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PubMedDate not supplied

[The clinical picture of non-traumatic apallic syndrome].

Clinical signs of non-traumatic apallic syndrome (AS) are caused by universal necrosis of the brain cortex, with the brain stem remaining intact. The reasons of AS are heart and respiration arrest, stable collapses of various genesis, vascular brain diseases. Management was ineffective. Strict AS prevention is necessary, i.e. timely and expert cardiorespiratory resuscitation. Intensive care and cardiorespiratory resuscitation are not recommended in patients with vast brain infarction secondary to brain vascular diseases.

Adult↗
PubMed2006

[Lifestyle to prevent cardiovascular disease in NIDDM].

Major risk factors for cardiovascular diseases (myocardial infarction, angina pectoris, brain infarction) are age, male, smoking, high LDL-cholesterol, low HDL-cholesterol, high blood pressure, and diabetes mellitus. In Japanese population at large, healthy life-style to prevent cardiovascular diseases are; quit smoking, walking faster, saturated fat intake ranging 4.5-7 en%, lesser intake of trans fatty acids, cholesterol intake less 750 mg/day (male) and 600 mg/day (female), eat fish everyday, eat more folic acid, B6, and B12, eat grain, eat soybean products. However, it is not known whether this recommendation is also applied to NIDDM to prevent cardiovascular diseases. Based on reported evidences, to prevent cardiovascular diseases, NIDDM should quit smoking, eat fish everyday, and increase physical activity.

Arteriosclerosis↗
PubMed1994

VCAM-1 expression on reactive and tumour astrocytes.

In our studies we used a monoclonal antibody recognizing the vascular adhesion molecule (VCAM-1). Tissue samples were collected at autopsy from human brain infarcts and from brain tumours, removed during surgical procedure (Neurological and Neurosurgical Clinic, Cracow). A novel, unexpected finding were VCAM-1-positive fibrous astrocytes in the stroke tissue, and astrocyte-like cells in the tumours. No staining was obtained either in the contralateral hemisphere or outside of ischemic areas. Likewise, no positive staining of cells was seen outside the tumour tissue. The above findings, taken together, strongly support the concept that astrocytes take part in the immune defense during various pathological processes in the human brain.

Astrocytes↗
PubMed1994

Primary angiitis of the CNS diagnosed by angiography.

Sixteen patients (8 female, 8 male) with primary angiitis of the CNS (PACNS), were followed prospectively in a vasculitis clinic. Diagnosis was by angiography in patients without underlying disease. Median age at diagnosis was 36.5 years, and median duration of follow-up was 28 months. Onset was acute in 14 patients (88%), with 3.5 weeks (median) from onset symptoms to diagnosis. Three women developed symptoms within 3 weeks postpartum. The most frequent symptoms were severe headaches (12, 75%), stroke (6, 30%), transient ischaemic attack (TIA) (4, 28%), seizures (7, 44%), visual aberration (3, 19%), and cognitive impairment (5, 31%). Laboratory data included high ESR (2, 13%), leucocytosis (8, 80%), thrombocytosis (1, 6%), positive antinuclear antibody titre (3, 15%), and high levels of complement (5, 31%). Lumbar puncture was performed in 12 patients (75%). CSF analysis was abnormal in five patients (42%). EEG was abnormal in 5/9 patients. The major CT/MRI scan findings were cerebral haemorrhage (4, 25%), brain infarcts (5, 31%), brain atrophy (2, 13%) and non-specific lesions (2, 13%). Four patients had normal studies. All patients received corticosteroids (CS), and five were treated with oral cyclophosphamide. Two patients relapsed despite CS and cyclophosphamide therapy. All patients are alive, and at the last assessment, eight had a permanent neurological deficit, which included paresis (3, 19%), neurocognitive abnormalities (2, 13%), visual loss (2, 13%) and seizure activity (5, 31%). Our data suggest a non-progressive, non-fatal course in those PACNS patients diagnosed angiographically and treated with CS with or without cyclophosphamide.

Adult↗
PubMed1997

[Sleep apnea syndrome and cerebral lesions--a prospective MRI study].

It seems well known that sleep apnea syndrome (SAS) is associated with cardiovascular complications, inclusive myocardial infarctions. Our study aimed to test the hypothesis that patients suffering from cerebral SAS have more cerebrovascular findings resp. brain infarctions than a matched control group. We analysed prospectively MRI studies of 14 patients with SAS and controls without SAS in respect of specific and nonspecific vascular cerebral lesions including atrophic changes of the brain. In contrast to our expectations, the rate of SAS-associated ischemic brain lesions is unimportant and not significantly different from age-associated brain lesions in controls. The rate of brain infarctions is distinctly different from that of myocardial infarctions. The outcomes are discussed with regard to new results of "ischemia-induced" ischemic tolerance on different tissues.

Adult↗
PubMed2005

[Risk factors for cerebrovascular diseases].

Cardiovascular diseases have been increasing in association with life style changes and increasing trends of hyperlipidemia and diabetes in Japan. On the other hand, cerebrovascular diseases, which largely comprise of small-vessel diseases such as hypertensive brain hemorrhage and lacunar brain infarction, have been considered to be dependent on aging and hypertension. Recently, however, atherothrombotic brain infarction (ATBI) has been rapidly increasing in Japan, and this increase occurs precedently in urban area such as Kanto and Kansai Districts. The present paper, therefore, summarizes the classification of diverse subtypes of cerebrovascular diseases and their underlying vascular lesions. Furthermore, it also focuses the risk factors for cerebrovascular diseases and the vascular lesions, and aims to clarify the factors and background which may have contributed to the increase of ATBI in Japan. Arteriosclerotic changes of small arteries in the brain parenchyma are considered to play an important role in development of cerebral white matter lesions (leucoaraiosis) and lacunar infarction. Oxidative stresses such as smoking, lipid peroxidation, and others are suggested to give impacts on the lesion formation through the effects on various functions of arterial trees and nitric oxide (NO) production from the arterial endothelial cells. Therefore, This paper presents the data indicating the significant correlation of these oxidative stress markers and polymorphism of endothelial NO synthase gene which may be relating to the pathogenesis of cerebral white matter lesions, and discusses about the usefulness of these new risk factors for cerebrovascular diseases.

Cerebrovascular Disorders↗
PubMed1985

[Speech disorders with localization of the vascular focus in deep structures of the dominant hemisphere of the brain].

The authors present the clinical picture and time-course of aphasia (A) in 25 patients, 18 of whom had had hemorrhagic and 7 ischemic stroke. Dynamic neuropsychological examination and computer-aided tomography (CT) of the brain were carried out. The development of marked and stable A was observed in 20% of the cases. The frequency was higher with brain infarction and lower with cerebral hemorrhage. In 3 cases of deep localization of brain infarction the authors describe a peculiar speech syndrome not observed in other aphasic patients. It was characterized by (1) intactness of mechanisms underlying the realization of speech despite the presence of marked aphasia, (2) greater variability and inconsistence of results of implementation by patients of speech tasks. Clinico-CT correlations gave grounds for explaining the rate and degree of speech recovery, as well as the nature of A with the predominant lesion to some or other deep structures of the left hemisphere of the brain.

Adult↗
PubMed1989

Imaging of brain tissue pH and metabolites. A new approach for the validation of volume-selective NMR spectroscopy.

For the validation of volume-selective 1H and 31P NMR spectroscopy of the brain methods are required that allow high resolution quantitative mapping of tissue pH and metabolites on intact brain slices. The following techniques are proposed for this purpose. Tissue pH is imaged on cryostat sections of in situ frozen brains, using umbelliferone as a fluorescent pH indicator (Csiba et al, Brain Res 289, 334-337 (1983]. Regional tissue ATP content is measured in adjacent cryostat sections, using the luciferine/luciferase system of fireflies for evoking substrate-specific bioluminescence (Kogure and Furones Alonso, Brain Res. 154, 273-284 (1978]. Lactate content is imaged in a similar way by inducing substrate-specific bioluminescence with lactate dehydrogenase and luciferase from vibrio Fischeri (Paschen, J. Cereb. Blood Flow Metab. 5, 609-612 (1985]. The spatial resolution of these techniques is better than 100 mu, as exemplified in experimental brain tumors and brain infarct of cats. The applicability of biochemical mapping for the validation of NMR spectroscopy was tested in a global brain ischemia model of cat by correlating surface coil 31P and 1H spectra with the corresponding regional biochemical data, measured in the sensitive volume of the coil. Correlation coefficients were r = 0.907, 0.852 and 0.924 for pH, lactate and ATP, respectively. These results demonstrate that the biochemical measurements obtained by bioluminescence and fluoroscopic imaging correlate closely with the NMR data and, therefore, are appropriate for the validation of more complex applications, such as volume-selective spectroscopy of brain infarcts or tumors.

Animals↗
PubMed2006

Enhanced connexin 43 immunoreactivity in penumbral areas in the human brain following ischemia.

Astrocytes support neurons not only physically but also chemically by secreting neurotrophic factors and energy substrates. Moreover, astrocytes establish a glial network and communicate through gap junctions in the brain. Connexin 43 (Cx43) is one of major component proteins in astrocytic gap junctions. Heterozygote Cx43 KO mice and astrocyte specific Cx43 KO mice exhibited amplified brain damage after ischemic insults, suggesting a neuroprotective role for astrocytic gap junctions. However, some reports mentioned unfavorable effects of gap junctions in neuronal support. Therefore, the role of astrocytic gap junctions under ischemic condition remains controversial. Since these studies have been performed using animal models, we investigated the Cx43 expression in human brain after stroke. Brain slice sections were prepared from pathological samples in our hospital. Embolic stroke brains sectioned because of the stroke were considered as acute ischemic models. Multiple infarction brains sectioned because of pneumonia or cancer were considered as chronic models. We observed the levels of Cx43 in both lesioned and intact areas, and compared them with acute and chronic models. As the results, astrocytes were strongly activated in penumbral lesions both of acute and chronic ischemic models. The Cx43 immunoreactivity was significantly amplified in the penumbra of chronic model compared to that of the acute model. Neurons were well preserved in chronic model compared to acute model. These findings suggested that the brain may generate neuronal protection by increasing the levels of Cx43 and amplifying the astrocytic gap junctional intercellular communication under hypoxic condition.

Acute Disease↗
PubMed2004

Interregional differences in health in Slovenia. I. Estimated prevalence of selected cardiovascular and related diseases.

AIM: To determine estimates of prevalence of selected cardiovascular and related diseases (myocardial and brain infarction, angina pectoris, hypertension, diabetes, and obesity) in western, central, and eastern regions of Slovenia. METHODS: A national survey on health status and health behavior of the adult population included 15,379 Slovene inhabitants, aged 25-64. The overall response rate to a mailed questionnaire was 63,8%, and finally 9,043 questionnaires were eligible for analysis. The prevalence rates per 100 of population were determined, and chi-square test was used for global assessment of interregional prevalence differences. Logistic regression was carried out for sex and age adjusted assessment. RESULTS: The highest prevalence was confirmed in eastern Slovenia and the lowest in western Slovenia, with the exception of myocardial infarction, whose prevalence was lowest in central Slovenia. Differences were statistically significant for brain infarction (west: 0.5, center: 0.8, east: 1.1; p=0.045), angina pectoris (west: 3.5, center: 5.0, east: 6.9; p<0.001), hypertension (west: 15.6, center: 19.2, east: 20.0; p<0.001), and obesity (west: 12.5, center: 14.1, east: 16.8; p<0.001), but not in myocardial infarction (west: 1.3, center: 1.2, east: 1.5; p=0.583) and diabetes (west: 3.5, center: 4.5, east: 4.6; p=0.097). CONCLUSION: Our study globally confirmed the hypothesis of existence of interregional differences in the prevalence of selected cardiovascular and related diseases.

Adult↗
PubMed2003

Buspirone treatment for apneustic breathing in brain stem infarct.

We report a case of brainstem infarction resulting in apneustic breathing, which was alleviated with buspirone. We discuss apneusis, review the literature, and speculate about the benefit of serotonin 1A receptor agonists in the treatment of apneusis and other respiratory disorders.

Apnea↗
PubMedDate not supplied

[Cerebral infarction--a general-medical problem].

A knowledge of events accompanying the acute coronary failure may help understanding the acute cerebral blood flow insufficiency leading to brain infarction. Cerebral blood flow should be treated as an integral part of the systemic blood circulation. It is of importance when the disease produces lesions to the vascular wall, and the brain looses its autoregulation functions. In such a situation every extracerebral disorders--even slight--may produce extensive lesions to nervous tissue. Therefore, the treatment of the acute cerebral circulation failure requires proper functioning of all factors which may affect hemodynamics and tissue metabolism. Duration of cerebral flow disorders plays an important role in the avoidance of unfavourable complications such as brain infarction. Therefore, every physician is obliged to undertake any possible actions preventing such complications.

Brain↗
PubMed1993

Prediction of specific damage or infarction from the measurement of tissue impedance following repetitive brain ischaemia in the rat.

The development of irreversible brain damage during repetitive periods of hypoxia and normoxia was studied in anaesthetized rats with unilateral occlusion of the carotid artery (modified Levine model). Rats were exposed to 10 min hypoxia and normoxia until severe damage developed. As indices of damage, whole striatal tissue impedance (reflecting cellular water uptake), sodium/potassium contents (due to exchange with blood). Evans Blue staining (blood-brain barrier [BBB] integrity) and silver staining (increased in irreversibly damaged neurons) were used. A substantial decrease in blood pressure was observed during the hypoxic periods possibly producing severe ischaemia. Irreversibly increased impedance, massive changes in silver staining, accumulation of whole tissue Na and loss of K occurred only after a minimum of two periods of hypoxia, but there was no disruption of the BBB. Microscopic examination of tissue sections revealed that cell death was selective with reversible impedance changes, but became massive and non-specific after irreversible increase of the impedance. The development of brain infarcts could, however, not be predicted from measurements of physiological parameters in the blood. We suggest that the development of cerebral infarction during repetitive periods of hypoxia may serve as a model for the development of brain damage in a variety of clinical conditions. Furthermore, the present model allows the screening of potential therapeutic measuring of the prevention and treatment of both infarction and selective cell death.

Animals↗
PubMed2005

Effects of nasogastric tube feeding on serum sodium, potassium, and glucose levels.

PURPOSE: To examine whether significant alterations in serum sodium, potassium, and glucose levels occurred after nasogastric tube feeding with iso-osmolar formula in acute brain infarction patients. DESIGN AND METHODS: Serum sodium, potassium, and glucose levels were analyzed by a retrospective medical record review of 85 nasogastric tube-fed patients. FINDINGS: The mean values of serum sodium and potassium levels on the day before, and 1st, 2nd, and 3rd days of nasogastric feeding were within the normal range. Alterations in the incidence rates of high, normal, and low level of serum sodium and potassium after tube feeding were not statistically significant. The mean blood glucose levels on the day before, and 1st, 2nd, and 3rd days of tube feeding were above normal, and the increase after tube feading was not statistically significant. CONCLUSIONS: Enteral tube feeding using iso-osmolar formula did not significantly alter serum sodium and potassium balance. However, most participants were hyperglycemic before and after tube feeding, indicating that hyperglycemia can be induced in the acute stages of brain infarction regardless of tube feeding.

Acute Disease↗