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1.
J Cereb Blood Flow Metab ; 25(1): 87-97, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15678115

ABSTRACT

Suppression of platelet activation improves the efficacy of thrombolytic therapy for stroke. Thus, combination treatment with recombinant tissue plasminogen activator (r-tPA) and 7E3 F(ab')2, a GPIIb/IIIa inhibitor that binds the platelet to fibrin, may improve the efficacy of thrombolytic therapy in embolic stroke. Magnetic resonance imaging (MRI) was used to monitor treatment response in rats subjected to embolic middle cerebral artery (MCA) occlusion (MCAo). Animals were randomized into treated (n=12) and control (n=10) groups and received intravenous combination therapy or saline, respectively, 4 hours after MCAo. Magnetic resonance imaging (MRI) measurements performed 1 hour after MCAo showed no difference between groups. However, an increased incidence (50%) of MCA recanalization was found in the treated group at 24 hours compared with 20% in the control group. The area of low cerebral blood flow at 24 and 48 hours was significantly smaller in the combination treatment group, and the lesion size, as indicated from the T2 and T1 maps, differed significantly between groups. Fluorescence microscopy measurements of cerebral microvessels perfused with fluorescein isothiocyanate-dextran and measurements of infarct volume revealed that the combination treatment significantly increased microvascular patency and reduced infarct volume, respectively, compared with the control rats. The efficacy of combination treatment 4 hours after ischemia is reflected by MRI indices of tissue perfusion, MCA recanalization, and reduction of lesion volume. The treatment also reduced secondary microvascular perfusion deficits.


Subject(s)
Antibodies, Monoclonal/administration & dosage , Fluorescein-5-isothiocyanate/analogs & derivatives , Immunoglobulin Fab Fragments/administration & dosage , Infarction, Middle Cerebral Artery/drug therapy , Plasminogen Activators/administration & dosage , Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors , Tissue Plasminogen Activator/administration & dosage , Animals , Blood Platelets/metabolism , Blood Platelets/pathology , Brain/blood supply , Brain/diagnostic imaging , Brain/pathology , Cerebrovascular Circulation/drug effects , Dextrans , Drug Therapy, Combination , Echo-Planar Imaging , Fibrin/metabolism , Infarction, Middle Cerebral Artery/diagnostic imaging , Infarction, Middle Cerebral Artery/metabolism , Infarction, Middle Cerebral Artery/pathology , Intracranial Embolism and Thrombosis/diagnostic imaging , Intracranial Embolism and Thrombosis/diet therapy , Intracranial Embolism and Thrombosis/metabolism , Intracranial Embolism and Thrombosis/pathology , Male , Microcirculation/drug effects , Microcirculation/metabolism , Microscopy, Fluorescence , Middle Cerebral Artery/diagnostic imaging , Middle Cerebral Artery/pathology , Platelet Aggregation/drug effects , Radiography , Rats , Rats, Wistar , Recombinant Proteins/administration & dosage , Stroke/diagnostic imaging , Stroke/drug therapy , Stroke/metabolism , Stroke/pathology
2.
Radiology ; 221(1): 35-42, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11568318

ABSTRACT

PURPOSE: To examine possible differences between the evolution of cerebral watershed infarction (WI) and that of territorial thromboembolic infarction (TI) by using diffusion-weighted (DW) and T2-weighted magnetic resonance (MR) images and apparent diffusion coefficient (ADC) maps. MATERIALS AND METHODS: Fourteen patients with TI and nine with WI underwent MR imaging from the acute to chronic infarction stages. ADC maps were derived from DW images. Lesion-to-normal tissue signal intensity ratios on ADC maps (rADC), echo-planar T2-weighted images, and DW images were calculated. Lesion volumes at acute or early subacute infarction stages were measured on DW images, and final lesion volumes were estimated on fluid-attenuated inversion-recovery images. RESULTS: Analysis of variance revealed a significant difference in temporal evolution patterns of rADC between WI and TI (P <.001). rADC pseudonormalization following TI began about 10 days after symptom onset, but that following WI did not occur until about 1 month after symptom onset. The Pearson correlation coefficient between final and initial infarct volumes was 0.9899 for both infarction subtypes, indicating that the initial ischemic injury volume measured at the acute or early subacute stage predicted the final lesion volume fairly well. CONCLUSION: The evolution time of ADC is faster for TI than for WI. This difference, which likely originates from the different pathophysiologic and hemodynamic features of the two infarction types, might account for the relatively large range of ADC values reported for the time course of ischemic strokes.


Subject(s)
Infarction, Middle Cerebral Artery/pathology , Intracranial Embolism and Thrombosis/pathology , Magnetic Resonance Imaging/methods , Acute Disease , Adult , Aged , Aged, 80 and over , Chronic Disease , Diffusion , Female , Humans , Infarction, Middle Cerebral Artery/metabolism , Intracranial Embolism and Thrombosis/metabolism , Male , Middle Aged , Time Factors , Water
3.
Brain Res ; 837(1-2): 169-76, 1999 Aug 07.
Article in English | MEDLINE | ID: mdl-10433999

ABSTRACT

Urokinase-type plasminogen activator (u-PA) and tissue-type plasminogen activator (t-PA) play important roles in fibrinolysis, cell migration, tissue destruction, angiogenesis and tissue remodeling. u-PA and t-PA activity in tissue are tightly regulated by plasminogen activator inhibitor-1 (PAI-1). However, little is known of the activity of endogenous plasminogen activators (PAs) and PAI-1 in ischemic brain. To evaluate whether cerebral ischemic injury induces endogenous PAs and PAI-1, we measured PA activity from brain homogenates, and examined the expression of t-PA mRNA, u-PA mRNA and PAI-1 mRNA from brain homogenates in C57BL/6J mice (n=45) weighing 29-35 g in which the middle cerebral artery (MCA) was occluded by a fibrin-rich clot. Brain homogenates were prepared for direct casein zymography from control non-ischemic mice (n=4) and mice at 2 h (n=5), 4 h (n=5), and 24 h (n=4) after MCA occlusion (MCAO). Also, u-PA and t-PA knockout mice at 4 h (n=2, each) after MCAO were used as a negative control for direct casein zymography. Frozen sections for in situ zymography were obtained from control mice (n=2) and mice at 2 h, 4 h, and 24 h (n=2, per time point) after clot occlusion. Brain homogenates were prepared for reverse transcriptase-polymerase chain reaction (RT-PCR) to examine t-PA mRNA, u-PA mRNA and PAI-1 mRNA expression from control non-ischemic mice (n=4) and mice at 2 h (n=5), 4 h (n=5), and 24 h (n=5) after MCAO. By direct casein zymography, u-PA activity increased at 4 h (P<0.05), and 24 h (P<0.05) after stroke in the ischemic hemisphere compared with the non-ischemic mice. Activity of t-PA in ischemic brain was not significantly different from the control group. As measured by in situ zymography, PA activity, most likely u-PA, was present in the ischemic hemisphere. By RT-PCR, expression of PAI-1 mRNA, but not u-PA mRNA and t-PA mRNA, increased 3-, 15- and 25-folds in the ischemic hemisphere at 2 h, 4 h and 24 h after stroke, respectively, compared with control mice. This study demonstrates that PAI-1 mRNA and u-PA activity increase in mouse brain after stroke.


Subject(s)
Brain/metabolism , Intracranial Embolism and Thrombosis/metabolism , Ischemic Attack, Transient/metabolism , Plasminogen Activator Inhibitor 1/genetics , Tissue Plasminogen Activator/genetics , Urokinase-Type Plasminogen Activator/genetics , Animals , Gene Expression Regulation , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , RNA, Messenger/genetics , Reference Values , Tissue Plasminogen Activator/deficiency , Transcription, Genetic , Urokinase-Type Plasminogen Activator/deficiency
4.
J Tradit Chin Med ; 19(1): 54-8, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10453586

ABSTRACT

The levels of somatostatin (SS) in CSF and blood and pancreatic polypeptide (PP) in plasma were measured by radioimmunoassay in 64 patients with acute ischemic cerebrovascular diseases (ICVD), randomly divided into two groups: group 1 (n = 31, both electro-acupuncture and routine treatments given) and group 2 (n = 33, routine treatment) and 26 non-ICVD patients were used as controls. The points of electro-acupuncture were Quchi (LI 12), Waiguan (SJ 5) and Huantiao (GB 30) and Zusanli (St 36). After a course of treatment, the SS levels in plasma and CSF were significantly increased in the patients of group 1 with good result and their plasma PP level had no significant change. In the patients with poor result, however, the PP level was significantly decreased. The results suggested that electro-acupuncture might play an active role in alleviating the SS metabolic disturbance in CNS of ICVD patients.


Subject(s)
Cerebral Infarction/therapy , Electroacupuncture , Pancreatic Polypeptide/blood , Somatostatin/cerebrospinal fluid , Adult , Aged , Cerebral Infarction/metabolism , Female , Humans , Intracranial Embolism and Thrombosis/metabolism , Intracranial Embolism and Thrombosis/therapy , Male , Middle Aged , Somatostatin/blood
5.
Brain Res Bull ; 48(3): 325-31, 1999 Feb.
Article in English | MEDLINE | ID: mdl-10229342

ABSTRACT

The contribution of the complement system to cerebral ischemic and ischemia/reperfusion injury was examined in a rabbit model of thromboembolic stroke by delivery of an autologous clot embolus to the intracranial circulation via the internal carotid artery. A two-by-two factorial design was employed to study the impact of complement depletion via pretreatment with cobra venom factor (CVF, 100 U/kg i.v.) in the setting of permanent (without tissue plasminogen activator; t-PA) and transient (with t-PA) cerebral ischemia. Thirty-two New Zealand white rabbits were assigned to one of four groups (n=8, each group): control without t-PA, control with t-PA, CVF without t-PA and CVF with t-PA. In the complement intact animals, t-PA administration resulted in an approximate 30% reduction in infarct size when compared to the group not receiving t-PA (20.4+/-6.6% of hemisphere area vs. 30.1+/-7.2%; mean+/-SEM). However, infarct sizes in the complement depleted rabbits, with (30.7+/-8.2%) or without (30.2+/-7.9%) t-PA, were no different from the control group receiving no therapy. Similarly, no difference in regional cerebral blood flow or final intracranial pressure values was noted between any of the four groups. Complement activation does not appear to be a primary contributor to brain injury in acute thromboembolic stroke.


Subject(s)
Brain Ischemia/metabolism , Cerebrovascular Disorders/metabolism , Complement System Proteins/metabolism , Intracranial Embolism and Thrombosis/metabolism , Reperfusion Injury/metabolism , Animals , Brain/blood supply , Brain/enzymology , Brain Ischemia/drug therapy , Cerebrovascular Circulation/physiology , Cerebrovascular Disorders/drug therapy , Complement C3-C5 Convertases/metabolism , Complement Inactivator Proteins/pharmacology , Disease Models, Animal , Elapid Venoms/pharmacology , Female , Fibrinolytic Agents/pharmacology , Intracranial Embolism and Thrombosis/drug therapy , Male , Neutrophils/physiology , Rabbits , Reperfusion Injury/drug therapy , Tissue Plasminogen Activator/pharmacology
6.
J Neurosci Res ; 55(6): 749-61, 1999 Mar 15.
Article in English | MEDLINE | ID: mdl-10220115

ABSTRACT

Changes in nerve growth factor (NGF) level and type of cells producing NGF were investigated in the rat brain after sustained cerebral embolism. The NGF level was determined by a two-site enzyme immunoassay specific for NGF. The cerebral cortex, striatum, and hippocampus of the embolized hemisphere maximally contained 2.4-, 2.4-, and 1.7-times higher NGF levels than the corresponding regions of the nonembolized hemisphere. A significant increase was transiently observed for 1 week in the cerebral cortex and striatum, whereas the increase was longer lasting, at least of 4 weeks' duration, in the hippocampus. To examine the localization of NGF-like immunoreactivity (NGF-LI), we used a newly developed anti-NGF peptide antiserum that specifically recognized a 30-kDa molecule(s) in the hippocampal extracts or in NGF cDNA-transfected cells, suggesting that the antibody predominantly reacted with the putative NGF precursor protein(s). NGF-LI, which was localized in neurons of the normal or non-embolized hemisphere, was reduced, and on the embolized side new signals emerged in small non-neuronal cells having a round shape. These included cells with common leukocyte antigen CD45 and T-lymphocyte antigen CD3, which did not appear in the normal or non-embolized hemisphere. NGF-LI and CD3 were colocalized in a substantial number of the cells, suggesting that some activated T-lymphocytes produce NGF for neuronal regeneration after sustained cerebral embolism.


Subject(s)
Brain/immunology , Brain/metabolism , Intracranial Embolism and Thrombosis/immunology , Intracranial Embolism and Thrombosis/metabolism , Nerve Growth Factors/metabolism , T-Lymphocytes/immunology , Animals , Brain/pathology , Brain-Derived Neurotrophic Factor/metabolism , Cerebral Cortex/metabolism , Corpus Striatum/metabolism , Functional Laterality , Hippocampus/metabolism , Immunoenzyme Techniques , Intracranial Embolism and Thrombosis/pathology , Leukocyte Common Antigens/analysis , Lymphocyte Activation , Male , Microspheres , Nerve Growth Factors/analysis , Neurotrophin 3 , Rats , Rats, Wistar , T-Lymphocytes/pathology , Time Factors
7.
Stroke ; 30(3): 624-9, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10066862

ABSTRACT

BACKGROUND AND PURPOSE: We tested the hypothesis that treatment of embolic stroke with recombinant human tissue plasminogen activator (rhtPA) alters cerebral expression of adhesion molecules. METHODS: Male Wistar rats were subjected to middle cerebral artery occlusion by a single fibrin-rich clot. P-selectin, E-selectin, and intercellular adhesion molecule-1 (ICAM-1) immunoreactivity was measured at 6 or 24 hours after embolic stroke in control rats and in rats treated with rhtPA at 1 or 4 hours after stroke. To examine the therapeutic efficacy of combined rhtPA and anti-ICAM-1 antibody treatment at 4 hours after embolization, ischemic lesion volumes were measured in rats treated with rhtPA alone, rats treated with rhtPA and anti-ICAM-1 antibody, and nontreated rats. RESULTS: Administration of rhtPA at 1 hour after embolization resulted in a significant reduction of adhesion molecule vascular immunoreactivity after embolization in the ipsilateral hemisphere compared with corresponding control rats. However, when rhtPA was administered to rats at 4 hours after embolization, significant increases of adhesion molecule immunoreactivity in the ipsilateral hemisphere were detected. A significant increase of ICAM-1 immunoreactivity was also detected in the contralateral hemisphere at 24 hours after ischemia. A significant reduction in lesion volume was found in rats treated with the combination of rhtPA and anti-ICAM-1 antibody compared with rats treated only with rhtPA. CONCLUSIONS: The present study suggests that the time of initiation of thrombolytic therapy alters vascular immunoreactivity of inflammatory adhesion molecules in the ischemic brain and that therapeutic benefit can be obtained by combining rhtPA and anti-ICAM-1 antibody treatment 4 hours after stroke.


Subject(s)
Brain Ischemia/drug therapy , Cell Adhesion Molecules/biosynthesis , Fibrinolytic Agents/therapeutic use , Intracranial Embolism and Thrombosis/etiology , Thrombolytic Therapy , Tissue Plasminogen Activator/therapeutic use , Animals , Brain/metabolism , Brain Ischemia/metabolism , E-Selectin/immunology , Intercellular Adhesion Molecule-1/immunology , Intracranial Embolism and Thrombosis/metabolism , Male , P-Selectin/immunology , Rats , Rats, Wistar
9.
Brain Res ; 808(2): 190-6, 1998 Oct 19.
Article in English | MEDLINE | ID: mdl-9767164

ABSTRACT

The present study was undertaken to elucidate pathophysiological changes in noradrenaline (NA) transporter and Na+/K+-ATPase, key regulators of cation gradient across the plasma membrane, in nerve terminals of the cerebral cortex after microsphere-induced cerebral embolism in rats. The Vmax value of NA uptake, when analyzed by the Eadie-Hofstee plot, tended to decrease on the 1st day and decreased on the 3rd and 7th days after the embolism without any change in the Km value. The NA content in cerebrocortical synaptosomes did not alter on the 1st day, but decreased on the 3rd and 7th days after the embolism. Ouabain (1 mM) inhibited NA uptake on the 1st day, but did not alter the uptake on the 3rd and 7th days after the embolism. The activity of Na+/K+-ATPase of cerebrocortical synaptosomes increased on the 1st day and gradually decreased up to the 7th day after the embolim. These results suggest that NA uptake in nerve terminals of the cerebral cortex decreased after microsphere embolism, which may be due to a reduction in function of NA transporters. The changes in Na+/K+-ATPase following microsphere embolism may represent a compensatory action to maintain ion homeostasis in nerve terminals at an early stage of ischemic injury.


Subject(s)
Cerebral Cortex/blood supply , Cerebral Cortex/enzymology , Intracranial Embolism and Thrombosis/etiology , Intracranial Embolism and Thrombosis/metabolism , Norepinephrine/metabolism , Animals , Foreign Bodies , Immunoblotting , Male , Microspheres , Rats , Rats, Wistar , Sodium-Potassium-Exchanging ATPase/analysis , Sodium-Potassium-Exchanging ATPase/metabolism , Synaptosomes/enzymology
10.
J Thorac Cardiovasc Surg ; 115(5): 1142-59, 1998 May.
Article in English | MEDLINE | ID: mdl-9605085

ABSTRACT

OBJECTIVE: We assessed the impact on histologic and behavioral outcome of an interval of retrograde cerebral perfusion after arterial embolization, comparing retrograde cerebral perfusion with and without inferior vena caval occlusion with continued antegrade perfusion. METHODS: Sixty Yorkshire pigs (27 to 30 kg) were randomly assigned to the following groups: antegrade cerebral perfusion control; antegrade cerebral perfusion after embolization; retrograde cerebral perfusion control; retrograde cerebral perfusion after embolization; retrograde cerebral perfusion with inferior vena cava occlusion, retrograde cerebral perfusion with inferior vena cava occlusion control, and retrograde cerebral perfusion with inferior vena cava occlusion after embolization. After cooling to 20 degrees C, a bolus of 200 mg of polystyrene microspheres 250 to 750 (microm diameter (or saline solution) was injected into the isolated aortic arch. After 5 minutes of antegrade cerebral perfusion, 25 minutes of antegrade cerebral perfusion, retrograde cerebral perfusion, or retrograde cerebral perfusion with inferior vena cava occlusion was instituted. After the operation, all animals underwent daily assessment of neurologic status until the time of death on day 7. RESULTS: Aortic arch return, cerebral vascular resistance, and oxygen extraction data during retrograde cerebral perfusion showed differences, suggesting that more effective flow occurs during retrograde cerebral perfusion with inferior vena cava occlusion, which also resulted in more pronounced fluid sequestration. Microsphere recovery from the brain revealed significantly fewer emboli after retrograde cerebral perfusion with inferior vena cava occlusion. Behavioral scores showed full recovery in all but one control animal (after retrograde cerebral perfusion with inferior vena cava occlusion) by day 7 but were considerably lower after embolization, with no significant differences between groups. The extent of histopathologic injury was not significantly different among embolized groups. Although no histopathologic lesions were present in either the antegrade cerebral perfusion control group or the retrograde cerebral perfusion control group, mild significant ischemic damage occurred after retrograde cerebral perfusion with inferior vena cava occlusion even in control animals. CONCLUSIONS: Although effective washout of particulate emboli from the brain can be achieved with retrograde cerebral perfusion with inferior vena cava occlusion, no advantage of retrograde cerebral perfusion with inferior vena cava occlusion after embolization is seen from behavioral scores, electroencephalographic recovery, or histopathologic examination; retrograde cerebral perfusion with inferior vena cava occlusion results in greater fluid sequestration and mild histopathologic injury even in control animals. Retrograde cerebral perfusion with inferior vena cava occlusion shows clear promise in the management of embolization, but further refinements must be sought to address its still worrisome potential for harm.


Subject(s)
Brain/blood supply , Cerebrovascular Circulation/physiology , Intracranial Embolism and Thrombosis/therapy , Perfusion , Animals , Blood Gas Analysis , Brain/pathology , Cardiopulmonary Bypass , Electroencephalography , Evoked Potentials , Follow-Up Studies , Intracranial Embolism and Thrombosis/metabolism , Intracranial Embolism and Thrombosis/physiopathology , Lactic Acid/metabolism , Microspheres , Oxygen Consumption , Perfusion/methods , Random Allocation , Regional Blood Flow , Swine , Treatment Outcome , Vascular Resistance
11.
Undersea Hyperb Med ; 25(1): 43-50, 1998.
Article in English | MEDLINE | ID: mdl-9566086

ABSTRACT

Microscopic cerebral arterial air emboli (MCAAE) cause neurologic injury during cardiac surgery. We used a mathematical model of gas absorption to gain a preliminary assessment of what physical or physiologic parameters affect MCAAE absorption in the setting of cardiac surgery with its unique set of normal values. Simulated MCAAE of radii 50 and 200 microns have absorption times of 2 and 32 min, respectively. Predicted absorption times depend dramatically on PaN2. MCAAE are predicted to be absorbed twice as quickly at a PaN2 of 0 vs. 380 mmHg (FiO2 approximately equal to 0.50). Moderate hypothermia (27 degrees C) is predicted to cause only small decreases in absorption time. Changes in cerebral blood flow (for example, as affected by hemoglobin concentration, PaCO2, PaO2, collateral circulation, anesthetics, or cerebral metabolism) probably have only small effects on absorption time. Intravascular perfluorocarbons are predicted to cause small-to-moderate decreases in absorption time. In conclusion, there is probably only one important determinant of MCAAE absorption time during normothermic or moderately hypothermic CPB: arterial nitrogen partial pressure.


Subject(s)
Computer Simulation , Embolism, Air/metabolism , Intracranial Embolism and Thrombosis/metabolism , Models, Biological , Absorption , Cardiac Surgical Procedures , Cerebrovascular Circulation , Embolism, Air/physiopathology , Intracranial Embolism and Thrombosis/physiopathology , Models, Theoretical , Nitrogen/blood
12.
Brain Res ; 784(1-2): 210-7, 1998 Feb 16.
Article in English | MEDLINE | ID: mdl-9518616

ABSTRACT

Rapid and marked increased levels of expression of interleukin 1beta (IL-1beta) mRNA have been detected in animal models of cerebral ischemia. However, the protein production of IL-1beta and the cellular sources of IL-1beta are largely undefined after cerebral ischemia. In the present study, we have measured the cellular localization of IL-1beta protein in brain tissue from non-ischemic and ischemic mice using immunohistochemistry. Male C57B/6J (n=45) mice were subjected to middle cerebral artery (MCA) occlusion by a clot or a suture. The mice were sacrificed at time points spanning the period from 15 min to 24 h after onset of the MCA occlusion. Non-operated and sham-operated mice were used as control groups. A monoclonal anti-IL-1beta antibody was used to detect IL-1beta. In the non-operated and sham-operated mice, a few IL-1beta immunoreactive cells were detected scattered throughout both hemispheres. IL-1beta immunoreactive cells increased in the ischemic lesion as early as 15 min and peaked at 1 h to 2 h after MCA occlusion. IL-1beta immunoreactivity was detected in the cortex of the contralateral hemisphere 1 h after ischemia. By 24 h after onset of ischemia, IL-1beta immunoreactivity was mainly present adjacent to the ischemic lesion and in the non-ischemic cortex. IL-1beta immunoreactivity was found on endothelial cells and microglia. This study demonstrates an early bilateral expression of IL-1beta on endothelium after MCA occlusion in mice.


Subject(s)
Cerebral Arteries/metabolism , Interleukin-1/biosynthesis , Ischemic Attack, Transient/metabolism , Animals , Antibodies, Monoclonal , Endothelium, Vascular/metabolism , Immunohistochemistry , Intracranial Embolism and Thrombosis/metabolism , Male , Mice , Mice, Inbred C57BL , Sutures
13.
J Neurol Sci ; 156(2): 138-43, 1998 Apr 01.
Article in English | MEDLINE | ID: mdl-9588848

ABSTRACT

This study was designed to determine the distribution of fat which reaches the brain by the internal carotid artery, and the consequent alterations in the blood brain barrier, in a rat model of cerebral arterial fat embolism. The distribution of the blood flow in this model was determined by the injection of radiolabelled microspheres. Over 44% were trapped in the brain, 43% in the extracerebral tissues of the head and neck, and 7% in the lungs. Over 30% of radiolabelled triolein was present within the brain 30 min after injection, and 4% still remained after 17 days. Approximately 25% of the triolein which went to the brain moved through the cerebral vessels and left within the first 15 min. The majority of the triolein distributed to the ipsilateral cerebral hemisphere, with significantly less to the contralateral cerebral hemisphere, brain stem and cerebellum. The blood brain barrier opened, as measured by uptake of 99mTc, within the first 15 min and remained open for at least 3 days. A significant percentage of fat reaching the brain persists for days, and causes rapid and long-lasting damage to the blood brain barrier.


Subject(s)
Blood-Brain Barrier , Embolism, Fat/metabolism , Embolism, Fat/physiopathology , Fats/pharmacokinetics , Intracranial Embolism and Thrombosis/metabolism , Intracranial Embolism and Thrombosis/physiopathology , Animals , Blood-Brain Barrier/drug effects , Carotid Artery, Internal/drug effects , Disease Models, Animal , Fats/pharmacology , Injections, Intra-Arterial , Microspheres , Rats , Rats, Wistar , Tissue Distribution , Triolein/pharmacokinetics
14.
J Cereb Blood Flow Metab ; 18(4): 407-18, 1998 Apr.
Article in English | MEDLINE | ID: mdl-9538906

ABSTRACT

The effect of thrombolytic therapy was studied in rats submitted to thromboembolic stroke by intracarotid injection of autologous blood clots. Thrombolysis was initiated after 15 minutes with an intracarotid infusion of recombinant tissue-type activator (10 mg/kg body weight). Reperfusion was monitored for 3 hours using serial perfusion- and diffusion magnetic resonance imaging, and the outcome of treatment was quantified by pictorial measurements of ATP, tissue pH, and blood flow. In untreated animals, clot embolism resulted in an immediate decrease in blood flow and a sharp decrease in the apparent diffusion coefficient (ADC) that persisted throughout the observation period. Thrombolysis successfully recanalized the embolized middle cerebral artery origin and led to gradual improvement of blood flow and a slowly progressing reversal of ADC changes in the periphery of the ischemic territory, but only to transient and partial improvement in the center. Three hours after initiation of thrombolysis, the tissue volume with ADC values less than 80% of control was 39 +/- 22% as compared to 61 +/- 20% of ipsilateral hemisphere in untreated animals (means +/- SD, P = .03) and the volume of ATP-depleted brain tissue was 25 +/- 31% as compared to 46 +/- 29% in untreated animals. Recovery of ischemic brain injury after thromboembolism is incomplete even when therapy is started as early as 15 minutes after clot embolism. Possible explanations for our findings include downstream displacement of clot material, microembolism of the vascular periphery, and events associated with reperfusion injury.


Subject(s)
Brain Damage, Chronic/etiology , Cerebrovascular Circulation/drug effects , Fibrinolytic Agents/therapeutic use , Intracranial Embolism and Thrombosis/drug therapy , Magnetic Resonance Imaging , Thrombolytic Therapy , Tissue Plasminogen Activator/therapeutic use , Adenosine Triphosphate/analysis , Animals , Brain Chemistry , Brain Damage, Chronic/metabolism , Brain Damage, Chronic/pathology , Brain Ischemia/etiology , Diffusion , Energy Metabolism , Fibrinolytic Agents/pharmacology , Glucose/analysis , Hemodynamics , Image Processing, Computer-Assisted , Intracranial Embolism and Thrombosis/complications , Intracranial Embolism and Thrombosis/metabolism , Intracranial Embolism and Thrombosis/pathology , Male , Rats , Rats, Wistar , Recombinant Proteins/pharmacology , Recombinant Proteins/therapeutic use , Reperfusion , Reperfusion Injury/etiology , Reperfusion Injury/metabolism , Reperfusion Injury/pathology , Tissue Plasminogen Activator/pharmacology
15.
Neurosurgery ; 42(1): 109-15; discussion 115-6, 1998 Jan.
Article in English | MEDLINE | ID: mdl-9442511

ABSTRACT

OBJECTIVE: A drug delivery system using copoly(lactic/glycolic acid) was developed for the intracranial administration of papaverine. A rod-shaped implant prepared by a heat compression method was tested to determine its efficacy in preventing cerebral vasospasm in dogs. METHODS: Sixteen dogs were randomly assigned to one of two groups, i.e., placebo or papaverine. Control angiography was performed, followed by right craniectomy and the induction of subarachnoid hemorrhage by the placement of a clot in the Sylvian fissure. Two pellets, containing either 25 mg of papaverine or no papaverine, were placed in the cistern. In in vitro studies, 56% of the actual papaverine loading was released in the first 4 days and 78% within 8 days. On Day 7, angiography was repeated and the animals were killed. A similar experiment using low-dose pellets containing 5 mg of papaverine, half of which was released within 7 days, was performed with 16 mongrel dogs. RESULTS: There were significant differences between the papaverine- and placebo-treated groups in the reductions of vessel diameters of the internal carotid, middle cerebral, and anterior cerebral arteries on the clot side. The mean concentration of papaverine in the clot was 4.5 x 10(-4) mol/L. The low-dose pellet failed to prevent cerebral vasospasm, although the mean concentration of papaverine in the clot was 2.3 x 10(-5) mol/L. CONCLUSION: A prolonged-release preparation of papaverine that could be implanted intracranially at the time of surgery prevented vasospasm significantly while maintaining an appropriate concentration of papaverine in the cistern.


Subject(s)
Ischemic Attack, Transient/prevention & control , Papaverine/administration & dosage , Animals , Blood/metabolism , Cerebrospinal Fluid/metabolism , Delayed-Action Preparations , Dogs , Dose-Response Relationship, Drug , Female , Intracranial Embolism and Thrombosis/metabolism , Male , Papaverine/pharmacokinetics , Papaverine/therapeutic use , Preventive Medicine/methods
16.
Arterioscler Thromb Vasc Biol ; 17(11): 3139-46, 1997 Nov.
Article in English | MEDLINE | ID: mdl-9409303

ABSTRACT

Thrombomodulin (TM), a key cofactor of the TM-protein C pathway, is of major biologic significance for the antithrombotic properties of endothelial cells. Yet, there is uncertainty whether TM is expressed in brain and what mechanisms govern brain endothelial anticoagulant activity. In this study, bovine brain capillaries were used as an in vitro model of the blood-brain barrier to determine factors involved in the regulation of TM expression in cerebral vasculature. Quantitative competitive-polymerase chain reaction assay revealed significant regional differences in the amount of brain capillary TM mRNA, i.e., cortical > cerebellar > pontine, consistent with the reverse transcription-polymerase chain reaction findings in which the abundance of TM mRNA was analyzed relative to beta-actin mRNA. Regional differences in TM mRNA brain capillary level correlated well with differences in protein C activation. The TM mRNA and activity were not detectable in brain parenchyma. Pathogenic mediators of ischemic stroke, interleukin 1 beta (10 U/mL), and tumor necrosis factor alpha (10 U/mL), produced a time-dependent decrease in brain capillary TM mRNA (t1/2 of 2.1 and 3.9 hours, respectively) and reduced endothelial TM activity. Incubation of brain capillaries with retinoic acid (10 mumol/L) and dibutyryl cAMP (3 mmol/L) resulted in a 4-fold increase in TM mRNA at 4 and 8 hours, respectively, followed by an increase in protein C activation. We conclude that TM at the blood-brain barrier is likely to be an important physiologic anticoagulant in brain microcirculation. Its downregulation by cytokines may contribute to ischemic brain damage and potentially could be counteracted by retinoic acid and cAMP.


Subject(s)
Blood-Brain Barrier/physiology , Brain/blood supply , Endothelium, Vascular/metabolism , Gene Expression Regulation , Intracranial Embolism and Thrombosis/metabolism , Thrombomodulin/biosynthesis , Animals , Astrocytes/metabolism , Brain/anatomy & histology , Bucladesine/pharmacology , Capillaries/drug effects , Capillaries/metabolism , Cattle , Endothelium, Vascular/drug effects , Enzyme Activation/drug effects , Gene Expression Regulation/drug effects , Interleukin-1/pharmacology , Intracranial Embolism and Thrombosis/prevention & control , Organ Culture Techniques , Organ Specificity , Polymerase Chain Reaction , Protein C/metabolism , RNA, Messenger/biosynthesis , Recombinant Proteins/pharmacology , Thrombomodulin/genetics , Tretinoin/pharmacology , Tumor Necrosis Factor-alpha/pharmacology
17.
Br J Pharmacol ; 121(3): 477-84, 1997 Jun.
Article in English | MEDLINE | ID: mdl-9179389

ABSTRACT

1. The effects of delayed treatment with nebracetam, a novel nootropic drug, on neurotransmitters of brain regions were examined in rats with microsphere embolism-induced cerebral ischaemia. 2. Cerebral ischaemia was induced by administration of 900 microspheres (48 microns) into the internal carotid artery. The rats with stroke-like symptoms were treated p.o. with 30 mg kg-1 nebracetam twice daily. The levels of acetylcholine, dopamine, noradrenaline, 5-hydroxytryptamine (5-HT) and their metabolites in the cerebral cortex, striatum and hippocampus of animals with microsphere embolism were determined by high performance liquid chromatography (h.p.l.c.) on the 3rd and 7th days after the operation. 3. Although the microsphere embolism induced significant changes in most of the neurotransmitters and some of their metabolites in the brain regions, the delayed treatment with nebracetam partially restored only the hippocampal 5-HT and the striatal dopamine metabolite contents on the 3rd day. 4. The hippocampal in vivo 5-HT synthesis, but not the striatal dopamine synthesis, was attenuated in rats with microsphere embolism on the 3rd day, but was restored by treatment with nebracetam. In vivo striatal dopamine turnover rate of the rats with microsphere embolism was inhibited on the 3rd day irrespective of treatment with nebracetam. 5. The present study provides evidence for a possible action of nebracetam on 5-HT metabolism in the ischaemic brain.


Subject(s)
Brain Ischemia/drug therapy , Brain/metabolism , Neurotransmitter Agents/metabolism , Pyrrolidinones/pharmacology , Acetylcholine/analysis , Animals , Brain Ischemia/metabolism , Choline/analysis , Dopamine/metabolism , Intracranial Embolism and Thrombosis/metabolism , Male , Rats , Rats, Wistar , Tryptophan/metabolism , Tyrosine/metabolism
18.
Brain Res Mol Brain Res ; 45(2): 239-46, 1997 May.
Article in English | MEDLINE | ID: mdl-9149098

ABSTRACT

In situ hybridization and immunohistochemistry were used to examine the expression of c-fos, Hsp70 and Hsp27 following photothrombotic injury in the right fronto-parietal cortex of the rat. C-fos mRNA and protein were detected in the entire cerebral cortex on the lesioned side. Hsp70 mRNA accumulation was observed only adjacent and peripheral to the site of the lesion. At 1 h after photothrombotic injury, Hsp70 expression delineates the area of necrosis at 24 h after photothrombotic injury. Hsp27 protein was observed in the ipsilateral cerebral cortex with the exception of the deep layers of the cingulate cortex. In addition, while c-Fos immunoreactivity was localized in cell nuclei, Hsp27 immunoreactivity was detected in the cytoplasm of astrocytes. These results demonstrate that unilateral cortical injury induces changes in gene expression that vary according to cell type and brain region.


Subject(s)
Cerebral Cortex/metabolism , Gene Expression , HSP70 Heat-Shock Proteins/biosynthesis , Heat-Shock Proteins/biosynthesis , Intracranial Embolism and Thrombosis/metabolism , Proto-Oncogene Proteins c-fos/biosynthesis , Animals , Brain Injuries/metabolism , Brain Injuries/pathology , Cerebral Cortex/pathology , Fiber Optic Technology , Frontal Lobe/injuries , Intracranial Embolism and Thrombosis/pathology , Male , Necrosis , Parietal Lobe/injuries , Protein Biosynthesis , RNA, Messenger/biosynthesis , Rats , Rats, Inbred Strains , Transcription, Genetic
19.
Int J Exp Pathol ; 77(5): 229-36, 1996 Oct.
Article in English | MEDLINE | ID: mdl-8977375

ABSTRACT

A new rat model for multifocal cerebral thrombosis has recently been reported (Tani et al., 1994; 1995). Ultrastructural changes in the cerebral neocortex in the acute phase were investigated in order to characterize the early pathological events in this model. A bolus injection of alkaline phenytoin solution (pH 10.8) into one internal carotid artery in the rat caused severe endothelial injury accompanied by thrombosis in the cerebral vasculature within 5 minutes, and severe oedema of the ipsilateral hemisphere within an hour. Cerebral water content was measured by the simple dry-wet method, and cerebral surface area and the surface area and volume of the ischaemic zone were measured using computer-aided image analysis. Good correlations were demonstrated between cerebral water content and cerebral surface area, and between the surface area and volume of the ischaemic zone. We report here that quantitative evaluation of acute cerebral damage induced by phenytoin solution is possible with high reliability using simple image analysis.


Subject(s)
Brain Edema/pathology , Brain Ischemia/pathology , Cerebral Cortex/ultrastructure , Intracranial Embolism and Thrombosis/pathology , Phenytoin/toxicity , Acute Disease , Animals , Arteries/ultrastructure , Brain Edema/chemically induced , Brain Ischemia/chemically induced , Cerebral Cortex/blood supply , Disease Models, Animal , Dose-Response Relationship, Drug , Image Processing, Computer-Assisted , Intracranial Embolism and Thrombosis/chemically induced , Intracranial Embolism and Thrombosis/metabolism , Male , Microscopy, Electron , Rats , Rats, Sprague-Dawley
20.
Thromb Haemost ; 76(1): 111-7, 1996 Jul.
Article in English | MEDLINE | ID: mdl-8819262

ABSTRACT

Sodium nitroprusside (SNP) and 3-morpholinosydnonimine (SIN-1), are known to liberate nitric oxide (NO). In this study the effects of SNP and SIN-1 on thrombus formation in rat cerebral arterioles and venules in vivo were assessed using a helium-neon (He-Ne) laser. SNP infused at doses from 10 micrograms/kg/h significantly inhibited thrombus formation in a dose dependent manner. This inhibition of thrombus formation was suppressed by methylene blue. SIN-1 at a dose of 100 micrograms/kg/h also demonstrated a significant antithrombotic effect. Moreover, treatment with SNP increased vessel diameter in a dose dependent manner and enhanced the mean red cell velocity measured with a fiber-optic laser-Doppler anemometer microscope (FLDAM). Blood flow, calculated from the mean red cell velocity and vessel diameters was increased significantly during infusion. In contrast, mean wall shear rates in the arterioles and venules were not changed by SNP infusion. The results indicated that SNP and SIN-1 possessed potent antithrombotic activities, whilst SNP increased cerebral blood flow without changing wall shear rate. The findings suggest that the NO released by SNP and SIN-1 may be beneficial for the treatment and protection of cerebral infarction.


Subject(s)
Intracranial Embolism and Thrombosis/physiopathology , Nitric Oxide/metabolism , Animals , Cerebrovascular Circulation/drug effects , Fibrinolytic Agents/pharmacology , Intracranial Embolism and Thrombosis/metabolism , Microcirculation/drug effects , Molsidomine/analogs & derivatives , Molsidomine/pharmacology , Nitroprusside/pharmacology , Rats , Rats, Wistar
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