Spinal fluid, Abnormalities

Calcium dysregulation has long been implicated in the potential pathophysiology of different phases of affective disorders [Carman et al. 1984 Dubovsky and Franks 1983 Dubovsky et al. 1992b, 1994 Jimerson et al. 1979 H. L. Meltzer 1990]. This is based on a combination of data suggesting that 1] calcium-related endocrinopathies are associated with mood disorders 2] abnormal levels of calcium have been found in blood and spinal fluid in association with mood dysregulation 3] abnormalities in intracellular cal-... 

Diagnosis of mitochondrial myopathies is initially clinical, involving phenotypic (observable expression of characters and traits) evaluation, followed by laboratory evaluation. If an mtDNA mutation is detected, diagnosis is relatively straightforward in the absence of an mtDNA mutation, diagnosis becomes difficult. Laboratory studies may include blood plasma or cerebral spinal fluid measurement for lactic acid, ketone bodies, plasma acylcarnitines and organic acids in the urine. If they are abnormal, a muscle biopsy is performed. 

Leukemia begins in the bone marrow and spreads through the lymph and blood system to tissues, organs, and sometimes testicles, brain, and spinal fluid. Leukocytes normally attack, kill, and help to expel invading microbes, but the leukocytes of patients with leukemia are abnormally shaped, increased in number, and immature of development (termed lymphoblasts). As the lymphoblasts multiply and spread, they outnumber and overwhelm the erythrocytes that transport oxygen and carbon dioxide in opposite directions, and hamper the function of platelets (thrombocytes), which help blood to clot. 

Assays of neurotransmitter derivatives (metabolites HIAA from serotonin and MHPG from norepinephrine) in blood, urine, and cerebral spinal fluid have found abnormally low levels of these important neurotransmitters during major depressive episodes. 

The function of clinical chemistry in toxicology (as well as in human and veterinary medicine) is to provide, via laboratory analysis, evaluations of the qualitative and quantitative characteristics of specific endogenous chemical components present in samples of blood, urine, feces, spinal fluid, and tissues. The purpose is to help identify abnormal or pathological changes in organ system functions. The most common specimens used in clinical chemistry are blood and urine, and many different tests exist to test for almost any type of chemical component in blood or urine for example, blood glucose, electrolytes, enzymes, hormones, lipids (fats), other metabolic substances, and proteins. The tests used were all initially applied to human clinical medicine, and may not possess the same utility when performed as part of nonclinical toxicity studies in a wide variety of other species. 

The pathogenesis of the neuro-behavioral abnormalities associated with the Lesch-Nyhan syndrome remains obscure despite recent reports of neurotransmitter abnormalities in these patients. Many attempts to correct the characteristic manifestations of spasticity, mental retardation, choreoathetosis, and compulsive self-mutilation have been reported but none have reported sustained clinical efficacy. Many pathogenic mechanisms have been proposed over the past two decades to explain the relationship between the known aberration in purine metabolism and the observed neurologic dysfunction. One of these proposed mechanisms is that the absence of the purine salvage pathway in the central nervous system (CNS) results in (1) the accumulation of oxy-purines in the spinal fluid which then may act as toxic endogenous mediators and (2) the depletion of guanine and adenine nucleotides that are important to normal CNS function. Supplementation of purine intermediates with dietary adenine, guanosine, inosine, and GMP have not altered the clinical course of the disease. 

Abnormalities in Spinal Fluid Detected by Gas-Liquid Chromatography Chromatographia 12(9) 583-586 (1979) CA 91 190740r... 

As Barcroft has shown, the freedom of human life, as expressed in repose and action, requires constancy in the composition of the blood and the cerebro-spinal fluid, while the stability of the internal environment as a whole requires inter-dependent mechanisms for storage, distribution and removal of solutes. Transitory changes in the blood due to metabolic activity are compensated for by si)ecially adapted systems for neutralisation, detoxication, and pulmonary and renal excretion, and form part of the routine physiological activities of life. Excessive changes in the blood composition are the result of pathological processes, resulting in abnormal metabolism or in defective compensation and excretory dysfunction. 

T. pallidum rapidly penetrates intact mucous membranes or microscopic dermal abrasions, and within a few hours, enters the lymphatics and blood to produce systemic illness. During the secondary stage, examinations commonly demonstrate abnormal findings in the cerebrospinal fluid (CSF). As the infection progresses, the parenchyma of the brain and spinal cord may subsequently be damaged. 

The chemistry, metabolism, and clinical importance of folic acid have been the subject of many excellent reviews (A7, Gil, H14, H20, Rl). Folic acid deficiency leads to a macrocytic anemia and leucopenia. These symptoms are due to inadequate synthesis of nucleic acid. The synthesis of purine bases and of thymine, required for nucleic acid synthesis, is impaired in folic acid deficiency. Detection of folic acid activity in biologic fluids and tissues is of the utmost importance it distinguishes between the various anemias, e.g., those due to vitamin Bi2 or folic acid deficiency. Because morphology of the abnormal red cell does not help in diagnosing vitamin deficiency, one must rely on assay methods for differential diagnosis. Treatment of pernicious anemia with folic acid has led to subacute combined degeneration of the spinal cord despite... 

Figure 18.1. MRI signal abnormalities in the brain and spinal cord in a 55-year-old woman with multiple sclerosis. (A) FLAIR (Fluid attenuated inversion recovery) image of axial brain image at the level of the lateral ventricles. Arrows point to hyperintense periventricular lesions demonstrating a characteristics MS demyelination pattern (B) T2W image of sagittal view of the spinal cord of the same individual, demonstrating focal bright signal (arrow) representing demyelination in the cervical spinal cord.

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