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Objective: 1. T o study the added utility of computed tomography perfusion study in the assessment of early ischemic stroke in comparison with non-contrast computed tomography. 2. To study the role of computed tomography perfusion study in deciding thrombolytic treatment/ therapeutic protocols aimed at reversing the cerebral ischemic insult. Conclusions and Results: It was observed that 15 (46.68%) patients were in the 61-70 years of age group followed by 8 (25%) in the age group of 51-60 years. The mean age of the patients was 58.87 ±12.14 years. Ÿ Females were affected more i.e. 18 (56.25%) compared to the male patients 14 (43.75%). Ÿ Most observed co-morbid condition was hypertension in 9 (28.13%) patients followed by hypertension and diabetes in 7 (21.87%) patients and diabetes in 6 (18.75%) patients. Ÿ Among the study participants 4 (12.50%) were smokers followed by 6 (18.75%) were alcoholic and smokers & alcoholic (15.62%) respectively. Ÿ It was observed that the symptoms of palsy were present among 23 (71.88%) patients Ÿ The most commonly observed time of onset of symptoms was 3-5 hours in 23 (71.88%) patients followed by 1-3 hours (21.87%) and >5 hours in 2 (6.25%) patients. Ÿ NCCT ?ndings observed was de?nite signs of stroke in 12 (37.5%) patients followed by suspected signs of stroke on NCCT (25%) Ÿ It was observed that no sign of stroke was observed in 12 (37.5%) patients. Ÿ CT perfusion ?ndings observed was increased mean transient time (MTT) in all (100%) patients followed by decreased blood ?ow in all (100%) patients. It was observed that cerebral blood volume decreased in 12 (37.5%) patients, increased in 8 (25%) and normal in 12 (37.5%) patients. Ÿ The correlation of NCCT and CT perfusion ?ndings observed that out of total 32 patients NCCT study identi?es 20 patients while all 32 patients were identi?ed by CT perfusion study with sensitivity of 100%. Ÿ CT perfusion provides early diagnosis of ischemic stroke thus helps in management of stroke patients. Inference : The present study concludes that CT-perfusion had more sensitivity compared to NCCT in identifying early ischemic stroke. CT perfusion has additional utility in management of early ischemic stroke. CT Perfusion study provides important information to the neurologist and neuro-interventionalist when evaluating patients for endovascular reperfusion therapy by identifying the size of core infarction and penumbra
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OBJECTIVE:To study the relationship of GSTP 1(rs1695)(simply as GSTP 1)gene polymorphism with the hematological toxicity in autologous hematopoietic stem cell transplantation(AHSCT)patients who used CBV regimen (cyclophosphamide,carmustine,etoposide). METHODS:A total of 83 AHSCT patients receiving CBV regimen were retrospective analyzed in our hospital during Apr. 2015-Jun. 2017. The gene polymorphism of GSTP 1 A313G was detected by fluorescence staining in situ hybridization. The hematological toxicity and the incidence of agranulocytosis fever,the implantation time of leukocyte,neutrophils and platelet were analyzed statistically. The relationship of GSTP 1 with above indexes were analyzed. RESULTS:Among 83 patients,gene variation was observed in one gene loci at least of 28 patients(33.73%).The gene frequency of A allele was 81.3%,while that of G allele was 18.7%. The reduce time of Ⅳ grade leukopenia,Ⅳ grade neutropenia and Ⅳgrade thrombocytopenia in GSTP 1 AA genotype patients were(8.91 ± 1.25),(9.02 ± 1.19),(11.56 ± 1.58)d after chemotherapy;those of patients with GSTP 1 313 allele G(AG/GG genotype) were(8.61 ± 1.17),(8.68 ± 1.19),(11.44 ± 1.34)d after chemotherapy. The implantation time of leukocyte,neutrophils and platelet in patients with GSTP 1 AA genotype were(11.98±1.99),(10.44±1.35),(15.55±2.18)d after autologus peripheral blood stem cell reinfusion;those of patients with GSTP1 313 allele G(AG/GG genotype)were(12.41±2.44),(10.36±1.62),(16.29±3.15)d after autologus peripheral blood stem cell reinfusion. The case number of grade Ⅲ-Ⅳ anemia were 24 and 11,accounting for 43.64% and 39.29% of corresponding genotype patients. The case number of agranulocytosis fever in patients with GSTP 1 AA genotype or GSTP 1 313 allele G(AG/GG genotype)were 21 and 11 during transplantation,accounting for 38.18% and 39.29% of corresponding genotype patients, respectively,without statistical significantly(P>0.05). CONCLUSIONS:There is no relationship between GSTP 1 gene polymorphism and hematological toxicity of AHSCT patients receiving CBV regimen.
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OBJECTIVE: Our goal was to evaluate the usefulness of CT perfusion (CTP) in early detection of the post operative cerebral ischemia, alteration of treatment modality and patient prognosis in cerebral aneurysm patients. METHODS: 24 patients who underwent either surgical operation or endovascular coiling for ruptured aneurysms were selected. All patients undertook an angiogram, conventional CT, and CTP scan immediately following surgical operation or endovascular coiling. All patients performed a CT 2 weeks after treatment to evaluate possible development of a cerebral infarction. Postoperative CT results of patients with abnormal postoperative CTP scan findings were compared, and these results were compared with the CT results and clinical symptoms of patients who developed infarction or not. RESULTS: Of the 24 patients evaluated, 11 patients showed abnormal findings on CTP. 9 patients were diagnosed with cerebral infarction through a CT scan done 2 weeks after treatment; all exhibited abnormal CTP results immediately after treatment. Abnormal CTP findings were divided into two groups; patients with abnormal CBF and MTT maps, but with normal CBV maps, and patients with abnormal CBF, CBV and MTT maps. A correlation was seen between abnormality on CBV maps and cerebral infarction. Patients with abnormal CTP findings also exhibited poorer prognostic value. CONCLUSION: Postoperative CTP in ruptured aneurysm patients is a very useful and objective tool in evaluating abnormal cerebral hemodynamics. The CBV map of CTP is the most precisely predictable value of postoperative patient's status and alteration of treatement modality.