Acute panautonomic neuropathy: a report of 4 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the clinical manifestations, diagnosis, treatment and prognosis of acute panautonomic neuropathy (APN).</p><p><b>METHODS</b>We reviewed the history, clinical findings, electrophysiological characteristics, laboratory features of CSF and treatment of 4 patients with APN.</p><p><b>RESULTS</b>All these patients showed acute onset with apparent involvement of the autonomic nervous system. The clinical features of autonomic involvement included fixed dilated pupils, abdominal pain, diarrhea, and anhidrosis. Electromyography showed evidence of peripheral neuropathy. Early treatment with corticosteroid and intravenous immunoglobulins resulted in improved prognosis of the patients.</p><p><b>CONCLUSION</b>APN is a rare autonomic nervous system disorder, and understanding of the clinical features may help in early diagnosis and treatment of the patients.</p>

The expression of matrix metalloproteinases-9, transforming growth factor-beta1 and transforming growth factor-beta receptor I in human atherosclerotic plaque and their relationship with plaque stability / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transforming growth factor-beta (TGF-beta) and matrix metalloproteinases-9 (MMP-9) have been implicated in the pathogenesis of human atherosclerosis but their relationship during lesion progression are poorly understood. The objective of this study was to investigate the expression of MMP-9, TGF-beta1 and TGF-beta receptor I (TbetaR-I) in human atherosclerotic plaque and their relationship and plaque stability.</p><p><b>METHODS</b>Specimens of human coronary artery atherosclerotic plaques were obtained from 41 patients undergoing coronary endarterectomy, and were paraffin embedded, sectioned at 4 microm intervals then stained with haematoxylin and eosin. They were divided into stable (with no or only little lipid core) and unstable plaque groups (with lipid core size > 40%): the immunohistochemical staining were performed for MMP-9, TGF-beta1 and TbetaR-I.</p><p><b>RESULTS</b>The expression of MMP-9 in the unstable plaques was much higher than in the stable ones, but the expression of TGF-beta1 was higher in the stable plaques. There was no similar significant difference for TbetaR-I. Correlation analysis showed that there was a negative correlation between the expression of MMP-9 and TGF-beta1 (r = -0.332, P = 0.034 for average areal density; r = -0.373, P = 0.016 for average optical density).</p><p><b>CONCLUSIONS</b>There were close relationships between MMP-9, TGF-beta1 and plaque stability. Enhanced production of MMP-9 may participate in the formation of unstable plaque, while TGF-beta1 maybe an important stabilizing factor in preventing transition into an unstable plaque phenotype.</p>