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Sample records for cerebrovascular reactivity including

  1. Cerebrovascular reactivity and dynamic autoregulation in tetraplegia.

    Science.gov (United States)

    Wilson, Luke C; Cotter, James D; Fan, Jui-Lin; Lucas, Rebekah A I; Thomas, Kate N; Ainslie, Philip N

    2010-04-01

    Humans with spinal cord injury have impaired cardiovascular function proportional to the level and completeness of the lesion. The effect on cerebrovascular function is unclear, especially for high-level lesions. The purpose of this study was to evaluate the integrity of dynamic cerebral autoregulation (CA) and the cerebrovascular reactivity in chronic tetraplegia (Tetra). After baseline, steady-state hypercapnia (5% CO(2)) and hypocapnia (controlled hyperventilation) were used to assess cerebrovascular reactivity in 6 men with Tetra (C5-C7 lesion) and 14 men without [able-bodied (AB)]. Middle cerebral artery blood flow velocity (MCAv), cerebral oxygenation, arterial blood pressure (BP), heart rate (HR), cardiac output (Q; model flow), partial pressure of end-tidal CO(2) (Pet(CO(2))), and plasma catecholamines were measured. Dynamic CA was assessed by transfer function analysis of spontaneous fluctuations in BP and MCAv. MCAv pulsatility index (MCAv PI) was calculated as (MCAv(systolic) - MCAv(diastolic))/MCAv(mean) and standardized by dividing by mean arterial pressure (MAP). Resting BP, total peripheral resistance, and catecholamines were lower in Tetra (P 0.05). Although phase and transfer function gain relationships in dynamic CA were maintained with Tetra (P > 0.05), coherence in the very low-frequency range (0.02-0.07 Hz) was approximately 21% lower in Tetra (P = 0.006). Full (hypo- and hypercapnic) cerebrovascular reactivity to CO(2) was unchanged with Tetra (P > 0.05). During hypercapnia, standardized MCAv PI reactivity was enhanced by approximately 78% in Tetra (P = 0.016). Despite impaired cardiovascular function, chronic Tetra involves subtle changes in dynamic CA and cerebrovascular reactivity to CO(2). Changes are evident in coherence at baseline and MCAv PI during baseline and hypercapnic states in chronic Tetra, which may be indicative of cerebrovascular adaptation. PMID:20089710

  2. Monitoring cerebrovascular pressure reactivity with rheoencephalography

    Science.gov (United States)

    Brady, K. M.; Mytar, J. O.; Kibler, K. K.; Easley, R. B.; Koehler, R. C.; Czosnyka, M.; Smielewski, P.; Zweifel, C.; Bodo, M.; Pearce, F. J.; Armonda, R. A.

    2010-04-01

    Determining optimal perfusion pressure for patients with traumatic brain injury can be accomplished by monitoring the pressure reactivity index, or PRx, which requires an intracranial pressure monitor. We hypothesized that pressure reactivity could be quantified using a rheoencephalography index, or REGx. We measured the REGx and PRx as repetitive, low-frequency linear correlation between arterial blood pressure and intracranial pressure (PRx) or arterial blood pressure and REG pulse amplitude (REGx) in a piglet model of progressive hypotension. We compared the PRx and REGx against a gold standard determination of the lower limit of autoregulation using laser-Doppler measurements of cortical red cell flux. The PRx produced an accurate metric of vascular reactivity in this cohort, with area under the receiver-operator characteristic curves of 0.91. REGx was moderately correlated to the PRx, (Spearman r = 0.63, p < 0.0001; Bland-Altman bias-0.13). The area under the receiver-operator curve for the REGx was 0.86. Disagreement occurred at extremes of hypotension.

  3. Cerebrovascular mental stress reactivity is impaired in hypertension

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    Naqvi Tasneem Z

    2009-07-01

    Full Text Available Abstract Background Brachial artery reactivity in response to shear stress is altered in subjects with hypertension. Since endothelial dysfunction is generalized, we hypothesized that carotid artery (CA reactivity would also be altered in hypertension. Purpose To compare (CA endothelium-dependent vasodilation in response to mental stress in normal and hypertensive subjects. Methods We evaluated CA reactivity to mental stress in 10 young healthy human volunteers (aged 23 ± 4 years, 20 older healthy volunteers (aged 49 ± 11 years and in 28 patients with essential hypertension (aged 51 ± 13 years. In 10 healthy volunteers and 12 hypertensive subjects, middle cerebral artery (MCA PW transcranial Doppler was performed before and 3 minutes after mental stress. Results Mental stress by Stroop color word conflict, math or anger recall tests caused CA vasodilation in young healthy subjects (0.61 ± 0.06 to 0.65 ± 0.07 cm, p Conclusion Mental stress produces CA vasodilation and is accompanied by an increase in CA and MCA blood flow in healthy subjects. This mental stress induced CA vasodilation and flow reserve is attenuated in subjects with hypertension and may reflect cerebral vascular endothelial dysfunction. Assessment of mental stress induced CA reactivity by ultrasound is a novel method for assessing the impact of hypertension on cerebrovascular endothelial function and blood flow reserve.

  4. Cerebrovascular reactivity in migraineurs as measured by transcranial Doppler

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    Thomas, T.D.; Harpold, G.J. (Alabama Univ., Birmingham, AL (USA). School of Medicine); Troost, B.T. (Bowman Gray School of Medicine, Winston-Salem, NC (USA))

    1990-04-01

    Transcranial Doppler ultrasound is a relatively new diagnostic modality which allows the non-invasive assessment of intracranial circulation. A total of 10 migraine patients were studied and compared to healthy controls without headaches. Migraineurs during the headache-free interval demonstrated excessive cerebrovascular reactivity to CO{sub 2}, evidenced by an increase in middle cerebral artery blood flow velocity of 47% {plus minus} 15% compared to 28% {plus minus} 14% in controls. Differences between the two study groups revealed no significant decrease in middle cerebral artery blood flow velocity with hypocapnia. However, the differences between middle cerebral artery blood flow velocity during hyperventilation and CO{sub 2} inhalation were significantly different comparing migraineurs and controls. Instability of the baseline blood flow velocities was also noted in migraineurs during the interictal period. Characteristics which may allow differentiation of migraineurs from other headache populations could possibly be obtained from transcranial Doppler ultrasound flow studies. 24 refs., 2 tabs.

  5. Mapping white matter diffusion and cerebrovascular reactivity in carotid occlusive disease

    NARCIS (Netherlands)

    Conklin, J.; Fierstra, J.; Crawley, A. P.; Han, J. S.; Poublanc, J.; Silver, F. L.; Tymianski, M.; Fisher, J. A.; Mandell, D. M.; Mikulis, D. J.

    2011-01-01

    Objective: To characterize the relationship between cerebrovascular reactivity (CVR) and white matter (WM) diffusion in patients with internal carotid artery (ICA) occlusive disease. Methods: In this exploratory observational study, 41 patients with severe stenosis or occlusion of the extracranial I

  6. Neckties and Cerebrovascular Reactivity in Young Healthy Males: A Pilot Randomised Crossover Trial

    OpenAIRE

    Mark Rafferty; Quinn, Terence J.; Jesse Dawson; Matthew Walters

    2010-01-01

    Background. A necktie may elevate intracranial pressure through compression of venous return. We hypothesised that a tight necktie would deleteriously alter cerebrovascular reactivity. Materials and Methods. A necktie was simulated using bespoke apparatus comprising pneumatic inner-tube with aneroid pressure-gauge. Using a randomised crossover design, cerebrovascular reactivity was measured with the “pseudo-tie” worn inflated or deflated for 5 minutes (simulating tight/loose necktie resp.)....

  7. Relationship of obesity and insulin resistance with the cerebrovascular reactivity: a case control study

    OpenAIRE

    Rodríguez-Flores, Marcela; García-García, Eduardo; Cano-Nigenda, Claudia Vanessa; Cantú-Brito, Carlos

    2014-01-01

    Background Obesity is associated with increased risk for stroke. The breath-holding index (BHI) is a measure of vasomotor reactivity of the brain which can be measured with the transcranial Doppler (TCD). We aim to evaluate obesity as an independent factor for altered cerebrovascular reactivity. Methods Cerebrovascular hemodynamics (mean flow velocities MFV, pulsatility index, PI, resistance index, RI, and BHI) was determined in 85 non-obese (Body Mass Index, BMI ≤27 kg/m2) and 85 obese subje...

  8. HIGH SENSITIVE C-REACTIVE PROTEIN IN CEREBROVASCULAR ISCHEMIA

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    Padmalatha

    2016-02-01

    Full Text Available BACKGROUND Cerebrovascular ischemia is recognized as a major health problem, which causes significant morbidity and mortality. The main pathophysiology of ischemic stroke is atherosclerosis of cerebral vessels. Hs-CRP is a sensitive marker of inflammation tissue injury in the arterial wall, which contributes to atherosclerosis. In this study, we aim to investigate the association of hs-CRP in patients with ischemic stroke and to correlate hs-CRP levels with possible risk factors of ischemic stroke and to assess the prognostic value of hs-CRP in ischemic stroke. METHODS In the present case control study after meeting inclusion and exclusion criteria, 50 patients with acute ischemic stroke admitted in the medical ward, King George Hospital, during the period between April 2014 and October 2014 and 40 asymptomatic age and sex matched control subjects were included. RESULTS The mean hs-CRP value in cases is 3.78+5.28mg/dl and in controls is 0.425+0.305mg/dl. Mean hs-CRP value is higher (3.78mg/dl in cases when compared to controls (0.425mg/dl, which is statistically significant. P admitted with severe degree of weakness (0-1/5 power with mean hs-CRP value of 4.28+4.07 without significant improvement in the power at the time of discharge; 8(16%> with mean hs-CRP value of 10.43+7.74 were expired. CONCLUSION Acute ischemic patients had higher mean hs-CRP values when compared to healthy asymptomatic control subjects P0.05. Higher mean hs-CRP values were associated with poor outcome after acute ischemic stroke. P<0.001.

  9. Cerebral blood flow, oxidative metabolism and cerebrovascular carbon dioxide reactivity in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Strauss, Gitte Irene; Thomsen, Gerda;

    2002-01-01

    BACKGROUND: The optimal arterial carbon dioxide tension (P(a)CO(2)) in patients with acute bacterial meningitis (ABM) is unknown and controversial. The objective of this study was to measure global cerebral blood flow (CBF), cerebrovascular CO(2) reactivity (CO(2)R), and cerebral metabolic rates...... to baseline ventilation, whereas CMR(glu) increased. CONCLUSION: In patients with acute bacterial meningitis, we found variable levels of CBF and cerebrovascular CO(2) reactivity, a low a-v DO(2), low cerebral metabolic rates of oxygen and glucose, and a cerebral lactate efflux. In these patients...

  10. Neckties and cerebrovascular reactivity in young healthy males: a pilot randomised crossover trial.

    Science.gov (United States)

    Rafferty, Mark; Quinn, Terence J; Dawson, Jesse; Walters, Matthew

    2010-01-01

    Background. A necktie may elevate intracranial pressure through compression of venous return. We hypothesised that a tight necktie would deleteriously alter cerebrovascular reactivity. Materials and Methods. A necktie was simulated using bespoke apparatus comprising pneumatic inner-tube with aneroid pressure-gauge. Using a randomised crossover design, cerebrovascular reactivity was measured with the "pseudo-tie" worn inflated or deflated for 5 minutes (simulating tight/loose necktie resp.). Reactivity was calculated using breath hold index (BHI) and paired "t" testing used for comparative analysis. Results. We enrolled 40 healthy male volunteers. There was a reduction in cerebrovascular reactivity of 0.23 units with "tight" pseudotie (BHI loose 1.44 (SD 0.48); BHI tight 1.21 (SD 0.38) P < .001). Conclusion. Impairment in cerebrovascular reactivity was found with inflated pseudo-tie. However, mean BHI is still within a range of considered normal. The situation may differ in patients with vascular risk factors, and confirmatory work is recommended. PMID:21076611

  11. Neckties and Cerebrovascular Reactivity in Young Healthy Males: A Pilot Randomised Crossover Trial

    Directory of Open Access Journals (Sweden)

    Mark Rafferty

    2011-01-01

    Full Text Available Background. A necktie may elevate intracranial pressure through compression of venous return. We hypothesised that a tight necktie would deleteriously alter cerebrovascular reactivity. Materials and Methods. A necktie was simulated using bespoke apparatus comprising pneumatic inner-tube with aneroid pressure-gauge. Using a randomised crossover design, cerebrovascular reactivity was measured with the “pseudo-tie” worn inflated or deflated for 5 minutes (simulating tight/loose necktie resp.. Reactivity was calculated using breath hold index (BHI and paired “t” testing used for comparative analysis. Results. We enrolled 40 healthy male volunteers. There was a reduction in cerebrovascular reactivity of 0.23 units with “tight” pseudotie (BHI loose 1.44 (SD 0.48; BHI tight 1.21 (SD 0.38 P<.001. Conclusion. Impairment in cerebrovascular reactivity was found with inflated pseudo-tie. However, mean BHI is still within a range of considered normal. The situation may differ in patients with vascular risk factors, and confirmatory work is recommended.

  12. The involvement of cerebrovascular reactivity in pathogenesis of space motion sickness

    Science.gov (United States)

    Moskalenko, Yu. E.; Beketov, A. I.; Weinstein, G. B.; Maximuk, V. F.; Skoromny, N. A.; Vasiljev, K. K.; Vorobjev, M. V.

    The aim of the presented work is to investigate the mechanisms of involvement of cerebral circulation in pathogenesis of space motion sickness. In experiments on chronic rabbits the 2-hours rocking and antiorthostasis served as a model of influences of the zero-gravity conditions intracranial hemo- and liquorodynamics. Cerebrovascular reactivity was evaluated as a response of cerebral blood flow and intracerebral rheoencephalography to functional loads (photostimulation, CO 2-inhalation, Stookey test). Shifts of water balance in the brain tissue has been assessed by means of three-frequency brain electrical impedance. Rocking plus antiorthostasis resulted in decrease of the cerebrovascular reactivity and hyperhydration. The data obtained show a significant decrease of compensatory abilities of the cerebrovascular system under the zero-gravity conditions.

  13. Cerebrovascular Reactivity, Intima-Media Thickness, and Nephropathy Presence in Patients With Type 1 Diabetes

    OpenAIRE

    Kozera, Grzegorz M.; Wolnik, Bogumił; Kunicka, Katarzyna B.; Szczyrba, Sebastian; Wojczal, Joanna; Schminke, Ulf; Nyka, Walenty M.; Bieniaszewski, Leszek

    2009-01-01

    OBJECTIVE Cerebrovascular reactivity impairment was reported as a marker of cerebral microangiopathy in long-term type 1 diabetes. Intima-media complex thickening reflects early stages of macroangiopathy in type 1 diabetes. The analysis of the relationship between these variables and other microangiopathic complications might serve as a beneficial indicator for early prophylaxis in these patients. RESEARCH DESIGN AND METHODS Vasomotor reactivity reserve (VMRr) and breath-holding index (BHI) o...

  14. Cerebrovascular CO2 reactivity in normotensive and hypertensive man

    DEFF Research Database (Denmark)

    Tominaga, S; Strandgaard, S; Uemura, K;

    1976-01-01

    curve suggested a decrease in reactivity below a PaCO2 of 30 to 35 mm Hg in both groups. Above a PaCO2 of 35 mm Hg, exponential regression analysis yielded a mean reactivity of 6 +/- 2%, whereas below a PaCO2 of 30 mm Hg it was about 2%. The rise in CBF during CO2 inhalation was not influenced...

  15. Cerebrovascular reactivity is associated with maximal aerobic capacity in healthy older adults

    OpenAIRE

    Barnes, Jill N.; Taylor, Jennifer L.; Kluck, Breann N.; Johnson, Christopher P.; Joyner, Michael J.

    2013-01-01

    Recently, several high-impact reviews suggest that regular aerobic exercise is beneficial for maintaining cognitive function in aging adults. Higher cerebral blood flow and/or cerebrovascular reactivity may explain the favorable effect of exercise on cognition. In addition, prostaglandin-mediated vasodilator responses may be influenced by regular exercise. Therefore, our purpose was to evaluate middle cerebral artery (MCA) vasodilator responses in healthy adults before and after cyclooxygenas...

  16. Modelling Cerebrovascular Reactivity: A Novel Near-Infrared Biomarker of Cerebral Autoregulation?

    OpenAIRE

    Highton, D.; Panovska-Griffiths, J; Ghosh, A; Tachtsidis, I; Banaji, M.; Elwell, C.; Smith, M.

    2013-01-01

    Understanding changes in cerebral oxygenation, haemodynamics and metabolism holds the key to individualised, optimised therapy after acute brain injury. Near-infrared spectroscopy (NIRS) offers the potential for non-invasive, continuous bedside measurement of surrogates for these processes. Interest has grown in applying this technique to interpret cerebrovascular pressure reactivity (CVPR), a surrogate of the brain's ability to autoregulate blood flow. We describe a physiological model-based...

  17. Cerebrovascular reactivity is associated with maximal aerobic capacity in healthy older adults.

    Science.gov (United States)

    Barnes, Jill N; Taylor, Jennifer L; Kluck, Breann N; Johnson, Christopher P; Joyner, Michael J

    2013-05-15

    Recently, several high-impact reviews suggest that regular aerobic exercise is beneficial for maintaining cognitive function in aging adults. Higher cerebral blood flow and/or cerebrovascular reactivity may explain the favorable effect of exercise on cognition. In addition, prostaglandin-mediated vasodilator responses may be influenced by regular exercise. Therefore, our purpose was to evaluate middle cerebral artery (MCA) vasodilator responses in healthy adults before and after cyclooxygenase inhibition. A total of 16 young (26 ± 6 yr; 8 males, 8 females) and 13 older (64 ± 6 yr; 7 males, 6 females) healthy adults participated in the study. Aerobic fitness was determined by maximal aerobic capacity (Vo2max) on a cycle ergometer. MCA velocity (MCAv) was measured at baseline and during stepped hypercapnia (2%, 4%, and 6% FiCO2) before and after cyclooxygenase inhibition using indomethacin. To account for differences in blood pressure, cerebrovascular conductance index (CVCi) was calculated as MCAv/mean arterial pressure. Cerebrovascular reactivity slopes were calculated from the correlation between either MCAv or CVCi and end-tidal CO2. Young adults demonstrated greater MCAv reactivity (1.61 ± 0.17 vs. 1.06 ± 0.15 cm·s(-1)·mmHg(-1); P exercise and improved cognitive function in aging adults. PMID:23471946

  18. Evaluation of the cerebrovascular pressure reactivity index using non-invasive finapres arterial blood pressure

    International Nuclear Information System (INIS)

    A pressure reactivity index (PRx) can be assessed in patients with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP) as a moving correlation coefficient between slow fluctuations of these two signals within a low frequency bandwidth. The study aimed to investigate whether the invasive ABP monitoring can be replaced with non-invasive measurement of ABP using a Finapres plethysmograph (fABP) to calculate the fPRx. There is a well-defined group of patients, suffering from hydrocephalus and undergoing CSF pressure monitoring, which may benefit from such a measurement. 41 simultaneous day-by-day monitoring of ICP, ABP and fABP were performed for about 30 min in 10 head injury patients. A Bland–Altman assessment for agreement was used to compare PRx and fPRx calculations. Performance metrics and the McNemary test were used to determine whether fPRx is sensitive enough to distinguish between functioning and disturbed cerebrovascular pressure reactivity. The fPRx correlated with PRx (RSpearman = 0.92, p < 0.001; bias = −0.04; lower and upper limits of agreement: −0.26 and 0.17, respectively). The fPRx distinguished between active and passive reactivity in more than 89% cases. The fPRx can be used with care for assessment of cerebrovascular reactivity in patients for whom invasive ABP measurement is not feasible. The fPRx is sensitive enough to distinguish between functional and deranged reactivity

  19. Evaluation of the cerebrovascular pressure reactivity index using non-invasive finapres arterial blood pressure.

    Science.gov (United States)

    Kasprowicz, M; Schmidt, E; Kim, D J; Haubrich, C; Czosnyka, Z; Smielewski, P; Czosnyka, M

    2010-09-01

    A pressure reactivity index (PRx) can be assessed in patients with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP) as a moving correlation coefficient between slow fluctuations of these two signals within a low frequency bandwidth. The study aimed to investigate whether the invasive ABP monitoring can be replaced with non-invasive measurement of ABP using a Finapres plethysmograph (fABP) to calculate the fPRx. There is a well-defined group of patients, suffering from hydrocephalus and undergoing CSF pressure monitoring, which may benefit from such a measurement. 41 simultaneous day-by-day monitoring of ICP, ABP and fABP were performed for about 30 min in 10 head injury patients. A Bland-Altman assessment for agreement was used to compare PRx and fPRx calculations. Performance metrics and the McNemary test were used to determine whether fPRx is sensitive enough to distinguish between functioning and disturbed cerebrovascular pressure reactivity. The fPRx correlated with PRx (R(Spearman) = 0.92, p agreement: -0.26 and 0.17, respectively). The fPRx distinguished between active and passive reactivity in more than 89% cases. The fPRx can be used with care for assessment of cerebrovascular reactivity in patients for whom invasive ABP measurement is not feasible. The fPRx is sensitive enough to distinguish between functional and deranged reactivity. PMID:20664157

  20. Cerebral Endothelial Function Determined by Cerebrovascular Reactivity to L-Arginine

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    Janja Pretnar-Oblak

    2014-01-01

    Full Text Available Endothelium forms the inner cellular lining of blood vessels and plays an important role in many physiological functions including the control of vasomotor tone. Cerebral endothelium is probably one of the most specific types but until recently it was impossible to determine its function. In this review, the role of cerebrovascular reactivity to L-arginine (CVR-L-Arg for assessment of cerebral endothelial function is discussed. L-Arginine induces vasodilatation through enhanced production of nitric oxide (NO in the cerebral endothelium. Transcranial Doppler sonography is used for evaluation of cerebral blood flow changes. The method is noninvasive, inexpensive, and enables reproducible measurements. CVR-L-Arg has been compared to flow-mediated dilatation as a gold standard for systemic endothelial function and intima-media thickness as a marker for morphological changes. However, it seems to show specific cerebral endothelial function. So far CVR-L-Arg has been used to study cerebral endothelial function in many pathological conditions such as stroke, migraine, etc. In addition CVR-L-Arg has also proven its usefulness in order to show potential improvement after pharmacological interventions. In conclusion CVR-L-Arg is a promising noninvasive research method that could provide means for evaluation of cerebral endothelial function in physiological and pathological conditions.

  1. Assessment of Unconstrained Cerebrovascular Reactivity Marker for Large Age-Range fMRI Studies

    OpenAIRE

    Kannurpatti, Sridhar S.; Motes, Michael A.; Biswal, Bharat B; Rypma, Bart

    2014-01-01

    Breath hold (BH), a commonly used task to measure cerebrovascular reactivity (CVR) in fMRI studies varies in outcome among individuals due to subject-physiology and/or BH-inspiration/expiration differences (i.e., performance). In prior age-related fMRI studies, smaller task-related BOLD response variability is observed among younger than older individuals. Also, a linear CVR versus task relationship exists in younger individuals which maybe useful to test the accuracy of CVR responses in olde...

  2. Calcitonin gene-related peptide (CGRP receptors are important to maintain cerebrovascular reactivity in chronic hypertension.

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    Zhenghui Wang

    Full Text Available Cerebral blood flow autoregulation (CA shifts to higher blood pressures in chronic hypertensive patients, which increases their risk for brain damage. Although cerebral vascular smooth muscle cells express the potent vasodilatatory peptides calcitonin gene-related peptide (CGRP and adrenomedullin (AM and their receptors (calcitonin receptor-like receptor (Calclr, receptor-modifying proteins (RAMP 1 and 2, their contribution to CA during chronic hypertension is poorly understood. Here we report that chronic (10 weeks hypertensive (one-kidney-one-clip-method mice overexpressing the Calclr in smooth muscle cells (CLR-tg, which increases the natural sensitivity of the brain vasculature to CGRP and AM show significantly better blood pressure drop-induced cerebrovascular reactivity than wt controls. Compared to sham mice, this was paralleled by increased cerebral CGRP-binding sites (receptor autoradiography, significantly in CLR-tg but not wt mice. AM-binding sites remained unchanged. Whereas hypertension did not alter RAMP-1 expression (droplet digital (dd PCR in either mouse line, RAMP-2 expression dropped significantly in both mouse lines by about 65%. Moreover, in wt only Calclr expression was reduced by about 70% parallel to an increase of smooth muscle actin (Acta2 expression. Thus, chronic hypertension induces a stoichiometric shift between CGRP and AM receptors in favor of the CGRP receptor. However, the parallel reduction of Calclr expression observed in wt mice but not CLR-tg mice appears to be a key mechanism in chronic hypertension impairing cerebrovascular reactivity.

  3. Neuroimaging assessment of cerebrovascular reactivity in concussion: current concepts, methodological considerations and review of the literature

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    Michael John Ellis

    2016-04-01

    Full Text Available Concussion is a form of traumatic brain injury (TBI that presents with a wide spectrum of subjective symptoms and few objective clinical findings. Emerging research suggests that one of the processes that may contribute to concussion pathophysiology is dysregulation of cerebral blood flow (CBF leading to a mismatch between CBF delivery and the metabolic needs of the injured brain. Cerebrovascular reactivity (CVR is defined as the change in CBF in response to a measured vasoactive stimulus. Several magnetic resonance imaging (MRI techniques can be used as a surrogate measure of CBF in clinical and laboratory studies. In order to provide an accurate assessment of CVR, these sequences must be combined with a reliable, reproducible vasoactive stimulus that can manipulate CBF. Although CVR imaging currently plays a crucial role in the diagnosis and management of many cerebrovascular diseases, only recently have studies begun to apply this assessment tool in patients with concussion. In order to evaluate the quality, reliability and relevance of CVR studies in concussion, it is important that clinicians and researchers have a strong foundational understanding of the role of cerebral blood flow regulation in health, concussion and more severe forms of TBI, and an awareness of the advantages and limitations of currently available CVR measurement techniques. Accordingly, in this review we 1 discuss the role of CVR in TBI and concussion; 2 examine methodological considerations for MRI-based measurement of CVR; and 3 provide an overview of published CVR studies in concussion patients.

  4. Evaluation of cerebrovascular reactivity by ultrasonography in type 2 diabetic patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    Jinhui Zhao; Yuxiang Chen; Zhen Zhao; Qingchun Zhao; Dongmei Hao; Shanshan Tang

    2007-01-01

    BACKGROUND: Cerebrovascular reactivity (CVR) reflects cerebrovascular reserve capacity, and cerebrovascular reactivity damage prognosticates a very high risk of stroke.OBJECTIVE: To evaluate CVR by detecting the increase rate of blood flow volume of middle cerebral artery (MCA) before and after breathholding in diabetic patients with hypertension, and observe the effects of hypertension on cerebrovascular reserve capacity of diabetic patients. DESIGN: Controlled observation.SETTINGS: Department of Function, Affiliated Hospital of Hebei University; Department of Special Diagnosis, the 202 Hospital of Chinese PLA.PARTICIPANTS: Inpatients or outpatients with type 2 diabetes mellitus (DM) or primary hypertension admitted to Departments of Gastroenterology and Cardiology, Affiliated Hospital of Hebei University and the 202 Hospital of Chinese PLA from April to December 2004 were involved in this experiment. Inclusive criteria: type 2 DM met the criteria of the report on diabetes diagnosis announced in 1999 by WHO expert committee, totally 88 patients were involved. Primary hypertension met the diagnosis criteria announced in 1999 by WHO/1SH, totally 42 patients were involved. Another group of 43 concurrent subjects who received physical examination served as controls. According to the disease condition, the involved patients were assigned into 3 groups: DM group (only diabetic patients), hypertension group (only hypertension patients) and DM complicated with hypertension group (diabetic patients with hypertension). Informed consent for the examination was obtained from all the involved subjects.METHODS: Before MCA of subjects was detected, bilateral carotid artery was routinely detected by high-frequency ultrasonography. Subjects were rejected when stenosis rate of unilateral internal carotid artery or common carotid artery≥70%. Vessels were expanded with transcranial color Duplex Doppler by breath holding test for detecting vascular reactivity. Hypercapnia was

  5. Assessment of cerebrovascular reactivity during major depression and after remission of disease

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    Vakilian Alireza

    2010-01-01

    Full Text Available Background: There are a growing number of studies suggesting that depression may increase the risk of stroke. Impaired autoregulation of vascular tone may contribute to a higher risk of developing cerebrovascular diseases. Cerebrovascular reactivity (CVR reflects the compensatory dilatory capacity of cerebral arterioles to a dilatory stimulus and is an important mechanism that ensures constant cerebral blood flow. There is a hypothesis that CVR is reduced in major depression, which would explain the association between depression and stroke. Objectives: The aim of this study was to investigate the effect of depression on CVR in cerebral vessels by comparing CVR during the depression phase with that during remission. Material and Methods: Using the apnea test, we assessed CVR in 16 patients with unipolar depression during disease and after remission of disease by calculating the increase in cerebral blood flow velocity after breath-holding (the apnea test. Blood flow velocities were measured by transcranial Doppler ultrasound (TCD. Results: CVR was significantly reduced in the depression phase in comparison to that in the remission phase. However, this change was not seen in all the patients. Conclusion: CVR was reduced in most of the depressed patients. The decreased CVR, as indicated by the changes in peak systolic velocity (PSV and mean flow velocity (MFV of the middle cerebral artery, in depressed patients was more marked on the right side, which could point to a vascular basis for some kinds of depression. We recommend that other studies, with larger samples, be done; future studies should assess whether the changes in the CVR varies with the severity and type of depression.

  6. Dynamic cerebral autoregulation and cerebrovascular reactivity: a comparative study in lacunar infarct patients

    International Nuclear Information System (INIS)

    The major purpose of this study was to simultaneously evaluate dCA before and shortly after cerebral vasodilatation evoked by infusion of acetazolamide (ACZ). It was questioned if and to what degree dCA was changed after ACZ infusion. Using 15 mg kg−1 ACZ infusion cerebrovascular reactivity (CVR) was assessed in 29 first ever lacunar stroke patients (19 M/10 F). During the CVR-test, the electrocardiogram, non-invasive finger arterial blood pressure (ABP) and middle cerebral artery blood flow velocity (CBFV) were recorded. DCA based on spontaneous blood pressure variations was evaluated in 24 subjects by linear transfer function analysis. Squared coherence, gain and phase angle in the frequency range of autoregulation (0.04–0.16 Hz) were compared before and after ACZ infusion. After ACZ infusion, median phase angle decreased significantly (p < 0.005 Wilcoxon) to 0.77 rad compared to a pre-test baseline value of 1.05 rad, indicating less efficient dCA due to ACZ. However, post-test phase values are still mostly within the normal range. Poor and statistically non-significant correlations were found between CVR and absolute dCA phase angle. It can be concluded that CVR testing with body weight adjusted infusion of ACZ lowers dCA performance but by no means exhausts dCA, suggesting that in this way maximal CVR is not determined. Characterizing dCA based on transfer function analysis of ABP to CBFV needs no provocation and adverse patient effects are minimal. The poor correlation between CVR and dCA phase angle supports an interpretation that CVR and dCA study different mechanisms of cerebrovascular control

  7. Effects of peritumoural oedema on cerebral blood flow and cerebrovascular reactivity in patients with alert consciousness

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Chia-Cheng [Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Yokohama (Japan); Department of Neurosurgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan 236-0004; Kuwana, Nobumasa; Ito, Susumu [Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Yokohama (Japan); Ikegami, Tadashi [Department of Radiology, Yokohama Minami Kyosai Hospital, Yokohama (Japan); Yamamoto, Isao [Department of Neurosurgery, Yokohama City University School of Medicine, Yokohama (Japan)

    1999-11-01

    The effects of peritumoural oedema on cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) were studied in 18 patients with alert consciousness. Hemispheric mean CBF was measured by performing first-pass radionuclide angiography using technetium-99m hexamethylpropylene amine oxime. CVR was measured as the percentage change from the baseline mean CBF value after acetazolamide administration. Patients were classified into three groups according to the severity of peritumoural oedema. The mean CBF of both hemispheres in each group was not significantly different from that of age-matched controls. CVR was preserved in patients with mild peritumoural oedema (n=6), but was significantly (P<0.01) reduced in patients with moderate (n=7) and severe peritumoural oedema (n=5). No significant correlation was found between the degree of midline shift and the mean CVR of both hemispheres (P=0.09). Surgical removal of the tumour significantly (P<0.05) improved the impaired CVR, although the mean CBF did not change. Administration of glucocorticoid improved the impaired CVR, without a change in the mean CBF, in a patient with a metastatic brain tumour. We conclude that CVR is impaired by the development of peritumoural oedema prior to changes in mean CBF. (orig.)

  8. Assessment of unconstrained cerebrovascular reactivity marker for large age-range FMRI studies.

    Directory of Open Access Journals (Sweden)

    Sridhar S Kannurpatti

    Full Text Available Breath hold (BH, a commonly used task to measure cerebrovascular reactivity (CVR in fMRI studies varies in outcome among individuals due to subject-physiology and/or BH-inspiration/expiration differences (i.e., performance. In prior age-related fMRI studies, smaller task-related BOLD response variability is observed among younger than older individuals. Also, a linear CVR versus task relationship exists in younger individuals which maybe useful to test the accuracy of CVR responses in older groups. Hence we hypothesized that subject-related physiological and/or BH differences, if present, may compromise CVR versus task linearity in older individuals. To test the hypothesis, empirical BH versus task relationships from motor and cognitive areas were obtained in younger (mean age = 26 years and older (mean age = 58 years human subjects. BH versus task linearity was observed only in the younger group, confirming our hypothesis. Further analysis indicated BH responses and its variability to be similar in both younger and older groups, suggesting that BH may not accurately represent CVR in a large age range. Using the resting state fluctuation of amplitude (RSFA as an unconstrained alternative to BH, subject-wise correspondence between BH and RSFA was tested. Correlation between BH versus RSFA was significant within the motor but was not significant in the cognitive areas in the younger and was completely disrupted in both areas in the older subjects indicating that BH responses are constrained by subject-related physiology and/or performance-related differences. Contrasting BH to task, RSFA-task relationships were independent of age accompanied by age-related increases in CVR variability as measured by RSFA, not observed with BH. Together the results obtained indicate that RSFA accurately represents CVR in any age range avoiding multiple and yet unknown physiologic and task-related pitfalls of BH.

  9. Magnetic Resonance Imaging Quantification of Regional Cerebral Blood Flow and Cerebrovascular Reactivity to Carbon Dioxide in Normotensive and Hypertensive Rats

    Science.gov (United States)

    Leoni, Renata F.; Paiva, Fernando F.; Henning, Erica C.; Nascimento, George C.; Tannús, Alberto; de Araujo, Draulio B.; Silva, Afonso C.

    2011-01-01

    Hypertension afflicts 25% of the general population and over 50% of the elderly. In the present work, arterial spin labeling MRI was used to non-invasively quantify regional cerebral blood flow (CBF), cerebrovascular resistance and CO2 reactivity in spontaneously hypertensive rats (SHR) and in normotensive Wistar Kyoto rats (WKY), at two different ages (3 months and 10 months) and under the effects of two anesthetics, α-chloralose and 2% isoflurane (1.5 MAC). Repeated CBF measurements were highly consistent, differing by less than 10% and 18% within and across animals, respectively. Under α-chloralose, whole brain CBF at normocapnia did not differ between groups (young WKY: 61±3ml/100g/min; adult WKY: 62±4ml/100g/min; young SHR: 70±9ml/100g/min; adult SHR: 69±8ml/100g/min), indicating normal cerebral autoregulation in SHR. At hypercapnia, CBF values increased significantly, and a linear relationship between CBF and PaCO2 levels was observed. In contrast, 2% isoflurane impaired cerebral autoregulation. Whole brain CBF in SHR was significantly higher than in WKY rats at normocapnia (young SHR: 139±25ml/100g/min; adult SHR: 104±23ml/100g/min; young WKY: 55±9ml/100g/min; adult WKY: 71±19ml/100g/min). CBF values increased significantly with increasing CO2; however, there was a clear saturation of CBF at PaCO2 levels greater than 70 mmHg in both young and adult rats, regardless of absolute CBF values, suggesting that isoflurane interferes with the vasodilatory mechanisms of CO2. This behavior was observed for both cortical and subcortical structures. Under either anesthetic, CO2 reactivity values in adult SHR were decreased, confirming that hypertension, when combined with age, increases cerebrovascular resistance and reduces cerebrovascular compliance. PMID:21708273

  10. Effects of Hyul-Bu-Chuke-Tang on Erythrocyte Deformability and Cerebrovascular CO2 Reactivity in Normal Subjects

    Directory of Open Access Journals (Sweden)

    Woo-Sang Jung

    2012-01-01

    Full Text Available Aim. Hyul-bu-chuke-tang (HCEt is a well-known traditional herbal medicine that is used for the treatment of ischemic cerebrovascular disorders. We investigated the acute effects of HCEt on erythrocyte deformability and cerebrovascular CO2 reactivity (CVR in healthy male subjects. Materials and Methods. We examined erythrocyte deformability in an HCEt group (n=14 and a control group (n=10. CVR was measured using hyperventilation-induced CO2 reactivity of the middle cerebral artery and transcranial Doppler (TCD in the HCEt group (n=11. A historical control group (n=10 of CVR measurements was also created from our previous study. All measurements were performed prior to and 1, 2, and 3 hours after HCEt administration. Results. HCEt significantly improved erythrocyte deformability 1 hour after administration compared to the control group (2.9±1.1% versus -0.6±1.0%, P=0.034. HCEt significantly improved the CVR 2 hours after administration compared to the historical control group (9.1±4.0% versus -8.1±4.1%, P=0.007. The mean blood pressure and pulse rate did not vary from baseline values in either group. Conclusions. We demonstrated that HCEt improved erythrocyte deformability and CVR. Our findings suggest that an improvement in erythrocyte deformability contributes to HCEt’s effect on cerebral microcirculation.

  11. Incorrect performance of the breath hold method in the old underestimates cerebrovascular reactivity and goes unnoticed without concomitant blood pressure and end-tidal CO(2) registration

    NARCIS (Netherlands)

    Beek, A. van; Wit, H.M. de; Olde Rikkert, M.G.M.; Claassen, J.A.H.R.

    2011-01-01

    BACKGROUND AND PURPOSE: The breath hold maneuver is a convenient and frequently used method to assess cerebrovascular reactivity (CR). This study aimed to assess feasibility and reproducibility of this method in healthy older persons. METHODS: Twenty-five healthy volunteers, aged 75 (SD 4) years, pe

  12. Cerebrovascular reactivity by quantitative magnetic resonance angiography with a co{sub 2} challenge. Validation as a new imaging biomarker

    Energy Technology Data Exchange (ETDEWEB)

    Caputi, Luigi, E-mail: lcaputi@istituto-besta.it [Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Ghielmetti, Francesco, E-mail: Francesco.Ghielmetti@istituto-besta.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Faragò, Giuseppe, E-mail: Giuseppe.Farago@istituto-besta.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Longaretti, Fabio, E-mail: fabio.longaretti@libero.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Lamperti, Massimo, E-mail: docmassimomd@gmail.com [Department of Neuroanesthesia and Intensive Care, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Anzola, Gian Paolo, E-mail: gpanzola@speedyposta.it [Service of Neurology, S. Orsola Hospital, Fondazione Poliambulanza, Via Vittorio Emanuele II 27, 25122 Brescia (Italy); Carriero, Maria Rita, E-mail: MariaRita.Carriero@istituto-besta.it [Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Charbel, Fady T., E-mail: fcharbel@uic.edu [Department of Neurosurgery, University of Illinois at Chicago College of Medicine, Chicago, IL 60612 (United States); Bruzzone, Maria Grazia, E-mail: Maria.Bruzzone@istituto-besta.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Parati, Eugenio, E-mail: Eugenio.Parati@istituto-besta.it [Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Ciceri, Elisa, E-mail: Elisa.Ciceri@istituto-besta.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy)

    2014-06-15

    Assessment of cerebrovascular reactivity (CVR) is essential in cerebrovascular diseases, as exhausted CVR may enhance the risk of cerebral ischemic events. Transcranial Doppler (TCD) with a vasodilatory stimulus is currently used for CVR evaluation. Scanty data are available for Quantitative Magnetic Resonance Angiography (QMRA), which supplies higher spatial resolution and quantitative cerebral blood flow values. Aims of our pilot study were: (a) to assess safety and feasibility of CO{sub 2} administration during QMRA, (b) evaluation of CVR under QMRA compared to TCD, and (c) quantitative evaluation of blood flow from the major intracranial arterial vessels both at rest and after CO{sub 2}. CVR during 5% CO{sub 2} air breathing was measured with TCD as a reference method and compared with QMRA. Fifteen healthy subjects (age 60.47 ± 2.24; male 11/15) were evaluated at rest and during CO{sub 2} challenge. Feasibility and safety of QMRA under CO{sub 2} were ensured in all subjects. CVR from middle cerebral artery territory was not statistically different between TCD and MRI (p > 0.05). Mean arterial pressure (MAP) and heart rate (HR) increased during QMRA and TCD (MAP p = 0.007 and p = 0.001; HR p = 0.043 and p = 0.068, respectively). Blood flow values from all intracranial vessels increased after CO{sub 2} inhalation (p < 0.001). CO{sub 2} administration during QMRA sessions is safe and feasible. Good correlation in terms of CVR was obtained comparing TCD and QMRA. Blood flow values significantly increased from all intracranial arterial vessels after CO{sub 2}. Studies regarding CVR in physiopathological conditions might consider the utilization of QMRA both in routine clinical settings and in research projects.

  13. Cerebrovascular reactivity by quantitative magnetic resonance angiography with a co2 challenge. Validation as a new imaging biomarker

    International Nuclear Information System (INIS)

    Assessment of cerebrovascular reactivity (CVR) is essential in cerebrovascular diseases, as exhausted CVR may enhance the risk of cerebral ischemic events. Transcranial Doppler (TCD) with a vasodilatory stimulus is currently used for CVR evaluation. Scanty data are available for Quantitative Magnetic Resonance Angiography (QMRA), which supplies higher spatial resolution and quantitative cerebral blood flow values. Aims of our pilot study were: (a) to assess safety and feasibility of CO2 administration during QMRA, (b) evaluation of CVR under QMRA compared to TCD, and (c) quantitative evaluation of blood flow from the major intracranial arterial vessels both at rest and after CO2. CVR during 5% CO2 air breathing was measured with TCD as a reference method and compared with QMRA. Fifteen healthy subjects (age 60.47 ± 2.24; male 11/15) were evaluated at rest and during CO2 challenge. Feasibility and safety of QMRA under CO2 were ensured in all subjects. CVR from middle cerebral artery territory was not statistically different between TCD and MRI (p > 0.05). Mean arterial pressure (MAP) and heart rate (HR) increased during QMRA and TCD (MAP p = 0.007 and p = 0.001; HR p = 0.043 and p = 0.068, respectively). Blood flow values from all intracranial vessels increased after CO2 inhalation (p < 0.001). CO2 administration during QMRA sessions is safe and feasible. Good correlation in terms of CVR was obtained comparing TCD and QMRA. Blood flow values significantly increased from all intracranial arterial vessels after CO2. Studies regarding CVR in physiopathological conditions might consider the utilization of QMRA both in routine clinical settings and in research projects

  14. Cerebral perfusion and cerebrovascular reactivity are reduced in white matter hyperintensities

    DEFF Research Database (Denmark)

    Marstrand, J.R.; Garde, E; Rostrup, Egill;

    2002-01-01

    reported global reductions in cerebral blood flow (CBF) and cerebral vascular reactivity. In this study, we examined localized hemodynamic status to compare WMH to normal appearing white matter (NAWM). METHODS: A group of 21 normal 85-year-old subjects were studied using dynamic contrast-enhanced MRI...... together with administration of acetazolamide. From a combination of anatomic images with different signal weighting, regions of interest were generated corresponding to gray and white matter and WMH. Localized measurements of CBF and cerebral blood volume (CBV) and mean transit time were obtained directly...

  15. Targeted overexpression of endothelial nitric oxide synthase in endothelial cells improves cerebrovascular reactivity in Ins2Akita-type-1 diabetic mice.

    Science.gov (United States)

    Chandra, Saurav B; Mohan, Sumathy; Ford, Bridget M; Huang, Lei; Janardhanan, Preethi; Deo, Kaiwalya S; Cong, Linlin; Muir, Eric R; Duong, Timothy Q

    2016-06-01

    Reduced bioavailability of nitric oxide due to impaired endothelial nitric oxide synthase (eNOS) activity is a leading cause of endothelial dysfunction in diabetes. Enhancing eNOS activity in diabetes is a potential therapeutic target. This study investigated basal cerebral blood flow and cerebrovascular reactivity in wild-type mice, diabetic mice (Ins2(Akita+/-)), nondiabetic eNOS-overexpressing mice (TgeNOS), and the cross of two transgenic mice (TgeNOS-Ins2(Akita+/-)) at six months of age. The cross was aimed at improving eNOS expression in diabetic mice. The major findings were: (i) Body weights of Ins2(Akita+/-) and TgeNOS-Ins2(Akita+/-) were significantly different from wild-type and TgeNOS mice. Blood pressure of TgeNOS mice was lower than wild-type. (ii) Basal cerebral blood flow of the TgeNOS group was significantly higher than cerebral blood flow of the other three groups. (iii) The cerebrovascular reactivity in the Ins2(Akita+/-) mice was significantly lower compared with wild-type, whereas that in the TgeNOS-Ins2(Akita+/-) was significantly higher compared with the Ins2(Akita+/-) and TgeNOS groups. Overexpression of eNOS rescued cerebrovascular dysfunction in diabetic animals, resulting in improved cerebrovascular reactivity. These results underscore the possible role of eNOS in vascular dysfunction in the brain of diabetic mice and support the notion that enhancing eNOS activity in diabetes is a potential therapeutic target. PMID:26661212

  16. Combined effects of type 2 diabetes and hypertension associated with cortical thinning and impaired cerebrovascular reactivity relative to hypertension alone in older adults

    Science.gov (United States)

    Tchistiakova, Ekaterina; Anderson, Nicole D.; Greenwood, Carol E.; MacIntosh, Bradley J.

    2014-01-01

    Objective Type 2 diabetes mellitus is characterized by metabolic dysregulation in the form of hyperglycemia and insulin resistance and can have a profound impact on brain structure and vasculature. The primary aim of this study was to identify brain regions where the combined effects of type 2 diabetes and hypertension on brain health exceed those of hypertension alone. A secondary objective was to test whether vascular impairment and structural brain measures in this population are associated with cognitive function. Research design and methods We enrolled 18 diabetic participants with hypertension (HTN + T2DM, 7 women, 71.8 ± 5.6 years) and 22 participants with hypertension only (HTN, 12 women, 73.4 ± 6.2 years). Cerebrovascular reactivity (CVR) was assessed using blood oxygenation level dependent (BOLD) MRI during successive breath holds. Gray matter structure was evaluated using cortical thickness (CThk) measures estimated from T1-weighted images. Analyses of cognitive and blood data were also performed. Results Compared to HTN, HTN + T2DM had decreased CVR and CThk in a spatially overlapping region of the right occipital lobe (P  0.05), CThk in the right lingual gyrus ROI and regions resulting from a vertex-wise analysis (including posterior cingulate, precuneus, superior and middle frontal, and middle and inferior temporal regions (P brain regions that are impacted by the combined effects of comorbid T2DM and HTN conditions, with new evidence that the corresponding cortical thinning may contribute to cognitive decline. PMID:24967157

  17. A Reactive Behavior Agent: Including Emotions into a Video Game

    Directory of Open Access Journals (Sweden)

    A. L. Laureano-Cruces

    2012-10-01

    Full Text Available Why we have emotions and how they influence human behavior are two questions we constantly ask ourselves.According to researchers in the field, there are two kinds of information that the person receives to make a decision.This information is integrated to generate a whole. One comes from ourselves it is proprioceptive and refers toemotions; the other one is external, it comes from the environment. Thus, emotions are immersed in different areas ofa person’s life, including social, functional, and cognitive aspects. It has an important role in the decision-makingprocess. It is on this last point that this paper focuses its approach, which consists of including a cognitive structure ofemotions in a reactive behavior in order to enrich behavior, including the information generated through internalevaluation of the external physical stimuli. Our work is based on the OCC theory (named after the name of its authors:Ortony, Collins and Clore. This theory proposes that a decision-making process is affected through differentperspectives: a goals and events, b agents and their actions, and c objects and their capacity for attraction. Thecase study is situated within a scenario that represents an approach that seeks to include a module of emotions withinthe design of the architecture of a videogame.

  18. Increased cerebrovascular pCO2 reactivity in migraine with aura--a transcranial Doppler study during hyperventilation

    DEFF Research Database (Denmark)

    Thomsen, L L; Iversen, Helle Klingenberg; Olesen, J

    1995-01-01

    cerebral artery was measured with transcranial Doppler. In each subject a pCO2 reactivity index (RI) was calculated as (delta Vmean/baseline Vmean)/delta pCO2. Interictally, patients with migraine with aura showed higher RI (p ANOVA and multiple range test) than controls, whereas migraineurs without......-nitroglycerin-provoked healthy controls (p > 0.05, ANOVA and multiple range test). The exaggerated response in migraine with aura might predispose for the characteristic changes in rCBF seen during attacks....

  19. Cerebrovascular endothelin-1 hyper-reactivity is associated with transient receptor potential canonical channels 1 and 6 activation and delayed cerebral hypoperfusion after forebrain ischaemia in rats

    DEFF Research Database (Denmark)

    Johansson, S E; Andersen, X E D R; Hansen, R H;

    2015-01-01

    AIM: In this study, we aimed to investigate whether changes in cerebrovascular voltage-dependent calcium channels and non-selective cation channels contribute to the enhanced endothelin-1-mediated vasoconstriction in the delayed hypoperfusion phase after experimental transient forebrain ischaemia...

  20. 飞行员脑血管反应性影响因素的分析%Analysis of the factors affecting cerebrovascular reactivity of pilots

    Institute of Scientific and Technical Information of China (English)

    李丽; 石进; 崔丽; 王海音

    2012-01-01

    目的 检测飞行员脑血管反应性,观察影响其脑血管反应性的因素. 方法 应用经颅多普勒超声结合屏气试验测定90名现役飞行员大脑中动脉的屏气指数,评估脑血管反应性.应用多元逐步线性回归法,分析受试者年龄、空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白、红细胞计数、血红蛋白含量、收缩压、舒张压、飞行时间、所飞机种(1:歼击机,0:其他机种)以及吸烟(1:吸烟,0:不吸烟)与屏气指数的相关性. 结果 线性逐步回归方差分析提示:吸烟与否及所飞机种对飞行员屏气指数的影响有统计学意义(F=5.25、4.75,P=0.02、0.01),且吸烟与屏气指数呈负相关,偏回归系数为 -0.17(t=-2.14,P=0.04),所飞机种与屏气指数呈正相关,偏回归系数分别为0.16(t=2.01,P=0.05).年龄、血糖、甘油三酯、总胆固醇、低密度脂蛋白、红细胞计数、血红蛋白含量、收缩压、舒张压及飞行时间对屏气指数的影响无统计学意义(P>0.10). 结论 吸烟可降低飞行员脑血管反应性;歼击机飞行员的脑血管反应性较直升机和运输机飞行员好.%Objective To investigate the influencing factors of cerebrovascular reactivity of pilots. Methods Ninety pilots' breathholding index (BHI) of middle cerebral arteries was examined by transcranial Doppler (TCD) for the assessment of cerebrovascular reactivity (CVR).Following data were obtained:pilot's age,blood glucose,serum triglycerides,total cholesterol,serum low-density lipoprotein,red blood cell count,hemoglobin detection value,systolic blood pressure,diastolic blood pressure,flying hours,type of aircraft (1:fighter,0:others) and smoking history(1:smoking,no 0:smoking).The data were subjected to multiple stepwise linear regression analysis by SPSS 13.0 software. Results Analysis of variance showed that pilot's smoking behavior and the type of aircraft had significant influence to BHI (F =5.25,4.75 ; P =0.02,0.01 )but

  1. Adverse effects of intravenous acetazolamide administration for evaluation of cerebrovascular reactivity using brain perfusion single-photon emission computed tomography in patients with major cerebral artery steno-occlusive diseases

    International Nuclear Information System (INIS)

    Adverse effects of intravenous acetazolamide administration for evaluation of cerebrovascular reactivity using brain perfusion single-photon emission computed tomography (SPECT) were prospectively investigated in 100 patients with major cerebral artery, atherosclerotic, and steno-occlusive diseases. All patients underwent two SPECT studies (with and without acetazolamide challenge) at an interval of 2 or 3 days, received a questionnaire immediately after each SPECT study, and returned the answered questionnaire within 7 days after the study. None of the 100 patients studied experienced any symptoms during the SPECT study without acetazolamide challenge. Sixty-three patients (63%) developed symptoms during the SPECT study with acetazolamide challenge, such as headache, nausea, dizziness, tinnitus, numbness of the extremities, motor weakness of the extremities, and general malaise 1-3 hours (mean 1.6 hours) after administration of acetazolamide, and these symptoms lasted for 0.5-72 hours (mean 7.9 hours). Multivariate statistical analysis revealed that younger age (95% confidence interval [CI] 0.896-0.980, p=0.0047) and female sex (95% CI 1.178-16.129, p=0.0274) were significantly associated with development of symptoms with acetazolamide challenge. The incidences of the development of symptoms with acetazolamide challenge were 91% (21/23) and 41% (12/29) in subgroups of women <70 years and men ≥70 years, respectively. Patients should be informed of such adverse effects of intravenous acetazolamide administration prior to the acetazolamide challenge test for evaluation of cerebrovascular reactivity. (author)

  2. Categorization of cerebrovascular intervention methods

    Institute of Scientific and Technical Information of China (English)

    Wenxin Zhao; Gelin Xu; Xinfeng Liu

    2008-01-01

    BACKGROUND: Cerebrovascular intervention is a medical strategy to diagnose and treat cerebrovascular disease by intravascular intervention techniques. With the continual developments of computer technology, imageology, and angiography, cerebrovascular intervention techniques have developed rapidly.OBJECTIVE: To summarize and to evaluate vascular imaging diagnostic techniques, vascular intra-arterial thrombolysis, vascular intra-arterial angioplasty, and vascular embolization in clinical applications.RETRIEVAL STRATEGY: An online search was conducted in PubMed for English language reports, published from January 2002 to January 2008, containing the key words: intervention therapy, cerebral vascular disease, endovascular intervention and angioplasty. A total of 57 publications were identified. Inclusion criteria: articles about cerebrovascular intervention for cerebrovascular disease; articles published either in high impact factor journals or in recent years. Exclusion criteria: duplicated articles.LITERATURE EVALUATION: 30 articles were identified concerning intravascular intervention techniques and arterial angioplasty. Of those, 7 articles were reviews and 23 were clinical or basic studies.DATA SYNTHESIS: Carotid artery and basilar artery stenosis were important etiological factors for ischemic cerebrovascular disease. The mechanism of stenosis induction included atherosclerotic plaque exfoliation and stenosis could cause hemodynamic changes to induce cerebral infarction. Therefore, the treatment of carotid artery and basilar artery stenosis played a key role in preventing ischemic cerebral infarction. The international organization for subarachnoid hemorrhage aneurysm has conclusively shown that both relative and absolute risk factors of intravascular embolotherapy were reduced compared to those of surgical occlusion, demonstrating the important role of vascular embolization for the treatment of intracranial aneurysm. Endovascular stents were placed into the

  3. Mixed Cerebrovascular Disease and the Future of Stroke Prevention

    OpenAIRE

    Fisher, Mark; Vasilevko, Vitaly; Cribbs, David H.

    2012-01-01

    Stroke prevention efforts typically focus on either ischemic or hemorrhagic stroke. This approach is overly simplistic due to the frequent coexistence of ischemic and hemorrhagic cerebrovascular disease. This coexistence, termed “mixed cerebrovascular disease”, offers a conceptual framework that appears useful for stroke prevention strategies. Mixed cerebrovascular disease incorporates clinical and subclinical syndromes, including ischemic stroke, subclinical infarct, white matter disease of ...

  4. Prothrombotic Gene Polymorphisms in Young Patients with Cerebrovascular Accident

    OpenAIRE

    Kuyaþ Hekimler Öztürk

    2013-01-01

    Aim: Cerebrovascular diseases are complex multifactorial disorders showing an increased incidence with increasing age and affected by genetic and environmental factors. Although risk factors for cerebrovascular diseases include age, sex, lineage, hypertension, diabetes mellitus, hypercholesterolemia; in young cerebrovascular patients below age 45, genetic factors may also contribute to the etiology. In this retrospective study, prothrombotic gene polymorphisms which are thought to be related ...

  5. Assessment and Imaging of the Cerebrovascular Glycocalyx.

    Science.gov (United States)

    Haeren, Roel Hubert Louis; van de Ven, Steffi Elisabeth Maria; van Zandvoort, Marcus Anna Maria Jacobus; Vink, Hans; van Overbeeke, Jacobus Johannes; Hoogland, Govert; Rijkers, Kim

    2016-01-01

    The glycocalyx is a gel-like layer lining the luminal surface of the endothelium. The glycocalyx exerts an important barrier role because it prevents exposure of plasma components to the endothelial surface. Disruption of the glycocalyx by local inflammation or ischemia results in decreased glycocalyx thickness which is associated with a number of vascular diseases. The cerebrovascular glycocalyx has sparsely been studied, but is of great interest because of its potential role in cerebrovascular disease. In this review, we describe all existing techniques to visualize the glycocalyx and designate techniques that may be suitable for studying the cerebrovascular glycocalyx. A total of seven imaging techniques are discussed thoroughly, including transmission electron microscopy, intravital microscopy, micro-particle image velocimetry, confocal laser scanning microscopy, two-photon laser scanning microscopy, orthogonal polarization spectral imaging and sidestream dark field/oblique imaging. Measurement of serum concentrations of glycocalyx-specific constituents is another method for glycocalyx analysis. Also, we have reviewed the methods of glycocalyx analysis by using these imaging techniques. So far, the cerebrovascular glycocalyx has only been studied in vitro. However, other cerebral microcirculatory properties have been studied in vivo. This suggests that the cerebrovascular glycocalyx can be studied in vivo by using some of the described techniques, when specific software is subjoined to the analysis. In conclusion, we have summarized techniques available for glycocalyx assessment, and explained the significance and technical possibilities regarding cerebrovascular glycocalyx visualization. Cerebrovascular glycocalyx assessment would add valuable information to our understanding of the pathophysiology of cerebrovascular disease. Moreover, as a part of the blood-brain barrier, more knowledge on the cerebrovascular glycocalyx may lead to better understanding of

  6. Clinic Practical Guides for Cerebrovascular Diseases

    OpenAIRE

    Miguel Angel Buergo Zuaznábar; Otman Fernández Concepción; Jesús Pérez Nellar; Gloria Lara Fernández; Carlos Maya Entenza; Alejandro Pando Cabrera

    2007-01-01

    The clinic practical guides for cerebrovascular diseases are presented. They include different aspects as its concept, classification, and epidemiological data in Cuba as well as worldwide. They also offer its diagnosis, classification, complications and treatment. The frequency of assessment of its application including the tools to measure the quality of life in patients with cerebrovascular accident and the way to proceed with them are shown

  7. Cross-reactivity of designer drugs, including cathinone derivatives, in commercial enzyme-linked immunosorbent assays.

    Science.gov (United States)

    Swortwood, Madeleine J; Hearn, W Lee; DeCaprio, Anthony P

    2014-01-01

    Since the introduction of synthetic heroin, designer drugs have been increasing in prevalence in the United States drug market over the past few decades. Recently, 'legal highs' sold as 'bath salts' have become a household term for one such class of designer drugs. While a number of federal and state bans have been enacted, the abuse of these designer drugs still continues. Few assays have been developed for the comprehensive detection of such compounds, so it is important to investigate how they may or may not react in presumptive screens, i.e. pre-existing commercial immunoassays. In this experiment, 16 different ELISA reagents were evaluated to determine the cross-reactivity of 30 designer drugs, including 24 phenylethylamines (including 8 cathinone derivatives), 3 piperazines, and 3 tryptamines. Cross-reactivity towards most drugs was <4% in assays targeting amphetamine or methamphetamine. Compounds such as MDA, MDMA, ethylamphetamine, and α-methyltryptamine demonstrated cross-reactivities in the range of 30-250%, but data were consistent with both manufacturer's inserts and published literature. When tested against the Randox Mephedrone/Methcathinone kit, cathinone derivatives demonstrated cross-reactivity at concentrations as low as 150 ng/ml. Since this same reagent did not cross-react with other amphetamine-like compounds, it opens the possibility to screen post-mortem specimens without the interference of putrefactive amines. All other assays demonstrated essentially no cross-reactivity towards any of the analytes evaluated. Given these results, a great need exists for more broad-range screening techniques to be applied when analyzing biological specimens by immunoassays for drugs of abuse, specifically the more recent designer drugs. PMID:23677923

  8. Dietary Curcumin Ameliorates Aging-Related Cerebrovascular Dysfunction through the AMPK/Uncoupling Protein 2 Pathway

    Directory of Open Access Journals (Sweden)

    Yunfei Pu

    2013-11-01

    Full Text Available Background/Aims: Age-related cerebrovascular dysfunction contributes to stroke, cerebral amyloid angiopathy, cognitive decline and neurodegenerative diseases. One pathogenic mechanism underlying this effect is increased oxidative stress. Up-regulation of mitochondrial uncoupling protein 2 (UCP2 plays a crucial role in regulating reactive oxygen species (ROS production. Dietary patterns are widely recognized as contributors to cardiovascular and cerebrovascular disease. In this study, we tested the hypothesis that dietary curcumin, which has an antioxidant effect, can improve aging-related cerebrovascular dysfunction via UCP2 up-regulation. Methods: The 24-month-old male rodents used in this study, including male Sprague Dawley (SD rats and UCP2 knockout (UCP2-/- and matched wild type mice, were given dietary curcumin (0.2%. The young control rodents were 6-month-old. Rodent cerebral artery vasorelaxation was detected by wire myograph. The AMPK/UCP2 pathway and p-eNOS in cerebrovascular and endothelial cells were observed by immunoblotting. Results: Dietary curcumin administration for one month remarkably restored the impaired cerebrovascular endothelium-dependent vasorelaxation in aging SD rats. In cerebral arteries from aging SD rats and cultured endothelial cells, curcumin promoted eNOS and AMPK phosphorylation, up-regulated UCP2 and reduced ROS production. These effects of curcumin were abolished by either AMPK or UCP2 inhibition. Chronic dietary curcumin significantly reduced ROS production and improved cerebrovascular endothelium-dependent relaxation in aging wild type mice but not in aging UCP2-/- mice. Conclusions: Curcumin improves aging-related cerebrovascular dysfunction via the AMPK/UCP2 pathway.

  9. Factors influencing ischemic cerebrovascular disease complicated by hyperhomocysteinemia

    Institute of Scientific and Technical Information of China (English)

    Zhongping An; Yonghong Xing; Sha Jin

    2008-01-01

    BACKGROUND: Hyperhomocysteinemia, as an important risk factor for ischemic cerebrovascular disease is receiving increasing attention.OBJECTIVE: To analyze whether differences of gender, age, cerebrovascular disease typing, and disease conditions exist when ischemic cerebrovascular disease occurs together with hyperhomocysteinemia. DESIGN: A controlled observation. SETTING: Department of Neurology, Tianjin Huanhu Hospital. PARTICIPANTS: A total of 601 acute ischemic cerebrovascular disease inpatients, comprising 386 males and 215 females, aged 33-90 years old, were admitted to the Department of Stroke, Tianjin Huanhu Hospital between August 2005 and April 2007, and were recruited for this study. All included patients consisted of 342 aged patients (≥ 60 years old) and 92 middle-aged and young patients ( 0.05). No significant difference in incidence of hyperhomocysteinemia existed between mild, moderate, and severe cerebrovascular disease patients (P > 0.05). CONCLUSION: There is a greater chance of ischemic cerebrovascular disease complicated by hyperhomocysteinemia in older, male patients.

  10. Hypertension and cerebrovascular damage.

    Science.gov (United States)

    Veglio, Franco; Paglieri, Cristina; Rabbia, Franco; Bisbocci, Daniela; Bergui, Mauro; Cerrato, Paolo

    2009-08-01

    Hypertension is the most important modifiable factor for cerebrovascular disease. Stroke and dementia are growing health problems that have considerable social and economical consequences. Hypertension causes brain lesions by several mechanisms predisposing to lacunar infarctions, leucoaraiosis, and white matter changes as well as to intracerebral haemorrhages. These parenchymal damages determine evident or silent neurological alterations that often precede the onset of cognitive decline. It is important to recognize cerebrovascular disease and, above all, to correlate typical lesions to hypertension. Antihypertensive therapy has shown clinical benefits in primary and secondary prevention of stroke. These drugs represent important instruments against cerebrovascular disease but their effects on cognition are still matter of debate. Cerebral parenchymal and functional damages have to be considered together to make medical intervention more incisive. PMID:19100549

  11. TCD breath-holding test for evaluation of cerebrovascular reactivity in smoking men%TCD屏气试验评价男性吸烟者的脑血管反应性

    Institute of Scientific and Technical Information of China (English)

    王晖; 张勇

    2013-01-01

    Objective To apply transcranial doppler (TCD) combined with breath-holding test for evaluat ing cerebrovascular reactivity in healthy smoking men. Methods Thirty healthy smoking men were selected as the smoking group, and 40 healthy non-smoking men were selected as the control group. All the subjects received the ex amination before and after breath-holding test. The velocity of flow and Doppler spectra of bilateral MCA were moni tored by TCD. Then the change rates of mean flow velocity of MCA and pulsatiity index (PI) were calculated to ana lyze the cerebrovascular reactivity (CVR). Results Before breath-holding test, the peak velocity (Vp), end of diastol ic velocity (Vd) and mean flow velocity (Vm) of MCA of the smoking group was significantly slower than those of the control group (P<0.05). Pulsatility index (PI) and resistance index (RI) of the smoking group was significantly higher than those of the control group (P<0.05). After breath-holding test, the peak velocity, end of diastolic velocity and mean flow velocity of MCA of all the subjects all have varying degrees of increase (P<0.01), with the spectrum in creased slowly, pulsatility index (PI) and resistance index (RI) significantly decreased (P<0.01). The change rate of mean flow velocity of MCA in the smoking group [(25.60±3.53)%] was significantly lower than that in the control group (28.54±4.57)%], P<0.01. The change rate of PI in the smoking group [(19.02±4.20)%] was significantly lower than that of the control group [(21.10±4.63)%], P<0.01. Conclusion The cerebrovascular reactivity of healthy men with long-term smoking shows a decreasing trend.%目的 应用经颅多普勒超声(TCD)结合屏气试验评价健康吸烟者的脑血管反应性.方法 应用TCD检查70例健康男性(其中30例吸烟者为吸烟组,40例不吸烟者为对照组)静息状态下及屏气30s后双侧大脑中动脉(MCA)血流速度及频谱形态,计算MCA平均血流速度增加率及搏

  12. Method of extruding and packaging a thin sample of reactive material including forming the extrusion die

    Science.gov (United States)

    Lewandowski, Edward F.; Peterson, Leroy L.

    1985-01-01

    This invention teaches a method of cutting a narrow slot in an extrusion die with an electrical discharge machine by first drilling spaced holes at the ends of where the slot will be, whereby the oil can flow through the holes and slot to flush the material eroded away as the slot is being cut. The invention further teaches a method of extruding a very thin ribbon of solid highly reactive material such as lithium or sodium through the die in an inert atmosphere of nitrogen, argon or the like as in a glovebox. The invention further teaches a method of stamping out sample discs from the ribbon and of packaging each disc by sandwiching it between two aluminum sheets and cold welding the sheets together along an annular seam beyond the outer periphery of the disc. This provides a sample of high purity reactive material that can have a long shelf life.

  13. Design of specially adapted reactive coordinates to economically compute potential and kinetic energy operators including geometry relaxation.

    Science.gov (United States)

    Thallmair, Sebastian; Roos, Matthias K; de Vivie-Riedle, Regina

    2016-06-21

    Quantum dynamics simulations require prior knowledge of the potential energy surface as well as the kinetic energy operator. Typically, they are evaluated in a low-dimensional subspace of the full configuration space of the molecule as its dimensionality increases proportional to the number of atoms. This entails the challenge to find the most suitable subspace. We present an approach to design specially adapted reactive coordinates spanning this subspace. In addition to the essential geometric changes, these coordinates take into account the relaxation of the non-reactive coordinates without the necessity of performing geometry optimizations at each grid point. The method is demonstrated for an ultrafast photoinduced bond cleavage in a commonly used organic precursor for the generation of electrophiles. The potential energy surfaces for the reaction as well as the Wilson G-matrix as part of the kinetic energy operator are shown for a complex chemical reaction, both including the relaxation of the non-reactive coordinates on equal footing. A microscopic interpretation of the shape of the G-matrix elements allows to analyze the impact of the non-reactive coordinates on the kinetic energy operator. Additionally, we compare quantum dynamics simulations with and without the relaxation of the non-reactive coordinates included in the kinetic energy operator to demonstrate its influence.

  14. Design of specially adapted reactive coordinates to economically compute potential and kinetic energy operators including geometry relaxation.

    Science.gov (United States)

    Thallmair, Sebastian; Roos, Matthias K; de Vivie-Riedle, Regina

    2016-06-21

    Quantum dynamics simulations require prior knowledge of the potential energy surface as well as the kinetic energy operator. Typically, they are evaluated in a low-dimensional subspace of the full configuration space of the molecule as its dimensionality increases proportional to the number of atoms. This entails the challenge to find the most suitable subspace. We present an approach to design specially adapted reactive coordinates spanning this subspace. In addition to the essential geometric changes, these coordinates take into account the relaxation of the non-reactive coordinates without the necessity of performing geometry optimizations at each grid point. The method is demonstrated for an ultrafast photoinduced bond cleavage in a commonly used organic precursor for the generation of electrophiles. The potential energy surfaces for the reaction as well as the Wilson G-matrix as part of the kinetic energy operator are shown for a complex chemical reaction, both including the relaxation of the non-reactive coordinates on equal footing. A microscopic interpretation of the shape of the G-matrix elements allows to analyze the impact of the non-reactive coordinates on the kinetic energy operator. Additionally, we compare quantum dynamics simulations with and without the relaxation of the non-reactive coordinates included in the kinetic energy operator to demonstrate its influence. PMID:27334151

  15. Design of specially adapted reactive coordinates to economically compute potential and kinetic energy operators including geometry relaxation

    Science.gov (United States)

    Thallmair, Sebastian; Roos, Matthias K.; de Vivie-Riedle, Regina

    2016-06-01

    Quantum dynamics simulations require prior knowledge of the potential energy surface as well as the kinetic energy operator. Typically, they are evaluated in a low-dimensional subspace of the full configuration space of the molecule as its dimensionality increases proportional to the number of atoms. This entails the challenge to find the most suitable subspace. We present an approach to design specially adapted reactive coordinates spanning this subspace. In addition to the essential geometric changes, these coordinates take into account the relaxation of the non-reactive coordinates without the necessity of performing geometry optimizations at each grid point. The method is demonstrated for an ultrafast photoinduced bond cleavage in a commonly used organic precursor for the generation of electrophiles. The potential energy surfaces for the reaction as well as the Wilson G-matrix as part of the kinetic energy operator are shown for a complex chemical reaction, both including the relaxation of the non-reactive coordinates on equal footing. A microscopic interpretation of the shape of the G-matrix elements allows to analyze the impact of the non-reactive coordinates on the kinetic energy operator. Additionally, we compare quantum dynamics simulations with and without the relaxation of the non-reactive coordinates included in the kinetic energy operator to demonstrate its influence.

  16. Risk factors of cerebrovascular diseases and their intervention and management

    OpenAIRE

    En XU; Hai-xia WEN

    2015-01-01

    Cerebrovascular diseases are important causes of clinical death and disability because of high prevalence and morbidity and easy to recurrence. A number of risk factors have involved in the progress of cerebrovascular diseases, which include uncontrolled and controlled risk factors. The former refers to old age, gender, low birth weight, race/ethnicity, genetic factors, etc. The latter includes hypertension, diabetes mellitus, atrial fibrillation and other cardiac diseases, dyslipidemia...

  17. 血清超敏-C反应蛋白水平对糖尿病患者脑血管意外的预测价值%Predictive value of serum hypersensitivity C-reactive protein in diabetes patients with cerebrovascular accident

    Institute of Scientific and Technical Information of China (English)

    王艳

    2014-01-01

    Objective To investigate the predictive value of serum hypersensitivity C-reactive protein in diabetes pa-tients with cerebrovascular accident. Methods 66 cases of type 2 diabetes combined with cerebrovascular accident from Mau 2012 to May 2013 in the Southern District of the Second People's Hospital of Yibin City were selected as cere-brovascular accident group, 66 cases of type 2 diabetes without cerebrovascular accident in the same term were chosen as simple diabetes group, 66 cases of healthy people were selected as control group. Fasting blood-glucose (FRG), oral glucose tolerance test (OGTT), hs-CRP level among the three groups were detected and compared. Results①The value of FPG, 2 h PG in cerebrovascular accident group [(8.53±2.03), (13.89±2.27) mmol/L] and simple diabetes group [(8.62±1.35), (14.19±1.86) mmol/L] were all higher than those in control group [(4.01±1.10), (6.17±1.71) mmol/L], the differences were statistically significant (P0.05).② The differences of hs-CRP level and abnormal proportion among the three groups were statistically significant (F= 3.973, χ2 = 4.730, P0.05)。②三组间hs-CRP水平及异常比例比较,差异均有统计学意义(F=3.973,χ2=4.730,P<0.05);其中脑血管意外组hs-CRP水平[(12.58±3.53)μg/mL]高于单纯糖尿病组[(4.87±1.94)mg/L]及对照组[(2.03±0.71)mg/L],差异有统计学意义(P<0.05);单纯糖尿病组hs-CRP水平高于对照组,差异有统计学意义(P<0.05)。结论 hs-CRP对糖尿病合并脑血管意外具有明显的预测价值,可作为脑血管事件的预测因子。

  18. Performance of Trasuranic-Loaded Fully Ceramic Micro-Encapsulated Fuel in LWRs Interim Report, Including Void Reactivity Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Michael A. Pope; Brian Boer; Gilles Youinou; Abderrafi M. Ougouag

    2011-03-01

    The current focus of the Deep Burn Project is on once-through burning of transuranice (TRU) in light water reactors (LWRs). The fuel form is called Fully-Ceramic Micro-encapsulated (FCM) fuel, a concept that borrows the tri-isotropic (TRISO) fuel particle design from high-temperature reactor technology. In the Deep Burn LWR (DB-LWR) concept, these fuel particles would be pressed into compacts using SiC matrix material and loaded into fuel pins for use in conventional LWRs. The TRU loading comes from the spent fuel of a conventional LWR after 5 years of cooling. Unit cell calculations have been performed using the DRAGON-4 code in order assess the physics attributes of TRU-only FCM fuel in an LWR lattice. Depletion calculations assuming an infinite lattice condition were performed with calculations of various reactivity coefficients performed at each step. Unit cells containing typical UO2 and MOX fuel were analyzed in the same way to provide a baseline against which to compare the TRU-only FCM fuel. Loading of TRU-only FCM fuel into a pin without significant quantities of uranium challenges the design from the standpoint of several key reactivity parameters, particularly void reactivity, and to some degree, the Doppler coefficient. These unit cells, while providing an indication of how a whole core of similar fuel would behave, also provide information of how individual pins of TRU-only FCM fuel would influence the reactivity behavior of a heterogeneous assembly. If these FCM fuel pins are included in a heterogeneous assembly with LEU fuel pins, the overall reactivity behavior would be dominated by the uranium pins while attractive TRU destruction performance of the TRU-only FCM fuel pins may be preserved. A configuration such as this would be similar to CONFU assemblies analyzed in previous studies. Analogous to the plutonium content limits imposed on MOX fuel, some amount of TRU-only FCM pins in an otherwise-uranium fuel assembly may give acceptable reactivity

  19. Progress on diabetic cerebrovascular diseases

    OpenAIRE

    Houguang Zhou; Xiaoming Zhang; Jianfeng Lu

    2014-01-01

    Diabetic cerebrovascular diseases are defined as cerebral vascular diseases induced by diabetes with sugar, fat and a series of nutrient substance metabolic disorders, resulting in intracranial large and small vessel diseases. About 20%-40% patients with type 2 diabetes suffer from cerebral blood vessel diseases. Diabetic cerebrovascular diseases are the main causes of death in patients with diabetes mellitus. The major clinical manifestations are asymptomatic cerebral atherosclerosis, stroke...

  20. Role of transcranial Doppler in cerebrovascular disease.

    Science.gov (United States)

    Kulkarni, Amit A; Sharma, Vijay K

    2016-01-01

    Transcranial Doppler (TCD) is the only noninvasive modality for the assessment of real-time cerebral blood flow. It complements various anatomic imaging modalities by providing physiological-flow related information. It is relatively cheap, easily available, and can be performed at the bedside. It has been suggested as an essential component of a comprehensive stroke centre. In addition to its importance in acute cerebrovascular ischemia, its role is expanding in the evaluation of cerebral hemodynamics in various disorders of the brain. The "established" clinical indications for the use of TCD include cerebral ischemia, sickle cell disease, detection of right-to-left shunts, subarachnoid hemorrhage, periprocedural or surgical monitoring, and brain death. We present the role of TCD in acute cerebrovascular ischemia, sonothrombolysis, and intracranial stenosis. PMID:27625245

  1. The role of social psychological factors in the primary prevention of cerebrovascular diseases

    OpenAIRE

    Wang, Kai; Zhang, Jun

    2015-01-01

    Cerebrovascular diseases are the second leading cause of death worldwide. In recent years, a growing body of evidence has shown that rather than the traditional cardio-cerebrovascular risk factors such as hypertension, diabetes mellitus, coronary heart disease, hyperlipemia and obesity, the social psychological factors including psychosocial stress, anxiety and depressive disorders play an important role in the incidence of cerebrovascular diseases. Therefore, this review will mainly di...

  2. Cerebrovascular manifestations following scorpion sting

    Directory of Open Access Journals (Sweden)

    Nataraja P

    2016-07-01

    Full Text Available Scorpion sting is a common clinical problem in Rayalaseema area of Andhra Pradesh State in India. Clilnical presentation of scorpion envenomation can range from mild local pain to systemic manifestations involving almost all systems. Cerebrovascular manifestations of scorpion sting have been sparsely documented. We report two cases who presented with ischaemic stroke and haemorrhagic stroke following scorpion sting.

  3. Cerebrovascular manifestations following scorpion sting

    OpenAIRE

    Nataraja P; Naveen Prasad SV; Obulareddy G; Anil Ch; Naveen T; Vengamma B

    2016-01-01

    Scorpion sting is a common clinical problem in Rayalaseema area of Andhra Pradesh State in India. Clilnical presentation of scorpion envenomation can range from mild local pain to systemic manifestations involving almost all systems. Cerebrovascular manifestations of scorpion sting have been sparsely documented. We report two cases who presented with ischaemic stroke and haemorrhagic stroke following scorpion sting.

  4. Risk factors of cerebrovascular diseases and their intervention and management

    Directory of Open Access Journals (Sweden)

    En XU

    2015-01-01

    Full Text Available Cerebrovascular diseases are important causes of clinical death and disability because of high prevalence and morbidity and easy to recurrence. A number of risk factors have involved in the progress of cerebrovascular diseases, which include uncontrolled and controlled risk factors. The former refers to old age, gender, low birth weight, race/ethnicity, genetic factors, etc. The latter includes hypertension, diabetes mellitus, atrial fibrillation and other cardiac diseases, dyslipidemia, asymptomatic carotid stenosis, obesity, smoking, unhealthy lifestyle, alcoholism, metabolic syndrome, hyperhomocysteinemia, etc. Meanwhile, hypertension is the most important one in the above-mentioned risk factors. It would effectively reduce or postpone the onset of cerebrovascular diseases through proper intervention and management on those risk factors. DOI: 10.3969/j.issn.1672-6731.2015.01.006

  5. Clinical study on dl-3 n-butylphthalide in improving cerebrovascular reactivity and cognitive function in patients with Binswanger disease%丁苯酞改善Binswanger病患者脑血管反应性及认知功能的临床研究

    Institute of Scientific and Technical Information of China (English)

    周瑜; 梁静静; 曾艳平; 罗瑛; 黄兴汉; 卢祖能

    2016-01-01

    Objective To investigate the effects of dl-3n-butylphthalide on cerebrovascular reactivity and cog-nitive function in patients with Binswanger disease( BD). Methods Sixty patients with BD were randomly assigned into treatment group and control group,30 patients in each group. Both groups were given vinpocetine intravenously once a day for two weeks,and treatment group were also given dl-3n-butylphthalide orally,200 mg once,3 times a day. Transcranial color Doppler ultrasound and breathing-holding test were used to detect the mean velocity of double side middle cerebral artery( MCA)and cerebrovascular reactivity. The therapeutic effects were measured with Event-related potential P300,MMSE and HDS. Results The mean velocity and cerebrovascular reactivity of MCA were improved after dl-3n-butylphthalide treatment. The latency of P300 was reduced and the amplitude of P300 was increased in treat-ment group compared with patients before treatment,and the scores of MMSE and HDS were also improved obviously after treatment. The total effective rates of dl-3n-butylphthalide and control group were 73. 3% and 46. 7% respectively (P﹤0. 05). Conclusion Dl-3n-butylphthalide has therapeutic potential in the treatment of Binswanger disease.%目的:探讨丁苯酞对 Binswanger 病患者脑血管反应性及认知功能的影响。方法将60例Binswanger病患者随机分为治疗组和对照组,每组30例,对照组给予长春西汀注射液静滴,治疗组在此基础上给予丁苯酞软胶囊口服,200 mg/次,3次/d;疗程为2周。治疗前后应用经颅多普勒超声屏气试验评价脑血管反应性,同时进行P300数据采样和MMSE、HDS量表评分以及疗效评价。结果丁苯酞治疗后大脑中动脉的平均流速和血管反应性显著改善,治疗组治疗前、后P300波潜伏期及P300波幅比较,差异均有统计学意义( P﹤0.05);MMSE和HDS量表评分显著改善,治疗组有效率为73.3

  6. 糖尿病患者血清hs-CRP水平与脑血管意外发生的临床相关性探究%The Relevant Research of Serum Hypersensitive C-reactive Protein Levels and Cerebrovascular Accident of Diabetic Patients

    Institute of Scientific and Technical Information of China (English)

    李晋莹; 蔡跃波

    2014-01-01

    Objective To research the relevant of serum hypersensitive C-reactive protein levels(hs-CRP) and cerebrovascular accident of diabetic patients. Methods During the time of February 2013 to February 2014, 100 diabetic patients in our hospital were selected and divided into group A1 and group A2, the patients in group A1 were simple diabetes and the patients in group A2 diabetic patients with cerebrovascular accident, choose another 100 healthy people to be as group B. Detected hs-CRP levels of all the patients. Results The hs-CRP levels of group B was(6.0±1.9)mg/L, which was lower than that in group A(12.8±2.8)mg/L. The hs-CRP levels of group A2 was(13.9±3.1)mg/L, which was higher than that in group A1(7.9±2.6)mg/L. All the results above were statistically significance while P<0.05. Conclusion It has strong relevant of hs-CRP and cerebrovascular accident of diabetic patients, and it has important clinical value for diagnosis and treating diabetic patients with cerebrovascular accident to detect the levels of hs-CRP.%目的:探析糖尿病患者体内血清超敏C-反应蛋白(hs-CRP)含量与患者发生脑血管意外的相关性。方法自2013年2月至2014年2月期间在我院治疗的糖尿病患者中随机抽取100例,将其作为A组,并按照是否并发有脑血管意外将A组患者分为A1和A2两组,其中A1为单纯糖尿病患者,A2为糖尿病并发脑血管意外患者;另外随机抽取100例健康体检者作为B组。检测所有患者的hs-CRP水平。结果A组患者的hs-CRP水平为(12.8±2.8)mg/L,显著高于B组的(6.0±1.9)mg/L。A2组患者的hs-CRP水平为(13.9±3.1)mg/L,显著高于A1组的(7.9±2.6)mg/L。以上比较在P<0.05下差异具有统计学意义。结论糖尿病患者血清内的hs-CRP含量与患者发生脑血管意外间具有很强的相关性,故对糖尿病患者而言,检测其体内血清的hs-CRP对诊治脑血管意外具有重要的临床价值。

  7. Cerebrovascular stroke at high altitude

    International Nuclear Information System (INIS)

    Objective: To asses the high altitude as a risk factor for cerebrovascular stroke in people residing at a height greater than 15,000 feet above sea level. Results: Ten patients suffered from stroke at high altitude while just one case had stroke in indexed age group at lower heights (p-value<0.05). Relative risk was 10 times greater at high altitude. Conclusion: High altitude is a risk factor for stroke in persons residing at altitudes of over 15, 000 ft. (author)

  8. Genetic Causes of Cerebrovascular Disorders in Childhood

    NARCIS (Netherlands)

    M.E.C. Meuwissen (Marije)

    2014-01-01

    markdownabstract__Abstract__ Cerebrovascular disorders in childhood comprise ischemic stroke and hemorrhagic stroke. This thesis comprises a escription of genetic causes of childhood cerebrovascular disorders. Two examples of genetic causes of ischemic stroke, comprising a case of ACTA2 mutation an

  9. Cerebrovascular arteriopathy (arteriosclerosis) and ischemic childhood stroke.

    Science.gov (United States)

    Daniels, S R; Bates, S; Lukin, R R; Benton, C; Third, J; Glueck, C J

    1982-01-01

    The aim of this report is to describe the intracranial cerebrovascular abnormalities and clinical status of 8 children who had familial lipoprotein disorders and evidence of thromboembolic cerebrovascular disease. Six of the 8 children had low levels of plasma high density lipoprotein cholesterol, two had high triglyceride levels, and all came from kindreds characterized by familial lipoprotein abnormalities and premature cardio- and/or cerebrovascular atherosclerosis. Vascular occlusion, irregularities of the arterial lumen, beading, tortuosity, and evidence of collateralization were consistently noted. We speculate that cerebrovascular arteriosclerosis in pediatric ischemic stroke victims who have familial lipoprotein abnormalities may be related to lipoprotein-mediated endothelial damage and thrombosis formation, or to the failure to restore endothelial cells' integrity following damage. The apparent association of lipoproteins and strokes in children and their families merits further exploration, particularly when assessing cerebral angiograms in pediatric ischemic stroke victims. In children with unexplained ischemic cerebrovascular accidents, the diagnostic possibility of occlusive arteriosclerosis with thrombosis must be entertained.

  10. Chronic cerebrovascular dysfunction after traumatic brain injury.

    Science.gov (United States)

    Jullienne, Amandine; Obenaus, Andre; Ichkova, Aleksandra; Savona-Baron, Catherine; Pearce, William J; Badaut, Jerome

    2016-07-01

    Traumatic brain injuries (TBI) often involve vascular dysfunction that leads to long-term alterations in physiological and cognitive functions of the brain. Indeed, all the cells that form blood vessels and that are involved in maintaining their proper function can be altered by TBI. This Review focuses on the different types of cerebrovascular dysfunction that occur after TBI, including cerebral blood flow alterations, autoregulation impairments, subarachnoid hemorrhage, vasospasms, blood-brain barrier disruption, and edema formation. We also discuss the mechanisms that mediate these dysfunctions, focusing on the cellular components of cerebral blood vessels (endothelial cells, smooth muscle cells, astrocytes, pericytes, perivascular nerves) and their known and potential roles in the secondary injury cascade. © 2016 Wiley Periodicals, Inc. PMID:27117494

  11. Alterations of TH1/TH2 reactivity by heavy metals: possible consequences include induction of autoimmune diseases.

    Science.gov (United States)

    Hemdan, Nasr Y A; Emmrich, Frank; Faber, Sonya; Lehmann, Joerg; Sack, Ulrich

    2007-08-01

    Heavy metal pollution still represents a primary concern regarding human health. Recently, it become evident that the contribution of heavy metals extends far beyond their accepted role in allergic diseases, and that they may play a more extensive role in a variety of other diseases. Several lines of evidence indicate that heavy metals have a key role in the induction or exacerbation of several autoimmune diseases (AD). Moreover, the association between exposure to heavy metals and the signs of autoimmunity are supported by some studies. The mechanisms by which heavy metals induce the development of AD are not yet fully understood. Our objective here is to highlight the association of exposure to some heavy metals and AD. In addition, we present recent results showing the possible alterations in Th1/Th2 reactivity by some heavy metals, which may constitute the trigger for the incidence of autoimmunity in susceptible individuals.

  12. Different cerebrovascular effects of medroxyprogesterone acetate and norethisterone acetate in the New Zealand White rabbit

    DEFF Research Database (Denmark)

    Pedersen, S H; Pedersen, N G; Dalsgaard, T;

    2004-01-01

    of different progestins on cerebrovascular reactivity in an animal model. METHODS: Fifty-six ovariectomized New Zealand White rabbits were randomized into seven groups receiving hormone treatment for 4 weeks: medroxyprogesterone acetate (MPA) (10 mg/day); norethisterone acetate (NETA) (3 mg/day); conjugated....... No overall differences were seen between CEE and E2. CONCLUSIONS: In rabbit cerebral arteries, MPA treatment causes a higher development in arterial tension compared with NETA, indicating that different progestins may display different cerebrovascular effects. However, when accompanied by estrogens...

  13. Silent cerebrovascular damage and its early correlates in essential hypertensive patients.

    Science.gov (United States)

    Paglieri, Cristina; Rabbia, Franco; Bergui, Mauro; Genesia, Maria Luisa; Canadè, Antonella; Berra, Elena; Fulcheri, Chiara; Covella, Michele; Di Stefano, Cristina; Cerrato, Paolo; Veglio, Franco

    2012-01-01

    This study tested the association between cognitive functions, cerebrovascular damage, and cerebrovascular reactivity in 71 essential young hypertensives (age matched) and 22 normotensives (age matched). They underwent ambulatory blood pressure monitoring, neurocognitive tests, cerebral magnetic resonance, and transcranial Doppler. Twenty-three percent of patients showed more than 10 white matter lesions and 8% showed none. No control subjects showed more than 10 white matter lesions and 90% of normal controls showed no lesions. Patients with more than 10 white matter alterations had longer hypertensive story and showed significant lower nocturnal blood pressure fall. Pulsatility index was correlated with the number of white matter lesions. PMID:22574940

  14. Performance of Transuranic-Loaded Fully Ceramic Micro-Encapsulated Fuel in LWRs Final Report, Including Void Reactivity Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Michael A. Pope; R. Sonat Sen; Brian Boer; Abderrafi M. Ougouag; Gilles Youinou

    2011-09-01

    The current focus of the Deep Burn Project is on once-through burning of transuranics (TRU) in light-water reactors (LWRs). The fuel form is called Fully-Ceramic Micro-encapsulated (FCM) fuel, a concept that borrows the tri-isotropic (TRISO) fuel particle design from high-temperature reactor technology. In the Deep Burn LWR (DB-LWR) concept, these fuel particles are pressed into compacts using SiC matrix material and loaded into fuel pins for use in conventional LWRs. The TRU loading comes from the spent fuel of a conventional LWR after 5 years of cooling. Unit cell and assembly calculations have been performed using the DRAGON-4 code to assess the physics attributes of TRU-only FCM fuel in an LWR lattice. Depletion calculations assuming an infinite lattice condition were performed with calculations of various reactivity coefficients performed at each step. Unit cells and assemblies containing typical UO2 and mixed oxide (MOX) fuel were analyzed in the same way to provide a baseline against which to compare the TRU-only FCM fuel. Then, assembly calculations were performed evaluating the performance of heterogeneous arrangements of TRU-only FCM fuel pins along with UO2 pins.

  15. FastStats: Cerebrovascular Disease or Stroke

    Science.gov (United States)

    ... this? Submit Button NCHS Home Cerebrovascular Disease or Stroke Recommend on Facebook Tweet Share Compartir Data are ... Morbidity Number of adults who ever had a stroke: 6.3 million Percent of adults who ever ...

  16. Risk of Cerebrovascular Events in Pneumoconiosis Patients

    OpenAIRE

    Chuang, Chieh-Sen; Ho, Shang-Chang; Lin, Cheng-Li; Lin, Ming-Chia; Kao, Chia-Hung

    2016-01-01

    Abstract Pneumoconiosis is a parenchymal lung disease that develops through the inhalation of inorganic dust at work. Cerebrovascular and cardiovascular events are leading causes of mortality and adult disability worldwide. This retrospective cohort study investigated the association between pneumoconiosis, and cerebrovascular and cardiovascular events by using a nationwide population-based database in Taiwan. The data analyzed in this study was retrieved from the Taiwan National Health Insur...

  17. Asymmetric Synthesis, Structure, and Reactivity of Unexpectedly Stable Spiroepoxy-β-Lactones Including Facile Conversion to Tetronic Acids: Application to (+)-Maculalactone A

    OpenAIRE

    Duffy, Richard J.; Morris, Kay A.; Vallakati, Ravikrishna; Zhang, Wei; Romo, Daniel

    2009-01-01

    A novel class of small spirocyclic heterocycles, spiroepoxy-β-lactones (1,4-dioxaspiro[2.3]-hexan-5-ones), is described that exhibit a number of interesting reactivity patterns. These spiroheterocycles, including an optically active series, are readily synthesized by epoxidation of ketene dimers (4-alkylidene-2-oxetanones) available from homo- or heteroketene dimerization. An analysis of bond lengths in these systems by X-ray crystallography and comparison to data for known spirocycles and th...

  18. Mortalidad intrahospitalaria por accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Federico Rodríguez Lucci

    2013-08-01

    Full Text Available La mortalidad global por accidente cerebrovascular (ACV ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Stroke de FLENI y los registros institucionales de mortalidad entre los años 2000 y 2010. Los subtipos de ACV isquémicos se clasificaron según criterios TOAST y los ACV hemorrágicos en hematomas intrapanquimatosos, hemorragias subaracnoideas aneurismáticas, malformaciones arteriovenosas y otros hematomas intraparenquimatosos. Se analizaron 1514 pacientes, 1079 (71% con ACV isquémico (grandes vasos 39%, cardioembólicos 27%, lacunares 9%, etiología indeterminada 14%, otras etiologías 11% y 435 (29% con ACV hemorrágico (intraparenquimatosos 27%, hemorragia subaracnoidea 30%, malformaciones arteriovenosas 25% y otros hematomas espontáneos 18%. Se registraron 38 muertes intrahospitalarias (17 ACV isquémicos y 21 ACV hemorrágicos, representando una mortalidad global del 2.5% (1.7% en ACV isquémicos y 4.8% en ACV hemorrágicos. No se registraron muertes asociadas al uso de fibrinolíticos endovenosos. La mortalidad intrahospitalaria en pacientes con ACV isquémico y hemorrágico en nuestro centro fue baja. El manejo en un centro dedicado a las enfermedades neurológicas y el enfoque multidisciplinario por personal médico y no médico entrenado en el cuidado de la enfermedad cerebrovascular podrían explicar, al menos en parte, estos resultados.

  19. Symptomatic Epilepsies due to Cerebrovascular Diseases

    Science.gov (United States)

    Dakaj, Nazim; Shatri, Nexhat; Isaku, Enver; Zeqiraj, Kamber

    2014-01-01

    Introduction: Cerebro-vascular diseases (CVD) are the leading cause of symptomatic epilepsies. This study aims to investigate: a) Frequency of epilepsy in patients with CVD; b) Correlation of epilepsy with the type of CVD (ischemic and hemorrhage) and with age. Methodology: It is analyzed medical documentation of 816 hospitalized patients with CVD in the clinic of Neurology in University Clinical Center (UCC) during the period January - December 2010. The study included data on patients presenting with epileptic seizures after CVD, and those with previously diagnosed epilepsy, are not included in the study. The diagnosis of CVD, are established in clinical neurological examination and the brain imaging (computer tomography and magnetic resonance imaging). The diagnosis of epilepsy is established by the criteria of ILAE (International League against Epilepsy) 1983, and epileptic seizures are classified according to the ILAE classification, of 1981. Results: Out of 816 patients with CVD, 692 were with ischemic stroke and 124 with hemorrhage. From 816 patients, epileptic seizures had 81 (10%), of which 9 patients had been diagnosed with epilepsy earlier and they are not included in the study. From 72 (99%) patients with seizures after CVD 25 (33%) have been with ischemia, whereas 47 (67%) with hemorrhage. Conclusion: CVD present fairly frequent cause of symptomatic epilepsies among patients treated in the clinic of Neurology at UCC (about 10%). The biggest number of patients with epilepsy after CVD was with intracerebral hemorrhage. PMID:25685086

  20. A market based active/reactive dispatch including transformer taps and reactor and capacitor banks using Simulated Annealing

    International Nuclear Information System (INIS)

    This paper describes an optimization model to be used by System Operators in order to validate the economic schedules obtained by Market Operators together with the injections from Bilateral Contracts. These studies will be performed off-line in the day before operation and the developed model is based on adjustment bids submitted by generators and loads and it is used by System Operators if that is necessary to enforce technical or security constraints. This model corresponds to an enhancement of an approach described in a previous paper and it now includes discrete components as transformer taps and reactor and capacitor banks. The resulting mixed integer formulation is solved using Simulated Annealing, a well known metaheuristic specially suited for combinatorial problems. Once the Simulated Annealing converges and the values of the discrete variables are fixed, the resulting non-linear continuous problem is solved using Sequential Linear Programming to get the final solution. The developed model corresponds to an AC version, it includes constraints related with the capability diagram of synchronous generators and variables allowing the computation of the active power required to balance active losses. Finally, the paper includes a Case Study based on the IEEE 118 bus system to illustrate the results that it is possible to obtain and their interest. (author)

  1. A market based active/reactive dispatch including transformer taps and reactor and capacitor banks using Simulated Annealing

    Energy Technology Data Exchange (ETDEWEB)

    Gomes, Mario Helder [Departamento de Engenharia Electrotecnica, Instituto Politecnico de Tomar, Quinta do Contador, Estrada da Serra, 2300 Tomar (Portugal); Saraiva, Joao Tome [INESC Porto, Faculdade de Engenharia, Universidade do Porto, Campus da FEUP, Rua Dr. Roberto Frias, 4200-465 Porto (Portugal)

    2009-06-15

    This paper describes an optimization model to be used by System Operators in order to validate the economic schedules obtained by Market Operators together with the injections from Bilateral Contracts. These studies will be performed off-line in the day before operation and the developed model is based on adjustment bids submitted by generators and loads and it is used by System Operators if that is necessary to enforce technical or security constraints. This model corresponds to an enhancement of an approach described in a previous paper and it now includes discrete components as transformer taps and reactor and capacitor banks. The resulting mixed integer formulation is solved using Simulated Annealing, a well known metaheuristic specially suited for combinatorial problems. Once the Simulated Annealing converges and the values of the discrete variables are fixed, the resulting non-linear continuous problem is solved using Sequential Linear Programming to get the final solution. The developed model corresponds to an AC version, it includes constraints related with the capability diagram of synchronous generators and variables allowing the computation of the active power required to balance active losses. Finally, the paper includes a Case Study based on the IEEE 118 bus system to illustrate the results that it is possible to obtain and their interest. (author)

  2. Pioglitazone improves reversal learning and exerts mixed cerebrovascular effects in a mouse model of Alzheimer's disease with combined amyloid-β and cerebrovascular pathology.

    Directory of Open Access Journals (Sweden)

    Panayiota Papadopoulos

    Full Text Available Animal models of Alzheimer's disease (AD are invaluable in dissecting the pathogenic mechanisms and assessing the efficacy of potential new therapies. Here, we used the peroxisome proliferator-activated receptor gamma agonist pioglitazone in an attempt to rescue the pathogenic phenotype in adult (12 months and aged (>18 months bitransgenic A/T mice that overexpress a mutated human amyloid precursor protein (APPSwe,Ind and a constitutively active form of transforming growth factor-β1 (TGF-β1. A/T mice recapitulate the AD-related cognitive deficits, amyloid beta (Aβ and cerebrovascular pathologies, as well as the altered metabolic and vascular coupling responses to increased neuronal activity. Pioglitazone normalized neurometabolic and neurovascular coupling responses to sensory stimulation, and reduced cortical astroglial and hippocampal microglial activation in both age groups. Spatial learning and memory deficits in the Morris water maze were not rescued by pioglitazone, but reversal learning was improved in the adult cohort notwithstanding a progressing Aβ pathology. While pioglitazone preserved the constitutive nitric oxide synthesis in the vessel wall, it unexpectedly failed to restore cerebrovascular reactivity in A/T mice and even exacerbated the dilatory deficits. These data demonstrate pioglitazone's efficacy on selective AD hallmarks in a complex AD mouse model of comorbid amyloidosis and cerebrovascular pathology. They further suggest a potential benefit of pioglitazone in managing neuroinflammation, cerebral perfusion and glucose metabolism in AD patients devoid of cerebrovascular pathology.

  3. Cognitive impairments in cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    A. Yu. Emelin

    2014-01-01

    Full Text Available Cerebrovascular diseases belong to a group of the major causes of cognitive impairments, in the elderly in particular. The paper presents current ideas on the etiology and pathogenesis of vascular cognitive impairments (VCI. The etiological factors of VCI may be divided into genetic, sociodemographic, and common risk factors for vascular and other diseases. The pathogenesis of VCI is multifactorial; cognitive function decrement results from brain damage due to cerebral circulatory disorders. Damage to the deep white matter portions and basal ganglions plays a leading role in the development of cognitive deficit in cerebral circulatory insufficiency, disrupting the connections between the frontal lobes and subcortical structures (a dissociation phenomenon. Regulatory functions are impaired; instability of volitional attention develops; the speed of thinking processes and the performance of professional and everyday skills are suffered, mnestic functions being impaired to a lesser extent. Impairments in other higher cortical functions, such as speech, gnosis, praxis, thinking, generally occur in the later stages of cognitive deficit. The comprehensive approach to examining patients with cognitive dysfunctions, which encompasses physical examination with a mandatory evaluation of neurological symptoms, neuropsychological testing, laboratory studies, instrumental diagnostic methods, and structural and functional neuroimaging techniques, are most justified now. VCI therapy is a challenging task requiring the specific features of different types of cognitive deficit to be analyzed, by providing a rationale for the choice of medications. Therapeutic effectiveness may be enhanced by rational combined multimodal therapy, by keeping in mind a variety of factors for the pathogenesis of VCI.

  4. Molecular analysis of hepatitis B virus (HBV in an HIV co-infected patient with reactivation of occult HBV infection following discontinuation of lamivudine-including antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Costantini Andrea

    2011-11-01

    Full Text Available Abstract Background Occult hepatitis B virus (HBV infection (OBI is characterized by HBV DNA persistence even though the pattern of serological markers indicates an otherwise resolved HBV infection. Although OBI is usually clinically silent, immunocompromised patients may experience reactivation of the liver disease. Case presentation We report the case of an individual with human immunodeficiency virus (HIV infection and anti-HBV core antibody positivity, who experienced severe HBV reactivation after discontinuation of lamivudine-including antiretroviral therapy (ART. HBV sequencing analysis showed a hepatitis B surface antigen escape mutant whose presence in an earlier sample excluded reinfection. Molecular sequencing showed some differences between two isolates collected at a 9-year interval, indicating HBV evolution. Resumption of ART containing an emtricitabine/tenofovir combination allowed control of plasma HBV DNA, which fell to undetectable levels. Conclusion This case stresses the ability of HBV to evolve continuously, even during occult infection, and the effectiveness of ART in controlling OBI reactivation in HIV-infected individuals.

  5. Laboratory Studies of the Reactive Chemistry and Changing CCN Properties of Secondary Organic Aerosol, Including Model Development

    Energy Technology Data Exchange (ETDEWEB)

    Scot Martin

    2013-01-31

    The chemical evolution of secondary-organic-aerosol (SOA) particles and how this evolution alters their cloud-nucleating properties were studied. Simplified forms of full Koehler theory were targeted, specifically forms that contain only those aspects essential to describing the laboratory observations, because of the requirement to minimize computational burden for use in integrated climate and chemistry models. The associated data analysis and interpretation have therefore focused on model development in the framework of modified kappa-Koehler theory. Kappa is a single parameter describing effective hygroscopicity, grouping together several separate physicochemical parameters (e.g., molar volume, surface tension, and van't Hoff factor) that otherwise must be tracked and evaluated in an iterative full-Koehler equation in a large-scale model. A major finding of the project was that secondary organic materials produced by the oxidation of a range of biogenic volatile organic compounds for diverse conditions have kappa values bracketed in the range of 0.10 +/- 0.05. In these same experiments, somewhat incongruently there was significant chemical variation in the secondary organic material, especially oxidation state, as was indicated by changes in the particle mass spectra. Taken together, these findings then support the use of kappa as a simplified yet accurate general parameter to represent the CCN activation of secondary organic material in large-scale atmospheric and climate models, thereby greatly reducing the computational burden while simultaneously including the most recent mechanistic findings of laboratory studies.

  6. Thickness of the Human Cerebral Cortex is Associated with Metrics of Cerebrovascular Health in a Normative Sample of Community Dwelling Older Adults

    OpenAIRE

    Leritz, Elizabeth C.; Salat, David H.; Williams, Victoria J.; Schnyer, David M.; Rudolph, James L.; Lipsitz, Lewis; Fischl, Bruce; McGlinchey, Regina E.; Milberg, William P.

    2010-01-01

    We examined how wide ranges in levels of risk factors for cerebrovascular disease are associated with thickness of the human cerebral cortex in 115 individuals ages 43–83 with no cerebrovascular or neurologic history. Cerebrovascular risk factors included blood pressure, cholesterol, body mass index, creatinine, and diabetes-related factors. Variables were submitted into a principal components analysis that confirmed four orthogonal factors (Blood Pressure, Cholesterol, Cholesterol/Metabolic ...

  7. Migraine, cerebrovascular disease and the metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Alexandra J Sinclair

    2012-01-01

    Full Text Available Evidence is emerging that migraine is not solely a headache disorder. Observations that ischemic stroke could occur in the setting of a migraine attack, and that migraine headaches could be precipitated by cerebral ischemia, initially highlighted a possibly association between migraine and cerebrovascular disease. More recently, large population-based studies that have demonstrated that migraineurs are at increased risk of stroke outside the setting of a migraine attack have prompted the concept that migraine and cerebrovascular disease are comorbid conditions. Explanations for this association are numerous and widely debated, particularly as the comorbid association does not appear to be confined to the cerebral circulation as cardiovascular and peripheral vascular disease also appear to be comorbid with migraine. A growing body of evidence has also suggested that migraineurs are more likely to be obese, hypertensive, hyperlipidemic and have impaired insulin sensitivity, all features of the metabolic syndrome. The comorbid association between migraine and cerebrovascular disease may consequently be explained by migraineurs having the metabolic syndrome and consequently being at increased risk of cerebrovascular disease. This review will summarise the salient evidence suggesting a comorbid association between migraine, cerebrovascular disease and the metabolic syndrome.

  8. Cognitive impairments in patients with cerebrovascular steno-occlusive disease

    Institute of Scientific and Technical Information of China (English)

    石丹

    2012-01-01

    Objective To explore the relationship between cerebrovascular steno-occlusive disease and neuropsychological performance by cognitive function assessment. Methods Using a case-control study,45 patients with cerebrovascular steno-occlusive lesions (patient group) and 59 control subjects without cerebrovascular

  9. Caregiver awareness of cerebrovascular risk of patients with dementia due to Alzheimer's disease in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Fabricio Ferreira de Oliveira

    2014-07-01

    Full Text Available Background Proper control of cerebrovascular risk is essential to prevent cognitive change in dementia due to Alzheimer’s disease (AD. Objective To investigate whether caregiver awareness to control cerebrovascular risk impacts the lifestyles of patients with AD. Methods Consecutive outpatients with AD were assessed for demographic features, Clinical Dementia Rating scores, cerebrovascular risk, pharmacotherapy, dietary therapy and practice of physical activities. Patients and caregivers were inquired on awareness of the importance of measures to control cerebrovascular risk. Chi-square test was employed for statistics, significance at ρ < 0.05. Results A total of 217 patients were included; whereas 149 caregivers (68.7% were aware of the need to control cerebrovascular risk, only 11 patients (5.1% simultaneously practiced physical activities and received pharmacological treatment and dietary therapy. Patients with hypertension and diabetes mellitus were more likely to receive dietary therapy (ρ = 0.007. Male patients were more engaged in physical activities (ρ = 0.018. Patients in earlier AD stages exercised (ρ = 0.0003 and received pharmacological treatment more often (ρ = 0.0072. Caregiver awareness of the need to control cerebrovascular risk was higher when patients had hypertension (ρ = 0.024 and/or hypercholesterolemia (ρ = 0.006, and influenced adherence to dietary therapy (ρ = 0.002 and to pharmacological treatment (ρ = 0.001. Discussion Caregiver awareness of the need to control cerebrovascular risk has positive impacts for patients with AD.

  10. 磁敏感加权成像毛刷征与急性缺血性卒中患者血管反应性的关系%Relationship between brush sign on susceptibility-weighted imaging and cerebrovascular reactivity in patients with acute ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    韩献军; 黄红莉; 单树崇

    2014-01-01

    目的 探讨大脑中动脉(middle cerebral artery,MCA)供血区急性脑梗死患者磁敏感加权成像(susc eptibility-weighted imaging,SWI)显示的患侧侧脑室旁深部髓质静脉(deep medullary vein,DMV)数量与同侧颈内动脉(internal carotid artery,ICA)系统大动脉狭窄程度和脑血管反应性(cerebrovascular reactivity,CVR)的关系.方法 回顾性纳入在住院期间接受SWI、脑血管造影以及经颅多普勒CO2激发试验的MCA供血区急性脑梗死患者,根据SWI图像中可辨别的侧脑室旁DMV数量分为3级:1级,<5条;2级:5~10条;3级:>10条.分析DMV分级与同侧ICA/MCA狭窄程度和CVR的相关性.结果 共纳入MCA供血区急性脑梗死患者44例,DMV 1级24例,2级15例,3级5例,患侧ICA系统主干动脉平均狭窄程度为(40.52 ±30.62)%,MCA平均CVR为0.41 ±0.16.DMV 1级、2级和3级组血管狭窄程度分别为(31.31±26.02)%、(44.93±31.03)%和(71.76±26.68)%,3组间存在显著性差异(F=4.589,P=0.018),且DMV 3级组显著性高于DMV 1级组(P=0.014).DMV 1级、2级和3级组CVR分别为(0.45 ±0.12)、(0.41 ±0.18)和(0.22±0.12),3组间存在显著性差异(F=6.179,P=0.005),且DMV 3级组显著性低于DMV 1级组(P =0.006)和DMV2级组(P=0.038).Spearman相关分析显示,DMV分级与血管狭窄程度呈显著正相关(rs=0.381,P=0.013),与CVR呈显著负相关(rs=-0.375,P=0.012).结论 脑梗死患者DMV分级与责任大动脉狭窄程度呈正相关联系,与责任侧MCACVR呈负相关.%Objective To investigate the relationship between the numbers of deep medullary veins (DMV) beside the ipsilateral lateral ventricle and the stenotic degree of large artery of ipsilateral internal carotid artery (ICA) system and cerebrovascular reactivity (CVR) in patients with acute cerebral infarction showed on susceptibility-weighted imaging (SWI) in middle cerebral artery (MCA) territory.Methods The patients with acute cerebral infarction in MCA territory who underwent SWI

  11. Nitric oxide synthase inhibition and cerebrovascular regulation

    DEFF Research Database (Denmark)

    Iadecola, C; Pelligrino, D A; Moskowitz, M A;

    1994-01-01

    There is increasing evidence that nitric oxide (NO) is an important molecular messenger involved in a wide variety of biological processes. Recent data suggest that NO is also involved in the regulation of the cerebral circulation. Thus, NO participants in the maintenance of resting cerebrovascular...

  12. Brain imaging changes associated with risk factors for cardiovascular and cerebrovascular disease in asymptomatic patients.

    Science.gov (United States)

    Friedman, Joseph I; Tang, Cheuk Y; de Haas, Hans J; Changchien, Lisa; Goliasch, Georg; Dabas, Puneet; Wang, Victoria; Fayad, Zahi A; Fuster, Valentin; Narula, Jagat

    2014-10-01

    Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients' clinical course.

  13. NIRS-based noninvasive cerebrovascular regulation assessment

    Science.gov (United States)

    Miller, S.; Richmond, I.; Borgos, J.; Mitra, K.

    2016-03-01

    Alterations to cerebral blood flow (CBF) have been implicated in diverse neurological conditions, including mild traumatic brain injury, microgravity induced intracranial pressure (ICP) increases, mild cognitive impairment, and Alzheimer's disease. Near infrared spectroscopy (NIRS)-measured regional cerebral tissue oxygen saturation (rSO2) provides an estimate of oxygenation of the interrogated cerebral volume that is useful in identifying trends and changes in oxygen supply to cerebral tissue and has been used to monitor cerebrovascular function during surgery and ventilation. In this study, CO2-inhalation-based hypercapnic breathing challenges were used as a tool to simulate CBF dysregulation, and NIRS was used to monitor the CBF autoregulatory response. A breathing circuit for the selective administration of CO2-compressed air mixtures was designed and used to assess CBF regulatory responses to hypercapnia in 26 healthy young adults using non-invasive methods and real-time sensors. After a 5 or 10 minute baseline period, 1 to 3 hypercapnic challenges of 5 or 10 minutes duration were delivered to each subject while rSO2, partial pressure of end tidal CO2 (PETCO2), and vital signs were continuously monitored. Change in rSO2 measurements from pre- to intrachallenge (ΔrSO2) detected periods of hypercapnic challenges. Subjects were grouped into three exercise factor levels (hr/wk), 1: 0, 2:>0 and 10. Exercise factor level 3 subjects showed significantly greater ΔrSO2 responses to CO2 challenges than level 2 and 1 subjects. No significant difference in ΔPETCO2 existed between these factor levels. Establishing baseline values of rSO2 in clinical practice may be useful in early detection of CBF changes.

  14. The investigation of cerebrovascular disorders with positron emission tomography

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) provides a non-invasive, regional, in vivo method to measure physiological parameters including cerebral blood flow, glucose and oxygen metabolism, blood volume, and pH. Measurement of these parameters not only enables a more complete understanding of the pathophysiology of acute cerebral ischemia and infarction, but provides objective criteria with which to better manage patients. This chapter will first discuss PET methodology and tracer techniques used in the investigation of patients with cerebrovascular disease and then describe the progress that has already resulted from applying these methods. 73 refs.; 7 figs

  15. Clinic Practical Guides for Cerebrovascular Diseases Guías de práctica clínica para las enfermedades cerebrovasculares

    Directory of Open Access Journals (Sweden)

    Alejandro Pando Cabrera

    Full Text Available The clinic practical guides for cerebrovascular diseases are presented. They include different aspects as its concept, classification, and epidemiological data in Cuba as well as worldwide. They also offer its diagnosis, classification, complications and treatment. The frequency of assessment of its application including the tools to measure the quality of life in patients with cerebrovascular accident and the way to proceed with them are shown
    Se presentan las guías de práctica clínica para las enfermedades cerebrovasculares. Incluye aspectos como su concepto y clasificación, datos epidemiológicos en el mundo y en Cuba, así como su diagnóstico, clasificación, complicaciones y tratamiento. Se ofrece la forma y frecuencia de la evaluación de su aplicación e incluye instrumentos para medir calidad de vida de los enfermos con accidentes cerebrovasculares.

  16. Clinical and Paraclinical Findings of Cerebrovascular Accidents in Children Admitted to Pediatric Medical Center from 1993 till 2003

    OpenAIRE

    M Dehghani; H Montazer Lotfe Elahi; Ashrafi, M.

    2011-01-01

    Introduction: Stroke is a clinical diagnosis which brings up cerebrovascular diseases. Stroke includes any cerebrovascular accident which leads to local neural defect and lasts more than 24 hours. Stroke has severe and irreversible complications and high rates of recurrence after first episode, therefore we decided to study clinical and paraclinical findings of this disease for better diagnosis and prevention of it. Methods: We prepared a case series study to review medical files of the patie...

  17. Association of Fibrin Monomer Polymerization Function, Cerebrovascular Risk Factors and Ischemic Cerebrovascular Disease in Old People

    Institute of Scientific and Technical Information of China (English)

    洪梅; 魏文宁; 李红戈; 杨锐; 杨焰

    2003-01-01

    Summary: In order to investigate the association of fibrin monomer polymerization function (FMPF)with traditional cerebrovascular risk factors and ischemic cerebrovascular disease in old people, 1 : 1paired case-control comparative study was performed for FMPF and traditional cerebrovascular riskfactors on 110 cases of old ischemic cerebrovascular disease and 110 controls matched on age, sex andliving condition. The results showed that cerebrovascular risk factors were more prevalent in casegroup than in control group. In the case group, FMPF was significantly higher than in controlgroup. There was a significant positive correlation between hypertension and fibrin monomer poly-merization velocity (FMPV), hypertension and fibrinogen (Fbg), alcohol consumption and Fbg, butno significant correlation between diabetic mellitus, smoking and FMPF was found. Among the pa-rameters of blood lipids, there were significant positive correlations between total cholesterol (TC)and parameters of FMPF to varying degrees, triglycerides (TG) and FMPV, TG and Fbg. Our re-sults also showed there were significant linear trends between TC and FMPV (P<0. 001), TC andFbg (P=0. 0087), TG and FMPV/Amax (maximum absorbance)(P=0. 0143) respectively. Multi-ple logistic regression analysis revealed that FMPF in case group remained significantly higher thancontrol group after adjustment of all risk factors that were significant in univariate analysis. It wasconcluded that there is a possible pathophysiological link between FMPF and cerebrovascular risk fac-tors. An elevated FMPF is associated with ischemic cerebrovascular disease and an independent riskfactor of this disease. In old people, detection of FMPF might be a useful screening to identify indi-viduals at increased cerebrothrombotic risk.

  18. The Cerebrovascular Disease and Nutritional State. Enfermedad cerebrovascular y estado nutricional

    Directory of Open Access Journals (Sweden)

    Fidel Pérez Pérez

    Full Text Available Background: It is recognized the importance of malnutrition as a cause of morbidity and mortality in medical and surgical affections. The nutritional assessment of the patient should be based on a correct evaluation of different aspects. Objective: To assess the nutritional state of patients affected by cerebrovascular diseases in its ischemic form and the incidence of complications and deaths. Methods: A randomized simple and open clinical trial which is also prospective and longitudinal, not controlled by placebos that included 80 patients with a tomographed-clinical diagnosis of cerebral infarction admitted at the Higher Institute of Military Medicine during 2005. Clinical and dietary record, weight, size, daily assessments of the immunological performance by means of peripheral count of lymphocytes were analyzed. Results: Out of the total, 90 per cent of the patients had a weight loss lesser than 10 % of the ideal weight and, the 10% made evident a discrete increasing of weight. Patients with complications presented higher per cent of loss of weight and higher figures of urinary nitrogen. The higher per cent of loss of weight and the lowest lymphocytes count were found in patients with septic complications. An abbaissement in adequate nutritional parameters was found in deceased patients. Significant differences in the report of the initial malnourished patient’s complication existed. Conclusions: It was evident the relationship between the evolution of the cerebrovascular disease and the nutritional state which is conditioned by the appearance of complications with emphasis on sepsis. That’s why it is necessary to pay special attention to the nutrition of patients with neuroictus.
    Fundamento: Se reconoce la trascendencia de la desnutrición como causa de morbilidad y mortalidad en afecciones médicas y quir

  19. NADPH OXIDASE IN STROKE AND CEREBROVASCULAR DISEASE

    OpenAIRE

    Tang, Xian Nan; Cairns, Belinda; Kim, Jong Youl; Midori A Yenari

    2012-01-01

    NADPH oxidase (NOX) was originally identified in immune cells as playing an important microbicidal role. In stroke and cerebrovascular disease, inflammation is increasingly being recognized as contributing negatively to neurological outcome, with NOX as an important source of superoxide. Several labs have now shown that blocking or deleting NOX in the experimental stroke models protects from brain ischemic. Recent work has implicated glucose as an important NOX substrate leading to reperfusio...

  20. Risk of Cerebrovascular Events in Pneumoconiosis Patients

    Science.gov (United States)

    Chuang, Chieh-Sen; Ho, Shang-Chang; Lin, Cheng-Li; Lin, Ming-Chia; Kao, Chia-Hung

    2016-01-01

    Abstract Pneumoconiosis is a parenchymal lung disease that develops through the inhalation of inorganic dust at work. Cerebrovascular and cardiovascular events are leading causes of mortality and adult disability worldwide. This retrospective cohort study investigated the association between pneumoconiosis, and cerebrovascular and cardiovascular events by using a nationwide population-based database in Taiwan. The data analyzed in this study was retrieved from the Taiwan National Health Insurance Research Database. We selected 6940 patients with pneumoconiosis from the database as our study cohort. Another 27,760 patients without pneumoconiosis were selected and matched with those with pneumoconiosis according to age and sex as the comparison cohort. We used univariate and multivariate Cox proportional-hazard regression analyses to determine the association between pneumoconiosis and the risk of cerebrovascular and cardiovascular events after adjusting for medical comorbidities. After adjustment for age, sex, and comorbidities, the patients with pneumoconiosis exhibited a significantly higher incidence of ischemic stroke (hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.05–1.24) than did those without pneumoconiosis. The incidence of hemorrhagic stroke was higher, but not significant, in the pneumoconiosis patients (HR 1.20, 95% CI 0.99–1.46). No statistically significant differences were observed between the pneumoconiosis and nonpneumoconiosis groups in acute coronary syndrome (HR 1.10, 95% CI 0.95–1.26). The findings of this study reveal an association between pneumoconiosis and a higher risk of cerebrovascular events after adjustment for comorbidities. Healthcare providers should control the related risk factors for primary prevention of stroke in pneumoconiosis patients. PMID:26945404

  1. Cerebrovascular Complications of Diabetes: Focus on Stroke

    OpenAIRE

    Ergul, Adviye; Kelly-Cobbs, Aisha; Abdalla, Maha; Fagan, Susan C

    2012-01-01

    Cerebrovascular complications make diabetic patients 2–6 times more susceptible to a stroke event and this risk is magnified in younger individuals and in patients with hypertension and complications in other vascular beds. In addition, when patients with diabetes and hyperglycemia experience an acute ischemic stroke they are more likely to die or be severely disabled and less likely to benefit from the one FDA-approved therapy, intravenous tissue plasminogen activator. Experimental stroke mo...

  2. EMPREGO DE STENTS CEREBRAIS NAS PATOLOGIAS CEREBROVASCULARES

    Directory of Open Access Journals (Sweden)

    Laís Rocha Lopes

    2015-06-01

    Full Text Available Objective: To understand the applicability and characteristics of the stents for the treatment of cerebrovascular pathologies in order to understand its viability for the therapy. Methods: Scientific articles were used based on electronic search as PubMed, Scientific Electronic Library Online (SciELO, Intechopen, Medscape. An international and up to date source of articles was used. Results: Cerebrovascular diseases have emerged as the second most important cause of mortality worldwide, from this principle we observe the importance of this study. Recently, as a solution form, stents have become a major treatment option for difficult and not feasible cerebral aneurysms single winding. Intracranial stents serve as a bridge to the neo-endothelialization by providing a reduction in blood flow into the aneurysm. The use of stents for treatment should be seriously analyzed according to their feasibility, the knowledge of the professional about their brands, features and deployment techniques, and theoretical part of the professional needs to have dexterity to the application of an intracranial stent. Conclusions: This review raises an awareness of this subject, starts from the concept of cerebrovascular disease and aneurysms as well as the genesis of the stents, progressing to elucidate all product brands and specific characteristics of each, ending with its applicability, as well as making clear the purpose and mechanism of stents.

  3. Asymmetric synthesis, structure, and reactivity of unexpectedly stable spiroepoxy-beta-lactones including facile conversion to tetronic acids: application to (+)-maculalactone A.

    Science.gov (United States)

    Duffy, Richard J; Morris, Kay A; Vallakati, Ravikrishna; Zhang, Wei; Romo, Daniel

    2009-07-01

    A novel class of small spirocyclic heterocycles, spiroepoxy-beta-lactones (1,4-dioxaspiro[2.3]-hexan-5-ones), is described that exhibit a number of interesting reactivity patterns. These spiroheterocycles, including an optically active series, are readily synthesized by epoxidation of ketene dimers (4-alkylidene-2-oxetanones) available from homo- or heteroketene dimerization. An analysis of bond lengths in these systems by X-ray crystallography and comparison to data for known spirocycles and those determined computationally suggest that anomeric effects in these systems may be more pronounced due to their rigidity and may contribute to their surprising stability. The synthetic utility of spiroepoxy-beta-lactones was explored, and one facile rearrangement identified under several conditions provides a three-step route from acid chlorides to optically active tetronic acids, ubiquitous heterocycles in bioactive natural products. The addition of various nucleophiles to these spirocycles leads primarily to addition at C5 and C2. The utility of an optically active spiroepoxy-beta-lactone was demonstrated in the concise, enantioselective synthesis of the antifouling agent, (+)-maculalactone A, which proceeds in five steps from hydrocinnamoyl chloride by way of a tetronic acid intermediate. PMID:19453152

  4. Asymmetric Synthesis, Structure, and Reactivity of Unexpectedly Stable Spiroepoxy-β-Lactones Including Facile Conversion to Tetronic Acids: Application to (+)-Maculalactone A

    Science.gov (United States)

    Duffy, Richard J.; Morris, Kay A.; Vallakati, Ravikrishna; Zhang, Wei; Romo, Daniel

    2009-01-01

    A novel class of small spirocyclic heterocycles, spiroepoxy-β-lactones (1,4-dioxaspiro[2.3]-hexan-5-ones), is described that exhibit a number of interesting reactivity patterns. These spiroheterocycles, including an optically active series, are readily synthesized by epoxidation of ketene dimers (4-alkylidene-2-oxetanones) available from homo- or heteroketene dimerization. An analysis of bond lengths in these systems by X-ray crystallography and comparison to data for known spirocycles and those determined computationally, suggest that anomeric effects in these systems may be more pronounced due to their rigidity and may contribute to their surprising stability. The synthetic utility of spiroepoxy-β-lactones was explored and one facile rearrangement identified under several conditions provides a 3-step route from acid chlorides to optically active tetronic acids, ubiquitous heterocycles in bioactive natural products. The addition of various nucleophiles to these spirocycles leads primarily to addition at C5 and C2. The utility of an optically active spiroepoxy-β-lactone was demonstrated in the concise, enantioselective synthesis of the anti-fouling agent, (+)-maculalactone A, which proceeds in 5 steps from hydrocinnamoyl chloride by way of a tetronic acid intermediate. PMID:19453152

  5. Correlation of cerebrovascular disorder and anxiety: The Kecskemet study

    Science.gov (United States)

    Sipos, Kornel; Bodo, Michael; Szalay, Piroska; Szucs, Attila

    2010-04-01

    In order to test the hypothesis that anxiety is a risk factor for cardiovascular disease, specifically stroke, we simultaneously measured anxiety and cerebral vascular alternation, using a computer-based system, "Cerberus." Sixty nine psychiatric patients (including an alcoholic subgroup) were selected as subjects for measurements conducted in Kecskemet, Hungary. The five-item short form of anxiety test (STAI) was administered twice during the same session. Between each test, brain pulse waves were recorded by rheoencephalogram (REG). A REG peak time above 180 milliseconds was considered a cerebrovascular alteration (modified after Jenkner). Data were sorted into two groups: low anxiety (N=10) and high anxiety (N=10). Significant differences were found between cardiovascular risk factors (panxiety group, and two in the low anxiety group. For the two anxiety groups, there were no significant differences in body mass index, cardiovascular sympathetic-parasympathetic balance, age and symptoms of transient ischemic attack. The correlation of REG and age was significantly different only for the alcoholic subgroup (Szalay et al, 2007). These data support the hypothesis that a correlation exists between cerebrovascular disorder and anxiety in the studied population.

  6. Cerebrovascular Accident Incidence in the NASA Astronaut Population

    Science.gov (United States)

    LaPelusa, Michael B.; Charvat, Jacqueline M.; Lee, Lesley R.; Wear, Mary L.; Van Baalen, Mary

    2016-01-01

    The development of atherosclerosis is strongly associated with an increased risk for cerebrovascular accidents (CVA), including stroke and transient ischemic attacks (TIA). Certain unique occupational exposures that individuals in the NASA astronaut corps face, specifically high-performance aircraft training, SCUBA training, and spaceflight, are hypothesized to cause changes to the cardiovascular system. These changes, which include (but are not limited to) oxidative damage as a result of radiation exposure and circadian rhythm disturbance, increased arterial stiffness, and increased carotid-intima-media thickness (CIMT), may contribute to the development of atherosclerosis and subsequent CVA. The purpose of this study was to review cases of CVA in the NASA astronaut corps and describe the comorbidities and occupational exposures associated with CVA.

  7. Dynamic computed tomography findings in cerebrovascular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Yutaka; Tomoda, Kaname; Kariya, Mitsumasa; Mori, Shigeru; Mitomo, Masanori.

    1988-01-01

    Dynamic CT was performed with 41 patients with the clinically diagnosed cerebrovascular diseases. A visual evaluation based on the dynamic CT images classified six patterns of brain parenchymal enhancement, especially four patterns of which could only be detected by dynamic CT technique. Dynamic CT was proved of great value in detecting regional cerebral tissue filled by collaterals in retrograde fashion because of the occlusion of main arteries, namely brain tissue perfusion of internal carotid occlusion disease and moyamoya disease was best understood by dynamic CT with adequate resolution.

  8. NADPH Oxidase Accounts for Changes in Cerebrovascular Redox Status in Hindlimb Unweighting Rats

    Institute of Scientific and Technical Information of China (English)

    PENG Liang; RAN Hai Hong; ZHANG Ying; ZHAO Yu; FAN Yong Yan; PENG Li; ZHANG Ran; CAO Feng

    2015-01-01

    ObjectiveThe roles of cerebrovascular oxidative stress in vascular functional remodeling have been described in hindlimb-unweighting (HU) rats. However, the underlying mechanism remains to be established. MethodsWe investigated the generation of vascular reactive oxygen species (ROS),Nox2/Nox4 protein and mRNA levels, NADPH oxidase activity, and manganese superoxide dismutase (MnSOD) and glutathione peroxidase-1 (GPx-1) mRNA levels in cerebral and mesenteric smooth muscle cells (VSMCs) of HU rats. ResultsROS production increased in cerebral but not in mesenteric VSMCs of HU rats compared with those in control rats.Nox2 and Nox4 protein and mRNA levels were increased significantly but MnSOD/GPx-1 mRNA levels decreased in HU rat cerebral arteries but not in mesenteric arteries. NADPH oxidases were activated significantly more in cerebral but not in mesenteric arteries of HU rats. NADPH oxidase inhibition with apocynin attenuated cerebrovascular ROS production and partially restored Nox2/Nox4 protein and mRNA levels, NADPH oxidase activity, and MnSOD/GPx-1 mRNA levels in cerebral VSMCs of HU rats. ConclusionThese results suggest that vascular NADPH oxidases regulate cerebrovascular redox status and participate in vascular oxidative stress injury during simulated microgravity.

  9. Cognitive performance correlates with cerebrovascular impairments in multi-infarct dementia

    International Nuclear Information System (INIS)

    Cerebral blood flow (CBF) was measured by the 133Xe inhalation method in patients with multi-infarct dementia (MID, N = 26), Alzheimer's dementia (AD, N = 19), and among age-matched, neurologically normal, healthy volunteers (N = 26). Cognitive performance was assessed in all subjects using the Cognitive Capacity Screening Examination (CCSE). Cerebral vasomotor responses were calculated from differences in values of mean hemispheric gray matter blood flow (Delta CBF) measured during inhalation of 100% oxygen (hyperoxia) compared with CBF measured while breathing room air. Significant correlations were found between CCSE performance and vasomotor responsiveness in patients with MID (P less than .01), but not in patients with AD or in neurologically normal volunteers. Loss of vasomotor responsiveness is an indicator of cerebrovascular disease with rigidity and/or loss of reactivity of cerebral vessels, which impairs cerebrovascular responses to situational demands and predisposes to cerebral ischemia. Loss of cerebral vasomotor responsiveness among MID patients, which is a biologic marker of cerebrovascular disease, provides confirmatory evidence of the vascular etiology of MID and assists in separating MID from AD patients

  10. Cerebrovascular responses to hypoxia and hypocapnia in high-altitude dwellers.

    Science.gov (United States)

    Norcliffe, L J; Rivera-Ch, M; Claydon, V E; Moore, J P; Leon-Velarde, F; Appenzeller, O; Hainsworth, R

    2005-07-01

    Cerebral blood flow is known to increase in response to hypoxia and to decrease with hypocapnia. It is not known, however, whether these responses are altered in high-altitude dwellers who are not only chronically hypoxic and hypocapnic, but also polycythaemic. Here we examined cerebral blood flow responses to hypoxia and hypocapnia, separately and together, in Andean high-altitude dwellers, including some with chronic mountain sickness (CMS), which is characterized by excessive polycythaemia. Studies were carried out at high altitude (Cerro de Pasco (CP), Peru; barometric pressure (P(B)) 450 mmHg) and repeated, following relief of the hypoxia, on the day following arrival at sea level (Lima, Peru; P(B) 755 mmHg). We compared these results with those from eight sea-level residents studied at sea level. In nine high-altitude normal subjects (HA) and nine CMS patients, we recorded middle cerebral artery mean blood flow velocity (MCAVm) using transcranial Doppler ultrasonography, and expressed responses as changes from baseline. MCAVm responses to hypoxia were determined by changing end-tidal partial pressure of oxygen (P(ET,O2)) from 100 to 50 mmHg, with end-tidal partial pressure of carbon dioxide clamped. MCAVm responses to hypocapnia were studied by voluntary hyperventilation with (P(ET,O2)) clamped at 100 and 50 mmHg. There were no significant differences between the cerebrovascular responses of the two groups to any of the interventions at either location. In both groups, the MCAVm responses to hypoxia were significantly greater at Lima than at CP (HA, 12.1 +/- 1.3 and 6.1 +/- 1.0%; CMS, 12.5 +/- 0.8 and 5.6 +/- 1.2%; P < 0.01 both groups). The responses at Lima were similar to those in the sea-level subjects (13.6 +/- 2.3%). The responses to normoxic hypocapnia in the altitude subjects were also similar at both locations and greater than those in sea-level residents. During hypoxia, both high-altitude groups showed responses to hypocapnia that were

  11. CT findings of cerebrovascular diseases in patients with atrial fibrillation

    International Nuclear Information System (INIS)

    CT findings of cerebrovascular diseases were studied in 111 patients with atrial fibrillation (Af). One of these patients had cerebral hemorrhage, and another, subarachnoid hemorrhage, while the others all had cerebral infarctions. CT revealed 122 lesions with a low-density area (LDA) in 105 patients. Based on the cerebral artery territory, the 122 CT lesions were classified into the following 8 types: 10 hemispheric, 43 superficial, 23 deep, 28 superficial+deep, 1 anterior cerebral artery, 6 posterior cerebral artery, 10 watershed, and 1 vertebrobasilar. Therefore, infarctions of the internal carotid artery (ICA) system, including 94 infarctions of the middle cerebral artery territory, were most frequent, accounting for 94% of all lesions. The ratio of the left to the right infarctions of the ICA system was 1.1:1. However, it should be noted that non-embolic infarctions can occur even patients with Af. (author)

  12. Serum Lipid Profile in Nigerian Patients with Ischaemic Cerebrovascular Accident

    Directory of Open Access Journals (Sweden)

    H.B. Osadolor

    2013-05-01

    Full Text Available Ischaemic Cerebrovascular Accident (CVA has been shown to be associated with abnormal lipid profile (dyslipidaemia as a risk factor. There is paucity of data regarding this in this environment hence this study. In this study, a total number of 63 subjects were recruited comprised of 33 patients with cerebrovascular accident (stroke and 30 apparently healthy volunteers as control. A complete lipid profile which included Total serum Cholesterol (TC, serum Triglyceride (TG, High Density Lipoprotein cholesterol (HDL-c and Low Density Lipoprotein cholesterol (LDL-c were assayed for both patients and controls. The lipid profile was determined using standard methods. The TC for both patients and control were 212±53 and 196±46 mg/dL respectively, TG for both patients and controls were 159±9 and 79±13 mg/dL respectively, HDL-c was 55±9 mg/dL for patients and 61±7 mg/dL for controls and LDL-c was 151±34 mg/dL for patients and 117±51 mg/dL for control subjects. TC, TG and LDL-c were higher in the ischaemic CVA patients than the controls; however only TG showed a significant increase while HDL-c although not significant was lower than control. The study therefore showed that ischaemic CVA is associated with hypercholesterolaemia, hypertriglyceridaemia and high LDL-cholesterol. We thus suggest preventive and management strategies that will reduce lipid levels (TC, TG and LDL and enhance HDL-cholesterol in Nigeria patients that are prone to or diagnosed of ischaemic CVA.

  13. The Cerebrovascular Disease and Nutritional State. Enfermedad cerebrovascular y estado nutricional

    OpenAIRE

    Fidel Pérez Pérez; José Miguel Rodríguez Perón; Manuel Guzmán Noa; Mildred Díaz Masip; Mayelin Blanco Suárez; Leticia del Rosario Cruz

    2007-01-01

    Background: It is recognized the importance of malnutrition as a cause of morbidity and mortality in medical and surgical affections. The nutritional assessment of the patient should be based on a correct evaluation of different aspects. Objective: To assess the nutritional state of patients affected by cerebrovascular diseases in its ischemic form and the incidence of complications and deaths. Methods: A r...

  14. Impact of Cerebrovascular Disease Mortality on Life Expectancy in China

    Institute of Scientific and Technical Information of China (English)

    LI Guo Qi; LI Yan; ZHAO Dong; FAN Jie; LIU Jing; WANG Wei; WANG Miao; QI Yue; XIE Wu Xiang; LIU Jun; ZHAO Fan

    2014-01-01

    Objective To evaluate the impact of cerebrovascular disease mortality on life expectancy (LE) in China in 2010 compared with 2005, and to identify the high-risk population (age, sex, and region) where cerebrovascular disease mortality has had a major impact on LE. Methods LE and cause-eliminated LE were calculated by using standard life tables which used adjusted mortality data from the Death Surveillance Data Sets in 2005 and 2010 from the National Disease Surveillance System. Decomposition was used to quantitate the impact of cerebrovascular disease in different age groups. Results LE in China was 73.24 years in 2010, which was higher in women and urban residents compared with men and rural residents. The loss of LE caused by cerebrovascular disease mortality was 2.26 years, which was higher in men and rural residents compared with women and urban residents. More than 30%of the loss of LE were attributed to premature death from cerebrovascular disease in people aged Conclusion Cerebrovascular disease mortality had a major impact on LE in China, with a significant difference between urban and rural residents. LE is likely to be further increased by reducing cerebrovascular disease mortality, and special attention should be paid to reducing premature deaths in people aged<65 years.

  15. SYSTOLIC HYPERTENSION. IMPACT ON CEREBROVASCULAR DISEASE

    Directory of Open Access Journals (Sweden)

    Juan Eloy Cruz Quesada

    2011-08-01

    Full Text Available Fundamento: La aterosclerosis es un proceso multifactorial sobre el cual actúan varios factores de riesgo. Constituye la principal causa de muerte y de morbilidad en ingresados hospitalarios, y puede ocasionar una acentuada disminución del flujo sanguíneo hacia todos los órganos del cuerpo humano Objetivo: Determinar el impacto de la hipertensión arterial sistólica sobre la enfermedad cerebrovascular. Métodos: Se realizó un estudio transversal, observacional y analítico, en 59 fallecidos hipertensos. Se analizaron las arterias cerebrales y se cuantificó la lesión aterosclerótica y su variedad, aplicándose el sistema aterométrico, teniendo en cuenta los tipos de hipertensión arterial. Se emplearon procedimientos estadísticos (medidas de tendencia central y comparativos (prueba de comparación de media aritmética basadas en el test “t” de student. Resultados: Los infartos cerebrales recientes fueron más frecuentes en hipertensos sistodiastólicos. No hubo diferencia significativa en cuanto a la edad en el momento de aparición de las lesiones para ambos sexos, pero las mujeres con hipertensión sistólica, fueron significativamente más dañadas desde el punto de vista morfométrico. Se observó correlación significativa para ambos grupos de hipertensos entre tipo de accidente cerebrovascular y variables del sistema aterométrico. Conclusiones: La hipertensión arterial sistólica es un factor importante en la génesis de la enfermedad vasculocerebral y está asociada con la progresión de la placa de ateroma.

  16. 7-T MRI in Cerebrovascular Diseases: Challenges to Overcome and Initial Results.

    Science.gov (United States)

    Harteveld, Anita A; van der Kolk, Anja G; Zwanenburg, Jaco J M; Luijten, Peter R; Hendrikse, Jeroen

    2016-04-01

    Magnetic resonance imaging (MRI) plays a key role in the investigation of cerebrovascular diseases. Compared with computed tomography (CT) and digital subtraction angiography (DSA), its advantages in diagnosing cerebrovascular pathology include its superior tissue contrast, its ability to visualize blood vessels without the use of a contrast agent, and its use of magnetic fields and radiofrequency pulses instead of ionizing radiation. In recent years, ultrahigh field MRI at 7 tesla (7 T) has shown promise in the diagnosis of many cerebrovascular diseases. The increased signal-to-noise ratio (SNR; 2.3x and 4.7x increase compared with 3 and 1.5 T, respectively) and contrast-to-noise ratio (CNR) at this higher field strength can be exploited to obtain a higher spatial resolution and higher lesion conspicuousness, enabling assessment of smaller brain structures and lesions. Cerebrovascular diseases can be assessed at different tissue levels; for instance, changes of the arteries feeding the brain can be visualized to determine the cause of ischemic stroke, regional changes in brain perfusion can be mapped to predict outcome after revascularization, and tissue damage, including old and recent ischemic infarcts, can be evaluated as a marker of ischemic burden. For the purpose of this review, we will discriminate 3 levels of assessment of cerebrovascular diseases using MRI: Pipes, Perfusion, and Parenchyma (3 Ps). The term Pipes refers to the brain-feeding arteries from the heart and aortic arch, upwards to the carotid arteries, vertebral arteries, circle of Willis, and smaller intracranial arterial branches. Perfusion is the amount of blood arriving at the brain tissue level, and includes the vascular reserve and perfusion territories. Parenchyma refers to the acute and chronic burden of brain tissue damage, which includes larger infarcts, smaller microinfarcts, and small vessel disease manifestations such as white matter lesions, lacunar infarcts, and microbleeds

  17. [Ketamine racemate and S-(+)-ketamine. Cerebrovascular effects and neuroprotection following focal ischemia].

    Science.gov (United States)

    Werner, C; Reeker, W; Engelhard, K; Lu, H; Kochs, E

    1997-03-01

    The phencyclidine derivative ketamine is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist with the thalamo-neocortical projection system as the primary site of action. Racemic ketamine consists of the enantiomers S(+)-ketamine and R(-)-ketamine. Racemic ketamine has never been considered an adequate anaesthetic agent in neurosurgical patients since it produces regionally specific stimulation of cerebral metabolism (CMRO2) and increases cerebral blood flow (CBF) and intracranial pressure (ICP). However, recent experiments suggest that both tracemic ketamine and S(+)-ketamine may reduce infarct size in animal models of incomplete cerebral ischaemia and brain injury. This experimental protective effect appears to be related to decreases in Ca++ influx and maintenance of brain tissue magnesium levels due to NMDA and quisqualate receptor blockade by ketamine. Studies in dogs have shown that racemic ketamine (2.0 mg/kg) increases CBF in the presence of the cerebral vasodilator N2O. In contrast, studies in rats without background anaesthesia showed increases in CBF after racemic ketamine (100 mg/kg i.p.). This suggests that the cerebrovascular effects of racemic ketamine are related to the pre-existing cerebrovascular tone induced by background anaesthetics. Cerebrovascular CO2 reactivity was maintained regardless of the baseline cerebrovascular resistance. There are several mechanisms by which racemic ketamine may increase CBF. It induces dose-dependent respiratory depression with consequent mild hypercapnia in spontaneously ventilating subjects. This produces vasodilation due to the intact cerebrovascular CO2 reactivity. Racemic ketamine also induces regional neuroexcitation, which leads to stimulation of cerebral glucose consumption in the limbic, extrapyramidal, auditory, and sensory-motor systems. This regional neuroexcitation with increased CMRO2 produces increases in CBF that can be blocked by infusion of barbiturates or benzodiazepines. However

  18. PLUVIUS: a generalized one-dimensional model of reactive pollutant behavior, including dry deposition, precipitation formation, and wet removal. Second edition

    Energy Technology Data Exchange (ETDEWEB)

    Easter, R.C.; Hales, J.M.

    1984-11-01

    This report is a second-edition user's manual for the PLUVIUS reactive-storm model. The PLUVIUS code simulates the formation of storm systems of a variety of types, and characterizes the behavior of air pollutants as they flow through, react within, and are scavenged by the storms. The computer code supplied with this report is known as PLUVIUS MOD 5.0, and is a substantial improvement over the MOD 3.1 version given in the original user's manual. Example applications of MOD 5.0 are given in the report to facilitate rapid application of the code for a variety of specific uses. 22 references, 7 figures, 48 tables.

  19. Effect of Chronic Endothelin Receptor Antagonism on Cerebrovascular Function in Type 2 Diabetes

    OpenAIRE

    Harris, Alex K; Elgebaly, Mostafa M.; Li, Weiguo; Sachidanandam, Kamakshi; Ergul, Adviye

    2008-01-01

    Diabetes increases the risk of stroke and contributes to poor clinical outcomes in this patient population. Myogenic tone of the cerebral vasculature, including basilar arteries, plays a key role in controlling cerebral blood flow. Increased myogenic tone is ameliorated with ET receptor antagonism in Type 1 diabetes. However, the role of ET-1 and its receptors in cerebrovascular dysfunction in Type-2 diabetes, a common comorbidity in stroke patients, remains poorly elucidated. Therefore, we h...

  20. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  1. Alzheimer's disease: Cerebrovascular dysfunction, oxidative stress, and advanced clinical therapies

    NARCIS (Netherlands)

    M.W. Marlatt; P.J. Lucassen; G. Perry; M.A. Smith; X. Zhu

    2008-01-01

    Many lines of independent research have provided convergent evidence regarding oxidative stress, cerebrovascular disease, dementia, and Alzheimer's disease (AD). Clinical studies spurred by these findings engage basic and clinical communities with tangible results regarding molecular targets and pat

  2. Obesity Paradox in the Course of Cerebrovascular Diseases.

    Science.gov (United States)

    Brzecka, Anna; Ejma, Maria

    2015-01-01

    Obesity remains an important risk factor of cardiovascular and cerebrovascular diseases. However, it has been observed that increased body fat and body mass index predicted longer survival after the occurrence of a cardiovascular event. This observation has been named the obesity paradox. Initially, the term obesity paradox referred to the observation of the better outcome of cardiovascular diseases, such as heart failure and coronary heart disease, in obese patients as compared to underweight and normal-weight patients. Recently, similar, although fewer, observations confirm the occurrence of the obesity paradox in patients with acute cerebrovascular diseases. The underlying reasons for the protective effects of excessive body fat tissue against the consequences of acute cardiovascular and cerebrovascular diseases are poorly understood. The effect of preconditioning may be associated with the obesity paradox. The issue of the correlation between obesity and better survival of patients with cardiovascular and cerebrovascular diseases still remains largely unexplored. Debates for and against the obesity paradox continue.

  3. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis.......The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  4. Thrombin, a mediator of cerebrovascular inflammation in AD and hypoxia

    Directory of Open Access Journals (Sweden)

    Debjani eTripathy

    2013-05-01

    Full Text Available Considerable evidence implicates hypoxia and vascular inflammation in Alzheimer’s disease (AD. Thrombin, a multifunctional inflammatory mediator, is demonstrable in the brains of AD patients both in the vessel walls and senile plaques. Hypoxia-inducible factor 1α (HIF-1α, a key regulator of the cellular response to hypoxia, is also upregulated in the vasculature of human AD brains. The objective of this study is to investigate inflammatory protein expression in the cerebrovasculature of transgenic AD mice and to explore the role of thrombin as a mediator of cerebrovascular inflammation and oxidative stress in AD and in hypoxia-induced changes in brain endothelial cells. Immunofluorescent analysis of the cerebrovasculature in AD mice demonstrates significant (p<0.01-0.001 increases in thrombin, HIF-1α, interleukin-6 (IL-6, monocyte chemoattractant protein-1 (MCP-1, matrix metalloproteinases (MMPs, and reactive oxygen species (ROS compared to controls. Administration of the thrombin inhibitor dabigatran (100 mg/kg to AD mice for 34 wks significantly decreases expression of inflammatory proteins and ROS. Exposure of cultured brain endothelial cells to hypoxia for 6 h causes an upregulation of thrombin, HIF-1α, MCP-1, IL-6 and MMP2 and ROS. Treatment of endothelial cells with the dabigatran (1 nM reduces ROS generation and inflammatory protein expression (p<0.01-0.001. The data demonstrate that inhibition of thrombin in culture blocks the increase in inflammatory protein expression and ROS generation evoked by hypoxia. Also, administration of dabigatran to transgenic AD mice diminishes expression of inflammatory proteins and ROS in the cerebromicrovasculature. Taken together, these results suggest that inhibiting thrombin generation could have therapeutic value in AD and other disorders where hypoxia, inflammation and oxidative stress are involved.

  5. Analytical resolution of the reactive diffusion equation for transient electronics including materials whose porosity value changes in terms of their thickness

    Science.gov (United States)

    Vargas Toro, Agustín.

    2014-05-01

    Transient electronic devices are a new technology development whose main characteristic is that its components can disappear in a programmed and controlled way, which means such devices have a pre-engineered service life. Nowadays, transient electronics have a large application field, involving from the reduction of e-waste in the planet until the development of medical instruments and implants that can be discarded when the patients do not need it anymore, avoiding the trouble of having an extra procedure for them. These devices must be made from biocompatible materials avoiding long-term adverse effects in the environment and patients. It is fundamental to develop an analytical model that allows describing the behavior of these materials considering cases which its porosity may be constant or not, in presence of water or any other biofluid. In order to accomplish this analysis was solve the reactive diffusion equation based on Bromwich's integral and the Residue theorem for two material cases, those whose porosity is constant, and those whose porosity increases linearly in terms of its thickness, where was found a general expression. This allows to the analysis of the relation of the electric resistance (per unit length) and the rate of dissolution of the material.

  6. Sol-gel chemistry applied to the synthesis of polymetallic oxides including actinides reactivity and structure from solution to solid state

    International Nuclear Information System (INIS)

    Minor actinides transmutation is studied at present in order to reduce the radiotoxicity of nuclear waste and the assessment of its technical feasibility requires specific designed materials. When considering americium, yttria stabilized zirconia (AmIII YII Zriv)Orx is among the ceramic phases that one which presents the required physico-chemical properties. An innovative synthesis of this mixed oxide by sol-gel process is reported in this manuscript. The main aim of this work is to adjust the reactivity of the different metallic cations in aqueous media using complexing agent, in order to initiate a favourable interaction for a homogeneous elements repartition in the forming solid phase. The originality of the settled synthesis lies on an in-situ formation of a stable and monodisperse nano-particles dispersion in the presence of acetylacetone. The main reaction mechanisms have been identified: the sol stabilisation results from an original interaction between the three compounds (Zrly, trivalent cations and acetylacetone). The sol corresponds to a structured system at the nanometer scale for which zirconium and trivalent cations are homogeneously dispersed, preliminary to the sol-gel transition. Furthermore, preliminary studies were carried out with a view to developing materials. They have demonstrated that numerous innovative and potential applications can be developed by taking advantage of the direct and controlled formation of the sol and by adapting the sol-gel transition. The most illustrating result is the preparation of a sintered pellet with the composition Am0,13Zro,73Yo,0901,89 using this approach. (author)

  7. Endothelin-2/Vasoactive Intestinal Contractor: Regulation of Expression via Reactive Oxygen Species Induced by CoCl22, and Biological Activities Including Neurite Outgrowth in PC12 Cells

    Directory of Open Access Journals (Sweden)

    Eiichi Kotake-Nara

    2006-01-01

    Full Text Available This paper reviews the local hormone endothelin-2 (ET-2, or vasoactive intestinal contractor (VIC, a member of the vasoconstrictor ET peptide family, where ET-2 is the human orthologous peptide of the murine VIC. While ET-2/VIC gene expression has been observed in some normal tissues, ET-2 recently has been reported to act as a tumor marker and as a hypoxia-induced autocrine survival factor in tumor cells. A recently published study reported that the hypoxic mimetic agent CoCl2 at 200 µM increased expression of the ET-2/VIC gene, decreased expression of the ET-1 gene, and induced intracellular reactive oxygen species (ROS increase and neurite outgrowth in neuronal model PC12 cells. The ROS was generated by addition of CoCl2 to the culture medium, and the CoCl2-induced effects were completely inhibited by the antioxidant N-acetyl cysteine. Furthermore, interleukin-6 (IL-6 gene expression was up-regulated upon the differentiation induced by CoCl2. These results suggest that expression of ET-2/VIC and ET-1 mediated by CoCl2-induced ROS may be associated with neuronal differentiation through the regulation of IL-6 expression. CoCl2 acts as a pro-oxidant, as do Fe(II, III and Cu(II. However, some biological activities have been reported for CoCl2 that have not been observed for other metal salts such as FeCl3, CuSO4, and NiCl2. The characteristic actions of CoCl2 may be associated with the differentiation of PC12 cells. Further elucidation of the mechanism of neurite outgrowth and regulation of ET-2/VIC expression by CoCl2 may lead to the development of treatments for neuronal disorders.

  8. Angiotensin II type 1 receptor blocker losartan prevents and rescues cerebrovascular, neuropathological and cognitive deficits in an Alzheimer's disease model.

    Science.gov (United States)

    Ongali, Brice; Nicolakakis, Nektaria; Tong, Xin-Kang; Aboulkassim, Tahar; Papadopoulos, Panayiota; Rosa-Neto, Pedro; Lecrux, Clotilde; Imboden, Hans; Hamel, Edith

    2014-08-01

    Angiotensin II (AngII) receptor blockers that bind selectively AngII type 1 (AT1) receptors may protect from Alzheimer's disease (AD). We studied the ability of the AT1 receptor antagonist losartan to cure or prevent AD hallmarks in aged (~18months at endpoint, 3months treatment) or adult (~12months at endpoint, 10months treatment) human amyloid precursor protein (APP) transgenic mice. We tested learning and memory with the Morris water maze, and evaluated neurometabolic and neurovascular coupling using [(18)F]fluoro-2-deoxy-D-glucose-PET and laser Doppler flowmetry responses to whisker stimulation. Cerebrovascular reactivity was assessed with on-line videomicroscopy. We measured protein levels of oxidative stress enzymes (superoxide dismutases SOD1, SOD2 and NADPH oxidase subunit p67phox), and quantified soluble and deposited amyloid-β (Aβ) peptide, glial fibrillary acidic protein (GFAP), AngII receptors AT1 and AT2, angiotensin IV receptor AT4, and cortical cholinergic innervation. In aged APP mice, losartan did not improve learning but it consolidated memory acquisition and recall, and rescued neurovascular and neurometabolic coupling and cerebrovascular dilatory capacity. Losartan normalized cerebrovascular p67phox and SOD2 protein levels and up-regulated those of SOD1. Losartan attenuated astrogliosis, normalized AT1 and AT4 receptor levels, but failed to rescue the cholinergic deficit and the Aβ pathology. Given preventively, losartan protected cognitive function, cerebrovascular reactivity, and AT4 receptor levels. Like in aged APP mice, these benefits occurred without a decrease in soluble Aβ species or plaque load. We conclude that losartan exerts potent preventive and restorative effects on AD hallmarks, possibly by mitigating AT1-initiated oxidative stress and normalizing memory-related AT4 receptors.

  9. TYPES OF TREMOR IN PATIENTS WITH CEREBROVASCULAR DISEASES AND CARDIOVASCULAR EVENTS

    Directory of Open Access Journals (Sweden)

    Petrov Igor

    2016-03-01

    Full Text Available Introduction: Tremor can occur as a part of the clinical feature of cerebrovascular diseases. Many patients with cerebral stroke have cardiovascular diseases as a comorbidity or complication of stroke; sometimes cardiovascular events can lead to embolic stroke. Aim: To present types of tremor in patients with cerebrovascular diseases and cardiovascular events and diabetes mellitus type 2, clinical characteristics of tremor and investigations used. Material and methods: In our study we included 36 patients, 24 men and 12 women, that were examined and followed for 3 years, from 2012-2015. All patients were subjected to the following investigations: neurological examination, laboratory analysis, computerized tomography of brain, magnetic resonance imaging and electroencephalography. In cardiovascular patients we also performed Doppler sonography of carotid arteries, electrocardiography, cardiac ultrasound. The patients were examined and treated by cardiologists. Results: Of all patients 22% had cerebral infarction, 41% atherosclerosis, 36% multiple lacunar infarctions and 28% diabetes mellitus type 2. Three patients with cerebral infarction had chorea, hemiballismus, dystonia and dystonic tremor, three had postural tremor and two cerebellar intention tremor. Atherosclerotic patients had atherosclerotic action tremor, while diabetic patients predominantly presented with action-type tremor. Electroencephalography showed irritative basic brain activity with slow waves, while carotid arteries stenosis was diagnosed by Doppler sonography. Computerized tomography of the brain and magnetic resonance imaging revealed cerebrovascular diseases in certain areas. Patients with cardiomyopathy, rhythm disorders, high blood pressure, hyperlipidemia was investigated and medically treated by a cardiologist. Conclusion: In cerebrovascular diseases different types of tremor can occur as the result of the damage of the extrapyramidal system.

  10. Dipyridamole cerebral flow stress test evaluating ischemic cerebrovascular diseases

    International Nuclear Information System (INIS)

    To detect the clinical value of dipyridamole cerebral blood flow stress test in cerebrovascular diseases (CVD). Nineteen patients (9 male, 10 female, mean age=65) who were diagnosed as CVD were included. One suffered from infarct, two suffered from thrombosis, one feel dizziness. All 4 performed rest and stress test. The other 15 were VBI, 9 of them performed stress test. Rest and stress test were done two-day method using Elscint Apex SP-6 SPECT equipped with low energy all purpose collimator. Rest perfusion imaging was started 30 min after injecting 1.11 GBq 99mTc-ECD. Dipyridamole stress test was done within one week. 0.56 mg/Kg dipyridamole was injected intravenously during 4 min the same dose of ECD was injected 2 min later. The acquisition started 30 min later with the same parameter. Heart rate, ECG and the patient's complaint were monitored 2 min before and after dipyridamole. After correction for attenuation, transverse, coronal and sagittal slices were reconstructed. Eighteen ROIs were drawn symmetrically on cingulate, frontal, temporal-parietal, temporal, occipital, vision cortex, basal ganglia, superior frontal and parietal on the 3rd, 6th, 9th transverse slices, selecting the contralateral as the reference region. The counts per pixel in each ROI were divided by the counts of the mirror region to obtain the relative uptake ratio. We think it abnormality when the ratio is above 1,1 or below 0.9. The sensitivity for rest and stress rCBF test was compared. rCBF was decreased at 10 of 19 patients (sensitivity 52.6%). 14 had low rCBF after dipyridamole (sensitivity 72.3%), Among the patients who studied stress test, 6 had normal rCBF at rest and low rCBF after stress. The abnormal area was enlarged after dipyridamole for 1 patients, 2 improved and 2 unchanged. 8 of 15 VBI had normal rCBF at rest (sensitivity 53.3%). 9 of 15 VBI performed stress test. rCBF was normal at rest for 5 patients, rCBF was decreased after stress, it was improved for one

  11. Genetic polymorphisms and cerebrovascular disease in children with sickle cell anemia from Rio de Janeiro, Brazil.

    Science.gov (United States)

    Filho, Isaac Lima da Silva; Leite, Ana Claudia Celestino Bezerra; Moura, Patrícia Gomes; Ribeiro, Georgina Severo; Cavalcante, Andréa Cony; Azevedo, Flávia Carolina Marques de; Andrada-Serpa, Maria José de

    2011-06-01

    The aim of the present work was to examine possible genetic risk factors related to the occurrence of cerebrovascular disease (CVD) in Brazilian population, the frequency of β(S)-globin gene haplotypes and co-inheritance with α-thalassemia (-α(3.7kb)) and single nucleotide polymorphism of methylenetetrahydrofolate reductase (MTHFR-C677T), Factor V Leiden (FV-G1691A) and prothrombin (PT-G20210A) genes in children from Rio de Janeiro. Ninety four children with sickle cell anemia (SCA) were included, 24 patients with cerebrovascular involvement and 70 patients without CVD as control group. The mean age of children at the time of the cerebrovascular event was similar to the control group. The frequency of -α(3.7kb) thalassemia was similar in both groups (p=0.751). Children with Bantu/Atypical β(S)-globin gene haplotype presented 15 times more chance (OR=15.4 CI 95% 2.9-81.6) of CVD than the other β(S)-globin gene haplotypes. The C677T polymorphism of MTHFR gene was similar in both groups (p=0.085). No mutation in the FV Leiden or PT genes was found. A large study seems necessary to establish the role of these genetic polymorphisms in Brazilian miscegenated population. PMID:21755116

  12. Genetic polymorphisms and cerebrovascular disease in children with sickle cell anemia from Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Isaac Lima da Silva Filho

    2011-06-01

    Full Text Available The aim of the present work was to examine possible genetic risk factors related to the occurrence of cerebrovascular disease (CVD in Brazilian population, the frequency of βS-globin gene haplotypes and co-inheritance with α-thalassemia (-α3.7kb and single nucleotide polymorphism of methylenetetrahydrofolate reductase (MTHFR-C677T, Factor V Leiden (FV-G1691A and prothrombin (PT-G20210A genes in children from Rio de Janeiro. Ninety four children with sickle cell anemia (SCA were included, 24 patients with cerebrovascular involvement and 70 patients without CVD as control group. The mean age of children at the time of the cerebrovascular event was similar to the control group. The frequency of -α3.7kb thalassemia was similar in both groups (p=0.751. Children with Bantu/Atypical βS-globin gene haplotype presented 15 times more chance (OR=15.4 CI 95% 2.9-81.6 of CVD than the other βS-globin gene haplotypes. The C677T polymorphism of MTHFR gene was similar in both groups (p=0.085. No mutation in the FV Leiden or PT genes was found. A large study seems necessary to establish the role of these genetic polymorphisms in Brazilian miscegenated population.

  13. Cognitive impairments in cerebrovascular disease: What is between health and dementia?

    Directory of Open Access Journals (Sweden)

    A. Yu. Emelin

    2015-01-01

    Full Text Available The problem of cerebrovascular lesions takes on even greater significance with the higher prevalence of both acute and chronic forms of cerebrovascular diseases (CVD. Cognitive dysfunctions that have a pronounced negative impact on the quality of life in patients hold a special place among the various neurological symptoms resulting from cerebrovascular lesions. The incidence of vascular dementia increases with age. The paper considers the main issues of the etiology, pathogenesis and classification of vascular cognitive impairments (VCIs. It proposes criteria for the diagnosis of VCIs in the early stages of the disease. Potentially modifiable factors, such as hypertension, coronary heart disease, orthostatic hypotension, diabetes mellitus, hypercholesterolemia, hyperhomocysteinemia, obesity, et al., are indicated to have a special place among the main etiological causes of VCIs. The timely detection of etiological factors and the assessment of their role in the development of cognitive impairments (CI in CVD form the basis for managing these patients. The issues of treating CI no dementia in patients with CVD are considered. These included the administration of nootropic, vasoactive drugs, as well as agents that exert a modulatory effect on the cholinergic and glutamatergic systems. The use of neuroprotective and neurotrophic drugs is noted to be promising in terms of the multicomponent mechanism of their action. 

  14. Clinical analysis of 34 cases symptomatic epilepsy secondary to cerebrovascular disease

    International Nuclear Information System (INIS)

    Objective: To investigate the relation between cerebrovascular disease and symptomatic epilepsy. Method: 786 patients suffered cerebrovascular disease were retrospectively analyzed. Result: The occurrence rate of Secondary to Cerebrovascular Disease symptomatic epilepsy Secondary to Cerebrovascular Disease was 4.3%. Those older than 60 are prone to develop Acrodynia symptomatic epilepsy. Generalized epileptic seizure were often seen. Secondary to Cerebrovascular Disease epilepsy die to cortical lesion are more easily seem than subcortical lesion. Early epilepsy is more than late epilepsy. Conclusion: The cause of symptomatic epilepsy after cerebrovascular disease is not same in different types and course of CVD. Those who developed epilepsy particularly epilepsy continua would have bad prognosis

  15. [Treatment and rehabilitation of dysphagia following cerebrovascular disease].

    Science.gov (United States)

    López-Liria, Remedios; Fernández-Alonso, Melodie; Vega-Ramírez, Francisco A; Salido-Campos, M Ángeles; Padilla-Góngora, David

    2014-03-16

    INTRODUCTION. Bronchopneumonia is a frequent complication in the first days after a cerebrovascular disease and is linked with a higher rate of mortality. It occurs in patients with an altered level of consciousness or tussigenic reflex, and could be prevented with an early dysphagia rehabilitation programme. AIMS. To review the scientific literature on the treatment and rehabilitation of patients with dysphagia after suffering a stroke, published between 2002 and 2012. DEVELOPMENT. A search conducted in the PubMed, Cochrane, PEDro, CINAHL and ENFISPO databases yielded 15 papers that fulfilled eligibility criteria and the initial aims of the study, providing information about 3,212 patients. The different protocols and techniques for re-education in dysphagia are described and include compensatory strategies, orofacial regulation therapy, music therapy, sensory stimulation, lip muscle, tongue, pharynx, larynx and respiratory tract training, Mendelsohn manoeuvre, neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation and acupuncture. CONCLUSIONS. The studies examined in this research claim that the treatment of dysphagia following a stroke can improve the function of deglutition (coordination, speed, volume), quality of life and people's social relationships. Further work needs to be carried out to establish or define what kind of therapies, techniques, exercises or manoeuvres are the most effective in dysphagia. Generally agreed treatment or rehabilitation protocols also need to be drawn up within units that address stroke in an integrated manner. PMID:24610693

  16. Cerebrovascular accidents in sickle cell disease: rates and risk factors.

    Science.gov (United States)

    Ohene-Frempong, K; Weiner, S J; Sleeper, L A; Miller, S T; Embury, S; Moohr, J W; Wethers, D L; Pegelow, C H; Gill, F M

    1998-01-01

    Cerebrovascular accident (CVA) is a major complication of sickle cell disease. The incidence and mortality of and risk factors for CVA in sickle cell disease patients in the United States have been reported only in small patient samples. The Cooperative Study of Sickle Cell Disease collected clinical data on 4,082 sickle cell disease patients enrolled from 1978 to 1988. Patients were followed for an average of 5.2 +/- 2.0 years. Age-specific prevalence and incidence rates of CVA in patients with the common genotypes of sickle cell disease were determined, and the effects of hematologic and clinical events on the risk of CVA were analyzed. The highest rates of prevalence of CVA (4.01%) and incidence (0.61 per 100 patient-years) were in sickle cell anemia (SS) patients, but CVA occurred in all common genotypes. The incidence of infarctive CVA was lowest in SS patients 20 to 29 years of age and higher in children and older patients. Conversely, the incidence of hemorrhagic stroke in SS patients was highest among patients aged 20 to 29 years. Across all ages the mortality rate was 26% in the 2 weeks after hemorrhagic stroke. No deaths occurred after infarctive stroke. Risk factors for infarctive stroke included prior transient ischemic attack, low steady-state hemoglobin concentration and rate of and recent episode of acute chest syndrome, and elevated systolic blood pressure. Hemorrhagic stroke was associated with low steady-state hemoglobin and high leukocyte count.

  17. 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

  18. Evento cerebrovascular isquémico en el adulto joven

    OpenAIRE

    Verónica Leandro-Sandí; Miguel Barboza-Elizondo; Gustavo Vindas-Angulo

    2013-01-01

    El evento cerebrovascular isquémico es un desorden multifactorial, en el que contribuyen factores genéticos y ambientales. A pesar de que se reconoce un aumento del riesgo de eventos cerebrovasculares cuando existe una historia familiar positiva (de hasta un 75% en ciertos estudios), no se conoce la contribución exacta que tiene la genética en el desarrollo de eventos cerebrales isquémicos en el paciente joven. El papel que desempeña la predisposición genética sobre la ocurrencia de estos eve...

  19. Intermittent hypoxia training protects cerebrovascular function in Alzheimer's disease.

    Science.gov (United States)

    Manukhina, Eugenia B; Downey, H Fred; Shi, Xiangrong; Mallet, Robert T

    2016-06-01

    Alzheimer's disease (AD) is a leading cause of death and disability among older adults. Modifiable vascular risk factors for AD (VRF) include obesity, hypertension, type 2 diabetes mellitus, sleep apnea, and metabolic syndrome. Here, interactions between cerebrovascular function and development of AD are reviewed, as are interventions to improve cerebral blood flow and reduce VRF. Atherosclerosis and small vessel cerebral disease impair metabolic regulation of cerebral blood flow and, along with microvascular rarefaction and altered trans-capillary exchange, create conditions favoring AD development. Although currently there are no definitive therapies for treatment or prevention of AD, reduction of VRFs lowers the risk for cognitive decline. There is increasing evidence that brief repeated exposures to moderate hypoxia, i.e. intermittent hypoxic training (IHT), improve cerebral vascular function and reduce VRFs including systemic hypertension, cardiac arrhythmias, and mental stress. In experimental AD, IHT nearly prevented endothelial dysfunction of both cerebral and extra-cerebral blood vessels, rarefaction of the brain vascular network, and the loss of neurons in the brain cortex. Associated with these vasoprotective effects, IHT improved memory and lessened AD pathology. IHT increases endothelial production of nitric oxide (NO), thereby increasing regional cerebral blood flow and augmenting the vaso- and neuroprotective effects of endothelial NO. On the other hand, in AD excessive production of NO in microglia, astrocytes, and cortical neurons generates neurotoxic peroxynitrite. IHT enhances storage of excessive NO in the form of S-nitrosothiols and dinitrosyl iron complexes. Oxidative stress plays a pivotal role in the pathogenesis of AD, and IHT reduces oxidative stress in a number of experimental pathologies. Beneficial effects of IHT in experimental neuropathologies other than AD, including dyscirculatory encephalopathy, ischemic stroke injury, audiogenic

  20. Different cerebrovascular effects of medroxyprogesterone acetate and norethisterone acetate in the New Zealand White rabbit

    DEFF Research Database (Denmark)

    Pedersen, S H; Pedersen, N G; Dalsgaard, T;

    2004-01-01

    of different progestins on cerebrovascular reactivity in an animal model. METHODS: Fifty-six ovariectomized New Zealand White rabbits were randomized into seven groups receiving hormone treatment for 4 weeks: medroxyprogesterone acetate (MPA) (10 mg/day); norethisterone acetate (NETA) (3 mg/day); conjugated......, acetylcholine, sodium nitroprusside, L-NAME (N(omega)-nitro-L-arginine methyl ester), calcium and endothelin-1 were established. RESULTS: Treatment with MPA caused a significant increase in vasoconstriction, expressed as E(max) (mN/mm, mean +/- SEM; p ....47 +/- 0.19) and calcium (4.00 +/- 0.22 vs. 3.34 +/- 0.14) in the posterior cerebral artery, and to endothelin-1 (6.88 +/- 0.69 vs. 5.22 +/- 0.30) in the basilar artery, when compared with NETA. This difference was neutralized in the groups receiving the combined treatment of MPA + CEE and NETA + E2...

  1. Uric acid levels and their relation to incapacities in acute cerebrovascular disease

    OpenAIRE

    Julio López Argüelles; Joan Rojas Fuentes; Ricardo Verdecia Fraga

    2010-01-01

    Background: cerebrovascular disease and ischemic cardiopathy can be considered as an epidemic and constitute the first cause of incapacities in developed countries. Multiple studies have shown the association between uric acid levels and cerebrovascular diseases. Objective: To correlate the levels of serum uric acid and incapacities in the acute phase of cerebrovascular disease. Methods: A correlational study was carried out with 217 patients with acute cerebrovascular disease. The patient’s ...

  2. Evento cerebrovascular isquémico en el adulto joven

    Directory of Open Access Journals (Sweden)

    Verónica Leandro-Sandí

    2013-09-01

    Full Text Available El evento cerebrovascular isquémico es un desorden multifactorial, en el que contribuyen factores genéticos y ambientales. A pesar de que se reconoce un aumento del riesgo de eventos cerebrovasculares cuando existe una historia familiar positiva (de hasta un 75% en ciertos estudios, no se conoce la contribución exacta que tiene la genética en el desarrollo de eventos cerebrales isquémicos en el paciente joven. El papel que desempeña la predisposición genética sobre la ocurrencia de estos eventos, difiere según la edad y el tipo de evento. Los factores genéticos se conjugan con los factores de riesgo convencionales, como hipertensión arterial, diabetes y niveles de homocisteína, que a su vez interactúan con el ambiente en el desarrollo de aterosclerosis. La homocisteína por sí sola, ha sido considerada un factor aterogénico en enfermedades cardiovasculares y cerebrovasculares. Se refiere el caso de un paciente de 49 años conocido sano, quien presenta un evento cerebrovascular isquémico de la circulación cerebral anterior, con un valor en la escala para derrame del Instituto Nacional de Salud de 7 puntos al ingreso y una mutación heterocigota del gen de la metiltetrahidrofolato reductasa (región de mutación C677T.

  3. NSAIDs and cardiovascular drugs in neurodegenerative and cerebrovascular diseases

    NARCIS (Netherlands)

    M.D.M. Haag (Mendel)

    2009-01-01

    textabstractNeurodegenerative and cerebrovascular diseases are frequent in elderly populations and comprise primarily of dementia (mainly Alzheimer disease (AD)), Parkinson disease (PD) and stroke. The prevalence of these neurological disorders rises with older age. From 55 years to 90 years and abo

  4. Myocardial stress in patients with acute cerebrovascular events

    DEFF Research Database (Denmark)

    Jespersen, Christian M; Fischer Hansen, Jørgen

    2008-01-01

    Signs of myocardial involvement are common in patients with acute cerebrovascular events. ST segment deviations, abnormal left ventricular function, increased N-terminal pro-brain natriuretic peptide (NT-proBNP), prolonged QT interval, and/or raised troponins are observed in up to one third of the...

  5. Depression as the cause and consequence of cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Rabi-Žikić Tamara

    2007-01-01

    Full Text Available Inbtroduction: Recent epidemiological, clinical, neuroimaging and neuropathological studies have reported substantial evidence on the complex interactive relationships between depression and cerebrovascular diseases, especially in older populations, and plausible explanations of the etiopathogenetic mechanisms in both directions have been proposed. Poststroke depression Although there is no general consensus regarding its prevalence, it is widely accepted that major depression after stroke is common and that it should be recognized as a key factor in rehabilitation and outcome following stroke. Vascular depression The "vascular depression" hypothesis presupposes that late-onset depression may often result from vascular damage to frontal-subcortical circuits implicated in mood regulation. This concept has stimulated many researches and the obtained results support the proposed hypothesis. Depression as a stroke risk factor Recent large studies have emphasized the role of depression per se in the development of subsequent stroke. Mechanisms proposed to explain the increased risk of cerebrovascular diseases in depressed patients There are a number of plausible mechanisms that could explain why depression may increase the risk of subsequent cerebrovascular disease, the most important being sympathoadrenal hyperactivity, platelet activation, an increase in inflammatory cytokines and an increased risk of arrhythmias. Conclusion: Thorough clinical examinations determining the conventional stroke risk factors in the population with depression, as well as management of depression as part of the overall measures for the reduction of cerebrovascular risk factors are of utmost importance.

  6. Cerebrovascular angiotensin AT1 receptor regulation in cerebral ischemia

    DEFF Research Database (Denmark)

    Edvinsson, L.

    2008-01-01

    The mechanism behind the positive response to the inhibition of the angiotensin II receptor AT(1) in conjunction with stroke is elusive. Here we demonstrate that cerebrovascular AT(1) receptors show increased expression (upregulation) after cerebral ischemia via enhanced translation. This enhanced...

  7. Cerebrovascular response to acute metabolic acidosis in humans.

    NARCIS (Netherlands)

    Ven, M.T.P. van de; Colier, W.N.J.M.; Kersten, B.T.P.; Oeseburg, B.; Folgering, H.T.M.

    2003-01-01

    OBJECTIVES: Evaluation of the cerebrovascular response (delta CBV/delta PaCO2) during baseline metabolic conditions and acute metabolic acidosis. METHODS: 15 healthy subjects, 5 m, 10 f, 56 +/- 10 yrs were investigated. For acidification, NH4Cl was given orally. CBV was measured using Near Infrared

  8. Reactive Kripke semantics

    CERN Document Server

    Gabbay, Dov M

    2013-01-01

    This text offers an extension to the traditional Kripke semantics for non-classical logics by adding the notion of reactivity. Reactive Kripke models change their accessibility relation as we progress in the evaluation process of formulas in the model. This feature makes the reactive Kripke semantics strictly stronger and more applicable than the traditional one. Here we investigate the properties and axiomatisations of this new and most effective semantics, and we offer a wide landscape of applications of the idea of reactivity. Applied topics include reactive automata, reactive grammars, rea

  9. Neuroimaging research on cerebrovascular spasm and its current progress.

    Science.gov (United States)

    Chen, Fang; Wang, Xiaoming; Wu, Bihua

    2011-01-01

    The cerebrovascular spasm is a common complication of subarachnoid hemorrhage. The prognosis is affected severely with regard to quality of life of patients, and earlier determination of the cerebral vasospasm becomes very important. In recent years, there have been many research results in early judgment of cerebrovascular spasm, and imaging technology research is particularly prominent in this area. This article summarizes the advantages and disadvantages and the specific roles of several common imaging technologies to determine the early stage of cerebral vasospasm. Transcranial Doppler (TCD) was the first used to examine cerebral vasospasm and mainly detected vascular hemodynamic changes of cerebrovascular spasm in patients. Digital subtraction angiography is the gold standard for diagnosis of cerebral vasospasm, but its efficacy in determining severity of cerebrovascular spasm indexing is still in dispute. It is invasive, it is difficult to repeat the examination, and it can induce complications, so its clinical application is limited. CT imaging technology is a hot topic in this area. There is an important guiding significance in early diagnosis and treatment of cerebral vasospasm in CT perfusion imaging (PCT) and CT angiography (CTA). PCT mainly performs qualitative and quantitative analysis through hemodynamic parameters such as cerebral blood flow, cerebral blood volume, and mean transit time. CTA is minimally invasive, fast, and reliable as an efficient imaging technology, and will possibly replace DSA for the assessment of vasospasm, particularly in critically ill patients with cerebral vasospasm in an urgent examination. This means it has greater value and helps to improve the prognosis of patients. MR imaging in the early stages to judge cerebral vasospasm has great value. DWI can effectively assess the cerebral vascular spasm earlier to detect trace bleeding sites and reflect the damage of cerebral vasospasm by apparent diffusion coefficient. Combined

  10. Subjective and objective knowledge and decisional role preferences in cerebrovascular patients compared to controls

    Science.gov (United States)

    Riechel, Christina; Alegiani, Anna Christina; Köpke, Sascha; Kasper, Jürgen; Rosenkranz, Michael; Thomalla, Götz; Heesen, Christoph

    2016-01-01

    Background Risk knowledge and active role preferences are important for patient involvement in treatment decision-making and adherence. Although knowledge about stroke warning signs and risk factors has received considerable attention, objective knowledge on secondary prevention and further self-esteem subjective knowledge have rarely been studied. The aim of our study was to investigate knowledge and treatment decisional role preferences in cerebrovascular patients compared to controls. Methods We performed a survey on subjective and objective stroke risk knowledge and autonomy preferences in cerebrovascular patients from our stroke outpatient clinic (n=262) and from pedestrians on the street taken as controls during a “World Stroke Day” (n=274). The questionnaire includes measures for knowledge and decisional role preferences from previously published questionnaires and newly developed measures, for example, subjective knowledge, revealed on a visual analog scale. Results The overall stroke knowledge was low to moderate, with no differences between patients and controls. Knowledge about secondary prevention was particularly low. Only 10%–15% of participants correctly estimated the stroke absolute risk reduction potential of aspirin. The medical data interpretation competence was moderate in both groups. Age and basic mathematical and statistical understanding (numeracy) were the only independent predictors of objective stroke knowledge, whereas previous stroke had no impact on stroke knowledge. However, patients were thought to be better informed than controls. Approximately 60% of both patients and controls claimed to prefer a shared decision-making approach in treatment decisions. Conclusion The level of stroke risk knowledge in patients with cerebrovascular diseases was as low as in randomly selected pedestrians, although patients felt better informed. Both groups preferred involvement in treatment decision-making. We conclude that educational concepts

  11. Cerebral Blood Flow and Transcranial Doppler Sonography Measurements of CO(2)-Reactivity in Acute Traumatic Brain Injured Patients

    DEFF Research Database (Denmark)

    Reinstrup, Peter; Ryding, Erik Hilmer; Asgeirsson, Bogi;

    2013-01-01

    BACKGROUND: Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements lim...... demonstrating deviation in the same direction during hypocapnia. TCD and CBF measurements both provide useful information on cerebrovascular events which, although not interchangeable, may complement each other in clinical scenarios....

  12. Regional partition coefficient of water in patients with cerebrovascular disease and its effect on rCBF assessment

    OpenAIRE

    Hirata, Kenji; Hattori, Naoya; Katoh, Chietsugu; Shiga, Tohru; KURODA, Satoshi; Kubo, Naoki; Usui, Reiko; Kuge, Yuji; Tamaki, Nagara

    2011-01-01

    Objective: Cerebral blood flow (CBF) estimation with C15O2 PET usually assumes a single tissue compartment model and a fixed brain-blood partition coefficient of water. However, the partition coefficient may change in pathological conditions. The purpose of this study was to investigate the changes of partition coefficient of water in pathological regions and its effect on regional CBF assessment. Methods: Study protocol included 22 patients with occlusive cerebrovascular disease to compare p...

  13. Impaired cerebrovascular function in coronary artery disease patients and recovery following cardiac rehabilitation.

    Directory of Open Access Journals (Sweden)

    Udunna C Anazodo

    2016-01-01

    Full Text Available Coronary artery disease (CAD poses a risk to the cerebrovascular function of older adults and has been linked to impaired cognitive abilities. Using magnetic resonance perfusion imaging, we investigated changes in resting cerebral blood flow (CBF and cerebrovascular reactivity (CVR to hypercapnia in 34 coronary artery disease (CAD patients and 21 age-matched controls. Gray matter volume images were acquired and used as a confounding variable to separate changes in structure from function. Compared to healthy controls, CAD patients demonstrated reduced CBF in the superior frontal, anterior cingulate, insular, pre- and post-central gyri, middle temporal and superior temporal regions. Subsequent analysis of these regions demonstrated decreased CVR in the anterior cingulate, insula, postcentral and superior frontal regions. Except in the superior frontal and precentral regions, regional reductions in CBF and CVR were identified in brain areas where no detectable reductions in gray matter volume were observed, demonstrating that these vascular changes were independent of brain atrophy. Because aerobic fitness training can improve brain function, potential changes in regional CBF were investigated in the CAD patients after completion of a 6-month exercise-based cardiac rehabilitation program. Increased CBF was observed in the bilateral anterior cingulate, as well as recovery of CBF in the dorsal aspect of the right anterior cingulate, where the magnitude of increased CBF was roughly equal to the reduction in CBF at baseline compared to controls. These exercise-related improvements in CBF in the anterior cingulate is intriguing given the role of this area in cognitive processing and regulation of cardiovascular autonomic control.

  14. Subjective and objective knowledge and decisional role preferences in cerebrovascular patients compared to controls

    Directory of Open Access Journals (Sweden)

    Riechel C

    2016-08-01

    Full Text Available Christina Riechel,1,* Anna Christina Alegiani,1,* Sascha Köpke,2 Jürgen Kasper,3,4 Michael Rosenkranz,1,5 Götz Thomalla,1 Christoph Heesen1,4 1Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany; 3Department of Health and Caring Sciences, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; 4Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 5Department of Neurology, Albertinen-Krankenhaus, Hamburg, Germany *These authors contributed equally to this work Background: Risk knowledge and active role preferences are important for patient involvement in treatment decision-making and adherence. Although knowledge about stroke warning signs and risk factors has received considerable attention, objective knowledge on secondary prevention and further self-esteem subjective knowledge have rarely been studied. The aim of our study was to investigate knowledge and treatment decisional role preferences in cerebrovascular patients compared to controls. Methods: We performed a survey on subjective and objective stroke risk knowledge and autonomy preferences in cerebrovascular patients from our stroke outpatient clinic (n=262 and from pedestrians on the street taken as controls during a “World Stroke Day” (n=274. The questionnaire includes measures for knowledge and decisional role preferences from previously published questionnaires and newly developed measures, for example, subjective knowledge, revealed on a visual analog scale. Results: The overall stroke knowledge was low to moderate, with no differences between patients and controls. Knowledge about secondary prevention was particularly low. Only 10%–15% of participants correctly estimated the stroke absolute risk reduction potential of aspirin. The medical data

  15. Biosimulation and visualization: effect of cerebrovascular geometry on hemodynamics.

    Science.gov (United States)

    Oshima, Marie; Kobayashi, Toshio; Takagi, Kiyoshi

    2002-10-01

    Hemodynamics plays an important role in cardiovascular disorders, and the authors are applying numerical and experimental studies of cerebrovascular blood flow to the creation and rupture of cerebral aneurysms. In particular, this study aims to investigate the effects of cerebrovascular geometry on hemodynamics, such as flow pattern, wall shear stress distribution, and pressure. This report consists mainly of two parts: numerical study of blood flow in the artery extracted from computer tomography data, and numerical and experimental studies of a curved pipe model. The simulation was conducted by using a finite element method; the experiment was conducted by particle imaging velocimetry. Numerical and experimental results are compared and both show similar secondary flow behavior. PMID:12496038

  16. Gray Cerebrovascular Image Skeleton Extraction Algorithm Using Level Set Model

    Directory of Open Access Journals (Sweden)

    Jian Wu

    2010-06-01

    Full Text Available The ambiguity and complexity of medical cerebrovascular image makes the skeleton gained by conventional skeleton algorithm discontinuous, which is sensitive at the weak edges, with poor robustness and too many burrs. This paper proposes a cerebrovascular image skeleton extraction algorithm based on Level Set model, using Euclidean distance field and improved gradient vector flow to obtain two different energy functions. The first energy function controls the  obtain of topological nodes for the beginning of skeleton curve. The second energy function controls the extraction of skeleton surface. This algorithm avoids the locating and classifying of the skeleton connection points which guide the skeleton extraction. Because all its parameters are gotten by the analysis and reasoning, no artificial interference is needed.

  17. Etiological and clinical analysis on 220 children with cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Zhi-hong TANG

    2014-03-01

    Full Text Available Etiological and clinical analyses of 220 children with cerebrovascular diseases were retrospectively analyzed. One hundred and forty-nine cases (67.73% were male, and 71 cases (32.27% were female. There were 186 cases (84.55% of patients to be found with clear causes, most of which were arteriovenous malformation (80/220, 36.36%, traumatic brain injury (38/220, 17.27%, intracranial infection (15/220, 6.82% , intracranial aneurysm (13/220, 5.91% , delayed vitamin K deficiency (12/220, 5.45% , congenital heart disease (9/220, 4.09% and cavernous malformation (7/220, 3.18%. The etiological and clinical features of children cerebrovascular diseases are distinct, and timely diagnosis and treatment will help to improve patients' prognosis. doi: 10.3969/j.issn.1672-6731.2014.03.017

  18. Study of nanosensor systems for hypertension associated cerebrovascular and cardiovascular disorders

    Science.gov (United States)

    Ramasamy, Mouli; Varadan, Vijay K.

    2015-04-01

    Hypertension and hypertension associated cerebrovascular and cardiovascular diseases are on a rise. At-least 970 million people in the world and Seventy percent of the American adults are affected by high blood pressure, also known as hypertension. Even though blood pressure monitoring systems are readily available, the number of people being affected has been increasing. Most of the blood pressure monitoring systems require cumbersome approaches. Even the noninvasive techniques have not lowered the number of people affected nor did at-least increase the user base of these systems. Uncontrolled or untreated hypertension may lead to various cerebrovascular disorders including stroke, hypertensive crisis, lacunar infarcts intracerebral damage, microaneurysm, and cardiovascular disorders including heart failure, myocardial infraction, and ischemic heart disease. Hypertension is rated as the one of the most important causes of premature death in spite of the technical advances in biomedical technology. This paper briefs a review of the widely adopted blood pressure monitoring methods, research techniques, and finally, proposes a concept of implementing nanosensors and wireless communication for real time non-invasive blood pressure monitoring.

  19. Evolution of Management and Investigations of Cerebrovascular Diseases in Croatia

    OpenAIRE

    Barac, Boško

    2009-01-01

    The author presents the history of management of cerebrovascular diseases (CVD) in Croatia since the beginning of medical health service in the country in the 19th and its evolution to the end of the 20th century. The foundation of the Zagreb School of Medicine in 1917 had paramount importance for the development of neurology, during the first period within the common specialty of neuropsychiatry. The interest for the CVD in Croatia became evident in the sixties of the past century, particula...

  20. Physiological and pathophysiological cerebrovascular regulation monitored by transcranial doppler

    OpenAIRE

    Hellström, Gunnar

    1997-01-01

    PHYSIOLOGICAL AND PATHOPHYSIOLOGICAL CEREBROVASCULAR REGULATION MONITORED BY TRANSCRANIAL DOPPLER Thesis by Gunnar Hellström, M D., Department of Clinical Neuroscience, Division of Neurology, Karolinska Hospital and Insbtute, Stocknolm, Sweden Transcranial Doppler ultrasonography (TCD) became available in the middle of the 1980s as a new technique for examinmg cerebral circulation. With this technique it is possible to measure the velocity of blood flow in major ...

  1. EFFECT OF ACUPUNCTURE ON THE INTELLIGENCE OF CEREBROVASCULAR DEMENTIA PATIENT

    Institute of Scientific and Technical Information of China (English)

    陈邦国

    2000-01-01

    Cerebrovascular dementia is a common disese in the old and medium-aged people. Its morbidity constitutes about 10-20% of all the dementia patients and results mainly from all-round decline of the brain function due to cerebral atheroscleorsis and cerebral infarction. The author of the present paper adopted acupuncture therapy to; treat this kind of disease and observed its effect on dementia patient's intelligence. Here is the report.

  2. Impaired verbal communication - research in the post cerebrovascular accident

    OpenAIRE

    Daniel Bruno Resende Chaves; Alice Gabrielle de Souza Costa; Ana Railka de Souza Oliveira; Viviane Martins Silva; Thelma Leite de Araujo; Marcos Venícios de Oliveira Lopes

    2013-01-01

    One of the most common sequelae in people with Cerebrovascular accident, and that affect the quality of life of the patients, is the alteration in communication. The study aimed at investigating the prevalence of the nursing diagnosis Impaired Verbal Communication in patients with stroke in the rehabilitation phase. It is an exploratory cross-sectional study, conducted in two rehabilitation institutions in Fortaleza, CE, Brazil. 40 patients were assessed in the period March-April, 2008. Impai...

  3. Influence of cerebrovascular arteriosclerosis on cerebral oxygenation during exercise

    International Nuclear Information System (INIS)

    Although it is assumed that cerebral oxygenation during exercise is influenced by both cardiopulmonary function and cerebrovascular arteriosclerosis, the latter factor has not been fully clarified. In the present study the relationship between the degree of cerebrovascular arteriosclerosis and cerebral oxygenation during exercise was investigated. A total of 109 patients (69 patients with coronary artery disease, 40 patients with hypertensive heart disease) (61.7±9.7 years) performed a symptom-limited exercise test with respiratory gas measurements (CPX). From the respiratory gas analysis, peak O2 uptake (VO2), the slope of the increase in VO2 to the increase in work rate (ΔVO2/ΔWR), and the slope of the increase in ventilation to the increase in CO2 output (VE/VCO2 slope) were calculated. Oxyhemoglobin (O2Hb) at the forehead was monitored using near-infrared spectroscopy. The brain ischemic score was counted based upon fluid-attenuated inversion recovery images of magnetic resonance imaging and expressed from 0 to 4. When compared with patients with a lower ischemic score (2Hb during exercise (-1.08±2.7 vs 0.77±4.1 μmol/L, p=0.011). Of brain ischemic score, left ventricular ejection fraction, peak VO2, ΔVO2/ΔWR, and the VE/VCO2 slope, ΔVO2/ΔWR was found to be the sole independent index determining cerebral O2Hb during exercise. The CPX parameters were also significantly related to the degree of cerebrovascular arteriosclerosis. Although cerebral oxygenation during exercise is mainly related to cardiopulmonary function, the degree of cerebrovascular arteriosclerosis partly influences cerebral oxygenation in patients with risk factors for atherosclerosis. (author)

  4. Chronic mild cerebrovascular dysfunction as a cause for Alzheimer's disease?

    OpenAIRE

    Humpel, Christian

    2011-01-01

    Alzheimer's disease (AD) is a progressive chronic disorder and is characterized by β-amyloid plaques and angiopathy, tau pathology, neuronal cell death, and inflammatory responses. The reasons for this disease are not known. This review proposes the hypothesis that a chronic mild longlasting cerebrovascular dysfunction could initiate a cascade of events leading to AD. It is suggested that (vascular) risk factors (e.g. hypercholesterolemia, type 2 diabetes, hyperhomocysteinemia) causes either ...

  5. Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors

    Directory of Open Access Journals (Sweden)

    Eman M Khedr

    2009-02-01

    Full Text Available Eman M Khedr1, Sherifa A Hamed1, Hala K El-Shereef2, Ola A Shawky1, Khalid A Mohamed1, Effat M Awad3, Mohamed A Ahmed2, Ghaydaa A Shehata1, Mahmoud A Eltahtawy41Department of Neurology and Psychiatry, 2Department of Internal Medicine, 3Department of Physiology, 4Department of Clinical Pathology, Assiut University, Faculty of Medicine, Assiut, EgyptBackground: Cognitive decline after cerebrovascular stroke has adverse outcome consequences. Since some vascular causes can be prevented and treated, the identification of stroke-related cognitive impairment is a challenge. Patients with cognitive impairment and vascular diseases exhibit higher homocysteine (Hcy concentrations. Whether Hcy is an independent risk factor for cognitive impairment after stoke is still in question. The objectives of this study were to determine: 1 the relative frequency of first-ever post-stroke dementia (PSD (three months after onset in a consecutive sample of our population, 2 the risk factors associated with PSD, and 3 the relationship between Hcy levels and PSD.Methods: Eighty-one inpatients with first-ever stroke were prospectively evaluated with a neuropsychological battery and event-related evoked potentials (P300 at onset and then after three months. A wide range of demographic, clinical, radiological and laboratory variables were examined. PSD was diagnosed if the clinical presentation fulfilled DSM-IV criteria of vascular dementia, the patient scored ≤21 on Mini Mental State Examination (MMSE and ≤67 points on Cognitive Abilities Screening Instruments (CASI.Results: PSD was diagnosed in 21%. PSD was significantly associated with increasing age, low levels of education, large sized and lacunar infarctions, severity of stroke, prolonged P300 latency, smoking, hypertension, and elevated Hcy levels. High Hcy levels increased the odds ratio of PSD after adjustment of significantly relevant variables including age, smoking, size of infarction, and carotid stenosis

  6. 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.

  7. Predicting cerebral amyloid angiopathy-realated intracerebral hemorrhages and other cerebrovascular disorders in Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Masahito eYamada

    2012-04-01

    Full Text Available Cerebral amyloid angiopathy (CAA of amyloid β-protein (Aβ type is common in Alzheimer’s disease (AD. Aβ immunotherapies have been reported to induce CAA-related intracerebral hemorrhages (ICH or vasogenic edema. For the purpose of developing a method to predict CAA-related ICH and other cerebrovascular disorders in AD, the biomarkers and risk factors are reviewed. The biomarkers include (1 greater occipital uptake on amyloid PET imaging and a decrease of cerebrospinal fluid Aβ40 levels as markers suggestive of CAA, and (2 symptomatic lobar ICH, lobar microhemorrhages, focal subrachnoidal hemorrhages/superficial siderosis, cortical microinfarcts, and subacute encephalopathy (caused by CAA-related inflammation or angiitis as imaging findings of CAA-related ICH and other disorders. The risk factors include (1 old age and AD, (2 CAA-related gene mutations and apolipoprotein E genotype as genetic factors, (3 thrombolytic, anti-coagulation, and anti-platelet therapies, hyertension, and minor head trauma as hemorrhage-inducing factors, and (4 anti-amyloid therapies. Positive findings for one or more biomarkers plus one or more risk factors would be associated with a significant risk of CAA-related ICH and other cerebrovascular disorders. To establish a method to predict future occurrence of CAA-related ICH and other cerebrovascular disorders in AD, prospective studies with a large number of AD patients are necessary, which will allow us to statistically evaluate to what extent each biomarker or risk factor would increase the risk. In addition, further studies with progress of technologies are necessary to more precisely detect CAA and CAA-related cerebrovascular disorders.

  8. Effects of propofol-alfentanil and sevoflurane-N2O anesthesia on cerebrovascular CO2 reactivity%异丙酚-阿芬太尼静脉麻醉和七氟醚-氧化亚氮吸入麻醉对脑血管CO2反应性的影响

    Institute of Scientific and Technical Information of China (English)

    徐仲煌; 黄宇光; 张秀华; 罗爱伦; 黄一宁; 杨洪波; 高山

    2000-01-01

    目的 比较异丙酚-阿芬太尼和七氟醚-氧化亚氮麻醉对脑血管CO2反应性的影响.方法 选择40例ASA Ⅰ~Ⅱ级的腹部外科手术病人,常规诱导插管后,随机分成两组,异丙酚组(n=20例)采用异丙酚0.1mg·kg-1·min-1+阿芬太尼1μg·kg-1·min-1微量泵静脉输注维持麻醉,七氟醚组(n=20例)则采用1%七氟醚+N2O/O2吸入维持,术中调节通气指数使呼气末二氧化碳分压(PETCO2)依次分别达到40、45、50、45、40、35、30、40mmHg,同时记录大脑中动脉血流速率(CBFV),包括平均血流速率(Vm)、收缩期血流速率(Vs)、舒张期血流速率(Vd)、搏动指数(PI)、阻力指数(RI)以及平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO2)、体温(T),并计算二氧化碳反应指数(CRI,CO2 reactivity index=△Vm/PETCO2).结果 异丙酚组与七氟醚组相比,当PETCO2升高时,Vm的增加幅度较低(P<0.05),而当PETCO2降低时,其Vm减小幅度两者相近(P>0.05),但CRI在异丙酚组较低(P<0.05),同时,在相同的PETCO2下,其Vm、Vs、Vd也较七氟醚组明显降低(P<0.05).结论 用异丙酚+阿芬太尼静脉输注麻醉时,脑血管的CO2反应性仍然存在,但较七氟醚-氧化亚氮麻醉时有所降低,可能是异丙酚和阿芬太尼使脑血管收缩所致.

  9. Cardiovascular and cerebrovascular outcomes in elderly hypertensive patients treated with either ARB or ACEI

    Institute of Scientific and Technical Information of China (English)

    Cong Ma; Jian Cao; Xue-Chun Lu; Xin-Hong Guo; Yan Gao; Xian-Feng Liu; Li Fan

    2012-01-01

    Background Although angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are equally important in the treatment of hypertension, there is less evidence whether they have equal cardiovascular and cerebrovascular protective effects, especially in elder hypertensive patients. This study aims to clarify this unresolved issue. Methods This cross-sectional study included clinical data on 933 aged male patients with hypertension who received either an ARB or ACEI for more than two months between January 2007 and May 2011. The primary outcome was the composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. The secondary endpoints were unstable angina, new atrial fibrillation, and transient ischemic attack. Results The median follow-up time was 24 months. Age, drug types, cerebral infarction history, renal dysfunction history were the independent predictors of the primary endpoint. The risk of an occurrence of a primary endpoint event was higher in the ARB group than the ACEI group [P = 0.037, hazard ratios occurrence was higher in the ARB group than the ACEI group (P = 0.04). In regard to the secondary endpoints, there were no significant were independent predictors of the secondary endpoint. Conclusion ACEI were more effective than ARB in reducing cardiovascular and cerebrovascular morbidity and mortality in aged patients with hypertension.

  10. Principles and Clinical Application of Dual-energy Computed Tomography in the Evaluation of Cerebrovascular Disease.

    Science.gov (United States)

    Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi; Singh, Dalveer; Pratap, Jit; Watkins, Trevor William

    2016-01-01

    Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imaging cerebrovascular diseases, which includes: (1) Identification of active extravasation of iodinated contrast in various types of intracranial hemorrhage; (2) differentiation between hemorrhagic transformation and iodine staining in acute ischemic stroke following diagnostic and/or therapeutic catheter angiography; (3) identification of culprit lesions in intra-axial hemorrhage; (4) calcium subtraction from atheromatous plaque for the assessment of plaque morphology and improved quantification of luminal stenosis; (5) bone subtraction to improve the depiction of vascular anatomy with more clarity, especially at the skull base; (6) metal artifact reduction utilizing virtual monoenergetic reconstructions for improved luminal assessment postaneurysm coiling or clipping. We discuss the physical principles of DECT and review the clinical applications of DECT for the evaluation of cerebrovascular diseases. PMID:27512615

  11. Principles and Clinical Application of Dual-energy Computed Tomography in the Evaluation of Cerebrovascular Disease

    Science.gov (United States)

    Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi; Singh, Dalveer; Pratap, Jit; Watkins, Trevor William

    2016-01-01

    Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imaging cerebrovascular diseases, which includes: (1) Identification of active extravasation of iodinated contrast in various types of intracranial hemorrhage; (2) differentiation between hemorrhagic transformation and iodine staining in acute ischemic stroke following diagnostic and/or therapeutic catheter angiography; (3) identification of culprit lesions in intra-axial hemorrhage; (4) calcium subtraction from atheromatous plaque for the assessment of plaque morphology and improved quantification of luminal stenosis; (5) bone subtraction to improve the depiction of vascular anatomy with more clarity, especially at the skull base; (6) metal artifact reduction utilizing virtual monoenergetic reconstructions for improved luminal assessment postaneurysm coiling or clipping. We discuss the physical principles of DECT and review the clinical applications of DECT for the evaluation of cerebrovascular diseases. PMID:27512615

  12. Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Gang Wang; Xue Cheng; Xianglin Zhang

    2013-01-01

    Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases (83%) with convict vascular stenosis and perfusion abnormalities, and five cases (45%) with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores ≥ 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores < 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.

  13. Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Alberto Lo Gullo

    Full Text Available To investigate the incidence of venous thromboembolism (VTE and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA compared to the general population.A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review.The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (% of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014 but similar rates of stroke, transient ischemic attack (TIA, and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events.In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects.

  14. Vascular Steal Explains Early Paradoxical Blood Oxygen Level-Dependent Cerebrovascular Response in Brain Regions with Delayed Arterial Transit Times

    Directory of Open Access Journals (Sweden)

    Julien Poublanc

    2013-04-01

    Full Text Available Introduction: Blood oxygen level-dependent (BOLD magnetic resonance imaging (MRI during manipulation of inhaled carbon dioxide (CO2 can be used to measure cerebrovascular reactivity (CVR and map regions of exhausted cerebrovascular reserve. These regions exhibit a reduced or negative BOLD response to inhaled CO2. In this study, we sought to clarify the mechanism behind the negative BOLD response by investigating its time delay (TD. Dynamic susceptibility contrast (DSC MRI with the injection of a contrast agent was used as the gold standard in order to provide measurement of the blood arrival time to which CVR TD could be compared. We hypothesize that if negative BOLD responses are the result of a steal phenomenon, they should be synchronized with positive BOLD responses from healthy brain tissue, even though the blood arrival time would be delayed. Methods: On a 3-tesla MRI system, BOLD CVR and DSC images were collected in a group of 19 patients with steno-occlusive cerebrovascular disease. For each patient, we generated a CVR magnitude map by regressing the BOLD signal with the end-tidal partial pressure of CO2 (PETCO2, and a CVR TD map by extracting the time of maximum cross-correlation between the BOLD signal and PETCO2. In addition, a blood arrival time map was generated by fitting the DSC signal with a gamma variate function. ROI masks corresponding to varying degrees of reactivity were constructed. Within these masks, the mean CVR magnitude, CVR TD and DSC blood arrival time were extracted and averaged over the 19 patients. CVR magnitude and CVR TD were then plotted against DSC blood arrival time. Results: The results show that CVR magnitude is highly correlated to DSC blood arrival time. As expected, the most compromised tissues with the longest blood arrival time have the lowest (most negative CVR magnitude. However, CVR TD shows a noncontinuous relationship with DSC blood arrival time. CVR TD is well correlated to DSC blood arrival time

  15. The cerebrovascular structure and brain tissue volume: a comparative study between beagle dogs and mongrel dogs

    International Nuclear Information System (INIS)

    Objective: To compare the differences of cerebrovascular structure and brain tissue volume between beagle and mongrel dogs by using angiography and MR scanning. Methods: A total of 40 dogs, including 20 beagle dogs (beagle group) and 20 mongrel dogs (mongrel group), were enrolled in this study. Under general anesthesia, all dogs were examined with cerebral angiography and MR scanning. The cerebrovascular structure was evaluated with angiography via selective catheterization of aortic arch, bilateral external cerebral arteries (ECA), maxillary arteries, internal cerebral arteries (ICA) and vertebral arteries separately. The diameters of the ICA, middle cerebral artery (MCA), rostral cerebral artery (RCA), the anastomosis channel ICA and ECA, and basilar artery (BA) were measured at the similar point of each dog. Meanwhile the volumes of the brain tissue were calculated in coronal T2 view of MR scanning. The statistical analysis was performed among the weight of dogs, the diameter of arteries and the volume of brain tissue. The differences in the diameters and brain tissue volume were compared between the two groups. Results: No obvious variations in the cerebrovascular structure and brain tissue volume were found in these dogs. One mongrel dog was excluded from this study because of the severe stenosis of ICA. The mean weight of 20 beagle dogs and 19 mongrel dogs was (12.81±1.29) kg and (12.85±1.12) kg, respectively. The diameters of the ICA, MCA, RCA, the anastomosis channel between ICA and ECA and BA in beagle group were (1.26±0.07) mm, (0.90±0.05) mm, (0.58±0.07) mm, (0.55±0.07) mm and (0.95±0.06) mm, respectively. These parameters in mongrel group were (1.27±0.07) mm, (0.92±0.05) mm, (0.59±0.06) mm, (0.67±0.07) mm and (0.94±0.05) mm, respectively. The volume of brain in two groups was (76232.33±5018.51) mm3 and (71863.96±4626.87) mm3, respectively. There were no obvious correlation among the body weight, the cerebrovascular diameters and brain

  16. The role of APOE in cerebrovascular dysfunction.

    Science.gov (United States)

    Tai, Leon M; Thomas, Riya; Marottoli, Felecia M; Koster, Kevin P; Kanekiyo, Takahisa; Morris, Alan W J; Bu, Guojun

    2016-05-01

    The ε4 allele of the apolipoprotein E gene (APOE4) is associated with cognitive decline during aging, is the greatest genetic risk factor for Alzheimer's disease and has links to other neurodegenerative conditions that affect cognition. Increasing evidence indicates that APOE genotypes differentially modulate the function of the cerebrovasculature (CV), with apoE and its receptors expressed by different cell types at the CV interface (astrocytes, pericytes, smooth muscle cells, brain endothelial cells). However, research on the role of apoE in CV dysfunction has not advanced as quickly as other apoE-modulated pathways. This review will assess what aspects of the CV are modulated by APOE genotypes during aging and under disease states, discuss potential mechanisms, and summarize the therapeutic significance of the topic. We propose that APOE4 induces CV dysfunction through direct signaling at the CV, and indirectly via modulation of peripheral and central pathways. Further, that APOE4 predisposes the CV to damage by, and exacerbates the effects of, additional risk factors (such as sex, hypertension, and diabetes). ApoE4-induced detrimental CV changes include reduced cerebral blood flow (CBF), modified neuron-CBF coupling, increased blood-brain barrier leakiness, cerebral amyloid angiopathy, hemorrhages and disrupted transport of nutrients and toxins. The apoE4-induced detrimental changes may be linked to pericyte migration/activation, astrocyte activation, smooth muscle cell damage, basement membrane degradation and alterations in brain endothelial cells. PMID:26884068

  17. Nonurgent commercial air travel after nonhemorrhagic cerebrovascular accident.

    Science.gov (United States)

    Barros, Andrew; Duchateau, François-Xavier; Huff, J Stephen; Verner, Laurent; O'Connor, Robert E; Brady, William J

    2014-01-01

    Nonurgent commercial air travel in patients who have experienced a nonhemorrhagic cerebrovascular accident (CVA) may occur, particularly in the elderly traveling population. A recent CVA, particularly occurring during a person's travel, presents a significant challenge to the patient, companions, family, and health care team. Specific medical recommendation, based on accumulated scientific data and interpreted by medical experts, is needed so that travel health care professionals can appropriately guide the patient. Unfortunately, such recommendations are almost entirely lacking despite the relative frequency of CVA and air travel. This article reviews the existing recommendations with conclusions based on both these limited data and rationale conjecture. PMID:24787513

  18. Cerebrovascular angiotensin AT1 receptor regulation in cerebral ischemia

    DEFF Research Database (Denmark)

    Edvinsson, Lars

    2008-01-01

    The mechanism behind the positive response to the inhibition of the angiotensin II receptor AT(1) in conjunction with stroke is elusive. Here we demonstrate that cerebrovascular AT(1) receptors show increased expression (upregulation) after cerebral ischemia via enhanced translation. This enhanced...... expression of AT(1) receptors occurs in the ischemic cerebral arteries and microvessels, and their inhibition results in a reduction in infarct volume. These findings add to the understanding of the vascular component in stroke, and the identified inhibition provides a new way to reduce the extent...... of cerebral ischemic damage....

  19. Correlation between serum fructosamine and hyperglycemia in patients with acute cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Kaiqiu Chu; Pengpeng Liu; Lijuan Tan; Shuhua Zhou; Lisheng Ren

    2006-01-01

    BACKGROUND: Diabetes mellitus is one of the risk factors in patients with acute cerebral disease, and always leads to stroke or get it worse. There is often a high level of blood glucose in those patients with diabetes mellitus and cerebral disease, but it is hard to distinguish from both kinds of hyperglycemia. Serum fructosamine is said to be correlated with blood glucose.OBJECTIVE: To explore the relationship between serum fructosamine and blood glucose in patients with acute cerebrovascular disease.DESTGN: A case-controlled study.SETTINGS: Department of Clinical Laboratory, Health Department for Cadres and Department of Neurology of Affiliated Hospital, Qingdao University Medical College.PARTICIPANTS: Forty-eight inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology, Affiliated Hospital of Qingdao University Medical College from December 2004 to April 2005. All the patients were confirmed with CT and MRI. There were 25 patients with diabetes mellitus secondary cerebrovascular diseases, who met the diagnostic standards of diabetes mellitus set by WHO,including 12 males and 13 females with an average of (60±8) years old, the course of diabetes mellitus ranged from 1 to 21 years.. The other 23 patients had no diabetes mellitus (without diabetes mellitus group), including 14 males and 9 females with an average of (62±6) years old. Meanwhile, another 50 healthy physical examinees in the hospital were selected as control group, including 26 males and 24 females with the average age of (62±5) years old. Informed content was obtained from all the participants.METHODS: Venous blood was drawn from all the participants, and content of blood glucose was assayed by means of glucose oxidase, and the concentration of serum fructosamine was determined by nitroblue tetrazolium colorimetric method. Comparison between groups was performed by the analysis of variance and q test, and the correlation was tested by linear

  20. Congenital and genetic cerebrovascular anomalies as risk factors for stroke in Saudi Arabia

    International Nuclear Information System (INIS)

    To explore the role of and report congenital and genetic cerebrovascular anomalies as risk factors for stroke in a prospective and retrospective cohort of Saudi children. Children with stroke were evaluated at the Division of Pediatric Neurology (Dpn), or were seen as inpatients in the Pediatric Wards at King Khalid University Hospital (KKUH), Riyadh, Kingdom of Saudi Arabia during the periods July 1992 to February 2001 (retrospective study) and February 2001 to March 2003 (prospective study). Stroke work-up for each suspected case included hemostatic assays, serological, biochemical and neurophysiological tests. Neuroimaging modalities included routine skill x-rays, CT, MRI, magnetic resonance angiography (MRA) and conventional cerebral angiography. Of 104 children with stroke, congenital and genetic cerebrovascular anomalies were the underlying risk factor in 7 (6.7%). The patients were evaluated at the DPN at a mean age of 66 months (range = 8 months to 11 years, median = 6 years); and they had stroke at a mean age of 48 months (range = 2 months to 10 years, median = 8 months). Four patients had stroke in association with neurocutaneous syndromes. Two had Sturge-Weber syndrome (SWS), one had Klippel-Trenaunay syndrome associated with SWS, and the fourth had neurofibromatosis type 1. Two patients had intracranial hemorrhage secondary to ruptured aneurysm. A girl (aged 9 years and 4 months) had left posterior cerebral artery aneurysm. She was diagnosed to have autosomal dominant polycystic kidney disease following renal ultrasonography. She died 5 months later despite surgical intervention (clipping of aneurysm). The second child was an 8-months-old boy who presented with subarachnoid and intraventricular hemorrhage (IVH) following ruptured anterior communicating artery aneurysm. He recovered with no residual symptoms following successful clipping of the aneurysm. Arteriovenous malformation (AVM) caused IVH in a 7-year-old boy who reported to hospital 5 hours

  1. Clinical Characteristics of Cerebrovascular Pathology with Patients Suffering from Ph-Negative Myeloproliferative Disease

    Directory of Open Access Journals (Sweden)

    Marine M. Tanashyan

    2016-09-01

    Full Text Available Background: Disturbances of microcirculation play a significant role in the development and progression of both acute and chronic cerebrovascular diseases (CVD and may be associated with different hemogram abnormalities. One of the reasons of the prothrombogenic state of the endothelium is the increase in the number of blood corpuscles leading to (non-Ph myeloproliferative disorders (MPD including essential thrombocythemia (ET, polycythemia vera (PV, and primary myelofibrosis (PM. Materials and Methods: The study included 167 patients: 102 patients with Ph-MPD and the control group comprising 65 patients with CVD. According to MPD subtype, the patients were divided into three groups: patients with ET (37%, n = 38, male/female 7/31, age 52 ± 7 years, those with PV (40%, n = 41, male/female 20/21, age 50 ± 6 years and those with PM (23%, n = 23, male/female 5/18, age 54 ± 4 years. Results: In 79% (n = 81 of cases in the study group (with Ph-MPD, patients had chronic CVD, with the most frequently identified symptoms being asthenia (92% and headache (72%. Headache in Ph-MPD patients was more frequently (86% associated with PM, while in patients with PV and ET it was equally distributed (70%. Neurological symptoms in 53% of cases were associated with focal changes of the brain on MRI localized in the subcortical area of the frontal and parietal lobes. Twenty-one (21% patients suffered an acute cerebrovascular accident, 8 of them had thrombotic occlusion of one of the internal carotid arteries leading to hemispheric infarcts. Endothelial function (as measured by flow-dependent dilation of the brachial artery was severely impaired in all study groups (median 5% with normal cut-off at 10%, the lowest degree of vasodilator activity being specific for patients with a history of stroke (p = 0.011. Conclusion: Patients suffering from MPD had asymptomatic focal changes in the brain in the absence of concomitant vascular disease (hypertension

  2. The impact of ambient particulate matter (PM10) on the population mortality for cerebrovascular diseasesa case-crossover study

    Institute of Scientific and Technical Information of China (English)

    王旭英

    2013-01-01

    Objective To analyze the association between the concentration of ambient inhalable particulate matter(PM10) and population mortality for cerebrovascular diseases and to explore the impact of PM10 on cerebrovascular

  3. Genetic risk factors for cerebrovascular disease in children with sickle cell disease: design of a case-control association study and genomewide screen

    Directory of Open Access Journals (Sweden)

    Brambilla Donald

    2003-07-01

    Full Text Available Abstract Background The phenotypic heterogeneity of sickle cell disease is likely the result of multiple genetic factors and their interaction with the sickle mutation. High transcranial doppler (TCD velocities define a subgroup of children with sickle cell disease who are at increased risk for developing ischemic stroke. The genetic factors leading to the development of a high TCD velocity (i.e. cerebrovascular disease and ultimately to stroke are not well characterized. Methods We have designed a case-control association study to elucidate the role of genetic polymorphisms as risk factors for cerebrovascular disease as measured by a high TCD velocity in children with sickle cell disease. The study will consist of two parts: a candidate gene study and a genomewide screen and will be performed in 230 cases and 400 controls. Cases will include 130 patients (TCD ≥ 200 cm/s randomized in the Stroke Prevention Trial in Sickle Cell Anemia (STOP study as well as 100 other patients found to have high TCD in STOP II screening. Four hundred sickle cell disease patients with a normal TCD velocity (TCD Discussion It is expected that this study will yield important information on genetic risk factors for the cerebrovascular disease phenotype in sickle cell disease by clarifying the role of candidate genes in the development of high TCD. The genomewide screen for a large number of SNPs may uncover the association of novel polymorphisms with cerebrovascular disease and stroke in sickle cell disease.

  4. Thirty-Year Trends in Mortality from Cerebrovascular Diseases in Korea

    Science.gov (United States)

    Lee, Seung Won; Lee, Hye Sun; Suh, Il

    2016-01-01

    Background and Objectives Cerebrovascular disease is a leading cause of mortality and morbidity in Korea. Understanding of cerebrovascular disease mortality trends is important to reduce the health burden from cerebrovascular diseases. We examined the changing pattern of mortality related to cerebrovascular disease in Korea over 30 years from 1983 to 2012. Subjects and Methods Numbers of deaths from cerebrovascular disease, hemorrhagic stroke, and cerebral infarction were obtained from the national Cause of Death Statistics. Crude and age-adjusted mortality rates were calculated for men and women for each year. Penalized B-spline methods, which reduce bias and variability in curve fitting, were used to identify the trends of 30-year mortality and identify the year of highest mortality. Results During the 30 years, cerebrovascular disease mortality has markedly declined. The age-adjusted cerebrovascular disease mortality rate has decreased by 78% in men and by 68% in women. In the case of hemorrhagic stroke, crude mortality peaked in 2001 but age-adjusted mortality peaked in 1994. Between 1994 and 2012, age-adjusted mortality from hemorrhagic stroke has decreased by 68% in men and 59% in women. In the case of cerebral infarction, crude and age-adjusted mortality rates steeply increased until 2004 and 2003, respectively, and both rates decreased rapidly thereafter. Conclusion Cerebrovascular disease mortality rate has significantly decreased over the last 30 years in Korea, but remains a health burden. The prevalence of major cardiovascular risk factors are still highly prevalent in Korea. PMID:27482259

  5. TYPES OF TREMOR IN PATIENTS WITH CEREBROVASCULAR DISEASES AND CARDIOVASCULAR EVENTS

    OpenAIRE

    Petrov Igor; Mulic Mersudin; Antonio Georgiev

    2016-01-01

    Introduction: Tremor can occur as a part of the clinical feature of cerebrovascular diseases. Many patients with cerebral stroke have cardiovascular diseases as a comorbidity or complication of stroke; sometimes cardiovascular events can lead to embolic stroke. Aim: To present types of tremor in patients with cerebrovascular diseases and cardiovascular events and diabetes mellitus type 2, clinical characteristics of tremor and investigations used. Materia...

  6. Cerebral perfusion and cerebrovascular reactivity are reduced in white matter hyperintensities

    DEFF Research Database (Denmark)

    Marstrand, J.R.; Garde, E; Rostrup, Egill;

    2002-01-01

    together with administration of acetazolamide. From a combination of anatomic images with different signal weighting, regions of interest were generated corresponding to gray and white matter and WMH. Localized measurements of CBF and cerebral blood volume (CBV) and mean transit time were obtained directly...... within WMH and NAWM. RESULTS: When comparing WMH to NAWM, measurements showed significantly lower CBF (P=0.004) and longer mean transit time (P

  7. Continuous Monitoring of Cerebrovascular Reactivity Using Pulse Waveform of Intracranial Pressure

    NARCIS (Netherlands)

    Aries, M.J.H.; Czosnyka, Marek; Budohoski, Karol P.; Kolias, Angelos G.; Radolovich, Danila K.; Lavinio, Andrea; Pickard, John D.; Smielewski, Peter

    2012-01-01

    Guidelines for the management of traumatic brain injury (TBI) call for the development of accurate methods for assessment of the relationship between cerebral perfusion pressure (CPP) and cerebral autoregulation and to determine the influence of quantitative indices of pressure autoregulation on out

  8. Anton's syndrome due to cerebrovascular disease: a case report

    Directory of Open Access Journals (Sweden)

    Maddula Mohana

    2009-09-01

    Full Text Available Abstract Introduction Anton's syndrome describes the condition in which patients deny their blindness despite objective evidence of visual loss, and moreover confabulate to support their stance. It is a rare extension of cortical blindness in which, in addition to the injury to the occipital cortex, other cortical centres are also affected, with patients typically behaving as if they were sighted. Case presentation We present a case report of an 83-year-old white woman with cortical blindness as a result of bilateral occipital lobe infarcts. Despite her obvious blindness, illustrated by her walking into objects, the patient expressed denial of visual loss and demonstrated confabulation in her accounts of her surroundings, consistent with a diagnosis of Anton's syndrome. Conclusions A suspicion of cortical blindness and Anton's syndrome should be considered in patients with atypical visual loss and evidence of occipital lobe injury. Cerebrovascular disease is the most common cause of Anton's syndrome, as in our patient. However, any condition that may result in cortical blindness can potentially lead to Anton's syndrome. Recovery of visual function will depend on the underlying aetiology, with cases due to occipital lobe infarction after cerebrovascular events being less likely to result in complete recovery. Management in these circumstances should accordingly focus on secondary prevention and rehabilitation.

  9. Head position modifies cerebrovascular response to orthostatic stress.

    Science.gov (United States)

    Wilson, Timothy D; Serrador, Jorge M; Shoemaker, J Kevin

    2003-01-31

    Previous experiments have shown that the vestibular system participates in cardiovascular control. However, the effects of vestibular activation on cerebrovascular regulation are not known. Therefore, the present experiment tested the hypothesis that specific vestibular activations may be beneficial to cerebral circulation during simulated orthostatic stress. Middle cerebral artery blood flow velocity (CBV; Doppler ultrasound) was measured to examine the effects of head-down neck flexion (HDNF) compared to head-down neck extension (HDNE) with and without lower body negative pressure (LBNP; -40 mmHg) (n=9). The change in CBV (DeltaCBV) during HDNF and HDNE were not different during baseline conditions, however, during LBNP, DeltaCBV was greater in HDNE compared to HDNF (-5.5+/-3.2 cm/s, -11+/-4.6%) vs. (-0.7+/-1.0 cm/s, -1.9+/-1.9%), respectively (PHDNF (0.26+/-0.05 mmHg/cm per s, 22+/-4.1%) (PHDNF (42+/-2 mmHg; P<0.05) during LBNP. These results suggest that the vestibular system may affect cerebrovascular tone during simulated postural stress by either constriction or dilation, depending on the vestibular stimulus. PMID:12531493

  10. [Descriptive study of cerebrovascular accidents in Douala, Cameroon].

    Science.gov (United States)

    Chiasseu, Mbeumi M T; Mbahe, S

    2011-10-01

    A cerebrovascular accident or stroke is a sudden-onset cerebral deficit of vascular origin lasting more than 24 hours. These events represent the second leading cause of death in the world and take a particularly heavy toll in third world countries. The purpose of this study was to describe cerebrovascular lesions (type, location, size) as well as patient age and gender in Cameroon. Brain CT-scan and MRI findings from 50 stroke patients admitted to two health centers in Douala were reviewed. Data showed that 74% of patients were over 50 years of age, the 51-60 year group being the most affected. Patients were male in 64% of cases. Ischemic stroke accounted for 60% of cases versus 40% for hemorrhagic stroke. The most affected sites were the sylvian territory site in ischemic stroke and the temporal lobe in hemorrhagic stroke, acconting for 43.3% and 35% of cases respectively. The median size of ischemic and hemorrhagic lesions were 2.81 cm3, and 26.98 cm3 respectively. Hemorrhagic stroke and lacunar infarcts were more common in this sample. Discrepancies between results at the two hospitals may be due to the use of different imaging techniques. Indeed, MRI is known to be more sensitive than CT-scan for acute detection of stroke lesions. PMID:22235625

  11. ROLE OF SMOKING AND ALCOHOLISM IN CEREBROVASCULAR ACCIDENTS

    Directory of Open Access Journals (Sweden)

    Y. Indira,

    2014-06-01

    Full Text Available Though previously stroke was considered an old man disease, it is increasing among the young and middle aged people are not likely to die of stroke as they are of heart attack, but they are likely to be disabled for rest of their lives. As the cases of stroke admitted to medical wards, formed nearly 1/10th to 1/8th of total bed strength at any time, and their prolonged stay at hospital attracted our attention. To study the etiological factors for the present study we have thoroughly evaluated 50 pts, with acute cerebrovascular disease and focused more attention in the revaluation of physiological variants of clinical importance by examining the blood for complete blood picture, which may help a long way in near future to predict the risk group in developing an acute cerebrovascular stroke and to avoid risk factors and to take measures to rectify the variations so as to minimize the mortality due to stroke.

  12. Study on the cerebrovascular reserve capacity by MR perfusion weighted imaging in SHR

    Science.gov (United States)

    Zhou, Quan; Dong, Yang; Chen, WenLi; Lin, Xueying; Xing, Da; Huang, Li

    2007-05-01

    Cerebrovascular disease is one of the leading causes of death, and approximately 50% of survivors have a residual neurologic deficit and greater than 25% require chronic care. Cerebrovascular reserve capacity (CVRC) describes how far cerebral perfusion can increase from a baseline value after stimulation. High blood pressure is the most important independent risk factor for stroke and other vascular diseases. The incidence of stroke in the hypertensive is six times higher than in the patient with normal blood pressure. CVRC in the hypertensive was even lower than in control patients. MR perfusion weighted imaging (MR PWI) with the well-established acetazolamide (ACZ) stimulation test has been used for assessing brain function. The aim of this work is to assess the cerebrovascular reserve capacity by MR PWI with "ACZ" tolerance test in spontaneous hypertensive rat (SHR) and to identify its value in evaluating the CVRC. Experimental animal including 3 groups: Wistar-Kyoto rats (WKY) (12-week-old) as control group, SHR (12-week-old and 20-week-old) as experimental group. MR PWI was performed respectively before and after acetazolamide administrated orally in 3 groups on a clinical 1.5 Tesla GE Signa MR fx/i whole-body MR system. The ROI was chosen in the bilateral frontal lobe to measure the value of rCBV, rCBF and MTT. The results showed that before ACZ-test, there was statistic differences between the WKY and SHR(12-week-old), and between SHR(12-week-old) and SHR(20-week-old) in the values of rCBV and rCBF (P>0.05), and after ACZ-test, there were statistic differences between WKY and SHR (20-week-old), and between SHR(12-week-old) and SHR(20-week-old) in the rCBV value (Pstress test" can provide more qualitative and half-quantitative information on the cerebral perfusion to evaluate the CVRC in SHR.

  13. The coexistence of carotid and lower extremity atherosclerosis further increases cardio-cerebrovascular risk in type 2 diabetes

    OpenAIRE

    Li, Mei-Fang; Zhao, Cui-Chun; Li, Ting-ting; Tu, Yin-Fang; Lu, Jun-Xi; Zhang, Rong; Chen, Ming-Yun; Bao, Yu-Qian; Li, Lian-Xi; Jia, Wei-Ping

    2016-01-01

    Background Both carotid and lower limb atherosclerosis are associated with increased cardiovascular and cerebrovascular risks. However, it is still unclear whether the concomitant presence of carotid and lower extremity atherosclerosis further increases the cardiovascular and cerebrovascular risks. Therefore, our aim is to investigate whether the coexistence of carotid and lower extremity atherosclerosis was associated with higher cardiovascular and cerebrovascular risks in patients with type...

  14. Evaluation of cerebrovascular reserve capacity in normal individuals%TCD对正常人大脑中动脉血流储备功能的评价

    Institute of Scientific and Technical Information of China (English)

    李倩; 孔丽; 刘玲; 戴加飞; 程茅薇; 张申宁; 陈光辉; 杨昉

    2012-01-01

    Objective To investigate the capacity of cerebrovascular reserve in normal individuals. Methods Ninety cases of normal individuals were included in this study. After TCD routine examination, the mean blood flow velocity in the middle cerebral artery during the eupnea and the end of breathholding were detected with transcranial Dopple. Results the capacity of cerebrovascular reserve in right side MCA was different from left side,and sexual did not correlated to cerebrovascular reserve,but age correlated to it. Conclusion In normal individuals,the capacity of cerebrovascular reserve was change with age. The evaluation of cerebrovascular reserve capacity with breath holding lest was safe and effective.%目的 探讨经颅超声多普勒(TCD)屏气试验对健康人群脑血流储备能力的评价.方法 试验组90例健康人,TCD检测双侧大脑中动脉的血流频谱,经过屏气试验,观察试验前后血流速度的变化值.结果 18 ~ 39岁脑血流储备能力(CVR)为(41.44+12.56)%,40 ~ 59岁为(36.36±12.15)%,≥60岁为(33.80±10.12)%,组间比较差异均有统计学意义.结论 健康人群CVR随着年龄的增长而下降;超声多普勒屏气试验评价CVR安全可靠.

  15. PET in cerebrovascular disease; PET bei zerebrovaskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Herholz, K. [Neurologische Universitaetsklinik der Univ. Koeln (Germany)]|[Max-Planck-Institut fuer Neurologische Forschung, Koeln (Germany)

    1997-03-01

    Tissue viability is of particular interest in acute cerebral ischemia because it may be preserved if reperfusion can be achieved rapidly, e.g. by acute thrombolysis. Measurements of regional cerebral blood flow (CBF) and oxygen consumption by PET can assess tissue viability, and they have substantially increased our knowledge of th pathophysiology of ischemic stroke and the associated penumbra. Widerspread clinical application in acute stroke, however, is unlikely because of the large logistic and personnel resources required. In chronic cerebrovascular disease, measurement of regional CBF and glucose metabolism, which is usually coupled, provide detailed insights in disturbance of cortical function, e.g. due to deafferentiation, and contribute to differentiation of dementia types. Chronic misery perfusion, i.e. reduced perfusion that does not match the metabolic demand of the tissue, can be demonstrated by PET. It may be found in some patients with high-grade arterial stenoses. Less severe impairment of brain perfusion can be demonstrated by measurement of the cerebrovascular reserve capacity. The most frequent clinical situations can be assessed by less demanding procedures, e.g. by SPECT. In conclusion, PET has its role in cerebrovascular disease primarily within scientific studies, where high resolution and absolute quantitation of physiological variables are essential. (orig.). 65 refs. [Deutsch] Beim akuten ischaemischen Insult ist die Vitalitaet des Gewebes von besonderem Interesse, da sie durch rasche Reperfusion, z.B. durch Thrombolyse, erhalten bleiben kann. Messungen der zerebralen Durchblutung und des Sauerstoffumsatzes mittels PET geben darueber wesentliche Aufschluesse, und sie sind wichtig fuer das Verstaendnis der Pathophysiologie ischaemischer Infarkte und der Penumbra mit kritischer Perfusion beim Menschen. Ihre breitere Anwendung in der klinischen Patientenversorgung kommt allerdings wegen des hohen Aufwandes derzeit kaum in Betracht. Bei

  16. The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

    Directory of Open Access Journals (Sweden)

    Levent Güngör

    2011-06-01

    Full Text Available OBJECTIVE: Dysphagia and malnutrition are not so rare in stroke patients, and have an unfavorable influence on recovery. Nutritional support may reduce infections, duration of hospital stay and mortality. However, there is no clear evidence about the modality of nasogastric nutrition. In this study, intermittent and continuous enteral nutrition is compared by means of pulmonary infections and gastrointestinal tolerance, among acute cerebrovascular patients. METHODS: Sixty two acute cerebrovascular patients with dysphagia were included the study. The same volume of nutrition product was infused 4 times daily to 31 patients, and continuously for 24 hours to the remaining 31. After 10 days of follow-up, the rates of pulmonary infections, diarrhea, increased gastric residual volumes, vomiting and tube occlusion were compared between two groups. RESULTS: Twenty patients developed pneumonia (32% and 8 diarrhea (13%. Mortality due to complications associated with tube feeding was 6%. Aspiration and related pneumonia was present in 11 patients in the intermittent nutrition group (35%, and in 9 patients in the continuous nutrition group (29%. The rate of pulmonary infection was not statistically different between two groups (p>0.05. Diarrhea was observed in 7 intermittently fed patients (23%, while was present only in 1 patient (3% in the continuously fed group. Diarrhea was more common in the intermittent nutrition group, just at the statistical border (p=0.05. None of the patients developed tube occlusion, vomiting and gastric retention. The rate of mortality and the interruption of feeding was not significantly different between two groups (p>0.05. CONCLUSION: Diarrhea and pulmonary infections are more prevalent with intermittent tube feeding with respect to continuous enteral nutrition, though the difference is not so conspicuous. The reason may be contamination of the equipments and the feeding solution because of frequent manipulation and

  17. Cardiovascular and cerebrovascular effects in response to red bull consumption combined with mental stress.

    Science.gov (United States)

    Grasser, Erik Konrad; Dulloo, Abdul G; Montani, Jean-Pierre

    2015-01-15

    The sale of energy drinks is often accompanied by a comprehensive and intense marketing with claims of benefits during periods of mental stress. As it has been shown that Red Bull negatively impacts human hemodynamics at rest, we investigated the cardiovascular and cerebrovascular consequences when Red Bull is combined with mental stress. In a randomized cross-over study, 20 young healthy humans ingested either 355 ml of a can Red Bull or water and underwent 80 minutes after the respective drink a mental arithmetic test for 5 minutes. Continuous cardiovascular and cerebrovascular recordings were performed for 20 minutes before and up to 90 minutes after drink ingestion. Measurements included beat-to-beat blood pressure (BP), heart rate, stroke volume, and cerebral blood flow velocity. Red Bull increased systolic BP (+7 mm Hg), diastolic BP (+4 mm Hg), and heart rate (+7 beats/min), whereas water drinking had no significant effects. Cerebral blood flow velocity decreased more in response to Red Bull than to water (-9 vs -3 cm/s, p <0.005). Additional mental stress further increased both systolic BP and diastolic BP (+3 mm Hg, p <0.05) and heart rate (+13 beats/min, p <0.005) in response to Red Bull; similar increases were also observed after water ingestion. In combination, Red Bull and mental stress increased systolic BP by about 10 mm Hg, diastolic BP by 7 mm Hg, and heart rate by 20 beats/min and decreased cerebral blood flow velocity by -7 cm/s. In conclusion, the combination of Red Bull and mental stress impose a cumulative cardiovascular load and reduces cerebral blood flow even under a mental challenge.

  18. A Parallel Markov Cerebrovascular Segmentation Algorithm Based on Statistical Model

    Institute of Scientific and Technical Information of China (English)

    Rong-Fei Cao; Xing-Ce Wang; Zhong-Ke Wu; Ming-Quan Zhou; Xin-Yu Liu

    2016-01-01

    For segmenting cerebral blood vessels from the time-of-flight magnetic resonance angiography (TOF-MRA) images accurately, we propose a parallel segmentation algorithm based on statistical model with Markov random field (MRF). Firstly, we improve traditional non-local means filter with patch-based Fourier transformation to preprocess the TOF-MRA images. In this step, we mainly utilize the sparseness and self-similarity of the MRA brain images sequence. Secondly, we add the MRF information to the finite mixture mode (FMM) to fit the intensity distribution of medical images. We make use of the MRF in image sequence to estimate the proportion of cerebral tissues. Finally, we choose the particle swarm optimization (PSO) algorithm to parallelize the parameter estimation of FMM. A large number of experiments verify the high accuracy and robustness of our approach especially for narrow vessels. The work will offer significant assistance for physicians on the prevention and diagnosis of cerebrovascular diseases.

  19. /sup 111/In platelet scintigraphy in cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Powers, W.J.; Siegel, B.A.; Davis, H.H.; Mathias, C.J.; Clark, H.B.; Welch, M.J.

    1982-09-01

    We obtained scintigraphic images of the neck from 100 patients with suspected cerebrovascular disease after injecting /sup 111/In-labeled autologous platelets. One or more focuses of increased activity, implying local platelet accumulation, were seen along the course of the cervical carotid arteries in 52 patients. In 64 patients, there was a highly significant correlation between the results of scintigraphy and carotid arteriography (p . 10(6)). There was no significant correlation between the scintigraphic findings and the previous or subsequent occurrence of transient ischemic attack or cerebral infarction in the carotid circulation. These data suggest that factors other than the simple formation of platlet thrombi in the cervical carotid arteries are of primary importance in the pathogenesis of stroke.

  20. Prothrombin and risk of venous thromboembolism, ischemic heart disease and ischemic cerebrovascular disease in the general population

    DEFF Research Database (Denmark)

    Weischer, Maren; Juul, Klaus; Zacho, Jeppe;

    2010-01-01

    -control studies. METHODS: 9231 individuals from the Danish general population were followed for VTE (VTE=DVT+PE), deep venous thrombosis (DVT), pulmonary embolism (PE), IHD, myocardial infarction (MI), ICVD, and ischemic stroke (IS) for a median of 24 years. Case-control studies included 2461 IHD cases and 867......OBJECTIVE: We tested the hypotheses that Prothrombin G20210A heterozygosity associate with increased risk of venous thromboembolism (VTE), ischemic heart disease (IHD), and ischemic cerebrovascular disease (ICVD) in the general population and re-tested risk of IHD and ICVD in two case...

  1. Aspirin in Cardiovascular and Cerebrovascular Events: Does Market Failure Matter?

    Directory of Open Access Journals (Sweden)

    Roger Lee Mendoza

    2010-01-01

    Full Text Available Problem statement: Against the backdrop of the 2009 scientific studies qualifying the cardiovascular and cerebrovascular benefits of aspirin, two interrelated questions are raised for investigation in this study. First, why may the government intervene in an otherwise private transaction between physician and patient and between drug manufacturer and buyer, when it involves contentious pharmacological information? Second, does government intervention make a difference in what these transacting parties would otherwise have chosen to do in its absence? Approach: An Internet literature search was performed, using query term combinations, to identify relevant aspirin studies. The search yielded 61 juried publications that met our predetermined criteria for inclusion and thematic analysis. Results: Variance exists within the mix of economic and non-economic literature on aspirin information regulation. The study identified 4 instances of market failure that offer some of the most compelling theoretical and practical considerations for public policy intervention in the context of the 2009 findings. However, there is also indication that the sense of increased protection arising from safety regulations could stimulate risky behavior that nullifies their net protective effects or benefits. Conclusion: It is not clear either from the surveyed literature or existing economic theory if, ceteris paribus, regulated information alters or modifies the marginal propensity of a physician to recommend, and a patient to consume, aspirin to prevent cardiovascular and cerebrovascular events, particularly heart attacks, strokes and vascular death. The study suggests the need for policy reinforcements to safety information, if market failures are to be efficiently addressed and risk compensating behavior reduced.

  2. Pharmacoepidemiological Study on Cerebrovascular Accident in Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Prathyusha GR

    2016-08-01

    Full Text Available Stroke is the third leading cause of death in the United States (US and a leading cause of serious, long-term disability. Incidence of ischemic stroke is higher than hemorrhagic stroke. The aim is to conduct pharmacoepidemiology study on cerebrovascular accident patient by evaluating the use and the effects of drugs, and quantification of adverse drug reactions, drug utilization studies to improve the quality and use of medicines. A prospective observational study was conducted in department of general medicine and ICU at Mallareddy hospital, data was collected from 130 patients and it was proposed to be conducted for 6 months. Among 130 patients 78(60% are males and 52(40% are females. Among all age groups major number of CVA patients was seen in 60-69 years (30%. Among them 92% of strokes are Ischemic majorly seen in both males and females and8% strokes are hemorrhagic. Ischemic stroke (94.87% is majorly seen in 60-69 yr age group. Among various risk factors Hypertension (36.43% is the major risk factor found in males (60% and females (40%.Antiplatelet drugs (25.75% are the highest number of drugs given in patients 71.27% in males and 28.72% in females. Highest numbers of drugs are given in 50-59yrs age group and are antiplatelets. As a clinical pharmacist 16 adverse drug reactions and 25 drug interactions are reported. Proper patient counselling is needed to reduce hypertension and to reduce the risk for cerebrovascular accident. Among all antiplatelet drugs are majorly given in males and lipid lowering drugs in females.

  3. Flows of Reactive Fluids

    CERN Document Server

    Prud'homme, Roger

    2010-01-01

    The modeling of reactive flows has progressed mainly with advances in aerospace, which gave birth to a new science called aerothermochemistry, as well as through developments in chemical and process engineering. The methods employed, the phenomena investigated, and the aims of modeling differ for each field; however, in all cases, the results obtained have considerably enriched the working knowledge of reactive flows. This work examines basic concepts and methods necessary to study reactive flows and transfer phenomena in areas such as fluid mechanics, thermodynamics, and chemistry. Specific topics covered include: * Equations of state * Transfer phenomena and chemical kinetics * Balance equations of reactive flows * Dimensionless numbers and similarity * Chemical reactors * Coupled phenomena * Turbulent flow concepts * Boundary layers and fluid layers * Reactive and nonreactive waves * Interface phenomena * Multiphase flow concepts The book presents tools of interest to graduate students, researchers in math...

  4. Case-control study of platelet glycoprotein receptor Ib and IIb/IIIa expression in patients with acute and chronic cerebrovascular disease.

    Directory of Open Access Journals (Sweden)

    Peter Kraft

    Full Text Available Animal models have been instrumental in defining thrombus formation, including the role of platelet surface glycoprotein (GP receptors, in acute ischemic stroke (AIS. However, the involvement of GP receptors in human ischemic stroke pathophysiology and their utility as biomarkers for ischemic stroke risk and severity requires elucidation.To determine whether platelet GPIb and GPIIb/IIIa receptors are differentially expressed in patients with AIS and chronic cerebrovascular disease (CCD compared with healthy volunteers (HV and to identify predictors of GPIb and GPIIb/IIIa expression.This was a case-control study of 116 patients with AIS or transient ischemic attack (TIA, 117 patients with CCD, and 104 HV who were enrolled at our University hospital from 2010 to 2013. Blood sampling was performed once in the CCD and HV groups, and at several time points in patients with AIS or TIA. Linear regression and analysis of variance were used to analyze correlations between platelet GPIb and GPIIb/IIIa receptor numbers and demographic and clinical parameters.GPIb and GPIIb/IIIa receptor numbers did not significantly differ between the AIS, CCD, and HV groups. GPIb receptor expression level correlated significantly with the magnitude of GPIIb/IIIa receptor expression and the neutrophil count. In contrast, GPIIb/IIIa receptor numbers were not associated with peripheral immune-cell sub-population counts. C-reactive protein was an independent predictor of GPIIb/IIIa (not GPIb receptor numbers.Platelet GPIb and GPIIb/IIIa receptor numbers did not distinguish between patient or control groups in this study, negating their potential use as a biomarker for predicting stroke risk.

  5. Add-on quetiapine in the treatment of major depressive disorder in elderly patients with cerebrovascular damage

    Directory of Open Access Journals (Sweden)

    Zairo Fausta

    2007-11-01

    Full Text Available Abstract Background Depressive episodes in elderly patients with cerebrovascular damage are characterized by poor responses to standard antidepressants. Recent reports have suggested that the atypical antipsychotic, quetiapine may have antidepressant properties and, in mice, may prevents memory impairment and hippocampus neurodegeneration induced by global cerebral ischemia. Objective To evaluate the efficacy of combination therapy with quetiapine in depressed elderly patients with cerebrovascular damage. Methods An open-label, 6-month follow-up study of patients with major depressive disorder (DSM-IV and cerebral abnormalities (assessed by MRI without severe cognitive impairment. Patients who had not responded to standard antidepressants (months of treatment 6.5 ± 7.2 additionally received quetiapine (300 ± 111 mg/d. Patients were evaluated at baseline (t0 and Months 1, 3, and 6 (t1, t3, t6 using the Clinical Global Impressions Scale for Severity (CGI-S and the Hamilton Depression Rating Scale (HAM-D. Results Nine patients were included in the study, with a mean age of 72.8 ± 9.4 years. CGI-S scores decreased from baseline to Month 6: 5.8 ± 0.7 (t0, 5.4 ± 0.7 (t1, 5.0 ± 0.8 (t3, and 4.5 ± 1.0 (t6, with a significant improvement at 6 months compared with baseline (P = 0.006. A significant improvement over the 6-month period was also observed with HAM-D scores (t0 = 27.2 ± 4.0, t6 = 14.8 ± 3.8, P Conclusion In this study, quetiapine was efficacious as combination therapy in depressed elderly patients with cerebrovascular damage. The promising results from this study warrant confirmation in large, randomized, double-blind, placebo-controlled studies.

  6. Central and cerebrovascular effects of leg crossing in humans with sympathetic failure

    NARCIS (Netherlands)

    M.P. Harms; W. Wieling; W.N. Colier; J.W. Lenders; N.H. Secher; J.J. van Lieshout

    2010-01-01

    Leg crossing increases arterial pressure and combats symptomatic orthostatic hypotension in patients with sympathetic failure This study compared the central and cerebrovascular effects of leg crossing in patients with sympathetic failure and healthy controls. We addressed the relationship between M

  7. A cohort study on the relationship between cerebrovascular hemodynamic changing and risk of strok

    Institute of Scientific and Technical Information of China (English)

    郭吉平

    2013-01-01

    Objective To study the role of cerebrovascular hemodynamic indexes(CVHI)changing in stroke and to provide reference for stroke prevention and risk factor study.Methods From 2003 to 2004,participants aged 40 years

  8. Clinical Observation on Acupuncture Treatment of Cerebrovascular Dementia- A Report of 32 Cases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Cerebrovascular dementia is a common disease in the middle-aged and old people. Its incidence makes up about 10-20% of all kinds of dementia. It is mainly caused by general degeneration of the brain function resulted from cerebral arteriosclerosis and cerebral infarction. The author has treated 32 cases of cerebrovascular dementia with acupuncture in the recent years with satisfactory therapeutic results. A report follows.

  9. Persistent primitive trigeminal artery associated with cerebrovascular diseases and other cerebrosis

    International Nuclear Information System (INIS)

    Persistent primitive trigeminal artery (PPTA) is the most common permanent abnormal vascular anastomosis between carotid artery and basilar artery. PPTA is a rare cerebrovascular variation and is often associated with cerebrovascular disease (CVD). Clinically, PPTA manifests itself in symptoms such as trigeminal neuralgia, oculomotor paralysis, abducens nerve paralysis, subarachnoid hemorrhage, etc. This paper aims to review 116 PPTA cases with CVD and other cerebrosis, which have ever been reported since 1983 in English or Chinese medical literature. (authors)

  10. Clinical Significance of Cerebrovascular Biomarkers and White Matter Tract Integrity in Alzheimer Disease

    OpenAIRE

    Wu, Ming-Kung; Lu, Yan-Ting; Huang, Chi-Wei; Lin, Pin-Hsuan; Chen, Nai-Ching; Lui, Chun-Chung; Chang, Wen-Neng; Lee, Chen-Chang; Chang, Ya-Ting; Chen, Sz-Fan; Chang, Chiung-Chih

    2015-01-01

    Abstract Cerebrovascular risk factors and white matter (WM) damage lead to worse cognitive performance in Alzheimer dementia (AD). This study investigated WM microstructure using diffusion tensor imaging in patients with mild to moderate AD and investigated specific fiber tract involvement with respect to predefined cerebrovascular risk factors and neurobehavioral data prediction cross-sectionally and after 18 months. To identify the primary pathoanatomic relationships of risk biomarkers to f...

  11. Cerebrovascular risk factors and brain microstructural abnormalities on diffusion tensor images in HIV-infected individuals

    OpenAIRE

    Nakamoto, BK; Jahanshad, N.; McMurtray, A; Kallianpur, KJ; Chow, DC; Valcour, VG; Paul, RH; Marotz, L; Thompson, PM; Shikuma, CM

    2012-01-01

    HIV-associated neurocognitive disorder remains prevalent in HIV-infected individuals despite effective antire-troviral therapy. As these individuals age, comorbid cerebro-vascular disease will likely impact cognitive function. Effective tools to study this impact are needed. This study used diffusion tensor imaging (DTI) to characterize brain microstructural changes in HIV-infected individuals with and without cerebrovascular risk factors. Diffusion-weighted MRIs were obtained in 22 HIV-infec...

  12. Effect of Medicine Adherence on the Occurrence of Cerebrovascular Disorders in Diabetes Mellitus Patients

    OpenAIRE

    Park, Il-Su; Sohn, Hae-Sook

    2011-01-01

    OBJECTIVES To assess the association between the occurrence of cerebrovascular disorders and a medication adherence in diabetes mellitus patients. METHODS Medical records from 1,114 new patients with diabetes mellitus were collected and the occurrence of cerebrovascular disorders was observed. Data was gathered from the health examination records of diabetes mellitus patients registered at the Korean Metabolic Syndrome Research from 1996 to 2005, medication records from the National Health In...

  13. Reactive Arthritis

    Directory of Open Access Journals (Sweden)

    Eren Erken

    2013-06-01

    Full Text Available Reactive arthritis is an acute, sterile, non-suppurative and inflammatory arthropaty which has occured as a result of an infectious processes, mostly after gastrointestinal and genitourinary tract infections. Reiter syndrome is a frequent type of reactive arthritis. Both reactive arthritis and Reiter syndrome belong to the group of seronegative spondyloarthropathies, associated with HLA-B27 positivity and characterized by ongoing inflammation after an infectious episode. The classical triad of Reiter syndrome is defined as arthritis, conjuctivitis and urethritis and is seen only in one third of patients with Reiter syndrome. Recently, seronegative asymmetric arthritis and typical extraarticular involvement are thought to be adequate for the diagnosis. However, there is no established criteria for the diagnosis of reactive arthritis and the number of randomized and controlled studies about the therapy is not enough. [Archives Medical Review Journal 2013; 22(3.000: 283-299

  14. Crossed cerebellar atrophy in cases with cerebrovascular disease

    International Nuclear Information System (INIS)

    Crossed cerebellar atrophy (CCA) was investigated by X-ray CT to establish the incidence, mechanism, and the relation to cerebral lesions in 130 cases of unilateral supratentorial cerebrovascular diseases. The 130 cases consisted of 83 males and 47 females with cerebral infarction (65 cases) and cerebral hemorrhage (65 cases). The patients' average age was 57.6 years. Crossed cerebellar atrophy was demonstrated in 8 cases (6.2%), 6 of whom had massive cerebral infarction in the middle cerebral artery area (9.2% of the 65 cases of cerebral infarction. The six cases of CCA caused by cerebral infarction had lesions in the frontal and temporal lobes. Two had a cerebral hemorrhage in the putamen and in the thalamus, respectively, accounting for 3.1% of the 65 cases of cerebral hemorrhage. Of the 2 cases, one had putaminal hemorrhage, and the other had thalamic hemorrhage. Cerebrovascular stroke had occured in these patients with CCA more than 2 months previously. In 5 of the 8 cases of CCA, atrophy was present in the basis pedunculi and the basis pontis on the side of the cerebral lesion. However, neither dilation nor deformity of the fourth ventricle was present in any of the patients, suggesting that none of the CCA patients had atrophy of the dentate nucleus. The CCA patients had massive cerebral lesion in the frontal and temporal lobes or atrophy of the basis pedunculi and basis pontis, suggesting the presence of the transsynaptic degeneration of the cortico-ponto-cerebellar pathway. In the case of the thalamic hemorrhage, who had not hemorrhagic lesion in the frontal and temporal lobes, atrophy of the basis peduncli and basis pontis was not observed. Though dilation or deformity of the fourth ventricle is not observed in this case, presence of the degeneration of the dentate-rubro-thalamic pathway cannot be denied. CCA seems to be caused by both the transsynaptic degeneration of the cortico-ponto-cerebellar pathway and the dentate-rubro-thalamic pathway. (J.P.N.)

  15. Uric acid levels and their relation to incapacities in acute cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Julio López Argüelles

    2010-02-01

    Full Text Available Background: cerebrovascular disease and ischemic cardiopathy can be considered as an epidemic and constitute the first cause of incapacities in developed countries. Multiple studies have shown the association between uric acid levels and cerebrovascular diseases. Objective: To correlate the levels of serum uric acid and incapacities in the acute phase of cerebrovascular disease. Methods: A correlational study was carried out with 217 patients with acute cerebrovascular disease. The patient’s incapacity level was measured by using the Barthel Index and those results were related with the serum uric acid levels and other variables. Results: Male patients have higher levels of uric acid (p=0, 04; r=0, 13. Age and Barthel index were p < 0,001; r = -0, 30 and uric acid levels and Barthel Index were p=0, 03; r=-0, 14. The principal predicting factors of incapacity in the acute phase of cerebrovascular disease were the high levels of uric acid, age and diabetes mellitus. Conclusions: It is shown that the highest is the level of uric acid at advanced age; the greatest is the risk of suffering from incapacity in acute phases of cerebrovascular diseases.

  16. RECOVERY ASSESSMENT OF DAILY AND LABOUR ACTIVITIES (FOOD PREPARING AND FEEDING IN PATIENTS WITH CEREBROVASCULAR DISEASE

    Directory of Open Access Journals (Sweden)

    Danelina Vacheva

    2013-08-01

    Full Text Available Bulgaria is in a leading position concerning morbidity and mortality rate from cerebrovascular disease (CVD. The goal of this research was to examine, follow up and assess the recovery and the ability for food preparation and feeding in patients with CVD.Materials and methods: Sixty one patients were included in the research. All of them underwent physical rehabilitation program, based on their individual status. The program included: kinesitherapy, labour-therapy [(occupational therapy (OT and activities of daily life (ADL]; electrotherapy. The patients were assessed twice: in the beginning and at the end of the rehabilitation course. They self evaluated the basic parameters nevertheless which of the limbs was particularly affected. Wilcoxon rank test was used for the statistical analysis of non parametrical data and distribution. Results and analysis: At the end of the rehabilitation course the Wilcoxon’s curves were found shifted to the right, which confirmes improvement of the main parameter (self independence in the main task set to be fulfilled, no matter which limb was paretic.Conclusion: Early initiation of the rehabilitation course including labour activities and elements of ADL, given as instructions is essential for achieving better results in the rehabilitation of patients with CVD and for enhancing the self service ability. Functional OT stimulates the independence of patients and facilitates their recovering to independent everyday life and social activities.

  17. Change of blood rheology in newborn and its cerebrovascular damage

    Institute of Scientific and Technical Information of China (English)

    Guang-Ming Chen; Chun-Hua Lai; Jun-Feng Lv; Bing-Yan Yang; Li Xing-Xi

    2016-01-01

    Objective:To explore the blood rheology, changes in myocardial enzyme spectrum and brain damage in newborn whose hematocritg (HCT) are among 60%-65%.Methods:A total of 100 cases newborn whose HCT among 60%-65% with blood routine examination were set as observation group, 100 cases newborn whose HCT <60% were set as control group, compared the blood rheology, changes in myocardial enzyme spectrum and brain damage between two groups.Results:The HCT, whole blood viscosity (high), whole blood viscosity (low shear), erythrocyte aggregation index, erythrocyte rigidity index, aspertate aminotransferase, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, Vs, Vs and the abnormal rate of aEEG examination in observation group were significantly higher than the control group, the difference had statistical significance, RI in observation group were significantly lower than the control group, the difference had statistical significance.Conclusions:newborn whose HCT among 60%-65% but not with polycythemia have appeared and cerebrovascular lesions, it should cause clinical positive value.

  18. Magnetization transfer MR of cerebrovascular disorders using calculated images

    Energy Technology Data Exchange (ETDEWEB)

    Enomoto, Kyoko; Watabe, Tsuneya; Amanuma, Makoto; Heshiki, Atsuko [Saitama Medical School, Moroyama, Saitama (Japan)

    1997-06-01

    This study applied a magnetization transfer contrast method to patients with cerebrovascular disorders. A 1.5 T superconducting MR unit was used, and magnetization transfer ratio (MTR) images were calculated by evaluating two paired images before and after off-resonance gradient echo pulse sequences. The normal white matter showed the highest MTRs, CSF the lowest, and gray matter, intermediate. Cerebral ischemic patients showed two patterns according to the chronological stage of the affected area. Lesions in the acute and subacute stages revealed higher transfer rates than those in the chronic stage. Patients with cerebral hemorrhage were divided into three groups: the hyperacute group showed a low transfer pattern; the acute group presented inhomogeneous high transfer rates; and the subacute group showed remarkably low transfer rates. In the acute and subacute ischemic stages, increased macromolecules caused higher MTRs than in the chronic stage. In hemorrhagic groups, low MTRs in subacute hemorrhage reflected the transfer of methemoglobin. High MTRs in acute hemorrhage with rich deoxyhemoglobin suggested increased fibrin, plasma, and serum components of macromolecules. The MTC method provided new chronological information on cerebral hemorrhage, adding to that provided by routine MR images. (author)

  19. Aspirin in Cardiovascular and Cerebrovascular Events: Does Market Failure Matter?

    Directory of Open Access Journals (Sweden)

    Roger L. Mendoza

    2011-01-01

    Full Text Available Problem statement: Two interrelated questions were raised for investigation in this study: (1 why may government intervene in an otherwise private transaction between physician and patient and between drug manufacturer and buyer? (2 Does government intervention make a difference in what these transacting parties would otherwise have decided or chosen in its absence? Approach: An internet literature search was performed, using query term combinations, to identify aspirin-related studies. The search yielded 51 juried publications that met our predetermined criteria for inclusion and thematic analysis. Results: Some variance exists within the surveyed literature concerning government intervention in aspirin prophylaxis for cardiovascular and cerebrovascular events, particularly heart attacks, strokes and cardiovascular death. This study identified 4 instances of market failure that offer some of the strongest theoretical and practical considerations for public policy intervention in aspirin’s pharmacological information. However, there is also indication that the sense of increased protection arising from safety regulations could stimulate risky behavior that nullifies their net protective effects or benefits. Conclusion: It is not clear either from the surveyed literature or existing economic theory if, ceteris paribus, mandatory safety information is necessary to alter or modify the marginal propensity of a physician to recommend and a patient to purchase, aspirin. The study suggested the need for policy reinforcements to any safety information regulation, if market failures are to be effectively addressed and risk compensating behavior reduced.

  20. Cerebrovascular complications in children with sickle cell disease.

    Science.gov (United States)

    De Montalembert, M; Wang, W

    2013-01-01

    Cerebrovascular accidents were until recently responsible for much mortality and morbidity in children with sickle cell disease; the likelihood of a child with HbSS having a stroke was 11% before age 20 years, with a peak incidence of ischemic stroke between 2 and 5 years of age, and of hemorrhagic strokes between 20 and 29 years of age. Vessels occlusion is likely initiated by intimal proliferation and amplified by inflammation, excessive adhesion of cells to activated endothelium, hypercoagulable state, and vascular tone dysregulation. Silent infarcts may occur and are associated with decreased cognitive functions. Transcranial Doppler ultrasonography (TCD) was more recently demonstrated able to achieve early detection of the children at high risk for clinical strokes. A randomized study demonstrated that a first stroke may be prevented by monthly transfusion in children with abnormal TCD, leading to a recommendation for annual TCD screening of children aged between 2 and 16 years and monthly transfusion for those with abnormal results. In children who have had a first stroke, the risk of recurrence is more than 50% and is greatly reduced by chronic transfusion, although not completely abolished. Hematopoietic stem cell transplant is indicated in children with cerebral vasculopathy who have an HLA-identical sibling.

  1. Uric acid levels and their relation to incapacities in acute cerebrovascular disease Los niveles de ácido úrico y su relación con la discapacidad en la fase aguda de la enfermedad cerebrovascular.

    OpenAIRE

    Ricardo Verdecia Fraga; Joan Rojas Fuentes; Julio López Argüelles

    2010-01-01

    Background: cerebrovascular disease and ischemic cardiopathy can be considered as an epidemic and constitute the first cause of incapacities in developed countries. Multiple studies have shown the association between uric acid levels and cerebrovascular diseases. Objective: To correlate the levels of serum uric acid and incapacities in the acute phase of cerebrovascular disease. Methods: A correlational stu...

  2. Acute cerebrovascular incident in a young woman: Venous or arterial stroke? – Comparative analysis based on two case reports

    International Nuclear Information System (INIS)

    Cerebrovascular diseases are the most common neurological disorders. Most of them are arterial strokes, mainly ischemic, less often of hemorrhagic origin. Changes in the course of cerebral venous thrombosis are less common causes of acute cerebrovascular events. Clinical and radiological presentation of arterial and venous strokes (especially in emergency head CT) may pose a diagnostic problem because of great resemblance. However, the distinction between arterial and venous stroke is important from a clinical point of view, as it carries implications for the treatment and determinates patient’s prognosis. In this article, we present cases of two young women (one with an acute venous infarction, the second with an arterial stroke) who presented with similar both clinical and radiological signs of acute vascular incident in the cerebral cortex. We present main similarities and differences between arterial and venous strokes regarding the etiology, clinical symptoms and radiological appearance in various imaging techniques. We emphasize that thorough analysis of CT (including cerebral vessels), knowledge of symptoms and additional clinical information (e.g. risk factors) may facilitate correct diagnosis and allow planning further diagnostic imaging studies. We also emphasize the importance of MRI, especially among young people, in the differential diagnosis of venous and arterial infarcts

  3. Fusiform aneurysm of a persistent primitive trigeminal artery associated with cerebrovascular anatomic variations: a report of two cases.

    Science.gov (United States)

    Pleş, Horia; Loukas, Marios; Andall, Rebecca G; Andall, Naomi R; Iacob, Nicoleta; Miclăuş, GraŢian Dragoslav; Matusz, Petru; Tubbs, R Shane

    2015-01-01

    There are four embryonic anastomoses that exist between the internal carotid artery (ICA) and the vertebrobasilar (VB) system, which may fail to regress postfetal life; one of which is the trigeminal artery. Other persistent anastomoses include those formed by the hypoglossal, otic and proatlantic intersegmental arteries. In addition, other cerebrovascular variations may accompany a persistent primitive trigeminal artery (PPTA); such as arteriovenous malformations, aneurysms, carotid-cavernous fistulas and stenotic cerebral vessels. We present two very rare cases of a left PPTA. In the first case, there was a past medical history significant for cervico-thoraco-lumbar spondylitis and in the second case of an operated occipital astrocytoma. In both cases, the PPTA was associated with a fusiform aneurysm located in the carotidian (lateral) aspect of the PPTA as well as other cerebrovascular anatomic variations. In the first case, the length of the PPTA was 26.0 mm and its endoluminal diameter, at its origin at the ICA, was 1.8 mm; the aneurysm has a length of 8.4 mm. In the second case, the length of the PPTA was 31.0 mm and its endoluminal diameter at its origin at the ICA was 3.0 mm; the aneurysm have a length of 7.6 mm. Identification of these variant vessels should not be ignored before planning and execution of neurosurgeries to prevent possible perioperative risks. PMID:26662153

  4. Impact of age on the cerebrovascular proteomes of wild-type and Tg-SwDI mice.

    Directory of Open Access Journals (Sweden)

    James L Searcy

    Full Text Available The structural integrity of cerebral vessels is compromised during ageing. Abnormal amyloid (Aβ deposition in the vasculature can accelerate age-related pathologies. The cerebrovascular response associated with ageing and microvascular Aβ deposition was defined using quantitative label-free shotgun proteomic analysis. Over 650 proteins were quantified in vessel-enriched fractions from the brains of 3 and 9 month-old wild-type (WT and Tg-SwDI mice. Sixty-five proteins were significantly increased in older WT animals and included several basement membrane proteins (nidogen-1, basement membrane-specific heparan sulfate proteoglycan core protein, laminin subunit gamma-1 precursor and collagen alpha-2(IV chain preproprotein. Twenty-four proteins were increased and twenty-one decreased in older Tg-SwDI mice. Of these, increases in Apolipoprotein E (APOE and high temperature requirement serine protease-1 (HTRA1 and decreases in spliceosome and RNA-binding proteins were the most prominent. Only six shared proteins were altered in both 9-month old WT and Tg-SwDI animals. The age-related proteomic response in the cerebrovasculature was distinctly different in the presence of microvascular Aβ deposition. Proteins found differentially expressed within the WT and Tg-SwDI animals give greater insight to the mechanisms behind age-related cerebrovascular dysfunction and pathologies and may provide novel therapeutic targets.

  5. Rho激酶与缺血性脑血管病%Rho kinase and ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    刘薇薇; 崔桂云; 沈霞

    2009-01-01

    缺血性脑血管病可导致严重的神经功能缺损.甚至死亡.Rho激酶是Rho蛋白的重要下游底物,参与血管平滑肌收缩、细胞迁移、炎症细胞浸润以及血管内皮功能障碍等多种生物学效应,在缺血性脑血管病的发生、发展和梗死体积扩大等过程中起着重要作用.Rho激酶抑制剂可有效舒张痉李血管,减轻局部炎症反应,保护内皮功能,增加缺血区域血流,缩小梗死体积,改善神经功能.%Ischemic cerebrovascular disease may result in severe neurological deficits, and even death. Rho kinase is an important downstream substrate of Rho protein. It involves in multiple biological effects, including vascular smooth muscle contraction, cell migration, inflammatory cell infiltration and vascular endothelial dysfunction. It plays important roles in the processes of the occurrence, development and expansion of infarct volume in ischemic cerebrovascular disease. Rho kinase inhibitor can effectively relax vascular spasm, reduce local inflammatory response, protect endothelial function, increase blood flow in ischemic region, reduce infarct volume, and improve neurological function.

  6. Acute cerebrovascular incident in a young woman: Venous or arterial stroke? – Comparative analysis based on two case reports

    Science.gov (United States)

    Sleiman, Katarzyna; Zimny, Anna; Kowalczyk, Edyta; Sąsiadek, Marek

    2013-01-01

    Summary Background Cerebrovascular diseases are the most common neurological disorders. Most of them are arterial strokes, mainly ischemic, less often of hemorrhagic origin. Changes in the course of cerebral venous thrombosis are less common causes of acute cerebrovascular events. Clinical and radiological presentation of arterial and venous strokes (especially in emergency head CT) may pose a diagnostic problem because of great resemblance. However, the distinction between arterial and venous stroke is important from a clinical point of view, as it carries implications for the treatment and determinates patient’s prognosis. Case Report In this article, we present cases of two young women (one with an acute venous infarction, the second with an arterial stroke) who presented with similar both clinical and radiological signs of acute vascular incident in the cerebral cortex. We present main similarities and differences between arterial and venous strokes regarding the etiology, clinical symptoms and radiological appearance in various imaging techniques. Conclusions We emphasize that thorough analysis of CT (including cerebral vessels), knowledge of symptoms and additional clinical information (e.g. risk factors) may facilitate correct diagnosis and allow planning further diagnostic imaging studies. We also emphasize the importance of MRI, especially among young people, in the differential diagnosis of venous and arterial infarcts. PMID:24505227

  7. Blunt cerebrovascular injury in rugby and other contact sports: case report and review of the literature.

    Science.gov (United States)

    Cuellar, Trajan A; Lottenberg, Lawrence; Moore, Frederick A

    2014-01-01

    Contact sports have long been a part of human existence. The two earliest recorded organized contact games, both of which still exist, include Royal Shrovetide Football played since the 12(th) century in England and Caid played since 1308 AD in Ireland. Rugby is the premier contact sport played throughout the world with the very popular derivative American football being the premier contact sport of the North American continent. American football in the USA has on average 1,205,037 players at the high school and collegiate level per year while rugby in the USA boasts a playing enrollment of 457,983 at all levels. Recent media have highlighted injury in the context of competitive contact sports including their long-term sequelae such as chronic traumatic encephalopathy (CTE) that had previously been underappreciated. Blunt cerebrovascular injury (BCVI) has become a recognized injury pattern for trauma; however, a paucity of data regarding this injury can be found in the sports trauma literature. We present a case of an international level scrum-half playing Rugby Union at club level for a local non-professional team, in which a player sustained a fatal BCVI followed by a discussion of the literature surrounding sport related BCVI. PMID:24872841

  8. Caregiver awareness of cerebrovascular risk of patients with dementia due to Alzheimer's disease in São Paulo, Brazil

    OpenAIRE

    Fabricio Ferreira de Oliveira; Jose Roberto Wajman; Paulo Henrique Ferreira Bertolucci

    2014-01-01

    Background Proper control of cerebrovascular risk is essential to prevent cognitive change in dementia due to Alzheimer’s disease (AD). Objective To investigate whether caregiver awareness to control cerebrovascular risk impacts the lifestyles of patients with AD. Methods Consecutive outpatients with AD were assessed for demographic features, Clinical Dementia Rating scores, cerebrovascular risk, pharmacotherapy, dietary therapy and practice of physical activities. Patients and caregiv...

  9. Reactive Systems

    DEFF Research Database (Denmark)

    Aceto, Luca; Ingolfsdottir, Anna; Larsen, Kim Guldstrand;

    A reactive system comprises networks of computing components, achieving their goals through interaction among themselves and their environment. Thus even relatively small systems may exhibit unexpectedly complex behaviours. As moreover reactive systems are often used in safety critical systems......, the need for mathematically based formal methodology is increasingly important. There are many books that look at particular methodologies for such systems. This book offers a more balanced introduction for graduate students and describes the various approaches, their strengths and weaknesses, and when...... into account. The book has arisen from various courses taught in Denmark and Iceland and is designed to give students a broad introduction to the area, with exercises throughout....

  10. FGF21 represses cerebrovascular aging via improving mitochondrial biogenesis and inhibiting p53 signaling pathway in an AMPK-dependent manner.

    Science.gov (United States)

    Wang, Xiao-Mei; Xiao, Hang; Liu, Ling-Lin; Cheng, Dang; Li, Xue-Jun; Si, Liang-Yi

    2016-08-15

    Cerebrovascular aging has a high relationship with stroke and neurodegenerative disease. In the present study, we evaluated the influence of fibroblast growth factor 21 (FGF21) on angiotensin (Ang II)-mediated cerebrovascular aging in human brain vascular smooth muscle cells (hBVSMCs). Ang II induced remarkable aging-phenotypes in hBVSMCs, including enhanced SA-β-gal staining and NBS1 protein expression. First, we used immunoblotting assay to confirm protein expression of FGF21 receptor (FGFR1) and the co-receptor β-Klotho in cultured hBVSMCs. Second, we found that FGF21 treatment partly prevented the aging-related changes induced by Ang II. FGF21 inhibited Ang II-enhanced ROS production/superoxide anion levels, rescued the Ang II-reduced Complex IV and citrate synthase activities, and suppressed the Ang II-induced meprin protein expression. Third, we showed that FGF21 not only inhibited the Ang II-induced p53 activation, but also blocked the action of Ang II on Siah-1-TRF signaling pathway which is upstream factors for p53 activation. At last, either chemical inhibition of AMPK signaling pathway by a specific antagonist Compound C or knockdown of AMPKα1/2 isoform using siRNA, successfully abolished the anti-aging action of FGF21 in hBVSMCs. These results indicate that FGF21 protects against Ang II-induced cerebrovascular aging via improving mitochondrial biogenesis and inhibiting p53 activation in an AMPK-dependent manner, and highlight the therapeutic value of FGF21 in cerebrovascular aging-related diseases such as stroke and neurodegenerative disease. PMID:27364911

  11. Evaluation of high-pitch dual-source CT angiography for evaluation of coronary and carotid-cerebrovascular arteries

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Kai [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Li, Kuncheng, E-mail: cjr.likuncheng@vip.163.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Han, Ruijuan [Department of Cardiology, Chaoyang Hospital, Capital Medical University, Beijing 100020 (China); Li, Wenhuan; Chen, Nan; Yang, Qi; Du, Xiangying; Wang, Chen [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Liu, Guorong; Li, Yuechun [Department of Neurology Baotou Central Hospital, Inner Mongolia, Baotou 014040 (China); Zhou, Maorong [Department of Radiology, Baotou Central Hospital, Inner Mongolia, Baotou 014040 (China); Li, Ligang; Heidrun, Endt [CT BM Clinic Marketing, Siemens Healthcare, Beijing 100102 (China)

    2015-03-15

    Objectives: To explore the feasibility and diagnostic accuracy of a combined one-step high-pitch dual-source computed tomography angiography (CTA) technique for evaluation of coronary and carotid-cerebrovascular arteries. Materials and methods: 85 symptomatic patients suspected of coronary artery and cerebrovascular disease referred for simultaneous coronary and carotid-cerebrovascular CTA were included. Additional invasive angiography of the coronary and cerebral arteries was performed within 30 days in 23 and 13 patients, respectively. The objective parameters of image quality, the mean CT attenuations, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were evaluated. The subjective image quality of vessels was also assessed by 2 independent radiologists blinded to the patients’ medical history and scan protocols. The diagnostic performance of CTA including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection or exclusion of significant artery stenosis was calculated using the chi-squared test of contingency and correlated with the results of invasive angiography representing the standard of reference. Results: Image quality was rated excellent (score 1) in 95.3% (1074/1127), good (score 2) in 3.3% (37/1127), adequate (score 3) in 1.0% (11/1127), and non-diagnostic (score 4) in 0.4% (5/1127) of coronary segments. Image quality of carotid and cerebral vessels was rated mostly excellent (score 1, 95.12% [78/82]; score 2, 3.66% [3/82]; score 3, 1.22% [1/82]). The sensitivity, specificity, PPV and NPV for the detection of coronary stenosis were 92.2% (81.1–97.7%), 95.2% (91.7–97.5%), 79.6% (67.1–89.1%) and 98.3% (95.8–99.5%), respectively. For the detection of carotid and cerebral artery stenosis, CTA demonstrated a sensitivity of 92.8% (80.5–98.4%), a specificity of 93.5% (88.3–96.8%), a PPV of 79.6% (65.6–89.7%) and a NPV of 97.9% (94.1–99.5%). The effective

  12. Correlation of cerebrovascular reserve as measured by acetazolamide-challenged perfusion CT with collateral circulation in unilateral high grade carotid stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Doran; Lee, Young Hen; Seo, Hyung Suk; Je, Bo Kyoung [Dept. of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Suh, Sang Il; Seol, Hae Young [Dept. of Radiology, Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Jung Hyuk; Lee, Nam Joon [Dept. of Radiology, Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Yang, Kyung Sook [Dept. of Biostatistics, Korea University College of Medicine, Seoul (Korea, Republic of)

    2014-01-15

    We correlated cerebrovascular reserve in unilateral high grade carotid artery stenosis or occlusion with a type of collateral circulation using acetazolamide-challenged perfusion CT (ACZ-PCT). Among the patients who underwent ACZ-PCT in our institution, we retrospectively selected the patients with unilateral high grade internal carotid artery or middle cerebral artery stenosis (> 70%) or occlusion; we verified the types of their dominant collateral circulation by digital subtraction angiography or 3T MR-angiography; first, the primary collaterals flow through the circle of Willis; second, the secondary collaterals that flow through the opthalmic artery, the basal artery or other external carotid artery. Using ACZ-PCT, we measured the difference in percentage change of cerebral blood flow of the stenotic hemisphere against contralateral normal hemisphere and compared cerebrovascular reserves of lesional hemisphere, according to the type of collaterals. A total of 28 patients were included. The percentage changes of cerebral blood flow were significantly lower in the stenotic hemisphere than the contralateral hemisphere (14.34 ± 36.43% and 34.53 ± 47.82%, p < 0.001), and in the hemisphere predominantly supplied by secondary collaterals than primary (7.03 ± 32.71% and 24.37 ± 42.03%, p < 0.05), respectively. Cerebrovascular reserves in the ipsilateral hemisphere predominantly supplied by secondary collaterals were more impaired than primary collaterals in patients with unilateral high grade carotid stenosis or occlusion.

  13. Tratamiento de Terapia Ocupacional en el accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Domingo García, AM

    2006-02-01

    Full Text Available RESUMENEntre los muchos pacientes que necesitan tratamiento rehabilitador en Terapia Ocupacional están los que en la edad adulta han sufrido un accidente cerebrovascular.Uno de los factores de riesgo asociados con más frecuencia a las alteraciones del sistema nervioso central es el progresivo envejecimiento de la población, debido a esto orientaré el siguiente artículo hacia la intervención sobre la población geriátrica.La Terapia Ocupacional ofrece un tratamiento global que abarca las áreas funcional, motriz, sensorial, perceptivo y cognitiva. No debemos olvidar el asesoramiento realizado al paciente, a la familia y/ o cuidadores sobre el manejo de la persona que ha sufrido un ictus, la adaptación del entorno y la prescripción, uso y manejo de ayudas técnicas cuando sea necesario.Las propuestas terapéuticas que expondré a continuación, no son recetas únicas que se puedan emplear del mismo modo en todos las personas que hayan sufrido un ictus. Con cada paciente será necesario una evaluación individualizada de su situación y una adaptación de la terapia según sus déficit específicos.La meta final de la Terapia Ocupacional es la integración óptima del paciente dentro de su entorno familiar y social, con el mayor grado de autonomía posible.ABSTRACTAmong the patients who need Occupational Therapy’s rehabilitation treatment, there are those who have suffered a cerebrovascular damage when elderly.People’s gradual ageing is one of the risk factors in the nervous central system’s alterations and this is why I am going to write about intervention on geriatric population.The Occupational Therapy’s rehabilitation treatment works on the functional, motor, sensorial, perceptive and cognitive areas. Moreover, we should not forget to advise the patient and his/her family or caregivers about the way of treating ,the environment’s adaptation, the prescription and use of technical aids when needed.The following therapeutic

  14. Nonlinear effects of respiration on the crosstalk between cardiovascular and cerebrovascular control systems.

    Science.gov (United States)

    Bari, Vlasta; Marchi, Andrea; De Maria, Beatrice; Rossato, Gianluca; Nollo, Giandomenico; Faes, Luca; Porta, Alberto

    2016-05-13

    Cardiovascular and cerebrovascular regulatory systems are vital control mechanisms responsible for guaranteeing homeostasis and are affected by respiration. This work proposes the investigation of cardiovascular and cerebrovascular control systems and the nonlinear influences of respiration on both regulations through joint symbolic analysis (JSA), conditioned or unconditioned on respiration. Interactions between cardiovascular and cerebrovascular regulatory systems were evaluated as well by performing correlation analysis between JSA indexes describing the two control systems. Heart period, systolic and mean arterial pressure, mean cerebral blood flow velocity and respiration were acquired on a beat-to-beat basis in 13 subjects experiencing recurrent syncope episodes (SYNC) and 13 healthy individuals (non-SYNC) in supine resting condition and during head-up tilt test at 60° (TILT). Results showed that JSA distinguished conditions and groups, whereas time domain parameters detected only the effect of TILT. Respiration affected cardiovascular and cerebrovascular regulatory systems in a nonlinear way and was able to modulate the interactions between the two control systems with different outcome in non-SYNC and SYNC groups, thus suggesting that the analysis of the impact of respiration on cardiovascular and cerebrovascular regulatory systems might improve our understanding of the mechanisms underpinning the development of postural-related syncope.

  15. Nonlinear effects of respiration on the crosstalk between cardiovascular and cerebrovascular control systems

    Science.gov (United States)

    Bari, Vlasta; Marchi, Andrea; De Maria, Beatrice; Rossato, Gianluca; Nollo, Giandomenico; Faes, Luca; Porta, Alberto

    2016-05-01

    Cardiovascular and cerebrovascular regulatory systems are vital control mechanisms responsible for guaranteeing homeostasis and are affected by respiration. This work proposes the investigation of cardiovascular and cerebrovascular control systems and the nonlinear influences of respiration on both regulations through joint symbolic analysis (JSA), conditioned or unconditioned on respiration. Interactions between cardiovascular and cerebrovascular regulatory systems were evaluated as well by performing correlation analysis between JSA indexes describing the two control systems. Heart period, systolic and mean arterial pressure, mean cerebral blood flow velocity and respiration were acquired on a beat-to-beat basis in 13 subjects experiencing recurrent syncope episodes (SYNC) and 13 healthy individuals (non-SYNC) in supine resting condition and during head-up tilt test at 60° (TILT). Results showed that JSA distinguished conditions and groups, whereas time domain parameters detected only the effect of TILT. Respiration affected cardiovascular and cerebrovascular regulatory systems in a nonlinear way and was able to modulate the interactions between the two control systems with different outcome in non-SYNC and SYNC groups, thus suggesting that the analysis of the impact of respiration on cardiovascular and cerebrovascular regulatory systems might improve our understanding of the mechanisms underpinning the development of postural-related syncope.

  16. In-hospital cerebrovascular complications following orthotopic liver transplantation: A retrospective study

    Directory of Open Access Journals (Sweden)

    Liang Zhijian

    2008-12-01

    Full Text Available Abstract Background Cerebrovascular complications are severe events following orthotopic liver transplantation (OLT. This study aimed to observe the clinical and neuroimaging features and possible risk factors of in-hospital cerebrovascular complications in the patients who underwent OLT. Patients and methods We retrospectively reviewed 337 consecutive patients who underwent 358 OLTs. Cerebrovascular complications were determined by clinical and neuroimaging manifestations, and the possible risk factors were analyzed in the patients with intracranial hemorrhage. Results Ten of 337 (3.0% patients developed in-hospital cerebrovascular complications (8 cases experienced intracranial hemorrhage and 2 cases had cerebral infarction, and 6 of them died. The clinical presentations were similar to common stroke, but with rapid deterioration at early stage. The hematomas on brain CT scan were massive, irregular, multifocal and diffuse, and most of them were located at brain lobes and might enlarge or rebleed. Infarcts presented lacunar and multifocal lesions in basal gangliar but with possible hemorrhagic transformation. The patients with intracranial hemorrhage had older age and a more frequency of systemic infection than non-intracranial hemorrhage patients. (P = 0.011 and 0.029, respectively. Conclusion Posttransplant cerebrovascular complications have severe impact on outcome of the patients who received OLT. Older age and systemic infection may be the possible risk factors of in-hospital intracranial hemorrhage following OLT.

  17. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    Energy Technology Data Exchange (ETDEWEB)

    Buch, Karen; Nguyen, Thanh; Norbash, Alex; Mian, Asim [Boston University School of Medicine, Department of Radiology, Boston Medical Center, Boston, MA (United States); Mahoney, Eric; Burke, Peter [Boston University School of Medicine, Department of Surgery, Boston Medical Center, Boston, MA (United States); Libby, Brandon; Calner, Paul [Boston University School of Medicine, Department of Emergency Medicine, Boston Medical Center, Boston, MA (United States)

    2016-02-15

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  18. Relationship between retinal vascular occlusions and incident cerebrovascular diseases: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhou, Yue; Zhu, Wengen; Wang, Changyun

    2016-06-01

    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. Open-Heart surgery and cerebrovascular accident: retrospective study at King Khalid University Hospital

    International Nuclear Information System (INIS)

    Stroke after coronary by-pass grafting (CABG) is often disabling. The incidence of ischemic stroke may approach 3% to 5%. Several risk factors have been identified including previous history of stroke, prolonged cardiopulmonary bypass time, and postoperative atrial fibrillation. Objective was to determine the incidence and risk factors of neurological deficit after open heart surgery. Retrospective study was done during the period 1992-1995 at the King Khalid University Hospital, Riyadh, Saudi Arabia. There were 350 patients who were subjected to (CABG), 10 patients (2.8%) found to suffer from cerebrovascular accidents (CVA) following open-heart surgery. In 8 patients, the complaint lasted more than 24 hours (stroke), while 2 patients developed transient ischemic attacks (TIA). Five factors were found to be associated with increased risk of post cardiac surgery CVA. These factors are postoperative atrial fibrillation, carotid bruit, past history of heart failure, past history of CVA and smoking. The authors concluded that it is necessary to start a prospective study to verify the area of improvement with regards to technique, selection of patients and mode of perfusion during cardiopulmonary bypass (CPB) Arabia. (author)

  20. Antithrombotic therapy for secondary prevention of atherothrombotic events in cerebrovascular disease.

    Science.gov (United States)

    Capodanno, Davide; Alberts, Mark; Angiolillo, Dominick J

    2016-10-01

    Atherothrombosis is the common underlying process for numerous progressive manifestations of cardiovascular disease, including coronary artery disease (CAD) and cerebrovascular disease (CVD). Antiplatelet therapy is the cornerstone of pharmacological management in patients with atherothrombosis. Over the past 20 years, major advances in antiplatelet pharmacotherapy have been made, particularly for the treatment of patients with CAD. The treatment of patients with concomitant CAD and CVD is complex, owing to their increased risk of both ischaemia and bleeding. When CVD arises from large artery atherosclerosis, antithrombotic therapies are essential to prevent stroke or transient ischaemic attack (TIA). However, the use of antithrombotic medications in patients with CVD can put them at high risk of intracranial haemorrhage. As such, the risk-benefit profile of various combinations of antiplatelet agents in patients with both CAD and CVD is uncertain. This Review provides a state-of-the-art account of the available evidence on antithrombotic therapies for the secondary prevention of atherothrombotic events in patients with concomitant CAD and CVD, particularly those with a history of noncardioembolic stroke or TIA.

  1. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    International Nuclear Information System (INIS)

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  2. Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know.

    Science.gov (United States)

    Thomas, Grace; Kloner, Robert A; Rezkalla, Shereif

    2014-01-01

    Marijuana is the most widely used illicit drug, with approximately 200 million users worldwide. Once illegal throughout the United States, cannabis is now legal for medicinal purposes in several states and for recreational use in 3 states. The current wave of decriminalization may lead to more widespread use, and it is important that cardiologists be made aware of the potential for marijuana-associated adverse cardiovascular effects that may begin to occur in the population at a greater frequency. In this report, the investigators focus on the known cardiovascular, cerebrovascular, and peripheral effects of marijuana inhalation. Temporal associations between marijuana use and serious adverse events, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis have been described. In conclusion, the potential for increased use of marijuana in the changing legal landscape suggests the need for the community to intensify research regarding the safety of marijuana use and for cardiologists to maintain an awareness of the potential for adverse effects. PMID:24176069

  3. Postprandial hyperglycemia and cerebrovascular diseases%餐后高血糖与脑血管病

    Institute of Scientific and Technical Information of China (English)

    辛家厚; 周农

    2009-01-01

    Postprandial hyperglycemia is a risk factor for atherosclerosis and cerebro-vascular diseases. This article reviews the mechanisms of cerebrovascular diseases caused by postprandial hyperglycemia from aspects of postprandial hyperglycemia participating in the pathophysiological mechanisms of atherosclerosis, and the relations between postprandial hyperglycemia and cerebrovascular diseases.%餐后血糖升高是动脉粥样硬化和脑血管病的危险因素.文章分别从餐后高血糖参与动脉粥样硬化的病理生理学机制、餐后高血糖与脑血管病的关系及其病理生理学机制等方面,综述了餐后高血糖引起脑血管病的机制.

  4. Acupuncture and Cupping for Treatment of Hiccup in Cases of Cerebrovascular Accident

    Institute of Scientific and Technical Information of China (English)

    Xie Hongliang; Cao Xuemei; Huang Shizhao; Liao Chaofeng

    2006-01-01

    Objective:To observe the therapeutic effects of acupuncture and cupping for hiccup in cases of cerebrovascular accident.Method:80 cases of hiccup due to cerebrovascular accident were randomly divided into the treatment group of 40 cases treated by acupuncture and cupping and the control group of 40 cases treated with Ritaline.Result:In the treatment group,24 cases were cured,8 cases markedly effective,5 cases improved,and 3 cases failed,with a total effective rate of 92.5%.In the control group,9 cases were cured,12 cases markedly effective,8 cases improved,and 11 cases failed,with a total effective rate of 72.5%.There was a statistically significant difference in the therapeutic effects between the two groups(μ=3.3259,P=0.0009).Conclusion:The effect of acupuncture and cupping for hiccup due to cerebrovascular accident was noticeably superior to Ritaline.

  5. The relationship between cerebrovascular disease and homocysteine, folate and vitamin B12 in serum

    International Nuclear Information System (INIS)

    To investigate the relationship between cerebrovascular disease and the serum levels of homocysteine(Hcy), folate and vitamin B12, the serum levels of Hcy, folate and vitamin B12 in 148 patients with cerebrovascular disease were measured by fluorescence polarization immuno- assay and chemiluminescence and were compared with those in healthy controls. The result showed that the serum Hcy levels in patients with cerebral infarction, cerebral hemorrhage and vertebrobasilar ischemiay were significantly higher than those in healthy controls (P12 levels were signifieantly lower (P0.05). No significantly higher ratio of increased Hcy levels was observed in patient with complications (P> 0.05). Our conclusion is that hyperhomocysteinemia may be a new and an independent risk factor for cerebrovascular disease. The serum Hcy level is correlated with decreased levels of folate and vitamin B12 but not obviously correlated with hypertension, diabetes and coronary heart disease. (authors)

  6. Beyond Volume: Hospital-Based Healthcare Technology for Better Outcomes in Cerebrovascular Surgical Patients Diagnosed With Ischemic Stroke: A Population-Based Nationwide Cohort Study From 2002 to 2013.

    Science.gov (United States)

    Kim, Jae-Hyun; Park, Eun-Cheol; Lee, Sang Gyu; Lee, Tae-Hyun; Jang, Sung-In

    2016-03-01

    We examined whether the level of hospital-based healthcare technology was related to the 30-day postoperative mortality rates, after adjusting for hospital volume, of ischemic stroke patients who underwent a cerebrovascular surgical procedure. Using the National Health Insurance Service-Cohort Sample Database, we reviewed records from 2002 to 2013 for data on patients with ischemic stroke who underwent cerebrovascular surgical procedures. Statistical analysis was performed using Cox proportional hazard models to test our hypothesis. A total of 798 subjects were included in our study. After adjusting for hospital volume of cerebrovascular surgical procedures as well as all for other potential confounders, the hazard ratio (HR) of 30-day mortality in low healthcare technology hospitals as compared to high healthcare technology hospitals was 2.583 (P technology hospitals with high volume as compared to high healthcare technology hospitals with high volume was the highest (10.014, P technology hospitals had the highest 30-day mortality rate, irrespective of hospital volume. Although results of our study provide scientific evidence for a hospital volume/30-day mortality rate relationship in ischemic stroke patients who underwent cerebrovascular surgical procedures, our results also suggest that the level of hospital-based healthcare technology is associated with mortality rates independent of hospital volume. Given these results, further research into what components of hospital-based healthcare technology significantly impact mortality is warranted.

  7. Tomography methods for diagnostic examination of cerebrovascular disease: a comparative evaluation of SPECT, PET and MR/CT findings

    International Nuclear Information System (INIS)

    Single Photon Emissions Computerized Tomography (SPECT), Positron Emissions Tomography (PET), Magnetic Resonance Tomography (MR), and Transmission Computerized Tomography (CT) complement each other and lead to a consideration of the cerebrovascular disease under patho-physiological aspects. Indications for the combined application of functionally oriented (SPECT/PET) and morphologically oriented (CT/MR) examination methods with cerebrovascular disease are presented. (orig./MG)

  8. Serum C-Reactive Protein Level as a Biomarker for Differentiation of Ischemic from Hemorrhagic Stroke

    OpenAIRE

    Seyed Ali Roudbary; Farshid Saadat; Kambiz Forghanparast; Reza Sohrabnejad

    2011-01-01

    Cerebrovascular accidents rank first in the frequency and importance among all neurological disease. Although a number of studies had shown increased level of the high sensitive C-reactive protein (hs-CRP) in patients with ischemic stroke, the association of increased hs-CRP with various type of stroke especially the assessment hs-CRP level in ischemic and hemorrhagic stroke have not been investigated. In the present study, we assessed the concentration of hs-CRP in patients with documented i...

  9. Radioiodine therapy increases the risk of cerebrovascular events in hyperthyroid and euthyroid patients

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Jensen, Lars Thorbjoern; Vej-Hansen, Anders;

    2015-01-01

    BACKGROUND AND OBJECTIVE: Hyperthyroid patients treated with radioiodine have increased morbidity and mortality from cerebrovascular events. This risk has until now has been attributed to the hyperthyroidism. However, radioiodine therapy of benign thyroid diseases exposes the carotid arteries...... with radioiodine between 1975 and 2008 were matched 1:4 on age and sex with random controls. The cohort was followed from the date of treatment until hospitalization due to cerebrovascular event, death, 20 years of follow-up or March 2013. Data were analyzed in competing risk models adjusting for age, sex...

  10. Lack of CAR impacts neuronal function and cerebrovascular integrity in vivo.

    Science.gov (United States)

    Boussadia, Baddreddine; Gangarossa, Giuseppe; Mselli-Lakhal, Laila; Rousset, Marie-Claude; de Bock, Frederic; Lassere, Frederic; Ghosh, Chaitali; Pascussi, Jean-Marc; Janigro, Damir; Marchi, Nicola

    2016-09-01

    Nuclear receptors (NRs) are a group of transcription factors emerging as players in normal and pathological CNS development. Clinically, an association between the constitutive androstane NR (CAR) and cognitive impairment was proposed, however never experimentally investigated. We wished to test the hypothesis that the impact of CAR on neurophysiology and behavior is underlined by cerebrovascular-neuronal modifications. We have used CAR(-/-) C57BL/6 and wild type mice and performed a battery of behavioral tests (recognition, memory, motor coordination, learning and anxiety) as well as longitudinal video-electroencephalographic recordings (EEG). Brain cell morphology was assessed using 2-photon or electron microscopy and fluorescent immunohistochemistry. We observed recognition memory impairment and increased anxiety-like behavior in CAR(-/-) mice, while locomotor activity was not affected. Concomitantly to memory deficits, EEG monitoring revealed a decrease in 3.5-7Hz waves during the awake/exploration and sleep periods. Behavioral and EEG abnormalities in CAR(-/-) mice mirrored structural changes, including tortuous fronto-parietal penetrating vessels. At the cellular level we found reduced ZO-1, but not CLDN5, tight junction protein expression in cortical and hippocampal isolated microvessel preparations. Interestingly, the neurotoxin kainic acid, when injected peripherally, provoked a rapid onset of generalized convulsions in CAR(-/-) as compared to WT mice, supporting the hypothesis of vascular permeability. The morphological phenotype of CAR(-/-) mice also included some modifications of GFAP/IBA1 glial cells in the parenchymal or adjacent to collagen-IV(+) or FITC(+) microvessels. Neuronal defects were also observed including increased cortical NEUN(+) cell density, hippocampal granule cell dispersion and increased NPY immunoreactivity in the CA1 region in CAR(-/-) mice. The latter may contribute to the in vivo phenotype. Our results indicate that behavioral

  11. Lack of CAR impacts neuronal function and cerebrovascular integrity in vivo.

    Science.gov (United States)

    Boussadia, Baddreddine; Gangarossa, Giuseppe; Mselli-Lakhal, Laila; Rousset, Marie-Claude; de Bock, Frederic; Lassere, Frederic; Ghosh, Chaitali; Pascussi, Jean-Marc; Janigro, Damir; Marchi, Nicola

    2016-09-01

    Nuclear receptors (NRs) are a group of transcription factors emerging as players in normal and pathological CNS development. Clinically, an association between the constitutive androstane NR (CAR) and cognitive impairment was proposed, however never experimentally investigated. We wished to test the hypothesis that the impact of CAR on neurophysiology and behavior is underlined by cerebrovascular-neuronal modifications. We have used CAR(-/-) C57BL/6 and wild type mice and performed a battery of behavioral tests (recognition, memory, motor coordination, learning and anxiety) as well as longitudinal video-electroencephalographic recordings (EEG). Brain cell morphology was assessed using 2-photon or electron microscopy and fluorescent immunohistochemistry. We observed recognition memory impairment and increased anxiety-like behavior in CAR(-/-) mice, while locomotor activity was not affected. Concomitantly to memory deficits, EEG monitoring revealed a decrease in 3.5-7Hz waves during the awake/exploration and sleep periods. Behavioral and EEG abnormalities in CAR(-/-) mice mirrored structural changes, including tortuous fronto-parietal penetrating vessels. At the cellular level we found reduced ZO-1, but not CLDN5, tight junction protein expression in cortical and hippocampal isolated microvessel preparations. Interestingly, the neurotoxin kainic acid, when injected peripherally, provoked a rapid onset of generalized convulsions in CAR(-/-) as compared to WT mice, supporting the hypothesis of vascular permeability. The morphological phenotype of CAR(-/-) mice also included some modifications of GFAP/IBA1 glial cells in the parenchymal or adjacent to collagen-IV(+) or FITC(+) microvessels. Neuronal defects were also observed including increased cortical NEUN(+) cell density, hippocampal granule cell dispersion and increased NPY immunoreactivity in the CA1 region in CAR(-/-) mice. The latter may contribute to the in vivo phenotype. Our results indicate that behavioral

  12. Cerebrovascular Diseases and Risk Factors: a Strategy of Primary Prevention Factores de riesgo y enfermedad cerebrovascular: una estrategia de prevención primaria

    OpenAIRE

    Rubén Bembibre Taboada; Miguel Angel Buergo Zuaznábar

    2007-01-01

    Cerebrovascular diseases constitute a health problem worldwide and have the tendency to grow up. Chronic diseases sometimes are considered transmissible diseases at a level of risk factors. The alimentary habits and the levels of physical activity at present are risk behaviors which are spread all over the world passing from one population to another as an infectious disease with incidence in the morbidity profiles worldwide. While age and sex as well as genetic vulnerability are no modifiabl...

  13. What Is Reactive Arthritis?

    Science.gov (United States)

    ... Arthritis PDF Version Size: 69 KB November 2014 What is Reactive Arthritis? Fast Facts: An Easy-to- ... Information About Reactive Arthritis and Other Related Conditions What Causes Reactive Arthritis? Sometimes, reactive arthritis is set ...

  14. 77 FR 24949 - Reactive Power Resources; Supplemental Notice Requesting Comments

    Science.gov (United States)

    2012-04-26

    ... ] reactive power resources, including synchronous and asynchronous generation resources, transmission... methods used to determine the reactive power requirements for a transmission system and how system...

  15. Cardiomyopathy and Cerebrovascular Accident Associated with Anabolic-Androgenic Steroid Use.

    Science.gov (United States)

    Mochizuki, Ronald M.; Richter, Kenneth J.

    1988-01-01

    A case report is presented of a 32 year-old male bodybuilder who sustained an ischemic cerebrovascular accident and showed signs of cardiomyopathy. Although no cause was found, the man had been taking steroids for 16 years. Harmful effects of steroid use are discussed. (IAH)

  16. Rare cerebrovascular anomalies in a patient with Cornelia De Lange Syndrome

    Directory of Open Access Journals (Sweden)

    Jesse Jones

    2015-01-01

    Conclusion: Advance knowledge of cerebrovascular variants associated with CDL may help interventionalists prepare to approach such cases. Additionally, further inquiry into the function of proteins encoded by genes associated with CDL could better our understanding of vascular development in the brain.

  17. Effects of hyperglycemia on the cerebrovascular response to rhythmic handgrip exercise

    NARCIS (Netherlands)

    Y.S. Kim; R. Krogh-Madsen; P. Rasmussen; P. Plomgaard; S. Ogoh; N.H. Secher; J.J. van Lieshout

    2007-01-01

    Dynamic cerebral autoregulation (CA) is challenged by exercise and may become less effective when exercise is exhaustive. Exercise may increase arterial glucose concentration, and we evaluated whether the cerebrovascular response to exercise is affected by hyperglycemia. The effects of a hyperinsuli

  18. Long-Term Exposure to Ambient Air Pollution and Incidence of Cerebrovascular Events

    DEFF Research Database (Denmark)

    Stafoggia, Massimo; Cesaroni, Giulia; Peters, Annette;

    2014-01-01

    BACKGROUND: Few studies have investigated effects of air pollution on the incidence of cerebrovascular events. OBJECTIVES: We assessed the association between long-term exposure to multiple air pollutants and the incidence of stroke in European cohorts. METHODS: Data from 11 cohorts were collecte...

  19. Impaired dynamic cerebrovascular response to hypercapnia predicts development of white matter hyperintensities

    Directory of Open Access Journals (Sweden)

    Kevin Sam

    2016-01-01

    Conclusions: Vascular impairment in regions of NAWM that progresses to WMH consists not only of decreased magnitude of ssCVR, but also a pathological decrease in the speed of vascular response. These findings support the association between cerebrovascular dysregulation and the development of WMH.

  20. Awake craniotomy in a patient with ejection fraction of 10%: considerations of cerebrovascular and cardiovascular physiology.

    Science.gov (United States)

    Meng, Lingzhong; Weston, Stephen D; Chang, Edward F; Gelb, Adrian W

    2015-05-01

    A 37-year-old man with nonischemic 4-chamber dilated cardiomyopathy and low-output cardiac failure (estimated ejection fraction of 10%) underwent awake craniotomy for a low-grade oligodendroglioma resection under monitored anesthesia care. The cerebrovascular and cardiovascular physiologic challenges and our management of this patient are discussed.

  1. The role of inflammation and interleukin-1 in acute cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Galea J

    2013-08-01

    Full Text Available James Galea,1 David Brough21Manchester Academic Health Sciences Center, Brain Injury Research Group, Clinical Sciences Building, Salford Royal Foundation Trust, Salford, UK; 2Faculty of Life Sciences, University of Manchester, AV Hill Building, Manchester, UKAbstract: Acute cerebrovascular disease can affect people at all stages of life, from neonates to the elderly, with devastating consequences. It is responsible for up to 10% of deaths worldwide, is a major cause of disability, and represents an area of real unmet clinical need. Acute cerebrovascular disease is multifactorial with many mechanisms contributing to a complex pathophysiology. One of the major processes worsening disease severity and outcome is inflammation. Pro-inflammatory cytokines of the interleukin (IL-1 family are now known to drive damaging inflammatory processes in the brain. The aim of this review is to discuss the recent literature describing the role of IL-1 in acute cerebrovascular disease and to provide an update on our current understanding of the mechanisms of IL-1 production. We also discuss the recent literature where the effects of IL-1 have been targeted in animal models, thus reviewing potential future strategies that may limit the devastating effects of acute cerebrovascular disease.Keywords: cerebral ischemia, stroke, inflammation, microglia, interleukin-1, caspase-1

  2. A novel distinctive cerebrovascular phenotype is associated with heterozygous Arg179 ACTA2 mutations

    NARCIS (Netherlands)

    Munot, Pinki; Saunders, Dawn E.; Milewicz, Dianna M.; Regalado, Ellen S.; Ostergaard, John R.; Braun, Kees P.; Kerr, Timothy; Lichtenbelt, Klaske D.; Philip, Sunny; Rittey, Christopher; Jacques, Thomas S.; Cox, Timothy C.; Ganesan, Vijeya

    2012-01-01

    Mutations in the ACTA2 gene lead to diffuse and diverse vascular diseases; the Arg179His mutation is associated with an early onset severe phenotype due to global smooth muscle dysfunction. Cerebrovascular disease associated with ACTA2 mutations has been likened to moyamoya disease, but appears to h

  3. Promotor polymorphisms in leukotriene C4 synthase and risk of ischemic cerebrovascular disease

    DEFF Research Database (Denmark)

    Freiberg, J.J.; Tybjaerg-Hansen, A.; Sillesen, H.;

    2008-01-01

    OBJECTIVE: Cysteinyl leukotrienes are involved in inflammation and possibly in early carotid atherosclerosis. We tested the hypothesis that the -444 A/C and -1072 G/A polymorphisms of the leukotriene C(4) synthase associate with risk of ischemic cerebrovascular disease. METHODS AND RESULTS: We ge...

  4. An ontological modeling approach to cerebrovascular disease studies : The NEUROWEB case

    NARCIS (Netherlands)

    Colombo, Gianluca; Merico, Daniele; Boncoraglio, Giorgio; De Paoli, Flavio; Ellul, John; Frisoni, Giuseppe; Nagy, Zoltan; van der Lugt, Aad; Vassanyi, Istvan; Antoniotti, Marco

    2010-01-01

    The NEUROWEB project supports cerebrovascular researchers' association studies, intended as the search for statistical correlations between a feature (e.g., a genotype) and a phenotype. In this project the phenotype refers to the patients' pathological state, and thus it is formulated on the basis o

  5. Dichotic auditory-verbal memory in adults with cerebro-vascular accident

    Directory of Open Access Journals (Sweden)

    Samaneh Yekta

    2014-01-01

    Full Text Available Background and Aim: Cerebrovascular accident is a neurological disorder involves central nervous system. Studies have shown that it affects the outputs of behavioral auditory tests such as dichotic auditory verbal memory test. The purpose of this study was to compare this memory test results between patients with cerebrovascular accident and normal subjects.Methods: This cross-sectional study was conducted on 20 patients with cerebrovascular accident aged 50-70 years and 20 controls matched for age and gender in Emam Khomeini Hospital, Tehran, Iran. Dichotic auditory verbal memory test was performed on each subject.Results: The mean score in the two groups was significantly different (p<0.0001. The results indicated that the right-ear score was significantly greater than the left-ear score in normal subjects (p<0.0001 and in patients with right hemisphere lesion (p<0.0001. The right-ear and left-ear scores were not significantly different in patients with left hemisphere lesion (p=0.0860.Conclusion: Among other methods, Dichotic auditory verbal memory test is a beneficial test in assessing the central auditory nervous system of patients with cerebrovascular accident. It seems that it is sensitive to the damages occur following temporal lobe strokes.

  6. Prevalence and Incidence of Myocardial Infarction and Cerebrovascular Accident in Ageing Persons with Intellectual Disability

    Science.gov (United States)

    Jansen, J.; Rozeboom, W.; Penning, C.; Evenhuis, H. M.

    2013-01-01

    Background: Epidemiological information on age-related cardiovascular disease in people with intellectual disability (ID) is scarce and inconclusive. We compared prevalence and incidence of cerebrovascular accident and myocardial infarction over age 50 in a residential population with ID to that in a general practice population. Method: Lifetime…

  7. Elevated cardiac troponin I predicts cardiovascular or cerebrovascular events in hypertensive patients

    International Nuclear Information System (INIS)

    Objective: Whether elevated cTnI is associated with cardiovascular or cerebrovascular events in patients with hypertension (HT) without left ventricular(LV) systolic dysfunction is not clear. Method: We measured cTnI serum level in 170 patients with essential HT without LV systolic dysfunction (LVEF 55%),renal failure,and prior cardiovascular or cerebrovascular diseases. Besides, control group of 40 normal presons was established and following up (45±38)months. Results: Level of cTnI was elevated (≥0.04 ng/ml) in 15 (8.8%) of the 170 patients and in 0 (0%) of the 40 normal controls. The rate of diabetes mellitus(DM), the cardiothoracic ratio, serum NT-proBNP value, and LV mass index were significantly higher in patients with than without elevated cTnI (DM, 9/15 versus 25/155, P2, P=0.0001). Kaplan-Meier analysis demonstrated that significantly fewer (P<0.000001) patients with, than without elevated cTnI remained free of events (hospitalization due to cardiovascular or cerebrovascular disease). Stepwise Cox multivariate analysis revealed that elevated cTnT (hazard ratio, 6.59, P=0.000001) and smoking (hazard ratio, 2.26, P=0.04) were independent predictors of events. Conclusion: The present findings indicate that cTnI is a biomarker and useful predictor of future cardiovascular or cerebrovascular events in hypertensive patients. (authors)

  8. Endothelial dysfunction in development of cerebrovascular disorders in patients with diabetes mellitus

    OpenAIRE

    Evgeniya Pavlovna Kosobyan; Ivona Renata Yarek-Martynova; Mikhail Yur'evich Martynov; Alla Nikolaevna Yasamanova; Tat'yana Ivanovna Kolesnikova

    2012-01-01

    Endothelial dysfunction and aberrations of haemostasis play an important part in development of cerebrovascular disorders in patients with diabetes mellitus. Such factors as hyper- and hypoglycemia, hyperinsulinism, insulin resistance and excessive weight affect progression of microcirculation deficiency and cerebral ischemia. Transcranial Doppler ultrasound examination is useful as a noninvasive method of hemodynamic assessment.

  9. Factors associated with delayed intracerebral hemorrhage after superficial temporal artery-middle cerebral artery bypass in stenoocclusive cerebrovascular diseases

    Institute of Scientific and Technical Information of China (English)

    Mao Zhiqi; Li Meng; William A.Li; Yu Xinguang

    2014-01-01

    Background Intra-cerebral hemorrhage (ICH) is a devastating complication that can result from superficial temporal artery-middle cerebral artery (STA-MCA) bypass in patients undergoing treatment for steno-occlusive cerebrovascular disease (CVD).There is a clinical need to find the possible risk factors to prevent ICH,as it is a significant cause of mortality and morbidity.The aim of the study was to investigate the factors associated with delayed ICH after STA-MCA bypass in patients with steno-occlusive CVDs.Methods We retrospectively analyzed the records of 163 patients seen from 2002 to 2011 with STA-MCA bypass for steno-occlusive cerebrovascular diseases at the Department of Neurosurgery,Xuan Wu Hospital,Beijing.Demographic and clinical data,including age,gender,vascular risk factors,preoperative syndrome,preoperative National Institutes of Health Stroke Scale (NIHSS),ipsilateral ischemic lesions,classification of steno-occlusive CVDs,donor branches of STA,graft patency,postoperative hypertension,and postoperative-increased MCA velocity were recorded and analyzed.Binary Logistic regression served to identify factors associated with delayed ICH after STA-MCA bypass.Results We identified 8 (4.9%) patients with delayed ICH after STA-MCA bypass.Patients with hypertension,preoperative stroke,ipsilateral ischemic lesions,postoperative hypertension and postoperative-increased MCA velocity were significantly more prone to experiencing delayed ICH after STA-MCA bypass.Logistic regression analysis shows ipsilateral ischemic lesions,postoperative hypertension,and postoperative-increased MCA velocity remained independent predictors for delayed ICH after STA-MCA bypass.Conclusion Despite the varied associated factors in patients with steno-occlusive CVDs,ipsilateral ischemic lesions,postoperative hypertension,and postoperative-increased MCA velocity could be associated with delayed ICH after STAMCA bypass.

  10. Clinical and Paraclinical Findings of Cerebrovascular Accidents in Children Admitted to Pediatric Medical Center from 1993 till 2003

    Directory of Open Access Journals (Sweden)

    M Dehghani

    2011-10-01

    Full Text Available Introduction: Stroke is a clinical diagnosis which brings up cerebrovascular diseases. Stroke includes any cerebrovascular accident which leads to local neural defect and lasts more than 24 hours. Stroke has severe and irreversible complications and high rates of recurrence after first episode, therefore we decided to study clinical and paraclinical findings of this disease for better diagnosis and prevention of it. Methods: We prepared a case series study to review medical files of the patients admitted to pediatric medical center with the diagnosis of CVA between 1993 and 2003. 19 patients were assessed in this study. Results: Their mean age was 5.72 (SD=3.801. Among clinical signs hemiparesis was the most common finding (89.5%. Vital signs were normal except for two patients with low-grade fever or hypertension. Such cardiac diseases as cardiomyopathy, valvular disorder, d-TGA, and congestive heart failure were common predisposing factors. According to CT scan reports, 6 patients (31.6% suffered from deep ischemic stroke, and 5 (21.3%, and 2 patients (10.5% suffered from superficial ischemic stroke and and hemorrhagic stroke, respectively. 2 patients manifested signs of both superficial and deep ischemic stroke. One of them suffered from Moyamoys syndrome and the other was a known case of MELAS (mitochondrial encepholomyopaty lactic acidosis syndrome. CBC was the most important abnormal test. Conclusion: According to this study, congenital heart diseases are the most common cause of stroke in children. Stroke in children is not frequently associated with vital signs change, and deep ischemic stroke is the most common type of the stroke in children.

  11. Significance of ultrasound evaluation of carotid atherosclerotic plaque for diagnosing ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease.Therefore, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease.OBJECTIVE: This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic.DESIGN: Clinical randomized concurrent control experiment.SETTING: Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects.METHODS: The plaque thickness of mid portion, distal end and crotch of common carotid artery (CCA),internal carotid artery (ICA), external carotid artery (ECA) and vertebral artery (VA) of involved subjects,who received health examination was separately detected with color Doppler ultrasonograph (HDI-5000).Then, total integral of plaque was calculated. The intima-media thickness (IMT) was measured with two-dimensional ultrasonography. The inner diameter

  12. Epidemiologia dos acidentes cerebrovasculares em Joinville, Brasil: estudo institucional Epidemiology of cerebrovascular disease in Joinville, Brazil: an institutional study

    Directory of Open Access Journals (Sweden)

    Norberto L. Cabral

    1997-09-01

    Full Text Available A carência de dados epidemiológicos e a impressão prévia de elevada incidência de acidente vascular cerebral (AVC no Brasil criou o estímulo para estudo institucional prospectivo em Joinville. No período de 1-março-1995 a 1-março-1996, avaliamos o primeiro episódio e episódios recorrentes em AVC, incidência, mortalidade, taxa de fatalidade-caso em 30 dias (letalidade, freqüência de fatores de risco, tempo para admissão hospitalar e distribuição dos infartos cerebrais por subtipos patológicos. Registramos 429 pacientes no período, 320 destes com primeiro episódio. Tomografia de crânio foi realizada em 98% dos casos. A taxa de incidência anual ajustada por idade em primeiro episódio de AVC foi de 156/100000. A distribuição por diagnóstico foi: 73,4% para infarto cerebral, 18.4% para hemorragia cerebral e 7,5% para hemorragia subaracnóide. A taxa de mortalidade anual padronizada foi 25/100000. A letalidade foi 26%. Hipertensão, AVC prévio e diabetes foram os fatores de risco mais freqüentes. Somente 25% dos pacientes chegaram ao hospital nas primeiras três horas iniciais. Concluímos que a taxa de incidência em primeiro episódio de AVC em pacientes institucionalizados em Joinville, Brasil, é elevada. A taxa de mortalidade e letalidade são similares as de outras populações.The paucity of epidemiologic data, and the previous impression of high incidence of cerebrovascular disease in Brazil, made us elaborate a prospective institutional study in Joinville, Brazil, with the objective of identifying first and recurrent episodes in stroke. This study occurred from March 1995 to March 1996. We evaluated during the first episode of stroke: incidence, mortality and fatality-case rate (in 30 days letality, frequency of risk factor, time in hospital and distribution of cerebral infarcts by pathological subtypes. In this period, 429 patients with stroke were registered, 320 with the first episode. 98% of all the patients

  13. Diffusion tensor imaging of the brain in patients with Alzheimer's disease and cerebrovascular lesions

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-qiong; KANG Zhuang; HU Xi-quan; HU Bing; ZOU Yan

    2007-01-01

    Background: Recent autopsy study showed a high incidence ofcerebrovascular lesions in Alzheimer's disease (AD).To assess the impact of cerebrovascular pathology in AD, we used diffusion tensor imaging (DTI) to study AD patients with and without cerebrovascular lesions. Materials and Methods: Conventional and DTI scans were obtained from 10 patients with probable AD, 10 AD/V patients (probable AD with cerebrovascular lesions) and ten normal controls. Mean diffusivity (D) and fractional anisotropy (FA) values of some structures involved with AD pathology were measured. Results: D value was higher in AD patients than in controls in hippocampus and the cingulate gyrus. In AD/V patients, increased D value was found in the same structures and also in the thalamus and basal ganglia compared to controls. There was a significant difference of D value between AD and AD/V patients. FA value reduced in the white matter of left inferior temporal gyrus and in the bilateral middle cingulate gyrus in patients with AD/V compared with controls. The MMSE (mini-mental state examination) score significantly correlated with FA value in the right hippocampus (r=0.639, P<0.019), in the right anterior cingulate gyrus (r=0.587, P<0.035) and in left parahippocampal gyrus (r=0.559, P<0.047). Conclusion: Cerebrovascular pathology had stronger impact on the D value than the AD pathology alone did. Elevated D value in thalamic and basal ganglia may contribute to cognitive decline in AD/V patients.Reduced FA values in AD/V patients may indicate that cerebrovascular pathology induced more severe white matter damage than the AD pathology alone did.

  14. Environmental Air Pollution and Acute Cerebrovascular Complications: An Ecologic Study in Tehran, Iran

    Science.gov (United States)

    Nabavi, Seyed Massood; Jafari, Batoul; Jalali, Mozhgan Sadat; Nedjat, Saharnaz; Ashrafi, Khosro; Salahesh, Alireza

    2012-01-01

    Background: In this study, we aimed to assess the association between air pollution and cerebrovascular complications in Tehran, one of the most air-polluted cities in the world, among different subgroups of patients with stroke in 2004. Methods: In this ecologic study, we calculated the daily average levels of different air pollutants including CO, NOX, SO2, O3, and PM10 and also humidity and temperature on the day of stroke and 48 hours prior to stroke in 1 491 patients admitted with the diagnosis of stroke in eight referral hospitals in different areas of Tehran. Then, we evaluated the association between the rate of stroke admissions and the level of the selected pollutants, humidity, and temperature on the day of stroke and 48 hours prior to stroke among different subgroups of patients. Results: There was no significant association between the same-day level of the pollutants and the rate of stroke admissions, but an association was seen for their level 48 hours before stroke. These associations differed among different subgroups of age, sex, history of underlying diseases, and type of stroke. Same-day temperature had a reverse association in patients with hemorrhagic stroke and in patients without a history of heart disease or previous stroke. A direct significant association was seen for humidity level 48 hours before stroke in patients with a history of heart disease. Conclusions: It is inferred that air pollution has a direct association with the incidence of stroke and these association differs among different subgroups of patients. The results of this study are not time-dependant and can be generalized to different times and regions. Moreover, these results may be useful for environmental health policy makers. PMID:23112900

  15. APOE genotype and MRI markers of cerebrovascular disease: systematic review and meta-analysis

    International Nuclear Information System (INIS)

    We aimed to examine the association of APOE ε genotype with MRI markers of cerebrovascular disease (CVD): white matter hyper intensities, brain infarcts, and cerebral micro-bleeds. We performed a systematic review and meta-analysis of 42 cross-sectional or longitudinal studies identified in PubMed from 1966 to June 2012 (n = 29,965). This included unpublished data from 3 population-based studies: 3C-Dijon, Framingham Heart Study, and Sydney Memory and Ageing Study. When necessary, authors were contacted to provide effect estimates for the meta-analysis. APOE ε4 carrier status and APOE ε44 genotype were associated with increasing white matter hyperintensity burden (sample size-weighted z score meta-analysis [meta]-p = 0.0034 and 0.0030) and presence of cerebral micro-bleeds (meta odds ratio [OR] = 1.24, 95% confidence interval [CI] [1.07, 1.43], p = 0.004, and 1.87 [1.26, 2.78], p = 0.002), especially lobar. APOE ε2 carrier status was associated with increasing white matter hyperintensity load (z score meta-p = 0.00053) and risk of brain infarct (meta OR = 1.41[1.09, 1.81], p = 0.008). APOE ε4 and APOE ε2 were associated with increasing burden in MRI markers for both hemorrhagic and ischemic CVD. While the association of APOE ε4 with an increased burden of CVD could be partly contributing to the relationship between APOE ε4 and AD, APOE ε2 was associated with MRI markers of CVD in the opposite direction compared to AD. (authors)

  16. Cerebral angiography, blood flow and vascular reactivity in progressive hypertension

    Science.gov (United States)

    Li, Yunxia; Shen, Qiang; Huang, Shiliang; Li, Wei; Muir, Eric R.; Long, Justin; Duong, Timothy Q.

    2015-01-01

    Chronic hypertension alters cerebral vascular morphology, cerebral blood flow (CBF), cerebrovascular reactivity, increasing susceptibility to neurological disorders. This study evaluated: i) the lumen diameters of major cerebral and downstream arteries using magnetic resonance angiography, and ii) basal CBF, and iii) cerebrovascular reactivity to hypercapnia of multiple brain regions using arterial-spin-labeling technique in spontaneously hypertensive rats (SHR) at different stages. Comparisons were made with age-matched normotensive Wistar Kyoto (WKY) rats. In 10-week SHR, lumen diameter started to reduce, basal CBF, and hypercapnic CBF response were higher from elevated arterial blood pressure, but there was no evidence of stenosis, compared to age-matched WKY. In 20-week SHR, lumen diameter remained reduced, CBF returned toward normal from vasoconstriction, hypercapnic CBF response reversed and became smaller, but without apparent stenosis. In 40-week SHR, lumen diameter remained reduced and basal CBF further decreased, resulting in larger differences compared to WKY. There was significant stenosis in main supplying cerebral vessels. Hypercapnic CBF response further decreased, with some animals showing negative hypercapnic CBF responses in some brain regions, indicative of compromised cerebrovascular reserve. The territory with negative hypercapnia CBF responses corresponded with the severity of stenosis in arteries that supplied those territories. We also found enlargement of downstream vessels and formation of collateral vessels as compensatory responses to vasoconstriction upstream vessels. The middle cerebral and azygos arteries were amongst the most susceptible to hypertension-induced changes. Multimodal MRI provides clinically relevant data that might be useful to characterize disease pathogenesis, stage disease progression, and monitor treatment effects in hypertension. PMID:25731987

  17. Meta-analysis of 5,10-methylenetetrahydrofolate reductase gene polymorphism as a risk factor for ischemic cerebrovascular disease in a Chinese Han population

    Institute of Scientific and Technical Information of China (English)

    Hua Bai

    2011-01-01

    OBJECTIVE: To assess whether 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism(-genotype or T allele) is a risk factor for ischemic cerebrovascular disease (ICVD).DATA SOURCES: MEDLINE and PubMed databases from September 1997 to December 2009 were searched for case-control studies that examined MTHFR genotype in human ICVD using "MTHFR, gene, polymorphism, and ischemic cerebrovascular disease" as search kev words.J I UU T JCLCU I 1Urv: cigmeen associatea stuaies were identified.1 he methods used to collect relevant information factors were similar between case and control groups, and diagnosis of ischemic cerebrovascular disease was in accordance with Trial of ORG 10172 in Acute Stroke Treatment criteria classification, with some referring to European Stroke Diagnostic Criteria.Quality of all included studies was evaluated, and meta-analysis was conducted using RevMan4.2 software (Cochrane Collaboration, http://www.cochrane-handbook.orq) following strict screenina.MAIN UU r UUMt MLAJUrrts: I ne correlation Detween M 1 Hi-H gene I I genotype or T allele and ICVD was determined.RESULTS: Eighteen studies involving 4 295 patients with ICVD and 6 169 control subjects were included for this meta-analysis.There was a significant difference in MTHFR gene TT aenotvoe or T auele frequency(X2=15.31, 9.156, P U.U5) in the Uhinese Han population.CONCLUSION: Results from the present meta-analysis suggested that the MTHFR gene TT genotype or T allele is a risk factor for ICVD.However, the-genotype or T allele is not a risk factor for ICVD in the Chinese Han population.

  18. Quantitative Measurement of Cerebrovascular Reactivity by Blood Oxygen Level-Dependent MR Imaging in Patients with Intracranial Stenosis : Preoperative Cerebrovascular Reactivity Predicts the Effect of Extracranial-Intracranial Bypass Surgery

    NARCIS (Netherlands)

    Mandell, D. M.; Han, J. S.; Poublanc, J.; Crawley, A. P.; Fierstra, J.; Tymianski, M.; Fisher, J. A.; Mikulis, D. J.

    2011-01-01

    BACKGROUND AND PURPOSE: CVR is a measure of cerebral hemodynamic impairment. A recently validated technique quantifies CVR by using a precise CO2 vasodilatory stimulus and BOLD MR imaging. Our aim was to determine whether preoperative CO2 BOLD CVR predicts the hemodynamic effect of ECIC bypass surge

  19. Usefulness of preoperative coronary angiography and brain computed tomography in cases of coronary artery disease and cerebrovascular disease undergoing revascularization for arteriosclerosis obliterans

    Energy Technology Data Exchange (ETDEWEB)

    Sakurada, Tall; Shibata, Yoshiki [Southern Tohoku Fukushima Hospital (Japan)

    2003-05-01

    Coronary angiography and brain computed tomography were preoperatively performed to evaluate the clinical condition of coronary artery disease and cerebrovascular disease in 101 patients (mean age, 68.4 years) with revascularization for arteriosclerosis obliterans. Eighty patients had hypertension, 12 had diabetes, and 26 had hyperlipidemia. Seventy-one patients (70.3%) had coronary stenosis. Significant stenoses in major coronary artery branches were confirmed in 35 patients, including 13 patients with old myocardial infarction. Coronary artery bypass grafting and percutaneous coronary angioplasty were performed in 2 and 7 patients with critical stenosis, respectively. Of 57 patients, who underwent brain computed tomography, abnormalities were found in 52 patients (91.2%), including cortical infarction in 9, lacunar infarction in 35, and leukoaraiosis in 27 patients. During the follow-up period 13 patients died (including 3 cases of myocardial infarction and 3 cases of stroke). Actuarial survival rate at 5 years was 80.4%. The influence of ischemic heart disease and cerebrovascular disease on early and late mortality after surgical reconstruction for peripheral occlusive vascular disease is significant. Using visual diagnostic techniques, such as coronary angiography and brain computed tomography, long term survivor should be closely observed for multiple arteriosclerotic vascular diseases. (author)

  20. Usefulness of preoperative coronary angiography and brain computed tomography in cases of coronary artery disease and cerebrovascular disease undergoing revascularization for arteriosclerosis obliterans

    International Nuclear Information System (INIS)

    Coronary angiography and brain computed tomography were preoperatively performed to evaluate the clinical condition of coronary artery disease and cerebrovascular disease in 101 patients (mean age, 68.4 years) with revascularization for arteriosclerosis obliterans. Eighty patients had hypertension, 12 had diabetes, and 26 had hyperlipidemia. Seventy-one patients (70.3%) had coronary stenosis. Significant stenoses in major coronary artery branches were confirmed in 35 patients, including 13 patients with old myocardial infarction. Coronary artery bypass grafting and percutaneous coronary angioplasty were performed in 2 and 7 patients with critical stenosis, respectively. Of 57 patients, who underwent brain computed tomography, abnormalities were found in 52 patients (91.2%), including cortical infarction in 9, lacunar infarction in 35, and leukoaraiosis in 27 patients. During the follow-up period 13 patients died (including 3 cases of myocardial infarction and 3 cases of stroke). Actuarial survival rate at 5 years was 80.4%. The influence of ischemic heart disease and cerebrovascular disease on early and late mortality after surgical reconstruction for peripheral occlusive vascular disease is significant. Using visual diagnostic techniques, such as coronary angiography and brain computed tomography, long term survivor should be closely observed for multiple arteriosclerotic vascular diseases. (author)

  1. The relationship between cerebrovascular complications and previously established use of antiplatelet therapy in left-sided infective endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, Ulrika; Rasmussen, Rasmus Vedby; Hassager, Christian;

    2011-01-01

    Cerebrovascular complications (CVC) in infective endocarditis (IE) are common. The only established treatments to reduce the incidence of CVC in IE are antibiotics and in selected cases early cardiac surgery. Potential effects of previously established antiplatelet therapy are under debate....

  2. A Tariff for Reactive Power

    Energy Technology Data Exchange (ETDEWEB)

    Kueck, John D [ORNL; Kirby, Brendan J [ORNL; Li, Fangxing [ORNL; Tufon, Christopher [Pacific Gas and Electric Company; Isemonger, Alan [California Independent System Operator

    2008-07-01

    Two kinds of power are required to operate an electric power system: real power, measured in watts, and reactive power, measured in volt-amperes reactive or VARs. Reactive power supply is one of a class of power system reliability services collectively known as ancillary services, and is essential for the reliable operation of the bulk power system. Reactive power flows when current leads or lags behind voltage. Typically, the current in a distribution system lags behind voltage because of inductive loads such as motors. Reactive power flow wastes energy and capacity and causes voltage droop. To correct lagging power flow, leading reactive power (current leading voltage) is supplied to bring the current into phase with voltage. When the current is in phase with voltage, there is a reduction in system losses, an increase in system capacity, and a rise in voltage. Reactive power can be supplied from either static or dynamic VAR sources. Static sources are typically transmission and distribution equipment, such as capacitors at substations, and their cost has historically been included in the revenue requirement of the transmission operator (TO), and recovered through cost-of-service rates. By contrast, dynamic sources are typically generators capable of producing variable levels of reactive power by automatically controlling the generator to regulate voltage. Transmission system devices such as synchronous condensers can also provide dynamic reactive power. A class of solid state devices (called flexible AC transmission system devices or FACTs) can provide dynamic reactive power. One specific device has the unfortunate name of static VAR compensator (SVC), where 'static' refers to the solid state nature of the device (it does not include rotating equipment) and not to the production of static reactive power. Dynamic sources at the distribution level, while more costly would be very useful in helping to regulate local voltage. Local voltage regulation would

  3. Reactive Oxygen Species, Endoplasmic Reticulum Stress and Mitochondrial Dysfunction: The Link with Cardiac Arrhythmogenesis

    Science.gov (United States)

    Tse, Gary; Yan, Bryan P.; Chan, Yin W. F.; Tian, Xiao Yu; Huang, Yu

    2016-01-01

    Background: Cardiac arrhythmias represent a significant problem globally, leading to cerebrovascular accidents, myocardial infarction, and sudden cardiac death. There is increasing evidence to suggest that increased oxidative stress from reactive oxygen species (ROS), which is elevated in conditions such as diabetes and hypertension, can lead to arrhythmogenesis. Method: A literature review was undertaken to screen for articles that investigated the effects of ROS on cardiac ion channel function, remodeling and arrhythmogenesis. Results: Prolonged endoplasmic reticulum stress is observed in heart failure, leading to increased production of ROS. Mitochondrial ROS, which is elevated in diabetes and hypertension, can stimulate its own production in a positive feedback loop, termed ROS-induced ROS release. Together with activation of mitochondrial inner membrane anion channels, it leads to mitochondrial depolarization. Abnormal function of these organelles can then activate downstream signaling pathways, ultimately culminating in altered function or expression of cardiac ion channels responsible for generating the cardiac action potential (AP). Vascular and cardiac endothelial cells become dysfunctional, leading to altered paracrine signaling to influence the electrophysiology of adjacent cardiomyocytes. All of these changes can in turn produce abnormalities in AP repolarization or conduction, thereby increasing likelihood of triggered activity and reentry. Conclusion: ROS plays a significant role in producing arrhythmic substrate. Therapeutic strategies targeting upstream events include production of a strong reducing environment or the use of pharmacological agents that target organelle-specific proteins and ion channels. These may relieve oxidative stress and in turn prevent arrhythmic complications in patients with diabetes, hypertension, and heart failure. PMID:27536244

  4. Cerebrovascular responsiveness to steady-state changes in end-tidal CO2 during passive heat stress

    OpenAIRE

    Low, DA; Wingo, JE; Keller, DM; Davis, SL; Zhang, R.; Crandall, CG

    2008-01-01

    This study tested the hypothesis that passive heat stress alters cerebrovascular responsiveness to steady-state changes in end-tidal CO2 (PetCO2). Nine healthy subjects (4 men and 5 women), each dressed in a water-perfused suit, underwent normoxic hypocapnic hyperventilation (decrease PetCO2 ~20 Torr) and normoxic hypercapnic (increase in PetCO2 ~9 Torr) challenges under normothermic and passive heat stress conditions. The slope of the relationship between calculated cerebrovascular conductan...

  5. Blood pressure, risk of ischemic cerebrovascular and ischemic heart disease, and longevity in alpha(1)-antitrypsin deficiency

    DEFF Research Database (Denmark)

    Dahl, Morten; Tybjaerg-Hansen, Anne; Sillesen, Henrik;

    2003-01-01

    Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity.......Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity....

  6. Risk of cerebrovascular events in persons with and without HIV: a Danish nationwide population-based cohort study

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Engsig, Frederik N; Christensen, Hanne;

    2011-01-01

    To assess the risk of cerebrovascular events (CVEs) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, HAART and family-related risk factors.......To assess the risk of cerebrovascular events (CVEs) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, HAART and family-related risk factors....

  7. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery

    DEFF Research Database (Denmark)

    Tully, Phillip J; Winefield, Helen R; Baker, Robert A;

    2015-01-01

    BACKGROUND: Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretical...... anhedonia, anxious arousal and general distress/negative affect symptom dimensions. Incident MACCE was defined as fatal or non-fatal; myocardial infarction, unstable angina pectoris, repeat revascularization, heart failure, sustained arrhythmia, stroke or cerebrovascular accident, left ventricular failure...

  8. Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy-confirmed Alzheimer’s disease

    OpenAIRE

    Bangen, Katherine J.; Nation, Daniel A.; Delano-Wood, Lisa; Weissberger, Gali H.; Hansen, Lawrence A.; Galasko, Douglas R.; Salmon, David P.; Bondi, Mark W.

    2014-01-01

    We examined the relationships of ante-mortem vascular risk factors to post-mortem cerebrovascular and AD pathologies. Eighty-four AD patients underwent assessment of vascular risk (blood pressure, cholesterol, smoking, cardiovascular disease, diabetes, atrial fibrillation, transient ischemic attack [TIA] or stroke) and later underwent brain autopsy. Given our aim to examine mild cerebrovascular changes (CVC), individuals were excluded if autopsy revealed large stroke. The most common forms of...

  9. Central Respiratory Chemosensitivity and Cerebrovascular CO[subscript 2] Reactivity: A Rebreathing Demonstration Illustrating Integrative Human Physiology

    Science.gov (United States)

    MacKay, Christina M.; Skow, Rachel J.; Tymko, Michael M.; Boulet, Lindsey M.; Davenport, Margie H.; Steinback, Craig D.; Ainslie, Philip N.; Lemieux, Chantelle C. M.; Day, Trevor A.

    2016-01-01

    One of the most effective ways of engaging students of physiology and medicine is through laboratory demonstrations and case studies that combine 1) the use of equipment, 2) problem solving, 3) visual representations, and 4) manipulation and interpretation of data. Depending on the measurements made and the type of test, laboratory demonstrations…

  10. Apolipoprotein E gene polymorphism in cerebrovascular diseases of the Chinese Naxi populations from Yunnan province

    Institute of Scientific and Technical Information of China (English)

    Hong Xu; Qihong Yuan; Xijun Fan; Guoqiang He

    2011-01-01

    Currently it is not well known whether apolipoprotein E (ApoE) is a genetic susceptibility factor for cerebrovascular diseases in the Chinese Naxi population. The present study detected and sequenced ApoE polymorphisms of 90 patients with cerebrovascular diseases (58 cases of cerebral infarction and 32 cases of intracerebral hemorrhage), and 50 normal people of Naxi nationality from Yunnan province, China. The populations were used to analyze the relationship of ApoE polymorphisms with cerebral infarction and intracerebral hemorrhage. Results showed an association between ApoE gene polymorphism and the onset of cerebral infarction, and a possibility that the ε4 allele is a susceptibility locus for the risk of cerebral infarction. However, there was no evidence of a relationship between the ApoE gene polymorphism and cerebral hemorrhage.

  11. Assessment of Vitamin D level in Cerebrovascular Accident Patients in Eastern India

    OpenAIRE

    Kaushik Chatterjee; Sanjay Kumar Mandal; Sumanta Chatterjee; Pankaj sarkar; Soumya Sarathi Mondal; Jacky Ganguly; Debasis Sardar; Siddhartha Mani; Binod Das

    2014-01-01

    Aims and objectives: Vitamin D in addition to its effect on bone- mineral homeostasis has many extra-skeletal effects. Recently its association with cardiovascular disease, diabetes, hypertension are well described. In our study we have tried to find out any of its association with cerebrovascular accident (CVA) patients. Material and Methods: In a cross sectional study serum 25 OH vitamin D3, parathormone, calcium and phosphate were estimated in 38 CVA patients and 46 age and sex match...

  12. Delayed diagnosis of a cerebrovascular accident associated with anabolic steroid use

    OpenAIRE

    Cooper, Isabelle; Reeve, Nina; Doherty, Warren

    2011-01-01

    The authors report a case of atherosclerotic stroke in a 46-year-old recreational bodybuilder with a 20 year history of anabolic-adrenergic steroid (AAS) abuse. Cerebrovascular accident (CVA) occurred during his third week of hospital admission for an acute abdomen and on day 8, postemergency laparotomy. CVA presented with collapse, generalised seizures, reduced Glasgow Coma Score and severe hypertension. He was subsequently admitted to the intensive care unit (ICU), where initial investigati...

  13. Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

    OpenAIRE

    Snygg-Martin, U.; Rasmussen, R. V.; Hassager, C; Bruun, N. E.; Andersson, R.; Olaison, L.

    2010-01-01

    Abstract Anticoagulant therapy has been anticipated to increase the risk of cerebrovascular complications (CVC) in native valve endocarditis (NVE). This study investigates the relationship between ongoing oral anticoagulant therapy and the incidence of symptomatic CVC in left-sided NVE. In a prospective cohort study, the CVC incidence was compared between NVE patients with and without ongoing warfarin. Among 587 NVE episodes, 48 (8%) occurred in patients on warfarin. A symptomatic ...

  14. Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents

    OpenAIRE

    Purushothaman, Suja; Salmani, Deepalaxmi; Prarthana, Kaleramma Gopalakrishna; Bandelkar, Srinidhi Muddanna Gundappa; Varghese, Sarah

    2014-01-01

    Background: Its being long recognized about the highly debilitating and destructive nature of cerebrovascular accidents (CVAs). Around the world CVAs has posed as a major factor in medical morbidity and mortality. It has thrown up challenges with regards to their medical management and also towards posttreatment rehabilitation. It is well-known that neurologic disorder contributes variously towards varied electrocardiogram (ECG) changes and stroke is no exception. Objective: To study the ECG ...

  15. Risk of Cerebrovascular Events in Pneumoconiosis Patients: A Population-based Study, 1996-2011.

    Science.gov (United States)

    Chuang, Chieh-Sen; Ho, Shang-Chang; Lin, Cheng-Li; Lin, Ming-Chia; Kao, Chia-Hung

    2016-03-01

    Pneumoconiosis is a parenchymal lung disease that develops through the inhalation of inorganic dust at work. Cerebrovascular and cardiovascular events are leading causes of mortality and adult disability worldwide. This retrospective cohort study investigated the association between pneumoconiosis, and cerebrovascular and cardiovascular events by using a nationwide population-based database in Taiwan. The data analyzed in this study was retrieved from the Taiwan National Health Insurance Research Database. We selected 6940 patients with pneumoconiosis from the database as our study cohort. Another 27,760 patients without pneumoconiosis were selected and matched with those with pneumoconiosis according to age and sex as the comparison cohort. We used univariate and multivariate Cox proportional-hazard regression analyses to determine the association between pneumoconiosis and the risk of cerebrovascular and cardiovascular events after adjusting for medical comorbidities. After adjustment for age, sex, and comorbidities, the patients with pneumoconiosis exhibited a significantly higher incidence of ischemic stroke (hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.05-1.24) than did those without pneumoconiosis. The incidence of hemorrhagic stroke was higher, but not significant, in the pneumoconiosis patients (HR 1.20, 95% CI 0.99-1.46). No statistically significant differences were observed between the pneumoconiosis and nonpneumoconiosis groups in acute coronary syndrome (HR 1.10, 95% CI 0.95-1.26). The findings of this study reveal an association between pneumoconiosis and a higher risk of cerebrovascular events after adjustment for comorbidities. Healthcare providers should control the related risk factors for primary prevention of stroke in pneumoconiosis patients. PMID:26945404

  16. PIXE analysis of trace elements in hair and their correlation with acute cerebrovascular diseases

    International Nuclear Information System (INIS)

    The PIXE (proton induced X-ray emission) technique has been used to analyze trace elements in more than 200 human hair samples from 60 patients with acute cerebrovascular diseases and 28 normal controls. Trace element differences in hair between the patients and the normal controls have been observed. A Van de Graaff accelerator and a Si(Li) semiconductor at Institute of Nuclear Science and Technology of Sichuan University were used. (author)

  17. Brain MRI hyperintense lesions and cerebrovascular risk factors in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Iidaka, Tetsuya (Kanto Teishin Hospital, Tokyo (Japan))

    1993-04-01

    It is known that asymptomatic MRI lesions of the brain are found in elderly subjects, but the significance of the lesions has not been determined. In previous reports, the prevalence of MRI lesions varied from 11% to 59%, but many of the authors indicated a close relationship with cerebrovascular risk factors. We evaluated 76 elderly subjects (over 60 years old, average age [+-]SD was 66.7[+-]4.5) without a history of cerebrovascular disease and dementia, and determined the prevalence of periventricular (PVH), white matter (WMH) and pontine (PH) hyperintensity and risk factors. The severity of MRI lesion was evaluated in T2-weighted images by Fazekas' scoring method of MRI hyperintense lesions. PVH, WMH and PH were graded visually from 0 to 3 by the author and these points are added to the MRI score. In T1-weighted images, we also measured the diameter of the third ventricle, frontal horn and body of the lateral ventricle. Our results were that 62% of subjects had PVH, 64% had WMH and 8% had PH. In regard to risk factors, 38% of subjects had hypertension, 17% had diabetes mellitus, 8% had ischemic heart disease. The PVH (+) group was significantly older (p<0.01) and had larger lateral ventricles (p<0.05) than the PVH (-) group. The WMH (+) group was significantly older (p<0.05) and had higher risk of cerebrovascular disease (0.05) than the WMH (-) group. The MRI score was related, but not significantly, to a history of hypertension, diabetes mellitus and ischemic heart disease. The MRI score and index of ventricular enlargement correlated with age (p<0.05). In conclusion, PVH was related to aging and cerebrovascular risk factors. Therefore, PVH and WMH were suspected to have different pathogenesis and WMH was more closely related to risk factors. Our scoring method permits evaluation and comparison of MRI lesions of different groups. (author).

  18. Brain MRI hyperintense lesions and cerebrovascular risk factors in the elderly

    International Nuclear Information System (INIS)

    It is known that asymptomatic MRI lesions of the brain are found in elderly subjects, but the significance of the lesions has not been determined. In previous reports, the prevalence of MRI lesions varied from 11% to 59%, but many of the authors indicated a close relationship with cerebrovascular risk factors. We evaluated 76 elderly subjects (over 60 years old, average age ±SD was 66.7±4.5) without a history of cerebrovascular disease and dementia, and determined the prevalence of periventricular (PVH), white matter (WMH) and pontine (PH) hyperintensity and risk factors. The severity of MRI lesion was evaluated in T2-weighted images by Fazekas' scoring method of MRI hyperintense lesions. PVH, WMH and PH were graded visually from 0 to 3 by the author and these points are added to the MRI score. In T1-weighted images, we also measured the diameter of the third ventricle, frontal horn and body of the lateral ventricle. Our results were that 62% of subjects had PVH, 64% had WMH and 8% had PH. In regard to risk factors, 38% of subjects had hypertension, 17% had diabetes mellitus, 8% had ischemic heart disease. The PVH (+) group was significantly older (p<0.01) and had larger lateral ventricles (p<0.05) than the PVH (-) group. The WMH (+) group was significantly older (p<0.05) and had higher risk of cerebrovascular disease (0.05) than the WMH (-) group. The MRI score was related, but not significantly, to a history of hypertension, diabetes mellitus and ischemic heart disease. The MRI score and index of ventricular enlargement correlated with age (p<0.05). In conclusion, PVH was related to aging and cerebrovascular risk factors. Therefore, PVH and WMH were suspected to have different pathogenesis and WMH was more closely related to risk factors. Our scoring method permits evaluation and comparison of MRI lesions of different groups. (author)

  19. Searching of the peripheric arterial disease in which patient have cerebrovascular event

    OpenAIRE

    Kanar, Rayiha Görkem

    2012-01-01

    Arteriosclerotic disease a systemic disease. Arteriosclerotic disease may affect more than one region in vascular system. In the presence of risk factors of arteriosclerosis; clinical manifestations will emerge depending on organ involvement. The aim of our study is searching the association of peripheral artery disease and determining related risk factors in patients who had cerebrovascular event. This study was performed by Cardiovascular Surgery Department of Trakya Universty Faculty of Me...

  20. High prevalence of peripheral arterial disease in patients with previous cerebrovascular or coronary event

    DEFF Research Database (Denmark)

    Mehlsen, Jesper; Wiinberg, Niels; Joergensen, Bjarne S;

    2010-01-01

    The presence of peripheral arterial disease (PAD) in patients with other manifestations of cardiovascular disease identifies a population at increased risk of complications both during acute coronary events and on a long-term basis and possibly a population in whom secondary prevention of cardiov...... of cardiovascular events should be addressed aggressively. The present study was aimed at providing a valid estimate on the prevalence of PAD in patients attending their general practitioner and having previously suffered a cardio- or cerebrovascular event....

  1. Plasma homocysteine, Alzheimer and cerebrovascular pathology: a population-based autopsy study

    Science.gov (United States)

    Polvikoski, Tuomo; Kivipelto, Miia; Tanskanen, Maarit; Myllykangas, Liisa; Erkinjuntti, Timo; Mäkelä, Mira; Oinas, Minna; Paetau, Anders; Scheltens, Philip; van Straaten, Elizabeth C. W.; Sulkava, Raimo; Solomon, Alina

    2013-01-01

    several potential confounders, including common vascular risk factors. No relationships between homocysteine and cerebral macro- or microinfarcts, cerebral amyoloid angiopathy or α-synuclein pathology were detected. These results suggest that elevated homocysteine in adults aged ≥85 years may contribute to increased Alzheimer-type pathology, particularly neurofibrillary tangles burden. This effect seems to be more pronounced in the presence of cerebrovascular pathology. Randomized controlled trials are needed to determine the impact of homocysteine-lowering treatments on dementia-related pathology. PMID:23983028

  2. Loss-of-function mutation in ABCA1 and risk of Alzheimer's disease and cerebrovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, Liv Tybjærg; Tybjærg-Hansen, Anne; Nordestgaard, Børge G;

    2015-01-01

    -brain barrier via apoE-mediated pathways. METHODS: We tested whether a loss-of-function mutation in ABCA1, N1800H, is associated with plasma levels of apoE and with risk of Alzheimer's disease (AD) in 92,726 individuals and with risk of cerebrovascular disease in 64,181 individuals. RESULTS: N1800H AC (0.......2%) versus AA (99.8%) was associated with a 13% lower plasma level of apoE (P = 1 × 10(-11)). Multifactorially adjusted hazard ratios for N1800H AC versus AA were 4.13 (95% confidence interval, 1.32-12.9) for AD, 2.46 (1.10-5.50) for cerebrovascular disease, and 8.28 (2.03-33.7) for the hemorrhagic stroke...... subtype. DISCUSSION: A loss-of-function mutation in ABCA1, present in 1:500 individuals, was associated with low plasma levels of apoE and with high risk of AD and cerebrovascular disease in the general population....

  3. Cuidado popular de familias con un adulto mayor sobreviviente del primer accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Lucero López-Díaz

    2016-01-01

    Full Text Available Introducción: el accidente cerebrovascular afecta a numerosas personas en el mundo y se constituye en la principal causa de muer- te. Los sobrevivientes pueden padecer discapacidad y sufrir modificaciones en las actividades cotidianas. La familia es el principal apoyo del sobreviviente y al ser parte de una misma cultura, construye acciones de cuidado en búsqueda del bienestar. Objetivo: describir las acciones del cuidado popular de las familias con un adulto mayor sobreviviente del primer accidente cerebrovascular. Método: estudio etnográfico, con observación participante y entrevistas en profundidad. Participaron siete familias bogotanas (siete adultos mayores entre los dos y diez meses posteriores al primer accidente cerebrovascular y los siete cuidadores principales respectivos. Resultados: cuidadores y adulto mayor comparten acciones de cuidado para la recuperación, relacionadas con la alimentación, el cuidado personal y la ingesta de medicamentos permeadas por la creencia religiosa, fuente de soporte y vínculo afectivo. Conclusión: conocer el cuidado popular de esta población posibilita proponer acciones culturalmente congruentes con sus valores y creencias para potencializar las ca- pacidades familiares e intermediar en los procesos de tratamiento.

  4. The Emerging Role of Ferumoxytol-Enhanced MRI in the Management of Cerebrovascular Lesions

    Directory of Open Access Journals (Sweden)

    David Hasan

    2013-08-01

    Full Text Available Inflammation is increasingly being understood to be a key component to the pathophysiology of cerebrovascular lesions. Ferumoxytol, an iron oxide nanoparticle coated by a carbohydrate shell, has been used in MRI studies as an inflammatory marker because it is cleared by macrophages. Ferumoxytol-enhanced MRI has emerged as an important tool for noninvasive assessment of the inflammatory status of cerebrovascular lesions, namely aneurysms and arteriovenous malformations. Moreover, preliminary evidence suggests that ferumoxytol-enhanced MRI could be applied as a non-invasive tool to differentiate “unstable” lesions that require early intervention from “stable” lesions in which observation may be safe. Assessment of the effects of anti-inflammatory pharmacological interventions on cerebrovascular lesions is also a potentially crucial application of the technique. Future improvements in technique and MRI signal quantification will certainly pave the way for widespread and efficient use of ferumoxytol-enhanced MRI in clinical practice. In this paper, we review current data regarding ferumoxytol-enhanced MRI and discuss its current/potential applications and future perspectives.

  5. Genetic stabilization of transthyretin, cerebrovascular disease, and life expectancy

    DEFF Research Database (Denmark)

    Hornstrup, Louise S; Frikke-Schmidt, Ruth; Nordestgaard, Børge G;

    2013-01-01

    Transthyretin can cause amyloidosis attributable to destabilization of transthyretin tetramers in plasma. We tested the hypothesis that genetic stabilization of transthyretin associates with reduced risk of vascular disease and increased life expectancy. APPROACH AND RESULTS: We included 68 602 p...

  6. A study of cerebral hemodynamics in various cerebrovascular disorders by means of rCBF measurement with single photon emission computed tomography

    International Nuclear Information System (INIS)

    Using single photon emission computed tomography (SPECT) with Xe-133 inhalation method, regional cerebral blood flow (rCBF) was measured for the purpose of analyzing the pathophysiology of various cerebrovascular disorders. Included in this series were 38 normal volunteers (N), 72 patients with ischemic cerebrovascular disease (ICD), 16 with subarachnoid hemorrhage (SAH), 9 with arteriovenous malformation (AVM), 6 with Moyamoya disease (MD), and 4 with hypertensive intracerebral hematoma (HIH). In the N group, rCBF was independent of sex and laterality. Increased rCBF was observed in the frontal region, as compared with other regions. A significantly increased rCBF was observed in the thirties decade of life; the difference in rCBF was, however, not statistically significant above the age of 30 years. In the ICD group, rCBF decreased in association with severer disorder. In cases of severe disorder, a significantly decreased rCBF was observed in the whole area, as compared with the control group. SPECT allowed early detection of decreased rCBF due to vaso-spasm in the SAH group. The groups of AVM, MD, and HIH showed decreased rCBF in the surrounding areas of the lesions. (Namekawa, K.)

  7. Alterations of cerebral blood flow and cerebrovascular reserve in patients with chronic traumatic brain injury accompanying deteriorated intelligence

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate alterations of regional cerbral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunctin in patients with chronic traumatic brain injury (TBI) and normal brain MRI findings. Thirty TBI patients and 19 healthy volunteers underwent rest/acetazolaminde brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM '97). CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities. In patients with lower performance scale scores, CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a part of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal lobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.=20

  8. Multifunctional reactive nanocomposite materials

    Science.gov (United States)

    Stamatis, Demitrios

    Many multifunctional nanocomposite materials have been developed for use in propellants, explosives, pyrotechnics, and reactive structures. These materials exhibit high reaction rates due to their developed reaction interfacial area. Two applications addressed in this work include nanocomposite powders prepared by arrested reactive milling (ARM) for burn rate modifiers and reactive structures. In burn rate modifiers, addition of reactive nanocomposite powders to aluminized propellants increases the burn rate of aluminum and thus the overall reaction rate of an energetic formulation. Replacing only a small fraction of aluminum by 8Al·MoO3 and 2B·Ti nanocomposite powders enhances the reaction rate with little change to the thermodynamic performance of the formulation; both the rate of pressure rise and maximum pressure measured in the constant volume explosion test increase. For reactive structures, nanocomposite powders with bulk compositions of 8Al·MoO3, 12Al·MoO3, and 8Al·3CuO were prepared by ARM and consolidated using a uniaxial die. Consolidated samples had densities greater than 90% of theoretical maximum density while maintaining their high reactivity. Pellets prepared using 8Al·MoO3 powders were ignited by a CO2 laser. Ignition delays increased at lower laser powers and greater pellet densities. A simplified numerical model describing heating and thermal initiation of the reactive pellets predicted adequately the observed effects of both laser power and pellet density on the measured ignition delays. To investigate the reaction mechanisms in nanocomposite thermites, two types of nanocomposite reactive materials with the same bulk compositions 8Al·MoO3 were prepared by different methods. One of the materials was manufactured by ARM and the other, so called metastable interstitial composite (MIC), by mixing of nano-scaled individual powders. Clear differences in the low-temperature redox reactions, welldetectable by differential scanning calorimetry

  9. Headache associated with transient or permanent cerebrovascular disease

    OpenAIRE

    Hamdy, S.M.; Barrada, H.O.; Fahmy, M.S.; Samir, H.

    2002-01-01

    Headache is a common symptom in stroke, however the frequency, location, duration and other characteristics of the patients who developed headache during stroke are difficult to define. We studied headache characteristics in patients with first-ever acute stroke (hemorrhagic or ischemic) or transient ischemic attack (TIA) and assessed the relationship between headache, stroke location, and etiology. The study included 104 consecutive patients (mean age 55.8±0.8 years; range, 40–70 years) admi...

  10. Plasticity of cerebrovascular smooth muscle cells after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Edvinsson, Lars; Larsen, Stine Schmidt; Maddahi, Aida;

    2014-01-01

    Subarachnoid hemorrhage (SAH) is most often followed by a delayed phase of cerebral ischemia which is associated with high morbidity and mortality rates. The causes underlying this delayed phase are still unsettled, but are believed to include cerebral vasospasm, cortical spreading depression, in...... signaling involved in the vascular plasticity is discussed with a focus on the Raf-MEK1/2-ERK1/2 pathway which seems to play a crucial role in SAH pathology....

  11. Heterogeneous Impact of ROCK2 on Carotid and Cerebrovascular Function.

    Science.gov (United States)

    De Silva, T Michael; Kinzenbaw, Dale A; Modrick, Mary L; Reinhardt, Lindsey D; Faraci, Frank M

    2016-09-01

    Rho kinase (ROCK) has been implicated in physiological and pathophysiological processes, including regulation of vascular function. ROCK signaling is thought to be a critical contributor to cardiovascular disease, including hypertension and effects of angiotensin II (Ang II). Two isoforms of ROCK (1 and 2) have been identified and are expressed in vascular cells. In this study, we examined the importance of ROCK2 in relation to vessel function using several models and a novel inhibitor of ROCK2. First, incubation of carotid arteries with the direct RhoA activator CN-03 or Ang II impaired endothelium-dependent relaxation by ≈40% to 50% (PROCK isoforms) or the selective ROCK2 inhibitor SLX-2119. In contrast, SLX-2119 had little effect on contraction of carotid arteries to receptor-mediated agonists (serotonin, phenylephrine, vasopressin, or U46619). Second, in basilar arteries, SLX-2119 inhibited constriction to Ang II by ≈90% without significantly affecting responses to serotonin or KCl. Third, in isolated pressurized brain parenchymal arterioles, SLX-2119 inhibited myogenic tone in a concentration-dependent manner (eg, 1 μmol/L SLX-2119 dilated by 79±4%). Finally, SLX-2119 dilated small pial arterioles in vivo, an effect that was augmented by inhibition of nitric oxide synthase. These findings suggest that ROCK2 has major, but heterogeneous, effects on function of endothelium and vascular muscle. The data support the concept that aberrant ROCK2 signaling may be a key contributor to select aspects of large and small vessel disease, including Ang II-induced endothelial dysfunction. PMID:27432870

  12. Cerebrospinal Fluid Mechanics and Its Coupling to Cerebrovascular Dynamics

    Science.gov (United States)

    Linninger, Andreas A.; Tangen, Kevin; Hsu, Chih-Yang; Frim, David

    2016-01-01

    Cerebrospinal fluid (CSF) is not stagnant but displays fascinating oscillatory flow patterns inside the ventricular system and reversing fluid exchange between the cranial vault and spinal compartment. This review provides an overview of the current knowledge of pulsatile CSF motion. Observations contradicting classical views about its bulk production and clearance are highlighted. A clinical account of diseases of abnormal CSF flow dynamics, including hydrocephalus, syringomyelia, Chiari malformation type 1, and pseudotumor cerebri, is also given. We survey medical imaging modalities used to observe intracranial dynamics in vivo. Additionally, we assess the state of the art in predictive models of CSF dynamics. The discussion addresses open questions regarding CSF dynamics as they relate to the understanding and management of diseases.

  13. Time series analysis of the association between ambient temperature and cerebrovascular morbidity in the elderly in Shanghai, China

    Science.gov (United States)

    Zhang, Xian-Jing; Ma, Wei-Ping; Zhao, Nai-Qing; Wang, Xi-Ling

    2016-01-01

    Research on the association between ambient temperature and cerebrovascular morbidity is scarce in China. In this study, we applied mixed generalized additive model (MGAM) to daily counts of cerebrovascular disease of Shanghai residents aged 65 years or older from 2007–2011, stratified by gender. Weighted daily mean temperature up to lags of one week was smoothed by natural cubic spline, and was added into the model to assess both linear and nonlinear effects of temperature. We found that when the mean temperature increased by 1 °C, the male cases of cerebrovascular disease reduced by 0.95% (95% Confidence Interval (CI): 0.80%, 1.10%) or reduced by 0.34% (95% CI: ‑0.68, 1.36%) in conditions of temperature was below or above 27 °C. However, for every 1 °C increase in temperature, the female cases of cerebrovascular disease increased by 0.34% (95% CI: ‑0.26%, 0.94%) or decreased by 0.92% (95% CI: 0.72, 1.11%) in conditions of temperature was below or above 8 °C, respectively. Temperature and cerebrovascular morbidity is negatively associated in Shanghai. MGAM is recommended in assessing the association between environmental hazards and health outcomes in time series studies.

  14. Assessment of the arteriovenous cerebrovascular system by multi-slice CT. A single-bolus, monophasic protocol

    Energy Technology Data Exchange (ETDEWEB)

    Klingebiel, R.; Zimmer, C. [Charite CM, Humboldt Univ., Berlin (Germany). Neuroradiology Section; Rogalla, P.; Kivelitz, D. [Charite CM, Humboldt Univ., Berlin (Germany). Dept. of Radiology; Bohner, G. [Charite CM, Humboldt Univ., Berlin (Germany). Neuroradiology Section; Goetze, R. [Charite CM, Humboldt Univ., Berlin (Germany). Dept. of Radiology; Lehmann, R. [Charite CM, Humboldt Univ., Berlin (Germany). Neuroradiology Section

    2001-11-01

    Purpose: We present a protocol for the non-invasive angiographic assessment of the arterial and venous cerebrovascular (CV) system by multi-slice CT. Material and Methods: Data acquisition was performed in a multi-slice CT scanner with a scan range from the carotid bifurcation to the vertex and manual scan start following i.v. administration of 120 ml iodinated contrast medium with a flow rate of 4 ml/s. This protocol was applied in 12 patients with symptoms of acute CV insufficiency. Results: In all patients, comprehensive imaging of the arteriovenous CV system was achieved including the common carotid bifurcation, the third segment of the major cerebral arteries, the dural sinus and the internal cerebral veins. Various CV pathologies, such as a territorial artery occlusion, a thrombotic obstruction of the internal carotid artery, an intracranial arteriovenous malformation and a sinus vein thrombosis, were successfully evaluated. Conclusion: Comprehensive assessment of the arteriovenous CV system is possible by the use of a single-bolus, monophasic multi-slice scan technique.

  15. Bioinformatics investigation of therapeutic mechanisms of Xuesaitong capsule treating ischemic cerebrovascular rat model with comparative transcriptome analysis

    Science.gov (United States)

    Liao, Jiangquan; Wei, Benjun; Chen, Hengwen; Liu, Yongmei; Wang, Jie

    2016-01-01

    Background: Xuesaitong soft capsule (XST) which consists of panax notoginseng saponin (PNS) has been used to treat ischemic cerebrovascular diseases in China. The therapeutic mechanism of XST has not been elucidated yet from prospective of genomics and bioinformatics. Methods: A transcriptome analysis was performed to review series concerning middle cerebral artery occlusion (MCAO) rat model and XST intervention after MCAO from Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were compared between blank group and model group, model group and XST group. Functional enrichment and pathway analysis were performed. Protein-Protein interaction network was constructed. The overlapping genes from two DEGs sets were screened out and profound analysis was performed. Results: Two series including 22 samples were obtained. 870 DEGs were identified between blank group and model group, and 1189 DEGs were identified between model group and XST group. GO terms and KEGG pathways of MCAO and XST intervention were significantly enriched. PPI networks were constructed to demonstrate the gene-gene interactions. The overlapping genes from two DEGs sets were highlighted. ANTXR2, FHL3, PRCP, TYROBP, TAF9B, FGFR2, BCL11B, RB1CC1 and MBNL2 were the pivotal genes and possible action sites of XST therapeutic mechanisms. Conclusion: MCAO is a pathological process with multiple. PMID:27347353

  16. Cerebrovascular ischemic changes associated with fetal posterior cerebral artery- descriptive retrospective study with magnetic resonance imaging and angiography of brain

    Directory of Open Access Journals (Sweden)

    Venkatraman Indiran

    2016-04-01

    Full Text Available Objectives: Circle of Willis, the main collateral pathway for cerebral circulation, is complete in only a portion of the population. There are many variations in the Circle of Willis. Fetal posterior cerebral artery, which is defined as posterior cerebral artery arising from internal carotid artery, is a common variant of the Circle of Willis. Though association between the fetal posterior cerebral artery and ischemia have been studied, no specific study has been conducted in the Indian population. We aim to identify the incidence of small and large vessel strokes in patients with fetal posterior cerebral artery using Magnetic Resonance Imaging (MRI and Magnetic Resonance Angiography (MRA of brain in the Indian population. Materials and methods: We retrospectively reviewed MR angiographies of the brain performed in our institution, in order to assess the posterior cerebral circulation and its association with small ischemic changes and large vessel strokes. Results: 92 of the 140 patients (65% with fetal posterior cerebral artery (PCA had small vessel ischemic changes. 72 patients (51.4% had large vessel infarcts in any of the vascular territories. 35% of the patients included in this study showed infarcts in the middle cerebral artery (MCA territory and 15 % showed infarcts in the PCA territory. Conclusion: Higher incidence of MCA infarcts in our study probably suggests that PCA cannot aid in collateral formation cases of reduced flow across the internal carotid artery and that fetal PCA could be an important risk factor in cerebrovascular ischemic diseases.

  17. Applying Craniofacial Principles to Neurosurgical Exposures in Cerebrovascular Aneurysm Repair.

    Science.gov (United States)

    Alperovich, Michael; Frey, Jordan D; Potts, Matthew B; Riina, Howard A; Staffenberg, David A

    2016-06-01

    The subspecialty of craniofacial surgery emphasizes skeletal exposure, preservation of critical structures, and provision of a superior cosmetic result. In recent decades, an emphasis on minimally invasive neurosurgical exposure has paved the way for increased collaboration between neurosurgeons and craniofacial surgeons.The 1990s saw the growing popularity of an eyebrow incision for orbital roof craniotomies in neurosurgery to address lesions in the anterior skull base. Disadvantages of this approach included conspicuous scarring above the brow skin, risk of injury to the frontal branch of the facial nerve, and numbness from supraorbital or supratrochlear nerve transection.A transpalpebral approach was first described in 2008 in the neurosurgical literature. An approach familiar to the craniofacial surgeon, transpalpebral exposure is used for zygomaticomaxillary complex fractures as well as aesthetic brow and periorbital surgery.In conjunction with neurosurgery, the authors have applied craniofacial principles to address the major pitfalls of the transpalpebral craniotomy. The authors present their patient series experience. Hopefully, in the future, other institutions will have increased collaboration between craniofacial surgeons and neurosurgeons. PMID:27192638

  18. Trends in Mortality from Cerebrovascular and Hypertensive Diseases in Brazil Between 1980 and 2012

    Directory of Open Access Journals (Sweden)

    Paolo Blanco Villela

    2016-01-01

    Full Text Available Abstract Background: Cerebrovascular and hypertensive diseases are among the main causes of death worldwide. However, there are limited data about the trends of these diseases over the years. Objective: To evaluate the temporal trends in mortality rates and proportional mortality from cerebrovascular and hypertensive diseases according to sex and age in Brazil between 1980 and 2012. Methods: We evaluated the underlying causes of death between 1980 and 2012 in both sexes and by age groups for circulatory diseases (CD, cerebrovascular diseases (CBVD, and hypertensive diseases (HD. We also evaluated death due to all causes (AC, external causes (EC, and ill-defined causes of death (IDCD. Data on deaths and population were obtained from the Department of Information Technology of the Unified Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS/MS. We estimated crude and standardized annual mortality rates per 100,000 inhabitants and percentages of proportional mortality rates. Results: With the exception of EC, the mortality rates per 100,000 inhabitants of all other diseases increased with age. The proportional mortality of CD, CBVD, and HD increased up to the age range of 60-69 years in men and 70-79 years in women, and reached a plateau in both sexes after that. The standardized rates of CD and CBVD declined in both sexes. However, the HD rates showed the opposite trend and increased mildly during the study period. Conclusion: Despite the decline in standardized mortality rates due to CD and CBVD, there was an increase in deaths due to HD, which could be related to factors associated with the completion of the death certificates, decline in IDCD rates, and increase in the prevalence of hypertension.

  19. The balance between cognitive reserve and brain imaging biomarkers of cerebrovascular and Alzheimer's diseases.

    Science.gov (United States)

    Murray, Alison D; Staff, Roger T; McNeil, Christopher J; Salarirad, Sima; Ahearn, Trevor S; Mustafa, Nazahah; Whalley, Lawrence J

    2011-12-01

    The cognitive reserve hypothesis explains the disparity between clinical and pathological phenotypes and why, in two individuals with the same extent of neuropathology, one may be demented while the other remains cognitively intact. We examined the balance between brain magnetic resonance imaging measures of the two most common pathologies associated with brain ageing, cerebrovascular disease and Alzheimer's disease, and parameters of cerebral reserve in well-characterized participants born in 1936, for whom childhood intelligence is known. Brain magnetic resonance imaging was carried out at 1.5T using fluid attenuation inversion recovery and T(1)-weighted volumetric sequences in 249 participants. Cerebrovascular disease was quantified by measuring brain white matter hyperintensities on fluid attenuation inversion recovery images using Scheltens' scale and Alzheimer's disease was measured from volumetric data using FreeSurfer to extract whole brain volume and hippocampal volumes in turn. The effect of these measures of brain burden on life-long cognitive ageing from the age of 11 to 68 years was compared with the effect of educational attainment and occupational grade using structural equation modelling. Complete brain burden and reserve data were available in 224 participants. We found that educational attainment, but not occupation, has a measurable and positive effect, with a standardized regression weight of +0.23, on late life cognitive ability in people without cognitive impairment aged 68 years, allowing for the influence of childhood intelligence and the two most common subclinical brain pathological burdens in the ageing brain. In addition, we demonstrate that the magnitude of the contribution of education is greater than the negative impact of either neuropathological burden alone, with standardized regression weights of -0.14 for white matter hyperintensities and -0.20 for hippocampal atrophy. This study illustrates how education counteracts the

  20. Trends in Mortality from Cerebrovascular and Hypertensive Diseases in Brazil Between 1980 and 2012

    Science.gov (United States)

    Villela, Paolo Blanco; Klein, Carlos Henrique; de Oliveira, Gláucia Maria Moraes

    2016-01-01

    Background Cerebrovascular and hypertensive diseases are among the main causes of death worldwide. However, there are limited data about the trends of these diseases over the years. Objective To evaluate the temporal trends in mortality rates and proportional mortality from cerebrovascular and hypertensive diseases according to sex and age in Brazil between 1980 and 2012. Methods We evaluated the underlying causes of death between 1980 and 2012 in both sexes and by age groups for circulatory diseases (CD), cerebrovascular diseases (CBVD), and hypertensive diseases (HD). We also evaluated death due to all causes (AC), external causes (EC), and ill-defined causes of death (IDCD). Data on deaths and population were obtained from the Department of Information Technology of the Unified Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS/MS). We estimated crude and standardized annual mortality rates per 100,000 inhabitants and percentages of proportional mortality rates. Results With the exception of EC, the mortality rates per 100,000 inhabitants of all other diseases increased with age. The proportional mortality of CD, CBVD, and HD increased up to the age range of 60-69 years in men and 70-79 years in women, and reached a plateau in both sexes after that. The standardized rates of CD and CBVD declined in both sexes. However, the HD rates showed the opposite trend and increased mildly during the study period. Conclusion Despite the decline in standardized mortality rates due to CD and CBVD, there was an increase in deaths due to HD, which could be related to factors associated with the completion of the death certificates, decline in IDCD rates, and increase in the prevalence of hypertension. PMID:27355586

  1. Kinetic analysis of cerebrovascular transport based on indicator diffusion technique

    International Nuclear Information System (INIS)

    The indicator diffusion method was used for studies of the blood-brain barrier in rats and [131I]iodoantipyrine (IAP) was used as a highly diffusable model test substance. Interlaminar (Taylor) diffusion and effects of red cell carriage were studied with 57Co-diethylene-triaminepentaacetic acid (DTPA), 125I-human serum albumin, and 46Sc-microspheres (15 microns diameter). Vascular shunting from the pterygopalatine artery (PPA) into the torcula sinus was observed in some animals, and ligation of the PPA was required to obtain reliable data. Dilution curve of the reference compound was corrected to compensate for any difference in interlaminar diffusion and red cell plus protein carriage of the test substance. Apparent extraction ratio of IAP was calculated for each torcula sinus sample and found to increase during the initial phase of the dilution curve, reach a peak of approximately 0.85, and fall during the latter portion of the curve. These results suggest a heterogeneity of intravascular transit times in the cerebral circulation and a rapid efflux of IAP from brain into venous blood. Because of the topography of cerebral capillaries, we developed a modification of the distributed model for intravascular transit and capillary exchange proposed by Goresky et al. and Rose and Goresky; this modification included a well-mixed tissue compartment, as suggested by Johnson and Wilson and is named the tissue homogeneity model. The experimental data was analyzed by both the tissue homogeneity and Goresky models. The estimated mean extraction E (0.95 and 0.94) and the estimated permeability-surface area product of influx (PS)1 (3.1 and 2.8 ml.min-1.g-1) for IAP in a whole blood injectate were similar using the two different models

  2. Muertes por enfermedades cardiacas y accidentes cerebrovasculares prevenibles - (Preventable Deaths from Heart Disease and Stroke)

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    Este podcast se basa en la edición de septiembre del 2013 del informe Signos Vitales de los CDC. Más de 800,000 personas en los Estados Unidos mueren cada año a causa de enfermedades cardiacas y accidentes cerebrovasculares. Aprenda cómo controlar todos los principales factores de riesgo.  Created: 9/3/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 9/3/2013.

  3. Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, U; Rasmussen, Rasmus Vedby; Hassager, C;

    2011-01-01

    Anticoagulant therapy has been anticipated to increase the risk of cerebrovascular complications (CVC) in native valve endocarditis (NVE). This study investigates the relationship between ongoing oral anticoagulant therapy and the incidence of symptomatic CVC in left-sided NVE. In a prospective...... factors for CVC, while warfarin on admission (aOR 0.26, 95% CI 0.07-0.94), history of congestive heart failure (adjusted OR 0.22, 95% CI 0.1-0.52) and previous endocarditis (aOR 0.1, 95% CI 0.01-0.79) correlated with lower CVC frequency....

  4. Reactive perforating collagenosis

    OpenAIRE

    Yadav Mukesh; Sangal B; Bhargav Puneet; Jai P; Goyal Mukul

    2009-01-01

    Reactive perforating collagenosis is a rare cutaneous disorder of unknown etiology. We hereby describe a case of acquired reactive perforating collagenosis in a patient of diabetes and chronic renal failure.

  5. Reactive perforating collagenosis

    Directory of Open Access Journals (Sweden)

    Yadav Mukesh

    2009-01-01

    Full Text Available Reactive perforating collagenosis is a rare cutaneous disorder of unknown etiology. We hereby describe a case of acquired reactive perforating collagenosis in a patient of diabetes and chronic renal failure.

  6. Cerebral blood flow in asymptomatic individuals; Relationship with cerebrovascular risk factors and magnetic resonance imaging signal abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Isaka, Yoshinari; Iiji, Osamu; Ashida, Keiichi; Imaizumi, Masatoshi (National Osaka Hospital (Japan))

    1993-04-01

    We studied the relationship between cortical grey matter flow (CBF) and age, cerebrovascular risk factors and the severity of subcortical hypersignals (HS, hyperintensity score in MRI) in 47 asymptomatic subjects with cerebrovascular risk factors. Multiple regression analysis revealed that HS was most strongly related to CBF, and that hematocrit, age and evidence of ischemic change detected in the electrocardiogram also appeared to be independent determinants of CBF. Both the severity and location of hypersignals were correlated with CBF. The most significant negative correlation observed was that between CBF and HS in the basal ganglia-thalamic region, where the degree of signal abnormality was modest. Decreased CBF in asymptomatic subjects with cerebrovascular risk factors may be related to microcirculatory disturbance associated with elevated hematocrit and an increase in the number of risk factors, and functional suppression of cerebral cortex due to the neuronal disconnection associated with subcortical lesions. In addition, impaired cerebral circulation may be related to MRI signal abnormalities. (author).

  7. [Research on distribution of patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular based on cluster analysis].

    Science.gov (United States)

    YANG, Xu-Jie; XIAO, Shi-Ying

    2015-09-01

    To discuss the distribution of patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular, the patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular were cluster analyzed by means of simple statistics and cluster analysis. Clustering variables were composed of patent applications, patent maintained number, related papers' quantity, etc. Chinese herbal compound patents' holders were divided into four categories according to their different scientific research and patent strength. It is the magic weapon for Chinese herbal compound patents' holders that have scientific research patents' transforming and make coordination of patent protection and scientific innovation.

  8. Estudio clínico del proceso conductual de la emergencia del coma grave por accidente cerebrovascular

    OpenAIRE

    Romero López, Modesto Jesús

    2007-01-01

    Objetivos: Estudiar el proceso de la emergencia del coma en pacientes en coma grave por accidente cerebrovascular (ACV). Método: Se han evaluado a 32 pacientes ingresados en una unidad de cuidados intensivos por un coma de origen cerebrovascular. Se ha realizado un seguimiento diario por neuropsicólogos e intensivistas y monitorizado el despertar del coma mediante 8 escalas de evalua ... ción clínica de los niveles de coma. Se han analizado las variables: edad, género, residencia, índice prem...

  9. Possibilities of using naftidrofuryl in the therapy of cerebrovascular diseases: Literature review and the authors’ observations

    Directory of Open Access Journals (Sweden)

    A. N. Belova

    2015-01-01

    Full Text Available The efficacy of naftidrofuryl in treating cerebrovascular diseases is analyzed on the basis of a review of the Russian and foreign literature. Naftidrofuryl is a seroton 5-HT2 receptor antagonist and acts on brain energy metabolism mainly during hypoxia or ischemia. The results of preclinical studies proving the antispasmodic and neuroprotective properties of the drug and its capacity to normalize microcirculation in hypoxia are briefly considered. Experimental findings served as a basis for further studies of the efficacy of naftidrofuryl in patients with stroke, chronic cerebral ischemia, or vascular dementia. The use of naftidrofuryl (dusopharm was demonstrated to statistically significantly enhance the efficiency of rehabilitation in post-stroke patients and to be followed by significant psychoemotional improvement. According to a Cochrane review, the naftidrofuryl-treated patients with vascular dementia showed a tendency towards better executive and cognitive functions, behavior, and mood. The drug was noted to have a positive effect on the health of patients with chronic cerebral ischemia.The authors provide the data of their trial of naftidrofuryl used in patients with dyscirculatory encephalopathy, which have confirmed its efficacy in this category of patients. The data available in the literature suggest that oral naftidrofuryl has a good tolerability and safety profile in patients with cerebrovascular diseases.

  10. The complex contribution of NOS interneurons in the physiology of cerebrovascular regulation

    Directory of Open Access Journals (Sweden)

    Sonia eDuchemin

    2012-08-01

    Full Text Available Following the discovery of the vasorelaxant properties of nitric oxide (NO by Furchgott and Ignarro, the finding by Bredt and coll. of a constitutively expressed NO synthase in neurons (nNOS led to the presumption that neuronal NO may control cerebrovascular functions. Consequently, numerous studies have sought to determine whether neuraly-derived NO is involved in the regulation of cerebral blood flow. Anatomically, axons, dendrites or somata of NO neurons have been found to contact the basement membrane of blood vessels or perivascular astrocytes in all segments of the cortical microcirculation. Functionally, various experimental approaches support a role of neuronal NO in the maintenance of resting cerebral blood flow as well as in the vascular response to neuronal activity. Since decades, it has been assumed that neuronal NO simply diffuses to the local blood vessels and produce vasodilation through a cGMP-PKG dependent mechanism. However, NO is not the sole mediator of vasodilation in the cerebral microcirculation and is known to interact with a myriad of signaling pathways also involved in vascular control. In addition, cerebrovascular regulation is the result of a complex orchestration between all components of the neurovascular unit (i.e. neuronal, glial and vascular cells also known to produce NO. In this review article, the role of NO interneuron in the regulation of cortical microcirculation will be discussed in the context of the neurovascular unit.

  11. SPECT with N-isopropyl-p iodoamphetamine in occlusive cerebrovascular diseases.

    Science.gov (United States)

    Higa, T; Tanaka, T; Ikekubo, K; Komatsu, T; Torizuka, K

    1986-12-01

    The role of SPECT imaging with N-isopropyl-p iodoamphetamine (I-123 IMP) in the detection of angiographically documented occlusive cerebrovascular diseases was evaluated in 24 patients, and the results of regional cerebral blood flow (rCBF) were compared with x-ray CT. Twelve patients had internal carotid occlusion, ten had intracranial occlusion beyond the circle of Willis, one had common carotid occlusion, and one had basilar artery occlusion. SPECT images were obtained with a gamma camera, which was rotated 360 degrees around the patient's head 30 minutes after an intravenous injection of 3 mCi of I-123 IMP. CT images in the transverse plane were obtained, and the regions of reduced attenuation were identified for comparison of topographic extension of the lesion with the regions of decreased rCBF seen on SPECT. In six cases, the lesions seen on the SPECT images were distinctly more extensive than those seen on CT. In the remaining 18 cases, the extent of the lesion was identical on both CT and SPECT images. Radiochemical and radionuclide impurities, the distance of the detector from the head, and the nature of the collimator affected the SPECT results. I-123 IMP SPECT imaging complements CT findings in detecting the ischemic zones beyond the regions identified on CT images, and may have a major rule in the management of patients with occlusive cerebrovascular diseases.

  12. Clinical study on magnetic resonance imaging of lacunar infarcts and cerebrovascular high-risk group

    Energy Technology Data Exchange (ETDEWEB)

    Hironaka, Masatoshi (Hiroshima Univ. (Japan). School of Medicine)

    1990-04-01

    Magnetic resonance imaging (MRI) study was performed in 32 patients with recent lacunar stroke. T2-weighted images showed ischemic lesions more clearly than T1-weighted images. Sixty-six percent of 32 patients had periventricular lesions. Eighty-four percent had subcortical white matter lesions. Sixty-nine percent had lesions in basal ganglia. Twenty-eight percent had lesions in brainstem. Periventricular lesions were revealed symmetrically. On the other hand, lesions in other areas were not detected symmetrically. Severe periventricular lesions on MRI were similar to those of Binswanger's disease. Patients with severe periventricular lesions had often hypertension. Moreover, two of them had dementia. Twenty-three patients with transient ischemic attack had less remarkable lesions than patients with lacunar stroke. Thirty-seven patients with a history of cerebrovascular risk factors (hypertension, diabetes mellitus) had severer lesions compared with normal controls. Sixty-one percent of controls, who had no cerebrovascular symptoms and signs, had MRI lesions. These results suggest that MRI is useful for detection of cerebral ischemic lesions with no associated clinical symptoms or signs. (author).

  13. Clinical application of dynamic digital subtraction angiography in cerebrovascular ischemic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Yoshifumi; Nonaka, Nobuhito; Matsukado, Yasuhiko; Takahashi, Mutsumasa.

    1987-09-01

    Dynamic intravenous digital subtraction angiography (IV-DSA) was performed in 37 patients with cerebrovascular ischemic diseases. The time density curve of IV-DSA was analysed, and peak time, mean transit time and mode of transit time were obtained in each patient. On the basis of these values, cerebral perfusion was classified into low, normal and high perfusion patterns. Normal perfusion pattern was noted in 40% of patients with transient ischemic attack (TIA) and 7 % of patients with cerebral infarction. Low perfusion pattern was observed in 60 % of patients with TIA and 87 % of patients with cerebral infarction. High perfusion pattern was encountered only in 7 % of patients with cerebral infarction. In ischemic patients with moyamoya disease, extremely prolonged cerebral circulation time was evidenced by the presence of a flat or uphill type of the time density curve. This finding well correlated with decreased cerebral blood flow on single photon emission tomography. These findings suggest that the analysis of dynamic DSA is very important and useful in the clinical evaluation of patients with cerebrovascular ischemic diseases.

  14. Clinical study on magnetic resonance imaging of lacunar infarcts and cerebrovascular high-risk group

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) study was performed in 32 patients with recent lacunar stroke. T2-weighted images showed ischemic lesions more clearly than T1-weighted images. Sixty-six percent of 32 patients had periventricular lesions. Eighty-four percent had subcortical white matter lesions. Sixty-nine percent had lesions in basal ganglia. Twenty-eight percent had lesions in brainstem. Periventricular lesions were revealed symmetrically. On the other hand, lesions in other areas were not detected symmetrically. Severe periventricular lesions on MRI were similar to those of Binswanger's disease. Patients with severe periventricular lesions had often hypertension. Moreover, two of them had dementia. Twenty-three patients with transient ischemic attack had less remarkable lesions than patients with lacunar stroke. Thirty-seven patients with a history of cerebrovascular risk factors (hypertension, diabetes mellitus) had severer lesions compared with normal controls. Sixty-one percent of controls, who had no cerebrovascular symptoms and signs, had MRI lesions. These results suggest that MRI is useful for detection of cerebral ischemic lesions with no associated clinical symptoms or signs. (author)

  15. Positron emission tomographic studies using C-11-glucose in normal aging and cerebrovascular dementia

    International Nuclear Information System (INIS)

    Seven normal volunteers and 11 patients with cerebrovascular dementia were studied about the relations between effect of aging, severity of dementia, cerebral glucose metabolism and metabolic response to verbal stimuli by positron emission tomography (PET) using C-11-glucose. Regional distribution of glycogenic metabolites (RDGM: mg/100 g brain), which was a semi-quantitation of the pool of glycogenic metabolites mainly amino acids, were calculated. The RDGM values in elder normal subjects were significantly low compared with young normal subjects in frontal cortex (p < 0.05). The decline in frontal cortex metabolism could have been caused by the morphological changes in the course of aging. In temporal cortex, there was no significance between two groups. RDGM increased significantly respond to the verbal stimuli in frontal and temporal cortex both young and elder normal subjects. The RDGM values in vascular dementias were significantly low (p < 0.001) compared with elder normal subjects' in frontal and temporal cortex. Significant difference existed between mild and severe dementia in frontal cortex (p < 0.05). However, there was no significance between mild and severe dementias in temporal cortex. In mild dementias, RDGM increased significantly respond to the verbal stimuli in frontal and temporal cortex. In severe dementias, metabolic response to the verbal stimuli was less or lacking. Our results suggest that the cerebral metabolic functional reserve and the ability of the cerebral cortex to function respond to psychophysiologic stimulation are preserved in young and elder normal subjects and mild cerebrovascular dementias. (J.P.N.)

  16. The impact of P2Y12 promoter DNA methylation on the recurrence of ischemic events in Chinese patients with ischemic cerebrovascular disease

    Science.gov (United States)

    Li, Xin-Gang; Ma, Ning; Wang, Bo; Li, Xiao-Qing; Mei, Sheng-Hui; Zhao, Kun; Wang, Yong-Jun; Li, Wei; Zhao, Zhi-Gang; Sun, Shu-Sen; Miao, Zhong-Rong

    2016-01-01

    The primary mechanism of clopidogrel resistance is still unclear. We aimed to investigate whether the methylation status of the P2Y12 promoter has effects on platelet function and clinical ischemic events. Patients with ischemic cerebrovascular disease were enrolled into our study. Venous blood samples were drawn for thrombelastograpy (TEG) and active metabolite assay. Patients were divided into a case- or control-group based on the occurrence of ischemic events during a one year follow-up. Two TEG parameters between the case and control groups were statistically significant [ADP inhibition rate (ADP%): P = 0.018; ADP-induced platelet-fibrin clot strength (MAADP): P = 0.030]. The concentrations of clopidogrel active metabolite had no significant difference (P = 0.281). Sixteen CpG dinucleotides on P2Y12 promoter were tested. Three CpG sites (CpG11 and CpG12 + 13) showed lower methylation status, which correlated with a strong association with increased risk of clinical events. Changes of MAADP and ADP% were also associated with methylation levels of CpG 11 and CpG 12 + 13. Hypomethylation of the P2Y12 promoter is associated with a higher platelet reactivity and increased risk of ischemic events in our patients. Methylation analysis of peripheral blood samples might be a novel molecular marker to help early identification of patients at high risk for clinical ischemic events. PMID:27686864

  17. Cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920743 A prospective trial of hemodilutiontherapy in acute cerebral infarction. DINGMingchen(丁铭臣), et al. Dept Neurol, XuanwuHosp, Capital Instit Med, Beijing, 100053. ChinJ Neurol & Psychiat 1992; 25(3): 146-148. Ninety two patients with acute (<72hours) cerebral infarction involving middle

  18. Cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008482 Risk factors for ischemic lacunar stroke associated headache. HU Wei(胡伟), et al. Dept Neurol, Nanjing General Hosp, Nanjing Milit Command, Nanjing 210002. Chin J Nerv Ment Dis 2008;34(5):262-265. Objective To analyze risk factors of stroke-associated headache (SH) and explore its underlying mechanisms. Methods First-ever lacunar infarction patients (n=371) were extracted from Nanjing Stroke Registration Program.

  19. Cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950404 Operative treatment of multiple intracranialaneurvsms in one stage.GAO Yongzhong(高永中),etal.Dept Neurosurg.Tianjin Med Coll Hosp.Tianjin,300052.Chin J Nerv & Ment Dis 1994;20(6):329-331In this study,seven patients with intracranial multi-ple aneurysms are reported.Every patient sufferedfrom two aneurysms simultaneously.Totally,therewere fourteen aneurysms(thirteen saccular and onefusiform aneurysm).There was one patient with bilat-eral arterior chorioid artery aneurysms.All of the sac-cular aneurysms were clipped through a single pterion-al approach and the fusiform aneurysm was wrappedwith muscle tissue.After clipping,some of the a-neurysmal sacs were punctured or an angiographical

  20. Cerebrovascular Diseases and Risk Factors: a Strategy of Primary Prevention Factores de riesgo y enfermedad cerebrovascular: una estrategia de prevención primaria

    Directory of Open Access Journals (Sweden)

    Rubén Bembibre Taboada

    2007-05-01

    Full Text Available Cerebrovascular diseases constitute a health problem worldwide and have the tendency to grow up. Chronic diseases sometimes are considered transmissible diseases at a level of risk factors. The alimentary habits and the levels of physical activity at present are risk behaviors which are spread all over the world passing from one population to another as an infectious disease with incidence in the morbidity profiles worldwide. While age and sex as well as genetic vulnerability are no modifiable elements, great part of the risks associated to age and sex can be reduced. In such risks, behavior factors (alimentary habits, physical inactivity, smoking habit and alcoholism, biological factors (dyslipidemia, hypertension, overweight, and hyperinsulinemia and finally the social factors which cover a complex combination of socio-economic, cultural parameters, and other elements of the environment that interact among them. This work covers risk factors and the behavior to be followed for its modification.
    Las enfermedades cerebrovasculares constituyen un problema de salud mundial con tendencia creciente. A veces las enfermedades crónicas son consideradas transmisibles a nivel de los factores de riesgo. Los hábitos alimentarios y el nivel de actividad física modernos son comportamientos de riesgo que se difunden por los países y pasan de una población a otra como una enfermedad infecciosa, con incidencia en los perfiles de morbilidad a nivel mundial. Mientras que la edad, el sexo y la vulnerabilidad genética son elementos no modificables, gran parte de los riesgos asociados a la edad y el sexo pueden ser aminorados. Tales riesgos incluyen factores conductuales (régimen alimentario, inactividad física, consumo de tabaco y consumo de alcohol, factores biológicos (dislipidemia, hipertensión, sobrepeso e hiperinsulinemia y, por último, factores sociales, que abarcan una compleja combinación de parámetros socioecon

  1. A multidisciplinary stroke clinic for outpatient care of veterans with cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Moran E

    2011-04-01

    Full Text Available Arlene A Schmid1,2,3,4, John R Kapoor5, Edward J Miech1, Deborah Kuehn6, Mary I Dallas7, Robert D Kerns8, Albert C Lo9,10, John Concato11,12, Michael S Phipps13,14,15, Cody D Couch13, Eileen Moran13, Linda S Williams1,2,3,16, Layne A Goble17,18, Dawn M Bravata1,2,3,191Department of Veteran Affairs (VA Health Services Research & Development (HSR&D Center of Excellence on Implementing Evidence-Based Practice (CIEBP, 2VA HSR&D Stroke Quality Enhancement Research Initiative (QUERI Program, Richard L Roudebush VA Medical Center, Indianapolis, IN, USA; 3Regenstrief Institute, Indianapolis, IN, USA; 4Department of Occupational Therapy, Indiana University, IN, USA; 5Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, IL, USA; 6Nursing Service, 7Physical Medicine and Rehabilitation Service, 8Psychology Service, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA; 9Departments of Neurology, Community Health, and Engineering at Brown University, Providence, RI, USA; 10Providence Veterans Administration Medical Center, Providence, RI, USA; 11Clinical Epidemiology Research Center (CERC, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA; 12Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; 13Department of Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA; 14Robert Wood Johnson Clinical Scholars Program, 15Department of Neurology, Yale University School of Medicine, New Haven, CT, USA; 16Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA; 17Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA; 18Veterans Administration Medical Center, Charleston, SC, USA; 19Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USABackground: Managing cerebrovascular risk factors is complex and difficult. The objective of this

  2. Hipertensión arterial sistólica. Impacto sobre la enfermedad cerebrovascular.

    Directory of Open Access Journals (Sweden)

    María C. Valle Campo

    2011-08-01

    Full Text Available Fundamento: La aterosclerosis es un proceso multifactorial sobre el cual actúan varios factores de riesgo. Constituye la principal causa de muerte y de morbilidad en ingresados hospitalarios, y puede ocasionar una acentuada disminución del flujo sanguíneo hacia todos los órganos del cuerpo humano
    Objetivo
    : Determinar el impacto de la hipertensión arterial sistólica sobre la enfermedad cerebrovascular.
    Métodos
    : Se realizó un estudio transversal, observacional y analítico, en 59 fallecidos hipertensos. Se analizaron las arterias cerebrales y se cuantificó la lesión aterosclerótica y su variedad, aplicándose el sistema aterométrico, teniendo en cuenta los tipos de hipertensión arterial. Se emplearon procedimientos estadísticos (medidas de tendencia central y comparativos (prueba de comparación de media aritmética basadas en el test “t” de student.
    Resultados: Los infartos cerebrales recientes fueron más frecuentes en hipertensos sistodiastólicos. No hubo diferencia significativa en cuanto a la edad en el momento de aparición de las lesiones para ambos sexos, pero las mujeres con hipertensión sistólica, fueron significativamente más dañadas desde el punto de vista morfométrico. Se observó correlación significativa para ambos grupos de hipertensos entre tipo de accidente cerebrovascular y variables del sistema aterométrico. Conclusiones: La hipertensión arterial sistólica es un factor importante en la génesis de la enfermedad vasculocerebral y está asociada con la progresión de la placa de ateroma.

    SYSTOLIC HYPERTENSION. IMPACT ON CEREBROVASCULAR DISEASE

    Background: Atherosclerosis is a multifactor process in which several risk factors are involved. It is the leading cause of death and morbidity in hospital admitted patients, and it may cause

  3. Paraneoplastic importance of reactive dermatoses

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    Algün Polat Ekinci

    2013-12-01

    Full Text Available Reactive dermatoses may occur related to many underlying causes including infections, inflammatory diseases, medications and malignancies. In the management of these dermatoses the investigation of underlying cause is crucial besides the therapy of dermatosis. In this review, mainly the paraneoplastic potentials of reactive dermatoses have been evaluated and additionally the etiology, follow-up and treatment have been discussed. Recent literature about figurated erythemas (erythema annulare centrifugum, erythema gyratum repens, necrolytic migratory erythema, neutrophilic dermatoses (Sweet’s syndrome, pyoderma gangrenosum, subcorneal pustular dermatosis and erythema nodosum have been scrutinized.

  4. The death risk factors analysis of severe cerebrovascular disease%重症脑血管病死亡危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈志华

    2014-01-01

    Objective To investigate the death risk factors of severe cerebrovascular disease.Methods The clinical data of 226 patients with severe cerebrovascular disease were analyzed retrospectively.All of the death risk factors were divided into three types.Type Ⅰ was the uncontrollable factors,including age,gender and family genetic history.Type Ⅱ was morbid risk factors,including hypertension,hyperlipemia,diabetes,valvular heart disease,cardiovascular diseases and history of stroke.Type Ⅲ was life style risk factors,including smoking,drinking,obesity,high salt diet,high protein diet and less movement.The risk factors were evaluated with single factor and multiple factors analysis.Results Single factor analysis showed that age,hypertension,diabetes,history of stroke,smoking,drinking,high salt diet and less movement were the high risk factors (P < 0.01 or < 0.05).Multiple factors analysis showed that age (OR =1.242,P =0.001),history of stroke (OR =2.325,P =0.000),less movement (OR =-1.172,P =0.010) were correlated with the death.Conclusions Severe cerebrovascular disease is associated with multiple factors.Early intervention to the risk factors in patients with severe cerebrovascular disease can effectively decrease the risk of death and reduce the mortality.%目的 分析影响重症脑血管病患者死亡的危险因素.方法 回顾性分析226例重症脑血管病患者的临床资料.将死亡危险因素分为三类进行分析:Ⅰ类为不可干预因素,包括性别、年龄以及家族遗传史.Ⅱ类为疾病危险因素,包括高血压、高血脂、糖尿病、心血管疾病(冠心病、心脏瓣膜病、心房颤动)、脑血管病发作史.Ⅲ类为生活方式因素,包括吸烟、饮酒、肥胖、高盐饮食、高蛋白饮食、缺乏运动.采用单因素和多因素Logistic回归方法进行分析.结果 单因素分析结果显示年龄、高血压、糖尿病、心脏瓣膜病、脑血管病发作史、吸烟、饮酒、高盐饮食以及

  5. Characterization of cerebro-vascular disease in the Intermediate Care Unit. Multicentre study in the central part of Cuba. Caracterización de la enfermedad cerebrovascular en Servicios de Cuidados Intermedios. Estudio multicentro en la región central de Cuba.

    Directory of Open Access Journals (Sweden)

    Aleida Hernández Lara

    Full Text Available Fundament: Cerebrovascular diseasets constitute the third cause of death and the first cause of disability worldwide and in Cuba, hence it has been included among the prioritised programs of the World Health Organisation and by our Ministry of Public Health. Objective: To characterize cerebrovascular diseasets in the Polivalent Therapy Service of the central region of the country. Method: multicenter descriptive study of a series of cases carried out at the Clinical Surgical Hospitals ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province, and ¨Arnaldo Milián Castro¨ from Villa Clara with a revision of 1218 clinical records of patients who were interviewed and whose data was processed afterwards. Results: There was a predominance of the white race ( 75,3 %, male sex (56,7 % and hypertension was the risk marker ( 71,3 % . The isquemic cerebrovascular desease was the most frequent reported with 86,7 % and anti-aggregate platelets was the medication most frequently used (77,5 % In regards to the location of the lesion 51,1 % were reported in the parietal region and the predominant diagnosis was the atherothrombotic infarct ( 59,9 %. The most common complication was cerebral oedema ( 45,2% . On discharge the state was ¨alive with disability¨ ( 62,2%. Conclusions: Cerebrovascular diseases is a health problem in our environment. Hypertension is the most frequent risk marker observed and there is a predominance of ischemic ictus . Once established the disease is established, it evolves to disabilities or death in most of the cases.

    Fundamento: Las enfermedades cerebrovasculares constituyen la tercera causa de muerte y primera de discapacidad en el mundo y en Cuba; se encuentran dentro de los programas priorizados por la Organización Mundial de la Salud y por nuestro Ministerio de Salud

  6. Clinical values of intraoperative indocyanine green fluorescence video angiography with Flow 800 software in cerebrovascular surgery

    Institute of Scientific and Technical Information of China (English)

    YE Xun; LIU Xing-ju; MA Li; LIU Ling-tong; WANG Wen-lei; WANG Shuo; CAO Yong

    2013-01-01

    Background Microscope-integrated near-infrared indocyanine green video angiography (ICG-VA) has been used in neurosurgery for a decade.This study aimed to assess the value of intraoperative indocyanine green (ICG) video angiography with Flow 800 software in cerebrovascular surgery and to discover its hemodynamic features and changes of cerebrovascular diseases during surgery.Methods A total of 87 patients who received ICG-VA during various surgical procedures were enrolled in this study.Among them,45 cases were cerebral aneurysms,25 were cerebral arteriovenous malformations (AVMs),and 17 were moyamoya disease (MMD).A surgical microscope integrating an infrared fluorescence module was used to confirm the residual aneurysms and blocking of perforating arteries in aneurysms.Feeder arteries,draining veins,and normal cortical vessels were identified by the time delay color mode of Flow 800 software.Hemodynamic parameters were recorded.All data were analyzed by SPSS version 18.0 (SPSS Inc.,USA).T-test was used to analyze the hemodynamic features of AVMs and MMDs,the influence on peripheral cortex after resection in AVMs,and superficial temporal artery to middle cerebral artery (STA-MCA) bypass in MMDs.Results The visual delay map obtained by Flow 800 software had more advantages than the traditional playback mode in identifying the feeder arteries,draining veins,and their relations to normal cortex vessels.The maximum fluorescence intensity (MFI) and the slope of ICG fluorescence curve of feeder arteries and draining veins were higher than normal peripheral vessels (MFI:584.24±85.86 vs.382.94±91.50,slope:144.95±38.08 vs.69.20±13.08,P <0.05).The artefiovenous transit time in AVM was significantly shorter than in normal cortical vessels ((0.60±0.27) vs.(2.08±1.42) seconds,P <0.05).After resection of AVM,the slope of artery in the cortex increased,which reflected the increased cerebral flow.In patients with MMD,after STA-MCA bypass,cortex perfusion of

  7. The family – care sponsor of patients suffering from cerebrovascular accidents

    Directory of Open Access Journals (Sweden)

    Ourania Govina

    2007-07-01

    Full Text Available The purpose of this bibliographical review is to show the role of the family in the application of care of a patient suffering from a cerebrovascular accident (CVA. CVA's are, second to arthritis, one of the most impairing illnesses in terms of ability that creates the need for training the patient on a new basis and giving the family information on new roles. One of the dimensions of holistic family care is the increased support the patient receives from family care givers. Studies and clinical research both show that informing families on care giver roles is inadequate or non‐existent. Adequate training of nurses to prepare care givers via specialized programs stimulates the family to respond to the new challenge and take on roles that are multidimensional and complicated. It is important that family care givers of people with CVA's are given new information and taught new skills in order for these patients to maximize their own self‐care potential. CVA patients, following the acute phase of their illness and rehabilitation in specialized centers are nursed at home, mainly by their families with the help of healthcare services. Usually, the responsibilities the family takes on are mainly those of self‐care needs of the patient and his motivation, so that he will organize and carry out basic life activities via learning new ways to face everyday life, always within his impaired abilities. Care guidance is a most important nursing intervention so that activities of daily living problems can be addressed. The interventions are tailored according to the care givers' educational level and the patients' needs. CONCLUSIONS The most important findings of the study are: Patients with cerebrovascular accidents have impaired ability concerning mobility, communication and socialization and need special attention and education in order to improve daily life activities. The education of hemiplegic patients with informative intervention, awareness and

  8. Beneficial effects of estrogen in a mouse model of cerebrovascular insufficiency.

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    Naohito Kitamura

    Full Text Available BACKGROUND: The M(5 muscarinic acetylcholine receptor is known to play a crucial role in mediating acetylcholine dependent dilation of cerebral blood vessels. Previously, we reported that male M(5 muscarinic acetylcholine knockout mice (M5R(-/- mice suffer from a constitutive constriction of cerebral arteries, reduced cerebral blood flow, dendritic atrophy, and short-term memory loss, without necrosis and/or inflammation in the brain. METHODOLOGY/PRINCIPAL FINDINGS: We employed the Magnetic Resonance Angiography to study the area of the basilar artery in male and female M5R(-/- mice. Here we show that female M5R(-/- mice did not show the reduction in vascular area observed in male M5R(-/- mice. However, ovariectomized female M5R(-/- mice displayed phenotypic changes similar to male M5R(-/- mice, strongly suggesting that estrogen plays a key role in the observed gender differences. We found that 17beta-estradiol (E2 induced nitric oxide release and ERK activation in a conditional immortalized mouse brain cerebrovascular endothelial cell line. Agonists of ERalpha, ERbeta, and GPR30 promoted ERK activation in this cell line. Moreover, in vivo magnetic resonance imaging studies showed that the cross section of the basilar artery was restored to normal in male M5R(-/- mice treated with E2. Treatment with E2 also improved the performance of male M5R(-/- mice in a cognitive test and reduced the atrophy of neural dendrites in the cerebral cortex and hippocampus. M5R(-/- mice also showed astrocyte swelling in cortex and hippocampus using the three-dimensional reconstruction of electron microscope images. This phenotype was reversed by E2 treatment, similar to the observed deficits in dendrite morphology and the number of synapses. CONCLUSIONS/SIGNIFICANCE: Our findings indicate that M5R(-/- mice represent an excellent novel model system to study the beneficial effects of estrogen on cerebrovascular function and cognition. E2 may offer new therapeutic

  9. Ultra-sensitive molecular MRI of cerebrovascular cell activation enables early detection of chronic central nervous system disorders

    International Nuclear Information System (INIS)

    Since endothelial cells can be targeted by large contrast-carrying particles, molecular imaging of cerebrovascular cell activation is highly promising to evaluate the underlying inflammation of the central nervous system (CNS). In this study, we aimed to demonstrate that molecular magnetic resonance imaging (MRI) of cerebrovascular cell activation can reveal CNS disorders in the absence of visible lesions and symptoms. To this aim, we optimized contrast carrying particles targeting vascular cell adhesion molecule-1 and MRI protocols through both in vitro and in vivo experiments. Although, pre-contrast MRI images failed to reveal the ongoing pathology, contrast-enhanced MRI revealed hypoperfusion-triggered CNS injury in vascular dementia, unmasked amyloid-induced cerebrovascular activation in Alzheimer's disease and allowed monitoring of disease activity during experimental autoimmune encephalomyelitis. Moreover, contrast-enhanced MRI revealed the cerebrovascular cell activation associated with known risk factors of CNS disorders such as peripheral inflammation, ethanol consumption, hyperglycemia and aging. By providing a dramatically higher sensitivity than previously reported methods and molecular contrast agents, the technology described in the present study opens new avenues of investigation in the field of neuro-inflammation. (authors)

  10. Risk of cerebrovascular events in persons with and without HIV: A Danish nationwide population-based cohort study

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Engsig, Frederik Neess; Christensen, Hanne;

    2011-01-01

    OBJECTIVE:: To assess the risk of cerebrovascular events (CVE) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, highly active antiretroviral therapy (HAART) and family-related risk factors. DESIGN:: Nationwide, population...

  11. Carbon dioxide induced changes in cerebral blood flow and flow velocity: Role of cerebrovascular resistance and effective cerebral perfusion pressure

    NARCIS (Netherlands)

    F. Grüne (Frank); S. Kazmaier (Stephan); R.J. Stolker (Robert J.); G.H. Visser (Gerhard Henk); A. Weyland (Andreas)

    2015-01-01

    textabstractIn addition to cerebrovascular resistance (CVR) zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe) and the resistance area product (RAP) are supplemental determinants of cerebral blood flow (CBF). Until now, the interrelationship of PaCO2 -induced changes in CBF, CVR,

  12. Cerebrovascular disease in newborn infants: report of three cases with clinical follow-up and brain SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Moura-Ribeiro, Maria Valeriana L. de; Ciasca, Sylvia Maria; Vale-Cavalcanti, Mariza; Etchebehere, Elba C.S.C.; Camargo, Edwaldo E. [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas

    1999-07-01

    The clinical and neurological findings of three neonates with the diagnosis of cerebrovascular disease are reported. The neuropsychological evaluation disclosed impairment of fine motor function, coordination, language, perception and behavioral disturbances. Brain SPECT imaging revealed perfusional deficits in the three cases. (author)

  13. Association between ALT level and the rate of cardio/cerebrovascular events in HIV-positive individuals

    DEFF Research Database (Denmark)

    Sabin, Caroline A; Ryom, Lene; Kovari, Helen;

    2013-01-01

    An inverse association between serum alanine aminotransferase (ALT) levels and the risk of myocardial infarction (MI) has been reported in the general population. We investigated associations between ALT levels and the risk of various cardiovascular and cerebrovascular outcomes in a large cohort...

  14. Inhibition of cerebrovascular raf activation attenuates cerebral blood flow and prevents upregulation of contractile receptors after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Maddahi, Aida; Edvinsson, Lars

    2011-01-01

    of mitogen-activated protein kinase (MAPK) of the extracellular signal-regulated kinase (ERK)1/2 signal pathway. We hypothesize that SAH initiates cerebrovascular ERK1/2 activation, resulting in receptor upregulation. The raf inhibitor will inhibit the molecular events upstream ERK1/2 and may provide...

  15. Cerebrovascular accident in the aged: changes in family relations El anciano tras accidente cerebrovascular: alteraciones en el relacionamento familiar O idoso após acidente vascular cerebral: alterações no relacionamento familiar

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    Sueli Marques

    2006-06-01

    Full Text Available The aims of this study were: to identify aged persons who were victims of Cerebrovascular Accident and received care at the Emergency Unit of a Public Hospital in Ribeirão Preto-SP, Brazil, and their respective families, as well as to identify the changes in family relations that occurred after the event. In order to identify these changes, the adapted Critical Incident Technique was used, while the analysis was based on the idea of Current of Thought. The sample consisted of 11 families, totaling 34 participants. The analysis of the consequences displayed the changes in family relations, which made up 13 subcategories, 5 of which were positive and 8 negative, totaling 58 alterations, 30 of which were positive and 28 negative. The study revealed the need to work with the family in order to identify changes and develop an action plan to favor the family's relations and adaptation to the demands, with a view to improving the living conditions of its members, including the aged person.Las finalidades de este estudio fueron las de identificar a los ancianos con diagnóstico médico de Accidente Cerebrovascular, atendidos en la Unidad de Emergencia de un Hospital Gubernamental de Ribeirão Preto-SP, Brasil, y a sus respectivas familias y también identificar las alteraciones en el relacionamiento familiar, que ocurrieron tras el evento. Fue utilizada la Técnica de Incidentes Críticos adaptada para identificar las alteraciones en el relacionamiento familiar ocurridas tras la enfermedad. Para el análisis, fue adoptada la reflexión del Camino del Pensamiento. La muestra fue compuesta por 11 familias, totalizando 34 participantes. El análisis de las consecuencias reveló las alteraciones en el relacionamiento familiar, que constituyeron 13 subcategorías, 5 positivas y 8 negativas, con un total de 58 alteraciones, siendo 30 positivas y 28 negativas. El estudio reveló la necesidad de trabajar con la familia para identificar las alteraciones y

  16. The Sarcoglycan complex is expressed in the cerebrovascular system and is specifically regulated by astroglial Cx30 channels

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    Anne-Cécile eBoulay

    2015-02-01

    Full Text Available Astrocytes, the most prominent glial cell type in the brain, send specialized processes called endfeet, around blood vessels and express a large molecular repertoire regulating the cerebrovascular system physiology. One of the most striking properties of astrocyte endfeet is their enrichment in gap junction protein Connexin 43 and 30 (Cx43 and Cx30 allowing in particular for direct intercellular trafficking of ions and small signaling molecules through perivascular astroglial networks. In this study, we addressed the specific role of Cx30 at the gliovascular interface. Using an inactivation mouse model for Cx30 (Cx30Δ/Δ, we showed that absence of Cx30 does not affect blood-brain barrier (BBB organization and permeability. However, it results in the cerebrovascular fraction, in a strong upregulation of Sgcg encoding γ-Sarcoglycan (SG, a member of the Dystrophin-associated protein complex (DAPC connecting cytoskeleton and the extracellular matrix. The same molecular event occurs in Cx30T5M/T5M mutated mice, where Cx30 channels are closed, demonstrating that Sgcg regulation relied on Cx30 channel functions. We further characterized the expression of other Sarcoglycan complex (SGC molecules in the cerebrovascular system and showed the presence of α-, β-, δ-, γ-, ε- and ζ- SG, as well as Sarcospan. Their expression was however not modified in Cx30Δ/Δ. These results suggest that a full SGC might be present in the cerebrovascular system, and that expression of one of its member, γ-Sarcoglycan, depends on Cx30 channels. As described in skeletal muscles, the SGC may contribute to membrane stabilization and signal transduction in the cerebrovascular system, which may therefore be regulated by Cx30 channel-mediated functions.

  17. Clinical value of dipyridamole brain perfusion imaging in the diagnosis of ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Using dipyridamole stress test to evaluate cerebral blood flow reserve in cerebrovascular disease (CVD). Dipyridamole stress tests were performed first, the baseline SPECT images were obtained under similar conditions 2-5 days later. By visual and semiquantitative analysis, the responses of cerebral blood flow to dipyridamole were divided into the following four patterns: A: The dipyridamole SPECT showed an expanded area of hypoperfusion, Asymmetry Index(AI) and Uptake Rate(UR) were all decreased; B: Rest images was normal but new hypoperfused areas appeared on stress test with decreased Al and UR; C: Hypoperfused areas were decreased in size or disappeared after stress test with increased Al and UR; D: No changes showed in cerebral perfusion imaging patterns, and in Al and UR between stress and rest studies. Dipyridarnole brain perfusion imaging may be helpful to the diagnosis of CVD, to the decision the therapeutic plan, and to predicting the therapeutic effect.

  18. Modeling Cerebrovascular Pathophysiology in Amyloid-β Metabolism using Neural-Crest-Derived Smooth Muscle Cells

    Directory of Open Access Journals (Sweden)

    Christine Cheung

    2014-10-01

    Full Text Available There is growing recognition of cerebrovascular contributions to neurodegenerative diseases. In the walls of cerebral arteries, amyloid-beta (Aβ accumulation is evident in a majority of aged people and patients with cerebral amyloid angiopathy. Here, we leverage human pluripotent stem cells to generate vascular smooth muscle cells (SMCs from neural crest progenitors, recapitulating brain-vasculature-specific attributes of Aβ metabolism. We confirm that the lipoprotein receptor, LRP1, functions in our neural-crest-derived SMCs to mediate Aβ uptake and intracellular lysosomal degradation. Hypoxia significantly compromises the contribution of SMCs to Aβ clearance by suppressing LRP1 expression. This enabled us to develop an assay of Aβ uptake by using the neural crest-derived SMCs with hypoxia as a stress paradigm. We then tested several vascular protective compounds in a high-throughput format, demonstrating the value of stem-cell-based phenotypic screening for novel therapeutics and drug repurposing, aimed at alleviating amyloid burden.

  19. The TCM-Combined Treatment for Aphasia Due to Cerebrovascular Disorders

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To evaluate the therapeutic effects of scalp acupuncture (with the cluster needling, a long needle-retention and an intermittent manipulation) combined with the Schuell's stimulation and psychological care for treatment of aphasia due to cerebrovascular disorders. Method: 36 eligible cases of aphasia were randomly assigned into a treatment group and a control group. The scoring system for assessment of aphasia in speaking Chinese set by CMA Neurological Branch and that of BADE were adopted for grading the severity/degree of aphasia before and after the treatment. Results: The total effective rate in the treatment group was 84.21%, and that in the control group was 70.59%, with a very statistically significant difference (P<0.01). Conclusion: The combined scheme produced a better therapeutic effect.

  20. Use of nonsteroidal anti-inflammatory drugs among healthy people and specific cerebrovascular safety

    DEFF Research Database (Denmark)

    Fosbøl, Emil L; Olsen, Anne-Marie Schjerning; Olesen, Jonas Bjerring;

    2014-01-01

    stroke). RESULTS: We selected 1,028,437 healthy individuals (median age 39 years). At least one nonsteroidal anti-inflammatory drug was claimed by 44·7% of the study population, and the drugs were generally used for a short period of time and in low doses. High-dose ibuprofen and diclofenac were......BACKGROUND: Nonsteroidal anti-inflammatory drugs can increase bleeding and thrombosis, but little is known about the cerebrovascular safety of these drugs, especially among healthy people. AIMS: The aim of this study was to examine the risk of ischemic and hemorrhagic stroke associated with the use...... of nonsteroidal anti-inflammatory drugs in healthy people. METHODS: By individual-level linkage of nationwide administrative registers in Denmark, information on hospital admissions, prescription claims, vital status, and cause of death were obtained. A cohort of healthy people without hospital admissions...

  1. Cardiovascular and cerebrovascular pharmacology%心脑血管药理学

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@心脑血管药理学 文献标识码:D Cardiovascular and cerebrovascular pharmacology 024 Effect of flavones of Mukdenia rossiikoidz on cardiac infarction in rats   LI Yan1, LUO Ji-Hua2   (1. National Institutes of Pharmaceutical Research and Development, Beijing 102206, China; 2. Medical College, Beihua University, Jilin 132001, China)   AIM: To study the effect of flavones of Mukdenia ross ii koidz on cardiac infarction caused by coronary artery ligation. M ETH ODS: Coronary artery ligation. RESULTS: Flavones of Mukd enia rossiikoidz reduced the area of infarction and attenuated the change in S-T section. CONCLUSION: Flavones of M. rossiikoidz has protective effects against myocardial ischemia.   Key words: Mukdenia rossiikoidz; coronary artery

  2. [Soft tissue calcifications in panoramic radiography. A risk factor for cerebrovascular accidents?].

    Science.gov (United States)

    Ariayi, Ayesha Shekeba; Berndt, Dorothea; Lambrecht, J Thomas

    2009-01-01

    Panoramic radiography is a basic diagnostic tool in the dental field where calcifications are seen occasionally in the lateral parts of the x-ray. The differential diagnosis are carotid artery atheromas, calcified submandibular lymphnodes and sialoliths of the submandibular gland. 4007 panoramic radiographs (100%) from patients >40 years were scanned retrospectively. Special emphasis was given to the carotid artery territory (CAT). 225 soft tissue calcifications were found (5.6%). 144 patients had calcifications in the CAT (3.6%), 73 showed calcified submandibular lymphnodes (1.8%), and 8 (0.2%) sialoliths. The female to male ratio was 54.7%:45.3%. Pneumatic diseases were beside hypertension and smoking a risk factor for CAT calcification. Carotid artery atheromas are the main risk for cerebrovascular insults. Dentists can help to detect patients at risk for stroke. Their patients can be referred for further diagnostics (ultrasound). PMID:19954131

  3. Multimodal CT techniques for cerebrovascular and hemodynamic evaluation of ischemic stroke: occlusion, collaterals, and perfusion.

    Science.gov (United States)

    Jia, Baixue; Scalzo, Fabien; Agbayani, Elijah; Woolf, Graham W; Liu, Liping; Miao, Zhongrong; Liebeskind, David S

    2016-05-01

    Neuroimaging of cerebrovascular status and hemodynamics has vastly improved our understanding of stroke mechanisms and provided information for therapeutic decision-making. CT techniques are the most commonly used techniques due to wide availability, rapid acquisition and acceptable tolerance. Numerous multimodal CT techniques have been developed in the last few years. We summarize and explain the various multimodal CT acquisition techniques within three categories based on the scanning mode, namely static mode (single-phase CTA), multiple static mode (multi-phase CTA) and continuous mode (CT perfusion and dynamic CTA). Post-processing methods based on different acquisition modes are also introduced in an easy manner by focusing on the information extracted and products generated. We also describe the applications for these techniques along with their advantages and disadvantages.

  4. Neurosonological examination: A non-invasive approach for the detection of cerebrovascular impairment in AD

    Directory of Open Access Journals (Sweden)

    Barbora eUrbanova

    2014-01-01

    Full Text Available There has been a growing interest in vascular impairment associated with Alzheimer’s disease (AD. This interest was stimulated by the findings of higher incidence of vascular risk factors in AD. Signs of vascular impairment were investigated notably in the field of imaging methods. Our aim was to explore ultrasonographic studies of extra- and intracranial vessels in patients with AD and mild cognitive impairment (MCI and define implications for diagnosis, treatment and prevention of the disease. The most frequently studied parameters with extracranial ultrasound are intima-media thickness in common carotid artery, carotid atherosclerosis, and total cerebral blood flow. The transcranial ultrasound concentrates mostly on flow velocities, pulsatility indices, cerebrovascular reserve capacity, cerebral microembolization. Studies suggest there is morphological and functional impairment of cerebral circulation in AD compared to healthy subjects. Ultrasound as a non-invasive method could be potentially useful in identifying individuals in a higher risk of progression of cognitive decline.

  5. Computerized three-dimensional reconstruction reveals cerebrovascular regulatory subregions in rat brain stem.

    Science.gov (United States)

    Underwood, M D; Arango, V; Smith, R W; Bakalian, M J; Mann, J J

    1993-09-01

    Three-dimensional wireframe reconstructions were used to examine the relationship between the anatomical localization of electrode sites and the cerebrovascular response which was elicited by electrical stimulation of the dorsal raphe nucleus (DRN). Reconstructions of the rat brain and DRN were done from atlas plates and from Nissl-stained coronal sections (100-micron increments). Data points were entered and three-dimensional reconstructions were performed using commercially available software and a personal computer. Display of the entire brain yielded views which obscured visualization of the DRN. The data file was edited to reduce the number of contours without affecting the display resolution of the DRN. Selective display of the DRN and electronic rotation from the coronal to a sagittal view revealed a functional organization of the cerebral blood flow responses which was not apparent in two-dimensional coronal sections.

  6. Microwave Tomographic Imaging of Cerebrovascular Accidents by Using High-Performance Computing

    CERN Document Server

    Tournier, P -H; Bonazzoli, M; de Buhan, M; Darbas, M; Dolean, V; Hecht, F; Jolivet, P; Kanfoud, I El; Migliaccio, C; Nataf, F; Pichot, C; Semenov, S

    2016-01-01

    The motivation of this work is the detection of cerebrovascular accidents by microwave tomographic imaging. This requires the solution of an inverse problem relying on a minimization algorithm (for example, gradient-based), where successive iterations consist in repeated solutions of a direct problem. The reconstruction algorithm is extremely computationally intensive and makes use of efficient parallel algorithms and high-performance computing. The feasibility of this type of imaging is conditioned on one hand by an accurate reconstruction of the material properties of the propagation medium and on the other hand by a considerable reduction in simulation time. Fulfilling these two requirements will enable a very rapid and accurate diagnosis. From the mathematical and numerical point of view, this means solving Maxwell's equations in time-harmonic regime by appropriate domain decomposition methods, which are naturally adapted to parallel architectures.

  7. Effects of hypoxia-inducible factor 1 on ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Yongjie Luo; Xiaoping Wang; Hongbin Sun

    2008-01-01

    Hypoxia-inducible factor I, a nuclear transcription factor, is induced by hypoxia. Hypoxia-inducible factor I, a heterodimeric DNA-binding protein, is composed of hypoxia-inducible factor 1α and hypoxia-inducible factor 1 β subunits, which are family members of the basic helix-loop-helix-PER, ARNT, SIM (PAS) protein. O2 concentration regulates hypoxia-inducible factor 1 activity via this subunit. Hypoxia-inducible factor 1α plays a major role in response to hypoxia and transcriptional activation, as well as in the target gene specificity of the DNA enhancer. Hypoxia-inducible factor 1β cannot be induced by hypoxia. This effect may be due to hypoxia-inducible factor 1 stability and activated conformation due to dimerization. Previous studies have shown that hypoxia-inducible factor 1 mRNA expression increases in the penumbra following ischemia/hypoxia. Hypoxia-inducible factor 1 plays an important role in brain tissue injury alter ischemia by affecting a series of target genes, elevating tolerance to hypoxia, and ensuring survival of neural cells. This article summarizes the structure, function, expression, regulatory mechanisms, biological effects, and significance of hypoxia-inducible factor 1 in patients with ischemic cerebrovascular disease. As a transcriptional activator, hypoxia- inducible factor 1 plays a key role in hypoxic responses by stabilizing the internal environment. It also has been shown to regulate the expression of several genes. The regulatory effects of hypoxia-inducible factor 1 in patients with ischemic cerebrovascular disease have been described. The present review re-examined the concept of brain protection at the level of gene regulation.

  8. LIPOMA CEREBRAL EN CUERPO CALLOSO: HALLAZGO INCIDENTAL EN PACIENTE CON EVENTO CEREBROVASCULAR

    Directory of Open Access Journals (Sweden)

    Gloria Cárcamo-Portillo

    2016-07-01

    Full Text Available Los lipomas intracraneales son lesiones infrecuentes y benignas que representan el 0,03 al 0,08% de todas las masas intracraneales. Estos se encuentran relacionados a un defecto de la línea media debido a un mal cierre del tubo neural; lo que conlleva a una mala diferenciación y una persistencia anormal de la meninge primitiva con posterior diferenciación al tejido adiposo. La mitad de los casos permanecen asintomáticos y son diagnosticados como un hallazgo incidental en los estudios imagenológicos. Sin embargo, otros casos se asocian a sintomatología neurológica como retraso psicomotor, cefalea, epilepsia y parálisis cerebral. Se presenta el caso de una paciente de 46 años de edad, con antecedentes de hipertensión arterial y diabetes mellitus tipo 2; que cursa con sintomatología de Evento Cerebrovascular Isquémico por lo que le realizan –una Tomografía Computarizada (TC y una Resonancia Magnética (RM. En el reporte se describen múltiples infartos a nivel del hemisferio cerebral izquierdo mientras que al nivel de la línea media se observó una imagen compatible con lipoma cerebral que afectaba el rostro, la rodilla y la porción anterior del cuerpo calloso. La identificación de este hallazgo fue incidental. Palabras claves: Lipoma Cerebral; Cuerpo Calloso; Resonancia Magnética; Accidente Cerebrovascular. (Fuente: DeCS BIREME.

  9. Crossed cerebellar atrophy in cases with cerebrovascular disease; Investigation using X-ray computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yagishita, Toshiyuki; Kojima, Shigeyuki; Hirayama, Keizo (Chiba Univ. (Japan). School of Medicine (Japan)); Iwabuchi, Sadamu

    1989-10-01

    Crossed cerebellar atrophy (CCA) was investigated by X-ray CT to establish the incidence, mechanism, and the relation to cerebral lesions in 130 cases of unilateral supratentorial cerebrovascular diseases. The cases consisted of 83 males and 47 females with cerebral infarction (65) and cerebral hemorrhage (65). The patients' average age was 57.6 years. Crossed cerebellar atrophy was demonstrated in 8 cases (6.2%), 6 of whom had massive cerebral infarction in the middle cerebral artery area (9.2%). The six cases of CCA caused by cerebral infarction had lesions in the frontal and temporal lobes. Two had a cerebral hemorrhage in the putamen and in the thalamus, respectively, accounting for 3.1% of the cases of cerebral hemorrhage. One case had putaminal hemorrhage, and another had thalamic hemorrhage. Cerebrovascular stroke had occured in these patients with CCA more than 2 months previously. In 5 of the 8 cases of CCA, atrophy was present in the basis pedunculi and the basis pontis on the side of the cerebral lesion. However, neither dilation nor deformity of the fourth ventricle was present in any of the patients, suggesting that none of the CCA patients had atrophy of the dentate nucleus. The CCA patients had massive cerebral lesion in the frontal and temporal lobes or atrophy of the basis pedunculi and basis pontis, suggesting the presence of the transsynaptic degeneration of the cortico-ponto-cerebellar pathway. In the case of the thalamic hemorrhage, who had not hemorrhagic lesion in the frontal and temporal lobes, atrophy of the basis peduncli and basis pontis was not observed. Though dilation or deformity of the fourth ventricle is not observed in this case, presence of the degeneration of the dentate-rubro-thalamic pathway cannot be denied. CCA seems to be caused by both the transsynaptic degeneration of the cortico-ponto-cerebellar pathway and the dentate-rubro-thalamic pathway.

  10. Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic accumulative score

    Institute of Scientific and Technical Information of China (English)

    HUANG Jiuyi; WANG Guiqing; GUO Jiping; CAO Yifeng; WANG Yan; YANG Yongju; YU Xuehai

    2007-01-01

    The relative risk(RR)of stroke in patients with hypertension was evaluated by using synthetic index of cerebrovascular hemodynamics.A total of 7,371 patients with hypertension with ages≥40 years were selected from a population-based cohort study of the risk factors for stroke.The data on the baseline investigation of risk factors,the determination of cerebrovascular hemodynamic parameters (CVHP),and stroke follow-up were analyzed.The RR of stroke in patients with hypertension was evaluated by CVHP scores.Univariate analysis indicated that hypertension,complicated by other risk factors,had significant statistical association with the onset of stroke.RRS for stroke when hypertension complicated with decrease of hemodynamic scores,heart disease,cigarette smoking and alcohol consumption were 4.93(95%CI,3.26-7.45),1.90(95%CI,1.36-2.66),1.99(95%CI,1.42-2.79)and 1.73(95%CI,1.19-2.53)respectively.In multivariate analysis,hemodynamic score,age,sex,cigarette smoking,family history of stroke and systolic blood pressure were selected by the Cox regression for inclusion in the final analysis.Among them,the RR of hemodynamic score was highest.The analysis of doseresponse relationships indicated that when the hemodynamic scores in patients with hypertension were lower than 75 points,the RR of stroke at 75,60,45,30 and 15 points were 2.85,4.43,4.54,5.40 and 9.88,respectively.The risk of stroke in patients with hypertension is closely associated with hemodynamic impairment and the hemodynamic score may be used for quantitative evaluation of relative risks of stroke.

  11. Effect of extracranial electric stimulation at cerebellar fastigial nucleus on serum C-reactive protein of patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Some reports indicate that electric and/or chemical stimulation at various brain sites of experimental animals can raise regional cerebral blood flow and improve cerebral circulation; however, its mechanism is still unclear.OBJECTIVE: To observe the effects of electric stimulation at cerebellar fastigial nucleus on serum C-reactive protein of patients with acute cerebral infarction.DESIGN: Non-randomized synchronized contrast study.SETTING: The Second People's Hospital of Xinxiang City.PARTICIPANTS: A total of 54 patients with acute cerebral infarction were selected from the Department of Neurology, the Second People's Hospital of Xinxiang from December 2005 to December 2006. There were 31 males and 23 females, and their ages ranged from 56 to 80 years. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Academic Meeting, were finally diagnosed by using CT examination,and provided the confirmed consent. Based on therapeutic demands, patients were divided into electric stimulation group and routine treatment group with 27 cases in each group. In addition, 21 healthy subjects,including 11 males and 10 females and aging 53 - 78 years, were selected as the control group. All the subjects in the control group did not have any histories of cerebrovascular diseases and severe body diseases.METHODS: Based on routine drug therapy, patients in the electric stimulation group were also treated by using CVFT-010M cerebral circulation function therapeutic device (made in Shanghai). Electrode was fixed at bilateral mastoid in the first group and at extensible sides of upper limbs in the second group. Electric stimulation was given twice a day and lasted for 30 minutes each time. Ten days were regarded as a course.Parameters of device: mode Ⅲ, frequency 198%, and intensity 90% - 110% (bionic current). Patients in the routine treatment group received the routine drug treatment. Content of serum C-reactive protein was measured in both

  12. Sobrecarga dos cuidadores de idosos com acidente vascular cerebral Sobrecarga de los cuidadores de ancianos con accidente cerebrovascular Burden on caregivers of elderly victims of cerebrovascular accident

    Directory of Open Access Journals (Sweden)

    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.Se objetivó evaluar la sobrecarga de cuidadores de ancianos con accidente cerebrovascular (ACV, y correlacionarla con horas de cuidado, edad e independencia funcional de los ancianos. Estudio transversal con 62 ancianos con ACV y sus cuidadores. El instrumento contenía variables sociodemográficas y económicas, Mini-Examen del Estado Mental, Medida de la Independencia Funcional (MIF y la Escala de Zarit. La posible correlación entre los puntajes de la escala de Zarit y las otras variables fue evaluada por Coeficiente de Correlación de Pearson. La mayoría de los cuidadores eran adultos, hijos, casados y de sexo femenino. El promedio de puntaje de Zarit fue 34,92 (15,8. La MIF presentó correlación negativa con la sobrecarga del cuidador, sin embargo no hubo correlación con edad y horas de cuidado. La sobrecarga de la mayoría de los cuidadores varió entre moderada y severa, y parece relacionarse con el nivel de independencia funcional del anciano.The aim was to

  13. Doença cerebrovascular na infância: I. Manifestações epilépticas Cerebrovascular disease in children: I. Epileptic manifestations

    Directory of Open Access Journals (Sweden)

    M. AUGUSTA MONTENEGRO

    1999-09-01

    Full Text Available As crises epilépticas podem constituir complicação de doença cerebrovascular (DCV, e a sua prevalência, apresentação clínica, fatores de risco e evolução em crianças tem sido estudadas por poucos autores. Neste estudo, 39 crianças com diagnóstico de DCV foram avaliadas quanto à ocorrência de manifestações epilépticas. Vinte e quatro (61,5% apresentaram crises durante algum momento da doença (22 na fase aguda e 2 na tardia; 13 (54,2% apresentaram crises generalizadas, 7 (29,2% parciais, e 4 (16,6% secundariamente generalizadas. A prevalência de manifestação epiléptica em lactentes foi significativamente maior (p=0,0362 do que nas outras faixas etárias. A localização cortical da DCV mostrou determinar de modo estatisticamente significante (p=0,0101 a ocorrência de crises. Não houve relação significativa entre o tipo de insulto vascular (isquêmico ou hemorrágico e a ocorrência de crises. Quatorze pacientes evoluíram sem crise após a fase aguda; os 2 pacientes previamente epilépticos tiveram suas crises controladas com droga anti-epiléptica (DAE; 3 evoluíram com epilepsia (1 controlado com DAE e 2 de difícil controle; 3 continuaram em acompanhamento ambulatorial e não houve tempo hábil para definir se o quadro evoluirá para epilepsia e em 2 ocorreu óbito na fase aguda.Seizures may occur as a complication of cerebrovascular disease (CVD and its prevalence, clinical presentation, risk factors and evolution have been reported by few authors. We evaluated 39 children with CVD and analysed the association with seizures. Seizures occurred in 24 (61.5% patients and were classified as partial (29.2%, generalized (54.2% and secondarily generalized (16.6%. Infants had a significantly higher prevalence of seizures (p=0.0362 than children at other ages. Cortical localization was associated with a significantly higher prevalence of seizures (p=0.0101. There were no differences between ischemic and hemorrhagic strokes

  14. Treating water-reactive wastes

    International Nuclear Information System (INIS)

    Some compounds and elements, such as lithium hydride, magnesium, sodium, and calcium react violently with water to generate much heat and produce hydrogen. The hydrogen can ignite or even form an explosive mixture with air. Other metals may react rapidly only if they are finely divided. Some of the waste produced at Los Alamos National Lab. includes these metals that are contaminated with radioactivity. By far the greatest volume of water-reactive waste is lithium hydride contaminated with depleted uranium. Reactivity of the water-reactive wastes is neutralized with an atmosphere of humid nitrogen, which prevents the formation of an explosive mixture of hydrogen and air. When we adjust the temperature of the nitrogen and the humidifier, the nitrogen can be more or less humid, and the rate of reaction can be adjusted and controlled. Los Alamos has investigated the rates of reaction of lithium hydride as a function of the temperature and humidity. Los Alamos will investigate other variables. For example, the nitrogen flow will be optimized to conserve nitrogen and yet keep the reaction rates high. Reaction rates will be determined for various forms of lithium waste, from small chips to powder. Bench work will lead to the design of a skid-mounted process for treating wastes. Other water-reactive wastes will also be investigated

  15. Optical modulator including grapene

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Ming; Yin, Xiaobo; Zhang, Xiang

    2016-06-07

    The present invention provides for a one or more layer graphene optical modulator. In a first exemplary embodiment the optical modulator includes an optical waveguide, a nanoscale oxide spacer adjacent to a working region of the waveguide, and a monolayer graphene sheet adjacent to the spacer. In a second exemplary embodiment, the optical modulator includes at least one pair of active media, where the pair includes an oxide spacer, a first monolayer graphene sheet adjacent to a first side of the spacer, and a second monolayer graphene sheet adjacent to a second side of the spacer, and at least one optical waveguide adjacent to the pair.

  16. Reactive multiphase flow simulation workshop summary

    Energy Technology Data Exchange (ETDEWEB)

    VanderHeyden, W.B.

    1995-09-01

    A workshop on computer simulation of reactive multiphase flow was held on May 18 and 19, 1995 in the Computational Testbed for Industry at Los Alamos National Laboratory (LANL), Los Alamos, New Mexico. Approximately 35 to 40 people attended the workshop. This included 21 participants from 12 companies representing the petroleum, chemical, environmental and consumer products industries, two representatives from the DOE Office of Industrial Technologies and several from Los Alamos. The dialog at the meeting suggested that reactive multiphase flow simulation represents an excellent candidate for government/industry/academia collaborative research. A white paper on a potential consortium for reactive multiphase flow with input from workshop participants will be issued separately.

  17. The brain-in-motion study: effect of a 6-month aerobic exercise intervention on cerebrovascular regulation and cognitive function in older adults

    OpenAIRE

    Amanda V Tyndall; Davenport, Margie H; Wilson, Ben J.; Burek, Grazyna M; Arsenault-Lapierre, Genevieve; Haley, Eryka; Eskes, Gail A.; Friedenreich, Christine M.; Michael D Hill; Hogan, David B.; Longman, R Stewart; Anderson, Todd J.; Leigh, Richard; Smith, Eric E.; Poulin, Marc J.

    2013-01-01

    Background Aging and physical inactivity are associated with declines in some cognitive domains and cerebrovascular function, as well as an elevated risk of cerebrovascular disease and other morbidities. With the increase in the number of sedentary older Canadians, promoting healthy brain aging is becoming an increasingly important population health issue. Emerging research suggests that higher levels of physical fitness at any age are associated with better cognitive functioning and this may...

  18. Plasma renin activity and its association with ischemic heart disease, congestive heart failure, and cerebrovascular disease in a large hypertensive cohort

    OpenAIRE

    Sim, John J.; Shi, Jiaxiao; Al-Moomen, Rushdy; Behayaa, Hind; Kalantar-Zadeh, Kamyar; Jacobsen, Steven J.

    2014-01-01

    Plasma renin activity (PRA) may be a surrogate for vascular damage. We hypothesize that PRA is associated with cardiovascular and cerebrovascular disease. Cross sectional study (1/1/1998–12/31/2009) on hypertensive individuals >/=18yrs using multivariable logistic regression models to estimate odds ratios (OR) for ischemic heart disease (IHD), congestive heart failure (CHF), and cerebrovascular disease (CED) based on PRA quartiles controlling for age, sex, race, diabetes mellitus (DM), and me...

  19. Efficacy of Standard and Intensive Statin Treatment for the Secondary Prevention of Cardiovascular and Cerebrovascular Events in Diabetes Patients: A Meta-Analysis

    OpenAIRE

    de Vries, Folgerdiena M.; Kolthof, Johan; Postma, Maarten J.; Denig, Petra; Hak, Eelko

    2014-01-01

    Aims To estimate the efficacy of standard and intensive statin treatment in the secondary prevention of major cardiovascular and cerebrovascular events in diabetes patients. Methods A systematic search was conducted in Medline over the years 1990 to September 2013. Randomized, double-blind, clinical trials comparing a standard-dose statin with placebo or a standard-dose statin with an intensive-dose statin for the secondary prevention of cardiovascular and cerebrovascular events in diabetes p...

  20. 脂肪酸结合蛋白与心脑血管病的早期诊断%Fatty acid-binding proteins and the early diagnosis of cardio-cerebrovascular diseases

    Institute of Scientific and Technical Information of China (English)

    张黎军; 赵中

    2010-01-01

    Currently, the commonly used diagnostic markers have the shortcomings of lower sensitivity or specificity in the early diagnosis of cardio-cerebrovascular diseases. Therefore, it needs to use the novel specific biochemical markers for the early diagnosis arid treatment, so as to decrease the high mortality and disability caused by cardio-cerebrovascular events. Fatty acid-binding proteins (FABPs) are a family of low-molecular-weight intracellular lipid-binding proteins. They are divided into 9 different subtypes, including the liver-, intestinal-, heart-, brain-, adipocyte-, skin-, ileal-, myelin-, and testis-subtype. Their primary function is to transport long-chain fatty acids into the cells, and thus regulate intracellular lipid metabolism. The structures of all FABP subtypes are similar, inclusive of two α2 helices arid one β2 fold structure. Among them, the sensitivities and specificities of the heart- and brain-subtype FABPs are higher in the early diagnosis of cardio-cerebrovascular diseases. It is promising to become the novel markers in the early diagnosis of cardio-cerebrovascular diseases.%在心脑血管病的早期诊断方面,目前常用的诊断标志物存在敏感性或特异性较低的缺点,因此需要利用新的生化特异标志物来进行早期诊断和早期治疗,以降低心脑血管事件导致的高病死率和高致残率.脂肪酸结合蛋白(fatty acid-binding protein,FABP)是一种低分子胞内脂质结合蛋白,分为肝脏型、肠型、心型、脑型、脂肪细胞型、表皮型、回肠型、髓磷脂型和睾丸型等9种亚型,其主要功能是转运长链脂肪酸至细胞内,从而调节细胞内脂质代谢.各种FABP亚型的结构相似,均含有2个α2螺旋和1个β2折叠结构.其中,心型和脑型FABP早期诊断心脑血管病的敏感性和特异性较高,有望成为心脑血管病早期诊断的新型标志物.

  1. Vinpocetine and Pyritinol: A New Model for Blood Rheological Modulation in Cerebrovascular Disorders—A Randomized Controlled Clinical Study

    Directory of Open Access Journals (Sweden)

    Hayder M. Alkuraishy

    2014-01-01

    Full Text Available Blood and plasma viscosity are the major factors affecting blood flow and normal circulation. Whole blood viscosity is mainly affected by plasma viscosity, red blood cell deformability/aggregation and hematocrit, and other physiological factors. Thirty patients (twenty males + ten females with age range 50–65 years, normotensive with history of cerebrovascular disorders, were selected according to the American Heart Stroke Association. Blood viscosity and other rheological parameters were measured after two-day abstinence from any medications. Dual effects of vinpocetine and pyritinol exhibit significant effects on all hemorheological parameters (P0.05. Therefore, joint effects of vinpocetine and pyritinol improve blood and plasma viscosity in patients with cerebrovascular disorders.

  2. Incidence of cardiovascular and cerebrovascular disease in Danish men and women with a prolonged heavy alcohol intake

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla Arthur; Frederiksen, M.E.; Thygesen, L.C.;

    2008-01-01

    rates of cardio- and cerebrovascular diseases than the population in general. METHODS: The cohort comprised 19,185 subjects (15,368 men and 3,817 women) who attended outpatient clinics for alcohol abusers within the Copenhagen Hospital Corporation (1954 to 1992). Incidence rates were standardized (SIR......BACKGROUND: Several epidemiological studies have found U- or J-shaped relationships between alcohol intake and cardiovascular conditions. The influence of heavy drinking is, however, sparsely studied. The objective of the present study was to examine whether alcohol addicts have higher incidence.......45-2.99; women: SIR = 2.77; 95% CI 2.18-3.48). CONCLUSIONS: The study indicates increased risks of cardio- and cerebrovascular diseases in subjects with an excessive alcohol intake Udgivelsesdato: 2008/11...

  3. Transferencia del aprendizaje motor en pacientes con antecedentes de accidente cerebrovascular: serie de casos

    Directory of Open Access Journals (Sweden)

    Karen Castro-Medina

    2015-04-01

    Full Text Available Antecedentes. La rehabilitación es un proceso de reaprendizaje motor, que mejora el desempeño en términos de adquisición de nuevas habilidades y adaptación o refinamiento de habilidades aprendidas previamente. A pesar de este conocimiento, existen, considerablemente, pocos estudios que describan el aprendizaje motor después de un accidente cerebrovascular (ACV y la relevancia del mismo en los procesos de rehabilitación y recuperación. Objetivo. Describir la transferencia del aprendizaje motor en pacientes con antecedentes de accidente cerebrovascular después de un tratamiento con procedimientos de reeducación funcional. Materiales y métodos. Se realizó un estudio descriptivo de dos casos con pacientes que recibieron tratamiento fisioterapéutico ambulatorio con los principios de reeducación funcional desarrollados en el Hospital de las Clínicas de la Universidad de São Paulo (Brasil, entre los meses de agosto y octubre de 2013. La transferencia del aprendizaje motor se determinó según los resultados obtenidos en la evaluación de balance funcional (Mini-BESTest. Se evaluó el test antes y después del tratamiento y se compararon los resultados para determinar el porcentaje de mejora. Resultados. En los dos casos se observó mejora clínica en el desempeño de la evaluación de balance funcional Mini-BESTest con un porcentaje de mejora entre el 21% y el 41%. Conclusión. Existen pocos hallazgos literarios que describen el mantenimiento de la capacidad de aprendizaje motor en pacientes con antecedentes de ACV. Este estudio reportó la capacidad para transferir el aprendizaje motor a una habilidad motora no aprendida (balance en dos casos, con base en la mejoría clínica del desempeño motor en el test aplicado.

  4. A Fast and Fully Automatic Method for Cerebrovascular Segmentation on Time-of-Flight (TOF) MRA Image

    OpenAIRE

    Gao, Xin; Uchiyama, Yoshikazu; Zhou, Xiangrong; HARA, TAKESHI; Asano, Takahiko; Fujita, Hiroshi

    2010-01-01

    The precise three-dimensional (3-D) segmentation of cerebral vessels from magnetic resonance angiography (MRA) images is essential for the detection of cerebrovascular diseases (e.g., occlusion, aneurysm). The complex 3-D structure of cerebral vessels and the low contrast of thin vessels in MRA images make precise segmentation difficult. We present a fast, fully automatic segmentation algorithm based on statistical model analysis and improved curve evolution for extracting the 3-D cerebral ve...

  5. Non-ionizing radiofrequency electromagnetic waves traversing the head can be used to detect cerebrovascular autoregulation responses

    OpenAIRE

    Oziel, M.; M. Hjouj; Gonzalez, C.A.; Lavee, J.; Rubinsky, B

    2016-01-01

    Monitoring changes in non-ionizing radiofrequency electromagnetic waves as they traverse the brain can detect the effects of stimuli employed in cerebrovascular autoregulation (CVA) tests on the brain, without contact and in real time. CVA is a physiological phenomenon of importance to health, used for diagnosis of a number of diseases of the brain with a vascular component. The technology described here is being developed for use in diagnosis of injuries and diseases of the brain in rural an...

  6. Cerebrovascular diseases in a fixed population Hiroshima and Nagasaki with special reference to relationship between type and risk factors

    International Nuclear Information System (INIS)

    A study was made of the incidence of cerebrovascular diseases, their chronological trend, and relationship between the disease types and risk factors on 16,491 subjects of Hiroshima and Nagasaki who underwent medical examination at least once between 1958 - 74, and who were free of cerebrovascular disease at the initial examination. During the 16-year period, 1,162 cases of cerebrovascular disease developed in this study population with the diagnosis definite in 621, and the annual incidence was 3.2 per 1,000 population. By type, there were 108 cases of cerebral hemorrhage, 469 cases of cerebral infarction, 33 cases of subarachnoid hemorrhage, and 11 cases of other unclassifiable types, with cerebral infarction occurring more frequently than cerebral hemorrhage at the ratio of 4.5 : 1. The incidence of cerebrovascular diseases increased with age in both types, but the proportion of younger subjects in cerebral hemorrhage was greater than that in cerebral infarction. A secular trend of declining incidence was noted for both cerebral hemorrhage and cerebral infarction. As a risk factor of cerebral hemorrhage, elevation of systolic and diastolic blood pressure was the most closely related to onset, and left ventricular hypertrophy on electrocardiogram (ECG) and proteinuria were also related. However, a tendency was seen for the risk to be somewhat higher the lower the levels of serum cholesterol. In cerebral infarction, aging, like systolic blood pressure, was a most important risk factor. Left ventricular hypertrophy on ECG, proteinuria, and diabetes could also be risk factors. However, the relation to blood pressure, especially diastolic blood pressure, was not so great as in the case of cerebral hemorrhage. (author)

  7. Association between NADPH Oxidase p22phox C242T Polymorphism and Ischemic Cerebrovascular Disease: A Meta-Analysis

    OpenAIRE

    Li, Bing-Hu; Zhang, Li-li; Zhang, Bei-Bei; Yin, Yan-Wei; Dai, Li-Meng; Pi, Yan; Guo, Lu; Chang-yue GAO; Fang, Chuan-Qin; Wang, Jing-Zhou; Li, Jing-Cheng

    2013-01-01

    Background Epidemiological studies have evaluated the association between nicotinamide adenine dinucleotide phosphate (NADPH) oxidase p22phox C242T polymorphism and risk of ischemic cerebrovascular disease (ICVD), but the results remain inconclusive. This meta-analysis was therefore designed to clarify these controversies. Methodology/Principal Findings Systematic searches of electronic databases Embase, PubMed and Web of Science, as well as hand searching of the references of identified arti...

  8. Acute Cerebrovascular Radiation Syndrome: Radiation Neurotoxicity , mechanisms of CNS radiation injury, advanced countermeasures for Radiation Protection of Central Nervous System.

    Science.gov (United States)

    Popov, Dmitri; Jones, Jeffrey; Maliev, Slava

    Key words: Cerebrovascular Acute Radiation Syndrome (Cv ARS), Radiation Neurotoxins (RNT), Neurotransmitters, Radiation Countermeasures, Antiradiation Vaccine (ArV), Antiradiation Blocking Antibodies, Antiradiation Antidote. Psychoneuroimmunology, Neurotoxicity. ABSTRACT: To review the role of Radiation Neurotoxins in triggering, developing of radiation induced central nervous system injury. Radiation Neurotoxins - rapidly acting blood toxic lethal agent, which activated after irradiation and concentrated, circulated in interstitial fluid, lymph, blood with interactions with cell membranes, receptors and cell compartments. Radiation Neurotoxins - biological molecules with high enzymatic activity and/or specific lipids and activated or modified after irradiation. The Radiation Neurotoxins induce increased permeability of blood vessels, disruption of the blood-brain barrier, blood-cerebrospinal fluid (CSF) barrier and developing severe disorder of blood macro- and micro-circulation. Principles of Radiation Psychoneuro-immunology and Psychoneuro-allergology were applied for determination of pathological processes developed after irradiation or selective administration of Radiation Neurotoxins to radiation naïve mammals. Effects of radiation and exposure to radiation can develop severe irreversible abnormalities of Central Nervous System, brain structures and functions. Antiradiation Vaccine - most effective, advanced methods of protection, prevention, mitigation and treatment and was used for of Acute Radiation Syndromes and elaboration of new technology for immune-prophylaxis and immune-protection against ϒ, Heavy Ion, Neutron irradiation. Results of experiments suggested that blocking, antitoxic, antiradiation antibodies can significantly reduce toxicity of Radiation Toxins. New advanced technology include active immune-prophylaxis with Antiradiation Vaccine and Antiradiation therapy that included specific blocking antibodies to Radiation Neurotoxins

  9. 77 FR 11109 - Reactive Power Resources; Notice of Technical Conference

    Science.gov (United States)

    2012-02-24

    ... power resources, including synchronous and asynchronous generation resources, transmission resources and... methods used to determine the reactive power requirements for a transmission system and how system...

  10. Interactive Chemical Reactivity Exploration

    OpenAIRE

    Haag, Moritz P.; Vaucher, Alain C.; Bosson, Mael; Redon, Stephane; Reiher, Markus

    2014-01-01

    Elucidating chemical reactivity in complex molecular assemblies of a few hundred atoms is, despite the remarkable progress in quantum chemistry, still a major challenge. Black-box search methods to find intermediates and transition-state structures might fail in such situations because of the high-dimensionality of the potential energy surface. Here, we propose the concept of interactive chemical reactivity exploration to effectively introduce the chemist's intuition into the search process. ...

  11. Reactive sputter deposition

    CERN Document Server

    Mahieu, Stijn

    2008-01-01

    In this valuable work, all aspects of the reactive magnetron sputtering process, from the discharge up to the resulting thin film growth, are described in detail, allowing the reader to understand the complete process. Hence, this book gives necessary information for those who want to start with reactive magnetron sputtering, understand and investigate the technique, control their sputtering process and tune their existing process, obtaining the desired thin films.

  12. Reactive plasma spraying

    OpenAIRE

    Al-Sabouni, Omar

    1999-01-01

    Reactive Plasma Spraying (RPS) with a hydrocarbon gas has been studied as a method to improve the mechanical properties of a commercially available 80: 20 nickel-chromium alloy, and subsequently as a method to reduce the oxygen content of sprayed MCrAlY coatings. A conventional d. c. plasma torch has been modified by attaching a conical graphite tube (reactor) onto the end of the gun. The powder is then sprayed through the reactor with injected reactive hydrocarbon gas. The ...

  13. Cognitive impairments in patients with cerebrovascular steno-occlusive disease%脑血管狭窄患者的认知功能损害

    Institute of Scientific and Technical Information of China (English)

    石丹; 冯治中; 李建军

    2012-01-01

    Objective To explore the relationship between cerebrovascular steno-occlusive disease and neuropsychological performance by cognitive function assessment.Methods Using a case-control study,45 patients with cerebrovascular steno-occlusive lesions (patient group) and 59 control subjects without cerebrovascular steno-occlusive disease were included,36 simple hypertension (hypertension group)and 34 simple diabetes mellitus subjects (diabetes mellitus group) without cerebrovascular steno-occlusive disease were also included.A battery of neuropsychological was performed in all subjects.The test battery included tests of memory,executive functions,mental speed,visuospatial ability and visuoconstructive skill,anxietas and depression.Results Patient group showed impairments in multiple cognitive domains compared with other three groups.The immediate recall of auditory verbal learning test (controls 56.8 ± 6.5 ;patient group 48.5 ± 10.1 ;hypertension group 53.5 ±9.0 ;diabetes mellitus group 55.9 ± 7.9;t =-3.57-4.822,P =0.000-0.021) were impaired seriously.Moreover,visual memory Modified Rey-Osterrieth Complex Figure Test immediate recall,long time delayed recall and executive function California cards sorting test were also impaired.Patient group was divided into two subgroups,and neuropsychological tests of these subgroups were compared.Multiple stenosis subgroup had significantly worse performance in tests of verbal memory and some executive functions than the single artery stenosis subgroup.Conclusions Cerebrovascular steno-occlusive disease was associated with poorer neuropsychological performance,which could not be explained by vascular risk factors.Multiple stenosis subgroup had lower performance levels in neuropsychological tests than simple stenosis subgroup.Ischemia or hypoperfusion caused by steno-occlusive disease might be responsible for these cognitive impairments.%目的 探讨脑血管狭窄或闭塞与认知功能损害的关系.方法 为病例对照研

  14. Neurobiological Basis of Reactive Aggression: A Review

    OpenAIRE

    Shiina A

    2015-01-01

    Reactive aggression is a response to salient threats that may have evolved as a strategy for survival. The likelihood of its outburst is mediated by several factors including the activity of serotonin and other neurotransmitters that regulate reactive aggression through the corticolimbic circuit. Specifically, this circuit is modulated by monoamine oxidase A (MAOA) such that low levels of activity incline an animal to impulsive behavior. Evidence also indicates that aggressive ...

  15. Rosacea, Reactive Oxygen Species, and Azelaic Acid

    OpenAIRE

    Jones, David A.

    2009-01-01

    Rosacea is a common skin condition thought to be primarily an inflammatory disorder. Neutrophils, in particular, have been implicated in the inflammation associated with rosacea and mediate many of their effects through the release of reactive oxygen species. Recently, the role of reactive oxygen species in the pathophysiology of rosacea has been recognized. Many effective agents for rosacea, including topical azelaic acid and topical metronidazole, have anti-inflammatory properties. in-vitro...

  16. The Vulnerability of Vessels Involved in the Role of Embolism and Hypoperfusion in the Mechanisms of Ischemic Cerebrovascular Diseases

    Directory of Open Access Journals (Sweden)

    Yong Peng Yu

    2016-01-01

    Full Text Available Accurate definition and better understanding of the mechanisms of stroke are crucial as this will guide the effective care and therapy. In this paper, we review the previous basic and clinical researches on the causes or mechanisms of ischemic cerebrovascular diseases (ICVD and interpret the correlation between embolism and hypoperfusion based on vascular stenosis and arterial intimal lesions. It was suggested that if there is no embolus (dynamic or in situ emboli, there might be no cerebral infarction. Three kinds of different clinical outcomes of TIA were theoretically interpreted based on its mechanisms. We suppose that there is a correlation between embolism and hypoperfusion, and which mechanisms (hypoperfusion or hypoperfusion induced microemboli playing the dominant role in each type of ICVD depends on the unique background of arterial intimal lesions (the vulnerability of vessels. That is to say, the vulnerability of vessels is involved in the role of embolism and hypoperfusion in the mechanisms of ischemic cerebrovascular diseases. This inference might enrich and provide better understandings for the underlying etiologies of ischemic cerebrovascular events.

  17. β-FIBRINOGEN PROMOTER-455 G/A (HaeⅢ) POLYMORPHISM PREDICTION OF PLASMA FIBRINOGEN BUT NOT OF ISCHEMIC CEREBROVASCULAR DISEASE

    Institute of Scientific and Technical Information of China (English)

    毕胜; 王德生; 李国忠; 温世荣; 潘尚哈

    2004-01-01

    Objective The-455 G/A (HaeⅢ) polymorphism of β-fibrinogen gene influences levels of plasma fibrinogen. We further investigated whether it influences the risk of ischemic cerebrovascular disease. Methods We accumulated 134 acute ischemic cerebrovascular disease (ICVD) cases and compared their -455 G/A status with a control group (n = 166). The β-fibrinogen gene -455 G/A polymorphism was analyzed for all subjects by PCR-RFLP with the restrictive enzyme HaeⅢ. Results Plasma fibrinogen was higher in AA homozygous participants (341 mg/dL) than in participants carrying the G allele: GA (290 mg/dL), GG (298 mg/dL) in the control group. Plasma fibrinogen was also higher in AA homozygous patients (353 mg/dL) than in cases carrying the G allele: GA (287mg/dL), GG (302 mg/dL) in the ICVD group. However, there was no significant association between β-fibrinogen gene -455 G/A polymorphism and ICVD group. Conclusions Although a small effect cannot be excluded, β-fibrinogen gene -455 G/A polymorphism is an independent predictor of plasma fibrinogen, but not of ischemic cerebrovascular disease.

  18. Placental ischemia-induced increases in brain water content and cerebrovascular permeability: role of TNF-α.

    Science.gov (United States)

    Warrington, Junie P; Drummond, Heather A; Granger, Joey P; Ryan, Michael J

    2015-12-01

    Cerebrovascular complications and increased risk of encephalopathies are characteristic of preeclampsia and contribute to 40% of preeclampsia/eclampsia-related deaths. Circulating tumor necrosis factor-α (TNF-α) is elevated in preeclamptic women, and infusion of TNF-α into pregnant rats mimics characteristics of preeclampsia. While this suggests that TNF-α has a mechanistic role to promote preeclampsia, the impact of TNF-α on the cerebral vasculature during pregnancy remains unclear. We tested the hypothesis that TNF-α contributes to cerebrovascular abnormalities during placental ischemia by first infusing TNF-α in pregnant rats (200 ng/day ip, from gestational day 14 to 19) at levels to mimic those reported in preeclamptic women. TNF-α increased mean arterial pressure (MAP, P blood-brain barrier (BBB) permeability in the anterior cerebrum or posterior cerebrum. We then assessed the role of endogenous TNF-α in mediating these abnormalities in a model of placental ischemia induced by reducing uterine perfusion pressure followed by treatment with the soluble TNF-α receptor (etanercept, 0.8 mg/kg sc) on gestational day 18. Etanercept reduced placental ischemia-mediated increases in MAP, anterior brain water content (P permeability (202 ± 44% in placental ischemic rats to 101 ± 28% of normal pregnant rats). Our results indicate that TNF-α mechanistically contributes to cerebral edema by increasing BBB permeability and is an underlying factor in the development of cerebrovascular abnormalities associated with preeclampsia complicated by placental ischemia.

  19. Analytic device including nanostructures

    KAUST Repository

    Di, Fabrizio, E.

    2015-07-02

    A device for detecting an analyte in a sample comprising: an array including a plurality of pixels, each pixel including a nanochain comprising: a first nanostructure, a second nanostructure, and a third nanostructure, wherein size of the first nanostructure is larger than that of the second nanostructure, and size of the second nanostructure is larger than that of the third nanostructure, and wherein the first nanostructure, the second nanostructure, and the third nanostructure are positioned on a substrate such that when the nanochain is excited by an energy, an optical field between the second nanostructure and the third nanostructure is stronger than an optical field between the first nanostructure and the second nanostructure, wherein the array is configured to receive a sample; and a detector arranged to collect spectral data from a plurality of pixels of the array.

  20. Assessment of Vitamin D level in Cerebrovascular Accident Patients in Eastern India

    Directory of Open Access Journals (Sweden)

    Kaushik Chatterjee

    2014-12-01

    Full Text Available Aims and objectives: Vitamin D in addition to its effect on bone- mineral homeostasis has many extra-skeletal effects. Recently its association with cardiovascular disease, diabetes, hypertension are well described. In our study we have tried to find out any of its association with cerebrovascular accident (CVA patients. Material and Methods: In a cross sectional study serum 25 OH vitamin D3, parathormone, calcium and phosphate were estimated in 38 CVA patients and 46 age and sex matched controls. Results: Vitamin D level was found to be low in CVA patients [mean 20.01(+/-7.13 ng/ml] irrespective of their sex, residence, diabetes and hypertension. However there was no significant difference with control population [mean 20.37(+/-5.74 ng/ml; P= 0.79]. Conclusion: There is no significant difference in vitamin D level between CVA patients or non-CVA population. So the role of vitamin D deficiency in the causation of CVA needs reevaluation, especially in Indian patients." [Natl J Med Res 2014; 4(4.000: 264-269

  1. Cerebrovascular expression of proteins related to inflammation, oxidative stress and neurotoxicity is altered with aging

    Directory of Open Access Journals (Sweden)

    Luo Jinhua

    2010-10-01

    Full Text Available Abstract Background Most neurodegenerative diseases are age-related disorders; however, how aging predisposes the brain to disease has not been adequately addressed. The objective of this study is to determine whether expression of proteins in the cerebromicrovasculature related to inflammation, oxidative stress and neurotoxicity is altered with aging. Methods Brain microvessels are isolated from Fischer 344 rats at 6, 12, 18 and 24 months of age. Levels of interleukin (IL-1β and IL-6 RNA are determined by RT-PCR and release of cytokines into the media by ELISA. Vessel conditioned media are also screened by ELISA for IL-1α, monocyte chemoattractant protein-1 (MCP-1, tumor necrosis factor-α, (TNFα, and interferon γ (IFNγ. Immunofluorescent analysis of brain sections for IL-1β and IL-6 is performed. Results Expression of IL-1β and IL-6, both at RNA and protein levels, significantly (p Conclusions These data demonstrate that cerebrovascular expression of proteins related to inflammation, oxidative stress and neurotoxicity is altered with aging and suggest that the microvasculature may contribute to functional changes in the aging brain.

  2. Cholesteryl ester transfer protein levels and gene deficiency in Chinese patients with cardio-cerebrovascular diseases

    Institute of Scientific and Technical Information of China (English)

    庄一义; 汪俊军; 张宏娟; 李勇; 刘小传; 李露言; 陈光辉

    2002-01-01

    Objective To detect cholesteryl ester transfer protein (CETP) levels, frequencies of CETP D442G and Ⅰ14A mutations and characteristics of abnormal lipids in patients with cardio-cerebro vascular diseases. Methods Ninety-four myocardial infarction (MI) patients,110 stroke patients and 335 healthy controls were selected. The CETP concentration was determined using ELISA. The CETP activity was measured using a substrate of 14 C-radiolabeled discoidal bilayer particles. The CETP gene mutations were detected by PCR-RFLP. Results The CETP concentrations in the MI and stroke group, were higher than those in the controls. The gene mutation frequencies of D442G in the MI, stroke and control group were 3.5%, 3.6% and 5%, respectively, and the frequencies of Ⅰ14A were 1.05%, 0.91% and 1%, respectively. One case of D442G homozygote was detected in the healthy group. The frequency of two CETP gene mutations showed no significant difference among the patients and controls. The CETP concentration and activity in subjects with CETP mutations were one-third of those in the control group. The level of HDL-C, apo-A1 increased in the mutation subjects, while the TG level decreased. Conclusions The CETP level increased significantly in patients with cardio-cerebrovascular diseases. The carriers of CETP deficiency had CETP and lipid abnormalities.

  3. Relationship between the severity of obstructive sleep apnea syndrome and asymptomatic cerebrovascular disease

    International Nuclear Information System (INIS)

    In this study, examined were prevalence of asymptomatic cerebrovascular disease (ACD) in patients with obstructive sleep apnea syndrome (OSAS) and relationship between its severity and ACD prevalence. Subjects were 192 cases (M 170/F 20, av. age 50.6 y) with chief complaint of snore, sleep apnea (apnea-hypopnea index/AHI 0-118.4/h), midday drowsiness and so on without CD history, who underwent the overnight polysomnographic recording, vascular risk assessment like life habits, blood pressure and impaired GT, and brain MRI. The last item was conducted with Siemence 1.5T machine to get T1-, T2-weighted and FLAIR images to evaluate asymptomatic lacunar infarction (ALI) and periventricular hyperintensity (PVH). Light (AHI<15/h), moderate (15≤AHI<30) and severe (AHI≥30) OSASs were found in 44, 35 and 61 cases, respectively. ALIs were found in 7 light, 17 moderate and 61 severe cases and PVH, in 9, 19 and 61 cases, respectively. Thus it was revealed that patients with moderate to severe OSAS had complication of ACD in a higher rate than those with light OSAS and that prevalence of ACD was higher in OSAS patients with AHI 15/h or more. (R.T.)

  4. Pharmacogenetics of cerebrovascular metabolism modulators in dementia due to Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Fabricio Ferreira de Oliveira

    2015-03-01

    Full Text Available The aims of this study were to investigate risk factors for cognitive and functional decline among 193 patients with Alzheimer’s disease dementia (AD, and to conduct pharmacogenetic analysis on cerebrovascular metabolism modulators, taking into account APOE haplotypes and the genotypes of ACE, CETP, LDLR and the LXR-β gene. For all patients, later age at AD onset was the most important risk factor for faster cognitive and functional decline, while the late-life coronary heart disease risk was inversely related to cognitive decline only for carriers of APOE4+ haplotypes. Schooling was protective against cognitive decline only for women and carriers of APOE4+ haplotypes, while higher body mass index in late life was protective against cognitive decline only for men. Carriers of the APOE-ε4/ε4 haplotype had earlier AD onset, whereas genotypes of CETP and LDLR that had traditionally been associated with higher risk of AD were associated with later onset of dementia. Angiotensin-converting enzyme inhibitors caused a 50% reduction in Mini-Mental State Examination score changes, and had better disease-modifying properties than did centrally-acting angiotensin-converting enzyme inhibitors alone. Angiotensin receptor blockers had genetically mediated effects that led to faster cognitive and functional decline, while patients with genetic tendencies towards faster cognitive and functional decline had maximum benefits when they used lipophilic statins, and vice versa.

  5. The role of endothelial progenitor cells in transient ischemic attack patients for future cerebrovascular events

    Directory of Open Access Journals (Sweden)

    Rokhsareh Meamar

    2016-01-01

    Full Text Available Background: The role of endothelial progenitor cells (EPCs in the maintenance of vascularization following ischemic brain after experimental stroke has been established. Accordingly, in this study, we evaluated the role of circulating EPCs in transient ischemic attack (TIA patients for future cerebrovascular (CV events. Materials and Methods: The level of circulating EPCs (staining markers: CD34, CD309 were determined using flow cytometry at 24 h after TIA in thirty consecutive patients. The EPCs level was also evaluated once in thirty healthy volunteers. Over a period of 12 months, all patients were evaluated by an experienced neurologist for recurrent TIA, stroke or death induced by CV disorders. Results: Circulating EPCs increased in patients group following the first attack of TIA when compared with controls. By analysis of covariance, cardiovascular event history, hyperlipidemia, and statin therapy remained significant independent predictors of EPCs. The mean (standard deviation duration of follow-up was 10.5 (3.1 months (range, 2–12 months. During follow-up, a total of three patients died due to CV accident and four patients experienced again recurrent TIA. By analyzing data with Cox regression, EPC did not predict the future CV events in TIA patients. Conclusion: Increased incidence of future CV events did not occur in those patients with elevated EPCs in the first attack of TIA. The significant predicting factors of EPCs were cardiovascular event history, hyperlipidemia, and statin therapy.

  6. Systems pharmacology for traditional Chinese medicine with application to cardio-cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Yingxue Fu

    2014-10-01

    Full Text Available Identified as a treasure of natural herbal products, traditional Chinese medicine (TCM has attracted extensive attention for their moderate treatment effect and lower side effect. Cardio-cerebrovascular diseases (CCVD are a leading cause of death. TCM is used in China to prevent and treat CCVD. However, the complexity of TCM poses challenges in understanding the mechanisms of herbs at a systems-level, thus hampering the modernization and globalization of TCM. A novel model, termed traditional Chinese medicine systems pharmacology (TCMSP analysis platform, which relies on the theory of systems pharmacology and integrates absorption, distribution, metabolism, excretion and toxicity (ADME/T evaluation, target prediction and network/pathway analysis, was proposed to address these problems. Here, we review the development of systems pharmacology, the TCMSP approach and its applications in the investigations of CCVD and compare it with other methods. TCMSP assists in uncovering the mechanisms of action of herbal formulas used in treating CCVD. It can also be applied in ascertaining the different syndrome patterns of coronary artery disease, decoding the multi-scale mechanisms of herbs, and in understanding the mechanisms of herbal synergism.

  7. Study of 185 diabetic patients with cerebrovascular accident as confirmed on CT

    International Nuclear Information System (INIS)

    In 185 diabetic patients with cerebrovascular accident (CVA) from 15 institutions, responsible lesions were confirmed on CT. The ratio of men to women was 2:1. Multiple cerebral infarction was seen in 22%. According to the type and lesions of CVA, CVA was classified as cerebral infarction confined to the perforating branch (Group 1), that confined to the cortical branch (Group II), and cerebral hemorrhage (Group III). The common background factors for initial CVA were a history of hypertension, abnormal ECG findings, abnormality in the fundus of the eyes, and 121-199 mmHg/dl of fasting blood sugar in all groups. Groups I and II were characterized by comprising many patients with diabetic retinopathy, proteinuria, and hyperlipemia. In Group I, the patients tended to be young and managed unfavorably, and to have hypertriglyceremia, while patients in Group II were old and managed favorably and had frequently atrial fibrillation. Many patients in Group III had a history of diabetes mellitus over less than 5 years and were not managed for diabetes mellitus and hypertension. Prognosis was the most favorable in Group I. There was no background factor for prognosis in Group III. (Namekawa, K)

  8. Prescripción facilitada de drogas antihipertensivas y disminución de la muerte prematura por accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Javier Mariani

    2016-04-01

    Full Text Available Introducción: Desde 2003, el programa Remediar (+Redes distribuye gratuitamente medicación antihipertensiva. Durante este período, la mortalidad por accidente cerebrovascular disminuyó, aunque con inequidades entre grupos socioeconómicos. Objetivos: Evaluar la asociación entre la mortalidad por accidente cerebrovascular y la provisión de fármacos antihipertensivos. Estudiar la posible interacción entre los efectos de los antihipertensivos sobre la mortalidad y el nivel socioeconómico. Material y métodos: Se realizó un estudio ecológico para datos de panel. La mortalidad se expresa como tasas estandarizadas.Los fármacos antihipertensivos están ajustados a la población entre la que se distribuyeron y se expresan en cuartiles dedispensación. El nivel socioeconómico se midió por las necesidades básicas insatisfechas. Resultados: Desde el inicio del programa en 2003, la distribución de antihipertensivos aumentó significativamente, sobre todo en los grupos menos afluentes (p < 0,001. No hubo una asociación estadísticamente significativa entre la tasa de dispensaciónde antihipertensivos y la mortalidad por accidente cerebrovascular globalmente. Sin embargo, en los análisis de interacción se observó que en los quintiles 3 a 5 de necesidades básicas insatisfechas (menos afluentes, los cuartiles en los que se distribuyeron más antihipertensivos tuvieron significativamente menor mortalidad por accidente cerebrovascular (p = 0,004,p = 0,015 y p = 0,017, para los quintiles 3 a 5 de nivel socioeconómico. Conclusiones: Los resultados del presente análisis sugieren la ausencia de efectos globales de la provisión de antihipertensivossobre la mortalidad por accidente cerebrovascular. Sin embargo, los datos muestran que, entre los grupos más desfavorecidos,la distribución de antihipertensivos estuvo asociada con una reducción de la mortalidad por esta causa.

  9. Arsenic in drinking water and cerebrovascular disease, diabetes mellitus, and kidney disease in Michigan: a standardized mortality ratio analysis

    Science.gov (United States)

    Meliker, Jaymie R; Wahl, Robert L; Cameron, Lorraine L; Nriagu, Jerome O

    2007-01-01

    Background Exposure to arsenic concentrations in drinking water in excess of 300 μg/L is associated with diseases of the circulatory and respiratory system, several types of cancer, and diabetes; however, little is known about the health consequences of exposure to low-to-moderate levels of arsenic (10–100 μg/L). Methods A standardized mortality ratio (SMR) analysis was conducted in a contiguous six county study area of southeastern Michigan to investigate the relationship between moderate arsenic levels and twenty-three selected disease outcomes. Disease outcomes included several types of cancer, diseases of the circulatory and respiratory system, diabetes mellitus, and kidney and liver diseases. Arsenic data were compiled from 9251 well water samples tested by the Michigan Department of Environmental Quality from 1983 through 2002. Michigan Resident Death Files data were amassed for 1979 through 1997 and sex-specific SMR analyses were conducted with indirect adjustment for age and race; 99% confidence intervals (CI) were reported. Results The six county study area had a population-weighted mean arsenic concentration of 11.00 μg/L and a population-weighted median of 7.58 μg/L. SMR analyses were conducted for the entire six county study area, for only Genesee County (the most populous and urban county), and for the five counties besides Genesee. Concordance of results across analyses is used to interpret the findings. Elevated mortality rates were observed for both males (M) and females (F) for all diseases of the circulatory system (M SMR, 1.11; CI, 1.09–1.13; F SMR, 1.15; CI, 1.13,-1.17), cerebrovascular diseases (M SMR, 1.19; CI, 1.14–1.25; F SMR, 1.19; CI, 1.15–1.23), diabetes mellitus (M SMR, 1.28; CI, 1.18–1.37; F SMR, 1.27; CI, 1.19–1.35), and kidney diseases (M SMR, 1.28; CI, 1.15–1.42; F SMR, 1.38; CI, 1.25–1.52). Conclusion This is some of the first evidence to suggest that exposure to low-to-moderate levels of arsenic in drinking

  10. Arsenic in drinking water and cerebrovascular disease, diabetes mellitus, and kidney disease in Michigan: a standardized mortality ratio analysis

    Directory of Open Access Journals (Sweden)

    Cameron Lorraine L

    2007-02-01

    Full Text Available Abstract Background Exposure to arsenic concentrations in drinking water in excess of 300 μg/L is associated with diseases of the circulatory and respiratory system, several types of cancer, and diabetes; however, little is known about the health consequences of exposure to low-to-moderate levels of arsenic (10–100 μg/L. Methods A standardized mortality ratio (SMR analysis was conducted in a contiguous six county study area of southeastern Michigan to investigate the relationship between moderate arsenic levels and twenty-three selected disease outcomes. Disease outcomes included several types of cancer, diseases of the circulatory and respiratory system, diabetes mellitus, and kidney and liver diseases. Arsenic data were compiled from 9251 well water samples tested by the Michigan Department of Environmental Quality from 1983 through 2002. Michigan Resident Death Files data were amassed for 1979 through 1997 and sex-specific SMR analyses were conducted with indirect adjustment for age and race; 99% confidence intervals (CI were reported. Results The six county study area had a population-weighted mean arsenic concentration of 11.00 μg/L and a population-weighted median of 7.58 μg/L. SMR analyses were conducted for the entire six county study area, for only Genesee County (the most populous and urban county, and for the five counties besides Genesee. Concordance of results across analyses is used to interpret the findings. Elevated mortality rates were observed for both males (M and females (F for all diseases of the circulatory system (M SMR, 1.11; CI, 1.09–1.13; F SMR, 1.15; CI, 1.13,-1.17, cerebrovascular diseases (M SMR, 1.19; CI, 1.14–1.25; F SMR, 1.19; CI, 1.15–1.23, diabetes mellitus (M SMR, 1.28; CI, 1.18–1.37; F SMR, 1.27; CI, 1.19–1.35, and kidney diseases (M SMR, 1.28; CI, 1.15–1.42; F SMR, 1.38; CI, 1.25–1.52. Conclusion This is some of the first evidence to suggest that exposure to low-to-moderate levels of

  11. 儿童脑血管病的临床及影像学分析%Clinical manifestation of cerebrovascular diseases in children

    Institute of Scientific and Technical Information of China (English)

    沈文俊; 施伟; 李昊

    2013-01-01

    目的 探讨儿童脑血管病的临床特点.方法 回顾性分析8例平均年龄为6.86岁的脑血管病患儿的年龄和性别分布情况与发病特点、病因、部位、诊断方法、治疗及预后情况.颅内出血诊断主要依赖头颅计算机断层扫描及核磁共振成像和数字减影血管成像.结果 男女比例为6:2,起病以急性或者亚急性为主(7/8,87.5%).主要临床表现依次为:单侧肢体乏力(4/8,50.0%),意识障碍(4/8,50.0%),头痛(4/8,50.0%),失语(1/8,12.5%),暂时性缺血性发作(1/8,12.5%).全部病例中已知病因动静脉畸形(3/8,37.5%)与烟雾病(3/8,37.5%)为首位病因,其余病因为微小动脉瘤(1/8,12.5%)及海绵状血管瘤(1/8,12.5%).烟雾病患儿均施以脑-硬膜-动脉-肌肉贴敷术,而动静脉畸形及微小动脉瘤患儿施以伽玛刀治疗.患儿总体治愈率为87.5%(7/8),好转率为12.5%(1/8),病死率为0%.结论 儿童脑血管病的发病有其特殊性,应高度重视伴有神经体征的患儿,尽早进行诊断与治疗,努力提高改善患儿预后.%Objective To demonstrate the clinical features of pediatric cerebrovascular diseases.Methods Data of 8 cases of pediatric cerebrovascular diseases,aged 6.86 years,hospitalized in the past half year were analyzed retrospectively.The diagnosis of intracranial hemorrhage was mainly based on computer tomography (CT),magnetic resonance imaging (MRI) and digital substraction angiography (DSA).Results We study 6 boys and 2 girls.The onset of symptoms was acute or subacute in 87.5 % of the patients (7/8).The main manifestation included limbs debilitation (50.0%),loss of consciousness (50.0%),headache (50.0%),aphasia (12.5%) and transient ischemic attack (12.5%).The causes included arteriovenous malformation(AVM) (37.5%,3/8),aneurysm (12.5%,1/8),cavernoma (12.5,1/8),moyamoya disease (37.3 %,3/8).7 patients (87.5 %) recovered,while 1 patients (12.5 %) showed improvement at

  12. Correlation between carotid atherosclerosis and serum high-sensitivity C-reactive protein in patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Yan Du; Yan Ren; Bo Chen; Chun Li

    2007-01-01

    BACKROUND: Some researches demonstrate that high-sensitivity C-reactive protein may be a risk factor to cause carotid atherosclerosis in patients with cerebral infarction. Inflammatory reaction may participate in formation of carotid atherosclerosis in patients with acute cerebral infarction.OBJECTIVE: To investigate the correlation between levels of serum high-sensitivity C-reactive protein and carotid atherosclerosis in patients with acute cerebral infarction accompanied with carotid atherosclerosis.DESIGN: Contrast observation between two groups.SETTING: Department of Neurology, Zhenzhou Hospital, Shenyang Medical College.PARTICIPANTS: A total of 102 patients with acute cerebral infarction regarded as cerebral infarction group were selected from Department of Neurology, Shenzhou Hospital Affiliated to Shenyang Medical College from February 2005 to September 2006. There were 55 males and 47 females and their ages ranged from 55 to 86 years. All patients met the variously diagnostic points of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were finally diagnosed with CT or MRI examination. Illness course was in an acute phase. A total of 96 healthy subjects were regarded as control group, including 51 males and 45 females aged from 48 to 78 years. All accepted subjects provided the confirmed consent.METHODS: ① Patients in the cerebral infarction group received carotid ultrasound Doppler examination and serum high-sensitivity C-reactive protein detection within 72 hours after onset. IMMAGE immune biochemical system and latex reinforcement particle-enhanced nephelometric immunoassay (PENIA) were used for quantitative detection of serum high-sensitivity C-reactive protein. ② Healthy subjects in the control group received the same detection. SEQUOIA512 color Doppler ultrasound (Siemens Company,USA) was used to detect carotid artery of all subjects so as to observe intima media thickness of artery and formation of

  13. 干预高血压、高血脂、高黏滞血症对心脑血管疾患发生率的影响%Impact of intervened hypertension,hyperlipemia ,hyperviscosity syndrome in incidence of card-iovascular and cerebrovascular diseases

    Institute of Scientific and Technical Information of China (English)

    王建文; 王清; 徐培清

    2002-01-01

    Background:According to American Heart Association's report,death composition of cerebrovascular and cerebrovascular disease was increased to 29% in 1996,and now 33% from 25% in 1992.Now,atherosclerosis seriously endanger human's health.Hypertension,hyperlipemia and hyperviscosity syndrome are main risk factors of cardiovascular and cerebrovascular diseases.There conditions often existed simultaneously in elders.Intervention to these diseases can prevent cardiovascular and cerebrovascular events,which is feasible. Objective:To investigate impact of hypertension,hyperlipemia and hyperviscosity syndrome on incidence of cardiovascular and cereborvascular events. Design:Random,controlled study. Unit:Department of Senile Diseases, Qianfoshan Hospital of Shandong. Subjects:In study group, 52 senile subjects with complete hospitalizing data were recruited from 1995~ 2000.Patients with hypertension,hyperlipemia ,hyperviscosity syndrome were included in the current study.13 subjects asked medical help due to hypertension,25 due to hyperlipemia and 14 due to hyperviscosity syndrome.Sometimes blood pressure of hypertension patients was 140~ 160/90~ 100 mmHg.Patients' mean age was 65.21.Ratio of male to female was 13:1.In control group,50 outpatients were included who had similar diseases those in study group.Mean age was 62.34 and ratio of male to female was 17.33:1. Intervention:In study group,calcium antagonist such as adalatcc, nitrendipine, plendil and/or ASCE inhibitor such as perindopril and captopril were given o.s.Blood pressure was con trolled to normal level.Blood lipid regulating drugs such as pravastatin, ticlopidine,and lipanthy were given for hyperlipemia patients.For patients with hyperviscosity syndrome,enteral aspirin or persantine was given,50~ 75 mg/day.Interval of drugs was 1 day to 2 months.Detailed data was unavailable.Red sage root or its compound form injecto was given i.v.,70 mg/day,pueraria root was given i.v.300~ 500 mg

  14. Dynamic reactive astrocytes after focal ischemia

    Institute of Scientific and Technical Information of China (English)

    Shinghua Ding

    2014-01-01

    Astrocytes are specialized and most numerous glial cell type in the central nervous system and play important roles in physiology. Astrocytes are also critically involved in many neural disor-ders including focal ischemic stroke, a leading cause of brain injury and human death. One of the prominent pathological features of focal ischemic stroke is reactive astrogliosis and glial scar for-mation associated with morphological changes and proliferation. This review paper discusses the recent advances in spatial and temporal dynamics of morphology and proliferation of reactive astrocytes after ischemic stroke based on results from experimental animal studies. As reactive astrocytes exhibit stem cell-like properties, knowledge of dynamics of reactive astrocytes and glial scar formation will provide important insights for astrocyte-based cell therapy in stroke.

  15. Anti-inflamatórios não esteroides: Efeitos cardiovasculares, cérebro-vasculares e renais Antiinflamatorios no esteroides: efectos cardiovasculares, cerebrovasculares y renales Nonsteroidal anti-inflammatory drugs: cardiovascular, cerebrovascular and renal effects

    Directory of Open Access Journals (Sweden)

    Michel Batlouni

    2010-04-01

    inhibidores de la ciclo-oxigenase (COX, selectivos o no. Los AINEs no selectivos son los más antiguos, y designados como tradicionales o convencionales. Los AINEs selectivos para la COX-2 se designan COXIBEs. En los últimos años, ha sido cuestionada la seguridad del uso de los AINEs en la práctica clínica, particularmente de los inhibidores selectivos de la COX-2. Las evidencias sobre el aumento del riesgo cardiovascular con el uso de AINEs son todavía incompletas, debido a la ausencia de ensayos randomizados y controlados con poder para evaluar desenlaces cardiovasculares relevantes. Sin embargo, los resultados de estudios clínicos prospectivos y de metaanálisis indican que los inhibidores selectivos de la COX-2 ejercen importantes efectos cardiovasculares adversos, que incluyen aumento del riesgo de infarto del miocardio, accidente cerebrovascular, insuficiencia cardiaca, insuficiencia renal y hipertensión arterial. El riesgo de estos efectos adversos es mayor en pacientes con historia previa de enfermedad cardiovascular o con alto riesgo para desarrollarla. En estos pacientes, el uso de inhibidores de la COX-2 debe ser limitado a aquellos para los que no hay alternativa apropiada y, aun así, solamente en dosis bajas y por el menor tiempo necesario. Aunque los efectos adversos más frecuentes se relacionen a la inhibición selectiva de la COX-2, la ausencia de selectividad para esta isoenzima no elimina completamente el riesgo de eventos cardiovasculares, de modo que todos los fármacos del largo espectro de los AINEs se deben prescribir solamente tras consideración del balance riesgo/beneficio.The nonsteroidal anti-inflammatory drugs (NSAIDs are among the most often prescribed drugs in the world. This heterogeneous class of drugs includes aspirin and several other selective or non-selective cyclooxygenase (COX inhibitors. The non-selective NSAIDs are the oldest ones and are called traditional or conventional NSAIDs. The selective NSAIDs are called COX-2

  16. Interactive Chemical Reactivity Exploration

    CERN Document Server

    Haag, Moritz P; Bosson, Mael; Redon, Stephane; Reiher, Markus

    2014-01-01

    Elucidating chemical reactivity in complex molecular assemblies of a few hundred atoms is, despite the remarkable progress in quantum chemistry, still a major challenge. Black-box search methods to find intermediates and transition-state structures might fail in such situations because of the high-dimensionality of the potential energy surface. Here, we propose the concept of interactive chemical reactivity exploration to effectively introduce the chemist's intuition into the search process. We employ a haptic pointer device with force-feedback to allow the operator the direct manipulation of structures in three dimensions along with simultaneous perception of the quantum mechanical response upon structure modification as forces. We elaborate on the details of how such an interactive exploration should proceed and which technical difficulties need to be overcome. All reactivity-exploration concepts developed for this purpose have been implemented in the Samson programming environment.

  17. Cerebral blood flow distribution and reactivity during the symptom-free stages of transient ischemic attacks

    International Nuclear Information System (INIS)

    Even during the symptom-free stages, patients with transient ischemic attacks (TIA) often show cerebral blood flow (CBF) disturbances. For evaluating the factors which cause these abnormalities, we studied CBF and CBF reactivity to acetazolamide (diamox) using a 99mTc-hexamethylpropyleneamine oxime (HMPAO) SPECT. The results from CBF-SPECT were compared with X-ray computed tomography (CT), cerebral arteriogram, clinical characteristics of TIA and cerebrovascular risk factors. The overall sensitivity rates in detecting the lesion were 68% in CBF-SPECT and 9% in CT. The size of the hypoperfused area tended to be wide in patients who had intracranial, severe stenotic or multiple arterial lesions on the ipsilateral side. No such relations were found between CBF and other examinations. Brain hypoperfusion was located in the subcortical region in eight patients; two patients showed a small hypodense lesion on CT which corresponded to the hypoperfusion on SPECT, and three patients showed no arteriographic abnormality. Hypoperfusion in the cortex was seen in seven patients; all patients showed arteriographic abnormality, but no CT abnormality. The severity rating of the vascular stenosis and hypoperfusion, and the incidence of the intracranial lesions were higher in this group than the group with subcortical hypoperfusion. Seven patients showed fixed normoperfusion before and after diamox injection. Two patients with a subcortical small infarction showed fixed hypoperfusion even after diamox injection. Twelve patients showed focal hypoperfusion before diamox with a new filling-in after diamox. Only one patient showed resting hypoperfusion and decreased CBF reactivity to diamox. The results suggest that most of the patients with a brain hypoperfusion in the symptom-free stages of TIAs have preserved cerebrovascular reactivity although a few patients show hypoperfusion having cerebral infarction or hemodynamically compromised tissue. (author)

  18. Accidente cerebrovascular isquémico en mayores de 80 años Acute ischemic stroke in patients aged 80 or older

    Directory of Open Access Journals (Sweden)

    Juan I Rojas

    2007-12-01

    Full Text Available En los pacientes de edad avanzada, el perfil de factores de riesgo vascular y el subtipo de accidente cerebrovascular (ACV es diferente en comparación con pacientes más jóvenes. El objetivo del presente trabajo fue describir el perfil de factores de riesgo y subtipo de ACV isquémico en nuestra población de pacientes ancianos. Incluimos a pacientes mayores de 80 años con diagnóstico de ACV isquémico y ataque isquémico transitorio (AIT entre junio de 2003 y junio de 2006. De 535 pacientes con eventos cerebrovasculares isquémicos, en 366 casos el diagnóstico fue de ACV y 169 de AIT. El 33.5% (179 pacientes fueron mayores de 80 años. La edad media fue de 84.4 ± 4.4 años. Los factores de riesgo más frecuentes fueron: hipertensión arterial 82.7%, dislipemia 40.2% y fibrilación auricular 24.6%. El subtipo de ACV que se presentó con mayor frecuencia fue la enfermedad de pequeñas arterias en un 41.7%, seguido por el evento cardioembólico en el 19.7%, enfermedad de gran arteria 6%, otras causas en el 0.8%. De los factores de riesgo vasculares tradicionales, los más significativos fueron hipertensión e hipercolesterolemia. Estos datos son coincidentes con estudios epidemiológicos previos y explican la mayor incidencia de infartos lacunares.Young and old age stroke groups have different vascular risk profiles for cerebral ischemic events. The objective of the study was to describe the risk factor profile and stroke subtype in this population of very elderly people. We included patients over 80 years old with diagnosis of ischemic stroke and transient ischemic attack registered between June 2003 and June 2006. We described the demographic data and subtype of ischemic stroke. Of 535 patients with cerebrovascular ischemic events, the final diagnosis was stroke in 366 cases and transient ischemic attack in 169. Of these patients 33.5% were over 80 years old (179. The mean age was 84.4 ± 4.4 years. The most frequent risk factors were

  19. A test of reactive scope: Reducing reactive scope causes delayed wound healing.

    Science.gov (United States)

    DuRant, S E; Arciniega, M L; Bauer, C M; Romero, L M

    2016-09-15

    Reactive scope predicts that all animals have an adaptive ability to respond to stressors in their environment, termed reactive homeostasis, and that only when an animal's response to stressful stimuli exceeds a certain threshold (homeostatic overload) will stress have pathological effects. While this framework has successfully helped interpret effects of stressors on wildlife, no study has designed an experiment to directly test this framework. This study was designed to expose house sparrows (Passer domesticus) to treatments that would result in varying ranges of reactive homeostasis during chronic stress, which based on the reactive scope model should cause birds with the lowest reactive homeostasis range to exhibit signs of pathology during a subsequent challenge. To modulate the reactive homeostasis range, we altered allostatic load of birds by exposing them to chronic stress while either elevating, blocking, or not manipulating corticosterone. After concluding chronic stress treatments, birds were exposed to the subsequent challenge of a superficial wound. Individuals treated with corticosterone during chronic stress (high allostatic load) experienced the most pathology, including both weight loss and slower wound healing. Unmanipulated birds (medium allostatic load) also experienced weight loss but had normal healing rates, while birds with blocked corticosterone (low allostatic load) had minimal weight loss and normal healing rates. Our results indicate that increased allostatic load reduces the reactive homeostasis range, thereby causing individuals to cross the homeostatic overload threshold sooner, and thus support the reactive scope framework.

  20. 妊娠期高血压疾病合并脑血管疾病的临床观察%Clinical observation on hypertensive disorder complicating pregnancy combined with cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    阚淑娟; 陈永立; 李云霞

    2011-01-01

    Objective: To explore the causes, preventive measures and therapeutic schedule of hypertensive disorder complicating pregnancy (HDCP) combined with cerebrovascular disease. Methods: The clinical data of 487 cases with HDCP combined with cerebrovas-cular disease who were treated in the hospital from 2003 to 2008 were analyzed retrospectively. Results: 2 416 patients with HDCP were treated in the hospital from 2003 to 2008, and 487 patients were combined with cerebrovascular disease (20. 16% ) , including 23 patients with subarachnoid hemorrhage, 58 patients with cerebral hemorrhage and 406 patients with cerebral infarction. The clinical symptoms included headache, dizziness, somnolence, blurred vision, disturbance of consciousness, vomiting, hyperspasmia, limb sensory disturbance or mild dyskinesia; the diagnosis was confirmed by CT or MRI; after termination of pregnancy timely, spasmolysis and depressurization, one pregnant woman and three fetuses died. Conclusion: HDCP should be prevented actively during pregnancy, and cerebrovascular blood flow should be monitored regularly. For patients with HDCP combined with cerebrovascular disease, timely cerebral CT and MRI should be carried out for definite diagnosis, terminating pregnancy timely and active treatment are important to ensure the safety of mothers and their infants.%目的:探讨妊娠期高血压合并脑血管疾病的发病原因、预防措施以及治疗方案.方法:回顾性分析该院2003~2008年收治的487例妊娠期高血压疾病合并脑血管疾病的临床资料.结果:2003~2008年共收治妊娠期高血压疾病患者2 416例,其中合并脑血管疾病487例(20.16%),包括蛛网膜下腔出血23例,脑出血58例和脑梗死406例.临床症状包括头痛、眩晕、嗜睡、视物模糊、意识障碍、呕吐、抽搐以及肢体感觉或轻度运动障碍;头颅CT或MRI检查后可确诊;及时终止妊娠,解痉降压治疗后,1例产妇死亡,3例胎儿死亡.结论:妊娠

  1. Cerebrovascular Acute Radiation Syndrome : Radiation Neurotoxins, Mechanisms of Toxicity, Neuroimmune Interactions.

    Science.gov (United States)

    Popov, Dmitri; Maliev, Slava

    Introduction: Cerebrovascular Acute Radiation Syndrome (CvARS) is an extremely severe in-jury of Central Nervous System (CNS) and Peripheral Nervous System (PNS). CvARS can be induced by the high doses of neutron, heavy ions, or gamma radiation. The Syndrome clinical picture depends on a type, timing, and the doses of radiation. Four grades of the CvARS were defined: mild, moderate, severe, and extremely severe. Also, four stages of CvARS were developed: prodromal, latent, manifest, outcome -death. Duration of stages depends on the types, doses, and time of radiation. The CvARS clinical symptoms are: respiratory distress, hypotension, cerebral edema, severe disorder of cerebral blood microcirculation, and acute motor weakness. The radiation toxins, Cerebro-Vascular Radiation Neurotoxins (SvARSn), determine development of the acute radiation syndrome. Mechanism of action of the toxins: Though pathogenesis of radiation injury of CNS remains unknown, our concept describes the Cv ARS as a result of Neurotoxicity and Excitotoxicity, cell death through apoptotic necrosis. Neurotoxicity occurs after the high doses radiation exposure, formation of radiation neuro-toxins, possible bioradicals, or group of specific enzymes. Intracerebral hemorrhage can be a consequence of the damage of endothelial cells caused by radiation and the radiation tox-ins. Disruption of blood-brain barrier (BBB)and blood-cerebrospinal fluid barrier (BCFB)is possibly the most significant effect of microcirculation disorder and metabolic insufficiency. NMDA-receptors excitotoxic injury mediated by cerebral ischemia and cerebral hypoxia. Dam-age of the pyramidal cells in layers 3 and 5 and Purkinje cell layer the cerebral cortex , damage of pyramidal cells in the hippocampus occur as a result of cerebral ischemia and intracerebral bleeding. Methods: Radiation Toxins of CV ARS are defined as glycoproteins with the molec-ular weight of RT toxins ranges from 200-250 kDa and with high enzymatic activity

  2. Characterization and prognosis factors of cerebro-vascular disease in Cienfuegos province. Caracterización y factores pronósticos de la enfermedad cerebrovascular en la Provincia de Cienfuegos.

    Directory of Open Access Journals (Sweden)

    Roberto Suárez Suri

    Full Text Available Fundaments: Cerebrovascular disease constitutes the third cause of death and the first cause of severe discapacity in adults in those countries that have a developed health system like ours. Objective: To characterise the patients with cerebrovascular disease and to determine the variables that influence upon their prognosis once it is established. Method: Prospective, descriptive, longitudinal study of a series of cases developed at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Questionnaires were applied to the patients that fitted the inclusion criteria (n 1318 Results: The mean age was 66,08 years with a predominance of white patients ( 75,26 %, mainly males ( 56,67%. The risk factor of highest frequency was hypertension ( 43,24 % The evolution for alive patients without discapacities was 14,71%, alive with discapacities ( 57,96% and death 27,31%. There was a predominance of ischemic cerebrovascular disease (46,13 % of aterothrombotic infarcts and 14,94 % cardioembolic disease. In regards to hemorrhagic disease 13,42 % were intracerebral hemorrhage and 4,55% subarachnoid hemorrhage. There was a prognostic correlation between the clinical variables: consciousness, sight, sensibility, language, tone, Babinski , osteotendious reflexes and muscular force. For the general variables cerebral edema, bacterial bronchopneumonia , displacement of the medial line, diagnosis is some values, CT scan diagnoses in some values for diabetes mellitus and convulsions.

    Fundamento: Las enfermedades cerebrovasculares constituyen la tercera causa de muerte y la primera de discapacidad grave del adulto en los países con sistemas de salud desarrollados similares al nuestro. Objetivo : Caracterizar a los pacientes con enfermedades cerebrovasculares y determinar las variables que influyen en su pron

  3. Aortic Complex Plaque Predicts the Risk of Cryptogenic Ischemic Cerebrovascular Disease Recurrence.

    Science.gov (United States)

    Dong, Jing; Ma, Xin; Qie, Jingyuan; Ji, Xunming

    2016-03-01

    To evaluate the correlations between aortic complex plaque (ACP) and the recurrence of cryptogenic ischemic cerebrovascular disease (CICVD), and to investigate the clinical significance of ACP in CICVD. Methods CICVD patients (aged 17 to 84 years) admitted into the Department of Neurology, Xuanwu Hospital, from July 2011 to December 2013, were consecutively recruited, and divided into ACP and non-ACP groups according to head and neck computerized tomographic (CT) angiography. Recurrences of cerebral ischemic events (CIEs) were compared between these groups after follow-up. Results A total of 117 patients were enrolled (ACP group: 69, non-ACP group: 48) and followed up for a mean of 9.86 months (range: 3-33). The average age of the ACP group was 62.88 years, with 59.4% older than 60 years; the average age of the non-ACP group was 50.29 years, with 37.5% older than 60 years. At the 6-month follow-up, the recurrence rate of CIEs in the ACP group was significantly higher than that of the non-ACP group (17.0% [7/47] and 0% [0/36], respectively; χ2 = 4.283, P = 0.046). The cumulative recurrence risk for CIEs of the ACP group was significantly higher than for the non-ACP group (P = 0.004). Multivariate Cox survival analysis showed that ACP presence was an independent risk factor for CIE recurrence for CICVD patients (relative risk [RR] = 7.803, 95% confidence interval [CI], 1.827~33.319, P = 0.006). Conclusions ACP increased the recurrence risk of CIE in CICVD, and elderly CICVD patients should receive greater attention regarding the significance of ACP in recurrent CICVD.

  4. Effect of hypoxia on cerebrovascular and cognitive function during moderate intensity exercise.

    Science.gov (United States)

    Lefferts, Wesley K; Babcock, Matthew C; Tiss, Matthew J; Ives, Stephen J; White, Corey N; Brutsaert, Tom D; Heffernan, Kevin S

    2016-10-15

    Exercise in hypoxia places added demands on the brain and cerebrovasculature that can impact cognitive function. The purpose of this study was to investigate the effect of acute hypoxia on cerebrovascular hemodynamics, markers of neuro-steroidal modulation and brain-blood barrier (BBB) integrity, and cognition during exercise. Thirty healthy participants (21±4yrs., BMI 24.0±2.6kg∙m(-2); 15 men) were randomized to both a≈2.5h normoxic (FiO2 20.0%) and hypoxic (FiO2 12.5%) condition on two separate days. After 1.25h, participants underwent 10min of exercise-alone (cycling at 55% HRmax) and 15min of exercise+cognitive testing. Prefrontal cortex (PFC) tissue oxygenation and middle cerebral artery (MCA) mean blood velocity (MnV) were measured using near-infrared spectroscopy and transcranial Doppler respectively at rest, during exercise-alone, and during exercise+cognitive testing. Salivary levels of dehydroepiandosterone [DHEA], DHEA-sulfate [DHEAS]) and neuron specific enolase (NSE) were measured pre and post exercise. Cognition was assessed using standard metrics of accuracy and reaction time (RT), and advanced metrics from drift-diffusion modeling across memory recognition, N-Back and Flanker tasks. MCA MnV increased from rest to exercise (pexercise in both normoxia and hypoxia. PFC oxygenation increased during exercise (pexercise in hypoxia (pexercise, respectively, in both normoxia and hypoxia (pexercise in hypoxia concomitant with slower RT in select cognitive tasks and reduced oxygenation in the PFC. These changes were accompanied by slight increases in neuro-steroidal modulation but appear independent of changes in NSE, a biomarker of BBB integrity. Maintained accuracy and select increases in RT during hypoxic exercise may be related behavioral changes in caution. PMID:27402021

  5. Cerebrovascular plaque segmentation using object class uncertainty snake in MR images

    Science.gov (United States)

    Das, Bipul; Saha, Punam K.; Wolf, Ronald; Song, Hee Kwon; Wright, Alexander C.; Wehrli, Felix W.

    2005-04-01

    Atherosclerotic cerebrovascular disease leads to formation of lipid-laden plaques that can form emboli when ruptured causing blockage to cerebral vessels. The clinical manifestation of this event sequence is stroke; a leading cause of disability and death. In vivo MR imaging provides detailed image of vascular architecture for the carotid artery making it suitable for analysis of morphological features. Assessing the status of carotid arteries that supplies blood to the brain is of primary interest to such investigations. Reproducible quantification of carotid artery dimensions in MR images is essential for plaque analysis. Manual segmentation being the only method presently makes it time consuming and sensitive to inter and intra observer variability. This paper presents a deformable model for lumen and vessel wall segmentation of carotid artery from MR images. The major challenges of carotid artery segmentation are (a) low signal-to-noise ratio, (b) background intensity inhomogeneity and (c) indistinct inner and/or outer vessel wall. We propose a new, effective object-class uncertainty based deformable model with additional features tailored toward this specific application. Object-class uncertainty optimally utilizes MR intensity characteristics of various anatomic entities that enable the snake to avert leakage through fuzzy boundaries. To strengthen the deformable model for this application, some other properties are attributed to it in the form of (1) fully arc-based deformation using a Gaussian model to maximally exploit vessel wall smoothness, (2) construction of a forbidden region for outer-wall segmentation to reduce interferences by prominent lumen features and (3) arc-based landmark for efficient user interaction. The algorithm has been tested upon T1- and PD- weighted images. Measures of lumen area and vessel wall area are computed from segmented data of 10 patient MR images and their accuracy and reproducibility are examined. These results correspond

  6. [Secular trends in mortality for cerebrovascular diseases in Taiwan (1959-1989)].

    Science.gov (United States)

    Su, C L; Chang, S F; Hung, T P

    1992-03-01

    Cerebrovascular disease (CVD) is predominantly a disease of the elderly, and its morbidity effects increase with advancing age. In Taiwan, the increasing proportion of the elderly, as a result of medical progress and improved health care in the past 30 years, is largely responsible for the apparent increase in the number of CVD deaths. From 1963 to 1981, CVD was the leading cause of death. The crude mortality rate (CMR) and age-specific mortality rate (ASMR) of CVD by sex were derived from vital statistical data from 1959 to 1989 in Taiwan. The age-adjusted mortality rate (AAMR) using the standard world population of WHO and the cumulative mortality rate (CUMR) from birth to less than 80 years of age were calculated. Before 1983, the total number of CVD deaths had increased steadily for 30 years. In 1989, the CMR was 76.6/100,000 in men and 67.7/100,000 in women. The highest AAMR was 158.5/100,000 in 1973 for men and 130.2/100,000 in 1972 for women, and the lowest AAMR was 91.3/100,000 in 1989 for men and 81.1/100,000 in 1972 for women. The highest CUMR was 26.3% in 1968 for men and 20.8% in 1972 for women, and the lowest CUMR was 14.5% in 1989 for men and 13.6% in 1989 for women. The AAMR and CUMR for both sexes reached a maximum in 1972 and began to decline thereafter. The declines in AAMR and CUMR were averaging 2%/yr for both sexes after 1972 and were averaging 5%/yr for men and 4%/yr for women after 1983. This declining trend in CVD deaths in Taiwan began later and has been slower than similar trends in Japan and the U.S.

  7. Magnesium sulphate and cardiovascular and cerebrovascular adaptations to asphyxia in preterm fetal sheep.

    Science.gov (United States)

    Galinsky, Robert; Davidson, Joanne O; Drury, Paul P; Wassink, Guido; Lear, Christopher A; van den Heuij, Lotte G; Gunn, Alistair J; Bennet, Laura

    2016-03-01

    Magnesium sulphate is a standard therapy for eclampsia in pregnancy and is widely recommended for perinatal neuroprotection during threatened preterm labour. MgSO4 is a vasodilator and negative inotrope. Therefore the aim of this study was to investigate the effect of MgSO4 on the cardiovascular and cerebrovascular responses of the preterm fetus to asphyxia. Fetal sheep were instrumented at 98 ± 1 days of gestation (term = 147 days). At 104 days, unanaesthetised fetuses were randomly assigned to receive an intravenous infusion of MgSO4 (n = 6) or saline (n = 9). At 105 days all fetuses underwent umbilical cord occlusion for 25 min. Before occlusion, MgSO4 treatment reduced heart rate and increased femoral blood flow (FBF) and vascular conductance compared to controls. During occlusion, carotid and femoral arterial conductance and blood flows were higher in MgSO4-treated fetuses than controls. After occlusion, fetal heart rate was lower and carotid and femoral arterial conductance and blood flows were higher in MgSO4-treated fetuses than controls. Femoral arterial waveform height and width were increased during MgSO4 infusion, consistent with increased stroke volume. MgSO4 did not alter the fetal neurophysiological or nuchal electromyographic responses to asphyxia. These data demonstrate that a clinically comparable dose of MgSO4 increased FBF and stroke volume without impairing mean arterial pressure (MAP) or carotid blood flow (CaBF) during and immediately after profound asphyxia. Thus, MgSO4 may increase perfusion of peripheral vascular beds during adverse perinatal events. PMID:26077461

  8. Modelo basado en SIG para el estudio de la mortalidad por enfermedad cerebro-vascular

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    Carlos Alberto Tangarife Villa

    2013-06-01

    Full Text Available En los últimos 15 años el estudio para una de las tres primeras causas de muerte a nivel mundial –enfermedad cerebrovascular (ECV– se caracteriza por utilizar el enfoque epidemiológico tradicional y sus técnicas de análisis estadístico bivariado y multivariado orientadas a identificar su composición según variables de persona y explorar relaciones con sus determinantes pero sin impactar significativamente su ocurrencia, sin embargo, en el presente artículo se identifica como alternativa de análisis la modelación espacio-temporal con SIG a niveles de desagregación detallados; en este sentido el análisis comparativo de los modelos utilizados en los estudios conocidos, desvela el uso de datos y técnicas de análisis espacial básicas para identificar patrones como los evidenciados en los cinturones de diabetes y ECV en USA o el clúster colombiano de enfermedades del aparato circulatorio identificado en la región andina que sugiere un comportamiento similar para la ECV. El panorama anterior demanda la combinación de enfoques con énfasis en sus técnicas de análisis avanzadas –análisis multi-criterio, kriging, interpolación, correlación y regresión espacial– soportadas con SIG y por lo tanto, como contribución final se propone un modelo integrado dirigido a impactar positivamente la mortalidad por ECV.

  9. Blunt cerebrovascular trauma causing vertebral arteryd issection in combination with a laryngeal fracture: a case report

    Directory of Open Access Journals (Sweden)

    Krettek Christian

    2011-08-01

    Full Text Available Abstract Introduction The diagnosis and therapy of blunt cerebrovascular injuries has become a focus since improved imaging technology allows adequate description of the injury. Although it represents a rare injury the long-term complications can be fatal but mostly prevented by adequate treatment. Case presentation A 33-year-old Caucasian man fell down a 7-meter scarp after losing control of his quad bike in a remote area. Since endotracheal intubation was unsuccessfully attempted due to the severe cervical swelling as well as oral bleeding an emergency tracheotomy was performed on scene. He was hemodynamically unstable despite fluid resuscitation and intravenous therapy with vasopressors and was transported by a helicopter to our trauma center. He had a stable fracture of the arch of the seventh cervical vertebra and fractures of the transverse processes of C5-C7 with involvement of the lateral wall of the transverse foramen. An abort of the left vertebral artery signal at the first thoracic vertebrae with massive hemorrhage as well as a laryngeal fracture was also detected. Further imaging showed retrograde filling of the left vertebral artery at C5 distal of the described abort. After stabilization and reconfirmation of intracranial perfusion during the clinical course weaning was started. At the time of discharge, he was aware and was able to move all extremities. Conclusion We report a rare case of a patient with vertebral artery dissection in combination with a laryngeal fracture after blunt trauma. Thorough diagnostic and frequent reassessments are recommended. Most patients can be managed with conservative treatment.

  10. [Home-based rehabilitation in the functional recovery of patients with cerebrovascular disease].

    Science.gov (United States)

    López-Liria, Remedios; Ferre-Salmerón, Rocío; Arrebola-López, Clara; Granados-Valverde, Rocío; Gobernado-Cabero, Miguel Ángel; Padilla-Góngora, David

    2013-06-16

    Introduccion. El estudio de la eficacia en los tratamientos de rehabilitacion aplicados a pacientes con secuelas tras una enfermedad cerebrovascular (ECV) resulta decisivo en la actualidad para planificar su abordaje desde la sanidad publica y mejorar las directrices de evaluacion y tratamiento existentes. Objetivo. Describir las caracteristicas que presentan los pacientes que han sufrido ECV atendidos por las unidades moviles de rehabilitacion-fisioterapia (UMRF) y como influyen estos tratamientos sobre su recuperacion funcional. Pacientes y metodos. Estudio descriptivo prospectivo en 124 pacientes derivados a las UMRF de la provincia de Almeria entre 2008 y 2011. Se analizaron variables (pre y postratamiento) como las caracteristicas y antecedentes personales, indice de Barthel, escala de espasticidad de Ashworth modificada, dolor (hombro) y escala neurologica canadiense. Resultados. La muestra final estuvo compuesta por 106 participantes (edad media: 73,72 años). El proceso discapacitante fue isquemico en un 77,4%, y la hipertension, el factor de riesgo mas prevalente (81%). La media del indice de Barthel inicial fue de 31,04, y la media del indice final, de 57,62 (t = –11,75; p escala canadiense mostro una evolucion favorable en el nivel de conciencia, orientacion y lenguaje (p < 0,001). El 56,2% de los pacientes recibio alta por mejoria, sin precisar rehabilitacion ambulatoria adicional. Conclusiones. Los resultados obtenidos reflejan una importante mejora funcional en los pacientes tratados en las UMRF. La rehabilitacion domiciliaria se plantea como una herramienta necesaria para las personas con mayor vulnerabilidad clinica y sin acceso a los cuidados ambulatorios, que logra los beneficios de tratamientos que son efectivos.

  11. Skin cooling aids cerebrovascular function more effectively under severe than moderate heat stress.

    Science.gov (United States)

    Lucas, Rebekah A I; Ainslie, Philip N; Fan, Jui-Lin; Wilson, Luke C; Thomas, Kate N; Cotter, James D

    2010-05-01

    Skin surface cooling has been shown to improve orthostatic tolerance; however, the influence of severe heat stress on cardiovascular and cerebrovascular responses to skin cooling remains unknown. Nine healthy males, resting supine in a water-perfusion suit, were heated to +1.0 and +2.0 degrees C elevation in body core temperature (T (c)). Blood flow velocity in the middle cerebral artery (transcranial Doppler ultrasound), mean arterial pressure (MAP; photoplethysmography), stroke volume (SV; Modelflow), total peripheral resistance (TPR; Modelflow), heart rate (HR; ECG) and the partial pressure of end-tidal carbon dioxide (P(ET)CO(2)) were measured continuously during 1-min baseline and 3-min lower body negative pressure (LBNP, -15 mm Hg) when heated without and again with skin surface cooling. Nine participants tolerated +1 degrees C and six participants reached +2 degrees C. Skin cooling elevated (P = 0.004) MAP ~4% during baseline and LBNP at +1 degrees C T (c). During LBNP, skin cooling increased SV (9%; P = 0.010) and TPR (0.9 mm Hg L(-1) min, P = 0.013) and lowered HR (13 b min(-1), P = 0.012) at +1 degrees C T (c) and +2 degrees C T (c) collectively. At +2 degrees C T (c), skin cooling elevated P(ET)CO(2) ~4.3 mm Hg (P = 0.011) and therefore reduced cerebral vascular resistance ~0.1 mm Hg cm(-1) s at baseline and LBNP (P = 0.012). In conclusion, skin cooling under severe heating and mild orthostatic stress maintained cerebral blood flow more effectively than it did under moderate heating, in conjunction with elevated carbon dioxide pressure, SV and arterial resistance. PMID:19946700

  12. Wallerian degeneration demonstrated by MRI and functional outcome in patients suffering from supratentorial cerebrovascular disease

    International Nuclear Information System (INIS)

    An early diagnosis of the outcome of patients with cerebrovascular disease is important for selecting the optimal treatment strategy. The purpose of this study was to estimate the prognosis of Wallerian degeneration on MRI in stroke patients with hemiparesis. The subjects consisted of 87 stroke patients, 50 hemorrhagic patients and 37 ischemic patients, who were evaluated by MRI at 1 to 6,275 days after stroke onset. Among the 36 patients who were evaluated by consecutive MRI, 161 films were obtained and analyzed. Wallerian degeneration was diagnosed when a small prolonged T2 lesion was seen in the corticospinal tract of the brainstem on at least two contiguous slices. The atrophic rate of the midbrain was calculated as: (the area of the unaffected side of the midbrain - the area of the affected side of the midbrain)/2 x (the area of the unaffected side of the midbrain). The patients' ability to perform the activities of daily living was scored by the Barthel index (BI). Wallerian degeneration in the ipsilateral brainstem was seen for two to three months in 32 cases (37%) and in 58 films (36%) and disappeared about 3 years after the onset of stroke. Wallerian degeneration correlated with the BI scores from 2 to 6 months after stroke (p<0.05), although no relationship was observed at 7 months or later. From 2 to 6 months after stroke, the shrinkage of the midbrain on MRI correlated with the BI scores (p<0.001), although no relationship was observed at 7 months or later. It was therefore both Wallerian degeneration and a shrunken midbrain observed on MRIs, evaluated from 2 to 6 months after stroke were thus suggested to indicate a poor outcome in such patients. (author)

  13. An evaluation of reverse T3 as a diagnostic and prognostic parameter in cerebrovascular disease

    International Nuclear Information System (INIS)

    Reverse triiodothyronine (rT3) has no biological activity in humans, but in some chronic non-thyroidal diseases it was found that high levels of rT3 could be of clinical importance. The paper attempts to evaluate the changes in T3 and rT3 concentrations in human sera of patients with acute cerebrovascular disease (ACD). TIR-IM T3 polyethylene glycol was used in measurements of T3, and RIA-mat-rT3 kits for the determination of rT3 concentration. Sixteen patients were divided into two groups according to the neurological diagnosis of ACD, which was either hemorrhagic or ischaemic. All 16 patients showed very good inverse correlation between serum concentration of T3 and rT3. A low T3 was always followed by high rT3 levels. In the group of nine patients with the clinical diagnosis of hemorrhagic stroke we noticed a rapid increase in rT3 levels in the first few days after the onset of the disease with low T3 concentration in sera, but in the following days levels of T3 and rT3 normalized in five patients, which proved to be a good prognostic factor. If the levels of rT3 remained elevated, as found in four patients with hemorrhagic stroke, the prognosis was unfavourable. In patients with the clinical diagnosis of ischaemic stroke, the pattern of hormone changes was different, owing to the systematic property of ischaemic disease. Levels of rT3 increased more slowly and remained elevated longer than in the first group, regardless of the severity of the disease. (author). 4 refs, 3 figs

  14. A comparative study of computerized tomograms and neuropathological findings in cerebrovascular diseases

    International Nuclear Information System (INIS)

    The reliability of computed tomography (CT) in the diagnosis of cerebrovascular diseases was studied by comparing CT images and neuropathological findings in 38 autopsied cases. Our special concern was directed toward several factors which caused false positive and false negative results in CT: the size and location of lesions, and the interval between the onset of the disease and the time of CT studies. Infarctions smaller than 5 mm should be interpreted as such with great care, because only 32.1% of them could be detected in CT, and 81.0% of small low density areas supposed to be small infarctions in CT films proved to be false positive in postmortem examination. 41.9% of middle-sized infarctions were detected in CT and 40.9% of middle-sized low density areas were false positive. Most of false positive low density areas appeared on the surface of the cerebrum where deep sulci join, or in the white matter anterior to the anterior horn or posterior to the posterior horn of the lateral ventricles. The possibility of false positive findings became far less, when the number of slices showing low density areas increased. All of the large infarctions were detected in CT. However, immediately after stroke they did not stand out as low density areas. In such cases, the decrease of cerebral sulci due to brain edema and signs of compression in the ventricular system could be the clues to make the diagnosis of large infarctions. The diagnosis of hemorrhagic infarctions was often difficult. Cerebral bleeding could be diagnosed easily by CT in its early period. However, old hematomas which rapidly resolved and became shrunken, could hardly be identified in CT. (author)

  15. Wallerian degeneration demonstrated by MRI and functional outcome in patients suffering from supratentorial cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Shirotani, Toshiki; Takahara, Takashi; Arimoto, Hirohiko; Inohara, Masashi; Ono, Kenichiro; Shimizu, Akira [Self-Defense Force Central Hospital, Tokyo (Japan)

    2002-07-01

    An early diagnosis of the outcome of patients with cerebrovascular disease is important for selecting the optimal treatment strategy. The purpose of this study was to estimate the prognosis of Wallerian degeneration on MRI in stroke patients with hemiparesis. The subjects consisted of 87 stroke patients, 50 hemorrhagic patients and 37 ischemic patients, who were evaluated by MRI at 1 to 6,275 days after stroke onset. Among the 36 patients who were evaluated by consecutive MRI, 161 films were obtained and analyzed. Wallerian degeneration was diagnosed when a small prolonged T2 lesion was seen in the corticospinal tract of the brainstem on at least two contiguous slices. The atrophic rate of the midbrain was calculated as: (the area of the unaffected side of the midbrain - the area of the affected side of the midbrain)/2 x (the area of the unaffected side of the midbrain). The patients' ability to perform the activities of daily living was scored by the Barthel index (BI). Wallerian degeneration in the ipsilateral brainstem was seen for two to three months in 32 cases (37%) and in 58 films (36%) and disappeared about 3 years after the onset of stroke. Wallerian degeneration correlated with the BI scores from 2 to 6 months after stroke (p<0.05), although no relationship was observed at 7 months or later. From 2 to 6 months after stroke, the shrinkage of the midbrain on MRI correlated with the BI scores (p<0.001), although no relationship was observed at 7 months or later. It was therefore both Wallerian degeneration and a shrunken midbrain observed on MRIs, evaluated from 2 to 6 months after stroke were thus suggested to indicate a poor outcome in such patients. (author)

  16. Changes in the EEG and SEP of patients with cerebrovascular major strokes

    International Nuclear Information System (INIS)

    Changes in the electroencephalogram (EEG) and somatosensory evoked potential (SEP) were studied in 27 cases with unilateral cerebrovascular disorders. From the CT findings (EMI-1010), the locations of the diseases were divided into two types: superficial (within the cortex and subcortical white matter) or deep (at the level of the basal ganglia and thalamus). Each of these was then further subdivided according to the nature of the disease, whether hemorrhage or infarction. The EEG and SEP were recorded from the scalp area corresponding to the post-Rolandic arm area (Shagass' point) throughout the investigation. The stimulus intensities applied to the median nerve were fixed at 5 - 10 V. higher than the motor threshold. EEG power spectrum analysis was done with an ATAC 2300 computer, while slow-wave indices (SWI), the ratio of power in the slow-wave range (2 - 6 Hz) to the total power (2 - 25 Hz), were calculated manually. In deep lesions, the deterioration of the SEP was prominent. Especially in the 5 cases with bleeding, all 5 showed a ''flat SEP.'' These patients also revealed motor and sensory disturbance clinically. In the 6 cases with infarction, although no one showed sensory disturbances, the changes in the SEP were also remarkable. In deep lesions, a decrease in the amplitude of the early components of SEP (N1, P1) was the most conspicuous feature. On the contrary, in superficial lesions, changes in the SEP were less prominent, and if they occurred, the late components (P2, N3) were more easily affected. The amount of the slow wave increased remarkably and bilaterally in these superficial cases, and the slower the frequency of the EEG, the more attenuation of the amplitude of SEP was noted on the lesion side. On the opposite side, however, no such correlations could be noted between an increased slow-wave power and a decreased amplitude of SEP. Further studies to clarify these differences will be necessary. (author)

  17. Insomnia, daytime sleepiness and cardio-cerebrovascular diseases in the elderly: a 6-year prospective study.

    Directory of Open Access Journals (Sweden)

    Isabelle Jaussent

    Full Text Available OBJECTIVE: To examine 1 the associations between history of cardio-cerebrovascular diseases (CVD and insomnia complaints and excessive daytime sleepiness (EDS, and 2 the relationships between sleep complaints and future CVD in persons over 65. METHODS: CVD was assessed at baseline and during two, four, and six-year follow-up in 5494 non-demented subjects. Self-reported insomnia complaints (poor sleep quality, difficulty in initiating sleep, difficulty in maintening sleep, and early morning awakening, EDS and sleep medication use were evaluated at baseline. Logistic regression models and Cox proportional hazard models, with delayed entry and age of participants as the time scale, were adjusted for socio-demographic, lifestyle and clinical variables. RESULTS: At baseline, 748 participants had a past-history of CVD. A past-history of CVD was associated with EDS (OR = 1.28 95%CI = [1.05-1.57] and the number of insomnia complaints (OR = 1.26 95%CI = [1.03-1.55] for 1-2 insomnia complaints; OR = 1.32 95%CI = [1.03-1.71] for ≥3 complaints. In longitudinal analyses, neither the four components of insomnia nor the number of insomnia complaints were significantly associated with first or recurrent CVD events (n = 391 events. EDS was independently associated with future CVD events even after adjusting for prescribed sleep medication and past-history of CVD (HR = 1.35 95%CI = [1.06-1.71]. CONCLUSION: Our results suggest that the relationships between sleep complaints and CVD could be complex. Insomnia complaints are more likely a consequence of CVD, whereas EDS appears to be a determinant of CVD independently of past-history of CVD. EDS screening may thus constitute a means of detecting persons at high risk of CVD.

  18. Cerebrovascular responses during rowing: Do circadian rhythms explain morning and afternoon performance differences?

    Science.gov (United States)

    Faull, O K; Cotter, J D; Lucas, S J E

    2015-08-01

    The purpose of this study was to characterize cerebrovascular responses to rowing exercise, investigating whether their diurnal variation might explain performance differences across a day. Twelve male rowers completed incremental rowing exercise and a 2000-m ergometer time trial at 07:00 h and 16:00 h, 1 week apart, while middle cerebral artery velocity (MCAv), cerebral (prefrontal), and muscular (vastus lateralis) tissue oxygenation and hemoglobin volume (via near-infrared spectroscopy), heart rate, and pressure of end-tidal CO2 (PET CO2) were recorded. MCAv was 20-25% above resting levels (68 ± 12 cm/s) during submaximal and maximal exercise intensities, despite PET CO2 being reduced during maximal efforts (down ∼ 0.5-0.8 kPa); thus revealing a different perfusion profile to the inverted-U observed in other exercise modes. The afternoon time trial was 3.4 s faster (95% confidence interval 0.9-5.8 s) and mean power output 3.2% higher (337 vs 347 W; P = 0.04), in conjunction with similar exercise-induced elevations in MCAv (P = 0.60) and reductions in cerebral oxygenation (TOI) (P = 0.12). At the muscle, afternoon trials involved similar oxygen extraction (HHb volume and TOI) albeit from a relatively lower total Hb volume (P rowing performance was better in the afternoon, but not in conjunction with differences in MCAv or exercise-induced differences in cerebral oxygenation. PMID:24942089

  19. Terapéuticas intervencionistas para el accidente cerebrovascular isquémico

    Directory of Open Access Journals (Sweden)

    Alejandra T. Rabadán

    2010-10-01

    Full Text Available En los últimos 20 años se han desarrollado nuevas opciones para el tratamiento y para la prevención del accidente cerebrovascular (ACV isquémico, muchas de ellas de carácter intervencionista, tales como la endarterectomía carotídea y la trombolisis intravenosa con activador tisular del plasminógeno. La evidencia científica ha llevado a su difusión y utilización en países desarrollados mientras que en naciones emergentes se observa un retraso en su adopción. Otras modalidades terapéuticas que parecen ser muy promisorias, aunque sin tanta evidencia científica que las avale, requieren la realización y conclusión de estudios randomizados. Dentro de la evolución del ACV isquémico existe una situación particular como es el infarto cerebral "maligno". Constituye un evento devastador, que se presenta en aproximadamente el 10 al 15% de los ACV carotídeos o silvianos, y está asociado con elevada morbimortalidad. Con la información disponible actualmente, es posible recomendar la craniectomía descompresiva (CD como un método efectivo y seguro para disminuir rápidamente la presión intracraneal y lograr un pronóstico favorable sobre una base racional. Aunque no hay estudios randomizados y controlados en la literatura, existe suficiente evidencia para recomendar la CD en casos especiales.

  20. Factores relacionados con presentación de ataques cerebrovasculares en niños

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    Angélica María Uscátegui Daccarett

    2008-04-01

    Full Text Available El ataque cerebrovascular (ACV se considera una patologíainusual en la edad pediátrica, siendo diferente en sus causasy en sus factores ambientales y raciales frente a los adultos.El objetivo del estudio consiste en describir los factoresrelacionados en la población atendida. Materiales ymétodos: Se evaluó una serie de pacientes con ataquecerebro vascular atendidos por el servicio de Neuropediatríade la Universidad Nacional de Colombia Fundación Hospitalde la Misericordia, durante el periodo enero 1 de 2001 a 31de diciembre de 2003. Resultados: Se registraron 65 casos,siendo el 61% varones; el grupo etáreo más comprometidoes el de lactantes (44,7%. El síntoma de consulta predomi-nante fueron las convulsiones (60% de los casos. El 56,9%correspondió a eventos isquémicos y el territorio másafectado fue el de la arteria cerebral media (33,2%. Lacausa más común fue infecciosa (20% de los casos, conuna frecuencia similar para quienes registraron causadesconocida. La mortalidad fue de 21,9%. Conclusiones: ElACV en los niños es una alteración frecuente y con causasmuy variadas. No determinarla dificulta establecer tratamien-to, pronóstico y prevenir las recurrencias. Los factoresrelacionados difieren de los encontrados en otras series,posiblemente por variantes genéticas y ambientales.

  1. Hydroxyquinones: Synthesis and Reactivity

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    Spyros Spyroudis

    2000-12-01

    Full Text Available Quinones having hydroxy groups directly attached to the quinone ring constitute a very interesting class of quinoid compounds. A great number of hydroxyquinones are found in nature and the majority of them exhibit unique biological activity. Their syntheses and their main reactivity patterns are reviewed in this paper.

  2. Clojure reactive programming

    CERN Document Server

    Borges, Leonardo

    2015-01-01

    If you are a Clojure developer who is interested in using Reactive Programming to build asynchronous and concurrent applications, this book is for you. Knowledge of Clojure and Leiningen is required. Basic understanding of ClojureScript will be helpful for the web chapters, although it is not strictly necessary.

  3. A Universal Reactive Machine

    DEFF Research Database (Denmark)

    Andersen, Henrik Reif; Mørk, Simon; Sørensen, Morten U.

    1997-01-01

    Turing showed the existence of a model universal for the set of Turing machines in the sense that given an encoding of any Turing machine asinput the universal Turing machine simulates it. We introduce the concept of universality for reactive systems and construct a CCS processuniversal...

  4. Reactive Turing machines

    NARCIS (Netherlands)

    Baeten, J.C.M.; Luttik, B.; Tilburg, P.J.A. van

    2013-01-01

    We propose reactive Turing machines (RTMs), extending classical Turing machines with a process-theoretical notion of interaction, and use it to define a notion of executable transition system. We show that every computable transition system with a bounded branching degree is simulated modulo diverge

  5. Modelling reactive distillation

    NARCIS (Netherlands)

    Taylor, R.; Krishna, R.

    2000-01-01

    The design and operation issues for reactive distillation systems are considerably more complex than those involved for either conventional reactors or conventional distillation columns. The introduction of an in situ separation function within the reaction zone leads to complex interactions between

  6. Total OH reactivity emissions from Norway spruce

    Science.gov (United States)

    Nölscher, Anke; Bourtsoukidis, Efstratios; Bonn, Boris; Kesselmeier, Jürgen; Lelieveld, Jos; Williams, Jonathan

    2013-04-01

    Forest emissions represent a strong potential sink for the main tropospheric oxidant, the hydroxyl radical (OH). In forested environments, the comparison of the directly determined overall sink of OH radicals, the total OH reactivity, and the individually measured OH sink compounds often exposes a significant gap. This "missing" OH reactivity can be high and influenced by both direct biogenic emissions and secondary photo-oxidation products. To investigate the source of the missing OH sinks in forests, total OH reactivity emission rates were determined for the first time from a Norway spruce (Picea abies) throughout spring, summer and autumn 2011. The total OH reactivity was measured inside a branch enclosure using the Comparative Reactivity Method (CRM) with a Proton Transfer Reaction-Mass Spectrometer (PTR-MS) as the detector. In parallel, separate volatile organic compounds (VOC) emission rates were monitored by a second PTR-MS, including the signal of isoprene, acetaldehyde, total monoterpenes and total sesquiterpenes. The comparison of known and PTR-MS detected OH sink compounds and the directly measured total OH reactivity emitted from Norway spruce revealed unmeasured and possibly unknown primary biogenic emissions. These were found to be highest in late summer during daytime coincident with highest temperatures and ozone levels.

  7. Water reactive hydrogen fuel cell power system

    Science.gov (United States)

    Wallace, Andrew P; Melack, John M; Lefenfeld, Michael

    2014-01-21

    A water reactive hydrogen fueled power system includes devices and methods to combine reactant fuel materials and aqueous solutions to generate hydrogen. The generated hydrogen is converted in a fuel cell to provide electricity. The water reactive hydrogen fueled power system includes a fuel cell, a water feed tray, and a fuel cartridge to generate power for portable power electronics. The removable fuel cartridge is encompassed by the water feed tray and fuel cell. The water feed tray is refillable with water by a user. The water is then transferred from the water feed tray into a fuel cartridge to generate hydrogen for the fuel cell which then produces power for the user.

  8. Genetic relationship between serum pregnancy-associated plasma protein-A gene polymorphism and ischemic cerebrovascular disease in a Northern Han Chinese population

    Institute of Scientific and Technical Information of China (English)

    Haiping Wang; Yan Song; Chen Zhang; Jingjing Zhan; Rui Zhang; Haiji Wang

    2012-01-01

    The present study recruited 193 patients with ischemic cerebrovascular disease from Inpatient and Outpatient Departments at the Affiliated Hospital of Qingdao University Medical College, China from August 2008 to May 2010, as well as 120 healthy volunteers from the Medical Examination Center at the Affiliated Hospital of Qingdao University Medical College, China, who served as controls for this study.Patients and control subjects were from the Han population in northern China.Enzyme- linked immunosorbent assay analysis revealed increased levels of serum pregnancy-associated plasma protein-A (PAPP-A) in ischemic cerebrovascular disease patients compared with healthy controls.In addition, the patients exhibited greater frequency of genotype CC and C alleles in a missense A/C (Tyr/Ser) polymorphism (dbSNP: rs7020782) of exon 14 in the PAPP-A gene.Multiple-factor logistic regression analysis on correction of age, gender, history of smoking, hypertension, diabetes mellitus, hypercholesteremia, and ischemic stroke family history showed that the risk for ischemic cerebrovascular disease in the population without the A allele at the A/C genetic locus in exon 14 of the PAPP-A was 2-folds greater than the population expressing the A allele.These experimental findings suggested that ischemic cerebrovascular disease correlated with the C allele in exon 14 of PAPP-A.In addition, the A allele is likely a protective gene; individuals carrying the A allele were less prone to ischemic cerebrovascular disease compared with individuals without the A allele.

  9. Cardiac Iodine-123 metaiodobenzylguanidine (123I-MIBG) scintigraphy parameter predicts cardiac and cerebrovascular events in type 2 diabetic patients without structural heart disease

    International Nuclear Information System (INIS)

    Cardiac iodine-123 metaiodobenzylguanidine (123I-MIBG) scintigraphy is an established method of assessment of cardiovascular sympathetic function. The aim of the present study was to investigate the long-term cardiovascular predictive value of cardiac 123I-MIBG scintigraphy parameters in Japanese type 2 diabetic patients without structural heart disease. Cardiac 123I-MIBG scintigraphy in 108 patients with type 2 diabetes who did not have structural heart disease, was evaluated. The washout rate (WR) was considered enhanced if it was ≥40%. Accurate follow-up information for 4.6 years was obtained in 54 enhanced WR patients (27 male; mean age, 61±11 years) and in 54 sex- and age-matched preserved WR patients (27 male; mean age, 61±10 years). Major adverse cardiac and cerebrovascular events (MACCE) were investigated. During follow-up, 10 enhanced WR patients developed MACCE including cardiac death, coronary revascularization, stroke, and congestive heart failure, while MACCE occurred in only 3 male patients. The Kaplan-Meier curves indicated that enhanced WR patients had higher incidence of MACCE than those with preserved WR (P123I-MIBG scintigraphy at baseline has long-term cardiovascular predictive value in Japanese patients with type 2 diabetes without structural heart disease. (author)

  10. Cerebrovascular and blood-brain barrier morphology in spontaneously hypertensive rats: effect of treatment with choline alphoscerate.

    Science.gov (United States)

    Tayebati, Seyed Khosrow; Amenta, Francesco; Tomassoni, Daniele

    2015-01-01

    Cholinergic precursors increasing choline availability and acetylcholine synthesis/release may represent a therapeutic approach for countering cognitive impairment occurring in adult-onset dementia disorders. Choline alphoscerate (alpha-gliceryl-phosphoryl-choline, GPC) is among cholinergic precursors the most effective in enhancing acetylcholine biosynthesis and release in animal models. This study was designed to assess if a long-term treatment with GPC modify cerebrovascular components [perivascular astrocytes, blood-brain barrier (BBB) and microvessels] and endothelial inflammatory markers expression in spontaneously hypertensive rats (SHR) used as a model of brain vascular injury. Male SHR aged 32 weeks and age-matched normotensive Wistar-Kyoto rats were treated for 4 weeks with GPC (150 mg/kg/day) or a vehicle. Intracerebral arteries of different brain areas, perivascular astrocytes, BBB and endothelial inflammatory markers were assessed by quantitative morphological and immunohistochemical techniques. No significant changes in the size of perivascular astrocytes were observed in SHR versus normotensive Wistar-Kyoto rats, whereas the expression of the BBB marker aquaporin-4 increased in SHR. This phenomenon was countered by GPC treatment. On the contrary, GPC has no vasodilator effect on brain micro-vessels. Endothelial markers and vascular adhesion molecules expression were not homogeneously affected by hypertension and GPC treatment in intracerebral vessels. The observation that treatment with GPC reversed BBB changes and countered to some extent micro-vessels changes occurring in SHR could explain data of clinical trials reporting an improvement of cognitive function in subjects suffering from cerebrovascular disorders and treated with GPC. These preclinical data suggest that the compound could have a cerebrovascular protective effect deserving a further characterization. PMID:25714975

  11. Inhibition of cerebrovascular raf activation attenuates cerebral blood flow and prevents upregulation of contractile receptors after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Maddahi Aida

    2011-10-01

    Full Text Available Abstract Background Late cerebral ischemia carries high morbidity and mortality after subarachnoid hemorrhage (SAH due to reduced cerebral blood flow (CBF and the subsequent cerebral ischemia which is associated with upregulation of contractile receptors in the vascular smooth muscle cells (SMC via activation of mitogen-activated protein kinase (MAPK of the extracellular signal-regulated kinase (ERK1/2 signal pathway. We hypothesize that SAH initiates cerebrovascular ERK1/2 activation, resulting in receptor upregulation. The raf inhibitor will inhibit the molecular events upstream ERK1/2 and may provide a therapeutic window for treatment of cerebral ischemia after SAH. Results Here we demonstrate that SAH increases the phosphorylation level of ERK1/2 in cerebral vessels and reduces the neurology score in rats in additional with the CBF measured by an autoradiographic method. The intracisternal administration of SB-386023-b, a specific inhibitor of raf, given 6 h after SAH, aborts the receptor changes and protects the brain from the development of late cerebral ischemia at 48 h. This is accompanied by reduced phosphorylation of ERK1/2 in cerebrovascular SMC. SAH per se enhances contractile responses to endothelin-1 (ET-1, 5-carboxamidotryptamine (5-CT and angiotensin II (Ang II, upregulates ETB, 5-HT1B and AT1 receptor mRNA and protein levels. Treatment with SB-386023-b given as late as at 6 h but not at 12 h after the SAH significantly decreased the receptor upregulation, the reduction in CBF and the neurology score. Conclusion These results provide evidence for a role of the ERK1/2 pathway in regulation of expression of cerebrovascular SMC receptors. It is suggested that raf inhibition may reduce late cerebral ischemia after SAH and provides a realistic time window for therapy.

  12. Risk of Cerebrovascular Events in Elderly Patients After Radiation Therapy Versus Surgery for Early-Stage Glottic Cancer

    International Nuclear Information System (INIS)

    Purpose: Comprehensive neck radiation therapy (RT) has been shown to increase cerebrovascular disease (CVD) risk in advanced-stage head-and-neck cancer. We assessed whether more limited neck RT used for early-stage (T1-T2 N0) glottic cancer is associated with increased CVD risk, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: We identified patients ≥66 years of age with early-stage glottic laryngeal cancer from SEER diagnosed from 1992 to 2007. Patients treated with combined surgery and RT were excluded. Medicare CPT codes for carotid interventions, Medicare ICD-9 codes for cerebrovascular events, and SEER data for stroke as the cause of death were collected. Similarly, Medicare CPT and ICD-9 codes for peripheral vascular disease (PVD) were assessed to serve as an internal control between treatment groups. Results: A total of 1413 assessable patients (RT, n=1055; surgery, n=358) were analyzed. The actuarial 10-year risk of CVD was 56.5% (95% confidence interval 51.5%-61.5%) for the RT cohort versus 48.7% (41.1%-56.3%) in the surgery cohort (P=.27). The actuarial 10-year risk of PVD did not differ between the RT (52.7% [48.1%-57.3%]) and surgery cohorts (52.6% [45.2%-60.0%]) (P=.89). Univariate analysis showed an increased association of CVD with more recent diagnosis (P=.001) and increasing age (P=.001). On multivariate Cox analysis, increasing age (P<.001) and recent diagnosis (P=.002) remained significantly associated with a higher CVD risk, whereas the association of RT and CVD remained not statistically significant (HR=1.11 [0.91-1.37,] P=.31). Conclusions: Elderly patients with early-stage laryngeal cancer have a high burden of cerebrovascular events after surgical management or RT. RT and surgery are associated with comparable risk for subsequent CVD development after treatment in elderly patients

  13. Risk of Cerebrovascular Events in Elderly Patients After Radiation Therapy Versus Surgery for Early-Stage Glottic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Julian C.; Kruser, Tim J. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Gondi, Vinai [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); Mohindra, Pranshu; Cannon, Donald M.; Harari, Paul M. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Bentzen, Søren M., E-mail: bentzen@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States)

    2013-10-01

    Purpose: Comprehensive neck radiation therapy (RT) has been shown to increase cerebrovascular disease (CVD) risk in advanced-stage head-and-neck cancer. We assessed whether more limited neck RT used for early-stage (T1-T2 N0) glottic cancer is associated with increased CVD risk, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: We identified patients ≥66 years of age with early-stage glottic laryngeal cancer from SEER diagnosed from 1992 to 2007. Patients treated with combined surgery and RT were excluded. Medicare CPT codes for carotid interventions, Medicare ICD-9 codes for cerebrovascular events, and SEER data for stroke as the cause of death were collected. Similarly, Medicare CPT and ICD-9 codes for peripheral vascular disease (PVD) were assessed to serve as an internal control between treatment groups. Results: A total of 1413 assessable patients (RT, n=1055; surgery, n=358) were analyzed. The actuarial 10-year risk of CVD was 56.5% (95% confidence interval 51.5%-61.5%) for the RT cohort versus 48.7% (41.1%-56.3%) in the surgery cohort (P=.27). The actuarial 10-year risk of PVD did not differ between the RT (52.7% [48.1%-57.3%]) and surgery cohorts (52.6% [45.2%-60.0%]) (P=.89). Univariate analysis showed an increased association of CVD with more recent diagnosis (P=.001) and increasing age (P=.001). On multivariate Cox analysis, increasing age (P<.001) and recent diagnosis (P=.002) remained significantly associated with a higher CVD risk, whereas the association of RT and CVD remained not statistically significant (HR=1.11 [0.91-1.37,] P=.31). Conclusions: Elderly patients with early-stage laryngeal cancer have a high burden of cerebrovascular events after surgical management or RT. RT and surgery are associated with comparable risk for subsequent CVD development after treatment in elderly patients.

  14. Reactivity Network: Secondary Sources for Inorganic Reactivity Information.

    Science.gov (United States)

    Mellon, E. K.

    1989-01-01

    Provides an eclectic annotated bibliography of secondary sources for inorganic reactivity information of interest to reactivity network review authors and to anyone seeking information about simple inorganic reactions in order to develop experiments and demonstrations. Gives 119 sources. (MVL)

  15. Function of ginger on cerebrovascular disease and its gateway%姜对脑血管疾病的作用与途径

    Institute of Scientific and Technical Information of China (English)

    卢传坚

    2005-01-01

    OBJECTIVE: A probing study of pharmacological action and gateway of ginger, a traditional Chinese medicine, on cerebrovascular disease.DATA SOURCE: Retrieved on documents via computer in Medline from January 1980 to December 2003 about function and mechanism of ginger on cerebrovascular disease with retrieval subjects: "Zingiber officinale Rosc", and the defined type of language in English.STUDY SELECTION: Retrieved on documents relative to ginger, and screened the documentations about function and mechanism of cerebrovascular disease one by one, and including in vivo animal test, in vivo and in vitro and clinical researches.DATA EXTRACTION: Totally 108 articles about ginger were retrieved,of which 24 articles relative to analysis of chemical compositions were included; 80 articles about pharmacological action were retrieved, including 29 articles about function of cardio-cerebral vessels, 8 articles about function of cerebral vessels. The articles were classified, summarized and appraised respectively, and views and prospects about the existing problems were put forward.DATA SYNTHESIS:①Pharmacological action of ginger with regard to the formation of anticoagulation and antithromboembolism: Test in vitro indicated that the water extract and its organic solvent extract could inhibit platelet aggregation and blood platelet thromboebolism, and its function would be enhanced with the enlargement of dosage. Test in vivo indicated that administration by gavage in terms of water extract, volatile oil, and ethyl alcohol could inhibit platelet aggregation. The inhibitory function of ginger on platelet aggregation were related with cyclooxygenase activity. Clinical researches showed that Rhizoma Zingiberis Recents and powder of ginger could inhibit platelet aggregation, but the effect would depend on the dosage of ginger.②Pharmacological action with regard to improvement of ceberal circulation: Manifested by remission of vasospasm, diminution of velocity of blood flow

  16. The changes of serum ferritin and β2-microglobulin in the cardiovascular and cerebrovascular diseases and their clinical significance

    International Nuclear Information System (INIS)

    To study the changes of serum ferritin (SF) and β2-microglobulin (β2-MG) in the cardiovascular and cerebrovascular diseases and their clinical significance, serum SF and β2-MG in 22 patients with coronary cardiopathy, 46 patients with hypertension and 21 patients with cerebral infarction were tested by RIA and compared with control group. The results showed that serum SF and β2-MG in patients with the above-mentioned diseases were significantly higher than those in control group (P2-MG participate in the pathophysiological processes, so that they may be used as references to therapeutic effectiveness and prognosis

  17. Cerebrovascular ETB, 5-HT1B, and AT1 receptor upregulation correlates with reduction in regional CBF after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Vikman, Petter; Nielsen, Marianne;

    2007-01-01

    We hypothesize that cerebral ischemia leads to enhanced expression of endothelin (ET), 5-hydroxytryptamine (5-HT), and angiotensin II (ANG II) receptors in the vascular smooth muscle cells. Our aim is to correlate the upregulation of cerebrovascular receptors and the underlying molecular mechanisms...... with the reduction in regional and global cerebral blood flow (CBF) after subarachnoid hemorrhage (SAH). SAH was induced by injecting 250 microl blood into the prechiasmatic cistern in rats. The cerebral arteries were removed 0, 1, 3, 6, 12, 24, and 48 h after the SAH for functional and molecular studies...

  18. Muerte prematura por accidente cerebrovascular y condición socioeconómica en la Argentina

    Directory of Open Access Journals (Sweden)

    Mauricio Monsalvo

    2016-04-01

    Full Text Available Introducción: La asociación entre mortalidad por accidente cerebrovascular y el nivel socioeconómico está escasamente descripta en Argentina. Objetivos: Describir la evolución temporal de la mortalidad por accidente cerebrovascular y su asociación con el nivel socioeconómico en Argentina entre 2000 y 2011. Material y métodos: Se realizó un estudio ecológico longitudinal. La mortalidad se cuantificó mediante tasas estandarizadas por edad y sexo, y el nivel socioeconómico mediante quintilos de necesidades básicas insatisfechas. Las unidades de observación fueron los departamentos de Argentina. La asociación entre mortalidad y nivel socioeconómico se evaluó utilizando un modelo de regresión de Poisson para datos de panel. Resultados: La mortalidad por accidente cerebrovascular aumentó progresivamente entre los quintilos de nivel socioeconómico (26,2, 28,4, 30,5, 34,5 y 36,9 por 100.000 personas, para los quintilos 1 a 5, respectivamente en el año 2000. La mortalidad en todos los grupos de nivel socioeconómico disminuyó, aunque persistieron diferencias entre ellos (17,2, 18,5, 20,1, 22,1 y 25,3 por 100.000 personas, para los quintilos 1 a 5, respectivamente en el año 2011. Las razones de tasas de incidencias fueron 1,15 (IC 95% 1,09 a 1,22; p<0,001, 1,27 (IC 95% 1,21 a 1,34; p<0,001, 1,32 (IC 95% 1,26 a 1,39; p<0,001, y de 1,48 (IC 95% 1,41 a 1,56; p<0,001, para los quintilos 2 a 5. Conclusiones: Los resultados sugieren una asociación inversa entre el nivel socioeconómico y la mortalidad por accidente cerebrovascular. Además, persistió una diferencia de mortalidad entre los niveles socioeconómicos durante el período de estudio.

  19. Dynamic SPECT with Xe-133: regional cerebral blood flow in patients with unilaterial cerebrovascular disease: concise communication

    International Nuclear Information System (INIS)

    To validate xenon-133 dynamic single photon emission tomography (SPECT) clinically, 74 patients were examined. Strictly unilateral cerebrovascular disease was confirmed in 47 patients by clinical history and by transmission computerized tomography (TCT) and contrast angiography. Twenty-seven were excluded, considered normal. SPECT flow maps were evaluated visually (against TCT) or by automated region of interest (ROI) techniques. Visually, low-flow areas were detected twice as frequently in SPECT as areas of low density in TCT. In reversible episodes, sensitivity of AF alone was significantly below the sensitivity of combined evaluation of flow and ratio

  20. Differential properties of Van der Pol — Duffing mathematical model of cerebrovascular haemodynamics based on clinical measurements

    Science.gov (United States)

    Parshin, D. V.; Ufimtseva, I. V.; Cherevko, A. A.; Khe, A. K.; Orlov, K. Yu; Krivoshapkin, A. L.; Chupakhin, A. P.

    2016-06-01

    The present paper discusses the method of identification (diseased/healthy) human cerebral vessels by using of mathematical model. Human cerebral circulation as a single tuned circuit, which consists of blood flow, elastic vessels and elastic brain gel tissue is under consideration. Non linear Van der Pol-Duffing equation is assumed as mathematical model of cerebrovascular circulation. Hypothesis of vascular pathology existence in some position of blood vessel, based on mathematical model properties for this position is formulated. Good reliability of hypothesis is proved statistically for 7 patients with arterial aneurysms.

  1. Sol-gel chemistry applied to the synthesis of polymetallic oxides including actinides reactivity and structure from solution to solid state; Synthese par voie douce d'oxydes polymetalliques incluant des actinides: reactivite et structure de la solution au solide

    Energy Technology Data Exchange (ETDEWEB)

    Lemonnier, St

    2006-02-15

    Minor actinides transmutation is studied at present in order to reduce the radiotoxicity of nuclear waste and the assessment of its technical feasibility requires specific designed materials. When considering americium, yttria stabilized zirconia (Am{sup III} YII Zriv)Or{sub x} is among the ceramic phases that one which presents the required physico-chemical properties. An innovative synthesis of this mixed oxide by sol-gel process is reported in this manuscript. The main aim of this work is to adjust the reactivity of the different metallic cations in aqueous media using complexing agent, in order to initiate a favourable interaction for a homogeneous elements repartition in the forming solid phase. The originality of the settled synthesis lies on an in-situ formation of a stable and monodisperse nano-particles dispersion in the presence of acetylacetone. The main reaction mechanisms have been identified: the sol stabilisation results from an original interaction between the three compounds (Zrly, trivalent cations and acetylacetone). The sol corresponds to a structured system at the nanometer scale for which zirconium and trivalent cations are homogeneously dispersed, preliminary to the sol-gel transition. Furthermore, preliminary studies were carried out with a view to developing materials. They have demonstrated that numerous innovative and potential applications can be developed by taking advantage of the direct and controlled formation of the sol and by adapting the sol-gel transition. The most illustrating result is the preparation of a sintered pellet with the composition Am0,13Zro,73Yo,0901,89 using this approach. (author)

  2. Targeting Reactive Carbonyl Species with Natural Sequestering Agents

    OpenAIRE

    Sung Won Hwang; Yoon-Mi Lee; Giancarlo Aldini; Kyung-Jin Yeum

    2016-01-01

    Reactive carbonyl species generated by the oxidation of polyunsaturated fatty acids and sugars are highly reactive due to their electrophilic nature, and are able to easily react with the nucleophilic sites of proteins as well as DNA causing cellular dysfunction. Levels of reactive carbonyl species and their reaction products have been reported to be elevated in various chronic diseases, including metabolic disorders and neurodegenerative diseases. In an effort to identify sequestering agents...

  3. Epidemiology of non-fatal cerebrovascular stroke and transient ischemic attacks in Al Quseir, Egypt

    Directory of Open Access Journals (Sweden)

    El-Tallawy HN

    2013-11-01

    Full Text Available Hamdy N El-Tallawy,1 Wafaa MA Farghaly,1 Ghaydaa A Shehata,1 Nabil M Abdel-Hakeem,2 Tarek A Rageh,1 Reda Badry,1 Mahmoud R Kandil1 1Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, 2Department of Neurology, Faculty of Medicine, Al-Azhar University, Assiut branch, Assuit, Egypt Background and purpose: Stroke is a medical emergency that can cause permanent neurological damage, complications, and disability. We aim to determine the epidemiology of non-fatal cerebrovascular stroke (CVS and transient ischemic attacks (TIAs in Al Quseir City, Red Sea, Egypt. Methods: The total population (n=33,285 was screened through a door to door study by three specialists of neurology and 15 female social workers (for demographic data collection. All suspected stroke patients were subjected to a full clinical examination, computerized tomography (CT and/or magnetic resonance imaging (MRI of their brain, blood sugar, lipogram, serum uric acid, complete blood cells, blood urea, and serum creatinine, as well as evaluated by Barthel Index and Scandinavian Stroke Scale. Carotid doppler, echocardiography, and thyroid functions were done for selected cases. Results: CVS was recorded among 130 patients out of 19,848 subjects aged 20 years and more, yielding a total prevalence of 6.55/1,000 population. From June 1, 2010 to May 31, 2011, 36 patients were recorded to have stroke within 1-year, yielding an incidence rate of 1.81/1,000. Prevalence and incidence rates were higher among males than females, and both indices increased steadily with advancing age to reach the highest prevalence (37.02/1,000 and incidence rate (9.5/1,000 among aged persons 60 years and more. Conclusion: The prevalence of non-fatal stroke in Al Quseir city (6.55/1,000 was at the lower range of that recorded in developing countries (5–10/1,000 and slightly higher than that recorded in industrialized countries (5/1,000 population. Ischemic stroke is the most

  4. Alkylidynephosphines : syntheses and reactivity

    OpenAIRE

    Becker, Gerd; Becker, Winfried; Knebl, Robert; Schmidt, Helmut; Hildenbrand, Ute; Westerhausen, Matthias

    1987-01-01

    In the past, different methods have been utilized for the preparation of alkylidynephosphines. Whereas, however, small amounts of thermally instable derivatives might be obtained from reactions in the gas phase, the synthesis of phosphines which are stable under an inert atmosphere, as for instance those with a tert-butyl or a 1-adamantyl substituent at the carbon atom of the PEC group, is best started with tris (trimethylsilyl) phosphine itself or with the more reactive lithium bis (trimethy...

  5. Reactive Turing Machines

    OpenAIRE

    Baeten, J.C.M.; Luttik, B.; Tilburg, van, T.G.

    2011-01-01

    We propose reactive Turing machines (RTMs), extending classical Turing machines with a process-theoretical notion of interaction, and use it to define a notion of executable transition system. We show that every computable transition system with a bounded branching degree is simulated modulo divergence-preserving branching bisimilarity by an RTM, and that every effective transition system is simulated modulo the variant of branching bisimilarity that does not require divergence preservation. ...

  6. Relationship of acute cerebrovascular diseases and hypothyroidism%急性脑血管病与甲状腺功能减退

    Institute of Scientific and Technical Information of China (English)

    杨华; 马召玺; 毛慧慧; 王万华; 张炎

    2013-01-01

    急性脑血管病后可引起临床甲状腺功能低下及亚临床甲状腺功能退减,甲状腺功能低下及亚临床甲状腺功能退减可能为急性脑血管病的危险因素,本文将二者关系综述如下。%Acute cerebrovascular diseases may result in overt hypothyroidism and subclinical hypothyroidism, however, overt hypothyroidism and subclinical hypothyroidism may be risk factors of acute cerebrovascular diseases. The relationship between the two aspects is reviewed as follows.

  7. Combined effects of type 2 diabetes and hypertension associated with cortical thinning and impaired cerebrovascular reactivity relative to hypertension alone in older adults

    Directory of Open Access Journals (Sweden)

    Ekaterina Tchistiakova

    2014-01-01

    Conclusions: Individuals with T2DM and HTN showed decreased CVR and CThk compared to age-matched HTN controls. This study identifies brain regions that are impacted by the combined effects of comorbid T2DM and HTN conditions, with new evidence that the corresponding cortical thinning may contribute to cognitive decline.

  8. Combined effects of type 2 diabetes and hypertension associated with cortical thinning and impaired cerebrovascular reactivity relative to hypertension alone in older adults

    OpenAIRE

    Ekaterina Tchistiakova; Nicole D Anderson; Greenwood, Carol E.; MacIntosh, Bradley J.

    2014-01-01

    Objective: Type 2 diabetes mellitus is characterized by metabolic dysregulation in the form of hyperglycemia and insulin resistance and can have a profound impact on brain structure and vasculature. The primary aim of this study was to identify brain regions where the combined effects of type 2 diabetes and hypertension on brain health exceed those of hypertension alone. A secondary objective was to test whether vascular impairment and structural brain measures in this population are associat...

  9. Creating a Computing Programs Package to Aid in the Assessment and Prognosis of Patients Suffering from Cerebrovascular Diseases

    Directory of Open Access Journals (Sweden)

    Carlos Jaime Geroy Gómez

    2007-05-01

    Full Text Available Fundament: The have an evaluation and prognosis of patients suffering from cerebrovascular diseases in its acute phase is important in order to define the medical management as well as others several aspects. Objective: To create computing programs package to aid in the assessment and prognosis of patients suffering from cerebrovascular diseases. Method: A research and development study to create a package of programs using a C chart computing language (NET language with recognized international scale compendium and the Cuban scale prognosis. Results: A Software which shows in different screens the correspondent variables to the different evaluative scales and the prognosis Cuban scale ¨Stroke¨ is created. It is applicable to every type of patient suffering from cardiovascular diseases and an immediate assessment and prognosis is obtained. It also has a data base. It is applicable in all ictus units of our country and abroad. Conclusions: A unique software was created as a valuable tool to the attention of patients suffering from cardiovascular diseases which permit to obtain a better assessment and prognosis of this kind of patient.

  10. Compromised cerebrovascular modulation in chronic anxiety: evidence from cerebral blood flow velocity measured by transcranial Doppler sonography

    Institute of Scientific and Technical Information of China (English)

    Hong-Liang Zhang; Zhen-Ni Guo; Ge Yang; Le Yang; Ke Han; Jiang Wu; Yingqi Xing; Yi Yang

    2012-01-01

    Objective Cerebral autoregulation (CA) is the mechanism by which constant cerebral blood flow is maintained despite changes in cerebral perfusion pressure.CA can be evaluated by dynamic monitoring of cerebral blood flow velocity (CBFV) with transcranial Doppler sonography (TCD).The present study aimed to explore CA in chronic anxiety.Methods Subjects with Hamilton anxiety scale scores ≥14 were enrolled and the dynamic changes of CBFV in response to an orthostatic challenge were investigated using TCD.Results In both the anxious and the healthy subjects,the mean CBFV was significantly lower in the upright position than when supine.However,the CBFV changes from supine to upright differed between the anxious and the healthy groups.Anxious subjects showed more pronounced decreases in CBFV with abrupt standing.Conclusion Our results indicate that cerebrovascular modulation is compromised in chronic anxiety; anxious subjects have some insufficiency in maintaining cerebral perfusion after postural change.Given the fact that anxiety and impaired CA are associated with cardiovascular disease,early ascertainment of compromised cerebrovascular modulation using TCD might suggest interventional therapies in the anxious population,and improve the primary prevention of cardiovascular disease.

  11. Carbon dioxide induced changes in cerebral blood flow and flow velocity: role of cerebrovascular resistance and effective cerebral perfusion pressure.

    Science.gov (United States)

    Grüne, Frank; Kazmaier, Stephan; Stolker, Robert J; Visser, Gerhard H; Weyland, Andreas

    2015-09-01

    In addition to cerebrovascular resistance (CVR) zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe) and the resistance area product (RAP) are supplemental determinants of cerebral blood flow (CBF). Until now, the interrelationship of PaCO2-induced changes in CBF, CVR, CPPe, ZFP, and RAP is not fully understood. In a controlled crossover trial, we investigated 10 anesthetized patients aiming at PaCO2 levels of 30, 37, 43, and 50 mm Hg. Cerebral blood flow was measured with a modified Kety-Schmidt-technique. Zero flow pressure and RAP was estimated by linear regression analysis of pressure-flow velocity relationships of the middle cerebral artery. Effective cerebral perfusion pressure was calculated as the difference between mean arterial pressure and ZFP, CVR as the ratio CPPe/CBF. Statistical analysis was performed by one-way RM-ANOVA. When comparing hypocapnia with hypercapnia, CBF showed a significant exponential reduction by 55% and mean VMCA by 41%. Effective cerebral perfusion pressure linearly decreased by 17% while ZFP increased from 14 to 29 mm Hg. Cerebrovascular resistance increased by 96% and RAP by 39%; despite these concordant changes in mean CVR and Doppler-derived RAP correlation between these variables was weak (r=0.43). In conclusion, under general anesthesia hypocapnia-induced reduction in CBF is caused by both an increase in CVR and a decrease in CPPe, as a consequence of an increase in ZFP.

  12. [The role of electronic databases in practical decision making in the care of patients with cerebrovascular diseases].

    Science.gov (United States)

    Bereczki, Dániel

    2002-06-01

    The information revolution of recent years, the general accessibility of computers and especially the Internet, provided the possibility of immediate access to the newest and most reliable results of clinical research in everyday medical practice. When a question arises regarding the care of a certain patient, we can have answers within minutes. Summaries of systematic reviews of the Cochrane Library and abstracts of papers of several thousand journals indexed on MEDLINE are available free of charge. In addition, over 70,000 Internet home pages provide some sort of health care information. The fast accessibility of information made it possible to apply a new method, called evidence-based medicine, in everyday practice. This method implies the effective search of an answer to a well formed question, and the critical evaluation of the results found during the search. This paper summarises the most important electronic databases that can be used in the care of patients with cerebrovascular diseases. The paper emphasises the advantages and dangers of the use of the Internet. Enlisted are the most important English- and Hungarian-language home pages with information on cerebrovascular diseases. Internet addresses of home pages providing methodological help in critically evaluating the literature are also given. The paper summarises the most important questions to consider when we want to evaluate the validity and importance of papers on diagnostic methods, on prognosis, on treatment effect, when we read systematic reviews, economic evaluations, clinical decision analyses and guidelines.

  13. Comparison of carotid and cerebrovascular disease between diabetic and non-diabetic patients using dual-source CT

    International Nuclear Information System (INIS)

    Purpose: To clarify the differences of the carotid and cerebrovascular disease between patients with and without type 2 diabetes using dual-source CT angiography. Materials and methods: Dual-source CT angiography of the carotid and cerebrovascular arteries was performed in 79 type 2 diabetic patients and 207 non-diabetic patients. The type, extent and distribution of plaques, and luminal stenosis were compared. Results: Compared with non-diabetic patients, diabetic patients had a higher overall incidence of plaque (p 0.05), as well as for the number of diseased segments and the distribution of plaques; both mainly involved the bilateral cavernous segment of the internal carotid artery. As for the stenosis, non-obstructive lesions were more common in diabetic patients (p 0.05). Conclusion: Diabetes is associated with a higher incidence of plaque and non-obstructive stenosis. However, no significant differences were observed in the type, extent and distribution of involved plaques between diabetic and non-diabetic patients.

  14. Application of electroencephalography in cerebrovascular disease%脑电图在脑血管疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    王乾; 苏立凯

    2014-01-01

    Cerebrovascular disease is one of diseases which threatens human’s health seriously. It is of vital significance for patients with stroke to be diagnosed timely. Efficient treatment can help to decrease the damage of stroke. Acute evaluation of prognosis of stroke is of importance for patients and their family. Electroencephalography is an approach that can be easily operated. The defection of motor or language function has little influence to electroencephalography. Electroencephalography plays a role in early diagnosing of cerebrovascular disease, focus detection, recognition of secondary epilepsy, valuing the effect of medicine and prediction the prognosis of coma patients.%脑血管疾病严重威胁人类健康,对脑卒中病人及时确诊、积极治疗、评估病情具有重要意义。脑电图检查具有方便易行,适于床旁操作;可重复性好;不受运动、语言等功能损伤的限制等优点。脑电图可以协助脑血管疾病的早期诊断,帮助病灶定侧,发现继发性癫痫,监测药物效果及预测昏迷病人预后。

  15. Asymptomatic cerebrovascular lesions detected by magnetic resonance imaging in patients with systemic lupus erythematosus lacking a history of neuropsychiatric events

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Kumiko; Yamano, Shigeru; Ikeda, Yukiko [Nara Medical Univ., Kashihara (Japan)] (and others)

    1999-10-01

    To clarify the extent of asymptomatic cerebrovascular involvement in systemic lupus erythematosus (SLE). Cerebral magnetic resonance imaging (MRI) findings and ultrasonography findings of 100 patients with SLE lacking present or past clinical neurologic deficits were compared with 66 age-matched volunteers to determine the combined intima-media thickness (IMT) of the common carotid artery, and tests for anti-cardiolipin antibodies (aCL). Thirty-eight patients, but only 2 controls, showed imaging abnormalities. Among 23 SLE patients with cerebrovascular lesions by MRI who underwent single-photon emission computed tomography (SPECT), 14 showed hypoperfusion of the lesion. The IMT value and prevalence of aCL did not differ between the 55 SLE patients tested and controls. SLE disease activity index (SLEDAI) as assessed by a quantitative clinical index was significantly greater in patients with brain lesions than in those without. The prevalence of asymptomatic brain lesions in SLE patients is high, and shows a relationship to disease activity. (author)

  16. Cerebrovascular fibromuscular dysplasia: a report of 5 cases and literature review%脑动脉肌纤维发育不良五例报告并文献复习

    Institute of Scientific and Technical Information of China (English)

    姜春黎; 曹勇军; 石际俊; 肖国栋; 李艳艳; 徐加平; 章春园

    2015-01-01

    Objective To analyze the basal conditions of 5 patients with cerebrovascular fibromuscular dysplasia (FMD),and explore the clinical presentation,imaging features,therapies and outcomes of cerebrovascular FMD.Methods Five patients with cerebrovascular FMD,admitted to our hospital from January 2012 to April 2013,were chosen in our study; their medical history and imaging features were collected,and their clinical presentation,imaging features,therapies and outcomes were retrospectively analyzed when combining with literature review.Results Five patients all presented with stroke,including four having hemiplegia as the initial symptom,and one having headache with nausea and vomiting as the main performance.One was diagnosed as having subarachnoid hemorrhage by CT scan,and four had different infarction lesions in lobes and basal ganglia on MRI.Artery dissection was discovered in all patients by cerebral digital substraction angiography,including two with right internal carotid artery dissection,one with right vertebral artery dissection combined with aneurysm in anterior communicating artery associated with "string-of-beads" appearance on C1 segment of right internal carotid artery and left vertebral artery,one with bilateral vertebral artery dissection,and the last one with bilateral internal carotid artery dissection and moyamoya disease-like vessels.No abnormality was discovered in two patients by renal artery angiography.The patient with anterior communicating artery aneurysm was treated with endovascular aneurysm embolization,having poor prognosis.In the remaining 4 patients with cerebral infarction,two were treated with carotid artery stenting,and the other 2 were only given antiplatelet therapy.No patient suffered cerebrovascular accidents during the 12-month follow-up.Conclusions Cerebrovascular FMD is a rare cause of young stroke,and patients with cerebrovascular FMD often manifest headache,neck bruit,carotid artery dissection and stroke.It is particularly

  17. Towards a quantitative understanding of total OH reactivity: A review

    Science.gov (United States)

    Yang, Yudong; Shao, Min; Wang, Xuemei; Nölscher, Anke C.; Kessel, Stephan; Guenther, Alex; Williams, Jonathan

    2016-06-01

    Over the past fifty years, considerable efforts have been devoted to measuring the concentration and chemical speciation of volatile organic compounds (VOCs) in ambient air and emissions. Recently, it has become possible to directly determine the overall effect of atmospheric trace gases on the oxidant hydroxyl radicals (OH), by measuring OH reactivity (OH loss frequency). Quantifying total OH reactivity is one way to characterize the roles of VOCs in formation of ground-level ozone and secondary organic aerosols (SOA). Approaches for measuring total OH reactivity in both emissions and ambient air have been progressing and have been applied in a wide range of studies. Here we evaluate the main techniques used to measure OH reactivity, including two methods directly measuring OH decay and one comparative reactivity method (CRM), and summarize the existing experimental and modeling studies. Total OH reactivity varies significantly on spatial, diurnal, seasonal and vertical bases. Comparison with individually detected OH sinks often reveals a significant missing reactivity, ranging from 20% to over 80% in some environments. Missing reactivity has also been determined in most source emission studies. These source measurements, as well as numerical models, have indicated that both undetected primary emissions and unmeasured secondary products could contribute to missing reactivity. A quantitative understanding of total OH reactivity of various sources and ambient environments will enhance our understanding of the suite of compounds found in emissions as well as chemical processes, and will also provide an opportunity for the improvement of atmospheric chemical mechanisms.

  18. Prospective, multidisciplinary recording of perioperative errors in cerebrovascular surgery: is error in the eye of the beholder?

    Science.gov (United States)

    Michalak, Suzanne M; Rolston, John D; Lawton, Michael T

    2016-06-01

    OBJECT Surgery requires careful coordination of multiple team members, each playing a vital role in mitigating errors. Previous studies have focused on eliciting errors from only the attending surgeon, likely missing events observed by other team members. METHODS Surveys were administered to the attending surgeon, resident surgeon, anesthesiologist, and nursing staff immediately following each of 31 cerebrovascular surgeries; participants were instructed to record any deviation from optimal course (DOC). DOCs were categorized and sorted by reporter and perioperative timing, then correlated with delays and outcome measures. RESULTS Errors were recorded in 93.5% of the 31 cases surveyed. The number of errors recorded per case ranged from 0 to 8, with an average of 3.1 ± 2.1 errors (± SD). Overall, technical errors were most common (24.5%), followed by communication (22.4%), management/judgment (16.0%), and equipment (11.7%). The resident surgeon reported the most errors (52.1%), followed by the circulating nurse (31.9%), the attending surgeon (26.6%), and the anesthesiologist (14.9%). The attending and resident surgeons were most likely to report technical errors (52% and 30.6%, respectively), while anesthesiologists and circulating nurses mostly reported anesthesia errors (36%) and communication errors (50%), respectively. The overlap in reported errors was 20.3%. If this study had used only the surveys completed by the attending surgeon, as in prior studies, 72% of equipment errors, 90% of anesthesia and communication errors, and 100% of nursing errors would have been missed. In addition, it would have been concluded that errors occurred in only 45.2% of cases (rather than 93.5%) and that errors resulting in a delay occurred in 3.2% of cases instead of the 74.2% calculated using data from 4 team members. Compiled results from all team members yielded significant correlations between technical DOCs and prolonged hospital stays and reported and actual delays (p = 0

  19. Programming Reactive Extensions and LINQ

    CERN Document Server

    Liberty, Jesse

    2011-01-01

    Pro Reactive Extensions and LINQ is a deep dive into the next important technology for .NET developers: Reactive Extensions. This in-depth tutorial goes beyond what is available anywhere else to teach how to write WPF, Silverlight, and Windows Phone applications using the Reactive Extensions (Rx) to handle events and asynchronous method calls. Reactive programming allows you to turn those aspects of your code that are currently imperative into something much more event-driven and flexible. For this reason, it's sometimes referred to as LINQ for Events. Reactive programming hinges on the concep

  20. Human herpesvirus type 6 reactivation after haematopoietic stem cell transplantation

    NARCIS (Netherlands)

    Pagter, P.J. de; Schuurman, R.; Meijer, Ellen; Baarle, D. van; Sanders, E.A.M.; Boelens, J.J.

    2008-01-01

    Human herpesvirus type 6 (HHV6) is known to reactivate after hematopoetic stem cell transplantation (HSCT) and has been suggested to be associated with increased mortality and severe clinical manifestations, including graft versus host disease (GvHD). The exact etiological role of HHV6 reactivation

  1. Stress Reactivity and Corticolimbic Response to Emotional Faces in Adolescents

    Science.gov (United States)

    Liu, Jie; Chaplin, Tara M.; Wang, Fei; Sinha, Rajita; Mayes, Linda C.; Blumberg, Hilary P.

    2012-01-01

    Objective: Adolescence is a critical period in the development of lifelong patterns of responding to stress. Understanding underpinnings of variations in stress reactivity in adolescents is important, as adolescents with altered stress reactivity are vulnerable to negative risk-taking behaviors including substance use, and have increased lifelong…

  2. Evaluating advanced LMR reactivity feedbacks using SSC

    International Nuclear Information System (INIS)

    Analyses of the PRISM and SAFR liquid metal reactor transients, using SSC, are discussed. These two advanced reactors incorporate innovative approaches to safety, utilizing passive rather than active engineered safety systems. A key feature of these designs is their reliance on the inherent negative reactivity feedbacks of the metal fuel to accommodate unscrammed events passively. These feedbacks include Doppler, sodium density, and thermal expansion of the reactor and the control rod drive lines. Each of these feedbacks is discussed, as is the modeling implemented into the SSC code. These calculations provide an independent evaluation of the proposed reactors, and show how the reactivity feedbacks can provide an inherent shutdown in response to key anticipated events. The results from the SSC calculations support the contention that the inherent reactivity feedbacks can provide an extra degree of safety for the proposed liquid metal reactors

  3. Registro de enfermedad cerebrovascular isquémica Ischemic stroke registry

    Directory of Open Access Journals (Sweden)

    Juan I. Rojas

    2006-12-01

    Full Text Available El conocimiento de los factores de riesgo y los aspectos epidemiológicos del accidente cerebrovascular (ACV provienen fundamentalmente de estudios de EE.UU. y Europa, con escasa información procedente de los países en desarrollo. Las características clínicas y epidemiológicas del ACV son variables en relación a factores regionales, por lo cual es necesario conocer cuál es la situación en nuestro continente. El objetivo del trabajo es describir los subtipos clínicos y los factores de riesgo de los pacientes con ACV isquémico. Se analizaron consecutivamente los pacientes ingresados desde el 01/06/2003 al 01/06/2005 con diagnostico de ACV isquémico. Sobre un total de 395 pacientes, la edad media fue de 71.36 años (± 13.82, el 55% fueron varones. Los subtipos de ACV fueron los siguientes: infarto lacunar (40%, enfermedad de gran arteria (20%, cardioembolia (10% y otras causas (5%. La hipertensión arterial (76%, la dislipidemia (50% y el antecedente de ACV previo (34% fueron los factores de riesgo más frecuentes. Los pacientes con síntomas corticales presentaron más frecuentemente estenosis carotídea > del 70% en el doppler de vasos de cuello, siendo esto estadísticamente significativo. La información sobre el ACV en los países en desarrollo es difícil de obtener. Esta puede ser la razón del escaso número de registros provenientes de Sudamérica. La hipertensión fue el factor de riesgo más prevalente en nuestra serie. El subtipo de ACV difiere de lo informado en otras regiones del mundo predominando la enfermedad de pequeña arteria.Current knowledge of stroke risk factors and epidemiology is based mostly on USA or European studies; scarce data have been published from developing countries. Because epidemiological and clinical characteristics in stroke vary according to regional factors, we need to know the peculiarities of stroke on this subcontinent. The purpose is to describe the clinical subtypes and risk factors in

  4. Adenovirus viral interleukin-10 inhibits adhesion molecule expressions induced by hypoxia/reoxygenation in cerebrovascular endothelial cells1

    Institute of Scientific and Technical Information of China (English)

    Hui KANG; Peng-yuan YANG; Yao-cheng RUI

    2008-01-01

    Aim: To investigate the effects of recombinant adenovirus encoding viral interleukin-10 (vIL-10), a potent anti-inflammatory cytokine, on adhesion mol-ecule expressions and the adhesion rates of leukocytes to endothelial cells in cerebrovascular endothelial cells injured by hypoxia/reoxygenation (H/R). Methods: A recombinant adenovirus expressing vIL-10 (Ad/vIL-10 (or the green fluorescent protein (Ad/GFP) gene was constructed. A cerebrovascular endothe-lial cell line bend.3 was pretreated with a different multiplicity of infection (MOI) of Ad/vIL-10 or Ad/GFP and then exposed to hypoxia for 9 h followed by reoxygenation for 12 h. The culture supernatants were tested for the expression of vIL-10 and endogenous murine IL-10 (mIL-10) by ELISA. The effects of Ad/vIL-10 on monocyte-endothelial cell adhesion were represented as the adhesion rate. Subsequently, the expressions of intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1(VCAM-1) in the endothelial cells after treat-ment with Ad/vIL-10 and H/R were analyzed by Western blotting and real-time PCR. Results: vIL-10 was expressed in cultured bEnd.3 after Ad/vIL-10 transfec-tion and was significantly increased by H/R. Ad/vIL-10 or Ad/GFP did not affect the mlL-10 level. H/R increased the mIL-10 expression, but insignificantly. Mono-cyte-endothelial cell adhesion induced by H/R was significantly inhibited by pretreatment with Ad/vIL-10 (MOI: 80). ICAM-I, and VCAM-1 in bEnd.3 and were significantly increased after H/R, while pretreatment with Ad/vIL-10 (MOI: 80) significantly inhibited their expressions. Ad/GFP did not markedly affect mono-cyte-endothelial adhesion and the expressions of ICAM-1 and VCAM-1 induced by H/R. Conclusion: Ad/vIL-10 significantly inhibits the upregulation of endot-helial adhesion molecule expressions and the increase of adhesion of monocytes-endothelial cells induced by H/R, indicating that vIL-10 gene transfer is of far-reaching significance in the therapy of

  5. Lower prevalence of carotid plaque hemorrhage in women, and its mediator effect on sex differences in recurrent cerebrovascular events.

    Directory of Open Access Journals (Sweden)

    Neghal Kandiyil

    Full Text Available Women are at lower risk of stroke, and appear to benefit less from carotid endarterectomy (CEA than men. We hypothesised that this is due to more benign carotid disease in women mediating a lower risk of recurrent cerebrovascular events. To test this, we investigated sex differences in the prevalence of MRI detectable plaque hemorrhage (MRI PH as an index of plaque instability, and secondly whether MRI PH mediates sex differences in the rate of cerebrovascular recurrence.Prevalence of PH between sexes was analysed in a single centre pooled cohort of 176 patients with recently symptomatic, significant carotid stenosis (106 severe [≥70%], 70 moderate [50-69%] who underwent prospective carotid MRI scanning for identification of MRI PH. Further, a meta-analysis of published evidence was undertaken. Recurrent events were noted during clinical follow up for survival analysis.Women with symptomatic carotid stenosis (50%≥ were less likely to have plaque hemorrhage (PH than men (46% vs. 70% with an adjusted OR of 0.23 [95% CI 0.10-0.50, P<0.0001] controlling for other known vascular risk factors. This negative association was only significant for the severe stenosis subgroup (adjusted OR 0.18, 95% CI 0.067-0.50 not the moderate degree stenosis. Female sex in this subgroup also predicted a longer time to recurrent cerebral ischemic events (HR 0.38 95% CI 0.15-0.98, P = 0.045. Further addition of MRI PH or smoking abolished the sex effects with only MRI PH exerting a direct effect. Meta-analysis confirmed a protective effect of female sex on development of PH: unadjusted OR for presence of PH = 0.54 (95% CI 0.45-0.67, p<0.00001.MRI PH is significantly less prevalent in women. Women with MRI PH and severe stenosis have a similar risk as men for recurrent cerebrovascular events. MRI PH thus allows overcoming the sex bias in selection for CEA.

  6. Uso de esteronitronas para el tratamiento y prevención del ictus o accidente cerebrovascular, enfermedades de alzheimer, parkinson y esclerosis lateral amiotrófica

    OpenAIRE

    Marco Contelles, José Luis; Alcázar González, Alberto

    2013-01-01

    Uso y preparación de esteronitronas con alta permeabilidad a la barrera hematoencefálica, capacidad antioxidante y neuroprotectora, como potenciales fármacos para el tratamiento del ictus o accidente cerebrovascular, enfermedades de Alzheimer, Parkinson y esclerosis lateral amiotrófica.

  7. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: A five year longitudinal cohort study

    NARCIS (Netherlands)

    P.J. Tully (Phillip); H.R. Winefield (Helen); R.A. Baker (Robert); J. Denollet (Johan); S.S. Pedersen (Susanne); G.A. Wittert (Gary); D.A. Turnbull (Deborah)

    2015-01-01

    textabstractBackground: Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretic

  8. Changes of serum high sensitive C-reactive protein in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Yan Du; Yan Ren; Ying Li

    2007-01-01

    BACKGROUND: Serum high sensitive C-reactive protein (hs-CRP), which regards as a high sensitive mark of systemic inflammatory response syndrome, can provide a lot of valuable information for the treatment and prognosis of cerebrovascular disease.OBJECTIVE: To observe the differences of blood glucose, lipid, homocysteine and previous disease history among patients with acute cerebral infarction at various levels of hs-CRP and compare changes of hs-CRP of patients with various degrees ofneurologic impairment.DESIGN: Contrast observation.SETTING: Department of Neurology, Shenzhou Hospital, Shenyang Medical College.PARTICIPANTS: A total of 102 patients with acute cerebral infarction were selected from Department of Neurology, Shenzhou Hospital of Shenyang Medical College from February 2005 to September 2006,including 55 males and 47 females aged from 55 to 86 years. All accepted patients met the diagnostic criteria of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were diagnosed with CT or MRI examination. All patients provided the confirmed consent. Based on clinical criteria of neurologic impairment established by the Fourth National Cerebrovascular Disease Academic Meeting, patients were randomly divided into mild group (0- 15 points, n =46), moderate group (16- 30points, n =38) and severe group (31 - 45 points, n =18). In addition, based on hs-CRP level within 72 hours,patients were divided into normal group (hs-CRP ≤ 3 mg/L, n =53) and increasing group (hs-CRP > 3 mg/L,n =49).METHODS: ① 2 mL venous blood was selected from hospitalized patients in the next morning to separate serum. Quantitative measurement of hs-CRP was dealt with Latex Enhnced Turbidimetric Immunoassay (LETIA). ② Fasting venous blood was colleted from hospitalized patients in the next morning to measure numeration of white blood cells, fibrinogen, blood glucose, total cholesterol (TC), triacylglycerol (TG), high density lipoprotein

  9. Reactive Metabolites: Current and Emerging Risk and Hazard Assessments.

    Science.gov (United States)

    Thompson, Richard A; Isin, Emre M; Ogese, Monday O; Mettetal, Jerome T; Williams, Dominic P

    2016-04-18

    Although idiosyncratic adverse drug reactions are rare, they are still a major concern to patient safety. Reactive metabolites are widely accepted as playing a pivotal role in the pathogenesis of idiosyncratic adverse drug reactions. While there are today well established strategies for the risk assessment of stable metabolites within the pharmaceutical industry, there is still no consensus on reactive metabolite risk assessment strategies. This is due to the complexity of the mechanisms of these toxicities as well as the difficulty in identifying and quantifying short-lived reactive intermediates such as reactive metabolites. In this review, reactive metabolite risk and hazard assessment approaches are discussed, and their pros and cons highlighted. We also discuss the nature of idiosyncratic adverse drug reactions, using acetaminophen and nefazodone to exemplify the complexity of the underlying mechanisms of reactive metabolite mediated hepatotoxicity. One of the key gaps moving forward is our understanding of and ability to predict the contribution of immune activation in idiosyncratic adverse drug reactions. Sections are included on the clinical phenotypes of immune mediated idiosyncratic adverse drug reactions and on the present understanding of immune activation by reactive metabolites. The advances being made in microphysiological systems have a great potential to transform our ability to risk assess reactive metabolites, and an overview of the key components of these systems is presented. Finally, the potential impact of systems pharmacology approaches in reactive metabolite risk assessments is highlighted. PMID:26735163

  10. Measuring Memory Reactivation With Functional MRI: Implications for Psychological Theory.

    Science.gov (United States)

    Levy, Benjamin J; Wagner, Anthony D

    2013-01-01

    Environmental cues often remind us of earlier experiences by triggering the reactivation of memories of events past. Recent evidence suggests that memory reactivation can be observed using functional MRI and that distributed pattern analyses can even provide evidence of reactivation on individual trials. The ability to measure memory reactivation offers unique and powerful leverage on theoretical issues of long-standing interest in cognitive psychology, providing a means to address questions that have proven difficult to answer with behavioral data alone. In this article, we consider three instances. First, reactivation measures can indicate whether memory-based inferences (i.e., generalization) arise through the encoding of integrated cross-event representations or through the flexible expression of separable event memories. Second, online measures of memory reactivation may inform theories of forgetting by providing information about when competing memories are reactivated during competitive retrieval situations. Finally, neural reactivation may provide a window onto the role of replay in memory consolidation. The ability to track memory reactivation, including at the individual trial level, provides unique leverage that is not afforded by behavioral measures and thus promises to shed light on such varied topics as generalization, integration, forgetting, and consolidation.

  11. Measuring Memory Reactivation With Functional MRI: Implications for Psychological Theory.

    Science.gov (United States)

    Levy, Benjamin J; Wagner, Anthony D

    2013-01-01

    Environmental cues often remind us of earlier experiences by triggering the reactivation of memories of events past. Recent evidence suggests that memory reactivation can be observed using functional MRI and that distributed pattern analyses can even provide evidence of reactivation on individual trials. The ability to measure memory reactivation offers unique and powerful leverage on theoretical issues of long-standing interest in cognitive psychology, providing a means to address questions that have proven difficult to answer with behavioral data alone. In this article, we consider three instances. First, reactivation measures can indicate whether memory-based inferences (i.e., generalization) arise through the encoding of integrated cross-event representations or through the flexible expression of separable event memories. Second, online measures of memory reactivation may inform theories of forgetting by providing information about when competing memories are reactivated during competitive retrieval situations. Finally, neural reactivation may provide a window onto the role of replay in memory consolidation. The ability to track memory reactivation, including at the individual trial level, provides unique leverage that is not afforded by behavioral measures and thus promises to shed light on such varied topics as generalization, integration, forgetting, and consolidation. PMID:25484909

  12. Dynamic analysis of BWR scram reactivity characteristics

    International Nuclear Information System (INIS)

    An extensive study of BWR scram reactivity behavior is presented. It is based on a space-time analysis of a BWR/4 code using the two-dimensional (R, Z) dynamics code BNL-TWIGL which includes a two-phase thermal-hydraulic model. Calculations were made of the sensitivity of scram to physical quantities such as initial control rod position and power distribution, scram speed, system pressure and varying inlet flow rate and temperature. The end-of-cycle Haling operating condition was found to give rise to the limiting scram reactivity function. Even with scram a power surge was found to be possible with severely decreasing inlet temperature. Calculations were also made to find the effect on scram of commonly used modeling approximations. These included the effect of neglecting delayed neutrons (conservative), using a time invariant void distribution (non-conservative) and defining point kinetics parameters such as reactivity, amplitude function and generation time in terms of different weighting functions. The importance of defining point kinetics parameters consistent with their use in plant transient analyses was demonstrated with particular emphasis on the role of ''residual reactivity''

  13. Evaluation of ischemic cerebrovascular lesions by carotid ultrasonography in patients with coronary atherosclerosis heart disease and its value for predicting cerebrovascular stenosis%颈动脉超声对冠状动脉粥样硬化性心脏病合并缺血性脑血管疾病患者颅内动脉狭窄性病变的预测价值

    Institute of Scientific and Technical Information of China (English)

    张蕾; 王维平; 李亚琼; 高承梅; 刘晶; 李晓辉

    2013-01-01

    目的 探讨颈动脉超声评价冠状动脉粥样硬化性心脏病(CAD)合并缺血性脑血管(ICVD)患者颅内动脉狭窄性病变的预测价值.方法 对209例经血管造影证实冠状动脉狭窄(≥70%)同时合并缺血性脑血管疾病的患者采用彩色多谱勒超声(CDFI)和经颅多普勒超声(TCD)分别检查颈动脉和颅内动脉,并将患者分为脑动脉狭窄组与非狭窄组,分别比较两组患者颈动脉超声检查结果 中差异有统计学意义的指标.结果 颈动脉球部内-中膜(IMT)增厚、不均质回声斑块、多发斑块、颈动脉狭窄与CAD患者合并颅内动脉狭窄性病变之间具有良好的相关关系,(P<0.05).结论 颈动脉内膜增厚、不均质回声斑块,多发斑块、颈动脉狭窄与CAD合并ICVD患者颅内动脉狭窄性病变之间有明显的相关性.采用CDFI对冠状动脉狭窄的患者进行颈动脉检测,在心脑血管事件高危人群中进行筛选,对临床诊断与治疗具有重要的指导意义.%Objective To evaluate the clinic value for predicting ischemic cerebrovascular atherosclerosis disease (ICVD) in patients with coronary atherosclerosis heart disease (CAD) via carotid ultrosonography.Methods CDFI and TCD were used to examine the carotid artery and intracranial artery respectively for the 209 patients whose diagnosis of coronary artery stenosis (≥70% ) and intracranial arterial stenosis via selective coronary angiography. The patients were divided into intracranial artery stenosis and non -intracranial artery stenosis groups. The carotid ultrasound findings variables were evaluated in the stenosis and non -stenosis groups respectively. Results There was a significant correlation between cerebrovascular stenosis disease in patients with CAD and the carotid ultrasound findings variables, including carotid maximum intima -media thickness (IMT) , heterogeneous plaque, multi -plaques and carotid stenosis ( P < 0. 05 ) . Conclusion Cerebrovascular stenosis

  14. Evaluation of Vasomotor Reactivity by Transcranial Doppler Sonography: Age and Sex Related Differences in Breath Holding Index in Iranian Population

    Directory of Open Access Journals (Sweden)

    SA Mousavi

    2005-03-01

    Full Text Available Background: The assessment of cerebral vasoreactivity can provide information regarding the reserve capacity of cerebral circulation. Reduction of this property has been found in association with situations predisposing one toward cerebrovascular disease. In this study, we defined the vasoreactivity of brain vesseles according to age and sex of the patients. Methods: In this descriptive study, 289 healthy subjects (without hypertension, diabetes mellitus, obesity, smoking, CHF, CHD, were admitted from January 2004 to June 2004. The population was divided to four groups, according to age and sex (women and men more and less than 30. After determination of each patient’s flow velocity of middle cerebral artery (MCA by mean of a transcranial doppler instrument (TCD, before and after 30s apnea, breath holding index (BHI was calculated. Data was analyzed, using SPSS software. Results: BHI was significantly higher in women than men (0.918±0.40 versus 0.637±0.22; P<0.001. BHI was significantly lower in older (age > 30 women (0.812±0.31 than in younger ( ≤ 30 years women (0.995±0.44; P<0.001 but there was no significant difference between older (age > 30 men (0.62±0.23 and younger ( ≤ 30 years men (0.65±0.20; P > 0.05. Conclusion: The average of BHI was lower in men than in women in total and in all age subgroups. BHI was relatively constant in all age subgroups in men but there was significant decline in BHI by increasing age in women. So despite of many physiologic changes related to aging, vasomotor reactivity remains relatively constant in men but decreases in women. Findings of our study suggest that changes of cerebrovascular vasomotor reactivity in healthy subjects may be related to aging, but they are probably mainly influenced by sex. Keywords: vasomotor reactivity, BHI, TCD

  15. Wastewater treatment after reactive printing

    OpenAIRE

    Šostar-Turk, Sonja; Simonič, Marjana; Petrinić, Irena

    2012-01-01

    Membrane filtration of wastewater after textile printing with reactive dyes isdescribed. The wastewater from a Slovenian factory, whose output is approx. 80% reactive dyes printed and dyed on cotton, was studied. In particular, the presence of urea, sodium alginate, oxidation agent and reactive dyes, used forthe printing paste preparation, in the wastewater was studied. Chemical analyses of actual, non-purified, wastewater showed that many Slovenian regulations were exceeded. The study of mem...

  16. Controlling Material Reactivity Using Architecture.

    Science.gov (United States)

    Sullivan, Kyle T; Zhu, Cheng; Duoss, Eric B; Gash, Alexander E; Kolesky, David B; Kuntz, Joshua D; Lewis, Jennifer A; Spadaccini, Christopher M

    2016-03-01

    3D-printing methods are used to generate reactive material architectures. Several geometric parameters are observed to influence the resultant flame propagation velocity, indicating that the architecture can be utilized to control reactivity. Two different architectures, channels and hurdles, are generated, and thin films of thermite are deposited onto the surface. The architecture offers an additional route to control, at will, the energy release rate in reactive composite materials. PMID:26669517

  17. Focal ischaemia caused by instability of cerebrovascular tone during attacks of hemiplegic migraine. A regional cerebral blood flow study

    DEFF Research Database (Denmark)

    Friberg, L; Olsen, T S; Roland, P E;

    1987-01-01

    During the course of hemiplegic migraine in 3 patients, changes in regional cerebral blood flow (rCBF) were recorded by the intracarotid 133Xe method and a 254 multidetector camera covering one hemisphere. The rCBF measurements were performed in conjunction with cerebral angiography. During...... repeated rCBF measurements all 3 patients developed focal hypoperfusion originating in the frontal lobe, subsequently spreading posteriorly to involve the precentral and postcentral regions. In 2 cases focal hyperperfusion appeared to precede the hypoperfusion. In association with the rCBF changes...... the patients developed transient motor and/or sensory deficits and subsequently severe headache. No signs of arterial occlusion were found. In the over and underperfused regions blood flow fluctuated rapidly because of instability of cerebrovascular tone, defined as transient constriction of the smallest...

  18. Application of infrared thermal imaging in the study of preventing cardiovascular and cerebrovascular diseases with Chinese medicine health food

    Science.gov (United States)

    Li, Ziru; Zhang, Xusheng

    2009-08-01

    To explore the assessing technique which could objectively reflect the characteristics of Chinese medicine in the prevention of cardiovascular and cerebrovascular diseases, four balance features of infrared thermal images (ITI) corresponding to the up and down, left and right, proximal and distal balance of blood circulation of human body were studied. First, the ITI features of the middle-aged and elderly people with lipid abnormality history were compared with those of the healthy youth. It was found that the balance state of the youth was significantly better than that of the middle-aged and elderly, Ppathology basis of the influences of Shengyi on the four balance features and its relationship with the clinical outcome deserves further study. So the prospect of infrared thermal imaging is indicated as the suitable evaluation technique which could objectively reflect the whole balance regulation advantage of Chinese medicinal compounds.

  19. Non-ionizing radiofrequency electromagnetic waves traversing the head can be used to detect cerebrovascular autoregulation responses

    Science.gov (United States)

    Oziel, M.; Hjouj, M.; Gonzalez, C. A.; Lavee, J.; Rubinsky, B.

    2016-02-01

    Monitoring changes in non-ionizing radiofrequency electromagnetic waves as they traverse the brain can detect the effects of stimuli employed in cerebrovascular autoregulation (CVA) tests on the brain, without contact and in real time. CVA is a physiological phenomenon of importance to health, used for diagnosis of a number of diseases of the brain with a vascular component. The technology described here is being developed for use in diagnosis of injuries and diseases of the brain in rural and economically underdeveloped parts of the world. A group of nine subjects participated in this pilot clinical evaluation of the technology. Substantial research remains to be done on correlating the measurements with physiology and anatomy.

  20. Quality of life of caregivers for patients of cerebrovascular accidents: association of (socio-demographic characteristics and burden

    Directory of Open Access Journals (Sweden)

    Tatiana Ferreira da Costa

    2015-04-01

    Full Text Available OBJECTIVE Investigating the association between quality of life with socio-demographic characteristics and the burden of caregivers for individuals with cerebrovascular accident sequelae. METHOD A descriptive, cross-sectional study with a sample composed of 136 caregivers. For data collection, a semi-structured questionnaire, the Barthel, Burden Interview and Short-Form-36 scales were used. Correlation analysis, t-Student test and F-test were used for the analysis in order to compare averages. RESULTS Significant averages in quality of life were demonstrated in association with female caregivers and those over 60 years in the field 'functional capacity,' and in the domains of 'mental health' and 'vitality' for those with higher income. Regarding burden association, the highlighted areas were 'functional capacity,' 'physical aspects,' 'emotional aspects' and 'pain.' CONCLUSION The creation of public policies and social support to effectively reduce the burden on caregivers is a necessity.