ethanol embolization, followed by transcatheter or direct percutaneous injection of anhydrous ethanol into the malformed vascular tissues. Angiography was performed every time with ethanol injection. The volume of malformed vascular tissues and injection pressure and speed were measured by hand-push angiography. The injection speed of the contrast agent was usually 0.2 ml/s, and malformed vascular tissue volume equal to the dose of the contrast medium filled with the malformed vascular tissues. With the same dose, injection pressure and speed, anhydrous ethanol was injected until all or part of the lesion was cured. The series of treatments were performed with the interval of 1 to 2 months. After embolization, wedge resection combined with lesion was performed to improve the shape of auricle, and to repair the defect of auricle in the cases of obvious auricle hypertrophy. The skin flap adjacent to the auricle was used to treat the auricle defect caused by embolization.@*Results@#The clinical manifestations of 30 patients such as ulcer, bleeding and tinnitus, were improved after 3 times of ethanol embolization. Angiography showed that the abnormal vascular mass completely disappeared in 8 patients. The vascular mass was shrunken by 50% to 75% in 15 patients, and that of 7 patients shrunken less than 50%. Six cases with obvious hypertrophic deformation of auricle were treated with wedge-shaped resection of auricle lesion to reduce the auricles. Three patients suffered partial auricle necrosis after ethanol embolization. They were treated with periauricular pedicle flap to repair the defects.@*Conclusions@#Sequential embolization with anhydrous ethanol could effectively improve the clinical manifestations and control the development of the lesions in patients with auricular arteriovenous malformations. When the auricle was obviously hypertrophic and deformed, the shape of the auricle could be improved with surgery.
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BACKGROUND AND PURPOSE: It has been reported that taking antiepileptic drugs (AEDs) may increase the risk of atherosclerosis. We performed a meta-analysis to evaluate the carotid artery intima-media thickness (CA-IMT) as a surrogate factor for atherosclerosis in epileptic patients. METHODS: We searched NCBI (PubMed), ISI Web of Knowledge, EMBASE, and the Cochrane Library databases for studies of the association between AEDs and CA-IMT in epileptic patients. A random-effects meta-analysis was used to pool results across studies. RESULTS: Fifteen studies involving 1,775 epileptic patients were included in the analysis. The overall CA-IMT was significantly larger among users of AEDs [mean difference (MD)=0.09 mm, 95% confidence interval (CI)=0.06–0.12 mm). When stratified by age, the MD was similar in adult patients (MD=0.09 mm, 95% CI=0.06–0.13 mm), but no significant difference was observed in children (MD=0.03 mm, 95% CI=0.00–0.07 mm). Regarding specific AEDs, monotherapy with carbamazepine (CBZ) or valproic acid (VPA) was associated with a larger CA-IMT, while phenytoin monotherapy was not and the result for lamotrigine was inconclusive. CONCLUSIONS: This study suggests that using AEDs is associated with the CA-IMT in patients with epilepsy, particularly for adult patients. In particular, CBZ and VPA may be related to a significant increase in CA-IMT.
Subject(s)
Adult , Child , Humans , Anticonvulsants , Atherosclerosis , Carbamazepine , Carotid Arteries , Epilepsy , Phenytoin , Valproic AcidABSTRACT
OBJECTIVE To investigate the significance of expression of p53, Mdm2 and p21WAF/ CIP1 proteins and their relationships. METHODS Pathological specimens from thyroid carcinoma, adjacent non-tumor thyroid tissues and thyroid benign lesions were examined for p53, Mdm2 and p21WAF/CIP1 proteins by tissue microarray technique and immunohistochemistry method. RESULTS The positive expression rate of p53, Mdm2 and p21WAF/CIP1 in thyroid carcinoma was 50.6 %(37/73), 63.0 %(47/73) and 38.4 %(28/73) respectively. The expression of p53 and Mdm2 increased(P