OBJECTIVE: Despite the recent progress that has been made in intracerebral monitoring, it is still difficult to quantify the exact extent of primary brain damage after severe head injury. In this work, we investigate the role of S-100B protein as a serum marker of brain damage after severe head injury. METHODS: 21 patients with severe head injury (GCS score <9) were selected for this prospective study. A venous blood sample was taken as soon as possible after head injury and the serum concentration of S-100B protein was measured daily for five consecutive days. The serum level of S-100B protein was compared with the patients' outcome. The outcome was measured twice, at hospital discharge and after 6 months of follow-up using the Glasgow Outcome Scale(GOS). RESULTS: Those patients who died within two weeks (after head injury) had a significantly higher serum S-100B value than those who survived (median, 9.64 ug/L versus 2.91 ug/L). Seven (78%) of the nine patients who died had a maximum S-100B value of 2 ug/L or higher, while three (25%) of the twelve surviving patients showed a maximum S-100B protein value of more than 2 ug/L (P<0.05). CONCLUSION: These results indicate that S-100B protein appears to be the most reliable index for estimating the extent of brain damage.
Biomarkers ; Brain ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Humans ; Mortality ; Prognosis ; Prospective Studies ; S100 Calcium Binding Protein beta Subunit*

BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
Area Under Curve ; Heart Arrest* ; Humans ; Hypothermia* ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit* ; Sensitivity and Specificity

Carotid endarterectomy(CEA)has been proved to be an effective surgery to treat the cerebral ischemia caused by carotid atherosclerotic stenosis. However,there is still no effective mean for the early diagnosis of the CEA-related severe complications such as stroke and death. Many studies have explored the potential biomarkers for stroke alert,although there is still a long way to go for their actual application in clinical settings. The carotid atherosclerotic stenosis,the perioperative complications of CEA,and the stroke share similar pathogenic mechanisms,and some biomarkers such as S100B,matrix metalloproteinase 9,asymmetric dimethylarginine,and neuron-specific enolase have been studied in the clinical trails of CEA. This article summarizes recent advances in this field.
Biomarkers ; metabolism ; Endarterectomy, Carotid ; Humans ; Intraoperative Period ; Postoperative Complications ; prevention & control ; Risk Assessment ; S100 Calcium Binding Protein beta Subunit ; metabolism

OBJECTIVE: To explore the effect and clinical significance of serum S100β and NSE on moderate and severe obstructive sleep apnea syndrome (OSAHS) after the continuous positive airway pressure (CPAP). METHOD: A total of 60 cases with obstructive sleep apnea were choosed with PSG in our hospital in June 2009 to June 2009. According to apnea hypoventilation index and at night the lowest oxygen saturation, divided into severe group (n=60) and moderate group (n=60), selecting 60 cases of healthy physical examination for a control over the same period. According to the length of the course of the disease in patients with each group can be divided into <5 years group, 5-10 years and > 10 years group, severe and moderate groups were recruited to undergo an CPAP treatment,both before and after treatment for 3 months, the lowest oxygen saturation, average blood oxygen saturation and apnea hypoventilation index were determined in moderate and severe groups with PSG, at the same time, serum S100β and NSE were determined with immune enzyme-linked adsorption testing before and after patients in different course of treatment and control group. RESULT: Compared with pretherapy of severe and moderate groups, the lowest oxygen saturation, average blood oxygen saturation and apnea hypoventilation index were ower after treatment (P<0. 05), serum S100β and NSE in severe and moderate groups before and after treatment were significantly higher than control group (P<0. 05), and two groups > 10 years before and after treatment in patients with serum according to beta and NSE levels higher than 5-10 patients, 5-10 patients before and after treatment according to beta and NSE serum levels higher than <5 years group of patients, the relation between the two groups of patients before and after treatment according to beta and NSE serum levels with the extension of history time increased. Before the treatment serum according to beta and NSE in patients with severe group were higher than moderate group before treatment (P< 0.05). Relation between the two groups after treatment according to beta and serum NSE was significantly decreased the (P<0. 05), the relation between the two groups after treatment according to beta and serum NSE, there was no statistically significant difference (p>0. 05), the relation between two groups according to beta, NSE serum are positively correlated with AHI (P < 0. 01). CONCLUTION CPAP significantly reduced serum S100β and NSE levels in patients with OSAHS, both may be important index which evaluated nervous system protection of CPAP in patients with OSAHS.
Continuous Positive Airway Pressure ; Humans ; Phosphopyruvate Hydratase ; blood ; S100 Calcium Binding Protein beta Subunit ; blood ; Sleep Apnea, Obstructive ; blood ; therapy

BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
Area Under Curve ; Heart Arrest ; Humans ; Hypothermia ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit ; Sensitivity and Specificity

While the survival rate of preterm infants has continually increased with the development of perinatal and neonatal monitoring techniques, the incidence of brain injury in preterm infants has been increasing, resulting in varying degrees of cognitive impairment and movement disorders. Measuring the biomarkers of brain damage is an important means to diagnose brain injury. The biomarkers can be divided into neuroglial damage markers, neuronal damage markers and other markers according to the features of injured cells. The biomarkers widely used in clinical practice include S100B protein, myelin basic protein and neuron-specific enolase. Recent studies have newly discovered a collection of markers that can suggest potential brain injury in preterm infants, such as glial fibrillary acidic protein, neurofilament light chain protein, α-II spectrin breakdown products, chemokines, melatonin and urinary metabolomics. These biomarkers can contribute to the early diagnosis and treatment of preterm brain injury, essential for improving neural development and prognosis. This article reviews the latest research advances in the biomarkers of preterm brain injury, in order to provide evidence for the early diagnosis and treatment of this condition.
Biomarkers ; Brain ; Brain Injuries ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Pregnancy ; S100 Calcium Binding Protein beta Subunit

PURPOSE: Ninety percent of patients with minor head injury(MHI) who undergo computed tomography (CCT) under current clinical decision rules have normal scans. Serum concentrations of astroglial protein S-100B were recently found to provide useful information in such cases, but there is no clinical data in this country. We have investigated whether S-100B concentrations in alert patients with MHI can serve as an indicator of the need for an initial CCT scan. METHODS: 40 patients with MHI and a control group of 54 healthy volunteers were enrolled in this prospective study. All patients with MHI had a CCT scan to confirm diagnosis, and blood was drawn from all study participants in order to measure S-100B concentrations. Data were analyzed using contingency table and a receiver operating characteristic (ROC) curve to determine the diagnostic value of S-100B. RESULTS: Using a concentration cutoff of 0.12 microgram/L, patients with abnormal CCT findings were identified by S-100B measurement with a sensitivity level of 100% and a specificity level of 46%. S-100B concentrations for head injury patients with multiple trauma were increased more than for patients without combined injuries. CONCLUSION: Adding measurement of S-100B concentration to the clinical decision rules for a CCT scan in alert patients with MHI could allow a 46% reduction in scans in our study. However, before S-100B testing can be used clinically, larger domestic trials conforming to all appropriate ethical guidelines need to be conducted in the near future.
Craniocerebral Trauma* ; Diagnosis ; Head ; Healthy Volunteers ; Humans ; Multiple Trauma ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit* ; S100 Proteins ; Sensitivity and Specificity

BACKGROUND: We previously published the data that proved the safety of retrograde cerebral perfusion for 120 minutes. At this time, we planned to check the neuron-specific enolase and S100-beta in serum and urine to assess the possibility of early detection of cerebral injury. MATERIAL AND METHOD: We used pigs(Landrace species) weighing 35 kg and performed RCP for 120 minutes. After the weaning of cardiopulmonary bypass, we observed the pigs for another 120 minutes. Systemic arterial pressure, central venous pressure, and serum and urine levels of neuron-specific enolose (NSE) and S100beta protein were checked. Central venous pressure during RCP was maintained in the range of 20 to 25 mmHg. RESULT: Serum levels of NSE(ng/ml) were 0.67+/-0.18(induction of anesthesia), 0.53+/-0.47(soon after CPB), 0.44+/-0.27(20min after CPB), 0.24+/-0.09(RCP 20min), 0.37+/-0.35(RCP 40min), 0.33+/-0.21(RCP 60min), 0.37+/-0.22(RCP 80min), 0.41+/-0.23(RCP 100 min), 0.48+/-0.26(RCP 120min), 0.42+/-0.29(30min after rewarming), 0.35+/-0.32(60min after rewarming, 0.42+/-0.37(CPBoff 30min), 0.47+/-0.34(CPBoff 60min), 0.47+/-0.28(CPBoff 90min), and 0.57+/-0.29(CPBoff 120min). There was no statistically significant difference in levels between before and after RCP(ANOVA, p>0.05). Urine levels of NSE also showed no statistically significant difference in levels between before and after RCP. There was no correlation between urine and serum levels of NSE(Pearson correlation, p>0.05). Serum levels of S100beta protein(ng/ml) during the same time frames were 0.14+/-0.08, 0.15+/-0.07, 0.22+/-0.15, 0.23+/-0.07, 0.28+/-0.10, 0.40+/-0.05, 0.47+/-0.03, 0.49+/-0.12, 0.43+/-0.11, 0.46+/-0.15, 0.62+/-0.17, 0.77+/-0.21, 0.78+/-0.23, 0.77+/-0.23, and 0.82+/-0.33. There was statistically significant difference in levels between before and after RCP(ANOVA, p<0.05). Urine levels of NSE also showed statistically significant difference in levels between before and after RCP(ANOVA, p<0.05). There was significant correlation between urine and serum levels of NSE(Pearson correlation, p<0.05). CONCLUSION: The author observed the increase in serum and urine levels of S100beta after 120 minutes of RCP. Significant correlation between serum and urine levels was observed. The results were considered to be the fundamental data that could correlate this study with human-based study.
Arterial Pressure ; Brain Injuries* ; Brain* ; Cardiopulmonary Bypass ; Central Venous Pressure ; Perfusion* ; Phosphopyruvate Hydratase ; Rewarming ; S100 Calcium Binding Protein beta Subunit ; S100 Proteins ; Swine* ; Weaning

OBJECTIVETo analyze the dynamic change of serum protein S100b in patients with traumatic brain injury and its clinical value in assessing brain damage.

METHODSAccording to Glasgow coma scale (GCS), 102 cases of traumatic brain injury were divided into mild brain injury group (GCS > or = 13, n = 31, Group A), moderate brain injury group (8 < GCS < 13, n = 37, Group B) and severe brain injury group (GCS < or = 8, n = 34, Group C). Serial S100b concentrations were analyzed by enzyme-linked immunosorbent assay (ELISA) in blood samples taken on admission, 12 h, 24 h, 48 h, 72 h and 7 days after traumatic brain injury.

RESULTSThe severe brain injury group showed significantly higher concentration of serum S100b, with earlier increase and longer duration, than the mild and moderate brain injury groups. The patients with higher S100b exhibited lower GCS scores and poor clinical prognosis. The increase in S100b could emerge before clinical image evidence indicated so.

CONCLUSIONSSerum S100b can be used as a sensitive index for assessment and prediction of traumatic brain injury severity and prognosis.

Adolescent ; Adult ; Aged ; Brain Injuries ; blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Middle Aged ; Nerve Growth Factors ; blood ; S100 Calcium Binding Protein beta Subunit ; S100 Proteins ; blood

OBJECTIVETo explore the role of S100B protein in the early diagnosis, treatment, and prognosis judgement of craniocerebral injury.

METHODSIn this study, we reviewed the domestic and foreign research reports about the relationship between S100B protein and craniocerebral injury.

RESULTSThe concentration of S100B protein had a different increase based on the degree of injury in early stage after craniocerebral injury, and the increasing degree of S100B protein showed a positive correlation with the grading of pathogenetic condition and prognosis of craniocerebral injury.

CONCLUSIONSS100B protein may be taken as a specific index of early diagnosis, grading of pathogenetic condition, and prognosis judgement after craniocerebral injury. To grasp and regulate the mechanism of neurotoxicity and to elucidate the therapeutic effect of S100B protein will be a research direction in clinical treatment of craniocerebral injury.

Craniocerebral Trauma ; cerebrospinal fluid ; diagnosis ; Humans ; Nerve Growth Factors ; cerebrospinal fluid ; Prognosis ; S100 Calcium Binding Protein beta Subunit ; S100 Proteins ; cerebrospinal fluid