Therapeutic hypothermia in patients with poor-grade aneurysmal subarachnoid hemorrhage.

OBJECTIVE: Therapeutic hypothermia improves the prognosis of patients with poor-grade subarachnoid hemorrhage (SAH). We investigated the clinical and radiological effects of therapeutic hypothermia in patients with poor-grade SAH. METHODS: Clinical and radiological data were compared between patients who underwent mild hypothermic treatment and those who underwent treatment without hypothermia. RESULTS: Among 670 patients with SAH, 72 had poor-grade SAH. After early clipping or coiling of the aneurysm, 25 patients underwent mild hypothermia and the remaining 47 patients underwent no hypothermia. The medical complication occurrence rates were similar between the hypothermia treatment and control groups. Significantly, cerebral edema was reduced in patients in the hypothermia group (44 %) compared with those in the no-hypothermia group (9 %) (p = 0.025). The poor clinical outcome rate (modified Rankin scale score > 4) assessed at discharge (p = 1.000) and 3 months after admission (p = 0.688) was similar between the two groups. However, 1 month after admission, the mortality rate of the hypothermia group (20.0 %) was remarkably lower than that of the control group (46.8 %) (p = 0.025). Multivariate logistic regression showed the therapeutic hypothermia was the most effective treatment for decreasing the mortality (OR = 4.86, P = 0.023). CONCLUSION: Mild hypothermia treatment appears to be feasible and safe for patients with poor-grade SAH. The study supports mild hypothermia treatment and its neuroprotective effects in patients with poor-grade SAH.

Simultaneous detection of antibacterial sulfonamides in a microfluidic device with amperometry.

A highly sensitive and robust method for simultaneous detection of five sulfonamide drugs is developed by integrating the preconcentration and separation steps in a microfluidic device. An ampetrometry is performed for the selective detection of sulfonamides using an aluminum oxide-gold nanoparticle (Al(2)O(3)-AuNPs) modified carbon paste (CP) electrode at the end of separation channel. The preconcentration capacity of the channel is enhanced by using the field amplified sample stacking and the field amplified sample injection techniques. The experimental parameters affecting the analytical performances, such as pH, % of Al(2)O(3), volume of AuNPs, buffer concentration, and water plug length are optimized. A reproducible response is observed during the multiple injections of samples with RSDs<4%. The calibration plots are linear with the correlation coefficient between 0.991 and 0.997 over the range between 0.01 and 2025pM. The detection limits of five drugs are determined to be between 0.91 (±0.03) and 2.21 (±0.09)fM. The interference effects of common biological compounds are also investigated and the applicability of the method to the direct analysis of sulfonamides in real meat samples is successfully demonstrated. Long term stability of the modified electrode was also investigated.

Electrophoretic total analysis of trace tetracycline antibiotics in a microchip with amperometry.

The preconcentration, separation, and electrochemical detection of a series of tetracycline (TC) antibiotics in a microfluidic channel were preformed. The electrophoretic experimental parameters to analyze TC, oxytetracycline, chlortetracycline, and doxycycline antibiotics were investigated with a cellulose-dsDNA-modified carbon paste electrode. Modification of the electrode improved detection performance by enhancing the signal-to-noise characteristics without surface fouling of the electrode. Field-amplified sample stacking and field-amplified sample injection techniques were employed for on-chip preconcentration of the TC series. The sensitivity of the method was improved 10 900-fold when compared with conventional MEKC-electrochemical detection analysis. The overall recoveries for TC, oxytetracycline, chlortetracycline, and doxycycline were 87, 89, 87, and 81%, respectively, with 6.0% RSD. The limits of detection for the series were estimated between 1.5 and 4.3 nM. Applicability of the method to beef samples was successfully demonstrated.

Anti-inflammatory and related pharmacological activities of cultured mycelia and fruiting bodies of Cordyceps militaris.

This study aimed to elucidate pharmacological activities of Cordyceps militaris. The 70% ethanolic extracts of cultured mycelia (CME) and fruiting bodies (FBE) of Cordyceps militaris were prepared. CME was able to directly scavenge the stable free radical diphenyl-2-picrylhydrazyl (DPPH), indicating its antioxidant activity. Both CME and FBE showed topical anti-inflammatory activity in the croton oil-induced ear edema in mice. CME was found to contain acute anti-inflammatory activity, which was evaluated using the carrageenin-induced edema, and also strong antinociceptive activity in writhing test. CME and FBE contain potent inhibitory activity on the chick embryo chorioallantoic membrane (CAM) angiogenesis in a dose-dependent manner. Cordycepin, a metabolite of Cordyceps militaris, appeared to be at least partly responsible for its anti-inflammatory and anti-angiogenic activities. CME concentration-dependently inhibited the NO production and iNOS expression upon stimulation by lipoposaccharide in RAW 264.7, a murine macrophage cell line. In brief, we demontrate that Cordyceps militaris possesses anti-inflammatory and antinociceptive activites, and related antioxidant, anti-angiogenic, and NO production-inhibitory activities.

Major gene evidence after MTHFR-segregation analysis of serum homocysteine in families of patients undergoing coronary arteriography.

Elevated levels of homocysteine is a risk factor for coronary artery disease. Polymorphic alleles in the MTHFR genes that cause recessively inherited increased homocysteine level can explain only a small proportion of the observed variation in homocysteine level. To investigate additional genetic influences, we examined environmental, familial, and genetic influences on serum homocysteine levels in 661 family members of 112 probands who underwent elective coronary arteriography. Maximum likelihood methods were used to fit several genetic and non-genetic models of inheritance to these data to determine if an unobserved Mendelian major gene could explain the familial homocysteine distribution. Adjustments for age, lifestyle (smoking and alcohol consumption), serum folate and vitamin B12, and the measured genotype effect of the MTHFR C677T mutation was carried out separately for males and females using multiple regression models for homocysteine, before and after log-transformation prior to this segregation analysis. After excluding the effects of mutations in the MTHFR genes, we found evidence of a major gene acting in a co-dominant manner. Estimated mean homocysteine levels for the three putative genotypes (LL, LH, and HH) were 8.0, 10.1, and 15.9 micro mol/l, respectively, with relative frequencies of 56.8%, 37.2%, and 6%, respectively. Our analysis suggested the presence of a co-dominantly expressed major gene, in addition to the effects of the MTHFR C677T mutation. The results of this study also indicated that multifactorial inheritance was supported more strongly than Mendelian inheritance alone. Our findings may have implications for attempts to identify new homocysteine susceptible genes.

Familial correlation and heritability for cardiovascular risk factors.

The goal of this study was to describe the overall genetic contribution of phenotypic variation to cardiovascular disease. The study population included 7,589 family members of 1,891 families, derived from Korean Medical Insurance Corporation. The risk factors considered were systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and high serum cholesterol. The levels of cardiovascular disease risk factors were adjusted for age, gender, smoking and alcohol drinking. Heritability was estimated from the slope of the line linear regression of offspring on mid-parent. All risk factors showed positive familial correlations, and correlations were generally lower for spouses than for parent- offspring pairs. Spouse correlations showed increasing patterns with age. Parents-offspring correlations showed little variation with age, suggesting that the observed correlations with CVD risk factors were primarily due to genetic influences rather than environmental effects. Estimated heritabilities were 26% for BMI, 26% for high serum cholesterol, 19% for SBP, and 9% for DBP. These results highlight the importance of considering genetic factors in studies of cardiovascular risk factors.