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1.
J Vet Cardiol ; 34: 80-92, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33626419

RESUMO

INTRODUCTION/OBJECTIVES: In humans with impaired right-sided cardiac function, the caudal vena cava (CVC) diameter serves as a marker of venous congestion. This study aimed to investigate whether ultrasonographic CVC variables could identify the presence of right-sided congestive heart failure (R-CHF) in dogs with right-sided heart disease (RHD). ANIMALS: Fifty client-owned control dogs and 67 dogs with RHD were enrolled. The dogs with RHD were subdivided into the non-R-CHF (n = 43) and R-CHF (n = 24) groups. MATERIALS AND METHODS: We measured and compared the ultrasonographic CVC variables and echocardiographic variables among the groups. Receiver operating characteristic (ROC) curve analysis was performed to calculate the sensitivity and specificity of the variables at optimal cutoff values. RESULTS: We obtained the highest accuracies of the ratio of the shortest diameter (SD) of the minimal CVC area to the aorta diameter (Ao) during inspiration [SD(min)/Ao] and of the ratio of SD(min) to the longest diameter of the minimal CVC area during inspiration [LD(min),SD/LD(min)], with high sensitivities, specificities, and an area under the ROC curve greater than 0.925. CONCLUSIONS: In addition to the echocardiographic assessment of right-sided cardiac function, the CVC variables in this study, especially SD(min)/Ao and SD/LD(min), would be useful diagnostic indices for identifying R-CHF in dogs with RHD.


Assuntos
Doenças do Cão , Insuficiência Cardíaca , Animais , Doenças do Cão/diagnóstico por imagem , Cães , Ecocardiografia/veterinária , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/veterinária , Curva ROC , Veia Cava Inferior/diagnóstico por imagem
2.
Aust Vet J ; 91(10): 411-415, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30049052

RESUMO

CASE REPORT: A 13-month-old Thoroughbred filly was diagnosed with osteochondritis dissecans (OCD) of the medial tibial malleolus. A sponge impregnated with platelet-rich plasma, bone morphogenetic protein-2, mesenchymal stem cells and gelatin ß-tricalcium phosphate was applied to the OCD site following arthroscopy and debridement. Postoperative radiography (every week for 16 weeks), computed tomography (CT) (16 weeks postoperatively), arthroscopy (16 weeks postoperatively) and biopsy of the regenerated tissue (16 weeks postoperatively) were performed to evaluate the outcome. Radiographically, the defect began to diminish 3 weeks postoperatively and had disappeared by 12 weeks. CT images showed that the debrided site was filled with ossified tissue and arthroscopy showed that the regenerated tissue was covered with smooth tissue, which a biopsy showed was fibrocartilage. CONCLUSIONS: Placing the impregnated sponge in the OCD lesion facilitated satisfactory regeneration of tissue in the debrided area, but the regenerated cartilage was fibrocartilage. This method may be a viable option for the treatment of cases of equine OCD, but further work to determine how to induce hyaline cartilage regeneration is required.

3.
Res Vet Sci ; 93(2): 1021-5, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22280550

RESUMO

This study evaluated the therapeutic effects of a gelatin-ß-TCP sponge (sponge) incorporating BMP-2 (BMP-2/sponge) on bone regeneration in equines. Six bone defects were created in third metacarpals of five thoroughbred horses, and a total of six treatments were applied in a randomized manner. The treatments were BMP-2/sponge, BMP-2/gelatin hydrogel sheet (sheet), free BMP-2, bFGF/sheet, plain sponge, and plain sheet. The defects were monitored for 16 weeks by radiography and then examined by histological analysis. Radiographic evaluation scores of bone regeneration revealed significantly greater bone regeneration of defects treated with BMP-2/sponge than defects treated with plain sponge or BMP-2 sheet (P<0.05). In histological analysis, compact bone was observed over a wide area in the BMP-2/sponge treatment. We concluded that the treatment with BMP-2/sponge accelerated bone regeneration in the equines of this study.


Assuntos
Proteína Morfogenética Óssea 2/farmacologia , Fosfatos de Cálcio/farmacologia , Membro Anterior/patologia , Gelatina/farmacologia , Cavalos , Animais , Materiais Biocompatíveis , Regeneração Óssea/efeitos dos fármacos , Fosfatos de Cálcio/química , Feminino , Gelatina/química , Osteogênese , Engenharia Tecidual/métodos , Alicerces Teciduais/química
5.
J Bone Joint Surg Br ; 93(1): 68-72, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21196546

RESUMO

We reviewed 75 patients (57 men and 18 women), who had undergone tension-band laminoplasty for cervical spondylotic myelopathy (42 patients) or compression myelopathy due to ossification of the posterior longitudinal ligament (33 patients) and had been followed for more than ten years. Clinical and functional results were estimated using the Japanese Orthopaedic Association score. The rate of recovery and the level of postoperative axial neck pain were also recorded. The pre- and post-operative alignment of the cervical spine (Ishihara curve index indicating lordosis of the cervical spine) and the range of movement (ROM) of the cervical spine were also measured. The mean rate of recovery of the Japanese Orthopaedic Association score at final follow-up was 52.1% (SD 24.6) and significant axial pain was reported by 19 patients (25.3%). Axial pain was reported more frequently in patients with ossification of the posterior longitudinal ligament than in those with cervical spondylotic myelopathy (p = 0.027). A kyphotic deformity was not seen post-operatively in any patient. The mean ROM decreased post-operatively from 32.8° (SD 12.3) to 16.2° (SD 12.3) (p < 0.001). The mean ROM ratio was 46.9% (SD 28.1) for all the patients. The mean ROM ratio was lower in patients with ossification of the posterior longitudinal ligament than in those with cervical spondylotic myelopathy (p < 0.001). Compared to those with cervical spondylotic myelopathy, patients with ossification of the posterior longitudinal ligament had less ROM and more post-operative axial neck pain.


Assuntos
Vértebras Cervicais/cirurgia , Laminectomia/métodos , Compressão da Medula Espinal/cirurgia , Estenose Espinal/cirurgia , Espondilose/cirurgia , Adulto , Idoso , Vértebras Cervicais/fisiopatologia , Feminino , Seguimentos , Humanos , Laminectomia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Ossificação do Ligamento Longitudinal Posterior/complicações , Amplitude de Movimento Articular , Compressão da Medula Espinal/etiologia , Estenose Espinal/complicações , Espondilose/complicações , Resultado do Tratamento
6.
Acta Neurochir Suppl ; 86: 267-9, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14753450

RESUMO

Astrocytes perform a variety of functions in the adult central nervous system (CNS). Recent evidence suggests the robust upregulation of glial fibrillary acidic protein (GFAP) after CNS insult. However, little is known about the role of GFAP in the hippocampal degeneration after brain injury. We herein compared the GFAP knockout (KO) and wild type (WT) mice on the histological and behavioral outcome in response to cerebral trauma or kainic acid (KA)-induced seizure. Although all KO mice showed hippocampal CA3 neuronal degeneration. WT mice did not show any neuronal degeneration in CA3 subfield at 72 hrs after trauma. Thereafter, KO mice showed a higher susceptibility to KA-induced seizures and an increased number of pyknotic CA3 neurons 72 hrs after KA administration. These results indicate that GFAP plays a crucial role in the hippocampal neurodegeneration after CNS insult.


Assuntos
Lesões Encefálicas/metabolismo , Lesões Encefálicas/patologia , Proteína Glial Fibrilar Ácida/metabolismo , Hipocampo/patologia , Degeneração Neural/patologia , Convulsões/metabolismo , Convulsões/patologia , Animais , Sobrevivência Celular , Hipocampo/metabolismo , Hipocampo/fisiopatologia , Ácido Caínico , Camundongos , Camundongos Knockout , Neurônios , Convulsões/induzido quimicamente , Ferimentos não Penetrantes/metabolismo , Ferimentos não Penetrantes/patologia
7.
Acta Neurochir Suppl ; 86: 287-9, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14753454

RESUMO

Mitogenic stimulation of the Mitogen-activated protein kinase (MAPK) pathway modulates the activity of many transcriptional factors leading to biological responses. Of these, three MAPK cascades are well characterized as extracellular signal-regulated protein kinase (ERK), c-Jun NH(2)-terminal kinase (JNK), and p38 pathways. The aim of this study was to investigate the topographic distribution and the role of activated MAPK pathways after fluid percussion injury (FPI) in rats. In the present results, FPI significantly induced ERK- and JNK-phosphorylation, but not p38-phosphorylation in the cortex and hippocampus at the injury site. The immunoreactivity for phospho-ERK was localized in the superficial neuronal layers, dentate hilar neurons, and the damaged CA3 neurons after 30 mins of FPI. Double immunostaining showed that phospho-ERK was prominent in astrocytes 6 hrs after TBI. The current results suggest that MAPK pathways are involved in signal transduction after FPI.


Assuntos
Lesões Encefálicas/enzimologia , Encéfalo/enzimologia , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Animais , Córtex Cerebral/enzimologia , Hipocampo/enzimologia , Imuno-Histoquímica , Proteínas Quinases JNK Ativadas por Mitógeno , Masculino , Fosforilação , Ratos , Ratos Sprague-Dawley , Distribuição Tecidual , Ferimentos não Penetrantes/enzimologia , Proteínas Quinases p38 Ativadas por Mitógeno
8.
Acta Neurochir Suppl ; 86: 489-91, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14753492

RESUMO

Central salt wasting syndrome may be caused by pathological increases in serum natriuretic peptides after subarachnoid hemorrhage (SAH). However, it is unclear as to why the serum concentration of atrial natriuretic peptide (ANP) or brain natriuretic peptide (BNP) increases in the subacute phase of SAH. The present study was designed to assess the correlation between focal brain edema and serum concentration of ANP or BNP in patients with SAH. Focal brain edema was found in 8 SAH-patients and peaked between days 4 and 7 of SAH. The mean serum ANP and BNP levels in patients with focal brain edema were significantly higher than those in patients without focal brain edema between days 4 and 14 of SAH. These results suggest that focal brain edema might correlate with increased levels of ANP and BNP in the subacute phase of SAH.


Assuntos
Fator Natriurético Atrial/sangue , Edema Encefálico/sangue , Edema Encefálico/etiologia , Peptídeo Natriurético Encefálico/sangue , Hemorragia Subaracnóidea/sangue , Hemorragia Subaracnóidea/complicações , Edema Encefálico/diagnóstico por imagem , Humanos , Estudos Retrospectivos , Hemorragia Subaracnóidea/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Vasopressinas/sangue
9.
Acta Neurochir Suppl ; 86: 519-21, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14753498

RESUMO

Vascular endothelial growth factor (VEGF) is known to be a mediator of angiogenesis and vascular permeability. A cystic component and hemorrhage are often found in pituitary adenomas. In the present study we assess the VEGF expression based on immunohistochemical examinations in 48 pituitary adenomas. All the adenomas showed some VEGF immunoreactivity mainly in the cytoplasm of tumor cells. Of the 48 adenoma-cases, 16 cases had a strong VEGF immunoreactivity, 26 cases had a moderate one, and 6 cases had a weak one. On the MR images, a cystic component was found in 16 cases (33.3%), and a hemorrhage was found in 18 cases (37.5%). The VEGF immunoreactivity had a significant relationship with the cystic component but neither the hemorrhage, size, recurrence, or HE classification. These findings suggest that VEGF might play a potential role in the pathogenesis of cystic formation in pituitary adenomas.


Assuntos
Adenoma/metabolismo , Neoplasias Hipofisárias/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adenoma/diagnóstico , Adenoma/patologia , Adolescente , Adulto , Idoso , Cistos/metabolismo , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/patologia , Estudos Retrospectivos
10.
Neurology ; 59(1): 134-6, 2002 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-12105324

RESUMO

Subarachnoid hemorrhage (SAH) often causes hypokalemia and QT prolongation. The sex disparities among 73 patients with SAH and 96 control subjects were examined. On the first day of SAH, the mean serum potassium level was significantly lower and the mean corrected QT interval was significantly longer in the female SAH group compared with either the female control or male SAH group. These findings suggest female susceptibility to hypokalemia and QT prolongation after SAH.


Assuntos
Hipopotassemia/epidemiologia , Síndrome do QT Longo/epidemiologia , Hemorragia Subaracnóidea/epidemiologia , Doença Aguda , Adulto , Idoso , Eletrocardiografia , Feminino , Humanos , Hipopotassemia/etiologia , Síndrome do QT Longo/diagnóstico , Síndrome do QT Longo/etiologia , Masculino , Pessoa de Meia-Idade , Potássio/sangue , Fatores de Risco , Distribuição por Sexo , Hemorragia Subaracnóidea/complicações
12.
J Neurosurg ; 95(3): 500-2, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11565874

RESUMO

The authors report the case of a 53-year-old woman who experienced visual hallucinations diagnosed as peduncular hallucinosis (PH). The cause of the PH was compression of the quadrigeminal plate and/or the splenium due to a meningioma originating from the falcotentorial junction (pineal meningioma). The nature of the visual hallucinations was depicted in drawings created by the patient herself. This is the first report of PH caused by a tumor located in the pineal region.


Assuntos
Alucinações/fisiopatologia , Mesencéfalo/fisiopatologia , Pinealoma/fisiopatologia , Feminino , Alucinações/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Mesencéfalo/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/fisiopatologia , Recidiva Local de Neoplasia/cirurgia , Pinealoma/diagnóstico , Pinealoma/cirurgia , Reoperação , Tomografia Computadorizada por Raios X , Percepção Visual/fisiologia
13.
Pathol Res Pract ; 197(8): 577-82, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11518052

RESUMO

Lymphoepithelioma-like carcinoma (LEC) of the colon is very rare. Here we report a case of LEC originating in the rectum that was closely associated with Epstein-Barr virus (EBV) infection. The histologic and immunohistologic features, namely, poorly differentiated adenocarcinoma with lymphoid stroma, showed this tumor to be an LEC. The EBV genome was detected by PCR using DNA obtained from tumor tissue sections. Immunohistochemically, EBV-determined nuclear antigen 2 was detected in the tumor cells, and in situ hybridization using EBV-encoded small RNAs probe showed positive labeling in some tumor cells together with a few stromal lymphoid cells. There are some reports of LEC cases that originated in the colon; however, a relation with EBV was not demonstrated. We report here a case of LEC of the rectum demonstrating a possible relation with EBV.


Assuntos
Carcinoma de Células Escamosas/patologia , Infecções por Vírus Epstein-Barr/patologia , Neoplasias Retais/patologia , Idoso , Carcinoma de Células Escamosas/virologia , DNA de Neoplasias/análise , Infecções por Vírus Epstein-Barr/complicações , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/isolamento & purificação , Humanos , Técnicas Imunoenzimáticas , Hibridização In Situ , Masculino , RNA Viral/análise , Neoplasias Retais/virologia
14.
Br J Neurosurg ; 15(3): 239-41, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11478059

RESUMO

We describe two recent cases of spontaneous intracranial hypotension. A 38-year-old woman developed a severe postural headache. Magnetic resonance imaging (MRI) showed marked dural enhancement. Histopathological findings of dural biopsy showed numerous dilated vessels in the dura, rather than hypertrophic change. Lumber CSF pressure was 5 cmH2O and RI cisternography suggested CSF leakage. A 58-year-old woman with postural headache and vertigo had bilateral subdural haematoma associated with diffuse dural enhancement on MRI. Lumber CSF monitoring confirmed persistent low pressure ranging from 0-5 cm H2O. MRI myelography revealed multiple CSF pouches along the whole spinal axis. CSF leakage was demonstrated on Radioisotope (RI) cisternography. Both cases described in this report were diagnosed as spontaneous intracranial hypotension caused by CSF leakage from spinal meningeal diverticula and were successfully treated by intravenous Factor XIII administration.


Assuntos
Pressão do Líquido Cefalorraquidiano , Divertículo/fisiopatologia , Cefaleia/etiologia , Hipotensão Intracraniana/diagnóstico , Doenças da Medula Espinal/fisiopatologia , Adulto , Pressão do Líquido Cefalorraquidiano/fisiologia , Fator XIII/uso terapêutico , Feminino , Cefaleia/diagnóstico , Cefaleia/tratamento farmacológico , Humanos , Hipotensão Intracraniana/tratamento farmacológico , Hipotensão Intracraniana/etiologia , Imageamento por Ressonância Magnética/métodos , Meninges , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos
15.
Neurosurgery ; 49(1): 160-6; discussion 166-7, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11440438

RESUMO

OBJECTIVE: We reported previously that repeated hyperbaric oxygenation (HBO) as pretreatment induced ischemic tolerance in the gerbil hippocampus. This study was conducted to determine the preferential conditions for induction of ischemic tolerance by HBO and the mechanism of this induction through immunohistochemical analysis of Bcl-2, Bax, and manganese superoxide dismutase expression. METHODS: Five-minute forebrain ischemia was produced in gerbils after pretreatment with 2 atmospheres absolute (ATA) HBO once every other day for one, three, or five sessions, 2 ATA hyperbaric air once every other day for five sessions, or 3 ATA HBO once daily for 10 sessions. Histological examinations were then performed. Two days after pretreatment with 2 ATA HBO once every other day for five sessions or with 3 ATA HBO once daily for 10 sessions, sections were analyzed immunohistochemically. RESULTS: Pretreatment with 2 ATA HBO once every other day for three or five sessions induced ischemic tolerance; however, pretreatment with 2 ATA HBO for one session, 2 ATA hyperbaric air once every other day for five sessions, or 3 ATA HBO once daily for 10 sessions did not. Pretreatment with 2 ATA HBO once every other day for five sessions, but not with 3 ATA HBO once daily for 10 sessions, significantly increased Bcl-2 and manganese superoxide dismutase immunoreactivity in the CA1 sector. CONCLUSION: These results suggest that protection against mitochondrial alterations after ischemia through manganese superoxide dismutase and/or Bcl-2 expression may be related to induction of ischemic tolerance by repeated HBO pretreatment.


Assuntos
Isquemia Encefálica/fisiopatologia , Hipocampo/irrigação sanguínea , Oxigenoterapia Hiperbárica , Precondicionamento Isquêmico/métodos , Animais , Isquemia Encefálica/patologia , Gerbillinae , Hipocampo/patologia , Imuno-Histoquímica , Masculino , Proteínas Proto-Oncogênicas/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Superóxido Dismutase/metabolismo , Proteína X Associada a bcl-2
16.
Spine (Phila Pa 1976) ; 26(14): 1623-30, 2001 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-11464158

RESUMO

STUDY DESIGN: Prospective clinical study of the effect of staged elimination of anatomic factors inhibiting posterior shift of the thoracic spinal cord on the degree of posterior shift of the thoracic spinal cord and its significance in augmenting the safety of ossification of posterior longitudinal ligament (OPLL) manipulation in thoracic OPLL myelopathy. OBJECTIVES: To develop a comprehensive method that enables safe and sufficient decompression of the spinal cord for thoracic OPLL myelopathy. SUMMARY OF BACKGROUND DATA: Decompression of the spinal cord by direct manipulations of thoracic OPLLs, via either anterior or posterior approach, caused some iatrogenic catastrophic spinal cord injuries, and methods to prevent such injuries during surgery have not yet been developed. METHODS: Procedures of elimination of anatomic factors inhibiting posterior shift of the thoracic spinal cord were performed in stages at intervals of between 1 month and 11 years depending on patients' neurologic status. The first stage operation consisted of extensive cervicothoracic laminoplastic decompression with or without posterior longitudinal durotomy, and if the decompression were insufficient, measures for OPLL-spinal cord separation with or without OPLL manipulation were added. RESULTS: All 17 patients with thoracic OPLL myelopathy showed improvements of neurology comparable with those with successful anterior approaches after decompression. The mean follow-up period was 42 months (range 6-101 months). Neurologic improvements persisted for the entire follow-up period in all patients except one patient who developed arachnoid cyst compressing the dorsum of the once-decompressed spinal cord 30 months after surgery. CONCLUSIONS: Staged posterior decompression to eliminate anatomic factors inhibiting posterior shift of the thoracic spinal cord is the safest and the most reliable method of spinal cord decompression to treat thoracic OPLL myelopathy, so far. However, long-term results are required before the methods can be established.


Assuntos
Descompressão Cirúrgica/métodos , Ossificação do Ligamento Longitudinal Posterior/cirurgia , Compressão da Medula Espinal/cirurgia , Vértebras Torácicas/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação do Ligamento Longitudinal Posterior/complicações , Ossificação do Ligamento Longitudinal Posterior/fisiopatologia , Estudos Prospectivos , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/fisiopatologia , Resultado do Tratamento
17.
Neurol Res ; 23(4): 417-24, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11428524

RESUMO

Hepatocyte growth factor (HGF) was originally discovered as a powerful mitogen for hepatocytes. HGF also has been reported to function as a neurotrophic factor as well as an angiogenetic factor. The present study examined the neuroprotective effect of HGF against transient focal cerebral ischemia in rats, in which an anti-apoptotic and an angiogenetic effect of HGF was assumed to contribute to the reduction of the infarct volume. The intraventricular administration of human recombinant HGF prevented neuronal death after 120 min of occlusion in the right middle cerebral artery and the bilateral common carotid arteries. HGF significantly reduced the infarct volume in a dose-dependent manner. In a separate series of experiments, we next histopathologically investigated both the anti-apoptotic effect on neurons and the angiogenetic effect of HGF. A large number of TUNEL positive neurons were observed in the inner boundary of the infarct area in both the control and the vehicle group whereas only a few TUNEL positive neurons were observed in the corresponding area in the HGF group. In the HGF group, Bcl-2 protein was obviously represented in surviving neurons subjected to ischemia. The number of the vascular lamina in HGF group were significantly higher than those in the vehicle group. These data suggest that HGF appears to have an ability to prevent apoptotic neuronal cell death while also possessing an angiogenetic effect in the central nervous system which was affected with transient focal cerebral ischemia.


Assuntos
Infarto Cerebral/etiologia , Infarto Cerebral/patologia , Fator de Crescimento de Hepatócito/farmacologia , Ataque Isquêmico Transitório/complicações , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Células CHO , Circulação Cerebrovascular/efeitos dos fármacos , Cricetinae , Humanos , Masculino , Ratos , Ratos Sprague-Dawley , Proteínas Recombinantes/farmacologia
18.
No To Shinkei ; 53(3): 247-51, 2001 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-11296398

RESUMO

PURPOSE: To clarify the influence of intubation maneuver with or without premedication for intracranial hemorrhage with unconsciousness. METHODS: Between May 1995 and May 2000, we analyzed retrospectively 46 patients who had received intubation for unconsciousness and were found non-traumatic intracranial hemorrhage by head computer tomography at the Trauma and Critical Care Center, National Defense Medical College. They were divided into two groups, Drug group in which drugs were used before intubation and Control group which were intubated without drugs. Physical findings on admission, head CT findings, Glasgow Outcome Score(GOS) at discharge were analyzed between the groups. RESULTS: There were no significant differences for background of subjects between the groups. In the Drug group, diazepam, pentazocine, lidocaine, nifedipine and nicardipine were used before intubation. GOS in the Control group was significantly greater than in the Drug group(p < 0.01). CONCLUSION: In case of intubation for unconscious patients who may suffer intracranial hemorrhage, using premedication leads to favorable outcome.


Assuntos
Hemorragias Intracranianas/complicações , Intubação/métodos , Pré-Medicação , Inconsciência/etiologia , Adulto , Idoso , Analgésicos Opioides/administração & dosagem , Diazepam/administração & dosagem , Feminino , Escala de Resultado de Glasgow , Humanos , Hipnóticos e Sedativos/administração & dosagem , Masculino , Pessoa de Meia-Idade , Pentazocina/administração & dosagem , Estudos Retrospectivos
19.
No To Shinkei ; 53(1): 84-6, 2001 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-11211738

RESUMO

A case of an acute subdural hematoma due to the rupture of a tiny aneurysm of a cortical artery is described. A 68-year-old man lightly hit the right side of his head. About 1 hour later, he became drowsy and exhibited moderate hemiparesis on the left side on admission. Computed tomographic scanning demonstrated an acute subdural hematoma on the right temporoparietal region. In the past, he had undergone the clipping of a non-ruptured aneurysm and a subdural-peritoneal shunt operation on the same side in another hospital. On surgical evacuation of the subdural hematoma, a pulsating bleeding from a ruptured tiny aneurysm of a cortical artery was observed. There were also some similar tiny aneurysms on other cortical arteries. A photograph of such a tiny aneurysm was first taken and presented.


Assuntos
Córtex Cerebral/irrigação sanguínea , Hematoma Subdural Agudo/etiologia , Aneurisma Intracraniano/complicações , Idoso , Humanos , Masculino
20.
Mol Cell Neurosci ; 18(5): 443-57, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11922137

RESUMO

Because recent studies have indicated that tissue plasminogen activator (tPA) aggravates neurodegenerative processes in many neural pathologies, we studied whether the endogenous tPA antagonist neuroserpin has a neuroprotective effect in an animal model of focal ischemic stroke. After induction of a focal ischemic stroke in the mouse by occlusion of the middle cerebral artery, we found that microglial cells accumulated in the marginal zone of the infarct are the most important source for both plasminogen activators, tPA and uPA. To investigate the effect of neuroserpin on the size and the histology of the infarct we produced transgenic mice overexpressing neuroserpin approximately sixfold in the nervous system. In the brain of these mice the total tPA activity in the uninjured tissue was strongly reduced. After induction of a focal ischemic stroke in the transgenic mice by a permanent occlusion of the middle cerebral artery (MCA), the infarcts were 30% smaller than in the wild-type mice. Immunohistochemical analyses and in situ hybridization revealed an attenuation of the microglial activation in the reactive zone. Concomitantly, the microglial production of tPA and uPA, as well as the PA-activity in the infarct region was markedly reduced. Thus, our results indicate that neuroserpin reduces microglial activation and, therefore, the PA activity and has a neuroprotective role after focal ischemic stroke.


Assuntos
Isquemia Encefálica/metabolismo , Encéfalo/metabolismo , Infarto da Artéria Cerebral Média/metabolismo , Microglia/metabolismo , Degeneração Neural/metabolismo , Neuropeptídeos/metabolismo , Fármacos Neuroprotetores/metabolismo , Serpinas/metabolismo , Animais , Encéfalo/patologia , Encéfalo/fisiopatologia , Isquemia Encefálica/genética , Isquemia Encefálica/patologia , Infarto Cerebral/genética , Infarto Cerebral/metabolismo , Infarto Cerebral/patologia , Regulação para Baixo/fisiologia , Regulação da Expressão Gênica/fisiologia , Gliose/genética , Gliose/metabolismo , Gliose/patologia , Infarto da Artéria Cerebral Média/genética , Infarto da Artéria Cerebral Média/patologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Microglia/patologia , Modelos Neurológicos , Degeneração Neural/genética , Degeneração Neural/patologia , Neuropeptídeos/genética , Serpinas/genética , Ativador de Plasminogênio Tecidual/metabolismo , Ativador de Plasminogênio Tipo Uroquinase/metabolismo , Neuroserpina
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