Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 67
Filtrar
1.
Int J Mol Sci ; 22(3)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33513710

RESUMO

Stimulation of thermogenesis in brown adipose tissue (BAT) could have far-reaching health benefits in combatting obesity and obesity-related complications. Apolipoprotein A-IV (ApoA-IV), produced by the gut and the brain in the presence of dietary lipids, is a well-known short-term satiating protein. While our previous studies have demonstrated reduced diet-induced thermogenesis in ApoA-IV-deficient mice, it is unclear whether this reduction is due to a loss of peripheral or central effects of ApoA-IV. We hypothesized that central administration of ApoA-IV stimulates BAT thermogenesis and that sympathetic and sensory innervation is necessary for this action. To test this hypothesis, mice with unilateral denervation of interscapular BAT received central injections of recombinant ApoA-IV protein or artificial cerebrospinal fluid (CSF). The effects of central ApoA-IV on BAT temperature and thermogenesis in mice with unilateral denervation of the intrascapular BAT were monitored using transponder probe implantation, qPCR, and immunoblots. Relative to CSF, central administration of ApoA-IV significantly increased temperature and UCP expression in BAT. However, all of these effects were significantly attenuated or prevented in mice with unilateral denervation. Together, these results clearly demonstrate that ApoA-IV regulates BAT thermogenesis centrally, and this effect is mediated through sympathetic and sensory nerves.


Assuntos
Tecido Adiposo Marrom/fisiologia , Apolipoproteínas A/administração & dosagem , Regulação da Expressão Gênica/efeitos dos fármacos , Sistema Nervoso Simpático/fisiologia , Termogênese/efeitos dos fármacos , Proteínas Quinases Ativadas por AMP/genética , Proteínas Quinases Ativadas por AMP/metabolismo , Tecido Adiposo Marrom/enzimologia , Tecido Adiposo Marrom/metabolismo , Animais , Apolipoproteínas A/deficiência , Peptídeo Relacionado com Gene de Calcitonina/genética , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Regulação da Expressão Gênica/genética , Lipase/genética , Lipase/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Recombinantes , Terceiro Ventrículo/fisiologia , Tirosina 3-Mono-Oxigenase/metabolismo , Proteína Desacopladora 1/genética , Proteína Desacopladora 1/metabolismo
2.
Int J Mol Sci ; 21(18)2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899645

RESUMO

The volume, composition, and movement of the cerebrospinal fluid (CSF) are important for brain physiology, pathology, and diagnostics. Nevertheless, few studies have focused on the main structure that produces CSF, the choroid plexus (CP). Due to the presence of monocarboxylate transporters (MCTs) in the CP, changes in blood and brain lactate levels are reflected in the CSF. A lactate receptor, the hydroxycarboxylic acid receptor 1 (HCA1), is present in the brain, but whether it is located in the CP or in other periventricular structures has not been studied. Here, we investigated the distribution of HCA1 in the cerebral ventricular system using monomeric red fluorescent protein (mRFP)-HCA1 reporter mice. The reporter signal was only detected in the dorsal part of the third ventricle, where strong mRFP-HCA1 labeling was present in cells of the CP, the tela choroidea, and the neuroepithelial ventricular lining. Co-labeling experiments identified these cells as fibroblasts (in the CP, the tela choroidea, and the ventricle lining) and ependymal cells (in the tela choroidea and the ventricle lining). Our data suggest that the HCA1-containing fibroblasts and ependymal cells have the ability to respond to alterations in CSF lactate in body-brain signaling, but also as a sign of neuropathology (e.g., stroke and Alzheimer's disease biomarker).


Assuntos
Plexo Corióideo/metabolismo , Receptores Acoplados a Proteínas G/metabolismo , Terceiro Ventrículo/metabolismo , Animais , Encéfalo/metabolismo , Ventrículos Cerebrais/metabolismo , Ventrículos Cerebrais/fisiologia , Líquido Cefalorraquidiano/metabolismo , Plexo Corióideo/fisiologia , Fibroblastos/metabolismo , Humanos , Ácido Láctico/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Terceiro Ventrículo/fisiologia
3.
Philos Trans R Soc Lond B Biol Sci ; 375(1792): 20190154, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-31884922

RESUMO

The brain ventricles are interconnected, elaborate cavities that traverse the brain. They are filled with cerebrospinal fluid (CSF) that is, to a large part, produced by the choroid plexus, a secretory epithelium that reaches into the ventricles. CSF is rich in cytokines, growth factors and extracellular vesicles that glide along the walls of ventricles, powered by bundles of motile cilia that coat the ventricular wall. We review the cellular and biochemical properties of the ventral part of the third ventricle that is surrounded by the hypothalamus. In particular, we consider the recently discovered intricate network of cilia-driven flows that characterize this ventricle and discuss the potential physiological significance of this flow for the directional transport of CSF signals to cellular targets located either within the third ventricle or in the adjacent hypothalamic brain parenchyma. Cilia-driven streams of signalling molecules offer an exciting perspective on how fluid-borne signals are dynamically transmitted in the brain. This article is part of the Theo Murphy meeting issue 'Unity and diversity of cilia in locomotion and transport'.


Assuntos
Transporte Biológico , Cílios/fisiologia , Terceiro Ventrículo/fisiologia , Hipotálamo/fisiologia
4.
Ultrason Imaging ; 40(2): 127-138, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29207924

RESUMO

Cerebrospinal fluid (CSF) flow is sensitive to many cerebral disorders. We aimed to develop a noninvasive bedside method to detect physiological and pathological CSF phenomena by measuring pulsation patterns of the third ventricle. By transcranial B-mode ultrasound, electrocardiography (ECG)-gated video loops of the third ventricle were acquired. "Speckle tracking" software was used to quantify the relative change of its width. We conducted measurements of nine cardiac cycles in 11 healthy subjects in sitting and in supine position during Valsalva maneuver to investigate the influence of an increased intracranial pressure on the relative deformation of the third ventricle. In one patient with occlusive hydrocephalus, 19 cardiac cycles were measured in sitting position before and after removal of a tumorous obstruction of the aqueduct of Sylvius. Healthy subjects expressed a pulse-related increased width of the third ventricle ([Formula: see text]: +5.69, 95% confidence interval [CI] = [4.38, 7.00]). No significant difference was found between the sitting and the supine position in healthy adults. In the preoperative state of occlusive hydrocephalus, we found a negative, pulse-related deformation ([Formula: see text]: -1.86, 95% CI = [-2.15, -1.58]) with delayed onset. After surgery, the deformation pattern resembled that of our healthy controls. The difference between pre- and postoperative condition was significant (p < 0.001). Transcranial B-mode sonography can be used to record small movements of the sidewalls of the third ventricle. This noninvasive bedside method is suitable to assess CSF pulsatility within the third ventricle and might be able to distinguish between physiological and pathological flows.


Assuntos
Hidrocefalia/fisiopatologia , Processamento de Imagem Assistida por Computador/métodos , Terceiro Ventrículo/fisiopatologia , Ultrassonografia Doppler Transcraniana/métodos , Adulto , Velocidade do Fluxo Sanguíneo , Eletrocardiografia , Feminino , Humanos , Masculino , Terceiro Ventrículo/diagnóstico por imagem , Terceiro Ventrículo/fisiologia , Adulto Jovem
5.
PLoS One ; 11(10): e0164221, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27716782

RESUMO

BACKGROUND AND PURPOSE: Understanding the anatomy of the anterior septal vein (ASV) is critical for minimally invasive procedures to the third ventricle and for assessing lesion size and venous drainage in the anterior cranial fossa. Accordingly, this study evaluated topographic anatomy and anatomic variation of the ASV using susceptibility-weighted imaging (SWI). METHODS: Sixty volunteers were examined using a 3.0T MR system. The diameter of the ASV and distance between bilateral septal points were measured. ASVs were divided into types 1 (only drains frontal lobe) and 2 (drains both frontal lobe and head of the caudate nucleus). We evaluated the ASV-internal cerebral vein (ICV) junction based on its positional relationship with the appearance of a venous angle or a false venous angle and the foramen of Monro. Fused SW and T1-weighted images were used to observe positional relationships between the course of the ASV and the surrounding brain structures. RESULTS: The ASV and its small tributaries were clearly visualized in 120 hemispheres (100%). The average diameter of ASVs was 1.05±0.17 mm (range 0.9-1.6 mm). The average distance between bilateral septal points was 2.23±1.03 mm (range 1.3-6.6 mm). The ASV types 1 and 2 were in 77 (64.2%) and 43 (35.8%) hemispheres, respectively. In 83 (69.2%) hemispheres, the ASV-ICV junction was situated at the venous angle and the posterior margin of the foramen of Monro. In 37 (30.8%) hemispheres, the ASV-ICV junction was situated beyond the posterior margin of the foramen of Monro. The average distance between the posteriorly located ASV-ICV junction and the posterior margin of the foramen of Monro was 6.41±3.95 mm (range 2.4-15.9 mm). CONCLUSION: Using SWI, the topographic anatomy and anatomic variation of the ASV were clearly demonstrated. Preoperative assessment of anatomic variation of the ASV may be advantageous for minimally invasive neurosurgical procedures.


Assuntos
Variação Anatômica/fisiologia , Veias Cerebrais/anatomia & histologia , Veias Cerebrais/fisiologia , Adulto , Núcleo Caudado/fisiologia , Feminino , Lobo Frontal/fisiologia , Humanos , Masculino , Procedimentos Neurocirúrgicos/métodos , Terceiro Ventrículo/irrigação sanguínea , Terceiro Ventrículo/fisiologia
6.
Neuropathol Appl Neurobiol ; 42(7): 621-638, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27424496

RESUMO

AIMS: Neurogenesis in the postnatal human brain occurs in two neurogenic niches; the subventricular zone (SVZ) in the wall of the lateral ventricles and the subgranular zone (SGZ) of the hippocampus. The extent to which this physiological process continues into adulthood is an area of ongoing research. This study aimed to characterize markers of cell proliferation and assess the efficacy of antibodies used to identify neurogenesis in both neurogenic niches of the human brain. METHODS: Cell proliferation and neurogenesis were simultaneously examined in the SVZ and SGZ of 23 individuals aged 0.2-59 years, using immunohistochemistry and immunofluorescence in combination with unbiased stereology. RESULTS: There was a marked decline in proliferating cells in both neurogenic niches in early infancy with levels reaching those seen in the adjacent parenchyma by 4 and 1 year of age, in the SVZ and SGZ, respectively. Furthermore, the phenotype of these proliferating cells in both niches changed with age. In infants, proliferating cells co-expressed neural progenitor (epidermal growth factor receptor), immature neuronal (doublecortin and beta III tubulin) and oligodendrocytic (Olig2) markers. However, after 3 years of age, microglia were the only proliferating cells found in either niche or in the adjacent parenchyma. CONCLUSIONS: This study demonstrates a marked decline in neurogenesis in both neurogenic niches in early childhood, and that the sparse proliferating cells in the adult brain are largely microglia.


Assuntos
Envelhecimento , Encéfalo/citologia , Encéfalo/crescimento & desenvolvimento , Neurogênese , Adolescente , Adulto , Encéfalo/fisiologia , Proliferação de Células , Criança , Pré-Escolar , Feminino , Hipocampo/citologia , Hipocampo/fisiologia , Humanos , Imuno-Histoquímica , Lactente , Masculino , Pessoa de Meia-Idade , Células-Tronco Neurais/citologia , Células-Tronco Neurais/fisiologia , Terceiro Ventrículo/citologia , Terceiro Ventrículo/fisiologia , Adulto Jovem
7.
Science ; 353(6295): 176-8, 2016 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-27387952

RESUMO

Cerebrospinal fluid conveys many physiologically important signaling factors through the ventricular cavities of the brain. We investigated the transport of cerebrospinal fluid in the third ventricle of the mouse brain and discovered a highly organized pattern of cilia modules, which collectively give rise to a network of fluid flows that allows for precise transport within this ventricle. We also discovered a cilia-based switch that reliably and periodically alters the flow pattern so as to create a dynamic subdivision that may control substance distribution in the third ventricle. Complex flow patterns were also present in the third ventricles of rats and pigs. Our work suggests that ciliated epithelia can generate and maintain complex, spatiotemporally regulated flow networks.


Assuntos
Líquido Cefalorraquidiano/fisiologia , Terceiro Ventrículo/fisiologia , Animais , Cílios/fisiologia , Epêndima/fisiologia , Células Epiteliais/fisiologia , Hidrodinâmica , Camundongos , Ratos , Suínos , Terceiro Ventrículo/anatomia & histologia
8.
Med Hypotheses ; 86: 3-9, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26804589

RESUMO

Pineal gland is an important organ for the regulation of the bio-clock in all vertebrate species. Its major secretory product is melatonin which is considered as the chemical expression of darkness due to its circadian peak exclusively at night. Pineal melatonin can be either released into the blood stream or directly enter into the CSF of the third ventricle via the pineal recess. We have hypothesized that rather than the peripheral circulatory melatonin circadian rhythm serving as the light/dark signal, it is the melatonin rhythm in CSF of the third ventricle that serves this purpose. This is due to the fact that melatonin circadian rhythm in the CSF is more robust in terms of its extremely high concentration and its precise on/off peaks. Thus, extrapineal-generated melatonin or diet-derived melatonin which enters blood would not interfere with the bio-clock function of vertebrates. In addition, based on the relationship of the pineal gland to the CSF and the vascular structure of this gland, we also hypothesize that pineal gland is an essential player for CSF production. We feel it participates in both the formation and reabsorption of CSF. The mechanisms associated with these processes are reviewed and discussed in this brief review.


Assuntos
Líquido Cefalorraquidiano/metabolismo , Ritmo Circadiano/fisiologia , Melatonina/metabolismo , Fotoperíodo , Glândula Pineal/fisiologia , Terceiro Ventrículo/fisiologia , Animais , Humanos , Modelos Neurológicos
9.
Hypertension ; 64(3): 583-9, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24914195

RESUMO

Previous studies have reported that chronic increases in dietary salt intake enhance sympathetic nerve activity and arterial blood pressure (ABP) responses evoked from brain stem nuclei of normotensive, salt-resistant rats. The purpose of the present study was to determine whether this sensitization results in exaggerated sympathetic nerve activity and ABP responses during activation of various cardiovascular reflexes and also increases ABP variability. Male Sprague-Dawley rats were fed 0.1% NaCl chow (low), 0.5% NaCl chow (medium), 4.0% NaCl chow (high) for 14 to 17 days. Then, the animals were prepared for recordings of lumbar, renal, and splanchnic sympathetic nerve activity and ABP. The level of dietary salt intake directly correlated with the magnitude of sympathetic nerve activity and ABP responses to electrical stimulation of sciatic afferents or intracerebroventricular infusion of 0.6 mol/L or 1.0 mol/L NaCl. Similarly, there was a direct correlation between the level of dietary salt intake and the sympathoinhibitory responses produced by acute volume expansion and stimulation of the aortic depressor nerve or cervical vagal afferents. In contrast, dietary salt intake did not affect the sympathetic and ABP responses to chemoreflex activation produced by hypoxia or hypercapnia. Chronic lesion of the anteroventral third ventricle region eliminated the ability of dietary salt intake to modulate these cardiovascular reflexes. Finally, rats chronically instrumented with telemetry units indicate that increased dietary salt intake elevated blood pressure variability but not mean ABP. These findings indicate that dietary salt intake works through the forebrain hypothalamus to modulate various centrally mediated cardiovascular reflexes and increase blood pressure variability.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Reflexo/efeitos dos fármacos , Cloreto de Sódio na Dieta/farmacologia , Sistema Nervoso Simpático/efeitos dos fármacos , Animais , Pressão Sanguínea/fisiologia , Tronco Encefálico/efeitos dos fármacos , Tronco Encefálico/fisiologia , Relação Dose-Resposta a Droga , Estimulação Elétrica , Masculino , Modelos Animais , Ratos , Ratos Sprague-Dawley , Reflexo/fisiologia , Sistema Nervoso Simpático/fisiologia , Terceiro Ventrículo/efeitos dos fármacos , Terceiro Ventrículo/fisiologia
10.
Am J Physiol Regul Integr Comp Physiol ; 305(5): R499-505, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23824960

RESUMO

Administration of metformin is known to reduce both body weight and food intake. Although the hypothalamus is recognized as a critical regulator of energy balance and body weight, there is currently no evidence for an effect of metformin in the hypothalamus. Therefore, we sought to determine the central action of metformin on energy balance and body weight, as well as its potential involvement with key hypothalamic energy sensors, including adenosine monophosphate-activated protein kinase (AMPK) and S6 kinase (S6K). We used meal pattern analysis and a conditioned taste aversion (CTA) test and measured energy expenditure in C56BL/6 mice administered metformin (0, 7.5, 15, or 30 µg) into the third ventricle (I3V). Furthermore, we I3V-administered either control or metformin (30 µg) and compared the phosphorylation of AMPK and S6K in the mouse mediobasal hypothalamus. Compared with the control, I3V administration of metformin decreased body weight and food intake in a dose-dependent manner and did not result in CTA. Furthermore, the reduction in food intake induced by I3V administration of metformin was accomplished by decreases in both nocturnal meal size and number. Compared with the control, I3V administration of metformin significantly increased phosphorylation of S6K at Thr(389) and AMPK at Ser(485/491) in the mediobasal hypothalamus, while AMPK phosphorylation at Thr(172) was not significantly altered. Moreover, I3V rapamycin pretreatment restored the metformin-induced anorexia and weight loss. These results suggest that the reduction in food intake induced by the central administration of metformin in the mice may be mediated by activation of S6K pathway.


Assuntos
Regulação do Apetite/efeitos dos fármacos , Regulação do Apetite/fisiologia , Hipotálamo/enzimologia , Refeições/efeitos dos fármacos , Refeições/fisiologia , Metformina/administração & dosagem , Proteínas Quinases S6 Ribossômicas/biossíntese , Animais , Ativação Enzimática , Hipoglicemiantes/administração & dosagem , Hipotálamo/efeitos dos fármacos , Infusões Intraventriculares , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Terceiro Ventrículo/efeitos dos fármacos , Terceiro Ventrículo/fisiologia
11.
Neurosci Res ; 76(4): 213-23, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23735424

RESUMO

This study aimed to investigate how stimulation of ß-adrenoceptors in the anteroventral third ventricular region (AV3V; a pivotal forebrain area for autonomic functions) and other brain regions affects heart rate (HR) in conscious rats. Topical injections of the ß-adrenergic agonist isoproterenol (Isop) into the AV3V caused dose-related and reversible increases in HR. Only its highest dose utilized significantly affected blood pressure (BP), inducing a decrease. The tachycardia due to AV3V Isop lasted significantly longer than that elicited by hypotension, and was inhibited by AV3V administration of the ß-adrenergic antagonist propranolol or systemic infusion of a ganglion blocker hexamethonium. Plasma noradrenaline indicative of sympathetic nerve activity increased in parallel with rises in HR after the AV3V application of Isop. When Isop was locally injected into various brain regions other than the AV3V, region-related effectiveness in provoking tachycardia was observed that tended to be large in limbic structures and the hypothalamic paraventricular nucleus. No region responded to Isop applications with decreases in HR. These results suggest that ß-adrenoceptors in the AV3V and other brain regions may be able to produce tachycardia by enhancing, at least in part, the efferent sympathetic nerve activity controlling cardiac function.


Assuntos
Receptores Adrenérgicos/metabolismo , Terceiro Ventrículo/efeitos dos fármacos , Antagonistas Adrenérgicos beta/farmacologia , Animais , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Isoproterenol/farmacologia , Masculino , Ratos , Ratos Wistar , Terceiro Ventrículo/fisiologia
12.
J Neuroendocrinol ; 24(6): 907-15, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22340076

RESUMO

Kisspeptin and its G-protein coupled receptor Gpr54 are essential for the pubertal activation of gonadotrophin-releasing hormone (GnRH) neurones, with Gpr54 mutation or deletion resulting in failed puberty and infertility in humans and mice. The number of kisspeptin-immunoreactive neurones in the rostral periventricular area of the third ventricle (RP3V) increases during pubertal development in concert with the appearance of kisspeptin appositions with GnRH neurones in the mouse rostral preoptic area. We recently demonstrated that the pubertal increase in RP3V kisspeptin neuronal number in females is dependent upon circulating oestradiol levels. The present experiments investigated the potential role of gonadal steroids in the induction of kisspeptin expression in the RP3V during pubertal development in the male mouse. Using immunocytochemistry (ICC), we show that gonadectomy of male pups at postnatal day (P) 20 resulted in a 60-70% reduction in the number of kisspeptin immunoreactive (IR) neurones within the RP3V of P45 mice (P<0.05) compared to sham-treated littermates. We established a profile of circulating testosterone levels during postnatal development in male mice and found that circulating testosterone was low throughout early postnatal development and increased from P35-40 to reach adult levels. Treatment of P20-gonadectomised male mice with 17ß-oestradiol or testosterone from P38-45 restored kisspeptin-IR neurone number in the RP3V to intact control levels (P>0.05). Using double-label ICC, we demonstrate that the majority of RP3V kisspeptin neurones express androgen receptors and oestrogen receptor α, indicating that RP3V kisspeptin neurones in the male mouse are equipped to respond to both androgen and oestrogen signals. These results indicate that, as in females, gonadal steroids are essential for the increase in kisspeptin immunoreactive cell number that occurs in the RP3V during pubertal development in the male mouse.


Assuntos
Hormônios Esteroides Gonadais/biossíntese , Hormônio Liberador de Gonadotropina/metabolismo , Kisspeptinas/biossíntese , Terceiro Ventrículo/crescimento & desenvolvimento , Terceiro Ventrículo/metabolismo , Animais , Feminino , Hormônios Esteroides Gonadais/genética , Kisspeptinas/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Terceiro Ventrículo/fisiologia
13.
J Neurosurg ; 116(2): 445-52, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22098198

RESUMO

OBJECT: The evaluation of third ventriculostomy function in hydrocephalic patients is challenging. The utility of the constant flow infusion test in predicting response to shunt insertion in normal-pressure hydrocephalus, as well as in identifying shunt malfunction, has been previously demonstrated. The object of this study was to evaluate its usefulness in determining whether a revision CSF diversion procedure was indicated in patients presenting with recurring symptoms and persisting ventriculomegaly after endoscopic third ventriculostomy (ETV). METHODS: The authors conducted a prospective study of all patients who, after undergoing ETV at their institution, presented postoperatively with recurring symptoms and persisting ventriculomegaly. RESULTS: Forty-six patients (mean age 40.7 years, including 11 patients younger than 18 years) underwent 56 constant flow ventricular infusion tests (VITs) at a mean of 24.7 months post-ETV. Thirty-three patients with resistance to CSF outflow (R(out)) less than 13 mm Hg/ml/min underwent follow-up (median 17 months) and experienced resolution of symptoms. In 10 episodes R(out) was greater than 13 mm Hg/ml/min; the patients in these cases underwent revisional CSF diversion. Two patients demonstrated high and frequent B (slow) waves despite a low R(out); these patients also underwent successful revisions. Patients who improved after surgery had increased B wave activity in the plateau phase of the VIT (p = 0.01). Thirty-four patients underwent MR imaging at the same time; 4 had high R(out) despite evidence of flow across the stoma. These 4 patients underwent surgery and experienced resolution of symptoms. Of 9 patients without flow, R(out) was less than 13 mm Hg/ml/min in 4; these patients were successfully treated conservatively. CONCLUSIONS: The VIT is a useful and safe adjunct to clinical and MR imaging evaluation when ETV failure is suspected.


Assuntos
Hidrocefalia , Neuroendoscopia/métodos , Terceiro Ventrículo/fisiologia , Terceiro Ventrículo/cirurgia , Ventriculostomia/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Líquido Cefalorraquidiano/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Hidrocefalia/diagnóstico , Hidrocefalia/fisiopatologia , Hidrocefalia/cirurgia , Lactente , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Estudos Prospectivos , Reoperação , Falha de Tratamento , Adulto Jovem
14.
World Neurosurg ; 78(3-4): 312-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22120264

RESUMO

OBJECTIVE: Endoscopic third ventriculostomy (ETV) is being used increasingly in adults as an alternative to cerebrospinal fluid (CSF) shunting. We analyze patient, radiographic, and operative factors associated with CSF diversion surgery-free outcomes after ETV. METHODS: One hundred twenty four consecutive adult patients (>18 years) treated with ETV at an academic institution were retrospectively reviewed according to demographic, clinical, operative, radiographic, and follow-up variables. After excluding patients with unclear etiologies or complex previous CSF shunting regimens, there remained 103 patients undergoing ETV for obstructive hydrocephalus, either as initial intervention or in the setting of shunt failure. The primary end point used to assess ETV failure was return to the operating room for CSF diversion. Return of radiographic findings consistent with uncompensated hydrocephalus was considered as a secondary end point. Associations with ETV failure were assessed via Cox proportionate-hazards regression analysis. RESULTS: Clinical improvement was seen in 76 (74%) patients within a median of one month after surgery. Radiographic improvement was seen in 59 (57%) patients within a median of two months after surgery. Fifty-seven (55%) of the patients remained symptom and surgery-free through last follow-up, a median of 5 [2-9] years after ETV. Lasting morbidity and mortality occurred in less than 1%. Multivariate, independent associations with ETV failure included perioperative steroid use, intraoperative image guidance, and time to radiographic improvement. Patients who had image-guided surgery or perioperative steroid treatment were approximately 2.5 times less likely to experience ETV failure. CONCLUSION: ETV is a safe and effective procedure in adult patients. Perioperative factors, intraoperative image guidance, and steroid treatment may lower ETV failure rates.


Assuntos
Hidrocefalia/cirurgia , Terceiro Ventrículo/cirurgia , Ventriculostomia/métodos , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Valor Preditivo dos Testes , Radiografia , Reoperação/métodos , Reoperação/mortalidade , Estudos Retrospectivos , Terceiro Ventrículo/fisiologia , Resultado do Tratamento , Ventriculostomia/efeitos adversos
16.
Acta Neurochir (Wien) ; 153(10): 2049-55; discussion 2055-6, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21805286

RESUMO

BACKGROUND: To review the outcome after endoscopic third ventriculostomy (ETV) for symptomatic, persistent hydrocephalus in three patients with perimesencephalic angiographically negative subarachnoid hemorrhage (PNH) who were dependent on an external ventricular drain (EVD). METHODS: All patients initially presented with severe headache, nuchal rigidity, confusion and lethargy (Hunt-Hess Grade II or III), and persistent, EVD-dependent hydrocephalus. Cranial CT images in each revealed acute hydrocephalus and perimesencephalic hemorrhage pattern with a heavy clot burden (Fisher grade 3). A 3D-CT angiogram on admission and two four-vessel cerebral angiograms failed to demonstrate a bleeding source. All three patients failed trial EVD clamping, with clinical deterioration and elevated intracranial pressure (ICP). ETV was performed with a 0-degree endoscope in a 4.6-mm irrigating sheath using an endoscopic-coring/"cookie-cut" technique. An EVD was left in place for postoperative ICP monitoring but was clamped. RESULTS: ETV was accomplished in all patients. In one case, a tiny basilar tip aneurysm was seen during the endoscopic procedure. Intraoperatively, the prepontine cistern revealed dense, degraded blood products. Postprocedure ICP measurements were reduced to normal range. Clinical improvement, normal ICP readings, and/or radiographic evidence of resolution of hydrocephalus allowed uneventful removal of the EVD within 36-48 h post-ETV in all patients. All remained headache-free, with a normal neurological examination, during a follow-up period of 10, 11, and 12 months, respectively. CONCLUSION: To our knowledge, this is the first report of ETV for PNH with hydrocephalus and the first report of a basilar tip microaneurysm seen intraoperatively during ETV. ETV is a viable treatment option for refractory hydrocephalus secondary to a perimesencephalic pattern of subarachnoid hemorrhage (SAH). Its early application can avoid placement of a ventriculoperitoneal shunt, curtail the extended use of an EVD, and reduce the associated infection risks. Despite thorough angiographic investigation for an aneurysmal cause of SAH, a "microaneurysm" of the basilar artery was found at ETV. No complication or rebleeding was encountered.


Assuntos
Hidrocefalia/etiologia , Hidrocefalia/cirurgia , Neuroendoscopia/métodos , Hemorragia Subaracnóidea/complicações , Terceiro Ventrículo/cirurgia , Ventriculostomia/métodos , Idoso , Derivações do Líquido Cefalorraquidiano/métodos , Feminino , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/patologia , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/etiologia , Embolia Intracraniana/patologia , Masculino , Pessoa de Meia-Idade , Neuroendoscopia/instrumentação , Radiografia , Hemorragia Subaracnóidea/patologia , Terceiro Ventrículo/fisiologia , Resultado do Tratamento , Ventriculostomia/instrumentação
17.
Endocr J ; 58(7): 559-73, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21532213

RESUMO

The anteroventral third ventricular region (AV3V) is a pivotal area for osmotic responses and integration of autonomic functions. The purpose of this study was to investigate whether the gamma-aminobutyric acid (GABA)-ergic activity in the AV3V may be involved in the regulation of arginine vasopressin (AVP) secretion and related phenomena under the conditions with or without hypovolemia. Experiments were performed in conscious rats. We found that AV3V infusion with the GABA(A) receptor antagonist bicuculline in euvolemic rats caused prompt increases in plasma AVP, osmolality, glucose, arterial pressure and heart rate. The effects of the bicuculline infusion were abolished by prior infusion of a GABA(A) receptor agonist, muscimol. When repeated twice with a 10-min interval, removal of systemic blood (10 mL/kg body weight) lowered arterial pressure and enhanced plasma AVP, osmolality, glucose and angiotensin II. Muscimol infusion in the AV3V, but not in the cerebral ventricle, inhibited the responses of plasma AVP and glucose, despite having no effect in a sham hemorrhagic state. The inhibition of the AVP response by the muscimol infusion was also verified in rats given a combined stimulus of bleeding plus an osmotic load. In contrast, AV3V infusion with the GABA(B) receptor agonist baclofen tended to intensify the hemorrhagic responses of plasma AVP and glucose, despite its potency to prevent the hemorrhagic fall in arterial pressure. These results, taken together with our previous data, suggest that hypovolemic stimuli, like hyperosmotic stimuli, may promote AVP secretion by causing the inhibition of AV3V GABA(A)-ergic activity responsible for potentiation of glutamatergic activity.


Assuntos
Arginina Vasopressina/fisiologia , Bicuculina/farmacologia , Agonistas de Receptores de GABA-A/farmacologia , Antagonistas de Receptores de GABA-A/farmacologia , Muscimol/farmacologia , Terceiro Ventrículo/fisiologia , Ácido gama-Aminobutírico/fisiologia , Animais , Arginina Vasopressina/sangue , Arginina Vasopressina/metabolismo , Bicuculina/administração & dosagem , Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Hipovolemia/fisiopatologia , Masculino , Ratos , Ratos Wistar , Terceiro Ventrículo/metabolismo
18.
CNS Neurol Disord Drug Targets ; 10(4): 433-9, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21495965

RESUMO

Neurogenesis occurs in the adult brain in a constitutive manner under physiological circumstances within two regions: the dentate gyrus of the hippocampus and the subventricular zone of the lateral ventricles. In contrast to these two so-called neurogenic areas, other regions of the brain were considered to be primarily non-neurogenic in nature, implying that no new neurons were formed there under normal conditions. Recently, low proliferative activity was reported in the hypothalamus and the cell layers surrounding the third ventricle. This review summarizes recent evidence for adult neurogenesis in the hypothalamus, and points out the potential contributions of these new neurons to neural processing. We also discussed some technical considerations in investigating neurogenesis in the adult hypothalamus. It is believed that the hypothalamus could serve as a new source and target for stem cell transplantation.


Assuntos
Hipotálamo/fisiologia , Neurogênese/fisiologia , Transplante de Células-Tronco , Células-Tronco/fisiologia , Adulto , Encéfalo/fisiologia , Proliferação de Células , Giro Denteado/fisiologia , Hipocampo/fisiologia , Humanos , Ventrículos Laterais/fisiologia , Neurônios/fisiologia , Terceiro Ventrículo/fisiologia
19.
Neuromolecular Med ; 13(2): 138-50, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21290199

RESUMO

Multiple sclerosis frequently affects the optic apparatus, particularly optic chiasm and nerves. Here, we have reported the structural and molecular characteristics of remyelination in the adult rat optic chiasm and nerves. Moreover, considering the proximity of optic chiasm and 3rd ventricle, we have tried to determine if proliferating cells residing in 3rd ventricle region are able to migrate in response to experimental demyelination of the optic chiasm. Following local demyelination by lysolecithin, remyelination pattern in longitude of optic chiasm and proximal nerves was investigated using myelin staining and marker genes expression. Furthermore, cell tracing was carried out using BrdU labeling of proliferating cells prior to gliotoxin injection. Morphometric analysis revealed that demyelination was considerable on days 7 and 14 and an incomplete remyelination occurred on day 28 post-lesion. Interestingly, myelin repair was more evident in the caudal part of chiasm, compared to rostral part and proximal optic nerves. Following chiasm and nerve demyelination, trains of BrdU+ cells were seen near the 3rd ventricle which subsequently moved to lesion site. Nestin was significantly up-regulated in 3rd ventricle surroundings. At the lesion site, Nogo-A gene expression was significantly decreased on days 7 and 14 post lesion, while Olig2, nestin, and GFAP expression was increased on day 7. The changes were then reversed by the time. Myelin repair in optic chiasm seems to be mediated by endogenous progenitors and stem cells. Adult 3rd ventricle proliferating cells may play a role in this context by mobilization into the demyelinated chiasm.


Assuntos
Proliferação de Células , Doenças Desmielinizantes/metabolismo , Regeneração Nervosa/fisiologia , Quiasma Óptico/metabolismo , Nervo Óptico/metabolismo , Neurite Óptica/metabolismo , Terceiro Ventrículo/citologia , Terceiro Ventrículo/fisiologia , Animais , Doenças Desmielinizantes/patologia , Feminino , Quiasma Óptico/fisiologia , Nervo Óptico/fisiologia , Neurite Óptica/patologia , Ratos , Ratos Sprague-Dawley
20.
J Clin Neurosci ; 18(2): 253-9, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20926296

RESUMO

Microanatomical dissection was performed on 14 formalin-fixed human cadaveric head specimens to provide information relevant for surgical procedures involving the cistern of the lamina terminalis (LT). The cistern of the LT was located in the midline of the telencephalon and was tent-shaped. The superior wall was located between the septal areas bilaterally, the lateral walls leaned laterally downwards, the anterior wall was the integrated line of the bilateral leptomeninges, the posterior and the inferoposterior walls were composed of the LT, the inferior margin was the arachnoid membrane between the optic nerves, and the inferoanterior wall usually formed a recess in front of the optic chiasm. In summary, the shape of the cistern of the LT is relatively constant, which is helpful for predicting the direction of hemorrhage of an aneurysm of the anterior communicating artery; in distinguishing its neural, vascular, and fibrous contents; and guiding surgical procedures.


Assuntos
Líquido Cefalorraquidiano/fisiologia , Hipotálamo/anatomia & histologia , Espaço Subaracnóideo/anatomia & histologia , Terceiro Ventrículo/anatomia & histologia , Adulto , Idoso , Cadáver , Feminino , Humanos , Hipotálamo/fisiologia , Masculino , Pessoa de Meia-Idade , Espaço Subaracnóideo/fisiologia , Terceiro Ventrículo/fisiologia , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...