Low degree of anesthesia increases the risk of neurogenic pulmonary edema development.

Neurogenic pulmonary edema is an acute life-threatening complication following central nervous system injury. The exact pathogenic mechanism leading to its development is still unclear. We introduce a new hypothesis that high levels of anesthesia might protect the organism against the development of neurogenic pulmonary edema due to a more pronounced inhibition of the hypothalamic, brainstem and spinal vasoactive sympathetic centers. On the basis of a more pronounced neuronal inhibition of the vasoactive centers, a severe sympathetic discharge does not occur and neurogenic pulmonary edema does not develop. In contrast, an insufficient anesthesia level is not able to inhibit the sympathetic nervous system during an injury of the central nervous system and thus neurogenic pulmonary edema develops. During experiments with central nervous system injury, low-anesthesia-induced neurogenic pulmonary edema might negatively influence the overall recovery of the animal. More importantly, during a neurosurgical intervention, insufficient anesthesia might similarly lead to neurogenic pulmonary edema development in operated patients. Our hypothesis indicates the necessity of precisely monitoring of the level anesthesia during experimental manipulations of the central nervous system in animals or neurosurgical interventions in humans.

In vitro study of astrocytic tumour metabolism by proton magnetic resonance spectroscopy.

In vivo magnetic resonance spectroscopy (MRS) studies of glial brain tumours reported that higher grade of astrocytoma is associated with increased level of choline-containing compounds (Cho) and decreased levels of N-acetylaspartate (NAA) and creatine and phosphocreatine (Cr). In this work, we studied the metabolism of glioma tumours by in vitro proton magnetic resonance spectroscopy (1H-MRS). 1H-MR spectra were recorded in vitro from perchloric acid extracts of astrocytoma (WHO II) and glioblastoma multiforme (WHO IV) samples. We observed differences between astrocytoma and glioblastoma multiforme in the levels of Cho, alanine, lactate, NAA, and glutamate/glutamine. In astrocytoma samples, we found higher MR signal of NAA and lower signal of Cho and alanine. MR spectra of glioblastoma samples reported significantly higher levels of lactate and glutamate/glutamine. In contrast, levels of Cr were the same in both tumour types. We also determined NAA/Cr and Cho/Cr ratios in the tumour samples. The NAA/Cr ratio was higher in astrocytomas than in glioblastomas multiforme. Conversely, the Cho/Cr ratio was higher in glioblastoma multiforme. The results indicate that MRS is a promising method for distinguishing pathologies in human brain and for pre-surgical grading of brain tumours.

Changes of phospholipid composition and superoxide dismutase activity during global brain ischemia and reperfusion in rats.

Alterations in phospholipid content and Cu/Zn superoxide dismutase (SOD) activity were examined in rat brain after 15 min of global ischemia (four-vessel occlusion) followed by 2-, 24- or 48-h reperfusion. Phosphatidylcholine (PC) and phosphatidylethanolamine (PE), the main brain phospholipids, were markedly decreased in ischemic rats and remained decreased during the whole reperfusion period. Concentrations of phosphatidylinositol (PI) and sphingomyelin (SM) were also significantly reduced during ischemia but recovered during reperfusion period. In contrast, phosphatidylserine (PS) and lysophospholipids (LysoPL) were unchanged during ischemia but were elevated after 24 h of reperfusion. Significant reductions in blood plasma phospholipids were also demonstrated. 24-48 h of reperfusion markedly decreased PE, PC and PS contents, while the concentrations were almost unchanged by ischemia alone. Brain SOD activity decreased significantly during ischemia and was recovered to control value already after 2 h of reperfusion. These results suggest that ischemia/reperfusion is accompanied by a significant and selective degradation of brain phospholipids that may be attributable to oxidative stress and activation of phospholipases.