Serum tumor necrosis factor-like weak inducer of apoptosis levels are elevated in schizophrenia

Objective: The purpose of this study was to assess serum Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) concentrations to determine whether changes in patients with schizophrenia could have etiopathogenetic importance. Since very little research has addressed the connection between the inflammatory marker TWEAK and schizophrenia, we wanted to examine alterations of TWEAK and investigate the possible correlation between clinical symptomatology and serum concentrations. Methods: A total of 45 schizophrenia patients and 40 healthy controls were included in this study. The Positive Symptom Assessment scale and the Negative Symptom Assessment scale were administered to determine symptom severity. Venous blood samples were collected and serum TWEAK levels were measured. Results: Serum TWEAK levels were significantly higher in the schizophrenia group than the control group, independently of potential confounders, including sex, age, body mass index and smoking status. Conclusion: The results indicate that TWEAK is elevated in schizophrenia patients, which could deepen our understanding of the role of inflammation in the pathogenesis of schizophrenia.

Serum galectin-3 levels are decreased in schizophrenia

Objective: To determine whether changes in serum galectin-3 (gal-3) concentrations in schizophrenia patients have etiopathogenetic importance. Since very little research has assessed the connection between galectins and schizophrenia, we wanted to examine alterations in the inflammatory marker gal-3 in schizophrenia and investigate possible correlations between clinical symptomatology and serum concentrations. Methods: Forty-eight schizophrenia patients and 44 healthy controls were included in this study. The Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were administered to determine symptom severity. Venous blood samples were collected, and serum gal-3 levels were measured. Results: Mean serum gal-3 levels were significantly lower in schizophrenia patients, and there were no significant differences in age or sex with the control group. There was also a significant positive correlation between serum gal-3 concentrations and negative schizophrenia symptoms according to the SANS. Conclusion: The results indicate that gal-3 is decreased in schizophrenia patients, which could contribute to inflammation in the pathogenesis of schizophrenia.

Serum albumin and total protein level as plausible marker for diagnosis of protein energy malnutrition in children under age 5 years

Background: The circulating concentration of transport protein, traditionally albumin, has been used to define protein deficiency. However, few studies have been conducted to see if there is any correlation between serum total protein and albumin levels in children with PEM. Hence the study was planned to estimate serum total protein, serum albumin levels in children with PEM and healthy controls.Methods: All the children were divided in two groups. Case Group A consist of 250 children with protein energy malnutrition and control Group B consist of healthy 250 children. Venous blood of amount 3 ml was collected with full aseptic precautions. The blood was collected in the EDTA vacutainer and test tube. Serum total protein was estimated by Biuret method, serum albumin was estimated by Bromocresol green dye method (BCG dye).Results: When the mean serum levels of albumin levels and the total protein levels were measured in the controls as well as case groups, there was decrease in levels in case group as compared to control group. This difference of decrease when evaluated statistically it was found to be statistically significant. When the albumin/globulin ratio was calculated in both the groups, it was found to be statistically lower in case group as compared to control group. PEM children have low serum total protein and albumin levels as compared to healthy controls (p<0.001), this is probably due to decreased intake of proteins and reduced biosynthesis. PEM children have lower hemoglobin levels as compared to healthy controls; this is probably due to deficiency of iron and other micronutrients, which is often found in a child with malnutrition.Conclusions: Early diagnosis and prompt management of PEM and its complications can prevent development of permanent physical and mental retardation.

Effect of age and sex on serum phenytoin concentration in epileptic patients: experience from therapeutic drug monitoring

Background: Phenytoin is a widely prescribed anticonvulsant drug. There is a wide interpatient as well as intrapatient variability in serum phenytoin levels despite standard doses. Phenytoin dosing is challenging because the drug exhibits nonlinear kinetics and interacts with a number of drugs. Children metabolize the drug faster as compared to adults. Ageing is also associated with progressive decline in phenytoin clearance. Many CYP450 enzymes show a sex-dependent difference in activity. The objective for this study was to find the effects of sex and ageing on serum phenytoin levels.Methods: The influence of sex and ageing on the serum phenytoin levels was evaluated retrospectively in 96 anonymized epileptic patients who had received phenytoin alone for more than four weeks. These patients were divided into three age groups, up to 18 years (children), 19-60 years (adults) and more than 60 years (elderly).Results: There were 6.25% children, 84.37% adults and 9.37% elderly. The majority (71.87%) of patients were males. Children achieved a mean phenytoin level of 15.71±4.85 µg/ml after a daily dose of 225.00±75.82 mg. Adults attained a mean serum phenytoin level of 16.12±3.90 µg/ml with a mean daily dose of 282.72±69.44 mg. The elderly achieved a mean serum phenytoin level of 15.85±2.19µg/ml after a mean daily dose of 266.67±70.71 mg. As compared to 77.77% females, 84.05% males had phenytoin levels in therapeutic range. 50.00% children, 82.71% adults, and 100.00% elderly had phenytoin levels in therapeutic range. There was a correlation between sex, age and serum phenytoin levels (r = 0.003 to 0.762).Conclusions: There was a correlation between sex, age and serum phenytoin levels in this study. A better understanding of the effects of sex and age on the clinical pharmacology of phenytoin would enhance the quality of prescribing.

The clinical diagnosis value and significance of serum sH2a level on early hepatic fibrosis degree / 中华实验和临床病毒学杂志

Objective@#We aimed, in our prospective study, to assess the predictive value of serum non-invasive and biochemical markers for clinical diagnosis of significant fibrosis (including early stages).@*Methods@#We measured sH2a levels in serum, comparing with routine liver function markers. We compared blindly pretreatment serum samples from a cohort of hepatitis B patients without non-alcoholic fatty liver disease(NAFLD), which had histological grades of liver fibrosis, with NAFLD individuals and CHB with NAFLD patients. Statistical analysis was by Student′s t test, and receiver-operating characteristic (ROC) curves were drawn.@*Results@#ROC curves showed that serum sH2a had greater diagnostic performance than routine liver function markers compared with histological grades of liver fibrosis(S0, S1-2, S3-4). ROC curves showed that using a sH2a cut-off point of 0.79 was with highest sensitivity as 63% and highest specificity as 80%. And sensitivity as 96.7% and specificity as 75.5% when using a sH2a cut-off point of 0.77.@*Conclusions@#sH2a has the potential to be a uniquely sensitive and specific novel marker for liver fibrosis and function.

Serum methotrexate level is inversely related to the outcome of osteosarcoma patients / 소아과

PURPOSE: To evaluate the correlation between serum methotrexate (MTX) peak levels and clinical outcome of osteosarcoma, as well as to determine the correlation of these levels with the histologic response and event-free survival (EFS). METHODS: To maintain the homogeneity of the study population, we selected 52 patients with localized extremity osteosarcoma who had received two cycles of neoadjuvant chemotherapy consisting of high-dose (HD) MTX (12 g/m2), cisplatin (100 mg/m2), and doxorubicin (60 mg/m2). RESULTS: Totally, 204 courses of HD MTX were administered. The serial MTX levels (mean+/-SE) at 4 h (peak), 24 h, 48 h, and 72 h were 1292.14+/-12.83 micrometer, 9.29+/-3.89 micrometer, 1.73+/-1.37 micrometer, and 0.58+/-0.44 micrometer, respectively. The peak MTX serum level was 1292.14+/-12.83 micrometer. Neither the continuous average MTX peak level nor the dichotomized MTX peak level was related to the histologic response. However, the patients with a high 24-h MTX level (3.4 micrometer) had a poor histologic response (P=0.044). An inverse relationship was observed between MTX levels and survival: the EFS was better in the patients with a mean MTX peak level of less than 1,400 micrometer (P=0.002) and mean 24-h MTX level of less than 3.4 micrometer (P=0.011). CONCLUSION: The inverse correlation between the MTX level and the outcome is an unexpected finding. Further study on the pharmacokinetics of MTX is required to substantiate our findings and elucidate the mechanism involved.

Serum methotrexate level is inversely related to the outcome of osteosarcoma patients / 소아과

PURPOSE: To evaluate the correlation between serum methotrexate (MTX) peak levels and clinical outcome of osteosarcoma, as well as to determine the correlation of these levels with the histologic response and event-free survival (EFS). METHODS: To maintain the homogeneity of the study population, we selected 52 patients with localized extremity osteosarcoma who had received two cycles of neoadjuvant chemotherapy consisting of high-dose (HD) MTX (12 g/m2), cisplatin (100 mg/m2), and doxorubicin (60 mg/m2). RESULTS: Totally, 204 courses of HD MTX were administered. The serial MTX levels (mean+/-SE) at 4 h (peak), 24 h, 48 h, and 72 h were 1292.14+/-12.83 micrometer, 9.29+/-3.89 micrometer, 1.73+/-1.37 micrometer, and 0.58+/-0.44 micrometer, respectively. The peak MTX serum level was 1292.14+/-12.83 micrometer. Neither the continuous average MTX peak level nor the dichotomized MTX peak level was related to the histologic response. However, the patients with a high 24-h MTX level (3.4 micrometer) had a poor histologic response (P=0.044). An inverse relationship was observed between MTX levels and survival: the EFS was better in the patients with a mean MTX peak level of less than 1,400 micrometer (P=0.002) and mean 24-h MTX level of less than 3.4 micrometer (P=0.011). CONCLUSION: The inverse correlation between the MTX level and the outcome is an unexpected finding. Further study on the pharmacokinetics of MTX is required to substantiate our findings and elucidate the mechanism involved.

Prognostic Significance of Serum and Tissue Carcinoembryonic Antigen in Patients with Gastric Adenocarcinomas / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Carcinoembryonic antigen (CEA) is known to be elevated in nearly all solid malignancies. The prognostic role of CEA in gastric cancers however, is still controversial. We evaluated preoperative serum CEA levels and CEA expression from the resected tumor tissues to determine whether they have prognostic significance in gastric cancer patients. MATERIALS AND METHODS: Medical records of 810 patients who underwent surgery for gastric adenocarcinoma from June, 1998 to February, 2002 in Kyungpook National University Hospital were reviewed. Serum CEA level was evaluated by radioimmunoassay preoperatively, and the cut-off level for positivity was 7.0 ng/ml. Labeled streptavidin-biotin peroxidase method was used to determine CEA expression from the gastric cancer tissues. RESULTS: Serum and tissue CEA were positive in 9.3% and 91.1% of the patients, respectively. They had no correlation with each other. The positivity rate of serum CEA had positive correlation with invasion depth (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.006), and final stage (p<0.001). Well differentiated tumors showed higher serum CEA positivity (p=0.002). Patients with positive serum CEA had higher recurrence rate (p<0.001). Multivariate analysis showed significantly lower survival rate in patients with preoperative CEA levels over 7 ng/ml than those with lower levels (48.0% vs. 80.7%; p<0.001). The positivity rates of tissue CEA were higher in advanced cancers (p=0.033) and in more advanced stages (p=0.029). Tissue CEA positivity showed no correlation with recurrence or survival. CONCLUSIONS: Preoperative serum CEA level had correlation with disease progression and survival in gastric cancer patients, and proved to be an independent prognostic factor. Tissue CEA expression in gastric cancers had no prognostic information.

Protective effects of propofol on renal injury during liver ischemia-reperfusion / 中国康复理论与实践

@#ObjectiveTo investigate the remote renal injury after liver ischemia-reperfusion(I/R) and the renal protection afforded by propofol.Methods 72 male SD rats were randomly divided into three groups:normol control group, I/R group and propofol group .The animals were killed after 60 minutes ischemia of liver followed by reperfusion for 4 h,2 h. Blood urea nitrogen (BUN) and creatinine (Cr) were detected,and renal histopathologic lesion were observed.ResultsIn I/R group,the serum level of BUN and Cr increased significantly compared with the baseline before liver I/R,while propofol could decrease the serum level of BUN and Cr significantly.ConclusionPropofol can reduce the renal injury during liver I/R.

Detection of tryptase and its clinical implication / 医学研究生学报

Tryptase,a multifunctional inflammatory mediator,is mainly secreted by activated mast cells and can initiate the development of many diseases.Accordingly the plasma tryptase level is increased with the degranulation of the mast cells,and the detection of the changes in its serum level may provide valuable evidence for the clinical diagnosis and treatment of related diseases.

Tumor Necrosis Rate to Peak Serum Level of MTX in the Preoperative Chemotherapy of Osteosarcoma / 대한정형외과학회잡지

PURPOSE: High dose methotrexate (HDMTX) dramatically increases survival rate, which is related to the histologic response of tumornecrosis rate in the treatment of osteosarcoma. But, the study of tumor necrosis rate after preoperative chemotherapy with MTX has notbeen systemically evaluated. We analysed tumor necrosis rate versus related parameters such as the MTX serum peak level, age, sex, location, pathologic type under two chemotherapeutic protocols (modified T10 & T20). MATERIALS AND METHODS: From June 1995 to June 2001, 44 cases of Enneking stage IIB osteosarcoma patients (29 males, 15 females, mean age 18) were treated with two similar neoajuvant chemotherapeutic protocols involving intravenous injections of MTX, ifosphamide, adriamycin and the intra-arterial injection of cisplatin preoperatively. The histologic response to the chemotherapy was graded as complete(100% necrosis) or incomplete (less than 100%). RESULTS: Of 44 patients, 26 showed serum MTX concentrations greater than 1, 000 micromol/L. Complete response was seen in 9 patients with a peak serum MTX level of 1, 000 micromol/L or greater. Complete response was seen in 34.6% of patients with 1, 000 mol/L orgreater MTX serum peak level (p=0.031). Seven of 15 female patients showed complete response. Three of 29 male patients showed complete response. The complete response rate of females was significantly higher than that of males (p=0.019). Histological response was not significantly correlated with other variables. CONCLUSION: In this study, the rate of complete necrosis was significantly higher in patients with a preoperative peak serum MTX levelover 1, 000 micromol/L, especially in females, than in those with a serum MTX below this level. We suggest the preoperative dose of MTXserum peak level should be maintained at over 1, 000 micromol/L, and suggest that the preoperative MTX dose should be maintained at ahigh level in order to increase the tumor necrosis rate.

Study on Serum Level of Phenobarbital after Intravenous Administration of Loading Dose

PURPOSE: To learn the changes of phenobarbital serum level after intravenous administration of loading dose and to determine the optimal time of maintenance therapy to support therapeutic concentration. METHODS: A total of 24 patients, who were admitted to the pediatric ward for treatment of ongoing and recurrent seizure, were enrolled in this study from November, 1994 to August, 1996. None of them had taken other anticonvulsants before and their age varied from 8 days old to 7 years old. Loading dose of 20mg per kg of phenobarbital was administered intravenously, and sequential plasma samples were obtained at 2, 6, and 12 hours after administration. RESULTS: The mean serum concentration of phenobarbital was 23.65 (11.53-36.81) microgram/ml after 2 hours, 22.78 (10.97-35.29) microgram/ml after 6 hours and 20.79 (9.79-33.01) microgram/ml after 12 hours. We divided the patients into 2 groups by the 12-hour levels, group A : therapeutic level (>20 microgram/ml), and group B : subtherapeutic level. The mean 12-hour level in group A was 25.39 (20.13-33.01) microgram/ ml and 16.24 (9.79-19.48) microgram/ml in group B. The mean 2-hour level in group A was 28.30 microgram/ml and 19.00 microgram/ml in group B (P<0.05). The mean decline rate of serum phenobarbital level was 0.34 microgram/ml/hr in group A and 0.29 microgram/ml/hr in group B. And there was no significant difference between the two groups. CONCLUSION: It is usually effective to begin maintenance therapy 12 hours after loading dose, but in cases where 2-hour serum level of phenobarbital is below 20 microgram/ml, it is better to begin maintenance therapy earlier.

A Study on the Serum Level of Phenytoin after Intravenous Administration of Loading Dose

PURPOSE: Phenytoin is effectively and widely used drug for the treatment of status epilepticus and patient with ongoing seizure by intravenous infusion. It is generally recommended to maintain serum concentration above 10microgram/ml for the sustained effective anticonvulsant effect. This study was designed to know the optimal time to begin oral maintenance therapy after initial intravenous infusion. METHODS: Total 17 patients with status epilepticus and ongoing seizure who were admitted to the pediatric department of Han Yang University during the period from July 1993 to September 1995 were enrolled in this study and serum level was monitored at 2, 6 and 12 hours after the intravenous phenytoin infusion of loading dose, 20mg/kg of body weight by enzyme multiplict immunoassay technic. Student t-test was used for statistical analysis and P value below 0.05 interpreted as statistically significant. RESULTS: 1) The subjects were 5 boys and 12 girls, average age was 7.6 years old and age distribution was from 3 months to 15 years old. 2) The serum concentration ranged from 9.42microgram/ml to 43.98microgram/ml (24.04+/-8.97microgram/ml) after 2 hours, 8.82microgram/ml to 33.95microgram/ml (18.62+/-6.43microgram/ml) after 6 hours, and 7.20microgram/ml to 31.38microgram/ml (14.97+/-6.58microgram/ml) after 12 hours. 3) There was no significant differences of average serum concentration and the decline of serum concentration by time between patients over and below 2 years of age and both sexes. 4) The average decrease in serum phenytoin concentration per hour was 0.91microgram/ml. 5) The average maintenance duration of therapeutic serum level after initial infusion of loading dose was 22.4 hours. CONCLUSIONS: The average maintenance duration of therapeutic serum level after initial infusion of loading dose was 22.4 hours, hence it would be appropriate to administer maintenance dose of phenytoin if the serum level at 2 hours after loading dose is satisfactory.

Intravenous Sodium Valproate(Depakine(R)):Antiepileptic Effect and Safety Assessment During the Postoperative Seven Days in Neurosurgical Patients

Diphenylhydantoin(DPH) has been used intravenously as a drug of choice in conditions which seizure patients are incapable of oral feeding or in a state of status epilepticus. However, its clinical use has limitations because of its serious side effects of cardiac depression or systemic hypotension. In Western countries, the recently developed intravenous sodium valproate has been reported as safe and effective for seizure control in such patients. To assess the safety and effectiveness in seizure control, we investigated the serum levels of the drug at 24 hours, 48 hours, and 7 days after intravenous administration of sodium valproate(Depakine(R)), occurrence of seizures in the perioperative period, and the side effects of the drugs in 30 neurosurgical patients older than 3 years of age. The mean serum concentrations of valproic acid after bolus injection of 15mg/kg followed by continuous infusion with the rate of 0.5mg/kg/hour, were over 45.0 microgram/ml;45.0+/-16.3 microgram/ml at 24 hours, 50.4+/-21.0 microgram/ml at 48 hours, and 58.9+/-20.7 microgram/ml at 7 days after the start of the administration. All the patients whose serum valproic acid level was within the therapeutic range(40-100 microgram/ml), had never experienced an episode of seizure attack during the perioperative days. There was no evidence of elevated liver enzyme activity, but there were evidence of some tendency of decreased platelet count in the peripheral blood at 2 days after the administration of intravenous valproic acid. Four patients experienced episodes of mild nausea and/or vomiting. In conclusion, perioperative intravenous administration of valproic acids in neurosurgical patients was safe and effective in seizure control. However, it must be used precauciously in the patients with compromised coagulation system.

Evaluating the renal function in goats submitted to a treatment with hemolysed blood / Alterações renais funcionais em caprinos submetidos a infusão intravenosa de hemolisado

In order to evaluate the effects of hemoglobinemia on renal function, urinalysis, blood urea nitrogen and serum creatinine tests were done onthirty two goats submitted to a treatment with hemolysed blood. Blood samples were collected from five animals of the first group in an amount of 5 ml/kg of body weight, submitted to mechanical rupture by freezing and 2 days later, given to the same animal by intravenous route. The second and third groups were each consisted by five goats; 10 ml/kg/BU blood samples were collected from goats of the group II and 15 ml/kg/BW blood samples from group III animals and afterward submitted to the same procedure as done in group I. Animal of the group IV were submitted to intravenous adninistration of 2.5 ml hemolysed blood/kg/BW every other day for 8 days, following a single collection of 10 ml/kg/BU in the first day. Urinalysis revealed glucosuria, hemoglobinuria and isosthenuria, but no alterations were found in the blood urea nitrogen and serun creatinine levels throughout the experiment.

0 presente estudo foi realizado em 32 caprinos, adultos. Sem Raça Definida (SRD), sendo 16 machos e 16 fêmeas, com propósito de constatar a existência de alterações funcionais renais em caprinos submetidos à aplicação intravenosa de hemolisado, através de quantificação dos níveis séricos de uréia e creatinina. Constitui ram-se 4 grupos, cada um composto de 8 animais, dos quais 5 foram submetidos a infusão de hemolísado e 3 permaneceram como controle. Nos animais dos grupos I, II e III retiraram-se volumes sangüíneos respectivamente a 5, 10 e 15 ml/kg de peso corpóreo. Cada animal do grupo hemólise recebeu, por via intravenosa lenta, após ruptura mecânica das hemácias por congelamento, o hemolisado em igual volume ao sangue retirado. Os animais controle receberam, também por via intravenosa lenta, solução salina fisiológica a 0,87% em igual volune ao do sangue retirado. No grupo IV, realizou-se a sangria de 10 ml/kg de peso, e a reposição do hemolisado se fez na dose de 2,5 ml/kg de peso vivo, com intervalos de 48 horas. Os resultados encontrados nas diferentes dosagens adninistradas, permitiram concluir que, ao nível tubular, houve alterações funcionais, demonstradas pelo exame de urina (glicosúria, hemoglobinúria e tendência a isostenúria) e que, ao nível glomerular, não houve alterações de fluxo nem da função que pudessem ser identificadas através da determ