Plasma copeptin and functional outcome in patients with ischemic stroke and type 2 diabetes.

BACKGROUND: The activation of the arginine vasopressin system may be involved in the pathology of stroke and diabetes. In this study, we therefore evaluated the short-term prognostic value of early measurement of plasma copeptin levels in Chinese patients with type 2 diabetes mellitus (T2DM) and acute ischemic stroke (AIS). METHODS: From July 2014 to June 2015, all T2DM patients with first-ever AIS were included. Plasma levels of copeptin were tested at admission. The prognostic value of copeptin to predict the functional outcome and mortality 3months after stroke was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors. RESULTS: We recorded 247 stroke patients with T2DM. The copeptin levels were obtained in those patients with a median value of 14.3pmol/L (IQR, 9.5-17.1pmol/L). At 3-month follow-up, a favorable functional outcome was found in 86 patients (34.8%). Plasma copeptin levels in patients with an unfavorable outcome were significantly greater than those in patients with a favorable outcome (16.2 [IQR, 12.2-20.3] vs. 12.4 [IQR, 8.6-15.2] pmol/L; Z=5.399; P<0.0001). In univariate logistic regression analysis, with an unadjusted OR of 1.123 (95% CI, 1.072-1.177, P<0.001), copeptin had a strong association with unfavorable functional outcome. In multivariate analyses, a copeptin level in the highest inter-quartile (>17.1pmol/L) was associated with a higher risk of unfavorable functional outcome (OR=4.62; 95% CI=2.63-9.21; P<0.001). After adjusting for other outcome predictors, a copeptin level in the highest inter-quartile (>17.1pmol/L) was associated with a higher risk of mortality (OR=5.12; 95% CI=2.20-11.38; P<0.001). CONCLUSION: Our study suggested that copeptin levels may reliably predict short-term stroke prognosis at its onset in Chinese patients with T2DM and stroke.

Intracranial Rosai-Dorfman disease.

Rosai-Dorfman disease (RDD) is a rare histioproliferative disorder that only occasionally involves the central nervous system. We present the diagnosis and treatment of five patients with intracranial RDD. The patients were preoperatively misdiagnosed as meningioma or eosinophilic granuloma. All five patients were treated by total or subtotal surgical resection and none of them experienced recurrence. Histopathological examination showed a characteristic emperipolesis, the lymphocytes were engulfed in the S-100 protein and CD68 positive histiocytes, with negative expression of CD1a. Preoperative diagnosis of intracranial RDD is still challenging because the lesion is usually a dural-based lesion that mimics a meningioma. Surgical resection is an effective treatment and radiotherapy, steroid and chemotherapy has not demonstrated reliable therapeutic efficiency.

A comparative analysis of ESM-1 and vascular endothelial cell marker (CD34/CD105) expression on pituitary adenoma invasion.

OBJECTIVE: Pituitary adenomas are benign neoplasms that display invasive behavior-a characteristic traditionally associated with malignancy-through an ill-defined mechanism. The role of angiogenesis-related molecules in this pathological condition remains perplexing. Our purpose is to assess the impact of endocan (endothelial cell specific molecule-1, ESM-1), CD34 and CD105 on pituitary adenoma invasion. METHODS: In this study, immunohistochemical analyses for endocan, CD34 and CD105 were performed on paraffin-embedded samples of 66 pituitary adenomas, five normal pituitaries, and five primary hepatic carcinomas. Knosp tumor grades based on magnetic resonance imaging coronal scanning were used to assess the invasiveness of each sample. The associations between endocan expression, CD34/CD105-positive microvessel densities (MVDs), and Knosp tumor invasion grades were evaluated. RESULTS: These results showed that endocan protein expression in tumor cells (TCs) was higher than that in endothelial cells (ECs) and strongly correlated with Knosp grades (P < 0.001, Spearman's r = 0.616). Moreover, while endocan-positive TCs localized around the blood vessels in adenomas with higher Knosp grades, no significant association was found between CD34/CD105-MVDs and Knosp grades (CD34: P = 0.256, r = 0.142; CD105: P = 0.183, r = 0.166). Normal pituitary seemed to exhibit lower endocan expression and contained more CD34/CD105-MVDs than pituitary adenomas. CONCLUSION: Endocan expresses in both TCs and ECs of pituitary adenoma. Endocan overexpression in TCs more accurately reflects invasiveness compared to that of CD34/CD105-MVDs and that angiogenesis may not be the primary driver of endocan-medicated pituitary adenoma invasion.

WS0701: a novel sedative-hypnotic agent acting on the adenosine system.

To characterize the sedative and hypnotic profile of the novel adenosine derivative ((3S,4R,5R)-3,4-dihydroxy-5-(6-((4-hydroxy-3-methoxybenzyl)amino)-9H-purin-9-yl)tetrahydrofuran-2-yl) methyl diaconate (WS0701), we performed a variety of behavioural tests and investigated the influence of WS0701 on various sleep stages. In mice, WS0701 significantly increased the number of entries and time spent in open arms in the elevated plus maze test, indicating an anxiolytic effect. WS0701 decreased locomotor activity counts and head dips in the hole-board test and enhanced sodium pentobarbital-induced hypnosis. However, WS0701 did not induce the loss of the righting reflex or amnesic effects in behavioural models. In rats, WS0701 exerted a sedative effect and markedly prolonged the time spent in non-rapid-eye-movement sleep, especially slow-wave sleep, but reduced the time spent in rapid-eye-movement sleep (REMS). Pretreatment with the selective adenosine A2a receptor antagonist SCH58261 attenuated the sedative and hypnotic effects of WS0701. WS0701 did not protect mice against picrotoxin-induced seizures, but inhibited adenosine deaminase activity and increased adenosine levels in the frontal cortex and hypothalamus of mice. In conclusion, WS0701 shows anxiolytic, sedative as well as sleep stage alterative effects, which may be related to the adenosine system.