The Role of Ceruloplasmin in Neurodegeneration in Parkinson's Disease

WOS: 000377538300005Objective: Oxidative stress has been implicated to play a major role in the neuronal cell death in idiopathic Parkinson's disease (IPD). Ceruloplasmin is a ferroxidase that oxidizes toxic ferrous iron to its nontoxic ferric form and thus helps prevent oxidative damage to proteins, lipids, and DNA. The aim of this study was to determine the serum ceruloplasmin levels in patients with IPD and evaluate its role in neurodegeneration using hydrogen proton magnetic resonance spectroscopic imaging (H-1 MRSI). Materials and Methods: Twenty-three patients with the IPD and 12 healthy controls were studied using single-voxel H-1 MRSI of the bilateral putamen. The peak ratios of N-acetyl aspartate (NAA) to creatinine (Cr) and choline (Cho) were measured in both groups and serum ceruloplasmin levels were detected. Results: Compared with the controls, the ratios of NAA/Cho and NAA/Cr in putamen contralateral (CL) to the symptomatic limbs were significantly lower in patients with IPD. Also in the IPD group, CL NAA/Cho and NAA/Cr ratios were significantly lower than the ipsilateral (IL) values (p<0.001). There was no significant difference between ratios of metabolites in putamen IL to the symptomatic limbs in the IPD group compared with the healthy controls. The mean serum ceruloplasmin level of IPD patients was significantly lower than that of the control group (p<0.001). In the IPD group, a significant direct correlation was found between levels of ceruloplasmin and CL putamen NAA/Cho ratio (p=0.011). Conclusion: In our study the direct correlation between low levels of ceruloplasmin and CL putamen NAA/Cho ratio supports the hypothesis that ceruloplasmin deficiency may contribute to free radical-induced death of neuronal cells

The Evaluation of Leukoaraiosis Etiopathogenesis with MR-Spectroscopy

OBJECTIVE: Leukoaraiosis (LA), is a radiological finding with bilateral, either patchy or diffuse areas of the cerebral white matter.We aimed to determine proton MRS findings of LA and compare to those with chronic ischemic infarcts and control subjects, in order to understand the metabolic changes in LA. METHODS: We compared 25 patients with LA, 10 patients with chronic ischemic infarct and 9 control subjects without LA. Ratios for n-acetyl aspartate (NAA)/creatine (Cr) and myoinositol (MI)/Cr were obtained from leukoaraiotic area, chronic ischemic infarct and normal white matter. For the cognitive impairment Minimental Status Examination (MMSE) was applied to all individuals. RESULTS: Between LA and normal white matter, NAA/Cr values were shown no statistically significant difference. MI/Cr value of LA was significantly increased when compared with normal white matter (0.72±0.22 to 0.59±0.15; p<0.0001). NAA/Cr value of chronic ischemic infarct was significantly reduced when compared with both normal white matter (0.68±0.64 to 1.47±0.11; p<0.01) and leukoaraiotic area (0.68±0.64 to 1.70±0.28; p<0.01). MMSE scores of leukoaraiotic patients were significantly decreased when compared with control subjects (p<0.01). CONCLUSION: Nonsignificant changes in NAA concentrations and high MI values of LA, indicate that gliosis is the major pathological finding. Because of the risk factors that disturbing arterioler structure in LA, altered cerebral blood flow autoregulation seems to contribute to develop gliosis before neuronal or axonal los

Tumor-mimicking musculoskeletal infectious lesions – experience of a single referral center

Introduction/Objectives Bone and soft tissue infections might mimic bone and soft tissue tumors. Therefore, differential diagnosis is important to prevent errors in treatment. This report aims to present the data of patients with indistinct clinical and radiological findings mimicking benign and malignant bone and soft tissue tumors, which were later diagnosed as inflammatory infections. Methods A retrospective chart review of the clinical, microbiological, radiologic, and pathologic findings of patients presented with a presumed diagnosis of a possible malignant lesion was performed. Results The study included 21 patients with a median age (IQR) of 37 (1 month – 72 years) years, and 13 (61%) patients were men. In total, 16 (76%) patients were admitted to the hospital with complaints of pain. The diagnoses were hydatid cyst, tuberculous osteomyelitis, cat-scratch disease, chronic osteo-myelitis, subacute osteomyelitis, and soft tissue abscess. All patients were treated depending on the diagnosis of the lesion. Conclusion There are chances of misdiagnosis due to shared common characteristics of tumoral and infectious lesions which might be mildly increased inflammatory markers with deeply seated non-mobile soft tissue masses and aggressive periosteal reactions and/or bone destruction patterns. So, each pseudo-tumoral lesion due to possible infectious causes should be histopathologically examined and correlated with other clinical and laboratory data in order to achieve a final diagnosis