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Sample records for cerebral vascular disease

  1. Studies on Treatment of Cerebral Vascular Disease with Integrative Medicine

    Institute of Scientific and Technical Information of China (English)

    孙怡; 韩景献; 谢道珍; 李如奎; 高利; 许健鹏

    2003-01-01

    @@Cerebral vascular disease (CVD) also called the cerebral stroke or wind stroke. There are two common types in clinic, that is, thrombotic CVD and hemorrhagic CVD. CVD has both a high incidence rate and a high mortality rate. It has become the most dangerous factor that costs the lives of the urban population in our country. People of different age groups can develop this kind of disease, and the morbidity rate increases dramatically for those middle-aged in recent years. At present, the harms done by CVD to the human heath are more prominent.

  2. Study on the Relationship between Plasma Homocysteine and Acute Cerebral Vascular Disease

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The levels of plasma homocysteine were determined by using high-performance liquid chromatographic method. It was found that plasma homocysteine levels were significantly higher in the patients with stroke than that in the controls. There was no correlation between plasma homocysteine levels and hypertension, smoking, concentrations of blood glucose or hypertriglyceridesemia. It was suggested that hyperhomocysteinemia may be an independent risk factor for acute cerebral vascular disease.

  3. Low Cerebral Glucose Metabolism: A Potential Predictor for the Severity of Vascular Parkinsonism and Parkinson's Disease.

    Science.gov (United States)

    Xu, Yunqi; Wei, Xiaobo; Liu, Xu; Liao, Jinchi; Lin, Jiaping; Zhu, Cansheng; Meng, Xiaochun; Xie, Dongsi; Chao, Dongman; Fenoy, Albert J; Cheng, Muhua; Tang, Beisha; Zhang, Zhuohua; Xia, Ying; Wang, Qing

    2015-11-01

    This study explored the association between cerebral metabolic rates of glucose (CMRGlc) and the severity of Vascular Parkinsonism (VP) and Parkinson's disease (PD). A cross-sectional study was performed to compare CMRGlc in normal subjects vs. VP and PD patients. Twelve normal subjects, 22 VP, and 11 PD patients were evaluated with the H&Y and MMSE, and underwent 18F-FDG measurements. Pearson's correlations were used to identify potential associations between the severity of VP/PD and CMRGlc. A pronounced reduction of CMRGlc in the frontal lobe and caudate putamen was detected in patients with VP and PD when compared with normal subjects. The VP patients displayed a slight CMRGlc decrease in the caudate putamen and frontal lobe in comparison with PD patients. These decreases in CMRGlc in the frontal lobe and caudate putamen were significantly correlated with the VP patients' H&Y, UPDRS II, UPDRS III, MMSE, cardiovascular, and attention/memory scores. Similarly, significant correlations were observed in patients with PD. This is the first clinical study finding strong evidence for an association between low cerebral glucose metabolism and the severity of VP and PD. Our findings suggest that these changes in glucose metabolism in the frontal lobe and caudate putamen may underlie the pathophysiological mechanisms of VP and PD. As the scramble to find imaging biomarkers or predictors of the disease intensifies, a better understanding of the roles of cerebral glucose metabolism may give us insight into the pathogenesis of VP and PD.

  4. Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Scott Paul J

    2005-01-01

    Full Text Available Abstract Background Asthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome. Methods A 5-year retrospective chart analysis was performed investigating 48 children ages 3–18 years with asthma and sickle cell disease and 48 children with sickle cell disease alone. Children were matched for age, gender, and type of sickle cell defect. Hospital admissions were recorded for acute chest syndrome, cerebral vascular accident, vaso-occlusive pain crises, and blood transfusions (total, exchange and chronic. Mann-Whitney test and Chi square analysis were used to assess differences between the groups. Results Children with sickle cell disease and asthma had significantly more episodes of acute chest syndrome (p = 0.03 and cerebral vascular accidents (p = 0.05 compared to children with sickle cell disease without asthma. As expected, these children received more total blood transfusions (p = 0.01 and chronic transfusions (p = 0.04. Admissions for vasoocclusive pain crises and exchange transfusions were not statistically different between cases and controls. SS disease is more severe than SC disease. Conclusions Children with concomitant asthma and sickle cell disease have increased episodes of acute chest syndrome, cerebral vascular accidents and the need for blood transfusions. Whether aggressive asthma therapy can reduce these complications in this subset of children is unknown and requires further studies.

  5. Cerebral cavernous malformations as a disease of vascular permeability: from bench to bedside with caution.

    Science.gov (United States)

    Yadla, Sanjay; Jabbour, Pascal M; Shenkar, Robert; Shi, Changbin; Campbell, Peter G; Awad, Issam A

    2010-09-01

    Tremendous insight into the molecular and genetic pathogenesis of cerebral cavernous malformations (CCMs) has been gained over the past 2 decades. This includes the identification of 3 distinct genes involved in familial CCMs. Still, a number of unanswered questions regarding the process from gene mutation to vascular malformation remain. It is becoming more evident that the disruption of interendothelial junctions and ensuing vascular hyperpermeability play a principal role. The purpose of this review is to summarize the current understanding of CCM genes, associated proteins, and functional pathways. Promising molecular and genetic therapies targeted at identified molecular aberrations are discussed as well.

  6. Vascular Disease Foundation

    Science.gov (United States)

    ... Contact Us Vascular Disease What is Vascular Disease? Education and Awareness Vascular Diseases Abdominal Aortic Aneurysm Aortic Dissection Arteriovenous Malformation Atherosclerosis Buerger's Disease Carotid Artery Disease ...

  7. What Is Vascular Disease?

    Science.gov (United States)

    ... Contact Us Vascular Disease What is Vascular Disease? Education and Awareness Vascular Diseases Abdominal Aortic Aneurysm Aortic Dissection Arteriovenous Malformation Atherosclerosis Buerger's Disease Carotid Artery Disease ...

  8. Transcranial Doppler blood flow measurement during cesarean section in two patients with cerebral vascular disease.

    Science.gov (United States)

    Smiley, R M; Ridley, D M; Hartmann, A; Ciliberto, C F; Baxi, L

    2002-07-01

    We present two cases of neurovascular disease in pregnancy in which transcranial Doppler was used to assess the status of the cerebral circulation during cesarean section under regional anesthesia. One woman had been found to have moyamoya disease, following a series of transient ischemic attacks during her first pregnancy, which ended in spontaneous abortion. On this occasion she was delivered by cesarean section under slowly-induced epidural anesthesia, using ephedrine to maintain the blood pressure, and transcranial Doppler revealed no change in signal in her left middle cerebral artery. Both mother and baby had an uneventful post natal course. The second case involved a primiparous woman with a large arteriovenous malformation that had been detected following generalized seizures, which were treated with valproic acid. Her cesarean section was conducted under spinal anesthesia, and her blood pressure maintained with ephedrine. Again transcranial Doppler revealed no change in signal in her middle cerebral artery during the procedure. We believe this is a potentially useful technique to monitor the cerebral circulation intraoperatively in the presence of cerebrovascular disease.

  9. [Diabetes mellitus and aging as a risk factor for cerebral vascular disease: epidemiology, pathophysiology and prevention].

    Science.gov (United States)

    Cantú-Brito, Carlos; Mimenza-Alvarado, Alberto; Sánchez-Hernández, Juan José

    2010-01-01

    Older patients with diabetes have a high risk of vascular complications. They have an increase of approximately 3 times for developing stroke compared with subjects without diabetes. In addition, up to 75-80% of deaths in diabetic patients are associated with major cardiovascular events including stroke. The risk of stroke is high within 5 years of diagnosis for type 2 diabetes is 9% (mortality 21%), that is more than doubles the rate for the general population. From observational registries in a collaborative stroke study in Mexico, we analyzed clinical data, risk factors, and outcome of 1182 diabetic patients with cerebral ischemia, with focus in elderly subjects. There was a high frequency of hyperglycemia during the acute phase of stroke: the median value was 140 mg/dL and 40% had values higher than 180 mg/dL. Clinical outcome was usually unfavorable in elderly stroke patients with diabetes: case fatality rate was 30% at 30 days and survivors had moderate to severe disability, usually as consequence of the propensity to develop more systemic medical complications during hospital stay. Primary stroke prevention studies in patients with diabetes reveal that tight control of glucose is not associated with reduction in stroke risk. Therefore, proper control of other vascular risk factors is mandatory in patients with diabetes, in particular of arterial hypertension.

  10. Vascular permeability in cerebral cavernous malformations.

    Science.gov (United States)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik B W; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-10-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy.

  11. Analyzing the Correlation between the Level of Serum Markers and Ischemic Cerebral Vascular Disease by Multiple Parameters

    Directory of Open Access Journals (Sweden)

    Laibin Dong

    2015-01-01

    Full Text Available Objective. To explore the serum markers associated with ischemic cerebral vascular disease (ICVD and discuss their diagnostic value. Methods. Two hundred and eighty-eight patients with ICVD and one hundred and eighty healthy persons were enrolled as the case group and the control group, respectively. This paper then carried out the univariate and multivariate logistic regression analyses of their respective levels of serum markers, made combined analysis of related factors, and detected the diagnostic value. Results. Meta-analysis results showed that for ICVD patients the levels of CRP, S-100, TNF-α, HCY, NSE, and IL-6 were higher than those of the healthy persons, while the level of HDL was obviously lower than that of the healthy persons. The multivariate regression analysis indicated that the association between the level of HDL and TNF-α and the occurrence of ICVD was statistically significant (P<0.05. The area under the curves (AUC of receiver operating characteristic (ROC curve of HDL and TNF-α was 0.916, with sensitivity of 90.91% and specificity of 76.47%. Conclusion. HDL has negative correlation with the occurrence of ICVD, while TNF-α was positively correlated with it. The combination test of HDL and TNF-α could raise the accuracy of ICVD diagnosis.

  12. Vascular permeability in cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao;

    2015-01-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observ......Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case......-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability...... correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive...

  13. 视网膜血管异常与脑小血管病%Retinal vascular abnormalities and cerebral small vessel disease

    Institute of Scientific and Technical Information of China (English)

    李華; 吴丹紅

    2014-01-01

    Cerebral small vessel disease is common and is gradually being understood,but it is difficult to visualize directly in the body.The retinal vessels share the similar anatomic,physiological,and embryological characteristics with the cerebral small vessels.Their changes may reflect the changes of cerebral small vessels in a certain extent.Studies in recent years have shown that retinal vascular abnormalities are associated with lacunar infarction and white matter lesions.This article summarizes the research evidence of the correlation of between retinal vascular abnormalities and cerebral small vessel disease.%脑小血管病很常见并逐渐被认识,但在体内很难直接观察.视网膜血管与脑小血管具有相似的解剖学、生理学和胚胎学特征,其改变可能在一定程度上能反映脑小血管改变.近年来的研究显示,视网膜血管异常与腔隙性梗死和脑白质病变相关.文章对视网膜血管异常与脑小血管病相关性的研究证据进行了总结.

  14. Sleep Apnea, Sleep Duration and Brain MRI Markers of Cerebral Vascular Disease and Alzheimer's Disease: The Atherosclerosis Risk in Communities Study (ARIC.

    Directory of Open Access Journals (Sweden)

    Pamela L Lutsey

    Full Text Available A growing body of literature has suggested that obstructive sleep apnea (OSA and habitual short sleep duration are linked to poor cognitive function. Neuroimaging studies may provide insight into this relation.We tested the hypotheses that OSA and habitual short sleep duration, measured at ages 54-73 years, would be associated with adverse brain morphology at ages 67-89 years.Included in this analysis are 312 ARIC study participants who underwent in-home overnight polysomnography in 1996-1998 and brain MRI scans about 15 years later (2012-2013. Sleep apnea was quantified by the apnea-hypopnea index and categorized as moderate/severe (≥15.0 events/hour, mild (5.0-14.9 events/hour, or normal (<5.0 events/hour. Habitual sleep duration was categorized, in hours, as <7, 7 to <8, ≥8. MRI outcomes included number of infarcts (total, subcortical, and cortical and white matter hyperintensity (WMH and Alzheimer's disease signature region volumes. Multivariable adjusted logistic and linear regression models were used. All models incorporated inverse probability weighting, to adjust for potential selection bias.At the time of the sleep study participants were 61.7 (SD: 5.0 years old and 54% female; 19% had moderate/severe sleep apnea. MRI imaging took place 14.8 (SD: 1.0 years later, when participants were 76.5 (SD: 5.2 years old. In multivariable models which accounted for body mass index, neither OSA nor abnormal sleep duration were statistically significantly associated with odds of cerebral infarcts, WMH brain volumes or regional brain volumes.In this community-based sample, mid-life OSA and habitually short sleep duration were not associated with later-life cerebral markers of vascular dementia and Alzheimer's disease. However, selection bias may have influenced our results and the modest sample size led to relatively imprecise associations.

  15. Renovascular hypertension causes cerebral vascular remodeling

    Institute of Scientific and Technical Information of China (English)

    Yamei Tang; Xiangpen Li; Yi Li; Qingyu Shen; Xiaoming Rong; Ruxun Huang; Ying Peng

    2011-01-01

    Renovascular hypertensive rats (RHRs) were developed using the 2-kidney, 2-clip method. All RHRs at 10 weeks displayed high permeability of the cerebral surface blood vessels. Vascular casts of the RHRs showed that the vascular network was sparse. The arterioles of the RHRs at 10 weeks had smaller lumen diameters, but thicker vessel walls with hyalinosis formation compared with control animals. The endothelial cell membrane appeared damaged, and microthrombus formed. After ischemia, the infarction size was larger in RHRs than in control animals. These results suggest that cerebral arterioles in RHRs underwent structural remodeling. High blood pressure may aggravate the severity of brain injury in cerebral ischemia and affect the recovery of ischemia.

  16. [Transcranial electrostimulation in chronic cerebral vascular insufficiency].

    Science.gov (United States)

    Voropaev, A A; Mochalov, A D

    2006-01-01

    The method of transcranial electrostimulation (TCES) has been used for treatment of 68 patients with chronic cerebral vascular insufficiency, stages I and II. A treatment course included 7 daily procedures. The influence of TCES was evaluated clinically, by EEG, transcranial ultrasonic Doppler study and hemodynamic indices in arteries and veins as well as by expression of trait and state anxiety. All the parameters were compared to those of the control group which was treated using conventional methods. TCES resulted in normalization of cerebral vascular reactivity, a decrease of venous circulation disturbances, positive influence on cerebral blood flow and EEG parameters, that corresponded to global improvement of the patients' state, regress of cephalgic syndrome and reduction of trait and state anxiety. The method is simple and safety and can be recommended for wide application including outpatient setting.

  17. Pediatric Stroke: The Importance of Cerebral Arteriopathy and Vascular Malformations

    OpenAIRE

    Beslow, Lauren A.; Jordan, Lori C

    2010-01-01

    Stroke is an important cause of neurologic morbidity in childhood. Population-based estimates of the annual incidence of childhood stroke range from 2 to 13 per 100,000 children. This article will review recent literature on both hemorrhagic and ischemic stroke in children with a focus on cerebral arteriopathy and vascular malformations as stroke risk factors. Additional risk factors include congenital heart disease, sickle cell disease, and hematologic abnormalities among others. Outcomes ar...

  18. Acidente vascular cerebral e demência vascular no idoso

    OpenAIRE

    Ionel, Cristina

    2015-01-01

    Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra. Em consequência de um fenómeno global de envelhecimento populacional, é expectável um aumento na prevalência de demência. A demência vascular é a segunda causa mais comum de demência, depois da doença de Alzheimer. Trata-se de uma entidade clínica bastante heterogénea, sendo o acidente vascular cerebral (AVC) um dos seus mecanismos subjacentes. No entanto, nem todos os doentes ...

  19. iFlow in the auxiliary diagnosis of cerebral vascular disease%iFlow成像辅助诊断脑血管性病变

    Institute of Scientific and Technical Information of China (English)

    黄远亮; 周玉明; 童绥君; 傅建新; 王向东; 姜园

    2011-01-01

    目的 评估iFlow成像在脑血管性病变中的辅助诊断价值.方法对65例脑血管病变患者进行常规全脑2DDSA检查,对所采集的图像用iFlow软件编码,由低年资和高年资医师分别观察2D DSA图像及iFlow彩色编码血流图的血管解剖、病灶形态、大小、血流动力学情况,评估iFlow对脑血管病变是否具有辅助诊断价值.结果 iFlow成像能在一幅iFlow彩色编码血流图上完整显示脑血管DSA采集的动态序列所包含的病变信息,包括病灶的解剖形态、血流动力学变化及组织灌注情况,较2D DSA更加直观.低年资医师和高年资医师对iFlow辅助诊断价值认定的差异有统计学意义(x2=6.032,P=0.014).结论iFlow较单独2D DSA图像显示病变更全面,能对临床医师、尤其是低年资医师诊断和评估脑血管病变提供帮助.%Objective To evaluate the impact of iFlow in the auxiliary diagnosis of cerebral vascular diseases.Methods Totally 65 patients with cerebral vascular diseases underwent whole brain 2D DSA.Then the data were converted to color coded images with iFlow.The vascular anatomy,the shape and size of lesions,the blood dynamics on 2D DSA and iFlow images were evaluated by junior and senior physicians,who then reported whether iFlow images had supplementary diagnosis value.Results iFlow images displayed whole information of lesions more clearly than those of 2D DSA in brain vascular dynamic sequence,including vascular anatomy,hemodynamic changes and tissues perfusions.The evaluation of 2D DSA and iFlow images with junior and senior physicians had statistical difference (x2 =6.032,P=0.014).Conclusion Compared to single DSA,iFlow can facilitate the diagnosis and evaluation of cerebral vascular diseases,especially for junior physicians.

  20. Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral Temporal variation in memory tests performance in cerebral vascular disease patients

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    Tania Fernandes Campos

    2007-01-01

    Full Text Available Buscando adequar a avaliação neuropsicológica à organização temporal do organismo humano, avaliou-se o desempenho em testes de memória em 12 pacientes pós Doença Vascular Cerebral e 12 indivíduos controle, de ambos os sexos, com idade de 45 a 65 anos. Foram aplicados dois testes de memória com estímulos visuais (figuras e dois com estímulos verbais (palavras, em 3 dias consecutivos por semana, às 08:00, 10:00 e 12:00 h na primeira semana e às 14:00 e 16:00 h na seguinte. Os pacientes apresentaram menor número de acertos do que os indivíduos controle em todos os testes aplicados (pThis study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures and two with verbal stimuli (words were applied three times a day (08:00, 10:00 and 12:00 h during the first week and twice a day (14:00 and 16:00 h in the second week, during three consecutive days in two consecutive weeks. The patients showed lower scores than control subjects in all applied tests (p<0,05. The greater test sensitivity was at 14:00 h for the free recall test and at 16:00 h for recognition tests. According to these results, it is concluded that neuropsychological evaluations should be conducted preferably in the afternoon, as well for the first evaluation as for the re-evaluations.

  1. Value of cerebral perfusion and vascular reserve for the treatment of symptomatic intracranial arterial stenosis

    Institute of Scientific and Technical Information of China (English)

    Li'an Huang; Xuewen Song; Anding Xu

    2008-01-01

    BACKGROUND: It is crucial to understand cerebral perfusion and vascular reserve in stegnotic arterial blood-supply regions to treat ischemic cerebrovascular diseases. However, effects on symptomatic intracrani-al arterial stenosis (SICAS) need to be further studied in additional applications. OBJECTIVE: To evaluate and summarize the effects of cerebral perfusion and vascular reserve on the treatment of SICAS. RETRIEVAL STRATEGY: A computer-based online search of English language publications from January 2000 to July 2007 was conducted in PubMed to identify publications that addressed cerebral perfusion and vascular reserve of SICAS. Search key words were "intracranial stenosis, perfusion, brain reserve". Relevant data were also searched with the China Journal Net, using the same key words in Chinese from January 2000 to January 2007. In total, 101 articles were retrieved. Inclusion criteria: ① Articles describing the current status for the diagnosis and treatment of SICAS; ② Articles concerning research developments of cerebral perfusion and vascular reserve of SICAS. Exclusion criteria: duplicated articles. LITERATURE EVALUATION: This study included 21 articles of experimental studies and conference re-ports.DATA SYNTHESIS: When performing interventional surgery in SICAS patients, it is important to under-stand cerebral perfusion and vascular reserve in addition to knowing the clinical symptoms and degrees of arterial stenosis. In recent years, there are a growing number of reports on measurements of vascular reserve through the use of magnetic resonance perfusion imaging (MR-PWI). Investigations demonstrate cerebral perfusion and vascular reserve decrease in many SICAS patients. Many studies show that both improve after surgical intervention. CONCLUSION: Cerebral perfusion could provide direct evidence of whether ischemia has occurred in the brain. Because of lateral circulation and cerebral vascular reserve, intracranial vascular stenosis and/or decreased

  2. Acidente vascular cerebral e outras complicações do sistema nervoso central nas doenças falciformes Stroke and other vascular complications of the central nervous system in sickle cell disease

    Directory of Open Access Journals (Sweden)

    Ivan L. Angulo

    2007-09-01

    Full Text Available A principal complicação da doença falciforme na infância é a das artérias cerebrais, mas após os 20 anos também pode se manifestar, como seqüela de lesões anteriores ou neoformadas. A vasculopatia tem a maior importância no desenvolvimento da criança e na qualidade de vida. Além do acidente vascular cerebral completo ou incompleto ("silencioso", existem outras complicações do sistema nervoso central, porém não exclusivas. O diagnóstico da vasculopatia cerebral falciforme necessita auxílio neurorradiológico. O tratamento se faz basicamente com transfusões de eritrócitos contendo hemoglobina A. O objetivo deste trabalho é rever a literatura médica, procurando selecionar a melhor conduta em diagnóstico e tratamento que seja possível empregar de imediato, para reduzir a morbidade e mortalidade da vasculopatia cerebral e elevar a qualidade de vida dos pacientes, principalmente na infância. Os fatores de risco clínicos e laboratoriais, incluindo a triagem por ultra-sonografia Doppler das artérias cerebrais e imagens de ressonância magnética, devem influenciar a decisão de instituir transfusões crônicas e a quelação do ferro transfusional deve acompanhar este tratamento.In children with sickle cell disease, cerebral arteries are prone to lesions that may cause deficiencies and poor quality of life. After the age of 20, new lesions may also occur. Besides stroke and silent cerebral ischemia, other lesions may occur. Radiologic images are necessary to diagnose and blood transfusions to treat. We reviewed the literature to choose best practices and guidelines to reduce morbidity and mortality and improve the quality of life of children with sickle cell disease. Risk factors identified from clinical and laboratory data and screening by Doppler ultrasonography and magnetic resonance must be used in order to make decisions about transfusion and iron chelation therapy.

  3. 血尿酸与脑血管病关系初探%A Study of the Relation between Serum Uric Acid and Cerebral Vascular Disease

    Institute of Scientific and Technical Information of China (English)

    谭来勋; 刘志超; 龙庆红

    2001-01-01

    To study the relation between the level of serum uric acid and cerebral vascular disease.Methods:The level of serum uric acid was investigated in 120 patients with acute cerebral vascular disease. Results:Patients with high uric acid level were more obese and likely to have a history of MI stroke and hypetrension(P<0.001).Furthermore, they had higher levels of serum creation,total cholesterol and total triglycerides and lower levels of LDL cholesterol,HDL cholesterol and serum glucose (P<0.001).High uric acid level was associated with the severity and outcome prognosis (P<0.05,0.005).Conclusion:Hyperuricemia is a strong predictor of stroke events and serum uric acid level is helpful in evaluating the severity and the outcome.%目的:探讨血尿酸与脑血管病的关系。方法:分析120例脑血管病患者临床资料及血尿酸含量。结果:高尿酸血症患者肥胖、有心肌梗塞史、脑卒中史、高血压病吏者较多(P<0.001),血肌酐、总胆固醇、总甘油三脂水平较高(P<0.001);而低密度脂蛋白胆固醇和高密度脂蛋白胆固醇水平、血糖水平较低(P<0.001);尿酸水平与病情、预后有关(P<0.01,0.005)。结论:高尿酸血症是脑血管危险因素;测定血尿酸含量有利于判断病情及评估预后。

  4. Pediatric neuroradiology: Cerebral and cranial diseases

    Energy Technology Data Exchange (ETDEWEB)

    Diebler, C.; Dulac, O.

    1987-01-01

    In this book, a neuroradiologist and a neuropediatrician have combined forces to provide the widest possible knowledge in investigating cranial and cerebral disorders in infancy and childhood. Based on more than 20,000 pediatric CT examinations, with a follow-up time often exceeding ten years, the book aims to bridge interdisciplinary gaps and help radiologists, pediatricians and neurosurgeons solve the various problems of pediatric neuroradiology that frequently confront them. For each disease, the etiology, clinical manifestation, pathological lesions and radiological presentations are discussed, supported by extensive illustrations. Malformative, vascular, traumatic, tumoral, infectious and metabolic diseases are reviewed. Miscellaneous conditions presenting particular symptoms or syndromes are also studied, such as hydrocephalus and neurological complications of leukemia. Contents: Cerebral and cranial malformations; neurocutaneous syndromes; inherited metabolic diseases; infectious diseases - vascular disorders; intracranial tumors; cranial trauma - miscellaneous and subject index.

  5. Investigation of Sleep Quality and Correlation Factors of Acute Cerebral Vascular Disease%急性脑血管病患者睡眠质量和相关因素分析

    Institute of Scientific and Technical Information of China (English)

    梅川; 王真真; 钟伟丽; 牛富生

    2012-01-01

    目的 研究急性脑血管病患者的睡眠质量和相关因素.方法 对急性脑血管病组和健康对照组进行匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQl)量表测定,比较两组的各项分值差异;进一步对急性脑血管患者进行艾森克人格特征问卷(Eysenck personality questionaire,EPQ)和简易应对方式问卷调查,并与患者的PSQl进行相关分析.结果 急性脑血管病患者PSQl平均得分13.12±2.73分,PSQl>7分者126例(54.07%).急性脑血管病组患者睡眠质量、入睡时间、睡眠时间、睡眠障碍、睡眠药物、日间功能和睡眠质量指数得分均明显高于对照组患者,差异有显著性(P均<0.001).Logistic回归分析显示,增龄、左侧病变、前循环病变是影响急性脑血管病患者睡眠质量的独立危险因素,同时急性脑血管病患者的睡眠质量与患者个性特点和积极、消极应对分值具有相关性.结论 急性脑血管病患者睡眠障碍发生率较高,其睡眠质量受年龄、左右侧别、病变血管、个性特点和应对方式等多个因素的影响.%Objective To study the sleep quality and correlation factors in acute cerebral vascular disease. Methods Two hundred and thirty-three acute cerebral vascular disease patients were evaluated by Pittsburgh sleep quality index(PSQI), Eysenck personality questionaire(EPQ) and simplified coping style questionaire. One hundred and eighty-nine persons of normal control group were evaluated by PSQI. Results The average score of PSQI of the acute cerebral vascular disease patients was 13.12±2.73, and the incidence of sleep disorder(total PSQI score>7 points) was 54.07%. There was significant difference(P<0.001) between the acute cerebral vascular disease patients and the control group in the score of the sleep index and six factors of PSQI. The result of logistic regression analysis indicates that age, diseased region and criminal blood vessel were independently

  6. Pathogenesis of diabetic cerebral vascular diseasecomplication

    Institute of Scientific and Technical Information of China (English)

    Ren-Shi Xu

    2015-01-01

    Diabetes mellitus is one of the most potent independentrisk factors for the development of diabetic cerebralvascular disease (CVD). Many evidences suggested thathyperglycemia caused excess free fatty acids, the lossof endothelium-derived nitric oxide, insulin resistance,the prothrombotic state, endothelial dysfunction,the abnormal release of endothelial vasoactivators,vascular smooth muscle dysfunction, oxidative stress,and the downregulation of miRs participated in vesselgeneration and recovery as well as the balance ofendotheliocytes. In turn, these abnormalities, mainly viaphosphatidylinositol 3 kinase, mitogen-activated proteinkinase, polyol, hexosamine, protein kinase C activation,and increased generation of advanced glycosylation endproducts pathway, play an important role in inducingdiabetic CVD complication. A deeper comprehensionof pathogenesis producing diabetic CVD could offerbase for developing new therapeutic ways preventingdiabetic CVD complications, therefore, in the paper wemainly reviewed present information about the possiblepathogenesis of diabetic CVD complication.

  7. 脑小血管病与血管性认知功能障碍的关系%Relationship between Cerebral Small Vessel Disease and Vascular Cognitive Impairment

    Institute of Scientific and Technical Information of China (English)

    何敏; 朱晓钢

    2015-01-01

    主要简述脑小血管病(cerebral small vessel disease,SVD)与血管性认知功能障碍(vascular cognitive impair-ment,VCI)的关系。SVD 包括腔隙性脑梗死、脑微出血、脑白质病变或脑白质疏松三种类型,三者均与 VCI 密切相关,均可导致认知功能下降。因 SVD 起病隐袭,在临床工作中常被忽略,早发现、早干预 SVD 对预防 VCI 至关重要。%ABSTRACT:This paper reviews the relationship between cerebral small vessel disease (SVD)and vas-cular cognitive impairment (VCI).SVD includes lacunar infarction,cerebral microbleeds,and white mat-ter lesions or leukoaraiosis.The three types of SVD are closely correlated with VCI and can result in cog-nitive decline.Because of the insidious onset,SVD is often neglected in the clinical work.Therefore,early detection and intervention of SVD are very important for the prevention of VCI.

  8. Arterioles in cerebral amyloid angiopathy and vascular dementia

    Institute of Scientific and Technical Information of China (English)

    ZHU Guang-ming; ZHANG Wei-wei; LIU Ying; LI Juan

    2009-01-01

    Background Small cerebrovascular lesions are one of the most important factors in cerebral amyloid angiopathy (CM) and vascular dementia (VaD). We analyzed the difference of arteriolar pathology between CM patients (CMs) and vascular dementia patients without CAA (VaDs).Methods Ten deceased CMs and twelve deceased VaDs were available for this study. Five deceased patients without known cerebrovascular diseases served as controls. These patients were all autopsy cases. All transversely cut arterioles in the gray matter and white matter with an external diameter equal to or larger than 30 μm and with a maximum of 300 μm were examined. The internal and external diameters of arterioles were measured. Results The external diameter of gray matter arterioles in the CAAs was significantly greater than in controls. In gray matter arterioles, the diameter of the lumen in VaDs was markedly smaller than in the CAAs, whereas there was no significant difference between CAAs and controls. CMs and VaDs may cause remarkable thickening of the arteriolar walls in either white matter or gray matter. The sclerotic index of arterioles in VaDs was significantly greater than in CAAs and controls. Conclusions Stenosis of arterioles occurred in both CM and VaD, but the tendency was greater in VaD. Arterioles of CM were also expanded in gray matter, which may be related to lobar hemorrhage. The loss and/or degeneration of vascular smooth muscle cells was predominant in CM, while the over-proliferation of vascular smooth muscle cells was greater in VaD.

  9. Demographic features and neuropsychological correlates in a cohort of 200 patients with vascular cognitive decline due to cerebral small vessel disease

    Directory of Open Access Journals (Sweden)

    Thomas Gregor Issac

    2016-01-01

    Full Text Available Introduction: Vascular dementia is the second most common form of dementia and is potentially reversible. Small vessel disease (SVD closely mimics degenerative dementia in view of its sub-acute onset and progressive course. Therefore, unlike large vessel disease, Hachinski Ischemic scale score may not always reflect vascular cognitive decline resulting in diagnostic and therapeutic confusions. Therefore, there is a need for detailed neuropsychological assessment for various cognitive domains for early identification of vascular cognitive decline as it carries a very good long term prognosis for cognitive morbidity, unlike degenerative dementias. Patients and Methods: This prospective study involves thorough domain based neuropsychological assessment of patients with a radiological diagnosis of SVD involving the following parameters-digit forward and backward, category fluency, color trails, stick test, logical memory test, and bender gestalt test. Magnetic resonance imaging scans done using 3-tesla machines and SVD graded using Fazekas visual scale. Results: The mean Hachinskis score was less sensitive for differentiating vascular dementia from degenerative dementia. However, the domain based neuropsychological scores were highly sensitive showing statistically significant impairment in all 6 domains tested and compared with Fazekas 1-3 grades in imaging. Discussion and Conclusion: This study aimed at establishing an early diagnosis of vascular mild cognitive impairment using domain wise neuropsychological testing and correlating it with radiological scores. Hachinskis score is more sensitive for large vessel disease in view of acute onset and step-like progression as against steady progression in SVD. However, domain-wise testing was highly sensitive in identifying early cognitive impairment in patients with SVD, and early therapeutic interventions are highly rewarding.

  10. Cerebral vascular control and metabolism in heat stress

    DEFF Research Database (Denmark)

    Bain, Anthony R; Nybo, Lars; Ainslie, Philip N

    2015-01-01

    in cerebral oxygen extraction. However, severe increases in whole-body and brain temperature may increase blood-brain barrier permeability, potentially leading to cerebral vasogenic edema. The cerebrovascular challenges associated with hyperthermia are of paramount importance for populations with compromised......This review provides an in-depth update on the impact of heat stress on cerebrovascular functioning. The regulation of cerebral temperature, blood flow, and metabolism are discussed. We further provide an overview of vascular permeability, the neurocognitive changes, and the key clinical...... implications and pathologies known to confound cerebral functioning during hyperthermia. A reduction in cerebral blood flow (CBF), derived primarily from a respiratory-induced alkalosis, underscores the cerebrovascular changes to hyperthermia. Arterial pressures may also become compromised because of reduced...

  11. Association factor analysis between osteoporosis with cerebral artery disease

    Science.gov (United States)

    Jin, Eun-Sun; Jeong, Je Hoon; Lee, Bora; Im, Soo Bin

    2017-01-01

    Abstract The purpose of this study was to determine the clinical association factors between osteoporosis and cerebral artery disease in Korean population. Two hundred nineteen postmenopausal women and men undergoing cerebral computed tomography angiography were enrolled in this study to evaluate the cerebral artery disease by cross-sectional study. Cerebral artery disease was diagnosed if there was narrowing of 50% higher diameter in one or more cerebral vessel artery or presence of vascular calcification. History of osteoporotic fracture was assessed using medical record, and radiographic data such as simple radiography, MRI, and bone scan. Bone mineral density was checked by dual-energy x-ray absorptiometry. We reviewed clinical characteristics in all patients and also performed subgroup analysis for total or extracranial/ intracranial cerebral artery disease group retrospectively. We performed statistical analysis by means of chi-square test or Fisher's exact test for categorical variables and Student's t-test or Wilcoxon's rank sum test for continuous variables. We also used univariate and multivariate logistic regression analyses were conducted to assess the factors associated with the prevalence of cerebral artery disease. A two-tailed p-value of less than 0.05 was considered as statistically significant. All statistical analyses were performed using R (version 3.1.3; The R Foundation for Statistical Computing, Vienna, Austria) and SPSS (version 14.0; SPSS, Inc, Chicago, Ill, USA). Of the 219 patients, 142 had cerebral artery disease. All vertebral fracture was observed in 29 (13.24%) patients. There was significant difference in hip fracture according to the presence or absence of cerebral artery disease. In logistic regression analysis, osteoporotic hip fracture was significantly associated with extracranial cerebral artery disease after adjusting for multiple risk factors. Females with osteoporotic hip fracture were associated with total calcified

  12. Sublingual Microvascular Changes in Patients With Cerebral Small Vessel Disease

    NARCIS (Netherlands)

    M. Khalilzada; K. Dogan; C. Ince; J. Stam

    2011-01-01

    Background and Purpose-It is unknown whether changes in cerebral small vessel disease (SVD) are limited to the brain or part of a generalized vascular disorder. Methods-We examined the sublingual microcirculation of 10 healthy controls, 10 patients with large vessel disease, and 8 with SVD, with sid

  13. Cerebral microvascular amyloid beta protein deposition induces vascular degeneration and neuroinflammation in transgenic mice expressing human vasculotropic mutant amyloid beta precursor protein.

    NARCIS (Netherlands)

    Miao, J.; Xu, F.; Davis, J.; Otte-Holler, I.; Verbeek, M.M.; Nostrand, W.E. van

    2005-01-01

    Cerebral vascular amyloid beta-protein (Abeta) deposition, also known as cerebral amyloid angiopathy, is a common pathological feature of Alzheimer's disease. Additionally, several familial forms of cerebral amyloid angiopathy exist including the Dutch (E22Q) and Iowa (D23N) mutations of Abeta. Incr

  14. Role of Mitochondria in Cerebral Vascular Function: Energy Production, Cellular Protection, and Regulation of Vascular Tone.

    Science.gov (United States)

    Busija, David W; Rutkai, Ibolya; Dutta, Somhrita; Katakam, Prasad V

    2016-06-13

    Mitochondria not only produce energy in the form of ATP to support the activities of cells comprising the neurovascular unit, but mitochondrial events, such as depolarization and/or ROS release, also initiate signaling events which protect the endothelium and neurons against lethal stresses via pre-/postconditioning as well as promote changes in cerebral vascular tone. Mitochondrial depolarization in vascular smooth muscle (VSM), via pharmacological activation of the ATP-dependent potassium channels on the inner mitochondrial membrane (mitoKATP channels), leads to vasorelaxation through generation of calcium sparks by the sarcoplasmic reticulum and subsequent downstream signaling mechanisms. Increased release of ROS by mitochondria has similar effects. Relaxation of VSM can also be indirectly achieved via actions of nitric oxide (NO) and other vasoactive agents produced by endothelium, perivascular and parenchymal nerves, and astroglia following mitochondrial activation. Additionally, NO production following mitochondrial activation is involved in neuronal preconditioning. Cerebral arteries from female rats have greater mitochondrial mass and respiration and enhanced cerebral arterial dilation to mitochondrial activators. Preexisting chronic conditions such as insulin resistance and/or diabetes impair mitoKATP channel relaxation of cerebral arteries and preconditioning. Surprisingly, mitoKATP channel function after transient ischemia appears to be retained in the endothelium of large cerebral arteries despite generalized cerebral vascular dysfunction. Thus, mitochondrial mechanisms may represent the elusive signaling link between metabolic rate and blood flow as well as mediators of vascular change according to physiological status. Mitochondrial mechanisms are an important, but underutilized target for improving vascular function and decreasing brain injury in stroke patients. © 2016 American Physiological Society. Compr Physiol 6:1529-1548, 2016.

  15. Cerebral vascular accident: some characteristics of occupational therapy evaluation forms.

    Science.gov (United States)

    Ottenbacher, K

    1980-04-01

    To determine areas most commonly evaluated by occupational therapists and to ascertain methods in which evaluative information is gathered, 35 evaluation forms currently employed by occupational therapists to assess dysfunction in patients with cerebral vascular accident were collected. Five general areas including motor function, sensory deficit, hadn function, activities of daily living, and visual perception were found to be most frequently listed on the forms. These areas were divided into sub areas to operationally define the information collected. Analysis revealed that the level of measurement most frequently employed by therapists to record evaluate findings was the descriptive level. There was a tendency to collect data at "higher" or more sophisticated levels of measurement in those areas evaluated most frequently. The findings are discussed in relation to professional competency concerns and the need to develop unique occupational therapy evaluative instruments for areas of practice such as cerebral vascular accident.

  16. Acupuncture Treatment of Depressive Syndromes after Cerebral Vascular Accidents

    Institute of Scientific and Technical Information of China (English)

    王海荣

    2002-01-01

    @@ Depressive syndrome is a common complication in cerebral vascular accidents (CVA), which accounts for 70% of the complications. A mild case of the syndrome is marked by grief, sleeping disturbance, weakened mental activities, worry, loss of interest, and irritability. A severe case may have worse symptoms and signs, except the above mentioned ones, such as anxiety, reduced appetite, hallucination, delusion, desperation, etc. The author has adopted acupuncture to treat depressive syndromes after CVA with good therapeutic result as reported in the following.

  17. Peripheral Vascular Disease

    Science.gov (United States)

    ... Murmurs High Blood Pressure (Hypertension) Infective Endocarditis Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  18. Evaluation of computer tomography in cerebro-vascular disease (Strokes)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Sik; Baek, Seung Yon; Rhee, Chung Sik; Kim, Hee Seup [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1984-06-15

    Most of cerebrovascular disease are composed of vascular occulusive changes and hemorrhage. Now a day, the computed tomography is the best way for evaluation of cerebrovascular disease including detection of nature, location, and associated changes. This study includes evaluation of computed tomography of 70 patients with cerebrovascular disease during the period of 10 months from April. 1983 to Feb. 1984 in Department of Radiology, Ewha Womans University Hospital. The results were as follows: 1. Age distribution of the total 70 patients was broad ranging from 25 years to 79 years. 78.6% of patients were over the age of 50. The male and female sex ratio was 1.4:1. 2. 4 out of 70 patients were normal and 66 patients revealed abnormal on C.T. findings; those were intracranial hemorrhage (28 patients), cerebral infarction (34 patients) and brain atrophy (4 patients). 3. In cases of cerebral infarction, the cerebral hemisphere was most common site of lesion (28 cases), and next was basal ganglia (2 cases). Most of the infarcts in cerebral hemisphere were located in the parietal and temporal lobes. 4. In cases of intracranial hemorrhage, the basal ganglia was most common site of lesion (15 cases). The next common site was cerebral hemisphere (9 cases). 6 patients of all intracranial hemorrhage were combined with intraventricular hemorrhage. Ratio of right and left was 2:3. 5. In patients with motor weakness or hemiparesis, more common findings on CT scan were cerebral infarction. In case with hemiplegia, more common CT findings were intracerebral hemorrhage. 6. Of the 40 cases thought to be cerebral infarction initially by clinical findings and spinal tap. 8 cases (20.0%) were proved to be cerebral hemorrhage by the CT scan. However, of the 22 cases thought to be cerebral hemorrhage, initially, only two cases (9.0%) were cerebral infarction.

  19. Interactive effects of vascular risk burden and advanced age on cerebral blood flow

    Directory of Open Access Journals (Sweden)

    Katherine eBangen

    2014-07-01

    Full Text Available Vascular risk factors and cerebral blood flow (CBF reduction have been linked to increased risk of cognitive impairment and Alzheimer’s disease (AD; however the possible moderating effects of age and vascular risk burden on CBF in late life remain understudied. We examined the relationships among elevated vascular risk burden, age, CBF, and cognition. Seventy-one non-demented older adults completed an arterial spin labeling MR scan, neuropsychological assessment, and medical history interview. Relationships among vascular risk burden, age, and CBF were examined in a priori regions of interest (ROIs previously implicated in aging and AD. Interaction effects indicated that, among older adults with elevated vascular risk burden (i.e., multiple vascular risk factors, advancing age was significantly associated with reduced cortical CBF whereas there was no such relationship for those with low vascular risk burden (i.e., no or one vascular risk factor. This pattern was observed in cortical ROIs including medial temporal (hippocampus, parahippocampal gyrus, uncus, inferior parietal (supramarginal gyrus, inferior parietal lobule, angular gyrus, and frontal (anterior cingulate, middle frontal gyrus, medial frontal gyrus cortices. Furthermore, among those with elevated vascular risk, reduced CBF was associated with poorer cognitive performance. Such findings suggest that older adults with elevated vascular risk burden may be particularly vulnerable to cognitive change as a function of CBF reductions. Findings support the use of CBF as a potential biomarker in preclinical AD and suggest that vascular risk burden and regionally-specific CBF changes may contribute to differential age-related cognitive declines.

  20. Bobath、Brunnstrom、Rood及PNF技术对脑血管病迟缓期的康复疗效观察%Efficacy Observation on Bobath, Brunnstrom, Rood and PNF Technique on Rehabilitation of Cerebral Vascular Diseases in Lag Phase

    Institute of Scientific and Technical Information of China (English)

    黄妃凤; 朱炯端; 谭明芳; 孙芳; 成晓霞

    2014-01-01

    目的:观察Bobath技术、Brunnstrom技术、Rood技术及PNF技术对脑血管病迟缓期的康复疗效。方法:85例患者随机分为Bobath技术组、Rood技术组、Brunnstrom技术组、PNF技术组和对照组,五组均接受基础治疗至迟缓期结束,四组技术组分别予以相应的康复技术,治疗前后采用FMA、MBI进行康复评定,并记录迟缓期持续的时间。结果:治疗后五组患者FMA、MBI评分均较治疗前显著升高(P<0.05),且四组技术组MBI评分均显著高于对照组(P<0.05);四组技术组迟缓期持续时间均显著少于对照组(P<0.05)。结论:脑血管病迟缓期患者早期介入Bobath技术、Brunnstrom技术、Rood技术或PNF技术均可缩短迟缓期持续时间,促进患者肢体功能恢复,提高日常生活活动能力;且四种康复技术对脑血管病迟缓期患者的康复疗效相当,可康复治疗中灵活运用。%Objective:To study the rehabilitation efficacy of Bobath, Brunnstrom, Rood and PNF technique on rehabilitation of cerebral vascular dis-eases in lag phase. Methods:85 patients were randomly divided into Bobath group, Rood group, Brunnstrom group, PNF group and control group, five groups received basic treatment until the lag phase ended, four technique groups with corresponding rehabilitation technology, rehabilitation evaluation was made before and after treatment with FMA and MBI, and the duration of lag phase was recorded. Results:The FMA、MBI scores of five groups after treatment were all significantly higher than those before treatment (P<0.05);MBI scores of four technique group were all signifi-cantly higher than that of control group (P<0.05);duration of lag phase of four technique group were all significantly lower than that of control group (P<0.05). Conclusion:Cerebral vascular disease of lag phase with early intervention of Bobath, Brunnstrom, Rood and PNF technique can shorten duration of lag phase, promote the limb

  1. Vascular risk factors, atherosclerosis, cerebral white matter lesions and cerebral perfusion in a population-based study

    Energy Technology Data Exchange (ETDEWEB)

    Claus, J.J. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Breteler, M.M.B. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Hasan, D. [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Krenning, E.P. [Dept. of Nuclear Medicine, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Bots, M.L. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Grobbee, D.E. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Swieten, J.C. van [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Harskamp, F. van [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Hofman, A. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands)

    1996-06-01

    We studied risk factors for cerebral vascular disease (blood pressure and hypertension, factor VIIc, factor VIIIc, fibrinogen), indicators of atherosclerosis (intima-media thickness and plaques in the carotid artery) and cerebral white matter lesions in relation to regional cerebral blood flow (rCBF) in 60 persons (aged 65-85 years) recruited from a population-based study. rCBF was assessed with single-photon emission tomography using technetium-99m d,l-hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO). Statistical analysis was performed with multiple linear regression with adjustment for age, sex and ventricle-to-brain ratio. A significant positive association was found between systolic and diastolic blood pressure and temporo-parietal rCBF. In analysis with quartiles of the distribution, we found a threshold effect for the relation of low diastolic blood pressure ({<=}60 mmHg) and low temporo-parietal rCBF. Levels of plasma fibrinogen were inversely related to parietal rCBF, with a threshold effect of high fibrinogen levels (>3.2 g/l) and low rCBF. Increased atherosclerosis was related to low rCBF in all cortical regions, but these associations were not significant. No consistent relation was observed between severity of cerebral white matter lesions and rCBF. Our results may have implications for blood pressure control in the elderly population. (orig.)

  2. Altered cerebral vascular volumes and solute transport at the blood-brain barriers of two transgenic mouse models of Alzheimer's disease.

    Science.gov (United States)

    Do, Tuan Minh; Alata, Wael; Dodacki, Agnès; Traversy, Marie-Thérèse; Chacun, Hélène; Pradier, Laurent; Scherrmann, Jean-Michel; Farinotti, Robert; Calon, Frédéric; Bourasset, Fanchon

    2014-06-01

    We evaluated the integrity and function of the blood-brain barrier in 3xTg-AD mice aged 3-18 months and in APP/PS1 mice aged 8-months to determine the impacts of changes in amyloid and tau proteins on the brain vascular changes. The vascular volume (Vvasc) was sub-normal in 3xTg-AD mice aged from 6 to 18 months, but not in the APP/PS1 mice. The uptakes of [(3)H]-diazepam by the brains of 3xTg-AD, APP/PS1 and their age-matched control mice were similar at all the times studied, suggesting that the simple diffusion of small solutes is unchanged in transgenic animals. The uptake of d-glucose by the brains of 18-month old 3xTg-AD mice, but not by those of 8-month old APP/PS1 mice, was reduced compared to their age-matched controls. Accordingly, the amount of Glut-1 protein was 1.4 times lower in the brain capillaries of 18 month-old 3xTg-AD mice than in those of age-matched control mice. We conclude that the brain vascular volume is reduced early in 3xTg-AD mice, 6 months before the appearance of pathological lesions, and that this reduction persists until they are at least 18 months old. The absence of alterations in the BBB of APP/PS1 mice suggests that hyperphosphorylated tau proteins contribute to the vascular changes that occur in AD.

  3. Impact of Endothelial Microparticles on Coagulation, Inflammation, and Angiogenesis in Age-Related Vascular Diseases

    Directory of Open Access Journals (Sweden)

    Margaret Markiewicz

    2013-01-01

    Full Text Available Endothelial microparticles (EMPs are complex vesicular structures that originate from plasma membranes of activated or apoptotic endothelial cells. EMPs play a significant role in vascular function by altering the processes of inflammation, coagulation, and angiogenesis, and they are key players in the pathogenesis of several vascular diseases. Circulating EMPs are increased in many age-related vascular diseases such as coronary artery disease, peripheral vascular disease, cerebral ischemia, and congestive heart failure. Their elevation in plasma has been considered as both a biomarker and bioactive effector of vascular damage and a target for vascular diseases. This review focuses on the pleiotropic roles of EMPs and the mechanisms that trigger their formation, particularly the involvement of decreased estrogen levels, thrombin, and PAI-1 as major factors that induce EMPs in age-related vascular diseases.

  4. Cerebral cavernous malformations proteins inhibit Rho kinase to stabilize vascular integrity.

    Science.gov (United States)

    Stockton, Rebecca A; Shenkar, Robert; Awad, Issam A; Ginsberg, Mark H

    2010-04-12

    Endothelial cell-cell junctions regulate vascular permeability, vasculogenesis, and angiogenesis. Familial cerebral cavernous malformations (CCMs) in humans result from mutations of CCM2 (malcavernin, OSM, MGC4607), PDCD10 (CCM3), or KRIT1 (CCM1), a Rap1 effector which stabilizes endothelial cell-cell junctions. Homozygous loss of KRIT1 or CCM2 produces lethal vascular phenotypes in mice and zebrafish. We report that the physical interaction of KRIT1 and CCM2 proteins is required for endothelial cell-cell junctional localization, and lack of either protein destabilizes barrier function by sustaining activity of RhoA and its effector Rho kinase (ROCK). Protein haploinsufficient Krit1(+/-) or Ccm2(+/-) mouse endothelial cells manifested increased monolayer permeability in vitro, and both Krit1(+/-) and Ccm2(+/-) mice exhibited increased vascular leak in vivo, reversible by fasudil, a ROCK inhibitor. Furthermore, we show that ROCK hyperactivity occurs in sporadic and familial human CCM endothelium as judged by increased phosphorylation of myosin light chain. These data establish that KRIT1-CCM2 interaction regulates vascular barrier function by suppressing Rho/ROCK signaling and that this pathway is dysregulated in human CCM endothelium, and they suggest that fasudil could ameliorate both CCM disease and vascular leak.

  5. Research progress of cerebral small vessel disease

    Directory of Open Access Journals (Sweden)

    Jun-dong JIA

    2015-03-01

    Full Text Available Cerebral small vessel disease refers to a group of pathological processes with various etiologies that affect small arteries, arterioles, venules, and capillaries of the brain. Recently, the researches of cerebral small vessel disease have got initial progressions, and a definite diagnosis of this disease is comfirmed by biopsy. Given the pathological material is difficult to obtain, clinicians should pay more attention to the imaging features and clinical manifestations. Correct understanding of imaging and clinical manifestations contributes to the early identification of cerebral small vessel disease. Herein, an overview is provided on the present status, common imaging features, pathogenesis, clinical manifestations and treatment of cerebral small vessel disease. DOI: 10.3969/j.issn.1672-6731.2015.02.003

  6. Analysis of risk factors of cerebral vascular disease in maternal women%孕产妇发生脑血管病危险因素分析

    Institute of Scientific and Technical Information of China (English)

    张荣绶

    2010-01-01

    目的 探讨孕产妇发生脑血管病的危险因素,预防及降低脑血管病对孕产妇的危害.方法 选择合并脑血管病的孕产妇16例以及健康孕产妇30例,通过Logistic回归分析方法筛选与孕产妇脑血管病发生相关的危险因素.结果 孕产妇发生脑血管病的危险因素主要包括电解质紊乱、未进行产前检查、妊娠期高血压疾病以及妊娠期或产褥期感染;其中妊娠期高血压疾病以及妊娠期或产褥期感染是独立危险因素.结论 妊娠期高血压疾病和感染与孕产妇合并脑血管病关系密切,重视并预防危险因素的发生是降低孕产妇因脑血管病死亡的的重要措施.%Objective To investigate risk factors related to cerebrovascular disease of maternal women.Methods 16 cases of maternal women with cerebrovascular disease and 30 cases of healthy maternal women were colected.Then the risk factors related to cerebrovascular disease of maternal women were researched by use Logistic regression analysis.Results The risk factors related to cerebrovascular disease of maternal women contained electro-lyre disturbance,not prenatal examination,hypertensive disorder complicating pregnancy,infection in gestation period and puerperium.Moreover.hypertensive disorder complicating pregnancy and infection were independent risk factors.Conclusions Cerebrovascular disease of maternal women was closely related to hypertensive disorder complicating pregnancy and infection.Prevention of those risk factors could contribute to the fall in mortality of maternal women.

  7. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A;

    2017-01-01

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability (...

  8. Nursing of Patients with Severe Cerebral Vascular Disease with Hyponatremia%重症脑血管病伴低钠血症患者的护理

    Institute of Scientific and Technical Information of China (English)

    周娟

    2015-01-01

    目的研究重症脑血管病伴低钠血症患者的护理工作,总结低钠血症对重症脑血管疾病治疗工作的有效,并得出有效护理结论。方法采用回顾分析法,随机选取某医院收治的重症脑血管病伴低钠血症患者70例,搜集其入院后治疗期间的临床资料,对比观察不同程度地低钠血症患者,有哪些护理需求,并统计分析经有效护理后患者的疾病反应,得出护理有效率。结果70例患者经有效护理后,64例血钠恢复正常,4例补钠后疾病出现反复,2例病死,护理有效率为91.43%。结论低钠血症是重症脑血管患者极为常见的并发症之一,它对患者疾病治疗、恢复有严重影响,及时采取有效护理措施预防重症脑血管患者出现低钠并发症、最大限度消除低钠血症的并发危害。%Objective To study the patients with hyponatremia with severe cerebrovascular disease nursing,conclusion hyponatremia ef ective for the treatment of severe cerebrovascular disease,and ef ective nursing conclusions.Methods Retrospective analysis,randomly selected from a hospital treated 70 cases of patients with severe cerebrovascular disease with hyponatremia,col ected the clinical data of treatment after admission,the comparative observation of hyponatremia patients in dif erent degrees,what are the care needs,and statistical analysis by the ef ective nursing of patients after disease reaction,it is concluded that nursing ef iciency.Results 70 cases of patients after ef ective nursing,60 cases of normal blood sodium,8 cases of fil after sodium disease occur repeatedly,2 cases died, Nursing ef ective rate was 91.43%.Conclusion Hyponatremia is one of the most common complication of patients with severe cerebrovascular it has a serious ef ect on patients'disease treatment, recovery,timely take ef ective nursing measures to prevent low sodium in patients with severe cerebrovascular complications,eliminate hyponatremia

  9. Correction of vegetative-vascular regulation in cerebral palsy by means of sports games.

    Directory of Open Access Journals (Sweden)

    Kucherov D.S.

    2011-08-01

    Full Text Available The peculiarities of the physical rehabilitation of sports facilities aimed at correcting the condition of vegetative-vascular regulation of children with cerebral palsy at the age of 11-13 years. The results of heart rate variability. The positive effects of the application of physical rehabilitation with elements of sports in children with cerebral palsy, effective changes in the state of vegetative-vascular regulation and improvement of cardiac regulation.

  10. ESTUDIO DEL EFECTO DE LA CRANEOACUPUNTURA EN PACIENTES CON ENFERMEDAD VASCULAR CEREBRAL. (EVC)

    OpenAIRE

    PEREZ BRAVO, MIGUEL

    2009-01-01

    LA ENFERMEDAD VASCULAR CEREBRAL (EVC) EN MEXICO ES UN IMPORTANTE PROBLEMA DE SALUD PUBLICA, ES LA TERCERA CAUSA DE MUERTE Y LA SEGUNDA EN PRODUCIR INCAPACIDAD NEUROLOGICA. EL OBJETIVO DE ESTE ESTUDIO FUE EVALUAR EL EFECTO DE LA CRANEOACUPUNTURA EN PACIENTES CON ENFERMEDAD VASCULAR CEREBRAL (ZHONG FENG). EL PRESENTE ES UN ESTUDIO EXPERIMENTAL, PROSPECTIVO Y LONGITUDINAL, REALIZADO EN EL HOSPITAL DEL ISSSTE DE LA CIUDAD DE PUEBLA, A UN GRUPO DE 11 PACIENTES DE AMBOS SEXOS, CON...

  11. Presión arterial sistólica y pronóstico funcional en pacientes con enfermedad vascular cerebral aguda: Registro mexicano de enfermedad vascular cerebral

    OpenAIRE

    Baños-González,Manuel; Cantú-Brito, Carlos; Chiquete, Erwin; Arauz, Antonio; Ruiz-Sandoval,José Luís; Villarreal-Careaga,Jorge; Barinagarrementeria,Fernando; Lozano,José Juan

    2011-01-01

    Objetivo: Analizar la asociación de la presión arterial sistólica (PAS) al ingreso hospitalario y la evolución clínica a 30 días en pacientes con enfermedad vascular cerebral (EVC) aguda. Métodos: El REgistro NAcional Mexicano de Enfermedad VAScular Cerebral (RENAMEVASC) es un registro hospitalario multicéntrico realizado de noviembre de 2002 a octubre de 2004. Se registraron 2000 pacientes con distintos síndromes clínicos de EVC aguda confirmados por neuroimagen. La estratificación de la evo...

  12. Related risk factors for pulmonary infections in cerebral vascular disease patients%脑血管疾病患者合并肺部感染的相关危险因素调查

    Institute of Scientific and Technical Information of China (English)

    黄贞

    2013-01-01

    OBJECTIVE To explore the related risk factors for the pulmonary infections in the patients with cerebral vascular diseases so as to perform the targeted prevention. METHODS The medical records of 176 cases with cerebral vascular diseases were retrospectively analyzed, the related risk factors for the combined pulmonary infections were analyzed as well. RESULTS There were 36 cases with pulmonary infections, and the incidence rate was 20. 46%. The incidence rates of the pulmonary infections were as follows:the people whose age was less than 70 years 11. 98% , the people whose age was more than 70 years 4. 38% , the male 23. 91 % , the female 16. 67% , the people with disorder of consciousness 51. 72%, the people without consciousness disorder 14. 29%, the hemorrhagic patients 31. 96%, the ischemic patients 6. 33%, the people with invasive operation 37. 50%, the people without the invasive operation 10. 71%, the people complicated with diabetes mellitus 60. 00%, the people without complicated diabetes mellitus 10. 64% , the people combined with chronic bronchitis 76. 92%, the people without chronic bronchitis 10. 67%, the people with intracranial hypertension 55. 56%, the people without intracranial hypertension 16. 46% , the people with the bedridden duration less than 10 days 6. 67% ,and the people with the bedridden duration more than 10 days 25. 19%. The difference in the incidence of pulmonary infections between the patients with different age, consciousness disorders, cerebrovascular disease types, invasive operations, diabetes, chronic bronchitis, intracranial hypertension, and bedridden duration was statistically significant(P< 0. 05). Multivariate logistic analysis revealed that the age, impaired consciousness, cerebrovascular disease types, invasive operation, diabetes, chronic bronchitis, and bedridden time were the independent risk factors(P<0. 01). CONCLUSION The incidence rate of the pulmonary infections is relatively high in the patients with the

  13. Sobrecarga dos cuidadores de idosos com acidente vascular cerebral

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    Roberta Amorim Pereira

    2013-02-01

    Full Text Available O objetivo deste estudo foi avaliar a sobrecarga dos cuidadores de idosos com acidente vascular cerebral (AVC, assim como correlacioná-la com as horas de cuidado, a idade e a independência funcional dos idosos. Trata-se de estudo transversal feito com 62 idosos com AVC e seus cuidadores. O instrumento continha variáveis sociodemográficas e econômicas, Mini-Exame do Estado Mental, Medida da Independência Funcional (MIF e a Escala de Zarit. A possível correlação entre os escores da escala de Zarit e as outras variáveis foi avaliada por meio do Coeficiente de Correlação de Pearson. A maioria dos cuidadores era adultos, filhos, casados e do sexo feminino. A média do escore de Zarit foi 34,92 (15,8. A MIF apresentou correlação negativa com a sobrecarga do cuidador, porém, não houve correlação com a idade e as horas de cuidado. A sobrecarga da maioria dos cuidadores variou de moderada a severa e parece estar relacionada ao nível de independência funcional dos idosos.

  14. Occupational performance and satisfaction of individuals after cerebral vascular accident

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    Kátia Vanessa Pinto de Meneses

    2014-12-01

    Full Text Available Introduction: Scientific studies show that occupational therapy interventions with patients after cerebral vascular accident (CVA - post-stroke patients, help them resume the performance of important meaningful tasks. Objective: To measure changes in the perception of post-stroke patients on their occupational performance and satisfaction after the intervention of occupational therapy. Methodology: An observational, longitudinal, prospective study with CVA patients treated at occupational therapy service at the ‘Unidade Mista de Taguatinga’, Federal District, Brazil. The Canadian Occupational Performance Measure (COPM was applied in three distinct times: during the initial assessment (time 1, after 3 months (time 2, and after 6 months (time 3 of occupational therapy intervention. Results: The analysis after 3 months of intervention was performed with 17 patients; all showed increased performance scores (p = 0.000, and only one patient presented decrease in satisfaction scores. The analysis after 6 months was conducted with 13 patients; all showed significant improvement (p = 0.000 in scores for performance and satisfaction. Conclusions: The study shows the improvement in satisfaction and occupational performance of CVA patients after occupational therapy intervention. The study suggests that occupational therapy intervention helps the rehabilitation process of post-stroke patients, enabling them to improve their occupational performance and satisfaction and, consequently, their independence.

  15. Nursing experience of cerebral-vascular disease in early rehab%34例脑血管病的早期康复护理体会

    Institute of Scientific and Technical Information of China (English)

    姚红娜

    2014-01-01

    目的:减轻脑血管病患者的后遗症程度,提高病人的日常生活质量。方法:对34例脑血管患者进行药物治疗同时,积极地进行早期康复护理,并适当进行正确的心理疏导。结果:2年的治疗后,进行早期康复护理的患者康复率比以前未进行早期康复护理的患者的高,促进了患者的康复,提高了患者的生活质量。结论:脑血管的早期康复护理对患者的康复有很大的疗效,减轻了患者在患病期间的痛苦,值得推广使用。%Objective:To relieve sequelae of cerebrovascular disease , improve the quality of the patient's daily life.Methods:34 cases of cerebrovascular patients for drug treatment at the same time , actively for early rehabilitation nursing , and appropriate for the correct psychological counseling .Results:After two years of treatment , promote the patient's rehabilitation , to improve the patient's quality of life . Conclusions:The early rehabilitation nursing on cerebrovascular patients could have a lot to the curative effect of rehabilitation , reduce the pain of the patients during the period of illness , be worth promoting .

  16. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

    Directory of Open Access Journals (Sweden)

    Sueli Luciano Pires

    2004-09-01

    Full Text Available Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é significativamente freqüente (87,8% entre pacientes idosos com AVCi, independentemente do sexo e da faixa etária. Tabagismo (46,9% e etilismo (35,1% revelaram-se fatores de riscos modificáveis freqüentes especialmente entre os homens. As cardiopatias (27,0%, o Diabete Melito (19,9% e as dislipidemias (15,6% também se revelaram fatores de risco modificáveis freqüentes em pacientes idosos com AVCi, em ambos os sexos e em ambas as faixas etárias estudadas (60 a 70 anos e mais que 71 anos. Foi relativamente baixa a freqüência de hiperuricemia nesta amostra.Two hundred and sixty two patients with clinical diagnosis of permanent ischemic stroke, all of them aged 60 or more were retrospectively studied from the 1015 cerebrovascular diseases (CVD records of the Atherosclerosis Ligue of the Neurology Clinics of the ISCMSP, from 1990 to 2002. The study emphasized modifiable risk factors frequencies for ischemic stroke in this population, considering gender and age of the patients. Results have evidenced that systemic arterial hypertension is a main risk factor significantly frequent in old people (87.8%, independently of gender and age. Smoking (46.9% and alcohol consumption (35.1% have revealed to be very frequent important modifiable risk factors especially among men. Lower frequencies have been presented for cardiac diseases (27.0%, Diabetes Melitus (19.9%, and dislipidemia (15.6% as risk factors for ischemic stroke in old people of both

  17. Clinical application of three-dimensional DSA combined with roadmap technique in diagnosis of cerebral vascular diseases%3D-DSA联合roadmap技术在脑血管疾病介入诊治中的应用价值

    Institute of Scientific and Technical Information of China (English)

    陈建华; 贺雄军; 段传志; 刘亚杰; 张炘; 彭志康; 刘亚洪; 汪求精; 何旭英; 黎凯锋

    2015-01-01

    Objective To discuss the application value of three-dimensional digital subtraction angiography(3D-DSA) combined with roadmap technology in diagnosis and therapy for cerebral vascular disease. Methods A total of 169 patients with cerebral vascular disease were enrolled, which included 73 males and 57 females;aged 6-81 years old with mean age of 49.31 years old. All of them were performed by DSA and endovascular treatment, and divided into 2 groups accorded to treatment process. The first group(n=104) received 3D-DSA and 2D-DSA examination which combined with roadmap treatment to identify features of aneurysm, arteriovenous malformations(AVM) and artery stenosis in image exposure of 3D-DSA, and compared results with those of 2D-DSA. The second group (n=65) was received 2D-DSA examination and interventional treatment, which also combined with roadmap treatment to compare with 3D-DSA examination combined roadmap treatment in first group. Results In aneurysmal neck detection rate, the accurate rate of 3D-DSA aneurysm was higher 16.3 %(7/43) than that of 2D-DSA, the exposure of aneurysmal neck was higher 48.2%than that of 2D-DSA. There were significant statistic differences in blood flow pattern of AVM artery and vascular malformation construction(P<0.05). The exposure of intravascular plaque by 3D-DSA was higher 30.7%than that of 2D-DSA, and accurate measurement of blood vessels stenosis of 3D-DSA was higher 42.3%than that of 2D-DSA. In treatment, there was significant statistic difference(P<0.05) in operation time and X-ray exposure time between 3D-DSA combined with roadmap technology and 2D-DSA combined with roadmap technology. And there were significant statistic differences between 3D-DSA and 2D-DSA in roadmap image times, image volume dose and X-ray radiation dosage( P<0.05). Conclusion It is demonstrated that compared with traditional 2D-DSA, the 3D-DSA combined with roadmap techniquein cerebrovascular disease has more important application value in diagnosis and

  18. Cerebral vascular effects of hypovolemia and dopamine infusions

    DEFF Research Database (Denmark)

    Holst Hahn, Gitte; Heiring, Christian; Pryds, Ole

    2012-01-01

    Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature.......Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature....

  19. Cerebral Small Vessel Disease and Risk of Death, Ischemic Stroke, and Cardiac Complications in Patients With Atherosclerotic Disease The Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) Study

    NARCIS (Netherlands)

    M.M.A. Conijn; R.P. Kloppenborg; A. Algra; W.P.T.M. Mali; L.J. Kappelle; K.L. Vincken; Y. van der Graaf; M.I. Geerlings

    2011-01-01

    Background and Purpose-Cerebral small vessel disease may be related to vascular and nonvascular pathology. We assessed whether lacunar infarcts and white matter lesions on MRI increased the risk of vascular and nonvascular death and future vascular events in patients with atherosclerotic disease. Me

  20. Association factor analysis between osteoporosis with cerebral artery disease: The STROBE study.

    Science.gov (United States)

    Jin, Eun-Sun; Jeong, Je Hoon; Lee, Bora; Im, Soo Bin

    2017-03-01

    The purpose of this study was to determine the clinical association factors between osteoporosis and cerebral artery disease in Korean population. Two hundred nineteen postmenopausal women and men undergoing cerebral computed tomography angiography were enrolled in this study to evaluate the cerebral artery disease by cross-sectional study. Cerebral artery disease was diagnosed if there was narrowing of 50% higher diameter in one or more cerebral vessel artery or presence of vascular calcification. History of osteoporotic fracture was assessed using medical record, and radiographic data such as simple radiography, MRI, and bone scan. Bone mineral density was checked by dual-energy x-ray absorptiometry. We reviewed clinical characteristics in all patients and also performed subgroup analysis for total or extracranial/ intracranial cerebral artery disease group retrospectively. We performed statistical analysis by means of chi-square test or Fisher's exact test for categorical variables and Student's t-test or Wilcoxon's rank sum test for continuous variables. We also used univariate and multivariate logistic regression analyses were conducted to assess the factors associated with the prevalence of cerebral artery disease. A two-tailed p-value of less than 0.05 was considered as statistically significant. All statistical analyses were performed using R (version 3.1.3; The R Foundation for Statistical Computing, Vienna, Austria) and SPSS (version 14.0; SPSS, Inc, Chicago, Ill, USA). Of the 219 patients, 142 had cerebral artery disease. All vertebral fracture was observed in 29 (13.24%) patients. There was significant difference in hip fracture according to the presence or absence of cerebral artery disease. In logistic regression analysis, osteoporotic hip fracture was significantly associated with extracranial cerebral artery disease after adjusting for multiple risk factors. Females with osteoporotic hip fracture were associated with total calcified cerebral artery

  1. Clinical study of senile cerebral vascular disease sequelae hyponatremia in elderly%老年脑血管病后遗症患者低钠血症临床研究

    Institute of Scientific and Technical Information of China (English)

    刘莹; 张敏; 李景刚

    2014-01-01

    Objective We aimed to research on the causes of senile cerebrovascular disease sequela patients complicated with hyponatremia, to facilitate the treatment process of the intervention. Method 80 patients with cerebral vascular disease sequelae from January 2012 to December 2013 in our hospital ward neural department of internal medicine were taken as the research objects. In terms of hyponatremia, they were divided into two groups: 32 cases in low sodium group, 48 cases in normal group. The related factors were analyzed. Results The main influence factors of senile cerebrovascular disease sequela patients complicated with hyponatremia is old age, being bedridden, nasal feeding, unconsciousness, combined with tumor, with pneumonia or respiratory failure, incomplete cardiac function in coronary heart disease, poor nutrition. The above factors were representative index (P<0.05). The clinical manifestations were mainly fatigue, anorexia, increase of disturbance of consciousness which accounted for 68.75%, 65.63%, 59.38%respectively, according to the incidences of qualifying are fatigue, anorexia, exacerbation of disturbance of consciousness, weak pulse, nausea, vomiting, cold extremities, dizziness, irritability, delirium and seizures. 32 cases were found in a timely manner. With timely supplement of sodium, 30 patients with hyponatremia were corrected, 2 patients with recurrent hyponatremia finally complicated with multiple organ failure, pulmonary infection were died. Conclusion The figure of elderly patients with cerebral vascular disease sequela of hyponatremia incidence is still high, the causes and severity of sequelae, complications, survival status are closely related, and the clinical manifestations were not specific. As for intervention on high risk factors of high-risk patients, the monitoring is the main means of prevention and treatment.%目的:研究老年脑血管病后遗症患者并发低钠血症的原因,以利于治疗

  2. Desigualdades entre pacientes hospitalizados por doenças cardíacas e vasculares-cerebrais em localidade do Estado de São Paulo (Brasil, 1986 Inequalities among patients hospitalized for cardiac and cerebral-vascular diseases in the City of the State of S. Paulo, Brazil, 1986

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    Juan Stuardo Yazlle Rocha

    1989-10-01

    Full Text Available Valendo-se de um sistema de informações sobre hospitalizações no Município de Ribeirão Preto, SP (Brasil foram estudadas as características clínico-epidemiológicas referidas dos pacientes internados, em 1986, por doenças cardíacas e vasculares-cerebrais (DCVC. De 43.499 hospitalizações ocorridas naquele ano, 4.673 foram ocasionadas por doenças cardíacas e vasculares-cerebrais. Utilizando a fonte de financiamento da internação como indicador do estrato social ao qual pertence o paciente, foram compostos 4 grupos de estudo: particulares, "outros", previdenciários e "não pagantes"; estes grupos apresentaram diferenças significativas quanto a coeficiente de internações por DCVC, média e mediana de idade na hospitalização, perfil ocupacional, duração da internação, freqüência dos sub-grupos diagnósticos, coeficientes de mortalidade e a idade média e mediana nos casos de óbitos. Estas diferenças foram atribuídas às disparidades sociais no nível de vida e condições de trabalho dos grupos estudados o que determina diferenças no adoecer, ser assistido e no morrer.The clinical and epidemiological characteristics of hospitalizations due to cardiac and cerebral-vascular diseases (CCVD - ICD 390 - 438, which occurred in 1986, were studied on the basis of data from an information system relating to medical care in the City of Ribeirão Preto, State of S. Paulo, Brazil. These causes accounted for 4,673 of the annual total of 43,449 hospital admissions. Using the sources of payment of the hospitalization as an indicator of the patients' social strata, the following four study groups were defined: private, social insurance, non-paying and "others". These groups showed significant differences in relation to the following variables: hospitalization rates due to CCVD, mean and median age at admission and time of death, occupation, average length of stay in the hospital, mortality rates and relative frequencies of specific

  3. Current pathophysiological concepts in Cerebral Small Vessel Disease

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    Fred eRincon

    2014-03-01

    Full Text Available The association between cerebral small vessel disease (SVD – in the form of white matter lesions, infarctions, and hemorrhages – with vascular cognitive impairment (VCI, has mostly been deduced from observational studies. Pathological conditions affecting the small vessels of the brain and leading to SVD have suggested plausible molecular mechanisms involved in vascular damage and their impact on brain function. However, much still needs to be clarified in understanding the pathophysiology of VCI, the role of neurodegenerative processes such as Alzheimer disease, and the impact of aging itself. In addition, both genetic predispositions and environmental exposures may potentiate the development of SVD and interact with normal aging to impact cognitive function and require further study. Advances in technology, in the analysis of genetic and epigenetic data, neuroimaging such as MRI, and new biomarkers will help to clarify the complex factors leading to SVD and the expression of VCI.

  4. Olanzapine vs Sulpiride in Treating Delusional Syndrome after Acute Cerebral Vascular Disease%奥氮平与舒必利治疗急性脑血管疾病后妄想综合征比较

    Institute of Scientific and Technical Information of China (English)

    唐斌

    2013-01-01

    目的观察奥氮平治疗急性脑血管疾病后妄想综合征的疗效。方法 急性脑血管疾病后妄想综合征病人100例,分为2组奥氮平组50例,男性28例,女性22例,年龄(60±S11)岁,给予奥氮平2.5mg/d逐渐加至5~10mg/d、PO×4周;舒必利组50例,男性26例,女性24例,年龄(62±S13)岁,给予舒必利0.3g/d逐渐加至0.4~0.6g/d、PO×4周。结果奥氮平组和舒必利组经过4WK的治疗后总有效率分别为88%和83%(P>0.05)、两组在2周末有效率分别为78%和26%(P<0.05)。结论 奥氮平治疗急性脑血管疾病后妄想综合征与舒必利对比显效早、药物不良反应少且轻。%Objective:To observe the effects of olanzapine for curing delusions syndrome after acute cerebral vascular disease(ACVD).Method:One hundred patients with ACVD were divided into two groups; olanzapine group (50 patients) male28, female22, age(60±12)a. were given olanzapine 2.5mg/d with gradual increase dosage of 5~10>mg/d, po× 4wk;Sulpiride group of 50 patients, M26, F24, age(62±13)a, sulpiride 0.3g/d also with gradual increase of dosage into 0.4~0.6g/d, po for 4weeks. Result: After 4weeks, the general effective rates of olanzapine group and sulpivide group were 88% and 80%, respectively(P>0.05), those of two group by the end of 2weeks were 78% and 26%, respectively(P<0.05). Conclusion: Delusional syndrome disappearing after ACVD with olanzapine is earlier than sulpiride with more effective results and less adverse reactions.

  5. Vascular cognitive impairments in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    I. V. Rogova

    2015-01-01

    Full Text Available Objective: to study the specific features of development of cognitive impairments (CIs, the role of traditional cardiovascular risk factors and renal failure-induced factors in patients with Stages I–IV chronic kidney disease (CKD and to assess an association of CIs with the signs of vascular wall remodeling in them. Patients and methods. Fifty-one patients aged 53±10 years with CKD were examined. Among them, there were 20 patients with Stages I–II CKD: a glomerular filtration rate (GFR of і60 ml/min/1.73 m2, signs of renal lesion; 20 with Stages III CKD: a GFR of <60–30 ml/min/1.73 m2, and 11 with Stages VI CKD: a GFR of <30–15 ml/min/1.73 m2. Results and discussion. CIs were more common in the patients with Stages III–IV than in those with Stages I–II, as shown by the scores of the mini-mental state examination (p<0.001, the frontal assessment battery (p=0.001, and the regulatory function test (p<0.001. These tests showed that the magnitude of CIs increased with the higher stage of CKD. Stages III–IV CKD is an independent predictor of CIs in persons with predialysis-stage kidney lesion. CIs were found to be related to hyperhomocysteinemia, anemia, abdominal obesity, left ventricular hypertrophy, and patient age. The signs of atherosclerotic lesion of the common carotid arteries and the indicators of arterial stiffness were also associated with the incidence and magnitude of CIs in CKD. The detection of CIs in patients with early CKD allows one to timely initiate adequate therapy aimed particularly at improving cerebral circulation, eliminating the impact of risk factors, and slowing down the vascular remodeling. The management tactics for patients with CKD must involve the identification and correction of cardiovascular risk factors, and duplex scanning of the wall of the common carotid arteries may be used as a noninvasive method to assess the risk of the development and progression of CIs in predialysis CKD. 

  6. Psoriasis and vascular disease: an unsolved mystery.

    Science.gov (United States)

    Shelling, Michael L; Federman, Daniel G; Prodanovich, Srdjan; Kirsner, Robert S

    2008-05-01

    Psoriasis is an immune disease most commonly recognized for its skin and joint manifestations. These produce significant physical, social, and psychological distress in affected patients and resultant reductions in their quality of life. As expected, these concerns are vital in providing symptomatic improvement and in selecting an individualized therapy. Yet, the approach in management of these patients is likely to change given the growing body of evidence linking psoriasis and vascular disease. Stemming from an anecdotally described relationship, the association between psoriasis and vascular disease has become a focus of current research to further elucidate the pathophysiology underlying and connecting these two diseases. This article includes a review of the classical cardiovascular risk factors, the atherothrombotic markers, and the environmental stressors associated with psoriasis, as well as a critical review of the observed vascular diseases, the proposed mechanism of atherosclerosis, and the benefits of treatment of psoriasis.

  7. Structure and vascular function of MEKK3–cerebral cavernous malformations 2 complex

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, Oriana S. [Yale Univ., New Haven, CT (United States); Deng, Hanqiang [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Liu, Dou [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Ya [Yale Univ. School of Medicine, New Haven, CT (United States); Wei, Rong [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Deng, Yong [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Fan [Yale Univ. School of Medicine, New Haven, CT (United States); Louvi, Angeliki [Yale Univ. School of Medicine, New Haven, CT (United States); Turk, Benjamin E. [Yale Univ., New Haven, CT (United States); Boggon, Titus J. [Yale Univ., New Haven, CT (United States); Su, Bing [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China)

    2015-08-03

    Cerebral cavernous malformations 2 (CCM2) loss is associated with the familial form of CCM disease. The protein kinase MEKK3 (MAP3K3) is essential for embryonic angiogenesis in mice and interacts physically with CCM2, but how this interaction is mediated and its relevance to cerebral vasculature are unknown. Here we report that Mekk3 plays an intrinsic role in embryonic vascular development. Inducible endothelial Mekk3 knockout in neonatal mice is lethal due to multiple intracranial haemorrhages and brain blood vessels leakage. We discover direct interaction between CCM2 harmonin homology domain (HHD) and the N terminus of MEKK3, and determine a 2.35 Å cocrystal structure. We find Mekk3 deficiency impairs neurovascular integrity, which is partially dependent on Rho–ROCK signalling, and that disruption of MEKK3:CCM2 interaction leads to similar neurovascular leakage. We conclude that CCM2:MEKK3-mediated regulation of Rho signalling is required for maintenance of neurovascular integrity, unravelling a mechanism by which CCM2 loss leads to disease.

  8. Gene transfer therapy in vascular diseases.

    Science.gov (United States)

    McKay, M J; Gaballa, M A

    2001-01-01

    Somatic gene therapy of vascular diseases is a promising new field in modern medicine. Recent advancements in gene transfer technology have greatly evolved our understanding of the pathophysiologic role of candidate disease genes. With this knowledge, the expression of selective gene products provides the means to test the therapeutic use of gene therapy in a multitude of medical conditions. In addition, with the completion of genome sequencing programs, gene transfer can be used also to study the biologic function of novel genes in vivo. Novel genes are delivered to targeted tissue via several different vehicles. These vectors include adenoviruses, retroviruses, plasmids, plasmid/liposomes, and oligonucleotides. However, each one of these vectors has inherent limitations. Further investigations into developing delivery systems that not only allow for efficient, targeted gene transfer, but also are stable and nonimmunogenic, will optimize the clinical application of gene therapy in vascular diseases. This review further discusses the available mode of gene delivery and examines six major areas in vascular gene therapy, namely prevention of restenosis, thrombosis, hypertension, atherosclerosis, peripheral vascular disease in congestive heart failure, and ischemia. Although we highlight some of the recent advances in the use of gene therapy in treating vascular disease discovered primarily during the past two years, many excellent studies published during that period are not included in this review due to space limitations. The following is a selective review of practical uses of gene transfer therapy in vascular diseases. This review primarily covers work performed in the last 2 years. For earlier work, the reader may refer to several excellent review articles. For instance, Belalcazer et al. (6) reviewed general aspects of somatic gene therapy and the different vehicles used for the delivery of therapeutic genes. Gene therapy in restenosis and stimulation of

  9. Mechanisms of vascular calcification and associated diseases.

    Science.gov (United States)

    Marulanda, Juliana; Alqarni, Saleh; Murshed, Monzur

    2014-01-01

    Mineralization of bone and tooth extracellular matrix (ECM) is a physiologic process, while soft tissue mineralization, also known as ectopic mineralization (calcification), is a pathologic condition. Vascular calcification is common in aging and also in a number of genetic and metabolic disorders. The calcific deposits in arteries complicate the prognosis and increase the morbidity in diseases such as atherosclerosis, diabetes and chronic kidney disease (CKD). To completely understand the pathophysiology of these lifethreatening diseases, it is critical to elucidate the molecular mechanisms underlying vascular calcification. Unveiling these mechanisms will eventually identify new therapeutic targets and also improve the management of the associated complications. In the current review, we discussed the common determinants of ECM mineralization, the mechanism of vascular calcification associated with several human diseases and outlined the most common therapeutic approaches to prevent its progression.

  10. Hypertensive organ damage in patients with vascular disease

    NARCIS (Netherlands)

    Vlek, A.L.M.

    2009-01-01

    Hypertension is one of the most common vascular risk factors, and is an important cause of development of different vascular diseases. The main aim of this thesis was to determine the burden of hypertension-associated vascular diseases and end-organ damage in patients with manifest vascular disease.

  11. Cerebral ischemia upregulates vascular endothelin ET(B) receptors in rat

    DEFF Research Database (Denmark)

    Stenman, Emelie; Malmsjö, Malin; Uddman, Erik;

    2002-01-01

    BACKGROUND AND PURPOSE: Elevated levels of endothelin-1 (ET-1) have been reported in cerebral ischemia. A role for ET may prove more important if the vascular receptors were changed. We addressed whether there is any change in ET receptor expression in cerebral ischemia. METHODS: The right middle...... receptors in the pathogenesis of a vascular component after cerebral ischemia....... cerebral artery (MCA) was occluded in male Wistar rats for 2 hours with the intraluminal filament method. The basilar artery and both MCAs were removed after 46 hours of recirculation. The contractile responses to ET-1, a combined ET(A) and ET(B) receptor agonist, and sarafotoxin 6c (S6c), a selective ET...

  12. Acidente vascular cerebral ou doença encéfalo vascular ?: Revendo a designação e respeitando a anatomia

    Directory of Open Access Journals (Sweden)

    João Eliézer Ferri-de-Barros

    1994-06-01

    Full Text Available Desde que a doença vascular que acomete o sistema nervoso central de localização intracraniana pode comprometer estruturas supra ou/e infratentoriais, propomos a mudança de "Acidente vascular cerebral" para "Doença encéfalo vascular".

  13. Acidente vascular cerebral ou doença encéfalo vascular ?: Revendo a designação e respeitando a anatomia

    OpenAIRE

    1994-01-01

    Desde que a doença vascular que acomete o sistema nervoso central de localização intracraniana pode comprometer estruturas supra ou/e infratentoriais, propomos a mudança de "Acidente vascular cerebral" para "Doença encéfalo vascular".

  14. Vascular Stem Cells in Vascular Remodeling and Diseases

    Directory of Open Access Journals (Sweden)

    Anna Meiliana

    2013-12-01

    Full Text Available BACKGROUND: Blood vessels are a source of stem and progenitor cells, which likely contribute to a variety of vascular processes and diseases. Emerging concepts in this field could influence therapeutic approaches to diseases of blood vessels such as atherosclerosis. CONTENT: Vascular Stem Cells (VSCs field is only beginning to emerge, and thus, many issues regarding VSCs’s identity and function remain poorly understood. In fact, even after decades of intensive research, Mesenchymal Stem Cells (MSC, which is suggested to be VSCs, is still having many outstanding issues of its own. And, on top of this, likewise decades-long intensive pericyte research has not been able resolve the identity issue. While favors Adventitial Progenitor Cells (APCs over pericytes as the likely VSC candidate, it should be pointed out that currently the opposite view (i.e., pericytes as VSCs is more prevalent, and many excellent reviews, including a recent one, have discussed this issue extensively. SUMMARY: It has been postulated that, within the vasculature, APCs could differentiate into pericytes (CD34- CD31- CD140b+ SMA-, endothelial cells (CD34+ CD31+ CD140b- SMA-, and smooth muscle cells (SMCs (CD34- CD31- CD140b- SMA+; and during tissue expansion or repair, APCs could also differentiate into tissue-specific cell types (e.g., muscle and fat Thus, in vitro, APCs fulfill all criteria for being VSCs. Meanwhile, in vivo evidence is still limited and will require further investigation. KEYWORDS: vascular stem cells, VSC, mesenchymal stem cells, MSC, endothelial progenitor cells, EPC, adventitial progenitor cells, APC.

  15. Hemodynamic changes after vascular reconstructive surgery for moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Kuyama, Hideyuki; Niimi, Hitohisa; Kawauchi, Masamitsu; Tanimoto, Takaho; Murota, Takenobu; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira; Nagao, Seigo.

    1988-06-01

    The regional cerebral blood flow (rCBF) was measured in eight juvenile cases with moyamoya disease before and after vascular reconstructive surgery consisting either of encephalo-duro-arterio-synangiosis (EDAS) or of encephalo-duro-arterio-myo-synangiosis (EDAMS). The rCBF was measured quantitatively using the inert-gas washout technique with xenon-133 and single-photon-emission computed tomography. A patient with a completed stroke showed a low value of the mean hemispheric blood flow on the lesion side. There was no significant difference in the mean hemispheric blood flow between the two hemispheres in the patients with a transient ischemic attack. The variation in the rCBF versus the mean hemispheric blood flow was studied before and after the operation. The preoperative rCBF was relatively high in the basal ganglia and occipital regions and low in the frontal region. One month after the operation, the rCBF in each region was not significantly changed in comparison with the preoperative rCBF. Six months after the operation, however, the rCBF was significantly reduced in the basal ganglia and significantly increased in the temporal region. On the other hand, the rCBF was almost identical with the mean hemispheric blood flow in the frontal and occipital regions. These results may be explained by the angiographic findings, which showed a diminution in the moyamoya vessels and a good filling of the middle cerebral artery area via the external carotid artery on the postoperative angiogram. Vascular reconstructive surgery for moyamoya disease in children may, therefore, be thought to be an effective procedure for smoothing the cerebral-blood-flow distribution.

  16. Estimation of cerebral vascular tone during exercise; evaluation by critical closing pressure in humans

    DEFF Research Database (Denmark)

    Ogoh, Shigehiko; Brothers, R Matthew; Jeschke, Monica;

    2010-01-01

    The aim of the present study was to calculate critical closing pressure (CCP) of the cerebral vasculature at rest and during exercise to estimate cerebral vascular tone. Five men and two women were seated upright for 15 min and then performed 15 min of right-legged knee extension exercise at 40, 60...... and 75% of their maximal workload (WL(max)). Middle cerebral artery blood velocity (MCA V) and blood pressure in the radial artery were recorded. The CCP was calculated by linear extrapolation from 1 min recordings of pairs of systolic and diastolic pressure and MCA V waveforms from both the right...

  17. 贝前列素联合维生素E治疗2型糖尿病合并下肢血管病变对防止心脑血管疾病发生的研究%Research on the prevention of cardio-cerebral vascular diseases to beraprost combined with Vitamin E in the treatment of type 2 diabetes mellitus with lower limb vascular diseases

    Institute of Scientific and Technical Information of China (English)

    黄文权; 陈俏洁; 陈聪

    2014-01-01

    目的:探讨贝前列素联合维生素E对心脑血管疾病的预防效果,为贝前列素和维生素E的使用提供理论依据。方法把2型糖尿病合并下肢血管病变患者随机分为实验组(95例)和对照组(86例),实验组的治疗方案采用贝前列素联合维生素E,而对照组采用阿司匹林肠溶片联合维生素E。时间从患者接受治疗算起,1年和2年后回访,统计两组患者发生心血管疾病、致死性心血管疾病、卒中、致死性卒中的情况,采用x2检验分析相关数据。结果1年和2年后发生心脑血管疾病和心血管疾病在实验组与对照组间的差异均有统计学意义(P<0.05)。结论在治疗2型糖尿病合并下肢血管病时,采用贝前列素联合维生素E较阿司匹林肠溶片联合维生素E更能预防心脑血管疾病的发生。%ObjectiveTo investigate the combinatory preventing effect of beraprost and Vitamin E against cardio-cerebral vascular diseases, thus providing a theory base for the usage of these two drugs.Methods Type 2 diabetes mellitus patients with lower limb vascular lesion were randomly divided into experimental group (EG, 95 cases) and control group (CG, 86 cases). EG was treated by the combination of beraprost and Vitamin E, and CG by the combination of aspirin enteric-coated tablets and Vitamin E. The 1 year and 2 year incidence of cardiovascular disease, fatal cardiovascular disease, stroke, fatal stroke in two groups were recorded since the initiation of treatment. Data was analyzed with chi-square test. ResultsThere were statistical difference in incidence of cardio-cerebro-vascular diseases and cardiovascular diseases between the experimental and control groups after 1 year and 2 year (P<0.05).Conclusion In the treatment of type 2 diabetes mellitus patients with lower limb vascular lesion, the preventing effect of combination of beraprost and Vitamin against ecardio-cerebro-vascular diseases is better than

  18. Targeting heme oxygenase-1 in vascular disease.

    Science.gov (United States)

    Durante, William

    2010-12-01

    Heme oxygenase-1 (HO-1) metabolizes heme to generate carbon monoxide (CO), biliverdin, and iron. Biliverdin is subsequently metabolized to bilirubin by biliverdin reductase. HO-1 has recently emerged as a promising therapeutic target in the treatment of vascular disease. Pharmacological induction or gene transfer of HO-1 ameliorates vascular dysfunction in animal models of atherosclerosis, post-angioplasty restenosis, vein graft stenosis, thrombosis, myocardial infarction, and hypertension, while inhibition of HO-1 activity or gene deletion exacerbates these disorders. The vasoprotection afforded by HO-1 is largely attributable to its end products: CO and the bile pigments, biliverdin and bilirubin. These end products exert potent anti-inflammatory, antioxidant, anti-apoptotic, and anti-thrombotic actions. In addition, CO and bile pigments act to preserve vascular homeostasis at sites of arterial injury by influencing the proliferation, migration, and adhesion of vascular smooth muscle cells, endothelial cells, endothelial progenitor cells, or leukocytes. Several strategies are currently being developed to target HO-1 in vascular disease. Pharmacological induction of HO-1 by heme derivatives, dietary antioxidants, or currently available drugs, is a promising near-term approach, while HO-1 gene delivery is a long-term therapeutic goal. Direct administration of CO via inhalation or through the use of CO-releasing molecules and/or CO-sensitizing agents provides an attractive alternative approach in targeting HO-1. Furthermore, delivery of bile pigments, either alone or in combination with CO, presents another avenue for protecting against vascular disease. Since HO-1 and its products are potentially toxic, a major challenge will be to devise clinically effective therapeutic modalities that target HO-1 without causing any adverse effects.

  19. Hereditary cerebral hemorrhage with amyloidosis in patients of Dutch origin is related to Alzheimer disease

    Energy Technology Data Exchange (ETDEWEB)

    van Duinen, S.G.; Castano, E.M.; Prelli, F.; Bots, G.T.A.B.; Luyendijk, W.; Frangione, B.

    1987-08-01

    Hereditary cerebral hemorrhage with amyloidosis in Dutch patients is an autosomal dominant form of vascular amyloidosis restricted to the leptomeninges and cerebral cortex. Clinically the disease is characterized by cerebral hemorrhages leading to an early death. Immunohistochemical studies of five patients revealed that the vascular amyloid deposits reacted intensely with an antiserum raised against a synthetic peptide homologous to the Alzheimer disease-related ..beta..-protein. Silver stain-positive, senile plaque-like structures were also labeled by the antiserum, yet these lesions lacked the dense amyloid cores present in typical plaques of Alzheimer disease. No neurofibrillary tangles were present. Amyloid fibrils were purified from the leptomeningeal vessels of one patient who clinically had no signs of dementia. The protein had a molecular weight of approx. 4000 and its partial amino acid sequence to position 21 showed homology to the ..beta..-protein of Alzheimer disease and Down syndrome. These results suggest that hereditary cerebral hemorrhage with amyloidosis of Dutch origin is pathogenetically related to Alzheimer disease and support the concept that the initial amyloid deposition in this disorder occurs in the vessel walls before damaging the brain parenchyma. Thus, deposition of ..beta..-protein in brain tissue seems to be related to a spectrum of diseases involving vascular syndromes, progressive dementia, or both.

  20. An improvement of cerebral hemodynamics in a newly developed perfusion area evaluated by intra-arterial SPECT following vascular reconstructive surgery

    Energy Technology Data Exchange (ETDEWEB)

    Nochide, Ichiro [Ehime Univ., Shigenobu (Japan). School of Medicine

    1999-06-01

    The purpose of this study was to evaluate the changes in regional cerebral blood flow (rCBF) and vascular reserve ({Delta}CBF) responding to acetazolamide loading by {sup 133}Xe SPECT. In combination, this study assessed the newly developed region of cerebral perfusion via bypass arteries after surgical vascular reconstruction in 11 hemispheres of 11 patients with atherosclerotic arterial occlusive disease and adult onset moyamoya disease. In patients with atherosclerotic occlusive disease, the cerebral perfusion from bypass arteries mainly developed in the preoperatively low {Delta}CBF territory. Although rCBF did not significantly alter after vascular reconstruction, preoperatively low {Delta}CBF was significantly improved to the normal range in the promotion of postoperatively newly born perfusion from bypass arteries. In 21 hemispheres of 13 patients with adult onset moyamoya disease, the postoperatively newly born perfusion from bypass arteries was significantly developed in the regions with either preoperative low rCBF or low {Delta}CBF. Although both rCBF and {Delta}CBF were significantly improved after the operation, {Delta}CBF was not restored satisfactorily up to the normal range in contrast to the sufficient increase of rCBF, even where the perfusion from the bypass artery was observed after the reconstructive surgeries. Vascular reconstructive surgeries were beneficial for the improvement of {Delta}CBF in the atherosclerotic arterial occlusive disease and rCBF in the adult-onset moyamoya disease, respectively. (author)

  1. Calpains and Coronary Vascular Disease.

    Science.gov (United States)

    Potz, Brittany A; Sabe, Ashraf A; Abid, M Ruhul; Sellke, Frank W

    2016-01-01

    Despite many advances in percutaneous and surgical interventions in the treatment of coronary artery disease (CAD), up to one-third of patients are still either not candidates or receive suboptimal revascularization. Calpains are a class of calcium-activated non-lysosomal cysteine proteases that serve as a proteolytic unit for cellular homeostasis. Uncontrolled activation of calpain has been found to be involved in the pathogenesis of myocardial reperfusion injury, cardiac hypertrophy, myocardial stunning and cardiac ischemia. Inhibition of calpains has been shown to significantly attenuate myocardial stunning and reduced infarct size after ischemia-reperfusion. Calpain inhibition therefore serves as a potential medical therapy for patients suffering from a number of diseases, including CAD.

  2. Risk factors for vascular disease and dementia.

    Science.gov (United States)

    Breteler, M M; Bots, M L; Ott, A; Hofman, A

    1998-01-01

    There is increasing evidence that risk factors for vascular disease and stroke are associated with cognitive impairment and Alzheimer's disease. This paper reviews current knowledge on the relationship between risk factors for stroke and Alzheimer's disease. The focus will be on 'classical' risk factors, including age and gender, socioeconomic status, diabetes, cholesterol, prior cardiovascular disease, atrial fibrillation, cigarette smoking and alcohol use; as well as on factors that more recently have been recognized as putative risk factors, including APOE genotype, serum homocysteine concentration, relative abnormalities in the hemostatic and thrombotic systems, and inflammation.

  3. Castleman′s disease: Hyaline vascular type

    Directory of Open Access Journals (Sweden)

    Srikanth Shastry

    2014-01-01

    Full Text Available Castleman′s disease is a rare disease of lymph node with two identified forms, the hyaline vascular type and plasma cell type. It presents as localized or systemic lymphadenopathy or even as extranodal mass and may give rise to several differential diagnoses. Castleman′s disease represents a morphologically distinct form of lymph node hyperplasia rather than a neoplasm or a hamartoma. It occurs most commonly in adults but it can also affect children. Here we present a case of Castleman′s disease in a 22 year male patient involving right cervical lymphnode.

  4. Pulmonary manifestations of the collagen vascular diseases.

    Science.gov (United States)

    Wiedemann, H P; Matthay, R A

    1989-12-01

    The collagen vascular diseases are a heterogeneous group of immunologically mediated inflammatory disorders. The organs and tissues that compose the respiratory system are frequently affected by these diseases. Potential targets of the inflammation and injury include the lung parenchyma, tracheobronchial tree, pulmonary vasculature, pleura, larynx, and respiratory muscles. In this article, the spectrum of respiratory disease caused by systemic lupus erythematosus, rheumatoid arthritis, scleroderma, polymyositis/dermatomyositis, mixed connective tissue disease, ankylosing spondylitis, relapsing polychondritis, and Sjögren's syndrome is reviewed. Where appropriate, therapeutic options are discussed.

  5. Cerebral microbleeds in early Alzheimer's disease.

    Science.gov (United States)

    Poliakova, T; Levin, O; Arablinskiy, A; Vasenina, E; Zerr, I

    2016-10-01

    We hypothesize that cerebral microbleeds (CMB) in patients with different neuropsychological profiles (amnestic or non-amnestic) and MRI features of vascular damage could provide important information on the underlying pathological process in early Alzheimer's disease. The study was performed at two trial sites. We studied 136 outpatients with cognitive decline. MRI was performed using a magnetic field of 1.5 and 3 T. Neuropsychological assessment included Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment scale (MoCA), Addenbrooke's Cognitive Examination (ACE-R), Cambridge Cognitive Examination battery (CAMCOG) (Part 3), Clock Drawing Test, fluency test and the visual memory test (SCT). CSF was examined for standard parameters such as tau, phosphorylated tau, amyloid-β 1-40 and 42 and Qalbumin, in accordance with established protocols and genotype. In 61 patients (45 %), at least 1 CMB was found. Most of the CMBs were described in the amnestic profile (67 %). In 86 % of the cases, multiple CMB were observed. The ratio of Aβ1-40/42 in non-amnestic patients with CMB was significantly lower (mean 0.6) than in patients without CMB (mean 1.2). A notable difference in the albumin ratio as an indicator of the BBB was observed between groups with and without CMB. In the CMP-positive group, the E2 genotype was observed more frequently, and the E4 genotype less frequently, than in the CMB-negative group. Based on the cerebrospinal fluid-serum albumin ratio, we were able to show that patients with CMB present several features of BBB dysfunction. According to logistic regression, the predictive factors for CMB in patients with cognitive decline were age, WMHs score and albumin ratio. We found a significant reduction in the Aβ-amyloid ratio in the non-amnestic profile group with CMB (particularly in the cortical region) in comparison to those without CMB. While this is an interesting finding, its significance needs to be assessed in a prospective follow-up.

  6. Study of the Dynamics of Transcephalic Cerebral Impedance Data during Cardio-Vascular Surgery

    Science.gov (United States)

    Atefi, S. R.; Seoane, F.; Lindecrantz, K.

    2013-04-01

    Postoperative neurological deficits are one of the risks associated with cardio vascular surgery, necessitating development of new techniques for cerebral monitoring. In this study an experimental observation regarding the dynamics of transcephalic Electrical Bioimpedance (EBI) in patients undergoing cardiac surgery with and without extracorporeal circulation (ECC) was conducted to investigate the potential use of electrical Bioimpedance for cerebral monitoring in cardio vascular surgery. Tetrapolar transcephalic EBI measurements at single frequency of 50 kHz were recorded prior to and during cardio vascular surgery. The obtained results show that the transcephalic impedance decreases in both groups of patients as operation starts, however slight differences in these two groups were also observed with the cerebral impedance reduction in patients having no ECC being less common and not as pronounced as in the ECC group. Changes in the cerebral impedance were in agreement with changes of haematocrit and temperature. The origin of EBI changes is still unexplained however these results encourage us to continue investigating the application of electrical bioimpedance cerebral monitoring clinically.

  7. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations.

    Science.gov (United States)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A; Tan, Huan; Mikati, Abdul Ghani; Shi, Changbin; Jesselson, Michael; Shenkar, Robert; Wu, Meijing; Cao, Ying; Hobson, Nicholas; Larsson, Henrik B W; Christoforidis, Gregory A; Awad, Issam A

    2016-08-05

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability (DCEQP) and quantitative susceptibility mapping (QSM) assessed by MRI. METHODS Forty-six patients with CCMs underwent 2 or more permeability and/or susceptibility studies in conjunction with baseline and follow-up imaging and clinical surveillance during a mean 12.05 months of follow-up (range 2.4-31.27 months). Based on clinical and imaging features, cases/lesions were classified as stable, unstable, or recovering. Associated and predictive changes in quantitative permeability and susceptibility were investigated. RESULTS Lesional mean permeability and QSM values were not significantly different in stable versus unstable lesions at baseline. Mean lesional permeability in unstable CCMs with lesional bleeding or growth increased significantly (+85.9% change; p = 0.005), while mean permeability in stable and recovering lesions did not significantly change. Mean lesional QSM values significantly increased in unstable lesions (+44.1% change; p = 0.01), decreased slightly with statistical significance in stable lesions (-3.2% change; p = 0.003), and did not significantly change in recovering lesions. Familial cases developing new lesions during the follow-up period showed a higher background brain permeability at baseline (p = 0.001), as well as higher regional permeability (p = 0.003) in the area that would later develop a new lesion as compared with the homologous contralateral brain region. CONCLUSIONS In vivo assessment of vascular permeability and iron deposition on MRI can serve as objective and quantifiable biomarkers of disease activity in CCMs. This may be applied in natural history studies and may help calibrate clinical trials. The 2 techniques are likely applicable in

  8. Visfatin and cardio-cerebro-vascular disease.

    Science.gov (United States)

    Wang, Pei; Vanhoutte, Paul M; Miao, Chao-Yu

    2012-01-01

    Nicotinamide phosphoribosyltransferase is the rate-limiting enzyme that catalyzes the first step in the biosynthesis of nicotinamide adenine dinucleotide from nicotinamide. This protein was originally cloned as a putative pre-B cell colony-enhancing factor and also found to be a visceral fat-derived adipokine (visfatin). As a multifunctional protein, visfatin plays an important role in immunity, metabolism, aging, inflammation, and responses to stress. Visfatin also participates in several pathophysiological processes contributing to cardio-cerebro-vascular diseases, including hypertension, atherosclerosis, ischemic heart disease, and ischemic stroke. However, whether visfatin is a friend or a foe in these diseases remains uncertain. This brief review focuses on the current understanding of the complex role of visfatin in the cardio-cerebro-vascular system under normal and pathophysiological conditions.

  9. Vascular disease and stroke risk in atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Lip, Gregory Y.H.; Lane, Deirdre A;

    2012-01-01

    Vascular disease (including myocardial infarction and peripheral artery disease) has been proposed as a less well-validated risk factor for stroke in patients with atrial fibrillation. We investigated whether vascular disease is an independent risk factor of stroke/thromboembolism in atrial fibri...... fibrillation and whether adding vascular disease improves Congestive heart failure, Hypertension, Age 75 years, Diabetes, previous Stroke (CHADS(2)) risk stratification.......Vascular disease (including myocardial infarction and peripheral artery disease) has been proposed as a less well-validated risk factor for stroke in patients with atrial fibrillation. We investigated whether vascular disease is an independent risk factor of stroke/thromboembolism in atrial...

  10. Mesoglycan: Clinical Evidences for Use in Vascular Diseases

    Directory of Open Access Journals (Sweden)

    Antonella Tufano

    2010-01-01

    Full Text Available Vascular glycosaminoglycans (GAG are essential components of the endothelium and vessel wall and have been shown to be involved in several biologic functions. Mesoglycan, a natural GAG preparation, is a polysaccharide complex rich in sulphur radicals with strong negative electric charge. It is extracted from porcine intestinal mucosa and is composed of heparan sulfate, dermatan sulfate, electrophoretically slow-moving heparin, and variable and minimal quantities of chondroitin sulfate. Data on antithrombotic and profibrinolytic activities of the drug show that mesoglycan, although not indicated in the treatment of acute arterial or venous thrombosis because of the low antithrombotic effect, may be useful in the management of vascular diseases, when combined with antithrombotics in the case of disease of cerebral vasculature, and with antithrombotics and vasodilator drugs in the case of chronic peripheral arterial disease. The protective effect of mesoglycan in patients with venous thrombosis and the absence of side effects, support the use of GAG in patients with chronic venous insufficiency and persistent venous ulcers, in association with compression therapy (zinc bandages, multiple layer bandages, etc., elastic compression stockings, and local care, and in the prevention of recurrences in patients with previous DVT following the standard course of oral anticoagulation treatment.

  11. Cerebral vascular effects of loading dose of dexmedetomidine: A Transcranial Color Doppler study

    Directory of Open Access Journals (Sweden)

    Appavoo Arulvelan

    2016-01-01

    Full Text Available Background: Dexmedetomidine has been widely used in critical care settings because of its property of maintaining stable hemodynamics and inducing conscious sedation. The use of dexmedetomidine is in increasing trend particularly in patients with neurological disorders. Very few studies have focused on the cerebral hemodynamic effects of dexmedetomidine. This study is aimed to address this issue. Methods: Thirty patients without any intracranial pathology were included in this study. Middle cerebral artery flow velocity obtained from transcranial color Doppler was used to assess the cerebral hemodynamic indices. Mean flow velocity (mFV, pulsatility index (PI, cerebral vascular resistant index (CVRi, estimated cerebral perfusion pressure (eCPP, and zero flow pressure (ZFP were calculated bilaterally at baseline and after infusion of injection Dexmedetomidine 1 mcg/Kg over 10 min. Results: Twenty-six patients completed the study protocol. After administration of loading dose of dexmedetomidine, mFV and eCPP values were significantly decreased in both hemispheres (P < 0.05; PI, CVRi, and ZFP values showed significant increase (P < 0.05 after dexmedetomidine infusion. Conclusion: Increase in PI, CVRi, and ZFP suggests that there is a possibility of an increase in distal cerebral vascular resistance (CVR with loading dose of dexmedetomidine. Decrease in mFV and eCPP along with an increase in CVR may lead to a decrease in cerebral perfusion. This effect can be exaggerated in patients with preexisting neurological illness. Further studies are needed to evaluate the effect of dexmedetomidine on various other pathological conditions involving brain like traumatic brain injury and vascular malformations.

  12. Vascular endothelial growth factor induced angiogenesis following focal cerebral ischemia/reperfusion injury in rabbits

    Institute of Scientific and Technical Information of China (English)

    Huaijun Liu; Jiping Yang; Fenghai Liu; Qiang Zhang; Hui Li

    2006-01-01

    BACKGROUND: Therapeutic angiogenesis has opened up new pathway for the treatment of ischemic cerebrovascular disease in recent years. The exploration of the effect of vascular endothelial growth factor (VEGF) on inducing angiogenesis following ischemia/reperfusion injury can provide better help for the long-term treatment of cerebrovascular disease in clinic.OBJECTIVE: To observe the effect of VEGF on inducing angiogenesis following focal cerebral ischemia/reperfusion injury in rabbits through the angiogenesis of microvessels reflected by the expression of the factors of vascular pseudohemophilia.DESIGN: A randomized controlled animal trial.SETTING: Department of Medical Imaging, Second Hospital of Hebei Medical University.MATERIALS: Sixty-five healthy male New Zealand rabbits of clean degree, weighing (2.6±0.2) kg, aged4.5-5 months, were used. The polyclonal antibody against vascular pseudohemophilia (Beijing Zhongshan Company), recombinant VEGF165 (Peprotech Company, USA), biotinylated second antibody and ABC compound (Wuhan Boster Company) were applied.METHODS: The experiments were carried out in the Laboratory of Neuromolecular Imaging and Neuropathy,Second Hospital of Hebei Medical University from May to August in 2005. ① The rabbits were randomly divided into three groups: sham-operated group (n=15), control group (n=25) and VEGF-treated group(n=25). In the control group and VEGF-treated group, models were established by middle cerebral artery occlusion (MCAO) induced focal cerebral ischemia/reperfusion. In the VEGF-treated group, VEGF165(2.5 mg/L) was stereotactically injected into the surrounding regions of the infarcted sites immediately after the 2-hour ischemia/reperfusion; Saline of the same dosage was injected in the control group. But the rabobserved on the 3rd, 7th, 14th, 28th and 70th days of the experiment respectively, 3 rabbits in the sham-operated group and 5 in the control group and VEGF-treated group were observed at each time point. The

  13. Human apolipoprotein E ɛ4 expression impairs cerebral vascularization and blood-brain barrier function in mice.

    Science.gov (United States)

    Alata, Wael; Ye, Yue; St-Amour, Isabelle; Vandal, Milène; Calon, Frédéric

    2015-01-01

    Human apolipoprotein E (APOE) exists in three isoforms ɛ2, ɛ3, and ɛ4, of which APOE4 is the main genetic risk factor of Alzheimer's disease (AD). As cerebrovascular defects are associated with AD, we tested whether APOE genotype has an impact on the integrity and function of the blood-brain barrier (BBB) in human APOE-targeted replacement mice. Using the quantitative in situ brain perfusion technique, we first found lower (13.0% and 17.0%) brain transport coefficient (Clup) of [(3)H]-diazepam in APOE4 mice at 4 and 12 months, compared with APOE2 and APOE3 mice, reflecting a decrease in cerebral vascularization. Accordingly, results from immunohistofluorescence experiments revealed a structurally reduced cerebral vascularization (26% and 38%) and thinner basement membranes (30% and 35%) in 12-month-old APOE4 mice compared with APOE2 and APOE3 mice, suggesting vascular atrophy. In addition, APOE4 mice displayed a 29% reduction in [(3)H]-d-glucose transport through the BBB compared with APOE2 mice without significant changes in the expression of its transporter GLUT1 in brain capillaries. However, an increase of 41.3% of receptor for advanced glycation end products (RAGE) was found in brain capillaries of 12-month-old APOE4 mice. In conclusion, profound divergences were observed between APOE genotypes at the cerebrovascular interface, suggesting that APOE4-induced BBB anomalies may contribute to AD development.

  14. Human apolipoprotein E ɛ4 expression impairs cerebral vascularization and blood–brain barrier function in mice

    Science.gov (United States)

    Alata, Wael; Ye, Yue; St-Amour, Isabelle; Vandal, Milène; Calon, Frédéric

    2015-01-01

    Human apolipoprotein E (APOE) exists in three isoforms ɛ2, ɛ3, and ɛ4, of which APOE4 is the main genetic risk factor of Alzheimer's disease (AD). As cerebrovascular defects are associated with AD, we tested whether APOE genotype has an impact on the integrity and function of the blood–brain barrier (BBB) in human APOE-targeted replacement mice. Using the quantitative in situ brain perfusion technique, we first found lower (13.0% and 17.0%) brain transport coefficient (Clup) of [3H]-diazepam in APOE4 mice at 4 and 12 months, compared with APOE2 and APOE3 mice, reflecting a decrease in cerebral vascularization. Accordingly, results from immunohistofluorescence experiments revealed a structurally reduced cerebral vascularization (26% and 38%) and thinner basement membranes (30% and 35%) in 12-month-old APOE4 mice compared with APOE2 and APOE3 mice, suggesting vascular atrophy. In addition, APOE4 mice displayed a 29% reduction in [3H]-d-glucose transport through the BBB compared with APOE2 mice without significant changes in the expression of its transporter GLUT1 in brain capillaries. However, an increase of 41.3% of receptor for advanced glycation end products (RAGE) was found in brain capillaries of 12-month-old APOE4 mice. In conclusion, profound divergences were observed between APOE genotypes at the cerebrovascular interface, suggesting that APOE4-induced BBB anomalies may contribute to AD development. PMID:25335802

  15. MEK1/2 inhibition attenuates vascular ETA and ETB receptor alterations after cerebral ischaemia

    DEFF Research Database (Denmark)

    Henriksson, Marie; Stenman, Emelie; Vikman, Petter;

    2007-01-01

    Cerebral ischaemia is associated with elevated levels of endothelin B (ETB) receptors in the ipsilateral middle cerebral artery (MCA). This up-regulation of ET receptors occurs via de novo transcription involving mitogen-activated protein kinases (MAPK). The aim of this study was to examine the e......, neurological symptoms, and ET receptor alteration. The vascular effects of U0126 provide new perspective on possible mechanisms of actions of MAPK inhibition in cerebral ischaemia.......Cerebral ischaemia is associated with elevated levels of endothelin B (ETB) receptors in the ipsilateral middle cerebral artery (MCA). This up-regulation of ET receptors occurs via de novo transcription involving mitogen-activated protein kinases (MAPK). The aim of this study was to examine...... the effect of inhibition of the MAP kinase/ERK kinase (MEK)1/2 on ET receptor alteration, brain damage, and neurology in experimental cerebral ischaemia. Transient middle cerebral artery occlusion (MCAO) was induced in male Wistar rats by the intraluminal filament technique. The animals received 100 mg...

  16. Model-based Quantification of Cerebral Hemodynamics as a Physiomarker for Alzheimer’s Disease?

    Science.gov (United States)

    Marmarelis, V. Z.; Shin, D. C.; Orme, M. E.; Zhang, R.

    2013-01-01

    Previous studies have found that Alzheimer’s disease (AD) impairs cerebral vascular function, even at early stages of the disease. This offers the prospect of a useful diagnostic method for AD, if cerebral vascular dysfunction can be quantified reliably within practical clinical constraints. We present a recently developed methodology that utilizes a data-based dynamic nonlinear closed-loop model of cerebral hemodynamics to compute “physiomarkers” quantifying the state of cerebral flow autoregulation to pressure-changes (CA) and cerebral CO2 vasomotor reactivity (CVMR) in each subject. This model is estimated from beat-to-beat measurements of mean arterial blood pressure, mean cerebral blood flow velocity and end-tidal CO2, which can be made reliably and non-invasively under resting conditions. This model may also take an open-loop form and comparisons are made with the closed-loop counterpart. The proposed model-based physiomarkers take the form of two indices that quantify the gain of the CA and CVMR processes in each subject. It was found in an initial set of clinical data that the CVMR index delineates AD patients from control subjects and, therefore, may prove useful in the improved diagnosis of early-stage AD. PMID:23771298

  17. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.

    Science.gov (United States)

    Khatibi, Kasra; Heit, Jeremy J; Telischak, Nicholas A; Elbers, Jorina M; Do, Huy M

    2016-08-01

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

  18. The Association of Type 2 Diabetes Mellitus with Cerebral Gray Matter Volume Is Independent of Retinal Vascular Architecture and Retinopathy

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    C. Moran

    2016-01-01

    Full Text Available It is uncertain whether small vessel disease underlies the relationship between Type 2 Diabetes Mellitus (T2DM and brain atrophy. We aimed to study whether retinal vascular architecture, as a proxy for cerebral small vessel disease, may modify or mediate the associations of T2DM with brain volumes. In this cross-sectional study using Magnetic Resonance Imaging (MRI scans and retinal photographs in 451 people with and without T2DM, we measured brain volumes, geometric measures of retinal vascular architecture, clinical retinopathy, and MRI cerebrovascular lesions. There were 270 people with (mean age 67.3 years and 181 without T2DM (mean age 72.9 years. T2DM was associated with lower gray matter volume (p=0.008. T2DM was associated with greater arteriolar diameter (p=0.03 and optimality ratio (p=0.04, but these associations were attenuated by adjustments for age and sex. Only optimality ratio was associated with lower gray matter volume (p=0.03. The inclusion of retinal measures in regression models did not attenuate the association of T2DM with gray matter volume. The association of T2DM with lower gray matter volume was independent of retinal vascular architecture and clinical retinopathy. Retinal vascular measures or retinopathy may not be sufficiently sensitive to confirm a microvascular basis for T2DM-related brain atrophy.

  19. The effect of ASK1 on vascular permeability and edema formation in cerebral ischemia.

    Science.gov (United States)

    Song, Juhyun; Cheon, So Yeong; Lee, Won Taek; Park, Kyung Ah; Lee, Jong Eun

    2015-01-21

    Apoptosis signal-regulating kinase-1 (ASK1) is the mitogen-activated protein kinase kinase kinase (MAPKKK) and participates in the various central nervous system (CNS) signaling pathways. In cerebral ischemia, vascular permeability in the brain is an important issue because regulation failure of it results in edema formation and blood-brain barrier (BBB) disruption. To determine the role of ASK1 on vascular permeability and edema formation following cerebral ischemia, we first investigated ASK1-related gene expression using microarray analyses of ischemic brain tissue. We then measured protein levels of ASK1 and vascular endothelial growth factor (VEGF) in brain endothelial cells after hypoxia injury. We also examined protein expression of ASK1 and VEGF, edema formation, and morphological alteration through cresyl violet staining in ischemic brain tissue using ASK1-small interference RNA (ASK1-siRNA). Finally, immunohistochemistry was performed to examine VEGF and aquaporin-1 (AQP-1) expression in ischemic brain injury. Based on our findings, we propose that ASK1 is a regulating factor of vascular permeability and edema formation in cerebral ischemia.

  20. Venular degeneration leads to vascular dysfunction in a transgenic model of Alzheimer's disease.

    Science.gov (United States)

    Lai, Aaron Y; Dorr, Adrienne; Thomason, Lynsie A M; Koletar, Margaret M; Sled, John G; Stefanovic, Bojana; McLaurin, JoAnne

    2015-04-01

    Most patients with Alzheimer's disease exhibit accumulation of amyloid-β peptide on leptomeningeal and cortical arterioles, or cerebral amyloid angiopathy, which is associated with impaired vascular reactivity and accelerated cognitive decline. Despite widespread recognition of the significance of vascular dysfunction in Alzheimer's disease aetiology and progression, much uncertainty still surrounds the mechanism underlying Alzheimer's disease vascular injury. Studies to date have focused on amyloid-β-induced damage to capillaries and plaque-associated arterioles, without examining effects across the entire vascular bed. In the present study, we investigated the structural and functional impairment of the feeding arteriolar versus draining venular vessels in a transgenic murine Alzheimer's disease model, with a particular focus on the mural cell populations that dictate these vessels' contractility. Although amyloid-β deposition was restricted to arterioles, we found that vascular impairment extended to the venules, which showed significant depletion of their mural cell coverage by the mid-stage of Alzheimer's disease pathophysiology. These structural abnormalities were accompanied by an abolishment of the normal vascular network flow response to hypercapnia: this functional impairment was so severe as to result in hypercapnia-induced flow decreases in the arterioles. Further pharmacological depletion of mural cells using SU6668, a platelet-derived growth factor receptor-β antagonist, resulted in profound structural abnormalities of the cortical microvasculature, including vessel coiling and short-range looping, increased tortuosity of the venules but not of the arterioles, increased amyloid-β deposition on the arterioles, and further alterations of the microvascular network cerebral blood flow response to hypercapnia. Together, this work shows hitherto unrecognized structural alterations in penetrating venules, demonstrates their functional significance and

  1. CT Perfusion and MR Perfusion Weighted Imaging in Evaluating the Effect of Vascular Reconstruction on Short-term Cerebral Blood Flow in Patients with Moyamoya Disease%CT灌注与MR灌注加权成像评价烟雾病血管重建术对烟雾病患者短期脑血流的影响

    Institute of Scientific and Technical Information of China (English)

    崔若棣; 易明岗

    2015-01-01

    Objective To study CT perfusion (CTP) and MR perfusion (PWI) weighted imaging in evaluating the effect of vascular reconstruction on short-term cerebral blood flow in patients with moyamoya disease.Methods 47 patients with unilateral vascular reconstruction confirmed by DSA in the hospital were selected as the research objects and all received vascular reconstruction. All the patients received CTP and PWI examination before and after operation to obtain parameters, such as cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP). The preoperative and postoperative distribution of cerebral middle artery (MCA) and ipsilateral cerebellar perfusion parameters in control part (rCBF, rCBV, rMTT and rTTP) were compared as well as the differences in preoperative and postoperative relative value of CTP and PWI perfusion parameters.Results Postoperative CT perfusion image showed that CBF, CBV, MTT and TTP in the right distribution area of MCA significantly changed, compared with those before operation. Postoperative PWI perfusion image showed that CBF, CBV, MTT and TTP significantly significantly changed, compared with those before operation. After operation, rCBF and rCBV values in the distribution area of operation side MCA and the control ares were significantly higher than those before operation (P<0.05) while rMTT and rTTP were significantly lower than those before operation (P<0.05).Conclusion Both of CT perfusion and MR perfusion weighted imaging are the effective observation methods to observe the changes of cerebral blood flow in patients with moyamoya disease, which can be used in clinic.%目的:研究CT灌注(CTP)与MR灌注(PWI)加权成像评价烟雾病血管重建术对烟雾病患者短期脑血流的影响。方法选取我院47例经DSA证实的单侧血管重建术患者为研究对象,均行血管重建术治疗,术前术后接受CTP、PWI检查,获得脑血容量(CBV)、脑血流量(CBF)、平均通

  2. Contribution of blood platelets to vascular pathology in Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Zhang W

    2013-11-01

    Full Text Available Wei Zhang,1,2 Wei Huang,1 Fang Jing11Department of Pharmacology, Institutes for Advanced Interdisciplinary Research, East China Normal University, Shanghai, People's Republic of China; 2Shanghai Engineering Research Center of Molecular Therapy and Pharmaceutical Innovation, Shanghai, People's Republic of ChinaAbstract: Cerebral amyloid angiopathy (CAA is a critical factor in the pathogenesis of Alzheimer's disease (AD. In the clinical setting, nearly 98% AD patients have CAA, and 75% of these patients are rated as severe CAA. It is characterized by the deposition of the β-amyloid peptide (mainly Aβ40 in the walls of cerebral vessels, which induces the degeneration of vessel wall components, reduces cerebral blood flow, and aggravates cognitive decline. Platelets are anuclear cell fragments from bone marrow megakaryocytes and their function in hemostasis and thrombosis has long been recognized. Recently, increasing evidence suggests that platelet activation can also mediate the onset and development of CAA. First, platelet activation and adhesion to a vessel wall is the initial step of vascular injury. Activated platelets contribute to more than 90% circulating Aß (mainly Aβ1-40, which in turn activates platelets and results in the vicious cycle of Aβ overproduction in damaged vessel. Second, the uncontrolled activation of platelets leads to a chronic inflammatory reaction by secretion of chemokines (eg, platelet factor 4 [PF4], regulated upon activation normal T-cell expressed and presumably secreted [RANTES], and macrophage inflammatory protein [MIP-1α], interleukins (IL-1 β, IL-7, and IL-8, prostaglandins, and CD40 ligand (CD40L. The interaction of these biological response modulators with platelets, endothelial cells, and leukocytes establishes a localized inflammatory response that contributes to CAA formation. Finally, activated platelets are the upholder of fibrin clots, which are structurally abnormal and resistant to degradation

  3. Autonomic cerebral vascular response to sildenafil in diabetic patient

    Directory of Open Access Journals (Sweden)

    Al-Amran Fadhil G

    2012-01-01

    Full Text Available Abstract Background Erectile dysfunction is a common problem in type 2 diabetic patients who are at higher risk of cerebrovascular events, and it's recorded with sildenafil, a drug which is primarily used for erectile dysfunction. Objectives We tested the hypothesis whether or not sildenafil modulates cerebrovascular reactivity (CVR in patients with type 2 diabetes mellitus. Methods A total of 35 male participants were enrolled; eighteen with type 2 diabetes mellitus matched with seventeen normal individuals. Transcranial Doppler Ultrasonographic examination (TCD was performed for all participants to insonate the middle cerebral artery (MCA through a trans-temporal window. CVR was assessed by using breath holding (BH-hyperventilation (HV test, before and after oral 50 mg sildenafil; recordings were analyzed by using SPSS program version 12. Results In normal individuals, sildenafil did not result in statistically significant change in breath holding index (BHI from 0.91 ± 0.11 to 0.81 ± 0.09 and full range of vasodilatation (FVD from (59.4% ± 6.3% to (53.7% ± 4.9%. In diabetic patients, giving sildenafil resulted in significant increase in BHI (from 0.74 ± 0.14 to 1.03 ± 0.14 and FVD (from 60.2% ± 4.96% to 74% ± 4.8%, (p Conclusion Sildenafil significantly improves CVR in type 2 diabetic patients but not in normal subjects.

  4. The vascular phenotype in pseudoxanthoma elasticum and related disorders: Contribution of a genetic disease to the understanding of vascular calcification.

    Directory of Open Access Journals (Sweden)

    Georges eLeftheriotis

    2013-02-01

    Full Text Available Vascular calcification is a complex and dynamic process occurring in various physiological conditions such as aging and exercise or in acquired metabolic disorders like diabetes or chronic renal insufficiency. Arterial calcifications are also observed in several genetic diseases revealing the important role of unbalanced or defective anti- or pro-calcifying factors. Pseudoxanthoma elasticum (PXE is an inherited disease (OMIM 264800 characterized by elastic fiber fragmentation and calcification in various soft conjunctive tissues including the skin, eyes and arterial media. The PXE disease results from mutations in the ABCC6 gene, encoding an ATP-binding cassette transporter primarily expressed in the liver, kidneys suggesting that it is a prototypic metabolic soft-tissue calcifying disease of genetic origin. The clinical expression of the PXE arterial disease is characterized by an increased risk for coronary (myocardial infarction, cerebral (aneurysm and stroke and lower limb peripheral artery disease. However, the structural and functional changes in the arterial wall induced by PXE are still unexplained. The use of a recombinant mouse model inactivated for the Abcc6 gene is an important tool for the understanding of the PXE pathophysiology although the vascular impact in this model remains limited to date. Overlapping of the PXE phenotype with other inherited calcifying diseases could bring important informations to our comprehension of the PXE disease.

  5. Studies of Japanese cases with cerebral basal rete mirabile (Moyamoya disease). Investigation of cerebrovascular hemodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Ueta, Kiyotaka

    1988-04-01

    Eight children under 15 years of age and 8 adults with basal cerebral rate (so called Moyamoya disease) were examined. Regional cerebral blood flow (rCBF) was measured in 12 of these patients under normocapneic, hypercapneic, hypocapneic and hypotensive states by a /sup 133/Xe-intracarotid injection method using a gamma camera. Patients with neurological deficits due to completed stroke (CS) had angiographically poor normograde vascularization of cortical branches of the middle cerebral artery (MCA) and poorly developed collateral circulation. Hemispheric cerebral blood flow (HCBF) in the resting state tended to decrease according to the severity of neurological deficits, but was within the normal range in patients with no neurological deficits. However, focal reduction of rCBF was seen in half of the patients with transient ischemic attacks. Development of leptomeningeal anastomosis of MCA territories from the posterior cerebral artery seemed to have a more important role than basal rete in maintaining cerebral blood flow. There was a significant reduction of the HCBF under the hypocaneic state, but no significant increase under the hypercapneic state. The lack of a CBF response to increased arterial CO/sub 2/ tension seemed to be due to maximum dilatation of cerebral arterioles. (author) 61 refs.

  6. Clinical Decision Support for Vascular Disease in Community Family Practice

    Science.gov (United States)

    Keshavjee, K; Holbrook, AM; Lau, E; Esporlas-Jewer, I; Troyan, S

    2006-01-01

    The COMPETE III Vascular Disease Tracker (C3VT) is a personalized, Web-based, clinical decision support tool that provides patients and physicians access to a patient’s 16 individual vascular risk markers, specific advice for each marker and links to best practices in vascular disease management. It utilizes the chronic care model1 so that physicians can better manage patients with chronic diseases. Over 1100 patients have been enrolled into the COMPETE III study to date.

  7. 踝臂指数对老年高血压合并下肢动脉病变患者发生心脑血管病风险的预测价值%Assessment of peripheral arterial disease in elderly hypertensive patients and risk prediction of cardio-cerebral vascular disease by ankle-brachial index

    Institute of Scientific and Technical Information of China (English)

    沈丹; 曹萍; 王桦; 刘珍丽

    2012-01-01

    目的 探讨踝臂指数(ABI)对老年高血压合并下肢动脉病变(PAD)患者发生心脑血管病变风险的预测价值.方法 回顾性分析老年高血压病患者285例,按照ABI值分为高血压合并PAD组(PAD组,55例)和高血压未合并PAD组(非PAD组,230例),比较2组间臂踝脉搏波传导速度(baPWV)及各种心脑血管病危险因素的差异.结果 与非PAD组比较,PAD组收缩压(SBP)、脉压(PP)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)[Lp(a)]、血尿酸(UA)、C反应蛋白(CRP)、糖化血红蛋白(HbA1c)以及baPWV值均明显增加(P<0.05,或P<0.01);且发生冠心病、脑梗死的风险分别增高3.17倍(95%CI 1.29~7.76)和5.57倍(95%CI 2.15~14.44);相关分析显示,ABI与年龄(r=-0.273,P=0.025)、PP(r=-0.230,P=0.034)、Lp(a)(r=-0.361,P=0.002)、UA(r=-0.210,P=0.046)、CRP(r=-0.311,P=0.030)、HbA1c(r=-0.272,P=0.017)、baPWV(r=-0.291,P=0.018)均呈负相关.Logistic回归分析提示,年龄、SBP、PP及Lp(a)是PAD的独立危险因素.结论 ABI可评估老年高血压患者下肢动脉病变的严重程度,并预测其心脑血管疾病的发生风险.%Objective To investigate whether the ankle-brachial index ( ABI ) can assess peripheral arterial disease ( PAD ) in elderly hypertensive patients and predict the risk of cardio-cerebral vascular diseases. Methods The data of 285 elderly hypertensive patients was retrospectively reviewed and analyzed. They were diagnosed as hypertension with PAD ( n = 55 ) or without PAD ( none-PAD, n = 230 ) according to ABI criteria. Brachial-ankle pulse wave velocity ( baPWV ) and various cardiovascular risk factors were compared between the two groups. Results The prevalence of PAD in elderly hypertensive patients was 19. 3% . Compared with patients without PAD, the levels of systolic blood pressure ( SBP ), pulse pressure ( PP ), low density lipoprotein-cholesterol ( LDL-C ), lipoprotein (a)[Lp(a)], uric acid ( UA ), C-reactive protein ( CRP ), HbAl c and ba

  8. Advances in diagnosis and treatment of cerebral venous system diseases

    Directory of Open Access Journals (Sweden)

    Xiao-yun LIU

    2016-11-01

    Full Text Available Cerebral venous system diseases include cerebral venous thrombosis (CVT, venous sinus stenosis, carotid cavernous fistula (CCF, intracranial arteriovenous malformation (AVM and so on. In recent years, due to the rapid development of neuroimaging and interventional technology, more and more cerebral venous system diseases have been timely diagnosed and treated, such as magnetic resonance black-blood thrombus imaging (MRBTI in the diagnosis of CVT, stenting in the treatment of venous sinus stenosis, micro coil plus Onyx glue or covered stents in the treatment of CCF, which allow us to make a deeper recognition of cerebral venous system diseases. Therefore, this paper will introduce the latest diagnosis and treatment of cerebral venous system diseases. DOI: 10.3969/j.issn.1672-6731.2016.11.006

  9. Effects of ginsenosides on vascular reactivity in rat cerebral and renal arteries

    Institute of Scientific and Technical Information of China (English)

    WONG Wing-tak; LEUNG Fung-ping; YUNG Lai-hang; TIAN Xiao-yu; WONG Ricky Ngok Shun; HUANG Yu

    2008-01-01

    Objective To investigate possible mechanisms underlying the antioxidant property (1) and the in vitro vasodilator effects (2) of the two ginsenosides, Rb1 and Rg1, in isolated rat renal and cerebral arteries. Methods Arterial rings were mounted in a multi-channel myograph for recording of isometric tension. To examine the antioxidant activity, some rings were exposed to a free radical-generating reaction (hypoxan-thine and xanthine oxidase) with and without pre-treatment with ginsenosides. The calcium antagonistic effects were tested on rings contracted by membrane depolarization in elevated extracellular potassium ions, a condition that promoted Ca2+ influx in vascular smooth muscle cells. Results Ginsenosides protected endothelial function (endothelial nitric oxide-dependent relaxation) against oxidative stress; (2) ginsenoside Rb1 reduced the high K+ -induced contractions of both renal and cerebral arteries while ginsenoside Rgl relaxed the rat cerebral artery but not the renal artery. Conclusions Ginsenosides are vaso-protective via (1) the antioxidant activity which protects endothelial cell function and (2) the inhibition of Ca2+ influx through voltage-sensitive Ca2+ channels in vascular smooth muscle. The vasodilator effects may suggest the potential preventive or therapeutic values of ginsenosides against stroke and renal hypertension.

  10. Herpes Zoster oftálmico e posterior acidente vascular cerebral: relato de caso

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    Carlos A. M. Guerreiro

    1984-12-01

    Full Text Available Um caso de acidente vascular cerebral (AVC 14 semanas após a instalação de herpes zoster oftálmico (HZO é apresentado. A tomografia computadorizada craniana documentou comprometimento em território de artéria cerebral média ipsilateral ao HZO. O diagnóstico de probabilidade é o de arterite por herpes zoster com posterior trombose. Os autores reviram a literatura e enfatizam o longo intervalo entre o HZO e a instalação da hemiplegia. Citam as novas drogas antivirais que tornam esta causa de AVC potencialmente passível de ser prevenida.

  11. Vascular Cures

    Science.gov (United States)

    ... Contact Us Vascular Disease What is Vascular Disease? Education and Awareness Vascular Diseases Abdominal Aortic Aneurysm Aortic Dissection Arteriovenous Malformation Atherosclerosis Buerger's Disease Carotid Artery Disease ...

  12. Cerebral blood flow in Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Roher AE

    2012-10-01

    Full Text Available Alex E Roher,1 Josef P Debbins,2 Michael Malek-Ahmadi,3 Kewei Chen,4 James G Pipe,2 Sharmeen Maze,2 Christine Belden,3 Chera L Maarouf,1 Pradeep Thiyyagura,4 Hua Mo,4 Jesse M Hunter,1 Tyler A Kokjohn,1,5 Douglas G Walker,6 Jane C Kruchowsky,6 Marek Belohlavek,7 Marwan N Sabbagh,3 Thomas G Beach81The Longtine Center for Neurodegenerative Biochemistry, Banner Sun Health Research Institute, Sun City, 2Keller Center for Imaging Innovation, Neuroimaging Research, Barrow Neurological Institute, Phoenix, 3Cleo Roberts Center for Clinical Research, Banner Sun Health Research Institute, Sun City, 4Computational Image Analysis Program, Banner Alzheimer’s Institute, Phoenix, 5Department of Microbiology, Midwestern University, Glendale, 6Laboratory of Neuroinflammation, Banner Sun Health Research Institute, Sun City, 7Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, 8Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ, USABackground: Alzheimer’s disease (AD dementia is a consequence of heterogeneous and complex interactions of age-related neurodegeneration and vascular-associated pathologies. Evidence has accumulated that there is increased atherosclerosis/arteriosclerosis of the intracranial arteries in AD and that this may be additive or synergistic with respect to the generation of hypoxia/ischemia and cognitive dysfunction. The effectiveness of pharmacologic therapies and lifestyle modification in reducing cardiovascular disease has prompted a reconsideration of the roles that cardiovascular disease and cerebrovascular function play in the pathogenesis of dementia.Methods: Using two-dimensional phase-contrast magnetic resonance imaging, we quantified cerebral blood flow within the internal carotid, basilar, and middle cerebral arteries in a group of individuals with mild to moderate AD (n = 8 and compared the results with those from a group of age-matched nondemented control (NDC subjects (n = 9

  13. MMP-2 Is Mainly Expressed in Arterioles and Contributes to Cerebral Vascular Remodeling Associated with TGF-β1 Signaling.

    Science.gov (United States)

    Hua, Ye; Zhang, Weifeng; Xie, Zhenying; Xu, Nanfei; Lu, Yunnan

    2016-07-01

    There is increasing evidence to suggest that matrix metalloproteinases (MMPs) play a crucial role in vascular remodeling. It has been reported that hypoxia stimulated MMP-9 expression in brain endothelial cells and MMP-9 plays an important role in cerebral vascular remodeling. However, little is known about MMP-2 in the cerebral vessels remodeling. Herein, the aim of this study is to examine the class of vessel and cell type expressing MMP-2 in cerebral vessels and to investigate its potential role in vascular remodeling. In the present study, dual-immunofluorescence assay showed that MMP-2 was mainly expressed in arterioles. In addition, we found that MMP-2 expression in cerebral vessels was derived from endothelial cells, not astrocyte cells. Notably, in the normoxic central nervous system (CNS), there was no effect on vascular development, integrity, or endothelial proliferation when MMP-2 was knocked out, but lack of MMP-2 led to defective arteriolar remodeling and associated with transforming growth factor β1 (TGF-β1) signaling in CNS. Moreover, blocking TGF-β with SB431542, a specific TGF-β inhibitor, significantly reduced the messenger RNA (mRNA) and protein expression levels of MMP-2 in human umbilical vein endothelial cells (HUVECs). Our findings reveal that the level of MMP-2 is high in arteriolar endothelial cells and demonstrate a novel connection between MMP-2 and TGF-β1 signaling in cerebral vascular remodeling.

  14. PERFIL DA DISFAGIA APÓS UM ACIDENTE VASCULAR CEREBRAL: UMA REVISÃO INTEGRATIVA

    OpenAIRE

    CARINA TEIXEIRA PAIXÃO; LOLITA DOPICO DA SILVA; FLAVIA GIRON CAMERINI

    2010-01-01

    Este artículo trata de disfagia decurrente de una enfermedad vascular cerebral (EVC). El objetivo fue determinar el perfil de las publicaciones acerca de la disfagia en pacientes víctimas de EVC. Investigación de revisión integradora que usó los mismos descriptores en las bases Medline, Scielo e Lilacs, seleccionando 17 artículos entre 1998 a 2008. Los datos fueron analizados a partir de las categorías correspondientes a los enfoques de las publicaciones encontradas. Los resultados muestran d...

  15. A distensibilidade da aorta prediz o acidente vascular cerebral em pacientes hipertensos

    OpenAIRE

    Telmo Pereira; João Maldonado; Liliana Pereira; Jorge Conde

    2013-01-01

    FUNDAMENTO: A doença cardiovascular continua a ser principal causa de morte nos países desenvolvidos e não é inteiramente prevista por fatores de risco clássicos. O aumento da rigidez arterial constitui um importante determinante de morbidade e mortalidade cardiovascular. OBJETIVO: Avaliar se a velocidade da onda de pulso prediz a ocorrência de acidente vascular cerebral (AVC) em pacientes hipertensos. MÉTODOS: Estudo de coorte, observacional, prospetivo, multicêntrico, incluindo 1.133 pacien...

  16. Effects of cerebrolysin on moderate cognitive impairments in cerebral vascular insufficiency (a clinical-electrophysiological study).

    Science.gov (United States)

    Damulin, I V; Koberskaya, N N; Mkhitaryan, E A

    2008-07-01

    The efficacy of treatment with cerebrolysin was studied in 40 patients with cerebral vascular insufficiency. Cerebrolysin (20 daily i.v. infusions of 10 ml in 200 ml of physiological saline) was found to be an effective means of treating this group of patients. Courses of cerebrolysin treatment decreased the severity of memory and attention impairments, improving the overall cognitive status of the patients. Clinical observations and neuropsychological testing were supported by electrophysiological results, in terms of the P300 cognitive evoked potential. The effects of treatment at the doses used here were delayed and were seen three months after completion of treatment.

  17. Factores asociados a crisis epilépticas en pacientes con enfermedad vascular cerebral aguda.

    OpenAIRE

    Salirrosas-Alegría, Cristopher; Médico residente de Psiquiatría, Instituto Nacional de Salud Mental Honorio Delgado - Hideyo Noguchi. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.; Pereda-Vásquez, Firdusi; Profesor Principal de Neurología Clínica y de Semiología Neurológica. Facultad de Medicina. Universidad Nacional de Trujillo. Coordinador Académico del Residentado de Neurología de la Facultad de Medicina. Universidad Nacional de Trujillo. Trujillo, Perú.

    2013-01-01

    Objetivos: Determinar la asociación entre el tipo de enfermedad vascular cerebral (EVC), la extensión de la lesióncerebral, la presencia de cardiopatía isquémica y/o fibrilación auricular; y las crisis epilépticas en pacientes con EVCaguda. Material y métodos: Se realizó un estudio descriptivo, de tipo casos y controles. Se estudiaron a los pacientesque presentaron crisis epilépticas luego de la EVC. Las variables fueron: crisis epilépticas, tipo de EVC, cardiopatíaisquémica, fibrilación auri...

  18. Stratification of cerebral hemodynamics of child moyamoya disease using CBF SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji; Saito, Norihiro; Osato, Toshiaki; Kamiyama, Kenji; Takeda, Rihei; Nakamura, Hirohiko [Nakamura Memorial Hospital, Sapporo (Japan)

    2002-12-01

    In order to make sure the stratification of cerebral hemodynamics of child moyamoya disease, we evaluated {sup 123}I-IMP SPECT before and after surgical revascularization. The aim of this paper is to establish the semiquantitative parameters that can be applied to estimate severity of hemodynamic cerebral ischemia instead of quantitative parameters. Quantitative studies using IMP-autoradiography (ARG) method were performed on thirteen patients to measure resting regional cerebral blood flow (rCBF), and vascular reserve (rVR): (Diamox-activated rCBF/resting rCBF-1) x 100%. Semiquantitative parameters were calculated from the ratio of region of interest (ROI) counts in the anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory to the dominant cerebellum counts (ROI/Ce ratio) at resting and Diamox-activated conditions. From the quantitative study, both mean resting rCBF less than 40 ml/100 g/min and rVR less than 10% could indicate stage 2 hemodynamic cerebral ischemia. The prediction of stage 2 ischemia using semiquantitative parameters (resting ROI/Ce ratio less than 0.9 and Diamox-activated ROI/Ce ratio less than 0.85 in the MCA territory) was not statistically different comparison to the diagnosis using quantitative parameters (using Fisher exact test<0.0001, Sensitivity and specificity were 87.5% and 90.9%, respectively). The ROI/Ce ratio can be utilized as simple parameters instead of quantitative parameters. (author)

  19. Effect of preceding exercise on cerebral and splanchnic vascular responses to mental task

    Directory of Open Access Journals (Sweden)

    Someya Nami

    2012-06-01

    Full Text Available Abstract Background To investigate the effect of preceding acute exercise on the peripheral vascular response to a mental task, we measured splanchnic and cerebral blood flow responses to performing a mental task after exercise and resting. Methods In the exercise trial, 11 males exercised for 30 min on a cycle ergometer with a workload set at 70% of the age-predicted maximal heart rate for each individual. After a 15-min recovery period, the subjects rested for 5 min for pre-task baseline measurement and then performed mental arithmetic for 5 min followed by 5 min of post-task measurement. In the resting trial, they rested for 45 min and pre-task baseline data was obtained for 5 min. Then mental arithmetic was performed for 5 min followed by post-task measurement. We measured the mean blood velocity in the middle cerebral artery and superior mesenteric artery and the mean arterial pressure. Results Mean arterial pressure and mean blood velocity in the middle cerebral artery were significantly higher than the baseline during mental arithmetic in both exercise and resting trials. Mean blood velocity in the middle cerebral artery during mental arithmetic was greater in the control trial than the exercise trial. Mean blood velocity in the superior mesenteric artery showed no significant change during mental arithmetic from baseline in both trials. Conclusion These results suggest that acute exercise can moderate the increase in cerebral blood flow induced by a mental task.

  20. Stabiliztin of VEGFR2 Signaling by Cerebral Cavernous Malformation 3 is Critical for Vascular Development

    Energy Technology Data Exchange (ETDEWEB)

    Y He; H Zhang; L Yu; M Gunel; T Boggon; H Chen; W Min

    2011-12-31

    Cerebral cavernous malformations (CCMs) are human vascular malformations caused by mutations in three genes of unknown function: CCM1, CCM2, and CCM3. CCM3, also known as PDCD10 (programmed cell death 10), was initially identified as a messenger RNA whose abundance was induced by apoptotic stimuli in vitro. However, the in vivo function of CCM3 has not been determined. Here, we describe mice with a deletion of the CCM3 gene either ubiquitously or specifically in the vascular endothelium, smooth muscle cells, or neurons. Mice with global or endothelial cell-specific deletion of CCM3 exhibited defects in embryonic angiogenesis and died at an early embryonic stage. CCM3 deletion reduced vascular endothelial growth factor receptor 2 (VEGFR2) signaling in embryos and endothelial cells. In response to VEGF stimulation, CCM3 was recruited to and stabilized VEGFR2, and the carboxyl-terminal domain of CCM3 was required for the stabilization of VEGFR2. Indeed, the CCM3 mutants found in human patients lacking the carboxyl-terminal domain were labile and were unable to stabilize and activate VEGFR2. These results demonstrate that CCM3 promotes VEGFR2 signaling during vascular development.

  1. Glutamatergic and central cholinergic dysfunction in the CA1, CA2 and CA3 fields on spatial learning and memory in chronic cerebral ischemia-Induced vascular dementia of rats.

    Science.gov (United States)

    Cao, Yanjing; Gou, Zengmei; Du, Yifeng; Fan, Yongjun; Liang, Lizhen; Yan, Yongxing; Lin, Ping; Jin, Mudan; Du, Yifenf

    2016-05-04

    Chronic cerebral ischemia (CCI) is associated with cognitive decline in aging, vascular dementia and Alzheimer's disease. Substantial evidence has shown that chronic cerebral ischemia may cause cognitive impairment, but the underlying neurobiological mechanism is poorly understood so far. In the present study, we used a rat model of chronic cerebral ischemia by permanent bilateral common carotid artery occlusion (BCCAO) to investigate the alterations of glutamatergic and central cholinergic dysfunction, and their causal relationship with the cognitive deficits induced by chronic cerebral ischemia. We found that BCCAO rats exhibited spatial learning and memory impairments dysfunction 3 month after BCCAO. Meanwhile, vGluT levels as well as glutamatergic and central cholinergic positive neurons in the hippocampus CA1-3 field significantly decreased. The protection of glutamergic and cholinergic neurons or regulating glutamate and central cholinergic levels in hippocampal subregion may have beneficial effects on cognitive impairments associated with the possible mechanism in CCI-induced vascular dementia.

  2. 急性脑梗死患者合并脑微出血的心脑血管事件发生的研究%Effect of cerebral microbleeds on cardiac and cerebral vascular events following acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    李晓晴; 毕齐; 王力; 王力峰

    2012-01-01

    目的 研究急性脑梗死合并脑微出血(CMB)患者后期心脑血管事件的发生率和危险因素.方法 将109例急性脑梗死患者分为CMB组38例和无CMB组71例,对其进行前瞻性研究,给予梯度回波T2* WI或磁敏感加权成像,并对患者的临床资料和影像学特点进行分析.平均随访(9.5±3.7)个月.结果 与无CMB组比较,CMB组脑梗死和脑出血两者兼有,单纯脑出血比例明显升高(7.9% vs 1.4%,P<0.05;10.5% vs 0,P<0.01).CMB组共检出CMB 153个.在随访中,16例患者再发脑卒中,包括11例脑梗死,5例脑出血.5例脑出血患者中有3例服用阿司匹林,2例接受抗凝治疗.CMB组有2例脑出血患者的出血部位与CMB部位相同.结论 CMB是脑微小血管病变特征之一;是急性缺血性脑血管病患者后期发生脑出血的危险因素之一;CMB对脑卒中患者长期服用阿司匹林或者抗凝治疗具有重要意义.%Objective To study the incidence and risk factor of cardiac and cerebral vascular events in patients with acute cerebral infarction accompanying cerebral mierobleeds(CMB). Methods One hundred and nine acute cerebral infarction patients were divided into CMB group(n = 38) and non-CMB group (n = 71). The patients underwent gradient echo T2-weighted MRI or magnetic susceptibility-weighted imaging. Their clinical data and imaging characteristics were analyzed. The patients were followed up for 9. 5 + 3. 7 months. Results The proportions of acute cerebral infarction and CMB were significantly higher in CMB group than in non-CMB group(7. 9% vs 1.4%,P<0. 05)10. 5% vs 0,P<0.01).One hundred and fifty-three CMB were detected in CMB group. Of the 16 patients who had relapse of cerebral stroke during the follow-up, 11 had cerebral infarction and 5 had intracerebral hemorrhage(3 were treated with aspirin and 2 received anti-coagulant therapy). The bleeding site was similar to that of CMB in 2 patients of CMB group. Conclusion CMB are one of the

  3. EFFECT OF ELECTROACUPUNCTURE ON CEREBRAL BLOOD FLOW,VIP AND ET IN RATS WITH VASCULAR DEMENTIA

    Institute of Scientific and Technical Information of China (English)

    申国明; 徐颖; 何峰; 许冠荪

    2004-01-01

    Objective: To investigate the relationship between electroacupuncture (EA)-induced improvement of regional cerebral blood flow and the alternations of vasoactive intestinal peptide (VIP) and endothelin (ET) in rats with experimental vascular dementia (VD).Methods: 40 Wistar rats were evenly randomized into sham-operation, model, medication (Nimotone) and EA groups.Vascular dementia model was established by repeated cerebral ischemia-reperfusion which was induced by occlusion and reopen of the bilateral common carotid arteries.EA (2~200 Hz, 2~3 mA) was applied to "Baihui"(GV 20), "Dazhui"(GV 14) and "Zusanli"(ST 36) for 30 min, once daily and continuously for 15 days.The regional cerebral blood flow (rCBF) in parietal lobe and hippocampus was determined with method of hydrogen clearance; a step-down avoidance test was adopted to observe the rats' behavior change; and plasma VIP and ET contents were assayed by radioimmunoassay.Results: In comparison with sham-operation group, the correct rate of step-down avoidance test, rCBF in parietal lobe and hippocampus and plasma VIP level in VD model group lowered significantly (P<0.01) and plasma ET increased considerably (P<0.01).However, compared with model group, the correct rate of step-down avoidance test, rCBF values and plasma VIP in EA group raised obviously while plasma ET declined significantly.No significant differences were found between EA and medication groups in the 4 indexes.Conclusion: EA can raise rCBF in the parietal lobe and hippocampus, elevate plasma VIP level and reduce plasma ET in rats with VD.

  4. Disruption of rich club organisation in cerebral small vessel disease.

    Science.gov (United States)

    Tuladhar, Anil M; Lawrence, Andrew; Norris, David G; Barrick, Thomas R; Markus, Hugh S; de Leeuw, Frank-Erik

    2017-04-01

    Cerebral small vessel disease (SVD) is an important cause of vascular cognitive impairment. Recent studies have demonstrated that structural connectivity of brain networks in SVD is disrupted. However, little is known about the extent and location of the reduced connectivity in SVD. Here they investigate the rich club organisation-a set of highly connected and interconnected regions-and investigate whether there is preferential rich club disruption in SVD. Diffusion tensor imaging (DTI) and cognitive assessment were performed in a discovery sample of SVD patients (n = 115) and healthy control subjects (n = 50). Results were replicated in an independent dataset (49 SVD with confluent WMH cases and 108 SVD controls) with SVD patients having a similar SVD phenotype to that of the discovery cases. Rich club organisation was examined in structural networks derived from DTI followed by deterministic tractography. Structural networks in SVD patients were less dense with lower network strength and efficiency. Reduced connectivity was found in SVD, which was preferentially located in the connectivity between the rich club nodes rather than in the feeder and peripheral connections, a finding confirmed in both datasets. In discovery dataset, lower rich club connectivity was associated with lower scores on psychomotor speed (β = 0.29, P SVD is characterized by abnormal connectivity between rich club hubs in SVD and provide evidence that abnormal rich club organisation might contribute to the development of cognitive impairment in SVD. Hum Brain Mapp 38:1751-1766, 2017. © 2017 Wiley Periodicals, Inc.

  5. A Voxel-based Morphometric Analysis of Cerebral Gray Matter in Subcortical Ischemic Vascular Dementia Patients and Normal Aged Controls

    Directory of Open Access Journals (Sweden)

    Chuanming Li, Hanjian Du, Jian Zheng, Jian Wang

    2011-01-01

    Full Text Available BACKGROUND AND PURPOSE: The present study was designed to detect the abnormalities of the cerebral grey-matter density in subcortical ischemic vascular dementia patients by FSL-VBM method to promote the early diagnosis of it.METHODS: Nine subcortical ischemic vascular dementia patients and nine age-matched normal controls underwent MRI brain structure scanning that was performed on a SIEMENS AVANTO 1.5 Tesla scanner and standard T1-weighted high-resolution anatomic scans of MPRAGE sequence were obtained. The 3-demensional MPRAGE images were processed with FSL-VBM package and the cerebral gray matter density was compared between the subcortical ischemic vascular dementia patients and normal controls.RESULTS: Compared with the normal control group, the cerebral gray matter density of subcortical ischemic vascular dementia patients was found significantly decreasing, including brain regions of thalamus, parietal lobe, frontal lobe and temporal lobe (P<0.05.CONCLUSIONS: The cerebral gray matter density alterations have closed correlation with cognitive dysfunction in subcortical ischemic vascular dementia patient and can be detected by MRI. MRI has some potential value in the diagnosis of them.

  6. l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease: A systematic review.

    Science.gov (United States)

    Karlsson, William K; Sørensen, Caspar G; Kruuse, Christina

    2017-01-01

    Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischaemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of l-arginine and N(G) -monomethyl-l-arginine (l-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to l-arginine or l-NMMA in human subjects with vascular risk factors or ischaemic cerebrovascular disease. Seven studies (315 subjects) were eligible according to inclusion and exclusion criteria. Studies investigated the effect of age (n=2), type 2 diabetes mellitus (DM) (n=1), cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) (n=1), leukoaraiosis (n=1), and prior ischaemic stroke or transient ischaemic attack (TIA) (n=2) on cerebral ED. Most studies applied transcranial Doppler to quantify cerebral ED. Endothelium-dependent vasodilatation (EDV) induced by l-arginine was impaired in elderly and subjects with leukoaraiosis, but enhanced in CADASIL patients. Studies including subjects with prior ischaemic stroke or TIA reported both enhanced and impaired EDV to l-arginine. Responses to l-NMMA deviated between subjects with type 2 DM and the elderly. We found only few studies investigating cerebral endothelial responses to l-arginine and l-NMMA in subjects with vascular risk factors or ischaemic cerebrovascular disease. Inconsistencies in results were most likely due to variations in methods and included subject populations. In order to use cerebral ED as a prognostic marker, further studies are required to evaluate the association to cerebrovascular disease.

  7. Effect of combined VEGF165/ SDF-1 gene therapy on vascular remodeling and blood perfusion in cerebral ischemia.

    Science.gov (United States)

    Hu, Guo-Jie; Feng, Yu-Gong; Lu, Wen-Peng; Li, Huan-Ting; Xie, Hong-Wei; Li, Shi-Fang

    2016-12-16

    OBJECTIVE Therapeutic neovascularization is a promising strategy for treating patients after an ischemic stroke; however, single-factor therapy has limitations. Stromal cell-derived factor 1 (SDF-1) and vascular endothelial growth factor (VEGF) proteins synergistically promote angiogenesis. In this study, the authors assessed the effect of combined gene therapy with VEGF165 and SDF-1 in a rat model of cerebral infarction. METHODS An adenoviral vector expressing VEGF165 and SDF-1 connected via an internal ribosome entry site was constructed (Ad- VEGF165-SDF-1). A rat model of middle cerebral artery occlusion (MCAO) was established; either Ad- VEGF165-SDF-1 or control adenovirus Ad- LacZ was stereotactically microinjected into the lateral ventricle of 80 rats 24 hours after MCAO. Coexpression and distribution of VEGF165 and SDF-1 were examined by reverse-transcription polymerase chain reaction, Western blotting, and immunofluorescence. The neurological severity score of each rat was measured on Days 3, 7, 14, 21, and 28 after MCAO. Angiogenesis and vascular remodeling were evaluated via bromodeoxyuridine and CD34 immunofluorescence labeling. Relative cerebral infarction volumes were determined by T2-weighted MRI and triphenyltetrazolium chloride staining. Cerebral blood flow, relative cerebral blood volume, and relative mean transmit time were assessed using perfusion-weighted MRI. RESULTS The Ad- VEGF165-SDF-1 vector mediated coexpression of VEGF165 and SDF-1 in multiple sites around the ischemic core, including the cortex, corpus striatum, and hippocampal granular layer. Coexpression of VEGF165 and SDF-1 improved neural function, reduced cerebral infarction volume, increased microvascular density and promoted angiogenesis in the ischemic penumbra, and improved cerebral blood flow and perfusion. CONCLUSIONS Combined VEGF165 and SDF-1 gene therapy represents a potential strategy for improving vascular remodeling and recovery of neural function after cerebral

  8. Diabetes and microvascular disease in Vascular Cognitive Impairment

    NARCIS (Netherlands)

    Brundel, M.

    2014-01-01

    The contribution of cerebrovascular disease in the development of cognitive dysfunction and dementia is increasingly recognized. Cerebrovascular damage is heterogeneous, ranging from a clinical stroke to more insidious brain changes. The term vascular cognitive impairment (VCI) has been introduced,

  9. Airway vascular reactivity and vascularisation in human chronic airway disease

    NARCIS (Netherlands)

    Bailey, Simon R; Boustany, Sarah; Burgess, Janette K; Hirst, Stuart J; Sharma, Hari S; Simcock, David E; Suravaram, Padmini R; Weckmann, Markus

    2009-01-01

    Altered bronchial vascular reactivity and remodelling including angiogenesis are documented features of asthma and other chronic inflammatory airway diseases. Expansion of the bronchial vasculature under these conditions involves both functional (vasodilation, hyperperfusion, increased microvascular

  10. Impaired vascular reactivity in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Tetzner, Fabian; Scholze, Alexandra; Wittstock, Antje;

    2008-01-01

    Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics.......Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics....

  11. Clinical manifestations and cerebral angiographic findings of moyamoya disease

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Objective To study the clinical features and angiographic findings of moyamoya disease (MMD) as well as their relationship. Methods A total of 22 MMD patients received routine digital substraction angiography (DSA). The clinical manifestations and angiographic findings were analyzed. Results Clinical manifestations varied and each patient often had multiple symptoms,including cerebral infarction in 9 patients with an average age of 23.6 (13-39 years) and cerebral hemorrhage in 7 patients with an average age...

  12. Andrographolide, a Novel NF-κB Inhibitor, Inhibits Vascular Smooth Muscle Cell Proliferation and Cerebral Endothelial Cell Inflammation

    Science.gov (United States)

    Chang, Chao-Chien; Duann, Yeh-Fang; Yen, Ting-Lin; Chen, Yu-Ying; Jayakumar, Thanasekaran; Ong, Eng-Thiam; Sheu, Joen-Rong

    2014-01-01

    Background Aberrant vascular smooth muscle cell (VSMC) proliferation and cerebral endothelial cell (CEC) dysfunction contribute significantly in the pathogenesis of cardiovascular diseases. Therefore, inhibition of these cellular events would be by candidate agents for treating these diseases. In the present study, the mechanism of anti-proliferative and anti-inflammatory effects of andrographolides, a novel nuclear factor-κB inhibitor, was investigated in VSMC and CEC cells. Methods VSMCs and CECs were isolated from rat artery and mouse brain, respectively, and cultured before experimentation. The effect of andro on platelet-derived growth factor-BB (PDGF-BB) induced VSMC cell proliferation was evaluated by cell number, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The expression of extracellular signal regulated kinase 1/2 (ERK1/2), proliferating cell nuclear antigen (PCNA), and the effects on lipopolysaccharide (LPS)-induced inducible nitric oxide synthase (iNOS) and, cyclooxygenase-2 (COX2) were detected by Western blotting. Results Andro significantly inhibited PDGF-BB (10 ng/ml) induced cell proliferation in a concentration (20-100 μM) dependent manner, which may be due to reducing the expression of ERK1/2, and by inhibiting the expression of PCNA. Andro also remarkably diminished LPS-induced iNOS and COX2 expression. Conclusions The results of this study suggested that the effects of andro against VSMCs proliferation and CECs dysfunction may represent a promising approach for treatment of vascular diseases. PMID:27122804

  13. Role of amyloid peptides in vascular dysfunction and platelet dysregulation in Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Ilaria eCanobbio

    2015-03-01

    Full Text Available Alzheimer’s disease (AD is the most common neurodegenerative cause of dementia in the elderly. AD is accompanied by the accumulation of amyloid peptides in the brain parenchyma and in the cerebral vessels. The sporadic form of the AD accounts for about 95% of all cases. It is characterized by a late onset, typically after the age of 65, with a complex and still poorly understood aetiology. Several observations point towards a central role of cerebrovascular dysfunction in the onset of sporadic AD. According to the vascular hypothesis, AD may be initiated by vascular dysfunctions that precede and promote the neurodegenerative process. In accordance to this, AD patients show increased hemorragic or ischemic stroke risks. It is now clear that multiple bidirectional connections exist between AD and cerebrovascular disease, and in this new scenario, the effect of amyloid peptides on vascular cells and blood platelets appear to be central to AD. In this review we analyse the effect of amyloid peptides on vascular function and platelet activation and its contribution to the cerebrovascular pathology associated with AD and the progression of this disease.

  14. Genetically elevated C-reactive protein and ischemic vascular disease

    DEFF Research Database (Denmark)

    Zacho, J.; Tybjaerg-Hansen, A.; Jensen, J.S.;

    2008-01-01

    in CRP levels of up to 64%, resulting in a theoretically predicted increased risk of up to 32% for ischemic heart disease and up to 25% for ischemic cerebrovascular disease. However, these genotype combinations were not associated with an increased risk of ischemic vascular disease. In contrast......, apolipoprotein E genotypes were associated with both elevated cholesterol levels and an increased risk of ischemic heart disease. Conclusions: Polymorphisms in the CRP gene are associated with marked increases in CRP levels and thus with a theoretically predicted increase in the risk of ischemic vascular disease....... However, these polymorphisms are not in themselves associated with an increased risk of ischemic vascular disease Udgivelsesdato: 2008/10/30...

  15. Atypical Vascular Involvement in a Case of Behçet's Disease

    Directory of Open Access Journals (Sweden)

    Alejandro Rodríguez Morata

    2012-01-01

    Full Text Available Introduction. Behçet's disease (BD is a form of vasculitis of unknown etiology which is rare in our environment. It is characterized by a variety of clinical manifestations and usually affects young adults. Recurrent oral and genital ulcers are a characteristic and extremely frequent symptom, but mortality is linked with more significant symptoms such as aortic pseudoaneurysm, pulmonary pseudoaneurysm, and cerebral venous thrombosis. Patient and Method. We present a case of a young male with atypical BD and severe polyvascular involvement (previous cerebral venous thrombosis and current peripheral venous thrombosis, acute ischemia, and peripheral arterial pseudoaneurysm who required urgent surgical intervention due to a symptomatic external iliac pseudoaneurysm. Result. The pseudoaneurysm was successfully treated, we performed an iliofemoral bypass, and we treated it with steroids and immunosuppressive therapy. Conclusions. These rare clinical manifestations highlight the importance of considering BD in young patients, even in usual cases of vascular intervention, whether arterial or venous in nature.

  16. Application of quality control circle management in the prevention of accidental prolapse of gastric tube in patients with cerebral-vascular disease%品管圈管理预防脑血管病患者胃管意外滑脱的效果

    Institute of Scientific and Technical Information of China (English)

    马虹颖; 杨存美; 冯瑞娟

    2014-01-01

    目的:探讨品管圈管理在预防脑血管病患者胃管滑脱中的作用。方法成立品管圈,应用头脑风暴法确立预防胃管滑脱为活动的主题,拟定计划,分析现状,统计绘制柏拉图及鱼骨图分析原因,针对3项主要原因设定目标,制定对策,将实施对策进行效果确认、标准化,修改并制定科室的胃管管理制度。结果实施措施后我科脑血管留置胃管患者拔管率由27.5%(55/200)降低至5.0%(10/200),差异有统计学意义(χ2=27.05,P<0.01);设定的目标值均已达到,目标达成率115%,进步率81%。圈员责任心、自信心、积极性、解决问题的能力、团队凝聚力等方面的能力得到提升。结论品管圈管理研究了影响胃管滑脱的主要因素,制定了切实有效的预防措施,有效解决了胃管滑脱的问题,提高了护士的综合素质,提高了临床护理质量。%Objective To investigate the effect of quality circle control ( QCC ) management in the prevention of accidental prolapse of gastric tube in patients with cerebral -vascular disease .Methods First, we set up the quality control circle , identified the theme , analyzed the current situation and drew the Pareto diagram and fishbone diagram to find out the three main causes .Then we set up the goals and developed strategies .At last we confirmed and standardized the results , modified and formulated the tube management system . Results After applying the QCC management , the extubation rate significantly reduced from 27.5%(55/200) to 5.0%(10/200) (χ2 =27.05,P<0.01), with an achievement rate of 115%and progress rate of 81%.The responsibility, self-confidence, initiative, problem solving ability, team cohesion, communicate and coordinated ability, happiness and quality control means had improved after the application of QCC management . Conclusions The application of QCC management can effectively solve the

  17. T cells in vascular inflammatory diseases

    NARCIS (Netherlands)

    Lintermans, Lucas L.; Stegeman, Coen A.; Heeringa, Peter; Abdulahad, Wayel H.

    2014-01-01

    Inflammation of the human vasculature is a manifestation of many different diseases ranging from systemic autoimmune diseases to chronic inflammatory diseases, in which multiple types of immune cells are involved. For both autoimmune diseases and chronic inflammatory diseases several observations su

  18. Both acute and prolonged administration of EPO reduce cerebral and systemic vascular conductance in humans.

    Science.gov (United States)

    Rasmussen, Peter; Kim, Yu-Sok; Krogh-Madsen, Rikke; Lundby, Carsten; Olsen, Niels V; Secher, Niels H; van Lieshout, Johannes J

    2012-03-01

    Administration of erythropoietin (EPO) has been linked to cerebrovascular events. EPO reduces vascular conductance, possibly because of the increase in hematocrit. Whether EPO in itself affects the vasculature remains unknown; here it was evaluated in healthy males by determining systemic and cerebrovascular variables following acute (30,000 IU/d for 3 d; n=8) and chronic (5000 IU/week for 13 wk; n=8) administration of EPO, while the responsiveness of the vasculature was challenged during cycling exercise, with and without hypoxia. Prolonged administration of EPO increased hematocrit from 42.5 ± 3.7 to 47.6 ± 4.1% (PEPO administration. Yet, the two EPO regimes increased arterial pressure similarly (by 8±4 and 7±3 mmHg, respectively; P=0.01) through reduced vascular conductance (by 7±3 and 5±2%; PEPO regimes widened the arterial-to-jugular O(2) differences at rest as well as during normoxic and hypoxic exercise (PEPO to healthy humans lowers systemic and cerebral conductance independent of its effect on hematocrit.

  19. Vascular inward rectifier K+ channels as external K+ sensors in the control of cerebral blood flow.

    Science.gov (United States)

    Longden, Thomas A; Nelson, Mark T

    2015-04-01

    For decades it has been known that external K(+) ions are rapid and potent vasodilators that increase CBF. Recent studies have implicated the local release of K(+) from astrocytic endfeet-which encase the entirety of the parenchymal vasculature-in the dynamic regulation of local CBF during NVC. It has been proposed that the activation of KIR channels in the vascular wall by external K(+) is a central component of these hyperemic responses; however, a number of significant gaps in our knowledge remain. Here, we explore the concept that vascular KIR channels are the major extracellular K(+) sensors in the control of CBF. We propose that K(+) is an ideal mediator of NVC, and discuss KIR channels as effectors that produce rapid hyperpolarization and robust vasodilation of cerebral arterioles. We provide evidence that KIR channels, of the KIR 2 subtype in particular, are present in both the endothelial and SM cells of parenchymal arterioles and propose that this dual positioning of KIR 2 channels increases the robustness of the vasodilation to external K(+), enables the endothelium to be actively engaged in NVC, and permits electrical signaling through the endothelial syncytium to promote upstream vasodilation to modulate CBF.

  20. Optical Assessment of Vascular Disease Progression and Treatment

    Science.gov (United States)

    Samuels, Joshua A.

    Vascular disease manifests itself in many different forms, including chronic ulcers which do not heal, impaired blood flow to the limbs, or damage to the natural reperfusion process. The current forms of assessing vascular disease are often subjective and provide incomplete knowledge about the tissue of interest. This work focused on developing non-invasive techniques to quantitatively evaluate three specific elements of vascular disease: diabetic ulcers, venous ulcers, and peripheral arterial disease. Diffuse Near Infrared Spectroscopy (DNIRS) was used to predict healing (82% positive predictive value) in diabetic ulcers after 4 weeks of assessment (sensitivity of 0.9 and specificity of 0.86; pulcers, using a low-frequency (20kHz), low intensity (ulcers compared to wounds which do not heal (p30 seconds) belonging to patients with PAD (pvascular health and the results obtained promise to develop new clinically relevant and quantitative techniques using non-invasive optical modalities.

  1. Differential effects of ischemic vascular disease and Alzheimer's disease on brain atrophy and cognition.

    Science.gov (United States)

    Zheng, Ling; Vinters, Harry V; Mack, Wendy J; Weiner, Michael W; Chui, Helena C

    2016-01-01

    We previously reported that pathologic measures of arteriosclerosis (AS), cerebral infarction, and Alzheimer’s disease (AD) are independently correlated with cortical gray matter (CGM) atrophy measured by in vivo magnetic resonance imaging (MRI). Here, we use path analyses to model the associations between these three pathology measures and cognitive impairment, as mediated by CGM atrophy, after controlling for age and education. In this sample of 116 elderly persons followed longitudinally to autopsy (ischemic vascular disease (IVD) program project), differential patterns were observed between AS and atrophy/cognition versus AD and atrophy/cognition. The total effect of AD pathology on global cognition (β = -0.61, s.e. = 0.06) was four times stronger than that of AS (β = -0.15, s.e. = 0.08). The effect of AS on cognition appears to occur through cerebral infarction and CGM atrophy (β = -0.13, s.e. = 0.04). In contrast, the effects of AD pathology on global cognition (β = -0.50, s.e. = 0.07) occur through a direct pathway that is five times stronger than the indirect pathway acting through CGM atrophy (β = -0.09, s.e. = 0.03). The strength of this direct AD pathway was not significantly mitigated by adding hippocampal volume to the model. AD pathology affects cognition not only through brain atrophy, but also via an unmeasured pathway that could be related to synaptic dysfunction before the development of cortical atrophy.

  2. Pulmonary vascular response of dogs with heartworm disease.

    Science.gov (United States)

    Rawlings, C A

    1978-10-01

    Heartworm diseases in dogs is an infectious disease that produces pulmonary hypertension. Dogs with the early vascular changes of heartworm disease, but without the clinical cardiopulmonary signs and pulmonary hypertension, were studied. Dogs with early heartworm were identified that had an exaggerated hypertensive response to hypoxia and to postaglandin F2alpha as compared to those of normal dogs. The pulmonary hypertensive response of dogs with spontaneous heartworm disease varied widely between individuals.

  3. Clinical study on cognitive function and the related factors of patients with ischemic cerebral vascular disease complicated with cerebral microbleeds%缺血性脑血管病并脑微出血相关因素分析及认知功能临床研究

    Institute of Scientific and Technical Information of China (English)

    刘军贤; 王志东; 黄润霞

    2015-01-01

    Objective To analyze cognitive function and the related factors of patients with ischemic cerebral vascular dis‐ease (ICVD) complicated with cerebral microbleeds (CMBs). Methods 240 cases of ICVD patients were selected as the re‐search objects and were divided into CMBs group and non CMBs group according to whether complicated with CMBs. 62 pa‐tients and 178 patients were included respectively. Mini Mental State Examination (MMSE) and Montreal cognitive assessment scale (MoCA) were applied to evaluate and compare the cognitive function of the patients.Results The age and proportions of patients with hypertension ,leukoaraiosis(LA) ,lacunar Infarction (LI) ,a history of previous stroke in CMBs group were sig‐nificantly higher than those in non CMBs group (P<0.05). The age (OR=1.376) ,hypertension (OR=3.965) ,and LI (OR=3.562) were the risk factors for the incidence of ICVD patients complicated with CMBs (P< 0.05). The total score of MMSE ,the total score of MoCA score and the scores of visuospatial/executive ,attention ,delayed memory items of patients in CMBs group were significantly lower than those of the patients in non CMBs group (P<0.05). The total score of MMSE ,the total score of MoCA score and the scores of visuospatial/executive ,attention ,language ,delayed memory items of patients with CMBs involving the cortico subcortical areas were significantly lower than those without involving CMBs involving the cortico subcortical areas (P<0.05).Conclusion The incidence of ICVD complicated with CMBs is associated with many factors ,and can lead to significant cognitive impairment ,which may be related with the occurrences of CMBs lesion involving the cortico subcortical areas.%目的分析缺血性脑血管病(ICVD)合并脑微出血(CMBs)的相关因素及对认知功能的影响。方法选取240例ICVD患者为研究对象,根据是否合并CMBs分为CMBs组和非CMBs组,分别纳入62例和178例患者,应用简易精神状况检查表

  4. Optical measures of changes in cerebral vascular tone during voluntary breath holding and a Sternberg memory task.

    Science.gov (United States)

    Tan, Chin Hong; Low, Kathy A; Schneider-Garces, Nils; Zimmerman, Benjamin; Fletcher, Mark A; Maclin, Edward L; Chiarelli, Antonio M; Gratton, Gabriele; Fabiani, Monica

    2016-07-01

    The human cerebral vasculature responds to changes in blood pressure and demands for oxygenation via cerebral autoregulation. Changes in cerebrovascular tone (vasoconstriction and vasodilation) also mediate the changes in blood flow measured by the BOLD fMRI signal. This cerebrovascular reactivity is known to vary with age. In two experiments, we demonstrate that cerebral pulse parameters measured using optical imaging can quantify changes in cerebral vascular tone, both globally and locally. In experiment 1, 51 older adults (age range=55-87) performed a voluntary breath-holding task while cerebral pulse amplitude measures were taken. We found significant pulse amplitude variations across breath-holding periods, indicating vasodilation during, and vasoconstriction after breath holding. The breath-holding index (BHI), a measure of cerebrovascular reactivity (CVR) was derived and found to correlate with age. BHI was also correlated with performance in the Modified Mini-Mental Status Examination, even after controlling for age and education. In experiment 2, the same participants performed a Sternberg task, and changes in regional pulse amplitude between high (set-size 6) and low (set-size 2) task loads were compared. Only task-related areas in the fronto-parietal network (FPN) showed significant reduction in pulse amplitude, indicating vasodilation. Non-task-related areas such as the somatosensory and auditory cortices did not show such reductions. Taken together, these experiments suggest that optical pulse parameters can index changes in brain vascular tone both globally and locally, using both physiological and cognitive load manipulations.

  5. Vascular contribution to Alzheimer disease: predictors of rapid progression.

    Science.gov (United States)

    Diomedi, Marina; Misaggi, Giulia

    2013-06-01

    Different courses of Alzheimer disease are observed in clinical practice. The rapidly progressive form could be associated with the presence of a major microcirculatory involvement and hemodynamic insufficiency. This short review aims to provide an overview of the current knowledge of cerebrovascular contribution to Alzheimer disease presentation and progression, hypothesizing the possible vascular markers of rapidly progressive form.

  6. PET/CT and vascular disease: Current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Cavalcanti Filho, Jose Leite Gondim; Souza Leao Lima, Ronaldo de [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Department of Radiology, Rio de Janeiro Federal University (UFRJ), Rio de Janeiro (Brazil); Souza Machado Neto, Luiz de [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Kayat Bittencourt, Leonardo, E-mail: lkayat@terra.com.br [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Department of Radiology, Rio de Janeiro Federal University (UFRJ), Rio de Janeiro (Brazil); Cortes Domingues, Romeu [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Fonseca, Lea Mirian Barbosa da [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Department of Radiology, Rio de Janeiro Federal University (UFRJ), Rio de Janeiro (Brazil)

    2011-10-15

    Since its introduction in 2001, positron emission tomography associated to computed tomography (PET/CT) has been established as a standard tool in cancer evaluation. Being a multimodality imaging method, it combines in a single session the sensitivity granted by PET for detection of molecular targets within the picomolar range, with an underlying submilimetric resolution inherent to CT, that can precisely localize the PET findings. In this last decade, there have been new insights regarding the pathophysiology of atherosclerosis, particularly about plaque rupture and vascular remodeling. This has increased the interest for research on PET/CT in vascular diseases as a potential new diagnostic tool, since some PET molecular targets could identify diseases before the manifestation of gross anatomic features. In this review, we will describe the current applications of PET/CT in vascular diseases, emphasizing its usefulness in the settings of vasculitis, aneurysms, vascular graft infection, aortic dissection, and atherosclerosis/plaque vulnerability. Although not being properly peripheral vascular conditions, ischemic cardiovascular disease and cerebrovascular disease will be briefly addressed as well, due to their widespread prevalence and importance.

  7. Influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Hui Lu; Ning-Ning Cui; Bin-Cheng Wang

    2016-01-01

    Objective:To study the influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease. Methods:A total of 58 patients with ischemic cerebrovascular disease in our hospital from April 2015 to January 2016 were selected as the study object, and 58 patients were randomly divided into two groups, 29 patients in control group were treated with routine treatment, 29 patients in observation group were treated with remote ischemic preconditioning on the basic treatment of control group, then the cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment and at first, third and sixth month after the treatment were respectively detected and compared.Results:The cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment all showed no significant differences (allP>0.05), while the cerebral oxygen metabolism and cerebral blood flow indexes of observation group at first, third and sixth month after the treatment were all significantly better than those before the treatment, and the results were all significantly better than those of control group at the same time too (allP>0.05).Conclusions: The influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease are better, and its application value for the patients with ischemic cerebrovascular disease is higher.

  8. Investigação de negligência espacial unilateral após Acidente Vascular Cerebral

    OpenAIRE

    Luvizutto, Gustavo José

    2016-01-01

    Introdução: A negligência espacial unilateral (NEU) é caracterizada pela incapacidade de reportar ou responder pessoas ou objetos do lado contralateral à lesão cerebral, e ocorre principalmente após Acidente Vascular Cerebral (AVC) do lobo parietal direito, sendo associada à pior desfecho funcional à longo prazo. Objetivo: Os objetivos desta tese foram: normatizar os principais testes diagnósticos de NEU e verificar a relação com fatores sócio-demográficos na população brasileira; avaliar as ...

  9. CEREBRAL HYDATID DISEASE: CT AND MR IMAGING FINDINGS

    Directory of Open Access Journals (Sweden)

    Ajay

    2014-10-01

    Full Text Available OBJECTIVE: Cerebral hydatid disease is very rare, representing only 2% of all cerebral space occupying lesions even in the countries where the disease is endemic. The aim of this paper is to describe the characteristic features of cerebral hydatid disease in computed tomography (CT and magnetic resonance imaging (MRI. METHODS: Here is a case 25yr/m who presented to neurosurgery OPD with complaints of headache, vomiting, right sided weakness and seizures for 2 weeks. CT and MRI were the imaging modalities to reach the diagnosis which was pathologically confirmed postoperatively as hydatid disease. RESULTS: CT and MR imaging findings of E. granulosus lesions were well defined, smooth thin-walled, spherical, homogeneous cystic lesions with no contrast enhancement, no calcification, and no surrounding oedema. CONCLUSION: Although cystic cerebral hydatid disease is well demonstrated by CT and MR examinations, CT is superior in detecting calcification in the cyst, when present, MR is better in demonstrating cyst capsule, detecting multiplicity and defining the anatomic relationship of the lesion with the adjacent structures, and it is more helpful in surgical planning.

  10. The metabolic syndrome and vascular disease

    NARCIS (Netherlands)

    Olijhoek, Jobien Karen

    2006-01-01

    In the Western population cardiovascular diseases are the most common cause of mortality and morbidity. There are several important risk factors for cardiovascular diseases, among them hypertension, hypercholesterolemia, diabetes and obesity. The clustering of cardiovascular risk factors associated

  11. Physical Activity and Vascular Events and Mortality in Patients with Vascular Disease

    NARCIS (Netherlands)

    Boss, H. Myrthe; Kappelle, L. Jaap; Van der Graaf, Yolanda; Kooistra, Minke; Visseren, Frank L. J.; Geerlings, Mirjam I.

    2015-01-01

    Introduction: In patients with CAD, moderate levels of leisure time physical activity are associated with lower risk of mortality. However, less is known about the effects in patients with vascular disease other than CAD. In this study, we examined the association between physical activity and risk

  12. Clinical Application of Vascular Regenerative Therapy for Peripheral Artery Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Suzuki

    2013-01-01

    Full Text Available Prognosis of peripheral artery disease (PAD, especially critical limb ischemia, is very poor despite the development of endovascular therapy and bypass surgery. Many patients result in leg amputation and, therefore, vascular regenerative therapy is expected in this field. Gene therapy using vascular endothelial growth factor is the first step of vascular regenerative therapy, but did not confirm effectiveness in a large-scale randomized comparative study. Based on animal experiments, bone marrow mononuclear cells (MNCs, peripheral blood MNCs were used as the cell source for regenerative therapy. Those cells were confirmed to be effective to decrease rest pain and ulcer size, but its effect was not fully satisfied. Mesenchymal stem cells (MSCs are expected as an effective cell source for vascular regeneration and clinical studies are ongoing, because the cells are able to differentiate into various cell types and produce a significant amount of vascular growth factors. Of vascular regeneration therapy, peripheral MNCs and bone marrow MNCs were recognized as advanced medical technology but do not attain to the standard therapy. However, clinical use of MSCs have already started, and induced pluripotent stem cells are surely promising tool for vascular regeneration therapy although further basic studies are required for clinical application.

  13. Alzheimer and vascular brain diseases: Focal and diffuse subforms

    Directory of Open Access Journals (Sweden)

    Eliasz Engelhardt

    Full Text Available Alois Alzheimer is best known for his description of the pre-senile neurodegenerative disease named after him. However, his previous interest in vascular brain diseases, underlying cognitive and behavioral changes, was very strong. Besides describing the Arteriosclerotic atrophy of the brain and the arteriosclerotic subtype of Senile dementia which he viewed as main forms of vascular brain diseases, he also identified and described a series of conditions he considered subforms. These may be divided, as suggested by the authors of the present paper, into 3 groups: gliosis and sclerosis, subcortical atrophies, and apoplectic. The subforms of the three groups present characteristic neuropathological features and clinical, cognitive and behavioral manifestations. These provide the basis, together with part of the main forms, for the contemporary condition known as Vascular Cognitive Impairment.

  14. Early Detection System of Vascular Disease and Its Application Prospect

    Directory of Open Access Journals (Sweden)

    Huan Liu

    2016-01-01

    Full Text Available Markers of imaging, structure, and function reflecting vascular damage, integrating a long time accumulation effect of traditional and unrecognized cardiovascular risk factors, can be regarded as surrogate endpoints of target organ damage before the occurrence of clinical events. Prevention of cardiovascular disease requires risk stratification and treatment of traditional risk factors, such as smoking, hypertension, hyperlipidemia, and diabetes. However, traditional risk stratification is not sufficient to provide accurate assessment of future cardiovascular events. Therefore, vascular injury related parameters obtained by ultrasound or other noninvasive devices, as a surrogate parameter of subclinical cardiovascular disease, can improve cardiovascular risk assessment and optimize the preventive treatment strategy. Thus, we will summarize the research progress and clinical application of early assessment technology of vascular diseases in the present review.

  15. Cerebral infarction following intracranial hemorrhage in pediatric Moyamoya disease - A case report and brief review of literature

    Directory of Open Access Journals (Sweden)

    Soumya Patra

    2012-01-01

    Full Text Available Moyamoya disease is a clinical entity characterized by progressive cerebrovascular occlusion with spontaneous development of a collateral vascular network called Moyamoya vessels. This disease mainly manifests as cerebral ischemia. Intracranial bleeding is another major presentation of patients with Moyamoya disease. We report here a 12-year-old male child who presented with severe headache, vomiting and meningismus. Initial neuroimaging study with noncontrast computed tomography scan revealed fresh intraventricular hemorrhage in right-sided lateral ventricle. Magnetic resonance imaging with angiography of brain was done 5 days later when the child developed right-sided hemiparesis, and the diagnosis of Moyamoya disease was confirmed along with lacunar infarction of right posterior peri and paraventricular area and in the left paraventricular area and centrum semiovale. Simultaneous presence of cerebral infarction along with intraventricular hemorrhage in adult with bleeding-type Moyamoya disease is reported in literature, but it is a rare entity in a child.

  16. Adiponectin as a potential biomarker of vascular disease

    Directory of Open Access Journals (Sweden)

    Ebrahimi-Mamaeghani M

    2015-01-01

    Full Text Available Mehrangiz Ebrahimi-Mamaeghani,1 Somayeh Mohammadi,2 Seyed Rafie Arefhosseini,3 Parviz Fallah,4 Zahra Bazi5 1Nutrition Research Center, 2Department of Nutrition, 3Department of Food Technology, Faculty of Nutrition Sciences, Tabriz University of Medical Sciences, Tabriz, 4Department of Molecular Biology and Genetic Engineering, Stem Cell Technology Research Center, Tehran, 5Department of Biotechnology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranAbstract: The increasing prevalence of diabetes and its complications heralds an alarming situation worldwide. Obesity-associated changes in circulating adiponectin concentrations have the capacity to predict insulin sensitivity and are a link between obesity and a number of vascular diseases. One obvious consequence of obesity is a decrease in circulating levels of adiponectin, which are associated with cardiovascular disorders and associated vascular comorbidities. Human and animal studies have demonstrated decreased adiponectin to be an independent risk factor for cardiovascular disease. However, in animal studies, increased circulating adiponectin alleviates obesity-induced endothelial dysfunction and hypertension, and also prevents atherosclerosis, myocardial infarction, and diabetic cardiac tissue disorders. Further, metabolism of a number of foods and medications are affected by induction of adiponectin. Adiponectin has beneficial effects on cardiovascular cells via its antidiabetic, anti-inflammatory, antioxidant, antiapoptotic, antiatherogenic, vasodilatory, and antithrombotic activity, and consequently has a favorable effect on cardiac and vascular health. Understanding the molecular mechanisms underlying the regulation of adiponectin secretion and signaling is critical for designing new therapeutic strategies. This review summarizes the recent evidence for the physiological role and clinical significance of adiponectin in vascular health, identification of

  17. Deviation from optimal vascular caliber control at middle cerebral artery bifurcations harboring aneurysms.

    Science.gov (United States)

    Baharoglu, Merih I; Lauric, Alexandra; Wu, Chengyuan; Hippelheuser, James; Malek, Adel M

    2014-10-17

    Cerebral aneurysms form preferentially at arterial bifurcations. The vascular optimality principle (VOP) decrees that minimal energy loss across bifurcations requires optimal caliber control between radii of parent (r₀) and daughter branches (r1 and r2): r₀(n)=r₁(n)+r₂(n), with n approximating three. VOP entails constant wall shear stress (WSS), an endothelial phenotype regulator. We sought to determine if caliber control is maintained in aneurysmal intracranial bifurcations. Three-dimensional rotational angiographic volumes of 159 middle cerebral artery (MCA) bifurcations (62 aneurysmal) were processed using 3D gradient edge-detection filtering, enabling threshold-insensitive radius measurement. Radius ratio (RR)=r₀(3)/(r₁(3)+r₂(3)) and estimated junction exponent (n) were compared between aneurysmal and non-aneurysmal bifurcations using Student t-test and Wilcoxon rank-sum analysis. The results show that non-aneurysmal bifurcations display optimal caliber control with mean RR of 1.05 and median n of 2.84. In contrast, aneurysmal bifurcations had significantly lower RR (0.76, pbifurcations revealed a daughter branch larger than its parent vessel, an absolute violation of optimality, not witnessed in non-aneurysmal bifurcations. The aneurysms originated more often off the smaller daughter (52%) vs. larger daughter branch (16%). Aneurysm size was not statistically correlated to RR or n. Aneurysmal males showed higher deviation from VOP. Non-aneurysmal MCA bifurcations contralateral to aneurysmal ones showed optimal caliber control. Aneurysmal bifurcations, in contrast to non-aneurysmal counterparts, disobey the VOP and may exhibit dysregulation in WSS-mediated caliber control. The mechanism of this focal divergence from optimality may underlie aneurysm pathogenesis and requires further study.

  18. Impact of standardized management of basic nursing operation on nosocomial infections in patients with cerebral vascular diseases%基础护理操作规范化管理对脑血管疾病患者医院感染的影响

    Institute of Scientific and Technical Information of China (English)

    郭公慧

    2012-01-01

    OBJECTIVE To explore the impact of the basic nursing standardized operation on the nosocomial infections in the patients with cerebral vascular diseases. METHODS A total of 950 patients with cerebrovascular disease were randomly divided into the control group and the observation group. The control group including 430 cases were given routine nursing care and the observation group including 520 cases were given nursing care according to the " 50 basic nursing operation standard" in the nursing model ward of Shangdong province. RESULTS There were 65 cases with infections in the control group with the infection rate of 15. 9% and 40 cases with infections in the observation group with the infection rate of 7. 6% , the difference was statistically significant (P< 0. 05). CONCLUSION The basic nursing standardized operation management can effectively control the incidence of nosocomial infections and reduce the incidence of complications in cerebrovascular ward.%目的 探讨基础护理操作规范化管理对脑血管疾病患者医院感染的影响.方法 将950例脑血管疾病患者随机分为对照组和观察组,对照组430例按照一般护理常规进行,观察组520例按山东省护理服务示范病房“50项基础护理操作标准要求”实施护理.结果 对照组感染65例,医院感染率为15.9%,观察组感染40例,医院感染率为7.6%,两组比较差异有统计学意义(P<0.05).结论 基础护理操作规范化管理能有效控制脑血管病房医院感染的发生率,减少并发症的发生.

  19. Cerebral oxygen metabolism in patients with early Parkinson's disease

    DEFF Research Database (Denmark)

    Borghammer, Per; Cumming, Paul; Østergaard, Karen;

    2012-01-01

    AIM: Decreased activity of the mitochondrial electron transport chain (ETC) has been implicated in the pathogenesis of Parkinson's disease (PD). This model would most likely predict a decrease in the rate of cerebral oxygen consumption (CMRO(2)). To test this hypothesis, we compared CMRO(2...

  20. Structural network connectivity and cognition in cerebral small vessel disease

    NARCIS (Netherlands)

    Tuladhar, A.M.; Dijk, E.J. van; Zwiers, M.P.; Norden, A.G.W. van; Laat, K.F. de; Shumskaya, A.N.; Norris, D.G; Leeuw, F.E. de

    2016-01-01

    Cerebral small vessel disease (SVD), including white matter hyperintensities (WMH), lacunes and microbleeds, and brain atrophy, are related to cognitive impairment. However, these magnetic resonance imaging (MRI) markers for SVD do not account for all the clinical variances observed in subjects with

  1. Imaging cerebral small vessel disease at 7 Tesla MRI

    NARCIS (Netherlands)

    Conijn, M.M.A.

    2011-01-01

    Cerebral small vessel disease is a term often used to refer to lacunar infarcts, white matter lesions (WML) and microbleeds; lesions that are thought to be caused by changes in the small vessels of the brain. These lesions are commonly found in the general elderly population. However, it is hard to

  2. The characteristics of vascular cognitive impairment no dementia in patients with cerebral small vessel disease and theevaluation of nimodipine treatment%脑小血管病患者伴发非痴呆血管性认知功能损害情况及尼莫地平疗效的研究

    Institute of Scientific and Technical Information of China (English)

    杜鹃; 赖娅莉; 陈嘉应; 田劲; 李延峰

    2012-01-01

    目的 探讨脑小血管病(cerebral small vessel disease,SVD)不同亚型伴发非痴呆血管性认知功能损害的情况,评价尼莫地平对SVD的疗效.方法 选择SVD患者118例,包括52例腔隙灶脑梗死(LI)和66例白质疏松(WML)患者.分别将LI组和WML组患者随机分组为治疗组(基础治疗加尼莫地平治疗)和对照组(基础治疗),进行6个月治疗.治疗前后对所有患者采用蒙特利尔认知评估量表( MoCA)、简易智能状态检查表(MMSE)、语义分类流畅测验(动物)、St roop测验(计算错误数)、画钟试验、积木测验、数字广度顺背测验、数字符号测验、逻辑记忆亚测验和再生亚测验进行认知功能评价,并比较各组患者治疗前后认知功能评分.结果 治疗前,LI组患者语义分类流畅测验(动物)、数字符号测验、逻辑记忆亚测验、视觉再生亚测验、MoCA、MMSE评分显著高于WML组患者,Stroop测验得分显著低于WML组患者.经过6个月治疗后,LI组和WML组患者中的对照组治疗前后各项认知功能评分均没有统计学差异(P>0.0S).LI组患者中治疗组MoCA、画钟试验和数字广度顺背测验得分升高,Stroop测验得分下降(均P<0.05);WML组患者中治疗组MoCA、MMSE、画钟试验、数字广度顺背测验和视觉再生亚测验得分升高,Stroop测验得分下降(均P<0.05).结论 SVD两个亚型伴发非痴呆血管性认知功能损害情况不同,LI患者损害程度比WML患者轻.尼莫地平治疗可较好的改善患者的执行功能、视空间结构能力和注意力.%Objective To explore the neuropsychological difference of vascular cognitive impairment no dementia in two subtpyes of cerebral small vessel disease (SVD) patients and to evaluate the therapeutic effects of nimodipine on the disease. Methods A total of 118 SVD patients, including 52 Lacunar Infarction (LI) and 66 White Matter Lesion (WML) patients, were enrolled. The patients were divided into experimental

  3. Detecting cerebral vascular diseases by transcranial Doppler ultrasound and dolor Doppler flow imaging in comparison with digital subtracted angiography%经颅多普勒及彩色多普勒超声与数字减影脑血管造影对脑血管病检测的比较研究

    Institute of Scientific and Technical Information of China (English)

    张小征; 吕健; 李俊; 胡军民; 龚杰; 徐国政; 马廉亭; 陈欣林

    2000-01-01

    目的 评价经颅多普勒(TCD)在脑血管病诊断、疗效评估中的应用价值.方法 应用TCD检测脑血管疾病患者306例,其中脑动静脉畸形170例,颈动脉海绵窦瘘(CCF)69例,颅内动脉瘤67例,并与数字减影脑血管造影(DSA)、彩色多普勒血流显像(CDFI)进行对比研究.结果 以DSA脑血管造影为金指标,TCD检出脑动静脉畸形93%,检出CCF 100%,判断CCF静脉回流方式96%,检出颅内动脉瘤67%.对颅内较大动脉瘤(>1.5 cm)的检测有特征性表现,提出"动脉瘤样频谱"的新概念.结论 TCD能实时、准确反映颅内血流动力学改变及侧支循环代偿情况,对脑血管病诊断、疗效评估有重要价值.%Objective To evaluate the effect of transcranial Doppler(TCD)on detecting cerebral vascular diseases.Methods One hundred and seventy patients with cerebral arterovenous malformation(AVM),69 carotid cavernous fistula (CCF)and 67 intracranial aneurysms were examined early or late by TCD, digital subtracted angiography(DSA)and color Dopplor flow imaging.The results of their examination were compared and analyzed.Results If the results of DSA examination was regarded as a golden criterion of diagnosing the cerebral vascular dNease,93%of the 170 patients with AVMs,100% of the 69 patients with CCFS and 67%of the 67 patients with the aneurysms were detected by TCD respectively.It was found that the relative larger aneurysm(diameter>1.5 crn)had a special TCD manifestation, the SO-called ”aneurysm-like spectrum”. Conclusion TCD is necessary for detecting the cerebral vascular lesions because it can reveal accurately a change in the intracranial hemodynamics and a condition of the collateral circulation.

  4. The follow-up research on the value of the plasma homocystine after methionine loading test on the recurrent ischemic vascular event in cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    刘怀翔

    2014-01-01

    Objective To evaluate the effect of the plasma homocystine(Hcy)after methionine loading test(MLT)on the recurrence of ischemic vascular event,including cerebral infarction,transient ischemic attack(TIA),acute coronary syndrome,other vascular embolism in cerebral infarction patients.Methods The fasting plasma homocystine(FHcy)and homocystine after MLT(PHcy)levels were measured by high-performance liquid chromatog-

  5. Protein Kinase C Inhibitors as Modulators of Vascular Function and Their Application in Vascular Disease

    Directory of Open Access Journals (Sweden)

    Raouf A. Khalil

    2013-03-01

    Full Text Available Blood pressure (BP is regulated by multiple neuronal, hormonal, renal and vascular control mechanisms. Changes in signaling mechanisms in the endothelium, vascular smooth muscle (VSM and extracellular matrix cause alterations in vascular tone and blood vessel remodeling and may lead to persistent increases in vascular resistance and hypertension (HTN. In VSM, activation of surface receptors by vasoconstrictor stimuli causes an increase in intracellular free Ca2+ concentration ([Ca2+]i, which forms a complex with calmodulin, activates myosin light chain (MLC kinase and leads to MLC phosphorylation, actin-myosin interaction and VSM contraction. Vasoconstrictor agonists could also increase the production of diacylglycerol which activates protein kinase C (PKC. PKC is a family of Ca2+-dependent and Ca2+-independent isozymes that have different distributions in various blood vessels, and undergo translocation from the cytosol to the plasma membrane, cytoskeleton or the nucleus during cell activation. In VSM, PKC translocation to the cell surface may trigger a cascade of biochemical events leading to activation of mitogen-activated protein kinase (MAPK and MAPK kinase (MEK, a pathway that ultimately increases the myofilament force sensitivity to [Ca2+]i, and enhances actin-myosin interaction and VSM contraction. PKC translocation to the nucleus may induce transactivation of various genes and promote VSM growth and proliferation. PKC could also affect endothelium-derived relaxing and contracting factors as well as matrix metalloproteinases (MMPs in the extracellular matrix further affecting vascular reactivity and remodeling. In addition to vasoactive factors, reactive oxygen species, inflammatory cytokines and other metabolic factors could affect PKC activity. Increased PKC expression and activity have been observed in vascular disease and in certain forms of experimental and human HTN. Targeting of vascular PKC using PKC inhibitors may function in

  6. Minocycline inhibits neuroinflammation and enhances vascular endothelial growth factor expression in a cerebral ischemia/reperfusion rat model

    Institute of Scientific and Technical Information of China (English)

    Zhiyou Cai; Yong Yan; Changyin Yu; Jun Zhang

    2008-01-01

    BACKGROUND: Brain ischemia involves secondary inflammation, which significantly contributes to the outcome of ischemic insults. Vascular endothelial growth factor (VEGF) may play an important role in the vascular response to cerebral ischemia, because ischemia stimulates VEGF expression in the brain, and VEGF promotes formation of new cerebral blood vessels. Minocyclinc, a tetracycline derivative, protects against cerebral ischemia and reduces inflammation, oxidative stress, and apoptosis.OBJECTIVE: To observe the influence of minocycline on VEGE interleukin-1 beta (IL-1β), and tumor necrosis factor alpha (TNF-α) expression in Wistar rats with focal cerebral ischemia/rcperfusion injury, and to study the neuroproteetion mechanism of minocycline against focal cerebral ischemia/rcpeffusion injury.DESIGN, TIME AND SETTING: Randomized, controlled experiment, which was performed in the Chongqing Key Laboratory of Neurology between March 2007 and March 2008.MATERIALS: A total of 36 female, Wistar rats underwent surgery to insert a thread into the left middle cerebral artery. Animals were randomly divided into sham-operation, minocyclinc treatment, and ischemia/reperfusion groups, with 12 rats in each group. Minocycline (Huishi Pharmaceutical Limited Company, China) was dissolved to 0.5 g/L in normal saline.METHODS: A 0.5- 1.0 cm thread was inserted into rats from the sham-operation group. Rats in the ischemia/reperfusion group underwent ischemia and reperfusion. The minocycline group received minocycline (50 mg/kg) 12 and 24 hours following ischemia and reperfusion, whereas the other groups received saline at the corresponding time points.MAIN OUTCOME MEASURES: mRNA and protein expression of IL-1β and TNF-α was measured by reverse transcriptase-polymerasc chain reaction (RT-PCR) and enzyme linked immunosorbent assay (ELISA), respectively. VEGF mRNA and protein expression was examined by RT-PCR, Western blot, and ELISA.RESULTS: Minocycline decreased the focal infarct

  7. PERFIL DA DISFAGIA APÓS UM ACIDENTE VASCULAR CEREBRAL: UMA REVISÃO INTEGRATIVA

    Directory of Open Access Journals (Sweden)

    CARINA TEIXEIRA PAIXÃO

    2010-01-01

    Full Text Available Este artículo trata de disfagia decurrente de una enfermedad vascular cerebral (EVC. El objetivo fue determinar el perfil de las publicaciones acerca de la disfagia en pacientes víctimas de EVC. Investigación de revisión integradora que usó los mismos descriptores en las bases Medline, Scielo e Lilacs, seleccionando 17 artículos entre 1998 a 2008. Los datos fueron analizados a partir de las categorías correspondientes a los enfoques de las publicaciones encontradas. Los resultados muestran diecisiete artículos agrupados en dos categorías, la que trató de la incidencia y características de la disfagia (9 y la que discutió las complicaciones de la disfagia (8. Las publicaciones de la primera categoría muestran una incidencia de la disfagia entre 30% a 91% e indican que tamaño y localización de la lesión son determinantes en la gravedad de la disfagia. La segunda categoría presenta la pulmonía y desnutrición como consecuencias de la disfagia. Se concluye que el enfermero debe guiar los cuidados direccionados a limitar el efecto de la disfagia post EVC y sus complicaciones para el paciente.

  8. The Utility of Cerebral Blood Flow as a Biomarker of Preclinical Alzheimer’s Disease

    Science.gov (United States)

    Hays, Chelsea C.; Zlatar, Zvinka Z.; Wierenga, Christina E.

    2017-01-01

    There is accumulating evidence suggesting that changes in brain perfusion are present long before the clinical symptoms of Alzheimer’s disease (AD), perhaps even before amyloid-β accumulation or brain atrophy. This evidence, consistent with the vascular hypothesis of AD, implicates cerebral blood flow (CBF) in the pathogenesis of AD and suggests its utility as a biomarker of preclinical AD. The extended preclinical phase of AD holds particular significance for disease-modification, as treatment would likely be most effective in this early asymptomatic stage of disease. This highlights the importance of identifying reliable and accurate biomarkers of AD that can differentiate normal aging from preclinical AD prior to clinical symptom manifestation. Cerebral perfusion, as measured by arterial spin labeling magnetic resonance imaging (ASL-MRI), has been shown to distinguish between normal controls and adults with AD. In addition to demonstrating diagnostic utility, CBF has shown usefulness as a tool for identifying those who are at risk for AD and for predicting subtle cognitive decline and conversion to mild cognitive impairment (MCI) and AD. Taken together, this evidence not only implicates CBF as a useful biomarker for tracking disease severity and progression, but also suggests that ASL-measured CBF may be useful for identifying candidates for future AD treatment trials, especially in the preclinical, asymptomatic phases of the disease. PMID:26898552

  9. Li Yunjie, an Expert on Cardio-Cerebral Vascular Diseases

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    LiYunjie,anExpertonCardio-CerebralVascularDiseasesByWANGLIJUN&ZHIRENATTHEThirdConferenceonAcademicExchangesofLeadingInternati...

  10. Cerebral Small Vessel Disease and Motoric Cognitive Risk Syndrome: Results from the Kerala-Einstein Study

    Science.gov (United States)

    Wang, Nan; Allali, Gilles; Kesavadas, Chandrasekharan; Noone, Mohan L.; Pradeep, Vayyattu G.; Blumen, Helena M.; Verghese, Joe

    2017-01-01

    Background The contribution of cerebral small vessel disease to cognitive decline, especially in non-Caucasian populations, is not well established. Objective We examined the relationship between cerebral small vessel disease and motoric cognitive risk syndrome (MCR), a recently described pre-dementia syndrome, in Indian seniors. Methods 139 participants (mean age 66.6 ± 5.4 y, 33.1% female) participating in the Kerala-Einstein study in Southern India were examined in a cross-sectional study. The presence of cerebral small vessel disease (lacunar infarcts and cerebral microbleeds (CMB)) and white matter hyperintensities on MRI was ascertained by raters blinded to clinical information. MCR was defined by the presence of cognitive complaints and slow gait in older adults without dementia or mobility disability. Results Thirty-eight (27.3%) participants met MCR criteria. The overall prevalence of lacunar infarcts and CMB was 49.6% and 9.4%, respectively. Lacunar infarcts in the frontal lobe, but no other brain regions, were associated with MCR even after adjusting for vascular risk factors and presence of white matter hyperintensities (adjusted Odds Ratio (aOR): 4.67, 95% CI: 1.69–12.94). Frontal lacunar infarcts were associated with slow gait (aOR: 3.98, 95% CI: 1.46–10.79) and poor performance on memory test (β: −1.24, 95% CI: −2.42 to −0.05), but not with cognitive complaints or non-memory tests. No association of CMB was found with MCR, individual MCR criterion or cognitive tests. Conclusions Frontal lacunar infarcts are associated with MCR in Indian seniors, perhaps, by contributing to slow gait and poor memory function. PMID:26757037

  11. Acute type II cryoglobulinaemic vasculitis mimicking atherosclerotic peripheral vascular disease.

    LENUS (Irish Health Repository)

    Saeed, A

    2012-01-31

    Atherosclerotic peripheral vascular disease is a common presenting cause for digital ischaemia in life long smokers. Acute severe Type II Cryoglobulinaemic vasculitis is a rare yet important cause, which may present with similar clinical features and which if undiagnosed may be rapidly fatal. Following the instigation of therapy with intravenous methylprednisolone and cyclophosphamide this patient made an excellent recovery.

  12. Investigation and analysis of mental health status of hospitalized patients with cerebral vascular disease in neurology department of a hospital%某三甲医院脑血管疾病住院患者心理健康状况的调查分析

    Institute of Scientific and Technical Information of China (English)

    倪健; 张秀军; 高国朋; 李修德; 李享; 王程成; 仝菲

    2014-01-01

    Objective To explore the mental health status of patients with cerebral vascular disease in neurology department of the Peo-ple’s hospital of Lu’an City in Anhui,and to investigate the related factors of emotional disorders.Methods Nearly 300 hospitalizedpatients(127 males,173 females,aged 22 ~81 yrs)with cerebral vascular disease at the neurology department of the hospital in thepast 2 years were selected as the study group,while 300 healthy people(142 males,158 females,aged 21 ~77 yrs)at the outpatientmedical examinations as the control group.To analysis the influence factors of emotional disorder,Hamilton anxiety and depression self-rating depression scale,social support scale were all taken for scoring records and statistics.Results Results of HAMD,HAMA scoreshowed,168 cases had been checked out symptoms of emotional disorders (56%)in the study group,there into the incidence of de-pressive symptoms patients was 76.79%,and the incidence of anxiety symptoms patients was 62.50%,were both higher than the con-trol group,and the difference had a statistically significant (P <0.001).Combined results of MESS assessment,the incidence of emo-tional disorders in severe neurological deficits patients for 87.34%,incidence in medium neurological deficits patients for 55.24%,were both significantly higher than the light neurologic deficits patients (35.34%),the difference was statistically significant (P <0.05).Results of PSSS assessment showed that social support score of study group (68.02 ±9.34),which were lower than that of thecontrol group(88.36 ±7.54),the differences were statistical significantly (t =29.35,P <0.001).Linear correlation analysis had beentaken between3 dimensions of the Neurologic rating and HAMD,HAMA standard,turned out that there was a positive correlation be-tween them,the difference was statistically significant (P <0.05).Conclusion The mental problems of hospitalized patients with ce-rebrovascular disease in neurology department are mainly

  13. Gestational diabetes, pregnancy hypertension, and late vascular disease.

    Science.gov (United States)

    Carpenter, Marshall W

    2007-07-01

    The complexity of the several pathogenic pathways that cause hypertension and vascular disease and the prolonged interval that appears to predate clinical morbidity have hindered inquiry into the association between GDM and vascular disorders. As a forme fruste of later type 2 diabetes, GDM-affected gravidas are identified as at risk of diabetes-related atherosclerosis, glomerular disruption, and pathogenic retinal angio-genesis. That GDM is evidence for underlying chronic conditions such as dysregulation of innate immune response that, independent of the diabetic state, produces vascular disease is difficult state, produces vascular disease is difficult to assert with the present published literature. Cross-sectional studies of patients with established gestational hypertension or preeclampsia are ambiguous as to the possible pathogenic effect of insulin resistance. Cohort studies initiated in early and mid-pregnancy show evidence that both gestational hypertension and preeclampsia may be more prevalent in gravidas with greater insulin resistance. The association of gestational glucose intolerance with gestational hypertension appears to be independent of obesity and ambient glycemia but explained in part by insulin resistance. Late pregnancy preeclampsia is associated with elevated mid-pregnancy BMI, blood pressure, fasting glucose and insulin, urate, and C-reactive protein, suggestive of metabolic and immune dysregulation. GDM appears to be associated with overexpressed innate immune response, which, in turn, is associated with vascular dysfunction and vascular disease. Among women with GDM, markers of insulin resistance do not appear to correlate with hypertension in short-term cohort studies. However, when non-GDM subjects are compared with subjects with GDM, postpregnancy studies do show an associated with vascular dysfunction and vascular disease. Among women with GDM, markers of insulin resistance do not appear to correlate with hypertension in short

  14. Genetic determinants of obesity and related vascular diseases.

    Science.gov (United States)

    Winter, Yaroslav; Sankowski, Roman; Back, Tobias

    2013-01-01

    Obesity is one of the major risk factors of vascular diseases, and its prevalence is increasing worldwide. In the past decade, progress has been made in the understanding of genetic determinants of obesity and obesity-associated diseases. Genome-wide association studies identified a number of genetic variants associated with obesity. In addition to common variants, FTO and MC4R, new loci, such as TMEM18, KCTD15, GNPDA2, SH2B1, MTCH2, and NEGR1 have been detected. In the past years, abdominal obesity has been shown to be a more important vascular risk factor than the body mass index. In the context of vascular risk assessment, identification of genetic polymorphisms associated with accumulation of visceral fat is of special importance. Some polymorphisms associated with abdominal obesity, such as variants of gene encoding microsomal triglyceride transfer protein, have been already discovered. In this chapter, we provide a review of genetic determinants of obesity and discuss their role in obesity-related vascular diseases.

  15. Effect of isovolemic, isothermic hemodialysis on cerebral perfusion and vascular stiffness using contrast computed tomography and pulse wave velocity.

    Directory of Open Access Journals (Sweden)

    Ansgar Reising

    Full Text Available BACKGROUND: Patients undergoing hemodialysis treatment have a six-fold increased risk for stroke relative to the general population. However, the effect of hemodialysis on cerebral blood flow is poorly studied and confounding factors like blood pressure and ultrafiltration as well as temperature changes have rarely been accounted for. The aim of our study was to use state-of-the-art technology to evaluate the effect of a single dialysis session on cerebral perfusion as well as on vascular stiffness. METHODS: Chronic hemodialysis patients (7 male/3 female, mean age 58 years were recruited. Cerebral blood flow and arterial pulse wave velocity were measured before and immediately after a hemodialysis session. To exclude effects of volume changes we kept ultrafiltration to a minimum, allowing no change in body weight. Isothermic conditions were maintained by using the GENIUS single-pass batch-dialysis system with a high-flux polysulfone dialyser. Cerebral blood flow was measured by contrast-enhanced computed tomography. Pulse wave velocity was measured using the SphygmoCor (AtCor Medical, USA device by a single operator. RESULTS: This study shows for the first time that isovolemic, isothermic hemodialysis neither affected blood pressure or heart rate, nor total or regional cerebral perfusion. There was also no change in pulse wave velocity. CONCLUSIONS: Mechanisms other than the dialysis procedure itself might be causative for the high incidence of ischemic strokes in this patient population. Moreover, the sole removal of uremic toxins does not lead to short-term effects on vascular stiffness, underlying the importance of volume control in this patient population.

  16. Bile pigments in pulmonary and vascular disease

    Directory of Open Access Journals (Sweden)

    Stefan W. Ryter

    2012-03-01

    Full Text Available The bile pigments, biliverdin and bilirubin, are endogenously-derived substances generated during enzymatic heme degradation. These compounds have been shown to act as chemical antioxidants in vitro. Bilirubin formed in tissues circulates in the serum, prior to undergoing hepatic conjugation and biliary excretion. The excess production of bilirubin has been associated with neurotoxicity, in particular to the newborn. Nevertheless, clinical evidence suggests that mild states of hyperbilirubinemia may be beneficial in protecting against cardiovascular disease in adults. Pharmacological application of either bilirubin and/or its biological precursor biliverdin, can provide therapeutic benefit in several animal models of cardiovascular and pulmonary disease. Furthermore, biliverdin and bilirubin can confer protection against ischemia/reperfusion injury and graft rejection secondary to organ transplantation in animal models. Several possible mechanisms for these effects have been proposed, including direct antioxidant and scavenging effects, and modulation of signaling pathways regulating inflammation, apoptosis, cell proliferation, and immune responses. The practicality and therapeutic-effectiveness of bile pigment application to humans remains unclear.

  17. Bile pigments in pulmonary and vascular disease.

    Science.gov (United States)

    Ryter, Stefan W

    2012-01-01

    The bile pigments, biliverdin, and bilirubin, are endogenously derived substances generated during enzymatic heme degradation. These compounds have been shown to act as chemical antioxidants in vitro. Bilirubin formed in tissues circulates in the serum, prior to undergoing hepatic conjugation and biliary excretion. The excess production of bilirubin has been associated with neurotoxicity, in particular to the newborn. Nevertheless, clinical evidence suggests that mild states of hyperbilirubinemia may be beneficial in protecting against cardiovascular disease in adults. Pharmacological application of either bilirubin and/or its biological precursor biliverdin, can provide therapeutic benefit in several animal models of cardiovascular and pulmonary disease. Furthermore, biliverdin and bilirubin can confer protection against ischemia/reperfusion injury and graft rejection secondary to organ transplantation in animal models. Several possible mechanisms for these effects have been proposed, including direct antioxidant and scavenging effects, and modulation of signaling pathways regulating inflammation, apoptosis, cell proliferation, and immune responses. The practicality and therapeutic-effectiveness of bile pigment application to humans remains unclear.

  18. Information entropy-based fitting of the disease trajectory of brain ischemia-induced vascular cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    Lin Liu; Ju Huo; Ying Zhao; Yu Tian

    2012-01-01

    The present study investigated the disease trajectory of vascular cognitive impairment using the entropy of information in a neural network mathematical simulation based on the free radical and excitatory amino acids theories.Glutamate, malondialdehyde, and inducible nitric oxide synthase content was significantly elevated, but acetylcholine, catalase, superoxide dismutase, glutathione peroxidase and constitutive nitric oxide synthase content was significantly decreased in our vascular cognitive impairment model.The fitting curves for each factor were obtained using Matlab software.Nineteen, 30 and 49 days post ischemia were the main output time frames of the influence of these seven factors.Our results demonstrated that vascular cognitive impairment involves multiple factors.These factors include excitatory amino acid toxicity and nitric oxide toxicity.These toxicities disrupt the dynamic equilibrium of the production and removal of oxygen free radicals after cerebral ischemia, reducing the ability to clear oxygen free radicals and worsening brain injury.

  19. 首次脑梗死伴脑小血管病患者认知功能障碍相关危险因素的研究分析%Analysis of risk fca tors of cognitived ysfunction in firts a ttack cerebral infra ction patients with c erebral small vascular disease

    Institute of Scientific and Technical Information of China (English)

    曹志勇; 郭啸鸣; 黄怀宇

    2014-01-01

    Objective To analyze the related risk factors in terms of cognitive dysfunction for the patients with cerebral infarction associated with cerebral small vessel disease .Methods One hundred and five patients in Neurology Department of Nantong First Peoples′Hospital with acute cerebral infarction from August 2012 to January 2014 were selected .According to MRI , 41 patients were associated with cerebral small vessel disease ( CSVD ) , and the other 64 patients were not associated with CSVD .The demographic indicators,such as the patient′s age,gender,education level,existing risk factors and clinical features were evaluated,looking for risk factors for CSVD.By using Montreal cognitive assessment (MoCA),49 patients were screened out with vascular cognitive impairment (VCI)from all the selected patients,the remaining 56 patients without cognitive dysfunction .The demographic characteristics of the two groups were compared to analyzerelated risk factors of cognitive dysfunction .The correlation between CSVD and cognitive dysfunction were studied by using the logistic regression and Spearman rank correlation analysis .Resulst Compared the group with CSVD and the group without CSVD ,the proportion of hypertension was34 cases (82.9%) and 29 cases(45.3%,χ2=14.732 ,P=0.000),the proportion of high cholesterol was 36 cases(87.8%) and 25 cases (39.1%,χ2 =24.834,P=0.000),the proportion of coronary heart disease was 37cases(90.2%)and 28 cases(43.8%,χ2=24.920,P=0.000);The age of CSVD group [(73.13 ±4.96)years] is greater than that of group without CSVD [ ( 68.45 ±7.05 ) years ,t=4.374,P=0.015 ];MoCA scores of groups with and without CSVD were ( 23.50 ±2.102 ) scores and( 27.46 ±1.823 ) scores;The attention function score [(3.09 ±0.916 )scores]and the visual spatial and executive ability score [(3.46 ±0.163)scores ]of the group with CSVD were less than the group without CSVD (t=5.384 ,11.546 ,all P<0.05 ) .The proportion of diabetes was20 cases ( 48.7%) and 34 cases

  20. Neutrophil lymphocyte ratio in peripheral vascular disease: a review.

    Science.gov (United States)

    Bhat, Tariq M; Afari, Maxwell E; Garcia, Lawrence A

    2016-07-01

    Peripheral vascular disease (PVD) carries a significant morbidity and mortality. The role of inflammatory markers in cardiovascular medicine has been extensively studied. Neutrophil Lymphocyte ratio (NLR) is a novel biomarker which has been proposed as a marker of cardiovascular disease. We review the association of NLR with PVD. NLR has been shown to be an independent predictor of early and midterm amputation in patients with acute limb ischemia after embolectomy. A recent risk stratification model including NLR has emerged as a predictor of mortality and/or major amputation in critical limb ischemia. NLR appears to be an independent predictor of severity of PVD based on TransAtlantic Inter-Society Consensus classification, which classifies PVD based on the nature of the lesion and its anatomic distribution. A review of a large cohort of patients who had major vascular surgery, an NLR > 5 was found to be an independent predictor of mortality. In patients with intermediate carotid artery disease, NLR of 2.6 was found to be an independent variable for symptomatic carotid artery disease. It is a good predictor of early death in acute pulmonary embolism. NLR is inexpensive and readily available and appears to have a major role in peripheral vascular disease.

  1. Multicentric hyaline-vascular Castleman's disease in the retroperitoneum

    Institute of Scientific and Technical Information of China (English)

    Li-Ying Wang; Tian-An Jiang; Xiao-Dong Teng; Qi-Yu Zhao; Fen Chen

    2009-01-01

    BACKGROUND: Castleman's disease is a rare lymphopro-liferative disease of unknown cause. Most multicentric cases described have been of the plasma-cell variety. This article presents a case of multicentric hyaline-vascular Castleman's disease in the retroperitoneum with the ultrasonographic and computed tomography (CT) imaging manifestations. METHODS: During routine physical examination, a mass was detected in the left abdomen of a 53-year-old man with no signs or symptoms. The patient underwent ultrasound-guided aspiration biopsy and operative excision after laboratory examination, ultrasonography, and CT. RESULTS: Ultrasonography demonstrated a dominant hypoechogenic mass with hypervascularity in the retroperitoneum. CT detected a relatively homogenous enhanced lesion and several satellite nodules. After the mass and several lymph nodes were resected, histopathologic examination demonstrated a lymphocyte-predominant infiltrate surrounding the germinal centres and extensive capillary proliferation, consistent with the hyaline-vascular type of Castleman's disease. The patient received postoperative chemotherapy and remained free of recurrence 3 months later. CONCLUSION: Ultrasonography and contrast-enhanced CT can provide a positive differential diagnosis of hyaline-vascular Castleman's disease which is a kind of giant lymph node hyperplasia with hypervascularity.

  2. Implications of Klotho in vascular health and disease

    Institute of Scientific and Technical Information of China (English)

    Ernesto; Martín-Nú?ez; Javier; Donate-Correa; Mercedes; Muros-de-Fuentes; Carmen; Mora-Fernández; Juan; F; Navarro-González

    2014-01-01

    Cardiovascular disease(CVD) is a prevalent condition in general population and the first cause of death overall. Klotho, a pleiotropic protein related to longevity that acts as a co-receptor of the fibroblast growth factor 23, has been proposed as a key regulator of the development of CVD. In the few clinical studies made, it has been observed a relationship between low levels of soluble Klotho and the occurrence and severity of CVD, as well as a reduction of cardiovascular risk when they are high. Also, different polymorphisms of human Klotho gene have been related to the incidence of cardiovascular events. Moreover, several experimental studies indicate that this protein acts in the maintenance of vascular homeostasis. Klotho improves endothelial dysfunction through promotion of NO production and mediates antiinflammatory and anti-aging effects such as suppression of adhesion molecules expression, attenuation of nuclear factor-kappa B or inhibition of Wnt signaling. Furthermore,this protein is related to the attenuation of vascular calcification as well as prevention of cardiac hypertrophy. The expression of this protein in the vascular wall implies a new scenario for the treatment of vascular disorders. The purpose of this review is to provide an overview of the relationship between the Klotho protein and CVD, in addition to its role in the maintenance of functional vascular integrity.

  3. Beta adrenergic overstimulation impaired vascular contractility via actin-cytoskeleton disorganization in rabbit cerebral artery.

    Directory of Open Access Journals (Sweden)

    Hyoung Kyu Kim

    Full Text Available BACKGROUND AND PURPOSE: Beta adrenergic overstimulation may increase the vascular damage and stroke. However, the underlying mechanisms of beta adrenergic overstimulation in cerebrovascular dysfunctions are not well known. We investigated the possible cerebrovascular dysfunction response to isoproterenol induced beta-adrenergic overstimulation (ISO in rabbit cerebral arteries (CAs. METHODS: ISO was induced in six weeks aged male New Zealand white rabbit (0.8-1.0 kg by 7-days isoproterenol injection (300 μg/kg/day. We investigated the alteration of protein expression in ISO treated CAs using 2DE proteomics and western blot analysis. Systemic properties of 2DE proteomics result were analyzed using bioinformatics software. ROS generation and following DNA damage were assessed to evaluate deteriorative effect of ISO on CAs. Intracellular Ca(2+ level change and vascular contractile response to vasoactive drug, angiotensin II (Ang II, were assessed to evaluate functional alteration of ISO treated CAs. Ang II-induced ROS generation was assessed to evaluated involvement of ROS generation in CA contractility. RESULTS: Proteomic analysis revealed remarkably decreased expression of cytoskeleton organizing proteins (e.g. actin related protein 1A and 2, α-actin, capping protein Z beta, and vimentin and anti-oxidative stress proteins (e.g. heat shock protein 9A and stress-induced-phosphoprotein 1 in ISO-CAs. As a cause of dysregulation of actin-cytoskeleton organization, we found decreased level of RhoA and ROCK1, which are major regulators of actin-cytoskeleton organization. As functional consequences of proteomic alteration, we found the decreased transient Ca(2+ efflux and constriction response to angiotensin II and high K(+ in ISO-CAs. ISO also increased basal ROS generation and induced oxidative damage in CA; however, it decreased the Ang II-induced ROS generation rate. These results indicate that ISO disrupted actin cytoskeleton proteome network

  4. Population Imaging of Cerebral Small Vessel Disease

    NARCIS (Netherlands)

    M.M.F. Poels (Mariëlle)

    2012-01-01

    textabstractAs we grow older, our brain tends to shrink. We become increasingly vul nerable to dementia and stroke, two common disorders in the elderly that have great impact on brain functioning and the way people live their lives. The burden of these diseases will rapidly grow over the coming year

  5. Cardio-Vascular Disease and Cancer

    Directory of Open Access Journals (Sweden)

    K. Mitchell-Fearon DrPh

    2015-11-01

    Full Text Available Objective: To report the level of utilization of clinical preventive services by older adults in Jamaica and to identify independent factors associated with utilization. Method: A nationally representative, community-based survey of 2,943 older adults was undertaken. Utilization frequency for six preventive, cardiovascular or cancer-related services was calculated. Logistic regression models were used to determine the independent factors associated with each service. Results: A dichotomy in annual utilization rates exists with cardiovascular services having much higher uptake than those for cancer (83.1% for blood pressure, 76.7% blood glucose, 68.1% cholesterol, 35.1% prostate, 11.3% mammograms, and 9.6% papanicolaou smears. Age, source of routine care, and having a chronic disease were most frequently associated with uptake. Discussion: Education of providers and patients on the need for utilizing preventive services in older adults is important. Improved access to services in the public sector may also help increase uptake of services.

  6. Visfatin, glucose metabolism and vascular disease: a review of evidence

    Directory of Open Access Journals (Sweden)

    Saddi-Rosa Pedro

    2010-03-01

    Full Text Available Abstract The adipose tissue is an endocrine organ producing substances called adipocytokines that have different effects on lipid metabolism, metabolic syndrome, and cardiovascular risk. Visfatin was recently described as an adipocytokine with potentially important effects on glucose metabolism and atherosclerosis. Visfatin has been linked to several inflammatory conditions, beta cell function, and cardiovascular disease. The growing number of publications on the subject shall bring further evidence about this adipocytokine. Its findings may contribute in the identification of higher risk individuals for diabetes and cardiovascular disease with a better comprehension about the complex intercorrelation between adiposity, glucose metabolism and vascular disease.

  7. Serum copper in Alzheimer’s disease and vascular dementia

    OpenAIRE

    Agarwal, Rachna; Kushwaha, Suman S.; Tripathi, C. B.; Singh, Neeraj; Chhillar, Neelam

    2008-01-01

    Alzheimer’s disease is the most common form of dementia in the elderly and it’s prevalence is rapidly rising. Oxidative stress plays important role in the pathophysiology of Alzheimer’s disease. Metals like copper, iron derived through diet can act as pro-oxidant under oxidative stress. In the present study, serum copper levels were evaluated in 50 patients with Alzheimer’s disease, 24 patients with Vascular Dementia and 30 controls. All the groups were also investigated for serum ceruloplsmi...

  8. Response of the sensorimotor cortex of cerebral palsy rats receiving transplantation of vascular endothelial growth factor 165-transfected neural stem cells

    Institute of Scientific and Technical Information of China (English)

    Jielu Tan; Xiangrong Zheng; Shanshan Zhang; Yujia Yang; Xia Wang; Xiaohe Yu; Le Zhong

    2014-01-01

    Neural stem cells are characterized by the ability to differentiate and stably express exogenous ge-nes. Vascular endothelial growth factor plays a role in protecting local blood vessels and neurons of newborn rats with hypoxic-ischemic encephalopathy. Transplantation of vascular endothelial growth factor-transfected neural stem cells may be neuroprotective in rats with cerebral palsy. In this study, 7-day-old Sprague-Dawley rats were divided into ifve groups: (1) sham operation (control), (2) cerebral palsy model alone or with (3) phosphate-buffered saline, (4) vascular en-dothelial growth factor 165 + neural stem cells, or (5) neural stem cells alone. hTe cerebral palsy model was established by ligating the letf common carotid artery followed by exposure to hypox-ia. Phosphate-buffered saline, vascular endothelial growth factor + neural stem cells, and neural stem cells alone were administered into the sensorimotor cortex using the stereotaxic instrument and microsyringe. Atfer transplantation, the radial-arm water maze test and holding test were performed. Immunohistochemistry for vascular endothelial growth factor and histology using hematoxylin-eosin were performed on cerebral cortex. Results revealed that the number of vas-cular endothelial growth factor-positive cells in cerebral palsy rats transplanted with vascular endothelial growth factor-transfected neural stem cells was increased, the time for ifnding water and the ifnding repetitions were reduced, the holding time was prolonged, and the degree of cell degeneration or necrosis was reduced. hTese ifndings indicate that the transplantation of vascu-lar endothelial growth factor-transfected neural stem cells alleviates brain damage and cognitive deifcits, and is neuroprotective in neonatal rats with hypoxia ischemic-mediated cerebral palsy.

  9. Intravascular brachytherapy for peripheral vascular disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2008-09-01

    Full Text Available Scientific background: Percutaneous transluminal angioplasties (PTA through balloon dilatation with or without stenting, i.e. vessel expansion through balloons with or without of implantation of small tubes, called stents, are used in the treatment of peripheral artery occlusive disease (PAOD. The intravascular vessel irradiation, called intravascular brachytherapy, promises a reduction in the rate of repeated stenosis (rate of restenosis after PTA. Research questions: The evaluation addresses questions on medical efficacy, cost-effectiveness as well as ethic, social and legal implications in the use of brachytherapy in PAOD patients. Methods: A systematic literature search was conducted in August 2007 in the most important medical electronic databases for publications beginning from 2002. The medical evaluation included randomized controlled trials (RCT. The information synthesis was performed using meta-analysis. Health economic modeling was performed with clinical assumptions derived from the meta-analysis and economical assumptions derived from the German Diagnosis Related Groups (G-DRG-2007. Results: Medical evaluation: Twelve publications about seven RCT on brachytherapy vs. no brachytherapy were included in the medical evaluation. Two RCT showed a significant reduction in the rate of restenosis at six and/or twelve months for brachytherapy vs. no brachytherapy after successful balloon dilatation, the relative risk in the meta-analysis was 0.62 (95% CI: 0.46 to 0.84. At five years, time to recurrence of restenosis was significantly delayed after brachytherapy. One RCT showed a significant reduction in the rate of restenosis at six months for brachytherapy vs. no brachytherapy after PTA with optional stenting, the relative risk in the meta-analysis was 0.76 (95% CI: 0.61 to 0.95. One RCT observed a significantly higher rate of late thrombotic occlusions after brachytherapy in the subgroup of stented patients. A single RCT for brachytherapy

  10. CT hypodensity on cerebral white matter in Wilson's disease

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    Laura B. Jardim

    1991-06-01

    Full Text Available Wilson's disease in an autosomal recessive disorder of copper metabolism where systemic manifestations are secondary to thei accumulation of copper in hepatic, nervous and other tissues. In CNS, the structural lesions most commonly found by CT scan are ventricular dilatation, cortical atrophy, basal ganglia hyperdensities, and brainstem and cerebellar atrophy. Degenerative changes of cerebral white matter seen on early anatomo-pathologic studies, but were almost never found on CT scan from recently described patients. We report a case of Wilson's disease with an unusually rapid deterioration where asymmetric low-densities in the subcortical white matter were disclosed by CT scan.

  11. Effect of cerebral amyloid angiopathy on brain iron, copper, and zinc in Alzheimer's disease.

    Science.gov (United States)

    Schrag, Matthew; Crofton, Andrew; Zabel, Matthew; Jiffry, Arshad; Kirsch, David; Dickson, April; Mao, Xiao Wen; Vinters, Harry V; Domaille, Dylan W; Chang, Christopher J; Kirsch, Wolff

    2011-01-01

    Cerebral amyloid angiopathy (CAA) is a vascular lesion associated with Alzheimer's disease (AD) present in up to 95% of AD patients and produces MRI-detectable microbleeds in many of these patients. It is possible that CAA-related microbleeding is a source of pathological iron in the AD brain. Because the homeostasis of copper, iron, and zinc are so intimately linked, we determined whether CAA contributes to changes in the brain levels of these metals. We obtained brain tissue from AD patients with severe CAA to compare to AD patients without evidence of vascular amyloid-β. Patients with severe CAA had significantly higher non-heme iron levels. Histologically, iron was deposited in the walls of large CAA-affected vessels. Zinc levels were significantly elevated in grey matter in both the CAA and non-CAA AD tissue, but no vascular staining was noted in CAA cases. Copper levels were decreased in both CAA and non-CAA AD tissues and copper was found to be prominently deposited on the vasculature in CAA. Together, these findings demonstrate that CAA is a significant variable affecting transition metals in AD.

  12. Crystal Structure of CCM3, a Cerebral Cavernous Malformation Protein Critical for Vascular Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Li, X.; Zhang, R; Zhang, H; He, Y; Ji, W; Min, W; Boggon, T

    2010-01-01

    CCM3 mutations are associated with cerebral cavernous malformation (CCM), a disease affecting 0.1-0.5% of the human population. CCM3 (PDCD10, TFAR15) is thought to form a CCM complex with CCM1 and CCM2; however, the molecular basis for these interactions is not known. We have determined the 2.5 {angstrom} crystal structure of CCM3. This structure shows an all {alpha}-helical protein containing two domains, an N-terminal dimerization domain with a fold not previously observed, and a C-terminal focal adhesion targeting (FAT)-homology domain. We show that CCM3 binds CCM2 via this FAT-homology domain and that mutation of a highly conserved FAK-like hydrophobic pocket (HP1) abrogates CCM3-CCM2 interaction. This CCM3 FAT-homology domain also interacts with paxillin LD motifs using the same surface, and partial CCM3 co-localization with paxillin in cells is lost on HP1 mutation. Disease-related CCM3 truncations affect the FAT-homology domain suggesting a role for the FAT-homology domain in the etiology of CCM.

  13. Oxidative Stress and MicroRNAs in Vascular Diseases

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    Fabio Martelli

    2013-08-01

    Full Text Available Oxidative stress has been demonstrated to play a causal role in different vascular diseases, such as hypertension, diabetic vasculopathy, hypercholesterolemia and atherosclerosis. Indeed, increased reactive oxygen species (ROS production is known to impair endothelial and vascular smooth muscle cell functions, contributing to the development of cardiovascular diseases. MicroRNAs (miRNAs are non-coding RNA molecules that modulate the stability and/or the translational efficiency of target messenger RNAs. They have been shown to be modulated in most biological processes, including in cellular responses to redox imbalance. In particular, miR-200 family members play a crucial role in oxidative-stress dependent endothelial dysfunction, as well as in cardiovascular complications of diabetes and obesity. In addition, different miRNAs, such as miR-210, have been demonstrated to play a key role in mitochondrial metabolism, therefore modulating ROS production and sensitivity. In this review, we will discuss miRNAs modulated by ROS or involved in ROS production, and implicated in vascular diseases in which redox imbalance has a pathogenetic role.

  14. Oxidative stress and microRNAs in vascular diseases.

    Science.gov (United States)

    Magenta, Alessandra; Greco, Simona; Gaetano, Carlo; Martelli, Fabio

    2013-08-22

    Oxidative stress has been demonstrated to play a causal role in different vascular diseases, such as hypertension, diabetic vasculopathy, hypercholesterolemia and atherosclerosis. Indeed, increased reactive oxygen species (ROS) production is known to impair endothelial and vascular smooth muscle cell functions, contributing to the development of cardiovascular diseases. MicroRNAs (miRNAs) are non-coding RNA molecules that modulate the stability and/or the translational efficiency of target messenger RNAs. They have been shown to be modulated in most biological processes, including in cellular responses to redox imbalance. In particular, miR-200 family members play a crucial role in oxidative-stress dependent endothelial dysfunction, as well as in cardiovascular complications of diabetes and obesity. In addition, different miRNAs, such as miR-210, have been demonstrated to play a key role in mitochondrial metabolism, therefore modulating ROS production and sensitivity. In this review, we will discuss miRNAs modulated by ROS or involved in ROS production, and implicated in vascular diseases in which redox imbalance has a pathogenetic role.

  15. 治疗心脑血管疾病中成药微量和常量元素含量与疗效的模糊分类法则%Contents of trace and constant elements and therapeutic effects of Chinese patent medicine on cardio-cerebral vascular disease: fuzzy classified principle

    Institute of Scientific and Technical Information of China (English)

    董顺福; 刘洁; 韩丽琴; 赵文秀; 栾静

    2005-01-01

    ,确定论域上的模糊矩阵,得相关药物的相关系数.r=0.55时,有9种药物聚类相似;相类似药物:血栓心脉宁胶囊,步长脑心通胶囊,利心丸,心宝丸,强力天麻杜仲丸,通塞脉片,脉通胶囊,大活络丹,消栓通络胶囊;r=0.65时,有6种药物聚类相似,相似药物有:步长脑心通胶囊,心宝丸,强力天麻杜仲丸,通塞脉片,脉通胶囊,消栓通络胶囊;r=0.87时,有2种药物聚类相似,相似药物有:步长脑心通胶囊,心宝丸.结论:药物中微量、常量元素含量丰富,相关系数较大的药物,其药物疗效相似,揭示该类药物中微量、常量元素与药物疗效密切相关.本研究运用模糊分类方法从微量元素的角度讨论了常用治疗心脑血管疾病中成药的药效定量指标的相似性,为中成药的质量评价提供一种新的方法.%BACKGROUND: It is discovered that trace elements in Chinese patent medicine play an important role in pharmaceutical efficacy and structural analysis. A new topic has been formed gradually in a further research on pharmaceutical efficacy and effective components of Chinese patent medicine in the view of inorganic trace elements. The fuzzy classified study on the interrelationship between trace and constant elements of Chinese herbs and therapeutic effects is to discuss the trace-element action of drugs in the holistic aspect of trace elenent and research rather scientifically the holistic coordination among trace elements in Chinese herbs.OBJECTIVE: To determine the contents of 21 kinds of trace and constant elements in Chinese patent medicines in the treatment of cardio-cerebral vascular disease. To study with fuzzy classified method the interdependence between trace, constant elements of drugs and therapeutic effects so as to provide a new approach for the quality evaluation of Chinese patent medicine.DESIGN: Testified observed study based on various Chinese patent medicines.SETTING: Chemistry teaching-research room in a

  16. Hyponatremia in acute brain disease: the cerebral salt wasting syndrome.

    Science.gov (United States)

    Betjes, Michiel G.H.

    2002-02-01

    Hyponatremia in acute brain disease is a common occurrence, especially after an aneurysmal subarachnoid hemorrhage. Originally, excessive natriuresis, called cerebral salt wasting, and later the syndrome of inappropriate antidiuretic hormone secretion (SIADH), were considered to be the causes of hyponatremia. In recent years, it has become clear that most of these patients are volume-depleted and have a negative sodium balance, consistent with the original description of cerebral salt wasting. Elevated plasma concentrations of atrial or brain natriuretic peptide have been identified as the putative natriuretic factor. Hyponatremia and volume depletion may aggravate neurological symptoms, and timely treatment with adequate replacement of water and NaCl is essential. The use of fludrocortisone to increase sodium reabsorption by the renal tubules may be an alternative approach.

  17. Effect of Solitaire AB stent thrombectomy on vascular endothelial function and inflammatory cytokines in patients with progressive cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Zhi-Bao Wu; Xue-Juan Han; Zi-Hao Zhang; Wen-Liang Zhang; Liang Liu

    2016-01-01

    Objective:To observe the effect of Solitaire AB stent thrombectomy on the vascular endothelial function and inflammatory cytokines in patients with progressive cerebral infarction.Methods:A total of 58 patients with progressive cerebral infarction who were admitted in our hospital were included in the study and divided into the observation group and the control group according to different treatment protocols with 29 cases in each group. The patients in the control group were given the conservation treatment. On this basis, the patients in the observation group were given Solitaire AB stent thrombectomy. The changes of vascular endothelial function and inflammatory cytokines before and after treatment in the two groups were compared.Results:ET-1 after treatment in the two groups was significantly reduced, while NO and CGRP were significantly elevated when compared with before treatment (P<0.05). ET-1 after treatment in the observation group was significantly lower than that in the control group (P<0.05), while NO and CGRP were significantly higher than those in the control group (P<0.05). S100β protein, IL-6, TNF-α, hs-CRP, and MMP-9 levels after treatment in the two groups were significantly reduced when compared with before treatment (P<0.05). The above indicators after treatment in the observation group were significantly lower than those in the control group (P<0.05). MCA and ACA blood flow velocity after treatment in the two groups were significantly elevated when compared with before treatment (P<0.05). MCA and ACA blood flow velocity after treatment in the observation group were significantly higher than those in the control group (P<0.05).Conclusions:Solitaire AB stent thrombectomy can effectively reduce the inflammatory reaction in patients with progressive cerebral infarction, and improve the vascular endothelial function and blood supply for brain tissues.

  18. Relationship between retinal vascular occlusions and incident cerebrovascular diseases

    Science.gov (United States)

    Zhou, Yue; Zhu, Wengen; Wang, Changyun

    2016-01-01

    Abstract Several studies investigating the role of retinal vascular occlusions, on cerebrovascular diseases (CVD) have been reported, but the results are still inconsistent. We therefore sought to evaluate the relationship between retinal vascular occlusions and CVD. We systematically searched the Cochrane Library, PubMed, and ScienceDirect databases through January 31, 2016 for studies evaluating the effect of retinal vascular occlusions on the risk of CVD. Data were abstracted using predefined criteria, and then pooled by RevMan 5.3 software. A total of 9 retrospective studies were included in this meta-analysis. When compared with individuals without retinal vascular occlusions, both individuals with retinal artery occlusion (RAO) (odds ratio [OR] = 2.01, 95% confidence interval [CI]: 1.21–3.34; P = 0.005) and individuals with retinal vein occlusion (RVO) (OR = 1.37, 95% CI: 1.24–1.50; P < 0.00001) had higher risks of developing CVD. Additionally, both individuals with central retinal artery occlusion (CRAO) (OR = 2.00, 95% CI: 1.12–3.56; P = 0.02) and branch retinal artery occlusion (BRAO) (OR = 1.60, 95% CI: 1.03–1.48; P = 0.04) were significantly associated with increased risk of CVD. Published literatures support both RVO and RAO are associated with increased risks of CVD. Further prospective studies are needed to confirm these findings. PMID:27368050

  19. Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados

    OpenAIRE

    Mota,Juliana Ferreira; Nicolato,Rodrigo

    2008-01-01

    OBJETIVOS: Os objetivos deste estudo foram identificar os instrumentos genéricos e específicos utilizados na avaliação da qualidade de vida (QV) e os seus resultados em sobreviventes de acidente vascular cerebral (AVC). MÉTODOS: Realizou-se revisão da literatura dos últimos dez anos, com população acima de 18 anos, nos bancos de dados MedLine e Lilacs, cujas publicações utilizassem instrumentos padronizados e validados no país de origem. Combinaram-se os descritores quality of life, cerebrova...

  20. Rac-1 as a new therapeutic target in cerebro- and cardio-vascular diseases.

    Science.gov (United States)

    Carrizzo, Albino; Forte, Maurizio; Lembo, Maria; Formisano, Luigi; Puca, Annibale A; Vecchione, Carmine

    2014-01-01

    Growing evidence indicates that overproduction of reactive oxygen species (ROS) plays a prominent role in the development of cardio- and cerebro-vascular diseases. Among the mechanisms identified to produce oxidative stress in the vascular wall, those mediated by membrane-bound NAD(P)H oxidases represent a major one. NAD(P)H oxidases are a family of enzymes that generate ROS both in phagocytic and non-phagocytic cell types. Vascular NAD(P)H oxidase contains the membrane-bound subunits Nox1, Nox2 (gp91phox), Nox4 and p22phox, the catalytic site of the oxidase, and the cytosolic components p47phox and p67phox. Rac1 (Ras-related C3 botulinum toxin substrate1) is a small GTPase essential for the assembly and activation of NADPH oxidase. Several molecular and cellular studies have reported the involvement of Rac1 in different cardiovascular pathologies, such as vascular smooth muscle proliferation, cardiomyocyte hypertrophy, endothelial cell shape change, atherosclerosis and endothelial dysfunction in hypertension. In addition, increased activation of NADPH oxidase by Rac1 has been reported in animals and humans after myocardial infarction and heart failure. The Rac1/NADPH pathway has also been found involved in different pathologies of the cerebral district, such as ischemic stroke, cognitive impairment, subaracnoid hemorrhage and neuronal oxidative damage typical of several neurodegenerative disorders. In addition, thrombotic events are an important step in the onset of cardio- and cerebrovascular diseases. Rac1 has been found involved also in platelet activation, inducing actin polymerization and lamellipodia formation, which are necessary steps for platelet aggregation. Taken together, the evidence candidates Rac1 as a new pharmacological target of cardiovascular and cerebrovascular diseases. Although the involvement of Rac1 in the beneficial pleiotropic effects of drugs such as statins is well known, and the onset of numerous side effects has raised concern for the

  1. Cerebral hemodynamics and metabolism in patients with moyamoya disease not demonstrating either cerebral infarct or hemorrhage on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo; Ichiya, Yuichi; Sasaki, Masayuki; Akashi, Yuko; Yoshida, Tsuyoshi; Fukumura, Toshimitsu; Masuda, Kouji; Matsushima, Toshio; Fukui, Masashi [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1995-12-01

    We evaluated the cerebral hemodynamics and metabolism in moyamoya patients who did not demonstrate either cerebral infarct or hemorrhage on MRI. The subjects consisted of 5 patients with moyamoya disease (4 females and one male, aged from 15 to 40 ears). The CBF, OEF and CMRO{sub 2} of the moyamoya patients did not differ from those of the normal control subjects. The CBV did increase significantly in the cerebral cortices and striatum, but not in the cerebellum. The TT was also significantly prolonged in the frontal and parietal regions. The cerebrovascular CO{sub 2} response was markedly impaired in the frontal, temporal and parietal cortices. However, it was relatively preserved in the occipital cortex, thalamus and cerebellum. Thus, the cerebral hemodynamic reserve capacity decreased even in the moyamoya patients not demonstrating either cerebral infarct or hemorrhage on MRI, and it should be considered in the management of these patients. (author).

  2. Current treatment strategies: Collagen vascular diseases in children

    Directory of Open Access Journals (Sweden)

    Aparna Palit

    2012-01-01

    Full Text Available Of the various collagen vascular diseases seen in pediatric age group, discoid lupus erythematosus, systemic lupus erythematosus, neonatal lupus erythematosus, juvenile dermatomyositis and childhood scleroderma are common and of practical importance to clinicians. Various treatment modalities of these conditions have been discussed at length. Of these, some are conventional and routine,while others are used in challenging situations of these diseases. Autologous stem cell transplant, biological therapies, intravenous immunoglobulin and narrow band ultraviolet B are among the latest therapeutic options for these difficult-to-treat conditions in children.

  3. Requirement for Tumor Necrosis Factor Receptor 2 Expression on Vascular Cells To Induce Experimental Cerebral Malaria

    OpenAIRE

    Stoelcker, Benjamin; Hehlgans, Thomas; Weigl, Karin; Bluethmann, Horst; Grau, Georges E.; Männel, Daniela N

    2002-01-01

    Using tumor necrosis factor receptor type 2 (TNFR2)-deficient mice and generating bone marrow chimeras which express TNFR2 on either hematopoietic or nonhematopoietic cells, we demonstrated the requirement for TNFR2 expression on tissue cells to induce lethal cerebral malaria. Thus, TNFR2 on the brain vasculature mediates tumor necrosis factor-induced neurovascular lesions in experimental cerebral malaria.

  4. Modeling the Role of the Glymphatic Pathway and Cerebral Blood Vessel Properties in Alzheimer's Disease Pathogenesis.

    Directory of Open Access Journals (Sweden)

    Christina Rose Kyrtsos

    Full Text Available Alzheimer's disease (AD is the most common cause of dementia in the elderly, affecting over 10% population over the age of 65 years. Clinically, AD is described by the symptom set of short term memory loss and cognitive decline, changes in mentation and behavior, and eventually long-term memory deficit as the disease progresses. On imaging studies, significant atrophy with subsequent increase in ventricular volume have been observed. Pathology on post-mortem brain specimens demonstrates the classic findings of increased beta amyloid (Aβ deposition and the presence of neurofibrillary tangles (NFTs within affected neurons. Neuroinflammation, dysregulation of blood-brain barrier transport and clearance, deposition of Aβ in cerebral blood vessels, vascular risk factors such as atherosclerosis and diabetes, and the presence of the apolipoprotein E4 allele have all been identified as playing possible roles in AD pathogenesis. Recent research has demonstrated the importance of the glymphatic system in the clearance of Aβ from the brain via the perivascular space surrounding cerebral blood vessels. Given the variety of hypotheses that have been proposed for AD pathogenesis, an interconnected, multilayer model offers a unique opportunity to combine these ideas into a single unifying model. Results of this model demonstrate the importance of vessel stiffness and heart rate in maintaining adequate clearance of Aβ from the brain.

  5. Modeling the Role of the Glymphatic Pathway and Cerebral Blood Vessel Properties in Alzheimer's Disease Pathogenesis.

    Science.gov (United States)

    Kyrtsos, Christina Rose; Baras, John S

    2015-01-01

    Alzheimer's disease (AD) is the most common cause of dementia in the elderly, affecting over 10% population over the age of 65 years. Clinically, AD is described by the symptom set of short term memory loss and cognitive decline, changes in mentation and behavior, and eventually long-term memory deficit as the disease progresses. On imaging studies, significant atrophy with subsequent increase in ventricular volume have been observed. Pathology on post-mortem brain specimens demonstrates the classic findings of increased beta amyloid (Aβ) deposition and the presence of neurofibrillary tangles (NFTs) within affected neurons. Neuroinflammation, dysregulation of blood-brain barrier transport and clearance, deposition of Aβ in cerebral blood vessels, vascular risk factors such as atherosclerosis and diabetes, and the presence of the apolipoprotein E4 allele have all been identified as playing possible roles in AD pathogenesis. Recent research has demonstrated the importance of the glymphatic system in the clearance of Aβ from the brain via the perivascular space surrounding cerebral blood vessels. Given the variety of hypotheses that have been proposed for AD pathogenesis, an interconnected, multilayer model offers a unique opportunity to combine these ideas into a single unifying model. Results of this model demonstrate the importance of vessel stiffness and heart rate in maintaining adequate clearance of Aβ from the brain.

  6. The prevalence of obesity-related hypertension and risk for new vascular events in patients with vascular diseases.

    Science.gov (United States)

    Vernooij, Joris W P; van der Graaf, Yolanda; Visseren, Frank L J; Spiering, Wilko

    2012-10-01

    Higher body weight is associated with an increased prevalence of vascular risk factors. Obesity leads to hypertension by various mechanisms, often referred to as obesity-related hypertension. Aim of the present study was to evaluate the prevalence and the vascular risk of the combination of obesity and hypertension in patients with vascular diseases. A cohort of patients with various clinical manifest vascular diseases (n = 4,868) was screened for vascular risk factors and followed (median follow-up 4.2 years) for the occurrence of vascular events (stroke, myocardial infarction, and vascular death). The prevalence of obesity was 18% (95% confidence interval (CI) 17-19%) and the prevalence of hypertension was 83% (95% CI 82-84%). The prevalence of the combination of obesity and hypertension was 16% (95% CI 15-17%). Patients with high blood pressure (BP) combined with a high weight (highest tertile systolic BP (SBP) in the highest tertile BMI) were not at higher risk for new vascular events (hazard ratios (HR) 1.29; 95% CI 0.89-1.88) or mortality (HR 1.18; 95% CI 0.81-1.73) compared to patients without high BP and high weight (patients in the lowest tertile of SBP in the lowest tertile of BMI). Patients with only high weight did not have an elevated risk either for vascular events (HR 1.34; 95% CI 0.91-1.98) or mortality (HR 1.22; 95% CI 0.81-1.83) compared to patients without high BP and high weight. The prevalence of the combination of hypertension and obesity is low in patients with vascular diseases and does not confer a higher risk for recurrent vascular diseases and mortality than each risk factor alone.

  7. Expression of cyclin-dependent protein kinase 5 in the hippocampus of vascular dementia mice after cerebral ischemia and reperfusion

    Institute of Scientific and Technical Information of China (English)

    Tianjun Wang; Peiyuan Lü; Hezhen Zhang; Hebo Wang; Wei Jin; Zongcheng Guo; Changlin Liu

    2009-01-01

    BACKGROUND: The p25-activated cyclin-dependent protein kinase 5 (Cdk5) may induce neuronal cell death and cause the development of dementia following cerebral ischemia and reperfusion. OBJECTIVE: To observe changes in the expression of Cdk5 and p25 in hippocampal tissue of vascular dementia mice at different time points following cerebral ischemia and reperfusion. DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed in the clinical trial center of Hebei Provincial People's Hospital between September 2007 and October 2008.MATERIALS: Cdk5 rabbit anti-mouse polyclonal antibody, p35 rabbit anti-mouse polyclonal antibody, and β-actin mouse monoclonal antibody were purchased from Santa Cruz Biotechnology, Inc., USA; horseradish peroxidase-labeled goat anti-rabbit IgG and horseradish peroxidase-labeled goat anti-mice IgG were offered by Beijing Zhongshan Goldenbridye Biotechnology Co.,Ltd., China; the protein quantitative kit was produced by Applygen Gene Technology Corp., Beijing, China; cDNA reverse transcription and PCR amplification reagents were products of TianGen&Biotech (Beijing) Co.,Ltd., China.METHODS: One hundred and sixty male Kunming mice were randomly divided into two groups: a sham-operated group (n=65) and a model group (n=95). Vascular dementia was induced with three periods of transient ischemia and reperfusion of the bilateral common carotid arteries. In the sham-operated group, the bilateral common carotid arteries were not blocked.MAIN OUTCOME MEASURES: Behavioral tests were done at four and six weeks post surgery. Pathological changes in the hippocampal CA1 region were observed with hematoxylin-eosin staining. Cdk5 mRNA expression was examined by RT-PCR, and Western blots were used to evaluate Cdk5 and p25 expression. Learning and memory performance were assayed using the Morris water maze. RESULTS: Vascular dementia reduced learning and memory performance at 4 and 6 weeks post surgery. Vascular dementia also caused

  8. Rastreio cognitivo em pacientes com acidente vascular cerebral: um estudo transversal

    Directory of Open Access Journals (Sweden)

    Ana Amália Torres Souza Gandour Dantas

    2014-07-01

    Full Text Available Objetivo O estudo objetivou-se a fazer um rastreio cognitivo nos pacientes com acidente vascular cerebral (AVC, a fim de determinar pontos de corte de acordo com a idade, escolaridade e grau de comprometimento neurológico. Métodos Foi realizado um estudo transversal no qual participaram 109 pacientes ambulatoriais, sendo 61 homens, com média da idade de 59 anos (± 11, média do tempo de escolaridade de 5 anos (± 4 e do tempo de sequela de 16 meses (± 14. Os pacientes foram avaliados por meio do Miniexame do Estado Mental (MEEM e pela National Institute of Health Stroke Scale. Os dados foram analisados pela regressão linear múltipla (stepwise forward. Resultados Verificou-se que as variáveis grau de comprometimento neurológico, idade e escolaridade contribuíram significativamente para o valor global do MEEM e explicaram a variância do estado cognitivo (R2 ajustado = 0,24. Cada aumento do comprometimento neurológico representou diminuição de 0,456 no escore do MEEM. Quanto maior a idade, ocorreu uma diminuição de 0,202 no MEEM, e à medida que diminui o tempo de escolaridade, houve uma diminuição de 0,190 no MEEM. Os pontos de corte variaram de 14 a 22 de acordo com o grau de comprometimento neurológico, idade e escolaridade. Conclusão Os resultados apontaram que, por meio do rastreio positivo de déficit cognitivo, foram encontrados pontos de corte associados ao comprometimento neurológico, necessitando também serem ajustados pela idade e escolaridade, sugerindo que essas associações sejam preferencialmente levadas em consideração na planificação da reabilitação neuropsicológica dos pacientes com AVC.

  9. Cerebral blood flow in sickle cell cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Huttenlocher, P.R.; Moohr, J.W.; Johns, L.; Brown, F.D.

    1984-05-01

    Cerebral blood flow (CBF) has been studied by the xenon-133 (/sup 133/Xe) inhalation method in 16 children with suspected sickle cell cerebrovascular disease. Abnormalities consisting of decreases in total, hemispheral, or regional CBF were found in 17 of 26 studies. Eleven studies performed immediately after stroke, transient ischemic attack, or depression of state of alertness showed abnormalities. In addition to confirming regional cerebrovascular insufficiency in children with stroke due to major cerebral artery occlusion, the method detected diffuse decrease in CBF in children with stupor, coma, and seizures who had normal angiographic findings. In contrast, six of seven studies obtained after exchange transfusion or during maintenance on hypertransfusion therapy showed normal findings. The difference between results in patients with acute neurologic disturbances and those receiving transfusion therapy was statistically significant (P less than .005). The data indicate that the /sup 133/Xe method reliably demonstrates cerebrovascular impairment in sickle cell disease. They also suggest that CBF changes in patients with sickle cell disease can be reversed by exchange transfusion and by hypertransfusion therapy. The /sup 133/Xe CBF method may be useful for following up children with sickle cell disease who are at high risk for recurrent stroke.

  10. Topographic patterns of vascular disease: HOX proteins as determining factors?

    Institute of Scientific and Technical Information of China (English)

    Richard; P; Visconti; Alexander; Awgulewitsch

    2015-01-01

    Steadily increasing evidence supports the idea that genetic diversities in the vascular bed are, in addition to hemodynamic influences, a major contributing factor in determining region-specific cardiovascular disease susceptibility. Members of the phylogenetically highly conserved Hox gene family of developmental regulators have to be viewed as prime candidates for determining these regional genetic differences in the vasculature. During embryonic patterning, the regionally distinct and precisely choreographed expression patterns of HOX transcription factors are essential for the correct specification of positional identities. Apparently, these topographic patterns are to some degree retained in certain adult tissues, including the circulatory system. While an understanding of the functional significance of these localized Hox activities in adult blood vessels is only beginning to emerge, an argument can be made for a role of Hox genes in the maintenance of vessel wall homeostasis and functional integrity on the one hand, and in regulating the development and progression of regionally restricted vascular pathologies, on the other. Initial functional studies in animal models, as well as data from clinical studies provide some level of support for this view. The data suggest that putative genetic regulatory networks of Hox-dependent cardiovascular disease processes include genes of diverse functional categories(extracellular matrix remodeling, transmembrane signaling, cell cycle control, inflammatory response, transcriptional control, etc.), as potential targets in both vascular smooth muscle and endothelial cells, as well as cell populations residing in the adventitia.

  11. Adipose tissue and vascular inflammation in coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Enrica; Golia; Giuseppe; Limongelli; Francesco; Natale; Fabio; Fimiani; Valeria; Maddaloni; Pina; Elvira; Russo; Lucia; Riegler; Renatomaria; Bianchi; Mario; Crisci; Gaetano; Di; Palma; Paolo; Golino; Maria; Giovanna; Russo; Raffaele; Calabrò; Paolo; Calabrò

    2014-01-01

    Obesity has become an important public health issue in Western and developing countries,with well known metabolic and cardiovascular complications.In the last decades,evidence have been growing about the active role of adipose tissue as an endocrine organ in determining these pathological consequences.As a consequence of the expansion of fat depots,in obese subjects,adipose tissue cells develope a phenotypic modification,which turns into a change of the secretory output.Adipocytokines produced by both adipocytes and adipose stromal cells are involved in the modulation of glucose and lipid handling,vascular biology and,moreover,participate to the systemic inflammatory response,which characterizes obesity and metabolic syndrome.This might represent an important pathophysiological link with atherosclerotic complications and cardiovascular events.A great number of adipocytokines have been described recently,linking inflammatory mileu and vascular pathology.The understanding of these pathways is crucial not only from a pathophysiological point of view,but also to a better cardiovascular disease risk stratification and to the identification of possible therapeutic targets.The aim of this paper is to review the role of Adipocytokines as a possible link between obesity and vascular disease.

  12. Vascular and Valvular Calcifications in Chronic Kidney Disease: An Update

    Directory of Open Access Journals (Sweden)

    Luca Di Lullo

    2016-07-01

    Full Text Available In chronic kidney disease (CKD and end-stage renal disease patients cardiovascular disease is the main cause of morbidity and mortality, with incidence of cardiac related mortality increasing as renal function declines. Even after controlling for traditional cardiovascular risk factors such as smoking, age, gender, dyslipidaemia, and arterial hypertension, patients with CKD have a higher incidence of major cardiovascular events. CKD is characterised by the presence of many other non-traditional cardiovascular risk factors, such as chronic inflammation and accelerated atherosclerosis, oxidative stress, and especially, secondary hyperparathyroidism. This review will summarise the current evidence on vascular calcifications and valvular heart disease in CKD patients, from pathophysiology to therapeutic strategies.

  13. Diffuse and uncontrolled vascular smooth muscle cell proliferation in rapidly progressing pediatric moyamoya disease.

    Science.gov (United States)

    Reid, Amy J; Bhattacharjee, Meenakshi B; Regalado, Ellen S; Milewicz, Allen L; El-Hakam, Lisa M; Dauser, Robert C; Milewicz, Dianna M

    2010-09-01

    Moyamoya disease is a rare stroke syndrome of unknown etiology resulting from stenosis or occlusion of the supraclinoid internal carotid artery (ICA) in association with an abnormal vascular network in the basal ganglia. Although the highest incidence of moyamoya disease is in pediatric patients, pathology reports have been primarily limited to adult samples and describe occlusive fibrocellular lesions in the intimae of affected arteries. We describe the case of a young girl with primary moyamoya disease who presented at 18 months of age with right hemiparesis following an ischemic stroke. Angiography showed stenosis of the distal left ICA, left middle cerebral artery, and right ICA. An emergent left-sided dural inversion was performed. Recurrent strokes and alternating hemiplegia necessitated a right dural inversion 6 months later. Nonetheless, her aggressive disease proved uniquely refractory to surgical revascularization, and she succumbed to recurrent strokes and neurological deterioration at 2.5 years of age. Pathological specimens revealed a striking bilateral occlusion of the anterior carotid circulation resulting from intimal proliferation of smooth muscle cells (SMCs). Most strikingly, the ascending aorta and the superior mesenteric artery demonstrated similar intimal proliferation, along with SMC proliferation in the media. The systemic pathology involving multiple arteries in this extremely young child, the first case of its kind available for autopsy, suggests that globally uncontrolled SMC proliferation, in the absence of environmental risk factors and likely resulting from an underlying genetic alteration, may be a primary etiologic event leading to moyamoya disease.

  14. Cerebral vasoconstriction after subarachnoid hemorrhage--role of changes in vascular receptor phenotype

    DEFF Research Database (Denmark)

    Hansen-Schwartz, Jacob; Ansar, Saema; Edvinsson, Lars

    2008-01-01

    The pathological constriction of cerebral arteries known as cerebral vasospasm (CVS) is with a delay of 4 to 10 days linked to subarachnoid hemorrhage. Several agents have been suggested as being responsible; amongst these perhaps 5-hydroxytryptamine (5-HT) and endothelin-1 (ET-1) are the most...... prominent given their ability to elicit powerful constriction of cerebral arteries. Investigating both 5-HT and ET receptors we have observed that there are distinct changes in receptor phenotype after experimental SAH, namely upregulation of the ETB and 5-HT1B receptors, and that this upregulation...

  15. Avaliação da linguagem após acidente vascular cerebral em adultos no estado de Sergipe

    Directory of Open Access Journals (Sweden)

    João Sigefredo Arruda

    2014-06-01

    Full Text Available Objetivo analisar a ocorrência de distúrbios de linguagem nos indivíduos que sofreram Acidente Vascular Cerebral. Métodos foi avaliada a linguagem de todos os pacientes acometidos por Acidente Vascular Cerebral, atendidos de fevereiro a agosto de 2012, no setor de fisioterapia de centro de referência em educação e saúde do Estado de Sergipe. A avaliação foi baseada no Teste do Rio de Janeiro (2005. A análise dos dados foi realizada por meio de estatística descritiva e probabilística através da distribuição de frequência, cálculos da média, desvio padrão e percentis, do Teste U de Mann-Whitney e Qui-Quadrado. Resultado foram encontrados 31 indivíduos, de ambos os gêneros, com idade variando de 30 a 94 anos. Foi evidenciado que as variáveis: gênero, escolaridade e idade, influenciam no desempenho do teste, verificando-se que o gênero masculino, sujeitos abaixo de 65 anos e os com escolaridade acima de fundamental incompleto pontuam mais. Conclusão maior percentual da amostra apresenta mais alteração na compreensão do que na expressão.

  16. Predictive factors for spasticity among ischemic stroke patients Fatores preditivos para espasticidade após acidente vascular cerebral

    Directory of Open Access Journals (Sweden)

    Rita de Cássia dos Reis Moura

    2009-12-01

    Full Text Available Spasticity is a determining for functional loss following ischemic stroke. OBJECTIVE: To detect possible predictive factors for its occurrence. METHOD: Demographic, clinical and tomographic data on 146 stroke patients were analyzed. RESULTS: Spasticity was noted more frequently among patients who underwent physiotherapy (pA espasticidade é fator determinante para perda funcional após o acidente vascular cerebral isquêmico (AVCI. OBJETIVO: Detectar possíveis fatores preditivos para a ocorrência da espasticidade. MÉTODO: Foram analisados dados demográficos, clínicos e tomográficos de 146 pacientes pós-AVCI. RESULTADOS: Na análise univariada a espasticidade foi notada com maior freqüência em pacientes que realizaram fisioterapia (p<0,0001; OR=19,4; 95% CI: 4,4-84,5, com maior tempo de duração desse tratamento (p=0,028; OR=4,80; 95% CI: 1,1-8,3 e que realizavam trabalho braçal (p=0,041; OR=2,2; 95% CI: 1,02-4,6, renda menor (p=0,038, referência de dor (p<0,0001; OR=107,0; 95% CI: 13,5-847,3 e seu aparecimento simultâneo à espasticidade (p<0,0001, acidente vascular cerebral (AVC pregresso (p=0,001; OR=4,2; 95% CI: 1,7-10,3, fraqueza muscular (p<0,0001; OR=91,9; 95% CI: 12,0-699,4, lesão tomográfica extensa (p=0,01 e lesão afetando mais de um lobo cerebral (p=0,018. Na análise de regressão multivariada a atividade braçal apresentou risco relativo de 2,9; acidente vascular cerebral prévio com risco relativo de 3,9 e lesão tomográfica extensa risco relativo de 3,6. CONCLUSÃO: A espasticidade afetou um quarto da população estudada e esteve associada ao trabalho braçal, AVC pregresso, lesões tomográficas extensas, diminuição da renda individual, realização de fisioterapia, realização de fisioterapia por um período maior, presença de dor, surgimento da dor simultânea à espasticidade e alteração da força.

  17. Bem-estar subjetivo e senso de ajustamento psicológico em idosos que sofreram acidente vascular cerebral: uma revisão

    OpenAIRE

    Rabelo, Dóris Firmino; Néri,Anita Liberalesso

    2006-01-01

    Foi feito um levantamento dos estudos brasileiros e estrangeiros publicados entre 1996 e 2005 que relacionavam bem-estar subjetivo, senso de ajustamento psicológico e acidente vascular cerebral, com o objetivo de identificar variáveis mediadoras dessa relação em idosos. Estudos transversais e prospectivos indicaram que os afetados por acidente vascular cerebral apresentam menor bem-estar subjetivo quando comparados com a população geral. Boa capacidade cognitiva, suporte social efetivo, conti...

  18. Doxycycline, a matrix metalloprotease inhibitor, reduces vascular remodeling and damage after cerebral ischemia in stroke-prone spontaneously hypertensive rats.

    Science.gov (United States)

    Pires, Paulo W; Rogers, Curt T; McClain, Jonathon L; Garver, Hannah S; Fink, Gregory D; Dorrance, Anne M

    2011-07-01

    Matrix metalloproteases (MMPs) are a family of zinc peptidases involved in extracellular matrix turnover. There is evidence that increased MMP activity is involved in remodeling of resistance vessels in chronic hypertension. Thus we hypothesized that inhibition of MMP activity with doxycycline (DOX) would attenuate vascular remodeling. Six-week-old male stroke-prone spontaneously hypertensive rats (SHRSP) were treated with DOX (50 mg·kg(-1)·day(-1) in the drinking water) for 6 wk. Untreated SHRSP were controls. Blood pressure was measured by telemetry during the last week. Middle cerebral artery (MCA) and mesenteric resistance artery (MRA) passive structures were assessed by pressure myography. MMP-2 expression in aortas was measured by Western blot. All results are means ± SE. DOX caused a small increase in mean arterial pressure (SHRSP, 154 ± 1; SHRSP + DOX, 159 ± 3 mmHg; P Damage after transient cerebral ischemia (transient MCA occlusion) was reduced in SHRSP + DOX (20.7 ± 4 vs. 45.5 ± 5% of hemisphere infarcted; P damage after cerebral ischemia.

  19. Exercise, vascular wall and cardiovascular diseases: an update (Part 1).

    Science.gov (United States)

    Leung, Fung Ping; Yung, Lai Ming; Laher, Ismail; Yao, Xiaoqiang; Chen, Zhen Yu; Huang, Yu

    2008-01-01

    Cardiovascular disease (CVD) remains the leading cause of morbidity and premature mortality in both women and men in most industrialized countries, and has for some time also established a prominent role in developing nations. In fact, obesity, diabetes mellitus and hypertension are now commonplace even in children and youths. Regular exercise is rapidly gaining widespread advocacy as a preventative measure in schools, medical circles and in the popular media. There is overwhelming evidence garnered from a number of sources, including epidemiological, prospective cohort and intervention studies, suggesting that CVD is largely a disease associated with physical inactivity. A rapidly advancing body of human and animal data confirms an important beneficial role for exercise in the prevention and treatment of CVD. In Part 1 of this review we discuss the impact of exercise on CVD, and we highlight the effects of exercise on (i) endothelial function by regulation of endothelial genes mediating oxidative metabolism, inflammation, apoptosis, cellular growth and proliferation, increased superoxide dismutase (SOD)-1, down-regulation of p67phox, changes in intracellular calcium level, increased vascular endothelial nitric oxide synthase (eNOS), expression and eNOS Ser-1177 phosphorylation; (ii) vascular smooth muscle function by either an increased affinity of the Ca2+ extrusion mechanism or an augmented Ca2+ buffering system by the superficial sarcoplasmic reticulum to increase Ca2+ sequestration, increase in K+ channel activity and/or expression, and increase in L-type Ca2+ current density; (iii) antioxidant systems by elevation of Mn-SOD, Cu/Zn-SOD and catalase, increases in glutathione peroxidase activity and activation of vascular nicotinamide adenine dinucleotide phosphate [(NAD(P)H] oxidase and p22phox expression; (iv) heat shock protein (HSP) expression by stimulating HSP70 expression in myocardium, skeletal muscle and even in human leucocytes, probably through heat

  20. N-acetylcysteine improves arterial vascular reactivity in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Wittstock, Antje; Burkert, Magdalena; Zidek, Walter;

    2009-01-01

    Patients with stage 5 chronic kidney disease show increased cardiovascular morbidity and mortality that are partly related to impaired arterial vascular reactivity. We investigated whether intravenous administration of the antioxidant acetylcysteine improves arterial vascular reactivity in these ......Patients with stage 5 chronic kidney disease show increased cardiovascular morbidity and mortality that are partly related to impaired arterial vascular reactivity. We investigated whether intravenous administration of the antioxidant acetylcysteine improves arterial vascular reactivity...

  1. Diffuse and vascular hepatic diseases; Diffuse und vaskulaere Lebererkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Kreimeyer, S.; Grenacher, L. [Universitaetsklinikum Heidelberg, Abteilung Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

    2011-08-15

    In addition to focal liver lesions, diffuse and vascular disorders of the liver represent a wide spectrum of liver diseases which are from the radiological point of view often difficult or nearly impossible to diagnose. Classical diagnostic methods are computed tomography and magnetic resonance imaging in addition to ultrasound. Diffuse parenchymal damage caused by diseases of various etiologies is therefore difficult to evaluate because it often lacks characteristic morphological features. For hepatic steatosis, hemochromatosis/siderosis as an example of a diffuse storage disease and sarcoidosis and candidiasis as infectious/inflammatory diseases, an image-based diagnosis is appropriate in some cases. For most diffuse liver diseases, however only nonspecific changes are visualized. Vascular pathologies of the liver, such as the Budd-Chiari syndrome and portal vein thrombosis, however, can usually be diagnosed very clearly using radiology and there is also a very effective interventional radiological treatment. Chronic diseases very often culminate in liver cirrhosis which is highly associated with an increased risk of liver cancer. (orig.) [German] Neben den fokalen Leberlaesionen stellen diffuse und vaskulaere Lebererkrankungen ein weites Spektrum an Erkrankungen der Leber dar, die radiologisch oft schwer oder gar nicht diagnostizierbar sind. Klassische diagnostische Verfahren sind dabei neben dem Ultraschall die Computertomographie und die Magnetresonanztomographie. Diffuse Parenchymschaeden, bedingt durch Erkrankungen unterschiedlichster Aetiologie, sind deshalb schwierig evaluierbar, weil haeufig charakteristische bildmorphologische Merkmale fehlen. Die Steatosis hepatis, die Haemochromatose/Siderose als Beispiel der Speicherkrankheiten sowie die Sarkoidose und die Candidose als infektioes-entzuendliche Erkrankungen sind einer bildbasierten Diagnosestellung z. T. zugaenglich, bei den meisten diffusen Lebererkrankungen jedoch zeigen sich lediglich unspezifische

  2. Effect of large decompressive craniectomy combined with vascular reconstruction on cerebral perfusion in patients with severe brain injury

    Directory of Open Access Journals (Sweden)

    Liang-zhen HUANG

    2015-11-01

    Full Text Available Objective To compare the efficacies of large decompressive craniectomy combined with vascular reconstruction and traditional decompressive craniectomy in treatment of severe brain injury. Methods Forty-eight patients with severe brain injury, which was dominated by brain contusion to the frontoparietal lobes, admitted to our hospital from March 2012 to March 2014 were divided equally into experimental group and control group. The patients in the experimental group underwent large decompressive craniectomy combined with vascular reconstruction, and the patients in the control group received traditional decompressive craniectomy. The hemodynamic changes including cerebral blood flow (CBF, cerebral blood volume (CBV, mean transit time (MTT, time to peak (TTP and the ratios of these values (rCBF, rCBV, rMTT and rTTP on two sides were observed by CT perfusion imaging, and the Glasgow outcome score (GOS was analyzed 6 months after operation. Results The CBF and CBV scores in experimental group were higher than those in the control group at 1 week and 1 month after the operation (P0.05. The rate of satisfactory recovery (including good recovery and moderate disability was higher in the experimental group than in the control group, while the rate of poor recovery (including severe disability, vegetative state and death was lower in the experimental group than in the control group (P<0.05. Conclusion The large decompressive craniectomy combined with vascular reconstruction can not only decrease the intracranial pressure, but also recover the blood supply of brain, thus deserving the clinical application and popularization. DOI: 10.11855/j.issn.0577-7402.2015.11.15

  3. Isometric Exercise Training for Managing Vascular Risk Factors in Mild Cognitive Impairment and Alzheimer’s Disease

    Science.gov (United States)

    Hess, Nicole C. L.; Smart, Neil A.

    2017-01-01

    Alzheimer’s disease (AD) is the most common form of dementia diagnosed amongst the elderly. Mild cognitive impairment (MCI) is a condition often indicative of the earliest symptomatology of AD with 10%–15% of MCI patients reportedly progressing to a diagnosis of AD. Individuals with a history of vascular risk factors (VRF’s) are considered high risk candidates for developing cognitive impairment in later life. Evidence suggests that vascular injury resulting from untreated VRF’s promotes progression from MCI to AD and exacerbates the severity of dementia in AD, and neuroimaging studies have found that the neurodegenerative processes associated with AD are heavily driven by VRF’s that promote cerebral hypoperfusion. Subsequently, common links between vascular disorders such as hypertension and neurodegenerative disorders such as AD include compromised vasculature, cerebral hypoperfusion and chronic low grade inflammation (a hallmark of both hypertension and AD). Exercise has been demonstrated to be an effective intervention for blood pressure management, chronic low grade inflammation and improvements in cognition. Data from recent analyses suggests that isometric exercise training (IET) may improve vascular integrity and elicit blood pressure reductions in hypertensives greater than those seen with dynamic aerobic and resistance exercise. IET may also play an effective role in the management of VRF’s at the MCI stage of AD and may prove to be a significant strategy in the prevention, attenuation or delay of progression to AD. A plausible hypothesis is that the reactive hyperemia stimulated by IET initiates a cascade of vascular, neurotrophic and neuro-endocrine events that lead to improvements in cognitive function.

  4. The management of combined coronary artery disease and peripheral vascular disease

    NARCIS (Netherlands)

    A. Cassar (Andrew); D. Poldermans (Don); C.S. Rihal (Charanjit); B.J. Gersh (Bernard)

    2010-01-01

    textabstractCoronary artery disease (CAD) and peripheral vascular disease (PVD) remain highly prevalent in the population due to population ageing, smoking, diabetes, unhealthy lifestyles, and the epidemic of obesity, and frequently coexist. The management of combined CAD and PVD is a common challen

  5. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  6. Vascular Disease in Patients with Nonalcoholic Fatty Liver Disease

    NARCIS (Netherlands)

    Potze, Wilma; Siddiqui, M. Shadab; Sanyal, Arun J.

    2015-01-01

    Nonalcoholic fatty liver disease (NAFLD) is increasingly being diagnosed and is considered to be the most frequent chronic liver disorder in Western countries. It represents a histopathological spectrum ranging from simple hepatic steatosis to steatohepatitis and finally cirrhosis. NAFLD is consider

  7. Arterial spin labelling MRI for assessment of cerebral perfusion in children with moyamoya disease: comparison with dynamic susceptibility contrast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Goetti, Robert [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); O' Gorman, Ruth [University Children' s Hospital Zurich, Center for MR Research, Zurich (Switzerland); Khan, Nadia [University Children' s Hospital Zurich, Moyamoya Center, Division of Neurosurgery, Department of Surgery, Zurich (Switzerland); Kellenberger, Christian J.; Scheer, Ianina [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland)

    2013-05-15

    This study seeks to evaluate the diagnostic accuracy of cerebral perfusion imaging with arterial spin labelling (ASL) MR imaging in children with moyamoya disease compared to dynamic susceptibility contrast (DSC) imaging. Ten children (7 females; age, 9.2 {+-} 5.4 years) with moyamoya disease underwent cerebral perfusion imaging with ASL and DSC on a 3-T MRI scanner in the same session. Cerebral perfusion images were acquired with ASL (pulsed continuous 3D ASL sequence, 32 axial slices, TR = 5.5 s, TE = 25 ms, FOV = 24 cm, matrix = 128 x 128) and DSC (gradient echo EPI sequence, 35 volumes of 28 axial slices, TR = 2,000 ms, TE = 36 ms, FOV = 24 cm, matrix = 96 x 96, 0.2 ml/kg Gd-DOTA). Cerebral blood flow maps were generated. ASL and DSC images were qualitatively assessed regarding perfusion of left and right ACA, MCA, and PCA territories by two independent readers using a 3-point-Likert scale and quantitative relative cerebral blood flow (rCBF) was calculated. Correlation between ASL and DSC for qualitative and quantitative assessment and the accuracy of ASL for the detection of reduced perfusion per territory with DSC serving as the standard of reference were calculated. With a good interreader agreement ({kappa} = 0.62) qualitative perfusion assessment with ASL and DSC showed a strong and significant correlation ({rho} = 0.77; p < 0.001), as did quantitative rCBF (r = 0.79; p < 0.001). ASL showed a sensitivity, specificity and accuracy of 94 %, 93 %, and 93 % for the detection of reduced perfusion per territory. In children with moyamoya disease, unenhanced ASL enables the detection of reduced perfusion per vascular territory with a good accuracy compared to contrast-enhanced DSC. (orig.)

  8. Cerebral imaging for Wilson disease; Zerebrale Bildgebung bei Morbus Wilson

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, K.; Saleh, A. [Universitaetsklinikum Duesseldorf (Germany). Inst. fuer Diagnostische Radiologie; Suedmeyer, M. [Universitaetsklinikum Duesseldorf (Germany). Klinik fuer Neurologie

    2007-03-15

    Wilson disease is an autosomal recessive inherited copper metabolic disorder that is characterized by diminished biliary excretion of copper and a raised serum level of free copper. This leads to a toxic copper accumulation, particularly in the liver and the brain. Therefore, clinical symptoms are dominated by hepatic and extrapyramidal symptoms. Untreated Wilson disease has an unfavorable outcome. Cerebral changes are depicted most sensitively by magnetic resonance tomography. Pathological findings mainly focus on the basal ganglia, the midbrain and the brainstem. Depending on the therapy and the severity of the neurological symptoms, signal increase as well as signal decrease may be observed in T1-weighted (T1w) and T2-weighted (T2w) images and can be reversible when using an appropriate therapy. Hyperintense areas in T2-weighted images are induced by edema, gliosis, demyelinisation or cystic degeneration. Signal increase in T1-weighted images are found in patients with hepatic insufficiency and are probably due to manganese deposits. Signal decrease in T2-weighted images is probably caused by the paramagnetic effect of the copper accumulation. Furthermore, recent studies show a correlation between the clinical severity and changes in diffusion-weighted sequences. Although cross-section imaging plays a rather subordinate role in the primary diagnostics of Wilson disease, the described cerebral changes in patients with extrapyramidal disturbances should include Wilson disease in the differential. Persistent or progressive hyperintense lesions in T2-weighted images reflect therapy failure, and clinical recovery correlates to an improvement in MR images. Therefore, repeat MR imaging can be used to monitor medical therapy.

  9. Lesion-symptom mapping in vascular cognitive impairment

    NARCIS (Netherlands)

    Biesbroek, J.M.

    2016-01-01

    Cerebral vascular disease (CVD) is an important cause of cognitive decline and dementia, either alone or in combination with neurodegenerative diseases, such as Alzheimer's Disease (AD). The contribution of CVD to cognitive decline and dementia is referred to as Vascular Cognitive Impairment (VCI).

  10. White matters - The influence of cerebral small-vessel disease on depression, cognition and functioning

    NARCIS (Netherlands)

    Grool, A.M.

    2012-01-01

    Depression and cognitive impairment are highly prevalent in later life, and frequently co-occur. One of the possible mechanisms that may underlie both conditions is the presence of cerebral small-vessel disease. The presence of cerebral small-vessel disease is strongly associated with common vascula

  11. Cerebral compensation during motor imagery in Parkinson's disease.

    Science.gov (United States)

    Helmich, Rick C; de Lange, Floris P; Bloem, Bastiaan R; Toni, Ivan

    2007-06-11

    In neurodegenerative disorders, neural damage can trigger compensatory mechanisms that minimize behavioural impairments. Here, we aimed at characterizing cerebral compensation during motor imagery in Parkinson's disease (PD), while controlling for altered motor execution and sensory feedback. We used a within-patient design to compare the most and least affected hand in 19 right-handed PD patients with markedly right-lateralized symptoms. We used a motor imagery (MI) task in which the patients were required to judge the laterality of hand images, rotated either in a lateral or in a medial orientation with respect to the body sagittal plane. This design allowed us to compare cerebral activity (using fMRI) evoked by MI of each hand separately, while objectively monitoring task performance. Reaction times and parieto-premotor activity increased in a similar manner as a function of stimulus rotation during motor imagery of left and right hands. However, patients were markedly slower when judging images of the affected hand in lateral orientations, and there was a corresponding increase in activity in the right extrastriate body area (EBA) and occipito-parietal cortex during mental rotation of the affected hand. Furthermore, these regions increased their connectivity towards the left PMd for right (affected) hands in a lateral orientation. We infer that, in strongly lateralized PD patients, motor imagery of the most-affected hand exploits additional resources in extrastriate visual areas. These findings characterize the cerebral bases of the increased dependence on visual information processing during the generation of motor plans in PD, pointing to its compensatory role.

  12. VASCULAR ENDOTHELIAL GROWTH FACTOR IN HEALTH AND DISEASE: A REVIEW

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    Niranjan Gopal

    2016-10-01

    Full Text Available BACKGROUND Vascular Endothelial Growth Factor (VEGF has been implicated as a key molecule, which regulates physiological angiogenesis. VEGF exerts its molecular actions through Receptor Tyrosine Kinases (RTKs VEGFR-1 and VEGFR-2, differ in signaling properties. VEGF plays a vital role in embryogenesis, growth and reproduction. VEGF as a mediator of pathological angiogenesis is associated with proliferation and micrometastasis of various tumours, ocular disorders involving neovascularisation, pre-eclampsia, etc. The pathogenesis of micro and macrovascular complications of diabetes mellitus and the role of VEGF is being studied extensively. Currently, several pharmacological interventions based on VEGF inhibitors and receptor antagonists have been tried to combat the pathological angiogenesis in a wide gamut of disorders. This review attempts to put together important properties, mechanism of action and the role of VEGF in common diseased states. CONCLUSION Effects of VEGF are widespread and have been implicated in several disease states. Therapeutic modalities targeting VEGF have been tried with success in recent years.

  13. Antiphospholipid syndrome and vascular ischemic (occlusive) diseases: an overview.

    Science.gov (United States)

    Atanassova, Penka A

    2007-12-31

    Antiphospholipid syndrome (APS) is primarily considered to be an autoimmune pathological condition that is also referred to as "Hughes syndrome". It is characterized by arterial and/or venous thrombosis and pregnancy pathologies in the presence of anticardiolipin antibodies and/or lupus anticoagulant. APS can occur either as a primary disease or secondary to a connective tissue disorder, most frequently systemic lupus erythematosus (SLE). Damage to the nervous system is one of the most prominent clinical constellations of sequelae in APS and includes (i) arterial/ venous thrombotic events, (ii) psychiatric features and (iii) other non- thrombotic neurological syndromes. In this overview we compare the most important vascular ischemic (occlusive) disturbances (VIOD) with neuro-psychiatric symptomatics, together with complete, updated classifications and hypotheses for the etio-pathogenesis of APS with underlying clinical and laboratory criteria for optimal diagnosis and disease management.

  14. Cerebrolysin improves symptoms and delays progression in patients with Alzheimer's disease and vascular dementia.

    Science.gov (United States)

    Allegri, R F; Guekht, A

    2012-04-01

    Dementia is the result of various cerebral disorders, leading to an acquired loss of memory and impaired cognitive ability. The most common forms are Alzheimer's disease (AD) and vascular dementia (VaD). Neurotrophic factors are essential for the survival and differentiation of developing neurons and protecting them against damage under pathologic conditions. Cerebrolysin is a peptide preparation that mimics the pleiotropic effects of neurotrophic factors. Several clinical trials investigating the therapeutic efficacy of Cerebrolysin in AD and VaD have confirmed the proof of concept. The results of these trials have shown statistically significant and clinically relevant treatment effects of Cerebrolysin on cognitive, global and functional domains in mild to moderately severe stages of dementia. Doses of 10 and 30 mL were the most effective, but higher doses of up to 60 mL turned out to be most effective in improving neuropsychiatric symptoms, which become relevant at later stages of the disease. Combining treatment with cholinesterase inhibitors and Cerebrolysin indicated long-term synergistic treatment effects in mild to moderate AD. The efficacy of Cerebrolysin persisted for up to several months after treatment suggesting Cerebrolysin has not merely symptomatic benefits, but a disease-delaying potential. This paper reviews the clinical efficacy of Cerebrolysin in the treatment of dementia. Data were obtained from international, multicenter, randomized clinical trials performed in compliance with Good Clinical Practice and the principles of the Declaration of Helsinki (1964) and subsequent revisions.

  15. Molecular pathogenesis of retinal and choroidal vascular diseases.

    Science.gov (United States)

    Campochiaro, Peter A

    2015-11-01

    There are two major types of ocular neovascularization that affect the retina, retinal neovascularization (NV) and subretinal or choroidal NV. Retinal NV occurs in a group of diseases referred to as ischemic retinopathies in which damage to retinal vessels results in retinal ischemia. Most prevalent of these are diabetic retinopathy and retinal vein occlusions. Subretinal and choroidal NV occur in diseases of the outer retina and Bruch's membrane, the most prevalent of which is age-related macular degeneration. Numerous studies in mouse models have helped to elucidate the molecular pathogenesis underlying retinal, subretinal, and choroidal NV. There is considerable overlap because the precipitating event in each is stabilization of hypoxia inducible factor-1 (HIF-1) which leads to upregulation of several hypoxia-regulated gene products, including vascular endothelial growth factor (VEGF), angiopoietin 2, vascular endothelial-protein tyrosine phosphatase (VE-PTP), and several others. Stimulation of VEGF signaling and suppression of Tie2 by angiopoietin 2 and VE-PTP are critical for sprouting of retinal, subretinal, and choroidal NV, with perturbation of Bruch's membrane also needed for the latter. Additional HIF-1-regulated gene products cause further stimulation of the NV. It is difficult to model macular edema in animals and therefore proof-of-concept clinical trials were done and demonstrated that VEGF plays a central role and that suppression of Tie2 is also important. Neutralization of VEGF is currently the first line therapy for all of the above disease processes, but new treatments directed at some of the other molecular targets, particularly stabilization of Tie2, are likely to provide additional benefit for subretinal/choroidal NV and macular edema. In addition, the chronicity of these diseases as well as the implication of VEGF as a cause of retinal nonperfusion and progression of background diabetic retinopathy make sustained delivery approaches for VEGF

  16. Reduced cerebral oxygen–carbohydrate index during endotracheal intubation in vascular surgical patients

    DEFF Research Database (Denmark)

    Fabricius-Bjerre, Andreas; Overgaard, Anders; Winther-Olesen, Marie

    2015-01-01

    Brain activation reduces balance between cerebral consumption of oxygen versus carbohydrate as expressed by the so-called cerebral oxygen-carbohydrate-index (OCI). We evaluated whether preparation for surgery, anaesthesia including tracheal intubation and surgery affect OCI. In patients undergoing.......2 versus 0.7 ± 0.2 mmol l(-1) , Pintubation (P... to 4.6 ± 1.4 during surgery and to 5.6 ± 1.7 in the recovery room. In conclusion, preparation for surgery and tracheal intubation decrease OCI that recovers during surgery under the influence of sensory blockade....

  17. O uso de tomografia computadorizada nas internações por Acidente Vascular Cerebral no Sistema Único de Saúde no Brasil Computerized tomography utilization for stroke inpatients in the Brazilian Health System

    Directory of Open Access Journals (Sweden)

    Cristina Lúcia Rocha Cubas Rolim

    2012-03-01

    Full Text Available O Acidente Vascular Cerebral é um dos principais motivos de internação no Sistema Único de Saúde. O exame de tomografia computadoriza tem sido indicado como o principal método diagnóstico de imagem para a definição do tratamento do Acidente Vascular Cerebral. O objetivo desse artigo é avaliar a utilização de exames de tomografia computadorizada em internações por Acidente Vascular Cerebral com base nas informações do Sistema de Informação Hospitalar do Sistema Único de Saúde. O universo de estudo incluiu as internações de pacientes adultos ocorridas no Brasil e financiadas pelo Sistema Único de Saúde entre abril de 2006 e dezembro de 2007. A análise dos dados foi descritiva para o conjunto de casos de Acidente Vascular Cerebral e para cada subgrupo separadamente. Das 328.087 internações por Acidente Vascular Cerebral, observou-se que em 73,5% o exame não foi realizado. Nas internações que realizaram tomografia computadorizada, 22,3% tiveram acesso a um exame e somente 4,2% a dois exames. Além de subutilizado, o exame de tomografia computadorizada, quando realizado, não trouxe melhora na codificação adequada do subgrupo da doença.Stroke is a leading reason for hospitalization in the Brazilian Health System. Computerized tomography has been indicated as the main diagnostic method to define stroke treatment. The aim of this paper was to evaluate the utilization of computerized tomography in hospitalizations due to stroke. The source of data was the Brazilian hospital information system. The study population comprised adult stroke inpatients in Brazil in the Brazilian Health System, between April 2006 and December 2007. Data analysis was descriptive for stroke and for each separate subgroup. Of the 328,087 stroke inpatients, 73.5% had not done a computerized tomography scan. Among hospitalizations that underwent a computed tomography scan, 22.3% had access to one test, and only 4.2% had two tests. Besides underuse

  18. Tratamento cirúrgico das patologias vasculares cerebrais nos pacientes epilépticos Surgical treatment of cerebral vascular pathologies in epiletic patients

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    Aziz Rassi-Neto

    1997-09-01

    Full Text Available A cirurgia das malformações arteriovenosas (MAV e dos cavernomas (angioma cavernoso na maioria das vezes é indicada após episódios de sangramento. Com o desenvolvimento das técnicas de diagnóstico e cirúrgicas na epilepsia de difícil controle, passou a ser cada vez maior a indicação cirúrgica destas lesões vasculares. Apresentamos nove pacientes com lesões vasculares cerebrais e crises muito frequentes, apesar do tratamento clínico adequado. A faixa etária variou de 12 a 42 anos de idade, com média de 25 anos; houve prevalência no sexo masculino (2:1. A cirurgia consistiu na exérese da lesão em todos os casos. Em quatro casos houve também ressecção da área irritativa perilesional, que foi demostrada pela eletrocorticografia. O estudo anatomopatológico das lesões mostrou cinco casos de cavernoma, três de MAV e um de angioma venoso. Quanto à localização, observamos três lesões no lobo temporal, quatro no frontal e duas na região parietal. O acompanhamento ambulatorial mostrou redução das crises em todos os pacientes, sendo que sete evoluíram sem crises após a cirurgia.Surgery of arteriovenous malformations (AVM and of cavernous angiomas (cavernoma in the majority of cases is indicated subsequently to episodes of bleeding. With the development of techniques for diagnosis and surgery for epilepsy of difficult control, indication for surgery of these vascular lesions has become greater. We present nine patients with cerebral vascular lesions and very frequent crises in spite of adequate clinical treatment. Ages ranged from 12 to 42 years with an average of 25 years; there was a prevalence of the male sex (2:1. Surgery consisted of exeresis of the lesion in all cases and in four there was also resection of the perilesional irritative area shown by electrocorticography. The pathologic study of lesions showed five cases of cavernoma, three cases of AVM, and one case of venous angioma. As to localization, we observed

  19. Dietary vitamin K and therapeutic warfarin alter susceptibility to vascular calcification in experimental chronic kidney disease

    Science.gov (United States)

    The leading cause of death in patients with chronic kidney disease (CKD) is cardiovascular disease (CVD), with vascular calcification (VC) being a key modifier of disease progression. A local regulator of vascular calcification is vitamin K. This gamma-glutamyl carboxylase substrate is an essential ...

  20. 1H-magnetic resonance spectroscopy of vascular endothelial growth factor-induced neuroprotection following acute cerebral ischemia and reperfusion

    Institute of Scientific and Technical Information of China (English)

    Li Yi; Haiou Zhang; Hao Lei; Li Wei

    2008-01-01

    BACKGROUND: It has become generally accepted that measuring N-acetyI-L-aspartic acid through the use of 1H-magnetic resonance spectroscopy (1H-MRS) could be used to evaluate neuronal injury. OBJECTIVE: To study metabolic changes of N-acetyl-L-aspanic acid surrounding the acute cerebral ischcmia area following vascular endothelial growth factor (VEGF) treatment using 1H-MRS imaging, and to evaluate the neuroprotective effects of VEGE.DESIGN, TIME AND SETTING: Randomly controlled animal study, according to one-factor analysis of variance, was performed at the Shenzhen Hospital of Peking University and State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences from August 2003 to December 2005.MATERIALS: Twelve healthy, adult, Sprague Dawley rats were used to establish an ischemia/reperfusion model through the use of middle cerebral artery occlusion. The 4.7T superconducting nuclear magnetic resonance meter was provided by Brucker Company. VEGF164 was purchased from Shenzhen Jingmei Bioengineering Co., Ltd. Titus ancsthesia machine was purchased from Draeger Medical AG & Co. KG.METHODS: The rats were randomly divided into model control (n = 6) and VEGF-injected (n = 6) groups. All animals received 60-minute middle cerebral artery occlusion and 24-hour repcrfusion. Lateral cerebral ventricle injection was performed by stereotaxic technique at respective time points. The VEGF group received 0. 1 μ g/μ L VEGF (5 μL), and the model group received the same amount of normal saline, once daily for 3 days.MAIN OUTCOME MEASURES: Metabolic changes of N-acetyl-L-aspartic acid and lactic acid following cerebral ischemia and reperfusion were detected using 1H-MRS, and the ischemic volume was measured.RESULTS: Twelve rats were included in the final analysis. =H-MRS results revealed that the ischemic volume increased in the control group compared with prior to injection (P < 0.01). In the

  1. Large cerebral vessel occlusive disease in Lyme neuroborreliosis.

    Science.gov (United States)

    Klingebiel, R; Benndorf, G; Schmitt, M; von Moers, A; Lehmann, R

    2002-02-01

    We report on a 12-year-old, previously healthy girl with an acute hemiparesis as the predominant clinical manifestation of Lyme neuroborreliosis (LNB). The diagnosis of LNB was based on cerebrospinal fluid (CSF) studies, laboratory findings and the clinical course whereas the patient's history and the lack of characteristic skin lesions obscured the diagnosis in the beginning. After four weeks of antibiotic and physiotherapeutic treatment, the hemiparetic symptoms had completely resolved. Although evidence of vasculitic and perivascular inflammation in LNB has been described in the literature, large cerebral vessel occlusive disease represents a rare finding. Appropriate treatment strategies can lead to good clinical rehabilitation, as shown in this case, making the timely diagnosis a crucial issue. We conclude that LNB should be considered in every stroke-like episode of unknown origin in children, even in the absence of a history of a tick bite or typical skin lesions.

  2. Cerebral small vessel disease: targeting oxidative stressas a novel therapeutic strategy?

    Directory of Open Access Journals (Sweden)

    Alyson Anne Miller

    2016-03-01

    Full Text Available Cerebral small vessel disease (SVD is a major contributor to stroke, and a leading cause of cognitive impairment and dementia. Despite the devastating effects of cerebral SVD, the pathogenesis of cerebral SVD is still not completely understood. Moreover, there are no specific pharmacological strategies for its prevention or treatment. Cerebral SVD is characterized by marked functional and structural abnormalities of the cerebral microcirculation. The clinical manifestations of these pathological changes include lacunar infarcts, white matter hyperintensities, and cerebral microbleeds. The main purpose of this review is to discuss evidence implicating oxidative stress in the ateriopathy of both non-amyloid and amyloid (cerebral amyloid angiopathy forms of cerebral SVD and its most important risk factors (hypertension and aging, as well as its contribution to cerebral SVD-related brain injury and cognitive impairment. We also highlight current evidence of the involvement of the NADPH oxidases in the development of oxidative stress, enzymes that are a major source of reactive oxygen species in the cerebral vasculature. Lastly, we discuss potential pharmacological strategies for oxidative stress in cerebral SVD, including some of the historical and emerging NADPH oxidase inhibitors.

  3. Cerebral hydatid disease: Is it primary or secondary?

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    Onteddu Joji Reddy

    2014-01-01

    Full Text Available Hydatid disease is a serious medical problem in Mediterranean and particularly among sheep farming countries, caused by larval stages of dog tapeworms belonging to the genus Echinococcus. Hydatid cysts may affect every organ in the human body; however, multiple organ involvement (spleen, adrenal gland, heart, pericardium, intravascular growth of hydatids and brain without affecting the two major filters in the body liver and the lung was very rare. In this case, myocardial hydatid cyst is considered as primary and involvement of other organs such as brain, spleen, adrenal glands, and vascular involvement are considered as secondary involvement due to the rupture of hydatid in heart. Rarity of this atypical presentation of hydatid disease leads to this case report.

  4. Influence of the gender on cerebral vascular diameters observed during the magnetic resonance angiographic examination of willis circle

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    Marco Antonio Stefani

    2013-02-01

    Full Text Available The present study evaluated the calibers and anatomic configurations based on the Magnetic Resonance analysis (MRA, assaying the cerebral vascular territories and sex-linked variations. A randomized sample of 30 angiographic examinations in adult patients of both sexes was obtained and components of the circle of Willis were identified. Branch diameters were measured on a transversal cut 5mm from the vessel origin in a typical angiographic frontal incidence. For the comparative statistical analysis, tests were divided in the groups considering the patients' sex and age. The classical Circle of Willis configuration was oberved in only 15 samples (50%. Greater calibers were observed in the arteries of the posterior circulation and multiple linear regression analysis established that the caliber of the posterior circulation was influenced by an independent variable related to the gender. Additional variations included unilateral and bilateral fetal and hypoplasic Posterior communicating arteries. In the anterior cerebral artery (ACA, the presence of an accessory developed ACA, an ACA giving branches to the distal portion of the two hemispheres and a third median ACA the variants were observed. Gender influenced the variations on internal diameters of posterior circulation vessels, with larger measurements in men.

  5. Family history of atherosclerotic vascular disease is associated with the presence of abdominal aortic aneurysm.

    Science.gov (United States)

    Ye, Zi; Bailey, Kent R; Austin, Erin; Kullo, Iftikhar J

    2016-02-01

    We investigated whether family history (FHx) of atherosclerotic cardiovascular disease (ASCVD) was associated with presence of abdominal aortic aneurysm (AAA). The study cohort comprised of 696 patients with AAA (70±8 years, 84% men) and 2686 controls (68±10 years, 61% men) recruited from noninvasive vascular and stress electrocardiogram (ECG) laboratories at Mayo Clinic. AAA was defined as a transverse diameter of abdominal aorta ⩾ 3 cm or history of AAA repair. Controls were not known to have AAA. FHx was defined as having at least one first-degree relative with aortic aneurysm or with onset of ASCVD (coronary, cerebral or peripheral artery disease) before age 65 years. FHx of aortic aneurysm or ASCVD were each associated with presence of AAA after adjustment for age, sex, conventional risk factors and ASCVD: adjusted odds ratios (OR; 95% confidence interval): 2.17 (1.66-2.83, p aortic aneurysm: adjusted OR: 1.27 (1.05-1.55, p = 0.01). FHx of ASCVD in multiple arterial locations was associated with higher odds of having AAA: the adjusted odds were 1.23 times higher for each additionally affected arterial location reported in the FHx (1.08-1.40, p = 0.01). Our results suggest both unique and shared environmental and genetic factors mediating susceptibility to AAA and ASCVD.

  6. Study comparing the use of dynamic CT and Xe-CT CBF for ischemic cerebro-vascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Terada, Tomoaki; Kikuchi, Haruhiko; Kuriyama, Yoshihiro; Nagata, Izumi; Yamagata, Sen; Naruo, Yoshito; Minamikawa, Jun; Kaneko, Takaji; Sakashita, Yoshiharu

    1987-06-01

    The simultaneous measurement of dynamic computerized tomography scanning (DCT) with an iodine-contrast enhancement material bolus injection and a simultaneous xenon CT-CBF-study was done on 15 patients (8 cases of unilateral internal carotid occlusion; 3, of unilateral middle cerebral arterial occlusion, and 4, without any major cerebral arterial occlusion or significant arterial stenosis) with ischemic cerebro-vascular diseases at the subacute and/or chronic stage. The value of the width and corrected first moment (cMT1) as well as their functional images, as acquired from DCT data, were compared to the 1-CBF value and the 1-CBF map of the xenon CT-CBF-study. A comparison of the functional images of DCT and 1-CBF showed that there was a good correlation between them in the cases without leptomeningeal anastomosis as a collateral circulation. However, a poor correlation between them was found in the cases with leptomeningeal anastomosis as a collateral circulation. The correlation of 1-CBF and 1/width with 1/cMT1 was significant (r = 0.78, p < 0.01) in the former cases, but it was not significant in the latter cases. The results of our data were thought to be due to the difference in the tracer inflow pattern between the cases without leptomeningeal anastomosis and those with it as a collateral circulation. The factor of cerebral blood volume should be considered in a more detailed study, although our cases did not include any patients with acute cerebral infarction or recanalized cases, which are thought to show various changes in the cerebral blood volume. The 1/width and 1/cMT1 values acquired from DCT well reflected the CBF in the cases without leptomeningeal anastomosis as a collateral circulation.

  7. Dual anca positivity in a child with moyamoya-like cerebral vascular changes: an unusual presentation with sudden homonymous hemianopsia.

    Science.gov (United States)

    Sakalli, Hale; Baskin, Esra; Alehan, Füsun; Agıldere, Muhteşem; Akova, Yonca Aydin; Caner, Hakan

    2012-10-01

    A 12-year-old girl presented with a sudden decrease in her right visual acuity and homonymous hemianopsia. An angiography of the retinal arteries demonstrated recanalized occlusion of the right retinal artery. Cerebral angiography showed bilateral internal carotid artery stenosis associated with the development of collateral circulation. Laboratory evaluations revealed dual antineutrophil cytoplasmic antibodies (ANCA) positivity [anti-proteinase (anti-PR3) ANCA and anti-myeloperoxidase (anti-MPO) ANCA], anticardiolipin (aCL) antibodies, and low titers of antinuclear antibodies (ANA). There was no evidence of active systemic lupus erythematosus (SLE), ANCA-related vasculitis, or other risk factors for cerebral occlusion, such as antiphospholipid syndrome (APS). Dual positivity for both cytoplasmic (c-ANCA) and perinuclear (p-ANCA) antineutrophil antibodies has been found previously in a small number of reports, but to our knowledge, this case represents the first case of moyamoya disease associated with dual ANCA positivity.

  8. Relationship Between Cerebral Oxygenation and Hemodynamic and Oxygen Transport Parameters in Surgery for Acquired Heart Diseases

    Directory of Open Access Journals (Sweden)

    A. I. Lenkin

    2012-01-01

    Full Text Available Objective: to evaluate the relationship between cerebral oxygenation and hemodynamic and oxygen transport parameters in surgical correction of concomitant acquired heart diseases. Subjects and methods. Informed consent was received from 40 patients who required surgery because of concomitant (two or more acquired heart defects. During procedure, perioperative monitoring of oxygen transport and cerebral oxygenation was performed with the aid of PiCCO2 monitor (Pulsion Medical Systems, Germany and a Fore-Sight cerebral oximeter (CASMED, USA. Anesthesia was maintained with propofol and fen-tanyl, by monitoring the depth of anesthesia. Early postoperative intensive therapy was based on the protocol for early targeted correction of hemodynamic disorders. Oxygen transport and cerebral oxygenation parameters were estimated intraopera-tively and within 24 postoperative hours. A statistical analysis including evaluation of Spearman correlations was performed with the aid of SPSS 15.0. Results. During perfusion, there was a relationship between cerebral oximetry values and hemat-ocrit levels, and oxygen partial pressure in the venous blood. Furthermore, a negative correlation between cerebral oximetry values and blood lactate levels was found 30 minutes after initiation of extracorporeal circulation (EC. During the study, there was a positive correlation between cerebral oxygenation and values of cardiac index, central venous saturation, and oxygen delivery index. There was a negative relationship between cerebral oxygenation and extravascular lung water at the beginning of surgery and a correlation between cerebral oximetry values and oxygenation index by the end of the first 24 postoperative hours. Conclusion. The cerebral oxygenation values correlate -with the main determinants of oxygen transport during EC and after cardiac surgical procedures. Cerebral oximetry may be used in early targeted therapy for the surgical correction of acquired combined

  9. Alcohol and cardiovascular disease--modulation of vascular cell function.

    Science.gov (United States)

    Cahill, Paul A; Redmond, Eileen M

    2012-04-01

    Alcohol is a commonly used drug worldwide. Epidemiological studies have identified alcohol consumption as a factor that may either positively or negatively influence many diseases including cardiovascular disease, certain cancers and dementia. Often there seems to be a differential effect of various drinking patterns, with frequent moderate consumption of alcohol being salutary and binge drinking or chronic abuse being deleterious to one's health. A better understanding of the cellular and molecular mechanisms mediating the many effects of alcohol consumption is beginning to emerge, as well as a clearer picture as to whether these effects are due to the direct actions of alcohol itself, or caused in part by its metabolites, e.g., acetaldehyde, or by incidental components present in the alcoholic beverage (e.g., polyphenols in red wine). This review will discuss evidence to date as to how alcohol (ethanol) might affect atherosclerosis that underlies cardiovascular and cerebrovascular disease, and the putative mechanisms involved, focusing on vascular endothelial and smooth muscle cell effects.

  10. Distinguishing between vascular dementia and Alzheimer's disease by means of the WAIS: a meta-analysis.

    Science.gov (United States)

    Oosterman, Joukje M; Scherder, Erik J A

    2006-10-01

    This study was intended to, meta-analytically, review whether the subtests of the Wechsler Adult Intelligence Scale are useful in differentiating between vascular dementia and Alzheimer's disease. We expected the Alzheimer's disease group to outperform the vascular dementia group on those subtests that require executive functions, whereas inferior performance of the Alzheimer's disease patients was expected on memory tests. Two steps in the analysis were undertaken in an attempt to clarify this issue. The first step consisted of including all studies examining Wechsler Adult Intelligence Scale subtest performance in vascular dementia and Alzheimer's disease patients. Secondly, a subcortical vascular dementia subgroup was distinguished and performance of this subgroup was compared to that of the Alzheimer's disease group.Overall, the analyses showed that both the vascular dementia and, more strongly, the subcortical vascular dementia group revealed decreased executive functions on several subtests compared to the Alzheimer's disease group. The Alzheimer's disease group showed inferior performance on a single semantic memory test only compared to both the vascular dementia and the subcortical vascular dementia groups. These results indicate that several subtests of the Wechsler Adult Intelligence Scale can differentiate between these two clinical groups, and that most of these tests reveal more impaired performance in the vascular dementia group.

  11. Chronic Supplementation of Paeonol Combined with Danshensu for the Improvement of Vascular Reactivity in the Cerebral Basilar Artery of Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Peng-Cheng Qiu

    2012-11-01

    Full Text Available One of the leading causes of death in the world is cerebrovascular disease. Numerous Chinese traditional medicines, such as Cortex Moutan (root bark of Paeonia suffruticosa Andrew and Radix Salviae miltiorrhizae (root and rhizome of Salvia miltiorrhiza Bunge, protect against cerebrovascular diseases and exhibit anti-atherosclerotic effects. Traditional medicines have been routinely used for a long time in China. In addition, these two herbs are prescribed together in clinical practice. Therefore, the pharmacodynamic interactions between the active constituents of these two herbs, which are paeonol (Pae and danshensu (DSS, should be particularly studied. The study of Pae and DSS can provide substantial foundations in understanding their mechanisms and empirical evidence to support clinical practice. This study investigated the effects and possible mechanisms of the pharmacodynamic interaction between Pae and DSS on cerebrovascular malfunctioning in diabetes. Experimental diabetes was induced in rats, which was then treated with Pae, DSS, and Pae + DSS for eight weeks. Afterward, cerebral arteries from all groups were isolated and equilibrated in an organ bath with Krebs buffer and ring tension. Effects of Pae, DSS, and Pae + DSS were observed on vessel relaxation with or without endothelium as well as on the basal tonus of vessels from normal and diabetic rats. Indexes about oxidative stress were also determined. We report that the cerebral arteries from diabetic rats show decreased vascular reactivity to acetylcholine (ACh which was corrected in Pae, DSS, and Pae + DSS treated groups. Furthermore, phenylephrine (PE-induced contraction response decreased in the treated groups. Phenylephrine and CaCl2-induced vasoconstrictions are partially inhibited in the three treated groups under Ca2+-free medium. Pre-incubated with tetraethylammonium, a non-selective K+ channel blocker, the antagonized relaxation responses increased in DSS and Pae + DSS

  12. Influence of mild hypothermia on vascular endothelial growth factor and infarct volume in brain tissues after cerebral ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    Fei Ye; Gangming Xi; Biyong Qin; Shifeng Wang; Chengyan Li

    2006-01-01

    BACKGROUND: It has been demonstrated that mild hypothermia has obvious protective effect on both whole and local cerebral ischemia. However, the definite mechanism is still unclear for the brain protection of mild hypothermia on cerebral edema, inhibiting inflammatory reaction, stabilizing blood brain barrier, etc.OBJECTIVE: To investigate the effect of mild hypothermia on the expression of vascular endothelial growth factor and the infarct volume after cerebral ischemia in rats, and analyze the brain protective mechanism of mild hypothermia.DESIGN: A randomized grouping and controlled animal trial.SETTING: Department of Neurology, People's Hospital of Yunyang Medical College.MATERIALS: Twenty adult male SD rats of clean degree, weighing (250±30) g, were provided by the animal experimental center, School of Medicine, Wuhan University. The kits for SP immunohistochemistry were purchased from Beijing Zhongshan Golden Bridge Biotechnology Co., Ltd.METHODS: The experiments were carried out in the laboratory of Department of Neurology, Renmen Hospital of Wuhan University from May to July 2005. ① The 20 rats were divided randomly into normal temperature group (n =10) and mild hypothermia group (n =10). Models of permanent middle cerebral artery occlusion were established with modified nylon suture embolization. The rats were assessed with the Longa standards: O point for without nerve dysfunction; 1 for mild neurological deficit (fore claws could no extend completely); 2 for moderate neurological deficit (circling towards the affected side); 3 for severe neurological deficit (tilting towards the affected side); 4 for coma and unconscious; 1 -3 points represented that models were successfully established. The rats of the normal temperature group were fed at room temperature, and those in the mild hypothermia group were induced by hypothermia from 2 hours postoperatively, and the rectal temperature was kept at 34-35 ℃ for 72 hours. ② Measurement of infarct volume

  13. [Clinical associations between retinal vascular diseases and cardiovascular diseases in patients with systemic atheromatosis].

    Science.gov (United States)

    Stefănescu-Dima, Alin; Bătăiosu, Constantin; Sas, Teodor; Puianu, Mihaela

    2013-01-01

    A clinical study was conducted on a sample of 48 patients examined within 3 months. Of these, 27 patients were recruited by ophtalmologic criteria and 21 recruited by cardiologic criteria, 25% of these patients coming for routine check. They were investigated by ophthalmic examination, cardiological examination, imaging and laboratory examination. Testing has shown a strong link between cardiovascular disease and the eye of the patients investigated. The study demonstrated the need for interdisciplinary consultation for patients with vascular complaints in the carotid territory and a close correlation between the vascular and ophthalmologic pathology at this level.

  14. Cerebral blood flow in small vessel disease : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Shi, Yulu; Thrippleton, Michael J; Makin, Stephen D; Marshall, Ian; Geerlings, Mirjam I; de Craen, Anton Jm; van Buchem, Mark A; Wardlaw, Joanna M

    2016-01-01

    White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that as

  15. Prevalence of cerebral and pulmonary thrombosis in patients with cyanotic congenital heart disease

    DEFF Research Database (Denmark)

    Jensen, A S; Idorn, L; Thomsen, C;

    2015-01-01

    BACKGROUND: Patients with cyanotic congenital heart disease (CCHD) have a high prevalence of thrombosis, the most frequently described locations being the cerebral and pulmonary vessels. The reported prevalence of both cerebral infarction and pulmonary thrombosis has been highly variable. The aim...

  16. Cerebral Small Vessel Disease in Dementia and Depression: a prospective population-based MRI study

    NARCIS (Netherlands)

    N.D. Prins (Niels)

    2004-01-01

    markdownabstract__Abstract__ Cerebral white matter lesions and asymptomatic brain infarcts are common in elderly people. These brain lesions are thought to result from cerebral small vessel disease, and their presence and severity increase with age and the presence of arterial hypertension. There i

  17. Focal Cerebral Ischemia Induces Alzheimer s Disease-like Pathological Change in Rats

    Institute of Scientific and Technical Information of China (English)

    王海均; 赵洪洋; 叶佑范; 熊南翔; 黄俊红; 姚东晓; 沈寅; 赵心同

    2010-01-01

    The changes in the tau protein phosphorylation and expression of bcl-2,and bax in rat parietal cortex neurons after focal cerebral ischemia-reperfusion(I/R)were explored,and the relationship between the tau protein phosphorylation and the expression of bax or apoptosis was clarified in order to elucidate the relationship between cerebral infarction and Alzheimer's disease.The rat focal cerebral I/R model was induced by occlusion of the right middle cerebral artery using the intraluminal suture method.The le...

  18. Imaging findings and cerebral perfusion in arterial ischemic stroke due to transient cerebral arteriopathy in children; Achados de imagem e perfusao arterial cerebral em acidente vascular cerebral isquemico devido a arteriopatia transitoria em crianca

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa Junior, Alcino Alves, E-mail: alcinojr@uol.com.br [Departamento de Diagnostico por Imagem, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Ellovitch, Saada Resende de Souza [Neuropediatria, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Pincerato, Rita de Cassia Maciel [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2012-04-15

    We report the case of a 4-year-old female child who developed an arterial ischemic stroke in the left middle cerebral artery territory, due to a proximal stenosis of the supraclinoid internal carotid artery, most probably related to transient cerebral arteriopathy of childhood. Computed tomography scan, magnetic resonance imaging, perfusion magnetic resonance and magnetic resonance angiography are presented, as well as follow-up by magnetic resonance and magnetic resonance angiography exams. Changes in cerebral perfusion and diffusion-perfusion mismatch call attention. As far as we know, this is the first report of magnetic resonance perfusion findings in transient cerebral arteriopathy. (author)

  19. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Frikke-Schmidt, Ruth; Schnohr, Peter

    2011-01-01

    To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population.......To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population....

  20. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease

    DEFF Research Database (Denmark)

    Sarwar, N; Gao, P; Seshasai, S R Kondapally

    2010-01-01

    : Diabetes confers about a two-fold excess risk for a wide range of vascular diseases, independently from other conventional risk factors. In people without diabetes, fasting blood glucose concentration is modestly and non-linearly associated with risk of vascular disease. FUNDING: British Heart Foundation......, UK Medical Research Council, and Pfizer....

  1. Distinguishing between vascular dementia and Alzheimer's disease by means of the WAIS: A meta-analysis

    NARCIS (Netherlands)

    Scherder, E.J A; Oosterman, J

    2006-01-01

    This study was intended to, meta-analytically, review whether the subtests of the Wechsler Adult Intelligence Scale are useful in differentiating between vascular dementia and Alzheimer's disease. We expected the Alzheimer's disease group to outperform the vascular dementia group on those subtests t

  2. Distinguishing between vascular dementia and Alzheimer's disease by means of the WAIS : A meta-analysis

    NARCIS (Netherlands)

    Scherder, Erik J. A.; Oosterman, J

    2006-01-01

    This study was intended to, meta-analytically, review whether the subtests of the Wechsler Adult Intelligence Scale are useful in differentiating between vascular dementia and Alzheimer's disease. We expected the Alzheimer's disease group to outperform the vascular dementia group on those subtests t

  3. Systemic and Pulmonary Vascular Remodelling in Chronic Obstructive Pulmonary Disease.

    Directory of Open Access Journals (Sweden)

    Mariana Muñoz-Esquerre

    Full Text Available Chronic Obstructive Pulmonary Disease (COPD is associated with subclinical systemic atherosclerosis and pulmonary vascular remodelling characterized by intimal hyperplasia and luminal narrowing. We aimed to determine differences in the intimal thickening of systemic and pulmonary arteries in COPD subjects and smokers. Secondary aims include comparisons with a non-smokers group; determining the clinical variables associated with systemic and pulmonary intimal thickening, and the correlations between systemic and pulmonary remodelling changes.All consecutive subjects undergoing lung resection were included and divided into 3 groups: 1 COPD, 2 smokers, and 3 non-smokers. Sections of the 5th intercostal artery and muscular pulmonary arteries were measured by histo-morphometry. Four parameters of intimal thickening were evaluated: 1 percentage of intimal area (%IA, 2 percentage of luminal narrowing, 3 intimal thickness index, and 4 intima-to-media ratio.In the adjusted analysis, the systemic arteries of COPD subjects showed greater intimal thickening (%IA than those of smokers (15.6±1.5% vs. 14.2±1.6%, p = 0.038. In the pulmonary arteries, significant differences were observed for %IA between the 2 groups (37.3±2.2% vs. 29.3±2.3%, p = 0.016. Among clinical factors, metabolic syndrome, gender and COPD status were associated with the systemic intimal thickening, while only COPD status was associated with pulmonary intimal thickening. A correlation between the %IA of the systemic and pulmonary arteries was observed (Spearman's rho = 0.46, p = 0.008.Greater intimal thickening in systemic and pulmonary arteries is observed in COPD patients than in smokers. There is a correlation between systemic and pulmonary vascular remodelling in the overall population.

  4. Functional vascular diseases: Raynaud's syndrome, acrocyanosis and erythromelalgia.

    Science.gov (United States)

    Heidrich, H

    2010-02-01

    Raynauds syndrome, acrocyanosis and erythromelalgia are functional vascular diseases that differ with respect to prevalence, clinical picture, therapy, prognosis, and impairment of quality of life. Raynauds syndrome occurs in 5 to 20 % of the population in Europe, is observed four times more often in women than in men and appears first at the age of 40 (3 to 80), on the average. Raynauds attacks are characterized by a paroxysmal white-blue-red or just white and blue discoloration of the fingers and toes; the attacks are induced by cold or stress, usually, cease after no more than some minutes (average 23 min.), but can also persist for hours. A distinction must be made between primary (aetiology unknown), secondary (aetiology known) and suspected secondary Raynauds syndromes (causal underlying disease suspected). There are several different therapy options, but not all of them have been substantiated by evidence. Acrocyanosis is rarer than Raynauds syndrome, and contrary to the latter, is characterized by nonparoxysmal, in most cases persistent, painless bluish-red symmetrical discolorations of the hands, feet and knees. It is more frequent in women than in men and becomes manifest before the 25th year of age, on the average (15th to 70th year of age). A distinction is made between primary acrocyanosis without detectable underlying disease and secondary acrocyanosis with a specific underlying disease. No effective therapy for primary acrocyanosis is known, but secondary forms can sometimes be treated. Patients with primary and secondary erythromelalgia, a very rare condition, sustain paroxysmal burning pain with marked reddening of the legs, feet and less often the hands. The attacks are triggered by warmth. Women are affected more often than men. The age of first manifestation is 40 to 55 years, but the first attacks may just as well occur during childhood. There are different therapeutic approaches with occasional success, but no general recommendations.

  5. [Present and future in the management of venous vascular diseases].

    Science.gov (United States)

    Gavorník, Peter; Dukát, Andrej; Gašpar, Ľudovít; Gavorníková, Eva

    2015-02-01

    The prevalence and the incidence of chronic and acute venous vascular disease has been shown to be globally very high, in both industrialized and developing countries. Chronic venous diseases of lower extremities are being an integral part of the third millennium's deadly angiopandemy, at the present time. The rate of the most severe cases with advanced stage of venous failure is approximately twice as high in the population (2.1 %) as has been assumed so far. Among venoactive drugs (VAD), micronized purified flavonoid fraction (MPFF) of diosmin hesperidin remains the agent with the highest degree of recommendation and it also indicated to pharmacotherapeutical support of leg ulcer healing, along with sulodexide and pentoxifylline. Compressive sclerotherapy, liquid or foam, is a safe and effective invasive method to treat telangiectasias, reticular varicose veins and subcutaneous varicose veins. Direct oral anticoagulants (DOAC) represent one of the therapeutic and preventive options of deep venous thrombosis (DVT) and of venous thromboembolism (VTE) with a limitation in patients with malignant conditions and in pregnancy. The most effective is triple simultaneous pharmaco-kinezio-mechano-phlebothromboemboloprophylaxis. Superficial vein thromboses longer than 5 cm are indicated to anticoagulant therapy too.

  6. Vascular function and mild renal impairment in stable coronary artery disease

    NARCIS (Netherlands)

    van der Harst, P; Smilde, TDJ; Buikema, H; Voors, AA; Navis, G; van Veldhuisen, DJ; van Gilst, WH

    2006-01-01

    Objective - In patients with coronary artery disease, the concomitant presence of renal function impairment is associated with decreased survival. We aimed to assess whether in coronary artery diseased patients renal function impairment is associated with systemic vascular function, functional param

  7. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  8. Familial hyperhomocysteinemia, age and peripheral vascular diseases - an Italian study

    Directory of Open Access Journals (Sweden)

    Sandro Michelini

    2013-01-01

    Full Text Available Hyperhomocysteinemia is a widely recognized, although not yet entirely understood, risk factor for cardiovascular disease. Particularly, the complex relationships between age, hyperhomocysteinemia, predisposing genetic factors and peripheral vascular diseases have not been fully evaluated. Our contribution to this issue is a retrospective analysis of a large series of patients with peripheral arterial, venous and lymphatic disease, and of their blood relatives, with special reference to homocysteine plasma levels, age and methylenetetrahydrofolate reductase (MTHFR polymorphisms. Serum homocysteine was measured in 477 patients (286 males, 191 females, age range 19-78 years with various vascular clinical conditions: postphlebitic syndrome (46 recurrent venous ulcers (78, arterial diseases (101 primary lymphoedema (87, secondary lymphoedema (161 and outlet thoracic syndrome (4, and in 50 normal controls. A MTHFR study for polymorphisms was carried on in the subjects with homocysteine values exceeding 15 mol/L. Serum homocysteine determination and MTHFR polymorphism studies were performed also in 1430 healthy blood related relatives (mainly siblings, descendents and sibling descendents of the subjects with hyperhomocysteinemia and MTHFR polymorphisms. We found MTHFR polymorphisms in 20% of controls and in 69.3%, 69.5% and 53.8% of hyperhomocysteinemic subjects with arterial diseases, postphlebitic syndrome and venous ulcers, respectively. As expected, the percentage of hyperhomocysteinemia in patients with secondary lymphoedema and with thoracic outlet syndrome did not show significant differences compared to the control group. A MTHFR polymorphism was found in 116 out of the 214 hyperhomocysteinemic patients, i.e., in the 54% of the overall patient population with hyperhomocysteinemia (214 patients. Interestingly 750 (52% out of the 1430 blood relatives of the 116 patients with hyperhomocysteinemia and MTHFR polymorphisms showed at least one

  9. Relationship between vascular endothelium and periodontal disease in atherosclerotic lesions: Review article

    Science.gov (United States)

    Saffi, Marco Aurélio Lumertz; Furtado, Mariana Vargas; Polanczyk, Carisi Anne; Montenegro, Márlon Munhoz; Ribeiro, Ingrid Webb Josephson; Kampits, Cassio; Haas, Alex Nogueira; Rösing, Cassiano Kuchenbecker; Rabelo-Silva, Eneida Rejane

    2015-01-01

    Inflammation and endothelial dysfunction are linked to the pathogenesis of atherosclerotic disease. Recent studies suggest that periodontal infection and the ensuing increase in the levels of inflammatory markers may be associated with myocardial infarction, peripheral vascular disease and cerebrovascular disease. The present article aimed at reviewing contemporary data on the pathophysiology of vascular endothelium and its association with periodontitis in the scenario of cardiovascular disease. PMID:25632316

  10. Relationship between vascular endothelium and periodontal disease in atherosclerotic lesions: Review article

    Institute of Scientific and Technical Information of China (English)

    Marco; Aurélio; Lumertz; Saffi; Mariana; Vargas; Furtado; Carisi; Anne; Polanczyk; Márlon; Munhoz; Montenegro; Ingrid; Webb; Josephson; Ribeiro; Cassio; Kampits; Alex; Nogueira; Haas; Cassiano; Kuchenbecker; R?sing; Eneida; Rejane; Rabelo-Silva

    2015-01-01

    Inflammation and endothelial dysfunction are linked to the pathogenesis of atherosclerotic disease. Recent studies suggest that periodontal infection and the ensuing increase in the levels of inflammatory markers may be associated with myocardial infarction, peripheral vascular disease and cerebrovascular disease. The present article aimed at reviewing contemporary data on the pathophysiology of vascular endothelium and its association with periodontitis in the scenario of cardiovascular disease.

  11. Edema and vascular permeability in cerebral ischemia: comparison between ischemic neuronal damage and infarction.

    Science.gov (United States)

    Petito, C K; Pulsinelli, W A; Jacobson, G; Plum, F

    1982-07-01

    The respective influences of ischemic neuronal damage and infarction on the development of abnormal blood-brain barrier (BBB) permeability and cerebral edema were evaluated in a rat model of temporary four-vessel occlusion in which ischemic neuronal damage with only infrequent infarction is produced. Survival times ranged from 40 minutes to 5 days after ischemia. Evans blue and horseradish peroxidase (HRP) were given before sacrifice. The majority of brain showed moderate ischemic neuronal damage inthe striatum. In these areas there was neither leakage of Evans blue nor extravasation of HRP. Astrocytic processes were moderately swollen. Large, grossly-visible unilateral infarcts were present in only 5 animals, and all showed abnormal BBB permeability of HRP which occurred via enchanced pinocytosis, and occasionally via diffuse leakage through necrotic vessels. Astrocytic processes were markedly swollen and their plasma membranes were disrupted. Whole brain and regional water content in a parallel series of animals were measured from 15 minutes (min) to 48 hours (h) postischemia. They showed a transient, 1% increase in whole brain water content from 15 to 60 min postischemia, but no increase in regional water content at any postischemic interval. These studies suggest that ischemia produces BBB permeability to large molecules, and sustained cerebral edema only when the process damages blood vessels and astrocytes; neuronal necrosis alone is insufficient.

  12. Can vessel dimension explain tolerance toward fungal vascular wilt diseases in woody plants? Lessons from Dutch elm disease and esca disease in grapevine.

    Directory of Open Access Journals (Sweden)

    Jerome ePouzoulet

    2014-06-01

    Full Text Available This review illuminates key findings in our understanding of grapevine xylem resistance to fungal vascular wilt diseases. Grapevine (Vitis spp. vascular diseases such as esca, botryosphaeria dieback, and eutypa dieback, are caused by a set of taxonomically unrelated ascomycete fungi. Fungal colonization of the vascular system leads to a decline of the plant host because of a loss of the xylem function and subsequent decrease in hydraulic conductivity. Fungal vascular pathogens use different colonization strategies to invade and kill their host. Vitis vinifera cultivars display different levels of tolerance towards vascular diseases caused by fungi, but the plant defense mechanisms underlying those observations have not been completely elucidated. In this review, we establish a parallel between two vascular diseases, grapevine esca disease and Dutch elm disease, and argue that the former should be viewed as a vascular wilt disease. Plant genotypes exhibit differences in xylem morphology and resistance to fungal pathogens causing vascular wilt diseases. We provide evidence that the susceptibility of three commercial V. vinifera cultivars to esca disease is correlated to large vessel diameter. Additionally, we explore how xylem morphological traits related to water transport are influenced by abiotic factors, and how these might impact host tolerance of vascular wilt fungi. Finally, we explore the utility of this concept for predicting which V. vinifera cultivars are most vulnerable of fungal vascular wilt diseases and propose new strategies for disease management.

  13. Cardiac catheterization in children with pulmonary hypertensive vascular disease.

    Science.gov (United States)

    Bobhate, Prashant; Guo, Long; Jain, Shreepal; Haugen, Richard; Coe, James Y; Cave, Dominic; Rutledge, Jennifer; Adatia, Ian

    2015-04-01

    The risks associated with cardiac catheterization in children with pulmonary hypertension (PH) are increased compared with adults. We reviewed retrospectively all clinical data in children with PH [mean pulmonary artery pressure (mean PAp) ≥25 mmHg and pulmonary vascular resistance index (PVRI) ≥3 Wood units m(2)] undergoing cardiac catheterization between 2009 and 2014. Our strategy included a team approach, minimal catheter manipulation and sildenafil administration prior to extubation. Adverse events occurring within 48 h were noted. Seventy-five patients (36 males), median age 4 years (0.3-17) and median weight 14.6 kg (2.6-77 kg), underwent 97 cardiac catheterizations. Diagnoses included idiopathic or heritable pulmonary arterial hypertension (PAH) (29 %), PAH associated with congenital heart disease (52 %), left heart disease (5 %) and lung disease (14 %). Mean PAp was 43 ± 19 mmHg; mean PVRI was 9.7 ± 6 Wood units m(2). There were no deaths or serious arrhythmias. No patient required cardiac massage. Three patients who suffered adverse events had suprasystemic PAp (3/3), heritable PAH (2/3), decreased right ventricular function (3/3), and pulmonary artery capacitance index <1 ml/mmHg/m(2) (3/3) and were treatment naïve (3/3). No patient undergoing follow-up cardiac catheterization suffered a complication. In 45 % of cases, the data acquired from the follow-up cardiac catheterization resulted in an alteration of therapy. Three percent of children with PH undergoing cardiac catheterization suffered adverse events. However, there were no intra or post procedural deaths and no one required cardiac massage or cardioversion. Follow-up cardiac catheterization in patients receiving pulmonary hypertensive targeted therapy is safe and provides useful information.

  14. Can vessel dimension explain tolerance toward fungal vascular wilt diseases in woody plants? Lessons from Dutch elm disease and esca disease in grapevine

    OpenAIRE

    Jerome ePouzoulet; Alexandria ePivovaroff; Louis eSantiago; Philippe Eric Rolshausen

    2014-01-01

    This review illuminates key findings in our understanding of grapevine xylem resistance to fungal vascular wilt diseases. Grapevine (Vitis spp.) vascular diseases such as esca, botryosphaeria dieback, and eutypa dieback, are caused by a set of taxonomically unrelated ascomycete fungi. Fungal colonization of the vascular system leads to a decline of the plant host because of a loss of the xylem function and subsequent decrease in hydraulic conductivity. Fungal vascular pathogens use different ...

  15. Estudo de fatores clínicos preditivos para crises epilépticas após acidente vascular cerebral isquêmico Preditive clinical factors for epileptic seizures after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Marcia Maiumi Fukujima

    1996-06-01

    Full Text Available Apresentamos aspectos clínicos de 35 pacientes com acidente vascular cerebral isquêmico que evoluíram com crises epilépticas (Grupo 1, comparando-os a 35 pacientes com AVCI sem crises epilépticas (Grupo 2. A comparação das idades entre os grupos não mostrou diferença significante. O sexo masculino e a raça branca predominaram em ambos os grupos. Diabetes melito, hipertensão arterial, ataque isquêmico transitório, acidente vascular cerebral pregresso, enxaqueca, doença de Chagas, embolia cerebral cardiogênica e uso de anticoncepcional oral não diferiram significantemente entre os grupos. Tabagismo e etilismo foram significantemente mais freqüentes no Grupo 1 (pPreditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1 were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2. The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p<0,05. Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.

  16. A study of radiation-induced cerebral vascular injury in nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis.

    Directory of Open Access Journals (Sweden)

    Jianhong Ye

    Full Text Available PURPOSE: To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC patients. METHODS AND MATERIALS: Fifty eight NPC patients with radiation-induced temporal lobe necrosis (TLN were recruited in the study. Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT and occurrence of plaque formation. Flow velocities of bilateral middle cerebral arteries (MCAs, internal carotid arteries (ICAs and basal artery (BA were estimated through Transcranial Color Doppler (TCD. The results were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals. RESULTS: Significant differences in IMT, occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after radiotherapy and healthy individuals (p<0.05. IMT had positive correlation with post radiation interval (p = 0.049. Compared with results from patients without radiation-induced TLN, the mean IMT was significantly thicker in patients with TLN (p<0.001. Plaques were more common in patients with TLN than patients without TLN (p = 0.038. In addition, flow velocities of MCAs and ICAs in patients with TLN were much faster (p<0.001, p<0.001. Among patients with unilateral TLN, flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (p = 0.001. CONCLUSION: Thickening of IMT, occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy, especially in those with TLN, compared with healthy individuals.

  17. Both acute and prolonged administration of EPO reduce cerebral and systemic vascular conductance in humans

    DEFF Research Database (Denmark)

    Rasmussen, Peter; Kim, Yu-Sok; Krogh-Madsen, Rikke;

    2012-01-01

    Administration of erythropoietin (EPO) has been linked to cerebrovascular events. EPO reduces vascular conductance, possibly because of the increase in hematocrit. Whether EPO in itself affects the vasculature remains unknown; here it was evaluated in healthy males by determining systemic...... and cerebrovascular variables following acute (30,000 IU/d for 3 d; n=8) and chronic (5000 IU/week for 13 wk; n=8) administration of EPO, while the responsiveness of the vasculature was challenged during cycling exercise, with and without hypoxia. Prolonged administration of EPO increased hematocrit from 42.5 ± 3...

  18. Paradoxical embolization: a potential cause of cerebral damage in Alzheimer's disease?

    NARCIS (Netherlands)

    Purandare, N.; Oude Voshaar, R.C.; Burns, A.; Velupandian, U.M.; McCollum, C.N.

    2006-01-01

    BACKGROUND: There are considerable overlaps between vascular dementia and Alzheimer's disease (AD), with a suggestion that cerebrovascular disease (CVD) contributes to the neurodegenerative pathology of AD. Paradoxical embolization of venous emboli into the systemic circulation through a venous to a

  19. The association between vibration and vascular injury in rheumatic diseases: a review of the literature.

    Science.gov (United States)

    Wang, Yu-Jie; Huang, Xiao-Lei; Yan, Jun-Wei; Wan, Ya-Nan; Wang, Bing-Xiang; Tao, Jin-Hui; Chen, Bing; Li, Bao-Zhu; Yang, Guo-Jun; Wang, Jing

    2015-02-01

    Vascular manifestations can be seen early in the pathogenesis of inflammatory rheumatic diseases. Animal experiments, laboratory and clinical findings indicated that acute or long-term vibration exposure can induce vascular abnormalities. Recent years, in addition to Raynaud's phenomenon (RP), vibration as a risk factor for other rheumatic diseases has also received corresponding considered. This review is concentrated upon the role of vibration in the disease of systemic sclerosis (SSc). In this review, we are going to discuss the main mechanisms which are thought to be important in pathophysiology of vascular injury under the three broad headings of "vascular", "neural" and "intravascular". Aspects on the vibration and vascular inflammation are briefly discussed. And the epidemiological studies related to vibration studies in SSc and other rheumatic diseases are taken into account.

  20. Vascular collateralization along ventriculoperitoneal shunt catheters in moyamoya disease.

    Science.gov (United States)

    Singla, Amit; Lin, Ning; Ho, Allen L; Scott, R Michael; Smith, Edward R

    2013-06-01

    Surgically created openings such as bur holes can serve as avenues for the development of collateral blood supply to the brain in patients with moyamoya disease. When such collateralization occurs through preexisting shunt catheter sites, the potential exists for perioperative stroke if these vessels are damaged during revision of a ventricular catheter for shunt malfunction. In this paper the authors report on a series of patients with a history of ventriculoperitoneal (VP) shunts who later developed moyamoya disease and were found to have spontaneous transdural collateral vessels at ventricular catheter sites readily visualized on diagnostic angiography. A consecutive surgical series of 412 patients with moyamoya disease treated at Boston Children's Hospital from 1990 to 2010 were reviewed to identify patients with concomitant moyamoya and a VP shunt. The clinical records and angiograms of these patients were reviewed to determine the extent of bur hole collaterals through the shunt site. Three patients were identified who had VP shunts placed for hydrocephalus and subsequently developed moyamoya disease. All 3 patients demonstrated spontaneous transdural collaterals at the ventricular catheter bur hole, as confirmed by angiography during the workup for moyamoya disease. No patients required subsequent revision of their ventricular catheters following the diagnosis of moyamoya. All patients have remained stroke free and clinically stable following pial synangiosis. Although the association of moyamoya and shunted hydrocephalus is rare, it may present a significant potential problem for the neurosurgeon treating a shunt malfunction in this patient population, because shunt bur holes may become entry sites for the ingrowth of significant cortical transdural collateral blood supply to the underlying brain. Shunt revision might therefore be associated with an increased risk of postoperative stroke or operative-site hemorrhage in this population if this

  1. Cerebral blood flow in small vessel disease: A systematic review and meta-analysis.

    Science.gov (United States)

    Shi, Yulu; Thrippleton, Michael J; Makin, Stephen D; Marshall, Ian; Geerlings, Mirjam I; de Craen, Anton Jm; van Buchem, Mark A; Wardlaw, Joanna M

    2016-10-01

    White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that assessed cerebral blood flow in small vessel disease patients, performed meta-analysis and sensitivity analysis of potential confounders. Thirty-eight studies (n = 4006) met the inclusion criteria, including four longitudinal and 34 cross-sectional studies. Most cerebral blood flow data were from grey matter. Twenty-four cross-sectional studies (n = 1161) were meta-analysed, showing that cerebral blood flow was lower in subjects with more white matter hyperintensity, globally and in most grey and white matter regions (e.g. mean global cerebral blood flow: standardised mean difference-0.71, 95% CI -1.12, -0.30). These cerebral blood flow differences were attenuated by excluding studies in dementia or that lacked age-matching. Four longitudinal studies (n = 1079) gave differing results, e.g., more baseline white matter hyperintensity predated falling cerebral blood flow (3.9 years, n = 575); cerebral blood flow was low in regions that developed white matter hyperintensity (1.5 years, n = 40). Cerebral blood flow is lower in subjects with more white matter hyperintensity cross-sectionally, but evidence for falling cerebral blood flow predating increasing white matter hyperintensity is conflicting. Future studies should be longitudinal, obtain more white matter data, use better age-correction and stratify by clinical diagnosis.

  2. Vascular disease and risk factors are associated with cognitive decline in the alzheimer disease spectrum.

    Science.gov (United States)

    Lorius, Natacha; Locascio, Joseph J; Rentz, Dorene M; Johnson, Keith A; Sperling, Reisa A; Viswanathan, Anand; Marshall, Gad A

    2015-01-01

    We investigated the relationship between vascular disease and risk factors versus cognitive decline cross-sectionally and longitudinally in normal older control, mild cognitive impairment, and mild Alzheimer disease (AD) dementia subjects. A total of 812 participants (229 normal older control, 395 mild cognitive impairment, 188 AD) underwent cognitive testing, brain magnetic resonance imaging, and clinical evaluations at baseline and over a period of 3 years. General linear, longitudinal mixed-effects, and Cox proportional hazards models were used. Greater homocysteine level and white matter hyperintensity volume were associated with processing speed impairment (homocysteine: P=0.02; white matter hyperintensity: Pdisease and risk factors with cognitive impairment at baseline and over time in the AD spectrum in a sample that was selected to have low vascular burden at baseline.

  3. Características morfológicas da distribuição vascular cerebral de Sus scrofa Linnaeus (Mammalia, Artiodactyla Morphological characteristics of the cerebral vascular distribution of Sus scrofa Linnaeus (Mammalia, Artiodactyla

    Directory of Open Access Journals (Sweden)

    Jurandyr de A. Câmara Filho

    2004-12-01

    Full Text Available O objetivo do presente estudo foi verificar a vascularização arterial do encéfalo do javali, Sus scrofa Linnaeus, 1758, Suidae, e comparar com outras espécies. Cinco machos e cinco fêmeas foram injetados com látex colorido. O suprimento arterial do encéfalo foi descrito e análises morfológicas foram feitas. Nesta espécie o circuito arterial do encéfalo é formado por ramos da artéria carótida interna, como: as artérias comunicantes caudais, o ramo rostral, as artérias cerebrais rostrais, e artérias comunicantes rostrais.The aim this study was to verify the arterial vascularization of the wild boar brain, Sus scrofa Linnaeus, 1758, Suidae, and compare with other species. Five male and five female were injected with colored latex. The arterial supply of the brain was described and were done morphological analyses. In this species the arterial circuit of the brain is formed by the internal carotid artery branches, such as: the caudal communicant arteries, rostral branch, rostral cerebral arteries and rostral communicant arteries.

  4. Antithrombotic Treatment in Patients With Heart Failure and Associated Atrial Fibrillation and Vascular Disease :

    DEFF Research Database (Denmark)

    Lamberts, Morten; Lip, Gregory Y H; Ruwald, Martin H;

    2014-01-01

    OBJECTIVES: The aim of this study was to investigate the impact of atrial fibrillation (AF) and antithrombotic treatment on the prognosis in patients with heart failure (HF) as well as vascular disease. BACKGROUND: HF, vascular disease, and AF are pathophysiologically related, and understanding...... antithrombotic treatment for these conditions is crucial. METHODS: In hospitalized patients with HF and coexisting vascular disease (coronary artery disease or peripheral arterial disease) followed from 1997 to 2009, AF status was categorized as prevalent AF, incident AF, or no AF. Risk of thromboembolism (TE...... differences were seen between antithrombotic therapies in TE or MI risk, whereas bleeding risk was significantly increased for VKA with and without single-antiplatelet therapy. CONCLUSIONS: In AF patients with coexisting HF and vascular disease, adding single-antiplatelet therapy to VKA therapy...

  5. Pulmonary manifestations in collagen vascular diseases; Pulmonale Manifestationen bei Kollagenosen

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, M.N.A. [Thoraxklinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Kreuter, M. [Thoraxklinik, Universitaetsklinikum Heidelberg, Zentrum fuer interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Kauczor, H.U. [Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Heussel, C.P. [Thoraxklinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany); Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany)

    2016-10-15

    Pulmonary complications are frequent in patients with collagen vascular diseases (CVD). Frequent causes are a direct manifestation of the underlying disease, side effects of specific medications and lung infections. The standard radiological procedure for the work-up of pulmonary pathologies in patients with CVD is multidetector computed tomography (MDCT) with thin-slice high-resolution reconstruction. The accuracy of thin-slice CT for the identification of particular disease patterns is very high. The pattern of usual interstitial pneumonia (UIP) representing the direct pulmonary manifestation of rheumatoid arthritis (RA) can be identified with a sensitivity of 45 % and a specificity of 96 %. Both direct pulmonary manifestations, drug-induced toxicity and certain infections can have a similar appearance in thin-slice MDCT in various forms of CVD. Knowledge of the patterns and causes contributes to the diagnostic certainty. At first diagnosis of a CVD and associated pulmonary symptoms thin-slice MDCT is recommended. Clinical, lung function and imaging follow-up examinations should be performed every 6-12 months depending on the results of the MDCT. In every case the individual CT morphological patterns of pulmonary involvement must be identified. The combination of information on the anamnesis, clinical and imaging results is a prerequisite for an appropriate disease management. (orig.) [German] Pulmonale Komplikationen sind bei Patienten mit Kollagenosen keine Seltenheit. Haeufig sind eine direkte Manifestation der Grunderkrankung, eine Nebenwirkung der medikamentoesen Therapie oder eine Lungeninfektion die Ursachen. Das radiologische Standardverfahren zur Klaerung pulmonaler Pathologien bei Patienten mit Kollagenosen ist die Multidetektorcomputertomographie mit duennschichtigen Rekonstruktionen (Duennschicht-MDCT). Die Treffsicherheit der Duennschicht-MDCT ist fuer die Identifikation eines Erkrankungsmusters sehr hoch. So kann beispielsweise das Muster einer

  6. Intravenous iloprost in the combination therapy of vascular disorders in patients with systemic connective tissue diseases

    Directory of Open Access Journals (Sweden)

    Aleksandr Vitalyevich Volkov

    2013-01-01

    Full Text Available Systemic connective tissue diseases, systemic scleroderma in particular, constitute a group of diseases in which vascular disorders underlying diverse clinical manifestations are one of the pathogenetic components. Raynaud 's syndrome and ulceration are the most common symptoms of these diseases, which influence quality of life in patients and require constant drug therapy. The paper discusses the authors' clinical experience with intravenous iloprost used in the combination therapy of the vascular manifestations of systemic scleroderma and systemic lupus erythematosus.

  7. Delayed cerebral ischemia associated with reversible cerebral vasoconstriction in a patient with Moyamoya disease with intraventricular hemorrhage: Case report.

    Science.gov (United States)

    Matsuoka, Go; Kubota, Yuichi; Okada, Yoshikazu

    2015-06-01

    We describe a case of cerebral infarctions caused by transient vasoconstrictions in the posterior circulation 2 weeks after intraventricular hemorrhage without subarachnoid hemorrhage in a 35-year-old patient with Moyamoya disease. To our knowledge, this is the first case report where diffuse segmental vasoconstrictions of the basilar and posterior cerebral arteries were recognized after intraventricular hemorrhage in Moyamoya disease. The patient complained of severe and acute-onset headache 14 days after the intraventricular hemorrhage, which had a different character and severity from the one she complained of at the onset of intraventricular hemorrhage. Finally, headache disappeared within 1 month and vasoconstriction resolved in 2 months. Reversible cerebral vasoconstriction syndrome was under consideration for the etiology of her condition because of the "thunderclap" characteristics of the headache and the delayed timing of occurrence of the vasoconstriction. This case report informs and alerts neurologists, neurosurgeons and neuroradiologists who observe and treat patients with Moyamoya disease that vasoconstriction in the posterior circulation may occur after intraventricular hemorrhage in these patients.

  8. Alois Alzheimer and vascular brain disease: Arteriosclerotic atrophy of the brain

    Directory of Open Access Journals (Sweden)

    Eliasz Engelhardt

    Full Text Available Alois Alzheimer is best known for his description of neurofibrillary changes in brain neurons of a demented patient, identifying a novel disease, soon named after him by Kraepelin. However, the range of his studies was broad, including vascular brain diseases, published between 1894 and 1902. Alzheimer described the clinical picture of Arteriosclerotic atrophy of the brain, differentiating it from other similar disorders. He stated that autopsy allowed pathological distinction between arteriosclerosis and syphilis, thereby achieving some of his objectives of segregating disorders and separating them from syphilis. His studies contributed greatly to establishing the key information on vascular brain diseases, predating the present state of knowledge on the issue, while providing early descriptions of what would be later regarded as the dimensional presentation of the now called "Vascular cognitive impairment", constituted by a spectrum that includes a stage of "Vascular cognitive impairment not dementia" and another of "Vascular dementia".

  9. A study on measurement of the regional cerebral blood flow using autoradiographic method in moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Tomohiro; Kiya, Katsuzo; Yuki, Kiyoshi; Kawamoto, Hitoshi; Mizoue, Tatsuya; Kiura, Yoshihiro; Uozumi, Tohru [Hiroshima Prefectural Hospital (Japan); Ikawa, Fusao

    1997-11-01

    Development of Autoradiographic method (ARG) has provided measurement of cerebral blood flow in moyamoya disease. We evaluate a cerebral vasodilatory capacity (CVC) for moyamoya disease using ARG method. We used 5 patients with moyamoya disease as a candidate for measurement of the cerebral blood flow (CBF) who admitted to Hiroshima Prefectural Hospital during the past one year. There were 3 patients in an adult age and 2 patients in a young age. We tried to measure the regional CBF (rCBF) using ARG method which was a easy way to estimate the rCBF on SPECT. The CVC was calculated from the difference of the rCBF between resting SPECT and Diamox-loading SPECT. Results were as follows; Reactivity of cerebral vessels to CO{sub 2} loading and CVC weakened in moyamoya disease. The rCBF and CVC in the territories of anterior and middle cerebral arteries reduced in comparison with those in the area supplied by the posterior cerebral artery. The CVC at the treated side with surgical reconstruction recovered somewhat in an adult type. From these results, measurement of CBF using ARG method seems to be useful for evaluation of the CVC in moyamoya disease. (author)

  10. Paradoxical embolisation and cerebral white matter lesions in dementia.

    NARCIS (Netherlands)

    Purandare, N.; Oude Voshaar, R.C.; McCollum, C.; Jackson, A.; Burns, A.

    2008-01-01

    The study aimed to examine the relationship between spontaneous cerebral emboli (SCE), patent foramen ovale (PFO) and white matter hyperintensities (WMH) on cerebral MRI in patients with Alzheimer's disease (AD) and vascular dementia (VaD). SCE were identified by transcranial Doppler of the middle c

  11. Selective disruption of the cerebral neocortex in Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Rahul S Desikan

    Full Text Available BACKGROUND: Alzheimer's disease (AD and its transitional state mild cognitive impairment (MCI are characterized by amyloid plaque and tau neurofibrillary tangle (NFT deposition within the cerebral neocortex and neuronal loss within the hippocampal formation. However, the precise relationship between pathologic changes in neocortical regions and hippocampal atrophy is largely unknown. METHODOLOGY/PRINCIPAL FINDINGS: In this study, combining structural MRI scans and automated image analysis tools with reduced cerebrospinal fluid (CSF Aβ levels, a surrogate for intra-cranial amyloid plaques and elevated CSF phosphorylated tau (p-tau levels, a surrogate for neocortical NFTs, we examined the relationship between the presence of Alzheimer's pathology, gray matter thickness of select neocortical regions, and hippocampal volume in cognitively normal older participants and individuals with MCI and AD (n = 724. Amongst all 3 groups, only select heteromodal cortical regions significantly correlated with hippocampal volume. Amongst MCI and AD individuals, gray matter thickness of the entorhinal cortex and inferior temporal gyrus significantly predicted longitudinal hippocampal volume loss in both amyloid positive and p-tau positive individuals. Amongst cognitively normal older adults, thinning only within the medial portion of the orbital frontal cortex significantly differentiated amyloid positive from amyloid negative individuals whereas thinning only within the entorhinal cortex significantly discriminated p-tau positive from p-tau negative individuals. CONCLUSIONS/SIGNIFICANCE: Cortical Aβ and tau pathology affects gray matter thinning within select neocortical regions and potentially contributes to downstream hippocampal degeneration. Neocortical Alzheimer's pathology is evident even amongst older asymptomatic individuals suggesting the existence of a preclinical phase of dementia.

  12. Complementary acupuncture treatment increases cerebral metabolism in patients with Parkinson's disease.

    Science.gov (United States)

    Huang, Yong; Jiang, Xuemei; Zhuo, Ying; Tang, Anwu; Wik, Gustav

    2009-01-01

    We used positron emission tomography (PET) and the 18-flourodeoxyglucose tracer to study cerebral effects of complementary acupuncture in Parkinson's disease. Five patients received scalp-acupuncture and Madopa, while the other five had Madopa only. PET scans before and after 5 weeks of complementary acupuncture treatment show increased glucose metabolisms in parietal, temporal, occipital lobes, the thalamus, and the cerebellum in the light-diseased hemisphere, and in parietal and occipital lobes of the severe-diseased hemisphere. No changes were observed in the Madopa-only group. Acupuncture in combination with Madopa may improve cerebral glucose metabolism in Parkinson's disease.

  13. Reactive oxygen species and angiotensin II signaling in vascular cells: implications in cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Touyz R.M.

    2004-01-01

    Full Text Available Diseases such as hypertension, atherosclerosis, hyperlipidemia, and diabetes are associated with vascular functional and structural changes including endothelial dysfunction, altered contractility and vascular remodeling. Cellular events underlying these processes involve changes in vascular smooth muscle cell (VSMC growth, apoptosis/anoikis, cell migration, inflammation, and fibrosis. Many factors influence cellular changes, of which angiotensin II (Ang II appears to be amongst the most important. The physiological and pathophysiological actions of Ang II are mediated primarily via the Ang II type 1 receptor. Growing evidence indicates that Ang II induces its pleiotropic vascular effects through NADPH-driven generation of reactive oxygen species (ROS. ROS function as important intracellular and intercellular second messengers to modulate many downstream signaling molecules, such as protein tyrosine phosphatases, protein tyrosine kinases, transcription factors, mitogen-activated protein kinases, and ion channels. Induction of these signaling cascades leads to VSMC growth and migration, regulation of endothelial function, expression of pro-inflammatory mediators, and modification of extracellular matrix. In addition, ROS increase intracellular free Ca2+ concentration ([Ca2+]i, a major determinant of vascular reactivity. ROS influence signaling molecules by altering the intracellular redox state and by oxidative modification of proteins. In physiological conditions, these events play an important role in maintaining vascular function and integrity. Under pathological conditions ROS contribute to vascular dysfunction and remodeling through oxidative damage. The present review focuses on the biology of ROS in Ang II signaling in vascular cells and discusses how oxidative stress contributes to vascular damage in cardiovascular disease.

  14. Neuropsychiatric symptoms in patients with Alzheimer’s disease with a vascular component

    Directory of Open Access Journals (Sweden)

    Mariola Bidzan

    2014-06-01

    Full Text Available objective. Vascular changes are observed in most cases of Alzheimer’s disease (AD. Observations of AD and vascular disease (VD allow us to surmise that vascular changes may not only affect cognitive impairment in AD but may also have a negative influence on the neuropsychiatric symptoms which often occur in the course of the disease. The aim of the study was to evaluate the impact of vascular factors on the neuropsychiatric symptoms in Alzheimer’s Disease. material and methods. The study included 48 people with a preliminary diagnosis of Alzheimer’s Disease on the basis of NINCDS/ADRDA criteria. The evaluation of impairments in cognitive functioning was carried out by means of the Alzheimer Disease Assessment Scale – the cognitive part (ADAS – cog, whereas the behavioural and psychological symptoms were evaluated by means of the Neuropsychiatric Inventory – the version adapted for residents of nursing homes for the elderly (Neuropsychiatric Inventory – Nursing Home Version (NPI – NH. The score on the Hachinski scale was the basis for dividing the study participants into two groups – those with a mild vascular component (0–1 points on the Hachinski scale and those with a severe vascular component (2–4 points. results. The analyzed groups did not differ with respect to the intensity of cognitive impairments (ADAS-cog or age of the participants. Scores obtained on the NPI – NH scale as well as some of its elements (depression/dysphoria and anxiety had a discriminating value. Studies show that vascular factors are a serious risk factor for neuropsychiatric symptoms in AD. conclusions. Vascular factors in Alzheimer’s Disease influence the presence of neuropsychiatric symptoms. In the course of angiogenic dementia a greater frequency in depressive disorders was shown. The most visible differences between individuals with a greater and lesser burden of vascular factors was in the realm of depressive and dysphoric disorders.

  15. Modeling the Role of the Glymphatic Pathway and Cerebral Blood Vessel Properties in Alzheimer’s Disease Pathogenesis

    Science.gov (United States)

    Kyrtsos, Christina Rose; Baras, John S.

    2015-01-01

    Alzheimer’s disease (AD) is the most common cause of dementia in the elderly, affecting over 10% population over the age of 65 years. Clinically, AD is described by the symptom set of short term memory loss and cognitive decline, changes in mentation and behavior, and eventually long-term memory deficit as the disease progresses. On imaging studies, significant atrophy with subsequent increase in ventricular volume have been observed. Pathology on post-mortem brain specimens demonstrates the classic findings of increased beta amyloid (Aβ) deposition and the presence of neurofibrillary tangles (NFTs) within affected neurons. Neuroinflammation, dysregulation of blood-brain barrier transport and clearance, deposition of Aβ in cerebral blood vessels, vascular risk factors such as atherosclerosis and diabetes, and the presence of the apolipoprotein E4 allele have all been identified as playing possible roles in AD pathogenesis. Recent research has demonstrated the importance of the glymphatic system in the clearance of Aβ from the brain via the perivascular space surrounding cerebral blood vessels. Given the variety of hypotheses that have been proposed for AD pathogenesis, an interconnected, multilayer model offers a unique opportunity to combine these ideas into a single unifying model. Results of this model demonstrate the importance of vessel stiffness and heart rate in maintaining adequate clearance of Aβ from the brain. PMID:26448331

  16. Brief Screening of Vascular Cognitive Impairment in Patients With Cerebral Autosomal-Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy Without Dementia

    OpenAIRE

    2016-01-01

    Background and Purpose - Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic form of cerebral small vessel disease leading to early-onset stroke and dementia, with younger patients frequently showing subclinical deficits in cognition. At present, there are no targeted cognitive screening measures for this population. However, the Brief Memory and Executive Test (BMET) and the Montreal Cognitive Assessment (MoCA) have shown utilit...

  17. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...

  18. In vivo vascular wall shear rate and circumferential strain of renal disease patients.

    Science.gov (United States)

    Park, Dae Woo; Kruger, Grant H; Rubin, Jonathan M; Hamilton, James; Gottschalk, Paul; Dodde, Robert E; Shih, Albert J; Weitzel, William F

    2013-02-01

    This study measures the vascular wall shear rate at the vessel edge using decorrelation based ultrasound speckle tracking. Results for nine healthy and eight renal disease subjects are presented. Additionally, the vascular wall shear rate and circumferential strain during physiologic pressure, pressure equalization and hyperemia are compared for five healthy and three renal disease subjects. The mean and maximum wall shear rates were measured during the cardiac cycle at the top and bottom wall edges. The healthy subjects had significantly higher mean and maximum vascular wall shear rate than the renal disease subjects. The key findings of this research were that the mean vascular wall shear rates and circumferential strain changes between physiologic pressure and hyperemia that was significantly different between healthy and renal disease subjects.

  19. Loss-of-function mutations in APOC3 and risk of ischemic vascular disease

    DEFF Research Database (Denmark)

    Jørgensen, Anders Berg; Frikke-Schmidt, Ruth; Nordestgaard, Børge G;

    2014-01-01

    BACKGROUND: High plasma levels of nonfasting triglycerides are associated with an increased risk of ischemic cardiovascular disease. Whether lifelong low levels of nonfasting triglycerides owing to mutations in the gene encoding apolipoprotein C3 (APOC3) are associated with a reduced risk...... of ischemic cardiovascular disease in the general population is unknown. METHODS: Using data from 75,725 participants in two general-population studies, we first tested whether low levels of nonfasting triglycerides were associated with reduced risks of ischemic vascular disease and ischemic heart disease....... Second, we tested whether loss-of-function mutations in APOC3, which were associated with reduced levels of nonfasting triglycerides, were also associated with reduced risks of ischemic vascular disease and ischemic heart disease. During follow-up, ischemic vascular disease developed in 10...

  20. More on Renal Salt Wasting Without Cerebral Disease: Response to Saline Infusion

    OpenAIRE

    Bitew, Solomon; Imbriano, Louis; Miyawaki, Nobuyuki; Fishbane, Steven; Maesaka, John K.

    2009-01-01

    Background and objectives: The existence and prevalence of cerebral salt wasting (CSW) or the preferred term, renal salt wasting (RSW), and its differentiation from syndrome of inappropriate antidiuretic hormone (SIADH) have been controversial. This controversy stems from overlapping clinical and laboratory findings and an inability to assess the volume status of these patients. The authors report another case of RSW without clinical cerebral disease and contrast it to SIADH.

  1. Clinical significance of posterior cerebral artery stenosis/occlusion in moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Satoshi; Ishikawa, Tatsuya; Iwasaki, Yoshinobu [Hokkaido Univ., Sapporo (Japan). Graduate School of Medicine; Houkin, Kiyohiro [Sapporo Medical Univ. (Japan)

    2002-12-01

    The present study was aimed at clarifying the clinical significance of posterior cerebral artery (PCA) stenosis/occlusion in pediatric and adult moyamoya disease. This study included a total of 132 patients (52 children and 80 adults) who were diagnosed as by cerebral angiography having moyamoya disease. CT or MRI was performed to examine the location of cerebral infarction in all subjects. Cerebral blood flow and vasoreactivity to acetazolamide were measured in 80 patients before surgery, using single photon emission computed tomography (SPECT). Three-dimensional MR angiography (3D-MRA) was repeated in 32 pediatric patients after surgery in order to clarify the natural course of the PCA stenosis/occlusion. Of 264 sides in 132 patients, PCA stenosis/occlusion was observed in 50 sides of 40 patients (30.3%). Its incidence was significantly higher in ischemic-type patients than in hemorrhagic-type and asymptomatic patients, and was higher in patients in the advanced stage of the disease. The hemisphere ipsilateral to PCA stenosis/occlusion had higher incidence of ischemic symptoms, cerebral infarction, and impaired cerebral hemodynamics. Transient ischemic attack (TIA) (hemianopsia) or cerebral infarction in the occipital lobe was noted in 4 (10%) of 40 patients during follow-up periods after bypass surgery for anterior circulation. Of 32 pediatric patients, none showed progression of PCA stenosis on 3D-MRA during follow-up periods. The present study showed that the involvement of PCA could increase the risk of TIA and/or cerebral infarction in both anterior and posterior circulation areas, suggesting that the PCA plays an important collateral role in moyamoya disease. (author)

  2. Investigation of Hydrogen Sulfide Gas as a Treatment against P. falciparum, Murine Cerebral Malaria, and the Importance of Thiolation State in the Development of Cerebral Malaria

    DEFF Research Database (Denmark)

    Dellavalle, Brian; Staalsoe, Trine; Kurtzhals, Jørgen Anders;

    2013-01-01

    Cerebral malaria (CM) is a potentially fatal cerebrovascular disease of complex pathogenesis caused by Plasmodium falciparum. Hydrogen sulfide (HS) is a physiological gas, similar to nitric oxide and carbon monoxide, involved in cellular metabolism, vascular tension, inflammation, and cell death...

  3. Usefulness of continuous suture using short-thread double-armed micro-suture for cerebral vascular anastomosis

    Directory of Open Access Journals (Sweden)

    Sei Haga

    2014-01-01

    Full Text Available Background: When microvascular anastomosis is performed in a deep, narrow operating field, securing space to throw knots is difficult. To simplify the procedure and avoid obstruction of the anastomosis, we use a continuous suturing with short-thread double-armed micro-suture. Methods: Sixty-four patients (38 cerebral revasculazation, 16 moyamoya disease, and 10 aneurysm surgery undergoing microvaucular anastomosis were included. During anastomosis, a continuous suture was placed with short-thread double-armed micro-suture. Results: During 64 microanastomosis procedures, 64 consecutive continuous sutures were performed with 1-year follow up. All patients showed patency of anastomosis with long-term follow up. Conclusions: This technique is especially useful for anastomosis in a deep, narrow surgical field, such as in superior cerebellar artery anastomosis.

  4. Control of Vascular Streak Dieback Disease of Cocoa with Flutriafol Fungicides

    Directory of Open Access Journals (Sweden)

    Febrilia Nur'aini

    2014-12-01

    Full Text Available Vascular streak dieback caused by the fungus Oncobasidium theobromae is one of the important diseases in cocoa crop in Indonesia. One approach to control the disease is by using fungicides. The aim of this research was to determine the effect of class triazole fungicides to the intensity of the vascular streak dieback disease on cocoa seedling phase, immature and mature cocoa. Experiments were conducted in Kotta Blater, PTPN XII and Kaliwining, Indonesian  Coffee and Cocoa Research Institute. Flutriafol 250 g/l with a concentration 0,05%, 0,1% and 0,15% foliar sprayed on cocoa seedlings, immature and mature cocoa. Active compound combination of Azoxystrobin and Difenoconazole with 0,1% concentration used as a comparation fungicides. The result showed that Flutriafol with 0,05%, 0,1% and 0,15% concentration and Azoxystrobin & Difenoconazol with 0,1% concentration could suppress the vascular streak dieback disease on seedlings. On immature plants, the application of Flutriafol was not effectively suppress the vascular streak dieback disease whereas the fungicide comparison could suppress with the efficacy level of 46.22%. On mature plants,both of fungicides could not suppress the vascular streak dieback disease. Key words: Fungicide, cocoa, vascular streak dieback, triazole, flutriafol, azoxystrobin+difenoconazol

  5. [Lin Xue-Jian's experience on treatment of a part of cerebral diseases with scalp acupuncture].

    Science.gov (United States)

    Wang, Hai-Li; Wu, Jiu-Wei

    2005-10-01

    LIN Xue-Jian adopts Chinese traditional acupuncture and moxibustion manipulation methods to stimulate the special area of scalp to treat a part of brain-derived diseases, such as infantile cerebral palsy, nerve deafness, cerebellar ataxia, lacunar cerebral infarction, senile dementia, Parkinson's disease, anxiety, insomnia and central constipation, and so on. Scalp acupuncture can improve ability of blood and oxygen supply for general blood vessels; stimulation of corresponding acupoint area according to symptoms and signs can control condition of disease; and can repair, activate and regenerate the injured, dormancy and aging neurons, so as to dredge nerve network in the brain, hence better therapeutic effect.

  6. The contribution of CXCL12-expressing radial glia cells to neuro-vascular patterning during human cerebral cortex development

    Directory of Open Access Journals (Sweden)

    Mariella eErrede

    2014-10-01

    Full Text Available This study was conducted on human developing brain by laser confocal and transmission electron microscopy to make a detailed analysis of important features of blood-brain barrier microvessels and possible control mechanisms of vessel growth and differentiation during cerebral cortex vascularization. The blood-brain barrier status of cortex microvessels was examined at a defined stage of cortex development, at the end of neuroblast waves of migration and before cortex lamination, with blood-brain barrier-endothelial cell markers, namely tight junction proteins (occludin and claudin-5 and influx and efflux transporters (Glut-1 and P-glycoprotein, the latter supporting evidence for functional effectiveness of the fetal blood-brain barrier. According to the well-known roles of astroglia cells on microvessel growth and differentiation, the early composition of astroglia/endothelial cell relationships was analysed by detecting the appropriate astroglia, endothelial, and pericyte markers. GFAP, chemokine CXCL12, and connexin 43 (Cx43 were utilized as markers of radial glia cells, CD105 (endoglin as a marker of angiogenically activated endothelial cells, and proteoglycan NG2 as a marker of immature pericytes. Immunolabeling for CXCL12 showed the highest level of the ligand in radial glial fibres in contact with the growing cortex microvessels. These specialized contacts, recognizable on both perforating radial vessels and growing collaterals, appeared as CXCL12-reactive en passant, symmetrical and asymmetrical vessel-specific RG fibre swellings. At the highest confocal resolution, these RG varicosities showed a CXCL12-reactive dot-like content whose microvesicular nature was confirmed by ultrastructural observations. A further analysis of radial glial varicosities reveals colocalization of CXCL12 with connexin Cx43, which is possibly implicated in vessel-specific chemokine signalling.

  7. Altered cerebral hemodynamics in early Alzheimer disease: a pilot study using transcranial Doppler.

    NARCIS (Netherlands)

    Claassen, J.A.H.R.; Diaz-Arrastia, R.; Martin-Cook, K.; Levine, B.D.; Zhang, R.

    2009-01-01

    Cerebrovascular disease may contribute to the development and progression of Alzheimer's disease (AD). This study investigated whether impairments in cerebral hemodynamics can be detected in early-stage AD. Nine patients with mild AD and eight cognitively normal controls matched for age underwent br

  8. Lymphatic vascular morphogenesis in development, physiology, and disease

    NARCIS (Netherlands)

    Schulte-Merker, Stefan; Sabine, Amelie; Petrova, Tatiana V.

    2011-01-01

    The lymphatic vasculature constitutes a highly specialized part of the vascular system that is essential for the maintenance of interstitial fluid balance, uptake of dietary fat, and immune response. Recently, there has been an increased awareness of the importance of lymphatic vessels in many commo

  9. Enhanced expression of fibroblast growth factors and receptor FGFR-1 during vascular remodeling in chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    A.R. Kranenburg (Andor); W.I. de Boer (Pim); J.H.J.M. van Krieken (Han); W.J. Mooi (Wolter); J.E. Walters (Jane); P.R. Saxena (Pramod Ranjan); P.J. Sterk (Peter); H.S. Sharma (Hari)

    2002-01-01

    textabstractImportant characteristics of chronic obstructive pulmonary disease (COPD) include airway and vascular remodeling, the molecular mechanisms of which are poorly understood. We assessed the role of fibroblast growth factors (FGF) in pulmonary vascular remodeling by examini

  10. T2’-Imaging to Assess Cerebral Oxygen Extraction Fraction in Carotid Occlusive Disease: Influence of Cerebral Autoregulation and Cerebral Blood Volume

    Science.gov (United States)

    Deichmann, Ralf; Pfeilschifter, Waltraud; Hattingen, Elke; Singer, Oliver C.; Wagner, Marlies

    2016-01-01

    Purpose Quantitative T2'-mapping detects regional changes of the relation of oxygenated and deoxygenated hemoglobin (Hb) by using their different magnetic properties in gradient echo imaging and might therefore be a surrogate marker of increased oxygen extraction fraction (OEF) in cerebral hypoperfusion. Since elevations of cerebral blood volume (CBV) with consecutive accumulation of Hb might also increase the fraction of deoxygenated Hb and, through this, decrease the T2’-values in these patients we evaluated the relationship between T2’-values and CBV in patients with unilateral high-grade large-artery stenosis. Materials and Methods Data from 16 patients (13 male, 3 female; mean age 53 years) with unilateral symptomatic or asymptomatic high-grade internal carotid artery (ICA) or middle cerebral artery (MCA) stenosis/occlusion were analyzed. MRI included perfusion-weighted imaging and high-resolution T2’-mapping. Representative relative (r)CBV-values were analyzed in areas of decreased T2’ with different degrees of perfusion delay and compared to corresponding contralateral areas. Results No significant elevations in cerebral rCBV were detected within areas with significantly decreased T2’-values. In contrast, rCBV was significantly decreased (pperfusion delay and decreased T2’. Furthermore, no significant correlation between T2’- and rCBV-values was found. Conclusions rCBV is not significantly increased in areas of decreased T2’ and in areas of restricted perfusion in patients with unilateral high-grade stenosis. Therefore, T2’ should only be influenced by changes of oxygen metabolism, regarding our patient collective especially by an increase of the OEF. T2’-mapping is suitable to detect altered oxygen consumption in chronic cerebrovascular disease. PMID:27560515

  11. Vascular Occlusions in Grapevines with Pierce’s Disease Make Disease Symptom Development Worse1[OA

    Science.gov (United States)

    Sun, Qiang; Sun, Yuliang; Walker, M. Andrew; Labavitch, John M.

    2013-01-01

    Vascular occlusions are common structural modifications made by many plant species in response to pathogen infection. However, the functional role(s) of occlusions in host plant disease resistance/susceptibility remains controversial. This study focuses on vascular occlusions that form in stem secondary xylem of grapevines (Vitis vinifera) infected with Pierce’s disease (PD) and the impact of occlusions on the hosts’ water transport and the systemic spread of the causal bacterium Xylella fastidiosa in infected vines. Tyloses are the predominant type of occlusion that forms in grapevine genotypes with differing PD resistances. Tyloses form throughout PD-susceptible grapevines with over 60% of the vessels in transverse sections of all examined internodes becoming fully blocked. By contrast, tylose development was mainly limited to a few internodes close to the point of inoculation in PD-resistant grapevines, impacting only 20% or less of the vessels. The extensive vessel blockage in PD-susceptible grapevines was correlated to a greater than 90% decrease in stem hydraulic conductivity, compared with an approximately 30% reduction in the stems of PD-resistant vines. Despite the systemic spread of X. fastidiosa in PD-susceptible grapevines, the pathogen colonized only 15% or less of the vessels in any internode and occurred in relatively small numbers, amounts much too small to directly block the vessels. Therefore, we concluded that the extensive formation of vascular occlusions in PD-susceptible grapevines does not prevent the pathogen’s systemic spread in them, but may significantly suppress the vines’ water conduction, contributing to PD symptom development and the vines’ eventual death. PMID:23292789

  12. Vascular occlusions in grapevines with Pierce's disease make disease symptom development worse.

    Science.gov (United States)

    Sun, Qiang; Sun, Yuliang; Walker, M Andrew; Labavitch, John M

    2013-03-01

    Vascular occlusions are common structural modifications made by many plant species in response to pathogen infection. However, the functional role(s) of occlusions in host plant disease resistance/susceptibility remains controversial. This study focuses on vascular occlusions that form in stem secondary xylem of grapevines (Vitis vinifera) infected with Pierce's disease (PD) and the impact of occlusions on the hosts' water transport and the systemic spread of the causal bacterium Xylella fastidiosa in infected vines. Tyloses are the predominant type of occlusion that forms in grapevine genotypes with differing PD resistances. Tyloses form throughout PD-susceptible grapevines with over 60% of the vessels in transverse sections of all examined internodes becoming fully blocked. By contrast, tylose development was mainly limited to a few internodes close to the point of inoculation in PD-resistant grapevines, impacting only 20% or less of the vessels. The extensive vessel blockage in PD-susceptible grapevines was correlated to a greater than 90% decrease in stem hydraulic conductivity, compared with an approximately 30% reduction in the stems of PD-resistant vines. Despite the systemic spread of X. fastidiosa in PD-susceptible grapevines, the pathogen colonized only 15% or less of the vessels in any internode and occurred in relatively small numbers, amounts much too small to directly block the vessels. Therefore, we concluded that the extensive formation of vascular occlusions in PD-susceptible grapevines does not prevent the pathogen's systemic spread in them, but may significantly suppress the vines' water conduction, contributing to PD symptom development and the vines' eventual death.

  13. Local Vasogenic Edema without Cerebral Hyperperfusion after Direct Revascularization Surgery for Moyamoya Disease.

    Science.gov (United States)

    Sakata, Hiroyuki; Fujimura, Miki; Mugikura, Shunji; Sato, Kenichi; Tominaga, Teiji

    2015-07-01

    Superficial temporal artery-middle cerebral artery anastomosis is generally used as the standard surgical treatment for moyamoya disease to prevent cerebral ischemic attacks. Although the main potential complications associated with this treatment are cerebral hyperperfusion and ischemia, the adverse impacts of revascularization surgery remain unclear. Of the 142 consecutive surgeries for moyamoya disease at our hospital from 2008, we herein presented 2 cases of adult-onset moyamoya disease that manifested local vasogenic edema at the site of anastomosis without cerebral hyperperfusion; 1 in a 31-year-old woman presented with transient ischemic attack and the other in a 22-year-old man manifested as minor completed stroke. Both patients underwent superficial temporal artery-middle cerebral artery anastomosis, resulting in the formation of a reversible high-signal-intensity lesion at the site of anastomosis on T2-weighted images along with an increase in apparent diffusion coefficient values, whereas diffusion-weighted images showed no changes. Neither hyperperfusion nor hypoperfusion, as assessed by single-photon emission computed tomography with N-isopropyl[123I]-p-iodoamphetamine, was observed postoperatively. In light of the increased risk of the further progression of vasogenic edema to intracerebral hemorrhage, these patients were treated with prophylactic blood pressure lowering and the intravenous infusion of a free radical scavenger. They did not have any further cerebrovascular events during the follow-up period. Regional vasogenic edema without cerebral hyperperfusion, possibly due to cerebral ischemia/reperfusion injury, may be another novel entity that needs to be considered as a potential complication after extracranial-intracranial bypass for moyamoya disease. Strict postoperative management should be used to avoid hemorrhagic transformation.

  14. Protective effects of low-intensity pulsed ultrasound on aluminum-induced cerebral damage in Alzheimer's disease rat model

    Science.gov (United States)

    Lin, Wei-Ting; Chen, Ran-Chou; Lu, Wen-Wei; Liu, Shing-Hwa; Yang, Feng-Yi

    2015-04-01

    The protein expressions of neurotrophic factors can be enhanced by low-intensity pulsed ultrasound (LIPUS) stimulation in the brain. The purpose of this study was to demonstrate the protective effect of LIPUS stimulation against aluminum-induced cerebral damage in Alzheimer's disease rat model. LIPUS was administered 7 days before each aluminum chloride (AlCl3) administration, and concomitantly given with AlCl3 daily for a period of 6 weeks. Neurotrophic factors in hippocampus were measured by western blot analysis. Behavioral changes in the Morris water maze and elevated plus maze were examined in rats after administration of AlCl3. Various biochemical analyses were performed to evaluate the extent of brain damages. LIPUS is capable of prompting levels of brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and vascular endothelial growth factor (VEGF) in rat brain. AlCl3 administration resulted in a significant increase in the aluminum concentration, acetylcholinesterase activity and beta-amyloid (Aβ) deposition in AlCl3 treated rats. LIPUS stimulation significantly attenuated aluminum concentration, acetylcholinesterase activity, Aβ deposition and karyopyknosis in AlCl3 treated rats. Furthermore, LIPUS significantly improved memory retention in AlCl3-induced memory impairment. These experimental results indicate that LIPUS has neuroprotective effects against AlCl3-induced cerebral damages and cognitive dysfunction.

  15. Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease

    DEFF Research Database (Denmark)

    Lidegaard, O

    1995-01-01

    multivariate analysis, pregnancy implied an odds ratio (OR) for a cerebral thromboembolic attack of 1.3 (nonsignificant), diabetes an OR of 5.4 (P hypertension an OR of 3.1 (P disease had an OR for cerebral......OBJECTIVE: To assess the risk of developing cerebral thromboembolism among pregnant women and among fertile women with hypertension, migraine, diabetes, and previous thrombotic disease, and to investigate the interaction of these risk factors with the use of oral contraceptives. DESIGN...... thrombo-embolism of 5.3 (P diseases had an OR of 8.3 (P pregnancy implied a non-significant elevated odds ratio of 1.3 for cerebral...

  16. Homocysteinemia control by cysteine in cerebral vascular patients after methionine loading test: evidences in physiological and pathological conditions in cerebro-vascular and multiple sclerosis patients.

    Science.gov (United States)

    Ulivelli, Monica; Priora, Raffaella; Di Giuseppe, Danila; Coppo, Lucia; Summa, Domenico; Margaritis, Antonios; Frosali, Simona; Bartalini, Sabina; Martini, Giuseppe; Cerase, Alfonso; Di Simplicio, Paolo

    2016-06-01

    The toxicity risk of hyperhomocysteinemia is prevented through thiol drug administration which reduces plasma total homocysteine (tHcy) concentrations by activating thiol exchange reactions. Assuming that cysteine (Cys) is a homocysteinemia regulator, the hypothesis was verified in healthy and pathological individuals after the methionine loading test (MLT). The plasma variations of redox species of Cys, Hcy, cysteinylglycine, glutathione and albumin (reduced, HS-ALB, and at mixed disulfide, XSS-ALB) were compared in patients with cerebral small vessels disease (CSVD) (n = 11), multiple sclerosis (MS) (n = 12) and healthy controls (n = 11) at 2-4-6 h after MLT. In MLT-treated subjects, the activation of thiol exchange reactions provoked significant changes over time in redox species concentrations of Cys, Hcy, and albumin. Significant differences between controls and pathological groups were also observed. In non-methionine-treated subjects, total Cys concentrations, tHcy and thiol-protein mixed disulfides (CSS-ALB, HSS-ALB) of CSVD patients were higher than controls. After MLT, all groups displayed significant cystine (CSSC) increases and CSS-ALB decreases, that in pathological groups were significantly higher than controls. These data would confirm the Cys regulatory role on the homocysteinemia; they also explain that the Cys-Hcy mixed disulfide excretion is an important point of hyperhomocysteinemia control. Moreover, in all groups after MLT, significant increases in albumin concentrations, named total albumin (tALB) and measured as sum of HS-ALB (spectrophometric), and XSS-ALB (assayed at HPLC) were observed. tALB increases, more pronounced in healthy than in the pathological subjects, could indicate alterations of albumin equilibria between plasma and other extracellular spaces, whose toxicological consequences deserve further studies.

  17. Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol

    Directory of Open Access Journals (Sweden)

    van der Vlugt Maureen J

    2011-02-01

    Full Text Available Abstract Background Cerebral small vessel disease (SVD is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML and the normal appearing white matter (NAWM. Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated. Methods/Design The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI. Discussion The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white

  18. Hippocampal expression of synaptic structural proteins and phosphorylated cAMP response element-binding protein in a rat model of vascular dementia induced by chronic cerebral hypoperfusion

    Institute of Scientific and Technical Information of China (English)

    Hui Zhao; Zhiyong Li; Yali Wang; Qiuxia Zhang

    2012-01-01

    The present study established a rat model of vascular dementia induced by chronic cerebral hy-poperfusion through permanent ligation of bilateral common carotid arteries. At 60 days after mod-eling, escape latency and swimming path length during hidden-platform acquisition training in Morris water maze significantly increased in the model group. In addition, the number of accurate crossings over the original platform significantly decreased, hippocampal CA1 synaptophysin and growth-associated protein 43 expression significantly decreased, cAMP response element-binding protein expression remained unchanged, and phosphorylated cAMP response element-binding protein expression significantly decreased. Results suggested that abnormal expression of hippo-campal synaptic structural protein and cAMP response element-binding protein phosphorylation played a role in cognitive impairment following chronic cerebral hypoperfusion.

  19. New Insights Into Tobacco-Induced Vascular Disease: Clinical Ramifications.

    Science.gov (United States)

    Cooke, John P

    2015-01-01

    Tobacco smoke contains more than 4,000 compounds. These include phenols, carbonyls, and nitrosamines that may be irritants and carcinogens; particulate matter such as tars; volatiles and gases such as carbon monoxide; and nicotine. Many of these compounds may contribute to the adverse health effects of tobacco. For example, recent findings have shown that the angiogenic and proliferative effects of nicotine are mediated by activation of nicotinic receptors on the vascular cells. Nicotine-induced activation of vascular cells may contribute to pathological neovascularization in cancer, age-related macular degeneration, and atherosclerosis. This review focuses on how nicotine adversely affects cardiovascular health and highlights intriguing new data about nicotine's potent angiogenic and proliferative properties.

  20. Total Cerebral Small Vessel Disease MRI Score Is Associated With Cognitive Decline In Executive Function In Patients With Hypertension

    Directory of Open Access Journals (Sweden)

    Renske Uiterwijk

    2016-12-01

    Full Text Available Objectives: Hypertension is a major risk factor for white matter hyperintensities, lacunes, cerebral microbleeds and perivascular spaces, which are MRI markers of cerebral small vessel disease (SVD. Studies have shown associations between these individual MRI markers and cognitive functioning and decline. Recently, a total SVD score was proposed in which the different MRI markers were combined into one measure of SVD, to capture total SVD-related brain damage. We investigated if this SVD score was associated with cognitive decline over 4 years in patients with hypertension. Methods: In this longitudinal cohort study, 130 hypertensive patients (91 patients with uncomplicated hypertension and 39 hypertensive patients with a lacunar stroke were included. They underwent a neuropsychological assessment at baseline and after 4 years. The presence of white matter hyperintensities, lacunes, cerebral microbleeds, and perivascular spaces were rated on baseline MRI. Presence of each individual marker was added to calculate the total SVD score (range 0-4 in each patient. Results: Uncorrected linear regression analyses showed associations between SVD score and decline in overall cognition (p=0.017, executive functioning (p<0.001 and information processing speed (p=0.037, but not with memory (p=0.911. The association between SVD score and decline in overall cognition and executive function remained significant after adjustment for age, sex, education, anxiety and depression score, potential vascular risk factors, patient group and baseline cognitive performance.Conclusions: Our study shows that a total SVD score can predict cognitive decline, specifically in executive function, over 4 years in hypertensive patients. This emphasizes the importance of considering total brain damage due to SVD.

  1. Cerebral Amyloidal Angiopathy--a disease with implications for neurology and psychiatry.

    Science.gov (United States)

    Gahr, Maximilian; Nowak, Dennis A; Connemann, Bernhard J; Schönfeldt-Lecuona, Carlos

    2013-06-26

    Cerebral Amyloidal Angiopathy (CAA), which occurs sporadically in most cases but can also occur hereditarily, belongs to the group amyloidoses and is characterized by the deposition and accumulation of beta-amyloid (Aβ) in smaller arterial vessels of the brain. The deposition of Aβ leads to degenerative changes in the cerebral vessel system (thickening of the vessel wall, microaneurysm, constriction of vascular lumen, dissection), which favour the development of the clinical symptomatology most often associated with CAA. Besides haemorrhages, cerebral ischaemia, transient neurological symptoms, leukoencephalopathy as well as cognitive decline and even dementia may appear in connection with CAA. A definite diagnosis of CAA can only be made on the basis of a pathological assessment, even though diagnostic findings of cerebral neuroimaging and clinical symptoms allow the diagnosis of a probable CAA. At present, no causal therapy options are available. Although CAA is placed within the range of neurological illnesses, psychiatric symptoms such as cognitive impairment, personality change or behavioural problems as well as depression are plausible clinical manifestations of CAA and may even dominate the clinical picture. Apart from epidemiological, pathogenetical, clinical and diagnostical aspects, possible psychiatric implications of CAA are discussed in the review article.

  2. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part I.

    Science.gov (United States)

    Paneni, Francesco; Beckman, Joshua A; Creager, Mark A; Cosentino, Francesco

    2013-08-01

    Hyperglycemia and insulin resistance are key players in the development of atherosclerosis and its complications. A large body of evidence suggest that metabolic abnormalities cause overproduction of reactive oxygen species (ROS). In turn, ROS, via endothelial dysfunction and inflammation, play a major role in precipitating diabetic vascular disease. A better understanding of ROS-generating pathways may provide the basis to develop novel therapeutic strategies against vascular complications in this setting. Part I of this review will focus on the most current advances in the pathophysiological mechanisms of vascular disease: (i) emerging role of endothelium in obesity-induced insulin resistance; (ii) hyperglycemia-dependent microRNAs deregulation and impairment of vascular repair capacities; (iii) alterations of coagulation, platelet reactivity, and microparticle release; (iv) epigenetic-driven transcription of ROS-generating and proinflammatory genes. Taken together these novel insights point to the development of mechanism-based therapeutic strategies as a promising option to prevent cardiovascular complications in diabetes.

  3. [Retinal vascular changes--predictive and prognostic factor in systemic disease].

    Science.gov (United States)

    Vicol, Anca Delia; Bogdănici, Tudor; Bogdănici, Camelia

    2014-01-01

    The retinal circulation represents a unique window for the direct, non invazive in vivo status of the systemic mycrocirculation, but it can also offer scientific support for theories related strictly to ocular diseases, such as glaucoma (vascular theory). The interaction between intraocular pressure, retinal vessels and cerebrospinal fluid pressure located at the retrolaminar part of the optic nerve has been of great interest for both ophthalmologists or neuroscientists, both clinicians and researchers. The retinal vascular bed has structural and functional similarities with other vascular teritories such as Central Nervous System (CNS), kidneys and heart, so as for the ophthalmologist any vascular change in the retina can signalize a systemic disease (diabetes mellitus, stroke, arterial hypertension) that is more or less symptomatic for the patient. The purpose of this meta-analysis was to reviview recent literature data related to the connections between different hemodynamic structures and their impact on the retinal blood flow.

  4. Multiple de novo vascular malformations in relation to diffuse venous occlusive disease: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Desal, H.A. [Hopital Laennec, University of Nantes, Department of Neuroradiology, Nantes (France); Toronto Western Hospital, Department of Medical Imaging, University Health Network, Toronto, Ont. (Canada); Lee, S.K.; Kim, B.S.; TerBrugge, K.G. [Toronto Western Hospital, Department of Medical Imaging, University Health Network, Toronto, Ont. (Canada); Raoul, S.; Tymianski, M. [Toronto Western Hospital, Department of Neurosurgery, University Health Network, Toronto, Ont. (Canada)

    2005-01-01

    Brain vascular malformations are dynamic disorders. Although mostly considered to be of congenital origin, the improvement of clinical imaging and vasculogenesis knowledge has shown that they might also result from a biological dysfunction of the remodeling process after birth. Venous occlusive disease and ishemia may represent powerful revealing triggers and support the capillary venous origin of some vascular malformations. We report a unique case of the development of multiple de novo vascular malformations (transverse sinus dural fistula and posterior fossa cavernomas) following acoustic neuroma surgery. (orig.)

  5. Resultados funcionais da aplicação da toxina botulínica tipo A em pacientes com acidente vascular cerebral

    OpenAIRE

    Vanessa Ribas Massia

    2009-01-01

    O Acidente Vascular Cerebral (AVC), junto com as demais doenças cerebrovasculares, é a terceira causa de óbito em países desenvolvidos e a principal causa de incapacidade em adultos. A espasticidade é a seqüela motora mais incapacitante, limitando as atividades funcionais. A toxina Botulínica (TB) tem se mostrado uma opção terapêutica benéfica, eficaz e segura. Pacientes submetidos à aplicação de TB devem iniciar um tratamento fisioterapeutico a fim de estabelecer a função perdida, tornando-o...

  6. Ischemic stroke in children: a study of the associated alterations Acidente vascular cerebral isquêmico na infância: estudo das alterações associadas

    Directory of Open Access Journals (Sweden)

    Josiane Ranzan

    2004-09-01

    Full Text Available Arterial ischemic stroke (AIS in children is a relatively rare disease, not yet clearly understood and with a multifactored etiology. It can cause a severe impact on the child and be the first manifestation of a systemic disease. Delayed diagnosis is still common and research on the subject in our field practically does not exist. Prothrombotic disorders have been described as important causative factors of the ischemic event in children. Forty-six patients from zero to 18 years of age diagnosed with AIS were studied in the period between March 2002 and September 2003. Laboratory tests were realised including coagulation proteins and echocardiogram. AIS of the newborn occurred in 37% of the cases. Focal seizures and hemiparesis were the most frequent symptoms; 40% of the patients presented prior pathologies. Abnormalities of the S and C proteins occurred in 22% and 17%. Associated alterations, particularly those that generate a hypercoagulability state, indicate more than one risk factor for this disease in childhood.Acidente vascular cerebral Isquêmico (AVCI na infância é relativamente raro, de conhecimento ainda obscuro, e com etiologia multifatorial. Pode causar grave impacto na criança e ser a primeira manifestação de doença sistêmica. O subdiagnóstico ainda é comum e são praticamente inexistentes as pesquisas sobre o assunto no nosso meio. Desordens protrombóticas têm sido descritas como importantes fatores causais do evento isquêmico na infância. Foram estudados 46 pacientes de zero a 18 anos, com diagnóstico de AVCI, no período de março/2002 a setembro/2003. Exames laboratoriais, incluindo proteínas de coagulação e ecocardiograma foram realizados. AVCI neonatal ocorreu em 35% dos casos. Crise focal e hemiparesia foram os sintomas iniciais mais freqüentes; 40% dos casos apresentaram patologia prévia. Anormalidades nas proteínas S e C ocorreram em 22% e 17% da amostra. Alterações associadas, principalmente as que

  7. Trends in vascular risk factors and medication use in patients with various manifestations of vascular diseases or type 2 diabetes mellitus from 1996 to 2007: the Second Manifestations of Arterial Disease (SMART) Study

    NARCIS (Netherlands)

    Vlek, A.L.M.; Visseren, F.L.J.; Algra, A.; Soedamah-Muthu, S.S.; Moll, F.L.; Doevendans, P.A.; Kappelle, L.J.; Graaf, van der Y.

    2010-01-01

    Aims: To investigate time trends in vascular risk factors and medication use for patients referred to a vascular specialist with manifest vascular disease or type 2 diabetes mellitus (DM2). Methods and results: Change in risk factor profile and medication use at referral over a 12-year period was ev

  8. Protein kinase C inhibition attenuates vascular ETB receptor upregulation and decreases brain damage after cerebral ischemia in rat

    Directory of Open Access Journals (Sweden)

    Vikman Petter

    2007-01-01

    Full Text Available Abstract Background Protein kinase C (PKC is known to be involved in the pathophysiology of experimental cerebral ischemia. We have previously shown that after transient middle cerebral artery occlusion, there is an upregulation of endothelin receptors in the ipsilateral middle cerebral artery. The present study aimed to examine the effect of the PKC inhibitor Ro-32-0432 on endothelin receptor upregulation, infarct volume and neurology outcome after middle cerebral artery occlusion in rat. Results At 24 hours after transient middle cerebral artery occlusion (MCAO, the contractile endothelin B receptor mediated response and the endothelin B receptor protein expression were upregulated in the ipsilateral but not the contralateral middle cerebral artery. In Ro-32-0432 treated rats, the upregulated endothelin receptor response was attenuated. Furthermore, Ro-32-0432 treatment decreased the ischemic brain damage significantly and improved neurological scores. Immunohistochemistry showed fainter staining of endothelin B receptor protein in the smooth muscle cells of the ipsilateral middle cerebral artery of Ro-32-0432 treated rats compared to control. Conclusion The results suggest that treatment with Ro-32-0432 in ischemic stroke decreases the ischemic infarction area, neurological symptoms and associated endothelin B receptor upregulation. This provides a new perspective on possible mechanisms of actions of PKC inhibition in cerebral ischemia.

  9. Nur77 and FHL2: Novel players in vascular and immune disease

    NARCIS (Netherlands)

    Kurakula, K.B.

    2015-01-01

    The nuclear receptor Nur77 is an early response gene that is induced by diverse extracellular signals in a wide range of tissues and cultured cells. It has been implicated in the regulation of genes involved in metabolic disease, adipogenesis, inflammation, and vascular disease. FHL2/DRAL/SLIM3 is a

  10. Vascular Imaging: The Evolving Role of the Multidisciplinary Team Meeting in Peripheral Vascular Disease

    OpenAIRE

    Christie, Andrew; Roditi, Giles

    2014-01-01

    This article reviews the importance of preinterventional cross-sectional imaging in the evaluation of peripheral arterial disease, as well as discussing the pros and cons of each imaging modality. The importance of a multidisciplinary team approach is emphasized.

  11. Vascular imaging: the evolving role of the multidisciplinary team meeting in peripheral vascular disease.

    Science.gov (United States)

    Christie, Andrew; Roditi, Giles

    2014-12-01

    This article reviews the importance of preinterventional cross-sectional imaging in the evaluation of peripheral arterial disease, as well as discussing the pros and cons of each imaging modality. The importance of a multidisciplinary team approach is emphasized.

  12. The changes of cognitive function in elderly patients with cerebral vascular stenosis%老年脑血管狭窄患者认知功能的改变及影响因素

    Institute of Scientific and Technical Information of China (English)

    王小永; 于翔; 李永强; 王军文; 任敏

    2016-01-01

    Objective To observed and analyze the changes of cognitive function in elderly patients with cere-bral vascular stenosis.Methods A total of 200 elderly patients with ischemic cerebral vascular disease were selected as research objects.The cerebral vascular stenosis,risk factors of cerebrovascular disease ,scores of mini-mentalstateexami-nation (MMSE)and incidence of cognitive dysfunction were observed and analyzed.Results The age,the rate of mer-ged diabetes,the rate of merged hypertension,the plasma homocysteine (Hcy),plasma fibrinogen,the serum total cho-lesterol of the patients with cerebral vascular stenosis were significantly higher than those ofthe patients without cerebral vascular stenosis (t =4.223,3.812,3.635,χ2 =33.734,9.814,all P <0.05 ).The MMSE score,immediate recall score,attention and calculationscore,delayed recall score of the patients with mild stenosis were significantly higher than those of patients with moderate stenosis or severe stenosis.The MMSE score and delayed recall score of the patients with moderate stenosis were significantly higher than those of patients with severe stenosis.The incidence of cognitive dys-function in the patients with severe stenosis was significantly higher than that in patients with moderate stenosis,and the incidence of cognitive dysfunction in patients with moderate stenosis was significantly higher than that in patients with mild stenosis (P <0.05).Logistic multivariate regression analysis showed that there were a statistical relation between age (OR =1.397),merged hypertension (OR =1.456),plasma Hcy level (OR =1.658)and degree of cerebral vascu-lar stenosis (OR =2.138)had a to cognitive dysfunction of patients (all P <0.05).Conclusions Cerebral vascular stenosis may be involved in the pathological processes of cognitive impairment,and can be used as an secondary indicati-or to predict the risk of cognitive dysfunction in the elderly patients.%目的:观察老年脑血管狭窄患者认知功能的改变,

  13. Systemic and cerebral vascular endothelial growth factor levels increase in murine cerebral malaria along with increased Calpain and caspase activity and can be reduced by erythropoietin treatment

    DEFF Research Database (Denmark)

    Hempel, Casper; Hoyer, Nils; Kildemoes, Anna

    2014-01-01

    increased levels of VEGF in brain and plasma and decreased plasma levels of soluble VEGF receptor 2. EPO treatment normalized VEGF receptor 2 levels and reduced brain VEGF levels. Hypoxia-inducible factor (HIF)-1α was significantly upregulated whereas cerebral HIF-2α and EPO levels remained unchanged....... Furthermore, we noticed increased caspase-3 and calpain activity in terminally ill mice, as measured by protease-specific cleavage of α-spectrin and p35. In conclusion, we detected increased cerebral and systemic VEGF as well as HIF-1α, which in the brain were reduced to normal in EPO-treated mice. Also...

  14. An Attempt to evaluate cerebral hemodynamics before and after neurosurgical treatment of Moyamoya disease by factor analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nakazawa, Keiji; Ishii, Katsumi; Sakai, Fumihiko; Matsubayashi, Takashi (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)

    1991-09-01

    We made factor analysis on the data obtained by the radionuclide angiography to evaluate cerebral hemodynamics before and after neurosurgical treatment in a patient with Moyamoya disease (bilateral occlusion of internal carotid arteries). Tracer used was {sup 99m}Tc-RBC or {sup 99m}TcHSA. Before the neurosurgical treatment, the cerebral factor image obtained by the factor analysis showed defects in the right and the left frontal cerebral regions, and the venous factor image showed abnormal accumulations in the right and the left frontal cerebral regions. After Encephalo-Myo-Synangiosis and burr hole operations, defects in the right and the left frontal cerebral regions on the cerebral factor image were improved and abnormal accumulations in the right and the left frontal cerebral regions on the venous factor image disappeared. (author).

  15. ADVANCE: Study to Evaluate Cinacalcet Plus Low Dose Vitamin D on Vascular Calcification in Subjects With Chronic Kidney Disease Receiving Hemodialysis

    Science.gov (United States)

    2014-07-14

    Chronic Kidney Disease; End Stage Renal Disease; Coronary Artery Calcification; Vascular Calcification; Calcification; Cardiovascular Disease; Chronic Renal Failure; Hyperparathyroidism; Kidney Disease; Nephrology; Secondary Hyperparathyroidism

  16. 老年缺血性脑卒中后轻度血管性认知障碍的影响因素%The factors of mild vascular cognitive impairment in elderly patients with ischemic cerebral stroke

    Institute of Scientific and Technical Information of China (English)

    王和平; 黄燕秋

    2016-01-01

    目的:分析老年缺血性脑卒中后轻度血管性认知障碍(VCI)的影响因素。方法对患者一般资料、体格检查、认知评估及影像学资料进行收集与调查,并行单因素分析与Logistic回归分析。结果老年缺血性卒中后轻度VCI的发生与患者年龄、文化程度、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积有关;与性别、BM I、吸烟、饮酒等无明显相关。Logistic回归分析显示,文化程度为老年缺血性脑卒中后轻度VCI发生的保护因素,而年龄、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积是危险因素。结论老年缺血性脑卒中后轻度 VCI发生的危险因素众多,临床上可进行针对性的早期干预。%Objective To analyze the factors of mild vascular cognitive impairment (VCI) in elderly patients with ischemic cerebral stroke. Methods The general information ,physical examination ,cognitive evaluation and imaging data were collected and investigated;single factor analysis and Logistic regression analysis were used. Results The occurrence of mild VCI in eld-erly patients with ischemic cerebral stroke was related with age ,educational level ,coronary heart disease ,diabetes ,hyperten-sion ,stroke frequency ,disease location and area of stroke ,and had non-obvious relation with sex ,BMI ,smoking ,alcohol con-sumption. Logistic regression analysis showed that education was a protective factor for mild VIC in elderly patients with is-chemic cerebral stroke ,and age ,coronary heart disease ,diabetes ,hypertension ,stroke frequency ,disease location and area were the risk factors. Conclusion The risk factors for mild VCI in elderly patients with ischemic cerebral stroke are many ;targeted early intervention can be applied in clinic.

  17. Albendazole treatment of cerebral hydatid disease: evaluation of results with CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kalaitzoglou, I.; Drevelengas, A.; Petridis, A.; Palladas, P. [Department of Radiology, ``G. Papanikolaou`` General Hospital, Thessaloniki (Greece)

    1998-01-01

    We report a case of cerebral hydatid disease demonstrated by CT and MRI, treated with albendazole. Follow-up showed complete dissapearance of the cysts with residual focal calcification on CT and presumed gliosis on MRI. (orig.) With 3 figs., 17 refs.

  18. Retinal vessel diameters and cerebral small vessel disease: the Rotterdam Scan Study

    NARCIS (Netherlands)

    Ikram, M.K.; Jong, F.J. de; Dijk, E.J. van; Prins, N.D.; Hofman, A.; Breteler, M.M.B.; de Jong, P.T.V.M.

    2006-01-01

    The direct visualization of retinal vessels provides a unique opportunity to study cerebral small vessel disease, because these vessels share many features. It was reported that persons with smaller retinal arteriolar-to-venular ratio tended to have more white matter lesions on MRI. It is unclear wh

  19. Microbleeds are independently related to gait disturbances in elderly individuals with cerebral small vessel disease

    NARCIS (Netherlands)

    Laat, Karlijn de; Berg, H.A. van den; Norden, Anouk van; Gons, R.A.R.; Olde Rikkert, M.G.M.; Leeuw, F.E. de

    2011-01-01

    BACKGROUND AND PURPOSE: Cerebral small vessel disease (SVD), including white matter lesions and lacunar infarcts, is related to gait disturbances. Microbleeds (MB) are another manifestation of SVD, but their clinical impact remains unclear. We therefore investigated the relation between the number a

  20. Demonstration of cerebral perfusion abnormalities in moyamoya disease using susceptibility perfusion- and diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Adams, W.M.; Laitt, R.D. [Department of Neuroradiology, Central Manchester Healthcare Trust, Oxford Road, Manchester M13 9WL (United Kingdom); Li, K.L.; Jackson, A. [Department of Diagnostic Radiology, University of Manchester, Manchester M13 9PT (United Kingdom); Sherrington, C.R.; Talbot, P. [Department of Neurology, Central Manchester Healthcare Trust, Oxford Road, Manchester M13 9WL (United Kingdom)

    1999-02-01

    We describe the use of diffusion-weighted imaging and perfusion MRI using a contrast-medium bolus in the preoperative investigation for young man presenting with a cerebral ischaemic episode as a manifestation of moyamoya disease. (orig.) With 6 figs., 21 refs.

  1. Application of Diffusion Tensor Imaging Parameters to Detect Change in Longitudinal Studies in Cerebral Small Vessel Disease.

    Directory of Open Access Journals (Sweden)

    Eva Anna Zeestraten

    Full Text Available Cerebral small vessel disease (SVD is the major cause of vascular cognitive impairment, resulting in significant disability and reduced quality of life. Cognitive tests have been shown to be insensitive to change in longitudinal studies and, therefore, sensitive surrogate markers are needed to monitor disease progression and assess treatment effects in clinical trials. Diffusion tensor imaging (DTI is thought to offer great potential in this regard. Sensitivity of the various parameters that can be derived from DTI is however unknown. We aimed to evaluate the differential sensitivity of DTI markers to detect SVD progression, and to estimate sample sizes required to assess therapeutic interventions aimed at halting decline based on DTI data. We investigated 99 patients with symptomatic SVD, defined as clinical lacunar syndrome with MRI confirmation of a corresponding infarct as well as confluent white matter hyperintensities over a 3 year follow-up period. We evaluated change in DTI histogram parameters using linear mixed effect models and calculated sample size estimates. Over a three-year follow-up period we observed a decline in fractional anisotropy and increase in diffusivity in white matter tissue and most parameters changed significantly. Mean diffusivity peak height was the most sensitive marker for SVD progression as it had the smallest sample size estimate. This suggests disease progression can be monitored sensitively using DTI histogram analysis and confirms DTI's potential as surrogate marker for SVD.

  2. Advanced Coats’ disease treated with intravitreal bevacizumab combined with laser vascular ablation

    Directory of Open Access Journals (Sweden)

    Villegas VM

    2014-05-01

    Full Text Available Victor M Villegas,1 Aaron S Gold,1 Audina M Berrocal,2 Timothy G Murray11Ocular Oncology and Retina, Miami, FL, USA; 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USAPurpose: To evaluate the impact of intravitreal bevacizumab combined with laser vascular ablation in the management of advanced Coats’ disease presenting with exudative retinal detachment.Methods: This was a retrospective review of 24 children that presented with exudative retinal detachments associated with advanced Coats’ disease. Mean patient age was 62 months (range 9–160 months. Presenting signs included retinal detachment in 24 children (100%, vascular telangiectasia in 24 children (100%, and retinal ischemia in 24 children (100%. Twenty of 24 children presented with elevated, vascular leakage in the fovea (83%. Two children presented with sub-retinal fibrosis associated with presumed long-standing retinal detachment without evidence of rhegmatogenous retinal detachment. Ten patients exhibited vascular alterations in the periphery of the second eye without clinical evidence of exudation. All 24 children were treated with a large-spot-size diode laser directly to areas of abnormal telangiectatic vasculature. All 24 children received intravitreal bevacizumab injection. Results: All 24 children had resolution of exudative retinal detachment, ablation of vascular telangiectasia, and anatomic improvement of the retina. No child exhibited progressive retinal detachment and no eye required enucleation. No cases of neovascular glaucoma were seen. Fellow eyes with peripheral vascular alterations showed no progression to exudative vasculopathy during the observation period. Intravitreal bevacizumab injection was not associated with endophthalmitis or systemically-observed complications.Conclusion: Repetitive intravitreal bevacizumab combined with laser vascular ablation may be utilized effectively

  3. Cerebral hemodynamics of the aging brain: risk of Alzheimer disease and benefit of aerobic exercise

    Directory of Open Access Journals (Sweden)

    Takashi eTarumi

    2014-01-01

    Full Text Available Alzheimer disease (AD and cerebrovascular disease often coexist with advanced age. Mounting evidence indicates that the presence of vascular disease and its risk factors increase the risk of AD, suggesting a potential overlap of the underlying pathophysiological mechanisms. In particular, atherosclerosis, endothelial dysfunction, and stiffening of central elastic arteries have been shown to associate with AD. Currently, there are no effective treatments for the cure and prevention of AD. Vascular risk factors are modifiable via either pharmacological or lifestyle intervention. In this regard, habitual aerobic exercise is increasingly recognized for its benefits on brain structure and cognitive function. Considering the well-established benefits of regular aerobic exercise on vascular health, exercise-related improvements in brain structure and cognitive function may be mediated by vascular adaptations. In this review, we will present the current evidence for the physiological mechanisms by which vascular health alters the structural and functional integrity of the aging brain and how improvements in vascular health, via regular aerobic exercise, potentially benefits cognitive function.

  4. Cerebral hemodynamics of the aging brain: risk of Alzheimer disease and benefit of aerobic exercise.

    Science.gov (United States)

    Tarumi, Takashi; Zhang, Rong

    2014-01-01

    Alzheimer disease (AD) and cerebrovascular disease often coexist with advanced age. Mounting evidence indicates that the presence of vascular disease and its risk factors increase the risk of AD, suggesting a potential overlap of the underlying pathophysiological mechanisms. In particular, atherosclerosis, endothelial dysfunction, and stiffening of central elastic arteries have been shown to associate with AD. Currently, there are no effective treatments for the cure and prevention of AD. Vascular risk factors are modifiable via either pharmacological or lifestyle intervention. In this regard, habitual aerobic exercise is increasingly recognized for its benefits on brain structure and cognitive function. Considering the well-established benefits of regular aerobic exercise on vascular health, exercise-related improvements in brain structure and cognitive function may be mediated by vascular adaptations. In this review, we will present the current evidence for the physiological mechanisms by which vascular health alters the structural and functional integrity of the aging brain and how improvements in vascular health, via regular aerobic exercise, potentially benefits cognitive function.

  5. Experimental Benefits of Sex Hormones on Vascular Function and the Outcome of Hormone Therapy in Cardiovascular Disease

    OpenAIRE

    Ross, Reagan L.; Serock, Michelle R; Khalil, Raouf A.

    2008-01-01

    Cardiovascular disease (CVD) is more common in men and postmenopausal women than premenopausal women, suggesting vascular benefits of female sex hormones. Experimental data have shown beneficial vascular effects of estrogen including stimulation of endothelium-dependent nitric oxide, prostacyclin and hyperpolarizing factor-mediated vascular relaxation. However, the experimental evidence did not translate into vascular benefits of hormone replacement therapy (HRT) in postmenopausal women, and ...

  6. Significance of Haemodynamic and Haemostatic Factors in the Course of Different Manifestations of Cerebral Small Vessel Disease: The SHEF-CSVD Study—Study Rationale and Protocol

    Directory of Open Access Journals (Sweden)

    Jacek Staszewski

    2013-01-01

    Full Text Available Rationale. This paper describes the rationale and design of the SHEF-CSVD Study, which aims to determine the long-term clinical and radiological course of cerebral small vessel disease (CSVD and to evaluate haemostatic and haemodynamic prognostic factors of the condition. Design. This single-centre, prospective, non-interventional cohort study will follow 150 consecutive patients with different clinical manifestations of CSVD (lacunar ischaemic stroke, vascular dementia, vascular parkinsonism or spontaneous deep, intracerebral haemorrhage and 50 age- and sex-matched controls over a period of 24 months. The clinical and radiological course will be evaluated basing on a detailed neurological, neuropsychological and MRI examinations. Haemodynamic (cerebral vasoreactivity, 24 h blood pressure control and haemostatic factors (markers of endothelial and platelet dysfunction, brachial artery flow-mediated dilatation test will be determined. Discussion. The scheduled study will specifically address the issue of haemodynamic and haemostatic prognostic factors and their course over time in various clinical manifestations of CSVD. The findings may aid the development of prophylactic strategies and individualised treatment plans, which are critical during the early stages of the disease.

  7. Cerebral computed tomography angiography using a 70 kVp protocol: improved vascular enhancement with a reduced volume of contrast medium and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eun-Suk; Chung, Tae-Sub; Baek, Jang Hun; Suh, Sang Hyun [Gangnam Severance Hospital, Department of Radiology, Yonsei University College of Medicine, Gangnam-gu, Seoul (Korea, Republic of); Ahn, Sung Jun [Severance Hospital, Department of Radiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul (Korea, Republic of); Chong, KyoungHoon [Siemens Healthcare Korea, Seodaemun-gu, Seoul (Korea, Republic of)

    2015-05-01

    To determine the feasibility of using a 70-kVp protocol compared with a 120-kVp protocol for cerebral CT angiography. An additional target was to investigate a possible reduction in the volume of contrast medium (CM) using the 70-kVp protocol. Attenuation value and CNR for iodine were determined at various tube voltage settings using a phantom. Sixty-nine volunteers were randomly assigned to one of three protocols: group A (120-kVp and CM 64 mL), group B (70-kVp and CM 64 mL), or group C (70-kVp and CM 40 mL). The attenuation value, SNR, and CNR of cerebral arteries, subjective image quality, and radiation dose were compared among the groups. The vascular attenuation, SNR, and CNR of group B were significantly higher than those of group A. Group C had a significantly higher vascular attenuation than group A. Groups B and C were significantly better than group A with respect to subjective image quality. An effective dose of 70-kVp was 10 % lower than that of 120-kVp. Using 70-kVp improved arterial enhancement, SNR, and CNR, and provided better subjective image quality, using a 10 % lower effective dose. Furthermore, the 70-kVp protocol may both reduce volume of CM by 37.5 % and improve arterial enhancement. (orig.)

  8. The Rare Association of Moyamoya Disease and Cerebral Arteriovenous Malformations: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Te Chang [Chi-Mei Foundation Hospital, Tainan (China); Guo, Wan Yuo; Wu, Hsiu Mei; Chang, Feng Chi; Shiau, Cheng Ying; Chung, Wen Yuh [Taipei Veterans General Hospital, Taipei (China)

    2008-07-15

    A 36-year-old man was diagnosed with a right temporal lobe grade II cerebral arteriovenous malformation (cAVM) and was treated with radiosurgery. At nine months after the cAVM radiosurgery, the patient began to develop bilateral focal narrowing at the M1 segments of the bilateral middle cerebral arteries. The narrowing progressively deteriorated as was demonstrated on longitudinal serial follow- up MR imaging. X-ray angiography performed at 51 months after radiosurgery confirmed that the cAVM was cured and a diagnosis of moyamoya disease. To the best of our knowledge, this is the first case of cAVM-associated moyamoya disease that developed after radiosurgery. Given the chronological sequence of disease development and radiation dose distribution of radiosurgery, it is proposed that humoral or unknown predisposing factors, rather than direct radiation effects, are the cause of moyamoya disease associated with cAVM.

  9. Dieta DASH na redução dos níveis de pressão arterial e prevenção do acidente vascular cerebral = DASH diet in reducing blood pressure and preventing stroke

    OpenAIRE

    Piper, Vanessa Alves

    2012-01-01

    Objetivos: Revisar a literatura científica buscando apurar o papel da dieta DASH (Dietary Approach to Stop Hypertension) na redução dos níveis de pressão arterial e na prevenção do acidente vascular cerebral Fonte de dados: Foi realizada uma revisão narrativa da literatura, utilizando as bases de dados Medline/PubMed, LILACS e SciELO. Buscaram-se artigos nos idiomas português e inglês, utilizando-se os descritores: acidente vascular cerebral/stroke, dieta/diet, hipertensão/hypertension e p...

  10. Papel da curva de agregação plaquetária no controle da antiagregação na prevenção secundária do acidente vascular cerebral isquêmico

    OpenAIRE

    Piedade Patrícia Regina; Gagliardi Rubens José; Damiani Ibsen Thadeo; Nassar Junior Antonio Paulo; Fuzaro Melissa Martins; Sanvito Wilson Luiz

    2003-01-01

    INTRODUÇÃO: O acidente vascular cerebral (AVC) é atualmente a primeira causa de morte no Brasil. O risco de recorrência de AVC é de aproximadamente 30% em cinco anos. Agentes antiagregantes plaquetários são frequentemente prescritos para a prevenção de recorrência do AVC, porém sem um parâmetro laboratorial de ajuste terapêutico. OBJETIVO: Determinar a aplicabilidade da curva de agregação plaquetária, no controle do antiagregante, na prevenção secundária do acidente vascular cerebral isquêmic...

  11. Activación del área motora primaria mediante RMf posrehabilitación en pacientes con miembro torácico parético, como secuela de enfermedad vascular cerebral

    OpenAIRE

    Cerrato-Cuadra,Alfonso; Carrillo-Mezo, Roger

    2005-01-01

    La rehabilitación es una parte básica en el tratamiento de las secuelas de un accidente vascular cerebral (AVC). Un 10% se recupera en su totalidad en forma espontánea y el 10 % no se recupera, 80 % se beneficia con el tratamiento. En el trabajo se presentan los resultados obtenidos en 20 pacientes tratados en el Instituto Nacional de Neurología y Neurocirugía con miembro torácico parético como secuela de un accidente vascular cerebral, usando distintos métodos de terapia.

  12. vascular hemiplegia

    OpenAIRE

    Voto Bernales, Jorge; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    The vascular hemiplegia is the functional disorder of a lateral half of the body produced by alterations of cerebral vessels. Should review the concepts of this common condition, with the dual aim of expanding its nosographic value and considering the hemiplegic patient as worthy of the highest professional care La hemiplejia vascular, es el trastorno funcional de una mitad lateral del cuerpo producido por alteraciones de los vasos cerebrales. Conviene revisar los conceptos sobre esta frec...

  13. Role of BKCa channels in diabetic vascular complications

    Institute of Scientific and Technical Information of China (English)

    Qian Lingling; Liu Xiaoyu; Wang Ruxing

    2014-01-01

    Objective This review focuses on the role of the large conductance calcium-activated potassium (BKCa) channels in diabetic vascular complications.Data sources Relevant articles published in English or Chinese from 1981 to present were selected from PubMed.The search terms were "BKCa channels" and "diabetes".Important references from selected articles were also retrieved.Study selection Articles regarding the role of BKCa channels in diabetic vascular complications and relevant mechanisms were selected.Results The BKCa channels are abundantly expressed in vascular smooth cells and play an important role in regulation of vascular tone.Multiple studies indicated that the expression and function of BKCa channels are altered by different mechanisms in diabetic vascular diseases such as coronary arterial disease,cerebral arterial disease,and diabetic retinopathy.Conclusion BKCa channels may play an important role in diabetic vascular complications and may be an effective therapeutic target for relieving and reducing the burden of diabetic vascular complications.

  14. Congenital Heart Disease: Vascular Risk Factors and Medication

    NARCIS (Netherlands)

    H.P.M. Smedts (Dineke)

    2011-01-01

    textabstractCongenital heart disease (CHD) is among the most common congenital abnormalities and involves structural anomalies of the heart and/or related major blood vessels. Congenital heart disease arises in the fi rst trimester of pregnancy, occurring often and in many forms. The reported CHD bi

  15. Use of an optical technique to evaluate the cerebral vascular effects of alcohol (A): Effects on deoxyhemoglobin (DH) and levels of reduced cytochrome oxidase (rCO)

    Energy Technology Data Exchange (ETDEWEB)

    Barbour, R.L.; Gebiewold, A.; Altura, B.M. (Southern Univ. of New York, Brooklyn (United States))

    1992-02-26

    The dose-response effects of acute A infusion were studied to examine the suggestion that A can induce stroke-like events as a consequence of cerebral vasospasm. By employing a single sending and receiving fiber, an optical backscatter measurement was employed to monitor the levels in DH and rCO in a closed cranium preparation. Anesthetized rats were prepared by cannulating a branch of the internal carotid artery and subjected to either a bolus infusion (BI) or to a constant infusion (CI) of 5 or 10% A at various rates. Results showed that low BI doses of A typically produced a slight increase in the oxyhemoglobin signal indicating that vasodilation had probably occurred. Higher BI doses, however, produced a prompt and significant reduction in the hemoglobin signal with a rise in rCO suggesting a vasoconstrictor response leading to ischemia, followed by recovery within 3-5 min. CI of A produced a similar cerebral vascular response, in a dose-related manner, but of a more sustained nature. At 30-50% of the BI dose levels, a global blanching of the brain surface occurred; rCO levels increased by 50-90% with a corresponding decline in levels of oxyhemoglobin. Control experiments using identical volumes/flow rates of Ringers solution failed to produce any alterations in the optical spectrum. Overall, these data indicate that, depending on dose, (a) A can induce vasodilatory or vasoconstrictor effects in the intact brain; (b) the more pronounced effects involve vasospasm in the cortical microcirculation leading to global ischemia as determined by elevated levels of rCO and DH; (c) optical measurements permit direct noninvasive assessment of the cerebral vascular effects of substances of abuse.

  16. Capillary pericytes regulate cerebral blood flow in health and disease

    DEFF Research Database (Denmark)

    Hall, Catherine N; Reynell, Clare; Gesslein, Bodil;

    2014-01-01

    Increases in brain blood flow, evoked by neuronal activity, power neural computation and form the basis of BOLD (blood-oxygen-level-dependent) functional imaging. Whether blood flow is controlled solely by arteriole smooth muscle, or also by capillary pericytes, is controversial. We demonstrate...... blood flow, capillaries dilate before arterioles and are estimated to produce 84% of the blood flow increase. In pathology, ischaemia evokes capillary constriction by pericytes. We show that this is followed by pericyte death in rigor, which may irreversibly constrict capillaries and damage the blood......-brain barrier. Thus, pericytes are major regulators of cerebral blood flow and initiators of functional imaging signals. Prevention of pericyte constriction and death may reduce the long-lasting blood flow decrease that damages neurons after stroke....

  17. Blood pressure and sodium: Association with MRI markers in cerebral small vessel disease

    OpenAIRE

    Heye, Anna K.; Thrippleton, Michael J; Chappell, Francesca M; Valdés Hernández, Maria del C.; Armitage, Paul A.; Makin, Stephen D.; Muñoz Maniega, Susana; Sakka, Eleni; Flatman, Peter W.; Dennis, Martin S.; Wardlaw, Joanna M.

    2016-01-01

    Dietary salt intake and hypertension are associated with increased risk of cardiovascular disease including stroke. We aimed to explore the influence of these factors, together with plasma sodium concentration, in cerebral small vessel disease (SVD). In all, 264 patients with nondisabling cortical or lacunar stroke were recruited. Patients were questioned about their salt intake and plasma sodium concentration was measured; brain tissue volume and white-matter hyperintensity (WMH) load were m...

  18. Cerebral microvascular pathology in aging and Alzheimer's disease

    NARCIS (Netherlands)

    Farkas, E; Luiten, PGM

    2001-01-01

    The aging of the central nervous system and the development of incapacitating neurological diseases like Alzheimer's disease (AD) are generally associated with a wide range of histological and pathophysiological changes eventually leading to compromised cognitive status. Although the diverse trigger

  19. Simultaneous occurrence of diabetic ketoacidosis, thyroid storm, and multiple cerebral infarctions due to Moyamoya disease.

    Science.gov (United States)

    Noh, Byoungho H; Cho, Sang-Won; Ahn, Sung Yeon

    2016-02-01

    Diabetic ketoacidosis (DKA) is one of the precipitating factors that can evoke a thyroid storm. Thyroid storm may cause cerebral ischemia in Moyamoya disease, which can coexist in patients with Graves' disease. A 16-year-old girl complaining of dizziness and palpitations visited the emergency department and was diagnosed with DKA combined with hyperthyroidism. A thyroid storm occurred 6 h after the start of DKA management. Her Burch and Wartofsky score was 65 points. Right hemiplegia developed during the thyroid storm, and brain magnetic resonance (MR) diffusion-weighted images revealed multiple acute infarcts in both hemispheres. MR angiography showed stenosis of both distal internal carotid arteries and both M1 portions of the middle cerebral arteries, consistent with Moyamoya disease. After acute management for the thyroid storm with methimazole, Lugol solution and hydrocortisone, the patient's neurological symptoms completely resolved within 1 month, and free T4 level normalized within 2 months. Thyroid storm may trigger cerebral ischemia in Moyamoya disease and lead to rapid progression of cerebrovascular occlusive disease. As a simultaneous occurrence of DKA, thyroid storm and cerebrovascular accident in Moyamoya disease highly elevates morbidity and mortality, prompt recognition and management are critical to save the patient's life.

  20. Regional cerebral blood flow and vasoreactivity to acetazolamide in childhood moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Satoshi; Hohkin, Kiyohiro; Kamiyama, Hiroyasu; Abe, Hiroshi [Hokkaido Univ., Sapporo (Japan). School of Medicine; Mitsumori, Kenji

    1995-04-01

    Using the 133-xenon inhalation method and single photon emission CT (SPECT), we measured regional cerebral blood flow (rCBF) and its reactivity to acetazolamide in 15 children with moyamoya disease (spontaneous occlusion of circle of Willis). In most of them, the mean hemispheric cerebral blood flow (mCBF) was similar to that of age-matched healthy children. However, their rCBF distribution was abnormal with low perfusion in the frontal and temporal lobes, and disturbed reactivity to acetazolamide in the frontal, temporal, and parietal lobes. After surgical revascularization of the anterior circulation with STA-MCA anastomosis and encephalo-duro-myo-anterio-sysnangiosis (EDAMS) these abnormal hemodynamics improved dramatically in the anterior circulation, including the frontal lobe. Postoperative SPECT studies revealed that cerebral vasodilatory capacity also improved in the occipital lobe and the basal ganglia. These results suggest that surgical revascularization of the anterior circulation should be carried out in order to improve cerebral hemodynamics as much as possible, especially in the frontal lobe, and it could also improve cerebral perfusion reserve in the posterior circulation. (author).

  1. MIXED HYALINE VASCULAR AND PLASMA CELL TYPE CASTLEMAN’S DISEASE: REPORT OF A CASE

    Directory of Open Access Journals (Sweden)

    F. Asgarani

    2006-05-01

    Full Text Available Castleman’s disease (angiofollicular lymphoid hyperplasia includes a heterogeneous group of lymphoproliferative disorders. The cause of this disease remains uncertain. There are two types of localized Castleman’s disease: the more common hyaline vascular and the plasma cell types. Mixed variant is an uncommon localized lesion in general population. The lesions can occur in any part of the body that contains lymphoid tissue, although seventy percent are found in the anterior mediastinum. We report a thirty years old boy with Castleman’s disease who presented with fever, anorexia, weight loss,sweating, anemia and abdominal mass. The histologic examination of the biopsy specimens revealed a mixed hyaline vascular and plasma cell type of Castleman’s disease.

  2. Systemic and cerebral vascular endothelial growth factor levels increase in murine cerebral malaria along with increased Calpain and caspase activity and can be reduced by erythropoietin treatment

    DEFF Research Database (Denmark)

    Hempel, Casper; Hoyer, Nils; Kildemoes, Anna;

    2014-01-01

    . Furthermore, we noticed increased caspase-3 and calpain activity in terminally ill mice, as measured by protease-specific cleavage of α-spectrin and p35. In conclusion, we detected increased cerebral and systemic VEGF as well as HIF-1α, which in the brain were reduced to normal in EPO-treated mice. Also...... caspase and calpain activity was reduced markedly in EPO-treated mice....

  3. Is misery perfusion still a predictor of stroke in symptomatic major cerebral artery disease?

    Science.gov (United States)

    Yamauchi, Hiroshi; Higashi, Tatsuya; Kagawa, Shinya; Nishii, Ryuichi; Kudo, Takashi; Sugimoto, Kanji; Okazawa, Hidehiko; Fukuyama, Hidenao

    2012-08-01

    Studies in the 1990s demonstrated that misery perfusion is a predictor of subsequent stroke in medically treated patients with symptomatic major cerebral artery disease. A recent randomized controlled trial demonstrated no benefit of bypass surgery for such patients. In this light, outcome in patients with misery perfusion has regained interest. The purpose of this study was to determine whether misery perfusion is still a predictor of subsequent stroke despite recent improvements in medical treatment for secondary prevention of stroke, and if so, whether the predictive value of misery perfusion has changed in recent years. We prospectively studied 165 non-disabled patients with symptomatic atherosclerotic internal carotid artery or middle cerebral artery occlusive diseases who underwent positron emission tomography from 1999 to 2008. Misery perfusion was defined as decreased cerebral blood flow, increased oxygen extraction fraction and decreased ratio of cerebral blood flow to blood volume in the hemisphere supplied by the diseased artery. All patients were followed up for 2 years until stroke recurrence or death. Bypass surgery was performed in 19 of 35 patients with and 16 of 130 patients without misery perfusion. The 2-year incidence of ipsilateral ischaemic stroke was six and four patients with and without misery perfusion, including two and one after surgery, respectively (P misery perfusion and 12 patients without (P misery perfusion in whole sample was 6.3 (95% confidence interval 1.7-22.4, P misery perfusion or bypass surgery did not differ. Between these periods, patients without misery perfusion demonstrated a decrease in stroke rate (from 16.2% to 0%), but patients with misery perfusion did not (26.3 and 25.0%). In symptomatic major cerebral artery disease, misery perfusion remains a predictor of subsequent stroke, although the recurrence rate was lower than the previous study. In patients without misery perfusion, the risk of stroke was reduced

  4. Prediction of vascular cerebral accidents by PET T.D.M. with {sup 18}F-F.D.G; Prediction des accidents vasculaires cerebraux par la TEP -TDM vasculaire au 18F-FDG

    Energy Technology Data Exchange (ETDEWEB)

    Grandpierre, S.; Chevalier, O.; Thomas, V.; Netter, F.; Meneroux, B.; Karcher, G.; Marie, P.Y. [Service de medecine nucleaire, CHU de Nancy, (France); Desandes, E. [departement d' informatique medical, centre Alexis-Vautrin, Nancy, (France)

    2009-05-15

    This study is the first to show a relationship between the vascular captation of the F.D.G. in PET and the risk of a later ischemic cerebral vascular accident. this relation seems particularly strong for the sources of the carotids junction, so that the PET with F.D.G. could be useful to evaluate the stability of atheromas injuries in this area. (N.C.)

  5. Clinical studies of cerebral circulation using single photon emission computed tomography, 2; Evaluation of cerebral blood flow after acetazolamide loading on moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Uno, Toshiro [Gifu Univ. (Japan). Faculty of Medicine

    1993-09-01

    To evaluate cerebral blood flow (CBF) in patients with moyamoya disease, single photon emission computed tomography (SPECT) was performed using acetazolamide-activated {sup 133}Xe inhalation method. In the present investigation, 15 patients were subjected: 6 pediatric cases with the mean age of 10.8 years and 9 adult cases with the mean age of 44.6 years. The regional CBF (rCBF) was measured in the territory of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), basal ganglia, and cerebellum. Cerebrovascular acetazolamide reactivity was evaluated from the rCBF measured before and after administration of acetazolamide. Namely, cerebrovascular acetazolamide reactivity was expressed as %CBF and calculated as follows: %CBF=100 x (CBF after acetazolamide administration-CBF at rest)/CBF at rest. rCBF in adult patients was decreased in the cerebral hemisphere, while that in childhood was significantly decreased in the territory of ACA. The %CBF after acetazolamide loading was decreased in the territory of ACA and MCA in both adult and childhood. When cerebral %CBF was compared to the cerebellar %CBF, the ratio of cerebral %CBF and cerebellar %CBF resulted in markedly lower in childhood than adult. rCBF and cerebrovascular acetazolamide reactivity were also measured before and after extracranial and intracranial (EC-IC) bypass surgery in three pediatric moyamoya patients. Although rCBF was increased immediately after EC-IC bypass surgery, the cerebrovascular acetazolamide reactivity remained blunted. These results meant that in the pediatric moyamoya patients cerebrovascular acetazolamide reactivity is more blunted than adult moyamoya patients. Also, the cerebral vessels in moyamoya disease were considered to be dilated to their limitation by the blood supplied through the EC-IC bypass and not to be expandable any more by acetazolamide. (author) 45 refs.

  6. [Multicentric hyaline vascular Castleman's disease. A POEMS type variant].

    Science.gov (United States)

    Gracia-Ramos, Abraham Edgar; Cruz-Domínguez, María del Pilar; Vera-Lastra, Olga Lidia

    2013-01-01

    Introducción: la enfermedad de Castleman es un trastorno linfoproliferativo atípico en el que pueden existir manifestaciones compatibles con síndrome POEMS. Caso clínico: hombre de 53 años de edad con antecedente de diabetes mellitus tipo 2, hipotiroidismo y enfermedad de Addison. Se iniciaron parestesias y debilidad en las extremidades y, posteriormente, disnea, endurecimiento cutáneo, fenómeno de Raynaud y pérdida de peso. Se identificó taquipnea, hiperpigmentación cutánea generalizada y extremidades con endurecimiento cutáneo, debilidad muscular, hipoestesia e hiporreflexia; así como hiperprolactinemia, testosterona baja, hipotiroidismo y enfermedad de Addison; los anticuerpos antinucleares y antiScl-70 fueron negativos. Los potenciales evocados somatosensoriales indicaron neuropatía periférica y la electromiografía, olineuropatía axonal severa. Radiografía torácica: infiltrado reticular bilateral y ensanchamiento mediastinal. Electrocardiograma: hipertensión arterial pulmonar moderada. Tomografía toracoabdominal: ganglios axilares, mediastinales y retroperitoneales. Con la biopsia se identificó enfermedad de Castleman multicéntrica hialina vascular. El paciente recibió rituximab. Conclusiones: si bien la experiencia con el rituximab aún es limitada, en el caso descrito se observó buena respuesta.

  7. Clinical value of detection on serum monocyte chemotactant protein-1 and vascular endothelial cadherin levels in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Xia Zhou; Cheng Zhang

    2016-01-01

    Objective: To study the correlation of serum monocyte chemotactant protein-1 (MCP-1) and vascular endothelia cadherin (VE-cadherin) levels in patients with acute cerebral infarction, and nerve injury molecules, interleukins and matrix metalloproteinases. Methods: A total of 86 patients with acute cerebral infarction treated in our hospital from April 2012 to October 2015 were selected as the observation group and 50 healthy subjects in the same period treated in our hospital were selected as the control group. The serums were collected and the contents of MCP-1, VE-cadherin, heart-type fatty acid binding protein (H-FABP), S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), interleukin-lb (IL-1b), IL-6, IL-17, IL-18, matrix metalloproteinase-2 (MMP2), MMP3 and MMP9 were measured. Results: The serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 in observation group were significantly higher than those of control group. Carotid artery plaque formation and unstable plaque properties will increase the serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 in patients with cerebral infarction. The serum levels of MCP-1, VE-cadherin and the contents of H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 were positively correlated. Conclusions: The serum levels of VE-cadherin and MCP-1 were significantly increased in patients with acute cerebral infarction. MCP-1 and VE-cadherin can increase the secretion of interleukins and matrix metalloproteinases, which can result in the carotid artery plaque formation, unstable plaque properties and the injury of nerve function.

  8. Clinical value of detection on ser um monocyte chemotactant protein-1 and vascular endothelial cadher in levels in patients with acute cerebral infarction

    Directory of Open Access Journals (Sweden)

    Xia Zhou

    2016-11-01

    Full Text Available Objective: To study the correlation of serum monocyte chemotactant protein-1 (MCP-1 and vascular endothelia cadherin (VE-cadherin levels in patients with acute cerebral infarction, and nerve injury molecules, interleukins and matrix metalloproteinases. Methods: A total of 86 patients with acute cerebral infarction treated in our hospital from April 2012 to October 2015 were selected as the observation group and 50 healthy subjects in the same period treated in our hospital were selected as the control group. The serums were collected and the contents of MCP-1, VE-cadherin, heart-type fatty acid binding protein (H-FABP, S100 calcium binding protein B (S100B, neuron-specific enolase (NSE, interleukin-lb (IL-1b, IL-6, IL-17, IL-18, matrix metalloproteinase-2 (MMP2, MMP3 and MMP9 were measured. Results: The serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL- 6, IL-17, IL-18, MMP2, MMP3 and MMP9 in observation group were significantly higher than those of control group. Carotid artery plaque formation and unstable plaque properties will increase the serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 in patients with cerebral infarction. The serum levels of MCP-1, VE-cadherin and the contents of H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 were positively correlated. Conclusions: The serum levels of VE-cadherin and MCP-1 were significantly increased in patients with acute cerebral infarction. MCP-1 and VE-cadherin can increase the secretion of interleukins and matrix metalloproteinases, which can result in the carotid artery plaque formation, unstable plaque properties and the injury of nerve function.

  9. Cerebral hemodynamics of the aging brain: risk of Alzheimer disease and benefit of aerobic exercise

    OpenAIRE

    Takashi eTarumi; Rong eZhang

    2014-01-01

    Alzheimer disease (AD) and cerebrovascular disease often coexist with advanced age. Mounting evidence indicates that the presence of vascular disease and its risk factors increase the risk of AD, suggesting a potential overlap of the underlying pathophysiological mechanisms. In particular, atherosclerosis, endothelial dysfunction, and stiffening of central elastic arteries have been shown to associate with AD. Currently, there are no effective treatments for the cure and prevention of AD. Vas...

  10. O G-CSF na terapia do acidente vascular cerebral The potential role of G-CSF in stroke

    Directory of Open Access Journals (Sweden)

    Angelo L. Maset

    2009-05-01

    Full Text Available O fator estimulador de colônias granulocitárias (G-CSF é uma glicoproteína descrita há mais de vinte anos, e é largamente utilizada para tratamento de estados neutropênicos e no transplante de medula óssea. O G-CSF estimula células-tronco hematopoéticas e regula crucialmente a sobrevivência de neutrófilos maduros, pós-mitóticos, através da inibição da apoptose. Além do efeito sistêmico, mais recentemente tem-se demonstrado uma surpreendente atividade do G-CSF no sistema nervoso central. A administração de G-CSF mobiliza células-tronco e progenitoras da medula óssea para o sangue periférico, que, por sua vez, atravessa a barreira hemato-encefálica (BHE e se dirige à área acometida do cérebro. A atividade do G-CSF no sistema nervoso central tem sido caracterizada como multimodal, pois, além do efeito mobilizador de células da medula óssea, demonstrou uma ação direta neuroprotetora através de diferentes mecanismos, tais como a atividade antiapoptótica em neurônios, regeneração da vascularização, efeito anti-inflamatório e estimulação da neurogênese endógena. Este relato sumariza a ação do G-CSF no sistema nervoso central e aborda seu potencial para o emprego no acidente vascular cerebral.The granulocyte colony-stimulating-factor (G-CSF is a glycoproteina which has been described for decades, and it is commonly utilized in the treatment of neutropenic states and bone marrow transplants. G-CSF stimulates hematopoietic stem-cels e crucially regulates the survival of mature neutrophils through a mechanism of apoptosis inhibition. Beyond its systemic effect, recently it has been shown its surprising activity in the central nervous system (CNS. G-CSF administration mobilizes bone marrow stem cells para systemic blood, and those cells cross the blood-brain-barrier e target brain's damaged area. G-CSF's activity in the CNS has been defined as multimodal, because additionally it has been demonstrated a direct

  11. Early expressions of hypoxia-inducible factor 1alpha and vascular endothelial growth factor increase the neuronal plasticity of activated endogenous neural stem cells after focal cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Seung Song; Jong-Tae Park; Joo Young Na; Man-Seok Park; Jeong-Kil Lee; Min-Cheol Lee; Hyung-Seok Kim

    2014-01-01

    Endogenous neural stem cells become “activated” after neuronal injury, but the activation sequence and fate of endogenous neural stem cells in focal cerebral ischemia model are little known. We evaluated the relationships between neural stem cells and hypoxia-inducible fac-tor-1α and vascular endothelial growth factor expression in a photothromobotic rat stroke model using immunohistochemistry and western blot analysis. We also evaluated the chrono-logical changes of neural stem cells by 5-bromo-2′-deoxyuridine (BrdU) incorporation. Hypoxia-inducible factor-1α expression was initially increased from 1 hour after ischemic injury, followed by vascular endothelial growth factor expression. Hypoxia-inducible factor-1αimmunoreactivity was detected in the ipsilateral cortical neurons of the infarct core and peri-in-farct area. Vascular endothelial growth factor immunoreactivity was detected in bilateral cortex, but ipsilateral cortex staining intensity and numbers were greater than the contralateral cortex. Vascular endothelial growth factor immunoreactive cells were easily found along the peri-infarct area 12 hours after focal cerebral ischemia. The expression of nestin increased throughout the microvasculature in the ischemic core and the peri-infarct area in all experimental rats after 24 hours of ischemic injury. Nestin immunoreactivity increased in the subventricular zone during 12 hours to 3 days, and prominently increased in the ipsilateral cortex between 3-7 days. Nes-tin-labeled cells showed dual differentiation with microvessels near the infarct core and reactive astrocytes in the peri-infarct area. BrdU-labeled cells were increased gradually from day 1 in the ipsilateral subventricular zone and cortex, and numerous BrdU-labeled cells were observed in the peri-infarct area and non-lesioned cortex at 3 days. BrdU-labeled cells rather than neu-rons, were mainly co-labeled with nestin and GFAP. Early expressions of hypoxia-inducible factor-1α and

  12. Age-related changes in the sympathetic innervation of cerebral vessels and in carotid vascular responses to norepinephrine in the rat: in vitro and in vivo studies.

    Science.gov (United States)

    Omar, Nisreen Mansour; Marshall, Janice M

    2010-08-01

    We hypothesized that the density of sympathetic noradrenergic innervation of cerebral arteries and vasoconstrictor responses evoked in carotid circulation by norepinephrine (NE) increase with maturation and age. In rats of 4-5, 10-12, and 42-44 wk of age (juvenile, mature, middle aged), glyoxylic acid applied to stretch preparations showed the density of noradrenergic nerves in basilar and middle cerebral arteries was greater in mature than juvenile or middle-aged rats. In anesthetized rats, infusion of NE (2.5 mug/kg iv) increased mean arterial pressure (ABP) to approximately 180 mmHg in mature and middle-aged but to only approximately 150 mmHg in juveniles rats. Concomitantly, carotid blood flow (CBF) decreased in mature and middle-aged rats but remained constant in juveniles because carotid vascular conductance (CVC) decreased more in mature and middle-aged than juvenile rats. We also hypothesized that nitric oxide (NO) blunts cerebral vasoconstrictor responses to NE. Inhibition of NO synthase with l-NAME (10 mg/kg iv) induced similar increases in baseline ABP in each group, but larger decreases in CVC and CBF in mature and middle-aged than juvenile rats. Thereafter, the NE-evoked increase in ABP was similar in juvenile and mature but accentuated in middle-aged rats. Concomitantly, NE decreased CVC in juvenile and mature, but not middle-aged rats; in them, CBF increased. Thus, in juvenile rats, sparse noradrenergic innervation of cerebral arteries is associated with weak NE-evoked pressor responses and weak carotid vasoconstriction that allows autoregulation of CBF. Cerebral artery innervation density increases with maturation but lessens by middle age. Meanwhile, NE-evoked pressor responses and carotid vasoconstriction are stronger in mature and middle-aged rats, such that CBF falls despite the evoked increase in ABP. We propose that in juvenile and mature rats, NO does not modulate NE-evoked pressor responses, cerebral vasoconstriction, or CBF autoregulation

  13. Atherosclerosis in vascular grafts for peripheral vascular disease. Part 2. Synthetic arterial prostheses.

    Science.gov (United States)

    Walton, K W; Slaney, G; Ashton, F

    1986-08-01

    Thirty-nine synthetic (32 Dacron and 7 Teflon) arterial prostheses (from 38 patients with peripheral arterial disease) removed after periods between 2 months and 18 years, were examined by histology and immuno-histology. The grafts were initially permeated by thrombus containing platelet antigens and this became organised and converted to granulation, and then to fibrous, tissue. The newly-formed tissue contained 'foreign-body' giant-cells in contact with the plastic prosthesis and showed evidence of permeation by plasma proteins. In grafts of over 2 years duration, this reactive tissue no longer contained platelet antigens but invariably revealed bound lipid, identifiable as apolipoprotein-B-containing lipoproteins (LpB), and fibrinogen-related antigens (FRA), in a distribution resembling that seen in atherosclerotic arteries. LpB and FRA were also seen in organised, or partially organised, mural thrombi in older grafts. The oldest grafts additionally showed stenosis, calcification or aneurysm formation. Lipid deposition increases with the age of grafts; is independent of the nature of the plastic fibre used or its mode of fabrication; and sometimes contributes to graft failure. Immuno-histology indicates that this is an insudative process indistinguishable from 'true' atherosclerosis which occurs in graft-linings of prostheses of long duration and in old mural thrombi in grafts and that the lipid in these lesions derives from plasma LpB rather than from platelets. This source for the lipid suggests that the insudative and thrombogenic theories of atherogenesis can be reconciled.

  14. Role of thalamic diffusion for disease differentiation between multiple sclerosis and ischemic cerebral small vessel disease

    Energy Technology Data Exchange (ETDEWEB)

    Oeztoprak, Bilge; Oeztoprak, Ibrahim; Salk, Ismail [Cumhuriyet University School of Medicine, Department of Radiology, Sivas (Turkey); Topalkara, Kamil [Bayindir Hospital, Department of Neurology, Ankara (Turkey); Erkoc, Mustafa F. [Bozok University School of Medicine, Department of Radiology, Yozgat (Turkey)

    2015-04-01

    Cerebral small vessel disease (CSVD) and multiple sclerosis (MS) both harbor multiple, T2-hyperintense white matter lesions on conventional magnetic resonance imaging (MRI).We aimed to determine the microstructural changes via diffusion-weighted imaging (DWI) in normal appearing thalami. We hypothesized that the apparent diffusion coefficient (ADC) values would be different in CSVD and MS, since the extent of arterial involvement is different in these two diseases. DWI was performed for 50 patients with CSVD and 35 patients with MS along with gender- and age-matched controls whose conventional MRI revealed normal findings. DWI was done with 1.5 Tesla MR devices using echo planar imaging (EPI) for b = 0, 1000 s/mm{sup 2}. ADC values were obtained from the thalami which appeared normal on T2-weighted and FLAIR images. Standard oval regions of interest (ROIs) of 0.5 cm{sup 2} which were oriented parallel to the long axis of the thalamus were used for this purpose. The mean ADC value of the thalamus was (0.99 ± 0.16) x 10{sup -3} mm{sup 2}/s in patients with CSVD, whereas the mean ADC value was (0.78 ± 0.06) x 10{sup -3} mm{sup 2}/s in the control group. The mean ADC value was significantly higher in patients with CSVD compared to the controls (p < 0.001). The mean ADC values of the thalamus were (0.78 ± 0.08) x 10{sup -3} mm{sup 2}/s in MS patients, and (0.75 ± 0.08) x 10{sup -3} mm{sup 2}/s in the control group, which are not significantly different (p > 0.05). Our study revealed a difference in the diffusion of the thalami between CSVD and MS. DWI may aid in the radiological disease differentiation. (orig.)

  15. Vascular function assessed with cardiovascular magnetic resonance predicts survival in patients with advanced chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Steedman Tracey

    2008-08-01

    Full Text Available Abstract Background Increased arterial stiffness is associated with mortality in patients with chronic kidney disease. Cardiovascular magnetic resonance (CMR permits assessment of the central arteries to measure aortic function. Methods We studied the relationship between central haemodynamics and outcome using CMR in 144 chronic kidney disease patients with estimated glomerular filtration rate Results Median follow up after the scan was 24 months. There were no significant differences in aortic distensibilty or aortic volumetric arterial strain between pre-dialysis and dialysis patients. Aortic distensibilty and volumetric arterial strain negatively correlated with age. Aortic distensibilty and volumetric arterial strain were lower in diabetics, patients with ischaemic heart disease and peripheral vascular disease. During follow up there were 20 deaths. Patients who died had lower aortic distensibilty than survivors. In a survival analysis, diabetes, systolic blood pressure and aortic distensibilty were independent predictors of mortality. There were 12 non-fatal cardiovascular events during follow up. Analysing the combined end point of death or a vascular event, diabetes, aortic distensibilty and volumetric arterial strain were predictors of events. Conclusion Deranged vascular function measured with CMR correlates with cardiovascular risk factors and predicts outcome. CMR measures of vascular function are potential targets for interventions to reduce cardiovascular risk.

  16. An update on type 2 diabetes, vascular dementia and Alzheimer's disease

    NARCIS (Netherlands)

    Exalto, L. G.; Whitmer, R. A.; Kappele, L. J.; Biessels, G. J.

    2012-01-01

    The risk of dementia is increased in people with type 2 diabetes mellitus (T2DM). This review gives an update on the relation between T2DM and specific dementia subtypes - i.e. Alzheimer's disease and vascular dementia and underlying pathologies. We will show that while epidemiological studies link

  17. Aspects of Subcortical Ischaemic Vascular Disease : Early clinical manifestations and associations with Type 2 diabetes mellitus

    NARCIS (Netherlands)

    Harten, van B.

    2006-01-01

    Summary Subcortical ischaemic vascular disease (SIVD) is an important cause of cognitive impairment in elderly patients. Screening and diagnostic tests are needed to identify these patients. The HIV dementia scale (HDS) is a reliable and quantitative scale for identifying HIV dementia1. The cogniti

  18. Digital subtraction angiography in cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sin Young; Kim, Ji Hun; Suh, Hong Kil; Kim, Hyo Heon; Kwack, Eun Young; Lee, Il Seong [College of Medicine Hallym University, Seoul (Korea, Republic of)

    1995-01-15

    The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the angiographic causes, findings, and the usefulness of DSA in cerebral infarction. The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional angiogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. Among the 51 patients of cerebral infarction 43 patients (84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in angiogram. DSA findings of cerebral atherosclerosis were multiple narrowing in 42 patients (97.7%), tortuosity in 22 (51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients (86.0%), middle cerebral artery in 29 (67.4%) posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement (16.2%). In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered.

  19. Clinical features and coronary backgrounds of coexistent peripheral vascular disease in Japanese coronary artery disease patients.

    Science.gov (United States)

    Seino, Y; Takita, T; Tanaka, K; Takano, T; Hayakawa, H; Okumura, H

    1991-11-01

    By use of noninvasive tests (Doppler segmental pressure study, supraorbital Doppler flow analysis, and segmental plethysmography), coexistent carotid (CTD) or lower extremity peripheral vascular disease (PVD) were diagnosed and correlated with subjective symptoms, coronary risk factors (CRFs), coronary arteriograms (CAGs), cardiac hemodynamics, and infarct size in 121 consecutive patients with documented coronary artery disease (CAD). PVD was found in 16.5%, CTD in 33.1%, and both PVD and CTD in 9.9% of the patients studied; 20% of PVD patients and 47.5% of CTD patients were asymptomatic with respect to coexistent PVD or CTD. There were no significant differences between the presence or absence of PVD or CTD as regards number of CRFs, Killip classification, cardiac hemodynamics, or number of stenotic coronary arteries. However, serum creatine kinase (CK) and CKMB release curves in the PVD group showed significantly higher peak CK and peak CKMB values than those in the PVD(-) group (4096 +/- 5408/282 +/- 263 vs 1706 +/- 1715/179 +/- 186, p less than 0.05) because of the higher prevalence (100%) of multivessel disease on CAG. Investigation of the relationship of CRFs to coexistent PVD revealed that the smoking ratio in men (86.7%) and the hypertension ratio in women (80%) were extremely high in PVD patients, and statistically significant differences between PVD(+) patients and PVD(-) groups were found with respect to the obesity ratio (p less than 0.05) in men and the hypercholesterolemia ratio (p less than 0.05) and obesity ratio (60%, p less than 0.05) in women.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Cohort study of predictive value of urinary albumin excretion for atherosclerotic vascular disease in patients with insulin dependent diabetes

    DEFF Research Database (Denmark)

    Deckert, T; Yokoyama, H; Mathiesen, E

    1996-01-01

    atherosclerotic vascular disease during follow up of 2457 person year. Elevated urinary albumin excretion was significantly predictive of atherosclerotic vascular disease (hazard ratio 1.06 (95% confidence interval 1.02 to 1.18) per 5 mg increase in 24 hour urinary albumin excretion, P = 0.002). Predictive effect...

  1. Notch Signaling in Vascular Smooth Muscle Cells.

    Science.gov (United States)

    Baeten, J T; Lilly, B

    2017-01-01

    The Notch signaling pathway is a highly conserved pathway involved in cell fate determination in embryonic development and also functions in the regulation of physiological processes in several systems. It plays an especially important role in vascular development and physiology by influencing angiogenesis, vessel patterning, arterial/venous specification, and vascular smooth muscle biology. Aberrant or dysregulated Notch signaling is the cause of or a contributing factor to many vascular disorders, including inherited vascular diseases, such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, associated with degeneration of the smooth muscle layer in cerebral arteries. Like most signaling pathways, the Notch signaling axis is influenced by complex interactions with mediators of other signaling pathways. This complexity is also compounded by different members of the Notch family having both overlapping and unique functions. Thus, it is vital to fully understand the roles and interactions of each Notch family member in order to effectively and specifically target their exact contributions to vascular disease. In this chapter, we will review the Notch signaling pathway in vascular smooth muscle cells as it relates to vascular development and human disease.

  2. Typical Cerebral Metabolic Patterns in Neurodegenerative Brain Diseases

    NARCIS (Netherlands)

    Teune, Laura K.; Bartels, Anna L.; de Jong, Bauke M.; Willemsen, Antoon T. M.; Eshuis, Silvia A.; de Vries, Jeroen J.; van Oostrom, Joost C. H.; Leenders, Klaus L.

    2010-01-01

    The differential diagnosis of neurodegenerative brain diseases on clinical grounds is difficult, especially at an early disease stage. Several studies have found specific regional differences of brain metabolism applying [F-18]-fluoro-deoxyglucose positron emission tomography (FDG-PET), suggesting t

  3. Microparticles: A Pivotal Nexus in Vascular Homeostasis and Disease.

    Science.gov (United States)

    McGinn, Ciaran M; MacDonnell, Brian F; Shan, Chun Xu; Wallace, Robert; Cummins, Philip M; Murphy, Ronan P

    2016-01-01

    Microvesicles (MVs) are submicron intact particles released from the cellular membrane of eukaryotic cells. MVs can be sub-categorised into microparticles (MPs), which are between 100nm- 1micron in size, and exosomes, measuring less than 100nm. Once thought to be cellular debris, MPs are now known to play important biological effector functions. Their biogenesis and release are as a result highly regulated processes in response to cellular activation or stress, and apoptosis. MPs are now known to play a crucial role in maintaining physiological homeostasis and have been demonstrated to be involved in numerous biological processes, including inflammation, cardiovascular disease, immune response, cancer dissemination, coagulation and angiogenesis. Consequently, there is active interest in studying MPs, and their 'cause and effect' in the initiation and potentiation of various pathologies. Circulating levels, both quantitative and qualitative, of MPs is thought to be a reflective index of cardiovascular competence. Therefore, studies to understand the biological relevance of the various permutations and combinations of circulating MPs, their cellular origin and bioactive cargo may lead to increased understanding of the sequelae of CVD and associated diseases. This review synopsizes our current understanding of the role of MPs in cardiovascular disease, their biogenesis and effector function, and their future use as both diagnostic and prognostic indices of cardiovascular disease.

  4. Thiopurines and inhibition of Rac1 in vascular disease

    NARCIS (Netherlands)

    G. Marinković

    2015-01-01

    The mechanism of immunosuppressive drug azathioprine is not clear, while azathioprine has been used for 60 years in clinical practice in patients undergoing transplantation surgery or to combat autoimmune disease. Part of the function of azathioprine became evident in specific immune cells, namely T

  5. Fatigue in Parkinson's disease: The contribution of cerebral metabolic changes.

    Science.gov (United States)

    Cho, Sang Soo; Aminian, Kelly; Li, Crystal; Lang, Anthony E; Houle, Sylvain; Strafella, Antonio P

    2017-01-01

    Fatigue is a common and disabling non-motor symptom in Parkinson's disease associated with a feeling of overwhelming lack of energy. The aim of this study was to identify the neural substrates that may contribute to the development of fatigue in Parkinson's disease. Twenty-three Parkinson's disease patients meeting UK Brain Bank criteria for the diagnosis of idiopathic Parkinson's disease were recruited and completed the 2-[(18) F]fluoro-2-deoxy-D-glucose (FDG)-PET scan. The metabolic activities of Parkinson's disease patients with fatigue were compared to those without fatigue using statistical parametric mapping analysis. The Parkinson's disease group exhibiting higher level of fatigue showed anti-correlated metabolic changes in cortical regions associated with the salience (i.e., right insular region) and default (i.e., bilateral posterior cingulate cortex) networks. The metabolic abnormalities detected in these brain regions displayed a significant correlation with level of fatigue and were associated with a disruption of the functional correlations with different cortical areas. These observations suggest that fatigue in Parkinson's disease may be the expression of metabolic abnormalities and impaired functional interactions between brain regions linked to the salience network and other neural networks. Hum Brain Mapp 38:283-292, 2017. © 2016 Wiley Periodicals, Inc.

  6. [Vascular rehabilitation in patients with peripheral arterial disease].

    Science.gov (United States)

    de Holanda, Ana; Aubourg, Marion; Dubus-Bausière, Valérie; Eveno, Dominique; Abraham, Pierre

    2013-06-01

    Lower limb peripheral arterial disease (PAD) is a frequent debilitating disease associated with a high morbidity and mortality rate. The benefit of rehabilitation in PAD patients has been largely demonstrated, both for patients that undergo amputation, and for patients with claudication. In these latter patients, rehabilitation programs rely on a variety of additional techniques or tools, among which: stretching, specific muscle proprioception, walking and a variety of other physical activities, exercise or situations adapted to community life, lower limb and respiratory physiotherapy, patient's education, support for smoking cessation and healthy nutrition, social support, etc. Whether rehabilitation is performed in specialised integrated structures or performed on a home-based basis, various clinicians are involved. Despite evidence-based proof of efficacy, rehabilitation of PAD patients with claudication is still under-used.

  7. Antiphospholipid Syndrome and Vascular Ischemic (Occlusive) Diseases: An Overview

    OpenAIRE

    2007-01-01

    Antiphospholipid syndrome (APS) is primarily considered to be an autoimmune pathological condition that is also referred to as "Hughes syndrome". It is characterized by arterial and/or venous thrombosis and pregnancy pathologies in the presence of anticardiolipin antibodies and/or lupus anticoagulant. APS can occur either as a primary disease or secondary to a connective tissue disorder, most frequently systemic lupus erythematosus (SLE). Damage to the nervous system is one of the most promin...

  8. The Role of Various Stressors in the Trigger Mechanism of Raynaud's Disease (Hemorheological and Vascular Reactions

    Directory of Open Access Journals (Sweden)

    Mantskava M.M.

    2014-05-01

    Full Text Available The emergence and spread of stress reactions are provided by the blood circulation system. In its turn, the adequacy of blood circulation depends on the hemorheological and vascular mechanisms. The changeability of their properties appears to be the basis of the increasing of stress stages. From the viewpoint of biophysical reactions, any change and movement occur with the expenditure and accumulation of energy. Higher level of adaptation energy waste and secondary level take place, when a small stressor entails a small expenditure. There is a maximum possible rate of adaptive energy consumption and at this maximum the organism cannot cope with any additional stimulus. At the same time adaptive and stress diseases develop. Let’s consider the duration and manifestation of Raynaud's disease from the perspective of adaptation diseases and diseases of the third grade, which appears to be the cause of the double stress effect - cold and emotional- physical and psychic. Total of 97 patients with Raynaud's disease were examined. For a new vision of the problem it was necessary to find out how the streessors of various nature impact the hemoreheological status and vascular resistance. For this purpose all the patients were examined for a resistance index of resistive arteries of the hand and the indices of erythrocyte aggregation and deformability. The patients were divided into four subgroups. The first subgroup – the patients after chilblain, the second subgroup – the patients with psychic strerssor, the third subgroup – the patients with prolonged chronic stress, and the fourth subgroup – the patients without the differentiation of the stressors. According to the obtained results, it is obvious that at cold and emotional stress (I and II subgroups the hemorheological and vascular parameters are changed. However, this change (hemorheological and vascular is more pronounced at chronic emotional stress (III subgroup as compared both to the

  9. Comparative assessment of vascular function in autoimmune rheumatic diseases: considerations of prevention and treatment.

    Science.gov (United States)

    Soltész, Pál; Kerekes, György; Dér, Henriett; Szücs, Gabriella; Szántó, Sándor; Kiss, Emese; Bodolay, Edit; Zeher, Margit; Timár, Orsolya; Szodoray, Péter; Szegedi, Gyula; Szekanecz, Zoltán

    2011-05-01

    Numerous autoimmune-inflammatory rheumatic diseases have been associated with accelerated atherosclerosis or other types of vasculopathy leading to increased cardio- and cerebrovascular disease risk. Traditional risk factors, as well as the role of systemic inflammation including cytokines, chemokines, proteases, autoantibodies, adhesion receptors and others have been implicated in the development of these vascular pathologies. The characteristics of vasculopathies may significantly differ depending on the underlying disease. While classical accelerated atherosclerosis has been associated with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or spondyloarthropathies (SpA), obliterative vasculopathy may rather be characteristic for systemic sclerosis (SSc) or mixed connective tissue disease (MCTD). Antiphospholipid antibodies have been implicated in vasculopathies underlying SLE, antiphospholipid syndrome (APS), RA and MCTD. There is also heterogeneity with respect to inflammatory risk factors. Cytokines, such as tumor necrosis factor-α (TNF-α) or interleukin 6 (IL-6) and immune complexes are primarily involved in arthritides, such as RA, SpA, as well as in SLE. On the other hand, autoantibodies including anti-oxLDL anti-cardiolipin and anti-β2GPI are rather involved in SLE- and APS-associated vasculopathies. Regarding the non-invasive assessment of vascular function, endothelial dysfunction, overt atherosclerosis and vascular stiffness may be indicated by brachial artery flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT) and aortic pulse-wave velocity (PWV), respectively. These abnormalities have been described in most inflammatory rheumatic diseases. While ccIMT and stiffness are relatively stable, FMD may be influenced by many confounding factors. In addition to traditional vasculoprotection, immunosuppressive agents including corticosteroids, traditional and biologic DMARDs may have significant vascular and metabolic

  10. Increased cerebral oxygen extraction capacity in patients with Alzheimer’s disease

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Gyldensted, Louise; Nagenthiraja, Kartheeban;

    Vascular risk factors are suspected to play a role in the etiology of Alzheimer’s disease. Recently, a model that relates capillary dysfunction to the development of AD was proposed [1]. The model predicts that increased capillary dysfunction leads to increased oxygen extraction in order to support...

  11. Clinical and magnetic resonance observations in cerebral small-vessel disease

    NARCIS (Netherlands)

    Kwa, V.I.H.

    1999-01-01

    The study reported in this thesis tried to address the following questions: 1. Is it possible to detect genetic factors and vascular risk factors that are specifically associated with the development of small- or large-vessel disease? 2. Are the different clinical and MRI manifestations, that are at

  12. Risk factors and ankle brachial indexes in cerebral infarction combined with peripheral arterial disease

    Institute of Scientific and Technical Information of China (English)

    Huihua Liu; Jun Wang

    2006-01-01

    BACKGROUND: Ankle brachial index(ABI)is widely involved in researches and clinical application of peripheral vascular injury of patients with diabetes (DM);however ,the application in cerebral infarction(CI)is rare.OBJECTIVE: To investigate the possible risk factor of cerebral infarction plus peripheral arterial disease(PAD),compare metabolic characteristics of patients who having CI plus PAD or only having CI,and understand the significance of ABI on screening and diagnosing CI plus PAD of lower limb.DESIGN: Contrast observation based on CI patients.SETTING: Deparment of Neurology,Nanxishan Hospital of Guangxi Zhang Autonomous Region.PARTICIPANTS:A total of 124 CI patients were selected from Department of Neurology.Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2005 to April 2006,including 72 males and 52 females aged from 45 to 88 years.All patients met the diagnostic criteria of cerebrovascular disease established by National Academic Conference of Cerebrovascular Diseases in 1995 and determined as cerebral infarction with MRI or CT examination.All patients provided informed consent.There were 46 cases(37.2%)with CI plus PAD and 78 cases(62.8%)only with CI.METHODS: Blood pressure of bilateral ankles and upper extremities was measured at plain clinostatism with DINAMAP blood pressure monitor(GE Company).The ratio between average systolic pressure of lateral ankle and average systolic pressure of both upper extremities was regarded as ABI.The normal ABI was equal to or more than 0.9.If ABI<0.9 occurred at one side,patients were diagnosed as PAD.On the second morning after hospitalization,blood was collected to measure fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG2h),glycosylated hemoglobin(HbAlc),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).Among them,blood glucose.lipid and other biochemical markers were measured with enzyme chemistry assay

  13. Reduced 25-hydroxyvitamin D and risk of Alzheimer's disease and vascular dementia

    DEFF Research Database (Denmark)

    Afzal, Shoaib; Bojesen, Stig E; Nordestgaard, Børge G

    2014-01-01

    BACKGROUND: Vitamin D deficiency has been implicated as a risk factor for dementia in several cross-sectional studies. We tested the hypothesis that reduced plasma 25-hydroxyvitamin D (25[OH]D) is associated with increased risk of Alzheimer's disease (AD) and vascular dementia in the general...... point of AD and vascular dementia in this prospective cohort study of the general population....... population. METHODS: We measured baseline plasma 25(OH)D in 10,186 white individuals from the Danish general population. RESULTS: During 30 years of follow-up, 418 participants developed AD and 92 developed vascular dementia. Multivariable adjusted hazard ratios for AD were 1.25 (95% confidence interval [CI...

  14. Decreased microRNA is involved in the vascular remodeling abnormalities in chronic kidney disease (CKD.

    Directory of Open Access Journals (Sweden)

    Neal X Chen

    Full Text Available Patients with CKD have abnormal vascular remodeling that is a risk factor for cardiovascular disease. MicroRNAs (miRNAs control mRNA expression intracellularly and are secreted into the circulation; three miRNAs (miR-125b, miR-145 and miR-155 are known to alter vascular smooth muscle cell (VSMC proliferation and differentiation. We measured these vascular miRNAs in blood from 90 patients with CKD and found decreased circulating levels with progressive loss of eGFR by multivariate analyses. Expression of these vascular miRNAs miR-125b, miR-145, and miR-155 was decreased in the thoracic aorta in CKD rats compared to normal rats, with concordant changes in target genes of RUNX2, angiotensin II type I receptor (AT1R, and myocardin. Furthermore, the expression of miR-155 was negatively correlated with the quantity of calcification in the aorta, a process known to be preceded by vascular de-differentiation in these animals. We then examined the mechanisms of miRNA regulation in primary VSMC and found decreased expression of miR-125b, 145, and 155 in VSMC from rats with CKD compared to normal littermates but no alteration in DROSHA or DICER, indicating that the low levels of expression is not due to altered intracellular processing. Finally, overexpression of miR-155 in VSMC from CKD rats inhibited AT1R expression and decreased cellular proliferation supporting a direct effect of miR-155 on VSMC. In conclusion, we have found ex vivo and in vitro evidence for decreased expression of these vascular miRNA in CKD, suggesting that alterations in miRNAs may lead to the synthetic state of VSMC found in CKD. The decreased levels in the circulation may reflect decreased vascular release but more studies are needed to confirm this relationship.

  15. Cerebral involvement in a patient with Goodpasture's disease due to shortened induction therapy: a case report

    Directory of Open Access Journals (Sweden)

    Preul Christoph

    2009-11-01

    Full Text Available Abstract Introduction Goodpasture's disease is a rare immunological disease with formation of pathognomonic antibodies against renal and pulmonary basement membranes. Cerebral involvement has been reported in several cases in the literature, yet the pathogenetic mechanism is not entirely clear. Case presentation A 21-year-old Caucasian man with Goodpasture's disease and end-stage renal disease presented with two generalized seizures after a period of mild cognitive disturbance. Blood pressure and routine laboratory tests did not exceed the patient's usual values, and examination of cerebrospinal fluid was unremarkable. Cerebral magnetic resonance imaging (MRI revealed multiple cortical and subcortical lesions on fluid-attenuated inversion recovery sequences. Since antiglomerular basement membrane antibodies were found to be positive with high titers, plasmapheresis was started. In addition, cyclophosphamide pulse therapy was given on day 13. Encephalopathy and MRI lesions disappeared during this therapy, and antiglomerular basement membrane antibodies were significantly reduced. Previous immunosuppressive therapy was performed without corticosteroids and terminated early after 3 months. The differential diagnostic considerations were cerebral vasculitis and posterior reversible encephalopathy syndrome. Vasculitis could be seen as an extrarenal manifestation of the underlying disease. Posterior reversible encephalopathy syndrome, on the other hand, can be triggered by immunosuppressive therapy and may appear without a hypertensive crisis. Conclusion A combination of central nervous system symptoms with a positive antiglomerular basement membrane test in a patient with Goodpasture's disease should immediately be treated as an acute exacerbation of the disease with likely cross-reactivity of antibodies with the choroid plexus. In our patient, a discontinuous strategy of immunosuppressive therapy may have favored recurrence of Goodpasture's disease.

  16. Exercise, vascular wall and cardiovascular diseases: an update (part 2).

    Science.gov (United States)

    Yung, Lai Ming; Laher, Ismail; Yao, Xiaoqiang; Chen, Zhen Yu; Huang, Yu; Leung, Fung Ping

    2009-01-01

    There is much evidence extolling the virtues of physical activity on cardiovascular disease (CVD). The evidence derives from different population groups where leisure time physical activity reduced the risk of coronary heart disease and cardiovascular mortality in both men and women. Recent meta-analyses have shown that large risk reductions for both ischaemic and haemorrhagic stroke can be achieved by moderate or intense physical activity. There are many data from human and animal studies confirming a beneficial role for exercise in the prevention and treatment of CVD. Physical inactivity and obesity/overweight are not only associated with a number of health-related risk factors, but are considered to be independent risk factors for CVD, type 2 diabetes mellitus and hypertension. Clinical trials confirm that lifestyle interventions (dietary modification and increased physical activity) reduce the risk of progressing from impaired glucose tolerance to type 2 diabetes. Moreover, epidemiological studies indicate that the risk of hypertension increases by being overweight. Modest increases in exercise intensity and frequency have hypotensive effects in sedentary hypertensive patients. Long-term training improves endothelium-dependent dilatation in the aorta and resistance arteries of the heart, whereas short-term training increases endothelial function in coronary conduit arteries. Overall, more scientific evidence will undoubtedly encourage the widespread advocacy of the clinical benefits of exercise therapy in the prevention and treatment of CVD.

  17. Vascular disease and risk factors are associated with cognitive decline in the Alzheimer’s disease spectrum

    Science.gov (United States)

    Lorius, Natacha; Locascio, Joseph J.; Rentz, Dorene M.; Johnson, Keith A.; Sperling, Reisa A.; Viswanathan, Anand; Marshall, Gad A.

    2015-01-01

    We investigated the relationship between vascular disease and risk factors versus cognitive decline cross-sectionally and longitudinally in normal older control (NC), mild cognitive impairment (MCI), and mild Alzheimer’s disease (AD) dementia subjects. 812 participants (229 NC, 395 MCI, 188 AD) underwent cognitive testing, brain magnetic resonance imaging, and clinical evaluations at baseline and over a period of 3 years. General linear, longitudinal mixed effects, and Cox proportional hazards models were used. Greater homocysteine level and white matter hyperintensity (WMH) volume were associated with processing speed impairment (homocysteine: p=0.02; WMH: p<0.0001); greater vascular index score was associated with memory impairment (p=0.007); and greater number of apolipoprotein E ε4 (APOE4) alleles was associated with global cognitive impairment (p=0.007) at baseline. APOE4 was associated with greater rate of increase in global cognitive impairment (p=0.002) and processing speed impairment (p=0.001) over time, while higher total cholesterol was associated with greater rate of increase in global cognitive impairment (p=0.02) and memory impairment (p=0.06) over time. These results suggest a significant association of increased vascular disease and risk factors with cognitive impairment at baseline and over time in the AD spectrum in a sample that was selected to have low vascular burden at baseline. PMID:24787033

  18. Elevated plasma YKL-40, lipids and lipoproteins, and ischemic vascular disease in the general population

    DEFF Research Database (Denmark)

    Kjaergaard, Alisa D; Johansen, Julia S; Bojesen, Stig E;

    2015-01-01

    BACKGROUND AND PURPOSE: We tested the hypothesis that observationally and genetically elevated YKL-40 is associated with elevated lipids and lipoproteins and with increased risk of ischemic vascular disease. METHODS: We conducted cohort and Mendelian randomization studies in 96 110 individuals from......) or tripling (GG) in YKL-40 levels, but not with triglyceride levels or with risk of ischemic vascular disease. A doubling in YKL-40 was associated with a multifactorially adjusted observational hazard ratio for ischemic stroke of 1.18 (1.11-1.27), and a genetic odds ratio of 1.04 (0.95-1.15). Corresponding...... the Danish general population, with measured plasma levels of YKL-40 (n=21 647), plasma lipids and lipoproteins (n=94 461), and CHI3L1 rs4950928 genotype (n=94 579). RESULTS: From 1977 to 2013, 3256 individuals developed ischemic stroke, 5629 ischemic cerebrovascular disease, 4183 myocardial infarction...

  19. Comparison of MEK/ERK pathway inhibitors on the upregulation of vascular G-protein coupled receptors in rat cerebral arteries

    DEFF Research Database (Denmark)

    Sandhu, Hardip; Ansar, Saema; Edvinsson, Lars

    2010-01-01

    on translational level and increased respective contractions. The prostanoid TP receptor mediated contraction curve was left-wards shifted by organ culture. Organ culture was associated with elevated pERK1/2 in the vascular smooth muscle cells: the MEK1/2 inhibitor U0126 attenuated the endothelin ET(B) receptor......Organ culture is an in vitro method for investigating cellular mechanisms involved in upregulation of vasocontractile G-protein coupled receptors. We hypothesize that mitogen-activated-protein kinase (MEK) and/or extracellular-signal-regulated kinase (ERK) specific inhibitors will attenuate the G......-protein coupled receptor expression following organ culture. Rat cerebral arteries were incubated 48h in the presence of MEK/ERK specific inhibitors U0126, PD98059, SL327, or AG126 for different time periods. Contractile responses by activation of endothelin receptor type A and type B, serotonin receptor 5-HT(1B...

  20. Associação entre função executiva e sintomas depressivos em pacientes com acidente  vascular cerebral isquêmico

    OpenAIRE

    2012-01-01

    INTRODUÇÃO: Associação entre sintomas depressivos e prejuízos cognitivos após o acidente vascular cerebral isquêmico tem sido descrito em vários estudos. Estudos recentes tem focado a associação de sintomas depressivos com a função executiva. A hipótese Depression Executive dysfunction tem sido investigada em pacientes com AVC e não se sabe se essa associação ocorre com algum grupo de sintomas depressivos específico. Portanto, o principal objetivo desse estudo, foi o de investigar a associaçã...

  1. Vascular effects of phytoestrogens and alternative menopausal hormone therapy in cardiovascular disease.

    Science.gov (United States)

    Gencel, V B; Benjamin, M M; Bahou, S N; Khalil, R A

    2012-02-01

    Phytoestrogens are estrogenic compounds of plant origin classified into different groups including isoflavones, lignans, coumestans and stilbenes. Isoflavones such as genistein and daidzein are the most studied and most potent phytoestrogens, and are found mainly in soy based foods. The effects of phytoestrogens are partly mediated via estrogen receptors (ERs): ERα, ERβ and possibly GPER. The interaction of phytoestrogens with ERs is thought to induce both genomic and non-genomic effects in many tissues including the vasculature. Some phytoestrogens such as genistein have additional non-ER-mediated effects involving signaling pathways such as tyrosine kinase. Experimental studies have shown beneficial effects of phytoestrogens on endothelial cells, vascular smooth muscle, and extracellular matrix. Phytoestrogens may also affect other pathophysiologic vascular processes such as lipid profile, angiogenesis, inflammation, tissue damage by reactive oxygen species, and these effects could delay the progression of atherosclerosis. As recent clinical trials showed no vascular benefits or even increased risk of cardiovascular disease (CVD) and CV events with conventional menopausal hormone therapy (MHT), phytoestrogens are being considered as alternatives to pharmacologic MHT. Epidemiological studies in the Far East population suggest that dietary intake of phytoestrogens may contribute to the decreased incidence of postmenopausal CVD and thromboembolic events. Also, the WHO-CARDIAC study supported that consumption of high soybean diet is associated with lower mortalities from coronary artery disease. However, as with estrogen, there has been some discrepancy between the experimental studies demonstrating the vascular benefits of phytoestrogens and the data from clinical trials. This is likely because the phytoestrogens clinical trials have been limited in many aspects including the number of participants enrolled, the clinical end points investigated, and the lack of

  2. Vascular hyperpolarization in human physiology and cardiovascular risk conditions and disease.

    Science.gov (United States)

    Schinzari, F; Tesauro, M; Cardillo, C

    2017-01-01

    Hyperpolarization causing smooth muscle relaxation contributes to the maintenance of vascular homeostasis, particularly in small-calibre arteries and arterioles. It may also become a compensatory vasodilator mechanism upregulated in states with impaired nitric oxide (NO) availability. Bioassay of vascular hyperpolarization in the human circulation has been hampered by the complexity of mechanisms involved and the limited availability of investigational tools. Firm evidence, however, supports the notion that hyperpolarization participates in the regulation of resting vasodilator tone and vascular reactivity in healthy subjects. In addition, an enhanced endothelium-derived hyperpolarization contributes to both resting and agonist-stimulated vasodilation in a variety of cardiovascular risk conditions and disease. Thus, hyperpolarization mediated by epoxyeicosatrienoic acids (EETs) and H2 O2 has been observed in coronary arterioles of patients with coronary artery disease. Similarly, ouabain-sensitive and EETs-mediated hyperpolarization has been observed to compensate for NO deficiency in patients with essential hypertension. Moreover, in non-hypertensive patients with multiple cardiovascular risk factors and in hypercholesterolaemia, KCa channel-mediated vasodilation appears to be activated. A novel paradigm establishes that perivascular adipose tissue (PVAT) is an additional regulator of vascular tone/function and endothelium is not the only agent in vascular hyperpolarization. Indeed, some PVAT-derived relaxing substances, such as adiponectin and angiotensin 1-7, may exert anticontractile and vasodilator actions by the opening of KCa channels in smooth muscle cells. Conversely, PVAT-derived factors impair coronary vasodilation via differential inhibition of some K(+) channels. In view of adipose tissue abnormalities occurring in human obesity, changes in PVAT-dependent hyperpolarization may be relevant for vascular dysfunction also in this condition.

  3. The renin-angiotensin system and its involvement in vascular disease.

    Science.gov (United States)

    van Thiel, Bibi S; van der Pluijm, Ingrid; te Riet, Luuk; Essers, Jeroen; Danser, A H Jan

    2015-09-15

    The renin-angiotensin system (RAS) plays a critical role in the pathogenesis of many types of cardiovascular diseases including cardiomyopathy, valvular heart disease, aneurysms, stroke, coronary artery disease and vascular injury. Besides the classical regulatory effects on blood pressure and sodium homoeostasis, the RAS is involved in the regulation of contractility and remodelling of the vessel wall. Numerous studies have shown beneficial effect of inhibition of this system in the pathogenesis of cardiovascular diseases. However, dysregulation and overexpression of the RAS, through different molecular mechanisms, also induces, the initiation of vascular damage. The key effector peptide of the RAS, angiotensin II (Ang II) promotes cell proliferation, apoptosis, fibrosis, oxidative stress and inflammation, processes known to contribute to remodelling of the vasculature. In this review, we focus on the components that are under the influence of the RAS and contribute to the development and progression of vascular disease; extracellular matrix defects, atherosclerosis and ageing. Furthermore, the beneficial therapeutic effects of inhibition of the RAS on the vasculature are discussed, as well as the need for additive effects on top of RAS inhibition.

  4. CARDIO-VASCULAR RISK FACTORS IN ELDERLY PATIENTS WITH DISEASES OF THE STOMATOGNATHIC SYSTEM

    Directory of Open Access Journals (Sweden)

    Botez C

    2011-09-01

    Full Text Available The association between dental and cardio-vascular diseases is essential as both are highly prevalent. Finding a possible causal relation between cardiovascular disease and chronic periodontal pathology, known to cause tooth loss, is therefore essential. The existence of some risk factors, such as smoking, bacterial infections, malnutrition and nutritional deficiencies, may explain the associations observed between cardio-vascular and oral pathologies. In the case of dental diseases, acceleration of atherosclerosis is supported by the role played by infections. The study – performed between 2008-2009 – analyzed 45 cases, selected from the patients hospitalized in the Medical Clinics of the Military Hospital of Ia[i. The patients included in the study suffered from arterial hypertension (HTA, cardiac insufficiency, ischemic cardiopathy, pectoral angina and subacute infectious endocarditis. All were subjected to a stomatological examination, for establishing their dental hygiene, the stomatological diseases they had had and the treatments performed. There are several ways in which infections of the oral cavity lead to cardiovascular disease. These include: transitory bacteriemia; inflammation and vascular lesions; diet and smoking.

  5. Heteroreceptors Modulating CGRP Release at Neurovascular Junction: Potential Therapeutic Implications on Some Vascular-Related Diseases

    Directory of Open Access Journals (Sweden)

    Abimael González-Hernández

    2016-01-01

    Full Text Available Calcitonin gene-related peptide (CGRP is a 37-amino-acid neuropeptide belonging to the calcitonin gene peptide superfamily. CGRP is a potent vasodilator with potential therapeutic usefulness for treating vascular-related disease. This peptide is primarily located on C- and Aδ-fibers, which have extensive perivascular presence and a dual sensory-efferent function. Although CGRP has two major isoforms (α-CGRP and β-CGRP, the α-CGRP is the isoform related to vascular actions. Release of CGRP from afferent perivascular nerve terminals has been shown to result in vasodilatation, an effect mediated by at least one receptor (the CGRP receptor. This receptor is an atypical G-protein coupled receptor (GPCR composed of three functional proteins: (i the calcitonin receptor-like receptor (CRLR; a seven-transmembrane protein, (ii the activity-modifying protein type 1 (RAMP1, and (iii a receptor component protein (RCP. Although under physiological conditions, CGRP seems not to play an important role in vascular tone regulation, this peptide has been strongly related as a key player in migraine and other vascular-related disorders (e.g., hypertension and preeclampsia. The present review aims at providing an overview on the role of sensory fibers and CGRP release on the modulation of vascular tone.

  6. Heteroreceptors Modulating CGRP Release at Neurovascular Junction: Potential Therapeutic Implications on Some Vascular-Related Diseases

    Science.gov (United States)

    Marichal-Cancino, Bruno A.; Lozano-Cuenca, Jair; López-Canales, Jorge S.; Muñoz-Islas, Enriqueta; Ramírez-Rosas, Martha B.; Villalón, Carlos M.

    2016-01-01

    Calcitonin gene-related peptide (CGRP) is a 37-amino-acid neuropeptide belonging to the calcitonin gene peptide superfamily. CGRP is a potent vasodilator with potential therapeutic usefulness for treating vascular-related disease. This peptide is primarily located on C- and Aδ-fibers, which have extensive perivascular presence and a dual sensory-efferent function. Although CGRP has two major isoforms (α-CGRP and β-CGRP), the α-CGRP is the isoform related to vascular actions. Release of CGRP from afferent perivascular nerve terminals has been shown to result in vasodilatation, an effect mediated by at least one receptor (the CGRP receptor). This receptor is an atypical G-protein coupled receptor (GPCR) composed of three functional proteins: (i) the calcitonin receptor-like receptor (CRLR; a seven-transmembrane protein), (ii) the activity-modifying protein type 1 (RAMP1), and (iii) a receptor component protein (RCP). Although under physiological conditions, CGRP seems not to play an important role in vascular tone regulation, this peptide has been strongly related as a key player in migraine and other vascular-related disorders (e.g., hypertension and preeclampsia). The present review aims at providing an overview on the role of sensory fibers and CGRP release on the modulation of vascular tone. PMID:28116293

  7. The value of MDCT in diagnosis of hyaline-vascular Castleman's disease

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Xiaoli [Department of Radiology, Beijing Shijitan Hospital affiliated to Capital University of Medical Sciences, Yangfangdian Tieyiyuan, Road No. 10, Haidian District, Beijing, 100038 China (China); Liu, Cheng [CT Department, Shandong Medical Imaging Research Institute (China); Wang, Rengui, E-mail: 490150302@qq.com [Department of Radiology, Beijing Shijitan Hospital affiliated to Capital University of Medical Sciences, Yangfangdian Tieyiyuan, Road No. 10, Haidian District, Beijing, 100038 China (China); Zhu, Xuejun [Dermatology Department, Beijing University First Hospital (China); Gao, Li [Department of Radiology, Beijing University First Hospital (China); Chen, Jiuhong [Healthcare, Siemens Ltd. (China)

    2012-09-15

    Purpose: Castleman's disease (CD) is an uncommon entity characterized by a massive growth of lymphoid tissue. There are two types: the hyaline-vascular (HV) type and the plasma cell (PC) type. The purpose of this study was to evaluate the clinical value of multiple detector computed tomography (MDCT) in the diagnosis and planning of treatment for hyaline-vascular CD. Materials and methods: Fifty-two cases of confirmed hyaline-vascular CD were retrospectively reviewed. Unenhanced and contrast-enhanced MDCT scans had been performed in all patients, followed by surgery and pathological analysis of the lesion. Original MDCT transverse and reconstructed images were used for image interpretation. Features of the lesion and its adjacent structures were identified. Results: The lesion was present in the thorax of 24 patients and the abdomen in 28. Obvious features of hyaline-vascular CD (especially feeding vessels and draining veins) and its adjacent structures were demonstrated on 52 patients. Conclusion: On MDCT imaging, original MDCT transverse and reconstructed images provide an excellent tool for diagnosis of hyaline-vascular CD and have high value in the determination of a treatment plan.

  8. Autonomic nervous system and risk factors for vascular disease. Effects of autonomic unbalance in schizophrenia and Parkinson's disease.

    Science.gov (United States)

    Scigliano, Giulio; Ronchetti, Gabriele; Girotti, Floriano

    2008-02-01

    Alterations of the cardiovascular system and of the glucose and lipid metabolism can represent important factors of vascular risk. The autonomic nervous system, through its two efferent branches, the parasympatheticcholinergic and the sympathetic-adrenergic, plays an important role in the control of the cardiovascular activity and of the glucose and lipid metabolism, and its impaired working can interfere with these functions. An increased sympathetic activity and an increased frequency of diabetes, dyslipidemia, hypertension and obesity have been reported in untreated schizophrenic patients, and a further worsening of these vascular risk factors has been signalled as a side effect of treatment with neuroleptic drugs. The opposite is observed in Parkinson's disease, where the reduced autonomic activity induced by the illness is associated with a decreased frequency of vascular risk factors, and their occurrence is further reduced by the treatment with dopaminergic drugs.

  9. Analysis of the Causes and Treatment of Cerebral Vascular Disease Caused by Pregnancy Induced Hypertension Syndrome%妊娠高血压综合征引起脑血管疾病的原因及治疗对策分析

    Institute of Scientific and Technical Information of China (English)

    赵阿霞; 金美玉

    2016-01-01

    目的:探讨妊娠高血压综合征引发脑血管疾病的发生原因及治疗方法。方法以在我院治疗的妊娠高血压综合征合并脑血管疾病的32例患者为研究对象,对合并脑血管疾病的发病原因进行分析,探讨治疗对策。结果所有患者均伴有高血压症状,血压平均水平为(18.6±3.1) kPa,蛋白尿平均水平为(1.8±0.7)g/L。结论妊娠高血压综合征并发脑血管疾病与患者血压升高、脑动脉缺氧痉挛有重要联系,选择合适的方法治疗可有效改善患者病症,确保患者生命安全。%Objective Analyses the causes of pregnancy-induced hypertension syndrome caused by cerebrovascular disease and treatment method.MethodsTo merge pregnancy-induced hypertension syndrome and cerebrovascular disease in our hospital treatment of 32 cases of patients as the research object, analyzes the causes of merger cerebrovascular disease, treatment countermeasures are discussed.Results All patients with symptoms of high blood pressure, blood pressure average of (18.6±3.1) kPa, average of albuminuria (1.8±0.7) g/L.Conclusion Patients with pregnancy-induced hypertension syndrome complicated with cerebrovascular disease and high blood pressure, oxygen to brain artery spasm is the important link, select the appropriate method of treatment can effectively improve the patients condition, to ensure patient safety.

  10. Cardiovascular Disease Risk, Vascular Health, and Erectile Dysfunction among Middle-Aged, Clinically Depressed Men

    Science.gov (United States)

    Hoffman, Benson M.; Sherwood, Andrew; Smith, Patrick J.; Babyak, Michael A.; Doraiswamy, P. Murali; Hinderliter, Alan; Blumenthal, James A.

    2013-01-01

    Background Erectile dysfunction (ED) is especially common in men with major depressive disorder (MDD). This study examined the extent to which risk factors for cardiovascular disease (CVD) and vascular dysfunction were associated with ED severity in a series of MDD patients. Methods The sample included 46 middle-aged [M (SD) age = 53 (7)], sedentary men diagnosed with MDD. ED severity was assessed by the Arizona Sexual Experiences Scale (ASEX), item 3. Depression severity was measured by the Beck Depression Inventory (BDI). CVD risk factors were quantitated by the Framingham Cardiovascular Disease Risk Profile score. Vascular function was measured by flow-mediated dilation (FMD) of the brachial artery. Results The average ASEX score for this sample was 3.2 (SD = 1.2). Regression analysis revealed that ASEX scores were predicted by greater CVD risk factors (p = .008, β = .41) and lower FMD (p = .03, β = −.33). When FMD was included in the regression model, the relationship between CVD risk factors and ASEX scores was partially attenuated (p = .08, β = .28). Conclusions ED was associated with CVD risk and impaired vascular function, although it appears that CVD risk factors may affect ED through impairment of vascular functioning. PMID:19776749

  11. Dysfunction of pulmonary vascular endothelium in chronic obstructive pulmonary disease: basic considerations for future drug development.

    Science.gov (United States)

    Yang, Qin; Underwood, Malcolm J; Hsin, Michael K Y; Liu, Xiao-Cheng; He, Guo-Wei

    2008-09-01

    Chronic obstructive pulmonary disease (COPD) is one of the leading health problems worldwide and continues to be a major cause of morbidity and mortality in developed countries. The clinical features of COPD are chronic obstructive bronchiolitis and emphysema. Pulmonary vascular endothelial dysfunction is a characteristic pathological finding of COPD at different stages of the disease. Functional changes of pulmonary endothelial cells in COPD include antiplatelet abnormalities, anticoagulant disturbances, endothelial activation, atherogenesis, and compromised regulation of vascular tone which may adversely affect the ventilation-perfusion match in COPD. As the most important risk factor of COPD, cigarette smoking may initiate pulmonary vascular impairment through direct injury of endothelial cells or release of inflammatory mediators. Morphological changes such as denudation of endothelium and endothelial cell apoptosis have been observed in the pulmonary vasculature in COPD patients as well as functional alterations. Changes in the expression of tissue factor pathway inhibitor (TFPI), thrombomodulin, selectins, and adhesion molecules in pulmonary endothelial cells as well as complex regulation and interaction of vasoactive substances and growth factors released from endothelium may underlie the mechanisms of pulmonary endothelial dysfunction in COPD. The mechanism of endothelial repair/regeneration in COPD, although not fully understood, may involve upregulation of vascular endothelial growth factors in the early stages along with an increased number of bone marrow-derived progenitor cells. These factors should be taken into account when developing new strategies for the pharmacological therapy of patients with COPD.

  12. Effect of diesel exhaust particles on renal vascular responses in rats with chronic kidney disease.

    Science.gov (United States)

    Al Suleimani, Y M; Al Mahruqi, A S; Al Za'abi, M; Shalaby, A; Ashique, M; Nemmar, A; Ali, B H

    2017-02-01

    Several recent studies have indicated the possible association between exposure to particulate air pollution and the increased rate of morbidity and mortality in patients with kidney diseases. The link of this observation to vascular damage has not been adequately addressed. Therefore, this study aims to investigate possible vascular damage that might be associated with exposure to diesel exhaust particles (DP) in adenine (AD)-induced chronic kidney disease (CKD) in rats, and the possible ameliorative effect of gum acacia (GA). CKD was induced by feeding AD (0.75%, w/w), and DP (0.5 mg/kg) was instilled intratracheally every second day and GA was given concomitantly in the drinking water at a dose of 15% w/v. All treatments were given concomitantly for 28 days. Changes in renal blood flow (RBF) and systolic and diastolic blood pressure were monitored in these animals after anesthesia, together with several other endpoints. Exposure to DP significantly reduced RBF and this was significantly potentiated in AD-treated rats. Phenylephrine-induced decreases in RBF and increases in systolic and diastolic blood pressure were severely potentiated in rats exposed to DP, and these actions were significantly augmented in AD-treated rats. GA did not significantly affect the vascular impairment induced by AD and DP given together. This study provides experimental evidence that exposure to particulate air pollution can exacerbate the vascular damage seen in patients with CKD. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 541-549, 2017.

  13. Possible involvement of microRNAs in vascular damage in experimental chronic kidney disease.

    Science.gov (United States)

    Taïbi, Fatiha; Metzinger-Le Meuth, Valérie; M'Baya-Moutoula, Eléonore; Djelouat, Mohamed seif el Islam; Louvet, Loïc; Bugnicourt, Jean-Marc; Poirot, Sabrina; Bengrine, Abderrahmane; Chillon, Jean-Marc; Massy, Ziad A; Metzinger, Laurent

    2014-01-01

    Chronic kidney disease (CKD) is associated with vascular calcifications and atherosclerosis. There is a need for novel predictors to allow earlier diagnosis of these disorders, predict disease progression, and improve assessment of treatment response. We focused on microRNAs since they are implicated in a variety of cellular functions in cardiovascular pathology. We examined changes of microRNA expression in aortas of CKD and non-CKD wild type mice and apolipoprotein E knock-out mice, respectively. Both vascular smooth muscle-specific miR-143 and miR-145 expressions were decreased in states of atherosclerosis and/or CKD or both, and the expression level of protein target Myocardin was increased. The inflammatory miR-223 was increased in more advanced stages of CKD, and specific protein targets NFI-A and GLUT-4 were dramatically decreased. Expression of miR-126 was markedly increased and expression of protein targets VCAM-1 and SDF-1 was altered during the course of CKD. The drug sevelamer, commonly used in CKD, corrected partially these changes in microRNA expression, suggesting a direct link between the observed microRNA alterations and uremic vascular toxicity. Finally, miR-126, -143 and -223 expression levels were deregulated in murine serum during the course of experimental CKD. In conclusion, these miRNAs could have role(s) in CKD vascular remodeling and may therefore represent useful targets to prevent or treat complications of CKD.

  14. Targeting Nitric Oxide with Natural Derived Compounds as a Therapeutic Strategy in Vascular Diseases

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    Maurizio Forte

    2016-01-01

    Full Text Available Within the family of endogenous gasotransmitters, nitric oxide (NO is the smallest gaseous intercellular messenger involved in the modulation of several processes, such as blood flow and platelet aggregation control, essential to maintain vascular homeostasis. NO is produced by nitric oxide synthases (NOS and its effects are mediated by cGMP-dependent or cGMP-independent mechanisms. Growing evidence suggests a crosstalk between the NO signaling and the occurrence of oxidative stress in the onset and progression of vascular diseases, such as hypertension, heart failure, ischemia, and stroke. For these reasons, NO is considered as an emerging molecular target for developing therapeutic strategies for cardio- and cerebrovascular pathologies. Several natural derived compounds, such as polyphenols, are now proposed as modulators of NO-mediated pathways. The aim of this review is to highlight the experimental evidence on the involvement of nitric oxide in vascular homeostasis focusing on the therapeutic potential of targeting NO with some natural compounds in patients with vascular diseases.

  15. Targeting Nitric Oxide with Natural Derived Compounds as a Therapeutic Strategy in Vascular Diseases

    Science.gov (United States)

    Forte, Maurizio; Damato, Antonio; Ambrosio, Mariateresa; Puca, Annibale A.; Sciarretta, Sebastiano; Frati, Giacomo; Vecchione, Carmine

    2016-01-01

    Within the family of endogenous gasotransmitters, nitric oxide (NO) is the smallest gaseous intercellular messenger involved in the modulation of several processes, such as blood flow and platelet aggregation control, essential to maintain vascular homeostasis. NO is produced by nitric oxide synthases (NOS) and its effects are mediated by cGMP-dependent or cGMP-independent mechanisms. Growing evidence suggests a crosstalk between the NO signaling and the occurrence of oxidative stress in the onset and progression of vascular diseases, such as hypertension, heart failure, ischemia, and stroke. For these reasons, NO is considered as an emerging molecular target for developing therapeutic strategies for cardio- and cerebrovascular pathologies. Several natural derived compounds, such as polyphenols, are now proposed as modulators of NO-mediated pathways. The aim of this review is to highlight the experimental evidence on the involvement of nitric oxide in vascular homeostasis focusing on the therapeutic potential of targeting NO with some natural compounds in patients with vascular diseases. PMID:27651855

  16. Regulation of cerebral cholesterol metabolism in Alzheimer disease.

    Science.gov (United States)

    Reiss, Allison B; Voloshyna, Iryna

    2012-03-01

    Alzheimer disease (AD) is an age-related neurodegenerative disorder that manifests as a progressive loss of memory and deterioration of higher cognitive functions. Alzheimer disease is characterized by accumulation in the brain of the β-amyloid peptide generated by β- and γ-secretase processing of amyloid precursor protein. Epidemiological studies have linked elevated plasma cholesterol and lipoprotein levels in midlife with AD development. Cholesterol-fed animal models exhibit neuropathologic features of AD including accumulation of β-amyloid peptide. Specific isoforms of the cholesterol transporter apolipoprotein E are associated with susceptibility to AD. Although multiple lines of evidence indicate a role for cholesterol in AD, the exact impact and mechanisms involved remain largely unknown. This review summarizes the current state of our knowledge of the influence of cholesterol and lipid pathways in AD pathogenesis in vitro and in vivo.

  17. Regulation of Cerebral Cholesterol Metabolism in Alzheimer’s Disease

    OpenAIRE

    Reiss, Allison B; Voloshyna, Iryna

    2012-01-01

    Alzheimer’s disease (AD) is an age-related neurodegenerative disorder that manifests as a progressive loss of memory and deterioration of higher cognitive functions. AD is characterized by accumulation in the brain of the β-amyloid peptide (Aβ) generated by β- and γ-secretase processing of amyloid precursor protein (APP). Epidemiological studies have linked elevated plasma cholesterol and lipoprotein levels in mid-life with AD development. Cholesterol-fed animal models exhibit neuropathologic...

  18. [Updates from the 45th Congress of French College for Vascular Disease (CFPV) Paris, March the 16th-18th, 2011].

    Science.gov (United States)

    Lazareth, I; Priollet, P

    2011-12-01

    The 45(th) Congress of the French College of Vascular Disease (CFPV) has been held in Paris in March 2011. Scientific sessions covered many fields of vascular diseases. A short synthesis is proposed there. A large part of the programme is related to new treatments for venous thrombo-embolic disease, healing factors of chronic leg ulcers, medical networks, hormones and atherothrombosis, cardiovascular risk in connective tissue diseases, vascular treatment and elderly, vascular compression syndromes, nailfold capillary microscopy.

  19. The clinical impact of MTHFR polymorphism on the vascular complications of sickle cell disease

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    F. Moreira Neto

    2006-10-01

    Full Text Available Sickle cell disease (SCD is one of the most common inherited diseases in the world and the patients present notorious clinical heterogeneity. It is known that patients with SCD present activation of the blood coagulation and fibrinolytic systems, especially during vaso-occlusive crises, but also during the steady state of the disease. We determined if the presence of the factor V gene G1691A mutation (factor V Leiden, the prothrombin gene G20210A variant, and methylenetetrahydrofolate reductase (MTHFR C677T polymorphism may be risk factors for vascular complications in individuals with SCD. We studied 53 patients with SCD (60% being women, 29 with SS (sickle cell anemia; 28 years, range: 13-52 years and 24 with SC (sickle-hemoglobin C disease; 38.5 years, range: 17-72 years hemoglobinopathy. Factor V Leiden, MTHFR C677T polymorphism, and prothrombin G20210A variant were identified by PCR followed by further digestion of the PCR product with specific endonucleases. The following vascular complications were recorded: stroke, retinopathy, acute thoracic syndrome, and X-ray-documented avascular necrosis. Only one patient was heterozygous for factor V Leiden (1.8% and there was no prothrombin G20210A variant. MTHFR 677TT polymorphism was detected in 1 patient (1.8% and the heterozygous form 677TC was observed in 18 patients (34%, 9 with SS and 9 with SC disease, a prevalence similar to that reported by others. No association was detected between the presence of the MTHFR 677T allele and other genetic modulation factors, such as alpha-thalassemia, ß-globin gene haplotype and fetal hemoglobin. The presence of the MTHFR 677T allele was associated with the occurrence of vascular complications in SCD, although this association was not significant when each complication was considered separately. In conclusion, MTHFR C677T polymorphism might be a risk factor for vascular complications in SCD.

  20. Matrix Metalloproteinase Inhibitors as Investigative Tools in the Pathogenesis and Management of Vascular Disease

    Science.gov (United States)

    Benjamin, Mina M.; Khalil, Raouf A.

    2012-01-01

    Matrix metalloproteinases (MMPs) are proteolytic enzymes that degrade various components of the extracellular matrix (ECM). MMPs could also regulate the activity of several non-ECM bioactive substrates, and consequently affect different cellular functions. Members of the MMPs family include collagenases, gelatinases, stromelysins, matrilysins, membrane-type MMPs and others. Pro-MMPs are cleaved into active MMPs, which in turn act on various substrates in the ECM and on the cell surface. MMPs play an important role in the regulation of numerous physiological processes including vascular remodeling and angiogenesis. MMPs may also be involved in vascular diseases such as hypertension, atherosclerosis, aortic aneurysm, and varicose veins. MMPs also play a role in the hemodynamic and vascular changes associated with pregnancy and preeclampsia. The role of MMPs is commonly assessed by measuring their gene expression, protein amount, and proteolyic activity using gel zymography. Because there are no specific activators of MMPs, MMP inhibitors are often used to investigate the role of MMPs in different physiologic processes and in the pathogenesis of specific diseases. MMP inhibitors include endogenous tissue inhibitors (TIMPs) and pharmacological inhibitors such as zinc chelators, doxycycline and marimastat. MMP inhibitors have been evaluated as diagnostic and therapeutic tools in cancer, autoimmune and cardiovascular disease. Although several MMP inhibitors have been synthesized and tested both experimentally and clinically, only on MMP inhibitor, i.e. doxycycline, is currently approved by the Food and Drug Administration. This is mainly due to the undesirable side effects of MMP inhibitors especially on the musculoskeletal system. While most experimental and clinical trials of MMP inhibitors have not demonstrated significant benefits, some trials still showed promising results. With the advent of new genetic and pharmacological tools, disease-specific MMP inhibitors

  1. Castleman Disease of Hyaline Vascular Type in the Infrathyroidal Region: A Masquerader of Parathyroid Adenoma

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    Lee, Sang Kwon; Kwon, Sun Young [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-03-15

    Castleman disease of the infrathyroidal region is extremely rare. We report both CT and sonographic findings of a case of infrathyroidal paratracheal Castleman disease of hyaline vascular type, which masquerades parathyroid adenoma, in a 48-year-old woman. We further provide its histological findings at sonographically guided core-needle biopsy (US-CNB) and excisional biopsy. The lesion was ovoid with homogeneous intense enhancement on contrast-enhanced CT (CECT), and was homogeneous, markedly hypoechoic, and hypervascular on ultrasonography (US). Histological findings of the specimen obtained by US-CNB suggested lymphoproliferative lesion, and thus was inconclusive; those obtained by excisional biopsy were characteristics of Castleman disease of hyaline vascular type. Hyaline vascular type Castleman's disease should be included in the differential diagnosis of a mass of the infrathyroidal region with homogeneous intense enhancement on CECT, as well as with marked hypoechogenicity and hypervascularity on US. US-CNB may be of limited value in the histological diagnosis of this entity.

  2. Exercise Training Could Improve Age-Related Changes in Cerebral Blood Flow and Capillary Vascularity through the Upregulation of VEGF and eNOS

    Directory of Open Access Journals (Sweden)

    Sheepsumon Viboolvorakul

    2014-01-01

    Full Text Available This study aimed to investigate the effect of exercise training on age-induced microvascular alterations in the brain. Additionally, the association with the protein levels of vascular endothelial growth factor (VEGF and endothelial nitric oxide synthase (eNOS was also assessed. Male Wistar rats were divided into four groups: sedentary-young (SE-Young, n=5, sedentary aged (SE-Aged, n=8, immersed-aged (IM-Aged, n=5, and exercise trained-aged (ET-Aged, 60 minutes/day and 5 days/week for 8 weeks, n=8 rats. The MAPs of all aged groups, SE-Aged, IM-Aged, and ET-Aged, were significantly higher than that of the SE-Young group. The regional cerebral blood flow (rCBF in the SE-Aged and IM-Aged was significantly decreased as compared to SE-Young groups. However, rCBF of ET-Aged group was significantly higher than that in the IM-Aged group (P<0.05. Moreover, the percentage of capillary vascularity (%CV and the levels of VEGF and eNOS in the ET-Aged group were significantly increased compared to the IM-Aged group (P<0.05. These results imply that exercise training could improve age-induced microvascular changes and hypoperfusion closely associated with the upregulation of VEGF and eNOS.

  3. Cerebral sinus thrombosis in patients with inflammatory bowel disease: A case report

    Institute of Scientific and Technical Information of China (English)

    Hasan Umit; Talip Asil; Yahya Celik; Ahmet Tezel; Gulbin Dokmeci; Nermin Tuncbilek; Ufuk Utku; Ali Riza Soylu

    2005-01-01

    Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease of the gastrointestinal tract. The pathophysiology of IBD is probably the result of the complex interaction of genetic susceptibility and environmental influences. There is a well-known risk of thrombosis in patients with IBD. We present the case of a 53-year-old man with ulcerative colitis, who spontaneously developed intracranial sinus thrombosis that was treated with low molecular weight heparin. Literature was searched to assess the frequency and characteristics of cerebral sinus thrombosis in IBD and the role of certain etiopathological factors in such thrombotic patients.

  4. 64层螺旋CT脑灌注成像联合CT血管造影评价颅内外血管搭桥术后疗效%Assessment of cerebral internal and external vascular bypass graft in patients with single middle cerebral artery stenosis or occlusion by combining 64-row CT cerebral perfusion with angiography

    Institute of Scientific and Technical Information of China (English)

    陈天金; 朱栓庄; 温有信; 王耀彬; 韩向东; 白莹; 于旋

    2012-01-01

    Objective To assess the curative effect of cerebral internal and external vascular bypass graft in patients with sin -gle middle cerebral artery (MCA) stenosis or occlusion by combining 64 -row CT cerebral perfusion (CTP) with angiography ( CTA ). Methods Patients with middle cerebral artery stenosis or occlusion were recruited and underwent superficial temporal artery and mid -die cerebral artery(STA -MCA) bypass graft between March 2009 and Mar 2011. CTP and CTA examinations were performed in all patients before and after operation. The cerebral perfusion parameters were analyzed quantitatively and qualitatively . The origin, travel and anastomotic stoma of bypass grafts were evaluated by reconstructed CTA images . Results 46 patients were found with severe MCA stenosis or occlusion. The time to peak (TTP) and relative mean transit time (rMTT) images before therapy displayed the existence of perfusion delay. The relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCRV) images did not change significantly. The decrease of TTP and rMTT after therapy was of statistical significance ( P 0.05). In reconstructed CTA images , 82 bridge vessels were well displayed, including double bridges in 39 patients. The accuracy of CTA examination was 96.5%. All the bypass grafts were well shown and the anastomotic stomas were unobstructed. Conclusions It is feasible to evaluate the curative effects of cerebral internal and ex — ternal vascular bypass graft by combining CTP images of cerebral perfusion after therapy with CTA images of cerebral internal and exter -nal bypass grafts.%目的 探讨64层螺旋CT脑灌注成像(CT perfusion,CTP)联合CT血管造影(CT angiography,CTA)评价单侧大脑中动脉(middle cerebral artery,MCA)重度狭窄(闭塞)颅内外血管搭桥术后疗效的可行性.方法 46例拟行颅内外血管搭桥术患者,术前、后均行CTP及CTA检查.计算脑灌注参数图,对治疗前后脑灌注参数进行定量和定性对

  5. Erythropoietin resistance in end-stage renal disease patient with gastric antral vascular ectasia

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    Desiree Ji Re Lee

    2015-09-01

    Full Text Available AbstractWe observed a case of recombinant human erythropoietin resistance caused by Gastric Antral Vascular Ectasia in a 40-year-old female with ESRD on hemodialysis. Some associated factors such as autoimmune disease, hemolysis, heart and liver disease were discarded on physical examination and complementary tests. The diagnosis is based on the clinical history and endoscopic appearance of watermelon stomach. The histologic findings are fibromuscular proliferation and capillary ectasia with microvascular thrombosis of the lamina propria. However, these histologic findings are not necessary to confirm the diagnosis. Gastric Antral Vascular Ectasia is a serious condition and should be considered in ESRD patients on hemodialysis with anemia and resistance to recombinant human erythropoietin because GAVE is potentially curable with specific endoscopic treatment method or through surgical procedure.

  6. Vasoespasmo cerebral

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    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  7. Factors influencing the early outcome of major lower limb amputation for vascular disease.

    OpenAIRE

    Campbell, W. B.; Marriott, S; Eve, R; Mapson, E.; Sexton, S.; Thompson, J F

    2001-01-01

    A consecutive series of 349 primary lower limb amputations for vascular disease, done during 1992-1998, were reviewed for amputation level, revision, complications and death, seeking associations with the American Society of Anesthesiology (ASA) grade and pre-operative co-morbidities of patients. Attempted revascularisation, and seniority of surgeon supervising the amputation were also examined for their possible influence on outcome. There were 312 patients (163 male) aged 39-92 years (media...

  8. Advanced Coats’ disease treated with intravitreal bevacizumab combined with laser vascular ablation

    OpenAIRE

    Villegas VM; Gold AS; Berrocal AM; Murray TG

    2014-01-01

    Victor M Villegas,1 Aaron S Gold,1 Audina M Berrocal,2 Timothy G Murray11Ocular Oncology and Retina, Miami, FL, USA; 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USAPurpose: To evaluate the impact of intravitreal bevacizumab combined with laser vascular ablation in the management of advanced Coats’ disease presenting with exudative retinal detachment.Methods: This was a retrospective review of 24 child...

  9. Regional cerebral blood flow and cognitive deficits in chronic lyme disease.

    Science.gov (United States)

    Fallon, Brian A; Keilp, John; Prohovnik, Isak; Heertum, Ronald Van; Mann, J John

    2003-01-01

    This study examined brain functioning in patients with Lyme encephalopathy. Eleven patients underwent neuropsychological tests and Xenon(133)-regional cerebral blood flow (rCBF) studies, using an external detector system. Each rCBF scan was age- and sex-matched to two archival, normal controls. While few differences were noted on gray-matter flow indices (ISI, fg), Lyme patients demonstrated significant flow reductions in white matter index (k(2)) (p=.004), particularly in the posterior temporal and parietal lobes bilaterally (p=.003). Flow reductions in white matter areas were significantly associated with deficits in memory (r=.66, p=.027) and visuospatial organization (r=.62, p=.041). Results suggest that Lyme encephalopathy may be a disease primarily affecting the cerebral white matter.

  10. Cerebral Small Vessel Disease: Cognition, Mood, Daily Functioning, and Imaging Findings from a Small Pilot Sample

    Directory of Open Access Journals (Sweden)

    John G. Baker

    2012-04-01

    Full Text Available Cerebral small vessel disease, a leading cause of cognitive decline, is considered a relatively homogeneous disease process, and it can co-occur with Alzheimer’s disease. Clinical reports of magnetic resonance imaging (MRI/computed tomography and single photon emission computed tomography (SPECT imaging and neuropsychology testing for a small pilot sample of 14 patients are presented to illustrate disease characteristics through findings from structural and functional imaging and cognitive assessment. Participants showed some decreases in executive functioning, attention, processing speed, and memory retrieval, consistent with previous literature. An older subgroup showed lower age-corrected scores at a single time point compared to younger participants. Performance on a computer-administered cognitive measure showed a slight overall decline over a period of 8–28 months. For a case study with mild neuropsychology findings, the MRI report was normal while the SPECT report identified perfusion abnormalities. Future research can test whether advances in imaging analysis allow for identification of cerebral small vessel disease before changes are detected in cognition.

  11. Association of brain amyloid-β with cerebral perfusion and structure in Alzheimer's disease and mild cognitive impairment.

    Science.gov (United States)

    Mattsson, Niklas; Tosun, Duygu; Insel, Philip S; Simonson, Alix; Jack, Clifford R; Beckett, Laurel A; Donohue, Michael; Jagust, William; Schuff, Norbert; Weiner, Michael W

    2014-05-01

    Patients with Alzheimer's disease have reduced cerebral blood flow measured by arterial spin labelling magnetic resonance imaging, but it is unclear how this is related to amyloid-β pathology. Using 182 subjects from the Alzheimer's Disease Neuroimaging Initiative we tested associations of amyloid-β with regional cerebral blood flow in healthy controls (n = 51), early (n = 66) and late (n = 41) mild cognitive impairment, and Alzheimer's disease with dementia (n = 24). Based on the theory that Alzheimer's disease starts with amyloid-β accumulation and progresses with symptoms and secondary pathologies in different trajectories, we tested if cerebral blood flow differed between amyloid-β-negative controls and -positive subjects in different diagnostic groups, and if amyloid-β had different associations with cerebral blood flow and grey matter volume. Global amyloid-β load was measured by florbetapir positron emission tomography, and regional blood flow and volume were measured in eight a priori defined regions of interest. Cerebral blood flow was reduced in patients with dementia in most brain regions. Higher amyloid-β load was related to lower cerebral blood flow in several regions, independent of diagnostic group. When comparing amyloid-β-positive subjects with -negative controls, we found reductions of cerebral blood flow in several diagnostic groups, including in precuneus, entorhinal cortex and hippocampus (dementia), inferior parietal cortex (late mild cognitive impairment and dementia), and inferior temporal cortex (early and late mild cognitive impairment and dementia). The associations of amyloid-β with cerebral blood flow and volume differed across the disease spectrum, with high amyloid-β being associated with greater cerebral blood flow reduction in controls and greater volume reduction in late mild cognitive impairment and dementia. In addition to disease stage, amyloid-β pathology affects cerebral blood flow across the span from controls to

  12. Changes of cerebral hemodynamics following the administration of surfactant in the hyaline membrane disease of prematurity

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    Yoo, Jeong Hyun; Kim, Kyung Hee [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2000-09-15

    To evaluate the changes of cerebral blood flow velocity according to the time, before and after surfactant administration in hyaline membrane disease using Doppler ultrasonography. The patients were 15 premature babies who were clinically and radiologically diagnosed HMD. The ratio of male : female was 11:4, the mean gestational age was 30.1 {+-} 2.5 wks, mean body weight was 1.4 {+-} 0.6 kg,mean Apgar score at 5 min was 6.28, and type of delivery was C-section : vaginal delivery 9.6. Before and after, 10 mm, 30 min, 1 hr, 6 hr, 12 hr, 1 day, 3 day, 5 day and 7 day after surfactant administration, peak systolic and end-diastolic cerebral blood flow velocity (PSFV, EDFV) and resistive index (RI) were estimated by Doppler ultrasonography measuring MCA flow velocity using temporal window. The averages of all data according to the time were obtained and analyzed statistical significance. For the evaluation of the clinical status systemic BP, FiO2, pH, and respiratory rate were also checked according to the same time. The clinical status of FiO2, metabolic acidosis, and tachypnea was significantly improved after surfactant administration. There was no significant change of cerebral blood flow velocity (PSFV, EDFV) after the surfactant administration. The change of RI was nor statistically significant. The changes of the systemic BP had no significant changes. In spite of clinical improvement, there were no significant increases of cerebral blood flow velocity and changes of RI after surfactant administration in hyaline membrane disease.

  13. Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

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    Wright F

    2012-10-01

    Full Text Available Abstract Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK, general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82] between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22, stroke, both overall (I60-64 and by subtype, and pulmonary embolism (I26, HES records appeared to be both reliable and complete. Conclusion Hospital admission data

  14. Pulse volume recording for peripheral vascular disease diagnosis in diabetes patients

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    Benitez E

    2015-10-01

    Full Text Available Erik Benitez, Bauer E Sumpio Department of Surgery (Vascular, Yale University School of Medicine, New Haven, CT, USA Abstract: Peripheral arterial disease is common in patients with diabetes mellitus. It has become routine to screen for peripheral arterial disease in diabetic patients. As clinicians' knowledge and understanding of the disease processes increase, the diagnosis and surveillance also rises. As an adjunct to clinical examination, pulse volume recordings are useful in assessing perfusion of patients with poorly compressible arteries. The development of this study during the early 70s helped create the concept of noninvasive vascular imaging and testing. The analysis of pressure–pulse waveforms localized the presence of high-grade lesions and delineated the extent of the disease process. Pulse volume recordings are currently extensively used with other modalities such as arterial duplex and angiography and help to establish an arterial etiology of a patient's disease process, as well as localizing the lesion, determining the prognosis, and performing surveillance after interventions. Keywords: pulse volume recordings, ankle brachial index, peripheral arterial disease, diabetes mellitus, critical limb ischemia, pulse wave contour, pressure–pulse waveforms

  15. [Vascular Calcification - Pathological Mechanism and Clinical Application - . Vascular calcification in chronic kidney disease-mineral and bone disorder (CKD-MBD)].

    Science.gov (United States)

    Omata, Momoyo; Fukagawa, Masafumi; Kakuta, Takatoshi

    2015-05-01

    Chronic kidney disease-mineral and bone disorder (CKD-MBD), is sequential pathophysiology that starts in the very early stages of CKD. Three major aspects of CKD-MBD are laboratory abnormalities, bone abnormalities and vascular calcification. In dialysis patients, the prevalence of death due to cardiovascular disease accounts for more than 40% of all-cause mortality. Therefore, arteriosclerosis with vascular calcification may be an important pathophysiological mechanism in the development of cardiovascular disease. Vascular calcification is known to be an important risk factor influencing mortality in CKD patients. A number of studies have suggested a close association between serum FGF23 concentration and the risks of mortality, cardiovascular disease vascular calcification as well as CKD progression. Renal insufficiency leads to decline in klotho level and impaired phosphate excretion. However serum phosphate levels are maintained in the normal range by up regulation of FGF23 and PTH in early CKD stage. Early treatment intervention is necessary to improve the prognosis of the CKD patient.

  16. Intraoperative dexmedetomidine and postoperative cerebral hyperperfusion syndrome in patients who underwent superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease

    Science.gov (United States)

    Seo, Hyungseok; Ryu, Ho-Geol; Son, Je Do; Kim, Jeong-Soo; Ha, Eun Jin; Kim, Jeong-Eun; Park, Hee-Pyoung

    2016-01-01

    Abstract Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease. The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively. The patients were divided into 2 groups: 48 patients received intraoperative dexmedetomidine (Group D), while 69 patients did not (Group ND). The incidence (primary outcome), onset, and duration of postoperative CHS were noted. The incidence of postoperative CHS was 45.8% and 40.6% in groups D and ND, respectively (P = 0.708). The duration of postoperative CHS was shorter in group D than in group ND (median [Q1–Q3], 5 [3–7] vs 8 [5–10] days, P = 0.021). There was no significant difference in the onset of CHS between group D and group ND (0 [0–2] vs 1 [0–3] days, P = 0.226). In conclusion, intraoperative dexmedetomidine did not reduce the incidence of postoperative CHS, although it reduced the duration of CHS, in patients who had undergone direct revascularization surgery for moyamoya disease. PMID:28033272

  17. Mechanisms of cognitive impairment in cerebral small vessel disease: multimodal MRI results from the St George's cognition and neuroimaging in stroke (SCANS study.

    Directory of Open Access Journals (Sweden)

    Andrew J Lawrence

    Full Text Available Cerebral small vessel disease (SVD is a common cause of vascular cognitive impairment. A number of disease features can be assessed on MRI including lacunar infarcts, T2 lesion volume, brain atrophy, and cerebral microbleeds. In addition, diffusion tensor imaging (DTI is sensitive to disruption of white matter ultrastructure, and recently it has been suggested that additional information on the pattern of damage may be obtained from axial diffusivity, a proposed marker of axonal damage, and radial diffusivity, an indicator of demyelination. We determined the contribution of these whole brain MRI markers to cognitive impairment in SVD. Consecutive patients with lacunar stroke and confluent leukoaraiosis were recruited into the ongoing SCANS study of cognitive impairment in SVD (n = 115, and underwent neuropsychological assessment and multimodal MRI. SVD subjects displayed poor performance on tests of executive function and processing speed. In the SVD group brain volume was lower, white matter hyperintensity volume higher and all diffusion characteristics differed significantly from control subjects (n = 50. On multi-predictor analysis independent predictors of executive function in SVD were lacunar infarct count and diffusivity of normal appearing white matter on DTI. Independent predictors of processing speed were lacunar infarct count and brain atrophy. Radial diffusivity was a stronger DTI predictor than axial diffusivity, suggesting ischaemic demyelination, seen neuropathologically in SVD, may be an important predictor of cognitive impairment in SVD. Our study provides information on the mechanism of cognitive impairment in SVD.

  18. Vascular disease modeling using induced pluripotent stem cells: Focus in Hutchinson-Gilford Progeria Syndrome.

    Science.gov (United States)

    Pitrez, P R; Rosa, S C; Praça, C; Ferreira, L

    2016-05-06

    Induced pluripotent stem cells (iPSCs) represent today an invaluable tool to create disease cell models for modeling and drug screening. Several lines of iPSCs have been generated in the last 7 years that changed the paradigm for studying diseases and the discovery of new drugs to treat them. In this article we focus our attention to vascular diseases in particular Hutchinson-Gilford Progeria Syndrome (HGPS), a devastating premature aging disease caused by a mutation in the lamin A gene. In general, patients die because of myocardial infarction or stroke. Because the patients are fragile the isolation of a particular type of cells is very difficult. Therefore in the last 5 years, researchers have used cells derived from iPSCs to model aspects of the HGPS and to screen libraries of chemicals to retard or treat the disease.

  19. An Intelligent System based on Fuzzy Inference System to prophesy the brutality of Cardio Vascular Disease

    Directory of Open Access Journals (Sweden)

    Sivagowry shathesh

    2015-11-01

    Full Text Available To unravel hidden relationships and diagnose diseases efficiently, Data Mining along with Soft Computing Techniques are used in several researches.  Cardio Vascular Disease is a condition which leads to severe disability and death.  Since the diagnosis involves vague symptoms and tedious procedures, diagnosis is usually time-consuming and erroneous.  For the healthier analysis and treatment of heart disease based on brutality, an Intellectual, accurate and proficient investigative system is needed.  For diagnosing heart disease with improved effectiveness, an Intelligent Fuzzy Inference System is needed.  This paper illustrates how Fuzzy Inference System is used to envisage the severity of disease by constructing an effective Fuzzy Rule Base.  It is also proved that a precision of 95.23% is obtained when Fuzzy System is used in severity prediction

  20. 18F-FDG PET imaging in detection of radiation-induced vascular disease in lymphoma survivors

    DEFF Research Database (Denmark)

    Ripa, Rasmus S.; Hag, Anne Mette; Knudsen, Andreas;

    2015-01-01

    Radiation therapy (RT) induces vascular changes that increase the risk of cardiovascular diseases in some patients. The objective was to determine if in vivo positron emission tomography (PET) with fluorodeoxyglucose (18F-FDG) can identify increased vascular inflammation in patients without changes...... in vascular intima media thickness (IMT). Patients previously receiving unilateral RT due to lymphoma were prospectively recruited (N=10). The untreated contralateral artery functioned as control. All patients underwent a dedicated vascular PET/CT. Vascular tracer uptake was quantified by drawing regions...... (P=0.04). Measurement of IMT showed that 4 patients had the highest thickness in the irradiated side, while the other 4 patients had the highest thickness in the non-irradiated side (P=0.8). In conclusion, we found that (18)F-FDG PET imaging may be used to detect vascular changes induced by RT...

  1. Treating Principles and Methods of Traditional Chinese Medicine in Treatment of Peripheral Vascular Diseases

    Institute of Scientific and Technical Information of China (English)

    张雅洁; 陈知行; 刘玉洁; 张雅琳

    2001-01-01

    @@Peripheral vascular disease embraces a variety of conditions such as thromboangiitis obliterans, Raynaud's disease, thrombophlebitis, aorto-arteritis, obliterate atherosclerosis, varix or phlebothrombosis of the lower limb. Although the affected blood vessel may be arterial or venous one and caused either by inflammation or degenerate changes, they share common symptoms and signs, such as blood stasis, ischemia, thrombosis, ecchymosis, swelling, constriction or obliteration of blood vessels due to circulatory impairment. Since they share common characteristics, the treating principles and methods will be discussed as follows.

  2. Logistic regression analysis on risk factors for vascular dementia following cerebral infarction in 403 patients from Chongqing City Hospital and family follow-up studies

    Institute of Scientific and Technical Information of China (English)

    Hong Yang; Jingcheng Li; Huadong Zhou

    2007-01-01

    BACKGROUND: Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects.OBJECTIVE: To analyze the conditions and incidental risk factors of vascular dementia in patients with acute cerebral infarction from Chongqing City. DESIGN: Case analysis.SETTING: Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA. PARTICIPANTS: Altogether 546 inpatients with acute ischemic stroke admitted to Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA between May 1999 and December 2002 were involved in this study. The involved patients, including 295 males and 251 females, aged 55 - 94 years, dwelled in Chongqing over 5 years. They were admitted to hospital within 48 hours of attack of acute ischemic stroke, and survived for over 3 months. Informed consents were obtained from all the involved subjects.METHODS: ①Following the same standard, cognitive and social function evaluations were conducted by one physician on admission and 3 months after admission. Unified questionnaire, consisting of general characteristics, vascular risk factors, stroke characteristics, neurological physical sign, and other 28 factors of involved subjects, was used in all the patients. According to the investigation results, the patients were assigned into 2 groups: dementia group and non-dementia group. ②Ischemic stroke was diagnosed according to acute ischemic brain disorder>24 hours and CT or MRI imageology.③Neurophysiological examination was conducted in all the patients at 7 to 10 days after stroke (score was two SD less than or equaled to normal level was considered as abnormal).④Diagnosis and statistics of dementia were carried out with Mini-Mental State Examination and The Diagnostic and Statistical Manual of Mental Disorders-IV (published by American Psychiatric Association) on admission and 3 months after admission. Neurologic

  3. Cerebral Small Vessel Disease Clinical, Neuropsychological, and Radiological Phenotypes, Histopathological Correlates, and Described Genotypes: A Review

    Directory of Open Access Journals (Sweden)

    Thomas Gregor Issac

    2015-01-01

    Full Text Available Introduction. Vascular cognitive impairment is a common yet preventable cause for dementia. It needs high degree of suspicion and appropriate designing of investigatory tools to confirm diagnosis, identify comorbidities, and ascertain the areas of impairment. Commonly DSM-IV criterion is applied for diagnosis and detailed clinical and neuropsychological examination for identifying the specific phenotype is used. Early diagnosis using the mandatory criteria will help in early initiation of disease modifying treatment strategies which can result in partial reversal of vascular changes and arrest of progression. Patients with young onset disease might require genetic characterization for designing more aggressive treatment. Discussion and Conclusion. Dementias as such carry poor course and prognosis resulting in severe Disability Adjusted Life Years (DALYs for patients and caregivers. Therefore, it is mandatory to identify treatable and preventable causes so that man power loss can be reduced.

  4. The scintigraphic appearance of childhood moyamoya disease on cerebral perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Miller, J.H. [Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States)]|[University of Southern California School of Medicine, Los Angeles (United States); Khonsary, A. [Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States)]|[University of Southern California School of Medicine, Los Angeles (United States); Raffel, C. [Department of Surgery, Childrens Hospital Los Angeles (United States)]|[University of Southern California School of Medicine, Los Angeles (United States)

    1996-12-01

    Objective. This study was performed to evaluate the role of single photon emission computed tomography (SPECT) perfusion imaging in the evaluation of patients with moyamoya disease. Materials and methods. Five patients (four female, one male) were studied utilizing iodine-123 iodoamphetamine or technetium-99m hexamethylpropyleneamine oxime SPECT. The data were reconstructed into axial, coronal and sagittal sections for review, and compared with CT, MR and/or angiographic images. Results. All five patients had significant perfusion defects. These areas of vascular compromise were seen to cross normal vascular territories, and were greater in number and extent than seen on anatomic sectional imaging. Conclusion. Patients with moyamoya disease have a recognizable pattern of scintigraphic perfusion deficits which should be identified by pediatric imaging physicians. SPECT perfusion studies should be performed in conjunction with other imaging modalities (CT, MR or angiography). (orig.). With 3 figs.

  5. 脑梗死患者血清可溶性血管细胞黏附分子1的变化%Variation of soluble vascular cell adhesion molecule-1 in serum of patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    李静; 周华东; 王延江

    2006-01-01

    平明显高于无感染(P<0.01).结论:可溶性血管细胞黏附分子1参与了脑梗死的病理变化过程,可作为脑梗死时病情变化的监测指标.阻断其生成和表达为改善脑梗死的预后提供了新的思路.%BACKGROUND: In subjects with different inflammatory and autoimmune diseases, soluble vascular cell adhesion molecule-1 (sVCAM-1) in sera increases, and its change may become an important monitoring index of immunological function, but its change rule has been unclear in acute cerebral infarction.OBJECTIVE: To observe the change of sVCAM-1 in sera of subjects with cerebral infarction and its clinical significance, and compare between the subjects with cerebral hemorrhage and normal population.DESIGN: A case controlled analysis.SETTING: Second Department of Brain, Research Institute of Surgery,Daping Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: A total of 132 inpatients were selected from Second Department of Brain, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between May 2002 and April 2004. Among them, 89 subjects with cerebral infarction were classified into large infarction group (n=25,> 10 cm3), medium infarction group (n=31,4-10 cm3) and small infarction group (n=33, < 4 cm3) respectively according to the size of infarct focus. There were 43 subjects in cerebral hemorrhage group, and 30 healthy persons were as normal control group.METHODS: Blood samples were isolated from subjects with cerebral infarction at hour 24, days 3, 7 and 14 after onset of the disease, while the blood samples were extracted from subjects with cerebral hemorrhage at hour24 and day 14 after the onset of the disease. 4 mL venous blood was obtained from the three groups. The serum concentration of sVCAM-1 was determined with double antibody sandwich method (DASM) in all the examinees.MAIN OUTCOME MEASURES: ①Dynamic change of the serum concentration of sVCAM-1 in the course of acute cerebral

  6. Experimental stereotactic gamma knife radiosurgery. Vascular contractility studies of the rat middle cerebral artery after chronic survival.

    Science.gov (United States)

    Major, Otto; Szeifert, György Tamás; Radatz, Matthias W R; Walton, Lee; Kemeny, Andras Armand

    2002-03-01

    In vitro isometric small vessel myograph experiments and pathological investigations were performed on rat middle cerebral arteries. Thirty-four animals provided 68 normal vessels, six further rats had the endothelial layer mechanically removed from their 12 arteries. Eighteen animals received gamma knife irradiation to the middle cerebral arteries. Fifteen of these received 50 Gray, and three 25 Gray dose to the 50% isodose and the contralateral vessels offered 20 Gray and 15 Gray irradiated specimens. Survival times varied from 12 weeks to 18 months. In the acute stage, abolition of potassium-induced relaxation occurred as early as 24 h after irradiation whilst in one year this reaction seemed to recover and remained active to 18 months. The contraction response to prostaglandin F2 alpha was diminished at six weeks in the 50 Gray-irradiated vessels. However, from one year further reduction was seen and by 18 months this response was totally abolished. We demonstrated reduction of contractile capability of the irradiated normal vessels while the vessels remained patent. When using low irradiation dose there were no pathological changes even at 18 months, but marked physiological changes could be demonstrated. Different vessel wall functions appear to have different radiosensitivity, time course and capability for regeneration.

  7. The role of bone in CKD-mediated mineral and vascular disease.

    Science.gov (United States)

    Khouzam, Nadine M; Wesseling-Perry, Katherine; Salusky, Isidro B

    2015-09-01

    Cardiovascular disease is the leading cause of death in pediatric patients with chronic kidney disease (CKD), and vascular calcifications start early in the course of CKD. Based on the growing body of evidence that alterations of bone and mineral metabolism and the therapies designed to treat the skeletal consequences of CKD are linked to cardiovascular calcifications, the Kidney Disease, Improving Global Outcomes (KDIGO) working group redefined renal osteodystrophy as a systemic disorder of mineral and bone metabolism due to CKD, and this newly defined disorder is now known as "chronic kidney disease-mineral bone disorder (CKD-MBD)". Elevated fibroblast growth factor 23 (FGF23), a bone-derived protein, is the first biochemical abnormality to be associated with CKD-MBD, and high FGF23 levels correlate with increased cardiovascular morbidity and mortality, suggesting that bone is central to both initiating and perpetuating the abnormal mineral metabolism and vascular disease in CKD. The current standard therapies for CKD-MBD affect FGF23 levels differently; non-calcium-based binders with or without concurrent use of dietary phosphate restriction reduce FGF23 levels, while calcium-based binders seem to either increase or have no effect on FGF23 levels. Active vitamin D sterols increase FGF23 levels, whereas therapy with calcimimetics decreases FGF23 levels. Thus, the appropriate therapy that will minimize the rise in FGF23 and prevent cardiovascular morbidity remains to be defined.

  8. CITICOLIN IN THE TREATMENT OF STROKE AND VASCULAR COGNITIVE DISORDERS

    Directory of Open Access Journals (Sweden)

    Vladimir Anatol'evich Parfenov

    2009-01-01

    Full Text Available Citicolin (ceraxon is used as a neuroprotector in the treatment of acute stroke and vascular cognitive disorders. Experimental animal studies have demonstrated that citicolin reduces the extent of cerebral infarct and increases the degree of functional recovery. A few clinical trials have provided evidence for the efficacy of intravenous or oral citicolin used within the first 24 hours of ischemic stroke or cerebral hemorrhage in recovery of neurological functions. Citicolin is effective in memory and behavioral disorders in elderly patients with chronic cerebrovascular diseases. The use of citicolin has been found to be safe in stroke and vascular cognitive disorders

  9. Selective accumulation of aluminum in cerebral arteries in Alzheimer's disease (AD).

    Science.gov (United States)

    Bhattacharjee, Surjyadipta; Zhao, Yuhai; Hill, James M; Culicchia, Frank; Kruck, Theodore P A; Percy, Maire E; Pogue, Aileen I; Walton, J R; Lukiw, Walter J

    2013-09-01

    Once biologically available aluminum bypasses gastrointestinal and blood-brain barriers, this environmentally-abundant neurotoxin has an exceedingly high affinity for the large pyramidal neurons of the human brain hippocampus. This same anatomical region of the brain is also targeted by the earliest evidence of Alzheimer's disease (AD) neuropathology. The mechanism for the selective targeting and transport of aluminum into the hippocampus of the human brain is not well understood. In an effort to improve our understanding of a pathological aluminum entry system into the brain, this study examined the aluminum content of 8 arteries that supply blood to the hippocampus, including the aorta and several cerebral arteries. In contrast to age-matched controls, in AD patients we found a gradient of increasing aluminum concentration from the aorta to the posterior cerebral artery that supplies blood to the hippocampus. Primary cultures of human brain endothelial cells were found to have an extremely high affinity for aluminum when compared to other types of brain cells. Together, these results suggest for the first time that endothelial cells that line the cerebral vasculature may have biochemical attributes conducive to binding and targeting aluminum to selective anatomical regions of the brain, such as the hippocampus, with potential downstream pro-inflammatory and pathogenic consequences.

  10. Lymphoma and cerebral vasculitis in association with X-linked lymphoproliferative disease

    Institute of Scientific and Technical Information of China (English)

    Jia Zhu; Yu Zhang; Zi-Jun Zhen; Yan Chen; Juan Wang; Rui-Qing Cai; Xiao-Fei Sun

    2013-01-01

    Lymphoma is seen in up to 30% of patients with X-linked lymphoproliferative disease (XLP), but cerebral vasculitis related with XLP after cure of Burkitt lymphoma is rarely reported. We describe a case of a 5-year-old boy with XLP who developed cerebral vasculitis two years after cure of Burkitt lymphoma. He had Burkitt lymphoma at the age of 3 years and received chemotherapy (non-Hodgkin’s lymphoma-Berlin-Frankfurt-Milan-90 protocol plus rituximab), which induced complete remission over the following two years. At the age of 5 years, the patient first developed headache, vomiting, and then intel ectual and motorial retrogression. His condition was not improved after anti-infection, dehydration, or dexamethasone therapy. No tumor cells were found in his cerebrospinal fluid. Magnetic resonance imaging showed multiple non-homogeneous, hypodense masses along the bilateral cortex. Pathology after biopsy revealed hyperplasia of neurogliocytes and vessels, accompanied by lymphocyte infiltration but no tumor cell infiltration. Despite aggressive treatment, his cognition and motor functions deteriorated in response to progressive cerebral changes. The patient is presently in a vegetative state. We present this case to inform clinicians of association between lymphoma and immunodeficiency and explore an optimal treatment for lymphoma patients with compromised immune system.

  11. Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease.

    Science.gov (United States)

    Ricotta, John J; Aburahma, Ali; Ascher, Enrico; Eskandari, Mark; Faries, Peter; Lal, Brajesh K

    2011-09-01

    Management of carotid bifurcation stenosis is a cornerstone of stroke prevention and has been the subject of extensive clinical investigation, including multiple controlled randomized trials. The appropriate treatment of patients with carotid bifurcation disease is of major interest to the community of vascular surgeons. In 2008, the Society for Vascular Surgery published guidelines for treatment of carotid artery disease. At the time, only one randomized trial, comparing carotid endarterectomy (CEA) and carotid stenting (CAS), had been published. Since that publication, four major randomized trials comparing CEA and CAS have been published, and the role of medical management has been re-emphasized. The current publication updates and expands the 2008 guidelines with specific emphasis on six areas: imaging in identification and characterization of carotid stenosis, medical therapy (as stand-alone management and also in conjunction with intervention in patients with carotid bifurcation stenosis), risk stratification to select patients for appropriate interventional management (CEA or CAS), technical standards for performing CEA and CAS, the relative roles of CEA and CAS, and management of unusual conditions associated with extracranial carotid pathology. Recommendations are made using the GRADE (Grades of Recommendation Assessment, Development and Evaluation) system, as has been done with other Society for Vascular Surgery guideline documents.[corrected] The perioperative risk of stroke and death in asymptomatic patients must be management as the first-line therapy.

  12. Cilostazol prevents foot ulcers in diabetic patients with peripheral vascular disease.

    Science.gov (United States)

    de Franciscis, Stefano; Gallelli, Luca; Battaglia, Luigi; Molinari, Vincenzo; Montemurro, Rossella; Stillitano, Domenico M; Buffone, Gianluca; Serra, Raffaele

    2015-06-01

    Diabetic patients are at high risk of foot ulcerations that may lead to limb amputations with important socio-economic impact. Peripheral vascular disease may be frequently associated in diabetes mellitus type II with its main symptom, intermittent claudication. Many studies reported the known efficacy of cilostazol in treating vascular claudication. Metalloproteinase-9 (MMP-9) seems to be a biochemical marker implicated in chronic wounds and in particular in diabetic foot ulcers. Cilostazol appears to have a lowering effect on MMP-9 levels and this may suggest a beneficial effect in order to prevent or retard the onset of foot ulcer in diabetic patients. In our study, two groups of diabetic patients with peripheral vascular disease were divided into two groups according to the presence of claudication in order to receive cilostazol. Group A (31 patients without claudication) were not eligible to receive cilostazol whereas Group B (47 patients with claudication) received cilostazol administration for 24 weeks (100 mg orally twice daily). Median follow up was of 16 months. During the follow up, 4·25% of patients of Group B and 35·48% of patients of Group A (P ulceration. Although further randomised and controlled studies are required cilostazol seems to show beneficial effects for primary prevention of diabetic foot ulcers.

  13. Placental vascular pathology and increased thrombin generation as mechanisms of disease in obstetrical syndromes

    Directory of Open Access Journals (Sweden)

    Salvatore Andrea Mastrolia

    2014-11-01

    Full Text Available Obstetrical complications including preeclampsia, fetal growth restriction, preterm labor, preterm prelabor rupture of membranes and fetal demise are all the clinical endpoint of several underlying mechanisms (i.e., infection, inflammation, thrombosis, endocrine disorder, immunologic rejection, genetic, and environmental, therefore, they may be regarded as syndromes. Placental vascular pathology and increased thrombin generation were reported in all of these obstetrical syndromes. Moreover, elevated concentrations of thrombin-anti thrombin III complexes and changes in the coagulation as well as anticoagulation factors can be detected in the maternal circulation prior to the clinical development of the disease in some of these syndromes. In this review, we will assess the changes in the hemostatic system during normal and complicated pregnancy in maternal blood, maternal–fetal interface and amniotic fluid, and describe the contribution of thrombosis and vascular pathology to the development of the great obstetrical syndromes.

  14. Pathogenesis of diabetic vascular disease: evidence for the role of reduced heparan sulfate proteoglycan

    DEFF Research Database (Denmark)

    Jensen, Tonny Joran

    1997-01-01

    . Moreover, heparin has been shown to reduce albuminuria in patients with incipient diabetic nephropathy. Although increasing evidence supports the hypothesis that loss of heparan sulfate may play a pathophysiological role in the development of diabetic vascular complications, there are still many unresolved...... problems. What are the mechanisms of action of glycosaminoglycans at the molecular biology level, and how can we select compounds without anticoagulant activity suitable for long-term use in the prevention and treatment of late diabetic complications?......Insulin-dependent diabetic patients with increased urinary albumin excretion are characterized by elevated blood pressure and declining kidney function. In addition, such patients have a high risk of atherosclerotic vascular disease, proliferative retinopathy, and cardiomyopathy, suggesting...

  15. Diffuse Dermal Angiomatosis: A Clue to the Diagnosis of Atherosclerotic Vascular Disease

    Directory of Open Access Journals (Sweden)

    Tueboon Sriphojanart

    2015-05-01

    Full Text Available Diffuse dermal angiomatosis (DDA is a benign, acquired, reactive vascular proliferation. DDA is clinically characterized by painful purpuric plaque with central ulceration. The histopathologic hallmark is diffuse proliferation of endothelial cells that are arranged interstitially between collagen bundles of the reticular dermis. DDA has been reported in association with peripheral atherosclerotic disease, arteriovenous fistula and heavy smoking. We report the case of a 49-year-old Asian male with DDA who presented with a painful stellate-shaped purpuric patch on the right thigh. Histopathologic examination showed proliferation of CD34-positive spindle cells in the dermis. Our patient underwent vascular bypass surgery along with tight control of cardiovascular risk factors, which yielded successful results.

  16. Widespread heterogeneous neuronal loss across the cerebral cortex in Huntington's disease.

    Science.gov (United States)

    Nana, Alissa L; Kim, Eric H; Thu, Doris C V; Oorschot, Dorothy E; Tippett, Lynette J; Hogg, Virginia M; Synek, Beth J; Roxburgh, Richard; Waldvogel, Henry J; Faull, Richard L M

    2014-01-01

    Huntington's disease is an autosomal dominant neurodegenerative disease characterized by neuronal degeneration in the basal ganglia and cerebral cortex, and a variable symptom profile. Although progressive striatal degeneration is known to occur and is related to symptom profile, little is known about the cellular basis of symptom heterogeneity across the entire cerebral cortex. To investigate this, we have undertaken a double blind study using unbiased stereological cell counting techniques to determine the pattern of cell loss in six representative cortical regions from the frontal, parietal, temporal, and occipital lobes in the brains of 14 Huntington's disease cases and 15 controls. The results clearly demonstrate a widespread loss of total neurons and pyramidal cells across all cortical regions studied, except for the primary visual cortex. Importantly, the results show that cell loss is remarkably variable both within and between Huntington's disease cases. The results also show that neuronal loss in the primary sensory and secondary visual cortices relate to Huntington's disease motor symptom profiles, and neuronal loss across the associational cortices in the frontal, parietal and temporal lobes is related to both Huntington's disease motor and to mood symptom profiles. This finding considerably extends a previous study (Thu et al., Brain, 2010; 133:1094-1110) which showed that neuronal loss in the primary motor cortex was related specifically to the motor symptom profiles while neuronal loss in the anterior cingulate cortex was related specifically to mood symptom profiles. The extent of cortical cell loss in the current study was generally related to the striatal neuropathological grade, but not to CAG repeat length on the HTT gene. Overall our findings show that Huntington's disease is characterized by a heterogeneous pattern of neuronal cell loss across the entire cerebrum which varies with symptom profile.

  17. A study on cerebral hemodynamic analysis of moyamoya disease by using perfusion MRI

    Science.gov (United States)

    Dong, Kyung-Rae; Goo, Eun-Hoe; Lee, Jae-Seung; Chung, Woon-Kwan

    2013-10-01

    This study examined the clinical applications of perfusion magnetic resonance imaging (MRI) in patients with moyamoya disease (MMD). Twenty-two patients with moyamoya disease (9 men and 13 women) with a mean age of 9.3 years (range: 4-22 years) were enrolled in this study. Perfusion MRI was performed by scanning the patients7.5 cm upward from the base of the cerebellum before their being process for post-treatment. The scan led to the acquisition of the following four map images: the cerebral blood volume (CBV), the cerebral blood flow (CBF), the mean transit time (MTT) for the contrast medium, and the time to peak (TTP) for the contrast medium. The lesions were assessed using the CBV, the CBF, the MTT and the TTP maps of perfusion MRI; the MTT and the TTP were measured in the lesion areas, as well as in the normal and the symmetric areas. Perfusion defects were recognizable in all four perfusion MRI maps, and the MTT and the TTP showed a conspicuous delay in the parts where perfusion defects were recognized. The MTT and the TTP images of perfusion MRI reflected a significant correlation between the degrees of stenosis and occlusion in the posterior cerebral artery (PCA), as well as the development of collateral vessels. The four perfusion MRI maps could be used to predict the degrees of stenosis and occlusion in the posterior circulation, as well as the development of the collateral vessels, which enabled a hemodynamic evaluation of the parts with perfusion defects. Overall, perfusion MRI is useful for the diagnosis and the treatment of moyamoya disease and can be applied to clinical practice.

  18. Complement depletion with humanised cobra venom factor: efficacy in preclinical models of vascular diseases.

    Science.gov (United States)

    Vogel, Carl-Wilhelm; Fritzinger, David C; Gorsuch, W Brian; Stahl, Gregory L

    2015-03-01

    The complement system is an intrinsic part of the immune system and has important functions in both innate and adaptive immunity. On the other hand, inadvertent or misdirected complement activation is also involved in the pathogenesis of many diseases, contributing solely or significantly to tissue injury and disease development. Multiple approaches to develop pharmacological agents to inhibit complement are currently being pursued. We have developed a conceptually different approach of not inhibiting but depleting complement, based on the complement-depleting activities of cobra venom factor (CVF), a non-toxic cobra venom component with structural and functional homology to complement component C3. We developed a humanised version of CVF by creating human complement component C3 derivatives with complement-depleting activities of CVF (humanised CVF) as a promising therapeutic agent for diseases with complement pathogenesis. Here we review the beneficial therapeutic effect of humanised CVF in several murine models of vascular diseases such as reperfusion injury.

  19. Secretion of interleukin-6 and vascular endothelial growth factor by spindle cell sarcoma complicating Castleman's disease (so-called 'vascular neoplasia').

    Science.gov (United States)

    Kakiuchi, Chihiro; Ishida, Tsuyoshi; Sato, Hitoshi; Katano, Harutaka; Ishiko, Tositaka; Mukai, Hiroyuki; Kogi, Mieko; Kasuga, Naoki; Takeuchi, Kengo; Yamane, Kenichi; Fukayama, Masashi; Mori, Shigeo

    2002-06-01

    So-called 'vascular neoplasia' (VN) is a rare tumour of unknown origin that complicates hyaline vascular type Castleman's disease (CD). This paper reports a case of VN complicating CD of hyaline vascular type, in which neoplastic cells were shown to secrete interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF). In this case, VN first occurred in the retroperitoneum of a 60-year-old male. The lesion showed typical morphology, with three distinct areas: (1) a lymph node-like area with regressively transformed lymph follicles showing hyaline vascular changes and with a hypervascular interfollicular region filled with slit-like vascular channels; (2) an area composed of spindle cell sarcoma; and (3) an area showing angiolipomatous hamartoma. A proportion of the cells in the spindle cell area showed severe pleomorphism. Subcutaneous recurrence after 8 months was composed purely of pleomorphic spindle cells. A karyotypic analysis of the recurrent tumour showed 47, XXY with some instability. Supernatant from primary culture contained high levels of IL-6 and VEGF, suggesting high secretion of these cytokines from neoplastic cells. Immunohistochemically, p53 overexpression was identified only in the pleomorphic spindle cells of the primary lesion and metastatic tumour. No features suggestive of vascular origin were shown on immunohistochemical or electron microscopic analysis of the neoplastic cells. Human herpesvirus type 8 was not detected by immunohistochemistry or PCR analysis. High levels of IL-6 and/or VEGF have been reported to play a role in CD. This is the first case report that clarifies the site of such cytokine production, showing the possibility of CD as a paraneoplastic phenomenon.

  20. Regional cerebral blood flow change in a case of Alzheimer's disease with musical hallucinations.

    Science.gov (United States)

    Mori, Takaaki; Ikeda, Manabu; Fukuhara, Ryuji; Sugawara, Yoshifumi; Nakata, Shigeru; Matsumoto, Naomi; Nestor, Peter J; Tanabe, Hirotaka

    2006-06-01

    We examined alteration of regional cerebral blood flow (rCBF) in a case of Alzheimer's disease (AD) patient with musical hallucination. To detect regions related to musical hallucination, single-photon emission computed tomography (SPECT) imaging of the patient and nine sex, age, and cognitive function-matched AD patients without delusions and hallucinations were compared using statistical parametric mapping 99 (SPM99). In comparison with controls, the patient had increased rCBF in left temporal regions and left angular gyrus. This profile could be relevant to the neuroanatomical basis of musical hallucinations.

  1. Recent Developments in Understanding Brain Aging: Implications for Alzheimer's Disease and Vascular Cognitive Impairment.

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    Deak, Ferenc; Freeman, Willard M; Ungvari, Zoltan; Csiszar, Anna; Sonntag, William E

    2016-01-01

    As the population of the Western world is aging, there is increasing awareness of age-related impairments in cognitive function and a rising interest in finding novel approaches to preserve cerebral health. A special collection of articles in The Journals of Gerontology: Biological Sciences and Medical Sciences brings together information of different aspects of brain aging, from latest developments in the field of neurodegenerative disorders to cerebral microvascular mechanisms of cognitive decline. It is emphasized that although the cellular changes that occur within aging neurons have been widely studied, more research is required as new signaling pathways are discovered that can potentially protect cells. New avenues for research targeting cellular senescence, epigenetics, and endocrine mechanisms of brain aging are also discussed. Based on the current literature it is clear that understanding brain aging and reducing risk for neurological disease with age requires searching for mechanisms and treatment options beyond the age-related changes in neuronal function. Thus, comprehensive approaches need to be developed that address the multiple, interrelated mechanisms of brain aging. Attention is brought to the importance of maintenance of cerebromicrovascular health, restoring neuroendocrine balance, and the pressing need for funding more innovative research into the interactions of neuronal, neuroendocrine, inflammatory and microvascular mechanisms of cognitive impairment, and Alzheimer's disease.

  2. [A Case of Ruptured Peripheral Cerebral Aneurysm at Abnormal Vessels Associated with Middle Cerebral Artery Stenosis:Similarity to Moyamoya Disease].

    Science.gov (United States)

    Miyazaki, Hajime; Kohno, Kanehisa; Tanaka, Hideo; Fukumoto, Shinya; Ichikawa, Haruhisa; Onoue, Shinji; Fumoto, Noriyuki; Ozaki, Saya; Maeda, Toshiharu

    2016-04-01

    We report a case of ruptured peripheral cerebral aneurysm at abnormal vessels associated with severe stenosis at the middle cerebral artery (MCA). A 66-year-old woman was admitted at our hospital with headache on foot. Computed tomography (CT) showed intracerebral hemorrhage in the left fronto-basal area. Three-dimensional-CT and conventional angiogram revealed abnormal vessels, which were similar to those seen in moyamoya disease, with a small enhancement close to the hematoma. On day 11, subsequent cerebral angiogram demonstrated an aneurysm at the peripheral portion of an abnormal vessel arising from the left A2. On day 17, soon after the diagnosis of the ruptured aneurysm was made (while still at the subacute stage), we operated on the aneurysm. Superficial temporal artery (STA)-MCA anastomosis was also performed to preserve cerebral blood flow and reduce hemodynamic stress. Several days after the operation, she had transient aphasia due to hyperperfusion of the MCA territory, but eventually recovered with no neurological deficit at discharge. Follow-up study revealed revascularization from the branches of the external carotid artery as well as the STA. On admission, we initially thought that this patient had abnormal vessels associated with arteriosclerotic MCA stenosis. However, the postoperative clinical course as well as the histopathological specimens of both the abnormal artery with the aneurysm and the STA revealed similar findings to those of moyamoya disease. Although this case did not satisfy the criteria for moyamoya disease, it is conceivable that a single arterial occlusive lesion associated with moyamoya-like vessels might develop in the same mechanism with that of moyamoya disease.

  3. A standardized vascular disease health check in europe: a cost-effectiveness analysis.

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    C Andy Schuetz

    Full Text Available BACKGROUND: No clinical trials have assessed the effects or cost-effectiveness of health check strategies to detect and manage vascular disease. We used a mathematical model to estimate the cost-effectiveness of several health check strategies in six European countries. METHODS: We used country-specific data from Denmark, France, Germany, Italy, Poland, and the United Kingdom to generate simulated populations of individuals aged 40-75 eligible for health checks in those countries (e.g. individuals without a previous diagnosis of diabetes, myocardial infarction, stroke, or serious chronic kidney disease. For each country, we used the Archimedes model to compare seven health check strategies consisting of assessments for diabetes, hypertension, lipids, and smoking. For patients diagnosed with vascular disease, treatment was simulated in a standard manner. We calculated the effects of each strategy on the incidence of type 2 diabetes, major adverse cardiovascular events (MACE, and microvascular complications in addition to quality of life, costs, and cost per quality-adjusted life-year (QALY. RESULTS: Compared with current care, health checks reduced the incidence of MACE (6-17 events prevented per 1000 people screened and diabetes related microvasular complications (5-11 events prevented per 1000 people screened, and increased QALYs (31-59 discounted QALYs over 30 years, in all countries. The cost per QALY of offering a health check to all individuals in the study cohort ranged from €14903 (France to cost saving (Poland. Pre-screening the population and offering health checks only to higher risk individuals lowered the cost per QALY. Pre-screening on the basis of obesity had a cost per QALY of €10200 (France or less, and pre-screening with a non-invasive risk score was similar. CONCLUSIONS: A vascular disease health check would likely be cost effective at 30 years in Denmark, France, Germany, Italy, Poland, and the United Kingdom.

  4. The Rendu-Osler-Weber Disease Revealed by a Refractory Hypoxemia and Severe Cerebral Fat Embolism

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    Leonel Barreto

    2013-01-01

    Full Text Available The Rendu-Osler-Weber disease is a genetic disease which may lead to severe hemorrhage and less frequently to severe organ dysfunction. We report the case of a 22-year-old patient with no personal medical history who was involved in a motorcycle accident and exhibited severe complications related to large arteriovenous pulmonary shunts during his ICU stay. The patient developed an unexplained severe hypoxemia which was attributed to several arteriovenous shunts of the pulmonary vasculature by a contrast study during a transesophageal echocardiographic examination. The course was subsequently complicated by a prolonged coma associated with hemiplegia which was attributed to a massive paradoxical fat embolism in the setting of an untreated femoral fracture. In addition to hemorrhagic complications which may lead to intractable shock, arteriovenous malformations associated with the Rendu-Osler-Weber disease may involve the pulmonary vasculature and result in unexpected complications, such as hypoxemia or severe cerebral fat embolism in high-risk patients.

  5. Motor phenotype is not associated with vascular dysfunction in symptomatic Huntington's disease transgenic R6/2 (160 CAG) mice.

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    Di Pardo, A; Carrizzo, A; Damato, A; Castaldo, S; Amico, E; Capocci, L; Ambrosio, M; Pompeo, F; De Sanctis, C; Spinelli, C C; Puca, A A; Remondelli, P; Maglione, V; Vecchione, C

    2017-02-17

    Whereas Huntington's disease (HD) is unequivocally a neurological disorder, a critical mass of emerging studies highlights the occurrence of peripheral pathology like cardiovascular defects in both animal models and humans. The overt impairment in cardiac function is normally expected to be associated with peripheral vascular dysfunction, however whether this assumption is reasonable or not in HD is still unknown. In this study we functionally characterized the vascular system in R6/2 mouse model (line 160 CAG), which recapitulates several features of human pathology including cardiac disease. Vascular reactivity in different arterial districts was determined by wire myography in symptomatic R6/2 mice and age-matched wild type (WT) littermates. Disease stage was assessed by using well-validated behavioural tests like rotarod and horizontal ladder task. Surprisingly, no signs of vascular dysfunction were detectable in symptomatic mice and no link with motor phenotype was found.

  6. Non-invasive assessment of intratumoral vascularity using arterial spin labeling: A comparison to susceptibility-weighted imaging for the differentiation of primary cerebral lymphoma and glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Furtner, J., E-mail: julia.furtner@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Schöpf, V., E-mail: veronika.schoepf@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Preusser, M., E-mail: matthias.preusser@meduniwien.ac.at [Department of Medicine I, Division of Oncology, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Asenbaum, U., E-mail: ulrika.asenbaum@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Woitek, R., E-mail: ramona.woitek@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Wöhrer, A., E-mail: adelheid.woehrer@meduniwien.ac.at [Institute of Neurology, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Hainfellner, J.A., E-mail: johannes.hainfellner@meduniwien.ac.at [Institute of Neurology, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Wolfsberger, S., E-mail: stefan.wolfsberger@meduniwien.ac.at [Department of Neurosurgery, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Prayer, D., E-mail: daniela.prayer@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria)

    2014-05-15

    Using conventional MRI methods, the differentiation of primary cerebral lymphomas (PCNSL) and other primary brain tumors, such as glioblastomas, is difficult due to overlapping imaging characteristics. This study was designed to discriminate tumor entities using normalized vascular intratumoral signal intensity values (nVITS) obtained from pulsed arterial spin labeling (PASL), combined with intratumoral susceptibility signals (ITSS) from susceptibility-weighted imaging (SWI). Thirty consecutive patients with glioblastoma (n = 22) and PCNSL (n = 8), histologically classified according to the WHO brain tumor classification, were included. MRIs were acquired on a 3 T scanner, and included PASL and SWI sequences. nVITS was defined by the signal intensity ratio between the tumor and the contralateral normal brain tissue, as obtained by PASL images. ITSS was determined as intratumoral low signal intensity structures detected on SWI sequences and were divided into four different grades. Potential differences in the nVITS and ITSS between glioblastomas and PCNSLs were revealed using statistical testing. To determine sensitivity, specificity, and diagnostic accuracy, as well as an optimum cut-off value for the differentiation of PCNSL and glioblastoma, a receiver operating characteristic analysis was used. We found that nVITS (p = 0.011) and ITSS (p = 0.001) values were significantly higher in glioblastoma than in PCNSL. The optimal cut-off value for nVITS was 1.41 and 1.5 for ITSS, with a sensitivity, specificity, and accuracy of more than 95%. These findings indicate that nVITS values have a comparable diagnostic accuracy to ITSS values in differentiating glioblastoma and PCNSL, offering a completely non-invasive and fast assessment of tumoral vascularity in a clinical setting.

  7. Cuidador familiar de seqüelados de acidente vascular cerebral: significado e implicações Family caregiver of stroke sequel patients: meanings and implications

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    Fernanda de Freitas Mendonça

    2008-01-01

    Full Text Available O acidente vascular cerebral (AVC está entre as principais causas de morte no mundo. Diante das incapacidades impostas pelo AVC, surge o cuidador familiar. O objetivo desta pesquisa foi analisar o significado e as implicações de se tornar cuidador de um indivíduo seqüelado de AVC. Trata-se de um estudo qualitativo, realizado com cinco cuidadores, em Londrina-PR, no período de agosto a dezembro de 2005. Os dados foram coletados por meio de entrevistas semi-estruturadas e submetidos à análise de discurso proposta por Martins e Bicudo. Da análise das entrevistas emergiram sete categorias: voltando-se para o Ser cuidado, descrevendo os cuidados, apresentando as mudanças, o apoio da espiritualidade, compreendendo o significado do cuidado, expressando as necessidades para cuidar e perspectivas para o futuro. Os resultados revelaram que ser cuidador familiar é um fenômeno complexo, que gera nos sujeitos sentimentos de alegria e felicidade concomitantes aos sentimentos de medo, ansiedade e revolta.The brain vascular accident (BVA is one of the main death causes worldwide. Due to the impairments imposed by the BVA, there is the family caregiver. This work aims to analyze the meaning and implications of being a caregiver of a stroke sequel person. It is a qualitative research, carried out with five caregivers in Londrina-PR, from August to December 2005. Data were collected in semi-structured interviews and were subjected to discourse analysis proposed by Martins and Bicudo. From the analysis of interviews seven categories arouse: turning to the being cared, describing care, presenting changes, spirituality support, understanding the meaning of care, expressing the needs to take care and future perspectives. Results revealed that being a family caregiver is a complex phenomenon, that creates in the subjects feelings of happiness and along with feelings of fear, anxiety and revolt.

  8. Dieta DASH na redução dos níveis de pressão arterial e prevenção do acidente vascular cerebral = DASH diet in reducing blood pressure and preventing stroke

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    Piper, Vanessa Alves

    2012-01-01

    Conclusões: As evidências disponíveis sugerem que modificações no estilo de vida, incluindo a adoção de uma dieta tipo DASH, são estratégias eficazes no controle da hipertensão arterial e na redução de eventos cardiovasculares, como o acidente vascular cerebral

  9. [The age-related macular degeneration as a vascular disease/part of systemic vasculopathy: contributions to its pathogenesis].

    Science.gov (United States)

    Fischer, Tamás

    2015-03-01

    The wall of blood vessels including those in choroids may be harmed by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic, and genetic impacts (risk factors), which may trigger a protracted response, the so-called host defense response. As a consequence, pathological changes resulting in vascular injury (e. g. atherosclerosis, age-related macular degeneration) may be evolved. Risk factors can also act directly on the endothelium through an increased production of reactive oxygen species promoting an endothelial activation, which leads to endothelial dysfunction, the onset of vascular disease. Thus, endothelial dysfunction is a link between the harmful stimulus and vascular injury; any kind of harmful stimuli may trigger the defensive chain that results in inflammation that may lead to vascular injury. It has been shown that even early age-related macular degeneration is associated with the presence of diffuse arterial disease and patients with early age-related macular degeneration demonstrate signs of systemic and retinal vascular alterations. Chronic inflammation, a feature of AMD, is tightly linked to diseases associated with ED: AMD is accompanied by a general inflammatory response, in the form of complement system activation, similar to that observed in degenerative vascular diseases such as atherosclerosis. All these facts indicate that age-related macular degeneration may be a vascular disease (or part of a systemic vasculopathy). This recognition could have therapeutic implications because restoration of endothelial dysfunction may prevent the development or improve vascular disease resulting in prevention or improvement of age-related macular degeneration as well.

  10. New therapeutic approaches for Alzheimer’s disease and cerebral amyloid angiopathy

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    Satoshi eSaito

    2014-10-01

    Full Text Available Accumulating evidence has shown a strong relationship between Alzheimer’s disease (AD, cerebral amyloid angiopathy (CAA, and cerebrovascular disease. Cognitive impairment in AD patients can result from cortical microinfarcts associated with CAA, as well as the synaptic and neuronal disturbances caused by cerebral accumulations of β-amyloid (Aβ and tau proteins. The pathophysiology of AD may lead to a toxic chain of events consisting of Aβ overproduction, impaired Aβ clearance, and brain ischemia. Insufficient removal of Aβ leads to development of CAA and plays a crucial role in sporadic AD cases, implicating promotion of Aβ clearance as an important therapeutic strategy. Aβ is mainly eliminated by three mechanisms: 1 enzymatic/glial degradation, 2 transcytotic delivery, and 3 perivascular drainage (3-‘d’ mechanisms. Enzymatic degradation may be facilitated by activation of Aβ-degrading enzymes such as neprilysin, angiotensin-converting enzyme, and insulin-degrading enzyme. Transcytotic delivery can be promoted by inhibition of the receptor for advanced glycation end products (RAGE, which mediates transcytotic influx of circulating Aβ into brain. Successful use of the RAGE inhibitor TTP488 in Phase II testing has led to a Phase III clinical trial for AD patients. The perivascular drainage system seems to be driven by motive force generated by cerebral arterial pulsations, suggesting that vasoactive drugs can facilitate Aβ clearance. One of the drugs promoting this system is cilostazol, a selective inhibitor of type 3 phosphodiesterase. The clearance of fluorescent soluble Aβ tracers was significantly enhanced in cilostazol-treated CAA model mice. Given that the balance between Aβ synthesis and clearance determines brain Aβ accumulation, and that Aβ is cleared by several pathways stated above, multi-drugs combination therapy could provide a mainstream cure for sporadic AD.

  11. Relation of cerebral small-vessel disease and brain atrophy to mild Parkinsonism in the elderly.

    Science.gov (United States)

    Reitz, Christiane; Trenkwalder, Claudia; Kretzschmar, Konrad; Roesler, Andreas; V Eckardstein, Arnold; Berger, Klaus

    2006-11-01

    The association between cerebral small-vessel disease, brain atrophy, and the risk and severity of mild parkinsonian signs (MPS) remains unclear. The objective of this study is to examine the effect of lacunar brain infarcts, cerebral white matter lesions (WMLs), and cortical atrophy on the risk and severity of MPS. This study is a cross-sectional community-based cohort study comprising 268 subjects, 65 to 83 years of age, residing in the Augsburg region of southern Germany, and without contraindications for magnetic resonance imaging (MRI) of the brain. Main outcome measures. Subcortical and periventricular WMLs, lacunar brain infarcts, and cortical atrophy determined using a standardized MRI protocol developed for the Rotterdam Scan Study and an established rating scale. MPS, assessed in a standardized neurological examination and based on the Unified Parkinson's Disease Rating Scale motor scale. Lacunar brain infarcts and large subcortical white matter lesions were associated with an elevated risk of resting tremor. More severe cortical atrophy was related to an increased risk of rigidity and bradykinesia. In a linear regression analysis relating each individual MRI measurement with the severity of MPS, the number of lacunar brain infarcts and the degree of brain atrophy were correlated with the severity of resting tremor, whereas the size of subcortical and periventricular WMLs was correlated with the severity of rigidity. A higher degree of brain atrophy was associated with increased severity of either cardinal sign. In our study, presence and volume of lacunar brain infarcts, cerebral WMLs, and cortical atrophy were associated with the risk as well as severity of MPS. Determining the presence of these brain changes using brain imaging might contribute to identify persons at risk for MPS.

  12. Traffic jam at the blood-brain barrier promotes greater accumulation of Alzheimer's disease amyloid-β proteins in the cerebral vasculature.

    Science.gov (United States)

    Agyare, Edward K; Leonard, Sarah R; Curran, Geoffry L; Yu, Caroline C; Lowe, Val J; Paravastu, Anant K; Poduslo, Joseph F; Kandimalla, Karunya K

    2013-05-06

    Amyloid-β (Aβ) deposition in the brain vasculature results in cerebral amyloid angiopathy (CAA), which occurs in about 80% of Alzheimer's disease (AD) patients. While Aβ42 predominates parenchymal amyloid plaques in AD brain, Aβ40 is prevalent in the cerebrovascular amyloid. Dutch mutation of Aβ40 (E22Q) promotes aggressive cerebrovascular accumulation and leads to severe CAA in the mutation carriers; knowledge of how DutchAβ40 drives this process more efficiently than Aβ40 could reveal various pathophysiological events that promote CAA. In this study we have demonstrated that DutchAβ40 shows preferential accumulation in the blood-brain-barrier (BBB) endothelial cells due to its inefficient blood-to-brain transcytosis. Consequently, DutchAβ40 establishes a permeation barrier in the BBB endothelium, prevents its own clearance from the brain, and promotes the formation of amyloid deposits in the cerebral microvessels. The BBB endothelial accumulation of native Aβ40 is not robust enough to exercise such a significant impact on its brain clearance. Hence, the cerebrovascular accumulation of Aβ40 is slow and may require other copathologies to precipitate into CAA. In conclusion, the magnitude of Aβ accumulation in the BBB endothelial cells is a critical factor that promotes CAA; hence, clearing vascular endothelium of Aβ proteins may halt or even reverse CAA.

  13. Small vascular and Alzheimer disease-related pathologic determinants of dementia in the oldest-old.

    Science.gov (United States)

    Sinka, Lidia; Kövari, Enikö; Gold, Gabriel; Hof, Patrick R; Herrmann, François R; Bouras, Constantin; Giannakopoulos, Panteleimon

    2010-12-01

    The relative contributions of Alzheimer disease (AD) and vascular lesion burden to the occurrence of cognitive decline are more difficult to define in the oldest-old than they are in younger cohorts. To address this issue, we examined 93 prospectively documented autopsy cases from 90 to 103 years with various degrees of AD lesions, lacunes, and microvascular pathology. Cognitive assessment was performed prospectively using the Clinical Dementia Rating scale. Neuropathologic evaluation included the Braak neurofibrillary tangle (NFT) and β-amyloid (Aβ) protein deposition staging and bilateral semiquantitative assessment of vascular lesions. Statistics included regression models and receiver operating characteristic analyses. Braak NFTs, Aβ deposition, and cortical microinfarcts (CMIs) predicted 30% of Clinical Dementia Rating variability and 49% of the presence of dementia. Braak NFT and CMI thresholds yielded 0.82 sensitivity, 0.91 specificity, and 0.84 correct classification rates for dementia. Using these threshold values, we could distinguish 3 groups of demented cases and propose criteria for neuropathologic definition of mixed dementia, pure vascular dementia, and AD in very old age. Braak NFT staging and severity of CMI allow for defining most of demented cases in the oldest-old. Most importantly, single cutoff scores for these variables that could be used in the future to formulate neuropathologic criteria for mixed dementia in this age group were identified.

  14. Apraxia for differentiating Alzheimer’s disease from subcortical vascular dementia and mild cognitive impairment

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    Ozkan S

    2013-07-01

    Full Text Available Serhat Ozkan,1 Demet Ozbabalik Adapinar,1 Nese Tuncer Elmaci,2 Didem Arslantas31Department of Neurology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey; 2Department of Neurology, Marmara University Medical Faculty, Istanbul, Turkey; 3Department of Public Health, Eskisehir Osmangazi University Medical Faculty, Eskisehir, TurkeyAbstract: Although ideomotor limb apraxia is considered to be a typical sign of cortical pathologies such as Alzheimer’s disease (AD, it has been also reported in subcortical neurodegenerative diseases and vascular lesions. We aimed to investigate the difference between AD, subcortical vascular dementia (SVaD and mild cognitive impairment (MCI patients by means of ideomotor limb apraxia frequency and severity. Ninety-six AD, 72 SVaD, and 84 MCI patients were assessed with the mini-mental status examination (MMSE, clinical dementia rating (CDR and the apraxia screening test of TULIA (AST. Apraxia was significantly more frequent in the AD patients (32.3% than in both of the SVaD (16.7% and MCI (4.8% patients. The frequency of apraxia was also significantly higher in SVaD patients than in MCI patients. AD patients had significantly lower apraxia scores than both SVaD and MCI patients. In addition, a significant difference was found between SVaD and MCI patients in terms of apraxia scores. These results suggest that the widespread belief of the association between apraxia and cortical dementias is not exactly correct. The significant difference between both of the dementia groups and the MCI patients suggests that the absence of apraxia can be an indicator for MCI diagnosis.Keywords: apraxia, Alzheimer’s disease, subcortical vascular dementia, mild cognitive impairment

  15. Features of cerebral vascular reactivity in patients with different clinical course of a high degree of myopia

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    G. V. Shkrebets

    2014-07-01

    Full Text Available Purpose: to examine the state rate parameters of cerebral and ocular vessels in patients with glaucoma combined with myopia of high degree.Methods: the study involved 3 groups of patients aged 16-32 years: