Displaying publications 1 - 20 of 425 in total

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  1. ß-blockers in congestive heart failure
    Teh BT, Wan Azman WA, Thuraisingham S, Choy AM, Tan KH, Jesudason P, et al.
    JUMMEC, 1999;4:26-33.
    Activation of the synlpathetic nervous system (SNS) and renin-angiotensin system (RAS) plays a pivotal role in the pathophysiology and progression of the disease in chronic heart failure (CHF). Blocking the activation of the RAS with angiotensin converting enzyme inhibitors not only improves sylnptonls but also prolongs life in symptomatic CHF. Does a similar analogy hold true for the use of ß-blockers in CHF? Evidence from a number of small trials and several recent large prospective trials show that b-blockers may improve ventricular function and symptoms in CHF. In a combination of trials investigating the use of carvedilol (an α, and ß-blocker) in congestive heart failure a mortality benefit appears to be evident. There are still a number of key questions that relnaill unanswered regarding the tolerability, patient type and stage of CHF in which ß-blockers should be advocated. Several large scale trials are in progress to answer some of these questions and also to add further information regarding its efficacy and impact on survival. KEYWORDS: Beta-adrenoreceptor antagonist, congestive heart failure.
    Matched MeSH terms: Nervous System
  2. trans-Cinnamic Acid Conjugated Gold Nanoparticles as Potent Therapeutics against Brain-Eating Amoeba Naegleria fowleri
    Rajendran K, Anwar A, Khan NA, Shah MR, Siddiqui R
    ACS Chem Neurosci, 2019 06 19;10(6):2692-2696.
    PMID: 30970208 DOI: 10.1021/acschemneuro.9b00111
    Primary amoebic meningoencephalitis (PAM), a deadly brain infection, is caused by brain-eating amoeba Naegleria fowleri. The current first line of treatment against PAM is a mixture of amphotericin B, rifampin, and miltefosine. Since, no single effective drug has been developed so far, the mortality rate is above 95%. Moreover, severe adverse side effects are associated with these drugs. Nanotechnology has provided several advances in biomedical applications especially in drug delivery and diagnosis. Herein, for the first time we report antiamoebic properties of cinnamic acid (CA) and gold nanoparticles conjugated with CA (CA-AuNPs) against N. fowleri. CA-AuNPs were successfully synthesized by sodium borohydride reduction of tetrachloroauric acid. Size and morphology were determined by atomic force microscopy (AFM) while the surface plasmon resonance band was analyzed by ultraviolet-visible (UV-vis) spectrophotometry for the characterization of the nanoparticles. Amoebicidal and cytopathogenicity (host cell cytotoxicity) assays revealed that both CA and CA-AuNPs displayed significant anti- N. fowleri properties ( P < 0.05), whereas nanoparticles conjugation further enhanced the anti- N. fowleri effects of CA. This study established a potential drug lead, while CA-AuNPs appear to be promising candidate for drug discovery against PAM.
    Matched MeSH terms: Central Nervous System Protozoal Infections
  3. Fulltext Zika - A Pandemic in Progress?
    Mohamad Idris F
    Malays J Med Sci, 2016 Mar;23(2):70-2.
    PMID: 27547117
    The emerging threat of Zika virus outbreak with associated neurological abnormalities needs to be assessed in perspective in terms of its ability to cause a pandemic. This article attempts to throw some light on the issue.
    Matched MeSH terms: Nervous System Malformations
  4. Which somatic symptoms are associated with an unfavorable course in Chinese patients with major depressive disorder?
    Novick D, Montgomery WS, Aguado J, Peng X, Brugnoli R, Haro JM
    Asia Pac Psychiatry, 2015 Dec;7(4):427-35.
    PMID: 26047023 DOI: 10.1111/appy.12189
    This was an analysis of the impact of somatic symptoms on the severity and course of depression in Chinese patients treated for an acute episode of major depressive disorder (MDD).
    Matched MeSH terms: Autonomic Nervous System Diseases/epidemiology*; Central Nervous System Diseases/epidemiology*
  5. Fulltext What We Know about the Molecular Genetics of Central Nervous System (CNS) Tumours in Malaysia
    Sulong S, Yusoff AA, Zainuddin N, Abdullah JM, Pannatil JG, Jaafar H, et al.
    Malays J Med Sci, 2004 Jan;11(1):37-43.
    PMID: 22977358 MyJurnal
    The new millennium has been regarded as a genomic era. A lot of researchers and pathologists are beginning to understand the scientific basis of molecular genetics and relates with the progression of the diseases. Central nervous system (CNS) tumours are among the most rapidly fatal of all cancers. It has been proposed that the progression of malignant tumours may result from multi-step of genetic alterations, including activation of oncogenes, inactivation of tumour suppressor genes and also the presence of certain molecular marker such as telomerase activity. In this paper, we review some recent data from the literature, including our own studies, on the molecular genetics analysis in CNS tumours. Our studies have shown that two types of tumour suppressor genes, p53 and PTEN were involved in the development of these tumours but not in p16 gene among the patients from Hospital Universiti Sains Malaysia (HUSM). Telomerase activity also has been detected in various types of CNS tumours. Thus, it is important to assemble all data which related to this study and may provide as a vital information in a new approach to neuro-oncology studies in Malaysia.
    Matched MeSH terms: Central Nervous System Neoplasms
  6. Vincristine-induced peripheral neuropathy in survivors of childhood acute lymphoblastic leukaemia
    Tay CG, Lee VWM, Ong LC, Goh KJ, Ariffin H, Fong CY
    Pediatr Blood Cancer, 2017 Aug;64(8).
    PMID: 28139029 DOI: 10.1002/pbc.26471
    BACKGROUND: Vincristine, an essential component of childhood acute lymphoblastic leukaemia (ALL) therapeutic protocols, is associated with dose-dependent neurotoxicity, but its long-term morbidity in treated children has not been clearly elucidated. The aim of this study is to determine the prevalence of vincristine-induced peripheral neuropathy (VIPN) among Malaysian childhood ALL survivors and its impact on motor function and quality of life.

    PROCEDURE: Survivors of childhood ALL aged 4-18 years who had completed chemotherapy for 2 years or more were evaluated for VIPN using both the clinical Total Neuropathy Score (cTNS) and nerve conduction studies. Motor function and quality of life of the survivors were assessed via the Bruininks-Oseretsky Test of Motor Proficiency Brief Form, Second Edition (BOT-2 Brief Form) and the Paediatric Quality of Life version 4.0 Generic Core Scales (PedsQL4.0) questionnaire, respectively.

    RESULTS: One hundred and one survivors with a duration of follow-up ranging from 2.0 to 10.3 years were recruited. Twenty-seven (26.7%) had abnormal cTNS scores and 69 (68.3%) had electrophysiological evidence of neuropathy. Of these, 16 (15.8%) had combined clinical and electrophysiological neuropathy (VIPN). Those previously treated on the intermediate- or high-risk treatment stratification arms had a higher risk of developing VIPN (67.3 vs. 32.7%; odds ratio [OR]: 9.06, 95% confidence interval [CI]: 1.14-71.86; P = 0.014). Survivors with VIPN had significantly lower quality of life scores in the physical (P = 0.024) and social domains (P = 0.039) compared with peers without VIPN, but no association with poorer motor function was observed.

    CONCLUSIONS: Sixteen percent of ALL survivors had VIPN. VIPN should be increasingly recognised as a late effect of chemotherapy, as it significantly affects physical and social function quality of life.

    Matched MeSH terms: Peripheral Nervous System Diseases/chemically induced*; Peripheral Nervous System Diseases/epidemiology
  7. Fulltext Variation in wood density and shrinkage in two latex timber clones of rubber trees in different planting densities
    Naji, H.R., Sahri, M.H., Bakar, E.S., Soltani, M., Hamid, H.A.
    ASM Science Journal, 2014;8(1):36-43.
    MyJurnal
    Wood density and types of shrinkage were examined in two rubberwood latex timber clones of rubber (Hevea brasiliensis) namely RRIM 2020 and RRIM 2025, planted at densities of 500, 1000, 1500, and 2000 trees/ha, within a trial plot. The mean wood density showed a low descending trend towards high planting densities in both clones. Wood density was significantly and negatively correlated with planting density. The strength of correlation was moderate. The mean longitudinal shrinkage in both clones and tangential shrinkages in clone RRIM 2020 showed no significant difference among planting densities. The tangential (in RRIM 2025), radial and volumetric shrinkages in both clones decreased from low to high planting densities and the differences were more pronounced between densities of 500 trees/ha and 2000 trees/ha. The magnitudes of correlation between these shrinkages and planting density were low. The regression models indicated that wood density could be more ascribed by planting density followed by volumetric shrinkage. This study exhibited low variations in wood density and shrinkages among clones and the respective planting densities; however, RRIM 2025 was more stable than RRIM 2020.
    Matched MeSH terms: Nervous System Diseases
  8. Vacuum epidural cyst with acute neurological presentation. A case report
    El Beltagi AH, Swamy N, Dashti F
    Neuroradiol J, 2013 Apr;26(2):213-7.
    PMID: 23859245
    The widespread use of MRI in the assessment of low back pain has led to increased detection of degenerative cysts of the spine, which was essentially a surgical diagnosis earlier. The awareness of degenerative cysts, the significance of their role in the etiology of radicular and back pain and their effective management is evolving. We describe a case of bilateral, gas-filled lumbar facet synovial/ ganglion cysts causing focal arachnoid inflammation and lateral lumbar canal stenosis.
    Matched MeSH terms: Nervous System Diseases/complications*; Nervous System Diseases/diagnosis
  9. Unusual, neurological and severe dengue manifestations during the outbreak in Sri Lanka, 2017
    Ngwe Tun MM, Muthugala R, Nabeshima T, Rajamanthri L, Jayawardana D, Attanayake S, et al.
    J Clin Virol, 2020 04;125:104304.
    PMID: 32145478 DOI: 10.1016/j.jcv.2020.104304
    BACKGROUND: Sri Lanka experienced its largest dengue outbreak in 2017 with more than 185,000 dengue cases including at least 250 fatalities.

    OBJECTIVES: Our study aimed to characterize the clinical, immunological and virological features of confirmed dengue patients in Sri Lanka during the outbreak in 2017 when unusual manifestations of severe dengue were observed.

    STUDY DESIGN: Sera from 295 patients who were admitted to Teaching Hospital Kandy, Kandy, Sri Lanka between March 2017- January 2018 were subjected to NS1 antigen, IgM and IgG ELISAs, virus isolation, conventional and real time RT-PCR and next generation sequencing.

    RESULTS: Primary and secondary infections were detected in 48.5 % and 51.5 % of the study population, respectively. Two hundred twenty five DENV strains were isolated (219 DENV-2, one DENV-3, two DENV-4, two mixed infections of DENV-2 and -3 and one mixed infection of DENV-2 and -4). Unusual and severe manifestations such as encephalitis, encephalopathy, liver failure, kidney failure, myocarditis, Guillain-Barré syndrome and multi-organ failure were noted in 44 dengue patients with 11 deaths. The viraemia levels in patients with primary infection and unusual manifestations were significantly higher compared to those in patients with secondary infection. A new clade of DENV-2 Cosmopolitan genotype strains was observed with the strains closely related to those from China, Malaysia, Indonesia, Singapore and Taiwan.

    CONCLUSIONS: The new clade of DENV-2 cosmopolitan genotype observed in Sri Lanka in 2017 caused an unprecedented, severe dengue outbreak. The emergence of DENV-3 and DENV-4 in the 2017 outbreak might cause future outbreaks in Sri Lanka.

    Matched MeSH terms: Nervous System Diseases/epidemiology; Nervous System Diseases/virology*
  10. Unusual clinical manifestations of dengue virus infection
    George R, Liam CK, Chua CT, Lam SK, Pang T, Geethan R, et al.
    Southeast Asian J. Trop. Med. Public Health, 1988 Dec;19(4):585-90.
    PMID: 3238469
    Four recent cases of dengue fever with severe, unusual clinical manifestations are described. Two of these cases had features of fulminant hepatitis and encephalopathy; one of these cases was fatal. The two remaining cases showed hepatitis with renal impairment. The significance and importance of these unusual manifestations of dengue disease are discussed.
    Matched MeSH terms: Central Nervous System/physiopathology
  11. Unusual case of cerebral demyelination and bilateral optic neuritis in an infant with suppurative BCG lymphadenitis
    Anandakrishnan P, Khoo TB
    BMJ Case Rep, 2018 May 30;2018.
    PMID: 29848532 DOI: 10.1136/bcr-2018-224496
    Cerebral demyelination and optic neuritis are often seen in children with acute disseminated encephalomyelitis following various infections and immunisations. An eight month old girl presented with a left axillary lymph node swelling and an erythematous lace-like rash over her cheeks and trunk. She then developed acute encephalopathy, bilateral nystagmus, right hemiparesis and left facial nerve palsy. Her electroencephalogram showed an encephalopathic process and visual evoked response study were grossly abnormal. Her MRI brain showed hyperintensities in the midbrain, pons and bilateral cerebellar peduncles. She was treated as postinfectious cerebral demyelination with intravenous antibiotics, methylprednisolone and immunoglobulin. Left axillary lymph node excision biopsy and GeneXpert test detected Mycobacterium tuberculosis complex that prompted initiation of antituberculous therapy. Her chest X-ray and cerebrospinal fluid examinations for tuberculosis were normal. She showed significant recovery after 2 weeks. This case illustrates a rare presentation of cerebral demyelination and bilateral optic neuritis following suppurative BCG lymphadenitis.
    Matched MeSH terms: Tuberculosis, Central Nervous System/chemically induced
  12. Understanding the mechanisms underlying the disruption of the blood-brain barrier in parasitic infections
    Jamil Al-Obaidi MM, Desa MNM
    J Neurosci Res, 2024 Jan;102(1).
    PMID: 38284852 DOI: 10.1002/jnr.25288
    Parasites have a significant impact on the neurological, cognitive, and mental well-being of humans, with a global population of over 1 billion individuals affected. The pathogenesis of central nervous system (CNS) injury in parasitic diseases remains limited, and prevention and control of parasitic CNS infections remain significant areas of research. Parasites, encompassing both unicellular and multicellular organisms, have intricate life cycles and possess the ability to infect a diverse range of hosts, including the human population. Parasitic illnesses that impact the central and peripheral nervous systems are a significant contributor to morbidity and mortality in low- to middle-income nations. The precise pathways through which neurotropic parasites infiltrate the CNS by crossing the blood-brain barrier (BBB) and cause neurological harm remain incompletely understood. Investigating brain infections caused by parasites is closely linked to studying neuroinflammation and cerebral impairment. The exact molecular and cellular mechanisms involved in this process remain incomplete, but understanding the exact mechanisms could provide insight into their pathogenesis and potentially reveal novel therapeutic targets. This review paper explores the underlying mechanisms involved in the development of neurological disorders caused by parasites, including parasite-derived elements, host immune responses, and modifications in tight junctions (TJs) proteins.
    Matched MeSH terms: Central Nervous System
  13. Uncovering neural tube defects in humans through candidate gene expression patterns in mouse embryos
    Nor Linda Abdullah, Mustakiza Muslimin, Hoo, Wan Mun, Fahimah Noor Ngah, Sheikh Mohd Norhafiz Abdul Aziz, Nor Syazwani Yip, et al.
    Orient Neuron Nexus, 2010;1(1):2-6.
    MyJurnal
    Neural tube defects (NTDs) are the leading cause of disability in humans arising from the malformation of the central nervous system. The genes responsible and their involvement in causing neural tube defects in humans are poorly understood. Gene expression analysis in a whole organism enables the identification of the possible role of the gene being studied. If the gene is expressed in a particular tissue at a certain period of development, this spatiotemporal pattern of the gene of interest signals the possibility that the gene serves a function of being switched on in those tissues at that particular time. In this report, we have identified possible gene candidates in the mouse which may be required for the development of the neural tube, the precursor to the brain and the spinal cord. Development of the brain occurs by closure of the anterior neuropore (forms the cranial neural tube) while the spinal cord forms due to resolution of the posterior neuropore (forms the caudal neural tube). The genes Tiaml and T-cadherin were found to be likely candidate genes for the development of the spinal cord and may serve as potential human NTDs genes.
    Matched MeSH terms: Central Nervous System
  14. Fulltext Tuberculous meningitis is a major cause of mortality and morbidity in adults with central nervous system infections in Kota Kinabalu, Sabah, Malaysia: an observational study
    Lee HG, William T, Menon J, Ralph AP, Ooi EE, Hou Y, et al.
    BMC Infect Dis, 2016 06 16;16:296.
    PMID: 27306100 DOI: 10.1186/s12879-016-1640-x
    BACKGROUND: Central nervous system (CNS) infections are a significant contributor to morbidity and mortality globally. However, most published studies have been conducted in developed countries where the epidemiology and aetiology differ significantly from less developed areas. Additionally, there may be regional differences due to variation in the socio-economic levels, public health services and vaccination policies. Currently, no prospective studies have been conducted in Sabah, East Malaysia to define the epidemiology and aetiology of CNS infections. A better understanding of these is essential for the development of local guidelines for diagnosis and management.

    METHODS: We conducted a prospective observational cohort study in patients aged 12 years and older with suspected central nervous system infections at Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia between February 2012 and March 2013. Cerebrospinal fluid was sent for microscopy, biochemistry, bacterial and mycobacterial cultures, Mycobacterium tuberculosis polymerase chain reaction (PCR), and multiplex and MassCode PCR for various viral and bacterial pathogens.

    RESULTS: A total of 84 patients with clinically suspected meningitis and encephalitis were enrolled. An aetiological agent was confirmed in 37/84 (44 %) of the patients. The most common diagnoses were tuberculous meningitis (TBM) (41/84, 48.8 %) and cryptococcal meningoencephalitis (14/84, 16.6 %). Mycobacterium tuberculosis was confirmed in 13/41 (31.7 %) clinically diagnosed TBM patients by cerebrospinal fluid PCR or culture. The acute case fatality rate during hospital admission was 16/84 (19 %) in all patients, 4/43 (9 %) in non-TBM, and 12/41 (29 %) in TBM patients respectively (p = 0.02).

    CONCLUSION: TBM is the most common cause of CNS infection in patients aged 12 years or older in Kota Kinabalu, Sabah, Malaysia and is associated with high mortality and morbidity. Further studies are required to improve the management and outcome of TBM.

    Matched MeSH terms: Central Nervous System Infections/cerebrospinal fluid; Central Nervous System Infections/microbiology; Central Nervous System Infections/mortality; Central Nervous System Infections/epidemiology
  15. Fulltext Tryptophan-catabolizing enzymes - party of three
    Ball HJ, Jusof FF, Bakmiwewa SM, Hunt NH, Yuasa HJ
    Front Immunol, 2014;5:485.
    PMID: 25346733 DOI: 10.3389/fimmu.2014.00485
    Indoleamine 2,3-dioxygenase (IDO) and tryptophan 2,3-dioxygenase (TDO) are tryptophan-degrading enzymes that have independently evolved to catalyze the first step in tryptophan catabolism via the kynurenine pathway (KP). The depletion of tryptophan and formation of KP metabolites modulates the activity of the mammalian immune, reproductive, and central nervous systems. IDO and TDO enzymes can have overlapping or distinct functions depending on their expression patterns. The expression of TDO and IDO enzymes in mammals differs not only by tissue/cellular localization but also by their induction by distinct stimuli. To add to the complexity, these genes also have undergone duplications in some organisms leading to multiple isoforms of IDO or TDO. For example, many vertebrates, including all mammals, have acquired two IDO genes via gene duplication, although the IDO1-like gene has been lost in some lower vertebrate lineages. Gene duplications can allow the homologs to diverge and acquire different properties to the original gene. There is evidence for IDO enzymes having differing enzymatic characteristics, signaling properties, and biological functions. This review analyzes the evolutionary convergence of IDO and TDO enzymes as tryptophan-catabolizing enzymes and the divergent evolution of IDO homologs to generate an enzyme family with diverse characteristics not possessed by TDO enzymes, with an emphasis on the immune system.
    Matched MeSH terms: Central Nervous System
  16. Fulltext Triterpene composition and bioactivities of Centella asiatica
    Hashim P, Sidek H, Helan MH, Sabery A, Palanisamy UD, Ilham M
    Molecules, 2011;16(2):1310-22.
    PMID: 21278681 DOI: 10.3390/molecules16021310
    Leaves of Centella asiatica (Centella) were analysed for their triterpene composition and bioactivity such as collagen enhancement, antioxidant, anticellulite and UV protection capacity properties. Triterpenes of Centella were measured using HPLC-PAD on an Excil ODS 5 mm (C18) column for the simultaneous determination of asiatic acid, madecassic acid, asiaticoside and madecassoside. Centella was found to contain significant amounts of madecassoside (3.10 ± 4.58 mg/mL) and asiaticoside (1.97 ± 2.65 mg/mL), but was low in asiatic and madecassic acid. The highest collagen synthesis was found at 50 mg/mL of Centella extracts. The antioxidant activity of Centella (84%) was compared to grape seed extract (83%) and Vitamin C (88%). Its lipolytic activity was observed by the release of glycerol (115.9 µmol/L) at 0.02% concentration. Centella extracts exhibited similar UV protection effect to OMC at 10% concentration. In view of these results, the potential application of Centella in food and pharmaceutical industries is now widely open.
    Matched MeSH terms: Central Nervous System Stimulants/pharmacology
  17. Treatment Barriers Associated with Amphetamine-Type Stimulant (ATS) Use in Malaysia
    Singh D, Narayanan S, Shanmugam T, Vicknasingam B
    J Psychoactive Drugs, 2021 Mar 22.
    PMID: 33749541 DOI: 10.1080/02791072.2021.1900627
    People who use amphetamine-type stimulant (ATS) are known to face barriers in seeking treatment. We sought to identify these barriers and gender differences in barriers (if any) faced by them. A convenience sample of 386 respondents who use ATS was recruited from five formal drug rehabilitation centers for this cross-sectional study. The majority were male (83%), with 17% being female. The barriers most frequently cited by both men and women were: the perception that ATS use needed no treatment, fears of community discrimination, peer influence, and long waiting time to get into a treatment programme. One-third of the sample held that the mandated treatment programmes were ineffective, based on past experience. In terms of male-female differences, long waiting time discouraged significantly more women than men, whereas more men than women asserted that formal treatment programmes were ineffective. We also found no significant differences in barriers faced by ATS users and those using ATS with other illicit substances. Outreach initiatives to minimize the impact of treatment barriers, coupled with offering separate treatment protocols and facilities, will encourage people who use ATS to seek treatment voluntarily.
    Matched MeSH terms: Central Nervous System Stimulants
  18. Toxic Elements in Food: Occurrence, Binding, and Reduction Approaches
    Hajeb P, Sloth JJ, Shakibazadeh S, Mahyudin NA, Afsah-Hejri L
    Compr Rev Food Sci Food Saf, 2014 Jul;13(4):457-472.
    PMID: 33412705 DOI: 10.1111/1541-4337.12068
    Toxic elements such as mercury, arsenic, cadmium, and lead, sometimes called heavy metals, can diminish mental and central nervous system function; elicit damage to blood composition as well as the kidneys, lungs, and liver; and reduce energy levels. Food is considered one of the main routes of their entry into the human body. Numerous studies have been performed to examine the effects of common food processing procedures on the levels of toxic elements in food. While some studies have reported negative effects of processing, several have shown that processing practices may have a positive effect on the reduction of toxic elements in foodstuffs. A number of studies have also introduced protocols and suggested chemical agents that reduce the amount of toxic elements in the final food products. In this review, the reported methods employed for the reduction of toxic elements are discussed with particular emphasis on the chemical binding of both the organic and inorganic forms of each element in various foods. The molecular groups and the ligands by which the food products bind with the metals and the types of these reactions are also presented.
    Matched MeSH terms: Central Nervous System
  19. Fulltext Torsade de pointes and sudden death associated with diabetic autonomic diarrhoea--a case report
    Quek DK, H'ng PK
    Singapore Med J, 1993 Jun;34(3):266-70.
    PMID: 8266190
    A 68-year-old diabetic and hypertensive woman presented with chronic autonomic diarrhoea, syncope and palpitations which were associated with QT prolongation and recurrent episodes of torsade de pointes. She was on glibenclamide, indapamide and probucol (for type V hyperlipidaemia). Despite intravenous infusions of potassium, lignocaine and amiodarone, the unstable rhythm persisted. However, intravenous magnesium sulphate with small doses of intravenous propranolol terminated the torsade de pointes. She was stabilised but following discharge she relapsed, and upon re-admission, succumbed to intractable ventricular fibrillation. Early recognition and aggressive treatment of this condition is emphasised. Multiple aggravating factors ie autonomic diarrhoea resulting in severe potassium and magnesium depletion, kaliuretic effect of indapamide, probable QT prolongation associated with diabetic autonomic neuropathy and probucol; probable underlying coronary artery disease and heightened emotional and sympathetic discharge could have contributed to this very unstable ventricular arrhythmia and sudden death.
    Matched MeSH terms: Autonomic Nervous System Diseases/complications*
  20. Tonsillar crypt epithelium is an important extra-central nervous system site for viral replication in EV71 encephalomyelitis
    He Y, Ong KC, Gao Z, Zhao X, Anderson VM, McNutt MA, et al.
    Am J Pathol, 2014 Mar;184(3):714-20.
    PMID: 24378407 DOI: 10.1016/j.ajpath.2013.11.009
    Enterovirus 71 (EV71; family Picornaviridae, species human Enterovirus A) usually causes hand, foot, and mouth disease, which may rarely be complicated by fatal encephalomyelitis. We investigated extra-central nervous system (extra-CNS) tissues capable of supporting EV71 infection and replication, and have correlated tissue infection with expression of putative viral entry receptors, scavenger receptor B2 (SCARB2), and P-selectin glycoprotein ligand-1 (PSGL-1). Formalin-fixed, paraffin-embedded CNS and extra-CNS tissues from seven autopsy cases were examined by IHC and in situ hybridization to evaluate viral antigens and RNA. Viral receptors were identified with IHC. In all seven cases, the CNS showed stereotypical distribution of inflammation and neuronal localization of viral antigens and RNA, confirming the clinical diagnosis of EV71 encephalomyelitis. In six cases in which tonsillar tissues were available, viral antigens and/or RNA were localized to squamous epithelium lining the tonsillar crypts. Tissues from the gastrointestinal tract, pancreas, mesenteric nodes, spleen, and skin were all negative for viral antigens/RNA. Our novel findings strongly suggest that tonsillar crypt squamous epithelium supports active viral replication and represents an important source of viral shedding that facilitates person-to-person transmission by both the fecal-oral or oral-oral routes. It may also be a portal for viral entry. A correlation between viral infection and SCARB2 expression appears to be more significant than for PSGL-1 expression.
    Matched MeSH terms: Central Nervous System/virology
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