Biomedical subjects

R Juul

Publications and source records attributed to R Juul.

23 records · Page 2Linked to original sources

PubMed1990

Peptidergic innervation of the cerebral circulation. Role in subarachnoid hemorrhage in man.

The present paper reviews recent studies in monkey and man adding further to understanding of the role of perivascular peptides in the pathophysiology of subarachnoid haemorrhage. 1. The perivascular fibers, sympathetic fibers (storing noradrenaline, neuropeptide Y), parasympathetic fibers (storing acetylcholine, vasoactive intestinal peptide, peptide histidine methionine and neuropeptide Y) and sensory fibers (storing tachykinins, calcitonin gene-related peptide) were traced using True Blue in monkey. 2. Tracing studies of the monkey middle-cerebral artery (MCA) innervation confirmed earlier studies in rats and cats, with superior cervical and trigeminal ganglia as main immunostaining areas, and contralateral involvement in the superior cervical and trigeminal ganglia. Sphenopalatine immunostaining was scarce. 3. The release of neuropeptides in the external jugular vein in humans in the postoperative course after subarachnoid hemorrhage, using radioimmunoassay, was correlated to hemodynamical changes (vasoconstriction) monitored with Doppler ultrasound on middle cerebral (MCA) and internal carotid arteries (ICA)). 4. Neuropeptide Y-like immunoreactivity (NPY-LI) levels were increased compared to controls in patients with hemodynamic changes, and in some patients a relationship was found between velocities and NPY-LI. 5. Calcitonin gene-related peptide-LI levels were also increased in connection with vasospasm. In patients with MCA lesions a correlation of 0.61, p = 0.0002 was found between hemodynamic index (V MCA/V ICA) and CGRP-LI. The possible sympathetic and trigemino-cerebrovascular activation are discussed.

Animals↗

PubMed1990

Changes in the levels of neuropeptide Y-LI in the external jugular vein in connection with vasoconstriction following subarachnoid haemorrhage in man. Involvement of sympathetic neuropeptide Y in cerebral vasospasm.

NPY is a putative neurotransmitter mainly co-localized with noradrenaline in sympathetic fibers which innervate the cerebral vasculature. The origin of most of the perivascular NPY fibers seems to be in the superior cervical ganglion. To investigate involvement of Neuropeptide Y (NPY) mechanisms in subarachnoid haemorrhage (SAH), twenty patients with SAH were investigated. NPY-LI (-like immunoreactivity) levels in the external jugular vein were assessed using radioimmunoassay in blood samples collected post-operatively (or after SAH in non-surgical patients) on days 1,2,3, 5,7 and 9. These levels were compared with the clinical course and blood flow velocity changes monitored with ultrasonic Doppler equipment from both middle cerebral arteries (MCA) and both internal carotid arteries (ICA). Compared to NPY-LI levels in 14 controls (mean 116 +/- 3 pmol/1), increased levels (up to 253 pmol/l) and a close relationship between velocities and NPY-LI levels were found in a subpopulation of the SAH patients. When comparing the mean haemodynamic index (V MCA/ipsilateral V ICA) and mean NPY-LI levels in each of the 20 patients, a correlation of r = 0.75, p = 0.0001 was found. Increased NPY-LI were found (131 +/- 8 pmol/l) when simultaneous Doppler velocity recordings showed vasoconstriction (Haemodynamic index greater than 5) compared with samples taken when the haemodynamic index was less than 5, p less than 0.05. When MCA velocity exceeded 120 cm/sec. increased levels were found (129 +/- 9 pmol/l) compared with the conditions when MCA velocity was less than 120 cm/sec (113 +/- 5 pmol/l), p = 0.06. The results indicate a possible NPY involvement in cerebral vasoconstriction after SAH.

Adult↗

PubMed1990

Atrial natriuretic peptide-LI following subarachnoid haemorrhage in man.

Atrial natriuretic peptide-like immunoreactivity (ANP-LI) was measured in plasma from the external jugular vein (EJV) in the postoperative course of 11 patients with aneurysmal subarachnoid haemorrhage. Samples were taken on day, 1, 2, 3, 5, 7 and 9 after operation and ANP-LI levels were determined using radioimmunoassay. Ten healthy volunteers were investigated with one EJV plasma sample. Comparing the whole group of SAH patients with the control group, no significant differences in ANP-LI levels were found. In one patient very high ANP-LI levels were found together with high mean plasma sodium levels and high urine sodium excretion. This suggests that there is no general correlation between plasma ANP-LI and SAH; in occasional patients such a correlation may be secondary to changes in plasma sodium levels.

Adult↗

PubMed1990

Calcitonin gene-related peptide-LI in subarachnoid haemorrhage in man. Signs of activation of the trigemino-cerebrovascular system?

Calcitonin gene-related peptide (CGRP) is a neurotransmitter candidate together with the tachykinins in sensory fibres in the cerebral vasculature, with possible vasodilating properties. The origin of most of the CGRP-immunoreactive cerebrovascular nerve fibres seems to be the trigeminal ganglion. Experimentally produced vasoconstriction in cats after lesions of the trigeminal ganglion have shown marked prolonged constriction compared to controls. The possible involvement of the trigemino-cerebrovascular system as a defence system, with CGRP probably being the more potent vasodilatator, was investigated in 12 patients with subarachnoid haemorrhage (SAH). After operation with clipping of the aneurysm and treatment according to department policy, blood samples were taken from the external jugular vein on postoperative days 1, 2, 3, 5, 7, 9, frozen and analysed (radioimmunoassay) for CGRP-LI (-like immunoreactivity) levels. The patients were monitored with Doppler recordings from the middle cerebral arteries (MCA) and internal carotid arteries (ICA) following blood sampling. The relationship Vmean MCA/V mean ICA was used as an index of vasospasm. The highest CGRP-LI levels were found in the patient with highest velocities/index values. In patients with MCA aneurysms (n = 7), a correlation of r = 0.61 was found between the index and CGRP-LI levels. However, significant changes in the group as a whole was not found. The possible involvement of the trigemino-cerebrovascular system in SAH is discussed.

Adult↗

PubMed1986

Prognosis in subarachnoid hemorrhage of unknown etiology.

Thirty-two patients with subarachnoid hemorrhage of unknown etiology were followed for periods from 1 to 6 1/2 years. Two more patients had normal initial angiograms, but were excluded when repeat angiography revealed an aneurysm. The mortality rate in this series was 6%. There was one possible early and no late episode of rebleeding. One patient developed epilepsy. Five patients developed communicating hydrocephalus and underwent a shunting procedure. A complete recovery was observed in 12 patients. An additional eight had minimal disability, seven were more severely disabled, and three patients were totally disabled. Antifibrinolytic treatment (tranexamic acid) was given in a nonstandardized regimen to 14 patients who showed a poorer result than did the 18 untreated patients.

Adolescent↗