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Biomedical subjects

M Novikov

Publications and source records attributed to M Novikov.

6 recordsLinked to original sources

The significance of persistent ST elevation versus early resolution of ST segment elevation after primary PTCA.

OBJECTIVES: To determine the prevalence and clinical significance of early ST segment elevation resolution after primary percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction (AMI). BACKGROUND: Despite angiographically successful restoration of coronary flow early during AMI, adequate myocardial reperfusion might not occur in a substantial portion of the jeopardized myocardium due to microvascular damage. This phenomenon comprises the potentially beneficial effect of early recanalization of the infarct related artery (IRA). METHODS: Included in the study were 117 consecutive patients who underwent angiographically successful [Thrombolysis in Myocardial Infarction (TIMI III)] primary PTCA. The patients were classified based on the presence or absence of reduction > or =50% in ST segment elevation in an ECG performed immediately upon return to the intensive cardiac care unit after the PTCA in comparison with ECG before the intervention. RESULTS: Eighty-nine patients (76%) had early ST segment elevation resolution (Group A) and 28 patients (24%) did not (Group B). Group A and B had similar clinical and hemodynamic features before referring to primary PTCA, as well as similar angiographic results. Despite this, ST segment elevation resolution was associated with better predischarge left ventricular ejection fraction (LVEF) (44.7 +/- 8.0 vs. 38.2 +/- 8.5, p < 0.01). Group B patients, as compared with those of Group A, had a higher incidence of in-hospital mortality (11% vs. 2%, p = 0.088), congestive heart failure (CHF) [28% vs. 19%, odds ratio (OR) = 4, 95% confidence interval (CI) 1 to 15, p = 0.04], higher long-term mortality (OR = 7.3, 95% CI 1.9 to 28, p = 0.004 with Cox proportional hazard regression analysis) and long-term CHF rate (OR = 6.5, 95% CI 1.3 to 33, p = 0.016 with logistic regression). CONCLUSIONS: Absence of early ST segment elevation resolution after angiographically successful primary PTCA identifies patients who are less likely to benefit from the early restoration of flow in the IRA, probably because of microvascular damage and subsequently less myocardial salvage.

Angioplasty, Balloon, Coronary↗

[A methodological study in a space flight simulation context].

To study the effects of isolation and confinement on small groups during long space flights, it is habitual to use closed hyperbaric ground chambers. For the first time, the European Space Agency made use of a nautral environment taking advantage of an Antarctic winter-over at the French Dumont d'Urville Station. The main objective of that study ("International Antarctic Psychological Programme"), was to compare different Russian tests used for training cosmonauts to a W. European approach validated during previous winter studies and European ground chamber simulations. Russian techniques appeared to be oriented to a narrow range of phenomena and unsuited to discern the adjustment to stress conditions.

Adaptation, Psychological↗

Long-term effect of HU-211, a novel non-competitive NMDA antagonist, on motor and memory functions after closed head injury in the rat.

HU-211 is a synthetic, non-psychotropic cannabinoid which acts as a non-competitive NMDA antagonist and antioxidant. We studied the drug's therapeutic window as well as its long-term effect on cognitive and motor functions in a model of closed head injury (CHI) in the rat. A weight-drop device was used to induce CHI in either anesthetized male rats. HU-211 (5 mg/kg) was administered i.v. to the experimental groups. For the therapeutic window study, drug was injected at 4 or 6 h after CHI. Edema (water content) and clinical status (neurological severity score, NSS) were evaluated at 24 h. Reduction of edema was slight, whereas improvement of NSS was significant when the drug was administered at 4 or 6 h (P = 0.0023 and 0.059, respectively). To determine the drug's long-term effect, it was administered 1 h after CHI and additional doses were later given. NSS was evaluated for a period of 30 d. A single dose of HU-211 given 1 h post-CHI improved the clinical outcome during the 30 d period (P < 0.01). Repetitive doses of HU-211 injected during the post traumatic period had similar effects. Cognitive functions were evaluated in the Morris water maze, with rats trained either before or after CHI. CHI resulted in a highly significant impairment of these abilities, whereas HU-211 treatment 1 h after CHI improved performance. Our results indicate that HU-211 is a potent cerebroprotective agent, with a therapeutic window of about 4 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Long term exposure to heat reduces edema formation after closed head injury in the rat.

Cerebral edema is one of the major consequences of head trauma (HT); its evolution may cause secondary ischemia and neuronal damage. In a closed head injury model in rats, we have shown BBB disruption and edema formation during the post traumatic period. We have previously shown that chronic exposure to moderate heat improves clinical outcome of rats subjected to HT. Long term exposure to heat results in the achievement of a stable acclimated state, characterized by a lower metabolic rate and improved heat tolerance. In the present study, we investigated the effect of chronic exposure to heat on edema formation after HT. Rats were held at 24 degrees C (CON) or 34 degrees C (ACC) for one month. Injury was then induced under ether anesthesia by a weight drop device. Four or 48 hours later, they were sacrificed for evaluation of BBB integrity (Evans blue, EB, extravasation) or edema formation (specific gravity, SG, or percent water). We found that EB uptake by the contused hemisphere was 6 fold lower in the ACC rats as compared to CON (p < 0.001). Furthermore, edema measured at 48 h by both SG and percent water methods was significantly lower in the acclimated rats (p < 0.01). We suggest that heat acclimation offers protection to rats subjected to head injury, possibly by reduction of plasma proteins extravasation.

Acclimatization↗

Closed head injury triggers early production of TNF alpha and IL-6 by brain tissue.

In a model of closed head injury (CHI) in the rat we have shown the activation of phospholipase A2 and the production of eicosanoids after injury: at 15 min, mainly 5-hydroxyeicosatetraenoic acid (5-HETE), and at 24 h, mainly prostaglandin E2. The present study was designed to test whether CHI can also trigger the production of cytokines in the brain. CHI was induced in ether-anesthesized rats by a weight-drop device falling over the exposed skull covering the left hemisphere, 1-2 mm lateral to the midline in the midcoronal plane. In the posttraumatic period (1-24 h), the rats were decapitated, cortical tissue from the injured zone of the contused and contralateral hemispheres was removed and sonicated, and cytokine activity was assessed. Whereas no tumor necrosis factor alpha (TNF alpha) activity was found in normal brain tissue, it was detectable in the contused hemisphere (approximately of 72 +/- 50 pg/mg protein) as early as 1 h post-CHI. TNF alpha levels increased at 2 h, peaked at 4 h, (approximately of 609 +/- 540 pg/mg protein), and declined thereafter. At parallel intervals, only low levels of TNF alpha were detected in the contralateral hemisphere. In normal brain, interleukin-6 (IL-6) was nondetectable. Following CHI, high levels of IL-6 were present, although their accumulation lagged behind that of TNF alpha by 2-4 h, peaking at 8 h (62 +/- 31 ng/mg protein). We suggest that the rapid production of TNF alpha and IL-6 following CHI is a local inflammatory response of brain tissue to primary insult.

Animals↗

A nonpsychotropic cannabinoid, HU-211, has cerebroprotective effects after closed head injury in the rat.

HU-211 is a synthetic, nonpsychotropic cannabinoid, which has been shown to act as a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist. The cerebroprotective effects of this compound were assessed in a model of closed head injury in rats. Head trauma (HT) was induced in ether-anesthetized rats by a weight-drop device; recovery was followed up to 48 h. The clinical status of the rats was evaluated at 1, 24, and 48 h after injury, and the extent of edema formation was determined by specific gravity (SG) and water content measurements at 24 or 48 h. The integrity of the blood-brain barrier (BBB) was investigated using Evans-Blue extravasation at 4 h after HT. HU-211 at a dose of 25 mg/kg in middle-chain triglycerides (MCT) oil was given intraperitoneally immediately and 1, 2, or 3 h after impact, and its effect on the various parameters was studied. The drug was found to be very effective in improving motor function recovery. When the drug was given 1 h after HT, the percent of rats able to perform beam walking task on 8.5- and 5-cm wide beams was increased from 30% and 0% to 79% (p = 0.0172) and 57% (p = 0.0029), respectively. The percent of rats able to balance on a 1.5-cm beam for 20 and 40 sec was also significantly increased, from 9% and 0% to 72% (p = 0.0037) and 50% (p = 0.078), respectively. The drug was also effective in reducing the BBB breakdown by more than four fold, as compared with control (548 +/- 94 versus 128 +/- 19 ng Evans blue/g tissue; p < 0.05) and attenuating cerebral edema. SG was 1.0367 +/- 0.0007 versus 1.0399 +/- 0.0005, and percent water content was 83.06 +/- 0.57 versus 80.78 +/- 0.36 (p < 0.05) in control and HU-211 treated rats, respectively. Similar significant protection was found when the drug was injected 2 h after the injury; however, at 3 h the effect was somewhat less pronounced. We suggest that this novel drug is a potential cerebroprotector in head trauma with a therapeutic window of at least 2 to 3 h.

Animals↗