Neuroprotective effect of intracarotid cold saline infusion following cardiopulmonary resuscitation in a hypothermic cardiac arrest canine model / 解放军医学杂志

Objective To evaluate the effect of intracarotid cold saline infusion (ICSI) on neurological outcomes in canines with cardiac arrest (CA) introduced by severe hypothermia.Methods Restoration of spontaneous circulation (ROSC) after hypothermic CA was induced in 10 Beagle dogs.These 10 dogs were randomly divided into 2 groups (5 each).Dogs in control group were rewarmed using warn water bath,and dogs in experimental group received the bath rewarming plus ICSI for 6 hours to maintain the brain temperature ＜36℃.In both groups,the Neurologic Disability Scores (NDS) were recorded at 24h after the ROSC,and their brains were removed for pathologic analysis using hematoxylin and eosin stain.The brain water content and sl00β of serum level were also measured.Results The water content (79.43％ ± 0.72％ vs.80.79％ ± 1.06％,P＜0.05) and serum level of s100β (119.83 ± 42.93pg/ml vs.329.82 ± 190.39pg/ml,P＜0.05) were significantly lower in experimental group than in the control group.Control group presented obvious pathological damage of the hippocampal pyramidal cells.There was no significant difference in NDS between the two groups.Conclusion ICSI could reduce the production of s100β and pathological brain damage in postarrest hypothermic canines.

The efficacy of intra-carotid infusion with cold saline in rats with acute cerebral ischemia / 实用医学杂志

Objective To investigate the safety and therapeutic effect of intra-carotid infusion with cold sa line in rats with acute focal cerebral ischemia-reperfusion injury.Methods 60 rats were randomly divided into six groups:sham operated group,normal infusion group,stroke group,local hypothermic group,local normothermic group,and systemic infusion group.Brain infarct volume and cerebral water content were analyzed 48 h after ischemia.Neurological deficits were assessed using the mNSS 24 h and 48 h after infarction.Results In the local hypothermic group,brain temperature was reduced to 33 to 34 ℃ within 5 to 10 minutes,and this significantly low temperature maintained to nearly 60 minutes after infusion continued.Physiological variables were not significantly different among each time point (P ＞ 0.05).No significant morphological abnormality was found in brain sections stained with TTC and HE.Animals receiving local cold infusion significantly decreased infarct volume and brain water content compared to stroke group (P ＜ 0.05).Both 24 h and 48 h mNSS in local hypothermic group was significantly lower than those in other groups (P ＜ 0.05).Conclusions Intra-carotid infusion with cold saline can quickly and effectively reduce brain temperature and is a relatively safe cooling method.Local hypothermia significantly reduced brain infarct volume,decreased brain water content and improved neurological functional outcomes after brain ischemia.

The effects of intracarotid transplantation of bone marrow stem cells on learning memory abilities in the brain of VD rats / 重庆医学

Objective To observe the survival and migration characteristics after intracarotid transplantation of bone marrow stem cells(BMSCs) and its effect on learning-memory abilities across the blood-brain barrier(BBB) in the vascular dementia(VD) rats .Methods Bone mononuclear cells(BMNCs) were isolated from bone marrow in vitro by standard Ficoll-Hypaque technique , then cells were enriched and expanded by using bone marrow adherent culture .72 Wistar rats were meanly divided into control group ,model group and treatment group .The VD rat model was established by modified pulsinellis 4-vessel occlusion(4 VO) .The treatment group received intracarotid infusion of 0 .5 mL 1 .2 × 107/mL BMSCs which were labeled with BrdU in vitro after opera-tion .Their survival ,migration and the learning-memory abilities were observed at 4th and 8th week .Results BMSCs transplanted by intracarotid transplantation survived and had been found throughout the brain tissue .They major migrated and localized in the is-chemic zone of injury such as hippocampus and cerebral cortex .Compared with the control group ,active avoidance response(AAR) ratio in the model group(42 .1 ± 4 .5) ,group(43 .6 ± 3 .6)showed significantly decrease compared with the control group (90 .0 ± 4 .3) ,(92 .5 ± 5 .0)(P<0 .01) ,and the treatment group(69 .2 ± 4 .7) ,(70 .8 ± 4 .7)was significant higher than the model group(P<0 .01) .Conclusion Intracarotid transplantation of BMSCs could enter the VD rats cerebra parenchyma via BBB ,migrate into the damaged brain tissue to gather and survive .Learning-memory abilities can be improved significantly by transplanted BMSCs .

The feasibility of GFP positive Lewis lung cancer cell line 3LL intracarotid injected to establish brain metastasis animal model * / 重庆医学

Objective To study the feasibility and surgical techniques of C57BL/6 mice intracarotid injected Lewis lung cancer cell line 3LL to establish a kind lung cancer brain metastasis animal model .Methods Green fluorescent protein(GFP) positive 3LL cells were intracarotid injected into C57BL/6 mice to establish lung cancer brain metastases animal models ,then tumor growth and survival time were analyzed .Results The intracarotid injection animal model could establish brain metastases animal model success-fully .Conclusion The intracarotid injection is an effective method to establish cancer brain metastatic animal model .

Doenças do sistema nervoso central de equídeos no semi-árido / Diseases of the central nervous system in equidae in the Brazilian semiarid

As doenças do sistema nervoso central (SNC) de equídeos representam uma parcela importante das enfermidades diagnosticadas nestas espécies. O estudo destas e de outras enfermidades nas diferentes regiões do país é necessária para estabelecer formas eficientes de controle e profilaxia. O presente trabalho teve como objetivo descrever as características clínicas, epidemiológicas e patológicas das doenças do SNC de equídeos diagnosticadas no Laboratório de Patologia da Universidade Federal de Campina Grande, em Patos, Paraíba, que ocorreram entre janeiro de 2007 e dezembro de 2008. No período estudado, 159 casos ou surtos de doenças de equídeos foram diagnosticados. Destes, 49 (30,8 por cento) afetaram o SNC. A encefalopatia hepática na intoxicação por Crotalaria retusa foi a principal enfermidade com 14 casos (28,5 por cento), seguida por tétano com 13 (26,5 por cento) casos e raiva com 11 (22,,4 por cento) casos. Sete (14,2 por cento) casos foram de traumatismos afetando o SNC. Foram, também, diagnosticados 1 caso de leucoencefalomalacia, 1 de encefalite por herpesvírus eqüino-1, 1 de injeção acidental na artéria carótida, 1 surto de encefalomielite viral equina tipo leste, 1 surto de intoxicação por Turbina cordata e 1 surto de doença tremogênica de causa desconhecida. Cinco casos tiveram diagnóstico inconclusivo. Este trabalho comprova a importância do funcionamento de laboratórios de diagnóstico, nas diferentes regiões do país, para o conhecimento das doenças do rebanho e para a vigilância epidemiológica das mesmas.

Diseases of the central nervous system (CNS) in equidae are important in these species, and their knowledge in the different Brazilian regions is necessary to determine efficient control and preventive measures. This paper reports epidemiologic aspects, clinical signs and pathology of diseases of the CNS in equidae diagnosed by the Veterinary Pathology Laboratory at the Federal University of Campina Grande in the city of Patos, state of Paraíba, northeastern Brazil, during 2002-2008. During the period, 159 cases or outbreaks of those diseases were studied, 49 (30.8 percent) affecting the CNS. Hepatic encephalopathy caused by Crotalaria retusa poisoning, with 14 cases (28.5 percent), was the main disease observed. Tetanus was diagnosed in 13 (26.5 percent) cases and rabies in 11 (22.4 percent). In seven (14.2 percent) cases the death or euthanasia was due to traumatic lesions of the CNS. Also were diagnosed 1 case of leucoencephalomalacia, 1 case of encephalitis by equine herpesvirus-1, 1 case of intracarotid artery injection, 1 outbreak of Eastern equine encephalitis, 1 of Turbina cordata poisoning, and 1 of a tremogenic disease of unknown cause. In 5 cases the diagnosis was inconclusive. This paper indicates the importance of diagnostic veterinary laboratories, in the different Brazilian regions, for the knowledge of livestock diseases.

The Related Factors to Atypical Language Dominance in Patients with Epileptic Foci in the Left Hemisphere

BACKGROUND: Several studies have revealed the increased incidence of atypical language dominance in patients with left hemisphere epileptic foci. We retrospectively investigated the incidence and related factors for language dominance shift determined by intracarotid amobarbital procedure (IAP) in patients with left hemispheric epilepsies. METHODS: We included 222 epileptic patients with epileptic foci in left hemisphere whose language dominance was determined by IAP at Asan Medical Center from 1994 to 2004. The items on the language test in IAP included spontaneous speech (6 items), understanding (2 items), and repetition (2 items). Language lateralization index (LI) was computed according to the formula L=(Score IAP right-Score IAP left)/(Score IAP right+Score IAP left). Clinical information was obtained from medical records including age, gender, age at onset of epilepsy, duration of epilepsy, frequency of seizures, risk factors, onset age of risk factors, and lateralization of MRI or EEG. RESULTS: Of the 222 patients (male 110 patients, 49.5%), complete left language dominance was 142 patients (64.0%), and complete right hemispheric language dominance was 29 patients (13.1%). Seizure onset age, onset age of risk factors, handedness and MRI lesions (hippocampal atrophy or left extensive lesion) had statistically significant association with atypical language dominance. On a linear regression analysis, the significant predictors of the atypical language dominancy were handedness and left extensive lesion (R2=.64). CONCLUSIONS: Atypical language dominancy in patients with left epileptic foci was highly correlated with non-right handedness and extensive lesion on the left hemisphere.

Novas perspectivas na avaliação neuropsicológica em pacientes com epilepsia refratária / News perspectives in epilepsy cirurgy neuropsychological evaluation

Passados mais de 50 anos, desde que Brenda Milner começou a avaliar pacientes com epilepsia refratária, os testes utilizados nos centros de cirurgia de epilepsia são praticamente os mesmos. Pouco progresso ocorreu em relação ao surgimento de novas técnicas e métodos mais sensíveis e específicos para este fim. Parece que alcançamos o máximo com as técnicas padrões que possuímos o que nos leva a concluir, que sem a inclusão de novas metodologias, a possibilidade de diagnósticos mais específicos e fidedignos, não será mais possível. Novos paradigmas precisam ser desenvolvidos, assim como técnicas que permitam o mapeamento de funções cognitivas, como a Ressonância Magnética funcional. Neste artigo, discutimos a investigação neuropsicológica de pacientes com epilepsia refratária e questionamos alguns aspectos da avaliação da linguagem e memória, bem como sua utilidade para predizer a extensão dos déficits de memória que poderão ocorrer após a cirurgia. Além disso, fazemos referência as novas perspectivas de investigação neste contexto.

More than fifth years have passed since Brenda Milner has started the epilepsy surgery neuropsychological evaluation and tests in use nowadays are mostly the same, i.e., there was little if any progress in terms of the development of new and more sensitive or specific methods. We may have reached the maximum of diagnostic differentiation with standard neuropsychological tests, and without inclusion of experimental test condition, more elaborate diagnostics will not be possible. We have examined several issues relevant to the utility of the current evaluation and also, some alternatives to help making surgery more safe in relation to the cognitive functions. We discuss also, the development of new paradigms to activate cortical functions, like functional Magnetic Resonance. In this article, we discuss neuropsychological investigation of patients epilepsy surgery and whether the approach of memory and language evaluation used is useful in predicting the extent of memory deficits following epilepsy surgery. Moreover, we make reference the new perspectives of investigation in this context.

Memory Functions of Temporal Lobe Epileptic Patients in the Intracarotid Amobarbital Procedure:I. Lateralizing Value

BACKGROUNDS: To examine the effects of seizure laterality and stimulus type on Wada memory performance in patients with temporal lobe epilepsy(TLE). METHODS: The subjects were 43 patients with medically intractable TLE (left TLE 26, Right TLE 17) who had no or rare seizures after surgery. The memory stimuli were concrete figures for some subjects and abstract figures for the other subjects. RESULTS: A clinical criterion of at least 2-points difference between left and right injections correctly classified 31(72%) patients into left and right TLE groups, with 4(9%) patients falsely classified. A discriminant function analysis(DFA) based on left and right injection scores allowed for a correct classification of 37(86%) patients into left and right TLE groups. When the memory stimuli were concrete figures, the correct classification rate was greater for right than left TLE patients. In contrast, with abstract figures, the correct classification rate was greater for left than right TLE patients. CONCLUSIONS: The Wada memory test is a valuable diagnostic aid in lateralizing temporal epileptogenic foci. Stimulus type as well as seizure lateralization is a major determinant of Wada memory asymmetries.

Influencing factors on interhemispheric language 'shift' and memory asymmetry in temporal lobe epilepsy

BACKGROUND AND OBJECTIVES: Interhemispheric memory asymmetry & language 'shift' (right hemisphere restitution of originally left hemisphere functions or vice versa) and its lateralizing value in temporal lobe epilepsy (TLE) have been repeatedly reported. We analyzed the factors influencing the memory asymmetry & language 'shift', which, to our knowledge, has rarely been reported. METHODS: The IAP (Intracarotid Amobarbital Procedure) was performed in 94 patients, who were candidates for temporal lobectomy. We determined language dominance (LD) hemisphere and calculated 'memory asymmetry indexes' (difference of percentage of memory recall between left and right hemisphere). We reviewed sex, history of 'risk factors' (episodes of febrile convulsion, head trauma, or meningoencephalitis during period of infant and early childhood), age of epilepsy-onset, duration of epilepsy, and then correlated each of them with the presence of language shift and the degree of memory asymmetry. RESULTS: Atypical LD (bilateral or right hemisphere LD) was significantly more frequent in left TLE group than in right (left TLE: 19%, right: 0%, p=0.009). The 'shift' of LD hemisphere was more frequent in patients with 'risk factors' (p=0.04). The 'shift' of LD hemisphere was seen only in patients with duration of epilepsy of > 10 years, but statistically not significant(p=0.07). Interhemispheric memory asymmetry occurred in most patients. The presence of 'risk factors' (p=0.05), duration of epilepsy of 10-20 years (p=0.04), and female sex (p=0.01) were significantly associated with the memory asymmetry in left TLE group. But in right TLE group, the memory asymmetry was not associated with above factors. CONCLUSION: Only in left TLE group, the presence of 'risk factors' and duration of epilepsy influenced both interhemispheric memory asymmetry & language 'shift', whereas sex influenced memory asymmetry only. In right TLE, we failed to find correlation. These results could be explained that in right TLE, memory might be easily or rapidly shifted to the contralateral hemisphere, even in absence of above factors.

Effect of intracarotid or intravenous injection of propofol on the neuronal apoptosis of hippocampus in rats undergoing cardiopulmonary bypass / 中国药理学通报

Aim To compare the different effect of intracarotid and intravenous injection of propofol on the neuronal apoptosis of hippocampus in rats undergoing cardiopulmonary bypass.Methods Fifty rats were randomly assigned to five groups. Shame group (Group Non-CPB,n=10); group cardiopulmonary bypass(group CPB,n=10);group intravenous injection of propofol 2 mg?kg -1?h -1 (group P_ 2V,n=10);group intravenous injection of propofol 10mg.kg -1?h -1 (group P_ 10V,n=10);group intracarotid injection of propofol 2 mg?kg -1?h -1 (group P_ 2a,n=10).Mean arterial pressure(MAP)and heart rate(HR) were monitored. Changes of the neuronal apoptosis of hippocampus were observed with TUNEL staining, Bax and bcl-2 mRNA and protein expressions were measured by RT-PCR and Western blot. In addition,neuronal ultrastructures were observed. Results Neuronal apoptosis and changes of neuronal ultrastructures of hippocampus were attenuated in group P_ 2a and P_ 10V,but the apoptosis of neurons was not attenuated in group P_ 2v. Bcl-2 and Bax mRNA expression increased undergoing CPB. Bax mRNA expression decreased after CPB in group P_ 2a and P_ 10V. Bcl-2 mRNA expression increased in group P_ 2a and P_ 10V. But Bcl-2 and Bax mRNA expression in group P_ 2V was not significantly different compared with that of group CPB. Bcl-2 and Bax protein expression measured by Western blot showed the same trend with mRNA expressions. Compared with baseline values, MAP and HR in group P_ 2V and P_ 2a remained unchanged. But the MAP and HR in group P_ 10V changed compared with group CPB and baseline value.Conclusions intracarotid injection of propofol attenuated the injury of brain at a fraction of the intravenous dose and with less adverse systemic and cerebrovascular side effects.