Serum Levels Of S-100 Protein Research Articles

Serum levels of S-100 protein are directly proportional to the size, number, thickness and degree of cellularity of congenital melanocytic nevi

Serum levels of S-100 protein are directly proportional to the size, number, thickness and degree of cellularity of congenital melanocytic nevi

Correlation of Serum S-100 Protein Level with Severity of Ischaemic Stroke

Background: Stroke is currently the second leading cause of death worldwide and the first leading cause of death in Bangladesh. The National Institute of Health Stroke Scale is the most commonly used deficit rating scale to assess stroke severity. S-100 protein is a low molecular weight calcium-binding protein expressed mostly in glial cells like astrocytes, oligodendrocytes, and microglial cells. During the ischaemic process, S-100 protein is secreted from the glial cells into the extracellular space. After secretion, S-100 protein releases initially into the cerebrospinal fluid and then eventually into the bloodstream due to disruption of the blood-brain barrier. Aim of the study: To correlate serum S-100 protein level with the severity of ischaemic stroke. Methods: This cross-sectional study was conducted at the Department of Laboratory Medicine in collaboration with the Department of Neurology, BSMMU, Dhaka, Bangladesh from September 2018 to August 2019. A total of 70 ischaemic stroke patients were enrolled in this study. After taking proper history and neurological examination, the severity of ischemic stroke was assessed on the basis of NIHSS score. Then, serum S-100 protein levels were measured by the Electrochemiluminescence Immunoassay method. Statistical analysis was done by SPSS version 22.0. Results: According to the NIHSS scores, 35(50.0%) of the patients had moderate stroke (NIHSS score=5-15), 17(24.3%) had minor stroke (NIHSS=1-4), 12(17.1%) had moderate to severe stroke (NIHSS=16-20) and 4(5.0%) had severe stroke (NIHSS=21-42). The mean S-100 protein level was found 0.283±0.165 μg/L. Mean S-100 protein levels was assessed in different categories of severity of ischaemic stroke. Maximum Mean± SD value of serum S-100 protein was found in case of severe stroke (NIHSS score=21-42; Mean ± SD: 0.739±0.207, range: 0.523-1.019). The significance test was done by ANOVA test which was found statistically significant (p-value <0.001). Pearson’s correlation test revealed a significant strong positive correlation (r=+943, p<0.001) between serum S-100 protein level and NIHSS scores of ischaemic stroke patients. Conclusion: In the present study it was found that serum S-100 protein levels were higher in severe ischaemic stroke in relation to the ischaemic stroke of lower severity. S-100 protein level is rapidly determined by the method used in the present study. Serum S-100 protein level in this regard can be used as an important tool to predict the severity of ischaemic stroke. Further study is needed to confirm the findings of the present study.

Risk Factors and Serum S-100 Protein Level Analysis of Ischaemic Stroke Patients: A Tertiary Care Hospital Study in Bangladesh

Background: Information regarding the associated risk factors is very important in treating patients with ischaemic stroke besides severity measurement. The National Institute of Health Stroke Scale (NIHSS) is the most commonly used deficit rating scale to assess stroke severity. Serum S-100 protein is a low molecular weight calcium-binding protein expressed mostly in glial cells like astrocytes, oligodendrocytes, and microglial cells. During ischaemic process, S-100 protein is secreted from the glial cells into the extracellular space. After secretion, S-100 protein releases initially into the cerebrospinal fluid and then eventually into the bloodstream due to disruption of the blood-brain barrier. Aim of the study: The aim of this study was to assess risk factors and Serum S-100 protein level of ischaemic stroke patients. Methods: This cross-sectional study was conducted at the Department of Laboratory Medicine in collaboration with the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2018 to August 2019. A total of 70 patients with ischaemic stroke from the Department of Neurology, BSMMU were enrolled in this study. After taking proper history and neurological examination, the severity of ischemic stroke was assessed on the basis of NIHSS score. Then, serum S-100 protein levels were measured by Electrochemiluminiscence Immunoassay (ECLIA) method. Statistical analysis was done by SPSS version 22.0. Results: In this study, as risk factors, maximum patients 45(64.3%) had hypertension followed by dyslipidemia 34(48.6%), diabetes mellitus 23(32.9%), heart disease 22(31.4%), history of previous vascular events 9(12.9%) and family history of stroke 8(11.4%). In assessing the relationship among severity of ischaemic stroke with Serum S-100 protein level we observed that the mean ± SD S-100 protein level was found 0.283± 0.165 μg/L with the range of 0.103-1.019 μg/L. Mean± SD levels of serum S-100 protein .....

Comparative Characterization of Candidate Molecular Markers in Ischemic and Hemorrhagic Stroke

According to epidemiological studies, the leading cause of morbidity, disability and mortality are cerebrovascular diseases, in particular ischemic and hemorrhagic strokes. In recent years considerable attention has been given to the study of molecular markers of ischemic and hemorrhagic strokes. These studies are relevant because brain-specific protein biomarkers of neurons and glial cells can provide valuable and timely diagnostic information necessary for clinical decision-making.The aim of the study was to reveal the differences in the serum level of molecular markers in acute, subacute and early recovery periods of ischemic and hemorrhagic strokes.Material and methods. The study included 59 patients. Twenty patients were diagnosed with hemorrhagic stroke and 39 had ischemic stroke. The control group included 20 volunteers. Serum levels of molecular CNS markers were determined in acute, subacute, and early recovery stages of stroke. The serum levels of CNS molecular markers of patients with ischemic and hemorrhagic stroke was measured quantitatively by enzyme immunoassay. Statistical analysis was performed by nonparametric Mann-Whitney method.Results. The level of brain-derived neurotrophic factor (BDNF) in the control volunteers was 574.5 [455.5; 615] pg/ml. Significant differences were found for acute and subacute periods of hemorrhagic stroke: it was 674 [560; 749] pg/ml (P=0.003) and 664 [616; 762] pg/ml (P=0.0001).The level of neuron-specific enolase was significantly increased in all periods of the study: it was 4.15 [3.53; 4.8] ng/ml in the control group, 5.4 [4.4; 6.4] ng/ml in acute period of ischemic stroke (P<0.001), 5.4 [4.4; 6.4] ng/ml in early recovery period of ischemic stroke (P=0.001), 5.1 [4.6; 6.4] ng/ml in acute period of hemorrhagic stroke (P=0.014), 664 [616; 762] ng/ml in subacute period of hemorrhagic stroke (P=0.003).In the control group, the serum S-100 protein level was 4.5 [3.8; 5.4] ng/ml. In the acute and early recovery periods of ischemic stroke, S-100 protein level has significantly fallen down to 4.1 [3.4; 4.6] ng/ml (P<0.031) and 3.9 [3.4; 6] ng/ml (P=0.014), respectively. Glial-cell derived neurotrophic factor level was 1.98 [1.64; 2.1] ng/ml in the controls and increased up to 2.4 [2.2; 5] ng/ml (P=0.002) in the acute period and 2.4 [2.3; 2.6] ng/ml (P<0.001) in the subacute period of hemorrhagic stroke.The vascular endothelial growth factor receptor-1 (VEGFR-1) was significantly lower in the subacute period of hemorrhagic stroke: 485 [211; 945] pg/ml in the subacute period vs 903.5 [626; 1115] pg/ml in the controls (P=0.001).Conclusion. We found differences in the serum level of molecular markers in patients with ischemic and hemorrhagic strokes. In the acute period, early recovery period of ischemic stroke, and subacute period of hemorrhagic stroke, there was an increase in the serum level of neuron-specific enolase. The level of brain-derived neurotrophic factor increased significantly in the acute and subacute periods of hemorrhagic stroke. In the acute and early recovery periods of ischemic stroke, the level of S-100 protein decreased. The level of glial cell-derived neurotrophic factor increased in the acute and subacute periods of hemorrhagic stroke. In the subacute period of hemorrhagic stroke, the level of endothelial growth factor receptor-1 significantly decreased. Moreover, there was significant difference between values of this parameter in the subacute period of hemorrhagic stroke and in the early recovery period of ischemic stroke.

Mitigating effect of biotin against irradiation-induced cerebral cortical and hippocampal damage in the rat brain tissue.

Radiation-induced brain injury is common and mainly occurs in patients receiving radiotherapy for malignant head and neck tumors. The brain is oversensitive to oxidant injury induced by radiation. Biotin is a member of the vitamin B complex family and its deficiency has been associated with neurogenesis impairment in animals and humans. The present study was undertaken to investigate the mitigating effect of biotin on the cerebral cortical and hippocampal damage induced by radiation exposure. Animals were exposed to radiation in the presence or absence of biotin and sacrificed on day 10. The results demonstrated that the administration of biotin 2mg to irradiated rats had no significant effect on the radiation-induced damage of the cerebral cortex and the hippocampus, while the administration of biotin 6mg has significantly attenuated oxidative stress in the hippocampus, manifested by a reduction of 4-hydroxynonenal (4HNE), total nitrate/nitrite (NOx), and xanthine oxidase (XO) levels associated with an elevation of glutathione (GSH) content as well as superoxide dismutase (SOD) and catalase (CAT) activities. In addition, biotin decreased the pro-inflammatory cytokines (interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrotic factor alpha (TNF-α)), caspase-3, poly(ADP-ribose) polymerase 1 (PARP1) level, and PARP1 gene expression. Moreover, biotin 6mg treatment diminished serum S100 protein (S100B) and neuron-specific enolase (NSE) levels. In conclusion, biotin treatment at high dose post-irradiation has efficiently neutralized the effect of free radicals in the hippocampal region of rats. Thus, it could be applicable as a radio-mitigator for reducing or delayed radiation-induced brain injury in patients post-radiotherapy.

Efficacy and safety of selective brain hypothermia therapy on neonatal hypoxic-ischemic encephalopathy

To evaluate the efficacy and safety of selective brain hypothermia (SBH) in the treatment of neonates with moderate or severe neonatal hypoxic-ischemic encephalopathy (HIE), and the effect of SBH treatment on serum levels of neuron-specific enolase (NSE) and central nervous specific protein S100. A prospective randomized controlled trial was conducted. From January 2015 to June 2017, 42 children with moderate to severe HIE in the neonatal intensive care unit (NICU) of the First Affiliated Hospital of Bengbu Medical College were enrolled, and they were randomly divided into SBH treatment group and routine treatment group after obtaining the consent of the guardian of the children. The children in routine treatment group were given the traditional symptomatic supportive treatment, supplemented by drugs to promote nerve cell growth. On the basis of traditional treatment, the children in the SBH treatment group were given SBH treatment within 6 hours after birth. The nasopharyngeal temperature was maintained at 33.0-34.5 centigrade and the rectal temperature was maintained at 34.5-35.0 centigrade. The general clinical data of the two groups including gender, gestational age, birth weight, age, 5-minute neonatal asphyxia score (Apgar score), score for neonatal acute physiology perinatal extension version II (SNAPPE II) were collected. The primary outcomes were hospitalized death, severe disability at 15 months of age, neonatal behavioral neurological assessment (NBNA) score at 28 days of age, and Bayley scales of infant development (BSID) score [including mental development index (MDI) score and psychomotor development index (PDI) score] at 15 months of age at follow-up. The secondary outcomes were serum levels of NSE and S100 protein. The occurrences of adverse events in the two groups were recorded. Among 42 HIE children, 1 child of severe congenital malformation and 1 child of platelet count (PLT) < 50×109/L were excluded, and 40 children were enrolled in the study group. During the follow-up period, 2 children of SBH treatment group and 2 children of routine treatment group were lost or the outcome was unknown. Finally, 18 children of each group were enrolled in the analysis. There was no significant difference in the baseline data of gender, gestational age, birth weight, age, 5-minure Apgar score or SNAPPE II score between the two groups, indicating that the baseline data of the two groups were balanced and comparable. The incidence of severe disability in the SBH treatment group was significantly lower than that in the routine treatment group [5.6% (1/18) vs. 44.4% (8/18), P < 0.05]. There was 1 child death in the routine treatment group and no death in the SBH treatment group. Compared with the routine treatment group, the 28-day NBNA score of the SBH treatment group was increased by 2.9 [95% confidence interval (95%CI) = 1.0-4.8], BSID score at 15 months of age was improved significantly, MDI score was increased by 11.8 (95%CI = 4.3-19.3), and PDI score was increased by 12.4 (95%CI = 2.5-22.3), with significant differences between the two groups (all P < 0.05). After 3 days of treatment, the serum NSE and S100 protein levels in both groups were significantly decreased as compared with those before treatment [NSE (μg/L): 30.15±15.18 vs. 31.32±14.75, S100 (ng/L): 387.5 (273.3, 573.0) vs. 890.0 (590.5, 1 162.5) in routine treatment group; NSE (μg/L): 29.09±16.22 vs. 32.25±15.43, S100 (ng/L): 402.5 (302.2, 580.5) vs. 842.0 (462.3, 1 200.5) in SBH treatment group, all P < 0.05]. There was no significant difference in serum NSE or S100 protein level between the two groups (all P > 0.05). There was no serious adverse event such as arrhythmia, large vein thrombosis or irreducible hypotension in both groups, and there was no significant difference in the incidence of general adverse events such as sinus bradycardia, scleredema, blood glucose disorder, or systemic infection between the two groups [16.7% (3/18) vs. 11.1% (2/18), 5.6% (1/18) vs. 5.6% (1/18), 22.2% (4/18) vs. 11.1% (2/18), 5.6% (1/18) vs. 5.6% (1/18), all P > 0.05]. SBH treatment could significantly increase the NBNA score at 28 days of birth and BSID score at 15 months of age, reduce the incidence of severe disability in moderate and severe HIE children, but it was not be proved that SBH could reduce the mortality. Compared with routine treatment, SBH treatment had no significant superiority on improving the levels of serum NSE and S100 protein, suggesting that SBH could not protect the brain by inhibiting the apoptosis of nerve cells and promoting the repair of nerve cells.

Dynamic changes and diagnostic and prognostic significance of serum PCT, hs-CRP and s-100 protein in central nervous system infection.

The aim of the study was to analyze the dynamic changes and diagnostic and prognostic significance of serum procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) and s-100 protein in central nervous system infection. A total of 110 patients diagnosed with central nervous system infection in Department of Neurology in the People's Hospital of Rizhao from January 2014 to January 2016 were selected and retrospectively analyzed; they were divided into the bacterium (n=70) and virus (n=40) groups. Another 45 normal subjects were selected as the control group. PCT, hs-CRP and s-100 protein values in serum and cerebrospinal fluid were measured. The serum PCT, hs-CRP and s-100 protein levels in the bacterium group were significantly higher than those in the virus and control groups (p<0.05). The serum PCT, hs-CRP and s-100 protein levels in the bacterium and virus groups after treatment were obviously decreased compared with those before treatment (p<0.05). PCT, hs-CRP and s-100 protein levels in serum and cerebrospinal fluid in the bacterium and virus groups had no statistically significant differences after treatment (p>0.05). PCT, hs-CRP and s-100 protein levels in deaths in bacterium group were significantly higher than those in survivors (p<0.05). The serum PCT, hs-CRP and s-100 protein levels, can serve as important indexes for the diagnosis of central nervous system infection and their dynamic changes can be used to monitor the changes in disease condition, severity of bacterial infection and prognosis, providing help for the clinical treatment thereof.

Serum S-100 protein levels in children with Henoch-Schonlein syndrome and its clinical significance

Seventy eight children with Henoch-Schonlein syndrome (HSP) admitted in our hospital from October 2013 to April 2015 were enrolled in this study, and 30 healthy children were also enrolled as controls. The serum S-100 protein levels were measured with enzyme-linked immunosorbent assay (ELISA) in two groups; and electroencephalogram (EEG) examination was performed in HSP patients. The serum S-100 protein level of HSP group (0.206±0.101) μg/L was significantly higher than that in the normal control group [(0.060±0.042) μg/L, P<0.001]; and the serum S-100 protein levels in patients with kidney type (0.284±0.099) μg/L and mixed type [(0.284±0.043) μg/L, P<0.01] were higher than those in patients with skin type (0.151±0.098) μg/L, gastrointestinal type (0.138±0.036) μg/L and joint type [(0.117±0.065) μg/L, P<0.001]. Abnormal EEG findings were detected in 52 cases (66.7%), however, no clinical manifestations of nervous system were found in those patients. Serum S-100 protein levels were higher in patients with abnormal EEG than those with normal EEG [(0.223±0.099) μg/L vs. (0.173±0.096) μg/L, P<0.05]. The results suggest that the serum S-100 protein is associated with HSP disease severity, and children with HSP may have subclinical neurological damage. Key words: Schonlein-Henoch; S100 Protein; Child

Correlation of serum S-100 protein level with involvement of territory and size of lesion in acute ischemic stroke

Background: Cerebrovascular accident is the most common and devastating disorders in old age group. The diagnosis of stroke remains a clinical one, with confirmatory evidence obtained through neuroimaging. Neurobiochemical markers have gained special importance in the determination of brain damage resulting from acute stroke. Aim: In this study, we aimed to evaluate serum S-100 protein in blood samples from patients with acute ischemic stroke and investigate the relationship of serum S-100 protein level with the involved territory and size of the lesion. Methods: This was a prospective observational study conducted among 94 patients of acute ischemic stroke admitted to the Medicine Department within 48 h. Serum sample was collected within 48 h and was sent for measurement of serum S-100 protein level. Patients were classified according to involved territory as anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), and more than one territory and correlate it with S-100 protein level. All patients had cranial computerized tomography scan and magnetic resonance imaging in the first 48 h. Neurological examination was done with National Institute of Health Stroke Scale in acute stage and Rankin scale at the time of discharge. Results: Serum S-100 protein levels were significantly higher and maximum in multiple territory involvements followed by MCA, PCA, and ACA infarct. Conclusions: As serum S-100 protein level correlates with the involved territory or infarct size, we can predict the involved territory with the level of S-100 protein.

To study the correlation of serum S-100 protein level with the severity of stroke and its prognostic implication.

Objective:This study investigated correlation between mortality, stroke subtype and stroke severity with serum S-100 protein level prior to the treatment of the patients admitted to the emergency department and diagnosed with a stroke.Methods:Pretreatment sample were collected from the patients (n = 142) to determine S-100 protein level, age and sex-matched healthy individuals (n = 40) served as control. All patients had cranial computerized tomography scan/magnetic resonance imaging in the first 24 h. The neurological evaluation was made with the National Institute of Health Stroke Scale (NIHSS) in the acute stage.Results:Compared with controls, S-100 protein level were significantly higher in the stroke groups. In stroke groups, S-100 protein level was more significantly higher in the ischemic group than hemorrhage and transient ischemic attack group and highest in expired patients.Conclusion:Serum S-100 protein measurement can be used as an early marker of brain damage. There is a role of S-100 protein as a co-predictor of outcome in patients with acute stroke.

Neurotrophic factors concentration in rat brain at the experimental coma

Aim. To study the changes of neurotrophic factors concentrations depending on stage of intoxication with deprivation substances (ethanol or sodium oxybutirate) in rats. Methods. Experiments were performed on male white laboratory rats. Control and experimental groups included 10 animals each. Half-lethal doses of a deprivation substance (ethanol or sodium oxybutirate) were introduced intraperitoneally 3, 6, 12, 24 and 72 hours before blood specimen collection. Neuron-specific enolase, S-100 protein, brain-derived neurotrophic factor, pigment epithelium-derived factor, glial fibrillary acidic protein serum levels were measured by enzyme immunoassay. Results. At single infusion of mean lethal dose of sodium oxybutyrate S-100 protein serum level significantly increased after 6 hours compared to control and stayed elevated during the first 24 hours. The levels of neurotrophic and neuroprotective factors also significantly increased 3 and 6 hours after the drug administration. The toxic dose of ethanol have significantly increased (over than 1.8 times compared to the controls) the concentration of protein S-100 in rats after 3 hours. The maximum increase in the protein S-100 level (by 2.6 times and over) was noted 12 hours after the toxicant administration. Glial fibrillar acidic protein concentration was 2.9 times higher compared to controls 3 hours after and 1.9 times higher 6 hours after higher the ethanol administration (р 0.05). The concentration of brain - derived neurotrophic factor has also increased from 3 to 12 hours after the toxicant administration, and was 2.1 to 2.4 times higher compared to intact animals. Conclusion. Studying of neurotrophic factors brain in plasma showed that the development of hypoxia, accompanying coma, leads to higher serum levels of S-100 protein, brain-derived neurotrophic factor and glial fibrillar acidic protein. The increase in the concentration of S-100 is a marker for the presence of brain damage. The observed increase of glial fibrillar acidic protein in experiments with ethanol may indicate its more severe brain tissue damage compared to sodium oxybutyrate.

Bispectral index predicts deaths within 2 weeks in coma patients, a better predictor than serum neuron-specific enolase or S100 protein

We assessed the ability of bispectral index (BIS) to predict clinical outcome (dead or alive within 2 weeks). In total, 90 coma patients with severe brain injuries underwent BIS monitoring, and serum neuron-specific enolase (NSE) and S100 protein levels were assayed within the first 3 days of admission. Receiver operator characteristic (ROC) curve analysis was used to assess the performance of BIS values for predicting death within 2 weeks. A cutoff value was calculated using the Youden index. A significant negative correlation was found between BIS value and serum NSE and S100 levels. The area under the curve for BIS value was 0.841 (p < 0.001, 95 % CI = 0.751-0.931), and higher than for NSE (0.713) (p = 0.002, 95 % CI = 0.582-0.844) or S100 (0.790) (p < 0.001, 95 % CI = 0.680-0.899). The optimal cutoff of BIS was 32.5. Serum NSE and S100 protein levels and the mortality rate were significantly lower in patients with a BIS value >32.5 than in patients with a BIS value ≤32.5. Bispectral index values may reflect degree of brain injury, and BIS is an objective and noninvasive monitoring method for helping clinicians to predict death in patients with a BIS value ≤32.5.

Comparing S-100 beta protein levels and neurocognitive functions between patients undergoing on-pump and off-pump coronary artery bypass grafting

BackgroundIn the present study, we aimed to investigate the effects of off-pump coronary artery bypass grafting and on-pump cardiopulmonary bypass on the serum S-100 beta (S-100B) protein levels and neurocognitive functions of the patients. Materials and methodsSixty-four patients undergoing coronary artery bypass grafting (CABG) were enrolled in the study and were divided into two groups: off-pump (group I, n = 24) and on-pump CABG (group II, n = 40) group. Serum S-100B levels were measured before and 0, 6, and 24 h after the operation. Neurocognitive function tests were done preoperatively and were repeated in the postoperative period as well. ResultsSerum S-100B levels were similar between the two groups preoperatively. However, median S-100B levels at 0, 6, and 24 h after the surgery were found to be significantly lower in the off-pump CABG group than in the on-pump group. The preoperative neurocognitive functions of the patients were similar between the two groups, whereas neurocognitive function was found to be significantly impaired postoperatively in the on-pump group in comparison with the off-pump CABG group. ConclusionWe concluded that off-pump CABG is associated with decreased serum S100 protein levels and less impairment on neurocognitive functions compared with the on-pump group.

Which Treatment Modality Is More Injurious to the Brain in Patients with Subarachnoid Hemorrhage? Degree of Brain Damage Assessed by Serum S100 Protein after Aneurysm Clipping or Coiling

Background: Serum S100 protein has been known to reflect the severity of brain damage. The purpose of this study was to compare the degree of brain damage based on the serum S100 protein level between aneurysm clipping and coiling groups and to evaluate the prognostic value of S100 protein in patients with subarachnoid hemorrhage (SAH). Methods: Serum S100 protein was measured by Elecsys S100 immunoassay at admission, and at 6 and 24 h, and days 3 and 5 postoperatively for 100 consecutive SAH patients (clipping group: 56, coiling group: 44) and for 74 healthy controls. Hunt-Hess grade (HHG), Fisher grade (FG), the presence of intraventricular (IVH) or intracerebral hemorrhage (ICH), and outcome at discharge were evaluated. The time course of serum S100 was compared between the groups. The prognostic value of S100 protein was evaluated by logistic regression analysis. Results: The median S100 level in SAH patients on admission was significantly higher than in healthy controls (0.081 vs. 0.05 µg/l, p < 0.0001) and it was also higher as HHG and FG increased (p < 0.0001). Logistic regression analysis revealed that only the S100 value at admission was an independent prognostic factor for poor outcomes after adjusting for age, sex, HHG, presence of IVH or ICH, and treatment modality (OR: 100.5, 95% CI: 1.65–6,053.61). The baseline S100 value of 0.168 predicted poor outcomes with a sensitivity of 75% and a specificity of 83%. The time course of the median S100 level peaked at 6 h and then decreased serially in both clipping and coiling groups. However, the degree of S100 elevation was marked in the clipping group, especially at 6 h postoperatively (0.177 vs. 0.116 µg/l, p = 0.022), suggesting more severe brain damage in the clipping group. In the coiling group, the S100 value was significantly higher in patients who showed high signal intensity lesions in diffusion-weighted images, suggesting ischemic brain damage. Furthermore, even in patients who were categorized as good clinical grade at admission and as good outcome at discharge, the median S100 values at 6 and 24 h postoperatively were significantly higher in the clipping group than in the coiling group (p < 0.05). Conclusion: The initial S100 protein value is an independent prognostic factor for poor outcomes in SAH patients. Based on the S100 protein level, aneurysm clipping seems to provoke more brain damage than aneurysm coiling. Endovascular coiling should be considered the first therapeutic option for aneurysmal SAH patients.

The Role of Serum Osteoprotegerin and S-100 Protein Levels in Patients with Acute Ischaemic Stroke: Determination of Stroke Subtype, Severity and Mortality

This study investigated correlations between mortality, stroke subtype and stroke severity with serum osteoprotegerin (OPG) and S-100 protein levels prior to the treatment of patients admitted to the emergency department and diagnosed with ischaemic stroke. Pretreatment serum samples were collected from patients (n = 90) to determine OPG and S-100 protein levels. Age- and sex-matched healthy individuals (n = 16) served as controls. Compared with controls, OPG and S-100 protein levels were significantly higher in the cardioembolic and atherothrombotic stroke groups. Within the stroke group, OPG levels were significantly higher in the cardioembolic and atherothrombotic stroke groups compared with the transient ischaemic attack (TIA) group. S-100 protein levels were significantly higher in the atherothrombotic stroke group than in the lacunar stroke and TIA groups, and in the cardioembolic stroke group compared with the lacunar stroke group. Serum OPG and S-100 protein levels were significantly higher in patients who died compared with survivors. In predicting stroke subtype and severity, although both OPG and S-100 protein levels were indicators, S-100 protein was more valuable for mortality prediction.

Evaluation of continuous monitoring of bispectral index in prognosis in patients with acute brain injury

To discuss the effect of continuous monitoring of bispectral index (BIS) on the prognosis of patients with acute brain injury. A retrospective study was carried out, 61 patients with acute brain injury admitted to the intensive care unit (ICU) from March 2009 to July 2010 were divided into survival group (n=25) and death group (n=36). The BIS was continuously monitored for 12 hours within the first 3 days or 24 hours after stoppage of sedative after admission to ICU. The mean value of BIS (BISmean), the maximal value of BIS (BISmax), and the minimal value of BIS (BISmin) were evaluated. At the same time, the acute physiology and chronic health evaluationII (APACHEII) score, probability of survival (PS) and Glasgow coma score (GCS) were evaluated. The values of serum S100 protein and neuron-specific enolase (NSE) were determined. The relationship between BISmean and GCS, S100 protein and NSE were respectively analyzed. (1)There was no significant difference in the sex, age, or duration of mechanical ventilation between two groups. APACHEII score in death group was significantly higher than the survival group (27.36±5.99 vs. 23.28±6.69), PS was significantly lower than the survival group (0.31±0.17 vs. 0.49±0.19), and length of stay in ICU (days) was significantly lower than that of the survival group (6.33±4.48 vs. 27.88±54.46), P<0.05 or P<0.01. (2) BISmean, BISmax, BISmin, GCS in death group were significantly lower than those in the survival group (BISmean: 35.45±28.31 vs. 55.91±17.53, BISmax: 51.92±34.24 vs. 74.84±16.58, BISmin: 22.39±24.83 vs. 39.68±15.72, GCS score: 3.64±1.19 vs. 5.60±2.22), P<0.05 or P<0.01, while serum S100 protein and NSE levels were significantly higher than the survival group [S100 protein (μg/L): 7.54±10.49 vs. 1.18±1.57, NSE (μg/L): 120.74±109.01 vs. 49.83±54.94], both P<0.01. (3) By bivariate analysis, BISmean was positively correlated with GCS (r=0.379, P=0.003), whereas it was found to be negatively correlated with S100 protein and NSE levels (r₁=-0.418, P₁=0.001; r₂=-0.290, P₂=0.023). BIS monitoring can be applied as an early objective indicator to evaluate the prognosis of the acute brain injured patients with the characteristics of being noninvasive, intuitive, easy-to-manipulate, and non-stop monitoring.

Neuromarkers as diagnostic adjuvant to cranial CT in closed traumatic brain injury patients admitted to ICU: A preliminary comparative study

ObjectivesEvaluating the diagnostic and/or prognostic yield of serum levels of three neuromarkers, serum S100 protein, neuron-specific enolase (NSE) and Glial Fibrillary Acidic Protein (GFAP), in patients who were admitted to surgical intensive care unit (SICU) and had closed traumatic brain injury with suspicious presence of intracranial hematoma compared versus cranial CT (CCT) as a gold standard diagnostic modality.Patients and methodsThe study included 70 patients who had sustained a closed traumatic brain injury (TBI) requiring intensive care and/or surgical interference. All patients underwent clinical evaluation for all traumatized organs using Injury Severity Score (ISS) and concerning TBI Glasgow Coma Scale (GCS) score was recorded after non-surgical resuscitation. Then, all underwent CT scanning of the brain and patients with a surgically treatable mass underwent decompressive craniotomy, while patients free of hematoma or with minute-to-small hematoma not necessitating surgical interference were kept under observation. Venous blood samples were obtained from all enrolled patients at time of admission and patients who showed deterioration during conservative treatment gave second sample for ELISA estimation of serum S100 protein, NSE and GFAP.ResultsForty-three patients had intracranial hematoma (Positive CCT); 26 patients underwent surgical interference, while the other 17 hematoma patients and 27 hematoma free patients (Negative CCT) were kept under observation. Of them 15 patients; 10 with hematoma and five who were hematoma free developed symptoms of increased ICP and follow-up CCT examination defined five cases required surgical interference with 66.7% rate for unnecessary follow-up CCT. Thirty-nine patients (55.7%) responded to conservative treatment and were discharged to the ward, while a total of 31 patients (44.3%) had surgical interference. Mean serum levels of studied parameters were significantly higher in all patients compared to controls with significantly higher levels in patients who had positive CCT compared to those who had negative CCT and in patients who required surgical interference compared to those managed conservatively. Patients who showed deterioration had significantly 2nd sample higher serum levels of S100 protein and GFAP, but non-significantly higher serum NSE levels compared to at admission levels. Percentage of increase of serum GFAP levels in follow-up sample obtained from patients who had positive CCT was significantly higher compared to the percentage of increase in serum S100 protein and NSE.ConclusionEstimation of serum levels of neuromarkers as adjuvant diagnostic and prognostic tools for closed TBI patients, but serum level of GFAP showed superior applicability and was more valid prognostic modality that could spare unnecessary CCT if applied as the percentage of change in comparison to at admission levels.

The effects of 4 ℃ hypertonic saline on S100 protein in serum and brain tissue of rats after cardiac arrest

Objective To investigate the effects of 4℃ hypertonic saline （FITS） on S100 protein in serum and brain tissues of rats after cardiac arrest（SCA）. Method Thirty SD male rats were randomly divided into shame-operated group （A）, NS group （B）,4℃ NS group （C）, HTS group （D） and4 ℃ FITS group （E）, in equal number （ n = 6）. Drugs were given to the rats of all groups at the initiation of CPR except group A. The rat model of CA was induced by asphyxia. Over 24 hours after rsstoration of spontanous circulation （ROSC）, venous blood sample was drawn to detcect the concentration of serum S100 protein in each group, and the rats were sacririced and their brain tissues were taken for comparing the expressions of S100 protein in hippocampus. One-way analysis of variance and q -test were used for comparison among groups. P 〈 0.05 was considered significant. Resuits Compared with group A, the concentration of serum S100 protein in other groups were much higher （ P 〈 0.01）. Compared with group B,the concentrations of serum S100 protein in groups C, D and E were also much lower （ P 〈 0.01 ）. Compared with groups D and E, the concentration of serum S100 protein in group C was much higher （ P 〈 0.01 ）. Compared with group D, the concentration of serum S100 protein in group D was higher （ P 〈 0.05）. Compared with group A, the expressions of S100 protein in rats brain tissues of groups B, C and D were much higher （ P 〈 0.01 ）. The expression of S100 protein in brain tissue of rats in group E was also higher than that in rats of group A （ P 〈 0.05）. Compared with group B, the expressions of S100 protein in brain tissues of rats in groups C,D and E were lower （P 〈 0.05 and P 〈 0.01）. Compared with group C,the expressions of S100 protein in brain tissues of rats in groups D and E were lower （ P 〈 0.01 ）. Compared with group D, the expression of S100 protein in brain tissue of rats in group E was lower （ P 〈 0.05）. Conclusions After CA the 4℃ HTS can decrease serum S100 protein level and inhibit the expression of S100 protein in hippocampus, then protecting the brain tissue. Key words: Mild hypothermia; Hypertonic saline; Sudden cardiac arrest; S100 protein; Cerebral protection

Baseline Staging of Melanoma with Unknown Primary Site: The Value of Serum S100 Protein and Positron Emission Tomography

Background: Baseline staging is important in all melanoma types, including melanoma with unknown primary site (MUP). Staging includes different examination strategies, each with different accuracy. Objective: To determine the value of serum S100 protein levels and positron emission tomography (PET) in the baseline staging of MUP. Methods: Twenty patients with MUP were evaluable for the analysis between 1996 and 2007 with both S100 assessment and PET performed for baseline staging. Results: Serum S100 was elevated in 7 patients (35%). The PET scan detected the metastases in 6 of 7 patients with elevated serum S100 protein showing a strong correlation (p = 0.005). Patients with metastases had significantly higher serum S100 levels (p = 0.01) than the ones without. Serum S100 protein was shown to be discriminative between patients with and without metastases (receiver-operating characteristic, p = 0.012) with 75% sensitivity and 92% specificity. Conclusion: Serum S100 protein appears to be a sensitive as well as specific marker to detect metastases. We therefore might recommend serum S100 assessment to be included in the baseline staging of MUP.

S-100 Protein Levels in Children with Kawaski Disease: Correlation with Irritability

Kawasaki Disease (KD) is a systemic vasculitis with central nervous system (CNS) manifestations including irritability, cerebrospinal fluid pleocytosis and cerebral hypoperfusion. S-100, a dimeric protein present in glial cells, is elevated in patients with brain tumors and stroke and following cardiopulmonary bypass. The purpose of this study was to determine if serum S-100 protein levels are abnormally elevated in children with KD and to correlate these measurements with markers for systemic and CNS inflammation. We measured S-100 levels in 15 children with classical KD, mean age 3.0 years (range 7 months-6 years), at 3 intervals: presentation, 11-21 days from onset of disease and 22-63 days from onset. Elevated S-100 levels (>0.2μg/L) were found in 3/15 (20%) both at presentation, and at 11-21 days, and 4/15 (26.7%) at 22-63 days. The subjects were subdivided into Group I (n=8), at least 1 abnormal S-100 measurement and Group II (n=7), normal S-100 at all times. The groups were compared for, age, duration of fever, echocardiographic changes, irritability and systemic inflammatory markers at each time period. Clinical associations were made independent of knowledge of S-100 levels. There was no difference in clinical signs or echo findings between the groups following treatment. Patients in Group I were younger at presentation (1.7±1.4 yrs. vs. 4.1±1.9 yrs., p=0.05) and more irritable at diagnosis (71% vs. 13% p=0.04). Fever persisted longer in Group II (9.6±2.8 days) following treatment than in Group I (6.1±1.8 days, p=0.035). The findings show that S-100 protein was elevated in a number of patients with KD who were younger and more irritable at presentation. We speculate that inflammatory changes of the CNS can lead to increased levels of S-100 which can serve as a marker for CNS inflammation.