Evaluación neuroepidemiológica a partir de anticuerpos antivirales de memoria generados por la vacuna triple viral / Neuro-Epidemiological Evaluation From Memory Antiviral Antibodies Generated By The MMR Vaccine

Introducción: La vacuna contra sarampión-parotiditis-rubéola es administrada en Cuba con un 99 por ciento de cobertura vacunal. Actualmente se plantea la baja inmunogenicidad de la cepa de parotiditis con que se fabrica por lo que resulta importante velar por la eficacia de las vacunas y su respuesta inmune protectora. Objetivos: Evaluar el comportamiento de los índices de anticuerpo antirubéola, antiparotiditis y antisarampión de acuerdo con la edad, y analizar la variación de la respuesta de anticuerpos antiparotiditis con respecto a estudios anteriores. Materiales y métodos: Se estudiaron muestras de suero y líquido cefalorraquídeo de 42 pacientes pediátricos con procesos neuroinflamatorios y se les cuantificó IgG total y albúmina y anticuerpos específicos contra los tres virus a partir de ensayos innmunoenzimáticos tipo ELISA. Se realizaron los reibergramas correspondientes e índices de anticuerpos específicos. Resultados: Se observó un incremento sostenido de anticuerpos contra los tres inmunógenos de forma general, sin diferencias significativas por razones de edad ni cambios notables posrevacunación. Existió un decrecimiento del índice de anticuerpos a medida que se alejaba de la fecha de revacunación por lo que se debe mantener una vigilancia en esos grupos de edades. La velocidad de producción de anticuerpos antiparotiditis fue mayor que frente a los otros virus, aunque no de forma significativa. Conclusiones: Esta vacuna garantiza protección por la uniformidad de la respuesta inmune de memoria inducida en todos los grupos de edades. Se demostró un aumento de protección de la población estudiada frente a la parotiditis con respecto a estudios previos(AU)

Introduction: The measles-mumps-rubella vaccine is administered in Cuba with 99 percent vaccination coverage. Currently, the low immunogenicity of the strain of mumps with which it is manufactured is raised, so it is important to ensure the effectiveness of vaccines and their protective immune response. Objectives: Evaluate the behavior of the anti-rubella, anti-mumps and anti-measles antibody indices according to age, and to analyze the variation of the anti-mumps antibody response with respect to previous studies. Materials and methods: Serum and cerebro-spinal fluid samples from 42 pediatric patients with neuro-inflammatory processes were studied and total IgG and albumin and specific antibodies against the three viruses were quantified from immunoenzymatic assays ELISA type. Corresponding reibergrams and specific antibody indices were performed. Results: A sustained increase in antibodies against the ethree immunogens was observed in general, without significant differences due to age or notable post-vaccination changes. There was a decrease in the antibody index as it moved away from the date of revaccination, so surveillance should be maintained in these age groups. The rate of production of anti-mumps antibodies was higher than against the other viruses, although not significantly. Conclusions: This vaccine guarantees protection by the uniformity of the memory induced immune response in all age groups. An increase in the protection of the studied population against mumps was demonstrated with respect to previous studies(AU)

Líquidos cerebroespinal, cefalorraquídeo o encéfaloespinal: una perspectiva holística para terminologia anatomica / Cerebrospinal, cephalic-rachid or encephalospinal fluids: a holistic perspective for terminologia anatomica

RESUMEN: En el campo morfológico internacional se utiliza el término líquido cerebroespinal, identificado en latín como Liquor cerebrospinalis. En el humano, este líquido circula por varias cavidades del sistema nervioso central, de las cuales, se reconocen cinco ventrículos. Cuatro son componentes encefálicos y uno se encuentra en la parte terminal de la médula espinal. El objetivo del presente trabajo fue determinar cuál es el nombre más apropiado para este líquido, valorando el uso corriente que se da en libros de texto usados para la enseñanza de la neuroanatomía y en artículos científicos. Para ello, se efectuó una búsqueda bibliografía, no sistemática y aleatoria, de libros y artículos científicos en los cuales se hace mención sobre el fluido del sistema ventricular encefálico y el espacio subaracnoideo del ser humano. El 100 % de los libros y artículos científicos publicados en inglés, utilizaron el término líquido cerebroespinal para denominar este fluido. El 90 % de los libros y artículos científicos publicados en español utilizaron el término líquido cefalorraquídeo y el 10 % de ellos, líquido cerebroespinal. Los resultados demuestran que en América Latina aún se utiliza más de un nombre para una misma estructura. Tanto libros como artículos científicos publicados en español no han seguido las recomendaciones de la Federación Internacional de Asociaciones de Anatomistas (IFAA), ya que la mayoría de ellos utilizó el término líquido cefalorraquídeo. Por otra parte, creemos que el término más apropiado para referirse al líquido extracelular que circula por el sistema ventricular nervioso y espacio subaracnoideo, es el de líquido encéfaloespinal. Este término se propone para suplir el vigente y tradicional líquido cerebroespinal en inglés y líquido encefalorraquídeo en español.

SUMMARY: The term cerebrospinal fluid is generally used in morphology. In Latin it is known as liquor cerebrospinalis. In the human, this fluid circulates through various cavities of the central nervous system, of which, five ventricles are recognized. Four are brain components and one is in the terminal part of the spinal cord. The objective of the present study was to determine the most appropriate term for this liquid, while evaluating the current use of terminology in scientific publications and in academic textbooks used to tech neuroanatomy. A non-systematic and randomized bibliographic search of books and scientific articles was carried out, making mention of the encephalic ventricular system fluid and the subarachnoid space of the humans. A total, (100 %) of identified scientific books and articles published in English, used the term cerebrospinal fluid to refer to this fluid; 90 % of the scientific books and articles published in Spanish used the term cephalic-rachid fluid; cerebrospinal fluid was used in 10 % of these. The results show that more than one term continues to be used in Latin America to refer to this structure. International Federation of Anatomical Associations (IFAA) recommendations have not been followed, since most books and scientific research publications use the term cerebrospinal fluid to describe the structure. Moreover, we believe that the cephalic-spinal fluid is the most appropriate term in this case, given that circulation occurs throughout the ventricular nervous system and the subarachnoid space. This term is proposed to replace the current and traditional cerebrospinal fluid in English and cephalic-rachid fluid in Spanish.

Catéter de drenaje de líquido cefalorraquídeo: usos, técnica y complicaciones para el anestesiólogo / Spinal fluid drainage catheter: uses, technique, and complications for the anesthesiologist

Spinal drainage catheter installation is a procedure indicated essentially in the repair of aortic aneurysms and the neurosurgery setting. It is not always a simple procedure where dilemmas arise about the indication, technique, and complications. The following article reviews each of these topics.

La instalación de un catéter de drenaje espinal es un procedimiento indicado principalmente en la reparación de aneurismas aórticos y en el escenario de neurocirugía. No siempre es un procedimiento fácil de realizar donde surgen dudas sobre indicación, técnica y eventuales complicaciones. En el siguiente artículo revisamos cada uno de estos temas.

Suspected transcutaneous cerebral spinal fluid leakage without postural headache after implantable intrathecal drug delivery system removal: A case report

A 55-year-old man with an implantable intrathecal drug delivery system (IDDS) implant removal surgery was performed to control a suspected implant infection. Clear discharge from a lumbar wound was detected after IDDS removal, but transcutaneous cerebral spinal fluid (CSF) leakage was not suspected because the patient did not suffer from a postural headache. Finally, a suspected CSF leakage was resolved with a single epidural blood patch.

Análise do líquido cérebro-espinhal de três doenças do sistema nervoso central de cães / Analysis of cerebral-spinal fluid of three central nervous system diseases of dogs

Foi realizado um estudo retrospectivo do líquido cérebro-espinhal de cães (LCE), atendidos pelo Serviço de Neurologia do Hospital Veterinário da Instituição, de 2004 a 2015, com o objetivo de analisar os resultados de cães com sinais neurológicos, comparar as alterações encontradas em dois locais de colheita no mesmo paciente e verificar se esse exame auxiliou o clínico em reforçar a suspeita clínica das principais doenças do sistema nervoso central. A pleocitose linfocítica esteve presente em 78,3% (29/37) das amostras de cães com cinomose e em 23,2% (10/43) de cães com DDIV. Houve dissociação albuminocitológica (DAC) em 73% (19/26) das amostras de cães com tumores IC e em 64,3% (9/14) de cães com tumores envolvendo a ME. Em cães com DDIV, houve significância estatística (p<0,05) entre o grau de disfunção neurológica e o total de células nucleadas (TCN) e total de proteínas (TP). Em 29 cães, houve a colheita do LCE da cisterna magna e da cisterna lombar e em 12 (41,4%) os resultados foram diferentes entre as duas amostras colhidas do mesmo cão, onde dois (6,9%) apresentaram alteração na amostra colhida cranial à lesão. Pode-se concluir que a pleocitose linfocítica foi a principal alteração encontrada no LCE de cães com cinomose e DDIV e DAC nas neoplasias, IC e ME, cães acometidos pela DDIV apresentaram sinais neurológicos mais severos conforme o TCN e o TP aumentaram e o LCE sofreu alteração, mesmo colhido cranial ao local da lesão e auxiliou o clínico em reforçar a suspeita clínica, mas não confirmou, as principais doenças neurológicas em cães.(AU)

A retrospective study including the analysis of the cerebrospinal fluid (CSF) of dogs neurologically affected was conducted by the Neurology Service of the Veterinary Hospital at the Institution, between 2004 and 2015. The aim of this study was to analyze the results of the CSF of dogs with neurological signs, and compare the changes in the CSF in two sampling sites in the same patient and see if this test helped the clinician to strengthen clinical suspicion of the major diseases of the central nervous system. Lymphocytic pleocytosis was present in 78.3% (29/37) of samples from dogs with distemper and in 23.2% (10/43) of samples from dogs with IVDD. The albumin cytologic dissociation (ACD) was found in 73% (19/26) of samples from dogs with IC tumors and in 64.3% (9/14) from dogs with tumors involving the SC. For dogs with IVDD, there was statistical significance (p<0.05) between the degree of neurological dysfunction and the total nucleated cells (TNC) and total protein (TP). In 29 dogs, CSF was collected from the cistern magna and the lumbar and in 12 (41.4%) the results were different between the samples of the same dog, where two cases (6,9%) showed alterations in the sample collected cranial to the injury. It can be concluded that the lymphocytic pleocytosis was the main alteration found in the CSF of dogs with distemper and IVDD and ACD in tumors. Dogs affected by IVDD had more severe neurological signs as TNC and TP increased and the CSF was altered even collected cranial to the lesion site and helped the clinician to strengthen the clinical suspicion, but not confirm, the major neurological diseases in dogs.(AU)

Free composite anterolateral thigh flap for reconstruction of craniofacial defects / 中华整形外科杂志

Objective@#To evaluate the clinical outcomes of a series of patients who have undergone reconstruction of craniofacial defects after resection of intracranial tumors or craniofacial trauma with free composite anterolateral thigh flaps.@*Methods@#Retrospective analyses the clinical cases from September 2007 to September 2016. Data included flap survival rate, complication, satisfaction survey was reviewed to evaluate the efficacy and safety of this surgical strategy.@*Results@#Totally 10 free anterolateral thigh flaps including 3 cases of fasciocutaneous flaps, 2 case of adipofascial flaps, 4 cases of myocutaneous flaps, 1 case of chimeric flap, were adopted to reconstruct craniofacial defects. Follow-up ranged from 3 to 17 months (average, 12 months). All flaps were transferred successfully. There were no cranial spinal fluid(CSF) leaks, intracranial infections or donor site complications. All patients were satisfied.@*Conclusions@#Because of its abundance of tissue, matched vessels to recipient site, versatility of muscular flaps to fill irregularly intracranial defects, reliable blood supply, feasibility of simultaneous fascia lata harvesting, free composite anterolateral thigh flap is the reconstructive method of choice for craniofacial defects reconstruction after resection of intracranial tumors or craniofacial trauma. The use of ALT flap was reliable in the decrease of CSF leak and infection rate and dependable according to long time follow-up.

The study on diagnostic feasibility of CSF Aβ42, T-tau, P-tau181 detection in Alzheimer dementia / 中国神经精神疾病杂志

Objective To explore the diagnostic feasibility of Alzheimer disease (AD) associated CSF biomarker (CSF Aβ42, T-tau, and P-tau181) through establishing the cutoff value and the sensitivity and specificity of each biomarker. Methods Seventeen AD dementia patients were enrolled from Peking university first hospital during 2015 July and 2017 Feb including 5 patients that received PET scan using Pittsburgh compound-B. Forty-nine cognitive normal subjects were also enrolled as controls according to the protocol. The levels of Aβ42, T-tau, P-tau181 and the ratio of Aβ42/T-tau、Aβ42/ P-tau181 from all participants were assessed using the innotest-ELISA methods and cutoff value,sensitivity as well as specificity of each biomarker were determined according to the ROC curve. Results There were significant differences in all biomarkers between the cognitive normal controls group and AD dementia group. The cutoff value of Aβ42, T-tau, P-tau181, Aβ42/T-tau and Aβ42/ P-tau181 were 511 ng/mL, 322 ng/mL, 63 ng/mL, 14.72 and 1.74. The sensitivity were 64.7% in Aβ42, 88.2% in T-tau, 58.8% in P-tau181, 82.35% in Aβ42/T-tau and 76.47% in Aβ42/ P-tau181, respectively. The specificity were 97.05% in Aβ42, 75.5% in T-tau, 93.87% in P-tau181, 95.51 % in Aβ42/T-tau and 93.87% in Aβ42/P-tau181, respectively. Conclusion Alzheimer disease associated biomarkers (CSF Aβ42,T-tau, and P-tau181) can distinguish the cognitive normal subjects from AD dementia patients. The methods are reliable and the sensitivity as well as specificity of each biomarker are good which are close to the values reported in the literatures. Thus, this methodology is worth being promoted in the clinic.

Effect of lead exposure on function of blood-cerebrospinal fluid barrier and ZO-1 and occludin protein expression in vitro / 中国药理学与毒理学杂志

OBJECTIVE To establish an in vitro blood-cerebrospinal fluid barrier (BCB) model to investigate the underlying mechanism of lead-induced BCB injuries.METHODS The in vitro BCB model was established by Z310 cells.Different concentrations of Pb(AC)2 (2.5,5.0 and 10.0 mmol·L-1) were used for 24,48 and 72 h.Transendothelial electrical resistance (TEER) and flux of FITC-dextran were performed to determine the permeability of the in vitro BCB model.Western blotting and immunofluorescence methods were used to observe the expression of tight junction protein ZO-1 and occludin.RESULTS Compared with control group,Pb(AC)2 2.5,5.0 and 10.0 mmol· L-1 exposure for 48 h to Z310 cells had no significant effect on survival rate and density.TEER in different groups was gradually increasing.At the 12th day after Pb(AC)2 exposure,the values of TEER and flux of FITC-dextran in Pb(AC)2 5 and 10 mmol· L-1 groups were significantly decreased (P＜0.05).Western blotting and immunofluorescence images showed that the expression of ZO-1 and occludin were significantly decreased (P＜0.05) after Pb(AC)2 exposure for 48 h.CONCLUSION Lead exposure can cause the breakdown of BCB barriers,and this effect may be mediated by reducing the expression of ZO-1 and occludin proteins.

Evidence-based clinical practice guidelines for the treatment of dural tears and the consequent cerebrospinal fluid leak during spine surgery / 中华外科杂志

Dural tears (DT) and the consequent cerebral spinal fluid (CSF) leak are not rare in spine surgeries. CSF leak can be troublesome, leading to pseudomeningocele, cutaneous CSF fistula, and meningitis. Revision surgery is unavoidable in some cases. The reported incidences of DT and CSF leak are different according to the various pathologies. Ossification of the posterior longitudinal ligament, revision spine surgery and multi-segment laminectomy have higher risks for DT. Various techniques have been described to manage this complication, such as bed rest, repair with dural substitutes, fibrin glue, gelatin sponge, lumbar drain, muscle flap, etc.Through objective evaluation of the evidence and transparency in the process of making recommendations, it is Chinese Association of Orthopaedic Surgeons′ goal to develop evidence-based clinical practice guidelines for the treatment of incidental DT and the consequent CSF leak during spine surgery. The current clinical guidelines focus on 9 clinical questions and the strength of recommendations were made based on the quality of the literature. The work group considers that this guideline recommendations aim to assist in delivering optimum, efficacious treatment and functional recovery from this complication.

A Case Report of ‘Pseudo Tumor Cerebri’

Pseudo tumor cerebri is a clinical entity of uncertain etiology characterized by intracranial hypertension. The syndrome classically manifests with headaches and visual changes in women with obesity. This case is being presented for the following points: raised ICT, bilateral CN VI palsy, bilateral papilledema (left > right), neck rigidity present without Kernig's and Brudginski signs. Keeping the history, Neurological findings, investigative results, point to the possibility of raised intracranial pressure with CN VI involvement. The final clinical diagnosis, to the above syndrome, points out to ‘Pseudo-tumor cerebri’.

Effects of hypoxia on production of ATP and expression of mitochrome C in human meningothelial cells as the cerebral fluid-optic nerve barrier / 中华实验眼科杂志

Background BackgroundMeningothelial cells (MECs) are major cell type in the meningeal sheath around optic nerve,which form a fluid barrier between optic nerve and the cerebral spinal fluid.The impairment of the cerebral fluid-optic nerve barrier probably affects the balance of cerebral fluid components.Currently,the investigation on the role of MECs in neuropathy is less performed.Objective This study attempted to explore hypoxia-induced function changes of MECs,and to shed a new clus for the future research of optic nerve disorders.Methods Human MECs strains were cultured in vitro and cell suspension was prepared with the cell densities of 2.5 ×103/hole,5.0× 103/hole and 1 x 104 /hole,respectively.The suspensions of 100 μl were separately collected to incubate in 96-well plates and cultivated for 2 days in 21％ O2(normoxia group) or 1％ O2(hypoxia group).MTS was used to detect and compare the proliferative value (A490) of MECs between the normoxia group and the hypoxia group.The changes of MECs diameter and volume were measured by CASY1 assay.ATP product in the cells after MECs exposed to different oxygen environments with or without substrate (100 mmol/L pyruvate and 100 mmol/L malate) for 1,2 days were assayed by Luminometer method.The expression and distribution of cytochrome C in the cells of the normoxia group and the hypoxia group were determined by immunofluorescence.Results A490 of MECs in the 2.5× 103/hole,5.0× 103/hole and 1 × 104/hole were 0.399±0.009,0.393±0.009 and 0.496±0.026 in the hypoxia group,which were lower than 0.424±0.131,0.413±0.111 and 0.537±0.021 in the normoxia group (t =3.777,P =0.004 ; t =3.251,P =0.009 ; t =3.037,P =0.013).Compared with the normoxia group,the diameter and volume were significantly increased in the hypoxia group ([20.970 ±0.127] μm vs.[21.198 ±0.048] μm,t =-3.762,P=0.006; [5805±73] fl vs.[6026±106] fl,t=-4.124,P=0.002).ATP products were (0.900±0.225)mmol/(L· g) and (0.952± 0.075) mmol/(L · g) in the hypoxia group and the hypoxia+substrate group,which were significantly lower than (1.389±0.145) mmol/(L · g) and (1.401±0.122) mmol/(L · g) in the normoxia group and the normoxia +substrate group (P =0.001,0.002,0.001).Immunofluorescense staining showed that the green fluorescence of cytochrome C located at mitochondria of MECs in the normoxia group,but in the hypoxia group,cytochrome C distributed in the cytoplasm extensively.Conclusions Hypoxia induces malfunction of MECs,which might impact the intact of the cerebral spinal fluid-optic nerve barrier and therefore influence the microenvironment of the subarachnoid space and neuronal function.

The effect of dexmedetomidine on amino acid in cerebro-spinal fluid of patients undergoing intracranial tumor surgery / 临床麻醉学杂志

Objective To investigate the effect of dexmedetomidine on excitatory aminoacid (EAA)and inhibition of amino acid(IAA)in cerebro-spinal fluid(CSF)of patients undergoing in-tracranial tumor surgery,and to explore the cerebral protective mechanism of dexmedetomidine in neurosurgery.Methods Sixty patients aged 18-64 years old,ASA Ⅰ or Ⅱ,weighing 50-90 kg un-dergoing elective intracranial tumor surgery were randomly divided into dexmedetomidine group (group D)and control group(group C).Dexmedetomidine 1 μg/kg was infused before anesthesia in-duction for more than 10 minutes and pumped continously with 0.2-0.7 μg·kg-1·h-1 in group D, while in group C midazolam 0.03-0.05 mg/kg was injected followed by intermittent administration of 0.03-0.05 mg/kg.BIS value was maintained between 40-50.MAP and HR was recorded at the time points before induction(T0 ),dura mater incision(T1 ),tumor resection(T2 ),at the end of the surgery (T3 ).And we collected CSF at T0 ,T3 ,6 hours after the surgery(T4 ),12 hours after the surgery (T5 ),24 hours after the surgery(T6 ),then the concentrations of EAA and IAA were determined with high-performance liquid chromatography (HPLC)at T0 ,T3 ,T4 ,T5 and T6 .Results The MAP and HR in group D at T1-T3 were much lower than that in T0 and in group C(P <0.05).Compared with T0 ,the Glu and Asp in CSF significantly increased in group C at T3-T6 and were much higher than those in group D (P < 0.05 ),GABA was significantly decreased and much lower than group D(P <0.05).Compared with T0 ,the Glu and Asp in group D at T3-T5 were increased and GABA was decreased, but without statistic significance. At T6 , the values recovered to the level at T0 . Conclusion Dexmedetomidine can be used to maintain hemodynamic stability in intracranial tumor surgery,and may play a role in cerebral protection through inhibiting expression of Glu and Asp (EAA).

Clinical Aspects of Bacterial Meningitis in Cerebrospinal Fluid Culture Positive Patients in a Tertiary Care University Hospital / 대한임상미생물학회지

BACKGROUND: There have been previous clinical research studies on clinical manifestations of meningitis in adults or children; however, few have focused on including both groups and none on the causative organism and its susceptibilities to antibiotics. Here we describe the distribution of causative organism and its antibiotic susceptibilities of meningitis from spinal fluid positive patients of a university hospital. METHODS: Cases of spinal fluid culture results from admitted patients in Kyung Hee Medical Center from July 2004 to June 2009 were analyzed retrospectively by their medical records and laboratory results. RESULTS: Ninety five cases of positive spinal fluid culture results were obtained and 25 cases fit the diagnostic criteria for bacterial meningitis. 5 cases were spontaneous meningitis and 20 were post cranial surgery meningitis. Among the 25 patients, fever was the most common clinical presentation (100%) and ventriculoperitoneal shunt was the most common causative procedure of post cranial surgery meningitis. Streptococcus pneumoniae for spontaneous meningitis and Acinetobacter species for post cranial surgery meningitis was identified as the most common causative organisms. CONCLUSION: Recurrent positive spinal fluid culture results of the same organism was found in expired patients due to post cranial surgery meningitis and also from the culture results of the wound and intra-cranial inserted instruments, suggesting post operative infection control is directly related to morbidity requiring adequate usage of antibiotics rather than empirical broad spectrum antibiotics.

Isolated Spinal Neurocysticercosis : Unusual Ocular Presentation Mimicking Pseudotumor Cerebri

Spinal intradural cysticercosis is a rare manifestation of neurocysticercosis. We report a unique patient who showed visual symptoms and normal imaging of the brain caused by isolated spinal neurocysticercosis. A 59-year-old male patient was admitted to the emergency unit with a history of severe headache and progressive blurred vision. Brain computed tomographic scanning and magnetic resonance imaging showed normal cerebral anatomy without hydrocephalus. The fundoscopic evaluation by an ophthalmologist showed bilateral papilledema. Perimetry studies revealed visual field defects in both eyes. With the diagnosis of pseudotumor cerebri, a lumbar tap was attempted; however, we could not drain the cerebrospinal fluid in spite of appropriate attempts. Lumbar magnetic resonance imaging revealed multilevel intraspinal lesions that were confirmed histologically to be neurocysticercosis. An intraoperative lumbar puncture revealed an increased opening pressure and cytochemical analysis showed elevated cerebrospinal fluid protein level. The headache resolved immediately after surgery. However, the visual symptoms remained and recovered only marginally despite antihelminthic medications after six months of operation.

Distribution and Antibiotic Resistance of Bacteria Isolated from Cerebral Spinal Fluid in Neurosurgical Patients: A Surveillance / 中华医院感染学杂志

OBJECTIVE To determine the distribution and antibiotic resistance of bacteria isolated from cerebral spinal fluid in neurosurgical patients. METHODS Bacterial isolates from cerebral spinal fluid specimens in Department of Neurosurgery,Beijing Tiantan Hospital were collected from Jan 2000 to Dec 2004.Distribution and antibiotic resistance of pathogens were analyzed retrospectively. RESULTS Of 438 isolates,Gram positive cocci and Gram negative bacilli accounted for 72.1%(316 isolates) and 27.9%(122 isolates),respectively.The most frequently isolated pathogen was coagulasenegative staphylococci(53.7%) followed by Staphylococcus aureus(10.5%),Enterobacter spp(6.2%),Acinetobacter spp(6.2%),and Pseudomonas aeruginosa(3.7%).The most active compounds against Gram-negative bacilli were imipenem(87% susceptibility),piperacillin/tazobactam(77%),amikacin(68%),cefepime(64%) and ceftazidime(63% susceptibility).Imipenem,cefepime,ceftazidime,and piperacillin/tazobactam demonstrated excellent activity against most of Gram negative bacilli.In S.aureus and coagulase-negative staphylococci,oxacillin resistance strains accounted for 76% and 100%,respectively. CONCLUSIONS Prevailing pathogens are Gram positive cocci in intracranial infection after neurosurgical operation,especially coagulase-negative staphylococci and S.aureus.Data collected in present study will provide valuable information for prophylactic and empirical antibiotic use in post-operative intracranial infection.

Changes of argiuine vaso-pression in blood and cerebral spinal fluid(CSF)in patients with severe brain injury after treated with mild hypothermia / 中华急诊医学杂志

Objective To study the changes of blood arginine vaso-pression(AVP)levels in patients with severe brain injury after treated with mild hypotherima.Methods Seventy-eight patients with severe brain injury were divided into mild hypothermia(33～35℃)group and normothermia group.The blood AVP levels and CSF AVP levels were determined at the third and the seventh day after brain injury.Results The AVP levels in blood and CSF of mild hypothermia group were lower than those of the normothermia group at the third and seventh day after brain injury(P＜0.05).According to GOS,prognosis of the mild hypothermia group was better than that of the nonnotbcrmia group(P＜0.05).Conclusion The mild hypothermia treatment may have inhibitive effects on the production of blood AVP,CSF AVP,and brain edema.Mild hypothermia is an effective method in the treatment of acute severe brain iniury in reducing the mortality and in increasing the survival rate.

Analysis that treatment of all ventricular haemorrhage by extrinsic drainage through ventricle combining with substitution of CSF / 中国基层医药

Objective To investigate the method for the treatment of haemorrhage of all ventricles.Methods 46 cases were treated by continuous extrinsic drainage through puncture of the lateral ventricle which accumulated more blood combming with substitution of CSF by meams of lumbus puncture per day.Urokinase was injected into ventricle at regular intervals.Results The symptoms were improved.Head CT were reexamined in 41 cases,which showed disappearance of hematocele in ventricle within 4～15 days.Except for 5 cases of death,other cases recovered from the disease.Conclusion The hematocele above and below the duct in ventricle can be eliminated by this method,and the mortality rate can reduced greatly and the quality of survival can improved.

Assessment of general and trace elements in CSF of patients with spinal cord injury / 中国康复理论与实践

@#Objective To analyze general and trace elements in cerebral spinal fluid (CSF)of patients with spinal cord injury (SCI). Methods To assess contents of general and trace elements (K, Na, Ca, Mg, Zn, Mn, Fe, Cu) in CSF of six SCI patients using ICP-AES. Results Compared with normal value, contents of Ca and Zn were significantly decreased (P<0.01), Fe and Mn were significantly increased (P<0.01), but no significant differences for Na, Mg, K and Cu in CSF of SCI patients. Conclusion The excitation of central nerve system in SCI patients may be higher than normal people indeed.

CSF Spinal Drainage Using CVP Catheter for Brain Surgery / 대한마취과학회지

Acute volume and ICP changes produce irreversible brain damage because the hard cranium is filled with soft brain tissue, blood in the intracranial vessels and cerebrsopinal fluid. Surgical manipulatins and anesthesia may also alter this delicate intracranial balance. Therefore, the control of ICP and brain volume is very importment for brain surgery. There are several known methods to decrease intracranial pressure and improve cerebral perfusion pressure such as the use of diuretics, hyperventilation and CSF drainage. The CSF spinal drainage is a method of reducing ICP and vloume to facilitate dissection and placement of clips for aneurysm surgery and reduce the incidence of aneurysm rupture. We had 207 cases of CSF spinal drainage in patients scheduled for brain surgery. CSF spinal drainage has been employed using a regular CVP intracatheter with the 14 gauze large needle. We have found that this techique is simple, economic and efficient and its conplications are minimal. CSF spinal drainage is believed to decrease the intracranial pressure and increase the cerebral perfusion pressure and to prevent development of ischemic symptoms or cerebral infarction as vasospasm.

Determination of isoniazid in rabbit's vitreous humor and spinal fluid by reversed-phase high performance liquid chromatography / 中国法医学杂志

Objective Develop a reversed-phase high performance liquid chromatography (HPLC) methodfor detecting isoniazid in vitreous humor and spinal fluid.Method Vanillin, as a derivative reagent, was added to the vitreous humor and spinal fluid samples. Isoniazid and vanillin reacted to form isonicotinoyl hydrazone which was separated and detected. The pretreatment method of sample, the linear range, the precision, the recovery of isoniazid were all established by using rabbit's vitreous humor and spinal fluid spiked with standard isoniazid. The HPLC method has then been applied to investigate the concentration of isoniazid in intoxicated rabbits'vitreous numor and spinal fluid respectively.Results As established in the method, the linear range was 0.2?g/ml～12.0?g/ml (for vitreous humor ?=0.9990, for spinal fluid ?=0.9988). The detective limit was 0.2?g/ml. The intra and inter-day precision of assay for isoniazid were less than 4.9%( n =5) in vitreous numor and spinal fluid. The average recoveries of isoniazid were more than 97.1%. The concentration of isoniazid was 74.60?7.40?g/ml in vitreous humor, 88.95?10.12?g /ml in spinal fluid.Conclusion The HPLC method is suitable for analyzing isoniazid in the vitreous numor and spinal fluid.