ABSTRACT
OBJECTIVES: beta 2-microglobulin (beta 2-m) is a small molecular weight protein (11 800 Daltons) which can transudate into the cerebrospinal fluid (CSF) in the same manner than albumin. Intrathecal synthesis is a sign of local immuno-stimulation and is correlated with immunoglobulin G. The aim of this study was to ascertain the relationship between beta 2-microglobulin levels in the CSF and neurological diseases. METHODS: beta 2-microglobulin was assayed in the CSF and blood using an immunoenzyme method in 64 patients with multiple sclerosis (n = 14), human immunodeficiency virus (HIV) infection (n = 5), meningitis (n = 12) or a peripheral neurological disease (n = 10) and in 7 control subjects. RESULTS: There was no overall correlation between beta 2-m in the CSF and blood levels (r = 0.35). In controls, beta 2-m CSF and blood levels were respectively 0.94 +/- 0.22 and 1.46 +/- 0.83 mg/l. beta 2-m was significantly higher in the CSF of patients with meningitis and in the HIV positive patients (4 +/- 3.5 and 3.69 +/- 2.06 mg/l respectively) (p < 0.05). Type of meningitis (bacterial or non-bacterial) had no effect on the CSF level. For the HIV patients, the CSF/blood ratio for beta 2-m was similar to that in controls due to a rise in both blood and CSF. Finally, in patients with multiple sclerosis, there was no significant change in CSF level of beta 2-m. CONCLUSION: beta 2-microglobulin in cerebrospinal fluid was not found to be correlated with the neurological diseases studied and cannot be used as a diagnostic test.
Subject(s)
Acquired Immunodeficiency Syndrome/cerebrospinal fluid , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Viral/cerebrospinal fluid , Multiple Sclerosis/cerebrospinal fluid , beta 2-Microglobulin/analysis , Adolescent , Adult , Aged , Cerebrospinal Fluid Proteins/analysis , Female , Humans , Male , Meningitis, Aseptic/cerebrospinal fluid , Middle Aged , Peripheral Nervous System Diseases/cerebrospinal fluid , Reference Values , beta 2-Microglobulin/cerebrospinal fluidABSTRACT
Fifty-eight female impatients consecutively hospitalized in the University Hospital Department of Psychiatry in Tours were interviewed with a clinician battery of instruments (among them, the SI-PTSD by Davidson). The diagnoses leading to hospitalization were: severe disorders of psychotic type (schizophrenic, schizophreniform, schizo-affective, schizoid and paranoid delusional disorders as well as bipolar disorder), borderline and narcissistic personalities for 7%, and other disorders for 53%. Among the results, we observed that 59% of these patients had experienced at least one major stressful event (rape 26%, other sexual assault 29%, physical assault 31%, seeing somebody dying in a violent way 8%, war scene 2%, injured in an accident 2%). As a consequence, 61% of the victims have suffered from PTSD and the diagnosis of PTSD was still present in 21%. In addition, in the victims, somatoform and dissociative disorders were significantly more frequent.
Subject(s)
Life Change Events , Mental Disorders/etiology , Stress Disorders, Post-Traumatic/psychology , Adult , Female , Hospitalization , Hospitals, Psychiatric , Humans , Mental Disorders/rehabilitationABSTRACT
The clinical and pathological features of a giant cauda equina paraganglioma arising from the intradural filum terminale is described. Scattered mature large neurons characterized the tumor as a gangliocytic paraganglioma. Histologically, these neoplasms have considerable similarity with ependymoma and the diagnosis can be easily missed unless special techniques are employed.
Subject(s)
Cauda Equina , Paraganglioma/diagnosis , Peripheral Nervous System Neoplasms/diagnosis , Adult , Cauda Equina/ultrastructure , Diagnosis, Differential , Ependymoma/diagnosis , Humans , Male , Paraganglioma/ultrastructure , Peripheral Nervous System Neoplasms/ultrastructureABSTRACT
Over a 9 months period, 394 cases of injuries among 0 to 15 year-old children were recorded in the pediatrics department of a general hospital. This included traffic accidents, falls, and blows. There was a male prevalence (59,4%), and a maximum frequency in the afternoon (14-17 h) and during the summer holidays (July and August). Seventy per cent of the children were seen in the emergency ward within 3 hours following the injury. Traffic accidents were mostly related to bike accidents. The incidence of injuries among 0-15 year old children appears to be 90 for every 1,000 children in ambulatory medicine, 30 for 1,000 in emergency wards and 8,5 for 1,000 in the pediatrics wards with hospitalization lasting longer than 24 hours. From our study, the cost of the hospitalized children has been evaluated at 2,5 MF for one year in our district.
Subject(s)
Wounds and Injuries/epidemiology , Accidents/statistics & numerical data , Adolescent , Age Factors , Child , Child, Hospitalized , Child, Preschool , Female , France/epidemiology , Health Surveys , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Time FactorsABSTRACT
A patient presenting with progressive paraparesis was found to have a dural sacral arteriovenous (AV) fistula. His condition deteriorated abruptly after thoracolumbar angiography. Embolization of the fistula improved the patient's status so that he was able to walk with crutches. One year later his neurological condition worsened. He was treated via an enlarged laminectomy because of uncertainty concerning a lipoma noted on the initial computerized tomography scan. The lesion consisted of an intradural filum terminale lipoma associated with an AV fistula, both of which were excised. The patient's condition was unchanged 6 months later. The different types of spinal lipomas and spinal AV malformations are reviewed, and mechanisms are proposed to explain the clinical deterioration in this patient. Venous hypertension seems to be the most likely possibility. The lipoma may have produced local hypervascularization of the dura mater with a subsequently acquired AV fistula.
