ABSTRACT
Here we report an 11-year-old boy with acute encephalopathy with neuropsychiatric symptoms. The patient had mildly decreased consciousness, delirious behavior, and affective changes next day of fever onset. Hematologic, biochemical, and metabolic examinations were unremarkable. CSF analysis revealed cell counts of 278 cells/mm(3) and a protein level of 87 mg/dL. Although MRI revealed no abnormal findings, an increase in regional cerebral blood flow was present in the bilateral frontal lobes, mesial temporal lobes, and basal ganglia on single photon emission computed tomography. The measurement of the concentrations of biomarkers such as cytokines in the patient's serum and cerebrospinal fluid revealed elevated levels of IL-4 and TNF-α in the cerebrospinal fluid. Immunohistochemical studies applying control human brain sections did not demonstrate the presence of autoantibodies. We considered that innate immunity rather than autoantibody response may have contributed to the neuropsychiatric symptoms of our patient. These results suggest heterogeneity of patients with acute encephalopathy with neuropsychiatric symptoms.
Subject(s)
Cerebrovascular Circulation/physiology , Limbic Encephalitis/diagnostic imaging , Limbic Encephalitis/physiopathology , Acute Disease , Biomarkers/blood , Biomarkers/cerebrospinal fluid , Brain/pathology , Child , Consciousness Disorders/etiology , Cytokines/blood , Cytokines/cerebrospinal fluid , Humans , Immunohistochemistry , Limbic Encephalitis/psychology , Magnetic Resonance Imaging , Male , Mental Disorders/etiology , Tomography, Emission-Computed, Single-PhotonABSTRACT
This report aims to highlight drugs that are able to inhibit parietal cells from the luminal side, resulting in suppressed gastric acid secretion. Histamine 2HCl was i.v. given continuously to obtain a submaximal stimulation of gastric acid secretion. Wortmannin and ME 3407 (a myosin light chain kinase inhibitor) and cytocharasin D (actin polymerizing inhibitor) were locally applied to denervated gastric pouches prepared in dogs for 5 to 30 min. Each drug, administered 0.5 hr before or 1 hr after histamine infusion was commenced, significantly inhibited stimulated-gastric acid secretion in a time-dependent manner. The antisecretory effect persisted for more than 24 hrs in the case of Wortmannin and 9 hr in the case of ME 3407 at a dosage 1 and 3 mg/pouch for 30 min, respectively. ME 2407, however, had no antisecretory effect when i.v. administered after histamine infusion, or orally administered before histamine infusion. Such results strongly suggest that the apical membrane of parietal cells possesses a ME 4307, Wortmannin and cytocharasin D sensitive portion similar to the basolateral membrane that usually mediates gastric acid secretion. The apical membrane represents an intriguing target for developing new antisecretory drugs, as well as for elucidating the functional features of parietal cells.
