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1.
CNS Neurosci Ther ; 26(1): 47-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31119898

RESUMO

AIMS: This study aimed to identify the clinical profiles of cervical spondylosis-related internal jugular vein stenosis (IJVS) comprehensively. METHODS: A total of 46 patients, who were diagnosed as IJVS induced by cervical spondylotic compression were recruited. The clinical manifestations and imaging features of IJVS were presented particularly in this study. RESULTS: Vascular stenosis was present in 69 out of the 92 internal jugular veins, in which, 50.7% (35/69) of the stenotic vessels were compressed by the transverse process of C1, and 44.9% (31/69) by the transverse process of C1 combined with the styloid process. The transverse process of C1 compression was more common in unilateral IJVS (69.6% vs 41.3%, P = 0.027) while the transverse process of C1 combined with the styloid process compression had a higher propensity to occur in bilateral IJVS (52.2% vs 30.4%, P = 0.087). A representative case underwent the resection of the elongated left lateral mass of C1 and styloid process. His symptoms were ameliorated obviously at 6-month follow-up. CONCLUSIONS: This study proposes cervical spondylotic internal jugular venous compression syndrome as a brand-new cervical spondylotic subtype. A better understanding of this disease entity can be of great relevance to clinicians in making a proper diagnosis.

2.
CNS Neurosci Ther ; 2019 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-31814317

RESUMO

AIMS: This study investigated the safety and efficacy of remote ischemic conditioning (RIC) on ameliorating the sequelae of ischemic moyamoya disease (iMMD). METHODS: A total of 30 iMMD patients underwent long-term RIC and were followed up at 0.5, 1, and 2 years for clinical outcomes, including frequency of stroke recurrence, Patient Global Impression of Change (PGIC) scale, peak systolic velocities (PSV), and cerebral perfusion. RESULTS: During the whole RIC treatment process, no RIC-related adverse event occurred. Only one of 30 patients suffered a onetime infarction (3.3%), and the ratios of acceptable PGIC were 88.2%, 64.3%, and 92.3% at 0.5, 1, and 2 years follow-up. Kaplan-Meier analysis showed the frequency of stroke recurrence was significantly reduced after RIC (P = .013). The frequency of TIA per week was 1.1 (0.6, 2.8) prior to RIC and 0.1 (0.0, 0.5) post-RIC (P < .01). Compared to baseline, PSV values were significantly reduced after RIC treatment (P = .002 at 0.5, P = .331 at 1, and P = .006 at 2 years). In patients undergoing perfusion studies, 75% obtained improvement on followed-up SPECT and 95% on followed-up PET maps. CONCLUSIONS: Remote ischemic conditioning may be beneficial on controlling iMMD-induced ischemic events, relieving symptoms, and improving cerebral perfusion, without incidence of complications in this case series.

3.
Front Neurol ; 10: 1032, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31636598

RESUMO

Background and purpose: Stroke is a leading cause of death and acquired disability in adults today. Inflammation plays an important role in the pathophysiology of stroke. The peripheral neutrophil-to-lymphocyte ratio (NLR) is an important global inflammatory indicator becoming more mainstream in stroke care. This meta-analysis aims to evaluate the relationship between the baseline NLR and acute ischemic and hemorrhagic stroke, as well as define the clinical significance of NLR in subtypes of ischemic stroke. Methods: This meta-analysis was registered in PROSPERO with the number CRD42018105305. We went through relevant articles from PubMed Central (PMC) and EMBASE. Prospective and retrospective studies were included if related to baseline NLR levels prior to treatment in patients with ischemic or hemorrhagic stroke. Studies were identified up until April 2019. The cutoff value for NLR and the sources of odds ratios (ORs)/risk ratios (RRs) were measured. Modified Rankin Scale (mRS) was used to investigate the outcomes during clinical follow-up. Predefined criteria were used to evaluate the risk of bias in eligible studies. P-values < 0.05 were considered statistically significant. STATA version 14.0 (STATA, College Station, TX) was used in all statistical analyses. Results: Thirty-seven studies with 43,979 individuals were included in the final analysis. Higher NLR levels were correlated with increased risk of ischemic stroke (ORs/RRs = 1.609; 95% CI = 1.283-2.019), unfavorable functional outcome at 3 months (ORs/RRs = 1.851; 95% CI = 1.325-2.584), and increased mortality in patients with ischemic stroke (ORs/RRs = 1.068; 95% CI = 1.027-1.111). While in terms of hemorrhagic stroke (including SAH and ICH), elevated NLR levels only had deleterious effects on mortality (ORs/RRs = 1.080; 95% CI = 1.018-1.146). Conclusions: Baseline NLR level is a promising predictor of the clinical outcomes in both ischemic and hemorrhagic stroke. In addition, elevated NLR is also associated with a high risk of ischemic stroke occurrence. However, future studies are needed to demonstrate the underlying mechanisms and further explain this association.

4.
Chin Med J (Engl) ; 132(12): 1390-1399, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31205095

RESUMO

BACKGROUND: Mental stress-induced myocardial ischemia (MSIMI) is closely associated with adverse cardiac events in patients with coronary artery disease (CAD) and we aimed to determine whether biomarkers and blood pressure could be potential predictors of MSIMI. METHODS: This study enrolled 82 patients with documented CAD between June 1, 2017 and November 9, 2017. Patient blood samples were obtained at resting period and at the end of mental arithmetic. Then, patients were assigned to MSIMI positive group and MSIMI negative group. The main statistical methods included linear regression, receiver operating characteristic (ROC) curves, and logistic regression. RESULTS: Patients with CAD with MSIMI had significantly greater median resting N-terminal pro-brain natriuretic peptide (NT-proBNP, 141.02 [45.85-202.76] pg/mL vs. 57.95 [27.06-117.64] pg/mL; Z = -2.23, P = 0.03) and mean systolic blood pressure (SBP) (145.56 ±â€Š16.87 mmHg vs. 134.92 ±â€Š18.16 mmHg, Z = -2.13, P = 0.04) when compared with those without MSIMI. After 5-min mental stress task, those who developed MSIMI presented higher elevation of median post-stressor high sensitivity cardiac troponin I (hs-cTnI, 0.020 [0.009-0.100] ng/mL vs. 0.009 [0.009-0.010] ng/mL; Z = -2.45, P = 0.01), post-stressor NT-proBNP (138.96 [39.93-201.56] pg/mL vs. 61.55 [25.66-86.50] pg/mL; Z = -2.15, P = 0.03) compared with those without MSIMI. Using the ROC curves, and after the adjustment for basic characteristics, the multiple logistic regression analysis showed that patients presenting a post-stressor hs-cTnI ≥ 0.015 ng/mL had seven-fold increase in the risk of developing MSIMI (odds ratio [OR]: 7.09; 95% confidence interval [CI]: 1.65-30.48; P = 0.009), a rest NT-proBNP ≥ 80.51 pg/mL had nearly eight-fold increase (OR: 7.85; 95% CI: 1.51-40.82; P = 0.014), a post-stressor NT-proBNP ≥ 98.80 pg/mL had 35-fold increase (OR: 34.96; 95% CI: 3.72-328.50; P = 0.002), a rest SBP ≥ 129.50 mmHg had 11-fold increase (OR: 11.42; 95% CI: 1.21-108.17; P = 0.034). CONCLUSIONS: The present study shows that CAD patients with higher hs-cTnI level, and/or greater NT-proBNP and/or SBP are at higher risk of suffering from MSIMI when compared with those without MSIMI, indicating that hs-cTnI, NT-proBNP, SBP might be potential predictors of MSIMI.


Assuntos
Doença da Artéria Coronariana/complicações , Isquemia Miocárdica/etiologia , Estresse Psicológico/complicações , Idoso , Ansiedade/sangue , Ansiedade/complicações , Biomarcadores/sangue , Pressão Sanguínea/fisiologia , Proteína C-Reativa/metabolismo , Doença da Artéria Coronariana/sangue , Depressão/sangue , Depressão/complicações , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/sangue , Peptídeo Natriurético Encefálico/sangue , Razão de Chances , Fragmentos de Peptídeos/sangue , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Estresse Psicológico/sangue , Tomografia Computadorizada de Emissão de Fóton Único , Troponina I/sangue , Troponina T/sangue
5.
Chin Med J (Engl) ; 132(8): 905-913, 2019 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-30958431

RESUMO

BACKGROUND: Asymptomatic coronary artery stenosis (ACAS) ≥50% is common in patients with acute ischemic cerebrovascular disease (AICVD), which portends a poor cardiovascular and cerebrovascular prognosis. Identifying ACAS ≥50% early may optimize the clinical management and improve the outcomes of these high-risk AICVD patients. This study aimed to investigate whether aortic arch plaque (AAP), an early atherosclerotic manifestation of brain blood-supplying arteries, could be a predictor for ACAS ≥50% in AICVD. METHODS: In this cross-sectional study, atherosclerosis of the coronary and brain blood-supplying arteries was simultaneously evaluated using one-step computed tomography angiography (CTA) in AICVD patients without coronary artery disease history. The patients were divided into ACAS ≥50% and non-ACAS ≥50% groups according to whether CTA showed stenosis ≥50% in at least one coronary arterial segment. The AAP characteristics of CTA were depicted from aspects of thickness, extent, and complexity. RESULTS: Among 118 analyzed patients with AICVD, 29/118 (24.6%) patients had ACAS ≥50%, while AAPs were observed in 86/118 (72.9%) patients. Increased AAP thickness per millimeter (adjusted odds ratio [OR]: 1.56, 95% confidence interval [CI]: 1.18-2.05), severe-extent AAP (adjusted OR: 13.66, 95% CI: 2.33-80.15), and presence of complex AAP (adjusted OR: 7.27, 95% CI: 2.30-23.03) were associated with ACAS ≥50% among patients with AICVD, independently of clinical demographics and cervicocephalic atherosclerotic stenosis. The combination of AAP thickness, extent, and complexity predicted ACAS ≥50% with an area under the receiver-operating characteristic curve of 0.78 (95% CI: 0.70-0.85, P < 0.001). All three AAP characteristics provided additional predictive power beyond cervical and intracranial atherosclerotic stenosis for ACAS ≥50% in AICVD (all P < 0.05). CONCLUSIONS: Thicker, severe-extent, and complex AAP were significant markers of the concomitant ACAS ≥50% in AICVD, possibly superior to the indicative value of cervical and intracranial atherosclerotic stenosis. As an integral part of atherosclerosis of brain blood-supplying arteries, AAP should not be overlooked in predicting ACAS ≥50% for patients with AICVD.


Assuntos
Aorta Torácica/patologia , Transtornos Cerebrovasculares/diagnóstico , Estenose Coronária/diagnóstico , Placa Aterosclerótica/diagnóstico , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
6.
CNS Neurosci Ther ; 25(5): 638-646, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30675757

RESUMO

AIMS: The objective of this study was to evaluate cerebral venous recanalization with magnetic resonance black-blood thrombus imaging (MRBTI) in patients with cerebral venous thrombosis (CVT) who underwent batroxobin treatment in combination with anticoagulation. METHODS: A total of 31 CVT patients were enrolled in this real-world registry study. The patients were divided into batroxobin (n = 21) and control groups (n = 10). In addition to the same standard anticoagulation as in the control group, patients in the batroxobin group underwent intravenous batroxobin for a total of three times. RESULTS: In the batroxobin group compared with the control group, we found better odds of recanalization degree [adjusted OR (95%CI) of 8.10 (1.61-40.7)] and segment-stenosis attenuation [adjusted OR (95%CI) of 4.48 (1.69-11.9)] with batroxobin treatment. We further noted a higher ratio of patients with the attenuation of stenosis [adjusted OR (95%CI) of 26.4 (1.10-635)]; as well as a higher ratio of segments with stenosis reversion [adjusted OR (95%CI) of 4.52 (1.48-13.8)]. However, neurological deficits between the two groups showed no statistical difference at 90-day follow-up (P > 0.05). CONCLUSIONS: Batroxobin may promote venous sinus recanalization and attenuate CVT-induced stenosis. Further randomized study of this promising drug may be warranted to better delineate the amount of benefit.

7.
Ecotoxicol Environ Saf ; 167: 178-187, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30336408

RESUMO

BACKGROUND: The increasing epidemic of fine particulate matter (PM2.5) is a serious threat to human health. It induces the occurrence of liver fibrosis, but its molecular mechanism is not yet clear. The molecular mechanisms of PM2.5 inducing liver fibrosis were investigated in this study. METHODS: The cell viability of LX-2 cells and primary hepatic stellate cells (HSCs) was detected using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. In vitro enzyme-linked immune sorbent assay (ELISA) kits were used to detect the concentrations of antioxidant enzymes and reactive oxygen species (ROS). The mitochondrial transmembrane potential (MTP) was determined by JC-1 dye. Knockdown of Parkin was carried out by Parkin-specific siRNA transfection. Relative mRNA and protein expressions were evaluated by qRT-PCR, Western blotting, and immunofluorescence analysis. RESULTS: PM2.5 activated LX-2 cells and primary HSCs, inducing the liver fibrosis along with down-regulation of the gelatinases MMP-2, and up-regulation of myofibroblast markers collagen type I and α-SMA. The levels of ROS and reactive nitrogen species (RNS), as well as the lipid peroxidation marker malondialdehyde (MDA) were significantly up-regulated in LX-2 cells and primary HSCs treated with PM2.5. Also, the enzymatic antioxidants levels were disturbed by PM2.5. Furthermore, PM2.5 decreased the MTP, releasing cytochrome c from the mitochondria to the cytosol. The dynamics of mitochondria were regulated by PM2.5 via facilitating mitochondrial fission. The excess ROS induced by PM2.5 triggered the mitophagy by activating PINK1/Parkin pathway, and inhibition of mitophagy induced by PM2.5 diminished the liver fibrosis. CONCLUSION: PM2.5 may induce mitophagy via activating PINK1/Parking signal pathway by increasing ROS, thereby activating HSCs and causing liver fibrosis.


Assuntos
Poluentes Atmosféricos/toxicidade , Cirrose Hepática/induzido quimicamente , Material Particulado/toxicidade , Antioxidantes/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Células Estreladas do Fígado/efeitos dos fármacos , Humanos , Potencial da Membrana Mitocondrial/fisiologia , Mitocôndrias/metabolismo , Dinâmica Mitocondrial/efeitos dos fármacos , Proteínas Mitocondriais/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos
8.
CNS Neurosci Ther ; 24(6): 473-482, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29687619

RESUMO

Extracranial venous abnormalities, especially jugular venous outflow disturbance, were originally viewed as nonpathological phenomena due to a lack of realization and exploration of their feature and clinical significance. The etiology and pathogenesis are still unclear, whereas a couple of causal factors have been conjectured. The clinical presentation of this condition is highly variable, ranging from insidious to symptomatic, such as headaches, dizziness, pulsatile tinnitus, visual impairment, sleep disturbance, and neck discomfort or pain. Standard diagnostic criteria are not available, and current diagnosis largely depends on a combinatory use of imaging modalities. Although few researches have been conducted to gain evidence-based therapeutic approach, several recent advances indicate that intravenous angioplasty in combination with stenting implantation may be a safe and efficient way to restore normal blood circulation, alleviate the discomfort symptoms, and enhance patients' quality of life. In addition, surgical removal of structures that constrain the internal jugular vein may serve as an alternative or adjunctive management when endovascular intervention is not feasible. Notably, discussion on every aspect of this newly recognized disease entity is in the infant stage and efforts with more rigorous designed, randomized controlled studies in attempt to identify the pathophysiology, diagnostic criteria, and effective approaches to its treatment will provide a profound insight into this issue.


Assuntos
Transtornos Cerebrovasculares/fisiopatologia , Veias Jugulares/fisiopatologia , Fluxo Sanguíneo Regional/fisiologia , Animais , Humanos
9.
CNS Neurosci Ther ; 24(1): 5-17, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29143463

RESUMO

Chronic cerebral circulation insufficiency (CCCI) may not be an independent disease; rather, it is a pervasive state of long-term cerebral blood flow insufficiency caused by a variety of etiologies, and considered to be associated with either occurrence or recurrence of ischemic stroke, vascular cognitive impairment, and development of vascular dementia, resulting in disability and mortality worldwide. This review summarizes the features and recent progress of CCCI, mainly focusing on epidemiology, experimental research, pathophysiology, etiology, clinical manifestations, imaging presentation, diagnosis, and potential therapeutic regimens. Some research directions are briefly discussed as well.


Assuntos
Isquemia Encefálica/complicações , Circulação Cerebrovascular/fisiologia , Demência Vascular/etiologia , Ataque Isquêmico Transitório/complicações , Animais , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/epidemiologia , Demência Vascular/diagnóstico por imagem , Demência Vascular/epidemiologia , Humanos , Ataque Isquêmico Transitório/diagnóstico por imagem , Ataque Isquêmico Transitório/epidemiologia , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia
10.
Neurol Res ; 38(6): 518-23, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27320246

RESUMO

OBJECTIVE: We sought to investigate whether serum cystatin C levels are correlated with either stroke severity or with potential risk factors of acute ischemic stroke. METHODS: 171 patients with acute ischemic stroke and 99 control subjects with minor, unrelated diseases with stroke were included in this retrospective study. Serum cystatin C levels were determined in all subjects. Serum concentrations of several vascular risk factors in stoke patients were determined by biochemical assays. The severity of strokes was scored via the National Institutes of Health Stroke Scale (NIHSS). RESULTS: Serum cystatin C levels were significantly increased in patients with acute ischemic stroke compared with control subjects (1.26 ± 0.34 mg/L vs. 0.78 ± 0.24 mg/L, p < 0.001).When analyzed in quartiles of serum cystatin C levels, concentrations were low (<0.75 mM) for 5 stroke patients (2.92%), intermediate (0.75-1 mM) for 42 patients (24.56%), high (1-1.25 mM) for 45 patients (26.32%), and very high (>1.25 mM) for 79 patients (46.20%). However, serum cystatin C levels were not correlated with NIHSS scores, serum total cholesterol, high-density lipoprotein, low-density lipoprotein, apolipoprotein a, or apolipoprotein b levels. Further, serum cystatin C concentrations in stroke patients were not correlated with the presence of intracranial arterial stenosis, hypertension, or diabetes. CONCLUSION: Our study suggests that there is a close relationship between cystatin C and acute ischemic stroke, independently of conventional risk factors. But the levels of cystatin C are not correlated with the stroke severity.


Assuntos
Isquemia Encefálica/complicações , Cistatina C/sangue , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Adulto , Idoso , Isquemia Encefálica/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Infarto Cerebral/etiologia , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Doenças Arteriais Intracranianas/sangue , Doenças Arteriais Intracranianas/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico por imagem
11.
Chin Med J (Engl) ; 128(13): 1732-7, 2015 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-26112712

RESUMO

BACKGROUND: Cerebral venous thrombosis (CVT) may lead to serious neurological disorders; however, little is known about the risk factors for recurrent CVT. Our aim was to determine the association between elevated fibrinogen and decreased high-density lipoprotein cholesterol (HDL-C) levels with recurrent CVT. METHODS: This retrospective cohort study included participants if they had a first episode of objectively defined CVT and were admitted to Xuan Wu Hospital, Capital Medical University from August 2005 to September 2009. Demographic and clinical variables were collected, as well as laboratory parameters, including plasma fibrinogen and HDL-C. Patients with CVT were followed for recurrent symptomatic CVT. Follow-up was through the end of September 2010. Potential predictors of recurrence were analyzed using Cox survival analysis. RESULTS: At the end of the follow-up, 95 patients were eligible for the study. Twelve of 95 patients (12.6%) had recurred CVT. The median time of recurrence was 7 months (range: 1-39 months). Eight of these 12 (66.7%) experienced recurrence within the first 12 months after their initial CVT. The recurrence rate of CVT was 2.76 per 100 patient-years. Multivariate Cox regression analysis demonstrated that the coexistence of high fibrinogen (>4.00 g/L) and low HDL-C (<1.08 mmol/L) levels at baseline was the only independent predictor for recurrent CVT (hazard ratio: 4.69; 95% confidence interval: 1.10-20.11; P < 0.05). Of the twelve patients with recurrent CVT in our study, 7 (58.3%) had high fibrinogen plus low HDL-C levels. All 7 of these patients took warfarin for 3-12 months, and 6 of 7 had recurrent CVT after the discontinuation of anticoagulant treatment. CONCLUSIONS: Concomitant high fibrinogen and low HDL-C levels may be associated with recurrence of CVT. The effect of potential risk factors related to atherothrombosis on recurrent CVT should be closely monitored.


Assuntos
HDL-Colesterol/metabolismo , Fibrinogênio/metabolismo , Trombose Intracraniana/metabolismo , Trombose Intracraniana/patologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Adulto Jovem
12.
Neurol Res ; 37(3): 246-52, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25213595

RESUMO

OBJECTIVE: To determine the pattern of muscle edema occurring in the lower limb muscles of Asian hypokalaemic periodic paralysis (hypoPP) patients using magnetic resonance imaging (MRI). Specifically, the relationship between muscle edema and muscle activity during daily use was examined by comparing the lower limb muscle MRI of healthy subjects following exercise and hypoPP patients. METHODS: Twenty Asian patients (mean age: 29·3±7·53 years) clinically diagnosed with hypoPP were enrolled in the present study. Ten healthy subjects were also enrolled. Direct automated DNA sequencing of the S4 regions of CACNA1S and SCN4A in all hypoPP patients was performed. The upper and lower legs of all hypoPP patients during the time interval between attacks and healthy subjects pre- and post-exercise were examined on a 3 T system with T2-weighted fat saturation sequence. Images were evaluated by means of a region of interest analysis. A scoring from 0 to 3 was used to compare the degree of muscle edema among individual muscles. RESULTS: Three hypoPP patients were identified with mutations in the screened genes: R1239H and R900S of CACNA1S and R672H of SCN4A. The lower leg muscles of both hypoPP patients and healthy subjects after exercise displayed significantly higher MRI signal intensities compared to healthy subjects before exercise (P < 0·0001 and P < 0·0001, respectively). In contrast, there was no significant change in the upper leg muscle signal intensities of hypoPP patients and healthy subjects following exercise compared to pre-exercise healthy subjects (P  =  0·7598 and P  =  0·9651, respectively). In the hypoPP patient group, high signal intensity in the upper leg muscles was seen only in the patient with the R1239H mutation. In the lower legs, muscle edema was most frequently seen in the gastrocnemius lateralis, soleus, and gastrocnemius medialis in the hypoPP patient group. Furthermore, the degree of muscle edema was the greatest in these muscles. This similar pattern of muscle edema was also seen in healthy subjects after exercise. CONCLUSIONS: In Asian hypoPP patients, muscle edema as well as the underlying abnormal ion distributions across the muscle membrane is present even during the time interval between attacks of muscle weakness. The muscles of the lower leg are more likely to be edematous than muscles of the upper leg since these muscles are more actively used in daily life. Thus, muscles subjected to high activity are more likely to be edematous and sodium-overloaded.


Assuntos
Edema/patologia , Paralisia Periódica Hipopotassêmica/patologia , Perna (Membro)/patologia , Imagem por Ressonância Magnética/métodos , Músculo Esquelético/patologia , Adulto , Grupo com Ancestrais do Continente Asiático , Canais de Cálcio/genética , Canais de Cálcio Tipo L , Exercício , Técnicas de Genotipagem , Humanos , Paralisia Periódica Hipopotassêmica/genética , Pessoa de Meia-Idade , Canal de Sódio Disparado por Voltagem NAV1.4/genética
13.
Neurol Res ; 31(1): 43-51, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18691447

RESUMO

OBJECTIVES: The aims of this study were to determine the effects of intra-arterial local hypothermia on infarct volume in rats with different durations of ischemia and to determine whether hypothermia can prolong the therapeutic time window compared with reperfusion without hypothermia. METHODS: Adult male Sprague-Dawley rats weighing 260-300 g were divided into control group (permanent MCA occlusion), normothermia groups (NT groups) and hypothermia groups (HT groups). NT groups included rats induced with blood reperfusion for 1.5, 2, 2.5 or 3 hour ischemia. In the HT groups with ischemia of 1.5, 2, 2.5 or 3 hours, 6 ml 20 degrees C normal saline solution was flushed at a speed of 0.6 ml/min, beginning 10 minutes before blood reperfusion. The infarct volumes of brains stained by TTC were observed 48 hours later. Brain temperature, blood flow and neurological scores were also recorded during this procedure. RESULTS: In the 1.5, 2, 2.5 and 3 hour ischemic groups, cold saline (20 degrees C infusion via the MCA) rapidly reduced the temperature of the MCA-supplied ischemic territory in the cortex from 37.0-37.1 to 32.8-33.2 degrees C and in the striatum from 37.3-37.5 to 33.2-33.3 degrees C. In NT groups, the average total infarct volumes of 1.5 and 2 hour ischemia (29.80 +/- 2.20 and 34.29 +/- 2.14%, respectively) were significantly less than that of the control group (48.41 +/- 5.82%), but the average total infarct volumes of the 2.5 and 3 hour ischemia groups (47.31 +/- 4.72 and 50.17 +/- 8.08%, respectively) did not change. Compared with the ischemia groups without local saline infusion, the average total infarct volumes of 1.5, 2 and 2.5 hours with local saline infusion to the ischemic territory (16.79 +/- 2.51, 23.09 +/- 4.63% and 25.19 +/- 7.82%, respectively) decreased significantly, but the average total infarct volume of 3 hour ischemia with local saline infusion (43.30 +/- 2.62%) was not different. CONCLUSION: Local cold saline infusion to the ischemic territory before reperfusion can lead to mild hypothermia of the ischemic territory and can prolong the therapeutic time window of reperfusion from 2 to 2.5 hours. Refinements of the cooling process, optimal target temperature, duration of the therapy and most importantly, clinical efficacy, require further study.


Assuntos
Hipotermia Induzida/métodos , Ataque Isquêmico Transitório/complicações , Traumatismo por Reperfusão/prevenção & controle , Animais , Circulação Cerebrovascular , Infarto da Artéria Cerebral Média/complicações , Infusões Intra-Arteriais , Masculino , Ratos , Ratos Sprague-Dawley , Recuperação de Função Fisiológica , Traumatismo por Reperfusão/etiologia , Cloreto de Sódio/administração & dosagem
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