ABSTRACT
OBJECTIVE: To assess the potential role of urinary S100B as a prognostic biochemical marker following head injury in children in a UK emergency department setting. METHODS: A case-control pilot study was performed in 20 patients with head injury and 15 controls (with extracranial trauma) aged <13 years and within 12 h of their injury recruited over a 4-month period. Urinary S100B levels were measured at presentation to the emergency department. RESULTS: The two groups showed no significant differences in basic characteristics (height, weight, time to sample collection). 50% of the case group had measurable concentrations of S100B following head injury (range 0.02-0.07 microg/l). All patients in the control group had measurable S100B concentrations following extracranial trauma (range 0.02-0.09 microg/l). No significant rise in S100B concentrations occurred in two patients with severe head injuries (Glasgow Coma Score (GCS) <9) and in one patient with a moderate head injury (GCS 10), despite significant injuries on the CT scan. CONCLUSION: Despite detecting measurable S100B levels in urine following head injury, the same levels are measured following extracranial trauma. Urinary S100B is therefore not useful as an early biochemical marker following head injury in children.
Subject(s)
Craniocerebral Trauma/urine , Emergency Service, Hospital , Nerve Growth Factors/urine , S100 Proteins/urine , Biomarkers/urine , Case-Control Studies , Child , Child, Preschool , Craniocerebral Trauma/diagnosis , Female , Glasgow Coma Scale , Humans , Infant , Infant, Newborn , Male , Pilot Projects , Prognosis , S100 Calcium Binding Protein beta SubunitABSTRACT
BACKGROUND: Biochemical markers released after head injury may reflect the degree of brain damage, which is related to subsequent disability. If the serum level of a marker were found to be related to outcome, then earlier identification and intervention would be possible. OBJECTIVE: To investigate the potential of the serum marker S-100B protein to predict the outcome after head injury. METHODS: Blood samples for S-100B concentrations were taken from 148 adults within six hours of a head injury (initial Glasgow coma score 4-15). Patients were recruited from the emergency departments of four hospitals in Greater Manchester, United Kingdom. Outcome was assessed in 119 patients (80%) at one month using the extended Glasgow outcome scale (GOSE). RESULTS: A significant inverse correlation between serum S-100B level and GOSE was found (Spearman's rho = -0.349, p < 0.0001). A serum S-100B concentration of > 0.32 micro g/l predicted severe disability (GOSE < 5) at one month with a sensitivity of 93% (95% confidence interval 68% to 100%), a specificity of 72% (54% to 79%), and a negative predictive value of 99% (93% to 100%). CONCLUSION: Serum S-100B concentration can be used in the emergency department to identify patients with head injury who are most likely to have a poor outcome at one month.
Subject(s)
Brain Injuries/metabolism , Brain Injuries/rehabilitation , Emergency Medical Services , Outcome Assessment, Health Care , S100 Proteins/metabolism , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers , Brain Injuries/blood , Female , Follow-Up Studies , Glasgow Coma Scale , Hospitalization , Humans , Male , Middle Aged , Predictive Value of TestsABSTRACT
A computerized microspectrophotometer was developed to provide rapid and accurate sequential measurements on cells, including nuclear DNA content, by fluorescence staining, photometric grain counting from autoradiographs, and nuclear size estimated by measurement aperture area. To alleviate bulk and vibrations caused by additional stepper motors, the excitation light and filters as well as the emission filters and photomultipliers were detached from the main microscope frame. The light was directed to and from the microscope through fibre optic bundles. This configuration provided an excellent light gathering faculty and made optical alignment easier. The machine provided highly accurate sequential measurements on a relatively large numbers of cells by static photometry.
