Magnetic Resonance Imaging for the Prediction of Delayed Neuro-psychiatric Sequelae in Patients with Carbon Monoxide Poisoning

PURPOSE: Delayed neuropsychiatric sequelae (DNS) encompass a broad spectrum of neurological deficits, cognitive impairments, and affective disorders which commonly occur after a recovery from acute carbon monoxide (CO) poisoning. The early identification of patients with a high risk of DNS might improve their quality of care. Thus, we studied the role of magnetic resonance imaging (MRI) for the prediction of DNS. METHODS: This retrospective study included 41 patients with CO poisoning from January 2009 to June 2012. Magnetic resonance imaging (MRI) was performed within seven days after CO poisoning. Positive MRI findings were defined as focal or diffuse signals in fluid-attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI), and T2 weighted imaging (T2WI). DNS was considered present when patients had clinical symptoms and signs of DNS within 3 months after CO poisoning. Clinical and biohumoral data were collected; univariate and multivariate statistical analyses were performed to identify the predictive role of MRI for DNS. RESULTS: DNS occurred at a rate of 58.5%, with abnormal MRI findings associated with the development of DNS in the multivariate analysis. The sensitivity of MRI to DNS was 82.6%. In contrast, a normal MRI was seen in eighteen patients (43.9%). MRI revealed abnormalities in the deep white matter (41.5%), globus pallidus (34.1%), cerebral cortex (12.2%), medial temporal lobe (MTL)/hippocampus (7.3%), and cerebellum (4.9%). Among the MRI abnormalities revealed, lesions in the deep white matter were significantly associated with DNS development. Abnormal findings of the globus pallidus, cerebral cortex, MTL/hippocampus, and cerebellum were not associated with DNS development. CONCLUSION: This study demonstrates the utility of early MRI for the prediction of DNS. Future studies will be required to ascertain the prevention of DNS with hyperbaric treatment in CO poisoning.

Effects of alpha-Lipoic Acid on the Antioxidant System in Prostate Cancer Cells / 대한비뇨기과학회지

PURPOSE: Overproduction of lipid peroxidation byproducts and disturbances in the antioxidant defense system have been implicated in the pathogenesis of several diseases, including prostate cancer. Although several studies have investigated the level of lipid peroxidation and antioxidants in prostate cancer, there are no reports on alpha-lipoic acid (ALA) in prostate cancer. Here we assessed the effects of ALA on the antioxidant system in prostate cancer cells. MATERIALS AND METHODS: PC-3, LNCaP, and RWPE-2 cell lines were used in this study. Redox factor (Ref)-1 protein was measured by Western blot analysis after treatment with ALA. Real-time polymerase chain reaction (RT-PCR) was performed to detect superoxide dismutase (SOD)-1 and -2, catalase, and glutathione peroxidase (GSH-Px) mRNA expression. RESULTS: Ref-1 was expressed in the PC-3, LNCaP, and RWPE-2 cell lines. The expression of Ref-1 protein was increased after treatment with 125, 250, and 500 microM ALA in the PC-3 (p0.05) cells compared with the RWPE-2 cells at 48 hours. In PC-3 cells, the mRNA expression of SOD-1, SOD-2, catalase, and GSH-Px decreased at 24 and 48 hours dose-dependently compared with that in RWPE-2 cells (p<0.05). The mRNA expression of SOD-2, catalase, and GSH-Px in LNCaP cell decreased at 48 hours dose-dependently (p<0.05). CONCLUSIONS: The expression of Ref-1 protein and antioxidant enzymes changed after ALA exposure in prostate cancer cells. Our findings suggest that ALA affects the antioxidant system in prostate cancer cells and may be related to compensatory changes in the antioxidant defense system of the cells.