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Sample records for high-altitude cerebral edema

  1. High Altitude Cerebral Edema

    Science.gov (United States)

    1986-03-01

    such enzyme inhibition would favor the creation of a metabolic acidosis to offset the hypoxic respiratory alkalosis of high altitude hyperventilation...that some of their symptoms might be due to the early respiratory alkalosis seen upon arrival at high altitude. Unfortunately 23 out of the 30 subjects...i I Hamilton-16 was negative in all cases and normal respiratory excursions were seen. CSF chemistries and cell counts were normal. Houston and

  2. Ataxia, acute mountain sickness, and high altitude cerebral edema

    Institute of Scientific and Technical Information of China (English)

    Wu Tianyi; Ma Siqing; Bian Huiping; Zhang Minming

    2013-01-01

    Previous investigations suggest that ataxia is common and often one of the most reliable warning signs of high altitude cerebral edema(HACE).The aim of this study was to investigate the diagnostic role of ataxia in acute mountain sickness (AMS) and HACE among mountain rescuers on the quake areas,and in approaching the relation between AMS and HACE.After the earthquake on April 14,2010,approximately 24080 lowland rescuers were rapidly transported from sea level or lowlands to the mountainous rescue sites at 3750 ~ 4568 m,and extremely hardly worked for an emergency treatment after arrival.Assessments of acute altitude illness on the quake areas were using the Lake Louise Scoring System.73 % of the rescuers were found to be developed AMS.The incidence of high altitude pulmonary edema(HAPE) and HACE was 0.73 % and 0.26 %,respectively,on the second to third day at altitude.Ataxia sign was measured by simple tests of coordination including a modified Romberg test.The clinical features of 62 patients with HACE were analyzed.It was found that the most frequent,serious neurological symptoms and signs were altered mental status(50/62,80.6 %)and truncal ataxia (47/62,75.8 %).Mental status change was rated slightly higher than ataxia,but ataxia occurred earlier than mental status change and other symptoms.The earliest sign of ataxia was a vague unsteadiness of gait,which may be present alone in association with or without AMS.Advanced ataxia was correlated with the AMS scores,but mild ataxia did not correlate with AMS scores at altitudes of 3750~4568 m.Of them,14 patients were further examined by computerized tomographic scanning of the brain and cerebral magnetic resonance imagines were examined in another 15 cases.These imaging studies indicated that the presence of the cerebral edema was in 97 % of cases who were clinically diagnosed as HACE (28/29).Ataxia seems to be a reliable sign of advanced AMS or HACE,so does altered mental status.

  3. Update on high altitude cerebral edema including recent work on the eye.

    Science.gov (United States)

    Willmann, Gabriel; Gekeler, Florian; Schommer, Kai; Bärtsch, Peter

    2014-06-01

    This review summarizes recent research on high altitude cerebral edema (HACE) and on the eye with focus on the retina and optic nerve as visible brain tissue at high altitude. Hemosiderin deposits in the corpus callosum have been characterized as rather specific long-lasting footprints of HACE, indicating a leak of the blood-brain barrier (BBB) and resulting in microhemorrhages. These are compatible with the concept of increased capillary pressure due to venous outflow limitation as suggested by Wilson et al. There are no human data on the role of vascular permeability in HACE, while animal models of uncertain relevance for human HACE suggest that an impaired integrity of the BBB through VEGF and ROS is more important than hemodynamic changes. Examinations by ultrasound show an inconsistent increase of the optic nerve sheath diameter, whereas unequivocal optic disc swelling (ODS), increased retinal vessel diameter, as well as retinal vessel leakage occur at high altitude. However, whether these morphological changes correlate with symptoms of AMS as a possible precursor of HACE or high altitude headache supporting the concept of venous outflow limitation remains questionable and is discussed in detail in this article.

  4. MRI evidence: acute mountain sickness is not associated with cerebral edema formation during simulated high altitude.

    Science.gov (United States)

    Mairer, Klemens; Göbel, Markus; Defrancesco, Michaela; Wille, Maria; Messner, Hubert; Loizides, Alexander; Schocke, Michael; Burtscher, Martin

    2012-01-01

    Acute mountain sickness (AMS) is a common condition among non-acclimatized individuals ascending to high altitude. However, the underlying mechanisms causing the symptoms of AMS are still unknown. It has been suggested that AMS is a mild form of high-altitude cerebral edema both sharing a common pathophysiological mechanism. We hypothesized that brain swelling and consequently AMS development is more pronounced when subjects exercise in hypoxia compared to resting conditions. Twenty males were studied before and after an eight hour passive (PHE) and active (plus exercise) hypoxic exposure (AHE) (F(i)O(2) = 11.0%, P(i)O(2)∼80 mmHg). Cerebral edema formation was investigated with a 1.5 Tesla magnetic resonance scanner and analyzed by voxel based morphometry (VBM), AMS was assessed using the Lake Louise Score. During PHE and AHE AMS was diagnosed in 50% and 70% of participants, respectively (p>0.05). While PHE slightly increased gray and white matter volume and the apparent diffusion coefficient, these changes were clearly more pronounced during AHE but were unrelated to AMS. In conclusion, our findings indicate that rest and especially exercise in normobaric hypoxia are associated with accumulation of water in the extracellular space, however independent of AMS development. Thus, it is suggested that AMS and HACE do not share a common pathophysiological mechanism.

  5. Protective effect of ginkgolide B on high altitude cerebral edema of rats.

    Science.gov (United States)

    Botao, Yu; Ma, Jie; Xiao, Wenjing; Xiang, Qingyu; Fan, Kaihua; Hou, Jun; Wu, Juan; Jing, Weihua

    2013-03-01

    Ginkgolide B (GB) is one of the ginkgolides isolated from leaves of the Ginkgo biloba tree. The aim of this study was to investigate whether GB has a protective effect on high altitude cerebral edema (HACE) of rats. HACE was induced by hypobaric hypoxia exposure for 24 hours in an animal decompression chamber with the chamber pressure of 267 mmHg to simulate an altitude of 8000 m. Before the exposure, three doses (3, 6, and 12 mg·kg(-1)) of GB were given intraperitoneally (ip) daily for 3 days. Effects of GB on brain water content (BWC), activity of superoxide dismutase (SOD), concentration of glutathione (GSH) and malondialdehyde (MDA), expression of active caspase-3 and poly(ADP-ribose) polymerase (PARP) were measured. In GB pretreatment groups (6 and 12 mg·kg(-1), but not 3 mg·kg(-1)), BWC, the concentration of MDA, the expression of active caspase-3 and PARP were reduced significantly, while the activity of SOD and concentration of GSH were significantly increased. In conclusion, these results indicate that GB has a protective effect on cerebral edema caused by high altitude in rats. The protective effect of GB might be attributed to its antioxidant properties and suppression of the caspase-dependent apoptosis pathway.

  6. Edema pulmonar de gran altura HIGH ALTITUDE PULMONARY EDEMA

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    FELIPE UNDURRAGA M

    2003-04-01

    Full Text Available Las enfermedades de altura son de causa cerebral y pulmonar. Las primeras se refieren fundamentalmente al mal agudo de montaña y al edema cerebral de altura y las segundas al edema pulmonar agudo de montaña. Actuales evidencias señalan que el edema cerebral sería un fenómeno universal de los que ascienden a altura y que tres de cada cuatro individuos sanos que se expongan a altura desarrollarán un edema pulmonar agudo de montaña subclínico. La hipoxia de altura es la responsable de estos cuadros y los sujetos susceptibles serían aquellos que genéticamente tienen una respuesta ventilatoria reducida a la hipoxia y una exagerada respuesta vasopresora pulmonar al ejercicio.Se presenta un caso de edema pulmonar agudo de montaña en un deportista previamente sano que participó en una expedición al cerro El Plomo (5.280 msnm en la Cordillera de los Andes central. Posteriormente, se comenta la fisiopatología y tratamiento de esta condiciónHigh altitude diseases are originated from brain and lung. The first are Acute Mountain Sickness and Brain edema and the second is High Altitude Pulmonary Edema (HAPE. Current evidence shows that brain edema is an universal event of the people who are exposed to high altitude. By other hand 3 out of 4 healthy subjects exposed to high altitude will present a subclinical HAPE. Hypoxia of altitude is the responsable for this condition. The susceptible subjects would be those who genetically have a low ventilatory response to hypoxia and an exaggerated increase of vascular pulmonary pressure during exercise. A clinical case of acute pulmonary edema in a young sportman who participated in an expedition to Cerro El Plomo (5.280 m in Chilean Central Andes Mountains is presented. Pathophysiology and treatment of these conditions are discussed

  7. 高原急性脑水肿昏迷的内科护理%Medical Nursing of Coma Patients with Acute Cerebral Edema at High Altitude

    Institute of Scientific and Technical Information of China (English)

    代金兰

    2016-01-01

    目的:探讨高原急性脑水肿昏迷的内科护理效果。方法选取并分析于本院治疗高原性脑水肿昏迷的70例患者的救护情况。结果除4例患者未能第一时间得到有效治疗,造成抢救无效外,所有患者均康复出院,治愈率为94.29%。结论高原急性脑水肿昏迷的患者在经过及时治疗,辅以有效的内科护理,能使死亡率大幅下降。%Objective To investigate the effect of medical nursing on coma of acute cerebral edema in high altitude. Methods Selection and analysis of 70 cases of patients with high altitude cerebral edema coma in our hospital. Results In addition to 4 patients failed to get effective treatment for the first time, resulting in the rescue is invalid, all patients were recovered and discharged, the cure rate was 94.29%. Conclusion The patients with acute cerebral edema in the plateau are treated in a timely manner,with the effective Department of internal medicine nursing,which can greatly decrease the mortality.

  8. High altitude pulmonary edema among "Amarnath Yatris"

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    Parvaiz A Koul

    2013-01-01

    Full Text Available Background: Annual pilgrimage (Yatra to the cave shrine of Shri Amarnath Ji′ is a holy ritual among the Hindu devotees of Lord Shiva. Located in the Himalayan Mountain Range (altitude 13,000 ft in south Kashmir, the shrine is visited by thousands of devotees and altitude sickness is reportedly common. Materials and Methods: More than 600,000 pilgrims visited the cave shrine in 2011 and 2012 with 239 recorded deaths. Thirty one patients with suspected altitude sickness were referred from medical centers en-route the cave to Sher-i-Kashmir Institute of Medical Sciences, a tertiary-care center in capital Srinagar (5,000 ft. The clinical features and the response to treatment were recorded. Results: Thirty-one patients (all lowlanders, 19 male; age 18-60 years, median 41 had presented with acute onset breathlessness of 1-4 days (median 1.9 d starting within 12-24 h of a rapid ascent; accompanied by cough (68%, headache (8%, dizziness and nausea (65%. Sixteen patients had associated encephalopathy. Clinical features on admission included tachypnea ( n = 31, tachycardia ( n = 23, bilateral chest rales ( n = 29, cyanosis ( n = 22 and grade 2-4 encephalopathy. Hypoxemia was demonstrable in 24 cases and bilateral infiltrates on radiologic imaging in 29. Ten patients had evidence of high-altitude cerebral edema. All patients were managed with oxygen, steroids, nifedipine, sildenafil and other supportive measures including invasive ventilation ( n = 3. Three patients died due to multiorgan dysfunction. Conclusions: Altitude sickness is common among Amaranath Yatris from the plains and appropriate educational strategies should be invoked for prevention and prompt treatment.

  9. Edema pulmonar de gran altura HIGH ALTITUDE PULMONARY EDEMA

    OpenAIRE

    FELIPE UNDURRAGA M.; ALVARO UNDURRAGA P

    2003-01-01

    Las enfermedades de altura son de causa cerebral y pulmonar. Las primeras se refieren fundamentalmente al mal agudo de montaña y al edema cerebral de altura y las segundas al edema pulmonar agudo de montaña. Actuales evidencias señalan que el edema cerebral sería un fenómeno universal de los que ascienden a altura y que tres de cada cuatro individuos sanos que se expongan a altura desarrollarán un edema pulmonar agudo de montaña subclínico. La hipoxia de altura es la responsable de estos cuad...

  10. Is High Altitude Pulmonary Edema Relevant to Hawai‘i?

    Science.gov (United States)

    2014-01-01

    High altitude clinical syndromes have been described in the medical literature but may be under recognized in the state of Hawai‘i. As tourism increases, high altitude injuries may follow given the easy access to high altitude attractions. Visitors and clinicians should be aware of the dangers associated with the rapid ascent to high altitudes in the perceived comfort of a vehicle. This paper will review the basic pathophysiology, prevention, and treatment of the most serious of the high altitude clinical syndromes, high altitude pulmonary edema. PMID:25478294

  11. Pulmonary Embolism Masquerading as High Altitude Pulmonary Edema at High Altitude.

    Science.gov (United States)

    Pandey, Prativa; Lohani, Benu; Murphy, Holly

    2016-12-01

    Pandey, Prativa, Benu Lohani, and Holly Murphy. Pulmonary embolism masquerading as high altitude pulmonary edema at high altitude. High Alt Med Biol. 17:353-358, 2016.-Pulmonary embolism (PE) at high altitude is a rare entity that can masquerade as or occur in conjunction with high altitude pulmonary edema (HAPE) and can complicate the diagnosis and management. When HAPE cases do not improve rapidly with descent, other diagnoses, including PE, ought to be considered. From 2013 to 2015, we identified eight cases of PE among 303 patients with initial diagnosis of HAPE. Upon further evaluation, five had deep vein thrombosis (DVT). One woman had a contraceptive ring and seven patients had no known thrombotic risks. PE can coexist with or mimic HAPE and should be considered in patients presenting with shortness of breath from high altitude regardless of thrombotic risk.

  12. 水通道蛋白4在高原脑水肿大鼠脑组织中的表达变化及意义%Expression of AQP4 in cerebral edema rats in high altitude

    Institute of Scientific and Technical Information of China (English)

    梁林; 杨术旺; 龚海英

    2011-01-01

    [Objective] To study the relationship between AQP4 and cerebral edema in high altitude. [Methods] The model of cerebral edema in high altitude was established. The content of water in brain was measured. The expression of AQP4 mRNA and protein were measured by RT-PCR, immunohistochemical and Western blotting. [ReSUlts] The water content increased and the edema was evident. HE staining showed neuron edema and condensation. The expression of AQP4 mRNA and protein were up-regulated obviously after 24 h of hypoxia(P < 0.05). [Conclusion] The results shows that AQP4 might play an important role in the formation of high altitude cerebral edema.%[目的]探讨水通道蛋白4(aquaporin4,AQP4)与高原脑水肿之间的关系.[方法]制作大鼠高原缺氧损伤模型,测脑组织含水量,采用RT-PCR、免疫组织化学、Western blotting技术测定脑组织缺氧损伤24 h后AQP4 mRNA和蛋白表达变化.[结果]缺氧损伤后,脑组织含水量增加,水肿明显;HE染色显示部分神经元肿胀或浓缩;缺氧24 h后,AQP4 mRNA和蛋白表达量均明显增加(P<0.05).[结论]AQP4在高原缺氧脑水肿的形成过程中可能发挥了重要作用.

  13. Novel drugs in the management of acute mountain sickness and high altitude pulmonary edema

    Directory of Open Access Journals (Sweden)

    Sikri G

    2015-12-01

    Full Text Available Gaurav Sikri, Anirban Bhattacharya Department of Physiology, Armed Forces Medical College, Wanowarie, Pune, IndiaWe read with great interest the review article titled “Wilderness medicine at high altitude: recent developments in the field” by Shah et al.1 The authors have comprehensively summarized the recent advances in the field of high altitude medicine relevant to sports and travel medicine. However, Shah et al have described potential drugs for management of high-altitude illnesses, such as acute mountain sickness (AMS, high altitude cerebral edema, and high altitude pulmonary edema (HAPE as one group under the section “Novel drug treatment for AMS”. The pathophysiologies of these two sets of diseases (AMS/high altitude cerebral edema as one and HAPE as another set are different2 and hence it would have been nice to have had the novel drugs described separately to elucidate the therapeutic approach for the two different classes of diseases.View original paper by Shah et al.

  14. Three plasma metabolite signatures for diagnosing high altitude pulmonary edema

    Science.gov (United States)

    Guo, Li; Tan, Guangguo; Liu, Ping; Li, Huijie; Tang, Lulu; Huang, Lan; Ren, Qian

    2015-10-01

    High-altitude pulmonary edema (HAPE) is a potentially fatal condition, occurring at altitudes greater than 3,000 m and affecting rapidly ascending, non-acclimatized healthy individuals. However, the lack of biomarkers for this disease still constitutes a bottleneck in the clinical diagnosis. Here, ultra-high performance liquid chromatography coupled with Q-TOF mass spectrometry was applied to study plasma metabolite profiling from 57 HAPE and 57 control subjects. 14 differential plasma metabolites responsible for the discrimination between the two groups from discovery set (35 HAPE subjects and 35 healthy controls) were identified. Furthermore, 3 of the 14 metabolites (C8-ceramide, sphingosine and glutamine) were selected as candidate diagnostic biomarkers for HAPE using metabolic pathway impact analysis. The feasibility of using the combination of these three biomarkers for HAPE was evaluated, where the area under the receiver operating characteristic curve (AUC) was 0.981 and 0.942 in the discovery set and the validation set (22 HAPE subjects and 22 healthy controls), respectively. Taken together, these results suggested that this composite plasma metabolite signature may be used in HAPE diagnosis, especially after further investigation and verification with larger samples.

  15. Subclinical high altitude pulmonary edema:A clinical observation of 12 cases in Yushu

    Institute of Scientific and Technical Information of China (English)

    Li Shuzhi; Zheng Bihai; Wu Tianyi; Chen Huixing; Zhang Ming

    2013-01-01

    During the Yushu Earthquake on April 14,2010,a high incidence of acute high altitude illness was observed in the mountain rescuers,and 0.73 % of these patients suffered from high altitude pulmonary edema,of which 12 patients developed subclinical pulmonary edema and concomitantly contracted acute mountain sickness.Symptoms and signs were atypically high heart rate with high respiratory rate,striking cyanosis,and significantly low oxygen saturation,whereas no moist rates were heard on auscultation,and Chest X-ray showed peripheral with a patchy distribution of mottled infiltrations in one or both lung fields.We believe that subclinical high altitude pulmonary edema is an earliest stage of pulmonary edema at high altitude.The possible pathogenesis and the diagnosis were discussed.

  16. Quantification of optic disc edema during exposure to high altitude shows no correlation to acute mountain sickness.

    Directory of Open Access Journals (Sweden)

    Gabriel Willmann

    Full Text Available BACKGROUND: The study aimed to quantify changes of the optic nerve head (ONH during exposure to high altitude and to assess a correlation with acute mountain sickness (AMS. This work is related to the Tuebingen High Altitude Ophthalmology (THAO study. METHODOLOGY/PRINCIPAL FINDINGS: A confocal scanning laser ophthalmoscope (cSLO, Heidelberg Retina Tomograph, HRT3® was used to quantify changes at the ONH in 18 healthy participants before, during and after rapid ascent to high altitude (4559 m. Slitlamp biomicroscopy was used for clinical optic disc evaluation; AMS was assessed with Lake Louise (LL and AMS-cerebral (AMS-c scores; oxygen saturation (SpO₂ and heart rate (HR were monitored. These parameters were used to correlate with changes at the ONH. After the first night spent at high altitude, incidence of AMS was 55% and presence of clinical optic disc edema (ODE 79%. Key stereometric parameters of the HRT3® used to describe ODE (mean retinal nerve fiber layer [RNFL] thickness, RNFL cross sectional area, optic disc rim volume and maximum contour elevation changed significantly at high altitude compared to baseline (p<0.05 and were consistent with clinically described ODE. All changes were reversible in all participants after descent. There was no significant correlation between parameters of ODE and AMS, SpO₂ or HR. CONCLUSIONS/SIGNIFICANCE: Exposure to high altitude leads to reversible ODE in the majority of healthy subjects. However, these changes did not correlate with AMS or basic physiologic parameters such as SpO₂ and HR. For the first time, a quantitative approach has been used to assess these changes during acute, non-acclimatized high altitude exposure. In conclusion, ODE presents a reaction of the body to high altitude exposure unrelated to AMS.

  17. Quantification of Optic Disc Edema during Exposure to High Altitude Shows No Correlation to Acute Mountain Sickness

    Science.gov (United States)

    Willmann, Gabriel; Fischer, M. Dominik; Schatz, Andreas; Schommer, Kai; Messias, Andre; Zrenner, Eberhart; Bartz-Schmidt, Karl U.; Gekeler, Florian

    2011-01-01

    Background The study aimed to quantify changes of the optic nerve head (ONH) during exposure to high altitude and to assess a correlation with acute mountain sickness (AMS). This work is related to the Tuebingen High Altitude Ophthalmology (THAO) study. Methodology/Principal Findings A confocal scanning laser ophthalmoscope (cSLO, Heidelberg Retina Tomograph, HRT3®) was used to quantify changes at the ONH in 18 healthy participants before, during and after rapid ascent to high altitude (4559 m). Slitlamp biomicroscopy was used for clinical optic disc evaluation; AMS was assessed with Lake Louise (LL) and AMS-cerebral (AMS-c) scores; oxygen saturation (SpO2) and heart rate (HR) were monitored. These parameters were used to correlate with changes at the ONH. After the first night spent at high altitude, incidence of AMS was 55% and presence of clinical optic disc edema (ODE) 79%. Key stereometric parameters of the HRT3® used to describe ODE (mean retinal nerve fiber layer [RNFL] thickness, RNFL cross sectional area, optic disc rim volume and maximum contour elevation) changed significantly at high altitude compared to baseline (p<0.05) and were consistent with clinically described ODE. All changes were reversible in all participants after descent. There was no significant correlation between parameters of ODE and AMS, SpO2 or HR. Conclusions/Significance Exposure to high altitude leads to reversible ODE in the majority of healthy subjects. However, these changes did not correlate with AMS or basic physiologic parameters such as SpO2 and HR. For the first time, a quantitative approach has been used to assess these changes during acute, non-acclimatized high altitude exposure. In conclusion, ODE presents a reaction of the body to high altitude exposure unrelated to AMS. PMID:22069483

  18. ROCK2 and MYLK variants and high-altitude pulmonary edema

    Directory of Open Access Journals (Sweden)

    Sikri G

    2016-08-01

    Full Text Available Gaurav Sikri, Srinivasa Bhattachar Department of Physiology, Armed Forces Medical College, Pune, Maharashtra, IndiaWe have read the article titled “ROCK2 and MYLK variants under hypobaric hypoxic environment of high altitude associate with high altitude pulmonary edema and adaptation” by Pandey et al1 with profound interest. View the original paper by Pandey and colleagues.

  19. High Altitude Pulmonary Edema in an Experienced Mountaineer. Possible Genetic Predisposition

    Directory of Open Access Journals (Sweden)

    Kenneth S. Whitlow,

    2014-11-01

    Full Text Available High altitude pulmonary edema (HAPE is a form of high altitude illness characterized by cough, dyspnea upon exertion progressing to dyspnea at rest and eventual death, seen in patients who ascend over 2,500 meters, particularly if that ascent is rapid. This case describes a patient with no prior history of HAPE and extensive experience hiking above 2,500 meters who developed progressive dyspnea and cough while ascending to 3,200 meters. His risk factors included rapid ascent, high altitude, male sex, and a possible genetic predisposition for HAPE. [West J Emerg Med. 2014;15(7:–0.

  20. High Altitude Pulmonary Edema in an Experienced Mountaineer. Possible Genetic Predisposition

    Science.gov (United States)

    Whitlow, Kenneth S.; Davis, Babette W.

    2014-01-01

    High altitude pulmonary edema (HAPE) is a form of high altitude illness characterized by cough, dyspnea upon exertion progressing to dyspnea at rest and eventual death, seen in patients who ascend over 2,500 meters, particularly if that ascent is rapid. This case describes a patient with no prior history of HAPE and extensive experience hiking above 2,500 meters who developed progressive dyspnea and cough while ascending to 3,200 meters. His risk factors included rapid ascent, high altitude, male sex, and a possible genetic predisposition for HAPE. PMID:25493133

  1. Cerebral autoregulation in subjects adapted and not adapted to high altitude.

    Science.gov (United States)

    Jansen, G F; Krins, A; Basnyat, B; Bosch, A; Odoom, J A

    2000-10-01

    Impaired cerebral autoregulation (CA) from high-altitude hypoxia may cause high-altitude cerebral edema in newcomers to a higher altitude. Furthermore, it is assumed that high-altitude natives have preserved CA. However, cerebral autoregulation has not been studied at altitude. We studied CA in 10 subjects at sea level and in 9 Sherpas and 10 newcomers at an altitude of 4243 m by evaluating the effect of an increase of mean arterial blood pressure (MABP) with phenylephrine infusion on the blood flow velocity in the middle cerebral artery (Vmca), using transcranial Doppler. Theoretically, no change of Vmca in response to an increase in MABP would imply perfect autoregulation. Complete loss of autoregulation is present if Vmca changes proportionally with changes of MABP. In the sea-level group, at a relative MABP increase of 23+/-4% during phenylephrine infusion, relative Vmca did not change essentially from baseline Vmca (2+/-7%, P=0.36), which indicated intact autoregulation. In the Sherpa group, at a relative MABP increase of 29+/-7%, there was a uniform and significant increase of Vmca of 24+/-9% (P<0.0001) from baseline Vmca, which indicated loss of autoregulation. The newcomers showed large variations of Vmca in response to a relative MABP increase of 21+/-6%. Five subjects showed increases of Vmca of 22% to 35%, and 2 subjects showed decreases of Vmca of 21% and 23%. All Sherpas and the majority of the newcomers showed impaired CA. It indicates that an intact autoregulatory response to changes in blood pressure is probably not a hallmark of the normal human cerebral vasculature at altitude and that impaired CA does not play a major role in the occurrence of cerebral edema in newcomers to the altitude.

  2. Comments on “High Altitude Pulmonary Edema in an Experienced Mountaineer. Possible Genetic Predisposition”

    Directory of Open Access Journals (Sweden)

    Gaurav Sikri

    2015-10-01

    Full Text Available We appreciate the letter to the editor and are pleased to respond regarding our recent case study regarding high altitude pulmonary edema in an experienced mountaineer. The letter raises some valid questions regarding our treatment decisions. With this, as with most emergency department (ED patients, it must be understood that the initial treatment reflected the breadth of our differential diagnosis.

  3. ROCK2 and MYLK variants under hypobaric hypoxic environment of high altitude associate with high altitude pulmonary edema and adaptation

    Directory of Open Access Journals (Sweden)

    Pandey P

    2015-11-01

    Full Text Available Priyanka Pandey,1,2 Ghulam Mohammad,1,3 Yogendra Singh,1,2 MA Qadar Pasha1,2 1Functional Genomics Unit, CSIR-Institute of Genomics and Integrative Biology, Delhi, 2Department of Biotechnology, University of Pune, Ganeshkhind, Pune, Maharashtra, 3Department of Medicine, SNM Hospital, Leh, Ladakh, Jammu and Kashmir, IndiaObjective: To date, a major class of kinases, serine–threonine kinase, has been scantly investigated in stress-induced rare, fatal (if not treated early, and morbid disorder, high altitude pulmonary edema (HAPE. This study examined three major serine–threonine kinases, ROCK2, MYLK, and JNK1, along with six other genes, tyrosine hydroxylase, G-protein subunits GNA11 and GNB3, and alpha1 adrenergic receptor isoforms 1A, 1B, and 1D as candidate gene markers of HAPE and adaptation.Methods: For this, 57 variants across these nine genes were genotyped in HAPE patients (n=225, HAPE controls (n=210, and highlanders (n=259 by Sequenom MS (TOF-based MassARRAY® platform using iPLEX™ Gold technology. In addition, to study the gene expression, quantitative real-time polymerase chain reaction was performed in human peripheral blood mononuclear cells of the three study groups.Results: A significant association was observed for C allele (ROCK2 single-nucleotide polymorphism, rs10929728 with HAPE (P=0.03 and C, T, and A alleles (MYLK single-nucleotide polymorphisms, rs11717814, rs40305, and rs820336 with both HAPE and adaptation (P=0.001, P=0.006, and P=0.02, respectively. ROCK2 88 kb GGGTTGGT haplotype was associated with lower risk of HAPE (P=0.0009. MYLK 7 kb haplotype CTA, composed of variant alleles, was associated with higher risk of HAPE (P=0.0006 and lower association with adaptation (P=1E–06, whereas haplotype GCG, composed of wild-type alleles, was associated with lower risk of HAPE (P=0.001 and higher association with adaptation (P=1E–06. Haplotype–haplotype and gene–gene interactions demonstrated a correlation in working

  4. Increase of cerebral blood flow at high altitude

    DEFF Research Database (Denmark)

    Lassen, N A

    1992-01-01

    CBF increases with acute hypoxia despite the opposing vasoconstrictor effects of the drop in pCO2 caused by hyperventilation. Maintaining normocapnia by adding CO2 the hypoxic CBF responsiveness about doubles. As we have shown recently by this test, the hypoxic CBF response is not blunted but rat...... vasodilatation cannot explain the usual (mild) form of AMS. But it may well be involved in the pathogenesis of the rare but severe cerebral form of AMS, as prolonged increased capillary pressure in vasodilated areas could lead to vasogenic cerebral edema....

  5. ROCK2 and MYLK variants under hypobaric hypoxic environment of high altitude associate with high altitude pulmonary edema and adaptation

    Science.gov (United States)

    Pandey, Priyanka; Mohammad, Ghulam; Singh, Yogendra; Qadar Pasha, MA

    2015-01-01

    Objective To date, a major class of kinases, serine–threonine kinase, has been scantly investigated in stress-induced rare, fatal (if not treated early), and morbid disorder, high altitude pulmonary edema (HAPE). This study examined three major serine–threonine kinases, ROCK2, MYLK, and JNK1, along with six other genes, tyrosine hydroxylase, G-protein subunits GNA11 and GNB3, and alpha1 adrenergic receptor isoforms 1A, 1B, and 1D as candidate gene markers of HAPE and adaptation. Methods For this, 57 variants across these nine genes were genotyped in HAPE patients (n=225), HAPE controls (n=210), and highlanders (n=259) by Sequenom MS (TOF)-based MassARRAY® platform using iPLEX™ Gold technology. In addition, to study the gene expression, quantitative real-time polymerase chain reaction was performed in human peripheral blood mononuclear cells of the three study groups. Results A significant association was observed for C allele (ROCK2 single-nucleotide polymorphism, rs10929728) with HAPE (P=0.03) and C, T, and A alleles (MYLK single-nucleotide polymorphisms, rs11717814, rs40305, and rs820336) with both HAPE and adaptation (P=0.001, P=0.006, and P=0.02, respectively). ROCK2 88 kb GGGTTGGT haplotype was associated with lower risk of HAPE (P=0.0009). MYLK 7 kb haplotype CTA, composed of variant alleles, was associated with higher risk of HAPE (P=0.0006) and lower association with adaptation (P=1E–06), whereas haplotype GCG, composed of wild-type alleles, was associated with lower risk of HAPE (P=0.001) and higher association with adaptation (P=1E–06). Haplotype–haplotype and gene–gene interactions demonstrated a correlation in working of ROCK2 and MYLK. Conclusion The data suggest the association of ROCK2 with HAPE and MYLK with HAPE and adaptation in Indian population. The outcome has provided new insights into the physiology of HAPE and adaptation. PMID:26586960

  6. Studies on monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome secondary to high altitude pulmonary edema

    Institute of Scientific and Technical Information of China (English)

    Ma Siqing; Wu Tianyi; Cheng Qiang; Li Pei; Bian Huiping

    2013-01-01

    To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS)secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who preliminarily developed high altitude cerebral edema (HACE) and then ARDS occurred at an altitude of 4500 m.After an initial emergency treatment on high mountains,all the patients were rapidly transported to a hospital at a lower altitude of 2808 m.The right cardiac catheterizations were carried out within 5 h after hospitalized.The monitoring hemodynamics and oxygen dynamics were studied via a thermodilution Swan-Gaze catheter.The results showed that before treatments at the beginning of monitoring,there presented a significant pulmonary artery hypertension with a decreased cardiac function,and a lower oxygen metabolism in all the 8 patients.However,after some effective treatments,including mechanical ventilation and using dexamethasone,furosemide,etc,four days later the result of a repeated monitoring showed that their pulmonary artery pressure had been decreased with an improved cardiac function with all the oxygen metabolic indexes increased significantly.Our studies suggested that performing monitoring hemodynamics in patients with ARDS secondary to HAPE will define the clinical therapeutic measures which will benefit the outcome.

  7. HIGH-ALTITUDE ILLNESS

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    Dwitya Elvira

    2015-05-01

    Full Text Available AbstrakHigh-altitude illness (HAI merupakan sekumpulan gejala paru dan otak yang terjadi pada orang yang baru pertama kali mendaki ke ketinggian. HAI terdiri dari acute mountain sickness (AMS, high-altitude cerebral edema (HACE dan high-altitude pulmonary edema (HAPE. Tujuan tinjauan pustaka ini adalah agar dokter dan wisatawan memahami risiko, tanda, gejala, dan pengobatan high-altitude illness. Perhatian banyak diberikan terhadap penyakit ini seiring dengan meningkatnya popularitas olahraga ekstrim (mendaki gunung tinggi, ski dan snowboarding dan adanya kemudahan serta ketersediaan perjalanan sehingga jutaan orang dapat terpapar bahaya HAI. Di Pherice, Nepal (ketinggian 4343 m, 43% pendaki mengalami gejala AMS. Pada studi yang dilakukan pada tempat wisata di resort ski Colorado, Honigman menggambarkan kejadian AMS 22% pada ketinggian 1850 m sampai 2750 m, sementara Dean menunjukkan 42% memiliki gejala pada ketinggian 3000 m. Aklimatisasi merupakan salah satu tindakan pencegahan yang dapat dilakukan sebelum pendakian, selain beberapa pengobatan seperti asetazolamid, dexamethasone, phosopodiestrase inhibitor, dan ginko biloba.Kata kunci: high-altitude illness, acute mountain sickness, edema cerebral, pulmonary edema AbstractHigh-altitude illness (HAI is symptoms of lung and brain that occurs in people who first climb to altitude. HAI includes acute mountain sickness (AMS, high-altitude cerebral edema (HACE and high altitude pulmonary edema (HAPE. The objective of this review was to understand the risks, signs, symptoms, and treatment of high-altitude illness. The attention was given to this disease due to the rising popularity of extreme sports (high mountain climbing, skiing and snowboarding and the ease and availability of the current travelling, almost each year, millions of people could be exposed to the danger of HAI. In Pherice, Nepal (altitude 4343 m, 43% of climbers have symptoms of AMS. Furthermore, in a study conducted at sites in

  8. Molecular pathophysiology of cerebral edema.

    Science.gov (United States)

    Stokum, Jesse A; Gerzanich, Volodymyr; Simard, J Marc

    2016-03-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema.

  9. Molecular pathophysiology of cerebral edema

    Science.gov (United States)

    Gerzanich, Volodymyr; Simard, J Marc

    2015-01-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema. PMID:26661240

  10. Response to Comments on “High Altitude Pulmonary Edema in an Experienced Mountaineer. Possible Genetic Predisposition”

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    Whitlow, K. Scott

    2015-10-01

    Full Text Available We appreciate the letter to the editor and are pleased to respond regarding our recent case study regarding high altitude pulmonary edema in an experienced mountaineer. The letter raises some valid questions regarding our treatment decisions.

  11. High Altitude Pulmonary Edema Without Appropriate Action Progresses to Right Ventricular Strain: A Case Study.

    Science.gov (United States)

    Mills, Logan; Harper, Chris; Rozwadowski, Sophie; Imray, Chris

    2016-09-01

    Mills, Logan, Chris Harper, Sophie Rozwadowski, and Chris Imray. High altitude pulmonary edema without appropriate action progresses to right ventricular strain: A case study. High Alt Med Biol. 17:228-232, 2016.-A 24-year-old male developed high altitude pulmonary edema (HAPE) after three ascents to 4061 m over 3 days, sleeping each night at 2735 m. He complained of exertional dyspnea, dry cough, chest pain, fever, nausea, vertigo, and a severe frontal headache. Inappropriate continuation of ascent despite symptoms led to functional impairment and forced a return to the valley, but dyspnea persisted in addition to new orthopnea. Hospital admission showed hypoxemia, resting tachycardia, and systemic hypertension. ECG revealed right ventricular strain and a chest X-ray revealed right lower zone infiltrates. This case demonstrates that HAPE can develop in previously unaffected individuals given certain precipitating factors, and that in the presence of HAPE, prolonged exposure to altitude with exercise (or exertion) does not confer acclimatization with protective adaptations and that rest and descent are the appropriate actions. The case additionally demonstrates well-characterized right ventricular involvement.

  12. Incidence of high altitude pulmonary edema in low-landers during re-exposure to high altitude after a sojourn in the plains

    Science.gov (United States)

    Apte, C.V.; Tomar, R.K.S.; Sharma, D.

    2015-01-01

    Background There is uncertainty whether acclimatized low-landers who return to high altitude after a sojourn at low altitude have a higher incidence of pulmonary edema than during the first exposure to high altitude. Methods This was a prospective cohort study consisting of men ascending to 3400 m by road (N = 1003) or by air (N = 4178). The study compared the incidence of high altitude pulmonary edema during first exposure vs the incidence during re-exposure in each of these cohorts. Results Pulmonary edema occurred in 13 of the 4178 entries by air (Incidence: 0.31%, 95% CI: 0.18%–0.53%). The incidence during first exposure was 0.18% (0.05%–0.66%) and 0.36% (0.2%–0.64%) during re-exposure (Fisher Exact Test for differences in the incidence (two-tailed) p = 0.534). The relative risk for the re-exposure cohort was 1.95 (95% CI, 0.43%–8.80%). Pulmonary edema occurred in 3 of the 1003 road entrants (Incidence: 0.30%, 95% CI: 0.08%–0.95%). All three cases occurred in the re-exposure cohort. Conclusion The large overlap of confidence intervals between incidence during first exposure and re-exposure; the nature of the confidence interval of the relative risk; and the result of the Fisher exact test, all suggest that this difference in incidence could have occurred purely by chance. We did not find evidence for a significantly higher incidence of HAPE during re-entry to HA after a sojourn in the plains. PMID:26288488

  13. Expression of AQP4 and susceptivity to high-altitude cerebral edema in bovine brain%黄牛脑水通道蛋白4的表达及其对高原脑水肿的易感性

    Institute of Scientific and Technical Information of China (English)

    宋国强; 王建林; 徐元青; 伍国芬; 邵宝平

    2011-01-01

    为了探讨黄牛对高原脑水肿的易感性,并为青藏高原养牛业提供参考,运用免疫组织化学SABC染色法并采用Image-Pro Plus 6.0软件,对成年黄牛大脑不同功能区水通道蛋白4(AQP4)的表达及分布特征进行了研究.结果显示,黄牛不同功能区脑组织中AQP4表达面积(S)和积分光密度(IOD)值的大小顺序为S扣带回>S中央前回>S丘脑>S尾状核,IOD扣带回>IOD中央前回>IOD丘脑>IOD尾状核,且扣带回和中央前回的S和IOD值均显著高于丘脑和尾状核(P<0.01).结果证实,成年黄牛脑不同功能区、同功能区不同层及同功能区同层不同类型细胞对水的通透性及代谢功能存在较大差异,对脑水肿的易感性是不同的.%To investigate the susceptivity of cattle to the high altitude cerebral edema as well as provide reference and theory evidence to the cattle-raising industry in Qinghai-Tibet Plateau, the expression and distributional characteristics of adult cattle cerebral aquaporin 4 (AQP4) in different functional area were studied by using immunohistochemical SABC and Image-Pro Plus 6.0 software. Statistical analysis showed that both the immunostaining area(S) and the integral optical density(IOD) value of the cingulated gyrus and precentral gyrus were significantly larger than thalamus and caudate nucleus(P<0. 01, Scingulated gyrus>Sprecentral gyrus > Sthalamus > Scaudate uncleus and IODcingulated gyrus > IODprecentral gyrus > IODthalamus > IODcaudate nucleus ). The results showed that there was comparatively large discrepancy of cell water permeability and metabolism function among different functional area in cattle brain, distinct peers of a functional area and distinguished type cells in the same functional area and peer which might have different susceptivity to cerebral edema.

  14. Acetazolamide improves cerebral oxygenation during exercise at high altitude

    NARCIS (Netherlands)

    Vuyk, J.; Bos, J. van den; Terhell, K.; Bos, R. de; Vletter, A.; Valk, P.; Beuzekom, M. van; Kleef, J. van; Dahan, A.

    2006-01-01

    Acute mountain sickness is thought to be triggered by cerebral hypoxemia and be prevented by acetazolamide (Actz). The effect of Actz on cerebral oxygenation at altitude remains unknown. In 16 members of the 2005 Dutch Cho Oyu (8201 m, Tibet) expedition, the influence of Actz and exercise (750 mg PO

  15. Unchanged cerebral blood flow and oxidative metabolism after acclimatization to high altitude

    DEFF Research Database (Denmark)

    Møller, Kirsten; Paulson, Olaf B; Hornbein, Thomas F.

    2002-01-01

    . At high altitude at rest, arterial carbon dioxide tension, oxygen saturation, and oxygen tension were significantly reduced, and arterial oxygen content was increased because of an increase in hemoglobin concentration. Global cerebral blood flow was similar in the four conditions. Cerebral oxygen delivery...

  16. Managing High-Altitude Pulmonary Edema with Oxygen Alone: Results of a Randomized Controlled Trial.

    Science.gov (United States)

    Yanamandra, Uday; Nair, Velu; Singh, Surinderpal; Gupta, Amul; Mulajkar, Deepak; Yanamandra, Sushma; Norgais, Konchok; Mukherjee, Ruchira; Singh, Vikrant; Bhattachar, Srinivasa A; Patyal, Sagarika; Grewal, Rajan; Chopra, Bhushan

    2016-12-01

    Yanamandra, Uday, Velu Nair, Surinderpal Singh, Amul Gupta, Deepak Mulajkar, Sushma Yanamandra, Konchok Norgais, Ruchira Mukherjee, Vikrant Singh, Srinivasa A. Bhattachar, Sagarika Patyal, and Rajan Grewal. High-altitude pulmonary edema management: Is anything other than oxygen required? Results of a randomized controlled trial. High Alt Med Biol. 17:294-299, 2016.-Treatment strategies for management of high-altitude pulmonary edema (HAPE) are mainly based on the observational studies with only two randomized controlled trials, thus the practice is very heterogeneous and individualized as per the choice of treating physician. To compare the response to different modalities of therapy in patients with HAPE in a randomized controlled manner. We conducted an open-label, randomized noninferiority trial to compare three modalities of therapy (Therapy 1: supplemental O2 with oral dexamethasone 8 mg q8 hours [n = 42], Therapy 2: supplemental O2 with sustained release oral nifedipine 20 mg q8 hours [n = 41], and Therapy 3: only supplemental O2 [n = 50]). Bed rest was mandated in all patients. The study was conducted in a cohort of previously healthy young lowlander males at an altitude of 3500 m. Baseline characteristics of the patients were comparable in the study arms. Complete response was defined as clinical and radiological resolution of features of HAPE, no oxygen dependency, a normal 6-minute walk test (6MWT) on 2 consecutive days, and normal two-dimensional echocardiography. Results were compared by analysis of variance using SPSS version 16.0. There was no statistical difference in duration of therapy to complete response between the three groups (Therapy 1: 8.1 ± 4.0 days, Therapy 2: 6.7 ± 3.9 days, Therapy 3: 6.8 ± 3.2 days; p = 0.15). There were no deaths in any of the groups. We conclude that oxygen and bed rest alone are adequate therapy for HAPE and that adjuvant pharmacotherapy with either dexamethasone or nifedipine

  17. Cerebral edema associated with acute hepatic failure.

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    Fujiwara,Masachika

    1985-02-01

    Full Text Available The clinicopathological findings of cerebral edema were investigated in patients with acute hepatic failure autopsied at Okayama University Hospital between 1970 and 1980 retrospectively. Nine (64% of 14 hepatic failure cases were found to have cerebral edema during a post-mortem examination of the brain. Clinical features of the patients with cerebral edema were not significantly different from those of the patients without cerebral edema. However, general convulsions were observed more frequently in patients later found to have cerebral edema. Moreover, the length of time from deep coma to death was much shorter in the brain edema cases with cerebral herniation than without herniation.

  18. Therapeutic implications of melatonin in cerebral edema.

    Science.gov (United States)

    Rathnasamy, Gurugirijha; Ling, Eng-Ang; Kaur, Charanjit

    2014-12-01

    Cerebral edema/brain edema refers to the accumulation of fluid in the brain and is one of the fatal conditions that require immediate medical attention. Cerebral edema develops as a consequence of cerebral trauma, cerebral infarction, hemorrhages, abscess, tumor, hypoxia, and other toxic or metabolic factors. Based on the causative factors cerebral edema is differentiated into cytotoxic cerebral edema, vasogenic cerebral edema, osmotic and interstitial cerebral edema. Treatment of cerebral edema depends on timely diagnosis and medical assistance. Pragmatic treatment strategies such as antihypertensive medications, nonsteroidal anti-inflammatory drugs, barbiturates, steroids, glutamate and N-methyl-D-aspartate receptor antagonists and trometamol are used in clinical practice. Although the above mentioned treatment approaches are being used, owing to the complexity of the mechanisms involved in cerebral edema, a single therapeutic strategy which could ameliorate cerebral edema is yet to be identified. However, recent experimental studies have suggested that melatonin, a neurohormone produced by the pineal gland, could be an effective alternative for treating cerebral edema. In animal models of stroke, melatonin was not only shown to reduce cerebral edema but also preserved the blood brain barrier. Melatonin's beneficial effects were attributed to its properties, such as being a potent anti-oxidant, and its ability to cross the blood brain barrier within minutes after its administration. This review summarizes the beneficial effects of melatonin when used for treating cerebral edema.

  19. Genome wide expression analysis suggests perturbation of vascular homeostasis during high altitude pulmonary edema.

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    Manish Sharma

    Full Text Available BACKGROUND: High altitude pulmonary edema (HAPE is a life-threatening form of non-cardiogenic edema which occurs in unacclimatized but otherwise normal individuals within two to four days after rapid ascent to altitude beyond 3000 m. The precise pathoetiology and inciting mechanisms regulating HAPE remain unclear. METHODOLOGY/PRINCIPLE FINDINGS: We performed global gene expression profiling in individuals with established HAPE compared to acclimatized individuals. Our data suggests concurrent modulation of multiple pathways which regulate vascular homeostasis and consequently lung fluid dynamics. These pathways included those which regulate vasoconstriction through smooth muscle contraction, cellular actin cytoskeleton rearrangements and endothelial permeability/dysfunction. Some notable genes within these pathways included MYLK; rho family members ARGEF11, ARHGAP24; cell adhesion molecules such as CLDN6, CLDN23, PXN and VCAM1 besides other signaling intermediates. Further, several important regulators of systemic/pulmonary hypertension including ADRA1D, ECE1, and EDNRA were upregulated in HAPE. We also observed significant upregulation of genes involved in paracrine signaling through chemokines and lymphocyte activation pathways during HAPE represented by transcripts of TNF, JAK2, MAP2K2, MAP2K7, MAPK10, PLCB1, ARAF, SOS1, PAK3 and RELA amongst others. Perturbation of such pathways can potentially skew vascular homeostatic equilibrium towards altered vascular permeability. Additionally, differential regulation of hypoxia-sensing, hypoxia-response and OXPHOS pathway genes in individuals with HAPE were also observed. CONCLUSIONS/SIGNIFICANCE: Our data reveals specific components of the complex molecular circuitry underlying HAPE. We show concurrent perturbation of multiple pathways regulating vascular homeostasis and suggest multi-genic nature of regulation of HAPE.

  20. Plasma proteomic study in patients with high altitude pulmonary edema (HAPE

    Directory of Open Access Journals (Sweden)

    Yong-jun LUO

    2012-01-01

    Full Text Available Objective  To investigate the differential expressions of protein in the plasma proteome in patients suffering from high altitude pulmonary edema (HAPE and their implications. Methods  The plasmas of six HAPE patients and six healthy controls were studied. The high-abundant proteins in the plasma were removed. The low-abundant proteins in the plasma/serum were segregated by 2-DE. MALDI-TOF/MS was adopted to measure the peptide fingerprints after the differential protein spots were digested by enzymes. Comparison and analysis were made in the GenBank. Results  The immunoglobulin K1 light chain, serum transferrin protein precursor, and α-trypsin inhibitor heavy chain-related protein expressions were upregulated in HAPE patients compared with the control group. However the human fibrin glue coagulation protein 3 was down-regulated. Conclusion  The differential expression of the above four proteins in the plasma of HAPE patients may be related to the occurrence of HAPE and can be used as the target point for the prediction of HAPE.

  1. Angiotensin II receptor 1 gene variants are associated with high-altitude pulmonary edema risk.

    Science.gov (United States)

    Jin, Tianbo; Ren, Yongchao; Zhu, Xikai; Li, Xun; Ouyang, Yongri; He, Xue; Zhang, Zhiying; Zhang, Yuan; Kang, Longli; Yuan, Dongya

    2016-11-22

    Previous studies demonstrated that Angiotensin II Receptor 1 (AGTR1) may play an important role in the development of high-altitude pulmonary edema. We envisaged a role for AGTR1 gene variants in the pathogenesis of HAPE and investigated their potential associations with HAPE in a Han Chinese population. We genotyped seven AGTR1 polymorphisms in 267 patients with diagnosed HAPE and 304 controls and evaluated their association with risk of HAPE. Statistically significant associations were found for the single nucleotide polymorphisms (SNPs) rs275651 (p = 0.017; odds ratio [OR] = 0.65) and rs275652 (p = 0.016; OR = 0.64). Another SNP rs10941679 showed a marginally significant association after adjusting for age and sex in the additive genetic model (adjusted OR = 1.44, 95% CI = 1.01-2.04, p = 0.040). Haplotype analysis confirmed that the haplotype "AG" was associated with a 35% reduction in the risk of developing HAPE, while the haplotype "AA" increased the risk of developing HAPE by 44%. These results provide the first evidence linking genetic variations in AGTR1 with HAPE risk in Han Chinese individuals.

  2. Role of the altitude level on cerebral autoregulation in residents at high altitude.

    Science.gov (United States)

    Jansen, Gerard F A; Krins, Anne; Basnyat, Buddha; Odoom, Joseph A; Ince, Can

    2007-08-01

    Cerebral autoregulation is impaired in Himalayan high-altitude residents who live above 4,200 m. This study was undertaken to determine the altitude at which this impairment of autoregulation occurs. A second aim of the study was to test the hypothesis that administration of oxygen can reverse this impairment in autoregulation at high altitudes. In four groups of 10 Himalayan high-altitude dwellers residing at 1,330, 2,650, 3,440, and 4,243 m, arterial oxygen saturation (Sa(O(2))), blood pressure, and middle cerebral artery blood velocity were monitored during infusion of phenylephrine to determine static cerebral autoregulation. On the basis of these measurements, the cerebral autoregulation index (AI) was calculated. Normally, AI is between zero and 1. AI of 0 implies absent autoregulation, and AI of 1 implies intact autoregulation. At 1,330 m (Sa(O(2)) = 97%), 2,650 m (Sa(O(2)) = 96%), and 3,440 m (Sa(O(2)) = 93%), AI values (mean +/- SD) were, respectively, 0.63 +/- 0.27, 0.57 +/- 0.22, and 0.57 +/- 0.15. At 4,243 m (Sa(O(2)) = 88%), AI was 0.22 +/- 0.18 (P < 0.0005, compared with AI at the lower altitudes) and increased to 0.49 +/- 0.23 (P = 0.008, paired t-test) when oxygen was administered (Sa(O(2)) = 98%). In conclusion, high-altitude residents living at 4,243 m have almost total loss of cerebral autoregulation, which improved during oxygen administration. Those people living at 3,440 m and lower have still functioning cerebral autoregulation. This study showed that the altitude region between 3,440 and 4,243 m, marked by Sa(O(2)) in the high-altitude dwellers of 93% and 88%, is a transitional zone, above which cerebral autoregulation becomes critically impaired.

  3. Cerebral edema in drug addicts

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    Daruši Dragana J.

    2014-01-01

    Full Text Available Background/Aim. The effect of drugs leaves permanent consequences on the brain, organic in type, followed by numerous manifestations, and it significantly affects the development of mental dysfunctions. The clinicians are often given a task to estimate a patient’s personality during treatment or during experts estimate of a drug addict. The aim of this research was to determine the differences, if any, in characteristics of addicts experience and personality traits in drug addicts with or without cerebral edema. Methods. The research was conducted on a sample of 252 male drug addicts, the average age of 23.3 (SD = 4.3 years. Cerebral edema was confirmed on magnetic resonance (MR images of the brain performed during the treatment of the addicts. The participants were tested by the psychologists using Minnesota Multiphasic Personality Inventory (MMPI-201 test, and the data were processed using canonical discriminate analysis within the SPSS program. The dependent variable in the study was cerebral edema. A block of independent variables, designed for the requirements of this study, consisted of two subgroups. The first one consisted of 12 variables describing the relevant characteristics of drug abuse. The second subgroup consisted of 8 psychopathological tendencies in the personality defined by the mentioned test. Results. Cerebral edema was confirmed in 52 (20.63% of the drug addicts. The differences between the groups of drug addicts with and without cerebral edema were determined in the following: the time span of taking drugs (0.301, use of alcohol parallel with drugs (0.466, and treatment for addiction (0.603. In the drug addicts with a cerebral edema, MMPI-201 confirmed the increase in the scales for hypochondria, psychopathic deviations and psychastenia, and the decrease in the scales for schizophrenia and depression. Conclusion. Our study confirmed a possible connection between cerebral edema and personality traits in a number of the

  4. Lung function and breathing pattern in subjects developing high altitude pulmonary edema.

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    Christian F Clarenbach

    Full Text Available INTRODUCTION: The purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE. We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage. METHODS: In 18 mountaineers, spirometry, diffusing capacity, nitrogen washout, nocturnal ventilation and pulse oximetry were recorded at 490 m and during 3 days after rapid ascent to 4559 m. Findings were compared among subjects developing HAPE and those remaining well (controls. RESULTS: In 8 subjects subsequently developing radiographically documented HAPE at 4559 m, median FVC declined to 82% of low altitude baseline while closing volume increased to 164% of baseline (P<0.05, both instances. In 10 controls, FVC decreased slightly (to 93% baseline, P<0.05 but significantly less than in subjects with HAPE and closing volume remained unchanged. Sniff nasal pressure was reduced in both subjects with and without subsequent HAPE. During nights at 4559 m, mean nocturnal oxygen saturation dropped to lower values while minute ventilation, the number of periodic breathing cycles and heart rate were higher (60%; 8.6 L/min; 97 cycles/h; 94 beats/min, respectively in subjects subsequently developing HAPE than in controls (73%; 5.1 L/min; 48 cycles/h; 79 beats/min; P<0.05 vs. HAPE, all instances. CONCLUSION: The results comprehensively represent the pattern of physiologic alterations that precede overt HAPE. The changes in lung function are consistent with reduced lung compliance and impaired gas exchange. Pronounced nocturnal hypoxemia, ventilatory control instability and sympathetic stimulation are further signs of subsequent overt HAPE.

  5. Raised HIF1α during normoxia in high altitude pulmonary edema susceptible non-mountaineers.

    Science.gov (United States)

    Soree, Poonam; Gupta, Rajinder K; Singh, Krishan; Desiraju, Koundinya; Agrawal, Anurag; Vats, Praveen; Bharadwaj, Abhishek; Baburaj, T P; Chaudhary, Pooja; Singh, Vijay K; Verma, Saroj; Bajaj, Amir Chand; Singh, Shashi Bala

    2016-05-23

    High altitude pulmonary edema (HAPE) susceptibility is associated with EGLN1 polymorphisms, we hypothesized that HAPE-susceptible (HAPE-S, had HAPE episode in past) subjects may exhibit abnormal HIF1α levels in normoxic conditions. We measured HIF1α levels in HAPE-S and HAPE resistant (HAPE-R, no HAPE episode) individuals with similar pulmonary functions. Hemodynamic responses were also measured before and after normobaric hypoxia (Fi02 = 0.12 for 30 min duration at sea level) in both groups. . HIF1α was higher in HAPE-S (320.3 ± 267.5 vs 58.75 ± 33.88 pg/ml, P < 0.05) than HAPE-R, at baseline, despite no significant difference in baseline oxygen saturations (97.7 ± 1.7% and 98.8 ± 0.7). As expected, HAPE-S showed an exaggerated increase in pulmonary artery pressure (27.9 ± 6 vs 19.3 ± 3.7 mm Hg, P < 0.05) and a fall in peripheral oxygen saturation (66.9 ± 11.7 vs 78.7 ± 3.8%, P < 0.05), when exposed to hypoxia. HIF1α levels at baseline could accurately classify members of the two groups (AUC = 0.87). In a subset of the groups where hemoglobin fractions were additionally measured to understand the cause of elevated hypoxic response at baseline, two of four HAPE-S subjects showed reduced HbA. In conclusion, HIF 1 α levels during normoxia may represent an important marker for determination of HAPE susceptibility.

  6. High Altitude and Heart

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    Murat Yalcin

    2011-04-01

    Full Text Available Nowadays, situations associated with high altitude such as mountaineering, aviation increasingly draw the attention of people. Gas pressure decreases and hypoxia is encountered when climbing higher. Physiological and pathological responses of human body to different heights are different. Therefore, physiological and pathological changes that may occur together with height and to know the clinical outcomes of these are important . Acute mountain sickness caused by high altitude and high altitude cerebral edema are preventable diseases with appropriate precautions. Atmospheric oxygen decreasing with height, initiates many adaptive mechanisms. These adaptation mechanisms and acclimatization vary widely among individuals because of reasons such as environmental factors, exercise and cold. High altitude causes different changes in the cardiovascular system with various mechanisms. Although normal individuals easily adapt to these changes, this situation can lead to undesirable results in people with heart disease. For this reason, it should be known the effective evaluation of the people with known heart disease before traveling to high altitude and the complications due to the changes with height and the recommendations can be made to these patients. [TAF Prev Med Bull 2011; 10(2.000: 211-222

  7. Progress in Drug Treatment of Cerebral Edema.

    Science.gov (United States)

    Deng, Y Y; Shen, F C; Xie, D; Han, Q P; Fang, M; Chen, C B; Zeng, H K

    2016-01-01

    Cerebral edema causes intracranial hypertension (ICH) which leads to severe outcome of patients in the clinical setting. Effective anti-edema therapy may significantly decrease the mortality in a variety of neurological conditions. At present drug treatment is a cornerstone in the management of cerebral edema. Osmotherapy has been the mainstay of pharmacologic therapy. Mannitol and hypertonic saline (HS) are the most commonly used osmotic agents. The relative safety and efficacy of HS and mannitol in the treatment of cerebral edema and reduction of enhanced ICP have been demonstrated in the past decades. Apart from its osmotic force, HS exerts anti-edema effects partly through inhibition of Na(+)-K(+)-2Cl(-) Cotransporter-1 (NKCC1) and aquaporin 4 (AQP4) expression in astrocytes. Melatonin may also reduce brain edema and exert neuroprotective effect on several central nervous system diseases through inhibition of inflammatory response. The inhibitors of Na/H exchanger, NKCC and AQP4 may attenuate brain edema formation through inhibition of excessive transportation of ion and water from blood into the cerebral tissue. In this review we survey some of the most recent findings in the drug treatment of brain edema focusing on the use of osmotherapy, melatonin and inhibitors of ion cotransporters and water channels. A better understanding of the molecular mechanism of these agents would help to improve in the clinical management of patients with brain edema.

  8. Soluble Urokinase-Type Plasminogen Activator Receptor Plasma Concentration May Predict Susceptibility to High Altitude Pulmonary Edema

    Science.gov (United States)

    Zügel, Stefanie; Schoeb, Michele; Auinger, Katja; Dehnert, Christoph; Maggiorini, Marco

    2016-01-01

    Introduction. Acute exposure to high altitude induces inflammation. However, the relationship between inflammation and high altitude related illness such as high altitude pulmonary edema (HAPE) and acute mountain sickness (AMS) is poorly understood. We tested if soluble urokinase-type plasminogen activator receptor (suPAR) plasma concentration, a prognostic factor for cardiovascular disease and marker for low grade activation of leukocytes, will predict susceptibility to HAPE and AMS. Methods. 41 healthy mountaineers were examined at sea level (SL, 446 m) and 24 h after rapid ascent to 4559 m (HA). 24/41 subjects had a history of HAPE and were thus considered HAPE-susceptible (HAPE-s). Out of the latter, 10/24 HAPE-s subjects were randomly chosen to suppress the inflammatory cascade with dexamethasone 8 mg bid 24 h prior to ascent. Results. Acute hypoxic exposure led to an acute inflammatory reaction represented by an increase in suPAR (1.9 ± 0.4 at SL versus 2.3 ± 0.5 at HA, p < 0.01), CRP (0.7 ± 0.5 at SL versus 3.6 ± 4.6 at HA, p < 0.01), and IL-6 (0.8 ± 0.4 at SL versus 3.3 ± 4.9 at HA, p < 0.01) in all subjects except those receiving dexamethasone. The ascent associated decrease in PaO2 correlated with the increase in IL-6 (r = 0.46, p < 0.001), but not suPAR (r = 0.27, p = 0.08); the increase in IL-6 was not correlated with suPAR (r = 0.16, p = 0.24). Baseline suPAR plasma concentration was higher in the HAPE-s group (2.0 ± 0.4 versus 1.8 ± 0.4, p = 0.04); no difference was found for CRP and IL-6 and for subjects developing AMS. Conclusion. High altitude exposure leads to an increase in suPAR plasma concentration, with the missing correlation between suPAR and IL-6 suggesting a cytokine independent, leukocyte mediated mechanism of low grade inflammation. The correlation between IL-6 and PaO2 suggests a direct effect of hypoxia, which is not the case for suPAR. However, suPAR plasma concentration measured before hypoxic exposure may predict

  9. Susceptibility To High Altitude Pulmonary Edema Is Associated With A More Uniform Distribution Of Regional Specific Ventilation.

    Science.gov (United States)

    Patz, Michael D; Sá, Rui Carlos; Darquenne, Chantal; Elliott, Ann R; Assadi, Amran K; Theilmann, Rebecca J; Dubowitz, David J; Swenson, Erik Richard; Prisk, Gordon Kim; Hopkins, Susan Roberta

    2017-01-05

    High altitude pulmonary edema (HAPE) is a potentially fatal condition affecting high altitude sojourners. The biggest predictor of HAPE development is a history of prior HAPE. Magnetic resonance imaging (MRI) shows HAPE-susceptible, with a history of HAPE, but not HAPE-resistant (a history of repeated ascents without illness) individuals develop greater heterogeneity of regional pulmonary perfusion breathing hypoxic gas (O2=12.5%), consistent with uneven hypoxic pulmonary vasoconstriction (HPV). Why HPV is uneven in HAPE-susceptibles is unknown, but may arise from regionally heterogeneous ventilation resulting in an uneven stimulus to HPV. We tested the hypothesis that ventilation is more heterogeneous in HAPE-susceptible subjects (n=6) compared to HAPE-resistant controls (n=7). MRI Specific Ventilation Imaging (SVI), was used to measure regional specific ventilation and the relative dispersion (SD/mean) of SVI used to quantify baseline heterogeneity. Ventilation heterogeneity from conductive and respiratory airways was measured in normoxia and hypoxia (O2=12.5%) using multiple breath washout and heterogeneity quantified from the indices Scond and Sacin, respectively. Contrary to our hypothesis, HAPE-susceptibles had significantly lower relative dispersion of specific ventilation than the HAPE-resistant controls (Susceptible=1.33±0.67, Resistant=2.36±0.98, p=0.05) and Sacin tended to be more uniform (Susceptible=0.085±0.009, Resistant=0.113±0.030, p=0.07). Scond was not significantly different between groups (Susceptible=0.019±0.007, Resistant=0.020±0.004, p=0.67). Sacin and Scond did not change significantly in hypoxia (p=0.56, 0.19, respectively). In conclusion, ventilation heterogeneity does not change with short-term hypoxia irrespective of HAPE susceptibility and lesser rather than greater ventilation heterogeneity is observed in HAPE-susceptible subjects. This suggests the basis for uneven HPV in HAPE involves vascular phenomena.

  10. Effect of hyperbaric oxygen preconditioning on the expression of aquaporin 5 in rats with high-altitude pulmonary edema

    Institute of Scientific and Technical Information of China (English)

    LI Zhuo; ZHAO Li-ming; WANG Cong; LIU Xue-hua; GAO Chun-jin

    2012-01-01

    Objective To investigate the possibility of applying hyperbaric oxygen preconditioning(HBO-PC)to reduce or prevent high-altitude pulmonary edema(HAPE)and to detect whether aquaporin 5(AQP5)are involved in HAPE pathogenesis.Methods Thirty eight rats were divided into three groups:the control,the HBO-PC and the HAPE groups.Western blot and real-time PCR were used to analyze the expression of AQP5 in the lungs.The wet-to-dry weight ratio(W/D weight ratio)and morphology of the lung were also examined.Results Lung W/D weight ratio in the HAPE group(4.36±0.53)compared with that of the control group(3.90±0.15)(P<0.05),were marked interstitial edema in all the lung sections in the HAPE group,and fewer changes in 10 of 13 sections in the HBO-PC group.Lung-injury scores of the HBO-PC group were much lower than those of the HAPE group.AQP5 of the HAPE group decreased significantly at the protein and gene levels compared with those in the control group(P<0.01,P<0.05).Protein and mRNA expression of AQP5 in the HBO-PC group were much higher than those of the HAPE group(P<0.05,P<0.01).Lung injuries in the HAPE rats were related positively to the AQP5 expression in the lung(protein expression r=-0.635,P<0.01;mRNA expression r=-0.399,P<0.05).Conclusions We concluded that HBO-PC could alleviate lung injury in rats caused by high-altitude hypobaric hypoxia and reduce HAPE incidence.HAPE in rats was associated with the down-regulation of expression of AQP5 in the lungs.This down-egulation could be attenuated by HBO-PC.This study is the first one introducing HBO-PC in the prevention of HAPE,and the first investigation on the expression of AQP5 in a rat model of HAPE.

  11. Mechanisms of Astrocyte-Mediated Cerebral Edema

    Science.gov (United States)

    Stokum, Jesse A.; Kurland, David B.; Gerzanich, Volodymyr; Simard, J. Marc

    2014-01-01

    Cerebral edema formation stems from disruption of blood brain barrier (BBB) integrity and occurs after injury to the CNS. Due to the restrictive skull, relatively small increases in brain volume can translate into impaired tissue perfusion and brain herniation. In excess, cerebral edema can be gravely harmful. Astrocytes are key participants in cerebral edema by virtue of their relationship with the cerebral vasculature, their unique compliment of solute and water transport proteins, and their general role in brain volume homeostasis. Following the discovery of aquaporins, passive conduits of water flow, aquaporin 4 (AQP4) was identified as the predominant astrocyte water channel. Normally, AQP4 is highly enriched at perivascular endfeet, the outermost layer of the BBB, whereas after injury, AQP4 expression disseminates to the entire astrocytic plasmalemma, a phenomenon termed dysregulation. Arguably, the most important role of AQP4 is to rapidly neutralize osmotic gradients generated by ionic transporters. In pathological conditions, AQP4 is believed to be intimately involved in the formation and clearance of cerebral edema. In this review, we discuss aquaporin function and localization in the BBB during health and injury, and we examine post-injury ionic events that modulate AQP4- dependent edema formation. PMID:24996934

  12. Interactions among Vascular-Tone Modulators Contribute to High Altitude Pulmonary Edema and Augmented Vasoreactivity in Highlanders

    Science.gov (United States)

    Ali, Zahara; Mishra, Aastha; Kumar, Rahul; Alam, Perwez; Pandey, Priyanka; Ram, Rekhbala; Thinlas, Tashi; Mohammad, Ghulam; Pasha, M. A. Qadar

    2012-01-01

    Background The interactions among various biomarkers remained unexplored under the stressful environment of high-altitude. Present study evaluated interactions among biomarkers to study susceptibility for high altitude pulmonary edema (HAPE) in HAPE-patients (HAPE-p) and adaptation in highland natives (HLs); both in comparison to HAPE-free sojourners (HAPE-f). Methodology/Principal Findings All the subjects were recruited at 3500 m. We measured clinical parameters, biochemical levels in plasma and gene expression using RNA from blood; analyzed various correlations between and among the clinical parameters, especially arterial oxygen saturation (SaO2) and mean arterial pressure (MAP) and biochemical parameters like, asymmetric dimethylarginine (ADMA), serotonin (5-HT), 8-iso-prostaglandin F2α (8-isoPGF2α), endothelin-1 (ET-1), plasma renin activity (PRA), plasma aldosterone concentration (PAC), superoxide dismutase (SOD) and nitric oxide (NO) in HAPE-p, HAPE-f and HLs. ADMA, 5-HT, 8-isoPGF2α, ET-1 levels, and PAC were significantly higher (p0.05) lower in HLs than HAPE-f. The expression of respective genes differed in the three groups. In the correlations, SaO2 inversely correlated with ADMA, 5-HT and 8-isoPGF2α and positively with SOD in HAPE-p (p≤0.009). MAP correlated positively with 5-HT and 8-isoPGF2α in HAPE-p and HLs (p≤0.004). A strong positive correlation was observed between ADMA and 5-HT, 5-HT and 8-isoPGF2α (p≤0.001), whereas inverse correlation of SOD with ET-1 in HAPE-p and HLs (p≤0.004), with 5-HT and 8-isoPGF2α in HAPE-p (p = 0.01) and with 5-HT in HLs (p = 0.05). Conclusions/Significance The interactions among these markers confer enhanced vascular activity in HLs and HAPE in sojourners. PMID:22984459

  13. Interactions among vascular-tone modulators contribute to high altitude pulmonary edema and augmented vasoreactivity in highlanders.

    Directory of Open Access Journals (Sweden)

    Zahara Ali

    Full Text Available BACKGROUND: The interactions among various biomarkers remained unexplored under the stressful environment of high-altitude. Present study evaluated interactions among biomarkers to study susceptibility for high altitude pulmonary edema (HAPE in HAPE-patients (HAPE-p and adaptation in highland natives (HLs; both in comparison to HAPE-free sojourners (HAPE-f. METHODOLOGY/PRINCIPAL FINDINGS: All the subjects were recruited at 3500 m. We measured clinical parameters, biochemical levels in plasma and gene expression using RNA from blood; analyzed various correlations between and among the clinical parameters, especially arterial oxygen saturation (SaO(2 and mean arterial pressure (MAP and biochemical parameters like, asymmetric dimethylarginine (ADMA, serotonin (5-HT, 8-iso-prostaglandin F2α (8-isoPGF2α, endothelin-1 (ET-1, plasma renin activity (PRA, plasma aldosterone concentration (PAC, superoxide dismutase (SOD and nitric oxide (NO in HAPE-p, HAPE-f and HLs. ADMA, 5-HT, 8-isoPGF2α, ET-1 levels, and PAC were significantly higher (p0.05 lower in HLs than HAPE-f. The expression of respective genes differed in the three groups. In the correlations, SaO(2 inversely correlated with ADMA, 5-HT and 8-isoPGF2α and positively with SOD in HAPE-p (p≤0.009. MAP correlated positively with 5-HT and 8-isoPGF2α in HAPE-p and HLs (p ≤ 0.004. A strong positive correlation was observed between ADMA and 5-HT, 5-HT and 8-isoPGF2α (p≤0.001, whereas inverse correlation of SOD with ET-1 in HAPE-p and HLs (p ≤ 0.004, with 5-HT and 8-isoPGF2α in HAPE-p (p = 0.01 and with 5-HT in HLs (p = 0.05. CONCLUSIONS/SIGNIFICANCE: The interactions among these markers confer enhanced vascular activity in HLs and HAPE in sojourners.

  14. Elevated pulmonary artery pressure and brain natriuretic peptide in high altitude pulmonary edema susceptible non-mountaineers

    Science.gov (United States)

    Gupta, Rajinder K.; Himashree, G.; Singh, Krishan; Soree, Poonam; Desiraju, Koundinya; Agrawal, Anurag; Ghosh, Dishari; Dass, Deepak; Reddy, Prassana K.; Panjwani, Usha; Singh, Shashi Bala

    2016-01-01

    Exaggerated pulmonary pressor response to hypoxia is a pathgonomic feature observed in high altitude pulmonary edema (HAPE) susceptible mountaineers. It was investigated whether measurement of basal pulmonary artery pressure (Ppa) and brain natriuretic peptide (BNP) could improve identification of HAPE susceptible subjects in a non-mountaineer population. We studied BNP levels, baseline hemodynamics and the response to hypoxia (FIo2 = 0.12 for 30 min duration at sea level) in 11 HAPE resistant (no past history of HAPE, Control) and 11 HAPE susceptible (past history of HAPE, HAPE-S) subjects. Baseline Ppa (19.31 ± 3.63 vs 15.68 ± 2.79 mm Hg, p < 0.05) and plasma BNP levels (52.39 ± 32.9 vs 15.05 ± 9.6 pg/ml, p < 0.05) were high and stroke volume was less (p < 0.05) in HAPE-S subjects compared to control. Acute hypoxia produced an exaggerated increase in heart rate (p < 0.05), mean arterial pressure (p < 0.05) and Ppa (28.2 ± 5.8 vs 19.33 ± 3.74 mm Hg, p < 0.05) and fall in peripheral oxygen saturation (p < 0.05) in HAPE-S compared to control. Receiver operating characteristic (ROC) curves showed that Ppa response to acute hypoxia was the best variable to identify HAPE susceptibility (AUC 0.92) but BNP levels provided comparable information (AUC 0.85). BNP levels are easy to determine and may represent an important marker for the determination of HAPE susceptibility. PMID:26892302

  15. The susceptibility gene screening in a Chinese high-altitude pulmonary edema family by whole-exome sequencing.

    Science.gov (United States)

    Yingzhong, Yang; Yaping, Wang; Jin, Xu; Rili, Ge

    2017-02-20

    High-altitude pulmonary edema (HAPE) is one of idiopathic mountain sicknesses that occur in healthy lowlanders when they quickly ascend to altitudes exceeding 2500 m above sea levels within 1-7 days. Growing evidence suggests that genetics plays an important role in the risk of HAPE. In this study, we recruited a Chinese HAPE family and screened genetic variations in the 7 family members (including 6 family members with a medical history of HAPE and the propositus's mother) by whole-exome sequencing. The results showed 18 genetic variations (9 SNVs and 9 Indels) were related to HAPE. Two SNV sites (CFHR4 (p.L85F) and OXER1 (p.R176C)) were predicted to be damaging and alter protein functions by SIFT, PolyPhen-2 and PROVEAN software. The biological function of OXER1 was highly related to the hypoxia-inducible factor pathway. Therefore, those two sites were identified as candidate pathological variations. Moreover, other SNVs (NMB p.S150P, APOB p.I4194T, EIF4ENIF1 p.Q763P) and Indels (KCNJ12 p.EE333-334E, ANKRD31 p.LMN251-253LN, OR2A14 p.HFFC175-178HFC) were also predicted to be damaging as well, which also might be considered as potential candidate pathological variations related to HAPE. Collectively we firstly screened the susceptibility genes in a Chinese HAPE family by whole-exome sequencing, which will provide new clues for further mechanistic studies of HAPE.

  16. Genetic differences and aberrant methylation in the apelin system predict the risk of high-altitude pulmonary edema

    Science.gov (United States)

    Mishra, Aastha; Kohli, Samantha; Dua, Sanchi; Thinlas, Tashi; Mohammad, Ghulam; Pasha, M. A. Qadar

    2015-01-01

    Hypoxia-inducible factor stimulates the expression of apelin, a potent vasodilator, in response to reduced blood arterial oxygen saturation. However, aberrations in the apelin system impair pulmonary vascular function, potentially resulting in the development of high-altitude (HA)-related disorders. This study aimed to elucidate the genetic and epigenetic regulation of apelin, apelin receptor (APLNR), and endothelial nitric oxide synthase (NOS3) in HA adaptation and HA pulmonary edema (HAPE). A genome-wide association study and sequencing identified variants of apelin, APLNR, and NOS3 that were validated in a larger sample size of HAPE-patients (HAPE-p), HAPE-free controls (HAPE-f), and healthy highland natives (HLs). Apelin-13 and nitrite levels and apelin and NOS3 expression were down-regulated in HAPE-p (P < 0.001). Among the several studied polymorphisms, apelin rs3761581, rs2235312, and rs3115757; APLNR rs11544374 and rs2282623; and NOS3 4b/4a, rs1799983, and rs7830 were associated with HAPE (P < 0.03). The risk allele rs3761581G was associated with a 58.6% reduction in gene expression (P = 0.017), and the risk alleles rs3761581G and rs2235312T were associated with low levels of apelin-13 and nitrite (P < 0.05). The latter two levels decreased further when both of these risk alleles were present in the patients (P < 0.05). Methylation of the apelin CpG island was significantly higher in HAPE-p at 11.92% than in HAPE-f and HLs at ≤7.1% (P < 0.05). Moreover, the methylation effect was 9% stronger in the 5′ UTR and was associated with decreased apelin expression and apelin-13 levels. The rs3761581 and rs2235312 polymorphisms and methylation of the CpG island influence the expression of apelin in HAPE. PMID:25918383

  17. Protective effect of phenylethanoid glycosides extracted from Phlomis younghusbandii on acute high altitude pulmonary edema in rats

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    Fei LUAN

    2015-10-01

    Full Text Available Objective To investigate the protective effect of phenylethanoid glycosides (PhGCs extracted from Phlomis younghusbandiion acute high altitude pulmonary edema (HAPE in rats. Methods Seventy male Wistar rats were randomly divided into 7 groups (10 each: normoxia control group (NG, distilled water, normoxia+PhGCs group (NG+PhGCs, 400mg/ kg, hypoxia model group (HG, distilled water, dexamethasone (Dex, 4mg/kg, and three groups of PhGCs in high (PhGCs-H, 400mg/kg, middle (PhGCs-M, 200mg/kg and low (PhGCs-L, 50mg/kg dosage. PhGCs extracted from Phlomis younghusbandiiwere administered prophylactically to rats for 3 days, and HAPE was induced by the hypobaric hypoxia exposure for 72 hours in an animal decompression chamber with the chamber pressure of 267mmHg to simulate an altitude of 8000m. The water content of rat lung tissue was determined with wet/dry specific gravity method, and histopathologic changes were observed with HE staining. The enzymatic activities of SOD and GSH, and the contents of MDA in lung tissue were determined with spectrophotometry, and the contents of IL-1β, TNF-α in serum and lung tissue were determined with ELISA. Results Compared with NG group, no obvious difference was found in the water content of rat lung tissue in NG+PhGCs group, but the water content increased obviously in HG group (P<0.05. Compared with NG group, lung tissue congestion and edema were found in HG group, with a heavy inflammatory cell infiltration, widening of alveolar interval, and thickening of alveolar wall were found. The enzymatic activities of SOD and GSH were notablely depressed, and the contents of MDA in lung tissue, and the contents of IL-1β and TNF-α in serum and lung tissue remarkably increased (P<0.05. Compared with HG group, the water content of rat lung tissue in each PhGCs group decreased obviously. Inflammatory cells infiltration, widening of alveolar interval, and thickening of alveolar wall, the enzymatic activity of SOD and

  18. An Adult Case of Diabetic Ketoacidosis Presenting with Cerebral Edema

    OpenAIRE

    Barış Akıncı; Abdurrahman Çömlekçi; Serkan Yener; Süleyman Men

    2009-01-01

    Cerebral edema is a life-threatening complication of diabetic ketoacidosis (DKA) which may predominantly develop in pediatric cases during the management of DKA.. Symptomatic cerebral edema in children is rarely detected at admission, before initiation of the treatment. Cerebral edema associated with DKA is extremely rare in adults. Here, we report an adult patient with DKA who presented with symptomatic cerebral edema. Turk Jem 2009; 13: 16-8

  19. Role of Aquaporin-4 in Cerebral Edema and Stroke

    OpenAIRE

    Zador, Zsolt; Stiver, Shirley; Wang, Vincent; MANLEY, GEOFFREY T.

    2009-01-01

    Cerebral edema plays a central role in the pathophysiology of many diseases of the central nervous system (CNS) including ischemia, trauma, tumors, inflammation, and metabolic disturbances. The formation of cerebral edema results in an increase in tissue water content and brain swelling which, if unchecked, can lead to elevated intracranial pressure (ICP), reduced cerebral blood flow, and ultimately cerebral herniation and death. Despite the clinical significance of cerebral edema, the mechan...

  20. Correlation of vascular endothelial growth factor to permeability of blood-brain barrier and brain edema during high-altitude exposure

    Institute of Scientific and Technical Information of China (English)

    Qiquan Zhou; Chang'e Liu; Jing Wang; Yunli Wang; Bo Zhou

    2009-01-01

    BACKGROUND:Many studies have evaluated the role of vascular endothelial growth factor (VEGF) in traumatic brain edema and hemorrhagic brain edema.OBJECTIVE:To observe the effects of VEGF expression on permeability of the blood-brain barrier (BBB) during high-altitude and hypoxia exposure,and to investigate the correlation between VEGF expression and BBB permeability with regard to Evans blue staining and brain edema during high-altitude exposure.DESIGN,TIME AND SETTING:The randomized,controlled,animal study was performed at the Tanggula Etape,Central Laboratory of Chengdu Medical College,and Central Laboratory of General Hospital of Chengdu Military Area Command of Chinese PLA,China,from July 2003 to November 2004.MATERIALS:Quantitative RT-PCR kit (Sigma,USA),VEGF ELISA kit (Biosource,USA),and Evans blue (Jingchun,China) were acquired for this study.METHODS:A total of 180 Wistar rats were equally and randomly assigned to 15 groups:low-altitude (500 m),middle-altitude (2 880 m),high-altitude (4 200 m),super-high-altitude (5 000 m),1,3,5,7,9,11,13,15,17,19,and 21 days of super high-altitude exposure.Wistar rats were exposed to various altitude gradients to establish a hypoxia model.MAIN OUTCOME MEASURES:Brain water content was calculated according to the wet-to-dry weight ratio.BBB permeability to Evans blue was determined by colorimetric method.VEGF mRNA and protein levels in brain tissues were detected using RT-PCR and double-antibody sandwich ELISA.RESULTS:Brain water content,BBB permeability to Evans blue,and VEGF mRNA and protein levels in brain tissues increased with increasing altitude and prolonged exposure to altitude.The greatest increase was determined on day 9 upon ascending 5 000 m.Simultaneously,VEGF expression positively correlated to BBB permeability of Evans blue and brain water content (r=0.975,0.917,P<0.01).CONCLUSION:Increased VEGF protein and mRNA expression was responsible for increased BBB permeability,which may be an important mechanism

  1. Radiosurgery for brain metastases and cerebral edema.

    Science.gov (United States)

    Gazit, Inbal; Har-Nof, Sagi; Cohen, Zvi R; Zibly, Zion; Nissim, Uzi; Spiegelmann, Roberto

    2015-03-01

    The objective of this study was to assess reduction in cerebral edema following linear accelerator radiosurgery (LINAC) as first line therapy for brain metastasis. We reviewed the medical records of all patients who underwent LINAC radiosurgery for brain metastasis at our institution during 2010-2012, and who had not previously undergone either surgery or whole brain radiotherapy. Data were analyzed for 55 brain metastases from 46 patients (24 males), mean age 59.9 years. During the 2 months following LINAC radiosurgery, the mean steroid dose decreased from 4.8 to 2.6 mg/day, the mean metastasis volume decreased from 3.79±4.12 cc to 2.8±4.48 cc (p=0.001), and the mean edema volume decreased from 16.91±30.15 cc to 12.85±24.47 cc (p=0.23). The 17 patients with reductions of more than 50% in brain edema volume had single metastases. Edema volume in the nine patients with two brain metastases remained stable in five patients (volume change 10%, 2-14 cc). In a subanalysis of eight metastases with baseline edema volume greater than 40 cc, edema volume decreased from 77.27±37.21 cc to 24.84±35.6 cc (p=0.034). Reductions in brain edema were greater in metastases for which non-small-cell lung carcinoma and breast cancers were the primary diseases. Overall, symptoms improved in most patients. No patients who were without symptoms or who had no signs of increased intracranial pressure at baseline developed signs of intracranial pressure following LINAC radiosurgery. In this series, LINAC stereotactic radiosurgery for metastatic brain lesions resulted in early reduction in brain edema volume in single metastasis patients and those with large edema volumes, and reduced the need for steroids.

  2. High Altitude Dermatology

    Science.gov (United States)

    Singh, Lt. Col. G K

    2017-01-01

    Approximately, 140 million people worldwide live permanently at high altitudes (HAs) and approximately another 40 million people travel to HA area (HAA) every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV) light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Acute mountain sickness, HA pulmonary edema, HA cerebral edema, and thromboembolic conditions are known to occur in HA. However, enough knowledge has not been shared on dermatoses peculiar to this region. Xerosis, UV-related skin disorders (tanning, photomelanosis, acute and chronic sunburn, polymorphic light eruption, chronic actinic dermatitis, actinic cheilitis, etc.), cold injuries (frostbite, chilblains, acrocyanosis, erythrocyanosis, etc.) nail changes (koilonychias), airborne contact dermatitis, insect bite reaction, and skin carcinoma (basal cell carcinomas, squamous cell carcinomas, and also rarely malignant melanoma) are the dermatoses seen in HAAs. Early diagnosis and knowledge of HA dermatoses may prevent serious consequences of disease and improve the quality of life for the visitors as well as for native of the place. PMID:28216727

  3. High altitude dermatology

    Directory of Open Access Journals (Sweden)

    G K Singh

    2017-01-01

    Full Text Available Approximately, 140 million people worldwide live permanently at high altitudes (HAs and approximately another 40 million people travel to HA area (HAA every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Acute mountain sickness, HA pulmonary edema, HA cerebral edema, and thromboembolic conditions are known to occur in HA. However, enough knowledge has not been shared on dermatoses peculiar to this region. Xerosis, UV-related skin disorders (tanning, photomelanosis, acute and chronic sunburn, polymorphic light eruption, chronic actinic dermatitis, actinic cheilitis, etc., cold injuries (frostbite, chilblains, acrocyanosis, erythrocyanosis, etc. nail changes (koilonychias, airborne contact dermatitis, insect bite reaction, and skin carcinoma (basal cell carcinomas, squamous cell carcinomas, and also rarely malignant melanoma are the dermatoses seen in HAAs. Early diagnosis and knowledge of HA dermatoses may prevent serious consequences of disease and improve the quality of life for the visitors as well as for native of the place.

  4. Therapeutic experience of 86 cases of child high altitude pulmonary edema%小儿高原肺水肿86例治疗体会

    Institute of Scientific and Technical Information of China (English)

    王启海; 王栋军; 武春华

    2001-01-01

    @@ 小儿高原肺水肿(high altitude pulmonary edema,HAPE)是高原地区特有的、危及生命的急重病症之一.由于小儿本身的生理特点,小儿HAPE在临床表现及治疗上与成人HAPE有所不同,治疗效果与年龄、病情有一定关系.现将我院1990-01~2000-01收治的小儿高原肺水肿86例报告如下:

  5. 'Ome' on the range: update on high-altitude acclimatization/adaptation and disease.

    Science.gov (United States)

    Luo, Yongjun; Wang, Yuxiao; Lu, Hongxiang; Gao, Yuqi

    2014-11-01

    The main physiological challenge in high-altitude plateau environments is hypoxia. When people living in a plain environment migrate to the plateau, they face the threat of hypoxia. Most people can acclimatize to high altitudes; the acclimatization process mainly consists of short-term hyperventilation and long-term compensation by increased oxygen uptake, transport, and use due to increased red blood cell mass, myoglobin, and mitochondria. If individuals cannot acclimatize to high altitude, they may suffer from a high-altitude disease, such as acute mountain disease (AMS), high-altitude pulmonary edema (HAPE), high-altitude cerebral edema (HACE) or chronic mountain sickness (CMS). Because some individuals are more susceptible to high altitude diseases than others, the incidence of these high-altitude diseases is variable and cannot be predicted. Studying "omes" using genomics, proteomics, metabolomics, transcriptomics, lipidomics, immunomics, glycomics and RNomics can help us understand the factors that mediate susceptibility to high altitude illnesses. Moreover, analysis of the "omes" using a systems biology approach may provide a greater understanding of high-altitude illness pathogenesis and improve the efficiency of the diagnosis and treatment of high-altitude illnesses in the future. Below, we summarize the current literature regarding the role of "omes" in high-altitude acclimatization/adaptation and disease and discuss key research gaps to better understand the contribution of "omes" to high-altitude illness susceptibility.

  6. Effects of race and sex on cerebral hemodynamics, oxygen delivery and blood flow distribution in response to high altitude

    Science.gov (United States)

    Liu, Jie; Liu, Yang; Ren, Li-Hua; Li, Li; Wang, Zhen; Liu, Shan-Shan; Li, Su-Zhi; Cao, Tie-Sheng

    2016-08-01

    To assess racial, sexual, and regional differences in cerebral hemodynamic response to high altitude (HA, 3658 m). We performed cross-sectional comparisons on total cerebral blood flow (TCBF = sum of bilateral internal carotid and vertebral arterial blood flows = QICA + QVA), total cerebrovascular resistance (TCVR), total cerebral oxygen delivery (TCOD) and QVA/TCBF (%), among six groups of young healthy subjects: Tibetans (2-year staying) and Han (Han Chinese) at sea level, Han (2-day, 1-year and 5-year) and Tibetans at HA. Bilateral ICA and VA diameters and flow velocities were derived from duplex ultrasonography; and simultaneous measurements of arterial pressure, oxygen saturation, and hemoglobin concentration were conducted. Neither acute (2-day) nor chronic (>1 year) responses showed sex differences in Han, except that women showed lower TCOD compared with men. Tibetans and Han exhibited different chronic responses (percentage alteration relative to the sea-level counterpart value) in TCBF (‑17% vs. 0%), TCVR (22% vs. 12%), TCOD (0% vs. 10%) and QVA/TCBF (0% vs. 2.4%, absolute increase), with lower resting TCOD found in SL- and HA-Tibetans. Our findings indicate racial but not sex differences in cerebral hemodynamic adaptations to HA, with Tibetans (but not Han) demonstrating an altitude-related change of CBF distribution.

  7. 高原肺水肿动物模型的初步建立%The primary estibalishment of rats model of high-altitude pulmonary edema

    Institute of Scientific and Technical Information of China (English)

    张兆瑞; 张波; 何萍萍; 王东

    2011-01-01

    Objective: To estibalish the rats model of high-altitude pulmonary edema by putting Wistar rats in hypobaric chamber, and compare the severity of pulmonary edema in different hypoxia time. Methods: Male Wistar rats were randomly divided into three groups: control group, 24 h hypoxia group, 48 h hypoxia group. Except for the control group, rats in the other groups were put in hypobaric chamber for 24 h and 48 h to produce a rat model of high-altitude pulmonary edema (HAPE). The wet to dry ratio (W/D), lung oxide synthase (NOS), lung endothelin (ET-1) and histological measurements were conducted on each animal. Results: Compared with the control group, the W/D ratio and the ET-1 had significantly increased, the activity of NOS was lower significantly in the 24 h hypoxia group and 48 h hypoxia group, and they all had statistically significant differences (P<0.05). The interstitial pulmonary edema performance of the alvedar interval widened and interstitial hyperemia were found in the 24 h and 48 h hypoxia group. Comparied with the 24 h hypoxia group, the wet to dry ratio and the endothelin had significantly increased, the activity of NOS were significantly lower of the 48 h hypoxia group, and there was a statistically significant difference (P<005). Conclusion: The model of high altitude pulmonary interstitial edema is successful set up by putting the Wistar rats in hypobaric chamber for 24 h and 48 h, the severity of pulmonary edema in the 48 h hypoxia group is more serious than the 24 h hypoxia group, which is more suitable for reality research.%目的:通过模拟高原低压低氧环境,建立高原肺水肿大鼠动物模型,探讨低氧时间对大鼠肺水肿程度影响.方法:雄性Wistar大鼠随机分为3组,分别为对照组、24 h低氧组、48 h低氧组.比较大鼠肺湿干比、肺组织匀浆中一氧化氮合酶(NOS)、内皮素-1(ET-1)及肺组织病理形态学的变化.结果:与地面对照组比较,24 h低氧组与48 h低氧组大鼠肺

  8. Medical continuing education: reform of teaching methods about high altitude disease in China.

    Science.gov (United States)

    Luo, Yongjun; Zhou, Qiquan; Huang, Jianjun; Luo, Rong; Yang, Xiaohong; Gao, Yuqi

    2013-06-01

    The purpose of high altitude continuing medical education is to adapt knowledge and skills for practical application on the plateau. Most trainees have experience with academic education and grassroots work experience on the plateau, so they want knowledge about new advances in the pathogenesis, diagnosis, and treatment of high altitude disease. As such, traditional classroom teaching methods are not useful to them. Training objects, content, and methods should attempt to conduct a variety of teaching practices. Through continuing medical education on high altitude disease, the authors seek to change the traditional teaching model away from a single classroom and traditional written examinations to expand trainees' abilities. These innovative methods of training can improve both the quality of teaching and students' abilities to prevent and treat acute mountain sickness, high altitude pulmonary edema, high altitude cerebral edema, and chronic mountain sickness to increase the quality of high altitude medical care.

  9. Association between single nucleotide polymorphisms in ADRB2, GNB3 and GSTP1 genes and high-altitude pulmonary edema (HAPE) in the Chinese Han population.

    Science.gov (United States)

    He, Yongjun; Liu, Lijun; Xu, Pengcheng; He, Na; Yuan, Dongya; Kang, Longli; Jin, Tianbo

    2017-02-14

    High altitude pulmonary edema (HAPE) occurs mainly under conditions such as high altitude, rapid ascent, or hypoxia. Previous studies suggest that ADRB2, GNB3, TH, and GSTP1 polymorphisms are associated with various lung diseases. We evaluated whether those polymorphisms are associated with the risk of HAPE in a Chinese Han population. ADRB2, GNB3, TH and GSTP1 polymorphisms were genotyped using a Sequenom MassARRAY. Logistic regression, adjusted for age and gender, was used to evaluate the association between the genotypes and the risk of HAPE by computing odds ratios (ORs) and 95% confidence intervals (95% CIs). The results revealed that GNB3 rs4963516 allele ''G'' (G vs T: OR = 0.70, 95% CI = 0.55-0.90, p = 0.006) was associated with HAPE risk. The ADRB2 rs1042718 alleles had a 1.29-fold (95%CI = 1.00-1.66; p = 0.045) increased risk of HAPE, and the GSTP1 rs749174 alleles had a 0.71-fold (95%CI = 0.52-0.99; p = 0.042) decreased risk of HAPE. Co-dominant and dominant models of GNB3 rs4963516 decreased the risk of HAPE (p = 0.023 and p = 0.008, respectively). Our results indicate GNB3 and GSTP1 polymorphisms may protect against HAPE progression, while ADRB2 polymorphisms are associated with an increased risk of HAPE.

  10. Image analysis of 88 cases with high altitude pulmonary edema%高原性肺水肿88例影像分析

    Institute of Scientific and Technical Information of China (English)

    高生江

    2012-01-01

    目的 探讨高原性肺水肿(high altitude pulmonary edema,HAPE)患者的临床影像学特征及影像诊断价值.方法 对88例HAPE患者临床影像学资料进行回顾性分析研究.结果 88例HAPE影像表现为单侧或双侧肺毛玻璃状、斑片状、片状影、肺门区团片状影、弥漫性实变影等,常合并出现,以右侧多见;肺门改变可正常或模糊、增大;可伴叶间裂增厚.结论 影像检查是诊断HAPE的简捷可靠的诊断手段,尤其是X线平片可作为HAPE的首选检查,胸部CT检查可对其作出早期诊断并作为重要的补充检查手段.%Objective To explore the imaging features of patients with high altitude pulmonary edema (HAPE) and their diagnostic value . Methods Clinical imaging data of 88 patiekts with HAPE were retrospectively analyzed. Results Images of 88 cases of HAPE showed unilateral or bilateral pulmonary ground-glass-like, patchy, patchy, group patchy hilar region, diffuse opacities, etc. , which were often associated with the emergence of the right side of the more common. Hilar changes may be normal or ambiguous or increase, which may be associated with interlobar fissure thickening. Conclusion The imaging diagnosis of HAPE is the simple and reliable diagnostic tools, especially, the X-ray can be used as the first choice for HAPE. Chest CT can make early diagnosis and its complement as an important means of inspection.

  11. Regional differences in the cerebral blood flow velocity response to hypobaric hypoxia at high altitudes.

    Science.gov (United States)

    Feddersen, Berend; Neupane, Pritam; Thanbichler, Florian; Hadolt, Irmgard; Sattelmeyer, Vera; Pfefferkorn, Thomas; Waanders, Robb; Noachtar, Soheyl; Ausserer, Harald

    2015-11-01

    Symptoms of acute mountain sickness (AMS) may appear above 2,500 m altitude, if the time allowed for acclimatization is insufficient. As the mechanisms underlying brain adaptation to the hypobaric hypoxic environment are not fully understood, a prospective study was performed investigating neurophysiological changes by means of near infrared spectroscopy, electroencephalograpy (EEG), and transcranial doppler sonography at 100, 3,440 and 5,050 m above sea level in the Khumbu Himal, Nepal. Fourteen of the 26 mountaineers reaching 5,050 m altitude developed symptoms of AMS between 3,440 and 5,050 m altitude (Lake-Louise Score ⩾3). Their EEG frontal beta activity and occipital alpha activity increased between 100 and 3,440 m altitude, i.e., before symptoms appeared. Cerebral blood flow velocity (CBFV) in the anterior and middle cerebral arteries (MCAs) increased in all mountaineers between 100 and 3,440 m altitude. During further ascent to 5,050 altitude, mountaineers with AMS developed a further increase in CBFV in the MCA, whereas in all mountaineers CBFV decreased continuously with increasing altitude in the posterior cerebral arteries. These results indicate that hypobaric hypoxia causes different regional changes in CBFV despite similar electrophysiological changes.

  12. Cerebral artery alpha-1 AR subtypes: high altitude long-term acclimatization responses.

    Directory of Open Access Journals (Sweden)

    Ravi Goyal

    Full Text Available In response to hypoxia and other stress, the sympathetic (adrenergic nervous system regulates arterial contractility and blood flow, partly through differential activities of the alpha1 (α1 - adrenergic receptor (AR subtypes (α1A-, α1B-, and α1D-AR. Thus, we tested the hypothesis that with acclimatization to long-term hypoxia (LTH, contractility of middle cerebral arteries (MCA is regulated by changes in expression and activation of the specific α1-AR subtypes. We conducted experiments in MCA from adult normoxic sheep maintained near sea level (300 m and those exposed to LTH (110 days at 3801 m. Following acclimatization to LTH, ovine MCA showed a 20% reduction (n = 5; P<0.05 in the maximum tension achieved by 10-5 M phenylephrine (PHE. LTH-acclimatized cerebral arteries also demonstrated a statistically significant (P<0.05 inhibition of PHE-induced contractility in the presence of specific α1-AR subtype antagonists. Importantly, compared to normoxic vessels, there was significantly greater (P<0.05 α1B-AR subtype mRNA and protein levels in LTH acclimatized MCA. Also, our results demonstrate that extracellular regulated kinase 1 and 2 (ERK1/2-mediated negative feedback regulation of PHE-induced contractility is modulated by α1B-AR subtype. Overall, in ovine MCA, LTH produces profound effects on α1-AR subtype expression and function.

  13. Patchy cerebral white matter edema in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Anlar, B.; Erzen, C.; Saatci, U.

    1989-07-01

    Bilateral patchy cerebral white matter edema was observed in two children with chronic renal failure. Uremia in one case and hypertension or hyponatremia in the other appeared to be the cause of the neurological and radiological findings. (orig.).

  14. Mitochondrial haplogroup D4 confers resistance and haplogroup B is a genetic risk factor for high-altitude pulmonary edema among Han Chinese.

    Science.gov (United States)

    Luo, Y J; Gao, W X; Li, S Z; Huang, X W; Chen, Y; Liu, F Y; Huang, Q Y; Gao, Y Q

    2012-10-09

    High-altitude pulmonary edema (HAPE) is a life-threatening condition caused by acute exposure to high altitude. Accumulating evidence suggests that genetic factors play an important role in the etiology of HAPE. However, conclusions from association studies have been hindered by limited sample size due to the rareness of this disease. It is known that mitochondria are critical for hypoxic adaptation, and mitochondrial malfunction can be an important factor in HAPE development. Therefore, we tested the hypothesis that mitochondrial DNA haplotypes and polymorphisms affect HAPE susceptibility. We recruited 204 HAPE patients and 174 healthy controls in Tibet (3658 m above sea level), all Han Chinese, constituting the largest sample size of all HAPE vulnerability studies. Among mtDNA haplogroups, we found that haplogroup D4 is associated with resistance to HAPE, while haplogroup B is a genetic risk factor for this condition. Haplogroup D4 (tagged by 3010A) may enhance the stability of 16S rRNA, resulting in reduced oxidative stress and protection against HAPE. Within haplogroup B, subhaplogroup B4c (tagged by 15436A and 1119C) was associated with increased risk for HAPE, while subhaplogroup B4b may protect against HAPE. We indicate that there are differences in HAPE susceptibility among mtDNA haplogroups. We conclude that mitochondria are involved in adverse reactions to acute hypoxic exposure; our finding of differences in susceptibility as a function of mitochondrial DNA haplotype may shed light on the pathogenesis of other disorders associated with hypoxia, such as chronic obstructive pulmonary disease.

  15. Objective criteria for diagnosing high altitude pulmonary edema in acclimatized patients at altitudes between 2700 m and 3500 m

    Science.gov (United States)

    Chawla, Anuj; Tripathi, K.K.

    2015-01-01

    Background The criteria used for diagnosing high altitude illnesses are largely based on Western literature. This study was undertaken to define objective, simple and reliable diagnostic criteria for high altitude pulmonary edema (HAPE) in Indian soldiers at altitudes between 2700 m and 3500 m. Methods Clinical data of 235 cases of HAPE that occurred between 2700 m and 3500 m were analysed. Receiver operator characteristic (ROC) curve analysis was used to select simple clinical parameters suitable for the diagnosis of HAPE at peripheral medical facilities. Cut-off values and their reliability for the diagnosis of HAPE were defined. Results HAPE occurred 2.8 ± 2.2 days after arrival at altitudes between 2700 m and 3500 m. Breathlessness, cough, chest discomfort and headache were the commonest symptoms. Low pulse oximetry (SPO2) values than normal for this altitude were seen in 89% of patients. ROC analysis of clinical parameters identified a heart rate more than 95 beats per minute (bpm), respiratory rate more than 21 per minute and SPO2 less than 86% while breathing ambient air at this altitude as diagnostic of HAPE. The sensitivity and specificity of these cut-offs was 0.66, 0.83 and 0.82 and 0.94, 0.95 and 0.93 respectively. Conclusion A heart rate of more than 95 bpm, respiratory rate more than 21 per minute and SPO2 less than 86% breathing room air in individuals complaining of breathlessness, cough, chest discomfort or headache within the first 5 days of arrival at altitudes between 2700 m and 3500 m is highly suggestive of HAPE. PMID:26663962

  16. A longitudinal study of cerebral blood flow under hypoxia at high altitude using 3D pseudo-continuous arterial spin labeling

    Science.gov (United States)

    Liu, Wenjia; Liu, Jie; Lou, Xin; Zheng, Dandan; Wu, Bing; Wang, Danny J. J.; Ma, Lin

    2017-01-01

    Changes in cerebral blood flow (CBF) may occur with acute exposure to high altitude; however, the CBF of the brain parenchyma has not been studied to date. In this study, identical magnetic resonance scans using arterial spin labeling (ASL) were performed to study the haemodynamic changes at both sea level and high altitude. We found that with acute exposure to high altitude, the CBF in acute mountain sickness (AMS) subjects was higher (P  0.05) compared with those at sea level. Moreover, magnetic resonance angiography in both AMS and non-AMS subjects showed a significant increase in the cross-sectional areas of the internal carotid, basilar, and middle cerebral arteries on the first day at high altitude. These findings support that AMS may be related to increased CBF rather than vasodilation; these results contradict most previous studies that reported no relationship between CBF changes and the occurrence of AMS. This discrepancy may be attributed to the use of ASL for CBF measurement at both sea level and high altitude in this study, which has substantial advantages over transcranial Doppler for the assessment of CBF. PMID:28240265

  17. Cerebral Edema and Cerebral Hemorrhages in Interleukin-10-Deficient Mice Infected with Plasmodium chabaudi

    OpenAIRE

    Sanni, Latifu A; Jarra, William; Li, Ching; Langhorne, Jean

    2004-01-01

    During a Plasmodium chabaudi infection in interleukin-10 (IL-10) knockout mice, there is greater parasite sequestration, more severe cerebral edema, and a high frequency of cerebral hemorrhage compared with infection of C57BL/6 mice. Anti-tumor necrosis factor alpha treatment ameliorated both cerebral edema and hemorrhages, suggesting that proinflammatory responses contributed to cerebral complications in infected IL-10−/− mice.

  18. Progesterone is neuroprotective by inhibiting cerebral edema after ischemia

    Institute of Scientific and Technical Information of China (English)

    Yuan-zheng Zhao; Min Zhang; Heng-fang Liu; Jian-ping Wang

    2015-01-01

    Ischemic edema can alter the structure and permeability of the blood-brain barrier. Recent stud-ies have reported that progesterone reduces cerebral edema after cerebral ischemia. However, the underlying mechanism of this effect has not yet been elucidated. In the present study, pro-gesterone effectively reduced Evans blue extravasation in the ischemic penumbra, but not in the ischemic core, 48 hours after cerebral ischemia in rats. Progesterone also inhibited the down-reg-ulation of gene and protein levels of occludin and zonula occludens-1 in the penumbra. These results indicate that progesterone may effectively inhibit the down-regulation of tight junctions, thereby maintaining the integrity of the blood-brain barrier and reducing cerebral edema.

  19. Critical Care Management of Cerebral Edema in Brain Tumors.

    Science.gov (United States)

    Esquenazi, Yoshua; Lo, Victor P; Lee, Kiwon

    2017-01-01

    Cerebral edema associated with brain tumors is extremely common and can occur in both primary and metastatic tumors. The edema surrounding brain tumors results from leakage of plasma across the vessel wall into the parenchyma secondary to disruption of the blood-brain barrier. The clinical signs of brain tumor edema depend on the location of the tumor as well as the extent of the edema, which often exceeds the mass effect induced by the tumor itself. Uncontrolled cerebral edema may result in increased intracranial pressure and acute herniation syndromes that can result in permanent neurological dysfunction and potentially fatal herniation. Treatment strategies for elevated intracranial pressure consist of general measures, medical interventions, and surgery. Alhough the definitive treatment for the edema may ultimately be surgical resection of the tumor, the impact of the critical care management cannot be underestimated and thus patients must be vigilantly monitored in the intensive care unit. In this review, we discuss the pathology, pathophysiology, and clinical features of patients presenting with cerebral edema. Imaging findings and treatment modalities used in the intensive care unit are also discussed.

  20. Cerebral Edema in Chronic Mountain Sickness: a New Finding

    Science.gov (United States)

    Bao, Haihua; Wang, Duoyao; Zhao, Xipeng; Wu, Youshen; Yin, Guixiu; Meng, Li; Wang, Fangfang; Ma, Lan; Hackett, Peter; Ge, Ri-Li

    2017-01-01

    We observed patients with chronic mountain sickness (CMS) in our clinic who developed progressive neurological deterioration (encephalopathy) and we wished to investigate this. We studied nine such CMS patients, and compared them to 21 CMS patients without encephalopathy, and to 15 healthy control subjects without CMS. All 45 subjects lived permanently at 3200–4000 m. Measurements at 2260 m included CMS symptom score, multi-slice CT, perfusion CT, pulse oximetry (SpO2%), and hemoglobin concentration (Hb). One patient had MRI imaging but not CT; 5 had CSF pressure measurements. CMS subjects had lower SpO2, higher Hb, higher brain blood density, lower mean cerebral blood flow (CBF), and significant cerebral circulatory delay compared to controls. The nine CMS subjects with neurological deterioration showed diffuse cerebral edema on imaging and more deranged cerebral hemodynamics. CSF pressure was elevated in those with edema. We conclude that cerebral edema, a previously unrecognized complication, may develop in CMS patients and cause encephalopathy. Contributing factors appear to be exaggerated polycythemia and hypoxemia, and lower and sluggish CBF compared to CMS patients without cerebral edema; but what triggers this complication is unknown. Recognition and treatment of this serious complication will help reduce morbidity and mortality from CMS. PMID:28233815

  1. Shilajit: A panacea for high-altitude problems.

    Science.gov (United States)

    Meena, Harsahay; Pandey, H K; Arya, M C; Ahmed, Zakwan

    2010-01-01

    High altitude problems like hypoxia, acute mountain sickness, high altitude cerebral edema, pulmonary edema, insomnia, tiredness, lethargy, lack of appetite, body pain, dementia, and depression may occur when a person or a soldier residing in a lower altitude ascends to high-altitude areas. These problems arise due to low atmospheric pressure, severe cold, high intensity of solar radiation, high wind velocity, and very high fluctuation of day and night temperatures in these regions. These problems may escalate rapidly and may sometimes become life-threatening. Shilajit is a herbomineral drug which is pale-brown to blackish-brown, is composed of a gummy exudate that oozes from the rocks of the Himalayas in the summer months. It contains humus, organic plant materials, and fulvic acid as the main carrier molecules. It actively takes part in the transportation of nutrients into deep tissues and helps to overcome tiredness, lethargy, and chronic fatigue. Shilajit improves the ability to handle high altitudinal stresses and stimulates the immune system. Thus, Shilajit can be given as a supplement to people ascending to high-altitude areas so that it can act as a "health rejuvenator" and help to overcome high-altitude related problems.

  2. Elevated blood plasma levels of epinephrine, norepinephrine, tyrosine hydroxylase, TGFβ1, and TNFα associated with high-altitude pulmonary edema in Indian population

    Directory of Open Access Journals (Sweden)

    Pandey P

    2016-08-01

    Full Text Available Priyanka Pandey,1,2 Zahara Ali,1,2 Ghulam Mohammad,3 MA Qadar Pasha1,2 1Functional Genomics Unit, CSIR-Institute of Genomics and Integrative Biology, Delhi, 2Department of Biotechnology, Savitribai Phule Pune University, Pune, 3Department of Medicine, SNM Hospital, Ladakh, Jammu and Kashmir, India Abstract: Biomarkers are essential to unravel the locked pathophysiology of any disease. This study investigated the role of biomarkers and their interactions with each other and with the clinical parameters to study the physiology of high-altitude pulmonary edema (HAPE in HAPE-patients (HAPE-p against adapted highlanders (HLs and healthy sojourners, HAPE-controls (HAPE-c. For this, seven circulatory biomarkers, namely, epinephrine, norepinephrine, tyrosine hydroxylase, transforming growth factor beta 1, tumor necrosis factor alpha (TNFα, platelet-derived growth factor beta beta, and C-reactive protein (CRP, were measured in blood plasma of the three study groups. All the subjects were recruited at ~3,500 m, and clinical features such as arterial oxygen saturation (SaO2, body mass index, and mean arterial pressure were measured. Increased levels of epinephrine, norepinephrine, tyrosine hydroxylase, transforming growth factor-beta 1, and TNFα were observed in HAPE-p against the healthy groups, HAPE-c, and HLs (P<0.0001. CRP levels were decreased in HAPE-p against HAPE-c and HLs (P<0.0001. There was no significant difference or very marginal difference in the levels of these biomarkers in HAPE-c and HLs (P>0.01. Correlation analysis revealed a negative correlation between epinephrine and norepinephrine (P=4.6E-06 in HAPE-p and positive correlation in HAPE-c (P=0.004 and HLs (P=9.78E-07. A positive correlation was observed between TNFα and CRP (P=0.004 in HAPE-p and a negative correlation in HAPE-c (P=4.6E-06. SaO2 correlated negatively with platelet-derived growth factor beta beta (HAPE-p; P=0.05, norepinephrine (P=0.01, and TNFα (P=0.005 and

  3. 高原肺水肿的早期识别预警研究%Early warning of high altitude pulmonary edema

    Institute of Scientific and Technical Information of China (English)

    李高元; 李宗斌; 张进武; 姜俊杰; 胡安忠; 刘安恒

    2015-01-01

    Objective By analyzing the clinical symptoms, heart rate ( HR) , arterial oxygen saturation ( SaO2 ) and the number of white blood cells (WBC), we aimed to explore the implication of the above-mentioned indexes for early warning of high altitude pulmonary edema ( HAPE) .Methods Based on the Lake Louise Self-assessmeat Scoring System ( LLSS) and the scoring of respiratory symptoms, 628 subjects were divided into three groups: group A ( the healthy;score3 and excluding HAPE),and group C (HAPE).Moreover, we analyzed the incidence of some clinical symptoms, HR and SaO2 , as well as the WBC number of some subjects in the three groups.Results The incidence of respiratory symptoms and WBC number were significantly increased in group C compared with group B(P30%) have high risk of HAPE.It is of special importance to detect HAPE earlier at high altitude.%目的:通过对急性轻型高原病(急性高原反应,AMS)及高原肺水肿( HAPE)的临床症状、心率( HR)、动脉氧饱和度( SaO2)及白细胞( WBC)计数的分析,探讨上述指标对HAPE早期预警的意义。方法以628名初入昆仑山的驻训人员为研究对象,按照急性高原病路易斯湖评分系统( LLSS)和临床出现的呼吸系统症状评分的总分归入:A组(健康组,评分<3分),B组( AMS组,至少1次评分>3分,排除HAPE)、C组( HAPE组),比较各组临床症状发生情况及HR、SaO2,并对部分对象进行WBC计数分析。结果 C组呼吸系统症状发生率及WBC计数较B组明显升高(P<0.05);初入高原3 d内,A、B两组平均HR呈逐渐下降趋势,而C组平均HR却逐渐上升,且在第3天较A、B两组明显升高(F=6.37,P<0.05);C组SaO2在第1、2、3天明显低于A、B两组(F=8.21,F=8.77,F=9.58,P<0.01)。结论初入高原人群中,出现呼吸系统症状、WBC计数升高、HR无适应性下降及SaO2显著减低(>30%)者发

  4. Elevated blood plasma levels of epinephrine, norepinephrine, tyrosine hydroxylase, TGFβ1, and TNFα associated with high-altitude pulmonary edema in an Indian population

    Science.gov (United States)

    Pandey, Priyanka; Ali, Zahara; Mohammad, Ghulam; Pasha, M A Qadar

    2016-01-01

    Biomarkers are essential to unravel the locked pathophysiology of any disease. This study investigated the role of biomarkers and their interactions with each other and with the clinical parameters to study the physiology of high-altitude pulmonary edema (HAPE) in HAPE-patients (HAPE-p) against adapted highlanders (HLs) and healthy sojourners, HAPE-controls (HAPE-c). For this, seven circulatory biomarkers, namely, epinephrine, norepinephrine, tyrosine hydroxylase, transforming growth factor beta 1, tumor necrosis factor alpha (TNFα), platelet-derived growth factor beta beta, and C-reactive protein (CRP), were measured in blood plasma of the three study groups. All the subjects were recruited at ~3,500 m, and clinical features such as arterial oxygen saturation (SaO2), body mass index, and mean arterial pressure were measured. Increased levels of epinephrine, norepinephrine, tyrosine hydroxylase, transforming growth factor-beta 1, and TNFα were observed in HAPE-p against the healthy groups, HAPE-c, and HLs (P0.01). Correlation analysis revealed a negative correlation between epinephrine and norepinephrine (P=4.6E−06) in HAPE-p and positive correlation in HAPE-c (P=0.004) and HLs (P=9.78E−07). A positive correlation was observed between TNFα and CRP (P=0.004) in HAPE-p and a negative correlation in HAPE-c (P=4.6E−06). SaO2 correlated negatively with platelet-derived growth factor beta beta (HAPE-p; P=0.05), norepinephrine (P=0.01), and TNFα (P=0.005) and positively with CRP (HAPE-c; P=0.02) and norepinephrine (HLs; P=0.04). Body mass index correlated negatively with epinephrine (HAPE-p; P=0.001) and positively with norepinephrine and tyrosine hydroxylase in HAPE-c (P0.70, P<0.05). The results clearly suggest that increased plasma levels of these circulatory biomarkers associated with HAPE. PMID:27540296

  5. Glyburide in Treating Malignant Cerebral Edema. Blocking Sulfonyl Urea One (SUR1) Receptors

    OpenAIRE

    Pallan, Tony V; Ahmed, Iftekhar

    2014-01-01

    Cerebral edema is a serious side effect of malignant stroke. On average 70,000 patients are diagnosed with malignant cerebral edema every year, of those patients, approximately 60-80% results in fatalities. The treatment of cerebral edema includes multimodality approaches.

  6. Decreased light attenuation in cerebral cortex during cerebral edema detected using optical coherence tomography

    OpenAIRE

    Rodriguez, Carissa L. R.; Szu, Jenny I.; Eberle, Melissa M.; Wang, Yan; Hsu, Mike S.; Binder, Devin K.; Park, B. Hyle

    2014-01-01

    Abstract. Cerebral edema develops in response to a variety of conditions, including traumatic brain injury and stroke, and contributes to the poor prognosis associated with these injuries. This study examines the use of optical coherence tomography (OCT) for detecting cerebral edema in vivo. Three-dimensional imaging of an in vivo water intoxication model in mice was performed using a spectral-domain OCT system centered at 1300 nm. The change in attenuation coefficient was calculated and cere...

  7. 高原肺水肿发病机制及防治研究进展%Pathogenesis,prevention and treatment of high altitude pulmonary edema:research advances

    Institute of Scientific and Technical Information of China (English)

    姜艳; 王雷琛; 王剑波

    2016-01-01

    High altitude pulmonary edema is a fatal acute non-cardiogenic pulmonary edema caused by the environment of low pressure and hypoxia,when people have their fast access to the plateau (general elevation≥2500 m). It is a serious threat to human health. Pathogenesis of high altitude pulmonary edema is still not entirely clear and may be due to ventilation/perfusion imbalance, chemical receptors changes, water channel protein decreased, pulmonary microvascular changes and genes. Treatment of high altitude pulmonary edema should be mainly far away from the environment of low pressure and hypoxia as soon as possible, and comply with ox⁃ygen or take diuretics, hormones and other drugs reducing pulmonary artery pressure. This article describes the epidemiological charac⁃teristics,the studies of the pathogenesis and the methods of prevention and treatment of high-altitude pulmonary edema in order to pro⁃vide a reference for the relevant medical staff and people engaged in activities plateau.%高原肺水肿是由于快速进入高原(一般海拔≥2500 m)因缺氧而引起的非心源性肺水肿,为高原地区特发病及常见病,严重威胁人类的健康。其发病机制复杂,可能是由于通气/血流比例失调、化学感受器异常变化、水通道蛋白减少、肺微血管变化以及基因等多种因素共同作用导致的,至今仍不完全清楚。治疗高原肺水肿主要应尽快脱离低压缺氧环境,并配合吸氧或服用利尿剂、激素等能降低肺动脉压的药物,严重时要联合用药。本文介绍了高原肺水肿的流行病学特征、各种发病机制的研究以及防治高原肺水肿的手段、方法和药物,以期能对相关医务人员和从事高原活动的人群提供参考。

  8. Edema pulmonar de altura: Modelo de estudio de la fisiopatología del edema pulmonar y de la hipertensión pulmonar hipóxica en humanos High altitude pulmonary edema: An experiment of Nature to study the underlying mechanisms of hypoxic pulmonary hypertension and pulmonary edema in humans

    Directory of Open Access Journals (Sweden)

    Marcos Schwab

    2007-02-01

    Full Text Available La altura, fascinante laboratorio natural de investigación médica, provee resultados con importantes implicancias para la comprensión de enfermedades que afectan a millones de personas que viven en ella, asi como para el tratamiento de enfermedades ligadas a la hipoxemia en pacientes que viven en baja altitud. El edema pulmonar de altura (EPA es una entidad que pone en peligro la vida y que ocurre en sujetos predispuestos pero sanos. Esto permite estudiar los mecanismos subyacentes del edema pulmonar en humanos, sin la presencia de factores que presten a la confusión como enfermedades concomitantes. El EPA resulta de la conjunción de dos defectos mayores: acumulación de líquido en el espacio alveolar debido a una hipertensión pulmonar hipóxica exagerada, y alteración en la eliminación del mismo por un defecto en el transporte transepitelial alveolar de sodio. En esta revisión, describimos brevemente las características clínicas y revisaremos este novedoso concepto. Proveemos evidencia experimental de como la síntesis alterada de óxido nítrico y/o la disminución de su biodisponibilidad representan el defecto central que predispone a la vasoconstricción pulmonar hipóxica exagerada y a la acumulación de líquido en el espacio alveolar. Mostramos que la hipertensión pulmonar hipóxica exagerada, per se, no es suficiente para producir un EPA, y que una alteración en la eliminación del fluido del espacio alveolar representa un segundo mecanismo fisiopatológico importante. Finalmente, describimos cómo los nuevos aportes obtenidos de los estudios del EPA pueden ser trasladados al manejo de otros estados patológicos ligados a la hipoxemia.High altitude constitutes an exciting natural laboratory for medical research. Over the past decade, it has become clear that the results of high-altitude research may have important implications not only for the understanding of diseases in the millions of people living permanently at high

  9. Imaging of cerebral ischemic edema and neuronal death

    Energy Technology Data Exchange (ETDEWEB)

    Kummer, Ruediger von [Universitaetsklinikum Carl Gustav Carus, Institut fuer Diagnostische und Interventionelle Neuroradiologie, Dresden (Germany); Dzialowski, Imanuel [Elblandklinikum Meissen, Neurologische Rehabilitationsklinik Grossenhain, Meissen (Germany)

    2017-06-15

    In acute cerebral ischemia, the assessment of irreversible injury is crucial for treatment decisions and the patient's prognosis. There is still uncertainty how imaging can safely differentiate reversible from irreversible ischemic brain tissue in the acute phase of stroke. We have searched PubMed and Google Scholar for experimental and clinical papers describing the pathology and pathophysiology of cerebral ischemia under controlled conditions. Within the first 6 h of stroke onset, ischemic cell injury is subtle and hard to recognize under the microscope. Functional impairment is obvious, but can be induced by ischemic blood flow allowing recovery with flow restoration. The critical cerebral blood flow (CBF) threshold for irreversible injury is ∝15 ml/100 g x min. Below this threshold, ischemic brain tissue takes up water in case of any residual capillary flow (ionic edema). Because tissue water content is linearly related to X-ray attenuation, computed tomography (CT) can detect and measure ionic edema and, thus, determine ischemic brain infarction. In contrast, diffusion-weighted magnetic resonance imaging (DWI) detects cytotoxic edema that develops at higher thresholds of ischemic CBF and is thus highly sensitive for milder levels of brain ischemia, but not specific for irreversible brain tissue injury. CT and MRI are complimentary in the detection of ischemic stroke pathology and are valuable for treatment decisions. (orig.)

  10. Blood-Brain Barrier Changes in High Altitude.

    Science.gov (United States)

    Lafuente, José V; Bermudez, Garazi; Camargo-Arce, Lorena; Bulnes, Susana

    2016-01-01

    Cerebral syndromes related to high-altitude exposure are becoming more frequent as the number of trips to high altitudes has increased in the last decade. The commonest symptom is headache, followed by acute mountain sickness (AMS) and high-altitude cerebral edema (HACE), which can be fatal. The pathophysiology of these syndromes is not fully understood. The classical "tight-fit hypothesis" posits that there are some anatomical variations that would obstruct the sinovenous outflow and worsen vasogenic edema and intracranial hypertension reactive to hypoxia. This could explain microhemorrhages seen in autopsies. However, recent magnetic resonance imaging studies have demonstrated some components of cytotoxic edema in HACE absent in AMS, suggesting a dysfunction in water balance at the cellular level. Currently, the "red-ox theory" supports trigemino-vascular system activation by free radicals formed after hypoxia and the consequent oxidative stress cascades. Apart from trigemino-vascular system activation, free radicals can also provoke membrane destabilisation mediated by lipid peroxidation, inflammation, and local hypoxia inducible factor-1α and vascular endothelial growth factor activation, resulting in gross blood-brain barrier (BBB) dysfunction. Besides alterations in endothelial cells such as increased pinocytotic vesicles and disassembly of interendothelial tight junction proteins, capillary permeability may also increase with subsequent swelling of astrocyte end-feet. In conclusion, although the pathophysiology of AMS and HACE is not completely understood, recent evidence proposes a multifactorial entity, with brain swelling and compromise of the BBB considered to play an important role. A fuller comprehension of these processes is crucial to reduce and prevent BBB alterations during high-altitude exposure.

  11. [Effects of palmitic acid on activity of uncoupling proteins and proton leak in in vitro cerebral mitochondria from the rats exposed to simulated high altitude hypoxia].

    Science.gov (United States)

    Xu, Yu; Liu, Jun-Ze; Xia, Chen

    2008-02-25

    To reveal the roles of uncoupling proteins (UCPs) in disorder of mitochondrial oxidative phosphorylation induced by free fatty acid during hypoxic exposure, the effects of palmitic acid on activity of UCPs, proton leak and mitochondrial membrane potential in hypoxia-exposed rat brain mitochondria were observed in vitro. Adult Sprague-Dawley (SD) rats were set randomly into control, acute hypoxia and chronic hypoxia groups (n=8 in each group). The acute and chronic hypoxic rats were exposed to simulated 5000 m high altitude in a hypobaric chamber 23 h/d for 3 d and 30 d, respectively. The brain mitochondria were isolated by centrifugation. UCP content and activity were detected by [(3)H]-GTP binding method. The proton leak was measured by TPMP(+) electrode and oxygen electrode. The membrane potential of mitochondria was calculated by detecting the fluorescence from Rodamine 123. Hypoxic exposure resulted in an increase in UCP activity and content as well as proton leak, but a decrease in the membrane potential of rat brain mitochondria. Palmitic acid resulted in further increases in UCP activity and content as well as proton leak, and further decrease in membrane potential of brain mitochondria in vitro from hypoxia-exposed rats, but hypoxic exposure decreased the reactivity of cerebral mitochondria to palmitic acid, especially in the acute hypoxia group. There was a negative correlation between mitochondrial proton leak and K(d) value (representing derivative of UCP activity, PB(max) (representing the maximal content of UCPs in mitochondrial inner membrane, P<0.01, r = 0.856). Cerebral mitochondrial membrane potential was negatively correlated with proton leak (P<0.01, r = -0.880). It is suggested that hypoxia-induced proton leak enhancement and membrane potential decrease are correlated with the increased activity of UCPs. Hypoxia can also decrease the sensitivity of cerebral mitochondria to palmitic acid, which may be a self-protective mechanism in high altitude

  12. Cerebral Edema in Traumatic Brain Injury: Pathophysiology and Prospective Therapeutic Targets.

    Science.gov (United States)

    Winkler, Ethan A; Minter, Daniel; Yue, John K; Manley, Geoffrey T

    2016-10-01

    Traumatic brain injury is a heterogeneous disorder resulting from an external force applied to the head. The development of cerebral edema plays a central role in the evolution of injury following brain trauma and is closely associated with neurologic outcomes. Recent advances in the understanding of the molecular and cellular pathways contributing to the posttraumatic development of cerebral edema have led to the identification of multiple prospective therapeutic targets. The authors summarize the pathogenic mechanisms underlying cerebral edema and highlight the molecular pathways that may be therapeutically targeted to mitigate cerebral edema and associated sequelae following traumatic brain injury.

  13. Hipertensión y edema pulmonar de altura: Rol de la disfunción endotelial y de la programación fetal Pulmonary hypertensión and lung edema at high altitude: Role of endothelial dysfunction and fetal programming

    Directory of Open Access Journals (Sweden)

    Marcos Schwab

    2012-04-01

    Full Text Available La altura constituye un fascinante laboratorio natural para la investigación médica. Si bien al principio el objetivo de la investigación en la altura fue la comprensión de los mecanismos de adaptación del organismo a la hipoxia y la búsqueda de tratamientos para las enfermedades relacionadas con la altura, durante la última década el alcance de esta investigación se ha ampliado considerablemente. Dos importantes observaciones han generado las bases para el crecimiento del alcance científico de la investigación en la altura. Primero, el hecho de que el edema pulmonar agudo de la altura constituye un modelo único para estudiar los mecanismos fundamentales de la hipertensión pulmonar y el edema pulmonar en humanos. Segundo, que la hipoxia ambiental asociada con la exposición a la altura facilita la detección de disfunción vascular pulmonar y sistémica en un estadio precoz. Aquí revisaremos los estudios que, capitalizando estas observaciones, han llevado a la descripción de nuevos mecanismos subyacentes del edema pulmonar y de la hipertensión pulmonar, y a la primera demostración directa de la existencia de una programación fetal sobre la disfunción vascular en humanos.High altitude constitutes an exciting natural laboratory for medical research. While initially, the aim of high-altitude research was to understand the adaptation of the organism to hypoxia and find treatments for altitude-related diseases, over the past decade or so, the scope of this research has broadened considerably. Two important observations led to the foundation for the broadening of the scientific scope of high-altitude research. First, high-altitude pulmonary edema (HAPE represents a unique model which allows studying fundamental mechanisms of pulmonary hypertension and lung edema in humans. Secondly, the ambient hypoxia associated with high-altitude exposure facilitates the detection of pulmonary and systemic vascular dysfunction at an early stage

  14. AN ANALYSIS OF X-RAY PICTURES OF PULMONARY EDEMA OF HIGH ALTITUDE IN CHILDREN%小儿急性高原肺水肿56例临床X线分析

    Institute of Scientific and Technical Information of China (English)

    王代敏; 张华耀; 杨得富; 梁大利; 李华利

    2001-01-01

    A retrospective analysis was made of 56 children with a definite diagnosis of pulmonary edema,in whom x-ray films were taken before and after treatment.Four patients had been in Tibet for five months to 6 years.In 50 patients,pulmonary edema occurred 6~72 hours after they flied into Tibet.Two of them died during treatment because of delayed treatment and critical conditions.All 56 patients were of Han nationality,aged 5 months to 12 years.Childhood acute pulmonary edema accountes for 6.9% of all high altitude pulmonary edema cases.Childhood pulmonary edema had an acute onset,and it ran a fulminating course.chest films usually showed disseminating alveolar changes,and the diagnosis may be misleading.X-ray physicians should get familiar with the diagnosis to avoid a delayed diagnosis and treatment.%采用回顾法对经临床治疗且治疗前后摄取X线片诊断明确的56例小儿急性高原肺水肿进行分析。56例中有4例为进藏5个月~6年中发生迟发性高原肺水肿;50例为乘飞机进藏6~72h发生急性高原肺水肿;2例因病情危重延误治疗抢救无效死亡。56例均为汉族,年龄5个月~12岁。小儿急性高原肺水肿约占高原肺水肿的6.88%。

  15. Edema cerebral crônico na neurocisticercose

    Directory of Open Access Journals (Sweden)

    AGAPEJEV SVETLANA

    1998-01-01

    Full Text Available Neste estudo retrospectivo, relatam-se as características clínicas do edema cerebral crônico (ECCr em 34 pacientes com neurocisticercose (NCC, que apresentavam edema cerebral difuso, à tomografia computadorizada (TC, como característica comum. Todos foram tratados com dextroclorofeniramina e, 32 deles, com albendazol. O ECCr predominou no sexo feminino (73,5% na faixa etária dos 11 - 40 anos (92,3%. A cefaléia ocorreu em 94,1% dos pacientes, náuseas/vômitos em 47,1%, crises epilépticas em 41,1% e distúrbios psíquicos em 38,2%. A hiperreflexia ocorreu em 82,3% e o papiledema em 58,8% e o exame neurológico normal em 11,8%. Na TC, o edema esteve associado a calcificações em 61,8% dos casos. As pressões liquóricas foram mais elevadas (p< 0,05 antes do tratamento. Atualmente, estão assintomáticos, ou com melhora clínica, 79,4% dos pacientes (57,1% deles sem medicação. Discute-se a possibilidade do ECCr, na NCC, ser uma manifestação antigênica, sem a presença concomitante de cistos parasitários, e poder representar mais uma condição clínica associada à hipertensão intracraniana benigna.

  16. Imaging Findings Associated with Space-Occupying Edema in Patients with Large Middle Cerebral Artery Infarcts

    NARCIS (Netherlands)

    Horsch, A D|info:eu-repo/dai/nl/341748145; Dankbaar, J W|info:eu-repo/dai/nl/314079408; Stemerdink, T A; Bennink, E|info:eu-repo/dai/nl/358202906; van Seeters, T; Kappelle, L J; Hofmeijer, J; de Jong, H W; van der Graaf, Y|info:eu-repo/dai/nl/072825847; Velthuis, B K|info:eu-repo/dai/nl/176956301

    2016-01-01

    BACKGROUND AND PURPOSE: Prominent space-occupying cerebral edema is a devastating complication occurring in some but not all patients with large MCA infarcts. It is unclear why differences in the extent of edema exist. Better knowledge of factors related to prominent edema formation could aid treatm

  17. Imaging Findings Associated with Space-Occupying Edema in Patients with Large Middle Cerebral Artery Infarcts

    NARCIS (Netherlands)

    Horsch, A D; Dankbaar, J W; Stemerdink, T A; Bennink, E; van Seeters, T; Kappelle, L J; Hofmeijer, J; de Jong, H W; van der Graaf, Y; Velthuis, B K

    2016-01-01

    BACKGROUND AND PURPOSE: Prominent space-occupying cerebral edema is a devastating complication occurring in some but not all patients with large MCA infarcts. It is unclear why differences in the extent of edema exist. Better knowledge of factors related to prominent edema formation could aid treatm

  18. Necrosis de médula espinal, edema cerebral y glioblastoma

    OpenAIRE

    Iglesias Rozas, José Rafael, 1942-

    1987-01-01

    Cinco imágenes de una necrosis de la médula espinal, un edema cerebral y un glioblastoma en una paciente de 76 años. Five pictures of a spinal cord necrosis, a cerebral edema and a glioblastoma in a 76-year-old female patient.

  19. Craniotomia descompressiva bifrontal no tratamento do edema cerebral grave

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1977-06-01

    Full Text Available São apresentados os resultados obtidos com craniotomia descompressiva bifrontal ampla em 12 doentes com edema cerebral grave e irreversível com os métodos convencionais de tratamento, provocado em 10 por traumatismo crânio-encefálico. Todos os pacientes apresentavam quadro neurológico muito grave, com sinais de comprometimento do tronco cerebral superior. Angiografia caro-tídea bilateral foi praticada sistematicamente, tanto no pré como no pós-operatório, constituindo-se no fator decisivo para a indicação cirúrgica. Seis (50% dos doentes sobreviveram, apresentando 5 (41,6% recuperação neurológica e psíquica praticamente totais. Levando em conta estes resultados, consideramos esta técnica cirúrgica o melhor recurso de tratamento em tais casos, máxime se indicada precocemente. São necessários, contudo, cuidados pós-operatórios especiais com estes pacientes, que devem, sempre que possível, ser mantidos em unidade de terapia intensiva, em virtude da grande incidência de complicações, mormente respiratórias.

  20. Application of Blood-Brain Barrier Permeability Imaging in Global Cerebral Edema.

    Science.gov (United States)

    Ivanidze, J; Kallas, O N; Gupta, A; Weidman, E; Baradaran, H; Mir, D; Giambrone, A; Segal, A Z; Claassen, J; Sanelli, P C

    2016-09-01

    Blood-brain barrier permeability is not routinely evaluated in the clinical setting. Global cerebral edema occurs after SAH and is associated with BBB disruption. Detection of global cerebral edema using current imaging techniques is challenging. Our purpose was to apply blood-brain barrier permeability imaging in patients with global cerebral edema by using extended CT perfusion. Patients with SAH underwent CTP in the early phase after aneurysmal rupture (days 0-3) and were classified as having global cerebral edema or nonglobal cerebral edema using established noncontrast CT criteria. CTP data were postprocessed into blood-brain barrier permeability quantitative maps of PS (permeability surface-area product), K(trans) (volume transfer constant from blood plasma to extravascular extracellular space), Kep (washout rate constant of the contrast agent from extravascular extracellular space to intravascular space), VE (extravascular extracellular space volume per unit of tissue volume), VP (plasmatic volume per unit of tissue volume), and F (plasma flow) by using Olea Sphere software. Mean values were compared using t tests. Twenty-two patients were included in the analysis. Kep (1.32 versus 1.52, P brain barrier permeability in patients with SAH with and without global cerebral edema. Kep is an important indicator of altered blood-brain barrier permeability in patients with decreased blood flow, as Kep is flow-independent. Further study of blood-brain barrier permeability is needed to improve diagnosis and monitoring of global cerebral edema. © 2016 by American Journal of Neuroradiology.

  1. Adaptation to High Altitude

    OpenAIRE

    1984-01-01

    Hypoxia is inconsequential for physiologically fit persons below an effective altitude of 2640 metres. At higher altitudes, the adaptation is brought about by four main factors, viz., hyperventilation, increased diffusion of oxygen across alveolar membrane, erythrocythemia and maintenance of body hydration. Carbon dioxide sensitivity is markedly elevated at high altitude, both in sojourners and acclimatized low-landers. The greater pulmonary diffusing capacity observed in high altitude native...

  2. Adaptation to High Altitude

    Directory of Open Access Journals (Sweden)

    H. S. Nayar

    1984-10-01

    Full Text Available Hypoxia is inconsequential for physiologically fit persons below an effective altitude of 2640 metres. At higher altitudes, the adaptation is brought about by four main factors, viz., hyperventilation, increased diffusion of oxygen across alveolar membrane, erythrocythemia and maintenance of body hydration. Carbon dioxide sensitivity is markedly elevated at high altitude, both in sojourners and acclimatized low-landers. The greater pulmonary diffusing capacity observed in high altitude natives is well documented. RBC count, haemoglobin and haematocrit increase whereas arterial oxyhaemoglobin saturation percentage decreases at high altitude. Diuretics (Furosemide have no role in adaptation to high altitude and adequate body hydration must be maintained.The ultimate adaptive mechanisms occur at tissue level which facilitate the diffusion of oxygen from blood to tissue and its utilization. The work capacity decreases at high altitude and a relationship between load carried and speed of marching has been determined at various altitudes. Although altitude has an adverse effect on process of cold acclimatization, yet it is possible to induce cold acclimatization by exposing subjects to a temperature of 0° to -5°C for a period of three hours daily for three weeks. The caloric requirements increase at high altitudes and are 4,286 K Cal and 4,380 K Cal at 13000 feet (3950 m and 17000 feet (5170 m, respectively.

  3. Cerebral edema associated to scorpion sting: a two-case sting report

    Directory of Open Access Journals (Sweden)

    N. O. Romero

    2005-12-01

    Full Text Available Scorpionism is a public health problem in some places in Mexico. The clinical symptoms of envenomation by scorpion sting are by sympathetic and parasympathetic stimulation, developing systemic and local symptoms. The Central Nervous System (CNS is one of the organs that are affected. In some cases, cerebral edema develops. In this report we present two pediatric cases with the association of envenomation by scorpion sting and cerebral edema. The first case developed severe cerebral edema, which progressed to a fatal outcome; and the other case developed mild cerebral edema with a satisfactory evolution. The pathophysiology of this complication is not well known and probably is the consequence of hypoxia, secondary to respiratory failure, laryngospasm and seizures that are manifestations of envenomation by scorpion sting.

  4. Imaging Manifestations and Diagnostic Value in Cold, High Altitude Pulmonary Edema%高寒、高海拔地区肺水肿的影像表现及诊断价值

    Institute of Scientific and Technical Information of China (English)

    朱磊; 唐龙

    2014-01-01

    Objective To investigate the value of clinical manifestations and diagnostic analysis of cold, high altitude pulmonary edema, offer the reliable reference data for clinical diagnosis. Methods The author in Ganzi Tibetan Autonomous Prefecture, Tibet during the Seda people's hospital, the hospital from July 2012 to November 2013 were cold, high sea area in patients with pulmonary edema in 72 cases, routine X-ray examination, all patients with CT scanning and pulmonary lesions were dynamic observation; analysis of the X-ray examination and CT scan characteristics, and to explore the diagnostic value. Results The routine X-ray examination, found 35 cases of patients with pulmonary changes obviously, lesions in 37 patients were not found to change significantly; CT scan, all were edema, and pulmonary interstitial abnormalities. Conclusion Pulmonary interstitial abnormality is cold, high altitude pulmonary edema in the early stage lung disease manifestation, imaging diagnosis and diagnosis of the reliable. X-ray examination can be used as the preferred examination; chest CT scan can make early diagnosis of and as a complement to check the important means.%目的:探讨分析高寒、高海拔地区肺水肿的临床影像表现及诊断价值,为临床诊断提供可靠的参考数据。方法选取作者在甘孜藏族自治州色达县人民医院援藏期间,对该院2012年7月至2013年11月收治的高寒、高海波地区肺水肿患者72例,对所有患者进行常规X 线检查、CT 扫描并对肺部病变进行动态观察;分析其 X 线检查及 CT 扫描特点,并探讨其诊断价值。结果常规 X 线检查,发现35例患者肺部均有明显改变,37例患者肺部未发现明显改变;CT 扫描,所有患者均存在水肿,且以肺间质异常为主。结论肺间质异常为高寒、高海拔地区肺水肿早期肺部病变表现,影像检查是对其进行确诊的简捷可靠的诊断手段。X 线检查

  5. Polymorphisms of the tissue inhibitor of metalloproteinase 3 gene are associated with resistance to high-altitude pulmonary edema (HAPE in a Japanese population: a case control study using polymorphic microsatellite markers.

    Directory of Open Access Journals (Sweden)

    Nobumitsu Kobayashi

    Full Text Available INTRODUCTION: High-altitude pulmonary edema (HAPE is a hypoxia-induced, life-threatening, high permeability type of edema attributable to pulmonary capillary stress failure. Genome-wide association analysis is necessary to better understand how genetics influence the outcome of HAPE. MATERIALS AND METHODS: DNA samples were collected from 53 subjects susceptible to HAPE (HAPE-s and 67 elite Alpinists resistant to HAPE (HAPE-r. The genome scan was carried out using 400 polymorphic microsatellite markers throughout the whole genome in all subjects. In addition, six single nucleotide polymorphisms (SNPs of the gene encoding the tissue inhibitor of metalloproteinase 3 (TIMP3 were genotyped by Taqman® SNP Genotyping Assays. RESULTS: The results were analyzed using case-control comparisons. Whole genome scanning revealed that allele frequencies in nine markers were statistically different between HAPE-s and HAPE-r subjects. The SNP genotyping of the TIMP3 gene revealed that the derived allele C of rs130293 was associated with resistance to HAPE [odds ratio (OR = 0.21, P = 0.0012 and recessive inheritance of the phenotype of HAPE-s (P = 0.0012. A haplotype CAC carrying allele C of rs130293 was associated with resistance to HAPE. DISCUSSION: This genome-wide association study revealed several novel candidate genes associated with susceptibility or resistance to HAPE in a Japanese population. Among those, the minor allele C of rs130293 (C/T in the TIMP3 gene was linked to resistance to HAPE; while, the ancestral allele T was associated with susceptibility to HAPE.

  6. Clinical and neuroradiological studies of eclampsia. Cerebral vasospasm and relation to the brain edema

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Yasuhiro; Niwa, Hisayoshi; Ando, Tetsuo; Yasuda, Takeshi; Yanagi, Tsutomu [Nagoya Daini Red Cross Hospital, Aichi (Japan)

    1995-04-01

    Clinical and neuroradiological studies involving cerebral angiography were conducted in four patients with eclampsia. In three cases (case 1, 2 and 4), neurological focal signs, abnormal low density areas on cranial CT and T{sub 2} high intensity areas on cranial MRI disappeared within a month. But in one case (case 3), cerebral infarction occurred and right hemiparesis and aphasia persisted. Cerebral angiography in the acute phase demonstrated vasospasm in all cases and arterial occlusion in the middle cerebral artery due to vasospasm in case 3. Angiography demonstrated several types of spasms, including diffuse, peripheral and multi local. Furthermore, in some cases, diffuse vasospasms were recognized at the siphon and extracranial portions of the internal carotid artery. In one case (Case 4), segmental vasospasms were detected in the bilateral vertebral arteries. Three to four weeks later, follow-up cerebral angiography was performed in three cases. Cerebral vasospasms had partially or completely recovered. Subarachnoid hemorrhage (SAH) was excluded by lumbar puncture and neuroradiological findings in all cases. We concluded that eclampsia itself causes cerebral vasospasm and that the mechanism of vasospasm is different from that of SAH, since cerebral vasospasm occurred in the extracranial cerebral arteries. We suspected that cerebral vasospasm in eclampsia causes cerebral ischemia, which leads to cytotoxic edema and dysfunction of the blood-brain barrier (BBB) and cerebral autoregulation. With this background, brain edema, especially vasogenic edema, may easily occur and clinical symptoms of eclampsia may appear when the blood pressure rapidly increases. (author).

  7. Edema

    Science.gov (United States)

    ... problem worse. Edema can also be a side effect of taking certain medicines.Some health problems, such as congestive heart failure, liver disease and kidney disease, can cause edema. You cannot ...

  8. Edema

    Science.gov (United States)

    Edema means swelling caused by fluid in your body's tissues. It usually occurs in the feet, ankles ... it can involve your entire body. Causes of edema include Eating too much salt Sunburn Heart failure ...

  9. Fluid Intake Related to Brain Edema in Acute Middle Cerebral Artery Infarction.

    Science.gov (United States)

    Dharmasaroja, Pornpatr A

    2016-02-01

    Evidence of the appropriate amount of fluid intake during the first few days after acute stroke was scarce. Concerns were raised in patients with acute malignant middle cerebral infarction, who tended to have malignant brain edema later. The purpose of the study was to evaluate the effect of fluid intake on the occurrence of malignant brain edema in patients with acute middle cerebral artery infarction. Patients with acute middle cerebral artery infarction who had National Institute of Health Stroke Scale (NIHSS) score of at least 15 were included. Baseline characteristics and amount of fluid intake during the first few days were compared in patients with and without malignant brain edema. One hundred ninety-three patients were studied. Mean NIHSS score was 20. Malignant brain edema occurred in 69 patients (36%). Higher amount of fluid intake (>1650 ml or >28 ml/kg/day or >93% of daily maintenance fluid) showed a significant association with malignant brain edema (OR = 13.86, 95% CI 5.11-37.60, p value edema, 39 patients (39/65, 60%) died and only 11% (7/65 patients) had favorable outcome. High amount of fluid intake in the first few days of acute middle cerebral infarction was related to the occurrence of malignant brain edema.

  10. In vivo photoacoustic tomography of mouse cerebral edema induced by cold injury

    Science.gov (United States)

    Xu, Zhun; Zhu, Quing; Wang, Lihong V.

    2011-06-01

    For the first time, we have implemented photoacoustic tomography (PAT) to image the water content of an edema in vivo. We produced and imaged a cold-induced cerebral edema transcranially, then obtained blood vessel and water accumulation images at 610 and 975 nm, respectively. We tracked the changes at 12, 24, and 36 h after the cold injury. The blood volume decreased after the cold injury, and the maximum area of edema was observed 24 h after the cold injury. We validated PAT of the water content of the edema through magnetic Resonance Imaging and the water spectrum from the spectrophotometric measurement.

  11. Rapamycin alleviates brain edema after focal cerebral ischemia reperfusion in rats.

    Science.gov (United States)

    Guo, Wei; Feng, Guoying; Miao, Yanying; Liu, Guixiang; Xu, Chunsheng

    2014-06-01

    Brain edema is a major consequence of cerebral ischemia reperfusion. However, few effective therapeutic options are available for retarding the brain edema progression after cerebral ischemia. Recently, rapamycin has been shown to produce neuroprotective effects in rats after cerebral ischemia reperfusion. Whether rapamycin could alleviate this brain edema injury is still unclear. In this study, the rat stroke model was induced by a 1-h left transient middle cerebral artery occlusion using an intraluminal filament, followed by 48 h of reperfusion. The effects of rapamycin (250 μg/kg body weight, intraperitoneal; i.p.) on brain edema progression were evaluated. The results showed that rapamycin treatment significantly reduced the infarct volume, the water content of the brain tissue and the Evans blue extravasation through the blood-brain barrier (BBB). Rapamycin treatment could improve histological appearance of the brain tissue, increased the capillary lumen space and maintain the integrity of BBB. Rapamycin also inhibited matrix metalloproteinase 9 (MMP9) and aquaporin 4 (AQP4) expression. These data imply that rapamycin could improve brain edema progression after reperfusion injury through maintaining BBB integrity and inhibiting MMP9 and AQP4 expression. The data of this study provide a new possible approach for improving brain edema after cerebral ischemia reperfusion by administration of rapamycin.

  12. Recirculation usually precedes malignant edema in middle cerebral artery infarcts

    DEFF Research Database (Denmark)

    Nielsen, T H; Ståhl, N; Schalén, W;

    2012-01-01

    In patients with large middle cerebral artery (MCA) infarcts, maximum brain swelling leading to cerebral herniation and death usually occurs 2-5 days after onset of stroke. The study aimed at exploring the pattern of compounds related to cerebral energy metabolism in infarcted brain tissue....

  13. A study on correlation of obstructive sleep apnea-hypopnea syndrome and perihematoma edema of hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    高晓刚

    2013-01-01

    Objective To analyse the correlation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and perihematoma edema of hypertensive cerebral hemorrhage.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage were collected and 78 of

  14. Ear - blocked at high altitudes

    Science.gov (United States)

    High altitudes and blocked ears; Flying and blocked ears; Eustachian tube dysfunction - high altitude ... eustachian tube is a connection between the middle ear (the space deep to the eardrum) and the ...

  15. Life-threatening Cerebral Edema Caused by Acute Occlusion of a Superior Vena Cava Stent

    Energy Technology Data Exchange (ETDEWEB)

    Sofue, Keitaro, E-mail: keitarosofue@yahoo.co.jp; Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp; Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Sugimura, Kazuro, E-mail: sugimura@med.kobe-u.ac.jp [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)

    2013-02-15

    A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required.

  16. Edema

    Science.gov (United States)

    ... one position for too long Eating too much salty food Premenstrual signs and symptoms Pregnancy Edema can ... Do you restrict your intake of salt and salty foods? Do you drink alcohol? Do you seem ...

  17. Using NIR spatial illumination for detection and mapping chromophore changes during cerebral edema

    Science.gov (United States)

    Abookasis, David; Mathews, Marlon S.; Owen, Christopher M.; Binder, Devin K.; Linskey, Mark E.; Frostig, Ron D.; Tromberg, Bruce J.

    2008-02-01

    We used spatially modulated near-infrared (NIR) light to detect and map chromophore changes during cerebral edema in the rat neocortex. Cerebral edema was induced by intraperitoneal injections of free water (35% of body weight). Intracranial pressure (ICP) was measured with an optical fiber based Fabry-Perot interferometer sensor inserted into the parenchyma of the right frontal lobe during water administration. Increase in ICP from a baseline value of 10 cm-water to 145 cm-water was observed. Following induction of cerebral edema, there was a 26+/-1.7% increase in tissue concentration of deoxyhemoglobin and a 47+/-4.7%, 17+/-3% and 37+/-3.7% decrease in oxyhemoglobin, total hemoglobin concentration and cerebral tissue oxygen saturation levels, respectively. To the best of our knowledge, this is the first report describing the use of NIR spatial modulation of light for detecting and mapping changes in tissue concentrations of physiologic chromophores over time in response to cerebral edema.

  18. Imaging Findings of a Survivor of Avalanche without Any Life Support at Very High Altitude and Extreme Low Temperatures

    Directory of Open Access Journals (Sweden)

    Abhishek Dwivedi

    2016-10-01

    Full Text Available Survival at high altitude is very challenging and in spite of adequate training and acclimatization, injuries are frequent. The fate of mountaineers and soldiers at such areas largely depends on the mercy of the climate. An avalanche causes physical trauma, cold injury and asphyxia to the victim. The patient in our report had diffuse cerebral edema, bilateral pulmonary consolidation and pneumothorax. In spite of the best efforts the victim succumbed to the injuries. There are many incidents of high altitude accidents in India. This case report is of a soldier deployed at the high altitude, is a lone ever reported survivor above 5000 meters, under 35 feet snow and below - 45°C for greater than 5 days of exposure to an avalanche

  19. Telmisartan reduced cerebral edema by inhibiting NLRP3 inflammasome in mice with cold brain injury.

    Science.gov (United States)

    Wei, Xin; Hu, Chen-Chen; Zhang, Ya-Li; Yao, Shang-Long; Mao, Wei-Ke

    2016-08-01

    The aim of this study was to investigate the possible beneficial role of telmisartan in cerebral edema after traumatic brain injury (TBI) and the potential mechanisms related to the nucleotide-binding oligomerization domain (NOD)-like receptor (NLR) pyrin domain-containing 3 (NLRP3) inflammasome activation. TBI model was established by cold-induced brain injury. Male C57BL/6 mice were randomly assigned into 3, 6, 12, 24, 48 and 72 h survival groups to investigate cerebral edema development with time and received 0, 5, 10, 20 and 40 mg/kg telmisartan by oral gavage, 1 h prior to TBI to determine the efficient anti-edemic dose. The therapeutic window was identified by post-treating 30 min, 1 h, 2 h and 4 h after TBI. Blood-brain barrier (BBB) integrity, the neurological function and histological injury were assessed, at the same time, the mRNA and protein expression levels of NLRP3 inflammasome, IL-1β and IL-18 concentrations in peri-contused brain tissue were measured 24 h post TBI. The results showed that the traumatic cerebral edema occurred from 6 h, reached the peak at 24 h and recovered to the baseline 72 h after TBI. A single oral dose of 5, 10 and 20 mg/kg telmisartan could reduce cerebral edema. Post-treatment up to 2 h effectively limited the edema development. Furthermore, prophylactic administration of telmisartan markedly inhibited BBB impairment, NLRP3, apoptotic speck-containing protein (ASC) and Caspase-1 activation, as well as IL-1β and IL-18 maturation, subsequently improved the neurological outcomes. In conclusion, telmisartan can reduce traumatic cerebral edema by inhibiting the NLRP3 inflammasome-regulated IL-1β and IL-18 accumulation.

  20. Imaging experimental cerebral malaria in vivo: significant role of ischemic brain edema.

    Science.gov (United States)

    Penet, Marie-France; Viola, Angèle; Confort-Gouny, Sylviane; Le Fur, Yann; Duhamel, Guillaume; Kober, Frank; Ibarrola, Danielle; Izquierdo, Marguerite; Coltel, Nicolas; Gharib, Bouchra; Grau, Georges E; Cozzone, Patrick J

    2005-08-10

    The first in vivo magnetic resonance study of experimental cerebral malaria is presented. Cerebral involvement is a lethal complication of malaria. To explore the brain of susceptible mice infected with Plasmodium berghei ANKA, multimodal magnetic resonance techniques were applied (imaging, diffusion, perfusion, angiography, spectroscopy). They reveal vascular damage including blood-brain barrier disruption and hemorrhages attributable to inflammatory processes. We provide the first in vivo demonstration for blood-brain barrier breakdown in cerebral malaria. Major edema formation as well as reduced brain perfusion was detected and is accompanied by an ischemic metabolic profile with reduction of high-energy phosphates and elevated brain lactate. In addition, angiography supplies compelling evidence for major hemodynamics dysfunction. Actually, edema further worsens ischemia by compressing cerebral arteries, which subsequently leads to a collapse of the blood flow that ultimately represents the cause of death. These findings demonstrate the coexistence of inflammatory and ischemic lesions and prove the preponderant role of edema in the fatal outcome of experimental cerebral malaria. They improve our understanding of the pathogenesis of cerebral malaria and may provide the necessary noninvasive surrogate markers for quantitative monitoring of treatment.

  1. High altitude pulmonary oedema (HAPE) in an Indian pilgrim.

    Science.gov (United States)

    Panthi, Sagar; Basnyat, Buddha

    2013-11-01

    Increasing number of Hindu pilgrims visit the Himalayas where some of them suffer from high altitude illness including the life threatening forms, high altitude pulmonary oedema (HAPE) and high altitude cerebral oedema. Compared to tourists and trekkers, pilgrims are usually ignorant about altitude illness. This is a case of a pilgrim who suffered from HAPE on his trip to Kailash-Mansarovar and is brought to a tertiary level hospital in Kathmandu. This report emphasises on how to treat a patient with HAPE, a disease which is increasingly being seen in the high altitude pilgrim population.

  2. Low Incidence of Early Postoperative Cerebral Edema After Coronary Artery Bypass Grafting

    NARCIS (Netherlands)

    Ottens, Thomas H.; Hendrikse, J; Slooter, Arjen J. C.; van Herwerden, LA; Dieleman, Stefan; van Dijk, Diederik

    2015-01-01

    Objective: Using magnetic resonance imaging, the authors studied the influence of a single high dose of intraoperative dexamethasone on the severity of cerebral edema that can occur early after coronary artery bypass grafting (CABG). It was hypothesized that high-dose intraoperative dexamethasone re

  3. The brain in acute liver failure. A tortuous path from hyperammonemia to cerebral edema

    DEFF Research Database (Denmark)

    Bjerring, Peter Nissen; Eefsen, Martin; Hansen, Bent Adel

    2008-01-01

    Acute liver failure (ALF) is a condition with an unfavourable prognosis. Multiorgan failure and circulatory collapse are frequent causes of death, but cerebral edema and intracranial hypertension (ICH) are also common complications with a high risk of fatal outcome. The underlying pathogenesis has...

  4. Dexamethasone exacerbates cerebral edema and brain injury following lithium-pilocarpine induced status epilepticus.

    Science.gov (United States)

    Duffy, B A; Chun, K P; Ma, D; Lythgoe, M F; Scott, R C

    2014-03-01

    Anti-inflammatory therapies are the current most plausible drug candidates for anti-epileptogenesis and neuroprotection following prolonged seizures. Given that vasogenic edema is widely considered to be detrimental for outcome following status epilepticus, the anti-inflammatory agent dexamethasone is sometimes used in clinic for alleviating cerebral edema. In this study we perform longitudinal magnetic resonance imaging in order to assess the contribution of dexamethasone on cerebral edema and subsequent neuroprotection following status epilepticus. Lithium-pilocarpine was used to induce status epilepticus in rats. Following status epilepticus, rats were either post-treated with saline or with dexamethasone sodium phosphate (10mg/kg or 2mg/kg). Brain edema was assessed by means of magnetic resonance imaging (T2 relaxometry) and hippocampal volumetry was used as a marker of neuronal injury. T2 relaxometry was performed prior to, 48 h and 96 h following status epilepticus. Volume measurements were performed between 18 and 21 days after status epilepticus. Unexpectedly, cerebral edema was worse in rats that were treated with dexamethasone compared to controls. Furthermore, dexamethasone treated rats had lower hippocampal volumes compared to controls 3 weeks after the initial insult. The T2 measurements at 2 days and 4 days in the hippocampus correlated with hippocampal volumes at 3 weeks. Finally, the mortality rate in the first week following status epilepticus increased from 14% in untreated rats to 33% and 46% in rats treated with 2mg/kg and 10mg/kg dexamethasone respectively. These findings suggest that dexamethasone can exacerbate the acute cerebral edema and brain injury associated with status epilepticus.

  5. Cerebral Taurine Levels are Associated with Brain Edema and Delayed Cerebral Infarction in Patients with Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Kofler, Mario; Schiefecker, Alois; Ferger, Boris; Beer, Ronny; Sohm, Florian; Broessner, Gregor; Hackl, Werner; Rhomberg, Paul; Lackner, Peter; Pfausler, Bettina; Thomé, Claudius; Schmutzhard, Erich; Helbok, Raimund

    2015-12-01

    Cerebral edema and delayed cerebral infarction (DCI) are common complications after aneurysmal subarachnoid hemorrhage (aSAH) and associated with poor functional outcome. Experimental data suggest that the amino acid taurine is released into the brain extracellular space secondary to cytotoxic edema and brain tissue hypoxia, and therefore may serve as a biomarker for secondary brain injury after aSAH. On the other hand, neuroprotective mechanisms of taurine treatment have been described in the experimental setting. We analyzed cerebral taurine levels using high-performance liquid chromatography in the brain extracellular fluid of 25 consecutive aSAH patients with multimodal neuromonitoring including cerebral microdialysis (CMD). Patient characteristics and clinical course were prospectively recorded. Associations with CMD-taurine levels were analyzed using generalized estimating equations with an autoregressive process to handle repeated observations within subjects. CMD-taurine levels were highest in the first days after aSAH (11.2 ± 3.2 µM/l) and significantly decreased over time (p taurine levels compared to those without (Wald = 7.3, df = 1, p taurine supplementation and brain extracellular taurine (p = 0.6). Moreover, a significant correlation with brain extracellular glutamate (r = 0.82, p taurine levels were found in patients with brain edema or DCI after aneurysmal subarachnoid hemorrhage. Its value as a potential biomarker deserves further investigation.

  6. Energy at high altitude.

    Science.gov (United States)

    Hill, N E; Stacey, M J; Woods, D R

    2011-03-01

    For the military doctor, an understanding of the metabolic effects of high altitude (HA) exposure is highly relevant. This review examines the acute metabolic challenge and subsequent changes in nutritional homeostasis that occur when troops deploy rapidly to HA. Key factors that impact on metabolism include the hypoxic-hypobaric environment, physical exercise and diet. Expected metabolic changes include augmentation of basal metabolic rate (BMR), decreased availability of oxygen in peripheral metabolic tissues, reduction in VO2 max, increased glucose dependency and lactate accumulation during exercise. The metabolic demands of exercise at HA are crucial. Equivalent activity requires greater effort and more energy than it does at sea level. Soldiers working at HA show high energy expenditure and this may exceed energy intake significantly. Energy intake at HA is affected adversely by reduced availability, reduced appetite and changes in endocrine parameters. Energy imbalance and loss of body water result in weight loss, which is extremely common at HA. Loss of fat predominates over loss of fat-free mass. This state resembles starvation and the preferential primary fuel source shifts from carbohydrate towards fat, reducing performance efficiency. However, these adverse effects can be mitigated by increasing energy intake in association with a high carbohydrate ration. Commanders must ensure that individuals are motivated, educated, strongly encouraged and empowered to meet their energy needs in order to maximise mission-effectiveness.

  7. 高原肺水肿的发病机制炎症并非致病因素%Pathogenesis of High-Altitude Pulmonary Edema Inflammation Is Not an Etiologic Factor

    Institute of Scientific and Technical Information of China (English)

    Erik R. Swenson; Marco Maggiorini; Stephen Mongovin

    2003-01-01

    背景:一般认为高原肺水肿(high-altitude pulmonary edema,HAPE)的发生为肺泡-毛细血管屏障通透性改变所致,后者继发于强烈的肺血管收缩和高毛细血管压,但是既往在明确诊断的HAPE,支气管肺泡灌洗(bronchoalveolarlavage,BAL)所见亦与炎性致病特征相一致.目的:确定炎症是否为HAPE的主要病变,并明确HEPA病变的时间顺序.设计、地点和参试者:1999年7月~8月进行的病例研究.10例为HAPE易感者,6例为HAPE抵抗者.16例均为非职业登山运动员,既往登山高度在3 000 m以上.主要观察指标:在低海拔高度(490 m)和4 559 m海拔高度,HAPE发病时或发病前不久的肺动脉压测定值和支气管肺泡灌洗所见.结果:与HAPE抵抗者相比,HAPE易感者于4 559 m高度时的肺动脉收缩压平均值(SD)更高(37 mm Hg比66 mm Hg;P=0.004).尽管大多数HAPE易感者都会发生HAPE,但是支气管肺泡灌洗液的白细胞总计数在HAPE抵抗者与易感者无差异,在低海拔与高海拔处进行计数也无差异.发生HAPE者的支气管肺泡灌洗液的血浆源性蛋白质浓度和红细胞增加,但是血浆中表面活性蛋白A和Clara细胞蛋白的浓度无增加.3例HAPE易感者在行支气管肺泡灌洗之前即发生了HAPE,其X线胸片评分为12.7;这3例病例在3~5小时内进行了灌洗.HAPE易感组的其余参试者在X线胸片出现明显水肿之前进行了灌洗.然而,HAPE易感组中6例参试者在随后一天发生了HAPE,其支气管镜检评分为1.5,该评分又增加到4.6,说明出现了轻度肺水肿.在HAPE病例,各种前炎症细胞因子和二十烷类(eicosanoid)以及一氧化氮代谢产物均无增加.结论:早期HAPE的特征表现为肺动脉压升高,它导致富含蛋白质并有轻度出血的水肿,但是白细胞、细胞因子和二十烷类水平正常.HAPE是一种流体静力学肺水肿,伴有肺泡-毛细血管通透性的改变.

  8. Brain Food at High Altitude.

    Science.gov (United States)

    Jain, Vishal

    2016-01-01

    Scenic view at high altitude is a pleasure to the eyes, but it has some shortcoming effects as well. High altitude can be divided into different categories, i.e., high altitude (3000-5000 ft), very high altitude (5000-8000 ft), and extreme altitude (above 8000 ft). Much of the population resides at high altitude, and others go there for tourism. Military personnel are also posted there to defend boundaries. As we ascent to high altitude, partial pressure of oxygen reduces, whereas concentration remains the same; this reduces the availability of oxygen to different body parts. This pathophysiological condition is known as hypobaric hypoxia (HH) which leads to oxidative stress and further causes cognitive dysfunction in some cases. Hypoxia causes neurodegeneration in different brain regions; however, the hippocampus is found to be more prone in comparison to other brain regions. As the hippocampus is affected most, therefore, spatial memory is impaired most during such condition. This chapter will give a brief review of the damaging effect of high altitude on cognition and also throw light on possible herbal interventions at high altitude, which can improve cognitive performance as well as provide protection against the deteriorating effect of hypobaric hypoxia at high altitude.

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

    Science.gov (United States)

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

    2015-01-21

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

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

    Science.gov (United States)

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

    2015-07-01

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

  11. Effect of propofol post-treatment on blood-brain barrier integrity and cerebral edema after transient cerebral ischemia in rats.

    Science.gov (United States)

    Lee, Jae Hoon; Cui, Hui Song; Shin, Seo Kyung; Kim, Jeong Min; Kim, So Yeon; Lee, Jong Eun; Koo, Bon-Nyeo

    2013-11-01

    Although propofol has been reported to offer neuroprotection against cerebral ischemia injury, its impact on cerebral edema following ischemia is not clear. The objective of this investigation is to evaluate the effects of propofol post-treatment on blood-brain barrier (BBB) integrity and cerebral edema after transient cerebral ischemia and its mechanism of action, focusing on modulation of aquaporins (AQPs), matrix metalloproteinases (MMPs), and hypoxia inducible factor (HIF)-1α. Cerebral ischemia was induced in male Sprague-Dawley rats (n = 78) by occlusion of the right middle cerebral artery for 1 h. For post-treatment with propofol, 1 mg kg(-1) min(-1) of propofol was administered for 1 h from the start of reperfusion. Nineteen rats undergoing sham surgery were also included in the investigation. Edema and BBB integrity were assessed by quantification of cerebral water content and extravasation of Evans blue, respectively, following 24 h of reperfusion. In addition, the expression of AQP-1, AQP-4, MMP-2, and MMP-9 was determined 24 h after reperfusion and the expression of HIF-1α was determined 8 h after reperfusion. Propofol post-treatment significantly reduced cerebral edema (P cerebral edema after transient cerebral ischemia, in association with reduced expression of AQP-1, AQP-4, MMP-2, and MMP-9. The decreased expression of AQPs and MMPs after propofol post-treatment might result from suppression of HIF-1α expression.

  12. Cardiovascular physiology at high altitude.

    Science.gov (United States)

    Hooper, T; Mellor, A

    2011-03-01

    The role of the cardiovascular system is to deliver oxygenated blood to the tissues and remove metabolic effluent. It is clear that this complex system will have to adapt to maintain oxygen deliver in the profound hypoxia of high altitude. The literature on the adaptation of both the systemic and pulmonary circulations to high altitude is reviewed.

  13. Effect of Maixuekang enteric coated tablets on absorption of hematoma and treatment of acute cerebral hemorrhage patients with cerebral edema

    Institute of Scientific and Technical Information of China (English)

    Bing-Ding Lu; Chuan Wang

    2016-01-01

    Objective:To study the clinical efficacy of Maixuekang in treating acute cerebral hemorrhage hematomas and promoting brain hemorrhage.Methods: A total of 192 patients with acute intracerebral hemorrhage treated within 3 hours in our hospital during April 2013 to February 2015 were selected. After admission immediately apply brain CT, blood, coagulation function tests were carried out. They were randomly divided into 2 groups. Both groups had anti-infective, mannitol and other conventional treatment. Observation group were treated with enteric-coated tablets Maixuekang on this basis. Clinical efficacy, various stages of treatment of cerebral hematoma volume, brain edema volume, NIHSS score were compared.Results: Before treatment, difference in edema volume and HIHSS scores were not statistically significant (P>0.05). After14 d and 28 d treatment, edema volume of observation group were significantly smaller than those of control group (P<0.01); NIHSS score of observation group were significantly lower than those of control group (P<0.01); 28 d after treatment total effective rate of observation group was significantly higher than that of the control group (P<0.01).Conclusions:Maixuekang enteric-coated tablets as a thrombin inhibitor, can effectively reduce a series of pathological changes after acute cerebral hemorrhage caused by partial thrombin content, promote absorption of hematoma and neurological recovery. The side effects is small, safe and worthy of promotion.

  14. Primary report of noninvasive impedance monitoring of cerebral hematoma and edema in patients with intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Xia Yi Lu; Dong Wei-Wei; Yang Hao; Long Men; Yang Hua

    2000-01-01

    Background and Objective Brain edema is one of the most important clinical process in many diseases. Tissue impedance monitoring offers a non-invasive, bedside, rapid, and reliable technique for the monitoring of the brain edema. Methods We use a bioelectrical impedance(BEI) monitoring unit to record the brain impedance in the healthy volunteer and the patients with intracerebral hemorrhage. Percent of BEI variations were calculation. Results and Conclusions Brain BEI haven f any difference between both hemispheres in normal ones. In 48hrs, BEI value at hematoma-side was obviously decreased; after 48hrs, BEI value was obviously increased and continue to tenth day. Brain bioelectrical impedance monitoring, particularly noninvasively, is a first time in this field. The primary results show brain BEI could reflect the evolution of cerebral hematoma and edema.

  15. Characterization and quantification of cerebral edema induced by synchrotron x-ray microbeam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Serduc, Raphael; Looij, Yohan van de; Francony, Gilles; Verdonck, Olivier; Sanden, Boudewijn van der; Farion, Regine; Segebarth, Christoph; Remy, Chantal; Lahrech, Hana [INSERM, U836, F-38043 Grenoble (France); Laissue, Jean [Institute of Pathology, University of Bern (Switzerland); Braeuer-Krisch, Elke; Siegbahn, Erik Albert; Bravin, Alberto; Prezado, Yolanda [European Synchrotron Radiation Facility, F-38043 Grenoble (France)], E-mail: serduc@esrf.fr

    2008-03-07

    Cerebral edema is one of the main acute complications arising after irradiation of brain tumors. Microbeam radiation therapy (MRT), an innovative experimental radiotherapy technique using spatially fractionated synchrotron x-rays, has been shown to spare radiosensitive tissues such as mammal brains. The aim of this study was to determine if cerebral edema occurs after MRT using diffusion-weighted MRI and microgravimetry. Prone Swiss nude mice's heads were positioned horizontally in the synchrotron x-ray beam and the upper part of the left hemisphere was irradiated in the antero-posterior direction by an array of 18 planar microbeams (25 mm wide, on-center spacing 211 mm, height 4 mm, entrance dose 312 Gy or 1000 Gy). An apparent diffusion coefficient (ADC) was measured at 7 T 1, 7, 14, 21 and 28 days after irradiation. Eventually, the cerebral water content (CWC) was determined by microgravimetry. The ADC and CWC in the irradiated (312 Gy or 1000 Gy) and in the contralateral non-irradiated hemispheres were not significantly different at all measurement times, with two exceptions: (1) a 9% ADC decrease (p < 0.05) was observed in the irradiated cortex 1 day after exposure to 312 Gy, (2) a 0.7% increase (p < 0.05) in the CWC was measured in the irradiated hemispheres 1 day after exposure to 1000 Gy. The results demonstrate the presence of a minor and transient cellular edema (ADC decrease) at 1 day after a 312 Gy exposure, without a significant CWC increase. One day after a 1000 Gy exposure, the CWC increased, while the ADC remained unchanged and may reflect the simultaneous presence of cellular and vasogenic edema. Both types of edema disappear within a week after microbeam exposure which may confirm the normal tissue sparing effect of MRT. For more information on this article, see medicalphysicsweb.org.

  16. Acute cerebral and pulmonary edema induced by hemodialysis in a dog model

    Institute of Scientific and Technical Information of China (English)

    SHI Zhen-wei; WANG Zhi-gang

    2008-01-01

    Background The dialysis disequilibrium syndrome is characterized by neurologic deterioration and cerebral edema which occurs after hemodialysis. The purpose of this study was to investigate the pathogenesis of acute cerebral and pulmonary edema induced by hemodialysis.Methods We evaluated the effects of hemodialysis on the biochemical and hemodynamic parameters of the plasma and cerebrospinal fluid, including the intracranial pressure, dry/wet ratio, and pulmonary edema index, and we also examined the pathological changes of the brain and lung tissue in dogs suffering from uremia.Results Seventy-two hours after bilateral ureteral ligation, 10 uremic dogs were hemodialyzed for 2 hours, yielding a 73.6% and 60.1% decrease in the plasma urea and creatinine, respectively, a decrease in the plasma osmolality from (359±18) mOsm/kgH2O to (304±6) mOsm/kgH2O (P <0.01 ), a decrease in the dry/wet ratio of the lung and brain tissue,and an increase in the hemodynamic parameters (right atrial pressure, right ventricular pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, and central venous pressure), intracranial pressure, total pulmonary resistance index, and pulmonary edema index. Moreover, the pathological examination revealed lung and brain edema in the dialyzed dogs. This group was compared to 3 control groups: 6 uremic dogs which were sham dialyzed without dialysate so that no fall in the plasma urea occurred, and 12 uremic and 12 nonuremic animals that were not dialyzed.However, the parameters mentioned above were not significantly changed among these 3 control groups.Conclusions The acute brain and lung edema in our model appeared to be primarily due to a large osmotic gradient between the plasma and the brain and lung. This is the "urea reverse effect" which promoted the osmotically-induced lung and brain swelling.

  17. Blockage of transient receptor potential vanilloid 4 inhibits brain edema in middle cerebral artery occlusion mice.

    Science.gov (United States)

    Jie, Pinghui; Tian, Yujing; Hong, Zhiwen; Li, Lin; Zhou, Libin; Chen, Lei; Chen, Ling

    2015-01-01

    Brain edema is an important pathological process during stroke. Activation of transient receptor potential vanilloid 4 (TRPV4) causes an up-regulation of matrix metalloproteinases (MMPs) in lung tissue. MMP can digest the endothelial basal lamina to destroy blood brain barrier, leading to vasogenic brain edema. Herein, we tested whether TRPV4-blockage could inhibit brain edema through inhibiting MMPs in middle cerebral artery occlusion (MCAO) mice. We found that the brain water content and Evans blue extravasation at 48 h post-MCAO were reduced by a TRPV4 antagonist HC-067047. The increased MMP-2/9 protein expression in hippocampi of MCAO mice was attenuated by HC-067046, but only the increased MMP-9 activity was blocked by HC-067047. The loss of zonula occludens-1 (ZO-1) and occludin protein in MCAO mice was also attenuated by HC-067047. Moreover, MMP-2/9 protein expression increased in mice treated with a TRPV4 agonist GSK1016790A, but only MMP-9 activity was increased by GSK1016790A. Finally, ZO-1 and occludin protein expression was decreased by GSK1016790A, which was reversed by an MMP-9 inhibitor. We conclude that blockage of TRPV4 may inhibit brain edema in cerebral ischemia through inhibiting MMP-9 activation and the loss of tight junction protein.

  18. Dimethyl fumarate attenuates cerebral edema formation by protecting the blood-brain barrier integrity.

    Science.gov (United States)

    Kunze, Reiner; Urrutia, Andrés; Hoffmann, Angelika; Liu, Hui; Helluy, Xavier; Pham, Mirko; Reischl, Stefan; Korff, Thomas; Marti, Hugo H

    2015-04-01

    Brain edema is a hallmark of various neuropathologies, but the underlying mechanisms are poorly understood. We aim to characterize how tissue hypoxia, together with oxidative stress and inflammation, leads to capillary dysfunction and breakdown of the blood-brain barrier (BBB). In a mouse stroke model we show that systemic treatment with dimethyl fumarate (DMF), an antioxidant drug clinically used for psoriasis and multiple sclerosis, significantly prevented edema formation in vivo. Indeed, DMF stabilized the BBB by preventing disruption of interendothelial tight junctions and gap formation, and decreased matrix metalloproteinase activity in brain tissue. In vitro, DMF directly sustained endothelial tight junctions, inhibited inflammatory cytokine expression, and attenuated leukocyte transmigration. We also demonstrate that these effects are mediated via activation of the redox sensitive transcription factor NF-E2 related factor 2 (Nrf2). DMF activated the Nrf2 pathway as shown by up-regulation of several Nrf2 target genes in the brain in vivo, as well as in cerebral endothelial cells and astrocytes in vitro, where DMF also increased protein abundance of nuclear Nrf2. Finally, Nrf2 knockdown in endothelial cells aggravated subcellular delocalization of tight junction proteins during ischemic conditions, and attenuated the protective effect exerted by DMF. Overall, our data suggest that DMF protects from cerebral edema formation during ischemic stroke by targeting interendothelial junctions in an Nrf2-dependent manner, and provide the basis for a completely new approach to treat brain edema.

  19. Reduction of cerebral edema after traumatic brain injury using an osmotic transport device.

    Science.gov (United States)

    McBride, Devin W; Szu, Jenny I; Hale, Chris; Hsu, Mike S; Rodgers, Victor G J; Binder, Devin K

    2014-12-01

    Traumatic brain injury (TBI) is significant, from a public health standpoint, because it is a major cause of the morbidity and mortality of young people. Cerebral edema after a TBI, if untreated, can lead to devastating damage of the remaining tissue. The current therapies of severe TBI (sTBI), as outlined by the Brain Trauma Foundation, are often ineffective, thus a new method for the treatment of sTBI is necessary. Herein, the reduction of cerebral edema, after TBI, using an osmotic transport device (OTD) was evaluated. Controlled cortical impact (CCI) was performed on adult female CD-1 mice, and cerebral edema was allowed to form for 3 h, followed by 2 h of treatment. The treatment groups were craniectomy only, craniectomy with a hydrogel, OTD without bovine serum albumin (BSA), and OTD. After CCI, brain water content was significantly higher for animals treated with a craniectomy only, craniectomy with a hydrogel, and OTD without BSA, compared to that of control animals. However, when TBI animals were treated with an OTD, brain water content was not significantly higher than that of controls. Further, brain water content of TBI animals treated with an OTD was significantly reduced, compared to that of untreated TBI animals, TBI animals treated with a craniectomy and a hydrogel, and TBI animals treated with an OTD without BSA. Here, we demonstrate the successful reduction of cerebral edema, as determined by brain water content, after TBI using an OTD. These results demonstrate proof of principle for direct water extraction from edematous brain tissue by direct osmotherapy using an OTD.

  20. Collaboration in the presence of cerebral edema: The complications of steroids

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    Camille Schwarzrock

    2016-01-01

    Conclusions: More high-quality, well-controlled studies are needed around dexamethasone dosing for the management of cerebral edema. Clinical practice guidelines need to encompass both the prescriber and nursing-based interventions. Collaboration between disciplines is a necessity when monitoring and managing steroid-induced toxicities in brain tumor patients. Future evidence-based guidelines need recommendations for appropriate interval screening tests and quantifiable tools needed to aid in monitoring steroid-induced complications.

  1. Effects of the mitochondrial calcium uniporter on cerebral edema in a rat model of cerebral ischemia reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Linlin Li; Shilei Wang; Haihong Luan

    2011-01-01

    The present study investigated the effects of the mitochondrial calcium uniporter inhibitor ruthenium red and the agonist spermine on cerebral edema in rats with cerebral ischemia reperfusion injury.Left middle cerebral artery occlusion (MCAO) was induced in rats using the suture method.Following 24 hours of ischemic reperfusion, neurological function scores of rats with MCAO, and rats pretreated with ruthenium red and spermine were significantly lower, however, water content of brain tissue, aquaporin 4 expression and immunoglobulin G (IgG) exudation were significantly higher than those of sham-operated rats.Compared with MCAO rats and spermine-treated rats, neurological function scores were considerably higher, and brain tissue water content, aquaporin 4 expression and IgG exudation decreased in ruthenium red-treated rats.These findings suggest that preventive application of the mitochondrial calcium uniporter inhibitor ruthenium red can significantly decrease aquaporin 4 and IgG expression, influence the permeability of the blood brain barrier, and thereby decrease the extent of cerebral edema.

  2. Severe cerebral edema following nivolumab treatment for pediatric glioblastoma: case report.

    Science.gov (United States)

    Zhu, Xiao; McDowell, Michael M; Newman, William C; Mason, Gary E; Greene, Stephanie; Tamber, Mandeep S

    2017-02-01

    Nivolumab is an immune checkpoint inhibitor (ICI) currently undergoing Phase III clinical trials for the treatment of glioblastoma. The authors present the case of a 10-year-old girl with glioblastoma treated with nivolumab under compassionate-use guidelines. After the first dose of nivolumab the patient developed hemiparesis, cerebral edema, and significant midline shift due to severe tumor necrosis. She was managed using intravenous dexamethasone and discharged on a dexamethasone taper. The patient's condition rapidly deteriorated after the second dose of nivolumab, demonstrating hemiplegia, seizures, and eventually unresponsiveness with a fixed and dilated left pupil. Computed tomography of her brain revealed malignant cerebral edema requiring emergency decompressive hemicraniectomy. Repeat imaging demonstrated increased size of the lesion, reflecting immune-mediated inflammation and tumor necrosis. The patient remained densely hemiplegic, but became progressively more interactive and was ultimately extubated. She resumed nivolumab several weeks later, but again her condition deteriorated with headache, vomiting, swelling at the craniectomy site, and limited right-sided facial movement following the sixth dose. MRI demonstrated severe midline shift and uncal herniation despite her craniectomy. Her condition gradually declined, and she died several days later under "do not resuscitate/do not intubate" orders. To the authors' knowledge, this represents the first case of malignant cerebral edema requiring operative intervention following nivolumab treatment for glioblastoma in a pediatric patient.

  3. Ischemic Postconditioning Alleviates Brain Edema After Focal Cerebral Ischemia Reperfusion in Rats Through Down-Regulation of Aquaporin-4.

    Science.gov (United States)

    Han, Dong; Sun, Miao; He, Ping-Ping; Wen, Lu-Lu; Zhang, Hong; Feng, Juan

    2015-07-01

    Cerebral edema is a serious complication associated with cerebral ischemia/reperfusion (I/R). Aquaporin-4 (AQP4) plays a role in generating postischemic edema after reperfusion. Recently, ischemic postconditioning (Postcond) has been shown to produce neuroprotective effects and reduce brain edema in rats after cerebral I/R. It is unclear if ischemic Postcond alleviates brain edema injury through regulation of AQP4. In this study, middle cerebral artery occlusion (MCAO) was induced in rats by filament insertion for 2 h following 24-h reperfusion: ischemic Postcond treatment was performed before reperfusion in the experimental group. We used the wet-dry weight ratio and transmission electron microscopy to evaluate brain edema after 24 h of reperfusion. We used immunohistochemistry and Western blot analyses to evaluate the distribution and expression of AQP4. Ischemic Postcond significantly reduced the water content of the brain tissue and swelling of the astrocytic foot processes. AQP4 expression increased in the I/R and Postcond groups compared to the sham group, but it decreased in the Postcond group compared to the I/R group. The results of our study suggest that ischemic Postcond effectively reduces brain edema after reperfusion by inhibiting AQP4 expression. The data in this study support the use of ischemic Postcond for alleviating brain edema after cerebral I/R.

  4. Racking the brain: Detection of cerebral edema on postmortem computed tomography compared with forensic autopsy

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    Berger, Nicole [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Ampanozi, Garyfalia; Schweitzer, Wolf; Ross, Steffen G.; Gascho, Dominic [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Ruder, Thomas D. [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Bern, Freiburgstrasse, 3010 Bern (Switzerland); Thali, Michael J. [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Flach, Patricia M., E-mail: patricia.flach@irm.uzh.ch [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2015-04-15

    Graphical abstract: -- Highlights: •Postmortem swelling of the brain is a typical finding on PMCT and occurs concomitant with potential antemortem or agonal brain edema. •Cerebral edema despite normal postmortem swelling is indicated by narrowed temporal horns and symmetrical herniation of the cerebral tonsils on PMCT. •Cases with intoxication or asphyxia demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units) and a ratio >1.58 between the gray and white matter. •The Hounsfield measurements of the white and gray matter help to determine the cause of death in cases of intoxication or asphyxia. -- Abstract: Purpose: The purpose of this study was to compare postmortem computed tomography with forensic autopsy regarding their diagnostic reliability of differentiating between pre-existing cerebral edema and physiological postmortem brain swelling. Materials and methods: The study collective included a total of 109 cases (n = 109/200, 83 male, 26 female, mean age: 53.2 years) and were retrospectively evaluated for the following parameters (as related to the distinct age groups and causes of death): tonsillar herniation, the width of the outer and inner cerebrospinal fluid spaces and the radiodensity measurements (in Hounsfield Units) of the gray and white matter. The results were compared with the findings of subsequent autopsies as the gold standard for diagnosing cerebral edema. p-Values <0.05 were considered statistically significant. Results: Cerebellar edema (despite normal postmortem swelling) can be reliably assessed using postmortem computed tomography and is indicated by narrowed temporal horns and symmetrical herniation of the cerebellar tonsils (p < 0.001). There was a significant difference (p < 0.001) between intoxication (or asphyxia) and all other causes of death; the former causes demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units), and the gray to

  5. Study on the relationship of cytochrome C expression and cerebral edema in perihematomal brain tissue in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    CAI Heng; LIU Guixiang; XU Chunsheng; LIU Qingxin; XU Xiaobo

    2007-01-01

    Objective To investigate the expression of cytochrome C in perihematomal brain tissue and its relationship with the histopathological change and formation of cerebral edema in patients with hypertensive cerebral hemorrhage. Methods Thirty four patients (23 male, 11 female) of hypertensive cerebral hemorrhage in hospital from Sep. 2001 to Sep. 2002 were selected with a mean age 55.6± 10.2 years (from 35 to 75 years). The mean volume of hemorrhagic blood was 50.4±11.6 ml (from 25 to 85 ml). The perihematomal brain tissue was obtained from the minimally invasive surgery. Histopathological change and expressions of cytochrome C in perihematomal brain tissue was detected by histopathological and immunohistochemical techniques. The volume of perihematomal cerebral edema was determined by computed tomographic scan before operation. The results of staining and the volume of perihematomal cerebral edema were analyzed with double blind fashion. Results Perihematomal cerebral edema were found 12-72h after cerebral hemorrhage. Myelin sheath degeneration, condensation of nucleus and typical apopototic body were observed in perihematomal brain tissue. Expression of cytochrome C in perihematomal brain tissue was observed at 4 h and reached peak around 48-72 h after cerebral hemorrhage. Cytochrome C expressed higher positively in 16 patients and lower positively in 13 patients. Cytochrome C expression was not detected only in 5 patints. There were significant differences in volume of perihematomal cerebral edema with different expression of cytochrome C in perihematomal brain tissue (P<0.01). Conclusions Cytochrome C expression was upregulated in perihematomal brain tissue in patients with hypertensive cerebral hemorrhage. Cytochrome C might involve in the histopathological change and the formation of perihematomal cerebral edema.

  6. Cerebral edema in children with diabetic ketoacidosis: vasogenic rather than cellular?

    Science.gov (United States)

    Tasker, Robert C; Acerini, Carlo L

    2014-06-01

    Cerebral edema (CE) is accumulation of water in the intracellular or extracellular spaces of the brain. Vasogenic edema occurs when there is breakdown of the tight endothelial junctions of the blood-brain barrier (BBB), leading to extravasation of intravascular protein and fluid into the interstitial space of the brain. In cellular edema the BBB remains intact and there is swelling of astrocytes with corresponding reduction in extracellular space. In this review we bring together clinical evidence from neuropathology and cerebral magnetic resonance (MR) studies in pediatric patients presenting in diabetic ketoacidosis (DKA), and use applied physiology to understand whether CE complicating DKA is vasogenic, rather than cellular in origin. Because the first-line of defense against CE is the interface between the intravascular compartment and the extracellular space in the brain much of the focus in this review is the BBB. The principal pathologic finding in fatal cases is perivascular with BBB disruption and albumin extravasation, suggesting increased vascular permeability. DKA induces an inflammatory response and the mechanism of BBB transcellular permeability may be an immunologic cascade that disrupts tight junctions. The principal MR finding in subclinical cases of CE is vasogenic rather than cellular edema. We propose that the following physiology be considered when treating cases: bolus dose of intravenous mannitol may result in fall in serum sodium concentration, and therefore clinical worsening. Failure to respond to mannitol should prompt the use of 3% hypertonic saline (HS). Bolus dose of intravenous 3% HS is expected to effect vasogenic edema provided that the reflection coefficient is close to 1. Failure to respond to 3% HS should prompt the use of mannitol.

  7. Nimodipine pretreatment improves cerebral blood flow and reduces brain edema in conscious rats subjected to focal cerebral ischemia.

    Science.gov (United States)

    Jacewicz, M; Brint, S; Tanabe, J; Wang, X J; Pulsinelli, W A

    1990-11-01

    The effect of nimodipine pretreatment on CBF and brain edema was studied in conscious rats subjected to 2.5 h of focal cortical ischemia. An infusion of nimodipine (2 micrograms/kg/min i.v.) or its vehicle, polyethylene glycol 400, was begun 2 h before the ischemic interval and was continued throughout the survival period. Under brief halothane anesthesia, the animals' right middle cerebral and common carotid arteries were permanently occluded, and 2.5 h later, they underwent a quantitative CBF study ([14C]iodoantipyrine autoradiography followed by Quantimet 970 image analysis). Nimodipine treatment improved blood flow to the middle cerebral artery territory without evidence of a "vascular steal" and reduced the volume of the ischemic core (cortex with CBF of less than 25 ml/100 g/min) and accompanying edema by approximately 50% when compared with controls (p = 0.006 and 0.0004, respectively). Mild hypotension induced by nimodipine did not aggravate the ischemic insult. The ischemic core volumes, however, were 50-75% smaller than the 24-h infarct volumes generated in a similar paradigm that demonstrated 20-30% infarct reduction with continuous nimodipine treatment. These results suggest that nimodipine pretreatment attenuates the severity of early focal cerebral ischemia, but that with persistent ischemia, cortex surrounding the ischemic core undergoes progressive infarction and the early benefit of nimodipine treatment is only partly preserved.

  8. Connectivity of default-mode network is associated with cerebral edema in hepatic encephalopathy.

    Directory of Open Access Journals (Sweden)

    Wei-Che Lin

    Full Text Available Cerebral edema, a well-known feature of acute liver disease, can occur in cirrhotic patients regardless of hepatic encephalopathy (HE and adversely affect prognosis. This study characterized and correlated functional HE abnormalities in the brain to cerebral edema using resting-state functional magnetic resonance imaging (rs-fMRI and diffusion tensor imaging (DTI. Forty-one cirrhotic patients (16 without HE, 14 minimal HE, 11 overt HE and 32 healthy controls were assessed. The HE grade in cirrhotic patients was evaluated by the West Haven criteria and neuro-psychological examinations. Functional connectivity correlation coefficient (fc-CC of the default mode network (DMN was determined by rs-fMRI, while the corresponding mean diffusivity (MD was obtained from DTI. Correlations among inter-cortical fc-CC, DTI indices, Cognitive Ability Screening Instrument scores, and laboratory tests were also analyzed. Results showed that gradual reductions of HE-related consciousness levels, from "without HE" or "minimal HE" to "overt HE", correlated with decreased anterior-posterior fc-CC in DMN [F(4.415, p = 0.000]. The MD values from regions with anterior-posterior fc-CC differences in DMN revealed significant differences between the overt HE group and other groups. Increased MD in this network was inversely associated with decreased fc-CC in DMN and linearly correlated with poor cognitive performance. In conclusion, cerebral edema can be linked to altered cerebral temporal architecture that modifies both within- and between-network connectivity in HE. Reduced fc-CC in DMN is associated with behavior and consciousness deterioration. Through appropriate targets, rs-fMRI technology may provide relevant supplemental information for monitoring HE and serve as a new biomarker for clinical diagnosis.

  9. Breathing and sleep at high altitude.

    Science.gov (United States)

    Ainslie, Philip N; Lucas, Samuel J E; Burgess, Keith R

    2013-09-15

    We provide an updated review on the current understanding of breathing and sleep at high altitude in humans. We conclude that: (1) progressive changes in pH initiated by the respiratory alkalosis do not underlie early (48 h), complex cellular and neurochemical re-organization occurs both in the peripheral chemoreceptors as well as within the central nervous system. The latter is likely influenced by central acid-base changes secondary to the extent of the initial respiratory responses to initial exposure to high altitude; (3) sleep at high altitude is disturbed by various factors, but principally by periodic breathing; (4) the extent of periodic breathing during sleep at altitude intensifies with duration and severity of exposure; (5) complex interactions between hypoxic-induced enhancement in peripheral and central chemoreflexes and cerebral blood flow--leading to higher loop gain and breathing instability--underpin this development of periodic breathing during sleep; (6) because periodic breathing may elevate rather than reduce mean SaO2 during sleep, this may represent an adaptive rather than maladaptive response; (7) although oral acetazolamide is an effective means to reduce periodic breathing by 50-80%, recent studies using positive airway pressure devices to increase dead space, hyponotics and theophylline are emerging but appear less practical and effective compared to acetazolamide. Finally, we suggest avenues for future research, and discuss implications for understanding sleep pathology.

  10. Characterization and quantification of cerebral edema induced by synchrotron x-ray microbeam radiation therapy

    Science.gov (United States)

    Serduc, Raphaël; van de Looij, Yohan; Francony, Gilles; Verdonck, Olivier; van der Sanden, Boudewijn; Laissue, Jean; Farion, Régine; Bräuer-Krisch, Elke; Siegbahn, Erik Albert; Bravin, Alberto; Prezado, Yolanda; Segebarth, Christoph; Rémy, Chantal; Lahrech, Hana

    2008-03-01

    Cerebral edema is one of the main acute complications arising after irradiation of brain tumors. Microbeam radiation therapy (MRT), an innovative experimental radiotherapy technique using spatially fractionated synchrotron x-rays, has been shown to spare radiosensitive tissues such as mammal brains. The aim of this study was to determine if cerebral edema occurs after MRT using diffusion-weighted MRI and microgravimetry. Prone Swiss nude mice's heads were positioned horizontally in the synchrotron x-ray beam and the upper part of the left hemisphere was irradiated in the antero-posterior direction by an array of 18 planar microbeams (25 mm wide, on-center spacing 211 mm, height 4 mm, entrance dose 312 Gy or 1000 Gy). An apparent diffusion coefficient (ADC) was measured at 7 T 1, 7, 14, 21 and 28 days after irradiation. Eventually, the cerebral water content (CWC) was determined by microgravimetry. The ADC and CWC in the irradiated (312 Gy or 1000 Gy) and in the contralateral non-irradiated hemispheres were not significantly different at all measurement times, with two exceptions: (1) a 9% ADC decrease (p disappear within a week after microbeam exposure which may confirm the normal tissue sparing effect of MRT. For more information on this article, see medicalphysicsweb.org

  11. Pseudo subarachnoid Hemorrhage: A Finding of Diffuse Cerebral Edema Leading to Misdiagnosis

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    Eda Kılıç Çoban

    2015-12-01

    Full Text Available Increased attenuation of the basal cisterns and subarachnoid spaces on CT scans is a characteristic finding of acute subarachnoid hemorrhage. CT mimics of SAH have been called pseudo-SAH. Our case is presented to underline the differentiation of two diagnosis. A 63-year-old man was admitted to the emergency room with right-sided hemiparesis and aphasia. He had middle cerebral artery enfarct on his CT. A week after his hospitalisation his neurological examination was deteriorated. A plain CT-scan of brain was consistent with sub-arachnoid hemorrhage. His antiagregant therapy was ended and anti edema therapy started. Urgent neurosurgical consultation was sought & surgery was not planned. Brain death was the finding in his CT angiography. So the CT-scan findings turned out to be `pseudo sub-arachnoid haemorrhage’.Pseudo sub-arachnoid haemorrhage is a rare CT scan finding that has been reported in different cerebral disease with cerebral edema. MR imaging studies, CSF examination by lumbar puncture and the criterias proposed by Yazawa can be useful to make the diagnosis. The aim is the unnecessary termination of antiagregant and anticoagulant therapy.

  12. Nimodipine for treatment of perifocal edema following aspiration and drainage in patients with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Xianzhong Ning; Qiang Liu; Hua Zhao

    2007-01-01

    BACKGROUND: After cephalophyma removal, perifocal edema does not disappear subsequently, but progresses occasionally. Nimodipine can improve cerebral blood flow, so it maybe reduce cerebral edema area, and speed up the absorption of edematous fluid. OBJECTIVE: To observe the effect of nimodipine on perifocal edema area and neurologic function in patients with hypertensive intracerebral hemorrhage (HIGH) following stereotaxic aspiration. DESIGN: Clinical controlled observation. SETTING: Department of Neurology, Third Hospital Affiliated to Liaoning Medical University. PARTICIPANTS: Totally 116 HIGH inpatients admitted to the Department of Neurology, Third Hospital Affiliated to Liaoning Medical University from January 2003 to January 2005 were involved in this experiment. They all met the classification and diagnosis of cerebrovascular disease proposed in 1995 4th National Conference on Cerebrovascular Disease. The bleeding volume≥35 Ml was confirmed by skull CT. The involved patients, 64 male and 52 femlae, averaged 63 years old, ranging from 40 to 70 years. All the patients suffered from unilateral cerebral hemisphere hemorrhage, and muscle strength of paralyzed limb was less than degree Ⅲ. Informed consents of therapeutic items were obtained from all the patients and relatives. METHODS: ①According to different wills, the patients were assigned into treatment group (n =60) and control group (n =56). In the treatment group, the involved patients, 32 male, 28 female, averaged 63 years. They underwent operation and administration of nimodipine. In the control group, the involved patients, 30 male and 26 female, averaged 62 years old. They all underwent operation simply. Patients in the two groups all received stereotaxic aspiration, drainage, dehydration, haemostasis, antiinflammation, blood pressure controlling and other treatments. Patients in the treatment group were also intravenously injected with 0.2 g/L nimodipine(Bayer Medicine Health Care Co., Ltd

  13. High altitude, a natural research laboratory for the study of cardiovascular physiology and pathophysiology.

    Science.gov (United States)

    Scherrer, Urs; Allemann, Yves; Jayet, Pierre-Yves; Rexhaj, Emrush; Sartori, Claudio

    2010-01-01

    High altitude constitutes an exciting natural laboratory for medical research. Although initially, the aim of high-altitude research was to understand the adaption of the organism to hypoxia and find treatments for altitude-related diseases, during the past decade or so, the scope of this research has broadened considerably. Two important observations led the foundation for the broadening of the scientific scope of high-altitude research. First, high-altitude pulmonary edema represents a unique model that allows studying fundamental mechanisms of pulmonary hypertension and lung edema in humans. Second, the ambient hypoxia associated with high-altitude exposure facilitates the detection of pulmonary and systemic vascular dysfunction at an early stage. Here, we will review studies that, by capitalizing on these observations, have led to the description of novel mechanisms underpinning lung edema and pulmonary hypertension and to the first direct demonstration of fetal programming of vascular dysfunction in humans.

  14. Variable manifestations of familial hemiplegic migraine associated with reversible cerebral edema in children.

    Science.gov (United States)

    Asghar, Sheila J; Milesi-Hallé, Alessandra; Kaushik, Chavvi; Glasier, Charles; Sharp, Gregory B

    2012-09-01

    Three children with familial hemiplegic migraine presented with right-sided weakness, speech difficulty, altered mental status, and gait abnormalities. These persistent aura signs were accompanied by left-sided slowing and cerebral dysfunction, documented by electroencephalograms. Cranial magnetic resonance imaging revealed cortical edema restricted to the left cerebral hemisphere. Follow-up electroencephalogram and imaging studies produced normal results 1-4 months afterward. However, cognitive changes persisted. Genetic testing demonstrated variable results: one child manifested a CACNA1A mutation compatible with familial hemiplegic migraine type 1, whereas another demonstrated an ATP1A2 sequence alteration. No known mutations were evident in the third child, with minor head trauma thought to precipitate the familial hemiplegic migraine. These findings demonstrate the variable clinical and genetic heterogeneity of childhood familial hemiplegic migraine. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Reduced brain edema and infarct volume in aquaporin-4 deficient mice after transient focal cerebral ischemia.

    Science.gov (United States)

    Yao, Xiaoming; Derugin, Nikita; Manley, Geoffrey T; Verkman, A S

    2015-01-01

    Aquaporin-4 (AQP4) is a water channel expressed in astrocyte end-feet lining the blood-brain barrier. AQP4 deletion in mice is associated with improved outcomes in global cerebral ischemia produced by transient carotid artery occlusion, and focal cerebral ischemia produced by permanent middle cerebral artery occlusion (MCAO). Here, we investigated the consequences of 1-h transient MCAO produced by intraluminal suture blockade followed by 23 h of reperfusion. In nine AQP4(+/+) and nine AQP4(-/-) mice, infarct volume was significantly reduced by an average of 39 ± 4% at 24h in AQP4(-/-) mice, cerebral hemispheric edema was reduced by 23 ± 3%, and Evans Blue extravasation was reduced by 31 ± 2% (mean ± SEM). Diffusion-weighted magnetic resonance imaging showed greatest reduction in apparent diffusion coefficient around the occlusion site after reperfusion, with remarkably lesser reduction in AQP4(-/-) mice. The reduced infarct volume in AQP4(-/-) mice following transient MCAO supports the potential utility of therapeutic AQP4 inhibition in stroke.

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

    Science.gov (United States)

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

    1982-07-01

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

  17. Histochemical characterization of cytotoxic brain edema. Potassium concentrations after cerebral ischemia and during the postmortem interval.

    Science.gov (United States)

    Oehmichen, M; Ochs, U; Meissner, C

    2000-08-01

    Cytotoxic edema is a phenomenon of the ischemically damaged brain. In the present study we tested a histochemical method that detects this phenomenon based on potassium (K+) levels in the brain. In a first series focal cerebral ischemia was induced by arterial occlusion in 23 gerbils (Meriones unguiculatus). After survival times of 30, 60 and 120 min, the animals were killed and brain section histochemically stained for potassium and quantitatively evaluated with a morphometric method. The results were compared with those using physicochemical techniques. A distinct K+ depletion could be demonstrated in the area of the focal ischemia within a survival time of 30 min, the depletion growing thereafter with increasing survival time. In a second series histochemical and chemical methods were used to study the stability of K+ levels in undamaged brains of 15 healthy rats during postmortem intervals of 2.5 and 5 h. Within these intervals K+ levels were clearly depleted, apparently as a result of cerebral spinal fluid (CSF) diffusion. Even if neuronal injury can be demonstrated histochemically after very brief survival times of about 30 min, postmortem storage of the cadavers rendered detection impossible due to electrolyte and water diffusion. In autoptic human cases, therefore, this technique is of no practical utility in detecting cytotoxic brain edema in postmortem tissue.

  18. Perfusion and diffusion MRI study detecting CBF disturbance and edema formation in the acute phase of cerebral contusion

    Energy Technology Data Exchange (ETDEWEB)

    Kawamata, Tatsuro; Aoyama, Naoki; Mori, Tatsuro; Maeda, Takeshi; Katayama, Yoichi [Nihon Univ., Tokyo (Japan). School of Medicine

    1998-12-01

    In order to clarify the mechanisms underlying cerebral contusion-induced CBF disturbance and edema formation, echoplanar diffusion and perfusion images were obtained in the patients with cerebral contusion. In the acute phase within 48 hours post-trauma, the apparent diffusion coefficient (ADC) showed various levels with a tendency to increase in the central area of contusion (ADC ratio=1.06{+-}0.21). In contrast, the ADC was significantly reduced in the peripheral area of contusion (ADC ratio=0.87{+-}0.16). The ADC at 2 weeks post-trauma increased both in the central (ADC ratio=1.16{+-}0.26) and the peripheral area of contusion (ADC ratio=1.10{+-}0.26, p<0.05), as compared to those within 48 hours post-trauma. The perfusion images showed a wide spread CBF depression extending beyond the area of contusion observed on the T1 and T2 weighted images. These results indicate that; in the early phase of contusion-induced edema formation, cytotoxic edema is predominant, especially in the peripheral area of contusion, and vasogenic edema appears thereafter. The CBF depression may contribute such cytotoxic edema formation in the surrounding area of cerebral contusion. It is concluded that echo-planar diffusion and perfusion images are excellent technique to investigate the evolution of CBF disturbance and edema formation following traumatic brain injury. (author)

  19. Effects of angiopoietin-1 on hemorrhagic transformation and cerebral edema after tissue plasminogen activator treatment for ischemic stroke in rats.

    Science.gov (United States)

    Kawamura, Kunio; Takahashi, Tetsuya; Kanazawa, Masato; Igarashi, Hironaka; Nakada, Tsutomu; Nishizawa, Masatoyo; Shimohata, Takayoshi

    2014-01-01

    An angiogenesis factor, angiopoietin-1 (Ang1), is associated with the blood-brain barrier (BBB) disruption after focal cerebral ischemia. However, whether hemorrhagic transformation and cerebral edema after tissue plasminogen activator (tPA) treatment are related to the decrease in Ang1 expression in the BBB remains unknown. We hypothesized that administering Ang1 might attenuate hemorrhagic transformation and cerebral edema after tPA treatment by stabilizing blood vessels and inhibiting hyperpermeability. Sprague-Dawley rats subjected to thromboembolic focal cerebral ischemia were assigned to a permanent ischemia group (permanent middle cerebral artery occlusion; PMCAO) and groups treated with tPA at 1 h or 4 h after ischemia. Endogenous Ang1 expression was observed in pericytes, astrocytes, and neuronal cells. Western blot analyses revealed that Ang1 expression levels on the ischemic side of the cerebral cortex were decreased in the tPA-1h, tPA-4h, and PMCAO groups as compared to those in the control group (P = 0.014, 0.003, and 0.014, respectively). Ang1-positive vessel densities in the tPA-4h and PMCAO groups were less than that in the control group (p = 0.002 and cerebral homogenate (p = 0.007) and cerebral edema due to BBB damage (p = 0.038), as compared to administering COMP protein alone. In conclusion, Ang1 might be a promising target molecule for developing vasoprotective therapies for controlling hemorrhagic transformation and cerebral edema after tPA treatment.

  20. Predictors of malignant brain edema in middle cerebral artery infarction observed on CT angiography.

    Science.gov (United States)

    Kim, Hoon; Jin, Seon Tak; Kim, Young Woo; Kim, Seong Rim; Park, Ik Seong; Jo, Kwang Wook

    2015-03-01

    Patients with middle cerebral artery (MCA) infarction accompanied by MCA occlusion with or without internal carotid artery (ICA) occlusion have a poor prognosis, as a result of brain cell damage caused by both the infarction and by space-occupying and life-threatening edema formation. Multiple treatments can reduce the likelihood of edema formation, but tend to show limited efficacy. Decompressive hemicraniectomy with duroplasty has been promising for improving functional outcomes and reducing mortality, particularly improved functional outcomes can be achieved with early decompressive surgery. Therefore, identifying patients at risk for developing fatal edema is important and should be performed as early as possible. Sixty-four patients diagnosed with major MCA infarction with MCA occlusion within 8 hours of symptom onset were retrospectively reviewed. Early clinical, laboratory, and computed tomography angiography (CTA) parameters were analyzed for malignant brain edema (MBE). Twenty of the 64 patients (31%) had MBE, and the clinical outcome was poor (3month modified Rankin Scale >2) in 95% of them. The National Institutes of Health Stroke Scale (NIHSS) score, Alberta Stroke Program Early Computed Tomography Score, Clot Burden Score, and Collateral Score (CS) showed statically significant differences in both groups. Multivariable analyses adjusted for age and sex identified the independent predictors of MBE: NIHSS score >18 (odds ratio [OR]: 4.4, 95% confidence interval [CI]: 1.2-16.0, p=0.023) and CS on CTA <2 (OR: 7.28, 95% CI: 1.7-30.3,p=0.006). Our results provide useful information for selecting patients in need of aggressive treatment such as decompressive surgery.

  1. 脑创伤后脑水肿52例临床分析%Progress procedure of cerebral edema and clinical analysis of 52 cerebral trauma patients

    Institute of Scientific and Technical Information of China (English)

    李岩

    2012-01-01

    目的 了解脑创伤后不同时间窗内脑水肿和肿胀的发展过程及与预后的关系.方法 结合52例经CT和手术证实有脑水肿的脑外伤患者影像资料和术中所见,对其预后情况进行分析.结果 脑水肿较轻者,预后相对较好,11例恶性脑膨胀者,10例死亡,1例植物生存.结论 脑创伤后出现水肿-脑压高-脑缺血、缺氧-脑水肿的恶性循环而使脑水肿-脑肿胀-恶性脑膨胀,病情进行性恶化,应采取有效手段阻止颅内压进行性增高.%Objective To understand cerebral edema and development procedure of different time windows.Methods To analyze their prognosis through image document and operation findings of 52 cerebral trauma patients which were confirmed cerebral edema by CT and operation.Results he light cerebral oedema patients have a better prognosis,10 patients died and 1 patient became a plant man in 11 malignant brain dilatation patients.Conclusion The infernal circle of high brain pressure-cerebral ischemia,cerebral anoxia-cerebral edema result in cerebral edema-brain dilatation-malignant brain dilatation after cerebral trauma which leads to unremitting aggravated pathogenefic condition.So effective means should be used to interrupt the unremitting heightening ICP.

  2. Cold Stress at High Altitudes

    Directory of Open Access Journals (Sweden)

    N. C. Majumdar

    1983-04-01

    Full Text Available The problem of cold at high altitudes has been analysed from a purely physical standpoint. It has been shown that Siple's Wind-Chill Index is not reliable because (i it does not make use of the well established principles governing the physical processes of heat transfer by convection and radiation, and (ii it assumes that the mean radiant temperature of the surroundings is the same as the ambient dry bulb temperature. A Cold Stress Index has been proposed which is likely to be a more reliable guide for assessing the climatic hazards of high altitude environments. The Index can be quickly estimated with the help of two nomograms devised for the purpose.

  3. Pentoxifylline attenuates TNF-α protein levels and brain edema following temporary focal cerebral ischemia in rats.

    Science.gov (United States)

    Vakili, Abedin; Mojarrad, Somye; Akhavan, Maziar Mohammad; Rashidy-Pour, Ali

    2011-03-04

    Cerebral edema is the most common cause of neurological deterioration and mortality during acute ischemic stroke. Despite the clinical importance of cerebral ischemia, the underlying mechanisms remain poorly understood. Recent studies suggest a role for TNF-α in the brain edema formation. To further investigate whether TNF-α would play a role in brain edema formation, we examined the effects of pentoxifylline (PTX, an inhibitor of TNF-α synthesis) on the brain edema and TNF-α levels in a model of transient focal cerebral ischemia. The right middle cerebral artery (MCA) of rats was occluded for 60 min using the intraluminal filament method. The animals received PTX (60 mg/kg) immediately, 1, 3, or 6h post-ischemic induction. Twenty-four hours after induction of ischemic injury, permeability of the blood-brain barrier (BBB) and brain edema were determined by in situ brain perfusion of Evans Blue (EB) and wet-to-dry weight ratio, respectively. TNF-α protein levels in ischemic cortex were also measured at 1, 4, and 24h after the beginning of an ischemic stroke by using an enzyme-linked immunosorbent assay method. The administration of PTX up to 6h after occlusion of the MCA significantly reduced the brain edema. Moreover, PTX significantly reduced the concentration of TNF-α in ischemic brain cortex up to 4h post-transient focal stroke (Pedema in a model of transient focal cerebral ischemia. The beneficial effects of PTX may be mediated, at least in part, through a decline in TNF-α production and BBB breakdown.

  4. Drug-Related Hyponatremic Encephalopathy: Rapid Clinical Response Averts Life-Threatening Acute Cerebral Edema

    Science.gov (United States)

    Siegel, Arthur J.; Forte, Sophie S.; Bhatti, Nasir A.; Gelda, Steven E.

    2016-01-01

    Patient: Female, 63 Final Diagnosis: Drug-induced hyponatremic encephalopathy Symptoms: Seizures • coma Medication: Hypertonic 3% saline infusion Clinical Procedure: — Specialty: Internal Medicine Objective: Unusual clinical course Background: Drug-induced hyponatremia characteristically presents with subtle psychomotor symptoms due to its slow onset, which permits compensatory volume adjustment to hypo-osmolality in the central nervous system. Due mainly to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), this condition readily resolves following discontinuation of the responsible pharmacological agent. Here, we present an unusual case of life-threatening encephalopathy due to adverse drug-related effects, in which a rapid clinical response facilitated emergent treatment to avert life-threatening acute cerebral edema. Case Report: A 63-year-old woman with refractory depression was admitted for inpatient psychiatric care with a normal physical examination and laboratory values, including a serum sodium [Na+] of 144 mEq/L. She had a grand mal seizure and became unresponsive on the fourth day of treatment with the dual serotonin and norepinephrine reuptake inhibitor [SNRI] duloxetine while being continued on a thiazide-containing diuretic for a hypertensive disorder. Emergent infusion of intravenous hypertonic (3%) saline was initiated after determination of a serum sodium [Na+] of 103 mEq/L with a urine osmolality of 314 mOsm/kg H20 and urine [Na+] of 12 mEq/L. Correction of hyposmolality in accordance with current guidelines resulted in progressive improvement over several days, and she returned to her baseline mental status. Conclusions: Seizures with life-threatening hyponatremic encephalopathy in this case likely resulted from co-occurring SIADH and sodium depletion due to duloxetine and hydrochlorothiazide, respectively. A rapid clinical response expedited diagnosis and emergent treatment to reverse life-threatening acute cerebral edema

  5. Perforin expression by CD8 T cells is sufficient to cause fatal brain edema during experimental cerebral malaria.

    Science.gov (United States)

    Huggins, Matthew; Johnson, Holly L; Jin, Fang; N'Songo, Aurelie; Hanson, Lisa M; LaFrance, Stephanie J; Butler, Noah S; Harty, John T; Johnson, Aaron J

    2017-03-06

    Human cerebral malaria (HCM) is a serious complication of Plasmodium falciparum infection. The most severe outcomes for patients include coma, permanent neurological deficits, and death. Recently, a large-scale magnetic resonance imaging (MRI) study in humans identified brain swelling as the most prominent predictor of fatal HCM. Therefore, in this study we sought to define the mechanism controlling brain edema through the use of the murine experimental cerebral malaria (ECM) model. Specifically, we investigated the ability of CD8 T cells to initiate brain edema during ECM. We determined that areas of blood-brain barrier (BBB) permeability colocalized with a reduction of the cerebral endothelial cell tight junction proteins claudin-5 and occludin. Furthermore, through small animal MRI we analyzed edema and vascular leakage. Using gadolinium enhanced T1-weighted MRI we determined that vascular permeability is not homogeneous, but rather confined to specific regions of the brain. Our findings show that BBB permeability was localized within the brainstem, olfactory bulb, and lateral ventricle. Concurrently with the initiation of vascular permeability, T2-weighted MRI revealed edema and brain swelling. Importantly, ablation of the cytolytic effector molecule perforin fully protected against vascular permeability and edema. Furthermore, perforin production specifically by CD8 T cells was required to cause fatal edema during ECM. We propose that CD8 T cells initiate BBB breakdown through perforin mediated disruption of tight junctions. In turn, leakage from the vasculature into the parenchyma causes brain swelling and edema. This results in a breakdown of homeostatic maintenance that likely contributes to ECM pathology.

  6. Influence of rotating magnetic field on cerebral infarction volume, cerebral edema and free radicals metabolism after cerebral ischemia/reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Xiaohong Liu; Zhiqiang Zhang; Lixin Zhang

    2006-01-01

    BACKGROUND: It has shown that magnetic field can improve blood circulation, decrease blood viscosity, inhibit free radicals, affect Ca2+ flow in nerve cells, control inflammatory and immunological reaction, and accelerate nerve cell regeneration. In addition, protective effect of magnetic field, which acts as an iatrophysics, on ischemic brain tissues has been understood gradually.OBJECTIVE: To investigate the effects of rotating magnetic field (RMF) on volume of cerebral infarction,cerebral edema and metabolism of free radicals in rats after cerebral ischemia/reperfusion injury.DESIGN: Randomized controlled animal study.SETTING: Rehabilitation Center of disabled children, Liaoniang; Department of Rehabilitation, the Second Affiliated Hospital, China Medical University; Department of Rehabilitation Physiotherapy, the First Affiliated Hospital, China Medical University.MATERIALS: A total of 70 healthy Wistar rats aged 18-20 weeks of both genders were selected and randomly divided into 3 groups: sham operation group with 12 rats, control group with 20 rats and treatment group with 38 rats. The treatment group included 4 time points: immediate reperfusion with 6 ones, 6-hour reperfusion with 20 ones, 12-hour reperfusion with 6 ones and 18-hour reperfusion with 6 rats. Main instruments were detailed as follows: magnetic head of rotating magnetic device was 6 cm in diameter; magnetic induction intensity at the surface of magnetic head was 0.25 T in silence; the maximal magnetic induction intensity was 0.09 T at the phase of rotation; the average rotating speed was 2500 r per minute.METHODS: The experiment was carried out in the China Medical University in March 2003. Focal cerebral ischemic animal models were established with modified Longa's method. Operation was the same in the sham operation, but the thread was inserted as 10 mm. Neurologic impairment was assessed with 5-rating method to screen out cases. Those survivals with grade 1 and grade 2 after ischemia for 2

  7. Inhibition of Myosin light-chain kinase attenuates cerebral edema after traumatic brain injury in postnatal mice.

    Science.gov (United States)

    Rossi, Janet L; Todd, Tracey; Bazan, Nicolas G; Belayev, Ludmila

    2013-10-01

    Traumatic brain injury (TBI) in children less than 8 years of age leads to decline in intelligence and executive functioning. Neurological outcomes after TBI correlate to development of cerebral edema, which affect survival rates after TBI. It has been shown that myosin light-chain kinase (MLCK) increases cerebral edema and that pretreatment with an MLCK inhibitor (ML-7) reduces cerebral edema. The aim of this study was to determine whether inhibition of MLCK after TBI in postnatal day 24 (PND-24) mice would prevent breakdown of the blood-brain barrier (BBB) and development of cerebral edema and improve neurological outcome. We used a closed head injury model of TBI. ML-7 or saline treatment was administered at 4 h and every 24 h until sacrifice or 5 days after TBI. Mice were sacrificed at 24 h, 48 h, and 72 h and 7 days after impact. Mice treated with ML-7 after TBI had decreased levels of MLCK-expressing cells (20.7±4.8 vs. 149.3±40.6), less albumin extravasation (28.3±11.2 vs. 116.2±60.7 mm(2)) into surrounding parenchymal tissue, less Evans Blue extravasation (339±314 vs. 4017±560 ng/g), and showed a significant difference in wet/dry weight ratio (1.9±0.07 vs. 2.2±0.05 g), compared to saline-treated groups. Treatment with ML-7 also resulted in preserved neurological function measured by the wire hang test (57 vs. 21 sec) and two-object novel recognition test (old vs. new, 10.5 touches). We concluded that inhibition of MLCK reduces cerebral edema and preserves neurological function in PND-24 mice.

  8. Effect of lavender oil (Lavandula angustifolia) on cerebral edema and its possible mechanisms in an experimental model of stroke.

    Science.gov (United States)

    Vakili, Abedin; Sharifat, Shaghayegh; Akhavan, Maziar Mohammad; Bandegi, Ahmad Reza

    2014-02-22

    Lavender belongs to the family Labiatae and has a variety of cosmetic uses as well as therapeutic purposes in herbal medicine. The present study was conducted to evaluate the protective effect of lavender oil against brain edema and its possible mechanisms in an experimental model of stroke. Under Laser-Doppler Flowmetry, focal cerebral ischemia was induced by the transient occlusion of the middle cerebral artery for 1h in rats. Lavender oil (100, 200, and 400 mg/kg ip (and/or vehicle was injected at the onset of ischemia. Infarct size, cerebral edema, functional outcome, and oxidative stress biomarkers were evaluated using standard methods. Western blotting was used to determine the protein expression of VEGF, Bax, and Bcl-2. Treatment with lavender oil at doses of 200 and 400 mg/kg significantly diminished infarct size, brain edema, and improved functional outcome after cerebral ischemia (P0.05). The results indicated that lavender oil has neuroprotective activity against cerebral ischemia and alleviated neurological function in rats, and the mechanism may be related to augmentation in endogenous antioxidant defense, inhibiting oxidative stress, and increasing VEGF expression in the rat brain. However, lavender oil could not suppress the apoptosis pathway.

  9. High Altitude Cooking and Food Safety

    Science.gov (United States)

    ... Standard Forms FSIS United States Department of Agriculture Food Safety and Inspection Service About FSIS District Offices Careers ... 286) Actions ${title} Loading... High Altitude Cooking and Food Safety What is considered a high altitude? How is ...

  10. Liposome-encapsulated hemoglobin alleviates brain edema after permanent occlusion of the middle cerebral artery in rats.

    Science.gov (United States)

    Kawaguchi, Akira T; Kurita, Daisaku; Furuya, Hiroyuki; Yamano, Mariko; Ogata, Yoshitaka; Haida, Munetaka

    2009-02-01

    Liposome-encapsulated hemoglobin (LEH) was proven to be protective in cerebral ischemia/reperfusion injury. The present study evaluated LEH in a rat model of permanent middle cerebral artery (MCA) occlusion to clarify its effect during ischemia and reperfusion. Five minutes after thread occlusion of the MCA, rats were infused with 10 mL/kg of LEH (LEH, n = 13), and compared with normal controls (n = 11). Additional animals received the same MCA occlusion with no treatment (CT, n = 11), saline (saline, n = 10), empty liposome solution (EL, n = 13), or washed red blood cells (RBC, n = 7). Severity of brain edema was determined 24 h later by signal strength in T2-weighted magnetic resonance imaging of the cortex, striatum, hippocampus, and pyriform lobe. The results showed that brain edema/infarction observed in any vehicle-infused control was significantly more severe than in LEH-treated rats. There was a tendency toward aggravated edema in rats receiving ELs. LEH infusion at a dose of 10 mL/kg significantly reduced edema formation as compared to other treatments in a wide area of the brain 24 h after permanent occlusion of the MCA. Low oncotic pressure of EL and LEH solution (vehicle solution) appeared to cause nonsignificant aggravation of edema and reduced protective effects of LEH.

  11. Electron microscopic features of brain edema in rodent cerebral malaria in relation to glial fibrillary acidic protein expression.

    Science.gov (United States)

    Ampawong, Sumate; Chaisri, Urai; Viriyavejakul, Parnpen; Nontprasert, Apichart; Grau, Georges E; Pongponratn, Emsri

    2014-01-01

    The mechanisms leading to cerebral malaria (CM) are not completely understood. Brain edema has been suggested as having an important role in experimental CM. In this study, CBA/CaH mice were infected with Plasmodium berghei ANKA blood-stage and when typical symptoms of CM developed on day 7, brain tissues were processed for electron-microscopic and immunohistochemical studies. The study demonstrated ultrastructural hallmarks of cerebral edema by perivascular edema and astroglial dilatation confirming existing evidence of vasogenic and cytogenic edema. This correlates closely with the clinical features of CM. An adaptive response of astrocytic activity, represented by increasing glial fibrillary acidic protein (GFAP) expression in the perivascular area and increasing numbers of large astrocyte clusters were predominately found in the CM mice. The presence of multivesicular and lamellar bodies indicates the severity of cerebral damage in experimental CM. Congestion of the microvessels with occluded white blood cells (WBCs), parasitized red blood cells (PRBCs) and platelets is also a crucial covariate role for CM pathogenesis.

  12. Lack of functional P2X7 receptor aggravates brain edema development after middle cerebral artery occlusion.

    Science.gov (United States)

    Kaiser, Melanie; Penk, Anja; Franke, Heike; Krügel, Ute; Nörenberg, Wolfgang; Huster, Daniel; Schaefer, Michael

    2016-09-01

    Effective therapeutic measures against the development of brain edema, a life-threatening complication of cerebral ischemia, are necessary to improve the functional outcome for the patient. Here, we identified a beneficial role of purinergic receptor P2X7 activation in acute ischemic stroke. Involvement of P2X7 in the development of neurological deficits, infarct size, brain edema, and glial responses after ischemic cerebral infarction has been analyzed. Neurologic evaluation, magnetic resonance imaging, and immunofluorescence assays were used to characterize the receptor's effect on the disease progress during 72 h after transient middle cerebral artery occlusion (tMCAO). Sham-operated animals were included in all experiments for control purposes. We found P2X7-deficient mice to develop a more prominent brain edema with a trend towards more severe neurological deficits 24 h after tMCAO. Infarct sizes, T2 times, and apparent diffusion coefficients did not differ significantly between wild-type and P2X7(-/-) animals. Our results show a characteristic spatial distribution of reactive glia cells with strongly attenuated microglia activation in P2X7(-/-) mice 72 h after tMCAO. Our data indicate that P2X7 exerts a role in limiting the early edema formation, possibly by modulating glial responses, and supports later microglia activation.

  13. 脑水肿分子机制的研究进展%Progression on Molecular Mechanisms of Cerebral Edema

    Institute of Scientific and Technical Information of China (English)

    武柠子; 马慧萍; 王宁; 贾正平

    2016-01-01

    Cerebral edema is a pathological sign of increased brain volume induced by accumulation of fluid in the brain,and it is the response of brain tissues to a variety of pathogenic factors. Intracranial injury,ischemia,hypoxia, inflammation,cerebral dysmetabolism,brain tumor and poisoning can all cause brain edema. Brain edema can induce el-evation of intracranial pressure,and functional and structural injuries can be found when level of intracranial pressure in-creases to a certain degree,and it also can lead to brain death. The previous study for the mechanism of cerebral edema includes blood-brain barrier theory,calcium ion theory,cerebral microcirculation disturbance theory and so on. The study of recent years has shown that incidence of cerebral edema closely relates to aquaporin-4(AQP4),matrix metalloprotein-ases(MMPs),tight junction(TJ)protein and inflammatory cytokines. This paper summarizes the molecular mechanisms of cerebral edema.%脑水肿是指脑内水分增加导致脑容积增大的一种病理现象,是脑组织对各种致病因素的反应。颅内损伤、缺血、缺氧、炎症、脑代谢障碍、肿瘤以及中毒都会引起脑水肿。脑水肿可导致颅内压的升高,当颅内压升高到一定程度时,脑组织就会发生功能和结构的损害,严重者导致脑死亡。先前对脑水肿发病机制的研究包括血脑屏障学说、钙离子学说、脑微循环障碍学说、脑细胞代谢障碍等。但是近年的研究表明脑水肿的发生与水通道蛋白4、基质金属蛋白酶、紧密连接蛋白、炎性细胞因子等密切相关。本文就脑水肿发生的分子机制进行综述。

  14. Relationship between AQP4 expression and DWI of the cerebral ischemic edema in rats

    Institute of Scientific and Technical Information of China (English)

    鲁宏; 孙善全

    2003-01-01

    Objective: To study the correlation between aquaporin-4(AQP4) expression and diffusion-weighted imaging (DWI) in the process of ischemic brain edema for the molecular biologic mechanism of DWI. Methods: A total of 34 Wistar rats were divided into 8 groups randomly: Non-operated group (n=4), sham-operated group (n=6), and operated group, receiving right middle cerebral artery occlusion (MCAO) for 15 and 30 min, and 1, 3, 6 and 24 h respectively (6 subgroups, n=4). All groups were imaged with DWI and T2WI. The apparent diffusion coefficient (ADC), relevant density (rd) and relevant area (rs) of hyperintensity of the lesions on DWI and T2WI were measured. Relevant ADC (rADC), relevant area of immunohistochemical staining for AQP4 (rS), optical density of AQP4 hybridization (α) were calculated. After that the animals were sacrificed and perfused at different time intervals, correlations between DWI, ADC, and AQP4 expression (rS, α) in ischemic tissue was made. Results: There was a significant correlation between rS and α (r=0.949). The abnormal high intensity was found in DWI of the ipsilateral MAC territory at 15 min after MCAO. The ADC value decreased quickly within 1 h after MCAO, the rd and rs of DWI increased rapidly and the expression of AQP4 increased quickly, too. However, there was no change on the T2WI. In the period of time (15 min-1 h), the AQP4 expression(α) had a strong relation to the rd and rs( r=0.914, 0.895). With the progress of the time, the ADC value of MCAO decreased further to (2.1±0.6)×10-4 mm2/s at 3 h, and then followed an increased slowly till 24 h, but the rd and the rs as well as the expression of AQP4 continuously increased during the stage. The T2WI detected the lesion at the average time (1.4 h) after MCAO, and the rs of T2WI was less than that of DWI at the same time in the same layer (P<0.05). Conclusion: The results imply that high expression of AQP4 may play a key role in ischemic brain edema. It is, certainly, one of the

  15. Minocycline effects on cerebral edema: relations with inflammatory and oxidative stress markers following traumatic brain injury in mice.

    Science.gov (United States)

    Homsi, Shadi; Federico, Fabiola; Croci, Nicole; Palmier, Bruno; Plotkine, Michel; Marchand-Leroux, Catherine; Jafarian-Tehrani, Mehrnaz

    2009-09-29

    One of the severe complications following traumatic brain injury (TBI) is cerebral edema and its effective treatment is of great interest to prevent further brain damage. This study investigated the effects of minocycline, known for its anti-inflammatory properties, on cerebral edema and its respective inflammatory markers by comparing different dose regimens, on oxidative stress and on neurological dysfunction following TBI. The weight drop model was used to induce TBI in mice. The brain water content was measured to evaluate cerebral edema. Inflammatory markers were detected by ELISA (IL-1beta), zymography and Western blot (MMP-9). The oxidative stress marker (glutathione levels) and neurological function were measured by Griffith technique and string test, respectively. Minocycline was administered i.p. once (5 min), twice (5 min and 3 h) or triple (5 min, 3 h and 9 h) following TBI. The first dose of minocycline only varied (45 or 90 mg/kg), whereas the following doses were all at 45 mg/kg. The single and double administrations of minocycline reduced the increase of inflammatory markers at 6 h post-TBI. Minocycline also reduced cerebral edema at this time point, only after double administration and at the high dose regimen, although with no effect on the TBI-induced oxidized glutathione increase. The anti-edematous effect of minocycline persisted up to 24 h, upon a triple administration, and accompanied by a neurological recovery. In conclusion, we reported an anti-edematous effect of minocycline after TBI in mice according to a specific treatment regimen. These findings emphasize that the beneficial effects of minocycline depend on the treatment regimen following a brain injury.

  16. Over hydration in diabetic ketoacidosis may increase the risk of cerebral edema in children

    Institute of Scientific and Technical Information of China (English)

    Zakaullh Khan; Dulikun Muzhapaer

    2013-01-01

    Objectives Over-hydration in diabetic ketoacidosis (DKA) may increase the risk of cerebral edema in children. Methods We have organized a prospective descriptive cohort study of 38 pediatric patients aged 1 month to 14 years, who were diagnosed with DKA with 41 episodes of diabetic ketoacidosis, presented to the pediatric emergency department at the First Affiliated Hospital of Xinjiang Medical University from January 2010 to February 2012.This study was approved by the Ethics Committee of The First Affiliated Hospital of Xinjiang Medical University. Results The magnitude presentation of the percentile 25%-70% was in the ratio of 5.6% (3.4%-8.2%) (6.1±4) .So there was no clinical and biochemical assessment variation needed. These both of the variations, all of the diabetic ketoacidosis patient approached. Further all the patient variations were not correlated with the amplitude of variation and magnitude presentation and did not affect the fluid concentration and the quantity of the fluid was 47.8 mL/kg (36.5-56.3) in the first 12 hours. Conclusion For the conclusion of the exact parameters and the magnitude variations of the fluid in the patients of diabetic ketoacidosis, all of the conformations need study on the larger scale.

  17. 1962 Satellite High Altitude Radiation Belt Database

    Science.gov (United States)

    2014-03-01

    TR-14-18 1962 Satellite High Altitude Radiation Belt Database Approved for public release; distribution is unlimited. March...the Status of the High Altitude Nuclear Explosion (HANE) Trapped Radiation Belt Database”, AFRL-VS-PS-TR- 2006-1079, Air Force Research Laboratory...Roth, B., “Blue Ribbon Panel and Support Work Assessing the Status of the High Altitude Nuclear Explosion (HANE) Trapped Radiation Belt Database

  18. Economy of Adaptation to High Altitude

    Institute of Scientific and Technical Information of China (English)

    Jean-Paul Richalet

    2004-01-01

    @@ The international meeting that will be held in Xining and Lhasa in August 2004 will be a wonderful occasion to share facts and concepts dealing with adaptation to high altitude. Life at high altitude is a challenge for thousands of animal species and millions of humans residing or visiting high altitude regions of the world. To try to understand the physiological mechanisms involved in the adaptation processes to high altitude hypoxia, it is convenient to start by defining what is "extreme" from a biological point of view.

  19. Aspirated Compressors for High Altitude Engines Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences proposes to incorporate aspirated compressor technology into a high altitude, long endurance (HALE) concept engine. Aspiration has been proven...

  20. Edema cerebral: aportaciones de la investigación básica al manejo clínico

    Directory of Open Access Journals (Sweden)

    Karina Tuz

    2004-01-01

    Full Text Available El edema cerebral es una complicación clínica severa, asociada a numerosas patologías y es causa frecuente de muerte. Puede ser vasogénico o celular, aunque generalmente ambos tipos de edema coexisten. El edema celular afecta de manera predominante a los astrocitos y ocurre en condiciones hiposmóticas (hiponatremia o isosmóticas (traumatismo craneoencefálico, isquemia, epilepsias, encefalopatía hepática. En el edema hiposmótico las células del cerebro tienen la capacidad de recuperar el volumen, mediante un mecanismo activo de adaptación, consistente en la movilización de osmolitos intracelulares, que son los iones K+ y Cl- y moléculas orgánicas, como aminoácidos, polialcoholes y aminas. La adaptación a la condición de hiponatremia modifica la concentración de estos osmolitos, restableciendo la isosmolaridad de la célula con el entorno hiposmótico. La corrección de la condición hiponatrémica debe tomar en cuenta estos mecanismos adaptativos para evitar que un ajuste demasiado rápido no sea seguido por el correspondiente cambio en la concentración de osmolitos intracelulares. En el edema isosmótico, aparentemente no existen los mecanismos de regulación activa del volumen debido, posiblemente a que es el cambio en la distribución iónica el responsable del edema. Por ello, la estrategia de prevención parece ser el mecanismo indicado para evitar las complicaciones asociadas a este tipo de edema.

  1. MRI findings of acute cerebral swelling and brain edema in the acute stage. A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Oki, Hideo; Ueda, Shin; Matsumoto, Keizo; Kashihara, Michiharu; Furuichi, Masashi.

    1988-08-01

    We report two cases, one of acute cerebral swelling and the other with a major stroke, whose MRI has shown very interesting findings. Case 1, a 32-year-old male, was admitted to our service because of a lowering of his consciousness immediately after a head injury. On admission, the patient was semicomatous (E/sub 1/M/sub 2/V/sub 1/, with anisocoria (R > L). His plain skull X-ray was normal. A CT scan, however, demonstrated right isodensity hemispheric swelling associated with a subarachnoid hemorrhage in the right Sylvian fissure. A right carotid angiogram showed no vascular disorders. MR imaging of the spin density demonstrated a hyperintensitive thickening of the gray matter in the whole right hemisphere. Case 2, a 58-year-old female, was admitted because of a sudden onset of loss of consciousness, with right hemiparesis and dysarthria. On admission, her consciousness was semicomatous (E/sub 1/M/sub 3/V/sub 1/), and it deteriorated to a deep coma 1 hour later. A CT scan demonstrated a diffuse left hemispheric low density, with a finding of hemorrhagic infarction in the basal ganglia. MR imaging of the spin density showed a hyperintensitive thickening of the gray matter resembling that of Case 1. The findings of the spin-echo images of our two cases showed a hyperintensitive thickening of the gray matter in both. The hyperintensity and thickening of the gray matter apparently indicated a sort of hyperemia and brain edema. These findings led us to suspect that the hyperemia associated with acute cerebral swelling and ischemic brain edema of our two cases originated in the gray matter, although it has been considered that the pathogenesis of acute cerebral swelling is not known and that brain edema, especially vasogenic edema, will mostly develop in the white matter rather than in the gray matter.

  2. High-altitude adaptations in vertebrate hemoglobins

    DEFF Research Database (Denmark)

    Weber, Roy E.

    2007-01-01

    Vertebrates at high altitude are subjected to hypoxic conditions that challenge aerobic metabolism. O2 transport from the respiratory surfaces to tissues requires matching between the O2 loading and unloading tensions and theO2-affinity of blood, which is an integrated function of hemoglobin......, birds and ectothermic vertebrates at high altitude....

  3. High-altitude adaptations in vertebrate hemoglobins

    DEFF Research Database (Denmark)

    Weber, Roy E.

    2007-01-01

    Vertebrates at high altitude are subjected to hypoxic conditions that challenge aerobic metabolism. O2 transport from the respiratory surfaces to tissues requires matching between the O2 loading and unloading tensions and theO2-affinity of blood, which is an integrated function of hemoglobin......, birds and ectothermic vertebrates at high altitude....

  4. Effect of siRNA‑induced inhibition of IL‑6 expression in rat cerebral gliocytes on cerebral edema following traumatic brain injury.

    Science.gov (United States)

    Xu, Bin; Yu, Dong-Ming; Liu, Fu-Sheng

    2014-10-01

    The present study aimed to investigate the effect of RNA interference (RNAi) on the inhibition of interleukin (IL)‑6 expression in rat cerebral gliocytes in vitro and rat cerebral traumatic tissues in vivo, as well as the effect of RNAi on cerebral edema. pSUPER vectors containing IL‑6 small hairpin RNA (pSUPER‑IL‑6 1‑5) were designed, constructed and transfected into C6 rat glioma cells using cationic liposomes. ELISA was used to select the plasmid with the strongest interference effect. A freefall method was used to generate a rat brain injury model and rats were randomly divided into treatment, empty plasmid and control groups (n=14/group). IL‑6 levels, water content and sodium content were determined in the brain tissues at 24 and 72 h post‑injury. pSUPER‑IL‑6 was effectively transfected into C6 cells and was found to inhibit the expression of IL‑6 rather than IL‑8. The pSUPER‑IL‑6 1 vector was most effective in inducing RNAi. In vivo, IL‑6 levels were observed to be lowest in the interference group and there were statistically significant differences in water and sodium content among the experimental groups (Pcerebral gliocytes, and the reduction of the IL‑6 levels was found to reduce post‑traumatic cerebral edema.

  5. The effects of Tanshinone IIA on blood-brain barrier and brain edema after transient middle cerebral artery occlusion in rats.

    Science.gov (United States)

    Tang, Chao; Xue, Hongli; Bai, Changlin; Fu, Rong; Wu, Anhua

    2010-12-01

    Disruption of blood-brain barrier (BBB) and edema formation play a key role in the development of neurological dysfunction after cerebral ischemia. In this study, the effects of Tanshinone IIA (Tan IIA), one of the active ingredients of Salvia miltiorrhiza root, on the BBB and brain edema after transient middle cerebral artery occlusion in rats were examined. Our study demonstrated that Tan IIA reduced brain infarct area, water content in the ischemic hemisphere. Furthermore, Tan IIA significantly decreased BBB permeability to Evans blue, suppressed the expression of intercellular adhesion molecule-1 (ICAM-1), matrix metalloproteinase-9 (MMP-9), inhibited the degradation of tight junction proteins zonula occludens-1 (ZO-1) and Occludin. These results demonstrated that Tan IIA was effective for attenuating the extent of brain edema formation in response to ischemia injury in rats, partly by Tan IIA's protective effect on the BBB. Our results may have implications in the treatment of brain edema in cerebral ischemia.

  6. Aneurysmal wall enhancement and perianeurysmal edema after endovascular treatment of unruptured cerebral aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Su, I. Chang [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, ON (Canada); Taipei Cathay General Hospital, Division of Neurosurgery, Department of Surgery, Taipei (China); Willinsky, Robert A.; Agid, Ronit [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, ON (Canada); Fanning, Noel F. [Cork University Hospital, Department of Interventional Neuroradiology, Cork (Ireland)

    2014-06-15

    Perianeurysmal edema and aneurysm wall enhancement are previously described phenomenon after coil embolization attributed to inflammatory reaction. We aimed to demonstrate the prevalence and natural course of these phenomena in unruptured aneurysms after endovascular treatment and to identify factors that contributed to their development. We performed a retrospective analysis of consecutively treated unruptured aneurysms between January 2000 and December 2011. The presence and evolution of wall enhancement and perianeurysmal edema on MRI after endovascular treatment were analyzed. Variable factors were compared among aneurysms with and without edema. One hundred thirty-two unruptured aneurysms in 124 patients underwent endovascular treatment. Eighty-five (64.4 %) aneurysms had wall enhancement, and 9 (6.8 %) aneurysms had perianeurysmal brain edema. Wall enhancement tends to persist for years with two patterns identified. Larger aneurysms and brain-embedded aneurysms were significantly associated with wall enhancement. In all edema cases, the aneurysms were embedded within the brain and had wall enhancement. Progressive thickening of wall enhancement was significantly associated with edema. Edema can be symptomatic when in eloquent brain and stabilizes or resolves over the years. Our study demonstrates the prevalence and some appreciation of the natural history of aneurysmal wall enhancement and perianeurysmal brain edema following endovascular treatment of unruptured aneurysms. Aneurysmal wall enhancement is a common phenomenon while perianeurysmal edema is rare. These phenomena are likely related to the presence of inflammatory reaction near the aneurysmal wall. Both phenomena are usually asymptomatic and self-limited, and prophylactic treatment is not recommended. (orig.)

  7. Activation of P2X7 promotes cerebral edema and neurological injury after traumatic brain injury in mice.

    Directory of Open Access Journals (Sweden)

    Donald E Kimbler

    Full Text Available Traumatic brain injury (TBI is a leading cause of death and disability worldwide. Cerebral edema, the abnormal accumulation of fluid within the brain parenchyma, contributes to elevated intracranial pressure (ICP and is a common life-threatening neurological complication following TBI. Unfortunately, neurosurgical approaches to alleviate increased ICP remain controversial and medical therapies are lacking due in part to the absence of viable drug targets. In the present study, genetic inhibition (P2X7-/- mice of the purinergic P2x7 receptor attenuated the expression of the pro-inflammatory cytokine, interleukin-1β (IL-1β and reduced cerebral edema following controlled cortical impact, as compared to wild-type mice. Similarly, brilliant blue G (BBG, a clinically non-toxic P2X7 inhibitor, inhibited IL-1β expression, limited edemic development, and improved neurobehavioral outcomes after TBI. The beneficial effects of BBG followed either prophylactic administration via the drinking water for one week prior to injury or via an intravenous bolus administration up to four hours after TBI, suggesting a clinically-implementable therapeutic window. Notably, P2X7 localized within astrocytic end feet and administration of BBG decreased the expression of glial fibrillary acidic protein (GFAP, a reactive astrocyte marker, and attenuated the expression of aquaporin-4 (AQP4, an astrocytic water channel that promotes cellular edema. Together, these data implicate P2X7 as a novel therapeutic target to prevent secondary neurological injury after TBI, a finding that warrants further investigation.

  8. Quantitation of brain edema and localisation of aquaporin 4 expression in relation to susceptibility to experimental cerebral malaria.

    Science.gov (United States)

    Ampawong, Sumate; Combes, Valéry; Hunt, Nicholas H; Radford, Jane; Chan-Ling, Tailoi; Pongponratn, Emsri; Grau, Georges E R

    2011-08-15

    The pathogenic mechanisms underlying the occurrence of cerebral malaria (CM) are still incompletely understood but, clearly, cerebral complications may result from concomitant microvessel obstruction and inflammation. The extent to which brain edema contributes to pathology has not been investigated. Using the model of P. berghei ANKA infection, we compared brain microvessel morphology of CM-susceptible and CM-resistant mice. By quantitative planimetry, we provide evidence that CM is characterized by enlarged perivascular spaces (PVS). We show a dramatic aquaporin 4 (AQP4) upregulation, selectively at the level of astrocytic foot processes, in both CM and non-CM disease, but significantly more pronounced in mice with malarial-induced neurological syndrome. This suggests that a threshold of AQP4 expression is needed to lead to neurovascular pathology, a view that is supported by significantly higher levels in mice with clinically overt CM. Numbers of intravascular leukocytes significantly correlated with both PVS enlargement and AQP4 overexpression. Thus, brain edema could be a contributing factor in CM pathogenesis and AQP4, specifically in its astrocytic location, a key molecule in this mechanism. Since experimental CM is associated with substantial brain edema, it models paediatric CM better than the adult syndrome and it is tempting to evaluate AQP4 in the former context. If AQP4 changes are confirmed in human CM, it may represent a novel target for therapeutic intervention.

  9. Activation of P2X7 promotes cerebral edema and neurological injury after traumatic brain injury in mice.

    Science.gov (United States)

    Kimbler, Donald E; Shields, Jessica; Yanasak, Nathan; Vender, John R; Dhandapani, Krishnan M

    2012-01-01

    Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Cerebral edema, the abnormal accumulation of fluid within the brain parenchyma, contributes to elevated intracranial pressure (ICP) and is a common life-threatening neurological complication following TBI. Unfortunately, neurosurgical approaches to alleviate increased ICP remain controversial and medical therapies are lacking due in part to the absence of viable drug targets. In the present study, genetic inhibition (P2X7-/- mice) of the purinergic P2x7 receptor attenuated the expression of the pro-inflammatory cytokine, interleukin-1β (IL-1β) and reduced cerebral edema following controlled cortical impact, as compared to wild-type mice. Similarly, brilliant blue G (BBG), a clinically non-toxic P2X7 inhibitor, inhibited IL-1β expression, limited edemic development, and improved neurobehavioral outcomes after TBI. The beneficial effects of BBG followed either prophylactic administration via the drinking water for one week prior to injury or via an intravenous bolus administration up to four hours after TBI, suggesting a clinically-implementable therapeutic window. Notably, P2X7 localized within astrocytic end feet and administration of BBG decreased the expression of glial fibrillary acidic protein (GFAP), a reactive astrocyte marker, and attenuated the expression of aquaporin-4 (AQP4), an astrocytic water channel that promotes cellular edema. Together, these data implicate P2X7 as a novel therapeutic target to prevent secondary neurological injury after TBI, a finding that warrants further investigation.

  10. Infarto cerebral e edema avaliação prognóstico-evolutiva por sinais neurológicos

    Directory of Open Access Journals (Sweden)

    Rubens José Gagliardi

    1991-03-01

    Full Text Available Trata-se de estudo prospectivo abrangendo 92 doentes com infarto cerebral (IC. O seguimento foi feito durante 10 dias com avaliação diária, sendo os doentes analisados por escala de notas para diferentes sinais costumeiramente pesquisados nesses casos. A metodologia foi especialmente desenvolvida no sentido de analisar exclusivamente alterações devidas ao edema oriundo da isquemia e IC. As conclusões foram obtidas por comparação isolada das médias das notas de cada sinal com a média do total das notas. Os resultados mostram que o exame da «consciência», isoladamente, é o melhor parâmetro clínico para averiguar a evolução do doente após um IC, sem outras complicações que não o edema.

  11. Dialysis Disequilibrium Syndrome-Induced Cerebral Edema in a Patient with Uremia Following Hemodialysis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Min; Kim, Heung Cheol [Dept. of Radiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2012-03-15

    Dialysis disequilibrium syndrome is a metabolic complication that can be caused by rapid removal of plasma urea during hemodialysis. Dialysis disequilibrium syndrome can lead to osmotic demyelinating syndrome. This case report describes one case of encephalopathy accompanied by dialysis disequilibrium syndrome with imaging findings acquired immediately after hemodialysis in a 55-year-old woman with chronic renal failure. The patient was observed to present repetitive seizures and sudden deterioration of consciousness immediately after hemodialysis. Shortly after the onset of symptoms, the patient underwent a CT scan. The imaging findings of the CT scan reveal symmetrical diffuse white matter edema of bilateral cerebral hemispheres that extends to the pons along the internal capsule. A follow-up MRI taken two years later shows that reversible changes without damage have occurred in the lesions. The patient can thus be seen to present symptoms characteristically associated with dialysis disequilibrium syndrome, while brain imaging reveals dif-fuse reversible brain edema.

  12. β-Dystroglycan cleavage by matrix metalloproteinase-2/-9 disturbs aquaporin-4 polarization and influences brain edema in acute cerebral ischemia.

    Science.gov (United States)

    Yan, W; Zhao, X; Chen, H; Zhong, D; Jin, J; Qin, Q; Zhang, H; Ma, S; Li, G

    2016-06-21

    Dystroglycan (DG) is widely expressed in various tissues, and throughout the cerebral microvasculature. It consists of two subunits, α-DG and β-DG, and the cleavage of the latter by matrix metalloproteinase (MMP)-2 and -9 underlies a number of physiological and pathological processes. However, the involvement of MMP-2/-9-mediated β-DG cleavage in cerebral ischemia remains uncertain. In astrocytes, DG is crucial for maintaining the polarization of aquaporin-4 (AQP4), which plays a role in the regulation of cytotoxic and vasogenic edema. The present study aimed to explore the effects of MMP-2/-9-mediated β-DG cleavage on AQP4 polarization and brain edema in acute cerebral ischemia. A model of cerebral ischemia was established via permanent middle cerebral artery occlusion (pMCAO) in male C57BL/6 mice. Western blotting, real-time polymerase chain reaction (PCR), immunohistochemical staining, immunofluorescent staining, electron microscopy, and light microscopy were used. Captopril was applied as a selective MMP-2/-9 inhibitor. Recombinant mouse MMP (rmMMP)-2 and -9 were used in an in vitro cleavage experiment. The present study demonstrated evidence of β-DG cleavage by MMP-2/-9 in pMCAO mouse brains; this cleavage was implicated in AQP4 redistribution and brain edema in cerebral ischemia. In addition, captopril exacerbated cytotoxic edema and ameliorated vasogenic edema at 24h after pMCAO, and alleviated brain edema and neurological deficit at 48h and 72h. In conclusion, this study provides novel insight into the effects of MMP-2/-9-mediated β-DG cleavage in acute cerebral ischemia. Such findings might facilitate the development of a therapeutic strategy for the optimization of MMP-2/-9 targeted treatment in cerebral ischemia.

  13. Pupillary light reaction during high altitude exposure.

    Directory of Open Access Journals (Sweden)

    Maximilian Schultheiss

    Full Text Available PURPOSE: This study aimed to quantify the pupillary light reaction during high altitude exposure using the state of the art Compact Integrated Pupillograph (CIP and to investigate a potential correlation of altered pupil reaction with severity of acute mountain sickness (AMS. This work is related to the Tübingen High Altitude Ophthalmology (THAO study. METHODS: Parameters of pupil dynamics (initial diameter, amplitude, relative amplitude, latency, constriction velocity were quantified in 14 healthy volunteers at baseline (341 m and high altitude (4559 m over several days using the CIP. Scores of AMS, peripheral oxygen saturation and heart rate were assessed for respective correlations with pupil dynamics. For statistical analysis JMP was used and data are shown in terms of intra-individual normalized values (value during exposure/value at baseline and the 95% confidence interval for each time point. RESULTS: During high altitude exposure the initial diameter size was significantly reduced (p<0.05. In contrast, the amplitude, the relative amplitude and the contraction velocity of the light reaction were significantly increased (p<0.05 on all days measured at high altitude. The latency did not show any significant differences at high altitude compared to baseline recordings. Changes in pupil parameters did not correlate with scores of AMS. CONCLUSIONS: Key parameters of the pupillary light reaction are significantly altered at high altitude. We hypothesize that high altitude hypoxia itself as well as known side effects of high altitude exposure such as fatigue or exhaustion after ascent may account for an altered pupillogram. Interestingly, none of these changes are related to AMS.

  14. Pupillary Light Reaction during High Altitude Exposure

    Science.gov (United States)

    Schatz, Andreas; Wilhelm, Barbara; Peters, Tobias; Fischer, M. Dominik; Zrenner, Eberhart; Bartz-Schmidt, Karl U.; Gekeler, Florian; Willmann, Gabriel

    2014-01-01

    Purpose This study aimed to quantify the pupillary light reaction during high altitude exposure using the state of the art Compact Integrated Pupillograph (CIP) and to investigate a potential correlation of altered pupil reaction with severity of acute mountain sickness (AMS). This work is related to the Tübingen High Altitude Ophthalmology (THAO) study. Methods Parameters of pupil dynamics (initial diameter, amplitude, relative amplitude, latency, constriction velocity) were quantified in 14 healthy volunteers at baseline (341 m) and high altitude (4559 m) over several days using the CIP. Scores of AMS, peripheral oxygen saturation and heart rate were assessed for respective correlations with pupil dynamics. For statistical analysis JMP was used and data are shown in terms of intra-individual normalized values (value during exposure/value at baseline) and the 95% confidence interval for each time point. Results During high altitude exposure the initial diameter size was significantly reduced (p<0.05). In contrast, the amplitude, the relative amplitude and the contraction velocity of the light reaction were significantly increased (p<0.05) on all days measured at high altitude. The latency did not show any significant differences at high altitude compared to baseline recordings. Changes in pupil parameters did not correlate with scores of AMS. Conclusions Key parameters of the pupillary light reaction are significantly altered at high altitude. We hypothesize that high altitude hypoxia itself as well as known side effects of high altitude exposure such as fatigue or exhaustion after ascent may account for an altered pupillogram. Interestingly, none of these changes are related to AMS. PMID:24503770

  15. Developmental functional adaptation to high altitude: review.

    Science.gov (United States)

    Frisancho, A Roberto

    2013-01-01

    Various approaches have been used to understand the origins of the functional traits that characterize the Andean high-altitude native. Based on the conceptual framework of developmental functional adaptation which postulates that environmental influences during the period of growth and development have long lasting effects that may be expressed during adulthood, we initiated a series of studies addressed at determining the pattern of physical growth and the contribution of growth and development to the attainment of full functional adaptation to high-altitude of low and high altitude natives living under rural and urban conditions. Current research indicate that: (a) the pattern of growth at high altitude due to limited nutritional resources, physical growth in body size is delayed but growth in lung volumes is accelerated because of hypoxic stress); (b) low-altitude male and female urban natives can attain a full functional adaptation to high altitude by exposure to high-altitude hypoxia during the period of growth and development; (c) both experimental studies on animals and comparative human studies indicate that exposure to high altitude during the period of growth and development results in the attainment of a large residual lung volume; (d) this developmentally acquired enlarged residual lung volume and its associated increase in alveolar area when combined with the increased tissue capillarization and moderate increase in red blood cells and hemoglobin concentration contributes to the successful functional adaptation of the Andean high-altitude native to hypoxia; and (e) any specific genetic traits that are related to the successful functional adaptation of Andean high-altitude natives have yet to be identified.

  16. The protective effect of HET0016 on brain edema and blood-brain barrier dysfunction after cerebral ischemia/reperfusion.

    Science.gov (United States)

    Liu, Yu; Wang, Di; Wang, Huan; Qu, Youyang; Xiao, Xingjun; Zhu, Yulan

    2014-01-28

    N-hydroxy-N-(4-butyl-2-methylphenyl) formamidine (HET0016) is a specific 20-hydroxyeicosatetraenoic acid (20-HETE) inhibitor which was first synthesized in 2001. It has been demonstrated that HET0016 reduces cerebral infarction volume in rat middle cerebral artery occlusion (MCAO) models. However, little is known about the role of HET0016 in the blood-brain barrier (BBB) dysfunction after cerebral ischemia/reperfusion (I/R) injury. The present study was designed to examine the effect of HET0016 in a MCAO and reperfusion rat model to determine whether it protects against brain edema and BBB disruption. Rats were subjected to 90 min MCAO, followed by 4, 24, 48, and 72 h reperfusion. Brain edema was measured according to the wet and dry weight method. BBB permeability based on the extravasation of Evans blue and sodium fluorescein was detected. BBB ultrastructure alterations were presented through transmission electron microscope. Superoxide production in ischemic tissue was also measured by dihydroethidium fluorescent probe. Western blot was used to analyze the expression of Claudin-5, ZO-1, MMP-9, and JNK pathway. At 24h after reperfusion, HET0016 reduced brain edema and BBB leakage. Ultrastructural damage of BBB and the increase of superoxide production were attenuated by HET0016 treatment. Western blot showed that HET0016 suppressed the activation of MMP-9 and JNK pathway but restored the expression of Claudin-5 and ZO-1. In conclusion, these results suggest that HET0016 protects BBB dysfunction after I/R by regulating the expression of MMP-9 and tight junction proteins. Furthermore, inhibition of oxidative stress and JNK pathway may be involved in this protecting effect.

  17. Brain edema and tumor necrosis factor-like weak inducer of apoptosis in rats with cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Renlan Zhou; Peng Xie

    2008-01-01

    BACKGROUND: Recent studies have demonstrated that tumor necrosis factor-like weak inducer of apoptosis (TWEAK) participates in brain edema. However, it is unclear whether blood-brain barrier (BBB) disruption is associated with TWEAK during the process of brain edema OBJECTIVE: To investigate the effects of TWEAK on BBB permeability in brain edema.DESIGN, TIME AND SETTING: An immunohistochemical observation, randomized, controlled animal experiment was pertbrmed at the Laboratory of Neurosurgical Anatomy, Xiangya Medical College, Central South University & Central Laboratory, Third Xiangya Hospital, Central South University between January 2006 and December 2007.MATERIALS: A total of 48 adult Wistar rats were randomly divided into three groups: normal control (n =8), sham-operated (n = 8), and ischemia/reperfusion (n = 32). Rats from the ischemia/reperfusion group were randomly assigned to four subgroups according to different time points, i.e., 2 hours of ischemia followed by 6 hours (n = 8), 12 hours {n = 8), 1 day (n = 8), or 12 days (n = 8) of reperfusion.METHODS: Focal cerebral ischemia/reperfusion injury was induced by middle cerebral artery occlusion (MCAO) using the suture method in rats from the ischemia/reperfusion group. Thread was introduced at a depth of 17-19 mm. Rats in the sham-operated group were subjected to experimental procedures similar to the ischemia/reperfusion group; however, the introducing depth of thread was 10 mm. The normal control group was not given any intervention.MAIN OUTCOME MEASURES: TWEAK expression was examined by immunohistochemistry; brain water content on the ischemic side was calculated as the ratio of dry to wet tissue weight; BBB permeability was measured by Evans blue extravasation.RESULTS: A total of eight rats died prior to and after surgery and an additional eight rats were randomly entered into the study. Thus 48 rats were included in the final analysis. In the ischemia/reperfusion group,TWEAK-positive cells were

  18. Twenty-Four-Hour Real-Time Continuous Monitoring of Cerebral Edema in Rabbits Based on a Noninvasive and Noncontact System of Magnetic Induction

    Directory of Open Access Journals (Sweden)

    Gen Li

    2017-03-01

    Full Text Available Cerebral edema is a common disease, secondary to craniocerebral injury, and real-time continuous monitoring of cerebral edema is crucial for treating patients after traumatic brain injury. This work established a noninvasive and noncontact system by monitoring the magnetic induction phase shift (MIPS which is associated with brain tissue conductivity. Sixteen rabbits (experimental group n = 10, control group, n = 6 were used to perform a 24 h MIPS and intracranial pressure (ICP simultaneously monitored experimental study. For the experimental group, after the establishment of epidural freeze-induced cerebral edema models, the MIPS presented a downward trend within 24 h, with a change magnitude of −13.1121 ± 2.3953°; the ICP presented an upward trend within 24 h, with a change magnitude of 12–41 mmHg. The ICP was negatively correlated with the MIPS. In the control group, the MIPS change amplitude was −0.87795 ± 1.5146 without obvious changes; the ICP fluctuated only slightly at the initial value of 12 mmHg. MIPS had a more sensitive performance than ICP in the early stage of cerebral edema. These results showed that this system is basically capable of monitoring gradual increases in the cerebral edema solution volume. To some extent, the MIPS has the potential to reflect the ICP changes.

  19. Risk prediction score for severe high altitude illness: a cohort study.

    Directory of Open Access Journals (Sweden)

    Florence Canouï-Poitrine

    Full Text Available Risk prediction of acute mountain sickness, high altitude (HA pulmonary or cerebral edema is currently based on clinical assessment. Our objective was to develop a risk prediction score of Severe High Altitude Illness (SHAI combining clinical and physiological factors. Study population was 1017 sea-level subjects who performed a hypoxia exercise test before a stay at HA. The outcome was the occurrence of SHAI during HA exposure. Two scores were built, according to the presence (PRE, n = 537 or absence (ABS, n = 480 of previous experience at HA, using multivariate logistic regression. Calibration was evaluated by Hosmer-Lemeshow chisquare test and discrimination by Area Under ROC Curve (AUC and Net Reclassification Index (NRI.The score was a linear combination of history of SHAI, ventilatory and cardiac response to hypoxia at exercise, speed of ascent, desaturation during hypoxic exercise, history of migraine, geographical location, female sex, age under 46 and regular physical activity. In the PRE/ABS groups, the score ranged from 0 to 12/10, a cut-off of 5/5.5 gave a sensitivity of 87%/87% and a specificity of 82%/73%. Adding physiological variables via the hypoxic exercise test improved the discrimination ability of the models: AUC increased by 7% to 0.91 (95%CI: 0.87-0.93 and 17% to 0.89 (95%CI: 0.85-0.91, NRI was 30% and 54% in the PRE and ABS groups respectively. A score computed with ten clinical, environmental and physiological factors accurately predicted the risk of SHAI in a large cohort of sea-level residents visiting HA regions.

  20. High Altitude Clear Air Turbulence Project

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Air Force Flight Dynamics Laboratory conducted the High Altitude Clear Air Turbulence Project in the mid 1960s with the intention of better understanding air...

  1. Missing correlation of retinal vessel diameter with high-altitude headache

    Science.gov (United States)

    Willmann, Gabriel; Fischer, M Dominik; Schommer, Kai; Bärtsch, Peter; Gekeler, Florian; Schatz, Andreas

    2014-01-01

    The most common altitude-related symptom, high-altitude headache (HAH), has recently been suggested to originate from restricted cerebral venous drainage in the presence of increased inflow caused by hypoxia. In support of this novel hypothesis, retinal venous distension was shown to correlate with the degree of HAH. We quantified for the first time retinal vessel diameter changes at 4559 m using infrared fundus images obtained from a state of the art Spectralis™ HRA+OCT with a semiautomatic VesselMap 1® software. High-altitude exposure resulted in altered arterial and venous diameter changes at high altitude, however, independent of headache burden. PMID:25356382

  2. Edema cerebral localizado como complicação tardia de traumatismo crânio-encefálico

    Directory of Open Access Journals (Sweden)

    Gilberto Machado de Almeida

    1960-03-01

    Full Text Available Entre os pacientes internados, por traumatismos cranianos, no Pronto Socorro de Neurocirurgia do Hospital das Clínicas da Faculdade de Medicina de São Paulo, de 1954 a 1957, foram selecionados três, nos quais a evolução ulterior infirmou o diagnóstico inicial de hematoma extra ou subdural. O aparecimento, algum tempo após o traumatismo, de sinais focais e de hipertensão intracraniana sugeriu a existência de hematoma intracraniano provavelmente subdural, sendo então indicada a realização, com urgência, de uma angiografia cerebral por via carotídea. Em todos os casos foram evidenciados desvios da artéria cerebral anterior, não havendo elementos para o diagnóstico da natureza do processo expansivo. Em dois casos foram feitas pneumografias que mostraram desvios do sistema ventricular e electrencefalogramas que mostraram depressão da atividade elétrica no hemisfério homolateral ao traumatismo. Exames radiológicos sucessivos mostraram diminuição progressiva, até a desaparição, dos desvios arteriais; um dos pacientes foi submetido a trepanação exploradora que mostrou apenas edema cerebral. Medicação visando combater o edema cerebral determinou melhora acentuada dos quadros clínicos. A finalidade do trabalho é de apresentar um quadro raramente descrito como complicação de traumatismos crânio-encefálicos e tecer comentários a respeito das dificuldades do diagnóstico diferencial com o hematoma subdural.

  3. High mobility group box protein-1 promotes cerebral edema after traumatic brain injury via activation of toll-like receptor 4.

    Science.gov (United States)

    Laird, Melissa D; Shields, Jessica S; Sukumari-Ramesh, Sangeetha; Kimbler, Donald E; Fessler, R David; Shakir, Basheer; Youssef, Patrick; Yanasak, Nathan; Vender, John R; Dhandapani, Krishnan M

    2014-01-01

    Traumatic brain injury (TBI) is a major cause of mortality and morbidity worldwide. Cerebral edema, a life-threatening medical complication, contributes to elevated intracranial pressure (ICP) and a poor clinical prognosis after TBI. Unfortunately, treatment options to reduce post-traumatic edema remain suboptimal, due in part, to a dearth of viable therapeutic targets. Herein, we tested the hypothesis that cerebral innate immune responses contribute to edema development after TBI. Our results demonstrate that high-mobility group box protein 1 (HMGB1) was released from necrotic neurons via a NR2B-mediated mechanism. HMGB1 was clinically associated with elevated ICP in patients and functionally promoted cerebral edema after TBI in mice. The detrimental effects of HMGB1 were mediated, at least in part, via activation of microglial toll-like receptor 4 (TLR4) and the subsequent expression of the astrocytic water channel, aquaporin-4 (AQP4). Genetic or pharmacological (VGX-1027) TLR4 inhibition attenuated the neuroinflammatory response and limited post-traumatic edema with a delayed, clinically implementable therapeutic window. Human and rodent tissue culture studies further defined the cellular mechanisms demonstrating neuronal HMGB1 initiates the microglial release of interleukin-6 (IL-6) in a TLR4 dependent mechanism. In turn, microglial IL-6 increased the astrocytic expression of AQP4. Taken together, these data implicate microglia as key mediators of post-traumatic brain edema and suggest HMGB1-TLR4 signaling promotes neurovascular dysfunction after TBI.

  4. The Physiopathologic Mechanism of Cerebral Edema with Intracerebral Hemorrhage%脑出血后脑水肿形成的病理生理机制

    Institute of Scientific and Technical Information of China (English)

    屈洪党; 殷亮; 陈齐鸣

    2011-01-01

    Objective: To investigate the physiopathologic mechanism of cerebral edema after intracere-bral hemorrhage. Methods: To analyze the physiopathologic mechanism of cerebral edema after intracerebral hemorrhage by summarizing pertinent literatures. Results:The cerebral edema generated after intracerebral hemorrhage in the ultra - early onset. The significant factors which aggravated cerebral edema included compression of hematoma, ischemia, thrombase, hemoglobin and plasma protein, leucocytes and inflammatory cell factor. Conclusions:The physiopathologic mechanism of cerebral edema with intracerebral hemorrhage is complicated, which can provide ways and methods to treat the edema in the surrounding tissues of cerebral hematom.%目的:探讨脑出血后脑水肿形成的病理生理机制.方法:总结相关文献,分析脑出血后脑水肿形成的病理生理机制.结果:脑水肿多在脑出血后超早期发生.血肿占位效应、缺血因素、凝血酶、血红蛋白和血浆蛋白、白细胞和炎性细胞因子等在脑水肿形成的过程中具有重要作用.结论:脑出血后脑水肿形成的病理机制十分复杂,研究脑水肿的形成机制,可以为临床医师治疗血肿周围脑组织水肿提供新的途径和方法.

  5. Evaluation of pharmacological efficacy of anti-edema agents in a rat cerebral infarction model by MRI image analysis

    Energy Technology Data Exchange (ETDEWEB)

    Izumi, Yoshio; Haida, Munetaka; Kurita, Daisaku; Shinohara, Yukito [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine; Sugiura, Takeo

    1997-04-01

    We investigated the efficacy of drugs used to treat brain edema in a rat acute cerebral infarction model by MRI image analysis. Twenty-six Sprague-Dawley rats were anesthetized with halothane, and the right middle cerebral artery was permanently occluded via a transvascular approach using a nylon 2-0 suture. At 24 hours after the occlusion, axial T{sub 2}-weighted MRI images were taken before and 2 hours after intraperitoneal administration of a test drug. After the administration of 1.7 g/kg glycerol (n=9), 3.3 g/kg mannitol (n=9) or 17 mg/kg furosemide (n=8), the high intensity area (HIA) in the whole brain amounted to 92% (p<0.01), 94% (p=0.07), or 95% (p=0.03), respectively as compared to the corresponding HIA before administration. The HIA in the cerebral cortex amounted to 87% (p<0.01), 89% (p=0.03), or 98% (p=0.47), and that in the striatum to 102%, 106%, or 87% (p<0.05), respectively. The signal intensity change (before{yields}after) was 54{yields}49 (p<0.01), 54{yields}50 (p<0.01), or 55{yields}54 in the left side normal cortex; 102{yields}97 (p<0.0l), 100{yields}98, or 98{yields}97 in the injured side cortex; and 100{yields}93 (p<0.0l), 94{yields}88 (p=0.03), or 94{yields}94 in the injured side striatum, respectively. Improvement of edema by the drugs was observed as a reduction in HIA and a decrease in signal intensity on MRI, and the changes were significant in the case of administration of each of glycerol, mannitol and furosemide. (author)

  6. Aneurysmal wall enhancement and perianeurysmal edema after endovascular treatment of unruptured cerebral aneurysms.

    LENUS (Irish Health Repository)

    Su, I-Chang

    2014-06-01

    Perianeurysmal edema and aneurysm wall enhancement are previously described phenomenon after coil embolization attributed to inflammatory reaction. We aimed to demonstrate the prevalence and natural course of these phenomena in unruptured aneurysms after endovascular treatment and to identify factors that contributed to their development.

  7. Diffusion-weighted MRI in cyclosporin A neurotoxicity for the classification of cerebral edema

    Energy Technology Data Exchange (ETDEWEB)

    Debaere, C.; Stadnik, T.; Maeseneer, M. de; Osteaux, M. [Dept. of Radiology, Academic Hospital, Vrije Universiteit Brussel (Belgium)

    1999-07-01

    Cyclosporin A, an immunosuppressive agent, is known to have neurotoxic effects, but until now, there has not been agreement on the underlying mechanism. Our report suggests, by using diffusion-weighted MRI, that the brain lesions caused by cyclosporin A, are probably related to vasogenic edema. This may explain the complete recovery of the lesions on imaging when cyclosporine therapy is stopped. (orig.)

  8. A comparative study on the efficacy of 10% hypertonic saline and equal volume of 20% mannitol in the treatment of experimentally induced cerebral edema in adult rats

    Directory of Open Access Journals (Sweden)

    Fang Ming

    2010-12-01

    Full Text Available Abstract Background Hypertonic saline and mannitol are commonly used in the treatment of cerebral edema and elevated intracranial pressure (ICP at present. In this connection, 10% hypertonic saline (HS alleviates cerebral edema more effectively than the equal volume of 20% mannitol. However, the exact underlying mechanism for this remains obscure. This study aimed to explore the possible mechanism whereby 10% hypertonic saline can ameliorate cerebral edema more effectively than mannitol. Results Adult male Sprague-Dawley (SD rats were subjected to permanent right-sided middle cerebral artery occlusion (MCAO and treated with a continuous intravenous infusion of 10% HS, 20% mannitol or D-[1-3H(N]-mannitol. Brain water content (BWC as analyzed by wet-to-dry ratios in the ischemic hemisphere of SD rats decreased more significantly after 10% HS treatment compared with 20% mannitol. Concentration of serum Na+ and plasma crystal osmotic pressure of the 10% HS group at 2, 6, 12 and 18 h following permanent MCAO increased significantly when compared with 20% mannitol treated group. Moreover, there was negative correlation between the BWC of the ipsilateral ischemic hemisphere and concentration of serum Na+, plasma crystal osmotic pressure and difference value of concentration of serum Na+ and concentration of brain Na+ in ipsilateral ischemic hemisphere in the 10% HS group at the various time points after MCAO. A remarkable finding was the progressive accumulation of mannitol in the ischemic brain tissue. Conclusions We conclude that 10% HS is more effective in alleviating cerebral edema than the equal volume of 20% mannitol. This is because 10% HS contributes to establish a higher osmotic gradient across BBB and, furthermore, the progressive accumulation of mannitol in the ischemic brain tissue counteracts its therapeutic efficacy on cerebral edema.

  9. Interferon-Stimulated Gene 15 Upregulation Precedes the Development of Blood-Brain Barrier Disruption and Cerebral Edema after Traumatic Brain Injury in Young Mice.

    Science.gov (United States)

    Rossi, Janet L; Todd, Tracey; Daniels, Zachary; Bazan, Nicolas G; Belayev, Ludmila

    2015-07-15

    Recent studies show that myosin light chain kinase (MLCK) plays a pivotal role in development of cerebral edema, a known complication following traumatic brain injury (TBI) in children and a contributing factor to worsened neurologic recovery. Interferon-stimulated gene 15 (ISG15) is upregulated after cerebral ischemia and is neuroprotective. The significant role of ISG15 after TBI has not been studied. Postnatal Day (PND) 21 and PND24 mice were subjected to lateral closed-skull injury with impact depth of 2.0 or 2.25 mm. Behavior was examined at 7 d using two-object novel recognition and Wire Hang tests. Mice were sacrificed at 6 h, 12 h, 24 h, 48 h, 72 h, and 7 d. ISG15 and MLCK were analyzed by Western blot and immunohistochemistry, blood-brain barrier (BBB) disruption with Evans Blue (EB), and cerebral edema with wet/dry weights. EB extravasation and edema peaked at 72 h in both ages. PND21 mice had more severe neurological deficits, compared with PND24 mice. PND24 mice showed peak ISG15 expression at 6 h, and PND21 mice at 72 h. MLCK peaked in both age groups at 12 h and co-localized with ISG15 on immunohistochemistry and co-immunoprecipitation. These studies provide evidence, ISG15 is elevated following TBI in mice, preceding MLCK elevation, development of BBB disruption, and cerebral edema.

  10. Early history of high-altitude physiology.

    Science.gov (United States)

    West, John B

    2016-02-01

    High-altitude physiology can be said to have begun in 1644 when Torricelli described the first mercury barometer and wrote the immortal words "We live submerged at the bottom of an ocean of the element air." Interestingly, the notion of atmospheric pressure had eluded his teacher, the great Galileo. Blaise Pascal was responsible for describing the fall in pressure with increasing altitude, and Otto von Guericke gave a dramatic demonstration of the enormous force that could be developed by atmospheric pressure. Robert Boyle learned of Guericke's experiment and, with Robert Hooke, constructed the first air pump that allowed small animals to be exposed to a low pressure. Hooke also constructed a small low-pressure chamber and exposed himself to a simulated altitude of about 2400 meters. With the advent of ballooning, humans were rapidly exposed to very low pressures, sometimes with tragic results. For example, the French balloon, Zénith, rose to over 8000 m, and two of the three aeronauts succumbed to the hypoxia. Paul Bert was the first person to clearly state that the deleterious effects of high altitude were caused by the low partial pressure of oxygen (PO2), and later research was accelerated by high-altitude stations and expeditions to high altitude.

  11. Oxidative stress at high altitude: genotype–phenotype correlations

    Directory of Open Access Journals (Sweden)

    Pandey P

    2014-05-01

    Full Text Available Priyanka Pandey,1,2 MA Qadar Pasha1,2 1CSIR-Institute of Genomics and Integrative Biology, Delhi, India; 2Department of Biotechnology, University of Pune, Ganeshkhind, Pune, India Abstract: It has been well-documented that the hypobaric hypoxic environment at high altitude (HA causes stress to both the permanent residents of HA and the sojourners. This oxidative stress primarily disturbs the oxygen-sensing and vascular homeostasis pathways, thereby upsetting normal human physiology, especially in sojourners. These environmental challenges have caused dynamic evolutionary changes within natives of HA, allowing them to develop adaptive plasticity. This review focuses on the genomic and biochemical features of the molecules involved in the oxygen-sensing and vascular homeostasis pathways with respect to HA pulmonary edema (HAPE and adaptation. We review the role of genetic markers such as HIF-prolyl hydroxylase 2, endothelial PAS domain-containing protein 1, endothelial nitric oxide synthase, endothelin 1, cytochrome b-245 alpha polypeptide, and glutathione S-transferase pi 1, as well as three circulatory biomarkers (nitric oxide, endothelin 1, and 8-iso-prostaglandin F2α, by highlighting approaches such as candidate gene and genome-wide, adopted in deciphering the pathways. A disagreement between the two approaches has also been highlighted. In addition, we discuss that an overrepresentation of wild-type alleles in HA natives and mutant alleles of same polymorphisms in HAPE patients implies that the allelic variants at the same locus are involved in adaptation and HAPE, respectively. Moreover, healthy sojourners present a number of genomic features similar to HA natives, further strengthening the concept of genetic predisposition. A trend in correlation between protective and risk alleles and altered levels of circulatory markers clearly documents the phenomenon of genotype–phenotype correlations. We conclude that the genetic and biochemical

  12. Purinergic 2Y1 receptor stimulation decreases cerebral edema and reactive gliosis in a traumatic brain injury model.

    Science.gov (United States)

    Talley Watts, Lora; Sprague, Shane; Zheng, Wei; Garling, R Justin; Jimenez, David; Digicaylioglu, Murat; Lechleiter, James

    2013-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability in children and young adults. Neuroprotective agents that may promote repair or counteract damage after injury do not currently exist. We recently reported that stimulation of the purinergic receptor subtype P2Y(1)R using 2-methylthioladenosine 5' diphosphate (2MeSADP) significantly reduced cytotoxic edema induced by photothrombosis. Here, we tested whether P2Y(1)R stimulation was neuroprotective after TBI. A controlled closed head injury model was established for mice using a pneumatic impact device. Brains were harvested at 1, 3, or 7 days post-injury and assayed for morphological changes by immunocytochemistry, Western blot analysis, and wet/dry weight. Cerebral edema and expression of both aquaporin type 4 and glial fibrillary acidic protein were increased at all time points examined. Immunocytochemical measurements in both cortical and hippocampal slices also revealed significant neuronal swelling and reactive gliosis. Treatment of mice with 2MeSADP (100 μM) or MRS2365 (100 μM) 30 min after trauma significantly reduced all post-injury symptoms of TBI including edema, neuronal swelling, reactive gliosis, and AQ4 expression. The neuroprotective effect was lost in IP(3)R2-/- mice treated with 2MeSADP. Immunocytochemical labeling of brain slices confirmed that P2Y(1)R expression was defined to cortical and hippocampal astrocytes, but not neurons. Taken together, the data show that stimulation of astrocytic P2Y(1)Rs significantly reduces brain injury after acute trauma and is mediated by the IP(3)-signaling pathway. We suggest that enhancing astrocyte mitochondrial metabolism offers a promising neuroprotective strategy for a broad range of brain injuries.

  13. Estimation of high altitude Martian dust parameters

    Science.gov (United States)

    Pabari, Jayesh; Bhalodi, Pinali

    2016-07-01

    Dust devils are known to occur near the Martian surface mostly during the mid of Southern hemisphere summer and they play vital role in deciding background dust opacity in the atmosphere. The second source of high altitude Martian dust could be due to the secondary ejecta caused by impacts on Martian Moons, Phobos and Deimos. Also, the surfaces of the Moons are charged positively due to ultraviolet rays from the Sun and negatively due to space plasma currents. Such surface charging may cause fine grains to be levitated, which can easily escape the Moons. It is expected that the escaping dust form dust rings within the orbits of the Moons and therefore also around the Mars. One more possible source of high altitude Martian dust is interplanetary in nature. Due to continuous supply of the dust from various sources and also due to a kind of feedback mechanism existing between the ring or tori and the sources, the dust rings or tori can sustain over a period of time. Recently, very high altitude dust at about 1000 km has been found by MAVEN mission and it is expected that the dust may be concentrated at about 150 to 500 km. However, it is mystery how dust has reached to such high altitudes. Estimation of dust parameters before-hand is necessary to design an instrument for the detection of high altitude Martian dust from a future orbiter. In this work, we have studied the dust supply rate responsible primarily for the formation of dust ring or tori, the life time of dust particles around the Mars, the dust number density as well as the effect of solar radiation pressure and Martian oblateness on dust dynamics. The results presented in this paper may be useful to space scientists for understanding the scenario and designing an orbiter based instrument to measure the dust surrounding the Mars for solving the mystery. The further work is underway.

  14. Effects of ganglioside GM1 on reduction of brain edema and amelioration of cerebral metabolism after traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    陈志刚; 卢亦成; 朱诚; 张光霁; 丁学华; 江基尧

    2003-01-01

    Objective: To observe the effects of ganglioside GM1 on reduction of brain edema and amelioration of cerebral metabolism after traumatic brain injury (TBI).Methods: An acute experimental closed TBI model in rats was induced by a fluid-percussion brain injury model. At five and sixty minutes after TBI, the animals were intraperitoneally injected by ganglioside GM1 (30 mg/kg) or the same volume of saline. At the 6th hour after TBI, effects of ganglioside GM1 or saline on changes of mean arterial pressure (MAP), contents of water, lactic acid (LA) and lipid peroxidation (LPO) in the injured cerebral tissues were observed.Results: After TBI, MAP decreased and contents of water, LA and LPO increased in brain injury group; however, MAP was back to normal levels and contents of water, LA and LPO decreased in ganglioside GM1 treated group, compared with those in brain injury group (P0.05) was observed.Conclusions: Ganglioside GM1 does have obvious neuroprotective effect on early TBI.

  15. Pediatric cerebral stroke: susceptibility-weighted imaging may predict post-ischemic malignant edema.

    Science.gov (United States)

    Bosemani, Thangamadhan; Poretti, Andrea; Orman, Gunes; Meoded, Avner; Huisman, Thierry A G M

    2013-10-01

    Susceptibility-weighted imaging (SWI) is an advanced MRI technique providing information on the blood oxygenation level. Deoxyhemoglobin is increased in hypoperfused tissue characterized by SWI-hypointensity, while high oxyhemoglobin concentration within hyperperfused tissue results in a SWI iso- or hyperintensity compared to healthy brain tissue. We describe a child with a stroke, where SWI in addition to excluding hemorrhage and delineating the thrombus proved invaluable in determining regions of hyperperfusion or luxury perfusion, which contributed further to the prognosis including an increased risk of developing post-ischemic malignant edema.

  16. Sleep of Andean high altitude natives.

    Science.gov (United States)

    Coote, J H; Stone, B M; Tsang, G

    1992-01-01

    The structure of sleep in lowland visitors to altitudes greater than 4000 m is grossly disturbed. There are no data on sleep in long-term residents of high altitudes. This paper describes an electroencephalographic study of sleep in high altitude dwellers who were born in and are permanent residents of Cerro de Pasco in the Peruvian Andes, situated at 4330 m. Eight healthy male volunteers aged between 18 and 69 years were studied. Sleep was measured on three consecutive nights for each subject. Electroencephalographs, submental electromyographs and electro-oculograms were recorded. Only data from the third night were used in the analysis. The sleep patterns of these subjects resembled the normal sleep patterns described by others in lowlanders at sea level. There were significant amounts of slow wave sleep in the younger subjects and rapid eye movement sleep seemed unimpaired.

  17. Can High Altitude Influence Cytokines and Sleep?

    Directory of Open Access Journals (Sweden)

    Valdir de Aquino Lemos

    2013-01-01

    Full Text Available The number of persons who relocate to regions of high altitude for work, pleasure, sport, or residence increases every year. It is known that the reduced supply of oxygen (O2 induced by acute or chronic increases in altitude stimulates the body to adapt to new metabolic challenges imposed by hypoxia. Sleep can suffer partial fragmentation because of the exposure to high altitudes, and these changes have been described as one of the responsible factors for the many consequences at high altitudes. We conducted a review of the literature during the period from 1987 to 2012. This work explored the relationships among inflammation, hypoxia and sleep in the period of adaptation and examined a novel mechanism that might explain the harmful effects of altitude on sleep, involving increased Interleukin-1 beta (IL-1β, Interleukin-6 (IL-6, and tumor necrosis factor-alpha (TNF-α production from several tissues and cells, such as leukocytes and cells from skeletal muscle and brain.

  18. Can High Altitude Influence Cytokines and Sleep?

    Science.gov (United States)

    de Aquino Lemos, Valdir; dos Santos, Ronaldo Vagner Thomatieli; Lira, Fabio Santos; Rodrigues, Bruno; Tufik, Sergio; de Mello, Marco Tulio

    2013-01-01

    The number of persons who relocate to regions of high altitude for work, pleasure, sport, or residence increases every year. It is known that the reduced supply of oxygen (O2) induced by acute or chronic increases in altitude stimulates the body to adapt to new metabolic challenges imposed by hypoxia. Sleep can suffer partial fragmentation because of the exposure to high altitudes, and these changes have been described as one of the responsible factors for the many consequences at high altitudes. We conducted a review of the literature during the period from 1987 to 2012. This work explored the relationships among inflammation, hypoxia and sleep in the period of adaptation and examined a novel mechanism that might explain the harmful effects of altitude on sleep, involving increased Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) production from several tissues and cells, such as leukocytes and cells from skeletal muscle and brain. PMID:23690660

  19. High-altitude physiology: lessons from Tibet

    Science.gov (United States)

    Wagner, Peter D.; Simonson, Tatum S.; Wei, Guan; Wagner, Harrieth; Wuren, Tanna; Yan, Ma; Qin, Ga; Ge, Rili

    2013-05-01

    Polycythemia is a universal lowlander response to altitude; healthy Andean high-altitude natives also have elevated [Hb]. While this may enhance O2 transport to tissues, studies have shown that acute isovolumic changes in [Hb] do not affect exercise capacity. Many high-altitude Tibetans have evolved sea-level values of [Hb], providing a natural opportunity to study this issue. In 21 young healthy male Tibetans with [Hb] between 15 and 23 g/dl, we measured VO2MAX and O2 transport capacity at 4200m. VO2MAX was higher when [Hb] was lower (Pcardiac output and muscle O2 diffusional conductance, but neither ventilation nor the alveolar-arterial PO2 difference (AaPO2) varied with [Hb]. In contrast, Andean high altitude natives remain polycythemic with larger lungs and higher lung diffusing capacity, a smaller exercising AaPO2, and lower ventilation. The challenges now are (1) to understand the different adaptive pathways used by Andeans and Tibetans, and (2) to determine in Tibetans whether, during evolution, reduced [Hb] appeared first, causing compensatory cardiac and muscle adaptations, or if enhanced cardiac function and muscle O2 transport capacity appeared first, permitting secondary reduction in [Hb]. For (2), further research is necessary to determine the basis of enhanced cardiac function and muscle O2 transport, and identify molecular targets of evolution in heart and muscle. Putative mutations can then be timed and compared to appearance of those affecting [Hb].

  20. Gene interference regulates aquaporin-4 expression in swollen tissue of rats with cerebral ischemic edema Correlation with variation in apparent diffusion coefficient

    Institute of Scientific and Technical Information of China (English)

    Hui Hu; Hong Lu; Zhanping He; Xiangjun Han; Jing Chen; Rong Tu

    2012-01-01

    To investigate the effects of mRNA interference on aquaporin-4 expression in swollen tissue of rats with ischemic cerebral edema, and diagnose the significance of diffusion-weighted MRI, we injected 5 μL shRNA- aquaporin-4 (control group) or siRNA- aquaporin-4 solution (1:800) (RNA interference group) into the rat right basal ganglia immediately before occlusion of the middle cerebral artery. At 0.25 hours after occlusion of the middle cerebral artery, diffusion-weighted MRI displayed a high signal; within 2 hours, the relative apparent diffusion coefficient decreased markedly, aquaporin-4 expression increased rapidly, and intracellular edema was obviously aggravated; at 4 and 6 hours, the relative apparent diffusion coefficient slowly returned to control levels, aquaporin-4 expression slightly increased, and angioedema was observed. In the RNA interference group, during 0.25- 6 hours after injection of siRNA- aquaporin-4 solution, the relative apparent diffusion coefficient slightly fluctuated and aquaporin-4 expression was upregulated; during 0.5-4 hours, the relative apparent diffusion coefficient was significantly higher, while aquaporin-4 expression was significantly lower when compared with the control group, and intracellular edema was markedly reduced; at 0.25 and 6 hours, the relative apparent diffusion coefficient and aquaporin-4 expression were similar when compared with the control group; obvious angioedema remained at 6 hours. Pearson's correlation test results showed that aquaporin-4 expression was negatively correlated with the apparent diffusion coefficient (r = -0.806, P < 0.01). These findings suggest that upregulated aquaporin-4 expression is likely to be the main molecular mechanism of intracellular edema and may be the molecular basis for decreased relative apparent diffusion coefficient. Aquaporin-4 gene interference can effectively inhibit the upregulation of aquaporin-4 expression during the stage of intracellular edema with time

  1. Cognitive Changes during Prolonged Stay at High Altitude and Its Correlation with C-Reactive Protein.

    Directory of Open Access Journals (Sweden)

    Sheng Li Hu

    Full Text Available Hypersensitive C-reaction protein (hsCRP may be a risk factor for cognitive impairment resulting from Alzheimer's disease (AD, stroke, and vascular dementia. This study explored the correlation of peripheral blood hsCRP level with cognitive decline due to high altitude exposure. The study was conducted on 100 male military participants who had never been to high altitude. Cerebral oxygen saturation monitoring, event related potentials (P300, N200 detection, and neurocognitive assessment was performed and total hsCRP, interleukin-6 (IL-6, and homocysteine was estimated at 500 m altitude, 3650 m altitude, 3 day, 1, and 3 month post arriving at the base camp (4400 m, and 1 month after coming back to the 500 m altitude. High altitude increased brain oxygen saturation, prolonged P300 and N200 latencies, injured cognitive functions, and raised plasma hsCRP levels. But they all recovered in varying degrees at 1 and 3 month post arriving at the base camp (4400 m. P300 latencies and hsCRP levels were strongly correlated to cognitive performances. These results suggested that cognitive deterioration occurred during the acute period of exposure to high altitude and may recover probably owning to acclimatization after extended stay at high altitude. Plasma hsCRP is inversely correlated to neurological cognition and it may be a potential biomarker for the prediction of high altitude induced cognitive dysfunction.

  2. Cognitive Changes during Prolonged Stay at High Altitude and Its Correlation with C-Reactive Protein

    Science.gov (United States)

    Hu, Sheng Li; Xiong, Wei; Dai, Zhi Qiang; Zhao, Heng Li; Feng, Hua

    2016-01-01

    Hypersensitive C-reaction protein (hsCRP) may be a risk factor for cognitive impairment resulting from Alzheimer’s disease (AD), stroke, and vascular dementia. This study explored the correlation of peripheral blood hsCRP level with cognitive decline due to high altitude exposure. The study was conducted on 100 male military participants who had never been to high altitude. Cerebral oxygen saturation monitoring, event related potentials (P300, N200) detection, and neurocognitive assessment was performed and total hsCRP, interleukin-6 (IL-6), and homocysteine was estimated at 500m altitude, 3650m altitude, 3day, 1, and 3 month post arriving at the base camp (4400m), and 1 month after coming back to the 500m altitude. High altitude increased brain oxygen saturation, prolonged P300 and N200 latencies, injured cognitive functions, and raised plasma hsCRP levels. But they all recovered in varying degrees at 1 and 3 month post arriving at the base camp (4400m). P300 latencies and hsCRP levels were strongly correlated to cognitive performances. These results suggested that cognitive deterioration occurred during the acute period of exposure to high altitude and may recover probably owning to acclimatization after extended stay at high altitude. Plasma hsCRP is inversely correlated to neurological cognition and it may be a potential biomarker for the prediction of high altitude induced cognitive dysfunction. PMID:26731740

  3. Estradiol reduces activity of the blood-brain barrier Na-K-Cl cotransporter and decreases edema formation in permanent middle cerebral artery occlusion.

    Science.gov (United States)

    O'Donnell, Martha E; Lam, Tina I; Tran, Lien Q; Foroutan, Shahin; Anderson, Steven E

    2006-10-01

    Estrogen has been shown to protect against stroke-induced brain damage, yet the mechanism is unknown. During the early hours of stroke, cerebral edema forms as increased transport of Na and Cl from blood into brain occurs across an intact blood-brain barrier (BBB). We showed previously that a luminal BBB Na-K-Cl cotransporter is stimulated by hypoxia and arginine vasopressin (AVP), factors present during cerebral ischemia, and that inhibition of the cotransporter by intravenous bumetanide greatly reduces edema in rats subjected to permanent middle cerebral artery occlusion (MCAO). The present study was conducted to determine whether estrogen protects in stroke at least in part by reducing activity of the BBB cotransporter, thereby decreasing edema formation. Ovariectomized rats were subjected to 210 mins of permanent MCAO after 7-day or 30-min pretreatment with 17beta-estradiol and then brain swelling and 2,3,5-triphenyltetrazolium chloride staining were assessed as measures of brain edema and lesion volume, respectively. Diffusion-weighed imaging was used to monitor permanent MCAO-induced decreases in apparent diffusion coefficient (ADC) values, an index of changes in brain water distribution and mobility. Na-K-Cl cotransporter activity of cerebral microvascular endothelial cells (CMECs) was assessed as bumetanide-sensitive K influx and cotransporter abundance by Western blot analysis after estradiol treatment. Estradiol significantly decreased brain swelling and lesion volume and attenuated the decrease in ADC values during permanent MCAO. Estradiol also abolished CMEC cotransporter stimulation by chemical hypoxia or AVP and decreased cotransporter abundance. These findings support the hypothesis that estrogen attenuates stimulation of BBB Na-K-Cl cotransporter activity, reducing edema formation during stroke.

  4. Effect of Xingnaojing injection on cerebral edema and blood-brain barrier in rats following traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    XU Miao; SU Wei; XU Qiu-ping; HUANG Wei-dong

    2010-01-01

    Objective:To explore the effects of Xingnaojing injection on cerebral edema and blood-brain barrier (BBB) in rats following traumatic brain injury (TBI).Methods: A total of 108 adult male Sprague-Dawley rats were used as subjects and randomly assigned to three groups:sham-operation,TBI and Xingnaojing injection was set up by the improved device of Feeney's weightcontent and BBB permeability expressed as Evans blue content were measured at 1, 3, 5 and 7 days after surgery.Results: In sham-operation group, brain water content and Evans blue content in brain tissue were 78.97%±1.22%and 5.13μg±0.71μg. Following TBI, water content in brain tissue was increased significantly at 1, 3, 5 and 7 days (83.49%±0.54%, 82.74%±0.72%, 80.22%±0.68%, 79.21%±0.60%), being significantly higher than that in sham operation group (P<0.05). Evans blue content was increased in TBI group (16.54 μg±0.60 μg, 14.92μg±0.71μg, 12.44 μg ±0.92μg, 10.14μg±0.52 μg) as compared with sham-operation group(P<0.05). After treatment with Xingnaojing injection, brain water content decreased as compared with TBI group (81.91%±1.04%, 80.38%±0.72%, 79.54%±0.58%,78.60%±0.77%, P<0.05). Xingnaojing injection also reduced the leakage of BBB as compared with TBI group (15.11 μg± 0.63 μg, 13.62 μg±0.85μg, 10.06 μg±0.67 μg, 9.54 μg±0.41 μg,P<0.05).Conclusion: Xingnaojing injection could alleviate cerebral edema following TBI via reducing permeability ofBBB.

  5. Sleep at high altitude: guesses and facts.

    Science.gov (United States)

    Bloch, Konrad E; Buenzli, Jana C; Latshang, Tsogyal D; Ulrich, Silvia

    2015-12-15

    Lowlanders commonly report a poor sleep quality during the first few nights after arriving at high altitude. Polysomnographic studies reveal that reductions in slow wave sleep are the most consistent altitude-induced changes in sleep structure identified by visual scoring. Quantitative spectral analyses of the sleep electroencephalogram have confirmed an altitude-related reduction in the low-frequency power (0.8-4.6 Hz). Although some studies suggest an increase in arousals from sleep at high altitude, this is not a consistent finding. Whether sleep instability at high altitude is triggered by periodic breathing or vice versa is still uncertain. Overnight changes in slow wave-derived encephalographic measures of neuronal synchronization in healthy subjects were less pronounced at moderately high (2,590 m) compared with low altitude (490 m), and this was associated with a decline in sleep-related memory consolidation. Correspondingly, exacerbation of breathing and sleep disturbances experienced by lowlanders with obstructive sleep apnea during a stay at 2,590 m was associated with poor performance in driving simulator tests. These findings suggest that altitude-related alterations in sleep may adversely affect daytime performance. Despite recent advances in our understanding of sleep at altitude, further research is required to better establish the role of gender and age in alterations of sleep at different altitudes, to determine the influence of acclimatization and of altitude-related illness, and to uncover the characteristics of sleep in highlanders that may serve as a study paradigm of sleep in patients exposed to chronic hypoxia due to cardiorespiratory disease.

  6. High altitude balloon experiments at IIA

    Science.gov (United States)

    Nayak, Akshata; Sreejith, A. G.; Safonova, Margarita; Murthy, Jayant

    Recent advances in balloon experiments as well as in electronics have made it possible to fly scientific payloads at costs accessible to university departments. We have begun a program of high altitude ballooning at the Indian Institute of Astrophysics, Bengaluru. The primary purpose of this activity is to test low-cost ultraviolet (UV) payloads for eventual space flight, but we will also try scientific exploration of the phenomena occurring in the upper atmosphere, including sprites and meteorite impacts. We present the results of the initial experiments carried out at the CREST campus of IIA, Hosakote, and describe our plans for the future.

  7. Lycium barbarum extracts protect the brain from blood-brain barrier disruption and cerebral edema in experimental stroke.

    Directory of Open Access Journals (Sweden)

    Di Yang

    Full Text Available BACKGROUND AND PURPOSE: Ischemic stroke is a destructive cerebrovascular disease and a leading cause of death. Yet, no ideal neuroprotective agents are available, leaving prevention an attractive alternative. The extracts from the fruits of Lycium barbarum (LBP, a Chinese anti-aging medicine and food supplement, showed neuroprotective function in the retina when given prophylactically. We aim to evaluate the protective effects of LBP pre-treatment in an experimental stroke model. METHODS: C57BL/6N male mice were first fed with either vehicle (PBS or LBP (1 or 10 mg/kg daily for 7 days. Mice were then subjected to 2-hour transient middle cerebral artery occlusion (MCAO by the intraluminal method followed by 22-hour reperfusion upon filament removal. Mice were evaluated for neurological deficits just before sacrifice. Brains were harvested for infarct size estimation, water content measurement, immunohistochemical analysis, and Western blot experiments. Evans blue (EB extravasation was determined to assess blood-brain barrier (BBB disruption after MCAO. RESULTS: LBP pre-treatment significantly improved neurological deficits as well as decreased infarct size, hemispheric swelling, and water content. Fewer apoptotic cells were identified in LBP-treated brains by TUNEL assay. Reduced EB extravasation, fewer IgG-leaky vessels, and up-regulation of occludin expression were also observed in LBP-treated brains. Moreover, immunoreactivity for aquaporin-4 and glial fibrillary acidic protein were significantly decreased in LBP-treated brains. CONCLUSIONS: Seven-day oral LBP pre-treatment effectively improved neurological deficits, decreased infarct size and cerebral edema as well as protected the brain from BBB disruption, aquaporin-4 up-regulation, and glial activation. The present study suggests that LBP may be used as a prophylactic neuroprotectant in patients at high risk for ischemic stroke.

  8. Gene interference regulates aquaporin-4 expression in swollen tissue of rats with cerebral ischemic edema: Correlation with variation in apparent diffusion coefficient.

    Science.gov (United States)

    Hu, Hui; Lu, Hong; He, Zhanping; Han, Xiangjun; Chen, Jing; Tu, Rong

    2012-07-25

    To investigate the effects of mRNA interference on aquaporin-4 expression in swollen tissue of rats with ischemic cerebral edema, and diagnose the significance of diffusion-weighted MRI, we injected 5 μL shRNA- aquaporin-4 (control group) or siRNA- aquaporin-4 solution (1:800) (RNA interference group) into the rat right basal ganglia immediately before occlusion of the middle cerebral artery. At 0.25 hours after occlusion of the middle cerebral artery, diffusion-weighted MRI displayed a high signal; within 2 hours, the relative apparent diffusion coefficient decreased markedly, aquaporin-4 expression increased rapidly, and intracellular edema was obviously aggravated; at 4 and 6 hours, the relative apparent diffusion coefficient slowly returned to control levels, aquaporin-4 expression slightly increased, and angioedema was observed. In the RNA interference group, during 0.25-6 hours after injection of siRNA- aquaporin-4 solution, the relative apparent diffusion coefficient slightly fluctuated and aquaporin-4 expression was upregulated; during 0.5-4 hours, the relative apparent diffusion coefficient was significantly higher, while aquaporin-4 expression was significantly lower when compared with the control group, and intracellular edema was markedly reduced; at 0.25 and 6 hours, the relative apparent diffusion coefficient and aquaporin-4 expression were similar when compared with the control group; obvious angioedema remained at 6 hours. Pearson's correlation test results showed that aquaporin-4 expression was negatively correlated with the apparent diffusion coefficient (r = -0.806, P coefficient. Aquaporin-4 gene interference can effectively inhibit the upregulation of aquaporin-4 expression during the stage of intracellular edema with time-effectiveness. Moreover, diffusion-weighted MRI can accurately detect intracellular edema.

  9. Plasma level of sFas and sFasL in acute cerebral hemorrhage with delayed cerebral edema%脑出血后迟发性脑水肿血浆sFas和sFasL水平分析

    Institute of Scientific and Technical Information of China (English)

    王兆平; 王文静; 王前友; 潘健; 孙一兵

    2011-01-01

    目的:探讨可溶性Fas (sFas)和可溶性Fas配体(sFasL)的变化与急性脑出血(ACH)后迟发性脑水肿的关系.方法:ACH后迟发性脑水肿患者12例,其中男性9例;随机选取同期ACH无迟发性脑水肿组12例,其中男性8例;同期年龄和性别相匹配的12例健康体检合格者作为对照组,其中男性8例.采用酶联免疫吸附法( ELISA)法测定血浆sFas和sFasL浓度,比较各组之间sFas和sFasL浓度差异.结果:ACH后迟发性脑水肿组14d血浆sFas和sFasL水平明显高于ACH无迟发性脑水肿组和对照组(P<0.01),ACH后迟发性脑水肿组较ACH无迟发性脑水肿组于发病7d后血浆sFas和sFasL水平下降速度缓慢,血浆sFasL水平稍有上升.结论:sFas和sFasL可能参与脑出血后迟发性脑水肿的形成,动态性检测血浆sFas和sFasL水平,可对于发现潜在的ACH后迟发性脑水肿具有一定的意义.%Objective To investigate the relationship between the changes of the plasma levels of soluble Fas (sFas) , soluble Fas-ligand(sFasL) and delayed cerebral edema following acute cerebral hemorrhage ( ACH). Methods Our study included 12 cases of ACH with delayed cerebral edema patients (male 9) and 12 cases of ACH without delayed cerebral edema (male 8) and 12 cases of the age and sex matched healthy subjects( male 8). The plasma levels of sFas and sFasL were measured by enzyme-linked immunosorbent assay ( ELISA) method in these groups and the difference in the levels of sFas and sFasL were compared among each groups. Results The levels of serum sFas and sFasL at 14d after onset in ACH with delayed cerebral edema group were significantly higher than that of the ACH without delayed cerebral e-dema and control groups(P <0.01) and that in ACH with delayed cerebral edema group was slow rate of decline at 7d after onset. The levels of serum sFasL in ACH with delayed cerebral edema group were increased slightly 7d after onset. Conclusion The sFas and sFasL probably take roles in the

  10. Edema cerebral: aportaciones de la investigación básica al manejo clínico

    National Research Council Canada - National Science Library

    Karina Tuz; Herminia Pasantes Morales

    2004-01-01

    ... vasogénico o celular, aunque generalmente ambos tipos de edema coexisten. El edema celular afecta de manera predominante a los astrocitos y ocurre en condiciones hiposmóticas (hiponatremia) o isosmóticas...

  11. Oxygen ion energization observed at high altitudes

    Directory of Open Access Journals (Sweden)

    M. Waara

    2010-04-01

    Full Text Available We present a case study of significant heating (up to 8 keV perpendicular to the geomagnetic field of outflowing oxygen ions at high altitude (12 RE above the polar cap. The shape of the distribution functions indicates that most of the heating occurs locally (within 0.2–0.4 RE in altitude. This is a clear example of local ion energization at much higher altitude than usually reported. In contrast to many events at lower altitudes, it is not likely that the locally observed wave fields can cause the observed ion energization. Also, it is not likely that the ions have drifted from some nearby energization region to the point of observation. This suggests that additional fundamentally different ion energization mechanisms are present at high altitudes. One possibility is that the magnetic moment of the ions is not conserved, resulting in slower outflow velocities and longer time for ion energization.

  12. The High Altitude Water Cherenkov Observatory

    Science.gov (United States)

    Mostafa, Miguel; HAWC Collaboration

    2016-03-01

    The High Altitude Water Cherenkov (HAWC) Observatory is a continuously operated, wide field of view experiment comprised of an array of 300 water Cherenkov detectors (WCDs) to study transient and steady emission of TeV gamma and cosmic rays. Each 200000 l WCD is instrumented with 4 PMTs providing charge and timing information. The array covers ~22000 m2 at an altitude of 4100 m a.s.l. inside the Pico de Orizaba national park in Mexico. The high altitude, large active area, and optical isolation of the PMTs allows us to reliably estimate the energy and determine the arrival direction of gamma and cosmic rays with significant sensitivity over energies from several hundred GeV to a hundred TeV. Continuously observing 2 / 3 of the sky every 24 h, HAWC plays a significant role as a survey instrument for multi-wavelength studies. The performance of HAWC makes possible the detection of both transient and steady emissions, the study of diffuse emission and the measurement of the spectra of gamma-ray sources at TeV energies. HAWC is also sensitive to the emission from GRBs above 100 GeV. I will highlight the results from the first year of operation of the full HAWC array, and describe the ongoing site work to expand the array by a factor of 4 to explore the high energy range.

  13. Automated quantification of cerebral edema following hemispheric infarction: Application of a machine-learning algorithm to evaluate CSF shifts on serial head CTs.

    Science.gov (United States)

    Chen, Yasheng; Dhar, Rajat; Heitsch, Laura; Ford, Andria; Fernandez-Cadenas, Israel; Carrera, Caty; Montaner, Joan; Lin, Weili; Shen, Dinggang; An, Hongyu; Lee, Jin-Moo

    2016-01-01

    Although cerebral edema is a major cause of death and deterioration following hemispheric stroke, there remains no validated biomarker that captures the full spectrum of this critical complication. We recently demonstrated that reduction in intracranial cerebrospinal fluid (CSF) volume (∆ CSF) on serial computed tomography (CT) scans provides an accurate measure of cerebral edema severity, which may aid in early triaging of stroke patients for craniectomy. However, application of such a volumetric approach would be too cumbersome to perform manually on serial scans in a real-world setting. We developed and validated an automated technique for CSF segmentation via integration of random forest (RF) based machine learning with geodesic active contour (GAC) segmentation. The proposed RF + GAC approach was compared to conventional Hounsfield Unit (HU) thresholding and RF segmentation methods using Dice similarity coefficient (DSC) and the correlation of volumetric measurements, with manual delineation serving as the ground truth. CSF spaces were outlined on scans performed at baseline (line of identity in RF + GAC. When we applied the algorithm trained from images of one stroke center to segment CTs from another center, similar findings held. In conclusion, we have developed and validated an accurate automated approach to segment CSF and calculate its shifts on serial CT scans. This algorithm will allow us to efficiently and accurately measure the evolution of cerebral edema in future studies including large multi-site patient populations.

  14. Analysis of Fibrinogen relevant factors in delayed cerebral edema of cerebral hemorrhage%脑出血后迟发性脑水肿与纤维蛋白原等相关因素的分析

    Institute of Scientific and Technical Information of China (English)

    黄园园; 陈吉相; 王芳; 肖海兵

    2011-01-01

    目的 研究脑出血迟发性脑水肿与纤维蛋白原(FIB)等因素的相互联系,并探讨对脑出血预后的影响.方法 回顾性分析本院2008年1月~2011年2月接受内科保守治疗的非外伤性急性脑出血60例,其中并发迟发性脑水肿29例,未发生迟发性脑水肿31例.于发病后连续3周监测FIB值等指标,并同时期行头颅CT检查,动态观察血肿及其周围水肿的变化.行χ2检验比较迟发性脑水肿组与未发生组间FIB的升高率; logistic回归分析迟发性脑水肿与各指标的相关性,并采用多元逐步COX模型分析脑出血预后的相关影响因素.结果 迟发性脑水肿组较未发生组FIB值明显升高(P<0.005); FIB升高、脑出血量大、吸烟、高血压病史与迟发性脑水肿相关(P<0.05);迟发性脑水肿、持续升高的FIB和高血压病影响脑出血的预后,其P值均<0.05,有统计学意义.结论 脑出血者FIB持续升高、脑出血量大、吸烟、高血压与迟发性脑水肿的发生密切相关,迟发性脑水肿、FIB升高和高血压病影响预后,对疾病恢复有不良影响.%Objective To observe Pibrinogen and other related factors on delayed cerebral edema in cerebral hemorrhage, and to explore related factor impact on prognosis in cerebral hemorrhage. Methods Analyzed retrospectively the 60 cases of acute non-traumatic and conservative treated cerebral hemorrhage in January 2008- February 2011, which 29 cases complicated with delayed cerebral edema and 31 cases not complicated . Monitored FIB values and other indicators for three weeks ,and observed hematoma and the surrounding low-density changes by head CT during the same period; x2 test to compare the increase rate of FIB in two groups; Analyze related factors on delayed cerebral edema and their relationship with prognosis. Results FIB significantly increased in delayed brain edema group(P<0. 005). Elevated FIB, hematoma volume, smoking, and hypertension associated with delayed

  15. Clinical Studies of Cerebral Edema Recanalization After Thrombolysis in Acute Cerebral Infarction%急性脑梗死动脉溶栓血管再通后的脑水肿临床研究

    Institute of Scientific and Technical Information of China (English)

    王喜春; 马冲; 张健莉; 于杰

    2015-01-01

    目的:探讨急性缺血性脑卒中动脉溶栓血管再通后脑水肿的临床研究,旨在为此类疾病患者的下一步临床工作提供借鉴。方法选择通过动脉溶栓血管再通的患者40例。将患者分为1~3 h组(A组)、>3~6h组(B组)。头颅CT监测、随访脑水肿情况。记录溶栓前、术后1周及1年NIHSS评分、MRS评分及BI指数。结果动脉溶栓血管再通后脑水肿发生率为100%,随访发现脑水肿局部有明显软化灶。两组患者脑水肿及临床结局比较差异无统计学意义(P>0.05)。结论动脉溶栓血管再通后脑水肿的及其脑组织缺失发生率极高,脑水肿局部有明显软化灶,良好的脑内局部循环和全身状况是改善此类脑水肿的重要因素。%Objective To investigate the acute arterial ischemic stroke thrombolytic recanalization clinical studies of cerebral edema, designed to provide a reference for the next clinical disease in these patients.Methods arterial thrombolysis recanalization by 40 patients. Patients were divided into 1 ~ 3h group (A),> 3 ~ 6h group (group B). Cranial CT monitoring, follow-up of brain edema. Recorded before thrombolysis, after 1 week and 1 year NIHSS score, MRS score and BI index.Results arterial thrombolysis recanalization rate was 97.5% of cerebral edema, cerebral edema partial follow-up found a significant malacia. Two groups of patients and clinical outcomes of cerebral edema was no significant difference (P> 0.05).Conclusion The arterial thrombolysis recanalization of cerebral edema and high incidence of brain tissue loss, good local circulation in the brain and body condition is such an important factor in improving brain edema.

  16. A new strategy of CyberKnife treatment system based radiosurgery followed by early use of adjuvant bevacizumab treatment for brain metastasis with extensive cerebral edema.

    Science.gov (United States)

    Wang, Yang; Wang, Enmin; Pan, Li; Dai, Jiazhong; Zhang, Nan; Wang, Xin; Liu, Xiaoxia; Mei, Guanghai; Sheng, Xiaofang

    2014-09-01

    Bevacizumab blocks the effects of vascular endothelial growth factor in leakage-prone capillaries and has been suggested as a new treatment for cerebral radiation edema and necrosis. CyberKnife is a new, frameless stereotactic radiosurgery system. This work investigated the safety and efficacy of CyberKnife followed by early bevacizumab treatment for brain metastasis with extensive cerebral edema. The eligibility criteria of the patients selected for radiosurgery followed by early use of adjuvant bevacizumab treatment were: (1) brain tumors from metastasis with one solitary brain lesion and symptomatic extensive cerebral edema; (2) >18 years of age; (3) the patient refused surgery due to the physical conditions and the risk of surgery; (4) no contraindications for bevacizumab. (5) bevacizumab was applied for a minimum of 2 injections and a maximum of 6 injections with a 2-week interval between treatments, beginning within 2 weeks of the CyberKnife therapy; (6) Karnofsky performance status (KPS) ≥30. Tumor size and edema were monitored by magnetic resonance imaging (MRI). Dexamethasone dosage, KPS, adverse event occurrence and associated clinical outcomes were also recorded. Eight patients were accrued for this new treatment. Radiation dose ranged from 20 to 33 Gy in one to five sessions, prescribed to the 61-71 % isodose line. Bevacizumab therapy was administered 3-10 days after completion of CyberKnife treatment for a minimum of two cycles (5 mg/kg, at 2-week intervals). MRI revealed average reductions of 55.8 % (post-gadolinium) and 63.4 % (T2/FLAIR). Seven patients showed significant clinical neurological improvements. Dexamethasone was reduced in all patients, with five successfully discontinuing dexamethasone treatment 4 weeks after bevacizumab initiation. Hypertension, a bevacizumab-related adverse event, occurred in one patient. After 3-8 months, all patients studied were alive and primary brain metastases were under control, 2 developed new brain

  17. 脑水肿与通道蛋白4的关系及进展%Correlation between cerebral edema and aquaporin 4

    Institute of Scientific and Technical Information of China (English)

    林锋; 吴江

    2012-01-01

    Cerebral edema is a common symptom in neurology and neurosurgery. Currently its cause is still not fully understood, thus its treatment means and effect are still limited. AQP (Aquaporin), a kind of molecule water channel in the body, is discovered in 1988. AQP4 (aquaporin-4) is a subtype of AQP and found to be closely related to the formation and prognosis of cerebral edema. The inhibiting and enhancing of AQP4 can affect the formation and prognosis of cerebral edema and it is also found that AQP4 may have other functions. In-depth study of the relationship between AQP4 and cerebral edema can help answer the questions regarding the formation and treatment of cerebral edema, and at the same time enhance understanding of water metabolism in the body.%脑水肿是神经内外科的一种常见症状,对于它的形成目前还未能全部了解,治疗手段有限,效果不一.水通道蛋白(aquaporin,AQP)是1988年发现的生物体内的一种水的分子通道.水通道蛋白4(aquaporin-4,AQP4)是AQP蛋白的一种,研究发现,AQP4蛋白对脑水肿的形成及预后有非常密切的关系,通过调节AQP4蛋白可影响脑水肿的形成及预后,同时AQP4可能还有一些其他功能.因此,对AQP4蛋白及脑水肿的关系进行深入研究有助于解决脑水肿的发生与治疗问题,同时对水在生物体内的代谢有更深入的了解.

  18. 20-Hydroxyeicosatetraenoic Acid Inhibition by HET0016 Offers Neuroprotection, Decreases Edema, and Increases Cortical Cerebral Blood Flow in a Pediatric Asphyxial Cardiac Arrest Model in Rats.

    Science.gov (United States)

    Shaik, Jafar Sadik B; Poloyac, Samuel M; Kochanek, Patrick M; Alexander, Henry; Tudorascu, Dana L; Clark, Robert Sb; Manole, Mioara D

    2015-11-01

    Vasoconstrictive and vasodilatory eicosanoids generated after cardiac arrest (CA) may contribute to cerebral vasomotor disturbances and neurodegeneration. We evaluated the balance of vasodilator/vasoconstrictor eicosanoids produced by cytochrome P450 (CYP) metabolism, and determined their role on cortical perfusion, functional outcome, and neurodegeneration after pediatric asphyxial CA. Cardiac arrest of 9 and 12 minutes was induced in 16- to 18-day-old rats. At 5 and 120 minutes after CA, we quantified the concentration of CYP eicosanoids in the cortex and subcortical areas. In separate rats, we inhibited 20-hydroxyeicosatetraenoic acid (20-HETE) synthesis after CA and assessed cortical cerebral blood flow (CBF), neurologic deficit score, neurodegeneration, and edema. After 9 minutes of CA, vasodilator eicosanoids markedly increased versus sham. Conversely, after 12 minutes of CA, vasoconstrictor eicosanoid 20-HETE increased versus sham, without compensatory increases in vasodilator eicosanoids. Inhibition of 20-HETE synthesis after 12 minutes of CA decreased cortical 20-HETE levels, increased CBF, reduced neurologic deficits at 3 hours, and reduced neurodegeneration and edema at 48 hours versus vehicle-treated rats. In conclusion, cerebral vasoconstrictor eicosanoids increased after a pediatric CA of 12 minutes. Inhibition of 20-HETE synthesis improved cortical perfusion and short-term neurologic outcome. These results suggest that alterations in CYP eicosanoids have a role in cerebral hypoperfusion and neurodegeneration after CA and may represent important therapeutic targets.

  19. HAWC - The High Altitude Water Cherenkov Detector

    Science.gov (United States)

    Tepe, Andreas; HAWC Collaboration

    2012-07-01

    The high altitude water Cherenkov observatory (HAWC) is an instrument for the detection of high energy cosmic gamma-rays. Its predecessor Milagro has successfully proven that the water Cherenkov technology for gamma-ray astronomy is a useful technique. HAWC is currently under construction at Sierra Negra in Mexico at an altitude of 4100 m and will include several improvements compared to Milagro. Two complementary DAQ systems of the HAWC detector allow for the observation of a large fraction of the sky with a very high duty cycle and independent of environmental conditions. HAWC will observe the gamma-ray sky from about 100 GeV up to 100 TeV. Also the cosmic ray flux anisotropy on different angular length scales is object of HAWC science. Because of HAWC's large effective area and field of view, we describe its prospects to observe gamma-ray bursts (GRBs) as an example for transient sources.

  20. Sleep apneas and high altitude newcomers.

    Science.gov (United States)

    Goldenberg, F; Richalet, J P; Onnen, I; Antezana, A M

    1992-10-01

    Sleep and respiration data from two French medical high altitude expeditions (Annapurna 4,800 m and Mt Sajama 6,542 m) are presented. Difficulties in maintaining sleep and a SWS decrease were found with periodic breathing (PB) during both non-REM and REM sleep. Extent of PB varied considerably among subjects and was not correlated to the number of arousals but to the intercurrent wakefulness duration. There was a positive correlation between the time spent in PB and the individual hypoxic ventilatory drive. The relation between PB, nocturnal desaturation, and mountain sickness intensity are discussed. Acclimatization decreased the latency toward PB and improved sleep. Hypnotic benzodiazepine intake (loprazolam 1 mg) did not worsen either SWS depression or apneas and allowed normal sleep reappearance after acclimatization.

  1. 小剂量糖皮质激素治疗脑出血迟发性脑水肿临床分析%Clinical analysis of low dose glucocorticoidin treatment of delayed cerebral edema after cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    林茵

    2014-01-01

    ObjectiveTo observe the clinical efifcacy of low dose glucocorticoidin treatment of delayed cerebral edema after cerebral hemorrhage.MethodsRetrospective analysis was performed on the clinical data of 13 patients, who were of delayed cerebral edema after cerebral hemorrhage and treated with small-dosed glucocorticoid. The efficacy of glucocorticoid treatment on these patients was probed.ResultsAfter treatment, the condition of patients was improved in various degrees; the activities of daily living were signiifcantly improved. Ultimately, all the 13 patientswere discharged with better health condition while three of them were improved dramatically. ConclusionsLow dose glucocorticoid is effective in treating delayed cerebral edema after cerebral hemorrhage with no serious side effects.%目的:观察糖皮质激素对脑出血迟发性脑水肿的治疗效果。方法回顾分析13例经小剂量糖皮质激素治疗的脑出血后迟发性脑水肿患者的临床资料,探讨糖皮质激素治疗对迟发性脑水肿的效用。结果治疗后脑出血迟发性脑水肿患者病情不同程度好转,生活能力明显改善,最终13例均好转出院,其中3例症状明显改善。结论小剂量糖皮质激素对于脑出血迟发性脑水肿有明显的治疗作用,无严重不良反应。

  2. Severe leukoencephalopathy with fulminant cerebral edema reflecting immune reconstitution inflammatory syndrome during HIV infection: a case report

    Directory of Open Access Journals (Sweden)

    Niederstadt Thomas

    2010-07-01

    Full Text Available Abstract Introduction Immune reconstitution inflammatory syndrome is a well-known complication in HIV-infected patients after initiation of highly active antiretroviral therapy resulting in rapid CD4+ cell count recovery and suppression of viral load. Generally, immune reconstitution inflammatory syndrome is based on opportunistic infections, but rare cases of immune reconstitution inflammatory syndrome inducing demyelinization of the nervous system have also been observed. Case presentation A 37-year-old African woman with HIV infection diagnosed at 13 years of age was admitted to the emergency department after experiencing backache, severe headache, acute aphasia and psychomotor slowing for one week. Nine weeks earlier, highly active antiretroviral therapy in this patient had been changed because of loss of efficacy, and a rapid increase in CD4+ cell count and decrease of HIV viral load were observed. Magnetic resonance imaging of the brain showed extensive white matter lesions, and analysis of cerebrospinal fluid revealed an immunoreactive syndrome. Intensive investigations detected no opportunistic infections. A salvage therapy, including osmotherapy, corticosteroids and treatment of epileptic seizures, was performed, but the patient died from brainstem herniation 48 hours after admission. Neuropathologic examination of the brain revealed diffuse swelling, leptomeningeal infiltration by CD8 cells and enhancement of perivascular spaces by CD8+ cells. Conclusion Immune reconstitution inflammatory syndrome in this form seems to represent a severe autoimmunologic disease of the brain with specific histopathologic findings. This form of immune reconstitution inflammatory syndrome did not respond to therapy, and extremely rapid deterioration led to death within two days. Immune reconstitution inflammatory syndrome may also occur as severe leukoencephalopathy with fulminant cerebral edema during HIV infection with rapid immune reconstitution.

  3. Incidence of cerebral edema in patients with cerebral arteriovenous malformations treated by radiosurgery%脑动静脉畸形γ刀放射治疗后脑水肿发生情况分析

    Institute of Scientific and Technical Information of China (English)

    利晞; 梁舜尧; 谭理连; 胡滨; 侯仲军; 陈耀棠; 于晓君; 曹兵艺

    2013-01-01

    目的 探讨脑动静脉畸形γ刀放射治疗后不同随访阶段放射性脑水肿的发生率.方法 回顾性分析广州医学院第二附属医院放射科自1995年1月至2010年12月十余年间内经γ刀治疗的脑动静脉畸形患者的临床资料,共经磁共振检查随访351例次.统计γ刀术后不同随访阶段放射性脑水肿发生率并采用采用x2检验分析. 结果 γ刀放射治疗后本组患者放射性脑水肿阳性率为36.2%;不同随访阶段放射性脑水肿阳性率分别为:≤12月43.0%,13~36月45.3%,37~60月23.1%,61~120月13.6%,>120月5.9%;各随访阶段间放射性脑水肿的发生率比较差异有统计学意义(x2=26.514,P=0.000). 结论 放射性脑水肿是脑动静脉畸形γ刀治疗后最常见的并发症之一,部分患者可出现顽固性放射性脑水肿.γ刀治疗后第一阶段(≤12月)、第二阶段(13~36月)放射性脑水肿发生率较高,应临床密切关注.%Objective To study the incidence of cerebral edema in patients with cerebral arteriovenous malformations (AVMs) treated by Gamma knife.Methods The clinical data of 351 patients with AVMs,admitted to and treated with gamma knife in our hospital from January 1995 to December 2010,were retrospectively analyzed.MR imaging was performed on these patients to review the characteristics of cerebral edema and compare the different incidences of cerebral edema at different follow up periods; chi-square analysis was employed on these data.Results After being treated with gamma knife,the total positive rate of cerebral edema was 36.2%.At different follow-up periods,the positive rates of cerebral edema were different:43.0% within 12 months of treatment,45.3% at 13-36 months after treatment,23.1% at 37-60 months after treatment,13.6% at 61-120 months after treatment,and 5.9% more than 120 months after treatment; significant difference was noted between each two follow up periods (x2=26.514,P=0.000).Conclusion

  4. THE HIGH ALTITUDE GAMMA RAY OBSERVATORY, HAWC

    Directory of Open Access Journals (Sweden)

    M. M. González

    2011-01-01

    Full Text Available El volcán Sierra Negra en Puebla, México fue seleccionado para albergar a HAWC (High Altitude Water Cherenkov, un observatorio de gran apertura (2Pi sr, único en el mundo, capaz de observar contínuamente el cielo a energías de 0.1 a 100 TeV. HAWC consiste en un arreglo a una altitud de 4100 m sobre el nivel del mar de 300 contenedores de 7.3 m de diámetro y 5 m de altura llenos de agua pura y sensores de luz que observan partículas sumamente energ´eticas provenientes de los eventos más violentos del universo y será 15 veces más sensible que su antecesor Milagro. Las aportaciones científicas de Milagro han demostrado las capacidades únicas de este tipo de observatorios. En este trabajo se presentará HAWC y se discutirá brevemente su caso científico y capacidades.

  5. Solar electric energy supply at high altitude

    Energy Technology Data Exchange (ETDEWEB)

    Knaupp, W.; Mundschau, E. [Zentrum fur Sonnenenergie- und Wasserstoff-Forschung (ZSW), Ulm (Germany)

    2004-04-01

    Solar-hydrogen systems were analyzed regarding their usability as energy supply system for high altitude platforms. In a first step for an assessment of solar and photovoltaic resources near-ground spectral transmittances of atmosphere were extended with simplified height correction functions to achieve spectral irradiance descriptions versus atmospheric height up to 25 km. The influence of atmospheric height to different solar cell technologies regarding electrical performance was quantified at some examples for the aspect of spectral distribution with the help of the introduced spectral height factor. The main attention during analysis of the whole solar-hydrogen energy system was directed to characteristics of current or near term available technology. Specific power weight of photovoltaic system, electrolyzer, fuel cell and gas tanks and their dependence on operation mode and power range were assessed. A pre-design of a solar-hydrogen energy system was carried out for an airship (volume 580,000 m3) withstanding continuous wind speeds up to {approx} 130 km/h. The calculated coverage ratio of photovoltaic and load share of energy system mark the frame of usability. Depending on the airship size, shape and other external boundary conditions the total electrical energy demand could be covered by a solar-hydrogen energy system of current or near term technology for full year operation. However further investigations are necessary regarding e.g. further mass reductions. (author)

  6. The High-Altitude Water Cherenkov Observatory

    Science.gov (United States)

    Mostafá, Miguel A.

    2014-10-01

    The High-Altitude Water Cherenkov (HAWC) observatory is a large field of view, continuously operated, TeV γ-ray experiment under construction at 4,100 m a.s.l. in Mexico. The HAWC observatory will have an order of magnitude better sensitivity, angular resolution, and background rejection than its predecessor, the Milagro experiment. The improved performance will allow us to detect both the transient and steady emissions, to study the Galactic diffuse emission at TeV energies, and to measure or constrain the TeV spectra of GeV γ-ray sources. In addition, HAWC will be the only ground-based instrument capable of detecting prompt emission from γ-ray bursts above 50 GeV. The HAWC observatory will consist of an array of 300 water Cherenkov detectors (WCDs), each with four photomultiplier tubes. This array is currently under construction on the flanks of the Sierra Negra volcano near the city of Puebla, Mexico. The first 30 WCDs (forming an array approximately the size of Milagro) were deployed in Summer 2012, and 100 WCDs will be taking data by May, 2013. We present in this paper the motivation for constructing the HAWC observatory, the status of the deployment, and the first results from the constantly growing array.

  7. The high-altitude water Cherenkov Observatory

    Energy Technology Data Exchange (ETDEWEB)

    Mostafa, Miguel A., E-mail: miguel@psu.edu [Department of Physics, Colorado State University, Ft Collins, CO (United States)

    2014-07-01

    The High-Altitude Water Cherenkov (HAWC) observatory is a large field of view, continuously operated, TeV γ -ray experiment under construction at 4,100ma.s.l. in Mexico. The HAWC observatory will have an order of magnitude better sensitivity, angular resolution, and background rejection than its predecessor, the Milagro experiment. The improved performance will allow to detect both the transient and steady emissions, to study the Galactic diffuse emission at TeV energies, and to measure or constrain the TeV spectra of GeV γ -ray sources. In addition, HAWC will be the only ground-based instrument capable of detecting prompt emission from γ -ray bursts above 50 GeV. The HAWC observatory will consist of an array of 300 water Cherenkov detectors (WCDs), each with four photomultiplier tubes. This array is currently under construction on the flanks of the Sierra Negra volcano near the city of Puebla, Mexico. The first 30 WCDs (forming an array approximately the size of Milagro) were deployed in Summer 2012, and 100 WCDs will be taking data by May, 2013. We present in this paper the motivation for constructing the HAWC observatory, the status of the deployment, and the first results from the constantly growing array. (author)

  8. The High Altitude Water Cherenkov (HAWC) Observatory

    Science.gov (United States)

    Springer, Wayne

    2014-06-01

    The High Altitude Water Cherenkov (HAWC) observatory is a continuously operated, wide field of view detector based upon a water Cherenkov technology developed by the Milagro experiment. HAWC observes, at an elevation of 4100 m on Sierra Negra Mountain in Mexico, extensive air showers initiated by gamma and cosmic rays. The completed detector will consist of 300 closely spaced water tanks each instrumented with four photomultiplier tubes that provide timing and charge information used to reconstruct energy and arrival direction. HAWC has been optimized to observe transient and steady emission from point as well as diffuse sources of gamma rays in the energy range from several hundred GeV to several hundred TeV. Studies in solar physics as well as the properties of cosmic rays will also be performed. HAWC has been making observations at various stages of deployment since completion of 10% of the array in summer 2012. A discussion of the detector design, science capabilities, current construction/commissioning status, and first results will be presented...

  9. Development of the High Altitude Student Platform

    Science.gov (United States)

    Guzik, T. G.; Besse, S.; Calongne, A.; Dominique, A.; Ellison, S. B.; Gould, R.; Granger, D.; Olano, D.; Smith, D.; Stewart, M.; Wefel, J. P.

    2008-11-01

    The High Altitude Student Platform (HASP) was originally conceived to provide student groups with access to the near-space environment for flight durations and experiment capabilities intermediate between what is possible with small sounding balloons and low Earth orbit rocket launches. HASP is designed to carry up to twelve student payloads to an altitude of about 36 km with flight durations of 15 20 h using a small zero-pressure polyethylene film balloon. This provides a flight capability that can be used to flight-test compact satellites, prototypes and other small payloads designed and built by students. HASP includes a standard mechanical, power and communication interface for the student payload to simplify integration and allows the payloads to be fully exercised. Over the last two years a partnership between the NASA Balloon Program Office (BPO), Columbia Scientific Balloon Facility (CSBF), Louisiana State University (LSU), the Louisiana Board of Regents (BoR), and the Louisiana Space Consortium (LaSPACE) has led to the development, construction and, finally, the first flight of HASP with a complement of eight student payloads on September 4, 2006. Here we discuss the primary as-built HASP systems and features, the student payload interface, HASP performance during the first flight and plans for continuing HASP flights. The HASP project maintains a website at http://laspace.lsu.edu/hasp/ where flight application, interface documentation and status information can be obtained.

  10. The High Altitude Water Cherenkov Observatory

    CERN Document Server

    ,

    2013-01-01

    The High Altitude Water Cherenkov (HAWC) observatory is a large field of view, continuously operated, TeV gamma-ray experiment under construction at 4,100 m a.s.l. in Mexico. The HAWC observatory will have an order of magnitude better sensitivity, angular resolution, and background rejection than its predecessor, the Milagro experiment. The improved performance will allow us to detect both transient and steady emissions, to study the Galactic diffuse emission at TeV energies, and to measure or constrain the TeV spectra of GeV gamma-ray sources. In addition, HAWC will be the only ground-based instrument capable of detecting prompt emission from gamma-ray bursts above 50 GeV. The HAWC observatory will consist of an array of 300 water Cherenkov detectors (WCDs), each with four photomultiplier tubes. This array is currently under construction on the flanks of the Sierra Negra volcano near the city of Puebla, Mexico. The first thirty WCDs (forming an array approximately the size of Milagro) were deployed in Summer...

  11. Pulmonary embolism in young natives of high altitude

    Directory of Open Access Journals (Sweden)

    Sanjay Singhal

    2016-01-01

    Full Text Available Thrombotic events are relatively common in high altitude areas and known to occur in young soldiers working at high altitude without usual risk factors associated with thrombosis at sea-level. However, till now, cases with thrombotic events were reported only in lowlanders staying at high altitude. These two cases of pulmonary embolism demonstrate that thrombotic events can occur in highlanders after a prolonged stay at the extreme altitude.

  12. Intravenous HOE-642 reduces brain edema and Na uptake in the rat permanent middle cerebral artery occlusion model of stroke: evidence for participation of the blood-brain barrier Na/H exchanger.

    Science.gov (United States)

    O'Donnell, Martha E; Chen, Yi-Je; Lam, Tina I; Taylor, Kelleen C; Walton, Jeffrey H; Anderson, Steven E

    2013-02-01

    Cerebral edema forms in the early hours of ischemic stroke by processes involving increased transport of Na and Cl from blood into brain across an intact blood-brain barrier (BBB). Our previous studies provided evidence that the BBB Na-K-Cl cotransporter is stimulated by the ischemic factors hypoxia, aglycemia, and arginine vasopressin (AVP), and that inhibition of the cotransporter by intravenous bumetanide greatly reduces edema and infarct in rats subjected to permanent middle cerebral artery occlusion (pMCAO). More recently, we showed that BBB Na/H exchanger activity is also stimulated by hypoxia, aglycemia, and AVP. The present study was conducted to further investigate the possibility that a BBB Na/H exchanger also participates in edema formation during ischemic stroke. Sprague-Dawley rats were subjected to pMCAO and then brain edema and Na content assessed by magnetic resonance imaging diffusion-weighed imaging and magnetic resonance spectroscopy Na spectroscopy, respectively, for up to 210 minutes. We found that intravenous administration of the specific Na/H exchange inhibitor HOE-642 significantly decreased brain Na uptake and reduced cerebral edema, brain swelling, and infarct volume. These findings support the hypothesis that edema formation and brain Na uptake during the early hours of cerebral ischemia involve BBB Na/H exchanger activity as well as Na-K-Cl cotransporter activity.

  13. Oxidative stress and the high altitude environment

    Directory of Open Access Journals (Sweden)

    Jakub Krzeszowiak

    2013-03-01

    Full Text Available In the recent years there has been considerable interest in mountain sports, including mountaineering, owing to the general availability of climbing clothing and equipment as well trainings and professional literature. This raised a new question for the environmental and mountain medicine: Is mountaineering harmful to health? Potential hazards include the conditions existing in the alpine environment, i.e. lower atmospheric pressure leading to the development of hypobaric hypoxia, extreme physical effort, increased UV radiation, lack of access to fresh food, and mental stress. A reasonable measure of harmfulness of these factors is to determine the increase in the level of oxidative stress. Alpine environment can stimulate the antioxidant enzyme system but under specific circumstances it may exceed its capabilities with simultaneous consumption of low-molecular antioxidants resulting in increased generation of reactive oxygen species (ROS. This situation is referred to as oxidative stress. Rapid and uncontrolled proliferation of reactive oxygen species leads to a number of adverse changes, resulting in the above-average damage to the lipid structures of cell membranes (peroxidation, proteins (denaturation, and nucleic acids. Such situation within the human body cannot take place without resultant systemic consequences. This explains the malaise of people returning from high altitude and a marked decrease in their physical fitness. In addition, a theory is put forward that the increase in the level of oxidative stress is one of the factors responsible for the onset of acute mountain sickness (AMS. However, such statement requires further investigation because the currently available literature is inconclusive. This article presents the causes and effects of development of oxidative stress in the high mountains.

  14. Mitochondrial DNA response to high altitude: a new perspective on high-altitude adaptation.

    Science.gov (United States)

    Luo, Yongjun; Yang, Xiaohong; Gao, Yuqi

    2013-08-01

    Mitochondria are the energy metabolism centers of the cell. More than 95% of cellular energy is produced by mitochondrial oxidative phosphorylation. Hypoxia affects a wide range of energy generation and consumption processes in animals. The most important mechanisms limiting ATP consumption increase the efficiency of ATP production and accommodate the reduced production of ATP by the body. All of these mechanisms relate to changes in mitochondrial function. Mitochondrial function can be affected by variations in mitochondrial DNA, including polymorphisms, content changes, and deletions. These variations play an important role in acclimatization or adaptation to hypoxia. In this paper, the association between mitochondrial genome sequences and high-altitude adaptation is reviewed.

  15. Introductory address: lessons to be learned from high altitude.

    Science.gov (United States)

    Houston, C S

    1979-07-01

    A historical account of the important landmarks in man's experience with the high altitude environment is followed by comments on the important stages in the understanding of its physiological effects. The work of The Mount Logan High Altitude Physiology Study on acute mountain sickness is reviewed from its inception in 1967 until the present.

  16. Soldier at High Altitude: Problem & Preventive Measures

    Directory of Open Access Journals (Sweden)

    S.S Purkayastha

    2000-04-01

    Full Text Available Due to military and j trategic reasons, a large body of troops is being regularly dcployed in the snowbound areas through ut the Himalayan regions to guard Ihe Ironliers. Thc mountain environment at high 'allitude (HA consisls of several faclors alien lo plain dwellers, which evoke a series of physiological responses in human system. Some of the sea' level residents on induction to HA suffer from several unloward symploms of HA" ailmenls varying from mild-lo-severe degrees. Suddenexposure to HA is detrimental to physical and mental  performance of the low landers and  certain cases, may even lead to dreaded condition like high altitude pulmonary oedema (HAPO. These may make a man Jisturbed physically and mentally. So, there is a need lo prevent such hazards v(hich ispossible if the individual is aware of the problems and prevenlive measures ofHA ailments in advance, before going to HA for a safe and happy living there. Hence, a noble effort has been made to provide guidelines to create awareness about physical and physiological problems of life at HA and themethods of protection against its ill-effects for the soldiers, mountaineers and sojourners conducting scientific trials it HA. In th.:s revieJ, an attempt has been made to describe vital aspects of HA in a popular way, st~ing with its concept and various environmental factors which exert considerableettects on human body functions, heallh and performance on exposure to such environment, on the b¥is of a series of studies coitlucted at Ithe Defence Institute of Physiology & Allied Sciences, Delhi, oVer the years. The most important featurelof HA (3,000 m and above is hypoxia or deficiency ofoxygej1 in the body. Olher cnvironmental tactors are: scverc cold, high velocity wind, low rclalivc humidily, high solar radiatior, increased ultraviolet radialion and difficult terrain. These faclors are responsible for various HA cWtdc old syndromes, viz., acute mountain sickness, HAPO, dehydration,4

  17. YiQiFuMai powder injection ameliorates blood-brain barrier dysfunction and brain edema after focal cerebral ischemia-reperfusion injury in mice.

    Science.gov (United States)

    Cao, Guosheng; Ye, Xinyi; Xu, Yingqiong; Yin, Mingzhu; Chen, Honglin; Kou, Junping; Yu, Boyang

    2016-01-01

    YiQiFuMai powder injection (YQFM) is a modern preparation derived from the traditional Chinese medicine Sheng-Mai-San. YQFM is widely used in clinical practice in the People's Republic of China, mainly for the treatment of microcirculatory disturbance-related diseases. However, little is known about its role in animals with ischemic stroke. The aim of this study was to examine the effect of YQFM on brain edema and blood-brain barrier (BBB) dysfunction induced by cerebral ischemia-reperfusion (I/R) injury. Male C57BL/6J mice underwent right middle cerebral artery occlusion for 1 hour with a subsequent 24-hour reperfusion to produce I/R injury. YQFM (three doses: 0.336, 0.671, and 1.342 g/kg) was then given intraperitoneally (IP). The results demonstrated that YQFM significantly decreased infarct size, improved neurological deficits, reduced brain water content, and increased cerebral blood flow after I/R injury. 18F-fluorodeoxyglucose micro-positron emission tomography imaging and hematoxylin and eosin staining results indicated that YQFM is able to ameliorate brain metabolism and histopathological damage after I/R. Moreover, YQFM administration reduced BBB leakage and upregulated the expression of zona occludens-1 (ZO-1) and occludin, which was confirmed by Evans Blue extravasation, Western blotting, and immunofluorescence assay. Our findings suggest that YQFM provides protection against focal cerebral I/R injury in mice, possibly by improving BBB dysfunction via upregulation of the expression of tight junction proteins.

  18. Reduced oxygen due to high-altitude exposure relates to atrophy in motor-function brain areas.

    Science.gov (United States)

    Di Paola, M; Paola, M D; Bozzali, M; Fadda, L; Musicco, M; Sabatini, U; Caltagirone, C

    2008-10-01

    At high altitudes barometric pressure is reduced and, thus, less oxygen is inhaled. Reduced oxygen concentration in brain tissue can lead to cerebral damage and neurological and cognitive deficits. The present study was designed to explore the effects of high-altitude exposure using a quantitative MRI technique, voxel-based morphometry. We studied nine world-class mountain climbers before (baseline) and after (follow-up) an extremely high-altitude ascent of Everest and K2. We investigated the effects of repeated extremely high-altitude exposures by comparing mountain climbers' scans at baseline with scans of 19 controls. In addition, we measured the effects of a single extremely high-altitude expedition by comparing mountain climbers' scans at baseline and follow-up. A region of reduced white matter density/volume was found in the left pyramidal tract near the primary (BA 4) and supplementary (BA 6) motor cortex when mountain climbers at baseline were compared with controls. Further, when mountain climbers' scans before and after the expedition were compared, a region of reduced grey matter density/volume was found in the left angular gyrus (BA 39). These findings suggest that extremely high-altitude exposures may cause subtle white and grey matter changes that mainly affect brain regions involved in motor activity.

  19. The effect of butylphthalide on the brain edema, blood-brain barrier of rats after focal cerebral infarction and the expression of Rho A.

    Science.gov (United States)

    Hu, Jinyang; Wen, Qingping; Wu, Yue; Li, Baozhu; Gao, Peng

    2014-06-01

    The aim of this study was to explore the effect of butylphthalide on the brain edema, blood-brain barrier of rats of rats after focal cerebral infarction and the expression of Rho A. A total of 195 sprague-dawley male rats were randomly divided into control group, model group, and butylphthalide group (40 mg/kg, once a day, by gavage). The model was made by photochemical method. After surgery 3, 12, 24, 72, and 144 h, brain water content was done to see the effect of butylphthalide for the cerebral edema. Evans blue extravasation method was done to see the changes in blood-brain barrier immunohistochemistry, and Western blot was done to see the expression of Rho A around the infarction. Compared with the control group, the brain water content of model group and butylphthalide group rats was increased, the permeability of blood-brain barrier of model group and butylphthalide group rats was increased, and the Rho A protein of model group and butylphthalide group rats was increased. Compared with the model group, the brain water content of butylphthalide group rats was induced (73.67 ± 0.67 vs 74.14 ± 0.46; 74.89 ± 0.57 vs 75.61 ± 0.52; 77.49 ± 0.34 vs 79.33 ± 0.49; 76.31 ± 0.56 vs 78.01 ± 0.48; 72.36 ± 0.44 vs 73.12 ± 0.73; P edema, protect the blood-brain barrier, and decrease the expression of Rho A around the infarction.

  20. Aging, High Altitude, and Blood Pressure: A Complex Relationship.

    Science.gov (United States)

    Parati, Gianfranco; Ochoa, Juan Eugenio; Torlasco, Camilla; Salvi, Paolo; Lombardi, Carolina; Bilo, Grzegorz

    2015-06-01

    Parati, Gianfranco, Juan Eugenio Ochoa, Camilla Torlasco, Paolo Salvi, Carolina Lombardi, and Grzegorz Bilo. Aging, high altitude, and blood pressure: A complex relationship. High Alt Biol Med 16:97-109, 2015.--Both aging and high altitude exposure may induce important changes in BP regulation, leading to significant increases in BP levels. By inducing atherosclerotic changes, stiffening of large arteries, renal dysfunction, and arterial baroreflex impairment, advancing age may induce progressive increases in systolic BP levels, promoting development and progression of arterial hypertension. It is also known, although mainly from studies in young or middle-aged subjects, that exposure to high altitude may influence different mechanisms involved in BP regulation (i.e., neural central and reflex control of sympathetic activity), leading to important increases in BP levels. The evidence is less clear, however, on whether and to what extent advancing age may influence the BP response to acute or chronic high altitude exposure. This is a question not only of scientific interest but also of practical relevance given the consistent number of elderly individuals who are exposed for short time periods (either for leisure or work) or live permanently at high altitude, in whom arterial hypertension is frequently observed. This article will review the evidence available on the relationship between aging and blood pressure levels at high altitude, the pathophysiological mechanisms behind this complex association, as well as some questions of practical interest regarding antihypertensive treatment in elderly subjects, and the effects of antihypertensive drugs on blood pressure response during high altitude exposure.

  1. Pulmonary edema

    Science.gov (United States)

    ... congestion; Lung water; Pulmonary congestion; Heart failure - pulmonary edema ... Pulmonary edema is often caused by congestive heart failure . When the heart is not able to pump efficiently, blood ...

  2. Kajian Teknologi High Altitude Platform (HAP [Study of High Altitude Platform (HAP Technology

    Directory of Open Access Journals (Sweden)

    Amry Daulat Gultom

    2016-07-01

    Full Text Available High Altitude Platform (HAP merupakan solusi alternatif untuk mengatasi keterbatasan infrastruktur terestrial maupun satelit. HAP merupakan pesawat ataupun balon udara yang ditempatkan pada ketinggian 20-50 km di atas permukaan bumi. Kelebihan yang utama dari HAP adalah kemudahan dalam penempatan, fleksibilitas, biaya operasionalnya rendah, delay  propagasi rendah, sudut elevasi lebar, cakupan yang luas. Penelitian ini dilakukan untuk mengetahui potensi HAP untuk komunikasi pita lebar dan perkembangannya di Indonesia. Analisis dilakukan secara deskriptif dengan mengolah data literatur yang didapat. Hasil penelitian menunjukkan bahwa di Indonesia terdapat potensi teknologi HAP untuk komunikasi pita lebar dengan lebar pita 2x300 MHz di band 27,9-28,2 GHz dan 31-31,3 GHz. Namun, belum ada peraturan yang mengatur alokasi frekuensi untuk HAP secara khusus di Indonesia.*****High Altitude Platform (HAP has been developed as an alternative solution in order to overcome limitation of terrestrial and satellite communication system. HAP is an aircraft or balloon situated on 20-50 km above the earth. Main advantages of HAP are flexibility in deployment, low propagation delay, wide elevation angle and broad coverage. The research is conducted to gather HAP potential for broadband communication and its development in Indonesia. Analysis is conducted by descriptive analysis from literature study gather. The research result shows that in Indonesia, there is potential of HAP technology for broadband communication with 2x300 MHz bandwidth within 27,9-28,2 GHz and 31-31,3 GHz. Yet, there are no specific regulations managing frequency allocation for HAP in Indonesia.

  3. Automated quantification of cerebral edema following hemispheric infarction: Application of a machine-learning algorithm to evaluate CSF shifts on serial head CTs

    Directory of Open Access Journals (Sweden)

    Yasheng Chen

    2016-01-01

    Full Text Available Although cerebral edema is a major cause of death and deterioration following hemispheric stroke, there remains no validated biomarker that captures the full spectrum of this critical complication. We recently demonstrated that reduction in intracranial cerebrospinal fluid (CSF volume (∆CSF on serial computed tomography (CT scans provides an accurate measure of cerebral edema severity, which may aid in early triaging of stroke patients for craniectomy. However, application of such a volumetric approach would be too cumbersome to perform manually on serial scans in a real-world setting. We developed and validated an automated technique for CSF segmentation via integration of random forest (RF based machine learning with geodesic active contour (GAC segmentation. The proposed RF + GAC approach was compared to conventional Hounsfield Unit (HU thresholding and RF segmentation methods using Dice similarity coefficient (DSC and the correlation of volumetric measurements, with manual delineation serving as the ground truth. CSF spaces were outlined on scans performed at baseline (<6 h after stroke onset and early follow-up (FU (closest to 24 h in 38 acute ischemic stroke patients. RF performed significantly better than optimized HU thresholding (p < 10−4 in baseline and p < 10−5 in FU and RF + GAC performed significantly better than RF (p < 10−3 in baseline and p < 10−5 in FU. Pearson correlation coefficients between the automatically detected ∆CSF and the ground truth were r = 0.178 (p = 0.285, r = 0.876 (p < 10−6 and r = 0.879 (p < 10−6 for thresholding, RF and RF + GAC, respectively, with a slope closer to the line of identity in RF + GAC. When we applied the algorithm trained from images of one stroke center to segment CTs from another center, similar findings held. In conclusion, we have developed and validated an accurate automated approach to segment CSF and calculate its shifts on serial CT scans

  4. NHAP = National High-Altitude Aerial Photography: 1980 - 1989

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The National High Altitude Photography (NHAP) program, which was operated from 1980-1989, was coordinated by the U.S. Geological Survey as an interagency project to...

  5. Ben Macdhui High Altitude Trace Gas and Aerosol Transport Experiment

    CSIR Research Space (South Africa)

    Piketh, SJ

    1999-01-01

    Full Text Available The Ben Macdhui High Altitude Aerosol and Trace Gas Transport Experiment (BHATTEX) was started to characterize the nature and magnitude of atmospheric, aerosol and trace gas transport paths recirculation over and exiting from southern Africa...

  6. NHAP = National High-Altitude Aerial Photography: 1980 - 1989

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The National High Altitude Photography (NHAP) program, which was operated from 1980-1989, was coordinated by the U.S. Geological Survey as an interagency project to...

  7. Travelling to new heights: practical high altitude medicine.

    Science.gov (United States)

    Plant, Tracie; Aref-Adib, Golnar

    2008-06-01

    Over 40 million people travel to high altitude for both work and pleasure each year, and all of them are at risk of the acute effects of hypoxia. This article reviews the prevention, diagnostic features and treatments of these illnesses.

  8. Functions and Design Scheme of Tibet High Altitude Test Base

    Institute of Scientific and Technical Information of China (English)

    Yu Yongqing; Guo Jian; Yin Yu; Mao Yan; Li Guangfan; Fan Jianbin; Lu Jiayu; Su Zhiyi; Li Peng; Li Qingfeng; Liao Weiming; Zhou Jun

    2010-01-01

    @@ The functional orientation of the Tibet High Altitude Test Base, subordinated to the State Grid Corporation of China (SGCC), is to serve power transmission projects in high altitude areas, especially to provide technical support for southwestern hydropower delivery projects by UHVDC transmission and Qinghai-Tibet grid interconnection project. This paper presents the matters concerned during siting and planning, functions,design scheme, the main performances and parameters of the test facilities, as well as the tests and research tasks already carried out.

  9. Increased oxidative stress following acute and chronic high altitude exposure.

    Science.gov (United States)

    Jefferson, J Ashley; Simoni, Jan; Escudero, Elizabeth; Hurtado, Maria-Elena; Swenson, Erik R; Wesson, Donald E; Schreiner, George F; Schoene, Robert B; Johnson, Richard J; Hurtado, Abdias

    2004-01-01

    The generation of reactive oxygen species is typically associated with hyperoxia and ischemia reperfusion. Recent evidence has suggested that increased oxidative stress may occur with hypoxia. We hypothesized that oxidative stress would be increased in subjects exposed to high altitude hypoxia. We studied 28 control subjects living in Lima, Peru (sea level), at baseline and following 48 h exposure to high altitude (4300 m). To assess the effects of chronic altitude exposure, we studied 25 adult males resident in Cerro de Pasco, Peru (altitude 4300 m). We also studied 27 subjects living in Cerro de Pasco who develop excessive erythrocytosis (hematocrit > 65%) and chronic mountain sickness. Acute high altitude exposure led to increased urinary F(2)-isoprostane, 8-iso PGF(2 alpha) (1.31 +/- 0.8 microg/g creatinine versus 2.15 +/- 1.1, p = 0.001) and plasma total glutathione (1.29 +/- 0.10 micromol versus 1.37 +/- 0.09, p = 0.002), with a trend to increased plasma thiobarbituric acid reactive substance (TBARS) (59.7 +/- 36 pmol/mg protein versus 63.8 +/- 27, p = NS). High altitude residents had significantly elevated levels of urinary 8-iso PGF(2 alpha) (1.3 +/- 0.8 microg/g creatinine versus 4.1 +/- 3.4, p = 0.007), plasma TBARS (59.7 +/- 36 pmol/mg protein versus 85 +/- 28, p = 0.008), and plasma total glutathione (1.29 +/- 0.10 micromol versus 1.55 +/- 0.19, p < 0.0001) compared to sea level. High altitude residents with excessive erythrocytosis had higher levels of oxidative stress compared to high altitude residents with normal hematological adaptation. In conclusion, oxidative stress is increased following both acute exposure to high altitude without exercise and with chronic residence at high altitude.

  10. Functions and Design Scheme of Tibet High Altitude Test Base

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The functional orientation of the Tibet High Altitude Test Base, subordinated to the State Grid Corporation of China (SGCC), is to serve power transmission projects in high altitude areas, especially to provide technical support for southwestern hydropower delivery projects by UHVDC transmission and Qinghai-Tibet grid interconnection project. This paper presents the matters concerned during siting and planning, functions, design scheme, the main performances and parameters of the test facilities, as well as...

  11. DLR HABLEG- High Altitude Balloon Launched Experimental Glider

    Science.gov (United States)

    Wlach, S.; Schwarzbauch, M.; Laiacker, M.

    2015-09-01

    The group Flying Robots at the DLR Institute of Robotics and Mechatronics in Oberpfaffenhofen conducts research on solar powered high altitude aircrafts. Due to the high altitude and the almost infinite mission duration, these platforms are also denoted as High Altitude Pseudo-Satellites (HAPS). This paper highlights some aspects of the design, building, integration and testing of a flying experimental platform for high altitudes. This unmanned aircraft, with a wingspan of 3 m and a mass of less than 10 kg, is meant to be launched as a glider from a high altitude balloon in 20 km altitude and shall investigate technologies for future large HAPS platforms. The aerodynamic requirements for high altitude flight included the development of a launch method allowing for a safe transition to horizontal flight from free-fall with low control authority. Due to the harsh environmental conditions in the stratosphere, the integration of electronic components in the airframe is a major effort. For regulatory reasons a reliable and situation dependent flight termination system had to be implemented. In May 2015 a flight campaign was conducted. The mission was a full success demonstrating that stratospheric research flights are feasible with rather small aircrafts.

  12. The effect of high altitude on nasal nitric oxide levels.

    Science.gov (United States)

    Altundag, Aytug; Salihoglu, Murat; Cayonu, Melih; Cingi, Cemal; Tekeli, Hakan; Hummel, Thomas

    2014-09-01

    The aim of the present study was to investigate whether nasal nitric oxide (nNO) levels change in relation to high altitude in a natural setting where the weather conditions were favorable. The present study included 41 healthy volunteers without a history of acute rhinosinusitis within 3 weeks and nasal polyposis. The study group consisted of 31 males (76 %) and 10 females (24 %) and the mean age of the study population was 38 ± 10 years. The volunteers encamped for 2 days in a mountain village at an altitude of 1,500 m above sea level (masl) and proceeded to highlands at an altitude of 2,200 masl throughout the day. The measurements of nNO were done randomly, either first at the mountain village or at sea level. Each participant had nNO values both at sea level and at high altitude at the end of the study. The nNO values of sea level and high altitude were compared to investigate the effect of high altitude on nNO levels. The mean of average nNO measurements at the high altitude was 74.2 ± 41 parts-per-billion (ppb) and the mean of the measurements at sea level was 93.4 ± 45 ppb. The change in nNO depending on the altitude level was statistically significant (p high altitude even if the weather conditions were favorable, such as temperature, humidity, and wind.

  13. YiQiFuMai powder injection ameliorates blood–brain barrier dysfunction and brain edema after focal cerebral ischemia–reperfusion injury in mice

    Directory of Open Access Journals (Sweden)

    Cao GS

    2016-01-01

    Full Text Available Guosheng Cao, Xinyi Ye, Yingqiong Xu, Mingzhu Yin, Honglin Chen, Junping Kou, Boyang Yu Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Department of Complex Prescription of TCM, China Pharmaceutical University, Nanjing, People’s Republic of China Abstract: YiQiFuMai powder injection (YQFM is a modern preparation derived from the traditional Chinese medicine Sheng-Mai-San. YQFM is widely used in clinical practice in the People’s Republic of China, mainly for the treatment of microcirculatory disturbance-related diseases. However, little is known about its role in animals with ischemic stroke. The aim of this study was to examine the effect of YQFM on brain edema and blood–brain barrier (BBB dysfunction induced by cerebral ischemia–reperfusion (I/R injury. Male C57BL/6J mice underwent right middle cerebral artery occlusion for 1 hour with a subsequent 24-hour reperfusion to produce I/R injury. YQFM (three doses: 0.336, 0.671, and 1.342 g/kg was then given intraperitoneally (IP. The results demonstrated that YQFM significantly decreased infarct size, improved neurological deficits, reduced brain water content, and increased cerebral blood flow after I/R injury. 18F-fluorodeoxyglucose micro-positron emission tomography imaging and hematoxylin and eosin staining results indicated that YQFM is able to ameliorate brain metabolism and histopathological damage after I/R. Moreover, YQFM administration reduced BBB leakage and upregulated the expression of zona occludens-1 (ZO-1 and occludin, which was confirmed by Evans Blue extravasation, Western blotting, and immunofluorescence assay. Our findings suggest that YQFM provides protection against focal cerebral I/R injury in mice, possibly by improving BBB dysfunction via upregulation of the expression of tight junction proteins. Keywords: YiQiFuMai powder injection, YQFM, ischemic stroke, blood–brain barrier, microvascular permeability, tight junctions

  14. 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

  15. Travel to High Altitude Following Solid Organ Transplantation.

    Science.gov (United States)

    Luks, Andrew M

    2016-09-01

    Luks, Andrew M. Clinician's corner: travel to high altitude following solid organ transplantation. High Alt Med Biol. 17:147-156, 2016.-As they regain active lifestyles following successful organ transplantation, transplant recipients may travel to high altitude for a variety of activities, including skiing, climbing, and trekking. This review is intended to provide information for medical providers who may encounter transplant patients seeking advice before planned high altitude travel or care for medical issues that develop during the actual sojourn. There is currently limited information in the literature about outcomes during high-altitude travel following solid organ transplantation, but the available evidence suggests that the physiologic responses to hypobaric hypoxia are comparable to those seen in nontransplanted individuals and well-selected transplant recipients with no evidence of organ rejection can tolerate ascents as high as 6200 m. All transplant recipients planning high-altitude travel should undergo pretravel assessment and counseling with an emphasis on the recognition, prevention, and treatment of altitude illness, as well as the importance of preventing infection and limiting sun exposure. Transplant recipients can use the standard medications for altitude illness prophylaxis and treatment, but the choice and dose of medication should take into account the patient's preexisting medication regimen and current renal function. With careful attention to these and other details, the healthy transplant recipient can safely experience the rewards of traveling in the mountains.

  16. Children's exercise capacity at high altitude in Tibet.

    Science.gov (United States)

    Bianba; Andersen, Lars Bo; Stigum, Hein; Ouzhuluobu; Bjertness, Espen

    2014-11-01

    Maximal oxygen uptake (exercise capacity) is a vital parameter in the evaluation of adaptation to high altitude, providing an index of the integrated function of the oxygen transport system. Previous studies of maximal oxygen uptake in population at high altitude have mainly focused on adults and adolescents, though data on children are uncommon. Maximal oxygen uptake can be measured directly, using an oxygen analyser, or indirectly through the development of equations for estimation from the maximal power output (W(max)). Such estimations and studies of the physiological aspects of children's capacity to work and live at different altitudes in Tibet ancestry were not reported previously, although differences similar to those seen in adults may be expected to occur. The present paper summarized the findings of studies on exercise capacity among children living at high altitude in Tibet.

  17. Microcomputer-controlled high-altitude data aquisition system

    Science.gov (United States)

    1985-05-01

    A new microcomputer controlled high altitude data acquisition system was developed. The system provides a new technique for data acquisition from China's astronomical, meteorological and other high altitude experiments and opens up new territory in microcomputer applications. This microcomputer controlled high altitude data acquisition system is made up of a Z80 single board computer, 10 K memory expansion board, and keyboard and display board which can collect 16 analog signals simultaneously, and through analog/digital conversion can convert external analog signals into digital signals then encode them in a certain form through program modulation and store them on audio cassette. The data is immediately retrieved from the tape and sent to the surface microcomputer system for data processing and analysis.

  18. The yak genome and adaptation to life at high altitude.

    Science.gov (United States)

    Qiu, Qiang; Zhang, Guojie; Ma, Tao; Qian, Wubin; Wang, Junyi; Ye, Zhiqiang; Cao, Changchang; Hu, Quanjun; Kim, Jaebum; Larkin, Denis M; Auvil, Loretta; Capitanu, Boris; Ma, Jian; Lewin, Harris A; Qian, Xiaoju; Lang, Yongshan; Zhou, Ran; Wang, Lizhong; Wang, Kun; Xia, Jinquan; Liao, Shengguang; Pan, Shengkai; Lu, Xu; Hou, Haolong; Wang, Yan; Zang, Xuetao; Yin, Ye; Ma, Hui; Zhang, Jian; Wang, Zhaofeng; Zhang, Yingmei; Zhang, Dawei; Yonezawa, Takahiro; Hasegawa, Masami; Zhong, Yang; Liu, Wenbin; Zhang, Yan; Huang, Zhiyong; Zhang, Shengxiang; Long, Ruijun; Yang, Huanming; Wang, Jian; Lenstra, Johannes A; Cooper, David N; Wu, Yi; Wang, Jun; Shi, Peng; Wang, Jian; Liu, Jianquan

    2012-07-01

    Domestic yaks (Bos grunniens) provide meat and other necessities for Tibetans living at high altitude on the Qinghai-Tibetan Plateau and in adjacent regions. Comparison between yak and the closely related low-altitude cattle (Bos taurus) is informative in studying animal adaptation to high altitude. Here, we present the draft genome sequence of a female domestic yak generated using Illumina-based technology at 65-fold coverage. Genomic comparisons between yak and cattle identify an expansion in yak of gene families related to sensory perception and energy metabolism, as well as an enrichment of protein domains involved in sensing the extracellular environment and hypoxic stress. Positively selected and rapidly evolving genes in the yak lineage are also found to be significantly enriched in functional categories and pathways related to hypoxia and nutrition metabolism. These findings may have important implications for understanding adaptation to high altitude in other animal species and for hypoxia-related diseases in humans.

  19. Clinical analysis on the related factors of cerebral edema after surgery for acute epidural hematoma%硬膜外血肿术后脑水肿的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    赵鹏洲; 罗江兵; 吴敬伦; 欧英雄; 余瑞钿

    2011-01-01

    Objective To analyze the related factors of cerebral edema after surgery for acute epidural hema-toma. Methods The clinical data of patients with cerebral edema after surgery for acute epidural hematoma from April 2007 to April 2011 were collected and analyzed. The correlation between the incidence & prognosis of cerebral edema and the following factors were investigated: age, sex, surgery preconscious level, clinical status, hematoma volume, hematoma, midline shift level, pupil size, Glasgow coma Scale (GCS), and time from injury to surgery. Results A total of 30 patients suffered cerebral edema after the surgery. ANOVA showed that coma, age, and location of hematoma showed no significant correlation with cerebral edema (P>0.05); Preoperative GCS score, clinical status, time from injury to surgery, shift of midline structures, hematoma volume, and pupil size were significantly related to postoperative cerebral edema (P<0.05); Preoperative pupil size is a relative high risk independent factor of postoperative cerebral edema. Conclusion Patients with acute epidural hematoma may have different degrees of cerebral edema. Therefore, patients should be carefully evaluated before and after surgery for the related factors of cerebral edema, in order to reduce the incidence of this disease.%目的 探讨硬膜外血肿术后脑水肿的相关因素.方法 收集2007年4月至2011年4月硬膜外血肿术后发生脑水肿的30例患者的资料,分析患者术后脑水肿发生及预后与年龄、性别、术前意识水平、临床状态、血肿体积、血肿部位、中线移位程度、瞳孔大小、格拉斯哥昏迷评分(GCS)、受伤至手术时间的关系.结果 63例硬膜外血肿患者术后共有30例患者出现脑水肿,经单因素方差分析显示是否有昏迷、年龄及血肿的部位与术后脑水肿无明显相关(P>.05);术前GCS评分、临床状态、受伤至手术时间、脑中线结构移位程度、血肿量、瞳孔大小、临床

  20. Protective effects of Astragalus-Lilygranules on intestinal mucosal barrier of mice in high altitude hypoxia

    Directory of Open Access Journals (Sweden)

    Ling LI

    2016-10-01

    Full Text Available Objective  To investigate the protective effect of Astragalus-Lily Granules on intestinal mucosa and intestinal flora homeostasis in mice under high altitude hypoxia condition. Methods  We put mice into high altitude hypoxia cabin to establish high altitude hypoxia model mice. Sixty Kunming mice were randomly divided into control group, model group, Astragalus-Lily particles (ALP low, medium and high dose groups [1.75, 3.5, 7g/(kg•d] respectively. After three days of routine feeding, the ALP mice received drug by intragastric administration, once a day for continuous 17 days,control group and model group were given double distilled water in same volume. From the 15th day, all the mice but control group were exposed to simulated high altitude hypoxia condition for 3 days in a high altitude hypoxia cabin after they were gavaged for half an hour daily. By the 18th day, the fresh mouse feces were collected and smeared to observe the changes of microflora. The pathological changes of intestinal tissues were observed by HE staining and the expression of HIF-1αprotein in intestines was detected by immunohistochemistry. Results  The enterococci and gram negative bacteria showed a higher proportion (65.2%±2.4% and 56.7%±3.3%, respectively in the model group compared with the control group (24.7%±1.2%, 23.2%±1.5%, respectively, P<0.05. The pathological score of intestinal mucosal necrosis and edema (3.10±0.99, 3.30±0.67 respectively and inflammatory cell count (15.93±3.30, 16.40±3.97/ HP respectively was higher compared with the model group (0.70±0.67, 0.80±0.78; 4.07±2.12, 4.28±2.16/HP respectively; P<0.05. HIF-1αexpression increased significantly compared with the model group (P<0.05. The enterococci (46.7%±2.0%, 32.0%±2.6% respectively and gram negative bacteria rate (34.2%±1.6%, 38.0%±2.8% respectively in the ALP medium and high dose groups were lower compared with the model group (24.7%±1.2%, 23.2%±1.5% respectively, P<0

  1. Effects of ascent to high altitude on human antimycobacterial immunity.

    Directory of Open Access Journals (Sweden)

    Sarah Eisen

    Full Text Available Tuberculosis infection, disease and mortality are all less common at high than low altitude and ascent to high altitude was historically recommended for treatment. The immunological and mycobacterial mechanisms underlying the association between altitude and tuberculosis are unclear. We studied the effects of altitude on mycobacteria and antimycobacterial immunity.Antimycobacterial immunity was assayed in 15 healthy adults residing at low altitude before and after they ascended to 3400 meters; and in 47 long-term high-altitude residents. Antimycobacterial immunity was assessed as the extent to which participants' whole blood supported or restricted growth of genetically modified luminescent Bacille Calmette-Guérin (BCG mycobacteria during 96 hours incubation. We developed a simplified whole blood assay that could be used by a technician in a low-technology setting. We used this to compare mycobacterial growth in participants' whole blood versus positive-control culture broth and versus negative-control plasma.Measurements of mycobacterial luminescence predicted the number of mycobacterial colonies cultured six weeks later. At low altitude, mycobacteria grew in blood at similar rates to positive-control culture broth whereas ascent to high altitude was associated with restriction (p ≤ 0.002 of mycobacterial growth to be 4-times less than in culture broth. At low altitude, mycobacteria grew in blood 25-times more than negative-control plasma whereas ascent to high altitude was associated with restriction (p ≤ 0.01 of mycobacterial growth to be only 6-times more than in plasma. There was no evidence of differences in antimycobacterial immunity at high altitude between people who had recently ascended to high altitude versus long-term high-altitude residents.An assay of luminescent mycobacterial growth in whole blood was adapted and found to be feasible in low-resource settings. This demonstrated that ascent to or residence at high altitude was

  2. Neurophysiological Problems in Snow Bound High Altitude Areas

    Directory of Open Access Journals (Sweden)

    W. Selvamurthy

    1984-10-01

    Full Text Available A series of studies have been conducted to evaluate the neurophysiological responses in young healthy soldiers during acclimatization at 3,500m altitude in Western Himalayas. The responses of autonomic nervous system, electroencephalogram hypothalamic thermoregulatory efficiency, orthostatic tolerance, sleep profile and effects of sleep deprivation have been studied in fresh inductees during three to five weeks of acclimatization at high altitude and compared with those of one year acclimatized lowlanders and high altitude natives. Physiological significance of these neurophysiological responses in the process of altitude adaptation is discussed in the light of current knowledge in the field.

  3. Effects of Ascent to High Altitude on Human Antimycobacterial Immunity

    Science.gov (United States)

    Aldridge, Robert W.; Siedner, Mark J.; Necochea, Alejandro; Leybell, Inna; Valencia, Teresa; Herrera, Beatriz; Wiles, Siouxsie; Friedland, Jon S.; Gilman, Robert H.; Evans, Carlton A.

    2013-01-01

    Background Tuberculosis infection, disease and mortality are all less common at high than low altitude and ascent to high altitude was historically recommended for treatment. The immunological and mycobacterial mechanisms underlying the association between altitude and tuberculosis are unclear. We studied the effects of altitude on mycobacteria and antimycobacterial immunity. Methods Antimycobacterial immunity was assayed in 15 healthy adults residing at low altitude before and after they ascended to 3400 meters; and in 47 long-term high-altitude residents. Antimycobacterial immunity was assessed as the extent to which participants’ whole blood supported or restricted growth of genetically modified luminescent Bacille Calmette-Guérin (BCG) mycobacteria during 96 hours incubation. We developed a simplified whole blood assay that could be used by a technician in a low-technology setting. We used this to compare mycobacterial growth in participants’ whole blood versus positive-control culture broth and versus negative-control plasma. Results Measurements of mycobacterial luminescence predicted the number of mycobacterial colonies cultured six weeks later. At low altitude, mycobacteria grew in blood at similar rates to positive-control culture broth whereas ascent to high altitude was associated with restriction (p≤0.002) of mycobacterial growth to be 4-times less than in culture broth. At low altitude, mycobacteria grew in blood 25-times more than negative-control plasma whereas ascent to high altitude was associated with restriction (p≤0.01) of mycobacterial growth to be only 6-times more than in plasma. There was no evidence of differences in antimycobacterial immunity at high altitude between people who had recently ascended to high altitude versus long-term high-altitude residents. Conclusions An assay of luminescent mycobacterial growth in whole blood was adapted and found to be feasible in low-resource settings. This demonstrated that ascent to or

  4. Glibenclamide for the prevention of cerebral edema and hemorrhagic transformation in ischemic stroke%格列本脲预防缺血性卒中患者脑水肿和出血性转化

    Institute of Scientific and Technical Information of China (English)

    陈红艳; 王红军

    2015-01-01

    Cerebral edema and hemorrhagic transformation(HT) are the common complications of ischemic stroke. Ischemic cerebral edema is the primary cause of death in patients w ith large infarction. The sulfonylurea receptor 1 (Sur1) transient receptor potential M4 (Trpm4) channel plays an important role in focal cerebral ischemia. Both animal experiment and clinical studies have show n that the Sur1 selective inhibitor glibenclamide provides neuroprotection for ischemic stroke, including infarct volume reduction and improvement of neurological function, especial y in attenuating cerebral edema and reducing the incidence of HT. This article review s the advances in research on glibenclamide for the prevention of cerebral edema and HT in patients w ith ischemic stroke.%脑水肿和出血性转化(hemorrhagictransformation,HT)是缺血性卒中的常见并发症。缺血性脑水肿是大面积脑梗死患者死亡的主要原因。磺脲类受体1(sulfonylurea receptor 1, Sur1)-瞬时受体电位通道M4型(transient receptor potential melastatin 4, Trpm4)通道在局灶性脑缺血中起着重要作用。动物实验和临床研究均显示,Sur1选择性抑制剂格列本脲可为缺血性卒中提供神经保护,包括缩小梗死体积和改善神经功能,特别是减轻脑水肿和降低HT 发生率。文章对格列本脲预防缺血性卒中患者脑水肿和HT的研究进展进行了综述。

  5. Cannabinoid type 2 receptor stimulation attenuates brain edema by reducing cerebral leukocyte infiltration following subarachnoid hemorrhage in rats.

    Science.gov (United States)

    Fujii, Mutsumi; Sherchan, Prativa; Krafft, Paul R; Rolland, William B; Soejima, Yoshiteru; Zhang, John H

    2014-07-15

    Early brain injury (EBI), following subarachnoid hemorrhage (SAH), comprises blood-brain barrier (BBB) disruption and consequent edema formation. Peripheral leukocytes can infiltrate the injured brain, thereby aggravating BBB leakage and neuroinflammation. Thus, anti-inflammatory pharmacotherapies may ameliorate EBI and provide neuroprotection after SAH. Cannabinoid type 2 receptor (CB2R) agonism has been shown to reduce neuroinflammation; however, the precise protective mechanisms remain to be elucidated. This study aimed to evaluate whether the selective CB2R agonist, JWH133 can ameliorate EBI by reducing brain-infiltrated leukocytes after SAH. Adult male Sprague-Dawley rats were randomly assigned to the following groups: sham-operated, SAH with vehicle, SAH with JWH133 (1.0mg/kg), or SAH with a co-administration of JWH133 and selective CB2R antagonist SR144528 (3.0mg/kg). SAH was induced by endovascular perforation, and JWH133 was administered 1h after surgery. Neurological deficits, brain water content, Evans blue dye extravasation, and Western blot assays were evaluated at 24h after surgery. JWH133 improved neurological scores and reduced brain water content; however, SR144528 reversed these treatment effects. JWH133 reduced Evans blue dye extravasation after SAH. Furthermore, JWH133 treatment significantly increased TGF-β1 expression and prevented an SAH-induced increase in E-selectin and myeloperoxidase. Lastly, SAH resulted in a decreased expression of the tight junction protein zonula occludens-1 (ZO-1); however, JWH133 treatment increased the ZO-1 expression. We suggest that CB2R stimulation attenuates neurological outcome and brain edema, by suppressing leukocyte infiltration into the brain through TGF-β1 up-regulation and E-selectin reduction, resulting in protection of the BBB after SAH.

  6. 高原肺水肿的CT诊断%CT diagnosis of high altitude pulmonary edema

    Institute of Scientific and Technical Information of China (English)

    向兴利; 马志习; 侯勇; 邓伟; 郭彦伟; 王旭梅; 杜智敏

    2002-01-01

    目的 探讨高原肺水肿的CT诊断价值.方法对16例急性高原适应不全患者进行胸部CT检查,总结其CT表现.结果其CT表现:(1)早期为磨玻璃样密度增高影,多出现于下叶背段及后基底段,且右下叶早于左下叶;(2)中期为云絮状密度增高影,若早期未得到及时有效的治疗,则病变密度逐渐增高而形成云絮状密度增高影;(3)晚期可发展到上叶后段及前段,病变充满整个肺叶,可见受累肺段支气管充气;(4)右肺表现重于左肺.结论 CT是高原肺水肿较理想的检查手段.对于高原肺水肿,CT诊断的准确率达100%.

  7. Accuracy of Handheld Blood Glucose Meters at High Altitude

    NARCIS (Netherlands)

    de Mol, Pieter; Krabbe, Hans G.; de Vries, Suzanna T.; Fokkert, Marion J.; Dikkeschei, Bert D.; Rienks, Rienk; Bilo, Karin M.; Bilo, Henk J. G.

    2010-01-01

    Background: Due to increasing numbers of people with diabetes taking part in extreme sports (e. g., high-altitude trekking), reliable handheld blood glucose meters (BGMs) are necessary. Accurate blood glucose measurement under extreme conditions is paramount for safe recreation at altitude. Prior st

  8. Climate Change Impacts on High-Altitude Ecosystems

    Directory of Open Access Journals (Sweden)

    Harald Pauli

    2016-02-01

    Full Text Available Reviewed: Climate Change Impacts on High-Altitude Ecosystems By Münir Öztürk, Khalid Rehman Hakeem, I. Faridah-Hanum and Efe. Recep, Cham, Switzerland: Springer International Publishing, 2015. xvii + 696 pp. US$ 239.00. ISBN 978-3-319-12858-0.

  9. Pathophysiology of acute mountain sickness and high altitude pulmonary oedema

    DEFF Research Database (Denmark)

    Sutton, J R; Lassen, N

    1979-01-01

    We review the evidence that acute mountain sickness (AMS) and high altitude pulmonary oedema (HAPO) occur together more often than is realized. We hypothesize that AMS and HAPO have a common pathophysiological basis: both are due to increased pressure and flow in the microcirculation, causing...

  10. Chicxulub High-Altitude Ballistic Ejecta from Central Belize

    Science.gov (United States)

    Pope, K. O.; Ocampo, A. C.

    2000-01-01

    Chicxulub ejecta are found in central Belize, 475 km southeast of the impact crater center. These deposits are ballistic ejecta launched along high-altitude trajectories above the atmosphere and deposited as a discontinuous sheet on the terminal Cretaceous land surface.

  11. Flight Control of the High Altitude Wind Power System

    NARCIS (Netherlands)

    Podgaets, A.R.; Ockels, W.J.

    2007-01-01

    Closed loop Laddermill flight control problem is considered in this paper. Laddermill is a high altitude kites system for energy production. The kites have been simulated as rigid bodies and the cable as a thin elastic line. Euler angles and cable speed are controls. Flight control is written as a f

  12. Cold induced peripheral vasodilation at high altitudes- a field study

    NARCIS (Netherlands)

    Daanen, H.A.M.; Ruiten, H.J.A. van

    2000-01-01

    A significant reduction in cold-induced vasodilation (CIVD) is observed at high altitudes. No agreement is found in the literature about acclimatization effects on CIVD. Two studies were performed to investigate the effect of altitude acclimatization on CIVD. In the first study 13 male subjects imme

  13. Reduced autonomic activity during stepwise exposure to high altitude

    NARCIS (Netherlands)

    Sevre, K; Bendz, B; Hanko, E; Nakstad, AR; Hauge, A; Kasin, JI; Lefrandt, JD; Smit, AJ; Eide, [No Value; Rostrup, M

    2001-01-01

    Several studies have shown increased sympathetic activity during acute exposure to hypobaric hypoxia. In a recent field study we found reduced plasma catecholamines during the first days after a stepwise ascent to high altitude. In the present study 14 subjects were exposed to a simulated ascent in

  14. Abnormal blood flow in the sublingual microcirculation at high altitude

    NARCIS (Netherlands)

    Martin, D.S.; Ince, C.; Goedhart, P.; Levett, D.Z.H.; Grocott, M.P.W.

    2009-01-01

    We report the first direct observations of deranged microcirculatory blood flow at high altitude, using sidestream dark-field imaging. Images of the sublingual microcirculation were obtained from a group of 12 volunteers during a climbing expedition to Cho Oyu (8,201 m) in the Himalayas.

  15. Acute occlusive mesenteric ischemia in high altitude of ...

    African Journals Online (AJOL)

    in our region. Keywords: Acute mesenteric ischemia, high altitude, Saudi Arabia. Résumé .... Saudi Arabia for many diseases such as stroke,[13] deep venous .... intestinal vascular failure: a collective review of 43 cases in Taiwan. Br J Clin ...

  16. Cold induced peripheral vasodilation at high altitudes- a field study

    NARCIS (Netherlands)

    Daanen, H.A.M.; Ruiten, H.J.A. van

    2000-01-01

    A significant reduction in cold-induced vasodilation (CIVD) is observed at high altitudes. No agreement is found in the literature about acclimatization effects on CIVD. Two studies were performed to investigate the effect of altitude acclimatization on CIVD. In the first study 13 male subjects imme

  17. Are macroinvertebrates in high altitude streams affected by oxygen deficiency?

    DEFF Research Database (Denmark)

    Jacobsen, Dean; Rostgaard, S.; Vásconez, J. J.

    2003-01-01

    conditions. However, this fails to take into account that oxygen solubility declines with decreasing atmospheric pressure, which may be of importance at high altitudes. 2. Based on samples of macroinvertebrate benthos and in situ measurements of respiratory oxygen demand of macroinvertebrates in small...

  18. 术中超声造影评价脑胶质瘤病理分级及瘤周水肿%Intraoperative contrast-enhanced ultrasonic imaging in the evaluation of pathologic grades of cerebral gliomas and peritumoral cerebral edema

    Institute of Scientific and Technical Information of China (English)

    贺焱; 何文; 杜丽娟; 黄文燕; 于书卿; 王集生; 李慧展

    2011-01-01

    目的 探讨术中超声造影技术在评价脑胶质瘤病理分级及区分肿瘤、瘤周水肿脑组织与正常脑组织范围中的价值.方法 对80例脑胶质瘤患者的术中超声造影图像进行回顾性分析,观察肿瘤、瘤周水肿脑组织与正常脑组织的强化情况,定量分析不同部位造影参数.结果 正常脑组织呈等增强,高级别胶质瘤瘤体组织与瘤周水肿脑组织呈高增强,瘤体组织增强强度高于瘤周水肿脑组织;低级别胶质瘤瘤体组织呈高增强,但瘤周水肿脑组织增强强度与正常脑组织相近.瘤体组织的绝对峰值强度高于瘤周水肿脑组织与正常脑组织,组间比较差异有统计学意义(P<0.05);高级别胶质瘤瘤体组织的造影达峰时间早于瘤周水肿脑组织与正常脑组织,组间比较差异有统计学意义(P<0.05);低级别胶质瘤瘤体组织造影达峰时间与瘤周水肿脑组织和正常脑组织比较,差异无统计学意义(P>0.05).结论 术中超声造影技术有助于切除肿瘤前判断胶质瘤病理级别及确定瘤周水肿脑组织的边界,有效指导临床手术.%Objective To explore the value of intraoperative contrast-enhanced ultrasonography in distinguishing gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues,and grading cerebral gliomas.Methods Intraoperative contrast-enhanced ultrasonic imaging in 80 patients diagnosed cerebral gliomas were studied retrospectively.The blood perfusion patterns of gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues were observed closely after contrast and parameters were recorded.Results After contrast-enhanced ultrasound,peripheral normal cerebral tissues showed homogeneous enhancement,the tumor tissues and peritumorous cerebral edema of high-grade gliomas (HGG) showed high enhancement,but peritumorous cerebral edema of low-grade gliomas (LGG) showed nearly homogeneous enhancement.Absolute peak intensity(API) of

  19. The time course changes in expression of aquaporin 4 and aquaporin 1 following global cerebral ischemic edema in rat

    OpenAIRE

    Gürsoy- Özdemir, Yasemin; Akdemir, G.; Kaymaz, F,; Akalan, N,; Akdemir, E.S.

    2016-01-01

    Background: The aim of this global cerebral ischemia study was to study the changes in expression levels of aquaporin 4 (AQP4) and AQP1 over time. Methods: Sprague-Dawley type male rats were divided into six groups. Sham group and ischemia/reperfusion were performed on five other groups using the four-vessel occlusion model. Reperfusion was done 30 min after the occlusion, and each group was tested at 1, 6, 12, 24, and 48 h for brain wet-dry weight ratio and AQP4 and AQP1 expression levels us...

  20. Preparation for football competition at moderate to high altitude.

    Science.gov (United States)

    Gore, C J; McSharry, P E; Hewitt, A J; Saunders, P U

    2008-08-01

    Analysis of approximately 100 years of home-and-away South American World Cup matches illustrate that football competition at moderate/high altitude (>2000 m) favors the home team, although this is more than compensated by the likelihood of sea-level teams winning at home against the same opponents who have descended from altitude. Nevertheless, the home team advantage at altitudes above approximately 2000 m may reflect that traditionally, teams from sea level or low altitude have not spent 1-2 weeks acclimatizing at altitude. Despite large differences between individuals, in the first few days at high altitude (e.g. La Paz, 3600 m) some players experience symptoms of acute mountain sickness (AMS) such as headache and disrupted sleep, and their maximum aerobic power (VO2max) is approximately 25% reduced while their ventilation, heart rate and blood lactate during submaximal exercise are elevated. Simulated altitude for a few weeks before competition at altitude can be used to attain partial ventilatory acclimation and ameliorated symptoms of AMS. The variety of simulated altitude exposures usually created with enriched nitrogen mixtures of air include resting or exercising for a few hours per day or sleeping approximately 8 h/night in hypoxia. Preparation for competition at moderate/high altitude by training at altitude is probably superior to simulated exposure; however, the optimal duration at moderate/high altitude is unclear. Preparing for 1-2 weeks at moderate/high altitude is a reasonable compromise between the benefits associated with overcoming AMS and partial restoration of VO2max vs the likelihood of detraining.

  1. Why Are High Altitude Natives So Strong at High Altitude? Nature vs. Nurture: Genetic Factors vs. Growth and Development.

    Science.gov (United States)

    Brutsaert, Tom

    Among high-altitude natives there is evidence of a general hypoxia tolerance leading to enhanced performance and/or increased capacity in several important domains. These domains likely include an enhanced physical work capacity, an enhanced reproductive capacity, and an ability to resist several common pathologies of chronic high-altitude exposure. The "strength" of the high-altitude native in this regard may have both a developmental and a genetic basis, although there is better evidence for the former (developmental effects) than for the latter. For example, early-life hypoxia exposure clearly results in lung growth and remodeling leading to an increased O2 diffusing capacity in adulthood. Genetic research has yet to reveal a population genetic basis for enhanced capacity in high-altitude natives, but several traits are clearly under genetic control in Andean and Tibetan populations e.g., resting and exercise arterial O2 saturation (SaO2). This chapter reviews the effects of nature and nurture on traits that are relevant to the process of gas exchange, including pulmonary volumes and diffusion capacity, the maximal oxygen consumption (VO2max), the SaO2, and the alveolar-arterial oxygen partial pressure difference (A-aDO2) during exercise.

  2. Quantitative analysis of electroencephalogram in patients with massive cerebral infarction complicated with cerebral edema%大面积脑梗死伴脑水肿患者的定量脑电图检测分析

    Institute of Scientific and Technical Information of China (English)

    王新一; 蔡增林; 徐丙超; 李路明; 周晓梅

    2015-01-01

    目的:探讨定量脑电图( qEEG)在大面积脑梗死伴脑水肿患者中的监护应用价值. 方法:将大面积脑梗死伴脑水肿30例老年患者作为观察组,选择同期体检老年人30 名为对照组,采用Bio-Logic脑电图仪分别检测患者发病6 h内( T1 )、24 h ( T2 )、72 h( T3 )、168 h( T4 )的qEEG,检测(δ+θ)波与(α+β)波的比率( DTABR)以及颅内脑水肿体积和美国国立卫生研究院卒中量表(NIHSS)评分,比较在不同病程阶段的变化. 结果:入院后观察组DTABR高于对照组(P0. 05),T3D TABR和脑水肿体积均多于T1 和T2(P0. 05). The change trends of DTABR index,NIHSS score and cerebral edema volume were similar, which arrived at the peak after 72 h,and began to decrease with the course of disease alleviating. The DTABR of the cure patients in observation group increased from T1 to T3 ,arrived at the peak,and gradually began to decrease from T3 to T4 ,while the declining trend of DTABR at T3 and T4 in the unhealed patients was not found. Conclusions:The qEEG can objectively and effectively evaluate the brain function in the patients with massive cerebral infarction complicated with cerebral edema,which can be expected to become an important bedside assessment means of brain function in neurological intensive care unit.

  3. Sustained (S)-roscovitine delivery promotes neuroprotection associated with functional recovery and decrease in brain edema in a randomized blind focal cerebral ischemia study.

    Science.gov (United States)

    Rousselet, Estelle; Létondor, Anne; Menn, Bénédicte; Courbebaisse, Yann; Quillé, Marie-Lise; Timsit, Serge

    2017-01-01

    Stroke is a devastating disorder that significantly contributes to death, disability and healthcare costs. In ischemic stroke, the only current acute therapy is recanalization, but the narrow therapeutic window less than 6 h limits its application. The current challenge is to prevent late cell death, with concomitant therapy targeting the ischemic cascade to widen the therapeutic window. Among potential neuroprotective drugs, cyclin-dependent kinase inhibitors such as (S)-roscovitine are of particular relevance. We previously showed that (S)-roscovitine crossed the blood-brain barrier and was neuroprotective in a dose-dependent manner in two models of middle cerebral artery occlusion (MCAo). According to the Stroke Therapy Academic Industry Roundtable guidelines, the pharmacokinetics of (S)-roscovitine and the optimal mode of delivery and therapeutic dose in rats were investigated. Combination of intravenous (IV) and continuous sub-cutaneous (SC) infusion led to early and sustained delivery of (S)-roscovitine. Furthermore, in a randomized blind study on a transient MCAo rat model, we showed that this mode of delivery reduced both infarct and edema volume and was beneficial to neurological outcome. Within the framework of preclinical studies for stroke therapy development, we here provide data to improve translation of pre-clinical studies into successful clinical human trials.

  4. Initial Feasibility Assessment of a High Altitude Long Endurance Airship

    Science.gov (United States)

    Colozza, Anthony; Dolce, James (Technical Monitor)

    2003-01-01

    A high altitude solar powered airship provides the ability to carry large payloads to high altitudes and remain on station for extended periods of time. This study examines the feasibility of this concept. Factors such as time of year, latitude, wind speeds and payload are considered in establishing the capabilities of a given size airship. East and West coast operation were evaluated. The key aspect to success of this type of airship is the design and operation of the propulsion and power system. A preliminary propulsion/power system design was produced based on a regenerative fuel cell energy storage system and solar photovoltaic array for energy production. A modular system design was chosen with four independent power/propulsion units utilized by the airship. Results on payload capacity and flight envelope (latitude and time of year) were produced for a range of airship sizes.

  5. 急性脑梗死动脉溶栓血管再通后的脑水肿研究%A clinical study on cerebral edema of intra-arterial thrombolytic recanalization in acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    马海; 任亚静; 张锡铎; 刘静; 郝锋利

    2013-01-01

    Objective To observe the cerebral edema occurrence ,evolution and prognosis of intra-arterial thrombolytic recanali-zation in patients with acute ischemic stroke .Methods From October 2010 to October 2012 ,36 patients who underwent the intra-arterial thrombolytic therapy were cerebral recanalization .They were randomly divided into two groups :1-3 h group and >3-6 h group .The alteration of brain edema was observed by cranial CT .Their mRS .NHISS and BI were scaled and recorded before and after intra-arterial thrombolytic therapy .Results After intra-arterial thrombolytic therapy ,the occurrence rate of cerebral edema was 94% ,appeared at the onset of more than 1 hours in all patients .Long-term follow-up showed ,cerebral edema location appeared obvious cerebromalacia .Cerebral edema and clinical outcome had not significant difference between 1-3 h group and 3-6 h group . Conclusion Cerebral edema and loss of cerebral tissue occurred almost inevitability in patients who received intra-artery thromboly-sis and recanalized their cerebral artery .It indicates that good local circulation and general condition may be favorable factors that can gradually reduce brain edema .%目的:观察急性缺血性脑卒中动脉溶栓血管再通后脑水肿的发生、演变及转归。方法2010年10月至2012年10月于该院就诊,通过动脉溶栓血管再通的患者共36例。将患者分为1~3 h组、>3~6 h组。头颅C T监测、随访脑水肿情况。记录溶栓前、术后1周及1年的美国国立卫生研究院卒中量表(NIHSS)、溶栓后1年改良蓝金评分(MRS)及巴塞尔指数(BI)。结果动脉溶栓血管再通后脑水肿的发生率为94%,出现在1~3 h组、>3~6 h组的所有患者中,长期随访表明,脑水肿局部出现了明显的软化灶。两组患者脑水肿及临床结局比较差异无统计学意义(P>0.05)。结论动脉溶栓血管再通后脑水肿的发生及其脑组织缺失几乎不可

  6. Nike Black Brant V high altitude dynamic instability characteristics

    Science.gov (United States)

    Montag, W. H.; Walker, L. L., Jr.

    1979-01-01

    Flight experience on the Nike Black Brant V has demonstrated the existence of plume induced flow separation over the fins and aft body of the Black Brant V motor. Modelling of the forces associated with this phenomenon as well as analysis of the resultant vehicle coning motion and its effect on the velocity vector heading are presented. A summary of Nike Black Brant V flight experience with high altitude dynamic instability is included.

  7. Body Structure and Respiratory Efficiency among High Altitude Himalayan Populations

    OpenAIRE

    2005-01-01

    To understand the morphological and physiological variations among the temporary and permanent residents of high altitude, this study was undertaken at Leh, Ladakh. It is situated at 3500 m (11500 feet) above sea level, the mean barometric pressure was 500 tors and air temperature varied from 2 °C to 20 °C. The highland Tibetans showed broadest chest and most developed musculature closely followed by Ladakhi Bods. These high altude natives also displayed significantly higher value of vital ca...

  8. Lens autofluorescence is not increased at high altitude

    DEFF Research Database (Denmark)

    Kessel, Line; Kofoed, Peter Kristian; Zubieta-Calleja, Gustavo

    2010-01-01

    PURPOSE: To study the relation between ambient environmental ultraviolet radiation exposure and lens fluorescence. METHODS: Non-invasive lens fluorometry measurements were compared in healthy Bolivian and Danish subjects. Background ultraviolet radiation was 4.5 times higher in Bolivia than...... in Denmark. RESULTS: No significant differences in lens fluorescence or transmittance were found between Bolivian and Danish volunteers. CONCLUSION: Age-corrected lens fluorescence and transmittance were comparable for healthy participants living at high altitude near the equator and healthy volunteers...

  9. Nike Black Brant V high altitude dynamic instability characteristics

    Science.gov (United States)

    Montag, W. H.; Walker, L. L., Jr.

    1979-01-01

    Flight experience on the Nike Black Brant V has demonstrated the existence of plume induced flow separation over the fins and aft body of the Black Brant V motor. Modelling of the forces associated with this phenomenon as well as analysis of the resultant vehicle coning motion and its effect on the velocity vector heading are presented. A summary of Nike Black Brant V flight experience with high altitude dynamic instability is included.

  10. Hyperuricemia, hypertension, and proteinuria associated with high-altitude polycythemia.

    Science.gov (United States)

    Jefferson, J Ashley; Escudero, Elizabeth; Hurtado, Maria-Elena; Kelly, Jackeline Pando; Swenson, Erik R; Wener, Mark H; Burnier, Michel; Maillard, Marc; Schreiner, George F; Schoene, Robert B; Hurtado, Abdias; Johnson, Richard J

    2002-06-01

    Chronic exposure to high altitude is associated with the development of erythrocytosis, proteinuria, and, in some cases, hyperuricemia. We examined the relationship between high-altitude polycythemia and proteinuria and hyperuricemia in Cerro de Pasco, Peru (altitude, 4,300 m). We studied 25 adult men with hematocrits less than 65% and 27 subjects with excessive erythrocytosis (EE; hematocrit > 65%) living in Cerro de Pasco, Peru and compared them with 28 control subjects living in Lima, Peru (at sea level) and after 48 hours of exposure to high altitude. Serum urate levels were significantly elevated in patients with EE at altitude, and gout occurred in 4 of 27 of these subjects. Urate level strongly correlated with hematocrit (r = 0.71; P < 0.0001). Urate production (24-hour urine urate excretion and urine urate-creatinine ratio) was increased in this group compared with those at sea level. Fractional urate excretion was not increased, and fractional lithium excretion was reduced, in keeping with increased proximal reabsorption of filtrate. Significantly higher blood pressures and decreased renin levels in the EE group were in keeping with increased proximal sodium reabsorption. Serum urate levels correlated with mean blood pressure (r = 0.50; P < 0.0001). Significant proteinuria was more prevalent in the EE group despite normal renal function. Hyperuricemia is common in subjects living at high altitude and associated with EE, hypertension, and proteinuria. The increase in uric acid levels appears to be caused by increased urate generation secondary to systemic hypoxia, although a relative impairment in renal excretion also may contribute.

  11. The University of Alberta High Altitude Balloon Program

    Science.gov (United States)

    Johnson, W.; Buttenschoen, A.; Farr, Q.; Hodgson, C.; Mann, I. R.; Mazzino, L.; Rae, J.; University of Alberta High Altitude Balloon Team

    2011-12-01

    The University of Alberta High Altitude Balloon (UA-HAB) program is a one and half year program sponsored by the Canadian Space Agency (CSA) that offers hands on experience for undergraduate and graduate students in the design, build, test and flight of an experimental payload on a high altitude balloon platform. Utilising low cost weather balloon platforms, and through utilisation of the CSA David Florida Laboratory for thermal-vacuum tests , in advance of the final flight of the payload on a NASA high altitude balloon platform. Collectively the program provided unique opportunities for students to experience mission phases which parallel those of a space satellite mission. The program has facilitated several weather balloon missions, which additionally provide educational opportunities for university students and staff, as well as outreach opportunities among junior and senior high school students. Weather balloon missions provide a cheap and quick alternative to suborbital missions; they can be used to test components for more expensive missions, as well as to host student based projects from different disciplines such as Earth and Atmospheric Sciences (EAS), Physics, and Engineering. In addition to extensive skills development, the program aims to promote recruitment of graduate and undergraduate students into careers in space science and engineering. Results from the UA-HAB program and the flight of the UA-HAB shielded Gieger counter payload for cosmic ray and space radiation studies will be presented. Lessons learned from developing and maintaining a weather balloon program will also be discussed. This project is undertaken in partnership with the High Altitude Student Platform, organized by Louisiana State University and the Louisiana Space Consortium (LaSpace), and sponsored by NASA, with the financial support of the Canadian Space Agency.

  12. Effectiveness of Preacclimatization Strategies for High-Altitude Exposure

    Science.gov (United States)

    2013-01-01

    hypobaric conditions. IAE 15, 15 d of intermittent altitude exposure; IAE 7, 7 d of intermittent altitude expo- sure; NH (Sleep), Ambient normobaric hypoxia ...than those using norm(!)baric hypoxia (breathing, ង.9% ox-ygen). Key Words: hypobaric hypoxia , normobaric hypoxia , staging, acute mountain sickness...large decrements in endurance exercise performance occur when unacclimatized individuals rapidly ascend to high altitudes. Six altitude and hypoxia

  13. The genetic architecture of adaptations to high altitude in Ethiopia.

    Science.gov (United States)

    Alkorta-Aranburu, Gorka; Beall, Cynthia M; Witonsky, David B; Gebremedhin, Amha; Pritchard, Jonathan K; Di Rienzo, Anna

    2012-01-01

    Although hypoxia is a major stress on physiological processes, several human populations have survived for millennia at high altitudes, suggesting that they have adapted to hypoxic conditions. This hypothesis was recently corroborated by studies of Tibetan highlanders, which showed that polymorphisms in candidate genes show signatures of natural selection as well as well-replicated association signals for variation in hemoglobin levels. We extended genomic analysis to two Ethiopian ethnic groups: Amhara and Oromo. For each ethnic group, we sampled low and high altitude residents, thus allowing genetic and phenotypic comparisons across altitudes and across ethnic groups. Genome-wide SNP genotype data were collected in these samples by using Illumina arrays. We find that variants associated with hemoglobin variation among Tibetans or other variants at the same loci do not influence the trait in Ethiopians. However, in the Amhara, SNP rs10803083 is associated with hemoglobin levels at genome-wide levels of significance. No significant genotype association was observed for oxygen saturation levels in either ethnic group. Approaches based on allele frequency divergence did not detect outliers in candidate hypoxia genes, but the most differentiated variants between high- and lowlanders have a clear role in pathogen defense. Interestingly, a significant excess of allele frequency divergence was consistently detected for genes involved in cell cycle control and DNA damage and repair, thus pointing to new pathways for high altitude adaptations. Finally, a comparison of CpG methylation levels between high- and lowlanders found several significant signals at individual genes in the Oromo.

  14. Joseph Barcroft's studies of high-altitude physiology.

    Science.gov (United States)

    West, John B

    2013-10-15

    Joseph Barcroft (1872-1947) was an eminent British physiologist who made contributions to many areas. Some of his studies at high altitude and related topics are reviewed here. In a remarkable experiment he spent 6 days in a small sealed room while the oxygen concentration of the air gradually fell, simulating an ascent to an altitude of nearly 5,500 m. The study was prompted by earlier reports by J. S. Haldane that the lung secreted oxygen at high altitude. Barcroft tested this by having blood removed from an exposed radial artery during both rest and exercise. No evidence for oxygen secretion was found, and the combination of 6 days incarceration and the loss of an artery was heroic. To obtain more data, Barcroft organized an expedition to Cerro de Pasco, Peru, altitude 4,300 m, that included investigators from both Cambridge, UK and Harvard. Again oxygen secretion was ruled out. The protocol included neuropsychometric measurements, and Barcroft famously concluded that all dwellers at high altitude are persons of impaired physical and mental powers, an assertion that has been hotly debated. Another colorful experiment in a low-pressure chamber involved reducing the pressure below that at the summit of Mt. Everest but giving the subjects 100% oxygen to breathe while exercising as a climber would on Everest. The conclusion was that it would be possible to reach the summit while breathing 100% oxygen. Barcroft was exceptional for his self-experimentation under hazardous conditions.

  15. Surgical decompression for space-occupying cerebral infarction (the Hemicraniectomy After Middle Cerebral Artery infarction with Life-threatening Edema Trial [HAMLET]): a multicentre, open, randomised trial.

    Science.gov (United States)

    Hofmeijer, Jeannette; Kappelle, L Jaap; Algra, Ale; Amelink, G Johan; van Gijn, Jan; van der Worp, H Bart

    2009-04-01

    Patients with space-occupying hemispheric infarctions have a poor prognosis, with case fatality rates of up to 80%. In a pooled analysis of randomised trials, surgical decompression within 48 h of stroke onset reduced case fatality and improved functional outcome; however, the effect of surgery after longer intervals is unknown. The aim of HAMLET was to assess the effect of decompressive surgery within 4 days of the onset of symptoms in patients with space-occupying hemispheric infarction. Patients with space-occupying hemispheric infarction were randomly assigned within 4 days of stroke onset to surgical decompression or best medical treatment. The primary outcome measure was the modified Rankin scale (mRS) score at 1 year, which was dichotomised between good (0-3) and poor (4-6) outcome. Other outcome measures were the dichotomy of mRS score between 4 and 5, case fatality, quality of life, and symptoms of depression. Analysis was by intention to treat. This trial is registered, ISRCTN94237756. Between November, 2002, and October, 2007, 64 patients were included; 32 were randomly assigned to surgical decompression and 32 to best medical treatment. Surgical decompression had no effect on the primary outcome measure (absolute risk reduction [ARR] 0%, 95% CI -21 to 21) but did reduce case fatality (ARR 38%, 15 to 60). In a meta-analysis of patients in DECIMAL (DEcompressive Craniectomy In MALignant middle cerebral artery infarction), DESTINY (DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY), and HAMLET who were randomised within 48 h of stroke onset, surgical decompression reduced poor outcome (ARR 16%, -0.1 to 33) and case fatality (ARR 50%, 34 to 66). Surgical decompression reduces case fatality and poor outcome in patients with space-occupying infarctions who are treated within 48 h of stroke onset. There is no evidence that this operation improves functional outcome when it is delayed for up to 96 h after stroke onset

  16. Dynamics of cerebral edema and the apparent diffusion coefficient of water changes in patients with severe traumatic brain injury. A prospective MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Pasco, Anne [Larrey Hospital, Angers University, Department of Radiology, Cedex (France); Inserm, Angers (France); Angers University, Angers (France); Minassian, Aram Ter [Larrey Hospital, Angers University, Department of Anaesthesiology, Cedex (France); Chapon, Catherine; Lemaire, Laurent; Benoit, Jean-Pierre; Jeune, Jean-Jacques Le [Inserm, Angers (France); Angers University, Angers (France); Franconi, Florence [Angers University, SCAS, Angers (France); Darabi, Dana; Caron, Christine [Larrey Hospital, Angers University, Department of Radiology, Cedex (France)

    2006-07-15

    The distinction between intracellular (ICE) and extracellular edema (ECE) has a crucial prognostic and therapeutic importance in patients with severe traumatic brain injury (STBI). Indeed, ICE usually leads to cellular death, and maintenance of a cerebral perfusion pressure (CPP) above 70 mmHg is still under debate since this practice may increase ECE. The purpose of this study was to describe the ECE and ICE kinetics associated with STBI using quantitative diffusion MRI. Twelve patients were prospectively studied. The initial ADC in ICE measured on day 1.3{+-}0.7 is significantly reduced compared to normal-appearing parenchyma (0.51{+-}0.12 * 10{sup -3} mm{sup 2}/s vs. 0.76{+-}0.03 * 10{sup -3} mm{sup 2}/s, n=12, P<0.0001) and reaches normality on MRI 3 performed on day 14.2{+-}3.3. In patients presenting an extension of ICE on MRI 2 performed on day 6.7{+-}1.4 (ADC{sub MRI2}=0.40{+-}0.11 * 10{sup -3} mm{sup 2}/s), ADC values in the extension area at the first MRI were slightly, but not significantly reduced compared to normal parenchyma (0.69{+-}0.05 * 10{sup -3} mm{sup 2}/s, P=0.29). Normalization occurred equally by day 14. ADC in ECE (1.34{+-}0.22 * 10{sup -3} mm{sup 2}/s) was elevated and stable with time under CPP therapy. Therefore, ECE is not worsened by CCP therapy, and ICE appears more relevant than ECE in STBI. (orig.)

  17. Nocturnal periodic breathing and the development of acute high altitude illness.

    Science.gov (United States)

    Eichenberger, U; Weiss, E; Riemann, D; Oelz, O; Bärtsch, P

    1996-12-01

    We tested the hypothesis that periodic breathing (PB) at high altitude is more frequent and arterial oxygen desaturation more severe during sleep in subjects developing high altitude pulmonary edema (HAPE) or acute mountain sickness (AMS) compared with subjects remaining healthy. We registered thoraco-abdominal movement, electro-encephalogram and oxygen saturation by pulse oximeter (pSao2) in 21 subjects during the first night spent at the altitude of 4,559 m. During the subsequent stay at 4,559 m, eight subjects remained well (controls), five subjects developed AMS and eight subjects developed HAPE. PB was found in all sleep stages and the percentage PB in any sleep stage was not significantly different between groups. There was a trend towards more PB in the HAPE vs. AMS and control group lasting 80 +/- 5 (mean +/- SE), 58 +/- 7, 57 +/- 9% of analyzable time, respectively (p = 0.09). The mean nocturnal decrease of pSao2 for these groups was 8.7 +/- 1.9, 5.4 +/- 2.1, 4.8 +/- 1.2%; (p = 0.36) and the median nocturnal pSao2 was 49 +/- 3, 63 +/- 3, and 63 +/- 4% (p = 0.02). Arterial blood gas analysis before and after sleep recordings indicate that the significantly lower Sao2 in the HAPE group is secondary to gas exchange rather than ventilation. The nocturnal decrease of pSao2 did not correlate with the time of PB nor the number of desaturation events > or = 4%. These findings suggest that more frequent PB in the HAPE group is a consequence of lower Sao2 due to impairment of gas exchange.

  18. Over-starvation aggravates intestinal injury and promotes bacterial and endotoxin translocation under high-altitude hypoxic environment

    Institute of Scientific and Technical Information of China (English)

    Qi-Quan Zhou; Ding-Zhou Yang; Yong-Jun Luo; Su-Zhi Li; Fu-Yu Liu; Guan-Song Wang

    2011-01-01

    AIM: To study whether over-starvation aggravates intestinal mucosal injury and promotes bacterial and endotoxin translocation in a high-altitude hypoxic environment. METHODS: Sprague-Dawley rats were exposed to hypobaric hypoxia at a simulated altitude of 7000 m for 72 h. Lanthanum nitrate was used as a tracer to detect intestinal injury. Epithelial apoptosis was observed with terminal deoxynucleotidyl transferase dUTP nick end labeling staining. Serum levels of diamino oxidase (DAO), malondialdehyde (MDA), glutamine (Gln), superoxide dismutase (SOD) and endotoxin were measured in intestinal mucosa. Bacterial translocation was detected in blood culture and intestinal homogenates. In addition, rats were given Gln intragastrically to observe its protective effect on intestinal injury. RESULTS: Apoptotic epithelial cells, exfoliated villi and inflammatory cells in intestine were increased with edema in the lamina propria accompanying effusion of red blood cells. Lanthanum particles were found in the intercellular space and intracellular compartment. Bacterial translocation to mesenteric lymph nodes (MLN) and spleen was evident. The serum endotoxin, DAO and MDA levels were significantly higher while the serum SOD, DAO and Gln levels were lower in intestine (P < 0.05). The bacterial translocation number was lower in the high altitude hypoxic group than in the high altitude starvation group (0.47 ± 0.83 vs 2.38 ± 1.45, P < 0.05). The bacterial translocation was found in each organ, especially in MLN and spleen but not in peripheral blood. The bacterial and endotoxin translocations were both markedly improved in rats after treatment with Gln. CONCLUSION: High-altitude hypoxia and starvation cause severe intestinal mucosal injury and increase bacterial and endotoxin translocation, which can be treated with Gln.

  19. Analysis of Different Surgical Treatment of Hypertensive Intracerebral Hemorrhage after Cerebral Edema%不同术式治疗高血压脑出血对术后脑水肿的影响分析

    Institute of Scientific and Technical Information of China (English)

    朱冠军

    2015-01-01

    ObjectiveTo investigate the effect on braln edema of different surgical methods for the treatment of hypertensive cerebral hemorrhage.Method For the patients with in our hospital from December 2011 to December 2013 were selected for hypertensive cerebral hemorrhage, 67 patients were randomly divided into two groups were observed and compared, including the control group using the traditional craniotomy operation, experimental group received minimally invasive evacuation of intracranial hematoma for treatment.Results After operation, the volume of edema, cerebral edema duration and idiotic left blood volume, the experimental group was statistically signiifcant difference compared with the control group(P<0.05).Conclusion In the treatment of hypertensive cerebral hemorrhage, intracranial hematoma can signiifcantly shorten the duration of postoperative braln edema, reduce the volume of edema, is worth the clinical promotion.%目的:了解不同术式治疗高血压脑出血对术后脑水肿的影响。方法对我院2011年12月至2013年12月收治的高血压脑出血患者进行抽样,选取67例患者随机分成两组进行对比观察,其中对照组采用传统开颅手术,实验组予以微创颅内血肿清除术进行治疗。结果术后在水肿体积、脑水肿持续时间以及脑残留血液量上,实验组较对照组差异具有显著统计学意义(P<0.05)。结论针对高血压脑出血治疗,微创颅内血肿清除术能显著缩短水肿持续时间,降低术后脑水肿体积,值得临床推广。

  20. The genetic architecture of adaptations to high altitude in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Gorka Alkorta-Aranburu

    Full Text Available Although hypoxia is a major stress on physiological processes, several human populations have survived for millennia at high altitudes, suggesting that they have adapted to hypoxic conditions. This hypothesis was recently corroborated by studies of Tibetan highlanders, which showed that polymorphisms in candidate genes show signatures of natural selection as well as well-replicated association signals for variation in hemoglobin levels. We extended genomic analysis to two Ethiopian ethnic groups: Amhara and Oromo. For each ethnic group, we sampled low and high altitude residents, thus allowing genetic and phenotypic comparisons across altitudes and across ethnic groups. Genome-wide SNP genotype data were collected in these samples by using Illumina arrays. We find that variants associated with hemoglobin variation among Tibetans or other variants at the same loci do not influence the trait in Ethiopians. However, in the Amhara, SNP rs10803083 is associated with hemoglobin levels at genome-wide levels of significance. No significant genotype association was observed for oxygen saturation levels in either ethnic group. Approaches based on allele frequency divergence did not detect outliers in candidate hypoxia genes, but the most differentiated variants between high- and lowlanders have a clear role in pathogen defense. Interestingly, a significant excess of allele frequency divergence was consistently detected for genes involved in cell cycle control and DNA damage and repair, thus pointing to new pathways for high altitude adaptations. Finally, a comparison of CpG methylation levels between high- and lowlanders found several significant signals at individual genes in the Oromo.

  1. Ergogenic properties of metformin in simulated high altitude.

    Science.gov (United States)

    Scalzo, Rebecca L; Paris, Hunter L; Binns, Scott E; Davis, Janelle L; Beals, Joseph W; Melby, Christopher L; Luckasen, Gary J; Hickey, Matthew S; Miller, Benjamin F; Hamilton, Karyn L; Bell, Christopher

    2017-07-01

    Metformin augments glucose/glycogen regulation and may acutely promote fatigue resistance during high-intensity exercise. In hypobaric environments, such as high altitude, the important contribution of carbohydrates to physiological function is accentuated as glucose/glycogen dependence is increased. Because hypoxia/hypobaria decreases insulin sensitivity, replenishing skeletal muscle glycogen in high altitude becomes challenging and subsequent physical performance may be compromised. We hypothesized that in conditions where glycogen repletion was critical to physical outcomes, metformin would attenuate hypoxia-mediated decrements in exercise performance. On three separate randomly ordered occasions, 13 healthy men performed glycogen-depleting exercise and ingested a low-carbohydrate dinner (1200 kcals, metformin (500 mg BID) was consumed 3 days prior to each hypoxia visit. Subjects completed a 12.5 km cycle ergometer time trial 3.5 hours following breakfast. Hypoxia decreased resting and exercise oxyhemoglobin saturation (Pmetformin affected the glucose response to breakfast (P=.977), however, compared with placebo, metformin lowered insulin concentration in hypoxia 45 minutes after breakfast (64.1±6.6 μU/mL vs 48.5±7.8 μU/mL; mean±SE; Pmetformin (+81%; P=.006), but not in hypoxia with placebo (+27%; P=.167). Hypoxia decreased time trial performance compared with normoxia (Pmetformin (+1.6±0.3 minutes). These results indicate that metformin promotes glycogen synthesis but not endurance exercise performance in healthy men exposed to simulated high altitude. © 2017 John Wiley & Sons Australia, Ltd.

  2. Pulmonary Edema

    Science.gov (United States)

    ... Accessed March 13, 2014. Pinto DS, et al. Pathophysiology of cardiogenic pulmonary edema. http://www.uptodate.com/ ... hvd/. Accessed March 10, 2014. What is pulmonary hypertension? National Heart, Lung, and Blood Institute. http://www. ...

  3. First scientific contributions from the High Altitude Water Cherenkov Observatory

    Science.gov (United States)

    León Vargas, H.; HAWC Collaboration

    2015-09-01

    The High Altitude Water Cherenkov Observatory (HAWC), located at the slopes of the volcanoes Sierra Negra and Pico de Orizaba in Mexico, was inaugurated on March 20, 2015. However, data taking started in August 2013 with a partially deployed observatory and since then the instrument has collected data as it got closer to its final configuration. HAWC is a ground based TeV gamma-ray observatory with a large field of view that will be used to study the Northern sky with high sensitivity. In this contribution we present some of the results obtained with the partially built instrument and the expected capabilities to detect different phenomena with the complete observatory.

  4. the APL Balloonborne High Altitude Research Platform (HARP)

    Science.gov (United States)

    Adams, D.; Arnold, S.; Bernasconi, P.

    2015-09-01

    The Johns Hopkins University Applied Physics Laboratory (APL) has developed and demonstrated a multi-purpose stratospheric balloonborne gondola known as the High Altitude Research Platform (HARP). HARP provides the power, mechanical supports, thermal control, and data transmission for multiple forms of high-altitude scientific research equipment. The platform has been used for astronomy, cosmology and heliophysics experiments but can also be applied to atmospheric studies, space weather and other forms of high altitude research. HARP has executed five missions. The first was Flare Genesis from Antarctica in 1993 and the most recent was the Balloon Observation Platform for Planetary Science (BOPPS) from New Mexico in 2014. HARP will next be used to perform again the Stratospheric Terahertz Observatory mission, a mission that it first performed in 2009. The structure, composed of an aluminum framework is designed for easy transport and field assembly while providing ready access to the payload and supporting avionics. A light-weighted structure, capable of supporting Ultra-Long Duration Balloon (ULDB) flights that can last more than 100 days is available. Scientific research payloads as heavy as 600 kg (1322 pounds) and requiring up to 800 Watts electrical power can be supported. The platform comprises all subsystems required to support and operate the science payload, including both line-of-sight (LOS) and over-the-horizon (0TH) telecommunications, the latter provided by Iridium Pilot. Electrical power is produced by solar panels for multi-day missions and batteries for single-day missions. The avionics design is primarily single-string; however, use of ruggedized industrial components provides high reliability. The avionics features a Command and Control (C&C) computer and a Pointing Control System (PCS) computer housed within a common unpressurized unit. The avionics operates from ground pressure to 2 Torr and over a temperature range from —30 C to +85 C

  5. Magnetic Monopole Search at high altitude with the SLIM experiment

    CERN Document Server

    Balestra, S; Cozzi, M; Errico, M; Fabbri, F; Giacomelli, G; Giacomelli, R; Giorgini, M; Kumar, A; Manzoor, S; McDonald, J; Mandrioli, G; Marcellini, S; Margiotta, A; Medinaceli, E; Patrizii, L; Pinfold, J L; Popa, V; Qureshi, I E; Saavedra, O; Sahnoun, Z; Sirri, G; Spurio, M; Togo, V; Velarde, A; Zanini, A

    2008-01-01

    The SLIM experiment was a large array of nuclear track detectors located at the Chacaltaya high altitude Laboratory (5230 m a.s.l.). The detector was in particular sensitive to Intermediate Mass Magnetic Monopoles, with masses 10^5 < M <10^{12} GeV. From the analysis of the full detector exposed for more than 4 years a flux upper limit of 1.3 x 10^{-15} cm^{-2} s^{-1} sr^{-1} for downgoing fast Intermediate Mass Monopoles was established at the 90% C.L.

  6. WCDMA Uplink Interference Assessment from Multiple High Altitude Platform Configurations

    Directory of Open Access Journals (Sweden)

    A. Mohammed

    2008-06-01

    Full Text Available We investigate the possibility of multiple high altitude platform (HAP coverage of a common cell area using a wideband code division multiple access (WCDMA system. In particular, we study the uplink system performance of the system. The results show that depending on the traffic demand and the type of service used, there is a possibility of deploying 3–6 HAPs covering the same cell area. The results also show the effect of cell radius on performance and the position of the multiple HAP base stations which give the worst performance.

  7. The Research of Acupuncture Combing with Ditan Decoction to Neuroethology and Cerebral Edema of Rat on the Acute Cerebral Hemorrhage%针刺结合涤痰汤对急性脑出血大鼠神经行为学指标及脑水肿影响的研究

    Institute of Scientific and Technical Information of China (English)

    王桂芳; 杨超; 崔海

    2012-01-01

    目的 探讨针刺结合涤痰汤对急性脑出血大鼠神经行为学指标和脑水肿功能的影响.方法 在SD大鼠身上复制急性脑出血模型,以针刺结合涤痰汤为治疗手段,观察脑出血急性期神经行为学评分和脑组织含水量状况,并与对照组进行比较.结果 针刺结合涤痰汤治疗组72 h后脑组织含水量均低于对照组.结论 针刺结合涤痰汤组对SD大鼠急性脑出血后神经行为学指标有改善作用,能够有效降低脑水肿的发生.%Objective: To explore the effect of acupuncture combing with Ditan Decoction for neuroethology and cerebral edema of rat on the acute cerebral hemorrhage. Methods: The SD rat models of acute cerebral hemorrhage were made and were treated by acupuncture combing with Ditan Decoction.Neuroethology and cerebral edema of them on the acute stage were observed and were compered to control group. Results: The water contents in cerebral tissues in the therapy group of acupuncture combing with Ditan Decoction after 72h was lower than the control group. Conclusion: The therapy of acupuncture combing with Ditant Decoction has the significant effect to improve neuroethology of SD rats on the acute cerebral hemorrhage, and effectively decrease the occurrences of cerebral edema.

  8. Pulmonary Edema

    OpenAIRE

    Tanser, Paul H.

    1981-01-01

    The physician who deals with pulmonary edema from a pathophysiologic basis will seldom make a diagnostic or therapeutic error. Recent additions to preload and afterload therapy have greatly helped in the emergency and ambulatory treatment of pulmonary edema due to left heart failure. Careful follow-up and patient self-monitoring are the most effective means of reducing hospitalization of chronic heart failure patients.

  9. Sub-Scale Re-entry Capsule Drop via High Altitude Balloons Project

    Data.gov (United States)

    National Aeronautics and Space Administration — High-altitude balloon flights are an inexpensive method used to lift payloads to high altitudes. Federal Aviation Administration (FAA) regulations permit payloads...

  10. Contemporary sediment production and transfer in high-altitude glaciers

    Science.gov (United States)

    Owen, Lewis A.; Derbyshire, Edward; Scott, Christine H.

    2003-01-01

    The nature of fine-grained sediment production and transfer in high-altitude debris-covered glaciers was studied by examining the Rakhiot and Chungphar glaciers in the Nanga Parbat Himalaya, Northern Pakistan. Transport pathways, from the source areas to the glacier snout, were mapped and samples collected for particle size analysis and scanning electron microscopy. Positive down-glacier trends in sediment fining and increased weathering showed that debris transport in the supraglacial zone of these Himalayan glaciers is an important contributor to contemporary glacial sediment production, resulting in intense comminution that yields large volumes of fine sediment. These findings cast doubt on the traditional view that the basal traction zone of glaciers is the only major source of fine sediment production in glaciated environments, although that view may hold true for classic alpine glaciers that are at lower altitudes and, as a consequence, generally have less supraglacial debris cover. To test this hypothesis, the Glacier de Cheilon, in the Swiss Alps was also studied. This glacier did not exhibit such striking down-glacier trends in the particle size characteristics measured. It is thus suggested that a thick debris-cover may be an important source of fine-grained sediments on glaciers that occur in high-altitude environments.

  11. Semianalytic Integration of High-Altitude Orbits under Lunisolar Effects

    Directory of Open Access Journals (Sweden)

    Martin Lara

    2012-01-01

    Full Text Available The long-term effect of lunisolar perturbations on high-altitude orbits is studied after a double averaging procedure that removes both the mean anomaly of the satellite and that of the moon. Lunisolar effects acting on high-altitude orbits are comparable in magnitude to the Earth’s oblateness perturbation. Hence, their accurate modeling does not allow for the usual truncation of the expansion of the third-body disturbing function up to the second degree. Using canonical perturbation theory, the averaging is carried out up to the order where second-order terms in the Earth oblateness coefficient are apparent. This truncation order forces to take into account up to the fifth degree in the expansion of the lunar disturbing function. The small values of the moon’s orbital eccentricity and inclination with respect to the ecliptic allow for some simplification. Nevertheless, as far as the averaging is carried out in closed form of the satellite’s orbit eccentricity, it is not restricted to low-eccentricity orbits.

  12. Increased insulin requirements during exercise at very high altitude in type 1 diabetes

    NARCIS (Netherlands)

    de Mol, Pieter; de Vries, Suzanna T.; de Koning, Eelco J. P.; Gans, Rijk O. B.; Tack, Cees J.; Bilo, Henk J. G.

    2011-01-01

    OBJECTIVE-Safe, very high altitude trekking in subjects with type 1 diabetes requires understanding of glucose regulation at high altitude. We investigated insulin requirements, energy expenditure, and glucose levels at very high altitude in relation to acute mountain sickness (AMS) symptoms in indi

  13. Increased insulin requirements during exercise at very high altitude in type 1 diabetes

    NARCIS (Netherlands)

    Mol, P. De; Vries, S.T. de; Koning, E.J. de; Gans, R.O.; Tack, C.J.J.; Bilo, H.J.

    2011-01-01

    OBJECTIVE: Safe, very high altitude trekking in subjects with type 1 diabetes requires understanding of glucose regulation at high altitude. We investigated insulin requirements, energy expenditure, and glucose levels at very high altitude in relation to acute mountain sickness (AMS) symptoms in ind

  14. Increased insulin requirements during exercise at very high altitude in type 1 diabetes

    NARCIS (Netherlands)

    Mol, P. De; Vries, S.T. de; Koning, E.J. de; Gans, R.O.; Tack, C.J.J.; Bilo, H.J.

    2011-01-01

    OBJECTIVE: Safe, very high altitude trekking in subjects with type 1 diabetes requires understanding of glucose regulation at high altitude. We investigated insulin requirements, energy expenditure, and glucose levels at very high altitude in relation to acute mountain sickness (AMS) symptoms in

  15. Increased insulin requirements during exercise at very high altitude in type 1 diabetes

    NARCIS (Netherlands)

    de Mol, Pieter; de Vries, Suzanna T.; de Koning, Eelco J. P.; Gans, Rijk O. B.; Tack, Cees J.; Bilo, Henk J. G.

    OBJECTIVE-Safe, very high altitude trekking in subjects with type 1 diabetes requires understanding of glucose regulation at high altitude. We investigated insulin requirements, energy expenditure, and glucose levels at very high altitude in relation to acute mountain sickness (AMS) symptoms in

  16. Acute mountain sickness

    Science.gov (United States)

    High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema ... Acute mountain sickness is caused by reduced air pressure and lower oxygen levels at high altitudes. The faster you ...

  17. 醒脑静联合纳络酮治疗对脑出血后水肿的影响%The Influence of Xingnaojing Combined with Naloxone for Edema after Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    戴启荷

    2013-01-01

    Objective:To investigate the influence of xingnaojing combined with naloxone for edema after cerebral hemorrhage. Methods:70 patients with cerebral hemorrhage were randomly divided into two groups.The treatment group (n=35) were treated by xingnaojing combined with naloxone,while the control group (n=35) were only treated with naloxone.The treatment duration lasted 14 days for both the groups.The total effective rates and the size of cerebral edema before and after treatment were compared.Results:The total effective rate of treatment group (88.6%) was significantly better than that of control group (71.4%)(P<0.05);The size of cerebral edema in treatment group was significantly smaller than that of control group after treatment(P<0.05).Conclusion:The treatment of xingnaojing combined with naloxone can significantly reduce brain edema and improve the clinical efficacy.It be worthy of clinical application.%  目的:观察醒脑静联合纳络酮治疗对脑出血后水肿的影响.方法:70例脑出血患者随机分为两组,治疗组(n=35)采用醒脑静联合纳络酮治疗,对照组(n=35)采用纳络酮治疗,两组疗程均为14天,比较两组治疗前后脑水肿大小及临床疗效.结果:治疗组总有效率88.6%,对照组总有效率71.4%,两组比较差异有显著性意义(P<0.05);治疗组治疗后的脑水肿体积明显小于对照组(P<0.05).结论:醒脑静联合纳络酮治疗脑出血可明显减轻脑水肿,提高临床疗效,值得临床推广应用.

  18. High-Altitude Platforms - Present Situation and Technology Trends

    Directory of Open Access Journals (Sweden)

    Flavio Araripe D'Oliveira

    2016-07-01

    Full Text Available High-altitude platforms (HAPs are aircraft, usually unmanned airships or airplanes positioned above 20 km, in the stratosphere, in order to compose a telecommunications network or perform remote sensing. In the 1990 and 2000 decades, several projects were launched, but very few had continued. In 2014, 2 major Internet companies (Google and Facebook announced investments in new HAP projects to provide Internet access in regions without communication infrastructure (terrestrial or satellite, bringing back attention to the development of HAP. This article aims to survey the history of HAPs, the current state-of-the-art (April 2016, technology trends and challenges. The main focus of this review will be on technologies directly related to the aerial platform, inserted in the aeronautical engineering field of knowledge, not detailing aspects of the telecommunications area.

  19. Thermoelectric Energy Conversion Technology for High-Altitude Airships

    Science.gov (United States)

    Choi, Sang H.; Elliott, James R.; King, Glen C.; Park, Yeonjoon; Kim, Jae-Woo; Chu, Sang-Hyon

    2011-01-01

    The High Altitude Airship (HAA) has various application potential and mission scenarios that require onboard energy harvesting and power distribution systems. The power technology for HAA maneuverability and mission-oriented applications must come from its surroundings, e.g. solar power. The energy harvesting system considered for HAA is based on the advanced thermoelectric (ATE) materials being developed at NASA Langley Research Center. The materials selected for ATE are silicon germanium (SiGe) and bismuth telluride (Bi2Te3), in multiple layers. The layered structure of the advanced TE materials is specifically engineered to provide maximum efficiency for the corresponding range of operational temperatures. For three layers of the advanced TE materials that operate at high, medium, and low temperatures, correspondingly in a tandem mode, the cascaded efficiency is estimated to be greater than 60 percent.

  20. Status of the large high altitude air shower observatory project

    Energy Technology Data Exchange (ETDEWEB)

    Zha, Min, E-mail: zham@ihep.ac.cn [Key Laboratory of Astroparticle and Cosmic Ray, Institute of High Energy Physics, YuQuan Road 19 B, 100049 Beijing (China)

    2012-11-11

    The Large High Altitude Air Shower Observatory (LHAASO) project is a multipurpose project. The main scientific tasks can be summarized as follows: (1) searching for galactic cosmic ray origins through gamma ray source detection above 30 TeV; (2) wide field of view survey for gamma ray sources at energies higher than 100 GeV; (3) energy spectrum measurements for individual cosmic ray species from 30 TeV to 10 PeV. To target above tasks, a complex detector array is designed. This paper describes the progress on the research and development of all kind of detectors. Construction and operation of a prototype detector array at Tibet site with 4300 m a.s.l. are also presented.

  1. STEERABLE ANTENNAS MOVEMENT COMPENSATION FOR HIGH ALTITUDE PLATFORM

    Institute of Scientific and Technical Information of China (English)

    Wang Zhenyong; Liu Xiaowei; Li Zhuoshi

    2011-01-01

    High Altitude Platform (HAP) must compensate for relative motion with respect to the ground because of the stratosphere complexity,which is important to guarantee Quality of Service(QoS) in intended coverage area.With analysis on HAP movement models for predicting the geographical coverage in the cases of shift horizontally and vertically,yaw,roll and pitch,the mechanisms of steerable antennas movement compensation are investigated.The mechanism is applied to a scenario of 127 cell architecture,with a cell cluster size of four.By the simulation results of Carrier to Interference Ratio (CIR),the steerable antenna movement compensation mechanism decrease influence of HAP movement and guarantee effective coverage of the service area.

  2. First year results of the High Altitude Water Cherenkov observatory

    CERN Document Server

    Carramiñana, Alberto

    2016-01-01

    The High Altitude Water Cherenkov (HAWC) gamma-ray observatory is a wide field of view (1.8 Sr) and high duty cycle (>95% up-time) detector of unique capabilities for the study of TeV gamma-ray sources. Installed at an altitude of 4100m in the Northern slope of Volc\\'an Sierra Negra, Puebla, by a collaboration of about thirty institutions of Mexico and the United States, HAWC has been in full operations since March 2015, surveying 2/3 of the sky every sidereal day, monitoring active galaxies and mapping sources in the Galactic Plane to a detection level of 1 Crab per day. This contribution summarizes the main results of the first year of observations of the HAWC gamma-ray observatory.

  3. High-altitude wind resources in the Middle East

    KAUST Repository

    Yip, Chak Man Andrew

    2017-08-23

    In the Middle East, near-surface wind resources are intermittent. However, high-altitude wind resources are abundant, persistent, and readily available and may provide alternative energy resources in this fossil-fuel-dependent region. Using wind field data from the Modern-Era Retrospective Analysis for Research and Applications Version 2 (MERRA-2), this study identifies areas favorable to the deployment of airborne wind energy (AWE) systems in the Middle East and computes the optimal heights at which such systems would best operate. AWE potential is estimated using realistic AWE system specifications and assumptions about deployment scenarios and is compared with the near-surface wind generation potential with respect to diurnal and seasonal variability. The results show the potential utility of AWE in areas in the Middle East where the energy demand is high. In particular, Oman and Saudi Arabia have a high level of the potential power generation with low annual variability.

  4. High-altitude wind resources in the Middle East.

    Science.gov (United States)

    Yip, Chak Man Andrew; Gunturu, Udaya Bhaskar; Stenchikov, Georgiy L

    2017-08-29

    In the Middle East, near-surface wind resources are intermittent. However, high-altitude wind resources are abundant, persistent, and readily available and may provide alternative energy resources in this fossil-fuel-dependent region. Using wind field data from the Modern-Era Retrospective Analysis for Research and Applications Version 2 (MERRA-2), this study identifies areas favorable to the deployment of airborne wind energy (AWE) systems in the Middle East and computes the optimal heights at which such systems would best operate. AWE potential is estimated using realistic AWE system specifications and assumptions about deployment scenarios and is compared with the near-surface wind generation potential with respect to diurnal and seasonal variability. The results show the potential utility of AWE in areas in the Middle East where the energy demand is high. In particular, Oman and Saudi Arabia have a high level of the potential power generation with low annual variability.

  5. Radiation Physics for Space and High Altitude Air Travel

    Science.gov (United States)

    Cucinotta, F. A.; Wilson, J. W.; Goldhagen, P.; Saganti, P.; Shavers, M. R.; McKay, Gordon A. (Technical Monitor)

    2000-01-01

    Galactic cosmic rays (GCR) are of extra-solar origin consisting of high-energy hydrogen, helium, and heavy ions. The GCR are modified by physical processes as they traverse through the solar system, spacecraft shielding, atmospheres, and tissues producing copious amounts of secondary radiation including fragmentation products, neutrons, mesons, and muons. We discuss physical models and measurements relevant for estimating biological risks in space and high-altitude air travel. Ambient and internal spacecraft computational models for the International Space Station and a Mars mission are discussed. Risk assessment is traditionally based on linear addition of components. We discuss alternative models that include stochastic treatments of columnar damage by heavy ion tracks and multi-cellular damage following nuclear fragmentation in tissue.

  6. First year results of the High Altitude Water Cherenkov observatory

    Science.gov (United States)

    Carramiñana, Alberto

    2016-10-01

    The High Altitude Water Cherenkov (HAWC) γ-ray observatory is a wide field of view (1.8 Sr) and high duty cycle (> 95% up-time) detector of unique capabilities for the study of TeV gamma-ray sources. Installed at an altitude of 4100m in the Northern slope of Volcan Sierra Negra, Puebla, by a collaboration of about thirty institutions of Mexico and the United States, HAWC has been in full operations since March 2015, surveying 2/3 of the sky every sidereal day, monitoring active galaxies and mapping sources in the Galactic Plane to a detection level of 1 Crab per day. This contribution summarizes the main results of the first year of observations of the HAWC γ-ray observatory.

  7. The High-Altitude Water Cherenkov Observatory: First Light

    Science.gov (United States)

    Weisgarber, Thomas

    2013-04-01

    The High-Altitude Water Cherenkov (HAWC) Observatory is under construction at Sierra Negra in the state of Puebla in Mexico. Operation began in September 2012, with the first 30 out of the final 300 water Cherenkov detectors deployed and in data acquisition. The HAWC Observatory is designed to record particle air showers from gamma rays and cosmic rays with TeV energies. Though the detector is only 10% complete, HAWC is already the world's largest water Cherenkov detector in the TeV band. In this presentation, I will summarize the performance of the detector to date and discuss preliminary observations of cosmic-ray and gamma-ray sources. I will also describe deployment plans for the remainder of the detector and outline prospects for TeV observations in the coming year.

  8. Cerebrovascular reactivity among native-raised high altitude residents: an fMRI study

    Directory of Open Access Journals (Sweden)

    Zhang Jiaxing

    2011-09-01

    Full Text Available Abstract Background The impact of long term residence on high altitude (HA on human brain has raised concern among researchers in recent years. This study investigated the cerebrovascular reactivity among native-born high altitude (HA residents as compared to native sea level (SL residents. The two groups were matched on the ancestral line, ages, gender ratios, and education levels. A visual cue guided maximum inspiration task with brief breath holding was performed by all the subjects while Blood-Oxygenation-Level-Dependent (BOLD functional Magnetic Resonance Imaging (fMRI data were acquired from them. Results Compared to SL controls, the HA group showed generally decreased cerebrovascular reactivity and longer delay in hemodynamic response. Clusters showing significant differences in the former aspect were located at the bilateral primary motor cortex, the right somatosensory association cortex, the right thalamus and the right caudate, the bilateral precuneus, the right cingulate gyrus and the right posterior cingulate cortex, as well as the left fusiform gyrus and the right lingual cortex; clusters showing significant differences in the latter aspect were located at the precuneus, the insula, the superior frontal and temporal gyrus, the somatosensory cortex (the postcentral gyrus and the cerebellar tonsil. Inspiratory reserve volume (IRV, which is an important aspect of pulmonary function, demonstrated significant correlation with the amount of BOLD signal change in multiple brain regions, particularly at the bilateral insula among the HA group. Conclusions Native-born HA residents generally showed reduced cerebrovascular reactivity as demonstrated in the hemodynamic response during a visual cue guided maximum inspiration task conducted with BOLD-fMRI. This effect was particularly manifested among brain regions that are typically involved in cerebral modulation of respiration.

  9. Wilderness medicine at high altitude: recent developments in the field

    Directory of Open Access Journals (Sweden)

    Shah NM

    2015-09-01

    Full Text Available Neeraj M Shah,1 Sidra Hussain,2 Mark Cooke,3 John P O’Hara,3 Adrian Mellor3,4 1Division of Asthma, Allergy and Lung Biology, King’s College London, UK; 2School of Medicine, University College London, London, UK; 3Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK; 4Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK Abstract: Travel to high altitude is increasingly popular. With this comes an increased incidence of high-altitude illness and therefore an increased need to improve our strategies to prevent and accurately diagnose these. In this review, we provide a summary of recent advances of relevance to practitioners who may be advising travelers to altitude. Although the Lake Louise Score is now widely used as a diagnostic tool for acute mountain sickness (AMS, increasing evidence questions the validity of doing so, and of considering AMS as a single condition. Biomarkers, such as brain natriuretic peptide, are likely correlating with pulmonary artery systolic pressure, thus potential markers of the development of altitude illness. Established drug treatments include acetazolamide, nifedipine, and dexamethasone. Drugs with a potential to reduce the risk of developing AMS include nitrate supplements, propagators of nitric oxide, and supplemental iron. The role of exercise in the development of altitude illness remains hotly debated, and it appears that the intensity of exercise is more important than the exercise itself. Finally, despite copious studies demonstrating the value of preacclimatization in reducing the risk of altitude illness and improving performance, an optimal protocol to preacclimatize an individual remains elusive. Keywords: hypoxia, acute mountain sickness, acclimatization, biomarkers, preacclimatization

  10. Mitogenomic analyses propose positive selection in mitochondrial genes for high-altitude adaptation in galliform birds.

    Science.gov (United States)

    Zhou, Taicheng; Shen, Xuejuan; Irwin, David M; Shen, Yongyi; Zhang, Yaping

    2014-09-01

    Galliform birds inhabit very diverse habitats, including plateaus that are above 3000 m in altitude. At high altitude, lower temperature and hypoxia are two important factors influencing survival. Mitochondria, as the ultimate oxygen transductor, play an important role in aerobic respiration through oxidative phosphorylation (OXPHOS). We analyzed the mitochondrial genomes of six high-altitude phasianidae birds and sixteen low-altitude relatives in an attempt to determine the role of mitochondrial genes in high-altitude adaptation. We reconstructed the phylogenetic relationships of these phasianidae birds and relatives and found at least four lineages that independently occupied this high-altitude habitat. Selective analyses revealed significant evidence for positive selection in the genes ND2, ND4, and ATP6 in three of the high-altitude lineages. This result strongly suggests that adaptive evolution of mitochondrial genes played a critical role during the independent acclimatization to high altitude by galliform birds.

  11. Latest news from the High Altitude Water Cherenkov Observatory

    Science.gov (United States)

    González Muñoz, A.; HAWC Collaboration

    2016-07-01

    The High Altitude Water Cherenkov Observatory is an air shower detector designed to study very-high-energy gamma rays (˜ 100 GeV to ˜ 100 TeV). It is located in the Pico de Orizaba National Park, Mexico, at an elevation of 4100 m. HAWC started operations since August 2013 with 111 tanks and in April of 2015 the 300 tanks array was completed. HAWC's unique capabilities, with a field of view of ˜ 2 sr and a high duty cycle of 5%, allow it to survey 2/3 of the sky every day. These features makes HAWC an excellent instrument for searching new TeV sources and for the detection of transient events, like gamma-ray bursts. Moreover, HAWC provides almost continuous monitoring of already known sources with variable gamma-ray fluxes in most of the northern and part of the southern sky. These observations will bring new information about the acceleration processes that take place in astrophysical environments. In this contribution, some of the latest scientific results of the observatory will be presented.

  12. An automatic parachute release for high altitude scientific balloons

    Science.gov (United States)

    Field, Chris

    NASA's Columbia Scientific Balloon Facility launches high altitude scientific research balloons at many locations around the world. Locations like Antarctica are flat for hundreds of miles and have nothing to snag a parachute consequently causing it to be more important to separate the parachute from the payload than in an area with vegetation and fences. Scientists are now building one of a kind payloads costing millions of dollars, taking five years or more to build, and are requesting multiple flights. In addition to that, the data gathering rate of many science payloads far exceeds the data downlink rate on over-the-horizon flights therefore making a recovery of at least the data hard drives a "minimum success requirement". The older mentality in ballooning; separating the parachute and payload from the balloon and getting it on the ground is more important than separating the parachute after the payload is on the ground has changed. It is now equally as important to separate the parachute from the gondola to prevent damage from dragging. Until now, commands had to be sent to separate the parachute from the gondola at approximately 60K ft, 30K ft, and 10K ft to use the Semi Automatic Parachute Release (SAPR), which is after the sometimes violent parachute opening shock. By using the Gondola controlled Automatic Parachute Release (GAPR) all commanding is done prior to termination, making the parachute release fully autonomous.

  13. 21st Century Lightning Protection for High Altitude Observatories

    Science.gov (United States)

    Kithil, Richard

    2013-05-01

    One of the first recorded lightning insults to an observatory was in January 1890 at the Ben Nevis Observatory in Scotland. In more recent times lightning has caused equipment losses and data destruction at the US Air Force Maui Space Surveillance Complex, the Cerro Tololo observatory and the nearby La Serena scientific and technical office, the VLLA, and the Apache Point Observatory. In August 1997 NOAA's Climate Monitoring and Diagnostic Laboratory at Mauna Loa Observatory was out of commission for a month due to lightning outages to data acquisition computers and connected cabling. The University of Arizona has reported "lightning strikes have taken a heavy toll at all Steward Observatory sites." At Kitt Peak, extensive power down protocols are in place where lightning protection for personnel, electrical systems, associated electronics and data are critical. Designstage lightning protection defenses are to be incorporated at NSO's ATST Hawaii facility. For high altitude observatories lightning protection no longer is as simple as Franklin's 1752 invention of a rod in the air, one in the ground and a connecting conductor. This paper discusses selection of engineered lightning protection subsystems in a carefully planned methodology which is specific to each site.

  14. An extremely high altitude plume seen at Mars morning terminator

    Science.gov (United States)

    Sanchez-Lavega, Agustin; Garcia-Muñoz, Antonio; Garcia-Melendo, Enrique; Perez-Hoyos, Santiago; Gomez-Forrellad, Josep M.; Pellier, Christophe; Delcroix, Marc; Lopez-Valverde, Miguel Angel; Gonzalez-Galindo, Francisco; Jaeschke, Wayne; Parker, Donald C.; Phillips, James H.; Peach, Damian

    2014-11-01

    We report the occurrence in March and April 2012 of two bright very high altitude plumes at the Martian terminator at 250 km or more above the surface, thus well into the ionosphere and bordering on the exosphere. They were located at about 195 deg West longitude and -45 deg latitude (at Terra Cimmeria) and lasted for about 10 days. The features showed day-to-day variability, and were seen at the morning terminator but not at the evening limb, which indicates rapid evolution in less than 10 hours and a cyclic behavior. Photometric measurements are used to explore two possible scenarios to explain their nature. If the phenomenon is due to suspended particles (dust, CO2 or H2O ice clouds) reflecting solar radiation, the mean size is about 0.1 microns with a nadir optical depth > 0.06. Alternatively, the plume could be auroral emission above a region with a strong magnetic anomaly and where aurora has previously been detected. Importantly, both explanations defy our current understanding of the Mars upper atmosphere.AcknowledgementsThis work was supported by the Spanish MINECO projects AYA2012-36666 with FEDER support, CONSOLIDER program ASTROMOL CSD2009-00038 and AYA2011-30613-CO2-1. Grupos Gobierno Vasco IT765-13 and UPV/EHU UFI11/55.

  15. Increased choroidal thickness in patient with high-altitude retinopathy

    Directory of Open Access Journals (Sweden)

    Kyoko Hirukawa-Nakayama

    2014-01-01

    Full Text Available We report a case of high-altitude retinopathy with increased choroidal thickness detected by spectral-domain optical coherence tomography (SD-OCT. A 36-year-old Japanese man developed an acute vision decrease in his left eye after he had trekked at an altitude of 4600 m in Tibet for 1 week. His visual acuity was 20/20 OD and 20/200 OS with refractive errors of − 0.25 diopters (D OD and − 0.50 D OS 3 weeks after the onset of the visual decrease. Funduscopic examinations revealed multiple intraretinal hemorrhages bilaterally and a macular hemorrhage in the left eye. SD-OCT showed that the thickness of choroidal layer at the fovea was 530 μm OD and 490 μm OS which is thicker than that in normal subjects of approximately 300 μm. We suggest that the increase in the retinal blood flow under hypoxic conditions may be associated with an increase in the choroidal blood flow resulting in an increase in choroidal thickness.

  16. Scientific verification of High Altitude Water Cherenkov observatory

    Energy Technology Data Exchange (ETDEWEB)

    Marinelli, Antonio, E-mail: antonio.marinelli@fisica.unam.mx [Instituto de Física, Universidad Nacional Autónoma de México, Mexico D.F. (Mexico); Sparks, Kathryne [Department of Physics, Pennsylvania State University, University Park, PA (United States); Alfaro, Ruben [Instituto de Física, Universidad Nacional Autónoma de México, Mexico D.F. (Mexico); González, María Magdalena; Patricelli, Barbara; Fraija, Nissim [Instituto de Astronomia, Universidad Nacional Autónoma de México, Mexico D.F. (Mexico)

    2014-04-01

    The High Altitude Water Cherenkov (HAWC) observatory is a TeV gamma-ray and cosmic-ray detector currently under construction at an altitude of 4100 m close to volcano Sierra Negra in the state of Puebla, Mexico. The HAWC [1] observatory is an extensive air-shower array composed of 300 optically isolated water Cherenkov detectors (WCDs). Each WCD contains ∼200,000 l of filtered water and four upward-facing photomultiplier tubes. In Fall 2014, when the HAWC observatory will reach an area of 22,000 m{sup 2}, the sensitivity will be 15 times higher than its predecessor Milagro [2]. Since September 2012, more than 30 WCDs have been instrumented and taking data. This first commissioning phase has been crucial for the verification of the data acquisition and event reconstruction algorithms. Moreover, with the increasing number of instrumented WCDs, it is important to verify the data taken with different configuration geometries. In this work we present a comparison between Monte Carlo simulation and data recorded by the experiment during 24 h of live time between 14 and 15 April of 2013 when 29 WCDs were active.

  17. HCN ice in Titan's high-altitude southern polar cloud

    CERN Document Server

    de Kok, Remco J; Maltagliati, Luca; Irwin, Patrick G J; Vinatier, Sandrine

    2014-01-01

    Titan's middle atmosphere is currently experiencing a rapid change of season after northern spring arrived in 2009. A large cloud was observed for the first time above Titan's southern pole in May 2012, at an altitude of 300 km. This altitude previously showed a temperature maximum and condensation was not expected for any of Titan's atmospheric gases. Here we show that this cloud is composed of micron-sized hydrogen cyanide (HCN) ice particles. The presence of HCN particles at this altitude, together with new temperature determinations from mid-infrared observations, indicate a very dramatic cooling of Titan's atmosphere inside the winter polar vortex in early 2012. Such a cooling is completely contrary to previously measured high-altitude warming in the polar vortex, and temperatures are a hundred degrees colder than predicted by circulation models. Besides elucidating the nature of Titan's mysterious polar cloud, these results thus show that post-equinox cooling at the winter pole is much more efficient th...

  18. High altitude headache occurs frequently among construction workers in Yushu

    Institute of Scientific and Technical Information of China (English)

    Wu Tianyi; Li Shuzhi; Jin Xinhui; Zhang Jianqing

    2013-01-01

    The aim was to measure the incidence of high altitude headache (HAH) and to determine clinical features,as well as the relation between acute mountain sickness (AMS) and HAH through a prospective study.We conducted a questionnaire-based study among construction workers in Yushu after a serious earthquake; they were under reconstruction using a structured questionnaire incorporating International Headache Society (IHS) and AMS Lake Louise Scoring System.A total of 608 workers were enrolled after their first ascent to altitudes of 3 750~4528 m.The results showed that 96 % reported at least 1 HAH(median 3.8,range from 1 to 10) in workers at a mean altitude of 4250 m.The magnitude of headache was divided as mild (38 %),moderate (44 %) and severe (18 %).This study indicates that HAH is the most common symptom of acute altitude exposure and closely correlated with altitude (r=0.165,p<0.001).However,52 % of headache was one of the main symptoms of AMS,while the other 48 % was the sole symptom of HAH.On the contrary we found that 2 % of AMS without headache,thus the "painless AMS" actually existed.The clinical features of HAH are presented,and the relationship between AMS and HAH is discussed.

  19. Naturally enhanced ion-acoustic lines at high altitudes

    Directory of Open Access Journals (Sweden)

    Y. Ogawa

    2006-12-01

    Full Text Available Naturally enhanced ion-acoustic lines (NEIALs between 1200 and 1900 km altitude are investigated. The NEIALs were found in the background gates of data from the European Incoherent Scatter (EISCAT Svalbard radar (ESR at 78° N looking field-aligned. Only strongly enhanced lines are detected at such high altitudes. The estimated enhancement above incoherent scattering integrated over the antenna beam and preintegration time of 10 s reaches about 10 000. Both lines are always enhanced above 1000 km altitude, and the downshifted line, corresponding to upward propagating ion-acoustic waves, is always stronger than the upshifted line, for downgoing waves. The ratio of the downshifted and upshifted peaks is often remarkably constant along a profile. Using the line positions as indicators of the ion-acoustic speeds and the bulk drift velocity, we find that the bulk drift does not exceed the ion-acoustic (sound speed, but extrapolation of the profiles suggests that the sound barrier is reached around 2000 km in one event. The highest ion-acoustic speed is seen near 600 km, above the density peak, indicating that electrons are heated not only by ionizing precipitation but significantly also by upgoing waves. Upflow continues to speed up above the estimated temperature maximum. A certain qualitative similarity to the solar corona seems to be the case.

  20. High Altitude Venus Operational Concept (HAVOC): Proofs of Concept

    Science.gov (United States)

    Jones, Christopher A.; Arney, Dale C.; Bassett, George Z.; Clark, James R.; Hennig, Anthony I.; Snyder, Jessica C.

    2015-01-01

    The atmosphere of Venus is an exciting destination for both further scientific study and future human exploration. A recent internal NASA study of a High Altitude Venus Operational Concept (HAVOC) led to the development of an evolutionary program for the exploration of Venus, with focus on the mission architecture and vehicle concept for a 30-day crewed mission into Venus's atmosphere at 50 kilometers. Key technical challenges for the mission include performing the aerocapture maneuvers at Venus and Earth, inserting and inflating the airship at Venus during the entry sequence, and protecting the solar panels and structure from the sulfuric acid in the atmosphere. Two proofs of concept were identified that would aid in addressing some of the key technical challenges. To mitigate the threat posed by the sulfuric acid ambient in the atmosphere of Venus, a material was needed that could protect the systems while being lightweight and not inhibiting the performance of the solar panels. The first proof of concept identified candidate materials and evaluated them, finding FEP-Teflon (Fluorinated Ethylene Propylene-Teflon) to maintain 90 percent transmittance to relevant spectra even after 30 days of immersion in concentrated sulfuric acid. The second proof of concept developed and verified a packaging algorithm for the airship envelope to inform the entry, descent, and inflation analysis.

  1. Highlights from the High Altitude Water Cherenkov Observatory

    CERN Document Server

    Pretz, John

    2015-01-01

    The High Altitude Water Cherenkov (HAWC) Gamma-Ray Observatory was completed this year at a 4100-meter site on the flank of the Sierra Negra volcano in Mexico. HAWC is a water Cherenkov ground array with the capability to distinguish 100 GeV - 100 TeV gamma rays from the hadronic cosmic-ray background. HAWC is uniquely suited to study extremely high energy cosmic-ray sources, search for regions of extended gamma-ray emission, and to identify transient gamma-ray phenomena. HAWC will play a key role in triggering multi-wavelength and multi-messenger studies of active galaxies, gamma-ray bursts, supernova remnants and pulsar wind nebulae. Observation of TeV photons also provide unique tests for a number of fundamental physics phenomena including dark matter annihilation and primordial black hole evaporation. Operation began mid-2013 with the partially-completed detector. Multi-TeV emission from the Galactic Plane is clearly seen in the first year of operation, confirming a number of known TeV sources, and a numb...

  2. High altitude hypoxia and blood pressure dysregulation in adult chickens.

    Science.gov (United States)

    Herrera, E A; Salinas, C E; Blanco, C E; Villena, M; Giussani, D A

    2013-02-01

    Although it is accepted that impaired placental perfusion in complicated pregnancy can slow fetal growth and programme an increased risk of cardiovascular dysfunction at adulthood, the relative contribution of reductions in fetal nutrition and in fetal oxygenation as the triggering stimulus remains unclear. By combining high altitude (HA) with the chick embryo model, we have previously isolated the direct effects of HA hypoxia on embryonic growth and cardiovascular development before hatching. This study isolated the effects of developmental hypoxia on cardiovascular function measured in vivo in conscious adult male and female chickens. Chick embryos were incubated, hatched and raised at sea level (SL, nine males and nine females) or incubated, hatched and raised at HA (seven males and seven females). At 6 months of age, vascular catheters were inserted under general anaesthesia. Five days later, basal blood gas status, basal cardiovascular function and cardiac baroreflex responses were investigated. HA chickens had significantly lower basal arterial PO2 and haemoglobin saturation, and significantly higher haematocrit than SL chickens, independent of the sex of the animal. HA chickens had significantly lower arterial blood pressure than SL chickens, independent of the sex of the animal. Although the gain of the arterial baroreflex was decreased in HA relative to SL male chickens, it was increased in HA relative to SL female chickens. We show that development at HA lowers basal arterial blood pressure and alters baroreflex sensitivity in a sex-dependent manner at adulthood.

  3. Scientific verification of High Altitude Water Cherenkov observatory

    Science.gov (United States)

    Marinelli, Antonio; Sparks, Kathryne; Alfaro, Ruben; González, María Magdalena; Patricelli, Barbara; Fraija, Nissim

    2014-04-01

    The High Altitude Water Cherenkov (HAWC) observatory is a TeV gamma-ray and cosmic-ray detector currently under construction at an altitude of 4100 m close to volcano Sierra Negra in the state of Puebla, Mexico. The HAWC [1] observatory is an extensive air-shower array composed of 300 optically isolated water Cherenkov detectors (WCDs). Each WCD contains ~200,000 l of filtered water and four upward-facing photomultiplier tubes. In Fall 2014, when the HAWC observatory will reach an area of 22,000 m2, the sensitivity will be 15 times higher than its predecessor Milagro [2]. Since September 2012, more than 30 WCDs have been instrumented and taking data. This first commissioning phase has been crucial for the verification of the data acquisition and event reconstruction algorithms. Moreover, with the increasing number of instrumented WCDs, it is important to verify the data taken with different configuration geometries. In this work we present a comparison between Monte Carlo simulation and data recorded by the experiment during 24 h of live time between 14 and 15 April of 2013 when 29 WCDs were active.

  4. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Español Eye Health / Eye Health A-Z Macular Edema Sections What Is Macular Edema? What Causes Macular ... Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Dec. 01, 2010 Macular edema is swelling or ...

  5. Iridium: Global OTH data communications for high altitude scientific ballooning

    Science.gov (United States)

    Denney, A.

    While the scientific community is no stranger to embracing commercially available technologies, the growth and availability of truly affordable cutting edge technologies is opening the door to an entirely new means of global communications. For many years high altitude ballooning has provided science an alternative to costly satellite based experimental platforms. As with any project, evolution becomes an integral part of development. Specifically in the NSBF ballooning program, where flight durations have evolved from the earlier days of hours to several weeks and plans are underway to provide missions up to 100 days. Addressing increased flight durations, the harsh operational environment, along with cumbersome and outdated systems used on existing systems, such as the balloon vehicles Support Instrumentation Package (SIP) and ground-based systems, a new Over-The-Horizon (OTH) communications medium is sought. Current OTH equipment planning to be phased-out include: HF commanding systems, ARGOS PTT telemetry downlinks and INMARSAT data terminals. Other aspects up for review in addition to the SIP to utilize this communications medium include pathfinder balloon platforms - thereby, adding commanding abilities and increased data rates, plus providing a package for ultra-small experiments to ride aloft. Existing communication systems employed by the National Scientific Balloon Facility ballooning program have been limited not only by increased cost, slow data rates and "special government use only" services such as TDRSS (Tracking and Data Relay Satellite System), but have had to make special provisions to geographical flight location. Development of the Support Instrumentation Packages whether LDB (Long Duration Balloon), ULDB (Ultra Long Duration Balloon) or conventional ballooning have been plagued by non-standard systems configurations requiring additional support equipment for different regions and missions along with a myriad of backup for redundancy. Several

  6. High Altitude Aerial Natural Gas Leak Detection System

    Energy Technology Data Exchange (ETDEWEB)

    Richard T. Wainner; Mickey B. Frish; B. David Green; Matthew C. Laderer; Mark G. Allen; Joseph R. Morency

    2006-12-31

    The objective of this program was to develop and demonstrate a cost-effective and power-efficient advanced standoff sensing technology able to detect and quantify, from a high-altitude (> 10,000 ft) aircraft, natural gas leaking from a high-pressure pipeline. The advanced technology is based on an enhanced version of the Remote Methane Leak Detector (RMLD) platform developed previously by Physical Sciences Inc. (PSI). The RMLD combines a telecommunications-style diode laser, fiber-optic components, and low-cost DSP electronics with the well-understood principles of Wavelength Modulation Spectroscopy (WMS), to indicate the presence of natural gas located between the operator and a topographic target. The transceiver transmits a laser beam onto a topographic target and receives some of the laser light reflected by the target. The controller processes the received light signal to deduce the amount of methane in the laser's path. For use in the airborne platform, we modified three aspects of the RMLD, by: (1) inserting an Erbium-doped optical fiber laser amplifier to increase the transmitted laser power from 10 mW to 5W; (2) increasing the optical receiver diameter from 10 cm to 25 cm; and (3) altering the laser wavelength from 1653 nm to 1618 nm. The modified RMLD system provides a path-integrated methane concentration sensitivity {approx}5000 ppm-m, sufficient to detect the presence of a leak from a high capacity transmission line while discriminating against attenuation by ambient methane. In ground-based simulations of the aerial leak detection scenario, we demonstrated the ability to measure methane leaks within the laser beam path when it illuminates a topographic target 2000 m away. We also demonstrated simulated leak detection from ranges of 200 m using the 25 cm optical receiver without the fiber amplifier.

  7. Effect of simulated high-altitude hypoxia on Porphyromonas gingivalis

    Directory of Open Access Journals (Sweden)

    Jing-jing HUANG

    2012-04-01

    Full Text Available Objective To investigate the effects of simulated high-altitude hypoxia on the detection rate and endotoxin level of Porphyromonas gingivalis (Pg of subgingival bacterial plagues in rabbit periodontitis models. Methods Forty male rabbits were randomly divided into four groups, namely, normoxia control group (group A1, normoxia experimental group (group A2, hypoxia control group (group B1, and hypoxia experimental group (group B2. Each group included 10 rabbits. Periodontitis models was established in groups A2 and B2 combined by ligating both lower central incisors with steel ligature and feeding periodontitis diets, and then the animals were housed in a hypoxia chamber (simulating 5000m altitude, 23h per day. Groups A1 and A2 were raised normal diet in normoxia environment. After eight weeks, the rabbit periodontitis model was evaluated by observing radiographic features of the X-ray films and histopathologic changes under a light microscope. Subgingival plague sample from periodontal pockets on both lower central incisors were collected for isolation, culture and identification of Pg, and for detection of the endotoxin level. Results The histopathologic observation and X-ray examination results showed that the periodontitis of rabbits in group B2 was significantly more severe than that in group A2. The detection rates of Pg in group A1, A2, B1 and B2 was 0%, 50%, 55% and 95% (P < 0.05. Pg detection rate and endotoxin level were higher in group B2 (95%, 0.46±0.04EU/ml than in group A2 (50%, 0.38±0.02EU/ml, P < 0.05. Conclusions The process speed and damage degree of periodontitis in hypoxic environment is higher than that in normoxic environment. Moreover, the hypoxic environment is more suitable in the colonization of Pg with higher endotoxin level in subgingival plague.

  8. Lidar observations of high-altitude aerosol layers (cirrus clouds)

    Science.gov (United States)

    Deleva, Atanaska D.; Grigorov, Ivan V.

    2013-03-01

    Aerosols, clouds and aerosol-cloud interactions are recognized as the key factors influencing the climate. Clouds are the primary modulators of the Earth's radiative budget. This paper focuses on the detection of high-altitude aerosol layers in the troposphere over mid-latitude lidar station in Sofia, Bulgaria. They are situated in the height-region 6 km÷16 km, with thickness in the range 0.2 km÷5 km and have varying optical characteristics. On the basis of the general utilized classification of the Cirrus clouds, high values of the calculated atmospheric backscatter coefficient and Angströmexponent estimation results we conclude that the registered strongly scattered aerosol layers are Cirrus clouds. Lidar measurements are performed with an aerosol lidar, equipped with Nd:YAG laser at wavelengths 532 nm and 1064 nm. Mainly, lidar data are presented in terms of vertical atmospheric backscatter coefficient profiles. We also include 2Dcolormap in height-time coordinates build on the basis of so called range corrected signals. It shows in general changes of the aerosol stratification over the lidar station during the measurement period. We employed HYSPLIT backward trajectories and DREAM forecasts to analyze the lidar profile outlines and characterize the events during which Cirrus cloud samples were observed. So was remarked that most of the results were obtained during Saharan dust long-way transport over the city of Sofia. Reported experimental examples are extracted from regular lidar investigations of the atmosphere within the frame of European project EARLINET.

  9. Diagnosis and treatment of 30 cases of high altitude sickness combined with urinary retention%高原反应合并尿潴留30例报告

    Institute of Scientific and Technical Information of China (English)

    董永超; 张俊; 徐越斌; 张斌; 马巍; 侯晓斌; 王养民

    2012-01-01

    Objective To explore the diagnosis and treatment of altitude sickness combined with urinary retention. Methods 30 cases of altitude sickness combined with urinary retention were treated from April 16th to 26th,2010.They were all male,The average age of them was 24 years (range,19 -38).All were the first time entering the high altitude area (3600 -5000 m) from low altitude area (600 - 1800 m ).The urinary frequency of 25 patients reduced from 8 to 10 times/d to 2 to 4 times/d,the urine output reduced from the 1500- 2400 ml/d to 600- 800 ml/d; the other 5 patients had no urine in 12 -18 h,even had no sense to urinate.26 patients also combined with altitude pulmonary edema and 4 combined with altitude cerebral edema.30 patients had double renal columns enlarged,21 cases had urinary protein ( + ~ ++ ). Results 30 patients were exported urine 300 -600 ml within 10 min,leaded to urine 1800 -2300ml in 12 h,returned to normal voiding after catheter removal in 18 -24 h. After comprehensive treatment such as oxygen,dehydration,diuretic,sedative,antispasmodic and anti-infection,22 cases who with chest tightness,shortness of breath,dyspnea,hemoptysis foam sputum,headache,vomiting and other symptoms of jet-like improved apparently after hospital admission within 1 hour.Their heart rate downed from 90 - 145beats/min to 68 -92 beats/min,respiration from 28 -45 times/min to 18 - 28 times/min,oxygen saturation from 48% - 84% to 92% - 100% ; 8 cases who with shortness of breath,palpitation and headache improved not obviously.After the antihypertensive treatment,their blood pressure was still high (systolic blood pressure 150 - 180 mm Hg,diastolic blood pressure 90 -110 mm Hg),oxygen saturation between 78% to 87%,so they were carried to rear area for further treatment.30 cases were all cured no death. Conclusions The high altitude urinary retention is reversible disease,which is often associated with high altitude pulmonary edema,altitude cerebral edema

  10. Schistosomiasis transmission at high altitude crater lakes in Western Uganda

    Directory of Open Access Journals (Sweden)

    Philbert Clouds

    2008-08-01

    Full Text Available Abstract Background Contrary to previous reports which indicated no transmission of schistosomiasis at altitude >1,400 m above sea level in Uganda, in this study it has been established that schistosomiasis transmission can take place at an altitude range of 1487–1682 m above sea level in western Uganda. Methods An epidemiological survey of intestinal schistosomiasis was carried out in school children staying around 13 high altitude crater lakes in Western Uganda. Stool samples were collected and then processed with the Kato-Katz technique using 42 mg templates. Thereafter schistosome eggs were counted under a microscope and eggs per gram (epg of stool calculated. A semi-structured questionnaire was used to obtain demographic data and information on risk factors. Results 36.7% of the pupils studied used crater lakes as the main source of domestic water and the crater lakes studied were at altitude ranging from 1487–1682 m above sea level. 84.6% of the crater lakes studied were infective with over 50% of the users infected. The overall prevalence of Schistosoma mansoni infection was 27.8% (103/370 with stool egg load ranging from 24–6048 per gram of stool. 84.3%( 312 had light infections (400 egg/gm of stool. Prevalence was highest in the age group 12–14 years (49.5% and geometric mean intensity was highest in the age group 9–11 years (238 epg. The prevalence and geometric mean intensity of infection among girls was lower (26%; 290 epg compared to that of boys (29.6%; 463 epg (t = 4.383, p Conclusion and recommendations The altitudinal threshold for S. mansoni transmission in Uganda has changed and use of crater water at an altitude higher than 1,400 m above sea level poses a risk of acquiring S. mansoni infection in western Uganda. However, further research is required to establish whether the observed altitudinal threshold change is as a result of climate change or other factors. It is also necessary to establish the impact this could

  11. Research Progress in Association of Matrix Metalloproteinases with Cerebral Edema after Hypertensive Intracerebral Hemorrhage%基质金属蛋白酶与高血压脑出血后脑水肿相关性的研究进展

    Institute of Scientific and Technical Information of China (English)

    周德生; 李煦昀; 王仙伟

    2012-01-01

    Hypertensive intracerebral hemorrhage is one of the critical diseases in neurological system. In addition to the mass effect of hematoma,the blood brain barrier damage and cerebral edema caused by hema-toma components and the secondary nerve damage caused by cerebral edema are the main causes of deterioration and death the cerebral hemorrhage patients. Recent studies suggested that matrix metalloproteinases increased expression after hypertensive intracerebral hemorrhage, which participated in and mediated cerebral edema, and the expression and adjustment of which has become the new target for the treatment of cerebral e-dema.%高血压脑出血是神经系统的危重病之一.除了血肿本身的占位效应外,血肿成分引发的血脑屏障的破坏和脑水肿反应,以及脑水肿导致的继发性神经损害,是脑出血患者病情恶化和引起死亡的主要原因.基质金属蛋白酶在高血压脑出血后表达增高,参与和介导了脑水肿的发生、发展,其表达和调控成为研究脑水肿的治疗靶点.

  12. Variations of brain edema and neurological function of rat models of cerebral infarction after hyperbaric oxygen therapy%高压氧干预脑梗死模型大鼠脑水肿及神经功能变化

    Institute of Scientific and Technical Information of China (English)

    田烜

    2015-01-01

    the edema of brain tissue in rats with cerebral infarction.

  13. Centurion solar-powered high-altitude aircraft in flight

    Science.gov (United States)

    1998-01-01

    Since 1980 AeroVironment, Inc. (founded in 1971 by the ultra-light airplane innovator--Dr. Paul MacCready) has been experimenting with solar-powered aircraft, often in conjunction with the NASA Dryden Flight Research Center, Edwards, California. Thus far, AeroVironment, now headquartered in Monrovia, California, has achieved several altitude records with its Solar Challenger, Pathfinder, and Pathfinder-Plus aircraft. It expects to exceed these records with the newer and larger solar-powered Centurion and its successors the Centelios and Helios vehicles, in the NASA Environmental Research Aircraft and Sensor Technology (ERAST) program. The Centurion is a lightweight, solar-powered, remotely piloted flying wing aircraft that is demonstrating the technology of applying solar power for long-duration, high-altitude flight. It is considered to be a prototype technology demonstrator for a future fleet of solar-powered aircraft that could stay airborne for weeks or months on scientific sampling and imaging missions or while serving as telecommunications relay platforms. Although it shares many of the design concepts of the Pathfinder, the Centurion has a wingspan of 206 feet, more than twice the 98-foot span of the original Pathfinder and 70-percent longer than the Pathfinder-Plus' 121-foot span. At the same time, Centurion maintains the 8-foot chord (front to rear distance) of the Pathfinder wing, giving the wing an aspect ratio (length-to-chord) of 26 to 1. Other visible changes from its predecessor include a modified wing airfoil designed for flight at extreme altitude and four underwing pods to support its landing gear and electronic systems (compared with two such pods on the Pathfinder). The flexible wing is primarily fabricated from carbon fiber, graphite epoxy composites, and kevlar. It is built in five sections, a 44-foot-long center section and middle and outer sections just over 40 feet long. All five sections have an identical thickness--12 percent of the chord

  14. Study on Oxygen Supply Standard for Physical Health of Construction Personnel of High-Altitude Tunnels

    Directory of Open Access Journals (Sweden)

    Chun Guo

    2015-12-01

    Full Text Available The low atmospheric pressure and low oxygen content in high-altitude environment have great impacts on the functions of human body. Especially for the personnel engaged in complicated physical labor such as tunnel construction, high altitude can cause a series of adverse physiological reactions, which may result in multiple high-altitude diseases and even death in severe cases. Artificial oxygen supply is required to ensure health and safety of construction personnel in hypoxic environments. However, there are no provisions for oxygen supply standard for tunnel construction personnel in high-altitude areas in current tunnel construction specifications. As a result, this paper has theoretically studied the impacts of high-altitude environment on human bodies, analyzed the relationship between labor intensity and oxygen consumption in high-altitude areas and determined the critical oxygen-supply altitude values for tunnel construction based on two different standard evaluation systems, i.e., variation of air density and equivalent PIO2. In addition, it has finally determined the oxygen supply standard for construction personnel in high-altitude areas based on the relationship between construction labor intensity and oxygen consumption.

  15. Identification of novel serum peptide biomarkers for high-altitude adaptation: a comparative approach

    Science.gov (United States)

    Yang, Juan; Li, Wenhua; Liu, Siyuan; Yuan, Dongya; Guo, Yijiao; Jia, Cheng; Song, Tusheng; Huang, Chen

    2016-05-01

    We aimed to identify serum biomarkers for screening individuals who could adapt to high-altitude hypoxia at sea level. HHA (high-altitude hypoxia acclimated; n = 48) and HHI (high-altitude hypoxia illness; n = 48) groups were distinguished at high altitude, routine blood tests were performed for both groups at high altitude and at sea level. Serum biomarkers were identified by comparing serum peptidome profiling between HHI and HHA groups collected at sea level. Routine blood tests revealed the concentration of hemoglobin and red blood cells were significantly higher in HHI than in HHA at high altitude. Serum peptidome profiling showed that ten significantly differentially expressed peaks between HHA and HHI at sea level. Three potential serum peptide peaks (m/z values: 1061.91, 1088.33, 4057.63) were further sequence identified as regions of the inter-α trypsin inhibitor heavy chain H4 fragment (ITIH4 347-356), regions of the inter-α trypsin inhibitor heavy chain H1 fragment (ITIH1 205-214), and isoform 1 of fibrinogen α chain precursor (FGA 588-624). Expression of their full proteins was also tested by ELISA in HHA and HHI samples collected at sea level. Our study provided a novel approach for identifying potential biomarkers for screening people at sea level who can adapt to high altitudes.

  16. Iron supplementation at high altitudes induces inflammation and oxidative injury to lung tissues in rats

    Energy Technology Data Exchange (ETDEWEB)

    Salama, Samir A., E-mail: salama.3@buckeyemail.osu.edu [High Altitude Research Center, Taif University, Al-Haweiah, Taif 21974 (Saudi Arabia); Department of Biochemistry, Faculty of Pharmacy, Al-Azhar University, Cairo 11751 (Egypt); Department of Pharmacology and GTMR Unit, College of Clinical Pharmacy, Taif University, Al-Haweiah, Taif 21974 (Saudi Arabia); Omar, Hany A. [Department of Pharmacology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62514 (Egypt); Maghrabi, Ibrahim A. [Department of Clinical Pharmacy, College of Clinical Pharmacy, Taif University, Al-Haweiah, Taif 21974 (Saudi Arabia); AlSaeed, Mohammed S. [Department of Surgery, College of Medicine, Taif University, Al-Haweiah, Taif 21974 (Saudi Arabia); EL-Tarras, Adel E. [High Altitude Research Center, Taif University, Al-Haweiah, Taif 21974 (Saudi Arabia)

    2014-01-01

    Exposure to high altitudes is associated with hypoxia and increased vulnerability to oxidative stress. Polycythemia (increased number of circulating erythrocytes) develops to compensate the high altitude associated hypoxia. Iron supplementation is, thus, recommended to meet the demand for the physiological polycythemia. Iron is a major player in redox reactions and may exacerbate the high altitudes-associated oxidative stress. The aim of this study was to explore the potential iron-induced oxidative lung tissue injury in rats at high altitudes (6000 ft above the sea level). Iron supplementation (2 mg elemental iron/kg, once daily for 15 days) induced histopathological changes to lung tissues that include severe congestion, dilatation of the blood vessels, emphysema in the air alveoli, and peribronchial inflammatory cell infiltration. The levels of pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α), lipid peroxidation product and protein carbonyl content in lung tissues were significantly elevated. Moreover, the levels of reduced glutathione and total antioxidant capacity were significantly reduced. Co-administration of trolox, a water soluble vitamin E analog (25 mg/kg, once daily for the last 7 days of iron supplementation), alleviated the lung histological impairments, significantly decreased the pro-inflammatory cytokines, and restored the oxidative stress markers. Together, our findings indicate that iron supplementation at high altitudes induces lung tissue injury in rats. This injury could be mediated through excessive production of reactive oxygen species and induction of inflammatory responses. The study highlights the tissue injury induced by iron supplementation at high altitudes and suggests the co-administration of antioxidants such as trolox as protective measures. - Highlights: • Iron supplementation at high altitudes induced lung histological changes in rats. • Iron induced oxidative stress in lung tissues of rats at high altitudes. • Iron

  17. Outdoor Activity and High Altitude Exposure During Pregnancy: A Survey of 459 Pregnancies.

    Science.gov (United States)

    Keyes, Linda E; Hackett, Peter H; Luks, Andrew M

    2016-06-01

    To evaluate whether women engage in outdoor activities and high altitude travel during pregnancy; the health care advice received regarding high altitude during pregnancy; and the association between high altitude exposure and self-reported pregnancy complications. An online survey of women with at least 1 pregnancy distributed on websites and e-mail lists targeting mothers and/or mountain activities. Outcome measures were outdoor activities during pregnancy, high altitude (>2440 m) exposure during pregnancy, and pregnancy and perinatal complications. Hiking, running, and swimming were the most common activities performed during pregnancy. Women traveled to high altitude in over half of the pregnancies (244/459), and most did not receive counseling regarding altitude (355, 77%), although a small proportion (14, 3%) were told not to go above 2440 m. Rates of miscarriage and most other complications were similar between pregnancies with and without travel above 2440 m. Pregnancies with high altitude exposure were more likely to have preterm labor (odds ratio [OR] 2.3; 95% CI 0.97-5.4; P = .05). Babies born to women who went to high altitude during pregnancy were more likely to need oxygen at birth (OR 2.34; 95% CI 1.04-5.26; P < .05) but had similar rates of neonatal intensive care unit admission (P = not significant). Our results suggest pregnant women who are active in outdoor sports and travel to high altitude have a low rate of complications. Given the limitations of our data, further research is necessary on the risks associated with high altitude travel and physical activity and how these apply to the general population. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  18. Oxidative DNA damage and repair in skeletal muscle of humans exposed to high-altitude hypoxia

    DEFF Research Database (Denmark)

    Lundby, Carsten; Pilegaard, Henriette; van Hall, Gerrit

    2003-01-01

    ) was unaltered by prolonged hypoxia, in accordance with the notion that HO-1 is an acute stress response protein. In conclusion, our data indicate high-altitude hypoxia may serve as a good model for oxidative stress and that antioxidant genes are not upregulated in muscle tissue by prolonged hypoxia despite......Recent research suggests that high-altitude hypoxia may serve as a model for prolonged oxidative stress in healthy humans. In this study, we investigated the consequences of prolonged high-altitude hypoxia on the basal level of oxidative damage to nuclear DNA in muscle cells, a major oxygen...

  19. Increased toll-like receptor 4 in cerebral endothelial cells contributes to the astrocyte swelling and brain edema in acute hepatic encephalopathy.

    Science.gov (United States)

    Jayakumar, Arumugam R; Tong, Xiao Y; Curtis, Kevin M; Ruiz-Cordero, Roberto; Abreu, Maria T; Norenberg, Michael D

    2014-03-01

    Astrocyte swelling and the subsequent increase in intracranial pressure and brain herniation are major clinical consequences in patients with acute hepatic encephalopathy. We recently reported that conditioned media from brain endothelial cells (ECs) exposed to ammonia, a mixture of cytokines (CKs) or lipopolysaccharide (LPS), when added to astrocytes caused cell swelling. In this study, we investigated the possibility that ammonia and inflammatory agents activate the toll-like receptor 4 (TLR4) in ECs, resulting in the release of factors that ultimately cause astrocyte swelling. We found a significant increase in TLR4 protein expression when ECs were exposed to ammonia, CKs or LPS alone, while exposure of ECs to a combination of these agents potentiate such effects. In addition, astrocytes exposed to conditioned media from TLR4-silenced ECs that were treated with ammonia, CKs or LPS, resulted in a significant reduction in astrocyte swelling. TLR4 protein up-regulation was also detected in rat brain ECs after treatment with the liver toxin thioacetamide, and that thioacetamide-treated TLR4 knock-out mice exhibited a reduction in brain edema. These studies strongly suggest that ECs significantly contribute to the astrocyte swelling/brain edema in acute hepatic encephalopathy, likely as a consequence of increased TLR4 protein expression by blood-borne noxious agents.

  20. Medical Treatment of High Altitude Pulmonary Edema%高原性肺水肿的内科治疗

    Institute of Scientific and Technical Information of China (English)

    蒲丹; 李为民

    2006-01-01

    高原性肺水肿是一种具有致命危险的高原特发病.近年来国内外研究日益活跃,尤其在治疗方面进展较快,死亡率逐年下降,本文就高原性肺水肿近年来的治疗进展进行概述.

  1. Oxygen Transport to Human Tissues.

    Science.gov (United States)

    1981-06-01

    though there is only anecdotal evidence to support this observation. High altitude cerebral edema (HACE) or high altitude encephalopathy . or hypoxic brain...acute hypoxia, (2) acute mountain sickness, (3) high altitude pulmonary edema. (4) high altitude encephalopathy (edema or brain injury), and (5...exposure Uremic anemia Anesthesia Acute maximal exercise Diabetes Steroids Septic shock Hemoglobinopathies Hemoglobinopathies (1969) stated, "we have been

  2. Superpressure Tow Balloon for Extending Durations and Modifying Trajectories of High Altitude Balloon Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed innovation involves the concept of using a Superpressure Tow Balloon (STB) with existing NASA high altitude balloon designs to form a tandem balloon...

  3. Scientific Approach for Optimising Performance, Health and Safety in High-Altitude Observatories

    Science.gov (United States)

    Böcker, Michael; Vogy, Joachim; Nolle-Gösser, Tanja

    2008-09-01

    The ESO coordinated study “Optimising Performance, Health and Safety in High-Altitude Observatories” is based on a psychological approach using a questionnaire for data collection and assessment of high-altitude effects. During 2007 and 2008, data from 28 staff and visitors involved in APEX and ALMA were collected and analysed and the first results of the study are summarised. While there is a lot of information about biomedical changes at high altitude, relatively few studies have focussed on psychological changes, for example with respect to performance of mental tasks, safety consciousness and emotions. Both, biomedical and psychological changes are relevant factors in occupational safety and health. The results of the questionnaire on safety, health and performance issues demonstrate that the working conditions at high altitude are less detrimental than expected.

  4. Thermally Stable Catalytic Combustors for Very High Altitude Airbreathing Propulsion Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aerospace vehicles operating at high altitudes have the potential to be less expensive and more versatile alternatives to space based systems for earth/space...

  5. Is Pulse Oximetry Useful for Screening Neonates for Critical Congenital Heart Disease at High Altitudes?

    Science.gov (United States)

    Hoffman, Julien I E

    2016-06-01

    Now that pulse oximetry is used widely to screen for critical congenital heart disease, it is time to consider whether this screening method is applicable to those who live at high altitudes. Consideration of basic physical principles and reports from the literature indicate that not only is the 95 % cutoff point for arterial oxygen saturation incorrect at high altitudes, but the lower saturations are accompanied by greater variability and therefore there is the possibility of a greater percentage of false-positive screening tests at high altitudes. Because of ethnic differences in response to high altitudes, normative data will have to be collected separately in different countries and perhaps for different ethnic groups.

  6. QT interval changes in term pregnant women living at moderately high altitude.

    Science.gov (United States)

    Batmaz, G; Aksoy, A N; Aydın, S; Ay, N K; Dane, B

    2016-01-01

    This study aimed to compare the QT interval changes in women with term pregnancy living at moderately high altitude (1890 m in Erzurum, Turkey) with those of women living at sea level (31 m in İstanbul, Turkey). One-hundred ten women (n = 55, for each group) with full-term and single child pregnancies. Two different locations in that state were selected: İstanbul, Turkey, which is at 31 m above sea level (Group 1) and Erzurum, Turkey, at 1890 m above sea level (Group 2). Physicians from the two locations participated in the study. We estimated QTc, QTc Max, QTc Min, QT, and QTcd intervals. Moderately high altitude group had significantly longer QT parameters (QTc, QTc Max, QTc Min, QT, and QTcd intervals) compared with sea level group (P anges occur in term pregnant women living moderately high altitude. These changes may be associated with pregnancy-related cardiovascular complications in moderately high altitude.

  7. Science 101: Why Does It Take Longer to Boil Potatoes at High Altitudes?

    Science.gov (United States)

    Robertson, Bill

    2017-01-01

    Why Does It Take Longer to Boil Potatoes at High Altitudes? This column provides background science information for elementary teachers. This month's issue looks at why water boils at different temperatures at different altitudes.

  8. Role of ammonia in the pathogenesis of brain edema.

    Directory of Open Access Journals (Sweden)

    Fujiwara,Masachika

    1986-12-01

    Full Text Available The role of hyperammonemia in the pathogenesis of cerebral edema was investigated using mongrel dogs to develop a treatment for cerebral edema in acute hepatic failure. Intravenous infusion of ammonium acetate alone into dogs did not induce brain edema, although blood ammonia reached unphysiologically high levels. However, ammonium acetate infusion during mannitol-induced reversible (osmotic opening of the blood-brain barrier (BBB effectively induced cytotoxic brain edema. Pretreatment with a branched-chain amino acid (BCAA; valine, leucine and isoleucine solution prevented an increase in intracranial pressure (ICP and brain water content, and caused a decrease in brain ammonia content and an increase in brain BCAA and glutamic acid. The results suggest that ammonia plays an important role in the pathogenesis of cerebral edema during acute hepatic failure and that BCAAs accelerate ammonia detoxification in the brain.

  9. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, 2010 ...

  10. Mitochondrial function in human skeletal muscle following high-altitude exposure

    DEFF Research Database (Denmark)

    Jacobs, Robert A; Boushel, Robert; Wright-Paradis, Cynthia

    2013-01-01

    Studies regarding mitochondrial modifications in human skeletal muscle following acclimatization to high altitude are conflicting, and these inconsistencies may be due to the prevalence of representing mitochondrial function through static and isolated measurements of specific mitochondrial.......059) to limit mass-specific maximal oxidative phosphorylation capacity. These data suggest that 9-11 days of exposure to high altitude do not markedly modify integrated measures of mitochondrial functional capacity in skeletal muscle despite significant decrements in the concentrations of enzymes involved...

  11. Analysis of mitochondrial DNA in Tibetan gastric cancer patients at high altitude

    OpenAIRE

    Jiang, Jun; Zhao, Jun-Hui; Wang, Xue-Lian; DI, JI; Liu, Zhi-Bo; Li, Guo-Yuan; WANG, MIAO-ZHOU; Li, Yan; Chen, Rong; Ge, Ri-Li

    2015-01-01

    The highest risk areas of gastric cancer are currently Japan, Korea and China; Qinghai, a high-altitude area, has one of the highest gastric cancer rates in China. The incidence of gastric cancer is higher in the Tibetan ethnic group compared to that in the Han ethnic group in Qinghai. This study was conducted to determine the clinical characteristics of mitochondrial DNA (mtDNA) mutations and copy numbers among Tibetans with gastric cancer residing at high altitudes and investigate the assoc...

  12. Parasympathetic neural activity accounts for the lowering of exercise heart rate at high altitude

    DEFF Research Database (Denmark)

    Boushel, Robert Christopher; Calbet, J A; Rådegran, G

    2001-01-01

    In chronic hypoxia, both heart rate (HR) and cardiac output (Q) are reduced during exercise. The role of parasympathetic neural activity in lowering HR is unresolved, and its influence on Q and oxygen transport at high altitude has never been studied.......In chronic hypoxia, both heart rate (HR) and cardiac output (Q) are reduced during exercise. The role of parasympathetic neural activity in lowering HR is unresolved, and its influence on Q and oxygen transport at high altitude has never been studied....

  13. The sleep of elite athletes at sea level and high altitude: a comparison of sea-level natives and high-altitude natives (ISA3600)

    Science.gov (United States)

    Roach, Gregory D; Schmidt, Walter F; Aughey, Robert J; Bourdon, Pitre C; Soria, Rudy; Claros, Jesus C Jimenez; Garvican-Lewis, Laura A; Buchheit, Martin; Simpson, Ben M; Hammond, Kristal; Kley, Marlen; Wachsmuth, Nadine; Gore, Christopher J; Sargent, Charli

    2013-01-01

    Background Altitude exposure causes acute sleep disruption in non-athletes, but little is known about its effects in elite athletes. The aim of this study was to examine the effects of altitude on two groups of elite athletes, that is, sea-level natives and high-altitude natives. Methods Sea-level natives were members of the Australian under-17 soccer team (n=14). High-altitude natives were members of a Bolivian under-20 club team (n=12). Teams participated in an 18-day (19 nights) training camp in Bolivia, with 6 nights at near sea level in Santa Cruz (430 m) and 13 nights at high altitude in La Paz (3600 m). Sleep was assessed on every day/night using activity monitors. Results The Australians’ sleep was shorter, and of poorer quality, on the first night at altitude compared with sea level. Sleep quality returned to normal by the end of the first week at altitude, but sleep quantity had still not stabilised at its normal level after 2 weeks. The quantity and quality of sleep obtained by the Bolivians was similar, or greater, on all nights at altitude compared with sea level. The Australians tended to obtain more sleep than the Bolivians at sea level and altitude, but the quality of the Bolivians’ sleep tended to be better than that of the Australians at altitude. Conclusions Exposure to high altitude causes acute and chronic disruption to the sleep of elite athletes who are sea-level natives, but it does not affect the sleep of elite athletes who are high-altitude natives. PMID:24282197

  14. Barcroft's bold assertion: All dwellers at high altitudes are persons of impaired physical and mental powers.

    Science.gov (United States)

    West, John B

    2016-03-01

    Barcroft's bold assertion that everyone at high altitude has physical and mental impairment compared with sea level was very provocative. It was a result of the expedition that he led to Cerro de Pasco in Peru, altitude 4300 m. Although it is clear that newcomers to high altitude have reduced physical powers, some people believe that this does not apply to permanent residents who have been at high altitude for generations. The best evidence supports Barcroft's contention, although permanent residents often perform better than acclimatized lowlanders. Turning to neuropsychological function, newcomers to high altitude certainly have some impairment, and there is evidence that the same applies to highlanders. However the notion that permanent residents are impaired is anathema to many people. For example the eminent Peruvian physician Carlos Monge took great exception to Barcroft's remark and even attributed it to the fact that Barcroft was suffering from acute mountain sickness when he made it! Monge referred to 'climatic aggression', by which he meant the negative consequences of the inevitable hypoxia of high altitude. Recent technological advances such as oxygen enrichment of room air can overcome this 'aggression'. This might be useful in some settings at high altitude such as a nursery where newborn babies are cared for, and possibly operating rooms where the surgeon's dexterity may be enhanced. Other situations might be dormitories, conference rooms, and perhaps some school rooms. These constitute possible ways by which the effects of Barcroft's assertion might be countered.

  15. Effect of high altitude exposure on spermatogenesis and epididymal sperm count in male rats.

    Science.gov (United States)

    Gasco, M; Rubio, J; Chung, A; Villegas, L; Gonzales, G F

    2003-12-01

    The present study was designed to determine the effect of exposure to high altitude on spermatogenesis using transillumination technique and sperm count in male rats. In addition, the effect of oral intubation for intragastric administration of vehicle on testicular parameters in adult male rats in a schedule of 42 days was assessed. Male rats were exposed to Cerro de Pasco (Peru) at 4340 m for 3, 7, 14, 21, 28, 35 and 42 days resulting in a modification of the pattern of the seminiferous tubule stages. At day 3, stages I, IV-V, VI, VII and IX-XI were relatively shorter at high altitude than at sea level. At day 7, stages VIII, IX-XI, XII and XIII-XIV were reduced. At day 14, stages VII, VIII and IX-XI were reduced. At day 21 and 28, stages VIII, XII and XIII-XIV were significantly increased at high altitude. At day 35 an increase in stage XIII-XIV was observed. At day 42, stages II-III, IX-XI and XII were significantly increased at high altitude. Epididymal sperm count was significantly reduced at day 7 of exposure to high altitude and maintained low levels with respect to sea level up to 42 days. In conclusion, high altitude exposure affects spermatogenesis, particularly onset of mitosis and spermiation. This in turn affects epididymal sperm count.

  16. Neurogenic pulmonary edema due to delayed radiation necrosis

    Directory of Open Access Journals (Sweden)

    Mani R

    2005-01-01

    Full Text Available Neurogenic pulmonary edema is oftten missed in the ICU setting as it is mistaken for pneumonia or ARDS. The case presented here illustrates how a high index of suspicion in the appropriate setting can lead to the diagnosis. The patient in this report developed acute-on-chronic cerebral edema due to radiation necrosis following gamma-knife radiation therapy for cerebral arteriovenous malformation.

  17. Transpulmonary plasma ET-1 and nitrite differences in high altitude pulmonary hypertension.

    Science.gov (United States)

    Berger, Marc M; Dehnert, Christoph; Bailey, Damian M; Luks, Andrew M; Menold, Elmar; Castell, Christian; Schendler, Guido; Faoro, Vitalie; Mairbäurl, Heimo; Bärtsch, Peter; Swenson, Erik R

    2009-01-01

    Berger, Marc M., Christoph Dehnert, Damian M. Bailey, Andrew M. Luks, Elmar Menold, Christian Castell, Guido Schendler, Vitalie Faoro, Heimo Mairbäurl, Peter Bärtsch, and Eric R. Swenson. Transpulmonary plasma ET-1 and nitrite differences in high altitude pulmonary hypertension. High Alt. Med. Biol. 10:17-24, 2009.- Thirty-four mountaineers were studied at low (110 m) and high altitude (4559 m) to evaluate if increased pulmonary artery systolic pressure (PASP) at high altitude is associated with increased pulmonary endothelin-1 (ET-1) availability and alterations in nitrite metabolism across the lung. Blood samples were obtained using central venous and radial artery catheters for plasma ET-1 and nitrite. Pulmonary blood flow was measured by inert gas rebreathing to calculate transpulmonary exchange of plasma ET-1 and nitrite, and PASP was assessed by transthoracic Doppler echocardiography. After ascent to high altitude, PASP increased from 23 +/- 4 to 39 +/- 10 mmHg. Arterial and central venous plasma ET-1 increased, while plasma nitrite did not change significantly. At low altitude there was a transpulmonary loss of plasma ET-1, but a transpulmonary gain at high altitude. In contrast was a transpulmonary gain of plasma nitrite at low altitude and a transpulmonary loss at high altitude. PASP positively correlated with a transpulmonary gain of plasma ET-1 and negatively correlated with a transpulmonary loss of plasma nitrite. These results suggest that a transpulmonary gain of plasma ET- 1 is associated with higher PASP at high altitude. Transpulmonary loss of plasma nitrite indicates either less pulmonary nitric oxide (NO) production, which contributes to higher PASP, or increased NO bioavailability arising from nitrite reduction, which may oppose ET-1-mediated vasoconstriction.

  18. Difference in blood microcirculation recovery between normal frostbite and high-altitude frostbite

    Directory of Open Access Journals (Sweden)

    Ming-ke JIAO

    2017-02-01

    Full Text Available Objective To determine the difference in blood microcirculation recovery between normal frostbite and high-altitude frostbite during the wound healing. Methods Twenty four male rats were randomly divided into control group (n=8, normal frostbite group (n=8, and high-altitude group (n=8. The normal frostbite group rats were frozen to produce mid-degree frostbite models by controlling the freezing time with liquid nitrogen penetration equipment. The high-altitude frostbite group rats were acclimated to a hypoxic and low-pressure environment for 1 week, and then the high-altitude frostbite models were constructed by the same way with liquid nitrogen penetration apparatus. On days 3, 7, 11, 15, 19, and 23 after modeling, the recovery situation of blood circulation of each group was observed with contrast ultrasonography by injecting SonoVue micro-bubble into rats' tail. Finally, the micro-bubble concentration (MC was calculated to confirm the blood circulation recovery with software Image Pro. Results At different time points, the wound area of the high-altitude frostbite group was bigger than that of the normal frostbite group, and the MC of control group was always about (27±0.2×109/ml. On day 3, 7, 11, 15, 19, and 23, the MC was significantly lower in the high-altitude frostbite group than in the control group and normal frostbite group (P<0.05. The MC of normal frostbite group was significantly lower than that of the control group on day 3, 7, 11, 15 and 19 (P<0.05. In addition, no obvious difference in MC was found between normal group and control group on the 23th day (P<0.05. Conclusion The blood microcirculation recovery after high-altitude frostbite is significantly slower than the normal frostbite. DOI: 10.11855/j.issn.0577-7402.2017.01.13

  19. Control of breathing and the circulation in high-altitude mammals and birds.

    Science.gov (United States)

    Ivy, Catherine M; Scott, Graham R

    2015-08-01

    Hypoxia is an unremitting stressor at high altitudes that places a premium on oxygen transport by the respiratory and cardiovascular systems. Phenotypic plasticity and genotypic adaptation at various steps in the O2 cascade could help offset the effects of hypoxia on cellular O2 supply in high-altitude natives. In this review, we will discuss the unique mechanisms by which ventilation, cardiac output, and blood flow are controlled in high-altitude mammals and birds. Acclimatization to high altitudes leads to some changes in respiratory and cardiovascular control that increase O2 transport in hypoxia (e.g., ventilatory acclimatization to hypoxia). However, acclimatization or development in hypoxia can also modify cardiorespiratory control in ways that are maladaptive for O2 transport. Hypoxia responses that arose as short-term solutions to O2 deprivation (e.g., peripheral vasoconstriction) or regional variation in O2 levels in the lungs (i.e., hypoxic pulmonary vasoconstriction) are detrimental at in chronic high-altitude hypoxia. Evolved changes in cardiorespiratory control have arisen in many high-altitude taxa, including increases in effective ventilation, attenuation of hypoxic pulmonary vasoconstriction, and changes in catecholamine sensitivity of the heart and systemic vasculature. Parallel evolution of some of these changes in independent highland lineages supports their adaptive significance. Much less is known about the genomic bases and potential interactive effects of adaptation, acclimatization, developmental plasticity, and trans-generational epigenetic transfer on cardiorespiratory control. Future work to understand these various influences on breathing and circulation in high-altitude natives will help elucidate how complex physiological systems can be pushed to their limits to maintain cellular function in hypoxia.

  20. 吡拉西坦联合甘露醇治疗脑出血后脑水肿的效果观察%Observation of the effect of piracetam combined with mannitol in the treatment of patients with brain edema after cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    赵宝顺

    2015-01-01

    目的:观察吡拉西坦联合甘露醇治疗脑出血后脑水肿的效果。方法:收治脑出血后脑水肿患者84例,随机平分为两组,对照组予以甘露醇治疗,观察组联合吡拉西坦治疗,观察并比较两组临床疗效及脑水肿体积情况。结果:观察组治疗总有效率80.95%高于对照组的59.52%,且治疗后脑水肿体积低于对照组(P<0.05)。结论:吡拉西坦联合甘露醇治疗脑出血后脑水肿效果显著,可有效减小脑水肿体积,降低颅内压,从而促进患者的神经功能恢复。%Objective:To observe the effect of piracetam combined with mannitol in the treatment of patients with brain edema after cerebral hemorrhage.Methods:84 patients with brain edema after cerebral hemorrhage were selected.They were randomly divided into the two groups with 42 patients in each group.Patients of the control group received mannitol treatment,and the observation group combined with piracetam for treatment.The clinical curative effect and cerebral edema volume of the two groups were observed and compared.Results:The total effective rate of the observation group of 80.95% was higher than the control group of 59.52% ,and the cerebral edema volume after treatment was lower than the control group(P<0.05).Conclusion:Piracetam combined with mannitol in the treatment of patients with brain edema after cerebral hemorrhage has significant effect can effectively reduce the volume of brain edema,and reduce intracranial pressure,in order to promote the recovery of neurological function.

  1. Reconciling high-altitude precipitation in the upper Indus basin with glacier mass balances and runoff

    Science.gov (United States)

    Immerzeel, Walter; Wanders, Niko; Lutz, Arthur; Shea, Joseph; Bierkens, Marc

    2016-04-01

    Mountain ranges in Asia are important water suppliers, especially if downstream climates are arid, water demands are high and glaciers are abundant. In such basins, the hydrological cycle depends heavily on high-altitude precipitation. Yet direct observations of high-altitude precipitation are lacking and satellite derived products are of insufficient resolution and quality to capture spatial variation and magnitude of mountain precipitation. Here we use glacier mass balances to inversely infer the high-altitude precipitation in the upper Indus basin and show that the amount of precipitation required to sustain the observed mass balances of large glacier systems is far beyond what is observed at valley stations or estimated by gridded precipitation products. An independent validation with observed river flow confirms that the water balance can indeed only be closed when the high altitude precipitation on average is more than twice as high and in extreme cases up to a factor of 10 higher than previously thought. We conclude that these findings alter the present understanding of high-altitude hydrology and will have an important bearing on climate change impact studies, planning and design of hydropower plants and irrigation reservoirs as well as the regional geopolitical situation in general.

  2. Chronic intermittent high altitude exposure, occupation, and body mass index in workers of mining industry.

    Science.gov (United States)

    Esenamanova, Marina K; Kochkorova, Firuza A; Tsivinskaya, Tatyana A; Vinnikov, Denis; Aikimbaev, Kairgeldy

    2014-09-01

    The obesity and overweight rates in population exposed to chronic intermittent exposure to high altitudes are not well studied. The aim of the retrospective study was to evaluate whether there are differences in body mass index in different occupation groups working in intermittent shifts at mining industry at high altitude: 3800-4500 meters above sea level. Our study demonstrated that obesity and overweight are common in workers of high altitude mining industry exposed to chronic intermittent hypoxia. The obesity rate was lowest among miners as compared to blue- and white-collar employees (9.5% vs. 15.6% and 14.7%, p=0.013). Obesity and overweight were associated with older age, higher rates of increased blood pressure (8.79% and 5.72% vs. 1.92%), cholesterol (45.8% and 45.6% vs. 32.8%) and glucose (4.3% and 1.26% vs. 0.57%) levels as compared to normal body mass index category (pmining industry exposed to intermittent high-altitude hypoxia. Therefore, assessment and monitoring of body mass index seems to be essential in those who live and work at high altitudes to supply the correct nutrition, modify risk factors, and prevent related disorders.

  3. Aquaporin-4 and traumatic brain edema

    Institute of Scientific and Technical Information of China (English)

    XU Miao; SU Wei; XU Qiu-ping

    2010-01-01

    Brain edema leading to an expansion of brain volume has a crucial impact on morbidity and mortal-ity following traumatic brain injury as it increases intracra-nial pressure, impairs cerebral perfusion and oxygenation,and contributes to additional ischemic injuries.Classically,two major types of traumatic brain edema exist: "vasogenic"and "cytotoxic/cellular".However, the cellular and molecu-lar mechanisms contributing to the development/resolution of traumatic brain edema are poorly understood and no ef-fective drugs can be used now.Aquaporin-4 (AQP4) is a water-channel protein expressed strongly in the brain, pre-dominantly in astrocyte foot processes at the borders be-tween the brain parenchyma and major fluid compartments, including cerebrospinal fluid and blood.This distribution suggests that AQP4 controls water fluxes into and out of the brain parenchyma.In cytotoxic edema, AQP4 deletion slows the rate of water entry into brain, whereas in vasogenic edema, AQP4 deletion reduces the rate of water outflow from brain parenchyma.AQP4 has been proposed as a novel drug target in brain edema.These findings sug-gest that modulation of AQP4 expression or function may be beneficial in traumatic brain edema.

  4. Unilateral pulmonary edema following acute subglottic edema.

    Science.gov (United States)

    Morisaki, H; Ochiai, R; Takeda, J; Nagano, M

    1990-01-01

    Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal of the endotracheal tube, he showed dyspnea and cyanosis and was later found to have acute subglottic edema. After reintubation of the trachea, frothy pink fluid was discharged from the tube, and chest roentgenogram showed a right-sided alveolar infiltrate. Many factors may cause unilateral pulmonary edema, but it is suggested that acute subglottic edema and unilateral bronchial fragility strongly affected this episode.

  5. Characteristics of flame spread over the surface of charring solid combustibles at high altitude

    Institute of Scientific and Technical Information of China (English)

    LI Jie; JI Jie; ZHANG Ying; SUN JinHua

    2009-01-01

    To explore the characteristics of flame spread over the surface of charring solid combustibles at high altitude, the whitewood with uniform texture was chosen to conduct a series of experiments in Lhasa and Hefei, with altitude of 3658 m and 50 m respectively. Several parameters, including the flame height, flame spread rate, flame temperature, surface temperature, were measured on samples with different width and inclinations. A quantitative analysis of flame spread characteristics over sample surface at high altitude was performed. Results showed that, in the environment of lower pressure and oxygen concentration at high altitude, the flame height and flame spread rate over sample surface decreased, but the flame temperature increased slightly. However, with increasing of sample width, the relative difference between the flame spread rates at different altitudes decreased.

  6. Analysis of high altitude clouds in the martian atmosphere based on Mars Climate Sounder observations

    Science.gov (United States)

    Puspitarini, L.; Määttänen, A.; Fouchet, T.; Kleinboehl, A.; Kass, D. M.; Schofield, J. T.

    2016-11-01

    High altitude clouds have been observed in the Martian atmosphere. However, their properties still remain to be characterized. Mars Climate Sounder (MCS) aboard Mars Reconnaissance Orbiter (MRO) is an instrument that measures radiances in the thermal infrared, both in limb and nadir views. It allows us to retrieve vertical profiles of radiance, temperature and aerosols. Using the MCS data and radiative transfer model coupled with an automated inversion routine, we can investigate the chemical composition of the high altitude clouds. We will present the first results on the properties of the clouds. CO2 ice is the best candidate to be the main component of some high altitude clouds due to the most similar spectral variation compared to water ice or dust, in agreement with previous studies. Using cloud composition of contaminated CO2 ice (dust core surrounded by CO2 ice) might improve the fitting result, but further study is needed.

  7. Carbonic anhydrase activity in the red blood cells of sea level and high altitude natives.

    Science.gov (United States)

    Gamboa, J; Caceda, R; Gamboa, A; Monge-C, C

    2000-01-01

    Red blood cell carbonic anhydrase (CA) activity has not been studied in high altitude natives. Because CA is an intraerythocytic enzyme and high altitude natives are polycythemic, it is important to know if the activity of CA per red cell volume is different from that of their sea level counterparts. Blood was collected from healthy subjects living in Lima (150m) and from twelve subjects from Cerro de Pasco (4330m), and hematocrit and carbonic anhydrase activity were measured. As expected, the high altitude natives had significantly higher hematocrits than the sea level controls (p = 0.0002). No difference in the CA activity per milliliter of red cells was found between the two populations. There was no correlation between the hematocrit and CA activity.

  8. Circulatory adaptation to long-term high altitude exposure in Aymaras and Caucasians.

    Science.gov (United States)

    Stuber, Thomas; Scherrer, Urs

    2010-01-01

    About 30 million people live above 2500 m in the Andean Mountains of South America. Among them are 5.5 million Aymaras, an ethnic group with its own language, living on the altiplano of Bolivia, Peru, and northern Chile at altitudes of up to 4400 m. In this high altitude region traces of human population go back for more than 2000 years with constant evolutionary pressure on its residents for genetic adaptation to high altitude. Aymaras as the assumed direct descendents of the ancient cultures living in this region were the focus of much research interest during the last decades and several distinctive adaptation patterns to life at high altitude have been described in this ethnic group. The aim of this article was to review the physiology and pathophysiology of circulatory adaptation and maladaptation to longtime altitude exposure in Aymaras and Caucasians.

  9. Fatalities in high altitude mountaineering: a review of quantitative risk estimates.

    Science.gov (United States)

    Weinbruch, Stephan; Nordby, Karl-Christian

    2013-12-01

    Quantitative estimates for mortality in high altitude mountaineering are reviewed. Special emphasis is placed on the heterogeneity of the risk estimates and on confounding. Crude estimates for mortality are on the order of 1/1000 to 40/1000 persons above base camp, for both expedition members and high altitude porters. High altitude porters have mostly a lower risk than expedition members (risk ratio for all Nepalese peaks requiring an expedition permit: 0.73; 95 % confidence interval 0.59-0.89). The summit bid is generally the most dangerous part of an expedition for members, whereas most high altitude porters die during route preparation. On 8000 m peaks, the mortality during descent from summit varies between 4/1000 and 134/1000 summiteers (members plus porters). The risk estimates are confounded by human and environmental factors. Information on confounding by gender and age is contradictory and requires further work. There are indications for safety segregation of men and women, with women being more risk averse than men. Citizenship appears to be a significant confounder. Prior high altitude mountaineering experience in Nepal has no protective effect. Commercial expeditions in the Nepalese Himalayas have a lower mortality than traditional expeditions, though after controlling for confounding, the difference is not statistically significant. The overall mortality is increasing with increasing peak altitude for expedition members but not for high altitude porters. In the Nepalese Himalayas and in Alaska, a significant decrease of mortality with calendar year was observed. A few suggestions for further work are made at the end of the article.

  10. High altitude and hemoglobin function in the vultures Gyps rueppelli and Aegypius monachus

    DEFF Research Database (Denmark)

    Weber, Roy E.; Hiebl, Inge; Braunitzer, Gerhard

    1988-01-01

    structures of the constituent polypeptide chains to trace molecular adaptations to high-altitude respiration, and to physiological factors (pulmonary hypoxia and hypocapnia, body temperature shifts, and lung and nasal gas and heat exchange) to discern their possible survival value at altitudes of 11300 m.......Functional characteristics of the stripped composite hemoglobins (Hbs) of lhevultures Gyps rueppellii and Aegypills monachus that can fly at extremely high altitudes, and of component Hbs of G. rueppellii are reported, in relation to influences of pH, temperalure and inositol hexaphosphate. G...

  11. Out of air: Is going to high altitude safe for your patient?

    Science.gov (United States)

    Mendenhall, Ann M; Forest, Christopher P

    2017-08-01

    As more people travel to high altitudes for recreation or work, more travelers with underlying medical conditions will need advice before traveling or treatment for altitude illness. This article focuses on the two main issues for travelers: whether travel to a high altitude will have a negative effect on their underlying medical condition and whether the medical condition increases the patient's risk of developing altitude illness. Although patients with severe pulmonary or cardiac conditions are most at risk in the hypoxic environment, other conditions such as diabetes and pregnancy warrant attention as well.

  12. Efficacy of Piracetam Injection Combined With Mannitol in the Treatment of Cerebral Edema After Intracerebral Hemorrhage%吡拉西坦注射液联合甘露醇治疗脑出血后脑水肿的疗效观察

    Institute of Scientific and Technical Information of China (English)

    师卫中

    2015-01-01

    目的:探讨吡拉西坦注射液联合甘露醇治疗脑出血后脑水肿的疗效。方法选自本院2013年7月~2014年7月收治64例脑出血后脑水肿患者,采用随机抽样法分为两组,予对照组32例甘露醇治疗,予观察组32例吡拉西坦注射液联合甘露醇治疗,比较两组疗效。结果两组治疗8d、20d后脑水肿体积均缩小,但观察组脑水肿体积在8d、20 d时均小于对照组,比较差异具有统计学意义(P<0.05);且两组均未发生严重不良反应(P>0.05)。结论吡拉西坦注射联合甘露醇能够有效治疗脑出血后脑水肿。%Objective To discuss the effect of piracetam injection combined with mannitol in the treatment of cerebral edema after intracerebral hemorrhage. Methods 64 cases of cerebral edema after intracerebral hemorrhage patients in July 2013~2014 July in our hospital were divided into two groups by random sampling, 32 cases in the control group were treated with mannitol, 32 cases in observation group were treated with piracetam injection combined with mannitol therapy, compared the effect between two groups. Results After treatment for 8 d, 20 d, cerebral edema volume were reduced, but the cerebral edema volume in 8 d and 20 d in observation group were less than the control group, the difference had statistically signiifcant (P0.05) . Conclusion Piracetam injection combined with mannitol are effective treatment for cerebral edema after intracerebral hemorrhage.

  13. Relationship of matrix metallo proteinase-9 dynamic expression at different time points with brain edema after cerebral hemorrhage%脑出血后不同时间点基质金属蛋白酶-9的动态变化及其与脑水肿的关系

    Institute of Scientific and Technical Information of China (English)

    崔巍; 谈颂; 许晓辉; 宋波; 许予明

    2010-01-01

    目的 探讨血清基质金属蛋白酶-9(MMP-9)水平在脑出血后不同时间点的动态变化在脑水肿形成过程中的作用.方法 采用放射免疫法检测90例符合纳入标准的急性脑出血患者及80例正常对照者24 h、72 h、7 d 和14 d时血清MMP-9水平,分析其在脑水肿形成过程中的作用.结果 脑水肿在入院72 h时达高峰,之后缓慢下降.在发病24 h 内患者血清MMP-9含量已明显升高,发病后72 h达高峰,与脑水肿高峰一致;7 d下降明显,与对照组比较均明显升高(P<0.01),第14天接近正常水平.血清MMP-9水平在脑出血后24 h、72 h与水肿体积、水肿比值呈正相关(P<0.01).结论 脑出血后血清MMP-9随着时间动态变化,MMP-9与脑水肿体积相关,与相对水肿体积相关性更强.%Objective To study the effect of dynamic expression at different time points of metallo proteinase-9 on brain edema after cerebral hemorrhage. Methods Serum levels of MMP-9 in 90 patients with brain hemorrhage and 80 normal patients were detected by radioimmunoassay on 24 h、72 h、7 d and 14 d.The relationship between levels of MMP-9 and brain edema after cerebral hemorrhage.Results Brain edema went up to the peak at 72 h and slowly decline after it. At 24 h, the serum level of MMP-9 were significantly higher, and reached the peak at 72 h according to the peak of cerebral edema, and then decreased significantly after 7 d. Cerebral hemorrhage group compared with the control group were significantly higher(P<0.01). The level of MMP-9 close to normal levels on 14 d. MMP-9 was positive correlated with edema volume and edema ratioat 24 h and 72 h (P=0.01).Conclusions Serum MMP-9 dynamic changes over time after cerebral hemorrhage. The level of MMP-9 was correlated with the brain edema volume and had more stronger correlation with relative size of brain edema. MMP-9 was correlated with inflammation after cerebral hemorrhage.

  14. Development of unmanned aerial vehicle (UAV) based high altitude balloon (HAB) platform for active aerosol sampling

    Science.gov (United States)

    Lateran, S.; Sedan, M. F.; Harithuddin, A. S. M.; Azrad, S.

    2016-10-01

    The knowledge on the abundance and diversity of the minute particles or aerosols in the earth's stratosphere is still in its infancy as aerosol sampling at high-altitude still possess a lot of challenges. Thus far, high-altitude aerosol sampling has been conducted mostly using manned flights, which requires enormous financial and logistical resources. There had been researches for the utilisation of high altitude balloon (HAB) for active and passive aerosol samplings within the stratosphere. However, the gathered samples in the payload were either brought down by controlling the balloon air pressure or were just dropped with a parachute to slow the descend speed in order to reduce the impact upon landing. In most cases, the drop location of the sample are unfavorable such as in the middle of the sea, dense foliage, etc. Hence a system that can actively sample aerosols at high-altitude and improve the delivery method in terms of quality and reliability using unmanned aerial vehicle (UAV) is designed and tested in this study.

  15. Persistence of chironomids in metal polluted Andean high altitude streams: does melanin play a role?

    NARCIS (Netherlands)

    Loayza Muro, R.A.; Marticorena-Ruíz, J.K.; Palomino, E.J.; Merritt, C.; de Baat, M.L.; van Gemert, M.; Verweij, R.A.; Kraak, M.H.S.; Admiraal, W.

    2013-01-01

    In high altitude Andean streams an intense solar radiation and coinciding metal pollution allow the persistence of only a few specialized taxa, including chironomids. The aim of the present study was therefore to determine the mechanisms underlying the persistence of chironomids under these multiple

  16. Study of high-altitude radar altimeter model accuracy and SITAN performance using HAAFT data

    Energy Technology Data Exchange (ETDEWEB)

    Shieves, T.C.; Callahan, M.W.

    1979-07-01

    Radar altimetry data, inertial navigation data, and scoring data were collected under the HAAFT program by Martin Marietta Corporation for the United States Air Force over several areas in the western United States at altitudes ranging from 3 to 20 km. The study reported here uses the HAAFT data in conjunction with Defense Mapping Agency (DMA) topographic data to evaluate the accuracy of a high-altitude pulsed-radar altimeter model and the resulting performance of the terrain-aided guidance concept SITAN. Previous SITAN flight tests at low altitudes (less than 1500 m AGL) have demonstrated 6-20 m CEP. The high-altitude flight test data analyzed herein show a SITAN CEP of 120 m. The radar altimeter model was required to achieve this performance includes the effects of the internal track loop, AGC loop, antenna beamwidth, and the terrain radar cross section and provided a factor of 6 improvement over simple nadir ground clearance for rough terrain. It is postulated that high-altitude CEP could be reduced to 50 m or less if an altimeter were designed specifically for high-altitude terrain sensing.

  17. Persistence of chironomids in metal polluted Andean high altitude streams: does melanin play a role?

    NARCIS (Netherlands)

    Loayza Muro, R.A.; Marticorena-Ruíz, J.K.; Palomino, E.J.; Merritt, C.; de Baat, M.L.; van Gemert, M.; Verweij, R.A.; Kraak, M.H.S.; Admiraal, W.

    2013-01-01

    In high altitude Andean streams an intense solar radiation and coinciding metal pollution allow the persistence of only a few specialized taxa, including chironomids. The aim of the present study was therefore to determine the mechanisms underlying the persistence of chironomids under these multiple

  18. A comparative high-altitude meteorological analysis from three catchments in the Nepalese Himalaya

    NARCIS (Netherlands)

    Shea, J. M.; Wagnon, P.; Immerzeel, W. W.; Biron, R.; Brun, F.; Pellicciotti, F.

    2015-01-01

    Meteorological studies in high-mountain environments form the basis of our understanding of catchment hydrology and glacier accumulation and melt processes, yet high-altitude (>4000 m above sea level, asl) observatories are rare. This research presents meteorological data recorded between December 2

  19. Oxygen enrichment and its application to life support systems for workers in high-altitude areas.

    Science.gov (United States)

    Li, Yongling; Liu, Yingshu

    2014-01-01

    Workers coming from lowland regions are at risk of developing acute mountain sickness (AMS) when working in low oxygen high-altitude areas. The aim of this study was to improve the conditions that lead to hypoxia and ensure the safety of the high-altitude workers. We analyzed the influence of low atmospheric pressure on the oxygen enrichment process in high-altitude areas using an engineering method called low-pressure swing adsorption (LPSA). Fourteen male subjects were screened and divided into three groups by type of oxygen supply system used: (1) oxygen cylinder group; (2) LPSA oxygen dispersal group; and (3) control group. These tests included arterial oxygen saturation (SaO2), pulse rate (PR), breaths per minute (BPM), and blood pressure (BP). The results showed that after supplying oxygen using the LPSA method at the tunnel face, the SaO2 of workers increased; the incidence of acute mountain sickness, PR, and BPM significantly decreased. The LPSA life support system was found to be a simple, convenient, efficient, reliable, and applicable approach to ensure proper working conditions at construction sites in high-altitude areas.

  20. Prevalence of Hypertension in a Tribal Land Locked Population at High Altitude

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Raina

    2016-01-01

    Full Text Available Introduction. Extensive pubmed search reveals paucity of data on prevalence of hypertension in tribal population at high altitude. The data is all the more scarce from our part of India. Studies among tribal populations at high altitudes provide an interesting epidemiological window to study human evolution and adaptation to hypobaric hypoxia. Material and Methods. 401 participants above the age of 20 years were evaluated for blood pressure using a stratified simple random technique among villages located at high altitude. Results. Out of a total of 401 individuals studied 43 (males: 35; females: 8 were identified as hypertensive yielding a crude prevalence of 10.7%. The prevalence was higher in males (35/270; 12.9% as compared to females (8/131; 6%. Prevalence was the highest in the age group of 30–39 among males (16/35; 45.7% while it was the highest in the age group of 40–49 among females (7/8; 87%. Conclusions. Prevalence of 10.5% is noteworthy when interpreted in light of prevalence of hypertension in general population especially if hypobaric hypoxia is considered to have a protective effect on blood pressure in high altitude native populations.

  1. Prevalence of Hypertension in a Tribal Land Locked Population at High Altitude

    Science.gov (United States)

    Raina, Sunil Kumar; Chander, Vishav; Prasher, Chaman Lal; Raina, Sujeet

    2016-01-01

    Introduction. Extensive pubmed search reveals paucity of data on prevalence of hypertension in tribal population at high altitude. The data is all the more scarce from our part of India. Studies among tribal populations at high altitudes provide an interesting epidemiological window to study human evolution and adaptation to hypobaric hypoxia. Material and Methods. 401 participants above the age of 20 years were evaluated for blood pressure using a stratified simple random technique among villages located at high altitude. Results. Out of a total of 401 individuals studied 43 (males: 35; females: 8) were identified as hypertensive yielding a crude prevalence of 10.7%. The prevalence was higher in males (35/270; 12.9%) as compared to females (8/131; 6%). Prevalence was the highest in the age group of 30–39 among males (16/35; 45.7%) while it was the highest in the age group of 40–49 among females (7/8; 87%). Conclusions. Prevalence of 10.5% is noteworthy when interpreted in light of prevalence of hypertension in general population especially if hypobaric hypoxia is considered to have a protective effect on blood pressure in high altitude native populations. PMID:26989560

  2. Pregnancy at high altitude in the Andes leads to increased total vessel density in healthy newborns

    NARCIS (Netherlands)

    Gassmann, N.N. (Norina N.); H.A. van Elteren (Hugo); T.G. Goos (Tom); Morales, C.R. (Claudia R.); Rivera-Ch, M. (Maria); D.S. Martin; Peralta, P.C. (Patricia Cabala); Del Carpio, A.P. (Agustin Passano); MacHaca, S.A. (Saul Aranibar); Huicho, L. (Luis); I.K.M. Reiss (Irwin); Gassmann, M. (Max); R.C.J. de Jonge (Rogier)

    2016-01-01

    markdownabstractThe developing human fetus is able to cope with the physiological reduction in oxygen supply occurring in utero. However, it is not known if microvascularization of the fetus is augmented when pregnancy occurs at high altitude. Fifty-three healthy term newborns in Puno, Peru (3,840

  3. On the High Altitude Platform (HAP W-CDMA System Capacity

    Directory of Open Access Journals (Sweden)

    L. de Haro-Ariet

    2004-06-01

    Full Text Available The performance of a downlink power control model, based on a n-thpower distance law, is evaluated for high altitude platform station(HAPS W-CDMA systems. The downlink capacity using this model iscompared with the uplink capacity. It is shown that the uplink capacityis higher than the downlink capacity.

  4. Responses of the autonomic nervous system in altitude adapted and high altitude pulmonary oedema subjects

    Science.gov (United States)

    Mathew, Lazar; Purkayastha, S. S.; Jayashankar, A.; Radhakrishnan, U.; Sen Gupta, J.; Nayar, H. S.

    1985-06-01

    Studies were carried out to ascertain the role of sympatho-parasympathetic responses in the process of adaptation to altitude. The assessment of status of autonomic balance was carried out in a group of 20 young male subjects by recording their resting heart rate, blood pressure, oral temperature, mean skin temperature, extremity temperatures, pupillary diameter, cold pressor response, oxygen consumption, cardioacceleration during orthostasis and urinary excretion of catecholamines; in a thermoneutral laboratory. The same parameters were repeated on day 3 and at weekly intervals for a period of 3 weeks, after exposing them to 3,500 m; and also after return to sea level. At altitude, similar studies were carried out in a group of 10 acclimatized lowlanders, 10 high altitude natives and 6 patients who had recently recovered from high altitude pulmonary oedema. In another phase, similar studies were done in two groups of subjects, one representing 15 subjects who had stayed at altitude (3,500 4,000 m) without any ill effects and the other comprising of 10 subjects who had either suffered from high altitude pulmonary oedema (HAPO) or acute mountain sickness (AMS). The results revealed sympathetic overactivity on acute induction to altitude which showed gradual recovery on prolonged stay, the high altitude natives had preponderance to parasympathetic system. Sympathetic preponderance may not be an essential etiological factor for the causation of maladaptation syndromes.

  5. Metabolic Effects of High Altitude Trekking in Patients With Type 2 Diabetes

    NARCIS (Netherlands)

    de Mol, Pieter; Fokkert, Marion J.; de Vries, Suzanna T.; de Koning, Eelco J. P.; Dikkeschei, Bert D.; Gans, Rijnold O. B.; Tack, Cees J.; Bilo, Henk J. G.

    2012-01-01

    OBJECTIVE-Limited information is available regarding the metabolic effects of high altitude trekking in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS-Thirteen individuals with type 2 diabetes took part, in a 12-day expedition to the summit of Mount Toubkal (altitude, 4,167 m), Morocco,

  6. Metabolic effects of high altitude trekking in patients with type 2 diabetes

    NARCIS (Netherlands)

    Mol, P. de; Fokkert, M.J.; Vries, S.T. de; Koning, E.J. de; Dikkeschei, B.D.; Gans, R.O.; Tack, C.J.J.; Bilo, H.J.

    2012-01-01

    OBJECTIVE Limited information is available regarding the metabolic effects of high altitude trekking in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Thirteen individuals with type 2 diabetes took part in a 12-day expedition to the summit of Mount Toubkal (altitude, 4,167 m), Morocco, a

  7. Elevated Suicide Rates at High Altitude: Sociodemographic and Health Issues May Be to Blame

    Science.gov (United States)

    Betz, Marian E.; Valley, Morgan A.; Lowenstein, Steven R.; Hedegaard, Holly; Thomas, Deborah; Stallones, Lorann; Honigman, Benjamin

    2011-01-01

    Suicide rates are higher at high altitudes; some hypothesize that hypoxia is the cause. We examined 8,871 suicides recorded in 2006 in 15 states by the National Violent Death Reporting System, with the victim's home county altitude determined from the National Elevation Dataset through FIPS code matching. We grouped cases by altitude (low less…

  8. The body weight loss during acute exposure to high-altitude hypoxia in sea level residents.

    Science.gov (United States)

    Ge, Ri-Li; Wood, Helen; Yang, Hui-Huang; Liu, Yi-Ning; Wang, Xiu-Juan; Babb, Tony

    2010-12-25

    Weight loss is frequently observed after acute exposure to high altitude. However, the magnitude and rate of weight loss during acute exposure to high altitude has not been clarified in a controlled prospective study. The present study was performed to evaluate weight loss at high altitude. A group of 120 male subjects [aged (32±6) years] who worked on the construction of the Golmud-Lhasa Railway at Kunlun Mountain (altitude of 4 678 m) served as volunteer subjects for this study. Eighty-five workers normally resided at sea level (sea level group) and 35 normally resided at an altitude of 2 200 m (moderate altitude group). Body weight, body mass index (BMI), and waist circumference were measured in all subjects after a 7-day stay at Golmud (altitude of 2 800 m, baseline measurements). Measurements were repeated after 33-day working on Kunlun Mountain. In order to examine the daily rate of weight loss at high altitude, body weight was measured in 20 subjects from the sea level group (sea level subset group) each morning before breakfast for 33 d at Kunlun Mountain. According to guidelines established by the Lake Louise acute mountain sickness (AMS) consensus report, each subject completed an AMS self-report questionnaire two days after arriving at Kunlun Mountain. After 33-day stay at an altitude of 4 678 m, the average weight loss for the sea level group was 10.4% (range 6.5% to 29%), while the average for the moderate altitude group was 2.2% (-2% to 9.1%). The degree of weight loss (Δ weight loss) after a 33-day stay at an altitude of 4 678 m was significantly correlated with baseline body weight in the sea level group (r=0.677, P0.05). In the sea level subset group, a significant weight loss was observed within 20 d, but the weight remained stable thereafter. AMS-score at high altitude was significantly higher in the sea level group (4.69±2.48) than that in the moderate altitude group (2.97±1.38), and was significantly correlated with baseline body weight

  9. High altitude syndromes at intermediate altitudes: a pilot study in the Australian Alps.

    Science.gov (United States)

    Slaney, Graham; Cook, Angus; Weinstein, Philip

    2013-10-01

    Our hypothesis is that symptoms of high altitude syndromes are detectable even at intermediate altitudes, as commonly encountered under Australian conditions (flatus expulsion (HAFE). Symptoms of high altitude syndromes are of growing concern because of the global trend toward increasing numbers of tourists and workers exposed to both rapid ascent and sustained physical activity at high altitude. However, in Australia, high altitude medicine has almost no profile because of our relatively low altitudes by international standards. Three factors lead us to believe that altitude sickness in Australia deserves more serious consideration: Australia is subject to rapid growth in alpine recreational industries; altitude sickness is highly variable between individuals, and some people do experience symptoms already at 1500 m; and there is potential for an occupational health and safety issue amongst workers. To test this hypothesis we examined the relationship between any high altitude symptoms and a rapid ascent to an intermediate altitude (1800 m) by undertaking an intervention study in a cohort of eight medical clinic staff, conducted during July of the 2012 (Southern Hemisphere) ski season, using self-reporting questionnaires, at Mansfield (316 m above sea level) and at the Ski Resort of Mt Buller (1800 m), Victoria, Australia. The intervention consisted of ascent by car from Mansfield to Mt Buller (approx. 40 min drive). Participants completed a self-reporting questionnaire including demographic data and information on frequency of normal homeostatic processes (fluid intake and output, food intake and output, symptoms including thirst and headaches, and frequency of passing wind or urine). Data were recorded in hourly periods extending over 18 h before and 18 h after ascent. We found that the frequency of flatus production more than doubled following ascent, with a post-ascent frequency of approximately 14 expulsions per person over the 18 h recording period (Rate

  10. Hypoxia: adapting to high altitude by mutating EPAS-1, the gene encoding HIF-2α.

    Science.gov (United States)

    van Patot, Martha C Tissot; Gassmann, Max

    2011-01-01

    Living at high altitude is demanding and thus drives adaptational mechanisms. The Tibetan population has had a longer evolutionary period to adapt to high altitude than other mountain populations such as Andeans. As a result, some Tibetans living at high altitudes do not show markedly elevated red blood cell production as compared to South American high altitude natives such as Quechuas or Aymaras, thereby avoiding high blood viscosity creating cardiovascular risk. Unexpectedly, the responsible mutation(s) reducing red blood cell production do not involve either the gene encoding the blood hormone erythropoietin (Epo), or the corresponding regulatory sequences flanking the Epo gene. Similarly, functional mutations in the hypoxia-inducible transcription factor 1α (HIF-1α) gene that represents the oxygen-dependent subunit of the HIF-1 heterodimer, the latter being the main regulator of over 100 hypoxia-inducible genes, have not been described so far. It was not until very recently that three independent groups showed that the gene encoding HIF-2α, EPAS-1 (Wenger et al. 1997), represents a key gene mutated in Tibetan populations adapted to living at high altitudes (Beall et al. 2010 , Yi et al. 2010 , Simonson et al. 2010). Hypoxia-inducible transcription factors were first identified by the description of HIF-1 (Semenza et al. 1991 , 1992), which was subsequently found to enhance transcription of multiple genes that encode proteins necessary for rescuing from hypoxic exposure, including erythropoietic, angiogenic and glycolytic proteins. Then HIF-2 was identified (Ema et al. 1997 ; Flamme et al. 1997 ; Hogenesch et al. 1997 ; and Tian et al. 1997) and although it is highly similar to HIF-1 and has the potential to bind (Camenisch et al. 2001) and mediate (Mole et al. 2009) many of the same genes as HIF-1, its biological actions in response to hypoxia are distinct from those of HIF-1 (reviewed by Loboda et al. 2010). By now, several of these HIF-2 mediated

  11. High-altitude adaptation of Tibetan chicken from MT-COI and ATP-6 perspective.

    Science.gov (United States)

    Zhao, Xiaoling; Wu, Nan; Zhu, Qing; Gaur, Uma; Gu, Ting; Li, Diyan

    2016-09-01

    The problem of hypoxia adaptation in high altitudes is an unsolved brainteaser in the field of life sciences. As one of the best chicken breeds with adaptability to highland environment, the Tibetan chicken, is genetically different from lowland chicken breeds. In order to gain a better understanding of the mechanism of hypoxic adaptability in high altitude, in the present study, we focused on the MT-COI together with ATP-6 gene to explore the regulatory mechanisms for hypoxia adaptability in Tibet chicken. Here, we sequenced MT-COI of 29 Tibetan chickens and 30 Chinese domestic chickens and ATP-6 gene of 28 Tibetan chickens and 29 Chinese domestic chickens. In MT-COI gene, 9 single nucleotide polymorphisms (SNPs) were detected though none of these was a missense mutation, confirming the fact that MT-COI gene is a largely conservative sequence. In ATP-6 gene, 6 single nucleotide polymorphisms (SNPs) were detected and we found a missense mutation (m.9441G > A) in the ATP-6 gene of Tibetan chicken resulting in an amino acid substitution. Due to the critical role of ATP-6 gene in the proton translocation and energy metabolism, we speculated the possibility of this mutation playing an important role in easier energy conversion and metabolism in Tibetan chickens than Chinese domestic chickens so as to better adapt to the harsh environment of the high-altitude areas. The Median-joining profile also suggested that haplotype Ha2 has the ancestral position to the other haplotypes and has significant relationship with high-altitude adaptation in ATP-6 gene. Therefore, we considered that the polymorphism (m.9441G > A) in the ATP-6 gene may affect the specific functions of ATP-6 enzyme relating to high-altitude adaptation of Tibetan chicken and MT-COI gene is a largely conservative sequence.

  12. Identifying positive selection candidate loci for high-altitude adaptation in Andean populations

    Directory of Open Access Journals (Sweden)

    Bigham Abigail W

    2009-12-01

    Full Text Available Abstract High-altitude environments (>2,500 m provide scientists with a natural laboratory to study the physiological and genetic effects of low ambient oxygen tension on human populations. One approach to understanding how life at high altitude has affected human metabolism is to survey genome-wide datasets for signatures of natural selection. In this work, we report on a study to identify selection-nominated candidate genes involved in adaptation to hypoxia in one highland group, Andeans from the South American Altiplano. We analysed dense microarray genotype data using four test statistics that detect departures from neutrality. Using a candidate gene, single nucleotide polymorphism-based approach, we identified genes exhibiting preliminary evidence of recent genetic adaptation in this population. These included genes that are part of the hypoxia-inducible transcription factor (HIF pathway, a biochemical pathway involved in oxygen homeostasis, as well as three other genomic regions previously not known to be associated with high-altitude phenotypes. In addition to identifying selection-nominated candidate genes, we also tested whether the HIF pathway shows evidence of natural selection. Our results indicate that the genes of this biochemical pathway as a group show no evidence of having evolved in response to hypoxia in Andeans. Results from particular HIF-targeted genes, however, suggest that genes in this pathway could play a role in Andean adaptation to high altitude, even if the pathway as a whole does not show higher relative rates of evolution. These data suggest a genetic role in high-altitude adaptation and provide a basis for genotype/phenotype association studies that are necessary to confirm the role of putative natural selection candidate genes and gene regions in adaptation to altitude.

  13. Changes in brain iron concentration after exposure to high-altitude hypoxia measured by quantitative susceptibility mapping.

    Science.gov (United States)

    Chen, Lin; Cai, Congbo; Yang, Tianhe; Lin, Jianzhong; Cai, Shuhui; Zhang, Jiaxing; Chen, Zhong

    2017-02-15

    Hypoxia can induce physiological changes. This study aims to explore effects of high-altitude (HA) hypoxia on cerebral iron concentration. Twenty-nine healthy sea-level participants were tested shortly before and after approximately 4-week adaptation to the HA environment at fQinghai-Tibet Plateau (4200m), and were re-investigated after re-adaptation to the sea-level environment one year later. Iron concentration was quantified with quantitative susceptibility mapping (QSM), and the results were compared with transverse relaxation rate (R(*)2) measurements. The variations of magnetic susceptibility indicate that the iron concentration in gray matter regions, especially in basal ganglia, including caudate nucleus, putamen, globus pallidus and substantia nigra, increases significantly after HA exposure. This increase appears consistent with the conclusion from R(*)2 value variations. However, unlike QSM, the R(*)2 value fails to demonstrate the statistical difference of iron content in red nucleus. The re-investigation results show that most variations are recovered after sea-level re-adaptation for one year. Additionally, hemisphere- and gender-related differences in iron concentration changes were analyzed among cerebral regions. The results show greater possibilities in the right hemisphere and females. Further studies based on diffusion tensor imaging (DTI) suggest that the fractional anisotropy increases and the mean diffusivity decreases after HA exposure in six deep gray matter nuclei, with linear dependence on iron concentration only in putamen. In conclusion, the magnetic susceptibility value can serve as a quantitative marker of brain iron, and variations of regional susceptibility reported herein indicate that HA hypoxia can result in significant iron deposition in most deep gray matter regions. Additionally, the linear dependence of DTI metrics on iron concentration in putamen indicates a potential relationship between ferritin and water diffusion.

  14. Isolated unilateral disk edema

    OpenAIRE

    Varner P

    2011-01-01

    Paul VarnerJohn J Pershing VAMC, Poplar Bluff, MO, USAAbstract: Isolated unilateral disk edema is a familiar clinical presentation with myriad associations. Related, non-consensus terminology is a barrier to understanding a common pathogenesis. Mechanisms for the development of disk edema are reviewed, and a new framework for clinical differentiation of medical associations is presented.Keywords: disk edema, axoplasmic flow, clinical multiplier, optic neuritis, ischemic optic neuropathy, papi...

  15. Isolated unilateral disk edema

    Directory of Open Access Journals (Sweden)

    Varner P

    2011-07-01

    Full Text Available Paul VarnerJohn J Pershing VAMC, Poplar Bluff, MO, USAAbstract: Isolated unilateral disk edema is a familiar clinical presentation with myriad associations. Related, non-consensus terminology is a barrier to understanding a common pathogenesis. Mechanisms for the development of disk edema are reviewed, and a new framework for clinical differentiation of medical associations is presented.Keywords: disk edema, axoplasmic flow, clinical multiplier, optic neuritis, ischemic optic neuropathy, papilledema

  16. Lung membrane conductance and capillary volume derived from the NO and CO transfer in high-altitude newcomers.

    Science.gov (United States)

    Martinot, Jean-Benoît; Mulè, Massimiliano; de Bisschop, Claire; Overbeek, Maria J; Le-Dong, Nhat-Nam; Naeije, Robert; Guénard, Hervé

    2013-07-15

    Acute exposure to high altitude may induce changes in carbon monoxide (CO) membrane conductance (DmCO) and capillary lung volume (Vc). Measurements were performed in 25 lowlanders at Brussels (D0), at 4,300 m after a 2- or 3-day exposure (D2,3) without preceding climbing, and 5 days later (D7,8), before and after an exercise test, under a trial with two arterial pulmonary vasodilators or a placebo. The nitric oxide (NO)/CO transfer method was used, assuming both infinite and finite values to the NO blood conductance (θNO). Doppler echocardiography provided hemodynamic data. Compared with sea level, lung diffusing capacity for CO increased by 24% at D2,3 and is returned to control at D7,8. The acute increase in lung diffusing capacity for CO resulted from increases in DmCO and Vc with finite and infinite θNO assumptions. The alveolar volume increased by 16% at D2,3 and normalized at D7,8. The mean increase in systolic arterial pulmonary pressure at rest at D2,3 was minimal. In conclusion, the acute increase in Vc may be related to the increase in alveolar volume and to the increase in capillary pressure. Compared with the infinite θNO value, the use of a finite θNO value led to about a twofold increase in DmCO value and to a persistent increase in DmCO at D7,8 compared with D0. After exercise, DmCO decreased slightly less in subjects treated by the vasodilators, suggesting a beneficial effect on interstitial edema.

  17. Systems Design and Experimental Evaluation of a High-Altitude Relight Test Facility

    Science.gov (United States)

    Paxton, Brendan

    Novel advances in gas turbine engine combustor technology, led by endeavors into fuel efficiency and demanding environmental regulations, have been fraught with performance and safety concerns. While the majority of low emissions gas turbine engine combustor technology has been necessary for power generation applications, the push for ultra-low NOx combustion in aircraft jet engines has been ever present. Recent state-of-the-art combustor designs notably tackle historic emissions challenges by operating at fuel-lean conditions, which are characterized by an increase in the amount of air flow sent to the primary combustion zone. While beneficial in reducing NOx emissions, the fuel-lean mechanisms that characterize these combustor designs rely heavily upon high-energy and high-velocity air flows to sufficiently mix and atomize fuel droplets, ultimately leading to flame stability concerns during low-power operation. When operating at high-altitude conditions, these issues are further exacerbated by the presence of low ambient air pressures and temperatures, which can lead to engine flame-out situations and hamper engine relight attempts. To aid academic and industrial research ventures into improving the high-altitude lean blow-out and relight performance of modern gas turbine engine combustor technologies, the High-Altitude Relight Test Facility (HARTF) was designed and constructed at the University of Cincinnati (UC) Combustion and Fire Research Laboratory (CFRL). Following its construction, an experimental evaluation of its abilities to facilitate optically-accessible ignition, combustion, and spray testing for gas turbine engine combustor hardware at simulated high-altitude conditions was performed. In its evaluation, performance limit references were established through testing of the HARTF vacuum and cryogenic air-chilling capabilities. These tests were conducted with regard to end-user control---the creation and the maintenance of a realistic high-altitude

  18. Structural and functional changes of the human macula during acute exposure to high altitude.

    Directory of Open Access Journals (Sweden)

    M Dominik Fischer

    Full Text Available BACKGROUND: This study aimed to quantify structural and functional changes at the macula during acute exposure to high altitude and to assess their structure/function relationship. This work is related to the Tuebingen High Altitude Ophthalmology (THAO study. METHODOLOGY/PRINCIPAL FINDINGS: Spectral domain optical coherence tomography and microperimetry were used to quantify changes of central retinal structure and function in 14 healthy subjects during acute exposure to high altitude (4559 m. High-resolution volume scans and fundus-controlled microperimetry of the posterior pole were performed in addition to best-corrected visual acuity (BCVA measurements and assessment of acute mountain sickness. Analysis of measurements at altitude vs. baseline revealed increased total retinal thickness (TRT in all four outer ETDRS grid subfields during acute altitude exposure (TRT(outer = 2.80 ± 1.00 μm; mean change ± 95%CI. This change was inverted towards the inner four subfields (TRT(inner = -1.89 ± 0.97 μm with significant reduction of TRT in the fovea (TRT(foveal = -6.62 ± 0.90 μm at altitude. BCVA revealed no significant difference compared to baseline (0.06 ± 0.08 logMAR. Microperimetry showed stable mean sensitivity in all but the foveal subfield (MS(foveal = -1.12 ± 0.68 dB. At baseline recordings before and >2 weeks after high altitude exposure, all subjects showed equal levels with no sign of persisting structural or functional sequels. CONCLUSIONS/SIGNIFICANCE: During acute exposure to high altitude central retinal thickness is subject to minor, yet statistically significant changes. These alterations describe a function of eccentricity with an increase in regions with relatively higher retinal nerve fiber content and vascular arcades. However, these changes did not correlate with measures of central retinal function or acute mountain sickness. For the first time a quantitative approach has been used to assess these changes during acute

  19. Structural and Functional Changes of the Human Macula during Acute Exposure to High Altitude

    Science.gov (United States)

    Fischer, M. Dominik; Willmann, Gabriel; Schatz, Andreas; Schommer, Kai; Zhour, Ahmad; Zrenner, Eberhart; Bartz-Schmidt, Karl U.; Gekeler, Florian

    2012-01-01

    Background This study aimed to quantify structural and functional changes at the macula during acute exposure to high altitude and to assess their structure/function relationship. This work is related to the Tuebingen High Altitude Ophthalmology (THAO) study. Methodology/Principal Findings Spectral domain optical coherence tomography and microperimetry were used to quantify changes of central retinal structure and function in 14 healthy subjects during acute exposure to high altitude (4559 m). High-resolution volume scans and fundus-controlled microperimetry of the posterior pole were performed in addition to best-corrected visual acuity (BCVA) measurements and assessment of acute mountain sickness. Analysis of measurements at altitude vs. baseline revealed increased total retinal thickness (TRT) in all four outer ETDRS grid subfields during acute altitude exposure (TRTouter = 2.80±1.00 μm; mean change±95%CI). This change was inverted towards the inner four subfields (TRTinner = −1.89±0.97 μm) with significant reduction of TRT in the fovea (TRTfoveal = −6.62±0.90 μm) at altitude. BCVA revealed no significant difference compared to baseline (0.06±0.08 logMAR). Microperimetry showed stable mean sensitivity in all but the foveal subfield (MSfoveal = −1.12±0.68 dB). At baseline recordings before and >2 weeks after high altitude exposure, all subjects showed equal levels with no sign of persisting structural or functional sequels. Conclusions/Significance During acute exposure to high altitude central retinal thickness is subject to minor, yet statistically significant changes. These alterations describe a function of eccentricity with an increase in regions with relatively higher retinal nerve fiber content and vascular arcades. However, these changes did not correlate with measures of central retinal function or acute mountain sickness. For the first time a quantitative approach has been used to assess these changes during acute, non

  20. Mammals of the high altitudes of western Arunachal Pradesh, eastern Himalaya: an assessment of threats and conservation needs

    NARCIS (Netherlands)

    Mishra, C.; Madhusudan, M.D.; Datta, A.

    2006-01-01

    he high altitudes of Arunachal Pradesh, India, located in the Eastern Himalaya biodiversity hotspot, remain zoologically unexplored and unprotected. We report results of recent mammal surveys in the high altitude habitats of western Arunachal Pradesh. A total of 35 mammal species (including 12 carni

  1. Mammals of the high altitudes of western Arunachal Pradesh, eastern Himalaya: an assessment of threats and conservation needs

    NARCIS (Netherlands)

    Mishra, C.; Madhusudan, M.D.; Datta, A.

    2006-01-01

    he high altitudes of Arunachal Pradesh, India, located in the Eastern Himalaya biodiversity hotspot, remain zoologically unexplored and unprotected. We report results of recent mammal surveys in the high altitude habitats of western Arunachal Pradesh. A total of 35 mammal species (including 12 carni

  2. Mammals of the high altitudes of western Arunachal Pradesh, eastern Himalaya: an assessment of threats and conservation needs

    NARCIS (Netherlands)

    Mishra, C.; Madhusudan, M.D.; Datta, A.

    2006-01-01

    he high altitudes of Arunachal Pradesh, India, located in the Eastern Himalaya biodiversity hotspot, remain zoologically unexplored and unprotected. We report results of recent mammal surveys in the high altitude habitats of western Arunachal Pradesh. A total of 35 mammal species (including 12

  3. Effect of reduced pressure, vibration and orientation to simulate high altitude testing of liquid pharmaceutical glass and plastic bottles

    NARCIS (Netherlands)

    Singh, S. Paul; Burgess, Gary; Kremer, Matt; Lockhart, Hugh

    2007-01-01

    This paper discusses the impact of high-altitude shipments of glass and plastic bottles on package integrity. High altitudes are encountered when trucks travel over mountain passes and when cargo and feeder aircraft transport packages in non-pressurized or partially pressurized cargo holds. This is

  4. Operating Water Cherenkov Detectors in high altitude sites for the Large Aperture GRB Observatory

    CERN Document Server

    Allard, D; Asorey, H; Barros, H; Bertou, X; Castillo, M; Chirinos, J M; De Castro, A; Flores, S; González, J; Berisso, M Gomez; Grajales, J; Guada, C; Day, W R Guevara; Ishitsuka, J; López, J A; Martínez, O; Melfo, A; Meza, E; Loza, P Miranda; Barbosa, E Moreno; Murrugarra, C; Núñez, L A; Ormachea, L J Otiniano; Pérez, G; Perez, Y; Ponce, E; Quispe, J; Quintero, C; Rivera, H; Rosales, M; Rovero, A C; Saavedra, O; Salazar, H; Tello, J C; Peralda, R Ticona; Varela, E; Velarde, A; Villaseñor, L; Wahl, D; Zamalloa, M A

    2009-01-01

    Water Cherenkov Detectors (WCD) are efficient detectors for detecting GRBs in the 10 GeV - 1 TeV energy range using the single particle technique, given their sensitivity to low energy secondary photons produced by high energy photons when cascading in the atmosphere. The Large Aperture GRB Observatory (LAGO) operates arrays of WCD in high altitude sites (above 4500 m a.s.l.) in Bolivia, Mexico and Venezuela, with planned extension to Peru. Details on the operation and stability of these WCD in remote sites with high background rates of particles will be detailed, and compared to simulations. Specific issues due to operation at high altitude, atmospheric effects and solar activity, as well as possible hardware enhancements will also be presented.

  5. Association between Serum Interleukin-17A Level and High-Altitude Deacclimatization Syndrome.

    Science.gov (United States)

    He, Binfeng; Li, Hongli; Hu, Mingdong; Dong, Weijie; Wei, Zhenghua; Li, Jin; Yao, Wei; Guo, Xiaolan

    2016-01-01

    High-altitude deacclimatization syndrome (HADAS) is emerging as a severe public health issue that threatens the quality of life of individuals who return to lower altitude from high altitude. In this study, we measured serum levels of SOD, MDA, IL-17A, IL-10, TNF-α, and HADAS score in HADAS subjects at baseline and 50th and 100th days and to evaluate the relationship between interleukins, including IL-17A, and HADAS. Our data showed that and the serum IL-17A levels and HADAS score decreased over time in the HADAS group, and serum IL-17A levels were significantly higher in the HADAS group at baseline and 50th day compared with controls (p HADAS subjects compared with controls (p HADAS incidence and severity (p HADAS incidence than serum levels of IL-17A or IL-10 alone. These data suggest that serum levels of IL-17A are a novel predictive index of HADAS.

  6. A strategy for reducing neonatal mortality at high altitude using oxygen conditioning.

    Science.gov (United States)

    West, J B

    2015-11-01

    Neonatal mortality increases with altitude. For example, in Peru the incidence of neonatal mortality in the highlands has been shown to be about double that at lower altitudes. An important factor is the low inspired PO2 of newborn babies. Typically, expectant mothers at high altitude will travel to low altitude to have their babies if possible, but often this is not feasible because of economic factors. The procedure described here raises the oxygen concentration in the air of rooms where neonates are being housed and, in effect, this means that both the mother and baby are at a much lower altitude. Oxygen conditioning is similar to air conditioning except that the oxygen concentration of the air is increased rather than the temperature being reduced. The procedure is now used at high altitude in many hotels, dormitories and telescope facilities, and has been shown to be feasible and effective.

  7. Current Status of a NASA High-Altitude Balloon-Based Observatory for Planetary Science

    Science.gov (United States)

    Varga, Denise M.; Dischner, Zach

    2015-01-01

    Recent studies have shown that progress can be made on over 20% of the key questions called out in the current Planetary Science Decadal Survey by a high-altitude balloon-borne observatory. Therefore, NASA has been assessing concepts for a gondola-based observatory that would achieve the greatest possible science return in a low-risk and cost-effective manner. This paper addresses results from the 2014 Balloon Observation Platform for Planetary Science (BOPPS) mission, namely successes in the design and performance of the Fine Pointing System. The paper also addresses technical challenges facing the new Gondola for High Altitude Planetary Science (GHAPS) reusable platform, including thermal control for the Optical Telescope Assembly, power generation and management, and weight-saving considerations that the team will be assessing in 2015 and beyond.

  8. [High frequency of dyslipidemia and impaired fasting glycemia in a high altitude Peruvian population].

    Science.gov (United States)

    Málaga, Germán; Zevallos-Palacios, Claudia; Lazo, María de los Ángeles; Huayanay, Carlos

    2010-01-01

    We performed a cross sectional study in Lari (3600 m), a highland rural community from Arequipa, Peru. We evaluated a body mass index (BMI), glycemia and lipid profile in 74 over 18 year persons. The mean age was 51.7 ± 18.0 years, 62.2% were women, mean of BMI was 25.6 ± 3.7. Prevalence of hypercholesterolemia was 40.6%, "low HDL" in 77% of the population (93.5% in women vs 50% in men, p <0.001) and elevated level of LDL was 71.7%. The prevalence of impaired fasting glycemia was 27%. In conclusion, we found high prevalence of impaired fasting glycemia, hypercholesterolemia and especially "low HDL" in high altitude rural natives. These findings must be considered to realize interventions in high altitude populations to avoid future cardiovascular complications.

  9. The physiology of extremes: Ancel Keys and the International High Altitude Expedition of 1935.

    Science.gov (United States)

    Tracy, Sarah W

    2012-01-01

    This article examines the International High Altitude Expedition of 1935 and its significance in the life and science of Ancel Keys. Both the expedition and Keys's story afford excellent opportunities to explore the growing reach of interwar physiology into extreme climates-whether built or natural. As IHAE scientists assessed human performance and adaptation to hypoxia, low barometric pressure, and cold, they not only illuminated the physiological and psychological processes of high altitude acclimatization, but they also drew borderlines between the normal and the pathological, paved the way for the neocolonial exploitation of natural and human resources in Latin America, and pioneered field methods in physiology that were adapted and adopted by the Allied Forces during the Second World War. This case study in the physiology of place reveals the power and persistence of environmental determinism within biomedicine well into the twentieth century.

  10. A gloss of Chronic Hypoxia in normal and diseased individuals at high altitude

    Institute of Scientific and Technical Information of China (English)

    Zubieta-Castillo,G.; Zubieta-Calleja,G.R.; Zubieta-Calleja L.

    2004-01-01

    @@ Introduction Millenary populations that live at high altitude in different continents like Asia (1) and South America (8), have endured biological adaptation in very adverse environmental conditions, of which to our understanding, paradoxically, chronic hypoxia is the most tolerable. Patients with pulmonary diseases at high altitude tolerate tissue hypoxia with an arterial tension (PaO2) even as low as 30 mmHg. Current scientific knowledge has made progress in many areas, clarifying many doubts, however due to preconception and lack of broad social studies chronic hypoxia is still not fully understood. Beings that inhabit different areas of the planet earth have lived under a variety of different hostile conditions: intense cold in the polar regions,intense heat in Africa and in the Middle East desserts,great pressure in the depth of the oceans, intense darkness of the caves and naturally the hypoxia of extreme altitudes.

  11. Increasing alpine transit traffic through Switzerland will considerably enhance high altitude alpine pollutant levels

    Energy Technology Data Exchange (ETDEWEB)

    Prevot, A.S.H.; Dommen, J.; Furger, M.; Graber, W.K. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1999-08-01

    Within the EU-Project VOTALP (Vertical Ozone Transports in the Alps), we have shown that deep alpine valleys like the Mesolcina Valley very efficiently transport air out of the polluted valley up to altitudes between 2000 and near 4000 m asl (above sea level). Pollutants emitted in these valleys are very efficiently transported up to high altitudes. (author) 2 figs., 1 tab., 2 refs.

  12. Pruning management of Chardonnay grapevines at high altitude in Brazilian southeast

    OpenAIRE

    2016-01-01

    ABSTRACT The agronomical responses of Chardonnay, a variety indicated for sparkling wine production, is influenced by the vineyard management and the edaphoclimatic conditions of the region. The objective of this study was to evaluate the effects of two pruning types (Royat and double Guyot) on vegetative and reproductive development of Chardonnay vine growing at high altitude in the Brazilian southeastern region. The experiment was carried out in a commercial vineyard located at 1,280 m of a...

  13. Feasibility of Laser Power Transmission to a High-Altitude Unmanned Aerial Vehicle

    Science.gov (United States)

    2011-01-01

    possible to imagine the laser beam arriving at the UAV from above, perhaps bounced down from a satel- lite or airship , but this seems like an excessive...thus lending themselves to applica- tion on the aerodynamic surfaces of a UAV. InGaAs cells can also be used to convert laser light at longer wavelengths...Design and Predictions for a High-Altitude (Low- Reynolds-Number) Aerodynamic Flight Experiment, Edwards Air Force Base, Calif.: NASA Dryden Flight

  14. America’s Achilles Heel: Defense Against High-altitude Electromagnetic Pulse-policy vs. Practice

    Science.gov (United States)

    2014-12-12

    Energy Regulatory Commission FM Field Manual GRID Act Grid Reliability and Infrastructure Defense Act HEMP High-Altitude Electromagnetic Pulse JP...product to the end user.41 Across the U.S., there are upwards of 40,000 miles of gathering lines from the oil wells, both on and offshore , that feed into...particles are emitted at nearly the speed of light. The emissions can cause disturbances in the solar wind that disrupt satellites and create powerful

  15. Fasciola hepatica and lymnaeid snails occurring at very high altitude in South America.

    Science.gov (United States)

    Mas-Coma, S; Funatsu, I R; Bargues, M D

    2001-01-01

    Fascioliasis due to the digenean species Fasciola hepatica has recently proved to be an important public health problem, with human cases reported in countries of the five continents, including severe symptoms and pathology, with singular epidemiological characteristics, and presenting human endemic areas ranging from hypo- to hyperendemic. One of the singular epidemiological characteristics of human fascioliasis is the link of the hyperendemic areas to very high altitude regions, at least in South America. The Northern Bolivian Altiplano, located at very high altitude (3800-4100 m), presents the highest prevalences and intensities of human fascioliasis known. Sequences of the internal transcribed spacers ITS-1 and ITS-2 of the nuclear ribosomal DNA of Altiplanic Fasciola hepatica and the intermediate snail host Lymnaea truncatula suggest that both were recently introduced from Europe. Studies were undertaken to understand how the liver fluke and its lymnaeid snail host adapted to the extreme environmental conditions of the high altitude and succeeded in giving rise to high infection rates. In experimental infections of Altiplanic lymnaeids carried out with liver fluke isolates from Altiplanic sheep and cattle, the following aspects were studied: miracidium development inside the egg, infectivity of miracidia, prepatent period, shedding period, chronobiology of cercarial emergence, number of cercariae shed by individual snails, survival of molluscs at the beginning of the shedding process, survival of infected snails after the end of the shedding period and longevity of shedding and non-shedding snails. When comparing the development characteristics of European F. hepatica and L. truncatula, a longer cercarial shedding period and a higher cercarial production were observed, both aspects related to a greater survival capacity of the infected lymnaeid snails from the Altiplano. These differences would appear to favour transmission and may be interpreted as strategies

  16. Genetic variants in EPAS1 contribute to adaptation to high-altitude hypoxia in Sherpas.

    Directory of Open Access Journals (Sweden)

    Masayuki Hanaoka

    Full Text Available Sherpas comprise a population of Tibetan ancestry in the Himalayan region that is renowned for its mountaineering prowess. The very small amount of available genetic information for Sherpas is insufficient to explain their physiological ability to adapt to high-altitude hypoxia. Recent genetic evidence has indicated that natural selection on the endothelial PAS domain protein 1 (EPAS1 gene was occurred in the Tibetan population during their occupation in the Tibetan Plateau for millennia. Tibetan-specific variations in EPAS1 may regulate the physiological responses to high-altitude hypoxia via a hypoxia-inducible transcription factor pathway. We examined three significant tag single-nucleotide polymorphisms (SNPs, rs13419896, rs4953354, and rs4953388 in the EPAS1 gene in Sherpas, and compared these variants with Tibetan highlanders on the Tibetan Plateau as well as with non-Sherpa lowlanders. We found that Sherpas and Tibetans on the Tibetan Plateau exhibit similar patterns in three EPAS1 significant tag SNPs, but these patterns are the reverse of those in non-Sherpa lowlanders. The three SNPs were in strong linkage in Sherpas, but in weak linkage in non-Sherpas. Importantly, the haplotype structured by the Sherpa-dominant alleles was present in Sherpas but rarely present in non-Sherpas. Surprisingly, the average level of serum erythropoietin in Sherpas at 3440 m was equal to that in non-Sherpas at 1300 m, indicating a resistant response of erythropoietin to high-altitude hypoxia in Sherpas. These observations strongly suggest that EPAS1 is under selection for adaptation to the high-altitude life of Tibetan populations, including Sherpas. Understanding of the mechanism of hypoxia tolerance in Tibetans is expected to provide lights to the therapeutic solutions of some hypoxia-related human diseases, such as cardiovascular disease and cancer.

  17. Influence of acute exposure to high altitude on basal and postprandial plasma levels of gastroenteropancreatic peptides.

    Directory of Open Access Journals (Sweden)

    Rudolf L Riepl

    Full Text Available Acute mountain sickness (AMS is characterized by headache often accompanied by gastrointestinal complaints that vary from anorexia through nausea to vomiting. The aim of this study was to investigate the influence of high altitude on plasma levels of gastroenteropancreatic (GEP peptides and their association to AMS symptoms. Plasma levels of 6 GEP peptides were measured by radioimmunoassay in 11 subjects at 490 m (Munich, Germany and, after rapid passive ascent to 3454 m (Jungfraujoch, Switzerland, over the course of three days. In a second study (n = 5, the same peptides and ghrelin were measured in subjects who consumed standardized liquid meals at these two elevations. AMS symptoms and oxygen saturation were monitored. In the first study, both fasting (morning 8 a.m. and stimulated (evening 8 p.m. plasma levels of pancreatic polypeptide (PP and cholecystokinin (CCK were significantly lower at high altitude as compared to baseline, whereas gastrin and motilin concentrations were significantly increased. Fasting plasma neurotensin was significantly enhanced whereas stimulated levels were reduced. Both fasting and stimulated plasma motilin levels correlated with gastrointestinal symptom severity (r = 0.294, p = 0.05, and r = 0.41, p = 0.006, respectively. Mean O(2-saturation dropped from 96% to 88% at high altitude. In the second study, meal-stimulated integrated (= area under curve plasma CCK, PP, and neurotensin values were significantly suppressed at high altitude, whereas integrated levels of gastrin were increased and integrated VIP and ghrelin levels were unchanged. In summary, our data show that acute exposure to a hypobaric hypoxic environment causes significant changes in fasting and stimulated plasma levels of GEP peptides over consecutive days and after a standardized meal. The changes of peptide levels were not uniform. Based on the inhibition of PP and neurotensin release a reduction of the cholinergic tone can be postulated.

  18. Agroforestry systems, nutrients in litter and microbial activity in soils cultivated with coffee at high altitude

    Directory of Open Access Journals (Sweden)

    Krystal de Alcantara Notaro

    2014-04-01

    Full Text Available Agroforestry systems are an alternative option for sustainable production management. These systems contain trees that absorb nutrients from deeper layers of the soil and leaf litter that help improve the soil quality of the rough terrain in high altitude areas, which are areas extremely susceptible to environmental degradation. The aim of this study was to characterize the stock and nutrients in litter, soil activity and the population of microorganisms in coffee (Coffea arabica L. plantations under high altitude agroforestry systems in the semi-arid region of the state of Pernambuco, Brazil. Samples were collected from the surface litter together with soil samples taken at two depths (0-10 and 10-20 cm from areas each subject to one of the following four treatments: agroforestry system (AS, native forest (NF, biodynamic system (BS and coffee control (CT.The coffee plantation had been abandoned for nearly 15 years and, although there had been no management or harvesting, still contained productive coffee plants. The accumulation of litter and mean nutrient content of the litter, the soil nutrient content, microbial biomass carbon, total carbon, total nitrogen, C/N ratio, basal respiration, microbial quotient, metabolic quotient and microbial populations (total bacteria, fluorescent bacteria group, total fungi and Trichoderma spp. were all analyzed. The systems thatwere exposed to human intervention (A and BS differed in their chemical attributes and contained higher levels of nutrients when compared to NF and CT. BS for coffee production at high altitude can be used as a sustainable alternative in the high altitude zones of the semi-arid region in Brazil, which is an area that is highly susceptible to environmental degradation.

  19. High Altitude Bird Migration at Temperate Latitudes: A Synoptic Perspective on Wind Assistance

    OpenAIRE

    2013-01-01

    At temperate latitudes the synoptic patterns of bird migration are strongly structured by the presence of cyclones and anticyclones, both in the horizontal and altitudinal dimensions. In certain synoptic conditions, birds may efficiently cross regions with opposing surface wind by choosing a higher flight altitude with more favourable wind. We observed migratory passerines at mid-latitudes that selected high altitude wind optima on particular nights, leading to the formation of structured mig...

  20. Decreased plasma soluble erythropoietin receptor in high-altitude excessive erythrocytosis and Chronic Mountain Sickness

    OpenAIRE

    Villafuerte, Francisco C.; Macarlupú, José Luis; Anza-Ramírez, Cecilia; Corrales-Melgar, Daniela; Vizcardo-Galindo, Gustavo; Corante, Noemí; León-Velarde, Fabiola

    2014-01-01

    Excessive erythrocytosis (EE) is the hallmark of chronic mountain sickness (CMS), a prevalent syndrome in high-altitude Andean populations. Although hypoxemia represents its underlying stimulus, why some individuals develop EE despite having altitude-normal blood erythropoietin (Epo) concentration is still unclear. A soluble form of the Epo receptor (sEpoR) has been identified in human blood and competes directly for Epo with its membrane counterpart (mEpoR). Thus, reduced levels of circulati...

  1. On the HEMP (high-altitude electromagnetic pulse) environment for protective relays

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, D.E.; Wiggins, C.M.; Salas, T.M. (BDM International, Inc., Albuquerque, NM (USA)); Barnes, P.R. (Oak Ridge National Lab., TN (USA))

    1990-01-01

    An assessment of the transient environment for protective relays produced by high-altitude electromagnetic pulse (HEMP) events is presented in this paper. Several mechanisms for coupling of HEMP to relay terminals are used to develop estimates of possible HEMP threats to relays. These predicted relay responses to HEMP events are compared to measured data on a solid state based relay's impulse strength. 12 refs., 13 figs., 3 tabs.

  2. Placental villus morphology in relation to maternal hypoxia at high altitude.

    Science.gov (United States)

    Espinoza, J; Sebire, N J; McAuliffe, F; Krampl, E; Nicolaides, K H

    2001-07-01

    Pregnancy at high altitude is associated with maternal hypoxaemic hypoxia with resultant intervillus blood hypoxia. Maternal haemoglobin concentration and blood gases were measured in pregnant women in two cities in Peru; Lima at sea level (n=18) and Cerro de Pasco at 4300 metres above sea level (n=12). Following delivery, placental sections from both groups were examined histomorphometrically using an image analysis system. Villus diameter, villus cross-sectional area, capillary diameter, capillary cross-sectional area and the percentage of villus cross-sectional area occupied by villus capillaries were calculated and parameters were compared between the two altitude groups. Maternal haemoglobin concentration and maternal blood pH were significantly higher, and maternal pO(2), pCO(2)and O(2)saturation were significantly lower in the high altitude group compared to those at sea level. The villus vessel area as a percentage of villus cross-sectional area and capillary diameter were significantly greater in the cases from the high altitude group and villus vessel area as a percentage of the villus cross-sectional area was significantly related to maternal pO(2)(r=-0.7, P=0.01), and maternal pCO(2)(r=0.7, P=0.02), but multiple regression analysis demonstrated that only pO(2)remained significantly independently associated with these villus histological findings (P=0.03). Placental terminal villi from term pregnancies at high altitude show different morphological features from pregnancies at sea level, and these changes are primarily related to maternal pO(2). The predominant morphological alteration is an increase in villus capillary diameter and therefore of the proportion of villus cross-sectional area occupied by capillary lumens.

  3. Interplanetary dust particles, not wind blown dust, control high altitude ice clouds on Mars

    Science.gov (United States)

    Hartwick, Victoria; Toon, Owen B.

    2016-10-01

    Water ice clouds on Mars are commonly observed at high altitudes. However, current generation Mars three-dimensional general circulation models (GCM) struggle to reproduce clouds above approximately 20-30 km. On Mars, as on Earth, ice cloud formation likely initiates by heterogeneous nucleation, which requires a population of suspended ice nuclei contiguous with supersaturated atmospheric water vapor. Although supersaturation is observed at high altitudes and has been reproduced in models, models predict very few ice nuclei. The small number of ice nuclei in the upper atmosphere is due to the assumption in Mars GCMs that the only source of ice nuclei is dust from the Martian surface. However, terrestrial mesospheric noctilucent clouds have been shown to form by ice nucleation on particles originating from ablated micrometeroids. Therefore, it is reasonable to assume that a population of micrometeoric ablation biproducts on Mars exists and can act as a site for cloud nucleation at high altitudes. We present simulations using the Community Atmosphere Model for Mars (MarsCAM) based on the National Center for Atmospheric Research (NCAR) Community Atmosphere Model for Earth,coupled with a physically based, state-of-the-art cloud and dust physics model, the Community Aerosol and Radiation Model for Atmospheres (CARMA) to show that ablating micrometeoroids can yield abundant ice nuclei throughout the upper atmosphere of Mars. We find that simulations including a constant annual micrometeoroid flux allows us to reproduce the observed properties of high altitude water ice clouds including vertical distribution and particle size. In general, effective radius decreases with increasing altitude. We have additionally explored the impact of variable ablation rates. Preliminary results suggest that relatively high ablation rates, near or greater than 50%, are required to reproduce observed cloud features.

  4. Side Effects: Edema

    Science.gov (United States)

    Edema, a condition in which fluid builds up in your body’s tissues, may be caused by chemotherapy, cancer, and conditions not related to cancer. Learn about signs of edema, including swelling in your feet, ankles, and legs. Learn how prevent swelling.

  5. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... for Thinning Retina Mar 10, 2014 Leer en Español: ¿Qué Es un Edema Macular? Find an Ophthalmologist ...

  6. Emission characteristics of a heavy-duty diesel engine at simulated high altitudes.

    Science.gov (United States)

    He, Chao; Ge, Yunshan; Ma, Chaochen; Tan, Jianwei; Liu, Zhihua; Wang, Chu; Yu, Linxiao; Ding, Yan

    2011-08-01

    In order to evaluate the effects of altitude on the pollutant emissions of a diesel engine, an experimental research was carried out using an engine test bench with an altitude simulation system. The emissions of HC, CO, NOx, smoke, and particle number of a heavy-duty diesel engine were measured under steady state operating conditions at sea level and simulated altitudes of 1000 and 2000 m. The experimental results indicate that the high altitude increases the emissions of HC, CO and smoke of the diesel engine, the average increasing rates of which are 30%, 35% and 34% with addition of altitude of 1000 m, respectively. The effect of high altitudes on the NOx emission varies with the engine types and working conditions. At 1000 m the particles number emissions are 1.6 to 4.2 times the levels at the low altitude. The pattern of the particle size distributions at 1000 m is similar with that at sea-level, which is the mono-modal lognormal distribution with geometric mean diameter around 0.1 μm. However, the peak number concentrations of particles are bigger and the exhausted particles are smaller at the high altitude.

  7. Analysis of the Hybrid Power System for High-Altitude Unmanned Aircraft

    Directory of Open Access Journals (Sweden)

    Kangwen Sun

    2015-01-01

    Full Text Available The application of single solar array on high-altitude unmanned aircraft will waste energy because of its low conversion efficiency. Furthermore, since its energy utilization is limited, the surface temperature of solar array will rise to 70°C due to the waste solar energy, thus reducing the electrical performance of the solar array. In order to reuse the energy converted into heat by solar array, a hybrid power system is presented in this paper. In the hybrid power system, a new electricity-generating method is adopted to spread the photovoltaic cell on the wing surface and arrange photothermal power in the wing box section. Because the temperature on the back of photovoltaic cell is high, it can be used as the high-temperature heat source. The lower wing surface can be a low-temperature cold source. A high-altitude unmanned aircraft was used to analyze the performances of pure solar-powered aircraft and hybrid powered aircraft. The analysis result showed that the hybrid system could reduce the area of wing by 19% and that high-altitude unmanned aircraft with a 35 m or less wingspan could raise the utilization rate of solar energy per unit area after adopting the hybrid power system.

  8. Freestanding Flag-Type Triboelectric Nanogenerator for Harvesting High-Altitude Wind Energy from Arbitrary Directions.

    Science.gov (United States)

    Zhao, Zhenfu; Pu, Xiong; Du, Chunhua; Li, Linxuan; Jiang, Chunyan; Hu, Weiguo; Wang, Zhong Lin

    2016-02-23

    Wind energy at a high altitude is far more stable and stronger than that near the ground, but it is out of reach of the wind turbine. Herein, we develop an innovative freestanding woven triboelectric nanogenerator flag (WTENG-flag) that can harvest high-altitude wind energy from arbitrary directions. The wind-driven fluttering of the woven unit leads to the current generation by a coupled effect of contact electrification and electrostatic induction. Systematic study is conducted to optimize the structure/material parameters of the WTENG-flag to improve the power output. This 2D WTENG-flag can also be stacked in parallel connections in many layers for a linearly increased output. Finally, a self-powered high-altitude platform with temperature/humidity sensing/telecommunicating capability is demonstrated with the WTENG-flag as a power source. Due to the light weight, low cost, and easy scale-up, this WTENG-flag has great potential for applications in weather/environmental sensing/monitoring systems.

  9. The Yak genome database: an integrative database for studying yak biology and high-altitude adaption.

    Science.gov (United States)

    Hu, Quanjun; Ma, Tao; Wang, Kun; Xu, Ting; Liu, Jianquan; Qiu, Qiang

    2012-11-07

    The yak (Bos grunniens) is a long-haired bovine that lives at high altitudes and is an important source of milk, meat, fiber and fuel. The recent sequencing, assembly and annotation of its genome are expected to further our understanding of the means by which it has adapted to life at high altitudes and its ecologically important traits. The Yak Genome Database (YGD) is an internet-based resource that provides access to genomic sequence data and predicted functional information concerning the genes and proteins of Bos grunniens. The curated data stored in the YGD includes genome sequences, predicted genes and associated annotations, non-coding RNA sequences, transposable elements, single nucleotide variants, and three-way whole-genome alignments between human, cattle and yak. YGD offers useful searching and data mining tools, including the ability to search for genes by name or using function keywords as well as GBrowse genome browsers and/or BLAST servers, which can be used to visualize genome regions and identify similar sequences. Sequence data from the YGD can also be downloaded to perform local searches. A new yak genome database (YGD) has been developed to facilitate studies on high-altitude adaption and bovine genomics. The database will be continuously updated to incorporate new information such as transcriptome data and population resequencing data. The YGD can be accessed at http://me.lzu.edu.cn/yak.

  10. A strategy for oxygen conditioning at high altitude: comparison with air conditioning.

    Science.gov (United States)

    West, John B

    2015-09-15

    Large numbers of people live or work at high altitude, and many visit to trek or ski. The inevitable hypoxia impairs physical working capacity, and at higher altitudes there is also cognitive impairment. Twenty years ago oxygen enrichment of room air was introduced to reduce the hypoxia, and this is now used in dormitories, hotels, mines, and telescopes. However, recent advances in technology now allow large amounts of oxygen to be obtained from air or cryogenic oxygen sources. As a result it is now feasible to oxygenate large buildings and even institutions such as hospitals. An analogy can be drawn between air conditioning that has improved the living and working conditions of millions of people who live in hot climates and oxygen conditioning that can do the same at high altitude. Oxygen conditioning is similar to air conditioning except that instead of cooling the air, the oxygen concentration is raised, thus reducing the equivalent altitude. Oxygen conditioning on a large scale could transform living and working conditions at high altitude, where it could be valuable in homes, hospitals, schools, dormitories, company headquarters, banks, and legislative settings. Copyright © 2015 the American Physiological Society.

  11. Genomic analysis of natural selection and phenotypic variation in high-altitude mongolians.

    Directory of Open Access Journals (Sweden)

    Jinchuan Xing

    Full Text Available Deedu (DU Mongolians, who migrated from the Mongolian steppes to the Qinghai-Tibetan Plateau approximately 500 years ago, are challenged by environmental conditions similar to native Tibetan highlanders. Identification of adaptive genetic factors in this population could provide insight into coordinated physiological responses to this environment. Here we examine genomic and phenotypic variation in this unique population and present the first complete analysis of a Mongolian whole-genome sequence. High-density SNP array data demonstrate that DU Mongolians share genetic ancestry with other Mongolian as well as Tibetan populations, specifically in genomic regions related with adaptation to high altitude. Several selection candidate genes identified in DU Mongolians are shared with other Asian groups (e.g., EDAR, neighboring Tibetan populations (including high-altitude candidates EPAS1, PKLR, and CYP2E1, as well as genes previously hypothesized to be associated with metabolic adaptation (e.g., PPARG. Hemoglobin concentration, a trait associated with high-altitude adaptation in Tibetans, is at an intermediate level in DU Mongolians compared to Tibetans and Han Chinese at comparable altitude. Whole-genome sequence from a DU Mongolian (Tianjiao1 shows that about 2% of the genomic variants, including more than 300 protein-coding changes, are specific to this individual. Our analyses of DU Mongolians and the first Mongolian genome provide valuable insight into genetic adaptation to extreme environments.

  12. Changes in body fluid compartments on re-induction to high altitude and effect of diuretics

    Science.gov (United States)

    Singh, M. V.; Rawal, S. B.; Tyagi, A. K.; Bhagat, Maj J. K.; Parshad, R.; Divekar, H. M.

    1988-03-01

    Studies were carried out in 29 healthy young adults in the Indian Army stationed in the plains and posted at an elevation of 3500 m for more than 6 months. After exposure to a low elevation in Delhi (260 m) for 3 weeks they were reinduced to a height of 3500 m. The subjects were divided into three groups, each of which was treated with either placebo or acetazolamide or spironolactone. The drug treatment was started immediately after their landing at high altitude and continued for 2 days only. Total body water, extracellular fluid, intracellular fluid, plasma volume, blood pH, PaO2, PaCO2 and blood viscosity were determined on exposure at Delhi and on re-induction to high altitude. Plasma volume was increased after the descent from high altitude and remained high for up to 21 day's study. This increased plasma volume may have some significance in the pathogenesis of pulmonary oedema. Total body water and intracellular fluid content were increased at 260 m elevation, while extracellular fluid decreased. On re-induction there was a decrease in total body water with no change in the extracellular fluid content.

  13. Measurement of the Space Radiation Dose for the Flight Aircrew at High-Altitude

    Science.gov (United States)

    Lee, Jaewon; Park, Inchun; Kim, Junsik; Lee, Jaejin; Hwang, Junga; Kim, Young-chul

    2014-03-01

    This paper describes an experimental approach to evaluate the effective doses of space radiations at high-altitude by combining the measured data from the Liulin-6K spectrometer loaded onto the air-borne RC-800 cockpit and the calculated data from CARI-6M code developed by FAA. In this paper, 15 exposed dose experiments for the flight missions at a highaltitude above 10 km and 3 experiments at a normal altitude below 4 km were executed over the Korean Peninsula in 2012. The results from the high-altitude flight measurements show a dramatic change in the exposed doses as the altitude increases. The effective dose levels (an average of 15.27 mSv) of aircrew at the high-altitude are an order of magnitude larger than those (an average of 0.30 mSv) of the normal altitude flight. The comparison was made between the measure dose levels and the calculated dose levels and those were similar each other. It indicates that the annual dose levels of the aircrew boarding RC- 800 could be above 1 mSv. These results suggest that a proper procedure to manage the exposed dose of aircrew is required for ROK Air Force.

  14. The Yak genome database: an integrative database for studying yak biology and high-altitude adaption

    Directory of Open Access Journals (Sweden)

    Hu Quanjun

    2012-11-01

    Full Text Available Abstract Background The yak (Bos grunniens is a long-haired bovine that lives at high altitudes and is an important source of milk, meat, fiber and fuel. The recent sequencing, assembly and annotation of its genome are expected to further our understanding of the means by which it has adapted to life at high altitudes and its ecologically important traits. Description The Yak Genome Database (YGD is an internet-based resource that provides access to genomic sequence data and predicted functional information concerning the genes and proteins of Bos grunniens. The curated data stored in the YGD includes genome sequences, predicted genes and associated annotations, non-coding RNA sequences, transposable elements, single nucleotide variants, and three-way whole-genome alignments between human, cattle and yak. YGD offers useful searching and data mining tools, including the ability to search for genes by name or using function keywords as well as GBrowse genome browsers and/or BLAST servers, which can be used to visualize genome regions and identify similar sequences. Sequence data from the YGD can also be downloaded to perform local searches. Conclusions A new yak genome database (YGD has been developed to facilitate studies on high-altitude adaption and bovine genomics. The database will be continuously updated to incorporate new information such as transcriptome data and population resequencing data. The YGD can be accessed at http://me.lzu.edu.cn/yak.

  15. On the Survival of High-Altitude Open Clusters within the Milky Way Galaxy Tides

    CERN Document Server

    Martinez-Medina, L A; Peimbert, A; Moreno, E

    2016-01-01

    It is a common assumption that high-altitude open clusters live longer compared with clusters moving close to the Galactic plane. This is because at high altitudes, open clusters are far from the disruptive effects of in-plane substructures, such as spiral arms, molecular clouds and the bar. However, an important aspect to consider in this scenario is that orbits of high-altitude open clusters will eventually cross the Galactic plane, where the vertical tidal field of the disk is strong. In this work we simulate the interaction of open clusters with the tidal field of a detailed Milky Way Galactic model at different average altitudes and galactocentric radii. We find that the life expectancy of clusters decreases as the maximum orbital altitude increases and reaches a minimum at altitudes of approximately 600 pc. Clusters near the Galactic plane live longer because they do not experience strong vertical tidal shocks from the Galactic disk; then, for orbital altitudes higher than 600 pc, clusters start again t...

  16. The Kilimanjaro score for assessing fitness to fly paragliders at high altitude.

    Science.gov (United States)

    Wilkes, Matt; Simpson, Alistair; Knox, Matt; Summers, Luke

    2013-09-01

    Extreme sports such as paragliding are increasing in popularity, providing continued challenges for the development of safe practice techniques. In January and February 2013, the Wings of Kilimanjaro expedition aimed to launch 95 paragliders from the summit of Mount Kilimanjaro, 5790 m above sea level. A safe launch was paramount but risked being impaired by adverse environmental conditions, in particular the pathophysiological effects of high altitude. There are no existing scores to assess fitness for high-altitude paraglider launches present in the literature. A novel scoring system, the Kilimanjaro Score, was therefore developed to rapidly assess pilots pre-flight. The Kilimanjaro Score aimed to assess cognition, memory, and visual-spatial skill within the context of standard pre-flight checks. Further testing, including the Lake Louise Score, was to be performed if the pilot's Kilimanjaro Score was deemed unsatisfactory. We present the Kilimanjaro Score here for comment and refinement, and we invite other parties to consider its use in the field for high altitude paragliding activities.

  17. A GIS-aided response model of high-altitude permafrost to global change

    Institute of Scientific and Technical Information of China (English)

    李新; 程国栋

    1999-01-01

    Two models are used to simulate the high-altitude permafrost distribution on the Qinghai-Xizang Plateau. The two models are the "altitude model", a Gaussian distribution function used to describe the latitudinal zonation of permafrost based on the three-dimensional rules of high-altitude permafrost, and the "frost number model", a dimensionless ratio defined by manipulation of freezing and thawing degree-day sums. The results show that the "altitude model" can simulate the high-altitude permafrost distribution under present climate conditions accurately. Given the essential hypotheses and using the GCM scenarios from HADCM2, the "altitude model" is used for predicting the permafrost distribution change on the Qinghai-Xizang Plateau. The results show that the permafrost on the plateau will not change significantly during 20—50 a, the percentage of the total disappeared area will not be over 19%. However, by the year 2099, if the air temperature increases by an average of 2.91℃ on the plateau, the decre

  18. Effect of high altitude on sensitivity to the taste of phenylthiocarbamide

    Science.gov (United States)

    Singh, S. B.; Chatterjee, A.; Panjwani, U.; Yadav, D. K.; Selvamurthy, W.; Sharma, K. N.

    Sensitivity to the taste of phenylthiocarbamide (PTC) was studied using the Harris-Kalmus method in healthy human volunteers at sea level and then subsequently at an altitude of 3500 m over a period of 3 weeks, after which they were brought back to sea level. Blood sugar, insulin and blood cortisol levels were estimated weekly. The results indicated that, out of 51 subjects studied, 26 (55%) were PTC tasters at sea level. Eight of those unable to taste PTC at sea level tested as tasters at high altitude, and 2 of them reverted to being non-tasters on return to sea level. In the blood, an increase in cortisol and blood insulin levels was seen without any significant change in sugar levels. All the changes recorded at high altitude tended to return to basal values after re-induction to sea level. The study suggests that high-altitude hypoxia in some way, possibly involving changes in hormonal profile among other factors, causes an alteration in sensitivity to the taste of PTC, resulting in some of the individuals shifting to lower PTC sensitivity.

  19. Solar Cell Short Circuit Current Errors and Uncertainties During High Altitude Calibrations

    Science.gov (United States)

    Snyder, David D.

    2012-01-01

    High altitude balloon based facilities can make solar cell calibration measurements above 99.5% of the atmosphere to use for adjusting laboratory solar simulators. While close to on-orbit illumination, the small attenuation to the spectra may result in under measurements of solar cell parameters. Variations of stratospheric weather, may produce flight-to-flight measurement variations. To support the NSCAP effort, this work quantifies some of the effects on solar cell short circuit current (Isc) measurements on triple junction sub-cells. This work looks at several types of high altitude methods, direct high altitude meas urements near 120 kft, and lower stratospheric Langley plots from aircraft. It also looks at Langley extrapolation from altitudes above most of the ozone, for potential small balloon payloads. A convolution of the sub-cell spectral response with the standard solar spectrum modified by several absorption processes is used to determine the relative change from AMO, lscllsc(AMO). Rayleigh scattering, molecular scatterin g from uniformly mixed gases, Ozone, and water vapor, are included in this analysis. A range of atmosph eric pressures are examined, from 0. 05 to 0.25 Atm to cover the range of atmospheric altitudes where solar cell calibrations a reperformed. Generally these errors and uncertainties are less than 0.2%

  20. 星形胶质细胞的缝隙连接蛋白43参与冷冻伤后脑水肿的形成∗%Astrocytic connexin 43 is involved in development of cryoinjury-induced cerebral edema

    Institute of Scientific and Technical Information of China (English)

    章科娜; 丁悦敏; 杜月光; 龚婉; 张雄

    2016-01-01

    AIM: To discuss the change of astrocytic connexin 43 (Cx43) expression in cerebral edema and the potential roles of Cx43 in the development of cerebral edema. METHODS:Cryoinjury-induced cerebral edema model was established in the right parietal lobe cortex in the rats. The animals were divided into sham group, cryoinjury-induced cerebral edema model group, and cryoinjury-induced cerebral edema model injected with carbenoxolone ( or octanol ) group. Dry and wet weight method was used to measure the content of brain water. Methanamide method was used to evalu-ate the permeability of blood-brain barrier ( BBB) after cryoinjury. HE staining showed the physiological changes in injured brain cortex. The protein expression of Cx43 was detected by Western blot and immunohistochemical staining. RESULTS:The brain water content in the injured cortex of rats was increased and cerebral edema developed to the peak at 24 h after cryoinjury. The permeability of BBB was increased in the injured cortex of the rats, and the area where BBB was damaged was larger than injured area. HE staining showed that many cells were dead in the central area of cryoinjury, and at the same time cerebral edema was appeared obviously in the surrounding area of injured brain cortex. The protein expression of Cx43 was up-regulated in the surrounding area of injured brain cortex, while Cx43 expression decreased in the injured cor-tex at different periods after cryoinjury. Both the content of brain water in the injured cortex and the permeability of BBB at 24 h after cryoinjury were reduced after injecting carbenoxolone or octanol intraperitoneally to block Cx43. CONCLU-SION:The cerebral edema up-regulates the expression of Cx43 and also strengthens its function. Once Cx43 is blocked, the degree of cerebral edema in rats is attenuated.%目的::探讨脑水肿后星形胶质细胞缝隙连接蛋白43(Cx43)的表达及其在脑水肿的发生发展过程中所起的作用。方法:采用颅骨外液

  1. High altitude environmental monitoring: the SHARE project and CEOP-HE

    Science.gov (United States)

    Tartari, G.

    2009-04-01

    Mountain areas above 2,500 m a.s.l. constitute about 25% of the Earth's surface and play a fundamental role in the global water balance, while influencing global climate and atmospheric circulation systems. Several millions, including lowlanders, are directly affected by the impacts of climate change on glaciers and water resource distribution. Mountains and high altitude plateaus are subject to the highest rate of temperature increase (e.g., Tibetan Plateau) and are recognized as particularly vulnerable to the effects of climate change. In spite of this, the number of permanent monitoring sites in the major environmental networks decreases with altitude. On a sample of two hundred high altitude automatic weather stations located above 2,500 m a.s.l., less than 20% are over 4,000 m, while there are only 24 stations in the world that could be considered "complete" high altitude observatories. Furthermore, entire mountain areas are left uncovered, creating significant data gaps which make reliable modelling and forecasting nearly impossible. In response to these problems, Ev-K2-CNR has developed the project SHARE (Stations at High Altitude for Research on the Environment) with the support of the Italian government and in collaboration with UNEP. This integrated environmental monitoring and research project aims to improve knowledge on the local, regional and global consequences of climate change in mountain regions and on the influence of high elevations on climate, atmospheric circulation and hydrology. SHARE today boasts a network of 13 permanent monitoring stations between 2,165 m and 8,000 m. Affiliated researchers have produced over 150 scientific publications in atmospheric sciences, meteorology and climate, glaciology, limnology and paleolimnology and geophysics. SHARE network data is also contributed to international programs (UNEP-ABC, WMO-GAW, WCRP-GEWEX-CEOP, NASA-AERONET, ILTER, EU-EUSAAR, EU-ACCENT). Within this context, the CEOP-High Elevations (CEOP

  2. Contribution of Neutron Beta Decay to Radiation Belt Pumping from High Altitude Nuclear Explosion

    Energy Technology Data Exchange (ETDEWEB)

    Marrs, R

    2002-11-13

    In 1962, several satellites were lost following high altitude nuclear tests by the United States and the Soviet Union. These satellite failures were caused by energetic electrons injected into the earth's radiation belts from the beta decay of bomb produced fission fragments and neutrons. It has been 40 years since the last high altitude nuclear test; there are now many more satellites in orbit, and it is important to understand their vulnerability to radiation belt pumping from nuclear explosions at high altitude or in space. This report presents the results of a calculation of the contribution of neutron beta decay to artificial belt pumping. For most high altitude nuclear explosions, neutrons are expected to make a smaller contribution than fission products to the total trapped electron inventory, and their contribution is usually neglected. However, the neutron contribution may dominate in cases where the fission product contribution is suppressed due to the altitude or geomagnetic latitude of the nuclear explosion, and for regions of the radiation belts with field lines far from the detonation point. In any case, an accurate model of belt pumping from high altitude nuclear explosions, and a self-consistent explanation of the 1962 data, require inclusion of the neutron contribution. One recent analysis of satellite measurements of electron flux from the 1962 tests found that a better fit to the data is obtained if the neutron contribution to the trapped electron inventory was larger than that of the fission products [l]. Belt pumping from high altitude nuclear explosions is a complicated process. Fission fragments are dispersed as part of the ionized bomb debris, which is constrained and guided by the earth's magnetic field. Those fission products that beta decay before being lost to the earth's atmosphere can contribute trapped energetic electrons to the earth's radiation belts. There has been a large effort to develop computer models for

  3. Reflections on the VI World Congress of Mountain Medicine and High-Altitude Physiology in Xining and Lhasa, August 2004

    Institute of Scientific and Technical Information of China (English)

    John B. West

    2005-01-01

    @@ The VI World Congress of Mountain Medicine and High-Altitude Physiology in Xining and Lhasa which was held in August 2004 was a landmark event in the burgeoning area of high-altitude