Diagnostic value of quantitative and qualitative variations in cerebrospinal fluid proteins]

Values of the liquor pherogram, which were obtained by means of electrophoresis on acetate folie and classified by disease groups and by the proportions of beta-globulin and first fraction, are compared, with respect to the absolute contents, by reference to tables and figures. The diagnostic importance of low total protein contents in the lumbar liquors of adults is considered in connection with a discussion of the usefulness of indicating the liquor pherogram in terms of percentage or absolute values.     

In-vitro experiments on the clarification of the fibrinolytic activity in normal cerebrospinal fluid]

A direct and indirect detection of plasmin in native CSF was not possible by the thrombelastographic and hot fibrin agar plate method and by electroimmunodiffusion analysis using Laurell's method of fibrin degradation product determination, respectively. The same method was used to determine concentrations of plasminogen and fibrinogen. The CSF, which were retrospectively judged to be normal, neither showed plasmin activity nor exhibited plasminogen and fibrinogen concentrations. Therefore, the liqour possesses only a plasminogen activator protein and does not represent a fibrinolytically active CSF.     

Assessment of prealbumin in cerebrospinal fluid

The paper describes statistical relationship between prealbumin and total protein in lumbal CSF of a control group and a total group of patients with neurological diseases. The equations of the regression lines and the boundary lines of the distribution areas did not significantly differ between both groups. Therefore, prealbumin seems to be not qualified for differential diagnosis. On the other hand, its application to characterize functional states of blood-brain-CSF barrier systems is discussed.     

Determination of dipeptidyl aminopeptidase activities in the cerebrospinal fluid

The investigation of enzyme activity in cerebrospinal fluid has been without relevant results for laboratories analysing spinal fluid. For neurochemical purposes, it is interesting that the Substance P is convered by Depeptidyl-aminopeptidase IV (DP IV), liberating dipeptides. The hydrolysis of nitroanilids of the form Xaa-Pro-NHNp in cerebrospinal fluid was analysed using them as peptidases substrates. Finally a method for measuring the activity was proposed.     

Diagnostic value of aspartate aminotransferase in the cerebrospinal fluid

As datum, the range of aspartate aminotransferase in the cerebrospinal fluid of adults was determined on the basis of 153 fluid samples and compared with the values obtained from 356 neurological patients. A significant increase in enzyme activity was established in respect of CVI, polyneuropathy, acute encephalitis, and SAB. It was possible to eliminate any dependence of the aspartate aminotransferase activity on serum activity, total protein, and cell count. The increase in activity of aspartate aminotransferase in the cerebrospinal fluid is thus identified as an independent pathological fact, and thus it can be incorporated in diagnostic routine more particularly in the diagnosis of CVI disorders.     

IgG determination in the cerebrospinal fluid--correlation of these results with other cerebrospinal fluid values

IgG determined by means of quantitative radial immunodiffusion in the cerebrospinal fluid of 225 neurological patients correlates in a statistically significant manner (p less than 0.001) with the gamma-globulin determined by the acetate foil electrophoresis. The indication of the IgG as a percentage of the total protein (limiting value of 10 per cent) is suitable for an orientating assessment in the diagnosis of inflammatory-immunoreactive diseases of the central nervous system. The IgG-values exceeding 10 per cent of the total protein correlate in 260 fluids examined in the respect with the percental value of the lymphocyte content which also lies above the reference range (p less than 0.001). For the assessment of the presence of a barrier disturbance, a comparison with the serum values should be carried out, either in the form of the frequently used fluid/serum quotients of the immunglobulin or the electrophoretically separated protein fraction.     

Cytodiagnosis in the cerebrospinal fluid with special reference to illness course phases in diseases of the central nervous system

The cytological diagnostic of CSF is indicated in inflammations, vascular and tumorous diseases. A change of normal ratio of 4:1 of CSF-lymphocytes and -monocytes and/or the appearance of functionally active forms of these cell-lines are typical for immunoreactive inflammation (lymphoid cells) or cleaning up (macrophages). Cellular reactions with differing pleocytosis are caused by different irritations within the space of CSF: during the acute phase of meningitis with granulocytosis, in the following cleaning up with monocytosis and macrophages and in inflammatory and immunological reactions with lymphocytosis, lymphoid cells and plasmocytes. Necessary to CSF-diagnostic is the correlation of the stages of the course of disease additional with regard to the quantitative and qualitative results of CSF-protein. Findings of the examination of CSF-cells in diseases of CNS are represented in tabular form.     

Diagnostic value of cerebrospinal fluid in childhood hydrocephalus and hydroma

A statistical analysis of 212 patients with infantile pressure hydrocephalus and 61 with infantile subdural hydromas shows that there are no significant differences in the investigated liquor parameters (cell count, differential sediment, total protein, electrophoresis) that permit differentiation between the two. The significant increase found in the beta-tau fraction by liquor electrophoresis in the hydrocephalus patients is unsuitable for use as a differential diagnostic criterion on account of its poor discrimination. The results of liquor examinations following drainage operations are dealt with separately, and a liquor syndrome found as a rule in liquor taken from a Rickham reservoir is described.     

Diagnostic value of alpha 1-acid glycoprotein in the cerebrospinal fluid

Samples from 1415 neurological patients were used to study the diagnostic value of acid alpha 1-glycoprotein in the lumbar cerebrospinal fluid. The value of analysis for this substance is considered to lie in the detection of non-specific acute-phase reactions of various causes in the CNS with special reference to barrier problems. The large number of pathologically elevated values associated with acute inflammations of the meninges and cerebral parenchyme is particularly striking. The results of the studies are analyzed on the basis of comprehensive control investigations (n = 559).     

Function of the blood-cerebrospinal fluid barrier and selected biochemical cerebrospinal fluid components in senile dementias of various types

Some selected CSF and serum components were determined in demental patients classified by the Hachinski test into vascular and primary-degenerative groups. As for the vascular group, the frequency distribution of the serum/CSF albumin ratios characterizing the barrier function corresponds to that of controls, in primary-degenerative cases, however, it is shifted to higher values. In vascular dementia higher CSF LAP activities pointing to actual cell damaging processes in the CNS were found. The concentrations of lactate and some trace metals in CSF and serum are not suitable for differential diagnostic purposes.     

Quantitative amino acid determination in the serum and cerebrospinal fluid in endogenous depressions

The levels of 20 amino acids were measured in the plasma and cerbrospinal fluid of 41 patients with endogenic depressions. The plasma levels of 12 amino acids were found to be significantly lower in the patients than in the control group, but cerebrospinal fluid levels were significantly lower only in the case of taurine, glutamine, phenylalanine and aginine. Comparison of the same amino acid levels in treated and non-treated patients showed that serine and alpha-aminobutyric acid serum concentrations were higher in the nontreated patients. The tyrosine and phenylalanine levels in the cerebrospinal fluid of the patients who had received medicamentous treatment were higher than in the other group.