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1.
Mol Psychiatry ; 21(8): 1130-6, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-26598069

RESUMEN

The mechanisms responsible for fear memory formation and extinction are far from being understood. Uncovering the molecules and mechanisms regulating these processes is vital for identifying molecular targets for the development of novel therapeutic strategies for anxiety and fear disorders. Cognitive abilities require the activation of gene expression necessary to the consolidation of lasting changes in neuronal function. In this study we established a key role for an epigenetic factor, the de novo DNA methyltransferase, Dnmt3a2, in memory formation and extinction. We found that Dnmt3a2 overexpression in the hippocampus of young adult mice induced memory enhancements in a variety of situations; it converted a weak learning experience into long-term memory, enhanced fear memory formation and facilitated fear memory extinction. Dnmt3a2 overexpression was also associated with the increased expression of plasticity-related genes. Furthermore, the knockdown of Dnmt3a2 expression impaired the animals' ability to extinguish memories, identifying Dnmt3a2 as a key player in extinction. Thus, Dnmt3a2 is at the core of memory processes and represents a novel target for cognition-enhancing therapies to ameliorate anxiety and fear disorders and boost memory consolidation.


Asunto(s)
ADN (Citosina-5-)-Metiltransferasas/genética , Extinción Psicológica/fisiología , Memoria/fisiología , Animales , Ansiedad , Trastornos de Ansiedad/metabolismo , Cognición/fisiología , Condicionamiento Psicológico/fisiología , ADN (Citosina-5-)-Metiltransferasas/metabolismo , ADN Metiltransferasa 3A , Epigénesis Genética/genética , Miedo/fisiología , Hipocampo/metabolismo , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Corteza Prefrontal/metabolismo
2.
J Biol Chem ; 289(14): 9970-82, 2014 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-24515113

RESUMEN

The focal swellings of dendrites ("dendritic beading") are an early morphological hallmark of neuronal injury and dendrotoxicity. They are associated with a variety of pathological conditions, including brain ischemia, and cause an acute disruption of synaptic transmission and neuronal network function, which contribute to subsequent neuronal death. Here, we show that increased synaptic activity prior to excitotoxic injury protects, in a transcription-dependent manner, against dendritic beading. Expression of activating transcription factor 3 (ATF3), a nuclear calcium-regulated gene and member of the core gene program for acquired neuroprotection, can protect against dendritic beading. Conversely, knockdown of ATF3 exacerbates dendritic beading. Assessment of neuronal network functions using microelectrode array recordings revealed that hippocampal neurons expressing ATF3 were able to regain their ability for functional synaptic transmission and to participate in coherent neuronal network activity within 48 h after exposure to toxic concentrations of NMDA. Thus, in addition to attenuating cell death, synaptic activity and expression of ATF3 render hippocampal neurons more resistant to acute dendrotoxicity and loss of synapses. Dendroprotection can enhance recovery of neuronal network functions after excitotoxic insults.


Asunto(s)
Factor de Transcripción Activador 3/metabolismo , Isquemia Encefálica/metabolismo , Señalización del Calcio , Dendritas/genética , Red Nerviosa/metabolismo , Proteínas del Tejido Nervioso/metabolismo , Transmisión Sináptica , Transcripción Genética , Factor de Transcripción Activador 3/genética , Animales , Isquemia Encefálica/genética , Isquemia Encefálica/patología , Muerte Celular/efectos de los fármacos , Muerte Celular/genética , Dendritas/patología , Agonistas de Aminoácidos Excitadores/efectos adversos , Agonistas de Aminoácidos Excitadores/farmacología , Regulación de la Expresión Génica/efectos de los fármacos , Regulación de la Expresión Génica/genética , Técnicas de Silenciamiento del Gen , Hipocampo/metabolismo , Hipocampo/patología , Ratones , N-Metilaspartato/efectos adversos , N-Metilaspartato/farmacología , Red Nerviosa/patología , Proteínas del Tejido Nervioso/genética
3.
J Biol Chem ; 288(12): 8074-8084, 2013 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-23364788

RESUMEN

In neurons, dynamic changes in the subcellular localization of histone deacetylases (HDACs) are thought to contribute to signal-regulated gene expression. Here we show that in mouse hippocampal neurons, synaptic activity-dependent nucleo-cytoplasmic shuttling is a common feature of all members of class IIa HDACs, which distinguishes them from other classes of HDACs. Nuclear calcium, a key regulator in neuronal gene expression, is required for the nuclear export of a subset of class IIa HDACs. We found that inhibition of nuclear calcium signaling using CaMBP4 or increasing the nuclear calcium buffering capacity by means of expression of a nuclear targeted version of parvalbumin (PV.NLS-mC) led to a build-up of HDAC4 and HDAC5 in the cell nucleus, which in the case of PV.NLS-mC can be reversed by nuclear calcium transients triggered by bursts of action potential firing. A similar nuclear accumulation of HDAC4 and HDAC5 was observed in vivo in the mouse hippocampus following stereotaxic delivery of recombinant adeno-associated viruses expressing either CaMBP4 or PV.NLS-mC. The modulation of HDAC4 activity either by RNA interference-mediated reduction of HDAC4 protein levels or by expression of a constitutively nuclear localized mutant of HDAC4 leads to changes in the mRNA levels of several nuclear calcium-regulated genes with known functions in acquired neuroprotection (atf3, serpinb2), memory consolidation (homer1, arc), and the development of chronic pain (ptgs2, c1qc). These results identify nuclear calcium as a regulator of nuclear export of HDAC4 and HDAC5. The reduction of nuclear localized HDACs represents a novel transcription-promoting pathway stimulated by nuclear calcium.


Asunto(s)
Señalización del Calcio , Núcleo Celular/metabolismo , Histona Desacetilasas/metabolismo , Proteínas Represoras/metabolismo , Transporte Activo de Núcleo Celular , Sustitución de Aminoácidos , Animales , Núcleo Celular/enzimología , Células Cultivadas , Citoplasma/enzimología , Expresión Génica , Regulación de la Expresión Génica , Hipocampo/citología , Histona Desacetilasas/genética , Histona Desacetilasas/fisiología , Humanos , Ratones , Ratones Endogámicos C57BL , Neuronas/enzimología , Parvalbúminas/farmacología , Ratas , Proteínas Represoras/genética , Proteínas Represoras/fisiología
4.
J Chem Phys ; 140(24): 244709, 2014 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-24985670

RESUMEN

Starting from the atomic structure of silicon quantum dots (QDs), and utilizing ab initio electronic structure calculations within the Förster resonance energy transfer (FRET) treatment, a model has been developed to characterize electronic excitation energy transfer between QDs. Electronic energy transfer rates, KEET, between selected identical pairs of crystalline silicon quantum dots systems, either bare, doped with Al or P, or adsorbed with Ag and Ag3, have been calculated and analyzed to extend previous work on light absorption by QDs. The effects of their size and relative orientation on energy transfer rates for each system have also been considered. Using time-dependent density functional theory and the hybrid functional HSE06, the FRET treatment was employed to model electronic energy transfer rates within the dipole-dipole interaction approximation. Calculations with adsorbed Ag show that: (a) addition of Ag increases rates up to 100 times, (b) addition of Ag3 increases rates up to 1000 times, (c) collinear alignment of permanent dipoles increases transfer rates by an order of magnitude compared to parallel orientation, and (d) smaller QD-size increases transfer due to greater electronic orbitals overlap. Calculations with dopants show that: (a) p-type and n-type dopants enhance energy transfer up to two orders of magnitude, (b) surface-doping with P and center-doping with Al show the greatest rates, and (c) KEET is largest for collinear permanent dipoles when the dopant is on the outer surface and for parallel permanent dipoles when the dopant is inside the QD.


Asunto(s)
Transferencia de Energía , Puntos Cuánticos/química , Silicio/química , Plata/química , Adsorción , Electrónica , Transferencia Resonante de Energía de Fluorescencia , Semiconductores
5.
J Chem Phys ; 137(14): 144301, 2012 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-23061842

RESUMEN

The optical properties of Si quantum dots (QDs) with phosphorous and aluminum dopants have been calculated with the recently tested Heyd-Scuseria-Ernzerhof (HSE) density functionals to ascertain the effect of functional corrections to electronic self-interaction. New results have been obtained for 20 crystalline and amorphous structures of Si(29) and Si(35) quantum dots and are compared to our previous results obtained using the PW91∕PW91 functionals. The bandgaps are greater in magnitude and shifted to higher energies in HSE calculations compared to PW91 calculations, and the absorption spectrum is blueshifted in HSE. Trends in the shifts of absorbances due to doping are similar for both sets of calculations, with doped QDs absorbing at lower photon energies than undoped QDs. Consistent with previous results, the bandgaps of QDs are found to decrease as the size of the QD increases, and the absorption spectra of amorphous QDs are redshifted compared to those of crystalline structures. The molecular orbitals involved in the transitions with the largest oscillator strengths show that the electron density moves towards the surface of the quantum dot as the structure is excited. The lifetimes of photoexcited states were found to differ substantially between the two functionals due to their sensitivity to the overlaps of initial and final orbitals. Comparison with available experimental and independent theoretical results supports the conclusion that the HSE functional better matches experimental results due to the partial inclusion of Hartree-Fock exchange.

6.
Biophys J ; 99(12): 4066-77, 2010 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-21156150

RESUMEN

Nuclear calcium is a key signal in the dialogue between synapse and nucleus that controls the genomic responses required for persistent adaptations, including memory and acquired neuroprotection. The amplitude and duration of nuclear calcium transients specify activity-induced transcriptional changes. However, the precise relationship between synaptic input and nuclear calcium output is unknown. Here, we used stereotaxic delivery to the rat brain of recombinant adeno-associated viruses encoding nuclear-targeted calcium sensors to assess nuclear calcium transients in CA1 pyramidal neurons after stimulation of the Schaffer collaterals. We show that in acute hippocampal slices, a burst of synaptic activity elicits a nuclear calcium signal with a regenerative component at above-threshold stimulation intensities. Using classical stimulation paradigms (i.e., high-frequency stimulation (HFS) and θ burst stimulation (TBS)) to induce early LTP (E-LTP) and transcription-dependent late LTP (L-LTP), we found that the magnitude of nuclear calcium signals and the number of action potentials activated by synaptic stimulation trains are greatly amplified by their repetition. Nuclear calcium signals and action potential generation were reduced by blockade of either NMDA receptors or L-type voltage-gated calcium channels, but not by procedures that lead to internal calcium store depletion or by blockade of metabotropic glutamate receptors. These findings identify a repetition-induced switch in nuclear calcium signaling that correlates with the transition from E-LTP to L-LTP, and may explain why the transcription-dependent phase of L-LTP is not induced by a single HFS or TBS but requires repeated trains of activity. Recombinant, nuclear-targeted indicators may prove useful for further analysis of nuclear calcium signaling in vivo.


Asunto(s)
Región CA1 Hipocampal/metabolismo , Señalización del Calcio , Núcleo Celular/metabolismo , Proteínas Sensoras del Calcio Neuronal/metabolismo , Células Piramidales/metabolismo , Sinapsis/metabolismo , Potenciales de Acción/fisiología , Animales , Región CA1 Hipocampal/citología , Calcio/metabolismo , Canales de Calcio Tipo L/metabolismo , Estimulación Eléctrica , Indicadores y Reactivos , Células Piramidales/citología , Ratas , Receptores de Glutamato Metabotrópico/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Umbral Sensorial
7.
Neuroscience ; 158(1): 344-52, 2009 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-18616988

RESUMEN

The stimulation of extrasynaptic N-methyl-D-aspartate (NMDA) receptors triggers cell death pathways and has been suggested to play a key role in cell degeneration and neuron loss associated with glutamate-induced excitotoxicity. In contrast, synaptic NMDA receptors promote neuronal survival. One mechanism through which extrasynaptic NMDA receptors damage neurons may involve Clca1, which encodes a putative calcium-activated chloride channel. Here we show that Clca1 expression is induced in cultured rat hippocampal neurons exposed to oxygen/glucose-free media; this induction is mediated by a signaling pathway activated by extrasynaptic NMDA receptors. Clca1 mRNA levels also increased in the gerbil hippocampus following a transient forebrain ischemia caused by bilateral carotid occlusion. Microelectrode array recordings revealed that oxygen-glucose deprivation enhances hippocampal network firing rates, which induces c-fos transcription through a signaling pathway that, in contrast to Clca1, is activated by synaptic but not extrasynaptic NMDA receptors. Thus, conditions of low oxygen/glucose lead to the activation of both extrasynaptic and synaptic NMDA receptors that regulate distinct target genes. Clca1 may be part of the genomic death program triggered by extrasynaptic NMDA receptors; it could be a marker for ischemic brain damage and a possible target for therapeutic interventions.


Asunto(s)
Canales de Cloruro/metabolismo , Hipocampo/metabolismo , Hipoxia-Isquemia Encefálica/metabolismo , Neuronas/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Potenciales de Acción/fisiología , Animales , Biomarcadores/metabolismo , Células Cultivadas , Canales de Cloruro/genética , Regulación de la Expresión Génica/genética , Gerbillinae , Hipocampo/fisiopatología , Hipoxia-Isquemia Encefálica/genética , Hipoxia-Isquemia Encefálica/fisiopatología , Masculino , Ratones , Ratones Endogámicos C57BL , Degeneración Nerviosa/genética , Degeneración Nerviosa/metabolismo , Degeneración Nerviosa/fisiopatología , Red Nerviosa/metabolismo , Red Nerviosa/fisiopatología , Proteínas Proto-Oncogénicas c-fos/metabolismo , ARN Mensajero/metabolismo , Sinapsis/metabolismo , Transmisión Sináptica/fisiología
8.
Epilepsy Behav ; 13(1): 83-9, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18358786

RESUMEN

Twenty-six Austrian, Dutch, German, and Swiss epilepsy centers were asked to report on use of the Wada test (intracarotid amobarbital procedure, IAP) from 2000 to 2005 and to give their opinion regarding its role in the presurgical diagnosis of epilepsy. Sixteen of the 23 centers providing information had performed 1421 Wada tests, predominantly the classic bilateral procedure (73%). A slight nonsignificant decrease over time in Wada test frequency, despite slightly increasing numbers of resective procedures, could be observed. Complication rates were relatively low (1.09%; 0.36% with permanent deficit). Test protocols were similar even though no universal standard protocol exists. Clinicians rated the Wada test as having good reliability and validity for language determination, whereas they questioned its reliability and validity for memory lateralization. Several noninvasive functional imaging techniques are already in use. However, clinicians currently do not want to rely solely on noninvasive functional imaging in all patients.


Asunto(s)
Epilepsia/fisiopatología , Lenguaje , Memoria/fisiología , Pruebas Neuropsicológicas/estadística & datos numéricos , Austria , Alemania , Humanos , Estudios Multicéntricos como Asunto , Países Bajos , Suiza
9.
Plant Biol (Stuttg) ; 9(6): 745-57, 2007 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17891703

RESUMEN

C (4) species of family Chenopodiaceae, subfamily Suaedoideae have two types of Kranz anatomy in genus Suaeda, sections Salsina and Schoberia, both of which have an outer (palisade mesophyll) and an inner (Kranz) layer of chlorenchyma cells in usually semi-terete leaves. Features of Salsina (S. AEGYPTIACA, S. arcuata, S. taxifolia) and Schoberia type (S. acuminata, S. Eltonica, S. cochlearifoliA) were compared to C (3) type S. Heterophylla. In Salsina type, two layers of chlorenchyma at the leaf periphery surround water-storage tissue in which the vascular bundles are embedded. In leaves of the Schoberia type, enlarged water-storage hypodermal cells surround two layers of chlorenchyma tissue, with the latter surrounding the vascular bundles. The chloroplasts in Kranz cells are located in the centripetal position in Salsina type and in the centrifugal position in the Schoberia type. Western blots on C (4) acid decarboxylases show that both Kranz forms are NAD-malic enzyme (NAD-ME) type C (4) species. Transmission electron microscopy shows that mesophyll cells have chloroplasts with reduced grana, while Kranz cells have chloroplasts with well-developed grana and large, specialized mitochondria, characteristic of NAD-ME type C (4) chenopods. In both C (4) types, phosphoenolpyruvate carboxylase is localized in the palisade mesophyll, and Rubisco and mitochondrial NAD-ME are localized in Kranz cells, where starch is mainly stored. The C (3) species S. heterophylla has Brezia type isolateral leaf structure, with several layers of Rubisco-containing chlorenchyma. Photosynthetic response curves to varying CO (2) and light in the Schoberia Type and Salsina type species were similar, and typical of C (4) plants. The results indicate that two structural forms of Kranz anatomy evolved in parallel in species of subfamily Suaedoideae having NAD-ME type C (4) photosynthesis.


Asunto(s)
Carbono/metabolismo , Chenopodiaceae/fisiología , Fotosíntesis/fisiología , Western Blotting , Chenopodiaceae/citología , Chenopodiaceae/ultraestructura , Cloroplastos/ultraestructura , Inmunohistoquímica , Hojas de la Planta/citología , Hojas de la Planta/metabolismo , Hojas de la Planta/fisiología , Proteínas de Plantas/metabolismo , Especificidad de la Especie , Almidón/metabolismo
10.
Neurology ; 52(1): 196-9, 1999 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-9921877

RESUMEN

A case of isolated angiitis of the CNS was observed for 5 years. Initial response to cyclophosphamide was followed by relapse on therapy interruption. After renewed treatment, clinical stabilization was achieved despite progressive stenoses shown by angiography. The patient died of cyclophosphamide-induced myelodysplastic syndrome. Autopsy revealed lack of inflammation, vascular scarring, and amyloid angiopathy. We conclude that cure from isolated angiitis of the CNS is possible and that the risk of overtreatment should be minimized.


Asunto(s)
Arteritis/tratamiento farmacológico , Arterias Cerebrales/inmunología , Ciclofosfamida/administración & dosificación , Inmunosupresores/administración & dosificación , Neuritis/tratamiento farmacológico , Adulto , Antiinflamatorios/administración & dosificación , Arteritis/diagnóstico , Arteritis/inmunología , Biopsia , Encéfalo/irrigación sanguínea , Encéfalo/inmunología , Arteria Carótida Interna , Angiografía Cerebral , Femenino , Humanos , Meninges/patología , Neuritis/inmunología , Prednisona/administración & dosificación , Resultado del Tratamiento
11.
AJNR Am J Neuroradiol ; 19(5): 839-46, 1998 May.
Artículo en Inglés | MEDLINE | ID: mdl-9613497

RESUMEN

PURPOSE: Our goal was to analyze the predictive value of early CT and arteriographic morphologic criteria to achieve a more reliable prediction of fatal outcome in patients undergoing fibrinolytic stroke treatment. METHODS: In 74 patients with acute carotid artery stroke, early signs of cerebral ischemia were determined by CT. The site of vascular occlusion was identified by digital subtraction angiography (DSA). The patients were subsequently treated by intraarterial (n = 68) or intravenous (n = 6) fibrinolysis by means of recombinant tissue plasminogen activator (rt-PA), urokinase, or rt-PA combined with lys-plasminogen and followed-up for a period of 3 months. CT and DSA data were compared with the clinical course, with special emphasis on signs of early fatal deterioration (ie, death by intracranial mass effect) as determined by corresponding CT and clinical observations, occurring within 7 days after stroke. RESULTS: Seventeen patients died, all of intracranial mass effect, and all within a week after stroke. In nine of these fatalities, DSA revealed carotid "T" occlusion (CTO), which affected 19 patients. In five of the fatalities, a major early sign of ischemia (MESI, referring to cortical hypodensity in more than a third of the territory of the middle cerebral artery, as seen in 14 patients) was recognizable on the initial CT scan. This led to a higher predictive value and sensitivity of CTO relative to MESI for estimating early fatality. CONCLUSION: CTO as determined by DSA is a substantially better predictor of fatal outcome in patients undergoing intraarterial thrombolytic therapy than is MESI as determined by CT.


Asunto(s)
Angiografía de Substracción Digital , Edema Encefálico/diagnóstico por imagen , Angiografía Cerebral , Trastornos Cerebrovasculares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Enfermedad Aguda , Adulto , Anciano , Edema Encefálico/mortalidad , Isquemia Encefálica/diagnóstico por imagen , Isquemia Encefálica/terapia , Trastornos Cerebrovasculares/mortalidad , Trastornos Cerebrovasculares/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Reperfusión , Terapia Trombolítica
12.
Hear Res ; 192(1-2): 36-46, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15157961

RESUMEN

OBJECTIVE: The purpose of the study was to identify acoustcomechanical properties of various biostable and biocompatible materials to create a middle ear prosthesis with the following properties: (i) improved handling including a good view of the head of the stapes or footplate and adjustable length, (ii) improved acoustical characteristics that are adequate for ossiculoplastic. The identified material should serve to build CE and FDA approved prostheses for clinical use in patients. METHODS: Test models made of Teflon, polyetheretherketone, polyethylenterephtalate, polysulfone, gold, Al2O3 ceramics, carbon and titanium were investigated for their potential to fulfill the requirements. Acoustical properties were investigated by laser Doppler velocimetry (LDV) in mechanical middle ear models (MMM). Measured data were fed in to a recently created computer model of the middle ear (multibody systems approach, MBS). Using computer-aided design (CAD) measured and computed data allowed creation and fine precision of titanium prostheses (Tübingen Titanium Protheses, TTP). Their handling was tested in temporal bones. Acoustomechanical properties were investigated using the MBS and mechanical middle ear models. MAIN OUTCOME MEASURES: Input impedance, mass, stiffness, and geometry of test models and prostheses were determined. Furthermore, their influence on the intraprosthetic transfer functions and on coupling to either tympanic membrane or stapes was investigated. RESULTS: Final results were FDA- and CE-approved filigreed titanium prostheses with an open head that fulfilled the four requirements detailed above. The prostheses (TTP) were developed in defined lengths of between 1.75 and 3.5 mm (partial) and 3.0 and 6.5 mm (total) as well as in adjustable lengths (TTP-Vario). CONCLUSIONS: The results suggest acoustomechanical advantages of TTPs because they combine a significantly low mass with high stiffness. In contrast to closed prostheses, the open head and filigreed design allow an excellent view of the prosthesis foot during coupling to the head or footplate of stapes, contributing to an improved intraoperative reliability of prosthesis coupling.


Asunto(s)
Prótesis Osicular , Acústica , Materiales Biocompatibles , Fenómenos Biomecánicos , Diseño Asistido por Computadora , Humanos , Técnicas In Vitro , Flujometría por Láser-Doppler , Ensayo de Materiales , Diseño de Prótesis , Titanio
13.
Clin Cardiol ; 15(4): 275-9, 1992 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-1373355

RESUMEN

The incidence of neurological residuals following anatomical correction of transposition of the great arteries (d-TGA) has not been described so far. Clinical examination, EEG recordings, and computed tomography (CT) scans were carried out in a consecutive series of 38 children with d-TGA surviving anatomic corrective surgery. The patients were classified into one of three groups according to the type of operation: 15 patients after two-stage approach (TSA) (Stage 1: pulmonary artery banding+aortopulmonary shunt; Stage 2: anatomic correction); 12 patients with primary anatomic correction within the first 2 weeks of life (early switch, ES); 11 patients with primary anatomic correction later in infancy (later switch, LS). In 26 patients (68%) we found no abnormalities on neurologic examination, CT scan, or EEG. Four patients suffered from spastic hemiplegia, 3 of these had cortical brain damage visible on CT scan, and 3 had focal epilepsy as well. In 2 otherwise clinical normal patients cortical infarction could be seen on a CT scan. Thus, in 5 cases (13% of 38 patients) cerebral infarcts were diagnosed by CT scan. The cortical vascular infarction was seen in 4 patients after TSA and in 1 after LS. In 6 patients we found other neurological abnormalities. Early anatomic correction in patients with d-TGA reduces the risk of cortical vascular infarction.


Asunto(s)
Trastornos Cerebrovasculares/epidemiología , Discapacidades del Desarrollo/epidemiología , Enfermedades del Sistema Nervioso/epidemiología , Transposición de los Grandes Vasos/cirugía , Trastornos Cerebrovasculares/diagnóstico , Preescolar , Discapacidades del Desarrollo/diagnóstico , Electroencefalografía , Humanos , Incidencia , Lactante , Recién Nacido , Enfermedades del Sistema Nervioso/diagnóstico , Examen Neurológico , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
14.
Surg Neurol ; 52(2): 160-5; discussion 165-6, 1999 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10447284

RESUMEN

PURPOSE: To describe a method for the preoperative embolization of arteriovenous malformations (AVM) containing vessels en passage (VeP). First, before embolization of the primary AVM, the distal portion of the VeP beyond the AVM, which supplies the parenchymal compartment, is blocked through placement of an endovascular ligature (fibered coils). This protects the post lesional parenchymal tissue and isolates malformational compartments before embolization. Thus the proximal AVM-supplying segment of the VeP can be safely embolized. PATIENTS AND METHODS: Five of 204 AVM patients admitted for preoperative embolization between 1989 and 1997 fulfilled the following treatment criteria for the placement of an endovascular ligature in a VeP before embolization: 1. The diameter of the distal portion of the VeP behind the AVM was large whereas the parenchymal blush was poor; 2. The VeP fed a large portion of the AVM; 3. The VeP was judged to be accessible only late in the surgical procedure; 4. The VeP and its off branches were an integral part of the AVM periphery and thus not suitable for microdissection. RESULTS: In all five cases the leptomeningeal collateral perfusion (the arterial supply to parenchymal brain areas) served to supply brain areas distal to the AVM after primary blockage of a VeP by endovascular ligature with fibered coils. Embolization and complete surgical dissection of the AVM was then achieved in all cases. No neurological deficits occurred. CONCLUSION: Experience with our five cases indicates that a preparatory endovascular ligature of a VeP between parenchyma and the malformational compartment followed by embolization of the AVM can serve as an alternative to open surgical dissection of a vessel en passage and that it safely allows effective preoperative embolization.


Asunto(s)
Embolización Terapéutica , Malformaciones Arteriovenosas Intracraneales/terapia , Adolescente , Adulto , Angiografía Cerebral , Circulación Cerebrovascular , Circulación Colateral , Terapia Combinada , Femenino , Humanos , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Malformaciones Arteriovenosas Intracraneales/cirugía , Masculino , Procedimientos Quirúrgicos Vasculares
15.
Wien Klin Wochenschr ; 113(17-18): 676-80, 2001 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-11603102

RESUMEN

BACKGROUND: Aspiration of gastric content frequently induces early onset of pneumonia in patients with impaired consciousness after closed head injury and thus worsens the prognosis. Early detection of aspiration and appropriate therapy are essential. The purpose of the study was to assess the diagnostic value of procalcitonin (ProCT) in aspiration of gastric content and to evaluate its prognostic impact in patients with closed head injury. METHODS: Twenty-three patients with isolated closed head injury (Glasgow Coma Scale [GCS] score < or = 8) were studied. Bronchoscopy was done on admission; chest radiographs and routine laboratory examination including C-reactive protein were performed daily. ProCT was analyzed 12, 24, 36 and 72 hours after trauma using an immunoluminometric assay. RESULTS: ProCT was higher throughout the study period in 9 patients with persistent radiological signs suspect for aspiration of gastric content and there was evidence of aspiration of gastric content during bronchoscopy on admission. Median ProCT values of 1.397 ng/ml (range, 0.372 to 8.358 ng/ml) on admission increased to 2.144 ng/ml (range, 0.716 to 6.910 ng/ml) 24 hours after trauma, and then decreased to baseline values of 1.711 ng/ml (range, 0.611 to 6.639 ng/ml) as early as 36 hours after trauma. In patients without signs of aspiration of gastric content, ProCT values did not exceed 0.418 ng/ml. Non-survivors had higher serum levels of ProCT throughout the study period. CONCLUSION: Our findings suggest that ProCT is a useful diagnostic marker for detecting aspiration of gastric content while the prognostic value of ProCT for predicting survival after isolated closed head injury was moderate.


Asunto(s)
Calcitonina/sangre , Traumatismos Cerrados de la Cabeza/sangre , Neumonía por Aspiración/diagnóstico , Precursores de Proteínas/sangre , Adulto , Anciano , Biomarcadores/sangre , Péptido Relacionado con Gen de Calcitonina , Femenino , Traumatismos Cerrados de la Cabeza/complicaciones , Traumatismos Cerrados de la Cabeza/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Neumonía por Aspiración/sangre , Neumonía por Aspiración/diagnóstico por imagen , Neumonía por Aspiración/etiología , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Proteína C , Radiografía , Análisis de Supervivencia , Índices de Gravedad del Trauma
16.
Wien Klin Wochenschr ; 113(1-2): 33-7, 2001 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-11233465

RESUMEN

OBJECTIVE: The cuffed oropharyngeal airway (COPA), a modified Guedel-type airway with a cuff at the distal end, has recently been introduced into anesthetic practice. The aim of this study was to compare the COPA with the well established laryngeal mask airway (LMA). Special consideration was granted to the difficult airway. PATIENTS AND METHODS: Two hundred and fifty-two women of ASA class I or II undergoing elective gynecological or breast surgery under general anesthesia were randomly assigned to either cuffed oropharyngeal or laryngeal mask airway management. Insertion and removal of the device, airway maintenance throughout the procedure, and postoperative course and complications were assessed. RESULTS: A patent airway was obtained with either device in all patients. Global first-time success rates for insertion were similar in the two study groups. Initial failure of correct placement occurred more frequently in the COPA as compared to the LMA group if the interincisor gap was < 5 cm and mandibular protrusion impossible (p < 0.01). Neither thyromental distance nor Mallampati scores nor body mass index (BMI) were of relevance for insertion success. The incidence of postoperative complaints and of mucosal injuries was significantly higher with the LMA. CONCLUSION: On the whole, high overall success and low complication rates render COPA and LMA equally suitable for routine anesthetic airway management.


Asunto(s)
Anestesia Endotraqueal/instrumentación , Procedimientos Quirúrgicos Ginecológicos/instrumentación , Ventilación con Presión Positiva Intermitente/instrumentación , Máscaras Laríngeas , Respiración Artificial/instrumentación , Adulto , Anestesia Endotraqueal/efectos adversos , Anestesia Endotraqueal/métodos , Femenino , Humanos , Ventilación con Presión Positiva Intermitente/métodos , Máscaras Laríngeas/efectos adversos , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Prospectivos , Respiración Artificial/métodos , Resultado del Tratamiento
17.
Neuron ; 77(1): 43-57, 2013 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-23312515

RESUMEN

Persistent pain induced by noxious stimuli is characterized by the transition from normosensitivity to hypersensitivity. Underlying mechanisms are not well understood, although gene expression is considered important. Here, we show that persistent nociceptive-like activity triggers calcium transients in neuronal nuclei within the superficial spinal dorsal horn, and that nuclear calcium is necessary for the development of long-term inflammatory hypersensitivity. Using a nucleus-specific calcium signal perturbation strategy in vivo complemented by gene profiling, bioinformatics, and functional analyses, we discovered a pain-associated, nuclear calcium-regulated gene program in spinal excitatory neurons. This includes C1q, a modulator of synaptic spine morphogenesis, which we found to contribute to activity-dependent spine remodelling on spinal neurons in a manner functionally associated with inflammatory hypersensitivity. Thus, nuclear calcium integrates synapse-to-nucleus communication following noxious stimulation and controls a spinal genomic response that mediates the transition between acute and long-term nociceptive sensitization by modulating functional and structural plasticity.


Asunto(s)
Señalización del Calcio/fisiología , Núcleo Celular/fisiología , Dolor Crónico/genética , Genómica , Células del Asta Posterior/fisiología , Animales , Animales Recién Nacidos , Células Cultivadas , Dolor Crónico/patología , Genómica/métodos , Inflamación/genética , Inflamación/patología , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Neuronas/patología , Neuronas/fisiología , Dimensión del Dolor/métodos , Células del Asta Posterior/patología , Médula Espinal/citología , Médula Espinal/patología , Médula Espinal/fisiología
18.
Neuron ; 71(1): 117-30, 2011 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-21745642

RESUMEN

The role of neuronal dendrites is to receive and process synaptic inputs. The geometry of the dendritic arbor can undergo neuronal activity-dependent changes that may impact the cognitive abilities of the organism. Here we show that vascular endothelial growth factor D (VEGFD), commonly known as an angiogenic mitogen, controls the total length and complexity of dendrites both in cultured hippocampal neurons and in the adult mouse hippocampus. VEGFD expression is dependent upon basal neuronal activity and requires nuclear calcium-calmodulin-dependent protein kinase IV (CaMKIV) signaling. Suppression of VEGFD expression in the mouse hippocampus by RNA interference causes memory impairments. Thus, nuclear calcium-VEGFD signaling mediates the effect of neuronal activity on the maintenance of dendritic arbors in the adult hippocampus and is required for cognitive functioning. These results suggest that caution be employed in the clinical use of blockers of VEGFD signaling for antiangiogenic cancer therapy.


Asunto(s)
Calcio/fisiología , Dendritas/fisiología , Hipocampo/fisiología , Memoria/fisiología , Neuronas/fisiología , Transducción de Señal/fisiología , Factor D de Crecimiento Endotelial Vascular/fisiología , Animales , Animales Recién Nacidos , Proteínas de Caenorhabditis elegans/antagonistas & inhibidores , Proteínas de Caenorhabditis elegans/fisiología , Proteína Quinasa Tipo 4 Dependiente de Calcio Calmodulina/genética , Proteína Quinasa Tipo 4 Dependiente de Calcio Calmodulina/metabolismo , Núcleo Celular/metabolismo , Células Cultivadas , Espinas Dendríticas/fisiología , Potenciales Postsinápticos Excitadores/fisiología , Hipocampo/citología , Hipocampo/metabolismo , Histona Acetiltransferasas/antagonistas & inhibidores , Histona Acetiltransferasas/fisiología , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Neuronas/citología , Neuronas/metabolismo , Receptores AMPA/metabolismo , Factores de Transcripción/antagonistas & inhibidores , Factores de Transcripción/fisiología , Factor D de Crecimiento Endotelial Vascular/metabolismo
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