ABSTRACT
OBJECTIVE@#To establish a diagnostic model for diffuse axonal injury (DAI) by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). To screen the proteins or peptides associated with DAI for providing the biomarkers with theoretic foundation.@*METHODS@#Fifteen male Sprague-Dawley rats were randomly divided into DAI group (n = 10) and control group (n = 5). The protein or peptide expression profiles of rat brain stem were detected by MALDI-TOF-MS. ClinProTools 2.2 software was used to find specific peaks, and a diagnostic model was established by the genetic algorithm.@*RESULTS@#There were significant differences in 61 peaks of DAI group (P < 0.05), 9 peaks were down-regulated and 52 up-regulated. The diagnostic model was established based on 5 different peaks. The specificity and sensitivity of cross validation was 96.14% and 95.98%; while the specificity and sensitivity of blind validation showed was 73.33% and 70.00%, respectively.@*CONCLUSION@#A specific and sensitive diagnostic model of DAI can be established by MALDI-TOF-MS to provide a potential value for determining DAI in forensic practice.
Subject(s)
Animals , Male , Rats , Biomarkers , Brain Stem/metabolism , Diffuse Axonal Injury/diagnosis , Down-Regulation , Peptides/blood , Proteomics , Rats, Sprague-Dawley , Sensitivity and Specificity , Software , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods , Up-RegulationABSTRACT
To evaluate the effects of nimodipine on hemodynamic state, vasospasm, and short time prognosis of diffuse axonal injury [DAI] patients. In a prospective, clinical trial double blind study, 40 DAI patients with Glasgow coma scale of 5-8 were selected and randomly divided into 2 equal groups. The first group was treated with 60 mg of nimodipine every 4 hours immediately after admission, and the control group did not receive this treatment. Mean blood flow velocity [MFV] and pulsatility index of both middle cerebral arteries were measured using transcranial Doppler on the 1st, 3rd, and 10th days of admission. Glasgow outcome scale was evaluated one month after admission. This study was performed from June 2003 to June 2004 at Imam Medical Center, Tabriz, Iran. There were significant differences in MFV among the 3 transcranial Doppler, which demonstrated hemodynamic changes in these patients. Nimodipine did not have any significant difference on MFV between the treatment and control groups. In the nimodipine group, 45% had good prognosis [30% in the control group] and nobody had vasospasm on the 10th day Doppler study [15% in the control group], although it did not show any statistical significant difference between them. Nimodipine improved the prognosis and decreased vasospasm, however, there was no statistical difference. Therefore, we suggest further studies in a larger number of DAI patients
Subject(s)
Humans , Male , Female , Prognosis , Diffuse Axonal Injury/diagnosis , Diffuse Axonal Injury/drug therapy , Diffuse Axonal Injury/etiology , Diffuse Axonal Injury/diagnostic imaging , Prospective Studies , Cerebrovascular Circulation/drug effects , Double-Blind Method , Glasgow Coma Scale , Ultrasonography, Doppler, Transcranial , Middle Cerebral Artery , Tomography, X-Ray Computed , Blood Flow Velocity , HemodynamicsABSTRACT
36 comatosed patients diagnosed as diffuse brain injury DBI [diffuse axonal injury DAI or/and diffuse brain swelling DBS] after severe head injury [unconscious from the moment of severe impact with or without evidence of space-occupying intracranial lesions on CT or MRI] were successfully managed in Kasr-El Aini trauma hospital via a novel classification and treatment protocol; in this paper we explain in detail our successful experience
Subject(s)
Humans , Male , Female , Coma , Diffuse Axonal Injury/diagnosis , Tomography, X-Ray Computed , Magnetic Resonance Imaging , Clinical Protocols , Treatment OutcomeABSTRACT
El daño axonal difuso es causa importante de morbimortalidad y de secuela neuro-sicológica. En TC los hallazgos son pocos significativos o ausentes. La RM es el método diagnóstico más importante para la identificación del tipo de lesiones y ubicación de ellas. La secuencia de difusión es especialmente sensible para detectarlas, y la espectroscopía por RM puede dar información pronóstica.