The cholinesterase activity of cerebrospinal fluid.
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Cerebrospinal Fluid↗
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[Potassium determination in cerebrospinal Fluid].
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Cerebrospinal Fluid↗
Cerebrospinal fluid leak rate after the use of BioGlue in translabyrinthine vestibular schwannoma surgery: a prospective study.
OBJECTIVE: To determine the effectiveness of BioGlue surgical adhesive in dural and middle ear closure after translabyrinthine vestibular schwannoma surgery. STUDY DESIGN: A prospective study. SETTING: Tertiary neurotological referral center. PATIENTS: There were 24 patients in the BioGlue series. BioGlue was used in the same manner in all cases. All patients received similar postoperative care. INTERVENTIONS: We studied the use of BioGlue and its possible effect on further reducing our department's cerebrospinal fluid leak rate for translabyrinthine vestibular schwannoma surgery. MAIN OUTCOME MEASURES: Postoperative events were documented that enabled us to determine the overall cerebrospinal fluid leak rate (including incidence of various leak routes and morbidity). RESULTS: The overall cerebrospinal fluid leak rate was 62.5% (15 of 24). Rhinorrhoea was the commonest route (80%), followed by postaural wound leak (33.3%) and external auditory canal otorrhoea (33.3%). Forty percent of cases had more than one cerebrospinal fluid leak route; 73.3% of leak cases required lumbar drain insertion, 40% needed pressure bandaging, and 66.7% had to undergo formal surgical repair. Forty percent had recurrent leaks after the initial episode had completely ceased. The mean extra stay in hospital as a result of the cerebrospinal fluid leak was 13.3 days. CONCLUSION: Our preliminary prospective study of the use of BioGlue for dural and middle ear closure in translabyrinthine vestibular schwannoma surgery demonstrated poor results. The high cerebrospinal fluid leak rate associated with the unusual presentations and ensuing management difficulties in controlling these leaks lead us to recommend that BioGlue not be used in translabyrinthine vestibular schwannoma surgery. The manufacturers have noted our results and have considered adding our recommendation to the product data sheet.
Adult↗
Deficient cerebrospinal fluid opsonization in experimental Escherichia coli meningitis.
Infected cerebrospinal fluid from rabbits with Escherichia coli meningitis failed to opsonize the infecting organism. Cerebrospinal fluid from rabbits with Staphylococcus aureus meningitis did opsinize E. coli.
Animals↗
Cerebrospinal fluid gangliosides in patients with Rett syndrome and infantile neuronal ceroid lipofuscinosis.
Concentrations of the four major brain gangliosides, GM1, GD1a, GD1b and GT1b, biochemical markers of neuronal membranes, were determined in cerebrospinal fluid from a large series of patients with classical Rett syndrome, aged 1.5-21 years at sampling, and from 11 patients with infantile neuronal ceroid lipofuscinosis, aged 1.5-11 years. The results were compared with age-matched healthy controls. Compared with fluid from the control group, the cerebrospinal fluid samples from Rett patients contained significantly reduced levels of gangliosides GD1a and GT1b. In cerebrospinal fluid of the infantile neuronal ceroid lipofuscinosis patients, even the very young ones, all four major brain gangliosides were significantly reduced compared with controls and the concentration levels also differed significantly from those in patients with Rett syndrome. The ganglioside pattern in the brain is reflected in the cerebrospinal fluid early in the course of the disease in Rett syndrome and infantile neuronal ceroid lipofuscinosis.
Adolescent↗
A safe and simple technique for obtaining cerebrospinal fluid from rabbits.
A safe and simple method for obtaining cerebrospinal fluid from the anesthetized rabbit was accomplished by cannulating the fourth ventricle. Cerebrospinal fluid (1.5--2.0 ml) was obtained for laboratory analysis. The procedure could be repeated at 2--3 day intervals without detrimental effects.
Animals↗
[Regional cerebral blood flow and cerebrospinal fluid amino acid analysis in elderly dementia].
Regional cerebral blood flow and amino acid concentration in the cerebrospinal fluid were studied in 12 cases of vascular dementia, 12 cases of Alzheimer's disease, 12 cases of chronic alcoholism, and 12 age-matched healthy controls. In vascular dementia, blood flows were decreased in the cerebral cortex, frontal white matter, thalamus, caudate nucleus, and putamen and alpha-aminobutyric acid and glutamic acid concentrations were increased in the cerebrospinal fluid. In Alzheimer's disease, blood flows were decreased in the frontal cortex, parietal cortex, temporal cortex, and frontal white matter and alanine concentration was increased in the cerebrospinal fluid. In chronic alcoholism, blood flows were decreased in the cerebral cortex, thalamus, and putamen and urea, alanine, and glycine concentrations were increased in the cerebrospinal fluid.
Alcoholism↗
Blood brain barrier disturbance and immunoglobulin G levels in the cerebrospinal fluid of the mouse following peripheral infection with the demyelinating strain of Semliki Forest virus.
Immunoglobulin G and albumin levels have been measured in the cerebrospinal fluid and serum of Swiss A2G mice following single intraperitoneal inoculation of Semliki Forest virus. This strain of virus used causes a meningoencephalitis followed by immunologically-mediated demyelination. By the use of the levels of immunoglobulin G and albumin in cerebrospinal fluid and serum to calculate the cerebrospinal fluid: serum ratios and the cerebrospinal fluid immunoglobulin G index, it has been shown that the blood-brain barrier breakdown is mild and restricted to within the first 7-8 days after virus inoculation when the inflammatory response is maximal. Immunoglobulin G index provides a measure of synthesis of immunoglobulin G within the blood-brain barrier. Synthesis has been shown to occur from day 10 onwards up to at least day 61 following infection. Arboviruses are known to persist in central nervous system tissue and it is suggested that a continuing immune response within the central nervous system occurs and is perpetuated by persisting virus. Because of the mode of replication of Semliki Forest virus it is also possible that some of the immune response is directed against central nervous system components.
Animals↗
A reproducible radionuclide procedure for measurement of cerebrospinal fluid shunt flow.
A radionuclide technique was developed to obtain reproducible measurements of cerebrospinal fluid flow in Rickham-Holter type shunt systems. In attempting to reproduce previously described radionuclide procedures, we found that different flow rate measurements can be obtained simply by changing the radiotracer injection technique or the method of analysis of the time activity curves which are generated. The importance of these technical pitfalls cannot be over-emphasized, since there is no gold standard to evaluate cerebrospinal fluid flow in vivo. An experimental model with a calibrated Harvard pump and a shunt system filled with normal saline was constructed. Aliquots of 500 microCi of pertechnetate in 0.05 ml of saline were injected serially into the center of Rickham reservoir using a size 28 needle. Time-activity curves were obtained after waiting five min to reach equilibrium, and standard curves of radiotracer clearance vs actual flow for each system used clinically in our institution were generated. In addition, a technique to quantify and thus correct for the small but significant leak of radiotracer which occurs at the site of injection in the reservoir is described. Excellent correlation was obtained between our results and the clinical and radiological findings in a preliminary clinical evaluation.
Cerebrospinal Fluid↗
[DEMONSTRATION OF LYSOLECITHIN IN THE SERUM OF DIFFERENT ANIMAL SPECIES AND IN HUMAN CEREBROSPINAL FLUID].
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Animals↗
Electrolytes and glucose in cerebrospinal fluid of premature infants with intraventricular haemorrhage: role of potassium in cerebral infarction.
Potassium, sodium, and glucose concentrations in cerebrospinal fluid and plasma were determined in 73 infants whose gestational ages ranged from 25 to 40 weeks. Six of 29 (21%) neonates with intraventricular haemorrhages had raised potassium concentrations in the cerebrospinal fluid (3.7-30 mmol/l); five developed cerebral infarctions. There was a significant correlation between sodium and glucose concentrations in plasma and cerebrospinal fluid with prolonged hypoglycorrhachia accompanying posthaemorrhagic hydrocephalus. Raised concentrations of potassium in cerebrospinal fluid occur with intraventricular haemorrhage and may contribute to the development of cerebral infarction.
Blood Glucose↗
Development and evaluation of a real-time RT-PCR assay on the LightCycler for the rapid detection of enterovirus in cerebrospinal fluid specimens.
BACKGROUND: Detection of enteroviral nucleic acid in cerebrospinal fluid (CSF) specimens has been demonstrated to improve the management of patients with aseptic meningitis. OBJECTIVE: To develop on the LightCycler (LC) instrument a real-time RT-PCR assay based on TaqMan technology for the detection of enteroviruses (EV) in cerebrospinal fluid (CSF) specimens. STUDY DESIGN: After evaluation of the analytical performances, seventy-four CSF samples collected prospectively from patients who have been suspected for a clinical diagnosis of meningitis were evaluated by two LC real-time RT-PCR assays and one conventional RT-PCR assay. RESULTS: Our assay detected all 30 different EV species tested, whereas no reactivity was observed with other neurotropic viruses. The analytical sensitivity of both LC RT-PCR real-time assays was 1 TCID50 for LC one-step and two-step RT-PCR assays. Results for LC one-step and LC two-step RT-PCR were compared to results of the conventional RT-PCR: of the 74 CSF specimens tested, 11 were positive and 56 were negative by all methods. Four other specimens were positive for EV by at least two of the methods (including the LC two-step RT-PCR and the conventional RT-PCR), two other CSF specimens were positive by the LC two-step RT-PCR assay only, and another one CSF specimen was positive by the LC one-step RT-PCR assay only. No CSF specimens were negative by the LC two-step RT-PCR assay and positive by the conventional RT-PCR assay. The sensitivity, specificity, positive and negative predictive values of both LC RT-PCR assays by using conventional RT-PCR as the "gold standard" were, respectively, 73.3, 98.3, 91.7, 93.5% for the LC one-step RT-PCR and 100, 96.6, 88.2, 100% for the LC two-step RT-PCR. There was substantial agreement between the three assays (k=0.80). CONCLUSIONS: The LC two-step RT-PCR assay is a rapid, sensitive and reliable method which can be routinely performed with CSF samples for diagnosis of EV infection and is an important improvement for optimal patient management.
Cerebrospinal Fluid↗
Plasma beta carotene in Alzheimer's disease. Association with cerebrospinal fluid beta-amyloid 1-40, (Abeta40), beta-amyloid 1-42 (Abeta42) and total Tau.
We studied the plasma beta carotene concentrations in 40 Alzheimer's disease patients and the association with cerebrospinal fluid beta-amyloid 1-40, (Abeta40), cerebrospinal fluid beta-amyloid 1-42 (Abeta42) and cerebrospinal fluid total Tau. We found that patients with plasma beta carotene levels below the 25th percentile had 55% reduced ratios of Abeta40/Tau and 51% reduced ratios of Abeta 40/Abeta 42 compared with patients in the highest quartile. Mean Tau concentrations in the lowest quartile of plasma beta-carotene levels were 74% higher compared with the highest quartile of plasma beta-carotene levels. Thus, we could demonstrate an statistically significant association between beta carotene levels in plasma and neurochemical markers in the cerebrospinal fluid of Alzheimer's disease patients.
Aged↗
Cerebrospinal fluid 5-hydroxyindoleacetic acid and homovanillic acid in the pediatric opsoclonus-myoclonus syndrome.
To study the purported role of central monoamine disturbances in the pathophysiology of the opsoclonus-myoclonus syndrome, the serotonin metabolite 5-hydroxyindoleacetic acid and the dopamine metabolite homovanillic acid were measured in cerebrospinal fluid samples from 27 affected children and 47 age- and gender-matched control subjects by high-pressure liquid chromatography with electrochemical detection. 5-Hydroxyindoleacetic acid and homovanillic acid concentrations in the cerebrospinal fluid were approximately 30 to 40% lower in opsoclonus-myoclonus patients compared to control subjects, and the normal inverse correlation between age and monoamine metabolite concentrations in the cerebrospinal fluid of control subjects was not found in opsoclonus-myoclonus patients. Patients with the lowest values were less than 4 years old, and a subgroup had extremely low levels, but differences in older children were not significant. Cerebrospinal fluid levels of 5-hydroxyindoleacetic acid and homovanillic acid were more positively correlated in control subjects than in opsoclonus-myoclonus patients. None of the patients exhibited high levels of monoamine metabolites. Homovanillic acid levels were slightly lower in the cerebrospinal fluid of patients receiving corticotropin or steroids at the time of lumbar puncture. Clinical variables that could be excluded were paraneoplastic etiology, anesthetic for lumbar puncture, syndrome duration, age at onset, gender, response to steroids, length of time until initiation of corticotropin or steroids, presence of seizures, opsoclonus, and functional impairment. These data suggest a disturbance and possible altered ontogeny of serotonin or dopamine neurotransmission in a subpopulation of children with opsoclonus-myoclonus with low cerebrospinal fluid levels of 5-hydroxyindoleacetic acid and homovanillic acid.(ABSTRACT TRUNCATED AT 250 WORDS)
Adrenal Cortex Hormones↗
Impact of quinidine on plasma and cerebrospinal fluid concentrations of codeine and morphine after codeine intake.
OBJECTIVE: The analgesic effect of codeine depends on its O-demethylation to morphine via sparteine oxygenase (CYP2D6) in the liver and presumably also via this enzyme in the CNS. We studied the ability of quinidine, which is a potent inhibitor of CYP2D6, to penetrate the blood brain barrier and its possible impact on codeine O-demethylation in CNS. METHODS: The study comprised 16 extensive and one poor metaboliser of sparteine, who underwent spinal anaesthesia for urinary tract surgery or examination. Eight patients were given an oral dose of 125 mg codeine and 9 patients (including the poor metaboliser) were given 200 mg quinidine 2 h before the same dose of codeine. Plasma and spinal fluid samples were collected 2 h after codeine intake. RESULTS: Free concentrations of quinidine were 11-times lower in cerebrospinal fluid than in plasma, and ranged from 9-15 nmol.l-1. Morphine concentrations were significantly lower in patients pre-treated with quinidine, both in plasma (median 1.45 nmol.l-1, range 0.74-1.95 nmol.l-1 vs 9.86 nmol.l-1, range 4.59-28.4 nmol.l-1) and in cerebrospinal fluid (0.23, 0.16-0.61 nmol.l-1 vs 3.63, 0.6-8.09 nmol.l-1). The morphine/codeine concentration ratio in plasma (3.07 x 10 (-3), 1.68-3.68 x 10 (-3) vs 19.87 x 10 (-3), 9.87-66.22 x 10 (-3) and in cerebrospinal fluid (0.83 d 10 (-3), 0.58-1.45 x 10 (-3) vs 7.19 x 10 (-3), 2.03-17.7 x 10 (-3) was also lower. The morphine/codeine concentration ratios were significantly lower in cerebrospinal fluid both without and with quinidine, but the difference between the plasma and spinal fluid ratio was significantly smaller with quinidine than without (p = 0.0002). CONCLUSION: Quinidine penetrates the blood brain barrier poorly, but quinidine pre-treatment leads to pronounced lowering of the cerebrospinal fluid concentration of morphine after codeine intake. However, the O-demethylation of codeine in CNS may not be totally blocked by quinidine.
Administration, Oral↗
Agarose gel electrophoresis of cerebrospinal fluid proteins and analysis of the pherogram profiles by analog computer.
A micro-method of agarose gel electrophoresis requiring 1--3 ml of cerebrospinal fluid for quantitative analysis of cerebrospinal fluid proteins is described. After concentration of CSF to about 50 microliter by ultrafiltration and refractometric determination of protein, approximately 20--40 microgram of total protein are used for electrophoresis. Photometric scanning of the electrophoretic pattern at two different wavelengths permits quantitative evaluation. The pherograms are analysed by means of a modified DU-PONT analog computer. Factors which influence quantitative electrophoresis are examined. In cerebrospinal fluid of normal children 15 protein fractions are demonstrated: 2 prealbumins, albumin, 5 alpha-, 3 beta- and 4 gamma-globulins.
Adolescent↗
Antimicrobial resistance in Haemophilus influenzae isolated from blood, cerebrospinal fluid, middle ear fluid and throat samples of children. A nationwide study in Finland in 1988-1990.
A nation-wide survey of the prevalence of antimicrobial resistance in Haemophilus influenzae was conducted on isolates collected in 1988-90 from middle ear fluid (MEF), blood, or cerebrospinal fluid (CSF) in infected children or throat samples of healthy children. Altogether 885 strains were examined regarding capsular type b, beta-lactamase production and the minimal inhibitory concentration (MIC) of ampicillin, cefaclor, erythromycin, tetracycline, chloramphenicol, trimethoprim and trimethoprim-sulfamethoxazole for these strains was determined by the agar dilution method. 99% (578/585) of MEF isolates, 93% (112/121) of throat isolates, but only 6% (10/179) of blood/CSF isolates were not of type b (Hib). The rate of beta-lactamase production was 11.4% among Hib strains, 8.0% among non-type b MEF isolates, and 4.5% among non-type b throat isolates. No increase in the prevalence of beta-lactamase production in H. influenzae has taken place in Finland since the early 1980s. Resistance to ampicillin among strains that lacked beta-lactamase activity was rare (0.2%). Of the non-type b MEF and throat isolates, 5.9% and 2.7%, respectively, were resistant to trimethoprim and 3.6% and 2.7%, respectively, to trimethoprim-sulfamethoxazole. Resistance to other drugs was rare (< 2%) in all isolate groups.
Ampicillin↗
The effect of embryonic cerebrospinal fluid pressure and morphogenetic brain expansion on wound healing in the midbrain of the chick embryo.
The role of increased cerebrospinal fluid pressure and morphogenetic brain expansion on midbrain wound healing was studied in chick embryos at stages 16-22. The embryos were divided into six groups as follows: group I (stages 16/17), group II (stages 18/19), group III (stages 20-22), group IV (stages 18/19), group V (stages 20-22) and group VI (stages 18/19). The mid-brains of embryos of groups I-III were wounded and the embryos re-incubated for varying periods up to 24 h. The neuroepithelial wounds of all group-I embryos healed completely within 24 h. However, complete healing was observed in only 25% of wounds in group II and 11.4% in group III by 24 h. To reduce cerebrospinal fluid pressure and thus slow down brain expansion, longitudinal wounds (about 0.8 mm long) were made in the hindbrain roof plate of group-IV and group-V embryos, and puncture wounds (0.1 mm in diameter) also in the hindbrain roof plate of group-VI embryos. This allowed cerebrospinal fluid to escape prior to wounding the midbrain. There was a significant increase in the proportion of group-IV and group-V embryos with completely healed midbrain neuroepithelial wounds (77.3% and 28.6% respectively). However, a comparison between groups II and VI embryos yielded no statistically significant difference in healing. Thus, increasing cerebrospinal fluid pressure and brain expansion adversely affect midbrain neuroepithelial wound healing.
Animals↗